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Article: Valve Type and Operative Risks in Surgical Explantation of Transcatheter Aortic Valves: A Systematic Review and Meta-Analysis.

Abbasciano, Riccardo G / Magouliotis, Dimitrios E / Koulouroudias, Marinos / Spiliopoulos, Kyriakos / Xanthopoulos, Andrew / Kourliouros, Antonios / Casula, Roberto / Athanasiou, Thanos / Viviano, Alessandro

Journal of clinical medicine

2024 Volume 13, Issue 5

Abstract: Indication to perform surgical explantation of TAVR is becoming increasingly more frequent, due to the higher number of transcatheter procedures performed in patients with longer life expectancy. We proposed to perform a systematic review and meta- ... ...

Abstract	Indication to perform surgical explantation of TAVR is becoming increasingly more frequent, due to the higher number of transcatheter procedures performed in patients with longer life expectancy. We proposed to perform a systematic review and meta-analysis with metaregression to identify potential factors that can determine an increase in the high mortality and morbidity that characterize these surgical procedures. MEDLINE and Embase were searched for relevant studies. Twelve studies were eligible according to our inclusion criteria. TAVR explantation was confirmed as a procedure with high 30-day mortality (0.17; 95% CI, 0.14-0.21) and morbidity (stroke incidence 5%; 95% CI, 0.04-0.07; kidney injury incidence 16%; 95% CI, 0.11-0.24). The type of transcatheter valve implanted during the index procedure did not influence the outcomes after surgical explantation. The role of these high-risk operations is growing, and it will likely expand in the coming years. Specific tools for risk stratification are required.
Language	English
Publishing date	2024-02-23
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13051262
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Article ; Online: Interpretation of network meta-analysis of isolated patient blood management interventions. Response to Br J Anaesth 2020 BJA-2020-01426-HH887.R1.

Roman, Marius A / Abbasciano, Riccardo G / Lai, Florence Y / Murphy, Gavin J

British journal of anaesthesia

2020 Volume 126, Issue 1, Page(s) e2–e4

MeSH term(s)	Blood Transfusion ; Humans ; Network Meta-Analysis
Language	English
Publishing date	2020-09-22
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2020.08.039
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Article ; Online: Is patient blood management cost-effective? Response to Br J Anaesth 2020 https://doi.org/10.1016/j.bja.2020.09.003.

Roman, Marius A / Abbasciano, Riccardo G / Yao, Guiqing / Murphy, Gavin J

British journal of anaesthesia

2020 Volume 126, Issue 1, Page(s) e6–e7

MeSH term(s)	Blood Transfusion ; Cost-Benefit Analysis ; Humans
Language	English
Publishing date	2020-09-08
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2020.08.029
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Article ; Online: Reporting conflicts of interest in randomised trials of patient blood management interventions in patients requiring major surgery: a systematic review and meta-analysis.

Roman, Marius / Fashina, Oluwatomini / Tomassini, Sara / Abbasciano, Riccardo G / Lai, Florence / Richards, Toby / Murphy, Gavin

BMJ open

2022 Volume 12, Issue 8, Page(s) e054582

Abstract: Objective: This study aimed to systematically review the effects of declared and undeclared conflicts of interest on randomised controlled trials (RCTs) of patient blood management (PBM) interventions.: Design: We performed a secondary analysis of a ... ...

Abstract	Objective: This study aimed to systematically review the effects of declared and undeclared conflicts of interest on randomised controlled trials (RCTs) of patient blood management (PBM) interventions. Design: We performed a secondary analysis of a recently published meta-analysis of RCTs evaluating five common PBM interventions in patients undergoing major surgery. Data sources: The databases searched by the original systematic reviews were searched using subject headings and Medical Subject Headings terms according to search strategies from the final search time-points until 1 June 2019. Eligibility criteria: RCTs on PBM irrespective of blinding, language, date of publication and sample size were included. Abstracts and unpublished trials were excluded. Conflicts of interest were defined as sponsorship, funding or authorship by industry, professional PBM advocacy groups or blood services. Data extraction and synthesis: Three independent reviewers extracted the data and assessed the risk of bias. Pooled treatment effect estimates were reported as risk ratios (RRs) or standardised mean difference with 95% CIs. Heterogeneity was quantified using the I Results: Three hundred and eighty-nine RCTs totalling 53 635 participants were included. Thirty-two trials (8%) were considered free from important sources of bias. There was reporting bias favouring PBM interventions on transfusion across all analyses. In trials with no declared author conflicts of interest, the treatment effect on mortality was RR 1.12 (0.86 to 1.45). In trials where author conflicts of interest were declared, the treatment effect on mortality was RR 0.84 (0.69 to 1.03), with significant reporting bias favouring PBM interventions. Trials with declared conflicts linked to professional PBM advocacy groups (five studies, n=977 patients) reported statistically significant reductions in mortality RR 0.40 (0.17 to 0.92), unlike other groups. Conclusions: Low certainty of the evidence that guides PBM implementation is confounded by evidence of reporting bias, and the effects of declared and undeclared conflicts of interest, favouring PBM on important trial outcomes.
MeSH term(s)	Conflict of Interest ; Humans ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2022-08-17
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-054582
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Article ; Online: Identifying research priorities in cardiac surgery: a report from the James Lind Alliance Priority Setting Partnership in adult heart surgery.

Lai, Florence Y / Abbasciano, Riccardo G / Tabberer, Bethany / Kumar, Tracy / Murphy, Gavin J

BMJ open

2020 Volume 10, Issue 9, Page(s) e038001

Abstract: Objective: To identify research priorities that address the needs of people affected by cardiac surgery and those who support and care for them.: Design: James Lind Alliance (JLA) process-two surveys and a consensus workshop guided by an independent ... ...

Abstract	Objective: To identify research priorities that address the needs of people affected by cardiac surgery and those who support and care for them. Design: James Lind Alliance (JLA) process-two surveys and a consensus workshop guided by an independent JLA adviser. Setting: The UK with international participation. Participants: Three stakeholder groups-heart surgery patients, carers and healthcare professionals involved in care delivery. Methods: The initial survey was set to collect potential research questions in cardiac surgery as identified by stakeholders. Submitted questions were summarised into indicative questions. The existing evidence was searched to verify that these indicative questions had not been answered. In the second survey, stakeholders then voted for their top 10 from the list of unanswered questions. The top voted questions were taken forward for final ranking in a workshop. Results: In the initial survey, 629 respondents (28% patients/carers, 62% healthcare professionals) submitted 1082 potential questions. Of these, 797 in-scope questions were summarised into 49 indicative questions and of which 45 had not been answered by existing research. In the second survey, 492 respondents (43% patients/carers, 49% healthcare professionals) cast their votes with the top 12 from each of the three stakeholder groups totalling 21 questions advancing to the final priority setting workshop. The workshop attended by 25 delegates (10 patients/carers and 15 healthcare professionals) agreed on the top 10 research questions including long-term outcomes (quality of life), and aspects from preoperative personalised care (prehabilitation, frailty, comorbidities), intraoperative management (minimally invasive techniques), to prevention and management of postoperative complications (organ injury, atrial fibrillation, infection). Conclusions: This Priority Setting Partnership (PSP) identified the priorities and unmet needs of patients and clinicians in cardiac surgery. The next step is to disseminate and implement the PSP results to ensure that these priorities shape future research and improve clinical services.
MeSH term(s)	Adult ; Biomedical Research ; Cardiac Surgical Procedures ; Caregivers ; Health Priorities ; Humans ; Quality of Life
Language	English
Publishing date	2020-09-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2020-038001
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Article ; Online: Large animal model of vein grafts intimal hyperplasia: A systematic review.

Fashina, Oluwatomini / Abbasciano, Riccardo G / McQueen, Liam W / Ladak, Shameem / George, Sarah J / Suleiman, Sadeeh / Punjabi, Prakash P / Angelini, Gianni D / Zakkar, Mustafa

Perfusion

2022 Volume 38, Issue 5, Page(s) 894–930

Abstract: Coronary artery bypass grafting remains the treatment of choice for a large cohort of patients with significant coronary disease. Despite the increased use of arterial grafts, the long saphenous vein remains the most commonly used conduit. Long-term ... ...

Abstract	Coronary artery bypass grafting remains the treatment of choice for a large cohort of patients with significant coronary disease. Despite the increased use of arterial grafts, the long saphenous vein remains the most commonly used conduit. Long-term graft patency continues to be the Achilles heel of saphenous vein grafts. This is due to the development of intimal hyperplasia, a chronic inflammatory disease that results in the narrowing and occlusion of a significant number of vein grafts. Research models for intimal hyperplasia are essential for a better understanding of pathophysiological processes of this condition. Large animal models resemble human anatomical structures and have been used as a surrogate to study disease development and prevention over the years. In this paper, we systematically review all published studies that utilized large animal models of vein graft disease with a focus on the type of model and any therapeutic intervention, specifically the use of external stents/mesh.
MeSH term(s)	Animals ; Humans ; Graft Occlusion, Vascular ; Vascular Patency/physiology ; Hyperplasia/pathology ; Coronary Artery Bypass/methods ; Saphenous Vein/surgery ; Models, Animal
Language	English
Publishing date	2022-05-27
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	645038-6
ISSN	1477-111X ; 0267-6591
ISSN (online)	1477-111X
ISSN	0267-6591
DOI	10.1177/02676591221091200
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Article ; Online: Patient blood management interventions do not lead to important clinical benefits or cost-effectiveness for major surgery: a network meta-analysis.

Roman, Marius A / Abbasciano, Riccardo G / Pathak, Suraj / Oo, Shwe / Yusoff, Syabira / Wozniak, Marcin / Qureshi, Saqib / Lai, Florence Y / Kumar, Tracy / Richards, Toby / Yao, Guiqing / Estcourt, Lise / Murphy, Gavin J

British journal of anaesthesia

2020 Volume 126, Issue 1, Page(s) 149–156

Abstract: Background: Patient blood management (PBM) interventions aim to improve clinical outcomes by reducing bleeding and transfusion. We assessed whether existing evidence supports the routine use of combinations of these interventions during and after major ... ...

Abstract	Background: Patient blood management (PBM) interventions aim to improve clinical outcomes by reducing bleeding and transfusion. We assessed whether existing evidence supports the routine use of combinations of these interventions during and after major surgery. Methods: Five systematic reviews and a National Institute of Health and Care Excellence health economic review of trials of common PBM interventions enrolling participants of any age undergoing surgery were updated. The last search was on June 1, 2019. Studies in trauma, burns, gastrointestinal haemorrhage, gynaecology, dentistry, or critical care were excluded. The co-primary outcomes were: risk of receiving red cell transfusion and 30-day or hospital all-cause mortality. Treatment effects were estimated using random-effects models and risk ratios (RR) with 95% confidence intervals (CIs). Heterogeneity assessments used I Results: Searches identified 393 eligible randomised controlled trials enrolling 54 917 participants. PBM interventions resulted in a reduction in exposure to red cell transfusion (RR=0.60; 95% CI 0.57, 0.63; I Conclusions: In randomised trials, PBM interventions do not have important clinical benefits beyond reducing bleeding and transfusion in people undergoing major surgery.
MeSH term(s)	Blood Loss, Surgical/prevention & control ; Blood Transfusion/economics ; Blood Transfusion/statistics & numerical data ; Cost-Benefit Analysis/economics ; Cost-Benefit Analysis/methods ; Cost-Benefit Analysis/statistics & numerical data ; Humans ; Network Meta-Analysis ; Postoperative Hemorrhage/economics ; Postoperative Hemorrhage/prevention & control ; Surgical Procedures, Operative
Language	English
Publishing date	2020-06-30
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2020.04.087
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Article ; Online: Activation of the innate immune response and organ injury after cardiac surgery: a systematic review and meta-analysis of randomised trials and analysis of individual patient data from randomised and non-randomised studies.

Abbasciano, Riccardo G / Lai, Florence Y / Roman, Marius A / Rizzello, Angelica / Pathak, Suraj / Ramzi, Joussi / Lucarelli, Carla / Layton, Georgia R / Kumar, Tracy / Wozniak, Marcin J / Eagle-Hemming, Bryony / Akowuah, Enoch / Rogers, Chris A / Angelini, Gianni D / Murphy, Gavin J

British journal of anaesthesia

2021 Volume 127, Issue 3, Page(s) 365–375

Abstract: Background: It is unclear whether the innate immune response represents a therapeutic target for organ protection strategies in cardiac surgery.: Methods: A systematic review of trials of interventions targeting the inflammatory response to cardiac ... ...

Abstract	Background: It is unclear whether the innate immune response represents a therapeutic target for organ protection strategies in cardiac surgery. Methods: A systematic review of trials of interventions targeting the inflammatory response to cardiac surgery reporting treatment effects on both innate immune system cytokines and organ injury was performed. The protocol was registered at the International Prospective Register of Systematic Reviews: CRD42020187239. Searches of the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase were performed. Random-effects meta-analyses were used for the primary analysis. A separate analysis of individual patient data from six studies (n=785) explored sources of heterogeneity for treatment effects on cytokine levels. Results: Searches to May 2020 identified 251 trials evaluating 24 interventions with 20 582 participants for inclusion. Most trials had important limitations. Methodological limitations of the included trials and heterogeneity of the treatment effects on cytokine levels between trials limited interpretation. The primary analysis demonstrated inconsistency in the direction of the treatment effects on innate immunity and organ failure or death between interventions. Analyses restricted to important subgroups or trials with fewer limitations showed similar results. Meta-regression, pooling available data from all trials, demonstrated no association between the direction of the treatment effects on inflammatory cytokines and organ injury or death. The analysis of individual patient data demonstrated heterogeneity in the association between the cytokine response and organ injury after cardiac surgery for people >75 yr old and those with some chronic diseases. Conclusions: The certainty of the evidence for a causal relationship between innate immune system activation and organ injury after cardiac surgery is low.
MeSH term(s)	Aged ; Aged, 80 and over ; Anti-Inflammatory Agents/therapeutic use ; Cardiac Surgical Procedures/adverse effects ; Cardiac Surgical Procedures/mortality ; Cytokines/blood ; Cytokines/immunology ; Female ; Humans ; Immunity, Innate/drug effects ; Male ; Middle Aged ; Randomized Controlled Trials as Topic ; Risk Assessment ; Risk Factors ; Systemic Inflammatory Response Syndrome/blood ; Systemic Inflammatory Response Syndrome/immunology ; Systemic Inflammatory Response Syndrome/mortality ; Systemic Inflammatory Response Syndrome/prevention & control ; Treatment Outcome
Chemical Substances	Anti-Inflammatory Agents ; Cytokines
Language	English
Publishing date	2021-07-03
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2021.04.032
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Article ; Online: Silent large vegetative mitral-aortic enterococcal endocarditis.

Conte, Luca / Rossi, Andrea / Picariello, Claudio / Zuin, Marco / Abbasciano, Riccardo G / Rigatelli, Gianluca / Roncon, Loris

Journal of cardiovascular medicine (Hagerstown, Md.)

2016 Volume 17 Suppl 2, Page(s) e199–e204

Abstract: In spite of the evolution of diagnostic and imaging tools, infective endocarditis still remains a challenging diagnostic problem. We report the case of a 77-year-old heart failure patient with a very large mitral vegetative lesion but without fever or ... ...

Abstract	: In spite of the evolution of diagnostic and imaging tools, infective endocarditis still remains a challenging diagnostic problem. We report the case of a 77-year-old heart failure patient with a very large mitral vegetative lesion but without fever or any other clinical or microbiological 'endocarditis criteria' except the echocardiographic findings. In this scenario, the second more likely differential diagnosis was neoformation of the mitral valve but despite an exhaustive preoperative diagnostic cardiac imaging, this hypothesis could not be excluded before surgical excision and microbiological examination of the surgical specimen.
Language	English
Publishing date	2016-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2223461-5
ISSN	1558-2035 ; 1558-2027
ISSN (online)	1558-2035
ISSN	1558-2027
DOI	10.2459/JCM.0000000000000445
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