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<1>
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Accession Number
2013565920
Authors
Ruetzler K. Fleck M. Nabecker S. Pinter K. Landskron G. Lassnigg A. You J.
Sessler D.I.
Institution
(Ruetzler, Fleck, Nabecker, Pinter, Landskron, Lassnigg) Department of
Cardiothoracic and Vascular Anaesthesia and Intensive Care Medicine,
Vienna Medical University, Vienna, Austria
(You) Departments of Quantatative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
(You, Sessler) Department of Outcomes Research, Cleveland Clinic, 9500
Euclid Ave-P77, Cleveland, OH 44195, United States
Title
A randomized, double-blind comparison of licorice versus sugar-water
gargle for prevention of postoperative sore throat and postextubation
coughing.
Source
Anesthesia and Analgesia. 117 (3) (pp 614-621), 2013. Date of Publication:
September 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background: One small study suggests that gargling with licorice before
induction of anesthesia reduces the risk of postoperative sore throat.
Double-lumen tubes are large and thus especially likely to provoke sore
throats. We therefore tested the hypothesis that preoperative gargling
with licorice solution prevents postoperative sore throat and
postextubation coughing in patients intubated with double-lumen tubes.
Methods: We enrolled 236 patients having elective thoracic surgery who
required intubation with a double-lumen endotracheal tube. Patients were
randomly assigned to gargle 5 minutes before induction of anesthesia for 1
minute with: (1) Extractum Liquiritiae Fluidum (licorice 0.5 g); or (2)
Sirupus Simplex (sugar 5 g); each diluted in 30 mL water. Sore throat and
postextubation coughing were evaluated 30 minutes, 90 minutes, and 4 hours
after arrival in the postanesthesia care unit, and the first postoperative
morning using an 11-point Likert scale by an investigator blinded to
treatment. Results: The incidence of postoperative sore throat was
significantly reduced in patients who gargled with licorice rather than
sugar-water: 19% and 36% at 30 minutes, 10% and 35% at 1.5 hours, and 21%
and 45% at 4 hours, respectively. The corresponding estimated treatment
effects (relative risks) were 0.54 (95% CI, 0.30-0.99, licorice versus
sugar-water; P = 0.005), 0.31 (0.14-0.68) (P < 0.001), and 0.48
(0.28-0.83) (P < 0.001). CONCLUSION: Licorice gargling halved the
incidence of sore throat. Preinduction gargling with licorice appears to
be a simple way to prevent a common and bothersome complication. 2013
International Anesthesia Research Society.

<2>
Accession Number
2013566944
Authors
Sainathan S. Andaz S.
Institution
(Sainathan) Department of Thoracic Surgery, Bronx-Lebanon Hospital Center,
Bronx, NY 10457, United States
(Andaz) Department of Thoracic Surgery, South Nassau Communities Hospital,
Oceanside, NY, United States
Title
A systematic review of transesophageal echocardiography-induced esophageal
perforation.
Source
Echocardiography. 30 (8) (pp 977-983), 2013. Date of Publication:
September 2013.
Publisher
Blackwell Publishing Inc. (350 Main Street, Malden MA 02148, United
States)
Abstract
A systematic review of transesophageal echocardiography (TEE)-induced
esophageal perforation was done using the MEDLINE (PubMed and OVID
interfaces), Google Scholar and EMBASE databases. Thirty-five cases of
esophageal perforation from 22 studies were analyzed. TEE-induced
esophageal perforation occurs in elderly female patients, predominantly in
an intra-operative setting. Thoracic esophagus is the most commonly
involved segment, especially, when TEE is performed intra-operatively.
Majority of the esophageal perforations occur in cases with a perceived
low risk or smooth TEE exam and thus, screening for high risk factors may
not eliminate the occurrence of a perforation. A delayed detection of
perforation occurs when it is a thoracic esophageal perforation, performed
intra-operatively and when there are no known preoperative risk factors.
Shock during the detection of the perforation is associated with
mortality. Majority of the perforations can be repaired primarily. 2013,
Wiley Periodicals, Inc.

<3>
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Accession Number
2013563793
Authors
Scott L.B. Gravely S. Sexton T.R. Brzostek S. Brown D.L.
Institution
(Scott) Program in Public Health, School of Health Technology and
Management, Stony Brook University Health Sciences Center, Stony Brook, NY
11794, United States
(Scott, Gravely, Brzostek, Brown) Department of Medicine, Stony Brook
University School of Medicine, United States
(Sexton) Stony Brook University College of Business, Stony Brook, NY,
United States
(Gravely) Peter Munk Cardiac Center, Toronto General Research Institute,
University Health Network, Toronto, ON, Canada
Title
Examining the effect of a patient navigation intervention on outpatient
cardiac rehabilitation awareness and enrollment.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 33 (5) (pp
281-291), 2013. Date of Publication: September-October 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
PURPOSE:: Awareness of and enrollment in outpatient cardiac rehabilitation
(OCR) following a cardiac event or procedure remain suboptimal. Thus, it
is important to identify new approaches to improve these outcomes. The
objectives of this study were to identify (1) the contributions of a
patient navigation (PN) intervention and other patient characteristics on
OCR awareness; and (2) the contributions of OCR awareness and other
patient characteristics on OCR enrollment among eligible cardiac patients
up to 12 weeks posthospitalization. METHODS:: In this randomized
controlled study, 181 eligible and consenting patients were assigned to
either PN (n = 90) or usual care (UC; n = 91) prior to hospital discharge.
Awareness of OCR was assessed by telephone interview at 12 weeks
posthospitalization, and OCR enrollment was confirmed by staff at
collaborating OCR programs. Of the 181 study participants, 3 died within 1
month of hospital discharge and 147 completed the 12-week telephone
interview. RESULTS:: Participants in the PN intervention arm were nearly 6
times more likely to have at least some awareness of OCR than UC
participants (OR = 5.99; P = .001). Moreover, participants who reported at
least some OCR awareness were more than 9 times more likely to enroll in
OCR (OR = 9.27, P = .034) and participants who were married were less
likely to enroll (P = .031). CONCLUSIONS:: Lay health advisors have
potential to improve awareness of outpatient rehabilitation services among
cardiac patients, which, in turn, can yield greater enrollment rates in a
program. 2013 Wolters Kluwer Health Lippincott Williams and Wilkins.

<4>
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Accession Number
2013565911
Authors
Johnston J. Pal S. Nagele P.
Institution
(Johnston, Pal, Nagele) Division of Clinical and Translational Research,
Department of Anesthesiology, Washington University School of Medicine,
660 S. Euclid Ave., Box 8054, St. Louis, MO 63110, United States
Title
Perioperative torsade de pointes: A systematic review of published case
reports.
Source
Anesthesia and Analgesia. 117 (3) (pp 559-564), 2013. Date of Publication:
September 2013.
Publisher
Lippincott Williams and Wilkins (530 Walnut Street,P O Box 327,
Philadelphia PA 19106-3621, United States)
Abstract
Background: Torsade de pointes is a rare but potentially fatal arrhythmia.
More than 40 cases of perioperative torsade de pointes have been reported
in the literature; however, the current evidence regarding this
complication is very limited. To improve our understanding, we performed a
systematic review and meta-analysis of all published case reports of
perioperative torsade de pointes. Methods: MEDLINE was systematically
searched for cases of perioperative torsade de pointes. We included
patients of all age groups and cases that occurred from the immediate
preoperative period to the third postoperative day. Patient and case
characteristics as well as QT interval data were extracted. Results:
Forty-six cases of perioperative torsade de pointes were identified; 29
occurred in women (67%), and 2 episodes were fatal (case fatality rate:
4%). Craniotomies and cardiac surgery accounted for 40% of all cases.
Preceding events identified by the authors were hypokalemia (12/46, 26%;
99% confidence interval [CI], 9%-43%) and bradycardia (7/46, 15%; 99% CI,
2%-28%). Drugs were implicated in approximately one third of the events
(14/46, 30%; 99% CI, 13%-48%). The mean corrected QT (QTc) at baseline was
457 +/- 67 milliseconds (minimum 320 milliseconds; maximum 647
milliseconds; data available in 27/46 patients). At the time of the event,
the mean QTc increased to 575 +/- 77 milliseconds (minimum 413
milliseconds; maximum 766 milliseconds; data available in 33/46 patients).
On average, QTc increased by +118 milliseconds (99% CI, 70-166
milliseconds; P < 0.001) between baseline and after the torsade de pointes
event. All patients, except for 2, had a substantial prolongation of their
QTc interval at the time of the event. Conclusions: This systematic review
identified several common risk factors for perioperative torsade de
pointes. Given the nearly uniform presence of a substantial QTc interval
prolongation at the time of a torsade de pointes episode, increased
vigilance for perioperative QTc interval prolongation may be warranted.
2013 International Anesthesia Research Society.

<5>
Accession Number
2013534978
Authors
Siontis K.C. Hernandez-Boussard T. Ioannidis J.P.A.
Institution
(Siontis) Department of Medicine, Mayo School of Graduate Medical
Education, College of Medicine, Rochester, MN, United States
(Hernandez-Boussard) Department of Surgery, Stanford University, School of
Medicine, Stanford, CA, United States
(Ioannidis) Department of Medicine, Stanford University, School of
Medicine, Stanford, CA, United States
(Ioannidis) Department of Statistics, Stanford University, School of
Humanities and Sciences, Stanford, CA, United States
Title
Overlapping meta-analyses on the same topic: Survey of published studies.
Source
BMJ (Online). 347 (7921) , 2013. Article Number: f4501. Date of
Publication: 17 Aug 2013.
Publisher
BMJ Publishing Group (Tavistock Square, London WC1H 9JR, United Kingdom)
Abstract
Objective To assess how common it is to have multiple overlapping
meta-analyses of randomized trials published on the same topic. Design
Survey of published meta-analyses. Data sources PubMed. Study selection
and methods Meta-analyses published in 2010 were identified, and 5% of
them were randomly selected. We further selected those that included
randomized trials and examined effectiveness of any medical intervention.
For eligible meta-analyses, we searched for other meta-analyses on the
same topic (covering the same comparisons, indications/settings, and
outcomes or overlapping subsets of them) published until February 2013.
Results Of 73 eligible meta-analyses published in 2010, 49 (67%) had at
least one other overlapping meta-analysis (median two meta-analyses per
topic, interquartile range 1-4, maximum 13). In 17 topics at least one
author was involved in at least two of the overlapping meta-analyses. No
characteristics of the index meta-analyses were associated with the
potential for overlapping meta-analyses. Among pairs of overlapping
meta-analyses in 20 randomly selected topics, 13 of the more recent
meta-analyses did not include any additional outcomes. In three of the
four topics with eight or more published meta-analyses, many meta-analyses
examined only a subset of the eligible interventions or
indications/settings covered by the index meta-analysis. Conversely, for
statins in the prevention of atrial fibrillation after cardiac surgery, 11
meta-analyses were published with similar eligibility criteria for
interventions and setting: there was still variability on which studies
were included, but the results were always similar or even identical
across meta-analyses. Conclusions While some independent replication of
meta-analyses by different teams is possibly useful, the overall picture
suggests that there is a waste of efforts with many topics covered by
multiple overlapping meta-analyses.

<6>
Accession Number
23486858
Authors
Chung S. Her S.-H. Song P.S. Song Y.B. Hahn J.-Y. Choi J.-H. Lee S.H. Jang
Y. Yoon J.H. Tahk S.-J. Park S.-J. Choi S.-H. Seung K.B. Gwon H.-C.
Institution
(Chung, Song, Song, Hahn, Choi, Lee, Choi, Gwon) Division of Cardiology,
Department of Medicine, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, South Korea
(Her, Seung) Division of Cardiology, Department of Internal Medicine, The
Catholic University of Korea College of Medicine, Seoul, South Korea
(Jang) Division of Cardiology, Severance Cardiovascular Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(Yoon) Division of Cardiology, Wonju Christian Hospital, Wonju, South
Korea
(Tahk) Division of Cardiology, Ajou Univeristy Hospital, Suwon, South
Korea
(Park) Department of Cardiology, University of Ulsan College of Medicine,
Asan Medical Center, Seoul, South Korea
Title
Trans-radial versus trans-femoral intervention for the treatment of
coronary bifurcations: Results from coronary bifurcation stenting
registry.
Source
Journal of Korean Medical Science. 28 (3) (pp 388-395), 2013. Date of
Publication: March 2013.
Publisher
Korean Academy of Medical Science (302-75 Dong bu Ichon-dong, Yongsan-ku,
Seoul 140-031, South Korea)
Abstract
Trans-radial (TR) approach is increasingly recognized as an alternative to
the routine use of trans-femoral (TF) approach. However, there are limited
data comparing the outcomes of these two approaches for the treatment of
coronary bifurcation lesions. We evaluated outcomes ofTR and TF
percutaneous coronary interventions (PCI) in this complex lesion.
Procedural outcomes and clinical events were compared in 1,668 patients
who underwent PCI for non-left main bifurcation lesions, according to the
vascular approach, either TR (n = 503) or TF (n = 1,165). The primary
outcome was major adverse cardiac events (MACE), including cardiac death,
myocardialinfarction (MI), and target lesion revascularization (TLR) in
all patients and in 424 propensity-score matched pairs of patients. There
were no significant differences between TR and TF approaches for
procedural success in the main vessel (99.6% vs 98.6%, P = 0.08) and side
branches (62.6% vs 66.7%, P = 0.11). Over a mean follow-up of 22 months,
cardiac death or MI (1.8% vs2.2%, P = 0.45), TLR (4.0% vs 5.2%, P = 0.22),
and MACE (5.2% vs 7.0%, P = 0.11) did not significantly differ between TR
and TF groups, respectively. These results were consistent after
propensity score-matched analysis. In conclusion, TR PCI is a feasible
alternative approach to conventional TF approaches for bifurcation PCI
(clinicaltrials.gov number: NCT00851526). 2013 The Korean Academy of
Medical Sciences.

<7>
Accession Number
2013548002
Authors
Emmert M.Y. Salzberg S.P. Seifert B. Scherman J. Plass A. Starck C.T.
Theusinger O. Hoerstrup S.P. Grunenfelder J. Jacobs S. Falk V.
Institution
(Emmert, Salzberg, Scherman, Plass, Starck, Hoerstrup, Grunenfelder,
Jacobs, Falk) Dept. of Cardiac and Vascular Surgery, University Hospital
Zurich, Switzerland
(Seifert) Biostatistics Unit, Institute of Social and Preventive Medicine,
University of Zurich, Switzerland
(Theusinger) Institute for Anaesthesiology, University Hospital Zurich,
Switzerland
Title
Clampless off-pump surgery reduces stroke in patients with left main
disease.
Source
International Journal of Cardiology. 167 (5) (pp 2097-2101), 2013. Date of
Publication: 01 Sep 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: Surgical revascularization is the most appropriate therapy for
patients with significant left main coronary-artery disease (LMD). An
incidence of perioperative stroke remains an issue when compared to the
early outcomes to percutaneous coronary intervention (PCI). This study
evaluates the safety and impact of standardized "clampless" OPCAB
techniques, composed of either complete in situ grafting or "clampless"
device enabled techniques for stroke reduction in patients undergoing
surgical revascularization for LMD. Methods: Between 1999 and 2009, 1031
patients with LMD underwent myocardial-revascularization at our
institution. Of these, 507 patients underwent "clampless" OPCAB and 524
patients underwent conventional on-pump CABG (ONCABG). Data-collection was
performed prospectively and a propensity-adjusted regression-analysis was
applied to balance patient characteristics. LMD was defined as a stenosis
> 50% and endpoints were mortality, stroke, a cardiac-composite (including
death, stroke and myocardial-infarction); a non-cardiac composite and
complete-revascularization. Results: In OPCAB patients, the cardiac
composite (3.0% vs. 7.8%; propensity-adjusted (PA)OR = 0.27; CI95%
0.12-0.65; p = 0.003) as well as the occurrence of stroke (0.4% vs. 2.9%;
PAOR = 0.04; CI95% 0.003-0.48; p = 0.012) were significantly lower while
the mortality-rate was well comparable between groups (1.8% vs. 2.5%; PAOR
= 0.44; CI95% 0.11-1.71; p = 0.24). The non-cardiac composite was also
significantly decreased after OPCAB (8.9% vs. 19.7%; PAOR = 0.55; CI95%
0.34-0.89; p = 0.014) and complete revascularization was achieved for
similar proportions in both groups (95.1% vs. 93.7%; p = 0.35).
Conclusions: This study shows the superiority of OPCAB for patients with
LMD with regards to risk-adjusted outcomes other than mortality. A
"clampless OPCAB strategy", effectively reduces stroke yielding similar
early outcomes as PCI. 2012 Elsevier Ireland Ltd.

<8>
Accession Number
2013548034
Authors
D'Errigo P. Barbanti M. Ranucci M. Onorati F. Covello R.D. Rosato S.
Tamburino C. Santini F. Santoro G. Seccareccia F.
Institution
(D'Errigo, Rosato, Seccareccia) National Centre for Epidemiology,
Surveillance and Health Promotion, Istituto Superiore di Sanita, Rome,
Italy
(Barbanti, Tamburino) Division of Cardiology, Ferrarotto Hospital,
University of Catania, Catania, Italy
(Barbanti, Tamburino) ETNA Foundation, Catania, Italy
(Ranucci) Department of Cardiothoracic and Vascular Anesthesia and ICU,
IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
(Onorati, Santini) Division of Cardiac Surgery, University of Verona
Medical School, Verona, Italy
(Covello) IRCCS San Raffaele, Milan, Italy
(Santoro) Division of Cardiology, Careggi Hospital, Florence, Italy
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement for severe aortic stenosis: Results from an intermediate risk
propensity-matched population of the Italian OBSERVANT study.
Source
International Journal of Cardiology. 167 (5) (pp 1945-1952), 2013. Date of
Publication: 01 Sep 2013.
Publisher
Elsevier Ireland Ltd (P.O. Box 85, Limerick, Ireland)
Abstract
Background: Few studies have yielded information on comparative
effectiveness of transcatheter aortic valve implantation (TAVI) versus
surgical aortic valve replacement (SAVR) procedures in a real-world
setting. The aim of this analysis is to describe procedural and
post-procedural outcomes in a TAVI/SAVR intermediate risk
propensity-matched population. Methods: OBSERVANT is an observational
prospective multicenter cohort study, enrolling AS patients undergoing
SAVR or TAVI. Propensity score method was applied to analyze procedural
and post-procedural outcomes. Pairs of patients with the same probability
score were matched (caliper matching). Results: The unadjusted enrolled
population (N = 2108) comprises 1383 SAVR patients, 602 transarterial-TAVI
patients and 123 transapical-TAVI patients. Matched population comprised a
total of 266 patients (133 patients for each group). A relatively low risk
population was selected (mean logistic EuroSCORE 9.4 +/- 10.4% vs 8.9 +/-
9.5%, SAVR vs TAVI; p = 0.650). Thirty-day mortality was 3.8% for both
SAVR and TAVI (p = 1.000). The incidence of stroke (1.5% SAVR and 0.0%
TAVI; p = 0.156) and myocardial infarction (0.8% SAVR and 0.8% TAVI; p =
1.000) was not statistically different between groups, whereas a higher
requirement for blood transfusion was reported across the surgical cohort
(49.6% vs 36.1%; p = 0.026). A higher incidence of major vascular damage
(5.3% vs. 0.0%; p = 0.007) and pacemaker implantation(0.8% vs 12.0%; p =
0.001) were reported in the TAVI group. Conclusions: Patients undergoing
transcatheter and surgical treatment of severe aortic stenosis are still
extremely distinct populations. In the relatively low-risk
propensity-matched population analyzed, despite similar procedural and
30-day mortality, SAVR was associated with a higher risk for blood
transfusion, whereas TAVI showed a significantly increased rate of
vascular damage, permanent AV block and residual aortic valve
regurgitation. 2012 Elsevier Ireland Ltd.

<9>
Accession Number
2013554615
Authors
Imantalab V. Nejad A.S. Mansouri A.M. Meibodi A.S. Dadkhah H. Farzam S.
Forghan-Parast K.
Institution
(Imantalab, Nejad, Mansouri) Fellowship of Cardiac Anesthesia, Department
of Cardiac Anesthesia, Heshmat Hospital, Rasht University of Medical
Sciences, Rasht, Iran, Islamic Republic of
(Meibodi, Dadkhah, Farzam, Forghan-Parast) Guilan University of Medical
Sciences, Rasht, Iran, Islamic Republic of
Title
Effect of Calcium Gluconate on mean arterial pressure after induction of
anesthesia with Propofol in patients undergoing coronary artery bypass
graft surgery.
Source
Iranian Heart Journal. 14 (2) (pp 30-36), 2013. Date of Publication: 2013.
Publisher
Iranian Heart Association (P.O. Box 15745-1341, Tehran, Iran, Islamic
Republic of)
Abstract
Introduction: A combination of Propofol and Fentanyl is used as a method
for inducing general anesthesia. Although Propofol is widely used for the
induction and maintenance of anesthesia, it has a significant effect on
reducing arterial blood pressure. It has been suggested that Calcium
Gluconate, when administered simultaneously with Propofol, may reduce the
inotrope negative effect of Propofol on heart function. Objective: To
determine the effect of Calcium Gluconate in decreasing the negative
effect of Propofol. Materials and Methods: This randomized, controlled,
double-blind, clinical trial divided 70 patients undergoing elective
coronary artery bypass graft surgery (CABG) into two groups: Group A
(Calcium Gluconate) and Group B (placebo). Each patient was injected with
Fentanyl (4 mug/kg), Pancuronium (0.1 mg/kg), and Propofol (1.5 mg/kg)
within 60 seconds via a central vein line. Calcium Gluconate (30 mg/kg)
and saline (placebo) were administered to Group A and Group B,
respectively. Homodynamic data were obtained at baseline (T0), 4 minutes
after anesthesia induction (T1), and 2 minutes after tracheal intubation
(T2). The data were analyzed using descriptive statistics, repeated
measurement, and T tests; a p value < 0.05 was considered statistically
significant. Results: The mean and SD of mean arterial pressure at T0 was
101.11 +/- 13.63 for Group A and 107.142 +/- 14.59 for Group B
(non-significant). These figures for T1 (4 minutes after anesthesia
induction) and T2 (2 minutes after tracheal intubation) were 70.14 +/-
14.67 and 80.22 +/- 23.29 for Group A and 72.05 +/- 15.45 and 82.42 +/-
14.86 for Group B (nonsignificant). Conclusion: The findings of this
research indicated no differences between the two groups. Calcium
Gluconate appeared to exert no impact on reducing the negative effect of
Propofol.

<10>
Accession Number
2013554614
Authors
Nezafati M.H. Esfahanizadeh J. Hosseinzadeh M. Nezafati P.
Institution
(Nezafati, Esfahanizadeh, Nezafati) Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
(Hosseinzadeh) Birjand University of Medical Sciences, Iran, Islamic
Republic of
Title
Comparison of antegrade cold blood and crystalloid cold cardioplegia for
repair of Tetralogy of Fallot in pediatric heart surgery: A randomized
controlled trial.
Source
Iranian Heart Journal. 14 (2) (pp 24-29), 2013. Date of Publication: 2013.
Publisher
Iranian Heart Association (P.O. Box 15745-1341, Tehran, Iran, Islamic
Republic of)
Abstract
Background: Many small-sized trials have evaluated the effectiveness of
cold blood cardioplegia (CBC) compared with crystalloid cold cardioplegia
(CCC) for myocardial protection during pediatric cardiac surgery. We
hypothesized that CBC might preserve the myocardium more effectively than
St. Thomas' crystalloid cardioplegia in pediatric cardiac surgery and,
thus, investigated the efficacy of CCC versus CBC in terms of myocardial
metabolism protection in patients undergoing the corrective repair of
Tetralogy of Fallot (TOF). Methods: Thirty pediatric patients with TOF
were randomly allocated to either CBC (n=15, 4:1 dilution, potassium
chloride 15 mEq/L) or CCC (4 degreeC, n=15). Arterial and coronary sinus
blood samples were analyzed for lactate and oxygen contents. Results: The
patients were demographically similar in both groups. The lactate
concentration in coronary sinus blood was not significantly different
between the two groups exactly after cardiopulmonary bypass (2.5+/-1.3 vs.
2.5+/-1.0 mmol/L; p value = 0.9) but coronary sinus blood O2 saturation
was higher early after cardiopulmonary bypass in the CBC group
(59.0+/-18.5 vs. 44.0+/-17.6 meq; p value = 0.03). Conclusion: Our results
showed no significant clinical advantages of antegrade CBC over CCC during
hypothermic cardioplegic arrest in pediatric cardiac surgery.

<11>
Accession Number
2013554612
Authors
Azarasa M. Faritous Z. Jalali A. Dehaki M.G. Massoumi G.
Institution
(Azarasa) Qazvin University of Medical Sciences, Qazvin, Iran, Islamic
Republic of
(Faritous) Rajaie Cardiovascular, Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Jalali) Baqiyatallah University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Dehaki) Rajaie Cardiovascular, Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Massoumi) Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
Title
Effect of low-dose Dopamine on lactate level in patients undergoing
coronary bypass surgery.
Source
Iranian Heart Journal. 14 (2) (pp 13-18), 2013. Date of Publication: 2013.
Publisher
Iranian Heart Association (P.O. Box 15745-1341, Tehran, Iran, Islamic
Republic of)
Abstract
Background: The aim of this study was to study the effect of low-dose
Dopamine on the blood lactate levels as a sign of visceral perfusion in
coronary artery bypass graft surgery (CABG) patients. Methods: In a
double-blinded, randomized clinical trial, 100 adult patients - who were
candidated for elective isolated CABG surgery - were divided equally into
two groups of low-dose Dopamine group (2 mug / kg / min) and control group
(n=50 in each). Lactate levels, arterial blood gas analyses, blood
pressure, and heart rate were recorded intraoperatively at four time
points: before the induction of anesthesia; 15 minutes after the beginning
of cardiopulmonary bypass (CPB); during CPB at rewarming to 34degreeC; and
15 minutes after separation from CPB. These biochemical and hemodynamic
parameters were compared in these four time points between the two study
groups. Results: Arterial blood gas and hemodynamic parameters were
similar between the two groups during surgery (p values > 0.05). There
were no significant differences between the lactate levels in the Dopamine
and control groups at the beginning of CPB (3.1 +/- 2.5 vs. 2.6 +/- 2.0
mg/dl; p value = 0.453), at the time of rewarming (3.1 +/- 2.5 vs. 2.6 +/-
2.0 mg/dl; p value = 0.510), and after CPB (3.1 +/- 2.5 vs. 2.6 +/- 2.0
mg/dl; p value = 0.551) - respectively. Conclusions: The use of low-dose
Dopamine did not decrease lactate levels in our CABG patients using CPB.

<12>
Accession Number
2013545943
Authors
Zhou H. Feng X.-L. Zhang H.-Y. Xu F.-F. Zhu J.
Institution
(Zhou, Feng, Zhang, Xu, Zhu) Department of Emergency, Fourth Affiliated
Hospital of China Medical University, Huanggu, Shenyang, Liaoning 110032,
China
Title
Triple versus dual antiplatelet therapy for coronary heart disease
patients undergoing percutaneous coronary intervention: A meta-analysis.
Source
Experimental and Therapeutic Medicine. 6 (4) (pp 1034-1040), 2013. Date of
Publication: 2013.
Publisher
Spandidos Publications Ltd. (10 Vriaxidos Street, Athens 11635, Greece)
Abstract
Coronary heart disease (CHD) is the leading cause of mortality worldwide.
Previous studies have suggested that cilostazol-based triple antiplatelet
therapy (TAT) may be more effective than conventional dual antiplatelet
therapy (DAT) at improving the clinical outcomes of patients with CHD
undergoing percutaneous coronary intervention (PCI). However, individually
published results are inconclusive. The present meta-analysis evaluated
controlled clinical studies to compare the clinical outcomes between TAT
and DAT in patients with CHD undergoing PCI. Ten controlled clinical
studies were included, with a total of 7,670 patients with CHD undergoing
PCI. The total number included 3,925 patients treated with DAT (aspirin
and clopidogrel) and 3745 patients treated with TAT (addition of
cilostazol to DAT). The crude odds ratio (OR) with a 95% confidence
interval (CI) was calculated with either the fixed or random effects
model. The meta-analysis results indicated that patients in the TAT group
had a significantly lower rate of restenosis compared with that of the DAT
group (OR=0.59, 95% CI: 0.45-0.77; P<0.001). The rate of major adverse
cardiac events (MACE) and target lesion revascularization (TLR) in the TAT
group were significantly lower compared with those in the DAT group (MACE:
OR=0.69, 95% CI: 0.56-0.85, P<0.001; TLR: OR=0.61, 95% CI: 0.43-0.88,
P=0.008). However, no significant differences between the TAT and DAT
groups in terms of mortality rate, myocardial infarction, target vessel
revascularization and stent thrombosis were observed. In conclusion, the
results of the present meta-analysis indicated that the efficacy and
safety of cilostazol-based TAT therapy is greater than that of
conventional DAT therapy for patients with CHD undergoing PCI.

<13>
Accession Number
2013536184
Authors
Tavlasoglu M. Durukan A.B. Kurkluoglu M. Guler A. Arslan Z. SahIn M.A.
Gurbuz H.A. Guler L.
Institution
(Tavlasoglu) Department of Cardiovascular Surgery, Diyarbakir Military
Hospital, Diyarbakir, Turkey
(Durukan, Gurbuz) Department of Cardiovascular Surgery, Medicana
International Ankara Hospital, Ankara, Turkey
(Kurkluoglu) Department of Cardiovascular Surgery, Children's National
Heart Institute, Children's National Medical Center, Washington DC, United
States
(Guler, SahIn) Department of Cardiovascular Surgery, Gulhane Military
Medical Academy, Ankara, Turkey
(Arslan) Department of Cardiology, Gulhane Military Medical Academy,
Ankara, Turkey
(Guler) Department of Anesthesiology, Gazi University, Ankara, Turkey
Title
Comparison of sternal intramedullary bleeding prevention strategies in
cardiac surgery.
Source
Turkish Journal of Medical Sciences. 43 (5) (pp 695-699), 2013. Date of
Publication: 2013.
Publisher
Turkiye Klinikleri Journal of Medical Sciences (Talapapa Bulvary no. 102,
Hamammonu 1 06230, Turkey)
Abstract
Aim: Sternal intramedullary bleeding is an important contributor to
postcardiac surgery hemorrhage. The aim of this study is to investigate
the effects of bone wax, oxidized regenerated cellulose, and
electrocoagulation on sternal intramedullary hemostatic control. Materials
and methods: A total of 142 patients undergoing on-pump coronary bypass
surgery were prospectively studied. The patients were randomized into 3
groups; bone wax concomitant with electrocauterization, oxidized
regenerated cellulose concomitant with electrocauterization, and
electrocauterization alone. The amount of postoperative hemorrhage was
noted at the 1st, 2nd, 3rd, 6th, 12th and 24th hours. Rates of
reexploration for hemorrhage and number of units of blood and its products
used were also studied. Results: The mean age of the patients was 64.23
+/- 5.81 years. There were 114 (79.7%) male patients. The patients were
comparable regarding preoperative demographics except age and
intraoperative variables. The amount of postoperative hemorrhage was
lowest in the oxidized regenerated cellulose and highest in the
electrocauterization alone group. The number of fresh frozen plasma and
erythrocyte suspension used was also lowest in the oxidized regenerated
cellulose group. Conclusion: To overcome hemorrhage originating from the
sternal intramedullary space, oxidized regenerated cellulose use
concomitant with electrocauterization is effective and can be safely used
immediately before closing the chest in open heart surgery. TUBITAK.

<14>
Accession Number
2013543382
Authors
Mohandas B.S. Jagadeesh A.M. Vikram S.B.
Institution
(Mohandas, Jagadeesh, Vikram) Department of Cardiac Anesthesia, Sri
Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta
Road, Bangalore - 560 069, Karnataka, India
Title
Impact of monitoring cerebral oxygen saturation on the outcome of patients
undergoing open heart surgery.
Source
Annals of Cardiac Anaesthesia. 16 (2) (pp 102-106), 2013. Date of
Publication: April-June 2013.
Publisher
Medknow Publications and Media Pvt. Ltd (B9, Kanara Business Centre, off
Link Road, Ghatkopar (E), Mumbai 400 075, India)
Abstract
Aims and Objectives: We studied the usefulness of regional cerebral oxygen
saturation (rSO₂ ) monitoring during cardiopulmonary bypass
(CPB) and evaluated effects of cerebral oxygen desaturation on the
postoperative neurological outcome. Materials and Methods: 100 patients
were randomly allocated to either control or intervention group. In the
control group rSO ₂ was recorded continuously, but the
attending anesthesiologist was blinded. In the intervention group specific
interventions were initiated in case of cerebral desaturation.
Neurocognitive testing was done using a simplified antisaccadic eye
movement test (ASEM) and mini-mental state examination (MMSE). Data was
analyzed using Chi-square test, and unpaired t-test. Results: In both the
groups rSO₂ declined during CPB. The decrease in
rSO₂ was significant (P < 0.001) in the control group compared
to the intervention group. In the intervention group the rSO₂
mainly responded to an increase in mean arterial pressure. The area under
the curve below threshold rSO₂ was significantly more (P <
0.0001) in the control group compared to intervention group and a
significant decrease in the MMSE and ASEM scores occurred in control group
at one week and three months postoperatively. Conclusions: Monitoring of
rSO₂ during CPB can significantly decrease the incidence of
postoperative neurocognitive decline.

<15>
Accession Number
2013543380
Authors
Kodalli R. Sundar A. Vakamudi M. Ravulapali H. Nandipati S. Chandrasekaran
N. Karthekeyan R.
Institution
(Kodalli, Sundar, Vakamudi, Ravulapali, Nandipati, Chandrasekaran,
Karthekeyan) Department of Cardiac Anesthesiology, Sri Ramachandra Medical
College and Research Institute, Porur, Chennai, Tamil Nadu, India
Title
Effect of levosimendan on hemodynamic changes in patients undergoing
off-pump coronary artery bypass grafting: A randomized controlled study.
Source
Annals of Cardiac Anaesthesia. 16 (2) (pp 94-99), 2013. Date of
Publication: April-June 2013.
Publisher
Medknow Publications and Media Pvt. Ltd (B9, Kanara Business Centre, off
Link Road, Ghatkopar (E), Mumbai 400 075, India)
Abstract
Aims and Objective: We tested the hypothesis that use of levosimendan
would be associated with better perioperative hemodynamics and cardiac
function during off-pump coronary artery bypass grafting (OPCAB) in
patients with good left ventricular function. Materials and Methods:
Thirty patients scheduled for OPCAB were randomized in a double-blind
manner to receive either levosimendan 0.1 mug/kg/min or placebo after
induction of general anesthesia. The hemodynamic variables were measured
after induction of anesthesia, at 6 minute after application of tissue
stabilizer for the anastomoses of left anterior descending artery,
diagonal artery, left circumflex artery, and right coronary artery and at
6, 12, 18, and 24 hours after completion of surgery. Results: Compared
with placebo group, cardiac index (CI) was significantly higher and
systemic vascular resistance index (SVRI) was significantly lower at 6,
12, 18, and 24 hour after surgery in levosimendan group. Norepinephrine
was infused in 60% of the patients in the levosimendan group compared to
6.7% in the control group (P < 0.05). Lactate and mixed venous oxygen
saturation were not significantly different between groups. Conclusions:
Levosimendan significantly increased CI and decreased SVRI after OPCAB but
it did not show any outcome benefit in terms of duration of ventilation
and intensive care unit stay.