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<1>
Accession Number
2036278126
Title
Increased Pulse Wave Velocity as a Predictor of Intraoperative Hypotension
in Hypertensive Patients Undergoing Spinal Anaesthesia.
Source
Journal of the College of Physicians and Surgeons Pakistan. 34(12) (pp
1419-1424), 2024. Date of Publication: December 2024.
Author
Balta E.; Yilmaz S.
Institution
(Balta, Yilmaz) Department of Anaesthesiology and Reanimation, Faculty of
Medicine, Aydin Adnan Menderes University, Aydin, Turkey
Publisher
College of Physicians and Surgeons Pakistan
Abstract
Objective: To investigate whether intra-operative hypotension could be
predicted with pulse wave velocity (PWV) if measured preoperatively.
 Study Design: Descriptive analytical study. Place and Duration of the
Study: The University Hospital in Turkiye between September 2021 and
September 2022. Methodology: All patients aged 30 years and older, whose
physical status was graded as I or II according to the American Society of
Anaesthesiologists (ASA) classification, were scheduled for elective lower
extremity surgery under spinal anaesthesia (SA). Patients previously
diagnosed with hypertension (HT) and/or using antihypertensive medication
constituted the HT group, and patients with a preoperative systolic blood
pressure (SBP) with a value of <140 mmHg constituted the control group.
Arterial stiffness measurements of the patient and control groups were
performed using the Oscillo metric device [Mobil-O-Graph]. The SBP and
diastolic blood pressure (DBP) values were measured. A 20% or more
decrease in systolic blood pressure (SBP) compared to the baseline SBP
indicated spinal anaesthesia-related hypotension (SARH). Result(s):
The PWV was higher in the HT group than the control group (p <0.001). The
rates of patients that developed hypotension at the 3rd,
5th, 10th, 20th, and 30th
minutes of SA were also higher in the HT group than in the control group
(p <0.05). The PWV value was significantly higher in patients with SARH
than those without SARH at the 3rd, 5th,
10th, 20th, and 30th minutes after SA (p
= 0.001, p = 0.001, p = 0.002, p = 0.001, and p = 0.001, respectively).
 Conclusion(s): Preoperative PWV may be an effective biomarker in
predicting spinal anaesthesia-related hypotension in hypertensive
patients. Copyright © 2024 College of Physicians and Surgeons
Pakistan. All rights reserved.

<2>
Accession Number
2036334706
Title
Ferric carboxymaltose with or without phosphate substitution in iron
deficiency or iron deficiency anemia before elective surgery - The DeFICIT
trial.
Source
Journal of Clinical Anesthesia. 101 (no pagination), 2025. Article Number:
111727. Date of Publication: February 2025.
Author
Kaserer A.; Braun J.; Mair A.; Akbas S.; Rossler J.; Bischoff-Ferrari
H.A.; Turina M.; Clavien P.-A.; Opitz I.; Hulsmeier A.; Karsai G.;
Gasciauskaite G.; Spahn G.H.; Schlapfer M.; Spahn D.R.
Institution
(Kaserer, Mair, Akbas, Rossler, Gasciauskaite, Spahn, Schlapfer, Spahn)
Institute of Anesthesiology, University of Zurich and University Hospital
Zurich, Zurich, Switzerland
(Braun) Departments of Epidemiology and Biostatistics, Epidemiology,
Biostatistics and Prevention Institute, University of Zurich, Zurich,
Switzerland
(Bischoff-Ferrari) Department of Geriatrics and Aging Research, University
of Zurich and University Hospital Zurich, Zurich, Switzerland
(Bischoff-Ferrari) Centre on Aging and Mobility, University of Zurich,
Zurich, Switzerland
(Turina, Clavien) Department of Surgery and Transplantation, University of
Zurich and University Hospital Zurich, Zurich, Switzerland
(Clavien) Wyss Zurich Translational Center, ETH Zurich and Swiss Medical
Network and Faculty of Medicine, University of Zurich, Zurich, Switzerland
(Opitz) Department of Thoracic Surgery, University of Zurich and
University Hospital Zurich, Zurich, Switzerland
(Hulsmeier, Karsai) Institute of Clinical Chemistry, University of Zurich
and University Hospital Zurich, Zurich, Switzerland
(Schlapfer) Institute of Physiology, University of Zurich, Zurich,
Switzerland
Publisher
Elsevier Inc.
Abstract
Background: Iron deficiency anemia in the perioperative setting is treated
predominantly with intravenous iron formulation, of which ferric
carboxymaltose may induce hypophosphatemia by modulating fibroblast growth
factor 23. Method(s): In this single-center, prospective, randomized,
double-blind trial, we consented 92 adult patients scheduled for elective
major abdominal or thoracic surgery. These patients either had isolated
iron deficiency (plasma ferritin <100 ng/mL or transferrin saturation < 20
%) or iron deficiency anemia (hemoglobin (Hb) 100-130 g/L with plasma
ferritin <100 ng/mL or transferrin saturation < 20 %). Preoperatively,
participants received a single preoperative intravenous dose of ferric
carboxymaltose and were then randomly assigned to receive either phosphate
or placebo, administered orally three times a day for 30 days
corresponding to an 18 mmol dose of daily phosphate supplementation in the
intervention group. The primary endpoint was the minimum serum phosphate
concentration during follow-up visits. The key secondary efficacy endpoint
was mean perioperative hemoglobin concentration of postoperative days 0, 2
and 4, assessing the non-inferiority of additional phosphate
supplementation. Result(s): We randomly consented 46 patients in each
group (mean +/- SD age 56 +/- 17 years, 57 % female). Minimal phosphate
concentration was 0.49 +/- 0.21 mmol/L in the treatment group and 0.42 +/-
0.17 mmol/L in the placebo group (p = 0.12, two-sided p-value). Average
mean hemoglobin was 110 +/- 16 g/L in the treatment and 113 +/- 13 g/L in
the placebo group (p = 0.023, one-sided p-value for non-inferiority).
Hypophosphatemia occurred in 32 patients (70 %) of the treatment group and
in 39 patients (85 %) of the placebo group (odds ratio 0.15, 95 % CI from
0.02 to 0.77, p = 0.014). Secondary outcomes, such as rescue medication
use, core muscle strength and MOCA test scores, did not differ between
groups. Conclusion(s): Co-administration of oral phosphate
supplementation to ferric carboxymaltose cannot prevent hypophosphatemia.
However, hypophosphatemia occurs in fewer patients. Phosphate
co-administration did not impede the treatment of iron deficiency anemia
with ferric carboxymaltose. Copyright © 2024 The Authors

<3>
Accession Number
2031832067
Title
Systemic immune inflammation index with all-cause and cause-specific
mortality: a meta-analysis.
Source
Inflammation Research. 73(12) (pp 2199-2216), 2024. Date of Publication:
December 2024.
Author
Li W.; Wang X.; Diao H.; Yang Y.; Ding L.; Huan W.; Chen Y.; Cui W.
Institution
(Li, Diao, Yang, Ding, Huan, Cui) Department of Nutrition and Food
Hygiene, School of Public Health, Jilin University, No. 1163, Xinmin
Street, Changchun, China
(Wang) Department of blood transfusion, The First Hospital of Jilin
University, Changchun, China
(Chen) Department of Cardiovascular Diseases, The First Hospital of Jilin
University, Xinmin Street 1, Changchun 130021, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Importance: Studies have reported an association among systemic immune
inflammation index (SII), all-cause and cause-specific mortality, but the
results are inconsistent. Objective(s): To comprehensively explore
the association between Systemic Immune Inflammation (SII) and the risk of
all-cause mortality, cardiovascular disease (CVD), and cancer mortality.
Evidence review: A meta-analysis was conducted by reviewing existing
literature. The search encompassed prominent databases including PubMed,
Embase, Cochrane, and the Web of Science, with the cutoff date set at
March 1, 2024. Furthermore, subgroup analyses and dose-response
assessments were undertaken to provide a nuanced exploration of mortality
risk factors. Finding(s): A total of 33 articles were included
(427,819 participants). In the study, SII was associated with an increased
risk of all-cause mortality (HR = 1.45, 95%CI [1.36,1.54], P < 0.05). SII
increased the risk of CVD mortality (HR = 1.44, 95%CI [1.29,1.60], P <
0.05). The Linear independence shows that for every 100 units increase in
SII, the risk of all-cause and CVD death increases by 5% and 6%. SII was
not associated with a statistically significant risk of cancer death (HR =
1.09, 95%CI [0.96,1.23], P < 0.05). Conclusions and relevance:
Meta-analysis showed that SII was associated with all-cause mortality and
CVD mortality. More data and basic research are needed to confirm the
association. Copyright © The Author(s), under exclusive licence
to Springer Nature Switzerland AG 2024.

<4>
Accession Number
2030090261
Title
The efficacy of wound catheter infusion with local anesthetics for the
treatment of postoperative pain in children: A systematic review.
Source
Paediatric and Neonatal Pain. 6(4) (pp 99-110), 2024. Date of Publication:
December 2024.
Author
Swenker D.J.; Dirckx M.; Staals L.M.
Institution
(Swenker) Department of Anesthesiology, Erasmus MC, University Medical
Center Rotterdam, Rotterdam, Netherlands
(Dirckx, Staals) Department of Anesthesiology, Erasmus MC Sophia
Children's Hospital, University Medical Center Rotterdam, Rotterdam,
Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Wound catheter infusion (WCI) with local anesthetics (LA) is a regional
anesthesia technique, which has shown to produce effective postoperative
analgesia in adults, without any adverse effects on wound healing. To
investigate the efficacy and safety of WCI with LA for the treatment of
postoperative pain in children, we conducted a systematic review of
literature published until 2020. The literature search included articles
concerning subcutaneous WCI with LA, in the surgical wound, as treatment
of postoperative pain, in children <18 years of age. Exclusion criteria
were studies describing peripheral nerve blocks, intercostal, abdominal or
thoracic wall blocks and single local anesthetic infiltration of the
surgical wound. The articles were appraised for quality and only
randomized controlled trials with a Jadad score >=3 were included for
evaluation of results concerning postoperative pain scores and opioid use.
All relevant original studies, including observational studies and case
reports, were assessed for adverse events and measurements of LA plasma
concentrations during WCI. A total of 1907 articles were found, leading to
92 relevant abstracts selected for further review. After exclusion of
articles of which full texts could not be retrieved or because of
exclusion criteria, 28 articles remained. Thirteen articles described
randomized controlled trials, of which 10 were assessed as good or
excellent in quality. Due to the small number and heterogeneity of the
studies, the data could not be pooled. Instead, results were described per
type of procedure: abdominal surgery, extremity surgery, thoracic surgery
and iliac crest bone harvesting. Reduced pain scores and opioid needs were
demonstrated after abdominal and extremity surgery. In five studies,
plasma levels of LA were measured, which all remained below toxic
thresholds. In all relevant studies, no serious adverse events concerning
the use of WCI were reported. Copyright © 2024 The Author(s).
Paediatric and Neonatal Pain published by John Wiley & Sons Ltd.

<5>
Accession Number
2032295062
Title
A Network Meta-Analysis of Vasodilator Therapies in Pulmonary Hypertension
Patients Undergoing Mitral Valve Replacement Surgery: Insights for
Optimizing Hemodynamics.
Source
Clinical Drug Investigation. 44(12) (pp 897-926), 2024. Date of
Publication: December 2024.
Author
Elrosasy A.; Maher A.; Ramadan A.; Hamam N.G.; Soliman M.; Kamal S.K.;
Milik B.E.; Shahat A.A.; Kamel M.N.; Ali A.A.; Hassan L.A.; Zabady A.;
Zeid M.A.; Abdelmottaleb W.; Nassar S.
Institution
(Elrosasy, Ramadan, Hamam, Soliman, Kamal, Milik, Shahat, Kamel, Hassan)
Faculty of Medicine, Kasr Al-Ainy, Cairo University, Al-Saray Street, El
Manial, Cairo 11562, Egypt
(Maher) Faculty of Medicine, Al-Azhar University, New-Damietta, Egypt
(Ali) Faculty of Medicine, Merit University, Sohag, Egypt
(Zabady) Faculty of Science, Damanhour University, Damanhour, Egypt
(Zeid) Faculty of Medicine, Tanta University, Tanta, Egypt
(Abdelmottaleb) Department of Medicine, New York Medical
College/Metropolitan Hospital, New York, NY, United States
(Nassar) Department of Cardiology, West Virginia University, Morgantown,
WV, United States
Publisher
Adis
Abstract
Background and Objective: Pulmonary hypertension (PH) is a progressive
hemodynamic condition associated with significant morbidity and mortality,
especially in patients undergoing cardiac surgery. Therefore, the
objective of this network meta-analysis (NMA) is to compare the efficacy
of various pulmonary vasodilators in perioperative control of PH among
patients undergoing mitral valve replacement surgery (MVRS), aiming to
address the existing knowledge gap and improve perioperative outcomes.
 Method(s): Electronic databases including PubMed, Cochrane Central
Registry of Controlled Trials, Scopus, Embase, and Web of Science (WOS)
from inception to 17 September 2024. Only randomized controlled trials
(RCTs) evaluating vasodilators in PH patients undergoing MVRS were
included. We used netmeta package in RStudio to analyze the outcome data
with their corresponding mean difference (MD) and confidence intervals
(CI). Result(s): Seventeen RCTs including 862 patients were analyzed.
Prostacyclin, nitric oxide (NO), and sodium nitroprusside (SN)
significantly reduced mean pulmonary arterial pressure with effect sizes
[MD, 95% confidence interval (CI)] of (11.77, - 18.78; - 4.76; - 8.3, -
15.9; - 0.6; - 11.02, - 20.1; - 3.8, respectively). While no treatment
showed significant efficacy on pulmonary capillary wedge pressure,
systolic pulmonary arterial pressure, or heart rate, nitroglycerin, NO,
and prostacyclin, showed significant increases in cardiac index with
effect sizes (MD, 95% CI) of (1, 0.3; 1.7; 1.2 0.8; 1.6; 1.2 0.8; 1.6,
respectively). Additionally, NO, prostacyclin, SN, and nitroglycerin
demonstrated significant reductions in systemic vascular resistance (SVR),
with effect sizes of. (- 0.54, - 0.82; - 0.26, - 0.37, - 0.65; - 0.09; -
0.47, - 0.77; - 0.16; - 0.14, - 0.24; - 0.03, respectively).
 Conclusion(s): This NMA highlights prostacyclin, nitroglycerin, NO,
and SN as consistently effective in improving hemodynamics for patients
with PH undergoing MVRS, and provides valuable insights for surgeons to
choose the suitable vasodilator for these surgeries. However, limitations
and the need for further RCTs are acknowledged. Copyright © The
Author(s) 2024.

<6>
Accession Number
2032572660
Title
The Impact of Neurological Complications in Endocarditis: A Systematic
Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 13(23) (no pagination), 2024. Article
Number: 7053. Date of Publication: December 2024.
Author
Sanguettoli F.; Marchini F.; Frascaro F.; Zanarelli L.; Campo G.; Sinning
C.; Tan T.C.; Pavasini R.
Institution
(Sanguettoli, Marchini, Frascaro, Zanarelli, Campo, Pavasini) UO
Cardiologia, Azienda Ospedaliero Universitaria di Ferrara, Ferrara 44124,
Italy
(Sinning) Department of Cardiology, University Heart & Vascular Center
Hamburg, Hamburg 20246, Germany
(Tan) Department of Cardiology, Blacktown Hospital, Western Sydney
University, Sydney 2148, Australia
(Tan) Department of Cardiology, Westmead Hospital, Sydney University,
Sydney 2148, Australia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Infective endocarditis (IE) is associated with significant
neurological complications (NCs). The impact of neurological sequelae due
to IE, however, is not well characterized. Thus, the aim of this
systematic review and meta-analysis is to determine whether patients who
experienced NCs from IE had worse outcomes compared to those without
neurological complications. Method(s): We conducted a systematic and
comprehensive literature search of MEDLINE, Cochrane Library, Google
Scholar, and BioMed Central (PROSPERO registration ID: CRD42024518651).
Data on the primary outcome of all-cause mortality and the secondary
outcome of surgical timing were extracted from 25 observational studies on
patients with confirmed IE, both with and without NC. Result(s): In
the pooled total of patients with IE, NCs were present in 23.7% (60.8%
ischaemic stroke and 16.4% haemorrhagic stroke). All-cause mortality was
significantly higher in patients with IE and NCs (OR 1.78, CI 1.47-2.17, p
< 0.0001) compared to those without, particularly in those with major
neurological events (OR 2.18, CI 1.53-3.10, p < 0.0001). Conversely, minor
or asymptomatic strokes showed no significant correlation with mortality
(OR 1.10, CI 0.82-1.47, p = 0.543). There was no significant difference in
the timing of surgical intervention (standardized mean difference -0.53,
CI -1.67 to 0.61, p = 0.359) between the two patient groups.
 Conclusion(s): Major NCs due to infective endocarditis were
associated with a significantly increased all-cause mortality. This
underscores the critical importance of early recognition and management
strategies tailored to the severity of neurological events. Copyright
© 2024 by the authors.

<7>
Accession Number
2032569349
Title
REmoval of cytokines during CArdiac surgery (RECCAS): a randomised
controlled trial.
Source
Critical Care. 28(1) (no pagination), 2024. Article Number: 406. Date of
Publication: December 2024.
Author
Hohn A.; Malewicz-Oeck N.M.; Buchwald D.; Annecke T.; Zahn P.K.; Baumann
A.
Institution
(Hohn, Annecke) Faculty of Medicine, University of Cologne, Kerpener Str.
62, Cologne 50937, Germany
(Hohn) Department of Anesthesiology and Intensive Care Medicine, Cologne
University Hospital, Kerpener Str. 62, Cologne 50937, Germany
(Hohn) Department of Anaesthesiology and Intensive Care Medicine, Kliniken
Maria Hilf GmbH, Viersener Str. 450, Moenchengladbach 41063, Germany
(Malewicz-Oeck, Zahn, Baumann) Department of Anaesthesiology, Intensive
Care Medicine and Pain Medicine, Medical Faculty of Ruhr-University
Bochum, BG University Hospital Bergmannsheil gGmbH,
Burkle-de-la-Camp-Platz 1, Bochum 44789, Germany
(Buchwald) Department of Cardiothoracic Surgery, BG University Hospital
Bergmannsheil, Burkle-de-la-Camp-Platz 1, Bochum 44789, Germany
(Annecke) Department of Anaesthesiology and Intensive Care Medicine,
Kliniken der Stadt Koln GmbH, University of Witten Herdecke, Cologne,
Ostmerheimer Strase 200, Cologne 51109, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Cardiopulmonary bypass (CPB) triggers marked cytokine release
often followed by a systemic inflammatory response syndrome, associated
with adverse postoperative outcomes. This trial investigates the
intraoperative use of haemoadsorption (HA) during cardiac surgery with CPB
to assess its impact on postoperative systemic inflammatory response.
 Method(s): In this prospective randomised controlled trial (ethics
approval no. 5094-14DRKS00007928), patients (> 65 years) undergoing
elective on-pump cardiac surgery were randomised to intraoperative HA
(CytoSorb) during CPB or standard care without HA. Primary outcome was the
difference in mean interleukin (IL)-6 serum concentrations between groups
on intensive care unit (ICU) admission. The secondary outcomes included
various clinical and biochemical endpoints. Statistical methods included
paired and unpaired t-tests, Wilcoxon, Mann-Whitney U-tests, and
chi-square tests. Result(s): Thirty-eight patients were allocated to
receive either intraoperative HA (n = 19) or standard care (n = 19). The
primary outcome, IL-6 levels on ICU admission, did not differ between the
study group and controls (214.4 +/- 328.8 vs. 155.8 +/- 159.6 pg/ml, p =
0.511). During surgery pre- versus post-adsorber IL-2, IL-6, IL-8, IL-10,
heparan sulfate and myoglobin post- levels were reduced. Furthermore, IL-6
levels did not differ between the study groups on day 1 and 2 in the ICU.
While sequential organ failure assessment scores, lactate levels, and
C-reactive protein and procalcitonin (PCT) showed no statistically
significant differences. Regarding haemodynamic stability in the treatment
group the cardiac index (3.2 +/- 0.7 vs. 2.47 +/- 0.47
l/min/m2, p = 0.012) on ICU day 2 increased, and lower fluid
requirements as well as decreased fibrinogen requirement were observed.
Need for renal replacement therapy did not differ though a shorter
duration was observed in the treatment group. Time on ventilator,
respiratory parameters, infectious complications, delirium scores, ICU and
hospital lengths of stay, and mortality did not differ between groups.
 Conclusion(s): HA did not reduce the IL-6 level on ICU admission or
afterwards. Even though HA reduced cytokine load during cardiac surgery in
the treatment group. There were no significant differences between groups
in the postoperative course of other cytokine concentrations, organ
dysfunction, ICU and hospital lengths of stay and mortality rates. Trial
registration prospectively DRKS00007928 and published under: Baumann A,
Buchwald D, Annecke T, Hellmich M, Zahn PK, Hohn A. RECCAS - REmoval of
Cytokines during Cardiac Surgery: study protocol for a randomised
controlled trial. Trials. 2016;17: 137. Copyright © The Author(s)
2024.

<8>
Accession Number
2035238804
Title
Pretreatment with Esketamine Reduces Etomidate-Induced Myoclonus During
the Induction of Anesthesia: A Randomized Controlled Trial.
Source
Therapeutics and Clinical Risk Management. 20 (pp 829-836), 2024. Date of
Publication: 2024.
Author
Wang J.; Zhu M.; Cao Y.; Zhang L.; Chen L.
Institution
(Wang, Zhu, Cao, Zhang, Chen) Department of Anesthesiology, The First
Affiliated Hospital of Anhui Medical University, Hefei 230022, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Myoclonus is a common problem during induction of anesthesia
with etomidate. A variety of agents, including opioids and lidocaine,
reduced the incidence of myoclonus. However, there is no reported
literature evaluating the effect of esketamine pretreatment on
etomidate-induced myoclonus. We investigated the influence of pretreatment
with esketamine on the incidence of etomidate-induced myoclonus.
 Method(s): This is a prospective, double-blind, and randomized
controlled trial. One hundred patients aged 18-65 scheduled for elective
surgery under general anesthesia (including urology surgery, gynaecology
surgery, general surgery, and thoracic surgery) were randomly allocated
into two groups, each consisting of 50 patients. Esketamine was pretreated
with 0.1 mg/kg 60 s before the initiation of etomidate in Group ESK, while
normal saline was administered as the placebo (Group C). During the first
1 minute after etomidate administration, myoclonus incidence and severity
were assessed. In addition, we measured the hemodynamic changes and side
effects of esketamine before administering etomidate. Result(s): In
group ESK, 14 patients (28%) had myoclonus (degrees of myoclonus: mild 2,
moderate 7, severe 5), and 32 patients (64%) in group C (mild 6, moderate
5, severe 21) (P< 0.001). In group ESK, myoclonus incidence and severity
were significantly lower than in group C (P< 0.001). Conclusion(s):
Esketamine 0.1mg/kg IV pretreatment significantly reduce the incidence and
the severity of severe myoclonus of etomidate-induced myoclonus without
significant adverse effects. Copyright © 2024 Wang et al.

<9>
Accession Number
2031515761
Title
Cell Salvage Using the Autotransfusion Device CATSmart: A
Randomized Controlled Bicentric Trial Evaluating the Quality of Two New
Flex Wash Programs.
Source
Transfusion Medicine and Hemotherapy. 51(6) (pp 367-372), 2024. Date of
Publication: 02 Apr 2024.
Author
Arends S.; Thomas M.; Nosch M.; Droll T.; Zwanziger D.; Brenner T.; Haddad
A.
Institution
(Arends, Droll, Brenner, Haddad) Department of Anesthesiology and
Intensive Care Medicine, University Hospital Essen, University
Duisburg-Essen, Essen, Germany
(Thomas, Nosch) Department of Anesthesiology, Intensive Care Medicine,
Pain Therapy, Marien Hospital Bottrop GGmbH, Bottrop, Germany
(Zwanziger) Department of Endocrinology Diabetology und Metabolism,
Clinical Chemistry , Division of Laboratory Research, University Hospital
Essen, University Duisburg-Essen, Essen, Germany
Publisher
S. Karger AG
Abstract
Background: The use of cell salvage and autologous blood transfusion is an
important and widespread method of blood conservation during surgeries
with expected high blood loss. The continuous autotransfusion device
CATSmart (Fresenius Kabi, Germany) contains two new washing
programs on the device called Flex wash 3 and Flex wash 5. To the best of
our knowledge, there are no published clinical data regarding the
performance of the two new washing programs. Method(s): In total, 69
patients undergoing cardiac or orthopedic surgery were included in this
randomized, controlled, bicentric trial to validate the red cell
separation process and washout quality of Flex wash 3 compared to Flex
wash 5. After washing, the primary quality target was to determine
hematocrit value, recovery rate, albumin, and total protein elimination
rate in the packed red cells (PRCs). The secondary objective was to assess
the elimination of heparin by measuring the factor anti-Xa activity by a
1- and 2-stage assay in PRC after washing. Result(s): In the whole
cohort of patients, hematocrit was 16.00% [9.15%; 21.30%] (median [Q1;
Q3]) in the wound blood and 69.90% [51.10%; 80.90%] in the PRC resulting
in a recovery rate of 63.92% [47.06%; 88.13%]. The albumin elimination
rate was 98.77% [97.94%; 99.27%], and the total protein elimination rate
was 98.85% [97.76%; 99.42%]. The heparin elimination rate was 99.95%
[99.90%; 99.97%] in the 1-stage assay and 99.70% [99.41%; 99.87%] in the
2-stage assay. There was no difference between Flex wash 3 and Flex wash 5
washing procedure regarding the recovery rate 63.75% [46.64%; 78.65%]
versus 67.89% [47.20%; 92.69%] (p = 0.85), albumin elimination rate 98.74%
[97.67%; 99.27%] versus 98.78% [98.10%; 99.28%] (p = 0.97), protein
elimination rate 98.79% [97.94%; 99.47%] versus 98.92% [97.58%; 99.42%] (p
= 0.88), and anti-Xa elimination rate in the 1-stage assay 99.94% [99.79%;
99.97%] versus 99.95% [99.92%; 99.97%] (p = 0.24) and in 2-stage assay
99.66% [99.20%; 99.86%] versus 99.77% [99.47%; 99.90%] (p = 0.23).
 Conclusion(s): The two new washing procedures, Flex wash 3 and Flex
wash 5, enable sufficient and comparable red cell separation and washout
quality of albumin, total protein, as well as heparin. Copyright
© 2024 The Author(s).

<10>
Accession Number
2036392320
Title
Outcome of Chair Aerobics & Pranayama on Anxiety and Exercise Tolerance in
Coronary Artery Bypass Grafting Patients: Study Protocol of a Randomized
Clinical Trial.
Source
International Journal of Surgery Protocols. 25(1) (pp 238-243), 2021. Date
of Publication: 2021.
Author
Ashok A.; Kumar K.U.D.; Gopalakrishnan M.
Institution
(Ashok, Kumar) Nitte Institute of Physiotherapy, NITTE (Deemed to be
University), Karnataka, Mangalore, India
(Gopalakrishnan) Department of Cardiothoracic and vascular surgery, K.S.
Hegde Medical Academy, NITTE (Deemed to be University), Karnataka,
Mangalore, India
Publisher
Wolters Kluwer Health
Abstract
Objectives: The current Indian scenario follows the western cardiac
rehabilitation protocol; hence the primary aim of the study is to develop
a cardiac rehabilitation phase 1 protocol for the Indian scenario. The
protocol will be used in the study as standard rehabilitation protocol for
the intervention groups. The literature suggests the use of Pranayama and
chair aerobics to improve the anxiety in CABG patients. This study also
aims to provide the answer for the effect of Pranayama and chair aerobics
on anxiety and exercise tolerance in CABG patients. And also try to find
out which among the two intervention is superior among one another.
 Method(s): The cardiac rehabilitation protocol will be validated by
experts in the field and applied in the patients and the results will be
analysed. Then the protocol will be used as the standard rehabilitation
protocol in both the groups. 100 patients will be randomised and allocated
into 2 groups. Group 1 will receive Nadi Sodhana Chair aerobics for 15
minutes along with phase I cardiac rehabilitation. The group 2 will
receive Chair aerobics for 15 minutes along with phase I cardiac
rehabilitation. The outcome measures will be taken before the surgery and
on the post-operative day 7. The primary outcome measures are Hospital
anxiety and depression scale (HADS) and Heart rate and the secondary
outcome measure is 6-minute walk test. The intention to treat analysis
will be done after the data collection. Result(s): The data will be
analysed using unpaired t test, p value <0.05 will be considered
significant. Conclusion(s): The result will give a new insight into
the field of cardiac surgery, where the effect of pranayama and chair
aerobics on anxiety and functional outcome will be proved. Copyright
© 2021 The Author(s).

<11>
Accession Number
2036442680
Title
Goal-directed Perfusion to Reduce Acute Kidney Injury After Pediatric
Cardiac Operation.
Source
Annals of Thoracic Surgery. (no pagination), 2024. Date of Publication:
2024.
Author
Long F.; Zhang Y.; Luo M.; Liu T.; Qin Z.; Wang B.; Zhou Y.; Zhou R.
Institution
(Long, Zhang, Luo, Liu, Qin, Wang, Zhou) Department of Anesthesiology,
West China Hospital of Sichuan University, Sichuan, Chengdu, China
(Zhou) Department of Clinical Medicine, Henan Medical College of Zhengzhou
University, Zhengzhou, China
Publisher
Elsevier Inc.
Abstract
Background: Although goal-directed perfusion (GDP) during cardiopulmonary
bypass (CPB) has been discussed extensively in adult studies, no pediatric
indexed oxygen delivery (DO<inf>2</inf>i) thresholds are universally
accepted, and no pediatric randomized controlled trial has been reported.
This study aimed to determine whether the GDP initiative (maintaining
DO<inf>2</inf>i >=360 mL/min/m2 during CPB) could reduce the
incidence of acute kidney injury (AKI) after pediatric cardiac operation
and improve clinical outcomes. Method(s): This single-center
randomized controlled trial enrolled 312 pediatric patients, who were
randomized to receive either the GDP strategy or a conventional perfusion
strategy during CPB. The primary outcome was the rate of postoperative
AKI. Secondary outcomes included major postoperative complications,
all-cause mortality within 30 days, and short-term clinical outcomes after
operation. Result(s): AKI occurred in 43 patients (28.1%) in the GDP
group and in 65 patients (42.2%) in the control group (relative risk,
0.67; 95% CI, 0.49-0.91; P =.010). In the subgroup analysis, the GDP group
had a lower AKI rate compared with the control group among patients aged
less than 1 year, with a nadir temperature greater than 32 degreeC and a
nadir hemoglobin value less than 8 g/L during CPB, with preoperative
cyanosis, and with CPB duration from 60 to 120 minutes.
 Conclusion(s): The GDP strategy aimed at maintaining DO<inf>2</inf>i
>=360 mL/min/m2 during CPB is effective in reducing the risk of
AKI after pediatric cardiac operation. Copyright © 2024 The
Society of Thoracic Surgeons

<12>
Accession Number
2036440906
Title
Radiofrequency and Cryoablation as Energy Sources in the Cox-Maze
Procedure: A Meta-Analysis of Rhythm Outcomes.
Source
Heart Lung and Circulation. (no pagination), 2024. Date of Publication:
2024.
Author
Baudo M.; Rosati F.; D'Alonzo M.; Benussi S.; Muneretto C.; Di Bacco L.
Institution
(Baudo, Rosati, D'Alonzo, Benussi, Muneretto, Di Bacco) Department of
Cardiac Surgery, Spedali Civili di Brescia, University of Brescia,
Brescia, Italy
Publisher
Elsevier Ltd
Abstract
Aim: Cox-maze IV is the most effective surgical procedure for atrial
fibrillation (AF) treatment to date; however, few studies have compared
the outcomes of the different energy sources applied to achieve
transmurality. This study aimed to analyse the impact of the different
energy sources on Cox-maze IV results in terms of sinus rhythm
restoration. Method(s): A systematic review and meta-analysis was
conducted by including studies reporting rhythm outcomes on biatrial
Cox-maze AF ablation with bipolar radio-frequency (BRF), cryoenergy
(Cryo), or both (BRF+Cryo). The primary endpoints were the early and late
rhythm outcomes of AF ablation using the different energy sources. Late AF
recurrences were evaluated through timepoint analysis, and freedom from AF
from Kaplan-derived data. Sixty articles including 8,293 patients were
selected (3,364 patients Cryo, 1,937 BRF, and 2,992 BRF+Cryo).
 Result(s): At 6 months, AF incidence was significantly lower in the
Cryo group at 6.73%; it was 25.52% in the BRF and 16.79% in the BRF+Cryo
groups (p=0.0112). At the 4-year timepoint, AF incidence was lower in the
Cryo group compared with the BRF and BRF+Cryo: 6.14% vs 51.59% vs 16.09%,
respectively (p=0.0392). Freedom from AF was 76.7%+/-2.2%, 60.9%+/-2.2%,
and 66.3%+/-1.6% for Cryo, BRF, and BRF+Cryo at 4 years, respectively
(p<0.001). At meta-regression, mean left atrial diameter was positively
associated with higher AF recurrences (OR 1.04, 95% CI 1.01-1.08;
p=0.0159). Conclusion(s): When performing this procedure,
cryoablation seems to be associated with improved rhythm outcomes when
compared with bipolar radiofrequency ablation. Copyright © 2024
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<13>
Accession Number
2036440193
Title
Tricuspid Transcatheter Edge-to-Edge Repair for Severe Tricuspid
Regurgitation: 1-Year Outcomes From the TRILUMINATE Randomized Cohort.
Source
Journal of the American College of Cardiology. (no pagination), 2024.
Date of Publication: 2024.
Author
Tang G.H.L.; Hahn R.T.; Whisenant B.K.; Hamid N.; Naik H.; Makkar R.R.;
Tadros P.; Price M.J.; Singh G.D.; Fam N.P.; Kar S.; Mehta S.R.; Bae R.;
Sekaran N.K.; Warner T.; Makar M.; Zorn G.; Benza R.; Jorde U.P.; McCarthy
P.M.; Thourani V.H.; Ren Q.; Trusty P.M.; Sorajja P.; Adams D.H.
Institution
(Tang, Benza, Adams) Mount Sinai Health System, New York, NY, United
States
(Hahn) NewYork-Presbyterian Columbia University Medical Center, New York,
NY, United States
(Whisenant, Sekaran) Intermountain Medical Center, Murray, UT, United
States
(Hamid, Bae, Sorajja) Allina Health Minneapolis Heart Institute at Abbott
Northwestern Hospital, Minneapolis, MN, United States
(Naik, Warner) St Joseph's Hospital and Medical Center Phoenix, AZ, United
States
(Makkar, Makar) Cedars-Sinai Medical Center, Los Angeles, CA, United
States
(Tadros, Zorn) Kansas University Medical Center, Kansas City, KS, United
States
(Price) Scripps Clinic, La Jolla, CA, United States
(Singh) University of California-Davis Medical Center, Sacramento, CA,
United States
(Fam) St Micheal's Hospital, Toronto, ON, Canada
(Kar) Los Robles Regional Medical Center, HCA Healthcare, Thousand Oaks,
CA, United States
(Mehta) Hamilton Health Science, Hamilton, ON, Canada
(Jorde) Montefiore Medical Center, Bronx, NY, United States
(McCarthy) Northwestern University, Chicago, IL, United States
(Thourani) Marcus Valve Center, Piedmont Heart Institute, Atlanta, GA,
United States
(Ren, Trusty) Abbott Structural Heart, Santa Clara, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Tricuspid regurgitation (TR) is a right-sided valvular disease
independently associated with morbidity and mortality. The TRILUMINATE
Pivotal (Clinical Trial to Evaluate Cardiovascular Outcomes In Patients
Treated With the Tricuspid Valve Repair System Pivotal) is the first
randomized controlled trial assessing the impact of TR reduction with
tricuspid transcatheter edge-to-edge repair (T-TEER). Objective(s):
Outcomes from the full randomized cohort of the TRILUMINATE Pivotal trial
have not been previously reported, and the additional enrollment may
further support the safety and effectiveness of T-TEER through 1 year.
 Method(s): The TRILUMINATE Pivotal trial is an international
randomized controlled trial of T-TEER with the TriClip device in patients
with symptomatic, severe TR. Adaptive trial design allowed enrollment past
the primary analysis population. The primary outcome was a hierarchical
composite of all-cause mortality or tricuspid valve surgery, heart failure
hospitalizations (HFHs), and quality-of-life improvement measured by
Kansas City Cardiomyopathy Questionnaire (KCCQ) at 1 year. Result(s):
Between August 21, 2019, and June 29, 2022, 572 subjects were randomized,
including the primary cohort (n = 350) and subsequent enrollment (n =
222). Subjects were older (78.1 +/- 7.8 years) and predominantly female
(58.9%), with atrial fibrillation (87.8%) and prior HFH (23.8%). The
primary endpoint was met for the full cohort (win ratio = 1.84; P <
0.0001). Freedom from all-cause mortality and tricuspid valve surgery
through 12 months was 90.6% and 89.9% for the device and control groups,
respectively (P = 0.82). Annualized HFH rate was comparable between device
and control subjects (0.17 vs 0.20 events/patient-year; P = 0.40). A
significant treatment effect was observed for change in quality of life
with 49.5% of device subjects achieving a >=15-point KCCQ score
improvement (compared with 25.6% of control subjects; P < 0.0001). All
secondary endpoints favored T-TEER: moderate or less TR at 30 days (88.9%
vs 5.3%; P < 0.0001), KCCQ change at 1 year (13.0 +/- 1.4 points vs -0.5
+/- 1.4 points; P < 0.0001), and 6-minute walk distance change at 1 year
(1.7 +/- 7.5 m vs -27.4 +/- 7.4 m; P < 0.0001). Freedom from major adverse
events was 98.9% for T-TEER (vs performance goal: 90%; P < 0.0001).
 Conclusion(s): TriClip was safe and effective in the full randomized
cohort of TRILUMINATE Pivotal with significant TR reduction and
improvements in 6-minute walk distance and health status. Rates of
all-cause mortality or tricuspid valve surgery and HFH through 1 year were
not reduced by T-TEER. Copyright © 2024 The Authors

<14>
Accession Number
646015396
Title
Systematic Review of Surgical Success, Complications, Revision Rates,
Radiation Dosage, and Operative Time of 3D-Navigated vs. Non-Navigated
Spinal Procedures.
Source
World neurosurgery. (no pagination), 2024. Date of Publication: 06 Dec
2024.
Author
Suri I.; Ezzat B.; Suthakaran S.; Arroyave J.; Kwon D.; Martin L.; Hu J.;
Yaeger K.; Carr M.
Institution
(Suri) Icahn School of Medicine at Mount Sinai, New York, USA,; Department
of Neurosurgery at Mount Sinai, New York, USA,; Illuminant Surgical, Los
Angeles, USA,
(Ezzat, Arroyave) Icahn School of Medicine at Mount Sinai, New York, USA,;
Department of Neurosurgery at Mount Sinai, New York, USA
(Suthakaran, Kwon, Martin) Icahn School of Medicine at Mount Sinai, NY,
United States
(Hu) Illuminant Surgical, Los Angeles, United States
(Yaeger) Illuminant Surgical, Los Angeles, USA,; Houston Methodist,
Houston, USA
(Carr) Department of Neurosurgery at Mount Sinai, NY, United States
Abstract
OBJECTIVES: 3D navigation offers real-time guidance in surgery. However,
there is limited and inconsistent data regarding the usability, safety,
and efficacy. To address gaps in knowledge about 3D navigation in spinal
surgery, we conducted a comprehensive review of success rates,
complications, revisions, radiation exposure, and operative time
associated with FDA-approved 3D surgical navigation tools. METHOD(S):
This study adhered to PRISMA guidelines and used a protocol registered on
PROSPERO (CRD42023404554). Ovid MEDLINE, Embase, and Cochrane Central
Register of Controlled Trials databases were searched using relevant
keywords for 3D surgical navigation and spinal procedures from 1946 to
March 02, 2023. Two independent reviewers assessed the studies using
inclusion/exclusion criteria and risk of bias tools. Statistical analyses
included one-way ANOVA, weighted-mean difference, and unpaired t-tests
with Welch's correction for associations and comparisons between groups,
respectively. RESULT(S): Of the total 11,324 studies identified and
7,198 screened, 62 studies totaling 3,170 adult patients were included in
this comprehensive review. Complication and surgical success rates have
remained constant since 2004, with overall rates of 5.5% and 94.0%,
respectively. When segmented by spinal region, complication rates may be
moderately positively correlated with frequency of cervical and thoracic
procedures (r = 0.25, p = 0.68). The most commonly reported complication
was pedicle screw malposition or breach. A subset of 20 studies, totaling
1,554 patients, compared the performance of 3D navigation to 2D
fluoroscopy or freehand navigation. There was a significant difference of
6.53% between surgical success rates of the 3D-navigated and control
groups (p = 0.03). However, there was no significant difference in
radiation exposure or operative time. CONCLUSION(S): 3D navigation in
spinal procedures has higher surgical success rates than 2D fluoroscopy
and freehand navigation. Included studies exhibited varying limitations,
including no patient follow-up (n = 1), less than 10 patients (n = 6),
various types of spinal disorders (n = 1), and varying comorbidities among
participants (n = 2). Improving 3D navigation tools remains imperative to
decrease operative time and radiation exposure. Copyright © 2024.
Published by Elsevier Inc.

<15>
Accession Number
2031867753
Title
Erector spinae plane block versus intravenous opioid for analgesia in
pediatric cardiac surgery: A systematic review and meta-analysis.
Source
Paediatric Anaesthesia. 35(1) (pp 17-24), 2025. Date of Publication:
January 2025.
Author
Lombardi R.A.; Pereira E.M.; Amaral S.; Medeiros H.J.S.; Alrayashi W.
Institution
(Lombardi) Department of Anesthesiology, University of Nebraska Medical
Center, Omaha, NE, United States
(Pereira) Division of Medicine, Federal University of Minas Gerais, Minas
Gerais, Belo Horizonte, Brazil
(Amaral) Department of Anesthesiology, Duke University Medical Center,
Durham, NC, United States
(Medeiros) Department of Anesthesiology, Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, MA, United States
(Alrayashi) Department of Anesthesiology, Critical Care, and Pain
Medicine, Boston Children's Hospital and Harvard Medical School, Boston,
MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The erector spinae plane block (ESPB) has recently emerged
as a regional anesthesia technique for perioperative pain management in
pediatric cardiac surgery. However, evidence comparing its effectiveness
with intravenous (IV) opioid-based analgesia is limited. We aimed to
evaluate and compare the analgesic efficacy of ESPB versus IV opioids in
this setting. Method(s): We systematically reviewed and meta-analyzed
studies comparing ESPB with IV opioid analgesia in pediatric cardiac
surgeries with midline sternotomy. Primary outcomes were intraoperative
fentanyl consumption and intensive care unit (ICU) length of stay (LOS).
Secondary outcomes included postoperative opioid consumption, time to
first rescue analgesia, pain scores, postoperative vomiting and other
complications, extubation time, and hospital LOS. Statistical analyses
were performed using RStudio version 4.2.3. Result(s): Five studies
with 384 patients were included, with 178 receiving ESPB. ESPB
significantly reduced intraoperative fentanyl use (MD -1.90
mug.kg-1; 95% CI -3.15 to -0.66 mug.kg-1; p =.003;
I2 = 58%) and ICU LOS (MD -3.50 h; 95% CI -4.32 to -2.69 h; p
<.0001; I2 = 0%). No significant differences were found in the
remaining outcomes. Conclusion(s): Our findings suggest the ESPB
might be an important adjunct to enhancing analgesia for midline
sternotomies in pediatric cardiac surgery, potentially reducing
intraoperative opioid requirements and ICU LOS. PROSPERO Registration: CRD
42024526961. Copyright © 2024 The Author(s). Pediatric Anesthesia
published by John Wiley & Sons Ltd.

<16>
Accession Number
2035240815
Title
Predictive Performance of Artificial intelligence Models on Heart and Lung
Posttransplant Health Outcomes: A Systematic Review.
Source
Experimental and Clinical Transplantation. 22(11) (pp 823-833), 2024. Date
of Publication: November 2024.
Author
Sargiotis G.C.; Sergentanis T.N.; Pavi E.; Athanasakis K.
Institution
(Sargiotis, Sergentanis) Department of Public Health Policy, University of
West Attica, Athens, Greece
(Pavi, Athanasakis) Laboratory for Health Technology Assessment,
Department of Public Health Policy, University of West Attica, Athens,
Greece
Publisher
Baskent University
Abstract
Objectives: The efficacy and capacity of artificial intelligence models to
predict posttransplant health complications have been disputed over the
past few years. In this systematic review, we assessed the performance of
different artificial intelligence models in predicting health outcomes
after heart and lung transplantations. Material(s) and Method(s): We
researched online databases. We gathered and analyzed data on performance
metrics of artificial intelligence applications in heart and lung
transplantations. In addition, we conducted a risk of bias assessment.
 Result(s): Of the 122 initial studies that we gathered, 15 were
included in the analyses. The artificial intelligence models showed high
performance, with metrics for discrimination such as the area under the
receiver operating curve ranging from 0.620 to 0.921 and good calibration
for long-term outcomes. Random forest and extreme gradient boosting models
outperformed other models, particularly traditional linear models. North
American, White people were the predominant subsample, and pediatric
populations were excluded from the analysis. Most studies demonstrated a
high overall risk of bias, whereas applicability to research questions
showed a low risk. Conclusion(s): Supervised machine learning models
performed well in predicting posttransplant health outcomes. However,
biases and ethical concerns on the application of artificial intelligence
models in transplantation must be considered to draw safe
conclusions. Copyright © Baskent University 2024 Printed in
Turkey. All Rights Reserved.

<17>
Accession Number
2030936031
Title
The effect of pre-operative exercise training on post-operative cognitive
function: a systematic review.
Source
European Geriatric Medicine. 15(5) (pp 1259-1266), 2024. Article Number:
699259. Date of Publication: October 2024.
Author
Ekici H.S.; Collins J.; Kafadar A.H.; Yildirim M.C.; Phillips B.E.; Gordon
A.L.
Institution
(Ekici, Collins, Yildirim, Phillips, Gordon) Academic Unit of Injury,
Recovery and Inflammation Sciences (IRIS), School of Medicine, University
of Nottingham, Royal Derby Hospital, Uttoxeter Road, Derby DE22 3NE,
United Kingdom
(Kafadar) Academic Unit of Mental Health and Clinical Neuroscience, School
of Medicine, University of Nottingham, Nottingham, United Kingdom
(Phillips, Gordon) NIHR Nottingham Biomedical Research Centre, School of
Medicine, University of Nottingham, Nottingham, United Kingdom
(Gordon) NIHR Applied Research Collaboration East Midlands (ARC-EM),
Nottingham, United Kingdom
(Gordon) Department of Medicine of the Elderly, University Hospitals of
Derby and Burton NHS Foundation Trust, Royal Derby Hospital, Derby, United
Kingdom
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aim: To investigate the effect of pre-operative exercise training on
post-operative cognition. Finding(s): There are very few studies
examining the effect of pre-operative exercise training on post-operative
cognition. However, based on the results of previous studies,
pre-operative exercise may increase post-operative cognition. More studies
are needed to demonstrate the effect of pre-operative exercise training
more clearly on post-operative cognition. Message: Preoperative exercise
training is a practice that may be effective on post-operative cognition,
and studies are needed to examine its effect on older
adults. Copyright © The Author(s) 2024.

<18>
Accession Number
2034691094
Title
Interatrial Shunt Treatment for Heart Failure: The Randomized RELIEVE-HF
Trial.
Source
Circulation. 150(24) (pp 1931-1943), 2024. Date of Publication: 10 Dec
2024.
Author
Stone G.W.; Lindenfeld J.; Rodes-Cabau J.; Anker S.D.; Zile M.R.; Kar S.;
Holcomb R.; Pfeiffer M.P.; Bayes-Genis A.; Bax J.J.; Bank A.J.; Costanzo
M.R.; Verheye S.; Roguin A.; Filippatos G.; Nunez J.; Lee E.C.;
Laufer-Perl M.; Moravsky G.; Litwin S.E.; Prihadi E.; Gada H.; Chung E.S.;
Price M.J.; Thohan V.; Schewel D.; Kumar S.; Kische S.; Shah K.S.; Donovan
D.J.; Zhang Y.; Eigler N.L.; Abraham W.T.
Institution
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Lindenfeld) Advanced Heart Failure, Vanderbilt Heart and Vascular
Institute, Nashville, TN, United States
(Rodes-Cabau) Quebec Heart & Lung Institute, Laval University, Quebec
City, Canada
(Rodes-Cabau) Clinic Barcelona, Spain
(Anker) Department of Cardiology (CVK) of German Heart Center Charite,
Institute of Health Center for Regenerative Therapies (BCRT), German
Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charite
University, Germany
(Zile) Division of Cardiology, Medical University of South Carolina, Ralph
H. Johnson Department of Veterans Affairs Medical Center, Charleston,
United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Holcomb) MinneapolisMNUnited States
(Pfeiffer) Penn State Heart and Vascular Institute, Hershey, PA, United
States
(Bayes-Genis) University Hospital Germans Trias and Pujol de Badalona,
Spain
(Bax) Leiden University Medical Center, Netherlands
(Bank) Allina Health Minneapolis Heart Institute-St-Paul, United States
(Costanzo) Midwest Cardiovascular Institute, Naperville, IL, United States
(Verheye) Antwerp Cardiovascular Center, ZNA Middelheim, Belgium
(Roguin) Hillel Yaffe Medical Center, Hadera, Israel
(Filippatos) National and Kapodistrian University of Athens, Attikon
University Hospital, Greece
(Nunez) Hospital Clinico Universitario, INCLIVA, University of Valencia,
Spain
(Lee) Rochester Regional Health, NY, United States
(Laufer-Perl) Tel Aviv Sourasky Medical Center, The Tel Aviv School of
Medicine, Tel Aviv University, Israel
(Moravsky) Assaf HaRofeh Medical Center, Be'er Ya'akov, Israel
(Litwin) Medical University of South Carolina, Charleston, United States
(Prihadi) Antwerp Cardiovascular Center, ZNA Middelheim Hospital, Belgium
(Gada) UPMC Pinnacle, Harrisburg, PA, United States
(Chung) The Christ Hospital Health Network, Cincinnati, OH, United States
(Price) Scripps Clinic, La Jolla, CA, United States
(Thohan) Mission Health, Ashville, NC, United States
(Schewel) Marienkrankenhaus, Hamburg, Germany
(Kumar) The University of Texas Medical Center-Houston, United States
(Kische) Vivantes Hospital Friedrichshain, Berlin, Germany
(Shah) University of Utah Health, Salt Lake City, United States
(Donovan) Methodist Cardiology Clinic of San Antonio, TX, United States
(Zhang) Cardiovascular Research Foundation, New York, NY, United States
(Eigler) V-Wave Ltd, Caesarea, Israel
(Eigler) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Abraham) Division of Cardiovascular Medicine, Davis Heart and Lung
Research Institute, The Ohio State University Wexner Medical Center,
Columbus, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: An interatrial shunt may provide an autoregulatory mechanism
to decrease left atrial pressure and improve heart failure (HF) symptoms
and prognosis. METHOD(S): Patients with symptomatic HF with any left
ventricular ejection fraction (LVEF) were randomized 1:1 to transcatheter
shunt implantation versus a placebo procedure, stratified by reduced
(<=40%) versus preserved (>40%) LVEF. The primary safety outcome was a
composite of device-related or procedure-related major adverse
cardiovascular or neurological events at 30 days compared with a
prespecified performance goal of 11%. The primary effectiveness outcome
was the hierarchical composite ranking of all-cause death, cardiac
transplantation or left ventricular assist device implantation, HF
hospitalization, outpatient worsening HF events, and change in quality of
life from baseline measured by the Kansas City Cardiomyopathy
Questionnaire overall summary score through maximum 2-year follow-up,
assessed when the last enrolled patient reached 1-year follow-up,
expressed as the win ratio. Prespecified hypothesis-generating analyses
were performed in patients with reduced and preserved LVEF.
 RESULT(S): Between October 24, 2018, and October 19, 2022, 508
patients were randomized at 94 sites in 11 countries to interatrial shunt
treatment (n=250) or a placebo procedure (n=258). Median (25th and 75th
percentiles) age was 73.0 years (66.0, 79.0), and 189 patients (37.2%)
were women. Median LVEF was reduced (<=40%) in 206 patients (40.6%) and
preserved (>40%) in 302 patients (59.4%). No primary safety events
occurred after shunt implantation (upper 97.5% confidence limit, 1.5%;
P<0.0001). There was no difference in the 2-year primary effectiveness
outcome between the shunt and placebo procedure groups (win ratio, 0.86
[95% CI, 0.61-1.22]; P=0.20). However, patients with reduced LVEF had
fewer adverse cardiovascular events with shunt treatment versus placebo
(annualized rate 49.0% versus 88.6%; relative risk, 0.55 [95% CI,
0.42-0.73]; P<0.0001), whereas patients with preserved LVEF had more
cardiovascular events with shunt treatment (annualized rate 60.2% versus
35.9%; relative risk, 1.68 [95% CI, 1.29-2.19]; P=0.0001;
P<inf>interaction</inf><0.0001). There were no between-group differences
in change in Kansas City Cardiomyopathy Questionnaire overall summary
score during follow-up in all patients or in those with reduced or
preserved LVEF. CONCLUSION(S): Transcatheter interatrial shunt
implantation was safe but did not improve outcomes in patients with HF.
However, the results from a prespecified exploratory analysis in
stratified randomized groups suggest that shunt implantation is beneficial
in patients with reduced LVEF and harmful in patients with preserved
LVEF. Copyright © 2024 The Authors.

<19>
Accession Number
2032549373
Title
Comparison of different exercise modalities on fatigue and muscular
fitness in patients with multiple sclerosis: a systematic review with
network, and dose-response meta-analyses.
Source
Frontiers in Neurology. 15 (no pagination), 2024. Article Number: 1494368.
Date of Publication: 2024.
Author
Zhang X.-N.; Liang Z.-D.; Li M.-D.
Institution
(Zhang, Li) School of Sports Training, Chengdu Sport University, Sichuan,
Chengdu, China
(Liang) Department of Physical Education, College of Physical Education,
Qingdao University, Qingdao, China
Publisher
Frontiers Media SA
Abstract
Background: Fatigue and muscular fitness are closely related to the
quality of life in patients with multiple sclerosis (MS). However, the
optimal exercise dosage to improve these outcomes remains unclear.
 Objective(s): We evaluated the effects of different exercise
modalities and dosages on fatigue levels and muscular fitness in patients
with MS. Method(s): A systematic search was conducted across five
electronic databases, including randomized controlled trials involving
exercise interventions for patients with MS. The data covered literature
from the establishment of each database up to August 2024. Two independent
reviewers assessed the quality of the studies. Network and dose-response
meta-analyses were performed using a random-effects model to evaluate the
impact of exercise. Result(s): A total of 84 papers were included,
involving 3,786 participants. The network meta-analysis revealed that
mind-body exercise (MBE) had the most significant effect on reducing
fatigue (SMD=-0.94; 95% CrI: -1.3 to -0.6), followed by resistance
training (RT) (SMD=-0.86; 95% CrI: -1.2 to -0.58), combined exercise (COM)
(SMD=-0.70; 95% CrI: -1.2 to -0.22), and high-intensity interval training
(HIIT) (SMD=-0.50; 95% CrI: -1.1 to 0.14). Additionally, HIIT were found
to be the most effective in improving muscular fitness (SMD=-0.86; 95%
CrI: -1.5 to -0.27), followed by COM (SMD=-0.81; 95% CrI: -1.2 to -0.41),
MBE (SMD=-0.64; 95% CrI: -1.1 to -0.16), and RT (SMD=-0.62; 95% CrI: -0.89
to -0.16). Moreover, a dose as low as 240 METs-min/week was sufficient to
improve fatigue, while a dose of 430 METs-min/week was required to enhance
muscular fitness. The optimal dose for reducing fatigue was 650
METs-min/week, and the best dose for improving muscular fitness was 530
METs-min/week. Conclusion(s): Exercise is an effective method for
improving fatigue and muscular fitness in patients with MS. While MBE and
COM rank relatively higher compared to other exercise modalities. The
optimal exercise dosage for reducing fatigue and improving muscular
fitness ranges between approximately 530 to 860 MET-minutes per week.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/,
CRD42024577643. Copyright © 2024 Zhang, Liang and Li.

<20>
Accession Number
2032300729
Title
The Effect of Family-Centered Education on the Quality of Life of
Reproductive Age Women with a History of Heart Valve Replacement.
Source
Razavi International Journal of Medicine. 12(4) (pp 78-89), 2024. Article
Number: e1363. Date of Publication: November 2024.
Author
Mohammadpour A.; Pashaei M.; Ghasemi R.; Eshagh-Zadeh M.; Afshar M.T.;
Yaghubi M.
Institution
(Mohammadpour) Department of Nursing, Social Determinants of Health
Research Center, Gonabad University of Medical Sciences, Gonabad, Iran,
Islamic Republic of
(Pashaei, Eshagh-Zadeh) Department of Medical-Surgical Nursing, Faculty of
Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences,
Torbat Heydariyeh, Iran, Islamic Republic of
(Ghasemi) Department of Cardiology, 9 Dey Educational Hospital, Torbat
Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran,
Islamic Republic of
(Afshar) Department of Medical-Surgical Nursing, Shahid Beheshti Hospital,
Babol University of Medical Sciences, Nowshahr, Iran, Islamic Republic of
(Yaghubi) Department of Extra-Corporeal Circulation (ECC), Razavi
Hospital, Mashhad, Iran, Islamic Republic of
Publisher
Mashhad Razavi Hospital
Abstract
Background: Patients undergoing surgical replacement of cardiac valves
face various physical, psychological, and social problems. This situation
leads to changes in quality of life parameters, especially in women of
reproductive ages. Objective(s): This study aimed to determine the
effect of family-centered education on the quality of life of women of
reproductive age with a history of cardiac valve replacement.
 Method(s): This randomized intervention-control prospective study was
performed on 62 patients and their companions. Participants were selected
in terms of inclusion criteria and randomly assigned to control and test
groups. First, the quality of life questionnaire participants completed
SF-36. Then, the test group received a family-centered education program
in four sessions. Immediately after the intervention and one month later,
we measured patients' quality of life. Data were analyzed using SPSS
version 23 using Chi-square, independent t-test, Mann-Whitney U, Wilcoxon,
and Friedman test. Result(s): The results of the Friedman test showed
that the mean score of total quality of life was significantly different
in the intervention group (P = 0.02), but this difference was not
significant in the control group (P = 0.23). Conclusion(s): Based on
the results of this study, family-centered education can improve the
quality of life of women of reproductive age with a history of cardiac
valve replacement. The purposeful, scientific, and guided family
interactions with the patient and the patients' close relationship and
dependence on relatives and families can be considered the leading cause
of this effect. Copyright © 2024, Razavi International Journal.

<21>
Accession Number
2032490180
Title
SOPRANO: Macitentan in patients with pulmonary hypertension following left
ventricular assist device implantation.
Source
Pulmonary Circulation. 14(4) (no pagination), 2024. Article Number:
e12446. Date of Publication: October 2024.
Author
Frantz R.P.; Desai S.S.; Ewald G.; Franco V.; Hage A.; Horn E.M.; LaRue
S.J.; Mathier M.A.; Mandras S.; Park M.H.; Ravichandran A.K.; Schilling
J.D.; Wang I.-W.; Zolty R.; Rendon G.G.; Rocco M.A.; Selej M.; Zhao C.;
Rame J.E.
Institution
(Frantz) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Desai) Inova Fairfax Medical Center, Falls Church, VA, United States
(Ewald, Schilling) Washington University, St. Louis, MO, United States
(Franco) Ohio State University, Columbus, OH, United States
(Hage) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Horn) Weill Cornell Medical College, New York, NY, United States
(LaRue) Hannibal Clinic, Hannibal, MO, United States
(Mathier) University of Pittsburgh, Pittsburgh, PA, United States
(Mandras) AdventHealth, Orlando, FL, United States
(Park) Virginia Mason Franciscan Health, Tacoma, WA, United States
(Ravichandran) Ascension Medical Group, Indianapolis, IN, United States
(Wang) Memorial Healthcare System, Hollywood, FL, United States
(Zolty) University of Nebraska Medical Center, Omaha, NE, United States
(Rendon, Rocco, Selej, Zhao) Actelion Pharmaceuticals US, Inc.,
Titusville, NJ, United States
(Rame) Thomas Jefferson University Hospital, Philadelphia, PA, United
States
Publisher
John Wiley and Sons Inc
Abstract
Macitentan is a dual endothelin receptor antagonist (ERA) approved for
treating pulmonary arterial hypertension (PAH). SOPRANO evaluated the
efficacy and safety of macitentan versus placebo in pulmonary hypertension
(PH) patients after left ventricular assist device (LVAD) implantation.
SOPRANO was a phase 2, multicenter, double-blind, randomized,
placebo-controlled, parallel-group study. Patients with an LVAD implanted
within the prior 90 days who had persistent PH (i.e., mean pulmonary
arterial pressure >=25 mmHg, pulmonary artery wedge pressure [PAWP] <=18
mmHg, and pulmonary vascular resistance [PVR] >3 Wood units [WU]) were
randomized (1:1) to macitentan 10 mg or placebo once daily for 12 weeks.
The primary endpoint was change in PVR. Secondary endpoints included
change in right-heart catheterization hemodynamic variables, N-terminal
prohormone of brain natriuretic peptide levels, World Health Organization
functional class, and safety/tolerability. Fifty-seven patients were
randomized to macitentan (n = 28) or placebo (n = 29). A statistically
significant reduction in PVR from baseline to Week 12 was observed with
macitentan versus placebo (placebo-corrected geometric mean ratio, 0.74;
95% confidence interval, 0.58-0.94; p =.0158). No statistically
significant differences were observed in secondary endpoints. In a
post-hoc analysis, 66.7% of patients receiving macitentan achieved PVR <3
WU versus 40.0% receiving placebo (p =.0383). Macitentan was generally
well tolerated; adverse events were consistent with those in previous PAH
studies with macitentan. In conclusion, macitentan showed promising
tolerability and significantly reduced PVR in PH patients with
persistently elevated PVR after LVAD implantation. ClinicalTrials. gov
identifier: NCT02554903. Copyright © 2024 Actelion
Pharmaceuticals US, Inc. Pulmonary Circulation published by John Wiley &
Sons Ltd on behalf of Pulmonary Vascular Research Institute.

<22>
Accession Number
2035944245
Title
The Society of Thoracic Surgeons Expert Consensus on the Multidisciplinary
Management and Resectability of Locally Advanced Non-small Cell Lung
Cancer.
Source
Annals of Thoracic Surgery. 119(1) (pp 16-33), 2025. Date of Publication:
January 2025.
Author
Kim S.S.; Cooke D.T.; Kidane B.; Tapias L.F.; Lazar J.F.; Awori Hayanga
J.W.; Patel J.D.; Neal J.W.; Abazeed M.E.; Willers H.; Shrager J.B.
Institution
(Kim) Canning Thoracic Institute, Northwestern Memorial Hospital,
Northwestern University Feinberg School of Medicine, Chicago, Illinois,
United States
(Cooke) Division of General Thoracic Surgery, University of California
Davis Health, Sacramento, California, United States
(Kidane) Section of Thoracic Surgery, CancerCare Manitoba and University
of Manitoba, Winnipeg, MB, Canada
(Tapias) Division of Thoracic Surgery, Mayo Clinic, Rochester, Minnesota,
United States
(Lazar) Division of Thoracic Surgery, Ascension Saint Thomas Hospital,
University of Tennessee Health Science Center, Nashville, TN, United
States
(Awori Hayanga) Department of Cardiothoracic and Vascular Surgery, West
Virginia University Medicine, Morgantown, West Virginia, United States
(Patel) Division of Hematology/Oncology, Department of Medicine,
Northwestern University, Chicago, Illinois, United States
(Neal) Division of Oncology, Department of Medicine, Stanford Cancer
Institute, Stanford, California, United States
(Abazeed) Department of Radiation Oncology, Northwestern University,
Feinberg School of Medicine, Chicago, Illinois, United States
(Willers) Department of Radiation Oncology, Massachusetts General
Hospital, Harvard Medical School, Boston, Massachusetts, United States
(Shrager) Division of Thoracic Surgery, Department of Cardiothoracic
Surgery, Stanford University School of Medicine, Stanford, California,
United States
(Shrager) Department of Surgery, Veterans Affairs Palo Altos Health Care
System, Stanford, California, United States
Publisher
Elsevier Inc.
Abstract
Background: The contemporary management and resectability of locally
advanced lung cancer are undergoing significant changes as new data emerge
regarding immunotherapy and targeted treatments. The objective of this
document is to review the literature and present consensus among a group
of multidisciplinary experts to guide the determination of resectability
and management of locally advanced non-small cell lung cancer (NSCLC) in
the context of contemporary evidence. Method(s): The Society of
Thoracic Surgeon Workforce on Thoracic Surgery assembled a
multidisciplinary expert panel composed of thoracic surgeons and medical
and radiation oncologists with established expertise in the management of
lung cancer. A focused literature review was performed, and expert
consensus statements were developed using a modified Delphi process to
address 3 major themes: (1) assessing resectability and multidisciplinary
management of locally advanced lung cancer, (2) neoadjuvant (including
perioperative) therapy, and (3) adjuvant therapy. Result(s): A
consensus was reached on 19 recommendations. These consensus statements
reflect updated insights on resectability and multidisciplinary management
of locally advanced lung cancer based on the latest literature and current
clinical experience, mainly focusing on the appropriateness of surgical
therapy and emerging data regarding neoadjuvant and adjuvant therapies.
 Conclusion(s): Despite the complex decision-making process in
managing locally advanced lung cancer, this expert panel agreed on several
key recommendations. This document provides guidance for thoracic surgeons
and other medical professionals in the optimal management of locally
advanced lung cancer based on the most updated evidence and
literature. Copyright © 2024 The Authors

<23>
Accession Number
2034916689
Title
Benefits and Harms of Coronary Revascularization in Non-Dialysis-Dependent
Chronic Kidney Disease and Ischemic Heart Disease: A Systematic Review and
Meta-Analysis.
Source
Clinical Journal of the American Society of Nephrology. 19(12) (pp
1562-1573), 2024. Date of Publication: 01 Dec 2024.
Author
Patel D.M.; Wilson L.M.; Wilson R.F.; Yang X.; Gharibani T.; Robinson K.A.
Institution
(Patel) Division of Nephrology, Department of Medicine, Johns Hopkins
University School of Medicine, Baltimore, MD, United States
(Wilson, Wilson, Yang, Gharibani, Robinson) Department of Health Policy
and Management, Johns Hopkins Bloomberg School of Public Health,
Baltimore, MD, United States
(Robinson) Department of Medicine, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Robinson) Department of Epidemiology, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Key PointsIn people with non-dialysis-dependent CKD, revascularization may
lower all-cause mortality and risk of cardiovascular events.Adverse kidney
events, which are often cited as a reason to avoid revascularization, were
uncommon.Additional research on the effect of revascularization on
patient-reported outcomes in people with non-dialysis-dependent CKD is
needed.BackgroundCardiovascular disease is the leading cause of death in
people with CKD. Coronary revascularization can improve cardiac function
and prognosis in people with ischemic heart disease; however, in people
with CKD, there is concern that potential harms could outweigh benefits of
revascularization. Evidence on the balance of these risks and benefits,
specifically in people with non-dialysis-dependent CKD, is
lacking.MethodsWe conducted a systematic review of randomized controlled
trials to assess the risks and benefits of revascularization, compared
with medical management, among adults or children with ischemic heart
disease and CKD not requiring KRT (dialysis or transplantation). We
searched PubMed, Embase, and the Cochrane Central Register of Controlled
Trials through December 12, 2023. Two people independently screened titles
and abstracts followed by full-Text review, serially extracted data using
standardized forms, independently assessed risk of bias, and graded the
certainty of evidence (COE).ResultsEvaluating data from nine randomized
controlled trials, we found that people with CKD and ischemic heart
disease treated with revascularization may experience lower all-cause
mortality compared with people receiving medical management (risk ratio
[RR], 0.80; 95% confidence interval [CI], 0.64 to 0.98; COE, low).
Revascularization may reduce incidence of myocardial infarction (RR, 0.81;
95% CI, 0.64 to 1.04; COE, low) and heart failure (RR, 0.80; 95% CI, 0.52
to 1.23; COE, low). The effect on cardiovascular mortality is uncertain
(hazard ratio, 0.67; 95% CI, 0.37 to 1.20; COE, very low). Evidence was
insufficient for patient-reported outcomes and adverse kidney events. Data
were limited by heterogeneity of patient populations and the limited
number of trials.ConclusionsIn people with non-dialysis-dependent CKD,
revascularization may be associated with lower all-cause mortality
compared with medical management and may also lower the risk of
cardiovascular events. Additional data surrounding kidney and
patient-reported outcomes are needed to comprehensively engage in shared
decision making and determine optimal treatment strategies for people with
CKD and ischemic heart disease.Clinical Trial registry name and
registration number:CRD42022349820 (PROSPERO). Copyright © 2024
The Author(s). Published by Wolters Kluwer Health, Inc.

<24>
Accession Number
646005035
Title
Should Intraoperative Red Blood Cell Transfusions be Given More Liberally
than Those in the ICU or Hospital Wards?.
Source
Anesthesia and Analgesia. Conference: Society for the Advancement of
Patient Blood Management Annual Meeting, SABM 2024. Phoenix, AZ United
States. 139(6 Supplement 1) (pp 26-27), 2024. Date of Publication:
December 2024.
Author
Sklar M.; Thomas A.; Asiedu J.; Rice A.; Nicholson R.; Webster C.; Crowe
E.; Frank S.M.
Institution
(Sklar, Thomas, Asiedu, Rice, Nicholson, Webster, Crowe, Frank) Johns
Hopkins Medicine, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Randomized controlled trials on hemoglobin (Hb) level
triggering red blood cell (RBC) transfusion are mostly done in stable,
non-bleeding, postoperative or non-surgical patients, which may explain
previously shown wide variation in intraoperative transfusion triggers.1
What remains unclear is whether intraoperative Hb transfusion triggers
should be different from the intensive care unit (ICU) or hospital floor
transfusion triggers.2 Methods: We compiled records of every RBC
transfusion across seven surgery services (cardiac surgery, obstetrics and
gynecology, general surgery, orthopedic surgery, urology, otolaryngology,
and plastic surgery) at a tertiary care hospital from November 2022 to
October 2023. Records for each unit included the Hb before transfusion and
the hospital location where each unit was given (operating room, ICU, or
hospital floor). Data analysis was performed using Chi-squared and
Student's t tests. Result(s): Results are reported as mean +/-
standard deviation. Out of 6,297 RBC transfusions, 3,582 (57%) were given
in the ICU, 1,935 (31%) were given on the floor, and 780 (12%) were given
in the OR. The mean Hb trigger for transfusion was 7.6 +/- 2.8 g/dL in the
OR, 7.2 +/- 1.2 g/dL in the ICU, and 6.7 +/- 1.5 g/dL on the floor (Figure
1). The differences in mean Hb between the OR and ICU, ICU and floor, and
OR and floor were statistically significant (all P < 0.01). The percentage
of RBC transfusions above a Hb of 8 g/dL was 5.2% on the floor, 11.7% in
the ICU, and 42.8% in the OR (Figure 2). The percentage of RBC
transfusions above a Hb of 7 g/dL was 33.6% on the floor, 55.3% in the
ICU, and 71.4% in the OR (Figure 2). There was a significant association
between hospital location and likelihood of transfusion above a Hb of 8
g/dL (P <.001), and above a Hb of 7 g/dL (P <.001). Conclusion(s):
Our findings suggest a more liberal transfusion strategy takes place in
the ORs compared to the ICUs, and a more liberal strategy takes place in
the ICUs compared to the hospital floors. Although active bleeding is a
valid reason for a higher Hb transfusion trigger, not all patients in the
OR or ICUs are actively bleeding. These findings suggest that a
substantial number of OR and perhaps ICU RBC transfusions may have been
avoidable.

<25>
Accession Number
646005026
Title
Platelet Transfusion Trigger Variation by Physician and Department in a
Tertiary Hospital.
Source
Anesthesia and Analgesia. Conference: Society for the Advancement of
Patient Blood Management Annual Meeting, SABM 2024. Phoenix, AZ United
States. 139(6 Supplement 1) (pp 20-21), 2024. Date of Publication:
December 2024.
Author
Asiedu J.; Thomas A.; Nicholson R.; Adegboye J.; Webster C.; Sklar M.;
Frank S.M.
Institution
(Asiedu, Thomas, Nicholson, Adegboye, Webster, Sklar, Frank) Johns Hopkins
Medicine, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: A systematic review by the Association for the Advancement of
Blood & Biotherapies concluded there was weak evidence supporting optimal
platelet transfusion triggers outside of Oncology.1 We sought to determine
variation for perioperative platelet transfusion triggers among surgical
departments and individual providers, to test whether there is wide
variation and need for room for improvement. Method(s): After
institutional review board approval, we conducted a retrospective study of
all perioperative platelet transfusions at our institution from January to
December 2023, stratified by the attending surgeon. Surgeries were divided
into either neurosurgery, cardiac surgery, or general surgery (which
includes all other surgical subspecialties such as vascular and transplant
surgery). Within each surgical category, we analyzed the amount of
variability present in the platelet transfusion trigger, defined as the
most recent platelet measurement within 24 hours before a transfusion was
ordered. Data excluded from this study were platelet orders without a
platelet count within 24 hours prior and those by a provider with less
than 10 orders throughout the year. ANOVA was used to compare the mean
platelet trigger of each department. Result(s): Within each
subspecialty, there was substantial variability in ordering practices. The
mean platelet transfusion trigger ranged from 101+/- 80 x103/?L in
neurosurgery, to 75+/-43 x103/?L in cardiac surgery, and 44+/-38 x103/?L
in general surgery (Figures 1a, 1b, 1c). The highest platelet transfusion
triggers tend to be in neurosurgery, while the lowest tend to be in
general surgery. The platelet transfusion triggers among the three groups
were statistically significantly different from each other (p < 0.001).
 Conclusion(s): With a paucity of high-quality evidence for
perioperative platelet transfusion triggers, we found a large variation
among specialties and providers, indicating room for improvement. Given
the high-cost, short shelf-life, and chronic shortage of platelets,
reducing avoidable platelet transfusions should be a high priority.

<26>
Accession Number
2036395028
Title
The effectiveness of a nurse-led home-based cardiac rehabilitation based
on instant information intervention in the prognosis of patients with
TAVR: A randomized controlled trial protocol.
Source
Current Problems in Cardiology. 50(3) (no pagination), 2025. Article
Number: 102967. Date of Publication: March 2025.
Author
Jia Y.Y.; Dong M.Q.; Feng J.; Hu J.N.; Hu H.T.; Yuan T.M.; Song J.P.
Institution
(Jia, Feng, Hu, Yuan, Song) Nursing Department, The Second Affiliated
Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China
(Jia) Nursing Department, Zhejiang University School of Medicine, Hangzhou
310000, China
(Dong) School of Nursing, Zibo Vocational Institute, Zibo 255000, China
(Hu) Nursing Department, Zhejiang Chinese medical university, Hangzhou
310000, China
Publisher
Elsevier Inc.
Abstract
Background: Patients with poor prognosis after TAVR surgery require
high-quality cardiac rehabilitation. Digital home-based rehabilitation
based on real-time information intervention can improve outcomes. However,
the parameters of the text message intervention, such as text message
content, intervention duration, text message frequency, and other
parameters, may vary. Method(s): This is an evaluator-blinded
randomized controlled trial. TAVR patients will be recruited from the
cardiology intensive care unit of a hospital and randomly assigned to
either the control group or the experimental group. The control group will
receive standard cardiac rehabilitation, while the experimental group will
receive instant message rehabilitation intervention over six months in
addition to the standard care. The primary outcomes are home-based cardiac
rehabilitation adherence and six-minute walk distance. Secondary outcomes
include quality of life, frailty, activities of daily living scale scores,
incidence of adverse events, death during follow-up, NYHA functional
classification, readmission rate, and length of hospital stay. Data will
be collected at three time points: baseline, three months after
intervention, and six months after intervention. Generalized equation
assessment will be used to evaluate the effectiveness of the instant
message intervention. Discussion(s): Using behavior change theory as
the overall framework, guided by behavior change techniques and based on
evidence-based medicine, the digital HBCR intervention program that can be
implemented by caregivers has been designed. If the intervention proves
effective, it will promote the development of home-based rehabilitation
for TAVR patients. Trial registration: NCT06418555. Copyright ©
2024 Elsevier Inc.

<27>
Accession Number
2036409790
Title
Efficacy of Erector Spinae Plane Block (ESPB) in pediatric cardiac
surgeries: a systematic review and meta-analysis.
Source
Brazilian Journal of Anesthesiology (English Edition). 75(2) (no
pagination), 2025. Article Number: 844579. Date of Publication: 01 Mar
2025.
Author
Damiao V.P.; Andrade P.P.; de Oliveira L.S.G.; Braga A.D.F.A.; Carvalho
V.H.
Institution
(Damiao, Braga, Carvalho) Universidade Estadual de Campinas (UNICAMP), SP,
Campinas, Brazil
(Andrade) Pontificia Universidade Catolica de Campinas (PUC-Campinas), SP,
Campinas, Brazil
(de Oliveira) Faculdade de Ciencias Medicas de Minas Gerais (FCMMG), MG,
Belo Horizonte, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background: Erector Spinae Plane Block (ESPB) effectively reduces pain
scores for sternotomy in adults. However, evidence is insufficient to
assert that the same result occurs in children. The aim of this systematic
review and meta-analysis was to evaluate the efficacy of ESPB in pediatric
cardiac surgeries. Method(s): Systematic Medline, Embase and Cochrane
searches were conducted for studies that compared ESPB versus no block or
sham block for pediatric cardiac surgery under sternotomy. The primary
outcome was cumulative opioid consumption for up to 48 hours. Statistical
analyses were carried out with the use of RStudio version 1.2.1335.
Heterogeneity was assessed by Cochran's Q test and I2
statistics. Quality assessment and risk of bias assessment complied with
Cochrane recommendations. Result(s): Five studies, involving 328
patients (3 Randomized Controlled Trials [RCT], and 2 cohorts) were
included. Of the 328 patients, 160 (48.7%) underwent ESPB. There were
significant reductions in cumulative opioid consumption up to 48 hours
after ESPB (SMD -0.68; 95% CI -1.13 - -0.23; p < 0.01). In the following
outcomes ESPB failed to show superiority: postoperative nausea and
vomiting (OR = 0.56; 95% CI 0.25-1.23; p = 0.54), fever (OR = 0.75; 95% CI
0.24-2.31; p = 0.58), length of intensive care unit stay in hours (MD
-2.42; 95% CI -5.47-0.64; p < 0.01] and length of hospital stay in days
(MD -0.87; 95% CI -2.69-0.96; p = 0.02). Only one cohort study had a high
risk of bias. Conclusion(s): ESPB potentially reduces postoperative
pain by significant reductions in cumulative opioid consumption up to 48
hours in pediatric cardiac surgery patients. Copyright © 2024
Sociedade Brasileira de Anestesiologia

<28>
Accession Number
2036321789
Title
Nontuberculous Mycobacterial Infective Endocarditis: A Systematic Review
of Clinical Characteristics and Outcomes.
Source
Open Forum Infectious Diseases. 11(12) (no pagination), 2024. Article
Number: ofae688. Date of Publication: 01 Dec 2024.
Author
Meena D.S.; Kumar D.; Bohra G.K.; Midha N.; Garg M.K.
Institution
(Meena, Kumar, Bohra, Midha, Garg) Division of Infectious Diseases,
Department of Internal Medicine, All India Institute of Medical Sciences,
Jodhpur, India
Publisher
Oxford University Press
Abstract
Background. Infective endocarditis (IE) due to nontuberculous mycobacteria
(NTM) is a rare infection, and several outbreaks have been reported in the
last 2 decades. However, the clinical spectrum is still poorly understood.
This systematic review aimed to evaluate the clinical characteristics and
outcomes in NTM IE. Methods. We searched the major electronic databases
(PubMed, Scopus, and Google Scholar) with appropriate keywords to December
2023. We included studies based on predefined diagnostic criteria, and
relevant data were collected on clinical presentation and treatment
outcomes. The study was registered with PROSPERO (CRD42023492577).
Results. A total of 97 studies were reviewed, encompassing 167 patients
with NTM IE. The earliest cases were reported in 1975, involving M
chelonae and M fortuitum. M chimaera was the most prevalent species
(38.9%), though rapidly growing NTM (RGM) were more common than
slow-growing NTM (SGM; 59.3% vs 40.7%). Disseminated NTM infection
occurred in 84% of cases, with bone marrow infiltration and osteomyelitis
as frequent manifestations. Prosthetic valves were the main risk factor,
present in 63.5% of cases. In native valve IE, nearly all cases (n = 27,
96%) were attributed to RGM. The overall mortality rate was 44.9%, with
conservative management without surgery associated with poorer outcomes
(66.7% vs 30.6%). Mortality was comparable between SGM and RGM IE,
although relapses were more common in SGM IE (17.6% vs 1.9%). Conclusions.
This review highlights the changing epidemiology of NTM IE with the
emergence of RGM IE. Disseminated infections in the setting of prosthetic
valves warrant NTM evaluation. The high mortality rate necessitates the
role of early surgery. Copyright © The Author(s) 2024.

<29>
Accession Number
2035244447
Title
Remote ischemic preconditioning in non-cardiac surgery (PRINCE): a
multinational, double blind, sham-controlled, randomized clinical trial.
Source
Signa Vitae. 20(12) (pp 1-9), 2024. Date of Publication: December 2024.
Author
Greco M.; Lombardi G.; Konkayev A.; Brusasco C.; Lei C.; Roasio A.; Rana
N.; Mantilla-Gutierrez H.A.; Micali M.; Gazivoda G.; Gandini M.; Ti L.K.;
Bosso S.; Konkayeva M.; Meroi F.; Wang L.; Russo A.; Efremov S.; Fresta
G.; Berikashvili L.; Livi F.; Situm I.; Guarracino F.; Leonova E.;
Cavenago F.; Shemetova M.; Cristallo E.; Smirnova A.; Schiavoni L.;
Subbotin V.; Boffa N.; Giardina G.; Introna M.; Nakhnoukh C.; Covello
R.D.; Pieri M.; Turi S.; Ajello V.; Monaco F.; Corradi F.; Yavorovskiy A.;
Likhvantsev V.; Longhini F.; Bove T.; Bellomo R.; Landoni G.; Zangrillo
A.; Lembo R.
Institution
(Greco) Department of Biomedical Sciences, Humanitas University, MI, Pieve
Emanuele 20072, Italy
(Greco) Department of Anesthesiology and Intensive Care, IRCCS Humanitas
Research Hospital, MI, Rozzano 20089, Italy
(Lombardi, Cavenago, Cristallo, Giardina, Nakhnoukh, Pieri, Turi, Monaco,
Landoni, Zangrillo, Lembo) Department of Anesthesia and Intensive Care,
IRCCS San Raffaele Scientific Institute, Milan 20132, Italy
(Konkayev, Konkayeva) Astana Medical University, Astana 010000, Kazakhstan
(Konkayev, Konkayeva) National Scientific Center of Traumatology and
Orthopedia Named N.Batpenov, Astana 010000, Kazakhstan
(Brusasco, Micali, Gandini) Anesthesia and Intensive Care Unit, Galliera
Hospital, Genova 16128, Italy
(Lei, Wang) Department of Anesthesiology and Perioperative Medicine,
Xijing Hospital, Shaanxi, Xi'an 710032, China
(Roasio, Bosso) Department of Anaesthesia and Intensive Care, Cardinal
Massaia Hospital, Asti 14100, Italy
(Rana) Division of Anaesthesiology, Ospedale Regionale di Lugano, TI,
Lugano 6900, Switzerland
(Mantilla-Gutierrez) Department of Anesthesiology, Fundacion
Cardioinfantil-Instituto de Cardiologia, Bogota 111321, Colombia
(Gazivoda) Cardiovascular Institute Dedinje, Belgrade 11040, Serbia
(Ti) Department of Anaesthesia, National University Hospital 119074,
Singapore
(Meroi, Bove) Department of Anesthesia and Intensive Care Medicine, ASUFC
University-Hospital of Central Friuli, Udine 33100, Italy
(Russo, Fresta) Department of Anesthesiology, Fondazione Policlinico
Universitario Agostino Gemelli, IRCCS, Roma 00168, Italy
(Efremov, Leonova) Saint-Petersburg State University Hospital,
Saint-Petersburg 190103, Russian Federation
(Berikashvili, Shemetova, Smirnova, Likhvantsev) Federal Research and
Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow
107031, Russian Federation
(Livi) Department of Anesthesia and Critical Care, Azienda
Ospedaliero-Universitaria Careggi, Florence 50134, Italy
(Situm) Department of Anesthesiologyand ICU University Hospital Centre
Zagreb, Zagreb 10000, Croatia
(Guarracino) Department of Cardiothoracic and vascular Anaesthesia and
Intensive Care, Azienda Ospedaliero Universitaria Pisana, Pisa 56123,
Italy
(Shemetova) Oncological Center No. 1 of the S. S. Yudin City Clinical
Hospital of the Moscow Department of Health, Moscow 117152, Russian
Federation
(Smirnova, Yavorovskiy) I.M. Sechenov First Moscow State Medical
University of the Russian Ministry of Health, Moscow 119991, Russian
Federation
(Schiavoni) Department of Anesthesia and Intensive Care, Fondazione
Policlinico Universitario Campus Bio-Medico, Roma 00128, Italy
(Subbotin) A. Loginov Moscow Clinical Scientific Center, Moscow 111123,
Russian Federation
(Boffa) Department of Anesthesia and Intensive Care, Azienda Ospedaliera
San Dona di Piave, Venezia 30027, Italy
(Introna) NeuroAnesthesia and NeuroIntensive Care, Fondazione IRCCS
Istituto Neurologico Carlo Besta, Milan 20133, Italy
(Covello) Anesthesia and Intensive Care Unit, Emergency Department, Busto
Arsizio Hospital, ASST Valle Olona, Varese 21052, Italy
(Ajello) Department of Cardiothoracic Anesthesia, Tor Vergata University
Hospital, Rome 00100, Italy
(Corradi) Department of Surgical, Medical, Molecular Pathology and
Critical Care Medicine, University of Pisa, Pisa 56126, Italy
(Longhini) Anesthesia and Intensive Care, Department of Medical and
Surgical Sciences, "Magna Graecia" University, Catanzaro 88100, Italy
(Bove) Department of Medicine (DMED), University of Udine, Udine 33100,
Italy
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, VIC 3010, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Monash University, Melbourne, VIC 3800, Australia
(Landoni, Zangrillo) School of Medicine, Vita-Salute San Raffaele
University, Milan 20132, Italy
Publisher
Pharmamed Mado Ltd
Abstract
Remote ischemic preconditioning (RIPC) is a clinical procedure aimed at
inducing myocardial protection by causing brief ischemia-reperfusion
episodes in an organ remote from the heart. We aim to assess whether RIPC
provides myocardial protection in patients undergoing non-cardiac surgery.
This study, called remote ischemic PReconditioning In Non-Cardiac surgEry
(PRINCE), is a double-blind, multinational randomized clinical trial (1:1
allocation ratio) which plans to enroll 1100 patients. The intervention
arm will receive RIPC at the beginning of surgery by inflating a blood
pressure cuff around a limb for three cycles of ten minutes (inflated cuff
for five minutes followed by deflated cuff for five minutes). In the
control group, a blood pressure cuff will be put on a limb, and a sham
inflation will be performed. Given a potential interaction of propofol
with RIPC, induction and maintenance of anesthesia will be performed
without propofol. The primary endpoint of the study is to document a
significant reduction in postoperative cardiac troponin values among
patients receiving RIPC. Secondary endpoints will be cardiac ischemic
events at 30 days and 1 year, mortality at 30 days and 1 year, neurologic
events at 30 days and 1 year, acute kidney injury at 7 days, need for
intensive care unit admission and length of hospital stay. The trial will
provide evidence for the effects of RIPC on cardioprotection and other
relevant outcomes in high-cardiac risk patients undergoing non-cardiac
surgery. Clinical Trial Registration: NCT02427867. Copyright ©
2024 The Author(s).

<30>
Accession Number
2032570026
Title
Transplant Trial Watch.
Source
Transplant International. 37 (no pagination), 2024. Article Number: 14062.
Date of Publication: 2024.
Author
O'Callaghan J.M.; Knight S.R.; Rana Magar R.
Institution
(O'Callaghan, Knight, Rana Magar) Centre for Evidence in Transplantation,
Nuffield Department of Surgical Sciences, University of Oxford, Oxford,
United Kingdom
(O'Callaghan) University Hospitals Coventry and Warwickshire, Coventry,
United Kingdom
(Knight) Oxford Transplant Centre, Churchill Hospital, Oxford, United
Kingdom
Publisher
Frontiers Media SA

<31>
Accession Number
646008032
Title
Prognostic impact of intravascular imaging in percutaneous coronary
intervention according to atherothrombotic risk: a post hoc analysis of a
randomized clinical trial.
Source
Revista espanola de cardiologia (English ed.). (no pagination), 2024.
Date of Publication: 04 Dec 2024.
Author
Hong D.; Ha J.; Hong Choi K.; Lee S.H.; Shin D.; Lee J.-Y.; Lee S.-J.; Lee
S.Y.; Kim S.M.; Yun K.H.; Cho J.Y.; Kim C.J.; Ahn H.-S.; Nam C.-W.; Yoon
H.-J.; Park Y.H.; Lee W.S.; Yang J.H.; Choi S.-H.; Gwon H.-C.; Song Y.B.;
Hahn J.-Y.; Park T.K.; Lee J.M.
Institution
(Hong, Ha, Hong Choi, Yang, Choi, Gwon, Song, Hahn, Park) Division of
Cardiology, Department of Medicine, Heart Vascular Stroke Institute,
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
South Korea
(Lee) Department of Internal Medicine and Cardiovascular Center, Chonnam
National University Hospital, Gwangju, South Korea
(Shin) Department of Cardiology, St Francis Hospital and Heart Center,
Roslyn, NY, United States
(Lee, Lee) Division of Cardiology, Department of Internal Medicine,
Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine,
Seoul, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Chungbuk
National University Hospital, Chungbuk National University College of
Medicine, Cheongju, Korea; Division of Cardiology, Department of Internal
Medicine, Chung-Ang University College of Medicine, Chung-Ang University
Gwangmyeong Hospital, Gwangmyeong, Korea
(Kim) Division of Cardiology, Department of Internal Medicine, Chungbuk
National University Hospital, Chungbuk National University College of
Medicine, Cheongju, South Korea
(Yun, Cho) Division of Cardiology, Department of Internal Medicine,
Wonkwang University Hospital, Iksan, South Korea
(Kim, Ahn) Division of Cardiology, Department of Internal Medicine,
Catholic University of Korea, Uijeongbu St. Mary's Hospital, Seoul, South
Korea
(Nam, Yoon) Division of Cardiology, Department of Internal Medicine,
Keimyung University Dongsan Hospital, Daegu, South Korea
(Park) Department of Cardiology, Samsung Changwon Hospital, Sungkyunkwan
University School of Medicine, Changwon, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Chung-Ang
University College of Medicine, Chung-Ang University Hospital, Seoul,
South Korea
(Lee) Division of Cardiology, Department of Medicine, Heart Vascular
Stroke Institute, Samsung Medical Center, Sungkyunkwan University School
of Medicine, Seoul, South Korea
Abstract
INTRODUCTION AND OBJECTIVES: Recent randomized controlled trials support
the use of intravascular imaging-guided percutaneous coronary intervention
(PCI) to improve patient prognosis. However, the subsequent risk of
clinical events in patients with coronary artery disease is not determined
solely by lesion characteristics or how these lesions are treated. The
current study investigated whether the effects of intravascular imaging in
complex PCI vary according to atherothrombotic risks. METHOD(S): This
study was a post hoc analysis of the RENOVATE-COMPLEX-PCI trial, which
compared intravascular imaging-guided PCI with angiography-guided PCI in
patients with complex coronary artery lesions. The study population was
stratified by atherothrombotic risk, assessed using the Thrombolysis in
Myocardial Infarction risk score for secondary prevention (TRS-2P). TRS-2P
is calculated based on the presence of the following factors: age >= 75
years, diabetes mellitus, hypertension, smoking, peripheral arterial
disease, stroke, coronary artery bypass grafting, heart failure, and renal
dysfunction. Patients were categorized into low-risk (TRS-2P < 3) or
high-risk (TRS-2P >= 3) groups. The primary endpoint was target vessel
failure, a composite of cardiac death, target vessel-related myocardial
infarction, or clinically driven target vessel revascularization.
 RESULT(S): Among the total study population, 1247 patients were
categorized as low-risk, and 392 as high-risk. The risk of target vessel
failure was significantly higher in the high-risk group than in the
low-risk group (15.5% vs 7.2%; hazard ratio [HR], 2.13; 95% confidence
interval [95%CI], 1.51-3.00; P < .001). The benefits of intravascular
imaging-guided PCI over angiography-guided PCI did not differ between the
low-risk group (5.6% vs 10.4%; HR, 0.56; 95%CI, 0.36-0.86) and the
high-risk group (14.1% vs 18.5%; HR, 0.71; 95%CI, 0.41-1.24), with no
significant interaction (interaction P = .496). CONCLUSION(S): In
this hypothesis-generating post hoc analysis of the RENOVATE-COMPLEX-PCI
trial, patients with high atherothrombotic risk had significantly worse
clinical outcomes than those with low atherothrombotic risk. Nevertheless,
the prognostic impact of intravascular imaging-guided PCI compared with
angiography-guided PCI was similarly observed in both low- and high-risk
groups. RENOVATE-COMPLEX-PCI clinical trial register number:
NCT03381872. Copyright © 2024 Sociedad Espanola de Cardiologia.
Published by Elsevier Espana, S.L.U. All rights reserved.

<32>
Accession Number
646006760
Title
Intravenous Amino-acid Infusion to Prevent Acute Kidney Injury after
Cardiac Surgery: A Review of the Evidence.
Source
The Annals of thoracic surgery. (no pagination), 2024. Date of
Publication: 04 Dec 2024.
Author
Losiggio R.; Redaelli M.B.; Landoni G.; Bellomo R.
Institution
(Losiggio, Redaelli) Department of Anesthesia and Intensive Care, IRCCS
San Raffaele Scientific Institute, Milan, Italy
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San
Raffaele University, Milan, Italy
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, Australia; Australian and New Zealand Intensive Care Research
Centre, Monash University, Melbourne, Australia; Data Analytics Research
and Evaluation Centre, Austin Hospital, Melbourne, Australia; Department
of Intensive Care, Austin Hospital, Melbourne, Australia; Centre for
Clinical Informatics, Royal Melbourne Hospital, Melbourne, Australia;
Department of Intensive Care, Royal Melbourne Hospital, Melbourne,
Australia
Abstract
BACKGROUND: Acute kidney injury (AKI) is a frequent and important
complication of cardiac surgery. Decreased perfusion is a key mechanism.
Such decreased perfusion may be attenuated by intravenous amino acids (AA)
through recruitment of renal functional reserve. METHOD(S): We
performed a PubMed search of all articles published from 1980 to August
30, 2024, combining in the search criteria of "renal functional reserve",
"amino acids", "cardiac surgery" and "cardiopulmonary bypass" using
MEDLINE (PubMed), Embase, and the Cochrane Central Register of Clinical
Trials. We included studies, describing the effect of AA on renal
functional reserve and studies of adult cardiac surgery patients with
information on renal function. We developed a narrative review.
 RESULT(S): Multiple experimental and human studies over > 40 years
have recurrently and consistently shown that the administration of an oral
protein load or intravenous AA increase renal blood flow and glomerular
filtration rate by > 30%. Moreover, several pilot investigations in
cardiac surgery with cardiopulmonary bypass have consistently shown renal
benefits with intravenous AA. Finally, a pivotal trial of 3511 cardiac
surgery patients (the PROTECTION trial) recently confirmed such beneficial
effects in a double-blind multicenter international setting.
 CONCLUSION(S): Intravenous AA consistently recruit renal functional
reserve and improve kidney function in cardiac surgery patients. These
findings have been confirmed by the PROTECTION trial. Intravenous AA
therapy is the only proven treatment to prevent and/or attenuate the
severity of cardiac surgery associated AKI. Copyright © 2024.
Published by Elsevier Inc.

<33>
Accession Number
646004742
Title
Surgeon-Led Point-Of-Care UltraSound-guided THORacic (POCUS-THOR) Biopsy:
A New Paradigm in Efficient Diagnosis and Resource-Sparing Care.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2024. Date of Publication: 05 Dec 2024.
Author
Gupta V.; Gowing S.D.; Pandya R.; Tan L.; Liu R.Y.; Srinathan S.K.; Kidane
B.
Institution
(Gupta, Pandya) Division of Thoracic Surgery, Department of Surgery,
Western University, London, Canada
(Gowing, Tan, Liu, Srinathan) Section of Thoracic Surgery, Rady Faculty of
Health Sciences, University of Manitoba, Winnipeg, Canada
(Kidane) Section of Thoracic Surgery, Rady Faculty of Health Sciences,
University of Manitoba, Winnipeg, Canada; CancerCare Manitoba Research
Institute, Winnipeg, Canada; Department of Physiology & Pathophysiology,
University of Manitoba, Winnipeg, Canada; Department of Biomedical
Engineering, University of Manitoba, Winnipeg, Canada; Children's Hospital
Research Institute of Manitoba, Winnipeg, Canada
Abstract
OBJECTIVE: Tissue diagnosis through a variety of interventional approaches
guides thoracic cancer management, but often introduces delay to
definitive treatment and can be resource intensive. We introduced a
thoracic surgeon-led, point-of-care ultrasound-guided biopsy program to
provide rapid diagnosis for patients with thoracic cancers. We assessed
the diagnostic yield and adverse events with this approach.
 METHOD(S): A prospective cohort study was performed of consecutive
patients undergoing ultrasound-guided biopsies performed by 5 thoracic
surgeons from June 2021 to April 2024 at a tertiary Canadian thoracic
surgery institution. Using a bedside ultrasound, 20-gauge tissue cores
were obtained using multiple passes with a standard spinal needle.
Descriptive univariable statistics were used. RESULT(S): 160 patients
underwent bedside biopsy for lung (n=101), liver (n=20), chest
wall/pleural (n=20), mediastinal (n=18), or other (n=1) lesions. Tissue
diagnosis was obtained in 86.3% of patients (n=138), and diagnostic yield
was similar for high and low-volume providers and over time. All liver
biopsies were diagnostic. Non-diagnostic biopsies were more likely to
occur with benign pathology, chest wall/pleural lesions, or extensive
necrosis; diagnosis was achieved with other modalities in most cases.
There was 1 post-procedure pneumothorax (adverse event rate 0.6%).
 CONCLUSION(S): Thoracic surgeon-led ultrasound-guided biopsies are
safe in an outpatient clinic setting, and have high diagnostic accuracy.
This results in reduced time to diagnosis by an estimated 28-35 days, and
frees up endoscopic and radiology resources for other patients. This
low-cost procedure can be adopted as part of comprehensive thoracic
malignancy assessment, and can accelerate patient access to cancer
treatment. Copyright © 2024. Published by Elsevier Inc.

<34>
Accession Number
646003874
Title
TransCatheter aortic valve implantation and fractional flow reserve-guided
percutaneous coronary intervention versus conventional surgical aortic
valve replacement and coronary bypass grafting for treatment of patients
with aortic valve stenosis and complex or multivessel coronary disease
(TCW): an international, multicentre, prospective, open-label,
non-inferiority, randomised controlled trial.
Source
Lancet (London, England). (no pagination), 2024. Date of Publication: 04
Dec 2024.
Author
Kedhi E.; Hermanides R.S.; Dambrink J.-H.E.; Singh S.K.; Ten Berg J.M.;
van Ginkel D.; Hudec M.; Amoroso G.; Amat-Santos I.J.; Andreas M.;
Campante Teles R.; Bonnet G.; Van Belle E.; Conradi L.; van Garsse L.;
Wojakowski W.; Voudris V.; Sacha J.; Cervinka P.; Lipsic E.; Somi S.;
Nombela-Franco L.; Postma S.; Piayda K.; De Luca G.; Kolkman E.;
Malinowski K.P.; Modine T.
Institution
(Kedhi) Royal Victoria Hospital, McGill University Health Center,
Montreal, QC, Canada; Department of Cardiology and Structural Heart
Disease, Medical University of Silesia, Katowice, Poland
(Hermanides, Dambrink) Department of Cardiology, Isala Heart Center,
Zwolle, Netherlands
(Singh) Department of Thoracic Surgery, Isala Heart Center, Zwolle,
Netherlands
(Ten Berg, van Ginkel) Department of Cardiology, St Antonius Hospital,
Nieuwegein, Netherlands; Cardiovascular Research Institute Maastricht,
Maastricht University Medical Center, Maastricht, Netherlands
(Hudec) Stredoslovensky Ustav Srdcovych a Cievnych Chorob, Banska,
Bystrica, Slovakia Slovakia
(Amoroso) Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam,
Netherlands
(Amat-Santos) Centro de Investigacion Biomedica en Red, Enfermedades
Cardiovasculares, Madrid, Spain; Hospital Clinico Universitario de
Valladolid, Valladolid, Spain
(Andreas) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Campante Teles) Hospital de Santa Cruz, Carnaxide, Portugal;
Comprehensive Health Research Center, Nova Medical School, Lisbon,
Portugal
(Bonnet, Modine) Hopital haut Leveque, Unite Medico Chirurgicale, Centre
Hospitalier Universitaire de Bordeaux, Bordeaux, France
(Van Belle) Department of Cardiology, Department of Interventional
Cardiology for Coronary, Valves and Structural Heart Diseases and Institut
Coeur Poumon, Centre Hospitalier Universitaire Lille, Lille, France;
INSERM U1011, Lille, France; Universite de Lille, Lille, France
(Conradi) Klinik und Poliklinik fur Herz- und Gefaschirurgie, Hamburg,
Germany
(van Garsse) Department of Cardiothoracic Surgery, Radboud University
Medical Centre, Nijmegen, Netherlands
(Wojakowski) Department of Cardiology and Structural Heart Disease,
Medical University of Silesia, Katowice, Poland
(Voudris) Interventional Department of Cardiology, Onassis Cardiac Surgery
Center, Athens, Greece
(Sacha) Department of Cardiology, University Hospital, Institute of
Medical Sciences, University of Opole, Opole, Poland; Faculty of Physical
Education and Physiotherapy, Opole University of Technology, Opole, Poland
(Cervinka) 1st Department Medicine-Cardioangiology, Charles University
Prague, Medical Faculty and University Hospital Hradec Kralove, Prague,
Czech Republic; University of Jan Evangelista Purkyne, Usti nad Labem,
Czech Republic
(Lipsic) Department of Cardiology, University Medical Center Groningen,
University of Groningen, Groningen, Netherlands
(Somi) Department of Cardiology, Haga Hospital, The Hague, Netherlands
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos
IdISSC, Madrid, Spain
(Postma, Kolkman) Diagram Research, Zwolle, Netherlands
(Piayda) Department of Cardiology and Vascular Medicine, Medical Faculty,
Justus-Liebig-University Giessen, Giessen, Germany
(De Luca) Division of Cardiology, Azienda Ospedaliera Universitaria
Policlinico Gaetano Martino, University of Messina, Messina, Italy;
Division of Cardiology, IRCCS Hospital Galeazzi-Sant'Ambrogio, Milan,
Italy
(Malinowski) Center for Digital Medicine and Robotics, Faculty of
Medicine, Jagiellonian University Medical College, Krakow, Poland;
Department of Bioinformatics and Telemedicine, Faculty of Medicine,
Jagiellonian University Medical College, Krakow, Poland
Abstract
BACKGROUND: Patients with severe aortic stenosis present frequently (~50%)
with concomitant obstructive coronary artery disease. Current guidelines
recommend combined surgical aortic valve replacement (SAVR) and coronary
artery bypass grafting (CABG) as the preferred treatment. Transcatheter
aortic valve implantation (TAVI) and fractional flow reserve (FFR)-guided
percutaneous coronary intervention (PCI) represent a valid treatment
alternative. We aimed to test the non-inferiority of FFR-guided PCI plus
TAVI versus SAVR plus CABG in patients with severe aortic stenosis and
complex coronary artery disease. METHOD(S): This international,
multicentre, prospective, open-label, non-inferiority, randomised
controlled trial was conducted at 18 tertiary medical centres across
Europe. Patients (aged >=70 years) with severe aortic stenosis and complex
coronary artery disease, deemed feasible for percutaneous or surgical
treatment according to the on-site Heart Team, were randomly assigned
(1:1) to FFR-guided PCI plus TAVI or SAVR plus CABG according to a
computer-generated sequence with random permuted blocks sizes stratified
by site. The primary endpoint was a composite of all-cause mortality,
myocardial infarction, disabling stroke, clinically driven target-vessel
revascularisation, valve reintervention, and life-threatening or disabling
bleeding at 1 year post-treatment. The trial was powered for
non-inferiority (with a margin of 15%) and if met, for superiority. The
primary and safety analyses were done per an intention-to-treat principle.
This trial is registered with ClinicalTrials.gov (NCT03424941) and is
closed. FINDINGS: Between May 31, 2018, and June 30, 2023, 172 patients
were enrolled, of whom 91 were assigned to the FFR-guided PCI plus TAVI
group and 81 to the SAVR plus CABG group. The mean age of patients was
76.5 years (SD 3.9). 118 (69%) of 172 patients were male and 54 (31%)
patients were female. FFR-guided PCI plus TAVI resulted in favourable
outcomes for the primary endpoint (four [4%] of 91 patients) versus SAVR
plus CABG (17 [23%] of 77 patients; risk difference -18.5 [90% CI -27.8 to
-9.7]), which was below the 15% prespecified non-inferiority margin
(pnon-inferiority<0.001). FFR-guided PCI plus TAVI was superior to SAVR
plus CABG (hazard ratio 0.17 [95% CI 0.06-0.51]; psuperiority<0.001),
which was driven mainly by all-cause mortality (none [0%] of 91 patients
vs seven (10%) of 77 patients; p=0.0025) and life-threatening bleeding
(two [2%] vs nine [12%]; p=0.010). INTERPRETATION: The TCW trial is the
first trial to compare percutaneous treatment versus surgical treatment in
patients with severe aortic stenosis and complex coronary artery disease,
showing favourable primary endpoint and mortality outcomes with
percutaneous treatment. FUNDING: Isala Heart Centre and
Medtronic. Copyright © 2024 Elsevier Ltd. All rights reserved,
including those for text and data mining, AI training, and similar
technologies.

<35>
Accession Number
645996750
Title
Sex Differences in Patients Undergoing FFR-Guided PCI or CABG in the FAME
3 Trial.
Source
JACC. Cardiovascular interventions. (no pagination), 2024. Date of
Publication: 11 Nov 2024.
Author
Takahashi K.; Otsuki H.; Zimmermann F.M.; Ding V.Y.; Oldroyd K.G.; Wendler
O.; Reardon M.J.; Woo Y.J.; Yeung A.C.; Pijls N.H.J.; De Bruyne B.; Fearon
W.F.
Institution
(Takahashi, Otsuki, Ding, Yeung) Stanford University School of Medicine
and Stanford Cardiovascular Institute, Stanford University, Stanford, CA,
United States
(Zimmermann) Department of Cardiology, Catharina Hospital, Eindhoven, the
Netherlands; St. Antonius Hospital, Nieuwegein, The Netherlands
(Oldroyd) Golden Jubilee National Hospital, Glasgow, United Kingdom
(Wendler) LondonUnited Kingdom
(Reardon) Houston Methodist Debakey Heart & Vascular Center, Houston, TX,
United States
(Woo) Department of Cardiothoracic Surgery, Division of Cardiovascular
Medicine and Stanford Cardiovascular Institute, Stanford University,
Stanford, CA, United States
(Pijls) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(De Bruyne) Cardiovascular Center Aalst, Belgium
(Fearon) Stanford University School of Medicine and Stanford
Cardiovascular Institute, Stanford University, Stanford, California, USA;
VA Palo Alto Medical Systems, Palo Alto, California, USA
Abstract
BACKGROUND: Outcomes in women after fractional flow reserve (FFR)-guided
percutaneous coronary intervention (PCI) using current-generation
drug-eluting stents (DES) compared with coronary artery bypass grafting
(CABG) are unknown. OBJECTIVE(S): This study sought to evaluate
differences in clinical outcomes according to sex after FFR-guided PCI
with current generation DES compared with CABG. METHOD(S): The FAME 3
trial was an investigator-initiated, randomized controlled trial,
comparing FFR-guided PCI with current generation DES or CABG in patients
with 3-vessel coronary artery disease. This prespecified subgroup analysis
compared the incidence of major adverse cardiac and cerebrovascular events
(MACCE) according to sex, defined as the composite of all-cause death,
myocardial infarction, stroke, or repeat revascularization at 3 years.
 RESULT(S): Of 1,500 patients included in the FAME 3 trial, 265
(17.7%) were women. Women had a significantly higher risk of MACCE at 3
years compared with men after CABG (18.1% vs 11.7%; adjusted HR: 2.07; 95%
CI: 1.19-3.60), whereas women had a similar risk of MACCE at 3 years
compared with men after PCI (18.2% vs 19.1%; adjusted HR: 1.27; 95% CI:
0.79-2.03). Regarding treatment effects by sex, women undergoing PCI had a
similar risk of MACCE at 3 years compared with CABG (adjusted HR: 1.15;
95% CI: 0.62-2.11). By contrast, men undergoing PCI had a higher risk of
MACCE at 3 years compared with CABG (adjusted HR: 1.68; 95% CI: 1.25-2.25;
Pinteraction = 0.142), which was mainly driven by a higher risk of
myocardial infarction (adjusted HR: 2.11; 95% CI: 1.26-3.56; Pinteraction
= 0.102) and repeat revascularization (adjusted HR: 2.26; 95% CI:
1.47-3.47; Pinteraction = 0.071). CONCLUSION(S): In the FAME 3 trial,
at 3 years, women had similar outcomes with FFR-guided PCI compared with
CABG, whereas men had improved outcomes with CABG. (A Comparison of
Fractional Flow Reserve-Guided Percutaneous Coronary Intervention and
Coronary Artery Bypass Graft Surgery in Patients With Multivessel Coronary
Artery Disease [FAME 3]; NCT02100722). Copyright © 2024 American
College of Cardiology Foundation. Published by Elsevier Inc. All rights
reserved.

<36>
Accession Number
2032517015
Title
The effect of omega-3 Polyunsaturated Fatty Acid (PUFA) prescription
preparations on the prevention of clinical cardiovascular disease: a
meta-analysis of RCTs.
Source
Nutrition Journal. 23(1) (no pagination), 2024. Article Number: 157. Date
of Publication: December 2024.
Author
Dong S.; Wang Y.; Bian J.; Chen H.; Dong J.; Zhu J.; Zhang T.; Du Q.; Zhao
R.
Institution
(Dong, Chen, Zhao) Department of Pharmacy, Peking University Third
Hospital, Beijing, China
(Wang, Dong, Zhu, Du) Department of Pharmacy, The Third Affiliated
Hospital of Chongqing Medical University, Chongqing, China
(Wang) College of Pharmacy, Chongqing Medical University, Chongqing, China
(Bian, Chen) Department of Pharmacy Administration and Clinical Pharmacy,
School of Pharmaceutical Sciences, Peking University, Beijing, China
(Bian) Department of Pharmacy, People's Hospital of Peking University,
Beijing, China
(Zhang) Infectious Diseases Department, Second Affiliated Hospital of
Tianjin University of Traditional Chinese Medicine, Tianjin, China
Publisher
BioMed Central Ltd
Abstract
Importance: Evidence from systematic reviews of the cardioprotective
effect of omega-3 polyunsaturated fatty acid (PUFA) remains controversial,
and interventions including PUFAs dietary supplements or prescription
medications cannot accurately reflect the role of PUFA RX in
cardiovascular disease (CVD) prevention. Objective(s): We conducted a
meta-analysis of randomized clinical trials (RCTs) to evaluate the
efficacy of PUFA prescription medication in preventing CVD.
 Method(s): Two reviewers conducted a literature search of Embase,
MEDLINE/PubMed, and the Cochrane Library from their inception to September
2023. The inclusion criteria were RCTs evaluating long-term
supplementation (>= 1 year) with PUFA prescriptions and reporting
cardiovascular outcomes. Data were extracted independently by two authors,
and the certainty of evidence for each outcome was assessed using the
GRADE system. Random-effects models were used to estimate the risk ratios
(RRs) and 95% confidence intervals (CIs). The primary outcomes were
cardiovascular events. Secondary endpoints included major adverse
cardiovascular events (MACEs), cardiac death, all-cause mortality,
myocardial infarction, stroke, and revascularization. Subgroup analyses
were performed based on PUFA components, dosage, follow-up duration, and
risk status. Result(s): Twelve RCTs involving 99,830 participants
were included. The mean age of participants ranged from 59.4 to 74.0
years, with a follow-up period varying from 1 to 6.2 years. Compared with
placebo and statins, PUFA prescription medication was associated with a
reduced risk of cardiovascular events (8 RCTs, n = 75,929, RR, 0.88 [95%
CI, 0.81-0.95]; P = 0.0007; I2 = 45%), cardiac death (10 RCTs,
n = 95,440, RR, 0.91 [95% CI, 0.84-0.99]; P = 0.02; I2 = 23%),
myocardial infarction (9 RCTs, n = 94,877, RR, 0.84 [95% CI, 0.73-0.96]; P
= 0.009; I2 = 62%), and revascularization (9 RCTs, n = 91,242,
RR, 0.91 [95% CI, 0.84-0.99]; P = 0.02; I2 = 63%). Conclusions
and relevance: PUFA prescription medication could lower the risks of
cardiovascular events, cardiac death, myocardial infarction and
revascularization. This research provides insight into the efficacy of
PUFA prescription medications in CVD prevention and contributes to the
ongoing debate on the role of PUFA products in cardiovascular
outcomes. Copyright © The Author(s) 2024.

<37>
Accession Number
358182848
Title
Anti-inflammatory effect of aprotinin: A meta-analysis.
Source
Journal of Extra-Corporeal Technology. 41(2) (pp 79-86), 2009. Date of
Publication: June 2009.
Author
Brown J.R.; Toler A.W.J.; Kramer R.S.; Clive Landis R.
Institution
(Brown, Toler) Dartmouth Institute for Health Policy and Clinical
Practice, Dartmouth Medical School, Lebanon, NH, United States
(Kramer) Division of Cardiothoracic Surgery, Maine Medical Center,
Portland, ME, United States
(Clive Landis) Edmund Cohen Laboratory for Vascular Research, University
of the West Indies, Barbados
Publisher
American Society of Extra-Corporeal Technology
Abstract
It is important to define the extent, and any limitations, of potential
anti-inflammatory regimens used in cardiac surgery to guide the rational
combination of drugs to suppress the systemic inflammatory response.
Aprotinin (Trasylol) is an anti-fibrinolytic agent with reported
anti-inflammatory properties. In this study, we investigated the published
data on aprotinin's effect on acute phase protein and cytokine levels in
cardiac surgery patients. Randomized placebo-controlled trials of
aprotinin published between 1985 and 2007, in adult cardiac surgery using
cardiopulmonary bypass, reporting tumor necrosis factor-alpha (TNF-alpha),
interleukin-6 (IL-6), IL-8, and IL-10 levels were included for review. Two
independent reviewers graded each paper and collected information on
inflammatory markers. RevMan 4.3 statistical software was used to
calculate and plot the weighted mean difference between placebo and
aprotinin groups. Thirteen studies met the review criteria. None of the
inflammatory markers were reduced by high-dose aprotinin treatment.
Low-dose aprotinin significantly reduced IL-10 levels after protamine
administration (?41.3 pg/ mL; 95% CI: ?59.5, ?23.1), but this result was
gone by the first post-operative day. These meta-analyses showed no
significant effect of aprotinin on acute phase proteins or systemic
cytokine markers of inflammation during clinical adult cardiac surgery
using cardiopulmonary bypass. While recognizing that other host defense
systems, such as coagulation and complement, contribute to the overall
systemic inflammatory response, the evidence presented here does not
support the clinical use of aprotinin as an anti-inflammatory agent on its
own.

<38>
Accession Number
2030221170
Title
Cerebral autoregulation in pediatric and neonatal intensive care: A
scoping review.
Source
Journal of Cerebral Blood Flow and Metabolism. 44(11) (pp 1208-1226),
2024. Date of Publication: November 2024.
Author
Fedriga M.; Martini S.; Iodice F.G.; Sortica da Costa C.; Pezzato S.;
Moscatelli A.; Beqiri E.; Czosnyka M.; Smielewski P.; Agrawal S.
Institution
(Fedriga, Pezzato, Moscatelli) Neonatal and Paediatric Intensive Care
Unit, IRCCS Giannina Gaslini Institute, Genoa, Italy
(Martini) Neonatal Intensive Care Unit, IRCCS AOUBO, Department of Medical
and Surgical Sciences, University of Bologna, Bologna, Italy
(Iodice) Paediatric Cardiac Anaesthesia and Intensive Care Unit, IRCCS,
Bambino Gesu' Hospital, Rome, Italy
(Sortica da Costa) Neonatal Intensive Care Unit, Great Ormond Street
Hospital, London, United Kingdom
(Beqiri, Czosnyka, Smielewski) Brain Physics Laboratory, Division of
Neurosurgery, Department of Clinical Neurosciences, University of
Cambridge, United Kingdom
(Agrawal) Department of Paediatric Intensive Care, Addenbrooke's Hospital,
University of Cambridge, Cambridge, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Deranged cerebral autoregulation (CA) is associated with worse outcome in
adult brain injury. Strategies for monitoring CA and maintaining the brain
at its 'best CA status' have been implemented, however, this approach has
not yet developed for the paediatric population. This scoping review aims
to find up-to-date evidence on CA assessment in children and neonates with
a view to identify patient categories in which CA has been measured so
far, CA monitoring methods and its relationship with clinical outcome if
any. A literature search was conducted for studies published within 31st
December 2022 in 3 bibliographic databases. Out of 494 papers screened,
this review includes 135 studies. Our literature search reveals evidence
for CA measurement in the paediatric population across different
diagnostic categories and age groups. The techniques adopted, indices and
thresholds used to assess and define CA are heterogeneous. We discuss the
relevance of available evidence for CA assessment in the paediatric
population. However, due to small number of studies and heterogeneity of
methods used, there is no conclusive evidence to support universal
adoption of CA monitoring, technique, and methodology. This calls for
further work to understand the clinical impact of CA monitoring in
paediatric and neonatal intensive care. Copyright © The Author(s)
2024.

<39>
Accession Number
2031550179
Title
Comprehensive geriatric assessment, and related interventions, to improve
outcomes for older patients undergoing transcatheter aortic valve
implantation (TAVI): a systematic review.
Source
European Geriatric Medicine. 15(6) (pp 1615-1630), 2024. Article Number:
e040459. Date of Publication: December 2024.
Author
Chin K.; Jones R.; Lester E.; Hegarty A.; Thielemans L.; Schiff R.
Institution
(Chin, Jones, Lester, Hegarty, Thielemans, Schiff) Department of Ageing
and Health, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH,
United Kingdom
(Schiff) King's College London, London WC2R 2LS, United Kingdom
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aim: To review the evidence for using Comprehensive Geriatric Assessment,
or related interventions, to improve outcomes for older patients
undergoing Transcatheter Aortic Valve Implantation (TAVI).
 Finding(s): There lacks evidence for use of CGA, or related
interventions, in older adults undergoing TAVI due to the low quality of
studies. Message: Further research is required to investigate whether CGA
improves outcomes for older adults undergoing TAVI. Copyright ©
The Author(s) 2024.

<40>
Accession Number
2031266803
Title
Proximal connection anomalies of the coronary arteries to the aorta:
Retrospective experience in a moroccan university hospital and literature
review.
Source
Pan African Medical Journal. 48 (no pagination), 2024. Article Number:
139. Date of Publication: May-Aug 2024.
Author
Lahmouch N.; Bouzerda A.; Asfalou I.; Lakhal Z.; Benyass A.
Institution
(Lahmouch, Asfalou, Lakhal, Benyass) Mohammed V University, Faculty of
Medicine and Pharmacy in Rabat Morocco, Mohammed V Military Hospital,
Department of Cardiology, Rabat, Morocco
(Bouzerda) Cadi Ayad University, Faculty of Medicine and Pharmacy in
Marrakech Morocco, Avicenne Military Hospital, Department of Cardiology,
Rabat, Morocco
Publisher
African Field Epidemiology Network
Abstract
Proximal connection anomalies of the coronary arteries to the aorta
represent a rare pathology, with an angiographic prevalence close to 1%.
The prognosis of this condition is contingent upon its anatomical form.
Some instances are linked to sudden deaths, while others may be associated
with myocardial ischemia. Utilizing computed tomography (CT) coronary
angiography as the optimal imaging tool, one can identify the origin and
course of the ectopic artery. Current guidelines suggest surgical
correction as the primary intervention for symptomatic abnormalities when
a risky form is identified. To enhance the management of these anomalies,
the establishment of comprehensive multicenter observational registers is
imperative. Our study, a retrospective analysis spanning two years,
focuses on 10 cases of proximal connection anomalies of coronary arteries
to the aorta diagnosed in the Cardiology department of the Mohammed V
Military Hospital of Rabat. By presenting this series and conducting a
literature review, we elucidate the anatomical, epidemiological,
physiopathological, clinical, angiographic, and CT angiography features of
these anomalies, along with insights into therapeutic
management. Copyright © 2024, Pan Afr. Med. J. All rights
reserved.

<41>
Accession Number
2030637747
Title
Daptomycin eosinophilic pneumonia, a systematic review of the literature
and case series.
Source
Infection. 52(6) (pp 2145-2168), 2024. Date of Publication: December 2024.
Author
Gidari A.; Pallotto C.; Francisci D.
Institution
(Gidari, Pallotto, Francisci) Department of Medicine, Clinic of Infectious
Diseases, "Santa Maria della Misericordia" Hospital, University of
Perugia, Piazzale Lucio Severi 1, Perugia 06132, Italy
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Daptomycin-induced eosinophilic pneumonia (DIEP) is a rare yet
severe adverse event that requires rapid recognition and management.
Diagnosing a definite case is challenging and involves meeting the
American Thoracic Society (ATS) criteria, although alternative criteria
have been suggested. This study aims to conduct a systematic review of
literature and includes a case series. Method(s): Six cases of DIEP
identified at Perugia Hospital, Perugia, Italy have been described. A
systematic review was carried out adhering to the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement
guidelines. Result(s): a total of 74 cases of DIEP were analysed.
Using ATS clinical criteria, 15 were classified as definite (20.3%), 54 as
probable (73.0%), and 5 as possible (6.8%). Phillips criteria and the Lyon
Algorithm identified 43/74 (58.2%) and 64/67 (95.5%) cases as definite,
respectively. Bronchoalveolar lavage (BAL) was performed in 43 cases,
revealing an average eosinophil count of 28.6% (SD 24.4). Radiological
findings highlighted recurring features like bilateral opacities (68.1%),
ground-glass opacities (41.7%), patchy infiltrates (30.6%), and peripheral
predominance (19.4%). Upon suspicion, daptomycin was discontinued; 20
cases required no additional treatment, 38 received corticosteroids, and
12 received both corticosteroids and antibiotics. Recovery rates were high
across all treatment types (>= 73.7%). Most reports described rapid
improvement post-withdrawal (within 96 h). Conclusion(s): DIEP is a
rare, fast-progressing condition where early diagnosis and prompt
treatment are vital. Diagnosis relies on clinical, laboratory, and
radiological evaluations. Stopping daptomycin is essential, with
corticosteroids often necessary. Further research is needed to enhance
diagnostic accuracy for this disease. Copyright © The Author(s)
2024.

<42>
Accession Number
2032505210
Title
Speckle-tracking echocardiography of left and right ventricle and acute
cellular rejection in orthotropic heart transplantation: a systematic
review and meta-analysis.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2024.
Date of Publication: 2024.
Author
Xourgia E.; Brignoli K.; Linder O.; Neagoe A.-M.; Capek L.; Bruno J.;
Strickler E.; Bakula A.; Pavlicek-Bahlo M.; Furholz M.; Muster C.;
Malagutti P.; Martinelli M.; Hunziker L.; Schnegg B.
Institution
(Xourgia, Neagoe, Capek, Bruno, Strickler, Bakula, Pavlicek-Bahlo,
Furholz, Muster, Malagutti, Martinelli, Hunziker, Schnegg) Department of
Cardiology, Inselspital, Bern University Hospital, University of Bern,
Bern, Switzerland
(Xourgia, Brignoli, Linder) Department of Internal Medicine, Burgerspital
Solothurn, Solothurn, Switzerland
Publisher
Springer Science and Business Media B.V.
Abstract
After a cardiac transplantation, the steering of immunosuppression
requires an active search for acute cellular rejection (ACR). Surveillance
with endomyocardial biopsy (EMB) is the gold standard. Given the costs and
potential complications, there is growing interest in the use of
non-invasive screening methods. Thus, we have conducted a systematic
review and meta-analysis to evaluate the role of speckle-tracking
echocardiography as a screening method for ACR. We searched PubMed
(CENTRAL) and gray literature for studies presenting data on speckle
tracking echocardiography in heart-transplant patients experiencing acute
cellular rejection. The primary outcomes of the meta-analysis were left
and right ventricular global longitudinal strain. We used random effects
models for all our calculations. We pre-registered our meta-analysis with
PROSPERO (CRD42024508654). By incorporating data from over 2000 biopsies
included in 18 studies, we found that both left (LVGLS, MD -1.96, 95% CI
-2.85 to -1.07, p < 0.0001), and right (RVGLS, MD -2.90, 95% CI -4.03 to
-1.76, p < 0.00001) ventricular longitudinal strain were lower among
patients without ACR. The change of LVGLS from baseline over time was also
greater among patients experiencing ACR (MD -2.43, 95% CI -4.82 to -0.05,
p = 0.045). Current data suggest that myocardial strain measured by
speckle tracking echocardiography is affected in ACR and could potentially
be used for early rejection detection as a rule-out strategy, leading to
reduction of routine EMB in heart transplant follow-up. Copyright
© The Author(s) 2024.

<43>
Accession Number
2036120458
Title
Aortic Valve Replacement vs Clinical Surveillance in Asymptomatic Severe
Aortic Stenosis: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. (no pagination), 2024.
Date of Publication: 2024.
Author
Genereux P.; Banovic M.; Kang D.-H.; Giustino G.; Prendergast B.D.;
Lindman B.R.; Newby D.E.; Pibarot P.; Redfors B.; Craig N.J.; Bartunek J.;
Schwartz A.; Seyedin R.; Cohen D.J.; Iung B.; Leon M.B.; Dweck M.R.
Institution
(Genereux, Giustino) Gagnon Cardiovascular Institute, Morristown Medical
Center, Morristown, NJ, United States
(Banovic) Belgrade Medical School, University of Belgrade, Belgrade,
Serbia
(Banovic) Cardiology Department, University Clinical Center of Serbia,
Belgrade, Serbia
(Kang) Asan Medical Center, College of Medicine, University of Ulsan,
Seoul, South Korea
(Prendergast) Department of Cardiology, Guys and St Thomas' NHS Foundation
Trust Hospital London, London, United Kingdom
(Prendergast) Heart, Vascular and Thoracic Institute, Cleveland Clinic
London, London, United Kingdom
(Lindman) Structural Heart and Valve Center, Vanderbilt University Medical
Center, Nashville, TN, United States
(Newby, Dweck) British Heart Foundation Centre for Cardiovascular Science,
University of Edinburgh, Edinburgh, United Kingdom
(Pibarot) Quebec Heart and Lung Institute, Laval University, Quebec City,
QC, Canada
(Redfors) Department of Molecular and Clinical Medicine, Institute of
Medicine, Gothenburg University, Gothenburg, Sweden
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Craig) Centre for Cardiovascular Sciences, University of Edinburgh,
Edinburgh, United Kingdom
(Bartunek) Clinical Trial Service Unit and Epidemiological Studies Unit,
Nuffield Department of Population Health, University of Oxford, Oxford,
United Kingdom
(Schwartz, Leon) Columbia University Medical Center/NewYork-Presbyterian
Hospital, New York, NY, United States
(Seyedin) Edwards Lifesciences, Irvine, CA, United States
(Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States
(Cohen, Leon) Cardiovascular Research Foundation, New York, NY, United
States
(Iung) Bichat Hospital, Assistance Publique-Hopitaux de Paris, and INSERM
LVTS 1148, Universite Paris-Cite, Paris, France
Publisher
Elsevier Inc.
Abstract
Background: Current guidelines recommend a strategy of clinical
surveillance (CS) for patients with asymptomatic severe aortic stenosis
(AS) and a normal left ventricular ejection fraction. Objective(s):
The aim of this study was to conduct a study-level meta-analysis of
randomized controlled trials (RCTs) evaluating the effect of early aortic
valve replacement (AVR) compared with CS in patients with asymptomatic
severe AS. Method(s): Studies were quantitatively assessed in a
meta-analysis using random-effects modeling. Prespecified outcomes
included all-cause and cardiovascular mortality, unplanned cardiovascular
or heart failure (HF) hospitalization, and stroke. The meta-analysis is
registered at the International Platform of Registered Systematic Review
and Meta-Analysis Protocols (INPLASY202490002). Result(s): Four RCTs
were identified, including a total of 1,427 patients (719 in the early AVR
group and 708 in the CS group). At an average follow-up time of 4.1 years,
early AVR was associated with a significant reduction in unplanned
cardiovascular or HF hospitalization (pooled rate 14.6% vs 31.9%; HR:
0.40; 95% CI: 0.30-0.53; I2 = 4%; P < 0.01) and stroke (pooled
rate 4.5% vs 7.2%; HR: 0.62; 95% CI: 0.40-0.97; I2 = 0%; P =
0.03). No differences in all-cause mortality (pooled rate 9.7% vs 13.7%;
HR: 0.68; 95% CI: 0.40-1.17; I2 = 61%; P = 0.17) and
cardiovascular mortality (pooled rate 5.1% vs 8.3%; HR: 0.67; 95% CI:
0.35-1.29; I2 = 50%; P = 0.23) were observed with early AVR
compared with CS, although there was a high degree of heterogeneity among
studies. Conclusion(s): In this meta-analysis of 4 RCTs, early AVR
was associated with a significant reduction in unplanned cardiovascular or
HF hospitalization and stroke and no differences in all-cause and
cardiovascular mortality compared with CS. Copyright © 2024 The
Authors

<44>
Accession Number
2007640188
Title
B-TYPE NATRIURETIC PEPTIDE LEVELS IN PATIENTS WITH PERICARDIAL EFFUSION
UNDERGOING PERICARDIOCENTESIS.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology's 65th Annual Meeting. McCormick Place Convention
Center, Chicago United States. 67(13 Supplement) (pp 1663), 2016. Date of
Publication: 05 Apr 2016.
Author
Cosentino N.; Lauri G.; Rossi C.; Rubino M.; Milazzo V.; Marana I.;
Moltrasio M.; De Metrio M.; Grazi M.; Campodonico J.; Marenzi G.
Institution
(Cosentino, Lauri, Rossi, Rubino, Milazzo, Marana, Moltrasio, De Metrio,
Grazi, Campodonico, Marenzi) Centro Cardiologico Monzino, Milan, Italy
Publisher
Elsevier Inc.
Abstract
Background Pericardial effusion (PE) is characterized by accumulation of
fluid within the pericardium, resulting in heart compression. As B-type
natriuretic peptide (BNP) is secreted by the ventricles in response to
increased myocardial stretch, we hypothesized that PE and its resolution
might influence BNP plasma levels. Methods In 146 patients with PE, we
measured BNP plasma levels at baseline, soon after, and 24 hours after
pericardiocentesis. A scoring system based on 7 clinical and
echocardiographic parameters was developed, and patients were classified
according to the number of variables as having low (0-2), intermediate
(3-4), or high (5-7) severity score. Results 42 (29%) patients had normal
BNP values (<100 pg/ml), whereas 104 (71%) had high values at baseline. In
the whole population, baseline BNP significantly decreased as the severity
score increased (r=-0.21; P=0.01). 24 hours after pericardiocentesis, a
significant increase in BNP was observed in patients with intermediate
(P=0.004) and with high (P<0.001) severity score; no increase occurred in
low score patients (P=0.56). The higher was the severity score the steeper
was the increase in BNP through the three time-points considered (P=0.04)
(Figure). Conclusions BNP plasma levels are suppressed in the presence of
hemodynamically significant PE, and they rise after pericardiocentesis.
Future studies should confirm the role of BNP in assisting clinicians in
the decision-making process of pericardial fluid drainage. [Formula
presented] Copyright © 2016 American College of Cardiology
Foundation

<45>
Accession Number
2007640181
Title
OUTCOMES IN 2824 PATIENTS WITH VALVULAR HEART DISEASE TREATED WITH
EDOXABAN OR WARFARIN IN THE ENGAGE AF-TIMI 48 TRIAL.
Source
Journal of the American College of Cardiology. Conference: American
College of Cardiology's 65th Annual Meeting. McCormick Place Convention
Center, Chicago United States. 67(13 Supplement) (pp 2194), 2016. Date of
Publication: 05 Apr 2016.
Author
Renda G.; De Caterina R.; Carnicelli A.; Nordio F.; Mercuri M.; Ruff C.;
Giugliano R.
Institution
(Renda, De Caterina, Carnicelli, Nordio, Mercuri, Ruff, Giugliano)
d'Annunzio University of Chieti-Pescara, CH, Chieti, Italy
Publisher
Elsevier Inc.
Abstract
Background Use of NOACs in patients (pts) with atrial fibrillation (AF)
and valvular heart disease (VHD) is under scrutiny. We explored outcomes
in pts with AF +/- VHD in ENGAGE AF-TIMI 48 comparing edoxaban with
warfarin. Methods We defined VHD as mitral/aortic valve surgery
(bioprosthetic valve, repair, valvuloplasty) or mod-to-severe MR/AS/AI.
Pts with mod-to-severe MS or mechanical heart valves were excluded. We
compared edoxaban with warfarin on rates of stroke/systemic embolism
(SSE), major bleeding (MB), and net outcome (SSE, MB, death) in pts +/-
VHD, using adjusted Cox proportional hazards. Results Pts with VHD
(n=2824) had rates of the composite outcome (HR: 1.42; 95% CI: 1.31-1.54,
P<0.001), compared to pts without VHD (n=18222). Even mod VHD mortality
and net outcome after adjustment. AS (n=165) had the highest impact on
mortality (HR: 2.77; 95% CI, 1.94-3.97, P<0.001). There was no effect
modification of VHD on relative outcomes with higher- or lower-dose
edoxaban vs warfarin (all PINT=NS). As in the main trial, in pts with VHD,
edoxaban had similar efficacy (HR: 0.69) and bleeding (HR: 0.74) vs
warfarin (Fig.). In 191 pts with bioprosthetic valves, the efficacy and
safety with edoxaban vs warfarin were consistent with the main trial, but
with even more favorable net outcomes in those with biologic valves
(HR=0.45, PINT=0.05). Conclusions Similar efficacy, but better safety and
net outcomes were observed with edoxaban as compared to warfarin in pts
+/- VHD. [Formula presented] Copyright © 2016 American College of
Cardiology Foundation

<46>
Accession Number
2036338322
Title
Crossing borders to meet cardiac surgical needs: A scoping review on
patients seeking cardiac surgery abroad.
Source
American Journal of Surgery. 240 (no pagination), 2025. Article Number:
116133. Date of Publication: February 2025.
Author
Mourad N.; Stefanyk K.; Vervoort D.
Institution
(Mourad, Stefanyk) Faculty of Medicine, University of British Columbia,
Vancouver, BC, Canada
(Vervoort) Division of Cardiac Surgery, University of Toronto, Toronto,
ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Over 100 countries do not have a local cardiac surgeon,
whereas capacity, coverage, or cultural constrains may limit access to
cardiac surgical care in-country. This scoping review aims to summarize
the current literature of patients seeking cardiac surgical care abroad
and determine research gaps for this understudied aspect of global
surgical care. Method(s): A scoping review was conducted on patients
seeking cardiac surgery outside of their home country using MEDLINE,
EMBASE, CINAHL, SCOPUS, WHO Global Index Medicus, and PubMed databases.
Relevant articles were descriptively and quantitatively summarized.
 Result(s): Out of a total of 49 articles and 6351 patients, the most
common procedures were coronary artery bypass grafts & valve procedures (N
= 3948; 62 %) and congenital heart disease repairs (N = 2049; 32 %). The
most prevalent countries of origin were Japan, Nigeria, and the United
Arab Emirates. The United States, France, and the United Kingdom were the
most common destination countries. Most patients (N = 1483; 23 %) sought
care abroad due to limited therapeutic options in the home country.
Funding sources stemmed comparably from government funding,
non-governmental organization funding, and out-of-pocket payments.
 Conclusion(s): The extent of and reasons for individuals traveling
abroad for cardiac surgery are poorly described. Localizing cardiac care,
while requiring significant resources, may lead to substantial cost
savings and improved access to care. Until then, improving access to
international travel for cardiac surgery remains an important
strategy. Copyright © 2024 Elsevier Inc.

<47>
Accession Number
2036337214
Title
Direct Oral Anticoagulants for Rheumatic Heart Disease-Associated Atrial
Fibrillation Post-Bioprosthetic Mitral Valve Replacement.
Source
JACC: Clinical Electrophysiology. 10(12) (pp 2701-2710), 2024. Date of
Publication: December 2024.
Author
Fath A.R.; Aglan A.; Altaee O.; Fichardt H.; Mansoor H.; Almomani A.;
Hammadah M.; Vinas A.; Nayak H.; Jneid H.; Saad M.; Elgendy I.Y.
Institution
(Fath, Fichardt, Almomani, Hammadah, Vinas, Nayak) Division of Cardiology,
University of Texas Health Science Center, San Antonio, TX, United States
(Aglan) Cardiology Department, Westchester Medical Center, New York
Medical College, Valhalla, NY, United States
(Altaee, Mansoor) Department of Pharmacy, Practice and Science, College of
Pharmacy University of Kentucky, Lexington, KY, United States
(Jneid) Division of Cardiology, University of Texas Medical Branch,
Galveston, TX, United States
(Saad) Lifespan Cardiovascular Institute, Providence, RI, United States
(Saad) Department of Cardiology, Warren Alpert Medical School of Brown
University, Providence, RI, United States
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky, Lexington, KY, United States
Publisher
Elsevier Inc.
Abstract
Background: The efficacy of direct oral anticoagulants (DOACs) in
preventing ischemic and thromboembolic events may be suboptimal in atrial
fibrillation (AF) patients with rheumatic mitral stenosis. However, their
safety and effectiveness after mitral valve replacement (MVR) using
bioprosthetic valves is unclear. Objective(s): This study sought to
evaluate the safety and effectiveness of DOACs vs warfarin among patients
with rheumatic heart disease (RHD)-associated AF after bioprosthetic MVR.
 Method(s): We performed an observational analysis identifying
patients with RHD and AF who underwent bioprosthetic MVR. Primary
effectiveness and safety outcomes were ischemic events and major bleeding,
respectively. Secondary outcomes included all-cause mortality, cardiac
thrombosis, myocardial infarction, and all-cause hospitalization.
Propensity score matching was performed to account for the differences in
baseline characteristics and comorbidities. Result(s): A total of
3,950 patients were identified; 76% were on warfarin and 24% on DOAC
post-MVR. The DOAC group had a higher burden of baseline comorbidities and
prior cardiovascular procedures compared with the warfarin group. The
propensity score matching balanced baseline characteristics in 1,832
patients (916 in each group), with a mean age of 69 years. At the 5-year
follow-up, DOACs were associated with a lower incidence of major bleeding
compared with warfarin (HR: 0.76; 95% CI: 0.62-0.94), with no significant
difference in ischemic events, mortality, cardiac thrombosis, myocardial
infarction, or hospitalization. Conclusion(s): Among patients with
RHD-associated AF patients post-bioprosthetic MVR, DOACs are associated
with lower major bleeding and comparable effectiveness, indicating a
potential alternative to warfarin. Further randomized controlled trials
are warranted to validate these findings in this population. Copyright
© 2024 American College of Cardiology Foundation

<48>
Accession Number
2036118390
Title
Self-Expandable Versus Balloon-Expandable Transcatheter Aortic Valve
Replacement for Treatment of Patients With Small Aortic Annulus An Updated
Meta-Analysis of Reconstructed Individual Patient Data.
Source
Cardiology in Review. (no pagination), 2024. Article Number: v. Date of
Publication: 2024.
Author
Khalefa B.B.; Yassin M.N.A.; Gonnah A.R.; Elkasaby M.H.; Hasan M.T.;
Altobaishat O.; Bani-Salame A.; Rashed M.A.; Mansour M.A.; Al Hennawi H.;
Roberts D.H.
Institution
(Khalefa) The Department of Medicine, Ain Shams University, Cairo, Egypt
(Yassin) Department of Medicine Kasr Al-Ainy, Cairo University, Cairo,
Egypt
(Gonnah) Department of Medicine, Imperial College Healthcare NHS Trust,
London, United Kingdom
(Elkasaby, Hasan, Rashed) Department of Medicine, Al-Azhar University,
Cairo, Egypt
(Altobaishat, Bani-Salame) Department of Medicine, Jordan University of
Science and Technology, Irbid, Jordan
(Mansour) Department of Medicine, Menoufia University, Menoufia, Egypt
(Al Hennawi) Department of Medicine, Jefferson Abington Hospital,
Abington, PA, United States
(Roberts) Department of Cardiology, Lancashire Cardiac Centre, Blackpool,
United Kingdom
(Roberts) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve replacement has emerged as an effective
alternative to surgery in selected patients with aortic stenosis. It needs
to be made clear which type of valve has better results in patients with
small aortic annulus. We searched PubMed, Scopus, Embase, Cochrane
Library, and Web of Science, following the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses statement. A total of 27 articles
were included, including 10,378 patients [5989 in balloon-expanding valve
(BEV) and 4389 in the self-expanding valve (SEV) groups] with small aortic
annulus. Our meta-analysis demonstrated no significant difference between
SEVs and BEVs for 1-year all-cause mortality. There was a statistically
significant increased risk of permanent pacemaker implantation (PPI)
within 30 days and ischemic stroke at 1 year with SEVs [risk ratio (RR) =
1.69, 95% confidence interval (CI) = 1.18-2.42, P < 0.01, and RR = 1.83,
95% CI = 1.03-3.26, P = 0.04, respectively]. Our meta-analysis showed that
SEVs are favored over BEVs in terms of 1-year change from baseline in
effective orifice area (mean difference = 0.45, 95% CI = 0.19-0.71, P <
0.01). Moreover, after 1-year follow-up, severe patient-prosthesis
mismatch was significantly lower in the SEV group (RR = 0.24, 95% CI =
0.11-0.53, P < 0.01). In conclusion, SEVs were associated with better
echocardiographic outcomes from baseline. Patients with SEVs were more
likely to develop stroke and require PPI but were less likely to have
patient-prosthesis mismatch. The benefit of a larger effective aortic
valve area with SEVs has to be balanced against higher PPI and stroke
rates. Copyright © 2024 Wolters Kluwer Health, Inc. All rights
reserved.

<49>
Accession Number
2031845553
Title
Uniform or Sex-Specific Cardiac Troponin Thresholds to Rule Out Myocardial
Infarction at Presentation.
Source
Journal of the American College of Cardiology. 83(19) (pp 1855-1866),
2024. Date of Publication: 14 May 2024.
Author
Lowry M.T.H.; Mills N.L.; Shah A.S.V.; Strachan F.E.; Tuck C.; Anand A.;
Akinlade O.M.; Barker S.; Blades J.; Boeddinghaus J.; Bularga A.; de
Bakker M.; Chapman A.R.; Doudesis D.; Ferry A.V.; Fujisawa T.; Georgiev
K.; Kimenai D.M.; Lee K.K.; Lyell I.; Li Z.; Lowry M.T.; McKinlay L.;
McDermott M.; McPherson J.; Mendusic F.; Sorbie A.; Souter G.; Schulberg
S.D.; Taggart C.; Thurston A.J.; Tew Y.Y.; Perez-Vicencio D.; Wang Y.;
Wereski R.; Williams K.; Newby D.E.; Fox K.A.; Berry C.; Walker S.; Weir
C.J.; Ford I.; Gray A.; Collinson P.O.; Apple F.S.; Reid A.; Cruikshank
A.; Findlay I.; Amoils S.; McAllister D.A.; Maguire D.; Stevens J.; Norrie
J.; Shah A.S.; Andrews J.P.; Adamson P.D.; Moss A.; Anwar M.S.; Hung J.;
Malo J.; Fischbacher C.M.; Croal B.L.; Leslie S.J.; Keerie C.; Parker
R.A.; Walker A.; Harkess R.; Wackett T.; Weir C.; Armstrong R.; Stirling
L.; MacDonald C.; Sadat I.; Finlay F.; Harrison K.; Linksted P.; Lavenberg
S.
Institution
(Li, Wereski, Anand, Lowry, Doudesis, McDermott, Ferry, Tuck, Chapman,
Lee, Mills, Kimenai) BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, United Kingdom
(Chapman) Department of Cardiology, Auckland City Hospital, Auckland, New
Zealand
(Shah) Department of Non-Communicable Disease, London School of Hygiene
and Tropical Medicine, London, United Kingdom
(Mills) Usher Institute, University of Edinburgh, Edinburgh, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Myocardial infarction can be ruled out in patients with a
single cardiac troponin measurement. Whether use of a uniform rule-out
threshold has resulted in sex differences in care remains unclear.
 Objective(s): The purpose of this study was to evaluate
implementation of a uniform rule-out threshold in females and males with
possible myocardial infarction, and to derive and validate sex-specific
thresholds. Method(s): The implementation of a uniform rule-out
threshold (<5 ng/L) with a high-sensitivity cardiac troponin I assay was
evaluated in consecutive patients presenting with possible myocardial
infarction. The proportion of low-risk patients discharged from the
emergency department and incidence of myocardial infarction or cardiac
death at 30 days were determined. Sex-specific thresholds were derived and
validated, and proportion of female and male patients were stratified as
low-risk compared with uniform threshold. Result(s): In 16,792
patients (age 58 +/- 17 years; 46% female) care was guided using a uniform
threshold. This identified more female than male patients as low risk (73%
vs 62%), but a similar proportion of low-risk patients were discharged
from the emergency department (81% for both) with fewer than 5 (<0.1%)
patients having a subsequent myocardial infarction or cardiac death at 30
days. Compared with a uniform threshold of <5 ng/L, use of sex-specific
thresholds would increase the proportion of female (61.8% vs 65.9%) and
reduce the proportion of male (54.8% vs 47.8%) patients identified as low
risk. Conclusion(s): Implementation of a uniform rule-out threshold
for myocardial infarction was safe and effective in both sexes.
Sex-specific rule-out thresholds should be considered, but their impact on
effectiveness and safety may be limited. Copyright © 2024

<50>
Accession Number
2028886721
Title
Superficial parasternal intercostal plane blocks in cardiac surgery: a
systematic review and meta-analysis.
Source
Canadian Journal of Anesthesia. 71(6) (pp 883-895), 2024. Date of
Publication: June 2024.
Author
Cameron M.J.; Long J.; Kardash K.; Yang S.S.
Institution
(Cameron, Long, Kardash, Yang) Faculty of Medicine, McGill University,
Montreal, QC, Canada
(Cameron) Department of Anesthesia, Jewish General Hospital, K1401-3755
Cote Sainte Catherine, Montreal, QC H3T 1E2, Canada
(Kardash, Yang) Department of Anesthesia, Jewish General Hospital,
Montreal, QC, Canada
(Cameron, Yang) Lady Davis Research Institute, Montreal, QC, Canada
Publisher
Springer
Abstract
Purpose: Traditional multimodal analgesic strategies have several
contraindications in cardiac surgery patients, forcing clinicians to use
alternative options. Superficial parasternal intercostal plane blocks,
anesthetizing the anterior cutaneous branches of the thoracic intercostal
nerves, are being explored as a straightforward method to treat pain after
sternotomy. We sought to evaluate the literature on the effects of
superficial parasternal blocks on pain control after cardiac surgery.
 Method(s): We conducted a systematic review and meta-analysis of
randomized controlled trials (RCTs). We searched MEDLINE, Embase, CENTRAL,
and Web of Science databases for RCTs evaluating superficial parasternal
intercostal plane blocks in adult patients undergoing cardiac surgery via
midline sternotomy published from inception to 11 March 2022. The
prespecified primary outcome was opioid consumption at 12 hr. The risk of
bias was assessed with the Cochrane Collaboration Risk of Bias Tool, and
the quality of evidence was evaluated using the grading of
recommendations, assessments, development, and evaluations. Outcomes were
analyzed with a random-effects model. All subgroups were prespecified.
 Result(s): We reviewed 1,275 citations. Eleven RCTs, comprising 756
patients, fulfilled the inclusion criteria. Only one study reported the
prespecified primary outcome, precluding the possibility of meta-analysis.
This study reported a reduction in opioid consumption (-11.2 mg iv
morphine equivalents; 95% confidence interval [CI], -8.2 to -14.1) There
was a reduction in opioid consumption at 24 hr (-7.2 mg iv morphine
equivalents; 95% CI, -5.6 to -8.7; five trials; 436 participants; moderate
certainty evidence). All five studies measuring complications reported
that none were detected, which included a sample of 196 blocks.
 Conclusion(s): The literature suggests a potential benefit of using
superficial parasternal blocks to improve acute postoperative pain control
after cardiac surgery via midline sternotomy. Future studies specifying
dosing regimens and adjuncts are required. Study registration: PROSPERO
(CRD42022306914); first submitted 22 March 2022. Copyright ©
Canadian Anesthesiologists' Society 2024.

<51>
Accession Number
2035810828
Title
Major Bleeding and Mortality After Revascularization of Left Main Disease.
Source
Journal of the American College of Cardiology. 84(24) (pp 2335-2346),
2024. Date of Publication: 10 Dec 2024.
Author
Giustino G.; Sabik J.F.; Serruys P.W.; Puskas J.D.; Karmpaliotis D.;
Kandzari D.E.; Morice M.-C.; Ragosta M.; Zhang Z.; Dressler O.; Redfors
B.; Ben-Yehuda O.; Sharma S.K.; Kappetein A.P.; Stone G.W.
Institution
(Giustino, Karmpaliotis) Gagnon Cardiovascular Institute, Atlantic Health
System, Morristown, NJ, United States
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
(Serruys) Imperial College of Science, Technology and Medicine, London,
United Kingdom
(Puskas) Mount Sinai Morningside, New York, NY, United States
(Kandzari) Piedmont Heart Institute, Atlanta, GA, United States
(Morice) Ramsay Generale de Sante, Hopital Prive Jacques Cartier, Massy,
France
(Ragosta) Division of Cardiovascular Medicine, University of Virginia
Health System, Charlottesville, VA, United States
(Zhang, Dressler, Redfors) Cardiovascular Research Foundation, New York,
NY, United States
(Ben-Yehuda) University of California-San Diego, San Diego, CA, United
States
(Sharma, Stone) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Kappetein) Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: The incidence and prognostic impact of major bleeding (MB)
after percutaneous coronary intervention (PCI) and coronary artery bypass
grafting (CABG) for left main coronary artery disease (LMCAD) are unknown.
 Objective(s): The goal of this study was to investigate the rates and
outcomes of MB after LMCAD revascularization. Method(s): In the EXCEL
(Evaluation of XIENCE versus Coronary Artery Bypass Surgery for
Effectiveness of Left Main Revascularization) trial, 1,905 patients with
unprotected LMCAD were randomized to undergo PCI (n = 948) or CABG (n =
957) and followed up for 5 years. MB was defined as TIMI major or minor
bleeding, BARC (Bleeding Academic Research Consortium) types 3 to 5
bleeding, or any overt bleeding requiring blood transfusion. The
association between MB and subsequent mortality was assessed in
time-adjusted Cox regression models. Result(s): At 5 years, 217
patients (11.4%) had at least 1 MB event. Rates of 5-year MB were 7.9%
after PCI vs 14.8% after CABG (OR: 0.48; 95% CI: 0.36-0.65; P < 0.0001).
However, in-hospital MB was lower after PCI (3.8% vs 13.5%; OR: 0.25; 95%
CI: 0.17-0.37), whereas postdischarge MB was lower after CABG (4.5% vs
2.0%; OR: 2.33; 95% CI: 1.33-3.09; P<inf>interaction</inf> < 0.0001). All
41 postdischarge MB events after PCI occurred in patients receiving dual
antiplatelet therapy. MB events within 5 years were associated with a
higher subsequent risk of all-cause mortality (adjusted HR: 2.71; 95% CI:
1.95-3.77; P < 0.0001), whether in-hospital or postdischarge
(P<inf>interaction</inf> = 1.00) and after both PCI and CABG
(P<inf>interaction</inf> = 0.95), driven both by increased cardiovascular
and non-cardiovascular mortality. Conclusion(s): In the EXCEL trial,
CABG resulted in higher 5-year rates of all MB and in-hospital MB,
although postdischarge MB was more frequent after PCI. MB after both
procedures was associated with increased cardiovascular and
noncardiovascular mortality within 5 years. (Evaluation of XIENCE versus
Coronary Artery Bypass Surgery for Effectiveness of Left Main
Revascularization [EXCEL]; NCT01205776) Copyright © 2024 American
College of Cardiology Foundation

<52>
Accession Number
2032495354
Title
Effect of Postoperative Atrial Fibrillation After Cardiac Surgery: A
Meta-Analysis.
Source
Clinical Cardiology. 47(12) (no pagination), 2024. Article Number: e70053.
Date of Publication: December 2024.
Author
Qu F.; Yang W.; He N.; Qu S.; Zhou X.; Ma H.; Jiang X.
Institution
(Qu, Ma) Medical School, Xizang Minzu University, Xianyang, China
(Yang) Emergency Department, The Affiliated Hospital of Xizang University
for Nationalities, Xianyang, China
(He, Jiang) Department of Cardiology, Shaanxi Provincial People's
Hospital, Shaanxi, China
(Qu) School of Mechanic Engineering, Sichuan University, Sichuan, China
(Zhou) Department of Dermatology, The Second Xiangya Hospital of Central
South University, Changsha, China
Publisher
John Wiley and Sons Inc
Abstract
Background: A meta-analysis study was conducted to determine how to
predict the effect of postoperative atrial fibrillation after cardiac
surgery. Hypothesis: Long-term mortality and cardiovascular morbidity are
linked to postoperative atrial fibrillation. Method(s): Until August
2024, a comprehensive literature study was completed, and 3486 connected
studies were revised. The 38 selected studies included 241 299 cardiac
surgery participants at the beginning of the study. The odds ratio (OR)
and 95% confidence intervals (CIs) were used to look at the effect of
atrial fibrillation after heart surgery using two-sided methods and either
a fixed or random model. Result(s): Individuals with cardiac surgery
with postoperative atrial fibrillation had significantly higher mortality
at 1 year (OR, 1.39; 95% CI, 1.12-1.72, p < 0.001), mortality at 5 years
(OR, 1.61; 95% CI, 1.33-1.94, p < 0.001), mortality at 10 years (OR, 1.61;
95% CI, 1.39-1.87, p < 0.001), and overall stroke (OR, 1.61; 95% CI,
1.34-1.94, p < 0.001) compared to without postoperative atrial
fibrillation. Conclusion(s): Individuals with cardiac surgery with
postoperative atrial fibrillation had significantly higher mortality at 1
year, mortality at 5 years, mortality at 10 years, and overall stroke
compared to those without postoperative atrial fibrillation. To validate
this discovery, more research and caution must be implemented when
interacting with its values. Copyright © 2024 The Author(s).
Clinical Cardiology published by Wiley Periodicals, LLC.

<53>
Accession Number
354391238
Title
A comparison of beating heart and arrested heart techniques for mitral
valve replacement surgery.
Source
MEDICC Review. 11(1) (pp 36-41), 2009. Date of Publication: 2009.
Author
Morfa G.M.; Blazquez J.T.; Cordero A.M.P.; Lopez H.P.; Echevarria J.R.L.;
Gonzalez L.G.
Institution
(Morfa, Blazquez, Lopez, Gonzalez) Cardiology and Cardiovascular Surgery
Institute (ICCCV), Havana, Cuba
(Cordero) Cardiovascular Surgery Services, Cardiology and Cardiovascular
Surgery Institute (ICCCV), Havana, Cuba
(Echevarria) Cardiopulmonary Bypass and Perfusion Services, Cardiology and
Cardiovascular Surgery Institute (ICCCV), Havana, Cuba
Publisher
MEDICC Medical Education Cooperation with Cuba
Abstract
Introduction: There is growing interest in beating heart cardiac surgery
(mainly myocardial revascularization) without aortic cross-clamping and,
if possible, without the use of a cardiopulmonary bypass (CPB) pump, since
better results can be obtained with this procedure than with conventional
myocardial protection techniques using cardioplegic solutions. This led us
to considerer mitral valve replacement (MVR) with beating heart and
continuous coronary perfusion as a surgical option at the Cardiology and
Cardiovascular Surgery Institute (ICCCV) in Havana, Cuba.
 Objective(s): To assess the safety and potential benefits of beating
heart MVR with continuous coronary perfusion compared to the conventional
cardioplegic arrested heart MVR procedure. Method(s): A randomized,
controlled intervention study was conducted with a sample of 64 patients
referred to the ICCCV for isolated MVR between January 2001 and December
2002. Patients were randomly divided into 2 groups: control group A and
study group B. Each group received a specific myocardial protection
technique during surgery. Group A underwent MVR using the arrested heart
technique with administration of a cold crystalloid cardioplegic solution
and with moderately hypothermic CPB. Group B underwent MVR using the
beating heart technique with normothermic CPB and continuous coronary
perfusion. The following variables were assessed: serum enzyme (CK and
CK-MB) and lactate concentrations; duration of aortic cross clamping, CPB,
mechanical ventilation support, drainage, postoperative bleeding, stay in
the surgical intensive care unit (SICU), and total operation time; amount
of blood lost, blood adminstered, and postoperative complications.
Quantitative variables were determined using Wilcoxon-Mann-Whitney and
Student's t-tests. Result(s): Differences between the two techniques
were not found to be statistically significant, which suggests that both
are equally safe. However, the differences found are clinically important
and favor the beating heart technique, since patients who underwent
beating heart MVR had lower serum concentrations of total CK, CK-MB and
lactate; less total blood loss, and less need for transfusion. They also
required less time on mechanical ventilation support in the SICU, spent
fewer days in the hospital, and presented fewer postoperative
complications compared to patients who underwent arrested heart MVR.
 Conclusion(s): The beating heart technique with continuous coronary
perfusion proved to be as safe as the conventional arrested heart
technique with cardioplegic solutions for MVR surgery in patients with low
surgical risk. This procedure is recommended as an alternative method of
myocardial protection for this type of surgery in Cuba and may be
considered as an option in other limited-resource settings.

<54>
Accession Number
2036281847
Title
How does regular exercise improve cardiovascular function: Congenital
heart disease and beyond.
Source
International Journal of Cardiology Congenital Heart Disease. 19 (no
pagination), 2025. Article Number: 100542. Date of Publication: March
2025.
Author
Drakopoulou M.; Vlachakis P.K.; Apostolos A.; Tsioufis K.; Toutouzas K.
Institution
(Drakopoulou, Vlachakis, Apostolos, Tsioufis, Toutouzas) First Department
of Cardiology, Medical School of Athens University, Hippokration Hospital,
Athens, Greece
Publisher
Elsevier B.V.
Abstract
Major advances in the fields of paediatric cardiology and cardiac surgery
over the past decades have dramatically improved the survival of patients
with congenital heart disease (CHD). Thus, care for CHD patients has
shifted from managing short-term survival to having the best possible
outcome in terms of long-term physical health, development and well-being.
In this article, with a special focus on adult CHD (ACHD) population, we
address the question: How does regular exercise improve cardiovascular
function? We aim to underscore that regular exercise not only offers
clinically relevant physiological benefits for patients living with a CHD
condition but has also a positive effect on reducing the risk of future
cardiovascular events. Copyright © 2024

<55>
[Use Link to view the full text]
Accession Number
2035740936
Title
Transcatheter Valve Repair in Heart Failure with Moderate to Severe Mitral
Regurgitation.
Source
New England Journal of Medicine. 391(19) (pp 1799-1809), 2024. Date of
Publication: 14 Nov 2024.
Author
Anker S.D.; Friede T.; von Bardeleben R.-S.; Butler J.; Khan M.-S.; Diek
M.; Heinrich J.; Geyer M.; Placzek M.; Ferrari R.; Abraham W.T.; Alfieri
O.; Auricchio A.; Bayes-Genis A.; Cleland J.G.F.; Filippatos G.;
Gustafsson F.; Haverkamp W.; Kelm M.; Kuck K.-H.; Landmesser U.; Maggioni
A.P.; Metra M.; Ninios V.; Petrie M.C.; Rassaf T.; Ruschitzka F.; Schafer
U.; Christian Schulze P.; Spargias K.; Vahanian A.; Zamorano J.L.; Zeiher
A.; Karakas M.; Koehler F.; Lainscak M.; Oner A.; Mezilis N.;
Theofilogiannakos E.K.; Ninios I.; Chrissoheris M.; Kourkoveli P.;
Papadopoulos K.; Smolka G.; Wojakowski W.; Reczuch K.; Pinto F.J.;
Wiewiorka L.; Kalarus Z.; Adamo M.; Santiago-Vacas E.; Ruf T.F.; Gross M.;
Tongers J.; Hasenfuss G.; Schillinger W.; Ponikowski P.
Institution
(Anker, Diek, Haverkamp) Department of Cardiology, German Heart Center
Charite, The Institute of Health Center for Regenerative Therapies, German
Center for Cardiovascular Research (DZHK) Partner Site Berlin, Charite
Universitatsmedizin, Germany
(von Bardeleben, Landmesser) Department of Cardiology, Angiology, and
Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus
Benjamin Franklin, The Berlin Institute of Health, DZHK Partner Site
Berlin, Germany
(Koehler) Deutsches Herzzentrum der Charite, The Department of Cardiology,
Angiology, and Intensive Care Medicine, Campus Charite Mitte, The Center
for Cardiovascular Telemedicine, DZHK Partner Site Berlin, Charite
Universitatsmedizin Berlin, Germany
(Anker, Diek, Hasenfuss, Schillinger) The Departments of Cardiology and
Pneumology, Germany
(Friede) Departments of Medical Statistics, Germany
(Heinrich) The Clinical Trial Unit, Germany
(Schillinger) University Medical Center Gottingen, The Heart Center,
Germany
(von Bardeleben) Department of Cardiology, Georg August University of
Gottingen, DZHK Partner Site Gottingen, Gottingen, Germany
(Geyer) The Department of Cardiology, University Medical Center, The
Johannes Gutenberg-University Mainz, Mainz, Germany
(Kelm) The Department of Cardiology, Pulmonology, and Vascular Medicine,
University Hospital Dusseldorf, Medical Faculty, The Heinrich Heine
University Dusseldorf, Cardiovascular Research Institute Dusseldorf,
Medical Faculty, University Hospital Dusseldorf, Heinrich Heine
University, Dusseldorf, Germany
(Placzek) The Department of Rhythmology, University Heart Center Lubeck,
University Hospital Schleswig-Holstein, Lubeck, Germany
(Kuck) The West German Heart and Vascular Center, Department of Cardiology
and Vascular Medicine, University Hospital Essen, University
Duisburg-Essen, Essen, Germany
(Schafer) The Heart and Vascular Center, Bad Bevensen, Germany
(Christian Schulze, Ruf) The Department of Internal Medicine I,
Cardiology, University Hospital Jena, Jena, Germany
(Zeiher) The Institute for Cardiovascular Regeneration, Goethe University
Frankfurt, DZHK Partner Site Rhein-Main, Frankfurt am Main, Germany
(Rassaf) The Department of Intensive Care Medicine, University Medical
Center Hamburg-Eppendorf, DZHK Partner Site Hamburg-Kiel-Lubeck, Hamburg,
Germany
(Oner) The Department of Cardiology, Rostock University Medical Center,
Rostock, Germany
(Karakas, Gross) The Department of Medicine, Heart and Vascular Center,
Division of Cardiology and Vascular Medicine, Johanniter Hospital Stendal,
Stendal, Germany
(Tongers) The Mid-German Heart Center, Department of Cardiology,
Angiology, and Intensive Care Medicine, University Hospital Halle, Halle,
Germany
(Butler) The Department of Medicine, University of Mississippi Medical
Center, Jackson, United States
(Butler, Khan) Baylor Scott and White Research Institute, Dallas Baylor
Scott and White the Heart Hospital Plano, Plano, United States
(Khan) The Department of Medicine, Baylor College of Medicine, Temple, TX,
United States
(Ferrari) The Department of Translational Medicine, University of Ferrara,
Ferrara, Italy
(Alfieri) The Cardiac Surgery Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Maggioni) ANMCO Associazione Nazionale Medici Cardiologi Ospedalieri
Research Center, Heart Care Foundation, Florence, Italy
(Metra, Adamo) The Institute of Cardiology, Azienda Socio Sanitaria
Territoriale degli Spedali Civili di Brescia, The Department of Medical
and Surgical Specialties, Radiologic Sciences and Public Health,
University of Brescia, Brescia, Italy
(Abraham) The Division of Cardiovascular Medicine, Ohio State University,
Columbus, United States
(Auricchio) The Department of Cardiology, Cardiocentro Ticino Institute,
Ente Ospedaliero Cantonale, Lugano, Switzerland
(Ruschitzka) The Center for Translational and Experimental Cardiology,
Department of Cardiology, University Hospital Zurich, University of
Zurich, Zurich, Switzerland
(Bayes-Genis, Santiago-Vacas) The Heart Institute, Hospital Universitari
Germans Trias i Pujol, Barcelona, Spain
(Zamorano) The Department of Cardiology, Hospital Universitario Ramon y
Cajal, Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
(Cleland, Petrie) The School of Cardiovascular and Metabolic Health,
University of Glasgow, British Heart Foundation Glasgow Cardiovascular
Research Centre, Glasgow, United Kingdom
(Filippatos) The Department of Cardiology, Attikon University Hospital,
School of Medicine, National and Kapodistrian University of Athens, Greece
(Spargias, Chrissoheris, Kourkoveli, Papadopoulos) The Department of
Transcatheter Heart Valves, Hygeia Hospital Athens, Greece
(Mezilis, Theofilogiannakos) The Department of Cardiology, St. Luke's
Hospital, Greece
(Ninios, Ninios, Papadopoulos) The European Interbalkan Medical Center,
Thessaloniki, Greece
(Gustafsson) The Department of Cardiology, Copenhagen University Hospital,
Rigshospitalet, Copenhagen, Denmark
(Vahanian) Unite Formation et Recherche Medecine, Universite de
Paris-Cite, site Bichat, Laboratoire de Recherche Vasculaire
Translationnelle, INSERM, Groupe Hospitalier Bichat, Paris, France
(Lainscak) The Division of Cardiology, General Hospital Murska Sobota,
Murska Sobota, Slovenia
(Lainscak) The Faculty of Medicine, University of Ljubljana, Ljubljana,
Slovenia
(Smolka, Wojakowski) The Division of Cardiology and Structural Heart
Diseases, Poland
(Kalarus) The Department of Cardiology, Congenital Heart Diseases,
Electrotherapy Medical University of Silesia, Katowice, Poland
(Reczuch, Ponikowski) The Institute of Heart Diseases, Medical University,
University Hospital, Wroclaw, Poland
(Wiewiorka) The Department of Interventional Cardiology, Department of
Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland
(Pinto) Centro Academico de Medicina de Lisboa, Faculdade de Medicina,
Universidade de Lisboa, Lisbon, Portugal
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Whether transcatheter mitral-valve repair improves outcomes in
patients with heart failure and functional mitral regurgitation is
uncertain. METHODS We conducted a randomized, controlled trial involving
patients with heart failure and moderate to severe functional mitral
regurgitation from 30 sites in nine countries. The patients were assigned
in a 1:1 ratio to either transcatheter mitral-valve repair and
guideline-recommended medical therapy (device group) or medical therapy
alone (control group). The three primary end points were the rate of the
composite of first or recurrent hospitalization for heart failure or
cardiovascular death during 24 months; the rate of first or recurrent
hospitalization for heart failure during 24 months; and the change from
baseline to 12 months in the score on the Kansas City Cardiomyopathy
Questionnaire-Overall Summary (KCCQ-OS; scores range from 0 to 100, with
higher scores indicating better health status). RESULTS A total of 505
patients underwent randomization: 250 were assigned to the device group
and 255 to the control group. At 24 months, the rate of first or recurrent
hospitalization for heart failure or cardiovascular death was 37.0 events
per 100 patient-years in the device group and 58.9 events per 100
patient-years in the control group (rate ratio, 0.64; 95% confidence
interval [CI], 0.48 to 0.85; P=0.002). The rate of first or recurrent
hospitalization for heart failure was 26.9 events per 100 patient-years in
the device group and 46.6 events per 100 patient-years in the control
group (rate ratio, 0.59; 95% CI, 0.42 to 0.82; P=0.002). The KCCQ-OS score
increased by a mean (+/-SD) of 21.6+/-26.9 points in the device group and
8.0+/-24.5 points in the control group (mean difference, 10.9 points; 95%
CI, 6.8 to 15.0; P<0.001). Device-specific safety events occurred in 4
patients (1.6%). CONCLUSIONS Among patients with heart failure with
moderate to severe functional mitral regurgitation who received medical
therapy, the addition of transcatheter mitral-valve repair led to a lower
rate of first or recurrent hospitalization for heart failure or
cardiovascular death and a lower rate of first or recurrent
hospitalization for heart failure at 24 months and better health status at
12 months than medical therapy Copyright © 2024 Massachusetts
Medical Society.

<56>
Accession Number
2023110344
Title
Takotsubo Syndrome in Orthotopic Liver Transplant: A Systematic Review and
Pooled Analysis of Published Studies and Case Reports.
Source
Transplantation Proceedings. 56(9) (pp 2075-2083), 2024. Date of
Publication: November 2024.
Author
Bachayev M.; Brereton B.; Mondal A.; Alli-Ramsaroop B.A.; Dhakal R.; Leon
M.C.B.; Quinones C.M.; Abdelal M.E.O.; Jain A.; Dhaduk K.; Desai R.
Institution
(Bachayev, Abdelal) Department of Medicine, International University of
the Health Sciences, St. Kitts, Saint Kitts and Nevis
(Brereton) Department of Medicine, Jersey General Hospital, Saint Helier,
Jersey, United States
(Mondal) Department of Internal Medicine, Nazareth Hospital, Philadelphia,
Pennsylvania, United States
(Alli-Ramsaroop) Department of Pediatric Surgery, Georgetown Public
Hospital Corporation, Georgetown, Guyana
(Dhakal) Department of Medicine, Nepal Medical College, Kathmandu, Nepal
(Leon, Quinones) Department of Medicine, Universidad de San Martin de
Porres, Lima, Peru
(Jain) Department of Internal Medicine, Mercy Catholic Medical Center,
Darby, Pennsylvania, United States
(Dhaduk) Department of Internal Medicine, Geisinger Wyoming Valley Medical
Center, Wilkes Barre, Pennsylvania, United States
(Desai) Independent Researcher, Atlanta, United States
Publisher
Elsevier Inc.
Abstract
Background: Takotsubo syndrome (TTS) has been reported in solid-organ
transplant recipients. However, the pooled data regarding TTS after liver
transplant remain limited. Method(s): A systematic review was
performed through February 2022 using PubMed, Embase, Scopus, and Google
Scholar to review case reports/series and original studies on liver
transplant-associated TTS. Descriptive analysis was performed for case
reports and pooled analysis for the prevalence using random effects
models. Result(s): A total of 56 case reports were included from 30
articles (51.8 % male; mean age, 53 years; India 56%, US 27%, and Europe
8.93%) and 10 original studies (US 88.65%, India 10.92%) revealing liver
transplant-associated TTS. The pooled prevalence of TTS was 1.1% (95% Cl,
0.6%-1.7%) of all liver transplants with comparable rates in studies from
India and the US (P = .92). Indications for liver transplant included
end-stage liver disease due to alcohol-related cirrhosis (25%), hepatitis
C virus infection (17.9%), hepatocellular carcinoma (10.7%), and
non-alcohol-related steatohepatitis (8.9%); the average Model for
End-Stage Liver Disease score was 24.75. TTS commonly presented as
hypotension (30%), dyspnea (14%), and oliguria, occurring mostly
post-transplant (82%), whereas 14% were intraoperative. Common
electrocardiogram findings were ST changes, ventricular tachycardia, and
atrial fibrillation. Common echocardiogram findings showed left
ventricular apical ballooning in 46.5% of cases and reduced ejection
fraction < 20% in 41.9% of cases. Common complications were cardiogenic
shock (32.1 %), acute kidney injury (12.5%), arrhythmia, stroke, cardiac
arrest, and hepatic artery thrombosis. Mechanical circulatory support was
required in 30.3%. Recurrence was reported in 15, and mortality in 30.4%
of patients. Conclusion(s): Takotsubo syndrome prevalence after liver
transplant is significantly higher than TTS prevalence in general US
hospitalizations with potentially worse outcomes. Prospective registries
reporting TTS in liver transplant recipients are warranted. Copyright
© 2022 Elsevier Inc.

<57>
Accession Number
2035031643
Title
Machine Learning for Prediction of Postoperative Delirium in Adult
Patients: A Systematic Review and Meta-analysis.
Source
Clinical Therapeutics. 46(12) (pp 1069-1081), 2024. Date of Publication:
December 2024.
Author
Chen H.; Yu D.; Zhang J.; Li J.
Institution
(Chen, Yu, Zhang, Li) Department of Anesthesiology, Hebei General
Hospital, Hebei Province, Shijiazhuang, China
(Chen) North China University of Science and Technology, Tangshan, China
Publisher
Elsevier Inc.
Abstract
Purpose: This meta-analysis aimed to evaluate the performance of machine
learning (ML) models in predicting postoperative delirium (POD) and to
provide guidance for clinical application. Method(s): PubMed, Embase,
Cochrane Library, and Web of Science databases were searched from
inception to April 29, 2024. Studies reported ML models for predicting POD
in adult patients were included. Data extraction and risk of bias
assessment were performed using the Transparent Reporting of a
multivariable prediction model for Individual Prognosis Or Diagnosis - AI
(TRIPOD-AI) and Prediction model Risk Of Bias ASsessment Tool (PROBAST)
tools. Meta-analysis with the area under the curve (AUC) was performed
using MedCalc software. Finding(s): A total of 23 studies were
included after screening. Age (n = 20, 86.95%) and Random Forest (RF) (n =
24, 17.27%) were the most frequently used feature and ML algorithm,
respectively. The meta-analysis showed an overall AUC of 0.792. The
ensemble models (AUC = 0.805) showed better predictive performance than
single models (AUC = 0.782). Additionally, considerable variations in AUC
were found among different ML algorithms, with AdaBoost (AB) demonstrating
good performance with AUC of 0.870. Notably, the generalizability of these
models was uncertain due to limitations in external validation and bias
assessment. Implications: The performance of ensemble models were higher
than single models, and the AB algorithms demonstrated better performance,
compared with other algorithms. However, further research was needed to
enhance the generalizability and transparency of ML models. Copyright
© 2024 Elsevier Inc.

<58>
Accession Number
2032473430
Title
Safety and therapeutic potential of allogeneic adipose-derived stem cell
spray transplantation in ischemic cardiomyopathy: a phase I clinical
trial.
Source
Journal of Translational Medicine. 22(1) (no pagination), 2024. Article
Number: 1091. Date of Publication: December 2024.
Author
Kawamura T.; Yoshioka D.; Kawamura A.; Misumi Y.; Taguchi T.; Mori D.;
Saito S.; Yamauchi T.; Hata H.; Miyagawa S.
Institution
(Kawamura, Yoshioka, Kawamura, Misumi, Taguchi, Mori, Saito, Yamauchi,
Hata, Miyagawa) Department of Cardiovascular Surgery, Osaka University
Graduate School of Medicine, 2-2 Yamada-Oka, Osaka, Suita 565-0871, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Ischemic cardiomyopathy, characterized by coronary artery
atherosclerosis, impairs the myocardial tissue. Coronary artery bypass
grafting (CABG) is commonly used to revascularize affected areas and
improve patient survival rates; however, it can fail to enhance cardiac
function. Impaired capillary blood flow may obstruct functional recovery,
prompting interest in treatments, such as angiogenic factor
administration. Adipose-derived stem cells (ADSCs), which are known for
immune evasion, have shown the potential to construct capillary networks
and improve myocardial function. This clinical trial aimed to evaluate the
safety and efficacy of ADSC spray therapy combined with CABG.
 Method(s): This single-center, randomized, double-blind study
involved patients with ischemic cardiomyopathy who were scheduled for CABG
and who had a left ventricular ejection fraction <= 40%. The participants
were randomized to receive CABG as well as ADSC spray therapy or placebo.
The primary endpoints were safety, changes in late gadolinium-enhanced
(LGE) magnetic resonance imaging (MRI) volumes, and feasibility. The
secondary endpoints included left ventricular function, exercise
tolerance, and heart failure symptoms. Result(s): Seven patients were
enrolled; of them, six were randomized to receive ADSC therapy (n = 3) or
placebo (n = 3). The procedure was successfully completed with minimal
adverse events. One patient in the ADSC group developed pleural effusion
that was resolved with drainage. The LGE-MRI volumes decreased in the ADSC
group but remained unchanged in the placebo group. Improvements in left
ventricular function and exercise tolerance were noted in the ADSC group,
with heart failure symptoms improving to New York Heart Association class
I. In contrast, the placebo group showed no significant changes, with one
patient experiencing worsening symptoms. Conclusion(s): ADSC spray
therapy combined with CABG demonstrated safety and efficacy at enhancing
cardiac function. ADSC likely contributes to capillary network
reconstruction, thereby augmenting the benefits of CABG. Future phase II
and III trials are warranted to confirm its therapeutic efficacy and
long-term outcomes. This novel approach represents a significant
advancement in the treatment of ischemic cardiomyopathy and offers a
viable strategy for improving myocardial function and patient prognosis.
Trial registration This study was registered with the Japan Registry of
Clinical Trials (jRCT2053190103) and ClinicalTrials.gov
(NCT04695522). Copyright © The Author(s) 2024.

<59>
Accession Number
2032456381
Title
Mechanical versus bioprosthetic valve for aortic valve replacement in
dialysis patients: Systematic review and individual patient data
meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. 32(8-9) (pp 484-493), 2024. Date
of Publication: November 2024.
Author
Zoupas I.; Loufopoulos G.; Tasoudis P.T.; Manaki V.; Namidis I.; Caranasos
T.G.; Iliopoulos D.C.; Athanasiou T.
Institution
(Zoupas, Loufopoulos, Tasoudis, Manaki, Namidis) Cardiothoracic and
Vascular Surgery Working Group, Society of Junior Doctors, Athens, Greece
(Zoupas, Iliopoulos) Department of Cardiac Surgery, Hygeia Hospital,
Athens, Greece
(Tasoudis, Caranasos) Department of Cardiothoracic Surgery, University of
North Carolina at Chapel Hill, Chapel Hill, NC, United States
(Manaki) Department of Vascular Surgery, AHEPA University Hospital,
Thessaloniki, Greece
(Iliopoulos) Department of Cardiac Surgery, Faculty of Medicine, National
and Kapodistrian University of Athens, Athens, Greece
(Athanasiou) Department of Cardiac Surgery, Imperial College London, UK,
London, United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Objective: There is little evidence regarding the most beneficial choice
between a mechanical and a bioprosthetic valve in the aortic position in
dialysis patients. This meta-analysis compares the survival and freedom
from reintervention rates between mechanical and bioprosthetic valves in
patients on dialysis undergoing aortic valve replacement surgery.
 Method(s): Two databases were searched, and the systematic review was
performed in accordance with the recommendations of the Preferred
Reporting Items for Systematic Reviews and Meta-analyses statement. We
conducted one-stage and two-stage meta-analysis with Kaplan-Meier-derived
individual patient data and meta-analysis with random-effects model.
 Result(s): Eight studies were included, providing data about 1215
dialysis patients receiving mechanical valves and 1851 patients receiving
bioprosthetic valves. During a mean follow-up of 43.1 months, overall
survival rates were significantly improved in the mechanical valve group
in comparison to the bioprosthetic one (hazard ratio [HR]: 0.76, 95%
confidence interval [CI]: 0.69-0.84, p < 0.001). This was confirmed by the
two-stage meta-analysis (HR: 0.72, 95% CI: 0.62-0.83, p = 0.00,
I2 = 17.79%). Regarding freedom from reintervention, no arm
offered a statistically significant advantage, according to the two-stage
generated analysis (HR: 1.025, 95% CI: 0.65-1.61, p = 0.914). Similarly,
there was no evident superiority of a valve type for perioperative
outcomes. Conclusion(s): Mechanical valves are likely to be
associated with a better survival outcome compared to bioprosthetic valves
for patients on dialysis undergoing aortic valve replacement. However,
freedom from reoperation rates and perioperative outcomes were comparable
between the two valve types, with no arm exhibiting a statistically
significant advantage. Copyright © The Author(s) 2024.

<60>
Accession Number
2036122623
Title
Clinical utility of echocardiography in internal medicine: a narrative
review.
Source
Italian Journal of Medicine. 18(4) (no pagination), 2024. Article Number:
1802. Date of Publication: 2024.
Author
Mumoli N.; Marengo S.
Institution
(Mumoli) Department of Cardiovascular Medicine, Ospedale di Circolo, VA,
Busto Arsizio, Italy
(Marengo) Department of Internal Medicine, AO Ordine Mauriziano, Turin,
Italy
Publisher
Page Press Publications
Abstract
Echocardiography has emerged as an invaluable tool in internal medicine,
providing real-time, non-invasive evaluation of cardiac structure and
function. Its clinical utility spans a wide range of applications,
including the diagnosis and management of heart failure, valvular heart
diseases, and cardiomyopathies, as well as systemic conditions like sepsis
and chronic kidney disease. The ability to perform bedside
echocardiography has made it particularly useful in critical care
settings, allowing for rapid assessment of cardiac function in
hemodynamically unstable patients. Echocardiography also plays a key role
in guiding therapeutic interventions, from fluid management to valvular
repair and replacement procedures. Despite its many advantages,
echocardiography is not without limitations. Image quality may be
compromised in patients with obesity, lung disease, or prior thoracic
surgery, necessitating alternative imaging modalities like cardiac
magnetic resonance imaging or computed tomography. Operator expertise is
another critical factor influencing diagnostic accuracy, underscoring the
importance of proper training. Recent advancements, including artificial
intelligence integration and portable devices, are expected to further
expand the role of echocardiography, making it more accessible in diverse
clinical settings. This narrative review highlights the broad clinical
utility of echocardiography in internal medicine, its challenges, and the
future directions that promise to enhance its role in patient
care. © Copyright: the Author(s), 2024.

<61>
Accession Number
2032227498
Title
Regional Analgesia Techniques Following Thoracic Surgery: A Systematic
Review and Network Meta-analysis.
Source
Pain Physician. 27(8) (pp E803-E818), 2024. Date of Publication: November
2024.
Author
Yang M.; Liu G.; Zhang X.; Yan W.; Zhang D.
Institution
(Yang, Zhang, Liu, Zhang) Department of Clinical Laboratory, Gansu
Provincial Hospital, Lanzhou, China
(Yan, Zhang) Department of Anesthesiology, Gansu Provincial Hospital,
Lanzhou, China
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: Regional analgesia techniques have become the basis of
multimodal analgesia for acute and chronic pain. They are widely used in
thoracic surgery, but the best treatment is still uncertain.
 Objective(s): We aimed to compare and rank the effectiveness of
regional analgesia techniques for thoracic surgery. Study Design: A
systematic review and network meta-analysis. Method(s): PubMed,
MEDLINE, Embase, Cochrane Library, Science-Direct, and Web of Science were
searched for articles published from inception through the end of January
2023. The network meta-analysis was conducted using Stata 15.1 software
(StataCorp, LLC). The certainty of evidence was assessed by using
Confidence in Network Meta-analysis (CINeMA https://cinema.ispm.unibe. ch/
A (unibe.ch). The primary outcome was cumulative opioid consumption within
postoperative 24 hours. The secondary outcomes included pain scores at
postoperative 6 hours, 12 hours, and 24 hours. Result(s): A total of
32 trials with 1,996 patients and 11 techniques were included. No major
network inconsistency or heterogeneity were found. Postoperative opioid
consumption within postoperative 24 hours was decreased most by continuous
extrapleural block (cEPB) (standardized mean difference [SMD] = 0.00; 95%
CI,: 0.00-0.00), followed by continuous thoracic epidural analgesia (cTEA)
and continuous serratus plane block (cSAPB). In the postoperative 6 hour
analysis, pain scores were decreased most by cTEA (SMD = 0.16; 95% CI,:
0.05-0.49), followed by thoracic paravertebral block (TPVB) and ESPB
(erector spinae plane block). In the postoperative 12 hour analysis, pain
scores were decreased most by cSAPB (SMD = 0.12; 95% CI, 0.011.84),
followed by TPVB and cTEA. In the postoperative 24 hour analysis, pain
scores were decreased most by ESPB (SMD = 0.09; 95% CI, 0.030.32),
followed by cSAPB and continuous thoracic paravertebral block (cTPVB).
 Limitation(s): Our study has several limitations. First, 4 enrolled
studies had a sample size of less than 40 patients. Second, the different
regimens were potential factors contributing to heterogeneity, such as
local anesthetic dose and volume, infusion time, infusion mode, adding
adjuncts, and rescue analgesic regimens. Third, the number of primary and
secondary outcomes is limited. Fourth, the number of randomized controlled
trials for cEPB is limited. Conclusion(s): The cTEA and cSAPB
techniques are more likely to reduce the cumulative opioid consumption
within 24 hours. The cTEA, cSAPB, ESPB techniques were more likely to
improve pain at postoperative 6, 12, and 24 hours. Therefore, cTEA, cSAPB,
and ESPB are the first choices for pain relief post thoracic surgery,
whereas wound infiltration, intercostal block, continuous wound
infiltration, and continuous intercostal block were less likely to be
effective. We need more high-quality randomized controlled trials with
larger sample sizes to validate our results and to determine the ideal
regional analgesia technique and the optimal drug formula. Copyright
© 2024, American Society of Interventional Pain Physicians. All
rights reserved.

<62>
Accession Number
2032213094
Title
Prophylactic 24 versus 48 h cephalosporins in cardiac surgery: A
randomized trial.
Source
Asian Cardiovascular and Thoracic Annals. 32(8-9) (pp 462-471), 2024. Date
of Publication: November 2024.
Author
Koudieh M.; Al Saif S.; Oueida F.; Baradai A.; Alkhamees K.; Otabi A.; Al
Tahir H.; Younis H.; Al Qudaihi G.; Essa M.; Maharem T.; Fadel M.; Al
Balwai D.; Eskander K.
Institution
(Koudieh, Oueida, Baradai, Alkhamees, Otabi, Essa, Eskander) Cardiac
Surgery Department, Saud Al Babtain Cardiac Center, Dammam, Saudi Arabia
(Al Saif) Cardiology Department, Saud Al Babtain Cardiac Center, Dammam,
Saudi Arabia
(Baradai) Cardiac Surgery Department, King Salman Heart Center, Riyadh,
Saudi Arabia
(Al Tahir, Maharem, Fadel) Anesthesia Department, Saud Al Babtain Cardiac
Center, Dammam, Saudi Arabia
(Younis) Intensive Care Unit, Saud Al Babtain Cardiac Center, Dammam,
Saudi Arabia
(Al Qudaihi) Epidemiology Department, Qatif Central Hospital, Dammam,
Saudi Arabia
(Al Balwai) Research Unit, Saud al Babtain Cardiac Center, Dammam, Saudi
Arabia
Publisher
SAGE Publications Inc.
Abstract
Background: Recommendations for cardiac surgery advocate for antibiotic
prophylaxis for up to 48 hour after surgery. However, recent reports found
a significant reduction in surgical site infection with extended duration.
We evaluated the effect of the type of prophylactic antibiotics and
administration durations on the postoperative surgical site infection rate
following cardiac surgery in adults. Method(s): An
investigator-initiated randomized controlled trial was conducted from 2018
to 2022 on adult patients undergoing cardiac surgery. Patients were
randomized into four groups based on antibiotic treatment type and
duration: 24 h cefazolin, 24 h cefuroxime, 48 h cefazolin, and 48 h
cefuroxime. The primary outcome was the rate of surgical site infections
within 90 days of surgery. Result(s): A total of 568 patients were
included in this study. The four groups had similar baseline
characteristics, including age, sex, EuroSCORE II, and baseline HbA1c. A
total of 75 patients developed infection within 90 days postoperative. The
overall infection rate was not statistically different across the four
groups (p = 0.193). The efficacy of cefazolin and cefuroxime in reducing
infection was comparable (p = 0.901). Extended prophylaxis was associated
with a significantly reduced overall infection rate within 90 days
postoperatively compared to 24-h prophylaxis (10.2% vs. 16.3%; risk ratio
= 0.62, 95% confidence interval: 0.40-0.96, p = 0.032).
 Conclusion(s): Using cefazolin or cefuroxime for 48 h instead of 24 h
was more effective in reducing the overall surgical site infections rate
up to 90 days after surgery. Copyright © The Author(s) 2024.

<63>
Accession Number
2029840360
Title
Transcatheter aortic valve replacement for aortic regurgitation: a
systematic review and meta-analysis.
Source
ESC Heart Failure. 11(6) (pp 3488-3500), 2024. Date of Publication:
December 2024.
Author
Liu R.; Fu Z.; Jiang Z.; Yan Y.; Yao J.; Liu X.; Yan X.; Song G.
Institution
(Liu, Fu, Jiang, Yan, Yao, Liu, Song) Department of Interventional Center
of Valvular Heart Disease, Beijing Anzhen Hospital Affiliated to Capital
Medical University, Beijing, China
(Yan) Center for Health Systems Research, Sutter Health, Sacramento, CA,
United States
Publisher
John Wiley and Sons Inc
Abstract
The efficacy and safety of new-generation devices (NGDs) for severe aortic
regurgitation (AR) have mostly been based on single-arm studies with
limited sample sizes. Our goal was to summarize the current evidence on
NGDs and compare the safety and efficacy of 'off-label' and 'on-label'
devices in NGDs. We searched MEDLINE, Embase, Cochrane Library, and Scopus
for articles on transcatheter aortic valve replacement in patients with
AR. A total of 31 studies that included 1851 patients were identified
through April 2023. Among these, 1067 (57.6%) patients received treatment
with 'on-label' devices (JenaValve and J-Valve). For NGDs, the total
device success rate at 30 days was 94.5% (on-label: 97.8%, off-label:
89.9%; P < 0.001), the all-cause mortality was 4.2% (on-label: 2.6%,
off-label: 5.1%; P = 0.006), permanent pacemaker implantation (PPI) was
8.8% (on-label: 6.9%, off-label: 18.4%; P < 0.001), and the rate of
greater-than-mild paravalvular leak (PVL) was 1.2% (on-label: 0.9%,
off-label: 3.8%; P = 0.003). On-label devices showed significantly better
safety and efficacy in terms of the success rate, PPI, greater-than-mild
PVL, and 30 day mortality than off-label devices. Copyright ©
2024 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on
behalf of European Society of Cardiology.

<64>
Accession Number
2032209357
Title
Effect of Acupoint Catgut Embedding on Subjective Appetite in Overweight
and Obese Adults with Strong and Moderate Appetite: A Secondary Analysis
of a Randomized Clinical Trial.
Source
Diabetes, Metabolic Syndrome and Obesity. 17 (pp 4573-4583), 2024. Date of
Publication: 2024.
Author
Tang X.; Huang G.; Li Q.; Zhao S.; Yang R.; Deng Y.; Liu Z.; Guo T.; Liang
F.; Wang H.
Institution
(Tang, Huang, Li, Zhao, Yang, Deng, Guo, Wang) Yunnan Key Laboratory of
Integrated Traditional Chinese and Western Medicine for Chronic Disease in
Prevention and Treatment, Yunnan University of Chinese Medicine, Kunming,
China
(Tang, Huang, Li, Zhao, Yang, Deng, Liu, Guo, Wang) School of Second
Clinical Medicine, The Second Affiliated Hospital, Yunnan University of
Chinese Medicine, Kunming, China
(Liang) School of Acupuncture and Tuina, Chengdu University of Traditional
Chinese Medicine, Chengdu, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Appetite plays a crucial role in obesity and weight loss
outcomes. while conventional therapies reduce appetite, They often have
limitations. Acupoint Catgut Embedding (ACE) is widely used for weight
loss, but its impact on subjective appetite, especially across different
appetite status, remains underexplored. Objective(s): To evaluate the
differential impact of ACE on the subjective appetite of overweight and
obese adults with strong and moderate appetites. Method(s): This
secondary analysis used data from a multicenter, double-blind, parallel
randomized clinical trial of the ACE intervention. A total of 122
overweight and obese patients aged 18-60 were randomly assigned to the ACE
and Non-acupoint Catgut Embedding (NACE) groups, each receiving six
sessions over 12 weeks and a 4-week follow-up. Appetite was measured using
the Visual Analogue Scale (VAS), and a generalized linear mixed-effects
model assessed changes in appetite scores. Bonferroni corrections were
applied for multiple comparisons (P < 0.05). Result(s): Participants
with strong appetite in the ACE group showed a significant reduction in
appetite VAS score from 7.78 (0.66) at baseline to 5.00 (0.72) at 16 weeks
(P < 0.05), compared to a reduction from 7.97 (0.93) to 6.54 (1.17) in the
NACE group. The adjusted relative rate ratio between the two groups was
0.411 (95% CI, 0.210 to 0.534; P < 0.05). In participants with moderate
appetite, no significant difference was observed between the two groups (P
> 0.05). The significant baseline difference in appetite scores between
participants with strong and moderate appetite (P < 0.05) became
non-significant by week 16 (P > 0.05). Conclusion(s): This study
reveals the stratified effect of ACE on appetite, with greater reduction
in those with strong appetite and no significant change in those with
moderate appetite. This suggests ACE reduces appetite effectively without
excessive suppression, supporting its potential as a sustainable obesity
management strategy. Copyright © 2024 Tang et al.

<65>
Accession Number
2032208943
Title
Techniques for Implementing Continuous Glucose Monitoring in Primary Care:
Key CGM Updates and Highlights from the EASD2024 Conference [Podcast].
Source
Diabetes, Metabolic Syndrome and Obesity. 17 (pp 4463-4468), 2024. Date of
Publication: 2024.
Author
Green J.
Institution
(Green) Division of Endocrinology, Metabolism, and Nutrition, Duke
University School of Medicine, Durham, NC, United States
Publisher
Dove Medical Press Ltd
Abstract
This article discusses innovations, advancements, and discoveries in
continuous glucose monitoring (CGM) that were presented at the European
Association for the Study of Diabetes 2024 Conference in Madrid, Spain,
held in September 2024. Specifically, the author will discuss data from
studies that discuss the impact of CGM on hemoglobin A1C in people with
type 2 diabetes; the impact of CGM use in hospitalization settings for
people with diabetes; the effectiveness of CGM in those who have undergone
cardiac surgery; the efficacy of real-time CGM in adults hospitalized with
diabetic ketoacidosis; time in rage in older individuals; and new devices
for glucose sensing. Copyright © 2024 Springer Healthcare.

<66>
Accession Number
2032199955
Title
Comparison of Ridaforolimus-Eluting and Zotarolimus-Eluting Coronary
Stents: 5-Year Outcomes From the BIONICS and NIREUS Trials.
Source
Journal of the American Heart Association. 3. 13(22) (no pagination),
2024. Article Number: e036210. Date of Publication: 19 Nov 2024.
Author
Zornitzki L.; Smits P.C.; Love M.P.; Stone G.W.; Kandzari D.E.; Redfors
B.; Ozan M.O.; Konigstein M.
Institution
(Zornitzki, Konigstein) Department of Cardiology, Tel Aviv Sourasky
Medical Center, Affiliated with the School of Medicine, Tel Aviv
University, Tel Aviv, Israel
(Smits) Maasstad Ziekenhuis, Rotterdam, Netherlands
(Love) St. Boniface General Hospital, University of Manitoba, Winnipeg,
MB, Canada
(Stone, Redfors, Ozan) Clinical Trials Center, Cardiovascular Research
Foundation, New York, NY, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Kandzari) Piedmont Heart Institute, Atlanta, GA, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The BIONICS (BioNIR Ridaforolimus-Eluting Coronary Stent
System in Coronary Stenosis) and the NIREUS (BioNIR Ridaforolimus Eluting
Coronary Stent System [BioNIR] European Angiography Study) randomized
clinical trials showed noninferiority of the ridaforolimus-eluting stent
(RES) compared with the zotarolimus-eluting stent (ZES) with respect to
1-year target-lesion failure and 6-month angiographic late lumen loss. We
aimed to evaluate clinical outcomes between treatment groups over a 5-year
follow-up. METHODS AND RESULTS: Patient-level data from the BIONICS
(n=1919) and NIREUS (n=302) were pooled, comparing the outcomes of
patients implanted with RES and ZES. The primary end point was the 5-year
rate of target-lesion failure. A total of 2221 patients (63.2+/-10.3
years, 79.7% men) undergoing percutaneous coronary intervention with RES
(n=1159) or ZES (n=1062) were included. Most clinical and angiographic
characteristics were similar between groups. At 5 years, the primary end
point of target-lesion failure was similar between treatment groups (12.2%
RES versus 11.3% ZES, P=0.52). Rates of TLR (7.6% RES versus 6.8% ZES,
P=0.42) target-vessel-related myocardial infarction (4.8% RES versus 4.9%
ZES, P=0.95) and stent thrombosis (0.9% RES versus 0.9% ZES, P=0.87) also
did not differ between groups. Target-vessel revascularization and cardiac
death were higher among the RES group (12.3% versus 9.5% P=0.037, and 3.6%
versus 2.2% P=0.042, respectively). However, after correction for baseline
characteristics, there was no significant difference in cardiac death
between groups. CONCLUSION(S): In a pooled analysis of 2 randomized
trials, 5-year clinical outcomes were similar between patients undergoing
percutaneous coronary intervention with RES and ZES. These results support
the long-term safety and efficacy of RES for the treatment of patients
with coronary artery disease. Copyright © 2024 The Author(s).

<67>
Accession Number
2036088356
Title
Large bore access for transcatheter aortic valve replacement, endovascular
aortic repair, and thoracic endovascular aortic repair A review of
anatomic challenges and operative considerations.
Source
Journal of Cardiovascular Surgery. 65(5) (pp 460-467), 2024. Date of
Publication: October 2024.
Author
Pozolo C.G.; Giese A.S.; Babrowski T.A.
Institution
(Pozolo) Division of Vascular Surgery, Department of Surgery, Mike
O'Callaghan Military Medical Center, Nellis Air Force Base, NV, United
States
(Giese) Division of Vascular and Endovascular Surgery, Department Surgery,
University of California - Davis, Sacramento, CA, United States
(Babrowski) Section of Vascular Surgery and Endovascular Therapy,
Department of Surgery, University of Chicago Medical Center, Chicago, IL,
United States
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Transcatheter aortic valve replacement (TAVR), endovascular
aortic repair (EVAR), and thoracic endovascular aortic repair (TEVAR) are
standard and prolific procedures in the modern cardiovascular world, and
appropriate delivery of these endoprostheses requires adequate
understanding of the requisite large bore access. Percutaneous large bore
access is the preferred route but may be accompanied by complications like
thrombosis, hemorrhage, or inability to deliver the device. Anatomic
limitations such as vessel tortuosity, small size, and heavy calcification
may require alternative approaches for successful large bore access. This
study aimed to better define large bore access, as well as to elucidate
optimal adjuncts and alternatives to enable successful delivery of large
bore endoprostheses. EVIDENCE ACQUISITION: A systematic review for "large
bore access" in the cardiovascular literature was conducted on PubMed and
the Cochrane Library Central according to PRISMA guidelines. Identified
articles were filtered and sub-selected for TAVR, EVAR, and TEVAR; studies
related to other large bore interventions were excluded. EVIDENCE
SYNTHESIS: A representative selection of 39 full-text studies included
both cardiac and vascular studies and was critically interpreted to
identify a consensus definition for large bore access, challenging
anatomy, and adjuncts or alternative approaches to the standard
transfemoral approach. CONCLUSION(S): Transfemoral access remains the
first-line approach but in the setting of unfavorable anatomy, adjunct
maneuvers (e.g. intravascular lithotripsy, endoconduits) or alternative
approaches (supra-aortic, transcaval) help decrease morbidity, mortality,
length of procedure, and overall health care cost in large bore
access. Copyright © 2024 EDIZIONI MINERVA MEDICA.

<68>
Accession Number
2036033248
Title
Multidisciplinary management of adult patients with chylothorax: a
consensus statement.
Source
European Respiratory Journal. 64(5) (no pagination), 2024. Article Number:
2400470. Date of Publication: 2024.
Author
Agrawal A.; Chaddha U.; Shojaee S.; Nadolski G.; Liberman M.; Lee Y.C.G.;
Rahman N.; Reisenauer J.S.; Ferguson M.K.; DeCamp M.M.; Gillaspie E.A.;
Bedawi E.O.; Currie B.; Feller-Kopman D.J.; Desai A.; Yasufuku K.; Bishay
V.; Gesthalter Y.; Grosu H.; Beecham Chick J.F.; Lentz R.; Kolli K.P.;
Kaufman A.; Mehta R.M.; Desai K.; Davis H.; Ghori U.K.; Maldonado F.
Institution
(Agrawal) Donald and Barbara Zucker School of Medicine at
Hofstra/Northwell, New Hyde Park, NY, United States
(Chaddha) Division of Pulmonary, Critical Care and Sleep Medicine, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Shojaee, Lentz, Maldonado) Division of Allergy, Pulmonary and Critical
Care Medicine, Vanderbilt University Medical Center, Nashville, TN, United
States
(Nadolski) University of Pennsylvania, Philadelphia, PA, United States
(Liberman) University of Montreal, Montreal, QC, Canada
(Lee) University of Western Australia, Perth, Australia
(Rahman) Oxford Respiratory Trials Unit, University of Oxford, Oxford,
United Kingdom
(Reisenauer) Mayo Clinic, Rochester, MN, United States
(Ferguson) University of Chicago, Chicago, IL, United States
(DeCamp) Division of Cardiothoracic Surgery, University of Wisconsin,
Madison, WI, United States
(Gillaspie) Creighton University Medical Center, Omaha, NE, United States
(Bedawi) Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield,
United Kingdom
(Currie) New York-Presbyterian Hospital, Weill Cornell Medical College,
New York, NY, United States
(Feller-Kopman) Pulmonary and Critical Care Medicine, Darmouth-Hitchcock
Medical Center, The Geisel School of Medicine at Dartmouth, Hanover, NH,
United States
(Desai) University of Mississippi Medical Center, Jackson, MS, United
States
(Yasufuku) Division of Thoracic Surgery, Toronto General Hospital,
University Health Network, University of Toronto, Toronto, ON, Canada
(Bishay, Kaufman) Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(Gesthalter) Division of Pulmonary, Critical Care, Allergy and Sleep,
University of California San Francisco, San Francisco, CA, United States
(Grosu, Davis) University of Texas, MD Anderson Cancer Center, Houston,
TX, United States
(Beecham Chick) University of Washington, Seattle, WA, United States
(Kolli) Division of Body Interventional Radiology, University of
California San Francisco, San Francisco, CA, United States
(Mehta) Apollo Bangalore Pulmonary Services, Apollo Hospitals Bangalore,
Bangalore, India
(Desai) Northwestern University Feinberg School of Medicine, Chicago, IL,
United States
(Ghori) Medical College of Wisconsin, Milwaukee, WI, United States
Publisher
European Respiratory Society
Abstract
The management of chylothorax remains challenging given the limited
evidence and significant heterogeneity in practice. In addition, there are
no practical guidelines on the optimal approach to manage this complex
condition. We convened an international group of 27 experts from 20
institutions across five countries and four specialties (pulmonary,
interventional radiology, thoracic surgery and nutrition) with experience
and expertise in managing adult patients with chylothorax. We performed a
literature and internet search for reports addressing seven clinically
relevant PICO (Patient, Intervention, Comparison and Outcome) questions
pertaining to the management of adult patients with chylothorax. This
consensus statement, consisting of best practice statements based on
expert consensus addressing these seven PICO questions, was formulated by
a systematic and rigorous process involving the evaluation of published
evidence, augmented with provider experience. Panel members participated
in the development of the final best practice statements using the
modified Delphi technique. Our consensus statement aims to offer guidance
in clinical decision making when managing patients with chylothorax while
also identifying gaps in knowledge and informing future
research. Copyright ©The authors 2024.

<69>
Accession Number
2036026353
Title
Global Cost-Effectiveness of Transcatheter vs Surgical Aortic Valve
Replacement in Severe Aortic Stenosis: A Systematic Review and
Meta-analysis.
Source
Canadian Journal of Cardiology. 40(12) (pp 2649-2659), 2024. Date of
Publication: December 2024.
Author
Zhou X.; Duan X.; Shao L.; Tan N.; Zuo S.; Shan H.; Li G.; Du X.; Shrestha
U.D.; Ke T.; Zhou F.; Ma H.; Xu Y.; Ouyang Z.; Liao C.
Institution
(Zhou, Duan, Shao, Tan, Zuo, Shan, Li, Du, Shrestha, Zhou, Xu, Ouyang,
Liao) Department of Radiology, Kunming Yan'an Hospital (Yan'an Hospital
Affiliated to Kunming Medical University), Kunming, China
(Ke) Department of Radiology, Yunnan Cancer Hospital (Third Affiliated
Hospital of Kunming Medical University), Kunming, China
(Ma) Department of Radiology, Third People's Hospital of Yunnan Province
(Second Affiliated Hospital of Dali University), Kunming, China
Publisher
Elsevier Inc.
Abstract
Backgroud: Transcatheter aortic valve replacement (TAVR) is a less
invasive treatment option for patients with severe aortic valve stenosis
(AS); however, its economic benefits in patients with low to intermediate
surgical risk remain controversial and vary by country. We conducted a
systematic review to compare the economic benefits of TAVR vs surgical
aortic valve replacement (SAVR). Method(s): We searched 6 databases,
including PubMed, Medline, Scopus, Web of Science, Embase, and Clinical
Trials for randomised controlled trials on the economic benefits of TAVR
with different valve types and SAVR in symptomatic AS patients with low to
intermediate surgical risk, from inception to October 2023. We extracted
data on quality-adjusted life-years (QALYs), and incremental
cost-effectiveness ratio (ICER), with ICER converted to 2023 US dollars.
 Result(s): Fifteen studies met the inclusion criteria, with the
overall quality ranging from intermediate to high. Among these, TAVR was
found to be cost-effective in 14 studies, whereas in 1 study conducted in
a developing country, TAVR was not cost-effective. When adjusted to 2023
USD, the ICER values ranged from $3,669 to $340,038 per QALY gained.
 Conclusion(s): TAVR appears to be a cost-effective alternative to
SAVR in patients with low- to intermediate-risk AS. In all studies, TAVR
was associated with a significant increase in QALYs compared with SAVR.
Because it is an expensive procedure, the cost-effectiveness of TAVR
depends on each country's ICER and willingness-to-pay
threshold. Copyright © 2024 Canadian Cardiovascular Society

<70>
Accession Number
2036013331
Title
Comparison of Various Surgical Approaches for Moderate-to-Severe Ischemic
Mitral Regurgitation: A Systematic Review and Network Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 25(11) (no pagination), 2024. Article
Number: 425. Date of Publication: November 2024.
Author
Wei Z.; Dong S.; Li X.; Chen Y.; Liu S.; Song B.
Institution
(Wei, Dong, Li, Chen, Liu) The First Clinical Medical College, Lanzhou
University, Gansu, Lanzhou 730000, China
(Wei, Dong, Li, Chen, Liu, Song) Department of Cardiovascular Surgery,
First Hospital of Lanzhou University, Gansu, Lanzhou 730000, China
Publisher
IMR Press Limited
Abstract
Background: This study aims to systematically review the efficacy of
various surgical approaches in the treatment of ischemic mitral
regurgitation (IMR). Method(s): A comprehensive literature search was
conducted using computerized databases, including PubMed, Cochrane
Library, Embase, and Web of Science, up to February 2024. In our network
meta-analysis, we utilized the Cochrane Handbook tool for quality
evaluation, while a consistency model and the odds ratio (OR) were used to
compile and analyze the data from the studies included, employing Stata
17.0 software for this purpose. Result(s): The systematic review
included a total of 20 randomized controlled trials (RCTs), which
collectively involved 3111 patients and evaluated six different surgical
techniques. The network metaanalysis demonstrated that mitral valve repair
(MVr) exhibited a significant reduction in 30-day all-cause mortality
rates when compared to coronary artery bypass grafting (CABG), mitral
valve replacement (MVR), CABG combined with MVR, and transcatheter mitral
valve edge-to-edge repair (TEER) using MitraClip. Furthermore, probability
ranking analysis suggested that MVr may be the most effective approach in
reducing 30-day all-cause mortality, while CABG combined with MVr had
significantly fewer renal complications compared to CABG combined with
MVR. Probability rankings also indicated that CABG+MVr may be the most
effective technique in minimizing renal complications. However, there were
no statistically significant differences observed in other outcome
measures among the different surgical techniques. Conclusion(s):
Current limited evidence indicates that CABG combined with MVr may be the
best surgical approach for patients with IMR. However, these conclusions
are tentative and require further confirmation from more additional
high-quality studies. INPLASY Registration Number: INPLASY202420049. This
study can be accessed at the following detailed address:
https://inplasy.com/inplasy-2024-2-0049/, last accessed on February 11,
2024. Copyright © 2024 The Author(s).

<71>
Accession Number
645566380
Title
Effects of Wab-WPPEP on post-intensive care syndrome-family in family
caregivers of heart valve replacement patients: A randomized controlled
trial.
Source
Intensive & critical care nursing. 86 (pp 103817), 2025. Date of
Publication: 01 Feb 2025.
Author
Xiong J.; Wu T.-T.; Cai H.; He J.-Y.; Wang T.-Y.; Lin X.-X.; Li H.
Institution
(Xiong) Department of Nursing, Second Affiliated Hospital of Fujian
Medical University, Quanzhou, China; School of Nursing, Fujian Medical
University, Fuzhou, China
(Wu) Department of Nursing, First Affiliated Hospital of Fujian Medical
University, Fuzhou, China
(Cai, He, Wang) Cardiovascular Surgery Department, Fujian Provincial
Hospital, Fuzhou, China
(Lin) Cardiac Intensive Care Unit, Fujian Provincial Hospital, Fuzhou,
China
(Li) School of Nursing, Fujian Medical University, Fuzhou, China; Shengli
Clinical College of Fujian Medical University, Fuzhou, China
Abstract
OBJECTIVES: To evaluate the effects of a WeChat applet-based whole process
psychological empowerment program (Wab-WPPEP) on post-intensive care
syndrome-family in family caregivers of heart valve replacement patients.
DESIGN: Two-arm, parallel, randomized controlled clinical trial. SETTINGS:
A tertiary general hospital in Fuzhou, China. METHOD(S): Participants
were randomly assigned to two groups. The intervention group received
Wab-WPPEP, while the control group received routine care. The intervention
was implemented from ICU admission to one month post-discharge. The
primary outcome was anxiety, while secondary outcomes included depression,
post-traumatic stress disorder (PTSD), and quality of life. Outcomes were
assessed at baseline (T0), before ICU transfer (T1), pre-discharge (T2),
and one month post-discharge (T3) using standardized questionnaires.
Generalized estimating equations were used to analyze the
repeated-measures data. RESULT(S): The intervention group exhibited
greater improvements in anxiety (T1: beta = -1.92, 95 % CI: -2.35 to
-1.49, P < 0.001; T2: beta = -1.66, 95 % CI: -2.03 to -1.29, P < 0.001;
T3: beta = -3.98, 95 % CI: -4.34 to -3.62, P < 0.001), depression (T1:
beta = -1.32, 95 % CI: -1.79 to -0.85, P < 0.001; T2: beta = -1.70, 95 %
CI: -2.08 to -1.32, P < 0.001), and quality of life (T2: beta = 31.16, 95
% CI: 21.35 to 40.98, P < 0.001) compared to the routine-care group. PTSD
scores were also significantly lower in the intervention group (t =
-6.454, P < 0.001). CONCLUSION(S): Wab-WPPEP significantly reduced
anxiety and depression, improved quality of life, and alleviated PTSD
symptoms in family caregivers of heart valve replacement patients.
IMPLICATIONS FOR CLINICAL PRACTICE: Comprehensive psychological
interventions should be implemented throughout the ICU stay and recovery
period to improve family caregiver well-being. Copyright © 2024
The Author(s). Published by Elsevier Ltd.. All rights reserved.

<72>
Accession Number
2032505171
Title
Thrombin generation after prothrombin complex concentrate or plasma
transfusion during cardiac surgery.
Source
Journal of Thrombosis and Thrombolysis. (no pagination), 2024. Date of
Publication: 2024.
Author
Welsby I.J.; Schroeder D.R.; Ghadimi K.; Nuttall G.A.; Smith M.M.
Institution
(Welsby, Ghadimi) Department of Anesthesiology & Critical Care, Duke
University Medical Center, Erwin Road, Durham, NC 27710, United States
(Schroeder) Department of Biomedical Statistics and Informatics, Mayo
Clinic College of Medicine and Science, Rochester, MN, United States
(Nuttall, Smith) Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic College of Medicine and Science, Rochester, MN, United States
Publisher
Springer
Abstract
Thrombin generation (TG) is reduced after cardiac surgery using
cardiopulmonary bypass (CPB), contributing to coagulopathy and bleeding.
Plasma transfusion or four-factor prothrombin complex concentrate (PCC)
are commonly used to treat coagulopathic bleeding after CPB without
knowledge of how each may restore TG. To determine the effect of PCC
infusion on restoration of thrombin generation compared with plasma
transfusion, we performed a laboratory-based secondary analysis of a
randomized, controlled trial of adult patients undergoing cardiac surgery
to assess efficacy and safety of 4 F-PCC versus plasma for treatment of
perioperative coagulopathic bleeding after CPB. Participants were
randomized to receive either PCC (15 IU/kg) or plasma (10-15 ml/kg) after
separation from CPB. Participant blood samples were obtained at
pre-specified serial timepoints, with laboratory assays for TG and factor
levels subsequently performed. The primary outcome was change in thrombin
generation (TG) parameters after each randomized treatment through
postoperative day 5. Secondary outcomes included serially derived clotting
factor levels. Of 100 randomized participants, 99 were included in this
laboratory analysis (PCC group, N = 51; plasma group, N = 48). After
treatment, participants in the PCC group compared with those in the plasma
group showed higher endogenous thrombin potential (ETP, Median,
Interquartile range, IQR: 688 [371-1069] vs. 1088 [550-1691] nM minutes, P
= 0.01), a greater increase din ETP (P = 0.002) and peak TG (P = 0.01) in
the timepoints between heparin reversal and after treatment
administration. Both groups demonstrated similar values in all TG assays
by postoperative day 1 (P > 0.05). The PCC group also demonstrated higher
levels of proteins C, S, and Factors II, VII, IX and X, early after
treatment (P < 0.001 for all comparisons). Antithrombin levels were
initially higher in the plasma group after treatment (Median, IQR: 66%
[61-71%] vs. 56% [51-65%], P = 0.002) but differences did not persist
beyond postoperative day 3. In this laboratory analysis from a recent
randomized trial in adult cardiac surgery, PCC administration restored
thrombin generation more rapidly than plasma in the early postoperative
period without laboratory evidence of hypercoagulability.
ClinicalTrials.gov identifier: NCT02557672 [1]. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<73>
Accession Number
2032504495
Title
Melatonin ameliorates inflammation and improves outcomes of
ischemia/reperfusion injury in patients undergoing coronary artery bypass
grafting surgery: a randomized placebo-controlled study.
Source
Apoptosis. (no pagination), 2024. Date of Publication: 2024.
Author
Casper E.A.; Wakeel L.E.; Sabri N.A.; Khorshid R.; Gamal M.A.; Fahmy S.F.
Institution
(Casper, Wakeel, Sabri, Fahmy) Department of Clinical Pharmacy, Faculty of
Pharmacy, Ain Shams University, Ankara Street, Sheraton buildings, Cairo
11566, Egypt
(Khorshid, Gamal) Department of Cardiovascular and Thoracic Surgery, Ain
Shams University Hospital, Faculty of Medicine, Ain Shams University,
Cairo, Egypt
Publisher
Springer
Abstract
To investigate the protective role of high dose melatonin concerning
myocardial I/R injury and inflammation in patients undergoing on-pump
coronary artery bypass grafting (CABG) surgery by evaluating
IR/inflammatory biomarkers and clinical outcomes. This was a prospective;
randomized; single-blinded placebo-controlled study conducted at
cardio-thoracic surgery department of the Academy of the Cardiovascular
and Thoracic Surgery, Ain Shams University. Eligible patients were
randomly allocated to; melatonin-treated group (MTG) or placebo-treated
group (PTG). The MTG (n = 17) received 60 mg/day melatonin capsules daily
starting 5 days before surgery in addition to the standard of care. PTG (n
= 17) received placebo also 5 days before surgery plus standard of care.
The levels of nuclear factor kappa beta (NF-kappab) (primary outcome),
tumor necrosis factor (TNF-alpha), cardiac troponins I, and IL-6 levels
were all assessed for both groups at five time points: baseline before
melatonin or placebo administration (T0), before cross-clamp
application(T1), 5 min after cross-clamp removal(T2), 6 h after
cross-clamp removal(T3) and 24 h after cross-clamp removal(T4). Blood
pressure was assessed at baseline, pre-operative and 24-hours
post-operative. The Quality of recovery-40 score (QOR-40) was assessed for
both groups on day 4 after surgery. TNF-alpha levels decreased in the MTG
at T1(p = 0.034) versus PTG. At T2(p = 0.005), and T3(p = 0.04), TNF-alpha
significantly increased in PTG versus MTG. Troponins significantly
increased in PTG at T3 (p = 0.04) versus MTG. NF-kappaB levels declined at
T1 (p = 0.013) and T2 (p = 0.0001) in MTG compared to PTG. IL-6
significantly increased in PTG versus MTG at T3 (p = 0.04). The QOR-40
score significantly decreased in MTG versus PTG. MTG had statistically
significant decrease in DBP compared to the placebo group (p = 0.024). MTG
had a statistically significant shorter intubation time than did the
placebo group (p = 0.03). Melatonin 60 mg was well-tolerated without any
reported side effects. Our findings suggested that melatonin could
ameliorate myocardial I/R injury after on-pump CABG and that this outcome
was essentially correlated to its antiapoptotic and anti-inflammatory
effects. Trial registration: ClinicalTrials.gov registration number
NCT05552586, 9/2022. Copyright © The Author(s) 2024.

<74>
Accession Number
2032095775
Title
Correction to: Superficial parasternal intercostal plane blocks in cardiac
surgery: a systematic review and meta-analysis (Canadian Journal of
Anesthesia/Journal canadien d'anesthesie, (2024), 71, 6, (883-895),
10.1007/s12630-024-02726-0).
Source
Canadian Journal of Anesthesia. 71(11) (pp 1572), 2024. Date of
Publication: November 2024.
Author
Cameron M.J.; Long J.; Kardash K.; Yang S.S.
Institution
(Cameron, Long, Kardash, Yang) Faculty of Medicine, McGill University,
Montreal, QC, Canada
(Cameron) Department of Anesthesia, Jewish General Hospital, K1401-3755
Cote Sainte Catherine, Montreal, QC H3T 1E2, Canada
(Cameron, Yang) Lady Davis Research Institute, Montreal, QC, Canada
(Kardash, Yang) Department of Anesthesia, Jewish General Hospital,
Montreal, QC, Canada
Publisher
Springer
Abstract
The correct reference for reference 19 is Kumar et al., 2021.1
Reference 32 should have been reference 21 of the manuscript, Zhang et
al., 2022.2 References 33 to 38 have been renumbered to
correspond to the order in which they appear. Copyright ©
Canadian Anesthesiologists' Society 2024.

<75>
Accession Number
2036338391
Title
Effectiveness of Anti-Inflammatory Agents to Prevent Atrial Fibrillation
After Cardiac Surgery: A Systematic Review and Network Meta-Analysis.
Source
CJC Open. (no pagination), 2024. Date of Publication: 2024.
Author
Malektojari A.; Javidfar Z.; Ghazizadeh S.; Lahuti S.; Shokraei R.;
Zeinaee M.; Badele A.; Mirzadeh R.; Ashrafi M.; Afra F.; Ersi M.H.;
Heydari M.; Ziaei A.; Rezvani Z.; Mah J.; Zeraatkar D.; Abbaszadeh S.;
Pitre T.
Institution
(Malektojari, Ghazizadeh, Abbaszadeh) Cardiovascular Research Center,
Hormozgan University of Medical Sciences, Bandar Abbas, Iran, Islamic
Republic of
(Malektojari, Ghazizadeh, Ashrafi, Ersi, Ziaei) Evidence Based Medicine
Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran,
Islamic Republic of
(Javidfar, Lahuti, Zeinaee, Badele, Mirzadeh, Afra, Ersi, Heydari) Faculty
of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran,
Islamic Republic of
(Shokraei) Infectious and Tropical Diseases Research Center, Hormozgan
University of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of
(Rezvani) Xi'an Jiaotong University Health Science Center, Shaanxi, Xi'an,
China
(Mah) Department of Medicine, Dalhousie University, Halifax, NS, Canada
(Zeraatkar) Department of Health Research Methods Evidence and Impact,
McMaster University, Hamilton, ON, Canada
(Zeraatkar) Department of Anesthesiology, McMaster University, Hamilton,
ON, Canada
(Pitre) Division of Respirology, Department of Medicine, University of
Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Preventing postoperative atrial fibrillation (POAF) as one of
the most significant complications of cardiovascular surgeries remains a
major clinical challenge. We conducted a systematic review with network
meta-analysis of randomized controlled trials, to identify the most
effective and safe anti-inflammatory drugs to prevent new-onset POAF.
 Method(s): MEDLINE, Embase, Web of Science, and Cochrane Library were
searched without language or publication-date restriction on August 8,
2022 (updated on August 8, 2023). We assessed the risk of bias of included
trials using the Cochrane risk-of-bias 2.0 tool. We conducted a
frequentist random-effects network meta-analysis in R, and we assessed the
certainty of evidence using the Grading of Recommendations, Assessment,
Development, and Evaluations (GRADE) approach. Result(s): A total of
85 trials reported the incidence of new-onset POAF, including 18,981
patients. Use of nonsteroidal anti-inflammatory drugs (relative risk [RR]
0.37 [95% confidence interval [CI] 0.23-0.59]) and statins (RR 0.56 [95%
CI 0.45-0.7]) potentially reduced the risk of POAF compared with placebo
(both with a moderate certainty level). Use of fish oil in combination
with vitamins C and E (RR 0.30 [95% CI 0.13-0.68]) may reduce the risk of
POAF, compared with placebo (low level of certainty). Use of colchicine
(RR 0.62 [95% CI 0.45- 0.85]), corticosteroids (RR 0.70 [95% CI
0.59-0.82]), and N-acetylcysteine (RR 0.69 [95% CI 0.49- 0.98]) may reduce
the risk of POAF (all with a low level of certainty). None of the
interventions had a significant effect on mortality rate or risk of
serious adverse effects. Conclusion(s): Use of nonsteroidal
anti-inflammatory drugs and statins probably are effective in preventing
new-onset POAF, with a moderate level of certainty, compared to
placebo. Copyright © 2024 The Authors

<76>
Accession Number
645979408
Title
Non-Pharmacological Sleep Interventions after Cardiac Surgery: A
Systematic Review and Meta-Analysis of Randomised Controlled Trials.
Source
Journal of clinical nursing. (no pagination), 2024. Date of Publication:
04 Dec 2024.
Author
Lee S.; Chen P.; Park C.; Zhu B.; Balserak B.I.
Institution
(Lee) Marcella Niehoff School of Nursing, Loyola University Chicago,
Maywood, IL, United States
(Chen, Park, Balserak) College of Nursing, University of Illinois Chicago,
Chicago, IL, United States
(Zhu) School of Nursing, Shanghai Jiao Tong University, Shanghai, China
Abstract
AIM: To synthesise up-to-date research evidence for non-pharmacological
interventions to improve various sleep outcomes (e.g., sleep quality,
duration) in postsurgical cardiac patients. BACKGROUND: Sleep disturbances
are common amongst postsurgical cardiac patients, yet the effectiveness of
non-pharmacological interventions in improving various sleep outcomes has
not been comprehensively reviewed. DESIGN: A systematic review and
meta-analysis guided by the PRISMA protocol. METHOD(S): CINAHL,
PubMed, PsycINFO, Embase, Web of Science, and Cochrane Library were
searched for relevant research in May 2023. Included studies used a
randomised controlled trial design that applied a non-pharmacological
intervention for postsurgical cardiac patients and reported sleep as an
outcome. For the meta-analysis, mean effect sizes were separately
calculated for studies with regular and reverse-scored scales.
 RESULT(S): Of 37 studies included, the most common cardiac surgery
was coronary artery bypass graft. Most interventions were performed within
the first postoperative week and assessed sleep quality outcomes using the
Pittsburgh Sleep Quality Index. The interventions are categorised into
five types. Human resource-based strategies emerged as the most effective.
The meta-analysis of 27 eligible studies showed a mean effect size of 0.76
for studies with regular scoring scales and-1.04 for those with
reverse-scored scales, indicating medium to large effect sizes.
 CONCLUSION(S): Our findings provide strong evidence that
non-pharmacological interventions, particularly human resource-based
strategies, significantly improve sleep quality in postsurgical cardiac
patients. The medium to large effect sizes underscore the clinical
significance of these findings. IMPLICATIONS: Healthcare professionals
should consider incorporating non-pharmacological interventions,
especially human resource-based strategies, in care plans for postsurgical
cardiac patients to improve sleep outcomes and promote recovery. These
interventions should be tailored to individual physical and cultural
differences for maximum effectiveness. Future research should evaluate the
long-term effects of these interventions on various sleep outcomes, using
both objective and subjective measures to provide a comprehensive
assessment of their efficacy. REPORTING METHOD: This study adheres to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) protocol. NO PATIENT OR PUBLIC CONTRIBUTION: Patient and public
contributions were not required for this review. Copyright © 2024
The Author(s). Journal of Clinical Nursing published by John Wiley & Sons
Ltd.

<77>
Accession Number
645968898
Title
Effectiveness of Virtual Reality Glasses on Surgical Fear and Anxiety in
Patients Before Open-heart Surgery: A Double-blind Randomized Controlled
Trial.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2024. Date of
Publication: 29 Nov 2024.
Author
Erol Akar T.; Unver S.
Institution
(Erol Akar) Trakya University Hospital, Department of Ophthalmology
Diseases, Edirne, Turkey
(Unver) Trakya University, Faculty of Health Sciences, Department of
Surgical Nursing, Edirne, Turkey
Abstract
PURPOSE: Fear and anxiety in open-heart surgery patients can adversely
affect their physiological well-being and recovery. Although virtual
reality glasses (VR-G) have been advanced for preoperative anxiety
management, their effectiveness specifically for open-heart surgery
patients remains under-researched. This study aims to evaluate the
efficacy of watching a video through VR-G on surgical fear and anxiety
levels of patients undergoing open-heart surgery. DESIGN: A randomized
controlled and double-blind study. METHOD(S): In total, 90 patients
were randomly assigned to the VR-G intervention group or control group. On
the surgery morning, intervention group patients watched a 360-degree
video with nature sounds through VR-G before being transferred to the
operating theater. The surgical fear and anxiety levels of the patients
were evaluated at three stages using the Surgical Fear Questionnaire and
Visual Analog Scale-Anxiety: initial evaluation in the morning, second
evaluation before being transferred, and third evaluation in the waiting
room of the operating theater. FINDINGS: The surgical fear level of the
intervention group at the third evaluation was significantly lower than
the control group (P < .000). There was no significant difference between
the anxiety levels of the study groups (P > .05). CONCLUSION(S):
Watching a 360-degree video with nature sounds through VR-G is an
effective intervention in reducing surgical fear levels of patients before
undergoing open-heart surgery. Use of VR-G interventions may be a
practical and fast-resulting nursing strategy to manage patients' surgical
fear in the preoperative period. REGISTRATION: NCT06165861. Copyright
© 2024 The American Society of PeriAnesthesia Nurses. Published by
Elsevier Inc. All rights reserved.

<78>
Accession Number
2035965256
Title
A systematic review of the use of GLP-1 receptor agonists in surgery.
Source
American Journal of Surgery. 240 (no pagination), 2025. Article Number:
116119. Date of Publication: February 2025.
Author
Ihnat J.M.H.; De Baun H.; Carrillo G.; Dony A.; Mukherjee T.J.; Ayyala
H.S.
Institution
(Ihnat, Carrillo, Mukherjee, Ayyala) Division of Plastic and
Reconstructive Surgery, Department of Surgery, Yale School of Medicine,
New Haven, CT, United States
(De Baun) Renaissance School of Medicine at Stony Brook University, Stony
Brook, NY, United States
(Dony) University of Leeds School of Medicine, Leeds, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Surgeons are likely to encounter patients on GLP-1 receptor
agonists (GLP-1RAs) and should be aware of any associated risks or
complications. Here we review the existing literature on GLP-1RA use as it
pertains to non-bariatric surgeons. Method(s): A systematic review
was conducted following PRISMA 2020 guidelines. Three databases were
queried for articles discussing the use of GLP-1RAs in a surgical context.
Articles went through two rounds of manual screening. Result(s): 21
articles were included in analysis, which found that pre-operatively,
GLP-1RAs can aid patients in meeting the BMI threshold for surgery.
Peri-operatively, GLP-1RAs were associated with improved glycemic control
and lower intraoperative insulin use. Complications such as delayed
gastric emptying and increased rates of hypoglycemic events were reported.
 Conclusion(s): Surgeons may leverage GLP-1RAs to help prepare
patients for surgery and should understand potential surgical
complications associated with the use of these medications and to screen
preoperative patients appropriately. Copyright © 2024 Elsevier
Inc.

<79>
Accession Number
2032467698
Title
Thromboelastography or rotational thromboelastometry guided algorithms in
bleeding patients: An updated systematic review with meta-analysis and
trial sequential analysis.
Source
Acta Anaesthesiologica Scandinavica. 69(1) (no pagination), 2025. Article
Number: e14558. Date of Publication: January 2025.
Author
Kvisselgaard A.D.; Wolthers S.A.; Wikkelso A.; Holst L.B.; Drivenes B.;
Afshari A.
Institution
(Kvisselgaard) Department of Anesthesia and Intensive Care, Copenhagen
University Hospital-Herlev, Copenhagen, Denmark
(Wolthers) Prehospital Centre Zealand, Naestved, Denmark
(Wikkelso) Department of Anesthesia and Intensive Care Medicine, Zealand
University Hospital-Roskilde, Roskilde, Denmark
(Holst, Afshari) Department of Anesthesia, Juliane Marie Center,
Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
(Drivenes) Department of Intensive Care, Copenhagen University Hospital,
Rigshospitalet, Copenhagen, Denmark
(Afshari) Institute of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Bleeding patients face significant morbidity and mortality due
to impaired haemostasis. Haemostatic resuscitation has evolved, yet the
optimal approach remains unclear. The primary objective was to assess the
benefits and risks of transfusion guided by TEG/ROTEM versus standard of
care in bleeding patients in an updated review. Method(s): This
systematic review of randomised controlled trials with meta-analyses and
trial sequential analysis was conducted according to Cochrane
Collaboration methodology, PRISMA and GRADE guidelines. A literature
search was conducted in five major databases. Both paediatric and adult
patients were included. The primary outcome was mortality, and secondary
outcomes were the administration of blood products, blood loss, surgical
reintervention, and dialysis-dependent renal injury. Result(s): This
systematic review included 31 randomised trials (n = 2756), with most
patients undergoing elective cardiac surgery. TEG-/ROTEM-guided algorithms
reduced the amount of transfused fresh frozen plasma (RR 0.5, 95% CI
0.32-0.72, I2: 94%), platelets (RR 0.7, 95% CI 0.55-0.91,
I2: 57%), the risk for surgical reintervention (RR 0.65, 95% CI
0.47-0.94, I2: 0%), and bleeding with a standard mean
difference of -0.31 (95% CI -0.55 to -0.08, I2: 75%). No
statistically significant difference was demonstrated for mortality (RR
0.76, 95% CI 0.57-1.00, I2: 5%). According to GRADE
methodology, the certainty of the evidence was very low for all outcomes.
Trial sequential analysis of mortality analysis indicated that 54% of the
optimal information size was reached with an alpha-boundary RR of 0.81
(95% CI 0.63-1.03). Conclusion(s): TEG-/ROTEM-guided transfusion
algorithms may reduce the risk of mortality, bleeding volume, and the need
for fresh frozen plasma and platelets, but the evidence is very uncertain.
Further, the results were primarily based on the adult population
undergoing elective cardiac surgery. Copyright © 2024 Acta
Anaesthesiologica Scandinavica Foundation.

<80>
Accession Number
2035997350
Title
Combined arm-leg endurance training vs. leg endurance training in patients
with an implantable cardioverter defibrillator: A randomized controlled
study.
Source
Heart and Lung. 70 (pp 82-92), 2025. Date of Publication: 01 Mar 2025.
Author
Akdal A.; Karavelioglu Y.; Gokdeniz T.; Turk A.C.; Unal F.; Kutukcu E.C.
Institution
(Akdal) Hitit University, Erol Olcok Education and Research Hospital,
Cardiac Rehabilitation Center, Corum, Turkey
(Karavelioglu, Gokdeniz) Istinye University Hospital Medical Park
Gaziosmanpasa, Department of Cardiology, Istanbul, Turkey
(Turk) Hitit University, Erol Olcok Education and Research Hospital,
Department of Physical Medicine and Rehabilitation, Corum, Turkey
(Unal) Data Management Unit, Middle East Technical University, Ankara,
Turkey
(Kutukcu) Hacettepe University, Faculty of Physical Physiotherapy and
Rehabilitation, Department of Cardiorespiratory Physiotherapy and
Rehabilitation, Ankara, Turkey
Publisher
Elsevier Inc.
Abstract
Background: There is a lack of evidence regarding the effect of combining
arm and leg training on arm exercise capacity, upper extremity
functionality and safety in patients with implantable
cardioverter-defibrillators (ICDs). Objective(s): The aim of this
study was to compare the effects of combined arm-leg endurance training
(ET<inf>arm+leg</inf>) with leg endurance training (ET<inf>leg</inf>)
alone on arm exercise capacity, cardiorespiratory fitness, and safety
issues in patients with ICDs. Method(s): In this prospective
randomized controlled study, 24 caucasian patients with an ICD (NYHA class
II-III, mean age: 59.38+/-11.54 years, 20 male, 4 female) underwent
cardiopulmonary exercise testing (CPET) and arm ergometry. The
ET<inf>leg</inf> intervention consisted of cycle ergometer training for 40
min at workload of 70-80 % of peak oxygen consumption
(VO<inf>2peak</inf>). The ET<inf>arm+leg</inf> intervention also included
arm ergometer training for 20 min at 60 % peak workload
(W<inf>peak</inf>). Both exercise programs were performed for a total of
30 sessions (5 days for 6 weeks). Quade's non-parametric covariance
analysis was performed for changes between groups by adjusting before
treatment. Result(s): Significant increases in time to reach
VO<inf>2peak</inf> (min), VO<inf>2peak</inf> (L), VO<inf>2peak</inf>/kg
(L/kg/min), VO<inf>2peak</inf> (%), W<inf>peak</inf>, and test duration
during arm ergometry were observed in the ET<inf>arm+leg</inf> group (p <
0.05). No shocks or ventricular tachycardia/fibrillation episodes were
recorded. Conclusion(s): ET<inf>arm+leg</inf> had a more pronounced
effect on cardiopulmonary exercise capacity and arm exercise capacity in
patients with ICDs. Arm exercise training is safe in terms of ICD
parameters and should be incorporated into cardiac rehabilitation for
patients with ICDs. Copyright © 2024

<81>
Accession Number
2034048298
Title
Comprehensive perioperative blood management in patients undergoing
elective bypass cardiac surgery: Benefit effect of health care education
and systematic correction of iron deficiency and anemia on red blood cell
transfusion.
Source
Journal of Clinical Anesthesia. 98 (no pagination), 2024. Article Number:
111560. Date of Publication: November 2024.
Author
Charbonneau H.; Savy S.; Savy N.; Pasquie M.; Mayeur N.; Angles O.; Balech
V.; Berthelot A.-L.; Croute-Bayle M.; Decramer I.; Duterque D.; Julien V.;
Mallet L.; M'rini M.; Quedreux J.-F.; Richard B.; Sidobre L.; Taillefer
L.; Thibaud A.; Abouliatim I.; Berthoumieu P.; Garcia O.; Soula P.; Vahdat
O.; Breil C.; Brunel P.; Sciacca G.
Institution
(Charbonneau, Mayeur, Angles, Balech, Berthelot, Croute-Bayle, Decramer,
Duterque, Julien, Mallet, M'rini, Quedreux, Richard, Sidobre, Taillefer,
Thibaud) Department of Anesthesiology and Intensive Care Unit, Clinique
Pasteur, Toulouse, France
(Savy, Pasquie) Clinical Research Committee, Clinique Pasteur, Toulouse,
France
(Savy) Toulouse Institute of Mathematics, UMR5219 - University of
Toulouse, CNRS - UPS IMT, Toulouse, France
(Abouliatim, Berthoumieu, Garcia, Soula, Vahdat, Breil, Brunel, Sciacca)
Department of Cardiothoracic and Vascular Surgery, Clinique Pasteur,
Toulouse, France
Publisher
Elsevier Inc.
Abstract
Study objective: The aim of this study was to investigate the efficacy of
a two-step patient blood management (PBM) program in red blood cell (RBC)
transfusion requirements among patients undergoing elective
cardiopulmonary bypass (CPB) surgery. Design(s): Prospective,
non-randomized, two-step protocol design. Setting(s): Cardiac surgery
department of Clinique Pasteur, Toulouse, France. Patient(s): 897
patients undergoing for elective CPB surgery. Intervention(s): We
conducted a two-steps protocol: PBMe and PBMc. PBMe involved a short
quality improvement program for health care workers, while PBMc introduced
a systematic approach to pre- and postoperative correction of
deficiencies, incorporating iron injections, oral vitamins, and
erythropoiesis-stimulating agents. Measurements: The PBM program's
effectiveness was evaluated through comparison with a pre-PBM
retrospective cohort after propensity score matching. The primary
objective was the proportion of patients requiring RBC transfusions during
their hospital stay. Secondary objectives were also analyzed. Main
Result(s): After matching, 343 patients were included in each group.
Primary outcomes were observed in 35.7% (pre-PBM), 26.7% (PBMe), and 21.1%
(PBMc) of patients, resulting in a significant reduction (40.6%) in the
overall RBC transfusion rate. Both the PBMe and PBMc groups exhibited
significantly lower risks of RBC transfusion compared to the pre-PBM
group, with adjusted odds ratios of 0.59 [95% CI 0.44-0.79] and 0.44 [95%
CI 0.32-0.60], respectively. Secondary endpoints included reductions in
transfusions exceeding 2 units, total RBC units transfused, administration
of allogeneic blood products, and total bleeding volume recorded on Day 1.
There were no significant differences noted in mortality rates or the
duration of hospital stays. Conclusion(s): This study suggests that
health care education and systematic deficiency correction are associated
with reduced RBC transfusion rates in elective CPB surgery. However,
further randomized, controlled studies are needed to validate these
findings and refine their clinical application. Copyright © 2024
Elsevier Inc.

<82>
Accession Number
2032467617
Title
Core Laboratory Versus Center-Reported Echocardiographic Assessment of the
Native and Bioprosthetic Aortic Valve.
Source
Echocardiography. 41(12) (no pagination), 2024. Article Number: e70047.
Date of Publication: December 2024.
Author
Velders B.J.J.; Vriesendorp M.D.; Weissman N.J.; Sabik J.F.; Reardon M.J.;
Dagenais F.; Moront M.G.; Rao V.; Fukuhara S.; Gunzinger R.; van Leeuwen
W.J.; Brown W.M.; Groenwold R.H.H.; Klautz R.J.M.; Asch F.M.
Institution
(Velders, Vriesendorp, Klautz) Cardiothoracic Surgery, Leiden University
Medical Centre, Leiden, Netherlands
(Weissman, Asch) Cardiovascular Core Laboratories, MedStar Health Research
Institute, and Georgetown University, Washington, DC, United States
(Sabik) Surgery, University Hospitals Cleveland Medical Center and Case
Western Reserve University School of Medicine, Cleveland, OH, United
States
(Reardon) Department of Cardiothoracic Surgery, Houston Methodist DeBakey
Heart and Vascular Center, Houston, TX, United States
(Dagenais) Division of Cardiac Surgery, Quebec Heart and Lung Institute,
Quebec, QC, Canada
(Moront) Cardiothoracic Surgery, ProMedica Toledo Hospital, Toledo, OH,
United States
(Rao) Department of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, Toronto, ON, Canada
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Gunzinger) Department of Cardiovascular Surgery, German Heart Center
Munich, Technische Universitat Munchen, Munich, Germany
(Gunzinger) Department of Cardiovascular Surgery, German Heart Center
Munich, Insure (Institute for Translational Cardiac Surgery), Technische
Universitat Munchen, Munich, Germany
(van Leeuwen) Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam,
Netherlands
(Brown) Cardiovascular Surgery, Piedmont Heart Institute, Atlanta, GA,
United States
(Groenwold) Clinical Epidemiology & Biomedical Data Science, Leiden
University Medical Center, Leiden, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background: Insights into quantitative differences between core laboratory
and center-reported echocardiographic assessment of the native and
bioprosthetic aortic valve are lacking. We aimed to explore clinically
relevant differences between these evaluations. Method(s): Data were
used from the PERIcardial SurGical AOrtic Valve ReplacemeNt (PERIGON)
Pivotal Trial for the Avalus valve. In this trial, patients with an
indication for surgical aortic valve replacement (SAVR) due to aortic
stenosis or regurgitation (AR) were enrolled. Serial echocardiographic
examinations were performed at each center and blindly reanalyzed by an
independent echocardiographic core laboratory (ECL). For the bioprosthetic
valve analysis, postoperative data throughout the 5-year follow-up were
pooled. Differences between the ECL and the centers in continuous
parameters were quantified in mean differences and intraclass correlation
coefficients (ICCs). Agreement on AR, paravalvular leak (PVL), and
prosthesis-patient mismatch (PPM) classification was investigated using
Cohen's kappa coefficients. Result(s): The analysis on the native
aortic valve was performed on 1118 echocardiograms. The relative mean
difference was largest for the left ventricular outflow tract (LVOT) area,
followed by stroke volume and effective orifice area (index), with
center-reported values being 11%-7% higher. High ICCs of around 0.90 were
observed for the parameters peak aortic jet velocity, mean pressure
gradient, and the velocity-time integral across the aortic valve. Over
5000 echocardiograms were available for the bioprosthetic valve analysis.
Therein, comparable results were observed. The kappa coefficient was 0.59
(95% confidence interval [CI] 0.56, 0.63) for agreement on native AR, 0.28
(95% CI 0.18, 0.37) for PVL, and 0.42 (95% CI 0.40, 0.44) for PPM.
 Conclusion(s): There is high agreement between the ECL and clinical
centers on continuous-wave Doppler-related measurements. In contrast,
agreement is low for parameters that involve measurement of the LVOT
diameter. These results provide important context for the interpretation
of aortic valve performance in studies that lack central ECL evaluation.
Trial Registration: ClinicalTrials.gov identifier:
NCT02088554. Copyright © 2024 The Author(s). Echocardiography
published by Wiley Periodicals LLC.

<83>
Accession Number
2032384438
Title
Comprehensive analysis of donor-site chest deformities after autologous
costal cartilage microtia reconstruction: A systematic review.
Source
Journal of Plastic, Reconstructive and Aesthetic Surgery. 94 (pp 128-140),
2024. Date of Publication: 01 Jul 2024.
Author
Kim J.; Park C.; Oh K.S.; Lim S.Y.
Institution
(Kim, Park, Lim) Department of Plastic Surgery, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Oh) Department of Plastic surgery, Kangbuk Samsung Hospital, Sungkyunkwan
University School of Medicine, Seoul, South Korea
Publisher
Churchill Livingstone
Abstract
Background: Autologous costal cartilage has gained widespread acceptance
as an important material for ear reconstruction in patients with microtia.
Despite its recognition as being "worth the trade-off," attention should
be directed toward donor-site deformities. This systematic review focused
on existing English literature related to microtia reconstruction and
aimed to reveal the incidence of chest wall deformities and assess the
effectiveness of the various proposed surgical techniques aimed at
reducing donor-site morbidities. Method(s): A comprehensive search
was conducted on Pubmed and OVID using the keywords "microtia," and "chest
deformity" or "rib harvest." Articles were screened based on predefined
inclusion and exclusion criteria. Data acquisition encompassed patient
demographics, employed surgical techniques, methods for evaluating chest
deformity, and incidence of associated complications. Result(s):
Among the 362 identified articles, 21 met the inclusion criteria. A total
of 2600 cases involving 2433 patients with microtia were analyzed in this
review. Perichondrium preservation during cartilage harvesting led to a
significant reduction in chest deformities. However, the wide incidence
range (0% to 50%) and the lack of specific assessment methods suggested
potential underestimation. Computed tomography revealed reduced chest wall
growth in the transverse and sagittal directions, resulting in decreased
thoracic area. Innovative surgical techniques have shown promising results
in reducing chest deformities. Conclusion(s): Although a quantitative
analysis was not feasible, objective evidence of deformities was
established through computed tomography scans. This analysis highlighted
the need for dedicated studies with larger sample sizes to further advance
our understanding of chest wall deformities in microtia
reconstruction. Copyright © 2024

<84>
Accession Number
2035610186
Title
Continuation versus discontinuation of renin-angiotensin aldosterone
system inhibitors before non-cardiac surgery: A systematic review and
meta-analysis.
Source
Journal of Clinical Anesthesia. 99 (no pagination), 2024. Article Number:
111679. Date of Publication: December 2024.
Author
Ahmed M.; Fatima E.; Shafiq A.; Ahsan A.; Zulfiqar E.; Masood F.; Ahmed
R.; Yasmin F.; Asghar M.S.
Institution
(Ahmed) Department of Medicine, Rawalpindi Medical University, Rawalpindi,
Pakistan
(Fatima) Department of Medicine, Services Institute of Medical Sciences,
Lahore, Pakistan
(Shafiq, Zulfiqar) Department of Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Ahsan) Department of Medicine, Foundation University Medical College,
Islamabad, Pakistan
(Masood) Department of Anesthesia, King Abdulaziz Medical City, Riyadh,
Saudi Arabia
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Ahmed) Department of Cardiology, National Heart and Lung Institute,
Imperial College London, United Kingdom
(Yasmin) Department of Internal Medicine, Yale University School of
Medicine, New Haven, CT, United States
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN, United States
(Asghar) Department of Internal Medicine, AdventHealth, Sebring, FL,
United States
Publisher
Elsevier Inc.
Abstract
Background: A large number of patients undergoing noncardiac surgeries are
on long-term use of angiotensin-converting enzyme inhibitors (ACEi) or
angiotensin receptor blockers (ARBs). The current guidelines regarding the
continuation or discontinuation of renin-angiotensin-aldosterone system
inhibitors (RAAS) inhibitors before noncardiac surgery are conflicting.
This meta-analysis aims to evaluate whether continuing or withholding RAAS
inhibitors before noncardiac surgery influences perioperative mortality
and complications. Method(s): A thorough literature search was
performed across PubMed/MEDLINE, Embase, and the Cochrane Library from
their inception up to August 30, 2024 to identify eligible randomized
controlled trials (RCTs) and cohort studies. Clinical outcomes were
evaluated using a random-effects model to pool odds ratios (ORs) with 95 %
confidence intervals (CIs). Result(s): The analysis included 16
studies with a total of 59,105 patients on RAAS inhibitors before
noncardiac surgery. Withholding RAAS inhibitors was associated with a
significantly lower incidence of intraoperative hypotension (OR = 0.49; 95
% CI = 0.29 to 0.83) and acute kidney injury (AKI) (OR = 0.88; 95 % CI =
0.82 to 0.95) than continuing the therapy. However, there was no
statistically significant difference in reducing mortality (OR = 1.10; 95
% CI = 0.86 to 1.40), major adverse cardiovascular events (MACE) (OR =
1.27; 95 % CI = 0.75 to 2.16), myocardial infarction (OR = 0.83; 95 % CI =
0.27 to 2.59) or stroke events (OR = 0.70; 95 % CI = 0.36 to 1.36) between
the two groups. Conclusion(s): Withholding RAAS inhibitors before
noncardiac surgery reduces intraoperative hypotension and AKI with
nonsignificant effects on mortality and MACE. Copyright © 2024

<85>
Accession Number
645883878
Title
Interventions to prevent surgical site infection in adults undergoing
cardiac surgery.
Source
Cochrane Database of Systematic Reviews. 2024(12) (no pagination), 2024.
Article Number: CD013332. Date of Publication: 02 Dec 2024.
Author
Rogers L.J.; Vaja R.; Bleetman D.; Ali J.M.; Rochon M.; Sanders J.; Tanner
J.; Lamagni T.L.; Talukder S.; Quijano-Campos J.C.; Lai F.; Loubani M.;
Murphy G.J.
Institution
(Rogers) Bristol Heart Institute, University Hospitals Bristol and Weston
NHS Foundation Trust, Bristol, United Kingdom
(Vaja) National Heart and Lung Institute, Imperial College London, London,
United Kingdom
(Vaja) Department of Cardiac Surgery, Guys and St Thomas' NHS Trust,
London, United Kingdom
(Bleetman, Sanders, Quijano-Campos) St. Bartholomew's Hospital, Barts
Health NHS Trust, London, United Kingdom
(Ali, Talukder) Department of Cardiothoracic Surgery, Royal Papworth
Hospital, Cambridge, United Kingdom
(Rochon) Directorate of Infection, Guy's and St Thomas' NHS Foundation
Trust, London, United Kingdom
(Sanders, Quijano-Campos) William Harvey Research Institute, Queen Mary
University of London, London, United Kingdom
(Tanner) School of Health Sciences, University of Nottingham, Nottingham,
United Kingdom
(Lamagni) Healthcare-Associated Infection & Antimicrobial Resistance
Division, UK Health Security Agency, London, United Kingdom
(Quijano-Campos) Royal Papworth Hospital NHS Foundation Trust, Cambridge,
United Kingdom
(Loubani) Department of Cardiothoracic Surgery, Hull and East Yorkshire
Hospitals NHS Trust, Hull, United Kingdom
(Murphy) Department of Cardiovascular Sciences, University of Leicester,
Leicester, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Surgical site infection (SSI) is a common type of
hospital-acquired infection and affects up to a third of patients
following surgical procedures. It is associated with significant mortality
and morbidity. In the United Kingdom alone, it is estimated to add another
30 million to the cost of adult cardiac surgery. Although generic guidance
for SSI prevention exists, this is not specific to adult cardiac surgery.
Furthermore, many of the risk factors for SSI are prevalent within the
cardiac surgery population. Despite this, there is currently no standard
of care for SSI prevention in adults undergoing cardiac surgery throughout
the preoperative, intraoperative and postoperative periods of care, with
variations in practice existing throughout from risk stratification,
decontamination strategies and surveillance. Objective(s):
 Primary Objective: to assess the clinical effectiveness of pre-,
intra-, and postoperative interventions in the prevention of cardiac SSI.
 Secondary Objectives: (i) to evaluate the effects of SSI prevention
interventions on morbidity, mortality, and resource use; (ii) to evaluate
the effects of SSI prevention care bundles on morbidity, mortality, and
resource use. Search Method(s): We searched the Cochrane Central
Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE
(Ovid, from inception) and Embase (Ovid, from inception) on 31 May 2021.
ClinicalTrials.gov and the WHO International Clinical Trials Registry
Platform (ICTRP) were also searched for ongoing or unpublished trials on
21 May 2021. No language restrictions were imposed. Selection
Criteria: We included RCTs evaluating interventions to reduce SSI in
adults (>= 18 years of age) who have undergone any cardiac surgery.
 Data Collection and Analysis: We followed the methods as per our
published Cochrane protocol. Our primary outcome was surgical site
infection. Our secondary outcomes were all-cause mortality, reoperation
for SSI, hospital length of stay, hospital readmissions for SSI,
healthcare costs and cost-effectiveness, quality of life (QoL), and
adverse effects. We used the GRADE approach to assess the certainty of
evidence. Main Result(s): A total of 118 studies involving 51,854
participants were included. Twenty-two interventions to reduce SSI in
adults undergoing cardiac surgery were identified. The risk of bias was
judged to be high in the majority of studies. There was heterogeneity in
the study populations and interventions; consequently, meta-analysis was
not appropriate for many of the comparisons and these are presented as
narrative summaries. We focused our reporting of findings on four
comparisons deemed to be of great clinical relevance by all review
authors. Decolonisation versus no decolonisation. Pooled data from three
studies (n = 1564) using preoperative topical oral/nasal decontamination
in all patients demonstrated an uncertain direction of treatment effect in
relation to total SSI (RR 0.98, 95% CI 0.70 to 1.36; I2 = 0%;
very low-certainty evidence). A single study reported that decolonisation
likely results in little to no difference in superficial SSI (RR 1.35, 95%
CI 0.84 to 2.15; moderate-certainty evidence) and a reduction in deep SSI
(RR 0.36, 95% CI 0.17 to 0.77; high-certainty evidence). The evidence on
all-cause mortality from three studies (n = 1564) is very uncertain (RR
0.66, 95% CI 0.24 to 1.84; I2 = 49%; very low-certainty
evidence). A single study (n = 954) demonstrated that decolonisation may
result in little to no difference in hospital readmission for SSI (RR
0.80, 95% CI 0.44 to 1.45; low-certainty evidence). A single study (n =
954) reported one case of temporary discolouration of teeth in the
decolonisation arm (low-certainty-evidence. Reoperation for SSI was not
reported. Tight glucose control versus standard glucose control. Pooled
data from seven studies (n = 880) showed that tight glucose control may
reduce total SSI, but the evidence is very uncertain (RR 0.41, 95% CI 0.19
to 0.85; I2 = 29%; numbers need to treat to benefit (NNTB) =
13; very-low certainty evidence). Pooled data from seven studies (n =
3334) showed tight glucose control may reduce all-cause mortality, but the
evidence is very uncertain (RR 0.61, 95% CI 0.41 to 0.91; I2 =
0%; very low-certainty evidence). Based on four studies (n = 2793), there
may be little to no difference in episodes of hypoglycaemia between tight
control vs. standard control, but the evidence is very uncertain (RR 2.12,
95% CI 0.51 to 8.76; I2 = 72%; very low-certainty evidence). No
studies reported superficial/deep SSI, reoperation for SSI, or hospital
readmission for SSI. Negative pressure wound therapy (NPWT) versus
standard dressings. NPWT was assessed in two studies (n = 144) and it may
reduce total SSI, but the evidence is very uncertain (RR 0.17, 95% CI 0.03
to 0.97; I2 = 0%; NNTB = 10; very low-certainty evidence). A
single study (n = 80) reported reoperation for SSI. The relative effect
could not be estimated. The certainty of evidence was judged to be very
low. No studies reported superficial/deep SSI, all-cause mortality,
hospital readmission for SSI, or adverse effects. Topical antimicrobials
versus no topical antimicrobials. Five studies (n = 5382) evaluated
topical gentamicin sponge, which may reduce total SSI (RR 0.62, 95% CI
0.46 to 0.84; I2 = 48%; NNTB = 32), superficial SSI (RR 0.60,
95% CI 0.37 to 0.98; I2 = 69%), and deep SSI (RR 0.67, 95% CI
0.47 to 0.96; I2 = 5%; low-certainty evidence. Four studies (n
= 4662) demonstrated that topical gentamicin sponge may result in little
to no difference in all-cause mortality, but the evidence is very
uncertain (RR 0.96, 95% CI 0.65 to 1.42; I2 = 0%; very
low-certainty evidence). Reoperation for SSI, hospital readmission for
SSI, and adverse effects were not reported in any included studies.
Authors' conclusions: This review provides the broadest and most recent
review of the current evidence base for interventions to reduce SSI in
adults undergoing cardiac surgery. Twenty-one interventions were
identified across the perioperative period. Evidence is of low to very low
certainty primarily due to significant heterogeneity in how interventions
were implemented and the definitions of SSI used. Knowledge gaps have been
identified across a number of practices that should represent key areas
for future research. Efforts to standardise SSI outcome reporting are
warranted. Copyright © 2024 The Cochrane Collaboration. Published
by John Wiley & Sons, Ltd.

<86>
Accession Number
2032308340
Title
Colchicine in post-operative Fontan patients.
Source
Cardiology in the Young. 33(6) (pp 910-916), 2023. Date of Publication: 20
Jun 2023.
Author
Goldstein S.A.; Nolan K.; Marchetti K.; Stoscup J.K.; Clewis H.; Jarvis
K.; Halligan N.L.N.; Dahmer M.K.; Schumacher K.R.; Rocchini A.
Institution
(Goldstein) University of Utah, Primary Children's Hospital, Department of
Pediatrics, Division of Pediatric Critical Care, Salt Lake City, UT,
United States
(Nolan, Marchetti, Stoscup, Clewis, Jarvis, Schumacher, Rocchini)
University of Michigan, C.S. Mott Children's Hospital, Department of
Pediatrics, Division of Pediatric Cardiology, Ann Arbor, MI, United States
(Halligan, Dahmer) University of Michigan, C.S. Mott Children's Hospital,
Department of Pediatrics, Division of Pediatric Critical Care, Ann Arbor,
MI, United States
Publisher
Cambridge University Press
Abstract
Background: Prolonged effusions post-Fontan procedure are associated with
morbidity. Fontan patients have higher pro-inflammatory cytokines in chest
tube drainage compared to controls. Colchicine, an anti-inflammatory
medication, decreases effusions in adults after cardiac surgery. We
hypothesised that patients post-Fontan treated with colchicine would have
decreased pro-inflammatory cytokine levels and shorter duration of chest
tube drainage. Method(s): This pilot clinical trial enrolled nine
patients (intention to treat); five completed the protocol (per protocol).
Post-operative Fontan patients 20 months to 5 years receiving colchicine
were compared to a previously published control cohort (n = 25). Per
protocol patients received 0.6 mg colchicine daily starting post-operative
day 2, ending 1 day after chest tube removal. Chest tube samples were
taken on days 1-4, 7 and 10, or until removal and analysed with a
17-cytokine Bio-Plex Assay. Descriptive statistics and basic univariate
comparisons were made. Result(s): There was no difference in duration
of chest tube drainage or length of stay between intention to treat
patients and controls. Per protocol patients had shorter duration of chest
tube drainage compared to controls (6 days [interquartile range 4.7-7],
versus 10 days [7-11], p = 0.007) and shorter length of stay (7 days
[5.5-9] versus 9 days [9-13], p = 0.005). Pro-inflammatory cytokines
trended lower in per protocol patients. Conclusion(s): In this pilot
cohort, patients who completed the colchicine protocol post-Fontan
procedure had shortened duration of chest tube drainage and length of
stay. A decrease of pro-inflammatory cytokines may contribute to the
mechanism of this change. ClinicalTrials.gov: Colchicine in Postoperative
Fontan Patients (CPFP); NCT03575572;
https://clinicaltrials.gov/ct2/show/NCT03575572. Copyright © The
Author(s), 2022. Published by Cambridge University Press.

<87>
Accession Number
2036120731
Title
Short Versus One-Year Dual Antiplatelet Therapy After Percutaneous
Coronary Intervention: an Updated Meta-Analysis.
Source
American Journal of Cardiology. 237 (pp 17-28), 2025. Date of Publication:
15 Feb 2025.
Author
Joseph M.; Krishna M.M.; Ezenna C.; Pereira V.; Ismayl M.; Nanna M.G.;
Bangalore S.; Goldsweig A.M.
Institution
(Joseph, Krishna) Department of Medicine, Medical College
Thiruvananthapuram, India
(Ezenna) Department of Medicine, Baystate Medical Center, University of
Massachusetts - Baystate, Springfield, Massachusetts, United States
(Pereira) Faculty of Medicine, Universidad Austral, Pilar, Argentina
(Ismayl) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
Minnesota, United States
(Nanna) Section of Cardiovascular Medicine, Yale School of Medicine, New
Haven, Connecticut, United States
(Bangalore) Division of Cardiovascular Medicine, New York University
Grossman School of Medicine, New York, United States
(Goldsweig) Division of Cardiovascular Medicine, Baystate Medical Center,
University of Massachusetts - Baystate, Springfield, Massachusetts, United
States
Publisher
Elsevier Inc.
Abstract
The present guidelines recommend dual antiplatelet therapy (DAPT) for 6 to
12 months after percutaneous coronary intervention (PCI), with recent
trials assessing the safety and efficacy of shortening DAPT duration to
<=3 months. A systematic search of PubMed, Scopus, and Cochrane Central
databases identified studies comparing short DAPT, followed by P2Y12i
monotherapy (78% ticagrelor) versus standard 12-month DAPT in patients who
underwent PCI with a drug-eluting stent. A total of 9 randomized
controlled trials, including 42,770 patients (short DAPT n = 21,370,
49.96%), of whom 28,307 (66.18%) presented with acute coronary syndrome
(ACS). Short DAPT significantly reduced net adverse clinical events
(NACEs) (risk ratio [RR] 0.78, 95% confidence interval [CI] 0.67 to 0.91,
p = 0.001, I2 = 62%), major bleeding (RR 0.54, 95% CI 0.39 to
0.73, p <0.001, I2 = 63%), and any bleeding (RR 0.55, 95% CI
0.43 to 0.72, p <0.001, I2 = 77%) at 12 months compared with
1-year DAPT. No significant differences were observed in major adverse
cardiovascular/cerebrovascular events, myocardial infarction, stroke,
stent thrombosis, mortality, or revascularization. Ticagrelor monotherapy
after short DAPT further reduced major adverse
cardiovascular/cerebrovascular events (RR 0.85, 95% CI 0.73 to 0.99, p =
0.040, I2 = 22%), NACE (RR 0.74, 95% CI 0.61 to 0.89, p = 0.001, I2 =
68%), and major bleeding (RR 0.56, 95% CI 0.40 to 0.78, p <0.001, I2 =
71%) compared with 1-year DAPT; however, the test for subgroup interaction
(P<inf>interaction</inf> >0.05) for clopidogrel subgroup was not
significant. P2Y12i monotherapy reduced the risk of NACEs (RR 0.77, 95%CI
0.66 to 0.90, p = 0.001, I2 = 52%, P<inf>interaction</inf> =
0.58) and major bleeding (RR 0.44, 95%CI 0.35 to 0.55, p <0.001,
I2 = 0%, P<inf>interaction</inf> <0.01) in the ACS cohort but
not in the chronic coronary syndrome cohort. In conclusion, short DAPT for
<=3 months followed by P2Y12i monotherapy (particularly, ticagrelor) was
associated with decreased NACEs and bleeding without differences in other
outcomes and should be considered a favorable option in patients with
either ACS or chronic coronary syndrome after PCI with a drug-eluting
stent. Copyright © 2024 Elsevier Inc.

<88>
Accession Number
2036090935
Title
Impact of pre-admission physical activity on benefits of physiology-guided
complete revascularization in older patients with myocardial infarction:
insights from the FIRE trial.
Source
European Journal of Preventive Cardiology. 31(12) (pp 1451-1459), 2024.
Date of Publication: 01 Sep 2024.
Author
Pavasini R.; Campo G.; Serenelli M.; Tonet E.; Guiducci V.; Escaned J.;
Moreno R.; Casella G.; Cavazza C.; Varbella F.; Sacchetta G.; Arena M.;
Santos I.A.; Ibanes E.G.; Scarsini R.; D'Amico G.; Ruiz-Poveda F.L.; Diez
Gil J.L.; Pignatelli G.; Iannopollo G.; Colaiori I.; Santos R.C.; Marrone
A.; Fileti L.; Rigattieri S.; Barbato E.; Ocaranza-Sanchez R.; Biscaglia
S.
Institution
(Pavasini, Campo, Serenelli, Tonet, Marrone, Biscaglia) Cardiology Unit,
Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro 8, Ferrara
44124, Italy
(Guiducci, Pignatelli) Cardiology Unit, Azienda USL-IRCCS Reggio Emilia,
S. Maria Nuova Hospital, Viale Risorgimento 80, Reggio Emilia 42123, Italy
(Escaned) Cardiovascular Department, Hospital Clinico San Carlos, IDISCC,
Complutense University of Madrid, Calle del Prof Martin Lagos s/n, Madrid
28040, Spain
(Moreno) Interventional Cardiology, University Hospital La Paz, Paseo La
Castellana, 261, Madrid 28046, Spain
(Casella, Iannopollo) Cardiology Unit, Ospedale Maggiore, Largo Nigrisoli
2, Bologna 40133, Italy
(Cavazza) Cardiovascular Department, Infermi Hospital, Viale Luigi
Settembrini 2, Rimini 47923, Italy
(Varbella) Interventional Cardiology Unit, San Luigi Gonzaga University
Hospital, Orbassano, and Rivoli Infermi Hospital ASLTO3, Rivoli 10098,
Italy
(Sacchetta) Cardiology Unit, Umberto I Hospital, ASP Siracusa, Via
Giuseppe Testaferrata, 1, Siracusa 96100, Italy
(Arena) S.C. Cardiologia, Ospedale Sant'Andrea, ASL5 Liguria, La Spezia
19124, Italy
(Santos) Department of Cardiology, Centro de Investigacion Biomedica en
Red en Enfermedades Cardiovasculares (CIBERCV), Hospital Clinico
Universitario, Av. Ramon y Cajal, 3, Valladolid 47003, Spain
(Ibanes) Department of Cardiology, Centro de Investigation Biomedica end
Red en Enfermedades Cardiovasculares, H. Universitario y Politecnico La
Fe, Valencia 46026, Spain
(Scarsini) Cardiovascular Department, Azienda Ospedaliero Universitaria
Integrata di Verona, Piazzale Aristide Stefani, 1, Verona 37126, Italy
(D'Amico) Interventional Cardiology, Department of Cardio-Thoracic and
Vascular Sciences, Ospedale dell'Angelo, Via Paccagnella, 12, Venice,
Mestre 35128, Italy
(Ruiz-Poveda) Cardiovascular Department, Hospital General Universitario de
Ciudad Real, Ciudad Real 13001, Spain
(Diez Gil) Cardiology Unit, Hospital San Giovanni di Dio, Azienda
Sanitaria Provinciale Agrigento, Agrigento 92100, Italy
(Colaiori) Cardiology Unit, Ospedale Santa Maria Goretti, Via Lucia
Scaravelli, Latina 04100, Italy
(Santos) Department of Interventional Cardiology, Complexo Hospitalario
Universitario A Coruna (CHUAC), As Xubias, 84, A Coruna 15006, Spain
(Fileti) Cardiology Department, S. Maria delle Croci Hospital, Viale Randi
5, Ravenna 48121, Italy
(Rigattieri, Barbato) Department of Clinical and Molecular Medicine,
Sapienza University of Rome, Via di Grottarossa, 1035/1039, Roma 00189,
Italy
(Ocaranza-Sanchez) Servicio de Cardiologia, Hospital Universitario Lucus
Augusti, Lugo 27001, Spain
Publisher
Oxford University Press
Abstract
Aims. The present analysis from the Functional Assessment in Elderly
Myocardial Infarction Patients with Multivessel Disease (FIRE) trial aims
to explore the significance of pre-admission physical activity and assess
whether the benefits of physiology-guided complete revascularization apply
consistently to sedentary and active older patients. Methods and results.
Patients aged 75 years or more with myocardial infarction (MI) and
multivessel disease were randomized to receive physiology-guided complete
revascularization or culprit-only strategy. The primary outcome was a
composite of death, MI, stroke, or any revascularization within a year.
Secondary endpoints included the composite of cardiovascular death or MI,
as well as single components of the primary endpoint. Pre-admission
physical activity was categorized into three groups: (i) absent
(sedentary), (ii) light, and (iii) vigorous. Among 1445 patients, 692
(48%) were sedentary, whereas 560 (39%) and 193 (13%) performed light and
vigorous physical activity, respectively. Patients engaging in light or
vigorous pre-admission physical activity exhibited a reduced risk of the
primary outcome compared with sedentary individuals [light hazard ratio
(HR) 0.70, 95% confidence interval (CI) 0.55-0.91 and vigorous HR 0.14,
95% CI 0.07-0.91, respectively]. These trends were also observed for
death, cardiovascular death, or MI. When comparing physiology-guided
complete revascularization vs. culprit-only strategy, no significant
interaction was observed for primary and secondary endpoints when
stratified by sedentary or active status. Conclusion. In older patients
with MI, pre-admission physical activity emerges as a robust and
independent prognostic determinant. Physiology-guided complete
revascularization stands out an effective strategy in reducing ischaemic
adverse events, irrespective of pre-admission physical activity status.
Clinical Trial Registration. Copyright © The Author(s) 2024.
Published by Oxford University Press on behalf of the European Society of
Cardiology. All rights reserved.

<89>
Accession Number
2032185990
Title
The Efficacy of Liposomal Bupivacaine in Thoracic Surgery: A Systematic
Review and Meta-Analysis.
Source
Journal of Pain Research. 17 (pp 4039-4051), 2024. Date of Publication:
2024.
Author
Gong R.; Tan G.; Huang Y.
Institution
(Gong, Tan, Huang) Department of Anesthesiology, Peking Union Medical
College Hospital, Beijing 100730, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Patients undergoing thoracic surgery suffer from severe
postoperative pain, and a series of complications will occur if there is
no effective analgesic treatment. Liposomal bupivacaine (LB) is a novel
multivesicular formulation with up to 72 hours of analgesia, which can be
used in thoracic surgery. This meta-analysis aimed to evaluate the
efficacy of LB in improving recovery in patients undergoing thoracic
surgery compared with non-liposomal local anesthetics. Patients and
Methods: A literature search was conducted using PubMed, Cochrane Library,
Embase, and Web of science, and to identify all observational or
retrospective studies and randomized controlled trials (RCTs) from
inception to December 2023. The primary outcome was the in-hospital
postsurgical opioid consumption in morphine milligram equivalents (MMEs).
Secondary outcomes included 24-hour postoperative MMEs, postoperative pain
score in the first 24 and 48 hours, hospital length of stay (LOS), time to
first ambulation, readmission, and perioperative complications. RevMan 5.3
was used for the data analysis. Result(s): A total of 10 studies were
included in the analysis, of which eight were observational or
retrospective analyses and two were RCTs. There were no significant
differences in the postoperative MMEs, pain score, LOS, time to first
ambulation, readmission, and perioperative complications.
 Conclusion(s): According to this meta-analysis, LB was found to be
not superior to non-liposomal local anesthetics for analgesic and
functional outcomes in thoracic surgery. Copyright © 2024 Gong et
al.

<90>
Accession Number
2029857636
Title
Management of urothelial cancer in patients with chronic kidney disease
receiving platinum-based chemotherapy.
Source
Future Oncology. 20(36) (pp 2889-2899), 2024. Date of Publication: 2024.
Author
TO'Dwyer R.; Jiang D.M.; Kitchlu A.; Coulombe A.M.; Sridhar S.S.
Institution
(T O'Dwyer, Jiang, Sridhar) Division of Medical Oncology, Department of
Medicine, Princess Margaret Cancer Centre, University Health Network,
University of Toronto, Toronto, ON, Canada
(Kitchlu) Division of Nephrology, Department of Medicine, Toronto General
Hospital, University Health Network, University of Toronto, Toronto, ON,
Canada
(Coulombe) Division of Medical Oncology, Department of Medicine, Centre
Integre de Cancerologie-CHU de Quebec, Universite Laval Hospital Network,
Quebec, Canada
Publisher
Taylor and Francis Ltd.
Abstract
Despite recent advances in the management of urothelial cancer (UC),
cisplatin-based combination chemotherapy regimens remain critical.
However, their use can be complicated in patients with chronic kidney
disease (CKD), which is not uncommon in UC patients. Based on the Galsky
criteria for cisplatin ineligibility, most patients with CKD will be
excluded from receiving cisplatin-based chemotherapy altogether. For
patients with borderline kidney function, several strategies - such as the
use of split-dose cisplatin, dose reductions, or extra hydration - may
facilitate the use of cisplatin, but these need to be prospectively
validated. This review highlights the critical need for a
multidisciplinary team, including onco-nephrologists, to help manage renal
complications and optimize delivery of cancer care in complex UC patients
with CKD. Copyright © 2024 Informa UK Limited, trading as Taylor
& Francis Group.

<91>
Accession Number
2035619319
Title
EJPC @ a glance: focus issue on lipid disorders and cardiovascular
prevention.
Source
European Journal of Preventive Cardiology. 31(15) (pp 1775-1777), 2024.
Date of Publication: 01 Oct 2024.
Author
Fauvel C.; Aboyans V.
Institution
(Fauvel) Department of Cardiology, Rouen University Hospital, 1 Rue de
Germont, Rouen F-76000, France
(Fauvel) Inserm EnVI U1096, Rouen University Hospital, Boulevard Gambetta,
Rouen F-76000, France
(Aboyans) Department of Cardiology, Dupuytren University Hospital, 2,
Martin Luther King Ave, Limoges 87042, France
(Aboyans) EpiMaCT Research Group, Inserm 1094 & IRD 270, Limoges
University, 2, Marcland Ave, Limoges 87025, France
Publisher
Oxford University Press

<92>
Accession Number
2035619317
Title
Effects of omega-3 fatty acids on coronary revascularization and
cardiovascular events: is there a role for fibrates? A reply.
Source
European Journal of Preventive Cardiology. 31(15) (pp e112), 2024. Date of
Publication: 01 Oct 2024.
Author
Ambrosio G.
Institution
(Ambrosio) Division of Cardiology, University of Perugia School of
Medicine, Piazzale Menghini 1, Perugia 06126, Italy
Publisher
Oxford University Press

<93>
Accession Number
2035283409
Title
The prevalence, incidence and risk factors of medical adhesive-related
skin injury in adult inpatients: A systematic review and meta-analysis.
Source
Journal of Tissue Viability. 33(4) (pp 960-967), 2024. Date of
Publication: November 2024.
Author
Wang P.; Luo X.; Chen H.; Feng Q.; Song H.
Institution
(Wang, Luo, Chen, Feng, Song) Nanfang Hospital, Southern Medical
University, China
Publisher
Tissue Viability Society
Abstract
Background: MARSI can occur in any population and clinical setting and is
prevalent among patients who are frequently exposed to medical adhesives.
It can disrupt the skin barrier and cause pain and infection, confusing
patients and medical staff and making it necessary to understand its
prevalence, incidence, and risk factors to improve patient health and
medical safety. Objective(s): To systematically evaluate the
prevalence, incidence and risk factors of medical adhesive-related skin
injury in adult inpatients. Design(s): Systematic literature review
and meta-analysis. Method(s): A computer search was conducted on nine
databases in both Chinese and English, covering studies from inception to
July 10, 2024, evaluating the prevalence, incidence and risk factors of
medical adhesive-related skin injuries. Meta-analyses were performed using
Review Manager 5.4 and Stata 14 software. Result(s): The analysis
included 22 studies, involving a total of 10510 research subjects. The
meta-analysis of fourteen cross-sectional studies showed that the
prevalence of medical adhesive-related skin injury in adult inpatients was
16 % [95 % CI: 13-18 %, Z = 10.95, P < 0.00001]. In the other seven
additional cohort studies, the meta-analysis of incidence was 25 % [95 %
CI: 17-33 %, Z = 5.90, P < 0.00001]. The results of the meta-analysis of
risk factors showed that the following six factors: age>50 years (OR =
1.21, 95%CI: 1.05-1.41), dry skin (OR = 3.51, 95%CI: 1.55-7.95), history
of MARSI (OR = 6.78, 95%CI: 1.69-27.15), history of skin allergies (OR =
3.82, 95%CI: 1.92-7.57), skin edema(OR = 3.59,95%CI:1.52-8.47), wet
skin(OR = 3.57,95%CI:1.65-13.35) were risk factors. Copyright ©
2024 Tissue Viability Society / Society of Tissue Viability

<94>
Accession Number
2036121155
Title
Using ChatGPT to perform a systematic review: a tutorial.
Source
Minerva Cardiology and Angiology. 72(6) (pp 547-567), 2024. Date of
Publication: December 2024.
Author
Teperikidis L.; Boulmpou A.; Papadopoulos C.; Biondi-Zoccai G.
Institution
(Teperikidis, Boulmpou, Papadopoulos) Third Department of Cardiology,
Ippokratio General Hospital, Aristotle University of Thessaloniki,
Thessaloniki, Greece
(Teperikidis) Clinical Research Unit, Special Unit for Biomedical Research
and Education (SUBRE), School of Medicine, Aristotle University of
Thessaloniki, Thessaloniki, Greece
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University, Latina, Italy
(Biondi-Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola,
Ravenna, Italy
Publisher
Edizioni Minerva Medica
Abstract
This tutorial provides a comprehensive guide on leveraging ChatGPT for
systematic literature reviews, leveraging actual applications in
cardiovascular research. Systematic reviews, while essential, are
resource-intensive, and ChatGPT offers a potential solution to streamline
the process. The tutorial covers the entire review process, from
preparation to finalization. In the preparation phase, ChatGPT assists in
defining research questions and generating search strings. During the
screening phase, ChatGPT can efficiently screen titles and abstracts,
processing multiple abstracts simultaneously. The tutorial also introduces
an intermediate step of generating study summaries that leads to the
generation of reliable data extraction tables. For assessing the risk of
bias, ChatGPT can be prompted to perform these tasks. Using each tool's
explanation document to generate an appropriate prompt is an efficient
method of reliable risk of bias assessments using ChatGPT. However, users
are cautioned about potential hallucinations in ChatGPT's outputs and the
importance of manual validation. The tutorial emphasizes the need for
vigilance, continuous refinement, and gaining experience with ChatGPT to
ensure accurate and reliable results. The methods presented have been
successfully tried in several projects, but they remain in nascent stages,
with ample room for improvement and refinement. Copyright © 2024
EDIZIONI MINERVA MEDICA.

<95>
Accession Number
640244831
Title
Efficacy and Safety of Oral Hydration 1 Hour After Extubation of Patients
Undergoing Cardiac Surgery: A Randomized Controlled Trial.
Source
The Journal of cardiovascular nursing. 40(1) (pp E1-E8), 2025. Date of
Publication: 01 Jan 2025.
Author
Liang T.; Li S.-L.; Peng Y.-C.; Chen Q.; Chen L.-W.; Lin Y.-J.
Abstract
BACKGROUND: Thirst is one of the most common and uncomfortable symptoms in
patients after cardiac surgery. The postextubation time for early oral
hydration (EOH) remains unclear, and there is a lack of studies on its
safety and effectiveness. OBJECTIVE(S): The aim of this study was to
investigate the effects of oral hydration 1 hour after extubation on
thirst, salivary pH, salivary flow, oral mucosa, halitosis,
gastrointestinal adverse reactions, aspiration pneumonia, and satisfaction
in patients undergoing cardiac surgery. METHOD(S): Eighty-four
patients who underwent cardiac surgery were randomly assigned into 2
groups, for either conventional oral hydration (COH) or EOH. The EOH group
drank 30 mL of warm water 1 hour post extubation and thereafter 50 mL
hourly for 4 hours. The COH group had nil per os for 4 hours after
extubation. If no dysphagia was evident after 4 hours, the patients were
instructed to slowly drink water. Thirst intensity was evaluated every
hour before the intervention. Nausea and vomiting were recorded after
drinking water. The salivary pH, unstimulated salivary flow rate, oral
odor, and oral mucosal moisture were evaluated at 1 hour post extubation,
immediately before the intervention, and at 4 hour post intervention.
Aspiration pneumonia data were collected within 72 hours post
intervention. Satisfaction was assessed before leaving the intensive care
unit. RESULT(S): The scores for thirst (3.38 +/- 1.04; F = 306.21, P
< .001), oral mucosa (2.03 +/- 0.74; P < .001), and halitosis (2.77 +/-
0.63; P < .001) in the EOH group were significantly lower than those in
the COH group. The EOH group had significantly higher salivary pH (6.44
+/- 1.06; P < .001), unstimulated salivary flow rates (0.18 +/- 0.08; P <
.001), and patient satisfaction (4.28 +/- 0.45; P < .001) than the COH
group. Nausea and vomiting did not differ significantly between groups ( P
= .60). Aspiration pneumonia was not observed in either group.
 CONCLUSION(S): Oral hydration 1 hour after extubation significantly
alleviated thirst and stabilized the oral environment without
gastrointestinal adverse reactions or aspiration pneumonia, and with
increased patient satisfaction. Copyright © 2022 Wolters Kluwer
Health, Inc. All rights reserved.

<96>
Accession Number
2036069254
Title
Effect of PCSK9 inhibitors on major cardiac adverse events and
lipoprotein-a in patients with coronary heart disease: A meta-analysis.
Source
Coronary Artery Disease. (no pagination), 2024. Article Number:
10.1097/MCA.0000000000001464. Date of Publication: 2024.
Author
Hu E.; Wan M.
Institution
(Hu) Department of Pharmacy, The Sixth Hospital of Wuhan, Affiliated
Hospital of Jianghan University, Hubei Province, Wuhan, China
(Wan) Department of the Second Clinic, The 940 Hospital of Joint Logistics
Support Force of Chinese PLA, Gansu Province, Lanzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background Lipoprotein(a) [Lp(a)] is an independent risk factor for
cardiovascular disease due to its unique apo(a) component and its
association with atherosclerosis and thrombogenesis. This meta-analysis
was conducted to evaluate the effects of PCSK9 inhibitors on major adverse
cardiac events (MACE) and Lp(a) levels in patients with coronary heart
disease. Methods Randomized controlled trials (RCTs) were systematically
searched in PubMed, the Cochrane Library, and other databases. Stata 15.1
software was used for data analysis, and a random- or fixed-effects model
was selected based on inter-study heterogeneity. Egger's test was applied
to detect publication bias. Results A total of 12 RCTs were included,
involving 48 116 patients with a mean age of 62 years, comprising 65%
males and diverse ethnic backgrounds. The results showed that compared
with the control group, PCSK9 inhibitors significantly reduced low-density
lipoprotein cholesterol (WMD = -1.24 mmol/L, 95% confidence interval (CI):
-1.28 to -1.20), total cholesterol, triglycerides, and Lp(a) levels while
increasing high-density lipoprotein cholesterol levels. In terms of
safety, there was no increased risk of adverse reactions other than
injection site reactions. For MACE, PCSK9 inhibitors significantly reduced
the risk of nonfatal myocardial infarction, stroke, and coronary
revascularization events (RR = 0.87, 95% CI: 0.84-0.89). Conclusion PCSK9
inhibitors not only significantly improve blood lipid profiles and reduce
Lp(a) levels but also reduce the risk of MACE in patients with coronary
heart disease. Therefore, PCSK9 inhibitors offer an effective and safe
treatment option for these patients. Copyright © 2024 Wolters
Kluwer Health, Inc. Unauthorized reproduction of this article is
prohibited.

<97>
Accession Number
2032458521
Title
Effect of Kuanxiong Aerosol on Perioperative Coronary Microcirculation in
Patients with Unstable Angina Undergoing Elective PCI: A Pilot Randomized
Controlled Trial.
Source
Chinese Journal of Integrative Medicine. (no pagination), 2024. Date of
Publication: 2024.
Author
Liu Z.-H.; Xing W.-L.; Liu H.-X.; Shang J.-J.; Li A.-Y.; Zhou Q.; Zhang
Z.-M.; Li Z.-B.; Chen K.-J.
Institution
(Liu, Xing, Liu, Shang, Li, Zhou, Zhang, Li) Cardiovascular Department,
Beijing Hospital of Traditional Chinese Medicine, Capital Medical
University, Beijing 100010, China
(Chen) Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing
100091, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To evaluate the immediate effect of Kuanxiong Aerosol (KXA) on
perioperative coronary microcirculation in patients with unstable angina
(UA) suffering from elective percutaneous coronary intervention (PCI).
 Method(s): From February 2021 to July 2023, UA inpatients who
underwent PCI alone in the left anterior descending (LAD) branch were
included. Random numbers were generated to divide patients into the trial
group and the control group at a ratio of 1:1. The index of coronary
microcirculation resistance (IMR) was measured before PCI, and the trial
group was given two sprays of KXA, while the control group was not given.
IMR was measured again after PCI, cardiac troponin I (cTnI) and creatine
kinase isoenzyme-MB (CK-MB) were detected before and 24 h after surgery,
and major cardiovascular adverse events (MACEs) were recorded for 30 days.
The data statistics and analysis personnel were blinded. Result(s):
Totally 859 patients were screened, and 62 of them were involved into this
study. Finally, 1 patient in the trial group failed to complete the
post-PCI IMR and was excluded, 30 patients were included for data
analysis, while 31 patients in the control group were enrolled in data
analysis. There was no significant difference in baseline data (age,
gender, risk factors, previous history, biochemical index, and drug
therapy, etc.) between the two groups. In addition, differences in IMR,
cTnI and CK-MB were not statistically significant between the two groups
before surgery. After PCI, the IMR level of the trial group was
significantly lower than that of the control group (19.56 +/- 14.37 vs.
27.15 +/- 15.03, P=0.048). Besides, the incidence of perioperative
myocardial injury (PMI) was lower in the trial group, but the difference
was not statistically significant (6.67% vs. 16.13%, P=0.425). No MACEs
were reported in either group. Conclusion(s): KXA has the potential
of improving coronary microvascular dysfunction. This study provides
reference for the application of KXA in UA patients undergoing elective
PCI. (Registration No. ChiCTR2300069831) Copyright © The Chinese
Journal of Integrated Traditional and Western Medicine Press and
Springer-Verlag GmbH Germany, part of Springer Nature 2024.

<98>
Accession Number
2035126736
Title
Platelet-sparing properties of aprotinin: A scoping review on mechanisms
and clinical effects.
Source
European Journal of Anaesthesiology. (no pagination), 2024. Article
Number: 10.1097/EJA.0000000000002081. Date of Publication: 2024.
Author
Vanglabeke L.L.W.; Rex S.; Van Den Eynde R.
Institution
(Vanglabeke, Rex, Van Den Eynde) The Department of Cardiovascular
Sciences, KU Leuven, Leuven, Belgium
(Vanglabeke, Rex, Van Den Eynde) The Department of Anesthesiology,
University Hospital of the KU Leuven, Leuven, Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND Cardiac surgery involving cardiopulmonary bypass (CPB) is
associated with the risk of acquired coagulopathy, including dysregulated
fibrinolysis, which can result in life-threatening bleeding complications.
Aprotinin, an antifibrinolytic agent, has been recommended for the
prevention of these complications. Its effectiveness has been attributed
to its ability to nonspecifically inhibit various serine proteases
involved in the coagulation and fibrinolysis cascade. Additionally,
aprotinin may protect platelets from CPB-induced dysfunction through a
platelet-sparing effect, further enhancing its efficacy. OBJECTIVES The
biochemical pathways underlying aprotinin's platelet-sparing effect remain
unclear. Furthermore, it is uncertain to what extent this effect
contributes to reducing blood loss and need for transfusion. DESIGN A
scoping review DATA SOURCES MEDLINE, Embase and Cochrane were searched
from inception until 21 December 2023. ELIGIBILITY CRITERIA Studies in
which a platelet-sparing effect of aprotinin was investigated. These
included systematic reviews; experimental, and observational studies
describing healthy humans, patients, or animals undergoing any type of
surgery; studies in which donated blood was used for in-vitro studies.
RESULTS Sixty-four studies were deemed eligible, the majority of which
observed a platelet-sparing effect, attributing it to the inhibition of
platelet aggregation (via protection of glycoprotein (GP) IIb/IIIa
receptors), platelet adhesion (by protection of GP Ib receptors), both
aggregation and adhesion receptors, proteolysis of protease-activated
receptor 1 receptors, platelet activation (by inhibition of plasmin) and
platelet activation (by inhibition of thrombin). A dose-dependency of the
platelet-sparing effect was investigated in both in-vitro studies and
randomised controlled trials, yielding mixed results. No studies have
explored the relative contribution of aprotinin's platelet-sparing effect
and its antifibrinolytic effect in reducing blood loss and need for
transfusion. CONCLUSIONS This review elucidated current knowledge on how
aprotinin influences platelets and exerts its platelet-sparing effect,
while highlighting gaps in the existing literature. Copyright ©
2024 European Society of Anaesthesiology and Intensive Care. Unauthorized
reproduction of this article is prohibited.

<99>
Accession Number
2032490562
Title
Hemoadsorption during cardiopulmonary bypass to absorb plasma-free
hemoglobin in patients with acute type a aortic dissection: A randomized
controlled trial.
Source
Perfusion (United Kingdom). (no pagination), 2024. Date of Publication:
2024.
Author
Bao Y.; Wang X.; Zi Y.; Qian X.; Li Y.; Li S.; Wang Z.
Institution
(Bao, Wang, Zi, Qian, Li, Li, Wang) Department of Cardiovascular Surgery,
Yan'an Affiliated Hospital of Kunming Medical University, Kunming, China
(Bao, Wang, Zi, Qian, Li, Li, Wang) Key Laboratory of Cardiovascular
Disease of Yunnan Province, China
Publisher
SAGE Publications Ltd
Abstract
Aims: This study aimed to investigate the effect of hemoadsorption (HA) on
plasma-free hemoglobin (pfHb) levels during cardiopulmonary bypass (CPB)
and the clinical outcomes in patients with acute type A aortic dissection
(ATAAD). Method(s): In this single-center randomized trial, patients
were assigned to either a group using the HA380 device or a control group
without it. The primary outcome was changes in pfHb levels during CPB and
within the first 48 hours after surgery. The study concentrated on
comparing compared the data between the two groups using analysis of
variance for repeated measures. Concurrently, both correlation and linear
regression analyses were employed to identify the factors influencing pfHb
levels. Result(s): The mean pfHb concentration was lower in the HA380
group than in the control group,but there were no significant differences
between the two groups (F = 2.883, 95% confidence interval CI: -0.006 to
0.072, p =.093) using a repeated measures analysis of covariance model.
Linear regression analysis identified body mass index (BMI) as the primary
factor influencing the adsorption effect (B = 0.01, 95% CI: 0.36-1.24, p
=.001). Additionally, the major postoperative complications within the
first 48 hours did not show significant differences between the groups,
including acute kidney injury (AKI) (25% HA380 group vs 36% control group,
p =.261) and postoperative liver dysfunction (PLD) (5% HA380 group vs 16%
control group, p =.106). Conclusion(s): The use of the HA380 device
in CPB during cardiac operations may contribute to reduced pfHb levels.
However, the difference was statistically non-significant because pfHb
adsorption was notably influenced by the patient's BMI. Consequently, BMI
should be considered when deploying HA380 in prolonged CPB procedures,
including ATADD repair. Enhancing either the number of devices or the
duration of HA in patients with overweight or obesity may potentially
improve postoperative clinical outcomes. Copyright © The
Author(s) 2024.

<100>
Accession Number
645961033
Title
Effect of serratus anterior plane block combined with oxycodone for
transition analgesia on preventing emergence agitation after
video-assisted thoracoscopic surgery: a randomized controlled trial.
Source
Scientific reports. 14(1) (pp 30016), 2024. Date of Publication: 03 Dec
2024.
Author
Wang T.; Wang Q.-B.; Hou Z.-J.; Chen W.; Cheng H.; He J.-K.; Zhu L.-L.;
Wang Y.-L.; Chen Y.-Q.
Institution
(Wang, Wang, Hou, Chen, Cheng, He, Zhu, Wang, Chen) Department of
Anesthesiology, Yijishan Hospital, Wannan Medical College, Wuhu 241001,
China
Abstract
Emergence agitation (EA) is more commonly observed after thoracic
surgeries and can lead to serious complications. This study aimed to
evaluate the effectiveness of serratus anterior plane block (SAPB)
combined with oxycodone for transitional analgesia in preventing EA after
video-assisted thoracoscopic surgery (VATS). A total of 121 adult patients
scheduled for VATS under one-lung ventilation anesthesia were enrolled and
randomly divided into three groups: preoperative SAPB without opioids for
transitional analgesia near the end of the surgery (SAPB+SAL group, n=39);
preoperative SAPB with sufentanil at 0.1 microg/kg for transitional
analgesia (SAPB+SF group, n=42); and preoperative SAPB with oxycodone at
0.1 mg/kg for transitional analgesia (SAPB+OCD group, n=40). In primary
outcomes, the incidences of EA in the SAPB+SAL, SAPB+SF, and SAPB+OCD
groups were 38.5%, 28.6%, and 7.5% respectively. There was a statistically
significant difference in EA incidence between the SAPB+OCD and SAPB+SF
groups (P=0.0136). In secondary outcomes, compared to the SAPB+SF group,
the SAPB+OCD group experienced shorter tracheal extubation time [15(9, 25)
min vs. 21.5(14.5, 32.5) min; P=0.0473] and PACU stay [67.5(55.0, 85.0)
min vs. 87.5(70.0, 110.0) min; P=0.0026]; lower NRS scores at 15 min and 2
h post-extubation (P<0.01), and higher Quality of Recovery-15 (QoR-15)
scores post-surgery [113(98, 123) vs. 102(88, 112); P=0.0122]. Our results
suggest SAPB combined with oxycodone for transitional analgesia, compared
with sufentanil, is more effective in preventing EA after VATS and
conductive to rapid recovery postoperatively.Trial registration: Chinese
Clinical Trial Registry, identifier: ChiCTR2300077473, Date:
09/11/2023. Copyright © 2024. The Author(s).

<101>
Accession Number
2036264450
Title
Practice Changing Updates in Perioperative Medicine Literature 2023. A
Systematic Review.
Source
American Journal of Medicine. (no pagination), 2024. Date of Publication:
2024.
Author
Silbert R.E.; Khambaty M.; Devalapalli A.P.; Kashiwagi D.T.; Stephenson
C.R.; Bartlett M.A.; Regan D.W.; Sundsted K.K.; Mauck K.F.
Institution
(Silbert, Stephenson, Bartlett, Mauck) Division of General Internal
Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic College of
Medicine, Rochester, Minn, United States
(Khambaty, Devalapalli, Kashiwagi, Regan, Sundsted) Division of Hospital
Internal Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic
College of Medicine, Rochester, Minn, United States
Publisher
Elsevier Inc.
Abstract
Perioperative medicine is an evolving field, with important publications
each year across multiple disciplines. Staying up to date in the field is
complicated due to the wide range of journals that publish relevant
articles. This review summarizes the most noteworthy perioperative
publications in 2023. We conducted a multi-database search of the
literature from January to December 2023 and included all original
research articles, meta-analyses, systematic reviews, and guidelines.
Abstracts, case reports, letters, protocols, pediatric and obstetric
articles, and cardiac surgery publications were excluded. Two authors
reviewed each reference using the Distiller SR systematic review software
(Evidence Partners Inc., Ottawa, Ont, Canada). A modified Delphi technique
was used to identify 8 practice-changing articles as well as another 8
articles for table-based summary. Copyright © 2024 Elsevier Inc.

<102>
Accession Number
2036263454
Title
Meta-Analysis of Dedicated vs Off-Label Transcatheter Devices for Native
Aortic Regurgitation.
Source
JACC: Cardiovascular Interventions. (no pagination), 2024. Date of
Publication: 2024.
Author
Samimi S.; Hatab T.; Kharsa C.; Khan S.U.; Bou Chaaya R.G.; Qamar F.; Aoun
J.; Zaid S.; Faza N.; Atkins M.D.; Little S.H.; Zoghbi W.A.; Reardon M.J.;
Kleiman N.S.; Goel S.S.
Institution
(Samimi, Hatab, Kharsa, Khan, Bou Chaaya, Aoun, Faza, Atkins, Little,
Zoghbi, Kleiman, Goel) Houston Methodist DeBakey Heart and Vascular
Center, Houston, TX, United States
(Qamar, Reardon) Department of Cardiovascular Surgery, Houston Methodist
Hospital, Houston, TX, United States
(Zaid) Section of Cardiology, Baylor College of Medicine, Michael E
DeBakey Veterans Affairs Medical Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) for high
surgical risk patients with severe native aortic regurgitation (AR)
presents unique challenges. Dedicated devices such as the JenaValve
(JenaValve Technology) and J-Valve (JC Medical Inc) show promising results
in addressing these challenges. Objective(s): This study compares the
safety and efficacy of dedicated vs off-label devices among high surgical
risk patients with pure native AR. Method(s): We systematically
searched PubMed, EMBASE, and Cochrane Central Register of Controlled
Trials through July 11, 2024, for studies on TAVR among patients with pure
severe native AR. The primary endpoint was 30-day all-cause mortality.
Secondary endpoints were device success, residual AR >= moderate, valve
embolization/migration, pacemaker implantation, reintervention, and
all-cause mortality at 1 year. Summary estimates were constructed using a
random effects model. Result(s): A total of 34 studies encompassing
2,162 patients (mean age 75.4 +/- 0.2, 42.8% women) were included in the
meta-analysis. Patients undergoing TAVR with dedicated devices had a lower
all-cause 30-day mortality rate (3% vs 9%; P < 0.01) and higher device
success (93% vs 82%; P < 0.01) compared with off-label devices. The risk
of AR >= moderate (2% vs 5%; P = 0.03), valve embolization/migration (2%
vs 8%; P < 0.01), pacemaker implantation (11% vs 20%; P < 0.01), and
reintervention (4% vs 10%; P < 0.01) at 30 days and all-cause mortality at
1 year (6% vs 24%; P < 0.01) were lower in the dedicated device group.
 Conclusion(s): Dedicated TAVR devices for native AR show superior
device success and reduced mortality, residual AR, and reintervention
rates compared with off-label devices. These findings support the use of
dedicated devices as a safer alternative for high-risk
patients. Copyright © 2024

<103>
Accession Number
645966443
Title
Long-term outcomes with medical therapy, transcatheter repair, or surgery
for isolated tricuspid regurgitation: a systematic review and network
meta-analysis.
Source
Clinical research in cardiology : official journal of the German Cardiac
Society. (no pagination), 2024. Date of Publication: 02 Dec 2024.
Author
Saito T.; Kuno T.; Aikawa T.; Ueyama H.A.; Kampaktsis P.N.; Kolte D.;
Misumida N.; Takagi H.; Ahmad Y.; Kaneko T.; Zajarias A.; Latib A.
Institution
(Saito) Department of Cardiology, Edogawa Hospital, Tokyo, Japan
(Kuno) Cardiology Division, Massachusetts General Hospital, Harvard
Medical School, 55 Fruit Street ,GRB 800, Boston, MA 02114, United States
(Kuno, Latib) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
(Aikawa) Department of Cardiovascular Biology and Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan
(Ueyama) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
(Kampaktsis) Structural and Congenital Center, Hackensack Medical Center,
Hackensack, NJ, United States
(Kolte) Cardiology Division, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Misumida) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, KY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Ahmad) Division of Cardiology, Department of Cardiology, University of
California San Francisco, San Francisco, CA, United States
(Kaneko) Cardiothoracic Surgery Division, Department of Surgery,
Washington University in St Louis School of Medicine, St Louis, MO, United
States
(Zajarias) Cardiovascular Division, Department of Medicine, Washington
University in St Louis School of Medicine, St Louis, MO, United States
Abstract
BACKGROUND: Several transcatheter tricuspid valve (TV) repair devices for
tricuspid regurgitation (TR) have emerged. However, few studies have
compared transcatheter TV repair with medical therapy (MT) alone or
isolated TV surgery. METHOD(S): PubMed and EMBASE were searched in
February 2024. Studies comparing at least any of the following 2 were
included: MT, surgical TV repair, surgical TV replacement, or
transcatheter TV repair. The primary outcome was long-term mortality ( 1
year). The secondary outcomes were short-term mortality (30-day or
in-hospital mortality) and periprocedural complications. We performed a
network meta-analysis using a random effects model. RESULT(S): A
total of 25,831 patients from 22 studies (one randomized trial and 21
observational studies) were included. MT alone was associated with higher
long-term mortality compared to surgical TV repair (HR [95% CI] 1.72
[1.34-2.23]), surgical TV replacement (HR [95% CI] 1.49 [1.14-1.96]), and
transcatheter TV repair (HR [95% CI] 1.52 [1.30-1.78]). Long-term
mortality was comparable between transcatheter and surgical interventions.
Transcatheter TV repair had a lower risk of short-term mortality (versus
surgical TV repair; RR [95% CI] 0.40 [0.22-0.72], versus surgical TV
replacement; RR [95% CI] 0.35 [0.19-0.66]) and lower rates of
periprocedural complications, including new pacemaker implantation, renal
complications, cardiogenic shock than surgical interventions.
 CONCLUSION(S): MT alone for TR was associated with higher long-term
mortality compared to surgical or transcatheter TV interventions.
Transcatheter TV repair had better periprocedural outcomes compared to
surgical interventions with similar long-term mortality. Despite the
possibility of selection bias, transcatheter TV repair appears to be an
attractive option for TR treatment. Copyright © 2024.
Springer-Verlag GmbH Germany, part of Springer Nature.

<104>
Accession Number
645961094
Title
Guidelines for assessing ventricular pressure-volume relationships in
rodents.
Source
American journal of physiology. Heart and circulatory physiology. (no
pagination), 2024. Date of Publication: 03 Dec 2024.
Author
Wearing O.H.; Chesler N.C.; Colebank M.J.; Hacker T.A.; Lorenz J.N.;
Simpson J.A.; West C.R.
Institution
(Wearing, West) Department of Cellular & Physiological Sciences,
University of British Columbia (UBC), Vancouver, BC, Canada
(Wearing, West) Centre for Chronic Disease Prevention and Management, UBC
Okanagan, Kelowna, BC, Canada
(Wearing, West) Centre for Heart, Lung & Vascular Health, UBC Okanagan,
Kelowna, BC, Canada
(Chesler) Department of Biomedical Engineering, University of California
Irvine, Irvine, CA, United States
(Chesler) Edwards Lifesciences Foundation Cardiovascular Innovation and
Research Center, University of California Irvine, Irvine, CA, United
States
(Colebank) Department of Mathematics, University of South Carolina,
Columbia, SC, United States
(Hacker) University of Wisconsin-Madison, Madison, WI, United States
(Lorenz) Department of Pharmacology and Systems Physiology, University of
Cincinnati, Cincinnati, OH, United States
(Simpson) Department of Human Health and Nutritional Sciences, University
of Guelph, Guelph, ON, Canada
(Simpson) IMPART Investigator Team Canada, Saint John, NB, Canada
Abstract
Ventricular catheterization with a pressure-volume (PV) catheter is the
gold-standard method for assessing in vivo cardiac function in animal
studies, providing valuable 'load-independent' indices of systolic and
diastolic heart performance. PV studies are commonly performed to
elucidate mechanistic insights into cardiovascular disease using surgical
and genetically engineered rat and mouse models, but there is considerable
heterogeneity in how these studies are performed. Wide variation in
protocol design, volume calibration, anesthesia, manipulation of cardiac
loading conditions and how load-independent indices of cardiac function
are derived, as well as in data analysis and reporting, is constraining
reliability and reproducibility in the field. The purpose of this
manuscript is to combine our collective expertise in performing open- and
closed-chest left and right ventricle PV studies in rodents to provide
consensus guidelines on how to perform, analyze and interpret these
studies using either conductance or admittance PV catheters. We first
review recent methodological reporting in rodent PV studies in this
journal, and discuss important details required to improve reproducibility
within and across PV studies. We then recommend steps to obtain
high-quality PV data, from volume calibration to choice of anesthetic
agent and acquiring load-independent indices of both systolic and
diastolic function. We also consider between- and within-animal variation
and recommend how to perform data analysis and visualization. We hope that
this consensus paper guides those performing PV studies in rodents and
helps align the field with best practices in surgical/analytical
methodologies and reporting, facilitating better reliability and
reproducibility in the PV field.

<105>
Accession Number
645959085
Title
Cardiovascular Diseases and Sensorineural Hearing Loss-A Systematic Review
of the Literature.
Source
Otology & neurotology : official publication of the American Otological
Society, American Neurotology Society [and] European Academy of Otology
and Neurotology. (no pagination), 2024. Date of Publication: 21 Nov 2024.
Author
Berezovsky A.N.; Espahbodi M.; LaPrade S.L.; Friedland D.R.; Harris M.S.
Institution
(Berezovsky, LaPrade, Friedland, Harris) Department of Otolaryngology and
Communication Sciences, Medical College of Wisconsin, Milwaukee, WI,
United States
(Espahbodi) Department of Otolaryngology-Head and Neck Surgery, University
of Utah School of Medicine, Salt Lake City, UT, United States
Abstract
OBJECTIVES: To assess the relationship of cardiovascular disease (CVD) and
sensorineural hearing loss (SNHL). DATABASES REVIEWED: Ovid MEDLINE, Web
of Science, Scopus, and Cochrane. METHOD(S): A systematic review was
performed. Studies were identified using Ovid MEDLINE, Web of Science,
Scopus, and Cochrane from 1946 to 2023. Per Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines, abstracts were
screened for primary review. Full texts were reviewed for secondary
review. RESULT(S): There were 3,440 unique abstracts screened. After
primary review of abstracts and secondary full text review, 68 articles
were included. The relationship between SNHL and the following CVDs, risk
factors, and interventions were ascertained: coronary artery bypass graft
(CABG) surgery, coronary artery disease (CAD), carotid stenosis (CS),
myocardial infarction (MI), percutaneous coronary intervention (PCI),
other arteriosclerosis, cerebral small vascular disease, cerebrovascular
accident (CVA), transient ischemic attack (TIA), peripheral vascular
disease (PVD), hyperlipidemia (HLD), hypertension (HTN), and diabetes
mellitus (DM). CABG and CAD were consistently associated with SNHL. DM was
associated with SNHL, but HTN and HLD were not consistently associated.
 CONCLUSION(S): There is a complex relationship between CVDs and SNHL.
CABG and CAD were consistently associated with SNHL. DM was associated
with SNHL, but other CVD risk factors (HTN and HLD) did not appear to
consistently correlate with SNHL, raising consideration that SNHL is a
later finding in those with CVD. Copyright © 2024, Otology &
Neurotology, Inc.

<106>
Accession Number
645955134
Title
Midterm Survival, Clinical, and Hemodynamic Outcomes of a Novel Mechanical
Mitral Valve Prosthesis.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2024. Date of Publication: 29 Nov 2024.
Author
Ruel M.; Chu M.W.A.; Graeve A.; Gerdisch M.W.; Damiano R.J.; Smith R.L.;
Keeling W.B.; Wait M.A.; Hagberg R.C.; Quinn R.D.; Sethi G.K.; Floridia
R.; Barreiro C.J.; Pruitt A.L.; Accola K.D.; Dagenais F.; Markowitz A.H.;
Ye J.; Sekela M.E.; Tsuda R.Y.; Duncan D.A.; Swistel D.G.; Harville L.E.;
DeRose J.J.; Lehr E.J.; Alexander J.H.; Puskas J.D.
Institution
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Chu) Division of Cardiac Surgery, London Health Sciences Centre, Western
University, London, ON, Canada
(Graeve) Cardiothoracic Division, MultiCare Health System, Tacoma, WA,
United States
(Gerdisch) Department of Cardiovascular and Thoracic Surgery, Franciscan
St. Francis Health, Indianapolis, IN, United States
(Damiano) Department of Surgery, Washington University SL, St. Louis, MO,
United States
(Smith) Robotic Cardiac Surgery, Heart Hospital Baylor Plano, Plano, TX,
United States
(Keeling) Division of Cardiothoracic Surgery, Emory University Hospital
Midtown, Atlanta, GA, United States
(Wait) Department of Cardiovascular & Thoracic Surgery, UT Southwestern
Medical Center, Dallas, TX, United States
(Hagberg) Department of Cardiac Surgery, Hartford Hospital, Hartford, CT,
United States
(Quinn) Department of Cardiac Services, Maine Medical Center, Portland, ME
(Sethi) Division of Cardiothoracic Surgery, University of Arizona, Tucson
Heart Center, Tucson, AZ, United States
(Floridia) Department of Cardiovascular & Thoracic Surgery, Loma Linda
University Medical Center, Loma Linda, CA, United States
(Barreiro) Sentara Health Research Center, Sentara Norfolk General
Hospital, Norfolk, VA, United States
(Pruitt) Cardiovascular & Thoracic Surgery, St. Joseph Mercy Hospital, Ann
Arbor, MI, United States
(Accola) Cardiovascular Surgery, Florida Hospital, Orlando, FL, Puerto
Rico
(Dagenais) Department of Cardiac Surgery, Institut universitaire de
cardiologie et de pneumologie de Quebec (IUCPQ), Quebec City, QC, Canada
(Markowitz) Heart & Vascular Institute, University Hospitals-Cleveland,
Cleveland, OH, United States
(Ye) Division of Cardiovascular Surgery, St. Paul's and Vancouver General
Hospital, Vancouver, BC, Canada
(Sekela) Division of Cardiothoracic Surgery, University of Kentucky,
Lexington, KY, United States
(Tsuda) Department of Cardiology, Southern Arizona VA Medical Center,
Tucson, AZ, United States
(Duncan) Cardiovascular & Thoracic Surgery, Novant Clinical Research
Institute, Winston-Salem, NC, United States
(Swistel) Department of Cardiac Surgery, NYU Langone Hospitals, New York,
NY
(Harville) Department of Surgery, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
(DeRose) Division of Cardiothoracic Surgery, Montefiore Medical Center,
Bronx, NY, United States
(Lehr) Cardiac Surgery, Swedish Medical Center, Seattle, WA, United States
(Alexander) Division of Cardiology, Duke Clinical Research Institute, Duke
University, Durham, NC, United States
(Puskas) Division of Cardiothoracic Surgery, Mount Sinai Saint Luke's, New
York, NY
Abstract
OBJECTIVES: To evaluate the midterm survival, clinical, and hemodynamic
outcomes of the On-X mechanical mitral valve, based on the 5-year results
of the Prospective Randomized On-X Anticoagulation Clinical Trial
(PROACT). METHOD(S): PROACT Mitral was a multicenter study evaluating
401 patients who underwent mitral valve replacement (MVR) with either
Standard or Conform-X On-X mitral valves, comparing low-dose and
standard-dose warfarin. Here, we report pre-specified, secondary outcomes
of survival, New York Heart Association (NYHA) Functional Classification,
and valve hemodynamics as assessed by core-lab-adjudicated
echocardiography at 1, 3, and 5 years within the pooled population.
 RESULT(S): Actuarial survival was 99.7%, 95.1%, and 92.4% at 1, 3,
and 5 years, with no significant difference between Standard and Conform-X
cuffs. Hemodynamic analysis revealed mean transvalvular gradients of 4.6
+/- 2.0 mmHg at 1 year with no interaction between valve size and patient
body surface area (BSA). MGs were consistent over time. Quality of life
improved with 96.6% of patients in NYHA class I or II at the latest
available follow-up of 3 or 5 years. There were no significant differences
in survival, clinical, or hemodynamic outcomes between valve sizes.
 CONCLUSION(S): The On-X mechanical mitral valve demonstrated
favorable survival, stable hemodynamics, and enhanced quality of life up
to five years post-implantation. Derived from high-quality, rigorous
randomized trial data, these findings can guide decision-making in young
patients requiring MVR. Copyright © 2024. Published by Elsevier
Inc.

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