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<1>
Accession Number
623417932
Title
Clinical outcomes and electrolyte balance factors in complex cardiac
operations in adults; del nido versus custodiol cardioplegia solutions: A
randomized controlled clinical trial.
Source
Iranian Red Crescent Medical Journal. 20 (4) (no pagination), 2018.
Article Number: e64648. Date of Publication: April 2018.
Author
Mehrabanian M.J.; Firoozabadi M.D.; Tafti S.H.A.; Nia S.K.F.; Najafi A.;
Mortazian M.; Davani S.Z.N.; Soltaninia H.; Ghiasi A.; Gorjipour F.;
Gorabi A.M.
Institution
(Mehrabanian, Firoozabadi) Department of Anesthesiology, Tehran Heart
Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Tafti, Nia, Soltaninia) Department of Cardiothoracic Surgery, Tehran
Heart Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Najafi) Department of Anesthesiology and Critical Care Medicine, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Mortazian) Cardiovascular Surgery Department, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Davani) Cardiovascular Surgery Department, Rasool Akram Hospital, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ghiasi, Gorabi) Department of Basic and Clinical Research, Tehran Heart
Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Gorjipour) Iranian Scientific Society of Extracorporeal Technology,
Rajaie Cardiovascular Medical and Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Kowsar Medical Publishing Company (E-mail: editor@anesthpain.com)
Abstract
Background: Cardioplegia is used for protection of myocardium during
cardiac operations. Del Nido (DN) and Custodiol cardioplegia solutions are
used for prolonged protection of the myocardium during cardiopulmonary
bypass (CPB). Custodiol cardioplegia (CC) solution is gaining popularity
for myocardial protection during cardiopulmonary bypass.
<br/>Objective(s): This study aimed to compare the effects of Custodiol
with another cardioplegia solution, Del Nido, on myocardial protection
during cardiopulmonary bypass. <br/>Method(s): In a randomized controlled
clinical trial, forty patients were randomly allocated to DN and Custodiol
(CC) groups. Patients in both groups received a normal anesthesia
protocol. For cardioplegia, in the DN group, the DN solution was
administered every 90 minutes by the antegrade route. In the Custodiol
group, the Custodiol solution was administered in the same way at the
beginning of the cardioplegia. Demographic information, blood chemistry
parameters and other related perioperative and postoperative clinical
indices were recorded. <br/>Result(s): Frequency of female patients was
14/21 (66.66%) in the DN and 12/19 (63.15%) in the CC group (P = 0.816),
age was 57.14 +/- 12.48 years in the DN and 59.47 +/- 11.96 years in the
CC group (P = 0.551), weight was 70.95 +/- 9.56 kilograms in the DN and
69.63 +/- 7.64 kilograms in the CC group (P = 0.635), CPB time was103.19
+/- 23.43 minutes in the DN versus 97.36 +/- 16.7 minutes in the CC group
(P = 0.376), and cross-clamp time was 73.76 +/- 19.66 minutes in the DN
and 83.95 +/- 16.14 minutes in the CC group (P = 0.083). Blood chemistry
and blood gas analysis revealed a similar trend between the two groups in
these parameters (P > 0.05) except for higher sodium levels after
cardioplegia (P = 0.016) and end of CPB (P = 0.002), potassium levels
after cardioplegia (P = 0.029), and bicarbonate anions at the end of
bypass (P = 0.03) in the custodiol group. <br/>Conclusion(s): In
conclusion, CC and DN offer effective myocardial protection during
cardiopulmonary bypass. It is recommended to restrict the use of CC in
patients susceptible to electrolyte disturbances.<br/>Copyright &#xa9;
2018, Author(s).

<2>
Accession Number
620563926
Title
Perioperative THR-184 and AKI after Cardiac Surgery.
Source
Journal of the American Society of Nephrology. 29 (2) (pp 670-679), 2018.
Date of Publication: February 2018.
Author
Himmelfarb J.; Chertow G.M.; McCullough P.A.; Mesana T.; Shaw A.D.; Sundt
T.M.; Brown C.; Cortville D.; Dagenais F.; De Varennes B.; Fontes M.;
Rossert J.; Tardif J.-C.
Institution
(Himmelfarb) Department of Medicine, Kidney Research Institute, University
of Washington, Seattle, WA, United States
(Chertow) School of Medicine, Stanford University, Stanford, CA, United
States
(McCullough) Department of Medicine, Baylor University, Medical Center,
Dallas, TX, United States
(Mesana) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Shaw) Department of Anesthesiology, Vanderbilt University, Medical
Center, Nashville, TN, United States
(Sundt) Department of Surgery, Massachusetts General Hospital, Boston, MA,
United States
(Brown) Department of Cardiac Surgery, New Brunswick Heart Centre, Saint
John, NB, Canada
(Cortville) Department of Cardiology, Cardiac and Vascular Research
Center, McLaren Northern Michigan, Petoskey, MI, United States
(Dagenais) Department of Cardiac Surgery, Institut Universitaire de
Cardiologie et de Pneumologie, Quebec City, QC, Canada
(De Varennes) Department of Surgery, McGill University Health Centre,
Montreal, QC, Canada
(Fontes) Department of Anesthesiology, Yale University, School of
Medicine, New Haven, CT, United States
(Rossert) Thrasos Therapeutics, Inc., Boston, MA, United States
(Tardif) Department of Medicine, Montreal Heart Institute, Montreal, QC,
Canada
Publisher
American Society of Nephrology (E-mail: email@asn-online.org)
Abstract
AKI after cardiac surgery is associated with mortality, prolonged hospital
length of stay, use of dialysis, and subsequent CKD. We evaluated the
effects of THR-184, a bone morphogenetic protein-7 agonist, in patients at
high risk for AKI after cardiac surgery. We conducted a randomized,
double-blind, placebo-controlled, multidose comparison of the safety and
efficacy of perioperative THR-184 using a two-stage seamless adaptive
design in 452 patients between 18 and 85 years of age who were scheduled
for nonemergent cardiac surgery requiring cardiopulmonary bypass and had
recognized risk factors for AKI. The primary efficacy end point was the
proportion of patients who developed AKI according to Kidney Disease
Improving Global Outcomes (KDIGO) criteria. The proportion of patients who
developed AKI within 7 days of surgery was similar in THR-184 treatment
groups and placebo groups (range, 74%-79%; P=0.43). Prespecified secondary
end point analysis did not show significant differences in the severity of
AKI stage (P=0.53) or the total duration of AKI (P=0.44). A composite of
death, dialysis, or sustained impaired renal function by day 30 after
surgery did not differ between groups (range, 11%-20%; P=0.46).
Safety-related outcomes were similar across all treatment groups. In
conclusion, compared with placebo, administration of perioperative THR-184
through a range of dose exposures failed to reduce the incidence,
severity, or duration of AKI after cardiac surgery in high-risk
patients.<br/>Copyright &#xa9; 2018 by the American Society of Nephrology

<3>
Accession Number
622367780
Title
Dexmedetomidine in pediatric intravenous general anesthesia without
tracheal intubation.
Source
International Journal of Clinical and Experimental Medicine. 11 (5) (pp
4891-4897), 2018. Article Number: IJCEM0077123. Date of Publication: 30
May 2018.
Author
Wei K.; Huang S.; Deng J.
Institution
(Wei, Huang, Deng) Department of Anesthesiology, Affiliated Hospital of
Youjiang Medical University for Nationalities, Baise, Guangxi Province,
China
Publisher
E-Century Publishing Corporation (40 White Oaks Lane, Madison WI 53711,
United States)
Abstract
Objective: The aim of this study was to investigate the application of
dexmedetomidine in pediatric intravenous general anesthesia without
tracheal intubation. <br/>Method(s): From January 2014 to January 2017, a
total of 152 children that received intravenous general anesthesia without
tracheal intubation, before scheduled surgeries, were recruited in this
study. They were divided into an observation group (n=82) and a control
group (n=70) by means of a random number table. For children in the
observation group, intravenous infusion of dexmedetomidine was
administered at 1.0 mug/kg within 10 minutes after initiation of
intravenous anesthesia. When complete, the maintaining dose was pumped
intravenously at 1.0 mug/kg/h and then propofol at 1-2 mg/kg per hour. The
70 children in the control group received equal doses of normal saline
during intravenous general anesthesia. Time for leaving the
post-anesthesia care unit (PACT), awakening time, scores on the pediatric
anesthesia emergence delirium (PAED) scale, adverse events in the recovery
period, heart rates (HR), mean arterial pressure (MAP), serum cortisol,
and aldosterone levels at different time points were compared between the
two study groups. <br/>Result(s): Time for leaving from the PACT and
awakening time of children were insignificantly different between the
observation group and control group (P>0.05). PAED scores for
postoperative emergence delirium (ED) and incidences of pain and
restlessness in the recovery period in the observation group were all
remarkably lower than the control group (all P<0.05). At different time
points (10 min, 20 min, and 30 min after dexmedetomidine or normal saline
pump infusion and at the end of surgery), slower heart rates (HR), higher
mean arterial pressure (MAP), and lower cortisol and aldosterone levels of
children were noted in the observation group compared to control group
(all P<0.05). <br/>Conclusion(s): The application of dexmedetomidine to
pediatric intravenous general anesthesia, without tracheal intubation, can
lead to stabilization of the circulatory system, relieve stress response,
and effectively reduce restlessness and pain during the recovery period.
Thus, it is worthy of extensive clinical use.<br/>Copyright &#xa9; 2018,
E-Century Publishing Corporation. All rights reserved.

<4>
Accession Number
623625417
Title
Comparison of hemodynamic stability and recovery profile with sevoflurane
as inhalational agent versus propofol as total intravenous anesthesia
during laparoscopic surgeries.
Source
Anaesthesia, Pain and Intensive Care. 22 (2) (pp 212-218), 2018. Date of
Publication: April-June 2018.
Author
Shah J.; Varma N.
Institution
(Shah, Varma) Department of Anesthesiology, GMERS Medical College, 225,
Sola Rd, Shenbhai Nagar, Sola, Ahmedabad, Gujarat 380081, India
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS (E-mail:
tariqhayatkhan@hotmail.com)
Abstract
Background and Aim: Propofol and sevoflurane, both meet the criteria of
rapid smooth induction, hemodynamic stability, rapid recovery with minimal
side effects. The present study investigated the hemodynamic stability and
recovery profile while maintaining anesthesia with sevoflurane as
inhalational agent versus propofol as total intravenous anesthesia during
laparoscopic surgeries. Methodology: This was a prospective study
conducted for one year at our hospital. Using convenient sampling
technique, a total of 50 adult patients of American Society of
Anesthesiologists (ASA) physical status I or II, aged between 18-60 years,
of either sex, who were scheduled for elective day care surgeries of less
than 2-hour duration under general anesthesia were selected for the study
after informed consent. All the patients were randomly allocated into one
of the two groups using computer generated random number table. Group-S
received induction with propofol and maintenance with sevoflurane, while
Group-P was induced and maintained with propofol only. Hemodynamic and
recovery profiles were then compared. The differences between two groups
were analyzed using unpaired t-test while categorical variables were
analyzed using chi-square test. All the statistical tests were performed
in Epi Info 3.5.1 software by CDC, USA.6 p < 0.05was considered as
statistically significant while p < 0.01 was considered as statistically
highly significant. <br/>Result(s): The baseline demographic analysis
showed that the two groups did not differ significantly in age, weight,
sex, ASA grade and operative times. During the course of surgery, heart
rate was significantly low in Group-P at 45 to 60 min than in Group-S.
Systolic and diastolic blood pressures were significantly low during
maintenance of anesthesia with propofol as compared to sevoflurane.
Group-S showed significantly shorter time for spontaneous eye opening and
recalling names and recognizing surroundings. Post-operative nausea and
vomiting was significantly low in Group-P. <br/>Conclusion(s): The present
study concludes that patients in both groups were hemodynamically stable.
Sevoflurane has the added advantage of providing rapid emergence and
recovery of cognitive function. Hence it can be considered as a useful
alternative to propofol for maintenance of anesthesia.<br/>Copyright
&#xa9; Anaesthesia, Pain & Intensive Care, 2010-2013.

<5>
Accession Number
623302332
Title
Therapeutic effect and safety of nicorandil in treatment of refractory
angina pectoris.
Source
International Journal of Clinical and Experimental Medicine. 11 (7) (pp
6993-6998), 2018. Article Number: IJCEM0075870. Date of Publication: 30
Jul 2018.
Author
Li Y.; Liu Y.; Peng W.; Wang B.; Geng T.; Xu Z.
Institution
(Li, Liu, Peng, Wang, Geng, Xu) Department of Cardiovascular Medicine,
Cangzhou Central Hospital, Cangzhou City, Hebei Province 061000, China
Publisher
E-Century Publishing Corporation (40 White Oaks Lane, Madison WI 53711,
United States)
Abstract
Objective: To investigate the therapeutic effect and adverse reactions to
nicorandil in patients with refractory angina pectoris (AP).
<br/>Method(s): Between March 2014 and December 2016, a total of 70
patients with refractory AP admitted to Cangzhou Central Hospital were
recruited in this study and subdivided into the experiment group (n=35)
and the control group (n=35) by means of a random number table. The
patients in the control group were assigned to receive placebo in addition
to basic care, while those in the experiment group were assigned to
receive nicorandil in addition to basic care. One month after treatment,
the therapeutic effects, frequency and duration of AP, the changes in ST-T
segment EEG, and adverse reactions of the patients were compared between
the two study groups. <br/>Result(s): The response rate of the experiment
group was remarkably higher than that of the control group (94.3% vs
77.1%, P=0.035); greater improvements in the duration (P=0.034) and
frequency (P=0.004) of refractory AP were observed in the experiment
group. The improvement rate of ECG in the experiment group after treatment
was significantly higher than that of the control group (91.4% vs 71.4%,
P=0.028). However, the rates of overall adverse reactions were generally
similar in both groups (P=0.167). <br/>Conclusion(s): Nicorandil was
effective in treating refractory AP, resulting in great improvements in
the frequency and duration of refractory AP, ST-T segment of ECG, and
adverse reactions. Therefore, it is a potent agent for the treatment of
refractory AP.<br/>Copyright &#xa9; 2018, E-Century Publishing
Corporation. All rights reserved.

<6>
Accession Number
621015895
Title
Comparative study on the analgesic effect of acute ipsilateral shoulder
pain after open thoracotomy between preoperative ultrasound guided
suprascapular nerve block (SNB) and intraoperative phrenic nerve
infiltration (PNI) in cancer lung patients.
Source
Journal of the Egyptian National Cancer Institute. 30 (1) (pp 27-31),
2018. Date of Publication: March 2018.
Author
Elfokery B.M.; Tawfic S.A.; Abdelrahman A.M.; Abbas D.N.; Abdelghaffar
I.M.
Institution
(Elfokery, Tawfic, Abdelrahman, Abbas, Abdelghaffar) Department of
Anaesthesia, National Cancer Institute, Cairo University, Egypt
Publisher
National Cancer Institute, Cairo University
Abstract
Introduction: Acute ipsilateral shoulder pain (ISP) is a common complaint
in patients after thoracotomy. The incidence ranges from 21% to 97%.
Unfortunately, clinical studies did not put enough focus on ISP post
thoracic surgery. Aim of the work: This study was designed to compare the
effectiveness of suprascapular nerve block (SNB) and phrenic nerve
infiltration (PNI) for controlling ISP. <br/>Patients and Methods: One
hundred and thirty-five lung cancer patients (135) scheduled for open-lung
surgery were randomly allocated into three equal groups; control group:
received thoracic epidural with general anesthesia, suprascapular group:
(SNB) one hour before the operation with 10 ml bupivacaine plus thoracic
epidural with general anesthesia and phrenic nerve group: (PNI) was
performed by the operating surgeon with 10 ml bupivacaine plus thoracic
epidural with general anesthesia. The visual analogue score (VAS) of ISP,
rescue of ketorolac for break through shoulder pain, peak expiratory flow
rate (PEFR) and arterial blood gases were measured every 6 h
postoperatively for 48 h. <br/>Result(s): The VAS, rescue doses of
ketorolc and PEFR were significantly lower in the phrenic nerve group
(P-value <0.05). There was no statistically significant difference between
the three groups postoperatively as regards arterial blood gases (P-value
>0.05). <br/>Conclusion(s): PNI is more effective than SNB for
ISP.<br/>Copyright &#xa9; 2018

<7>
Accession Number
620406133
Title
Application of pre-injection of dexmedetomidine of different doses in
pediatric intravenous general anesthesia without tracheal intubation.
Source
Experimental and Therapeutic Medicine. 15 (3) (pp 2973-2977), 2018. Date
of Publication: March 2018.
Author
Zhou M.; Wang Q.; Zhang Q.; Liu Y.; Zhan L.; Shu A.
Institution
(Zhou, Wang, Zhang, Liu, Zhan, Shu) Department of Anesthesiology, The
People's Hospital of China Three Gorges University, The First People's
Hospital of Yichang, Yichang, Hubei 443000, China
Publisher
Spandidos Publications (10 Vriaxidos Street, Athens 116 10, Greece.
E-mail: subscriptions@spandidos-publications.com)
Abstract
This study observed the clinical efficacy of pre-injection of
dexmedetomidine of different doses before surgery and the adverse
reactions during the recovery period in pediatric intravenous general
anesthesia without tracheal intubation. Pediatric patients who received
general anesthesia without tracheal intubation before surgery from January
2016 to March 2017 were randomly divided into four groups (n=30), and were
respectively treated with intravenous pump infusion of loaded
dexmedetomidine of high-dose (2.5 mug/kg), middle-dose (1.5 mug/kg) and
low-dose (0.5 mug/kg), while the children in the control group received
injection of normal saline in same dose. Then, the mean arterial pressure
(MAP) at different time points (5 and 10 min after administration, after
anesthesia and after surgery), heart rate, Ramsay sedation score changes
and adverse reactions during recovery period of anesthesia of pediatric
patients were compared among four groups. At 5 and 10 min after
administration, Ramsay scores of high-dose group and middle-dose group
were higher than that of the control group, and the differences had
statistical significance (P<0.05). There was no significant difference in
comparison of Ramsay scores between low-dose group and the control group.
The MAP and heart rate after anesthesia and after surgery of pediatric
patients with pump infusion of dexmedetomidine in the three groups were
decreased significantly compared to those of the control group, and the
differences had statistical significance (P<0.05). The incidence rate of
adverse reaction of pediatric patients during the recovery period after
pump infusion in the three groups and the control group was,
respec-tively, 13/30, 8/30, 7/30 and 8/30, and the differences were
statistically significant (P<0.05). The sedative effect and safety of
pre-injection of dexmedetomidine in pediatric intravenous general
anesthesia without tracheal intubation are promising, and the medium
dosage can maximize the anesthetic effect with less side
effects.<br/>Copyright &#xa9; 2018, Spandidos Publications. All rights
reserved.

<8>
Accession Number
2000588798
Title
New-Onset Atrial Fibrillation After PCI or CABG for Left Main Disease: The
EXCEL Trial.
Source
Journal of the American College of Cardiology. 71 (7) (pp 739-748), 2018.
Date of Publication: 20 February 2018.
Author
Kosmidou I.; Chen S.; Kappetein A.P.; Serruys P.W.; Gersh B.J.; Puskas
J.D.; Kandzari D.E.; Taggart D.P.; Morice M.-C.; Buszman P.E.; Bochenek
A.; Schampaert E.; Page P.; Sabik J.F.; McAndrew T.; Redfors B.;
Ben-Yehuda O.; Stone G.W.
Institution
(Kosmidou, Chen, McAndrew, Redfors, Ben-Yehuda, Stone) Clinical Trials
Center, Cardiovascular Research Foundation, New York, New York, United
States
(Kosmidou) Arrhythmia Center, Department of Cardiology, St. Francis
Hospital, Roslyn, New York, United States
(Kappetein) Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands
(Serruys) Imperial College of Science, Technology and Medicine, London,
United Kingdom
(Gersh) Department of Cardiovascular Medicine, Mayo Clinic College of
Medicine, Rochester, Minnesota, United States
(Puskas) Icahn School of Medicine at Mount Sinai, New York, New York,
United States
(Kandzari) Piedmont Heart Institute, Atlanta, Georgia
(Taggart) Department Cardiac Surgery, John Radcliffe Hospital, Oxford,
United Kingdom
(Morice) Ramsay Generale de Sante, Institut Cardiovasculaire Paris Sud,
Paris, France
(Buszman, Bochenek) Medical University of Silesia, Katowice, Poland
(Buszman, Bochenek) American Heart of Poland, Ustron, Poland
(Schampaert, Page) Hopital du Sacre-Coeur de Montreal, Montreal, Canada
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland,
Ohio, United States
(Ben-Yehuda, Stone) NewYork-Presbyterian Hospital/Columbia University
Medical Center, New York, New York, United States
Publisher
Elsevier USA
Abstract
Background: There is limited information on the incidence and prognostic
impact of new-onset atrial fibrillation (NOAF) following percutaneous
coronary intervention (PCI) and coronary artery bypass grafting (CABG) for
left main coronary artery disease (LMCAD). <br/>Objective(s): This study
sought to determine the incidence of NOAF following PCI and CABG for LMCAD
and its effect on 3-year cardiovascular outcomes. <br/>Method(s): In the
EXCEL (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for
Effectiveness of Left Main Revascularization) trial, 1,905 patients with
LMCAD and low or intermediate SYNTAX scores were randomized to PCI with
everolimus-eluting stents versus CABG. Outcomes were analyzed according to
the development of NOAF during the initial hospitalization following
revascularization. <br/>Result(s): Among 1,812 patients without atrial
fibrillation on presentation, NOAF developed at a mean of 2.7 +/- 2.5 days
after revascularization in 162 patients (8.9%), including 161 of 893
(18.0%) CABG-treated patients and 1 of 919 (0.1%) PCI-treated patients (p
< 0.0001). Older age, greater body mass index, and reduced left
ventricular ejection fraction were independent predictors of NOAF in
patients undergoing CABG. Patients with versus without NOAF had a
significantly longer duration of hospitalization, were more likely to be
discharged on anticoagulant therapy, and had an increased 30-day rate of
Thrombolysis In Myocardial Infarction major or minor bleeding (14.2% vs.
5.5%; p < 0.0001). By multivariable analysis, NOAF after CABG was an
independent predictor of 3-year stroke (6.6% vs. 2.4%; adjusted hazard
ratio [HR]: 4.19; 95% confidence interval [CI]: 1.74 to 10.11; p = 0.001),
death (11.4% vs. 4.3%; adjusted HR: 3.02; 95% CI: 1.60 to 5.70; p =
0.0006), and the primary composite endpoint of death, MI, or stroke (22.6%
vs. 12.8%; adjusted HR: 2.13; 95% CI: 1.39 to 3.25; p = 0.0004).
<br/>Conclusion(s): In patients with LMCAD undergoing revascularization in
the EXCEL trial, NOAF was common after CABG but extremely rare after PCI.
The development of NOAF was strongly associated with subsequent death and
stroke in CABG-treated patients. Further studies are warranted to
determine whether prophylactic strategies to prevent or treat atrial
fibrillation may improve prognosis in patients with LMCAD who are
undergoing CABG. (Evaluation of XIENCE Versus Coronary Artery Bypass
Surgery for Effectiveness of Left Main Revascularization [EXCEL];
NCT01205776)<br/>Copyright &#xa9; 2018 American College of Cardiology
Foundation

<9>
Accession Number
624895427
Title
Quality of life in patients with coronary artery disease treated with
coronary artery bypass grafting and hybrid coronary revascularization.
Source
Cardiology Journal. 25 (5) (pp 621-627), 2018. Date of Publication: 30 Oct
2018.
Author
Gierszewska K.; Jaworska I.; Skrzypek M.; Gasior M.; Pudlo R.
Institution
(Skrzypek) Department of Cardiology, SMDZ in Zabrze, Medical University of
Silesia, Katowice, Poland
(Gierszewska, Gasior) Department of Cardiology, SMDZ, Zabrze, Poland
(Gierszewska, Jaworska, Gasior, Pudlo) Medical University of Silesia,
Katowice, Poland
(Gierszewska, Jaworska, Gasior) Silesian Centre for Heart Disease, Zabrze,
Poland
(Jaworska) Department of Cardiac, Vascular and Endovascular Surgery and
Transplantology, SMDZ, Zabrze, Poland
(Skrzypek) Medical University of Silesia, School of Public Health in
Bytom, Department of Biostatistics, Poland
(Pudlo) Department of Psychiatry in Tarnowskie Gory, School of Medicine
with the Division of Dentistry, Zabrze, Poland
Publisher
Via Medica (Ul. Swietokrzyska 73, Gdansk 80-180, Poland. E-mail:
elzbieta.zabrocka@viamedica.pl)
Abstract
Background: Patients with stable coronary artery disease (CAD) have a
worse quality of life (QoL) in comparison to patients without stable CAD.
Standardized questionnaires are used in evaluation of QoL. Hybrid coronary
revascularization (HCR) is a recently-introduced, minimally invasive
option for patients requiring revascularization for coronary lesions. The
aim of this study was to assess health-related quality of life (HRQoL) in
patients with multivessel CAD (MVCAD), according to the mode of
revascularization: coronary artery bypass grafting (CABG) or HCR, using
the generic SF-36 v.2 questionnaire. <br/>Method(s): From November 2009 to
July 2012, 200 patients from POLMIDES study with diagnosed MVCAD and were
referred for conventional CABG were randomized to HCR (n = 98) or CABG (n
=102) groups in 1:1 ratio. HRQoL were measured at two time points:
hospital admission and 12-month follow up. The primary endpoint was the
difference in HRQoL after the procedure. <br/>Result(s): Both groups
showed the same improvement of HRQoL: in HCR group: 13.5 (3.82-22.34) vs.
CABG group: 10.48 (2.46-31.07); p = 0.76. <br/>Conclusion(s): HRQoL in
patients after both modes of revascularization significantly improved
after 12 months in all domains.<br/>Copyright &#xa9; 2018 Via Medica.

<10>
Accession Number
621663085
Title
Albumin priming improves the efficiency of the Minntech HPH Jr.
hemoconcentrator.
Source
Perfusion (United Kingdom). 33 (7) (pp 520-524), 2018. Date of
Publication: 01 Oct 2018.
Author
Burnside J.L.; Ratliff T.M.; Salvator A.; Hodge A.B.
Institution
(Burnside, Ratliff, Hodge) The Heart Center at Nationwide Children's
Hospital, Columbus, OH, United States
(Salvator) Department of Biostatistics Core, The Research Institute,
Nationwide Children's Hospital, Columbus, OH, United States
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
The desired use of the HPH Jr. is optimal due to the low priming volume;
however, the lower rate of volume removal necessitates utilization of a
larger hemofilter. Larger hemofilters carry a higher prime volume, which
is impactful in the pediatric setting. Pediatric cardiac surgery patients
under 18 kilograms requiring cardiopulmonary bypass were randomly assigned
to one of two study groups. Group 1 (coated) contained an HPH Jr.
hemofilter that was primed with the addition of 25% albumin and heparin.
Group 2 (non-coated) contained an HPH Jr. hemofilter that was primed with
only Normosol-R. After cardioplegia delivery, zero balance ultrafiltration
(ZBUF) was initiated and maintained for thirty consecutive minutes. The
flow through the hemofilter was standardized at 70 ml/min and the vacuum
applied to the effluent line was set at -150 mmHg. Effluent fluid removal
was measured at the termination of thirty minutes and compared between the
groups. Group comparisons between the coated vs non-coated hemofilter
groups were assessed using two-sample t-tests or the Mann-Whitney U test,
when appropriate. Forty-two patients were included in the analysis. There
were 22 patients who had the non-coated hemofilter and 20 patients with a
coated hemofilter. The differences between the two groups are illustrated
in Table 1. There was a statistically significant higher ultrafiltration
volume with the coated hemofilter group (p=0.008) (Figure 1). These
results illustrate the improved efficiency of the HPH Jr. with the
addition of 25% albumin and heparin during the priming
process.<br/>Copyright &#xa9; The Author(s) 2018.

<11>
Accession Number
2000609395
Title
Facilitating Hemostasis After Proximal Aortic Surgery: Results of The
PROTECT Trial.
Source
Annals of Thoracic Surgery. 105 (5) (pp 1357-1364), 2018. Date of
Publication: May 2018.
Author
Khoynezhad A.; DelaRosa J.; Moon M.R.; Brinkman W.T.; Thompson R.B.; Desai
N.D.; Malaisrie S.C.; Girardi L.N.; Bavaria J.E.; Reece T.B.
Institution
(Khoynezhad) Department of Cardiovascular Surgery, MemorialCare Health
System, Long Beach, California, United States
(DelaRosa) Cardiothoracic Surgery, Portneuf Medical Center, Pocatello,
Idaho, United States
(Moon) Department of Cardiothoracic Surgery, Washington University, St.
Louis, Missouri, United States
(Brinkman) Department of Cardiothoracic Surgery, Baylor Scott & White,
Plano, Texas, United States
(Thompson) Department of Cardiothoracic Surgery, Bryan Heart, Lincoln,
Nebraska, United States
(Desai, Bavaria) Division of Cardiovascular Surgery, Department of
Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, United
States
(Malaisrie) Division of Cardiac Surgery, Department of Surgery,
Northwestern University, Chicago, Illinois, United States
(Girardi) Department of Cardiothoracic Surgery, Cornell University, New
York, New York, United States
(Reece) Division of Cardiothoracic Surgery, Department of Surgery,
University of Colorado Hospital, Aurora, Colorado, United States
Publisher
Elsevier USA
Abstract
Background: This study intended to evaluate the safety and hemostatic
efficacy of a novel vascular sealant (Tridyne; Neomend, Inc, Irvine, CA)
compared with an accepted adjunctive hemostatic agent applied to aortotomy
and sutures lines in cardiovascular operations. <br/>Method(s): Patients
undergoing aortic valve replacement, ascending aortic replacement, or
aortic root replacement were randomly assigned 2:1 to Tridyne (n = 107) or
Gelfoam Plus (Baxter Healthcare Corp, Hayward, CA) (n = 51). These groups
were similar with regard to age, sex, race, medical history, duration of
bypass and cross-clamping, and number of suture lines treated. Suture
lines were treated after confirmation of some leakage but before formal
removal of the clamp. <br/>Result(s): The median bleeding time was
significantly lower for Tridyne versus Gelfoam Plus (0 versus 10.0
minutes, p < 0.0001). Immediate hemostasis was achieved in 59.4% of the
Tridyne group versus 16.0% of Gelfoam Plus group (p < 0.0001). A
significantly greater proportion of patients in the Tridyne group achieved
successful hemostasis at the aortic suture line than patients in the
Gelfoam Plus group (85.7% versus 40.0%, p < 0.0001). The Clinical Events
Committee adjudicated 7 patients with possible device-related serious
adverse events: 3 patients (2.9%) in the Tridyne group and 4 patients
(8.2%) in the Gelfoam Plus group (p = 0.2097). <br/>Conclusion(s): Tridyne
was safe and effective when used as an adjunct to conventional hemostasis
to treat high-pressure vessels in patients who receive anticoagulation
agents, in reducing time to hemostasis, and in promoting both immediate
and persistent hemostasis.<br/>Copyright &#xa9; 2018 The Society of
Thoracic Surgeons

<12>
Accession Number
624063457
Title
Effects of the first phase of cardiac rehabilitation training on
self-efficacy among patients undergoing coronary artery bypass graft
surgery.
Source
Journal of Tehran University Heart Center. 13 (3) (pp 126-131), 2018. Date
of Publication: 15 Jul 2018.
Author
Borzou S.R.; Amiri S.; Salavati M.; Soltanian A.R.; Safarpoor G.
Institution
(Borzou) Chronic Diseases (Home Care) Research Center, Faculty of Nursing
and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran,
Islamic Republic of
(Amiri) Faculty of Nursing and Midwifery, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
(Salavati) Department of Nursing, Nursing & Midwifery Faculty, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Soltanian) Modeling of Noncommunicable Diseases Research Center, School
of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran,
Islamic Republic of
(Safarpoor) Department of Cardiac Surgery, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
Publisher
Tehran Heart Center (E-mail: abbasi.hesam@gmail.com)
Abstract
Background: Heart surgery is vital for patients with coronary artery
diseases that do not respond to drug treatments. We aimed to determine the
effects of the implementation of the first phase of a cardiac
rehabilitation program on self-efficacy in patients after coronary artery
bypass graft surgery (CABG). <br/>Method(s): This clinical trial study was
conducted on 60 post-CABG patients by convenience sampling method in 2016.
Those selected were randomly assigned to intervention (n=30) and control
group (n=30). Overall, 72 hours after CABG, the first phase of the cardiac
rehabilitation program both in theory and in practice (face-to-face and
group methods) was conducted. Data were collected using a self-efficacy
questionnaire completed by the patients in 3 stages: before the
intervention, at discharge, and at 1 month after discharge. Data was
analyzed by using analysis of covariance and repeated measures.
<br/>Result(s): The mean of age in the intervention and control groups was
61.60+/-11.72 and 57.97+/-13. 4 years, respectively. There were 16 (53.3%)
male patients in each group. The mean score of self-efficacy was not
significantly different between the 2 groups before the intervention
(P=0.076), whereas it had a meaningful statistical difference between the
2 groups at discharge and 1 month afterward (P<0.001). <br/>Conclusion(s):
The implementation of the first phase of the cardiac rehabilitation
program not only augmented self-efficacy in regard to independent daily
activities but also lessened the need for the second phase of the program
among our post-CABG patients.<br/>Copyright &#xa9; 2018, Tehran Heart
Center. All rights reserved.

<13>
Accession Number
618780250
Title
Gastrointestinal motility following thoracic surgery: The effect of
thoracic epidural analgesia. A randomised controlled trial.
Source
BMC Anesthesiology. 17 (1) (no pagination), 2017. Article Number: 139.
Date of Publication: 16 Oct 2017.
Author
Zoumprouli A.; Chatzimichali A.; Papadimitriou S.; Papaioannou A.; Xynos
E.; Askitopoulou H.
Institution
(Zoumprouli) St. George's University Hospitals NHS Foundation Trust,
Anaesthetic Department, Blackshaw Road, London SW17 0QT, United Kingdom
(Chatzimichali, Papaioannou) University Hospital of Heraklion, Anaesthetic
Department, Stavrakia, Heraklion 71110, Greece
(Papadimitriou) Asklipeion Kritis, 8 Zografou str, Heraklion, Greece
(Xynos) Creta interclinic, Colorectal Surgery, Heraklion. Crete, Greece
(Askitopoulou) University of Crete, Faculty of Medicine, Stavrakia,
Heraklion 71003, Greece
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Backgrounds: Impairment of gastrointestinal (GI) motility is an
undesirable but inevitable consequence of surgery. This prospective
randomised controlled study tested the hypothesis that postoperative
thoracic epidural analgesia (TEA) with ropivacaine or a combination of
ropivacaine and morphine accelerates postoperative GI function and
shortens the duration of postoperative ileus following major thoracic
surgery compared to intravenous (IV) morphine. <br/>Method(s): Thirty
patients scheduled for major thoracic surgery were randomised to three
groups. All patients had bowel motility assessments 1 week preoperatively.
All patients received general anaesthesia. Group Ep-R received TEA with
ropivacaine, group Ep-RM received TEA with ropivacaine and morphine and
group IV-M received IV morphine via patient controlled analgesia pump
(PCA). Bowel motility was assessed by clinical examination in addition to
oro-ceacal transit time (OCTT) on the first and third postoperative days
and colonic transit time (CTT). <br/>Result(s): Overall the OCTT
demonstrated a 2.5-fold decrease in bowel motility on the first
postoperative day. The OCTT test revealed statistically significant
differences between all groups (Ep-R vs Ep-RM, p = 0.43/Ep-R vs IV-M, p =
0.039 / Ep-RM vs IV-M, p < 0.001). Also, very significant differences were
found in the OCCT test between days (Ep-R vs Ep-RM, p < 0.001/Ep-R vs
IV-M, p < 0.001 / Ep-RM vs IV-M, p = 0.014). There were no significant
differences in the CTT test or the clinical signs between groups. However,
70% of the patients in the Ep-R group and 80% in the Ep-RM group defecated
by the third day compared to only 10% in the IV-M group, (p = 0.004).
<br/>Conclusion(s): Objective tests demonstrated the delayed motility of
the whole GI system postoperatively following thoracic surgery. They also
demonstrated that continuous epidural analgesia with or without morphine
improved GI motility in comparison to intravenous morphine. These
differences were more pronounced on the third postoperative day. Trial
registration: ISRCTN number: 11953159 , retrospectively registered on
20/03/2017.<br/>Copyright &#xa9; 2017 The Author(s).

<14>
Accession Number
619331856
Title
Comparison of tidal volume and deep breath preoxygenation techniques
undergoing coronary artery bypass graft surgery: Effects of hemodynamic
response and arterial oxygenation.
Source
Turkish Journal of Medical Sciences. 47 (5) (pp 1576-1582), 2017. Date of
Publication: 2017.
Author
Tas Z.; Hosten T.; Kus A.; Cesur S.; Turkyilmaz N.; Arikan A.; Solak Z.M.
Institution
(Tas, Hosten, Kus, Cesur, Turkyilmaz, Solak) Department of Anesthesiology
and Reanimation, Faculty of Medicine, Kocaeli University, Umuttepe,
Kocaeli, Turkey
(Arikan) Department of Cardiovascular Surgery, Faculty of Medicine,
Kocaeli University, Umuttepe, Kocaeli, Turkey
Publisher
Turkiye Klinikleri (Talapapa Bulvary no. 102, Hamammonu 1 06230, Turkey)
Abstract
Background/aim: Different techniques exist for the preoxygenation of
patients that will be operated on under general anesthesia. Preoxygenation
with the deep breath (DB) method may affect cardiovascular stability,
which is crucial for coronary artery bypass graft (CABG) patients. In this
study, we aimed to compare the effects of the 3 min TVB preoxygenation
technique and 1 min 8DBs technique on hemodynamic response and arterial
oxygenation in patients with normal ejection fraction that were scheduled
for elective CABG surgery. <br/>Material(s) and Method(s): Forty patients
classified as ASA II-III and scheduled for elective CABG surgery were
randomly assigned to TVB/3 min or 8DBs/1 min for preoxygenation.
Cardiovascular variables, i.e. heart rate, mean arterial pressure, central
venous pressure, cardiac index, systemic vascular resistance index, and
stroke volume index, and arterial blood gas samples were analyzed before
and after preoxygenation and at the end of the apneic period before
intubation. <br/>Result(s): The preoxygenation methods affected the
hemodynamic response similarly. PaO2 increased significantly with 8DBs
compared to the TVB at the end of preoxygenation but was similar between
the groups at the end of the apneic period (respectively, P: 0.03; P:
0.15). PaCO2 changes were similar between the groups. <br/>Conclusion(s):
In patients with normal ejection fraction scheduled for CABG, 8DBs can be
an alternative to TVB preoxygenation. Our results should be compared with
those of other studies.<br/>Copyright &#xa9; TUBITAK.

<15>
Accession Number
619567760
Title
Effect of adaptive support ventilation weaning mode in conventional or
standard methods on respiratory and hemodynamic performance indices: A
randomized clinical trial.
Source
Trauma Monthly. 22 (5) (no pagination), 2017. Article Number: e37663. Date
of Publication: September 2017.
Author
Nouri J.M.; Sohrabi B.; Moradian S.T.; Ghiasi S.M.S.
Institution
(Nouri, Sohrabi, Moradian) Nursing Faculty, Baqiyatallah University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Ghiasi) Medical Faculty, Anesthetist, Baqiyatallah University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Kowsar Medical Publishing Company (E-mail: editor@anesthpain.com)
Abstract
Background: Adaptive support ventilation (ASV) is one of the advanced
modes of ventilation. The available evidence regarding the process of
tracheal extubation indicates that staff working in intensive care unit
usually performs the weaning process according to their own experiences
and conventional methods. <br/>Objective(s): This study aimed to assess
the effect of weaning with adaptive support ventilation in two
conventional or standard methods on respiratory and hemodynamic
performance indices in patients undergoing coronary artery bypass graft
(CABG) surgery. <br/>Method(s): In this clinical trial, 100 patients
candidate for coronary artery bypass graft (CABG) surgery at Jamaran
hospital were allocated to experimental and control groups in 2015. Each
group had patients. The conventional method of ASV was used in the control
group without any intervention, while the standard method of ASV was
applied in the experimental group. The groups were compared in terms of
arterial blood gases, vital signs, atelectasis, and duration of weaning
process. <br/>Result(s): There was no statistically significant difference
between the experimental and control groups in terms of demographic
variables and disease history. Also, duration of mechanical ventilation
and weaning process, duration of the patient's trigger to the tracheal
extubation as well as other respiratory performance indicators and vital
signs were similar between the groups (P > 0.05). <br/>Conclusion(s): The
results of this study indicate that in stable patients who have no history
of lung problems, there is no need to apply the difficult weaning
protocol. These patients can be weaned without any
complication.<br/>Copyright &#xa9; 2016, Trauma Monthly.

<16>
Accession Number
618502277
Title
Changes in P2Y12 reaction units after switching treatments from prasugrel
to clopidogrel in Japanese patients with acute coronary syndrome followed
by elective coronary stenting.
Source
Cardiovascular Intervention and Therapeutics. 32 (4) (pp 341-350), 2017.
Date of Publication: 01 Oct 2017.
Author
Ueno T.; Koiwaya H.; Sasaki K.-I.; Katsuki Y.; Katsuda Y.; Murasato Y.;
Shimamatsu J.; Umeji K.; Otsuka Y.; Kawasaki T.; Shibata Y.; Fukumoto Y.
Institution
(Ueno, Sasaki, Fukumoto) Division of Cardiovascular Medicine, Department
of Internal Medicine, Kurume University School of Medicine, 67
Asahi-machi, Kurume 830-0011, Japan
(Koiwaya, Shibata) Department of Cardiology, Cardiovascular Center,
Miyazaki Medical Association Hospital, Miyazaki, Japan
(Katsuki) Division of Cardiology, Sugi Hospital, Omuta, Japan
(Katsuda) Division of Cardiovascular Internal Medicine, Fukuoka City
Medical Association Hospital, Fukuoka, Japan
(Murasato) Department of Cardiology, Kyushu Medical Center, Fukuoka, Japan
(Shimamatsu) Division of Cardiovascular Internal Medicine, Tanushimaru
Chuo Hospital, Kurume, Japan
(Umeji, Kawasaki) Department of Cardiology, Cardiovascular Center,
Shin-Koga Hospital, Kurume, Japan
(Otsuka) Department of Cardiology, Fukuoka Wajiro Hospital, Fukuoka, Japan
Publisher
Springer Tokyo (E-mail: orders@springer.jp)
Abstract
Patients with ischemic heart disease are administered a dual antiplatelet
therapy after percutaneous coronary intervention. This consists of aspirin
and thienopyridine, which can be switched from prasugrel to clopidogrel.
However, the impact of switching is unknown. This study aimed to determine
the efficacy and safety of switching from prasugrel to clopidogrel in
Japanese patients. One-hundred and thirty-six patients with acute coronary
syndrome scheduled to undergo percutaneous coronary intervention and
patients with coronary artery disease requiring elective coronary stenting
were enrolled. Patients were randomly assigned into the following groups:
prasugrel for 6 weeks at loading/maintenance doses of 20/3.75 mg
(Continued Group; n = 68) or prasugrel at 20/3.75 mg for 2 weeks followed
by clopidogrel at 75 mg for 4 weeks (Switched Group; n = 68). Aspirin
(loading dose/maintenance dose 324/81-100 mg/day) was coadministered in
both groups. The primary endpoint was the mean P2Y<inf>12</inf> reaction
unit (PRU) at week 6 and the secondary endpoint was the PRU in groups
subdivided based on the presence of CYP2C19 gene polymorphisms. At week 6,
the PRU was significantly lower in the Continued Group relative to the
Switched Group (140.7 and 183.0, respectively; P < 0.001), which was also
evident after correction with the baseline values (144.1 vs. 176.6,
respectively; P = 0.005). Extensive and poor metabolizers in the Switched
Group, based on CYP2C19 gene polymorphisms, had significantly higher PRU
values than those in the Continued Group. Thus, switching treatments from
prasugrel to clopidogrel significantly increased the PRU in patients
receiving antiplatelet therapy subsequent to percutaneous coronary
intervention. Clinical Trial Registration UMIN ID,
UMIN000015122.<br/>Copyright &#xa9; 2016, Japanese Association of
Cardiovascular Intervention and Therapeutics.

<17>
Accession Number
618515572
Title
Sevoflurane versus total intravenous anesthesia for cardiac surgery.
Source
International Journal of Clinical and Experimental Medicine. 10 (9) (pp
13739-13745), 2017. Article Number: IJCEM0062939. Date of Publication: 30
Sep 2017.
Author
Zhao X.; Wu X.; Xu G.
Institution
(Zhao, Wu, Xu) Department of Anesthesiology, People's Hospital of Xinjiang
Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, China
Publisher
E-Century Publishing Corporation (40 White Oaks Lane, Madison WI 53711,
United States)
Abstract
Objective: To compare the effect of sevoflurane and total intravenous
anesthesia (TIVA) on anesthesia induction, maintenance and postoperative
recovery in patients receiving cardiac surgeries. <br/>Method(s): Overall,
80 patients admitted in our hospital to receive cardiac surgery between
January 2015 and January 2017 were enrolled in our study. They were
randomized into the sevoflurane anesthesia (SA) group (n=40) and the total
intravenous anesthesia (TIVA) group (n=40) in terms of a random number
table. Between the two groups, anesthesia induction parameters including
time to pain-free, loss of eyelash reflex and intubation; anesthesia
maintenance parameters including cardiopulmonary bypass time, anesthesia
time, operation time, intraoperative mean arterial pressure (MAP), heart
rate (HR) and blood oxygen saturation (SpO<inf>2</inf>), the total dosage
of vasoactive agents (dopamine and nitroprusside) and urine volume; other
postoperative outcomes including length of hospital stay, adverse
reactions, complications and return of spontaneous heartbeat were
compared. <br/>Result(s): The time to pain-free, loss of eyelash reflex
and intubation in the SA group were strikingly shorter than those in the
TIVA group (P=0.031, P=0.045, P=0.016). MAP before intubation and HR
before intubation, immediately and 3min after intubation were observed to
be lower in the SA group (P=0.023, P=0.033, P=0.025, P=0.036). The time
for cardiopulmonary bypass (CPB), anesthesia and operation were
significantly shorter (P=0.031, P=0.018, P=0.017), urine volume was more
(P=0.009), and length of hospital stay was shorter (P=0.022) in the SA
group than in the TIVA group. Besides, a lower rate of return of
spontaneous heartbeat was also observed in the SA group (27.5%, 11/40) as
compared with that of the TIVA group (80.0%, 32/40; P<0.001). Between the
groups, no statistical differences were found in the incidences of
postoperative adverse reactions and complications (P>0.05).
<br/>Conclusion(s): Sevoflurane anesthesia requires shorter time for
anesthesia induction and maintenance, and it improves the postoperative
body rehabilitation in patients undergoing cardiac surgery as compared
with total intravenous anesthesia.<br/>Copyright &#xa9; 2017, E-Century
Publishing Corporation. All rights reserved.

<18>
Accession Number
620745323
Title
Effect of threshold inspiratory muscle training on maximal inspiratory
pressure and pulmonary gas exchange in patients undergoing coronary artery
bypass graft surgery.
Source
Critical Reviews in Physical and Rehabilitation Medicine. 28 (4) (pp
249-261), 2016. Date of Publication: 2016.
Author
Elmarakby A.
Institution
(Elmarakby) Utica College, New York, United States
Publisher
Begell House Inc. (E-mail: orders@begellhouse.com)
Abstract
Objective. We sought to determine the effect of threshold inspiratory
muscle training (IMT) on maximum inspiratory pressure (MIP), pulmonary gas
exchange and atelectasis in patients undergoing coronary
revascularization. Design. Overall, 33 male patients were randomly
assigned into intervention group (17 patients) and control group (16
patients). Both groups received customary physical therapy care. The
intervention group received threshold IMT using an inspiratory
threshold-loading device preoperatively, postoperatively (for 15 minutes
twice daily) and during the intensive care unit stay (30 deep breaths,
twice daily) against resistance equal to 30% of MIP. The workload was
increased or decreased based on the patient's perception of exertion or
fatigue using the Borg CR10 scale. MIP, oxygen saturation, and atelectasis
(by calculating the alveolar-arterial oxygen [A-a] gradient) were assessed
perioperatively. Result. Before hospital discharge, the MIP and SpO2 in
the intervention group were significantly higher in the intervention group
than in the control group. In the intervention group, the A-a gradient was
lower than that in the control group immediately after surgery and after
40 hours. Conclusion. IMT caused an increase in both MIP and SpO2 and a
decrease in the A-a gradient, achieving an improvement in gas exchange and
a reduction in atelectasis after coronary revascularization
surgery.<br/>Copyright &#xa9; 2016 by Begell House, Inc.

<19>
Accession Number
2003409935
Title
The REDUCE FMR Trial: A Randomized Sham-Controlled Study of Percutaneous
Mitral Annuloplasty in Functional Mitral Regurgitation.
Source
JACC: Heart Failure. 7 (11) (pp 945-955), 2019. Date of Publication:
November 2019.
Author
Witte K.K.; Lipiecki J.; Siminiak T.; Meredith I.T.; Malkin C.J.; Goldberg
S.L.; Stark M.A.; von Bardeleben R.S.; Cremer P.C.; Jaber W.A.; Celermajer
D.S.; Kaye D.M.; Sievert H.
Institution
(Witte, Malkin) Leeds Institute for Cardiovascular and Metabolic Medicine,
University of Leeds, Leeds, United Kingdom
(Lipiecki) Clinique Pole Sanioyte Republique, Clermont Ferrand, France
(Siminiak) Poznan University of Medical Sciences, HCP Medical Center,
Poznan, Poland
(Meredith) Faculty of Medicine, Nursing and Health Sciences, Monash
University, Melbourne, Australia
(Goldberg) Tyler Heart Institute at Community Hospital of the Monterey
Peninsula, Monterey, CA, United States
(Goldberg, Stark) Cardiac Dimensions, Kirkland, WA, United States
(von Bardeleben) Department of Cardiology, University Medical Centre
Mainz, Mainz, Germany
(Cremer, Jaber) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Celermajer) Faculty of Medicine and Health, University of Sydney, New
South Wales, Australia
(Kaye) Department of Cardiology, Alfred Hospital, Melbourne, Victoria,
Australia
(Sievert) CardioVascular Center Sankt Katherinen, Frankfurt, Germany
(Sievert) Anglia Ruskin University, Chelmsford, United Kingdom
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: This study sought to evaluate the effects of the Carillon
device on mitral regurgitation severity and left ventricular remodeling.
<br/>Background(s): Functional mitral regurgitation (FMR) complicates
heart failure with reduced ejection fraction and is associated with a poor
prognosis. <br/>Method(s): In this blinded, randomized, proof-of-concept,
sham-controlled trial, 120 patients receiving optimal heart failure
medical therapy were assigned to a coronary sinus-based mitral annular
reduction approach for FMR or sham. The pre-specified primary endpoint was
change in mitral regurgitant volume at 12 months, measured by quantitative
echocardiography according to an intention-to-treat analysis.
<br/>Result(s): Patients (69.8 +/- 9.5 years of age) were randomized to
either the treatment (n = 87) or the sham-controlled (n = 33) arm. There
were no significant differences in baseline characteristics between the
groups. In the treatment group, 73 of 87 (84%) had the device implanted.
The primary endpoint was met, with a statistically significant reduction
in mitral regurgitant volume in the treatment group compared to the
control group (decrease of 7.1 ml/beat [95% confidence interval [CI]:
-11.7 to -2.5] vs. an increase of 3.3 ml/beat [95% CI: -6.0 to 12.6],
respectively; p = 0.049). Additionally, there was a significant reduction
in left ventricular volumes in patients receiving the device versus those
in the control group (left ventricular end-diastolic volume decrease of
10.4 ml [95% CI: -18.5 to -2.4] vs. an increase of 6.5 ml [95% CI: -5.1 to
18.2]; p = 0.03 and left ventricular end-systolic volume decrease of 6.2
ml [95% CI: -12.8 to 0.4] vs. an increase of 6.1 ml [95% CI: -1.42 to
13.6]; p = 0.04). <br/>Conclusion(s): The Carillon device significantly
reduced mitral regurgitant volume and left ventricular volumes in
symptomatic patients with functional mitral regurgitation receiving
optimal medical therapy. (Carillon Mitral Contour System for Reducing
Functional Mitral Regurgitation [REDUCE FMR]; NCT02325830)<br/>Copyright
&#xa9; 2019 The Authors

<20>
Accession Number
2003221676
Title
The use of mannitol in cardiopulmonary bypass prime solution-Prospective
randomized double-blind clinical trial.
Source
Acta Anaesthesiologica Scandinavica. 63 (10) (pp 1298-1305), 2019. Date of
Publication: 01 Nov 2019.
Author
Ljunggren M.; Skold A.; Dardashti A.; Hyllen S.
Institution
(Ljunggren, Skold, Dardashti, Hyllen) Department of Cardiothoracic
Surgery, Anesthesia and Intensive Care, Skane University Hospital, Lund,
Sweden
(Dardashti, Hyllen) Department of Clinical Sciences, Cardiothoracic
Surgery, Lund University, Lund, Sweden
Publisher
Blackwell Munksgaard (E-mail: info@mks.blackwellpublising.com)
Abstract
Background: The optimal prime solution for the cardiopulmonary bypass
(CPB) circuit in adult cardiac surgery has not yet been defined. Mannitol
is widely used in the priming solution for CPB despite the fact that there
is no clear consensus on the role of mannitol in cardiac surgery. The aim
of this study was to investigate the effect of mannitol in the CPB prime
solution. <br/>Method(s): This prospective, randomized, double-blind study
included 40 patients with normal cardiac and renal functions, who
underwent coronary artery bypass grafting. One group received a prime
based on Ringer's acetate (n = 20), and the other a prime consisting of
Ringer's acetate with 200 mL mannitol (n = 20). Changes in osmolality,
acid-base status, electrolytes, and renal-related parameters were
monitored. <br/>Result(s): No significant differences were found in
osmolality between the Ringer's acetate group and the mannitol group at
any time. The mannitol group showed a pronounced decrease in sodium, from
138.7 +/- 2.8 mmol/L at anaesthesia onset, to 133.9 +/- 2.6 mmol/L after
the start of CPB (P <.001). No differences were seen in the renal
parameters between the groups, apart from a short-term effect of mannitol
on peroperative urine production (P =.003). <br/>Conclusion(s): We
observed no effects on osmolality of a prime solution containing mannitol
compared to Ringer's acetate-based prime in patients with normal cardiac
and renal function. The use of mannitol in the prime resulted in a
short-term, significant decrease in sodium level.<br/>Copyright &#xa9;
2019 The Authors. Acta Anaesthesiologica Scandinavica published by John
Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica
Foundation

<21>
Accession Number
629650673
Title
Comparative evaluation of hemodynamic responses and ease of intubation
with airtraq video laryngoscope versus macintosh laryngoscope in patients
with ischemic heart disease.
Source
Annals of Cardiac Anaesthesia. 22 (4) (pp 365-371), 2019. Date of
Publication: October-December 2019.
Author
Varsha A.V.; George G.; Pillai R.; Sahajanandan R.
Institution
(Varsha) Department of Cardiothoracic Surgery, Christian Medical College
and Hospital, Vellore, Tamil Nadu, India
(George, Pillai, Sahajanandan) Department of Anaesthesia, Christian
Medical College and Hospital, Vellore, Tamil Nadu, India
Publisher
Wolters Kluwer Medknow Publications (B9, Kanara Business Centre, off Link
Road, Ghatkopar (E), Mumbai 400 075, India)
Abstract
Introduction: Hemodynamic responses during laryngoscopy can potentially
precipitate ischemia in patients with coronary artery disease. There are
conflicting reports regarding the hemodynamic stress responses between the
conventional Macintosh and video laryngoscopes. There is a paucity of
studies regarding the same in cardiac surgical patients. <br/>Material(s)
and Method(s): A prospective, randomized control study to compare the
hemodynamic responses and ease of intubation using Airtraq video
laryngoscope and Macintosh laryngoscope in patients with ischemic heart
disease. <br/>Result(s): Seventy patients were randomized into two groups.
Baseline variables including age, weight, Mallampati score, and
comorbidities were comparable between the two groups. There was
statistically significant elevation in mean heart rate in the Macintosh
group at 2^nd-min (P = 0.02) and 3^rd-min (P = 0.05)
postintubation. Similarly, there was a significant increase in mean
arterial pressure at 2^nd (P = 0.06), 3^rd (P = 0.03),
and 4^th (P = 0.03) in the Macintosh group. The time for
laryngoscopy and Intubation Difficulty Scale was significantly better in
the Airtraq group (P = 0.001 and 0.001). However, the median time to
intubation was longer in the Airtraq group (13 s vs. 11 s, P = 0.05).
Laryngoscopy view was better with Airtraq even in patients with Mallampati
score 3 (ten patients). The incidence of trauma was same in both the
groups. <br/>Conclusion(s): Airtraq provides the better hemodynamic
stability and ease of intubation and may be considered superior to
conventional Macintosh laryngoscope for intubation in patients with
ischemic heart disease.<br/>Copyright &#xa9; 2019 Annals of Cardiac
Anaesthesia <br/> Published by Wolters Kluwer - Medknow.

<22>
Accession Number
629650626
Title
The comparison of dexmedetomidine, esmolol, and combination of
dexmedetomidine with esmolol for attenuation of sympathomimetic response
to laryngoscopy and intubation in patients undergoing coronary artery
bypass grafting.
Source
Annals of Cardiac Anaesthesia. 22 (4) (pp 353-357), 2019. Date of
Publication: October-December 2019.
Author
Singh D.; Jagannath S.; Priye S.; Mudassar A.S.
Institution
(Singh, Jagannath, Priye, Mudassar) Department of Anaesthesiology, Vydehi
Institute of Medical Sciences, Whitefield, Bengaluru, Karnataka 560 066,
India
Publisher
Wolters Kluwer Medknow Publications (B9, Kanara Business Centre, off Link
Road, Ghatkopar (E), Mumbai 400 075, India)
Abstract
Background: The aim of this study was to compare the effects of
dexmedetomidine, esmolol, and combination of both on control of
sympathetic response to laryngoscopy and tracheal intubation in coronary
artery disease patients. <br/>Material(s) and Method(s): A prospective,
randomized, double-blinded clinical study included 90 patients scheduled
for elective coronary artery bypass surgery. Patients were randomly
allocated into three groups of 30 each: dexmedetomidine group (Group D) 1
mug/kg, esmolol group (Group E) 2 mg/kg, and group dexmedetomidine with
esmolol (Group DE) 0.5 mug/kg of dexmedetomidine with 1 mg/kg of esmolol.
Each drug was diluted with 0.9% normal saline to 20 ml volume and infused
in 10 min before induction of anesthesia. Hemodynamic changes (heart rate
[HR], arterial blood pressure, and pulmonary artery pressure) were
compared at various time intervals as follows-baseline, after study drug,
after induction, and 1, 3, and 5 min after intubation. Statistical
analysis included analysis of variance, Chi-square, and Fisher's exact
test. <br/>Result(s): In Group DE, there was no significant increase in HR
at all-time intervals, and the HR was stable compared to Group D and Group
E. Blood pressure values were comparable in all groups except in Group E
at 5 min. The pulmonary arterial pressures were statistically less in DE
group except at 3 and 5 min. <br/>Conclusion(s): The combination of
dexmedetomidine and esmolol group has beneficial effect on HR and
pulmonary arterial pressures but has no additional advantage with respect
to arterial blood pressure when compared with dexmedetomidine and esmolol
groups in patients undergoing elective coronary artery bypass
grafting.<br/>Copyright &#xa9; 2019 Annals of Cardiac Anaesthesia <br/>
Published by Wolters Kluwer - Medknow.

<23>
[Use Link to view the full text]
Accession Number
629650333
Title
Five-Year Outcome After Off-Pump or On-Pump Coronary Artery Bypass
Grafting in Elderly Patients.
Source
Circulation. 139 (16) (pp 1865-1871), 2019. Date of Publication: 16 Apr
2019.
Author
Diegeler A.; Borgermann J.; Kappert U.; Hilker M.; Doenst T.; Boning A.;
Albert M.; Farber G.; Holzhey D.; Conradi L.; Riess F.-C.; Veeckmann P.;
Minorics C.; Zacher M.; Reents W.
Institution
(Diegeler, Zacher, Reents) Herz- und Gefas-Klinik Bad Neustadt, Salzburger
Leite 1, Bad Neustadt 97616, Germany
(Borgermann) Herz- und Diabeteszentrum, Bad Oeynhausen, Germany
(Kappert) Herzzentrum Dresden, Dresden, Germany
(Hilker) Universitatsklinik Regensburg, Regensburg, Germany
(Doenst, Farber) Universitatsklinik Jena, Jena, Germany
(Boning) Universitatsklinik Giessen, Giessen, Germany
(Albert) Robert Bosch Krankenhaus, Stuttgart, Germany
(Holzhey) Herzzentrum Universitat Leipzig, Germany
(Conradi) Universitatsklinik Hamburg-Eppendorf, Hamburg, Germany
(Ries) Albertinen Herz- und Gefaszentrum, Hamburg, Germany
(Veeckmann) Klinikum fur Herzchirurgie Karlsruhe, Germany
(Minorics) Universitat Bochum, Germany
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: The 30-day and 1-year follow-up analysis of the GOPCABE trial
(German Off-Pump Coronary Artery Bypass Grafting in Elderly Patients)
revealed no significant difference in the composite end point consisting
of death, stroke, myocardial infarction, new renal replacement therapy, or
repeat revascularization. The 5-year follow-up data of this trial are
reported here. <br/>Method(s): From June 2008 to September 2011, a total
of 2539 patients aged >=75 years were randomly assigned to undergo
off-pump or on-pump coronary artery bypass grafting (CABG) at 12 centers
in Germany. The primary outcome was all-cause mortality at 5 years. The
secondary 5-year outcomes were a composite of death, myocardial
infarction, and repeat revascularization. Furthermore, the impact of
complete versus incomplete revascularization was assessed. <br/>Result(s):
After a median follow-up of 5 years, 361 patients (31%) assigned to
off-pump CABG and 352 patients (30%) assigned to on-pump CABG had died
(hazard ratio off-pump/on-pump CABG, 1.03; 95% CI, 0.89-1.19; P=0.71). The
composite outcome of death, myocardial infarction, and repeat
revascularization occurred in 397 (34%) after off-pump and in 389 (33%)
after on-pump CABG (hazard ratio, 1.03; 95% CI, 0.89-1.18; P=0.704).
Incomplete revascularization occurred in 403 (34%) patients randomly
assigned to off-pump and 354 (29%) patients randomly assigned to on-pump
CABG (P<0.001). Five-year survival rates were 72% (95% CI, 67-76) with
incomplete versus 76% (95% CI, 74-80) with complete revascularization
(log-rank test: P=0.02) after off-pump CABG and 72% (95% CI, 67-76) versus
77% (95% CI, 74-80) after on-pump CABG (log-rank test: P=0.03),
respectively. Cox regression analysis revealed a hazard ratio
incomplete/complete revascularization of 1.19 (95% CI, 1.01-1.39; P=0.04).
<br/>Conclusion(s): In elderly patients >=75 years of age, the 5-year
survival rates and the combined outcome of death, myocardial infarction,
and repeat revascularization, as well, were similar after on-pump and
off-pump CABG. Incomplete revascularization was associated with a lower
5-year survival rate, irrespective of the type of surgery.<br/>Copyright
&#xa9; 2019 American Heart Association, Inc.

<24>
[Use Link to view the full text]
Accession Number
629649728
Title
Effect of High-Intensity Interval Training in De Novo Heart Transplant
Recipients in Scandinavia: One-Year Follow-Up of the HITTS Randomized,
Controlled Study.
Source
Circulation. 139 (19) (pp 2198-2211), 2019. Date of Publication: 07 May
2019.
Author
Nytroen K.; Rolid K.; Andreassen A.K.; Yardley M.; Gude E.; Dahle D.O.;
Bjorkelund E.; Relbo Authen A.; Grov I.; Philip Wigh J.; Have Dall C.;
Gustafsson F.; Karason K.; Gullestad L.
Institution
(Nytroen, Rolid, Andreassen, Yardley, Gude, Bjorkelund, Relbo Authen,
Grov, Gullestad) Departments of Cardiology, Oslo University Hospital
Rikshospitalet, Postbox 4950, Nydalen, Oslo 0424, Norway
(Dahle) Transplantation Medicine, Oslo University Hospital Rikshospitalet,
Norway
(Nytroen, Rolid, Andreassen, Yardley, Gullestad) Institute of Clinical
Medicine, Faculty of Medicine, University of Oslo, Norway
(Nytroen, Rolid, Gude, Gullestad) KG Jebsen Center for Cardiac Research,
University of Oslo, Norway
(Rolid, Yardley) Norwegian Health Association, Oslo, Norway
(Philip Wigh, Karason) Transplant Institute, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Have Dall) Department of Cardiology, Bispebjerg University Hospital,
Copenhagen, Denmark
(Have Dall, Gustafsson) University of Copenhagen, Denmark
(Gustafsson) Rigshospitalet, Copenhagen, Denmark
(Nytroen, Rolid, Gude, Gullestad) Center for Heart Failure Research, Oslo
University Hospital, Norway
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: There is no consensus on how, when, or at what intensity
exercise should be performed after heart transplantation (HTx). We have
recently shown that high-intensity interval training (HIT) is safe, well
tolerated, and efficacious in the maintenance state after HTx, but studies
have not investigated HIT effects in the de novo HTx state. We
hypothesized that HIT could be introduced early after HTx and that it
could lead to clinically meaningful increases in exercise capacity and
health-related quality of life. <br/>Method(s): This multicenter,
prospective, randomized, controlled trial included 81 patients a mean of
11 weeks (range, 7-16 weeks) after an HTx. Patients were randomized 1:1 to
9 months of either HIT (4x4-minute intervals at 85%-95% of peak effort) or
moderate-intensity continuous training (60%-80% of peak effort). The
primary outcome was the effect of HIT versus moderate-intensity continuous
training on the change in aerobic exercise capacity, assessed as the peak
oxygen consumption (Vo<inf>2</inf>peak). Secondary outcomes included
tolerability, safety, adverse events, isokinetic muscular strength, body
composition, health-related quality of life, left ventricular function,
hemodynamics, endothelial function, and biomarkers. <br/>Result(s): From
baseline to follow-up, 96% of patients completed the study. There were no
serious exercise-related adverse events. The population comprised 73% men,
and the mean+/-SD age was 49+/-13 years. At the 1-year follow-up, the HIT
group demonstrated greater improvements than the moderate-intensity
continuous training group; the groups showed significantly different
changes in the Vo<inf>2</inf>peak (mean difference between groups, 1.8
mL.kg^-1.min^-1), the anaerobic threshold (0.28
L/min), the peak expiratory flow (11%), and the extensor muscle exercise
capacity (464 J). The 1.8-mL.kg^-1.min^-1 difference
was equal to =0.5 metabolic equivalents, which is regarded as clinically
meaningful and relevant. Health-related quality of life was similar
between the groups, as indicated by results from the Short Form-36
(version 2), Hospital Anxiety and Depression Scale, and a visual analog
scale. <br/>Conclusion(s): We demonstrated that HIT was a safe, efficient
exercise method in de novo HTx recipients. HIT, compared with
moderate-intensity continuous training, resulted in a clinically
significantly greater change in exercise capacity based on the
Vo<inf>2</inf>peak values (25% versus 15%), anaerobic threshold, peak
expiratory flow, and muscular exercise capacity. Clinical Trial
Registration: URL: https://www.clinicaltrials.gov. Unique identifier
NCT01796379.<br/>Copyright &#xa9; 2019 American Heart Association, Inc.

<25>
Accession Number
627182938
Title
Exercise testing after chronic total coronary occlusion revascularization
in patients with STEMI and a concurrent CTO: A subanalysis of the
EXPLORE-trial.
Source
Catheterization and Cardiovascular Interventions. 94 (4) (pp 536-545),
2019. Date of Publication: 01 Oct 2019.
Author
van Veelen A.; van Dongen I.M.; Elias J.; Ramunddal T.; Eriksen E.; van
der Schaaf R.J.; Claessen B.E.P.M.; Postema P.G.; Henriques J.P.S.
Institution
(van Veelen, van Dongen, Elias, Claessen, Postema, Henriques) Department
of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC,
University of Amsterdam, Heart Center, Netherlands
(van Dongen, van der Schaaf) Department of Cardiology, OLVG Hospital,
Amsterdam, Netherlands
(Ramunddal) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Eriksen) Department of Cardiology, Haukeland University Hospital, Bergen,
Norway
(Claessen) Department of Cardiology, Mount Sinai Hospital, New York City,
NY, United States
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objectives: To assess the effect of chronic total occlusion percutaneous
coronary intervention (CTO PCI) on ventricular ectopy (VE) and
symptomatology during exercise testing. <br/>Background(s): During
exercise, the hypoxic myocardium in the CTO-territory can act as a
substrate for VE and could lead to anginal complaints. <br/>Method(s): In
the EXPLORE-trial, 302 ST-segment elevation myocardial infarction
(STEMI)-patients were randomized to CTO PCI or no-CTO PCI. For this
sub-study, we analyzed all available exercise electrocardiograms (X-ECGs)
at 4 months follow-up on symptoms and electrocardiographic parameters.
<br/>Result(s): A total of 155 X-ECGs were available, 80 in the CTO PCI
group (51.6%) and 75 in the no-CTO PCI group (48.4%). There were no
differences regarding exercised time, achieved endurance, ST-deviation nor
maximum heart-rate. The percentage of patients experiencing chest-pain
during exercise was lower in the CTO PCI group (0% vs. 8.5%, p =.03).
Also, there was a trend towards a higher maximum systolic blood pressure
(SBP, 185 mmHg vs. 175, p =.09). No difference in VE was found between
randomization groups, but patients with successful CTO PCI had a higher
frequency of VE, compared to failed and no-CTO PCI (26% vs. 8%, p =.02).
This did not result in higher frequencies of sustained ventricular
arrhythmias or mortality. <br/>Conclusion(s): In conclusion, in
STEMI-patients, CTO PCI is associated with a small reduction of chest-pain
during exercise and tended to be associated with an increase of maximum
SBP. The observation that successful CTO PCI was associated with more VE
during exercise, compared with failed/no-CTO PCI needs further
exploration.<br/>Copyright &#xa9; 2019 Wiley Periodicals, Inc.

<26>
Accession Number
2002908819
Title
In-Hospital Physiotherapy and Physical Recovery 3 Months After Lung Cancer
Surgery: A Randomized Controlled Trial.
Source
Integrative Cancer Therapies. 18 (no pagination), 2019. Date of
Publication: 2019.
Author
Jonsson M.; Ahlsson A.; Hurtig-Wennlof A.; Vidlund M.; Cao Y.; Westerdahl
E.
Institution
(Jonsson, Hurtig-Wennlof, Vidlund, Cao, Westerdahl) Orebro University,
Orebro, Sweden
(Ahlsson) Karolinska University Hospital, Stockholm, Sweden
(Cao) Karolinska Institutet, Stockholm, Sweden
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Background. Lung cancer is the most frequently diagnosed cancer and one of
the leading causes of cancer deaths. Surgery is the primary approach for
curative treatment. Postoperative complications are common, and
physiotherapy is often routinely provided for their prevention and
treatment, even though the evidence is limited. The aim of this study was
to examine the effect of in-hospital physiotherapy on postoperative
physical capacity, physical activity, and lung function among patients
undergoing lung cancer surgery. Methods. A total of 107 patients
undergoing elective thoracic surgery were included in a single-blinded
randomized controlled trial, and randomized to a study group, receiving
in-hospital physiotherapy treatment, or a control group, not receiving
in-hospital physiotherapy treatment. The patients were assessed
preoperatively and 3 months after surgery. The in-hospital physiotherapy
treatment consisted of early mobilization, ambulation, breathing
exercises, and thoracic range of motion exercises. Physical capacity was
assessed with the 6-minute walk test. Level of physical activity was
objectively assessed with an accelerometer and subjectively assessed with
the International Physical Activity Questionnaire Modified for the
Elderly. Results. Physical capacity for the whole sample was significantly
decreased 3 months postoperatively compared with preoperative values (P
=.047). There were no statistically significant differences between the
groups regarding physical capacity, physical activity, spirometric values,
or dyspnea. However, patients in the study group increased their level of
self-reported physical activity from preoperatively to 3 months
postoperatively, while the patients in the control group did not.
Conclusions. No difference in physical capacity, physical activity, or
lung function was found 3 months postoperatively in lung cancer surgery
patients receiving in-hospital physiotherapy compared with control
patients.<br/>Copyright &#xa9; The Author(s) 2019.

<27>
Accession Number
629644099
Title
Prevention of Stroke in Atrial Fibrillation after Coronary Stenting:
Systematic Review and Network Meta-Analysis.
Source
Stroke. 50 (8) (pp 2125-2132), 2019. Date of Publication: 01 Aug 2019.
Author
Knijnik L.; Rivera M.; Blumer V.; Cardoso R.; Fernandes A.; Fernandes G.;
Ferreira T.; Romano J.G.; Lambrakos L.K.; Cohen M.G.
Institution
(Knijnik, Fernandes, Fernandes, Ferreira) Department of Internal Medicine,
University of Miami Miller, School of Medicine, 1611 NW 12th Ave, Miami,
FL 33136, United States
(Lambrakos, Cohen) Cardiovascular Division, Department of Medicine,
University of Miami Miller, School of Medicine, FL, United States
(Romano) Department of Neurology, University of Miami Miller, School of
Medicine, FL, United States
(Rivera) Cardiovascular Division, Washington University, School of
Medicine, St. Louis, MO, United States
(Blumer) Cardiovascular Division, Duke University Hospital, Durham, NC,
United States
(Cardoso) Division of Cardiology, Johns Hopkins Medical Institutions,
Baltimore, MD, United States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background and Purpose-The optimal antithrombotic strategy to balance
thromboembolic and bleeding events, especially acute stroke, for patients
with atrial fibrillation following coronary stenting remains a matter of
debate. We conducted a network meta-analysis to identify the
antithrombotic regimen associated with the lowest rate of bleeding and
thromboembolic events in atrial fibrillation after coronary stenting.
Methods-PubMed, Scopus, and Cochrane Central were searched for randomized
controlled trials and observational studies of patients with atrial
fibrillation after coronary stenting. The outcomes of interest were
stroke, myocardial infarction, major adverse cardiac events, mortality,
and major bleeding. A network meta-analysis was performed comparing the
available antithrombotic regimens in the literature. Results-Three
randomized and 15 observational studies were included, with a total of 23
478 participants. Median follow-up was 2 years. Network meta-analysis
demonstrated that Vitamin K antagonist plus single antiplatelet therapy or
direct-acting oral anticoagulant plus single antiplatelet therapy were the
most effective regimens in preventing stroke. Direct-acting oral
anticoagulant regimens were associated with lower major bleeding rates
than Vitamin K antagonist regimens. Regimens with dual antiplatelet
therapy were associated with lower rates of myocardial infarction. Vitamin
K antagonist plus dual antiplatelet therapy was associated with a lower
mortality and low-dose direct-acting oral anticoagulants with decreased
major cardiovascular adverse events. Conclusions-Direct-acting oral
anticoagulant regimens were associated with less major bleeding and major
cardiovascular adverse events, but Vitamin K antagonists were associated
with decreased mortality and stroke. These results suggest that the
decision of antithrombotic therapy in patients with atrial fibrillation
after percutaneous coronary intervention needs to be
individualized.<br/>Copyright &#xa9; 2019 American Heart Association, Inc.

<28>
Accession Number
2002712331
Title
Safety and efficacy of biatrial vs left atrial surgical ablation during
concomitant cardiac surgery: A meta-analysis of clinical studies with a
focus on the causes of pacemaker implantation.
Source
Journal of Cardiovascular Electrophysiology. 30 (10) (pp 2150-2163), 2019.
Date of Publication: 01 Oct 2019.
Author
Cappabianca G.; Ferrarese S.; Tutino C.; Corazzari C.; Matteucci M.;
Mantovani V.; Musazzi A.; De Ponti R.; Beghi C.
Institution
(Cappabianca, Ferrarese, Tutino, Corazzari, Matteucci, Mantovani, Musazzi,
De Ponti, Beghi) Department of Heart and Vessels, Ospedale di Circolo,
University of Insubria, Varese, Italy
(Cappabianca, Ferrarese, Tutino, Corazzari, Matteucci, Mantovani, Musazzi,
De Ponti, Beghi) Cardiac Surgery Research Center, University of Insubria,
Varese, Italy
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Introduction: The latest STS guidelines recommend concomitant atrial
fibrillation (AF) ablation not only during mitral surgery (Class IA) but
also during other-than-mitral cardiac surgery procedures (Class IB) in
patients with preoperative AF. Conventional Cox-Maze III/IV procedures are
performed on both atria (BA), but several studies reported excellent
results with left atrial only (LA) ablations: the scope of this study is
to compare the safety and efficacy of BA vs LA approach. <br/>Methods and
Results: Pubmed, Scopus, and WOS were searched from inception to November
2018: 28 studies including 7065 patients and comparing the performance of
BA vs LA approaches were identified: of these, 16 (57.1%) enrolled
exclusively patients with non-paroxysmal AF forms, 10 (35.7%) focused on
mitral surgery as main procedure, and 16 (57.1%) regarded patients
undergone Cox-Maze with radiofrequency. The 6- and 12-months prevalence of
sinus rhythm were higher in the BA group (OR, 1.37, CI, 1.09-1.73, P =.008
and OR, 1.37, CI, 0.99-1.88, P =.05 respectively). Permanent pacemaker
(PPM) implantation (OR, 1.85, CI, 1.38-2.49, P <.0001) and reopening for
bleeding (OR, 1.70, CI, 1.05-2.75, P =.03) were higher in the BA group.
Among patients undergone PPM implantation, BA group had a significantly
higher risk of sinoatrial node dysfunction (OR, 3.01, CI, 1.49-6.07, P
=.002). <br/>Conclusion(s): Concomitant BA ablation appears superior to LA
ablation in terms of efficacy but is associated with a higher risk of
bleeding and of PPM implantation, more frequently due to sinoatrial node
dysfunction. LA approach should be preferable in patients with a higher
risk of bleeding or with perioperative risk factors for PPM
implantation.<br/>Copyright &#xa9; 2019 Wiley Periodicals, Inc.

<29>
Accession Number
2002617426
Title
Current status of robot-assisted thoracoscopic surgery for lung cancer.
Source
Surgery Today. 49 (10) (pp 795-802), 2019. Date of Publication: 01 Oct
2019.
Author
Kanzaki M.
Institution
(Kanzaki) Department of Thoracic Surgery, School of Medicine, Tokyo
Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666,
Japan
Publisher
Springer Tokyo (E-mail: orders@springer.jp)
Abstract
The robotic surgical system was designed to overcome the drawbacks of
conventional endoscopic surgery. Since national health insurance in Japan
began covering robotic-assisted thoracoscopic surgery (RATS) for malignant
lung and mediastinal tumors in 2018, the number of RATS procedures being
performed domestically has increased rapidly. This review evaluates the
advantages and disadvantages of RATS for patients with lung cancers, based
on an electronic literature search of PubMed. The main advantages of RATS
are its ability to achieve excellent lymph-node removal with low morbidity
and mortality, and minimal postoperative pain. Conversely, its
disadvantages include a long operation time and the need for specialized
instruments. However, the learning curve for RATS is reported to be
shorter than that for VATS: some studies recommend that a surgeon needs to
perform 18-22 robotic operations to attain sufficient skill. RATS for lung
cancer is more expensive than VATS and the cost of training is high.
Although the main disadvantage of RATS is that it reduces operator's
tactile senses, the endoscope, which is directly manipulated by the
surgeon at the console, using various magnifications, and 3D HD images on
the monitor, may compensate for this. Ultimately, RATS offers better
maneuverability, accuracy, and stability over VATS.<br/>Copyright &#xa9;
2019, Springer Nature Singapore Pte Ltd.

<30>
Accession Number
622474694
Title
Effect of preoperative warming on intraoperative hypothermia: a
randomized-controlled trial.
Source
Canadian Journal of Anesthesia. 65 (9) (pp 1029-1040), 2018. Date of
Publication: 01 Sep 2018.
Author
Lau A.; Lowlaavar N.; Cooke E.M.; West N.; German A.; Morse D.J.; Gorges
M.; Merchant R.N.
Institution
(Lau, Lowlaavar, Cooke, West, Gorges, Merchant) Department of
Anesthesiology, Pharmacology, & Therapeutics, University of British
Columbia, Vancouver, BC, Canada
(German) Graduate School of Medicine, University of Wollongong,
Wollongong, Australia
(Morse) 3M Infection Prevention Division, 3M Corporation, St. Paul, MN,
United States
(Gorges) Research Institute, BC Children's Hospital, Vancouver, BC, Canada
(Merchant) Department of Anesthesia and Perioperative Medicine, Royal
Columbian Hospital, Fraser Health Authority, New Westminster, BC, Canada
Publisher
Springer New York LLC (E-mail: barbara.b.bertram@gsk.com)
Abstract
Purpose: The purpose of this study was to evaluate the effects of
preoperative forced-air warming on intraoperative hypothermia.
<br/>Method(s): In this randomized-controlled trial, adult patients
scheduled for elective, non-cardiac surgery under general anesthesia were
stratified by scheduled surgical duration (< 2.5 hr or >= 2.5 hr) and then
randomized to a pre-warming group using a BairPawsTM forced-air warming
system for at least 30 min preoperatively or to a control group with
warmed blankets on request. All patients were warmed intraoperatively via
convective forced-air warming blankets. Perioperative temperature was
measured using the SpotOnTM temperature system consisting of a single-use
disposable sensor applied to the participant's forehead. The primary
outcome was the magnitude of intraoperative hypothermia calculated as the
area under the time-temperature curve for core temperatures < 36degreeC
between induction of general anesthesia and leaving the operating room.
Secondary outcomes included surgical site infections, packed red blood
cell requirements, and 24 hr postoperative opioid consumption.
<br/>Result(s): Two hundred participants were analyzed (101 control; 99
pre-warmed). Pre-warmed participants had a lower median [interquartile
range] magnitude of hypothermia than controls (0.00 [0.00-0.12]
degreeC.hr^-1vs 0.05 [0.00-0.36] degreeC.hr^-1,
respectively; median difference, -0.01degreeC.hr^-1; 95%
confidence interval, -0.04 to 0.00degreeC.hr^-1; P = 0.005).
There were no between-group differences in the secondary outcomes.
<br/>Conclusion(s): A minimum of 30 min of preoperative forced-air
convective warming decreased the overall intraoperative hypothermic
exposure. While redistribution hypothermia still occurs despite pre- and
intraoperative forced-air warming, their combined application results in
greater preservation of intraoperative normothermia compared with
intraoperative forced-air warming alone. Trial registration:
www.clinicaltrials.gov (NCT02177903). Registered 25 June
2014.<br/>Copyright &#xa9; 2018, Canadian Anesthesiologists' Society.

<31>
Accession Number
625824043
Title
Effect of dexmedetomidine or propofol sedation on haemodynamic stability
of patients after thoracic surgery.
Source
Anaesthesiology Intensive Therapy. 50 (5) (pp 359-366), 2018. Date of
Publication: 31 Dec 2018.
Author
Bialka S.; Copik M.; Karpe J.; Przybyla M.; Sliwczynska M.; Czyzewski D.;
Misiolek H.
Institution
(Bialka, Copik, Karpe, Przybyla, Sliwczynska, Misiolek) Department of
Anaesthesiology and Intensive Care, School of Medicine, Division of
Dentistry in Zabrze, Medical University of Silesia, 3 Maja 13-15, Zabrze
41-800, Poland
(Czyzewski) Department of Thoracic Surgery, School of Medicine, Division
of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
Publisher
Via Medica (Ul. Swietokrzyska 73, Gdansk 80-180, Poland. E-mail:
elzbieta.zabrocka@viamedica.pl)
Abstract
Background: Dexmedetomidine and propofol are commonly used sedative agents
in non-invasive ventilation as they allow for straightforward arousal and
are easily controllable to a relative degree. Moreover, dexmedetomidine is
associated with a low risk of respiratory depression. However, both agents
are associated with significant haemodynamic side effects. The primary aim
of this study is to compare the influence of both drugs on haemodynamic
effects in patients after thoracic surgical procedures receiving
dexmedetomidine or propofol for non-invasive postoperative ventilation.
<br/>Method(s): A prospective, randomised, observational study conducted
in a university hospital. <br/>Intervention(s): Continuous sedation with
dexmedetomidine or propofol for six hours of postoperative non-invasive
ventilation after thoracic surgery, with concomitant use of continuous
epidural analgesia. <br/>Result(s): A total of 38 patients (20 on
dexmedetomidine and 18 on propofol) were included in the analysis. The
primary findings of this study were that although the heart rate, along
with the systolic and mean arterial blood pressure did not differ
significantly between the groups (P = 0.87; P = 0.42; P = 0.13,
respectively), diastolic arterial blood pressure was significantly higher
in the propofol group (P = 0.02). A comparative analysis of epinephrine
usage did not reveal significant differences between the groups. Although
cardiac output (P = 0.36) and cardiac index (P = 0.36) analyses did not
show significant differences between the groups, there is a clear tendency
toward lower values of CO/CI in the group receiving propofol. While we
also observed a similar tendency in the stroke volume index and stroke
volume variation values, these differences did not reach statistical
significance either (P = 0.16; P = 0.64, respectively). Despite systemic
vascular resistance index values being higher in the propofol group,
exceeding reference values, similarly, the difference between the groups
was not significant (P = 0.36). <br/>Conclusion(s): The main finding of
this study is that dexmedetomidine and propofol provide similar advantages
in haemodynamic stability during short-term sedation for non-invasive
ventilation after thoracic surgical procedures in patients receiving
continuous epidural analgesia.<br/>Copyright &#xa9; 2018 Via Medica. All
rights reserved.

<32>
Accession Number
2003476963
Title
Current state of leadless pacemakers: state of the art review.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2019. Date of
Publication: 2019.
Author
Afzal M.R.; Shah N.; Daoud G.; Houmsse M.
Institution
(Afzal, Daoud, Houmsse) Division of Cardiovascular Medicine, Wexner
Medical Center at the Ohio State University Medical Center, Columbus, OH,
United States
(Shah) Department of internal Medicine, St. Mary Mercy Hospital, Livonia,
MI, United States
Publisher
Taylor and Francis Ltd
Abstract
Introduction: Leadless pacemakers (LPs) are the latest advancement in the
field of pacing. Experience from pivotal trials and post-marketing studies
has proven the feasibility and safety of these devices. The LPs obviate
the need of pulse generator pocket and leads, which translates into lower
incidence of lead related complications and pocket related infections.
This review will summarize the existing literature on the LPs,
specifically indications; implant procedure, unique situations and long-
term follow up. Areas covered: This review will summarize the results of
published pivotal trials. Several multicenter studies where LP was used in
the unique situations such as during concomitant AV node ablation and
across bioprosthetic valve will also be discussed. An extensive search
using PUBMED was performed to identify the relevant articles. Expert
commentary: The use of LPs is expanding and the published results a
preferential use of such devices for patients who need single ventricle
pacing. Additionally, the use of these devices in several unique
situations such as patients with inferior vena cava filters, bioprosthetic
tricuspid valves and concomitant atrio-ventricular nodal (AV) ablation has
also been shown to be safe.<br/>Copyright &#xa9; 2019, &#xa9; 2019 Informa
UK Limited, trading as Taylor & Francis Group.

<33>
Accession Number
2003474279
Title
Transfusion-related immunomodulation: gamma irradiation alters the effects
of leukoreduction on alloimmunization.
Source
Transfusion. (no pagination), 2019. Date of Publication: 2019.
Author
Nelson K.A.; Aldea G.S.; Warner P.; Latchman Y.; Gunasekera D.; Tamir A.;
Gernsheimer T.; Bolgiano D.; Slichter S.J.
Institution
(Nelson, Warner, Latchman, Gunasekera, Tamir, Gernsheimer, Bolgiano,
Slichter) Bloodworks Northwest, Seattle, WA, United States
(Aldea) Department of Surgery, Division of Cardiothoracic Surgery,
University of Washington, Seattle, WA, United States
(Latchman) Silverback Therapeutics, Seattle, WA, United States
(Gunasekera) Uniformed Services University of Health Sciences, Bethesda,
MD, United States
(Gernsheimer, Slichter) Division of Hematology, University of Washington
School of Medicine, Seattle, WA, United States
(Gernsheimer, Slichter) Seattle Cancer Care Alliance, Seattle, WA, United
States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
BACKGROUND: Adverse events following blood transfusion include
allosensitization and generalized immunosuppression, collectively referred
to as transfusion-related immune modulation. We evaluated the
immunological effects of red blood cell (RBC) and platelet transfusions on
alloantibody responses and on immunoregulatory cells in
nonimmunosuppressed patients undergoing cardiovascular surgery. STUDY
DESIGN AND METHODS: Patients were randomized to receive standard
unmodified (STD), leukoreduced (LR), or leukoreduced and gamma-irradiated
(LRgamma) RBCs. Patients received only apheresis platelets that were
in-process LR and were gamma-irradiated for the third arm. Nontransfused
patients served as controls for the effects of surgery itself on
immunologic changes. Antibodies to HLA were assessed with use of
solid-phase assays. The effects of transfusion on adaptive and innate
immunity were evaluated by assessing T regulatory cells (Tregs) and
invariant natural killer T (iNKT) cells. <br/>RESULT(S): LR of blood
products reduced the development of human leukocyte antigen (HLA)
alloantibodies, but only in patients without preexisting HLA antibodies.
However, if LR blood products were gamma-irradiated, HLA antibody
production was not reduced. Compared to nontransfused patients, recipients
of STD or LR transfusions showed a significant increase in
CD4+CD25^hi T cells expressing FoxP3 or CTLA4 and also of iNKT
cells producing interleukin-4. In contrast, recipients of LRgamma blood
products showed markedly lower increases in all three cellular assays.
<br/>CONCLUSION(S): LR decreased HLA alloantibody production in naive
recipients, but did not reduce the immunosuppressive effects of
transfusion. LRgamma reduced immunosuppression and was not associated with
decreased HLA alloantibody production.<br/>Copyright &#xa9; 2019 AABB

<34>
Accession Number
2003473849
Title
Effects of Zoledronate on Cancer, Cardiac Events, and Mortality in
Osteopenic Older Women.
Source
Journal of Bone and Mineral Research. (no pagination), 2019. Date of
Publication: 2019.
Author
Reid I.R.; Horne A.M.; Mihov B.; Stewart A.; Garratt E.; Bastin S.; Gamble
G.D.
Institution
(Reid, Horne, Mihov, Stewart, Garratt, Gamble) Department of Medicine,
Faculty of Medical and Health Sciences, University of Auckland, Auckland,
New Zealand
(Reid, Bastin) Auckland District Health Board, Auckland, New Zealand
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
We recently showed that zoledronate prevented fractures in older women
with osteopenia (hip T-scores between -1.0 and -2.5). In addition to fewer
fractures, this study also suggested that women randomized to zoledronate
had fewer vascular events, a lower incidence of cancer, and a trend to
lower mortality. The present analysis provides a more detailed
presentation of the adverse event data from that study, a 6-year,
double-blind trial of 2000 women aged >65 years recruited using electoral
rolls. They were randomly assigned to receive four infusions of either
zoledronate 5 mg or normal saline at 18-month intervals. Supplements of
vitamin D, but not calcium, were provided. There were 1017 serious adverse
events in 443 participants in the placebo group, and 820 events in 400
participants in those randomized to zoledronate (relative risk = 0.90; 95%
CI, 0.81 to 1.00). These events included fractures resulting in hospital
admission. Myocardial infarction occurred in 39 women (43 events) in the
placebo group and in 24 women (25 events) in the zoledronate group (hazard
ratio 0.60 [95% CI, 0.36 to 1.00]; rate ratio 0.58 [95% CI, 0.35 to
0.94]). For a prespecified composite cardiovascular endpoint (sudden
death, myocardial infarction, coronary artery revascularization, or
stroke) 69 women had 98 events in the placebo group, and 53 women had 71
events in the zoledronate group (hazard ratio 0.76 [95% CI, 0.53 to 1.08];
rate ratio 0.72 [95% CI, 0.53 to 0.98]). Total cancers were significantly
reduced with zoledronate (hazard ratio 0.67 [95% CI, 0.51 to 0.89]; rate
ratio 0.68 [95% CI, 0.52 to 0.89]), and this was significant for both
breast cancers and for non-breast cancers. Eleven women had recurrent or
second breast cancers during the study, all in the placebo group. The
hazard ratio for death was 0.65 (95% CI, 0.40 to 1.06; p = 0.08), and 0.51
(95% CI, 0.30 to 0.87) in those without incident fragility fracture. These
apparent beneficial effects justify further appropriately powered trials
of zoledronate with these nonskeletal conditions as primary endpoints.
&#xa9; 2019 American Society for Bone and Mineral Research.

<35>
Accession Number
629455860
Title
MicroRNA-194-5p Levels Decrease during Deep Hypothermic Circulatory
Arrest.
Source
Scientific reports. 8 (1) (pp 14044), 2018. Date of Publication: 19 Sep
2018.
Author
Wang X.; You Z.; Zhao G.; Wang T.
Institution
(Wang) Department of Anesthesiology, Xuanwu Hospital, Capital Medical
University, Beijing 100053, China
(Wang, Zhao) Institute of Geriatrics, Beijing, China
(Wang, Zhao) National Clinical Research Center for Geriatric Disorders,
Beijing, China
(You) Department of Anesthesiology, MGH, Harvard medical school, Boston,
United States
(Zhao) Department of Neurosurgery, Xuanwu Hospital, Capital Medical
University, Beijing 100053, China
(Wang) Department of Anesthesiology, Xuanwu Hospital, Capital Medical
University, Beijing 100053, China
(Wang) Institute of Geriatrics, Beijing, China
(Wang) National Clinical Research Center for Geriatric Disorders, Beijing,
China
Publisher
NLM (Medline)
Abstract
Hypothermia has been reported to be effective in protecting the brain in
various clinical conditions, including resuscitation after cardiac arrest
and complex cardiovascular surgery, and is considered to be a promising
therapy for stroke. The present study aimed to confirm the pivotal role
that miRNA-194-5p plays in deep hypothermia circulation arrest. On the
basis of reductions in expression of miR-194-5p in the circulation of 21
aortic dissection patients who underwent deep hypothermia circulatory
arrest, the specific expression, target, and function of miR-194-5p was
investigated using primary neuron culture, polymerase chain reaction, in
situ hybridization, and flow cytometry methods. Our results showed that
miR-194-5p expression was significantly downregulated in hypothermia
oxygen glucose deprivation-treated neurons in vitro. Cortical neurons
transfected with miR-194-5p mimic exhibited increased death due to
oxygen-glucose deprivation. MiR-194-5p mediated the regulation of neuronal
death, which involves the downregulation of the specific target protein
SUMO2, which is crucial to ischemia tolerance. Collectively, these data
highlight the unique role of miR-194-5p in mediating the deep hypothermia
circulation arrest response via the regulation of SUMO2. These findings
suggest that miR-194-5p could be a potential therapeutic target for
intervention in ischemic disease.

<36>
Accession Number
2003557185
Title
The utility of traditional Chinese medicine (Shenmai) in the cardiac
rehabilitation after coronary artery bypass grafting: A single-center
randomized clinical trial.
Source
Complementary Therapies in Medicine. 47 (no pagination), 2019. Article
Number: 102203. Date of Publication: December 2019.
Author
Zhang C.; Zheng Y.; Chen T.; Wang S.; Xu M.
Institution
(Zhang, Wang, Xu) Department of Cardiovascular Surgery, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(Zheng) The University of Pittsburgh School of Nursing, Pittsburgh, PA,
United States
(Chen) Department of Clinical Sciences, Liverpool School of Tropical
Medicines, Pembroke Pl, Liverpool L3 5QA, United Kingdom
Publisher
Churchill Livingstone
Abstract
Objective: examine the efficacy and safety of Shenmai to the cardiac
rehabilitation in patients received coronary artery bypass grafting.
<br/>Design(s): a single-center randomized, single blind clinical trial.
<br/>Setting(s): Department of Cardiovascular Surgery, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China. Subjects: Patients
with coronary artery disease who received coronary artery bypass grafting
in our center were studied. They must be competent to complete the
6-minute walking test without any assistance and without any severe
comorbidity. <br/>Intervention(s): in Shemmai group, the participants were
treated with Shenmai injection (100 ml/day) right after the surgery to
discharge for 9.28 +/- 3.75 days and then capsule (3.6 g/day) sequentially
for 30 days in addition to the cardiac rehabilitation. In control group,
only cardiac rehabilitation was conducted. Main measures: the 6-Minute
Walking Test was measured at three time points: one day before operation,
on the day of discharge and 30 days follow up. <br/>Result(s): The sample
(n = 166) was predominately male (84%), with mean age was 61.12 +/- 9.13
years. There was no significant difference between groups in baseline
characteristics and the procedural characteristics. There was one death in
control group and one stroke in Shenmai group right after the surgery.
Overall, there was group (p =.005) and time effect (p <.001) on the
6-minute walking distance. Participants in the Shenmai group walked longer
distance in meters compared with control group on the day of discharge
(314.54 +/- 64.14 vs. 271.29 +/- 76.82, P <.001), while no significant
differences before operation (399.72 +/- 93.19 vs. 403.67 +/- 91.99, p
=.78) and on 30-day follow up (436.54 +/- 67.64 vs. 421.64 +/- 83.53, p
=.21). <br/>Conclusion(s): Shenmai improves the exercise tolerance in the
early stage of the cardiac rehabilitation for patients received coronary
artery bypass grafting.<br/>Copyright &#xa9; 2019 Elsevier Ltd

<37>
Accession Number
2003430332
Title
Dynamic predictive model for postoperative nausea and vomiting for
intravenous fentanyl patient-controlled analgesia.
Source
Anaesthesia. (no pagination), 2019. Date of Publication: 2019.
Author
Chae D.; Kim S.Y.; Song Y.; Baek W.; Shin H.; Park K.; Han D.W.
Institution
(Chae, Park) Department of Pharmacology, Severance Hospital, Anesthesia
and Pain Research Institute, Yonsei University College of Medicine, Seoul,
South Korea
(Kim, Baek, Shin) Department of Anesthesiology and Pain Medicine,
Severance Hospital, Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
(Song, Han) Department of Anesthesiology and Pain Medicine, Gangnam
Severance Hospital, Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
Publisher
Blackwell Publishing Ltd
Abstract
Postoperative nausea and vomiting is the most common side-effect of
opioid-based intravenous patient-controlled analgesia. Apfel's simplified
risk score is popular but it has some limitations. We developed and
validated a dynamic predictive model for nausea or vomiting up to 48
postoperative hours, available as an online web application. Fentanyl was
used by 22,144 adult patients for analgesia after non-cardiac surgery
under general anaesthesia: we randomly divided them into development (80%)
and validation (20%) cohorts, repeated 100 times. We used linear
discriminant analysis to select variables for multivariate logistic
regression. The incidences of postoperative nausea or vomiting were: 0-48
h, 5691/22,144 (26%); 0-6 h, 2749/22,144 (12%); 6-12 h, 2687/22,144 (12%);
12-18 h, 2624/22,144 (12%); 18-24 h, 1884/22,144 (9%); and 24-48 h,
1082/22,144 (5%). The median (95%CI) area under the receiver operating
characteristic curve was 0.72 (0.71-0.73) up to 48 postoperative hours
compared with 0.65 (0.64-0.66) for the Apfel model, p < 0.001. The
equivalent areas for 0-6 h, 6-12 h, 12-18 h, 18-24 h and 24-48 h were:
0.70 (0.69-0.72); 0.71 (0.69-0.73); 0.69 (0.68-0.71); 0.70 (0.67-0.72);
and 0.69 (0.66-0.71), respectively. Our web application allows clinicians
to calculate incidences of nausea and vomiting in patients receiving
intravenous fentanyl for patient-controlled analgesia.<br/>Copyright
&#xa9; 2019 Association of Anaesthetists

<38>
Accession Number
2003429932
Title
Effects of high-dose vitamin D supplementation on the occurrence of
post-operative atrial fibrillation after coronary artery bypass grafting:
randomized controlled trial.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2019. Date
of Publication: 2019.
Author
Kara H.; Yasim A.
Institution
(Kara) Department of Cardiovascular Surgery, Giresun Ada Hospital,
Giresun, Turkey
(Yasim) Department of Cardiovascular Surgery, Kahramanmaras Sutcu Imam
University, Kahramanmaras, Turkey
Publisher
Springer Tokyo (E-mail: orders@springer.jp)
Abstract
Objective: This study aimed to investigate the preventive effects of a
high-dose vitamin D administered preoperatively on the post-operative
atrial fibrillation (POAF) occurrence in patients with insufficient or
deficient serum vitamin D levels who underwent coronary artery bypass
grafting (CABG) surgery. <br/>Method(s): The study was a randomized
controlled, blinded and parallel-arm trial conducted on 116 who had
vitamin D deficiency or insufficiency during the pre-operative evaluation
were included in the study conducted between January 2018 and January
2019. Patients were divided into those who received oral vitamin D
(treatment group; n = 58) and those who did not (control group; n = 58) 48
h before CABG surgery. In the treatment group, patients with vitamin D
deficiency were administered 300.000 IU vitamin D orally and those with
vitamin D insufficiency 150.000 IU 48 h preoperatively. Patients were
followed up during hospitalisation process with respect to POAF.
<br/>Result(s): Both groups showed no significant differences with regard
to age, gender, body mass index, creatine level, left atrial diameter,
pre-operative drug use, calcium level, ejection fraction, diabetes
mellitus and hypertension. The ratio of POAF occurrence found in the
treatment and control groups were 12.07% and 27.59%, respectively. Vitamin
D treatment was found to reduce the risk of POAF development by 0.24 times
(p = 0.034). <br/>Conclusion(s): In this study with sufficient sample
size, preoperative short-term high-dose vitamin D supplementation was
found to be significantly preventive to the occurrence of POAF in patients
with vitamin D insufficiency and deficiency who underwent CABG
surgery.<br/>Copyright &#xa9; 2019, The Japanese Association for Thoracic
Surgery.

<39>
Accession Number
2002768022
Title
Health-related quality of life for patients with cardiovascular disease
after a coronary artery bypass graft: A systematic review.
Source
Indian Journal of Public Health Research and Development. 10 (8) (pp
2606-2610), 2019. Date of Publication: August 2019.
Author
Sukartini T.; Arifin H.; Rohmah U.N.; Ramadhani D.R.
Institution
(Sukartini, Arifin, Rohmah, Ramadhani) Faculty of Nursing, Universitas
Airlangga, Surabaya, Indonesia
Publisher
Indian Journal of Public Health Research and Development (Aster-06/603,
Supertech Emerald Court, Sector - 93 A, Expressway, NOIDA, UTTAR PRADESH
201 304, India)
Abstract
CABG can affect health-related quality of life (HRQoL) and it can take a
long time to improve. The following question was raised: 'How long does it
take for the HRQoL of patients with a Coronary Artery Bypass Graft (CBAG)
to increase?' The aim was to analyze the recent scientific production of
HRQoL in cardiovascular patients with CABG. The PRISMA approach was used
and we examined articles from Scopus, EBSCO and ProQuest that were
published between 2014 - 2018. We used "health related quality of life",
restricted our search to "coronary artery bypass graft" and used "after"
in the title, keywords and abstract connected by the Boolean operator
"AND". SF-36 was used to assess the HRQoL and it increased within six
months after CABG. This was influenced by self-control, obesity, age,
gender, emotions and personality. Improving the patient's quality of life
is key for the nurses to control so then the heart surgery patients become
prosperous and thus reduce their morbidity and mortality.<br/>Copyright
&#xa9; 2019, Indian Journal of Public Health Research and Development. All
rights reserved.

<40>
[Use Link to view the full text]
Accession Number
629627691
Title
Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac
Surgery: A Randomized Controlled Trial.
Source
Anesthesiology. 130 (6) (pp 958-970), 2019. Date of Publication: 01 Jun
2019.
Author
Klinger R.Y.; Cooter M.; Bisanar T.; Terrando N.; Berger M.; Podgoreanu
M.V.; Stafford-Smith M.; Newman M.F.; Mathew J.P.; Blumenthal J.A.;
Karhausen J.A.; Kertai M.D.; Krishnamoorthy V.; Li Y.-J.; Swaminathan M.;
Warner D.S.; Funk B.L.; Brassard R.; Toulgoat-Dubois Y.; Waweru P.; Babyak
M.A.; Browndyke J.N.; Welsh-Bohmer K.A.; Sketch M.H.; Bennett E.R.;
Graffagnino C.; Laskowitz D.T.; Strittmatter W.J.; Collins K.; Smigla G.;
Shearer I.; D'Amico T.A.; Daneshmand M.A.; Gaca J.G.; Glower D.D.; Haney
J.; Harpole D.; Hartwig M.G.; Hughes G.C.; Klapper J.A.; Lin S.S.; Lodge
A.J.; Milano C.A.; Plichta R.P.; Schroeder J.N.; Smith P.K.; Tong B.C.
Institution
(Klinger, Cooter, Bisanar, Terrando, Berger, Podgoreanu, Stafford-Smith,
Mathew) Department of Anesthesiology, Duke University Medical Center, Box
3094, Durham, NC 27710, United States
(Newman) Department of Anesthesiology, University of Kentucky School of
Medicine, Lexington, KY, United States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Editor's Perspective What We Already Know about This Topic Preclinical and
clinical studies suggest that lidocaine might be neuroprotective, which
could benefit surgical patients at risk of neurologic compromise What This
Article Tells Us That Is New This multicenter trial of intravenous
lidocaine administered during and after cardiac surgery did not show an
effect on cognition at 6 weeks postoperatively Background: Cognitive
decline after cardiac surgery occurs frequently and persists in a
significant proportion of patients. Preclinical studies and human trials
suggest that intravenous lidocaine may confer protection in the setting of
neurologic injury. It was hypothesized that lidocaine administration would
reduce cognitive decline after cardiac surgery compared to placebo.
<br/>Method(s): After institutional review board approval, 478 patients
undergoing cardiac surgery were enrolled into this multicenter,
prospective, randomized, double-blinded, placebo-controlled, parallel
group trial. Subjects were randomized to lidocaine 1 mg/kg bolus after the
induction of anesthesia followed by a continuous infusion (48 mug .
kg^-1 . min^-1 for the first hour, 24 mug .
kg^-1 . min^-1 for the second hour, and 10 mug .
kg^-1 . min^-1 for the next 46 h) or saline with
identical volume and rate changes to preserve blinding. Cognitive function
was assessed preoperatively and at 6 weeks and 1 yr postoperatively using
a standard neurocognitive test battery. The primary outcome was change in
cognitive function between baseline and 6 weeks postoperatively, adjusting
for age, years of education, baseline cognition, race, and procedure type.
<br/>Result(s): Among the 420 allocated subjects who returned for 6-week
follow-up (lidocaine: N = 211; placebo: N = 209), there was no difference
in the continuous cognitive score change (adjusted mean difference [95%
CI], 0.02 (-0.05, 0.08); P = 0.626). Cognitive deficit (greater than 1 SD
decline in at least one cognitive domain) at 6 weeks occurred in 41% (87
of 211) in the lidocaine group versus 40% (83 of 209) in the placebo group
(adjusted odds ratio [95% CI], 0.94 [0.63, 1.41]; P = 0.766). There were
no differences in any quality of life outcomes between treatment groups.
At the 1-yr follow-up, there continued to be no difference in cognitive
score change, cognitive deficit, or quality of life. <br/>Conclusion(s):
Intravenous lidocaine administered during and after cardiac surgery did
not reduce postoperative cognitive decline at 6 weeks.<br/>Copyright
&#xa9; 2019 the American Society of Anesthesiologists, Inc.

<41>
[Use Link to view the full text]
Accession Number
629626392
Title
Transcatheter Aortic Valve Replacement: New Gold Standard for the
Treatment of Aortic Stenosis.
Source
Circulation. 139 (24) (pp 2724-2727), 2019. Date of Publication: 11 Jun
2019.
Author
Prendergast B.D.; Redwood S.R.
Institution
(Prendergast, Redwood) Department of Cardiology, St Thomas' Hospital,
Westminster Bridge Rd, London SE1 7EH, United Kingdom
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)

<42>
[Use Link to view the full text]
Accession Number
629626178
Title
Five-Year Clinical and Echocardiographic Outcomes from the NOTION
Randomized Clinical Trial in Patients at Lower Surgical Risk.
Source
Circulation. 139 (24) (pp 2714-2723), 2019. Date of Publication: 11 Jun
2019.
Author
Thyregod H.G.H.; Ihlemann N.; Jorgensen T.H.; Nissen H.; Kjeldsen B.J.;
Petursson P.; Chang Y.; Franzen O.W.; Engstrom T.; Clemmensen P.; Hansen
P.B.; Andersen L.W.; Steinbruuchel D.A.; Olsen P.S.; Sondergaard L.
Institution
(Thyregod, Steinbruuchel, Olsen) Department of Cardiothoracic
Surgerys,Heart Centre, Rigshospitalet, Copenhagen University Hospital,
Blegdamsvej 9, Copenhagen DK-2100, Denmark
(Ihlemann, Jorgensen, Franzen, Engstrom, Sondergaard) Department of
Cardiology, Heart Centre, Rigshospitalet, Copenhagen University Hospital,
Denmark
(Hansen, Andersen) Department of Cardiac Anesthesia, Heart Centre,
Rigshospitalet, Copenhagen University Hospital, Denmark
(Nissen) Department of Cardiology, Odense University Hospital, Denmark
(Kjeldsen) Department of Cardiothoracic and Vascular Surgery, Odense
University Hospital, Denmark
(Petursson) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Chang) Coronary and Structural Heart Disease Clinical Department,
Medtronic Plc, Mounds View, MN, United States
(Clemmensen) Department of General and Interventional Cardiology,
University Heart Center Hamburg Eppendorf, Germany
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: The NOTION trial (Nordic Aortic Valve Intervention) was
designed to compare transcatheter aortic valve replacement (TAVR) with
surgical aortic valve replacement (SAVR) in patients >=70 years old with
isolated severe aortic valve stenosis. Clinical and echocardiographic
outcomes are presented after 5 years. <br/>Method(s): Patients were
enrolled at 3 Nordic centers and randomized 1:1 to TAVR using the
self-expanding CoreValve prosthesis (n=145) or SAVR using any stented
bioprostheses (n=135). The primary composite outcome was the rate of
all-cause mortality, stroke, or myocardial infarction at 1 year defined
according to Valve Academic Research Consortium-2 criteria.
<br/>Result(s): Baseline characteristics were similar. The mean age was
79.1+/-4.8 years and mean Society of Thoracic Surgeons Predicted Risk of
Mortality score was 3.0%+/-1.7%. After 5 years, there were no differences
between TAVR and SAVR in the composite outcome (Kaplan-Meier estimates
38.0% versus 36.3%, log-rank test P=0.86) or any of its components. TAVR
patients had larger prosthetic valve area (1.7 cm² versus 1.2
cm², P<0.001) with a lower mean transprosthetic gradient (8.2
mm Hg versus 13.7 mm Hg, P<0.001), both unchanged over time. More TAVR
patients had moderate/severe total aortic regurgitation (8.2% versus 0.0%,
P<0.001) and a new pacemaker (43.7% versus 8.7%, P<0.001). Four patients
had prosthetic reintervention and no difference was found for functional
outcomes. <br/>Conclusion(s): These are currently the longest follow-up
data comparing TAVR and SAVR in lower risk patients, demonstrating no
statistical difference for major clinical outcomes 5 years after TAVR with
a self-expanding prosthesis compared to SAVR. Higher rates of prosthetic
regurgitation and pacemaker implantation were seen after TAVR. Clinical
Trial Registration: URL: Https://clinicaltrials.gov. Unique identifier:
NCT01057173.<br/>Copyright &#xa9; 2019 Lippincott Williams and Wilkins.
All rights reserved.

<43>
Accession Number
629624035
Title
Cost-utility analysis of minimally invasive surgery for lung cancer: A
randomized controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 56 (4) (pp 754-761), 2019.
Date of Publication: 01 Oct 2019.
Author
Bendixen M.; Kronborg C.; Jorgensen O.D.; Andersen C.; Licht P.B.
Institution
(Bendixen, Jorgensen, Licht) Department of Cardiothoracic and Vascular
Surgery, Odense University Hospital, Odense, Denmark
(Kronborg) Centre of Health Economic Research, University of Southern
Denmark, Odense, Denmark
(Andersen) Department of Thoracic Anaesthesiology, Odense University
Hospital, Odense, Denmark
(Licht) Odense Patient Data Explorative Network (OPEN), University of
Southern Denmark, Odense, Denmark
Publisher
European Association for Cardio-Thoracic Surgery (E-mail:
info@eacts.co.uk)
Abstract
OBJECTIVES: Minimally invasive video-assisted thoracic surgery (VATS) was
first introduced in the early 1990s. For decades, numerous non-randomized
studies demonstrated advantages of VATS over thoracotomy with lower
morbidity and shorter hospital stay, but only recently did a randomized
trial document that VATS results in lower pain scores and better quality
of life. Opposing arguments for VATS have always been increased costs and
concerns about oncological adequacy. In this paper, we aim to investigate
the cost-effectiveness of VATS. <br/>METHOD(S): The study was designed as
a cost-utility analysis of the first 12 months following surgery and was
performed together with a clinical randomized controlled trial of VATS
versus thoracotomy for lobectomy of stage 1 lung cancer during a 6-year
period (2008-2014). All health-related expenses were retrieved from a
national database (Statistics Denmark) including hospital readmissions,
outpatient clinic visits, prescription medication costs, consultations
with general practitioners, specialists, physiotherapists, psychologists
and chiropractors. <br/>RESULT(S): One hundred and three VATS patients and
103 thoracotomy patients were randomized. Mean costs per patient operated
by VATS were 103 108 Danish Kroner (Dkr) (13 818) and 134 945 Dkr (18 085)
by thoracotomy, making the costs for VATS 31 837 Dkr (4267) lower than
thoracotomy (P < 0.001). The difference in quality-adjusted life years
gained over 52 weeks of follow-up was 0.021 (P = 0.048, 95% confidence
interval-0.04 to-0.00015) in favour of VATS. The median duration of the
surgical procedure was shorter after thoracotomy (79 vs 100 min; P <
0.001). The mean length of hospitalization was shorter following VATS (4.8
vs 6.7 days; P = 0.027). The use of other resources was not significantly
different between groups. The costs of resources were lower in the VATS
group. This difference was primarily due to reduced costs of readmissions
(VATS 29 247 Dkr vs thoracotomy 51 734 Dkr; P < 0.001) and costs of
outpatient visits (VATS 51 412 Dkr vs thoracotomy 61 575 Dkr; P = 0.012).
<br/>CONCLUSION(S): VATS is a cost-effective alternative to thoracotomy
following lobectomy for stage 1 lung cancer. Economical outcomes as
measured by quality-adjusted life years were significantly better and
overall costs were lower for VATS. Clinical Trial Registration Number:
NCT01278888.<br/>Copyright &#xa9; 2019 The Author(s).

<44>
Accession Number
629623922
Title
Improving coronary artery bypass grafting: A systematic review and
meta-analysis on the impact of adopting transit-time flow measurement.
Source
European Journal of Cardio-thoracic Surgery. 56 (4) (pp 654-663), 2019.
Date of Publication: 01 Oct 2019.
Author
Thuijs D.J.F.M.; Bekker M.W.A.; Taggart D.P.; Pieter Kappetein A.; Kieser
T.M.; Wendt D.; Di Giammarco G.; Trachiotis G.D.; Puskas J.D.; Head S.J.
Institution
(Thuijs, Bekker, Pieter Kappetein, Head) Department of Cardiothoracic
Surgery, Erasmus MC, University Medical Centre, Dr. Molewaterplein 40, GD
Rotterdam 3015, Netherlands
(Taggart) Department of Cardiovascular Surgery, University of Oxford, John
Radcliffe Hospital, Oxford, United Kingdom
(Kieser) Division of Cardiac Surgery, Department of Cardiac Sciences,
Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary,
Canada
(Wendt) Department of Thoracic and Cardiovascular Surgery, West German
Heart and Vascular Centre, University of Duisburg-Essen, Duisburg, Germany
(Di Giammarco) Department of Cardiac Surgery, Universita degli Studi "g.
d'Annunzio" Chieti-Pescara, Chieti, Italy
(Trachiotis) Department of Cardiothoracic Surgery, Veterans Affairs
Medical Centre, Washington, DC, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Saint Luke's,
New York, NY, United States
Publisher
European Association for Cardio-Thoracic Surgery (E-mail:
info@eacts.co.uk)

<45>
Accession Number
629623906
Title
Transthoracic clamp versus endoaortic balloon occlusion in minimally
invasive mitral valve surgery: A systematic review and meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 56 (4) (pp 643-653), 2019.
Date of Publication: 01 Oct 2019.
Author
Rival P.M.; Moore T.H.M.; McAleenan A.; Hamilton H.; Du Toit Z.; Akowuah
E.; Angelini G.D.; Vohra H.A.
Institution
(Rival, Hamilton, Du Toit) University of Bristol Medical School, Senate
House, Tyndall Ave, Bristol BS8 1TH, United Kingdom
(Moore) Natl. Inst. for Hlth. Research Collaboration for Leadership in
Applied Health Research and Care West, University Hospitals Bristol NHS
Foundation Trust, Bristol, United Kingdom
(McAleenan) Population Health Sciences, Bristol Medical School, University
of Bristol, Bristol, United Kingdom
(Akowuah) Department of Cardiac Surgery, James Cook Hospital,
Middlesbrough, United Kingdom
(Angelini, Vohra) Department of Cardiac Surgery, Bristol Heart Institute,
Bristol, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery (E-mail:
info@eacts.co.uk)

<46>
Accession Number
629550063
Title
Antithrombotic treatment after coronary artery bypass graft surgery:
Systematic review and network meta-analysis.
Source
The BMJ. 367 (no pagination), 2019. Article Number: l5476. Date of
Publication: 2019.
Author
Solo K.; Lavi S.; Kabali C.; Levine G.N.; Kulik A.; John-Baptiste A.A.;
Fremes S.E.; Martin J.; Eikelboom J.W.; Ruel M.; Huitema A.A.; Choudhury
T.; Bhatt D.L.; Tzemos N.; Mamas M.A.; Bagur R.
Institution
(Solo, John-Baptiste, Martin, Bagur) Department of Epidemiology and
Biostatistics, Schulich School of Medicine and Dentistry, Western
University, London, ON, Canada
(Solo) Cochrane Canada Center, MacGRADE Center, Department of Health
Research Methods, Evidence and Impact, McMaster University, Hamilton, ON,
Canada
(Lavi, Huitema, Choudhury, Tzemos, Bagur) London Health Sciences Centre,
Division of Cardiology, Department of Medicine, Schulich School of
Medicine and Dentistry, Western University, London, ON, Canada
(Kabali) Epidemiology Division, Dalla Lana School of Public Health,
University of Toronto, Toronto, ON, Canada
(Levine) Department of Medicine, Baylor College of Medicine, Houston, TX,
United States
(Kulik) Lynn Heart and Vascular Institute, Boca Raton Regional Hospital,
Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca
Raton, FL, United States
(John-Baptiste, Martin) Department of Anesthesia and Perioperative
Medicine and Centre for Medical Evidence, Decision Integrity and Clinical
Impact (MEDICI), Western University, London, ON, Canada
(John-Baptiste) Interfaculty Program in Public Health, Western University,
London, ON, Canada
(Fremes) Schulich Heart Centre, Sunnybrook Health Science, University of
Toronto, Toronto, ON, Canada
(Fremes) Institute of Health Policy Management and Evaluation, Dalla Lana
School of Public Health, University of Toronto, ON, Canada
(Eikelboom) Population Health Research Institute, McMaster University and
Hamilton Health Sciences, Hamilton, ON, Canada
(Ruel) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Bhatt) Division of Cardiovascular Medicine, Department of Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Mamas, Bagur) Keele Cardiovascular Research Group, Institute for Applied
Clinical Science, Centre for Prognosis Research, Institute of Primary Care
and Health Sciences, Keele University, Stoke on Trent, United Kingdom
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Objective To assess the effects of different oral antithrombotic drugs
that prevent saphenous vein graft failure in patients undergoing coronary
artery bypass graft surgery. Design Systematic review and network
meta-analysis. Data sources Medline, Embase, Web of Science, CINAHL, and
the Cochrane Library from inception to 25 January 2019. Eligibility
criteria for selecting studies Randomised controlled trials of
participants (aged >=18) who received oral antithrombotic drugs
(antiplatelets or anticoagulants) to prevent saphenous vein graft failure
after coronary artery bypass graft surgery. Main outcome measures The
primary efficacy endpoint was saphenous vein graft failure and the primary
safety endpoint was major bleeding. Secondary endpoints were myocardial
infarction and death. Results This review identified 3266 citations, and
21 articles that related to 20 randomised controlled trials were included
in the network meta-analysis. These 20 trials comprised 4803 participants
and investigated nine different interventions (eight active and one
placebo). Moderate certainty evidence supports the use of dual
antiplatelet therapy with either aspirin plus ticagrelor (odds ratio 0.50,
95% confidence interval 0.31 to 0.79, number needed to treat 10) or
aspirin plus clopidogrel (0.60, 0.42 to 0.86, 19) to reduce saphenous vein
graft failure when compared with aspirin monotherapy. The study found no
strong evidence of differences in major bleeding, myocardial infarction,
and death among different antithrombotic therapies. The possibility of
intransitivity could not be ruled out; however, between-trial
heterogeneity and incoherence were low in all included analyses.
Sensitivity analysis using per graft data did not change the effect
estimates. Conclusions The results of this network meta-analysis suggest
an important absolute benefit of adding ticagrelor or clopidogrel to
aspirin to prevent saphenous vein graft failure after coronary artery
bypass graft surgery. Dual antiplatelet therapy after surgery should be
tailored to the patient by balancing the safety and efficacy profile of
the drug intervention against important patient outcomes. Study
registration PROSPERO registration number CRD42017065678.<br/>Copyright
&#xa9; Published by the BMJ Publishing Group Limited. For permission to
use (where not already granted under a licence) please go to.

<47>
Accession Number
628021670
Title
Cardiovascular events associated with nicorandil administration prior to
primary percutaneous coronary intervention in patients with acute
ST-segment elevated myocardial infarction: a systematic review and
meta-analysis.
Source
Expert Opinion on Drug Safety. 18 (6) (pp 537-547), 2019. Date of
Publication: 03 Jun 2019.
Author
Li J.; Xu X.; Zhou X.; Dai J.; Ma L.; Chen C.; Li X.; Mao W.
Institution
(Li, Xu, Zhou, Dai, Ma, Chen, Li, Mao) Department of Cardiology, The First
Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou,
Zhejiang, China
Publisher
Taylor and Francis Ltd
Abstract
Introduction: Nicorandil may exert cardioprotective effects in ischemic
heart disease. However, its efficacy in combination with early reperfusion
is uncertain. The authors performed a meta-analysis of the short- and
long-term clinical outcomes of nicorandil administration at the time of
primary percutaneous coronary intervention (PCI) in patients with
ST-elevated myocardial infarction (STEMI). <br/>Method(s): PubMed,
MEDLINE, Embase, and the Cochrane Library databases were systematically
searched for eligible randomized controlled studies. The primary endpoint
was major adverse cardiovascular events (MACE), both in-hospital and
post-discharge. The secondary endpoint was the incidence of no-reflow
phenomenon. <br/>Result(s): Ten studies were included (n = 1105). Mean
patient age was 63.0 +/- 10.0 years; 76.6% of patients were male. Compared
with controls who received primary PCI, combined nicorandil/primary PCI
significantly reduced in-hospital MACE (pooled odds ratio [OR] 0.16; 95%
confidence interval [CI] 0.09-0.27), follow-up MACE (pooled OR 0.53; 95%
CI 0.37-0.75), and total MACE (pooled OR 0.27; 95% CI 0.15-0.49). The
combined treatment also reduced the incidence of no-reflow phenomenon
(pooled OR 0.34; 95% CI 0.23-0.50). <br/>Conclusion(s): Nicorandil
administration at the time of primary PCI is associated with reduced MACE
(both short- and long-term) and no-reflow phenomenon in patients with
STEMI.<br/>Copyright &#xa9; 2019, &#xa9; 2019 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<48>
Accession Number
2003290360
Title
Reperfusion therapy for minor stroke: A systematic review and
meta-analysis.
Source
Brain and Behavior. 9 (10) (no pagination), 2019. Article Number: e01398.
Date of Publication: 01 Oct 2019.
Author
Lan L.; Rong X.; Li X.; Zhang X.; Pan J.; Wang H.; Shen Q.; Peng Y.
Institution
(Lan, Rong, Li, Zhang, Pan, Wang, Shen, Peng) Department of Neurology, Sun
Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Objectives: Approximately, half of the acute stroke patients with minor
symptoms were excluded from thrombolysis in some randomized controlled
trials (RCTs). There is little evidence on treating minor strokes with
rt-PA. Here, we performed a systematic review and meta-analysis to assess
the safety and efficacy of thrombolysis in these patients. <br/>Method(s):
PubMed, Embase, Web of Science, and Cochrane Library were searched in July
2018. All available RCTs and retrospective comparative studies that
compared thrombolysis with nonthrombolysis' for acute minor stroke (NIHSS
<= 5) with quantitative outcomes were included. <br/>Result(s): Ten
studies, including a total of 4,333 patients, were identified. The risk of
intracranial hemorrhage (ICH) was higher in the rt-PA group as compared
with that in the non-rt-PA group (3.8% vs. 0.6%; p =.0001). However, there
is no significant difference in the rate of mortality between the two
groups (p =.96). The pooled rate of a good outcome in 90 days was 67.8% in
those with rt-PA and 63.3% in those without rt-PA (p =.07). Heterogeneity
was 43% between the studies (p =.08). After adjusting for the
heterogeneity, thrombolysis was associated with good outcome (68.3% vs.
63.0%, OR 1.47; 95% CI 1.14-1.89; p =.003). In post hoc analyses,
including only RCTs, the pooled rate of good outcome had no significant
differences between the two groups (86.6% vs. 85.7%, 95% CI 0.44-3.17, p
=.74; 87.4% vs. 91.9%, 95% CI 0.35-1.41, p =.32; before and after
adjusting separately). <br/>Conclusion(s): Although thrombolysis might
increase the risk of ICH based on existing studies, patients with acute
minor ischemic stroke could still benefit from thrombolysis at 3 months
from the onset.<br/>Copyright &#xa9; 2019 The Authors. Brain and Behavior
published by Wiley Periodicals, Inc.

<49>
Accession Number
624281684
Title
Challenges in Aortic Stenosis: Review of Antiplatelet/Anticoagulant
Therapy Management with Transcatheter Aortic Valve Replacement (TAVR):
TAVR with Recent PCI, TAVR in the Patient with Atrial Fibrillation, and
TAVR Thrombosis Management.
Source
Current Cardiology Reports. 20 (12) (no pagination), 2018. Article Number:
130. Date of Publication: 01 Dec 2018.
Author
Sherwood M.W.; Vora A.N.
Institution
(Sherwood) Inova Heart and Vascular Institute, 3300 Gallows Rd. 1st floor
Suite 1225, Falls Church, VA 22042, United States
(Vora) Duke Clinical Research Institute, 2400 Pratt Street, P.O. Box
17969, Durham, NC 27715, United States
Publisher
Current Medicine Group LLC 1 (E-mail: info@phl.cursci.com)
Abstract
Purpose of Review: This review aims to describe the current evidence and
consensus recommendations around antiplatelet and anticoagulant management
in three common clinical scenarios in transcatheter aortic valve
replacement (TAVR): (1) recent percutaneous coronary intervention (PCI)
preceding TAVR, (2) atrial fibrillation (AF) management in patients
undergoing TAVR, and (3) bioprosthetic valve thrombosis management in
TAVR. Recent Findings: Several small clinical trials have evaluated the
use of single vs. dual antiplatelet therapy in patients undergoing TAVR,
with most recent data favoring single antiplatelet therapy. There are
several trials currently enrolling and in follow-up that evaluate the use
of anticoagulants in combination with single and dual antiplatelet therapy
for patients with AF undergoing TAVR, but as yet, there is no data to
support a clear strategy. The use of DAPT after PCI continues to
potentially shorten in patients undergoing elective PCI, thus prolonged
DAPT may not be necessary post TAVR for the sake of PCI. Bioprosthetic
valve thrombosis occurs more commonly than previously thought, but has
uncertain clinical significance. In observational studies, antiplatelet
therapy has little effect on bioprosthetic valve thrombosis, whereas
anticoagulation is effective in both prevention and treatment of
thrombosis. <br/>Summary: DAPT is currently recommended for 1-6 months for
all patients without an indication for oral anticoagulation who undergo
TAVR; however, there is a growing amount of evidence for single
antiplatelet therapy. In the special situation of patients who have
recently undergone PCI, the length of DAPT will depend on stent selection
(BMS vs. DES), but may not be significantly prolonged unless the patient
experienced an acute coronary syndrome prior to TAVR. There is no clear,
optimal antithrombotic strategy for patients with AF who undergo TAVR, but
avoidance of triple therapy by using OAC and low-dose ASA seems to be
reasonable. OAC, not DAPT, is now known to prevent bioprosthetic valve
thrombosis in TAVR and SAVR patients; however, the optimal therapy remains
unknown. For patients who develop bioprosthetic valve thrombosis, OAC for
3-6 months, and repeat imaging is recommended to document
resolution.<br/>Copyright &#xa9; 2018, Springer Science+Business Media,
LLC, part of Springer Nature.

<50>
Accession Number
2003451981
Title
Efficacy and safety of tacrolimus in de novo pediatric transplant
recipients randomized to receive immediate- or prolonged-release
tacrolimus.
Source
Clinical Transplantation. (no pagination), 2019. Article Number: e13698.
Date of Publication: 2019.
Author
Vondrak K.; Parisi F.; Dhawan A.; Grenda R.; Webb N.J.A.; Marks S.D.;
Debray D.; Holt R.C.L.; Lachaux A.; Kelly D.; Kazeem G.; Undre N.
Institution
(Vondrak) University Hospital Motol, Prague, Czechia
(Parisi) Ospedale Pediatrico Bambino Gesu, Rome, Italy
(Dhawan) King's College Hospital, London, United Kingdom
(Grenda) The Children's Memorial Health Institute, Warsaw, Poland
(Webb) Manchester University Foundation Trust, Manchester, United Kingdom
(Marks) Great Ormond Street Hospital for Children, NHS Foundation Trust,
London, United Kingdom
(Debray) APHP-Hopital Universitaire Necker, Paris, France
(Holt) Alder Hey Children's Hospital, Liverpool, United Kingdom
(Lachaux) Universite Lyon 1 et Hospices Civils de Lyon, Lyon, France
(Kelly) Birmingham Women's & Children's Hospital, Birmingham, United
Kingdom
(Kazeem, Undre) Astellas Pharma Europe Ltd, Chertsey, United Kingdom
(Kazeem) BENKAZ Consulting Ltd, Cambridge, United Kingdom
Publisher
Blackwell Publishing Ltd
Abstract
Background and aims: This multicenter trial compared immediate-release
tacrolimus (IR-T) vs prolonged-release tacrolimus (PR-T) in de novo
kidney, liver, and heart transplant recipients aged <16 years. Each
formulation had similar pharmacokinetic (PK) profiles. Follow-up efficacy
and safety results are reported herein. <br/>Material(s) and Method(s):
Patients, randomized 1:1, received once-daily, PR-T or twice-daily, IR-T
within 4 days of surgery. After a 4-week PK assessment, patients continued
randomized treatment for 48 additional weeks. At Year 1, efficacy
assessments included the number of clinical acute rejections,
biopsy-confirmed acute rejection (BCAR) episodes (including severity),
patient and graft survival, and efficacy failure (composite of death,
graft loss, BCAR, or unknown outcome). Adverse events were assessed
throughout. <br/>Result(s): The study included 44 children. At Year 1,
mean +/- standard deviation tacrolimus trough levels were 6.6 +/- 2.2 and
5.4 +/- 1.6 ng/mL, and there were 2 and 7 acute rejection episodes in the
PR-T and IR-T groups, respectively. No cases of graft loss or death were
reported during the study. The overall efficacy failure rate was 18.2%
(PR-T n = 1; IR-T n = 7). <br/>Conclusion(s): In pediatric de novo solid
organ recipients, the low incidence of BCAR and low efficacy failure rate
suggest that PR-T-based immunosuppression is effective and well tolerated
to 1-year post-transplantation.<br/>Copyright &#xa9; 2019 John Wiley &
Sons A/S. Published by John Wiley & Sons Ltd

<51>
Accession Number
2003447321
Title
Effect of two different colloid priming strategies in infants weighing
less than 5 kg undergoing on-pump cardiac surgeries.
Source
Artificial Organs. (no pagination), 2019. Date of Publication: 2019.
Author
Zhou C.; Tong Y.; Feng Z.; Cui Y.; Zhao M.; Hu J.; Liu K.; Zhao J.; Liu J.
Institution
(Zhou, Tong, Feng, Cui, Zhao, Hu, Liu, Zhao, Liu) State Key Laboratory of
Cardiovascular Disease, Department of Cardiopulmonary Bypass, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Our aim was to explore the effect of two different priming strategies
(artificial colloid only vs. artificial colloid combined with human serum
albumin) on the prognosis of children weighing less than 5 kg undergoing
on-pump congenital heart disease (CHD) surgery. A total of 65 children
weighing less than 5 kg who underwent on-pump CHD surgery in our hospital
from September 2016 to December 2017 were enrolled in this study. The
children were randomly divided into two groups: artificial colloid priming
group (AC group, n = 33) and artificial colloid combined albumin priming
group (ACA group, n = 32). The primary clinical endpoint was the peri-CPB
colloid osmotic pressure (COP). Secondary clinical endpoints included
perioperative blood product and hemostatic drug consumption, postoperative
renal function, coagulation function, postoperative renal function, and
postoperative recovery parameters. COP values were not significant in the
priming system as well as peri-CPB time points between the two groups (P
>.05). Platelet consumption in the AC group was significantly lower than
that in the ACA group (P <.05). There were no significant differences in
the use of other blood products and hemostatic drugs as well as
perioperative coagulation parameters between the two groups (P >.05).
Postoperative length of stay in the AC group was significantly lower than
that in the ACA group (P <.05). There were no significant differences in
mortality, postoperative mechanical ventilation time, ICU time, and
perioperative adverse events (including postoperative AKI) occurrences
between the two groups (P >.05). In the on-pump cardiac surgeries of
patients weighing less than 5 kg, total colloidal priming would not affect
peri-CPB COP values, postoperative coagulation function, and blood
products consumption. Total artificial colloidal priming strategy is
feasible in low-weight patients.<br/>Copyright &#xa9; 2019 International
Center for Artificial Organs and Transplantation and Wiley Periodicals,
Inc.

<52>
Accession Number
2003442211
Title
What are the options for cardiac standstill during aneurysm surgery? A
systematic review.
Source
Neurosurgical Review. (no pagination), 2019. Date of Publication: 2019.
Author
Meling T.R.; Lave A.
Institution
(Meling, Lave) Department of Clinical Neurosciences, Division of
Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
(Meling) Faculty of Medicine, University of Geneva, Geneva, Switzerland
(Meling) Service de Neurochirurgie, Hopitaux Universitaires de Geneve, Rue
Gabriel-Perret-Gentil 5, Geneva 1205, Switzerland
Publisher
Springer Verlag (E-mail: service@springer.de)
Abstract
To perform a systematic review of the techniques for transient circulatory
arrest during intracerebral aneurysm surgery according to the PRISMA
guidelines. Search of PubMed and Google Scholar using the following:
("heart arrest" OR "cardiac standstill"[All Fields]) AND ("intracranial
aneurysm" OR "intracranial"[All Fields] AND "aneurysm"[All Fields]). A
total of 41 original articles were retrieved, of which 17 were excluded
(review articles, editorials and single-case reports). A total of 24
separate articles published between 1984 and 2018 were included in the
final analysis, where the majority of patients harbored anterior
circulation giant or large aneurysms. Adenosine-induced cardiac arrest
gave a short, temporary asystole. The method had benefits in aneurysm with
a broad neck, a thin wall, in specific localizations with narrow surgical
corridors or in case of intraoperative rupture. Rapid ventricular pacing
(RVP) allows a longer and more easily controlled hypotension. Its use is
largely limited to elective cases. Deep hypothermic circulatory arrest
required a complex infrastructure, and fatal procedure complications lead
to a 11.5-30% 30-day mortality rate, limiting its application to giant or
complex aneurysm of the basilar artery or to residual posterior
circulation aneurysm after endovascular treatment. Adenosine and RVP are
both effective options to facilitate clipping of complex aneurysms.
However, their use in patient with ischemic heart disease and cardiac
arrhythmias should be avoided, and their safety in the context of
subarachnoid hemorrhage is yet to be determined. Today, deep hypothermic
circulatory arrest is almost obsolete due to endovascular
alternatives.<br/>Copyright &#xa9; 2019, Springer-Verlag GmbH Germany,
part of Springer Nature.

<53>
Accession Number
2003422642
Title
Moderate ischemic mitral incompetence: does it worth more ischemic time?.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2019. Date
of Publication: 2019.
Author
El-Hag-Aly M.A.; El swaf Y.F.; Elkassas M.H.; Hagag M.G.; Allam H.K.
Institution
(El-Hag-Aly, Hagag) Cardiothoracic Surgery Department, Faculty of
Medicine, Menoufia University, Yassin Abdel Ghaffar Street, Shebin El-Kom,
Menoufia 32511, Egypt
(El swaf) Cardiothoracic Surgery Department, Mahalla Cardiac Institute,
Mahalla, Gharbia, Egypt
(Elkassas) Cardiothoracic Surgery Department, Faculty of Medicine, Suez
Canal University, Suez, Egypt
(Allam) Public Health and Community Medicine Department, Faculty of
Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt
Publisher
Springer Tokyo (E-mail: orders@springer.jp)
Abstract
Objectives: Ischemic mitral regurgitation (IMR) is a common finding
following myocardial infarction or ischemia. Management of moderate IMR is
still a hot topic. Adding mitral valve repair (MVr) to coronary artery
bypass grafting (CABG) is questionable. The goal of this study was to
assess and compare short-term clinical and echocardiographic results of
moderate IMR treated by CABG alone versus another group of patients
treated by CABG plus MVr. <br/>Method(s): Eighty consecutive patients with
ischemic heart disease (IHD) and moderate IMR were divided randomly into
two equal groups: group I (40) had only CABG and group II (40) had CABG
plus MVr. Patients were evaluated at 1-week, 3-months and 1-year intervals
postoperatively. <br/>Result(s): After 1-year follow-up, our study
revealed statistically significant improvement in the grade of mitral
regurgitation (MR) in group II than group I. The mean value for effective
regurgitant orifice area (EROA) was 0.22 +/- 0.13 for group I versus 0.03
+/- 0.03 for group II (P = 0.001) and for vena contracta (VC), it was 3.8
+/- 2.24 for group I versus 0.4 +/- 0.49 for group II (P = 0.000). There
was also a significant reduction in the New York Heart Association (NYHA)
functional class in both groups. <br/>Conclusion(s): MVr can be performed
safely and concomitantly with CABG in patients having moderate IMR, and
its addition to CABG have significant short-term impact on clinical or
echocardiographic outcome of patients.<br/>Copyright &#xa9; 2019, The
Japanese Association for Thoracic Surgery.

<54>
Accession Number
2003395091
Title
Hybrid Coronary Artery Revascularization: A Review and Current Evidence.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2019. Date of Publication: 2019.
Author
Kiaii B.; Teefy P.
Institution
(Kiaii) Department of Cardiac Surgery, London Health Sciences Centre,
London, ON, Canada
(Teefy) Department of Cardiology, London Health Sciences Centre, London,
ON, Canada
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Objective: The role of hybrid coronary revascularization (HCR), which
utilizes the combination of minimally invasive surgical coronary artery
bypass grafting of the left anterior descending artery and percutaneous
coronary intervention (PCI) of non-left anterior descending vessels to
treat multivessel coronary artery disease, is expanding. We set out to
provide a review of this technology. <br/>Method(s): We conducted a
retrospective analysis of all minimally invasive hybrid operations
performed at our institution from September 2004 to December 2018. An
effective analysis comparing patients undergoing HCR vs off-pump or
on-pump surgical coronary artery revascularization was undertaken using an
adjusted analysis with inverse-probability weighting based on the
propensity score. Outcomes that were assessed include death, myocardial
infarction, stroke, atrial fibrillation, renal failure, requirement of
blood transfusion, conversion to open procedure (in the hybrid group),
length of stay in intensive care unit, and total length of stay in
hospital. Intention-to-treat analysis was performed. An up-to-date
literature review of HCR complements this study. <br/>Result(s): Since
2004 a total of 191 consecutive patients (61.4+/-11.1 years; 142 males and
49 females) underwent HCR (robotic-assisted coronary artery bypass graft
of the left internal thoracic artery to the left anterior descending
coronary artery (LAD) and PCI of a non-LAD vessel) in a single- or
double-stage fashion. Successful HCR occurred in 183 of the 191 patients
(8 patients required intraoperative conversion to conventional coronary
bypass). From our comparative analysis and literature review we found no
significant difference between HCR and coronary artery bypass grafting
groups with respect to in-hospital and 1-year follow-up.
<br/>Conclusion(s): Current evidences suggest that HCR is a feasible,
safe, and effective coronary artery revascularization strategy in selected
patients with multivessel coronary artery disease.<br/>Copyright &#xa9;
The Author(s) 2019.

<55>
Accession Number
2003388374
Title
Early Emotional, Behavioural and Social Development of Infants and Young
Children with Congenital Heart Disease: A Systematic Review.
Source
Journal of Clinical Psychology in Medical Settings. (no pagination), 2019.
Date of Publication: 2019.
Author
Clancy T.; Jordan B.; de Weerth C.; Muscara F.
Institution
(Clancy) Department of Pediatrics, University of Melbourne, Melbourne,
Australia
(Jordan, Muscara) Brain and Mind, Murdoch Children's Research Institute,
Melbourne, Australia
(Jordan, Muscara) The Royal Children's Hospital, Melbourne, Australia
(de Weerth) Donders Institute for Brain, Cognition and Behaviour, Radboud
University Medical Center, Nijmegen, Netherlands
Publisher
Springer New York LLC (E-mail: barbara.b.bertram@gsk.com)
Abstract
The experiences of diagnosis of congenital heart disease (CHD), cardiac
surgery and hospitalisation(s) are distressing and represent a significant
stressor for a child and family, which may impact psychosocial
development. This systematic review provides a synthesis of psychosocial
outcomes of infants and young children with congenital heart disease who
had cardiac surgery early in life. Twenty-eight studies related to infant
and young children's psychosocial development, specifically emotional,
social and behavioural functioning were identified. Variability was
related to methodological factors including differences in study design,
varying measurement tools and heterogeneous samples. Despite these
limitations, the majority of studies were of high quality. The most common
finding was a high prevalence of low-severity emotional and behavioural
dysregulation. Young children with severe CHD or comorbid conditions
experienced greater impairment, with higher rates of externalising
behaviour problems, although internalising behaviour problems were also
evident. This review integrates findings from literature in the past 28
years on the psychosocial well-being of infants and young children with
CHD and demonstrates a risk for emotional, social and behavioural
development difficulty, and, importantly, that symptoms of psychosocial
impairment are detectable very early in infancy. We advocate for
assessment and monitoring of emotional and behavioural regulation and
social development to be routinely conducted from infancy to enable
prevention and early intervention.<br/>Copyright &#xa9; 2019, Springer
Science+Business Media, LLC, part of Springer Nature.

<56>
Accession Number
2003366147
Title
Prophylactic Noninvasive Ventilation Versus Conventional Care in Patients
After Cardiac Surgery.
Source
Journal of Surgical Research. (no pagination), 2019. Date of Publication:
2019.
Author
Liu Q.; Shan M.; Liu J.; Cui L.; Lan C.
Institution
(Liu, Shan, Lan) Department of Respiratory Mechanics Lab, Emergency
Intensive Care Ward, The First Affiliated Hospital of Zhengzhou
University, Zhengzhou, Henan, China
(Liu) Department of Thoracic Surgery, the First Affiliated Hospital of
Zhengzhou University, Zhengzhou, Henan, China
(Cui) Department of Preventive Medicine, Epidemiology and Health
Statistics School of Public Health, Zhengzhou University, Zhengzhou,
Henan, China
Publisher
Academic Press Inc. (E-mail: apjcs@harcourt.com)
Abstract
Background: Cardiac surgery can be accompanied by postoperative
complications, which are associated with increased postoperative morbidity
and mortality. Therefore, it is necessary to investigate the effect of
prophylactic noninvasive ventilation (NIV) after extubation versus
conventional pulmonary care on complications after cardiac surgery.
<br/>Material(s) and Method(s): An electronic search of PubMed, Cochrane
Library, Ovid, and EMBASE was conducted to find randomized controlled
trials which compared the effect of prophylactic NIV with controlled
strategies on complications and which were published before April 2018.
<br/>Result(s): Ten studies (1011 patients) were included in the final
analysis. The atelectasis rate was 32.6% in the prophylactic-NIV group,
which was lower than that in the control group (48.71%). Prophylactic NIV
could lower the rate of atelectasis, reintubation, and other respiratory
complications (pleural effusion, pneumonia, and hypoxia) (odds ratio =
0.43, 0.33, and 0.45; 95% confidence interval: 0.21-0.88, 0. 13-0.84,
0.27-0.75; P = 0.02, 0.02, and 0.002, respectively). The effect on cardiac
and distal organ complications (P = 0.07) and hospital mortality (P =
0.62) might be limited. <br/>Conclusion(s): Prophylactic NIV is associated
with a lower rate of postoperative pulmonary complications. The effect on
the other complications and hospital mortality might be limited. Further
evidence with randomized controlled trials can discern the
benefits.<br/>Copyright &#xa9; 2019 The Authors

<57>
Accession Number
2003460299
Title
Meta-Analysis of the Prognostic Role of Late Gadolinium Enhancement and
Global Systolic Impairment in Left Ventricular Noncompaction.
Source
JACC: Cardiovascular Imaging. 12 (11P1) (pp 2141-2151), 2019. Date of
Publication: November 2019.
Author
Grigoratos C.; Barison A.; Ivanov A.; Andreini D.; Amzulescu M.-S.;
Mazurkiewicz L.; De Luca A.; Grzybowski J.; Masci P.G.; Marczak M.;
Heitner J.F.; Schwitter J.; Gerber B.L.; Emdin M.; Aquaro G.D.
Institution
(Grigoratos, Barison, De Luca, Emdin, Aquaro) Fondazione Gabriele
Monasterio CNR/Regione Toscana, Pisa, Italy
(Grigoratos, Emdin) Institute of Life Sciences, Scuola Superiore
Sant'Anna, Pisa, Italy
(Ivanov, Heitner) Department of Cardiology, New York Methodist Hospital,
Brooklyn, NY, United States
(Andreini) Centro Cardiologico Monzino, IRCCS, Milan, Italy
(Andreini) Department of Clinical Sciences and Community Health,
Cardiovascular Section, University of Milan, Milan, Italy
(Amzulescu, Gerber) Division of Cardiology, Department of Cardiovascular
Diseases Cliniques St. Luc and Pole de Recherche Cardiovasculaire,
Institut de Recherche Experimentale et Clinique, Universite Catholique de
Louvain, Brussels, Belgium
(Mazurkiewicz, Grzybowski) Department of Cardiomyopathies, Institute of
Cardiology, Warsaw, Poland
(Mazurkiewicz, Marczak) CMR Unit, Institute of Cardiology, Warsaw, Poland
(Masci, Schwitter) Division of Cardiology and CMR-Center, University
Hospital Lausanne, Lausanne, Switzerland
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The objective of this meta-analysis was to assess the
predictive value of late gadolinium enhancement (LGE) and global systolic
impairment for future major adverse cardiovascular events in left
ventricular noncompaction (LVNC). <br/>Background(s): The prognosis of
patients with LVNC, with and without left ventricular dysfunction and LGE,
is still unclear. <br/>Method(s): A systematic review of published
research and a meta-analysis reporting a combined endpoint of hard
(cardiac death, sudden cardiac death, appropriate defibrillator firing,
resuscitated cardiac arrest, cardiac transplantation, assist device
implantation) and minor (heart failure hospitalization and thromboembolic
events) events was performed. <br/>Result(s): Four studies with 574
patients with LVNC and 677 with no LVNC and an average follow-up duration
of 5.2 years were analyzed. In patients with LVNC, LGE was associated with
the combined endpoint (pooled odds ratio: 4.9; 95% confidence interval:
1.63 to 14.6; p = 0.005) and cardiac death (pooled odds ratio: 9.8; 95%
confidence interval: 2.44 to 39.5; p < 0.001). Preserved left ventricular
systolic function was found in 183 patients with LVNC: 25 with positive
LGE and 158 with negative LGE. In LVNC with preserved ejection fraction,
positive LGE was associated with hard cardiac events (odds ratio: 6.1; 95%
confidence interval: 2.1 to 17.5; p < 0.001). No hard cardiac events were
recorded in patients with LVNC, preserved ejection fraction, and negative
LGE. <br/>Conclusion(s): Patients with LVNC but without LGE have a better
prognosis than those with LGE. When LGE is negative and global systolic
function is preserved, no hard cardiac events are to be expected.
Currently available criteria allow diagnosis of LVNC, but to further
define the presence and prognostic significance of the disease, LGE and/or
global systolic impairment must be considered for better risk
stratification.<br/>Copyright &#xa9; 2019 American College of Cardiology
Foundation

<58>
Accession Number
628176265
Title
Patency of Individual and Sequential Coronary Artery Bypass in Patients
with Ischemic Heart Disease: A Meta-analysis.
Source
Brazilian journal of cardiovascular surgery. 34 (4) (pp 420-427), 2019.
Date of Publication: 27 Aug 2019.
Author
Li Z.; Liu L.
Institution
(Li) Shandong Provincial PKUcare Luzhong Hospital Department of Thoracic
and Cardiovascular Surgery Zibo Shandong People's Republic of China
Department of Thoracic and Cardiovascular Surgery, Shandong Provincial
PKUcare Luzhong Hospital, Zibo, Shandong, China
(Li, Liu) Shandong University Shandong Provincial Qianfoshan Hospital
Department of Cardiac Surgery Jinan Shandong People's Republic of China
Department of Cardiac Surgery, Shandong Provincial Qianfoshan Hospital,
Shandong University, Jinan, Shandong, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the patency of individual and sequential coronary
artery bypass in patients with ischemic heart disease. <br/>METHOD(S): We
searched PubMed, Cochrane Library, Excerpta Medica Database, and
ClinicalTrials.gov databases for controlled trials. Endpoints included
graft patency, anastomosis patency, occluded rates in left anterior
descending (LAD) system and right coronary artery (RCA) system,
in-hospital mortality, and follow-up mortality. Pooled risk ratios (RRs)
and standardized mean difference (SMD) were used to assess the relative
data. <br/>RESULT(S): Nine cohorts, including 7100 patients and 1440
grafts under individual or sequential coronary artery bypass. There were
no significant differences between individual and sequential coronary
artery bypass in the graft patency (RR=0.96; 95% CI=0.91-1.02; P=0.16;
I2=87%), anastomosis patency (RR=0.95; 95% CI=0.91-1.00; P=0.05; I2=70%),
occluded rate in LAD system (RR=1.03; 95% CI=0.92-1.16; P=0.58; I2=37%),
occluded rate in RCA system (RR=1.36; 95% CI=0.72-2.57; P=0.35; I2=95%),
in-hospital mortality (RR=1.57; 95% CI=0.92-2.69; P=0.10; I2=0%), and
follow-up mortality (RR=0.96; 95% CI=0.36-2.53; P=0.93; I2=0%).
<br/>CONCLUSION(S): No significant differences on clinical data were
observed regarding anastomosis patency, occluded rate in LAD system,
occluded rate in RCA system, in-hospital mortality, and follow-up
mortality, indicating that the patency of individual and the patency of
sequential coronary artery bypass are similar to each other.

<59>
Accession Number
627212102
Title
Clinical and genetic insights into non-compaction: a meta-analysis and
systematic review on 7598 individuals.
Source
Clinical Research in Cardiology. (no pagination), 2019. Date of
Publication: 2019.
Author
Kayvanpour E.; Sedaghat-Hamedani F.; Gi W.-T.; Tugrul O.F.; Amr A.; Haas
J.; Zhu F.; Ehlermann P.; Uhlmann L.; Katus H.A.; Meder B.
Institution
(Kayvanpour, Sedaghat-Hamedani, Gi, Tugrul, Amr, Haas, Zhu, Ehlermann,
Katus, Meder) Department of Medicine III, Institute for Cardiomyopathy,
University of Heidelberg, INF 410, Heidelberg 69120, Germany
(Kayvanpour, Sedaghat-Hamedani, Gi, Tugrul, Amr, Haas, Katus, Meder) DZHK
(German Centre for Cardiovascular Research), Berlin, Germany
(Uhlmann) Institute of Medical Biometry and Informatics, University of
Heidelberg, Heidelberg, Germany
(Zhu) Department of Cardiology, Institute of Cardiology, Union Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan 430022, China
(Meder) Department of Genetics, Stanford Genome Technology Center,
Stanford University School of Medicine, Stanford, CA, United States
Publisher
Dr. Dietrich Steinkopff Verlag GmbH and Co. KG
Abstract
Background: Left ventricular non-compaction has been increasingly
diagnosed in recent years. However, it is still debated whether
non-compaction is a pathological condition or a physiological trait. In
this meta-analysis and systematic review, we compare studies, which
investigated these two different perspectives. Furthermore, we provide a
comprehensive overview on the clinical outcome as well as genetic
background of left ventricular non-compaction cardiomyopathy in adult
patients. <br/>Methods and Results: We retrieved PubMed/Medline
literatures in English language from 2000 to 19/09/2018 on clinical
outcome and genotype of patients with non-compaction. We summarized and
extensively reviewed all studies that passed selection criteria and
performed a meta-analysis on key phenotypic parameters. Altogether, 35
studies with 2271 non-compaction patients were included in our
meta-analysis. The mean age at diagnosis was the mid of their fifth
decade. Two-thirds of patients were male. Congenital heart diseases
including atrial or ventricular septum defect or Ebstein anomaly were
reported in 7% of patients. Twenty-four percent presented with family
history of cardiomyopathy. The mean frequency of neuromuscular diseases
was 5%. Heart rhythm abnormalities were reported frequently: conduction
disease in 26%, supraventricular tachycardia in 17%, and sustained or
non-sustained ventricular tachycardia in 18% of patients. Three important
outcome measures were reported including systemic thromboembolic events
with a mean frequency of 9%, heart transplantation with 4%, and adequate
ICD therapy with 15%. Nine studies investigated the genetics of
non-compaction cardiomyopathy. The most frequently mutated gene was TTN
with a pooled frequency of 11%. The average frequency of MYH7 mutations
was 9%, for MYBPC3 mutations 5%, and for CASQ2 and LDB3 3% each. TPM1,
MIB1, ACTC1, and LMNA mutations had an average frequency of 2% each.
Mutations in PLN, HCN4, TAZ, DTNA, TNNT2, and RBM20 were reported with a
frequency of 1% each. We also summarized the results of eight studies
investigating the non-compaction in altogether 5327 athletes, pregnant
women, patients with sickle cell disease, as well as individuals from
population-based cohorts, in which the presence of left ventricular
hypertrabeculation ranged from 1.3 to 37%. <br/>Conclusion(s): The
summarized data indicate that non-compaction may lead to unfavorable
outcome in different cardiomyopathy entities. The presence of key features
in a multimodal diagnostic approach could distinguish between benign
morphological trait and manifest cardiomyopathy.<br/>Copyright &#xa9;
2019, Springer-Verlag GmbH Germany, part of Springer Nature.

<60>
Accession Number
629379105
Title
A meta-analysis of pharmacological neuroprotection in noncardiac surgery:
focus on statins, lidocaine, ketamine, and magnesium sulfate.
Source
European review for medical and pharmacological sciences. 22 (6) (pp
1798-1811), 2018. Date of Publication: 01 Mar 2018.
Author
Zeng Z.-W.; Zhang Y.-N.; Lin W.-X.; Zhang W.-Q.; Luo R.
Institution
(Zeng) First Anesthesia Department, Meizhou People's Hospital, Guangdong
Province, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Non-cardiac surgery is associated with perioperative cerebral
complications (delirium, postoperative cognition dysfunction, stroke).
While rare, these complications can lead to disabilities and deaths.
Information is ambiguous as to whether pharmacological preoperative
treatment exerts neuroprotection. We wished to systematically assess
potential modulation by statins, lidocaine, ketamine or magnesium sulfate
of the relative risk of cerebral complications in noncardiac surgery.
Selection of these pharmacological agents was based on their known
neuroprotective abilities. <br/>PATIENTS AND METHODS: By searching
Medline, EMBASE and Cochrane databases, we identified 4 suitable
publications that collectively enrolled 1358 patients (intent-to-treat
population), of which 679 patients were treated preoperatively with
statins (404 patients on atorvastatin and 275 on rosuvastatin) and 679
patients with preoperative placebo. The reported cerebral outcome was
stroke, assessed either within 30 days (4 publications) or 6 months (2
publications) after surgery. <br/>RESULT(S): Episodes of stroke within 30
days and 6 months postoperatively were observed in several publications,
enabling aggregate analyses. No modulation by statins of the relative risk
of stroke at 30 days was observed (risk ratio 1.59, 95% confidence
interval 0.08-30.97; p = 0.76). At 6 months, statins showed an
insignificant trend toward neuroprotection (risk ratio 0.33, 95%
confidence interval 0.05-2.10; p = 0.24). <br/>CONCLUSION(S): The
available clinical data are still scarce. Our analyses indicate no
protective effects by statins against perioperative stroke but some
favorable trends toward delayed stroke. Further randomized trials are
needed to unequivocally assess the neuroprotective potential of current
pharmacological agents in non-cardiac surgery.

<61>
Accession Number
2003464680
Title
Cost-Effectiveness of Transcatheter Aortic Valve Implantation Using a
Balloon-Expandable Valve in Japan: Experience From the Japanese Pilot
Health Technology Assessment.
Source
Value in Health Regional Issues. 21 (pp 82-90), 2020. Date of Publication:
May 2020.
Author
Inoue S.; Nakao K.; Hanyu M.; Hayashida K.; Shibahara H.; Kobayashi M.;
Asaoka M.; Nishikawa K.; Clancy S.; Koshiishi J.; Sakamaki H.
Institution
(Inoue, Shibahara, Kobayashi) CRECON Medical Assessment Inc, Tokyo, Japan
(Nakao) Division of Cardiology, Cardiovascular Center, Saiseikai Kumamoto
Hospital, Kumamoto, Japan
(Hanyu) Cardiovascular Center, Kitano Hospital, Osaka, Japan
(Hayashida) Department of Cardiology, Keio University School of Medicine,
Tokyo, Japan
(Asaoka, Nishikawa) Edwards Lifesciences Limited, Tokyo, Japan
(Clancy) Edwards Lifesciences Corporation, Irvine, CA, United States
(Koshiishi) Abbott Vascular Japan Co, Ltd, Tokyo, Japan
(Sakamaki) Graduate School of Health Innovation, Kanagawa University of
Human Services, Kanagawa, Japan
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is an
innovative and effective treatment in high-surgical-risk (HR) and
inoperable patients with symptomatic severe aortic stenosis.
<br/>Objective(s): This cost-effectiveness analysis of transfemoral TAVI
(TF-TAVI) compared with surgical aortic valve replacement (SAVR) conforms
with the methodological guidelines for cost-effectiveness evaluation by
the Ministry of Health, Labor, and Welfare in Japan. <br/>Method(s): The
cost-effectiveness of TF-TAVI using SAPIEN XT was evaluated using a
lifetime Markov simulation from the national payer perspective.
Comparators were SAVR for HR patients and standard of care (SOC) for
inoperable patients. A systematic literature review for clinical evidence
of TF-TAVI and comparators was conducted. The evidence for TF-TAVI was
derived from the SOURCE XT registry and Japanese post marketing
surveillance. Because there was no literature directly or indirectly
comparing TF-TAVI using SAPIEN XT with comparators, the comparator data
were selected from relevant published studies, considering the similarity
of study eligibility criteria and patient backgrounds (eg, age and
surgical risk scores). Sensitivity analyses were used to validate the
robustness of results. <br/>Result(s): The incremental cost-effectiveness
ratio of TF-TAVI versus SAVR for HR patients was 1.3
million/quality-adjusted life-years (QALYs). The incremental
cost-effectiveness ratio of TF-TAVI versus SOC for inoperable patients was
3.5 million/QALY. <br/>Conclusion(s): TF-TAVI was cost-effective when
compared with SAVR for HR patients and when compared with SOC for
inoperable patients, using a threshold of 5 million/QALY.<br/>Copyright
&#xa9; 2019 ISPOR-The professional society for health economics and
outcomes research

<62>
Accession Number
2003460303
Title
Diagnostic Value of Advanced Imaging Modalities for the Detection and
Differentiation of Prosthetic Valve Obstruction: A Systematic Review and
Meta-Analysis.
Source
JACC: Cardiovascular Imaging. 12 (11P1) (pp 2182-2192), 2019. Date of
Publication: November 2019.
Author
Kim J.Y.; Suh Y.J.; Han K.; Kim Y.J.; Choi B.W.
Institution
(Kim) Department of Radiology, Dongsan Medical Center, Keimyung University
College of Medicine, Daegu, Korea, South Korea
(Suh, Han, Kim, Choi) Department of Radiology, Research Institute of
Radiological Science, Severance Hospital, Yonsei University College of
Medicine, Seoul, Korea, South Korea
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: This meta-analysis investigated the diagnostic values of
transthoracic echocardiography (TTE), 2-dimensional (2D) and 3-dimensional
(3D) transesophageal echocardiography (TEE), and multidetector-row
computed tomography (MDCT) in patients with suspected mechanical
prosthetic valve obstruction (PVO) for detecting subprosthetic mass and
differentiating its causes. <br/>Background(s): Diagnostic values of
advanced imaging modalities, such as MDCT and TEE, for the detection and
differentiation of PVO have not been investigated. <br/>Method(s): PubMed
and EMBASE were systematically searched for studies that evaluated PVO
using imaging modalities. The modified Quality Assessment of Diagnostic
Accuracy Studies-2 tool was used to evaluate study quality. Pooled
sensitivity of each modality for PVO detection and pooled diagnostic
accuracy of TEE and MDCT for differentiating the causes of PVO were
analyzed. Study heterogeneity was also assessed. <br/>Result(s): Seventeen
studies (229 patients) that used at least 1 index tool among TTE, TEE, or
MDCT were included. For detecting a subprosthetic mass that caused PVO, 3D
TEE and MDCT showed a higher sensitivity of 81% (95% confidence interval
[CI]: 40% to 95%) and 88% (95% CI: 81% to 93%), respectively, compared
with TTE (20%; 95% CI: 7% to 47%) and 2D TEE (68%; 95% CI: 46% to 84%).
Pooled sensitivity and specificity for diagnosing thrombus as a cause of
PVO was 75% (95% CI: 54% to 88%) and 75% (95% CI: 40% to 93%),
respectively, for TEE and 45% (95% CI: 16% to 77%) and 90% (95% CI: 77% to
96%), respectively, for MDCT. Pooled sensitivity for diagnosing pannus as
a cause of PVO was 62% (95% CI: 46% to 76%) for TEE and 85% (95% CI: 70%
to 93%) for MDCT. <br/>Conclusion(s): This meta-analysis suggested that
MDCT and 3D TEE have higher sensitivity than do TTE and 2D TEE, and can be
reliable imaging modalities for detecting a subprosthetic mass that causes
PVO. Moreover, MDCT can more accurately differentiate the cause of PVO
than does TEE.<br/>Copyright &#xa9; 2019 American College of Cardiology
Foundation

<63>
Accession Number
2003434883
Title
Perioperative Biomarkers Predicting Postoperative Atrial Fibrillation Risk
After Coronary Artery Bypass Grafting: A Narrative Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2019.
Date of Publication: 2019.
Author
Khan M.S.; Yamashita K.; Sharma V.; Ranjan R.; Selzman C.H.; Dosdall D.J.
Institution
(Khan, Yamashita, Ranjan, Selzman, Dosdall) Nora Eccles Harrison
Cardiovascular Research and Training Institute, University of Utah, Salt
Lake City, UT, United States
(Yamashita, Ranjan, Dosdall) Division of Cardiovascular Medicine,
University of Utah, Salt Lake City, UT, United States
(Sharma, Selzman, Dosdall) Division of Cardiothoracic Surgery, University
of Utah, Salt Lake City, UT, United States
(Ranjan, Dosdall) Department of Bioengineering, University of Utah, Salt
Lake City, UT, United States
Publisher
W.B. Saunders
Abstract
Postoperative atrial fibrillation (POAF) after cardiac surgery remains a
highly prevalent and costly condition that negatively impacts patient
quality of life and survival. Numerous retrospective studies,
meta-analysis, and review papers have been reported identifying POAF risk
based on patients' risk factors and clinical biomarkers. In this narrative
review, the authors report significant variations among selected pre- and
perioperative biomarkers used to predict POAF incidence in patients
without a history of atrial fibrillation (AF). POAF prediction based on
B-type natriuretic peptide, N-terminal pro B-type natriuretic peptide,
C-reactive protein, interleukin-6, creatinine, and plasminogen activator
inhibitor-1 differs significantly among different studies, thereby
limiting their clinical utility to predict POAF risk with high accuracy.
Conversely, soluble vascular endothelial cells adhesion molecule-1,
soluble CD40 ligand, Galectin-3, and aldosterone show promise for better
POAF prediction. However, the current datasets for these selected
biomarkers are not of sufficient size to validate the broad clinical
application specifically for patients with no prior history of
AF.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<64>
Accession Number
2003433121
Title
Meta-analysis Evaluating the Safety and Efficacy of Transcarotid
Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. (no pagination), 2019. Date of
Publication: 2019.
Author
Usman M.S.; Rawasia W.F.; Siddiqi T.J.; Mujeeb F.A.; Nadeem S.; Alkhouli
M.
Institution
(Usman, Siddiqi, Mujeeb, Nadeem) Dow University of Health Sciences,
Karachi, Pakistan
(Rawasia) River Region Cardiology Associates, Montgomery, AL, United
States
(Alkhouli) Mayo Clinic School of Medicine - Mayo Clinic, Rochester, MN,
United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
We performed a systemic review and meta-analysis of studies evaluating
transcarotid vascular access for transcatheter aortic valve implantation
(TAVI). Published studies evaluating transcarotid vascular access for TAVI
were included in this analysis. Outcomes of interest included 30-day
mortality, stroke/transient ischemic attack (TIA), new pacemaker
implantation, acute kidney injury (AKI), major vascular complication,
major bleeding, and myocardial infarction. Pooled estimate for 30-day
mortality was 5.3% (95% confidence interval [CI] 4.0% to 6.8%;
I² = 4%), stroke/TIA was 3.4% (95% CI 2.4% to 4.6%;
I² = 0%), new pacemaker implantation was 15.3% (95% CI 10.8% to
19.7%; I² = 72%), AKI was 3.4% (95% CI 1.3% to 6.5%;
I² = 58%), major vascular complication was 2.4% (95% CI 1.1% to
3.7%; I² = 46%), major bleeding was 4.3% (95% CI 2.8% to 6.1%;
I² = 11%), and myocardial infarction was 1.1% (95% CI 0.4% to
2.0%; I² = 0%). Metaregression was carried out to study the
association of effect size with the continuous study-level covariates that
included average age, proportion of males, and mean STS score. In this
regard, mean STS score showed association with major vascular
complications (coefficient: 0.008; p = 0.049). Cumulative meta-analysis
carried out showed that there was temporal trend of decreasing incidence
of stroke/TIA, major vascular complications, and AKI for transcarotid
TAVI. In conclusion, transcarotid access for TAVI is a reasonable choice
in patients requiring alternate access to transfemoral
route.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<65>
Accession Number
616133266
Title
Effect of high-dose sodium selenite in cardiac surgery patients: A
randomized controlled bi-center trial.
Source
Clinical Nutrition. 37 (4) (pp 1172-1180), 2018. Date of Publication:
August 2018.
Author
Schmidt T.; Pargger H.; Seeberger E.; Eckhart F.; von Felten S.; Haberthur
C.
Institution
(Schmidt, Eckhart, Haberthur) Department for Anesthesia, Intensive Care
Medicine and Rescue Medicine, Lucerne Cantonal Hospital, Lucerne,
Switzerland
(Pargger, Seeberger) Department of Anesthesiology, Operative Intensive
Care, Preclinical Emergency Medicine and Pain Management, University
Hospital Basel, Switzerland
(von Felten) Department of Clinical Research, Clinical Trial Unit,
University Hospital Basel, Switzerland
(Haberthur) Department of Anesthesiology and Intensive Care Medicine,
Hirslanden Clinic, Zurich, Switzerland
Publisher
Churchill Livingstone
Abstract
Background & aims: Cardiac surgery is accompanied by oxidative stress and
systemic inflammatory response, which may be associated with organ
dysfunction and increased mortality. Selenium and selenoenzymes are
important constituents of anti-oxidative defense. We hypothesized that
high-dose sodium selenite supplementation can attenuate the postoperative
inflammation and might, therefore, improve clinical outcome.
<br/>Method(s): Randomized, placebo-controlled, double-blinded, bi-center
study on 411 adult patients undergoing elective cardiac surgery. Patients
received an intravenous bolus of 4000 mug selenium (in the form of sodium
selenite) or placebo after induction of anesthesia and 1000 mug/d selenium
or placebo during their intensive care unit (ICU) stay. Primary outcome
measure was the Sequential Organ Failure Assessment (SOFA) score on the
second postoperative day. Secondary endpoints included the change in
perioperative selenium levels, change of inflammatory and cardiac markers,
use of vasoactive medication, incidence of acute kidney injury, ICU and
hospital length of stay, and mortality. <br/>Result(s): The perioperative
administration of high-dose sodium selenite prevented the postoperative
drop of blood and serum selenium levels, reduced the number of patients
depending on postoperative vasoactive support but failed to reduce the
postoperative SOFA score and its related organ-specific scores compared to
placebo. Except for an increase of postoperative procalcitonin and
bilirubin levels in the sodium selenite group, other inflammatory markers,
organ function variables and clinical endpoints remained unchanged.
<br/>Conclusion(s): The perioperative administration of high-dose sodium
selenite in cardiac surgery patients prevented the postoperative fall of
blood selenium levels and reduced the need for postoperative vasoactive
support by a yet unknown mechanism. Trial registration: Registered under
ClinicalTrials.gov Identifier no. NCT01141556.<br/>Copyright &#xa9; 2017
Elsevier Ltd and European Society for Clinical Nutrition and Metabolism

<66>
Accession Number
2002982431
Title
A Prolonged Air Leak Score for Lung Cancer Resection: An Analysis of The
Society of Thoracic Surgeons General Thoracic Surgery Database.
Source
Annals of Thoracic Surgery. 108 (5) (pp 1478-1483), 2019. Date of
Publication: November 2019.
Author
Seder C.W.; Basu S.; Ramsay T.; Rocco G.; Blackmon S.; Liptay M.J.;
Gilbert S.
Institution
(Seder, Liptay) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, IL, United States
(Basu) Department of Internal Medicine, Rush University Medical Center,
Chicago, IL, United States
(Ramsay) Ottawa Health Research Institute, University of Ottawa, Ottawa,
Ontario, Canada
(Rocco) Memorial Sloan Kettering Cancer Center, New York, NY, United
States
(Blackmon) Division of Thoracic Surgery, Department of Surgery, Mayo
Clinic, Rochester, MN, United States
(Gilbert) Division of Thoracic Surgery, Department of Surgery, University
of Ottawa, Ottawa, Ontario, Canada
Publisher
Elsevier USA
Abstract
Background: The objective of this study was to create a simple
preoperative tool to assess the risk of prolonged air leak (PAL) using The
Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD).
<br/>Method(s): The STS GTSD was queried for patients who underwent
elective lung cancer resection between 2009 and 2016. Exclusion criteria
included pneumonectomy, sleeve lobectomy, chest wall resection, bilateral
procedures, and patients with incomplete data sets. The primary outcome
was PAL exceeding 5 days. Multivariable logistic regression was used to
identify risk factors for a PAL. Model coefficients were used to generate
a PAL score (PALS). The approach was cross-validated in 100 replications
of a training set consisting of two-thirds of the cohort that was randomly
selected and a validation set of remaining patients. <br/>Result(s): A
total of 52,198 patients from the STS GTSD met inclusion criteria, with an
overall rate of PAL of 10.4% (n = 5453). Final variables incorporated into
the PALS included body mass index of 25 kg/m² or less (7
points), lobectomy or bilobectomy (6 points), forced expiratory volume in
1 second of 70% predicted or less (5 points), male sex (4 points), and
right upper lobe procedure (3 points). A cumulative PALS exceeding 17
points stratified patients as high-risk or low-risk for PAL (19.6% vs 9%
rate of PAL) with a cross-validated mean negative predictive value of 91%,
positive predictive value of 19%, sensitivity of 30%, specificity of 85%,
and correctly classifies 79% of patients. <br/>Conclusion(s): The PALS is
a simple preoperative clinical tool that can reliably risk-stratify
patients for PAL who are undergoing lung cancer resection.<br/>Copyright
&#xa9; 2019 The Society of Thoracic Surgeons

<67>
Accession Number
2003394705
Title
Carotid to subclavian bypass and Amplatzer vascular plug subclavian
endovascular occlusion before thoracic open or endovascular repair.
Source
Journal of Vascular Surgery. (no pagination), 2019. Date of Publication:
2019.
Author
Bertoglio L.; Salvati S.; Fittipialdi A.; Melloni A.; Kahlberg A.;
Cambiaghi T.; Melissano G.; Chiesa R.
Institution
(Bertoglio, Salvati, Fittipialdi, Melloni, Kahlberg, Melissano, Chiesa)
Division of Vascular Surgery, "Vita - Salute" University, Scientific
Institute H. San Raffaele, Milano, Italy
(Cambiaghi) Department of Cardiothoracic and Vascular Surgery, McGovern
Medical School at The University of Texas Health Science Center at Houston
(UTHealth) and Memorial Hermann Hospital, Houston, Tex, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: The aim of this study was to evaluate the safety and
effectiveness of endovascular occlusion of the prevertebral subclavian
artery (SA) using an Amplatzer vascular plug after prophylactic
revascularization with carotid-subclavian bypass (CSB) in the setting of
endovascular thoracic stent grafting or open arch repair with frozen
elephant trunk. <br/>Method(s): All patients who underwent SA plug
embolization (SAPE) and CSB from September 2009 to December 2018 were
enrolled in a registered study (SAPE study: clinicaltrials.gov
NCT03620006). The primary end point was technical success, defined as
complete occlusion of the origin of the SA, and how it was influenced by
SA anatomy. The secondary end points were access vessel complications,
cerebrovascular events, and CSB patency. <br/>Result(s): The 101 SAPE
procedures were performed using a type I (35 patients) or a type II (66
patients) Amplatzer vascular plug. A percutaneous ipsilateral upper
extremity access was used in 66% of patients and a radial artery access
was used in 50% of procedures. The 30-day primary technical success rate
was 95% (five patients received an additional plug during the index); five
type IC endoleaks were observed and successfully treated either with
surgical ligation (in open arch repair procedures) or secondary
embolization procedure (thoracic endovascular aneurysm repair group).
Three access vessel complications (3%) were recorded with percutaneous
brachial approach. At a median follow-up time of 11 months (range, 2-19
months), no new-onset type IC endoleak was observed, and the CSB patency
rate was 97%. <br/>Conclusion(s): SAPE after CSB is feasible and safe, and
has low incidence of type IC endoleaks. Further device developments are
needed to better adapt to the subclavian anatomy.<br/>Copyright &#xa9;
2019 Society for Vascular Surgery

<68>
Accession Number
2003392884
Title
Impact of diabetes mellitus on short term vascular complications after
TAVR: Results from the BRAVO-3 randomized trial.
Source
International Journal of Cardiology. (no pagination), 2019. Date of
Publication: 2019.
Author
Goel R.; Power D.; Tchetche D.; Chandiramani R.; Guedeney P.; Claessen
B.E.; Sartori S.; Cao D.; Meneveau N.; Tron C.; Dumonteil N.; Widder J.D.;
Hengstenberg C.; Ferrari M.; Violini R.; Stella P.R.; Jeger R.;
Anthopoulos P.; Deliargyris E.N.; Mehran R.; Dangas G.D.
Institution
(Goel, Power, Chandiramani, Claessen, Sartori, Cao, Mehran, Dangas) The
Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of
Medicine at Mount Sinai, New York City, NY, United States
(Tchetche, Dumonteil) Groupe CardioVasculaire Interventionnel, Clinique
Pasteur, Toulouse, France
(Guedeney) Sorbonne Universite, ACTION Study Group, Institut de
Cardiologie, Pitie Salpetriere Hospital (AP-HP), UMR_S, Paris 1166, France
(Meneveau) Department of Cardiology, University Hospital Jean Minjoz,
EA3920, Besancon 25000, France
(Tron) Division of Cardiology, CHU de Rouen, Rouen, France
(Widder) Department of Cardiology and Angiology, Hannover Medical School,
Hannover, Germany
(Hengstenberg) Department of Internal Medicine II, Division of Cardiology,
Medical University of Vienna, Waehringer Guertel 18-20, Vienna A-1090,
Austria
(Ferrari) Helios Dr. Horst Schmidt Kliniken Wiesbaden, Germany
(Violini) Interventional Cardiology Unit, San Camillo Hospital, Via
Circonvallazione Gianicolense, Rome, Italy
(Stella) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Jeger) Department of Cardiology, University Hospital Basel, University of
Basel, Switzerland
(Anthopoulos) Arena Pharmaceuticals Inc., Canton of Zug, Zug, Switzerland
(Deliargyris) PLx Pharma Inc., Sparta, NJ, United States
Publisher
Elsevier Ireland Ltd
Abstract
Aims: The impact of diabetes mellitus (DM) on clinical outcomes after
transcatheter aortic valve replacement (TAVR) remains unclear. The aim of
this study was to investigate the impact of DM on short-term clinical
outcomes after TAVR in a large randomized trial population. <br/>Methods
and Results: BRAVO-3 trial randomized 802 patients undergoing
trans-femoral TAVR to procedural anticoagulation with bivalirudin or
unfractionated heparin. The study population was divided according to the
presence of DM, and further stratified according to the use of insulin.
Net adverse cardiovascular outcomes (NACE - death, myocardial infarction
(MI), stroke or major bleeding by Bleeding Academic Research Consortium
(BARC) type 3b or above) was the primary outcome in-hospital and at
30-days. Of the total 802 randomized patients, 239 (30%) had DM at
baseline, with 87 (36%) being treated with insulin. At 30-days, DM
patients experienced numerically higher rates of net adverse
cardiovascular events (16.3% vs. 14.4%, p = 0.48) and acute kidney injury
(19.7% vs. 15.1%, p = 0.11), while non-DM (NDM) patients had numerically
higher rates of cerebrovascular accidents (3.6% vs. 1.7%, p = 0.22). After
multivariable adjustment, DM patients had higher odds of vascular
complications at 30-days (OR 1.57, p = 0.03) and life-threatening bleeding
both in-hospital (OR 1.50, p = 0.046) and at 30-days (OR 1.50, p = 0.03)
with the excess overall risk primarily attributed to the higher rates
observed among non-insulin dependent DM patients. <br/>Conclusion(s):
Patients with DM had higher adjusted odds of vascular and bleeding
complications up to 30-days post-TAVR. Overall, there was no significant
association between DM and early mortality following TAVR.<br/>Copyright
&#xa9; 2019 Elsevier B.V.

<69>
Accession Number
2003397064
Title
Reducing blood loss in pediatric craniosynostosis surgery by use of
tranexamic acid.
Source
Neurochirurgie. (no pagination), 2019. Date of Publication: 2019.
Author
Eustache G.; Riffaud L.
Institution
(Eustache) Rennes University, CHU of Rennes, Department of Anesthesiology,
Rennes 35000, France
(Riffaud) Rennes University, CHU of Rennes, Department of Neurosurgery,
Rennes 35000, France
(Riffaud) INSERM MediCIS, Unit U1099 LTSI, Rennes 1 University, Rennes,
35000, France
Publisher
Elsevier Masson SAS (62 rue Camille Desmoulins, Issy les Moulineaux Cedex
92442, France)
Abstract
Introduction: Craniosysnostosis surgical corrections are routine
procedures in the pediatric neurosurgical field. However, these procedures
result in significant blood loss. Tranexamic acid (TXA) is an
antifibrinolytic drug, which has demonstrated a significant reduction in
perioperative blood loss in many pediatric surgical procedures such as
cardiac surgery and scoliosis surgery. We conducted a systematic review to
evaluate protocols of TXA use in pediatric craniosynostosis procedures and
its effect on intraoperative blood loss and transfusions. <br/>Material(s)
and Method(s): A comprehensive literature review of the National Library
of Medicine (PubMed) database was performed to identify relevant studies.
We included any clinical study reporting on blood loss or blood
transfusion for pediatric craniosynostosis surgery with intraoperative use
of tranexamic acid, with the following limits: publication date from
inception to May 2019; reports in English. <br/>Result(s): Thirteen
studies were eligible for our review. Of the 13 studies, 4 were
prospective, randomised, double-blind controlled trials, 9 were
retrospective studies, tailored as a "before-after" studies, comparing
blood loss and transfusion without/with TXA. TXA significantly decreases
the number and volume of packed red blood cell transfusions and the rate
of transfusion in children undergoing craniosynostosis surgery.
Significantly fewer fresh frozen plasma transfusions were required in the
TXA groups in 2 randomised studies. Length of stay in hospital was
significantly lower with the use of TXA in three studies. Advantages of
TXA administration also include an excellent patient tolerance of side
effects, ease of administration and low cost. <br/>Conclusion(s): TXA
significantly reduces blood loss and the need for transfusions in children
undergoing craniosynostosis surgery. TXA administration should be a
routine part of strategy to reduce blood loss and limit transfusions in
these procedures.<br/>Copyright &#xa9; 2019 Elsevier Masson SAS

<70>
Accession Number
2003377263
Title
Postoperative Atrial Fibrillation Following Noncardiac Surgery Increases
Risk of Stroke.
Source
American Journal of Medicine. (no pagination), 2019. Date of Publication:
2019.
Author
Koshy A.N.; Hamilton G.; Theuerle J.; Teh A.W.; Han H.-C.; Gow P.J.; Lim
H.S.; Thijs V.; Farouque O.
Institution
(Koshy, Hamilton, Theuerle, Teh, Han, Lim, Farouque) Department of
Cardiology, Austin Health, Melbourne, Victoria, Australia
(Koshy, Teh, Han, Gow, Lim, Thijs, Farouque) Department of Medicine, The
University of Melbourne, Victoria, Australia
(Gow) Victorian Liver Transplant Unit, Austin Health, Melbourne, Victoria,
Australia
(Thijs) Stroke Division, Florey Institute of Neuroscience and Mental
Health and Department of Neurology, Austin Health, Melbourne, Victoria,
Australia
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: New-onset postoperative atrial fibrillation is well recognized
to be an adverse prognostic marker in patients undergoing noncardiac
surgery. Whether postoperative atrial fibrillation confers an increased
risk of stroke remains unclear. <br/>Method(s): A systematic review and
meta-analysis was performed to assess the risk of stroke after
postoperative atrial fibrillation in noncardiac surgery. MEDLINE,
Cochrane, and EMBASE databases were searched for articles published up to
May 2019 for studies of patients undergoing noncardiac surgery that
reported incidence of new atrial fibrillation and stroke. Event rates from
individual studies were pooled and risk ratios (RR) were pooled using a
random-effects model. <br/>Result(s): Fourteen studies of 3,536,291
patients undergoing noncardiac surgery were included in the quantitative
analysis (mean follow-up 1.4 +/- 1 year). New atrial fibrillation occurred
in 26,046 (0.74%), patients with a higher incidence following thoracic
surgery. Stroke occurred in 279 (1.5%) and 6199 (0.4%) patients with and
without postoperative atrial fibrillation, respectively. On pooled
analysis, postoperative atrial fibrillation was associated with a
significantly increased risk of stroke (RR 2.51; 95% confidence interval,
1.76-3.59), with moderate heterogeneity. The stroke risk was significantly
higher with atrial fibrillation following nonthoracic, compared with
thoracic, surgery (RR 3.09 vs RR 1.95; P = .01). <br/>Conclusion(s): New
postoperative atrial fibrillation following noncardiac surgery was
associated with a 2.5-fold increase in the risk of stroke. This risk was
highest among patients undergoing nonthoracic noncardiac surgery. Given
the documented efficacy of newer anticoagulants, randomized controlled
trials are warranted to assess whether they can reduce the risk of stroke
in these patients.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<71>
Accession Number
2003376600
Title
Prior Percutaneous Coronary Interventions May Be Associated With Increased
Mortality After Coronary Bypass Grafting: A Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2019.
Date of Publication: 2019.
Author
Luthra S.; Leiva-Juarez M.M.; Shine B.; Al-Attar N.; Ohri S.; Taggart D.P.
Institution
(Luthra, Ohri) Southampton University Hospitals, Southampton, United
Kingdom
(Leiva-Juarez) Department of Surgery, Brookdale University Hospital and
Medical Center, Brooklyn, NY, United States
(Shine, Taggart) University of Oxford, Oxford, United Kingdom
(Al-Attar) Golden Jubilee National Hospital, Glasgow, United Kingdom
Publisher
W.B. Saunders
Abstract
There is conflicting evidence for adverse outcomes after coronary artery
bypass surgery (CABG) with prior percutaneous intervention (PCI). A
literature search was performed from 1998 to 2017 and articles with
primary or secondary outcomes of survival, major adverse cardiovascular
events (MACE), and myocardial infarction in CABG patients with prior PCI
were included. Forest plots were generated from odds ratios for survival,
MACE, and myocardial infarction for unmatched and propensity-matched data.
Heterogeneity between studies was assessed for all outcomes using
I². Funnel plots were generated for early survival, survival at
5 years, survival at >5 years, and MACE. Thirty-one studies were included
over 18 years with 194,544 patients without PCI prior to CABG and 23,519
patients (12.09%) with prior PCI. Prior PCI did not adversely affect
survival among the included studies (inverse rate ratio: 1.12, 95%
confidence interval: 0.98-1.27, P = 0.110. MACE was significantly worse
for those with prior PCI (odds ratio: 1.26, confidence interval:
1.02-1.55, P = 0.03). The relative risk of mortality associated with prior
PCI has decreased significantly over the last 2 decades. Studies with
higher percentage of prior PCI patients had higher relative mortalities.
There was significant heterogeneity between studies for the treatment
effects. PCI prior to CABG in recent times does not adversely affect
survival despite adverse early and late MACE rates. However, high
institutional rates of prior PCI may be associated with increasing
mortality after CABG.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<72>
Accession Number
629662895
Title
Blood pressure in de novo heart transplant recipients treated with
everolimus compared with a cyclosporine-based regimen: Results from the
randomized schedule trial.
Source
Transplantation. 103 (4) (pp 781-788), 2019. Date of Publication: 01 Apr
2019.
Author
Andreassen A.K.; Broch K.; Eiskjaer H.; Karason K.; Gude E.; Molbak D.;
Stueflotten W.; Gullestad L.
Institution
(Andreassen, Broch, Gude, Stueflotten, Gullestad) Department of
Cardiology, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen
,Oslo 0424, Norway
(Andreassen, Gullestad) Faculty of Medicine, University of Oslo, Oslo,
Norway
(Eiskjaer, Molbak) Department of Cardiology, Aarhus University Hospital,
Skejby, Denmark
(Karason) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background. Systemic hypertension is prevalent in heart transplant
recipients and has been partially attributed to treatment with calcineurin
inhibitors (CNIs). SCandinavian HEart transplant De-novo stUdy with earLy
calcineurin inhibitors avoidancE trial was the first randomized trial to
study early withdrawal of CNIs in de novo heart transplant recipients,
comparing an everolimus-based immunosuppressive regimen with conventional
CNI-based treatment. As a prespecified secondary endpoint, blood pressure
was repeatedly compared across treatment arms. Methods. The The
SCandinavian HEart transplant De-novo stUdy with earLy calcineurin
inhibitors avoidancE trial was a prospective, multicenter, randomized,
controlled, parallel-group, open-label trial in de novo adult heart
transplant recipients, undertaken at transplant centers in Scandinavia.
Blood pressure was assessed with 24-hour ambulatory blood pressure
monitoring up to 3 years after heart transplantation (HTx) in 83 patients.
Results. Overall, systolic blood pressure fell with time, from 138 +/- 15
mm Hg 2 weeks after HTx to 134 +/- 11 mm Hg after 12 months and 132 +/- 14
mm Hg after 36 months (P = 0.003). Diastolic blood pressure did not change
over time. After 12 months, there was a numerically larger fall in
systolic blood pressure in the everolimus arm (between-group difference 8
mm Hg; P = 0.053), and after 36 months, there was a significant between
group difference of 13 mm Hg (P = 0.02) in favor of everolimus.
Conclusions. In this first, randomized trial with early CNI avoidance in
de novo HTx recipients, we observed a modest fall in systolic blood
pressure over the first 1 to 3 years after transplantation. The fall in
systolic blood pressure was more pronounced in patients allocated to
everolimus.<br/>Copyright &#xa9; 2018 Wolters Kluwer Health, Inc. All
rights reserved.

<73>
Accession Number
629660258
Title
Effect of Fibrinogen Concentrate vs Cryoprecipitate on Blood Component
Transfusion after Cardiac Surgery: The FIBRES Randomized Clinical Trial.
Source
JAMA - Journal of the American Medical Association. (no pagination), 2019.
Date of Publication: 2019.
Author
Callum J.; Farkouh M.E.; Scales D.C.; Heddle N.M.; Crowther M.; Rao V.;
Hucke H.-P.; Carroll J.; Grewal D.; Brar S.; Bussieres J.; Grocott H.;
Harle C.; Pavenski K.; Rochon A.; Saha T.; Shepherd L.; Syed S.; Tran D.;
Wong D.; Zeller M.; Karkouti K.
Institution
(Callum) Department of Laboratory Medicine and Molecular Diagnostics,
Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Callum) Laboratory Medicine Program, University Health Network, Toronto,
ON, Canada
(Callum) Department of Laboratory Medicine and Pathobiology, University of
Toronto, Toronto, ON, Canada
(Farkouh, Rao, Carroll, Grewal, Karkouti) Peter Munk Cardiac Centre,
University Health Network, Toronto, ON, Canada
(Farkouh) Heart and Stroke Richard Lewar Centre, University of Toronto,
Toronto, ON, Canada
(Scales, Karkouti) Interdepartmental Division of Critical Care, Department
of Medicine, University of Toronto, Toronto, ON, Canada
(Scales) Sunnybrook Research Institute, Department of Critical Care
Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Heddle) Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Heddle, Crowther) Department of Medicine, McMaster University, Hamilton,
ON, Canada
(Rao) University Health Network, Division of Cardiovascular Surgery,
Toronto General Hospital, Toronto, ON, Canada
(Rao, Carroll, Grewal) University of Toronto, Toronto, ON, Canada
(Hucke) Department of Biostatistics, ERGOMED CDS GmbH, Cologne, Germany
(Carroll, Grewal, Karkouti) Department of Anesthesia and Pain Management,
Sinai Health System, Women's College Hospital, University Health Network,
Toronto, ON, Canada
(Brar) Department of Anesthesiology, Pharmacology and Therapeutics,
University of British Columbia, Vancouver, Canada
(Brar) Royal Columbian Hospital, Vancouver, BC, Canada
(Bussieres) Anesthesiology Department, Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Universite Laval, Quebec City,
QC, Canada
(Grocott) Departments of Anesthesiology, Perioperative and Pain Medicine,
and Surgery, University of Manitoba, Winnipeg, Canada
(Harle) Department of Anesthesia and Perioperative Medicine, Western
University, London, ON, Canada
(Pavenski) St Michael's Hospital, Division of Transfusion Medicine,
Department of Laboratory Medicine and Pathobiology, University of Toronto,
Toronto, ON, Canada
(Rochon) Department of Anesthesiology, Montreal Heart Institute,
Universite de Montreal, Montreal, QC, Canada
(Saha) Department of Anesthesiology and Perioperative Medicine, Kingston
General Hospital, Queen's University, Kingston, ON, Canada
(Shepherd) Department of Pathology and Molecular Medicine, Kingston Health
Science Center, Queen's University, Kingston, ON, Canada
(Syed) Department of Anesthesiology, Hamilton Health Sciences Corporation,
McMaster University, Hamilton, ON, Canada
(Tran) University of Ottawa Heart Institute, Division of Cardiac
Anesthesiology and Critical Care, Department of Anesthesia and Pain
Medicine, University of Ottawa, School of Epidemiology and Public Health,
Ottawa, ON, Canada
(Wong) Cardiac Surgery, Royal Columbian Hospital, University of British
Columbia, Vancouver, Canada
(Zeller) McMaster Centre for Transfusion Research, Department of Medicine,
McMaster University, Hamilton, ON, Canada
(Karkouti) Department of Anesthesia, Institute of Health Policy,
Management, and Evaluation, University of Toronto, Toronto, ON, Canada
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
Importance: Excessive bleeding is a common complication of cardiac
surgery. An important cause of bleeding is acquired hypofibrinogenemia
(fibrinogen level <1.5-2.0 g/L), for which guidelines recommend fibrinogen
replacement with cryoprecipitate or fibrinogen concentrate. The 2 products
have important differences, but comparative clinical data are lacking.
<br/>Objective(s): To determine if fibrinogen concentrate is noninferior
to cryoprecipitate for treatment of bleeding related to hypofibrinogenemia
after cardiac surgery. <br/>Design, Setting, and Participant(s):
Randomized clinical trial at 11 Canadian hospitals enrolling adult
patients experiencing clinically significant bleeding and
hypofibrinogenemia after cardiac surgery (from February 10, 2017, to
November 1, 2018). Final 28-day follow-up visit was completed on November
28, 2018. <br/>Intervention(s): Fibrinogen concentrate (4 g; n = 415) or
cryoprecipitate (10 units; n = 412) for each ordered dose within 24 hours
after cardiopulmonary bypass. <br/>Main Outcomes and Measures: Primary
outcome was blood components (red blood cells, platelets, plasma)
administered during 24 hours post bypass. A 2-sample, 1-sided test for the
ratio of the mean number of units was conducted to evaluate noninferiority
(threshold for noninferiority ratio, <1.2). <br/>Result(s): Of 827
randomized patients, 735 (372 fibrinogen concentrate, 363 cryoprecipitate)
were treated and included in the primary analysis (median age, 64
[interquartile range, 53-72] years; 30% women; 72% underwent complex
operations; 95% moderate to severe bleeding; and pretreatment fibrinogen
level, 1.6 [interquartile range, 1.3-1.9] g/L). The trial met the a priori
stopping criterion for noninferiority at the interim analysis after 827 of
planned 1200 patients were randomized. Mean 24-hour postbypass allogeneic
transfusions were 16.3 (95% CI, 14.9 to 17.8) units in the fibrinogen
concentrate group and 17.0 (95% CI, 15.6 to 18.6) units in the
cryoprecipitate group (ratio, 0.96 [1-sided 97.5% CI, - to 1.09; P <.001
for noninferiority] [2-sided 95% CI, 0.84 to 1.09; P =.50 for
superiority]). Thromboembolic events occurred in 26 patients (7.0%) in the
fibrinogen concentrate group and 35 patients (9.6%) in the cryoprecipitate
group. <br/>Conclusions and Relevance: In patients undergoing cardiac
surgery who develop clinically significant bleeding and hypofibrinogenemia
after cardiopulmonary bypass, fibrinogen concentrate is noninferior to
cryoprecipitate with regard to number of blood components transfused in a
24-hour period post bypass. Use of fibrinogen concentrate may be
considered for management of bleeding in patients with acquired
hypofibrinogenemia in cardiac surgery. Trial Registration:
ClinicalTrials.gov Identifier: NCT03037424.<br/>Copyright &#xa9; 2019 BMJ
Publishing Group. All rights reserved.

<74>
Accession Number
625288499
Title
Effects of a prolonged intervention of breathing exercises after cardiac
surgery - a randomised controlled trial.
Source
European Journal of Physiotherapy. 21 (4) (pp 233-239), 2019. Date of
Publication: 02 Oct 2019.
Author
Carlsson M.; Berthelsen O.; Fagevik Olsen M.
Institution
(Carlsson, Berthelsen, Fagevik Olsen) Department of Physical Therapy,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Carlsson, Fagevik Olsen) Department of Physiotherapy, Institute of
Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
Publisher
Taylor and Francis Ltd
Abstract
Objectives: To evaluate the effect of a prolonged intervention of
breathing exercises with Inspiratory Resistance Positive Expiratory
Pressure for one month after open cardiac surgery concerning lung
function, respiratory movements and postoperative pulmonary complications.
<br/>Method(s): A randomised controlled trial comparing the effect of
home-based breathing exercise after discharge from the hospital or stop at
discharge. Eighty patients were randomly assigned to an intervention group
or control group. Forced vital capacity, forced expiratory volume in the
first second, peak expiratory flow, respratory movements and saturation
were measured at discharge and after the intervention. At follow-up
self-reported pulmonary complications were also recorded. <br/>Result(s):
A significant increase in forced vital capacity (p =.04) was found in the
intervention group compared with the control group, and there were a
tendency towards significant differences also in forced expiratory volume
in the first second and saturation (p =.06). Respiratory movements
increased significantly after one month but there were no significant
differences between groups. None of the patients reported being treated
for pneumonia. <br/>Conclusion(s): A prolonged intervention of breathing
exercise for one month after open cardiac surgery significantly increases
forced vital capacity and may accelerate recovery after cardiac surgery.
Clinical registration number: FoU in Sweden no 76141.<br/>Copyright &#xa9;
2018, &#xa9; 2018 Informa UK Limited, trading as Taylor & Francis Group.

<75>
Accession Number
614302509
Title
Comparison of late mortality after transcatheter aortic valve implantation
versus surgical aortic valve replacement: Insights from a meta-analysis.
Source
European Journal of Internal Medicine. 40 (pp 43-49), 2017. Date of
Publication: May 2017.
Author
Ando T.; Takagi H.
Institution
(Ando) Detroit Medical Center, Department of Cardiology, Detroit, MI,
United States
(Takagi) Shizuoka Medical Center, Department of Cardiovascular Surgery,
Shizuoka, Japan
Publisher
Elsevier B.V.
Abstract
Introduction Transcatheter aortic valve implantation (TAVI) has shown
non-inferior late mortality in severe aortic stenosis (AS) patients in
intermediate to inoperable risk for surgery compared to surgical aortic
valve replacement (SAVR). Late outcome of TAVI compared to SAVR is crucial
as the number of TAVI continues to increase over the last few years.
Methods A comprehensive literature search of PUBMED and EMBASE were
conducted. Inclusion criteria were that [1] study design was a randomized
controlled trial (RCT) or a propensity-score matched (PSM) study: [2]
outcomes included > 2-year all-cause mortality in both TAVI and SAVR. The
random-effects model was utilized to calculate an overall effect size of
TAVI compared to SAVR in all-cause mortality. Publication bias was
assessed quantitatively with Egger's test. Results A total of 14 studies
with 6503 (3292 TAVI and 3211 SAVR, respectively) were included in the
meta-analysis. There was no difference in late all-cause mortality between
TAVI and SAVR (HR 1.17, 95%CI 0.98-1.41, p = 0.08, I² = 61%).
The sub-group analysis of all-cause mortality of RCT (HR 0.93 95%CI
0.78-1.10, p = 0.38, I² = 40%) and PSM studies (HR 1.44 95%CI
1.15-1.80, p = 0.02, I² = 35%) differed significantly (p for
subgroup differences = 0.002). Meta-regression implicated that increased
age and co-existing CAD may be associated with more advantageous effects
of TAVI relative to SAVR on reducing late mortality. There was no evidence
of significant publication bias (p = 0.19 for Egger's test). Conclusions
TAVI conferred similar late all-cause mortality compared to SAVR in a
meta-analysis of RCT but had worse outcomes in a meta-analysis of
PSM.<br/>Copyright &#xa9; 2017 European Federation of Internal Medicine

<76>
Accession Number
629676710
Title
Incidence of cardiovascular events among tildrakizumabtreated patients
with moderateto-severe plaque psoriasis: Pooled data from three large,
randomized, clinical trials.
Source
Journal of Clinical and Aesthetic Dermatology. Conference: MauiDerm 2019
for Dermatologistss. United States. 12 (5 Supplement 1) (pp S25), 2019.
Date of Publication: May 2019.
Author
Bissonnette R.; Fernandez-Penas P.; Puig L.; Mendelsohn A.M.; Rozzo S.J.;
Menter A.M.
Institution
(Bissonnette) Innovaderm Research, Montreal, QC, Canada
(Fernandez-Penas) Department of Dermatology, Westmead Hospital, University
of Sydney, Sydney, NSW, Australia
(Puig) Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de
Barcelona, Barcelona, Spain
(Mendelsohn, Rozzo) Sun Pharmaceutical Industries,Inc., Princeton, NJ,
United States
(Menter) Division of Dermatology, Baylor Scott and White,and Texas A and M
College of Medicine, Dallas, TX, United States
Publisher
Matrix Medical Communications
Abstract
Background/Objective: Observational studies suggest that patients with
moderate-to-severe psoriasis might have an increased risk of major adverse
cardiovascular (CV) events (MACE). We assessed the incidence of CV events
during Phase II and III trials of tildrakizumab (TIL), a high-affinity,
humanized, immunoglobulin G1kappa, antiinterleukin- 23p19 antibody for
moderate-to-severe chronic plaque psoriasis. <br/>Method(s): This pooled
analysis included data from patients in P05495 (Phase IIb; NCT01225731)
and reSURFACE 1 and 2 (Phase III; NCT01722331 and NCT01729754) who
received placebo (PBO) or TIL 100 or 200mg at Weeks 0, 4, and every 12
weeks thereafter, and were followed up to Week 52 (P05495/reSURFACE 2) or
Week 64 (reSURFACE 1). reSURFACE 2 included an additional arm of
etanercept (ETN) 50mg administered twice per week for the first 12 weeks
and then once per week up to Week 28. PBO controls were included up to
Week 16 (P05495) or Week 12 (reSURFACE 1 and 2). Safety data from the
full-trial periods and Year 1 of the extensions were analyzed. In this
safety pool, patients with multiple treatments were counted in each
assigned treatment group after starting a different treatment. Extensions
to Phase III studies are ongoing. MACE comprised nonfatal myocardial
infarction (MI), stroke, and CV deaths confirmed as CV or sudden.
Confirmed composite-adjudicated CV (CACV) events included MACE; unstable
angina; coronary revascularization; resuscitated cardiac arrest; and fatal
or nonfatal thrombotic, embolic, or ischemic CV events. <br/>Result(s):
The pooled safety population included 588 patients who received PBO, 1,083
who received TIL 100mg, 1,041 TIL 200mg, and 313 ETN. The numbers of
patients with CACV events (exposure-adjusted rate, measured as the number
of patients with events/100 patient-years) were comparable for the TIL
100mg (4 [0.40]) and 200mg (8 [0.86]) groups versus PBO (1 [0.46]) and ETN
(1 [0.65]). Three deaths were adjudicated as MACE unrelated to study
treatment, all in patients with preexistent CV risk factors (e.g.,
hypertension): aneurysm (TIL 200mg) and respiratory arrest and MI (both
TIL 100mg). <br/>Conclusion(s): In the extension, across TIL 100 and 200mg
groups (n=1,237), only seven patients had CACV events (0.60%); no deaths
were due to CV events. In the TIL clinical program, the incidence of CV
events was low and comparable across TIL treatment groups and versus PBO
and ETN.

<77>
Accession Number
629659925
Title
Predictors of Late Mortality in D-Transposition of the Great Arteries
After Atrial Switch Repair: Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. 8 (21) (pp e012932), 2019. Date
of Publication: 05 Nov 2019.
Author
Venkatesh P.; Evans A.T.; Maw A.M.; Pashun R.A.; Patel A.; Kim L.; Feldman
D.; Minutello R.; Wong S.C.; Stribling J.C.; LaPar D.; Holzer R.; Ginns
J.; Bacha E.; Singh H.S.
Institution
(Venkatesh, Pashun, Patel, Kim, Feldman, Minutello, Wong, LaPar, Holzer,
Ginns, Bacha, Singh) Division of Cardiology Departments of Medicine and
Pediatrics Weill Cornell Medicine New York Presbyterian Hospital Cornell
Center for Adult Congenital Heart Disease New York NY
(Evans, Maw) Division of Hospital Medicine Weill Cornell Medicine New York
Presbyterian Hospital New York NY
(Stribling) Weill Cornell Medicine Samuel J. Wood Library Myra Mahon
Patient Resource Center New York NY
Publisher
NLM (Medline)
Abstract
Background Existing data on predictors of late mortality and prevention of
sudden cardiac death after atrial switch repair surgery for
D-transposition of the great arteries (D-TGA) are heterogeneous and
limited by statistical power. Methods and Results We conducted a
systematic review and meta-analysis of 29 observational studies,
comprising 5035 patients, that reported mortality after atrial switch
repair with a minimum follow-up of 10 years. We also examined 4 additional
studies comprising 105 patients who reported rates of implantable
cardioverter-defibrillator therapy in this population. Average survival
dropped to 65% at 40 years after atrial switch repair, with sudden cardiac
death accounting for 45% of all reported deaths. Mortality was
significantly lower in cohorts that were more recent and operated on
younger patients. Patient-level risk factors for late mortality were
history of supraventricular tachycardia (odds ratio [OR] 3.8, 95% CI
1.4-10.7), Mustard procedure compared with Senning (OR 2.9, 95% CI
1.9-4.5) and complex D-TGA compared with simple D-TGA (OR 4.4, 95% CI
2.2-8.8). Significant risk factors for sudden cardiac death were history
of supraventricular tachycardia (OR 4.7, 95% CI 2.2-9.8), Mustard
procedure (OR 2.2, 95% CI 1.1-4.1), and complex D-TGA (OR 5.7, 95% CI
1.8-18.0). Out of a total 124 implantable cardioverter-defibrillator
discharges over 330 patient-years in patients with implantable
cardioverter-defibrillators for primary prevention, only 8% were
appropriate. Conclusions Patient-level risk of both mortality and sudden
cardiac death after atrial switch repair are significantly increased by
history of supraventricular tachycardia, Mustard procedure, and complex
D-TGA. This knowledge may help refine current selection practices for
primary prevention implantable cardioverter-defibrillator implantation,
given disproportionately high rates of inappropriate discharges.

<78>
Accession Number
629667401
Title
High-Flow Nasal Cannula Therapy With Early Extubation for Subjects
Undergoing Off-Pump Coronary Artery Bypass Graft Surgery.
Source
Respiratory care. (no pagination), 2019. Date of Publication: 22 Oct 2019.
Author
Tatsuishi W.; Sato T.; Kataoka G.; Sato A.; Asano R.; Nakano K.
Institution
(Tatsuishi, Sato, Kataoka, Asano, Nakano) Department of Cardiovascular
Surgery
(Sato) Department of Clinical Engineering, Tokyo Women's Medical
University, Medical Center East, Tokyo, Japan
Publisher
NLM (Medline)
Abstract
BACKGROUND: The effects of high-flow nasal cannula (HFNC) therapy on
postoperative atelectasis and duration of oxygen therapy after off-pump
coronary artery bypass graft are unknown. The purpose of this study was to
compare the effects of HFNC therapy for subjects who underwent off-pump
coronary artery bypass graft with the effects of standard oxygen therapy
in terms of oxygen requirement and atelectasis. <br/>METHOD(S): This
prospective single-blinded randomized, controlled trial included 148
subjects who underwent off-pump coronary artery bypass graft between 2010
and 2015 with HFNC (n = 72) or without HFNC (standard O2, n = 76). The
primary end point was the percentage difference in loss of lung volume
between subjects with or without HFNC therapy. Secondary end points
included the total amount of oxygen administered and duration of oxygen
therapy with and without HFNC therapy. <br/>RESULT(S): There were
significant between-group differences in the percentage loss of lung
volume (P < .001), total amount of oxygen administered (P < .001),
duration of oxygen therapy (P < .001), and the need for postoperative
diuretic therapy (P = .037). The amount (rho = 0.569, P < .001) and
duration (rho = 0.678, P < .001) of oxygen administered were correlated
with atelectasis volume. <br/>CONCLUSION(S): Using HFNC therapy after
off-pump coronary artery bypass graft shortened the duration of oxygen
therapy and reduced the percentage loss of lung volume and total amount of
oxygen administered when compared with standard oxygen
therapy.<br/>Copyright &#xa9; 2019 by Daedalus Enterprises.

<79>
Accession Number
629667000
Title
Pacemaker Implantation and Dependency After Transcatheter Aortic Valve
Replacement in the REPRISE III Trial.
Source
Journal of the American Heart Association. 8 (21) (pp e012594), 2019. Date
of Publication: 05 Nov 2019.
Author
Meduri C.U.; Kereiakes D.J.; Rajagopal V.; Makkar R.R.; O'Hair D.; Linke
A.; Waksman R.; Babliaros V.; Stoler R.C.; Mishkel G.J.; Rizik D.G.; Iyer
V.S.; Schindler J.; Allocco D.J.; Meredith I.T.; Feldman T.E.; Reardon
M.J.
Institution
(Meduri, Rajagopal) Piedmont Heart Institute Atlanta GA
(Kereiakes) The Christ Hospital Heart and Vascular Center The Lindner
Research Center Cincinnati OH
(Makkar) Cedars-Sinai Heart Institute Los Angeles CA
(O'Hair) Aurora St. Luke's Medical Center Milwaukee WI
(Linke) Dresden University Hospital, Heart Center Dresden Germany
(Waksman) Washington Hospital Center Washington DC
(Babliaros) Emory University Hospital Emory University Atlanta GA
(Stoler) Baylor Heart & Vascular Hospital Dallas TX
(Mishkel) St. John's Hospital Springfield IL
(Rizik) HonorHealth and the Scottsdale-Lincoln Health Network Scottsdale
AZ
(Iyer) University at Buffalo/Gates Vascular Institute Buffalo NY
(Schindler) University of Pittsburgh Medical Center Pittsburgh PA
(Allocco, Meredith) Boston Scientific Corp Marlborough MA
(Feldman) Edwards Lifesciences Irvine California
(Feldman) Northshore University Health System Evanston Hospital Evanston
Illinois
(Reardon) Houston Methodist DeBakey Heart and Vascular Center Houston TX
Publisher
NLM (Medline)
Abstract
Background As transcatheter aortic valve replacement expands to younger
and/or lower risk patients, the long-term consequences of permanent
pacemaker implantation are a concern. Pacemaker dependency and impact have
not been methodically assessed in transcatheter aortic valve replacement
trials. We report the incidence and predictors of pacemaker implantation
and pacemaker dependency after transcatheter aortic valve replacement with
the Lotus valve. Methods and Results A total of 912 patients with
high/extreme surgical risk and symptomatic aortic stenosis were randomized
2:1 (Lotus:CoreValve) in REPRISE III (The Repositionable Percutaneous
Replacement of Stenotic Aortic Valve through Implantation of Lotus Valve
System-Randomized Clinical Evaluation) trial. Systematic assessment of
pacemaker dependency was pre-specified in the trial design. Pacemaker
implantation within 30 days was more frequent with Lotus than CoreValve.
By multivariable analysis, predictors of pacemaker implantation included
baseline right bundle branch block and depth of implantation; diabetes
mellitus was also a predictor with Lotus. No association between new
pacemaker implantation and clinical outcomes was found. Pacemaker
dependency was dynamic (30 days: 43%; 1 year: 50%) and not consistent for
individual patients over time. Predictors of pacemaker dependency at 30
days included baseline right bundle branch block, female sex, and depth of
implantation. No differences in mortality or stroke were found between
patients who were pacemaker dependent or not at 30 days. Rehospitalization
was higher in patients who were not pacemaker dependent versus patients
without a pacemaker or those who were dependent. Conclusions Pacemaker
implantation was not associated with adverse clinical outcomes. Most
patients with a new pacemaker at 30 days were not dependent at 1 year.
Mortality and stroke were similar between patients with or without
pacemaker dependency and patients without a pacemaker. Clinical Trial
Registration URL: https://www.clinicaltrials.gov/. Unique identifier
NCT02202434.

<80>
Accession Number
629661194
Title
Interatrial septum dissection and atrial wall hematoma following
transseptal puncture: A systematic review of the literature.
Source
Catheterization and cardiovascular interventions : official journal of the
Society for Cardiac Angiography & Interventions. (no pagination), 2019.
Date of Publication: 23 Oct 2019.
Author
Meier D.; Antiochos P.; Herrera-Siklody C.; Eeckhout E.; Delabays A.;
Tzimas G.; Fournier S.; Pascale P.; Muller O.; Monney P.
Institution
(Meier, Antiochos, Herrera-Siklody, Eeckhout, Delabays, Tzimas, Fournier,
Pascale, Muller, Monney) Division of Cardiology, University Hospital of
Lausanne (CHUV), Lausanne, Switzerland
(Fournier) Division of Cardiology, Department of Advanced Biomedical
Sciences, University of Naples Federico II, Italy
(Pascale, Muller, Monney) Faculty of Biology and Medicine, Lausanne
University, Lausanne, Switzerland
Publisher
NLM (Medline)
Abstract
BACKGROUND: Interatrial septum (IAS) dissection due to transseptal
puncture (TSP) is a rare, underreported complication of the procedure.
Data on the mechanism, diagnosis, and management of this complication are
lacking. <br/>METHOD(S): We conducted a systematic review of all reported
cases of IAS dissection with or without associated LA hematoma due to TSP,
by thoroughly searching MEDLINE and EMBASE through May 2019.
<br/>RESULT(S): After screening of n =882 studies, eight studies with a
total of 19 patients addressed the complication of IAS dissection and/or
LA hematoma secondary to TSP. Median age was 63years with a 1:1 male to
female ratio. Ablation of atrial fibrillation was the most frequently
reported procedure (84%). Diagnosis was established using fluoroscopy with
contrast injection (58%), TEE (32%) or intracardiac echocardiography (5%).
The mechanism identified involved puncture of the septum secundum portion
of the IAS, leading to transient needle passage into the extracardiac
space. In the majority of patients, the hematoma remained localized in the
IAS and management was conservative with progressive resolution of the
hematoma during follow-up (95%). Two patients (11%) required further
intervention by either pericardiocentesis or surgical drainage due to
hemodynamic instability. <br/>CONCLUSION(S): IAS dissection with or
without hematoma after TSP remains an underdiagnosed entity. The main
mechanism involves lesion to the septum secundum portion of the IAS,
resulting in needle passage into the extracardiac space and local
bleeding. Although conservative management may be sufficient in the
majority of cases, interventional cardiologists should be familiar with
this complication and its diagnosis.<br/>Copyright &#xa9; 2019 Wiley
Periodicals, Inc.

<81>
Accession Number
629662157
Title
Five-Year Outcomes of Transfemoral Transcatheter Aortic Valve Replacement
or Surgical Aortic Valve Replacement in a Real World Population: Final
Results from the OBSERVANT Study.
Source
Circulation: Cardiovascular Interventions. 12 (7) (no pagination), 2019.
Article Number: e007825. Date of Publication: 01 Jul 2019.
Author
Barbanti M.; Tamburino C.; D'Errigo P.; Biancari F.; Ranucci M.; Rosato
S.; Santoro G.; Fusco D.; Seccareccia F.
Institution
(Barbanti, Tamburino) Division of Cardiology, Policlinico-Vittorio
Emanuele Hospital, University of Catania, Via Santa Sofia 78, Catania
95123, Italy
(D'Errigo, Rosato, Seccareccia) National Centre for Global Health-Istituto
Superiore di Sanita, Rome, Italy
(Biancari) Department of Surgery, University of Oulu, Finland
(Biancari) Heart Center, Turku University Hospital, Department of Surgery,
University of Turku, Finland
(Ranucci) Department of Cardiothoracic and Vascular Anesthesia, ICU-IRCCS
Policlinico San Donato, San Donato Milanese (Milan), Italy
(Santoro) Fondazione G.Monasterio CNR/Regione Toscana per la Ricerca
Medica e la Sanita Pubblica, Florence, Italy
(Fusco) Department of Epidemiology of Lazio Regional Health Service, Rome,
Italy
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: The OBSERVANT study (Observational Study of Effectiveness of
SAVR-TAVI Procedures for Severe Aortic Stenosis Treatment) showed that
mortality at 1 year is similar after transfemoral transcatheter aortic
valve replacement (TAVR) or surgical aortic valve replacement (SAVR) for
real-world propensity-matched patients with aortic stenosis at low and
intermediate risk. We report the 5-year outcomes of the Italian OBSERVANT
study. <br/>Methods and Results: The unadjusted enrolled population
(N=7618) between December 2010 and June 2012 included 5707 patients on
SAVR and 1911 patients on TAVR. The propensity score method was applied to
select 2 groups with similar baseline characteristics. All outcomes were
adjudicated through a linkage with administrative databases. The primary
end points of this analysis were death from any cause and major adverse
cardiac and cerebrovascular events at 5 years. The matched population had
a total of 1300 patients (650 per group). The propensity score method
generated a low and intermediate-risk population (mean logistic EuroSCORE
2: 5.1+/-6.2% versus 4.9+/-5.1%, SAVR versus transfemoral TAVR; P=0.485).
At 5 years, the rate of 5 death from any cause was 35.8% in the surgical
group and 48.3% in the transcatheter group (hazard ratio, 1.38; 95% CI,
1.12-1.69; P=0.002). Similarly, TAVR was associated with an increased risk
of major adverse cardiac and cerebrovascular events as compared with SAVR
(42.5% versus 54.0%; hazard ratio, 1.35; 95% CI, 1.11-1.63; P=0.003). The
cumulative incidence of cerebrovascular events, myocardial infarction, and
coronary revascularization were similar in the study groups at 5 years.
<br/>Conclusion(s): The present results suggest that at 5 years, in a
real-world population with severe aortic stenosis and at low and
intermediate risk, suggest that SAVR is associated in with lower mortality
and major adverse cardiac and cerebrovascular events rates than
transfemoral TAVR performed using first-generation devices. These data
need to be confirmed in randomized trials using new-generation TAVR
devices.<br/>Copyright &#xa9; 2019 American Heart Association, Inc.

<82>
Accession Number
629662025
Title
Modified Lung Ultrasound Examinations in Assessment and Monitoring of
Positive End-Expiratory Pressure-Induced Lung Reaeration in Young Children
with Congenital Heart Disease under General Anesthesia.
Source
Pediatric Critical Care Medicine. 20 (5) (pp 442-449), 2019. Date of
Publication: 01 May 2019.
Author
Wu L.; Hou Q.; Bai J.; Zhang J.; Sun L.; Tan R.; Zhang M.; Zheng J.
Institution
(Wu, Bai, Zhang, Sun) Department of Anesthesiology, Shanghai Children's
Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong
University, Shanghai, China
(Hou) Diagnostic Imaging Center, Shanghai Children's Medical Center
Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai,
China
(Tan) Department of Obstetrics, Zhucheng People's Hospital, Shandong,
China
(Zhang, Zheng) Department of Anesthesiology, Pediatric Clinical
Pharmacology Laboratory, Shanghai Children's Medical Center Affiliated to
School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Objectives: Lung ultrasound can reliably diagnose pulmonary atelectasis.
The object of this study is to determine the most efficient region to
assess changes in atelectasis in children with congenital heart disease
under general anesthesia. <br/>Design(s): Randomized controlled trial.
<br/>Setting(s): Operating room at university-affiliated children's
hospital. <br/>Patient(s): Children between 3 months and 3 years old,
scheduled for elective congenital heart disease surgery under general
anesthesia. <br/>Intervention(s): Forty children with congenital heart
disease were randomly allocated to either a 5 cm H<inf>2</inf>O positive
end-expiratory pressure group or a standard therapy control group.
<br/>Measurements and Main Results: Preoperative lung ultrasound was
performed twice in each patient - after 1 and 15 minutes of mechanical
ventilation. Atelectatic areas and B-lines were compared between two
examinations. Different ultrasound regions were evaluated using
Bland-Altman plots. The occurrence rate of atelectasis was much higher in
inferoposterior lung regions (Scans 4-6) than in anterior and lateral
regions (Scans 1-3). The median (interquartile range) lung ultrasound
scores were lower in the positive end-expiratory pressure group than in
the control group after treatment: 8 (3.3-9.8) versus 13 (8.3-17.5; p <
0.001). The atelectatic area was significantly decreased after treatment
in the positive end-expiratory pressure group: 128 mm²
(34.5.5-213.3 mm²) versus 49.5 mm² (5.3-75.5
mm²; p < 0.001). Bland-Altman plots revealed concordance
between measurements in Scans 1-6 and those in Scans 4-6. In the posterior
axillary line regions, changes in atelectatic area were significantly
larger in the positive end-expiratory pressure group than in the control
group (p = 0.03, 0.007, and 0.018). <br/>Conclusion(s): Lung ultrasound in
inferoposterior lung regions may be more likely to reflect changes in
atelectasis and save examination time; 5 cm H<inf>2</inf>O positive
end-expiratory pressure may be useful in lung reaeration and can reduce,
but not eliminate, atelectasis in children with congenital heart
disease.<br/>Copyright &#xa9; 2019 by the Society of Critical Care
Medicine and the World Federation of Pediatric Intensive and Critical Care
Societies.

<83>
Accession Number
629661932
Title
Quantification of Ischemia As a Prognostic Mandate for Coronary
Revascularization in Asymptomatic Patients: How Much Is Enough?.
Source
Critical Pathways in Cardiology. 18 (2) (pp 98-101), 2019. Date of
Publication: 01 Jun 2019.
Author
Shabbir A.; Fan L.; Fraser G.; Cassar M.P.; Swinburn J.
Institution
(Shabbir, Fan, Fraser) John Radcliffe Hospital, Oxford University
Hospitals NHS Foundation Trust, Oxford OX3 9DU, United Kingdom
(Shabbir, Cassar, Swinburn) Royal Berkshire NHS Foundation Trust, Reading,
United Kingdom
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
The aim of this study was to investigate whether asymptomatic patients
with known coronary artery disease and demonstrable myocardial ischemia
warrant revascularization on prognostic grounds. A Medline and PubMed
search was performed, including 7 trials with data discussed and concise
reviews of prominent articles in the field. The magnitude of inducible
ischemia in those with known coronary disease correlates closely with poor
cardiovascular outcomes in terms of death, myocardial infarction,
hospitalization, and revascularization. Patients with >=10% inducible
ischemia experience a survival advantage when revascularized with a
reduction in mortality of greater than 50% regardless of symptoms (P <
0.00001). Evidence also suggests that left ventricular function remains
preserved in those who are revascularized when compared with medical
therapy alone; left ventricular ejection fraction 53.9% versus 48.8% (P <
0.001). Silent ischemia is a useful prognostic marker in those with known
coronary disease. It is recommended that asymptomatic patients with known
coronary disease be revascularized on prognostic grounds if >=10% ischemia
can be demonstrated on nuclear or myocardial perfusion scan, >=3 segments
of regional wall motion abnormality on stress echocardiography/cardiac
magnetic resonance imaging, or >=2 segments with perfusion deficits on
stress perfusion cardiac magnetic resonance imaging.<br/>Copyright &#xa9;
2018 Wolters Kluwer Health, Inc. All rights reserved.

<84>
Accession Number
629597722
Title
The use of a machine-learning algorithm that predicts hypotension during
surgery in combination with personalized treatment guidance: Study
protocol for a randomized clinical trial.
Source
Trials. 20 (1) (no pagination), 2019. Article Number: 582. Date of
Publication: 11 Oct 2019.
Author
Wijnberge M.; Schenk J.; Terwindt L.E.; Mulder M.P.; Hollmann M.W.; Vlaar
A.P.; Veelo D.P.; Geerts B.F.
Institution
(Wijnberge, Schenk, Terwindt, Mulder, Hollmann, Veelo, Geerts) Department
of Anesthesiology, Amsterdam UMC, Location Academic Medical Center,
University of Amsterdam, Meibergdreef 9, Postbus 22660, Amsterdam,AZ 1105,
Netherlands
(Wijnberge, Vlaar) Department of Intensive Care Medicine, Amsterdam UMC,
Location Academic Medical Center, University of Amsterdam, Meibergdreef 9,
Postbus 22660, Amsterdam AZ 1105, Netherlands
(Mulder) Department of Technical Medicine, University of Twente,
Drienerlolaan 5, Enschede,NB 7522, Netherlands
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Intraoperative hypotension is associated with increased
morbidity and mortality. Current treatment is mostly reactive. The
Hypotension Prediction Index (HPI) algorithm is able to predict
hypotension minutes before the blood pressure actually decreases. Internal
and external validation of this algorithm has shown good sensitivity and
specificity. We hypothesize that the use of this algorithm in combination
with a personalized treatment protocol will reduce the time weighted
average (TWA) in hypotension during surgery spent in hypotension
intraoperatively. Methods/design: We aim to include 100 adult patients
undergoing non-cardiac surgery with an anticipated duration of more than 2
h, necessitating the use of an arterial line, and an intraoperatively
targeted mean arterial pressure (MAP) of > 65 mmHg. This study is divided
into two parts; in phase A baseline TWA data from 40 patients will be
collected prospectively. A device (HemoSphere) with HPI software will be
connected but fully covered. Phase B is designed as a single-center,
randomized controlled trial were 60 patients will be randomized with
computer-generated blocks of four, six or eight, with an allocation ratio
of 1:1. In the intervention arm the HemoSphere with HPI will be used to
guide treatment; in the control arm the HemoSphere with HPI software will
be connected but fully covered. The primary outcome is the TWA in
hypotension during surgery. <br/>Discussion(s): The aim of this trial is
to explore whether the use of a machine-learning algorithm
intraoperatively can result in less hypotension. To test this, the
treating anesthesiologist will need to change treatment behavior from
reactive to proactive. Trial registration: This trial has been registered
with the NIH, U.S. National Library of Medicine at ClinicalTrials.gov, ID:
NCT03376347. The trial was submitted on 4 November 2017 and accepted for
registration on 18 December 2017.<br/>Copyright &#xa9; 2019 The Author(s).

<85>
Accession Number
629559378
Title
Impact of Prosthesis-Patient Mismatch on Survival after Mitral Valve
Replacement: A Meta-analysis.
Source
Thoracic and Cardiovascular Surgeon. 67 (7) (pp 538-545), 2019. Date of
Publication: 2019.
Author
Hwang H.-Y.; Sohn S.-H.; Jang M.-J.
Institution
(Hwang, Sohn, Jang) Medical Research Collaborating Center, Seoul National
University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea
Publisher
Georg Thieme Verlag (E-mail: iaorl@iaorl.org)
Abstract
Background: Numerous studies have demonstrated a negative impact of
prosthesis-patient mismatch (PPM) on long-term clinical outcomes after
aortic valve replacement. However, the impact of PPM after mitral valve
replacement (MVR) on clinical outcomes is still controversial. This study
was conducted to evaluate the impact of PPM on early and long-term
survival after MVR. <br/>Method(s): A literature search of five databases
was performed. The primary and secondary outcomes were all-cause mortality
and early mortality, respectively. Subgroup analyses were performed
according to the risk of bias, patients' age, proportion of female
patients, and proportion of patients with mechanical MVR. <br/>Result(s):
Eleven nonrandomized studies including 8,072 patients were included in
this meta-analysis. The overall incidence of PPM was 58.0% (range:
10.4-85.9%). The odds ratio of early mortality in nine studies was not
significantly different between the PPM and non-PPM patients (odds ratio:
1.35; 95% confidence interval [CI]: 0.98-1.86). A pooled analysis in 11
studies demonstrated that all-cause mortality after MVR was higher in the
PPM than non-PPM patients (hazard ratio [HR]: 1.39; 95% CI: 1.09-1.77).
This analysis revealed a moderate to high heterogeneity (I 2 = 69.4%).
When pooled analyses were performed in two subgroups according to the
proportion of patients with mechanical MVR, there were low heterogeneity
in each group. No other subgroup analyses demonstrated a significant
difference in the HR of all-cause mortality. Funnel plots and Egger's
tests showed no visually and statistically significant publication bias.
<br/>Conclusion(s): The present meta-analysis indicates that PPM
negatively affects long-term survival after MVR.<br/>Copyright &#xa9; 2019
Georg Thieme Verlag KG Stuttgart New York.

<86>
Accession Number
629638293
Title
Pericardial effusion under nivolumab: Case-reports and review of the
literature.
Source
Journal for ImmunoTherapy of Cancer. 7 (1) (no pagination), 2019. Article
Number: 266. Date of Publication: 18 Oct 2019.
Author
Anastasia S.; Audrey M.-L.; Jennifer A.; Constance T.; Mariana M.;
Francois G.; Stephane O.; Laurence W.
Institution
(Anastasia, Laurence) Immunologie Clinique, AP/HP, Hopital Europeen
Georges Pompidou, Paris, France
(Anastasia, Audrey, Mariana, Francois, Stephane, Laurence) Universite
Paris Descartes, Sorbonne Paris-Cite, Paris, France
(Audrey) Anatomopathologie, AP/HP, Hopital Cochin, Paris, France
(Jennifer, Francois) Oncologie Medicale, AP/HP, Hopital Cochin, Paris,
France
(Constance, Stephane) Oncologie Medicale, AP/HP, Hopital Europeen Georges
Pompidou, Paris, France
(Mariana) Unite Fonctionnelle de Cardio-oncologie et Prevention, AP/HP,
Hopital Europeen Georges Pompidou, Paris, France
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Nivolumab, a programmed death-1 (PD-1) inhibitor, is an immune
checkpoint inhibitor particularly used in the treatment of malignant
melanoma, non-small cell lung cancer and renal cell carcinoma.
Immune-related adverse events are frequent under immunotherapies.
Cardiotoxic side effects, initially thought to be rare, are more often
encountered paralleling the expanding use of immune checkpoint blockade.
Among them, pericardial effusion and tamponade deserve attention as they
may present with unusual symptomatology. Case presentation: We report
three cases of pericardial effusion under nivolumab for lung
adenocarcinoma. Two cases of early and late-onset pericardial effusion
were symptomatic with tamponade and one case occurred without any
symptoms. Pericardiocentesis with pericardial biopsy was performed in
symptomatic pericardial effusion followed by the administration of a
corticotherapy. Pericardial biopsies showed infiltration of T-lymphocytes,
mostly CD4⁺. Nivolumab was stopped in two cases and resumed for
one patient. Pericardial effusion evolved positively in all cases with or
without treatment. <br/>Conclusion(s): We review the literature on
pericardial effusion under nivolumab to further discuss the hallmarks of
pericardial effusion under nivolumab and the management of nivolumab
therapy in this situation. In conclusion, pericardial effusion as an
immune-related adverse event under nivolumab appears less rare than
initially thought and may require particular attention.<br/>Copyright
&#xa9; 2019 The Author(s).

<87>
Accession Number
2003365574
Title
Safety and efficacy of self-expandable Evolut R vs. balloon-expandable
Sapien 3 valves for transcatheter aortic valve implantation: A systematic
review and meta-analysis.
Source
Experimental and Therapeutic Medicine. 18 (5) (pp 3893-3904), 2019. Date
of Publication: 2019.
Author
He C.; Xiao L.; Liu J.
Institution
(He) Department of Cardiovascular Medicine, Hanchuan People's Hospital,
Hanchuan, Hubei 431600, China
(Xiao) Department of Haematology, Hanchuan Hospital of Traditional Chinese
Medicine, Hanchuan, Hubei 431600, China
(Liu) Department of Critical Care Medicine, Hanchuan People's Hospital, Te
1 People's Avenue, Hanchuan, Hubei 431600, China
Publisher
Spandidos Publications (10 Vriaxidos Street, Athens 116 10, Greece.
E-mail: subscriptions@spandidos-publications.com)
Abstract
The aim of this study was to systematically search literature and conduct
a meta-analysis comparing the clinical efficacy and safety of Evolut R and
Sapien 3 valves for transcatheter aortic valve implantation (TAVI). The
PubMed, Biomed Central, Scopus, Cochrane library and Google scholar
databases were searched for articles published up to June, 2019. A total
of 5 studies were included. In total, 795 patients underwent TAVI with
Evolut R, while 665 patients received the Sapien 3 valve in the included
studies. Overall device success with Evolut R was 95.7% and with Sapien 3
was 94.2%. Pooled data indicated no significant differences between the 2
valves (OR, 1.12; 95% CI, 0.66-1.89; P=0.68; I² =0%). No
significant differences were observed in the incidence of none to mild
paravalvular leakage between the 2 groups (OR, 1.71; 95% CI, 0.83-3.54;
P=0.14; I 2 =0%). Both mean [random; mean difference (MD) = -3.96; 95% CI,
-4.61 to -3.31; P<0.00001, I² =0%] and peak (random; MD =
-6.85; 95% CI, -8.22 to -5.48; P<0.00001, I² =0%) aortic valve
gradients were significantly lower with Evolut R. No significant
differences were observed in the 30-day mortality (OR, 1.32; 95% CI,
0.45-3.87; P=0.62; I² =0%) or 30-day stroke outcomes (OR, 0.76;
95% CI, 0.32-1.81; P=0.54; I² =0%) between the 2 devices. On
the whole, the findings of this study indicate that Evolut R and Sapien 3
valves may be comparable in terms of device success and short-term
complications. The differences between the 2 devices for post-operative
moderate to severe paravalvular leak and permanent pacemaker implantation
remain unclear. There is thus a need for a large multi-center randomized
controlled trial to provide stronger evidence on this
subject.<br/>Copyright &#xa9; 2019 Spandidos Publications. All rights
reserved.

<88>
Accession Number
2003332120
Title
Role of prophylactic magnesium supplementation in prevention of
postoperative atrial fibrillation in patients undergoing coronary artery
bypass grafting: A systematic review and meta-analysis of 20 randomized
controlled trials.
Source
Journal of Atrial Fibrillation. 12 (1) (no pagination), 2019. Date of
Publication: 2019.
Author
Garg J.; Turagam M.; Chaudhary R.; Gupta R.; Nazir T.; Bozorgnia B.;
Lakkireddy D.
Institution
(Chaudhary) Department of Medicine, Mayo Clinic, Rochester, MN, United
States
(Garg) Division of `Cardiology, Cardiac Arrhythmia Service, Medical
College of Wisconsin, Milwaukee, WI, United States
(Turagam) Helmsley Electrophysiology Center, Icahn School of Medicine,
Mount Sinai Hospital, New York, NY, United States
(Chaudhary) Peter Lee Associates, Sydney, Australia
(Gupta) Department of Medicine, Westchester Medical Center, New York
Medical College, Valhalla, NY, United States
(Nazir, Bozorgnia) Division of Cardiology, Lehigh Valley Health Network,
Allentown, PA, United States
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Kansas City, KS, United States
Publisher
CardioFront LLC (E-mail: editors.office@jafib.com)
Abstract
Background: Several randomized trials have evaluated the efficacy of
prophylactic magnesium (Mg) supplementation in prevention of
post-operative atrial fibrillation (POAF) in patients undergoing cardiac
artery bypass grafting (CABG). We aimed to determine the role of
prophylactic Mg in 3 different settings (intraoperative, postoperative,
intraoperative plus postoperative) in prevention of POAF. <br/>Method(s):
A systemic literature search was performed (until January 19, 2019) using
PubMed, EMBASE, Web of Science, and Cochrane Central Register of
Controlled Trials to identify trials evaluating Mg supplementation post
CABG. Primary outcome of our study was reduction in POAF post CABG.
<br/>Result(s): We included a total of 2,430 participants (1,196 in the Mg
group and 1,234 in the placebo group) enrolled in 20 randomized controlled
trials. Pooled analysis demonstrated no reduction in POAF between the two
groups (RR 0.90; 95% CI, 0.79-1.03; p=0.13; I²=42.9%). In
subgroup analysis, significant reduction in POAF was observed with
postoperative Mg supplementation (RR 0.76; 95% CI, 0.58-0.99; p=0.04;
I²=17.6%) but not with intraoperative or intraoperative plus
postoperative Mg supplementation (RR 0.77; 95% CI, 0.49-1.22; p = 0.27;
I²=49% and RR 0.92; 95% CI, 0.68-1.24; p = 0.58;
I²=51.8%, respectively). <br/>Conclusion(s): Magnesium
supplementation, especially in the postoperative period, is an effective
strategy in reducing POAF following CABG.<br/>Copyright &#xa9; 2019
CardioFront LLC. All rights reserved.

<89>
Accession Number
2003205620
Title
Hyperoxia during cardiopulmonary bypass does not decrease cardiovascular
complications following cardiac surgery: the CARDIOX randomized clinical
trial.
Source
Intensive Care Medicine. 45 (10) (pp 1413-1421), 2019. Date of
Publication: 01 Oct 2019.
Author
Abou-Arab O.; Huette P.; Martineau L.; Beauvalot C.; Beyls C.; Josse E.;
Touati G.; Bouchot O.; Bouhemad B.; Diouf M.; Lorne E.; Guinot P.-G.
Institution
(Abou-Arab, Huette, Martineau, Beyls, Lorne) Department of Anesthesiology
and Critical Care Medicine, Amiens Picardy University Hospital, 1, Rue du
Professeur Christian Cabrol, Amiens 80054, France
(Abou-Arab) MP3CV, EA7517, CURS, Jules Verne University of Picardy, Amiens
80054, France
(Beauvalot, Bouhemad, Guinot) Department of Anesthesiology and Critical
Care Medicine, Dijon University Hospital, Dijon 14033, France
(Josse, Diouf) Department of Clinical Research, Amiens Picardy University
Hospital, Amiens 80054, France
(Touati) Department of Cardiac Surgery, Amiens Picardy University
Hospital, Amiens 80054, France
(Bouchot) Department of Cardiac Surgery, Dijon University Hospital, Dijon
14033, France
Publisher
Springer Verlag (E-mail: service@springer.de)
Abstract
Purpose: Data on the benefit or or harmful effects of oxygen level on
ischemic reperfusion injuries in cardiac surgery are insufficient. We
hypothesized that hyperoxia during cardiopulmonary bypass decreases the
incidence of postoperative atrial fibrillation (POAF) and ventricular
fibrillation, and therefore decreases cardiovascular morbidity (CARDIOX
study). <br/>Method(s): An open-label, randomized clinical trial including
adults undergoing elective cardiac surgery, i.e. cardiopulmonary bypass
(CPB) randomized 1:1 to an intervention group or standard group at two
French University Hospitals from June 2016 to October 2018. The
intervention consisted in delivering of an inspired fraction of oxygen of
one to one during CPB. The standard care consisted in delivering oxygen to
achieve a partial arterial blood pressure less than 150 mmHg. The primary
endpoint was the occurrence of POAF and/or ventricular
tachycardia/ventricular fibrillation (VT/VF) within the 15 days following
cardiac surgery. The secondary endpoint was the occurrence of major
adverse cardiovascular events (MACCE: in-hospital mortality, stroke,
cardiac arrest, acute kidney injury, and mesenteric ischemia).
<br/>Result(s): 330 patients were randomly assigned to either the
intervention group (n = 161) or the standard group (n = 163). Mean
PaO<inf>2</inf> was 447 +/- 98 mmHg and 161 +/- 60 mmHg during CPB, for
the intervention and standard group (p < 0.0001) respectively. The
incidence of POAF or VT/VF were similar in the intervention group and the
standard group (30% [49 of 161 patients] and 30% [49 of 163 patients],
absolute risk reduction 0.4%; 95% CI, - 9.6-10.4; p = 0.94). MACCE was
similar between groups with, an occurrence of 24% and 21% for the
intervention group and the standard groups (absolute risk reduction 3.4%;
95% CI, - 5.7-12.5; p = 0.47) respectively. After adjustment, the primary
and secondary endpoints remained similar for both groups.
<br/>Conclusion(s): Hyperoxia did not decrease POAF and cardiovascular
morbidity following cardiac surgery with CPB. Clinicaltrial.gov
identifier: NCT02819739.<br/>Copyright &#xa9; 2019, Springer-Verlag GmbH
Germany, part of Springer Nature.

<90>
Accession Number
2003205625
Title
Effect of open-lung vs conventional perioperative ventilation strategies
on postoperative pulmonary complications after on-pump cardiac surgery:
the PROVECS randomized clinical trial.
Source
Intensive Care Medicine. 45 (10) (pp 1401-1412), 2019. Date of
Publication: 01 Oct 2019.
Author
Lagier D.; Fischer F.; Fornier W.; Huynh T.M.; Cholley B.; Guinard B.;
Heger B.; Quintana G.; Villacorta J.; Gaillat F.; Gomert R.; Degirmenci
S.; Colson P.; Lalande M.; Benkouiten S.; Minh T.H.; Pozzi M.; Collart F.;
Latremouille C.; Vidal Melo M.F.; Velly L.J.; Jaber S.; Fellahi J.-L.;
Baumstarck K.; Guidon C.
Institution
(Lagier, Guinard, Quintana, Villacorta, Gaillat, Gomert, Degirmenci,
Velly, Guidon) Departement d'Anesthesie et Reanimation (SAR 2), CHU La
Timone, Assistance Publique des Hopitaux de Marseille, Marseille, France
(Collart) Service de Chirurgie Cardiaque, CHU La Timone, Assistance
Publique des Hopitaux de Marseille, Marseille, France
(Lagier) C2VN, Inserm 1263, Inra 1260, Aix Marseille Universite,
Marseille, France
(Velly) INT, Aix Marseille Universite, Marseille, France
(Fischer, Heger) Departement d'Anesthesie et Reanimation, Nouvel Hopital
Civil, Hopitaux Universitaires de Strasbourg, Strasbourg, France
(Minh) Service de Chirurgie Cardiaque, Nouvel Hopital Civil, Strasbourg,
France
(Fornier, Fellahi) Service d'Anesthesie et Reanimation, Hospices Civils de
Lyon, Hopital Louis Pradel, Lyon, France
(Pozzi) Service de Chirurgie Cardiaque, Hospices Civils de Lyon, Hopital
Louis Pradel, Lyon, France
(Fellahi) IHU OPERA, Inserm 1060, Faculte de Medecine Lyon Est, Universite
Claude Bernard Lyon 1, Lyon, France
(Fornier) Centre d'Investigation Clinique de Lyon, INSERM 1407, Lyon,
France
(Huynh, Cholley) Service d'Anesthesie et Reanimation, Hopital Europeen
Georges Pompidou, AP-HP, Paris, France
(Huynh, Cholley, Latremouille) Service de Chirurgie Cardiaque, Hopital
Europeen Georges Pompidou, AP-HP, Paris, France
(Huynh, Cholley, Latremouille) Universite Paris Descartes-Sorbonne
Paris-Cite, Paris, France
(Colson, Lalande) CHU de Montpellier, Departement d'Anesthesie et
Reanimation, Hopital Arnaud de Villeneuve, Montpellier, France
(Jaber) Departement d'Anesthesie et Reanimation, Hopital Saint-Eloi,
Montpellier, France
(Colson) IGF, Cnrs, Inserm, Universite de Montpellier, Montpellier, France
(Jaber) UMR CNRS 9214-Inserm U1046, Universite de Montpellier,
Montpellier, France
(Vidal Melo) Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Harvard Medical School, Boston, United
States
(Benkouiten) Direction de la Recherche en Sante de l'Assistance Publique
des Hopitaux de Marseille, Marseille, France
(Baumstarck) Centre d'Etudes et de Recherches sur les Services de Sante et
Qualite, Faculte de Medecine, Aix-Marseille Universite, Marseille, France
Publisher
Springer Verlag (E-mail: service@springer.de)
Abstract
Purpose: To evaluate whether a perioperative open-lung ventilation
strategy prevents postoperative pulmonary complications after elective
on-pump cardiac surgery. <br/>Method(s): In a pragmatic, randomized,
multicenter, controlled trial, we assigned patients planned for on-pump
cardiac surgery to either a conventional ventilation strategy with no
ventilation during cardiopulmonary bypass (CPB) and lower perioperative
positive end-expiratory pressure (PEEP) levels (2 cm H<inf>2</inf>O) or an
open-lung ventilation strategy that included maintaining ventilation
during CPB along with perioperative recruitment maneuvers and higher PEEP
levels (8 cm H<inf>2</inf>O). All study patients were ventilated with
low-tidal volumes before and after CPB (6 to 8 ml/kg of predicted body
weight). The primary end point was a composite of pulmonary complications
occurring within the first 7 postoperative days. <br/>Result(s): Among 493
randomized patients, 488 completed the study (mean age, 65.7 years; 360
(73.7%) men; 230 (47.1%) underwent isolated valve surgery). Postoperative
pulmonary complications occurred in 133 of 243 patients (54.7%) assigned
to open-lung ventilation and in 145 of 245 patients (59.2%) assigned to
conventional ventilation (p = 0.32). Open-lung ventilation did not
significantly reduce the use of high-flow nasal oxygenotherapy (8.6% vs
9.4%; p = 0.77), non-invasive ventilation (13.2% vs 15.5%; p = 0.46) or
new invasive mechanical ventilation (0.8% vs 2.4%, p = 0.28). Mean alive
ICU-free days at postoperative day 7 was 4.4 +/- 1.3 days in the open-lung
group vs 4.3 +/- 1.3 days in the conventional group (mean difference, 0.1
+/- 0.1 day, p = 0.51). Extra-pulmonary complications and adverse events
did not significantly differ between groups. <br/>Conclusion(s): A
perioperative open-lung ventilation including ventilation during CPB does
not reduce the incidence of postoperative pulmonary complications as
compared with usual care. This finding does not support the use of such a
strategy in patients undergoing on-pump cardiac surgery. Trial
registration: Clinicaltrials.gov Identifier: NCT 02866578.
https://clinicaltrials.gov/ct2/show/NCT02866578.<br/>Copyright &#xa9;
2019, Springer-Verlag GmbH Germany, part of Springer Nature.

<91>
Accession Number
2002834883
Title
Effects of anesthetic depth on postoperative cognitive dysfunction (pocd)
in non-cardiac surgical patients: A meta-analysis.
Source
International Journal of Clinical and Experimental Medicine. 12 (9) (pp
11169-11177), 2019. Date of Publication: 2019.
Author
An R.; Pang Q.; Liu H.
Institution
(An, Pang, Liu) Department of Anesthesiology, Chongqing University Cancer
Hospital, Chongqing, China
Publisher
E-Century Publishing Corporation (40 White Oaks Lane, Madison WI 53711,
United States)
Abstract
The current study aimed to summarize related published articles concerning
the depth of anesthesia and postoperative cognitive dysfunction (POCD) in
non-cardiac surgical patients. Moreover, this study aimed to investigate
the effects of the depth of anesthesia on short- or long-term POCD.
<br/>Method(s): Medline, Embase, Ovid, Cochrane Library, Google Scholar,
CNKI, and Wan-fang databases were searched. Researchers focused on the
effects of the depth of anesthesia on POCD and on postoperative S100-beta
protein levels. <br/>Result(s): A total of 2,625 patients from 20
randomized controlled trials (RCTs) were enrolled. The current
meta-analysis shows that deep anesthesia significantly decreased incidence
of POCD, compared with light anesthesia, on day 1 [OR, 0.31; 95% CI (0.24,
0.40), P < 0.00001, from 3 to 5 days [OR, 0.35; 95% CI (0.24, 0.52), P <
0.00001], day 7 [OR, 0.45; 95% CI (0.27, 0.74), P=0.002], and from 1 to 3
months [OR, 0.66; 95% CI (0.45,0.99), P=0.04] after surgery. Serum
S100-beta protein levels in patients that received deep anesthesia were
much lower than those in patients receiving light anesthesia [MD, -270.29;
95% CI (-295.81, -244.77), P < 0.00001] on postoperative day 1.
<br/>Conclusion(s): Deep anesthesia can significantly reduce incidence
rates of short- or long-term POCD. Serum S100-beta protein levels on
postoperative day 1 could be reduced with deep anesthesia.<br/>Copyright
&#xa9; 2019, E-Century Publishing Corporation. All rights reserved.

<92>
Accession Number
2002629167
Title
Pterins as diagnostic markers of mechanical and impact-induced trauma: A
systematic review.
Source
Journal of Clinical Medicine. 8 (9) (no pagination), 2019. Article Number:
1383. Date of Publication: September 2019.
Author
Lindsay A.; Baxter-Parker G.; Gieseg S.P.
Institution
(Lindsay) Institution for Physical Activity and Nutrition (IPAN), School
of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
(Baxter-Parker, Gieseg) School of Biological Sciences, University of
Canterbury, Christchurch 8140, New Zealand
(Gieseg) Department of Radiology, University of Otago Christchurch, PO Box
4345, Christchurch 8011, New Zealand
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: indexing@mdpi.com)
Abstract
We performed a systematic review of the literature to evaluate pterins as
biomarkers of mechanical and impact-induced trauma. MEDLINE and Scopus
were searched in March 2019. We included in vivo human studies that
measured a pterin in response to mechanical or impact-induced trauma with
no underlying prior disease or complication. We included 40 studies with a
total of 3829 subjects. Seventy-seven percent of studies measured a
significant increase in a pterin, primarily neopterin or total neopterin
(neopterin + 7,8-dihydroneopterin). Fifty-one percent of studies measured
an increase within 24 h or trauma, while 46% measured increases beyond 48
h. Pterins also showed promise as predictors of post-trauma complications
such as sepsis, multi-organ failure and mortality. Exercise-induced trauma
and traumatic brain injury caused an immediate increase in neopterin or
total neopterin, while patients of multiple trauma had elevated pterin
levels that remained above baseline for several days. Pterin concentration
changes in response to surgery were variable with patients undergoing
cardiac surgery having immediate and sustained pterin increases, while
hysterectomy, liver resection or hysterectomy showed no change. This
review provides systematic evidence that pterins, in particular neopterin
and total neopterin, increase in response to multiple forms of mechanical
or impact-induced trauma.<br/>Copyright &#xa9; 2019 by the authors.
Licensee MDPI, Basel, Switzerland.

<93>
Accession Number
629676269
Title
Heart Transplantation with Donation after Circulatory Death: What Have We
Learned from Preclinical Studies?.
Source
Circulation: Heart Failure. 12 (4) (no pagination), 2019. Article Number:
e005517. Date of Publication: 01 Apr 2019.
Author
Niederberger P.; Farine E.; Raillard M.; Dornbierer M.; Freed D.H.; Large
S.R.; Chew H.C.; MacDonald P.S.; Messer S.J.; White C.W.; Carrel T.P.;
Tevaearai Stahel H.T.; Longnus S.L.
Institution
(Niederberger, Farine, Dornbierer, Carrel, Tevaearai Stahel, Longnus)
Department of Cardiovascular Surgery, Inselspital, Bern University
Hospital, Department for BioMedical Research, University of Bern,
Murtenstrasse 35, Bern CH-3008, Switzerland
(Raillard) Experimental Surgery Unit (ESI), Experimental Surgery Unit,
Dept. for Biomed. Res., Vetsuisse Fac., Dept. of Clin. Vet. Med., Inst. of
Anaesthiol. and Pain Ther., Univ. of Bern, Switzerland
(Freed, White) Cardiac Surgery, University of Alberta, Edmonton, Canada
(Large, Messer) Department of Transplantation, Royal Papworth Hospital,
Papworth Everard, Cambridge, United Kingdom
(Chew, MacDonald) St Vincent's Hospital, University of New South Wales,
Victor Chang Cardiac Research Institute, Sydney, Australia
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Heart transplantation remains the preferred option for improving quality
of life and survival for patients suffering from end-stage heart failure.
Unfortunately, insufficient supply of cardiac grafts has become an
obstacle. Increasing organ availability with donation after circulatory
death (DCD) may be a promising option to overcome the organ shortage.
Unlike conventional donation after brain death, DCD organs undergo a
period of warm, global ischemia between circulatory arrest and graft
procurement, which raises concerns for graft quality. Nonetheless, the
potential of DCD heart transplantation is being reconsidered, after
reports of more than 70 cases in Australia and the United Kingdom over the
past 3 years. Ensuring optimal patient outcomes and generalized adoption
of DCD in heart transplantation, however, requires further development of
clinical protocols, which in turn require a better understanding of
cardiac ischemia-reperfusion injury and the various possibilities to limit
its adverse effects. Thus, we aim to provide an overview of the knowledge
obtained with preclinical studies in animal models of DCD heart
transplantation, to facilitate and promote the most effective and
efficient advancement in preclinical research. A literature search of the
PubMed database was performed to identify all relevant preclinical studies
in DCD heart transplantation. Specific aspects relevant for DCD heart
transplantation were analyzed, including animal models, graft procurement
and storage conditions, cardioprotective approaches, and graft evaluation
strategies. Several potential therapeutic strategies for optimizing graft
quality are identified, and recommendations for further preclinical
research are provided.<br/>Copyright &#xa9; 2019 American Heart
Association, Inc.

<94>
Accession Number
629675822
Title
An economic analysis of medical and surgical management of aortopathy
associated with bicuspid aortic valve.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 5 (4) (pp
380-387), 2019. Date of Publication: 01 Oct 2019.
Author
Hardikar A.; Marwick T.H.
Institution
(Hardikar, Marwick) Cardiovascular Imaging Group, Menzies Institute for
Medical Research, 17 Liverpool Street, Hobart, TAS, Australia
(Hardikar) Department of Cardiothoracic Surgery, Royal Hobart Hospital, 48
Liverpool Street, Hobart, TAS, Australia
(Marwick) Imaging Research, Baker Heart and Diabetes Institute, 75
Commercial Road, Melbourne, VIC, Australia
Publisher
Oxford University Press
Abstract
Aims: To develop a cost-effectiveness model to address the outcome and
economic implications of different thresholds for surgery in the
management of aortopathy associated with bicuspid aortic valve disease.
<br/>Methods and Results: A model was created from the perspective of an
Australian healthcare funding agency. The index case was a 65-year-old
with bicuspid aortic valve (BAV) and ascending aorta diameter of 5.0 cm.
Health states were defined as: pre-operative with dilated aorta,
post-operative without complications, post-complication, and death. The
mean and variance of risks and transition probabilities were taken from a
local surgical database and local costs and utilities of elective and
urgent thoracic aortic surgery (AoS) with or without aortic valve
replacement, with a sensitivity analysis based on a systematic review.
Scenario analyses were provided for other aortic dimensions. Implications
for survival, quality-adjusted life years (QALYs), and costs were
calculated from healthcare delivery and economic perspectives. After 10
000 simulations for the reference case, the utility of watchful waiting
(WW) exceeded that of elective AoS (13 +/- 4 vs. 10 +/- 5 QALY). The net
monetary benefit was A$351 063 +/- 304 965 with immediate AoS vs. 534 797
+/- 198 570 with WW surveillance. The most important variables affecting
effectiveness were utility value of survivors, rate of aortic growth, and
probability of acute aortic event during WW. <br/>Conclusion(s): This
decision-analytic model informed by our practice, as well as a systematic
analysis, shows that AoS in a BAV patient with aorta <5 cm diameter is
costlier and less effective than WW.<br/>Copyright &#xa9; 2019 Published
on behalf of the European Society of Cardiology. All rights reserved.

<95>
Accession Number
629675183
Title
Randomized Trial Evaluating Percutaneous Coronary Intervention for the
Treatment of Chronic Total Occlusion: The DECISION-CTO Trial.
Source
Circulation. 139 (14) (pp 1674-1683), 2019. Date of Publication: 02 Apr
2019.
Author
Lee S.-W.; Lee P.H.; Ahn J.-M.; Park D.-W.; Yun S.-C.; Han S.; Kang H.;
Kang S.-J.; Kim Y.-H.; Lee C.W.; Park S.-W.; Hur S.H.; Rha S.-W.; Her
S.-H.; Choi S.W.; Lee B.-K.; Lee N.-H.; Lee J.-Y.; Cheong S.-S.; Kim M.H.;
Ahn Y.-K.; Lim S.W.; Lee S.-G.; Hiremath S.; Santoso T.; Udayachalerm W.;
Cheng J.J.; Cohen D.J.; Muramatsu T.; Tsuchikane E.; Asakura Y.; Park
S.-J.
Institution
(Lee, Lee, Ahn, Park, Kang, Kang, Kim, Lee, Park, Park) Department of
Cardiology, Center for Medical Research and Information, University of
Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil,
Songpa-gu, Seoul 05505, South Korea
(Yun) Biostatistics, Center for Medical Research and Information,
University of Ulsan College of Medicine, Asan Medical Center, Seoul, South
Korea
(Han) Department of Applied Statistics, Gachon University, Seongnam, South
Korea
(Hur) Department of Cardiology, Keimyung University Dongsan Medical
Center, Daegu, South Korea
(Rha) Department of Cardiology, Korea University Guro Hospital, South
Korea
(Her) Department of Cardiology, Catholic University of Korea, Daejeon St.
Mary's Hospital, South Korea
(Choi) Department of Cardiology, Chungnam National University Hospital,
Daejeon, South Korea
(Lee) Department of Cardiology, Kangwon National University Hospital,
Chuncheon, South Korea
(Lee) Department of Cardiology, Soon Chun Hyang University Hospital,
Bucheon, South Korea
(Lee) Department of Cardiology, Kangbuk Samsung Medical Center, Seoul,
Korea (J.-Y.L.)., South Korea
(Cheong) Department of Cardiology, Gangneung Asan Hospital, South Korea
(Kim) Department of Cardiology, Dong-A University Hospital, Busan, South
Korea
(Ahn) Department of Cardiology, Chonnam National University Hospital,
Gwangju, South Korea
(Lim) Department of Cardiology, CHA Bundang Medical Center, Seongnam,
South Korea
(Lee) Department of Cardiology, Ulsan University Hospital, South Korea
(Hiremath) Department of Cardiology, Ruby Hall Clinic, Pune, India
(Santoso) Department of Cardiology, Medistra Hospital, Jakarta, Indonesia
(Udayachalerm) Department of Cardiology, King Chulalongkorn Memorial
Hospital, Bangkok, Thailand
(Cheng) Department of Cardiology, Shin Kong Hospital, Taipei, Taiwan
(Republic of China)
(Cohen) Saint Luke's Mid America Heart Institute, Kansas City, MO, United
States
(Muramatsu) Department of Cardiology, Tokyo General Hospital, Japan
(Tsuchikane) Toyohashi Heart Center, Aichi, Japan
(Asakura) Department of Cardiology, Hakujikai Memorial Hospital, Tokyo,
Japan
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: Procedural results for percutaneous coronary intervention
(PCI) in coronary vessels with chronic total occlusion (CTO) have improved
in recent years, and PCI strategies have moved toward more complete
revascularization with more liberal use of CTO-PCI. However, evidence
evaluating CTO-PCI is limited to observational studies and small clinical
trials. <br/>Method(s): In this open-label, multicenter, randomized,
noninferiority trial, PCI-eligible patients were assigned to receive
either 1 of 2 strategies: PCI or no PCI for the qualifying de novo CTO
lesion with the option for PCI of obstructive non-CTO lesions at the
discretion of the operator. The primary end point was a composite of
death, myocardial infarction, stroke, or any revascularization.
Health-related quality of life was assessed at baseline and at 1, 6, 12,
24, and 36 months. Because of slow recruitment, the trial was stopped
before completion of the 1284 planned enrollments. <br/>Result(s): Between
March 2010 and September 2016, 834 patients were randomly assigned to the
CTO-PCI (n=417) or no CTO-PCI (n=398) strategy. Among the patients
assigned to the no CTO-PCI strategy, 78 (19.6%) crossed over to receive
staged CTO-PCI within 3 days of randomization. The overall CTO-PCI success
rate was 90.6%. Serious nonfatal complications associated with CTO-PCI
occurred in 3 patients (1 stroke, 1 cardiac tamponade, and 1 patient with
recurrent episodes of ventricular tachyarrhythmia induced by intracoronary
thrombus). Approximately half of the patients in each group underwent PCI
for an average of 1.3 non-CTO lesions, resulting in a comparable residual
SYNTAX score (Synergy Between PCI With TAXUS and Cardiac Surgery;
3.7+/-5.4 versus 4.0+/-5.9, P=0.42) confined to non-CTO vessels. During a
median follow-up of 4.0 years (interquartile range, 2.4 to 5.1 years),
there was no significant difference between the CTO-PCI and the no CTO-PCI
strategies in the incidence of the primary end point (22.3% versus 22.4%,
hazard ratio, 1.03; 95% CI, 0.77 to 1.37; P=0.86). Both CTO-PCI and no
CTO-PCI strategy were associated with significant improvements but without
between-group differences in disease-specific health status that was
sustained through 36 months. <br/>Conclusion(s): CTO-PCI was feasible with
high success rates. There was no difference in the incidence of major
adverse cardiovascular events with CTO-PCI versus no CTO-PCI, but the
study was limited by low power for clinical end points and high crossover
rates between groups. Clinical Trial Registration: URL:
https://www.clinicaltrials.gov. Unique identifier:
NCT01078051.<br/>Copyright &#xa9; 2018 American Heart Association, Inc.

<96>
Accession Number
2003382782
Title
Meta-analysis of ultrasound-guided vs conventional vascular access for
cardiac electrophysiology procedures.
Source
Journal of Arrhythmia. (no pagination), 2019. Date of Publication: 2019.
Author
Wang T.K.M.; Wang M.T.M.; Martin A.
Institution
(Wang, Wang, Martin) Green Lane Cardiovascular Service, Auckland City
Hospital, Auckland, New Zealand
Publisher
Wiley-Blackwell (E-mail: info@wiley.com)
Abstract
Background: Vascular complications are common during invasive cardiac
electrophysiology procedures. This meta-analysis compares outcomes
following ultrasound and nonultrasound-guided vascular access for these
procedures. <br/>Method(s): PubMed, Embase and Cochrane
01/01/1980-30/09/2018 were searched for relevant studies to meta-analyse.
<br/>Result(s): Seven studies (6269 patients) were included. Pooled rates
and odds ratio(95% confidence interval) for ultrasound and nonultrasound
subgroups were 1.2% vs 3.0%, 0.32 (0.21-0.49) for all vascular
complications, with less hematomas and arterial punctures but similar
arteriovenous fistulas, pseudoaneurysms or retroperitoneal bleeds.
<br/>Conclusion(s): Ultrasound guidance had less complications due to less
hematoma and arterial puncture, and is generally recommended for
electrophysiology procedures.<br/>Copyright &#xa9; 2019 The Authors.
Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on
behalf of the Japanese Heart Rhythm Society.

<97>
Accession Number
629665752
Title
Aortoesophageal fistula in a patient with a thoracic endovascular aortic
repair.
Source
Journal of Hospital Medicine. Conference: Hospital Medicine, HM 2018.
United States. 13 (4 Supplement 1) (no pagination), 2018. Date of
Publication: 2018.
Author
Perreault G.; Cytryn S.; Calvo-Friedman A.; Janjigian M.
Institution
(Perreault, Cytryn, Calvo-Friedman, Janjigian) NYU Langone Medical Center,
Bellevue Hospital
Publisher
Frontline Medical Communications
Abstract
Case Presentation: A 61 year-old man with a history of aortitis of
uncertain etiology and pseudoaneurysm s/p thoracic endovascular aortic
repair (TEVAR) with subclavian coiling eight months earlier presented with
progressive worsening left upper and lower extremity pain beginning
post-operatively. On admission the patient developed hemoptysis, usually
scant, but intermittently as much as 100cc. He was otherwise asymptomatic,
hemodynamically stable and with an unremarkable physical exam. Over the
next 48 hours, his hemoglobin dropped from 10.4 to 6.4 mg/dL. There was
concern for tracheo-aortic fistula given the history of TEVAR, however a
CTA of his chest did not reveal contrast extravasation. The patient
responded appropriately to pRBC transfusion and his hemoptysis resolved
without further intervention. Several days later he again had another
hemoglobin drop from 8.3 to 6.5 mg/dL but had no signs or symptoms of
overt bleeding including no hematemesis, melena, or hematochezia. A CT
scan of his abdomen and pelvis demonstrated no bleeding source and his
hemolysis labs were negative. Given no identified culprit for this
patient's continued acute anemia and transfusion dependence he underwent
endoscopy that revealed his aortic graft protruding through his esophagus
and no evidence of recent bleeding. <br/>Discussion(s): Aortoesophageal
fistula (AEF) is a rare, but recognized complication of TEVAR and cause of
upper gastrointestinal bleeding (UGIB). An international multicenter
registry including over two thousand TEVAR procedures over ten years found
an incidence of AEF of 1.5%. The most common clinical presentations were
fever of unknown origin (81%) and hematemesis (53%). 92% were diagnosed by
CT and 50% were confirmed on endoscopy (Czerny et al. 2014). It is unclear
if the remaining 8% had negative CT scans, or if clinical suspicion was so
high that upper endoscopy was pursued emergently before scanning. A
meta-analysis of studies on the role of CT scan in diagnosing AEF found
sensitivity ranging from 40-100% and specificity 33.3-100%, representing a
questionable diagnostic reliability (Malik et al. 2015). In this patient
with prior aortitis and pseudoaneurysm who had undergone TEVAR presenting
with hemoptysis and transfusion dependent anemia was highly suspicious for
fistulation, prompting upper endoscopy despite a negative CT scan.
References: Czerny, M et al. New insights regarding the incidence,
presentation and treatment options of aorto-oesophageal fistulation after
thoracic endovascular aortic repair: the European Registry of Endovascular
Aortic Repair Complications. European Journal of Cardio-Thoracic Surgery.
2014:45;452-457. Czerny M et al. Secondary organ fistulation after
thoracic endovascular repair. Minimally Invasive Therapy & Allied
Technologies, 2015. 24:5. 305-310. Malik, MU, et al. Critical
gastrointestinal bleed due to secondary aortoenteric fistula. Journal of
Community Hospital Internal Medicine Perspectives. 2015(5). Nazarewicz, GV
and Jain, R. Upper Gastrointestinal Bleeding Caused By Aortoesophageal
Fistula. Clinical Gastroenterology and Hepatology 2016:14(12);xxii. Image
of the month <br/>Conclusion(s): AEF is a rare, but perilous cause of UGIB
in patients with a history of prior TEVAR that may require endoscopic
evaluation to diagnose when clinical suspicion is high.

<98>
Accession Number
629666187
Title
Perioperative risk of hip fracture surgery among elderly patients with
severe aortic stenosis.
Source
Journal of Hospital Medicine. Conference: Hospital Medicine, HM 2018.
United States. 13 (4 Supplement 1) (no pagination), 2018. Date of
Publication: 2018.
Author
Takasaki T.; Hiraoka E.; Ito S.
Institution
(Takasaki) Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba,
Japan
(Hiraoka, Ito) Tokyo Bay Urayasu Ichikawa Medical Center
Publisher
Frontline Medical Communications
Abstract
Background: Severe aortic stenosis (SAS) had been identified as being at
elevated risk for non-cardiac surgery. However, two reports demonstrated
that SAS did not increase mortality of intermediate to high risk
non-cardiac surgery. The European Society of Cardiology guideline states
non-cardiac surgery of low to intermediate risk can be safely performed
among patients with SAS. Fall and fractures such as of hip or wrist as
well as vertebral compression fractures are common among elderly people.
For hip fractures, prompt surgery has been strongly recommended to improve
prognosis, but surgery is sometimes delayed for other clinical reason
including SAS incidentally found by preoperative evaluation. Outcomes of
elderly patients with hip fracture, complicated with SAS have not yet been
evaluated in Japan. <br/>Method(s): We performed a retrospective cohort
study in a single center. Patients 70 years or older undergoing hip
fracture surgery with or without SAS were identified from echo data base
between April 2012 to August 2017. Patients' demographic data, laboratory
data, and echocardiographic data (aortic valve area, mean aortic valve
gradient, peak aortic velocity and ejection fraction) and waiting period
from the time of injury to surgery as well as outcomes (intraoperative and
inhospital mortality and ability of ambulation on discharge) were
obtained. We investigated the factors associated ambulation on discharge
by using multivariate logistic regression analysis. <br/>Result(s): Among
the total of 279 patients, 71 patients were excluded. 20 SAS patients were
identified. 80 patients were selected randomly from 188 non-SAS patients
to control group. Mean age was 85.9 (female; N= 81 (81%)). There was no
significant difference in patients' demographic data and the period before
surgery (4days vs. 4days, p=0.959) between SAS and non-SAS groups. There
was no significant difference in ability of ambulation on discharge (72.2%
vs. 81.1%, p=0.405). No patient died intraoperatively. Only 1 non-SAS
patient died within 30-days after surgery. Seventy four patients became
able to ambulate on discharge. None of the factors, including age >85
years, SAS and the period before surgery, were associated with ability of
ambulation on discharge by using multivariate logistic regression
analysis. <br/>Conclusion(s): SAS was not associated with 30 days
mortality and ability of ambulation on discharge after hip surgery. We
should not delay surgery for hip fracture among elderly patients just
because they have SAS. ( Figure Presented).

<99>
Accession Number
604381414
Title
The effects of cinacalcet in older and younger patients on hemodialysis:
The evaluation of cinacalcet HCL therapy to lower cardiovascular events
(EVOLVE) trial.
Source
Clinical Journal of the American Society of Nephrology. 10 (5) (pp
791-799), 2015. Date of Publication: 01 Jan 2015.
Author
Parfrey P.S.; Drueke T.B.; Block G.A.; Correa-Rotter R.; Floege J.; Herzog
C.A.; London G.M.; Mahaffey K.W.; Moe S.M.; Wheeler D.; Kubo Y.; Dehmel
B.; Goodman W.G.; Chertow G.M.; Santos J.; Najun Zarazaga C.; Marin I.;
Garrote N.; Cusumano A.; Penalba N.; Del Valle E.; Juncos L.; Martinez
Saye J.; Lef L.; Altobelli V.; Petraglia G.; Rosa Diez G.; Douthat W.;
Lobo J.; Gallart C.; Lafalla A.; Diez G.; Linares B.; Lopez N.; Ramirez
N.; Gonzalez R.; Valtuille R.; Beresan H.; Hermida O.; Rudolf G.;
Marchetta N.; Rano M.; Ramirez M.; Garcia N.; Gillies A.; Jones B.;
Pedagogos E.; Walker R.; Talaulikar G.; Bannister K.; Suranyi M.; Kark A.;
Roger S.; Kerr P.; Disney A.; Mount P.; Fraenkel M.; Mathew M.; Fassett
R.; Jose M.; Hawley C.; Lonergan M.; Mackie J.; Ferrari P.; Menahem S.;
Sabto J.; Hutchison B.; Langham R.; Pollock C.; Holzer H.; Oberbauer R.;
Arias I.; Graf H.; Mayer G.; Lhotta K.; Neyer U.; Klauser R.; Hoerl W.;
Horn S.; Kovarik J.; Kramar R.; Eigner M.; Dhaene M.; Billiouw J.; De
Meester J.; Warling X.; Cambier-Dwelschauwers P.; Evenepoel P.; Daelemans
R.; Dratwa M.; Maes B.; Stolear J.; Dejagere T.; Vanwalleghem J.; Bouman
K.; Jadoul M.; Peeters J.; Vanholder R.; Tielemans C.; Donck J.; Almeida
F.; Picollo de Oliveira J.; Burdmann E.; Garcia V.; Saldanha Thome F.;
Deboni L.; Bregman R.; Lugon J.; Araujo S.; Ferreira Filho S.; de
Francesco Daher E.; Sperto Baptista M.; Carvalho A.; d'Avila D.; Moyses
Neto M.; Yu L.; Bastos M.; Sampaio Lacativa P.; Jorgetti V.; de Almeida
Romao E.; Cardeal da Costa J.; Pecoits Filho R.; Gordan P.; Salgado N.;
Teixeira Araujo M.; Neiva Coelho S.; Oliveira I.; Moyses R.; Vasconcellos
L.; Batista P.; Luiz Gross J.; Pedrosa A.; Cournoyer S.; LeBlanc M.; Chow
S.; Karunakaran S.; Wong G.; Tobe S.; Desmeules S.; Zimmerman D.; Murphy
S.; Montambault P.; Donnelly S.; MacRae J.; Culleton B.; Soroka S.; Rabbat
C.; Jindal K.; Vasilevsky M.; Michaud M.; Wijeyesinghe E.; Zacharias J.;
Lok C.; Muirhead N.; Verrelli M.; Da Roza G.; Sapir D.; Olgaard K.;
Daugaard H.; Brandi L.; Jensen P.; Boulechfar H.; Ang K.; Simon P.; Rieu
P.; Brunet P.; Touchard G.; London G.; Urena Torres P.; Combe C.; Durrbach
A.; Ortiz J.; Hannedouche T.; Vela C.; Lionet A.; Ryckelynck P.; Zaoui P.;
Choukroun G.; Fessi H.; Lang P.; Stroumza P.; Joly D.; Mousson C.; Laville
M.; Dellanna F.; Erley C.; Braun J.; Rambausek M.; Riegel W.; Klingberg
M.; Schwertfeger E.; Wizemann V.; Eckardt K.; Reichel H.; Passauer J.;
Hubel E.; Frischmuth N.; Liebl R.; Fiedler R.; Schwenger V.; Vosskuhler
A.; Kunzendorf U.; Renders L.; Rattensberger D.; Rump L.; Ketteler M.;
Neumayer H.; Zantvoort F.; Stahl R.; Ladanyi E.; Kulcsar I.; Mezei I.;
Csiky B.; Rikker C.; Arkossy O.; Berta K.; Szegedi J.; Major L.; Ferenczi
S.; Fekete A.; Szabo T.; Zakar G.; Wagner G.; Kazup Erdelyine S.; Borbas
B.; Eustace J.; Reddan D.; Capasso G.; Locatelli F.; Villa G.; Cozzolino
M.; Brancaccio D.; Messa P.; Bolasco P.; Ricciardi B.; Malberti F.;
Moriero E.; Cannella G.; Ortalda V.; Stefoni S.; Frasca G.; Cappelli G.;
Albertazzi A.; Zoccali C.; Farina M.; Elli A.; Avella F.; Ondei P.;
Mingardi G.; Errico R.; Losito A.; Di Giulio S.; Pertosa G.; Schena F.;
Grandaliano G.; Gesualdo L.; Auricchio M.; Bochicchio-Ricardelli T.;
Aranda Verastegui F.; Pena J.; Chew Wong A.; Cruz-Valdez J.; Torres Zamora
M.; Solis M.; Sebastian Diaz M.; Vital Flores M.; Alvarez Sandoval E.; van
den Dorpel M.; Brink H.; Van Kuijk W.; Vermeij C.; Smak Gregoor P.; Hagen
E.; van der Sande F.; Klinger M.; Nowicki M.; Muszytowski M.; Bidas K.;
Bentkowski W.; Wiecek A.; Ksiazek A.; Marczewski K.; Ostrowski M.;
Switalski M.; Sulowicz W.; Matuszkiewicz-Rowinska J.; Mysliwiec M.; Durlik
M.; Rutkowski B.; Macario F.; Carvalho B.; Frazao J.; Machado D.; Weigert
A.; Andrusev A.; Khrustalev O.; Zemtchenkov A.; Gurevich K.; Staroselsky
K.; Khadikova N.; Rozhinskaya L.; Timokhovskaya G.; Strokov A.; Balkarova
O.; Ermolenko V.; Kolmakova E.; Komandenko M.; Timofeev M.; Shilo V.;
Shostka G.; Smirnov A.; Anashkin V.; Volgina G.; Domashenko O.; Gurevich
A.; Perlin D.; Martinez Garcia J.; Andres Ribes E.; Coll Piera E.;
Fernandez Lucas M.; Galicia M.; Prados M.; Gonzalez M.; Romero R.; Martin
de Francisco A.; Montenegro J.; Santiago C.; Garcia F.; Alcazar de La Ossa
J.; Arrieta J.; Pons J.; Martin-Malo A.; Soler Amigo J.; Cases A.; Sterner
G.; Jensen G.; Wikstrom B.; Jacobson S.; Lund U.; Weiss L.; Stahl A.; von
Albertini B.; Burnier M.; Meier P.; Martin P.; Uehlinger D.; Dickenmann
M.; Yaqoob M.; Zehnder D.; Kalra P.; Padmanabhan N.; Roe S.; Eadington D.;
Pritchard N.; Hutchison A.; Davies S.; Wilkie M.; Davies M.; Pai P.; Swift
P.; Kwan J.; Goldsmith D.; Tomson C.; Stratton J.; Dasgupta I.; Sarkar S.;
Moustafa M.; Gandhi K.; Jamal A.; Galindo-Ramos E.; Tuazon J.; Batlle D.;
Tucker K.; Schiller-Moran B.; Assefi A.; Martinez C.; Samuels L.; Goldman
J.; Cangiano-Rivera J.; Darwish R.; Lee M.; Topf J.; Kapatkin K.; Baer H.;
Kopelman R.; Acharya M.; Tharpe D.; Bernardo M.; Nader P.; Guzman-Rivera
J.; Pergola P.; Sekkarie M.; Alas E.; Zager P.; Liss K.; Navarro J.;
Roppolo M.; Denu-Ciocca C.; Kshirsagar A.; El Khatib M.; Kant K.; Scott
D.; Murthyr B.; Finkelstein F.; Keightley G.; McCrary R.; Pitone J.;
Cavalieri T.; Tsang A.; Pellegrino B.; Schmidt R.; Ahmad S.; Brown C.;
Friedman E.; Mittman N.; Fadem S.; Shapiro W.; Reddy M.; Goldberger S.;
Woredekal Y.; Agarwal A.; Anger M.; Haque M.; Chidester P.; Kohli R.;
Rubinstein S.; Newman G.; Gladish R.; Ayodeji O.; Soman S.; Sprague S.;
Hunt N.; Gehr T.; Rizk D.; Warnock D.; Polack D.; Pahl M.; Fischer D.;
Dreyer P.; James G.; Husserl F.; Rogers T.; Raff A.; Sedor J.; Silver M.;
Smith M.; Steinberg S.; DelGiorno T.; Jones E.; Cunha P.D.; Cheng J.;
Pogue V.; Blumenthal S.; Brown E.; Charytan C.; Buerkert J.; Cook M.;
Felsenfeld A.; Tareen N.; Herman T.; Diamond S.; Hura C.; Laski M.;
MacLaurin J.; Plumb T.; Brosnahan G.; Kumar J.; Henriquez M.; Poole C.;
Osanloo E.; Matalon A.; Sholer C.; Arfeen S.; Azer M.; Belledonne M.;
Gross M.; Dunnigan E.; McConnell K.; Becker B.; Skinner F.; Rigolosi R.;
Spiegel D.; Stegman M.; Patak R.; Streja D.; Ranjit U.; Youell T.;
Wooldridge T.; Stafford C.; Cottiero R.; Weinberg M.; Schonefeld M.;
Shahmir E.; Hazzan A.; Ashfaq A.; Bhandari K.; Cleveland W.; Culpepper M.;
Golden J.; Lai L.; Lien Y.; Lorica V.; Robertson J.; Malireddi K.; Morse
S.; Thakur V.; Israelit A.; Raguram P.; Alfred H.; Weise W.; Al-Saghir F.;
El Shahawy M.; Rastogi A.; Nissenson A.; Kopyt N.; Lynn R.; Lea J.;
McClellan W.; Teredesai P.; Ong S.; Tolkan S.; Sugihara J.; Minga T.;
Mehrotra R.; Minasian R.; Bhatia D.; Specter R.; Capelli J.; Sidhu P.;
Dalal S.; Dykes P.; Khan M.; Rahim F.; Saklayen M.; Thomas A.; Michael B.;
Torres M.; Al-Bander H.; Murray B.; Abukurah A.; Gupta B.; Nosrati S.;
Raja R.; Zeig S.; Braun M.; Amatya A.; Endsley J.; Sharon Z.; Gupta A.;
Dolson G.; Dumler F.; Ntoso K.; Rosansky S.; Kumar N.; Gura V.; Thompson
N.; Goldfarb D.; Halligan R.; Middleton J.; Widerhorn A.; Arbeit L.;
Arruda J.; Crouch T.; Friedman L.; Khokhar S.; Mittleman J.; Light P.;
Taparia B.; West C.; Cotton J.; Dhingra R.; Kleinman L.; Arif F.; Lew S.;
Nammour T.; Sterrett J.; Williams M.; Ramirez J.; Rubin J.; McCarthy J.;
Noble S.; Chaffin M.; Rekhi A.
Institution
(Parfrey) Department of Medicine, Health Sciences Center, St. John's, NL,
Canada
(Drueke) French Institute of Health and Medical Research Unit 1088,
University of Picardie, Amiens, France
(Block) Denver Nephrology, Denver, CO, United States
(Correa-Rotter) Department of Nephrology and Mineral Metabolism, Salvador
Zubiran National Institute of Health Sciences and Nutrition, Mexico City,
Mexico
(Floege) Department of Nephrology, RWTH Aachen University Hospital,
Aachen, Germany
(Herzog) Department of Internal Medicine, University of Minnesota,
Minneapolis, MN, United States
(London) Service of Nephrology, Manhes Hospital, Paris, France
(Mahaffey, Chertow) Department of Medicine, Stanford University School of
Medicine, Palo Alto, CA, United States
(Moe) Department of Medicine, Indiana University School of Medicine,
Roudebush Veterans Administration Medical Center, Indianapolis, IN, United
States
(Wheeler) Centre for Nephrology, University College London, United Kingdom
(Kubo, Dehmel, Goodman) Amgen Inc, Thousand Oaks, CA, United States
(Santos, Najun Zarazaga, Marin, Garrote, Cusumano, Penalba, Del Valle,
Juncos, Martinez Saye, Lef, Altobelli, Petraglia, Rosa Diez, Douthat,
Lobo, Gallart, Lafalla, Diez, Linares, Lopez, Ramirez, Gonzalez,
Valtuille, Beresan, Hermida, Rudolf, Marchetta, Rano, Ramirez, Garcia)
Argentina
(Gillies, Jones, Pedagogos, Walker, Talaulikar, Bannister, Suranyi, Kark,
Roger, Kerr, Disney, Mount, Fraenkel, Mathew, Fassett, Jose, Hawley,
Lonergan, Mackie, Ferrari, Menahem, Sabto, Hutchison, Langham, Pollock)
Australia
(Holzer, Oberbauer, Arias, Graf, Mayer, Lhotta, Neyer, Klauser, Hoerl,
Horn, Kovarik, Kramar, Eigner) Austria
(Dhaene, Billiouw, De Meester, Warling, Cambier-Dwelschauwers, Evenepoel,
Daelemans, Dratwa, Maes, Stolear, Dejagere, Vanwalleghem, Bouman, Jadoul,
Peeters, Vanholder, Tielemans, Donck) Belgium
(Almeida, Picollo de Oliveira, Burdmann, Garcia, Saldanha Thome, Deboni,
Bregman, Lugon, Araujo, Ferreira Filho, de Francesco Daher, Sperto
Baptista, Carvalho, d'Avila, Moyses Neto, Yu, Bastos, Sampaio Lacativa,
Jorgetti, de Almeida Romao, Cardeal da Costa, Pecoits Filho, Gordan,
Salgado, Teixeira Araujo, Neiva Coelho, Oliveira, Moyses, Vasconcellos,
Batista, Luiz Gross, Pedrosa) Brazil
(Cournoyer, LeBlanc, Chow, Karunakaran, Wong, Tobe, Desmeules, Zimmerman,
Murphy, Montambault, Donnelly, MacRae, Culleton, Soroka, Rabbat, Jindal,
Vasilevsky, Michaud, Wijeyesinghe, Zacharias, Lok, Muirhead, Verrelli, Da
Roza, Sapir) Canada
(Olgaard, Daugaard, Brandi, Jensen) Denmark
(Boulechfar, Ang, Simon, Rieu, Brunet, Touchard, London, Urena Torres,
Combe, Durrbach, Ortiz, Hannedouche, Vela, Lionet, Ryckelynck, Zaoui,
Choukroun, Fessi, Lang, Stroumza, Joly, Mousson, Laville) France
(Dellanna, Erley, Braun, Rambausek, Riegel, Klingberg, Schwertfeger,
Wizemann, Eckardt, Reichel, Passauer, Hubel, Frischmuth, Liebl, Fiedler,
Schwenger, Voskuhler, Kunzendorf, Renders, Rattensberger, Rump, Ketteler,
Neumayer, Zantvoort, Stahl) Germany
(Ladanyi, Kulcsar, Mezei, Csiky, Rikker, Arkossy, Berta, Szegedi, Major,
Ferenczi, Fekete, Szabo, Zakar, Wagner, Kazup Erdelyine, Borbas) Hungary
(Eustace, Reddan) Ireland
(Capasso, Locatelli, Villa, Cozzolino, Brancaccio, Messa, Bolasco,
Ricciardi, Malberti, Moriero, Cannella, Ortalda, Stefoni, Frasca,
Cappelli, Albertazzi, Zoccali, Farina, Elli, Avella, Ondei, Mingardi,
Errico, Losito, Di Giulio, Pertosa, Schena, Grandaliano, Gesualdo,
Auricchio) Italy
(Bochicchio-Ricardelli, Aranda Verastegui, Pena, Chew Wong, Cruz-Valdez,
Torres Zamora, Solis, Sebastian Diaz, Vital Flores, Alvarez Sandoval)
Mexico
(van den Dorpel, Brink, Van Kuijk, Vermeij, Smak Gregoor, Hagen, van der
Sande) Netherlands
(Klinger, Nowicki, Muszytowski, Bidas, Bentkowski, Wiecek, Ksiazek,
Marczewski, Ostrowski, Switalski, Sulowicz, Matuszkiewicz-Rowinska,
Mysliwiec, Durlik, Rutkowski) Poland
(Macario, Carvalho, Frazao, Machado, Weigert) Portugal
(Andrusev, Khrustalev, Zemtchenkov, Gurevich, Staroselsky, Khadikova,
Rozhinskaya, Timokhovskaya, Strokov, Balkarova, Ermolenko, Kolmakova,
Komandenko, Timofeev, Shilo, Shostka, Smirnov, Anashkin, Volgina,
Domashenko, Gurevich, Perlin) Russian Federation
(Martinez Garcia, Andres Ribes, Coll Piera, Fernandez Lucas, Galicia,
Prados, Gonzalez, Romero, Martin de Francisco, Montenegro, Santiago,
Garcia, Alcazar de La Ossa, Arrieta, Pons, Martin-Malo, Soler Amigo,
Cases) Spain
(Sterner, Jensen, Wikstrom, Jacobson, Lund, Weiss, Stahl) Sweden
(von Albertini, Burnier, Meier, Martin, Uehlinger, Dickenmann) Switzerland
(Wheeler, Yaqoob, Zehnder, Kalra, Padmanabhan, Roe, Eadington, Pritchard,
Hutchison, Davies, Wilkie, Davies, Pai, Swift, Kwan, Goldsmith, Tomson,
Stratton, Dasgupta) United Kingdom
(Sarkar, Moustafa, Gandhi, Jamal, Galindo-Ramos, Tuazon, Batlle, Tucker,
Schiller-Moran, Assefi, Martinez, Samuels, Goldman, Cangiano-Rivera,
Darwish, Lee, Topf, Kapatkin, Baer, Kopelman, Acharya, Tharpe, Bernardo,
Nader, Guzman-Rivera, Pergola, Sekkarie, Alas, Zager, Liss, Navarro,
Roppolo, Denu-Ciocca, Kshirsagar, El Khatib, Kant, Scott, Murthyr,
Finkelstein, Keightley, McCrary, Pitone, Cavalieri, Tsang, Pellegrino,
Schmidt, Ahmad, Brown, Friedman, Mittman, Fadem, Shapiro, Reddy,
Goldberger, Woredekal, Agarwal, Anger, Haque, Chidester, Kohli,
Rubinstein, Newman, Gladish, Ayodeji, Soman, Sprague, Hunt, Gehr, Rizk,
Warnock, Polack, Pahl, Fischer, Dreyer, James, Husserl, Rogers, Raff,
Sedor, Silver, Smith, Steinberg, DelGiorno, Jones, Cunha, Cheng, Pogue,
Blumenthal, Brown, Charytan, Buerkert, Cook, Felsenfeld, Tareen, Gupta,
Herman, Diamond, Hura, Laski, MacLaurin, Plumb, Brosnahan, Kumar,
Henriquez, Poole, Osanloo, Matalon, Sholer, Arfeen, Azer, Belledonne,
Gross, Dunnigan, McConnell, Becker, Skinner, Rigolosi, Spiegel, Stegman,
Patak, Streja, Ranjit, Youell, Wooldridge, Stafford, Cottiero, Weinberg,
Schonefeld, Shahmir, Hazzan, Ashfaq, Bhandari, Cleveland, Culpepper,
Golden, Lai, Lien, Lorica, Robertson, Malireddi, Morse, Thakur, Israelit,
Raguram, Alfred, Weise, Al-Saghir, El Shahawy, Rastogi, Nissenson, Kopyt,
Lynn, Lea, McClellan, Teredesai, Ong, Tolkan, Sugihara, Minga, Mehrotra,
Minasian, Bhatia, Specter, Capelli, Sidhu, Dalal, Dykes, Khan, Rahim,
Saklayen, Thomas, Michael, Torres, Al-Bander, Murray, Abukurah, Gupta,
Nosrati, Raja, Zeig, Braun, Amatya, Endsley, Sharon, Gupta, Dolson,
Dumler, Ntoso, Rosansky, Kumar, Gura, Thompson, Goldfarb, Halligan,
Middleton, Widerhorn, Arbeit, Arruda, Crouch, Friedman, Khokhar,
Mittleman, Light, Taparia, West, Cotton, Dhingra, Kleinman, Arif, Lew,
Nammour, Sterrett, Williams, Ramirez, Rubin, McCarthy, Noble, Chaffin,
Rekhi) United States
Publisher
American Society of Nephrology (E-mail: email@asn-online.org)
Abstract
Background and objectives The calcimimetic cinacalcet reduced the risk of
death or cardiovascular (CV) events in older, but not younger, patients
with moderate to severe secondary hyperparathyroidism (HPT) who were
receiving hemodialysis. To determine whether the lower risk in younger
patients might be due to lower baseline CV risk and more frequent use of
cointerventions that reduce parathyroid hormone (kidney transplantation,
parathyroidectomy, and commercial cinacalcet use), this study examined the
effects of cinacalcet in older (>= 65 years, n=1005) and younger (<65
years, n=2878) patients. Design, setting, participants, & measurements
Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events
(EVOLVE) was a global, multicenter, randomized placebo-controlled trial in
3883 prevalent patients on hemodialysis, whose outcomes included death,
major CV events, and development of severe unremitting HPT. The age
subgroup analysis was prespecified. ResultsOlder patients had higher
baseline prevalence of diabetesmellitus and CV comorbidity. Annualized
rates of kidney transplantation and parathyroidectomy were > 3-fold higher
in younger relative to older patients and were more frequent in patients
randomized to placebo. In older patients, the adjusted relative hazard
(95% confidence interval) for the primary composite (CV) end point
(cinacalcet versus placebo) was 0.70 (0.60 to 0.81); in younger patients,
the relative hazard was 0.97 (0.86 to 1.09). Corresponding adjusted
relative hazards for mortality were 0.68 (0.51 to 0.81) and 0.99 (0.86 to
1.13). Reduction in the risk of severe unremitting HPT was similar in both
groups. Conclusions In the EVOLVE trial, cinacalcet decreased the risk of
death and of major CV events in older, but not younger, patients with
moderate to severe HPT who were receiving hemodialysis. Effect
modification by age may be partly explained by differences in underlying
CV risk and differential application of cointerventions that reduce
parathyroid hormone.<br/>Copyright &#xa9; 2015 by the American Society of
Nephrology.

<100>
Accession Number
629616827
Title
Implantable cardioverter-defibrillators and survival in advanced heart
failure patients with continuous-flow left ventricular assist devices: A
systematic review and meta-analysis.
Source
Europace. 21 (9) (pp 1353-1359), 2019. Date of Publication: 01 Sep 2019.
Author
Elkaryoni A.; Badarin F.A.; Khan M.S.; Ellakany K.; Potturi N.; Poonia J.;
Kennedy K.F.; Magalski A.; Sperry B.W.; Wimmer A.P.
Institution
(Elkaryoni, Badarin, Magalski, Sperry, Wimmer) Division of Internal
Medicine, University of Missouri-Kansas City, Kansas City, MO, United
States
(Badarin, Kennedy, Magalski, Sperry, Wimmer) Division of Cardiovascular
Disease, Saint Luke's Mid America Heart Institute, 4330 Wornall Road Ste
2000, Kansas City, MO, United States
(Khan) Division of Internal Medicine, John H Stroger Jr Hospital of Cook
County, Chicago, IL, United States
(Ellakany) Division of Cardiovascular Disease, Alexandria University,
Alexandria, Egypt
(Potturi, Poonia) University of Missouri-Kansas City, School of Medicine,
Kansas City, MO, United States
Publisher
Oxford University Press
Abstract
Aims: Implantable cardioverter-defibrillators (ICDs) implantation in heart
failure (HF) patients with reduced ejection fraction improves survival by
reducing mortality secondary to arrhythmic events. Whether advanced HF
patients treated with continuous-flow left ventricular assist devices
(CF-LVADs) derive similar benefit is controversial. <br/>Methods and
Results: We searched PubMed, Cochrane Central Register of Controlled
Trials, Embase, and Scopus from inception through November 2018 for
studies examining the association between ICD implantation and all-cause
mortality in patients with advanced HF and CF-LVADs. Analyses were
performed using a random-effects model. Hazard ratios (HRs) were
calculated with 95% confidence intervals (CIs). Heterogeneity and
publication bias were formally assessed, using I² and funnel
plots, respectively. Eight observational studies with a total of 6416
patients (ICD group = 3450, no ICD group = 2966) met inclusion criteria.
The majority of patients (84.6%) came from the two largest observational
studies. There was no difference in mortality in the ICD and no ICD groups
(HR 0.96, 95% CI 0.73-1.27, P = 0.79, I² = 42%), and ICD
implantation post-CF-LVAD was not associated with an improvement in
mortality (HR 0.87, 95% CI 0.48-1.57, P = 0.64, I² = 0%).
Additionally, there was no significant difference in the likelihood of
transplantation (HR 1.10, 95% CI 0.93-1.30, P = 0.28, I² = 26%)
or non-mortality adverse events between the two groups.
<br/>Conclusion(s): Implantable cardioverter-defibrillator use was not
associated with improved survival in advanced HF patients with CF-LVADs.
These findings underscore the need to formally study the efficacy of ICDs
in this population in a dedicated randomized controlled
study.<br/>Copyright &#xa9; 2019 Published on behalf of the European
Society of Cardiology. All rights reserved. For permissions, please email:
journals.permissions@oup.com.

<101>
Accession Number
629608105
Title
Non-intubated video-assisted thoracoscopic surgery vs. Intubated
video-assisted thoracoscopic surgery for thoracic disease: A systematic
review and meta-analysis of 1,684 cases.
Source
Journal of Thoracic Disease. 11 (8) (pp 3556-3568), 2019. Date of
Publication: 2019.
Author
Zhang K.; Chen H.-G.; Wu W.-B.; Li X.-J.; Wu Y.-H.; Xu J.-N.; Jia Y.-B.;
Zhang J.
Institution
(Zhang, Chen, Wu, Li, Wu, Xu, Jia, Zhang) Department of Thoracic Surgery,
Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630,
China
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Background: Non-intubated video-assisted thoracoscopic surgery (NIVATS)
has been increasingly used in lobectomy, bullectomy, wedge resection, lung
volume reduction, sympathectomy and talc pleurodesis, which may reduce
postoperative complications. However, the benefits of non-intubated and
intubated methods of VATS remain controversial. <br/>Method(s): We
comprehensively searched PubMed, Web of Science, Embase and the Cochrane
Library, and performed a systematic review to assess the two techniques.
Random and fixed-effects meta-analytical models were used based on the low
between-study heterogeneity. Study quality, publication bias, and
heterogeneity were assessed. <br/>Result(s): Compared to intubated
methods, NIVATS had a lower postoperative complications rate [odds ratio
(OR): 0.63; 95% confidence interval (CI), 0.46-0.86; P<0.01], shorter
global in-operating time [weighted mean difference (WMD): -35.96 min; 95%
CI, -48.00 to -23.91; P<0.01], shorter hospital stay (WMD: -1.35 days; 95%
CI, -1.72 to -0.98; P<0.01), shorter anesthesia time (WMD: -7.29 min; 95%
CI, -13.30 to -1.29; P<0.01), shorter chest-tube placement time (WMD:
-1.04 days; 95% CI, -1.75 to -0.33; P<0.01), less chest pain (WMD: -1.31;
95% CI, -2.45 to -0.17; P<0.05) and lower perioperative mortality rate
(OR: 0.13; 95% CI, 0.02-0.99; P=0.05). <br/>Conclusion(s): NIVATS is a
safe, efficient and feasible technique for thoracic surgery and may be a
better alternative procedure owing to its advantage in reducing
postoperative complications rate, hospital stay, and chest
pain.<br/>Copyright &#xa9; Journal of Thoracic Disease. All rights
reserved.

<102>
[Use Link to view the full text]
Accession Number
629606899
Title
Effects of bronchial blockers on one-lung ventilation in general
anesthesia: A randomized controlled trail.
Source
Medicine (United States). 98 (41) (no pagination), 2019. Article Number:
e17387. Date of Publication: 01 Oct 2019.
Author
Zheng M.; Niu Z.; Chen P.; Feng D.; Wang L.; Nie Y.; Wang B.; Zhang Z.;
Shan S.; Kapritsou M.
Institution
(Zheng, Niu, Chen, Feng, Wang, Nie, Wang, Zhang, Shan) Department of
Anesthesiology, Cangzhou Central Hospital, No.16 Xinhua West Road,
Cangzhou, Hebei Province 061001, China
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: Double-lumen bronchial tubes (DLBT) and bronchial blockers
(BB) are commonly used in the anesthesia for clinical thoracic surgery.
But there are few systematic clinical comparisons between them. In this
study, the effects of BB and DLBT on one-lung ventilation (OLV) are
studied. <br/>Method(s): The 200 patients with thoracic tuberculosis
undergoing thoracic surgery, were randomly assigned to group A (DLBT) and
group B (BB). Intubation time, hemodynamic changes (mean arterial pressure
[MAP], heart rate [HR]), and arterial blood gas indicators (arterial
partial pressure of carbon dioxide [PaCO<inf>2</inf>], arterial partial
pressure of oxygen [PaO<inf>2</inf>], airway plateau pressure [Pplat], and
airway peak pressure [Ppeak]) at 4 time points were recorded.
Complications such as hoarseness, pulmonary infection, pharyngalgia, and
surgical success rate were also evaluated postoperatively. <br/>Result(s):
Intubation times were shorter in group B. Both MAP and HR in group A were
significantly higher 1minute after intubation than before, but also higher
than those in group B. PaO<inf>2</inf> levels were lower in both groups
during (OLV) than immediately after anesthesia and after two-lung
ventilation (TLV), with PaO<inf>2</inf> being lower after 60minutes of OLV
than after 20minutes of OLV. Furthermore, at both points during OLV,
PaO<inf>2</inf> was lower in group A than in group B. No significant
differences in PaCO<inf>2</inf> were found between the 2 groups. Ppeak and
Pplat were increased in both groups during OLV, with both being higher in
group A than in group B. The incidence of postoperative hoarseness,
pulmonary infection, and pharyngalgia were lower in group B. There was no
significant difference in the success rate of operation between the 2
groups. <br/>Conclusion(s): Compare with using DLBT, implementation of BB
in general anesthesia has less impact on hemodynamics, PaO<inf>2</inf> and
airway pressures, and achieves lower incidence of postoperative
complication.<br/>Copyright &#xa9; 2019 the Author(s). Published by
Wolters Kluwer Health, Inc.

<103>
Accession Number
2003321959
Title
Intravascular ultrasound versus angiography-guided drug-eluting stent
implantation in patients with complex coronary lesions: An updated
meta-analysis of nine randomized clinical trials.
Source
Anatolian Journal of Cardiology. 22 (4) (pp 160-167), 2019. Date of
Publication: 2019.
Author
Fan Z.-G.; Xu M.-N.; Xiao Y.-Y.; Wang H.-L.; Xu B.; He S.-H.
Institution
(Xu) Department of Cardiology, Northern Jiangsu People's Hospital, Dalian
Medical University, Dalian, China
(Fan, Xiao, Wang, Xu, He) Department of Cardiology, Northern Jiangsu
People's Hospital, Yangzhou University, No. 98 Nantong West Road, Yangzhou
225002, China
Publisher
Turkish Society of Cardiology (E-mail: kareyayincilik@gmail.com)
Abstract
Objective: Intravascular ultrasound (IVUS) is not routinely performed in
the real-world practice, and the benefits of IVUS-guided drug-eluting
stent (DES) implantation in patients with complex coronary lesions remains
unclear. This updated meta-analysis attempts to evaluate the clinical
outcomes of the IVUS guidance in these patients. <br/>Method(s): We
searched potential eligible citations from the PubMed, EMBASE, Medline,
and other internet sources. The primary endpoint were major adverse
cardiovascular events (MACE), including cardiac death, myocardial
infarction (MI), and target vessel revascularization (TVR). The risk of
definite/probable stent thrombosis (ST) was chosen as the safety endpoint.
<br/>Result(s): Nine randomized trials including a total of 3,612 patients
with complex coronary lesions were finally analyzed. Compared to
angiography guidance, IVUS-guided DES implantation was associated with
significantly lower incidence of MACE [odds ratios (OR) 0.57, 95%
confidence intervals (CI): 0.45-0.72, p<0.001; I²=0.0%,
p=0.674], cardiac death (OR 0.42, 95% CI: 0.21-0.82, p=0.010;
I²=0.0%, p=0.961), MI (OR 0.65, 95% CI: 0.44-0.95, p=0.027;
I²=41.8%, p=0.089), TVR (OR 0.55, 95% CI: 0.38-0.79, p=0.001;
I²=0.0%, p=0.916), target lesion revascularization (TLR) (OR
0.58, 95% CI: 0.41-0.82, p=0.002; I²=0.0%, p=0.888), and ST (OR
0.48, 95% CI: 0.24-0.93, p=0.029; I²=0.0%, p=0.733).
<br/>Conclusion(s): The updated meta-analysis demonstrates that DES
implantation under IVUS guidance leads to a significant reduction in MACE,
cardiac death, MI, TVR, TLR, and ST among patients with complex coronary
lesions.<br/>&#xa9; Copyright 2019 by Turkish Society of Cardiology

<104>
Accession Number
2002699661
Title
Comparison of forced-air warming systems and intravenous fluid warmers in
the prevention of pediatric perioperative hypothermia.
Source
Haseki Tip Bulteni. 57 (3) (pp 225-231), 2019. Date of Publication: 2019.
Author
Erdogan H.; Isil C.T.; Turk H.S.; Ergen G.; Oba S.
Institution
(Erdogan) Tunceli State Hospital, Clinic of Anesthesiology and
Reanimation, Tunceli, Turkey
(Isil, Turk, Oba) Sisli Hamidiye Etfal Training and Research Hospital,
Clinic of Anesthesiology and Reanimation, Istanbul, Turkey
(Ergen) Tatvan State Hospital, Clinic of Anesthesiology and Reanimation,
Bitlis, Turkey
Publisher
Galenos (Molla Gurani Cad. 22/2, Findikzade, Istanbul 34093, Turkey)
Abstract
Aim: We aimed to compare the efficacy of intravenous blood-fluid warming
and forced-air warming systems for the prevention of perioperative
hypothermia in pediatric patients under six years of age. <br/>Method(s):
Two-hundred children aged 0-6 years, who underwent elective surgery, were
included in the study. Group 1 patients were warmed with forced-air
warming system at the operating room. Group 2 patients were warmed with
intravenous fluid and blood warming systems at the operating room. During
the entire operation, heart rate, SpO2, end Tidal CO2 and esophagus
temperature values were recorded at 10-minute intervals. The number of
patients, who needed rescue warming, the starting time and duration of
rescue warming were recorded. The duration of the anesthesia, the duration
of the operation, and the time of recovery were recorded. <br/>Result(s):
The groups were compared in terms of mean operating room temperature and
body temperature and no statistically significant difference was found
between the groups. There was no statistically significant difference
between the groups for additional rescue warming need and time to rescue
warming. The time to recovery was longer in the patients who needed rescue
warming. There was a statistically significant positive correlation
between the duration of the operation and the duration of the need for
rescue warming with a confidence of 99%. <br/>Conclusion(s): In pediatric
patients, i.v. fluid warming systems are as effective as forced-air
warming systems in avoiding perioperative hypothermia.<br/>Copyright
&#xa9; 2019 by The Medical Bulletin of Istanbul Haseki Training and
Research Hospital The Medical Bulletin of Haseki published by Galenos
Yayinevi.

<105>
Accession Number
2002631521
Title
Single-arm meta-analysis of Argentine studies reporting in-hospital
mortality after aortic valve replacement in low and intermediate risk
patients.
Source
Revista Argentina de Cardiologia. 87 (4) (pp 271-280), 2019. Date of
Publication: August 2019.
Author
Borracci R.A.; Navia D.O.; Kotowicz V.; Machain A.; Higa C.C.
Institution
(Borracci) Servicios de Cirugia Cardiovascular del, Hospital Aleman de
Buenos Aires, Argentina
(Navia) Servicios de Cirugia Cardiovascular del, Instituto Cardiovascular
de Buenos Aires, Argentina
(Kotowicz) Servicios de Cirugia Cardiovascular del, Hospital Italiano de
Buenos Aires, Argentina
(Machain) Servicios de Cirugia Cardiovascular del, Hospital Britanico de
Buenos Aires, Argentina
(Higa) Servicio de Cardiologia del Hospital Aleman de Buenos Aires,
Argentina
Publisher
Sociedad Argentina de Cardiologia (E-mail: info@sac.org.ar)
Abstract
Background: Current evidence favors surgical valve replacement to treat
symptomatic aortic disease, except in elderly patients at increased risk
for surgery, in whom transcatheter aortic valve implantation (TAVI) may be
eligible. <br/>Objective(s): Considering that the use of TAVI has been
proposed to be extended to other groups at lower risk, the purpose of this
study was to perform a single-arm meta-analysis of local studies reporting
in-hospital mortality after surgical aortic valve replacement in low and
intermediate risk patients in Argentina, as a benchmark for comparing with
local TAVI outcomes. <br/>Method(s): A systematic review search strategy
was performed using controlled trials and observational studies identified
in MEDLINE, Embase, SCOPUS, and the Cochrane library to March 2019.
<br/>Result(s): Among 80 studies identified through the search, 4
observational articles reported in-hospital mortality and postoperative
complications after aortic valve replacement, divided into intermediate
and/or low risk patients according to the STS score or the EuroSCORE II.
In 1,192 patients, in-hospital mortality was 3.1%. Weighted pooled
estimates were: Postoperative stroke1.3%, myocardial infarction 0.4%, need
for definite pacemaker 2.7%, mediastinitis 1.4%, and reoperation for
bleeding 2.6%. <br/>Conclusion(s): The proven efficacy of TAVI in
high-risk patients is leading to the expansion of its indications toward
lower-risk cases; but this shift should be supported by meaningful
evidence of its benefit over surgical valve replacement. This single-arm
metaanalysis of Argentine studies presents in-hospital mortality and
postoperative complications after aortic valve replacement in low and
intermediate risk patients. The updated information on local results of
surgery could serve as a benchmark for comparing with TAVI performance in
our setting.<br/>Copyright &#xa9; 2019, Sociedad Argentina de Cardiologia.
All rights reserved.

<106>
Accession Number
2002518247
Title
The effect of speed of normal saline injection on optic nerve sheath
diameter in thoracic epidural anesthesia.
Source
Pain Physician. 22 (4) (pp E325-E332), 2019. Date of Publication:
July-August 2019.
Author
Hong J.H.; Jung S.W.; Park J.H.
Institution
(Hong, Park) Department of Anesthesiology and Pain Medicine, Keimyung
University, DongSan Hospital, Daegu, South Korea
(Jung) Department of Psychiatry, Keimyung University DongSan Hospital,
Daegu, South Korea
Publisher
American Society of Interventional Pain Physicians (E-mail:
editor@painphysicianjournal.com)
Abstract
Background: Intracranial pressure (ICP) is affected after epidural saline
solution or local anesthetic injection. Both ICP and epidural pressures
have been shown to reach peak pressure just after epidural injection and
begin decline thereafter. Measuring the optic nerve sheath diameter (ONSD)
through ultrasonography is one of the noninvasive methods used for ICP
assessment. <br/>Objective(s): The purpose of this study was to
investigate the effect of the speed of epidural saline injection on the
ONSD under awake conditions. <br/>Study Design: Prospective randomized
trial. <br/>Setting(s): An interventional pain management practice in
South Korea. <br/>Method(s): This study included 40 patients receiving
thoracic epidural catheterization for pain management after upper
abdominal or thoracic surgery. Following successful epidural space
confirmation, patients were randomized to receive epidural saline infusion
with a speed of either 1 mL/second (slow speed, A group) or 3 mL/second
(rapid speed, B group), respectively. For the measurement of ONSD,
transorbital sonography was performed and ONSD was measured at 3 mm
posterior to the optic nerve head. <br/>Result(s): The A and B groups
showed significant increases in ONSD according to time. Post hoc analysis
of this result revealed that ONSD at T10 and T30 were significantly
increased from baseline values (T0) (*P < 0.05 vs. T0; +P < 0.001 vs. T0).
The mean values at any of the time points anddegree of changes (T1-T0,
T10-T0, and T30-T0) in ONSD between groups A and B did not show any
significance. <br/>Limitation(s): We could not confirm the time of
normalization of ONSD after the end of epidural injection of normal
saline. <br/>Conclusion(s): Thoracic epidural injection of 10 mL of normal
saline solution resulted in a significant increase of ONSD compared to
baseline, however, the speed of injection did not affect the increase of
ONSD.<br/>Copyright &#xa9; 2019 Pain Physician. All rights reserved.

<107>
Accession Number
2002515732
Title
Comparison of cardiovascular outcomes by dialysis modality:A systematic
review and meta-analysis.
Source
Peritoneal Dialysis International. 39 (4) (pp 306-314), 2019. Date of
Publication: 2019.
Author
Lozier M.R.; Sanchez A.M.; Lee J.J.; Tamariz L.J.; Valle G.A.
Institution
(Lozier, Sanchez) Internal Medicine Residency Program, University of Miami
at Holy Cross Hospital, Ft Lauderdale, FL, United States
(Lee) Division of Cardiology, Columbia University at Mount Sinai Medical
Center, Miami, FL, United States
(Tamariz, Valle) Department of Internal Medicine, University of Miami at
Holy Cross Hospital, Ft Lauderdale, FL, United States
(Valle) The Kidney and Hypertension Group of South Florida, Ft Lauderdale,
FL, United States
Publisher
Multimed Inc. (E-mail: Amanda_shand@multi-med.com)
Abstract
Debates exist regarding the merit of starting one dialysis modality over
the other for improved cardiovascular outcomes. Five previously published
prospective and retrospective cohort studies have reported inconsistent
conclusions on this topic. The aim of this systematic review and
meta-analysis is to evaluate the influence initiation of hemodialysis (HD)
vs peritoneal dialysis (PD) may have on the relative risk (RR) of
subsequent development of adverse cardiovascular events (ACVE) in patients
with end-stage renal disease (ESRD). Of the 518 records identified, 5
cohort studies, assessing a total of 47,062 patients were included in the
meta-analysis. With regard to the subsequent development of ACVE following
initiation on the different dialysis modalities, the pooled RR was found
to be non-significant. Peritoneal dialysis is a suitable and
cost-effective alternative to HD for ESRD patients at risk of
cardiovascular disease.<br/>Copyright &#xa9; 2019 International Society
for Peritoneal Dialysis.

<108>
Accession Number
2002703112
Title
Concurrent presentation of a hemorrhagic pericardial effusion and venous
thromboembolism in malignancy: a systematic review of case studies.
Source
Journal of Thrombosis and Thrombolysis. 48 (3) (pp 454-458), 2019. Date of
Publication: 01 Oct 2019.
Author
Pabba K.; Rojas-Hernandez C.M.
Institution
(Pabba) Department of Internal Medicine, McGovern Medical School at The
University of Texas Health Science Center at Houston, Houston, TX, United
States
(Rojas-Hernandez) Section of Benign Hematology, The University of Texas MD
Anderson Cancer Center, 1515 Holcombe Blvd., Suite 1464, Houston, TX
77030, United States
Publisher
Springer New York LLC (E-mail: barbara.b.bertram@gsk.com)
Abstract
The concurrent presentation of symptomatic malignant pericardial
hemorrhage and venous thromboembolism is a rare event that poses a
clinical dilemma. Existing VTE guidelines do not indicate when, or if,
anticoagulation therapy should be started after the treatment of the
pericardial bleed. We performed a systematic review to compile the
published clinical evidence on the occurrence of coexisting pericardial
hemorrhage and VTE in cancer patients and to describe the clinical
presentations and bleeding and thrombosis outcomes before and after
anticoagulation therapy. We studied published case reports on patients
with cancer who presented to the hospital with pericardial hemorrhage and
VTE through April 11, 2019. We found seven published case reports. All
patients had suffered from a pulmonary embolism and had pericardiocentesis
during hospitalization. Five patients (71%) had lung cancer. Four patients
(57%) were started on anticoagulation after pericardial drainage and
survived the index event. Two patients (29%) were not started on
anticoagulation after pericardiocentesis; only one of these patients
survived the hospitalization. Pericardial bleeding risk in cancer may be
inherent to malignancy, and it is unclear if anticoagulation use increases
the risk of recurrent pericardial bleeding. The management of pericardial
bleeding typically requires pericardiocentesis, and clinical registries,
prospective collaboration projects, and case adjudication are needed to
establish the safety of initiation of antithrombotic therapy in such
patients.<br/>Copyright &#xa9; 2019, Springer Science+Business Media, LLC,
part of Springer Nature.

<109>
Accession Number
629599809
Title
Protocol for the electroencephalography guidance of anesthesia to
alleviate geriatric syndromes (Engages-canada) study: A pragmatic,
randomized clinical trial [version 1; peer review: 2 approved].
Source
F1000Research. 8 (no pagination), 2019. Article Number: 1165. Date of
Publication: 2019.
Author
Deschamps A.; Saha T.; El-Gabalawy R.; Jacobsohn E.; Overbeek C.; Palermo
J.; Robichaud S.; Dumont A.A.; Djaiani G.; Carroll J.; Kavosh M.S.;
Tanzola R.; Schmitt E.M.; Inouye S.K.; Oberhaus J.; Mickle A.; Abdallah
A.B.; Avidan M.S.
Institution
(Deschamps) Department of Anesthesiology and Pain Medicine, Montreal Heart
Institute and Universite de Montreal, Montreal, QC H1T 1C8, Canada
(Saha, Tanzola) Department of Anesthesiology and Perioperative Medicine,
Queen's University, Kingston, Kingston, ON, Canada
(El-Gabalawy) Department of Clinical Health Psychology, Anesthesiology,
Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB,
Canada
(Jacobsohn) Departments of Anesthesia and Internal Medicine, University of
Manitoba, Winnipeg, MB, Canada
(Overbeek, Palermo) Department of Anesthesiology and Pain Medicine,
University of Montreal, Montreal, QC, Canada
(Robichaud) Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
(Dumont) Montreal Health Innovation Coordinating Center, Montreal Heart
Institute, Montreal, QC, Canada
(Djaiani, Carroll) Department of Anesthesia, University of Toronto,
Toronto, ON, Canada
(Kavosh) Department of Anesthesiology, Perioperative and Pain Medicine,
Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
(Schmitt, Inouye) Department of Medicine, Beth Israel Deaconess Medical
Center, Boston, Massachussetts, United States
(Oberhaus, Mickle, Abdallah, Avidan) Department of Anesthesiology,
Washington University School of Medicine, St-Louis, MO, United States
Department of Anesthesia, University of Manitoba, Winnipeg, MB, Canada
Publisher
F1000 Research Ltd
Abstract
Background: There is some evidence that electroencephalography guidance of
general anesthesia can decrease postoperative delirium after non-cardiac
surgery. There is limited evidence in this regard for cardiac surgery. A
suppressed electroencephalogram pattern, occurring with deep anesthesia,
is associated with increased incidence of postoperative delirium (POD) and
death. However, it is not yet clear whether this electroencephalographic
pattern reflects an underlying vulnerability associated with increased
incidence of delirium and mortality, or whether it is a modifiable risk
factor for these adverse outcomes. <br/>Method(s): The
Electroencephalography Guidance of Anesthesia to Alleviate Geriatric
Syndromes (ENGAGES-Canada) is an ongoing pragmatic 1200 patient trial at
four Canadian sites. The study compares the effect of two anesthetic
management approaches on the incidence of POD after cardiac surgery. One
approach is based on current standard anesthetic practice and the other on
electroencephalography guidance to reduce POD. In the guided arm,
clinicians are encouraged to decrease anesthetic administration, primarily
if there is electroencephalogram suppression and secondarily if the EEG
index is lower than the manufacturers recommended value (bispectral index
(BIS) or WAVcns below 40 or Patient State Index below 25). The aim in the
guided group is to administer the minimum concentration of anesthetic
considered safe for individual patients. The primary outcome of the study
is the incidence of POD, detected using the confusion assessment method or
the confusion assessment method for the intensive care unit; coupled with
structured delirium chart review. Secondary outcomes include unexpected
intraoperative movement, awareness, length of intensive care unit and
hospital stay, delirium severity and duration, quality of life, falls, and
predictors and outcomes of perioperative distress and dissociation.
<br/>Discussion(s): The ENGAGES-Canada trial will help to clarify whether
or not using the electroencephalogram to guide anesthetic administration
during cardiac surgery decreases the incidence, severity, and duration of
POD. Registration: ClinicalTrials.gov (NCT02692300)
26/02/2016.<br/>Copyright &#xa9; 2019 Deschamps A et al.

<110>
Accession Number
629596918
Title
Pragmatic randomised clinical trial of proton versus photon therapy for
patients with non-metastatic breast cancer: The Radiotherapy Comparative
Effectiveness (RadComp) Consortium trial protocol.
Source
BMJ Open. 9 (10) (no pagination), 2019. Article Number: e025556. Date of
Publication: 01 Oct 2019.
Author
Bekelman J.E.; Lu H.; Pugh S.; Baker K.; Berg C.D.; De Gonzalez A.B.;
Braunstein L.Z.; Bosch W.; Chauhan C.; Ellenberg S.; Fang L.C.; Freedman
G.M.; Hahn E.A.; Haffty B.G.; Khan A.J.; Jimenez R.B.; Kesslering C.; Ky
B.; Lee C.; Lu H.-M.; Mishra M.V.; Mullins C.D.; Mutter R.W.; Nagda S.;
Pankuch M.; Powell S.N.; Prior F.W.; Schupak K.; Taghian A.G.; Wilkinson
J.B.; Macdonald S.M.; Cahlon O.
Institution
(Bekelman, Lu, Freedman, Nagda) Department of Radiation Oncology,
University of Pennsylvania Perelman, School of Medicine, Philadelphia, PA,
United States
(Pugh) American College of Radiology, Philadelphia, PA, United States
(Baker, Mishra) Department of Radiation Oncology, University of Maryland,
School of Medicine, Baltimore, MD, United States
(Berg, De Gonzalez, Lee) Division of Cancer Epidemiology and Genetics,
National Cancer Institute, National Institutes of Health, Bethesda, MD,
United States
(Braunstein, Khan, Powell, Schupak, Cahlon) Department of Radiation
Oncology, Memorial Sloan Kettering Cancer Center, New York city, NY,
United States
(Bosch) Department of Radiation Oncology, Washington University in St.
Louis, St. Louis, MO, United States
(Chauhan) Mayo Clinic Minnesota, Rochester, MI, United States
(Ellenberg) Department of Biostatistics Epidemiology and Informatics,
University of Pennsylvania Perelman, School of Medicine, Philadelphia, PA,
United States
(Fang) Department of Radiation Oncology, University of Washington, School
of Medicine, Seattle, WA, United States
(Hahn) Department of Medical Social Sciences, Northwestern University,
Evanston, IL, United States
(Haffty) Department of Radiation Oncology, Rutgers Cancer Institute of New
Jersey, New Brunswick, NJ, United States
(Jimenez, Lu, Taghian, Macdonald) Department of Radiation Oncology,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United
States
(Kesslering, Pankuch) Northwestern Medicine Chicago Proton Center,
Warrenville, IL, United States
(Ky) Cardio-Oncology Program, Division of Cardiovascular Medicine,
University of Pennsylvania Perelman, School of Medicine, Philadelphia, PA,
United States
(Mullins) PHSR, University of Maryland, School of Pharmacy, Baltimore, MD,
United States
(Mutter) Department of Radiation Oncology, Mayo Clinic, Rochester, MN,
United States
(Prior) Department of Biomedical Informatics, University of Arkansas for
Medical Sciences, Little Rock, AR, United States
(Wilkinson) Provision Proton Therapy Center, Knoxville, TN, United States
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Introduction A broad range of stakeholders have called for randomised
evidence on the potential clinical benefits and harms of proton therapy, a
type of radiation therapy, for patients with breast cancer. Radiation
therapy is an important component of curative treatment, reducing cancer
recurrence and extending survival. Compared with photon therapy, the
international treatment standard, proton therapy reduces incidental
radiation to the heart. Our overall objective is to evaluate whether the
differences between proton and photon therapy cardiac radiation dose
distributions lead to meaningful reductions in cardiac morbidity and
mortality after treatment for breast cancer. Methods We are conducting a
large scale, multicentre pragmatic randomised clinical trial for patients
with breast cancer who will be followed longitudinally for cardiovascular
morbidity and mortality, health-related quality of life and cancer control
outcomes. A total of 1278 patients with non-metastatic breast cancer will
be randomly allocated to receive either photon or proton therapy. The
primary outcomes are major cardiovascular events, defined as myocardial
infarction, coronary revascularisation, cardiovascular death or
hospitalisation for unstable angina, heart failure, valvular disease,
arrhythmia or pericardial disease. Secondary endpoints are urgent or
unanticipated outpatient or emergency room visits for heart failure,
arrhythmia, valvular disease or pericardial disease. The Radiotherapy
Comparative Effectiveness (RadComp) Clinical Events Centre will conduct
centralised, blinded adjudication of primary outcome events. Ethics and
dissemination The RadComp trial has been approved by the institutional
review boards of all participating sites. Recruitment began in February
2016. Current version of the protocol is A3, dated 08 November 2018.
Dissemination plans include presentations at scientific conferences,
scientific publications, stakeholder engagement efforts and presentation
to the public via lay media outlets. Trial registration number
NCT02603341.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2019.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<111>
Accession Number
2003205621
Title
154 compared to 54 mmol per liter of sodium in intravenous maintenance
fluid therapy for adult patients undergoing major thoracic surgery
(TOPMAST): a single-center randomized controlled double-blind trial.
Source
Intensive Care Medicine. 45 (10) (pp 1422-1432), 2019. Date of
Publication: 01 Oct 2019.
Author
Van Regenmortel N.; Hendrickx S.; Roelant E.; Baar I.; Dams K.; Van
Vlimmeren K.; Embrecht B.; Wittock A.; Hendriks J.M.; Lauwers P.; Van
Schil P.E.; Van Craenenbroeck A.H.; Verbrugghe W.; Malbrain M.L.N.G.; Van
den Wyngaert T.; Jorens P.G.
Institution
(Van Regenmortel, Baar, Dams, Verbrugghe, Jorens) Department of Intensive
Care Medicine, Antwerp University Hospital, Wilrijkstraat 10, Edegem,
Antwerp 2650, Belgium
(Van Regenmortel) Department of Intensive Care Medicine, Ziekenhuis
Netwerk Antwerpen Campus Stuivenberg, Lange Beeldekensstraat 267, Antwerp
2060, Belgium
(Hendrickx, Van Vlimmeren, Embrecht, Wittock) Department of
Anesthesiology, Antwerp University Hospital, Wilrijkstraat 10, Edegem,
Antwerp 2650, Belgium
(Roelant) Clinical Trial Center (CTC), Clinical Research Center Antwerp,
Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10,
Edegem, Antwerp 2650, Belgium
(Roelant) StatUa, Center for Statistics, University of Antwerp,
Prinsstraat 13, Antwerp 2000, Belgium
(Hendriks, Lauwers, Van Schil) Department of Thoracic and Vascular
Surgery, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Antwerp
2650, Belgium
(Hendriks, Lauwers, Van Schil, Van Craenenbroeck, Van den Wyngaert,
Jorens) Faculty of Medicine and Health Sciences, University of Antwerp,
Universiteitsplein 1, Antwerp 2610, Belgium
(Van Craenenbroeck) Department of Nephrology, Antwerp University Hospital,
Wilrijkstraat 10, Edegem, Antwerp 2650, Belgium
(Malbrain) Department of Intensive Care Medicine, University Hospital
Brussels (UZB), Laarbeeklaan 101, Jette, Brussels 1090, Belgium
(Malbrain) Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel
(VUB), Laarbeeklaan 103, Jette, Brussels 1090, Belgium
(Van den Wyngaert) Department of Nuclear Medicine, Antwerp University
Hospital, Wilrijkstraat 10, Edegem, Antwerp 2650, Belgium
Publisher
Springer Verlag (E-mail: service@springer.de)
Abstract
Purpose: To determine the effects of the sodium content of maintenance
fluid therapy on cumulative fluid balance and electrolyte disorders.
<br/>Method(s): We performed a randomized controlled trial of adults
undergoing major thoracic surgery, randomly assigned (1:1) to receive
maintenance fluids containing 154 mmol/L (Na154) or 54 mmol/L (Na54) of
sodium from the start of surgery until their discharge from the ICU, the
occurrence of a serious adverse event or the third postoperative day at
the latest. Investigators, caregivers and patients were blinded to the
treatment. Primary outcome was cumulative fluid balance. Electrolyte
disturbances were assessed as secondary endpoints, different adverse
events and physiological markers as safety and exploratory endpoints.
<br/>Finding(s): We randomly assigned 70 patients; primary outcome data
were available for 33 and 34 patients in the Na54 and Na154 treatment
arms, respectively. Estimated cumulative fluid balance at 72 h was 1369 mL
(95% CI 601-2137) more positive in the Na154 arm (p < 0.001), despite
comparable non-study fluid sources. Hyponatremia < 135 mmol/L was
encountered in four patients (11.8%) under Na54 compared to none under
Na154 (p = 0.04), but there was no significantly more hyponatremia < 130
mmol/L (1 versus 0; p = 0.31). There was more hyperchloremia > 109 mmol/L
under Na154 (24/35 patients, 68.6%) than under Na54 (4/34 patients, 11.8%)
(p < 0.001). The treating clinicians discontinued the study due to
clinical or radiographic fluid overload in six patients receiving Na154
compared to one patient under Na54 (excess risk 14.2%; 95% CI - 0.2-30.4%,
p = 0.05). <br/>Conclusion(s): In adult surgical patients, sodium-rich
maintenance solutions were associated with a more positive cumulative
fluid balance and hyperchloremia; hypotonic fluids were associated with
mild and asymptomatic hyponatremia.<br/>Copyright &#xa9; 2019, The
Author(s).

<112>
Accession Number
2002506667
Title
Perioperative myocardial damage and heart failure in noncardiac surgery.
Part 2. Reduction of the risk of perioperative cardiac complications by
pharmacological measures and optimization of anesthetic and critical care
support.
Source
Obshchaya Reanimatologiya. 15 (3) (pp 83-101), 2019. Date of Publication:
2019.
Author
Kozlov I.A.; Ovezov A.M.; Petrovskaya E.L.
Institution
(Kozlov, Ovezov, Petrovskaya) M. F. Vladimirsky Moscow Regional Research
Clinical Institute, 61/2 Shchepkin Str., Moscow 129110, Russian Federation
Publisher
V.A. Negovsky Research Institute of General Reanimatology (E-mail:
v_reshetnyak@yahoo.com)
Abstract
The second part of the overview presents and analyzes the current data on
the methods of adjuvant pharmacological cardioprotection and possibilities
of optimizing the anesthetic support and perioperative monitoring in high
cardiac risk patients. Amendments made in international guidelines for the
last 2-3 years on the basis of conclusive studies and meta-analyses have
been examined. Cardioprotection mechanisms and information about its
implementation in real clinical practice have been analysed. It has been
shown that by no means all drugs under discussion can be widely used for
prophytlactic purposes. Contemporary evidencebased recommendations
concerning the optimization of anesthetic support and perioperative
monitoring are given. A conclusion has been made that practical
implementation of a comprehensive strategy aimed at reduction of the risk
of cardiac complications might ensure decrease of both the incidence of
severe cardiac complications and mortality due to them.<br/>Copyright
&#xa9; Obshchaya Reanimatologiya 2019. All Rights Reserved.

<113>
Accession Number
2003378172
Title
Sternal wound closure in the current era: the need of a tailored approach.
Source
General Thoracic and Cardiovascular Surgery. 67 (11) (pp 907-916), 2019.
Date of Publication: 01 Nov 2019.
Author
Nenna A.; Nappi F.; Dougal J.; Satriano U.; Chello C.; Mastroianni C.;
Lusini M.; Chello M.; Spadaccio C.
Institution
(Nenna, Satriano, Mastroianni, Lusini, Chello) Department of
Cardiovascular Surgery, Universita Campus Bio-Medico Di Roma, Via Alvaro
del Portillo 200, Rome 00128, Italy
(Nappi) Cardiac Surgery, Centre Cardiologique du Nord de Saint-Denis,
Paris, France
(Dougal, Spadaccio) Cardiac Surgery, Golden Jubilee National Hospital,
Glasgow, United Kingdom
(Chello) Dermatology, University of Rome "La Sapienza", Rome, Italy
Publisher
Springer Tokyo (E-mail: orders@springer.jp)
Abstract
Objective: Median sternotomy remains the most common access to perform
cardiac surgery procedures. However, the experience of the operating
surgeon remains a crucial factor during sternal closure to avoid potential
complications related to poor sternal healing, such as mediastinitis.
Considering the lack of major randomized controlled trials and the
heterogeneity of the current literature, this narrative review aims to
summarize the different techniques and approaches to sternal closure with
the aim to investigate their reflections into clinical outcomes and to
inform the choice on the most effective closure method after median
sternotomy. <br/>Method(s): A literature search through PubMed, Embase,
EBSCO, Cochrane database of systematic reviews, and Web of Science from
its inception up to April 2019 using the following search keywords in
various combinations: sternal, sternotomy, mediastinitis, deep sternal
wound infection, cardiac surgery, closure. <br/>Result(s): Single wire
fixation methods, at present, seems the most useful method to perform
sternal closure in routine patients, although patients with a fragile
sternum might benefit more from a figure-of-eight technique. In high-risk
patients (e.g. chronic pulmonary disease, obesity, bilateral internal
mammary artery harvesting, diabetes, off-midline sternotomy), rigid plate
fixation is currently the most effective method, if available;
alternatively, weave techniques could be used. <br/>Conclusion(s): The
choice among the sternal closure techniques should be mainly inspired and
tailored on the patient's characteristics, and correct judgement and
experience play a pivotal role. A decisional algorithm has been proposed
as an attempt to overcome the absence of specific guidelines and to guide
the operative approach. This operative approach might be used also in
non-cardiac procedure in which median sternotomy is required, such as in
case of thoracic surgery.<br/>Copyright &#xa9; 2019, The Japanese
Association for Thoracic Surgery.