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<1>
Accession Number
2002637677
Title
Meta-Analysis of Transcatheter Aortic Valve Replacement in Low-Risk
Patients.
Source
American Journal of Medicine. 133 (2) (pp e38-e41), 2020. Date of
Publication: February 2020.
Author
Kheiri B.; Osman M.; Bakhit A.; Radaideh Q.; Barbarawi M.; Zayed Y.;
Golwala H.; Zahr F.; Stone G.W.; Bhatt D.L.
Institution
(Kheiri, Barbarawi, Zayed, Golwala, Zahr) Knight Cardiovascular Institute,
Oregon Health & Science University, Portland
(Osman) Division of Cardiology, West Virginia University School of
Medicine, Morgantown, United States
(Bakhit) Division of Cardiology, Saint Vincent Hospital, Worcester, Mass,
United States
(Radaideh) Midwest Cardiovascular Research Foundation, Davenport, IA,
United States
(Stone) NewYork-Presbyterian Hospital/Columbia University Medical Center,
New York, NY; Cardiovascular Research Foundation, New York, United States
(Bhatt) Brigham and Women's Hospital Heart & Vascular Center, Harvard
Medical School, Boston, Mass, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Purpose: This study evaluated the efficacy and safety of transcatheter
aortic valve replacement (TAVR) compared with surgical aortic valve
replacement (SAVR) in low surgical risk patients. <br/>Method(s): An
electronic database search was conducted for randomized controlled trials
(RCTs). We calculated hazard ratios (HRs) and 95% confidence intervals
(CIs) using a random-effects model. <br/>Result(s): Five RCTs were
identified with a total of 3,072 patients (mean age 74.5 +/- 6.1 and 64.8%
male). Compared with SAVR, TAVR was associated with a significantly
reduced rate of death or disabling stroke (HR = 0.52; 95% CI = 0.27-0.99;
P =. 049), atrial-fibrillation (HR = 0.28; 95% CI = 0.18-0.46; P <. 01),
and post-procedure bleeding (HR = 0.38; 95% CI = 0.31-0.46; P <. 01),
along with a significantly improved quality-of-life at 1-year. However,
TAVR was associated with significantly increased rates of paravalvular
leak (HR = 4.09; 95% CI = 1.92-8.69; P <. 01) and pacemaker insertion (HR
= 2.81; 95% CI = 1.85-4.28; P <. 01) compared with SAVR.
<br/>Conclusion(s): Among older low-risk patients with severe aortic
stenosis, TAVR is associated with a lower rate of death or disabling
stroke compared with SAVR. Transcatheter aortic valve replacement is also
associated with improved quality-of-life, reduced bleeding and atrial
fibrillation, but higher paravalvular leak and pacemaker implantation
rates.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<2>
Accession Number
2003518383
Title
Evaluation of hyperoxia-induced hypercapnia in obese patients after
cardiac surgery: a randomized crossover comparison of conservative and
liberal oxygen administration.
Source
Canadian Journal of Anesthesia. 67 (2) (pp 194-202), 2020. Date of
Publication: 01 Feb 2020.
Author
Denault M.-H.; Ruel C.; Simon M.; Bouchard P.-A.; Simard S.; Lellouche F.
Institution
(Denault, Ruel, Simon, Bouchard, Simard, Lellouche) Institut universitaire
de cardiologie et de pneumologie de Quebec - Universite Laval Research
Center, 2725 Chemin Ste-Foy, Quebec, QC G1V 4G5, Canada
Publisher
Springer
Abstract
Purpose: Recent studies on patients with stable obesity-hypoventilation
syndrome have raised concerns about hyperoxia-induced hypercapnia in this
population. This study aimed to evaluate whether a higher oxygen
saturation target would increase arterial partial pressure of carbon
dioxide (PaCO<inf>2)</inf> in obese patients after coronary artery bypass
grafting surgery (CABG). <br/>Method(s): Obese patients having CABG were
recruited. With a randomized crossover design, we compared two oxygenation
strategies for 30 min each, immediately after extubation: a peripheral
oxygen saturation (SpO<inf>2</inf>) target of >= 95% achieved with manual
oxygen titration (liberal) and a SpO<inf>2</inf> target of 90% achieved
with FreeO<inf>2</inf>, an automated oxygen titration device
(conservative). The main outcome was end-of-period arterial
PaCO<inf>2</inf>. <br/>Result(s): Thirty patients were included. Mean
(standard deviation [SD]) body mass index (BMI) was 34 (3)
kg.m^-2 and mean (SD) baseline partial pressure of carbon
dioxide (PCO<inf>2</inf>) was 40.7 (3.1) mmHg. Mean (SD) end-of-period
PaCO<inf>2</inf> was 42.0 (5.4) mmHg in the conservative period, compared
with 42.6 (4.6) mmHg in the liberal period [mean difference - 0.6 (95%
confidence interval - 2.2 to 0.9) mmHg; P = 0.4]. Adjusted analysis for
age, BMI, narcotics, and preoperative PaCO<inf>2</inf> did not
substantively change the results. Fourteen patients were retainers,
showing an elevation in mean (SD) PaCO<inf>2</inf> in the liberal period
of 3.3 (4.1) mmHg. Eleven patients had the opposite response, with a mean
(SD) end-of-period PaCO<inf>2</inf> decrease of 1.8 (2.2) mmHg in the
liberal period. Five patients had a neutral response. <br/>Conclusion(s):
This study did not show a clinically important increase in
PaCO<inf>2</inf> associated with higher SpO<inf>2</inf> values in this
specific population of obese patients after CABG. Partial pressure of
carbon dioxide increased with liberal oxygen administration in almost half
of the patients, but no predictive factor was identified. Trial
registration: www.clinicaltrials.gov (NCT02917668); registered 25
September, 2016.<br/>Copyright &#xa9; 2019, Canadian Anesthesiologists'
Society.

<3>
Accession Number
2003473849
Title
Effects of Zoledronate on Cancer, Cardiac Events, and Mortality in
Osteopenic Older Women.
Source
Journal of Bone and Mineral Research. 35 (1) (pp 20-27), 2020. Date of
Publication: 01 Jan 2020.
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.

<4>
Accession Number
629419500
Title
Transcatheter aortic valve replacement versus surgery in low-risk
patients: A meta-analysis of randomized studies.
Source
Journal of Cardiovascular Medicine. 21 (2) (pp 168-170), 2020. Date of
Publication: 01 Feb 2020.
Author
Ferlini M.; Fortuni F.; Di Giacomo C.; Cornara S.; Somaschini A.; Oltrona
Visconti L.; Ferrario M.
Institution
(Ferlini, Fortuni, Di Giacomo, Cornara, Somaschini, Oltrona Visconti,
Ferrario) Division of Cardiology, Fondazione IRCCS Policlinico San Matteo,
Piazzale Golgi 1, Pavia 27100, Italy
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)

<5>
Accession Number
2003962886
Title
Meta-Analysis of Transcatheter Aortic Valve Implantation Versus Surgical
Aortic Valve Replacement in Patients With Low Surgical Risk.
Source
American Journal of Cardiology. 125 (3) (pp 459-468), 2020. Date of
Publication: 1 February 2020.
Author
Vipparthy S.C.; Ravi V.; Avula S.; Kambhatla S.; Mahmood M.; Kabour A.;
Ali S.S.; Barzallo M.; Mungee S.
Institution
(Vipparthy, Barzallo, Mungee) OSF St. Francis Medical Center, UICOMP,
Peoria, IL, United States
(Ravi) Rush University Medical Center, Chicago, IL, United States
(Avula, Mahmood, Kabour, Ali) Mercy St Vincent Medical Center, Toledo, OH,
United States
(Kambhatla) John H Stroger Jr. Hospital of Cook County, Chicago, IL,
United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Transcatheter aortic valve implantation (TAVI) is the current standard of
care for patients with severe aortic stenosis who are at high risk for
surgery. However, several recent studies have demonstrated the comparable
safety and efficacy of TAVI in low-risk patients as well. We sought to
pool the existing data to further assert its comparability. MEDLINE,
Cochrane, and Embase databases were evaluated for relevant articles
published from January 2005 to June 2019. Studies comparing outcomes of
TAVI versus surgical aortic valve replacement in patients who are at low
risk for surgery were included. Twelve studies (5 randomized controlled
trials and 7 observational studies) totaling 27,956 patients were
included. Follow-up ranged from 3 months to 5 years. Short-term all-cause
mortality, short-term, and 1-year cardiac mortality were significantly
lower in the TAVI group. One-year all-cause mortality, short-term, and
1-year stroke and myocardial infarction were similar in both groups. Rate
of acute kidney injury and new-onset atrial fibrillation were lower in the
TAVI group, whereas permanent pacemaker implantation and major vascular
complications were higher in the TAVI group. Subgroup analysis of
randomized controlled trials showed significantly lower 1-year all-cause
mortality in the TAVI group. In conclusion, in severe aortic stenosis
patients at low surgical risk, TAVI when compared with surgical aortic
valve replacement, demonstrated a lower rate of short-term all-cause
mortality, short-term, and 1-year cardiac mortality and similar in terms
of 1-year all-cause mortality. TAVI is emerging as a safe and efficacious
alternative for low surgical risk patients.<br/>Copyright &#xa9; 2019
Elsevier Inc.

<6>
Accession Number
2003861791
Title
Five-year clinical outcome of multicenter randomized trial comparing
amphilimus - with paclitaxel-eluting stents in de novo native coronary
artery lesions.
Source
International Journal of Cardiology. 301 (pp 50-55), 2020. Date of
Publication: 15 February 2020.
Author
Carrie D.; Berland J.; Verheye S.; Hauptmann K.E.; Vrolix M.; Musto C.;
Berti S.; Dibie A.; Maupas E.; Antoniucci D.; Schofer J.
Institution
(Carrie) Service de Cardiologie B, CHU Rangueil, Universite Paul Sabatier,
Toulouse, France
(Berland) Clinique Saint-Hilaire, Rouen, France
(Verheye) Division of Cardiology, Academisch Ziekenhuis Middelheim,
Antwerp, Belgium
(Hauptmann) Division of Cardiology, Krankenhaus der Barmherezigen Bruder,
Trier, Germany
(Vrolix) Division of Cardiology, Ziekenhuis Oost Limburg, Genk, Belgium
(Musto) UO Cardiologia Interventistica, Azinda Ospedaliera S. Camillo
Forlanini, Roma, Italy
(Berti) Ospedale del Cuore, Fondazione CNR G Monasterio, Massa, Italy
(Dibie) Service de Cardiologie, Institut Mutualiste Montsouris, Paris,
France
(Maupas) Service de Cardiologie, Clinique les Franciscaines, Nimes, France
(Antoniucci) Divisione di Cardiologia, Azienda Ospedaliera Careggi,
Firenze, Italy
(Schofer) Medical Care Center, Hamburg University Cardiovascular Center,
Hamburg, Germany
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: Long-term data from randomized studies on polymer-free stents
are scarce. Long-term data of Cre8 amphilimus eluting stent are still not
available. We sought to investigate contribution of a polymer-free design
versus a permanent-polymer one on the long-term. <br/>Methods and Results:
Patients undergoing percutaneous coronary intervention for de novo lesions
were randomized 1:1 to Cre8 or Taxus Liberte (323 overall, 126 Cre8).
Original primary endpoint (6-month angiographic in-stent late lumen loss)
already demonstrated the superiority of Cre8 vs Taxus (0.14 + 0.36 mm vs.
0.34 + 0.40 mm; p < 0.001). Secondary endpoints were the device oriented
composite endpoint (DOCE), patient oriented composite endpoint (POCE) up
to 5-year. Long-term follow-up data confirmed the superiority shown by
Cre8 in the analysis of the angiographic endpoint at 6-month, especially
in the diabetic patients, where the device strongly reduced the clinical
difference with non-diabetic. Landmark analysis demonstrated that the
incidence of DOCE after 1-year and up to 5-year follow up was
significantly lower in patients implanted with Cre8 AES (2.1% Cre8 vs.
9.3% Taxus, p = 0.009). While no differences were found in terms of DOCE
rate among diabetic and non-diabetic patients treated with the Cre8 AES
(HR 1.039; 95%CI 0.320-3.374), this was not true for Taxus (HR 2.64; 95%CI
1.112-6.278). <br/>Conclusion(s): Cre8 showed favourable safety and
efficacy results versus Taxus at 5-years follow-up, with a superior
clinical performance for the DOCE endpoint from 1 to 5 years. Cre8,
differently from Taxus, has been able to strongly reduce the differences
in clinical outcome between diabetic and non-diabetic up to 5 years,
suggesting the higher efficacy of Cre8 in the treatment of diabetic
patients.<br/>Copyright &#xa9; 2018

<7>
Accession Number
628651374
Title
Outcomes after surgery for functional tricuspid regurgitation: a
systematic review and meta-analysis.
Source
European heart journal. Quality of care & clinical outcomes. 6 (1) (pp
10-18), 2020. Date of Publication: 01 Jan 2020.
Author
Veen K.M.; Etnel J.R.G.; Quanjel T.J.M.; Mokhles M.M.; Huygens S.A.;
Rasheed M.; Oei F.B.S.; Ten Cate F.J.; Bogers A.J.J.C.; Takkenberg J.J.M.
Institution
(Veen, Etnel, Quanjel, Mokhles, Huygens, Rasheed, Oei, Bogers, Takkenberg)
Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus MC, University
Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam 3015,
Netherlands
(Ten Cate) Department of Cardiology, Thoraxcenter, Erasmus MC, University
Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam 3015,
Netherlands
Publisher
NLM (Medline)
Abstract
AIMS: This study aims to provide a contemporary overview of outcomes after
tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR).
METHODS AND RESULTS: The literature was systematically searched for papers
published between January 2005 and December 2017 reporting on
clinical/echocardiographic outcomes after TV surgery for functional TR. A
random effects meta-analysis was conducted for outcome variables, and late
outcomes are visualized by pooled Kaplan-Meier curves. Subgroup analyses
were performed for studies with a within-study comparison of suture vs.
ring repair and flexible vs. rigid ring repair. Eighty-seven publications
were included, encompassing 13 184 patients (mean age: 62.1+/-11.8years,
55% females). A mitral valve procedure was performed in 92% of patients.
Pooled mean follow-up was 4.0 +/- 2.8years. Pooled early mortality was
3.9% (95% CI: 3.2-4.6), and late mortality rate was 2.7%/year (95% CI:
2.0-3.5), of which approximately half was cardiac-related 1.2%/year (95%
CI: 0.8-1.9). Pooled risk of early moderate-to-severe TR at discharge was
9.4% (95% CI: 7.0-12.1). Late moderate-to-severe TR rate after discharge
was 1.9%/year (95% CI: 1.0-3.5). Late reintervention rate was 0.3%/year
(95% CI: 0.2-0.4). Mortality and overall (early and late) TR rate were
comparable between suture vs. ring annuloplasty (14 studies), whereas
overall TR rate was higher after flexible ring vs. rigid ring annuloplasty
(6 studies) (7.5%/year vs. 3.9%/year, P=0.002). <br/>CONCLUSION(S): This
study shows that patients undergoing surgery for functional tricuspid
regurgitation (FTR) have an acceptable early and late mortality. However,
TR remains prevalent after surgery. The results of this study can be used
to inform patients and clinicians about the expected outcome after surgery
for FTR and can results serve as a benchmark for the performance of
emerging transcatheter TV interventions.<br/>Copyright Published on behalf
of the European Society of Cardiology. All rights reserved. &#xa9; The
Author(s) 2019. For permissions, please email:
journals.permissions@oup.com.

<8>
Accession Number
2003906335
Title
Social Media Improves Cardiothoracic Surgery Literature Dissemination:
Results of a Randomized Trial.
Source
Annals of Thoracic Surgery. 109 (2) (pp 589-595), 2020. Date of
Publication: February 2020.
Author
Luc J.G.Y.; Archer M.A.; Arora R.C.; Bender E.M.; Blitz A.; Cooke D.T.;
Hlci T.N.; Kidane B.; Ouzounian M.; Varghese T.K.; Antonoff M.B.
Institution
(Luc) Division of Cardiovascular Surgery, Department of Surgery,
University of British Columbia, Vancouver, Canada
(Archer) Department of Thoracic Surgery, Vanderbilt University Medical
Center, Nashville, TN, United States
(Arora) Section of Cardiac Surgery, Department of Surgery, Max Rady
College of Medicine, University of Manitoba, St Boniface Hospital,
Winnipeg, Canada
(Bender) Department of Cardiothoracic Surgery, Stanford University, Palo
Alto, CA, United States
(Blitz) Division of Cardiac Surgery, University of Cincinnati Medical
Center, Cincinnati, OH, United States
(Cooke) Section of General Thoracic Surgery, UC Davis Health, Sacramento,
CA, United States
(Hlci) Department of Cardiothoracic Surgery, Morriston Hospital, Swansea
Bay University Health Board, Swansea, United Kingdom
(Kidane) Section of Thoracic Surgery, Department of Surgery, University of
Manitoba, Winnipeg, Canada
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, University of Toronto, Toronto, Canada
(Varghese) Division of Cardiothoracic Surgery, Department of Surgery,
University of Utah, Salt Lake City, UT, United States
(Antonoff) Department of Thoracic and Cardiovascular Surgery, University
of Texas MD Anderson Cancer Center, Houston, TX, United States
Publisher
Elsevier USA
Abstract
Background: The Thoracic Surgery Social Media Network (TSSMN) represents a
collaborative effort of leading journals in cardiothoracic surgery to
highlight publications via social media, specifically Twitter. We
conducted a prospective randomized trial to determine the effect of
scheduled tweeting on nontraditional bibliometrics of dissemination.
<br/>Method(s): A total of 112 representative original articles
(2017-2018) were selected and randomized 1:1 to an intervention group to
be tweeted via TSSMN or a control (non-tweeted) group. Four articles per
day were tweeted by TSSMN delegates for 14 days. Primary endpoints
included change in article-level metrics (Altmetric) score pre-tweet and
post-tweet compared with the control group. Secondary endpoints included
change in Twitter analytics day 1 post-tweet and day 7 post-tweet for each
article compared with baseline. <br/>Result(s): Tweeting via TSSMN
significantly improved article Altmetric scores (pre-tweet 1 vs post-tweet
8; P <.001), Mendeley reads (pre-tweet 1 vs post-tweet 3; P <.001), and
Twitter impressions (day 1 post-tweet 1599 vs day 7 post-tweet 2296; P
<.001). Subgroup analysis demonstrates that incorporating photos into the
tweets trended toward increased link clicks to the full-text article (P
=.08) whereas tweeting at 1 pm Eastern Standard Time and 9 pm Eastern
Standard Time generated the highest and lowest audience reach (P =.022),
respectively. Articles published in adult cardiac surgery achieved the
highest change in Altmetric score (P =.028) and Mendeley reads (P =.028),
and were more likely to be retweeted (P =.042) than were those published
on education, general thoracic surgery, and congenital surgery.
<br/>Conclusion(s): Social media highlights of scholarly literature via
TSSMN Twitter activity improves article Altmetric scores, Mendeley reads,
and Twitter analytics, with dissemination to a greater
audience.<br/>Copyright &#xa9; 2020 The Society of Thoracic Surgeons

<9>
Accession Number
628731886
Title
Meta-analysis of prognostic impact of peripheral arterial disease on
mortality after transcatheter aortic valve implantation.
Source
The Journal of cardiovascular surgery. 60 (6) (pp 723-732), 2019. Date of
Publication: 01 Dec 2019.
Author
Takagi H.; Hari Y.; Nakashima K.; Kuno T.; Ando T.
Institution
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Takagi) Department of Cardiovascular Surgery, Kitasato University School
of Medicine, Sagamihara, Japan
(Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
(Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Kuno) Department of Medicine, Mount Sinai Beth Israel Medical Center, NY,
NY, United States
(Ando) Department of Cardiology, Detroit Medical Center, MI, Detroit,
United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The aim of this study was to determine whether peripheral
arterial disease (PAD) is an independent predictor of mortality in
patients who undergo transcatheter aortic valve implantation (TAVI) and we
performed meta-analysis of currently available studies. EVIDENCE
ACQUISITION: MEDLINE and EMBASE were searched through June 2018 using
Web-based search engines (PubMed and OVID). We included comparative
studies of patients with PAD versus those without PAD and cohort studies
which investigated PAD as one of prognostic factors of mortality, which
used the multivariable analysis and reported an adjusted odds and hazard
ratio (OR/HR) for early (30-day or in-hospital) and late (including early)
mortality after TAVI. Study-specific estimates were combined using inverse
variance-weighted averages of logarithmic ORs/HRs in the random-effects
model. EVIDENCE SYNTHESIS: The primary meta-analysis which pooled all the
ORs/HRs demonstrated that PAD was associated with a statistically
significant increase in both early (OR, 1.21; P=0.02) and midterm (1-year
to 7-year) mortality (HR, 1.31; P<0.00001). The secondary meta-analysis
which exclusively pooled approach-adjusted/stratified ORs/HRs demonstrated
that PAD was associated with a strong trend toward (though statistically
non-significant) an increase in early mortality (OR, 1.18; P=0.07) and a
still statistically significant increase in midterm mortality (OR, 1.24;
P=0.0001). Meta-regression coefficients for the proportion of patients who
underwent transfemoral TAVI were not statistically significant (P for
early/midterm mortality =0.24/0.52). <br/>CONCLUSION(S): The present
meta-analysis clearly highlighted that PAD was an independent predictor of
both early and midterm mortality in patients who underwent TAVI.

<10>
Accession Number
630664278
Title
Mild acute cellular rejection and development of cardiac allograft
vasculopathy assessed by intravascular ultrasound and coronary angiography
in heart transplant recipients - a SCHEDULE trial substudy.
Source
Transplant international : official journal of the European Society for
Organ Transplantation. (no pagination), 2020. Date of Publication: 20 Jan
2020.
Author
Nelson L.M.; Andreassen A.K.; Arora S.; Andersson B.; Gude E.; Eiskjaer
H.; Radegran G.; Dellgren G.; Gullestad L.; Gustafsson F.
Institution
(Nelson, Gustafsson) Department of Cardiology, Copenhagen University
Hospital, Rigshospitalet, Copenhagen, Denmark
(Andreassen, Arora, Gude, Gullestad) Department of Cardiology, Oslo
University Hospital, Rikshospitalet, Oslo, Norway
(Arora, Gullestad) K.G. Jebsen Cardiac Research Centre and Center for
Heart Failure Research, Oslo, Norway
(Andersson) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Eiskjaer) Department of Cardiology, Aarhus University Hospital, Skejby
,Aarhus, Denmark
(Radegran) Section for Heart Failure and Valvular Disease, Skane
University Hospital and Department of Clinical Sciences Lund, Cardiology,
Lund University, Lund, Sweden
(Dellgren) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Gullestad) Faculty of Medicine, University of Oslo, Oslo, Norway
(Gustafsson) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
Publisher
NLM (Medline)
Abstract
PURPOSE: To evaluate the association between mild acute cellular rejection
(ACR) and the development of cardiac allograft vasculopathy (CAV) after
heart transplantation (HTx). <br/>METHOD(S): Substudy of the SCHEDULE
trial (n=115), where de novo HTx recipients were randomized to (i)
everolimus with early CNI elimination or (ii) CNI-based immunosuppression.
76 patients (66%) were included based on matched intravascular ultrasound
(IVUS) examinations at baseline and year 3 post-HTx. Biopsy proven ACR
within year 1 post-HTx was recorded and graded (1R, 2R, 3R). Development
of CAV was assessed by IVUS and coronary angiography at year 3 post-HTx.
<br/>RESULT(S): Median age was 53 years (45-61) and 71% were male. ACR was
recorded in 67% and patients were grouped by rejection profile: no ACR
(33%), only 1R (42%), >= 2R (25%). Median MIT(maximal intimal
thickness)BL-3Y was not significantly different between groups (p=0.84).
The incidence of CAV was 49% by IVUS and 26% by coronary angiography with
no significant differences between groups. No correlation was found
between number of 1R and MITBL-3Y (r=-0.025, p=0.83). Number of 1R was not
a significant predictor of MITBL-3Y (p=0.58) and no significant
interaction with treatment was found (p=0.98). <br/>CONCLUSION(S): The
burden of mild ACR was not associated with CAV development.<br/>Copyright
&#xa9; 2020 Steunstichting ESOT.

<11>
Accession Number
630661384
Title
Combined Tricuspid and Mitral Versus Isolated Mitral Valve Repair for
Severe Mitral and Tricuspid Regurgitation: An Analysis From the TriValve
and TRAMI Registries.
Source
JACC. Cardiovascular interventions. (no pagination), 2020. Date of
Publication: 10 Jan 2020.
Author
Mehr M.; Karam N.; Taramasso M.; Ouarrak T.; Schneider S.; Lurz P.; von
Bardeleben R.S.; Fam N.; Pozzoli A.; Lubos E.; Boekstegers P.; Schillinger
W.; Plicht B.; Eggebrecht H.; Baldus S.; Senges J.; Maisano F.; Hausleiter
J.
Institution
(Mehr, Hausleiter) Medizinische Klinik und Poliklinik I, Klinikum der
Universitat Munchen, Ludwig-Maximilians-Universitat, Munich, Germany;
German Centre for Cardiovascular Research, Partner Site Munich Heart
Alliance, Munich, Germany
(Karam) Medizinische Klinik und Poliklinik I, Klinikum der Universitat
Munchen, Ludwig-Maximilians-Universitat, Munich, Germany; European
Hospital Georges Pompidou (Cardiology Department) and Paris Cardiovascular
Research Center (INSERMU970), Paris, France
(Taramasso, Pozzoli, Maisano) Department of Cardiovascular Surgery,
University Hospital of Zurich, University of Zurich, Zurich, Switzerland
(Ouarrak, Schneider, Senges) Stiftung fur Herzinfarktforschung,
Ludwigshafen, Germany
(Lurz) Leipzig Heart Center, University of Leipzig, Leipzig, Germany
(von Bardeleben) Heart Valve Center Mainz, Center of Cardiology University
Medical Center, Mainz, Germany
(Fam) Division of Cardiology, St. Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Lubos) University Heart Center Hamburg, University of Hamburg, Hamburg,
Germany
(Boekstegers) Klinikum Siegburg, Siegburg, Germany
(Schillinger) Helios Albert-Schweitzer-Klinik, Northeim, Germany
(Plicht) Klinikum Westfalen, Dortmund, Germany
(Eggebrecht) Cardioangiologisches Centrum Bethanien, Frankfurt am Main,
Germany
(Baldus) Cologne University Hospital, Cologne, Germany
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The aim of this study was to retrospectively compare the
characteristics, procedural courses, and outcomes of patients presenting
with concomitant mitral regurgitation (MR) and tricuspid regurgitation
(TR) in the TriValve (Transcatheter Tricuspid Valve Therapies) and TRAMI
(Transcatheter Mitral Valve Interventions) registries. BACKGROUND:
Transcatheter mitral edge-to-edge valve repair (TMVR) has been shown to be
successful in patients with severe MR. Lately, edge-to-edge repair has
also emerged as a possible treatment for severe TR in patients at high
risk for cardiac surgery. In patients with both severe MR and TR, the
yield of concomitant transcatheter mitral and tricuspid valve repair
(TMTVR) for patients at high surgical risk is unknown. <br/>METHOD(S): The
characteristics, procedural data, and 1-year outcomes of all patients in
the international multicenter TriValve registry and the German multicenter
TRAMI registry, who presented with both severe MR and TR, were
retrospectively compared. Patients in TRAMI (n = 106) underwent isolated
TMVR, while those in TriValve (n = 122) additionally underwent concurrent
TMTVR in compassionate and/or off-label use. <br/>RESULT(S): All 228
patients (mean age 77 +/- 8 years, 44.3% women) presented with significant
dyspnea at baseline (New York Heart Association functional class III or IV
in 93.9%), without any differences in the rates of pulmonary hypertension
and chronic pulmonary disease. The proportion of patients with left
ventricular ejection fraction <30% was higher in the TMVR group (34.9% vs.
18.0%; p < 0.001), while patients in the TMTVR group had lower glomerular
filtration rates. At discharge, MR was comparably reduced in both groups.
At 1 year, overall all-cause mortality was 34.0% in the TMVR group and
16.4% in the TMTVR group (p = 0.035, Cox regression). On multivariate
analysis, TMTVR was associated with a 2-fold lower mortality rate (hazard
ratio: 0.52; p = 0.02). The rate of patients in New York Heart Association
functional class <=II at 1 year did not differ (69.4% vs. 67.0%; p =
0.54). <br/>CONCLUSION(S): Concurrent TMTVR was associated with a higher
1-year survival rate compared with isolated TMVR in patients with both MR
and TR. Further randomized trials are needed to confirm these
results.<br/>Copyright &#xa9; 2020. Published by Elsevier Inc.

<12>
Accession Number
630661374
Title
Mortality After Repeat Revascularization Following PCI or Coronary Artery
Bypass Grafting for Left Main Disease: The EXCEL Trial.
Source
JACC. Cardiovascular interventions. (no pagination), 2020. Date of
Publication: 10 Jan 2020.
Author
Giustino G.; Serruys P.W.; Sabik J.F.; Mehran R.; Maehara A.; Puskas J.D.;
Simonton C.A.; Lembo N.J.; Kandzari D.E.; Morice M.-C.; Taggart D.P.;
Gershlick A.H.; Ragosta M.; Kron I.L.; Liu Y.; Zhang Z.; McAndrew T.;
Dressler O.; Genereux P.; Ben-Yehuda O.; Pocock S.J.; Kappetein A.P.;
Stone G.W.
Institution
(Giustino) Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, NY
(Serruys) Imperial College of Science, Technology and Medicine, London,
United Kingdom
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
(Mehran, Stone) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, New York; Clinical
Trials Center, Cardiovascular Research Foundation, New York, New York
(Maehara, Lembo, Ben-Yehuda) Clinical Trials Center, Cardiovascular
Research Foundation, New York, New York; NewYork-Presbyterian
Hospital/Columbia University Medical Center, New York, New York
(Puskas) Mount Sinai Heart at Mount Sinai St Luke's, NY
(Simonton) Abbott Vascular, Santa Clara, CA, Mexico
(Kandzari) Piedmont Heart Institute, Atlanta, Georgia
(Morice) Ramsay Generale de Sante, Hopital Prive Jacques Cartier, Massy,
France
(Taggart) Department Cardiac Surgery, John Radcliffe Hospital, Oxford,
United Kingdom
(Gershlick) University Hospitals of Leicester, Leicester, United Kingdom
(Ragosta, Kron) Division of Cardiovascular Medicine, University of
Virginia Health System, Charlottesville, VA, United States
(Liu, Zhang, McAndrew, Dressler) Clinical Trials Center, Cardiovascular
Research Foundation, NY
(Genereux) Clinical Trials Center, Cardiovascular Research Foundation, New
York, New York; Gagnon Cardiovascular Institute, Morristown Medical
Center, Morristown, New Jersey; Hopital du Sacre-Coeur de Montreal,
Montreal, Quebec, Canada
(Pocock) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
(Kappetein) Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The aim of this study was to investigate the incidence and
impact on mortality of repeat revascularization after index percutaneous
coronary intervention (PCI) or coronary artery bypass grafting (CABG) for
left main coronary artery disease (LMCAD). BACKGROUND: The impact on
mortality of the need of repeat revascularization following PCI or CABG in
patients with unprotected LMCAD is unknown. <br/>METHOD(S): All patients
with LMCAD and site-assessed low or intermediate SYNTAX (Synergy Between
PCI With Taxus and Cardiac Surgery) scores randomized to PCI (n = 948) or
CABG (n = 957) in the EXCEL (Evaluation of XIENCE Versus Coronary Artery
Bypass Surgery for Effectiveness of Left Main Revascularization) trial
were included. Repeat revascularization events were adjudicated by an
independent clinical events committee. The effect of repeat
revascularization on mortality through 3-year follow-up was examined in
time-varying Cox regression models. <br/>RESULT(S): During 3-year
follow-up, there were 346 repeat revascularization procedures among 185
patients. PCI was associated with higher rates of any repeat
revascularization (12.9% vs. 7.6%; hazard ratio: 1.73; 95% confidence
interval: 1.28 to 2.33; p = 0.0003). Need for repeat revascularization was
independently associated with increased risk for 3-year all-cause
mortality (adjusted hazard ratio: 2.05; 95% confidence interval: 1.13 to
3.70; p = 0.02) and cardiovascular mortality (adjusted hazard ratio: 4.22;
95% confidence interval: 2.10 to 8.48; p < 0.0001) consistently after both
PCI and CABG (pint = 0.85 for both endpoints). Although target vessel
revascularization and target lesion revascularization were both associated
with an increased risk for mortality, target vessel non-target lesion
revascularization and non-target vessel revascularization were not.
<br/>CONCLUSION(S): In the EXCEL trial, repeat revascularization during
follow-up was performed less frequently after CABG than PCI and was
associated with increased mortality after both procedures. Reducing the
need for repeat revascularization may further improve long-term survival
after percutaneous or surgical treatment of LMCAD. (EXCEL Clinical Trial;
NCT01205776).<br/>Copyright &#xa9; 2020 American College of Cardiology
Foundation. Published by Elsevier Inc. All rights reserved.

<13>
Accession Number
630661360
Title
Ultrasound-Guided Continuous Deep Serratus Anterior Plane Block Versus
Continuous Thoracic Paravertebral Block for Perioperative Analgesia in
Videoscopic-Assisted Thoracic Surgery.
Source
European journal of pain (London, England). (no pagination), 2020. Date of
Publication: 18 Jan 2020.
Author
Hanley C.; Wall T.; Bukowska I.; Redmond K.; Eaton D.; Ni Mhuircheartaigh
R.; Hearty C.
Institution
(Hanley) Clinical Fellow in Cardiothoracic Anaesthesia and
Transoesophageal Echocardiography, Department of Anaesthesia, Mater
Misericordiae University Hospital, Dublin, Ireland
(Wall, Bukowska) Specialist Registrar, Cardiothoracic Anaesthesia, Mater
Misericordiae University Hospital, Dublin, Ireland
(Redmond, Eaton) Consultant in Cardiothoracic Surgery, Mater Misericordiae
University Hospital, Dublin, Ireland
(Ni Mhuircheartaigh, Hearty) Consultant Anaesthetist, Mater Misericordiae
University Hospital, Dublin, Ireland
Publisher
NLM (Medline)
Abstract
BACKGROUND: The deep serratus anterior plane blockade (SAPB) is a
promising novel regional anaesthesia technique for blockade of the
anterolateral chest wall. Evidence for the efficacy of SAPB versus other
analgesic techniques in thoracic surgery remains inadequate. AIMS: This
study compared ultrasound-guided continuous SAPB with a surgically-placed
continuous thoracic paravertebral block (SPVB) technique in patients
undergoing videoscopic-assisted thoracic surgery (VATS). <br/>METHOD(S):
In a single-centre, double-blinded, randomised, non-inferiority study we
allocated 40 patients undergoing VATS to either SAPB or SPVB, with both
groups receiving otherwise standardised treatment, including multimodal
analgesia. The primary outcome was 48-hour opioid consumption. Secondary
outcomes included numerical rating scores (NRS) for postoperative pain,
patient-reported "worst pain score" (WPS) as well as functional measures
(including mobilisation distance and cough strength). <br/>RESULT(S):
48-hour opioid consumption for the SAPB group was non-inferior compared
with SPVB. SAPB was associated with improved NRS pain scores at rest, with
cough and with movement at 24-hours postoperatively (p=0.007, p=0.001 and
p=0.012 respectively). SAPB was also associated with a lower "worst pain
score" (p=0.008). Day 1 walking distance (D1WD) was improved in the SAPB
group (p=0.012), whereas the difference in cough strength did not reach
statistical significance (p=0.071). There was no difference in
haemodynamics, opioid side-effects, length of hospital stay, or patient
satisfaction between the two groups. <br/>CONCLUSION(S): The SAPB, as part
of a multimodal analgesia regimen, is non-inferior in terms of 48-hour
opioid consumption compared to SPVB and is associated with improved
functional measures in thoracic surgical patients.<br/>Copyright &#xa9;
2020 European Pain Federation - EFIC.

<14>
Accession Number
630663596
Title
Impact of leaflet thrombosis on hemodynamics and clinical outcomes after
bioprosthetic aortic valve replacement: A meta-analysis.
Source
Clinical cardiology. (no pagination), 2020. Date of Publication: 20 Jan
2020.
Author
Tian Z.; Li T.; Ma S.
Institution
(Tian, Li, Ma) Department of Cardiology, Shengjing Hospital of China
Medical University, Liaoning Province, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Leaflet thrombosis (LT, also called cusp thrombosis) detected
by multidetector computed tomography (MDCT) is common in bioprosthetic
aortic valve replacement (bAVR). However, it remains contradictory whether
MDCT-defined LT following bAVR is associated with hemodynamic
deterioration and stroke. Thus, we performed the first meta-analysis to
assess hemodynamic outcomes and updated the latest researches on the
clinical outcomes of MDCT-defined LT after bAVR. HYPOTHESIS: MDCT-defined
LT might be associated with worse hemodynamic and clinical outcomes after
bAVR. <br/>METHOD(S): MEDLINE, EMBASE, Cochrane Library, and
ClinicalTrial.gov were searched from inception to 15th April 2019. The
fix-effect model was utilized to calculate odds ratio (OR) and 95%
confidence interval (CI). The primary outcomes were hemodynamic stability
indexes, including mean pressure gradient (MPG), left ventricular ejection
fraction (LVEF), paravalvular leak (PVL), and clinical heart failure. The
secondary endpoints were major adverse cardiovascular and cerebrovascular
events (MACCEs), which consisted of myocardial infarction, all-cause
death, stroke, and transient ischemic attack (TIA). <br/>RESULT(S): Twelve
studies with 4820 patients were included. The total prevalence of
MDCT-defined LT was 9.7%. MDCT-defined LT was associated with a
significantly increased risk of MPG (inverse variance 0.43, 95% CI: [0.30,
0.57]), MACCEs (OR 2.43, 95% CI: [1.45, 4.06]), stroke (OR 1.79, 95% CI:
[1.03, 3.11]), and TIA (OR 4.09, 95% CI: [1.59, 10.54]). There were no
differences for other outcomes. <br/>CONCLUSION(S): MDCT-defined LT after
bAVR is associated with increased MPG and increased risk of adverse
cerebrovascular events, including TIA and stroke. While LVEF, PVL, and
clinical heart failure were similar between patient with and without
LT.<br/>Copyright &#xa9; 2020 The Authors. Clinical Cardiology published
by Wiley Periodicals, Inc.

<15>
Accession Number
630663311
Title
Perioperative Outcomes of Adjunctive Hypnotherapy Compared with Conscious
Sedation Alone for Patients Undergoing Transfemoral Transcatheter Aortic
Valve Implantation.
Source
International heart journal. (no pagination), 2020. Date of Publication:
17 Jan 2020.
Author
Takahashi M.; Mouillet G.; Khaled A.; Boukantar M.; Gallet R.; Rubimbura
V.; Lim P.; Dubois-Rande J.-L.; Teiger E.
Institution
(Takahashi, Mouillet, Boukantar, Gallet, Rubimbura, Lim, Dubois-Rande,
Teiger) Department of Cardiology, Henri Mondor University Hospital
(Takahashi) Department of Cardiovascular Medicine, Jichi Medical
University School of Medicine
(Khaled) Department of Anesthesiology, Henri Mondor University Hospital
Publisher
NLM (Medline)
Abstract
Transcatheter aortic valve implantation (TAVI) using a transfemoral
approach under local anesthesia with conscious sedation (LACS) is becoming
an increasingly common TAVI strategy. However, patients who are awake
during the TAVI procedure can experience stress, anxiety, and pain, even
when LACS is used. Clinical hypnotherapy is an anxiolytic intervention
that can be beneficial for patients undergoing invasive surgery. This
study aimed to assess the perioperative outcomes of adjunctive
hypnotherapy undergoing transfemoral TAVI with LACS.Consecutive patients
(n = 143) with symptomatic severe aortic stenosis who underwent
transfemoral TAVI with LACS only (n = 107) or with LACS and hypnotherapy
(n = 36) between January 2015 and April 2016 were retrospectively included
in the study. The clinical outcomes were compared between the two groups.
The LACS with hypnotherapy group had a significantly shorter length of
stay in the intensive care unit (ICU; LACS only versus LACS with
hypnotherapy: 4.0 (4.0-5.5) days versus 3.0 (3.0-5.0) days, P < 0.01).
Moreover, the use of anesthetics (propofol and remifentanil) and
norepinephrine was significantly lower in the LACS with hypnotherapy group
(e.g., for propofol, LACS only versus LACS with hypnotherapy: 96.4 +/-
104.7 mg versus 15.0 +/- 31.8 mg, P < 0.001). The multiple regression
analysis showed that being male, hypnotherapy, and the composite
complication score were independently associated with the length of stay
in the ICU.The adjunctive hypnotherapy on LACS among transfemoral TAVI
patients may facilitate perioperative management. However, a prospective
randomized study is necessary to confirm the efficacy of hypnotherapy
among TAVI patients.

<16>
Accession Number
630663083
Title
Meta-Analysis of the Impact of Pre-Procedural Serum Albumin on Mortality
in Patients Undergoing Transcatheter Aortic Valve Replacement.
Source
International heart journal. (no pagination), 2020. Date of Publication:
17 Jan 2020.
Author
Liu G.; Hu X.; Long M.; Du Z.-M.; Li Y.; Hu C.-H.
Institution
(Liu, Hu, Long, Du, Li, Hu) Department of Cardiology, First Affiliated
Hospital, Sun Yat-Sen University, Key Laboratory on Assisted Circulation,
Ministry of Health
Publisher
NLM (Medline)
Abstract
Pre-procedural serum albumin's impact on prognosis after transcatheter
aortic valve replacement (TAVR) has been studied. Literature on the
prognostic role of serum albumin in the survival of patients undergoing
TAVR shows conflicting results. This meta-analysis was conducted to
evaluate the impact of pre-procedural serum albumin on outcomes after
TAVR. A comprehensive literature search of EMBASE, MEDLINE, and the
Cochrane Library was undertaken through July 2019. The primary end points
were 30-day and one-year all-cause mortality after TAVR. Risk ratios (HRs)
and 95% confidence intervals (CIs) were calculated using the random-effect
model. Ten eligible studies with 8,236 patients were analyzed. Of the
8,236 patients undergoing TAVR, with a mean age of 83 years, 48.8% were
men and were categorized into two groups according to low and normal serum
albumin (cut-off value: 3.5 or 4 g/dL). Overall, low albumin was
significantly associated with an approximately two-fold increase in 30-day
all-cause mortality (HR, 2.09; 95% CI, 1.53-2.86) and a 61% increase risk
for one-year mortality (HR, 1.61; 95% CI, 1.31-1.98) in patients after
TAVR. Sensitivity analyses showed the results to be robust. The
association of low albumin level with an increase in one-year mortality
risk was not modified by study design, albumin cut-off value, Society of
Thoracic Surgeons Predicted Risk of Mortality (STS-PROM), and study
quality. In conclusion, low albumin levels were associated with poor
prognosis in patients after TAVR. Pre-procedural albumin can be used as a
simple tool related to prognosis after TAVR.

<17>
Accession Number
2004681075
Title
Reduced rate of revascularization in schizophrenic patients with acute
myocardial infarction: A systematic review and meta-analysis.
Source
Progress in Neuro-Psychopharmacology and Biological Psychiatry. 99 (no
pagination), 2020. Article Number: 109870. Date of Publication: 20 April
2020.
Author
Shao M.; Zhuo C.; Gao X.; Chen C.; Xu Y.; Tian H.; Li G.; Jiang D.; Wang
W.
Institution
(Shao) National Integrated Traditional and Western Medicine Center for
Cardiovascular Disease, China-Japan Friendship Hospital, Beijing, China
(Zhuo, Li) Department of psychiatry, School of Mental Health, Jining
University, Jining, Shandong Province 27211, China
(Zhuo, Chen, Jiang) Department of Psychiatry, Wenzhou Seventh People's
Hospital, Wenzhou 325000, China
(Zhuo, Tian) Psychiatric-Neuroimging-Genetics and Comorbidity Laboratory
(PNGC-Lab), Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin
300222, China
(Zhuo, Xu) Department of Psychiatry, First Hospital/First Clinical Medical
College of Shanxi Medical University, Taiyuan, China
(Zhuo, Xu) MDT Center for Cognitive Impairment and Sleep Disorders, First
Hospital of Shanxi Medical University, Taiyuan 030001, China
(Zhuo, Wang) Co-collaboration Laboratory of China and Canada, Xiamen
Xianyue Hospital and University of Alberta, Xiamen Xianyue Hospital,
Xiamen 361000, China
(Gao) Center for Health Statistics, Big data center of chronic disease,
Health Management Institute, 301 Hospital of Chinese People's Liberation
Army, General Hospital of Chinese People's Liberation Army, Beijing
100191, China
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Importance: It has been suggested that patients with schizophrenia have
higher than expected mortality following acute coronary events. However,
the in-hospital revascularization rate in patients with schizophrenia and
acute myocardial infarction (AMI) compared to mentally healthy patients
remains unknown. <br/>Objective(s): To evaluate the revascularization rate
in schizophrenic patients after AMI with a meta-analysis of observational
studies. Data sources: PubMed and Embase electronical databases. Study
selection: Observational studies that evaluate the likelihood of
revascularization in AMI patients with schizophrenia compared to those
without schizophrenia, after adjustment for potential influencing factors.
Data extraction and synthesis: Data regarding study design,
characteristics of the AMI patients and schizophrenic patients, and
strategies of revascularization were extracted. Results were pooled and
analyzed with a random effect model to incorporate the potential
heterogeneity. Main outcome and measures: The likelihood of
revascularization in AMI patients with schizophrenia compared to those
without schizophrenia, after adjustment for potential influencing factors.
<br/>Result(s): Overall, 3,260,754 hospitalized AMI patients from six
follow-up studies were included, of which 17,875 patients had a prior
diagnosis of schizophrenia. Results of this meta-analysis suggest that
revascularization was significantly lower in AMI patients with
schizophrenia compared to those without schizophrenia (odds ratio [OR]:
0.48, 95% confidence interval [CI]: 0.38 to 0.62, p < .001; I²
= 93%), after adjustment for demographic characteristics, comorbidities,
and hospital and regional factors. Specifically, AMI patients with
schizophrenia had significantly fewer percutaneous coronary interventions
(OR: 0.48, 95% CI: 0.41 to 0.56, p < .001; I² = 49%) and
coronary artery bypass grafts (OR: 0.61, 95% CI: 0.53 to 0.70, p < .001;
I² = 20%) compared to those without schizophrenia. Conclusions
and relevance: Patients with schizophrenia and AMI have a lower rate of
coronary revascularization as compared with patients without
schizophrenia, which is an important cause of higher-than-expected
mortality rate in this population.<br/>Copyright &#xa9; 2020

<18>
Accession Number
2004658699
Title
Durability of Mitral Valve Bioprostheses: A Meta-Analysis of Long-Term
Follow-up Studies.
Source
Annals of Thoracic Surgery. 109 (2) (pp 603-611), 2020. Date of
Publication: February 2020.
Author
Malvindi P.G.; Mastro F.; Kowalewski M.; Ringold M.; Margari V.; Suwalski
P.; Speziale G.; Paparella D.
Institution
(Malvindi, Margari, Paparella) Cardiothoracic Department, Santa Maria
Hospital, GVM Care & Research, Bari, Italy
(Mastro, Ringold, Paparella) Department of Emergency and Organ Transplant,
University of Bari Aldo Moro, Bari, Italy
(Kowalewski, Suwalski) Department of Cardiac Surgery, Central Clinical
Hospital of the Ministry of Interior, Centre of Postgraduate Medical
Education, Warsaw, Poland
(Kowalewski) Cardiothoracic Research Centre, Innovative Medical Forum,
Bydgoszcz, Poland
(Kowalewski) Cardio-Thoracic Surgery Department, Heart and Vascular
Centre, Maastricht University Medical Centre, Maastricht, Netherlands
(Speziale) Cardiothoracic and Vascular Department, Maria Cecilia Hospital,
GVM Care & Research, Cotignola (RA), Italy
Publisher
Elsevier USA
Abstract
Background: Porcine and pericardial valves exhibited similar freedom from
structural valve deterioration after aortic valve replacement. Limited
data exist regarding their durability at long-term follow-up in the mitral
position. <br/>Method(s): A literature search was performed through online
databases. Papers reporting freedom from tissue valve deterioration after
mitral valve replacement with a follow-up longer than 5 years were
retrieved. Four porcine valves (Carpentier-Edwards [Edwards Lifesciences,
Irvine, CA] and Hancock, Hancock II, and Mosaic [Medtronic, Inc,
Minneapolis, MN]) and 1 pericardial prosthesis (Carpentier-Edwards) were
the objects of the study. The structural valve deterioration (SVD) rate
per year was calculated for each type of prosthesis. Kaplan-Meier curves
and log-rank test analysis were performed to compare the long-term
durability of porcine and pericardial valves. <br/>Result(s): Forty
full-text papers including more than 15,000 patients were considered for
the meta-analysis. Porcine valves were generally implanted in younger
patients in the first period after their introduction. The mean age of the
patients receiving a mitral bioprosthesis increased from 50 to 70 years
over the decades. In patients operated after 1980 who had similar mean age
at the time of implant, freedom from SVD was higher in the group of
porcine valves with Mosaic prosthesis, showing the lowest rate of SVD.
Long-term survival was higher for Mosaic porcine and Carpentier
pericardial valves. <br/>Conclusion(s): In surgical populations that
underwent mitral valve replacement after 1980 with new generation tissue
valves and similar mean age at the implant time, we found, at long-term
follow-up, a higher freedom from SVD in the group of porcine
prostheses.<br/>Copyright &#xa9; 2020 The Society of Thoracic Surgeons

<19>
Accession Number
2003412918
Title
Inflammatory response and endothelial dysfunction following
cardiopulmonary bypass: Pathophysiology and pharmacological targets.
Source
Recent Patents on Inflammation and Allergy Drug Discovery. 13 (2) (pp
158-173), 2019. Date of Publication: 2019.
Author
Giacinto O.; Satriano U.; Nenna A.; Spadaccio C.; Lusini M.; Mastroianni
C.; Nappi F.; Chello M.
Institution
(Giacinto, Satriano, Nenna, Lusini, Mastroianni, Chello) Department of
Cardiovascular Surgery, Universita Campus Bio-Medico di Roma, Rome, Italy
(Spadaccio) Department of Cardiac Surgery, Golden Jubilee National
Hospital, Glasgow, United Kingdom
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord de
Saint-Denis, Paris, France
Publisher
Bentham Science Publishers (P.O. Box 294, Bussum 1400 AG, Netherlands)
Abstract
Background: Endothelial injury occurring during cardiopulmonary bypass is
a major contributing factor in the development of organ dysfunction, which
leads to many of the postoperative complications occurring during cardiac
surgery. <br/>Objective(s): This narrative review aims to summarize the
main mechanisms of cardiopulmonary bypass-related disease, evaluating the
unfavorable events leading to tissue injury, with a description of current
pharmacologic and non-pharmacologic mechanisms to reduce CPB-related
injury. <br/>Method(s): A Medline/Pubmed/Scopus search was conducted using
clinical queries with the key terms "cardiac surgery", "cardiopulmonary
bypass", "inflammation" and "endothelial injury", and related MeSH terms,
until July 2019. The search strategy included meta-analyses, randomized
controlled trials, clinical trials, reviews and pertinent references.
Patents were searched using the same key terms from
https://patents.google.com/, www.uspto.gov, and www.freepatentsonline.com.
<br/>Result(s): In this review, we discuss the current knowledge of the
mechanisms of vascular endothelial cell injury, the acute inflammatory
response, and the regulatory factors that control the extent of vascular
injury during extracorporeal circulation, summarizing the main target of
anti-inflammatory pharmacologic and non-pharmacologic strategies.
<br/>Conclusion(s): Inflammatory response and endothelial dysfunction
following cardiopulmonary bypass are the prices to pay for the benefits
offered during cardiac surgery procedures. Counteracting the detrimental
effect of extracorporeal circulation appears to be crucial to improve
clinical outcomes in pediatric and adult cardiac surgery. The intrinsic
complexity and the tight interplay of the factors involved might require a
holistic approach against inflammation and endothelial
response.<br/>Copyright &#xa9; 2019 Bentham Science Publishers.

<20>
Accession Number
2004097924
Title
The importance of the Heart Team evaluation before transcatheter aortic
valve replacement: Results from the BRAVO-3 trial.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2020.
Date of Publication: 2020.
Author
Camaj A.; Claessen B.E.; Mehran R.; Yudi M.B.; Power D.; Baber U.;
Hengstenberg C.; Lefevre T.; Van Belle E.; Giustino G.; Guedeney P.;
Sorrentino S.; Kupatt C.; Webb J.G.; Hildick-Smith D.; Hink H.U.;
Deliargyris E.N.; Anthopoulos P.; Sharma S.K.; Kini A.; Sartori S.;
Chandrasekhar J.; Dangas G.D.
Institution
(Camaj, Claessen, Mehran, Power, Baber, Giustino, Sharma, Kini, Sartori,
Chandrasekhar, Dangas) The Zena and Michael A. Wiener Cardiovascular
Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Yudi) Austin Health, Heidelberg, VIC, Australia
(Hengstenberg) DZHK (German Centre for Cardiovascular Research), partner
site Munich Heart Alliance, Munich, Germany, and Deutsches Herzzentrum
Munchen, Technische Universitat Munchen, Munich, Germany
(Lefevre) Institut Cardio Vasculaire Paris Sud, Hopital Prive Jacques
Cartier, Massy, France
(Van Belle) Department of Cardiology and INSERM UMR 1011, University
Hospital, and CHRU Lille, Lille, France
(Guedeney) Sorbonne Universite, ACTION Study Group, INSERM UMRS_1166
Institut de cardiologie (AP-HP), Paris, France
(Sorrentino) Division of Cardiology, Department of Medical and Surgical
Sciences, Magna Graecia University, Catanzaro, Italy
(Kupatt) LMU Munich, Munich, Germany
(Webb) St. Paul's Hospital, Vancouver, BC, Canada
(Hildick-Smith) Sussex Cardiac Centre-Brighton & Sussex University
Hospitals NHS Trust, Brighton, East Sussex, United Kingdom
(Hink) Universitatsmedizin Mainz, Mainz, Germany
(Deliargyris) Science and Strategy Consulting Group, Basking Ridge, NJ,
United States
(Anthopoulos) Arena Pharmaceuticals, Inc., Zurich, Switzerland
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background/Objectives: Clinicians use validated scores to risk-stratify
patients undergoing transcatheter aortic valve replacement (TAVR).
However, evaluation by the Heart Team often deems patients to be at higher
risk than their formal scores suggest. We sought to assess clinical
outcomes of TAVR patients defined as high-risk by the Heart Team's
assessment versus the patient's logistic EuroSCORE (LES). <br/>Method(s):
The BRAVO-3 trial randomized patients at high risk (LES >= 18, or deemed
inoperable by the Heart Team) to TAVR with periprocedural anticoagulation
with unfractionated heparin versus bivalirudin. Endpoints included net
adverse cardiac events (NACE: the composite of all-cause mortality, MI,
stroke, or bleeding), major adverse cardiovascular events (MACE: death,
MI, or stroke), the individual components of MACE, major vascular
complications, BARC >= 3b bleeding and VARC life-threatening bleeding at
30 days. We compared patients deemed high-risk based on LES >= 18 versus
high-risk by the Heart Team despite lower LES. <br/>Result(s): A total of
467/800 (58.4%) patients were deemed high-risk by the Heart Team despite
LES < 18. After multivariable analysis, there were no differences in the
odds of endpoints between groups (NACE, OR<inf>LES>=18</inf>: 1.32, 95% CI
0.86-2.02, p =.21; MACE, OR<inf>LES>=18</inf>: 1.27, 95% CI 0.72-2.25, p
=.41; major vascular complications, OR<inf>LES>=18</inf>: 0.97, 95% CI
0.65-1.44, p =.88; BARC >=3b, OR<inf>LES>=18</inf>: 1.38, 95% CI
0.82-2.33, p =.23; and VARC life-threatening bleeding,
OR<inf>LES>=18</inf>: 0.99, 95% CI 0.69-1.41, p =.95). <br/>Conclusion(s):
Patients undergoing TAVR and labeled high-risk by LES >= 18 or Heart Team
assessment despite LES < 18 have comparable short-term outcomes.
Assignment of high-risk status to over 50% of patients is attributable to
Heart Team's clinical assessment.<br/>Copyright &#xa9; 2020 Wiley
Periodicals, Inc.

<21>
Accession Number
2004083783
Title
Inflammatory cardiomyopathies: short- and long-term outcomes after heart
transplantation-a protocol for a systematic review and meta-analysis.
Source
Heart Failure Reviews. (no pagination), 2020. Date of Publication: 2020.
Author
Bobbio E.; Lingbrant M.; Nwaru B.I.; Hessman E.; Lehtonen J.; Karason K.;
Bollano E.
Institution
(Bobbio, Lingbrant, Bollano) Department of Cardiology, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Nwaru) Krefting Research Centre, Institute of Medicine, University of
Gothenburg, Gothenburg, Sweden
(Hessman) University Library, University of Gothenburg, Gothenburg, Sweden
(Lehtonen) Heart and Lung Center, Helsinki University and Helsinki
University Hospital, Helsinki, Finland
(Karason) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Karason) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Bobbio, Lingbrant, Karason, Bollano) Institute of Medicine at Sahlgrenska
Academy, University of Gothenburg, Gothenburg, Sweden
Publisher
Springer
Abstract
Heart transplantation (HTx) for patients with "giant cell myocarditis"
(GCM) or "cardiac sarcoidosis" (CS) is still controversial. However, no
single center has accumulated enough experience to investigate post-HTx
outcome. The primary aim of this systematic review is to identify,
appraise, and synthesize existing literature investigating whether
patients who have undergone HTx because of GCM or CS have worse outcomes
as compared with patients transplanted because of other etiologies. A
systematic and comprehensive search will be performed using PubMed,
Scopus, Web of Science, EMBASE, and Google Scholar, for studies published
up to December 2019. Observational and interventional population-based
studies will be eligible for inclusion. The quality of observational
studies will be assessed using the Newcastle-Ottawa scale, while the
interventional studies will be assessed using the Cochrane Effective
Practice Organization of Care tool. The collected evidence will be
narratively synthesized; in addition, we will perform a meta-analysis to
pool estimates from studies considered to be homogenous. Reporting of the
systematic review and meta-analysis will be in accordance with the
Meta-analysis of Observational Studies in Epidemiology Preferred Reporting
Items for Systematic reviews and Meta-Analysis guidelines. To our
knowledge, this will be the first synthesis of outcomes, including
survival, acute cellular rejection, and disease recurrence, in patients
with either GCM or CS treated with HTx. Reviewing the suitability of HTx
in this population and highlighting areas for further research will
benefit both patients and healthcare providers. Trial registration:
CRD42019140574.<br/>Copyright &#xa9; 2020, The Author(s).

<22>
Accession Number
2004088178
Title
The prophylactic use of fibrinogen concentrate in high-risk cardiac
surgery.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2019. Date of
Publication: 2019.
Author
Kwapisz M.M.; Kent B.; DiQuinzio C.; LeGare J.-F.; Garnett S.; Swyer W.;
Whynot S.; Mingo H.; Scheffler M.
Institution
(Kwapisz, Kent, DiQuinzio, Garnett, Whynot, Mingo, Scheffler) Department
of Anesthesia, Pain Management and Perioperative Medicine, Queen Elizabeth
II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada
(LeGare) Department of Surgery, Division of Cardiac Surgery, New Brunswick
Heart Centre, Saint John, NB, Canada
(Swyer) Department of Surgery, Perfusion Services, Queen Elizabeth II
Health Sciences Centre, Dalhousie University, Halifax, NS, Canada
Publisher
Blackwell Munksgaard (E-mail: info@mks.blackwellpublising.com)
Abstract
Background: Perioperative blood loss is a major contributor to morbidity
and mortality in cardiac surgery. Plasma fibrinogen levels play an
essential role in hemostasis and deplete quickly during hemorrhage. The
objective of this study was to determine whether prophylactic fibrinogen
concentrate administration lowers overall blood product transfusion
requirements in high-risk cardiac surgery in patients with low fibrinogen
plasma levels. <br/>Method(s): The study was performed in a prospective,
randomized, and double-blinded design. The investigation included 62
patients undergoing elective, high-risk cardiac surgery. After weaning
from cardiopulmonary bypass and reversal of heparin patients received
either fibrinogen concentrate or placebo. The primary outcome variable was
overall blood product usage 24 hours after intervention. <br/>Result(s):
The fibrinogen group received numerically fewer total units of blood
products than the placebo group, but the difference was not statistically
or clinically significant (for groups n = 27; n = 29 and 19 vs 37 units,
respectively, P =.908). The overall transfusion rate in both groups was
significantly lower than the institutional average suggested (fibrinogen
group 26%, placebo group 28%). The fibrinogen group showed significantly
higher fibrinogen levels (2.38 vs 1.83 g/L (end of surgery), P <.001; 3.33
vs 2.68 g/L (12 hours after intervention), P =.003) and improved
viscoelastic coagulation parameters (FIBTEM MCF, 27 vs 23 mm, P =.022).
<br/>Conclusion(s): This randomized, controlled trial demonstrates that
point-of-care guided and prophylactic treatment with fibrinogen
concentrate does not reduce transfusion of blood products in a setting of
unexpectedly low transfusion rate as tested in this cohort, but may
improve coagulation parameters in the setting of high-risk cardiac
surgery.<br/>Copyright &#xa9; 2019 The Acta Anaesthesiologica Scandinavica
Foundation. Published by John Wiley & Sons Ltd

<23>
Accession Number
2004217606
Title
Pregnancy outcomes in women with cardiothoracic transplants: A Systematic
review and meta-analysis.
Source
Journal of Heart and Lung Transplantation. 39 (2) (pp 93-102), 2020. Date
of Publication: February 2020.
Author
Acuna S.; Zaffar N.; Dong S.; Ross H.; D'Souza R.
Institution
(Acuna, D'Souza) Institute of Health Policy, Management & Evaluation,
University of Toronto, Toronto, Ontario, Canada
(Zaffar, Dong, D'Souza) Division of Maternal-Fetal Medicine, Department of
Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto,
Toronto, Ontario, Canada
(Dong) Faculty of Medicine, University of Toronto, Toronto, Ontario,
Canada
(Ross) Peter Munk Cardiac Centre, University Health Network, University of
Toronto, Toronto, Ontario, Canada
(D'Souza) Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital,
Toronto, Ontario, Canada
Publisher
Elsevier USA
Abstract
Increasing numbers of women with thoracic transplants are planning and
continuing pregnancies. However, pregnancy outcomes and risks to the
mother and baby have not been systematically assessed. MEDLINE, EMBASE,
and Cochrane Central were searched from their inception to January 2018,
to identify studies reporting outcomes on 3 or more pregnancies following
thoracic transplants. Pooled incidences were calculated using a
random-effect meta-analysis. Risk-of-bias was assessed using the Joanna
Briggs Checklist for case series. Subgroup analysis was conducted based on
the organ transplanted. Of the 3,658 records identified, 12 studies were
included that reported on 385 pregnancies in 272 thoracic transplant
recipients. Maternal complications included mortality (pooled incidence
0.5% [95% confidence intervals 0, 1.1%] during pregnancy and 15.4% [10.4,
20.3%] during follow-up, which ranged between 3 and 7 years), graft
rejection (7.4% [4.2, 10.5%]), hypertensive disorders of pregnancy [26.6%
[13.7, 39.6%]), and cesarean deliveries (41.4% [33.4, 48.7%]). Maternal
mortality was more common in recipients of lung vs heart transplants
(41.4% [23.4, 59.3] vs 10.8% [5.9, 15.8]), respectively. Although 78.4%
(69.8, 86.9%) of the pregnancies resulted in live births, 51.2% (31,
71.3%) were born preterm and neonatal deaths occurred in 3.4% (1.3, 5.6%).
Congenital anomalies affected 4.3% (1.8, 6.8%) of the newborns. Although
few maternal deaths occurred during pregnancy, in keeping with median
survival data, delayed mortality for thoracic transplant recipients
remains high. Despite the high numbers of live births, these pregnancies
continue to be at risk for hypertensive disorders, graft rejection,
preterm birth, and neonatal mortality. Prospectively gathered data from
international registries should supplement these findings to better inform
clinical counseling and practice.<br/>Copyright &#xa9; 2019 International
Society for Heart and Lung Transplantation

<24>
Accession Number
2002323830
Title
Diabetes, dysglycemia, and vascular surgery.
Source
Journal of Vascular Surgery. 71 (2) (pp 701-711), 2020. Date of
Publication: February 2020.
Author
Duwayri Y.; Jordan W.D.
Institution
(Duwayri, Jordan) Division of Vascular Surgery and Endovascular Therapies,
Emory University School of Medicine, Atlanta, Ga, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Abnormalities in glucose metabolism are common in patients
with arterial disease. Chronic hyperglycemia and insulin resistance
contribute to the complexity of vascular disorders. They also overlap with
the effects of perioperative hyperglycemia on adverse perioperative
outcomes. We provide an overview of the pathophysiologic consequences of
dysglycemia and the evidence behind glycemic control in patients
undergoing vascular surgery. <br/>Method(s): We searched the literature
for major studies evaluating the pathophysiology of hyperglycemia in
microvascular and macrovascular beds, randomized trials in perioperative
populations, and meta-analyses. The literature was summarized to guide
therapy in the population of vascular patients and for the perioperative
period. <br/>Result(s): National standards for glycemic control after
vascular interventions were not identified. Mounting evidence exists for
the long-term consequences of poor glycemic control on the progression of
vascular disease. Similarly, there is a large body of evidence supporting
tight control of hyperglycemia after general and cardiac surgery during
the critical perioperative period. The absolute glucose target remains
controversial. Randomized controlled studies are lacking in vascular
surgery patients, but the current evidence can be extrapolated to guide
management after vascular interventions. Glycated hemoglobin is a
biomarker for increased mortality and vascular morbidity after vascular
surgery. <br/>Conclusion(s): Hyperglycemia contributes to poor outcome in
the vascular patient. Further vascular focused studies are required to
determine the proper perioperative serum glucose target and the long-term
glycated hemoglobin range.<br/>Copyright &#xa9; 2019 Society for Vascular
Surgery

<25>
Accession Number
2004264928
Title
PCV110 COST-EFFECTIVENESS OF SUTURELESS AORTIC VALVE REPLACEMENT VERSUS
CONVENTIONAL AORTIC VALVE REPLACEMENT AND TRANSCATHETER AORTIC VALVE
IMPLANTATION IN BRAZIL.
Source
Value in Health. Conference: ISPOR Europe 2019. Denmark. 22 (Supplement 3)
(pp S562), 2019. Date of Publication: November 2019.
Author
Coutinho B.; Chirita-Parker O.; Okumura L.; Riveros B.S.; Nita M.E.
Institution
(Coutinho) Livanova PLC, Sao Paulo, SP, Brazil
(Chirita-Parker) LivaNova, London, United Kingdom
(Okumura) MAPESolutions, Sao Paulo, PR, Brazil
(Riveros) Federal University of Parana and MAPESolutions, Curitiba, Brazil
(Nita) MAPESolutions and University of Sao Paulo, Sao Paulo, Brazil
Publisher
Elsevier Ltd
Abstract
Objectives: Sutureless aortic valve replacement (SAVR) is indicated for
patients with aortic stenosis. The aim of this study is to explore the
cost-effectiveness (CEA)of SAVR versus relevant comparators in the
Brazilian private health care setting. <br/>Method(s): Three treatment
modalities for aortic stenosis: SAVR, conventional aortic valve
replacement (CAVR) and transcatheter aortic valve implantation (TAVI) were
compared in the CEA. In line with the Valve Academic Research Consortium-2
Guidelines the time horizon chosen was 30 days. The probabilities (30-day
mortality, paravalvular regurgitation, arrhythmia, acute kidney injury and
other relevant outcomes) were identified via a systematic review and
network meta-analysis on randomized trials and propensity score matched
cohort studies. Predicted 30-day mortality outcome was reported as odds
ratio and 95% confidence intervals. The costs (ex.: cost of device,
dialysis, bleeding and complications related costs) were retrieved from
standardized tables such as CBHPM, CMED and SIMPRO. Probabilities and
costs were modelled as beta and gamma distributions in a decision tree
model. A probabilistic sensitivity analysis was performed to assess
uncertainty. <br/>Result(s): TAVI overall costs were higher than SAVR and
CAVR at R$ 78451.07. SAVR costs (R$ 50743.95) were comparable to CAVR (R$
50136.89). The network meta-analysis results showed that, SAVR was
associated with a lower probabilistic rate of death (2.3%) compared to
CAVR (4.5%) and TAVI (4.4%), suggesting that SAVR is associated with
better survival. The incremental cost-effectiveness ratio (ICER) between
SAVR and CAVR was R$ 27593.42 death avoided and, in comparison to TAVI,
SAVR was dominant. <br/>Conclusion(s): In the Brazilian private health
care setting, SAVR was associated with the best 30-day survival
probability profile between the three alternatives, whereas TAVI was the
most expensive therapy. The proposed economic model suggests that SAVR is
dominant over TAVI and is likely to be a highly cost-effective treatment
alternative when compared to CAVR.<br/>Copyright &#xa9; 2019

<26>
Accession Number
630656637
Title
Evaluating the role of transesophageal echocardiography (TEE) or
intracardiac echocardiography (ICE) in left atrial appendage occlusion: a
meta-analysis.
Source
Journal of interventional cardiac electrophysiology : an international
journal of arrhythmias and pacing. (no pagination), 2020. Date of
Publication: 17 Jan 2020.
Author
Akella K.; Murtaza G.; Turagam M.; Sharma S.; Madoukh B.; Amin A.;
Gopinathannair R.; Lakkireddy D.
Institution
(Akella, Murtaza, Gopinathannair, Lakkireddy) Overland Park Regional
Medical Center, Overland Park, 12200 W 106th Street 66215, United States
(Turagam) Division of Cardiology, Icahn School of Medicine at Mount Sinai,
NY, NY, United States
(Sharma) Department of Cardiology, Garden City Hospital, MI, Garden City,
United States
(Madoukh) Department of Internal Medicine, Overland Park Regional Medical
Center, Overland Park, United States
(Amin) Section of Cardiac Electrophysiology, Department of Cardiology,
OhioHealth Heart and Vascular Physicians, Riverside Methodist Hospital,
3535 Olentangy River Road, Columbus, OH, 43214, USA
Publisher
NLM (Medline)
Abstract
PURPOSE: Intracardiac echocardiography (ICE) is increasingly common among
periprocedural imaging modalities used during complex cardiac procedures.
We sought to perform a meta-analysis comparing transesophageal
echocardiography (TEE) and ICE in endocardial left atrial appendage
occlusion (LAAO). <br/>METHOD(S): We searched PubMed and Google Scholar
regarding abstracts and manuscripts using keywords: atrial fibrillation,
left atrial appendage occlusion, Watchman, Amplatzer Cardiac Plug, Amulet,
intracardiac echocardiography, and transesophageal echocardiography from
their inception to July 12, 2019. Data extraction was performed using
standard form for the following: title, year of publication, sample size,
comorbid conditions, LAAO device, type of pre-procedural imaging,
intraprocedural imaging, and clinical outcomes including the following:
acute procedural success, fluoroscopy, and total procedure time and
complications. <br/>RESULT(S): A total of 42 relevant studies were
screened resulting in inclusion of 8 observational studies comparing TEE
and ICE in endocardial LAAO. Outcomes assessed including procedural
success (RR 1.00, 95% CI (0.97-1.03, p=0.98)), complications (RR 0.77, 95%
CI (0.52 to 1.15, p=0.20)), fluoroscopy time (mean difference -0.40, 95%
CI (-3.12-2.32, p=0.77)), and procedural time (mean difference -8.02, 95%
CI (-22.81 to 6.76, p=0.29)) were found to be similar between both groups.
<br/>CONCLUSION(S): While TEE is the gold standard for perioperative
imaging with LAAO, ICE is a feasible and safe alternative that reduces
exposure to general anesthesia and associated potential risks.

<27>
Accession Number
630654491
Title
Papillary muscle intervention vs mitral ring annuloplasty in ischemic
mitral regurgitation.
Source
Journal of cardiac surgery. (no pagination), 2020. Date of Publication: 17
Jan 2020.
Author
Micali L.R.; Qadrouh M.N.; Parise O.; Parise G.; Matteucci F.; de Jong M.;
Tetta C.; Moula A.I.; Johnson D.M.; Gelsomino S.
Institution
(Micali, Qadrouh, Parise, Parise, Matteucci, de Jong, Tetta, Moula,
Johnson, Gelsomino) Department of Cardiothoracic Surgery, Maastricht
University Hospital, Maastricht, Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND AND AIMS: The main pathophysiological factor of chronic
ischemic mitral regurgitation (MR) is the outward displacement of the
papillary muscles (PMs) leading to leaflet tethering. For this reason,
papillary muscle intervention (PMI) in combination with mitral ring
annuloplasty (MRA) has recently been introduced into clinical practice to
correct this displacement, and to reduce the recurrence of regurgitation.
<br/>METHOD(S): A meta-analysis was conducted comparing the outcomes of
PMI and MRA performed in combination vs MRA performed alone, in terms of
MR recurrence and left ventricular reverse remodeling (LVRR). A
meta-regression was carried out to investigate the impact of the type of
PMI procedure on the outcomes. <br/>RESULT(S): MR recurrence in patients
undergoing both PMI and MRA was lower than in those who only had MRA (log
incidence rate ratio, -0.66; lower-upper limits, -1.13 to 0.20; I2 =0.0%;
p=.44; Egger's test: intercept 0.35 [-0.78 to 1.51]; p=.42). The group
with both PMI and MRA and that with only MRA showed a slightly higher
reduction in left ventricular diameters (-5.94%; -8.75% to 3.13%,).
However, in both groups, LVRR was <10%. No difference was detected between
PM relocation/repositioning and papillary muscle approximation in terms of
LVRR (p=.33). <br/>CONCLUSION(S): Using PMI and MRA together has a lower
MR recurrence than using MRA alone. No significant LVRR was observed
between the two groups nor between the PMI techniques
employed.<br/>Copyright &#xa9; 2020 The Authors. Journal of Cardiac
Surgery published by Wiley Periodicals, Inc.

<28>
Accession Number
630654474
Title
Infective endocarditis post-transcatheter aortic valve implantation
(TAVI), microbiological profile and clinical outcomes: A systematic
review.
Source
PloS one. 15 (1) (pp e0225077), 2020. Date of Publication: 2020.
Author
Khan A.; Aslam A.; Satti K.N.; Ashiq S.
Institution
(Khan, Aslam, Ashiq) Sharif Medical and Dental College, Lahore, Pakistan
(Satti) Senior Registrar Rawalpindi Institute of Cardiology, Rawalpindi,
Pakistan
Publisher
NLM (Medline)
Abstract
BACKGROUND: The data on infective endocarditis after transcatheter aortic
valve implantation (TAVI) is scarce and limited to case reports and case
series in the literature. It is the need of the hour to analyze the
available data on post-TAVI infective endocarditis from the available
literature. The objectives of this systematic review were to evaluate the
incidence of infective endocarditis after transcatheter aortic valve
implantation, its microbiological profile and clinical outcomes. It will
help us to improve the antibiotic prophylaxis strategies and treatment
options for infective endocarditis in the context of TAVI. <br/>METHOD(S):
EMBASE, Medline and the CENTRAL trials registry of the Cochrane
Collaboration were searched for articles on infective endocarditis in
post-TAVI patients till October 2018. Eleven articles were included in the
systematic review. The outcomes assessed werethe incidence of infective
endocarditis, its microbiological profile andclinical outcomes including
major adverse cardiac event (MACE), net adverse clinical event (NACE),
surgical intervention and valve-in-valve procedure. <br/>RESULT(S): The
incidence of infective endocarditis varied from 0%-14.3% in the included
studies, the mean was3.25%. The average duration of follow-up was 474 days
(1.3 years). Enterococci were the most common causative organism isolated
from 25.9% of cases followed by Staphylococcus aureus (16.1%) and
coagulase-negative Staphylococcus species (14.7%). The mean in-hospital
mortality and mortality at follow-up was 29.5% and 29.9%, respectively.
The cumulative incidence of heart failure, stroke and major bleeding were
37.1%, 5.3% and 11.3%,respectively. Only a single study by Martinez-Selles
et al. reported arrhythmias in 20% cases. The septic shock occurred in 10%
and 27.7% post-TAVI infective endocarditis patients according to 2
studies. The surgical intervention and valve-in-valve procedure were
reported in 11.4% and 6.4% cases, respectively. <br/>CONCLUSION(S): The
incidence of post-TAVI infective endocarditis is low being 3.25% but it is
associated with high mortality and complications. The most common
complication is heart failure with a cumulative incidence of 37.1%.
Enterococciare the most common causative organism isolated from 25.9% of
cases followed by Staphylococcus aureus in 16.1% of cases. Appropriate
measures should be taken to prevent infective endocarditis in post-TAVI
patients including adequate antibiotics prophylaxis directed specifically
against these organisms. STUDY REGISTRATION: PROSPERO registration number
CRD42018115943.

<29>
Accession Number
630648300
Title
Major Adverse Cardiovascular Events Associated with Post-Operative Atrial
Fibrillation after Non-Cardiac Surgery: A Systematic Review and
Meta-analysis.
Source
Circulation. Arrhythmia and electrophysiology. (no pagination), 2020. Date
of Publication: 16 Jan 2020.
Author
AlTurki A.; Marafi M.; Proietti R.; Cardinale D.; Blackwell R.; Dorian P.;
Bessissow A.; Vieira L.; Greiss I.; Essebag V.; Healey J.S.; Huynh T.
Institution
(AlTurki, Bessissow, Vieira, Essebag, Huynh) McGill University Health
Center, Montreal, QC, Canada
(Marafi) McGill University Health Center & Montreal Neurological
Institute, Montreal, QC, Canada
(Proietti) Department of Cardiac, Thoracic, Vascular Sciences, University
of Padua, Italy
(Cardinale) Cardioncology Unit, European Institute of Oncology, Milan,
Italy
(Blackwell) Loyola University Health Center, Chicago, Mexico
(Dorian) St Michael's Hospital, University of Toronto, Toronto, ON, Canada
(Greiss) Montreal University Hospital Center, Montreal, QC, Canada
(Healey) Population Health Research Institute, Hamilton, Ontario, Canada
Publisher
NLM (Medline)
Abstract
Background - Post-operative atrial fibrillation (POAF) is a frequent
occurrence after non-cardiac surgery. It remains unclear whether POAF is
associated with an increased risk of major adverse events. We aimed to
elucidate the risk of stroke, myocardial infarction and death associated
with POAF following non-cardiac surgery by a meta-analysis of randomized
controlled studies and observational studies. Methods - We searched
electronic databases from inception up to August 1st, 2019 for all studies
that reported stroke or myocardial infarction in adult patients who
developed POAF following non-cardiac surgery. We used random-effects
models to summarize the studies. Results - The final analyses included 28
studies enrolling 2,612,816 patients. At one-month (ten studies), POAF was
associated with an approximately three-fold increase in the risk of stroke
(weighted mean 2.1% vs 0.7%) [odds ratio (OR) 2.82 (95% Confidence
intervals (CI): 2.15-3.70); p< 0.001]. POAF was associated with
approximately four-fold increase in the long-term risk of stroke with
(weighted mean 2.0% vs 0.6%) (OR 4.12, 95% CI: 3.32-5.11; pA4;0.001) in
eight studies with A5;12-month follow-up. There was a significant overall
increase in the risk of stroke and myocardial infarction associated with
POAF (weighted mean 2.5% vs 0.9%) (OR 3.44,95% CI: 2.38-4.98; p<0.001) and
(weighted mean 12.6% vs 2.7%) (OR 4.02, 95% CI: 3.08-5.24; p<0.001)
respectively. Furthermore, POAF was associated with a three-fold increase
in all-cause mortality at 30 days (weighted mean 15.0% vs 5.4%) (OR: 3.36;
95% CI: 2.13-5.31; p<0.001). Conclusions - POAF was associated with
markedly higher risk of stroke, myocardial infarction and all-cause
mortality following non-cardiac surgery. Future studies are needed to
evaluate the impact of optimal cardiovascular pharmacotherapies to prevent
POAF and to decrease the risk of major adverse events in these high-risk
patients.

<30>
Accession Number
2003470384
Title
Remote ischemic preconditioning neither improves survival nor reduces
myocardial or kidney injury in patients undergoing transcatheter aortic
valve implantation (TAVI).
Source
Journal of Clinical Medicine. 9 (1) (no pagination), 2020. Article Number:
160. Date of Publication: January 2020.
Author
Flechsig M.; Ruf T.F.; Troeger W.; Wiedemann S.; Quick S.; Ibrahim K.;
Pfluecke C.; Youssef A.; Sveric K.M.; Winzer R.; Heinzel F.R.; Linke A.;
Strasser R.H.; Zhang K.; Heidrich F.M.
Institution
(Flechsig, Troeger, Pfluecke, Sveric, Linke, Heidrich) Department of
Internal Medicine and Cardiology, Herzzentrum Dresden at Technische
Universitat Dresden, Dresden 01307, Germany
(Ruf) Center for Cardiology, Cardiology I, University Medical Center
Mainz, Mainz 55131, Germany
(Wiedemann) Department of Internal Medicine and Cardiology, HELIOS
Klinikum Pirna, Pirna 01796, Germany
(Quick, Ibrahim, Youssef) Department of Cardiology, Klinikum Chemnitz,
Technische Universitat Dresden, Chemnitz 09116, Germany
(Winzer) Department of Radiology, Universitatsklinikum Dresden, Dresden
01307, Germany
(Heinzel, Zhang) Department of Internal Medicine and Cardiology,
Charite-Universitatsmedizin Berlin, Campus Virchow-Klinikum, Berlin 13353,
Germany
(Strasser) Medical Faculty, Technische Universitat Dresden, Dresden 01069,
Germany
(Zhang) Berlin Health Institute, Berlin 10178, Germany
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: indexing@mdpi.com)
Abstract
Background: Peri-interventional myocardial injury occurs frequently during
transcatheter aortic valve implantation (TAVI). We assessed the effect of
remote ischemic preconditioning (RIPC) on myocardial injury, acute kidney
injury (AKIN) and 6-month mortality in patients undergoing TAVI.
<br/>Method(s): We performed a prospective single-center controlled trial.
Sixty-six patients treated with RIPC prior to TAVI were enrolled in the
study and were matched to a control group by propensity-score. RIPC was
applied to the upper extremity using a conventional tourniquet. Myocardial
injury was assessed using high-sensitive troponin-T (hsTnT), and kidney
injury was assessed using serum creatinine levels. Data were compared with
the Wilcoxon-Rank and McNemar tests. Mortality was analysed with the
log-rank test. <br/>Result(s): TAVI led to a significant rise of hsTnT
across all patients (p < 0.001). No significant inter-group difference in
maximum troponin release or areas-under-the-curve was detected. Medtronic
CoreValve and Edwards Sapien valves showed similar peri-interventional
troponin kinetics and patients receiving neither valve did benefit from
RIPC. AKIN occurred in one RIPC patient and four non-RIPC patients (p =
0.250). No significant difference in 6-month mortality was observed. No
adverse events related to RIPC were recorded. <br/>Conclusion(s): Our data
do not show a beneficial role of RIPC in TAVI patients for cardio-or
renoprotection, or improved survival.<br/>Copyright &#xa9; 2020 by the
authors. Licensee MDPI, Basel, Switzerland.

<31>
Accession Number
630647257
Title
Comparison of effectiveness of tranexamic acid and
epsilon-amino-caproic-acid in decreasing postoperative bleeding in
off-pump CABG surgeries: A prospective, randomized, double-blind study.
Source
Annals of Cardiac Anaesthesia. 23 (1) (pp 65-69), 2020. Date of
Publication: January-March 2020.
Author
Verma S.; Srinivas U.; Sathpathy A.; Mittal P.
Institution
(Verma, Srinivas, Sathpathy, Mittal) Department of Anaesthesia, Apollo
Hospital, CTOT, International Block, First Floor Jubilee Hills, Hyderabad,
Telangana, India
Publisher
Wolters Kluwer Medknow Publications (B9, Kanara Business Centre, off Link
Road, Ghatkopar (E), Mumbai 400 075, India)
Abstract
Context: Off-pump coronary artery bypass graft (CABG) surgeries have been
shown to have increased fibrinolysis due to tissue plasminogen activator
release. There are no trials comparing the two available antifibrinolytics
(tranexemic acid and epsilon-amino-caproic acid) in off-pump CABG
surgeries. <br/>Aim(s): The aim of the present study was to compare the
effectiveness of tranexamic acid and epsilon-amino-caproic acid with
respect to postoperative bleeding at 4 and 24 hours as the primary
outcome, and rate of postoperative transfusion, re-operations,
complication rate, serum fibrinogen, and D-dimer levels as secondary
outcomes. Settings and Design: The study was carried out at a
tertiary-level hospital between June 2017 and June 2018. It was a
prospective, randomized, double-blind study. <br/>Material(s) and
Method(s): Eighty patients undergoing off-pump CABG, were randomly
allocated to receive tranexamic acid or epsilon-amino-caproic acid. The
patients were followed up in the postoperative period and were assessed
for primary and secondary outcomes. Statistical Analysis Used: Statistical
analysis was performed using SPSS software, version 19.0 (SPSS Inc.,
Chicago, IL). Nonparametric data were expressed as median with
interquartile range and compared using Mann-Whitney U-test, parametric
data was represented as mean with standard deviation and analyzed using
Student's t-test. Nominal data were analyzed using Chi-square test.
<br/>Result(s): Bleeding at 4 hours did not show significant difference
between groups, 180 ml (80-250) vs 200 ml (100-310). Bleeding at 24 hours
was significantly lesser in tranexamic acid group as compared to
epsilon-amino-caproic acid group, 350 ml (130-520) vs 430 ml (160-730) (P
= 0.0022) The rate of transfusion, re-operations, seizures, renal
dysfunction, fibrinogen levels, and D-dimer levels did not show
significant difference between the groups. <br/>Conclusion(s): Tranexamic
acid significantly reduced postoperative bleeding in off-pump CABG at 24
hours as compared to epsilon-amino-caproic-acid.<br/>Copyright &#xa9; 2020
Annals of Cardiac Anaesthesia <br/> Published by Wolters Kluwer - Medknow.

<32>
Accession Number
2004081214
Title
Overview and surgical aspects of Uhls anomaly.
Source
Expert Opinion on Orphan Drugs. (no pagination), 2020. Date of
Publication: 2020.
Author
Cherian K.M.; Lydia Jeris W.; Thayub M.
Institution
(Cherian) Department of Cardiothoracic Surgery, Frontier Lifeline Hospital
and Dr. K. M. Cherian Heart Foundation, Chennai, India
(Lydia Jeris) Department of Clinical Laboratory and Blood Bank, Frontier
Lifeline Hospital and Dr. K. M. Cherian Heart Foundation, Chennai, India
(Thayub) Department of Clinical Pharmacy, Frontier Lifeline Hospital and
Dr. K. M. Cherian Heart Foundation, Chennai, India
Publisher
Taylor and Francis Ltd
Abstract
Introduction: Uhls anomaly is an extremely rare congenital heart defect
characterized by partial or complete absence of right ventricular
myocardium. Less than 100 cases have been reported in the literature.
Survival depends on the severity of the right ventricular dysfunction. The
age at presentation is varied but usually presents in infancy or found
during autopsy. Diagnosis is made by echocardiogram (ECHO), magnetic
resonance imaging (MRI), and histopathological examination. Medical
management of this condition understanding the pathology is not possible.
Surgical treatment includes single ventricle strategy, one and a half
ventricle repair with partial right ventriculectomy, Fontan procedure, and
cardiac transplantation. Early recognition of the anomaly, institution of
drugs that improves cardiac function and right surgical planning may
improve the quality of life. Areas covered: An extensive literature search
has been done from many Pubmed and Scopus-indexed journals pertaining to
various aspects of Uhls anomaly including history of the disease,
etiology, clinical presentation, differential diagnosis, diagnostic aids,
and medical and surgical management. Expert opinion: Depending on the
hemodynamics, a bidirectional Glenn which is septectomy or a single
ventricle pathway would be a better approach. Of course heart
transplantation would be the last choice when other surgical options are
defied.<br/>Copyright &#xa9; 2019, &#xa9; 2019 Informa UK Limited, trading
as Taylor & Francis Group.

<33>
Accession Number
2004644782
Title
Meta-analysis Comparing Direct Oral Anticoagulants Versus Vitamin K
Antagonists After Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Ueyama H.; Kuno T.; Ando T.; Briasoulis A.; Fox J.; Hayashida K.; Takagi
H.
Institution
(Ueyama, Kuno) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Beth Israel, New York, NY, United States
(Ando) Division of Cardiology, Center for Interventional Vascular Therapy,
New York-Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
(Briasoulis) Division of Cardiology, Heart failure, and Transplantation,
University of Iowa, Iowa city, IA, United States
(Fox) Division of Cardiology, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
(Hayashida) Division of Cardiology, Keio University School of Medicine,
Tokyo, Japan
(Takagi) Division of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Atrial fibrillation (AF) is a common co-morbidity in patients undergoing
transcatheter aortic valve implantation (TAVI), but whether direct oral
anticoagulants (DOACs) confer similar safety and efficacy compared with
vitamin K antagonist (VKA) remains unclear in this population. The aim of
our study was to investigate the safety and efficacy of DOACs compared
with VKA in patients undergoing TAVI with concomitant indication of oral
anticoagulation. PUBMED and EMBASE were searched through October 2019 for
studies comparing DOACs versus VKA in patients undergoing TAVI with
indication of oral anticoagulation. The main efficacy outcomes were
all-cause mortality and stroke whereas the main safety outcome was major
and/or life-threatening bleeding. Our search identified 5 eligible studies
including 2,569 patients. Majority of patients had atrial fibrillation as
indication of anticoagulation. There were no significant differences in
all-cause mortality, major and/or life-threatening bleeding, and stroke in
patients treated with DOACs versus VKA (odds ratio [OR] 1.07, 95%
confidence interval [CI] [0.73 to 1.57], p = 0.72, OR = 0.85, 95% CI [0.64
to 1.12], p = 0.24, OR 1.52, 95% CI [0.93 to 2.48], p = 0.09,
respectively). In conclusion, in patients undergoing TAVI with concomitant
indication for oral anticoagulation, all-cause mortality, major and/or
life-threatening bleeding, and stroke were similar between DOACs and VKA.
Further large scale randomized controlled trials are needed to search the
optimal oral anticoagulation regimen in this population.<br/>Copyright
&#xa9; 2020 Elsevier Inc.

<34>
Accession Number
2001630099
Title
Outcomes of Evolut R Versus CoreValve After Transcatheter Aortic Valve
Implantation: A Meta-Analysis.
Source
Heart Lung and Circulation. 29 (2) (pp 288-294), 2020. Date of
Publication: February 2020.
Author
Sun Y.; Li J.; Fan R.; Li G.; Fu M.; Luo S.; Ding H.; Luo J.
Institution
(Sun, Li, Li, Fu, Luo, Ding, Luo) Department of Cardiology, Vascular
Center, Guangdong Cardiovascular Institute, Guangdong Provincial Key
Laboratory of Coronary Heart Disease Prevention, Guangdong General
Hospital, Guangdong Academy of Medical Sciences
(Fan) Department of Cardiovascular Surgery, Vascular Center, Guangdong
Cardiovascular Institute, Guangdong Provincial Key Laboratory of South
China Structural Heart Disease, Guangdong General Hospital, Guangdong
Academy of Medical Sciences
Publisher
Elsevier Ltd
Abstract
Background: Superiority of the new-generation, self-expanding Evolut R
compared with the first-generation CoreValve on outcomes after
transcatheter aortic valve implantation (TAVI) is unclear. This
meta-analysis sought to investigate the outcomes of Evolut R vs CoreValve
after TAVI. <br/>Method(s): A systematic review of studies comparing
outcomes of Evolut R and CoreValve after TAVI was performed through
PubMed, EMBASE and Cochrane Library. Crude risk ratios (RRs) were
calculated with 95% confidence intervals using a random effects model.
Outcomes of interest were mortality, myocardial infarction (MI), stroke or
transient ischaemic attack (TIA), severe bleeding, acute kidney injury
(AKI), major vascular complications (MVC), permanent pacemaker
implantation (PPI), moderate or severe paravalvular regurgitation (PVR),
and device failure. <br/>Result(s): Six studies involving 11,530 patients
(4,597 receiving Evolut R and 6,933 receiving CoreValve) were included.
There was no significant difference in 30-day all-cause mortality between
Evolut R and CoreValve (3.4% vs 5.0%, p = 0.10). The incidence of MI (0.2%
vs 0.5%, p = 0.02), AKI (6.0% vs 9.2%, p = 0.001), moderate or severe PVR
(6.4% vs 8.0%, p = 0.04), and device failure (3.5% vs 5.2%, p = 0.04) were
significantly lower in Evolut R than CoreValve. There were trends toward
less severe bleeding (7.2% vs 8.8%, p = 0.05) and PPI (18.6% vs 20.8%, p =
0.05) in Evolut R. The rates of stroke or TIA and MVC were similar between
the two prostheses. <br/>Conclusion(s): Compared with CoreValve, Evolut R
did not reduce 30-day all-cause mortality, but significantly improved
periprocedural complications after TAVI.<br/>Copyright &#xa9; 2019
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<35>
Accession Number
2003568378
Title
Optical coherence tomography enables more accurate detection of
functionally significant intermediate non-left main coronary artery
stenoses than intravascular ultrasound: A meta-analysis of 6919 patients
and 7537 lesions.
Source
International Journal of Cardiology. 301 (pp 226-234), 2020. Date of
Publication: 15 February 2020.
Author
Ramasamy A.; Chen Y.; Zanchin T.; Jones D.A.; Rathod K.; Jin C.; Onuma Y.;
Zhang Y.-J.; Amersey R.; Westwood M.; Ozkor M.; O'Mahony C.; Lansky A.;
Crake T.; Serruys P.W.; Mathur A.; Baumbach A.; Bourantas C.V.
Institution
(Ramasamy, Jones, Rathod, Amersey, Westwood, Ozkor, O'Mahony, Lansky,
Crake, Mathur, Baumbach, Bourantas) Department of Cardiology, Barts Heart
Centre, Barts Health NHS Trust, London, United Kingdom
(Chen) Department of Cardiology, North Middlesex University Hospital,
London, United Kingdom
(Chen, Bourantas) Institute of Cardiovascular Sciences, University College
London, London, United Kingdom
(Zanchin) Department of Cardiology, Bern University Hospital, Bern,
Switzerland
(Jin) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang
Province, China
(Onuma) Thoraxcenter, Erasmus University Medical Centre, Rotterdam,
Netherlands
(Zhang) XuZhou Third People's Hospital, China
(Lansky) Division of Cardiovascular Medicine, Department of Internal
Medicine, Yale School of Medicine, New Haven, CT, United States
(Serruys) International Centre for Circulatory Health, NHLI, Imperial
College London, London, United Kingdom
(Ramasamy, Jones, Rathod, Mathur, Baumbach, Bourantas) William Harvey
Research Institute, Queen Mary University London, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Objective: Fractional flow reserve (FFR) is regarded as the gold standard
for the physiological assessment of intermediate coronary artery stenoses.
However, FFR does not allow assessment of plaque morphology and lesion
geometry. Intracoronary imaging techniques such as intravascular
ultrasound (IVUS) and optical coherence tomography (OCT) can help
treatment planning by optimising stent implantation, which can improve
patient outcomes. The aim of this meta-analysis is to compare the efficacy
of IVUS and OCT-derived metrics in detecting flow limiting stenoses in
non-left main stem lesions. <br/>Method(s): A systematic review of PubMed,
Medline, and Cochrane databases was performed and identified studies
examining the diagnostic accuracy of IVUS and OCT in detecting significant
stenoses when compared to FFR. <br/>Result(s): A total of 33 (7537
lesions) studies (24 IVUS, 7 OCT and 2 IVUS & OCT studies) were included
in the meta-analysis. Pooled analysis showed that IVUS- and OCT-derived
minimum lumen area (MLA) had a similar sensitivity in predicting
haemodynamically significant lesions (IVUS-MLA: 0.747 vs OCT-MLA 0.732, p
= 0.519). However, OCT-MLA had a higher specificity (0.763 vs 0.665, p <
0.001) and diagnostic accuracy in detecting flow-limiting stenoses than
IVUS-MLA (AUC 0.810 vs 0.754, p = 0.045). Sub-analysis of the studies with
the clinically significant FFR cut-off value of 0.80 yielded similar
results demonstrating that OCT-MLA has a better accuracy than IVUS-MLA in
detecting haemodynamically significant stenoses (AUC 0.809 vs 0.750, p =
0.034). <br/>Conclusion(s): OCT with its superior image resolution appears
to be the preferable intravascular imaging modality for the detection of
haemodynamically significant stenoses in non-left main stem
lesions.<br/>Copyright &#xa9; 2019 Elsevier B.V.

<36>
Accession Number
2004581360
Title
Effect of music therapy on hospital induced anxiety and health related
quality of life in coronary artery bypass graft patients: A randomised
controlled trial.
Source
Journal of Clinical and Diagnostic Research. 13 (11) (pp YC05-YC09), 2019.
Date of Publication: 2019.
Author
Ashok A.; Shanmugam S.; SOmaN A.
Institution
(Ashok, Shanmugam) Department of Physiotherapy, Nitte Institute of
Physiotherapy, NITTE (Deemed to Be University), Mangalore, Karnataka,
India
(SOmaN) Department of Physical Therapy, College of Applied Medical
Sciences, Shaqra University, Saudi Arabia
Publisher
Journal of Clinical and Diagnostic Research (No 3, 1/9 Roop Nagar,GT
Karnal Road, Delhi 110007, India)
Abstract
Introduction: Augmented incidence of anxiety is associated with Coronary
Artery Bypass Graft (CABG) compared to other surgeries; it affects the
function of vital organ. Preoperative anxiety may persist after surgery
and affects health related quality of life. Music therapy is found to have
an impact on patient's anxiety. <br/>Aim(s): To find the effect of music
therapy on hospital induced anxiety and Health Related Quality of Life
(HRQoL) in patients after CABG. <br/>Material(s) and Method(s): Forty
participants were recruited for the study, (age group 30-80 years) and
randomised into two groups. The intervention group received music therapy
along with cardiac rehabilitation and control group received cardiac
rehabilitation alone once in a day. The primary outcome measure was
Hospital Anxiety and Depression Score (HADS) was measured by a trained
physiotherapist on preoperative day and postoperative day 2 and 7. The
secondary outcome measures were SF-36 and 6 minute walk distance, measured
by a trained physiotherapist on preoperative day and post operative day 7.
<br/>Result(s): HADS anxiety score showed significant difference within
the intervention as well as control group, with p-value <0.05. The p-value
of HADS depression component was <0.05 within each group. The values show
that there is the reduction in both anxiety and depression in both groups
nevertheless the p-value between the group was >0.05, which showed that
there is no significant difference in HADS score between groups. The
p-value of 6 MWT between the group was >0.05, but showed significant
difference in control group. Physical component of SF-36 outcome did not
show significant difference between the groups with p-value >0.05. Mental
component of SF-36 did not established significant improvement between the
groups. There was significant improvement in Physical component of SF-36
within the intervention group. <br/>Conclusion(s): Both Phase I cardiac
rehabilitation and music therapy has positive impact on anxiety, with
music therapy being the most advisable.<br/>Copyright &#xa9; 2019 Journal
of Clinical and Diagnostic Research. All rights reserved.

<37>
Accession Number
629829957
Title
Beneficial effect of left atrial appendage closure during cardiac surgery:
a meta-analysis of 280 585 patients.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 57 (2) (pp 252-262),
2020. Date of Publication: 01 Feb 2020.
Author
Martin Gutierrez E.; Castano M.; Gualis J.; Martinez-Comendador J.M.;
Maiorano P.; Castillo L.; Laguna G.
Institution
(Martin Gutierrez, Castano, Gualis, Maiorano, Castillo, Laguna) Servicio
de Cirugia Cardiaca, Hospital Universitario de Leon - CAULE, Leon, Spain
(Martinez-Comendador) Servicio de Cirugia Cardiaca, Complexo Hospitalario
Universitario A Coruna (CHUAC), A Coruna, Spain
Publisher
NLM (Medline)
Abstract
In non-rheumatic atrial fibrillation (AF), left atrial appendage (LAA) is
thought to be the source of embolism in 90% of the strokes. Thus, as
recent clinical trials have shown the non-inferiority of percutaneous LAA
closure (LAAc) in comparison to medical treatment, and despite a IIb
recommendation in the latest guidelines for concomitant surgical LAAc, we
sought to investigate the beneficial effect of LAAc in the surgical
population. A meta-analysis model was performed comparing studies
including any cardiac surgery with or without concomitant surgical LAAc
reporting stoke/embolic events and/or mortality, from inception to January
2019. Twenty-two studies (280 585 patients) were included in the model.
Stroke/embolic events both in the perioperative period [relative risk (RR)
0.66, 95% confidence interval (CI) 0.53-0.82; P = 0.0001] and during
follow-up of >2 years (RR 0.67, 95% CI 0.51-0.89; P < 0.005) were
significantly reduced in patients who underwent surgical LAAc (RR 0.71,
95% CI 0.58-0.87; P = 0.001). Regarding the rate of preoperative AF, LAAc
showed protective effect against stroke/embolic events in studies with
>70% preoperative AF (RR 0.64, 95% CI 0.53-0.77; P<0.00001) but no benefit
in the studies with <30% of preoperative AF (RR 0.77, 95% CI 0.46-1.28;
P=0.31). Postoperative mortality was also significantly lower in surgical
patients with LAAc at the mid- and long-term follow-up. (RR 0.72, 95% CI
0.67-0.78; P<0.00001; I2=0%). Based on these findings, concomitant
surgical LAAc is associated with lower rates of embolic events and stroke
in the postoperative period in patients with preoperative AF and also
improves postoperative mortality in the mid- and long-term
follow-up.<br/>Copyright &#xa9; The Author(s) 2019. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<38>
Accession Number
2003914641
Title
Vascular Complications after Transfemoral Transcatheter Aortic Valve
Implantation: A Systematic Review and Meta-Analysis.
Source
Structural Heart. 4 (1) (pp 62-71), 2020. Date of Publication: 02 Jan
2020.
Author
Rahhab Z.; Ramdat Misier K.; El Faquir N.; Kroon H.; Ziviello F.; Kardys
I.; Daemen J.; De Jaegere P.; Reardon M.J.; Popma J.; Van Mieghem N.M.
Institution
(Rahhab, Ramdat Misier, El Faquir, Kroon, Ziviello, Kardys, Daemen, De
Jaegere, Van Mieghem) Department of Cardiology, Thoraxcenter, Erasmus
Medical Center, Rotterdam, Netherlands
(Reardon) Department of Cardiovascular Surgery, Houston Methodist
Hospital, Houston, TX, United States
(Popma) Department of Cardiology, Beth Israel Deaconess Medical Center,
Harvard University, Boston, MA, United States
Publisher
Taylor and Francis Inc. (E-mail: customerservice@taylorandfrancis.com)
Abstract
Background: Vascular complications (VCs) after transcatheter aortic valve
implantation (TAVI) are associated with impaired outcome. We performed a
meta-analysis to determine in-hospital/30-day major VCs rate after
transfemoral-TAVI adjudicated by an independent clinical-event-committee,
and to compare the major VCs rate with regard to consecutive generations
of balloon-expandable and self-expanding platforms, device profile,
experience and patient risk-profile. <br/>Method(s): A systematic,
computerized search with predefined criteria was performed in PubMed,
Embase and Cochrane on March 27, 2018. The overall pooled proportion of VC
was calculated using a random-effects model. Subgroups were examined based
on sheath size, STS-score and start-date of inclusion (early (< January
2012); late-phase (>= January 2012) studies). <br/>Result(s): A total of
24 studies with 14308 patients were included. The pooled major VCs rate
was 7.71% and was lower in low-profile vs. high-profile device studies
(5.51% vs. 8.46%, p = 0.0015). Major VCs rate decreased significantly with
transition to newer generation balloon-expandable valves ((Sapien vs.
Sapien XT (15.18% vs. 8.48%, p < 0.00001); Sapien XT vs. Sapien 3 (8.48%
vs. 4.48%, p = 0.005)) and there was a tendency towards fewer major VCs in
EvolutR vs. CoreValve (5.98% vs. 7.97%, p = 0.094). Major VC rate was
lower in late-phase vs. early-phase studies (5.82% vs. 7.84%, p = 0.048)
and a tendency towards a lower rate was seen in intermediate vs. high-risk
studies (7.09% vs. 9.62%, p = 0.059). <br/>Conclusion(s): The pooled rate
of independently adjudicated major VCs after transfemoral-TAVI was 7.71%.
Experience and device profile are associated with fewer major
VCs.<br/>Copyright &#xa9; 2019, &#xa9; 2019 The Author(s). Published with
license by Taylor & Francis Group, LLC.

<39>
Accession Number
2003725188
Title
Temporal Trends in Mortality after Transcatheter Aortic Valve Replacement:
A Systematic Review and Meta-Regression Analysis.
Source
Structural Heart. 4 (1) (pp 16-23), 2020. Date of Publication: 02 Jan
2020.
Author
Mattke S.; Schneider S.; Orr P.; Lakdawalla D.; Goldman D.
Institution
(Mattke, Orr) Center for Improving Chronic Illness Care, University of
Southern California, Los Angeles, CA, United States
(Schneider) Center for Self-Report Science, University of Southern
California, Los Angeles, CA, United States
(Lakdawalla, Goldman) Leonard D. Schaeffer Center for Health Policy &
Economics, University of Southern California, Los Angeles, CA, United
States
Publisher
Taylor and Francis Inc. (E-mail: customerservice@taylorandfrancis.com)
Abstract
Background: We estimated trends for mortality after transcatheter aortic
valve replacement (TAVR) using meta-analytic techniques. Mortality rates
after TAVR have reportedly declined as the procedure became more
routinized and device technology improved. Confirming this finding with a
systematic assessment of the evidence could have substantial implications
for the choice between TAVR and surgical valve replacements.
<br/>Method(s): We conducted a systematic literature review up to June 20,
2018 and extracted data on 30-day and 1-year mortality rates, surgical
risk, device type, study design, and the proportion of procedures that
used a transapical approach. We used meta-regression to test whether
risk-adjusted 30-day and 1-year mortality rates declined over time.
<br/>Result(s): We identified 145 studies and 179 subsamples, once results
for separately reported subgroups were broken out. Of these, 160
subsamples (89%) representing 137 studies and 91,652 patients contained
information on 30-day mortality, and 93 subsamples (52%) representing 84
studies and 40,765 patients information on 1-year mortality. The adjusted
30-day mortality rate after TAVR fell from 10.48% (95% CI 7.97-11.65%) in
2007 to 2.27% (95% CI 1.14-4.49%) in 2016, corresponding to a relative
decrease of 78% over 10 years. The adjusted mortality rate within 1 year
after TAVR was 30.24% (95% CI 24.53-36.65%) in 2007 and fell to 11.35%
(95% CI 8.32-15.31%) in 2014, corresponding to a relative decrease of 63%
over 8 years. <br/>Conclusion(s): The results suggest that near-term
survival after TAVR has improved substantially within the short period
after the procedure was introduced and support the increasing utilization
of TAVR.<br/>Copyright &#xa9; 2019, &#xa9; 2019 Cardiovascular Research
Foundation.

<40>
Accession Number
2003557397
Title
Impact of Aortic Atherosclerosis Burden on Outcomes of Surgical Aortic
Valve Replacement.
Source
Annals of Thoracic Surgery. 109 (2) (pp 465-471), 2020. Date of
Publication: February 2020.
Author
Iribarne A.; Pan S.; McCullough J.N.; Mathew J.P.; Hung J.; Zeng X.;
Voisine P.; O'Gara P.T.; Sledz N.M.; Gelijns A.C.; Taddei-Peters W.C.;
Messe S.R.; Moskowitz A.J.; Thourani V.H.; Argenziano M.; Groh M.A.;
Giustino G.; Overbey J.R.; DiMaio J.M.; Smith P.K.
Institution
(Iribarne, McCullough) Section of Cardiac Surgery, Dartmouth-Hitchcock
Medical Center, New Hampshire, Lebanon
(Pan, Sledz, Gelijns, Moskowitz, Giustino, Overbey) Department of
Population Health Science & Policy, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Mathew) Division of Cardiothoracic Anesthesiology, Duke University
Medical Center, Durham, NC, United States
(Hung, Zeng) Division of Cardiology, Massachusetts General Hospital,
Boston, MA, United States
(Voisine) Institut Universitaire de Cardiologie et Pneumologie de Quebec,
Quebec, Quebec, Canada
(O'Gara) Cardiovascular Medicine, Brigham and Women's Hospital, Boston,
MA, United States
(Taddei-Peters) Division of Cardiovascular Sciences, National Heart, Lung,
and Blood Institute, Bethesda, MD, United States
(Messe) Department of Neurology, Perelman School of Medicine, University
of Pennsylvania, Philadelphia, PA, United States
(Thourani) Department of Cardiac Surgery, MedStar Heart and Vascular
Institute, Washington, DC, United States
(Argenziano) Division of Cardiothoracic Surgery, Department of Surgery,
New York-Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
(Groh) Cardiovascular and Thoracic Surgery, Mission Health and Hospitals,
Asheville, NC, United States
(DiMaio) Department of Cardiothoracic Surgery, The Heart Hospital Baylor
Plano, Baylor Scott & White Health, Plano, TX, United States
(Smith) Division of Cardiovascular and Thoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC, United States
Publisher
Elsevier USA
Abstract
Background: Epiaortic ultrasound detects and localizes ascending aortic
atherosclerosis. In this analysis we investigated the association between
epiaortic ultrasound-based atheroma grade during surgical aortic valve
replacement (SAVR) and perioperative adverse outcomes. <br/>Method(s):
SAVR patients in a randomized trial of 2 embolic protection devices
underwent a protocol-defined 5-view epiaortic ultrasound read at a core
laboratory. Aortic atherosclerosis was quantified with the Katz atheroma
grade, and patients were categorized as mild (grade I-II) or
moderate/severe (grade III-V). Multivariable logistic regression was used
to estimate associations between atheroma grade and adverse outcomes,
including death, clinically apparent stroke, cerebral infarction on
diffusion-weighted magnetic resonance imaging, delirium, and acute kidney
injury (AKI) by 7 and 30 days. <br/>Result(s): Precannulation epiaortic
ultrasound data were available for 326 of 383 randomized patients (85.1%).
Of these, 106 (32.5%) had moderate/severe Katz atheroma grade at any
segment of the ascending aorta. Although differences in the composite of
death, stroke, or cerebral infarction on diffusion-weighted magnetic
resonance imaging by 7 days were not statistically significant,
moderate/severe atheroma grade was associated with a greater risk of AKI
by 7 days (adjusted odds ratio, 2.63; 95% confidence interval, 1.24-5.58;
P = .01). At 30 days, patients with moderate/severe atheroma grade had a
greater risk of death, stroke, or AKI (adjusted odds ratio, 1.97; 95%
confidence interval, 1.04-3.71; P = .04). <br/>Conclusion(s):
Moderate/severe aortic atherosclerosis was associated with an increased
risk of adverse events after SAVR. Epiaortic ultrasound may serve as a
useful adjunct for identifying patients who may benefit from strategies to
reduce atheroembolic complications during SAVR.<br/>Copyright &#xa9; 2020
The Society of Thoracic Surgeons

<41>
Accession Number
630632054
Title
Incidence and timing of thromboembolic events after the norwood procedure
in the single ventricle reconstruction clinical trial of the pediatric
heart network (PHN).
Source
Pediatrics. Conference: National Conference on Education 2018. United
States. 144 (2) (no pagination), 2019. Date of Publication: August 2019.
Author
White M.H.; Kelleman M.; Sidonio R.F.; Kochilas L.; Patel K.N.
Institution
(White) Emory University, Atlanta, GA, United States
(Kelleman) Emory University School of Medicine, Atlanta, GA, United States
(Patel) Aflac Cancer and Blood Disorders Center, Emory University,
Children's Healthcare of Atlanta, Atlanta, GA, United States
Publisher
American Academy of Pediatrics
Abstract
Purpose: Thromboembolic events are a common cause of increased morbidity
and mortality in infants who undergo staged surgeries for single ventricle
congenital heart disease (CHD). However, previously reported rates vary,
from 1 to 46%, due to limitations from small sample size, retrospective
study design, heterogeneity of patient population, and single center
experience. We used the public dataset of the PHN Single Ventricle
Reconstruction (SVR) randomized clinical trial to determine the incidence,
timing of, and factors associated with thromboembolic events following the
Norwood procedure. <br/>Method(s): The SVR trial spans from 2005 to 2009
and includes infants diagnosed with hypoplastic left heart physiology who
underwent randomization to the Norwood procedure with modified
Blalock-Taussig shunt (mBTS) or right ventricle to pulmonary artery shunt
(RVPAS). Univariate analysis was performed using demographic, clinical,
and surgical factors available from this study to determine association
with thrombosis. Comparisons between groups were made using Wilcoxon
rank-sum tests for continuous variables and Chi-square tests for
categorical variables. Time to thrombosis was evaluated using survival
analysis. <br/>Result(s): Of the 549 infants included in the SVR trial,
the majority were term (88%) White (64%) males (62%) with a median birth
weight of 3.10 kg and predominant anatomic diagnosis of HLHS (86%) (Table
1). Thirty-five (6%) patients had thrombosis during Norwood
hospitalization, with the majority (33/35) developing thrombosis in the
first 30 days following the Norwood (Figure 1). Median time to first
thromboembolic event was 23 days. There was no difference in the rate of
thrombosis based on shunt types (mBTS vs. RVPAS). Factors associated with
thrombosis were male sex (p=0.0052), longer duration of cardiopulmonary
bypass (p=0.045), and aprotinin use (p=0.033). Gestational age, race,
anatomic diagnosis, ECMO use, and need for CPR were not associated with
thrombosis. Development of thrombosis during Norwood hospitalization was
associated with prolonged median ICU stay and length of hospital stay; 27
vs. 13 days (IQR 13-46 days vs. 9-25 days, p<0.001) and 36 vs. 23 days
(IQR 26-58 days vs. 15-38 days, p<0.001), respectively.
<br/>Conclusion(s): In this largest reported prospective cohort of infants
undergoing single ventricle reconstruction, the cumulative incidence of
thrombosis during the Norwood hospitalization was 6.4%. Aprotinin use and
male sex were associated with risk of thrombosis and this risk was highest
within 30 days post Norwood. Thrombosis is associated with longer length
of ICU and hospital stays. Further studies are needed to investigate the
utility of modification of current management practices, including
targeted thromboprophylaxis during this high risk period following the
Norwood procedure.

<42>
Accession Number
630629780
Title
Early versus late surgical decompression for acute spinal cord injury: An
individual patient data meta-analysis of 1548 patients.
Source
Clinical Neurosurgery. Conference: 2019 Annual Meeting Congress of
Neurological Surgeons, CNS 2019. United States. 66 (Supplement 1) (pp 33),
2019. Date of Publication: September 2019.
Author
Badhiwala J.H.; Witiw C.D.; Wilson J.R.; Fehlings M.G.
Publisher
Oxford University Press
Abstract
INTRODUCTION: We sought to leverage the statistical power derived from
pooling 4 high-quality prospective datasets to compare sensorimotor
recovery with early (< 24 hr) vs late (>= 24 hr) surgical decompression
for acute traumatic spinal cord injury (SCI). <br/>METHOD(S): Patients
with acute SCI who underwent surgical decompression were identified from 4
prospective, multi-center SCI datasets (NACTN, STASCIS, Sygen, and NASCIS
III). Patients were dichotomized into early (< 24 hr) and late (>= 24 hr)
surgery groups. The primary end point was change in ASIA motor score (AMS)
at 1-yr. Secondary outcomes included AIS grade and change in ASIA light
touch and pin prick scores at 1-yr. One-stage meta-analyses for each
outcome were performed by hierarchical mixed-effects regression using a
stratified intercept to account for clustering of patients within studies.
Fixedeffect covariates were specified for baseline score, age, injury
mechanism, AIS grade, neurological level, and steroids. The treatment
(early vs late surgery) was specified as a random-effect. <br/>RESULT(S):
A total of 1548 patients were eligible. The early surgery group
experienced greater improvement than the late surgery group at 1-yr for
AMS (MD 4.0, 95% CI 1.7-6.2, P = .001), light touch score (MD 4.6, 95% CI
1.9-7.2, P=.001), and pin prick score (MD4.2, 95% CI 1.5-6.9, P = .003).
Further, on 'shift analysis', the early surgery group achieved a more
favorable distribution of AIS grades at 1-yr compared to the late surgery
group (cOR 1.46, 95% CI 1.14-1.87, P = .003). The effect of early surgery
was strongest for cervical SCI (P = .003); however, we observed a trend
toward improved recovery with early versus late surgery for thoracic SCI
as well (MD 5.2, 95% CI -0.8-11.2, P = .088). <br/>CONCLUSION(S): In an
individual patient data meta-analysis adjusting for potential confounders,
we found early surgery, within 24 hr of injury, to be associated with
superior sensorimotor recovery at 1-yr following acute SCI, as compared to
late surgery.

<43>
Accession Number
630636279
Title
Long-Term Outcomes of Unprotected Left Main Coronary Artery Disease:
Comparison of Coronary Artery Bypass Grafting and Percutaneous Coronary
Intervention.
Source
The Journal of invasive cardiology. (no pagination), 2020. Date of
Publication: 15 Jan 2020.
Author
Song K.; Kim M.H.; Li J.X.; Kim S.J.; Lee K.M.; Cho Y.-R.; Park J.S.; Park
T.H.; Kim Y.D.; Lee M.S.
Institution
(Kim) Department of Cardiology, Dong-A University Hospital, 32
Daesingongwon-ro ,Seo-gu, Busan 602-714, South Korea
Publisher
NLM (Medline)
Abstract
OBJECTIVE: We compared the long-term outcomes of coronary artery bypass
grafting (CABG) and percutaneous coronary intervention (PCI) for
unprotected left main coronary artery (ULMCA) disease in a real-world
population. BACKGROUND: CABG is the standard of care for ULMCA disease.
Contemporary randomized trials have reported conflicting results with the
two revascularization strategies for the treatment of ULMCA disease at
intermediate-term follow-up. <br/>METHOD(S): We evaluated 422 consecutive
patients with ULMCA disease who underwent CABG (n = 273) or PCI (n = 149)
from 1998-2008. The primary outcome measure was major adverse cardiac and
cerebrovascular event (MACCE) rate, defined as the composite of all-cause
death, myocardial infarction (MI), stroke, or target-vessel
revascularization (TVR) at 10 years. Propensity-score matched (PSM)
analysis was used to assess long-term MACCE. <br/>RESULT(S): The
cumulative 10-year incidence of risk for MACCE was not significantly
different between the PCI and CABG groups (24.8% vs 20.5%, respectively;
log rank P=.22; log rank PSM P=.45). The risk for all-cause death was not
significantly different between the two groups (log rank P=.09; PSM log
rank P=.51). The risk for stroke was significantly lower with PCI (log
rank P=.02), but was not significant after matching (PSM log rank P=.27).
The risk for TVR was significantly higher with PCI vs CABG prior to and
after matching (log rank P<.001; log rank PSM P=.01). There were no
significant differences in MACCE between the two groups when stratified by
SYNTAX scores <=22% (log rank P=.61) and >23% (log rank P=.06).
<br/>CONCLUSION(S): In patients with ULMCA disease, PCI was comparable
with CABG for long-term MACCE and death rates. The TVR rate was higher in
the PCI group.

<44>
Accession Number
2004628600
Title
Randomized Clinical Trial of Surgical vs. Percutaneous vs. Hybrid
Revascularization in Multivessel Coronary Artery Disease: Residual
Myocardial Ischemia and Clinical Outcomes at One Year - Hybrid coronary
REvascularization Versus Stenting or Surgery (HREVS).
Source
Journal of Interventional Cardiology. 2020 (no pagination), 2020. Article
Number: 5458064. Date of Publication: 2020.
Author
Ganyukov V.; Kochergin N.; Shilov A.; Tarasov R.; Skupien J.; Szot W.;
Kokov A.; Popov V.; Kozyrin K.; Barbarash O.; Barbarash L.; Musialek P.
Institution
(Ganyukov, Kochergin, Shilov, Tarasov, Kokov, Kozyrin, Barbarash,
Barbarash) Federal State Budgetary Institution research Institute for
Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
(Skupien, Szot, Musialek) Jagiellonian University School of Medicine,
Krakow, Poland
(Szot) Dept. of Nuclear Medicine, John Paul II Hospital, Krakow, Poland
(Popov) Federal State Budgetary Institution A. V. Vishnevsky Institute of
Surgery, Moscow, Russian Federation
(Musialek) Jagiellonian University Dept. of Cardiac and Vascular Diseases,
John Paul II Hospital, Krakow, Poland
Publisher
Hindawi Limited (410 Park Avenue, 15th Floor, 287 pmb, New York NY 10022,
United States)
Abstract
Aim. Optimal revascularization strategy in multivessel (MV) coronary
artery disease (CAD) eligible for percutaneous management (PCI) and
surgery remains unresolved. We evaluated, in a randomized clinical trial,
residual myocardial ischemia (RI) and clinical outcomes of MV-CAD
revascularization using coronary artery bypass grafting (CABG), hybrid
coronary revascularization (HCR), or MV-PCI. Methods. Consecutive MV-CAD
patients (n = 155) were randomized (1: 1: 1) to conventional CABG
(LIMA-LAD plus venous grafts) or HCR (MIDCAB LIMA-LAD followed by PCI for
remaining vessels) or MV-PCI (everolimus-eluting CoCr stents) under Heart
Team agreement on equal technical and clinical feasibility of each
strategy. SPECT at 12 months (primary endpoint of RI that the trial was
powered for; a measure of revascularization midterm efficacy and an
independent predictor of long-term prognosis) preceded routine
angiographic control. Results. Data are given, respectively, for the CABG,
HCR, and MV-PCI arms. Incomplete revascularization rate was 8.0% vs. 7.7%
vs. 5.7% (p=0.71). Hospital stay was 13.8 vs. 13.5 vs. 4.5 days (p<0.001),
and sick-leave duration was 23 vs. 16 vs. 8 weeks (p<0.001). At 12 months,
RI was 5 (2, 9)% vs. 5 (3, 7)% vs. 6 (3, 10)% (median; Q1, Q3) with
noninferiority p values of 0.0006 (HCR vs. CABG) and 0.016 (MV-PCI vs.
CABG). Rates of angiographic graft stenosis/occlusion or in-segment
restenosis were 20.4% vs. 8.2% vs. 5.9% (p=0.05). Clinical target
vessel/graft failure occurred in 12.0% vs. 11.5% vs. 11.3% (p=0.62). Major
adverse cardiac and cerebral event (MACCE) rate was similar (12% vs. 13.4%
vs. 13.2%; p=0.83). Conclusion. In this first randomized controlled study
comparing CABG, HCR, and MV-PCI, residual myocardial ischemia and MACCE
were similar at 12 months. There was no midterm indication of any added
value of HCR. Hospital stay and sick-leave duration were shortest with
MV-PCI. While longer-term follow-up is warranted, these findings may
impact patient and physician choices and healthcare resources utilization.
This trial is registered with NCT01699048.<br/>Copyright &#xa9; 2020
Vladimir Ganyukov et al.

<45>
Accession Number
2004068892
Title
Current advances in biodegradable synthetic polymer based cardiac patches.
Source
Journal of Biomedical Materials Research - Part A. (no pagination), 2020.
Date of Publication: 2020.
Author
McMahan S.; Taylor A.; Copeland K.M.; Pan Z.; Liao J.; Hong Y.
Institution
(McMahan, Taylor, Copeland, Liao, Hong) Department of Bioengineering,
University of Texas at Arlington, Arlington, TX, United States
(Pan) College of Nursing and Health Innovation, University of Texas at
Arlington, Arlington, TX, United States
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
The number of people affected by heart disease such as coronary artery
disease and myocardial infarction increases at an alarming rate each year.
Currently, the methods to treat these diseases are restricted to lifestyle
change, pharmaceuticals, and eventually heart transplant if the condition
is severe enough. While these treatment options are the standard for
caring for patients who suffer from heart disease, limited regenerative
ability of the heart restricts the effectiveness of treatment and may lead
to other heart-related health problems in the future. Because of the
increasing need for more effective therapeutic technologies for treating
diseased heart tissue, cardiac patches are now a large focus for
researchers. The cardiac patches are designed to be integrated into the
patients' natural tissue to introduce mechanical support and healing to
the damaged areas. As a promising alternative, synthetic biodegradable
polymer based biomaterials can be easily manipulated to customize material
properties, as well as possess certain desired characteristics for cardiac
patch use. This comprehensive review summarizes recent works on synthetic
biodegradable cardiac patches implanted into infarcted animal models. In
addition, this review describes the basic requirements that should be met
for cardiac patch development, and discusses the inspirations to designing
new biomaterials and technologies for cardiac patches.<br/>Copyright
&#xa9; 2020 Wiley Periodicals, Inc.

<46>
Accession Number
2003729270
Title
Screening for iron deficiency in surgical patients based on noninvasive
zinc protoporphyrin measurements.
Source
Transfusion. 60 (1) (pp 62-72), 2020. Date of Publication: 01 Jan 2020.
Author
Fullenbach C.; Stein P.; Glaser P.; Triphaus C.; Lindau S.; Choorapoikayil
S.; Schmitt E.; Zacharowski K.; Hintereder G.; Hennig G.; Homann C.; Stepp
H.; Spahn G.H.; Kaserer A.; Schedler A.; Meybohm P.; Spahn D.R.
Institution
(Fullenbach, Glaser, Triphaus, Lindau, Choorapoikayil, Schmitt,
Zacharowski, Meybohm) Department of Anaesthesiology, Intensive Care
Medicine and Pain Therapy, University Hospital Frankfurt, Goethe
University, Frankfurt, Germany
(Stein, Spahn, Kaserer, Schedler, Spahn) Institute of Anesthesiology,
University and University Hospital of Zurich, Zurich, Switzerland
(Hintereder) Central Laboratory, Center of Internal Medicine, University
Hospital Frankfurt, Goethe University, Frankfurt, Germany
(Hennig, Homann, Stepp) Laser-Forschungslabor, LIFE-Zentrum, Klinikum der
Universitat Munchen, Munich, Germany
(Hennig, Homann, Stepp) Department of Urology, Klinikum der Universitat
Munchen, Munich, Germany
(Meybohm) Department of Anesthesiology, University Hospital Wuerzburg,
Wuerzburg, Germany
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
BACKGROUND: Approximately every third surgical patient is anemic. The most
common form, iron deficiency anemia, results from persisting
iron-deficient erythropoiesis (IDE). Zinc protoporphyrin (ZnPP) is a
promising parameter for diagnosing IDE, hitherto requiring blood drawing
and laboratory workup. STUDY DESIGN AND METHODS: Noninvasive ZnPP
(ZnPP-NI) measurements are compared to ZnPP reference determination of the
ZnPP/heme ratio by high-performance liquid chromatography (ZnPP-HPLC) and
the analytical performance in detecting IDE is evaluated against
traditional iron status parameters (ferritin, transferrin saturation
[TSAT], soluble transferrin receptor-ferritin index [sTfR-F], soluble
transferrin receptor [sTfR]), likewise measured in blood. The study was
conducted at the University Hospitals of Frankfurt and Zurich.
<br/>RESULT(S): Limits of agreement between ZnPP-NI and ZnPP-HPLC
measurements for 584 cardiac and noncardiac surgical patients equaled 19.7
mumol/mol heme (95% confidence interval, 18.0-21.3; acceptance criteria,
23.2 mumol/mol heme; absolute bias, 0 mumol/mol heme). Analytical
performance for detecting IDE (inferred from area under the curve receiver
operating characteristics) of parameters measured in blood was: ZnPP-HPLC
(0.95), sTfR (0.92), sTfR-F (0.89), TSAT (0.87), and ferritin (0.67).
Noninvasively measured ZnPP-NI yielded results of 0.90.
<br/>CONCLUSION(S): ZnPP-NI appears well suited for an initial IDE
screening, informing on the state of erythropoiesis at the point of care
without blood drawing and laboratory analysis. Comparison with a
multiparameter IDE test revealed that ZnPP-NI values of 40 mumol/mol heme
or less allows exclusion of IDE, whereas for 65 mumol/mol heme or greater,
IDE is very likely if other causes of increased values are excluded. In
these cases (77% of our patients) ZnPP-NI may suffice for a diagnosis,
while values in between require analyses of additional iron status
parameters.<br/>Copyright &#xa9; 2019 The Authors. Transfusion published
by Wiley Periodicals, Inc. on behalf of AABB.

<47>
Accession Number
627998047
Title
Case report and systematic review of iatrogenic left atrial dissection in
different cardiovascular specialties: A common treatment for an uncommon
complication?.
Source
Catheterization and Cardiovascular Interventions. 95 (1) (pp E30-E36),
2020. Date of Publication: 01 Jan 2020.
Author
Cereda A.F.; De Luca F.; Lanzone A.M.; Cottini M.; Pastori L.; Sangiorgi
G.
Institution
(Cereda) Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo,
Italy
(De Luca) Department of Cardiothoracic Surgery, Humanitas Gavazzeni
Hospital, Bergamo, Italy
(Lanzone, Pastori, Sangiorgi) Cardiac Cath Laboratory, Humanitas Gavazzeni
Hospital, Bergamo, Italy
(Cottini) Department of Cardiac Surgery and Heart Transplantation, De
Gasperis Center, Niguarda Hospital, Milan, Italy
(Sangiorgi) Department of Systemic Medicine, Division of Cardiology,
University of Rome Tor Vergata, Rome, Italy
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objectives: Left atrial dissection (LatD) is a rare and heterogeneous
condition affecting many cardiovascular areas. The present article, by the
means of personal case report illustration and systemic review of
different clinical management, is aimed to give to clinicians further
knowledge on this controversial topic. <br/>Background(s): LatD is an
exceedingly rare but potentially fatal complication of cardiac surgery or
catheter-based interventional procedures. Most of the cases are iatrogenic
and its incidence is expected to grow due to an increase in the number of
percutaneous coronary intervention and structural heart disease
procedures. The management of this complication is controversial, and it
may depend on related etiologies. <br/>Method(s): We have reported our
single-case experience and review of the scientific literature, focusing
on the decision-making process and the strategical approach by
multimodality imaging techniques. <br/>Result(s): Our case of LatD with
initial hemodynamic instability was surgically treated. Conservative
approach is often employed in literature despite the fact that
conservative versus surgical approach is debatable, depending on clinical
presentation, hemodynamic stability, multimodal imaging findings, and
personal experience of the center. <br/>Conclusion(s): According to
systematic literature review, a watchful-waiting strategy supported by
multimodality imaging could be a safe and effective management in stable
LatD.<br/>Copyright &#xa9; 2019 Wiley Periodicals, Inc.

<48>
Accession Number
2002839830
Title
A paradox in sex-specific clinical outcomes after bioresorbable scaffold
implantation: 2-year results from the AIDA trial.
Source
International Journal of Cardiology. 300 (pp 93-98), 2020. Date of
Publication: 1 February 2020.
Author
Kerkmeijer L.S.M.; Tijssen R.Y.G.; Hofma S.H.; Pinxterhuis T.H.; Kraak
R.P.; Kalkman D.N.; van der Schaaf R.J.; Arkenbout E.K.; Weevers A.P.J.D.;
Beijk M.A.; Baan J.; Vis M.M.; Koch K.T.; Tijssen J.G.P.; Piek J.J.;
Henriques J.P.S.; de Winter R.J.; Wykrzykowska J.J.
Institution
(Kerkmeijer, Tijssen, Kraak, Kalkman, Beijk, Baan, Vis, Koch, Tijssen,
Piek, Henriques, de Winter, Wykrzykowska) Amsterdam UMC, University of
Amsterdam, Department of Clinical and Experimental Cardiology, Amsterdam
Cardiovascular Sciences, Amsterdam, Netherlands
(Hofma, Pinxterhuis) Department of Cardiology, Medical Center Leeuwarden,
Leeuwarden, Netherlands
(Kraak, van der Schaaf) Department of Cardiology, Onze Lieve Vrouwe
Gasthuis, Amsterdam, Netherlands
(Arkenbout) Department of Cardiology, Tergooi Hospital, Blaricum,
Netherlands
(Weevers) Department of Cardiology, Albert Schweitzer Hospital, Dordrecht,
Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: Females are underrepresented in clinical trials evaluating new
stent technologies whilst results may differ between the sexes. Females
are known to have smaller, more tortuous coronary arteries and have
generally more comorbidities. On the other hand, they may have smaller
plaque burden. This subgroup-analysis sought to assess sex-specific
outcomes after Absorb bioresorbable vascular scaffold (BVS) or XIENCE
everolimus-eluting stent (EES) implantation. <br/>Method(s): The AIDA
trial was an investigator-initiated, non-inferiority, all-comers trial, in
which 1845 patients were randomly assigned to either Absorb BVS or XIENCE
EES. Baseline clinical, angiography and procedural variables, as well as
2-year clinical outcomes were analyzed by sex and device modality.
<br/>Result(s): Of the 1845 randomized patients, 475 (25.7%) were females.
The 2-year rates of target vessel failure (TVF) with Absorb BVS versus
XIENCE EES in females were 6.4% versus 10.6% (HR 0.59; 95% CI: 0.31-1.11;
p = 0.10) and in males 12.7% versus 9.7% (HR 1.34; 95% CI: 0.98-1.85; p =
0.07). Males treated with Absorb BVS were at higher risk for TVF compared
to females treated with Absorb BVS (HR 2.06; 95% CI 1.21-3.53; p = 0.007).
Definite/probable device thrombosis occurred in females with Absorb BVS
versus XIENCE EES in 1.6% versus 1.4% (HR 1.15; 95% CI: 0.26-5.12; p =
0.86) and in males 3.9% versus 0.7% (HR 5.55; 95% CI: 2.11-14.35; p <
0.001). A statistical significant interaction between sex and device was
present for TVF (p = 0.02), but was not seen for definite/probable device
thrombosis (p = 0.08). <br/>Conclusion(s): In this subgroup analysis,
Absorb BVS used in routine practice tends to result in better clinical
outcomes in females compared to males.<br/>Copyright &#xa9; 2019 Elsevier
B.V.

<49>
[Use Link to view the full text]
Accession Number
630562619
Title
Steroid therapy and outcome of parapneumonic pleural effusions (STOPPE):
Study protocol for a multicenter, double-blinded, placebo-controlled
randomized clinical trial.
Source
Medicine (United States). 98 (43) (no pagination), 2019. Article Number:
e17397. Date of Publication: 01 Oct 2019.
Author
Fitzgerald D.B.; Waterer G.W.; Read C.A.; Fysh E.T.; Shrestha R.; Stanley
C.; Muruganandan S.; Lan N.S.H.; Popowicz N.D.; Peddle-Mcintyre C.J.;
Rahman N.M.; Gan S.K.; Murray K.; Lee Y.C.G.
Institution
(Fitzgerald, Lan, Popowicz, Lee) Respiratory Medicine, Sir Charles
Gairdner Hospital, Australia
(Fitzgerald, Waterer, Read, Popowicz, Gan, Lee) Medical School, Faculty of
Health and Medical Sciences
(Fitzgerald, Read, Popowicz, Peddle-Mcintyre, Lee) Pleural Medicine Unit,
Institute for Respiratory Health, Australia
(Waterer, Stanley) Respiratory Medicine, Royal Perth Hospital, Australia
(Fysh) Respiratory Medicine, St John of God Midland, Australia
(Shrestha) Respiratory Medicine, Fiona Stanley Hospital, Australia
(Muruganandan) Respiratory Medicine, Northern Health, VIC, Australia
(Popowicz) School of Allied Health, University of Western Australia,
Australia
(Peddle-Mcintyre) School of Medical and Health Sciences, Edith Cowan
University, Australia
(Rahman) Oxford Respiratory Trials Unit, University of Oxford, United
Kingdom
(Gan) Endocrinology and Diabetes, Royal Perth Hospital, Perth, Australia
(Murray) School of Population and Global Health, University of Western
Australia, WA, Australia
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background:Community-acquired pneumonia (CAP) is a major global disease.
Parapneumonic effusions often complicate CAP and range from uninfected
(simple) to infected (complicated) parapneumonic effusions and empyema
(pus). CAP patients who have a pleural effusion at presentation are more
likely to require hospitalization, have a longer length of stay and higher
mortality than those without an effusion. Conventional management of
pleural infection, with antibiotics and chest tube drainage, fails in
about 30% of cases. Several randomized controlled trials (RCT) have
evaluated the use of corticosteroids in CAP and demonstrated some
potential benefits. Importantly, steroid use in pneumonia has an
acceptable safety profile with no adverse impact on mortality. A RCT
focused on pediatric patients with pneumonia and a parapneumonic effusion
demonstrated shorter time to recovery. The effects of corticosteroid use
on clinical outcomes in adults with parapneumonic effusions have not been
tested. We hypothesize that parapneumonic effusions develop from an
exaggerated pleural inflammatory response. Treatment with systemic
steroids may dampen the inflammation and lead to improved clinical
outcomes. The steroid therapy and outcome of parapneumonic pleural
effusions (STOPPE) trial will assess the efficacy and safety of systemic
corticosteroid as an adjunct therapy in adult patients with CAP and
pleural effusions. <br/>Method(s):STOPPE is a pilot multicenter,
double-blinded, placebo-controlled RCT that will randomize 80 patients
with parapneumonic effusions (2:1) to intravenous dexamethasone or
placebo, administered twice daily for 48 hours. This exploratory study
will capture a wide range of clinically relevant endpoints which have been
used in clinical trials of pneumonia and/or pleural infection; including,
but not limited to: time to clinical stability, inflammatory markers,
quality of life, length of hospital stay, proportion of patients requiring
escalation of care (thoracostomy or thoracoscopy), and mortality. Safety
will be assessed by monitoring for the incidence of adverse events during
the study. <br/>Discussion(s):STOPPE is the first trial to assess the
efficacy and safety profile of systemic corticosteroids in adults with CAP
and pleural effusions. This will inform future studies on feasibility and
appropriate trial endpoints.Trial registration:ACTRN12618000947202Protocol
version:version 3.00/26.07.18.<br/>Copyright &#xa9; 2019 the Author(s).
Published by Wolters Kluwer Health, Inc.

<50>
[Use Link to view the full text]
Accession Number
630550164
Title
Hemocoagulase reduces postoperative bleeding and blood transfusion in
cardiac surgical patients: A PRISMA-compliant systematic review and
meta-analysis.
Source
Medicine (United States). 98 (52) (no pagination), 2019. Article Number:
e18534. Date of Publication: 01 Dec 2019.
Author
Yao Y.-T.; Yuan X.; Fang N.-X.
Institution
(Yao, Fang) Department of Anesthesiology, Fuwai Hospital, National Center
for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy
of Medical Sciences, No. 167, Beilishi Road, Xicheng District, Beijing
100037, China
(Yuan) Department of Adult Cardiac Surgery, Fuwai Hospital, National
Center for Cardiovascular Diseases, Peking Union Medical College, Chinese
Academy of Medical Sciences, No. 167, Beilishi Road, Xicheng District,
Beijing 100037, China
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background:Hemocoagulase is isolated and purified from snake venoms.
Hemocoagulase agents have been widely used in the prevention and treatment
of surgical bleeding. A systematic review was performed to evaluate the
effects of hemocoagulase on postoperative bleeding and transfusion in
patients who underwent cardiac surgery. <br/>Method(s):Electronic
databases were searched to identify all clinical trials comparing
hemocoagulase with placebo/blank on postoperative bleeding and transfusion
in patients undergoing cardiac surgery. Two authors independently
extracted perioperative data and outcome data. For continuous variables,
treatment effects were calculated as weighted mean difference and 95%
confidential interval (CI). For dichotomous data, treatment effects were
calculated as odds ratio and 95% CI. Each outcome was tested for
heterogeneity, and randomized-effects or fixed-effects model was used in
the presence or absence of significant heterogeneity. Sensitivity analyses
were done by examining the influence of statistical model and individual
trial on estimated treatment effects. Publication bias was explored
through visual inspection of funnel plots of the outcomes. Statistical
significance was defined as P<.05. <br/>Result(s):Our search yielded 12
studies including 900 patients, and 510 patients were allocated into
hemocoagulase group and 390 into control group. Meta-analysis suggested
that, hemocoagulase-treated patients had less bleeding volume, reduced red
blood cells and fresh frozen plasma transfusion, and higher hemoglobin
level than those of controlled patients postoperatively. Meta-analysis
also showed that, hemocoagulase did not influence intraoperative heparin
or protamine dosages and postoperative platelet counts. Meta-analysis
demonstrated that, hemocoagulase-treated patients had significantly
shorter postoperative prothrombin time, activated partial thromboplastin
time, and thrombin time, higher fibrinogen level and similar D-dimer level
when compared to control patients. <br/>Conclusion(s):This meta-analysis
has found some evidence showing that hemocoagulase reduces postoperative
bleeding, and blood transfusion requirement in patients undergoing cardiac
surgery. However, these findings should be interpreted rigorously. Further
well-conducted trials are required to assess the blood-saving effects and
mechanisms of Hemocoagulase.<br/>Copyright &#xa9; 2019 the Author(s).
Published by Wolters Kluwer Health, Inc.

<51>
Accession Number
2003895247
Title
Toward a robust tool for pharmacokinetic-based personalization of
treatment with tacrolimus in solid organ transplantation: A model-based
meta-analysis approach.
Source
British Journal of Clinical Pharmacology. 85 (12) (pp 2793-2823), 2019.
Date of Publication: 01 Dec 2019.
Author
Nanga T.M.; Doan T.T.P.; Marquet P.; Musuamba F.T.
Institution
(Nanga, Doan, Marquet) INSERM UMR 1248, Universite de Limoges, FHU
support, Limoges Cedex 87025, France
(Musuamba) Federal Agency for Medicines and Health Products, Brussels,
Belgium
(Musuamba) Faculte des sciences pharmaceutiques, Universite de Lubumbashi,
Lubumbashi, Congo
Publisher
Blackwell Publishing Ltd
Abstract
Aims: The objective of this study is to develop a generic model for
tacrolimus pharmacokinetics modelling using a meta-analysis approach, that
could serve as a first step towards a prediction tool to inform
pharmacokinetics-based optimal dosing of tacrolimus in different
populations and indications. <br/>Method(s): A systematic literature
review was performed and a meta-model developed with NONMEM software using
a top-down approach. Historical (previously published) data were used for
model development and qualification. In-house individual rich and sparse
tacrolimus blood concentration profiles from adult and paediatric kidney,
liver, lung and heart transplant patients were used for model validation.
Model validation was based on successful numerical convergence, adequate
precision in parameter estimation, acceptable goodness of fit with respect
to measured blood concentrations with no indication of bias, and
acceptable performance of visual predictive checks. External validation
was performed by fitting the model to independent data from 3 external
cohorts and remaining previously published studies. <br/>Result(s): A
total of 76 models were found relevant for meta-model building from the
literature and the related parameters recorded. The meta-model developed
using patient level data was structurally a 2-compartment model with
first-order absorption, absorption lag time and first-time varying
elimination. Population values for clearance, intercompartmental
clearance, central and peripheral volume were 22.5 L/h, 24.2 L/h, 246.2 L
and 109.9 L, respectively. The absorption first-order rate and the lag
time were fixed to 3.37/h and 0.33 hours, respectively. Transplanted organ
and time after transplantation were found to influence drug apparent
clearance whereas body weight influenced both the apparent volume of
distribution and the apparent clearance. The model displayed good results
as regards the internal and external validation. <br/>Conclusion(s): A
meta-model was successfully developed for tacrolimus in solid organ
transplantation that can be used as a basis for the prediction of
concentrations in different groups of patients, and eventually for
effective dose individualization in different subgroups of the
population.<br/>Copyright &#xa9; 2019 The British Pharmacological Society

<52>
Accession Number
2004358741
Title
Distribution of polymorphisms in the CYP2C19 and ABCB1 genes among
patients with acute coronary syndrome in Lower Silesian population.
Source
Advances in Clinical and Experimental Medicine. 28 (12) (no pagination),
2019. Date of Publication: 2019.
Author
Wojcik T.; Szymkiewicz P.; Wisniewski J.; Lebioda A.; Jonkisz A.; Gamian
A.; Kuliczkowski W.; Sciborski K.; Mysiak A.; Protasiewicz M.
Institution
(Wojcik, Szymkiewicz, Kuliczkowski, Sciborski, Mysiak, Protasiewicz)
Department and Clinic of Cardiology, Wroclaw Medical University, Poland
(Wisniewski, Gamian) Department and Section of Biochemistry, Wroclaw
Medical University, Poland
(Lebioda, Jonkisz) Section of Molecular Techniques, Wroclaw Medical
University, Poland
Publisher
Wroclaw University of Medicine
Abstract
Background. Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel
administered totreat patients with acute coronary syndrome (ACS) is still
being used. However, despite theproven efficacy of this treatment regimen,
thromboembolic complications have been observed insome individuals.
Thereason for this phenomenon is linked totheso-called increased
responsiveness ofplatelets despite high platelet resistance (HPR). A
significant role in HPR is attributed to genetically determined
differences in the absorption and activation of clopidogrel. Objectives.
Theaim of thestudy was toassess theincidence ofpolymorphisms of the ABCB1
and CYPC19 genes that encode proteins involved intheabsorption and
metabolism of clopidogrel. Material and methods. The analysis was
performed in 199 consecutive patients from Lower Silesian voivodeship
(Poland) who underwent coronary angioplasty with stenting for ACS. The
single nucleotide polymorphism of the CYP2C19 and ABCB1 genes was
performed using a mini sequencing or restriction fragment length
polymorphism method. Results. Theresults of this study revealed thehigh
incidence ofpatients who may be unresponsive toantiplatelet treatment due
togenetic causes. TheCYPC19*2 allele intheform ofhomozygote ormutation
heterozygote appeared in26.1% of thestudy population. ABCB1 (C3435C>T)
polymorphism was associated with 84% ofpatients. Thetotal incidence
ofallelic disorders of low drug absorption and metabolism reached 14.6%.
Conclusions. Thedata obtained should prompt clinicians touse more recent
antiplatelet agents (ticagrelor orprasugrel) first, instead of
clopidogrel.<br/>Copyright &#xa9; 2019 by Wroclaw Medical University.

<53>
Accession Number
630415498
Title
Efficacy and safety of low-dose colchicine after myocardial infarction.
Source
New England Journal of Medicine. 381 (26) (pp 2497-2505), 2019. Date of
Publication: 26 Dec 2019.
Author
Tardif J.-C.; Kouz S.; Waters D.D.; Bertrand O.F.; Diaz R.; Maggioni A.P.;
Pinto F.J.; Ibrahim R.; Gamra H.; Kiwan G.S.; Berry C.; Lopez-Sendon J.;
Ostadal P.; Koenig W.; Angoulvant D.; Gregoire J.C.; Lavoie M.-A.; Dube
M.-P.; Rhainds D.; Provencher M.; Blondeau L.; Orfanos A.; L'Allier P.L.;
Guertin M.-C.; Roubille F.
Institution
(Tardif, Ibrahim, Gregoire, Lavoie, Dube, Rhainds, L'Allier) Montreal
Heart Institute, 5000 Belanger St., Montreal, PQ H1T 1C8, Canada
(Provencher, Blondeau, Orfanos, Guertin) Montreal Health Innovations
Coordinating Center, Montreal, Canada
(Kouz) Centre Hospitalier Regional de Lanaudiere, Joliette, Canada
(Bertrand) Institut de Cardiologie et Pneumologie de Quebec, Quebec City,
Canada
(Waters) San Francisco General Hospital, San Francisco, United States
(Diaz) Estudios Clinicos Latinoamerica, Rosario, Argentina
(Maggioni) Associazione Nazionale Medici Cardiologi Ospedalieri Research
Center, Florence, Italy
(Pinto) Santa Maria University Hospital (Centro Hospitalar Universitario
Lisboa Norte), Centro Academico de Medicina de Lisboa, Centro
Cardiovascular da Universidade de Lisboa, Faculdade de Medicina da
Universidade de Lisboa, Lisbon, Portugal
(Gamra) Fattouma Bourguiba University Hospital, Monastir, Tunisia
(Kiwan) Bellevue Medical Center, Beirut, Lebanon
(Berry) Institute of Cardiovascular and Medical Sciences, University of
Glasgow, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
(Lopez-Sendon) Hospital Universitario La Paz, Universidad Autonoma de
Madrid, Instituto de Investigacion La Paz, Centro de Investigacion
Biomedica en Red-Enfermedades Cardiovasculares, Madrid, Spain
(Ostadal) Cardiovascular Center, Na Homolce Hospital, Prague, Czechia
(Koenig) Deutsches Herzzentrum Munchen, Technische Universitat Munchen,
DZHK (German Center for Cardiovascular Research), Partner site Munich
Heart Alliance, Munich, Institute of Epidemiology and Medical Biometry,
University of Ulm, Ulm, Germany
(Angoulvant) Centre Hospitalier Universitaire (CHU) de Tours, Equipe
d'Accueil 4245 Transplantation Immunite Inflammation Loire Valley
Cardiovascular Collaboration, Tours University, Tours, France
(Roubille) PhyMedExp (Physiologie et Medecine Experimentale du Coeur et
des Muscles), Universite de Montpellier, INSERM, Centre National de la
Recherche Scientifique, Cardiology Department, CHU de Montpellier,
Montpellier, France
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND: Experimental and clinical evidence supports the role of
inflammation in atherosclerosis and its complications. Colchicine is an
orally administered, potent anti-inflammatory medication that is indicated
for the treatment of gout and pericarditis. <br/>METHOD(S): We performed a
randomized, double-blind trial involving patients recruited within 30 days
after a myocardial infarction. The patients were randomly assigned to
receive either low-dose colchicine (0.5 mg once daily) or placebo. The
primary efficacy end point was a composite of death from cardiovascular
causes, resuscitated cardiac arrest, myocardial infarction, stroke, or
urgent hospitalization for angina leading to coronary revascularization.
The components of the primary end point and safety were also assessed.
<br/>RESULT(S): A total of 4745 patients were enrolled; 2366 patients were
assigned to the colchicine group, and 2379 to the placebo group. Patients
were followed for a median of 22.6 months. The primary end point occurred
in 5.5% of the patients in the colchicine group, as compared with 7.1% of
those in the placebo group (hazard ratio, 0.77; 95% confidence interval
[CI], 0.61 to 0.96; P = 0.02). The hazard ratios were 0.84 (95% CI, 0.46
to 1.52) for death from cardiovascular causes, 0.83 (95% CI, 0.25 to 2.73)
for resuscitated cardiac arrest, 0.91 (95% CI, 0.68 to 1.21) for
myocardial infarction, 0.26 (95% CI, 0.10 to 0.70) for stroke, and 0.50
(95% CI, 0.31 to 0.81) for urgent hospitalization for angina leading to
coronary revascularization. Diarrhea was reported in 9.7% of the patients
in the colchicine group and in 8.9% of those in the placebo group (P =
0.35). Pneumonia was reported as a serious adverse event in 0.9% of the
patients in the colchicine group and in 0.4% of those in the placebo group
(P = 0.03). <br/>CONCLUSION(S): Among patients with a recent myocardial
infarction, colchicine at a dose of 0.5 mg daily led to a significantly
lower risk of ischemic cardiovascular events than placebo.<br/>Copyright
&#xa9; 2019 Massachusetts Medical Society.

<54>
Accession Number
630337640
Title
Pre-operative sildenafil for patients with pulmonary hypertension
undergoing mitral valve surgery: A systematic review and meta-analysis.
Source
Cardiology Research. 10 (6) (pp 369-377), 2019. Date of Publication: 2019.
Author
Villanueva D.L.E.; Agustin R.D.; Llanes E.J.
Institution
(Villanueva, Agustin, Llanes) Division of Cardiovascular Medicine,
University of the Philippines, Philippine General Hospital, Taft Avenue,
Manila 1000, Philippines
Publisher
Elmer Press (E-mail: production@elmerpress.com)
Abstract
Background: Pulmonary hypertension is a usual complication of
long-standing mitral valve disease. Perioperative pulmonary hypertension
is a risk factor for right ventricular failure and is an important cause
of morbidity and mortality in patients with pulmonary hypertension
undergoing mitral valve surgery. Phosphodiesterase-5 inhibitors
particularly sildenafil citrate have proven clinical benefit for pulmonary
arterial hypertension but have shown discordant results in group 2
pulmonary hypertension patients. We sought to determine the effect of
pre-operative sildenafil on the intra-operative hemodynamic parameters of
these patients. <br/>Method(s): Studies were included if they satisfied
the following criteria: 1) Randomized controlled trials; 2) Adult patients
with pulmonary hypertension scheduled for elective mitral valve surgery;
and 3) Reported data on changes in pre-, intra-, and post-operative
hemodynamic parameters. Using PUBMED, Clinical Key, Science Direct, and
Cochrane databases, a search for eligible studies was conducted from
September 1 to December 31, 2018. The quality of each study was evaluated
using the Cochrane Risk of Bias Tool. The primary outcome of interest is
on the effect of pre-operative sildenafil on the improvement of
intra-operative hemodynamic parameters such as systolic pulmonary artery
pressure (sPAP), mean pulmonary arterial pressure, mean arterial pressure,
pulmonary and systemic vascular resistances. We also investigated its
effect on the post-operative mortality, length of cardiopulmonary bypass
time, ventilation time, and inotrope support requirement. Review Manager
5.3 was utilized to perform analysis of random effects for continuous
outcomes. <br/>Result(s): We identified three studies involving 153
patients with pulmonary hypertension undergoing mitral valve surgery,
showing that among those who received pre-operative sildenafil there is a
significant decrease in intra-operative systolic pulmonary arterial
pressure (mean difference -11.19 (95% confidence interval (CI), -20.23 to
-2.15), P < 0.05) and post-operative sPAP (mean difference -13.67 (95% CI,
- 19.56 to - 7.78), P < 0.05) without significantly affecting the mean
arterial pressure (mean difference 1.94 (95% CI, -5.49 to 9.37), P <
0.05). The systemic and pulmonary vascular resistances were not affected
as well. <br/>Conclusion(s): Administration of pre-operative sildenafil to
patients with pulmonary hypertension undergoing mitral valve surgery
decreases intra-operative and post-operative systolic pulmonary arterial
pressure without significantly affecting other systemic hemodynamic
parameters.<br/>Copyright &#xa9; The authors.

<55>
Accession Number
630626609
Title
Association of Clinical Outcomes With Left Ventricular Assist Device Use
by Bridge to Transplant or Destination Therapy Intent: The Multicenter
Study of MagLev Technology in Patients Undergoing Mechanical Circulatory
Support Therapy With HeartMate 3 (MOMENTUM 3) Randomized Clinical Trial.
Source
JAMA cardiology. (no pagination), 2020. Date of Publication: 15 Jan 2020.
Author
Goldstein D.J.; Naka Y.; Horstmanshof D.; Ravichandran A.K.; Schroder J.;
Ransom J.; Itoh A.; Uriel N.; Cleveland J.C.; Raval N.Y.; Cogswell R.;
Suarez E.E.; Lowes B.D.; Kim G.; Bonde P.; Sheikh F.H.; Sood P.; Farrar
D.J.; Mehra M.R.
Institution
(Goldstein) Montefiore Einstein Center for Heart and Vascular Care, NY
(Naka, Uriel) Columbia University College of Physicians and Surgeons, New
York-Presbyterian Hospital, NY
(Horstmanshof) INTEGRIS Baptist Medical Center, Oklahoma City, OK, United
States
(Ravichandran) St Vincent Heart Center, Indianapolis, IN, United States
(Schroder) Duke University Medical Center, Durham, NC
(Ransom) Baptist Health Medical Center, Little Rock, AR
(Itoh) Washington University School of Medicine, St Louis, MO, United
States
(Cleveland) University of Colorado School of Medicine, Aurora, United
States
(Raval) Advent Health Transplant Institute, Orlando, FL, United States
(Cogswell) University of Minnesota, Minneapolis, United States
(Suarez) Houston Methodist Hospital, Houston, TX
(Lowes) University of Nebraska Medical Center, Omaha, United States
(Kim) Pritzker School of Medicine, University of Chicago, Chicago, IL,
Mexico
(Kim) University of Chicago Medical Center, Chicago, IL, Mexico
(Bonde) Yale Medical School, New Haven, CT, United States
(Sheikh) MedStar Washington Hospital Center, DC, WA
(Sood, Farrar) Abbott Laboratories, Abbott Park, IL
(Mehra) Heart and Vascular Center, Center for Advanced Heart Disease,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Publisher
NLM (Medline)
Abstract
Importance: Left ventricular assist devices (LVADs) are well established
in the treatment of advanced heart failure, but it is unclear whether
outcomes are different based on the intended goal of therapy in patients
who are eligible vs ineligible for heart transplant. <br/>Objective(s): To
determine whether clinical outcomes in the Multicenter Study of MagLev
Technology in Patients Undergoing Mechanical Circulatory Support Therapy
With HeartMate 3 (MOMENTUM 3) trial differed by preoperative categories of
bridge to transplant (BTT) or bridge to transplant candidacy (BTC) vs
destination therapy (DT). <br/>Design, Setting, and Participant(s): This
study was a prespecified secondary analysis of the MOMENTUM 3 trial, a
multicenter randomized clinical trial comparing the magnetically levitated
centrifugal-flow HeartMate 3 (HM3) LVAD to the axial-flow HeartMate II
(HMII) pump. It was conducted in 69 centers with expertise in managing
patients with advanced heart failure in the United States. Patients with
advanced heart failure were randomized to an LVAD, irrespective of the
intended goal of therapy (BTT/BTC or DT). <br/>Main Outcomes and Measures:
The primary end point was survival free of disabling stroke or reoperation
to remove or replace a malfunctioning device at 2 years. Secondary end
points included adverse events, functional status, and quality of life.
<br/>Result(s): Of the 1020 patients with implants (515 with HM3 devices
[50.5%] and 505 with HMII devices [49.5%]), 396 (38.8%) were in the
BTT/BTC group (mean [SD] age, 55 [12] years; 310 men [78.3%]) and 624
(61.2%) in the DT group (mean [SD] age, 63 [12] years; 513 men [82.2%]).
Of the patients initially deemed as transplant ineligible, 84 of 624
patients (13.5%) underwent heart transplant within 2 years of LVAD
implant. In the primary end point analysis, HM3 use was superior to HMII
use in patients in the BTT/BTC group (76.8% vs 67.3% for survival free of
disabling stroke and reoperation; hazard ratio, 0.62 [95% CI, 0.40-0.94];
log-rank P=.02) and patients in the DT group (73.2% vs 58.7%; hazard
ratio, 0.61 [95% CI, 0.46-0.81]; log-rank P<.001). For patients in both
BTT/BTC and DT groups, there were not significantly different reductions
in rates of pump thrombosis, stroke, and gastrointestinal bleeding with
HM3 use relative to HMII use. Improvements in quality of life and
functional capacity for either pump were not significantly different
regardless of preimplant strategy. <br/>Conclusions and Relevance: In this
trial, the superior treatment effect of HM3 over HMII was similar for
patients in the BTT/BTC or DT groups. It is possible that use of arbitrary
categorizations based on current or future transplant eligibility should
be clinically abandoned in favor of a single preimplant strategy: to
extend the survival and improve the quality of life of patients with
medically refractory heart failure. Trial Registration: ClinicalTrials.gov
identifier: NCT02224755.

<56>
[Use Link to view the full text]
Accession Number
630625323
Title
Postoperative Pain and Analgesic Requirements in the First Year after
Intraoperative Methadone for Complex Spine and Cardiac Surgery.
Source
Anesthesiology. 132 (2) (pp 330-342), 2020. Date of Publication: 01 Feb
2020.
Author
Murphy G.S.; Avram M.J.; Greenberg S.B.; Shear T.D.; Deshur M.A.;
Dickerson D.; Bilimoria S.; Benson J.; Maher C.E.; Trenk G.J.; Teister
K.J.; Szokol J.W.
Institution
(Murphy) From the Department of Anesthesiology, NorthShore University
HealthSystem, University of Chicago Pritzker School of Medicine, Evanston,
Illinois (G.S.M., S.B.G., T.D.S., M.A.D., D.D., S.B., J.B., C.E.M.,
G.J.T., K.J.T., J.W.S.) the Department of Anesthesiology, Northwestern
University Feinberg School of Medicine, Chicago, Illinois (M.J.A.)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Methadone is a long-acting opioid that has been reported to
reduce postoperative pain scores and analgesic requirements and may
attenuate development of chronic postsurgical pain. The aim of this
secondary analysis of two previous trials was to follow up with patients
who had received a single intraoperative dose of either methadone or
traditional opioids for complex spine or cardiac surgical procedures.
<br/>METHOD(S): Preplanned analyses of long-term outcomes were conducted
for spinal surgery patients randomized to receive 0.2 mg/kg methadone at
the start of surgery or 2 mg hydromorphone at surgical closure, and for
cardiac surgery patients randomized to receive 0.3 mg/kg methadone or 12
mug/kg fentanyl intraoperatively. A pain questionnaire assessing the
weekly frequency (the primary outcome) and intensity of pain was mailed to
subjects 1, 3, 6, and 12 months after surgery. Ordinal data were compared
with the Mann-Whitney U test, and nominal data were compared using the
chi-square test or Fisher exact probability test. The criterion for
rejection of the null hypothesis was P < 0.01. <br/>RESULT(S): Three
months after surgery, patients randomized to receive methadone for spine
procedures reported the weekly frequency of chronic pain was less (median
score 0 on a 0 to 4 scale [less than once a week] vs. 3 [daily] in the
hydromorphone group, P = 0.004). Patients randomized to receive methadone
for cardiac surgery reported the frequency of postsurgical pain was less
at 1 month (median score 0) than it was in patients randomized to receive
fentanyl (median score 2 [twice per week], P = 0.004). <br/>CONCLUSION(S):
Analgesic benefits of a single dose of intraoperative methadone were
observed during the first 3 months after spinal surgery (but not at 6 and
12 months), and during the first month after cardiac surgery, when the
intensity and frequency of pain were the greatest.

<57>
Accession Number
2004621435
Title
Percutaneous coronary angioplasty versus coronary artery bypass grafting
in the treatment of unprotected left main stenosis: updated 5-year
outcomes from the randomised, non-inferiority NOBLE trial.
Source
The Lancet. 395 (10219) (pp 191-199), 2020. Date of Publication: 18 - 24
January 2020.
Author
Holm N.R.; Makikallio T.; Lindsay M.M.; Spence M.S.; Erglis A.; Menown
I.B.A.; Trovik T.; Kalinauskas G.; Nielsen P.H.; Niemela M.; Lassen J.F.;
Oldroyd K.; Stradins P.; Walsh S.J.; Graham A.N.J.; Endresen P.C.; Frobert
O.; Trivedi U.; Hildick-Smith D.; Thuesen L.; Christiansen E.H.; Lindsay
M.; Eskola M.; Romppanen H.; Kellerth T.; Jensen L.O.; Linder R.B.A.;
Pentikainen M.; Hervold A.; Banning A.; Zaman A.; Cotton J.; Eriksen E.;
Margus S.; Mogensen L.J.H.; Kervinen K.; Berg G.; Hanratty C.G.; Kumsars
I.; Steigen T.K.; Graham A.N.; Corbascio M.; Kajander O.; Hartikainen J.;
Anttila V.
Institution
(Holm, Mogensen, Christiansen) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
(Nielsen) Department of Cardiac Surgery, Aarhus University Hospital,
Aarhus, Denmark
(Makikallio, Niemela) Department of Cardiology, Oulu University Hospital,
Oulu, Finland
(Anttila) Department of Cardiac Surgery, Oulu University Hospital, Oulu,
Finland
(Lindsay, Oldroyd) Department of Cardiology, Golden Jubilee National
Hospital, Clydebank, United Kingdom
(Berg) Department of Cardiac Surgery, Golden Jubilee National Hospital,
Clydebank, United Kingdom
(Spence, Walsh, Graham) Belfast Heart Centre, Belfast Trust, Belfast,
United Kingdom
(Erglis, Stradins) Latvia Centre of Cardiology, Paul Stradins Clinical
Hospital, Riga, Latvia
(Menown) Craigavon Cardiac Centre, Craigavon, United Kingdom
(Trovik) Department of Cardiology, University Hospital of North Norway,
Tromso, Norway
(Endresen) Department of Cardiovascular Surgery, University Hospital of
North Norway, Tromso, Norway
(Kellerth, Frobert) Department of Cardiology, Faculty of Health, Orebro
University, Orebro, Sweden
(Kalinauskas) Vilnius University, Clinic of Cardiac and Vascular Diseases,
Vilnius, Lithuania
(Lassen) Department of Cardiology, Odense University Hospital, Odense,
Denmark
(Trivedi, Hildick-Smith) Sussex Cardiac Centre, Brighton and Sussex
University Hospital, Brighton, United Kingdom
(Thuesen) Department of Cardiology, Aalborg University Hospital, Aalborg,
Denmark
Publisher
Lancet Publishing Group (E-mail: cususerv@lancet.com)
Abstract
Background: Percutaneous coronary intervention (PCI) is increasingly used
in revascularisation of patients with left main coronary artery disease in
place of the standard treatment, coronary artery bypass grafting (CABG).
The NOBLE trial aimed to evaluate whether PCI was non-inferior to CABG in
the treatment of left main coronary artery disease and reported outcomes
after a median follow-up of 3.1 years. We now report updated 5-year
outcomes of the trial. <br/>Method(s): The prospective, randomised,
open-label, non-inferiority NOBLE trial was done at 36 hospitals in nine
northern European countries. Patients with left main coronary artery
disease requiring revascularisation were enrolled and randomly assigned
(1:1) to receive PCI or CABG. The primary endpoint was major adverse
cardiac or cerebrovascular events (MACCE), a composite of all-cause
mortality, non-procedural myocardial infarction, repeat revascularisation,
and stroke. Non-inferiority of PCI to CABG was defined as the upper limit
of the 95% CI of the hazard ratio (HR) not exceeding 1.35 after 275 MACCE
had occurred. Secondary endpoints included all-cause mortality,
non-procedural myocardial infarction, and repeat revascularisation.
Outcomes were analysed in the intention-to-treat population. This trial is
registered with ClinicalTrials.gov, NCT01496651. <br/>Finding(s): Between
Dec 9, 2008, and Jan 21, 2015, 1201 patients were enrolled and allocated
to PCI (n=598) or CABG (n=603), with 17 subsequently lost to early
follow-up. 592 patients in each group were included in this analysis. At a
median of 4.9 years of follow-up, the predefined number of events was
reached for adequate power to assess the primary endpoint. Kaplan-Meier
5-year estimates of MACCE were 28% (165 events) for PCI and 19% (110
events) for CABG (HR 1.58 [95% CI 1.24-2.01]); the HR exceeded the limit
for non-inferiority of PCI compared to CABG. CABG was found to be superior
to PCI for the primary composite endpoint (p=0.0002). All-cause mortality
was estimated in 9% after PCI versus 9% after CABG (HR 1.08 [95% CI
0.74-1.59]; p=0.68); non-procedural myocardial infarction was estimated in
8% after PCI versus 3% after CABG (HR 2.99 [95% CI 1.66-5.39]; p=0.0002);
and repeat revascularisation was estimated in 17% after PCI versus 10%
after CABG (HR 1.73 [95% CI 1.25-2.40]; p=0.0009). <br/>Interpretation(s):
In revascularisation of left main coronary artery disease, PCI was
associated with an inferior clinical outcome at 5 years compared with
CABG. Mortality was similar after the two procedures but patients treated
with PCI had higher rates of non-procedural myocardial infarction and
repeat revascularisation. <br/>Funding(s): Biosensors.<br/>Copyright
&#xa9; 2020 Elsevier Ltd

<58>
Accession Number
2004065819
Title
Clinical and radiological outcome of non-surgical management of thoracic
and lumbar spinal fracture-dislocations - a historical analysis in the era
of modern spinal surgery.
Source
Journal of Spinal Cord Medicine. 43 (1) (pp 3-9), 2020. Date of
Publication: 02 Jan 2020.
Author
Joaquim A.F.; Schroeder G.D.; Patel A.A.; Vaccaro A.R.
Institution
(Joaquim) Neurosurgery Division, State University of Campinas,
Campinas-SP, Brazil
(Schroeder, Vaccaro) Department of Orthopaedic Surgery and Neurosurgery at
Thomas Jefferson University, Philadelphia, PA, United States
(Patel) Department of Orthopaedic Surgery, Northwestern University
Feinberg School of Medicine, Chicago, IL, United States
Publisher
Taylor and Francis Ltd. (E-mail: michael.wagreich@univie.ac.at)
Abstract
Context: It is well established that traumatic spinal dislocations (AO
Type C injuries) should be surgically treated. However, no recent
comparative study of surgical versus non-surgical management of type C
injuries was found attesting the superiority of surgical treatment.
<br/>Objective(s): Due to the lack of information about the natural
history of non-surgical management of type C injuries, we evaluated the
outcome of historical conservative treatment of type C injuries.
<br/>Method(s): An extensive manual search of articles was performed in
the Pubmed Database. We included articles that reported the clinical and/
or the radiological outcome of non-surgical management of thoracic and/ or
lumbar spinal fracture-dislocations. <br/>Result(s): Three well described
retrospective studies where fracture-dislocations of the thoracolumbar
spine were managed non-surgically were included. Non-surgical management
typically consisted in postural reduction and prolonged bed rest (about
10-13 weeks on average). Residual deformity was common, and some studies
reported a high rate of post treatment pain syndromes. Some studies
reported surgery for gibbus deformity after conservative treatment or
persistent instability requiring further bed rest. Neurological
deterioration was rare, and some patients had some improvement, although
the vast majority of the patients had persistent, severe neurological
deficits. <br/>Conclusion(s): Compared with historical non-surgical care,
surgery for type C injuries decreases the chances of post-operative pain,
late spinal deformity and also allowed early rehabilitation, once no bed
restriction is necessary. Ethical issues based on this historical analysis
may preclude performing a comparative study of non-surgical versus
surgical management of these injuries in the modern spine
era.<br/>Copyright &#xa9; 2018, &#xa9; The Academy of Spinal Cord Injury
Professionals, Inc. 2018.

<59>
Accession Number
630568718
Title
Early surgery or conservative care for asymptomatic aortic stenosis.
Source
New England Journal of Medicine. 382 (2) (pp 111-119), 2020. Date of
Publication: 09 Jan 2020.
Author
Kang D.-H.; Park S.-J.; Lee S.-A.; Lee S.; Kim D.-H.; Kim H.-K.; Yun
S.-C.; Hong G.-R.; Song J.-M.; Chung C.-H.; Song J.-K.; Lee J.-W.; Park
S.-W.
Institution
(Kang, Lee, Lee, Kim, Song, Song) Division of Cardiology, Sungkyunkwan
University, School of Medicine, Seoul, South Korea
(Chung, Lee) Department of Cardiothoracic Surgery, Sungkyunkwan
University, School of Medicine, Seoul, South Korea
(Yun) Department of Biostatistics, Sungkyunkwan University, School of
Medicine, Seoul, South Korea
(Park, Park) Asan Medical Center, College of Medicine, University of
Ulsan, Division of Cardiology, Samsung Medical Center, Sungkyunkwan
University, School of Medicine, Seoul, South Korea
(Hong) Division of Cardiology, Severance Hospital, Seoul, South Korea
(Kim) Cardiovascular Center, Seoul National University Hospital, Seoul,
South Korea
(Kang) Division of Cardiology, Asan Medical Center, College of Medicine,
University of Ulsan, 388-1, Poongnap-dong, Songpa-gu, Seoul, South Korea
(Park) Heart Vascular Stroke Institute, Samsung Medical Center,
Sungkyunkwan University, School of Medicine, 81 Irwon-ro, Gangnam-gu,
Seoul, South Korea
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND: The timing and indications for surgical intervention in
asymptomatic patients with severe aortic stenosis remain controversial.
<br/>METHOD(S): In a multicenter trial, we randomly assigned 145
asymptomatic patients with very severe aortic stenosis (defined as an
aortic-valve area of <=0.75 cm² with either an aortic jet
velocity of >=4.5 m per second or a mean transaortic gradient of >=50 mm
Hg) to early surgery or to conservative care according to the
recommendations of current guidelines. The primary end point was a
composite of death during or within 30 days after surgery (often called
operative mortality) or death from cardiovascular causes during the entire
follow-up period. The major secondary end point was death from any cause
during follow-up. <br/>RESULT(S): In the early-surgery group, 69 of 73
patients (95%) underwent surgery within 2 months after randomization, and
there was no operative mortality. In an intention-to-treat analysis, a
primary end-point event occurred in 1 patient in the early-surgery group
(1%) and in 11 of 72 patients in the conservative-care group (15%) (hazard
ratio, 0.09; 95% confidence interval [CI], 0.01 to 0.67; P=0.003). Death
from any cause occurred in 5 patients in the early-surgery group (7%) and
in 15 patients in the conservative-care group (21%) (hazard ratio, 0.33;
95% CI, 0.12 to 0.90). In the conservative-care group, the cumulative
incidence of sudden death was 4% at 4 years and 14% at 8 years.
<br/>CONCLUSION(S): Among asymptomatic patients with very severe aortic
stenosis, the incidence of the composite of operative mortality or death
from cardiovascular causes during the follow-up period was significantly
lower among those who underwent early aortic-valve replacement surgery
than among those who received conservative care.<br/>Copyright &#xa9; 2019
Massachusetts Medical Society.

<60>
Accession Number
630568712
Title
A controlled trial of rivaroxaban after transcatheter aortic-valve
replacement.
Source
New England Journal of Medicine. 382 (2) (pp 120-129), 2020. Date of
Publication: 09 Jan 2020.
Author
Dangas G.D.; Tijssen J.G.P.; Wohrle J.; Sondergaard L.; Gilard M.;
Mollmann H.; Makkar R.R.; Herrmann H.C.; Giustino G.; Baldus S.; de Backer
O.; Guimaraes A.H.C.; Gullestad L.; Kini A.; von Lewinski D.; Mack M.;
Moreno R.; Schafer U.; Seeger J.; Tchetche D.; Thomitzek K.; Valgimigli
M.; Vranckx P.; Welsh R.C.; Wildgoose P.; Volkl A.A.; Zazula A.; van
Amsterdam R.G.M.; Mehran R.; Windecker S.
Institution
(Dangas, Giustino, Kini, Mehran) Zena and Michael A. Wiener Cardiovascular
Institute, Icahn School of Medicine, Mount Sinai, NY, United States
(Dangas) National and Kapodistrian University of Athens, Athens, Greece
(Tijssen) Amsterdam University Medical Centers-University of Amsterdam,
Amsterdam, Netherlands
(Tijssen, Guimaraes, van Amsterdam) Cardialysis, Academic Research
Organization, Rotterdam, Netherlands
(Wohrle, Seeger) Department of Internal Medicine II, University of Ulm,
Ulm, Germany
(Mollmann) Department of Internal Medicine I, St. Johannes Hospital
Dortmund, Dortmund, Germany
(Baldus) Department of Internal Medicine III, Heart Center, University
Hospital of Cologne, Cologne, Germany
(Schafer) Department of General and Interventional Cardiology, University
Hospital Hamburg-Eppendorf, Hamburg, Germany
(Thomitzek) Bayer, Berlin, Germany
(Sondergaard, de Backer) Heart Center, Rigshospitalet, University of
Copenhagen, Copenhagen, Denmark
(Gilard) La Cavale Blanche University Hospital, Cardiology Department,
Brest, France
(Tchetche) Clinique Pasteur, Toulouse, France
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
United States
(Herrmann) University of Pennsylvania, Philadelphia, United States
(Gullestad) Department of Cardiology, Oslo University Hospital
Rikshospitalet, Institute of Clinical Medicine, University of Oslo, Oslo,
Norway
(von Lewinski) Department of Cardiology, Medical University of Graz, Graz,
Austria
(Mack) Baylor Scott and White Health, Temple, TX, United States
(Moreno) Department of Cardiology, University Hospital of La Paz, Hospital
La Paz Institute for Health Research, Madrid, Spain
(Valgimigli, Windecker) Department of Cardiology, Inselspital, Bern
University Hospital, University of Bern, Bern, Switzerland
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Faculty of Medicine and Life Sciences, University of Hasselt,
Hasselt, Belgium
(Welsh) Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, Canada
(Wildgoose, Volkl) Janssen Pharmaceuticals, Titusville, NJ, United States
(Zazula) Bayer, Sao Paulo, Brazil
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Whether the direct factor Xa inhibitor rivaroxaban can prevent
thromboembolic events after transcatheter aortic-valve replacement (TAVR)
is unclear. METHODS We randomly assigned 1644 patients without an
established indication for oral anticoagulation after successful TAVR to
receive rivaroxaban at a dose of 10 mg daily (with aspirin at a dose of 75
to 100 mg daily for the first 3 months) (rivaroxaban group) or aspirin at
a dose of 75 to 100 mg daily (with clopidogrel at a dose of 75 mg daily
for the first 3 months) (antiplatelet group). The primary efficacy outcome
was the composite of death or thromboembolic events. The primary safety
outcome was major, disabling, or life-threatening bleeding. The trial was
terminated prematurely by the data and safety monitoring board because of
safety concerns. RESULTS After a median of 17 months, death or a first
thromboembolic event (intention-to-treat analysis) had occurred in 105
patients in the rivaroxaban group and in 78 patients in the antiplatelet
group (incidence rates, 9.8 and 7.2 per 100 person-years, respectively;
hazard ratio with rivaroxaban, 1.35; 95% confidence interval [CI], 1.01 to
1.81; P=0.04). Major, disabling, or life-threatening bleeding
(intention-to-treat analysis) had occurred in 46 and 31 patients,
respectively (4.3 and 2.8 per 100 person-years; hazard ratio, 1.50; 95%
CI, 0.95 to 2.37; P=0.08). A total of 64 deaths occurred in the
rivaroxaban group and 38 in the antiplatelet group (5.8 and 3.4 per 100
person-years, respectively; hazard ratio, 1.69; 95% CI, 1.13 to 2.53).
CONCLUSIONS In patients without an established indication for oral
anticoagulation after successful TAVR, a treatment strategy including
rivaroxaban at a dose of 10 mg daily was associated with a higher risk of
death or thromboembolic complications and a higher risk of bleeding than
an antiplatelet-based strategy.<br/>Copyright &#xa9; 2019 Massachusetts
Medical Society.

<61>
Accession Number
630520784
Title
Advances in transcatheter mitral and tricuspid therapies.
Source
BMC Cardiovascular Disorders. 20 (1) (no pagination), 2020. Article
Number: 1. Date of Publication: 07 Jan 2020.
Author
Overtchouk P.; Piazza N.; Granada J.; Soliman O.; Prendergast B.; Modine
T.
Institution
(Overtchouk) Department of Cardiology, University Hospital of Bern, Bern,
Switzerland
(Overtchouk, Piazza) Interventional Cardiology, McGill University, Health
Centre, 1001 Boulevard Decarie, Montreal, QC H4A 3J1, Canada
(Granada) Cardiovascular Research Foundation, Columbia University Medical
Center, CRF Skirball Center for Innovation, New York, United States
(Soliman) Thoraxcenter, Erasmus University, Medical Center Rotterdam,
Medical Director Structural Heart and Heart Failure Research, Cardialysis,
Rotterdam, Netherlands
(Soliman) Department of Cardiology, University Hospital of Antwerp,
Antwerp, Belgium
(Prendergast) Department of Cardiology, St Thomas' Hospital, London,
United Kingdom
(Modine) Cardiology and Cardiovascular Surgery Department, Heart Valve
Center, Institut Coeur Poumon, CHU de Lille, 2 Av Oscar Lambret, Lille
59037, France
(Modine) Jioa Tong University, Shanghai, China
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: While rheumatic mitral stenosis has been effectively treated
percutaneously for more than 20 years, mitral and tricuspid regurgitation
treatment appear as a contemporary unmet need. The advent of transcatheter
therapies offer new treatment options to often elderly and frail patients
at high risk for open surgery. We aimed at providing an updated review of
fast-growing domain of transcatheter mitral and tricuspid technology. Main
body: We reviewed the existing literature on mitral and tricuspid
transcatheter therapies. Mitraclip is becoming an established therapy for
secondary mitral regurgitation in selected patients with
disproportionately severe regurgitation associated with moderate left
ventricle dysfunction. Evidence is less convincing for primary mitral
regurgitation. Transcatheter mitral valve replacement is a promising
emerging alternative to transcatheter repair, for secondary as well as
primary mitral regurgitation. But further development is needed to improve
delivery. Transcatheter tricuspid intervention arrives late after similar
technologies have been developed for aortic and mitral valves and is
currently at its infancy. This is likely due in part to previously
under-recognized impact of tricuspid regurgitation on patient outcomes.
Edge-to-edge repair is the most advanced transcatheter solution in
development. Data on tricuspid annuloplasty and replacement is limited,
and more research is warranted. <br/>Conclusion(s): The future appears
bright for transcatheter mitral therapies, albeit their place in clinical
practice is yet to be clearly defined. Tricuspid transcatheter therapies
might address the unmet need of tricuspid regurgitation
treatment.<br/>Copyright &#xa9; 2019 The Author(s).

<62>
Accession Number
2004065140
Title
Clinical Prediction Models for Valvular Heart Disease.
Source
Journal of the American Heart Association. 8 (20) (no pagination), 2019.
Article Number: e011972. Date of Publication: 15 Oct 2019.
Author
Wessler B.S.; Lundquist C.M.; Koethe B.; Park J.G.; Brown K.; Williamson
T.; Ajlan M.; Natto Z.; Lutz J.S.; Paulus J.K.; Kent D.M.
Institution
(Wessler, Lundquist, Koethe, Park, Brown, Williamson, Ajlan, Lutz, Paulus,
Kent) Predictive Analytics and Comparative Effectiveness (PACE) Center,
Institute for Clinical Research and Health Policy Studies (ICRHPS), Tufts
Medical Center, Boston, MA, United States
(Wessler) Division of Cardiology, Tufts Medical Center, Boston, MA, United
States
(Natto) Department of Dental Public Health, Faculty of Dentistry, King
Abdulaziz University, Jeddah, Saudi Arabia
Publisher
American Heart Association Inc.
Abstract
Background: While many clinical prediction models (CPMs) exist to guide
valvular heart disease treatment decisions, the relative performance of
these CPMs is largely unknown. We systematically describe the CPMs
available for patients with valvular heart disease with specific attention
to performance in external validations. <br/>Methods and Results: A
systematic review identified 49 CPMs for patients with valvular heart
disease treated with surgery (n=34), percutaneous interventions (n=12), or
no intervention (n=3). There were 204 external validations of these CPMs.
Only 35 (71%) CPMs have been externally validated. Sixty-five percent
(n=133) of the external validations were performed on distantly related
populations. There was substantial heterogeneity in model performance and
a median percentage change in discrimination of -27.1% (interquartile
range, -49.4%--5.7%). Nearly two-thirds of validations (n=129) demonstrate
at least a 10% relative decline in discrimination. Discriminatory
performance of EuroSCORE II and Society of Thoracic Surgeons (2009) models
(accounting for 73% of external validations) varied widely: EuroSCORE II
validation c-statistic range 0.50 to 0.95; Society of Thoracic Surgeons
(2009) Models validation c-statistic range 0.50 to 0.86. These models
performed well when tested on related populations (median related
validation c-statistics: EuroSCORE II, 0.82 [0.76, 0.85]; Society of
Thoracic Surgeons [2009], 0.72 [0.67, 0.79]). There remain few (n=9)
external validations of transcatheter aortic valve replacement CPMs.
<br/>Conclusion(s): Many CPMs for patients with valvular heart disease
have never been externally validated and isolated external validations
appear insufficient to assess the trustworthiness of predictions. For
surgical valve interventions, there are existing predictive models that
perform reasonably well on related populations. For transcatheter aortic
valve replacement (CPMs additional external validations are needed to
broadly understand the trustworthiness of predictions.<br/>Copyright
&#xa9; 2019 The Authors. Published on behalf of the American Heart
Association, Inc., by Wiley.

<63>
Accession Number
2002467081
Title
Impact of telephone follow-up and 24/7 hotline on 30-day readmission rates
following aortic valve replacement -A randomized controlled trial.
Source
International Journal of Cardiology. 300 (pp 66-72), 2020. Date of
Publication: 1 February 2020.
Author
Danielsen S.O.; Moons P.; Sandvik L.; Leegaard M.; Solheim S.; Tonnessen
T.; Lie I.
Institution
(Danielsen, Lie) Center for Patient-centered Heart and Lung Research,
Department of Cardiothoracic Surgery, Division of Cardiovascular and
Pulmonary Diseases, Oslo University Hospital, Ulleval, Oslo, Norway
(Danielsen, Tonnessen) Institute of Clinical Medicine, Faculty of
Medicine, University of Oslo, Oslo, Norway
(Danielsen, Moons) KU Leuven Department of Public Health and Primary Care,
KU Leuven-University of Leuven, Leuven, Belgium
(Moons) Institute of Health and Care Sciences, University of Gothenburg,
Gothenburg, Sweden
(Moons) Department of Paediatrics and Child Health, University of Cape
Town, South Africa
(Sandvik) Oslo Centre of Biostatistics and Epidemiology, Oslo University
Hospital, Oslo, Norway
(Tonnessen) Department of Cardiothoracic Surgery, Division of
Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Ulleval,
Oslo, Norway
(Solheim) Center for Clinical Heart Research, Department of Cardiology,
Division of Medicine, Oslo University Hospital, Ulleval, Oslo, Norway
(Leegaard) Department of Nursing and Health Promotion, Faculty of Health
Sciences, Oslo Metropolitan University, Oslo, Norway
Publisher
Elsevier Ireland Ltd
Abstract
Background: Thirty-day all-cause readmissions are high after aortic valve
replacement (AVR). We aimed to assess the effectiveness of a structured
telephone follow-up (TFU) and a 24/7 hotline on reducing 30-day all-cause
readmission (30-DACR) after AVR, on reducing symptoms of anxiety and
depression and on improving perceived health state. <br/>Method(s): A
prospective randomized controlled trial was conducted. Patients (n = 288)
were randomly allocated to either post-discharge usual care or to care
that provided TFU and access to a 24/7 hotline after AVR. Ancillary
endpoints were time-to-event (readmission), proportion of avoidable versus
unavoidable readmissions after AVR, and predictors of 30-DACR after AVR.
<br/>Result(s): 30-DACR was 22.3%. The structured TFU and 24/7 hotline
intervention failed to reduce 30-DACR rates after AVR (P = 0.274).
Symptoms of anxiety were significantly reduced 30 days after surgery (P =
0.031), an effect that did not persist one year after surgery (P = 0.108).
Most readmissions occurred before 15 days post-discharge, and 75% of them
were deemed to be unavoidable. Pleural drainage before hospital discharge
(P = 0.027) and symptoms of anxiety before surgery (P = 0.003) were
predictors of 30-DACR after AVR. <br/>Conclusion(s): The TFU and 24/7
hotline had no effect on reducing 30-DACR after AVR. However, we did
measure reduced symptoms of anxiety the first month after AVR. Anxiety
reduction appeared to be an important target for intervention, because we
found it to be a risk factor for readmission. Future research should focus
on the effectiveness of interventions to prevent avoidable unplanned
readmissions. Trial registration: ClinicalTrial.gov,
NCT02522663.<br/>Copyright &#xa9; 2019 Elsevier B.V.

<64>
Accession Number
2004572825
Title
Fractional flow reserve derived from computed tomography coronary
angiography in the assessment and management of stable chest pain:
Rationale and design of the FORECAST trial.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Mahmoudi M.; Nicholas Z.; Nuttall J.; Bresser M.; Maishman T.; Berry C.;
Hlatky M.A.; Douglas P.; Rajani R.; Fox K.; Curzen N.
Institution
(Mahmoudi, Curzen) Faculty of Medicine, University of Southampton, United
Kingdom
(Nicholas, Curzen) Coronary Research Group, University Hospital
Southampton, Southampton, United Kingdom
(Nuttall, Bresser, Maishman) Clinical Trials Unit, University of
Southampton, Southampton, United Kingdom
(Berry) British Heart Foundation Glasgow Cardiovascular Research Centre,
University of Glasgow, United Kingdom
(Hlatky) Stanford University School of Medicine, Stanford, CA, United
States
(Douglas) Duke University School of Medicine, Durham, NC, United States
(Rajani) Guy's & St Thomas' NHS Trust, London, United Kingdom
(Fox) Imperial College, London, United Kingdom
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Fractional flow reserve measurement based on computed
tomography (FFR<inf>CT</inf>) is a novel, well validated, non-invasive
method for determining the presence and extent of coronary artery disease
(CAD) combined with a physiological assessment of vessel-specific ischemia
in patients with chest pain. Previous studies indicate that
FFR<inf>CT</inf> reduces the uptake of invasive angiography that shows no
significant CAD, without compromising patient safety. The clinical
effectiveness and economic impact of using FFR<inf>CT</inf> instead of
other tests in the initial evaluation of patients with stable chest pain
has not been tested in a randomized trial. <br/>Method(s): The FORECAST
trial will randomise 1400 patients with stable chest pain to receive
either FFR<inf>CT</inf> or routine clinical assessment as directed by the
National Institute for Health and Care Excellence (NICE) CG95 guideline
for Chest Pain of Recent Onset. The primary endpoint will be resource
utilisation over the subsequent nine months, including non-invasive
cardiac investigations, invasive coronary angiography, coronary
revascularization, hospitalization for cardiac events, and the use of
cardiac medications. Key pre-specified secondary endpoints will be major
adverse cardiac events, angina severity, quality of life, patient
satisfaction, time to definitive management plan, time to completion of
initial evaluation, number of hospital attendances, and working days lost
in patients who are in employment. <br/>Conclusion(s): The FORECAST
randomized trial will assess the clinical and economic outcomes of using
FFR<inf>CT</inf> as the primary test to evaluate patients presenting with
stable chest pain.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<65>
Accession Number
629726620
Title
Outcome Measures in Gender-Confirming Chest Surgery: A Systematic Scoping
Review.
Source
Aesthetic plastic surgery. 44 (1) (pp 219-228), 2020. Date of Publication:
01 Feb 2020.
Author
Tolstrup A.; Zetner D.; Rosenberg J.
Institution
(Tolstrup, Zetner, Rosenberg) Centre for Perioperative Optimisation,
Department of Surgery, Herlev Hospital, University of Copenhagen,
Copenhagen, Denmark
Publisher
NLM (Medline)
Abstract
BACKGROUND: The aim of this scoping review was to provide an overview of
outcome measures in gender-confirming chest surgery. <br/>METHOD(S): A
comprehensive literature search was performed in PubMed, EMBASE, CINAHL,
PsycINFO, Scopus and the Cochrane Library to find studies evaluating
gender-confirming chest surgery in a non-cis gender population. The
systematic scoping review followed the PRISMA extension for scoping
reviews. Data were charted for outcome measures including complications,
reoperations, revision surgery, aesthetic outcome and patient-reported
outcome measures. <br/>RESULT(S): Our search yielded 849 records, which
were screened on title, abstract and full text. Of these, 47 were included
in the review. Feminising gender-confirming chest surgery was evaluated in
11 studies, and masculinising gender-confirming chest surgery was
evaluated in 39 studies. Clinician-reported outcome categories were used
in 40 studies and included complications, reoperation, revision surgery
and aesthetic outcome. Categories of patient-reported outcomes were used
in 29 studies and included aesthetic outcome, functional outcome and
mental health parameters. The summary of outcome domains and
classifications showed that there are large variations in outcome
evaluation between studies. Although several studies reported on similar
outcome categories, there was a high level of heterogeneity of domains and
classifications of outcomes. <br/>CONCLUSION(S): Evaluation of outcomes in
gender-confirming chest surgery showed large variations in reporting, and
further streamlining of reporting is therefore required to be able to
compare surgical outcomes between studies. LEVEL OF EVIDENCE III: This
journal requires that authors assign a level of evidence to each article.
For a full description of these Evidence-Based Medicine ratings, please
refer to the Table of Contents or the online Instructions to Authors
www.springer.com/00266.

<66>
[Use Link to view the full text]
Accession Number
630607160
Title
Arterial Grafts for Coronary Bypass: A Critical Review After the
Publication of ART and RADIAL.
Source
Circulation. 140 (15) (pp 1273-1284), 2019. Date of Publication: 08 Oct
2019.
Author
Gaudino M.; Bakaeen F.G.; Benedetto U.; Di Franco A.; Fremes S.; Glineur
D.; Girardi L.N.; Grau J.; Puskas J.D.; Ruel M.; Tam D.Y.; Taggart D.P.
Institution
(Gaudino, Di Franco, Girardi) Department of Cardio-Thoracic Surgery, Weill
Cornell Medicine
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic
(Benedetto) Bristol Heart Institute, University of Bristol, School of
Clinical Sciences
(Fremes, Tam) Schulich Heart Centre, Sunnybrook Health Science, University
of Toronto, ON
(Glineur, Grau, Ruel) Division of Cardiac Surgery, University of Ottawa
Heart Institute, ON
(Puskas) Department of Cardiovascular Surgery, Icahn School of Medicine at
Mount Sinai
(Taggart) Department of Cardiovascular Surgery, University of Oxford
Publisher
NLM (Medline)
Abstract
Observational and randomized evidence shows that arterial grafts have
better patency rates than saphenous vein grafts (SVGs) in coronary artery
bypass grafting. Observational studies suggest that the use of multiple
arterial grafts is associated with longer postoperative survival, but this
must be interpreted in the context of treatment allocation bias and hidden
confounders intrinsic to the study designs. Recently, a pooled analysis of
6 randomized trials comparing the radial artery with the SVG as the second
conduit and the largest randomized trial comparing the use of single and
bilateral internal thoracic arteries have provided apparently divergent
results about a clinical benefit with the use of >1 arterial conduit.
However, both analyses have methodological limitations that may have
influenced their results. At present, it is unclear whether the
well-documented increased patency rate of arterial grafts translates into
clinical benefits in the majority of patients undergoing coronary artery
bypass grafting. A large randomized trial testing the arterial grafts
hypothesis (ROMA [Randomized Comparison of the Clinical Outcome of Single
Versus Multiple Arterial Grafts]) is underway and will report the results
in a few years.

<67>
[Use Link to view the full text]
Accession Number
630600451
Title
Efficacy of paravertebral block techniques in thoracic surgery: Systematic
literature review.
Source
Colombian Journal of Anesthesiology. 48 (1) (pp 20-29), 2020. Date of
Publication: 01 Jan 2020.
Author
Cadavid-Puentes A.M.; Casas-Arroyave F.D.; Palacio-Montoya L.M.;
Valencia-Gallon E.
Institution
(Cadavid-Puentes, Casas-Arroyave) Anesthesiology and Reanimation Division,
Universidad de Antioquia, Hospital Universitario San Vicente Fundacion,
Calle 64 No. 51D-154, Medellin, Colombia
(Palacio-Montoya, Valencia-Gallon) IPS Universitaria, Universidad de
Antioquia, Medellin, Colombia
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Introduction:Postoperative pain in thoracic surgery in adults is usually
severe, and to control it there are many analgesic methods that include
paravertebral blockade (PVB). Until now, there is no clarity on which is
the most effective technique to perform this blockade.
<br/>Objective(s):To describe the different PVB techniques and its
analgesic effect in thoracic surgery. <br/>Method(s):A systematic review
of the literature was performed. We included studies that analyzed
patients in open chest surgery and used PVB as analgesic technique. The
Cochrane and Grading of Recommendation Assessment, Development and
Evaluation strategies were used to analyze biases and evidence. The
results are presented graphically by means of a visual analog scale (VAS)
pain and opioid consumption equivalent to morphine for each technique
found. We summarize the results with a qualitative approach without
meta-analysis. <br/>Result(s):A total of 38 articles were analyzed (2188
patients). 13 using PVB guided by surface anatomy (SA-PVB), 7
Ultrasound-guided PVB (US-PVB), 1 neurostimulation guided PVB (NE-PVB) and
the remaining using PVB performed under direct visualization by the
surgeon (S-PVB). A VAS of less than 3 was found in studies with SA-PVB and
US-PVB, and greater than 5 in studies with S-PVB; however, opioid
consumption in the postoperative period was similar between the techniques
described. <br/>Conclusion(s):PVB can be performed through 4 techniques.
Techniques of US-PVB or SA-PVB have shown better consistency to manage
postoperative acute pain in thoracic surgery.<br/>Copyright &#xa9; 2019
Sociedad Colombiana de Anestesiologia y Reanimacion (S.C.A.R.E.).
Published by Wolters Kluwer.

<68>
Accession Number
2004052081
Title
Baseline left ventricular diastolic dysfunction affects midterm mortality
after transcatheter aortic valve implantation.
Source
Journal of Cardiac Surgery. (no pagination), 2019. Date of Publication:
2019.
Author
Takagi H.; Hari Y.; Nakashima K.; Yokoyama Y.; Ueyama H.; Kuno T.; Ando T.
Institution
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Yokoyama) Department of Surgery, Easton Hospital, Easton, PA, United
States
(Ueyama, Kuno) Department of Medicine, Mount Sinai Beth Israel Medical
Center, New York, NY, United States
(Ando) Division of Interventional Cardiology, Department of Cardiology,
New York Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Objectives: To determine whether preprocedural left ventricular (LV)
diastolic dysfunction impairs midterm mortality after transcatheter aortic
valve implantation (TAVI) for patients with severe aortic stenosis (AS),
we performed a meta-analysis of currently available evidence.
<br/>Method(s): We identified all studies investigating impact of
preprocedural severity of LV diastolic dysfunction on midterm (>=1-year)
all-cause mortality after TAVI for patients with AS through a search of
databases (MEDLINE and EMBASE) until September 2019. From each study, we
extracted an adjusted (if unavailable, unadjusted) hazard ratio (HR) of
midterm mortality. We pooled study-specific estimates in the
random-effects model. <br/>Result(s): Ten eligible studies with a total of
2380 patients with AS undergoing TAVI were identified. In accordance with
pooled analyses, higher-grade preprocedural LV diastolic dysfunction was
associated with significantly worse midterm all-cause mortality after TAVI
compared to lower-grade dysfunction (HR for grade II vs I, 1.15; P =.002;
HR for grade III vs I, 1.35; P =.001; HR for grade III vs II; 1.16, P
=.002; HR for grade II-III vs I, II-III vs 0-I, or III vs I-II, 1.34; P
<.00001 [primary meta-analysis]; HR per grade, 1.16; P =.003). No funnel
plot asymmetry for the primary meta-analysis (for grade II-III vs I,
II-III vs 0-I, or III vs I-II) was identified, which probably indicated no
publication bias (P =.381 by the linear-regression test).
<br/>Conclusion(s): Higher-grade preprocedural LV diastolic dysfunction
was associated with worse midterm all-cause mortality after TAVI for
patients with AS compared to lower-grade dysfunction.<br/>Copyright &#xa9;
2019 Wiley Periodicals, Inc.