EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
611525576
Author
Zhou C.; Jeon Y.; Meybohm P.; Zarbock A.; Young P.J.; Li L.; Hausenloy
D.J.
Institution
(Zhou, Li) Department of Anesthesiology, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing 100037, China
(Jeon) Department of Anesthesiology and Pain Medicine, Seoul National
University Hospital, Daehakro 101, Seoul 110-744, South Korea
(Meybohm) Department of Anesthesiology, Intensive Care Medicine, and Pain
Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, Frankfurt
60590, Germany
(Zarbock) Department of Anesthesiology, Critical Care Medicine and Pain
Therapy, University Hospital Munster, Albert- Schweitzer-Campus 1, Gebaude
A1, Munster 48149, Germany
(Young) Wellington Hospital, Capital and Coast District Health Board,
Private Bag 7902, Wellington 6242, New Zealand
(Hausenloy) The Hatter Cardiovascular Institute, University College
London, 67 Chenies Mews, London WC1E 6HX, United Kingdom
(Hausenloy) The National Institute of Health Research University College
London Hospitals Biomedical Research Centre, London, United Kingdom
(Hausenloy) National Heart Research Institute Singapore, National Heart
Centre Singapore, Singapore
(Hausenloy) Cardiovascular and Metabolic Disorders Program, Duke-National
University of Singapore, Singapore
Title
Renoprotection by remote ischemic conditioning during elective coronary
revascularization: A systematic review and meta-analysis of randomized
controlled trials.
Source
International Journal of Cardiology. 222 (pp 295-302), 2016. Date of
Publication: 01 Nov 2016.
Publisher
Elsevier Ireland Ltd
Abstract
Background Remote ischemic conditioning (RIC) has been recognized an
emerging non-invasive approach for preventing acute kidney injury (AKI) in
patients undergoing either elective coronary artery bypass graft (CABG)
surgery or percutaneous coronary intervention (PCI). On the other hand,
accumulating evidence has indicated the involving role of pre-CABG
contrast usage for coronary angiography in post-surgery AKI risk. Along
with the shortening time delay of CABG after coronary angiography, and the
prevalent hybrid coronary revascularization (HCR), the AKI prevention by
RIC has faced challenges following coronary revascuralization. Methods
Randomized controlled trials (RCTs) were searched from Pubmed, EMBase, and
Cochrane library (until May 2016). The primary outcome was postoperative
AKI. The second outcomes were included the requirement for renal
replacement therapy (RRT), and in-hospital or 30-day mortality. Results
Twenty eligible RCTs (CABG, 3357 patients; PCI, 1501 patients) were
selected. RIC significantly halved the incidence of AKI following PCI when
compared with controls [n = 1501; odds ratio (OR) = 0.51; 95% CI, 0.32 to
0.82; P = 0.006; I² = 29.6%]. However, RIC did not affect the
incidence of AKI following CABG (n = 1850; OR = 0.94; 95% CI, 0.73 to
1.19; P = 0.586; I² = 12.4%). The requirement for RRT and
in-hospital mortality was not affected by RIC in CABG (n = 2049, OR =
1.04, P = 0.87; n = 1920, OR = 0.89, P = 0.7; respectively). Conclusions
Our meta-analysis suggests that RIC for preventing AKI following CABG has
faced with challenges in terms of AKI, the requirement for RRT, and
mortality. However, RIC shows a renoprotective benefit for PCI. Hence, our
findings may infer the preserved renal effects of RIC in CABG with
preconditioning before the coronary angiography, or in HCR. Copyright
&#xa9; 2016

<2>
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.

<3>
Accession Number
610923123
Author
Zaragoza R.; Aguado J.M.; Ferrer R.; Rodriguez A.H.; Maseda E.; Llinares
P.; Grau S.; Munoz P.; Fortun J.; Bouzada M.; Pozo J.C.D.; Leon R.
Institution
(Zaragoza, Aguado, Ferrer, Rodriguez, Maseda, Llinares, Grau, Munoz,
Fortun, Bouzada, Pozo, Leon) Servicio de Medicina Intensiva, Coordinador
Unidad de Sepsis, Hospital Universitario Dr. Peset, Avda Gaspar Aguilar,
90, Valencia, Spain
Title
EPICO 3.0. Antifungal prophylaxis in solid organ transplant recipients.
Source
Revista Iberoamericana de Micologia. 33 (4) (pp 187-195), 2016. Date of
Publication: 01 Oct 2016.
Publisher
Asociacion Espanola de Micologia
Abstract
Background Although over the past decade the management of invasive fungal
infection has improved, considerable controversy persists regarding
antifungal prophylaxis in solid organ transplant recipients. Aims To
identify the key clinical knowledge and make by consensus the high level
recommendations required for antifungal prophylaxis in solid organ
transplant recipients. Methods Spanish prospective questionnaire, which
measures consensus through the Delphi technique, was conducted anonymously
and by e-mail with 30 national multidisciplinary experts, specialists in
invasive fungal infections from six national scientific societies,
including intensivists, anesthetists, microbiologists, pharmacologists and
specialists in infectious diseases that responded to 12 questions prepared
by the coordination group, after an exhaustive review of the literature in
the last few years. The level of agreement achieved among experts in each
of the categories should be equal to or greater than 70% in order to make
a clinical recommendation. In a second term, after extracting the
recommendations of the selected topics, a face-to-face meeting was held
with more than 60 specialists who were asked to validate the pre-selected
recommendations and derived algorithm. Measurements and primary outcomes
Echinocandin antifungal prophylaxis should be considered in liver
transplant with major risk factors (retransplantation, renal failure
requiring dialysis after transplantation, pretransplant liver failure, not
early reoperation, or MELD > 30); heart transplant with hemodialysis, and
surgical re-exploration after transplantation; environmental colonization
by Aspergillus, or cytomegalovirus (CMV) infection; and pancreas and
intestinal transplant in case of acute graft rejection, hemodialysis,
initial graft dysfunction, post-perfusion pancreatitis with anastomotic
problems or need for laparotomy after transplantation. Antifungal
fluconazole prophylaxis should be considered in liver transplant without
major risk factors and MELD 20-30, split or living donor,
choledochojejunostomy, increased transfusion requirements, renal failure
without replacement therapy, early reoperation, or multifocal colonization
or infection with Candida; intestinal and pancreas transplant with no risk
factors for echinocandin treatment. Liposomal amphotericin B antifungal
prophylaxis should be considered in lung transplant (inhalant form) and
liver transplant with major risk factors. Antifungal prophylaxis with
voriconazole should be considered in lung transplant, and heart transplant
with hemodialysis, surgical re-exploration after transplantation,
environmental colonization by Aspergillus, or CMV infection. Conclusions
The management of antifungal prophylaxis in solid organ transplant
recipients requires the application of knowledge and skills that are
detailed in our recommendations and the algorithm developed therein. These
recommendations, based on the DELPHI methodology, may help to identify
potential patients, standardize their management and improve overall
prognosis. Copyright &#xa9; 2016 Asociacion Espanola de Micologia

<4>
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Accession Number
613247585
Author
Hajjar L.A.; Vincent J.L.; Barbosa Gomes Galas F.R.; Rhodes A.; Landoni
G.; Osawa E.A.; Melo R.R.; Sundin M.R.; Grande S.M.; Gaiotto F.A.;
Pomerantzeff P.M.; Dallan L.O.; Franco R.A.; Nakamura R.E.; Lisboa L.A.;
De Almeida J.P.; Gerent A.M.; Souza D.H.; Gaiane M.A.; Fukushima J.T.;
Park C.L.; Zambolim C.; Rocha Ferreira G.S.; Strabelli T.M.; Fernandes
F.L.; Camara L.; Zeferino S.; Santos V.G.; Piccioni M.A.; Jatene F.B.;
Costa Auler J.O.; Filho R.K.
Institution
(Hajjar, Barbosa Gomes Galas, Osawa, Melo, Sundin, Grande, Franco,
Nakamura, De Almeida, Gerent, Souza, Gaiane, Fukushima, Park, Zambolim,
Rocha Ferreira, Fernandes, Camara, Zeferino, Santos, Piccioni, Costa
Auler) Department of Cardiopneumology, InCor, Faculdade de Medicina da
Universidade de Sao Paulo, Universidade de Sao Paulo, Av Dr Eneas Carvalho
Aguiar 44, Sao Paulo, Brazil
(Gaiotto, Pomerantzeff, Dallan, Lisboa, Jatene) Division of Cardiovascular
Surgery, United States
(Strabelli) Division of Infectious Diseases, United States
(Filho) Division of Cardiology, Heart Institute (InCor), Hospital das
Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo,
Brazil
(Vincent) Department of Intensive Care, Erasme University Hospital,
Universite de Bruxelles, Brussels, Belgium
(Rhodes) Department of Intensive Care Medicine, St George's Healthcare NHS
Trust, St George's University of London, London, United Kingdom
(Landoni) Department of Anesthesia and Intensive Care, San Raffaele
Scientific Institute, Milan, Italy
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
Title
Vasopressin versus Norepinephrine in Patients with Vasoplegic Shock after
Cardiac Surgery.
Source
Anesthesiology. 126 (1) (pp 85-93), 2017. Date of Publication: 01 Jan
2017.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: Vasoplegic syndrome is a common complication after cardiac
surgery and impacts negatively on patient outcomes. The objective of this
study was to evaluate whether vasopressin is superior to norepinephrine in
reducing postoperative complications in patients with vasoplegic syndrome.
Methods: This prospective, randomized, double-blind trial was conducted at
the Heart Institute, University of Sao Paulo, Sao Paulo, Brazil, between
January 2012 and March 2014. Patients with vasoplegic shock (defined as
mean arterial pressure less than 65 mmHg resistant to fluid challenge and
cardiac index greater than 2.2 l . min -2 . m -2) after cardiac surgery
were randomized to receive vasopressin (0.01 to 0.06 U/min) or
norepinephrine (10 to 60 mug/min) to maintain arterial pressure. The
primary endpoint was a composite of mortality or severe complications
(stroke, requirement for mechanical ventilation for longer than 48 h, deep
sternal wound infection, reoperation, or acute renal failure) within 30
days. Results: A total of 330 patients were randomized, and 300 were
infused with one of the study drugs (vasopressin, 149; norepinephrine,
151). The primary outcome occurred in 32% of the vasopressin patients and
in 49% of the norepinephrine patients (unadjusted hazard ratio, 0.55; 95%
CI, 0.38 to 0.80; P = 0.0014). Regarding adverse events, the authors found
a lower occurrence of atrial fibrillation in the vasopressin group (63.8%
vs. 82.1%; P = 0.0004) and no difference between groups in the rates of
digital ischemia, mesenteric ischemia, hyponatremia, and myocardial
infarction. Conclusions: The authors' results suggest that vasopressin can
be used as a first-line vasopressor agent in postcardiac surgery
vasoplegic shock and improves clinical outcomes. Copyright &#xa9; 2016 the
American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc.
All Rights Reserved.

<5>
[Use Link to view the full text]
Accession Number
611864380
Author
Lee C.Y.; Wong J.K.; Ross R.E.; Liu D.C.; Khabbaz K.R.; Martellaro A.J.;
Gorea H.R.; Sauer J.S.; Knight P.A.
Institution
(Lee, Wong, Ross, Knight) Division of Cardiac Surgery, University of
Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, United
States
(Liu, Khabbaz) Division of Cardiac Surgery, Beth Israel Deaconess Medical
Center, Boston, MA, United States
(Martellaro, Gorea, Sauer) LSI SOLUTIONS, Victor, NY, United States
Title
Prosthetic aortic valve fixation study 48 replacement valves analyzed
using digital pressure mapping.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 11 (5) (pp 327-336), 2016. Date of Publication: 2016.
Publisher
Lippincott Williams and Wilkins (E-mail: agents@lww.com)
Abstract
Objective: Prostheses attachment is critical in aortic valve replacement
surgery, yet reliable prosthetic security remains a challenge. Accurate
techniques to analyze prosthetic fixation pressures may enable the use of
fewer sutures while reducing the risk of paravalvular leaks (PVL).
Methods: Customized digital thin film pressure transducers were sutured
between aortic annulus models and 21-mm bioprosthetic valves with 15 x
4-mm, 12 x 4-mm, or 9 x 6-mm-wide pledgeted mattress sutures. Simulating
open and minimally invasive access, 4 surgeons, blinded to data
acquisition, each secured 12 valves using manual knottying (hand-tied [HT]
or knot-pusher [KP]) or automated titanium fasteners (TFs). Real-time
pressure measurements and times were recorded. Two-dimensional (2D) and 3D
pressure maps were generated for all valves. Pressures less than 80 mm Hg
were considered at risk for PVL. Results: Pressures under each knot
(intrasuture) fell less than 80 mm Hg for 12 of 144 manual knots (5/144
HT, 7/144 KP) versus 0 of 288 TF (P < 0.001). Pressures outside adjacent
sutures (extrasuture) were less than 80 mm Hg in 10 of 60 HT, zero of 60
KP, and zero of 120 TF sites for 15 x 4-mm valves; 17 of 48 HT, 25 of 48
KP, and 12 of 96 TF for 12 x 4-mm valves; and 15 of 36 HT, 17 of 36 KP,
and 9 and 72 TF for 9 x 6-mm valves; P < 0.001 all manual versus TF.
Annular areas with pressures less than 80 mm Hg ranged from 0% of the
sewing-ring area (all open TF) to 31% (12 x 4 mm, KP). The average time
per manual knot, 46 seconds (HT, 31 seconds; KP, 61 seconds), was greater
than TF, 14 seconds (P < 0.005). Conclusions: Reduced operative times and
PVL risk would fortify the advantages of surgical aortic valve
replacement. This research encourages continued exploration of technical
factors in optimizing prosthetic valve security. Copyright &#xa9; 2016 by
the International Society for Minimally Invasive Cardiothoracic Surgery.

<6>
Accession Number
600651808
Author
Tie H.-T.; Luo M.-Z.; Li Z.-H.; Wang Q.; Wu Q.-C.
Institution
(Tie, Wu) Department of Cardiothoracic Surgery, First Affiliated Hospital
of Chongqing Medical University, Chongqing 400016, China
(Luo) Children's Hospital of Chongqing Medical University, Chongqing
400016, China
(Li, Wang) First College of Clinical Medicine, Chongqing Medical
University, Chongqing 400016, China
Title
Remote ischemic preconditioning for pediatric patients undergoing
congenital cardiac surgery: A meta-analysis.
Source
International Journal of Cardiology. 177 (2) (pp 551-553), 2014. Date of
Publication: 15 Dec 2014.
Publisher
Elsevier Ireland Ltd

<7>
Accession Number
613201732
Author
Sharma V.; Rao V.; Manlhiot C.; Boruvka A.; Fremes S.; Wasowicz M.
Institution
(Sharma, Wasowicz) Department of Anesthesia and Pain Management, Toronto
General Hospital, Toronto, Ontario, Canada
(Rao) Department of Surgery, Peter Munk Cardiac Centre, University Health
Network, Toronto, Ontario, Canada
(Manlhiot, Boruvka) Cardiovascular Data Management Centre, University of
Toronto, Toronto, Ontario, Canada
(Fremes) Division of Cardiac Surgery, Schulich Heart Centre, Sunnybrook
Health Sciences Centre, Toronto, Ontario, Canada
Title
A derived and validated score to predict prolonged mechanical ventilation
in patients undergoing cardiac surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 153 (1) (pp 108-115),
2017. Date of Publication: 01 Jan 2017.
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objectives Prolonged mechanical ventilation after cardiac surgery imposes
a significant burden on the patient in terms of morbidity as well as a
financial burden on the hospital. We undertook a retrospective analysis of
2 prospectively collected databases developed in tertiary cardiac care
centers to derive and validate a risk index predicting prolonged
mechanical ventilation after cardiac surgery. Methods We studied a
retrospective cohort of 32,045 patients undergoing cardiac surgery in 2
hospitals in Toronto, Canada. The development cohort consisted of 21,661
patients at Toronto General Hospital. Data Sunnybrook Health Sciences
Centre, Toronto, Canada, with 10,384 patients, served as an institutional
validation cohort. We operationally characterized prolonged mechanical
ventilation as the duration from surgery completion to extubation
exceeding 48 hours. Results Prolonged postoperative mechanical ventilation
rates in the development and validation cohort were 6% and 7%,
respectively. Multivariable regression in the development cohort showed
that the following factors were strong predictors of prolonged mechanical
ventilation after cardiac surgery: previous cardiac surgery, lower left
ventricular ejection fraction, shock, surgery involving repair of
congenital heart disease, and cardiopulmonary bypass time. The
intraoperative multivariable model retained good discrimination in the
validation cohort, achieving a c statistic of 0.787. Conclusions Prolonged
mechanical ventilation after cardiac surgery can be accurately predicted
by readily available pre- and intraoperative information. Copyright &#xa9;
2016 The American Association for Thoracic Surgery

<8>
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.

<9>
Accession Number
613571777
Author
Parthiban A.; Levine J.C.; Nathan M.; Marshall J.A.; Shirali G.S.; Simon
S.D.; Colan S.D.; Newburger J.W.; Raghuveer G.
Institution
(Parthiban, Marshall, Shirali, Raghuveer) Children's Mercy Hospital,
University of Missouri Kansas City School of Medicine, Kansas City,
Missouri, United States
(Simon) Department of Biostatistics, University of Missouri Kansas City
School of Medicine, Kansas City, Missouri, United States
(Levine, Colan, Newburger) Department of Cardiology, Boston Children's
Hospital, Boston, Massachusetts, United States
(Nathan) Department of Cardiac Surgery, Boston Children's Hospital,
Boston, Massachusetts, United States
(Levine, Colan, Newburger) Department of Pediatrics, Harvard Medical
School, Boston, Massachusetts, United States
(Nathan) Department of Surgery, Harvard Medical School, Boston,
Massachusetts, United States
Title
Implementation of a Quality Improvement Bundle Improves Echocardiographic
Imaging after Congenital Heart Surgery in Children.
Source
Journal of the American Society of Echocardiography. 29 (12) (pp
1163-1170.e3), 2016. Date of Publication: 01 Dec 2016.
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background Postoperative echocardiography after congenital heart disease
surgery is of prognostic importance, but variable image quality is
problematic. We implemented a quality improvement bundle comprising of
focused imaging protocols, procedural sedation, and sonographer education
to improve the rate of optimal imaging (OI). Methods Predischarge
echocardiograms were evaluated in 116 children (median age, 0.51 years;
range, 0.01-5.6 years) from two centers after tetralogy of Fallot repair,
arterial switch operation, and bidirectional Glenn and Fontan procedures.
OI rates were compared between the centers before and after the
implementation of a quality improvement bundle at center 1, with center 2
serving as the comparator. Echocardiographic images were independently
scored by a single reader from each center, blinded to center and time
period. For each echocardiographic variable, quality score was assigned as
0 (not imaged or suboptimally imaged) or 1 (optimally imaged); structures
were classified as intra- or extracardiac. The rate of OI was calculated
for each variable as the percentage of patients assigned a score of 1.
Results Intracardiac structures had higher OI than extracardiac structures
(81% vs 57%; adjusted odds ratio [OR], 3.47; P < .01). Center 1 improved
overall OI from 48% to 73% (OR, 4.44; P < .01), intracardiac OI from 69%
to 85% (OR, 3.53; P = .01), and extracardiac OI from 35% to 67% (OR, 5.16;
P < .01). There was no temporal difference for center 2. Conclusions After
congenital heart disease surgery in children, intracardiac structures are
imaged more optimally than extracardiac structures. Focused imaging
protocols, patient sedation, and sonographer education can improve OI
rates. Copyright &#xa9; 2016 American Society of Echocardiography

<10>
Accession Number
610516576
Author
Mamoun N.F.; Lin P.; Zimmerman N.M.; Mascha E.J.; Mick S.L.; Insler S.R.;
Sessler D.I.; Duncan A.E.
Institution
(Mamoun, Insler, Duncan) Department of Cardiothoracic Anesthesia,
Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, United States
(Mamoun, Lin, Zimmerman, Mascha, Insler, Sessler, Duncan) Department of
Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland,
Ohio, United States
(Zimmerman, Mascha) Department of Quantitative Health Sciences, Cleveland
Clinic, Cleveland, Ohio, United States
(Mick) Department of Cardiothoracic Surgery, Cleveland Clinic, Cleveland,
Ohio, United States
Title
Intravenous acetaminophen analgesia after cardiac surgery: A randomized,
blinded, controlled superiority trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 152 (3) (pp 881-889),
2016. Date of Publication: 2016.
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background Pain after cardiac surgery traditionally has been controlled by
intravenous opioids and nonsteroidal antiinflammatory drugs. An
intravenous analgesic with fewer adverse effects is needed. Therefore, we
tested the primary hypothesis that intravenous acetaminophen is more
effective than placebo for pain management, which was defined a priori as
superior on either pain intensity score and/or opioid consumption and not
worse on either. Methods In this single-center, double-blind trial, 147
patients having cardiac surgery via median sternotomy were randomized to
receive either 1 g of intravenous acetaminophen (73 patients) every 6
hours for 24 hours or comparable placebo (74 patients) starting in the
operating room after sternal closure. Cumulative opioid consumption (in
morphine equivalents) and pain intensity scores (on a 0-10 Numeric Rating
Scale) were measured at 4, 6, 8, 12, 16, 20, and 24 hours after surgery.
We estimated ratio of mean opioid consumption by using multivariable
linear regression (noninferiority delta = 1.15) and pain score difference
by using repeated measures regression (noninferiority delta = 1). Results
Acetaminophen was superior to placebo on mean pain intensity scores and
noninferior on opioid consumption, with estimated difference in mean pain
(95% confidence interval) of -0.90 (-1.39, -0.42), P < .001 (superior),
and estimated ratio of means in opioid consumption (90% confidence
interval) of 0.89 (0.73-1.10), P = .28 (noninferior; not superior).
Conclusions Intravenous acetaminophen reduced pain after cardiac surgery,
but not opioid consumption. Intravenous acetaminophen can be an effective
analgesic adjunct in patients recovering from median sternotomy. Copyright
&#xa9; 2016 The American Association for Thoracic Surgery

<11>
Accession Number
613695900
Author
Larsen J.B.; Troldborg A.; Christensen T.D.; Hvas C.L.; Thiel S.; Hvas
A.-M.
Institution
(Larsen, Hvas) Centre for Haemophilia and Thrombosis, Department of
Clinical Biochemistry, Aarhus University Hospital, Denmark
(Troldborg, Thiel) Department of Biomedicine, Aarhus University, Denmark
(Christensen) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Denmark
(Hvas) Department of Anaesthesiology and Intensive Care Medicine, Aarhus
University Hospital, Denmark
Title
The influence of heparin on the lectin pathway in pulmonary cancer
patients.
Source
Immunobiology. Conference: 26th ICW Kanazawa 2016. Japan. Conference
Start: 20160904. Conference End: 20160908. 221 (10) (pp 1203), 2016. Date
of Publication: October 2016.
Publisher
Elsevier GmbH
Abstract
Background: The complement system in cancer is a growing field of
interest. In particular, the lectin pathway has gained focus.
Mannose-binding lectin (MBL) can bind to tumour cells, and MBL plasma
levels are increased in patients with various types of cancer. The lectin
pathway activates coagulation in vitro, but its contribution to the
increased thrombosis risk in cancer is unresolved. The anticoagulant drug
heparin inhibits in vitro complement activation. This opens new
perspectives for the role of heparin in complement-mediated conditions.
However, the in vivo effect of heparin on complement protein plasma
concentrations has not been investigated. Aims: We aim to investigate (1)
lectin pathway protein concentrations in plasma, (2) correlations between
the lectin pathway and platelet aggregation as well as thrombin
generation, and (3) the influence of low molecular weight heparin (LMWH)
treatment on lectin pathway protein plasma concentrations in lung cancer
patients. Methods and materials: Patients with lung cancer (n = 61)
eligible for video-assisted thoracoscopic lobectomy were included in the
COPPVATS trial (EudraCT no: 2012-002409-23) at different cardiothoracic
surgery sites in Denmark. Patients were randomised to LMWH (Fragmin, 5000
IE/day) from the day prior to surgery and until discharge (n = 31) or no
anticoagulant treatment (n = 30). Blood samples were obtained before the
first heparin dose, perioperatively, and on the first postoperative day.
The lectin pathway proteins MBL, MBL-associated serine protease (MASP)-1,
-2 and -3, ficolins H and M, MAp19, MAp44, and CL-L1 will be measured by
time-resolved immunofluorometric assay. Platelet aggregation will be
analysed with whole blood impedance aggregometry using the platelet
agonists adenosine diphosphate, collagen and thrombinreceptor activating
peptide, and tissue factor-induced thrombin generation is determined by a
calibrated automated thrombogram. Results: Patient recruitment is
completed, and laboratory work is in progress. Laboratory analyses will be
finished during July 2016, allowing us to present our results on the
workshop. Conclusion: The project will provide new knowledge on the
relationship between the lectin pathway and coagulation in cancer, as well
as on the in vivo influence of heparin on complement. This helps improve
individual thrombosis risk assessment and prophylaxis. Finally, it paves
the road to new studies on prevention of thrombosis.

<12>
Accession Number
613351503
Author
Chang M.; Ahn J.M.; Lee C.W.
Institution
(Chang, Ahn, Lee) Duke University Medical Center, Durham, NC, United
States
(Lee) University of Ulsan, Seoul, South Korea
Title
Pooled RCTs: CABG reduces mortality more than PCI with des in nondiabetic
patients with multivessel CAD.
Source
Annals of Internal Medicine. 165 (10) (pp JC51), 2016. Date of
Publication: 15 Nov 2016.
Publisher
American College of Physicians (190 N. Indenpence Mall West, Philadelphia
PA 19106-1572, United States)

<13>
Accession Number
608854628
Author
Khan A.R.; Khan S.; Riaz H.; Luni F.K.; Simo H.; Bin Abdulhak A.; Bavishi
C.; Flaherty M.
Institution
(Khan, Flaherty) Division of Cardiovascular Medicine, Department of
Internal Medicine, University of Louisville, Louisville, KY, United States
(Khan, Simo) Department of Internal Medicine, University of Toledo Medical
Center, Toledo, OH, United States
(Riaz) Department of Internal Medicine, Cleveland Clinic, Cleveland, OH,
United States
(Luni) Division of Cardiovascular Medicine, Department of Internal
Medicine, Saint Vincent Mercy Hospital, Toledo, OH, United States
(Bin Abdulhak) Division of Cardiovascular Medicine, Department of Internal
Medicine, University of Iowa, Iowa City, IA, United States
(Bavishi) Division of Cardiovascular Medicine, Department of Internal
Medicine, St Lukes Roosevelt Hospital, New York, United States
Title
Efficacy and safety of transcatheter aortic valve replacement in
intermediate surgical risk patients: A systematic review and
meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 88 (6) (pp 934-944),
2016. Date of Publication: 15 Nov 2016.
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background: The efficacy of transcatheter aortic valve replacement (TAVR)
in aortic stenosis patients at high surgical risk has been established.
The data on patients with intermediate risk is not conclusive. We
performed a meta-analysis of studies which compared TAVR with surgical
aortic valve replacement (SAVR) in patients at intermediate surgical risk.
Methods: Several databases searched from inception to February 2015
yielded 7 eligible studies with 2,173 participants. The measured outcome
of efficacy was all-cause mortality. Data on safety included stroke,
permanent pacemaker implantation (PPI), aortic regurgitation (AR),
vascular access complications, and major bleeding. Outcomes were pooled
and relative risk (RR) was calculated with the Mantel-Haenszel method.
Results: There was no difference in either short-term (RR, 1.02; 95% CI:
0.63-1.63; P = 0.94; I² = 0%) or medium to long-term all-cause
mortality (RR, 0.99; 95% CI: 0.81-1.21; P = 0.91; I² = 0%).
There was increased incidence of stroke (RR, 2.96; 95% CI: 0.87-10.09; P =
0.08; I² = 0%), AR (RR, 3.59; 95% CI: 2.13-7.19; P < 0.00001;
I² = 2%), PPI (RR, 6.53; 95% CI: 1.91-22.32; P < 0.003;
I² = 0%) and vascular access complications (RR, 3.84; 95% CI:
0.65-22.76; P < 0.14; I² = 48%) in patients with TAVR. There
was a small, albeit increased risk of major or life threatening bleeding
with SAVR as compared to TAVR (RR, 1.36; 95% CI: 1.04-1.80; P < 0.03;
I² = 0%). Conclusions: In this meta-analysis we found that TAVR
may be an acceptable alternative to SAVR in patients with intermediate
risk for surgery. However, we must await evidence from the current large
randomized trials before widespread adoption of this procedure is
undertaken. &#xa9; 2016 Wiley Periodicals, Inc. Copyright &#xa9; 2016
Wiley Periodicals, Inc.

<14>
[Use Link to view the full text]
Accession Number
607209806
Author
Amat-Santos I.J.; Messika-Zeitoun D.; Eltchaninoff H.; Kapadia S.; Lerakis
S.; Cheema A.N.; Gutierrez-Ibanes E.; Munoz A.; Pan M.; Webb J.G.;
Herrmann H.; Kodali S.; Nombela-Franco L.; Tamburino C.; Jilaihawi H.;
Masson J.-B.; De Brito F.S.; Ferreira M.C.; Lima V.C.; Mangione J.A.; Iung
B.; Vahanian A.; Durand E.; Tuzcu M.; Hayek S.S.; Angulo-Llanos R.;
Gomez-Doblas J.J.; Castillo J.C.; Dvir D.; Leon M.B.; Garcia E.; Cobiella
J.; Barbanti M.; Makkar R.; Ribeiro H.B.; Urena M.; Dumont E.; Pibarot P.;
Lopez J.; Roman A.S.; Rodes-Cabau J.
Institution
(Amat-Santos, Ribeiro, Urena, Dumont, Pibarot, Rodes-Cabau) Quebec Heart
and Lung Institute, Quebec, QC, Canada
(Amat-Santos, Lopez, Roman) Hospital Clinico Universitario de Valladolid,
Valladolid, Spain
(Messika-Zeitoun, Iung, Vahanian) Assistance Publique-Hopitaux de Paris,
Bichat Hospital, Paris, France
(Eltchaninoff, Durand) Hopital Charles Nicolle, University of Rouen,
Rouen, France
(Kapadia, Tuzcu) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Lerakis, Hayek) Emory University, School of Medicine, Division of
Cardiology, Atlanta, GA, United States
(Cheema) St. Michael's Hospital, Toronto, ON, Canada
(Gutierrez-Ibanes, Angulo-Llanos) Instituto de Investigacion Sanitaria
Gregorio Maranon, Madrid, Spain
(Munoz, Gomez-Doblas) Hospital Regional Universitario Virgen de la
Victoria, Malaga, Spain
(Pan, Castillo) Hospital Universitario Reina Sofia, Cordoba, Spain
(Webb, Dvir) St. Paul's Hospital, Vancouver, BC, Canada
(Herrmann) Hospital of the University of Pennsylvania, Philadelphia, PA,
United States
(Kodali, Leon) New York Presbyterian Hospital, New York, NY, United States
(Nombela-Franco, Garcia, Cobiella) Hospital Universitario Clinico San
Carlos, Madrid, Spain
(Tamburino, Barbanti) Ferrarotto Hospital, University of Catania, Catania,
Italy
(Jilaihawi, Makkar) Cedars-Sinai Heart Institute, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Masson) Centre Hospitalier de l'Universite de Montreal, Montreal, QC,
Canada
(De Brito) Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Ferreira) Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil
(Lima) Hospital Sao Francisco-Santa Clara, Porto Alegre, Brazil
(Mangione) Hospital Beneficenca Portuguesa, Sao Paulo, Brazil
Title
Response to letters regarding article, "Infective endocarditis after
transcatheter aortic valve implantation: Results from a large multicenter
registry".
Source
Circulation. 132 (23) (pp e372-e374), 2015. Date of Publication: 08 Dec
2015.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)

<15>
[Use Link to view the full text]
Accession Number
607209691
Author
Pericas J.M.; Falces C.; Miro J.M.
Institution
(Pericas, Miro) Hospital Clinic of Barcelona, Institut d'Investigacions
Biomediques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
(Falces) Cardiology Department, Hospital Clinic of Barcelona, University
of Barcelona, Barcelona, Spain
Title
Letter by pericas et al regarding article, "Infective endocarditis after
transcatheter aortic valve implantation: Results from a large multicenter
registry".
Source
Circulation. 132 (23) (pp e370-e371), 2015. Date of Publication: 08 Dec
2015.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)

<16>
[Use Link to view the full text]
Accession Number
607209627
Author
Thuny F.; Cautela J.
Institution
(Thuny, Cautela) Unite Nord Insuffisance Cardiaque et Valvulopathies,
Centre Hospitalier Universitaire de Marseille, Hopital NORD, Marseille,
France
(Thuny) Inserm 1095, Faculte de Medecine, Aix-Marseille Universite,
Marseille, France
Title
Letter by thuny and cautela regarding article, "Infective endocarditis
after transcatheter aortic valve implantation: Results from a large
multicenter registry".
Source
Circulation. 132 (23) (pp e369), 2015. Date of Publication: 08 Dec 2015.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)

<17>
Accession Number
602187797
Author
Han Y.; Xu B.; Jing Q.; Lu S.; Yang L.; Xu K.; Li Y.; Li J.; Guan C.;
Kirtane A.J.; Yang Y.
Institution
(Han, Jing, Xu, Li, Li) Department of Cardiology, General Hospital of
Shenyang Military Region, 83 Wenhua Road, Shenhe District, Shenyang
110016, China
(Xu, Guan, Yang) Fu Wai Hospital, National Center for Cardiovascular
Diseases, Beijing, China
(Lu) Affiliated Anzhen Hospital of Capital Medical University, Beijing,
China
(Yang) Kunming General Hospital of Chengdu Military Region, Kunming, China
(Kirtane) Columbia University Medical Center, New York Presbyterian
Hospital, New York, NY, United States
Title
A randomized comparison of novel biodegradable polymer-and durable
polymer-coated cobalt-chromium sirolimus-eluting stents.
Source
JACC: Cardiovascular Interventions. 7 (12) (pp 1352-1360), 2014. Date of
Publication: 2014.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The aim of this study was to investigate the hypothesis that a
novel biodegradable polymer-coated, cobalt-chromium (CoCr),
sirolimus-eluting stent (BP-SES) is noninferior in safety and efficacy
outcomes compared with a durable polymer (DP)-SES. Background: No
randomized trials have the compared safety and efficacy of BP-SES versus
DP-SES on similar CoCr platforms, thereby isolating the effect of the
polymer type. Methods: In this prospective, single-blind, randomized trial
conducted at 32 Chinese sites, 2,737 patients eligible for coronary
stenting were treated with BP- or DP-SES in a 2:1 ratio. The primary
endpoint was 12-month target lesion failure (TLF), a composite of cardiac
death, target vessel myocardial infarction, or clinically indicated target
lesion revascularization. Secondary endpoints included TLF components, and
definite/probable stent thrombosis. Results: At 12 months, the difference
in the primary endpoint of TLF between BP-SES (6.3%) and DP-SES (6.1%)
groups was 0.25% (95% confidence interval: -1.67% to 2.17%, p for
noninferiority = 0.0002), demonstrating noninferiority of BP-SES to
DP-SES. Individual TLF components of cardiac death (0.7% vs. 0.6%, p =
0.62), target vessel myocardial infarction (3.6% vs. 4.3%, p = 0.39), and
clinically indicated target lesion revascularization (2.6% vs. 2.2%, p =
0.50) were similar, as were low definite/probable stent thrombosis rates
(0.4% vs. 0.6%, p = 0.55). Conclusions: In this large-scale real-world
trial, BP-SES was noninferior to DP-SES for 1-year TLF. (Evaluate Safety
and Effectiveness of the Tivoli DES and the Firebird DES for Treatment
of Coronary Revascularization;. NCT01681381). Copyright &#xa9; 2014 by the
American College of Cardiology Foundation.

<18>
Accession Number
372014319
Author
Vohra H.A.; Armstrong L.A.; Modi A.; Barlow C.W.
Institution
(Vohra, Armstrong, Modi, Barlow) Wessex Cardiothoracic Centre, Southampton
University Hospitals NHS Trust, Tremona Road, Southampton, Hampshire SO16
6YD, United Kingdom
Title
Outcomes following cardiac surgery in patients with preoperative renal
dialysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (1) (pp 103-111),
2014. Date of Publication: January 2014.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was that whether patients who
are dependent on chronic dialysis have higher morbidity and mortality
rates than the general population when undergoing cardiac surgery. These
patients often require surgery in view of their heightened risk of cardiac
disease. Altogether 278 relevant papers were identified using the below
mentioned search, 16 papers represented the best evidence to answer the
question. The author, journal, date and country of publication, patient
group studied, study type, relevant outcomes,-RESULTS:-and study
weaknesses were tabulated. Dialysis-dependent (DD) patients undergoing
coronary artery bypass grafting (CABG) or valve replacement have higher
morbidity but acceptable outcomes. There is some evidence to show that
outcomes after off-pump coronary artery bypass grafting (OPCAB) are better
than after on-pump coronary artery bypass grafting (ONCAB) and
that-RESULTS:-are worse in DD patients with diabetic nephropathy. Patients
undergoing combined procedures have a higher mortality. &#xa9; 2013 The
Author.

<19>
Accession Number
372014314
Author
Beattie G.W.; Jeffrey R.R.
Institution
(Beattie, Jeffrey) Department of Cardiothoracic Surgery, Aberdeen Royal
Infirmary, Aberdeen AB25 2ZN, United Kingdom
Title
Is there evidence that fresh frozen plasma is superior to antithrombin
administration to treat heparin resistance in cardiac surgery?.
Source
Interactive Cardiovascular and Thoracic Surgery. 18 (1) (pp 117-120),
2014. Date of Publication: January 2014.
Publisher
Oxford University Press (Great Clarendon Street, Oxford OX2 6DP, United
Kingdom)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was, 'in [patients with
heparin resistance] is [treatment with FFP] superior [to antithrombin
administration] in [achieving adequate anticoagulation to facilitate safe
cardiopulmonary bypass]?' More than 29 papers were found using the
reported search, of which six represented the best evidence to answer the
clinical question. The authors, journal, date and country of publication,
patient group studied, study type, relevant outcomes and results of these
papers are tabulated. Antithrombin (AT) binds to heparin and increases the
rate at which it binds to thrombin. The levels of antithrombin in the
blood are an important aspect of the heparin dose-response curve. When the
activated clotting time (ACT) fails to reach a target >480, this is
commonly defined as heparin resistance (HR). Heparin resistance is usually
treated with a combination of supplementary heparin, fresh frozen plasma
(FFP) or antithrombin III concentrate. There is a paucity of evidence on
the treatment of heparin resistance with FFP, with only five studies
identified, including one retrospective study, one in vitro trial and
three case reports. AT has been studied more extensively with multiple
studies, including a crossover trial comparing AT to supplemental heparin
and a multicentre, randomized, double blind, placebo-controlled trial.
Antithrombin (AT) concentrate is a safe and efficient treatment for
heparin resistance to elevate the activated clotting time (ACT). It avoids
the risk of transfusion-related acute lung injury (TRALI), volume
overload, intraoperative time delay and viral or vCJD transmission.
Antithrombin concentrates are more expensive than fresh frozen plasma and
may put patients at risk of heparin rebound in the early postoperative
period. Patients treated with AT have a lower risk of further FFP
transfusions during their stay in hospital. We conclude that the treatment
of HR with FFP may not restore the ACT to therapeutic levels with adequate
heparinization, but AT is efficient with benefits including lower volume
administration, less risk of TRALI and lower risk of transfusion-related
infections. &#xa9; 2013 The Author.

<20>
Accession Number
613411210
Author
Njuguna B.; Gardner A.; Karwa R.; Delahaye F.
Institution
(Njuguna) Department of Pharmacy, Moi Teaching and Referral Hospital, PO
Box 3, Eldoret 30100, Kenya
(Gardner) Department of Medicine, Indiana University School of Medicine,
340 West 10th Street #6200, Indianapolis, IN 46202, United States
(Njuguna, Karwa) Department of Pharmacy Practice, Purdue University
College of Pharmacy, 575 Stadium Mall Dr, West Lafayette, IN 47907, United
States
(Delahaye) Department of Cardiology, Hospices civils de Lyon, Universite
Claude Bernard, Equipe d'Accueil HESPER 7425, Hopital Louis Pradel, 28,
avenue du Doyen Lepine, Bron, Lyon 69677, France
Title
Infective Endocarditis in Low- and Middle-Income Countries.
Source
Cardiology Clinics. 35 (1) (pp 153-163), 2017. Date of Publication: 01 Feb
2017.
Publisher
W.B. Saunders
Abstract
Infective endocarditis (IE) is a rare, life-threatening disease with a
mortality rate of 25% and significant debilitating morbidities. Although
much has been reported on contemporary IE in high-income countries,
conclusions on the state of IE in low- and middle-income countries (LMICs)
are based on studies conducted before the year 2000. Furthermore, unique
challenges in the diagnosis and management of IE persist in LMICs. This
article reviews IE studies conducted in LMICs documenting clinical
experiences from the year 2000 to 2016. Presented are the causes of IE,
management of patients with IE, and prevailing challenges in diagnosis and
treatment of IE in LMICs. Copyright &#xa9; 2016 Elsevier Inc.

<21>
Accession Number
613312686
Author
Zonszein J.; Groop P.-H.
Institution
(Zonszein) Montefiore Medical Center, University Hospital for Albert
Einstein College of Medicine, Bronx, NY, United States
(Groop) Abdominal Center Nephrology, University of Helsinki and Helsinki
University Hospital, Helsinki, Finland
(Groop) Folkhalsan Institute of Genetics, Folkhalsan Research Center,
Biomedicum Helsinki, Helsinki, Finland
(Groop) Baker IDI Heart & Diabetes Institute, Melbourne, Australia
Title
Strategies for Diabetes Management: Using Newer Oral Combination Therapies
Early in the Disease.
Source
Diabetes Therapy. 7 (4) (pp 621-639), 2016. Date of Publication: 01 Dec
2016.
Publisher
Springer Healthcare (E-mail: kathleen.burke@springer.com)
Abstract
Introduction: The duration of uncontrolled type 2 diabetes mellitus (T2DM)
can adversely impact small and large vessels, eventually leading to
microvascular and macrovascular complications. Failure of therapeutic
lifestyle changes, monotherapy, and clinical inertia contribute to
persistent hyperglycemia and disease progression. The aim was to review
the complex pathophysiology of type 2 diabetes and how different oral
agents can be used effectively as first-line therapy in combination with
metformin, as well as in patients not achieving glycemic goals with
metformin therapy. Methods: For this review, a non-systematic literature
search of PubMed, NCBI, and Google Scholar was conducted. Results: New
oral agents have made it possible to improve glycemic control to
near-normal levels with a low risk of hypoglycemia and without weight
gain, and sometimes with weight loss. Early combination therapy is
effective and has been shown to have a favorable legacy effect. A number
of agents are available in a single-pill combination (SPC) that provides
fewer pills and better adherence. Compared with adding a sulfonylurea,
still the most common oral combination used, empagliflozin has been shown
to decrease cardiovascular (CV) events in a dedicated CV outcome study,
and pioglitazone has been effective in reducing the risk of secondary CV
endpoints, whereas sulfonylureas have been associated with an increased
risk of CV disease. In those failing metformin, triple oral therapy by
adding a non-metformin SPC such as empagliflozin/linagliptin or
pioglitazone/alogliptin is a good option for reducing glycated hemoglobin
(HbA1c) without significant hypoglycemia. Conclusion: Clinicians have a
comprehensive armamentarium of medications to treat patients with T2DM.
Clinical evidence has shown that dual or triple oral combination therapy
is effective for glycemic control, and early treatment is effective in
getting patients to goal more quickly. Use of SPCs is an option for double
or triple oral combination therapy and may result in better adherence.
Copyright &#xa9; 2016, The Author(s).

<22>
Accession Number
613241007
Author
Zhang W.; Wei Y.; Jiang H.; Xu J.; Yu D.
Institution
(Zhang, Wei, Jiang, Xu, Yu) The second affiliated hospital of Nanchang
University, Department of Cardiothoracic surgery, 1 Minde Rd, Nanchang,
Jiangxi Province 330006, China
Title
Thoracotomy is better than thoracoscopic lobectomy in the lymph node
dissection of lung cancer: A systematic review and meta-analysis.
Source
World Journal of Surgical Oncology. 14 (1) (no pagination), 2016. Article
Number: 290. Date of Publication: 17 Nov 2016.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: The aim of this study was to investigate which surgical method
is better in lymph node (LN) dissection of lung cancer. Methods: A
comprehensive search of PubMed, Ovid MEDLINE, EMBASE, Web of Science,
ScienceDirect, the Cochrane Library, Scopus, and Google Scholar was
performed to identify studies comparing thoracoscopic lobectomy
(video-assisted thoracic surgery (VATS) group) and thoracotomy (open
group) in LN dissection. Results: Twenty-nine articles met the inclusion
criteria and involved 2763 patients in the VATS group and 3484 patients in
the open group. The meta-analysis showed that fewer total LNs (95%
confidence interval [CI] -1.52 to -0.73, p<0.0001) and N2 LNs (95% CI
-1.25 to -0.10, p=0.02) were dissected in the VATS group. A similar number
of total LN stations, N2 LN stations, and N1 LNs were harvested in both
groups. Only one study reported that fewer N1 LN stations were dissected
in the VATS group (1.4+/-0.5 vs. 1.6+/-0.6, p=0.04). Conclusions: Open
lobectomy could achieve better LN dissection efficacy than thoracoscopic
lobectomy in the treatment of lung cancer, especially in the N2 LNs
dissection. These findings require validation by high-quality, large-scale
randomized controlled trials. Copyright &#xa9; 2016 The Author(s).

<23>
Accession Number
613631736
Author
Banerjee S.; Brilakis E.S.
Institution
(Banerjee, Brilakis) University of Texas, Southwestern Medical Center,
4500 S. Lancaster Road (111a), Dallas, TX 75230, United States
(Banerjee, Brilakis) Veterans Affairs Southwestern Medical Center, Dallas,
TX, United States
(Brilakis) Minneapolis Heart Institute, Minneapolis, MN, United States
Title
Comparing drug-eluting stents to bare-metal stents for saphenous vein
graft lesion PCI.
Source
Journal of Invasive Cardiology. 28 (12) (pp E170-E171), 2016. Date of
Publication: December 2016.
Publisher
HMP Communications

<24>
Accession Number
613479062
Author
Smelt J.L.C.; Phillips S.; Hamilton C.; Fricker P.; Spray D.; Nowell J.L.;
Jahangiri M.
Institution
(Smelt, Nowell, Jahangiri) Department of Cardiothoracic Surgery, St.
George's Hospital, London, United Kingdom
(Phillips, Hamilton, Fricker) Department of Perfusion, St. George's
Hospital, London, United Kingdom
(Spray) Department of Anesthesia, St. George's Hospital, London, United
Kingdom
Title
Simulator Teaching of Cardiopulmonary Bypass Complications: A Prospective,
Randomized Study.
Source
Journal of Surgical Education. 73 (6) (pp 1026-1031), 2016. Date of
Publication: 01 Nov 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objective Complications of cardiopulmonary bypass (CPB) are rare, but
life-threatening events that need prompt and rehearsed actions involving a
team. This is not adequately taught to cardiothoracic surgical trainees.
The objective of this study was to assess the knowledge of cardiothoracic
trainees required to manage these events after simulation-based vs.
lecture-based teaching. Participants and Design Totally, 17 cardiac
surgical trainees with no formal teaching in intraoperative complications
of CPB management were randomly assigned by computer to either a study
group receiving simulation-based complications of CPB teaching via the
Orpheus simulator (n = 9) or a control group receiving complications of
CPB teaching via a lecture (n = 8). Each subject undertook a written test
comprising 20 multiple choice questions on complications of CPB before and
after teaching. Trainees were then asked to rate their satisfaction with
each session from 1 to 5, with 5 being most satisfied. Setting St George
Simulation and Clinical Skills Laboratory, St George's Hospital, London.
Results There was no significant difference in the pretest scores between
the 2 groups (p = 0.29). After teaching, both groups showed a
statistically significant improvement in their knowledge (p < 0.05). The
trainees in the simulation group performed better than the lecture-based
group; however, this was not statistically significant (p = 0.21).
Satisfaction levels in both the lecture session and the simulation session
were very high with means of 4.4/5 and 4.8/5, respectively. Conclusion
Despite the familiarity with CPB during surgery, the simulation group
performed at least as well as the lecture group. Cardiothoracic trainees
would benefit from formal teaching of complications of CPB management via
either learning modality being incorporated into their training. Copyright
&#xa9; 2016 Association of Program Directors in Surgery

<25>
Accession Number
612327511
Author
Fernandes G.A.; Lima A.C.G.; Gonzaga I.C.A.; de Barros Araujo R.; de
Oliveira R.A.; Nicolau R.A.
Institution
(Fernandes, Lima, Gonzaga, Nicolau) Lasertherapy and Photobiology Center,
Research and Development Institute, IP&D, Universidade do Vale do Paraiba,
UNIVAP, Sao Paulo, Brazil
(Fernandes, Gonzaga) Uninovafapi College, Teresina, Piaui, Brazil
(Lima) University of Piaui State (UESPI), Teresina, Piaui, Brazil
(de Barros Araujo) Cardiac Surgery Department, Santa Maria Hospital,
Teresina, Piaui, Brazil
(de Oliveira) Uninovafapi College and University of Piaui State (UESPI),
Teresina, Piaui, Brazil
(Fernandes) Vitorino Orthigues Fernandes Street, 6123, Teresina, Piaui
64073-505, Brazil
Title
Low-intensity laser (660 nm) on sternotomy healing in patients who
underwent coronary artery bypass graft: a randomized, double-blind study.
Source
Lasers in Medical Science. 31 (9) (pp 1907-1913), 2016. Date of
Publication: 01 Dec 2016.
Publisher
Springer London
Abstract
The aim of this study was to analyze the healing effects of low-level
laser therapy (LLLT) on the longitudinal sternotomy incisions of patients
who underwent coronary artery bypass graft (CABG). The volunteers were
randomized into three groups of equal size (n = 30): control, placebo, and
laser (lambda = 660 nm and spatial average energy fluency [SAEF] = 1.06
J/cm²). The patients in the laser group underwent irradiation
on postoperative days 2, 4, 6, and 8, and their sternotomy incisions were
photographed immediately after the surgery and 8 days later for analysis.
Three researchers who were blinded to the patient treatment groups
analyzed the incision photographs to assess hyperemia and wound closure on
the day of hospital discharge (eighth postoperative day). The sternotomy
incisions in the LLLT group demonstrated less hyperemia, incisional
bleeding, and dehiscence (p < 0.005). Copyright &#xa9; 2016,
Springer-Verlag London.

<26>
[Use Link to view the full text]
Accession Number
613333633
Author
Rodes-Cabau J.; Jolly S.S.; Cairns J.; Mansour S.; L'Allier P.L.; Teefy
P.J.; Graham J.J.; Le May M.R.; Cantor W.J.; Wood D.; Balasubramanian K.;
Delarochelliere R.; Dzavik V.
Institution
(Rodes-Cabau, Delarochelliere) Department of Cardiology, Quebec Heart and
Lung Institute, Laval University, 2725 Chemin Sainte-Foy, Quebec City
G1V4G5, Canada
(Jolly) Population Health Research Institute, Hamilton General Hospital,
McMaster University, Ontario, Canada
(Cairns, Wood) Department of Medicine, Vancouver General Hospital, British
Columbia, Canada
(Mansour) Cardiology Department, Centre Hospitalier Universitaire,
Montreal, QC, Canada
(L'Allier) Department of Medicine, Montreal Heart Institute, Quebec,
Canada
(Teefy) Department of Medicine, University Hospital, London Health
Sciences Centre, Ontario, Canada
(Graham) Division of Cardiology, St. Michael's Hospital, Toronto, ON,
Canada
(Le May) Department of Cardiology, Ottawa Heart Institute, Ontario, Canada
(Cantor) York PCI Group, Division of Cardiology, Southlake Regional
Hospital, Newmarket, ON, Canada
(Balasubramanian) Statistics Department, Population Health Research
Centre, Hamilton, ON, Canada
(Dzavik) Department of Medicine, Toronto General Hospital, Ontario, Canada
Title
Sealing Intermediate Nonobstructive Coronary Saphenous Vein Graft Lesions
with Drug-Eluting Stents as a New Approach to Reducing Cardiac Events: A
Randomized Controlled Trial.
Source
Circulation: Cardiovascular Interventions. 9 (11) (no pagination), 2016.
Article Number: e004336. Date of Publication: 01 Nov 2016.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background-The objective of this study was to assess the efficacy of
sealing intermediate nonobstructive coronary saphenous vein graft (SVG)
lesions with drug-eluting stents (DES; paclitaxel-or everolimus-eluting
stents) for reducing major adverse cardiac events (MACE). Methods and
Results-This was a randomized controlled multicenter clinical trial that
enrolled patients with a previous coronary artery bypass graft who had
developed at least 1 intermediate nonobstructive SVG lesion (30%-60%
diameter stenosis by visual estimation). Patients were randomized (1:1) to
DES implantation (SVG-DES) or medical treatment (SVG-MT) of the target SVG
lesion. The primary efficacy outcome was the first occurrence of MACE
defined as the composite of cardiac death, myocardial infarction, or
coronary revascularization related to the target SVG during the duration
of follow-up (minimum of 2 years). Secondary efficacy outcomes included
MACE related to the target SVG lesion and overall MACE. A total of 125
patients (mean age 70+/-9 years, 87% men) were included, with a mean time
from coronary artery bypass graft of 12+/-5 years. Sixty and 65 patients
were allocated to the SVG-DES and SVG-MT groups, respectively. There were
no events related to the target SVG at 30 days. After a median follow-up
of 3.4 (interquartile range: 2.8-3.9) years, the MACE rate related to the
target SVG was not significantly different in the 2 groups (SVG-DES:
15.0%, SVG-MT: 20.0%; hazard ratio, 0.65; 95% confidence interval,
0.23-1.53; P=0.33). There were no significant differences between groups
in MACE related to the target SVG lesion (SVG-DES: 10.0%, SVG-MT: 16.9%;
hazard ratio, 0.53; 95% confidence interval, 0.20-1.43; P=0.21) or global
MACE (SVG-DES: 36.7%, SVG-MT: 44.6%; hazard ratio, 0.73; 95% confidence
interval, 0.42-1.27; P=0.26). Conclusions-Sealing intermediate
nonobstructive SVG lesions with DES was safe but was not associated with a
significant reduction of cardiac events at 3-year follow-up. Copyright
&#xa9; 2016 American Heart Association, Inc.

<27>
Accession Number
613319057
Author
Wang Z.; Ma S.; Zappitelli M.; Parikh C.; Wang C.-Y.; Devarajan P.
Institution
(Wang) Department of Research, Connecticut Children's Medical Center,
Hartford, CT, United States
(Ma) Department of Biostatistics, Yale University, New Haven, CT, United
States
(Zappitelli) Division of Nephrology, Department of Pediatrics, Montreal
Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
(Parikh) Section of Nephrology, Program of Applied Translational Research,
Yale University, School of Medicine, New Haven, CT, United States
(Wang) Division of Public Health Sciences, Fred Hutchinson Cancer Research
Center, Seattle, WA, United States
(Devarajan) Department of Nephrology and Hypertension, Cincinnati
Children's Hospital Medical Center, Cincinnati, OH, United States
Title
Penalized count data regression with application to hospital stay after
pediatric cardiac surgery.
Source
Statistical Methods in Medical Research. 25 (6) (pp 2685-2703), 2016. Date
of Publication: 01 Dec 2016.
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Pediatric cardiac surgery may lead to poor outcomes such as acute kidney
injury (AKI) and prolonged hospital length of stay (LOS). Plasma and urine
biomarkers may help with early identification and prediction of these
adverse clinical outcomes. In a recent multi-center study, 311 children
undergoing cardiac surgery were enrolled to evaluate multiple biomarkers
for diagnosis and prognosis of AKI and other clinical outcomes. LOS is
often analyzed as count data, thus Poisson regression and negative
binomial (NB) regression are common choices for developing predictive
models. With many correlated prognostic factors and biomarkers, variable
selection is an important step. The present paper proposes new variable
selection methods for Poisson and NB regression. We evaluated regularized
regression through penalized likelihood function. We first extend the
elastic net (Enet) Poisson to two penalized Poisson regression: Mnet, a
combination of minimax concave and ridge penalties; and Snet, a
combination of smoothly clipped absolute deviation (SCAD) and ridge
penalties. Furthermore, we extend the above methods to the penalized NB
regression. For the Enet, Mnet, and Snet penalties (EMSnet), we develop a
unified algorithm to estimate the parameters and conduct variable
selection simultaneously. Simulation studies show that the proposed
methods have advantages with highly correlated predictors, against some of
the competing methods. Applying the proposed methods to the aforementioned
data, it is discovered that early postoperative urine biomarkers including
NGAL, IL18, and KIM-1 independently predict LOS, after adjusting for risk
and biomarker variables. Copyright &#xa9; SAGE Publications.

<28>
Accession Number
613651347
Author
Anonymous
Title
Erratum: Percutaneous coronary angioplasty versus coronary artery bypass
grafting in treatment of unprotected left main stenosis (NOBLE): a
prospective, randomised, open-label, non-inferiority tria (The Lancet
(2016) 388(10061) (2743-2752) (S0140673616320529)
(10.1016/S0140-6736(16)32052-9)).
Source
The Lancet. 388 (10061) (pp 2742), 2016. Date of Publication: 03 Dec 2016.
Publisher
Lancet Publishing Group (E-mail: cususerv@lancet.com)
Abstract
Makikallio T, Holm NR, Lindsay M, et al, for the NOBLE study
investigators. Percutaneous coronary angioplasty versus coronary artery
bypass grafting in treatment of unprotected left main stenosis (NOBLE): a
prospective, randomised, open-label, non-inferiority trial. Lancet 2016;
388: 2743-52-In the results section of this Article, intravascular
ultrasound of the left main coronary artery was done pre-PCI in 270 (47%)
of 580 PCI-treated patients. These corrections have been made to the
online version as of Nov 2, 2016, and the printed Article is correct.
Copyright &#xa9; 2016 Elsevier Ltd

<29>
Accession Number
613651345
Author
Mack M.; Holmes D.R.
Institution
(Mack) Baylor Scott & White Health, 3110 Allied Drive, Plano, TX 75093,
United States
(Holmes) Mayo Clinic, Rochester, MN, United States
Title
Randomised trials in left main disease: a NOBLE effort.
Source
The Lancet. 388 (10061) (pp 2715-2716), 2016. Date of Publication: 03 Dec
2016.
Publisher
Lancet Publishing Group (E-mail: cususerv@lancet.com)

<30>
Accession Number
613651342
Author
Makikallio T.; Holm N.R.; Lindsay M.; Spence M.S.; Erglis A.; Menown
I.B.A.; Trovik T.; Eskola M.; Romppanen H.; Kellerth T.; Ravkilde J.;
Jensen L.O.; Kalinauskas G.; Linder R.B.A.; Pentikainen M.; Hervold A.;
Banning A.; Zaman A.; Cotton J.; Eriksen E.; Margus S.; Sorensen H.T.;
Nielsen P.H.; Niemela M.; Kervinen K.; Lassen J.F.; Maeng M.; Oldroyd K.;
Berg G.; Walsh S.J.; Hanratty C.G.; Kumsars I.; Stradins P.; Steigen T.K.;
Frobert O.; Graham A.N.J.; Endresen P.C.; Corbascio M.; Kajander O.;
Trivedi U.; Hartikainen J.; Anttila V.; Hildick-Smith D.; Thuesen L.;
Christiansen E.H.
Institution
(Makikallio, Niemela, Kervinen) Department of Cardiology, Oulu University
Hospital, Oulu, Finland
(Holm, Lassen, Maeng, Christiansen) Department of Cardiology, Aarhus
University Hospital, Skejby, Aarhus, Denmark
(Lindsay, Oldroyd, Berg) Department of Cardiology, Golden Jubilee National
Hospital, Clydebank, United Kingdom
(Spence, Walsh, Hanratty, Graham) Belfast Heart Centre, Belfast Trust,
Belfast, Ireland
(Erglis, Kumsars, Stradins) Latvia Centre of Cardiology, Paul Stradins
Clinical Hospital, Riga, Latvia
(Menown) Craigavon Cardiac Centre, Craigavon, Ireland
(Trovik, Steigen) Department of Cardiology, University of Northern Norway,
Tromso, Norway
(Endresen) Department of Cardiovascular Surgery, University of Northern
Norway, Tromso, Norway
(Eskola, Kajander) Heart Hospital, Tampere University Hospital, Tampere,
Finland
(Romppanen, Hartikainen) Heart Center, Kuopio University Hospital, Kuopio,
Finland
(Kellerth, Frobert) Department of Cardiology, Orebro University Hospital,
Orebro, Sweden
(Ravkilde, Thuesen) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Jensen) Department of Cardiology, Odense University Hospital, Odense,
Denmark
(Kalinauskas) Department of Cardiology, Vilnius University Hospital,
Vilnius, Lithuania
(Linder) Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
(Pentikainen) Heart and Lung Center, Helsinki University Hospital,
Helsinki, Finland
(Hervold) Department of Cardiology, Oslo University Hospital,
Rikshospitalet, Oslo, Norway
(Banning) Oxford Heart Centre, Oxford, United Kingdom
(Zaman) Department of Cardiology, Freeman Hospital and Institute of
Cellular Medicine, Newcastle, United Kingdom
(Cotton) Heart and Lung Centre, New Cross Hospital, Wolverhampton, United
Kingdom
(Eriksen) Department of Cardiology, Haukeland University Hospital, Bergen,
Norway
(Margus) Department of Cardiology, East Tallinn Hospital, Tallinn, Estonia
(Sorensen) Department of Clinical Epidemiology, Aarhus University
Hospital, Aarhus, Denmark
(Sorensen) Department of Health Research and Policy (Epidemiology),
Stanford University, Stanford, CA, United States
(Nielsen) Department of Cardiac Surgery, Aarhus University Hospital,
Skejby, Aarhus, Denmark
(Corbascio) Department of Cardiology, Karolinska University Hospital,
Huddinge, Stockholm, Sweden
(Anttila) Department of Cardiac Surgery, Oulu University Hospital, Finland
(Trivedi, Hildick-Smith) Sussex Cardiac Centre, Brighton and Sussex
University Hospital, Brighton, United Kingdom
Title
Percutaneous coronary angioplasty versus coronary artery bypass grafting
in treatment of unprotected left main stenosis (NOBLE): a prospective,
randomised, open-label, non-inferiority trial.
Source
The Lancet. 388 (10061) (pp 2743-2752), 2016. Date of Publication: 03 Dec
2016.
Publisher
Lancet Publishing Group (E-mail: cususerv@lancet.com)
Abstract
Background Coronary artery bypass grafting (CABG) is the standard
treatment for revascularisation in patients with left main coronary artery
disease, but use of percutaneous coronary intervention (PCI) for this
indication is increasing. We aimed to compare PCI and CABG for treatment
of left main coronary artery disease. Methods In this prospective,
randomised, open-label, non-inferiority trial, patients with left main
coronary artery disease were enrolled in 36 centres in northern Europe and
randomised 1:1 to treatment with PCI or CABG. Eligible patients had stable
angina pectoris, unstable angina pectoris, or non-ST-elevation myocardial
infarction. Exclusion criteria were ST-elevation myocardial infarction
within 24 h, being considered too high risk for CABG or PCI, or expected
survival of less than 1 year. The primary endpoint was major adverse
cardiac or cerebrovascular events (MACCE), a composite of all-cause
mortality, non-procedural myocardial infarction, any repeat coronary
revascularisation, and stroke. Non-inferiority of PCI to CABG required the
lower end of the 95% CI not to exceed a hazard ratio (HR) of 1.35 after up
to 5 years of follow-up. The intention-to-treat principle was used in the
analysis if not specified otherwise. This trial is registered with
ClinicalTrials.gov identifier, number NCT01496651. Findings Between Dec 9,
2008, and Jan 21, 2015, 1201 patients were randomly assigned, 598 to PCI
and 603 to CABG, and 592 in each group entered analysis by intention to
treat. Kaplan-Meier 5 year estimates of MACCE were 29% for PCI (121
events) and 19% for CABG (81 events), HR 1.48 (95% CI 1.11-1.96),
exceeding the limit for non-inferiority, and CABG was significantly better
than PCI (p=0.0066). As-treated estimates were 28% versus 19% (1.55,
1.18-2.04, p=0.0015). Comparing PCI with CABG, 5 year estimates were 12%
versus 9% (1.07, 0.67-1.72, p=0.77) for all-cause mortality, 7% versus 2%
(2.88, 1.40-5.90, p=0.0040) for non-procedural myocardial infarction, 16%
versus 10% (1.50, 1.04-2.17, p=0.032) for any revascularisation, and 5%
versus 2% (2.25, 0.93-5.48, p=0.073) for stroke. Interpretation The
findings of this study suggest that CABG might be better than PCI for
treatment of left main stem coronary artery disease. Funding Biosensors,
Aarhus University Hospital, and participating sites. Copyright &#xa9; 2016
Elsevier Ltd

<31>
Accession Number
613343742
Author
Habibollahi P.; Jam S.H.; Vahdati S.S.; Baghi H.M.; Amiri H.
Institution
(Habibollahi) Pharmacology and Toxicology Department, Tabriz University of
Medical Science, Tabriz, Iran, Islamic Republic of
(Jam, Vahdati, Baghi) Emergency Medicine Research Team, Emergency
Department, Tabriz University of Medical Science, Tabriz, Iran, Islamic
Republic of
(Amiri) Emergency Department, Iran University of Medical Science, Tehran,
Iran, Islamic Republic of
Title
Amiodaron in atrial fi brillation: Post coronary artery bypass graft.
Source
World Journal of Emergency Medicine. 7 (4) (pp 250-254), 2016. Date of
Publication: December 2016.
Publisher
Second Affiliated Hospital, Zhejiang University School of Medicine
(E-mail: em_nancy@zju.edu.cn)
Abstract
BACKGROUND: Atrial fibrilation (AF) is the most common complication
following heart surgeries; it often occurs in patients after coronary
artery bypass graft (CABG). The purpose of this review is to categorize
prophylaxes or treatment by administration of Amiodaron in patients with
CABG. DATA RESOURCES: We searched google scholar, pubmed, and Cochrane
Library databases (the period 1970-2010) for articles on Amiodaron in CABG
and cardiac surgery. A total of 1 561 articles were identifi ed, and 30
articles met the criteria and were enrolled in this review. RESULTS: Most
studies supported Amiodarone for prophylaxi purpose in patients who were
performed with CABG; few papers supported Amiodaron as a drug for treating
CABG. The prophylaxis can decrease the incidence rate of AF in CABG, but
if it uses as a treatment, the side effect of Amiodaron will decrease
because all of the patients will not get Amiodarone. In the other hand use
of Amiodarone as a treatment does not influence the length of hospital
stay signifi cantly but these kinds of study are so few. CONCLUSION: No
appropriate therapeutic method has been defi ned for AF. At present, the
common way of treating AF following cardiac surgery is mainly based on
prophylaxis in medical books and references. Copyright &#xa9; 2016 World
Journal of Emergency Medicine.

<32>
Accession Number
613211559
Author
Spreadborough P.; Lort S.; Pasquali S.; Popplewell M.; Owen A.; Kreis I.;
Tucker O.; Vohra R.S.
Institution
(Spreadborough, Lort, Popplewell, Vohra) West Midlands Research
Collaborative, University of Birmingham, Edgbaston, Birmingham B15 2TH,
United Kingdom
(Pasquali, Tucker) Department of Upper Gastro-Intestinal Surgery, Queen
Elizabeth Hospital, Birmingham, United Kingdom
(Owen) School of Immunity and Infection, University of Birmingham,
Birmingham, United Kingdom
(Kreis) Clinical Effectiveness Unit, Royal College of Surgeons England,
London, United Kingdom
(Tucker) Academic Department of Surgery, University of Birmingham, Queen
Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, United Kingdom
(Vohra) Nottingham Oesophagi-Gastric unit, Nottingham University Hospitals
NHS Trust, Queens Medical Centre, Nottingham NG7 2UH, United Kingdom
Title
A systematic review and meta-analysis of perioperative oral
decontamination in patients undergoing major elective surgery.
Source
Perioperative Medicine. 5 (1) (no pagination), 2016. Article Number: 6.
Date of Publication: 2016.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Oral antiseptics reduce nosocomial infections and
ventilator-associated pneumonia in critically ill medical and surgical
patients intubated for prolonged periods. However, the role of oral
antiseptics given before and after planned surgery is not clear. The aim
of this systematic review and meta-analysis is to determine the effect of
oral antiseptics (chlorhexidine or povidone-iodine) when administered
before and after major elective surgery. Methods: Searches were conducted
of the MEDLINE, EMBASE and Cochrane databases. The analysis was performed
using the random-effects method and the risk ratio (RR) with 95 %
confidence interval (CI). Results: Of 1114 unique identified articles,
perioperative chlorhexidine was administered to patients undergoing
elective surgery in four studies. This identified 2265 patients undergoing
elective cardiac surgery, of whom 1093 (48.3 %) received perioperative
chlorhexidine. Postoperative pneumonia and nosocomial infections were
observed in 5.3 and 20.2 % who received chlorhexidine compared to 10.4 and
31.3 % who received a control preparation, respectively. Oral
perioperative chlorhexidine significantly reduced the risk of
postoperative pneumonia (RR = 0.52; 95 % CI 0.39-0.71; p < 0.01) and
overall nosocomial infections (RR = 0.65; 95 % CI 0.52-0.81; p < 0.01),
with no effect on in-hospital mortality (RR = 1.01; 95 % CI 0.49-2.09; p =
0.98). Conclusions: Perioperative oral chlorhexidine significantly
decreases the incidence of nosocomial infection and postoperative
pneumonia in patients undergoing elective cardiac surgery. There are no
randomised controlled studies of this simple and cheap intervention in
patients undergoing elective non-cardiac surgery. Copyright &#xa9; 2016
Spreadborough et al.

<33>
Accession Number
613365541
Author
Calafiore A.M.; Prapas S.; Abukoudair W.; Di Mauro M.
Institution
(Calafiore, Prapas) Department of Cardiac Surgery, Henry Dunant Hospital,
Athens, Greece
(Abukoudair) Division of Cardiac Surgery, King Fahd Military Hospital,
Jeddah, Saudi Arabia
(Di Mauro) University G. D'Annunzio, Chieti, Italy
Title
Has moderate ischemic mitral regurgitation to be corrected?-Analysis of a
randomized trial.
Source
Annals of Translational Medicine. 4 (no pagination), 2016. Article Number:
S66. Date of Publication: October 2016.
Publisher
AME Publishing Company (E-mail: info@amepc.org)

<34>
Accession Number
612636079
Author
Hummel J.D.; Coppess M.A.; Osborn J.S.; Yee R.; Fung J.W.H.; Augostini R.;
Li S.; Hine D.; Singh J.P.
Institution
(Hummel, Augostini) Ohio State University, Columbus, OH, United States
(Coppess) Stern Cardiovascular Center, Germantown, TN, United States
(Osborn) Intermountain Medical Center, Murray, UT, United States
(Yee) London Health Sciences Centre, London, ON, Canada
(Fung) Chinese University of Hong Kong, Shatin, Hong Kong
(Li, Hine) Medtronic, Mounds View, MN, United States
(Singh) Massachusetts General Hospital, Boston, MA, United States
Title
Real-World Assessment of Acute Left Ventricular Lead Implant Success and
Complication Rates: Results from the Attain Success Clinical Trial.
Source
PACE - Pacing and Clinical Electrophysiology. 39 (11) (pp 1246-1253),
2016. Date of Publication: 01 Nov 2016.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Left ventricular lead (LVL) implant success rates have
historically ranged between 70.5% and 95.5%. To date, there are few large
studies that evaluate LVL implant success utilizing a single family of
delivery catheters and leads. The Attain Success study was a prospective
nonrandomized multicenter global study with the main objectives of
assessing single-system LVL implant success and complication rates.
Methods: Patients undergoing cardiac resynchronization therapy
implantation were eligible for enrollment. There was no prespecified level
of experience for investigator participation. LVL implant success and
complication rates were assessed though 3 months of follow-up. Results: A
total of 2,014 patients (69.1 +/- 12.0 years, 71% male and 38% atrial
fibrillation) were enrolled from 114 centers with a follow-up of 3.5 +/-
2.1 months. Coronary sinus cannulation success rate was 96.4% with Attain
Family delivery catheters. Implant success rate for Attain Family leads
using Attain Family catheters was 94.0%; overall LVL implant success rate
was 97.1%. Median procedure time was 4 minutes for cannulation and 9
minutes for LVL placement. Median fluoroscopy time was 17 minutes and
median contrast used was 25 cc. There were 55 catheter or LVL-related
complications in 53 subjects; the majority were LVL dislodgements (34,
1.7%) and extracardiac stimulation (11, 0.5%). The Kaplan-Meier estimate
of the 3-month complication probability was 2.6%. Conclusion: This study
represents the largest prospective evaluation of LVL implantation to date,
revealing a high LVL implant success rate and low complication rate using
a single family of leads and delivery catheters. Copyright &#xa9; 2016
Wiley Periodicals, Inc.

<35>
Accession Number
613222338
Author
Pedersen S.S.; Nielsen J.C.; Riahi S.; Haarbo J.; VidebAEk R.; Larsen
M.L.; Skov O.; Knudsen C.; Johansen J.B.
Institution
(Pedersen, Skov, Knudsen) Department of Psychology, University of Southern
Denmark, Odense, Denmark
(Pedersen, Johansen) Department of Cardiology, Odense University Hospital,
Odense, Denmark
(Pedersen) Department of Cardiology, Erasmus Medical Center, Rotterdam,
Netherlands
(Nielsen) Department of Cardiology, Skejby, Aarhus University Hospital,
Aarhus, Denmark
(Riahi, Larsen) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Haarbo) Department of Cardiology, Gentofte Hospital, Copenhagen
University Hospital, Copenhagen, Denmark
(VidebAEk) Department of Cardiology, Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark
Title
Study Design and Cohort Description of DEFIB-WOMEN: A National Danish
Study in Patients with an ICD.
Source
PACE - Pacing and Clinical Electrophysiology. 39 (11) (pp 1261-1268),
2016. Date of Publication: 01 Nov 2016.
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Little systematic evidence is available on potential gender
differences in patients with an implantable cardioverter defibrillator
(ICD) from a real-world cohort. We designed the DEFIB-WOMEN (The
Utilization of Implantable Cardioverter DEFIBrillator Therapy in the
Treatment of Heart Disease: Clinical and Psychological outcomes in WOMEN)
study to examine gender differences on (1) patient-reported outcomes
(PROs), (2) procedure- and device-related complications, and (3)
ventricular tachyarrhythmia and mortality. This presents the study design
and baseline characteristics of the cohort. Methods: DEFIB-WOMEN is a
national, multicenter, prospective, observational study. First-time
implanted patients are asked to complete PROs at several time points.
Information on baseline and follow-up characteristics are captured from
patients' medical records, purpose-designed questions, and the Danish
national registers. The DEFIB-WOMEN cohort is composed of 1,790 (19%
women; 343/1,790) patients implanted between June 2010 and April 2013.
Results: Women and men differed on several demographic and clinical
baseline characteristics, including on the prescription of beta-blockers,
statins, angiotensin-converting enzyme inhibitors, and psychotropic
agents. Although women generally had a healthier clinical profile, they
reported significantly more symptoms of anxiety and depression and ICD
concerns (fear of shock) as compared to men. These differences were not
only statistically significant but also clinically relevant, with the
magnitude of the differences in anxiety and ICD concerns being 0.44 and
0.42, respectively, as indicated by Cohen's effect size index.
Conclusions: These preliminary results indicate that women with an ICD
experience particularly more anxiety and ICD concerns as compared to men
at the time of implant. Future results of DEFIB-WOMEN will show whether
these gender differences persist and whether there are also gender
differences in complications and survival. Copyright &#xa9; 2016 Wiley
Periodicals, Inc.

<36>
[Use Link to view the full text]
Accession Number
606253587
Author
Ortmann E.; Besser M.W.; Sharples L.D.; Gerrard C.; Berman M.; Jenkins
D.P.; Klein A.A.
Institution
(Ortmann, Gerrard, Klein) Departments of Anaesthesia and Intensive Care,
Papworth Hospital, Cambridge, United Kingdom
(Besser) Department of Haematology, Addenbrooke's Hospital, Cambridge
University Hospitals Foundation Trust, Cambridge, United Kingdom
(Sharples) MRC Biostatistics Unit, Cambridge, United Kingdom
(Berman, Jenkins) Departments of Cardiothoracic Surgery, Papworth
Hospital, Cambridge, United Kingdom
Title
An exploratory cohort study comparing prothrombin complex concentrate and
fresh frozen plasma for the treatment of coagulopathy after complex
cardiac surgery.
Source
Anesthesia and Analgesia. 121 (1) (pp 26-33), 2015. Date of Publication:
04 Jul 2015.
Publisher
Lippincott Williams and Wilkins (E-mail: LRorders@phl.lrpub.com)
Abstract
BACKGROUND: Administration of coagulation factor concentrates to treat
bleeding after cardiac surgery with cardiopulmonary bypass might be a
strategy for reducing allogeneic blood transfusions, particularly for
patients treated with warfarin preoperatively. We performed an exploratory
analysis on whether the use of prothrombin complex concentrate (PCC) is
safe and effective compared with fresh frozen plasma (FFP) to treat
coagulopathy after pulmonary endarterectomy surgery with deep hypothermic
circulatory arrest. METHODS: Consecutive adult patients who underwent
pulmonary endarterectomy surgery between January 2010 and September 2012
and received PCC or FFP to treat coagulopathy were studied. Blood loss
during the first 12 hours of admission to the intensive care unit and
patient outcomes were compared with propensity score adjustment. RESULTS:
Three hundred fifty-one patients underwent pulmonary endarterectomy
surgery, all of whom had warfarin discontinued for up to 5 days before
surgery; bleeding complications requiring transfusion of blood products
were observed in 108 (31%) patients. Of those, 55 received only FFP and 45
received only PCC, whereas 8 received both. Blood loss was significantly
greater in the FFP group compared with the PCC group after 12 hours
(median [interquartile range], 650 mL [325-1075] vs 277 mL [175-608], P =
0.008). However, there was no difference in the frequency of patients
receiving a red blood cell transfusion (number [percent], 44 [80%] vs 34
[76%], P = 0.594) or in the number of units of red blood cells transfused
(median [interquartile range], 2 [1-4] vs 3 [1-5] units, P = 0.181). The
final propensity score included preoperative international normalized
ratio, postoperative activated partial thromboplastin time, and
postoperative platelet count. After inclusion of the propensity score in
the regression analyses, there were no differences between patients
receiving only PCC and patients receiving only FFP in the need for renal
replacement therapy (odds ratio [OR] 2.39, 95% confidence interval [CI]
0.51-11.20, P = 0.27), 30-day-mortality (OR 0.32, 95% CI 0.03-3.36, P =
0.35), intracranial hemorrhage (OR 0.73, 95% CI 0.14-3.89, P = 0.71),
hospital length of stay (hazard ratio 0.77, 95% CI 0.50-1.19, P = 0.24),
or duration of intensive care stay (hazard ratio 0.91, 95% CI 0.59-1.40, P
= 0.66). CONCLUSIONS: This retrospective analysis suggests that PCC may be
an alternative to FFP in patients previously treated with warfarin who are
coagulopathic after major cardiac surgery. Randomized controlled studies
powered to evaluate efficacy and important postoperative outcomes for
patients receiving PCC versus FFP for coagulopathic bleeding after
cardiopulmonary bypass are warranted. Copyright &#xa9; 2015 International
Anesthesia Research Society.

<37>
Accession Number
606028088
Author
Campanile A.; Sozzi F.B.; Consonni D.; Piscione F.; Sganzerla P.; Indolfi
C.; Stabile A.; Migliorini A.; Antoniucci D.; Ferraresi R.; Boccuzzi G.;
Danzi G.B.
Institution
(Campanile) Department of Adult Intensive Care Unit, Royal Brompton
Hospital, London, United Kingdom
(Campanile, Sozzi, Danzi) Department of Cardiology, Ca' Granda IRCCS
Foundation, Maggiore Policlinico Hospital, Milan, Italy
(Consonni) Epidemiology Unit, Ca' Granda IRCCS Foundation, Maggiore
Policlinico Hospital, Milan, Italy
(Piscione) Cardiology Department, University of Salerno, Salerno, Italy
(Sganzerla) Department of Cardiology, Ospedale di Treviglio, Treviglio,
Bergamo, Italy
(Indolfi) Magna Graecia University, Germaneto, Catanzaro, Italy
(Stabile) Department of Cardiology, Ospedale Civico ARNAS, Palermo, Italy
(Migliorini, Antoniucci) Department of Cardiology, Ospedale Careggi,
Florence, Italy
(Ferraresi) Interventional Cardiovascular Unit, Istituto Clinico Citta
Studi, Milan, Italy
(Boccuzzi) Department of Cardiology, Ospedale San Giovanni Bosco, Turin,
Italy
Title
Primary PCI for the treatment of ectatic infarct-related coronary artery.
Source
Minerva Cardioangiologica. 62 (4) (pp 327-333), 2014. Date of Publication:
01 Aug 2014.
Publisher
Edizioni Minerva Medica (E-mail: subscriptions.dept@minervamedica.it)
Abstract
Aim. There is lack of information on the outcome of patients treated with
primary angioplasty for lesions located in an ectatic coronary artery
segment in the setting of acute myocardial infarction. The aim of this
study was to analyse the 2-year follow-up of this specific patient
population. Methods. By means of a systematic review of the databases and
cine-films of 5912 primary angioplasties performed in eight Italian
cardiac centers we identified 101 patients with infarct-related coronary
artery ectasia. Ectasia was defined as a dilatation exceeding the 1.5-fold
of normal adjacent segment and was classified according to its severity.
The primary end point was the composite rate of cardiac death, recurrence
of acute myocardial infarction and a new revascularisation at 2-year.
Results. The procedure was successful in 70.3% of cases, unsuccessful or
complicated in 29.7%. The primary endpoint was met in 6.9% of cases during
hospitalization (95% CI: 2.0-11.8), in 17.8% (95% CI: 10.3-25.3) at 1
year, and in 38.5% (95% CI: 29-0-48.0) at 2 years. Nine patients had a
stent thrombosis: 3 acute and 6 sub-acute. A statistically significant
correlation between the dimensions of the stent and stent thrombosis was
observed (P=0.005). Conclusion. In subjects undergoing primary angioplasty
for acute myocardial infarction the rate of patients treated on lesions
located in an ectatic coronary artery segment is very small (1.7%). The
procedural success was low, whereas the rate of events at follow-up was
quit high reflecting the complexity of this disease.

<38>
Accession Number
52996033
Author
Ge Y.-Z.; Yu P.; Jia R.-P.; Wu R.; Ding A.-X.; Li L.-P.; Zhao Y.; Feng
Y.-M.; Gui Z.-L.; Liao S.
Institution
(Ge, Yu, Jia, Wu, Zhao, Feng, Gui, Liao) Department of Urology and Center
of Renal Transplantation, Nanjing First Hospital, Nanjing Medical
University, 68 Changle Road, Nanjing 210006, China
(Ding) Department of General Surgery, Nanjing First Hospital, Nanjing
Medical University, 68 Changle Road, Nanjing 210006, China
(Li) Department of Cardiothoracic Surgery, Nanjing First Hospital, Nanjing
Medical University, 68 Changle Road, Nanjing 210006, China
Title
Association between transforming growth factor beta-1 +869T/C polymorphism
and acute rejection of solid organ allograft: A meta-analysis and
systematic review.
Source
Transplant Immunology. 30 (2-3) (pp 76-83), 2014. Date of Publication:
March 2014.
Publisher
Elsevier (P.O. Box 211, Amsterdam 1000 AE, Netherlands)
Abstract
Background: Transforming growth factor beta-1(TGFB1) is involved in the
acute rejection (AR) episodes of solid organ transplant recipients.
However, results from published studies on the association between
donor/recipient TGFB1 + 869 T/C polymorphism and AR risk are conflicting
and inconclusive. Methods: PUBMED, EMBASE, CNKI and Wanfang Database were
searched to identify eligible studies investigating the association
between donor/recipient TGFB1 +. 869. T/C polymorphism and AR risk.
Statistical analysis was performed by using STATA 10.0. Results: A total
of 29 studies were included. Overall, the donor TGFB1 + 869 T/C
polymorphism was significantly associated with AR risk in heterozygote
comparison (CT vs. TT: OR = 1.67, 95%CI, 1.17-2.39; P heterogeneity =
0.285) and dominant model (CC vs. TC/TT: OR = 1.47, 95%CI, 1.05-2.06; P
heterogeneity = 0.445). In addition, subgroup analysis revealed that CT
variant (CT vs. TT: OR = 1.97, 95%CI, 1.20-3.25; P heterogeneity = 0.777)
and CC/CT genotype (CC/CT vs. TT: OR = 1.72, 95%CI, 1.07, 2.78; P
heterogeneity = 0.619) within donors contributed to higher risk of AR in
recipients administrated with CsA or FK506, compared with those applied
only CsA. On the other hand, no significant association between recipient
TGFB1 + 869 T/C polymorphism and AR was detected in all genetic models.
Conclusions: This meta-analysis and systematic review suggested that donor
TGFB1 + 869 T/C polymorphism was significantly associated with AR of solid
organ transplant recipients, and especially among patients in CsA/FK 506
group compared with those in CsA group. &#xa9; 2014 Elsevier B.V.

<39>
Accession Number
373552345
Author
Rogers C.A.; Pike K.; Campbell H.; Reeves B.C.; Angelini G.D.; Gray A.;
Altman D.G.; Miller H.; Wells S.; Taggart D.P.
Institution
(Rogers, Pike, Reeves, Miller, Wells) Clinical Trials and Evaluation Unit,
School of Clinical Sciences, University of Bristol, Bristol, United
Kingdom
(Campbell, Gray) Health Economics Research Centre, Nuffield Department of
Population Health, University of Oxford, Oxford, United Kingdom
(Angelini) Bristol Heart Institute, School of Clinical Sciences,
University of Bristol, Bristol, United Kingdom
(Altman) Centre for Statistics in Medicine, University of Oxford, Oxford,
United Kingdom
(Taggart) Nuffield Department of Surgical Science, University of Oxford,
Oxford, United Kingdom
Title
Coronary artery bypass grafting in high-RISk patients randomised to off-
or on-pump surgery: A randomized controlled trial (the CRISP trial).
Source
Health Technology Assessment. 18 (44) (pp 1-157), 2014. Date of
Publication: 2014.
Publisher
NIHR Journals Library
Abstract
Background: Coronary artery bypass grafting (CABG) is the treatment of
choice for patients with multivessel coronary artery disease (CAD).
Evidence from randomised controlled trials (RCTs) in low-risk populations
shows that 'off-pump' CABG is at least as safe as 'on-pump' CABG, but
high-quality trial data in high-risk populations are lacking. Objectives:
To test the hypothesis that, in high-risk patients, off-pump coronary
artery bypass grafting (OPCABG) reduces mortality and morbidity without
causing a higher risk of reintervention compared with on-pump coronary
artery bypass grafting (ONCABG). Design: Open parallel-group RCT with a 1:
1 allocation ratio and expertise-based randomisation. Setting: Eight
specialist cardiac surgery centres in the UK and one specialist centre in
Kolkata, India. Participants: Patients with an additive European system
for cardiac operative risk evaluation score (EuroSCORE) of > 5, undergoing
non-emergency isolated CABG via a median sternotomy. Interventions: CABG
without cardiopulmonary bypass (CPB), i.e. OPCABG on the beating heart, or
CABG with CPB, i.e. ONCABG on a chemically arrested heart. Main outcome
measures: Primary outcome - a composite of death or serious morbidity
[all-cause mortality, myocardial infarction (MI), stroke, prolonged
initial ventilation, sternal wound dehiscence] within 30 days of surgery.
Secondary outcomes - quality of life (QoL) [Rose Angina Questionnaire,
Canadian Cardiovascular Society (CCS) angina class, European QoL-5
Dimensions (EQ-5D), Coronary Revascularisation Outcome Questionnaire
(CROQ)] and resource utilisation. Results: The organisation of a tertiary
cardiac surgery service in the UK presented several barriers to
recruitment. Referral information was often inadequate to confirm
eligibility. Limited surgeon participation at a centre, the need to meet
referral-to-treatment performance targets and complex referral pathways
did not support an expertise-based allocation. Urgent patients waiting for
surgery in local 'feeder' hospitals were often not transferred until late
the night before surgery, which limited the time available to take consent
and organise the surgery on an expertise basis. Several elective patients
declined to take part because they wanted the surgeon they had met when
the surgery was first discussed in clinic to operate. Several initiatives
were explored to boost recruitment. After 10 months of recruitment, the
trial design was modified to permit both within-surgeon and
expertise-based randomisation within a centre. However, this did not have
sufficient impact and the trial was stopped on the grounds of futility
after 106 patients (< 2% of the target sample size) had been recruited in
18 months. Ninety-eight patients were included in the trial analyses, six
patients were withdrawn and two died before surgery. In both groups, 6% of
patients experienced the primary outcome [adjusted odds ratio (OR) (OPCABG
to ONCABG) 1.07; 95% confidence interval (CI) 0.27 to 4.14]. QoL scores at
4-8 weeks post surgery were similar in the two groups. Patients randomised
to OPCABG had a shorter stay in the intensive care unit and in hospital
after surgery (median 26.0 vs. 27.7 hours in intensive care and 7 vs. 8
days in hospital). Conclusions: The Coronary artery bypass grafting in
high-RISk patients randomised to off- or on-Pump surgery (CRISP) trial was
not successful for a range of logistical reasons. However, the experience
gained is of value for the design and conduct of future trials. The
surgical community have polarised views. A qualitative evaluation of the
reasons behind the views held by the advocates of the two techniques is an
area for future research. Trial registration: Current Controlled Trials
ISRCTN29161170. Funding: This project was funded by the Medical Research
Council/National Institute for Health Research (NIHR) Efficacy and
Mechanism Evaluation programme and will be published in full in Health
Technology Assessment; Vol. 18, No. 44. See the NIHR Journals Library
website for further project information. &#xa9; Queen'S Printer and
Controller of HMSO 2014.

<40>
Accession Number
613259923
Author
Vazquez N.H.
Institution
(Vazquez) Servicio de Neumologia, Hospital Universitario del Henares,
Avda. Marie Curie, s/n., Coslada, Madrid 28822, Spain
Title
Update on lung cancer: SEPAR recommendations.
Source
Revista de Patologia Respiratoria. 19 (3) (pp 73-75), 2016. Date of
Publication: 2016.
Publisher
Sociedad Madrinela de Neumologia y Cirugia Toracica (E-mail:
revistaNM@neumomadrid.org)
Abstract
Lung cancer (PC) is the highest incidence and mortality worldwide, so it
is vital that there are recommendations that facilitate diagnosis and
treatment. The Spanish Society of Pneumology and Thoracic Surgery (SEPAR)
has recently published a comprehensive supplement on Recommendations for
the diagnosis and treatment of non-small cell lung cancer. The evidence
does not allow recommending performing chest X-ray and screening in
patients at risk, however, the systematic review of studies that perform
annual screening by computed tomography (CT) low radiation in high-risk
individuals has been shown to reduce mortality. Moreover, at present the
combined use of CT and PET for diagnosis and treatment planning is
recommended. Minimally invasive diagnostic techniques (electromagnetic
navigation bronchoscopy and endobronchial ultrasound) are safe and prevent
complications are possible in patients with comorbidity. Regarding
treatment, TNM classification of the International Association for the
Study of Lung Cancer (IASLC) enables assessment of some surgical patients
directly before they were discarded. There are new molecular markers in
unresectable or inoperable tumors that identify subgroups that may benefit
from specific treatments with higher response rate (gene growth factor
epidermal -EGFR-, translocation gene anaplastic lymphoma kinase
-EML4-ALK-).

<41>
Accession Number
609329702
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. Copyright &#xa9; 2016 The Cochrane
Collaboration.

<42>
Accession Number
612609112
Author
De Donato G.; Setacci F.; Galzerano G.; Mele M.; Ruzzi U.; Setacci C.
Institution
(De Donato, Setacci, Galzerano, Mele, Ruzzi, Setacci) Unit of Vascular
Surgery, Department of Medicine, Surgery and Neuroscience, University of
Siena, Viale Bracci, Siena 53100, Italy
Title
The use of cilostazol in patients with peripheral arterial disease:
Results of a national physician survey.
Source
Journal of Cardiovascular Surgery. 57 (3) (pp 457-465), 2016. Date of
Publication: June 2016.
Publisher
Edizioni Minerva Medica (E-mail: subscriptions.dept@minervamedica.it)
Abstract
BACKGROUND: Although international guidelines recommend cilostazol as
first-line therapy for peripheral arterial disease (PAD) because it
improves the symptoms and quality of life, it remains an underused agent
for amputation-free survival. The objective of this study was to evaluate
the practice among Italian physicians of the use of cilostazol in patients
suffering from peripheral arterial disease (PAD). METHODS: For the present
study, a cross-sectional survey was carried out. Physicians specialized in
the medical and/or surgical treatment of PAD and who prescribe cilostazol
regularly were invited to a phone interview. A nationally-representative
probability sample of hospital-based physicians who diagnose and treat
patients with PAD was randomly selected among the members of the Italian
Physicians' Association. RESULTS: Out of a total of 641 physicians
contacted, 250 of them (39%) accepted to take part in this survey. Reasons
of survey refusal were the non-attitude to prescribe cilostazol (45%), or
unspecified motivations (16%). Among the 250 physicians participating the
survey: 120 were vascular surgeons, 80 internal medicine doctors, 50
angiologists. Cilostazol was suggested in 79% of patients with symptomatic
intermittent claudication, and in 30% of patients who had undergone
revascularization. The majority of physicians stated to prescribe
cilostazol at recommended dosage of 100 mg bid (46.4%). The principal
reason to suggest a reduced drug dosage was to limit early side effect at
the time of treatment onset, but the increase to the full dose of
cilostazol is suggested by 91.3% of interviewed within 4 weeks.
Sixty-three percent of physicians affirmed to prescribe cilostazol as a
continuous treatment for a mean of 4 months, while a lifelong treatment
was suggested by 17.6% of participants. CONCLUSIONS: Among physicians who
habitually prescribe cilostazol adherence to the recommended drug dosage
and length of treatment is high. The prescription of cilostazol is
particularly appreciated in patients with symptomatic intermittent
claudication, even before any noninvasive diagnosis of PAD, and before any
invasive therapy. Finally a relevant number of physicians regularly
prescribe cilostazol also after revascularization, advocating the
anti-restenotic properties of the drug.

<43>
Accession Number
612609092
Author
Guerrero M.; Urena M.; Pursnani A.; Wang D.D.; Vahanian A.; O'Neill W.;
Feldman T.; Himbert D.
Institution
(Guerrero, Pursnani, Feldman) Division of Cardiology, Evanston Hospital,
North Shore University Health System, 2650 Ridge Ave, Evanston, IL 60201,
United States
(Urena, Vahanian, Himbert) Department of Cardiology, Bichat Hospital,
Paris, France
(Wang, O'Neill) Institute of Structural Heart Disease, Henry Ford Health
System, Detroit, IL, United States
Title
Balloon expandable transcatheter heart valves for native mitral valve
disease with severe mitral annular calcification.
Source
Journal of Cardiovascular Surgery. 57 (3) (pp 401-409), 2016. Date of
Publication: June 2016.
Publisher
Edizioni Minerva Medica (E-mail: subscriptions.dept@minervamedica.it)
Abstract
Patients with mitral annular calcification (MAC) have high surgical risk
for mitral valve replacement due to associated comorbidities and technical
challenges related to calcium burden, precluding surgery in many patients.
Transcatheter mitral valve replacement (TMVR) with the compassionate use
of balloon expandable aortic transcatheter heart valves has been used in
this clinical scenario. The purpose of this review was to summarize the
early experience including successes and failures reported. TMVR might
evolve into an acceptable alternative for selected patients with severe
MAC who are not candidates for conventional mitral valve surgery. However,
this field is at a very early stage and the progress will be significantly
slower than the development of transcatheter aortic valve replacement due
to the complexity of the mitral valve anatomy and its pathology.
Optimizing patient selection process by using multimodality imaging tools
to accurately measure the mitral valve annulus and evaluate the risk of
left ventricular outflow tract obstruction is essential to minimize
complications. Strategies for treating and preventing left ventricular
outflow tract obstruction are being tested. Similarly, carefully selecting
candidates avoiding patients at the end of their disease process, might
improve the overall outcomes.

<44>
Accession Number
613337422
Author
Cao Y.; Tian X.-Y.; Zhang R.; Zhao J.-Q.; Zhang M.; Cheng Y.-T.; Li C.-F.;
Liu G.-L.; An Y.
Institution
(Cao, An) Department of Cardiology, Affiliated Hospital, Qingdao
University, No. 59, Haier Road, Laoshan District, Qingdao, Shandong, China
(Cao, Zhang, Zhao, Zhang, Cheng, Li, Liu) Department of Cardiology,
Affiliated Hospital of Jining Medical University, Jining, Shandong, China
(Tian) Department of Health Management, Community Service Center,
Affiliated Hospital of Jining Medical University, Jining, Shandong, China
Title
Short- and long-term efficacy and safety of triple vs. dual antithrombotic
therapy in patients with drug-eluting stent implantation and an indication
for oral anticoagulation: A meta-analysis.
Source
International Journal of Clinical Pharmacology and Therapeutics. 54 (12)
(pp 950-965), 2016. Date of Publication: 2016.
Publisher
Dustri-Verlag Dr. Karl Feistle (Bajuwarenring 4, Oberhaching 82041,
Germany)
Abstract
Background: The optimal antithrombotic regimen after coronary stenting in
patients taking oral anticoagulants (OACs) is still unclear. Therefore,
this meta-analysis focused on the short- and long-term efficacy and safety
of triple therapy (TT: OAC, aspirin, and thienopyridine) and dual therapy
(DT: OAC plus single antiplatelet drug or aspirin plus thienopyridine).
Methods: We searched PubMed, Embase, the Cochrane Library, Wangfang
database, and Google Scholar up to December 1, 2015 (January 1, 2000 -
December 2015), from randomized and nonrandomized studies comparing TT and
DT in patients with OACs undergoing drug-eluting stent (DES) implantation.
Major adverse cardiac and cerebrovascular events (MACCE) were the main
outcome. Safety outcome was major bleeding (MB). Results: Of 964
publications identifi ed, 1 randomized study and 27 nonrandomized studies
of 31,346 patients were included. Overall, TT and OAC plus clopidogrel
were associated with a lower risk of MACCE, stroke, MI, and allcause
mortality compared with dual antiplatelet therapy or OAC plus aspirin.
Additionally, short-term use of triple antithrombotic regimen with OAC,
aspirin, and clopidogrel is associated with equivalent risk of major
bleeding and decreased rate of MACCE. Long-term use of OAC plus
clopidogrel after TT was associated with equal or better benefit and
safety outcomes. Conclusion: For patients on OAC after coronary stenting,
triple therapy (OAC, aspirin, clopidogrel) should be considered in the
short term, followed by more long-term therapy with OAC plus clopidogrel.
More randomized studies are needed to confirm these findings. Copyright
&#xa9; 2016 Dustri-Verlag Dr. K. Feistle.

<45>
Accession Number
609158092
Author
Chhabra A.; Subramaniam R.; Srivastava A.; Prabhakar H.; Kalaivani M.;
Paranjape S.
Institution
(Chhabra, Subramaniam, Paranjape) All India Institute of Medical Sciences,
Department of Anaesthesiology, Ansari Nagar, New Delhi 110029, India
(Srivastava) All India Institute of Medical Sciences, Department of
Surgery, Ansari Nagar, New Delhi 110029, India
(Prabhakar) All India Institute of Medical Sciences, Department of
Neuroanaesthesiology, Ansari Nagar, New Delhi 110029, India
(Kalaivani) All India Institute of Medical Sciences, Department of
Biostatistics, Ansari Nagar, New Delhi, India
Title
Spectral entropy monitoring for adults and children undergoing general
anaesthesia.
Source
Cochrane Database of Systematic Reviews. 2016 (3) (no pagination), 2016.
Article Number: CD010135. Date of Publication: 14 Mar 2016.
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom)
Abstract
Background: Anaesthetic drugs during general anaesthesia are titrated
according to sympathetic or somatic responses to surgical stimuli. It is
now possible to measure depth of anaesthesia using electroencephalography
(EEG). Entropy, an EEG-based monitor can be used to assess the depth of
anaesthesia using a strip of electrodes applied to the forehead, and this
can guide intraoperative anaesthetic drug administration. Objectives: The
primary objective of this review was to assess the effectiveness of
entropy monitoring in facilitating faster recovery from general
anaesthesia. We also wanted to assess mortality at 24 hours, 30 days, and
one year following general anaesthesia with entropy monitoring. The
secondary objectives were to assess the effectiveness of the entropy
monitor in: preventing postoperative recall of intraoperative events
(awareness) following general anaesthesia; reducing the amount of
anaesthetic drugs used; reducing cost of the anaesthetic as well as in
reducing time to readiness to leave the postanaesthesia care unit (PACU).
Search methods: We searched the Cochrane Central Register of Controlled
Trials (CENTRAL; 2014, Issue 10), MEDLINE via Ovid SP (1990 to September
2014) and EMBASE via Ovid SP (1990 to September 2014). We reran the search
in CENTRAL, MEDLINE via Ovid SP and EMBASE via Ovid SP in January 2016. We
added one potential new study of interest to the list of 'Studies awaiting
Classification' and we will incorporate this study into the formal review
findings during the review update. Selection criteria: We included
randomized controlled trials (RCTs) conducted in adults and children (aged
greater than two years of age), where in one arm entropy monitoring was
used for titrating anaesthesia, and in the other standard practice
(increase in heart rate, mean arterial pressure, lacrimation, movement in
response to noxious surgical stimuli) was used for titrating anaesthetic
drug administration. We also included trials with an additional third arm,
wherein another EEG monitor, the Bispectral index (BIS) monitor was used
to assess anaesthetic depth. Data collection and analysis: We used
standard methodological procedures expected by Cochrane. Two review
authors independently extracted details of trial methodology and outcome
data from trials considered eligible for inclusion. All analyses were made
on an intention-to-treat basis. We used a random-effect model where there
was heterogeneity. For assessments of the overall quality of evidence for
each outcome that included pooled data from RCTs, we downgraded evidence
from 'high quality' by one level for serious (or by two for very serious)
study limitations (risk of bias, indirectness of evidence, serious
inconsistency, imprecision of effect or potential publication bias). Main
results: We included 11 RCTs (962 participants). Eight RCTs (762
participants) were carried out on adults (18 to 80 years of age), two (128
participants) involved children (two to 16 years) and one RCT (72
participants) included patients aged 60 to 75 years. Of the 11 included
studies, we judged three to be at low risk of bias, and the remaining
eight RCTs at unclear or high risk of bias. Six RCTs (383 participants)
estimated the primary outcome, time to awakening after stopping general
anaesthesia, which was reduced in the entropy as compared to the standard
practice group (mean difference (MD) -5.42 minutes, 95% confidence
interval (CI) -8.77 to -2.08; moderate quality of evidence). We noted
heterogeneity for this outcome; on performing subgroup analysis this was
found to be due to studies that included participants undergoing major,
long duration surgeries (off-pump coronary artery bypass grafting, major
urological surgery). The MD for time to awakening with four studies on
ambulatory procedures was -3.20 minutes (95% CI -3.94 to -2.45). No trial
reported the second primary outcome, mortality at 24 hours, 30 days, and
one year with the use of entropy monitoring. Eight trials (797
participants) compared the secondary outcome, postoperative recall of
intraoperative events (awareness) in the entropy and standard practice
groups. Awareness was reported by only one patient in the standard
practice group, making meaningful estimation of benefit of entropy
monitoring difficult; moderate quality of evidence. All 11 RCTs compared
the amount of anaesthetic agent used between the entropy and standard
practice groups. Six RCTs compared the amount of propofol, four compared
the amount of sevoflurane and one the amount of isoflurane used between
the groups. Analysis of three studies (166 participants) revealed that the
MD of propofol consumption between the entropy group and control group was
-11.56 mcg/kg/min (95% CI -24.05 to 0.92); low quality of evidence.
Analysis of another two studies (156 participants) showed that the MD in
sevoflurane consumption in the entropy group compared to the control group
was -3.42 mL (95% CI -6.49 to -0.35); moderate quality of evidence. No
trial reported on the secondary outcome of the cost of general
anaesthesia. Three trials (170 participants) estimated MD in time to
readiness to leave the PACU of the entropy group as compared to the
control group (MD -5.94 minutes, 95% CI -16.08 to 4.20; low quality of
evidence). Heterogeneity was noted, which was due to the difference in
anaesthetic technique (propofol-based general anaesthesia) in one study.
The remaining two studies had used volatile-based general anaesthesia. The
MD in time to readiness to leave the PACU was -4.17 minutes (95% CI -6.84
to -1.51) with these two studies. Authors' conclusions: The evidence as
regards time to awakening, recall of intraoperative awareness and
reduction in inhalational anaesthetic agent use was of moderate quality.
The quality of evidence of as regards reduction in intravenous anaesthetic
agent (propofol) use, as well as time to readiness to leave the PACU was
found to be of low quality. As the data are limited, further studies
consisting of more participants will be required for ascertaining benefits
of entropy monitoring. Further studies are needed to assess the effect of
entropy monitoring on focal issues such as short-term and long-term
mortality, as well as cost of general anaesthesia. Copyright &#xa9; 2016
The Cochrane Collaboration.

<46>
Accession Number
613199219
Author
Puri R.; Nicholls S.J.; St. John J.; Tuzcu E.M.; Kapadia S.R.; Uno K.;
Kataoka Y.; Wolski K.; Nissen S.E.
Institution
(Puri, St. John, Uno, Wolski, Nissen) Cleveland Clinic Coordinating Center
for Clinical Research (C5R), Cleveland, Ohio, United States
(Puri) Department of Medicine, University of Adelaide, Adelaide, Australia
(Nicholls, Kataoka) South Australian Health and Medical Research
Institute, University of Adelaide, Adelaide, Australia
(Tuzcu, Kapadia, Nissen) Department of Cardiovascular Medicine, Cleveland
Clinic, Cleveland, Ohio, United States
Title
Comparing Coronary Atheroma Progression Rates and Coronary Events in the
United States, Canada, Latin America, and Europe.
Source
American Journal of Cardiology. 118 (11) (pp 1616-1623), 2016. Date of
Publication: 01 Dec 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
We explored for geographic variations in coronary atheroma progression
rates in the United States compared to other world regions (Canada, Latin
America, Western Europe, and Central-Eastern Europe) and sought to
ascertain if this associated with regional differences in major adverse
cardiovascular events (MACE; cardiovascular death, nonfatal myocardial
infarction, coronary revascularization). Across 7 randomized trials with a
global recruitment pattern, 5,451 participants with angiographic coronary
disease underwent serial coronary intravascular ultrasonography during 18
or 24 months, with adjudicated MACE. Change in coronary percent atheroma
volume (DELTAPAV) and MACE in the United States versus other world regions
were assessed. Despite similar baseline angiographic and plaque
characteristics across participants and regions, following
propensity-weighted and multivariate analysis, US (n = 3,706) versus
non-US (n = 1,745) participants demonstrated marginal but significantly
greater annualized DELTAPAV (least-square means +/- SE: 0.27 +/- 0.14% vs
0.062 +/- 0.14%, p = 0.005). However, MACE rates were disproportionately
higher in US compared to non-US participants (23.5% vs 10.9%, p <0.001),
driven by a doubling in crude rates of coronary revascularization
procedures (16.1% vs 7.8%, p <0.001). The US participants hospitalized
with unstable angina demonstrated more significant disease progression
than their non-US counterparts (DELTAPAV: 0.57 +/- 0.19% vs -0.30 +/-
0.36%, p = 0.033) and greater MACE (9.1% vs 4.8%, p <0.001). A US
geographic disposition independently associated with MACE (hazard ratio
1.53, 95% confidence interval 1.22 to 1.92, p <0.001). In conclusion, in
participants with stable coronary disease, coronary atheroma progression
rates are modestly higher in US-based compared to non-US-based
participants. Elective coronary revascularization rates however are
disproportionately greater in US-based participants. Copyright &#xa9; 2016
Elsevier Inc.

<47>
Accession Number
600732005
Author
Fernando H.C.; Landreneau R.J.; Mandrekar S.J.; Nichols F.C.; Dipetrillo
T.A.; Meyers B.F.; Heron D.E.; Hillman S.L.; Jones D.R.; Starnes S.L.; Tan
A.D.; Daly B.D.T.; Putnam J.B.
Institution
(Fernando) Department of Cardiothoracic Surgery, Boston Medical Center, 88
East Newton St, Boston, MA 02118, United States
(Landreneau, Heron, Daly) University of Pittsburgh, Pittsburgh, PA, United
States
(Mandrekar, Hillman, Tan) Alliance Statistics and Data Center, Mayo
Clinic, Rochester, MN, United States
(Nichols) Mayo Clinic, Rochester, MN, United States
(Dipetrillo) Rhode Island Hospital, Providence, RI, United States
(Meyers) Washington University of St Louis, St Louis, Mo, United States
(Jones) University of Virginia, Charlottesville, VA, United States
(Starnes) University of Cincinnati, Cincinnati, OH, United States
(Putnam) Vanderbilt University Medical Center, Nashville, TN, United
States
Title
Analysis of longitudinal quality-of-life data in high-risk operable
patients with lung cancer: Results from the ACOSOG Z4032 (Alliance)
multicenter randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 149 (3) (pp 718-726),
2015. Date of Publication: 01 Mar 2015.
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background Prior studies have suggested that low baseline quality-of-life
(QOL) scores predict worse survival in patients undergoing lung cancer
surgery. However, these studies involved average-risk patients undergoing
lobectomy. We report QOL results from a multicenter trial, American
College of Surgeons Oncology Group Z4032, which randomized high-risk
operable patients to sublobar resection (SR), or SR with brachytherapy,
and included longitudinal QOL assessments. Methods Global QOL, using the
36-item Short-Form Health Survey (SF36), and the dyspnea score from the
University of California, San Diego Shortness of Breath Questionnaire
(SOBQ) scale, was measured at baseline, 3, 12, and 24 months. SF36
physical component summary (PCS) and mental component summary (MCS) scores
were standardized and adjusted for age and gender normals, with scores <50
indicating below-Average health status. SOBQ scores were transformed to a
0-100 (poor-excellent) scale. Aims were to: (1) determine the impact of
baseline scores on recurrence-free survival, overall survival, and 30-day
adverse events (AEs); and (2) identify subgroups (surgical approach,
resection type. tumor location, tumor size, respiratory function) with a
>10-point decline or improvement in QOL after SR. Results Two hundred
twelve eligible patients were included. There were no significant
differences in baseline QOL scores between arms. Median baseline PCS, MCS,
and SOBQ scores were 42.7, 51.1, and 70.8, respectively. There were no
differences in grade-3+ AEs, overall survival, or recurrence-free survival
in patients with baseline scores <median versus >median values, except for
a significantly worse overall survival for patients with baseline SOBQ
scores <median value. There were no significant differences between the
study arms in percentage change of QOL scores from baseline to 3, 12, or
24 months. Further comparison combining the 2 arms demonstrated a higher
percentage of patients with a >10-point decline in SOBQ scores with
segmentectomy compared with wedge resection (40.5% vs 21.9%, P =.03) at 12
months, with thoracotomy versus video-Assisted thoracic surgery (VATS)
(38.8% vs 20.4%, P =.03) at 12 months, and T1b versus T1a tumors (46.9% vs
23.5%, P =.020) at 24 months. A >10-point improvement in PCS score was
seen at 3 months with VATS versus thoracotomy (16.5% vs 3.6%, P =.02).
Conclusions In high-risk operable patients, poor baseline QOL scores were
not predictive for worse overall or recurrence-free survival, or for
higher risk for AEs following SR. VATS was associated with improvement in
physical function at 3 months, and improved dyspnea scores at 12 months,
lending support for the preferential use of VATS when SR is undertaken.
Copyright &#xa9; 2015 The American Association for Thoracic Surgery.

<48>
Accession Number
602935739
Author
Kunst G.; Klein A.A.
Institution
(Kunst) Department of Anaesthetics, King's College Hospital NHS Foundation
Trust, London, United Kingdom
(Klein) Department of Anaesthesia and Intensive Care, Papworth Hospital,
Cambridge, United Kingdom
Title
Peri-operative anaesthetic myocardial preconditioning and protection -
Cellular mechanisms and clinical relevance in cardiac anaesthesia.
Source
Anaesthesia. 70 (4) (pp 467-482), 2015. Date of Publication: 01 Apr 2015.
Publisher
Blackwell Publishing Ltd (E-mail:
customerservices@oxonblackwellpublishing.com)
Abstract
Preconditioning has been shown to reduce myocardial damage caused by
ischaemia-reperfusion injury peri-operatively. Volatile anaesthetic agents
have the potential to provide myocardial protection by anaesthetic
preconditioning and, in addition, they also mediate renal and cerebral
protection. A number of proof-of-concept trials have confirmed that the
experimental evidence can be translated into clinical practice with regard
to postoperative markers of myocardial injury; however, this effect has
not been ubiquitous. The clinical trials published to date have also been
too small to investigate clinical outcome and mortality. Data from recent
meta-analyses in cardiac anaesthesia are also not conclusive regarding
intra-operative volatile anaesthesia. These inconclusive clinical results
have led to great variability currently in the type of anaesthetic agent
used during cardiac surgery. This review summarises experimentally
proposed mechanisms of anaesthetic preconditioning, and assesses
randomised controlled clinical trials in cardiac anaesthesia that have
been aimed at translating experimental results into the clinical setting.
Copyright &#xa9; 2015 The Authors. Anaesthesia published by John Wiley &
Sons Ltd on behalf of Association of Anaesthetists of Great Britain and
Ireland.

<49>
Accession Number
604509175
Author
Campos C.M.; Christiansen E.H.; Stone G.W.; Serruys P.W.
Institution
(Campos, Serruys) Erasmus University Medical Center, Rotterdam,
Netherlands
(Campos) Heart Institute (InCor), University of Sao Paulo Medical School,
Sao Paulo, Brazil
(Christiansen) Department of Cardiology, B Aarhus University Hospital,
Skejby, Denmark
(Stone) Columbia University Medical Center, New York, NY, United States
(Serruys) International Centre for Circulatory Health, NHLI, South
Kensington Campus, London SW7 2AZ, United Kingdom
Title
The EXCEL and NOBLE trials: Similarities, contrasts and future
perspectives for left main revascularisation.
Source
EuroIntervention. 11 (pp V115-V119), 2015. Date of Publication: 01 May
2015.
Publisher
EuroPCR
Abstract
Unprotected left main coronary artery (ULMCA) stenosis has relatively high
prevalence and exposes patients to a high risk for adverse cardiovascular
events. The optimal revascularisation strategy (coronary artery bypass
surgery [CABG] or percutaneous coronary intervention [PCI]) for patients
with complex coronary artery disease is a topic of continuing debate. The
introduction of the newer-generation drug-eluting stents (DES) -with
documented improvements in both safety and efficacy -has prompted the
interventional community to design two new dedicated randomised trials
comparing CABG and PCI: the NOBLE (Coronary Artery Bypass Grafting Vs Drug
Eluting Stent Percutaneous Coronary Angioplasty in the Treatment of
Unprotected Left Main Stenosis) and EXCEL (Evaluation of XIENCE Everolimus
Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of
Left Main Revascularization) trials. The aims of the present review are to
describe the similarities and contrasts between these two trials as well
to explore their future implications in ULMCA treatment. Copyright &#xa9;
2015 Europa Digital & Publishing. All rights reserved.

<50>
Accession Number
600736493
Author
Trivedi C.; Sadadia M.
Institution
(Trivedi) St. Davids Medical Center, Austin, TX 78705, United States
(Sadadia) Department of Pharmacology, Smt. B K Shah Medical Institute and
Research Centre, Piparia, Vadodara, Gujarat, India
Title
Colchicine in prevention of atrial fibrillation following cardiac surgery:
Systematic review and meta-analysis.
Source
Indian Journal of Pharmacology. 46 (6) (pp 590-595), 2014. Date of
Publication: 01 Nov 2014.
Publisher
Medknow Publications (B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai 400 075, India)
Abstract
Objectives: Inflammation is one of the predictors of atrial fibrillation
(AF) following surgical or interventional cardiac procedures. Recent
evidence suggests that colchicine may represent a new strategy to prevent
AF following cardiac procedures. This study aims to assess the
antiinflammatory efficacy of colchicine in prevention of early AF event
(EAFE). Materials and Methods: We reviewed all available studies that
assessed the effectiveness of colchicine therapy on the occurrence of AF
in patients undergoing cardiac procedures. Meta-analysis was performed by
random effect inverse variance-weighted method by entering AF events and
the total population from each study. Results: After thorough review of
the databases, we found three studies comparing colchicine and placebo
which had EAFE as the outcome. Of 584 patients, 286 patients were on
colchicine and 298 on placebo. All the three studies were randomized.
After pooled analysis, colchicine was associated with significant
reduction in AF events compared to placebo (odds ratio = 0.44 [0.29,
0.66], P < 0.001). There was no statistical heterogeneity between included
studies (chi² = 0.45, P = 0.80, I² = 0%).
Conclusion: Colchicine may prove beneficial in the prevention of AF
following cardiac surgery. Further research is warranted.

<51>
Accession Number
613227014
Author
Takagi H.; Ando T.; Umemoto T.
Institution
(Takagi, Umemoto) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
(Ando) Department of Cardiology, Detroit Medical Center, Detroit, MI,
United States
Title
Direct and adjusted indirect comparisons of perioperative mortality after
sutureless or rapid-deployment aortic valve replacement versus
transcatheter aortic valve implantation.
Source
International Journal of Cardiology. 228 (pp 327-334), 2017. Date of
Publication: 01 Feb 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Objectives To determine which procedure, aortic valve replacement (AVR)
with a sutureless or rapid-deployment prosthesis (SL-AVR) or transcatheter
aortic valve implantation (TAVI), achieves better perioperative survival
for severe aortic stenosis (AS), we conducted direct-comparison
meta-analyses (DC-MAs) and an adjusted indirect-comparison meta-analysis
(IDC-MA). Methods We searched MEDLINE, EMBASE, and the Cochrane Central
Register of Controlled Trials through April 2016. Eligible studies were
randomized controlled trials (RCTs) and propensity-score matched (PSM)
studies. We performed a DC-MA-[A] of SL-AVR versus TAVI, a DC-MA-[B] of
SL-AVR versus conventional AVR (C-AVR), and a DC-MA-[C] TAVI versus C-AVR.
Then, we computed a IDC-MA-[A'] of TAVI versus SL-AVR from the results of
the DC-MA-[B] and the DC-MA-[C]. Results We identified 6 RCTs and 30 PSM
studies enrolling a total of 15,887 patients. The 3 DC-MAs demonstrated
significantly lower perioperative (30-day or in-hospital) all-cause
mortality after SL-AVR than after TAVI (odds ratio [OR], 0.48; 95%
confidence interval [CI], 0.28 to 0.80; p = 0.005) and no significant
differences between SL-AVR and C-AVR (OR, 1.07; 95% CI, 0.60 to 1.94; p =
0.81) and between TAVI and C-AVR (1.07; 95% CI, 0.90 to 1.27; p = 0.45).
The computed IDC-MA-[A'] indicated no significant difference in mortality
between SL-AVR and TAVI (1.01; 95% CI, 0.54 to 1.86). Combining the
results of the DC-MA-[A] and IDC-MA [A'] showed significantly lower
mortality after SL-AVR than after TAVI (OR, 0.65; 95% CI, 0.44 to 0.97; p
= 0.03). Conclusions For patients with severe AS, SL-AVR may achieve
better perioperative survival than TAVI. Copyright &#xa9; 2016 Elsevier
Ireland Ltd

<52>
Accession Number
613295781
Author
Zhou Y.; Wang Y.; Wu Y.; Zhu J.
Institution
(Zhou, Wu, Zhu) Department of Cardiology, The First Affiliated Hospital,
Zhejiang University, School of Medicine, Hangzhou 310003, China
(Wang) Department of Cardiology, Ningbo Medical Treatment Center Lihuili
Hospital, Ningbo 315000, China
Title
Transcatheter versus surgical aortic valve replacement in low to
intermediate risk patients: A meta-analysis of randomized and
observational studies.
Source
International Journal of Cardiology. 228 (pp 723-728), 2017. Date of
Publication: 01 Feb 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Background Transcatheter aortic valve replacement (TAVR) has become the
treatment of choice for patients with aortic stenosis and the preferred
alternative for high surgical risk patients. However, TAVR's suitability
for patients at low to intermediate risk still remains controversial.
Methods PubMed, MEDLINE and Clinical trials were systematically searched
for randomized control trials and observational cohort studies which
reported the clinical outcomes of TAVR versus surgical aortic valve
replacement (SAVR) in patients at low to intermediate surgical risk.
Clinical endpoints including death, acute kidney injury, myocardial
infarction, and major adverse cardiac and cerebrovascular events (MACCE)
were assessed. Results From 2000 to 2016, 7 clinical studies comprising
6214 patients were identified. In each time point (in-hospital or 30 days,
1 year), TAVR was associated with similar incidence of death from any
cause, cardiovascular death and MACCE. TAVR reduced short-term incidence
of myocardial infarction and cerebrovascular events. However, TAVR was
associated with a higher rate of major vascular complications and
permanent pacemaker implantation. Conclusions Comparing with SAVR in
patients at low to intermediate surgical risk, TAVR has similar rates of
mortality and MACCE, lower incidence of acute kidney injury and new-onset
atrial fibrillation, but an increase in major vascular complications and
permanent pacemaker implantation. Copyright &#xa9; 2016

<53>
Accession Number
611741837
Author
Sun H.-Y.; Alexander B.D.; Huprikar S.; Forrest G.N.; Bruno D.; Lyon G.M.;
Wray D.; Johnson L.B.; Sifri C.D.; Razonable R.R.; Morris M.I.; Stoser V.;
Wagener M.M.; Singh N.
Institution
(Sun) Department of Internal Medicine, National Taiwan University
Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
(Republic of China)
(Alexander) Duke University Medical Center, Durham, NC, United States
(Huprikar) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Forrest) University of Maryland School of Medicine, Baltimore, United
States
(Bruno) Department of Internal Medicine, Hospital Universitario Fundacion
Favaloro, Buenos Aires, Argentina
(Lyon) Department of Medicine, Emory University, Atlanta, United States
(Wray) Medical University of South Carolina, Charleston, United States
(Johnson) St John Medical Center, Detroit, MI, United States
(Sifri) Department of Medicine, University of Virginia, Charlottesville,
United States
(Razonable) Department of Medicine, Mayo Clinic, Rochester, MN, United
States
(Morris) Miller School of Medicine, University of Miami, Florida, United
States
(Stoser) Department of Medicine, Northwestern University, Chicago, IL,
United States
(Wagener, Singh) Veterans Affairs Medical Center, Department of Medicine,
University of Pittsburgh, Pittsburgh, PA 15240, United States
(Forrest) Oregon Health and Science University, Portland, United States
Title
Predictors of immune reconstitution syndrome in organ transplant
recipients with cryptococcosis: Implications for the management of
immunosuppression.
Source
Clinical Infectious Diseases. 60 (1) (pp 36-44), 2015. Date of
Publication: 01 Jan 2015.
Publisher
Oxford University Press (E-mail: jnl.info@oup.co.uk)
Abstract
Background. Risk factors including how changes in immunosuppression
influence the occurrence of immune reconstitution syndrome (IRS) in solid
organ transplant (SOT) recipients with cryptococcosis have not been fully
defined. Methods. SOT recipients with cryptococcosis were identified and
followed for 12 months. IRS was defined based on previously proposed
criteria. Results. Of 89 SOT recipients, 13 (14%) developed IRS. Central
nervous system (CNS) disease (adjusted odds ratio [AOR], 6.23; P = .03)
and discontinuation of calcineurin inhibitor (AOR, 5.11; P = .02) were
independently associated with IRS. Only 2.6% (1/13) of the patients
without these risk factors developed IRS compared with 18.8% (6/32) with 1
risk factor, and 50% (6/12) with both risk factors (X² for
trend, P = .0001). Among patients with CNS disease, those with
neuroimaging abnormalities (P = .03) were more likely to develop IRS,
irrespective of serum or CSF cryptococcal antigen titers and fungemia.
Graft rejection after cryptococcosis was observed in 15.4% (2/13) of the
patients with IRS compared with 2.6% (2/76) of those without IRS (P =
.07). Conclusions. We determined variables that pose a risk for IRS and
have shown that discontinuation of calcineurin inhibitors was
independently associated with 5-fold increased risk of IRS in transplant
recipients with cryptococcosis. Copyright &#xa9; The Author 2014.
Published by Oxford University Press on behalf of the Infectious Diseases
Society of America. All rights reserved.

<54>
Accession Number
613544724
Author
Malik H.H.; Darwood A.R.J.; Shaunak S.; Kulatilake P.; El-Hilly A.A.;
Mulki O.; Baskaradas A.
Institution
(Malik, Kulatilake, El-Hilly) Department of Medicine, School of Medicine,
Sir Alexander Fleming Building, South Kensington Campus, Imperial College
London, London, United Kingdom
(Darwood) Department of Undergraduate Medicine, School of Medicine
Education Centre B81A, Queen's Medical Centre, University of Nottingham
Medical School, The University of Nottingham, Nottingham, United Kingdom
(Shaunak) Department of Trauma and Orthopaedics, St George's Hospital, St
George's Healthcare NHS Trust, London, United Kingdom
(Mulki) Department of Obstetrics and Gynaecology, St Mary's Hospital,
Imperial College Healthcare NHS Trust, London, United Kingdom
(Baskaradas) Department of Trauma and Orthopaedics, St Mary's Hospital,
Imperial College Healthcare NHS Trust, London, United Kingdom
Title
Three-dimensional printing in surgery: a review of current surgical
applications.
Source
Journal of Surgical Research. 199 (2) (pp 512-522), 2015. Date of
Publication: 01 Dec 2015.
Publisher
Academic Press Inc. (E-mail: apjcs@harcourt.com)
Abstract
Background Three-dimensional printing (3DP) is gaining increasing
recognition as a technique that will transform the landscape of surgical
practice. It allows for the rapid conversion of anatomic images into
physical objects, which are being used across a variety of surgical
specialties. It has been unclear which groups are leading the way in
coming up with novel ways of using the technology and what specifically
the technology is being used for. The aim of this article was to review
the current applications of 3DP in modern surgical practice. Materials and
methods An electronic search was carried out in MEDLINE, EMBASE, and
PsycINFO for terms related to 3DP. These were then screened for relevance
and practical applications of the technology in surgery. Results Four
hundred eighty-eight articles were initially found, and these were
eventually narrowed down to 93 full-text articles. It was determined that
there were three main areas in which the technology is being used to
print: (1) anatomic models, (2) surgical instruments, and (3) implants and
prostheses. Conclusions Different specialties are at different stages in
the use of the technology. The costs involved with implementing the
technology and time taken for printing are important factors to consider
before widespread use. For the foreseeable future, this is an exciting and
interesting technology with the capacity to radically change health care
and revolutionize modern surgery. Copyright &#xa9; 2015 Elsevier Inc.

<55>
[Use Link to view the full text]
Accession Number
607372700
Author
Gunduz S.; Ozkan M.; Kalcik M.; Gursoy O.M.; Astarciotlu M.A.; Karakoyun
S.; Aykan A.C.; Biteker M.; Gokdeniz T.; Kaya H.; Yesin M.; Duran N.E.;
Sevinc D.; Guneysu T.
Institution
(Gunduz, Ozkan, Kalcik, Gursoy, Astarciotlu, Karakoyun, Aykan, Biteker,
Gokdeniz, Kaya, Yesin, Duran) Department of Cardiology, Kosuyolu Kartal
Heart Training and Research Hospital, Denizer C. No 2, Kartal, Istanbul
34846, Turkey
(Ozkan) Department of Cardiology, Faculty of Medicine, Kars Kafkas
University, Kars, Turkey
(Sevinc, Guneysu) Department of CT Coronary Angiography, Sonomed Imaging
Center, Istanbul, Turkey
Title
Sixty-Four-Section Cardiac Computed Tomography in Mechanical Prosthetic
Heart Valve Dysfunction: Thrombus or Pannus.
Source
Circulation: Cardiovascular Imaging. 8 (12) (no pagination), 2015. Article
Number: e003246. Date of Publication: 01 Dec 2015.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background - Distinguishing pannus and thrombus in patients with
prosthetic valve dysfunction is essential for the selection of proper
treatment. We have investigated the utility of 64-slice multidetector
computed tomography (MDCT) in distinguishing between pannus and thrombus,
the latter amenable to thrombolysis. Methods and Results - Sixty-two (23
men, mean age 44+/-14 years) patients with suspected mechanical prosthetic
valve dysfunction assessed by transesophageal echocardiography were
included in this prospective observational trial. Subsequently, MDCT was
performed before any treatment was started. Periprosthetic masses were
detected by MDCT in 46 patients, and their attenuation values were
measured as Hounsfield Units (HU). Patients underwent thrombolysis unless
contraindicated, and those with a contraindication or failed thrombolysis
underwent surgery. A mass which was completely lysed or surgically
detected as a clot was classified as thrombus, whereas a mass which was
surgically detected as tissue overgrowth was classified as pannus. A
definitive diagnosis could be achieved in 37 patients with 39 MDCT masses
(22 thrombus and 17 pannus). The mean attenuation value of 22 thrombotic
masses was significantly lower than that in 17 pannus (87+/-59 versus
322+/-122; P<0.001). Area under the receiver operating characteristic
curve was 0.96 (95% confidence interval: 0.91-0.99; P<0.001), and a cutoff
point of HU>145 provided high sensitivity (87.5%) and specificity (95.5%)
in discriminating pannus from thrombus. Complete lysis was more common for
masses with HU<90 compared with those with HU 90 to 145 (100% versus
42.1%; P=0.007). Conclusions - Sixty-four slice MDCT is helpful in
identifying masses amenable to thrombolysis in patients with prosthetic
valve dysfunction. A high (HU>145) attenuation suggests pannus overgrowth,
whereas a lower value is associated with thrombus formation. A higher
attenuation (HU>90) is associated with reduced lysis rates. Copyright
&#xa9; 2015 American Heart Association, Inc.

<56>
Accession Number
600664031
Author
Frommelt P.C.; Gerstenberger E.; Cnota J.F.; Cohen M.S.; Gorentz J.; Hill
K.D.; John J.B.; Levine J.C.; Lu J.; Mahle W.T.; Mccandless R.T.; Mertens
L.; Pearson G.D.; Spencer C.; Thacker D.; Williams I.A.; Wong P.C.;
Newburger J.W.
Institution
(Frommelt, Gorentz) Medical College of Wisconsin, Milwaukee, WI, United
States
(Gerstenberger) New England Research Institute, Watertown, MA, United
States
(Cnota) Cincinnati Children's Hospital, Cincinnati, OH, United States
(Cohen) Children's Hospital of Philadelphia, Philadelphia, PA, United
States
(Hill) Duke University, Durham, NC, United States
(John) Congenital Heart Institute of Florida/Pediatrix, Tampa, FL, United
States
(Levine, Newburger) Boston Children's Hospital, Boston, MA, United States
(Lu) University of Michigan, Ann Arbor, MI, United States
(Mahle) Emory University School of Medicine, Atlanta, GA, United States
(Mccandless) Primary Children's Hospital, Salt Lake City, UT, United
States
(Mertens) Hospital for Sick Children, Toronto, ON, Canada
(Pearson) National Heart, Lung and Blood Institute, National Institutes of
Health, Bethesda, MD, United States
(Spencer) Medical University of South Carolina, Charleston, SC, United
States
(Thacker) Alfred I. DuPont Hospital for Children, Wilmington, DE, United
States
(Williams) Columbia University Medical Center, New York, NY, United States
(Wong) Children's Hospital of Los Angeles, Los Angeles, CA, United States
Title
Impact of initial shunt type on cardiac size and function in children with
single right ventricle anomalies before the fontan procedure: The single
ventricle reconstruction extension trial.
Source
Journal of the American College of Cardiology. 64 (19) (pp 2026-2035),
2014. Date of Publication: 11 Nov 2014.
Publisher
Elsevier USA
Abstract
Background In children with single right ventricular (RV) anomalies,
changes in RV size and function may be influenced by shunt type chosen at
the time of the Norwood procedure.
Objectives The study sought to identify shunt-related differences in
echocardiographic findings at 14 months and > 6 months pre-Fontan in
survivors of the Norwood procedure.
Methods We compared 2-dimensional and Doppler echocardiographic indices of
RV size and function, neo-aortic and tricuspid valve annulus dimensions
and function, and aortic size and patency at 14.1 1.2 months and 33.6 9.6
months in subjects randomized to a Norwood procedure using either the
modified Blalock-Taussig shunt (MBTS) or right ventricle to pulmonary
artery shunt (RVPAS).
Results Acceptable echocardiograms were available at both time points in
240 subjects (114 MBTS, 126 RVPAS). At 14 months, all indices were similar
between shunt groups. From the 14-month to pre-Fontan echocardiogram, the
MBTS group had stable indexed RV volumes and ejection fraction, while the
RVPAS group had increased RV end-systolic volume (p = 0.004) and decreased
right ventricular ejection fraction (RVEF) (p = 0.004). From 14 months to
pre-Fontan, the treatment groups were similar with respect to decline in
indexed neo-aortic valve area, ;neo-aortic valve regurgitation (5% at each
time), indexed tricuspid valve area, and moderate tricuspid valve
regurgitation (20% at each time).
Conclusions Initial Norwood shunt type influences pre-Fontan RV remodeling
during the second and third years of life in survivors with single RV
anomalies, with greater RVEF deterioration after RVPAS. Encouragingly,
other indices of RV function remain stable before Fontan regardless of
shunt type. (Comparison of Two Types of Shunts in Infants with Single
Ventricle Defect Undergoing Staged Reconstruction - Pediatric Heart
Network; NCT00115934) Copyright &#xa9; 2014 American College of Cardiology
Foundation.

<57>
Accession Number
600483876
Author
Treasure T.; Milosevic M.; Fiorentino F.; Pfannschmidt J.
Institution
(Treasure) Clinical Operational Research Unit, University College London,
Gower St., London WC1E 6BT, United Kingdom
(Milosevic) Clinic for Thoracic Surgery, Institute for Pulmonary Diseases
of Vojvodina, University of Novi Sad, Novi Sad 402920, Serbia
(Fiorentino) Department of Cardiothoracic Surgery, National Heart and Lung
Institute, Imperial College, London W12 0NN, United Kingdom
(Pfannschmidt) HELIOS Klinikum Emil Von Behring, Lungenklinik Heckeshorn,
Berlin 14165, Germany
Title
History and present status of pulmonary metastasectomy in colorectal
cancer.
Source
World Journal of Gastroenterology. 20 (40) (pp 14517-14526), 2014. Date of
Publication: 28 Oct 2014.
Publisher
WJG Press (E-mail: wejd@public.bta.cn)
Abstract
Clinical practice with respect to metastatic colorectal cancer differs
from the other two most common cancers, breast and lung, in that routine
surveillance is recommended with the specific intent of detecting liver
and lung metastases and undertaking liver and lung resections for their
removal. We trace the history of this approach to colorectal cancer by
reviewing evidence for effectiveness from the 1950s to the present day.
Our sources included published citation network analyses, the documented
proposal for randomised trials, large systematic reviews, and
meta-analysis of observational studies. The present consensus position has
been adopted on the basis of a large number of observational studies but
the randomised trials proposed in the 1980s and 1990s were either not
done, or having been done, were not reported. Clinical opinion is the
mainstay of current practice but in the absence of randomised trials there
remains a possibility of selection bias. Randomised controlled trials
(RCTs) are now routine before adoption of a new practice but RCTs are
harder to run in evaluation of already established practice. One such
trial is recruiting and shows that controlled trial are possible.
Copyright &#xa9; 2014 Baishideng Publishing Group Inc. All rights
reserved.

<58>
Accession Number
607419337
Author
Sigterman T.
Institution
(Sigterman) Atrium Heerlen, Heerlen, Netherlands
Title
Response to Commentary on 'Remote Ischemic Preconditioning to Reduce
Contrast Induced Nephropathy: A Randomized Controlled Trial'.
Source
European Journal of Vascular and Endovascular Surgery. 51 (4) (pp
605-606), 2016. Date of Publication: 01 Apr 2016.
Publisher
W.B. Saunders Ltd

<59>
Accession Number
610177868
Author
Brewer Z.E.; Ogden W.D.; Fann J.I.; Burdon T.A.; Sheikh A.Y.
Institution
(Brewer, Ogden, Fann, Burdon, Sheikh) Department of Cardiothoracic
Surgery, Stanford University School of Medicine, Stanford, California,
United States
Title
Creation and Global Deployment of a Mobile, Application-Based Cognitive
Simulator for Cardiac Surgical Procedures.
Source
Seminars in Thoracic and Cardiovascular Surgery. 28 (1) (pp 1-9), 2016.
Date of Publication: 01 Feb 2016.
Publisher
W.B. Saunders
Abstract
Several modern learning frameworks (eg, cognitive apprenticeship, anchored
instruction, and situated cognition) posit the utility of nontraditional
methods for effective experiential learning. Thus, development of novel
educational tools emphasizing the cognitive framework of operative
sequences may be of benefit to surgical trainees. We propose the
development and global deployment of an effective, mobile cognitive
cardiac surgical simulator. In methods, 16 preclinical medical students
were assessed. Overall, 4 separate surgical modules (sternotomy,
cannulation, decannulation, and sternal closure) were created utilizing
the Touch Surgery (London, UK) platform. Modules were made available to
download free of charge for use on mobile devices. Usage data were
collected over a 6-month period. Educational efficacy of the modules was
evaluated by randomizing a cohort of medical students to either module
usage or traditional, reading-based self-study, followed by a
multiple-choice learning assessment tool. In results, downloads of the
simulator achieved global penetrance, with highest usage in the USA,
Brazil, Italy, UK, and India. Overall, 5368 unique users conducted a total
of 1971 hours of simulation. Evaluation of the medical student cohort
revealed significantly higher assessment scores in those randomized to
module use versus traditional reading (75% +/- 9% vs 61% +/- 7%,
respectively; P < 0.05). In conclusion, this study represents the first
effort to create a mobile, interactive cognitive simulator for cardiac
surgery. Simulators of this type may be effective for the training and
assessment of surgical students. We investigated whether an interactive,
mobile-computing-based cognitive task simulator for cardiac surgery could
be developed, deployed, and validated. Our findings suggest that such
simulators may be a useful learning tool. Copyright &#xa9; 2016

<60>
Accession Number
613197712
Author
McIsaac D.I.; Taljaard M.; Bryson G.L.; Beaule P.E.; Gagne S.; Hamilton
G.; Hladkowicz E.; Huang A.; Joanisse J.; Lavallee L.T.; Moloo H.; Thavorn
K.; van Walraven C.; Yang H.; Forster A.J.
Institution
(McIsaac, Bryson, Gagne, Yang) University of Ottawa, Department of
Anesthesiology and Pain Medicine, Ottawa, Canada
(McIsaac, Bryson, Hladkowicz, Lavallee, Thavorn, van Walraven, Forster)
Ottawa Hospital Research Institute, Ottawa, Canada
(McIsaac, Taljaard) Department of Anesthesiology, The Ottawa Hospital,
Ottawa, Canada
(Taljaard, Thavorn) University of Ottawa, School of Epidemiology, Public
Health and Preventive Medicine, Ottawa, Canada
(Beaule) University of Ottawa and The Ottawa Hospital, Ottawa, Canada
(Hamilton) Anesthesiology Resident, University of Ottawa, Ottawa, Canada
(Huang) Geriatric Medicine, The Ottawa Hospital, Ottawa, Canada
(Joanisse) Hopital Montfort, Ottawa, Canada
(Lavallee) Division of Urology, University of Ottawa, Ottawa, Canada
(Moloo) Division of General Surgery, University of Ottawa, Ottawa, Canada
(Thavorn, van Walraven) Institute for Clinical Evaluative Sciences,
Toronto, Canada
(van Walraven) University of Ottawa, Medicine and Epidemiology, Ottawa,
Canada
(Forster) University of Ottawa, Department of Medicine, Ottawa, Canada
(Forster) The Ottawa Hospital, Ottawa, Canada
Title
Comparative assessment of two frailty instruments for risk-stratification
in elderly surgical patients: Study protocol for a prospective cohort
study.
Source
BMC Anesthesiology. 16 (1) (no pagination), 2016. Article Number: 111.
Date of Publication: 14 Nov 2016.
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Frailty is an aggregate expression of susceptibility to poor
outcomes, owing to age-, and disease-related deficits that accumulate
within multiple domains. Older patients who are frail before surgery are
at an increased risk of morbidity and mortality, and use a
disproportionately high amount of healthcare resources. While frailty is
now a well-established risk factor for adverse postoperative outcomes, the
perioperative literature lacks studies that: 1) compare the predictive
accuracy of different frailty instruments; 2) consider the impact of
frailty on patient-reported outcome measures; and 3) consider the
acceptability and feasibility of using frailty instruments in clinical
practice. Methods: We will conduct a multicenter prospective cohort study
comparing the predictive accuracy of the modified Fried Index (mFI) with
the Clinical Frailty Scale (CFS) among consenting patients aged 65 years
and older having elective major non-cardiac surgery. The primary outcome
will be disability free survival at 90 days after surgery, a
patient-reported outcome measure. Secondary outcomes will include
complications, length of stay, discharge disposition, readmission and
total health system costs. We will compare the accuracy of frailty
instruments using the relative true positive rate and relative false
positive rate. These measures can be interpreted as the relative
difference in the probability of one instrument identifying a true case of
death or new disability compared to another instrument, or the relative
difference in the probability of one instrument identifying a false case
of death or new disability, respectively. We will also assess the
acceptability and feasibility of each instrument. Discussion: Frailty is
an important prognostic factor in the growing population of older patients
having surgery. This study will provide novel findings regarding the
choice of an accurate, clinically useable frailty instrument in predicting
patient reported outcomes, as well as morbidity, mortality and resource
use. These findings will inform current practice and future research.
Copyright &#xa9; 2016 The Author(s).

<61>
Accession Number
613566794
Author
Baker W.L.; Coleman C.I.
Institution
(Baker, Coleman) Department of Pharmacy Practice, School of Pharmacy,
University of Connecticut, Storrs, CT, United States
Title
Meta-analysis of ascorbic acid for prevention of postoperative atrial
fibrillation after cardiac surgery.
Source
American Journal of Health-System Pharmacy. 73 (24) (pp 2056-2066), 2016.
Date of Publication: 15 Dec 2016.
Publisher
American Society of Health-Systems Pharmacy
Abstract
Purpose. Results of a systematic review and meta-analysis of published
data on use of ascorbic acid to prevent postoperative atrial fibrillation
(POAF) after cardiac surgery are presented. Methods. MEDLINE and other
sources were searched for reports on trials evaluating the effects of
preoperative and/or postoperative use of ascorbic acid in patients
undergoing cardiac surgery. For each study selected for meta-analysis, an
assessment for risks of methodological bias was performed. Data on POAF
frequency and length of stay (LOS) outcomes were pooled and analyzed via
random-effects modeling. Results. The 11 identified studies involved
patients receiving coronary artery bypass grafts with or without valve
replacement; both i.v. and oral ascorbic acid formulations were used.
Analysis of pooled outcomes data on treatment and control groups indicated
that ascorbic acid prophylaxis was associated with reductions in POAF
frequency (odds ratio, 0.44; 95% confidence interval [CI], 0.32 to 0.61),
intensive care unit (ICU) LOS (difference in means, -0.24 day; 95% CI,
-0.45 to -0.03 day), and total hospital LOS (difference in means, -0.94
day; 95% CI, -1.65 to -0.23 day). Significant statistical, methodological,
and clinical heterogeneity were observed. Conclusion. A meta-analysis
revealed that, compared with use of a placebo or a nonplacebo control,
perioperative administration of ascorbic acid to patients undergoing
cardiac surgery was associated with a reduced frequency of POAF and a
shorter ICU LOS and total hospital LOS. &#xa9; Copyright 2016, American
Society of Health-System Pharmacists, Inc. All rights.

<62>
[Use Link to view the full text]
Accession Number
607896061
Author
Azarbal B.; Cheng R.; Vanichsarn C.; Patel J.K.; Czer L.S.; Chang D.H.;
Kittleson M.M.; Kobashigawa J.A.
Institution
(Azarbal, Cheng, Vanichsarn, Patel, Czer, Chang, Kittleson, Kobashigawa)
Cedars-Sinai Heart Institute, 8536 Wilshire Blvd #302, Los Angeles, CA
90211, United States
Title
Induction Therapy with Antithymocyte Globulin in Patients Undergoing
Cardiac Transplantation Is Associated with Decreased Coronary Plaque
Progression as Assessed by Intravascular Ultrasound.
Source
Circulation: Heart Failure. 9 (1) (no pagination), 2016. Date of
Publication: 01 Jan 2016.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Antithymocyte globulin (ATG) is used as induction therapy after cardiac
transplant for enhancing immunosuppression and delaying the initiation of
nephrotoxic drugs. It is unknown if ATG induction is associated with
decreased coronary plaque progression by intravascular ultrasound (IVUS).
Methods and Results-Patients transplanted between March 2010 and December
2012 with baseline and 1-year IVUS were included. All patients
transplanted were included in a secondary analysis. Change in plaque
progression was measured in a blinded fashion on matched coronary segments
and contrasted between patients induced with ATG and those who were not.
One hundred and three patients were included in IVUS arms. Mean age at
transplant was 55.8+/-12.6 years, and 33.0% were female. Patients induced
with ATG were more sensitized (54.3% versus 14.3%). Plaque progression was
attenuated in patients who received ATG by changes in maximal intimal area
(1.0+/-1.2 versus 2.3+/-2.6 mm²; P=0.001), maximal percent
stenosis (6.3+/-7.9 versus 12.8+/-12.3%; =0.003), maximal intimal
thickness (0.2+/-0.2 versus 0.3+/-0.3 mm; P=0.035), and plaque volume
(0.5+/-0.7 versus 1.0+/-1.3 mm³/mm; P=0.016). Rapid plaque
progression by maximal percent stenosis (>20%) occurred less frequently in
the ATG arm (4.3% versus 26.3; P=0.003). Survival (P=0.242) and any
treated rejection (P=0.166) were not statistically different between
groups. Patients receiving ATG had a higher rate of first-year infection
(P=0.003), perhaps related to increased intravenous antibiotic use
immediately postoperatively, and a trend toward more biopsy-proven
rejection (P=0.073). Conclusions-Induction therapy with ATG is associated
with reduced first-year coronary plaque progression as assessed by IVUS,
despite an increased prevalence of sensitized patients with a trend toward
more rejection. Copyright &#xa9; 2015 American Heart Association, Inc.

<63>
Accession Number
610218331
Author
Ando T.; Holmes A.A.; Taub C.C.; Slovut D.P.; DeRose J.J.
Institution
(Ando) Department of Internal Medicine Mount Sinai Beth Israel, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Holmes, Taub, Slovut) Division of Cardiology, Montefiore Medical Center,
Albert Einstein College of Medicine, Bronx, NY, United States
(Slovut, DeRose) Department of Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY,
United States
Title
Iatrogenic Ventricular Septal Defect Following Transcatheter Aortic Valve
Replacement: A Systematic Review.
Source
Heart Lung and Circulation. 25 (10) (pp 968-974), 2016. Date of
Publication: 01 Oct 2016.
Publisher
Elsevier Ltd
Abstract
Background Ventricular septal defects (VSD) are rarely reported as a
complication following transcatheter aortic valve replacement (TAVR). We
sought to characterise the patients, clinical management, and outcomes
regarding this rare phenomenon. Methods Relevant articles were identified
by a systematic search of MEDLINE and EMBASE databases from January, 2002
to September, 2015. Results A total of 18 case reports, including 20
patients, were identified. The median age was 83 years and six were male.
Twelve were performed by trans-femoral approach. Pre-dilation was
performed in 12 patients and post-dilation in four. Balloon expandable
valves were used in the majority (85%) of cases. The clinical presentation
varied from asymptomatic to progressive heart failure. The timing of the
diagnosis also varied significantly from immediately post valve
implantation to one year afterwards. There were two cases of Gerbode-type
defect while the rest were inter-ventricular defects. The location was
mostly membranous or perimembranous (79%) and adjacent to the valve
landing zone. A total of seven interventions (one open surgery and six
percutaneous closure) were performed. Four patients died during the same
hospital admission. Sixteen survived past discharge (range 12 days to two
years). Conclusions Ventricular septal defects post-TAVR were seen more
with balloon expandable valves and with pre-dilation or post-dilation.
Percutaneous treatment of the VSD was preferred over open cardiac surgery
given the high surgical risk in this patient population. Some, but not
all, patients survived TAVR and VSD and had a good prognosis for both
patient groups with or without VSD closure. Copyright &#xa9; 2016
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<64>
[Use Link to view the full text]
Accession Number
611201860
Author
Van Aelbrouck C.; Jorquera-Vasquez S.; Beukinga I.; Pradier O.; Ickx B.;
Barvais L.; Van Obbergh L.; Faraoni D.
Institution
(Van Aelbrouck, Jorquera-Vasquez, Ickx, Barvais, Van Obbergh) Department
of Anaesthesiology, Erasme University Hospital, Route de Lennik 808,
Brussels 1070, Belgium
(Beukinga, Pradier) Department of Haematology and Haemostasis, Erasme
University Hospital, Free University of Brussels, Brussels, Belgium
(Faraoni) Department of Anesthesiology, Peri-operative and Pain Medicine,
Boston Children's Hospital, Harvard Medical School, Boston, MA, United
States
Title
Tranexamic acid decreases the magnitude of platelet dysfunction in
aspirin-free patients undergoing cardiac surgery with cardiopulmonary
bypass: A pilot study.
Source
Blood Coagulation and Fibrinolysis. 27 (8) (pp 855-861), 2016. Date of
Publication: 13 Nov 2016.
Publisher
Lippincott Williams and Wilkins (E-mail: agents@lww.com)
Abstract
This study sought to compare the effect of tranexamic acid (TXA)
administration on cardiopulmonary bypass-induced platelet dysfunction in
patients who received preoperative aspirin or not. We performed a
prospective, randomized, double-blind pilot study, including patients
undergoing elective cardiac surgery with cardiopulmonary bypass (CPB).
Patients without aspirin interruption were enrolled in the 'group ASPIRIN'
(n U 18) and those who had never been treated with aspirin were included
in the 'group NO ASPIRIN' (n U 10). Patients were then randomized to
receive either TXA or the same infusion of normal saline. Multiple
electrode aggregometry was used to assess platelet function at the
different time points throughout the surgery: baseline, post-TXA loading
dose, aortic unclamping (End CPB), and 5 min after protamine (Protamine).
Compared to those included in the group NO ASPIRIN, patients included in
the group ASPIRIN presented a decreased baseline platelet function
measured by ASP test (P < 0.01) and collagen test (P < 0.01). In the group
NO ASPIRIN, treatment group (TXA vs. placebo) significantly influenced the
results for ADP test (P < 0.01), thrombin receptor-activating peptide test
(P U 0.01), and ASP test (P U 0.01). We observed that TXA improved
platelet function, as measured using multiple electrode aggregometry on
ADP test, thrombin receptoractivating peptide test, and ASP test, at the
end of CPB (P < 0.05). TXA might decrease the magnitude of platelet
dysfunction in aspirin-free patients undergoing cardiac surgery. Further
studies are needed to confirm these results and assess a potential
relationship with clinical endpoints. Copyright &#xa9; 2016 Wolters Kluwer
Health, Inc. All rights reserved.

<65>
Accession Number
609611832
Author
Agzarian J.; Fahim C.; Shargall Y.; Yasufuku K.; Waddell T.K.; Hanna W.C.
Institution
(Agzarian, Shargall, Hanna) Department of Surgery, McMaster University,
Hamilton, Ontario, Canada
(Fahim) Department of Epidemiology and Biostatistics, McMaster University,
Hamilton, Ontario, Canada
(Yasufuku, Waddell) Department of Surgery, University of Toronto, Toronto,
Canada
Title
The Use of Robotic-Assisted Thoracic Surgery for Lung Resection: A
Comprehensive Systematic Review.
Source
Seminars in Thoracic and Cardiovascular Surgery. 28 (1) (pp 182-192),
2016. Date of Publication: 01 Feb 2016.
Publisher
W.B. Saunders
Abstract
The primary objective of this study is to systematically review all
pertinent literature related to robotic-assisted lung resection.
Robotic-assisted thoracic surgery (RATS) case series and studies comparing
RATS with video-assisted thoracoscopic surgery (VATS) or thoracotomy were
included in the search. In accordance with preferred reporting items for
systematic reviews and meta-analyses guidelines, 2 independent reviewers
performed the search and review of resulting titles and abstracts.
Following full-text screening, a total of 20 articles met the inclusion
criteria and are presented in the review. Amenable results were pooled and
presented as a single outcome, and meta-analyses were performed for
outcomes having more than 3 comparative analyses. Data are presented in
the following 4 categories: technical outcomes, perioperative outcomes,
oncological outcomes, and cost comparison. RATS was associated with longer
operative time, but did not result in a greater rate of conversion to
thoracotomy than VATS. RATS was superior to thoracotomy and equivalent to
VATS for the incidence of prolonged air leak and hospital length-of-stay.
Oncological outcomes like nodal upstaging and survival were no different
between VATS and RATS. RATS was more costly than VATS, with most of the
costs attributed to capital and disposable expenses of the robotic
platform. Although limited by a lack of prospective analysis, lung
resection via RATS compares favorably with thoracotomy and appears to be
no different than VATS. Prospective studies are required to determine if
there are outcome differences between RATS and VATS. Copyright &#xa9; 2016
Elsevier Inc.

<66>
Accession Number
613308547
Author
Omerovic E.
Institution
(Omerovic) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, University of Gothenburg, Bruna straket 16,
Gothenburg, Sweden
(Omerovic) Department of Cardiology, Sahlgrenska University Hospital,
Bruna straket 16, Gothenburg 413 45, Sweden
Title
Takotsubo Syndrome-Scientific Basis for Current Treatment Strategies.
Source
Heart Failure Clinics. 12 (4) (pp 577-586), 2016. Date of Publication: 01
Oct 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Takotsubo syndrome (TS) is characterized by severe reversible left
ventricular (LV) wall motion abnormality in the absence of explanatory
coronary lesion. Despite an increasing number of patients diagnosed with
TS worldwide, there are no randomized clinical trials. In mild cases, no
treatment or a short course of limited anticoagulation therapy may be
sufficient. Positive inotropic and vasodilating agents should be avoided.
In severe cases with refractory cardiogenic shock, early treatment with
mechanical support using venoarterial extracorporeal membrane oxygenation
or a LV assist device should be considered. Copyright &#xa9; 2016 Elsevier
Inc.

<67>
Accession Number
610441758
Author
Korst R.J.; Lee B.E.
Institution
(Korst, Lee) The Daniel and Gloria Blumenthal Cancer Center, Paramus, New
Jersey, United States
(Korst) Department of Surgery, The Valley Hospital/Valley Health System,
Ridgewood, New Jersey, United States
Title
Robotic Assisted Thoracic Surgery Lobectomy versus Video Assisted Thoracic
Surgery Lobectomy: Is a Randomized Trial Really Necessary?.
Source
Seminars in Thoracic and Cardiovascular Surgery. 28 (1) (pp 193-194),
2016. Date of Publication: 01 Feb 2016.
Publisher
W.B. Saunders

<68>
Accession Number
606307497
Author
Phan K.; Phan S.; Yan T.D.
Institution
(Phan, Phan, Yan) Collaborative Research (CORE) Group, Macquarie
University, 2 Technology Place, Sydney, Australia
Title
How firm is the evidence for miniaturized extracorporeal circulation
versus conventional cardiopulmonary bypass for coronary revascularization?
A trial sequential analysis.
Source
International Journal of Cardiology. 201 (pp 422-423), 2015. Date of
Publication: 10 Oct 2015.
Publisher
Elsevier Ireland Ltd

<69>
Accession Number
606122978
Author
McKavanagh P.; Lusk L.; Ball P.A.; Verghis R.M.; Agus A.M.; Trinick T.R.;
Duly E.; Walls G.M.; Stevenson M.; James B.; Hamilton A.; Harbinson M.T.;
Donnelly P.M.
Institution
(McKavanagh, Lusk, Ball, Trinick, Duly, Walls, James, Hamilton, Donnelly)
Cardiology Department, Ulster Hospital, South Eastern Health and Social
Care Trust, Upper Newtownards Road, Dundonald, Belfast BT16 1RH, United
Kingdom
(McKavanagh, Harbinson, Donnelly) Centre for Vision and Vascular Science,
Institute of Clinical Science A, Queen's University Belfast, Royal
Victoria Hospital Belfast, Belfast BT126BA, United Kingdom
(Verghis, Agus, Stevenson) Northern Ireland Clinical Trials Unit,
Education and Research Centre, Royal Hospitals, Belfast BT12 6BA, United
Kingdom
Title
A comparison of cardiac computerized tomography and exercise stress
electrocardiogramtest for the investigation of stable chest pain: The
clinical results of the CAPP randomized prospective trial.
Source
European Heart Journal Cardiovascular Imaging. 16 (4) (pp 441-448), 2015.
Date of Publication: 2015.
Publisher
Oxford University Press (E-mail: jnl.info@oup.co.uk)
Abstract
Aims To determine the symptomatic and prognostic differences resulting
from a novel diagnostic pathway based on cardiac computerized tomography
(CT) compared with the traditional exercise stress electrocardiography
test (EST) in stable chest pain patients. Methods and results A
prospective randomized controlled trial compared selected patient outcomes
in EST and cardiac CT coronary angiography groups. Five hundred patients
with troponin-negative stable chest pain and without known coronary artery
disease were recruited. Patients completed the Seattle Angina
Questionnaires (SAQ) at baseline, 3, and 12 months to assess angina
symptoms. Patients were also followed for management strategies and
clinical events. Over the year 12 patients withdrew, resulting in 245 in
the EST cohort and 243 in the CT cohort. There was no significant
difference in baseline demographics. The CT arm had a statistical
difference in angina stability and quality-of-life domains of the SAQ at 3
and12 months, suggesting less angina compared with the EST arm. In the CT
arm, there was more significant disease identified and more
revascularizations. Significantly, more inconclusive results were seen in
the EST arm with a higher number of additional investigations ordered.
There was also a longer mean time to management. There were no differences
in major adverse cardiac events between the cohorts. At 1 year in the EST
arm, there were more Accident and Emergency (A&E) attendances and cardiac
admission. Conclusion Cardiac CTas an index investigation for stable chest
pain improved angina symptoms and resulted in fewer investigations and
re-hospitalizations compared with EST. Clinical trial registration
http://www.controlled-trials.com/ISRCTN52480460. Copyright &#xa9; The
Author 2015.

<70>
Accession Number
613678556
Author
Dixon B.; Smith R.; Santamaria J.D.; Orford N.R.; Wakefield B.J.; Ives K.;
McKenzie R.; Zhang B.; Yap C.H.
Institution
(Dixon) Department of Critical Care, St.Vincent's Hospital, Melbourne,
Victoria
(Smith) Department of Critical Care, St.Vincent's Hospital, Melbourne,
Victoria
(Santamaria) Department of Critical Care, St.Vincent's Hospital,
Melbourne, Victoria
(Orford) Department of Critical Care, Barwon Health University Hospital,
Geelong, Victoria
(Wakefield) Department of Critical Care, Barwon Health University
Hospital, Geelong, Victoria
(Ives) Department of Critical Care, Barwon Health University Hospital,
Geelong, Victoria
(McKenzie) Department of Critical Care, Barwon Health University Hospital,
Geelong, Victoria
(Zhang) Department of Cardiothoracic Surgery, Barwon Health University
Hospital, Geelong, Victoria
(Yap) Department of Epidemiology and Preventive Medicine, Monash
University and School of Medicine, Deakin University, Melbourne, Victoria
Title
A trial of nebulised heparin to limit lung injury following cardiac
surgery.
Source
Anaesthesia and intensive care. 44 (1) (pp 28-33), 2016. Date of
Publication: 01 Jan 2016.
Abstract
Cardiac surgery with cardiopulmonary bypass triggers an acute inflammatory
response in the lungs. This response gives rise to fibrin deposition in
the microvasculature and alveoli of the lungs. Fibrin deposition in the
microvasculature increases alveolar dead space, while fibrin deposition in
alveoli causes shunting. We investigated whether prophylactic nebulised
heparin could limit this form of lung injury. We undertook a single-centre
double-blind randomised trial. Forty patients undergoing elective cardiac
surgery with cardiopulmonary bypass were randomised to prophylactic
nebulised heparin (50,000 U) or placebo. The primary endpoint was the
change in arterial oxygen levels over the operative period. Secondary
endpoints included end-tidal CO2, the alveolar dead space fraction and
bleeding complications. We found nebulised heparin did not improve
arterial oxygen levels. Nebulised heparin was, however, associated with a
lower alveolar dead space fraction (P <0.05) and lower tidal volumes at
the end of surgery (P <0.01). Nebulised heparin was not associated with
bleeding complications. In conclusion, prophylactic nebulised heparin did
not improve oxygenation, but was associated with evidence of better
alveolar perfusion and CO2elimination at the end of surgery.

<71>
Accession Number
613659435
Author
Torina A.G.; Petrucci O.; Oliveira P.P.; Severino E.S.; Vilarinho K.A.;
Lavagnoli C.F.; Blotta M.H.; Vieira R.W.
Institution
(Torina, Petrucci, Oliveira, Severino, Vilarinho, Lavagnoli, Blotta,
Vieira) Surgery Department - Heart Surgery Division - Faculdade de
Ciencias-Medicas Universidade Estadual de Campinas - UNICAMP
Title
The effects of modified ultrafiltration on pulmonary function and
transfusion requirements in patients underwent coronary artery bypass
graft surgery.
Source
Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade
Brasileira de Cirurgia Cardiovascular. 25 (1) (pp 59-65), 2010. Date of
Publication: 01 Jan 2010.
Abstract
OBJECTIVE: The inflammatory response after cardiac surgery increases
vascular permeability leading to higher mortality and morbidity in the
post operative time. The modified ultrafiltration (MUF) had shown benefits
on respiratory, and hemodynamic in pediatric patients. This approach in
adults is not well established yet. We hypothesize that modified
ultrafiltration may improve respiratory, hemodynamic and coagulation
function in adults after cardiac surgeries.
METHODS: A prospective randomized study was carried out with 37 patients
who underwent coronary artery bypass graft surgery (CABG) were randomized
either to MUF (n=20) at the end of bypass or to control (no MUF) (n=17).
The anesthesia and ICU team were blinded for the group selection. The MUF
were carried out for 15 minutes after the end of bypass. The patients data
were taken at beginning of anesthesia, ending of bypass, ending MUF, 24
hours, and 48 hours after surgery. For clinical outcome the pulmonary,
hemodynamic and coagulation function were evaluated.
RESULTS: We observed lower drain loss in the MUF group compared to control
group after 48 hours (598 +/- 123 ml vs. 848 +/- 455 ml; P=0.04) and
required less red blood cells units transfusion compared to control group
(0.6 +/- 0.6 units/patient vs.1.6 +/- 1.1 units/patient; P=0.03). The MUF
group showed lower airway resistance (9.3 +/- 0.4 cmH2O.L-1s-1 vs. 12.1
+/- 0.8 cmH2O.L-1s-1; P=0.04). There were no deaths in both groups.
CONCLUSION: The MUF reduces post operatory bleeding and red blood cells
units transfusion, but with no differences on clinical outcome were
observed. The routinely MUF employment was not associated with hemodynamic
instability.

<72>
Accession Number
613696421
Author
Takagi H.; Ando T.; Umemoto T.
Institution
(Takagi, Umemoto) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
(Ando) Department of Cardiology, Detroit Medical Center, Detroit, MI,
United States
Title
A review of comparative studies of MitraClip versus surgical repair for
mitral regurgitation.
Source
International Journal of Cardiology. 228 (pp 289-294), 2017. Date of
Publication: 01 Feb 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Objectives We summarized comparative studies of MitraClip versus surgical
repair for mitral regurgitation (MR) with a systematic literature search
and meta-analytic estimates. Methods MEDLINE, EMBASE, and the Cochrane
Central Register of Controlled Trials were searched through June 2016.
Eligible studies were randomized controlled or observational comparative
studies of MitraClip versus surgical repair enrolling patients with MR and
reporting early (30-day or in-hospital) or late (> 6-month including
early) all-cause mortality. For each study, data regarding all-cause
mortality and incidence of recurrent > 2 + MR in both groups were used to
generate odds ratios (ORs). Alternatively, ORs or hazard ratios (HRs) for
mortality and recurrent MR themselves were directly abstracted from each
study. Results Eight reports of 7 studies comparing MitraClip with
surgical repair enrolling a total of 1015 patients with MR were identified
and included. Pooled analyses demonstrated significantly higher age and
logistic European System of Cardiac Operative Risk Evaluation and
significantly lower ejection fraction in the MitraClip than surgical
repair group, no significant difference in rate of women and patients with
New York Heart Association functional class of > II, no statistically
significant difference in early- (OR, 0.54; p = 0.08) and late-mortality
(HR/OR, 1.17; p = 0.46), and significantly higher incidence of recurrent
MR in the MitraClip than surgical repair group (HR/OR, 4.80; p < 0.00001).
Conclusions In patients with MR, the MitraClip procedure achieves similar
survival to surgical MV repair despite higher risk profiles. Recurrent MR,
however, occurs more frequently (4.8-fold) after the MitraClip than
surgical repair. Copyright &#xa9; 2016 Elsevier Ireland Ltd

<73>
Accession Number
613746668
Author
Carson J.L.; Guyatt G.; Heddle N.M.; Grossman B.J.; Cohn C.S.; Fung M.K.;
Gernsheimer T.; Holcomb J.B.; Kaplan L.J.; Katz L.M.; Peterson N.; Ramsey
G.; Rao S.V.; Roback J.D.; Shander A.; Tobian A.A.R.
Institution
(Carson) Division of General Internal Medicine, Rutgers Robert Wood
Johnson Medical School, Rutgers University, 125 Paterson St, New
Brunswick, NJ 08901, United States
(Guyatt) Department of Clinical Epidemiology and Biostatistics, McMaster
University, Hamilton, ON, Canada
(Heddle) Department of Medicine, McMaster University, Hamilton, ON, Canada
(Grossman) Department of Pathology and Immunology, Washington University,
School of Medicine, St Louis, MO, United States
(Cohn) Department of Laboratory Medicine and Pathology, University of
Minnesota Medical School, Minneapolis, United States
(Fung) Department of Pathology and Laboratory Medicine, University of
Vermont Medical Center, Burlington, United States
(Gernsheimer) Division of Hematology, University of Washington, Seattle,
United States
(Holcomb) Department of Surgery, University of Texas Medical School,
Galveston, United States
(Kaplan) Department of Surgery, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, United States
(Katz) America's Blood Centers, Washington, DC, United States
(Katz) Department of Medicine, Division of Infectious Diseases, Carver
College of Medicine, University of Iowa, Iowa City, United States
(Peterson) Glenn DaleMDUnited States
(Ramsey) Department of Pathology, Feinberg School of Medicine,
Northwestern University, Evanston, IL, United States
(Rao) Division of Cardiology, Duke University Medical Center, Durham, NC,
United States
(Roback) Department of Pathology and Laboratory Medicine, Emory
University, School of Medicine, Atlanta, GA, United States
(Shander) Departments of Anesthesiology, Critical Care Medicine, Pain
Management, and Hyperbaric Medicine, Englewood Hospital and Medical
Center, Englewood, NJ, United States
(Tobian) Department of Pathology, Johns Hopkins University, School of
Medicine, Baltimore, MD, United States
Title
Clinical practice guidelines from the AABB: Red blood cell transfusion
thresholds and storage.
Source
JAMA - Journal of the American Medical Association. 316 (19) (pp
2025-2035), 2016. Date of Publication: 15 Nov 2016.
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
IMPORTANCE More than 100 million units of blood are collected worldwide
each year, yet the indication for red blood cell (RBC) transfusion and the
optimal length of RBC storage prior to transfusion are uncertain.
OBJECTIVE To provide recommendations for the target hemoglobin level for
RBC transfusion among hospitalized adult patients who are hemodynamically
stable and the length of time RBCs should be stored prior to transfusion.
EVIDENCE REVIEW Reference librarians conducted a literature search for
randomized clinical trials (RCTs) evaluating hemoglobin thresholds for RBC
transfusion (1950-May 2016) and RBC storage duration (1948-May 2016)
without language restrictions. The results were summarized using the
Grading of Recommendations Assessment, Development and Evaluation method.
For RBC transfusion thresholds, 31 RCTs included 12 587 participants and
compared restrictive thresholds (transfusion not indicated until the
hemoglobin level is 7-8 g/dL) with liberal thresholds (transfusion not
indicated until the hemoglobin level is 9-10 g/dL). The summary estimates
across trials demonstrated that restrictive RBC transfusion thresholds
were not associated with higher rates of adverse clinical outcomes,
including 30-day mortality,myocardial infarction, cerebrovascular
accident, rebleeding, pneumonia, or thromboembolism. For RBC storage
duration, 13 RCTs included 5515 participants randomly allocated to receive
fresher blood or standard-issue blood. These RCTs demonstrated that
fresher blood did not improve clinical outcomes. FINDINGS It is good
practice to consider the hemoglobin level, the overall clinical context,
patient preferences, and alternative therapies when making transfusion
decisions regarding an individual patient. Recommendation 1: a restrictive
RBC transfusion threshold in which the transfusion is not indicated until
the hemoglobin level is 7 g/dL is recommended for hospitalized adult
patients who are hemodynamically stable, including critically ill
patients, rather than when the hemoglobin level is 10 g/dL (strong
recommendation, moderate quality evidence). A restrictive RBC transfusion
threshold of 8 g/dL is recommended for patients undergoing orthopedic
surgery, cardiac surgery, and those with preexisting cardiovascular
disease (strong recommendation, moderate quality evidence). The
restrictive transfusion threshold of 7 g/dL is likely comparable with 8
g/dL, but RCT evidence is not available for all patient categories. These
recommendations do not apply to patients with acute coronary syndrome,
severe thrombocytopenia (patients treated for hematological or oncological
reasons who are at risk of bleeding), and chronic transfusion-dependent
anemia (not recommended due to insufficient evidence). Recommendation 2:
patients, including neonates, should receive RBC units selected at any
point within their licensed dating period (standard issue) rather than
limiting patients to transfusion of only fresh (storage length: <10 days)
RBC units (strong recommendation, moderate quality evidence). CONCLUSIONS
AND RELEVANCE Research in RBC transfusion medicine has significantly
advanced the science in recent years and provides high-quality evidence to
inform guidelines. A restrictive transfusion threshold is safe in most
clinical settings and the current blood banking practices of using
standard-issue blood should be continued. Copyright 2016 American Medical
Association. All rights reserved.

<74>
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.

<75>
Accession Number
613644797
Author
Zhou C.; Jeon Y.; Meybohm P.; Zarbock A.; Li L.; Hausenloy D.J.
Institution
(Zhou, Li) Department of Anesthesiology, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing 100037, China
(Jeon) Department of Anesthesiology and Pain Medicine, Seoul National
University Hospital, Daehakro 101, Seoul 110-744, South Korea
(Meybohm) Department of Anesthesiology, Intensive Care Medicine, and Pain
Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, Frankfurt
60590, Germany
(Zarbock) Department of Anesthesiology, Critical Care Medicine and Pain
Therapy, University Hospital Munster, Albert-Schweitzer-Campus 1, Gebaude
A1, Munster 148149, Germany
(Hausenloy) The Hatter Cardiovascular Institute, University College
London, 67 Chenies Mews, London WC1E 6HX, United Kingdom
(Hausenloy) The National Institute of Health Research University College
London Hospitals, Biomedical Research Centre, London, United Kingdom
(Hausenloy) National Heart Research Institute Singapore, National Heart
Centre Singapore, Singapore
(Hausenloy) Cardiovascular and Metabolic Disorders Program, Duke-National
University of Singapore, Singapore
Title
Corrigendum to "Renoprotection by remote ischemic conditioning during
elective coronary revascularization: A systematic review and meta-analysis
of randomized controlled trials" (International Journal of Cardiology
(2016) 1(222) (295-302)(S016752731631573X)(10.1016/j.ijcard.2016.07.176)).
Source
International Journal of Cardiology. 226 (pp 141), 2017. Date of
Publication: 01 Jan 2017.
Publisher
Elsevier Ireland Ltd
Abstract
The authors regret that they have to make a change to the authorship of
this paper. Dr. Paul Young has been removed as a co-author, as he did not
review or approve the submitted manuscript and, therefore, did not fulfil
the criteria for authorship. The authors would like to apologise for any
inconvenience caused. Copyright &#xa9; 2016

<76>
Accession Number
613696739
Author
Zhang D.; Lyu S.; Song X.; Yuan F.; Xu F.; Zhang M.
Institution
(Zhang, Lyu, Song, Yuan, Xu, Zhang, Zhang) Department of Cardiology,
Beijing Institute of Heart, Lung and Blood Vessel Disease, Capital Medical
University, Beijing Anzhen Hospital, Anzhenli Avenue, Chao Yang District,
Beijing 100029, China
Title
Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention
in Patients with Left Ventricular Systolic Dysfunction.
Source
Angiology. 68 (1) (pp 19-28), 2017. Date of Publication: 01 Jan 2017.
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
The optimal method of coronary revascularization for patients with
coronary artery disease (CAD) and left ventricular (LV) systolic
dysfunction is unclear. The purpose of this meta-analysis was to compare
coronary artery bypass grafting (CABG) and percutaneous coronary
intervention (PCI) in these patients. Two investigators independently
searched PubMed, EMBASE, and the Cochrane Controlled Trials Register
databases for relevant studies. Four prospective and 5 retrospective
studies, published before March 2015, involving 6082 patients were
included. Compared with PCI, CABG was significantly associated with lower
long-term death (odds ratio [OR]: 0.82, 95% confidence interval [CI]:
0.70-0.96, P =.01, I ² = 0%), myocardial infarction (OR: 0.58,
95% CI: 0.36-0.95, P =.03, I ² = 44%), and repeat
revascularization (OR: 0.17, 95% CI: 0.14-0.22, P <.001, I ² =
32%). The short-term death rate was comparable between CABG and PCI (OR:
2.09, 95% CI: 0.80-5.45, P =.13, I ² = 9%). Coronary artery
bypass grafting has long-term benefits compared with PCI in patients with
CAD and LV dysfunction. Copyright &#xa9; The Author(s) 2016.

<77>
Accession Number
613630502
Author
Wang S.; Li H.; He N.; Sun Y.; Guo S.; Liao W.; Liao Y.; Chen Y.; Bin J.
Institution
(Wang, Li, He, Sun, Guo, Liao, Chen, Bin) State Key Laboratory of Organ
Failure Research, Department of Cardiology, Nanfang Hospital, Southern
Medical University, Guangzhou, China
(Liao) Department of Oncology, Nanfang Hospital, Southern Medical
University, Guangzhou, China
Title
Impact of remote ischaemic preconditioning on major clinical outcomes in
patients undergoing cardiovascular surgery: A meta-analysis with trial
sequential analysis of 32 randomised controlled trials.
Source
International Journal of Cardiology. 227 (pp 882-891), 2017. Date of
Publication: 15 Jan 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Background The impact of remote ischaemic preconditioning (RIPC) on major
clinical outcomes in patients undergoing cardiovascular surgery remains
controversial. We systematically reviewed the available evidence to
evaluate the potential benefits of RIPC in such patients. Methods PubMed,
Embase, and Cochrane Library databases were searched for relevant
randomised controlled trials (RCTs) conducted between January 2006 and
March 2016. The pooled population of patients who underwent cardiovascular
surgery was divided into the RIPC and control groups. Trial sequential
analysis was applied to judge data reliability. The pooled relative risks
(RRs) with 95% confidence intervals (CIs) between the groups were
calculated for all-cause mortality, major adverse cardiovascular and
cerebral events (MACCEs), myocardial infarction (MI), and renal failure.
Results RIPC was not associated with improvement in all-cause mortality
(RR, 1.04; 95%CI, 0.82-1.31; I² = 26%; P > 0.05) or MACCE
incidence (RR, 0.90; 95%CI, 0.71-1.14; I² = 40%; P > 0.05)
after cardiovascular surgery, and both results were assessed by trial
sequential analysis as sufficient and conclusive. Nevertheless, RIPC was
associated with a significantly lower incidence of MI (RR, 0.87; 95%CI,
0.76-1.00; I² = 13%; P < 0.05). However, after excluding a
study that had a high contribution to heterogeneity, RIPC was associated
with increased rates of renal failure (RR, 1.53; 95%CI, 1.12-2.10;
I² = 5%; P < 0.05). Conclusions In patients undergoing
cardiovascular surgery, RIPC reduced the risk for postoperative MI, but
not that for MACCEs or all-cause mortality, a discrepancy likely related
to the higher rate of renal failure associated with RIPC. Copyright &#xa9;
2016 Elsevier Ireland Ltd

<78>
Accession Number
613630429
Author
Wiebe J.; Detten G.; Scheckel C.; Gearhart D.; Wheeler D.; Sanders D.;
Vassar M.
Institution
(Wiebe, Detten, Scheckel, Gearhart, Wheeler, Sanders, Vassar) Oklahoma
State University Center for Health Sciences, United States
Title
The heart of the matter: Outcome reporting bias and registration status in
cardio-thoracic surgery.
Source
International Journal of Cardiology. 227 (pp 299-304), 2017. Date of
Publication: 15 Jan 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Background Our objective is to compare registered outcomes to published
reports; to evaluate for discrepancies favoring statistically significant
outcomes; to examine funding source and likelihood of outcome reporting
bias; and to evaluate for any temporal trends in outcome reporting bias.
Methods PubMed was searched for randomized controlled trials published
between 2008 and 2015 from 4 high impact cardio-thoracic journals:
European Journal of Cardio-thoracic Surgery (EJCS), The Journal of
Cardiothoracic Surgery (JCS), The Journal of Thoracic and Cardiovascular
Surgery (JTCS), and Annals of Cardiothoracic Surgery (ACS). Data was
collected using a standardized extraction form. Results We reviewed 287
articles, of which 214 (74.6%) did not meet registration criteria. Of
those 214, 94 (43.9%) were published in the EJCS, 34 (15.9%) in JCS, 86
(40.2%) in JTCS, and 0 (0%) in the ACS. Of the remaining 73 articles, 34
(46.6%) had a discrepancy between the primary outcome registered and the
published outcome, and 11 of the 34 reported p-values favoring the change.
We also found that 12 of the 73 registrations had updated primary outcomes
from the initial report to the final report. The timing of registration
was an incidental finding showing 14 (19.1%) articles retrospectively
registered, 29 (39.7%) registered during patient enrollment, and 30
(41.1%) registered prospectively. Conclusion The results indicated that
selective outcome reporting is prevalent in cardio-thoracic surgery
journals. The more concerning issue, however, is the lack of registration
or provision of registration number for randomized controlled trials
within these journals. Copyright &#xa9; 2016 Elsevier Ireland Ltd

<79>
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.

<80>
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.

<81>
Accession Number
613688511
Author
Papageorgiou N.; Briasoulis A.; Lazaros G.; Imazio M.; Tousoulis D.
Institution
(Papageorgiou) Barts Heart Centre, St Bartholomew's Hospital, London,
United Kingdom
(Papageorgiou, Lazaros, Tousoulis) First Cardiology Department, University
of Athens Medical School, Hippokration General Hospital, Athens, Greece
(Briasoulis) Cardiovascular Institute, Wayne State University, Detroit,
MI, United States
(Imazio) Cardiology Department, Maria Vittoria Hospital, Torino, Italy
(Imazio) Department of Public Health and Pediatrics, University of Torino,
Torino, Italy
Title
Colchicine for prevention and treatment of cardiac diseases: A
meta-analysis.
Source
Cardiovascular Therapeutics. 35 (1) (pp 10-18), 2017. Date of Publication:
01 Feb 2017.
Publisher
Blackwell Publishing Ltd (E-mail:
customerservices@oxonblackwellpublishing.com)
Abstract
Aims: Colchicine has been suggested to be beneficial in preventing
recurrent pericarditis. The goal of this study was to review all
randomized controlled trials that assess the use of colchicine for the
prevention and treatment of cardiac diseases. Methods: We performed a
meta-analysis of the effects of colchicine on pericarditis,
postpericardiotomy syndrome and postprocedural atrial fibrillation
recurrence, in-stent restenosis, gastrointestinal adverse effects, and
treatment discontinuation rates. We conducted an EMBASE and MEDLINE search
for prospective controlled trials. Results: We identified 17 prospective
controlled randomized studies with 2082 patients that received colchicine
and 1982 controls with an average follow-up duration of 12 months.
Treatment with colchicine is associated with reduced risk of pericarditis
recurrence/postpericardiotomy syndrome (OR: 0.37; 95% CI: 0.29-0.47;
P<0.001) and lower recurrence of atrial fibrillation rates after cardiac
surgery and ablation procedures. However, gastrointestinal side effects
were more common in patients treated with colchicine (OR: 2.6; 95% CI:
1.82-3.72; P<0.001) in all subgroups except for those treated for
prevention of recurrent pericarditis. The higher rates of side effects
resulted in higher incidence of treatment discontinuation in patients
treated with colchicine. Conclusion: Colchicine appears to be efficacious
and well tolerated for recurrent pericarditis/postpericardiotomy syndrome
and recurrence of postprocedural atrial fibrillation. However, its
efficacy may be limited by its gastrointestinal adverse events and
treatment discontinuation rates particularly in postoperative patients.
Copyright &#xa9; 2016 John Wiley & Sons Ltd

<82>
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

<83>
Accession Number
613630466
Author
Attizzani G.F.; Ohno Y.; Latib A.; Petronio A.S.; Giannini C.; Ettori F.;
Curello S.; Bedogni F.; Todaro D.; Brambilla N.; Bruschi G.; Colombo P.;
Presbitero P.; Fiorilli R.; Poli A.; Martina P.; Colombo A.; Barbanti M.;
Tamburino C.
Institution
(Attizzani, Ohno, Todaro, Barbanti, Tamburino) Ferrarotto Hospital,
University of Catania, Catania, Italy
(Latib, Colombo) Scientific Institute S. Raffaele, Milan, Italy
(Petronio, Giannini) AOU Pisana, Pisa, Italy
(Ettori, Curello) Ospedali Civili, Brescia, Italy
(Bedogni, Brambilla) IRCCS Policlinico San Donato, San Donato, Italy
(Bruschi, Colombo) "De Gasperis" Cardio Center ASST Niguarda Metropolitan
Hospital, Milan, Italy
(Presbitero) Clinical Institute Humanitas, Rozzano, Milan, Italy
(Fiorilli) A. O. San Camillo Forlanini Hospital, Rome, Italy
(Poli, Martina) Ospedale Civile, Legnano, Italy
Title
Acute and long-term (2-years) clinical outcomes of the CoreValve 31 mm in
large aortic annuli: A multicenter study.
Source
International Journal of Cardiology. 227 (pp 543-549), 2017. Date of
Publication: 15 Jan 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Introduction Little is known about the early and late performance of the
31 mm CoreValve Revalving System (CRS, Medtronic Inc., Galway, Ireland).
Our aim was to compare acute and long-term results of the 31 mm CRS with
other valve sizes. Methods Consecutive patients undergoing transcatheter
aortic valve implantation (TAVI) with CRS in nine Italian centers were
prospectively included and dichotomized according to prosthesis size in
two different groups, as follows: 31 mm and other valve sizes (i.e., 23,
26, and 29 mm combined). End points were defined according to Valve
Academic Research Consortium definitions. Propensity score matching was
performed. Results In total, 2069 patients (n = 169 [8%] in the 31 mm
group and n = 1900 [92%] in the other valve sizes group) were included.
After propensity matching, the implantation of the 31 mm valve was
associated with lower rates of procedural- (91.3% vs. 98.1%, p = 0.030)
and device-success (88.5% vs. 97.1%, p = 0.016), longer procedural time
(120 [80-180] min. vs. 90 [60-120] min., p < 0.001), and higher rates of
implantation of a second valve (10.6% vs. 2.9%, respectively, p = 0.027).
The rates of permanent pacemaker implantation in the 31 mm group were
higher but not statistically different from other valve sizes (41.7% vs.
30.9%, respectively, p = 0.149). Significant improvement, without
between-group differences, was observed in NYHA functional class.
Cardiovascular death was lower in the 31 mm valve group through 2-years
(3.8% vs. 13.5%, respectively, p = 0.014). Conclusions The acute
performance of the 31 mm CRS was worse than other valve sizes but no
negative impact was observed in long-term outcomes. Copyright &#xa9; 2016
Elsevier Ireland Ltd

<84>
Accession Number
613630461
Author
Kim T.K.; Min J.J.; Cho Y.J.; Hausenloy D.J.; Ahn H.; Kim K.-H.; Hwang
H.Y.; Hong D.M.; Jeon Y.
Institution
(Kim, Cho, Hong, Jeon) Department of Anesthesiology and Pain Medicine,
Seoul National University Hospital, Seoul, South Korea
(Min) Department of Anesthesiology and Pain Medicine, Samsung Medical
Center, Seoul, South Korea
(Hausenloy) The Hatter Cardiovascular Institute, University College
London, London, United Kingdom
(Hausenloy) The National Institute of Health Research, University College
London Hospitals Biomedical Research Center, London, United Kingdom
(Hausenloy) National Heart Research Institute Singapore, National Heart
Center Singapore, Singapore, Singapore
(Hausenloy) Cardiovascular and Metabolic Disorders Program, Duke-National
University of Singapore, Singapore, Singapore
(Ahn, Kim, Hwang) Department of Thoracic and Cardiovascular Surgery, Seoul
National University Hospital, Seoul, South Korea
Title
Effects of delayed remote ischemic preconditioning on peri-operative
myocardial injury in patients undergoing cardiac surgery - A randomized
controlled trial.
Source
International Journal of Cardiology. 227 (pp 511-515), 2017. Date of
Publication: 15 Jan 2017.
Publisher
Elsevier Ireland Ltd
Abstract
Background Remote ischemic preconditioning (RIPC) has two time windows for
organ protection: acute and delayed. Previous studies have mainly focused
on the acute time window to evaluate organ protection by RIPC. We
evaluated myocardial protection by delayed RIPC in adult patients
undergoing cardiac surgery. Methods A total of 160 adult patients
undergoing cardiac surgery with cardiopulmonary bypass were randomized to
receive either delayed RIPC (four cycles of 5 min of ischemia followed by
5 min of reperfusion by inflation to 200 mm Hg and deflation of a blood
pressure cuff on the upper arm) or the control treatment 24-48 h before
surgery. The primary endpoint was post-operative troponin I levels
serially measured for 72 h. Secondary endpoints included post-operative
serum creatinine levels, acute kidney injury, and composite complications.
Results There were no significant differences in post-operative troponin I
values. The incidence of acute kidney injury, defined by the Acute Kidney
Injury Network staging system, was lower in the delayed RIPC group
compared to the control group (30.0% vs. 47.5%; relative risk, 0.768; 95%
confidence interval, 0.599-0.985; p = 0.023). Moreover, the occurrence of
composite complications was lower in the delayed RIPC group compared with
the control group (65.0% vs. 81.3%; relative risk, 0.536; 95% confidence
interval, 0.311-0.924; p = 0.020). Conclusions While RIPC did not provide
cardioprotective effects in patients undergoing cardiac surgery, it
appeared to reduce acute kidney injury, as well as the rate of composite
complications. Copyright &#xa9; 2016 Elsevier Ireland Ltd

<85>
Accession Number
613674138
Author
Tang M.; Liu X.; Lin C.; He Y.; Cai X.; Xu Q.; Hu P.; Gao F.; Jiang J.;
Lin X.; Zhu Q.; Wang L.; Kong H.; Yu Y.; Wang J.
Institution
(Tang, Liu, Lin, He, Xu, Hu, Gao, Jiang, Lin, Zhu, Wang, Kong, Wang)
Department of Cardiology, Second Affiliated Hospital Zhejiang University
School of Medicine, Hangzhou, China
(Cai) Department of General Surgery, Ningbo Medical Treatment Center
Lihuili Hospital, Ningbo, China
(Yu) Department of Epidemiology and Health Statistics, School of Public
Health, School of Medicine, Zhejiang University, Hangzhou, China
Title
Meta-Analysis of Outcomes and Evolution of Pulmonary Hypertension Before
and After Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 119 (1) (pp 91-99), 2017. Date of
Publication: 01 Jan 2017.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Pulmonary hypertension (PH) is a common entity in patients with severe
aortic stenosis (AS) who underwent transcatheter aortic valve implantation
(TAVI), but its role on clinical outcomes remains undetermined. We
evaluated the impact of baseline and postprocedural PH on clinical
outcomes and changes in pulmonary artery systolic pressure after TAVI by
performing a meta-analysis of 16 studies enrolling 9,204 patients with AS
who underwent TAVI. In patients with baseline PH, all-cause mortality was
significantly increased, as shown by pooled odds ratio (ORs) for overall
30-day (OR 1.52, 95% confidence interval [CI] 1.28 to 1.80), 1-year (OR
1.39, 95% CI 1.27 to 1.51), and 2-year all-cause mortality (OR 2.00, 95%
CI 1.49 to 2.69), compared with those without PH, independent of different
methods of PH assessment. The presence of post-TAVI PH was associated with
a significant increase in 2-year all-cause mortality (OR 2.32, 95% CI 1.43
to 3.74). Nevertheless, pulmonary artery systolic pressure decreased at
3-month to 1-year follow-up (standardized mean difference -1.12, 95% CI
-1.46 to -0.78). Baseline PH was associated with higher 30-day and 1-year
cardiovascular mortality. Patients with baseline PH had higher risk of
stroke at 1 year and acute kidney injury at 30 days. But the risk of major
vascular complications was significantly lower in patients with baseline
PH. In conclusion, the presence of PH is associated with increased short-
and long-term mortality, also higher risk of stroke and acute kidney
injury after TAVI. A significant decrease in PSAP is detected in patients
with AS in midterm follow-up after TAVI. Copyright &#xa9; 2016 Elsevier
Inc.

<86>
Accession Number
613751708
Author
Ring A.; Morris T.; Wozniak M.; Sullo N.; Dott W.; Verheyden V.; Kumar T.;
Brunskill N.; Vaja R.; Murphy G.J.
Institution
(Ring) University of the Free State Bloemfontein South Africa
(Ring) medac GmbH Wedel Germany
(Ring, Morris) Leicester Clinical Trials Unit Leicester General Hospital
Leicester UK
(Wozniak, Sullo, Dott, Verheyden, Kumar, Murphy) University of Leicester,
Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit
Glenfield Hospital Leicester UK
(Brunskill, Vaja) University Hospitals Leicester NHS Trust Leicester UK
Title
A Phase I study to determine the pharmacokinetic profile, safety and
tolerability of sildenafil (Revatio) in cardiac surgery: The
REVAKI-1 study.
Source
British Journal of Clinical Pharmacology. (no pagination), 2016. Date of
Publication: 2016.
Publisher
Blackwell Publishing Ltd (E-mail:
customerservices@oxonblackwellpublishing.com)
Abstract
Aims: Acute kidney injury (AKI) is a common and severe complication of
cardiac surgery. There is no effective prevention or treatment. Sildenafil
citrate (Revatio, Pfizer Inc.), a phosphodiesterase type 5
inhibitor, prevents post cardiac surgery AKI in pre-clinical studies,
however its use is contraindicated in patients with symptomatic
cardiovascular disease. The aim of this study is to assess the safety and
pharmacokinetics of intravenous sildenafil in cardiac surgery patients.
Methods: We conducted an open label, dose escalation study with six
patients per dose level. The six doses were 2.5 mg, 5 mg or 10 mg as a
bolus, either alone or followed by an additional 2 h infusion of 2.5 mg
sildenafil. Results: Thirty-six patients entered the trial, of which 33
completed it. The mean age was 69.9 years. One patient died during
surgery, two others were removed from the trial before dosing (all at dose
level 5 mg + 2.5 mg). The pharmacokinetic profile of sildenafil was
similar to previously published studies. For a dose of 10 mg administered
as a bolus followed by 2.5 mg administered over 2 h the results were
AUC<inf></inf> 537 ng h ml^-1, C<inf>max</inf> 189.4 ng
ml^-1 and t<inf>1/2</inf> 10.5 h. The drug was well tolerated
with no serious adverse events related to drug administration. Higher
sildenafil doses stabilized post-surgery nitric oxide bioavailability.
Conclusions: Pharmacokinetics of sildenafil during cardiopulmonary bypass
were comparable to those of other patient groups. The drug was well
tolerated at therapeutic plasma levels. These results support the further
evaluation of sildenafil for the prevention of AKI in cardiac surgery.
Copyright &#xa9; 2016 The British Pharmacological Society.

<87>
Accession Number
613748997
Author
Barnhart G.R.; Accola K.D.; Grossi E.A.; Woo Y.J.; Mumtaz M.A.; Sabik
J.F.; Slachman F.N.; Patel H.J.; Borger M.A.; Garrett H.E.; Rodriguez E.;
McCarthy P.M.; Ryan W.H.; Duhay F.G.; Mack M.J.; Chitwood W.R.
Institution
(Barnhart) Swedish Heart and Vascular Institute, Structural Heart Program,
Seattle, Wash
(Accola) Florida Hospital Cardiovascular Institute, Florida Hospital
Orlando, Orlando, Fla
(Grossi) Department of Cardiothoracic Surgery, New York University School
of Medicine, New York, NY
(Woo) Department of Cardiothoracic Surgery, Stanford University, Palo
Alto, Calif
(Mumtaz) Cardiovascular and Thoracic Surgery, Pinnacle Health, Harrisburg,
Pa
(Sabik) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic Foundation, Cleveland, Ohio
(Slachman) Mercy Medical Group, Mercy General Hospital, Sacramento, Calif
(Patel) Cardiac Surgery Department, University of Michigan, Ann Arbor,
Mich
(Borger) Department of Surgery, Columbia University Medical Center, New
York, NY
(Garrett) Cardiovascular Surgery Clinic, Baptist Memorial Hospital,
Memphis, Tenn
(Rodriguez) Saint Thomas Heart Program, Saint Thomas Heart Hospital,
Nashville, Tenn
(McCarthy) Division of Cardiac Surgery, Northwestern Memorial Hospital,
Chicago, Ill
(Ryan, Mack) Cardiac Surgery Specialists, Baylor Plano Heart Hospital,
Plano, Tex
(Duhay) Edwards Lifesciences LLC, Irvine, Calif
(Chitwood) Department of Cardiovascular Sciences, East Carolina
University, Greenville, NC
Title
TRANSFORM (Multicenter Experience With Rapid Deployment Edwards INTUITY
Valve System for Aortic Valve Replacement) US clinical trial: Performance
of a rapid deployment aortic valve.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2016.
Date of Publication: March 23, 2016.
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: The TRANSFORM (Multicen. ter Experience With . Rapid
Deployment Edw. ards I. NTUITY Valve . System . for Aortic Valve Replace.
ment) trial (NCT01700439) evaluated the performance of the INTUITY rapid
deployment aortic valve replacement (RDAVR) system in patients with severe
aortic stenosis. Methods: TRANSFORM was a prospective, nonrandomized,
multicenter (n = 29), single-arm trial. INTUITY is comprised of a
cloth-covered balloon-expandable frame attached to a Carpentier-Edwards
PERIMOUNT Magna Ease aortic valve. Primary and effectiveness endpoints
were evaluated at 1 year. Results: Between 2012 and 2015, 839 patients
underwent RDAVR. Mean age was 73.5 +/- 8.3 years. Full sternotomy (FS) was
used in 59% and minimally invasive surgical incisions in 41%. Technical
success rate was 95%. For isolated RDAVR, mean crossclamp and
cardiopulmonary bypass times for FS were 49.3 +/- 26.9 minutes and 69.2
+/- 34.7 minutes, respectively, and for minimally invasive surgical 63.1
+/- 25.4 minutes and 84.6 +/- 33.5 minutes, respectively. These times were
favorable compared with Society of Thoracic Surgeons database comparators
for FS: 76.3 minutes and 104.2 minutes, respectively, and for minimally
invasive surgical, 82.9 minutes and 111.4 minutes, respectively (P <
.001). At 30 days, all-cause mortality was 0.8%; valve explant, 0.1%;
thromboembolism, 3.5%; and major bleeding, 1.3%. In patients with isolated
aortic valve replacement, the rate of permanent pacemaker implantation was
11.9%. At 1 year, mean effective orifice area was 1.7 cm²; mean
gradient, 10.3 mm Hg; and moderate and severe paravalvular leak, 1.2% and
0.4%, respectively. Conclusions: INTUITY RDAVR performed effectively in
this North American trial. It may lead to a relative reduction in aortic
crossclamp time and cardiopulmonary bypass time and has excellent
hemodynamic performance. Pacemaker implantation rate observed was somewhat
greater than European trials and requires further investigation. Copyright
&#xa9; 2016 The American Association for Thoracic Surgery.

<88>
Accession Number
613747563
Author
Takagi H.; Umemoto T.
Institution
(Takagi, Umemoto) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
Title
Similar Survival After Repair vs Replacement for Ischemic Mitral
Regurgitation.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2016.
Date of Publication: 2016.
Publisher
W.B. Saunders
Abstract
To determine whether mitral valve (MV) repair improves early and late
survival compared with MV replacement for patients with ischemic mitral
regurgitation (IMR), we performed a meta-analysis of randomized controlled
trials (RCTs) and adjusted observational studies. Databases including
MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials
were searched through January 2016 using PubMed and Ovid. Studies
considered for inclusion met the following criteria: the design was a RCT
or adjusted observational study, the study population was patients with
IMR; patients were assigned to MV repair vs replacement, and outcomes
included early (30 days or in hospital) or late (>1 year) overall survival
or all-cause mortality. An adjusted odds or hazard ratio (OR/HR) with its
95% CI of early or late (including early) all-cause mortality for MV
repair vs replacement was abstracted from each individual study. Our
search identified 12 articles from one RCT and 10 adjusted observational
studies including 2784 patients. Pooled analyses demonstrated no
statistically significant difference in both early (OR = 0.90; 95% CI:
0.69-1.16; . P = 0.41) and late mortality (HR = 0.90; 95% CI: 0.72-1.13; .
P = 0.38) between MV repair and replacement. Exclusion of any single study
from the meta-analysis did not substantively alter the overall result of
no statistically significant difference. There was no evidence of
significant publication bias. For patients with IMR, MV repair appears to
be unassociated with a significant decrease in both early and late
all-cause mortality compared with MV replacement. Copyright &#xa9; 2016
Elsevier Inc.

<89>
Accession Number
613732051
Author
Kowalewski M.; Malvindi P.G.; Suwalski P.; Raffa G.M.; Pawliszak W.;
Perlinski D.; Kowalkowska M.E.; Kowalewski J.; Carrel T.; Anisimowicz L.
Institution
(Kowalewski, Pawliszak, Perlinski, Anisimowicz) Department of Cardiac
Surgery, Dr Antoni Jurasz Memorial University Hospital, Bydgoszcz, Poland
(Kowalewski) Department of Hygiene, Epidemiology and Ergonomics, Division
of Ergonomics and Physical Effort, Collegium Medicum UMK in Bydgoszcz,
Bydgoszcz, Poland
(Malvindi) University Hospital Southampton NHS Foundation Trust, Wessex
Cardiothoracic Centre, Southampton, United Kingdom
(Suwalski) Clinical Department of Cardiac Surgery, Central Clinical
Hospital of the Ministry of the Interior and Administration in Warsaw,
Warsaw, Poland
(Suwalski) Faculty of Health Science and Physical Education, Pulaski
University of Technology and Humanities, Radom, 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) Department and Clinic of Obstetrics, Gynecology, and
Oncological Gynecology, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
(Kowalewski) Lung Cancer and Thoracic Surgery Department, Collegium
Medicum, Nicolaus Copernicus University, Torun, Poland
(Carrel) Clinic for Cardiovascular Surgery, University Hospital and
University of Bern, Bern, Switzerland
Title
Clinical Safety and Effectiveness of Endoaortic as Compared to
Transthoracic Clamp for Small Thoracotomy Mitral Valve Surgery:
Meta-Analysis of Observational Studies.
Source
Annals of Thoracic Surgery. (no pagination), 2016. Date of Publication:
2016.
Publisher
Elsevier USA
Abstract
Controversies remain on the increased rate of neurological events after
small thoracotomy mitral valve surgery attributed to endoaortic balloon
occlusion (EABO). Systematic literature search of databases identified 17
studies enrolling 6,643 patients comparing safety and effectiveness of
EABO versus transthoracic clamp. In a meta-analysis, there was no
difference in occurrence of cerebrovascular events, all-cause mortality,
and kidney injury. EABO was associated with a significantly higher risk of
iatrogenic aortic dissection (0.93% versus 0.13%; risk ratio, 4.67; 95%
confidence interval, 1.62 to 13.49; . p = 0.004) and a trend toward longer
operative times. The data is limited to observational studies. Copyright
&#xa9; 2016 The Society of Thoracic Surgeons.

<90>
Accession Number
613715117
Author
Zaman S.; Mccormick L.; Gooley R.; Rashid H.; Ramkumar S.; Jackson D.; Hui
S.; Meredith I.T.
Institution
(Zaman, Mccormick, Gooley, Rashid, Ramkumar, Jackson, Hui, Meredith)
Monash Cardiovascular Research Centre, Department of Medicine (Monash
Medical Centre), School of Clinical SciencesMonash University
(Zaman, Mccormick, Gooley, Meredith) Cardiovascular DivisionMonash Heart,
Monash Medical CentreMelbourne, Victoria Australia
Title
Incidence and predictors of permanent pacemaker implantation following
treatment with the repositionable LotusTM transcatheter aortic valve.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2016.
Date of Publication: 2016.
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objectives: To determine the incidence and predictors of permanent
pacemaker (PPM) requirement following transcatheter aortic valve
replacement (TAVR) with the mechanically expanded Lotus^TM Valve
System (Boston Scientific). Background: Pacemaker implantation is the most
common complication following TAVR. Predictors of pacing following TAVR
with the Lotus valve have not been systematically assessed. Methods:
Consecutive patients with severe aortic stenosis who underwent Lotus valve
implantation were prospectively recruited at a single-centre. Patients
with a pre-existing PPM were excluded. Baseline ECG, echocardiographic and
multiple detector computed tomography as well as procedural telemetry and
depth of implantation were independently analyzed in a blinded manner. The
primary endpoint was 30-day incidence of pacemaker requirement (PPM
implantation or death while pacing-dependent). Multivariate analysis was
performed to identify independent predictors of the primary endpoint.
Results: A total of 104 consecutive patients underwent TAVR with the Lotus
valve with 9/104 (9%) with a pre-existing PPM excluded. New or worsened
procedural LBBB occurred in 78%. Thirty-day incidence of the primary
pacing endpoint was 28%. The most common indication for PPM implantation
was complete heart block (CHB) (69%). Independent predictors of the
primary endpoint included pre-existing RBBB (hazard ratio [HR] 2.8, 95% CI
1.1-7.0; P=0.032) and depth of implantation below the noncoronary cusp
(NCC) (HR 2.4, 95% CI 1.0-5.7; P=0.045). Conclusions: Almost a third of
Lotus valve recipients require pacemaker implantation within 30 days. The
presence of pre-existing RBBB and the depth of prosthesis implantation
below the NCC were significant pacing predictors. Copyright &#xa9; 2016
Wiley Periodicals, Inc.

<91>
Accession Number
613715002
Author
Rozencwajg S.; Desthieux C.; Szymkiewicz O.; Ynineb Y.; Fulgencio J.-P.;
Bonnet F.
Institution
(Rozencwajg, Desthieux, Szymkiewicz, Ynineb, Fulgencio, Bonnet) Service
d'anesthesie-reanimation, universite Pierre-et-Marie-Curie Paris VI,
hopital Tenon, groupe hospitalier universitaire Est-Parisien, 4, rue de la
Chine, 75970 Paris cedex 20, France
Title
The risk of atrial fibrillation after pneumonectomy is not impaired by
preoperative administration of dexamethasone. A cohort study.
Source
Anaesthesia Critical Care and Pain Medicine. (no pagination), 2016. Date
of Publication: 2016.
Publisher
Elsevier Masson SAS (62 rue Camille Desmoulins, Issy les Moulineaux Cedex
92442, France)
Abstract
Introduction: Atrial fibrillation (AF) is one of the most frequent
complications occurring after thoracic surgery especially after lung
resection. It is associated with an increase in postoperative morbidity
and mortality. Recent data having documented the preventive role of
corticosteroids on the occurrence of AF in cardiac surgery, we sought to
evaluate the effect of preoperative administration of dexamethasone on the
incidence of AF after pneumonectomy. Methods: We reviewed the files of all
consecutive patients who underwent a pneumonectomy in one single centre
between July 2004 and July 2012. For each patient, demographics, medical
status, the surgical procedure and treatments administered including
dexamethasone, were recorded. The data were analysed using a univariate
analysis and a multivariate logistic regression. Results: Among them, 153
patients were included and analysed; 35 (23%) presented with at least one
episode of AF occurring within 48. hours after surgery. Mortality was
higher in these patients (26.5% versus 12.1%, . P=0.06). The univariate
analysis indicated that patients who had a postoperative course
complicated by the occurrence of AF were older (P=0.003), had a higher
SAPS2 score (P=0.002) and a higher CHADS score (P=0.05). Older age (OR.
=1.08; . P=0.048) and preoperative treatment by anti-arrhythmics (OR.
=3.9; . P=0.029) were documented as independent risk factors in the
multivariate analysis. Preoperative administration of dexamethasone 8-12.
mg did not impair the incidence of AF. Discussion: AF is a frequent
complication after pneumonectomy associated with increased mortality.
Whereas corticosteroids have been documented as preventing AF following
cardiac surgery, no such effect was found after pneumonectomy. Copyright
&#xa9; 2016 Societe francaise d'anesthesie et de reanimation (Sfar).

<92>
Accession Number
613709874
Author
Peek J.; Vos C.G.; Unlu C.; van de Pavoordt H.D.W.M.; van den Akker P.J.;
de Vries J.P.P.M.
Institution
(Peek, van de Pavoordt, de Vries) Department of Vascular Surgery, St
Antonius Hospital, Nieuwegein, The Netherlands
(Vos, Unlu, van den Akker) Department of Vascular Surgery, Noordwest
Ziekenhuisgroep, Alkmaar, The Netherlands
Title
Outcome of Surgical Treatment for Thoracic Outlet Syndrome: Systematic
Review and Meta-Analysis.
Source
Annals of Vascular Surgery. (no pagination), 2016. Date of Publication:
April 28, 2016.
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Many publications report outcomes of surgical treatment for
thoracic outlet syndrome (TOS); however, high-quality reviews and
meta-analyses are lacking. This systematic review and meta-analysis
summarizes and compares the outcomes and major complications of the
surgical procedures for the 3 types of TOS: arterial, venous, and
neurogenic. Methods: MEDLINE, EMBASE, and CINAHL databases, and the
Cochrane Database of Systematic Reviews were searched for papers published
between January 1980 and February 2015, using the keywords thoracic outlet
syndrome, and treatment and surgical. Articles were eligible for inclusion
if the following criteria were met: studies describing outcomes of surgery
for TOS, published in English, human studies, and available full-text. The
exclusion criteria were case-series and case reports (n < 5), reviews,
abstracts, and studies of endoscopic-assisted or robotic
endoscopic-assisted transaxillary first rib resection. Results: A total of
12 papers met our inclusion criteria and were finally included in this
systematic review. All included articles showed improvement of complaints
after surgical treatment. In our meta-analysis, improvement to Derkash's
classification category excellent/good was achieved in 90% of the arterial
and venous TOS groups. Preoperative and postoperative Disabilities of the
Arm, Shoulder, and Hand scores show improvement of 28.3 points after
operative treatment of neurogenic TOS. Conclusions: In conclusion,
surgical treatment of TOS seems to be beneficial in most patients and is
relatively safe. The largest challenge remains the diagnosis of TOS,
especially neurogenic TOS, because standardized diagnostic criteria are
lacking. Future studies should focus on the diagnostic work-up of TOS.
Copyright &#xa9; 2016 Elsevier Inc.

<93>
Accession Number
613696438
Author
Valkenet K.; Trappenburg J.C.A.; Hulzebos E.H.; van Meeteren N.L.U.; Backx
F.J.G.
Institution
(Valkenet, Trappenburg, Backx) University Medical Centre Utrecht, Academic
Hospital Utrecht, Department of Rehabilitation, Nursing Science and
Sports, Utrecht, The Netherlands
(Hulzebos) University Medical Centre Utrecht, Wilhelmina Children's
Hospital, Department of Child Development and Exercise Centre, Utrecht,
The Netherlands
(van Meeteren) Maastricht University, CAPHRI, and Centre for Care
Technology Research, and Dutch Sector Life Sciences and Health,
Maastricht, The Netherlands
Title
Effects of a pre-operative home-based inspiratory muscle training
programme on perceived health-related quality of life in patients
undergoing coronary artery bypass graft surgery.
Source
Physiotherapy (United Kingdom). (no pagination), 2016. Date of
Publication: 2016.
Publisher
Elsevier Ltd
Abstract
Objectives: Pre-operative inspiratory muscle training has been shown to
decrease the incidence of postoperative pneumonia and length of hospital
stay in patients undergoing coronary artery bypass graft surgery (CABG).
This study investigated if this decrease acted as a mediator on the time
course of quality of life. Design: Complementary analyses of a published
randomised controlled trial. Setting and participants: The initial trial
included patients awaiting CABG surgery at a Dutch university hospital.
The secondary analyses used data from the initial trial for patients who
had completed at least one quality-of-life questionnaire. Methods:
Participants were allocated at random to the intervention group or the
usual care group. The intervention group followed a home-based
pre-operative inspiratory muscle training programme. Quality of life was
measured at five time points. Between-group differences in quality-of-life
scores were analysed using mixed linear modelling. Results: The secondary
analyses used data for 235 patients. In line with the initial trial,
pneumonia and length of hospital stay were decreased significantly in the
intervention group. The time courses for all patients showed significant
improvements in quality of life after surgery compared with baseline. No
significant differences in quality of life were observed over time between
the two groups. Conclusion: Despite decreased incidence of pneumonia and
length of hospital stay in the intervention group, this study did not find
any improvements in quality of life due to the pre-operative home-based
inspiratory muscle training programme. Clinical trial registration number:
ISRCTN17691887. Copyright &#xa9; 2016 Chartered Society of Physiotherapy.

<94>
Accession Number
613690606
Author
Takase S.; Matoba T.; Nakashiro S.; Mukai Y.; Inoue S.; Oi K.; Higo T.;
Katsuki S.; Takemoto M.; Suematsu N.; Eshima K.; Miyata K.; Yamamoto M.;
Usui M.; Sadamatsu K.; Satoh S.; Kadokami T.; Hironaga K.; Ichi I.; Todaka
K.; Kishimoto J.; Egashira K.; Sunagawa K.
Institution
(Takase) From the Department of Cardiovascular Medicine, Kyushu University
Graduate School of Medical Sciences, Fukuoka, Japan (S.T., T.M., S.N.,
T.H., K. Egashira, K. Sunagawa); Department of Cardiovascular Medicine,
Kyushu University Hospital, Fukuoka, Japan (S.T., T.M., S.N., Y.M., S.I.,
K.O., T.H., S.K., M.T., K. Sunagawa); Japanese Red Cross Fukuoka Hospital,
Japan (N.S.); St. Mary's Hospital, Kurume, Japan (K. Eshima); Japan
Community Health Care Organization, Kyushu Hospital, Fukuoka, Japan
(K.M.); Harasanshin Hospital, Fukuoka, Japan (M.Y.); Hamanomachi Hospital,
Fukuoka, Japan (M.U.); Saga-ken Medical Centre Koseikan, Saga, Japan (K.
Sadamatsu); National Hospital Organization Kyushu Medical Centre, Fukuoka,
Japan (S.S.); Saiseikai Futsukaichi Hospital, Chikushino, Japan (T.K.);
Sais
Title
Ezetimibe in Combination With Statins Ameliorates Endothelial Dysfunction
in Coronary Arteries After Stenting: The CuVIC Trial (Effect of
Cholesterol Absorption Inhibitor Usage on Target Vessel Dysfunction After
Coronary Stenting), a Multicenter Randomized Controlled Trial.
Source
Arteriosclerosis, Thrombosis, and Vascular Biology. (no pagination), 2016.
Date of Publication: 08 Dec 2016.
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
OBJECTIVES-: We sought to investigate whether treatment with ezetimibe in
combination with statins improves coronary endothelial function in target
vessels in coronary artery disease patients after coronary stenting.
APPROACH AND RESULTS-: We conducted a multicenter, prospective,
randomized, open-label, blinded-end point trial among 11 cardiovascular
treatment centers. From 2011 to 2013, 260 coronary artery disease patients
who underwent coronary stenting were randomly allocated to 2 arms (statin
monotherapy (S) versus ezetimibe [10 mg/d]+statin combinational therapy
[E+S]). We defined target vessel dysfunction as the primary composite
outcome, which comprised target vessel failure during treatment and at the
6- to 8-month follow-up coronary angiography and coronary endothelial
dysfunction determined via intracoronary acetylcholine testing performed
in cases without target vessel failure at the follow-up coronary
angiography. Coadministration of ezetimibe with statins further lowered
low-density lipoprotein cholesterol levels (83+/-23 mg/dL in S versus
67+/-23 mg/dL in E+S; P<0.0001), with significant decreases in oxidized
low-density lipoprotein and oxysterol levels. Among patients without
target vessel failure, 46 out of 89 patients (52%) in the S arm and 34 out
of 96 patients (35%) in the E+S arm were found to have coronary
endothelial dysfunction (P=0.0256), and the incidence of target vessel
dysfunction at follow-up was significantly decreased in the E+S arm
(69/112 (62%) in S versus 47/109 (43%) in E+S; P=0.0059). A post hoc
analysis of post-treatment low-density lipoprotein cholesterol-matched
subgroups revealed that the incidence of both target vessel dysfunction
and coronary endothelial dysfunction significantly decreased in the E+S
arm, with significant reductions in oxysterol levels. CONCLUSIONS-: The
CuVIC trial (Effect of Cholesterol Absorption Inhibitor Usage on Target
Vessel Dysfunction after Coronary Stenting) has shown that ezetimibe with
statins, compared with statin monotherapy, improves functional prognoses,
ameliorating endothelial dysfunction in stented coronary arteries, and was
associated with larger decreases in oxysterol levels. Copyright &#xa9;
2016 American Heart Association, Inc.