EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 23

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<1>
Accession Number
26433633
Author
Kowalewski M.; Pawliszak W.; Malvindi P.G.; Bokszanski M.P.; Perlinski D.;
Raffa G.M.; Kowalkowska M.E.; Zaborowska K.; Navarese E.P.; Kolodziejczak
M.; Kowalewski J.; Tarelli G.; Taggart D.P.; Anisimowicz L.
Institution
(Kowalewski) Department of Cardiac Surgery, Dr Antoni Jurasz Memorial
University Hospital, Bydgoszcz, Poland; Faculty of Health Sciences,
Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland;
Systematic Investigation and Research on Interventions and Outcomes
(SIRIO) MEDICINE Research Network, Dusseldorf, Germany. Electronic
address:
(Pawliszak) Department of Cardiac Surgery, Dr Antoni Jurasz Memorial
University Hospital, Bydgoszcz, Poland
(Malvindi) University Hospital Southampton NHS Foundation Trust, Wessex
Cardiothoracic Centre, Southampton, United Kingdom
(Bokszanski) Department of Cardiac Surgery, Dr Antoni Jurasz Memorial
University Hospital, Bydgoszcz, Poland
(Perlinski) Department of Cardiac Surgery, Dr Antoni Jurasz Memorial
University Hospital, Bydgoszcz, Poland
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo
per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy
(Kowalkowska) Systematic Investigation and Research on Interventions and
Outcomes (SIRIO) MEDICINE Research Network, Dusseldorf, Germany;
Department and Clinic of Obstetrics, Gynecology, and Oncological
Gynecology, Collegium Medicum, Bydgoszcz, Poland
(Zaborowska) Department of Cardiac Surgery, Dr Antoni Jurasz Memorial
University Hospital, Bydgoszcz, Poland
(Navarese) Systematic Investigation and Research on Interventions and
Outcomes (SIRIO) MEDICINE Research Network, Dusseldorf, Germany; Division
of Cardiology, Pulmonology and Vascular Medicine, Department of Internal
Medicine, Heinrich-Heine-University, Dusseldorf, Germany
(Kolodziejczak) Systematic Investigation and Research on Interventions and
Outcomes (SIRIO) MEDICINE Research Network, Dusseldorf, Germany; Collegium
Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
(Kowalewski) Lung Cancer and Thoracic Surgery Department, Collegium
Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
(Tarelli) Department of Cardiac Surgery, Humanitas Clinical and Research
Center, Rozzano, Milan, Italy
(Taggart) Department of Cardiac Surgery, John Radcliffe Hospital, Oxford,
United Kingdom
(Anisimowicz) Department of Cardiac Surgery, Dr Antoni Jurasz Memorial
University Hospital, Bydgoszcz, Poland
Title
Off-pump coronary artery bypass grafting improves short-term outcomes in
high-risk patients compared with on-pump coronary artery bypass grafting:
Meta-analysis.
Source
The Journal of thoracic and cardiovascular surgery. 151 (1) (pp 60-77),
2016. Date of Publication: 01 Jan 2016.
Abstract
OBJECTIVES: To assess the benefits and risks of off-pump coronary artery
bypass (OPCAB) versus coronary artery bypass grafting (CABG) through a
meta-analysis of randomized controlled trials (RCTs), and to investigate
the relationship between outcomes and patient risk profile.
METHODS: PubMed, Embase, the Cumulative Index of Nursing and Allied Health
Literature, Scopus, Web of Science, Cochrane Library, and major conference
proceedings databases were searched for RCTs comparing OPCAB and CABG and
reporting short-term (< 30 days) outcomes. Endpoints assessed were
all-cause mortality, myocardial infarction (MI), and cerebral stroke.
RESULTS: The meta-analysis included 100 studies, with a total of 19,192
subjects. There was no difference between the 2 techniques with respect to
all-cause mortality and MI (odds ratio [OR], 0.88; 95% confidence interval
[CI], 0.71-1.09; P = .25; I(2) = 0% and OR, 0.90; 95% CI, 0.77-1.05; P =
.19; I(2) = 0%, respectively). OPCAB was associated with a significant 28%
reduction in the odds of cerebral stroke (OR, 0.72; 95% CI, 0.56-0.92; P =
.009; I(2) = 0%). A significant relationship between patient risk profile
and benefits from OPCAB was found in terms of all-cause mortality (P <
.01), MI (P < .01), and cerebral stroke (P < .01).
CONCLUSIONS: OPCAB is associated with a significant reduction in the odds
of cerebral stroke compared with conventional CABG. In addition, benefits
of OPCAB in terms of death, MI, and cerebral stroke are significantly
related to patient risk profile, suggesting that OPCAB should be strongly
considered in high-risk patients.

<2>
Accession Number
27040723
Author
Velazquez E.J.; Lee K.L.; Jones R.H.; Al-Khalidi H.R.; Hill J.A.; Panza
J.A.; Michler R.E.; Bonow R.O.; Doenst T.; Petrie M.C.; Oh J.K.; She L.;
Moore V.L.; Desvigne-Nickens P.; Sopko G.; Rouleau J.L.
Institution
(Velazquez) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Lee) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Jones) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Al-Khalidi) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Hill) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Panza) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Michler) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Bonow) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Doenst) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Petrie) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Oh) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(She) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Moore) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Desvigne-Nickens) From the Division of Cardiology (E.J.V.), Departments
of Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery
(R.H.J.), and Duke Clinical Research Institute (L.S., V.L.M.), Duke
University Medical Center, Durham, NC; the University of Florida,
Gainesville (J.A.H.); Westchester Medical Center and New York Medical
College, Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular
Surgery, Montefiore Medical Center, Albert Einstein College of Medicine,
New York (R.E.M.); Northwestern University Feinberg School of Medicine,
Chicago (R.O.B.); the Department of Cardiothoracic Surgery, University
Hospital Jena, Friedrich-Schiller-University of Jena, Jena, Germany
(T.D.); Glasgow University and Golden Jubilee National Hospital, Glasgow,
United Kingdom (M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division
of Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Sopko) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
(Rouleau) From the Division of Cardiology (E.J.V.), Departments of
Biostatistics and Bioinformatics (K.L.L., H.R.A.-K.) and Surgery (R.H.J.),
and Duke Clinical Research Institute (L.S., V.L.M.), Duke University
Medical Center, Durham, NC; the University of Florida, Gainesville
(J.A.H.); Westchester Medical Center and New York Medical College,
Valhalla (J.A.P.), and Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York
(R.E.M.); Northwestern University Feinberg School of Medicine, Chicago
(R.O.B.); the Department of Cardiothoracic Surgery, University Hospital
Jena, Friedrich-Schiller-University of Jena, Jena, Germany (T.D.); Glasgow
University and Golden Jubilee National Hospital, Glasgow, United Kingdom
(M.C.P.); Mayo Clinic, Rochester, MN (J.K.O.); the Division of
Cardiovascular Sciences, National Heart, Lung, and Blood Institute,
Bethesda, MD (P.D.-N., G.S.); and University of Montreal, Montreal Heart
Institute, Montreal (J.L.R.)
Title
Coronary-Artery Bypass Surgery in Patients with Ischemic Cardiomyopathy.
Source
The New England journal of medicine. 374 (16) (pp 1511-1520), 2016. Date
of Publication: 21 Apr 2016.
Abstract
BACKGROUND: The survival benefit of a strategy of coronary-artery bypass
grafting (CABG) added to guideline-directed medical therapy, as compared
with medical therapy alone, in patients with coronary artery disease,
heart failure, and severe left ventricular systolic dysfunction remains
unclear.
METHODS: From July 2002 to May 2007, a total of 1212 patients with an
ejection fraction of 35% or less and coronary artery disease amenable to
CABG were randomly assigned to undergo CABG plus medical therapy (CABG
group, 610 patients) or medical therapy alone (medical-therapy group, 602
patients). The primary outcome was death from any cause. Major secondary
outcomes included death from cardiovascular causes and death from any
cause or hospitalization for cardiovascular causes. The median duration of
follow-up, including the current extended-follow-up study, was 9.8 years.
RESULTS: A primary outcome event occurred in 359 patients (58.9%) in the
CABG group and in 398 patients (66.1%) in the medical-therapy group
(hazard ratio with CABG vs. medical therapy, 0.84; 95% confidence interval
[CI], 0.73 to 0.97; P=0.02 by log-rank test). A total of 247 patients
(40.5%) in the CABG group and 297 patients (49.3%) in the medical-therapy
group died from cardiovascular causes (hazard ratio, 0.79; 95% CI, 0.66 to
0.93; P=0.006 by log-rank test). Death from any cause or hospitalization
for cardiovascular causes occurred in 467 patients (76.6%) in the CABG
group and in 524 patients (87.0%) in the medical-therapy group (hazard
ratio, 0.72; 95% CI, 0.64 to 0.82; P<0.001 by log-rank test).
CONCLUSIONS: In a cohort of patients with ischemic cardiomyopathy, the
rates of death from any cause, death from cardiovascular causes, and death
from any cause or hospitalization for cardiovascular causes were
significantly lower over 10 years among patients who underwent CABG in
addition to receiving medical therapy than among those who received
medical therapy alone. (Funded by the National Institutes of Health; STICH
[and STICHES] ClinicalTrials.gov number, NCT00023595.).

<3>
Accession Number
26541831
Author
Etnel J.R.; Elmont L.C.; Ertekin E.; Mokhles M.M.; Heuvelman H.J.;
Roos-Hesselink J.W.; de Jong P.L.; Helbing W.A.; Bogers A.J.; Takkenberg
J.J.
Institution
(Etnel) Department of Cardiothoracic Surgery, Erasmus University Medical
Center, Rotterdam, The Netherlands
(Elmont) Department of Cardiothoracic Surgery, Erasmus University Medical
Center, Rotterdam, The Netherlands
(Ertekin) Department of Cardiothoracic Surgery, Erasmus University Medical
Center, Rotterdam, The Netherlands
(Mokhles) Department of Cardiothoracic Surgery, Erasmus University Medical
Center, Rotterdam, The Netherlands
(Heuvelman) Department of Cardiothoracic Surgery, Erasmus University
Medical Center, Rotterdam, The Netherlands
(Roos-Hesselink) Department of Cardiology, Erasmus University Medical
Center, Rotterdam, The Netherlands
(de Jong) Department of Cardiothoracic Surgery, Erasmus University Medical
Center, Rotterdam, The Netherlands
(Helbing) Department of Pediatric Cardiology, Erasmus University Medical
Center-Sophia Children's Hospital, Rotterdam, The Netherlands
(Bogers) Department of Cardiothoracic Surgery, Erasmus University Medical
Center, Rotterdam, The Netherlands
(Takkenberg) Department of Cardiothoracic Surgery, Erasmus University
Medical Center, Rotterdam, The Netherlands. Electronic address:
j.j.m.takkenberg@erasmusmc.nl
Title
Outcome after aortic valve replacement in children: A systematic review
and meta-analysis.
Source
The Journal of thoracic and cardiovascular surgery. 151 (1) (pp 143-152),
2016. Date of Publication: 01 Jan 2016.
Abstract
RESULTS: Thirty-four publications reporting on 42 cohorts were included in
this review: 26 concerning the Ross procedure (n = 2409), 13 concerning
mechanical prosthesis aortic valve replacement (n = 696), and 3 concerning
homograft aortic valve replacement (n = 224). There were no studies on
bioprostheses that met our inclusion criteria. The pooled mean patient age
was 9.4 years, 12.8 years, and 8.9 years for Ross, mechanical prosthesis,
and homograft recipients, respectively. Pooled mean follow-up was 6.6
years. The Ross procedure was associated with lower early (4.20%; 95%
confidence interval [CI], 3.37-5.22 vs 7.34%; 95% CI, 5.21-10.34 vs
12.82%; 95% CI, 8.91-18.46) and late mortality (0.64%/y; 95% CI, 0.49-0.84
vs 1.23%/y; 95% CI, 0.85-1.79 vs 1.59%/y; 95% CI, 1.03-2.46) compared with
mechanical prosthesis aortic valve replacement and homograft aortic valve
replacement, respectively. No significantly different aortic valve
reoperation rates were observed between the Ross procedure and mechanical
prosthesis aortic valve replacement (1.60%/y; 95% CI, 1.27-2.02 vs
1.07%/y; 95% CI, 0.68-1.68, respectively), whereas homograft aortic valve
replacement was associated with significantly higher aortic valve
reoperation rates (5.44%/y; 95% CI, 4.24-6.98). The Ross
procedure-associated right ventricular outflow tract reoperation rate was
1.91% per year (95% CI, 1.50-2.44).
CONCLUSIONS: This systematic review illustrates that all currently
available aortic valve substitutes are associated with suboptimal results
in children, reflecting the urgent need for reliable and durable repair
techniques and innovative replacement solutions for this challenging group
of patients.
METHODS: A systematic literature search for publications reporting outcome
after pediatric aortic valve replacement published between January 1990
and May 2015 was conducted. Studies written in English with a study size
of more than 30 patients were included.
OBJECTIVE: Despite an increasing interest in pediatric aortic valve
repair, aortic valve replacement in children may be unavoidable. The
evidence on outcome after pediatric aortic valve replacement is limited
and usually reported in small case series. This systematic review and
meta-analysis aims to provide an overview of reported outcome of pediatric
patients after aortic valve replacement.

<4>
Accession Number
20160153197
Author
Liao Y.-B.; He Z.-X.; Zhao Z.-G.; Wei X.; Zuo Z.-L.; Li Y.-J.; Xiong
T.-Y.; Xu Y.-N.; Feng Y.; Chen M.
Institution
(Liao, He, Zhao, Wei, Zuo, Li, Xiong, Xu, Feng, Chen) Department of
Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street,
Chengdu 610041, China
Title
The relationship between chronic obstructive pulmonary disease and
transcatheter aortic valve implantation - A systematic review and
meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 87 (pp 570-578), 2016.
Date of Publication: 01 Mar 2016.
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objective The present study was performed to investigate the relationship
between chronic obstructive pulmonary disease (COPD) and transcatheter
aortic valve implantation (TAVI). Background: Controversies regarding the
relationship between COPD and TAVI have intensified. Methods: A literature
review of the PubMed online database was performed, and articles published
between January 1, 2002 and March 20, 2015 were analyzed. Random-effect
and fixed-effect models were used, depending on the between-study
heterogeneity. Results: A total of 28 studies, involving 51,530 patients,
were identified in our review. The burden of COPD ranged from 12.5% to
43.4%, and COPD negatively impacted both short-term and long-term
all-cause survival (30 days: odds ratio [OR], 1.43, 95% CI, 1.14-1.79; >2
years: hazard ratio [HR], 1.34, 95% CI, 1.12-1.61). COPD was also
associated with increased short-term and mid-term cardiac-cause mortality
(30 days: OR, 1.29, 95% CI, 1.02-1.64; 1 year: HR: 1.09, 1.02-1.17).
Moreover, COPD (OR, 1.97, 95% CI, 1.29-3.0) predicted post-TAVI acute
kidney disease. Importantly, chronic kidney disease (CKD) (HR, 1.2, 95%
CI, 1.1-1.32) and the distance of the 6 minute walk test (6MWT) (HR, 1.16,
1.06-1.27) predicted TAVI futility in patients with COPD. Conclusion: COPD
is common among patients undergoing TAVI, and COPD impacts both short- and
long-term survival. COPD patients, who had a lower BMI, shorter distance
of 6MWT and CKD, were at higher risk for TAVI futility.

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Accession Number
20160060161
Author
Zhang L.; Gao S.
Institution
(Zhang, Gao) Department of Cerebral Surgery, Cancer Hospital Chinese,
Academy of Medical Sciences, No. 17, Panjiayuan Chaoyang District, Beijing
100021, China
Title
Systematic review and meta-analysis of atrial fibrillation prophylaxis
after lung surgery.
Source
Journal of Cardiovascular Pharmacology. 67 (4) (pp 351-357), 2016. Date of
Publication: April 2016.
Publisher
Lippincott Williams and Wilkins
Abstract
Atrial fibrillation (AF), which increases morbidity and mortality, is a
common occurrence after thoracic surgery and pulmonary resection. Despite
several investigations on various prophylactic measures for AF prevention,
the studies were not uniform and do not use similar controls making it
difficult to arrive at a meaningful conclusion. In the present systematic
analysis review, we evaluated the efficacy of different prophylactic
approaches to prevent AF after lung surgery in randomized trials reported
during 1991-2014. A total of 12 trials were identified that met the
criteria set for this meta-analysis. Among different trials, amiodarone
was found to be most effective in preventing postoperative AF (risk ratio,
0.22; P < 0.0001;95% confidence interval: 0.09-0.54). There were no
significant prophylactic effects by MgSO4 (risk ratio, 1.24; P < 0.007;
95% confidence interval, 0.27-5.68), digoxin, or Ca²⁺ blockers.
Single use of amiodarone was able to lower the incidence of AF from 39.2%
to 8.3% and seemed to be safe with no major complications. Although
several prophylactic measures have been tried to curtail the incidence of
AF in patients after lung surgery, prophylaxis with amiodarone seems to be
most effective of treatments studied.

<6>
Accession Number
20160318746
Author
Ando T.; Briasoulis A.; Holmes A.A.; Afonso L.; Schreiber T.; Kondur A.
Institution
(Ando, Briasoulis, Afonso, Schreiber, Kondur) Wayne State University,
Detroit Medical Center, Division of Cardiology, Detroit, MI 48226, United
States
(Holmes) Division of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY 10467, United States
Title
Transcatheter aortic valve replacement versus surgical aortic valve
replacement in patients with previous coronary artery bypass surgery: A
systematic review and meta-analysis.
Source
International Journal of Cardiology. 215 (pp 14-19), 2016. Date of
Publication: 15 Jul 2016.
Publisher
Elsevier Ireland Ltd
Abstract
Background Patients with severe aortic stenosis (AS) and previous coronary
artery bypass graft (CABG) surgery have increased risk for aortic valve
replacement. Whether surgical aortic valve replacement (SAVR) or
transcatheter aortic valve replacement (TAVR) offers better outcomes in
this population is unclear. We aimed to assess outcomes of TAVR and SAVR
in patients with previous CABG. Methods A systematic literature search of
Medline, EMBASE and Cochrane library was conducted. Studies that reported
clinical outcomes (perioperative or mid-term all-cause-mortality,
cardiovascular mortality, pacemaker implantation, hospital duration and
stroke) were included. Random-effect modeling was used to calculate odds
ratios (ORs) and 95% confidence intervals (CIs). Results Five cohort
studies including a total of 872 patients (423 in TAVR, 449 in SAVR) were
analyzed. STS scores were comparable between the two groups. No difference
in all-cause-mortality, cardiovascular mortality and stroke at 30 days, 1
year and total follow-up period was seen between the two groups. TAVR
patients had higher pacemaker implantation rates (OR 3.41, 95% CI
1.66-6.38, p < 0.001, I² = 21%) and shorter hospital stay (-
2.63 days, 95% CI - 5.20 to - 0.04, p = 0.05, I² = 43%).
Conclusions Patients with previous CABG who underwent TAVR had similar
perioperative and long-term survival while experiencing more pacemaker
implantations and shorter hospital stay compared to those who had SAVR
making TAVR a safe and efficacious alternative to SAVR.

<7>
Accession Number
20160323297
Author
O'Donoghue M.L.; Glaser R.; Cavender M.A.; Aylward P.E.; Bonaca M.P.;
Budaj A.; Davies R.Y.; Dellborg M.; Fox K.A.A.; Gutierrez J.A.T.; Hamm C.;
Kiss R.G.; Kovar F.; Kuder J.F.; Im K.A.; Lepore J.J.; Lopez-Sendon J.L.;
Ophuis T.O.; Parkhomenko A.; Shannon J.B.; Spinar J.; Tanguay J.-F.; Ruda
M.; Steg P.G.; Theroux P.; Wiviott S.D.; Laws I.; Sabatine M.S.; Morrow
D.A.
Institution
(O'Donoghue, Cavender, Bonaca, Gutierrez, Kuder, Im, Wiviott, Sabatine,
Morrow) TIMI Study Group, Cardiovascular Division, Brigham and Women's
Hospital, 350 Longwood Ave, Boston, MA 02115, United States
(Glaser, Davies, Lepore, Laws) Metabolic Pathways and Cardiovascular Unit,
Research and Development, GlaxoSmithKline, Collegeville, PA, United States
(Aylward) South Australian Health and Medical Research Institute, Flinders
University Medical Centre, Adelaide, SA, Australia
(Budaj) Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland
(Dellborg) Sahlgrenska University Hospital, Ostra and Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
(Fox) Centre for Cardiovascular Science, University of Edinburgh,
Edinburgh, United Kingdom
(Hamm) Kerckhoff Heart Center, Bad Nauheim, University of Giessen,
Giessen, Germany
(Kiss) Department of Cardiology, Military Hospital, Budapest, Hungary
(Kovar) Department of Internal Medicine I, Jessenius Faculty of Medicine
in Martin, Comenius University in Bratislava, Martin, Slovakia
(Lopez-Sendon) Cardiovascular Division, University Hospital La Paz,
Madrid, Spain
(Ophuis) Canisius-Wilhelmina Hospital, Nijmegen, Netherlands
(Parkhomenko) Ukranian Strazhesko Institute of Cardiology, Kiev, Ukraine
(Shannon) PAREXEL International, Durham, NC, United States
(Spinar) University Hospital, Jihlavska, Brno, Czech Republic
(Tanguay, Theroux) Montreal Heart Institute, University of Montreal,
Montreal, QC, Canada
(Ruda) Cardiology Research Center, Moscow, Russian Federation
(Steg) Departement Hospitalo-Universitaire FIRE, Hopital Bichat,
Assistance Publique-Hopitaux de Paris, Universite Paris-Diderot, Paris,
France
Title
Effect of losmapimod on cardiovascular outcomes in patients hospitalized
with acute myocardial infarction: A randomized clinical trial.
Source
JAMA - Journal of the American Medical Association. 315 (15) (pp
1591-1599), 2016. Date of Publication: 19 Apr 2016.
Publisher
American Medical Association
Abstract
Importance: p38 Mitogen-activated protein kinase (MAPK)-stimulated
inflammation is implicated in atherogenesis, plaque destabilization, and
maladaptive processes inmyocardial infarction (MI). Pilot data in a phase
2 trial in non-ST elevation MI indicated that the p38 MAPK inhibitor
losmapimod attenuates inflammation and may improve outcomes. Objective: To
evaluate the efficacy and safety of losmapimod on cardiovascular outcomes
in patients hospitalized with an acutemyocardial infarction. Design,
Setting, and Patients: LATITUDE-TIMI 60, a randomized, placebo-controlled,
double-blind, parallel-group trial conducted at 322 sites in 34 countries
from June 3, 2014, until December 8, 2015. Part A consisted of a leading
cohort (n = 3503) to provide an initial assessment of safety and
exploratory efficacy before considering progression to part B
(approximately 22 000 patients). Patients were considered potentially
eligible for enrollment if they had been hospitalized with an acute MI and
had at least 1 additional predictor of cardiovascular risk. Interventions:
Patients were randomized to either twice-daily losmapimod (7.5mg; n =
1738) or matching placebo (n = 1765) on a background of
guideline-recommended therapy. Patients were treated for 12 weeks and
followed up for an additional 12 weeks. Main Outcomes and Measures: The
primary end pointwas the composite of cardiovascular death, MI, or severe
recurrent ischemia requiring urgent coronary revascularization with the
principal analysis specified at week 12. Results: In part A, among the
3503 patients randomized (median age, 66 years; 1036 [29.6%] were women),
99.1%had complete ascertainment for the primary outcome. The primary end
point occurred by 12 weeks in 123 patients treated with placebo (7.0%) and
139 patients treated with losmapimod (8.1%; hazard ratio, 1.16; 95%CI,
0.91-1.47; P = .24). The on-treatment rates of serious adverse events were
16.0%with losmapimod and 14.2% with placebo. Conclusions and Relevance:
Among patients with acute MI, use of losmapimod compared with placebo did
not reduce the risk of major ischemic cardiovascular events. The results
of this exploratory efficacy study did not justify proceeding to a larger
efficacy trial in the existing patient population.

<8>
Accession Number
20160306234
Author
Naghshtabrizi B.; Sohrabi Z.; Emami F.; Manafi B.; Membari S.
Institution
(Naghshtabrizi, Sohrabi, Emami, Membari) Department of Cardiology, Ekbatan
University Hospital, Hamadan University of Medical Sciences, Hamadan,
Iran, Islamic Republic of
(Manafi) Department of Cardiac Surgery, Ekbatan University Hospital,
Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of
Title
Evaluation of the incidence of major adverse cardiac and cerebrovascular
events after percutaneous coronary intervention or coronary artery bypass
graft on proximal left anterior descending artery with and without other
coronary arteries involvement.
Source
International Cardiovascular Research Journal. 10 (2) (pp 61-66), 2016.
Date of Publication: 2016.
Publisher
Iranian Cardiovascular Research Journal
Abstract
Background: Major Adverse Cardiac and Cerebrovascular Events (MACCE)
include cardiac death, nonfatal Myocardial Infarction (MI),
cerebrovascular events, and Target Vessel Revascularization (TVR) that may
happen after Percutaneous Coronary Intervention (PCI) or Coronary Artery
Bypass Graft (CABG). Objectives: This study aimed to compare the incidence
of MACCE between the patients who underwent PCI or CABG due to significant
Left Anterior Descending (LAD) stenosis with and without other coronary
arteries involvement. Patients and Methods: This randomized mixed cohort
study was conducted on 400 patients with Coronary Artery Disease (CAD),
200 with proximal LAD stenosis and 200 with non-proximal LAD stenosis,
selected through census. Half of each group underwent PCI and the rest
underwent CABG. The participants were followed at fixed intervals after
the procedure and the incidence of MACCE was documented in their
checklists. Then, relative risk index was used to compare the two groups
regarding the incidence of MACCE. Statistical analysis was done using the
Stata software, version 11 and P < 0.05 was considered to be statistically
significant. Results: The study participants included 281 males and 119
females with the mean age of 61.36 +/- 10.66 years. The results showed a
significant difference between the two groups regarding the incidence of
MACCE (31.58% vs. 3%, P = 0.001). However, no significant difference was
found between the effects of PCI with drug eluting stent and CABG on
proximal LAD (3.70% vs. 3%, P = 1.00). Conclusions: Considering the
incidence of MACCE, CABG had no superiority over DES for proximal LAD
stenosis.

<9>
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Accession Number
20160060442
Author
Kinnaird T.; Anderson R.; Ossei-Gerning N.; Mamas M.A.; Ludman P.; Moat N.
Institution
(Kinnaird, Anderson, Ossei-Gerning) Department of Cardiology, University
Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom
(Mamas) Cardiovascular Research Group, Institute of Cardiovascular
Sciences, University of Manchester, Manchester, United Kingdom
(Ludman) Department of Cardiology, Queen Elizabeth Hospital, Birmingham,
United Kingdom
(Moat) Department of Cardiothoracic Surgery, Royal Brompton Hospital,
Sidney Street, London, United Kingdom
Title
Revascularization for left anterior descending artery stenosis: A review
of the evidence that supports practice.
Source
Cardiology in Review. 24 (3) (pp 136-140), 2016. Date of Publication:
2016.
Publisher
Lippincott Williams and Wilkins
Abstract
Disease of the proximal left anterior descending (LAD) artery is a common
pathological finding often combined with disease in other coronary
arteries. In this article, we review specifically the evidence (and the
guidelines arising from the data) for lesions isolated to the proximal LAD
only. Critical review of the data reveals limitations with few trials that
reflect contemporary practice. Much of the data are observational rather
than from randomized trials, and therefore subject to bias. We identified
2 randomized trials of drug-eluting stents versus left internal mammary
artery grafting for isolated lesions of the proximal LAD. One reported no
difference in major adverse cardiovascular events, but at an early
timepoint (6 months), which is likely to be too early to reveal treatment
differences. In the second trial, target lesion revascularization excess
was noted in the drug-eluting stent arm. Therefore, at the current time,
there are little data available to inform interventional cardiologists as
to the best revascularization strategy for isolated lesions of the
proximal LAD. Further randomized, controlled trials are needed.

<10>
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Accession Number
2015484558
Author
Marti D.; Salido L.; Mestre J.L.; Esteban M.J.; Casas E.; Jimenez-Mena M.;
Pey J.; Sanmartin M.; Hernandez-Antolin R.; Zamorano J.L.
Institution
(Marti, Salido, Mestre, Esteban, Casas, Jimenez-Mena, Pey, Sanmartin,
Hernandez-Antolin, Zamorano) Interventional Cardiology Unit, Department of
Cardiology, Central Defense Hospital, University of Alcala, Glorieta del
Ejercito, S/N, Madrid 28047, Spain
Title
Impact of thrombus burden on procedural and mid-term outcomes after
primary percutaneous coronary intervention.
Source
Coronary Artery Disease. 27 (3) (pp 169-175), 2016. Date of Publication:
2016.
Publisher
Lippincott Williams and Wilkins
Abstract
Objective Angiographic thrombus burden (TB) can be assessed early and
enable a decision on intervention. The aim of this study was to analyze
its effect on the incidence of cardiac events after a primary percutaneous
coronary intervention. Patients and methods We carried out a prospective
study of 480 consecutive ST-segment elevation myocardial infarction
patients treated by systematic primary percutaneous coronary intervention.
Large TB was defined as thrombus length at least 2 vessel diameters or as
solid thrombus obtained through catheter aspiration. The primary outcome
measure was a composite of death, reinfarction, or target vessel
revascularization. Results A total of 205 (47%) patients fulfilled the
criteria for large TB. These patients were more frequently treated with
abciximab (62.0 vs. 35.8%, P<0.001), showed more angiographic
complications (26.6 vs. 13.7%, P=0.001), and had larger infarcts (peak
troponin I, 74 vs. 50 ng/ml, P=0.015). During a follow-up of 19+/- 5
months, the rates of primary outcome were similar between groups of small
and large TB (16.2 vs. 12.8%, hazard ratio: 0.88, 95% confidence interval:
0.46-1.67, P=0.691). There were no differences in the rates of definite
stent thrombosis (0.5 vs. 2.2%, P=0.190). Conclusion Large TB is
associated with larger infarct size, but not with worse mid-term outcomes.
Selective use of adjuvant therapies according to TB may be an effective
approach to reduce thrombotic complications.

<11>
Accession Number
20160240593
Author
Tam M.K.P.; Wong W.T.; Gomersall C.D.; Tian Q.; Ng S.K.; Leung C.C.H.;
Underwood M.J.
Institution
(Tam, Ng) Department of Anaesthesia and Intensive Care, Prince of Wales
Hospital, Shatin, Hong Kong
(Wong, Gomersall, Tian, Leung) Department of Anaesthesia and Intensive
Care, The Chinese University of Hong Kong, Shatin, Hong Kong
(Underwood) Division of Cardiothoracic Surgery, Department of Surgery, The
Chinese University of Hong Kong, Shatin, Hong Kong
Title
A randomized controlled trial of 2 protocols for weaning cardiac surgical
patients receiving adaptive support ventilation.
Source
Journal of Critical Care. 33 (pp 163-168), 2016. Date of Publication: 01
Jun 2016.
Publisher
W.B. Saunders
Abstract
Purpose: This study aims to compare the effectiveness of weaning with
adaptive support ventilation (ASV) incorporating progressively reduced or
constant target minute ventilation in the protocol in postoperative care
after cardiac surgery. Material and methods: A randomized controlled
unblinded study of 52 patients after elective coronary artery bypass
surgery was carried out to determine whether a protocol incorporating a
decremental target minute ventilation (DTMV) results in more rapid weaning
of patients ventilated in ASV mode compared to a protocol incorporating a
constant target minute ventilation. Results: Median duration of mechanical
ventilation (145 vs 309 minutes; P =.001) and intubation (225 vs 423
minutes; P =.005) were significantly shorter in the DTMV group. There was
no difference in adverse effects (42% vs 46%) or mortality (0% vs 0%)
between the 2 groups. Conclusions: Use of a DTMV protocol for
postoperative ventilation of cardiac surgical patients in ASV mode results
in a shorter duration of ventilation and intubation without evidence of
increased risk of adverse effects.

<12>
Accession Number
20160294454
Author
Ruggieri V.G.; Anselmi A.; Chabanne C.; Lelong B.; Flecher E.; Verhoye
J.-P.; Leguerrier A.
Institution
(Ruggieri, Anselmi, Chabanne, Lelong, Flecher, Verhoye, Leguerrier)
Division of Thoracic and Cardiovascular Surgery, Pontchaillou University
Hospital, Rennes, France
Title
Three-year haemodynamic performance of the St Jude Trifecta bioprosthesis.
Source
European Journal of Cardio-thoracic Surgery. 49 (3) (pp 972-977), 2016.
Date of Publication: 01 Mar 2016.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: To examine the haemodynamic performance of the St Jude
Trifecta valve for aortic valve replacement (AVR) at 3 years after
implantation. METHODS: In a single-centre, prospective, observational,
independent study, we enrolled 122 patients who had AVR using a Trifecta
bioprosthesis in the July 2010-June 2011 period. A clinical and
echocardiographic in-house follow-up was scheduled. RESULTS: In our
series, 14.7% of patients received a 19-mm, 28.7% had a 21-mm, 35.2% had a
23-mm and 21.3% had a greater-size prosthesis. There were no cases of
operative mortality or of valve-related complications both early and at
follow-up (except one sudden unexplained death). Completeness of the
3-year echocardiographic follow-up was 80% among survivors. The average
mean transvalvular gradient (mTVG) at 3 years was 14.2, 10.8, 8.6, 7.1 and
6.8 mmHg (sizes 19 to 27/29, respectively). There was no statistically
significant difference between average mTVGs measured immediately after
implantation versus at the 3-year follow-up in the overall population. The
average peak transvalvular gradient (pTVG) at 3 years was 25, 20, 16.8,
13.9 and 14.4 mmHg (sizes 19 to 27/29, respectively). The average indexed
effective orifice area (iEOA) at 3 years was 0.8, 0.9, 1, 1.3 and 1.3
cm²/m² (sizes 19-27, respectively). The rate of
moderate patient- prosthesis mismatch (PPM) at 3 years was 15.7%; there
were two instances of severe PPM (2.2%). All cases of PPM occurred in the
19, 21 and 23 mm size subgroups. CONCLUSIONS: The Trifecta valve retains
its excellent haemodynamic properties at the 3-year follow-up. The rate of
PPMis considerably low.

<13>
Accession Number
20160294453
Author
Keyl C.; Schneider J.; Beyersdorf F.; Ruile P.; Siepe M.; Pioch K.;
Schneider R.; Jander N.
Institution
(Keyl, Pioch) Department of Anesthesiology, Heart Center Freiburg
University, Bad Krozingen, Germany
(Schneider, Ruile, Schneider, Jander) Department of Cardiology and
Angiology II, Heart Center Freiburg University, Bad Krozingen, Germany
(Beyersdorf, Siepe) Department of Cardiovascular Surgery, Heart Center
Freiburg University, Bad Krozingen, Germany
Title
Right ventricular function after aortic valve replacement: A pilot study
comparing surgical and transcatheter procedures using 3D echocardiography.
Source
European Journal of Cardio-thoracic Surgery. 49 (3) (pp 966-971), 2016.
Date of Publication: 01 Mar 2016.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Previous studies have found that standard echocardiographic
measures of right ventricular (RV) function were impaired after surgical
replacement of the aortic valve (SAVR), but not after transcatheter aortic
valve implantation (TAVI). We used 3D echocardiography to gain further
insight into the changes of RV performance in patient undergoing SAVR or
TAVI. METHODS: We conducted a prospective non-randomized study with two
parallel groups and performed echocardiographic evaluation in 20 patients
with aortic stenosis undergoing SAVR (age 77 +/- 4 years), and in 20
patients undergoing TAVI via the transfemoral approach (age 83 +/- 6
years) 1 week before and between the fifth and seventh day after the
procedure. RESULTS: Tricuspid annular plane systolic excursion was
postoperatively markedly reduced in patients undergoing SAVR (13 +/- 2 vs
26 +/- 4 mm, post- vs preoperative, P < 0.001), but not in patients
undergoing TAVI (24 +/- 7 vs 24 +/- 5 mm, P = 0.90). Fractional shortening
of the RV midcavity transverse diameter, however, increased after SAVR (50
+/- 8 vs 31 +/- 11%, P < 0.001) in contrast to TAVI (33 +/- 10 vs 34 +/-
9%, P = 0.85). The RV ejection fraction, assessed by 3D echocardiography,
remained unchanged in both patient groups (SAVR, 55 +/- 6 vs 55 +/- 7%, P
= 0.52; TAVI, 56 +/- 8 vs 54 +/- 7%, P = 0.28). CONCLUSIONS: RV
longitudinal contraction decreased after SAVR, whereas RV transverse
contraction increased. Both parameters did not change after TAVI. RV
ejection fraction and RV stroke volume remained constant irrespective of
the technique of aortic valve replacement, thus indicating that global
systolic RV function is not compromised after SAVR.

<14>
Accession Number
20160294451
Author
Gavina C.; Falcao-Pires I.; Pinho P.; Manso M.-C.; Goncalves A.;
Rocha-Goncalves F.; Leite-Moreira A.
Institution
(Gavina, Goncalves, Rocha-Goncalves) Department of Medicine, Faculty of
Medicine, University of Porto, Porto, Portugal
(Falcao-Pires, Leite-Moreira) Department of Physiology and Cardiothoracic
Surgery, Faculty of Medicine, University of Porto, Porto, Portugal
(Pinho, Leite-Moreira) Department of Cardiothoracic Surgery, Centro
Hospitalar Sao Joao, Porto, Portugal
(Manso) Department of Biostatistics, Faculty of Health Sciences,
University Fernando Pessoa - CIAGEB-UFP, Porto, Portugal
(Manso) REQUIMTE, University of Porto, Porto, Portugal
Title
Relevance of residual left ventricular hypertrophy after surgery for
isolated aortic stenosis.
Source
European Journal of Cardio-thoracic Surgery. 49 (3) (pp 952-959), 2016.
Date of Publication: 01 Mar 2016.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Persistent left ventricular (LV) hypertrophy after surgery is
frequent, but its clinical relevance is controversial. We evaluated if
residual LV hypertrophy (LVH) is associated with clinical outcomes after
aortic valve replacement (AVR) for severe aortic stenosis (AS). METHODS:
We analysed clinical and echocardiographic parameters before and after
AVR, in a prospective cohort of 132 patients with severe AS. The mean
follow-up was 6.0 +/- 1.5 years. Clinical endpoints were all-cause death
and combination of as in all-cause death and non-fatal cardiovascular
hospitalization. At AVR, myocardial biopsies for collagen volume fraction
(CVF) evaluation were done in 56 random patients. RESULTS: Residual LVH
was present in 44% of patients after AVR. Patients with residual LVH were
older, more frequently women and had hypertension (HT). Preoperatively,
they had higher LV mass indices (LVMI), higher E/e' and left atrial volume
indices, as well as lower peak systolic annular velocity. Female gender,
HT, LVMI and E/e' were independent predictors of persistent LVH. CVF at
the time of surgery was higher in those with residual LVH (20.0 +/- 14.6
vs 13.2 +/- 11.5%, P = 0.027). The risk of all-cause death and non-fatal
cardiovascular hospitalization was higher in patients with residual LVH
[OR 2.89 (95% CI 1.12-7.44); P = 0.035], but there were no differences in
all-cause mortality. Residual LVH was associated with a worse outcome in
women but not in men. CONCLUSIONS: Residual LVH after AVR is common and is
associated with worse prognosis, particularly in women. In addition, HT,
higher baseline LVM and worse diastolic dysfunction can help to identify
patients at risk for incomplete normalization of LVM.

<15>
Accession Number
20160294416
Author
Zhou F.; Luo Q.; Wang L.; Han L.
Institution
(Zhou, Luo, Wang, Han) Division of Nephrology, Ningbo No. 2 Hospital,
Affiliated Hospital of Ningbo University School of Medical, Ningbo,
Zhejiang, China
Title
Diagnostic value of neutrophil gelatinase-associated lipocalin for early
diagnosis of cardiac surgery-associated acute kidney injury: A
meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 49 (3) (pp 746-755), 2016.
Date of Publication: 01 Mar 2016.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Neutrophil gelatinase-associated lipocalin (NGAL) has been identified as
one of the most sensitive and specific biomarkers for predicting cardiac
surgery-associated acute kidney injury (CSA-AKI); however, variable
performance characteristics have been reported. We therefore performed a
diagnostic meta-analysis to investigate the diagnostic accuracy of NGAL in
early (within 12 h postoperatively) diagnosis of CSA-AKI using established
guidelines. The search was carried out electronically with Medline
(through PubMed interface), Embase, Cochrane library, ISI Web of Science,
Scopus and ClinicalTrials.gov (up to 5 September 2014), and hand-searching
was also done. Two reviewers conducted study inclusion, data extractions
and quality assessment of the studies independently. The diagnostic
capacity of NGAL for CSA-AKI was assessed using pooled sensitivity and
specificity, diagnostic odds ratio (DOR), area under the summary receiver
operating characteristic curve (AUC). Meta-Disc 1.4 and STATA 12.0 were
used to investigate the source of heterogeneity and to perform the
meta-analysis. Twenty-four studies (33 data sets of 4066 patients) were
considered, which were all of good methodological quality. The overall
pooled sensitivity of NGAL for the diagnosis of AKI was 0.68 [95%
confidence interval (CI), 0.65-0.70], and specificity was 0.79 (95% CI,
0.77-0.80). The overall pooled positive likelihood ratio and negative
likelihood ratio were 3.98 (95% CI, 3.05-5.20) and 0.33 (95% CI,
0.24-0.45), respectively, with a DOR of 13.05 (95% CI, 7.85-21.70). The
receiver operating characteristic analysis showed an AUC [standard error
(SE)] of 0.86 (0.02) and with a Q*-value (SE) of 0.79 (0.02). Subgroup
analysis showed that NGAL had better predictive ability in
neonates/children compared with adults (DOR, 19.37; AUC, 0.89 vs DOR,
8.98; AUC, 0.83), and adults without pre-existing renal insufficiency
(PRI) had higher diagnostic value than adults without PRI to predict
CSA-AKI (DOR, 15.43; AUC, 0.87 vs DOR, 6.56; AUC, 0.81). Both plasma/serum
and urine NGAL had the highly predictive nature for early diagnosis of
CSA-AKI (DOR, 13.09; AUC, 0.85 vs DOR, 13.20; AUC, 0.88), while lower DOR
and AUC values were shown (DOR, 8.31; AUC, 0.81) when measured using
standardized clinical platforms, compared with research-based assays (DOR,
19.22; AUC, 0.89). I²-values showed substantial heterogeneity,
which mainly stems from characteristics of patient population (P = 0.037).
NGAL diagnostic accuracy in early detection of CSA-AKI is high, especially
in neonates/children or adults with normal baseline renal function.

<16>
Accession Number
20160294415
Author
Soylu E.; Harling L.; Ashrafian H.; Rao C.; Casula R.; Athanasiou T.
Institution
(Soylu, Harling, Ashrafian, Rao, Casula, Athanasiou) Department of Surgery
and Cancer, Imperial College, London, United Kingdom
Title
A systematic review of the safety and efficacy of distal coronary artery
anastomotic devices.
Source
European Journal of Cardio-thoracic Surgery. 49 (3) (pp 732-745), 2016.
Date of Publication: 01 Mar 2016.
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Interest in minimally invasive and off-pump cardiac surgical techniques
has promoted the development of automated distal anastomotic devices
(DADs) to facilitate construction of coronary artery anastomosis. Several
DADs have been proposed for potential use in coronary surgery. However, a
number of technical failures and uncertainty around both short-term
morbidity and long-term patency have limited the generalized uptake of
these devices. A systematic literature search identified 28 studies,
incorporating 970 patients who underwent coronary artery bypass grafting
using a DAD. Eight different devices were identified including Heartflo,
St Jude, U-clip, vessel closure system, C-port, magnetic vascular
positioner and coronary anastomosis coupler. Thirty-day mortality,
cardiac-specific mortality and myocardial infarction were equal between
DADs and hand-sewn cases (1.3, 0.3 and 0.8%, respectively). The overall
proportion of postoperative haemorrhage was higher in the anastomotic
device group (2.3%) than in the group with hand-sewn anastomoses (1.5%)
although not statistically significant. Overall graft patency was 97.2% at
< 1 month, 94.6% at 1-3 months and 92.3% at > 3 months. Of the currently
available systems, the U-clip device was found to provide the best overall
postoperative outcomes, which included a patency of 96.1% at > 3months.
The current literature is limited by its predominantly observational study
design and lack of directly comparative studies. Furthermore, inter-study
variation in patient selection, anticoagulation strategies and follow-up
periods prevents quantitative comparison. Future research necessitates
multicentre randomized, controlled studies to provide a direct comparison
of current and future anastomotic device systems with established
hand-sewn techniques in both the short and long term.

<17>
Accession Number
20160315853
Author
Tu C.-C.; Hsu P.-K.
Institution
(Tu) Division of Thoracic Surgery, Department of Surgery, Chang Bing Show
Chwan Memorial Hospital, Changhua, Taiwan (Republic of China)
(Hsu) Division of Thoracic Surgery, Department of Surgery, Taipei Veterans
General Hospital, Taipei, Taiwan (Republic of China)
(Hsu) School of Medicine, National Yang-Ming University, Taipei, Taiwan
(Republic of China)
Title
Global development and current evidence of uniportal thoracoscopic
surgery.
Source
Journal of Thoracic Disease. 8 (pp S308-S318), 2016. Date of Publication:
01 Mar 2016.
Publisher
Pioneer Bioscience Publishing
Abstract
In the era of video-assisted thoracoscopic surgery (VATS), uniportal and
single incision thoracoscopic surgeries are gaining popularity. The
spectrum of uniportal VATS indications is now almost equal to that of
conventional VATS. For example, successful uniportal sleeve lobectomy, rib
segmental resection, and management of intraoperative bleeding have all
been reported. According to published data in the English-language
literature, more than 9,545 uniportal VATS have been performed to date,
including 1,293 lobectomies, 1,024 procedures for pneumothorax, and 6,845
sympathectomies. Of the 192 articles discussing this topic, 35 were
conducted in Spain, and there were an increasing number of publications
from China, Korea, and other Asian countries. There were 41 technical and
review articles, all of which provided an excellent foundation of surgical
concept and skill learning. The benefits of uniportal VATS include better
surgical geometry and cosmetics. Regarding postoperative outcomes,
thirteen out of the 15 articles reviewed showed that uniportal VATS has
similar or superior outcomes to conventional VATS. Most studies
demonstrated that uniportal VATS produced less postoperative pain and
paresthesia. In conclusion, uniportal VATS can produce excellent operative
outcome, which is becoming a mature surgical approach in thoracic disease,
supported by fast-accumulating and abundant experience.

<18>
Accession Number
20160272702
Author
Sibilitz K.L.; Berg S.K.; Tang L.H.; Risom S.S.; Gluud C.; Lindschou J.;
Kober L.; Hassager C.; Taylor R.S.; Zwisler A.-D.
Institution
(Sibilitz, Berg, Tang, Risom, Kober, Hassager, Zwisler) Rigshospitalet,
Copenhagen University Hospital, Department of Cardiology, The Heart
Centre, Blegdamsvej 9, Copenhagen 2100, Denmark
(Gluud) Copenhagen Trial Unit, Centre for Clinical Intervention Research,
Department 7812, Rigshospitalet, Copenhagen University Hospital, The
Cochrane Hepato-Biliary Group, Blegdamsvej 9, Copenhagen DK-2100, Denmark
(Lindschou) Department 7812, Rigshospitalet, Copenhagen University
Hospital, Copenhagen Trial Unit, Centre for Clinical Intervention
Research, Blegdamsvej 9, Copenhagen DK-2100, Denmark
(Taylor) University of Exeter Medical School, Institute of Health
Research, Exeter EX2 4SG, United Kingdom
Title
Exercise-based cardiac rehabilitation for adults after heart valve
surgery.
Source
Cochrane Database of Systematic Reviews. 2016 (3) (no pagination), 2016.
Article Number: CD010876. Date of Publication: March 21, 2016.
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom)
Abstract
Background: Exercise-based cardiac rehabilitation may benefit heart valve
surgery patients. We conducted a systematic review to assess the evidence
for the use of exercise-based intervention programmes following heart
valve surgery. Objectives: To assess the benefits and harms of
exercise-based cardiac rehabilitation compared with no exercise training
intervention, or treatment as usual, in adults following heart valve
surgery. We considered programmes including exercise training with or
without another intervention (such as a psycho-educational component).
Search methods: We searched: the Cochrane Central Register of Controlled
Trials (CENTRAL); the Database of Abstracts of Reviews of Effects (DARE);
MEDLINE (Ovid); EMBASE (Ovid); CINAHL (EBSCO); PsycINFO (Ovid); LILACS
(Bireme); and Conference Proceedings Citation Index-S (CPCI-S) on Web of
Science (Thomson Reuters) on 23 March 2015. We handsearched Web of
Science, bibliographies of systematic reviews and trial registers
(ClinicalTrials.gov, Controlled-trials.com, and The World Health
Organization International Clinical Trials Registry Platform). Selection
criteria: We included randomised clinical trials that investigated
exercise-based interventions compared with no exercise intervention
control. The trial participants comprised adults aged 18 years or older
who had undergone heart valve surgery for heart valve disease (from any
cause) and received either heart valve replacement, or heart valve repair.
Data collection and analysis: Two authors independently extracted data. We
assessed the risk of systematic errors ('bias') by evaluation of bias risk
domains. Clinical and statistical heterogeneity were assessed.
Meta-analyses were undertaken using both fixed-effect and random-effects
models. We used the GRADE approach to assess the quality of evidence. We
sought to assess the risk of random errors with trial sequential analysis.
Main results: We included two trials from 1987 and 2004 with a total 148
participants who have had heart valve surgery. Both trials had a high risk
of bias. There was insufficient evidence at 3 to 6 months follow-up to
judge the effect of exercise-based cardiac rehabilitation compared to no
exercise on mortality (RR 4.46 (95% confidence interval (CI) 0.22 to
90.78); participants = 104; studies = 1; quality of evidence: very low)
and on serious adverse events (RR 1.15 (95% CI 0.37 to 3.62); participants
= 148; studies = 2; quality of evidence: very low). Included trials did
not report on health-related quality of life (HRQoL), and the secondary
outcomes of New York Heart Association class, left ventricular ejection
fraction and cost. We did find that, compared with control (no exercise),
exercise-based rehabilitation may increase exercise capacity (SMD -0.47,
95% CI -0.81 to -0.13; participants = 140; studies = 2, quality of
evidence: moderate). There was insufficient evidence at 12 months
follow-up for the return to work outcome (RR 0.55 (95% CI 0.19 to 1.56);
participants = 44; studies = 1; quality of evidence: low). Due to limited
information, trial sequential analysis could not be performed as planned.
Authors' conclusions: Our findings suggest that exercise-based
rehabilitation for adults after heart valve surgery, compared with no
exercise, may improve exercise capacity. Due to a lack of evidence, we
cannot evaluate the impact on other outcomes. Further high-quality
randomised clinical trials are needed in order to assess the impact of
exercise-based rehabilitation on patient-relevant outcomes, including
mortality and quality of life.

<19>
Accession Number
20160263289
Author
Byrne M.; Doherty S.; Fridlund B.G.; Martensson J.; Steinke E.E.; Jaarsma
T.; Devane D.
Institution
(Byrne) National University of Ireland, Galway, School of Psychology, St.
Anthony's, Galway, County Galway, Ireland
(Doherty) RCSI, Department of Population and Health Science, School of
Psychology, St Stephens Green, Beaux Lane House, Dublin, Ireland
(Fridlund) Jonkoping University, School of Health Sciences, P O Box 1026,
Jonkoping 551 11, Sweden
(Martensson) Jonkoping University, Department of Nursing, School of Health
Sciences, P O Box 1026, Jonkoping 551 11, Sweden
(Steinke) Wichita State University, School of Nursing, 1845 Fairmount,
Wichita, KS 67260-0041, United States
(Jaarsma) University of Linkoping, Department of Social and Welfare
Studies, Kungsgatan 40, Norrkoping 601074, Sweden
(Devane) National University of Ireland Galway, School of Nursing and
Midwifery, University Road, Galway, Ireland
Title
Sexual counselling for sexual problems in patients with cardiovascular
disease.
Source
Cochrane Database of Systematic Reviews. 2016 (2) (no pagination), 2016.
Article Number: CD010988. Date of Publication: 24 Feb 2016.
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom)
Abstract
Background: Sexual problems are common among people with cardiovascular
disease. Although clinical guidelines recommend sexual counselling for
patients and their partners, there is little evidence on its
effectiveness. Objectives: To evaluate the effectiveness of sexual
counselling interventions (in comparison to usual care) on
sexuality-related outcomes in patients with cardiovascular disease and
their partners. Search methods: We searched CENTRAL, MEDLINE, EMBASE, and
three other databases up to 2 March 2015 and two trials registers up to 3
February 2016. Selection criteria: Randomised controlled trials (RCTs) and
quasi-RCTs, including individual and cluster RCTs. We included studies
that compared any intervention to counsel adult cardiac patients about
sexual problems with usual care. Data collection and analysis: We used
standard methodological procedures expected by Cochrane. Main results: We
included three trials with 381 participants. We were unable to pool the
data from the included studies due to the differences in interventions
used; therefore we synthesised the trial findings narratively. Two trials
were conducted in the USA and one was undertaken in Israel. All trials
included participants who were admitted to hospital with myocardial
infarction (MI), and one trial also included participants who had
undergone coronary artery bypass grafting. All trials followed up
participants for a minimum of three months post-intervention; the longest
follow-up timepoint was five months. One trial (N = 92) tested an
intensive (total five hours) psychotherapeutic sexual counselling
intervention delivered by a sexual therapist. One trial (N = 115) used a
15-minute educational video plus written material on resuming sexual
activity following a MI. One trial (N = 174) tested the addition of a
component that focused on resumption of sexual activity following a MI
within a hospital cardiac rehabilitation programme. The quality of the
evidence for all outcomes was very low. None of the included studies
reported any outcomes from partners. Two trials reported sexual function.
One trial compared intervention and control groups on 12 separate sexual
function subscales and used a repeated measures analysis of variance
(ANOVA) test. They reported statistically significant differences in
favour of the intervention. One trial compared intervention and control
groups using a repeated measures analysis of covariance (ANCOVA), and
concluded: "There were no significant differences between the two groups
[for sexual function] at any of the time points". Two trials reported
sexual satisfaction. In one trial, the authors compared sexual
satisfaction between intervention and control and used a repeated measured
ANOVA; they reported "differences were reported in favour of the
intervention". One trial compared intervention and control with a repeated
measures ANCOVA and reported: "There were no significant differences
between the two groups [for sexual satisfaction] at any of the
timepoints". All three included trials reported the number of patients
returning to sexual activity following MI. One trial found some evidence
of an effect of sexual counselling on reported rate of return to sexual
activity (yes/no) at four months after completion of the intervention
(relative risk (RR) 1.71, 95% confidence interval (CI) 1.26 to 2.32; one
trial, 92 participants, very low quality of evidence). Two trials found no
evidence of an effect of sexual counselling on rate of return to sexual
activity at 12 week (RR 1.01, 95% CI 0.94 to 1.09; one trial, 127
participants, very low quality of evidence) and three month follow-up (RR
0.98, 95% CI 0.88 to 1.10; one trial, 115 participants, very low quality
of evidence). Two trials reported psychological well-being. In one trial,
no scores were reported, but the trial authors stated: "No treatment
effects were observed on state anxiety as measured in three points in
time". In the other trial no scores were reported but, based on results of
a repeated measures ANCOVA to compare intervention and control groups, the
trial authors stated: "The experimental group had significantly greater
anxiety at one month post MI". They also reported: "There were no
significant differences between the two groups [for anxiety] at any other
time points". One trial reporting relationship satisfaction and one trial
reporting quality of life found no differences between intervention and
control. No trial reported on satisfaction in how sexual issues were
addressed in cardiac rehabilitation services. Authors' conclusions: We
found no high quality evidence to support the effectiveness of sexual
counselling for sexual problems in patients with cardiovascular disease.
There is a clear need for robust, methodologically rigorous, adequately
powered RCTs to test the effectiveness of sexual counselling interventions
for people with cardiovascular disease and their partners.

<20>
Accession Number
20160263264
Author
Yeung J.H.; Gates S.; Naidu B.V.; Wilson M.J.; Gao Smith F.
Institution
(Yeung, Gao Smith) Heart of England NHS Foundation Trust, Birmingham
Heartlands Hospital, Academic Department of Anaesthesia, Critical Care,
Pain and Resuscitation, Birmingham Heartlands Hospital, 1/F MIDRU
Building, Bordersley Green East, Birmingham B9 5SS, United Kingdom
(Yeung) University of Birmingham, School of Clinical and Experimental
Medicine, College of Medical and Dental Sciences, Birmingham, United
Kingdom
(Gates) Division of Health Sciences, Warwick Medical School, The
University of Warwick, Warwick Clinical Trials Unit, Gibbet Hill Road,
Coventry CV4 7AL, United Kingdom
(Naidu) Heart of England NHS Foundation Trust, Department of Thoracic
Surgery, Birmingham Heartlands Hospital, Bordersley Green East, Birmingham
B9 5SS, United Kingdom
(Wilson) The University of Sheffield, School of Health and Related
Research, Sheffield, United Kingdom
(Gao Smith) College of Medical and Dental Sciences, University of
Birmingham, School of Clinical and Experimental Medicine, Birmingham,
United Kingdom
Title
Paravertebral block versus thoracic epidural for patients undergoing
thoracotomy.
Source
Cochrane Database of Systematic Reviews. 2016 (2) (no pagination), 2016.
Article Number: CD009121. Date of Publication: February 21, 2016.
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom)
Abstract
Background: Operations on structures in the chest (usually the lungs)
involve cutting between the ribs (thoracotomy). Severe post-thoracotomy
pain can result from pleural (lung lining) and muscular damage,
costovertebral joint (ribcage) disruption and intercostal nerve (nerves
that run along the ribs) damage during surgery. Poor pain relief after
surgery can impede recovery and increase the risks of developing
complications such as lung collapse, chest infections and blood clots due
to ineffective breathing and clearing of secretions. Effective management
of acute pain following thoracotomy may prevent these complications and
reduce the likelihood of developing chronic pain. A multi-modal approach
to analgesia is widely employed by thoracic anaesthetists using a
combination of regional anaesthetic blockade and systemic analgesia, with
both non-opioid and opioid medications and local anaesthesia blockade.
There is some evidence that blocking the nerves as they emerge from the
spinal column (paravertebral block, PVB) may be associated with a lower
risk of major complications in thoracic surgery but the majority of
thoracic anaesthetists still prefer to use a thoracic epidural blockade
(TEB) as analgesia for their patients undergoing thoracotomy. In order to
bring about a change in practice, anaesthetists need a review that
evaluates the risk of all major complications associated with thoracic
epidural and paravertebral block in thoracotomy. Objectives: To compare
the two regional techniques of TEB and PVB in adults undergoing elective
thoracotomy with respect to: 1. analgesic efficacy;2. the incidence of
major complications (including mortality);3. the incidence of minor
complications;4. length of hospital stay;5. cost effectiveness. Search
methods: We searched for studies in the Cochrane Central Register of
Controlled Trials (CENTRAL 2013, Issue 9); MEDLINE via Ovid (1966 to 16
October 2013); EMBASE via Ovid (1980 to 16 October 2013); CINAHL via EBSCO
host (1982 to 16 October 2013); and reference lists of retrieved studies.
We handsearched the Journal of Cardiothoracic Surgery and Journal of
Cardiothoracic and Vascular Anesthesia (16 October 2013). We reran the
search on 31st January 2015. We found one additional study which is
awaiting classification and will be addressed when we update the review.
Selection criteria: We included all randomized controlled trials (RCTs)
comparing PVB with TEB in thoracotomy, including upper gastrointestinal
surgery. Data collection and analysis: We used standard methodological
procedures expected by Cochrane. Two review authors (JY and SG)
independently assessed the studies for inclusion and then extracted data
as eligible for inclusion in qualitative and quantitative synthesis
(meta-analysis). Main results: We included 14 studies with a total of 698
participants undergoing thoracotomy. There are two studies awaiting
classification. The studies demonstrated high heterogeneity in insertion
and use of both regional techniques, reflecting real-world differences in
the anaesthesia techniques. Overall, the included studies have a moderate
to high potential for bias, lacking details of randomization, group
allocation concealment or arrangements to blind participants or outcome
assessors. There was low to very low-quality evidence that showed no
significant difference in 30-day mortality (2 studies, 125 participants.
risk ratio (RR) 1.28, 95% confidence interval (CI) 0.39 to 4.23, P value =
0.68) and major complications (cardiovascular: 2 studies, 114
participants. Hypotension RR 0.30, 95% CI 0.01 to 6.62, P value = 0.45;
arrhythmias RR 0.36, 95% CI 0.04 to 3.29, P value = 0.36, myocardial
infarction RR 3.19, 95% CI 0.13, 76.42, P value = 0.47); respiratory: 5
studies, 280 participants. RR 0.62, 95% CI 0.26 to 1.52, P value = 0.30).
There was moderate-quality evidence that showed comparable analgesic
efficacy across all time points both at rest and after coughing or
physiotherapy (14 studies, 698 participants). There was moderate-quality
evidence that showed PVB had a better minor complication profile than TEB
including hypotension (8 studies, 445 participants. RR 0.16, 95% CI 0.07
to 0.38, P value < 0.0001), nausea and vomiting (6 studies, 345
participants. RR 0.48, 95% CI 0.30 to 0.75, P value = 0.001), pruritis (5
studies, 249 participants. RR 0.29, 95% CI 0.14 to 0.59, P value = 0.0005)
and urinary retention (5 studies, 258 participants. RR 0.22, 95% CI 0.11
to 0.46, P value < 0.0001). There was insufficient data in chronic pain
(six or 12 months). There was no difference found in and length of
hospital stay (3 studies, 124 participants). We found no studies that
reported costs. Authors' conclusions: Paravertebral blockade reduced the
risks of developing minor complications compared to thoracic epidural
blockade. Paravertebral blockade was as effective as thoracic epidural
blockade in controlling acute pain. There was a lack of evidence in other
outcomes. There was no difference in 30-day mortality, major
complications, or length of hospital stay. There was insufficient data on
chronic pain and costs. Results from this review should be interpreted
with caution due to the heterogeneity of the included studies and the lack
of reliable evidence. Future studies in this area need well-conducted,
adequately-powered RCTs that focus not only on acute pain but also on
major complications, chronic pain, length of stay and costs.

<21>
Accession Number
20160295807
Author
Egypto Rosa V.E.; De Santis Andrade Lopes A.S.; Duenhas Accorsi T.A.;
Cordeiro Fernandes J.R.; Spina G.S.; Sampaio R.O.; Paixao M.R.;
Pomerantzeff P.M.; Lemos Neto P.A.; Tarasoutchi F.
Institution
(Egypto Rosa, De Santis Andrade Lopes, Duenhas Accorsi, Cordeiro
Fernandes, Spina, Sampaio, Paixao) Clinical Unit of Heart Valve Disease,
Brazil
(Pomerantzeff, Tarasoutchi) Surgical Unit of Heart Valve Disease, Brazil
(Lemos Neto) Hemodynamics Unit, Brazil
(Egypto Rosa, De Santis Andrade Lopes, Duenhas Accorsi, Cordeiro
Fernandes, Spina, Sampaio, Paixao, Pomerantzeff, Lemos Neto, Tarasoutchi)
Instituto Do Coracao (InCor) Do Hospital das Clinicas, Faculdade de
Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo, SP, Brazil
Title
EuroSCORE II and STS as mortality predictors in patients undergoing TAVI.
Source
Revista da Associacao Medica Brasileira. 62 (1) (pp 32-37), 2016. Date of
Publication: January-February 2016.
Publisher
Associacao Medica Brasileira
Abstract
Introduction: the EuroSCORE II and STS are the most used scores for
surgical risk stratification and indication of transcatheter aortic valve
implantation (TAVI). However, its role as a tool for mortality prediction
in patients undergoing TAVI is still unclear. Objective: to evaluate the
performance of the EuroSCORE II and STS as predictors of in-hospital and
30-day mortality in patients undergoing TAVI. Methods: we included 59
symptomatic patients with severe aortic stenosis that underwent TAVI
between 2010 and 2014. The variables were analyzed using Student's t-test
and Fisher's exact test and the discriminative power was evaluated using
receiver operating characteristic curve (ROC) and area under the curve
(AUC) with a 95% confidence interval. Results: mean age was 81+/-7.3
years, 42.3% men. The mean EuroSCORE II was 7.6+/-7.3 % and STS was
20.7+/-10.3%. Transfemoral procedure was performed in 88.13%, transapical
in 3.38% and transaortic in 8.47%. In-hospital mortality was 10.1% and
30-day mortality was 13.5%. Patients who died had EuroSCORE II and STS
higher than the survivors (33.7+/-16.7 vs. 18.6+/-7.3% p=0,0001 for STS
and 13.9+/-16.1 vs. 4.8+/-3.8% p=0.0007 for EuroSCORE II). The STS showed
an AUC of 0.81 and the EuroSCORE II of 0.77 and there were no differences
in the discrimination ability using ROC curves (p=0.72). Conclusion: in
this cohort, the STS and EuroSCORE II were predictors of in-hospital and
30-days mortality in patients with severe aortic stenosis undergoing TAVI.

<22>
Accession Number
20160287542
Author
Sharma P.; Patel K.; Baria K.; Lakhia K.; Malhotra A.; Shah K.; Patel S.
Institution
(Sharma, Patel, Baria, Lakhia, Malhotra) Department of Cardiovascular and
Thoracic Surgery, U N Mehta Institute of Cardiology and Research Center,
Asarwa, Ahmedabad, Gujarat, India
(Shah, Patel) Department of Research, U N Mehta Institute of Cardiology
and Research Center, Asarwa, Ahmedabad, Gujarat, India
Title
Procalcitonin level for prediction of postoperative infection in cardiac
surgery.
Source
Asian Cardiovascular and Thoracic Annals. 24 (4) (pp 344-349), 2016. Date
of Publication: 2016.
Publisher
SAGE Publications Inc.
Abstract
Background Diagnosing infection after cardiac surgery remains difficult
due to the systemic inflammatory response induced by cardiopulmonary
bypass. We compared procalcitonin levels with white blood cell counts as
predictors of infection after cardiac surgery. Methods We prospectively
enrolled 100 consecutive adult cardiac patients. Postoperative white blood
cell counts, serum procalcitonin levels, and blood cultures were examined.
Result The sensitivity and specificity of white blood cell count and
procalcitonin > 2 ng mL^-1 were 60% and 100%, 58.8% and 42.5%,
respectively. Procalcitonin > 7 ng mL^-1 had 95% sensitivity and
80% specificity. Receiver-operating characteristic analysis showed a
greater area under the curve for procalcitonin level (p < 0.0001) compared
to white blood cell count (p = 0.31). Patients with positive blood
cultures had significantly higher procalcitonin levels (51.97 +/- 39.62
vs. 6.67 +/- 10.73 ng mL^-1), Acute Physiology and Chronic
Health Evaluation-II scores (16.95 +/- 3.24 vs. 13.60 +/- 2.98), and
intensive care unit stay (6.35 +/- 3.42 vs. 4.6 +/- 2.2 days).
Non-survivors had significantly higher Acute Physiology and Chronic Health
Evaluation-II scores (19.09 +/- 1.30 vs. 13.67 +/- 2.97) and procalcitonin
levels (43.83 +/- 52.15 vs. 12.26 +/- 19.89 ng mL^-1) but on
logistic regression analysis, only Acute Physiology and Chronic Health
Evaluation-II score was an independent risk factor for mortality.
Conclusion The diagnostic accuracy of procalcitonin for bacterial
infection is fairly high. Acute Physiology and Chronic Health
Evaluation-II score is a better predictor of mortality and morbidity than
absolute procalcitonin level. Procalcitonin > 7 ng mL^-1 can
prognosticate and identify the high-risk group.

<23>
Accession Number
72259845
Author
Salzmann S.; Euteneuer F.; Auer C.J.; Laferton J.A.; Schedlowski M.;
Moosdorf R.; Rief W.
Institution
(Salzmann, Euteneuer, Auer, Laferton, Rief) Clinical Psychology and
Psychotherapy, Philipps University of Marburg, Marburg, Hessen, Germany
(Schedlowski) Institute of Medical Psychology and Behavioral
Immunobiology, University Clinic Essen, Essen, Nordrhein-Westfalen,
Germany
(Moosdorf) Clinic for Cardiac and Thoracic Vessel Surgery, Heart Center,
Germany
Title
Pre-surgical psychological interventions lead to reduced levels of
adrenaline and cortisol after surgery in coronary artery bypass graft
patients: The PSY-heart study.
Source
Psychosomatic Medicine. Conference: 74th Annual Meeting of the American
Psychosomatic Society, APS 2016 Denver, CO United States. Conference
Start: 20160309 Conference End: 20160312. Conference Publication:
(var.pagings). 78 (3) (pp A29), 2016. Date of Publication: April 2016.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Outcomes of coronary artery bypass graft (CABG) surgeries are
associated with patients' pre-surgical expectations. Pre-surgical
psychological interventions targeting patients' expectations could help to
buffer patients stress response and to improve recovery after heart
surgery. This study examines whether pre-surgical psychological
interventions are capable of influencing the biological stress response
after CABG-surgery. Methods: Randomized controlled trial with assessments
at 10 days before surgery, post psychological intervention (day of
hospital admission, but before surgery) and post-surgery (6-8 days later).
Eligible patients (N=92) scheduled for elective on pump CABG or CABG with
valve replacement surgery were approached before hospital admission.
Standard medical care (SMC) was compared to two additional preoperative
psychological interventions: Either the expectation manipulation
intervention (EMI) to optimize patients' expectations about course and
outcomes, or the same amount of therapeutic attention with a focus on a
good therapeutic relationship and emotional expression, but without
specifically working on expectations (supportive therapy, or SUP). Main
outcomes were plasma adrenaline, noradrenaline and cortisol levels and
patients' disability expectations post-surgery. Results:EMI (P=.018) and
SUP (P=.009) led to significantly lower post-surgery adrenaline levels
compared to SMC only. SUP led to lower cortisol levels compared to SMC
after surgery (P=.021); time and treatment group interacted significantly
(F=2.01;P=.029;eta²=.147) while controlling for disability
expectations, demographic, psychological and medical variables. Higher
disability expectations at baseline were associated with higher adrenaline
levels after surgery (F=5.682;P=.021;eta²=.071), and patients'
baseline expectations were associated with changes of patients' adrenaline
levels over time(F=10.32,P<.001;eta² =.122). Conclusions: In
addition to standard medical care, preoperative psychological
interventions seem to be able to buffer psychobiological stress responses
and could thus facilitate recovery from CABG-surgery. (Figure Presented).