EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 18

Results Generated From:
Embase <1980 to 2015 Week 38>
Embase (updates since 2015-09-10)
Embase <1980 to 2015 Week 38>
Embase (updates since 2015-09-10)

<1>
Accession Number
2015791165
Authors
Billings F.T. Petracek M.R. Roberts L.J. Pretorius M.
Institution
(Roberts, Pretorius) Division of Clinical Pharmacology, Department of
Medicine, Vanderbilt University Medical School, Nashville, TN, United
States
(Petracek) Department of Cardiac Surgery, Vanderbilt University Medical
School, Nashville, TN, United States
(Roberts) Department of Pharmacology, Vanderbilt University Medical
School, Nashville, TN, United States
(Billings, Pretorius) Department of Anesthesiology, Vanderbilt University
Medical School, Nashville, TN, United States
Title
Perioperative intravenous acetaminophen attenuates lipid peroxidation in
adults undergoing cardiopulmonary bypass: A randomized clinical trial.
Source
PLoS ONE. 10 (2) , 2015. Article Number: e0117625. Date of Publication: 23
Feb 2015.
Publisher
Public Library of Science
Abstract
Background: Cardiopulmonary bypass (CPB) lyses erythrocytes and induces
lipid peroxidation, indicated by increasing plasma concentrations of free
hemoglobin, F<inf>2</inf>-isoprostanes, and isofurans. Acetaminophen
attenuates hemeprotein-mediated lipid peroxidation, reduces plasma and
urine concentrations of F<inf>2</inf>-isoprostanes, and preserves kidney
function in an animal model of rhabdomyolysis. Acetaminophen also
attenuates plasma concentrations of isofurans in children undergoing CPB.
The effect of acetaminophen on lipid peroxidation in adults has not been
studied. This was a pilot study designed to test the hypothesis that
acetaminophen attenuates lipid peroxidation in adults undergoing CPB and
to generate data for a clinical trial aimed to reduce acute kidney injury
following cardiac surgery. Methods and Results: In a prospective
double-blind placebo-controlled clinical trial, sixty adult patients were
randomized to receive intravenous acetaminophen or placebo starting prior
to initiation of CPB and for every 6 hours for 4 doses. Acetaminophen
concentrations measured 30 min into CPB and post-CPB were 11.9+/- 0.6
mug/mL (78.9+/-3.9 muM) and 8.7+/- 0.3 mug/mL (57.6+/-2.0 muM),
respectively. Plasma free hemoglobin increased more than 15-fold during
CPB, and haptoglobin decreased 73%, indicating hemolysis. Plasma and
urinary markers of lipid peroxidation also increased during CPB but
returned to baseline by the first postoperative day. Acetaminophen reduced
plasma isofuran concentrations over the duration of the study (P = 0.05),
and the intraoperative plasma isofuran concentrations that corresponded to
peak hemolysis were attenuated in those subjects randomized to
acetaminophen (P = 0.03). Perioperative acetaminophen did not affect
plasma concentrations of F<inf>2</inf>-isoprostanes or urinary markers of
lipid peroxidation. Conclusions: Intravenous acetaminophen attenuates the
increase in intraoperative plasma isofuran concentrations that occurs
during CPB, while urinary markers were unaffected. Trial Registration:
ClinicalTrials.gov NCT01366976.

<2>
Accession Number
2015184430
Authors
Chang J.-E. Min S.-W. Kim C.-S. Han S.-H. Kwon Y.-S. Hwang J.-Y.
Institution
(Chang, Min, Kim, Hwang) Department of Anesthesiology and Pain Medicine,
SMG-SNU Boramae Medical Center, Boramae-ro, Dongjak-gu, Seoul 156-707,
South Korea
(Han) Department of Anesthesiology & Pain Medicine, Seoul National
University Bundang Hospital, Seongnam, South Korea
(Kwon) Department of Anesthesiology & Pain Medicine, Seoul National
University Hospital, Seoul, South Korea
Title
Effect of prophylactic benzydamine hydrochloride on postoperative sore
throat and hoarseness after tracheal intubation using a double-lumen
endobronchial tube: a randomized controlled trial.
Source
Canadian Journal of Anesthesia. 62 (10) (pp 1097-1103), 2015. Date of
Publication: 07 Jul 2015.
Publisher
Springer New York LLC
Abstract
Purpose: We evaluated the prophylactic effect of benzydamine hydrochloride
(BH) spray on postoperative sore throat and hoarseness secondary to
intubation with a double-lumen endobronchial tube (DLT). Methods:
Ninety-two adult patients undergoing thoracic surgery using DLT intubation
were studied. The DLT cuff and oropharyngeal cavity were sprayed with
normal saline (Group S; n = 46) or BH (Group BH; n = 46) prior to
intubation. Postoperative sore throat and hoarseness were evaluated at
one, six, and 24 hr after surgery. Sore throat was evaluated using a 0-100
mm visual analogue scale (VAS). Hoarseness was defined as a change in
voice quality. Results: Compared with Group S, postoperative sore throat
occurred less frequently in Group BH at one hour (mean difference, 28.3%;
95% confidence interval [CI], 8.7 to 45.1; P = 0.01), at six hours (mean
difference, 32.6%; 95% CI, 12.6 to 49.2; P < 0.01), and at 24 hr (mean
difference, 28.3%; 95% CI, 9.3 to 44.7; P = 0.01) after surgery. Group BH
had lower VAS scores for postoperative sore throat at one hour (mean
difference, 12.8; 95% CI, 4.9 to 20.7), at six hours (mean difference,
11.9; 95% CI, 4.8 to 19.1; P < 0.01), and at 24 hr (mean difference, 5.3;
95% CI, 0.9 to 9.7; P = 0.01) after surgery. Hoarseness also occurred less
frequently in Group BH at one hour (mean difference, 23.9%; 95% CI, 6.8 to
39.6; P = 0.01), at six hours (mean difference, 23.9%; 95% CI, 7.4 to
39.3; P = 0.01), and at 24 hr (mean difference, 21.7%; 95% CI, 5.5 to
37.0; P = 0.02) after surgery (P < 0.01). Conclusions: Prophylactic
application of BH to the DLT cuff and oropharyngeal cavity reduces the
incidence and severity of postoperative sore throat and the incidence of
hoarseness associated with DLT intubation. The trial was registered at the
Clinical Research Information Service (KCT0001068).

<3>
Accession Number
2015168447
Authors
Can A. Ulus A.T. Cinar O. Topal Celikkan F. Simsek E. Akyol M. Canpolat U.
Erturk M. Kara F. Ilhan O.
Institution
(Can, Cinar, Topal Celikkan) Department of Histology and Embryology,
Laboratory for Stem Cells and Reproductive Cell Biology, Ankara University
School of Medicine, Ankara, Turkey
(Ulus) Department of Cardiovascular Surgery, Hacettepe University School
of Medicine, Ankara, Turkey
(Simsek) Ministry of Health, Cardiovascular Surgery Division, Ankara,
Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey
(Akyol) Department of Biostatistics, Yildirim Beyazit University, Ankara,
Turkey
(Canpolat) Department of Cardiology, Hacettepe University School of
Medicine, Ankara, Turkey
(Erturk) ATIGEN-CELL Technology, Trabzon, Turkey
(Kara) Ob-Gyn Division, Ministry of Health Dr. Sami Ulus Maternity
Hospital, Ankara, Turkey
(Ilhan) Department of Hematology, Ankara University School of Medicine,
Ankara, Turkey
Title
Human Umbilical Cord Mesenchymal Stromal Cell Transplantation in
Myocardial Ischemia (HUC-HEART Trial). A Study Protocol of a Phase 1/2,
Controlled and Randomized Trial in Combination with Coronary Artery Bypass
Grafting.
Source
Stem Cell Reviews and Reports. 11 (5) (pp 752-760), 2015. Date of
Publication: 10 Oct 2015.
Publisher
Humana Press Inc.
Abstract
Mesenchymal stem cells (MSCs), which may be obtained from the bone marrow,
have been studied for more than a decade in the setting of coronary artery
disease (CAD). Adipose tissue-derived MSCs have recently come into focus
and are being tested in a series of clinical trials. MSC-like cells have
also been derived from a variety of sources, including umbilical cord
stroma, or HUC-MSCs. The HUC-HEART trail (ClinicalTrials.gov Identifier:
NCT02323477) is a phase 1/2, controlled, multicenter, randomized clinical
study of the intramyocardial delivery of allogeneic HUC-MSCs in patients
with chronic ischemic cardiomyopathy. A total of 79 patients (ages 30-80)
with left ventricle ejection fractions ranging between 25 and 45 % will be
randomized in a 2:1:1 pattern in order to receive an intramyocardial
injection of either HUC-MSCs or autologous bone marrow-derived mononuclear
cells (BM-MNCs) in combination with coronary arterial bypass grafting
(CABG) surgery. The control group of patients will receive no cells and
undergo CABG alone. Human HUC-MSCs will be isolated, propagated and banked
in accordance with a cGMP protocol, whereas the autologous BM-MNCs will be
isolated via aspiration from the iliac crest and subsequently process in a
closed-circuit cell purification system shortly before cell
transplantation. The cell injections will be implemented in 10
peri-infarct areas. Baseline and post-transplantation outcome measures
will be primarily utilized to test both the safety and the efficacy of the
administered cells for up to 12 months.

<4>
Accession Number
2015354685
Authors
Passaglia L.G. de Barros G.M. de Sousa M.R.
Institution
(Passaglia, de Barros, de Sousa) School of Medicine, Universidade Federal
de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
(Passaglia, de Sousa) Hospital das Clinicas, Universidade Federal de Minas
Gerais, Belo Horizonte, Minas Gerais, Brazil
Title
Early postoperative bridging anticoagulation after mechanical heart valve
replacement: A systematic review and meta-analysis.
Source
Journal of Thrombosis and Haemostasis. 13 (9) (pp 1557-1567), 2015. Date
of Publication: 01 Sep 2015.
Publisher
Blackwell Publishing Ltd
Abstract
Objective: To perform a systematic review and meta-analysis of studies
evaluating anticoagulation during the early postoperative period following
mechanical heart valve implantation. Methods: Five literature databases
were searched to assess the rates of bleeding and thromboembolic events
among patients receiving oral anticoagulation (OAC), both with and without
bridging anticoagulation therapy with unfractionated heparin (UFH) or
subcutaneous low molecular weight heparin (LMWH). The studies' results
were pooled via a mixed effects meta-analysis. Heterogeneity
(I²) and publication bias were both evaluated. Results:
Twenty-three studies including 9534 patients were included. The bleeding
rates were 1.8% (95% confidence interval CI 1.0-3.3) in the group
receiving OAC, 2.2% (95% CI 0.9-5.3) in the OAC + UFH group, and 5.5% (95%
CI 2.9-10.4) in the OAC + LMWH group (P = 0.042). The thromboembolic event
rate was 2.1% (95% CI 1.5-2.9) in the group receiving OAC, as compared
with 1.1% (95% CI 0.7-1.8) when the bridging therapy groups were combined
as follows: OAC + UFH and OAC + LMWH (P = 0.035). Most of the analyses
showed moderate heterogeneity and negative test results for publication
bias. Conclusions: Bridging therapy following cardiac valve surgery was
associated with a lower thromboembolic event rate, although the difference
was small, with considerable overlap of the CIs. Direct comparisons are
missing. Bridging therapy with UFH appears to be safe; however, this
observation has a risk of bias. Early bridging therapy with LMWH appears
to be associated with consistently high bleeding rates across multiple
analyses. On the basis of the quality of the included studies, more trials
are necessary to establish the clinical relevance of bridging therapy and
the safety of LMWH.

<5>
Accession Number
2015364370
Authors
Demir T. Ergenoglu M.U. Demir H.B. Tanrikulu N. Sahin M. Gok E. Korkut K.
Demirsoy E.
Institution
(Demir, Ergenoglu, Korkut, Demirsoy) Department of Cardiovascular Surgery,
Kolan International Hospital, Turkey
(Demir) Department of Cardiovascular Surgery, Medicana International
Hospital, Turkey
(Tanrikulu) Department of Anesthesiology, Kolan International Hospital,
Turkey
(Sahin, Gok) Department of Cardiovascular Surgery, Istanbul Medical
Faculty, Istanbul University, Istanbul, Turkey
Title
Pretreatment with methylprednisolone improves myocardial protection during
on-pump coronary artery bypass surgery.
Source
Heart Surgery Forum. 18 (4) (pp E171-E177), 2015. Date of Publication: 01
Aug 2015.
Publisher
Carden Jennings Publishing Co. Ltd (375 Greenbrier Drive, Suite #100,
Charlottesville VA 22901-1618, United States. E-mail: ijh@cjp.com)
Abstract
Background: This study was undertaken to determine whether
methylprednisolone could improve myocardial protection by altering the
cytokine profile toward an anti-inflammatory course in patients undergoing
elective coronary artery bypass grafting (CABG) surgery with
cardiopulmonary bypass (CPB). Methods: Forty patients who were scheduled
for elective CABG surgery were randomized into two groups: the study group
(n = 20), who received 1 g of methylprednisolone intravenously before CPB,
and the control group (n = 20), who underwent a standard CABG surgery
without any additional medication. Blood samples were withdrawn prior to
surgery (T1) and then 4 hours (T2), 24 hours (T3), and 36 hours (T4) after
CPB. Plasma levels of interleukin (IL)-6, IL-10, creatine kinase isoenzyme
MB (CK-MB), cardiac troponin-t (cTnT), and blood glucose as well as
neutrophil counts were measured at each sampling time. Results: A
comparison of patients between both groups revealed significantly high
levels of IL-6 in the control group at T2, T3, and T4 with respect to T1
(T2: P < .001; T3: P < .001; T4: P < .001). IL-10 levels were
significantly higher in the study group at T2 compared with the control
group (P = .007). CK-MB levels were significantly lower in the study group
than in the control group at T4 (P = .001). The increase of cTnT was
higher in the control group at T3 and T4 compared with the study group
(T3: P = .002; T4: P = .001). Conclusions: This study demonstrates that
methylprednisolone is effective for ensuring better myocardial protection
during cardiac surgery by suppressing the inflammatory response via
decreasing the levels of IL-6 and by increasing anti-inflammatory activity
through IL-10.

<6>
Accession Number
2015364368
Authors
Zhao A. Minhui H. Li X. Zhiyun X.
Institution
(Zhao, Li, Zhiyun) Department of Cardiothoracic Surgery, Changhai
Hospital, Second Military Medical University, Changhai Road No. 168,
Shanghai 200433, China
(Minhui) Department of Colorectal Surgery, The, Sixth Affiliated Hospital,
Sun Yat-sen University, Guangzhou, China
Title
A meta-analysis of transfemoral versus transapical transcatheter aortic
valve implantation on 30-day and 1-year outcomes.
Source
Heart Surgery Forum. 18 (4) (pp E161-E166), 2015. Date of Publication: 01
Aug 2015.
Publisher
Carden Jennings Publishing Co. Ltd (375 Greenbrier Drive, Suite #100,
Charlottesville VA 22901-1618, United States. E-mail: ijh@cjp.com)
Abstract
Background: Transfemoral (TF) and transapical (TA) are two commonly used
accesses in transcatheter aortic valve implantation (TAVI). Currently, the
influence of TAVI access choice on 30-day and 1-year outcomes is unclear.
The purpose of this study was to compare the 30-day and 1-year outcomes
between TF-TAVI and TA-TAVI. Methods: Studies published from 2002 to
September 2014 were collected by searching PubMed and Web of Knowledge.
Studies were selected by two independent investigators. 30-day and 1-year
outcomes were endpoints. Odds ratios (ORs) and hazard ratio (HR) with 95%
confidence interval (CI) were computed. Fixed effect model was used if
I² < 50%; if I² > 50%, random effect model was used.
Results: 14 studies met inclusion criteria and were included in our
analysis (3837 patients in TF group, 1881 patients in TA group). Two were
retrospective trials and the others were prospective trials. Our
meta-analysis showed that compared with TA group, TF group had a lower
30-day mortality (7.5% versus 11.6%) and higher 1-year survival [HR 0.75,
95% CI (0.66, 0.86)], but the Logistic EuroSCORE was higher in TA group (P
= 0.00). TF group had a significantly higher stroke rate of 4.0% compared
with 2.2% in TA group at <30 days. The incidence of major vascular
complications was significantly higher in TF group compared with TA group
(8.2% versus 5.3%). MI was more common in TA group (2.4%) compared with TF
group (1.2%), but there were no significant difference [0.46, 95% CI
(0.20, 1.06)]. Conclusions: TF-TAVI had a higher 30-day and 1-year
survival rate compared with TA-TAVI, but these differences might be
because of the higher Logistic EuroSCORE in TA group. Stroke and major
vascular complications rates were higher in TF-TAVI patients at <30 days.

<7>
Accession Number
2015364367
Authors
Ariturk C. Ozgen Z.S. Kilercik M. Ulugol H. Okten E.M. Aksu U. Karabulut
H. Toraman F.
Institution
(Ariturk, Okten, Karabulut) Departmentof Cardiovascular Surgery, Istanbul,
Turkey
(Ozgen, Kilercik, Ulugol, Toraman) Department of Anesthesiology and
Reanimation, Acibadem University, School of Medicine, Istanbul, Turkey
(Aksu) Istanbul University, School of Biology, Istanbul, Turkey
(Ariturk) Haci Mehmet Efendi Sok, Ali Bey Apt. No:17 D:14 Kadikoy,
Istanbul, Turkey
Title
Comparative effects of hemodilutional anemia and transfusion during
cardiopulmonary bypass on acute kidney injury: A prospective randomized
study.
Source
Heart Surgery Forum. 18 (4) (pp E154-E160), 2015. Date of Publication: 01
Aug 2015.
Publisher
Carden Jennings Publishing Co. Ltd (375 Greenbrier Drive, Suite #100,
Charlottesville VA 22901-1618, United States. E-mail: ijh@cjp.com)
Abstract
Aim: Acute kidney injury after cardiopulmonary bypass has been associated
with dilutional anemia during surgery. We aimed both to explore if this
relation is modulated by blood transfusion and to understand the
postoperative contribution of protein oxidation. Methods: In this
randomized prospective study, after ethics committee approval and informed
consent, 30 patients undergoing first-time elective coronary artery bypass
grafting (CABG) with hematocrit between 21% and 25% at any time during
extracorporeal circulation (ECC) were randomly and equally allocated into
two groups. Group I consisted of patients who received red blood cells
(RBC) during ECC, while in Group II, patients did not receive any RBCs.
Besides routine hemodynamic and biochemical parameters, markers of renal
injury such as neutrophil gelatinase-associated lipocalin (NGAL),
creatinine clearance, and protein oxidation parameters (advanced oxidative
protein products [AOPP], total thiol [T-SH]) were determined in both
groups. Results: (1) Both cardiovascular parameters (MAP, HR) and the
hospitalization period of the transfused group were not significantly
different compared to the non-transfused group (P > .05); (2) While urine
NGAL level (P < .05) increased and GFR (P < .01) decreased in the
transfused group compared to the preoperative period, there were no
significant changes in respective parameters of the non-transfused group
compared to preoperative period; (3) AOPP concentrations did not change
compared to postoperative periods in both groups (P > .05). However, T-SH
concentration showed a transient increased at postoperative hour 6 (P <
.001 vs preoperative period) but normalized at postoperative hour 24 (P >
.05 versus preoperative period). Conclusion: These findings suggest that a
hematocrit value over 21% during ECC is safe for renal functions. RBC
transfusion just to increase hematocrit may be deleterious.

<8>
Accession Number
2015288675
Authors
Zhao X.M. Gao C.Y. Chu Y.J. Yang L. Yang X.Z. Xu W.K. He W.Q. Zhang P.R.
Liu X.Y. Tian L.X.
Institution
(Zhao, Chu, Yang, Yang, Xu, He, Zhang, Liu, Tian) Department of Emergency,
Henan Provincial People's Hospital and the People's Hospital of Zhengzhou
University, Zhengzhou, China
(Gao) Department of Cardiology, Henan Provincial People's Hospital and the
People's Hospital of Zhengzhou University, Zhengzhou, China
Title
Fondaparinux vs. enoxaparin in patients with non-ST elevation acute
coronary syndromes (NSTE-ACS) treated with percutaneous coronary
intervention and tirofiban: An exploratory study in China.
Source
Journal of Clinical Pharmacy and Therapeutics. 40 (5) (pp 584-589), 2015.
Date of Publication: 01 Oct 2015.
Publisher
Blackwell Publishing Ltd
Abstract
What is known and objective Fondaparinux and enoxaparin are used in
patients with acute coronary syndrome (ACS), but their effect in
particular populations of patients is not well known. The objective was to
explore the difference between fondaparinux and enoxaparin in patients
with non-ST elevation ACS (NSTE-ACS) treated with percutaneous coronary
intervention (PCI) and tirofiban. Methods We prospectively enrolled 461
patients with NSTE-ACS treated with PCI, tirofiban, and either
fondaparinux (n = 229) or enoxaparin (n = 232). Death, myocardial
infarction, recurrent ischaemia and its composite outcome were assessed.
The incidences of major or minor bleeding not related to coronary artery
bypass grafting were also evaluated. Results and discussion The rates of
death, MI or refractory angina did not differ between the fondaparinux and
enoxaparin groups at day 7 (440% vs. 470%), 30 (790% vs. 860%) or 180
(960% vs. 1080%). Similarly, there were not statistically significant
differences in the rates of major bleeding at day 7 (087% vs. 216%), 30
(131% vs. 259%) or 180 (218% vs. 388%), or in the rates of minor bleeding
at day 7 (349% vs. 647%), 30 (568% vs. 948%) or 180 (830% vs. 1336%). What
is new and conclusion In this relatively small study of Chinese patients
with NSTE-ACS treated with tirofiban, there was no statistically
significant difference in ischaemic or bleeding outcomes with the use of
either fondaparinux or enoxaparin. Death, MI or angina did not differ
between the fondaparinux and enoxaparin. Rates of major and minor
bleedings were similar in the two groups. Both drugs had similar effects
in patients with NSTE-ACS, PCI and tirofiban.

<9>
Accession Number
2015240674
Authors
Roh J.-H. Lee J.-H. Kim Y.-H. Kim H.-S. Yun S.-C. Lee P.H. Chang M. Park
H.W. Yoon S.-H. Ahn J.-M. Park D.-W. Kang S.-J. Lee S.-W. Lee C.W. Park
S.-W. Park S.-J.
Institution
(Roh, Kim, Lee, Chang, Park, Yoon, Ahn, Park, Kang, Lee, Lee, Park, Park)
Division of Cardiology, Asan Medical Center, Seoul, South Korea
(Yun) Division of Biostatistics, Asan Medical Center, Seoul, South Korea
(Lee) Division of Cardiology, Chungnam National University Hospital,
Daejeon, South Korea
(Kim) Division of Cardiology, Hallym University, Sacred Heart Hospital,
Anyang, South Korea
Title
Procedural Predictors of Angiographic Restenosis after Bifurcation
Coronary Stenting (from the Choice of Optimal Strategy for Bifurcation
Lesions with Normal Side Branch and Optimal Stenting Strategy for True
Bifurcation Lesions Studies).
Source
American Journal of Cardiology. 116 (7) (pp 1050-1056), 2015. Date of
Publication: 01 Oct 2015.
Publisher
Elsevier Inc.
Abstract
Most subordinate techniques accompanying bifurcation stenting have not
been supported by relevant clinical trials. The aim of this study was to
investigate the impact of technical specifications involved in bifurcation
stenting on angiographic outcomes. We analyzed patients enrolled in a
cohort consisting of the patients in 2 randomized studies: one comparing
routine final kissing inflation (FKI) versus leave-alone strategy after
the 1-stent technique for bifurcations without side branch (SB) stenosis
(<50%) and the other comparing crush versus the 1-stent technique for
lesions with SB stenosis (>50%). The effects of subordinate techniques and
devices on 8-month angiographic restenosis were studied using multivariate
models. Of 514 patients whose 8-month angiograms were available, 58
(11.3%) were found to have restenosis involving, in total, 35 main
branches (MBs) and 27 SBs. Using multivariate models, we identified FKI as
the only independent predictor of MB restenosis in the technically
modifiable variables. The effect of FKI was significantly different across
subgroups defined by bifurcation lesion type and stenting technique (test
for homogeneity, p = 0.003): FKI was unrelated to MB restenosis in the
1-stent for diseased SB (odds ratio [OR] 0.41, 95% confidence interval
[CI] 0.10 to 1.72; p = 0.22) and the 2-stent groups (OR 0.14, 95% CI 0.01
to 1.36; p = 0.09) but predictive of MB restenosis in the 1-stent for
normal SB group (OR 4.90, 95% CI 1.58 to 15.16; p = 0.006).

<10>
Accession Number
2015363855
Authors
Demir A. Ylmaz F.M. Ceylan C. Doluoglu O.G. Ucar P. Zungun C. Guclu C.Y.
Unal U. Karadeniz U. Gunertem E. Lafci G. Catl K. Ozgok A.
Institution
(Demir, Ucar, Karadeniz, Ozgok) Department of Anaesthesia, Turkiye Yuksek
Ihtisas Education and Research Hospital, Ankara, Turkey
(Ylmaz, Zungun) Department of Biochemistry, Ankara Numune Education and
Research Hospital, Ankara, Turkey
(Ceylan) Department of Urology, Turkiye Yuksek Ihtisas Education and
Research Hospital, Ankara, Turkey
(Doluoglu) Department of Urology, Ankara Training and Research Hospital,
Ankara, Turkey
(Guclu) Department of Anaesthesia, Ankara University Medical Faculty,
Ankara, Turkey
(Unal, Gunertem, Lafci, Catl) Department of Cardiac Surgery, Turkiye
Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
(Ceylan) Department of Urology, Clinic of Turkiye Yuksek Ihtisas Training
and Research Hospital, Ataturk Bulvari, Kizilay Sokak, Sihhiye, No: 4
06100, Turkey
Title
A comparison of the effects of ketamine and remifentanil on renal
functions in coronary artery bypass graft surgery.
Source
Renal Failure. 37 (5) (pp 819-826), 2015. Date of Publication: 28 May
2015.
Publisher
Taylor and Francis Ltd
Abstract
We have investigated the effects of ketamine-based and remifentanil-based
anesthetic protocol on perioperative serum cystatin-C levels, and
creatinine and/or cystatin-C-based eGFR equations in terms of acute kidney
injury in coronary artery bypass graft (CABG) surgery. Using a simple
randomization method (coin tossing), patients were divided into the two
groups and not-blinded to the anesthetist. Remifentanil-midazolam-propofol
or ketamine-midazolam-propofol-based anesthetic regimen was chosen.
Different eGFR formulas using creatinine (MDRD, CKD-EPI, Cockrauft Gault);
cystatin-C (eGFR1, eGFR2) or a combination of creatinine and cystatin-C
(eGFR 3) were used to calculate estimated glomerular filtration rates
(eGFRs). High-sensitive troponin T was used to determine if ketamine use
in coronary surgery contributed to myocardial cell damage. Thirty-seven
patients were included in the study (remifentanil group = 19, ketamine
Group = 18). Urea, creatinine, cystatin-C levels were comparable between
the groups in all the measurement times and also postoperative day 2
samples showed statistically higher results compared to baseline (p <
0.001). Effects of ketamine and remifentanil on renal functions were found
similar. Creatinine and cystatin-C-based eGFR equations resulted similar
in our study. Reversible stage 1 acute kidney injury (AKI) was observed on
postoperative day 2 in seven patients from the remifentanil group and six
patients from the ketamine group. Hs-troponin T was found to be higher in
postoperative day 1 samples; there were no significant difference between
the groups. Our results indicated that patients who have normal renal
functions undergoing on-pump coronary bypass surgery, effects of ketamine
and remifentanil on renal functions in terms of AKI were found to be
similar.

<11>
[Use Link to view the full text]
Accession Number
2015356962
Authors
Peelukhana S.V. Banerjee R. Kolli K.K. Fernandez-Ulloa M. Arif I. Effat M.
Helmy T. Kerr H.
Institution
(Peelukhana, Helmy) Departments of Mechanical and Materials Engineering,
United States
(Banerjee, Kolli) Departments of Nuclear Medicine, United States
(Kerr) UC Health Physicians Office - Montgomery, 9275 Montgomery Rd,
Cincinnati, OH 45242, United States
(Arif, Effat) Department of Biomedical Engineering, University of
Cincinnati, United States
(Fernandez-Ulloa, Kerr) Department of Veteran Affairs Medical Center,
Cincinnati, OH, United States
Title
Benefit of ECG-gated rest and stress N-13 cardiac PET imaging for
quantification of LVEF in ischemic patients.
Source
Nuclear Medicine Communications. 36 (10) (pp 986-998), 2015. Date of
Publication: 07 Sep 2015.
Publisher
Lippincott Williams and Wilkins
Abstract
Background ECG-gated rest-stress cardiac PET can lead to simultaneous
quantification of both left ventricular ejection fraction and flow
impairment. In this study, our aim was to assess the benefit of rest and
stress PET ejection fraction (EF) (EFp) in relation to single-photon
emission computed tomography (SPECT) EF (EFs) and echocardiography EF
(EFe). To this effect, the EFp was compared with EFs and EFe. Further, the
relation between rest and stress EFp was also assessed. Methods ECG-gated
N-13 ammonia rest and stress PET imaging was performed in 26 patients. EFp
values were obtained using gated reconstruction of the data in Flowquant.
In 13 patients, EFs and EFe values were obtained through chart review.
Correlation, analysis of variance, and Bland-Altman analyses were
performed. P values less than 0.05 were used for statistical significance.
Results The rest and stress EFp values correlated significantly (r=0.80
and 0.71, respectively; P0.05) with EFs values. There was moderate
correlation with statistical significance (P0.05) between the rest and
stress EFp and EFe values (r=0.58 and 0.50, respectively). The mean rest
and stress EFp values were not significantly different from mean EFs
values. Also, the rest EFp and stress EFp values correlated well (r=0.81,
P0.05) and were not significantly different. Bland-Altman analysis showed
no significant bias between the rest and stress EFp, and EFs, and EFe
values. Conclusion Rest and stress EFp values obtained through an
ECG-gated PET scan can be used for clinical diagnosis in place of
conventional methods like SPECT and echocardiography.

<12>
Accession Number
2015355852
Authors
Homvises B.
Institution
(Homvises) Department of Surgery, Thammasat University, Pathumthani,
Thailand
Title
A randomized trial between different suture materials (Polydioxanone vs.
Poliglecaprone 25) and different suturing techniques (running subcuticular
suture alone vs. with running horizontal mattress) in prevention of
hypertrophic scar development in median sternotomy wound.
Source
Journal of the Medical Association of Thailand. 97 (pp S88-S94), 2014.
Date of Publication: 01 Aug 2014.
Publisher
Medical Association of Thailand
Abstract
Background: Hypertrophic scar development after median sternotomy wound in
cardiac surgery patients is quite common in surgical practice and becomes
a major concern nowadays. Objective: To compare cosmetic outcome between
different suture materials and different suture techniques for skin
closure in median sternotomy wound. Material and Method: A randomized
clinical trial was conducted in 80 patients who underwent cardiac surgery
in Thammasat University Hospital, Thailand. In respect of the materials
and the techniques used to suture the skin, the patients were randomly
allocated to four groups. In group 1, the skin was closed with
subcuticular running 4-0 Poliglecaprone 25 (Monocryl). In group 2, the
skin was closed with subcuticular running 4-0 Polydioxanone (PDS). In
group 3, the skin was closed with subcuticular running 4-0 Poliglecaprone
25 (Monocryl) and running horizontal mattress 6-0 Nylon. In group 4, the
skin was closed with subcuticular running 4-0 Polydioxanone (PDS) and
running horizontal mattress 6-0 Nylon. Postoperative evaluation was
performed at 2 and 6 weeks, 3 and 6 months follow-up visits. The scar was
analyzed in three parts: upper, middle and lower one third of the sternal
wound. The outcome measures for surgical wound were width, height and
overall appearance of the scar using the Vancouver scar scale (VSS). A
linear visual analogue score (VAS) was preformed to assess pain and itch.
Results: At 6 months, there were no significant differences between 4
groups of patients in every parameters (width, height, VSS, pain score and
itch score) at three different wound sites (upper, middle and lower).
There was a statistically significant and progressive increase in scar
stretching, height and total VSS from top to bottom of the sternum with
the same pattern in all groups of patients (p<0.05). At 6 months, scar
showed a statistically significant difference in width when compares to 6
weeks and 3 months (p<0.001).Female had a statistically significant
difference of scar stretching at upper two third of the sternum (p<0.05).
Female scar width was approximately 2 folds greater than male patient.
During follow-up in group 3, two patients died postoperatively due to
multi-organ failure and one patient developed wound infection. Conclusion:
There were no significant differences in cosmetic outcomes between
different suture materials and different suture techniques.

<13>
Accession Number
2014742249
Authors
Petricevic M. Kopjar T. Biocina B. Milicic D. Kolic K. Boban M. Skoric B.
Lekic A. Gasparovic H.
Institution
(Petricevic, Kopjar, Biocina, Lekic, Gasparovic) Department of Cardiac
Surgery, University of Zagreb, School of Medicine, University Hospital
Center Zagreb, Kispaticeva 12, Zagreb 10000, Croatia
(Milicic, Skoric) Department of Cardiovascular Diseases, University of
Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb,
Croatia
(Kolic) Department of Medical Diagnostics, University of Split School of
Medicine, University Hospital Center Split, Split, Croatia
(Boban) Department of Cardiology, University Hospital Thalassotherapia
Opatija, Medical School University of Rijeka and Osijek, Opatija, Croatia
Title
The Predictive Value of Platelet Function Point-of-Care Tests for
Postoperative Blood Loss and Transfusion in Routine Cardiac Surgery: A
Systematic Review.
Source
Thoracic and Cardiovascular Surgeon. 63 (1) (pp 2-20), 2015. Date of
Publication: 01 Jan 2015.
Publisher
Georg Thieme Verlag
Abstract
Excessive bleeding after cardiopulmonary bypass (CPB) operations remains
to be a persistent problem and weak platelet function certainly
contributes to bleeding diathesis. Antiplatelet therapy (APT) is an
integral component of perioperative management in patients undergoing
cardiac surgery procedures, both with and without use of CPB. In addition
to individual variability in platelet function, different preoperative APT
administration/discontinuation management further affects platelet
function, which in turn may reflect bleeding tendency. However, the impact
of drug-induced platelet inhibition on early postoperative bleeding extent
remains difficult to predict. Herein, we reviewed the available evidence
on the association between platelet function testing values and the extent
of bleeding and transfusion requirements in early perioperative period.
Currently, the association between platelet function measured by ex vivo
assay and the occurrence of bleeding events remains uncertain. The intent
of this review is to provide comprehensive literature insight into
published evidence, investigating the possibility of platelet function
tests to predict bleeding extent as well as transfusion requirements in
cardiac surgery patients.

<14>
Accession Number
2015356828
Authors
Alak A. Lugomirski P. Aleksova N. Jolly S.S.
Institution
(Alak, Aleksova, Jolly) Department of Medicine, McMaster University,
Hamilton General, Hospital, Rm. C3-118 DBCSVRI Building, Hamilton, ON L8L
2X2, Canada
(Lugomirski) Division of Cardiology, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Title
A meta-analysis of randomized controlled trials of conventional stenting
versus direct stenting in patients with acute myocardial infarction.
Source
Journal of Invasive Cardiology. 27 (9) (pp 405-409), 2015. Date of
Publication: 01 Sep 2015.
Publisher
HMP Communications
Abstract
BACKGROUND: Direct stenting (DS) is commonly used during percutaneous
coronary intervention for acute myocardial infarction (AMI) to prevent
distal embolization; however, no guideline recommendations exist regarding
DS. We sought to compare DS with conventional stenting (CS) in patients
presenting with AMI in a meta-analysis of randomized controlled trials.
METHODS: Studies were identified from EMBASE, MEDLINE, and Cochrane
databases. To be included, randomized controlled trials must have compared
DS with CS in patients with AMI. Data were extracted and articles were
critically appraised by two authors. A fixed effects model was used, with
Peto odds ratios (ORs). The primary endpoint was death from cardiovascular
causes. RESULTS: Five trials (n < 754) met the eligibility criteria.
ST-segment resolution occurred in 68.9% (146/212) in the DS group vs 60.2%
(127/211) in the CS group (OR, 1.51; 95% CI, 1.00-2.27; P<.05;
I²<52%). No-reflow occurred in 6.6% in the DS group compared
with 6.9% in the CS group (OR, 0.78; 95% CI, 0.39-1.55; P<.48;
I²<0%). DS was associated with a significant reduction in the
risk of in-hospital cardiovascular death (OR, 0.21; 95% CI, 0.06-0.77;
P<.02; I²<0%). No significant differences were observed in
myocardial infarction (OR, 0.38; 95% CI, 0.09-1.51; P<.17;
I²<7%) or target lesion revascularization (OR, 1.20; 95% CI,
0.36-3.97; P<.76; I²<0%). CONCLUSION: Small trials suggest a
potential benefit to DS in AMI. Further large-scale randomized trials are
warranted to confirm the benefit of this approach.

<15>
Accession Number
2014707320
Authors
O'Sullivan K.E. Bracken-Clarke D. Segurado R. Barry M. Sugrue D. Flood G.
Hurley J.
Institution
(O'Sullivan, Bracken-Clarke, Barry, Sugrue, Flood, Hurley) Department of
Cardiothoracic Surgery, Mater Misericordiae University Hospital, Mater
Private Hospital, MRCSI Mater Misericordiae University, Hospital Eccles
Street, Dublin 7, Dublin, Ireland
(Segurado) CSTAR Centre for Statistical Training and Research, University
College Dublin, Dublin, Ireland
Title
Is Local Anesthesia the Optimum Strategy in Retrograde Transcatheter
Aortic Valve Implantation? A Systematic Review and Meta-Analysis.
Source
Thoracic and Cardiovascular Surgeon. 62 (6) (pp 489-497), 2014. Date of
Publication: 01 Sep 2014.
Publisher
Georg Thieme Verlag
Abstract
Background Retrograde transcatheter aortic valve implantation (TAVI) can
be performed under local anesthesia (LA) or general anesthesia (GA);
however, a wide variation in practice exists. Methods PubMed was searched
between 2009 and 2013. Data were extracted from eligible studies.
Random-effects meta-analysis was performed using DerSimonian Laird
between-study variance. Results There was no statistically significant
difference identified between groups based on age or EuroSCORE. There was
no statistically significant difference seen in all-cause mortality, or
complication rates between groups. Mean procedural duration was 36 minutes
shorter in the LA group (p=0.001). There was increased vasopressor use in
the GA group (odds ratio 3.92; p=0.017). Mean hospital stay was 3.41 days
shorter in the LA group (p=0.018). Conclusion Results suggest that the use
of LA for retrograde TAVI is feasible. There are several potential
benefits associated, shorter procedural duration, and hospital stay with
lower vasopressor requirements. Further studies and randomized trials are
mandatory to confirm the presented findings and to identify those patients
for whom LA would be appropriate.

<16>
Accession Number
25986492
Authors
Smelt J. Corredor C. Edsell M. Fletcher N. Jahangiri M. Sharma V.
Institution
(Smelt) Department of Cardiothoracic Surgery, St George's Hospital,
London, United Kingdom
(Corredor) Cardiothoracic Anesthesia, St George's Hospital, London, United
Kingdom
(Edsell) Cardiothoracic Anesthesia, St George's Hospital, London, United
Kingdom
(Fletcher) Cardiothoracic Anesthesia, St George's Hospital, London, United
Kingdom
(Jahangiri) Department of Cardiothoracic Surgery, St George's Hospital,
London, United Kingdom. Electronic address:
(Sharma) Cardiothoracic Anesthesia, St George's Hospital, London, United
Kingdom
Title
Simulation-based learning of transesophageal echocardiography in
cardiothoracic surgical trainees: A prospective, randomized study.
Source
The Journal of thoracic and cardiovascular surgery. 150 (1) (pp 22-25),
2015. Date of Publication: 01 Jul 2015.
Abstract
METHODS: A total of 25 cardiac surgical trainees with no formal
transesophageal echocardiography learning experience were randomly
assigned by computer to a study group receiving simulation-based
transesophageal echocardiography teaching via the Heartworks (Inventive
Medical, London, UK) simulator (n = 12) or a control group receiving
transesophageal echocardiography teaching during elective cardiac surgery
(n = 13). Each subject undertook a video-based test composed of 20
multiple choice questions on standard transesophageal echocardiography
views before and after teaching.
RESULTS: There was no significant difference in the pretest scores between
the 2 groups (P = .89). After transesophageal echocardiography teaching,
subjects within each group demonstrated a statistically significant
improvement in transesophageal echocardiography knowledge. Although the
subjects within the simulation group outperformed their counterparts in
the operating room teaching group in the post-test scores, this difference
was not significant (P = .14).
CONCLUSIONS: Despite the familiarity with transesophageal echocardiography
images during surgery, subjects in the simulation group performed at least
as well as those in the operating room group. Surgical trainees will
benefit from formal transesophageal echocardiography teaching incorporated
into their training via either learning method.
OBJECTIVES: The Intercollegiate Surgical Curriculum now recommends that
cardiac surgical trainees should be able to understand and interpret
transesophageal echocardiography images. However, cardiac surgical
trainees receive limited formal transesophageal echocardiography training.
The objective of this study was to assess the impact of simulation-based
teaching versus more traditional operating room teaching on
transesophageal echocardiography knowledge in cardiac surgical trainees.

<17>
Accession Number
25336669
Authors
Phan K. Xie A. Tsai Y.-C. Kumar N. La Meir M. Yan T.D.
Institution
(Phan) The Collaborative Research (CORE) Group, Macquarie University
Hospital, Macquarie University, 2 Technology Place, Sydney, Australia
Sydney Medical School, The University of Sydney, Sydney, Australia
(Xie) The Collaborative Research (CORE) Group, Macquarie University
Hospital, Macquarie University, 2 Technology Place, Sydney, Australia
(Tsai) The Prince Charles Hospital, Chermside, Australia
(Kumar) Department of Cardiothoracic Surgery and Cardiology, Academic
Hospital Maastricht and Cardiovascular Research Institute Maastricht,
Maastricht, The Netherlands
(La Meir) Department of Cardiothoracic Surgery and Cardiology, Academic
Hospital Maastricht and Cardiovascular Research Institute Maastricht,
Maastricht, The Netherlands University Hospital Brussels, Brussels,
Belgium
(Yan) The Collaborative Research (CORE) Group, Macquarie University
Hospital, Macquarie University, 2 Technology Place, Sydney, Australia
Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital,
University of Sydney, Sydney, Australia tristanyan@annalscts.com
Title
Biatrial ablation vs. left atrial concomitant surgical ablation for
treatment of atrial fibrillation: a meta-analysis.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. 17 (1)
(pp 38-47), 2015. Date of Publication: 01 Jan 2015.
Abstract
AIMS: Surgical ablation performed concomitantly with cardiac surgery has
emerged as an effective curative strategy for atrial fibrillation (AF).
Left atrial (LA) lesion sets for ablation have been suggested to reduce
procedural times and post-surgical bradycardia compared with biatrial (BA)
lesions. Given the inconclusive literature regarding BA vs. LA ablation,
the present meta-analysis sought to assess the current evidence.
METHODS AND RESULTS: Electronic searches were performed using six
databases from their inception to December 2013, identifying all relevant
randomized trials and observational studies comparing BA vs. LA surgical
ablation AF patients undertaking cardiac surgery. In 10 included studies,
2225 patient results were available for analysis to compare BA (n = 888)
vs. LA (n = 1337) ablation. Sinus rhythm prevalence was higher in the BA
cohort compared with the LA cohort at 6-month and 12-month follow-up, but
similar beyond 1 year. Permanent pacemaker implantations were higher in
the BA cohort, but 30-day and late mortality, neurological events, and
reoperation for bleeding were similar between BA and LA groups.
CONCLUSIONS: Biatrial and LA ablations produced comparable 30-day and late
mortality but LA was associated with significantly reduced permanent
pacemaker implantation rates. Biatrial ablation appeared to be more
efficacious than LA ablation in achieving SR at 1 year, but this
difference was not maintained beyond 1 year. Trends appear to be driven by
the preferential selection of long-standing and persistent AF patients for
the BA approach. Future randomized studies of adequate follow-up are
required to validate risks and benefits of BA vs. LA surgical ablation.

<18>
Accession Number
25555877
Authors
Guo J.-R. Guo W. Jin X.-J. Yu J. Jin B.-W. Xu F. Liu Y.
Institution
(Guo, Guo, Jin, Yu, Jin, Xu, Liu) Department of Anesthesiology, Gongli
Hospital of Shanghai Pudong New District, Shanghai, China.
jianrongguo@126.com
Title
Effects of stellate ganglionic block on hemodynamic changes and
intrapulmonary shunt in perioperative patients with esophageal cancer.
Source
European review for medical and pharmacological sciences. 18 (24) (pp
3864-3869), 2014. Date of Publication: 2014.
Abstract
OBJECTIVE: The aim of this study was to observe the effects of stellate
ganglion block (SGB) on hemodynamic changes and intrapulmonary shunt
during one-lung ventilation (OLV).
PATIENTS AND METHODS: Thirty ASA class I-II patients undergoing elective
esophageal surgery were randomly divided into two groups: general
anesthesia group (group N, n=15) and general anesthesia combined SGB group
(group S, n=15), patients in group S were received left SGB before
induction. Radial artery was cannulated for arterial blood pressure (ABP)
monitoring and blood sampling and Swan-Ganz catheter was position in the
pulmonary artery via right internal jugular vein under local anesthesia.
ECG, MAP, HR, CVP, continuous cardiac output (CCO) index and BIS were
continuously monitored during anesthesia. General anesthesia was induced
with propofol 1.5-2.0 mg/kg, sufentanil 0.4 mug/kg, and Rocuronium 0.6-0.9
mg/kg. Endobronchial occluder was placed blindly after tracheal indubation
and the correct position was verified by auscultation and fiberoptic
bronchoscopy. The patients were mechanically ventilated. The ventilation
conditions were Fio2=100%, VT = 8-10 ml/kg, I: E = 1:2 and respiratory
rate was adjusted to maintained PETCO2 at 35-45 mmHg during both two-lung
ventilation (TLV) and OLV. Anesthesia was maintained with continuous
infusion of propofol 4-10 mg/kgh, sufentanil 0.2 mug/kgh, vecuronium o.1
mg/kgh, BIS was maintained at 45-55. Blood samples were taken from radial
artery and S-G catheter for blood gas analysis at following intervals:
during spontaneous breathing when the patient was awake (T0), 1 min after
tracheal indubation (T1), 1 min after patient was placed in lateral
position (T2) and 15 min after it (T3), 1 min after ribs was braced (T4),
30, 60, 120 min during the course of OLV (T5, T6, T7), the two lungs were
ventilated again for 30 min (T8) and Qs/Qt was calculated.
RESULTS: SVRI, MAP, HR in group N increased significantly at T1, T2, T4
compared with group S (p < 0.05). Qs/Qt was significantly increased after
patient was placed in lateral position and increased further during OLV;
the calculated Qs/Qt values were highest at T5 PaO2 was significantly
lower after OLV was started and reached the lowest level at T6 then was
gradually increasing. There was no significant difference in Qs/Qt and
PaO2 at all time points between two groups.
CONCLUSIONS: SGB before induction effectively suppress the stress response
work as stable blood dynamics and does not affect Qs/Qt and arterial
oxygenation during OLV, SGB is a safe technique of anesthesia for general
thoracic surgery.