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<1>
Accession Number
613110328
Author
Mansourian S.; Bina P.; Fehri A.; Karimi A.A.; Boroumand M.A.; Abbasi K.
Institution
(Mansourian, Bina, Fehri, Karimi, Boroumand, Abbasi) Department of Cardiac
Surgery, Tehran Heart Center, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
Title
Preoperative oral pentoxifylline in case of coronary artery bypass
grafting with left ventricular dysfunction (Ejection fraction equal
to/less than 30%).
Source
Anatolian Journal of Cardiology. 15 (12) (pp 1014-1019), 2015. Date of
Publication: 2015.
Publisher
Turkish Society of Cardiology (E-mail: kareyayincilik@gmail.com)
Abstract
Objective: Most coronary artery bypass grafts are done by applying
cardiopulmonary bypass, which usually induces unwanted inflammatory
reactions and impairs the outcomes. In order to minimize the perilous
response of cardiopulmonary bypass, pentoxifylline was getting used
orally. Methods: In a prospective, placebo-controlled, randomized clinical
trial, 178 coronary artery bypass graft candidates with ejection fraction
lower/equal to 30%, divided into two equal groups (pentoxifylline and
control), participated in the study. Pentoxifylline patients received 400
mg pentoxifylline 3 times a day for 3 days before operation. The outcomes
were compared between groups using student's t-test, Mann-Whitney U-test,
Pearson chi-square, or Fisher's exact test. Results: Pentoxifylline
administration did not significantly affect troponin-T (p=0.68), but it
reduced tumor necrosis factor-alpha (p=0.01) and inter-leukin-6 (p=0.01).
It improved left ventricular ejection fraction significantly (p=0.01).
White blood cell and platelet counts, hemoglobin, and hematocrit were not
influenced by pentoxifylline. The drug did not affect blood urea nitrogen
and creatinine, occurrence of renal failure, cere-brovascular accidents,
and in-hospital mortality rate. The need for an intra-aortic balloon pump,
cardiopulmonary bypass, and aortic cross-clamp times were not affected,
either. Pentoxifylline decreased the intensive care unit stay (p<0.001),
ventilation time, 10.4 hours in the pentoxifylline group against 14.7
hours in the control group (p=0.01), and the requirement of inotropic
agents (p=0.02) and blood transfusion (p=0.01). Conclusion: Pentoxifylline
has more beneficial potencies in reducing adverse events after coronary
artery bypass graft using cardiopulmonary bypass, than what are known.
Copyright &#xa9; 2015 by Turkish Society of Cardiology.

<2>
Accession Number
603516695
Author
Gemma M.; Nicelli E.; Gioia L.; Moizo E.; Beretta L.; Calvi M.R.
Institution
(Gemma, Nicelli, Gioia, Moizo, Beretta, Calvi) Department of Anesthesia
and Neurointensive Care, San Raffaele Scientific Institute, Milan 20132,
Italy
Title
Acupuncture accelerates recovery after general anesthesia: A prospective
randomized controlled trial.
Source
Journal of Integrative Medicine. 13 (2) (pp 99-104), 2015. Date of
Publication: 01 Mar 2015.
Publisher
Elsevier (Singapore) Pte Ltd (3 Killiney Road, 08-01, Winsland House I,
Singapore 239519, Singapore)
Abstract
Background Acupuncture anesthesia was created in the 1950's in China and
continues to be used there today during most major surgeries. It is widely
used in China for such complex operations as brain, heart, and abdominal
surgery. It is popular in China because it is economical, practical, and
beneficial to the patients. With acupuncture anesthesia there is less
bleeding during surgery and there is also quicker post-operative recovery.
Objective This randomized prospective study aims at comparing the effect
of two acupoints (Yongquan, KI1 and Renzhong, DU26) with sham acupuncture
and no acupuncture on the time to recovery of consciousness after general
anesthesia by means of the Bispectral Index monitor (BIS). Design,
setting, participants and interventions This is a prospective randomized
controlled study. We randomly assigned 50 patients to 5 groups during
recovery from surgical anesthesia. Four groups had acupuncture on KI1
(group A), DU26 (groups B), both KI1 and DU26 (group C), and sham points
(group D), and one had no acupuncture (group E). Main outcome measures
Bispectral Index (BIS), time to spontaneous eye opening, time to tracheal
extubation, and time to following commands were measured as the main
outcome measures. Results Time to spontaneous eye opening differed among
groups (P=0.002), as well as time to tracheal extubation (P<0.000 1) and
time to following commands (P=0.000 6). BIS values differed significantly
among groups both 5 and 10 min after the end of anesthesia (P<0.000 1 and
P=0.000 4, respectively). BIS values of groups D and E were lower than
those of the other groups and those of group C were higher. The same
pattern was observed also 15 and 30 min after the end of anesthesia,
although the difference among groups was not significant at these time
points (P=0.164 and P=0.104, respectively). Conclusion Acupuncture on DU26
and KI1 accelerates recovery of consciousness after general anesthesia.
Moreover, a possible synergistic effect of DU26 and KI1 is suggested. This
issue may play a role in the optimization of operating room management and
raise interest about the usefulness of acupuncture on unconsciousness
states of different nature. Copyright &#xa9; 2015 Journal of Integrative
Medicine Editorial Office. E-edition published by Elsevier (Singapore) Pte
Ltd. All rights reserved.

<3>
Accession Number
604860735
Author
Huang F.; Lai W.; Chan C.; Peng H.; Zhang F.; Zhou Y.; Teng S.; Huang Z.
Institution
(Huang, Lai, Chan, Zhang, Teng, Huang) Department of Cardiology, Nanfang
Hospital, Southern Medical University, Guangzhou, Guangdong, China
(Peng) Department of Sleep Disorder Center, Nanfang Hospital, Southern
Medical University, Guangzhou, Guangdong, China
(Zhou) Department of Obstetrics and Gynecology, Nanfang Hospital, Southern
Medical University, Guangzhou, Guangdong, China
Title
Comparison of bypass surgery and drug-eluting stenting in diabetic
patients with left main and/or multivessel disease: A systematic review
and meta-analysis of randomized and nonrandomized studies.
Source
Cardiology Journal. 22 (2) (pp 123-134), 2015. Date of Publication: 2015.
Publisher
Via Medica (Ul. Swietokrzyska 73, Gdansk 80-180, Poland)
Abstract
Background: With advances in theinterventional feld, the choice between
coronary artery bypass grafting (CABG) and percutaneous coronary
intervention with drug-eluting stents (PCI-DES) for the diabetic subset
with left main (LM) and/or multivessel disease (MVD) remains consistently
controversial. Methods and results: We conducted a systematic review of
randomized controlled trials (RCTs) and observational controlled trials
(OCTs) comparing the two strategies for the diabetic subset with LM and/or
MVD. PubMed, EMBASE, CENTRAL databases, Google Scholar and SinoMed were
systematically searched for eligible studies without language and
publication restrictions. We identifed 19 trials (4 randomized and 15
nonrandomized), enrolling 5,805 patients in OCTs and 3,060 patients in
RCTs, respectively. PCI-DES was associated with higher mortality compared
with CABG (11.7% DES vs. 9.1% CABG, RR 1.23, 95% CI 1.00-1.53, p = 0.06).
Patients after PCI-DES had higher prevalence of myocardial infarction (MI)
when compared with CABG (8.5% DES vs. 4.6% CABG, RR 1.68, 95% CI
1.20-2.37, p = 0.003). PCI-DES patients were at substantially lower risk
of stroke (2.0% DES vs. 3.9% CABG, RR 0.51, 95% CI 0.39-0.67, p <
0.00001), but at several-fold higher risk of repeat revascularization
(19.0% DES vs. 6.3% CABG, RR 2.95, 95% CI 2.46-3.55, p < 0.00001). The OCT
patients risked a lower mortality as compared to the RCT patients (9.6%
OCTs vs. 11.9% RCTs, RR 0.81, 95% CI 0.71-0.92, p = 0.001). Conclusions:
CABG for patients with diabetes mellitus and LM and/or MVD had advantages
over PCI-DES in all-cause death, nonfatal MI, and repeat
revascularization, but the substantial disadvantage in nonfatal stroke.
The high-selected patients (RCTs) risked a higher mortality than the
real-world patients (OCTs). Copyright &#xa9; 2015 Via Medica.

<4>
Accession Number
607730044
Author
De Carvalho Cantarelli M.J.; Gioppato S.; Castello H.J.; Goncalves R.;
Ribeiro E.K.P.; De Freitas Guimaraes J.B.; Navarro E.C.; Maksud D.; Vardi
J.C.F.
Institution
(De Carvalho Cantarelli, De Freitas Guimaraes, Vardi) Hospital
Bandeirantes, Sao Paulo, SP, Brazil
(Gioppato) Hospital Vera Cruz, Campinas, SP, Brazil
(Castello, Ribeiro) Hospital Leforte, Sao Paulo, SP, Brazil
(Goncalves, Maksud) Hospital Rede d'Or Sao Luiz Analia Franco, Sao Paulo,
SP, Brazil
(Navarro) Hospital Regional Do Vale Do Paraiba, Taubate, SP, Brazil
Title
Impact of prior statin use on percutaneous coronary intervention outcomes
in acute coronary syndrome.
Source
Revista Brasileira de Cardiologia Invasiva. 23 (2) (pp 108-113), 2015.
Date of Publication: 2015.
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background The use of statins prior to percutaneous coronary intervention
(PCI) has reduced cardiac events in both short and long-term follow-up.
This study assessed the impact of prior statin use on in-hospital PCI
outcomes in patients with acute coronary syndrome (ACS). Methods
Retrospective analysis of a multicenter registry of 6,288 consecutive
patients undergoing PCI. Of these, 35% had ACS and were evaluated
according to statin use (Group 1, n = 1,203) or no use (Group 2, n = 999).
Results Group 1 showed higher prevalence of dyslipidemia, acute myocardial
infarction (AMI), previous coronary artery bypass graft, chronic renal
failure, multivessel involvement, bifurcation lesions, and use of
drug-eluting stents. Group 2 showed more primary and rescue PCIs, Killip
functional class III/IV, B2/C lesions, thrombi, total occlusions,
pre-procedural TIMI 0/1 flow, presence of collateral circulation, and use
of glycoprotein IIb/IIIa inhibitors and aspiration catheters. PCI success
was higher in Group 1 (95.1% vs. 92.5%; p = 0.01), and the occurrence of
major adverse cerebrovascular and cardiac events (MACCE) (3.7% vs. 5.7%)
was more frequent in Group 2. Although the non-use of statins showed an
association with MACCE in the univariate analysis, independent predictors
of in-hospital MACCE were limited to AMI in Killip III/IV and prior
coronary artery bypass graft. Conclusions ACS patients undergoing PCI who
previously used statins had better in-hospital clinical outcomes; however,
statin use was not an independent predictor of MACCE. Copyright &#xa9;
2015 Sociedade Brasileira de Hemodinamica e Cardiologia Intervencionista.

<5>
Accession Number
605950385
Author
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 (E-mail: healthcare.enquiries@informa.com)
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. Copyright &#xa9; 2015 Informa Healthcare USA, Inc. All rights
reserved.

<6>
Accession Number
373840190
Author
Ren X.; Liu W.; Peng Y.; Li Q.; Chai H.; Zhao Z.-G.; Meng Q.-T.; Chen C.;
Zhang C.; Luo X.-L.; Chen M.; Huang D.-J.
Institution
(Ren, Liu, Peng, Li, Chai, Zhao, Meng, Chen, Zhang, Luo, Chen, Huang)
Department of Cardiology, West China Hospital, Sichuan University, No. 37
Guoxue Alley, Chengdu, Sichuan 610041, China
Title
Percutaneous coronary intervention compared with coronary artery bypass
graft in coronary artery disease patients with chronic kidney disease: A
systematic review and meta-analysis.
Source
Renal Failure. 36 (8) (pp 1177-1186), 2014. Date of Publication: September
2014.
Publisher
Informa Healthcare (E-mail: healthcare.enquiries@informa.com)
Abstract
Previous reports of percutaneous coronary intervention versus coronary
artery bypass graft outcomes in coronary artery disease patients with
chronic kidney disease (CKD) were inconsistent. We evaluated the optimal
revascularization strategy for CKD patients. We searched Pub Med, EMBASE,
and the Cochrane Central Register of Controlled Trials and scanned the
references of relevant articles and reviews. All studies that compared
relevant clinical outcomes between percutaneous coronary intervention and
coronary artery bypass graft in CKD patients were selected. We defined
short-term and long-term all-cause mortality as primary outcome, and
long-term incidences of myocardial infarction and revascularization as
secondary outcomes. A total of 2235 citations were retrieved, and 31
studies involving 99,054 patients, with 55,383 receiving percutaneous
coronary intervention and 43,671 receiving coronary artery bypass graft,
were included. In subgroup analyses of dialysis patients receiving
percutaneous coronary intervention with stents versus coronary artery
bypass graft, CKD patients with multivessel coronary disease, and CKD
patients receiving drug-eluting stent versus coronary artery bypass graft,
the pooled outcomes revealed that percutaneous coronary intervention
possessed lower short-term mortality, but higher late revascularization
risk. No significant differences in long-term mortality were observed
between the two strategies in these subgroup analyses. In conclusion, in
some specific clinical circumstances, CKD patients receiving percutaneous
coronary intervention possessed lower short-term all-cause mortality, but
higher long-term revascularization risk, than coronary artery bypass
graft; long-term all-cause mortality was not different between the two
strategies. &#xa9; 2014 Informa Healthcare USA, Inc. All rights reserved.

<7>
Accession Number
372899070
Author
Mao S.; Huang S.
Institution
(Mao, Huang) Department of Nephrology, Nanjing Children's Hospital,
Nanjing Medical University, 72 Guangzhou Road, Nanjing, Jiangsu Province,
210008, China
Title
Statins use and the risk of acute kidney injury: A meta-analysis.
Source
Renal Failure. 36 (4) (pp 651-657), 2014. Date of Publication: May 2014.
Publisher
Informa Healthcare (E-mail: healthcare.enquiries@informa.com)
Abstract
The association between statins use and the risk of acute kidney injury
(AKI) remains elusive. We aimed to evaluate the association of statins use
with AKI risk by performing a meta-analysis. Twenty-one studies were
included in our meta-analysis by searching electronic databases according
to predefined criteria. No significant association between statins use and
AKI risk was observed in overall populations, Caucasians, Asians, and
patients undergoing cardiac and elective surgery (p=0.816, 0.981, 0.18,
0.709, and 0.122). Statins use decreased the risk of contrast-induced AKI
(CIN) (p=0.005) and increased AKI risk in patients with community acquired
pneumonia (CAP) (p=0.006). Meta-regression analyses showed almost no
impact on the pooled ORs of age and study length for overall populations.
Exclusion of any single study had little impact on the pooled ORs. In
conclusion, statins use is not associated with the risk of AKI in overall
populations, Caucasians, Asians, and patients undergoing cardiac and
elective surgery. Statins use decreases the risk of CIN and may increase
the risk of AKI in CAP patients. &#xa9; 2014 Informa Healthcare USA, Inc.
All rights reserved: reproduction in whole or part not permitted.

<8>
Accession Number
372224365
Author
Lippi G.; Cervellin G.
Institution
(Lippi) U.O. Diagnostica Ematochimica, Azienda Ospedaliero-Universitaria
di Parma, Via Gramsci, 14, 43126 Parma, Italy
(Cervellin) Emergency Department, Academic Hospital of Parma, Parma, Italy
Title
Risk assessment of post-infarction heart failure. Systematic review on the
role of emerging biomarkers.
Source
Critical Reviews in Clinical Laboratory Sciences. 51 (1) (pp 13-29), 2014.
Date of Publication: February 2014.
Publisher
Informa Healthcare (E-mail: healthcare.enquiries@informa.com)
Abstract
The prognostic significance of cardiospecific troponins and natriuretic
peptides in patients with myocardial ischemia is well established, and
their measurement is now endorsed by the most important guidelines and
recommendations for diagnosis and management of heart failure (HF).
Additional biomarkers have also been investigated to support clinical
judgment and diagnostic imaging in the stratification of risk of cardiac
dysfunction in patients with myocardial infarction (MI). We have performed
a systematic analysis of the current scientific literature regarding the
most important biomarkers of HF, selecting all prospective studies with
adequate sample size (i.e. >100 patients) that have assessed, during the
early phase of myocardial ischemia, the prognostic value of emergent
biomarkers for new-onset HF or deterioration of cardiac function in
patients with MI. This analysis has provided some good evidence suggesting
that, in most cases, the use of diagnostic biomarkers of cardiac
dysfunction does not translate into efficient risk prediction of HF.
However, some notable exceptions were found, including biomarkers of
cardiac fibrosis (especially galectin-3), growth differentiation factor-15
(GDF-15), osteoprotegerin, C-reactive protein (CRP), and red blood cell
distribution width (RDW). Nevertheless, future studies with well-defined
characteristics including the use of larger sample sizes, standardized end
points, and replication populations, along with benchmark analyses against
other consolidated biomarkers (i.e. cardiospecific troponins and
natriuretic peptides), should be planned. Such evaluations will help to
establish whether an integrated approach including biomarkers of different
pathogenetic pathways-for example, apoptosis, stress of cardiomyocytes,
cardiac fibrosis, inflammation, and extra-cardiac involvement-may be cost
effective for identifying patients at increased risk of developing HF, and
who, therefore, may benefit from a tailored therapeutic strategy. &#xa9;
2014 Informa Healthcare USA, Inc.

<9>
Accession Number
600290946
Author
Dehghani M.R.; Madjidi N.; Rahmani A.; Asgari B.; Rezaei Y.
Institution
(Dehghani) Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia
University of Medical Sciences, Urmia, Iran, Islamic Republic of
(Madjidi, Rahmani) Department of Medical Surgical Nursing, School of
Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran,
Islamic Republic of
(Asgari) Department of Cardiovascular Surgery, Seyyed-al-Shohada Heart
Center, Urmia University of Medical Sciences, Urmia, Iran, Islamic
Republic of
(Rezaei) Seyyed-al-Shohada Heart Center, Urmia University of Medical
Sciences, Urmia, Iran, Islamic Republic of
Title
Effect of oral vitamin C on atrial fibrillation development after isolated
coronary artery bypass grafting surgery: A prospective randomized clinical
trial.
Source
Cardiology Journal. 21 (5) (pp 492-499), 2014. Date of Publication: 2014.
Publisher
Via Medica (Ul. Swietokrzyska 73, Gdansk 80-180, Poland)
Abstract
Background: Some evidences have shown the role of antioxidant vitamins in
preventing atrial fibrillation (AF) after coronary artery bypass grafting
(CABG) surgery. We sought to determine the effect of oral vitamin C on the
incidence of postoperative AF in patients undergoing elective isolated
on-pump CABG surgery.
Methods: One-hundred patients who underwent isolated CABG surgery were
prospectively assigned into two groups: Group 1 - 50 patients received 2 g
of oral vitamin C before and 500 mg twice daily lasting for 5 days after
surgery; Group 2 - 50 patients as the control group did not receive any.
All patients were continuously monitored after surgery in the intensive
care unit (ICU), and then Holter monitoring was implemented for 72 h.
Results: The mean of patients' age was 61.31 +/- 6.42 years. Postoperative
AF occurred in 16 and 4 patients in control and treatment groups,
respectively (32% vs. 8%, p = 0.003). The ICU stay was 1.79 +/- 0.313 and
2.10 +/- 0.61 days for vitamin C and control groups, respectively (p =
0.002). The hospital stay was significantly lower in vitamin C group
compared with that of the control group (5.32 +/- 0.59 vs. 5.74 +/- 1.30
days, respectively, p = 0.041). Baseline erythrocyte sedimentation rate
(OR 1.030, 95% CI 1.003-1.058, p = 0.030) and taking vitamin C (OR 8.068,
95% CI 1.783-36.517, p = 0.007) were the independent predictors of
postoperative AF.
Conclusions: Oral vitamin C can be safely used to decrease the incidence
of postoperative AF in patients undergoing elective isolated on-pump CABG
surgery. Copyright &#xa9; 2014 Via Medica.

<10>
Accession Number
613513126
Author
Kotsoeva O.T.
Institution
(Kotsoeva) Department of Medical Rehabilitation, North-Caucasian
Multidisciplinary Medical Center, 139a, Frieva str., Beslan 363025,
Russian Federation
Title
Comparison of impact of medical therapy and surgical treatment on overall
mortality in patients with severe chronic heart failure: A meta-analysis.
Source
Russian Open Medical Journal. 5 (3) (no pagination), 2016. Article Number:
e0304. Date of Publication: 2016.
Publisher
Russian Open Medical Journal (E-mail: rusomj@mail.ru)
Abstract
Aim - Meta-analysis of clinical trials comparing the efficacy of medical
therapy (MT) and surgical treatment, including cardiac resynchronization
therapy with and without cardioversion-defibrillation (CRT and CRT-D),
circulatory support system (CSS) and heart transplantation (HT), in terms
of decreasing overall mortality in patients with severe chronic heart
failure (CHF). Material and Methods - Meta-analysis included 39 clinical
trials with a total number of 30,257 patients. Search was performed in
MEDLINE, Medscape, Pubmed databases and on web resources, dedicated to
clinical trials (National Institutes of Health, Clinical Center,
ClinicalStudyResults.org, ClinicalTrials.gov). Results - There was no
significant overall mortality reduction in patients receiving MT when
compared to control group: OR=0.97 (95% CI: 0.85-1.10), p=0.211. Treatment
with CRT and CRT-D, as well as CSS implantation and HT reduced overall
mortality: OR=0.67 (95% CI: 0.57-0.79), p < 0.001 for CRT/CRT-D and
OR=0.46 (95% CI: 0.24-0.86), p = 0.018 for CSS/HT. Conclusion -
Superiority of surgical treatment over traditional MT in terms of overall
mortality was observed in patients with severe CHF. Copyright &#xa9; 2016,
Kotsoeva O.T.

<11>
Accession Number
610983910
Author
Serio D.; Zierer A.; Doss M.; Moritz A.
Institution
(Serio, Doss) Department of Cardiovascular Surgery, Kerckhoff Klinik GmbH,
Benekestr. 2-8, Bad Nauheim 61231, Germany
(Zierer, Moritz) Department of Cardiovascular Surgery, Goethe Universitats
Klinik, Frankfurt am Main, Germany
Title
Transcatheter Valve Unable to Cure Patient-Prosthesis Mismatch of Mosaic
Bioprosthesis.
Source
Thoracic and Cardiovascular Surgeon Reports. 5 (1) (pp 27-29), 2016. Date
of Publication: 01 Dec 2016.
Publisher
Georg Thieme Verlag (E-mail: kunden.service@thieme.de)
Abstract
Transcatheter aortic valve implantation (TAVI) has been recently
established as a less invasive alternative to conventional aortic valve
replacement (CAVR) in patients presenting with expected high procedural
risk. The rapid technologic advances and the recent improvement of
clinical outcomes with TAVI have made it possible to treat degenerated
bioprosthesis using the valve-in-valve implantation concept (Walther T,
Simon P, Dewey T, et al. Transapical minimally invasive aortic valve
implantation: multicenter experience. Circulation 2007;116(11,
Suppl):I240-I245; Webb JG, Pasupati S, Humphries K, et al. Percutaneous
transarterial aortic valve replacement in selected high-risk patients with
aortic stenosis. Circulation 2007;116(7):755-763). Recently, concerns were
raised regarding the appropriate sizing of transcatheter valve prosthesis
and its effect on residual stenosis (Klaaborg KE, Egeblad H, Jakobsen CJ,
et al. Transapical transcatheter treatment of a stenosed aortic valve
bioprosthesis using the Edwards SAPIEN Transcatheter Heart Valve. Ann
Thorac Surg 2009;87(6):1943-1946; Zedig R, Achouh P, Berrebi A, et al.
Valve- in- a- valve implantation: a word of caution. Ann Thorac Surg
2009;87:1943-1946), eventually resulting in a patient-prosthesis mismatch
(PPM). We report a case with severe PPM after inserting a 23-mm Sapien
(Edwards Lifesciences, Irvine, United States) valve into degenerated 23-mm
Medtronic Mosaic prosthesis (Medtronic, Minneapolis, Minnesota, United
States). Copyright &#xa9; 2016 Georg Thieme Verlag KG Stuttgart . New
York.

<12>
Accession Number
613351083
Author
Kilic A.; Magruder J.T.; Grimm J.C.; Dungan S.P.; Crawford T.; Whitman
G.J.R.; Conte J.V.
Institution
(Kilic) Division of Cardiovascular Surgery, University of Pennsylvania,
Philadelphia, Pennsylvania, United States
(Magruder, Grimm, Dungan, Crawford, Whitman, Conte) Division of Cardiac
Surgery, Johns Hopkins University, Baltimore, Maryland, United States
Title
Development and Validation of a Score to Predict the Risk of Readmission
After Adult Cardiac Operations.
Source
Annals of Thoracic Surgery. 103 (1) (pp 66-73), 2017. Date of Publication:
01 Jan 2017.
Publisher
Elsevier USA
Abstract
Background The purpose of this study was to develop and validate a risk
score for readmissions after cardiac operations. Methods Adults surviving
to discharge after cardiac operations at a single institution from 2008 to
2013 were randomly divided 3:1 into training and validation cohorts. The
primary outcome was readmission within 30 days of discharge. A
multivariable model was constructed in the training cohort incorporating
variables associated with 30-day readmission in univariate logistic
regression. Points were assigned to predictors in the multivariable model
proportional to their odds ratios. Results Among 5,193 patients undergoing
cardiac operations and surviving to discharge, the 30-day readmission rate
was 10.3% (n = 537). The most common reasons for readmission were volume
overload (24%; n = 131) and infection (21%; n = 113). The risk score
incorporated 5 multivariable predictors and was out of 20 possible points.
The predicted rate of 30-day readmission based on the training cohort
ranged from 5.9% (score = 0) to 54.7% (score = 20). Patients were
categorized as low (score = 0; readmission 5.7%), moderate (score 1-7;
readmission 11.0%), and high risk (score >7; readmission 24.2%) (p <
0.001). Thirty-day readmission rates based on these score categories were
similar in the validation cohort (low 6.4%, moderate 11.0%, high 17.4%; p
< 0.001). There was a robust correlation between predicted rates of
readmission in the training cohort based on the composite risk score and
actual rates of readmission in the validation cohort (r = 0.95; p <
0.001). Conclusions We developed and validated a risk score for
readmission after cardiac operations that may have utility in targeting
interventions and modifying risk factors in high-risk populations.
Copyright &#xa9; 2017 The Society of Thoracic Surgeons

<13>
Accession Number
613358968
Author
Magruder J.T.; Blasco-Colmenares E.; Crawford T.; Alejo D.; Conte J.V.;
Salenger R.; Fonner C.E.; Kwon C.C.; Bobbitt J.; Brown J.M.; Nelson M.G.;
Horvath K.A.; Whitman G.R.
Institution
(Magruder, Crawford, Alejo, Conte, Whitman) Division of Cardiac Surgery,
Department of Medicine, The Johns Hopkins University School of Medicine,
Baltimore, Maryland, United States
(Blasco-Colmenares) Division of Cardiology, Department of Medicine, The
Johns Hopkins University School of Medicine, Baltimore, Maryland, United
States
(Salenger, Brown) Division of Cardiac Surgery, University of Maryland
School of Medicine, Baltimore, Maryland, United States
(Fonner) Maryland Cardiac Surgery Quality Initiative, Baltimore, Maryland,
United States
(Kwon) Beverly & Jerome Fine Cardiac Valve Center, Sinai Hospital of
Baltimore, Baltimore, Maryland, United States
(Bobbitt) Department of Cardiac Surgery, Washington Adventist Hospital,
Takoma Park, Maryland, United States
(Nelson) The Heart Institute, Western Maryland Health System, Cumberland,
Maryland, United States
(Horvath) Cardiothoracic Surgery Research Program, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Maryland,
United States
Title
Variation in Red Blood Cell Transfusion Practices During Cardiac
Operations Among Centers in Maryland: Results From a State
Quality-Improvement Collaborative.
Source
Annals of Thoracic Surgery. 103 (1) (pp 152-160), 2017. Date of
Publication: 01 Jan 2017.
Publisher
Elsevier USA
Abstract
Background Variation in red blood cell (RBC) transfusion practices exists
at cardiac surgery centers across the nation. We tested the hypothesis
that significant variation in RBC transfusion practices between centers in
our state's cardiac surgery quality collaborative remains even after risk
adjustment. Methods Using a multiinstitutional statewide database created
by the Maryland Cardiac Surgery Quality Initiative (MCSQI), we included
patient-level data from 8,141 patients undergoing isolated coronary artery
bypass (CAB) or aortic valve replacement at 1 of 10 centers. Risk-adjusted
multivariable logistic regression models were constructed to predict the
need for any intraoperative RBC transfusion, as well as for any
postoperative RBC transfusion, with anonymized center number included as a
factor variable. Results Unadjusted intraoperative RBC transfusion
probabilities at the 10 centers ranged from 13% to 60%; postoperative RBC
transfusion probabilities ranged from 16% to 41%. After risk adjustment
with demographic, comorbidity, and operative data, significant intercenter
variability was documented (intraoperative probability range, 4% -59%;
postoperative probability range, 13%-39%). When stratifying patients by
preoperative hematocrit quartiles, significant variability in
intraoperative transfusion probability was seen among all quartiles
(lowest quartile: mean hematocrit value, 30.5% +/- 4.1%, probability
range, 17%-89%; highest quartile: mean hematocrit value, 44.8% +/- 2.5%;
probability range, 1%-35%). Conclusions Significant variation in
intercenter RBC transfusion practices exists for both intraoperative and
postoperative transfusions, even after risk adjustment, among our state's
centers. Variability in intraoperative RBC transfusion persisted across
quartiles of preoperative hematocrit values. Copyright &#xa9; 2017 The
Society of Thoracic Surgeons

<14>
Accession Number
613593348
Author
Winkler B.; Heinisch P.P.; Gahl B.; Aghlmandi S.; Jenni H.J.; Carrel T.P.
Institution
(Winkler, Heinisch, Gahl, Jenni, Carrel) Department of Cardiovascular
Surgery, Inselspital, University of Bern, Bern, Switzerland
(Aghlmandi) Institute of Social and Preventive Medicine, University of
Bern, Bern, Switzerland
Title
Minimally Invasive Extracorporeal Circulation Circuit Is Not Inferior to
Off-Pump Coronary Artery Bypass Grafting: Meta-Analysis Using the Bayesian
Method.
Source
Annals of Thoracic Surgery. 103 (1) (pp 342-350), 2017. Date of
Publication: 01 Jan 2017.
Publisher
Elsevier USA
Abstract
The pathophysiologic side effects of cardiopulmonary bypass have already
been identified. Minimally invasive extracorporeal circulation
technologies (MiECT) and off-pump coronary artery bypass graft surgery
(OPCABG) aim to reduce these problems. This meta-analysis provides a
comparison of MiECT and OPCABG in randomized and observational studies. A
fully probabilistic, Bayesian approach of primary and secondary endpoints
was conducted. MiECT does not give inferior results when compared with
OPCABG. However, there is a trend to borderline significantly higher blood
loss in this group in randomized controlled trials. The question whether
MiECT is equivalent to OPCABG can be answered with the affirmative, but
long-term follow-up data are needed to detect any advantage over time.
Copyright &#xa9; 2017 The Society of Thoracic Surgeons

<15>
Accession Number
613459465
Author
Cholette J.M.; Swartz M.F.; Rubenstein J.; Henrichs K.F.; Wang H.; Powers
K.S.; Daugherty L.E.; Alfieris G.M.; Gensini F.; Blumberg N.
Institution
(Cholette, Rubenstein, Powers, Daugherty) Department of Pediatrics,
University of Rochester, Rochester, New York, United States
(Swartz, Alfieris, Gensini) Department of Surgery, University of
Rochester, Rochester, New York, United States
(Henrichs, Blumberg) Department of Pathology and Laboratory Medicine,
University of Rochester, Rochester, New York, United States
(Wang) Department of Biostatistics, University of Rochester, Rochester,
New York, United States
Title
Outcomes Using a Conservative Versus Liberal Red Blood Cell Transfusion
Strategy in Infants Requiring Cardiac Operation.
Source
Annals of Thoracic Surgery. 103 (1) (pp 206-214), 2017. Date of
Publication: 01 Jan 2017.
Publisher
Elsevier USA
Abstract
Background The optimal hemoglobin for infants after cardiac operation is
unknown. Red blood cells (RBCs) are commonly transfused to maintain high
hemoglobin concentrations in the absence of a clinical indication. We
hypothesized that infants can be managed with a postoperative conservative
RBC transfusion strategy, resulting in lower daily hemoglobin
concentrations, without evidence of impaired oxygen delivery (ie, lactate,
arteriovenous oxygen difference [avO<inf>2</inf>diff]), or adverse
clinical outcomes. Methods Infants weighing 10 kg or less undergoing
biventricular repair or palliative (nonseptated) operation were randomly
assigned to either a postoperative conservative or liberal transfusion
strategy. Conservative group strategy was RBC transfusion for a hemoglobin
less than 7.0 g/dL for biventricular repairs or less than 9.0 g/dL for
palliative procedures plus a clinical indication. Liberal group strategy
was RBC transfusion for hemoglobin less than 9.5 g/dL for biventricular
repairs or less than 12 g/dL for palliative procedures regardless of
clinical indication. Results After the operation of 162 infants (82
conservative [53 biventricular, 29 palliative], 80 liberal [52
biventricular, 28 palliative]), including 12 Norwood procedures (6
conservative, 6 liberal), daily hemoglobin concentrations were
significantly lower within the conservative group than the liberal group
by postoperative day 1 and remained lower for more than 10 days. The
percentage of patients requiring a RBC transfusion, number of
transfusions, and volume of transfusions were all significantly lower
within the conservative group. Despite lower hemoglobin concentrations
within the conservative group, lactate, avO<inf>2</inf>diff, and clinical
outcomes were similar. Conclusions Infants undergoing cardiac operation
can be managed with a conservative RBC transfusion strategy. Clinical
indications should help guide the decision for RBC transfusion even in
this uniquely vulnerable population. Larger multicenter trials are needed
to confirm these results, and focus on the highest risk patients would be
of great interest. Copyright &#xa9; 2017 The Society of Thoracic Surgeons

<16>
Accession Number
606034598
Author
Rodriguez-Caulo E.A.; Otero J.; Mataro M.J.; Sanchez-Espin G.; Porras C.;
Guzon A.; Such M.; Melero J.M.
Institution
(Rodriguez-Caulo, Otero, Mataro, Sanchez-Espin, Porras, Guzon, Such,
Melero) UGC Area del Corazon, Servicio de Cirugia Cardiovascular, Hospital
Clinico Universitario Virgen de la Victoria, Malaga, Spain
Title
Minimally invasive aortic valve surgery.
Source
Cirugia Cardiovascular. 23 (6) (pp 306-311), 2016. Date of Publication: 01
Nov 2016.
Publisher
Elsevier Doyma (E-mail: editorial@elsevier.com)
Abstract
The aging of the population has led to an increase in the number of
surgeries on the aortic valve. During the past 20 years the surgical
technique has progressed to less aggressive techniques, with new types of
minimally invasive aortic valve surgery (MIAVR) emerging. Of these
techniques, the upper hemi-sternotomy (UHS) or mini-sternotomy has become
the most commonly used, followed by the right anterior thoracotomy (RAT).
Compared with conventional surgery, both have shown a faster recovery,
better cosmetic results, shorter hospital and ICU stay, better respiratory
function, reduced blood loss and transfusions, as well as lower early and
late mortality. Despite these advances, their use has not been
definitively extended, due to an increase in the ischaemia and
cardiopulmonary bypass (CPB) times needed in these more complex
procedures. The emergence of new generation sutureless prosthesis can
overcome this setback by reducing the ischemic and CPB by up to 43%, and
allows MIAVR to expand and become a real alternative to the transcatheter
valves (TAVI) in high risk operable patients. Although prospective
randomised controlled trials are required to confirm these data, there is
sufficient available evidence to consider MIAVR (especially UHS) as the
current reference method for isolated aortic valve replacement. Copyright
&#xa9; 2015 Sociedad Espanola de Cirugia Toracica-Cardiovascular

<17>
Accession Number
610353211
Author
Sanchez-Espin G.; Otero J.J.; Rodriguez E.A.; Mataro M.J.; Melero J.M.;
Porras C.; Guzon A.; Such M.
Institution
(Sanchez-Espin, Otero, Rodriguez, Mataro, Melero, Porras, Guzon, Such)
Unidad de Gestion Clinica del Corazon y Patologia Cardiovascular, Servicio
de Cirugia Cardiaca, Hospital Universitario Virgen de la Victoria, Malaga,
Spain
Title
Minimally invasive mitral valve surgery.
Source
Cirugia Cardiovascular. 23 (6) (pp 276-281), 2016. Date of Publication: 01
Nov 2016.
Publisher
Elsevier Doyma (E-mail: editorial@elsevier.com)
Abstract
During the last two decades cardiac surgery has evolved into less-invasive
procedures, looking for a lesser body aggression and faster patient
recovery, these procedures becoming more attractive to patients and
clinical cardiologists. Currently, minimally invasive mitral valve surgery
(MIMVS) has established itself as an alternative for patients with mitral
valve pathology. Compared with conventional mitral surgery (full
sternotomy approach) and after overcoming initial learning curve, it turns
out to be a safe and effective technique, with equivalent short- and
long-term follow-up results. Despite involving an increase in operative
times (ischemic and cardiopulmonary bypass time), the MIMVS is associated
with shorter in-hospital and intensive care unit stay, reduced blood loss
and transfusions, earlier extubation and fewer arrhythmias and allows a
faster patient recovery with better cosmetic result. Therefore, MIMVS is a
steadily growing technique in different centers, being recommended
prospective randomized studies that allow a better assessment of clinical
outcomes and in terms of cost-efficiency. Copyright &#xa9; 2016 Sociedad
Espanola de Cirugia Toracica-Cardiovascular

<18>
Accession Number
608668727
Author
Izumo M.; Takeuchi M.; Seo Y.; Yamashita E.; Suzuki K.; Ishizu T.; Sato
K.; Oshima S.; Aonuma K.; Otsuji Y.; Akashi Y.J.
Institution
(Izumo, Suzuki, Akashi) Division of Cardiology, Department of Internal
Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
(Takeuchi) Department of Laboratory and Transfusion Medicine, University
of Occupational and Environmental Health, School of Medicine, Kitakyushu,
Japan
(Seo, Ishizu, Sato, Aonuma) Cardiovascular Division, Faculty of Medicine,
University of Tsukuba, Tsukuba, Japan
(Yamashita, Oshima) Division of Cardiology, Gunma Prefectural
Cardiovascular Center, Gunma, Japan
(Otsuji) Second Department of Internal Medicine, University of
Occupational and Environmental Health, School of Medicine, Kitakyushu,
Japan
Title
Prognostic implications in patients with symptomatic aortic stenosis and
preserved ejection fraction: Japanese multicenter aortic stenosis,
retrospective (JUST-R) registry.
Source
Journal of Cardiology. 69 (1) (pp 110-118), 2017. Date of Publication: 01
Jan 2017.
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background Current prognostic implication of symptomatic patients with
aortic stenosis (AS) remains undetermined. This study investigated the
current prognostic implications of AS-related symptoms and the effect of
aortic valve replacement (AVR) on outcome. Methods We enrolled 586
consecutive patients with severe AS (aortic valve area <1.0
cm²) with preserved left ventricular ejection fraction (>50%).
All patients were stratified into the following four groups based on the
predominant symptoms: Group 1, asymptomatic (n = 316); Group 2, chest pain
(n = 41); Group 3, heart failure (n = 192); or Group 4, syncope (n = 37).
Results AS-related symptoms were diagnosed in 270 patients (46.1%), among
whom 182 patients (32.2%) received AVR. Thirty-nine patients (6.7%) had
cardiac death during the mean follow-up of 16 +/- 14 months. AVR was
associated with significant reduction in cardiac death in Groups 3 (p <
0.001) and 4 (p = 0.004) whereas no significant prognostic advantage of
AVR was observed in Groups 1 or 2. Cox proportional-hazard multivariate
analysis revealed that age, heart failure, and mean pressure gradient (PG)
were associated with increased risk of cardiac death in all patients
regardless of AVR [hazard ratio (HR): 1.079, 2.090, and 1.008
respectively, all p < 0.05]. In the patients without AVR, age, heart
failure, syncope, and mean PG were independently associated with cardiac
death (HR: 1.130, 3.639, 4.638, and 1.008, all p < 0.05). Conclusion This
retrospective study demonstrated the current associations between the
types of AS symptoms and prognosis in Japanese patients with severe AS.
Copyright &#xa9; 2016 Japanese College of Cardiology

<19>
Accession Number
610067157
Author
Antonic M.; Lipovec R.; Gregorcic F.; Juric P.; Kosir G.
Institution
(Antonic, Lipovec, Gregorcic, Juric, Kosir) Department for Cardiac
Surgery, University Medical Center Maribor, Maribor, Slovenia
Title
Perioperative ascorbic acid supplementation does not reduce the incidence
of postoperative atrial fibrillation in on-pump coronary artery bypass
graft patients.
Source
Journal of Cardiology. 69 (1) (pp 98-102), 2017. Date of Publication: 01
Jan 2017.
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background Atrial fibrillation is the most common arrhythmia following
cardiac surgery. It is associated with increased hemodynamic instability,
systemic embolization, and complications linked to anticoagulant therapy.
Oxidative stress and consequent electrophysiological remodeling have been
proposed as a cause of postoperative atrial fibrillation. Ascorbic acid
supplementation was suggested as a novel and effective preventive agent.
The aim of this study was to evaluate the capability of ascorbic acid to
reduce the incidence of postoperative atrial fibrillation in coronary
artery bypass grafting (CABG) patients. Methods A prospective randomized
single-center trial was conducted in patients scheduled for an elective
on-pump CABG surgery. Subjects in the ascorbic acid group received 2 g of
ascorbic acid 24 h and 2 h before the surgery and 1 g twice a day for five
days after the surgery. Postoperatively, the patients were monitored for
atrial fibrillation and other complications. Results The ascorbic acid
group consisted of 52 patients and the control group included 53 patients.
The groups were well matched for baseline demographics, preoperative
medications, comorbidities, and had similar intraoperative
characteristics. The incidence of atrial fibrillation in the ascorbic acid
group was 13.5% and 18.9% in the control group (p = 0.314). No difference
was found between groups in the time of occurrence of atrial fibrillation
(3.71 +/- 1.89 vs. 2.91 +/- 1.58 days after the surgery; p = 0.342). There
was also no difference in the other observed postoperative complications.
Conclusions The results of this study do not support the effectiveness of
ascorbic acid supplementation in reducing the incidence of postoperative
atrial fibrillation in elective on-pump CABG patients. Copyright &#xa9;
2016 Japanese College of Cardiology

<20>
Accession Number
612819573
Author
Goudar S.P.; Baker G.H.; Chowdhury S.M.; Reid K.J.; Shirali G.; Scheurer
M.A.
Institution
(Goudar, Reid, Shirali) Ward Family Heart Center, Children's Mercy
Hospital, Kansas City, MO, United States
(Baker, Chowdhury, Scheurer) Department of Pediatrics, Division of
Pediatric Cardiology, Medical University of South Carolina, Charleston,
SA, United States
Title
Interpreting measurements of cardiac function using vendor-independent
speckle tracking echocardiography in children: a prospective, blinded
comparison with catheter-derived measurements.
Source
Echocardiography. 33 (12) (pp 1903-1910), 2016. Date of Publication: 01
Dec 2016.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Adult studies demonstrate that echocardiographic measurements
of cardiac function using speckle tracking correlate with invasive
measurements, but such data in the pediatric population are sparse. Our
aim was to compare speckle-derived measures of cardiac function to
measurements routinely obtained by cardiac catheterization in children.
Methods: Echocardiograms were performed on the day of cardiac
catheterization. Using Tomtec 2D Cardiac Performance Analysis,
longitudinal strain (LS), longitudinal strain rate (LSR), early diastolic
LSR, and ejection fraction (EF) for the right and left ventricle (RV and
LV) were calculated via speckle tracking. Global LS and LSR were
calculated for the LV. These results were compared to cardiac index,
maximum ventricular dp/dt (max dp/dt), ventricular end-diastolic pressure
(EDP), and pulmonary capillary wedge pressure (PCWP) obtained by
fluid-filled catheters. A blinded observer performed all echo
measurements. Results: Fifty studies were performed on 28 patients ages 4
months to 20 years old. Their diagnoses included cardiac transplant (48
studies), repaired AV septal defect (1), and dilated cardiomyopathy (1).
RVEDP ranged from 2 to 22 mm Hg (median=6) and PCWP ranged from 6 to 32
mmHg (median 10). LV global LS and LV 2-chamber LSR by speckle-tracking
negatively correlated with LV max dp/dt (LV global LS R=-.83, P=.001; LV
2-chamber LSR R=-.69, P=.009). RV LS weakly correlated with max dp/dt
(R=.363, P=.002). Early diastolic strain rate did not correlate with EDP
in either ventricle. Conclusion: Speckle-derived measurements of function
in the LV have stronger correlation than the RV to catheter-derived
measures. LV global LS has the strongest correlation with invasive
function measures in children. Copyright &#xa9; 2016, Wiley Periodicals,
Inc.

<21>
Accession Number
613821788
Author
Iyer G.; Caleb Alexander G.; Lucas E.; Lin D.; Singh S.
Institution
(Iyer, Caleb Alexander, Lucas, Lin) Epidemiology, Johns Hopkins Bloomberg
School of Public Health, Baltimore, MD, United States
(Iyer, Caleb Alexander, Lucas, Lin, Singh) Center for Drug Safety and
Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore,
MD, United States
(Caleb Alexander, Singh) General Internal Medicine, Johns Hopkins
Medicine, Baltimore, MD, United States
Title
Cardiovascular risks of exogenous testosterone use among men: A systematic
review and meta-analysis.
Source
Pharmacoepidemiology and Drug Safety. Conference: 32nd International
Conference on Pharmacoepidemiology and Therapeutic Risk Management.
Ireland. Conference Start: 20160825. Conference End: 20160828. 25 (pp
529), 2016. Date of Publication: August 2016.
Publisher
John Wiley and Sons Ltd
Abstract
Background: Exogenous testosterone products are widely used for symptoms
of age-related hypogonadism. However, their cardiovascular safety remains
uncertain. Objectives: We evaluated whether exogenous testosterone therapy
is associated with an increased risk of serious cardiovascular events, as
compared to other treatments or placebo. Methods: We searched Pubmed,
MEDLINE, EMBASE, Cochrane Collaboration Clinical Trials,
clinicaltrials.gov, and the US Food and Drug Administration website,
through August 28, 2015. Randomized controlled trials (RCTs) and
observational studies which enrolled men > 18 years receiving testosterone
for > 3 days were included. Two reviewers independently conducted all
stages of review, with adjudication by a third reviewer when necessary.
The primary outcomes were death due to all causes, myocardial infarction,
and stroke. Secondary outcomes included heart failure, arrhythmia, and
cardiac procedures. The risk of bias of RCTs and observational studies was
evaluated using the Cochrane Collaboration tool and the Newcastle and
Ottawa scale, respectively. The Peto odds ratio was used for metaanalysis.
PROSPERO (#CRD42015019259). Results: A total of 39 RCTs and 10
observational studies were included. Meta-analysis was conducted on 30
RCTs. Compared to placebo, exogenous testosterone treatment did not show
any statistically significant increase in risk of myocardial infarction
(odds ratio [OR] 0.87, 95% confidence interval [CI] 0.39- 1.93, 16 RCTs),
stroke (OR 2.17, CI 0.63-7.54, 9 RCTs) or mortality (OR 0.88, CI
0.55-1.41, 20 RCTs). Sensitivity analysis showed similar results. The
design and methodology of the studies were poorly reported. Observational
studies showed conflicting results with marked clinical and methodological
heterogeneity. Conclusions: We did not find any significant association
between exogenous testosterone treatment and myocardial infarction, stroke
or mortality, although the evidence was imprecise. Our results may differ
from previous reviews because of choice of outcomes and analytic
approaches used. The low quality of the evidence precludes definitive
conclusion.

<22>
Accession Number
613821346
Author
Adelborg K.; Sundboll J.; Munch T.; Froslev T.; Sorensen H.T.; Botker
H.E.; Schmidt M.
Institution
(Adelborg, Sundboll, Munch, Froslev, Sorensen, Schmidt) Department of
Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
(Adelborg, Sundboll, Botker) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
Title
Validity of cardiac examination, procedure, and surgery codes in the
danish national patient registry.
Source
Pharmacoepidemiology and Drug Safety. Conference: 32nd International
Conference on Pharmacoepidemiology and Therapeutic Risk Management.
Ireland. Conference Start: 20160825. Conference End: 20160828. 25 (pp
254-255), 2016. Date of Publication: August 2016.
Publisher
John Wiley and Sons Ltd
Abstract
Background: Danish registries are widely used for cardiovascular research.
Validation of registry codes is necessary to ensure high data quality.
Objectives: We calculated positive predictive values (PPVs) of codes for
cardiac examinations, procedures, and surgeries registered in the Danish
National Patient Registry (DNPR), to evaluate their potential use for
research. Methods: We randomly selected 1239 patients from one university
hospital and two regional hospitals in the Central Denmark Region
(2010-2012). All codes were validated using medical record review as gold
standard. Results: A total of 1233 medical records were available and
reviewed (99% of the total sample). The PPVs ranged from 83% to 100%
(median of 98%). For examinations, the overall PPV was 98%, which included
PPVs of 97% for echocardiography, 97% for right heart catheterization, and
100% for coronary angiogram. The overall PPV was 98% for procedures;
specifically the PPVs were 98% for thrombolysis, 92% for cardioversion,
100% for radiofrequency ablation, 98% for percutaneous coronary
intervention, and 100% for both cardiac pacemakers and implantable cardiac
defibrillators. The overall PPV was 99% for cardiac surgery, represented
by mitral and aortic valve surgery (100% and 99%), coronary artery bypass
graft surgery (98%), and heart transplantation (100%). The validity of the
codings were consistent within age-, sex-, and calendar year categories.
The completeness of the variables was not examined, but assumed high owing
to the diagnosis related group system as a prospective reimbursement
system for all Danish hospitals since 2002. Conclusions: Cardiac
examinations, procedures and surgeries in the DNPR are accurately recorded
in the DNPR and thus valuable data for cardiovascular research.

<23>
Accession Number
613816949
Author
Hasan S.; Desouza C.V.
Institution
(Hasan) University of Nebraska Medical Center, Omaha, NE, United States
(Desouza) Univ of Nebraska Med Center, Omaha, NE, United States
Title
The role of liothyronine in acute cardiac setting.
Source
Endocrine Reviews. Conference: 97th Annual Meeting and Expo of the
Endocrine Society, ENDO 2015. United States. Conference Start: 20150305.
Conference End: 20150308. 36 (no pagination), 2015. Date of Publication:
2015.
Publisher
Endocrine Society
Abstract
Introduction: The significance of thyroid hormone in cardiac physiology
has been studied extensively. Altered thyroid hormone metabolism (low Free
T3 index/Reverse T3) has been reported previously in chronic heart
failure. Thus far, only a few studies reported the use of Liothyronine
(T3) following cardiac arrest and cardiopulmonary bypass in patients
without underlying thyroid dysfunction. To our knowledge, this is the
first case report of short term T3 administration in cardiogenic shock
induced by hypothyroidism. Case: A 23 year-old, previously healthy female,
presented in cardiogenic shock. Her symptoms prior to presentation
consisted of cough, weight gain, orthopnea and lower extremity edema which
progressed over a period of 2 months. Physical examination was notable for
BP 84/56, delayed relaxation phase of DTR, JVD to mid neck, few bibasilar
crackles and 1+ pitting edema in lower extremity. Thyroid function tests
were consistent with profound hypothyroidism [Free T4-0.2 ng/dL (0.6-1.5),
TSH-23.54 mcIU/mL (0.4-5.0), TPO Ab-1340 IU/mL (0-9), Free T4 by dialysis
< 0.2 ng/dL (0.8-2.7) ]. Cardiac catheterization was negative for
ischemia, revealed an EF of 5% and bi-ventricular failure suggestive of
dilated cardiomyopathy. She was started on inotropic support (Dopamine and
Dobutamine) and levothyroxine 100 mcg IV daily. In addition, she underwent
Intra-Aortic Balloon placement. Microbiology and viral serologies were
negative and cardiac biopsy did not reveal any histologic evidence of
myocarditis, granulomatous or infiltrative cardiomyopathy. Further
evaluation for hematologic and rheumatologic disorders was negative. She
remained critically ill, subsequently requiring RVAD and LVAD
implantation. After 2 weeks of hospitalization, she continued to
deteriorate despite the normalization of Free T4 (1.0). She did not
qualify for cardiac transplantation due to Obesity. At this point, she was
started on T3 infusion (3mcg/hour for 6 hrs) for cardiac resuscitation.
During the next couple days, patient became hemodynamically stable and was
weaned off inotropes as left ventricular (LV) function continued to
improve (EF 15-20%). After 7 weeks of hospitalization, patient was stable
for discharge. Furthermore, a year and a half later, she remains
clinically euthyroid and has had significant recovery of her native LV
function and her EF is nearly normal. Conclusion: We found that acute,
short term T3 administration did improve cardiovascular function and
resulted in decreased inotropic requirement. This case highlights the
significance of the role of T3 in acute cardiac setting. Large,
multicenter prospective studies are needed to determine the protocol and
dosage of T3 analogs.

<24>
Accession Number
613792405
Author
Chiappetta M.; Nachira D.; Lococo F.; Petracca Ciavarella L.; Romano R.;
Pastina M.; Congedo M.T.; Porziella V.; Margaritora S.
Institution
(Chiappetta) Department of Surgical Oncology, Thoracic Surgery Unit,
Regina Elena National Cancer Institute - IFO, Rome, Italy
(Nachira, Petracca Ciavarella, Romano, Pastina, Congedo, Porziella,
Margaritora) Department of Thoracic Surgery, Catholic University of the
Sacred Heart, Rome, Italy
(Lococo) Unit of Thoracic Surgery, IRCCS-Arcispedale Santa Maria Nuova,
Reggio Emilia, Italy
Title
Digital devices in thoracic surgery: Are they really useful in clinical
practice to predictair leak? Results from a prospective randomized
clinicaltrial.
Source
Interactive Cardiovascular and Thoracic Surgery. Conference: 24th European
Conference on General Thoracic Surgery. Italy. Conference Start: 20160529.
Conference End: 20160601. 23 (pp i28), 2016. Date of Publication: 2016.
Publisher
Oxford University Press
Abstract
Objectives: Digital devices could help clinical practice measuring the air
leak, but their role is still debated. The aim of this study is to test
advantages using these devices. Methods: From June 2012 to May 2015 we
enrolled 95 patients who underwent lobectomy or wedge resection in a
prospective randomized trial at our division of thoracic surgery. The
patients were divided in group D (50 patients) and group E (45 patients):
air-leak was evaluated by digital device in group D and by water seal in
group E. In group D the chest drain was removed when the air leak was
absent or <0.5 l/h for 12 consecutive hours. In group E the chest drain
was removed when clinical signs of air leak were absent. Results:
Male/female ratio was 50/45, mean age was 63.63 +/- 12.95 years.
Cumulative mean postoperative hospitalization was 6.00 +/- 3.33 days
(range 2-31), mean chest tube stay was 5.17 +/- 3.54 days, persistent
air-leak (>5 days) occurred in 9 (9.9%). Postoperative hospital stay in
group D was 5.81 +/- 2.56 days and in group E it was 6.20 +/- 4.12 days (P
= 0.8), mean chest tube stay was 5.08 +/- 3.01 days in group D and 5.27
+/- 4.07 days in group E (P = 0.8); clamping test was needed in 1 patient
in group D and in 7 in group E (P = 0.02). Interestingly, air-leak in the
first postoperative day was a predictive factor of persistent air-leak
(AUC on the ROC curve of 69.7%, sensibility: 77.8%). In detail, in D group
an air-leak value >0.2 l/h with spikes over 0.5 l/h in III p.o was
predictive of a persistent air-leak; chest tube duration was 7.73+/-5.20
days in patients with spikes and 4.32+/-1.33 days in patients without
spikes, P = 0.001; AUC: 83%, sensitivity: 80%. Conclusion: Digital devices
reduced clamping tests and mistakes in chest drain removal timing. They
are also useful to assess and predict persistent air-leak, helping
clinical practice and chest tube management.

<25>
Accession Number
613792392
Author
Bonisch P.L.; Schweigert M.; Solymosi N.; John J.; Karmy-Jones R.; Dubecz
A.; Girlado Ospina C.F.; West D.; Witzigmann H.; Stein H.J.
Institution
(Bonisch, Schweigert) Thoracic Surgery, Stadtisches Klinikum
Dresden-Friedrichstadt, Dresden, Germany
(Solymosi) Faculty of Science, Szent Istvan University, Budapest, Hungary
(John, West) Thoracic Surgery, University Hospital Bristol, Bristol,
United Kingdom
(Karmy-Jones) Thoracic Surgery, PeathHealth Southwest Medical Center,
Vancouver, United States
(Dubecz, Stein) General and Thoracic Surgery, Klinikum Nuremberg,
Nuremberg, Germany
(Girlado Ospina) Thoracic Surgery, Hospital Universitario Virgen de Las
Nieves, Granada, Spain
(Witzigmann) General and Thoracic Surgery, Stadtisches Klinikum
Dresden-Friedrichstadt, Dresden, Germany
Title
Predictors of outcome in surgery for lung abscess in the contemporary
Western world.
Source
Interactive Cardiovascular and Thoracic Surgery. Conference: 24th European
Conference on General Thoracic Surgery. Italy. Conference Start: 20160529.
Conference End: 20160601. 23 (pp i26-i27), 2016. Date of Publication:
2016.
Publisher
Oxford University Press
Abstract
Objectives: Surgery for lung abscess is a challenging task. Timing and
indications for surgery are not well established. Identification of
predictors of outcome could help to clarify the role of surgery. Methods:
In a retrospective study, patients who underwent major thoracic surgery
for infectious lung abscess were identified in six centres in Germany,
Spain, the United Kingdom and the United States. The study period was
2000-2015. Results: There were 84 patients (male 64; median age 59 years,
interquartile range [IQR] 18). Pulmonary sepsis (43), pleural empyema
(41), persistent air leakage (24), acute renal failure (12) and
respiratory failure with mechanical ventilation (24) were already
preoperatively present. Chronic alcoholism (34), alcoholic liver cirrhosis
(8) and drug addiction (5) were common. The mean Charlson index of
comorbidity was 3.1 (median 2.0, IQR 3). Procedures were segmentectomy
(18), lobectomy (53) and pneumonectomy (13). The 30-daymortality following
surgery was 13/84. There were no significant differences in age,
Charlson-index-of-comorbidity and
Charlson-combined-age-and-conditionrelated-score between lobectomy and
pneumonectomy patients. Segmentectomy patients were significantly younger
(P = 0.03). Preoperative sepsis (OR: 15.08, 95% CI: 2.03-675.72, P <
0.01), preoperative persistent air leak (OR: 13.02, 95% CI: 2.87-83.31, P
< 0.01), respiratory failure (OR: 5.36, 95% CI: 1.34-24.00, P < 0.01),
acute renal failure (OR: 5.54, 95% CI: 1.12-26.73, P = 0.02) and
Charlson-index of comorbidity >3 (OR: 7.60, 95% CI: 1.49-75.54, P < 0.01)
are associated with higher mortality whereas age >70 years (P = 0.46) and
the extent of pulmonary resection (segmentectomy, lobectomy,
pneumonectomy) have no significant influence on mortality. Patients with
fatal outcome have significantly higher Charlson-index-of-comorbidity (P <
0.01) and Charlson combined age and condition related score (P < 0.01).
Conclusion: Delayed referral for surgery is common. Significant predictors
for fatal outcome are pulmonary sepsis, septic multi-organ failure
(respiratory failure, acute renal failure) and pre-existing comorbidity
(Charlson-index-ofcomorbidity >3). The extent of surgical resection shows
no significant influence. Further improvement seems achievable by earlier
surgical intervention before the onset of pulmonary sepsis.

<26>
Accession Number
613792367
Author
Laisaar T.; Agocs L.; Bagajevas A.; Silins I.; Batirel H.
Institution
(Laisaar) Thoracic Surgery, Tartu University Hospital, Tartu, Estonia
(Agocs) Thoracic Surgery, National Institute of Oncology, Budapest,
Hungary
(Bagajevas) Thoracic Surgery, Klaipeda University Hospital, Klaipeda,
Lithuania
(Silins) Thoracic Surgery, Centre of TB and Lung Diseases, Riga East
University Hospital, Riga, Latvia
(Batirel) Thoracic Surgery, Marmara University Hospital, Istanbul, Turkey
Title
Transition from two-three port to uniportal approach in video-assisted
thoracoscopic lobectomy: A multicentre comparative study.
Source
Interactive Cardiovascular and Thoracic Surgery. Conference: 24th European
Conference on General Thoracic Surgery. Italy. Conference Start: 20160529.
Conference End: 20160601. 23 (pp i65), 2016. Date of Publication: 2016.
Publisher
Oxford University Press
Abstract
Objectives: Minimal invasiveness is currently aimed in most surgical
interventions. In thoracic surgery VATS lobectomy has become a standard. A
step further would be a uniportal approach. The current study aimed to
compare main indicators of VATS lobectomies before and after switching to
a uniportal approach in five European thoracic surgery centres with
significant previous 2-3 port VATS lobectomy experience. Methods: Last 20
(consecutive) VATS lobectomies before implementing the uniportal approach
were compared to first 20 (consecutive) uniportal VATS lobectomies in each
of the five centres. Data were extracted from medical records. In two
centres, by the end of the data collection, less than 20 uniportal
operations had been performed. Student's t-test and Mann-Whitney U-test
were used for statistical analysis. Results: Data from 100 2-3 port VATS
lobectomies were compared to 72 uniportal VATS lobectomies. The study
groups did not differ in terms of age, gender, BMI, diagnosis, or lobe
removed. In 8 cases (11.1%) the uniportal approach was converted to a 2-3
port approach. No intrahospital mortality occurred in either of the
groups. Conclusion: Transition from 2-3 port to uniportal approach in VATS
lobectomy did not prolong the operation or increased the rate of
complications and conversion to thoracotomy. Postoperative stay after
uniportal lobectomy was significantly shorter compared to the 2-3 port
technique. There was no evidence of a learning curve while implementing
uniportal VATS lobectomy.

<27>
Accession Number
613792358
Author
Abbas N.; Healy D.
Institution
(Abbas) Cardiothoracic Surgery, Mater Misericordiae Hospital, Dublin,
Ireland
(Healy) Thoracic Surgery, St Vincent's University Hospital, Dublin,
Ireland
Title
A randomized trial of analgesia in video-assisted thoracic surgery: Local
anaesthetic delivery by wound infiltration catheter compared with topical
transdermal patch delivery.
Source
Interactive Cardiovascular and Thoracic Surgery. Conference: 24th European
Conference on General Thoracic Surgery. Italy. Conference Start: 20160529.
Conference End: 20160601. 23 (pp i10), 2016. Date of Publication: 2016.
Publisher
Oxford University Press
Abstract
Objectives: The optimal postoperative analgesia regime in minimally
invasive thoracic surgery is a continuing quest. Local anaesthetic
delivery to the wounds aids pain relief, has a favourable side effect
profile and is a part of an opioid sparing strategy. However
intraoperative delivery is limited by the drug half life. Therefore for
extended postoperative pain relief with local anaesthetic agents,
additional delivery mechanisms need to be explored. Here we compare a
continuous wound infusion catheter delivery with transdermal patch
application in the first 48 hours after surgery Methods: Patients
undergoing minimally invasive VATS surgery were recruited. Randomization
was with a blind envelope method. The camera port site is recycled as a
drain site in all cases. Group Awas allocated to the placement of a wound
infiltration catheter (bupivacaine) to a subpleural level under direct
camera vision, in the intercostal level of the camera/drain entry site.
Group B instead had a lidocaine 5% patch placed proximally to the drain
site. Patients were managed with a standardized postoperative pain
strategy otherwise, and opioids delivered by an intravenous PCA method.
Pain scores and opioid usage were collected. Additional opioid usage was
also noted and morphine equivalence added to the total. Results:
Fifty-five patients were available for analysis. There were no adverse
effects with either agent. Demography across the groups was homogenous.
The lidocaine patch was assessed as more expensive on cost analysis. There
was no significant difference between the groups in regard to opioid usage
or subjected pain scores. Conclusion: The two methods under test provided
similar pain relief. The transdermal patch provides less of an obstacle to
patient mobility postoperatively but is a more costly method then a wound
catheter. Our recommendation is to use the wound infiltration catheter
based on cost effectiveness.

<28>
Accession Number
613792332
Author
Pinos N.; Moreno-Merino S.; Lopez-Porras M.; Giron J.C.; Zuniga G.;
Jimenez-Merchan R.; Congregado M.
Institution
(Pinos, Moreno-Merino, Lopez-Porras, Giron, Zuniga, Jimenez-Merchan,
Congregado) General Thoracic Surgery, Virgen Macarena University Hospital,
Sevilla, Spain
Title
Usefulness of flexible silicone drainage versus conventional plastic
drainage in thoracic surgery.
Source
Interactive Cardiovascular and Thoracic Surgery. Conference: 24th European
Conference on General Thoracic Surgery. Italy. Conference Start: 20160529.
Conference End: 20160601. 23 (pp i38-i39), 2016. Date of Publication:
2016.
Publisher
Oxford University Press
Abstract
Objectives: Pleural drainages are used in general thoracic surgery to
evacuate air and liquids after surgery. It also works as a witness to
detect early postoperative complications. Nowadays rigid drainages are
more commonly used but they have some disadvantages like postoperative
pain that causes respiratory complications due to less physiotherapy
exercises after surgery. Flexible silicone drainages seem to be better
tolerated by patients. The aim of this study is to compare flexible versus
rigid drainage after lung resection surgery. Methods: A randomized
clinical trial was performed to compare flexible versus rigid drains after
lung resection surgery. Two homogeneous groups of 50 patients were
enrolled: Group A (rigid plastic drainage 24 Fr Medovations), Group B
(round silicone fluted drain 24 Fr BiovacTM). Variables studied: age,
gender, pre- and postoperative diagnosis, type of resection and approach,
intraoperative incidents, air leaks, subcutaneous emphysema, pleural
liquid evacuated, postoperative complications, days with drainage, length
of stay (LOS). Statistical analysis: Chi square for qualitative data and
Student's t-test for quantitative variables (SSPS 22.0). Results: Both
groups were comparable and no significant differences were found in age (P
= 0.55), gender (P = 0.79), malignant diagnosis (P = 0.61), type of
resection (P = 0.21), videothoracoscopic or conventional approach (P =
0.82) and intraoperative complications (P = 0.61). Although LOS seems to
be shorter in group B and there were more subcutaneous emphysema in group
B, no statistically significant differences were found in any variable.
Conclusion: According to the data of our study, there are no differences
in the efficacy of rigid drainages against flexible silicone drains after
lung resection surgery. Considering that the patients better tolerate this
kind of drainage, flexible silicon drains can be a good choice after lung
surgery.

<29>
Accession Number
613792257
Author
Bessissow A.; Agzarian J.; Srinathan S.; Schneider L.; Devereaux P.; Neary
J.; Dechert W.; Gandy L.; Finley C.; Hanna W.C.; Schieman C.; Shargall Y.
Institution
(Bessissow, Devereaux) Medicine, McMaster University, Hamilton, Canada
(Agzarian, Schneider) Surgery, McMaster University, Hamilton, Canada
(Srinathan) Surgery, University of Manitoba, Winnipeg, Canada
(Neary) Medicine, McMaster University, St. Joseph's Healthcare Hamilton,
Hamilton, Canada
(Dechert) Medicine, St. Joseph's Healthcare Hamilton, Hamilton, Canada
(Gandy) Nursing, St. Joseph's Healthcare Hamilton, Hamilton, Canada
(Finley, Hanna, Schieman, Shargall) Surgery, McMaster University, St.
Joseph's Healthcare Hamilton, Hamilton, Canada
Title
The effect of Colchicine administration on postoperative pleural effusion
following thoracic surgery: A randomized, double blind,
placebo-controlled, feasibility pilot study.
Source
Interactive Cardiovascular and Thoracic Surgery. Conference: 24th European
Conference on General Thoracic Surgery. Italy. Conference Start: 20160529.
Conference End: 20160601. 23 (pp i20), 2016. Date of Publication: 2016.
Publisher
Oxford University Press
Abstract
Objectives: Colchicine was previously found to be effective in preventing
postoperative pericardial effusion following cardiac surgery with potent
antiinflammatory effects. This study seeks to assess its effect on the
volume of postoperative pleural drainage, duration of chest tube in-situ
and length of stay following lung resection. Methods: Between April 2014
and April 2015, 100 patients undergoing lung resection at two tertiary
care centres were randomized to either colchicine (n = 49) or placebo (n =
51) treatment arms), as part of a feasibility, pilot double-blind study
assessing colchicine for prevention of perioperative atrial fibrillation.
Patients received either colchicine 0.6 mg or placebo orally twice daily
for 10 days, with the first dose given 4 hours prior to surgery. Pleural
drainage volumes were recorded in 8-hour intervals until chest tube
removal as per a standardized, pre-defined protocol. Results: The two
groups were comparable on baseline characteristics with regard to cancer
stage, comorbidities, surgical approach and extent of resection (51% open
procedures; 86% anatomic resections), but not for gender, coronary artery
disease and hypertension. Analysis of total drainage volumes demonstrated
a statistically significant difference in favour of the colchicine group
(583.8 vs 763.3 ml, P = 0.039), with findings that remained consistent
across the time intervals collected. The volume of pleural drainage at
1-hour postop was significantly less in the colchicine group (92.9 vs
156.6 ml, P = 0.008), and remained lower at the 40-hour interval (550.9 vs
741.3 ml, P = 0.039). There were no differences in time to chest tube
removal (6.8 vs 5.9 days, P = 0.585), hospital length of stay (7.4 vs 6.9
days, P = 0.641), or with regards to major bleeding, infection or adverse
events. Conclusion: Perioperative administration of oral colchicine is
potentially effective in diminishing the amount of pleural drainage
post-lung resection. A full-scale, prospective placebo-control randomized
trial is needed to assess the clinical significance of perioperative
colchicine administration.

<30>
Accession Number
613792223
Author
Gonfiotti A.; Bongiolatti S.; Borgianni S.; Borrelli R.; Costagli A.;
Tancredi G.; Viggiano D.; Voltolini L.
Institution
(Gonfiotti, Bongiolatti, Borgianni, Borrelli, Costagli, Tancredi,
Viggiano, Voltolini) Careggi University Hospital, Thoracic Surgery Unit,
Florence, Italy
Title
Uniportal thoracoscopic decortication for pleural empyema: Role of
ultra-sonographic preoperative staging.
Source
Interactive Cardiovascular and Thoracic Surgery. Conference: 24th European
Conference on General Thoracic Surgery. Italy. Conference Start: 20160529.
Conference End: 20160601. 23 (pp i59), 2016. Date of Publication: 2016.
Publisher
Oxford University Press
Abstract
Objectives: Surgical approach of chronic pleural empyema (phase III) is
still controversial. Studies reported favourable outcomes in terms of
resolution of the disease for VATS debridement and decortication when
compared to open thoracotomic approach. The last frontier of minimally
invasive thoracic surgery is uniportal approach, but its application in
pleural infection is still anecdotal. We report our initial experience
with uniportal VATS debridement and decortication for pleural empyema
after failure of medical treatment. Methods: We performed a retrospective
analysis of patients who underwent surgical treatment for stage II or III
pleural empyema from January 2012 to December 2015. Pre-, intra- and
postoperative data were analyzed for all patients to evaluate surgical
outcomes including postoperative complications and disease recurrence.
Results were analyzed according to preoperative ultra-sonographic
appearance of pleural space (stage I-IV) and surgical approach
(thoracotomy vs uniportal VATS). Results: We performed 30 (47%) uniportal
thoracoscopic pleural decortications and 34 (53%) open decortications for
empyema in stage II (40%) or III (60%). Complete debridement and
decortication were accomplished in all patients. In-hospital mortality was
zero and overall morbidity was 29%. Uniportal surgery was associated with
lower blood loss (118 +/- 80 ml vs 247 +/- 140 ml, P < 0.01), lower
maintenance of chest tubes (5.6 +/- 1.4 vs 10.6 +/- 4.4 days, P < 0.01)
and lower hospital stay (6.7 +/- 1.9 vs 12.2 +/- 4.7 days, P < 0.01).
Elevated ultra-sonographic patterns were associated to thoracotomic
approach, higher blood loss, operative time and significant incidence of
complications. Conclusion: Uniportal thoracoscopic decortication for
pleural empyema is a safe and efficacious approach for well selected
patients based on a combination of clinical and imaging staging.

<31>
Accession Number
613792197
Author
Sandri A.; Petersen R.; Decaluwe H.; Moons J.; Ferguson M.K.; Hansen H.J.;
Brunelli A.
Institution
(Sandri, Brunelli) Department of Thoracic Surgery, St.James's Hospital,
Bexley Wing, Leeds, United Kingdom
(Petersen, Hansen) Department of Cardiothoracic Surgery, Copenhagen
University Hospital Rigshospitalet, Copenhagen, Denmark
(Decaluwe, Moons) Thoracic Surgery, University Hospital Leuven, Leuven,
Belgium
(Ferguson) Department of Thoracic Surgery, University of Chicago, Chicago,
United States
Title
Incidence of major cardiac complications and mortality in patients with
and without coronaryartery disease after video-assisted thoracoscopic
lobectomy.
Source
Interactive Cardiovascular and Thoracic Surgery. Conference: 24th European
Conference on General Thoracic Surgery. Italy. Conference Start: 20160529.
Conference End: 20160601. 23 (pp i31-i32), 2016. Date of Publication:
2016.
Publisher
Oxford University Press
Abstract
Objectives: To assess whether the incidence of postoperative major cardiac
events (MACE) and mortality is higher in patients with a history of
coronary artery disease (CAD) than in those without CAD following VATS
lobectomy. Methods: This is a multicentre retrospective analysis performed
on prospectively collected data of 1699 patients submitted to an
intention-to-treat VATS lobectomy (January 2012-March 2015). Eighty-eight
patients converted to open surgery were included. CAD definition: previous
acute myocardial infarct (AMI), angina, percutaneous coronary intervention
(PCI) or coronary artery bypass graft (CABG). MACE definition:
postoperative acute myocardial ischaemia, cardiac arrest or any cardiac
death. A propensity score analysis was performed. Patients with and
without CAD were matched for several baseline and surgical
characteristics. Outcomes of the two matched groups were compared.
Results: Two hundred and eighteen patients had a history of CAD (13%): 106
previous AMI, 55 angina, 32 CABG and 81 PCI. MACE and mortality rates of
the entire population were 0.4% (7 cases) and 1.7% (29 cases). The
propensity score yielded two well-balanced groups of 218 pairs, with and
without CAD. Rates of MACE (CAD: two patients-0.9% vs no-CAD: 1, P = 0.5),
total cardiopulmonary complications (CAD: 61 patients [28%] vs no-CAD: 55
patients [23%], P = 0.5) and postoperative stay (CAD: 7.3 days vs no-CAD:
6.9 days, P = 0.6) were alike between the groups. The incidence of atrial
fibrillation (CAD: 31 patients [14%] vs no-CAD: 16 patients [7.3%], P =
0.02), in-hospital or 30-days mortality (CAD: 11 patients [5%] vs no-CAD:
2 patients [0.9%], P = 0.02) and death among patients with postoperative
complications (CAD: 18% vs no-CAD: 3.6%, P = 0.01) were higher in the CAD
group. Sixteen VATS lobectomies of CAD patients were converted to open
surgery and their mortality rate was higher than in those who were not
converted (13% vs 4.5%, P = 0.2). Conclusion: VATS lobectomy patients with
CAD history incur in minimal MACE risk, which is analogous to non-CAD
patients. Nevertheless, they need careful cardiopulmonary function
evaluation since their postoperative risk of mortality is five-fold higher
compared to non-CAD patients.

<32>
Accession Number
613792143
Author
Sihoe A.; Kim H.K.; Lee J.M.; Fang W.
Institution
(Sihoe) Department of Surgery, University of Hong Kong, Hong Kong
(Kim) Department of Thoracic and Cardiovascular Surgery, Korea University,
Guro Hospital, Seoul, South Korea
(Lee) Department of Surgery, National Taiwan University Hospital, Taipei,
Taiwan (Republic of China)
(Fang) Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai,
China
Title
The impactof the number of ports on short-term outcomes following
video-assisted thoracic surgery for anatomical lung resection: A
multicentre study.
Source
Interactive Cardiovascular and Thoracic Surgery. Conference: 24th European
Conference on General Thoracic Surgery. Italy. Conference Start: 20160529.
Conference End: 20160601. 23 (pp i15), 2016. Date of Publication: 2016.
Publisher
Oxford University Press
Abstract
Objectives: Despite the recent trend for video assisted thoracic surgery
(VATS) being performed with fewer ports, evidence that the number of ports
has any influence on postoperative morbidity is hitherto lacking. Methods:
Prospectively collected data of 458 consecutive adult patients receiving
VATS lobectomy or segmentectomy for lung malignancy at University Teaching
hospitals in four countries were retrospectively analyzed. The experience
represented a period of transition between traditional multiportal VATS
and uniportal VATS at all centers, and hence the number of ports was
varied (range 1-4). Results: Amongst patients receiving a lobectomy,
although patients with one or two ports had more comorbidities and
suspected advanced disease preoperatively, rates of postoperative
morbidity were not increased compared to patients with three or four
ports. Lymph node dissection and rate of postoperative upstaging were
non-inferior amongst patients with one or two ports. Although the use of
fewer ports resulted in higher intraoperative blood loss, the absolute
difference in volume was small and postoperative drainage was actually
less. The proportion of patients with more than mild pain postoperatively
was also lower amongst patients with fewer ports. This difference in pain
was even more marked amongst patients receiving segmentectomy. Chest drain
duration and length of stay appear unaffected by the number of ports.
Differences between the use of one or two ports could not be demonstrated.
Conclusion: The use of fewer (one-two) ports for VATS anatomical lung
resections does reduce early postoperative pain, but does not
substantively reduce recovery times ormorbidity. It does not compromise
patient safety or radicality of resection.

<33>
Accession Number
613755853
Author
Sangesland A.; Storen C.; Vaegter H.B.
Institution
(Sangesland, Storen, Vaegter) Department of Clinical Research, Faculty of
Health Sciences, University of Southern Denmark, Denmark
(Vaegter) Pain Research Group, Pain Center South, Odense University
Hospital, Odense, Denmark
Title
Are preoperative experimental pain assessments correlated with clinical
pain outcomes after surgery? A systematic review.
Source
Scandinavian Journal of Pain. 15 (pp 44-52), 2017. Date of Publication: 01
Apr 2017.
Publisher
Elsevier B.V.
Abstract
Background Pain after surgery is not uncommon with 30% of patients
reporting moderate to severe postoperative pain. Early identification of
patients prone to postoperative pain may be a step forward towards
individualized pain medicine providing a basis for improved clinical
management through treatment strategies targeting relevant pain mechanisms
in each patient. Assessment of pain processing by quantitative sensory
testing (QST) prior to surgery has been proposed as a method to identify
patients at risk for postoperative pain, although results have been
conflicting. Since the last systematic review, several studies
investigating the association between postoperative pain and more dynamic
measures of pain processing like temporal summation of pain and
conditioned pain modulation have been conducted. Objectives According to
the PRISMA guidelines, the aim of this systematic review was to evaluate
whether assessment of experimental pain processing including measures of
central pain mechanisms prior to surgery was associated with pain
intensity after surgery. Methods Systematic database searches in PubMed
and EMBASE with the following search components: QST, association, and
postoperative pain, for studies that assessed the association between QST
and pain after surgery were performed. Two authors independently reviewed
all titles and abstracts to assess their relevance for inclusion. Studies
were included if (1) QST was performed prior to surgery, (2) pain was
assessed after surgery, and (3) the association between QST and pain after
surgery was investigated. Forty-four unique studies were identified, with
30 studies on 2738 subjects meeting inclusion criteria. The methodological
quality of the include studies was assessed and data extraction included
study population, type of surgery, QST variables, clinical pain outcome
measure and main result. Results Most studies showed moderate to high risk
of bias. Type of surgery investigated include 7 studies on total knee
replacement, 5 studies on caesarean section, 4 studies on thoracic
surgery, 2 studies on herniotomy, 2 studies on hysterectomy/myomectomy, 1
study on tubal ligation, 1 study on gynecologic laparoscopy, 1 study on
arthroscopic knee surgery, 1 study on shoulder surgery, 1 study on disc
herniation surgery, 1 study on cholecystectomy, 1 study on percutaneous
nephrolithotomy, 1 study on molar surgery, 1 study on abdominal surgery,
and 1 study on total knee replacement and total hip replacement. The
majority of the preoperative QST variables showed no consistent
association with pain intensity after surgery. Thermal heat pain above the
pain threshold and temporal summation of pressure pain were the QST
variables, which showed the most consistent association with acute or
chronic pain after surgery. Conclusions QST before surgery does not
consistently predict pain after surgery. High quality studies
investigating the presence of different QST variables in combination or
along with other pain-related psychosocial factors are warranted to
confirm the clinical relevance of QST prior to surgery. Implications
Although preoperative QST does not show consistent results, future studies
in this area should include assessment of central pain mechanisms like
temporal summation of pressure pain, conditioned pain modulation, and
responses to pain above the pain threshold since these variables show
promising associations to pain after surgery. Copyright &#xa9; 2016
Scandinavian Association for the Study of Pain

<34>
Accession Number
613772861
Author
Fouquet O.; Baufreton C.; Tassin A.; Pinaud F.; Binuani J.-P.; DangVan S.;
Prunier F.; Rouleau F.; Willoteaux S.; De Brux J.-L.; Furber A.
Institution
(Fouquet, Baufreton, Pinaud, Binuani, DangVan, De Brux) Department of
Thoracic and Cardiovascular Surgery, University Hospital, Angers, France
(Fouquet, Baufreton, Pinaud, DangVan) Institut MITOVASC CNRS UMR 6214,
INSERM U1083, University Hospital, Angers, France
(Tassin, Prunier, Rouleau, Furber) Department of Cardiology, University
Hospital, Angers, France
(Tassin, Binuani, Prunier, Rouleau, Willoteaux, De Brux, Furber) Institut
MITOVASC EA 3860, University Hospital, Angers, France
(Willoteaux) Department of Radiology, University Hospital, Angers, France
Title
Influence of stentless versus stented valves on ventricular remodeling
assessed at 6 months by magnetic resonance imaging and long-term
follow-up.
Source
Journal of Cardiology. 69 (1) (pp 264-271), 2017. Date of Publication: 01
Jan 2017.
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background To compare the effect of stented versus stentless bioprostheses
on left ventricular remodeling and assess their impact on long-term
survival. Methods From January 2002 to December 2009, 62 severe aortic
stenosis patients without coronary artery disease were randomized for
bioprosthetic aortic valve replacement. After randomization, a cross-over
was possible based on intraoperative data. Ventricular remodeling was
studied by cardiovascular magnetic resonance imaging six months after
surgery. Long-term survival was assessed by telephone survey. Results
Thirty-five patients received a porcine Mosaic Medtronic
bioprosthesis (Stented Group; Medtronic, Minneapolis, MN, USA) inserted
using the usual supra-annular technique and 27 received a porcine
Freestyle Medtronic bioprosthesis (Stentless Group) inserted in
the subcoronary position. Mean age was 75 +/- 3 and 73 +/- 4 years in the
stentless and stented group, respectively. Nine patients who should have
been implanted with a stentless bioprosthesis received a stented
bioprosthesis for anatomical reasons. At 6 months, the left ventricular
mass (LVM) decreased significantly in both groups (Stentless Group: 214.6
+/- 56.1 g and 156.3 +/- 23 g and Stented Group: 237 +/- 75.7 g and 181
+/- 53.3 g, respectively after surgery and at 6 months), this decrease was
significantly greater in the stentless group (p = 0.026). Reserve and
coronary flow were increased in both groups at 6 months. Mean follow-up
duration was 6.6 +/- 3.0 years and 7.2 +/- 4.0 years in the stentless and
stented group, respectively. The 5-year actuarial survival was 87.5 +/-
11.7% and 82.5 +/- 17.1% for the stentless and stented group, respectively
(p = 0.81). Conclusion Porcine stentless prosthesis results in a better
LVM regression than a stented valve at 6 months without changing the
long-term survival. Copyright &#xa9; 2016 Japanese College of Cardiology

<35>
Accession Number
613343204
Author
Balachandran S.; Lee A.; Denehy L.; Lin K.-Y.; Royse A.; Royse C.;
El-Ansary D.
Institution
(Balachandran, Lee, Denehy, Lin, El-Ansary) Physiotherapy Department, The
University of Melbourne, Carlton, Victoria, Australia
(Royse, Royse) Department of Surgery, The University of Melbourne,
Carlton, Victoria, Australia
(Royse) Department of Cardiothoracic Surgery, The Royal Melbourne
Hospital, Parkville, Victoria, Australia
(Royse) Department of Anaesthesia and Pain Management, The Royal Melbourne
Hospital, Parkville, Victoria, Australia
Title
Risk Factors for Sternal Complications After Cardiac Operations: A
Systematic Review.
Source
Annals of Thoracic Surgery. 102 (6) (pp 2109-2117), 2016. Date of
Publication: 01 Dec 2016.
Publisher
Elsevier USA
Abstract
Early detection of patients at risk of sternal complications is essential
to facilitate prevention and optimize timely intervention. A systematic
review and meta-analysis was conducted to identify risk factors associated
with sternal complications. The review included 17 full-text studies, of
which 10 were entered into meta-analyses. Female gender, diabetes
mellitus, obesity, bilateral internal mammary artery grafts, reoperation
for postoperative complications, and blood product requirement were
reported as significant predictors of sternal infection. The compilation
of these risk factors may help to screen and stratify patients at risk of
impaired sternal healing and warrants further investigation. Copyright
&#xa9; 2016 The Society of Thoracic Surgeons

<36>
Accession Number
613342764
Author
Wang C.; Hua K.; Yin L.; Wang Y.; Li W.
Institution
(Wang, Yin, Wang, Li) State Key Laboratory of Cardiovascular Disease,
Fuwai Hospital, National Center for Cardiovascular Disease, Peking Union
Medical College and Chinese Academy of Medical Sciences, Beijing, China
(Hua) Beijing Anzhen Hospital, Capital Medical University, Beijing, China
Title
A Meta-Analysis of Miniaturized Versus Conventional Extracorporeal
Circulation in Valve Surgery.
Source
Annals of Thoracic Surgery. 102 (6) (pp 2099-2108), 2016. Date of
Publication: 01 Dec 2016.
Publisher
Elsevier USA
Abstract
The effects of miniaturized extracorporeal circulation in patients
operated on for heart valve surgery are still inconsistent. We performed a
meta-analysis of eight studies involving 1,011 patients to evaluate the
comprehensive effects of miniaturized extracorporeal circulation. The
results suggested its application significantly reduced the length of stay
in the intensive care unit and total hospital stay after heart valve
surgery, but no significant effects on reducing postoperative morbidity
and mortality were observed. Further studies with long-term follow-up are
needed to confirm our results. Copyright &#xa9; 2016 The Society of
Thoracic Surgeons

<37>
Accession Number
613342714
Author
Repossini A.; Fischlein T.; Santarpino G.; Schafer C.; Claus B.;
Passaretti B.; Di Bacco L.; Giroletti L.; Bisleri G.; Muneretto C.;
Grubitzsch H.
Institution
(Repossini, Di Bacco, Giroletti, Bisleri, Muneretto) Clinical Department
of Cardiac Surgery, University of Brescia, Brescia, Italy
(Fischlein, Santarpino) Department of Cardiac Surgery, Paracelsus Medical
University Nuremberg, Nuremberg, Germany
(Schafer, Claus, Grubitzsch) Department of Cardiovascular Surgery,
Charite-Universitatsmedizin Berlin, Berlin, Germany
(Passaretti) Cliniche Humanitas Gavazzeni, Bergamo, Italy
Title
Pericardial Stentless Valve for Aortic Valve Replacement: Long-Term
Results.
Source
Annals of Thoracic Surgery. 102 (6) (pp 1956-1965), 2016. Date of
Publication: 01 Dec 2016.
Publisher
Elsevier USA
Abstract
Background The Freedom Solo (FS) bovine pericardial valve (Sorin Group,
Milan, Italy) is a stentless bioprosthesis that was introduced in 2004 and
approved by the United States Food and Drug Administration in 2014. No
long-term follow-up series are available to date. We report the
multicenter experience of 4 European institutions that began implanting FS
extensively from its introduction, providing the largest series with
long-term follow-up. Methods From 2004 to 2009, 565 patients (242 women
[42.8%]; mean age, 74.6 +/- 8.3 years) underwent isolated (n = 350) or
combined (n = 215) aortic valve replacement with the FS. Mean follow-up,
including clinical and strict echocardiographic evaluation, was 6.9 +/-
3.7 years (maximum, 11.8 years; cumulative 2,965 patient-years). Primary
end point was freedom from structural valve deterioration (SVD), and
secondary end points were freedom from reoperation and overall survival.
Results Mean logistic European System for Cardiac Operative Risk
Evaluation I was 10.3% +/- 6.7%. Overall 30-day mortality was 3.7%, and no
deaths were valve related. There was no severe prostheses-patient
mismatch, and moderate prostheses-patient mismatch occurred only in 1
patient (0.17%). Twenty-eight patients (5.2%) underwent reoperation (20
surgical replacements, 8 transcatheter aortic valve-in-valve replacements)
due to endocarditis in 9, blunt trauma in 1, and SVD in 18. SVD was
reported in 5 other patients alive at time of censoring. Freedom from SVD
and reoperation was 90.8% (95% confidence interval, 89.1% to 92.5%) and
87.3% (95% confidence interval, 85.6% to 89.0%), respectively, at 10 years
of follow-up, and the overall actuarial survival was 56.4% (95% confidence
interval, 53.3% to 59.5%). Conclusions The FS valve provided excellent
long-term durability and hemodynamic performance in this large,
multicenter European experience. Moreover, the FS, given the low rate of
SVD, along with a simple implantability, proved to be a reliable
bioprosthesis in the aortic position as a valid alternative to stented
bioprostheses. Copyright &#xa9; 2016 The Society of Thoracic Surgeons

<38>
Accession Number
613342603
Author
D'Onofrio A.; Tarja E.; Besola L.; Luzi G.; Agrifoglio M.; Aiello M.;
Gabbieri D.; Tarantini G.; Rizzoli G.; Musumeci F.; Gerosa G.
Institution
(D'Onofrio, Tarja, Besola, Rizzoli, Gerosa) Division of Cardiac Surgery,
University of Padova, Padova, Italy
(Tarantini) Division of Cardiology, University of Padova, Padova, Italy
(Luzi, Musumeci) Division of Cardiac Surgery, San Camillo Hospital, Rome,
Italy
(Agrifoglio) Centro Cardiologico Monzino, University of Milan, Milan,
Italy
(Aiello) Division of Cardiac Surgery, San Matteo Hospital, University of
Pavia, Pavia, Italy
(Gabbieri) Division of Cardiac Surgery, Hesperia Hospital, Modena, Italy
Title
Early and Midterm Clinical and Hemodynamic Outcomes of Transcatheter
Valve-in-Valve Implantation: Results From a Multicenter Experience.
Source
Annals of Thoracic Surgery. 102 (6) (pp 1966-1973), 2016. Date of
Publication: 01 Dec 2016.
Publisher
Elsevier USA
Abstract
Background Transcatheter valve-in-valve (VIV) implantation is an
alternative option in inoperable or high-risk patients with prosthetic
valve dysfunction. Aim of this retrospective multicenter study was to
evaluate early and midterm clinical and hemodynamic outcomes of patients
undergoing aortic (VIV-A) and mitral VIV (VIV-M). Methods We analyzed data
of 66 procedures performed in 65 patients who underwent VIV procedures in
the VIV-A and VIV-M position at 5 Italian institutions from January 2008
to May 2015. VIV-A and VIV-M were 44 (68%) and 22 (32%), respectively; 1
patient underwent combined mitroaortic VIV. Study devices were both
balloon-expandable and self-expandable. Outcomes were defined according to
the updated Valve Academic Research Consortium definitions. Results
Overall all-cause 30-day mortality was 6% (4 patients), and it was 4.5%
and 9% in VIV-A and VIV-M, respectively (2 patients in each group). Mean
follow-up was 14 +/- 14 months. Kaplan-Meier survival of the entire cohort
at 1, 2, 3, and 4 years was 84.4% +/- 4.9%, 80.5% +/- 6%, 74.3 +/- 8.1%,
and 62% +/- 13.2%, respectively. Age (hazard ratio: 1.1; 95% confidence
interval: 1.0 to 1.3; p = 0.035) and diabetes (hazard ratio: 7.2, 95%
confidence interval: 2.1 to 23.7; p = 0.001) were identified as
independent predictors of mortality. Degenerated surgical aortic
prostheses with an internal diameter (ID) less than 20 mm had
significantly higher gradients if compared to prostheses with ID 21 to 23
mm and greater than 23 mm. After VIV-A, a severe stenosis (mean gradient
greater than 35 mm Hg) was detected in 3 (6.8%) cases, all with ID less
than 20 mm. Conclusions VIV provides good early and midterm results in
high-risk or inoperable patients with mitral or aortic bioprosthesis
dysfunction. Age and diabetes are independently associated with mortality.
Size of bioprosthesis ID has a significant impact on postoperative
gradients. Copyright &#xa9; 2016 The Society of Thoracic Surgeons

<39>
Accession Number
613342600
Author
Rabiu T.B.; Oshola H.A.; Adebayo B.O.
Institution
(Rabiu, Oshola) Division of Neurological Surgery Department of Surgery,
Ladoke Akintola University of Technology Teaching Hospital, Osogbo,
Nigeria
(Rabiu, Adebayo) Division of Neurological Surgery, Department of Surgery,
Federal Medical Centre, Ido Ekiti, Nigeria
Title
Survey of the Knowledge of Brainstem Death and Attitude Toward Organ
Donation Among Relations of Neurosurgical Patients in Nigeria.
Source
Transplantation Proceedings. 48 (6) (pp 1898-1903), 2016. Date of
Publication: 01 Jul 2016.
Publisher
Elsevier USA
Abstract
Background Organ transplantation is a developing field in Nigeria, and
availability of organs for donation would be a determining factor of the
success of the transplant programs. Patients with brainstem death (BSD)
are a major source of organs for transplantation. The level of knowledge
of BSD as well as attitudes toward organ donation are very important
determinants of people's willingness or otherwise to donate organs. We
conducted a survey of relations of our in-service neurosurgical patients
to assess their knowledge of brainstem death and attitude toward organ
donation. To our knowledge, this is the first study of its kind among the
growing Nigerian neurosurgery patient and patient-relations population.
Methods Convenience sampling of randomly selected relations of
neurosurgical patients on admission using interviewer-administered
questionnaires was performed. Demographic information and information
about brainstem death, attitude toward brainstem death, knowledge of organ
donation, and attitude toward organ donation were obtained. Results The
study comprised 127 respondents with a mean age of 36 years (range,
19-72). The majority of the respondents (87, 62.4%) were Christians, 122
(96.1%) were Yorubas, and 66 (52.0%) were women. Eighty-five (66.9%) of
the respondents had at least a secondary level of education, and 77
(60.6%) were of low socioeconomic status. Twenty-eight (22.2%) of the
respondents had heard of brainstem death. Twenty-six (92.9%) of those who
had heard of brainstem death believed that the brain could die long before
life finally ceases. One hundred twenty-five (98.4%) of the respondents
believed that death only occurs when both breathing and heartbeat stop,
and 107 (83.6%) would agree with the physician on a diagnosis of brainstem
death in the relation. Sixty-five (51.2%) would want such patients put on
a ventilator, and, of these, 43 (66.2%) would want such patients on the
ventilator in hope that he or she may recover. One hundred twelve (88.2%)
of the relations were aware of organ donation, 109 (85.8%) knew that the
kidney can be transplanted, and 27 (21.6%) and 17 (13.4%), respectively,
were aware of heart and cornea transplant. One hundred five (82.7%)
supported organ transplantation, 85 (66.9%) would donate an organ, and 97
(76.4%) would accept a transplanted organ. The majority of the respondents
(76, 59.8%) would generally not allow an organ to be taken from their
relation, although 70 (55.1%) would allow organ(s) to be harvested from
their relation if the person had consented to it before death. More men
are likely to donate organs and allow organs to be harvested from their
relations than were women. Likewise, respondents with at least a secondary
level of education had better awareness of brainstem death and were more
likely to donate organs and allow organs to be harvested from their
relations than were their less-educated counterparts. Conclusions The
knowledge of brainstem death was low among respondents, although most of
them would agree with the physician if such diagnosis was made for their
relation. Most of the respondents were aware of organ donation and
supported it, but the majority would not allow an organ to be harvested
from their relations. Hence, education of the Nigerian people about
brainstem death and organ donation is essential to increase the pool of
available organs for transplantation in our community. Copyright &#xa9;
2016 Elsevier Inc.

<40>
Accession Number
613500210
Author
Yanagawa B.; Nedadur R.; Puskas J.D.
Institution
(Yanagawa, Nedadur) Division of Cardiac Surgery, St. Michael's Hospital,
Toronto, Canada
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Saint Luke's
Hospital, New York, NY, United States
Title
The future of off-pump coronary artery bypass grafting: A North American
perspective.
Source
Journal of Thoracic Disease. 8 (pp S832-S838), 2016. Date of Publication:
2016.
Publisher
AME Publishing Company (E-mail: jtd@thepbpc.org)
Abstract
Off-pump coronary artery bypass graft (OPCAB) is currently performed
routinely in a minority of specialized centers and in many more centers,
utilized only when a porcelain aorta mandates a no-touch aortic technique.
The OPCAB literature can be summarized as follows: (I) large-scale
randomized trials in relatively low risk patients that include surgeons
with a range of experience demonstrating no consistent beneficial
differences in major cardiovascular and cerebrovascular outcomes but lower
transfusion rates and shorter length of stay, tempered by some reports of
higher rates of incomplete revascularization and lower rates of long term
graft patency; (II) smaller randomized controlled trials (RCTs) from
highly specialized programs demonstrating equivalent or superior outcomes
with OPCAB and similar completeness of revascularization and graft
patency; and (III) observational data from large databases demonstrating a
consistent benefit of OPCAB, especially in higher-risk patient subsets.
Our rationale for OPCAB remains that if complete and precise
revascularization can be safely and routinely accomplished, then the
patient should benefit by avoiding the morbidities that can be attributed
to aortic cannulation/clamping, cardiopulmonary bypass (CPB),
hemodilution, hypothermia and global myocardial ischemia/cardioplegia. We
further believe that OPCAB procedures should emphasize the use of arterial
grafts to optimize long term patency and minimize aortic manipulation to
limit the risk of stroke. Moving forward, the off-pump surgical community
and specialty societies must address the challenge of training surgeons
and their teams to master this technically demanding procedure.
Furthermore, OPCAB opens the door to minimally-invasive surgical
revascularization via hybrid coronary revascularization (HCR). A large
NIH-funded RCT is currently underway to determine whether hybrid
revascularization can offer a superior alternative to multi-vessel
percutaneous coronary intervention for patients with low SYNTAX score and
proximal LAD disease. Copyright &#xa9; Journal of Thoracic Disease. All
rights reserved.

<41>
Accession Number
613500209
Author
Taggart D.P.
Institution
(Taggart) Department of Cardiovascular Surgery, University of Oxford,
Oxford, United Kingdom
Title
Off-pump coronary artery bypass grafting (OPCABG)-a 'personal' European
perspective.
Source
Journal of Thoracic Disease. 8 (pp S829-S831), 2016. Date of Publication:
2016.
Publisher
AME Publishing Company (E-mail: jtd@thepbpc.org)
Abstract
Although popularised over two decades ago off-pump coronary artery bypass
grafting (OPCABG) has seen a decrease in utilisation especially over the
last decade. This has been due to publication of a number of trials which
suggested inferior outcomes with OPCABG. However, the validity of the
findings in these trials has been questioned on the basis of doubts over
operator experience as witnessed by large numbers of cross-overs. Two more
recent large randomised trials have shown very similar outcomes between on
and off-pump surgery up to 1- and 5-year outcomes are imminently due.
Furthermore several meta-analyses have reported that OPCABG reduces
mortality, myocardial infarction and major morbidity in higher risk
patients. Consequently there is a clear rationale for OPCABG in certain
cohorts of patients and especially when combined with a no touch aortic
technique in those with significant disease of the ascending aorta. The
article discusses the importance of routine performance of OPCABG if it is
to produce high quality results and especially in higher risk patients.
Copyright &#xa9; Journal of Thoracic Disease. All rights reserved.

<42>
Accession Number
613500206
Author
Chivasso P.; Guida G.A.; Fudulu D.; Bruno V.D.; Marsico R.; Sedmakov H.;
Zakkar M.; Rapetto F.; Bryan A.J.; Angelini G.D.
Institution
(Chivasso, Guida, Fudulu, Bruno, Marsico, Sedmakov, Zakkar, Rapetto,
Bryan, Angelini) Bristol Heart Institute, Bristol University, Upper
Maudlin Street, Bristol BS2 8HW, United Kingdom
Title
Impact of off-pump coronary artery bypass grafting on survival: Current
best available evidence.
Source
Journal of Thoracic Disease. 8 (pp S808-S817), 2016. Date of Publication:
2016.
Publisher
AME Publishing Company (E-mail: jtd@thepbpc.org)
Abstract
The superiority of either off-pump (OPCAB) or on-pump (ONCAB) coronary
artery bypass grafting (CABG) remains unclear despite a large body of
literature evidence comparing the two approaches. The potential advantages
of avoiding cardiopulmonary bypass (CPB), minimizing aortic manipulation
and maintaining pulsatile flow may be associated with reduced inflammatory
responses and embolic events. Numerous studies compared OPCAB with ONCAB
and the cumulative data have been presented in metaanalyses of both
randomized and observational studies. Although there is an abundance of
data with respect to the operative morbidity and mortality and the
short-term outcomes associated with these two strategies, not much is
known about how they impact long-term survival and recurrence of
myocardial ischaemic events. Recent studies and meta-analyses have focused
on long-term survival and major secondary outcomes in OPCAB vs. ONCAB
within the general population. Significant limitations in methodology,
however, have raised concerns about the strength of several randomized
trials with restrictive inclusion criteria that reduced the populations to
those at low risk only, thus creating result bias. Here, we present a
review of the best available evidence with a focus on long-term outcomes.
Copyright &#xa9; Journal of Thoracic Disease. All rights reserved.

<43>
Accession Number
613500201
Author
Davierwala P.M.
Institution
(Davierwala) Department of Cardiac Surgery, Heart Center, University of
Leipzig, Herzzentrum Leipzig, Struempellstrase 39, Leipzig 04289, Germany
Title
Current outcomes of off-pump coronary artery bypass grafting: Evidence
from real world practice.
Source
Journal of Thoracic Disease. 8 (pp S772-S786), 2016. Date of Publication:
2016.
Publisher
AME Publishing Company (E-mail: jtd@thepbpc.org)
Abstract
Coronary artery bypass grafting (CABG) can be performed conventionally
using cardiopulmonary bypass (CPB) and aortic clamping or on a beating
heart (BH) without the use of CPB, the so-called off-pump CABG. Some
surgeons, who are proponents of off-pump CABG, preferentially use this
technique for the majority of operations, whereas others use it only in
certain situations which warrant avoidance of CPB. Ever since the
conception of off-pump CABG, the never-ending debate about which technique
of CABG is safe and efficacious continues to date. Several randomized
controlled trials (RCTs) have been conducted that have either favored
on-pump CABG or have failed to show a significant difference in outcomes
between the two techniques. However, these RCTs have been fraught with
claims that they do not represent the majority of patients undergoing CABG
in real world practice. Therefore, assessment of the benefits and
drawbacks of each technique through observational and registry studies
would be more representative of patients encountered in daily practice.
The present review examines various retrospective studies and
meta-analyses of observational studies that compare the early and
long-term outcomes of off- and on-pump CABG, which assesses their safety
and efficacy. Additionally, their outcomes in older patients, females, and
those with diabetes mellitus, renal dysfunction, presence of ascending
aortic disease, and/or acute coronary syndrome (ACS) have also been
discussed separately. The general consensus is that early results of
off-pump CABG are comparable to or in some cases better than on-pump CABG.
However, on-pump CABG provides a survival benefit in the long term
according to a majority of publications in literature. Copyright &#xa9;
Journal of Thoracic Disease. All rights reserved.

<44>
Accession Number
613500200
Author
Fudulu D.; Benedetto U.; Pecchinenda G.G.; Chivasso P.; Bruno V.D.;
Rapetto F.; Bryan A.; Angelini G.D.
Institution
(Fudulu, Benedetto, Pecchinenda, Chivasso, Bruno, Rapetto, Bryan,
Angelini) Bristol Heart Institute, University Hospitals Bristol, Bristol,
United Kingdom
Title
Current outcomes of off-pump versus on-pump coronary artery bypass
grafting: Evidence from randomized controlled trials.
Source
Journal of Thoracic Disease. 8 (pp S758-S771), 2016. Date of Publication:
2016.
Publisher
AME Publishing Company (E-mail: jtd@thepbpc.org)
Abstract
Coronary artery bypass grafting remains the standard treatment for
patients with extensive coronary artery disease. Coronary surgery without
use of cardiopulmonary bypass avoids the deleterious systemic inflammatory
effects of the extracorporeal circuit. However there is an ongoing debate
surrounding the clinical outcomes after on-pump versus off-pump coronary
artery bypass (ONCAB versus OPCAB) surgery. The current review is based on
evidence from randomized controlled trials (RCTs) and metaanalyses of
randomized studies. It focuses on operative mortality, mid- and long-term
survival, graft patency, completeness of revascularisation, neurologic and
neurophysiologic outcomes, perioperative complications and outcomes in the
high risk groups. Early and late survival rates for both OPCAB and ONCAB
grafting are similar. Some studies suggest early poorer vein graft patency
with off-pump when compared with onpump, comparable midterm arterial
conduit patency with no difference in long term venous and arterial graft
patency. A recent, pooled analysis of randomised trials shows a reduction
in stroke rates with use offpump techniques. Furthermore, OPCAB grafting
seems to reduce postoperative renal dysfunction, bleeding, transfusion
requirement and respiratory complications while perioperative myocardial
infarction rates are similar to ONCAB grafting. The high risk patient
groups seem to benefit from off-pump coronary surgery. Copyright &#xa9;
Journal of Thoracic Disease. All rights reserved.

<45>
Accession Number
613706984
Author
Gombotz H.; Schreier G.; Neubauer S.; Kastner P.; Hofmann A.
Institution
(Gombotz) Department of Anaesthesiology and Intensive Care, General
Hospital Linz, Vienna, Austria
(Gombotz, Schreier, Neubauer, Kastner) AIT Austrian Institute of
Technology GmbH, Graz 8020, Austria
(Hofmann) Department of Anaesthesiology, University Hospital Zurich,
Zurich, Switzerland
(Hofmann) School of Surgery, Dentistry and Health Sciences, University of
Western Australia, WA, Australia
(Hofmann) Faculty of Health Sciences, Curtin University, WA, Australia
Title
Gender disparities in red blood cell transfusion in elective surgery: A
post hoc multicentre cohort study.
Source
BMJ Open. 6 (12) (no pagination), 2016. Article Number: e012210. Date of
Publication: 01 Dec 2016.
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Objectives: A post hoc gender comparison of transfusion-related modifiable
risk factors among patients undergoing elective surgery. Settings: 23
Austrian centres randomly selected and stratified by region and level of
care. Participants: We consecutively enrolled in total 6530 patients (3465
women and 3065 men); 1491 underwent coronary artery bypass graft (CABG)
surgery, 2570 primary unilateral total hip replacement (THR) and 2469
primary unilateral total knee replacement (TKR). Main outcome measures:
Primary outcome measures were the number of allogeneic and autologous red
blood cell (RBC) units transfused (postoperative day 5 included) and
differences in intraoperative and postoperative transfusion rate between
men and women. Secondary outcomes included perioperative blood loss in
transfused and non-transfused patients, volume of RBCs transfused,
perioperative haemoglobin values and circulating red blood volume on
postoperative day 5. Results: In all surgical groups, the transfusion rate
was significantly higher in women than in men (CABG 81 vs 49%, THR 46 vs
24% and TKR 37 vs 23%). In transfused patients, the absolute blood loss
was higher among men in all surgical categories while the relative blood
loss was higher among women in the CABG group (52.8 vs 47.8%) but
comparable in orthopaedic surgery. The relative RBC volume transfused was
significantly higher among women in all categories (CABG 40.0 vs 22.3; TKR
25.2 vs 20.2; THR 26.4 vs 20.8%). On postoperative day 5, the relative
haemoglobin values and the relative circulating RBC volume were higher in
women in all surgical categories. Conclusions: The higher transfusion rate
and volume in women when compared with men in elective surgery can be
explained by clinicians applying the same absolute transfusion thresholds
irrespective of a patient's gender. This, together with the common use of
a liberal transfusion strategy, leads to further overtransfusion in women.

<46>
Accession Number
613355207
Author
Roncada G.
Institution
(Roncada) Jessa Hospital, Heart Centre Hasselt, Stadsomvaart 11, Hasselt
3500, Belgium
(Roncada) Commission for Osteopathic Research, Practice and Promotion,
Mechelen, Belgium
Title
Effects of osteopathic treatment on pulmonary function and chronic
thoracic pain after coronary artery bypass graft surgery (OstinCaRe):
Study protocol for a randomised controlled trial.
Source
BMC Complementary and Alternative Medicine. 16 (1) (no pagination), 2016.
Article Number: 482. Date of Publication: 25 Nov 2016.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Coronary artery bypass graft surgery (CABG) is an effective
and widespread coronary revascularisation technique, nevertheless there
are a number of long-term postoperative complications from which patients
can suffer. One year after CABG surgery pulmonary function is decreased by
12% and 30% of the patients suffer from chronic thoracic pain. To date and
to our knowledge there are no effective treatments for these conditions.
The aim of the present clinical trial is to explore the effectiveness of
osteopathic treatment on these conditions. Methods: The study is designed
as a randomised controlled trial with two parallel groups. Group A will
receive a standard cardiac rehabilitation programme during 12 weeks and
group B will receive the same standard cardiac rehabilitation programme
supplemented with four osteopathic treatments (OT). OT will be performed
at week 4, 5, 8 and 12 after surgery. Three hundred and eight patients
(Group A: n = 154, Group B: n = 154) will be enrolled from the
cardiothoracic surgery department of the Jessa Hospital Hasselt. Blinding
will be assured for the staff of the cardiac rehabilitation centre and
outcome assessors. Primary outcome measure will be the mean difference in
change from baseline in slow vital capacity (SVC) at 12 weeks after
surgery between groups. Secondary outcome measures will be the change from
baseline in quality of life, pain, thoracic stiffness and maximal aerobic
capacity at 12 weeks after surgery. A follow-up is planned 52 weeks after
surgery for SVC, quality of life, pain and thoracic stiffness. Intention
to treat analysis will be executed. Discussion: The OstinCare study has
been designed to explore the potential long-term added value of
osteopathic treatment in the management of decreased pulmonary function,
chronic thoracic pain and diminished thoracic mobility after CABG surgery.
Trial registration: The protocol has been retrospectively registered on
ClinicalTrials.gov (NCT01714791). Copyright &#xa9; 2016 The Author(s).

<47>
Accession Number
613511480
Author
Yamawaki M.; Terashita D.; Takahashi H.; Shinke T.; Fujii K.; Shimada Y.;
Takeda Y.; Yamada S.; Kinoshita Y.; Murasato Y.
Institution
(Yamawaki) Department of Cardiology, Saiseikai Yokohama City Eastern
Hospital, Yokohama, Japan
(Terashita, Takahashi, Shinke) Department of Cardiology, Kobe University
Graduate School of Medicine, Kobe, Japan
(Fujii) Department of Cardiology, Hyogo Medical University, Nishinomiya,
Japan
(Shimada) Department of Cardiology, Shiroyama Hospital, Habikino, Japan
(Takeda) Department of Cardiology, Rinku General Hospital, Izumi-Sano,
Japan
(Yamada) Department of Cardiology, North Harima Medical Center, Ono, Japan
(Kinoshita) Department of Cardiology, Toyohashi Heart Center, Toyohashi,
Japan
(Murasato) Department of Cardiology, Kyushu Medical Center, Fukuoka, Japan
Title
Impact of Diabetes Mellitus on Intravascular Ultrasound-Guided Provisional
Stenting in Coronary Bifurcation Lesions J-REVERSE Sub-Study.
Source
Journal of Interventional Cardiology. 29 (6) (pp 576-587), 2016. Date of
Publication: 01 Dec 2016.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Objective: To investigate the impact of diabetes mellitus (DM) on
provisional coronary bifurcation stenting under the complete guidance of
intravascular-ultrasound (IVUS). Background: The efficacy of such
intervention has not yet been fully elucidated in the DM patients.
Methods: A total of 100 DM and 139 non-DM patients in a prospective
multi-center registry of IVUS-guided bifurcation stenting were compared in
angiographic results at 9 months. Vessel and luminal changes during the
intervention were analyzed using the IVUS. Vascular healing at the
follow-up was also investigated in 23 lesions in each group using optical
coherence tomography (OCT). Results: No difference was detected regarding
baseline reference vessel diameter and minimum lumen diameter in proximal
main vessel (MV), distal MV, and side branch (SB). The rate of
everolimus-eluting stent use (78.4% vs. 78.3%), final kissing inflation
(60.1% vs. 49.0%), and conversion to 2-stent strategy (2.9% vs. 2.8%) were
also similar. In the DM group, late loss was greater in proximal MV (DM
0.23 +/- 0.29 vs. non-DM 0.16 +/- 0.24 mm, P < 0.05) and SB (0.04 +/- 0.49
vs. -0.08 +/- 0.35 mm, P < 0.05). Smaller vessel area restricted stent
expansion in the proximal MV (6.18 +/- 1.67 vs. 6.72 +/- 2.07
mm², P < 0.05). More inhomogeneous neointimal coverage
(unevenness score, 1.90 +/- 0.33 vs. 1.72 +/- 0.29, P < 0.05) and more
frequent thrombus attachment (26% vs. 4%, P < 0.05) were documented in the
proximal MV at 9-month follow-up OCT. Conclusions: Despite IVUS
optimization for coronary bifurcation, DM is potentially associated with
smaller luminal gain, higher late-loss, and inhomogeneous vascular healing
with frequent thrombus attachment in the proximal MV. Copyright &#xa9;
2016, Wiley Periodicals, Inc.

<48>
Accession Number
613511320
Author
Putzu A.; Capelli B.; Belletti A.; Cassina T.; Ferrari E.; Gallo M.; Casso
G.; Landoni G.
Institution
(Putzu, Capelli, Cassina, Casso) Cardiocentro Ticino, Department of
Cardiovascular Anesthesia and Intensive Care, Via Tesserete 48, Lugano,
Switzerland
(Belletti, Landoni) IRCCS San Raffaele Scientific Institute, Department of
Anesthesia and Intensive Care, Via Olgettina 60, Milano, Italy
(Ferrari, Gallo) Cardiocentro Ticino, Department of Cardiac Surgery, Via
Tesserete 48, Lugano, Switzerland
(Landoni) Vita-Salute San Raffaele University, Via Olgettina 58, Milano,
Italy
Title
Perioperative statin therapy in cardiac surgery: A meta-analysis of
randomized controlled trials.
Source
Critical Care. 20 (1) (no pagination), 2016. Article Number: 395. Date of
Publication: 05 Dec 2016.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Several studies suggest beneficial effects of perioperative
statin therapy on postoperative outcome after cardiac surgery. However,
recent randomized controlled trials (RCTs) show potential detrimental
effects. The objective of this systematic review is to examine the
association between perioperative statin therapy and clinical outcomes in
cardiac surgery patients. Methods: Electronic databases were searched up
to 1 November 2016 for RCTs of preoperative statin therapy versus placebo
or no treatment in adult cardiac surgery. Postoperative outcomes were
acute kidney injury, atrial fibrillation, myocardial infarction, stroke,
infections, and mortality. We calculated odds ratios (ORs) and 95%
confidence intervals (CIs) using fixed-effects meta-analyses. Primary
analysis was restricted to trials with low risk of bias according to
Cochrane methodology, and sensitivity analyses examined whether the risk
of bias of included studies was associated with different results. We
performed trial sequential analysis (TSA) to test the strength of the
results. Results: We included data from 23 RCTs involving 5102 patients.
Meta-analysis of trials with low risk of bias showed that statin therapy
was associated with an increase in acute kidney injury (314 of 1318
(23.82%) with statins versus 262 of 1319 (19.86%) with placebo; OR 1.26
(95%CI 1.05 to 1.52); p = 0.01); these results were supported by TSA. No
difference in postoperative atrial fibrillation, myocardial infarction,
stroke, infections, or mortality was present. On sensitivity analysis,
statin therapy was associated with a slight increase in hospital
mortality. Meta-analysis including also trials with high or unclear risk
of bias showed no beneficial effects of statin therapy on any
postoperative outcomes. Conclusions: There is no evidence that statin
therapy in the days prior to cardiac surgery is beneficial for patients'
outcomes. Particularly, statins are not protective against postoperative
atrial fibrillation, myocardial infarction, stroke, or infections. Statins
are associated with a possible increased risk of acute kidney injury and a
detrimental effect on hospital survival could not be excluded. Future RCTs
should further evaluate the safety profile of this therapy in relation to
patients' outcomes and assess the more appropriate time point for
discontinuation of statins before cardiac surgery. Copyright &#xa9; 2016
The Author(s).

<49>
Accession Number
613354937
Author
Venkata G.K.; Forder J.R.; Clark D.; Shih A.; Udassi S.; Badugu S.; Lamb
M.A.; Porvasnik S.L.; Shih R.S.; Colon-Lopez D.; Zaritsky A.L.; Haque
I.U.; Udassi J.P.
Institution
(Venkata, Lamb) Division of Pediatric Critical Care Medicine, Department
of Pediatrics, University of Florida, College of Medicine, Gainesville,
FL, United States
(Venkata, Porvasnik, Shih, Colon-Lopez, Udassi) Division of Pediatric
Cardiology, Congenital Heart Center, Department of Pediatrics, University
of Florida, College of Medicine, Gainesville, FL, United States
(Forder, Clark) Divisions of Radiology and Biomedical Engineering,
University of Florida, Gainesville, FL, United States
(Shih) Department of Anesthesiology, College of Veterinarian School,
University of Florida, Gainesville, FL, United States
(Udassi) Division of Pediatric Hospitalist Medicine, Department of
Pediatrics, University of Florida, College of Medicine, Gainesville, FL,
United States
(Udassi, Udassi) Department of Pediatrics, Sidra Research and Medical
Center, Doha, Qatar
(Badugu) Division of Pediatric Critical Care, Department of Pediatrics,
Texas Tech University Health Sciences, El Paso Children's Hospital, El
Paso, TX, United States
(Zaritsky) Department of Pediatrics, Children's Hospital of the King's
Daughters, Eastern Virginia Medical School, Norfolk, VA, United States
(Haque) Division of Pediatric Critical Care, Department of Pediatrics,
University of Texas, Health Science Center at Houston, Houston, TX, United
States
Title
Ventricular fibrillation-induced cardiac arrest results in regional
cardiac injury preferentially in left anterior descending coronary artery
territory in piglet model.
Source
BioMed Research International. 2016 (no pagination), 2016. Article Number:
5958196. Date of Publication: 2016.
Publisher
Hindawi Publishing Corporation (410 Park Avenue, 15th Floor, 287 pmb, New
York NY 10022, United States)
Abstract
Objective. Decreased cardiac function after resuscitation from cardiac
arrest (CA) results from global ischemia of the myocardium. In the
evolution of postarrest myocardial dysfunction, preferential involvement
of any coronary arterial territory is not known. We hypothesized that
there is no preferential involvement of any coronary artery during
electrical induced ventricular fibrillation (VF) in piglet model. Design.
Prospective, randomized controlled study. Methods. 12 piglets were
randomized to baseline and electrical induced VF. After 5 min, the animals
were resuscitated according to AHA PALS guidelines. After return of
spontaneous circulation (ROSC), animals were observed for an additional 4
hours prior to cardiac MRI. Data (mean +/- SD) was analyzed using unpaired
t-test; p value < 0.05 was considered statistically significant. Results.
Segmental wall motion (mm; baseline versus postarrest group) in segment 7
(left anterior descending (LAD)) was 4.68+/-0.54 versus 3.31+/-0.64,
p=0.0026. In segment 13, it was 3.82+/-0.96 versus 2.58+/-0.82, p=0.02. In
segment 14, it was 2.42+/-0.44 versus 1.29+/-0.99, p=0.028. Conclusion.
Postarrest myocardial dysfunction resulted in segmental wall motion
defects in the LAD territory. There were no perfusion defects in the
involved segments. Copyright &#xa9; 2016 Giridhar Kaliki Venkata et al.

<50>
Accession Number
613487568
Author
El Ashkar A.M.; Khallaf A.N.
Institution
(El Ashkar) Cardio-thoracic Surgery Department, Benisuef University,
Benisuef, Egypt
(Khallaf) Cardio-thoracic Surgery Department, Fayoum University, Fayoum,
Egypt
Title
Video-assisted minimally invasive mitral valve surgery: Early experience.
Source
Journal of the Egyptian Society of Cardio-Thoracic Surgery. 24 (3) (pp
223-227), 2016. Date of Publication: 01 Oct 2016.
Publisher
Egyptian Society of Cardio-thoracic Surgery
Abstract
Background: The post-operative complications of median sternotomy,
especially the post-operative pain and wound complications, has led many
surgeons to adopt less invasive techniques to perform open heart surgery.
Video-assisted mitral valve surgery via mini thoracotomy is now widely
used and is becoming the standard of care in many centers all-over the
world. Aim of the study: Comparing the early post-operative outcome of
video-assisted minimally invasive mitral valve replacement versus the
conventional approach via median sternotomy. Patients and methods: 34
patients undergoing mitral valve replacement (MVR) were randomly selected
for this study and were divided in 2 equal groups. Group (A) included 17
patients who had MVR via median sternotomy while group (B) included 17
patients who had MVR via video-assisted anterior minithoracotomy. Results:
The cross-clamp time was 63.7 +/- 2.34 min in group (A) versus 83.4 +/-
7.21 min in group (B), which was statistically significant. The operative
time was 3.27 +/- 1.22 h in group (A) versus 5.62 +/- 1.67 h in group (B),
which was statistically significant. The duration of mechanical
ventilation and the mean units of blood needed were significantly higher
in group (A) compared to group (B). There was no statistically significant
difference between the 2 groups regarding the postoperative complications
including mortality, bleeding or mediastinitis. Conclusion: Minimally
invasive mitral valve replacement is a safe procedure, with comparable
post-operative outcome to conventional median sternotomy. Copyright &#xa9;
2016, The Egyptian Society of Cardio-thoracic Surgery.

<51>
Accession Number
613487514
Author
Mourad F.A.; Fadala M.A.; Ibrahim A.A.; Ammar A.M.; Elnahas Y.M.; Elghanam
M.A.; Elkilany I.S.
Institution
(Mourad, Fadala, Ibrahim, Ammar, Elnahas, Elghanam, Elkilany) Department
of Cardiothoracic Surgery, Ain Shams University, Cairo, Egypt
Title
Myocardial protection during CABG: Warm blood versus cold crystalloid
cardioplegia, is there any difference?.
Source
Journal of the Egyptian Society of Cardio-Thoracic Surgery. 24 (3) (pp
215-222), 2016. Date of Publication: 01 Oct 2016.
Publisher
Egyptian Society of Cardio-thoracic Surgery
Abstract
Background: Up till now there is lack of consensus to the optimal method
for cardioplegia delivery in coronary artery bypass graft (CABG) patients.
Various strategies have been developed to minimize ischemic-reperfusion
injury. The aim of this study was to compare cold crystalloid cardioplegia
and warm blood cardioplegia in patients undergoing CABG. Methods: Patients
(n = 100) undergoing CABG were prospectively randomized into group 1 (n =
50) which received antegrade cold crystalloid cardioplegia, group 2 (n =
50) which received antegrade warm blood cardioplegia. Blood samples were
collected immediately, 12, and 24 h postoperatively and CK, CKMB, and
Cardiac Troponin I were measured and compared between the two groups which
were the indicator of myocardial cell injury (the primary end point of
this study). Other indicators such as spontaneous defibrillation, use of
intra-aortic balloon counter pulsation (IABC), and use of inotropic
support were also documented. Results: Preoperative demographic and
clinical variables were matched in both groups. However, intraoperatively,
the use of inotropic support was significantly higher in Group I compared
to Group II (P = 0.032). Postoperative CK, CKMB and Troponin I were
significantly higher in group (I) compared to group (II). Conclusion: A
significant reduction in the release of cardiac enzymes in patients who
received antegrade warm blood cardioplegia suggests better myocardial
protection compared to cold crystalloid cardioplegia. Copyright &#xa9;
2016, The Egyptian Society of Cardio-thoracic Surgery.

<52>
[Use Link to view the full text]
Accession Number
613246159
Author
Jerkic H.; Letilovic T.; Stipinovic M.; Pocanic D.; Catic J.; Knotek M.
Institution
(Jerkic, Letilovic, Stipinovic, Pocanic) Division of Cardiology,
Department of Medicine, University Hospital Merkur, Zajceva 19, Zagreb,
Croatia
(Letilovic, Knotek) Division of Nephrology, Department of Medicine,
University Hospital Merkur, Croatia
(Catic) Division of Cardiology, Department of Medicine, University
Hospital Dubrava, Croatia
(Knotek) University of Zagreb Medical School, Zagreb, Croatia
Title
Association of chronic kidney disease with periprocedural myocardial
injury after elective stent implantation: A single center prospective
cohort study.
Source
Medicine (United States). 95 (45) (no pagination), 2016. Article Number:
381. Date of Publication: 2016.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Coronary artery disease (CAD) is the leading cause of mortality in
patients with chronic kidney disease (CKD). Patients with CKD who undergo
percutaneous coronary intervention (PCI) may have more ischemic events
than patients without CKD. The aim of our study was to determine the
incidence of periprocedural myocardial injury (PMI) after elective stent
implantation in patients with CKD using the Third Joint ESC/ACCF/AHA/WHF
PMI definition. In a single center prospective cohort study, we enrolled
344 consecutive patients who underwent elective PCI in a period of 39
months. Serum troponin I (cTnI) concentrations were measured at baseline
and at 8 and 16hours after PCI. Periprocedural increase of cTnI, according
to the most recent PMI definition, was used to define both the presence
and intensity of PMI. Patients were further stratified according to the
estimated glomerular filtration rate (EGFR) using 4 variable Modification
of Diet in Renal Disease (MDRD) equation: control group with EGFR
>90mL/min/1.73 m² and the CKD group with EGFR<90mL/min/1.73
m², with further subdivision according to the CKD stage. We
found no significant difference in the incidence as well as intensity of
the PMI in the control (>90mL/min/1.73 m²) and the CKD group
(<90mL/min/1.73 m²) both 8 and 16hours after PCI. When the CKD
patients were further subdivided according to their CKD stage, there was
again no difference in the intensity or incidence of PMI compared to the
control group. Further analyses of our data showed angina pectoris CCS IV,
bare metal stent (BMS) implantation, and treatment with
angiotensin-converting enzyme inhibitors (ACEI) as independent predictors
of PMI. Furthermore, the presence of hypertension was inversely related to
the occurrence of PMI. Applying the new guidelines for PMI and using the
EGFR equation most suitable for our patients, we found no association
between PMI and CKD. Further analyses showed other factors that could
potentially influence the occurrence of PMI. Abbreviations: ACCF/AHA =
American College of Cardiology Foundation/American Heart Association, ACEI
= angiotensinconverting enzyme inhibitor, ARB = angiotensin II receptor
blocker, BMI = body mass index, BMS = bare metal stent, CABG = coronary
artery bypass grafting, CAD = coronary artery disease, CCS = Canadian
Cardiovascular Society, CK-MB = creatine kinase MB fraction, CKD = chronic
kidney disease, CRP = C-reactive protein, cTnI = cardiac troponin I, DES =
drug-eluting stent, EGFR = estimated glomerular filtration rate, ESC =
European Society of Cardiology, ESRD = end-stage renal disease, MACE =
major adverse cardiovascular events, MDRD = Modification of Diet in Renal
Disease, MI = myocardial infarction, PCI = percutaneous coronary
intervention, PMI = periprocedural myocardial injury, QCA = quantitative
coronary angiography, ST = stent thrombosis, TIMI = thrombolysis in
myocardial infarction, TVR = target vessel revascularization, URL = upper
reference limit, WHR = World Heart Federation. Copyright &#xa9; 2016 the
Author(s).

<53>
Accession Number
613254259
Author
Brown D.W.; Mangeot C.; Anderson J.B.; Peterson L.E.; King E.C.; Lihn
S.L.; Neish S.R.; Fleishman C.; Phelps C.; Hanke S.; Beekman R.H.; Lannon
C.M.
Institution
(Brown, Lihn) Department of Cardiology, Boston Children's Hospital,
Boston, MA, United States
(Mangeot, Anderson, King, Hanke, Beekman, Lannon) Cincinnati Children's
Hospital Medical Center, Cincinnati, OH, United States
(Peterson) BostonMAUnited States
(Neish) University of Texas Health Science Center, San Antonio, TX, United
States
(Fleishman) Arnold Palmer Hospital for Children, Orlando, FL, United
States
(Phelps) Nationwide Children's Hospital, Columbus, OH, United States
Title
Digoxin use is associated with reduced interstage mortality in patients
with no history of arrhythmia after stage i palliation for single
ventricle heart disease.
Source
Journal of the American Heart Association. 5 (1) (no pagination), 2016.
Article Number: e002376. Date of Publication: 2016.
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background-Interstage mortality (IM) remains significant after stage 1
palliation (S1P) for single-ventricle heart disease (SVD), with many
deaths sudden and unexpected. We sought to determine whether digoxin use
post-S1P is associated with reduced IM, utilizing the multicenter database
of the National Pediatric Cardiology Quality Improvement Collaborative
(NPCQIC). Methods and Results-From June 2008 to July 2013, 816 infants
discharged after S1P from 50 surgical sites completed the interstage to
stage II palliation, transplant, or IM. Arrhythmia during S1P
hospitalization or discharge on antiarrhythmic medications were exclusions
(n=270); 2 patients were lost to follow-up. Two analyses were performed:
(1) propensity-score adjusted logistic regression with IM as outcome and
(2) retrospective cohort analysis for patients discharged on digoxin
versus not, matched for surgical site and other established IM risk
factors. Of 544 study patients, 119 (21.9%) were discharged on digoxin.
Logistic regression analysis with propensity score, site-size group, and
digoxin use as predictor variables showed an increased risk of IM in those
not discharged on digoxin (odds ratio, 8.6; lower confidence limit, 1.9;
upper confidence limit, 38.3; P<0.01). The retrospective cohort analysis
for 60 patients on digoxin (matched for site of care, type of S1P,
post-S1P ECMO use, genetic syndrome, discharge feeding route, ventricular
function, tricuspid regurgitation, and aortic arch gradient) showed 0% IM
in the digoxin at discharge group and an estimated IM difference between
the 2 groups of 9% (P=0.04). Conclusions-Among SVD infants in the NPCQIC
database discharged post-S1P with no history of arrhythmia, use of digoxin
at discharge was associated with reduced IM. Copyright &#xa9; 2016 The
Authors.

<54>
Accession Number
612636007
Author
Ando T.; Briasoulis A.; Holmes A.A.; Takagi H.; Slovut D.P.
Institution
(Ando) Department of Internal Medicine, Mount Sinai Beth Israel, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Briasoulis) Division of Cardiology, Wayne State University/Detroit
Medical Center, Detroit, MI, United States
(Holmes) Leon H. Charney Division of Cardiology, NYU Langone Medical
Center, New York, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Slovut) Department of Cardiothoracic and Vascular Surgery, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Slovut) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
Title
Percutaneous versus surgical cut-down access in transfemoral transcatheter
aortic valve replacement: A meta-analysis.
Source
Journal of Cardiac Surgery. 31 (12) (pp 710-717), 2016. Date of
Publication: 01 Dec 2016.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: The transfemoral (TF) approach has become the preferred
approach for transcatheter aortic valve replacement (TAVR) because of its
low risk profile. However, the relative safety of the percutaneous
approach (PC) compared to surgical cut-down (SC) remains unclear. Our aim
was to compare the outcomes between PC versus SC access in patients
undergoing TF-TAVR using a meta-analysis. Methods: We conducted a
systematic electronic database search for studies reporting major and
minor vascular complications (VC), major and minor bleeding, and
perioperative all-cause mortality, in PC versus SC TF-TAVR cases.
Complications were reported based on the Valve Academic Research
Consortium criteria. A random-effects model was used to calculate odds
ratios and 95% confidence intervals. Results: Eight observational cohort
studies and one randomized control trial (2513 patients in PC and 1767
patients in SC) were included in the analysis. Major and minor VC, as well
as bleeding complications, were comparable between the two approaches. The
need for surgical intervention for VC was comparable between PC and SC.
There was no difference in perioperative all-cause mortality. Conclusions:
PC and SC have similar safety profiles and outcomes when used
appropriately in selected patients. Copyright &#xa9; 2016 Wiley
Periodicals, Inc.

<55>
Accession Number
613219415
Author
Quevedo H.C.; Alonso A.
Institution
(Quevedo, Alonso) Tulane University Heart and Vascular Institute, Tulane
University School of Medicine, New Orleans, LA, United States
Title
Endovascular therapy for ascending aorta pseudoaneurysm.
Source
Cardiovascular Revascularization Medicine. 17 (8) (pp 586-588), 2016. Date
of Publication: 01 Dec 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Ascending Aortic pseudoaneurysms (AAP) are often formed as a result of
prior thoracic surgery. In patients with large AAP, surgical correction is
the established therapy. However, a group of patients are not suitable
surgical candidates because of advanced age or multiple comorbidities.
Instead, endovascular approach represents a viable option in this
population. Here, we review the literature of the surgical and
trans-catheter therapy for AAP. Additionally, we complement the review
with a case presentation of a prohibitive surgical risk case that was
treated with endovascular options including an unsuccessful septal
occluder deployment, but final excellent angiographic AAP exclusion with
coil embolization. Copyright &#xa9; 2016 Elsevier Inc.

<56>
Accession Number
613216126
Author
Verma D.R.; Pershad Y.; Pershad A.; Fang K.; Gellert G.; Morris M.F.
Institution
(Verma, Pershad, Fang, Gellert, Morris) Cardiovascular Institute, Banner
University Medical Center, Phoenix, United States
(Verma, Pershad) Division of Interventional Cardiology, Banner University
Medical Center, Phoenix, United States
(Pershad, Morris) Department of Radiology, Banner University Medical
Center, Phoenix, United States
(Fang) Division of Cardiothoracic Surgery, Banner University Medical
Center, Phoenix, United States
(Gellert) Department of Anesthesiology, Banner University Medical Center,
Phoenix, United States
Title
Impact of institutional volume and experience with CT interpretation on
sizing of transcatheter aortic valves: A multicenter retrospective study.
Source
Cardiovascular Revascularization Medicine. 17 (8) (pp 566-570), 2016. Date
of Publication: 01 Dec 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background Computed tomography (CT) has become the standard imaging
modality for pre-procedural aortic annular sizing prior to transcatheter
aortic valve replacement (TAVR). We hypothesized that the accuracy of CT
derived annular measurements would be greater at sites with higher TAVR
procedural volume. Methods Within a large integrated health system, TAVR
was performed at low (<40 cases), intermediate (40-75 cases), and
high-volume sites (>75 cases). 181 patients underwent TAVR with a Sapien
XT transcatheter heart valve (THV). Two blinded experienced readers
independently remeasured the annulus on CT and compared their measurements
to site reported measurements. Hypothetical THV sizes were chosen based on
measurements from site CT reports and independent readers' measurements,
and compared to the implanted THV size. Results Correlation between site
reported measurements and independent readers measurements of mean annulus
size varied between low-volume (r = 0.31, p = 0.18), intermediate-volume
(r = 0.34, p = 0.01), and high-volume sites (r = 0.96, p < 0.01). On
multivariate analysis, interpretation of >20 CT scans (OR 0.29; 95% CI
0.03-0.81; p 0.02) and high-volume site (OR 0.16; 95% CI 0.10-0.82; p
0.02) were associated with reduced mismatch between the site predicted THV
size and independent readers predicted THV size. Mismatch between site
predicted THV size and implanted THV size was associated with a worse
30-day composite of mortality, dialysis-dependent renal failure,
cerebrovascular accident, new permanent pacemaker, and hospital
readmission (55.3 vs. 38.7%; p = 0.05). Conclusions Accuracy of CT aortic
annular sizing is improved with higher individual experience and site TAVR
volume. These findings should be confirmed in larger, prospective studies.
Copyright &#xa9; 2016 Elsevier Inc.

<57>
Accession Number
613115280
Author
Bernabe-Garcia M.; Lopez-Alarcon M.; Salgado-Sosa A.; Villegas-Silva R.;
Maldonado-Hernandez J.; Rodriguez-Cruz M.; Rivas-Ruiz R.; Chavez-Sanchez
L.; Blanco-Favela F.A.; Mancilla-Ramirez J.; Gordillo-Alvarez V.;
Madrigal-Muniz O.
Institution
(Bernabe-Garcia, Lopez-Alarcon, Maldonado-Hernandez, Rodriguez-Cruz) Unit
of Medical Research in Nutrition, Instituto Mexicano del Seguro Social,
Mexico City, Mexico
(Salgado-Sosa, Villegas-Silva, Madrigal-Muniz) Neonatal Intensive Care
Unit, Instituto Mexicano del Seguro Social, Mexico City, Mexico
(Chavez-Sanchez, Blanco-Favela) Unit of Medical Research in Immunology,
Instituto Mexicano del Seguro Social, Mexico City, Mexico
(Gordillo-Alvarez) Pain Clinic, Hospital de Pediatria, Instituto Mexicano
del Seguro Social, Mexico City, Mexico
(Rivas-Ruiz) Coordinacion de Investigacion en Salud, Instituto Mexicano
del Seguro Social, Mexico City, Mexico
(Villegas-Silva) Neonatal Intensive Care Unit, Hospital Infantil de Mexico
Federico Gomez, Mexico City, Mexico
(Mancilla-Ramirez) Escuela Superior de Medicina, IPN, Hospital de la
Mujer, Mexico City, Mexico
Title
Enteral docosahexaenoic acid reduces analgesic administration in neonates
undergoing cardiovascular surgery.
Source
Annals of Nutrition and Metabolism. 69 (2) (pp 150-160), 2016. Date of
Publication: 01 Nov 2016.
Publisher
S. Karger AG
Abstract
Background: Neonates undergoing surgery require analgesic medication to
ameliorate acute pain. These medications produce negative side effects.
Docosahexaenoic acid (DHA) has an antinociceptive effect in animals, but
this has not been evaluated in human neonates. We evaluated the DHA effect
on cumulative dose and duration of analgesics administered to neonates
undergoing cardiovascular surgery. Methods: A secondary analysis was
performed with data from a clinical trial, in which enteral DHA was
administered perioperatively compared with sunflower oil (SO). Present
study assessed the antinociceptive effect of DHA by measuring the
cumulative dose and duration of analgesics administered during
postoperative stay in a neonatal intensive care unit. Multivariate linear
regression models were performed. Results: Seventeen neonates received DHA
and 18 received SO in the control group. Compared with the control group,
the DHA group received lower cumulative dose (14.6 +/- 2.2 vs. 25.2 +/-
4.8 mug/kg, p = 0.029) and shorter duration of buprenorphine (2 days (1-8)
vs. 4.5 days (1-12); p = 0.053). After adjusting for confounders, the DHA
group received significantly lesser buprenorphine (beta = -27 mug/kg, p =
0.028; R² model = 0.90) for shorter duration (beta = -9 days, p
= 0.003; R² model = 0.94). No differences in fentanyl or
ketorolac were detected. Conclusions: Buprenorphine administration was
reduced in neonates who received DHA, suggesting that DHA likely has
analgesic effects. Copyright &#xa9; 2016 S. Karger AG, Basel.

<58>
Accession Number
613458686
Author
Khan J.N.; Nazir S.A.; Greenwood J.P.; Dalby M.; Curzen N.; Hetherington
S.; Kelly D.J.; Blackman D.; Ring A.; Peebles C.; Wong J.; Sasikaran T.;
Flather M.; Swanton H.; Gershlick A.H.; McCann G.P.
Institution
(Khan, Nazir, Gershlick, McCann) Department of Cardiovascular Sciences,
University of Leicester, NIHR Leicester Cardiovascular Biomedical Research
Unit, University Hospitals of Leicester NHS Trust, Glenfield Hospital,
Leicester, United Kingdom
(Greenwood, Blackman) Multidisciplinary Cardiovascular Research Centre,
Division of Cardiovascular and Diabetes Research, Leeds Institute of
Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United
Kingdom
(Dalby, Wong, Sasikaran) Harefield Hospital, Royal Brompton and Harefield
Foundation Trust, NIHR Cardiovascular Biomedical Research Unit, Middlesex,
United Kingdom
(Curzen, Peebles) University Hospital Southampton NHS Foundation Trust and
University of Southampton, Southampton, United Kingdom
(Hetherington) Kettering General Hospital, Kettering NN16 8UZ, United
Kingdom
(Kelly) Royal Derby Hospital, Derby, United Kingdom
(Ring) Leicester Clinical Trials Unit, University of Leicester, UK,
Department of Mathematical Statistics and Actuarial Science, University of
Leicester, University of the Free State, Bloemfontein, South Africa
(Flather) Norfolk and Norwich University Hospitals NHS Foundation Trust
and Norwich Medical School, University of East Anglia, Norwich, United
Kingdom
(Swanton) Heart Hospital, University College London Hospitals, London,
United Kingdom
Title
Infarct size following complete revascularization in patients presenting
with STEMI: a comparison of immediate and staged in-hospital non-infarct
related artery PCI subgroups in the CvLPRIT study.
Source
Journal of Cardiovascular Magnetic Resonance. 18 (1) (pp 1-9), 2016. Date
of Publication: 09 Nov 2016.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: The CvLPRIT study showed a trend for improved clinical
outcomes in the complete revascularisation (CR) group in those treated
with an immediate, as opposed to staged in-hospital approach in patients
with multivessel coronary disease undergoing primary percutaneous
intervention (PPCI). We aimed to assess infarct size and left ventricular
function in patients undergoing immediate compared with staged CR for
multivessel disease at PPCI. Methods: The Cardiovascular Magnetic
Resonance (CMR) substudy of CvLPRIT was a multicentre, prospective,
randomized, open label, blinded endpoint trial in PPCI patients with
multivessel disease. These data refer to a post-hoc analysis in 93
patients randomized to the CR arm (63 immediate, 30 staged) who completed
a pre-discharge CMR scan (median 2 and 4 days respectively) after PPCI.
The decision to stage non-IRA revascularization was at the discretion of
the treating interventional cardiologist. Results: Patients treated with a
staged approach had more visible thrombus (26/30 vs. 31/62, p = 0.001),
higher SYNTAX score in the IRA (9.5, 8-16 vs. 8.0, 5.5-11, p = 0.04) and a
greater incidence of no-reflow (23.3 % vs. 1.6 % p < 0.001) than those
treated with immediate CR. After adjustment for confounders, staged
patients had larger infarct size (19.7 % [11.7-37.6] vs. 11.6 % [6.8-18.2]
of LV Mass, p = 0.012) and lower ejection fraction (42.2 +/- 10 % vs. 47.4
+/- 9 %, p = 0.019) compared with immediate CR. Conclusions: Of patients
randomized to CR in the CMR substudy of CvLPRIT, those in whom the
operator chose to stage revascularization had larger infarct size and
lower ejection fraction, which persisted after adjusting for important
covariates than those who underwent immediate CR. Prospective randomized
trials are needed to assess whether immediate CR results in better
clinical outcomes than staged CR. Trial registration: ISRCTN70913605 ,
Registered 24th February 2011. Copyright &#xa9; 2016 The Author(s).

<59>
Accession Number
613458676
Author
Reinstadler S.J.; Stiermaier T.; Eitel C.; Saad M.; Metzler B.; De Waha
S.; Fuernau G.; Desch S.; Thiele H.; Eitel I.
Institution
(Reinstadler, Stiermaier, Eitel, Saad, De Waha, Fuernau, Desch, Thiele,
Eitel) University Heart Center Lubeck, Medical Clinic II, Department of
Cardiology, Angiology and Intensive Care Medicine, University of Lubeck,
Ratzeburger Allee 160, Lubeck 23538, Germany
(Reinstadler, Stiermaier, Eitel, Saad, De Waha, Fuernau, Desch, Thiele,
Eitel) German Center for Cardiovascular Research (DZHK), Partner Site
Hamburg/Kiel/Lubeck, Ratzeburger Allee 160, Lubeck 23538, Germany
(Reinstadler, Metzler) University Clinic of Internal Medicine III,
Cardiology and Angiology, Medical University of Innsbruck, Anichstrase 35,
Innsbruck A-6020, Austria
Title
Antecedent hypertension and myocardial injury in patients with reperfused
ST-elevation myocardial infarction.
Source
Journal of Cardiovascular Magnetic Resonance. 18 (1) (pp 1-8), 2016. Date
of Publication: 11 Nov 2016.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Antecedent hypertension is associated with poor outcome in
patients with ST-elevation myocardial infarction (STEMI). Whether
differences in myocardial salvage, infarct size and microvascular injury
contribute to the adverse outcome is unknown. We investigated the
association between antecedent hypertension and cardiovascular magnetic
resonance (CMR) parameters of myocardial salvage and damage in a
multicenter CMR substudy of the AIDA-STEMI trial (Abciximab Intracoronary
versus intravenously Drug Application in ST-elevation myocardial
infarction). Methods: We analyzed 792 consecutive STEMI patients
reperfused within 12 h after symptom onset. Patients underwent CMR imaging
for assessment of myocardial salvage, infarct size and microvascular
obstruction within 10 days after infarction. Major adverse cardiac events
(MACE) were recorded at 12-month follow-up. Results: Antecedent
hypertension was present in 540 patients (68 %) and was associated with a
significantly increased baseline risk profile (advanced age, higher body
mass index, higher incidence of diabetes, hypercholesterolemia, previous
angioplasty and multivessel disease, p < 0.001 for all). MACE were more
frequent in patients with hypertension as compared to patients without
hypertension (45 [8 %] vs. 8 [3 %], p < 0.01). Antecedent hypertension
remained an independent predictor of MACE after multivariate adjustment
(hazard ratio 3.42 [confidence interval 1.45-8.08], p < 0.01). There was,
however, no significant difference in the area at risk, infarct size,
myocardial salvage index, extent of microvascular obstruction, and left
ventricular ejection fraction between the groups (all p > 0.05).
Conclusion: Despite a higher rate of MACE in contemporary reperfused STEMI
patients with antecedent hypertension, there was no difference in
reperfusion efficacy, infarct size and reperfusion injury as visualized by
CMR. Trial registration: NCT00712101 . Copyright &#xa9; 2016 The
Author(s).

<60>
Accession Number
613400989
Author
Li N.; Yang Y.-G.; Chen M.-H.
Institution
(Li, Yang, Chen) the First Affiliated Hospital of Guangxi Medical
University, Institute of Cardiovascular Diseases, Nanning, Guangxi 530027,
China
Title
Comparing the adverse clinical outcomes in patients with non-insulin
treated type 2 diabetes mellitus and patients without type 2 diabetes
mellitus following percutaneous coronary intervention: A systematic review
and meta-analysis.
Source
BMC Cardiovascular Disorders. 16 (1) (no pagination), 2016. Article
Number: 238. Date of Publication: 25 Nov 2016.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Several studies showed Type 2 Diabetes Mellitus (T2DM) to be
associated with worse adverse clinical outcomes compared to non-T2DM (NDM)
following Percutaneous Coronary Intervention (PCI). In addition, patients
with insulin-treated T2DM (ITDM) showed worse clinical outcomes compared
to patients with non-insulin treated T2DM (NITDM). Since NITDM and NDM
have seldom been systematically analyzed, this study aimed to compare the
short and long term adverse clinical outcomes observed in patients with
NITDM and patients without T2DM following PCI. Methods: Medline/PubMed,
EMBASE and the Cochrane library were searched for Randomized Controlled
Trials (RCTs) and observational studies comparing patients with (including
ITDM and NITDM) and without T2DM following PCI. Endpoints included adverse
clinical outcomes reported during a short and a long term follow up
period. Odd Ratios (OR) and 95% Confidence Intervals (CI) in accordance
with either a fixed or a random effects model appropriately, were
calculated and the pooled analyses were performed with RevMan 5.3.
Results: Twelve studies consisting of a total number of 52,451 patients
(14,863 NITDM and 37,588 NDM) were included. Patients with NITDM were
found to have significantly higher short-term Major Adverse Cardiac Events
(MACEs) and mortality with OR: 1.63, 95% CI (1.17, 2.27); P = 0.004 and
OR: 1.71, 95% CI (1.40, 2.10), P < 0.00001 respectively and higher
long-term MACEs and mortality with OR: 1.25, 95% CI (1.12, 1.40), P =
0.0001 and OR: 1.32, 95% CI (1.19, 1.47), P < 0.00001 respectively
compared to NDM following PCI. In addition, compared to NDM, long-term
Target Vessel Revascularization (TVR) and Target Lesion Revascularization
(TLR) were significantly higher in the NITDM group with OR: 1.36, 95% CI
(1.18, 1.56), P < 0.0001 and OR: 1.32, 95% CI (1.10, 1.59), P = 0.003
respectively. However, even if an increased long-term stent thrombosis was
observed in the NITDM group with OR: 1.13; 95% CI (0.91, 1.40), P = 0.28,
the result was insignificant. Conclusion: Short and long term MACEs and
mortality were significantly higher in patients with NITDM compared to
patients without diabetes following PCI. Revascularization also
significantly favored patients without T2DM. However, stent thrombosis was
not significantly different. Copyright &#xa9; 2016 The Author(s).

<61>
Accession Number
613749426
Author
Kuss O.
Institution
(Kuss) Institute for Biometry and Epidemiology, German Diabetes Center,
Leibniz Institute for Diabetes Research at Heinrich Heine University
Dusseldorf, Dusseldorf, Germany
Title
Statistical methods for meta-analyses including information from studies
without any events-add nothing to nothing and succeed nevertheless.
Source
Statistics in Medicine. 34 (7) (pp 1097-1116), 2015. Date of Publication:
30 Mar 2015.
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom)
Abstract
Meta-analyses with rare events, especially those that include studies with
no event in one ('single-zero') or even both ('double-zero') treatment
arms, are still a statistical challenge. In the case of double-zero
studies, researchers in general delete these studies or use continuity
corrections to avoid them. A number of arguments against both options has
been given, and statistical methods that use the information from
double-zero studies without using continuity corrections have been
proposed. In this paper, we collect them and compare them by simulation.
This simulation study tries to mirror real-life situations as completely
as possible by deriving true underlying parameters from empirical data on
actually performed meta-analyses. It is shown that for each of the
commonly encountered effect estimators valid statistical methods are
available that use the information from double-zero studies without using
continuity corrections. Interestingly, all of them are truly random
effects models, and so also the current standard method for very sparse
data as recommended from the Cochrane collaboration, the Yusuf-Peto odds
ratio, can be improved on. For actual analysis, we recommend to use
beta-binomial regression methods to arrive at summary estimates for the
odds ratio, the relative risk, or the risk difference. Methods that ignore
information from double-zero studies or use continuity corrections should
no longer be used. We illustrate the situation with an example where the
original analysis ignores 35 double-zero studies, and a superior analysis
discovers a clinically relevant advantage of off-pump surgery in coronary
artery bypass grafting. Copyright &#xa9; 2014 John Wiley & Sons, Ltd.
Copyright &#xa9; 2014 John Wiley & Sons, Ltd.

<62>
Accession Number
613488204
Author
Yuan X.; Du J.; Liu Q.; Zhang L.
Institution
(Yuan, Zhang) Department of Nephrology, the Second Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Du) Department of Cardiology, the Second Affiliated Hospital of Chongqing
Medical University, Chongqing, China
(Liu) Institute for Viral Hepatitis, Key Laboratory of Molecular Biology
for Infectious Diseases, the Second Affiliated Hospital of Chongqing
Medical University, Chongqing, China
Title
Defining the role of perioperative statin treatment in patients after
cardiac surgery: A meta-analysis and systematic review of 20 randomized
controlled trials.
Source
International Journal of Cardiology. 228 (pp 958-966), 2017. Date of
Publication: 01 Feb 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Background Although statin use has been indicated to prevent atrial
fibrillation in previous observational and experimental trials, the issue
remains inadequately and insufficiently explored. We therefore performed
this meta-analysis to evaluate the effects of perioperative statin therapy
on complications and short-term prognosis following cardiac surgery.
Methods A search of the PubMed, EMBASE and the Cochrane database of
controlled trials was performed from inception to June 2016 to identify
relevant randomized controlled trials (RCTs). The primary endpoints
included postoperative atrial fibrillation, acute kidney injury and
all-cause mortality. Results Twenty studies involving 4338 patients were
included in the meta-analysis. Among the patients who underwent cardiac
surgery, perioperative statin therapy was significantly associated with a
decreased risk of postoperative atrial fibrillation (OR: 0.50; P =
0.0004), particularly in the subgroup of patients who used atorvastatin
and those who underwent isolated coronary artery bypass grafting (CABG)
surgery. Moreover, perioperative statin use significantly decreased the
length of hospital stay (weighted mean difference (WMD): - 0.43; P =
0.002). However, no reductions were observed in acute kidney injury,
myocardial infarction, postoperative serum creatinine concentration or the
length of intensive care unit (ICU) stay. Conclusions Perioperative statin
therapy might be promising for the prevention of postoperative atrial
fibrillation following cardiac surgery, especially for patients undergoing
isolated CABG surgery or atorvastatin administration. Additionally, statin
use can decrease the length of the hospital stay. Copyright &#xa9; 2016

<63>
Accession Number
613705277
Author
Hedman K.F.; Mann C.L.; Spulecki C.; Castner J.
Institution
(Hedman, Mann) University at Buffalo, Buffalo, NY, United States
(Hedman, Mann) University of Rochester Medical Center, Rochester, NY,
United States
(Spulecki) University at Buffalo School of Nursing, Nurse Anesthesia
Program, Buffalo, NY, United States
(Castner) University at Buffalo School of Nursing, Buffalo, NY, United
States
Title
Low-dose vasopressin and analogues to treat intraoperative refractory
hypotension in patients prescribed angiotensin-converting enzyme
inhibitors undergoing general anesthesia: A systematic review.
Source
AANA Journal. 84 (6) (pp 413-419), 2016. Date of Publication: 2016.
Publisher
AANA Publishing Inc. (E-mail: llacey@aana.com )
Abstract
This review assessed the utility of vasopressin and vasopressin analogues
for the treatment of refractory hypotension associated with
angiotensin-converting enzyme (ACE) inhibitors in the perioperative
setting. A systematic review of the literature was conducted using
MEDLINE, Embase, and ProQuest. Six randomized controlled trials met
eligibility criteria. In the perioperative setting, continued use of ACE
inhibitors within 24 hours before surgery remains controversial. Authors
of the reviewed studies suggested that the morning dose of the ACE
inhibitor be held, and those patients experienced decreased catecholamine
use postoperatively and shorter duration of decreased mean arterial
pressure. No incidence of refractory hypertension from withholding the
morning dose of the ACE inhibitor was mentioned. All of the patients
receiving vasopressin demonstrated improved hemodynamic stability with
small, intermittent doses, without profound ischemic changes. For
management (prevention and treatment) of ACE inhibitor-associated
hypotension in the perioperative setting, all studies showed statistically
significant success with vasopressin or vasopressin analogues for
improvement of systemic blood pressures. Before vasopressin is widely
accepted as a standard of care, further studies are needed to confirm
these findings and assess the general utility of vasopressin in surgical
populations for management of ACE inhibitor-associated refractory
hypotension.

<64>
Accession Number
613645171
Author
Andes D.R.; Safdar N.; Baddley J.W.; Alexander B.; Brumble L.; Freifeld
A.; Hadley S.; Herwaldt L.; Kauffman C.; Lyon G.M.; Morrison V.; Patterson
T.; Perl T.; Walker R.; Hess T.; Chiller T.; Pappas P.G.
Institution
(Andes, Safdar, Hess) Department of Medicine and Microbiology, University
of Wisconsin, Madison, WI, United States
(Baddley, Pappas) Department of Medicine, University of Alabama at
Birmingham, Birmingham, AL, United States
(Alexander) Department of Medicine, Duke University School of Medicine,
Durham, NC, United States
(Brumble, Walker) Department of Medicine, Mayo Clinic, Rochester, MN,
United States
(Freifeld) Department of Medicine, University of Nebraska, Lincoln, NE,
United States
(Hadley) Department of Medicine, Tufts University, Boston, MA, United
States
(Herwaldt) Department of Medicine, University of Iowa School of Medicine,
Iowa City, IA, United States
(Kauffman) Department of Medicine, Michigan University School of Medicine,
Ann Arbor, MI, United States
(Lyon) Emory University, Atlanta, GA, United States
(Morrison) Department of Medicine, University of Minnesota School of
Medicine, Minneapolis, MN, United States
(Patterson) Department of Medicine, University of Texas at San Antonio,
San Antonio, TX, United States
(Perl) Department of Medicine, Johns Hopkins University, Baltimore, MD,
United States
(Chiller) Centers for Disease Control and Prevention, Atlanta, GA, United
States
Title
The epidemiology and outcomes of invasive Candida infections among organ
transplant recipients in the United States: results of the
Transplant-Associated Infection Surveillance Network (TRANSNET).
Source
Transplant Infectious Disease. 18 (6) (pp 921-931), 2016. Date of
Publication: 01 Dec 2016.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Invasive candidiasis (IC) is a common cause of mortality in
solid organ transplant recipients (OTRs), but knowledge of epidemiology in
this population is limited. Method: The present analysis describes data
from 15 US centers that prospectively identified IC from nearly 17 000
OTRs. Analyses were undertaken to determine predictors of infection and
mortality. Results: A total of 639 cases of IC were identified. The most
common species was Candida albicans (46.3%), followed by Candida glabrata
(24.4%) and Candida parapsilosis (8.1%). In 68 cases >1 species was
identified. The most common infection site was bloodstream (44%), followed
by intra-abdominal (14%). The most frequently affected allograft groups
were liver (41.1%) and kidney (35.3%). All-cause mortality at 90 days was
26.5% for all species and was highest for Candida tropicalis (44%) and C.
parapsilosis (35.2%). Non-white race and female gender were more commonly
associated with non-albicans species. A high rate of breakthrough IC was
seen in patients receiving antifungal prophylaxis (39%). Factors
associated with mortality include organ dysfunction, lung transplant, and
treatment with a polyene antifungal. The only modifiable factor identified
was choice of antifungal drug class based upon infecting Candida species.
Conclusion: These data highlight the common and distinct features of IC in
OTRs. Copyright &#xa9; 2016 John Wiley & Sons A/S. Published by John Wiley
& Sons Ltd

<65>
Accession Number
605474929
Author
Zheng S.; Zhang H.; Li Y.; Han J.; Jia Y.; Meng X.
Institution
(Zheng, Zhang, Li, Han, Jia, Meng) Department of Cardiac Surgery, Beijing
Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang
District, Beijing 100029, China
Title
Comparison of Left Atrial and Biatrial Maze Procedure in the Treatment of
Atrial Fibrillation: A Meta-Analysis of Clinical Studies.
Source
Thoracic and Cardiovascular Surgeon. 64 (8) (pp 661-671), 2016. Article
Number: 143952oc. Date of Publication: 01 Dec 2016.
Publisher
Georg Thieme Verlag (E-mail: kunden.service@thieme.de)
Abstract
Background The outcomes of atrial fibrillation (AF) between biatrial maze
(BAM) and left atrial maze (LAM) are still controversial. The purpose of
this study was to compare the clinical and rhythm outcomes between BAM and
LAM in patients with AF. Methods Electronic databases and article
references were systematically searched (1990-2014) to access relevant
studies. Odds ratio (OR) and weight mean difference (WMD) with 95%
confidence interval (CI) were reported. Results Fourteen studies with
2,075 patients were finally involved in the present meta-analysis. The
rate of restored sinus rhythm (SR) was similar in BAM and LAM groups (OR:
1.25, 95% CI: 0.91-1.72, p = 0.163). BAM reduced the prevalence of atrial
flutter during follow-up (OR: 0.12, 95% CI: 0.01-0.96, p = 0.046).
Compared with BAM, LAM shorten aortic cross-clamping time (WMD = 9.05
minutes, 95% CI: 1.28-16.82, p = 0.023) and cardiopulmonary bypass time
(WMD = 20.21 minutes, 95% CI: 7.40-33.03, p = 0.002). No significant
difference was found between groups in the risk of death (OR: 1.22, 95%
CI: 0.70-2.14, p = 0.233), cerebrovascular events (OR: 1.44, 95% CI:
0.51-4.06, p = 0.493), and reoperation for bleeding (OR: 1.34, 95% CI:
0.70-2.55, p = 0.374). However, the risk for implantation of permanent
pacemaker was significantly higher in BAM group (OR: 2.60, 95% CI:
1.09-6.20, p = 0.031). Conclusion No significant difference was found
between BAM and LAM in the rate of restored SR, the risk of death,
cerebrovascular events, and reoperation for bleeding. BAM is superior to
LAM in reducing the prevalence of atrial flutter during follow-up, but LAM
shortens the aortic cross-clamping time and cardiopulmonary bypass time,
and decreases the risk of permanent pacemaker implantation. Copyright
&#xa9; Georg Thieme Verlag KGStuttgart . New York.

<66>
[Use Link to view the full text]
Accession Number
613333945
Author
Li T.; Sun Z.-L.; Xie Q.-Y.
Institution
(Li) Department of Emergency, First Affiliated Hospital, Zhejiang
University, Hangzhou, China
(Sun, Xie) Department of Cardiology, Xiangya Hospital, Central South
University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, China
Title
Meta-analysis identifies serum c-reactive protein as an indicator of
atrial fibrillation risk after coronary artery bypass graft.
Source
American Journal of Therapeutics. 23 (6) (pp e1586-e1596), 2016. Date of
Publication: 28 Nov 2016.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
A meta-analysis-based study was conducted to examine the clinical value of
serum C-reactive protein (CRP) levels in predicting postoperative atrial
fibrillation (POAF) in patients with coronary artery disease (CAD) who
underwent coronary artery bypass graft. Computer-based search of
scientific literature databases was performed to identify relevant studies
in strict accordance with our inclusion and exclusion criteria. Data
extracted from the selected studies were used to perform metaanalysis
using the STATA 12.0 statistical software. Standardized mean differences
(SMDs) with their 95% confidence interval (95% CI) were calculated. The
database search strategy initially identified 62 articles (Chinese 5 17,
English 5 45). After multiple levels of screening and validation, 15
case-control studies (Chinese 5 1, English 5 14), containing of a total of
3110 atrial fibrillation patients (POAF 5 925, non-POAF 5 2185), were
selected for our meta-analysis. The meta-analysis results confirmed that
serum CRP level was remarkably higher in patients with POAF compared with
non-POAF (SMD 5 1.36; 95% CI, 0.44-2.28; P 5 0.004). Ethnicity-stratified
analysis revealed that elevated serum CRP levels were associated with an
increased risk of POAF in white patients with CAD (SMD 5 0.85; 95% CI,
0.12-1.58; P 5 0.022), but not Asian patients with CAD (SMD 5 3.31, 95%
CI, 20.04 to 6.66; P 5 0.053). Elevated CRP levels, indicating profound
inflammation, may be associated with significantly increased risk of POAF
in patients with CAD who underwent coronary artery bypass graft. Thus,
serum CRP levels are important for early diagnosis and monitoring of POAF
in high-risk patients. Copyright &#xa9; 2015 Wolters Kluwer Health, Inc.

<67>
Accession Number
613318337
Author
Sommer M.S.; Trier K.; Vibe-Petersen J.; Missel M.; Christensen M.; Larsen
K.R.; Langer S.W.; Hendriksen C.; Clementsen P.F.; Pedersen J.H.; Langberg
H.
Institution
(Sommer, Trier, Vibe-Petersen) Copenhagen Centre for Cancer and Health,
City of Copenhagen, Norre Alle 45, Copenhagen DK-2200, Denmark
(Missel, Christensen, Langer, Hendriksen, Clementsen, Pedersen, Langberg)
University of Copenhagen, Copenhagen, Denmark
(Larsen) Bispebjerg University Hospital, Copenhagen, Denmark
(Clementsen) Gentofte University Hospital, Hellerup, Denmark
Title
Perioperative Rehabilitation in Operable Lung Cancer Patients (PROLUCA): A
Feasibility Study.
Source
Integrative Cancer Therapies. 15 (4) (pp 455-466), 2016. Date of
Publication: 01 Dec 2016.
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Introduction. Surgical resection in patients with non-small cell lung
cancer (NSCLC) may be associated with significant morbidity, functional
limitations, and decreased quality of life. Objectives. The safety and
feasibility of a preoperative and early postoperative rehabilitation
program in patients operated for NSCLC was determined in a nonhospital
setting, with focus on high-intensity interval exercise. Methods. Forty
patients with biopsy-proven NSCLC stages I to IIIa referred for surgical
resection at the Department of Cardiothoracic Surgery RT, Rigshospitalet,
University of Copenhagen, were randomly assigned to 1 of 4 groups (3
intervention groups and 1 control group). The preoperative intervention
consisted of a home-based exercise program, while the postoperative
exercise program comprised a supervised group exercise program involving
resistance and high-intensity interval cardiorespiratory exercise 2 hours
weekly for 12 weeks combined with individual counseling. The study
endpoints were inclusion rate, adherence, and number of adverse events.
Results. Forty patients (of 124 screened; 32%) were included and
randomized into the 4 groups. The postoperative exercise was completed by
73% of the patients randomized to this intervention. No adverse events
were observed, indicating that the early postoperative exercise program is
safe. The preoperative home-based exercise program was not feasible due to
interfering diagnostic procedures and fast-track surgery that left only 1
to 2 weeks between diagnosis and surgery. Conclusion. The early
postoperative exercise program for patients with NSCLC was safe and
feasible, but in a fast-track set up, a preoperative home-based exercise
program was not feasible for this population. Copyright &#xa9; The
Author(s) 2016.

<68>
Accession Number
613449381
Author
Thongprayoon C.; Cheungpasitporn W.; Podboy A.J.; Gillaspie E.A.; Greason
K.L.; Kashani K.B.
Institution
(Thongprayoon, Cheungpasitporn, Kashani) Division of Nephrology and
Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN,
United States
(Podboy) Department of Hospital Internal Medicine, Department of Internal
Medicine, Mayo Clinic, Rochester, MN, United States
(Gillaspie, Greason) Division of Cardiovascular Surgery, Department of
Surgery, Mayo Clinic, Rochester, MN, United States
(Kashani) Division of Pulmonary and Critical Care Medicine, Department of
Internal Medicine, Mayo Clinic, Rochester, MN, United States
Title
The effects of contrast media volume on acute kidney injury after
transcatheter aortic valve replacement: a systematic review and
meta-analysis.
Source
Journal of Evidence-Based Medicine. 9 (4) (pp 188-193), 2016. Date of
Publication: 01 Nov 2016.
Publisher
Blackwell Publishing (E-mail: info@asia.blackpublishing.com.au)
Abstract
Objective: The goal of this systematic review was to assess the effects of
contrast media volume on transcatheter aortic valve replacement-related
acute kidney injury. Methods: A literature search was performed using
Medline, EMbase, the Cochrane Database of Systematic Reviews, and
clinicaltrials.gov from the inception of these databases through December
2015. Studies that reported relative risk, odds ratio, or hazard ratio
comparing the risks of acute kidney injury following transcatheter aortic
valve replacement in patients who received high contrast media volume were
included. Pooled risk ratio (RR) and 95% confidence intervals (95% CI)
were calculated using a random-effect, generic inverse variance method.
Results: Four cohort studies composed of 891 patients were included in the
analyses to assess the risk of acute kidney injury after transcatheter
aortic valve replacement in patients who received high contrast media
volume. The pooled RR of acute kidney injury after transcatheter aortic
valve replacement in patients who received a large volume of contrast
media was 1.41 (95% CI, 0.87 to 2.28) compared with low contrast media
volume. The meta-analysis was limited to studies using standard acute
kidney injury definitions, and the pooled RR of acute kidney injury in
patients who received high contrast media volume is 1.12 (95% CI, 0.78 to
1.62). Conclusion: Our meta-analysis shows no significant association
between contrast media volume and risk of acute kidney injury after
transcatheter aortic valve replacement. Copyright &#xa9; 2016 Chinese
Cochrane Center, West China Hospital of Sichuan University and John Wiley
& Sons Australia, Ltd

<69>
Accession Number
613647878
Author
Lipinski M.J.; Lee R.C.; Gaglia M.A.; Torguson R.; Garcia-Garcia H.M.;
Pichard A.D.; Satler L.F.; Waksman R.
Institution
(Lipinski, Lee, Gaglia, Torguson, Garcia-Garcia, Pichard, Satler, Waksman)
Section of Interventional Cardiology, MedStar Washington Hospital Center,
Washington, DC, United States
Title
Comparison of heparin, bivalirudin, and different glycoprotein IIb/IIIa
inhibitor regimens for anticoagulation during percutaneous coronary
intervention: A network meta-analysis.
Source
Cardiovascular Revascularization Medicine. 17 (8) (pp 535-545), 2016. Date
of Publication: 01 Dec 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background/purpose Numerous GPIs are available for PCI. Although they were
tested in randomized controlled trials, a comparison between the different
GPI strategies is lacking. Thus, we performed a Bayesian network
meta-analysis to compare different glycoprotein IIb/IIIa inhibitor (GPI)
strategies with heparin and bivalirudin for percutaneous coronary
intervention (PCI). Methods MEDLINE, Cochrane CENTRAL, and
ClinicalTrials.gov were searched by two independent reviewers for
randomized controlled trials comparing high-dose bolus tirofiban,
abciximab, eptifibatide, heparin with provisional glycoprotein IIb/IIIa
inhibitors, and bivalirudin with provisional GPI that reported clinical
outcomes. Mixed treatment comparison model generation was performed to
directly and indirectly compare between different anticoagulation
strategies for all-cause mortality, myocardial infarction, major adverse
cardiovascular events, major bleeding, minor bleeding, need for
transfusion, and thrombocytopenia. Results A total of 41 randomized
controlled trials with 38,645 patients were included in the analysis,
among which 2654 were randomized to high-dose bolus tirofiban, 6752 to
abciximab, 1669 to eptifibatide, 16,500 to heparin, and 11,070 to
bivalirudin. Mean age was 64 +/- 11 years, 75% were male, 91% were treated
with stenting, 71% with clopidogrel, and 74% for acute coronary syndrome.
High-dose bolus tirofiban was associated with a significant reduction in
all-cause mortality compared with heparin (OR 0.57 [credible intervals
0.37, 0.9]) and eptifibatide (OR 0.44 [credible intervals 0.19, 1.0]). GPI
regimens had less myocardial infarction and major adverse cardiovascular
events but greater bleeding compared with heparin and bivalirudin. There
was no difference among the GPI therapies for other outcomes, including
myocardial infarction, major adverse cardiovascular events, and major
bleeding. Conclusions Our network meta-analysis of 38,645 patients
demonstrated that GPI regimens were associated with a reduction in
recurrent myocardial infarction or major adverse cardiovascular events for
PCI, while bivalirudin was associated with the lowest risk of bleeding.
Copyright &#xa9; 2016

<70>
Accession Number
613696401
Author
Takousi M.G.; Schmeer S.; Manaras I.; Olympios C.D.; Makos G.; Troop N.A.
Institution
(Takousi, Schmeer, Troop) Department of Psychology, Health & Human
Sciences Research Institute, University of Hertfordshire, Hatfield, United
Kingdom
(Manaras) School of Health Sciences, Metropolitan College, Athens, Greece
(Olympios) Department of Cardiology, Thriasio Hospital, Elefsina, Greece
(Makos) Department of Cardiothoracic surgery, Metropolitan Hospital, N.
Faliro, Greece
Title
Health-related quality of life after coronary revascularization: A
systematic review with meta-analysis.
Source
Hellenic Journal of Cardiology. 57 (4) (pp 223-237), 2016. Date of
Publication: 01 Jul 2016.
Publisher
Hellenic Cardiological Society
Abstract
Objective: To conduct a systematic review and meta-analysis to summarize
evidence and determine the impact of coronary revascularization (CR) on
cardiac patients' Health-Related Quality of Life (HRQoL), highlighting
factors that may affect this outcome in patients. Methods: A systematic
search of Medline (Pubmed), EMBASE, Cochrane Library, Sciverse (Science
Direct and Scopus) and PsycInfo was conducted to identify studies
published from January 2000 to December 2012. Data were analyzed using MIX
2.0 Pro and SPSS 20. Results: Thirty-four longitudinal studies met the
inclusion criteria; these studies included 15,992 patients, of whom 8,027
had undergone PCI, 6,348 had undergone CABG and 1,617 had received
medication treatment. Moderate long-term effect sizes were revealed for
both CR procedures. Both percutaneous coronary interventions (PCI) and
coronary artery bypass graft surgery (CABG) had significantly greater
effects on HRQoL than did medication; however, the CR procedures did not
differ significantly from each other. Moderators included the type of
instrument used to assess HRQoL and the study quality. Benefits related to
physical functioning were greater than those related to psychosocial
functioning in patients treated with CABG. Conclusions: Empirical research
highlights the positive effect of CR on patient HRQoL. Researchers should
carefully select the instrument they use to measure HRQoL, as this may
affect the results and thus conclusions. More RCTs and between-group
studies employing pre-post designs should be conducted before clear
conclusions can be drawn. Copyright &#xa9; 2016 Hellenic Cardiological
Society.

<71>
Accession Number
613737307
Author
Conti V.; Marchi M.; Turrini C.; Contoli M.; Rinaldi R.; Cavicchi C.; Papi
A.; Ravenna F.
Institution
(Conti) Unit of Pneumology, San Marino Republic State Hospital, Borgo
Maggiore, San Marino, United States
(Marchi, Turrini, Contoli) Pneumology Unit, Department of Emergency,
University Hospital Arcispedale S. Anna of Ferrara, Cona, Ferrara, Italy
(Rinaldi, Cavicchi, Papi) Pathology Unit, Department of Diagnostic Imaging
and Laboratory Medicine, University Hospital Arcispedale S. Anna of
Ferrara, Cona, Ferrara, Italy
(Ravenna) Unit of Pneumology, Carlo Poma Hospital, Mantova, Italy
Title
Transbronchial needle aspiration: ThinPrep versus the conventional smear
technique in the diagnosis of lung cancer.
Source
Minerva Pneumologica. 55 (4) (pp 85-93), 2016. Date of Publication:
December 2016.
Publisher
Edizioni Minerva Medica (E-mail: subscriptions.dept@minervamedica.it)
Abstract
Background: approximately 70% of patients with lung cancer present at an
advanced stage of their disease and are therefore unresectable.
Bronchoscopy is often the frst procedure performed, and the diagnosis is
usually based on small biopsies and cytology specimens. cytology is
assuming an increasingly relevant role, not only to make a pathologic
diagnosis but also to obtain a biomolecular profle of the cancer.
Liquid-based cytology, such as ThinPrep (TP), unlike the conventional
smear (CS) technique, attempts to preserve enough material for ancillary
tests, such as immunochemistry and molecular tests. The aim of this study
was to evaluate the role of TP compared to cS in the diagnosis of lung
cancer using transbronchial needle aspiration (TBNA) to obtain samples.
MeTHoDS: We performed bronchoschopy on 101 consecutive patients with
suspicious pulmonary lesions. For each patient, approximately 4
cytological samples were collected using TBNa. The 4 samples were
examined, alternating TP and CS techniques. For each patient, the method
employed in the examination of the frst sample was decided using a
randomized list. The cytopathologic results from each method were compared
to the defnitive diagnosis obtained through bronchoscopy techniques,
thoracic surgery, other invasive procedures or clinical follow-up.
RESULTS: In 81 of the 101 cases (81%), lung cancer diagnosis was confrmed.
In 20 cases (19%), the disease was benign. CS and TP have shown
sensitivities of 57% and 58%, specifcities of 100% and 100%, positive
predictive values of 100% and 100%, negative predictive values of 39% and
46% and accuracies of 66% and 74%, respectively. roc curves were then used
to compare the two methods; the difference was not statistically
signifcant (P=0.415). Inadequate material was observed in 7 cases with CS
and in no cases with TP. In 19 patients (19%), a rapid on-site evaluation
(ROSE) was also performed. in these cases, the sensitivity, negative
predictive value and accuracy of TBNa were 85%, 75% and 90%, respectively;
in the remaining 82 cases in which roSe was not employed, the cS and TP
results were 54%, 33% and 62%. In particular, the difference detected was
statistically signifcant for NPV (P<0.0005) and accuracy (P<0.05) when
comparing roSe to cS or TP alone using Fisher s exact Test. coNcluSioNS:
We demonstrated that the diagnostic yield of TP is substantially equal to
that achieved with cS in lung cancer disease. TP offers advantages in
terms of reproducibility, easier slide evaluation, and above all, the
possibility of molecular testing. However, cS allows the use of roSe,
which considerably improves TBNa accuracy. We believe that the two methods
could be used together in the diagnosis of lung cancer, integrating their
respective advantages to choose the most appropriate and personalized
treatment for the patient. Copyright &#xa9; 2016 Edizioni Minerva Medica.

<72>
[Use Link to view the full text]
Accession Number
613408824
Author
Gibson C.M.; Korjian S.; Tricoci P.; Daaboul Y.; Yee M.; Jain P.;
Alexander J.H.; Steg P.G.; Lincoff A.M.; Kastelein J.J.P.; Mehran R.;
D'Andrea D.M.; Deckelbaum L.I.; Merkely B.; Zarebinski M.; Ophuis T.O.;
Harrington R.A.
Institution
(Gibson, Korjian, Daaboul, Yee, Jain) PERFUSE Study Group, Cardiovascular
Division, Department of Medicine, Beth Israel Deaconess Medical Center,
Harvard Medical School, 330 Brookline Avenue, Overland 540, Boston, MA
02215, United States
(Tricoci, Alexander) Duke Clinical Research Institute, Cardiovascular
Division, Department of Medicine, Duke University Health, Durham, NC,
United States
(Steg) INSERM-Unite 1148, France Assistance Publique-Hopitaux de Paris,
Hopital Bichat, France Universite Paris-Diderot, Sorbonne- Paris Cite,
France National Heart and Lung Institute, Paris, France
(Steg) Imperial College London, UK Institute of Cardiovascular Medicine
and Science, Royal Brompton Hospital, London, United Kingdom
(Lincoff) Department of Cardiovascular Medicine, Cleveland Clinic
Foundation, Cleveland, OH, United States
(Kastelein) Department of Vascular Medicine, Academic Medical Center,
University of Amsterdam, Amsterdam, Netherlands
(Mehran) Cardiovascular Institute, Mount Sinai Medical Center, Icahn
School of Medicine at Mount Sinai, New York, United States
(D'Andrea, Deckelbaum) CSL Behring, LLC, King of Prussia, PA, United
States
(Merkely) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
(Zarebinski) Department of Cardiology, Warsaw Medical University, Warsaw,
Poland
(Ophuis) Department of Cardiology, Canisius Wilhelmina Ziekenhuis,
Nijmegen, Netherlands
(Harrington) Department of Medicine, Stanford University, Stanford, CA,
United States
Title
Safety and Tolerability of CSL112, a Reconstituted, Infusible,
Plasma-Derived Apolipoprotein A-I, after Acute Myocardial Infarction: The
AEGIS-I Trial (ApoA-I Event Reducing in Ischemic Syndromes I).
Source
Circulation. 134 (24) (pp 1918-1930), 2016. Date of Publication: 13 Dec
2016.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: Human or recombinant apolipoprotein A-I (apoA-I) has been
shown to increase high-density lipoprotein-mediated cholesterol efflux
capacity and to regress atherosclerotic disease in animal and clinical
studies. CSL112 is an infusible, plasma-derived apoA-I that has been
studied in normal subjects or those with stable coronary artery disease.
This study aimed to characterize the safety, tolerability,
pharmacokinetics, and pharmacodynamics of CSL112 in patients with a recent
acute myocardial infarction. Methods: The AEGIS-I trial (Apo-I Event
Reducing in Ischemic Syndromes I) was a multicenter, randomized,
double-blind, placebo-controlled, dose-ranging phase 2b trial. Patients
with myocardial infarction were stratified by renal function and
randomized 1:1:1 to CSL112 (2 g apoA-I per dose) and high-dose CSL112 (6 g
apoA-I per dose), or placebo for 4 consecutive weekly infusions. Coprimary
safety end points were occurrence of either a hepatic safety event (an
increase in alanine transaminase >3 times the upper limit of normal or an
increase in total bilirubin >2 times the upper limit of normal) or a renal
safety event (an increase in serum creatinine >1.5 times the baseline
value or a new requirement for renal replacement therapy). Results: A
total of 1258 patients were randomized, and 91.2% received all 4
infusions. The difference in incidence rates for an increase in alanine
transaminase or total bilirubin between both CSL112 arms and placebo was
within the protocol-defined noninferiority margin of 4%. Similarly, the
difference in incidence rates for an increase in serum creatinine or a new
requirement for renal replacement therapy was within the protocol-defined
noninferiority margin of 5%. CSL112 was associated with increases in
apoA-I and ex vivo cholesterol efflux similar to that achieved in patients
with stable coronary artery disease. In regard to the secondary efficacy
end point, the risk for the composite of major adverse cardiovascular
events among the groups was similar. Conclusions: Among patients with
acute myocardial infarction, 4 weekly infusions of CSL112 are feasible,
well tolerated, and not associated with any significant alterations in
liver or kidney function or other safety concern. The ability of CSL112 to
acutely enhance cholesterol efflux was confirmed. The potential benefit of
CSL112 to reduce major adverse cardiovascular events needs to be assessed
in an adequately powered phase 3 trial. Copyright &#xa9; 2016 The Authors.

<73>
Accession Number
611991426
Author
Vlahou A.; Diplaris K.; Ampatzidou F.; Karagounnis L.; Drossos G.
Institution
(Vlahou, Diplaris, Ampatzidou, Drossos) Department of Cardiothoracic
Surgery, General Hospital "George Papanikolaou", Exohi Thessalonikis,
Thessaloniki 57010, Greece
(Karagounnis) Departement of Cardiology, Interbalkan Medical Center,
Thessaloniki, Greece
Title
The Role of Blood Transfusion in the Development of Atrial Fibrillation
after Coronary Artery Bypass Grafting.
Source
Thoracic and Cardiovascular Surgeon. 64 (8) (pp 688-692), 2016. Article
Number: 154399oc. Date of Publication: 01 Dec 2016.
Publisher
Georg Thieme Verlag (E-mail: kunden.service@thieme.de)
Abstract
Objectives Atrial fibrillation (AF) is the most common complication after
coronary artery bypass grafting (CABG). It is associated with prolonged
hospital stay and increased cost. The aim of this study is to investigate
the relationship between transfusion of blood derivatives and occurrence
of postoperative paroxysmal AF. Materials and Methods From June 2012 to
February 2014, 446 patients undergoing CABG with cardiopulmonary bypass
(CPB) were prospectively evaluated for occurrence of postoperative AF.
Patients and procedural variables were recorded and were associated with
the development of new-onset AF with logistic regression analysis. Results
AF developed in 111 patients (24.9%). Preoperative factors associated with
the development of new-onset AF included age (p < 0.05), higher EuroSCORE
II (p < 0.05), carotid disease (p = 0.01), peripheral vascular disease (p
= 0.02), chronic obstructive pulmonary disease (p = 0.03), renal failure
(p = 0.05), and cardiac failure (p = 0.01). Intraoperative and
postoperative parameters included duration of CPB (p < 0.05), number of
grafts (p = 0.009), intubation time (p = 0.001), occurrence of
postoperative stroke (p = 0.01), transient ischemic attack (p = 0.02),
need for prolonged ventilation (p = 0.002), development of respiratory
tract infection (p = 0.02), need for noninvasive ventilation (p = 0.001),
reintubation (p = 0.02), development of postoperative acute kidney injury
(p = 0.002), and postoperative neurocognitive dysfunction (p = 0.002). The
number of red blood cell (RBC) units transfused during surgery (p = 0.7)
and the total number of RBC units transfused (p = 0.2) as well as units of
fresh frozen plasma (p = 0. 7) and platelets units transfused in total (p
= 0.3) were not found to increase the risk of postoperative AF. Conclusion
Intraoperative and postoperative blood products transfusion in patients
operated for CABG is not associated with increased risk of developing
postoperative AF. Copyright &#xa9; Georg Thieme Verlag KGStuttgart . New
York.

<74>
Accession Number
613629810
Author
Adelborg K.; Sundboll J.; Munch T.; Froslev T.; Sorensen H.T.; Botker
H.E.; Schmidt M.
Institution
(Adelborg, Sundboll, Munch, Froslev, Sorensen, Schmidt) Department of
Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
(Adelborg, Sundboll, Botker) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
(Schmidt) Department of Internal Medicine, Randers Regional Hospital,
Randers, Denmark
Title
Positive predictive value of cardiac examination, procedure and surgery
codes in the Danish National Patient Registry: A population-based
validation study.
Source
BMJ Open. 6 (12) (no pagination), 2016. Article Number: e012817. Date of
Publication: 01 Dec 2016.
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Objective: Danish medical registries are widely used for cardiovascular
research, but little is known about the data quality of cardiac
interventions. We computed positive predictive values (PPVs) of codes for
cardiac examinations, procedures and surgeries registered in the Danish
National Patient Registry during 2010-2012. Design: Population-based
validation study. Setting: We randomly sampled patients from 1 university
hospital and 2 regional hospitals in the Central Denmark Region.
Participants: 1239 patients undergoing different cardiac interventions.
Main outcome measure: PPVs with medical record review as reference
standard. Results: A total of 1233 medical records (99% of the total
sample) were available for review. PPVs ranged from 83% to 100%. For
examinations, the PPV was overall 98%, reflecting PPVs of 97% for
echocardiography, 97% for right heart catheterisation and 100% for
coronary angiogram. For procedures, the PPV was 98% overall, with PPVs of
98% for thrombolysis, 92% for cardioversion, 100% for radiofrequency
ablation, 98% for percutaneous coronary intervention, and 100% for both
cardiac pacemakers and implantable cardiac defibrillators. For cardiac
surgery, the overall PPVs was 99%, encompassing PPVs of 100% for mitral
valve surgery, 99% for aortic valve surgery, 98% for coronary artery
bypass graft surgery, and 100% for heart transplantation. The accuracy of
coding was consistent within age, sex, and calendar year categories, and
the agreement between independent reviewers was high (99%). Conclusions:
Cardiac examinations, procedures and surgeries have high PPVs in the
Danish National Patient Registry.

<75>
Accession Number
613626628
Author
Hatemi A.C.; Ceviker K.; Tongut A.; Ozgol I.; Mert M.; Kaya A.
Institution
(Hatemi, Mert) Department of Cardiovascular Surgery, Institute of
Cardiology, Istanbul University, Istanbul, Turkey
(Ceviker, Ozgol) Department of Cardiovascular Surgery, Faculty of
Medicine, Suleyman Demirel University, Isparta, Turkey
(Tongut) Pediatric Cardiac Surgery Clinic, Kartal Kosuyolu YIEAH,
Istanbul, Turkey
(Kaya) Division of Biochemistry, Institute of Cardiology, Istanbul
University, Istanbul, Turkey
Title
Oxidant Status following Cardiac Surgery with Phosphorylcholine-Coated
Extracorporeal Circulation Systems.
Source
Oxidative Medicine and Cellular Longevity. 2016 (no pagination), 2016.
Article Number: 3932092. Date of Publication: 2016.
Publisher
Hindawi Publishing Corporation (410 Park Avenue, 15th Floor, 287 pmb, New
York NY 10022, United States)
Abstract
Introduction. Extracorporeal circulation (ECC) related systemic oxidative
stress is a well-known entity but the underlying mechanisms are not
clearly described. Our aim was to investigate the relation between the
oxidative stress indices, inflammatory markers, and
phosphorylcholine-coated (PCC) ECC systems. Patients and Methods.
Thirty-two consecutive coronary artery bypass grafting (CABG) cases were
randomly assigned to Group I (PCC, n=18) and Group II (noncoated, n=14)
ECC circuits. Total Antioxidant Status (TAS), Total Oxidant Status (TOS),
Tumor Necrosis Factor-alpha (TNF-alpha), Interleukin-1beta (IL-beta),
Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-10 (IL-10), and
Procalcitonin (PCT) levels were measured at 5 different time points. The
association between the oxidative indices levels and PCC system used was
analyzed. Results. In Group I TOS and TAS statuses were increased at T1,
T2, T3, and T4, while IL-10 and TNF-alpha levels accompanied those raises
only at T2 (Group I-Group II, 4.73+/-2.04 versus 2.79+/-0.63, p=0.002, and
30.56+/-8.11 versus 23.97+/-7.8, p=0.031, resp.). In contrast, mean TAS
and TOS levels were similar to baseline at all time points in Group II but
IL-6 and IL-8 levels were increased at T2 (Group I-Group II, 16.84+/-5.63
versus 44.81+/-17.0, p=0.001, and 38.88+/-9.8 versus 46.14+/-9.25,
p=0.038, resp.). Conclusion. Even coated ECC systems are still incapable
of attenuating the inflammatory response to cardiopulmonary bypass (CPB).
Copyright &#xa9; 2016 Ali Can Hatemi et al.

<76>
Accession Number
613675060
Author
Khorasani H.; Lassen M.H.; Kuzon W.; Bonde C.
Institution
(Khorasani, Lassen, Bonde) Department of Plastic Surgery, Breast Surgery
and Burns, Section 2102, Centre of Head and Orthopaedics, Rigshospitalet,
Copenhagen University Hospital, Denmark
(Kuzon) Section of Plastic Surgery, University of Michigan, Ann Arbor, MI,
United States
Title
Scientific impact of presentations from the EURAPS and the AAPS meetings:
A 10-year review.
Source
Journal of Plastic, Reconstructive and Aesthetic Surgery. 70 (1) (pp
31-36), 2017. Date of Publication: 01 Jan 2017.
Publisher
Churchill Livingstone
Abstract
Introduction Presentation at scientific meetings is the usual first step
to communicate new research findings. However, without subsequent,
peer-reviewed publication, the wider propagation and the permanent
documentation of important scholarly work may be lost. Our aim was to
analyze and compare the publication status of the work presented at the
European Association of Plastic Surgeons' (EURAPS) and at the American
Association of Plastic Surgeons' (AAPS) annual meetings. Materials and
methods By using the abstract booklets from the annual meetings, all
presentations given over a 10-year period (2000-2009) were analyzed. A
search using PubMed and Google Scholar was performed to obtain publication
status of each presentation as of 2014 (observation period: 5 years). Data
were analyzed according to subspecialty. Weighted chi-square was used to
examine differences in publication rates for the two societies and for
English speaking vs. non-English speaking countries. Results Seventy-two
percent (n = 246) of the abstracts from the AAPS were published in
peer-reviewed journals. The most published subspecialty was "Craniofacial
surgery" followed by "Breast surgery." Mean time to publication was 22.1
months (range -72-111 months). The most common journal for publication was
Plastic and Reconstructive Surgery (PRS). Sixty-seven percent (n = 449) of
the EURAPS abstracts were published in peer-reviewed journals. The most
published subspecialty was "Microsurgery" followed by "Clinical studies."
The mean time to publication was 17.3 months (range -67-111 months). The
most common journal for publication was PRS. Differences between the two
societies' publication status were not observed (p = 0.157), but EURAPS
abstracts had a significantly shorter time to publication (p = 0.007).
Differences between English-speaking and non-English-speaking countries
were not observed (p = 0.931). Mean level of evidence for published
studies from the AAPS and the EURAPS meetings was 3.5 and 3.7,
respectively. Conclusion A majority of the presented abstracts from both
societies have resulted in publication. After "The Society for
Cardiothoracic Surgery," AAPS and EURAPS have the highest publication
rates for surgical abstracts, indicating a high scientific value of these
meetings. Copyright &#xa9; 2016 British Association of Plastic,
Reconstructive and Aesthetic Surgeons

<77>
Accession Number
612895883
Author
Panosian J.; Ding S.-A.; Wewalka M.; Simonson D.C.; Goebel-Fabbri A.;
Foster K.; Halperin F.; Vernon A.; Goldfine A.B.
Institution
(Panosian, Ding, Wewalka, Goebel-Fabbri, Foster, Halperin, Goldfine)
Research Division, Section of Clinical Behavioral and Outcomes Research,
Joslin Diabetes Center, Boston, Mass, United States
(Ding, Wewalka, Simonson, Goebel-Fabbri, Halperin, Vernon, Goldfine)
Harvard Medical School, Boston, Mass, United States
(Simonson, Halperin, Vernon, Goldfine) Division of Endocrinology, Brigham
and Women's Hospital, Boston, Mass, United States
(Vernon) Division of General & Gastrointestinal Surgery, Department of
Surgery, Brigham and Women's Hospital, Boston, Mass, United States
Title
Physical Activity in Obese Type 2 Diabetes After Gastric Bypass or Medical
Management.
Source
American Journal of Medicine. 130 (1) (pp 83-92), 2017. Date of
Publication: 01 Jan 2017.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background The purpose of this study was to compare effects of Roux-en-Y
gastric bypass versus a multidisciplinary, group-based medical diabetes
and weight management program on physical fitness and behaviors. Methods
Physical behavior and fitness were assessed in participants of the study
Surgery or Lifestyle With Intensive Medical Management in the Treatment of
Type 2 Diabetes (SLIMM-T2D) (NCT01073020), a randomized, parallel-group
trial conducted at a US academic hospital and diabetes clinic with 18- to
24-month follow-up. Thirty-eight type 2 diabetes patients with hemoglobin
A<inf>1c</inf> >6.5% and body mass index 30-42 kg/m² were
randomized to Roux-en-Y gastric bypass or the medical program. A 6-minute
walk test to evaluate fitness, self-reported physical activity,
standardized physical surveys, and cardiometabolic risk assessment were
performed at baseline and after intervention. Results Both groups
similarly improved 6-minute walk test distance, with greater improvements
in oxygen saturation and reduced heart rate after surgery. Self-reported
physical activity improved similarly at 18-24 months after interventions,
although exercise increased gradually after surgery, whereas early
substantial increases in the medical group were not fully sustained.
Self-reported total and physical health were similar by Short Form-36 but
improved more in the Impact of Weight on Quality of Life survey after
surgery. Improvement in cardiovascular risk scores, HbA<inf>1c</inf>, and
body mass index were greater after surgery. Conclusion In this small,
randomized study, both interventions led to therapeutic lifestyle changes
and improved objective and self-reported physical fitness. Greater
improvements in heart rate, oxygen saturation, and perceived impact of
weight on health were seen after surgery, which could be attributable to
greater weight loss. The clinical importance of these improvements with
greater weight loss warrants further investigation. Copyright &#xa9; 2016
Elsevier Inc.

<78>
[Use Link to view the full text]
Accession Number
611973953
Author
Bradley D.; Moreira S.; Subramoney V.; Chin C.; Ives J.; Wang K.
Institution
(Bradley, Ives) Roche Products Ltd, Welwyn Garden City, United Kingdom
(Moreira) Pfizer, Inc, Madison, NJ, United States
(Subramoney) Certara USA, Inc, Princeton, NJ, United States
(Chin) Cincinnati Children's Hospital Medical Center, Cincinnati, OH,
United States
(Wang) Pharma Research and Early Development, Roche Translational and
Clinical Research Center, 430 E. 29th St., New York, NY 10016, United
States
Title
Pharmacokinetics and safety of valganciclovir in pediatric heart
transplant recipients 4 months of age and younger.
Source
Pediatric Infectious Disease Journal. 35 (12) (pp 1324-1328), 2016. Date
of Publication: 28 Nov 2016.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: Valganciclovir (VGCV) effectively prevents cytomegalovirus
disease in adult and pediatric solid organ transplant recipients. A dosing
algorithm for VGCV for pediatric patients, based on body surface area and
renal function, provides a personalized dose using age-Appropriate
formulations. The suitability of this dosing algorithm has not been
assessed specifically in infants and neonates 4 months of age and younger
receiving a solid organ transplant. Methods: This multicenter prospective
study evaluated the pharmacokinetics (PK) and safety of VGCV oral solution
in 17 heart transplant recipients 4 months of age and younger who received
2 doses of VGCV on consecutive days using the pediatric dosing algorithm.
Plasma concentrations of ganciclovir (GCV) were analyzed at specified
times up to 24 hours post VGCV administration. Results: GCV concentration
data were available from 16 patients. The combined data from this study
and historic study datasets were used to establish a 2-compartment
population PK model with first-order formation to describe the PK of GCV
after oral VGCV administration in patients across all pediatric age
ranges, including those younger than 4 months of age. Estimated mean area
under the curve during the 0-24 hours dosing interval for these patients
was 68.1 mug.h/mL. Conclusions: The pediatric dosing algorithm for VGCV
(utilizing individuals' body surface area and renal function) provides
systemic GCV exposures in patients younger than 4 months that are similar
to those observed in older pediatric populations. The data indicate that
this dosing algorithm is appropriate across the entire pediatric age
range, including this youngest age group. Copyright &#xa9; 2016 Wolters
Kluwer Health, Inc. All rights reserved.

<79>
Accession Number
613255156
Author
Yoon J.H.; Choi J.-I.; Jeong Y.Y.; Schenk A.; Chen L.; Laue H.; Kim S.Y.;
Lee J.M.
Institution
(Yoon, Lee) Radiology, Seoul National University Hospital, Seoul, South
Korea
(Yoon, Lee) College of Medicine, Seoul, South Korea
(Choi) Radiology, Catholic Medical Center, Seoul, South Korea
(Jeong) Chonnam National University Hwasun Hospital and Medical School,
Gwang-Ju, South Korea
(Schenk, Chen, Laue) Fraunhofer Mevis, Bremen, Germany
(Kim) Radiology, Asan Medical Center, Seoul, South Korea
(Lee) Institute of Radiation Medicine, Seoul National University Medical
Research Center, 103 Daehak-ro, Jongno-gu, Seoul 03087, South Korea
Title
Pre-treatment estimation of future remnant liver function using gadoxetic
acid MRI in patients with HCC.
Source
Journal of Hepatology. 65 (6) (pp 1155-1162), 2016. Date of Publication:
01 Dec 2016.
Publisher
Elsevier B.V.
Abstract
Background & Aims This study aimed to determine whether the predicted
remnant liver function on dynamic hepatocyte-specific contrast
media-enhanced magnetic resonance (DHCE-MR) imaging correlates with the
results of the indocyanin green retention test (ICG R<inf>15</inf>) after
hepatic resection or radiofrequency ablation (RFA). Methods This
prospective multicenter study was approved by the Institutional Review
Boards of each hospital. Informed consents were obtained from all.
DHCE-MRI and ICG R<inf>15</inf> were performed in 57 patients scheduled to
undergo hepatectomy or RFA for hepatocellular carcinoma, once before
treatment and repeated on post-treatment day 3. In nine donors and three
recipients, DHCE-MRI and ICG R<inf>15</inf> were performed only
preoperatively. The predicted remnant liver function (HEFml) was estimated
using the hepatic extraction fraction (HEF) multiplied by the remnant
liver volume, and compared with post-treatment ICG R<inf>15</inf>.
Intra-individual heterogeneity of HEF was assessed using pooled
coefficients of variation (CV) among hepatic segments. Finally,
development of post-treatment hepatic failure was assessed according to
the 50-50 criteria on post-treatment day 5. Results Predicted remnant
HEFml showed a negative correlation with post-treatment ICG R<inf>15</inf>
(r = -0.45, p = 0.001), whereas liver volume did not (p >0.05). There were
significant correlations between pre-treatment HEFml and pre-treatment ICG
R<inf>15</inf> (r = -0.33, p = 0.006) and between post-treatment HEFml and
post-treatment ICG R<inf>15</inf> (r = -0.54, p <0.001). Pooled CV among
segmental HEFs was 12.6%. No patients showed post-treatment liver failure
on post-treatment day 5. Conclusions DHCE-MRI using Gd-EOB-DTPA was able
to provide both global and segmental liver function information, and
post-treatment remnant liver function predicted on pre-treatment DHCE-MRI
showed a significant negative correlation with post-treatment ICG
R<inf>15</inf>. Lay summary Post-treatment liver function could be
predicted at pre-treatment DHCE-MRI. Liver function was heterogeneous
among the liver segments. Liver anatomy, disease extent, and underlying
liver function can be assessed in one DHCE-MRI examination. Clinical trial
number ClinicalTrials.gov number, NCT01490203. Copyright &#xa9; 2016
European Association for the Study of the Liver

<80>
Accession Number
613335187
Author
Kinnaird T.; Kwok C.S.; Narain A.; Butler R.; Ossei-Gerning N.; Ludman P.;
Moat N.; Anderson R.; Mamas M.A.
Institution
(Kinnaird, Ossei-Gerning, Anderson) Department of Cardiology, University
Hospital of Wales, Cardiff, United Kingdom
(Kwok, Butler, Mamas) Academic Department of Cardiology, University
Hospital of North Midlands, Stoke-on-Trent, United Kingdom
(Kwok, Narain, Butler, Mamas) Cardiovascular Research Group, Keele
University, Stoke-on-Trent, United Kingdom
(Ludman) Department of Cardiology, Queen Elizabeth Hospital, Birmingham,
United Kingdom
(Moat) Department of Cardiothoracic Surgery, Royal Brompton Hospital,
United Kingdom
Title
Meta-Analysis of Percutaneous Coronary Intervention With Drug-Eluting
Stent Versus Coronary Artery Bypass Grafting for Isolated Proximal Left
Anterior Descending Coronary Disease.
Source
American Journal of Cardiology. 118 (8) (pp 1171-1177), 2016. Date of
Publication: 15 Oct 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
We performed a meta-analysis of the studies comparing the efficacy and
safety of coronary artery bypass surgery against percutaneous coronary
intervention with drug-eluting stents (PCI-DES) in patients with isolated
LAD disease. Because of the limited randomized trial data, the optimal
revascularization strategy for patients with isolated LAD disease remains
uncertain. Using MEDLINE and EMBASE to source data, 11 studies (3
randomized trials and 8 cohort studies) including 5,044 participants were
identified. No significant difference in mortality between PCI-DES and
coronary artery bypass surgery (CABG; 111 of 2,122 [5.2%] and 120 of 2,574
[4.7%]; relative risk [RR] 1.23; 95% confidence interval [CI] 0.90 to
1.69) was detected. For MACE, PCI-DES was associated with significant
increase in adverse events (RR 1.41; 95% CI 1.03 to 1.93, 8 studies, 4,230
participants). There were no significant differences in the risk of
myocardial infarction (RR 0.86; 95% CI 0.58 to 1.26) or stroke (RR 2.36;
95% CI 0.54 to 10.43) between the 2 groups. There were 239 target vessel
revascularization (TVR) events among 2,237 participants in the PCI-DES
group (10.7%) and 145 TVR events among 2,793 participants in the CABG
group (5.2%) with a significant increased risk of TVR in the PCI group (RR
2.52; 95% CI 1.69 to 3.77, 5,030 participants) compared with CABG. In
conclusion, for patients with isolated disease of the LAD, meta-analysis
of the available data suggests revascularization with a PCI-DES strategy
offers similar mortality, MI, and stroke rates to CABG at the expense of
increased TVR. Much of the data are derived from registries using
first-generation DES, and further randomized trials with more contemporary
platforms are needed. Copyright &#xa9; 2016 Elsevier Inc.

<81>
[Use Link to view the full text]
Accession Number
613845446
Author
Batra J.; Toyoda N.; Goldstone A.B.; Itagaki S.; Egorova N.N.; Chikwe J.
Institution
(Batra, Toyoda, Itagaki, Chikwe) Department of Cardiovascular Surgery,
Mount Sinai Hospital, 1190 Fifth Ave, New York, NY 10029, United States
(Egorova) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Goldstone) Department of Cardiothoracic Surgery, Stanford University
School of Medicine, CA, United States
Title
Extracorporeal Membrane Oxygenation in New York State: Trends, Outcomes,
and Implications for Patient Selection.
Source
Circulation: Heart Failure. 9 (12) (no pagination), 2016. Article Number:
e003179. Date of Publication: 01 Dec 2016.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background - Utilization of extracorporeal membrane oxygenation (ECMO) is
expanding despite limited outcome data defining appropriate use. Methods
and Results - To quantify determinants of early and 1-year survival after
ECMO in adult patients, we conducted a retrospective cohort analysis of
1286 patients aged >18 years who underwent ECMO in New York State from
2003 to 2014. Median follow-up time was 4.9 months (range, 0-12 months).
ECMO utilization increased from 13 patients in 8 hospitals in 2003 to 330
patients in 30 hospitals in 2014. Compared with patients undergoing ECMO
before 2009, later patients were older (54.4 versus 52.3 years; P=0.013)
and more likely to have major comorbidity including chronic kidney disease
(25.2% versus 13.2%; P=0.02) and liver disease (20.0% versus 10.7%;
P=0.001). In the overall cohort, 30-day mortality was 52.2% (95%
confidence interval, 49.5-54.9). Mortality at 30 days was 65.2% for
patients aged >75 years (n=73/112) and 74.6% in patients who required
cardiopulmonary resuscitation (n=91/122). Survival at 1 year was 38.4%
(95% confidence interval, 35.7-41.0). The 30-day mortality and 1-year
survival improved across the study period. In multivariable analysis,
earlier year of ECMO, lower hospital volume, indication for ECMO after a
cardiac procedure, cardiopulmonary resuscitation before ECMO placement,
and age >65 years were independent predictors of worse survival.
Conclusions - Outcomes of ECMO have improved despite increasing
comorbidity. Extreme mortality after ECMO in elderly patients and patients
requiring cardiopulmonary resuscitation indicates that less invasive
therapeutic or palliative modalities may be more appropriate in this
end-of-life setting. Copyright &#xa9; 2016 American Heart Association,
Inc.

<82>
Accession Number
613800486
Author
Badhwar V.; Rankin J.S.; Damiano R.J.; Gillinov A.M.; Bakaeen F.G.;
Edgerton J.R.; Philpott J.M.; McCarthy P.M.; Bolling S.F.; Roberts H.G.;
Thourani V.H.; Suri R.M.; Shemin R.J.; Firestone S.; Ad N.
Institution
(Badhwar, Rankin, Ad) Division of Cardiothoracic Surgery, West Virginia
University, Morgantown, West Virginia, United States
(Damiano) Division of Cardiothoracic Surgery, Washington University, St.
Louis, Missouri, United States
(Gillinov, Bakaeen, Suri) Division of Thoracic and Cardiovascular Surgery,
Cleveland Clinic, Cleveland, Ohio, United States
(Edgerton) Department of Cardiothoracic Surgery, Baylor Plano Heart
Hospital, Plano, Texas, United States
(Philpott) Department of Cardiothoracic Surgery, Sentara Heart Hospital,
Norfolk, Virginia, United States
(McCarthy) Division of Cardiac Surgery, Northwestern University Feinberg
School of Medicine, Chicago, Illinois, United States
(Bolling) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, Michigan, United States
(Roberts) Department of Cardiovascular Services, Florida Heart and
Vascular Care at Aventura, Aventura, Florida, United States
(Thourani) Division of Cardiothoracic Surgery, Emory University, Atlanta,
Georgia
(Shemin) Division of Cardiothoracic Surgery, University of California Los
Angeles David Geffen School of Medicine, Los Angeles, California, United
States
(Firestone) The Society of Thoracic Surgeons, Chicago, Illinois, United
States
Title
The Society of Thoracic Surgeons 2017 Clinical Practice Guidelines for the
Surgical Treatment of Atrial Fibrillation.
Source
Annals of Thoracic Surgery. 103 (1) (pp 329-341), 2017. Date of
Publication: 01 Jan 2017.
Publisher
Elsevier USA
Abstract
Executive Summary Surgical ablation for atrial fibrillation (AF) can be
performed without additional risk of operative mortality or major
morbidity, and is recommended at the time of concomitant mitral operations
to restore sinus rhythm. (Class I, Level A) Surgical ablation for AF can
be performed without additional operative risk of mortality or major
morbidity, and is recommended at the time of concomitant isolated aortic
valve replacement, isolated coronary artery bypass graft surgery, and
aortic valve replacement plus coronary artery bypass graft operations to
restore sinus rhythm. (Class I, Level B nonrandomized) Surgical ablation
for symptomatic AF in the absence of structural heart disease that is
refractory to class I/III antiarrhythmic drugs or catheter-based therapy
or both is reasonable as a primary stand-alone procedure, to restore sinus
rhythm. (Class IIA, Level B randomized) Surgical ablation for symptomatic
persistent or longstanding persistent AF in the absence of structural
heart disease is reasonable, as a stand-alone procedure using the Cox-Maze
III/IV lesion set compared with pulmonary vein isolation alone. (Class
IIA, Level B nonrandomized) Surgical ablation for symptomatic AF in the
setting of left atrial enlargement (>4.5 cm) or more than moderate mitral
regurgitation by pulmonary vein isolation alone is not recommended. (Class
III no benefit, Level C expert opinion) It is reasonable to perform left
atrial appendage excision or exclusion in conjunction with surgical
ablation for AF for longitudinal thromboembolic morbidity prevention.
(Class IIA, Level C limited data) At the time of concomitant cardiac
operations in patients with AF, it is reasonable to surgically manage the
left atrial appendage for longitudinal thromboembolic morbidity
prevention. (Class IIA, Level C expert opinion) In the treatment of AF,
multidisciplinary heart team assessment, treatment planning, and long-term
follow-up can be useful and beneficial to optimize patient outcomes.
(Class I, Level C expert opinion) Copyright &#xa9; 2017 The Society of
Thoracic Surgeons

<83>
Accession Number
613811038
Author
Ongkasuwan J.; Ocampo E.; Tran B.
Institution
(Ongkasuwan) Department of Otolaryngology Head and Neck Surgery, Baylor
College of Medicine/Texas Children's Hospital, Texas, United States
(Ocampo) Department of Pediatric Cardiology, Texas Children's Hospital,
Houston, TX, United States
(Tran) Department of Pediatric Radiology, Texas Children's Hospital,
Houston, TX, United States
Title
Laryngeal ultrasound and vocal fold movement in the pediatric
cardiovascular intensive care unit.
Source
Laryngoscope. 127 (1) (pp 167-172), 2017. Date of Publication: 01 Jan
2017.
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objectives/Hypothesis: Vocal fold motion impairment (VFMI) is a known
sequela of cardiovascular surgery. The gold standard for the evaluation of
vocal fold movement is flexible nasolaryngoscopy (FNL). Although safe, FNL
does cause measurable physiologic changes. Noxious stimuli in
cardiovascular intensive care unit (CVICU) neonates may cause imbalance
between the pulmonary and systemic circulations and potentially
circulatory collapse. The goals of this project were to determine the
accuracy of laryngeal ultrasound (LUS) compared to FNL to identify VFMI in
CVICU neonates and compare their physiologic impact. Study Type: Case
control. Design: Prospective case-control study. Methods: Forty-six
consecutive infants from the CVICU were recruited, 23 with VFMI and 23
without based on FNL findings. They then underwent LUS, which was
subsequently reviewed by two pediatric radiologists blinded to the FNL
results. Physiologic parameters were recorded before and after the
procedures. Data analysis was performed with Cohen's kappa and Wilcoxon
signed-rank test. Results: Agreement between LUS and FNL was substantial
(kappa = 0.78). Laryngeal ultrasound had a sensitivity of 0.84 and
specificity of 0.95 for identifying VFMI. In terms of physiologic impact,
LUS caused statistically significantly less change in diastolic blood
pressure (P = 0.01), pulse (P = 0.001), and O<inf>2</inf> saturation (P =
0.004) compared to FNL. Arytenoid rotation could be seen clearly, and the
vocal fold-arytenoid angle in abduction was most predictive of symmetry
and movement (P = 0.17). However, it was difficult to determine vocal fold
closure patterns with LUS. Conclusion: Laryngeal ultrasound is a
comparable to FNL for evaluating vocal fold mobility with less physiologic
impact. Level of Evidence: 3b. Laryngoscope, 127:167-172, 2017. Copyright
&#xa9; 2016 The American Laryngological, Rhinological and Otological
Society, Inc.

<84>
Accession Number
613800714
Author
Gong M.; Zhang Z.; Fragakis N.; Korantzopoulos P.; Letsas K.P.; Li G.; Yan
G.-X.; Liu T.
Institution
(Gong, Zhang, Li, Liu) Tianjin Key Laboratory of Ionic-Molecular Function
of Cardiovascular disease, Department of Cardiology, Tianjin Institute of
Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
(Fragakis) Third Cardiology Department, Hippokrateion Hospital, Aristotle
University, Medical School, Thessaloniki, Greece
(Korantzopoulos) First Department of Cardiology, University of Ioannina
Medical School, Ioannina, Greece
(Letsas) Second Department of Cardiology, Laboratory of Cardiac
Electrophysiology, "Evangelismos" General Hospital of Athens, Athens,
Greece
(Yan) Lankenau Institute for Medical Research and Lankenau Medical Center,
Wynnewood, Pennsylvania, United States
(Yan) Beijing Anzhen Hospital, Capital Medical University, Beijing, China
Title
Role of ranolazine in the prevention and treatment of atrial fibrillation:
A meta-analysis of randomized clinical trials.
Source
Heart Rhythm. 14 (1) (pp 3-11), 2017. Date of Publication: 01 Jan 2017.
Publisher
Elsevier B.V.
Abstract
Background Randomized controlled trials (RCTs) on the use of ranolazine
(RN) for prevention and cardioversion of atrial fibrillation (AF) have
yielded conflicting results. Objective The purpose of this study was to
conduct a meta-analysis of RCTs to examine the potential role of RN in the
prevention and cardioversion of AF. Methods PubMed and EMBASE were
searched until June 2016. Of 484 initially identified studies, 8 RCTs were
finally analyzed. Results The analysis of RCTs showed that RN
significantly reduced the incidence of AF compared to the control group in
various clinical settings, such as after cardiac surgery, in acute
coronary syndromes, and post-electrical cardioversion of AF (relative risk
[RR] 0.67, 95% confidence interval [CI] 0.52-0.87, Z = 3.06, P =.002).
Furthermore, a higher conversion rate of AF from the combined use of RN
and amiodarone compared to amiodarone alone (RR 1.23, 95% CI 1.08-1.40, Z
= 3.07, P =.002) was clear, with conversion time significantly shorter in
RN plus amiodarone compared to the amiodarone group (weighted mean
difference [WMD] = -10.38 hours, 95% CI -18.18 to -2.57, Z = 2.61, P
=.009). Conclusion Our meta-analysis suggests that RN may be effective in
AF prevention, whereas it potentiates and accelerates the conversion
effect of amiodarone of recent-onset AF. Larger RCTs with long-term
follow-up in diverse clinical settings are needed to further clarify the
impact of RN on AF therapy. Copyright &#xa9; 2016 Heart Rhythm Society

<85>
Accession Number
613807117
Author
Ebrahimi L.; Kheirandish M.; Foroughi M.
Institution
(Ebrahimi, Kheirandish) Department of Immunology, Blood Transfusion
Research Center, High Institute for Research and Education in Transfusion
Medicine, Tehran, Iran, Islamic Republic of
(Foroughi) Cardiovascular Research Center, Modarres Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
Title
The effect of methylprednisolone treatment on fibrinolysis, the
coagulation system, and blood loss in cardiac surgery.
Source
Turkish Journal of Medical Sciences. 46 (6) (pp 1645-1654), 2016. Date of
Publication: 2016.
Publisher
Turkiye Klinikleri Journal of Medical Sciences (Talapapa Bulvary no. 102,
Hamammonu 1 06230, Turkey)
Abstract
Background/aim: The purpose of this study was to examine steroid
pretreatment in order to decrease postoperative coagulopathy disorders and
bleeding. Materials and methods: In this randomized double-blinded study,
the efficacy of low versus high doses of methylprednisolone on the
coagulation system and postoperative bleeding was compared in patients who
were undergoing cardiac surgery with cardiopulmonary bypass (CPB). The
platelet response to agonists, D-dimer concentration, tissue plasminogen
activator (tPA), plasminogen activator inhibitor (PAI-1) antigens, and
platelet receptors CD42b, CD62P, and CD41a were evaluated. Results: The
platelet response to agonists was reduced. The mean concentrations of
D-dimer and tPA antigen increased although PAI-1 concentration did not
show any significant changes following heparin neutralization.
Postoperative expression of CD42b showed no changes in comparison with
preoperation values in both groups. There was a significant increase in
the expression of CD62P with a methylprednisolone dose of 15 mg/kg, while
there was just a slight increase with a dose of 5 mg/kg. CD41a, as a
fibrinogen receptor, was increased significantly after CPB in both groups.
Significant data were shown in decreasing blood loss with a high dose of
methylprednisolone. Conclusion: Methylprednisolone at a dose of 15 mg/kg
reduced bleeding, probably by increasing CD62P after heparin
neutralization, which can activate platelet activation in favor of better
hemostasis. Copyright &#xa9; TUBITAK.

<86>
Accession Number
613791885
Author
Gorki H.; Hoenicka M.; Rupp P.; Muller-Eising K.; Deininger S.; Kunert A.;
Liebold A.
Institution
(Gorki, Hoenicka, Rupp, Muller-Eising, Deininger, Kunert, Liebold) Dept.
of Cardiothoracic and Vascular Surgery, University Hospital,
Albert-Einstein-Allee 23, Ulm 89081, Germany
Title
Similarity of coagulation and inflammation despite different surgical
revascularization strategies - A prospective randomized trial.
Source
Perfusion (United Kingdom). 31 (8) (pp 640-647), 2016. Date of
Publication: 01 Nov 2016.
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Background: Supposedly, minimized extracorporeal circulation or off-pump
revascularization as alternatives to conventional extracorporeal
circulation (ONCAB) reduce inflammation and coagulation disturbances.
Methods: One hundred and twenty coronary artery bypass graft (CABG)
patients were prospectively randomized for three surgical techniques.
Coagulation and inflammation markers were measured up to 72 hours
postoperatively. Results: Coagulation factors I, II, V, X, antithrombin
III and C-reactive protein did not differ perioperatively between the
groups and increased, as did several other markers, 12 to 72 hours
postoperatively. Compared to its alternatives, ONCAB showed the most
obvious transient increase in thrombin-antithrombin complexes (p<0.0001),
D-dimers (p=0.0059), tissue factor pathway inhibitor (p=0.0005), factor
VIII (p=0.0041) and tumor necrosis factor alpha (p=0.0300) during the
operation and up to 12 hours postoperatively. Furthermore, ONCAB generated
lower leukocyte and platelet counts and higher values of soluble
P-selectin and soluble intercellular adhesion molecule 1 at some time
points. Conclusions: With similarity in pivot coagulation factors, a
specific detrimental influence of ONCAB on common coagulation pathways was
excluded. Higher perioperative concentrations of products from the
coagulation cascade most likely indicate activation of pericardial blood -
recirculated only in ONCAB. Furthermore, with only temporary differences
in markers of inflammation, the alternatives to ONCAB altogether were
without advantage at 72 hours postoperatively. In the general answer to
surgical trauma, the part of modern extracorporeal circulation is possibly
overestimated. The study is registered at the German Clinical Trial
Registry. Registration number DRKS00007580. URL:
https://drks-neu.uniklinik-freiburg.de/drks-web/ URL:
http://apps.who.int/trialsearch/ Copyright &#xa9; SAGE Publications.

<87>
Accession Number
613790758
Author
Lee C.W.; Ahn J.-M.; Cavalcante R.; Sotomi Y.; Onuma Y.; Suwannasom P.;
Tenekecioglu E.; Yun S.-C.; Park D.-W.; Kang S.-J.; Lee S.-W.; Kim Y.-H.;
Park S.-W.; Serruys P.W.; Park S.-J.
Institution
(Lee, Ahn, Park, Kang, Lee, Kim, Park, Park) Heart Institute, University
of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
(Cavalcante, Onuma, Suwannasom, Tenekecioglu, Serruys) Erasmus University
Medical Center, Amsterdam, Netherlands
(Sotomi) Academic Medical Center, University of Amsterdam, Amsterdam,
Netherlands
(Yun) Division of Biostatistics, Center for Medical Research and
Information, University of Ulsan College of Medicine, Asan Medical Center,
Seoul, South Korea
(Serruys) International Center for Circulatory Health, Imperial College
London, London, United Kingdom
Title
Coronary Artery Bypass Surgery Versus Drug-Eluting Stent Implantation for
Left Main or Multivessel Coronary Artery Disease: A Meta-Analysis of
Individual Patient Data.
Source
JACC: Cardiovascular Interventions. 9 (24) (pp 2481-2489), 2016. Date of
Publication: 26 Dec 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives The authors undertook a patient-level meta-analysis to compare
long-term outcomes after coronary artery bypass grafting (CABG) versus
percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in
3,280 patients with left main or multivessel coronary artery disease
(CAD). Background The relative efficacy and safety of CABG versus PCI with
DES for left main or multivessel CAD remain controversial. Methods Data
were pooled from the BEST (Randomized Comparison of Coronary Artery Bypass
Surgery and Everolimus Eluting Stent Implantation in the Treatment of
Patients With Multivessel Coronary Artery Disease), PRECOMBAT (Premier of
Randomized Comparison of Bypass Surgery vs. Angioplasty Using
Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery
Disease), and SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery)
trials. The primary outcome was a composite of all-cause death, myocardial
infarction, or stroke. Results The median follow-up was 60 months, and
follow-up was completed for 96.2% of patients. The rate of primary outcome
was significantly lower with CABG than with PCI (13.0% vs. 16.0%; hazard
ratio [HR]: 0.83; 95% confidence interval [CI]: 0.69 to 1.00; p = 0.046).
The difference was mainly driven by reduction in myocardial infarction
(HR: 0.46; 95% CI: 0.33 to 0.64; p < 0.001). There was significant
interaction between treatment effect and types of CAD, showing CABG to be
superior compared with PCI with DES in patients with multivessel CAD (p =
0.001), but no between-group difference in those with left main CAD (p =
0.427). The rates for all-cause death and stroke were similar between the
2 groups. By contrast, the need for repeat revascularization was
significantly lower in the CABG group compared with the PCI group.
Conclusions CABG, as compared with PCI with DES, reduced long-term rates
of the composite of all-cause death, myocardial infarction, or stroke in
patients with left main or multivessel CAD. The advantage of CABG over PCI
with DES was particularly pronounced in those with multivessel CAD.
Copyright &#xa9; 2016 American College of Cardiology Foundation

<88>
Accession Number
613790708
Author
Rojas P.; Amat-Santos I.J.; Cortes C.; Castrodeza J.; Tobar J.; Puri R.;
Sevilla T.; Vera S.; Varela-Falcon L.H.; Zunzunegui J.L.; Gomez I.;
Rodes-Cabau J.; San Roman J.A.
Institution
(Rojas, Amat-Santos, Cortes, Castrodeza, Tobar, Sevilla, Vera,
Varela-Falcon, Gomez, San Roman) Institute of Heart Sciences, Hospital
Clinico Universitario, Valladolid, Spain
(Puri, Rodes-Cabau) Quebec Heart & Lung Institute, Quebec, Quebec, Canada
(Zunzunegui) Hospital General Universitario Gregorio Maranon, Madrid,
Spain
Title
Acquired Aseptic Intracardiac Shunts Following Transcatheter Aortic Valve
Replacement: A Systematic Review.
Source
JACC: Cardiovascular Interventions. 9 (24) (pp 2527-2538), 2016. Date of
Publication: 26 Dec 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives The aim of this study was to describe the incidence,
mechanisms, features, and management of aseptic intracardiac shunts
(AICS). Background AICS following transcatheter aortic valve replacement
(TAVR) are an uncommon and barely described complication. Methods A
systematic review was performed of all published cases of AICS following
TAVR, and the incidence, predictors, main features, management, and
related outcomes were analyzed. Results A total of 31 post-TAVR AICS were
gathered. After excluding transapical fistulas, the 28 remaining cases
corresponded with an incidence of about 0.5%. Mean age and mean logistic
European System for Cardiac Operative Risk Evaluation score were 80 +/- 11
years and 19.2 +/- 8.3%, respectively. Prior radiation therapy for cancer
was present in 14.3%, and 42.8% had severe calcification of the aortic
valve. TAVR was undertaken using balloon-expandable prostheses in the
majority of cases (85.7%), via the transapical approach in one-third.
Median time from TAVR to diagnosis was 21 days (interquartile range: 7 to
30 days), with intraprocedural suspicion in 12 cases (42.9%) and a mean
Q<inf>p</inf>/Q<inf>s</inf> ratio of 1.8 +/- 0.6. The most common location
for AICS was the interventricular septum (60.7%). Heart failure was
frequent (46.4%), but 14 patients (50%) remained asymptomatic. Medical
treatment (71.4%) was associated with poor outcomes (30-day mortality rate
25%), especially in symptomatic patients (35% vs. 0%; p = 0.020) and in
those with higher Q<inf>p</inf>/Q<inf>s</inf> ratios (1.9 +/- 0.6 vs. 1.4
+/- 0.1), while cardiac surgery (3.6%), and percutaneous closure (25%) led
to good outcomes after a median follow-up period of 3 months
(interquartile range: 1 to 9 months). Conclusions Post-TAVR AICS are
uncommon but have high 30-day mortality if left untreated, especially in
symptomatic patients. Percutaneous closure was feasible and safe in
symptomatic patients but remains controversial in asymptomatic subjects.
Copyright &#xa9; 2016 American College of Cardiology Foundation

<89>
Accession Number
613769716
Author
Nesterov M.A.; Afonnikov D.A.; Sergeeva E.M.; Miroshnichenko L.A.; Bragina
M.K.; Bragin A.O.; Vasiliev G.V.; Salina E.A.
Institution
(Nesterov, Afonnikov, Sergeeva, Bragina, Bragin, Vasiliev, Salina)
Institute of Cytology and Genetics, Siberian Branch, Russian Academy of
Sciences, Novosibirsk 630090, Russian Federation
(Miroshnichenko) Sobolev Institute of Mathematics, Siberian Branch,
Russian Academy of Sciences, Novosibirsk 630090, Russian Federation
Title
Identification of microsatellite loci based on BAC sequencing data and
their physical mapping into the soft wheat 5B chromosome.
Source
Russian Journal of Genetics: Applied Research. 6 (8) (pp 825-837), 2016.
Date of Publication: 01 Dec 2016.
Publisher
Maik Nauka Publishing / Springer SBM (E-mail: compmg@maik.ru)
Abstract
The shortage of polymorphic markers for the regions of the wheat
chromosomes that encode commercially valuable traits determines the need
for studying the wheat microsatellite SSR loci. In this work, SSR markers
for individual regions of the short arm of soft wheat chromosome 5B (5BS)
were designed based on the sequence data obtained from BAC clones, and
regions of the corresponding chromosome were saturated with these markers.
Totally, 130 randomly selected BAC clones from 5BS library were sequenced
using the IonTorrent platform and assembled in contigs using MIRA
software. The assembly characteristics (N50 = 4136 bp) are comparable to
the recently obtained data for wheat and related species and are
acceptable for the identification of the microsatellite loci. The
algorithm utilizing the properties of complex decompositions in the
sliding-window mode was used to detect DNA sequences with a repeat unit of
2-4 bp. Analysis of 17770 contigs with a total length of 25879921 bp
allowed for the design of 113, 79, and 67 microsatellite SSR loci with a
repeat unit of 2, 3, and 4 bp, respectively. SSR markers with a motif of 3
bp were tested using nullitetrasomic lines of Chinese Spring wheat
homoeologous group 5. In total, 21 markers specific for chromosome 5B were
identified. Eight of these markers were mapped into the distal region of
this chromosome (bin 5BS6) using a set of Chinese Spring deletion lines
for 5BS. Eight and four markers were mapped to the interstitial region
(bins 5BS5 and 5BS4, respectively). One marker was mapped to a
pericentromeric bin. Comparative analysis of the distribution of
trinucleotide microsatellites over wheat chromosome 5B, and in different
cereal species, suggests that the (AAG)<inf>n</inf> repeat proliferates
and is conserved during the evolution of cereals. Copyright &#xa9; 2016,
Pleiades Publishing, Ltd.

<90>
Accession Number
613749226
Author
Knezevic I.; Poglajen G.; Hrovat E.; Oman A.; Pintar T.; Wu J.C.; Vrtovec
B.; Haddad F.
Institution
(Knezevic, Poglajen, Hrovat, Oman, Pintar, Vrtovec) Advanced Heart Failure
and Transplantation Center, UMC, Ljubljana, Slovenia
(Wu, Vrtovec, Haddad) Department of Medicine, Division of Cardiology,
Stanford University School of Medicine, Stanford, CA, United States
(Wu, Haddad) Stanford Cardiovascular Institute, Stanford University School
of Medicine, Stanford, CA, United States
Title
The effects of levosimendan on renal function early after heart
transplantation: results from a pilot randomized trial.
Source
Clinical Transplantation. 28 (10) (pp 1105-1111), 2014. Date of
Publication: 01 Oct 2014.
Publisher
Blackwell Publishing Ltd (E-mail:
customerservices@oxonblackwellpublishing.com)
Abstract
Background: We evaluated the effects of a levosimendan (LS)-based strategy
compared with standard inotropic therapy on renal function in heart
transplantation. Methods and results: Using a randomized study design, 94
patients were assigned to LS-based therapy or standard inotropic support.
At the time of transplantation, the groups did not differ in age, gender,
heart failure etiology, hemodynamic profile, LVEF, or comorbidities. While
there were no differences in serum creatinine (sCr) or eGFR between groups
at baseline, patients in the LS group had a greater increase in their
relative eGFR (62% vs. 12%, p = 0.002) and a lower incidence of acute
kidney injury (AKI) (28% vs. 6%, p = 0.01) during the first
post-transplant week. On logistic regression analysis, correlates of AKI
were randomization to LS therapy (OR = 0.21 [0.09-0.62], p = 0.01),
baseline renal dysfunction (OR = 3.9 [1.1-13.6], p = 0.032), and diabetes
mellitus (OR = 4.2 [1.1-16.5], p = 0.038). However, LS was associated with
a greater need for additional norepinephrine therapy (40 [85%] vs. 15
[31%], p < 0.001) and a trend toward longer intensive care unit stay (9.5
+/- 9.0 d vs. 7.0 +/- 6.0 d, p = 0.13). Conclusions: In patients
undergoing heart transplantation, levosimendan-based strategy may be
associated with better renal function when compared to standard therapy.
Copyright &#xa9; 2014 John Wiley & Sons A/S. Published by John Wiley &
Sons Ltd

<91>
Accession Number
613668721
Author
Lamy A.; Devereaux P.J.; Prabhakaran D.; Taggart D.P.; Hu S.; Straka Z.;
Piegas L.S.; Avezum A.; Akar A.R.; Zanetti F.L.; Jain A.R.; Noiseux N.;
Padmanabhan C.; Bahamondes J.C.; Novick R.J.; Tao L.; Olavegogeascoechea
P.A.; Airan B.; Sulling T.A.; Whitlock R.P.; Ou Y.; Gao P.; Pettit S.;
Yusuf S.
Institution
(Lamy, Devereaux, Pettit, Yusuf) Population Health Research Institute,
Hamilton Health Sciences, McMaster University, Hamilton, ON, New Zealand
(Noiseux) Centre Hospitalier de l'Universite de Montral, Montreal, Canada
(Novick) University of Calgary, Calgary, AB, Canada
(Prabhakaran, Airan) Center for Chronic Disease Control, Gurgaon, India
(Taggart, Jain) SAL Hospital, Ahmedabad, India
(Hu, Padmanabhan) G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, India
(Tao, Airan) All India Institute of Medical Sciences, New Delhi, India
(Taggart, Straka) University of Oxford, Oxford, United Kingdom
(Hu, Piegas, Avezum) Fu Wai Cardiovascular Hospital, Xicheng
District,Beijing, China
(Akar) Wuhan Asia Heart Hospital, Wuhan, China
(Zanetti, Bahamondes) Third Faculty of Medicine Charles University,
University Hospital Kralovske Vinohrady, Prague, Czech Republic
(Olavegogeascoechea) Instituto Dante Pazzanese de Cardiologia, Sao Paulo,
Brazil
(Sulling) Ankara University School of Medicine, Ankara, Turkey
(Whitlock) Hospital Regional de Temuco and Universidad de la Frontera,
Temuco, Chile
(Ou) Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina
(Gao) North Estonia Medical Center, Tallinn, Estonia
Title
Five-year outcomes after off-pump or on-pump coronary-artery bypass
grafting.
Source
New England Journal of Medicine. 375 (24) (pp 2359-2368), 2016. Date of
Publication: 15 Dec 2016.
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND We previously reported that there was no significant difference
at 30 days or at 1 year in the rate of the composite outcome of death,
stroke, myocardial infarction, or renal failure between patients who
underwent coronary-artery bypass grafting (CABG) performed with a
beating-heart technique (off-pump) and those who underwent CABG performed
with cardiopulmonary bypass (on-pump). We now report the results at 5
years (the end of the trial). METHODS A total of 4752 patients (from 19
countries) who had coronary artery disease were randomly assigned to
undergo off-pump or on-pump CABG. For this report, we analyzed a composite
outcome of death, stroke, myocardial infarction, renal failure, or repeat
coronary revascularization (either CABG or percutaneous coronary
intervention). The mean follow-up period was 4.8 years. RESULTS There were
no significant differences between the off-pump group and the onpump group
in the rate of the composite outcome (23.1% and 23.6%, respectively;
hazard ratio with off-pump CABG, 0.98; 95% confidence interval [CI], 0.87
to 1.10; P = 0.72) or in the rates of the components of the outcome,
including repeat coronary revascularization, which was performed in 2.8%
of the patients in the offpump group and in 2.3% of the patients in the
on-pump group (hazard ratio, 1.21; 95% CI, 0.85 to 1.73; P = 0.29). The
secondary outcome for the overall period of the trial - The mean cost in
U.S. dollars per patient - Also did not differ significantly between the
off-pump group and the on-pump group ($15,107 and $14,992, respectively;
between-group difference, $115; 95% CI, -$697 to $927). There were no
significant between-group differences in quality-of-life measures.
CONCLUSIONS In our trial, the rate of the composite outcome of death,
stroke, myocardial infarction, renal failure, or repeat revascularization
at 5 years of follow-up was similar among patients who underwent off-pump
CABG and those who underwent onpump CABG. (Funded by the Canadian
Institutes of Health Research; CORONARY ClinicalTrials.gov number,
NCT00463294.). Copyright &#xa9; 2016 Massachusetts Medical Society. All
rights reserved.

<92>
Accession Number
613696392
Author
Panoulas V.F.; Montorfano M.; Taramasso M.; Giustino G.; La Canna G.;
Latib A.; Colombo A.
Institution
(Panoulas, Montorfano, Taramasso, Giustino, Latib, Colombo) Interventional
Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
(Panoulas, Giustino, Latib, Colombo) EMO-GVM Centro Cuore Columbus, Milan,
Italy
(Panoulas) Imperial College London, National Heart and Lung Institute,
London, United Kingdom
(La Canna) Cardiac surgery echocardiography unit, San Raffaele Scientific
Institute, Milan, Italy
Title
A tricky percutaneous paravalvular leak closure two years after
implantation of 3f enable sutureless bioprosthetic aortic valve.
Source
Hellenic Journal of Cardiology. 57 (1) (pp 41-44), 2016. Date of
Publication: 01 Jan 2016.
Publisher
Hellenic Cardiological Society
Abstract
Sutureless valves were designed in an attempt to simplify the aortic valve
replacement procedure and reduce extracorporeal circuit time, whilst
allowing complete excision of the calcified native valve using a minimally
invasive approach. Elderly patients with significant comorbidities are
considered to benefit the most, although randomized data are lacking. In
registries of patients treated with implantation of a 3f Enable sutureless
bioprosthetic aortic valve, all patients who developed paravalvular leak
have been treated with valve explantation. This is the first case report
describing a tricky yet successful percutaneous paravalvular leak closure
2 years after implantation of a 3f Enable sutureless aortic bioprosthesis.
Copyright &#xa9; 2016 Hellenic Cardiological Society. All Right Reserved.

<93>
Accession Number
613716507
Author
Liebenberg J.J.; Dold C.J.; Olivier L.R.
Institution
(Liebenberg) Worcester Hospital, Worcester, South Africa
(Dold) Hanover Park Day Hospital, Cape Town, South Africa
(Olivier) Medi-Clinic Hospital, Durbanville, South Africa
Title
A prospective investigation into the effect of colchicine on tuberculous
pericarditis.
Source
Cardiovascular Journal of Africa. 27 (6) (pp 350-355), 2016. Date of
Publication: November-December 2016.
Publisher
Clinics Cardive Publishing (PTY)Ltd (PO Box 1013, Durbanville 7551, South
Africa)
Abstract
Introduction: Tuberculous (TB) pericarditis carries significant mortality
and morbidity rates, not only during the primary infection, but also as
part of the granulomatous scar-forming fibrocalcific constrictive
pericarditis so commonly associated with this disease. Numerous therapies
have previously been investigated as adjuvant strategies in the prevention
of pericardial constriction. Colchicine is well described in the treatment
of various aetiologies of pericarditis. The aim of this research was to
investigate the merit for the use of colchicine in the management of
tuberculous pericarditis, specifically to prevent constrictive
pericarditis. Methods: This pilot study was designed as a prospective,
double-blinded, randomised, control cohort study and was conducted at a
secondary level hospital in the Northern Cape of South Africa between
August 2013 and December 2015. Patients with a probable or definite
diagnosis of TB pericarditis were included (n = 33). Study participants
with pericardial effusions amenable to pericardiocentesis underwent
aspiration until dryness. All patients were treated with standard TB
treatment and corticosteroids in accordance with the South African
Tuberculosis Treatment Guidelines. Patients were randomised to an
intervention and control group using a webbased computer system that
ensured assignment concealment. The intervention group received colchicine
1.0 mg per day for six weeks and the control group received a placebo for
the same period. Patients were followed up with serial echocardiography
for 16 weeks. The primary outcome assessed was the development of
pericardial constriction. Upon completion of the research period, the
blinding was unveiled and data were presented for statistical analysis.
Results: TB pericarditis was found exclusively in HIV-positive
individuals. The incidence of pericardial constriction in our cohort was
23.8%. No demonstrable benefit with the use of colchicine was found in
terms of prevention of pericardial constriction (p = 0.88, relative risk
1.07, 95% CI: 0.46-2.46). Interestingly, pericardiocentesis appeared to
decrease the incidence of pericardial constriction. Conclusion: Based on
this research, the use of colchicine in TB pericarditis cannot be advised.
Adjuvant therapy in the prevention of pericardial constriction is still
being investigated and routine pericardiocentesis may prove to be
beneficial in this regard.

<94>
Accession Number
613702373
Author
Hu X.; Yuan L.; Wang H.; Li C.; Cai J.; Hu Y.; Ma C.
Institution
(Hu, Yuan, Wang, Li, Cai, Hu, Ma) Department of Anaesthesiology, The
Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
Title
Efficacy and safety of vitamin C for atrial fibrillation after cardiac
surgery: A meta-analysis with trial sequential analysis of randomized
controlled trials.
Source
International Journal of Surgery. 37 (pp 58-64), 2017. Date of
Publication: 01 Jan 2017.
Publisher
Elsevier Ltd
Abstract
Objectives Antioxidant supplement is an option in preventing postoperative
atrial fibrillation (AF) after cardiac surgery. However, the benefits and
adverse effects of vitamin C have not been well assessed. We aimed to
systematically evaluate the efficacy and safety of vitamin C in preventing
postoperative AF in adult patients after cardiac surgery. Methods PubMed,
EMBASE, and the Cochrane library databases from inception to September
2016 were searched. Randomized controlled trials (RCTs) that evaluated the
efficacy and safety of vitamin C in preventing postoperative AF in adult
patients after cardiac surgery were identified. The primary outcome was
the incidence of postoperative AF. Secondary outcomes included the length
of intensive care unit (ICU) stay, length of hospital stay, and stroke
events. Results Eight RCTs incorporating 1060 patients were included.
Compared with placebo group, vitamin C treatment was associated with a
substantial reduction in postoperative AF (OR, 0.47; 95% CI, 0.36-0.62;
evidence rank: moderate), with no significant heterogeneity (I²
44%; P = 0.09). Trial sequential analysis showed that the cumulative
Z-curve crossed the trial sequential monitoring boundary for benefit,
establishing sufficient and conclusive evidence. In addition, vitamin C
administration was not associated with any length of stay, including in
the ICU (evidence rank: low) and hospital (evidence rank: low),
respectively. Conclusions Short-term treatment with vitamin C is safe, and
may reduce the incidence of postoperative AF after cardiac surgery. Future
studies as well as more high quality RCTs are still warranted to confirm
the effects of different durations of vitamin C on cardiac surgery.
Copyright &#xa9; 2016 IJS Publishing Group Ltd

<95>
Accession Number
613672296
Author
Vallabhajosyula S.; Kanmanthareddy A.; Erwin P.J.; Esterbrooks D.J.;
Morrow L.E.
Institution
(Vallabhajosyula) Division of Pulmonary and Critical Care Medicine,
Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
(Vallabhajosyula) Multidisciplinary Epidemiology and Translational
Research in Intensive Care (METRIC) Laboratory, Mayo Clinic, Rochester,
MN, United States
(Kanmanthareddy, Esterbrooks) Division of Cardiovascular Diseases,
Department of Internal Medicine, Creighton University School of Medicine,
Omaha, NE, United States
(Erwin) Mayo Clinic Libraries, Mayo Clinic College of Medicine, Mayo
Clinic, Rochester, MN, United States
(Erwin) Evidence-Based Practice Research Program, Mayo Clinic, Rochester,
MN, United States
(Morrow) Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Internal Medicine, Creighton University School of Medicine,
Omaha, NE, United States
(Morrow) Division of Pulmonary, Critical Care and Sleep Medicine,
Department of Internal Medicine, Veterans Affairs Nebraska-Western Iowa
Health Care System, Omaha, NE, United States
Title
Role of statins in delirium prevention in critical ill and cardiac surgery
patients: A systematic review and meta-analysis.
Source
Journal of Critical Care. 37 (pp 189-196), 2017. Date of Publication: 01
Feb 2017.
Publisher
W.B. Saunders
Abstract
Background The data evaluating the role of statins in delirium prevention
in the intensive care unit are conflicting and limited. Methods We
performed a systematic review and meta-analysis of literature from 1975 to
2015. All English-language adult studies evaluating delirium incidence in
statin and statin nonusers were included and studies without a control
group were excluded. Mantel-Haenszel model was used to calculate pooled
risk ratios (RRs) and 95% confidence intervals (CIs). Statistical
significance was defined as CI not including unity and P value less
than.05. Results Of a total 57 identified studies, 6 were included. The
studies showed high heterogeneity (I² = 73%) for all and
moderate for cardiac surgery studies (I² = 55%). Of 289 773
patients, statins were used in 22 292 (7.7%). Cardiac surgery was
performed in 4382 (1.5%) patients and 2321 (53.0%) used statins. Delirium
was noted in 710 (3.2%) and 3478 (1.3%) of the patients in the statin and
nonstatin groups, respectively, with no difference between groups in the
total cohort (RR, 1.05 [95% CI, 0.85-1.29]; P =.56) or in cardiac surgery
patients (RR, 1.03 [95% CI, 0.68-1.56]; P =.89). Conclusions In critically
ill and cardiac surgery patients, this meta-analysis did not show a
benefit with statin therapy in the prevention of delirium. Copyright
&#xa9; 2016 Elsevier Inc.

<96>
Accession Number
613767530
Author
Nagendran J.; Catrip J.; Losenno K.L.; Adams C.; Kiaii B.; Chu M.W.A.
Institution
(Nagendran) Division of Cardiac Surgery, Department of Surgery,
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton,
Canada
(Catrip) Department of Cardiovascular Surgery, Instituto Nacional de
Cardiologia Ignacio Chavez, Mexico City, Mexico
(Losenno, Kiaii, Chu) Division of Cardiac Surgery, Department of Surgery,
Lawson Health Research Institute, Western University, London, Canada
(Adams) Division of Cardiac Surgery, Department of Surgery, Health Science
Center, Memorial University, St. John's, Canada
Title
Minimally invasive mitral repair surgery: why does controversy still
persist?.
Source
Expert Review of Cardiovascular Therapy. 15 (1) (pp 15-24), 2017. Date of
Publication: 02 Jan 2017.
Publisher
Taylor and Francis Ltd (E-mail: info@expert-reviews.com)
Abstract
Introduction: Surgical treatment for mitral valve disease has evolved and
remains a rapidly expanding field. Minimally invasive mitral valve repair
(MI-MVR) is a well-known alternative to conventional sternotomy mitral
valve repair (cMVR). However, controversy as to the efficacy of MI-MVR
persists, hindering the adoption and potential benefits of this less
invasive approach. Areas covered: In this review, we provide an updated
summary evaluation of the latest evidence, including observational
studies, clinical trials and meta-analyses, regarding MI-MVR in comparison
to cMVR. Expert commentary: The controversy that persists around the
widespread adoption of MI-MVR procedures is addressed with the wealth of
evidence published establishing similarly excellent outcomes between
MI-MVR and cMVR. Copyright &#xa9; 2016 Informa UK Limited, trading as
Taylor & Francis Group.

<97>
Accession Number
613851474
Author
Butler E.; Chin M.; Aneman A.
Institution
(Butler) Faculty of Medicine, University of New South Wales, Sydney,
Australia
(Chin, Aneman) Intensive Care Unit, Liverpool Hospital, Sydney, Australia
(Aneman) University of New South Wales, South Western Sydney Clinical
School, Sydney, Australia
(Aneman) Ingham Institute for Applied Medical Research, Sydney, Australia
Title
Peripheral Near-Infrared Spectroscopy: Methodologic Aspects and a
Systematic Review in Post-Cardiac Surgical Patients.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2016.
Date of Publication: 2016.
Publisher
W.B. Saunders

<98>
Accession Number
613835199
Author
Anastasiadis K.; Antonitsis P.; Asteriou C.; Argiriadou H.; Deliopoulos
A.; Konstantinou D.; Grosomanidis V.; Tossios P.
Institution
(Anastasiadis, Antonitsis, Asteriou, Argiriadou, Deliopoulos,
Konstantinou, Grosomanidis, Tossios) Cardiothoracic DepartmentAHEPA
University HospitalThessaloniki Greece
Title
Quantification of Operational Learning in Minimal Invasive Extracorporeal
Circulation.
Source
Artificial Organs. (no pagination), 2016. Date of Publication: 2016.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Minimal invasive extracorporeal circulation (MiECC) has initiated
important new efforts within science and technology towards a more
physiologic perfusion. In this study, we aim to investigate the learning
curve of our center regarding MiECC. We studied a series of 150
consecutive patients who underwent elective coronary artery bypass
grafting by the same surgical team during the initial phase of MiECC
application. Patients were randomly assigned into two groups. Group A
(n=75) included patients operated on MiECC, while group B (n=75) included
patients operated with conventional cardiopulmonary bypass (cCPB). The
primary end-point of the study was to identify whether there is a learning
curve when operating on MiECC. The following parameters were unrelated
with increasing experience, even though the results favored MiECC use:
reduced CPB duration (102.9+/-25 vs. 122.2+/-33 min, P <0.001), peak
troponin release (0.07+/-0.02 vs. 0.1+/-0.04 ng/mL, P<0.01), peak
creatinine levels (0.97+/-0.24 vs. 1.2+/-0.3 mg/dL, P<0.001), duration of
mechanical ventilation (14.1+/-7.2 vs. 36.9+/-59.8 h, P<0.01) and ICU stay
(2.1+/-0.7 vs. 4.4+/-6.4 days, P<0.01). However, need for intraoperative
blood transfusion showed a trend towards a gradual decrease as experience
with MiECC system was accumulating (R²=0.094, P=0.007).
Subsequently, operational learning applied to postoperative hematocrit and
hemoglobin levels (R²=0.098, P=0.006). We identified that
advantages of MiECC technology in terms of reduced hemodilution and
improved end-organ protection and clinical outcome are evident from the
first patient. Optimal results are obtained with 50 cases; this refers
mainly to significant reduction in the need for intraoperative blood
transfusion. Teamwork from surgeons, anesthesiologists, and perfusionists
is of paramount importance in order to maximize the clinical benefits from
this technology. Copyright &#xa9; 2016 International Center for Artificial
Organs and Transplantation and Wiley Periodicals, Inc.

<99>
Accession Number
613834952
Author
Wei W.; Liu Y.; Zhang Q.; Wang Y.; Zhang X.; Zhang H.
Institution
(Wei, Liu, Zhang, Zhang) State Key Laboratory for Cardiovascular Diseases,
Center for Pediatric Cardiac Surgery, Key Laboratory of Cardiac
Regenerative MedicineNational Center for Cardiovascular Diseases and Fuwai
HospitalBeijing China
(Zhang, Wang) Beijing Key Laboratory of Cardiometabolic Molecular
MedicineInstitute of Molecular Medicine, Peking UniversityBeijing China
Title
Danshen-Enhanced Cardioprotective Effect of Cardioplegia on Ischemia
Reperfusion Injury in a Human-Induced Pluripotent Stem Cell-Derived
Cardiomyocytes Model.
Source
Artificial Organs. (no pagination), 2016. Date of Publication: 2016.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Myocardial ischemia-reperfusion (I/R) injury is unavoidable during
cardioplegic arrest and open-heart surgery. Danshen is one of the most
popular traditional herbal medicines in China, which has entered the Food
and Drug Administration-approved phase III clinical trial. This study was
aimed to develop a human-induced pluripotent stem cell-derived
cardiomyocytes (hiPSC-CMs) model to mimic I/R injury and evaluate the
cardioprotective effect of regular cardioplegic solution with Danshen.
hiPSC-CMs were cultured with the crystalloid cardioplegic solution (Thomas
group) and Thomas solution with 2 or 10 mug/mL Danshen (Thomas plus
Danshen groups). The cells under normoxic culture condition served as
baseline group. Then, the cells were placed in a modular incubator
chamber. After 45 min hypoxia and 3 h reoxygenation, hiPSC-CMs subjected
to hypoxia/reoxygenation resulted in a sharp increase of reactive oxygen
species (ROS) content in Thomas group versus baseline group. Compared with
the Thomas group, ROS accumulation was significant suppressed in Thomas
plus Danshen groups, which might result from elevating the content of
glutathione and enhanced activities of superoxide dismutase and
glutathione peroxidase. The enhanced L-type Ca²⁺ current in
hiPSC-CMs after I/R injury was also significantly decreased by Danshen,
and meanwhile intracellular Ca²⁺ level was reduced and calcium
overload was suppressed. Thomas plus Danshen groups also presented less
irregular transients and lower apoptosis rates. As a result, Danshen could
improve antioxidant and calcium handling in cardiomyocytes during I/R and
lead to reduced arrhythmia events and apoptosis rates. hiPSC-CMs model
offered a platform for the future translational study of the cardioplegia.
Copyright &#xa9; 2016 International Center for Artificial Organs and
Transplantation and Wiley Periodicals, Inc.

<100>
Accession Number
613834196
Author
Alexander G.C.; Iyer G.; Lucas E.; Lin D.; Singh S.
Institution
(Alexander, Iyer, Lucas, Lin) Department of Epidemiology, Johns Hopkins
Bloomberg School of Public Health, Baltimore, Md
(Alexander, Iyer, Lucas, Lin, Singh) Center for Drug Safety and
Effectiveness, Johns Hopkins University, Baltimore, Md
(Alexander, Singh) Division of General Internal Medicine, Department of
Medicine, Johns Hopkins Medicine, Baltimore, Md
Title
Cardiovascular Risks of Exogenous Testosterone Use Among Men: A Systematic
Review and Meta-Analysis.
Source
American Journal of Medicine. (no pagination), 2016. Date of Publication:
2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Purpose: We sought to evaluate whether exogenous testosterone therapy is
associated with increased risk of serious cardiovascular events as
compared with other treatments or placebo. Methods: Study selection
included randomized controlled trials (RCTs) and observational studies
that enrolled men aged 18 years or older receiving exogenous testosterone
for 3 or more days. The primary outcomes were death due to all causes,
myocardial infarction, and stroke. Secondary outcomes were other hard
clinical outcomes such as heart failure, arrhythmia, and cardiac
procedures. Peto odds ratio was used to pool data from RCTs. Risk of bias
was assessed using Cochrane Collaboration tool and Newcastle and Ottawa
scale, respectively. The strength of evidence was evaluated using the
Grades of Recommendation, Assessment, Development, and Evaluation Working
Group approach. Results: A total of 39 RCTs and 10 observational studies
were included. Meta-analysis was done using data from 30 RCTs. Compared
with placebo, exogenous testosterone treatment did not show any
significant increase in risk of myocardial infarction (odds ratio [OR]
0.87; 95% CI, 0.39-1.93; 16 RCTs), stroke (OR 2.17; 95% CI, 0.63-7.54; 9
RCTs), or mortality (OR 0.88; 95% CI, 0.55-1.41; 20 RCTs). Observational
studies showed marked clinical and methodological heterogeneity. The
evidence was rated as very low quality due to the high risk of bias,
imprecision, and inconsistency. Conclusions: We did not find any
significant association between exogenous testosterone treatment and
myocardial infarction, stroke, or mortality in randomized controlled
trials. The very low quality of the evidence precludes definitive
conclusion on the cardiovascular effects of testosterone. Copyright &#xa9;
2016 Elsevier Inc.

<101>
Accession Number
613820003
Author
Sarmiento E.; Jaramillo M.; Calahorra L.; Fernandez-Yanez J.;
Gomez-Sanchez M.; Crespo-Leiro M.G.; Paniagua M.; Almenar L.; Cebrian M.;
Rabago G.; Levy B.; Segovia J.; Gomez-Bueno M.; Lopez J.; Mirabet S.;
Navarro J.; Rodriguez-Molina J.J.; Fernandez-Cruz E.; Carbone J.
Institution
(Sarmiento, Jaramillo, Calahorra, Navarro, Rodriguez-Molina,
Fernandez-Cruz, Carbone) Clinical Immunology Department, Hospital General
Universitario Gregorio Maranon, Madrid, Spain
(Fernandez-Yanez) Cardiology Department, Hospital General Universitario
Gregorio Maranon, Madrid, Spain
(Gomez-Sanchez) Cardiology Department, Hospital Universitario Doce de
Octubre, Madrid, Spain
(Crespo-Leiro, Paniagua) Cardiology Department, Complexo Hospitalario
Universitario de A Coruna, A Coruna, Spain
(Almenar, Cebrian) Heart Failure and Heart Transplant Unit, Cardiology
Department, Hospital Universitario La Fe, Valencia, Spain
(Rabago, Levy) Heart Surgery Department, Clinica Universidad de Navarra,
Pamplona, Spain
(Segovia, Gomez-Bueno) Heart Failure and Cardiomyopathy Unit, Heart
Failure and Heart Transplant Section, Department of Cardiology, Hospital
Universitario Puerta de Hierro, Madrid, Spain
(Lopez) Heart Failure and Heart Transplant Unit, Hospital Clinico
Universitario, Valladolid, Spain
(Mirabet) Cardiology Department, Sant Pau Hospital, Barcelona, Spain
Title
Evaluation of humoral immunity profiles to identify heart recipients at
risk for development of severe infections: A multicenter prospective
study.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2016. Date of
Publication: 2016.
Publisher
Elsevier USA
Abstract
Background: New biomarkers are necessary to improve detection of the risk
of infection in heart transplantation. We performed a multicenter study to
evaluate humoral immunity profiles that could better enable us to identify
heart recipients at risk of severe infections. Methods: We prospectively
analyzed 170 adult heart recipients at 8 centers in Spain. Study points
were before transplantation and 7 and 30 days after transplantation.
Immune parameters included IgG, IgM, IgA and complement factors C3 and C4,
and titers of specific antibody to pneumococcal polysaccharide antigens
(anti-PPS) and to cytomegalovirus (CMV). To evaluate potential immunologic
mechanisms leading to IgG hypogammaglobulinemia, before heart
transplantation we assessed serum B-cell activating factor (BAFF) levels
using enzyme-linked immunoassay. The clinical follow-up period lasted 6
months. Clinical outcome was need for intravenous anti-microbials for
therapy of infection. Results: During follow-up, 53 patients (31.2%)
developed at least 1 severe infection. We confirmed that IgG
hypogammaglobulinemia at Day 7 (defined as IgG <600 mg/dl) is a risk
factor for infection in general, bacterial infections in particular, and
CMV disease. At Day 7 after transplantation, the combination of IgG <600
mg/dl + C3 <80 mg/dl was more strongly associated with the outcome
(adjusted odds ratio 7.40; 95% confidence interval 1.48 to 37.03; . p =
0.014). We found that quantification of anti-CMV antibody titers and lower
anti-PPS antibody concentrations were independent predictors of CMV
disease and bacterial infections, respectively. Higher pre-transplant BAFF
levels were a risk factor of acute cellular rejection. Conclusion: Early
immunologic monitoring of humoral immunity profiles proved useful for the
identification of heart recipients who are at risk of severe infection.
Copyright &#xa9; 2016 International Society for Heart and Lung
Transplantation.

<102>
Accession Number
613819706
Author
Prodhan P.; Agarwal A.; ElHassan N.O.; Bolin E.H.; Beam B.; Garcia X.;
Gaies M.; Tang X.
Institution
(Prodhan, Bolin, Beam, Garcia) Pediatric Cardiology, University of
Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock,
Arkansas
(Prodhan, Garcia) Pediatric Critical Care, University of Arkansas for
Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas
(Agarwal) Pulmonary Medicine, University of Arkansas for Medical Sciences,
Arkansas Children's Hospital, Little Rock, Arkansas
(ElHassan) Neonatology, University of Arkansas for Medical Sciences,
Arkansas Children's Hospital, Little Rock, Arkansas
(Gaies) Pediatric Cardiology, University of Michigan, C.S. Mott Children's
Hospital, Ann Arbor, Michigan
(Tang) Biostatistics, University of Arkansas for Medical Sciences,
Arkansas Children's Hospital, Little Rock, Arkansas
Title
Tracheostomy Among Infants With Hypoplastic Left Heart Syndrome Undergoing
Cardiac Operations: A Multicenter Analysis.
Source
Annals of Thoracic Surgery. (no pagination), 2016. Date of Publication:
2016.
Publisher
Elsevier USA
Abstract
Background: Less than 2.7% of infants undergoing congenital heart disease
operations have difficulty weaning from invasive mechanical ventilation.
In such instances, clinicians may choose to perform tracheostomy. Limited
literature has examined tracheostomy placement specifically in infants
with hypoplastic left heart syndrome (HLHS). This study evaluated the risk
factors for tracheostomy placement in infants with HLHS and examined the
outcomes of these infants before their first hospital discharge. Methods:
This retrospective analysis of the Pediatric Heath Information System data
set included infants with HLHS who underwent stage 1 Norwood operation, a
hybrid procedure, or heart transplant from 2004 through 2013. Results: We
identified 5721 infants with HLHS, and 126 underwent tracheostomy
placement. Infants in the tracheostomy group had more morbidities and a
higher mortality rate across the study period. Diagnosis of chromosomal
abnormalities, anomalies of the trachea and esophagus, larynx, diaphragm
and nervous system, bilateral vocal cord paralysis, and necrotizing
enterocolitis, and procedures including extracorporeal membrane
oxygenation support, cardiac catheterization, and gastrostomy tube were
independently associated with tracheostomy placement in the study
population. Despite an overall increase in rates of tracheostomy performed
in infants with HLHS during the study period, the mortality rate did not
improve among tracheostomy patients. Conclusions: Several risk factors
were identified in infants with HLHS in whom a tracheostomy was placed
during their first hospitalization. Despite an overall increase in rates
of tracheostomies during the study period, the mortality rate did not
improve among these patients. Appropriate family counseling and thorough
preoperative case selection is suggested when discussing possible
tracheostomy placement in infants with HLHS. Copyright &#xa9; 2016 The
Society of Thoracic Surgeons.

<103>
Accession Number
613819482
Author
Langlois P.L.; Hardy G.; Manzanares W.
Institution
(Langlois) Department of Anesthesiology and Reanimation, Faculty of
Medicine and Health Sciences, Sherbrooke University Hospital, Sherbrooke,
Quebec, Canada
(Hardy) Ipanema Research Trust, Auckland, New Zealand
(Manzanares) Department of Critical Care, Intensive Care Unit, University
Hospital, Faculty of Medicine, UDELAR, Montevideo, Uruguay
Title
Omega-3 polyunsaturated fatty acids in cardiac surgery patients: An
updated systematic review and meta-analysis.
Source
Clinical Nutrition. (no pagination), 2016. Date of Publication: March 04,
2016.
Publisher
Churchill Livingstone
Abstract
Background: Omega-3 polyunsaturated fatty acids (omega-3 PUFA)
supplementation is an attractive therapeutic option for patients
undergoing open-heart surgery due to their anti-inflammatory and
anti-arrhythmic properties. Several randomized controlled trials (RCT)
have found contradictory results for perioperative omega-3 PUFA
administration. Therefore, we conducted an updated systematic review and
meta-analysis evaluating the effects of perioperative omega-3 PUFA on some
clinically important outcomes for cardiac surgery. Methods: A systematic
literature search was conducted to find RCT evaluating clinical outcomes
after omega-3 PUFA therapy in adult patients undergoing cardiac surgery.
Intensive care unit (ICU) length of stay (LOS) was the primary outcome;
secondary outcomes were hospital LOS, postoperative atrial fibrillation
(POAF), mortality and duration of mechanical ventilation (MV). Predefined
subgroup analysis and sensibility analysis were performed. Results: A
total of 19 RCT including 4335 patients met inclusion criteria. No effect
of omega-3 PUFA on ICU LOS was found (weighted mean difference WMD -2.95,
95%. confidence interval, CI -10.28 to 4.39, P = 0.43). However, omega-3
PUFA reduced hospital LOS (WMD -1.37, 95% CI -2.41 to -0.33; P = 0.010)
and POAF incidence (Odds Ratio OR = 0.78, 95% CI 0.68 to 0.90; P = 0.004).
No effects were found on mortality or MV duration. Heterogeneity remained
in subgroup analysis and we found a significant POAF reduction when
omega-3 PUFA doses were administered to patients exposed to
extra-corporeal circulation. Oral/enteral administration seemed to further
reduce POAF. Conclusions: In patients undergoing cardiac surgery, omega-3
PUFA supplementation by oral/enteral and parenteral route reduces hospital
LOS and POAF. Nonetheless considerable clinical and statistical
heterogeneity weaken our findings. Copyright &#xa9; 2016 Elsevier Ltd and
European Society for Clinical Nutrition and Metabolism.

<104>
Accession Number
613813542
Author
Yue D.M.; Song C.; Zhang B.; Liu Z.; Chai J.; Luo Y.; Wu H.
Institution
(Yue) Employee Health, Southwest Hospital, Third Military Medical
University, Chongqing, China
(Song) Nursing Department, Xinqiao Hospital, Third Military Medical
University, Chongqing, China
(Zhang) Department of Hospital Infection Control, Southwest Hospital,
Third Military Medical University, Chongqing, China
(Liu) The Clinical Laboratory of Hospital, Southwest Hospital, Third
Military Medical University, Chongqing, China
(Chai) Cholestatic Liver Diseases Center, Digestive Diseases Institute of
PLA, Southwest Hospital, Third Military Medical University, Chongqing,
China
(Luo) Medical Research Center, Southwest Hospital, Third Military Medical
University, Chongqing, China
(Wu) Bureau of Medical Administration, Southwest Hospital, Third Military
Medical University, Chongqing, China
Title
Hospital-wide comparison of health care-associated infection among 8
intensive care units: A retrospective analysis for 2010-2015.
Source
American Journal of Infection Control. (no pagination), 2016. Date of
Publication: 2016.
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Exploring the distribution of nosocomial pathogens among
different categories of intensive care units (ICUs) is critical to
improving the management of health care-associated infection (HAI).
Despite both single- and multicenter studies, the nature of the variations
of HAIs within various ICUs remains inadequately evaluated. Methods: Data
on HAIs at our hospital during the period January 2010-December 2015 were
collected from 8 ICUs, namely, respiratory, cardiovascular, neurology,
neonatal, hematology, emergency, cardiothoracic surgery, and neurosurgery
ICUs, at a tertiary hospital. Results: We observed a cumulative HAI
incidence of 15.6/1,000 patient-days among 6,254 cases of infection at the
hospital, as well as obvious interunit variations in HAI distribution +
Acinetobacter baumannii was the leading organism of infection in almost
every ICU, especially in emergency, neurosurgery, and neonatal ICUs. The
most common pathogens were. Pseudomonas aeruginosa in the cardiothoracic
surgery, emergency, and neonatal ICUs;. Klebsiella pneumoniae and.
Escherichia coli in the neurosurgery, emergency, neonatal, and neurology
ICUs; and. Candida albicans in both neurology and emergency ICUs.
Conclusions: Our findings revealed that. A baumannii and P aeruginosa were
the most common pathogens associated with invasive operations, whereas. K
pneumoniae and. E coli were the most common pathogens in the medical ICUs.
Copyright &#xa9; 2016 Association for Professionals in Infection Control
and Epidemiology, Inc.

<105>
Accession Number
613802186
Author
Vijarnsorn C.; Noga M.; Schantz D.; Pepelassis D.; Tham E.B.
Institution
(Vijarnsorn, Noga, Tham) Stollery Children's Hospital and Mazankowski
Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada
(Vijarnsorn) Department of Pediatrics, Faculty of Medicine, Siriraj
Hospital, Mahidol University, Bangkok, Thailand
(Schantz, Pepelassis) Variety Children's Hospital, Winnipeg, MB, Canada
Title
Stress perfusion magnetic resonance imaging to detect coronary artery
lesions in children.
Source
International Journal of Cardiovascular Imaging. (pp 1-11), 2016. Date of
Publication: 20 Dec 2016.
Publisher
Springer Netherlands
Abstract
Background: Stress perfusion cardiovascular magnetic resonance (CMR) is
used widely in adult ischemic heart disease, but data in children is
limited. We sought to evaluate feasibility, accuracy and prognostic value
of stress CMR in children with suspected coronary artery disease (CAD).
Methods: Stress CMR was reviewed from two pediatric centers over 5 years
using a standard pharmacologic protocol. Wall motion abnormalities,
perfusion deficits and late enhancement were correlated with coronary
angiogram (CAG) when available, and clinical status at 1 year follow-up
for major adverse cardiovascular events (MACE; coronary revascularization,
non-fatal myocardial infarction and death due to CAD) was recorded.
Results: Sixty-four stress perfusion CMR studies in 48 children (10.9 +/-
4.8 years) using adenosine; 59 (92%) and dipyridamole; 5 (8%), were
reviewed. Indications were Kawasaki disease (39%), post arterial switch
operation (12.5%), post heart transplantation (12.5%), post anomalous
coronary artery repair (11%), chest pain (11%), suspected myocarditis or
CAD (3%), post coronary revascularization (3%), and others (8%).
Twenty-six studies were performed under sedation. Of all studies
performed, 66% showed no evidence of ischemia or infarction, 28% had
perfusion deficits and 6% had late gadolinium enhancement (LGE) without
perfusion deficit. Compared to CAG, the positive predictive value (PPV) of
stress CMR was 80% with negative predictive value (NPV) of 88%. At 1 year
clinical follow-up, the PPV and NPV of stress CMR to predict MACE were 78
and 98%. Conclusion: Stress-perfusion CMR, in combination with LGE and
wall motion-analysis is a feasible and an accurate method of diagnosing
CAD in children. In difficult cases, it also helps guide clinical
intervention by complementing conventional CAG with functional
information. Copyright &#xa9; 2016 Springer Science+Business Media
Dordrecht

<106>
Accession Number
613785903
Author
Welsby I.J.; Krakow E.F.; Heit J.A.; Williams E.C.; Arepally G.M.;
Bar-Yosef S.; Kong D.F.; Martinelli S.; Dhakal I.; Liu W.W.; Krischer J.;
Ortel T.L.
Institution
(Welsby) Department of Anesthesiology and Critical Care Durham, NC USA
(Krakow, Kong) Department of Medicine Duke University Medical
CenterDurham, NC USA
(Heit) Department of Medicine Division of Cardiovascular Diseases Mayo
ClinicDurham, NC USA
(Williams) Department of Medicine Division of Hematology University of
WisconsinDurham, NC USA
(Arepally) Department of Medicine Division of Hematology Duke University
Medical CenterDurham, NC USA
(Bar-Yosef) Department of Anesthesiology Durham VA Medical CenterDurham,
NC USA
(Martinelli) Department of Anesthesiology University of North
CarolinaDurham, NC USA
(Dhakal, Liu) Department of Biostatistics and Bioinformatics Duke
University Medical CenterDurham, NC USA
(Krischer) Pediatric Epidemiology Center University of South Florida
Morsani College of MedicineDurham, NC USA
(Ortel) Department of Pathology Duke University Medical Center Durham, NC
USA
Title
The association of anti-platelet factor 4/heparin antibodies with early
and delayed thromboembolism after cardiac surgery.
Source
Journal of Thrombosis and Haemostasis. (no pagination), 2016. Date of
Publication: 2016.
Publisher
Blackwell Publishing Ltd (E-mail:
customerservices@oxonblackwellpublishing.com)
Abstract
Essentials: We evaluated antibody status, thromboembolism and survival
after cardiac surgery. Positive antibody tests are common - over 50% are
seropositive at 30 days. Seropositivity did not increase thromboembolism
or impair survival after cardiac surgery. Results show heparin induced
thrombocytopenia antibody screening after surgery is not warranted.
Summary: Background: Heparin-induced thrombocytopenia (HIT) is a
prothrombotic response to heparin therapy with platelet-activating,
anti-platelet factor 4 (PF4)/heparin antibodies leading to
thrombocytopenia associated with thromboembolism. Objective: We tested the
hypothesis that anti-PF4/heparin antibodies are associated with
thromboembolism after cardiac surgery. Methods: This multicenter,
prospective cohort study collected laboratory and clinical data up to 30
days after surgery and longer-term clinical follow-up data. The primary
outcome variable combined new arterial or venous thromboembolic
complications (TECs) with all-cause death until 90 days after surgery.
Laboratory analyses included platelet counts and anti-PF4/heparin antibody
titers (GTI ELISA), with a confirmatory excess heparin step and serotonin
release assay. Chi-square testing was used to test the relationship
between our outcome and HIT antibody seropositivity. Results: Initially,
1021 patients were enrolled between August 2006 and May 2009, and
follow-up was completed in December 2014. Seropositivity defined by OD >
0.4 was common, being almost 20% preoperatively, > 30% by discharge, and >
60% by day 30. Death (1.7% within 30 days) or TECs (69 in total) were more
likely if the partient was seronegative (OD < 0.4), but positivity defined
by OD > 1.0 or including an excess heparin confirmatory step resulted in
equal incidence of death or TECs, whether the patient was seronegative or
seropositive. Incorporating the serotonin release assay for
platelet-activating antibodies did not alter these findings. Conclusions:
Seropositivity for anti-PF4/heparin antibodies does not increase the risk
of death or thromboembolism after cardiac surgery. Screening is not
indicated, and seropositivity should only be interpreted in the context of
clinical evidence for HIT. Trial registration: Duke IRB Protocol #00010736
Copyright &#xa9; 2016 International Society on Thrombosis and Haemostasis.

<107>
Accession Number
613768398
Author
Erden I.; Golcuk E.; Bozyel S.; Erden E.C.; Balaban Y.; Yalin K.; Turan B.
Institution
(Erden, Erden, Balaban) Department of CardiologyVM Medicalpark Kocaeli
HospitalKocaeliTurkey
(Golcuk, Bozyel, Turan) Department of CardiologyKocaeli Derince Training
and Research HospitalKocaeliTurkey
(Yalin) Department of CardiologyBayrampasa Kolan HospitalIstanbulTurkey
Title
Effectiveness of Handmade "Jacky-Like Catheter" As a Single Multipurpose
Catheter in Transradial Coronary Angiography: A Randomized Comparison With
Conventional Two-Catheter Strategy.
Source
Journal of Interventional Cardiology. (no pagination), 2016. Date of
Publication: 2016.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Objective: To investigate safety and efficacy of specialized hand-modified
"Jacky-Like" catheter (JLC) as a single dual-purpose catheter in
transradial coronary angiography. Methods: Patients over 18 years
undergoing diagnostic CAG through right radial artery (RRA) were
prospectively enrolled. Procedures were performed with a single JLC
modified from a left Judkins (JL) 3.5 catheter or by using 2-catheter
approach (2C). Procedures with coronary artery bypass grafts or
ventricular angiographies were excluded from the study. Three hundred and
eighty-seven transradial procedures were performed successfully. One
hundred and ninety-four procedures were performed with 2C and 193
procedures with a JLC. Inability to use intended catheters, total
fluoroscopic time in minutes, the consumption of contrast medium in
milliliter, development of radial artery spasm (RAS), and radial artery
occlusion (RAO) were evaluated. Results: In the 2C group, angiography was
successfully performed on the RCA of 191 patients (98.9%) and on LCA in
192 patients (99.4%). In the JLC group, angiography was successfully
performed on the RCA and LCA of 193 (99.4%) and 174 (89.6%) patients,
respectively. Utilization of supplemental catheters was significantly
greater in the JLC group (21; 10.8%) versus the 2C group (3; 1.5%
P=0.001). Mean fluoroscopy time was shorter in the JLC group (2.0+/-2.3min
vs. 2.3+/-1.5min; P=0.043). Mean procedure time was also decreased with
JLC but did not reach statistical significance (5.7+/-3.1 min vs.
6.2+/-2.5min; P=0.081). When additional time for reshaping the JLC was not
taken into account, mean procedure time was significantly decreased in the
JLC group (5.6+/-2.9min vs. 6.2+/-2.4min; P=0.031). There was a trend
toward lower incidence of consumption of contrast medium in the 2C group
(49+/-13mL vs. 52+/-18mL; P=0.061). RAS was observed more frequently in
the 2C group (11.3% vs. 21.7%, P=0.005). There was a trend toward high
incidence of RAO in the 2C group (4.1 vs. 8.3% P=0.064). Conclusion: In
transradial procedures from RRA, a JLC catheter can be very effective when
dedicated dual-purpose catheter is not available. Copyright &#xa9; 2016,
Wiley Periodicals, Inc.

<108>
Accession Number
613762011
Author
Sannino A.; Schiattarella G.G.; Toscano E.; Gargiulo G.; Giugliano G.;
Galderisi M.; Losi M.-A.; Stabile E.; Cirillo P.; Imbriaco M.; Grayburn
P.A.; Trimarco B.; Esposito G.
Institution
(Sannino, Schiattarella, Toscano, Gargiulo, Giugliano, Galderisi, Losi,
Stabile, Cirillo, Imbriaco, Trimarco, Esposito) Division of Cardiology,
Department of Advanced Biomedical Sciences, Federico II University,
Naples, Italy
(Sannino, Grayburn) Division of Cardiology, Baylor University Medical
Center, Dallas, Texas
(Schiattarella) Department of Internal Medicine (Cardiology), University
of Texas Southwestern Medical Center, Dallas, Texas
Title
Meta-Analysis of Effect of Body Mass Index on Outcomes After Transcatheter
Aortic Valve Implantation.
Source
American Journal of Cardiology. (no pagination), 2016. Date of
Publication: September 13, 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Controversial data exist regarding the impact of body mass index (BMI) on
TAVI outcomes. Thirteen TAVI studies were included and analyzed for the
incidence of procedural complications, 30-day, and long-term all-cause
mortality. Three comparisons were executed: (1) underweight versus normal
weight, (2) overweight versus normal weight, and (3) obese versus normal
weight patients. Underweight patients (BMI <20 kg/m²) had
similar 30-day all-cause mortality compared with the normal, although they
displayed a significant worse survival at long-term follow-up (hazard
ratio 1.68, 95% confidence interval (CI) 1.09 to 2.59, p = 0.02).
Underweight patients showed a higher incidence of major and
life-threatening bleedings (2,566 patients, odds ratio 1.64, 95% CI 1.10
to 2.45, p = 0.02) and of major vascular complications (2,566 patients,
odds ratio 1.86, 95% CI 1.16 to 2.98, p = 0.01), compared with normal
weight patients. Overweight patients (BMI >25 and <30 kg/m²)
display similar 30-day and long-term all-cause mortality, as well as
similar procedural complication rate compared with normal weight patients.
Obese patients (BMI >30 kg/m²) had similar 30-day all-cause
mortality rates compared with the normal weight category, whereas they
displayed a significant better survival at long-term (hazard ratio 0.79,
95% CI 0.67 to 0.93, p = 0.004). Procedural complications did not differ
between obese and normal body weight patients. In conclusion, a low BMI is
linked to a significantly worse prognosis after TAVI. Therefore, BMI
represents an important and handily tool that might be used in the risk
prediction of patients to be addressed for TAVI. Copyright &#xa9; 2016
Elsevier Inc.