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<1>
Accession Number
2004655746
Title
Multi-arterial and total-arterial coronary revascularization: Past,
present, and future perspective.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Torregrossa G.; Amabile A.; Williams E.E.; Fonceva A.; Hosseinian L.;
Balkhy H.H.
Institution
(Torregrossa, Amabile, Fonceva, Balkhy) Division of Cardiac Surgery,
Department of Surgery, University of Chicago Medicine, Chicago, IL, United
States
(Williams) Department of Cardiovascular Surgery, Mount Sinai Hospital, New
York City, NY, United States
(Hosseinian) Department of Anesthesiology and Perioperative Medicine,
Loyola University Medical Center, Chicago, IL, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background and Aim of the Study: Although abundant biological, clinical,
and scientific evidence exists on the superiority of multi-arterial (MAR)
and total-arterial revascularization (TAR) over the conventional strategy
with a single internal thoracic artery, only 10% of patients undergoing
coronary artery bypass grafting (CABG) in the United States receives a
second arterial conduit, and only 5% of patients receives TAR.
 Methods and Results: In January 2020, the authors performed
comprehensive search to identify studies that evaluated MAR and TAR
strategies through the MEDLINE database. Conclusion(s): In this
paper, the authors reviewed the literature on the historical and current
evidence in favor of MAR and TAR, thus underlying why current CABG
practice needs qualitative improvement. Copyright © 2020 Wiley
Periodicals, Inc.

<2>
Accession Number
2004244391
Title
Invasive haemodynamics in de novo everolimus vs. calcineurin inhibitor
heart transplant recipients.
Source
ESC Heart Failure. 7 (2) (pp 567-576), 2020. Date of Publication: 01 Apr
2020.
Author
Bergh N.; Gude E.; Bartfay S.-E.; K Andreassen A.; Arora S.; Dahlberg P.;
Dellgren G.; Gullestad L.; Gustafsson F.; Karasson K.; Radegran G.;
Bollano E.; Andersson B.
Institution
(Bergh, Bartfay, Dahlberg, Bollano, Andersson) Department of Cardiology,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Bergh, Bartfay, Dahlberg, Karasson, Bollano) Institute of Medicine,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Gude, K Andreassen, Arora, Gullestad) Department of Cardiology, Oslo
University Hospital Rikshospitalet, Oslo, Norway
(Gustafsson) Department of Cardiology, Rigshospitalet, University of
Copenhagen, Copenhagen, Denmark
(Radegran) The Section for Heart Failure and Valvular Disease, VO Heart
and Lung Medicine, Skane University Hospital, Lund, Sweden
(Dellgren, Radegran) Department of Clinical Sciences, Lund University,
Lund, SwedenTransplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(K Andreassen, Arora, Gullestad) KG Jebsen Center for Cardiac Research,
University of Oslo, Oslo, Norway
(K Andreassen, Arora, Gullestad) Center for Heart Failure Research, Oslo
University Hospital, Oslo, Norway
(Gullestad) Faculty of Medicine, University of Oslo, Oslo, Norway
Publisher
Wiley-Blackwell (E-mail: info@wiley.com)
Abstract
Aims: Invasive haemodynamic profiles at rest and during exercise after
heart transplantation (HTx) have never been described in a randomized
trial where de novo everolimus (EVR)-based therapy with early calcineurin
inhibitor (CNI) withdrawal has been compared with conventional CNI
treatment. We report central invasive haemodynamic parameters at rest and
exercise during a 3 year follow-up after HTx in a sub-study of the
SCandiavian Heart transplant Everolimus De novo stUdy with earLy
calcineurin inhibitor avoidancE trial. We hypothesized that the
nephroprotective properties, the less development of cardiac allograft
vasculopathy (CAV), and the antifibrotic properties of EVR, in comparison
with CNI-based immunosuppression, would demonstrate favourable invasive
haemodynamic profiles in patients at rest and during exercise.
 Methods and Results: Ninety of 115 HTx recipients randomized to EVR
or CNI treatment performed right heart catheterization at rest and 68
performed right heart catheterization at exercise up to 3 years after HTx.
Haemodynamic profiles were compared between EVR and CNI treatment groups.
Resting haemodynamics improved in both groups from pre-HTx to the first
follow-up at 7-11 weeks post-HTx and thereafter remained unchanged up to 3
years of follow-up. During follow-up, cardiac reserve during exercise
increased with higher levels of maximum heart rate (118 to 148 b.p.m., P <
0.001), mean arterial pressure (103 to 128 mmHg, P < 0.001), and cardiac
output (10.3 to 12.2 l/min, P < 0.001). No significant differences in
haemodynamic parameters were observed between the EVR and CNI groups at
rest or exercise. Isolated post-capillary pulmonary hypertension (mean
pulmonary arterial pressure > 20 mmHg, pulmonary arterial wedge pressure
>= 15 mmHg, and pulmonary vascular resistance <3) were measured in 11% of
the patients at 7-11 weeks, 5% at 12 months, and 6% at 36 months after
HTx. The EVR group had significantly better kidney function (76 mL/min/1
vs. 60 mL/min/1, P < 0.001) and reduced CAV (P < 0.01) but an increased
rate of early biopsy-proven treated rejections (21.2% vs 5.7%, P < 0.01)
compared with the CNI group at any time point. The differences in renal
function, CAV, or early biopsy-proven treated acute rejections were not
associated with altered haemodynamics. Conclusion(s): De novo EVR
treatment with early CNI withdrawal compared with conventional CNI therapy
did not result in differences in haemodynamics at rest or during exercise
up to 3 years after HTx despite significant differences in renal function,
reduced CAV, and number of early biopsy-proven treated
rejections. Copyright © 2020 The Authors. ESC Heart Failure
published by John Wiley & Sons Ltd on behalf of the European Society of
Cardiology

<3>
Accession Number
631522299
Title
Can hypnosis and virtual reality reduce anxiety, pain and fatigue among
patients who undergo cardiac surgery: a randomised controlled trial.
Source
Trials. 21 (1) (pp 330), 2020. Date of Publication: 15 Apr 2020.
Author
Rousseaux F.; Faymonville M.-E.; Nyssen A.-S.; Dardenne N.; Ledoux D.;
Massion P.B.; Vanhaudenhuyse A.
Institution
(Rousseaux, Nyssen) Laboratory of Cognitive Ergonomics and Work
Intervention, University of Liege, Quartier Agora - Place des Orateurs,
Liege 4000, Belgium
(Rousseaux, Faymonville, Vanhaudenhuyse) Algology Department, University
Hospital of Liege, CHU Sart Tilman ,Domaine Universitaire du Sart Tilman
B35, Liege 4000, Belgium
(Rousseaux, Faymonville, Nyssen, Vanhaudenhuyse) Sensation and Perception
Research Group, GIGA Consciousness, University of Liege, GIGA (B34),
Quartier Hopital - Avenue de l'Hopital, 11, 4000, Liege, Belgium
(Dardenne) Public Health Department, Biostatistics, University of Liege,
CHU (B35), Quartier Hopital - Avenue de l'Hopital, 11, 4000, Liege,
Belgium
(Ledoux, Massion) Intensive Care Units, University Hospital of Liege, CHU
(B35), Quartier Hopital - Avenue de l'Hopital, 11, 4000, Liege, Belgium
(Ledoux) Anesthesia & Intensive care, GIGA Consciousness, University of
Liege, GIGA (B34), Quartier Hopital - Avenue de l'Hopital, 11, 4000,
Liege, Belgium
Publisher
NLM (Medline)
Abstract
BACKGROUND: Different non-pharmacological techniques, including hypnosis
and virtual reality (VR) are currently used as complementary tools in the
treatment of anxiety, acute and chronic pain. A new technique called
virtual reality hypnosis (VRH), which encompasses a combination of both
tools, is regularly used although its benefits and underlying mechanisms
remain unknown to date. With the goal to improve our understanding of VRH
combination effects, it is necessary to conduct randomised and controlled
research trials in order to understand their clinical interest and
potential benefits. METHOD(S): Patients (n = 100) undergoing cardiac
surgery at the Liege University Hospital will be randomly assigned to one
of four conditions (control, hypnosis, VR or VRH). Each patient will
receive two sessions of one of the techniques: one the day before the
surgery and one the day after. Physiological assessments will be made on
the monitor and patients will rate their levels of anxiety, fatigue, pain,
absorption and dissociation. DISCUSSION: This study will help to expand
knowledge on the application of virtual reality, hypnosis and VRH in the
specific context of cardiac and intensive care procedures, and the
influence of these non-pharmacological techniques on patient's anxiety,
fatigue, pain and phenomenological experience. TRIAL REGISTRATION:
ClinicalTrials.gov: NCT03820700. Date registered on 29 January 2019. Study
recruitment date: October 6, 2018. Study anticipated completion date:
December 28, 2020.

<4>
Accession Number
627811904
Title
The impact of pre-existing peripheral artery disease on transcatheter
aortic valve implantation outcomes: A systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 95 (5) (pp 993-1000),
2020. Date of Publication: 01 Apr 2020.
Author
Ueshima D.; Barioli A.; Nai Fovino L.; D'Amico G.; Fabris T.; Brener S.J.;
Tarantini G.
Institution
(Ueshima, Barioli, Nai Fovino, D'Amico, Fabris, Tarantini) Cardiology
Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of
Padua Medical School, Padua, Italy
(Brener) Department of Medicine, Cardiac Catheterization Laboratory, New
York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, United States
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background: Peripheral arterial disease (PAD) plays a decisive role in the
preinterventional selection process of the optimal vascular access site in
patients undergoing transcatheter aortic valve implantation (TAVI).
However, the impact of PAD on mortality and vascular complications (VCs)
in TAVI-treated patients remains unclear. Accordingly, we aimed to assess
the outcomes of patients with and without PAD undergoing TAVI, by
performing a meta-regression analysis. Method(s): Studies published
between January 2002 and March 2018 and reporting outcomes according to
the presence of PAD in TAVI patients were identified. Outcome measures
analyzed were short-, mid- and long-term mortality, and peri-procedural
VC. The interaction between sheath size and PAD on outcomes was also
assessed. Result(s): A total of 26 studies (68,581 TAVI patients, of
whom 17,326 with preprocedural PAD) were included in the analysis.
Patients with PAD had higher risk of mortality at short- (HR 1.36, 95%
confidence interval [CI] 1.13-1.63, p =.0009), mid- (HR 1.18, 95% CI
1.08-1.30, p =.0005), and long-term (HR 1.36, 95% CI 1.24-1.48, p <.0001)
follow-up, and higher risk of VC (RR 1.55, 95% CI 1.27; 1.89, p <.0001).
Moreover, the adoption of smaller sheaths during TAVI procedures was
associated with fewer VC both in PAD and non-PAD patients, but the latter
group had a more pronounced benefit. Conclusion(s): Patients with
pre-existent PAD are at increased risk of all-cause mortality and VC after
TAVI. The adoption of smaller sheaths during the procedure seems to be
associated with fewer peri-procedural VC both in PAD and non-PAD
patients. Copyright © 2019 Wiley Periodicals, Inc.

<5>
Accession Number
631522028
Title
Extracorporeal Hemadsorption versus Glucocorticoids during Cardiopulmonary
Bypass: A Prospective, Randomized, Controlled Trial.
Source
Cardiovascular therapeutics. 2020 (pp 7834173), 2020. Date of Publication:
2020.
Author
Taleska Stupica G.; Sostaric M.; Bozhinovska M.; Rupert L.; Bosnic Z.;
Jerin A.; Ihan A.; Klokocovnik T.; Podbregar M.
Institution
(Taleska Stupica, Sostaric, Bozhinovska, Rupert, Podbregar) Clinical
Department of Anaesthesiology and Perioperative Intensive Therapy,
University Medical Centre Ljubljana, Ljubljana, Slovenia
(Sostaric, Podbregar) University of Ljubljana, Faculty of Medicine,
Ljubljana, Slovenia
(Bosnic) University of Ljubljana, Faculty of Computer and Information
Science, Ljubljana, Slovenia
(Jerin) Institute of Clinical Chemistry and Biochemistry, University
Medical Centre Ljubljana, Ljubljana, Slovenia
(Ihan) University of Ljubljana, Faculty of Medicine, Institute of
Microbiology and Immunology, Ljubljana, Slovenia
(Klokocovnik) Clinical Department of Cardio-Vascular Surgery, University
Medical Centre Ljubljana, Ljubljana, Slovenia
(Podbregar) Department of Internal Intensive Medicine, General and
Teaching Hospital, Celje, Slovenia
Publisher
NLM (Medline)
Abstract
Extracorporeal hemadsorption may reduce inflammatory reaction in
cardiopulmonary bypass (CPB) surgery. Glucocorticoids have been used
during open-heart surgery for alleviation of systemic inflammation after
CPB. We compared intraoperative hemadsorption and methylprednisolone, with
usual care, during complex cardiac surgery on CPB, for inflammatory
responses, hemodynamics, and perioperative course. Seventy-six patients
with prolonged CPB were recruited and randomized, with 60 included in
final analysis. Allocation was into three groups: Methylprednisolone
(n=20), Cytosorb (n=20), and Control group (usual care, n=20).
Proinflammatory (TNF-alpha, IL-1beta, IL-6, and IL-8) and
anti-inflammatory (IL-10) cytokines which complement C5a, CD64, and CD163
expression by immune cells were analyzed within the first five
postoperative days, in addition to hemodynamic and clinical outcome
parameters. Methylprednisolone group, compared to Cytosorb and Control had
significantly lower levels of TNF-alpha (until the end of surgery, p <
0.001), IL-6 (until 48h after surgery, p < 0.001), and IL-8 (until 24h
after surgery, p < 0.016). CD64 expression on monocytes was the highest in
the Cytosorb group and lasted until the 5th postoperative day (p < 0.016).
IL-10 concentration (until the end of surgery) and CD163 expression on
monocytes (until 48h after surgery) were the highest in the
Methylprednisolone group (p < 0.016, for all measurements between three
groups). No differences between groups in the cardiac index or clinical
outcome parameters were found. Methylprednisolone more effectively
ameliorates inflammatory responses after CPB surgery compared to
hemadsorption and usual care. Hemadsorption compared with usual care
causes higher prolonged expression of CD64 on monocytes but short lasting
expression of CD163 on granulocytes. Hemadsorption with CytoSorb was safe
and well tolerated. This trial is registered with clinicaltrials.gov
(NCT02666703). Copyright © 2020 Gordana Taleska Stupica et al.

<6>
Accession Number
2005636838
Title
"Beta-blocker exposure for short-term outcomes following non-cardiac
surgery: A meta-analysis of observational studies" Int J Surg. 2020 Mar
10. pii: S1743-9191(20)30206-5. doi: 10.1016/j.ijsu.2020.02.041. [Epub
ahead of print].
Source
International Journal of Surgery. 78 (pp 46-47), 2020. Date of
Publication: June 2020.
Author
Baram A.
Institution
(Baram) Cardiovascular and Thoracic Surgery, Department of Surgery, School
of Medicine, Faculty of Medical Sciences, University of Sulaimani, Iraq
(Baram) Department of Thoracic and Cardiovascular Surgery, Sulaimani
Teaching Hospital, Al Sulaymaniyah 46001, Iraq
Publisher
Elsevier Ltd

<7>
Accession Number
631457606
Title
Biomarker-guided implementation of the KDIGO guidelines to reduce the
occurrence of acute kidney injury in patients after cardiac surgery
(PrevAKI-multicentre): protocol for a multicentre, observational study
followed by randomised controlled feasibility trial.
Source
BMJ Open. 10 (4) (no pagination), 2020. Article Number: e034201. Date of
Publication: 06 Apr 2020.
Author
Kullmar M.; Massoth C.; Ostermann M.; Campos S.; Grau Novellas N.; Thomson
G.; Haffner M.; Arndt C.; Wulf H.; Irqsusi M.; Monaco F.; Di Prima A.;
Garcia Alvarez M.; Italiano S.; Cegarra Sanmartin V.; Kunst G.; Nair S.;
L'acqua C.; Hoste E.A.J.; Vandenberghe W.; Honore P.; Kellum J.; Forni L.;
Grieshaber P.; Weiss R.; Gerss J.; Wempe C.; Meersch M.; Zarbock A.
Institution
(Kullmar, Massoth, Wempe, Meersch, Zarbock) Anesthesiology, Intensive Care
and Pain Medicine, Universitatsklinikum Munster, Munster,
Nordrhein-Westfalen, Germany
(Ostermann, Campos, Grau Novellas, Thomson, Haffner) Department of
Critical Care, King's College London, Guy's and St Thomas' Hospital,
London, United Kingdom
(Arndt) Department of Anesthesiology and Operative Intensive Care,
University Hospital Marburg, United Kingdom
(Wulf) Anesthesiology and Intensive Care Medicine, Philipps-Universitat
Marburg Fachbereich Medizin, Marburg, Germany
(Irqsusi) Department of Cardiothoracic Surgery, Philipps-Universitat
Marburg Fachbereich Medizin, Marburg, Germany
(Monaco, Di Prima) Intensive Care and Anesthesia Unit, Scientific
Institute San Raffaele, Milano, Italy
(Garcia Alvarez, Italiano, Cegarra Sanmartin) Department of
Anesthesiology, Hospital de la Santa Creu i Sant Pau, Barcelona,
Catalunya, Spain
(Kunst, Nair) Department of Anesthesia, Critical Care and Pain, King's
College London, London, United Kingdom
(L'acqua) Department of Anesthesia and Critical Care, Centro Cardiologico
Monzino IRCCS, Milano, Lombardia, Italy
(Hoste, Vandenberghe) ICU, Universiteit Gent, Gent, Belgium
(Honore) Department of Intensive Care, CHU Brugmann, Brussels, Belgium
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, PA, United States
(Forni) Department of Intensive Care Medicine, Royal Surrey County
Hospital NHS Trust, Guildford, Surrey, United Kingdom
(Grieshaber) Department of Cardiac Surgery, Justus Liebig Universitat
Giessen Fachbereich Medizin, Giessen, Hessen, Germany
(Weiss) Department of Anaesthesiology, University Hospital Munster,
Munster, Germany
(Gerss) Institute of Biostatistics and Clinical Research, Westfalische
Wilhelms-Universitat Munster, Munster, Germany
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Introduction Acute kidney injury (AKI) is a frequent complication after
cardiac surgery with adverse short-term and long-term outcomes. Although
prevention of AKI (PrevAKI) is strongly recommended, the optimal strategy
is uncertain. The Kidney Disease: Improving Global Outcomes (KDIGO)
guideline recommended a bundle of supportive measures in high-risk
patients. In a single-centre trial, we recently demonstrated that the
strict implementation of the KDIGO bundle significantly reduced the
occurrence of AKI after cardiac surgery. In this feasibility study, we aim
to evaluate whether the study protocol can be implemented in a multicentre
setting in preparation for a large multicentre trial. Methods and analysis
We plan to conduct a prospective, observational survey followed by a
randomised controlled, multicentre, multinational clinical trial including
280 patients undergoing cardiac surgery with cardiopulmonary bypass. The
purpose of the observational survey is to explore the adherence to the
KDIGO recommendations in routine clinical practice. The second phase is a
randomised controlled trial. The objective is to investigate whether the
trial protocol is implementable in a large multicentre, multinational
setting. The primary endpoint of the interventional part is the compliance
rate with the protocol. Secondary endpoints include the occurrence of any
AKI and moderate/severe AKI as defined by the KDIGO criteria within 72
hours after surgery, renal recovery at day 90, use of renal replacement
therapy (RRT) and mortality at days 30, 60 and 90, the combined endpoint
major adverse kidney events consisting of persistent renal dysfunction,
RRT and mortality at day 90 and safety outcomes. Ethics and dissemination
The PrevAKI multicentre study has been approved by the leading Research
Ethics Committee of the University of Munster and the respective Research
Ethics Committee at each participating site. The results will be used to
design a large, definitive trial. Trial registration number
NCT03244514. Copyright © Author(s) (or their employer(s)) 2020.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<8>
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Accession Number
631398736
Title
Safety of Carotid Revascularization in Patients with a History of Coronary
Heart Disease.
Source
Stroke. 50 (2) (pp 413-418), 2019. Date of Publication: 2019.
Author
Volkers E.J.; Algra A.; Kappelle L.J.; Becquemin J.-P.; De Borst G.J.;
Brown M.M.; Bulbulia R.; Calvet D.; Eckstein H.-H.; Fraedrich G.; Gregson
J.; Halliday A.; Hendrikse J.; Howard G.; Jansen O.; Roubin G.S.; Bonati
L.H.; Brott T.G.; Mas J.-L.; Ringleb P.A.; Greving J.P.
Institution
(Volkers, Algra, Kappelle) Department of Neurology and Neurosurgery, Brain
Center Rudolf Magnus, University Medical Center Utrecht, Utrecht
University, Utrecht, Netherlands
(Volkers, Algra, Greving) Julius Center for Health Sciences and Primary
Care, University Medical Center Utrecht, Utrecht University, Intern Mail
No Stratenum 6.131, PO Box 85500, Utrecht 3508 GA, Netherlands
(De Borst) Department of Vascular Surgery, University Medical Center
Utrecht, Utrecht University, Utrecht, Netherlands
(Hendrikse) Department of Radiology, University Medical Center Utrecht,
Utrecht University, Utrecht, Netherlands
(Becquemin) IVPE, Hopital Prive Paul d'Egine, Champigny, France
(Brown, Bonati) Department of Brain Repair and Rehabilitation, UCL
Institute of Neurology, University College London, United Kingdom
(Bulbulia) MRC Population Health Research Unit, Clinical Trial Service
Unit and Epidemiological Studies Unit, Nuffield Department of Population
Health, University of Oxford, United Kingdom
(Calvet, Mas) Department of Neurology, Hopital Sainte-Anne, Universite
Paris-Descartes, DHU Neurovasc Sorbonne Paris Cite, INSERM U894, Paris,
France
(Eckstein) Department of Vascular and Endovascular Surgery/Vascular
Center, Klinikum Rechts der Isar, Technical University, Munich, Germany
(Fraedrich) Department of Vascular Surgery, Medical University of
Innsbruck, Austria
(Gregson) Department of Medical Statistics, London School for Hygiene and
Tropical Medicine, United Kingdom
(Halliday) Nuffield Department of Surgical Sciences, John Radcliffe
Hospital, Oxford, United Kingdom
(Howard) Department of Biostatistics, UAB School of Public Health,
Birmingham, AL, United States
(Jansen) Clinic for Radiology and Neuroradiology, UKSH Campus Kiel,
Germany
(Roubin) Cardiovascular Associates of the Southeast, Birmingham, AL,
United States
(Roubin) Department of Neurology and Stroke Center, Department of Clinical
Research, University Hospital Basel, University of Basel, Switzerland
(Brott) Department of Neurology, Mayo Clinic, Jacksonville, FL, United
States
(Ringleb) Department of Neurology, University of Heidelberg Medical
School, Germany
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background and Purpose - We investigated whether procedural stroke or
death risk of carotid artery stenting (CAS) compared with carotid
endarterectomy (CEA) is different in patients with and without history of
coronary heart disease (CHD) and whether the treatment-specific impact of
age differs. Methods - We combined individual patient data of 4754
patients with symptomatic carotid stenosis from 4 randomized trials
(EVA-3S [Endarterectomy Versus Angioplasty in Patients With Symptomatic
Severe Carotid Stenosis], SPACE [Stent-Protected Angioplasty Versus
Carotid Endarterectomy], ICSS [International Carotid Stenting Study], and
CREST [Carotid Revascularization Endarterectomy Versus Stenting Trial]).
Procedural risk was defined as any stroke or death <=30 days after
treatment. We compared procedural risk between both treatments with Cox
regression analysis, stratified by history of CHD and age (<70, 70-74,
>=75 years). History of CHD included myocardial infarction, angina, or
coronary revascularization. Results - One thousand two hundred
ninety-three (28%) patients had history of CHD. Procedural stroke or death
risk was higher in patients with history of CHD. Procedural risk in
patients treated with CAS compared with CEA was consistent in patients
with history of CHD (8.3% versus 4.6%; hazard ratio [HR], 1.96; 95% CI,
0.67-5.73) and in those without (6.9% versus 3.6%; HR, 1.93; 95% CI,
1.40-2.65; Pinteraction=0.89). In patients with history of CHD, procedural
risk was significantly higher after CAS compared with CEA in patients aged
>=75 (CAS-to-CEA HR, 2.78; 95% CI, 1.32-5.85), but not in patients aged
<70 (HR, 1.71; 95% CI, 0.79-3.71) and 70 to 74 years (HR, 1.09; 95% CI,
0.45-2.65). In contrast, in patients without history of CHD, procedural
risk after CAS was higher in patients aged 70 to 74 (HR, 3.62; 95% CI,
1.80-7.29) and >=75 years (HR, 2.64; 95% CI, 1.52-4.59), but equal in
patients aged <70 years (HR, 1.05; 95% CI, 0.63-1.73; 3-way
Pinteraction=0.09). Conclusions - History of CHD does not modify
procedural stroke or death risk of CAS compared with CEA. CAS might be as
safe as CEA in patients with history of CHD aged <75 years, whereas for
patients without history of CHD, risk after CAS compared with CEA was only
equal in those aged <70 years. Copyright © 2018 American Heart
Association, Inc.

<9>
Accession Number
2005634061
Title
New Onset Atrial Fibrillation Following Transcatheter and Surgical Aortic
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2020. Date of Publication:
2020.
Author
Indja B.; Woldendorp K.; Vallely M.P.; Grieve S.M.
Institution
(Indja, Grieve) Sydney Translational Imaging Laboratory, Heart Research
Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW,
Australia
(Indja, Woldendorp, Grieve) Faculty of Medicine and Health, The University
of Sydney, Sydney, NSW, Australia
(Vallely) Division of Cardiac Surgery, The Ohio State University,
Columbus, OH, United States
(Grieve) Department of Radiology, Royal Prince Alfred Hospital, Sydney,
NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background: New-onset atrial fibrillation (NOAF) is a well-recognised,
although variably reported complication following surgical aortic valve
replacement (SAVR). Rates of NOAF following transcatheter aortic valve
implantation (TAVI) seem to be notably less than SAVR, even though this
population is typically older and of higher risk. The aim of this study
was to determine the prevalence of NOAF in both these populations and
associated postoperative outcomes. Method(s): We conducted a
systematic review and meta-analysis of studies reporting rates of NOAF
post SAVR or TAVI, along with early postoperative outcomes. Twenty-five
(25) studies with a total of 13,010 patients were included in the final
analysis. Result(s): The prevalence of NOAF post SAVR was 0.4 (95% CI
0.36-0.44) and post TAVI 0.15 (95% CI 0.11-0.18). NOAF was associated with
an increased risk of postoperative cerebrovascular accident (CVA) for SAVR
and TAVI (RR 1.44 95% CI 1.01-2.06 and RR 2.24 95% CI 1.46-3.45
respectively). NOAF was associated with increased mortality in the TAVI
group (RR 3.02 95% CI 1.55-5.9) but not the SAVR group (RR 1.00, 95% CI
0.54-1.84). Hospital length of stay was increased for both TAVI and SAVR
patients with NOAF (MD 2.54 days, 95% CI 2.0-3.00) and (MD 1.64 days, 95%
CI 0.04-3.24 respectively). Conclusion(s): The prevalence of NOAF is
significantly less following TAVI, as compared to SAVR. While NOAF is
associated with increased risk of postoperative stroke for both groups,
for TAVI alone NOAF confers increased risk of early
mortality. Copyright © 2020 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<10>
Accession Number
2004088178
Title
The prophylactic use of fibrinogen concentrate in high-risk cardiac
surgery.
Source
Acta Anaesthesiologica Scandinavica. 64 (5) (pp 602-612), 2020. Date of
Publication: 01 May 2020.
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. 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. 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).
 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. Copyright © 2019 The Acta Anaesthesiologica Scandinavica
Foundation. Published by John Wiley & Sons Ltd

<11>
Accession Number
2002106080
Title
Single-dose cardioplegia protects myocardium as well as traditional
repetitive dosing: A noninferiority randomized study.
Source
Journal of Thoracic and Cardiovascular Surgery. 159 (5) (pp 1857-1863.e1),
2020. Date of Publication: May 2020.
Author
Vivacqua A.; Robinson J.; Abbas A.E.; Altshuler J.M.; Shannon F.L.;
Podolsky R.H.; Sakwa M.P.
Institution
(Vivacqua, Abbas, Altshuler, Shannon, Sakwa) Department of Cardiovascular
Surgery, Beaumont Hospital, Royal Oak, Mich, United States
(Robinson) Wayne State University School of Medicine, Detroit, Mich,
United States
(Podolsky) Beaumont Research Institute, Royal Oak, Mich, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: The present prospective noninferiority randomized trial was
designed to demonstrate the safety and efficacy of a single dose of
Custodiol histidine-tryptophan-ketoglutarate compared with repetitive
cold-blood cardioplegia. Method(s): From October 2012 to May 2014,
110 patients were randomly assigned to 1 of 2 groups: Group 1 (55
patients) received repetitive cold-blood cardioplegia, and group 2 (55
patients) received single-dose Custodiol
histidine-tryptophan-ketoglutarate. Isolated aortic valve replacement,
isolated mitral valve replacement, and multivalve procedures represented
the most frequent operations, with 39 cases (71%) in group 1 and 49 cases
(89%) in group 2. There was no difference in cardiopulmonary bypass time
(102 +/- 26 minutes vs 99 +/- 19 minutes, P = .70) or aortic crossclamp
time (77 +/- 19 minutes vs 74 +/- 17 minutes, P = .33). All patients
underwent preoperative electrocardiogram and determination of creatine
kinase-MB, troponin I, left ventricular ejection fraction, and regional
wall motion. Postoperative cardiac biomarkers were checked at 7, 24, and
48 hours, and an echocardiogram was obtained to check for left ventricular
function abnormalities. Result(s): There was no difference in cardiac
biomarkers release between the 2 groups at baseline and 7, 24, and 48
hours postoperatively (creatine kinase, P = .18, troponin P = .23). Left
ventricular function was similar between groups preoperatively and at 24
hours after surgery. No death or myocardial infarction was observed in
either group. There were no differences in intensive care unit length of
stay, incidence of atrial fibrillation, use of inotropes or vasopressors
support, time of intubation, or creatinine levels. Conclusion(s): A
single dose of Custodiol histidine-tryptophan-ketoglutarate cardioplegia
is not inferior to repeated cold-blood cardioplegia during elective
cardiac surgery. Copyright © 2019 The American Association for
Thoracic Surgery

<12>
Accession Number
631460456
Title
Cardiac interventions in patients with achondroplasia: A systematic
review.
Source
Journal of Thoracic Disease. 12 (3) (pp 998-1006), 2020. Date of
Publication: 01 Mar 2020.
Author
Sukhavasi A.; O'Malley T.J.; Maynes E.J.; Choi J.H.; Gordon J.S.; Phan K.;
Tchantchaleishvili V.
Institution
(Sukhavasi, O'Malley, Maynes, Choi, Gordon, Tchantchaleishvili) Division
of Cardiothoracic Surgery, Thomas Jefferson University, Philadelphia, PA,
United States
(Phan) Southwest Sydney Clinical School, University of New South Wales
(UNSW), Liverpool Hospital, Sydney, Australia
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Patients with achondroplasia and other causes of dwarfism suffer from
increased rates of cardiovascular disease relative to the remainder of the
population. Few studies have examined these patients when undergoing
cardiac surgery or percutaneous intervention. This systematic review
examines the literature to determine outcomes following cardiac
intervention in this unique population. An electronic search was performed
in the English literature to identify all reports of achondroplasia,
dwarfism, and cardiac intervention. Of the 5,274 articles identified, 14
articles with 14 cases met inclusion criteria. Patient-level data was
extracted and analyzed. Median patient age was 55.5 [interquartile ranges
(IQR), 43.8, 59.8] years, median height 102.0 [98.8, 112.5] cm, median BMI
32.1 [27.0, 45.9], and 57.1% (8/14) were male. Of these 14 patients, nine
had the following documented skeletal abnormalities: 66.7% (6/9) had
scoliosis, 66.7% (6/9) had kyphosis, 11.1% (1/9) had lordosis, 11.1% (1/9)
pectus carinatum and 11.1% (1/9) spinal stenosis. Coronary artery disease
was present in 53.8% (7/13), and 30.8% (4/13) patients previously suffered
a myocardial infarction. Of the eight patients who underwent cardiac
surgery, 37.5% (3/8) underwent multivessel coronary artery bypass
grafting, 37.5% (3/8) underwent aortic valve replacement, 25.0% (2/8)
underwent type A aortic dissection repair, and the remaining 12.5% (1/8)
underwent pulmonary thromboendarterectomy. Six patients underwent
percutaneous intervention. Median cardiopulmonary bypass time was 136.5
[110.0, 178.8] minutes. Median arterial cannula size was 20.0 [20.0, 24.0]
Fr. Bicaval cannulation was performed in all cases describing cannulation
strategy (5/5). Median superior vena cava cannula size was 28.0 [28.0,
28.0] Fr, and inferior vena cava cannula size was 28.0 [28.0, 28.0] Fr. No
mortality was reported with a median follow up time of 6.0 [6.0, 10.5]
months. In conclusion, Common cardiac procedures can be performed with
reasonable safety in this patient population. Operative adjustments may
need to be made with respect to equipment to accommodate patient-specific
needs. Copyright © Journal of Thoracic Disease. All rights
reserved.

<13>
Accession Number
631460417
Title
Transcatheter aortic valve replacement with Lotus and Sapien 3 prosthetic
valves: A systematic review and meta-analysis.
Source
Journal of Thoracic Disease. 12 (3) (pp 893-906), 2020. Date of
Publication: 01 Mar 2020.
Author
Gozdek M.; Ratajczak J.; Arndt A.; Zielinski K.; Pasierski M.; Matteucci
M.; Fina D.; Jiritano F.; Meani P.; Raffa G.M.; Malvindi P.G.; Pilato M.;
Paparella D.; Slomka A.; Landes U.; Kornowski R.; Kubica J.; Lorusso R.;
Suwalski P.; Kowalewski M.
Institution
(Gozdek, Ratajczak, Kubica) Department of Cardiology and Internal
Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz,
Poland
(Arndt) Department of Anesthesiology and Intensive Therapy, Collegium
Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Zielinski) Warsaw Medical University, Warsaw, Poland
(Pasierski, Suwalski, Kowalewski) Clinical Department of Cardiac Surgery,
Central Clinical Hospital of the Ministry of Interior and Administration,
Centre of Postgraduate Medical Education, Warsaw, Poland
(Matteucci, Fina, Jiritano, Meani, Lorusso, Kowalewski) Department of
Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University
Medical Centre, Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
(Matteucci) Department of Cardiac Surgery, Circolo Hospital, University of
Insubria, Varese, Italy
(Fina) Cardiovascular Intensive Care, IRCCS Policlinico San Donato, Milan,
Italy
(Jiritano) Cardiac Surgery Unit, Department of Experimental and Clinical
Medicine, Magna Graecia University, Catanzaro, Italy
(Meani) Department of Intensive Care Unit, Maastricht University Medical
Centre (MUMC+), Maastricht, Netherlands
(Raffa, Pilato) Department for the Treatment and Study of Cardiothoracic
Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Instituto
Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo,
Italy
(Malvindi, Paparella) Wessex Cardiothoracic Centre, University Hospital
Southampton, Southampton, United Kingdom
(Paparella) Department of Emergency and Organ Transplant, University of
Bari Aldo Moro, Bari, Italy
(Slomka) Department of Pathophysiology, Collegium Medicum, Nicolaus
Copernicus University, Bydgoszcz, Poland
(Landes, Kornowski) Department of Cardiology, Institute of Interventional
Cardiology, Rabin Medical Center, Petach Tikva and Tel Aviv University,
Tel Aviv, Israel
(Kowalewski) Thoracic Research Centre, Collegium Medicum, Nicolaus
Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Background: Frequent occurrence of paravalvular leak (PVL) after
transcatheter aortic valve replacement (TAVR) was the main concern with
early-generation devices and focused technological improvements. Current
systematic review and meta-analysis sought to compare outcomes of TAVR for
severe native valve stenosis with next-generation devices: Lotus and
Sapien 3. Method(s): Electronic databases were screened for studies
comparing outcomes of TAVR with Lotus and Sapien 3. In a random-effects
meta-analysis, the pooled incidence rates of procedural, clinical and
functional outcomes according to VARC-2 definitions were assessed.
 Result(s): Eleven observational studies including 2,836 patients
(Lotus N=862 vs. Sapien 3 N=1,974) met inclusion criteria. No differences
were observed regarding composite endpoints-device success and early
safety. Similarly, 30-day mortality, major vascular complications, acute
kidney injury and serious bleeding events were similar with both devices.
Lotus valve demonstrated 35% reduction of the risk for mild PVL: risk
ratio (RR) 0.65, 95% confidence interval (CI): 0.49-0.85, P=0.002; but
there were no statistical differences with regard to moderate/severe PVL
(RR 0.56, 95% CI: 0.18-1.77, P=0.320). Lotus valves produced significantly
higher mean transaortic gradients: mean difference (MD) 0.88 mmHg, 95% CI,
0.24-1.53 mmHg, P=0.007; however, without translation into higher rate of
prosthesis-patient mismatch (RR 1.10, 95% CI: 0.82-1.47, P=0.540). As
compared to Sapien 3, Lotus device placement was associated with
significantly higher rate of permanent pacemaker implantation (RR 2.30,
95% CI: 1.95-2.71, P<0.00001) and cerebrovascular events (RR 1.76, 95% CI:
1.03-2.99, P=0.040). Conclusion(s): Lotus valve, as compared with
Sapien 3, was associated with lower risk for PVL but higher risk for
permanent pacemaker implantation and cerebrovascular events. Copyright
© Journal of Thoracic Disease. All rights reserved.

<14>
Accession Number
631444116
Title
Pericardial diseases in patients with cancer: Contemporary prevalence,
management and outcomes.
Source
Heart. 106 (8) (pp 569-574), 2020. Date of Publication: 01 Apr 2020.
Author
Imazio M.; Colopi M.; De Ferrari G.M.
Institution
(Imazio, Colopi, De Ferrari) University Cardiology, AOU Citta della Salute
e della Scienza di Torino, Torino, Piemonte, Italy
(Imazio) Department of Medical Sciences, University of Turin, Torino,
Piemonte, Italy
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Neoplastic pericardial effusion is a common and serious manifestation of
advanced malignancies. Lung and breast carcinoma, haematological
malignancies, and gastrointestinal cancer are the most common types of
cancer involving the pericardium. Pericardial involvement in neoplasia may
arise from several different pathophysiological mechanisms and may be
manifested by pericardial effusion with or without tamponade,
effusive-constrictive pericarditis and constrictive pericarditis.
Management of these patients is a complex multidisciplinary problem,
affected by clinical status and prognosis of patients. Copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See
rights and permissions. Published by BMJ.

<15>
Accession Number
2005551168
Title
Viscoelastic haemostatic assays in the perioperative period of surgical
procedures: Systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 64 (no pagination), 2020. Article Number:
109809. Date of Publication: September 2020.
Author
Santos A.S.; Oliveira A.J.F.; Barbosa M.C.L.; Nogueira J.L.D.S.
Institution
(Santos, Oliveira, Barbosa, Nogueira) Centre for Health Technology
Assessment of the UFMG Teaching Hospital (NATS-HC/UFMG), Universidade
Federal de Minas Gerais, Av. Alfredo Balena, 110, Santa Efigenia, Belo
Horizonte 30.130-100, Brazil
(Santos) Department of Economical Sciences, School of Economics,
Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627,
Pampulha, Belo Horizonte 31.270-901, Brazil
(Oliveira) Department of Health Management, School of Nursing,
Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Santa
Efigenia, Belo Horizonte 30.130-100, Brazil
(Barbosa) Collegy of Pharmacy, Universidade Federal de Minas Gerais, Av.
Presidente Antonio Carlos, 6627, Pampulha, Belo Horizonte 31.270-901,
Brazil
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objective: The aim of this study is to evaluate the safety and efficacy of
Viscoelastic Haemostatic Assays (VHA) to guide transfusions in patients
undergoing surgical procedures. Design(s): Systematic review with
meta-analysis of randomized controlled trials up until June 5, 2019.
 Setting(s): Hospitalized patients. Intervention(s): VHAs
compared to the Standard-Of-Care (SOC), which are represented by standard
laboratory tests and/or clinical decisions. Measurements: Primary - Risk
of death, acute kidney injury, thrombotic events and reoperation for
bleeding; Secondary - Risk of use of red blood cells (RBC), platelets,
fresh frozen plasma (FFP), fibrinogen, factor VIIa, prothrombin complex,
volume of RBC, platelets and FFP, length of hospital stay, and length of
ICU stay. Result(s): VHAs were associated to a statistically
significant reduction in mortality (7.3% vs. 12.1%; RR = 0.64, p-value =
0.03), risk of acute kidney injury (10.5% vs. 17.6%; RR = 0.53, p-value =
0.005), volume of red blood cells (RBCs) transfused (MD = -1.63 U, p-value
= 0.02), risk of platelet transfusion (23.9% vs. 27.3%; RR = 0.74, p-value
= 0.006), risk of fresh frozen plasma (FFP) transfusion (RR = 0.57,
p-value = 0.001), and volume of FFP transfused (MD = -0.90, p-value =
0.0003). No significant differences were observed in terms of thrombotic
events, reexploration for bleeding, RBC transfusion, volume of platelets
transfused, use of fibrinogen, prothrombin complex, or factor VIIa, length
of hospitalization and length of ICU stay. Conclusion(s):
Viscoelastic haemostatic assays are safe and efficacious for coagulation
control in patients undergoing surgical procedures, therefore it should be
considered for use in practice. Copyright © 2020 Elsevier Inc.

<16>
Accession Number
2004439164
Title
A Comparison of Endovascular Versus Open Repair of Popliteal Artery
Aneurysms: An Updated Meta-Analysis.
Source
Vascular and Endovascular Surgery. 54 (4) (pp 355-361), 2020. Date of
Publication: 01 May 2020.
Author
Tian Y.; Yuan B.; Huang Z.; Zhang N.
Institution
(Tian, Huang, Zhang) Department of Vascular Surgery, The Third Affiliated
Hospital of Shenzhen University, Shenzhen, Guangdong Province, China
(Yuan) Department of Vascular Surgery, Beijing Chao Yang Hospital
Affiliated to Capital Medical University, Beijing, China
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Objective: Traditionally, popliteal artery aneurysms (PPAs) were treated
via open repair (OR). However, more recently endovascular repair (EVR)
approaches have become more common for the treatment of PPAs. The present
meta-analysis therefore sought to conduct an up-to-date review of studies
comparing the relative safety and efficacy of these 2 repair strategies.
To that end, patient outcomes including primary patency, operating time,
hospital stay duration, and re-intervention, amputation, and graft
occlusion within 30 days were compared for these OR and EVR approaches.
 Method(s): Studies in which OR and EVR were compared as treatments
for PPAs were identified through systematic searching of the PubMed and
Embase databases. Any studies either analyzing only one of these
treatments in isolation or analyzing <5 patients were not included in this
analysis. For all relevant studies, patient demographic information and
outcome details were compiled. Risk of bias was analyzed using a modified
Newcastle-Ottawa Scale. The odds ratios, mean differences, and hazard
ratios (HRs) for patient outcomes were estimated using a random-effects
model. Result(s): In total, we identified 17 relevant studies
including a single randomized controlled trial and 16 retrospective cohort
studies, incorporating 6887 total cases (1662 EVR and 5225 OR). The
quality of evidence for all measured outcomes was deemed to be very low or
low according to the Grading of Recommendations Assessment, Development
and Evaluation (GRADE) criteria. Rates of primary patency were found to be
significantly higher for patients treated via OR relative to those treated
via EVR (HR = 1.60; 95% confidence interval [CI]: 1.12-2.30; P =.03).
Operative and hospitalization durations, in contrast, were significantly
lower for patients treated via EVR. Patients treated via EVR also
experienced significantly higher rates of graft thrombosis and
reintervention within 30 days relative to patients treated via OR.
However, no significant differences were observed between treatments with
respect to rates of patient amputation (OR = 1.01; 95% CI: 0.55-1.85; P
=.98). Conclusion(s): The available data suggest that PPA repair via
EVR is a safe alternative to OR, but that short-term graft thrombosis and
reintervention rates are significantly greater for the former approach.
Moreover, few studies to date have compared these techniques and those
that were largely retrospective in nature with relatively low-quality
evidence, making it difficult to make definitive statements regarding the
relative safety and efficacy of these 2 repair strategies. Additional
population-based large-scale studies are therefore essential in order to
conduct a robust evaluation of the safety and utility of EVR as an
alternative to OR for PPA repair. Copyright © The Author(s) 2020.

<17>
Accession Number
2004400913
Title
Meta-analysis of results of subvalvular repair for severe ischemic mitral
regurgitation.
Source
Journal of Cardiac Surgery. 35 (4) (pp 886-896), 2020. Date of
Publication: 01 Apr 2020.
Author
Meco M.; Lio A.; Montisci A.; Panisi P.; Ferrarini M.; Miceli A.; Glauber
M.
Institution
(Meco, Panisi) Cardiac Centre, Humanitas Gavazzeni Hospital, Bergamo,
Italy
(Lio, Glauber) Department of Cardiac Surgery and Transplantation, S.
Camillo Hospital, Rome, Italy
(Lio, Montisci, Ferrarini, Miceli, Glauber) Cardiothoracic Center,
Istituto Clinico Sant'Ambrogio, Gruppo Ospedaliero San Donato, Milan,
Italy
(Montisci) University of Milan, Milan, Italy
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background and Aim of the Study: The aim of this meta-analysis was to
compare short- and long-term outcomes of patients undergoing mitral
annuloplasty (MA) with or without papillary muscle surgery (PMS) for the
treatment of ischemic mitral regurgitation (IMR). Method(s): A
systematic review and meta-analysis in accordance with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
statement were performed. Result(s): Nine studies met the inclusion
criteria. This meta-analysis identified 478 patients: 228 patients
underwent MA alone and 250 patients underwent concomitant PMS. Early
mortality was similar between two groups (odds ratio [OR] 1.14, 95%
confidence interval [CI], 0.51-2.53; P =.75). PMS was associated at
follow-up with a higher freedom from cardiac-related events (P =.050);
moreover, although both surgical techniques had a positive impact on
ventricular remodeling, the PMS group showed a significant higher
reduction of left ventricle end-diastolic diameter (OR, 4.89, 95% CI,
2.77-7.01; P <.001) and left ventricle end-systolic diameter values (OR,
4.11, 95% CI, 1.98-6.24; P <.001). Finally, PMS compared with MA alone was
associated with a significant reduction of recurrent mitral regurgitation
at follow-up (OR, 3.25, 95% CI, 1.60-6.59; P =.001). Conclusion(s):
This meta-analysis demonstrated superiority in terms of ventricular
remodeling of a combined approach encompassing PMS and MA over MA alone in
IMR. Moreover, the association of subvalvular surgery with restrictive MA
decreases the incidence of mitral regurgitation recurrence and
cardiac-related events at follow-up. Copyright © 2020 Wiley
Periodicals, Inc.

<18>
Accession Number
2004246906
Title
Combined transepicardial and transseptal implantation of autologous CD
133+ bone marrow cells during bypass grafting improves cardiac function in
patients with low ejection fraction.
Source
Journal of Cardiac Surgery. 35 (4) (pp 740-746), 2020. Date of
Publication: 01 Apr 2020.
Author
Soetisna T.W.; Sukmawan R.; Setianto B.; Mansyur M.; Murni T.W.;
Listiyaningsih E.; Santoso A.
Institution
(Soetisna) Department of Cardiothoracic and Vascular Surgery, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Soetisna) Department of Surgery, Faculty of Medicine, Universitas
Indonesia, Jakarta, Indonesia
(Sukmawan, Setianto) Department of Cardiology and Vascular Medicine,
National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Sukmawan, Setianto, Santoso) Department of Cardiology and Vascular
Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
(Mansyur) Department of Community Medicine, Faculty of Medicine,
Universitas Indonesia, Jakarta Pusat, Indonesia
(Murni) Department of Cardiothoracic and Vascular Surgery, Hasan Sadikin
Hospital, Universitas Padjadjaran, Bandung, Indonesia
(Listiyaningsih) Molecular Laboratory & Stem Cell Facility, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Objectives: Autologous CD133+ bone marrow stem cells may improve cardiac
function. This randomized, single-blind clinical trial inquired whether a
combined transepicardial and transseptal implantation of CD133+ stem cells
during coronary artery bypass grafting (CABG) improve cardiac function
with ejection fraction (EF) changes as a primary endpoint in patients with
low EF. Method(s): Thirty patients with coronary heart disease and EF
<35% were randomized to undergo CABG alone or CABG with transseptal and
transepicardial implantation of CD133+. Cardiac function was evaluated
using cardiac magnetic resonance imaging (MRI) before and 6 months after
CABG. Result(s): Preoperative EF was lower in the intervention group
(25.88% +/- 5.66%) than in the control group (30.18% +/- 3.85%; P =.04).
The adverse event incidence was similar between both groups. At 6 months,
EF changes were significantly higher (8.69% +/- 9.49; P =.04) in the
CD133+ group than in the CABG-only group. Compared to the control group,
significant improvements were seen in the wall motion score index (P
=.003) and scar size proportion (P =.047) in the CD133+ group. The quality
of life (QOL), assessed by a 6-minute walking test, showed considerable
improvement in the CD133+ group compared to that in the control group (P
=.03). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) scale
did not show improvement in the intervention group (P =.09, vs control).
 Conclusion(s): Combined transepicardial and transseptal autologous
CD133+ BMC implantation during bypass grafting improved cardiac function
in low EF coronary artery disease patients. Copyright © 2020 The
Authors. Journal of Cardiac Surgery Published by Wiley Periodicals, Inc.

<19>
Accession Number
631460332
Title
A Prospective Randomized Clinical Trial of Efficacy of Algorithm-Based
Point of Care Guided Hemostatic Therapy in Cyanotic Congenital Heart
Disease Surgical Patients.
Source
Journal of Cardiac Critical Care. 3 (1) (pp 8-16), 2019. Date of
Publication: 2019.
Author
Karanjkar A.; Kapoor P.M.; Sharan S.; Bhardwaj V.; Malik V.; Hasija S.;
Choudhury A.; Chowdhury U.K.; Rajashekar P.
Institution
(Karanjkar, Kapoor, Sharan, Bhardwaj, Malik, Hasija, Choudhury) Department
of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of
Medical Sciences, New Delhi, India
(Chowdhury, Rajashekar) Department of Cardiothoracic and Vascular Surgery,
Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi,
India
(Kapoor) Department of Cardiac Anaesthesia, Cardiothoracic Centre, All
India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
Publisher
Thieme India
Abstract
Objective Point of care (POC) testing-based algorithm-guided hemostatic
therapy has been used in adult as well as pediatric cardiac surgical
patients to administer blood components. The authors hypothesized that
implementation of POC-based algorithm in pediatric cyanotic congenital
surgical patients would reduce the exposure to blood component therapy and
improve the clinical outcome. Design Prospective randomized control trial.
Setting Single-center academic institute. Participants One hundred seventy
pediatric congenital cyanotic surgical patients. Intervention
Implementation of POC and conventional tests-based algorithms.
Measurements and Main Results Algorithm-based blood component therapy was
administered in each group. There were no group differences regarding the
demographic, clinical, and laboratory characteristics. Amount of packed
red blood cells (PRBCs), fresh frozen plasma (FFP), platelets, and
cryoprecipitate (primary outcomes) administered was significantly lower in
POC group than that in the conventional group (p < 0.001). Among the
secondary outcomes, the chest drain output at 6, 12, and 24 hours and
number of re-explorations was comparable among both the groups. The
duration of mechanical ventilation, duration of intensive care unit (ICU)
stay, and hospital stay was significantly short in POC group (p = 0.008,
<0.001 and 0.019, respectively). Conclusion Implementation of POC-based
algorithm-guided hemostatic therapy reduced the exposure to blood and
blood component therapy and was associated with reduced ICU and hospital
stay in pediatric congenital cyanotic surgical patients. Copyright
© 2020 Official Publication of The Simulation Society (TSS),
accredited by International Society of Cardiovascular Ultrasound (ISCU).

<20>
Accession Number
631460325
Title
Vitamin D Deficiency and Its Response to Supplementation as Stoss Therapy
in Children with Cyanotic Congenital Heart Disease Undergoing Open Heart
Surgery.
Source
Journal of Cardiac Critical Care. 3 (1) (pp 17-23), 2019. Date of
Publication: 2019.
Author
Sahu M.K.; Bipin C.; Niraghatam H.V.; Karanjkar A.; Singh S.P.; Rajashekar
P.; Ramakrishnan L.; Devagourou V.; Upadhyay A.D.; Choudhary S.K.
Institution
(Sahu, Bipin, Niraghatam, Singh, Rajashekar, Devagourou, Choudhary)
Department of Cardiothoracic and Vascular Surgery, CN Centre, All India
Institute of Medical Sciences, New Delhi, India
(Karanjkar) Department of Cardiac Anaesthesiology, CN Centre, All India
Institute of Medical Sciences, New Delhi, India
(Ramakrishnan) Department of Laboratory Medicine, CN Centre, All India
Institute of Medical Sciences, New Delhi, India
(Upadhyay) Department of Biostatistics, All India Institute of Medical
Sciences, New Delhi, India
(Sahu) Department of Cardiothoracic and Vascular Surgery, CTVS Office, CN
Centre, All India Institute of Medical Sciences, New Delhi 110029, India
Publisher
Thieme India
Abstract
Background Data from many studies suggest that patients with congenital
heart disease are vitamin D (vitD) deficient. Following cardiac surgery as
a result of intraoperative institution of cardiopulmonary bypass (CPB),
serum vitD levels become even low. This may affect postoperative
convalescence in terms of mechanical ventilation, inotropic support,
infection, and so forth. Objective We intended to study the prevalence of
vitD deficiency pre and post cardiac surgery and the effect of vitD
supplementation (stoss therapy) on postoperative convalescence of the
children with tetralogy of Fallot (TOF) undergoing intracardiac repair
(ICR). Methodology In this randomized controlled trial (RCT), 60 children
younger than 18 years with TOF and serum vitD levels < 20ng/dL were
randomized into two groups. The study group received vitD supplementation
as stoss therapy at 10,000 units/kg body weight. All these children
underwent ICR with CPB. Demographic data, preoperative, intraoperative,
and postoperative variables were compared between the study and the
control groups. Results Prevalence of severe vitD deficiency was 93.1%.
When compared with the control group, study group showed higher serum vitD
levels in the immediate preoperative period (p = 0.001), postoperative
period following CPB (p = 0.012), and on the first postoperative day (p =
0.003). No statistically significant difference was observed in
postoperative mechanical ventilation (p = 0.35), intensive care unit (ICU)
stay (p = 0.15), and inotropic duration (p = 0.19). Conclusion Children
with TOF are highly deficient of vitD, its level falls further after CPB,
and supplementing vitD preoperatively does not influence postoperative
recovery pattern. Supplementation of vitD as stoss therapy was useful in
raising the serum levels before and after cardiac surgery. Copyright
© 2020 Official Publication of The Simulation Society (TSS),
accredited by International Society of Cardiovascular Ultrasound (ISCU).

<21>
Accession Number
631514330
Title
Proceedings of Reanimation 2020, the French Intensive Care Society
International Congress.
Source
Annals of Intensive Care. Conference: French Intensive Care Society
International Congress, 2020. France. 10 (Supplement 1) (no pagination),
2020. Date of Publication: 2020.
Author
Anonymous
Publisher
Springer
Abstract
The proceedings contain 425 papers. The topics discussed include:
expiratory muscle weakness quantified by maximal expiratory pressure may
be insufficient in predicting critical outcomes in mechanically ventilated
patients; consequences of ICU acquired weakness: a systematic review and
meta- analysis; accuracy of diaphragm ultrasound to predict weaning
outcome during spontaneous breathing trial: a meta- analysis; risk factors
for candidemia: a prospective matched case-control study; use and impact
of aminoglycoside empirical therapy in extended spectrum beta-lactamase
enterobacteriaceae bloodstream infections in intensive care unit; awake
venoarterial extracorporeal membrane oxygenation in cardiogenic shock: a
propensity score matched analysis; impact of pulmonary hypertension on
post heart transplant outcome; hemodynamic and microcirculation evaluation
of vasopressin versus norepinephrine in a porcine model of refractory
cardiac arrest resuscitated by venous-arterial ECMO; and veno-arterial
extracorporeal membrane oxygenation flow or dobutamine to increase
microcirculation for refractory cardiogenic shock.

<22>
[Use Link to view the full text]
Accession Number
631516961
Title
A Randomized Controlled Trial Comparing Flat Times Versus Standard Care in
Pediatric Patients Post Cardiac Catheterization.
Source
The Journal of cardiovascular nursing. 35 (3) (pp 307-313), 2020. Date of
Publication: 01 May 2020.
Author
Raic R.; Steurer L.M.; Balakas K.; Ercole P.M.
Institution
(Raic) Rebecca Raic, MSN, RN, CPNP-PCI Nurse Practitioner, Cardiac
Catheterization Laboratory, St. Louis Children's Hospital, Missouri. Lisa
M. Steurer, PhD, RN, CPNP-PC Manager, Research & Outcomes, St. Louis
Children's Hospital, Missouri. Karen Balakas, PhD, RN Manager, Research &
Outcomes (retired), St. Louis Children's Hospital, Missouri. Patrick M.
Ercole, PhD, MPH Senior Statistician, Sansom Consulting, San Antonio,
Texas
Publisher
NLM (Medline)
Abstract
BACKGROUND: Pediatric patients undergoing cardiac catheterization
procedures are required to lie flat for 4 hours for femoral venous access
and 6 hours for femoral arterial access. Authors of research in adults
suggest the flat time for the same access can be safely reduced to 1.5 to
2 hours post procedure. No literature was found that flat times could be
safely reduced for pediatric patients. OBJECTIVE(S): The purpose of
this study was to determine whether decreased flat time for the
post-cardiac catheterization pediatric patient would impact the incidence
of site bleeding, additional sedation, and the need for a critical care
admission. METHOD(S): A randomized controlled trial was designed and
participants were randomly assigned to experimental or control group. The
experimental group reduced flat times to 2 hours for venous and 4 hours
for arterial. The control group was standard care of 4 hours for venous
and 6 hours for arterial. RESULT(S): A total of 119 participants were
enrolled, 60 in the experimental group and 59 in the control group.
Results suggest no difference in the incidence of site bleeding (P =
.999), additional sedation (P = .653), or need for a critical care
admission. CONCLUSION(S): For pediatric patients undergoing arterial
or venous cardiac catheterizations, flat times can safely be reduced
without increasing site bleeding, additional sedation, or critical care
admissions.

<23>
Accession Number
631515256
Title
Non-coding RNAs in Cardiac Regeneration.
Source
Advances in experimental medicine and biology. 1229 (pp 163-180), 2020.
Date of Publication: 2020.
Author
van der Ven C.F.T.; Hogewoning B.C.R.; van Mil A.; Sluijter J.P.G.
Institution
(van der Ven, Hogewoning, van Mil, Sluijter) Laboratory of Experimental
Cardiology, UMC Utrecht Regenerative Medicine Center, University Utrecht,
University Medical Center Utrecht, Utrecht, Netherlands
(Sluijter) Department of Cardiology, Regenerative Medicine Centre, UMC
Utrecht, Utrecht, Netherlands
Publisher
NLM (Medline)
Abstract
Cardiovascular disease is a leading cause of death worldwide, and with the
dramatically increasing numbers of heart failure patients in the next 10
years, mortality will only increase [1]. For patients with end-stage heart
failure, heart transplantation is the sole option. Regrettably, the number
of available donor hearts is drastically lower than the number of patients
waiting for heart transplantation. Despite evidence of cardiomyocyte
renewal in adult human hearts, regeneration of functional myocardium after
injury can be neglected. The limited regenerative capacity due to
inadequate proliferation of existing cardiomyocytes is insufficient to
repopulate areas of lost myocardium [2]. As a solution, the hypothesis
that adult stem cells could be employed to generate functional
cardiomyocytes was proposed. One of the early studies that supported this
hypothesis involved direct injection of hematopoietic c-kit-positive cells
derived from bone marrow into the infarcted heart [3]. However, in sharp
contrast, more recent evidence emerged demonstrating that these
hematopoietic stem cells only differentiate into cells down the
hematopoietic lineage rather than into cardiomyocytes [4, 5], and the
focus shifted towards stem cells residing in the heart, called cardiac
progenitor cells. These CPCs were extracted and injected into the
myocardium to regenerate the heart [6]. In recent years, over 80
pre-clinical studies employing cardiac stem cells in vivo in large and
small animals to evaluate the effect on functional parameters were
systematically reviewed, identifying differences between large and small
animals [7]. Despite the positive outcome of these stem cell therapies on
functional parameters, c-kit-positive cardiac progenitor cells were shown
to contribute minimally to the generation of functional cardiomyocytes [8,
9]. This heavily debated topic is summarized concisely by van Berlo and
Molkentin [10]. Recently, single-cell sequencing and genetic lineage
tracing of proliferative cells in the murine heart in both homeostatic and
regenerating conditions did not yield a quiescent cardiac stem cell
population or other cell types that support transdifferentiation into
cardiomyocytes, nor did it support proliferation of cardiac myocytes [11,
12]. Now, the focus is shifting towards exploiting the limited
regenerative capacity of the cardiomyocytes themselves, by re-activating
proliferation of existing cardiomyocytes through dedifferentiation,
reentry into the cell cycle, and cytokinesis. This process is the new
focus of research to promote cardiac regeneration, and can be controlled
on multiple levels, including cell-cycle manipulation, reprogramming,
small molecules, extra-cellular matrix (ECM), proteins, and RNA regulation
[13].

<24>
Accession Number
631515080
Title
What Interventions Do Physical Therapists Provide for Patients With
Cardiorespiratory Conditions, Neurological Conditions, and Conditions
Requiring Acute Hospital Care? A Systematic Review.
Source
Physical therapy. (no pagination), 2020. Date of Publication: 14 Apr 2020.
Author
Zadro J.R.; Cheng S.; O'Keeffe M.; Maher C.G.
Institution
(Zadro) Sydney School of Public Health, Institute for Musculoskeletal
Health, Faculty of Medicine and Health, University of Sydney, King George
V Building, Royal Prince Alfred Hospital, Missenden Road ,Camperdown, NSW
2050, Australia
(Cheng) Discipline of Physiotherapy, Faculty of Health Sciences,
University of Sydney, NSW, Australia
(O'Keeffe, Maher) Sydney School of Public Health, Institute for
Musculoskeletal Health, Faculty of Medicine and Health, University of
Sydney
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The aim of this systematic review was to determine what
percentage of physical therapists provide interventions that are of high
value, low value, or unknown value for cardiorespiratory conditions,
neurological conditions, or conditions requiring acute hospital care.
Whether an intervention was considered high or low value was determined by
reference to guidelines or systematic reviews. METHOD(S): Searches of
numerous databases were performed by combining terms synonymous with
"practice patterns" and "physical therapy" until April 2018. Studies that
investigated what interventions physical therapists provide for any
cardiorespiratory condition, neurological condition, or condition
requiring acute hospital care through surveys and audits of clinical notes
were included. Through the use of medians and interquartile ranges, the
percentages of physical therapists who provided interventions that were of
high value, low value, or unknown value were summarized. RESULT(S):
Twenty-six studies were included. The median percentages of physical
therapists who provided interventions of high value, low value, and
unknown value for chronic obstructive pulmonary disease ranged from 78% to
96%, 67% to 100%, and 56% to 91%, respectively. These percentages ranged
from 61% to 97%, 87% to 98%, and 83% to 98% for adults who were critically
ill in intensive care units; 70% to 93%, 38% to 50%, and 8% to 95% before
or after cardiac/thoracic surgery; 25% to 96%, 23% to 84%, and 96% for
acute stroke; and 11% (high value) and 13% (unknown value) for Parkinson
disease. CONCLUSION(S): This review found patterns of physical
therapist practice for cardiorespiratory conditions, neurological
conditions, and conditions requiring acute hospital care that were both
evidence based and not evidence based. A concern is that a substantial
percentage of physical therapists provided interventions that were of low
value or unknown value, despite the availability of high-value
interventions. IMPACT: This systematic review is the first to summarize
the percentage of physical therapist treatment choices that were high
value versus low value for cardiorespiratory conditions, neurological
conditions, and conditions requiring acute hospital care. The findings
highlight areas of practice where low-value care could be replaced with
high-value care-such as in the management of patients who have chronic
obstructive pulmonary disease or who are in intensive care-and identify an
urgent need to develop and test strategies to ensure that patients with
these conditions receive the interventions most likely to improve their
outcomes. Copyright © The Authors 2020. Published by Oxford
University Press on behalf of the American Physical Therapy Association.
All rights reserved. For permissions, please email:
journals.permissions@oup.com.

<25>
Accession Number
631514970
Title
Metabolic Disorders with Kidney Transplant.
Source
Clinical journal of the American Society of Nephrology : CJASN. (no
pagination), 2020. Date of Publication: 13 Apr 2020.
Author
Cohen E.; Korah M.; Callender G.; Belfort de Aguiar R.; Haakinson D.
Institution
(Cohen) Department of Pharmacy, Yale-New Haven Hospital, New Haven, CT,
United States
(Korah) Yale University School of Medicine, New Haven, CT, United States
(Callender) Department of Surgery, Section of Endocrine Surgery, Yale
University, New Haven, CT, United States
(Belfort de Aguiar) Department of Medicine, Section of Endocrinology, Yale
University, New Haven, CT, United States
(Haakinson) Department of Surgery, Section of Transplant, Yale University,
New Haven, CT, United States
Publisher
NLM (Medline)
Abstract
Metabolic disorders are highly prevalent in kidney transplant candidates
and recipients and can adversely affect post-transplant graft outcomes.
Management of diabetes, hyperparathyroidism, and obesity presents distinct
opportunities to optimize patients both before and after transplant as
well as the ability to track objective data over time to assess a
patient's ability to partner effectively with the health care team and
adhere to complex treatment regimens. Optimization of these particular
disorders can most dramatically decrease the risk of surgical and
cardiovascular complications post-transplant. Approximately 60% of
nondiabetic patients experience hyperglycemia in the immediate
post-transplant phase. Multiple risk factors have been identified related
to development of new onset diabetes after transplant, and it is estimated
that upward of 7%-30% of patients will develop new onset diabetes within
the first year post-transplant. There are a number of medications studied
in the kidney transplant population for diabetes management, and recent
data and the risks and benefits of each regimen should be optimized.
Secondary hyperparathyroidism occurs in most patients with CKD and can
persist after kidney transplant in up to 66% of patients, despite an
initial decrease in parathyroid hormone levels. Parathyroidectomy and
medical management are the options for treatment of secondary
hyperparathyroidism, but there is no randomized, controlled trial
providing clear recommendations for optimal management, and
patient-specific factors should be considered. Obesity is the most common
metabolic disorder affecting the transplant population in both the pre-
and post-transplant phases of care. Not only does obesity have
associations and interactions with comorbid illnesses, such as diabetes,
dyslipidemia, and cardiovascular disease, all of which increase morbidity
and mortality post-transplant, but it also is intimately inter-related
with access to transplantation for patients with kidney failure. We review
these metabolic disorders and their management, including data in patients
with kidney transplants. Copyright © 2020 by the American Society
of Nephrology.

<26>
Accession Number
631485522
Title
Effects of nitroglycerin versus labetalol on peripheral perfusion during
deliberate hypotension for sinus endoscopic surgery: A randomized,
controlled, double-blinded trial.
Source
BMC Anesthesiology. 20 (1) (no pagination), 2020. Article Number: 85. Date
of Publication: 17 Apr 2020.
Author
Zayed M.; Nassar H.; Hasanin A.; Saleh A.H.; Hassan P.; Saad D.; Mahmoud
S.; Abo Bakr G.; Fouad E.; Saleh N.; Ismail M.; El-Hadi H.
Institution
(Zayed, Nassar, Hasanin, Saleh, Hassan, Fouad, Ismail) Department of
Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
(Zayed, Saad, Mahmoud, Abo Bakr, Saleh, El-Hadi) Department of Anesthesia
and Critical Care Medicine, Faculty of Medicine, Cairo University, 01
elsarayah street, Elmanyal, Cairo 11559, Egypt
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Deliberate hypotension is used to provide a bloodless field
during functional endoscopic sinus surgery; however, the impact of
controlled hypotension during anesthesia on peripheral tissue perfusion
has not been extensively evaluated. The aim of this study was to compare
the impact of nitroglycerin- versus labetalol-induced hypotension on
peripheral perfusion. Method(s): The present randomized,
double-blinded, controlled trial included adult patients undergoing
endoscopic sinus surgery. Patients were allocated to one of two groups
according to the drug received for induction of deliberate hypotension:
nitroglycerin (n = 20) or labetalol (n = 20). Mean arterial pressure was
maintained at 55-65 mmHg in both groups. Both study groups were compared
according to pulse oximeter-derived peripheral perfusion index (primary
outcome), serum lactate level, mean arterial pressure, heart rate,
surgical field score, and intraoperative blood loss. Result(s): Forty
patients were included in the final analysis. The nitroglycerin group
exhibited a higher peripheral perfusion index at nearly all records (p <
0.0001) and lower postoperative serum lactate levels (1.3 +/- 0.2 mmol/L
vs. 1.7 +/- 0.4 mmol/L; p = 0.001) than the labetalol group. The
peripheral perfusion index was higher in the nitroglycerin group than at
baseline at most intraoperative readings. The median surgical field score
was modestly lower in the labetalol group than in the nitroglycerin group
in the first 20 min (2 [interquartile range (IQR) 2-2.5] versus 1.5 [IQR
1-2]; p = 0.001). Both groups demonstrated comparable and acceptable
surgical field scores in all subsequent readings. Conclusion(s):
Nitroglycerin-induced deliberate hypotension was accompanied by higher
peripheral perfusion index and lower serum lactate levels than
labetalol-induced deliberate hypotension during sinus endoscopic surgery.
Trial registration: The study was registered at clinicaltrials registry
system with trial number: NCT03809065. Registered at 19 January 2019. This
study adheres to CONSORT guidelines. Copyright © 2020 The
Author(s).

<27>
Accession Number
2005600974
Title
Stroke after transcatheter edge-to-edge mitral valve repair: A systematic
review and meta-analysis.
Source
EuroIntervention. 14 (16) (pp 1401-1408), 2020. Date of Publication: March
2020.
Author
Da Silva P.B.; Sousa J.P.; Oliveiros B.; Donato H.; Costa M.; Goncalves
L.; Teixeira R.
Institution
(Da Silva, Sousa, Oliveiros, Donato, Goncalves, Teixeira) Faculdade de
Medicina, Universidade de Coimbra, Coimbra, Portugal
(Donato) Servico de Documentacao, Centro Hospitalare Universitario de
Coimbra, Coimbra, Portugal
(Costa, Goncalves, Teixeira) Servico de Cardiologia, Centro Hospitalar e
Universitario de Coimbra, Coimbra, Portugal
Publisher
Europa Group
Abstract
Aims: The aim of this study was to assess the stroke rate after
transcatheter mitral valve repair (TMVR) with the MitraClip, comparing it
with surgical mitral valve repair (SMVR) and optimal medical treatment
(OMT). Methods and Results: In December 2018, we systematically
searched PubMed, Embase and Cochrane Controlled Register of Trials for
studies comparing TMVR with SMVR and/or OMT for the treatment of severe
mitral regurgitation. Random-effects and cumulative meta-analysis was
performed. Ten studies were included (seven of TMVR versus SMVR and three
of TMVR versus OMT), providing a total of 1,881 patients and 61 pooled
strokes (16 in TMVR versus SMVR and 45 in TMVR versus OMT). There was no
difference in stroke incidence between TMVR and SMVR (pooled OR 0.49
[0.17, 1.42], p=0.19). However, there was a trend towards a lower stroke
risk in TMVR. For TMVR versus OMT, no difference in stroke rate was
identified (pooled OR 1.09 [0.60, 1.97], p=0.79). Post-procedure de novo
atrial fibrillation was more frequent in SMVR when compared with TMVR.
 Conclusion(s): Despite both a low number of pooled stroke events and
the failure to reach the pre-specified statistical significance, there was
a trend for a lower post-procedure stroke rate in TMVR when compared with
SMVR and a similar one between TMVR and OMT alone. Copyright ©
Europa Digital & Publishing 2020.

<28>
Accession Number
2005600963
Title
Treatment of Severe TRIcuspid regurgitation in patients with advanced
heart failure with caval vein implantation of the edwards sapien XT valve
(TRICAVAL): A randomised controlled trial.
Source
EuroIntervention. 15 (17) (pp 1506-1513), 2020. Date of Publication: April
2020.
Author
Dreger H.; Mattig I.; Hewing B.; Knebel F.; Lauten A.; Lembcke A.; Thoenes
M.; Roehle R.; Stangl V.; Landmesser U.; Grubitzsch H.; Stangl K.; Laule
M.
Institution
(Dreger, Mattig, Hewing, Knebel, Stangl, Stangl, Laule) Medizinische
Klinik fur Kardiologie und Angiologie, Campus Charite Mitte, Charite -
Universitatsmedizin Berlin, Chariteplatz 1, Berlin D-10117, Germany
(Dreger, Hewing, Knebel, Stangl, Landmesser, Stangl) DZHK (German Centre
for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
(Hewing, Knebel, Roehle, Landmesser, Laule) Berlin Institute of Health
(BIH), Berlin, Germany
(Lauten, Landmesser) Medizinische Klinik fur Kardiologie, Campus Benjamin
Franklin, Charite - Universitatsmedizin Berlin, Berlin, Germany
(Lembcke) Institut fur Radiologie, Campus Charite Mitte, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Thoenes) Edwards Lifesciences, Nyon, Switzerland
(Roehle) Coordinating Center for Clinical Studies, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Roehle) Institute of Biometry and Clinical Epidemiology, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Grubitzsch) Klinik fur Kardiovaskulare Chirurgie, Charite -
Universitatsmedizin Berlin, Berlin, Germany
Publisher
Europa Group
Abstract
Aims: The aim of our study was to compare the impact of implantation of a
balloon-expandable transcatheter valve into the inferior vena cava (CAVI)
on exercise capacity with optimal medical therapy (OMT) in patients with
severe tricuspid regurgitation (TR) and high surgical risk. Methods
and Results: Twenty-eight patients were randomised to OMT (n=14) or CAVI
(n=14). The primary endpoint was maximal oxygen uptake at the three-month
follow-up. Secondary endpoints included six-minute walk test, NYHA class,
NT-proBNP levels, right heart function, unscheduled heart failure
hospitalisation, and quality of life as assessed by the Minnesota Living
with Heart Failure Questionnaire (MLHFQ). Patients underwent follow-up
examinations one, three, six, and twelve months after randomisation.
Maximal oxygen uptake did not change significantly in either group after
three months and there was no difference between the OMT and CAVI groups
(-0.1+/-1.8 ml kg-1 min-1 vs -1.0+/-1.6 ml kg-1 min-1, p=0.4995). Compared
to baseline, CAVI improved NYHA class, dyspnoea, and quality of life after
three months. However, there were no statistically significant differences
in the secondary endpoints between the groups. Four periprocedural
complications occurred after CAVI, resulting in open heart surgery. Four
patients in the OMT group and eight patients (including four after
conversion to surgery) in the CAVI group died from right heart failure,
sepsis or haemorrhage. Conclusion(s): CAVI did not result in a
superior functional outcome compared to OMT. Due to an unexpectedly high
rate of valve dislocations, the study was stopped for safety
reasons. Copyright © Europa Digital & Publishing 2020.

<29>
Accession Number
2005600962
Title
Systematic review and meta-analysis of current risk models in predicting
short-term mortality after transcatheter aortic valve replacement.
Source
EuroIntervention. 15 (17) (pp 1497-1505), 2020. Date of Publication: April
2020.
Author
Siddiqi T.J.; Usman M.S.; Khan M.S.; Khan M.A.A.; Riaz H.; Khan S.U.;
Murad M.H.; Kavinsky C.J.; Doukky R.; Kalra A.; Desai M.Y.; Bhatt D.L.
Institution
(Siddiqi, Usman, Khan) Department of Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Khan, Doukky) Department of Medicine, John H. Stroger Jr. Hospital of
Cook County, Chicago, IL, United States
(Riaz, Kalra, Desai) Department of Cardiovascular Medicine, Cleveland
Clinic, Cleveland, OH, United States
(Khan) Department of Medicine, West Virginia University, Morgantown, WV,
United States
(Murad) Evidence-Based Practice Center, Mayo Clinic, Rochester, NY, United
States
(Kavinsky, Doukky) Division of Cardiology, Rush University Medical Center,
Chicago, IL, United States
(Bhatt) Department of Cardiovascular Medicine, Brigham and Women's
Hospital, Heart and Vascular Center, Boston, MA, United States
Publisher
Europa Group
Abstract
Aims: The aim of this study was to evaluate the performance of risk
stratification models (RSMs) in predicting short-term mortality after
transcatheter aortic valve replacement (TAVR). Methods and Results:
MEDLINE and Scopus were queried to identify studies which validated RSMs
designed to assess 30-day or in-hospital mortality after TAVR.
Discrimination and calibration were assessed using C-statistics and
observed/expected ratios (OERs), respectively. C-statistics were pooled
using a random- effects inverse-variance method, while OERs were pooled
using the Peto odds ratio. A good RSM is defined as one with a C-statistic
>0.7 and an OER close to 1.0. Twenty-four studies (n=68,215 patients)
testing 11 different RSMs were identified. Discrimination of all RSMs was
poor (C-statistic <0.7); however, certain TAVR-specific RSMs such as the
in-hospital STS/ACC TVT (C-statistic=0.65) and STT (C-statistic=0.66)
predicted individual mortality more reliably than surgical models
(C-statistic range=0.59-0.61). A good calibration was demonstrated by the
in-hospital STS/ACC TVT (OER=0.99), 30-day STS/ACC TVT (OER=1.08) and STS
(OER=1.01) models. Baseline dialysis (OER: 2.64 [1.88, 3.70]; p<0.001) was
the strongest predictor of mortality. Conclusion(s): This study
demonstrates that the STS/ACC TVT model (in-hospital and 30-day) and the
STS model have accurate calibration, making them useful for comparison of
centre-level risk-adjusted mortality. In contrast, the discriminative
ability of currently available models is limited. Copyright ©
Europa Digital & Publishing 2020.

<30>
Accession Number
2005595418
Title
Comprehensive treatment effect and clinical characteristics of lung cancer
and esophageal cancer after surgery.
Source
Acta Medica Mediterranea. 36 (2) (pp 865-870), 2020. Date of Publication:
2020.
Author
Wang P.; Zhang Y.; Xue F.; He B.
Institution
(Wang, Xue, He) Department of Thoracic Surgery, Nucleus Industry 215
Hospital, Xianyang, Shaanxi, China
(Zhang) School of Arts and Sciences, Shaanxi University of Science and
Technology, Xi'an, Shaanxi, China
Publisher
A. CARBONE Editore
Abstract
Introduction: To investigate the clinical features and comprehensive
treatment effects of patients with lung cancer and esophageal cancer.
 Material(s) and Method(s): A retrospective analysis of patients with
lung cancer and esophageal cancer admitted to the Department of Thoracic
Surgery, NO. 215 Hospital of Shaanxi Nuclear Industry from January 2013 to
December 2018. Statistical analysis of patients' case data with radical
esophageal cancer, definitive radiotherapy and chemotherapy completed the
patient. Lung cancer resection and radiotherapy and/or chemotherapy
postoperative evaluation analysis, evaluation of comprehensive treatment
effect of lung cancer and esophageal cancer patients, improve patient
survival. Result(s): 224 patients with esophageal cancer and solitary
pulmonary nodules who underwent surgical resection were retrospectively
reviewed. Pathological results showed that 5 cases of malignant lesions
were primary lung adenocarcinoma, and no esophageal metastases were found.
Most patients with recurrence can still undergo endoscopic surgical
resection or esophagectomy. There is no difference in survival between the
two groups. Lung cancer patients underwent postoperative radiotherapy
alone and postoperative comprehensive treatment group. The long-term
survival rate of the comprehensive treatment group was better than that of
the postoperative simple group. The 1-year survival rate was 48.1% in the
comprehensive treatment group, the 3-year survival rate was 16.2%, and the
5-year survival rate was 6.3%. Conclusion(s): In the absence of
multiple systemic metastases, solitary pulmonary nodules in patients with
esophageal cancer are rarely pulmonary metastases of esophageal tumors,
more benign nodules or primary tumors in the lungs. Postoperative
radiotherapy and chemotherapy is feasible in patients undergoing
pneumonectomy, but further randomized studies needed to select a more
appropriate model to improve long-term survival. Copyright © 2020
A. CARBONE Editore. All rights reserved.

<31>
Accession Number
631475474
Title
Serum trace elements in coronary artery bypass graft surgery: The
relationship between trace element supplementation and period of
mechanical ventilation in a randomized double-blind placebo-controlled
trial.
Source
Jundishapur Journal of Natural Pharmaceutical Products. 14 (4) (no
pagination), 2019. Article Number: 68735. Date of Publication: 01 Nov
2019.
Author
Amirizadeh M.; Salehifar E.; Habibi M.; Shokrzadeh M.; Soleimani A.;
Charati J.Y.; Ghaffari R.; Habibi V.; Eslami G.
Institution
(Amirizadeh, Salehifar) Department of Clinical Pharmacy, Pharmaceutical
Sciences Research Center, Faculty of Pharmacy, Mazandaran University of
Medical Sciences, Sari, Iran, Islamic Republic of
(Habibi, Soleimani) Department of Anesthesiology, Faculty of Medicine,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Shokrzadeh) Department of Toxicology, Faculty of Pharmacy, Mazandaran
University of Medical Sciences, Sari, Iran, Islamic Republic of
(Charati) Department of Biostatics, Health Sciences Research Center,
Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran,
Islamic Republic of
(Ghaffari, Habibi) Department of Cardiac Surgery, Faculty of Medicine,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Eslami) Department of Clinical Pharmacy, Faculty of Pharmacy,
Cardiovascular Research Center, Mazandaran University of Medical Sciences,
Sari, Iran, Islamic Republic of
Publisher
Kowsar Medical Publishing Company (E-mail: library@kowsarpub.com)
Abstract
Background: Coronary artery bypass graft surgery (CABG) may cause a
substantial decrease in trace elements of whole blood during the
operation, as well as increased oxidative stress and result in lung
damage. Objective(s): This study aimed to evaluate the effect of
Addamel, as a complete mixture of trace elements, in reducing the period
of mechanical ventilation following the cardiac surgery. Method(s):
In this randomized, double-blind, placebo-controlled trial, two hundred
patients receiving CABG were randomized to receive three doses of either
Addamel or normal saline. Selenium, zinc, copper, ferrous, and manganese
serum levels were measured before the operation, on days one and two in
all groups. Besides, the effects of Addamel on the mechanical ventilation
period were evaluated. Result(s): The mean length of stay on the
mechanical ventilator was lower in the supplemented patients (21.98 +/-
8.4 days) than the control patients (25.16 +/- 8.44 days), and the
difference was statistically significant (P = 0.009). Conclusion(s):
A substantial number of patients undergoing CABG may benefit from
supplementation with Addamel, as a source of trace elements. Copyright
© 2019, Jundishapur Journal of Natural Pharmaceutical Products. This
is an open-access article distributed under the terms of the Creative
Commons Attribution-NonCommercial 4.0 International License
(http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and
redistribute the material just in noncommercial usages, provided the
original work is properly cited.

<32>
Accession Number
626735698
Title
Intraoperative infusion of noradrenaline improves platelet aggregation in
patients undergoing coronary artery bypass grafting: a randomized
controlled trial.
Source
Journal of Thrombosis and Haemostasis. 17 (4) (pp 657-665), 2019. Date of
Publication: April 2019.
Author
Singh S.; Damen T.; Dellborg M.; Jeppsson A.; Nygren A.
Institution
(Singh, Dellborg, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Damen, Nygren) Department of Anesthesiology and Intensive Care Medicine,
Institute of Clinical Sciences, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
(Damen, Nygren) Department of Cardiothoracic Anesthesia and Intensive
Care, Sahlgrenska University Hospital, Gothenburg, Sweden
Publisher
Blackwell Publishing Ltd
Abstract
Essentials Strategies to improve platelet function may reduce excessive
bleeding during cardiac surgery. Patients were randomized to standard care
or standard care + noradrenaline infusion. Low-dose noradrenaline improved
intraoperative platelet aggregation and clot formation. Noradrenaline may
be considered to improve intraoperative hemostasis during cardiac surgery.
 Summary: Background New approaches to prevent bleeding complications
during cardiac surgery are needed. Objective To investigate if
noradrenaline (NA) enhances platelet aggregation in patients undergoing
coronary artery bypass grafting (CABG). Patients/Methods Twenty-four
patients undergoing coronary artery bypass grafting (CABG) were included
in a prospective parallel-group randomized study. All patients but one
were treated with acetylsalicylic acid (ASA). In the treatment group (n =
12), mean arterial blood pressure (MAP) was maintained at pre-induction
levels by NA infusion. In the control group (n = 12), NA was administered
only if MAP decreased below 60 mmHg. Platelet aggregation (impedance
aggregometry with ADP, arachidonic acid [AA] and thrombin-receptor
activating peptide [TRAP] as initiators) and clot formation (clotting
time, clot formation time and maximum clot firmness by EXTEM, INTEM and
FIBTEM tests with thromboelastometry) were assessed before and 50 min
after anesthesia induction (before cardiopulmonary bypass was initiated).
Results All patients in the treatment group received NA (median dose after
50 min 0.09 (range 0-0.26) mug kg-1 min-1). Four
patients in the control group also received NA (0.03-0.12 mug
kg-1 min-1). There were differences between the
treatment group and the control group in ADP- and AA-induced aggregation
changes (ADP, +16 [25th-75th percentiles, 5-26] vs. -7 [-19 to -1] U; AA,
+12 [-4 to 16] vs. -9 [-13 to 1] U). INTEM maximum clot firmness increased
in the treatment group but not in the control group. Conclusion Infusion
of clinically relevant doses of NA enhanced platelet aggregation and clot
firmness in ASA-treated CABG patients. NA infusion is hence a potential
new method to acutely improve platelet reactivity in patients on
antiplatelet therapy undergoing surgery. Copyright © 2019
International Society on Thrombosis and Haemostasis

<33>
Accession Number
629281002
Title
Comparing outcomes between valve-sparing root replacement and the Bentall
procedure in proximal aortic aneurysms: systematic review and
meta-analysis.
Source
Interactive cardiovascular and thoracic surgery. 29 (6) (pp 911-922),
2019. Date of Publication: 01 Dec 2019.
Author
Salmasi M.Y.; Theodoulou I.; Iyer P.; Al-Zubaidy M.; Naqvi D.; Snober M.;
Oo A.; Athanasiou T.
Institution
(Salmasi) Department of Surgery and Cancer, Imperial College, London,
United Kingdom
(Theodoulou, Iyer, Athanasiou) Faculty of Life Sciences and Medicine,
King's College London, London, United Kingdom
(Al-Zubaidy, Naqvi, Snober) Faculty of Medicine, Imperial College London,
London, United Kingdom
(Oo) Department of Cardiac Surgery, Barts Heart Centre, St. Bartholomew's
Hospital, London, United Kingdom
Publisher
NLM (Medline)
Abstract
In aortic root aneurysms, the challenge of a valve-sparing aortic root
replacement (VSRR) procedure is to ensure durable aortic valve function
without reintervention. Although the Bentall procedure defers the
durability of valve function to the prosthesis, short- and long-term
complications tend to be higher. The aim of this study was to compare the
outcomes of VSRR and Bentall procedures in patients with aortic root
aneurysms. A systematic literature review was conducted using PubMed
regarding the outcomes of the Bentall procedure compared with those of
VSRR from the inception of the 2 procedures until July 2018. Studies with
short- and long-term comparative data were included. An initial search
yielded 9517 titles. Thirty-four studies were finally included for
meta-analysis (all retrospective, non-randomized), comprising 7313
patients (2944 valve-sparing and 4369 Bentall procedures) with no evidence
of publication bias. Operative mortality was found to be significantly
lower in the VSRR group [odds ratio (OR) 0.51, 95% confidence interval
(CI) 0.37-0.70; P<0.001] despite overall higher cardiopulmonary bypass and
aortic cross-clamp times. The 5-year survival rate was also more
favourable in the VSRR group (OR 1.93 95% CI 1.15-3.23; P<0.05).
Significantly lower rates of cerebral thromboembolism (OR 0.668, 95% CI
0.477-0.935; P=0.019) and heart block (OR 0.386, 95% CI 0.195-0.767;
P=0.007) were also found after VSRR. There was no significant difference
in rates of reoperation between the groups at long-term follow-up (OR
1.32, 95% CI 0.75-2.33; P=0.336). Meta-regression of patient and operative
covariates yielded no influence on the main outcomes (P>0.05). These
findings suggest that VSRR is an appropriate and potentially better
treatment option for a root aneurysm when the aortic valve is
repairable. Copyright © The Author(s) 2019. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<34>
Accession Number
631502919
Title
Derivation and Validation of a Risk Stratification System for Predicting
Postoperative Cognitive Impairment.
Source
Journal of investigative surgery : the official journal of the Academy of
Surgical Research. (pp 1-7), 2020. Date of Publication: 13 Apr 2020.
Author
Liao Y.; Su X.; Ouyang W.; Li L.; Chen S.; Chou J.; Le Y.
Institution
(Liao, Su, Ouyang, Li, Chen, Chou, Le) Department of Anesthesiology, Third
Xiangya Hospital, Central South University, Changsha, China
Publisher
NLM (Medline)
Abstract
Background: To establish and validate a risk stratification scoring system
(we name it as PreOp-BFS, which represents Pre-Operative Brain Fragility
Score) for postoperative cognitive impairment containing postoperative
cognitive dysfunction (POCD) and postoperative delirium (POD) in elderly
patients undergoing non-cardiac surgery. Method(s): We searched for
relevant literatures and reviews reported in PubMed and ScienceDirect
databases from January 1994 to December 2017. We performed a preoperative
risk factor for cognitive impairment in elderly patients (age >= 60years)
who underwent non-cardiac surgery, and finally constructed a risk scoring
system to predict postoperative cognitive impairment. Result(s): The
test data included 49 patients with postoperative cognitive impairment and
31 patients without postoperative cognitive impairment. The postoperative
risk scale score ranged from 0 to 8 points. The incidence of postoperative
cognitive impairment was 16.2%, 62.9% and 96.2% in the low (0-2 scores),
medium (3-4 scores) and high (5-8 scores) risk groups, respectively. In
addition, the risk of postoperative cognitive impairment was significantly
higher in high and medium risk groups than in low risk group. Receiver
operating characteristic (ROC) analysis showed that the area under the
curve (AUC) of the risk scoring system was 0.862 [95% CI 0.784-0.941].
 Conclusion(s): The preoperative risk stratification scoring system
(PreOp-BFS) established in this study had a good prediction effect, which
was helpful for rapid identification and screening of high-risk
susceptible patients with early postoperative cognitive impairment, and
for performing targeted perioperative prevention.

<35>
Accession Number
2003704150
Title
Pragmatic analysis of dyslipidemia involvement in coronary artery disease:
A narrative review.
Source
Current Cardiology Reviews. 16 (1) (pp 36-47), 2020. Date of Publication:
2020.
Author
Mihaila R.-G.
Institution
(Mihaila) Faculty of Medicine, "Lucian Blaga" University of Sibiu, Sibiu,
Romania
(Mihaila) CVASIC Laboratory, Emergency County Clinical Hospital Sibiu,
Sibiu, Romania
Publisher
Bentham Science Publishers (P.O. Box 294, Bussum 1400 AG, Netherlands)
Abstract
Background: Dyslipidemia is the main factor involved in the occurrence and
progression of coronary artery disease. Objective(s): The research
strategy is aimed at analyzing new data on the pathophysiology of
dyslipidemia involvement in coronary artery disease, the modalities of
atherogenic risk estimation and therapeutic advances. Method(s):
Scientific articles published in PubMed from January 2017 to February 2018
were searched using the terms "dyslipidemia" and "ischemic heart disease".
 Result(s): PCSK9 contributes to the increase in serum levels of
low-density lipoprotein-cholesterol and lipoprotein (a). The inflammation
is involved in the progression of hyperlipidemia and atherosclerosis.
Hypercholesterolemia changes the global cardiac gene expression profile
and is thus involved in the increase of oxidative stress, mitochondrial
dysfunction, and apoptosis initiated by inflammation. Coronary artery
calcifications may estimate the risk of coronary events. The cardio-ankle
vascular index evaluates the arterial stiffness and correlates with
subclinical coronary atherosclerosis. The carotid plaque score is superior
to carotid intima-media thickness for risk stratification in patients with
familial hypercholesterolemia and both can independently predict coronary
artery disease. The lipoprotein (a) and familial hypercholesterolemia have
a synergistic role in predicting the risk of early onset and severity of
coronary atherosclerosis. A decrease in atherosclerotic coronary plaque
progression can be achieved in patients with plasma LDL-cholesterol levels
below 70 mg/dL. A highly durable RNA interference therapeutic inhibitor of
PCSK9 synthesis could be a future solution. Conclusion(s): The
prophylaxis and treatment of coronary artery disease in a dyslipidemic
patient should be based on a careful assessment of cardio-vascular risk
factors and individual metabolic particularities, so it may be
personalized. Copyright © 2020 Bentham Science Publishers.

<36>
Accession Number
2004334320
Title
Mitral valve prosthesis choice in patients <70 years: A systematic review
and meta-analysis of 20 219 patients.
Source
Journal of Cardiac Surgery. 35 (4) (pp 818-825), 2020. Date of
Publication: 01 Apr 2020.
Author
Yanagawa B.; Lee J.; Ouzounian M.; Bagai A.; Cheema A.; Verma S.;
Friedrich J.O.
Institution
(Yanagawa, Lee, Verma) Divisions of Cardiac Surgery, St Michael's
Hospital, University of Toronto, Toronto, ON, Canada
(Ouzounian) Division of Cardiac Surgery, Toronto General Hospital,
University of Toronto, Toronto, ON, Canada
(Bagai, Cheema) Department of Cardiology, St Michael's Hospital,
University of Toronto, Toronto, ON, Canada
(Friedrich) Department of Critical Care and Medicine, St Michael's
Hospital, University of Toronto, Toronto, ON, Canada
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: The optimal mitral prosthesis in young patients is unclear.
This systematic review and meta-analysis were performed to compare
outcomes between bileaflet mechanical mitral valve replacement (mMVR) and
bioprosthesis mitral valve replacement (bioMVR) for MVR patients aged less
than 70 years. Method(s): We searched MEDLINE and EMBASE databases
from inception to July 2018 for studies comparing surgical outcomes of
mMVR vs bioMVR. Result(s): There were 14 observational studies with
20 219 patients (n = 14 658 mMVR and n = 5561 bioMVR). Patients receiving
an mMVR were younger with fewer comorbidities including renal failure,
dialysis, and less-infective endocarditis (P <.001). The estimated 10-year
mortality ranged from 19% to 49% for mMVR and 22% to 58% for bioMVR among
studies. Comparing matched or adjusted data, mMVR was associated with
lower operative (risk ratio [RR]: 0.61; 95% confidence interval [CI]:
0.39, 0.94; P =.03) and long-term (HR: 0.81; 95% CI: 0.71, 0.92; P =.002)
mortality at a median follow-up of 8 years (IQR: 6-10 years). Estimated
10-year risk for mitral valve reoperation ranged from 0% to 8% for mMVR
and 8% to 22% for bioMVR among matched/adjusted studies. mMVR was
associated with lower matched/adjusted risk of reoperation (HR: 0.35; 95%
CI: 0.19, 0.65; P =.001) but with greater risk of bleeding (HR: 1.59; 95%
CI: 1.19, 2.13; P =.002) and a trend to greater risk of stroke and
embolism (HR: 1.70; 95% CI: 0.92, 3.15; P =.09). Conclusion(s):
Mechanical MVR in patients aged less than 70 years is associated with a
lower risk of operative mortality as well as a 20% lower risk of long-term
death and 65% lower risk of mitral valve reoperation but 60% greater risk
of bleeding compared with bioMVR in matched or adjusted
data. Copyright © 2020 Wiley Periodicals, Inc.

<37>
Accession Number
2004144097
Title
Pre-procedural elevated cardiac troponin predict risk of long-term
all-cause mortality after transcatheter aortic valve replacement: a
meta-analysis of prospective studies.
Source
Biomarkers. 25 (2) (pp 164-170), 2020. Date of Publication: 17 Feb 2020.
Author
Li Y.; Pei H.; Zhou C.; Lou Y.
Institution
(Li, Lou) Department of Cardiology, State Key Laboratory of Cardiovascular
Disease, Fuwai Hospital, National Center for Cardiovascular Disease,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
(Pei) Department of Cardiology, The First Affiliated Hospital of Baotou
Medical College, Baotou, China
(Zhou) Department of Anesthesiology, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular
Disease, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
Publisher
Taylor and Francis Ltd
Abstract
Background: The purpose of this meta-analysis was to evaluate the
relationship between elevated cardiac troponin pre-transcatheter aortic
valve replacement (TAVR) and long-term all-cause mortality.
 Method(s): Prospective studies with the endpoint of all-cause
mortality were included. We primarily used the fixed-effect model weighted
by inverse variance. Meta-regression and subgroup analyses were conducted
to explore the potential sources of heterogeneity by specified study
characteristics. Result(s): Seven prospective studies comprising of
3049 subjects were included in our meta-analysis. Pre-procedural elevated
cardiac troponin was associated with increased risk of long-term mortality
post TAVR [hazard ratio (HR) 2.25, 95% CI 1.83-2.78, p = 0.000,
I2 = 30.3%, p for heterogeneity 0.197]. In addition, subgroup
analyses have shown that the group with an younger age (<82 y) seemed to
have a higher risk of all-cause mortality than the group with older age
(>=82 y) [HR 4.08 (2.41 to 6.89) VS 2.01 (1.60 to 2.53), p = 0.016 for
subgroup difference]. Conclusion(s): Pre-procedural elevated cardiac
troponin was associated with increased long-term all-cause mortality in
patients undergoing TAVR. Copyright © 2020, © 2020 Informa
UK Limited, trading as Taylor & Francis Group.

<38>
Accession Number
2004133279
Title
Anxiety administrated by dexmedetomidine to prevent new-onset of
postoperative atrial fibrillation in patients undergoing off-pump coronary
artery bypass graft.
Source
International Heart Journal. 61 (2) (pp 263-272), 2020. Date of
Publication: 2020.
Author
Zi J.; Fan Y.; Dong C.; Zhao Y.; Li D.; Tan Q.
Institution
(Zi, Dong, Zhao, Li, Tan) Department of Cardiovascular Surgery, Shandong
Provincial Hospital Affiliated to Shandong First Medical University,
Jinan, China
(Zi, Dong, Zhao, Li, Tan) Department of Cardiovascular Surgery, Shandong
Provincial Hospital Affiliated to Shandong University, Jinan, China
(Fan) Department of Toxicological and Functional Test, Shandong Centers
for Disease Control and Prevention, Jinan, China
Publisher
International Heart Journal Association (E-mail: : jhj-office@umin.ac.jp)
Abstract
This study aims to evaluate the effect of dexmedetomidine (DEX) sedation
for relieving anxiety and the incidence of atrial fibrillation (AF) after
off-pump coronary artery bypass graft (OPCABG). This randomized,
double-blind, controlled trial was conducted on 196 patients who underwent
OPCABG in Shandong Provincial Hospital from July 2017 to June 2018. The
patients were randomly assigned to two groups, intervention of DEX group
and Propofol (PROP) group. Episodes of postoperative AF (POAF) were
identified within 5 days after OPCABG. Perioperative anxiety status was
assessed using Zung's Self-Rating Anxiety Scale (SAS). The baseline
demographic and surgical characteristics of the population and other
outcome variables were evaluated. We analyzed 62 patients in the DEX group
and 61 patients in the PROP group. There was no significant difference in
SAS anxiety scores between two groups before surgery (P = 0.104), while
SAS had significantly after surgery (P = 0.018). The incidence of POAF in
the DEX group was lower than that of the PROP group (16.1% versus 32.8%, P
= 0.037), and a total of 30 patients (30/123, 24.4%) manifested POAF after
OPCABG. Some univariable predictors of POAF were detected. The conceptual
model of mediator analyses showed DEX was not only directly related to
POAF but was also indirectly related through the independent effect of
anxiety level. The findings indicated that patients receiving DEX were
more likely to have less incidence of POAF, also uniquely showed DEX
administration and POAF processes as a function of anxiety
status. Copyright © 2020, International Heart Journal
Association. All rights reserved.

<39>
Accession Number
2005468767
Title
Anthracycline-induced cardiotoxicity prevention with
angiotensin-converting enzyme inhibitor ramipril in women with low-risk
breast cancer: Results of a prospective randomized study.
Source
Kardiologia Polska. 78 (2) (pp 131-137), 2020. Date of Publication: 25 Feb
2020.
Author
Slowik A.J.; Jagielski P.; Potocki P.; Streb J.; Ochenduszko S.; Wysocki
P.; Gajos G.; Konduracka E.
Institution
(Slowik, Potocki, Streb, Wysocki) Department of Oncology, Jagiellonian
University Medical College, Krakow, Poland
(Jagielski) Human Nutrition Department, Faculty of Health Science,
Jagiellonian University Medical College, Krakow, Poland
(Ochenduszko) Department of Medical Oncology, Dr. Peset University
Hospital, Valencia, Spain
(Gajos, Konduracka) Department of Coronary Disease and Heart Failure,
Jagiellonian University Medical College, Krakow, Poland
(Gajos, Konduracka) Institute of Cardiology, John Paul II Hospital,
Krakow, Poland
Publisher
Medycyna Praktyczna Cholerzyn (E-mail: listy@mp.pl)
Abstract
Background: Anthracycline-induced cardiotoxicity (AIC) remains the main
long-term irreversible side effect in malignancy survivors. Cardiotoxicity
prevention is one of the most reasonable approaches. Aim(s): In this
prospective randomized open-label study, we aimed to verify whether
ramipril protects from early-onset AIC in women with breast cancer (BC).
 Method(s): We analyzed data from 96 women (median age, 47 years) with
BC after breast surgery, without significant cardiovascular diseases, who
were eligible for adjuvant anthracyclines. They were randomized to a
ramipril or control arm. Cardiotoxicity was estimated with repeat
echocardiography and the measurement of troponin I and N-terminal fragment
of the prohormone brain natriuretic peptide (NT-proBNP) levels over 1-year
follow-up. Anthracycline-induced cardiotoxicity was defined as a decrease
in left ventricular ejection fraction (LVEF), elevated biomarker levels,
and/or occurrence of heart failure (HF) or cardiac death. Result(s):
A decrease in LVEF above 10-percent points occurred in 6.3% of ramipril
patients and 18.5% of controls (P = 0.15). No cases of HF, cardiac death,
or LVEF decline below 50% were reported. The percentage of patients with
elevated NT-proBNP levels increased with time in controls (P = 0.003) and
remained unchanged in the ramipril arm. At the end of follow-up, an
increase in NT-proBNP levels was more common and decline was less common
in the control than ramipril arm (P = 0.01). No significant differences in
troponin levels were found between the study arms. Ramipril was well
tolerated in normotensive women. Conclusion(s): In relatively young
women with BC without serious comorbidities, who received anthracyclines,
1-year treatment with ramipril exerts potentially protective effects on
cardiotoxicity assessed with NT-proBNP levels. Copyright © 2020
by the Author(s).

<40>
[Use Link to view the full text]
Accession Number
631402592
Title
Impact of Preoperative Erythropoietin on Allogeneic Blood Transfusions in
Surgical Patients: Results from a Systematic Review and Meta-analysis.
Source
Anesthesia and Analgesia. 128 (5) (pp 981-992), 2019. Date of Publication:
2019.
Author
Cho B.C.; Serini J.; Zorrilla-Vaca A.; Scott M.J.; Gehrie E.A.; Frank
S.M.; Grant M.C.
Institution
(Cho, Frank, Grant) Department of Anesthesiology/Critical Care Medicine,
Johns Hopkins Medical Institutions, Baltimore, MD, United States
(Serini) Department of Anesthesiology/Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Zorrilla-Vaca) Universidad Del Valle School of Medicine, Cali, Colombia
(Scott) Department of Anesthesiology, Virginia Commonwealth University
School of Medicine, Richmond, VA, United States
(Gehrie) Departments of Pathology, Johns Hopkins Medical Institutions,
Baltimore, MD, United States
(Grant) Departments of Surgery, Johns Hopkins Medical Institutions,
Baltimore, MD, United States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
BACKGROUND: Erythropoietic-stimulating agents such as erythropoietin have
been used as part of patient blood management programs to reduce or even
avoid the use of allogeneic blood transfusions. We review the literature
to evaluate the effect of preoperative erythropoietin use on the risk of
exposure to perioperative allogeneic blood transfusions. METHOD(S):
The study involved a systematic review and meta-analysis of randomized
controlled trials evaluating the use of preoperative erythropoietin. The
primary outcome was the reported incidence of allogeneic red blood cell
transfusions during inpatient hospitalizations. Secondary outcomes
included phase-specific allogeneic red blood cell transfusions (ie,
intraoperative, postoperative), intraoperative estimated blood loss,
perioperative hemoglobin levels, length of stay, and thromboembolic
events. RESULT(S): A total of 32 randomized controlled trials (n =
4750 patients) were included, comparing preoperative erythropoietin (n =
2482 patients) to placebo (n = 2268 patients). Preoperative erythropoietin
is associated with a significant decrease in incidence of allogeneic blood
transfusions among all patients (n = 28 studies; risk ratio, 0.59; 95% CI,
0.47-0.73; P <.001) as well as patients undergoing cardiac (n = 9 studies;
risk ratio, 0.55; 95% CI, 0.37-0.81; P =.003) and elective orthopedic (n =
5 studies; risk ratio, 0.36; 95% CI, 0.28-0.46; P <.001) surgery compared
to placebo, respectively. Preoperative erythropoietin was also associated
with fewer phase-specific red blood cell transfusions. There was no
difference between groups in incidence of thromboembolic events (n = 28
studies; risk ratio, 1.02; 95% CI, 0.78-1.33; P =.68). CONCLUSION(S):
Preoperative erythropoietin is associated with a significant reduction in
perioperative allogeneic blood transfusions. This finding is also
confirmed among the subset of patients undergoing cardiac and orthopedic
surgery. Furthermore, our study demonstrates no significant increase in
risk of thromboembolic complications with preoperative erythropoietin
administration. Copyright © 2020 American Society of Civil
Engineers (ASCE). All rights reserved.

<41>
[Use Link to view the full text]
Accession Number
631006864
Title
The authors reply.
Source
Critical Care Medicine. 47 (12) (pp e1043-e1044), 2019. Date of
Publication: 01 Dec 2019.
Author
Putzu A.; Lopez Delgado J.C.; Landoni G.
Institution
(Putzu) Division of Anesthesiology, Department of Anesthesiology,
Pharmacology, Intensive Care, and Emergency Medicine, Geneva University
Hospitals, Geneva, Switzerland
(Lopez Delgado) Intensive Care Department, Hospital Universitari de
Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
(Lopez Delgado, Landoni) Department of Anesthesia and Intensive Care,
IRCCS San Raffaele Scientific Institute, Milan, Italy
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)

<42>
[Use Link to view the full text]
Accession Number
630995166
Title
Ramelteon for Prevention of Postoperative Delirium: A Randomized
Controlled Trial in Patients Undergoing Elective Pulmonary
Thromboendarterectomy*.
Source
Critical Care Medicine. 47 (12) (pp 1751-1758), 2019. Date of Publication:
01 Dec 2019.
Author
Jaiswal S.J.; Vyas A.D.; Heisel A.J.; Ackula H.; Aggarwal A.; Kim N.H.;
Kerr K.M.; Madani M.; Pretorius V.; Auger W.R.; Fernandes T.M.; Malhotra
A.; Owens R.L.
Institution
(Jaiswal, Aggarwal) Scripps Research Translational Institute, San Diego,
CA, United States
(Jaiswal, Heisel) Division of Hospital Medicine, Scripps Clinic/Scripps
Green Hospital, San Diego, CA, United States
(Vyas, Ackula, Kim, Kerr, Madani, Pretorius, Auger, Fernandes, Malhotra,
Owens) Division of Pulmonary, Critical Care and Sleep Medicine, University
of California San Diego, School of Medicine, San Diego, CA, United States
(Owens) Division of Cardiovascular and Thoracic Surgery, University of
California San Diego, School of Medicine, San Diego, CA, United States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Objectives: To assess the efficacy of ramelteon in preventing delirium, an
acute neuropsychiatric condition associated with increased morbidity and
mortality, in the perioperative, ICU setting. Design(s):
Parallel-arm, randomized, double-blinded, placebo-controlled trial.
 Setting(s): Academic medical center in La Jolla, California.
 Patient(s): Patients greater than or equal to 18 years undergoing
elective pulmonary thromboendarterectomy. Intervention(s): Ramelteon
8 mg or matching placebo starting the night prior to surgery and for a
maximum of six nights while in the ICU. Measurements and Main
Results: Incident delirium was measured twice daily using the Confusion
Assessment Method-ICU. The safety outcome was coma-free days assessed by
the Richmond Agitation-Sedation Scale. One-hundred twenty participants
were enrolled and analysis completed in 117. Delirium occurred in 22 of 58
patients allocated to placebo versus 19 of 59 allocated to ramelteon
(relative risk, 0.8; 95% CI, 0.5-1.4; p = 0.516). Delirium duration, as
assessed by the number of delirium-free days was also similar in both
groups (placebo median 2 d [interquartile range, 2-3 d] vs ramelteon 3 d
[2-5 d]; p = 0.181). Coma-free days was also similar between groups
(placebo median 2 d [interquartile range, 1-3 d] vs ramelteon 3 d [2-4 d];
p = 0.210). We found no difference in ICU length of stay (median 4 d
[interquartile range, 3-5 d] vs 4 d [3-6 d]; p = 0.349), or in-hospital
mortality (four vs three deaths; relative risk ratio, 0.7; 95% CI,
0.2-3.2; p = 0.717), all placebo versus ramelteon, respectively.
 Conclusion(s): Ramelteon 8 mg did not prevent postoperative delirium
in patients admitted for elective cardiac surgery. Copyright ©
2019 by the Society of Critical Care Medicine and Wolters Kluwer Health,
Inc. All Rights Reserved.

<43>
[Use Link to view the full text]
Accession Number
628572983
Title
Changes in Physical Performance and Their Association with Health-Related
Quality of Life in a Mixed Nonischemic Cardiac Population That
Participates in Rehabilitation.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 40 (2) (pp
102-107), 2020. Date of Publication: 01 Mar 2020.
Author
Tang L.H.; Zwisler A.-D.; Doherty P.; Oldridge N.; Berg S.K.; Christensen
J.
Institution
(Tang, Zwisler) National Centre for Rehabilitation and Palliative Care,
University of Southern Denmark, Odense University Hospital, Nyborg,
Denmark
(Tang) Department of Physiotherapy and Occupational Therapy,
Naestved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
(Doherty) Department of Health Sciences, University of York, United
Kingdom
(Oldridge) College of Health Sciences, University of Wisconsin-Milwaukee,
Wisconsin-Milwaukee, United States
(Berg) Department of Cardiology, Heart Centre, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
(Christensen) Department of Occupational Therapy and Physiotherapy,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Purpose: Exercise-based cardiac rehabilitation improves physical
performance and health-related quality of life (HRQoL). However, whether
improvements in physical performance are associated with changes in HRQoL
has not been adequately investigated in a nonischemic cardiac population.
 Method(s): Patients who were ablated for atrial fibrillation, who
underwent heart valve surgery or who were treated for infective
endocarditis, and who participated in 1 of 3 randomized controlled
rehabilitation trials were eligible for the current study. Change in
physical performance and HRQoL were measured before and after a 12-wk
exercise intervention. Physical performance was assessed using a
cardiopulmonary exercise test, a 6-min walk test, and a sit-to-stand test.
Health-related quality of life was assessed using the generic 36-Item
Short Form Health Survey and the disease-specific HeartQoL questionnaire.
Spearman correlation coefficient (rho) and linear regressions quantified
the association between changes in physical outcome measures and changes
in HRQoL. Result(s): A total of 344 patients were included (mean age:
60.8 +/- 11.6 yr and 77% males). Associations between changes in physical
outcome measures and HRQoL ranged from very weak to weak (rho =-0.056 to
0.228). The observed associations were more dominant within physical
dimensions of the HRQoL compared with mental or emotional dimensions.
After adjusting for sex, age, and diagnosis, changes in physical
performance explained no more than 20% of the variation in the HRQoL.
 Conclusion(s): The findings show that the positive improvement in
HRQoL from exercise-based cardiac rehabilitation cannot simply be
explained by an improvement in physical performance. Copyright ©
2020 Wolters Kluwer Health, Inc. All rights reserved.

<44>
Accession Number
2005534459
Title
Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in
Low-Risk Patients.
Source
Heart Lung and Circulation. (no pagination), 2020. Date of Publication:
2020.
Author
Koshy A.N.; Murphy A.; Farouque O.; Horrigan M.; Yudi M.B.
Institution
(Koshy, Murphy, Farouque, Horrigan, Yudi) Department of Cardiology, Austin
Health, Melbourne, Vic, Australia
(Koshy, Murphy, Farouque, Horrigan, Yudi) The University of Melbourne,
Melbourne, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has
revolutionised the treatment of severe aortic stenosis (AS), though its
safety and efficacy in low-risk patients remains to be established.
 Method(s): A systematic review of PubMed, Medline and EMBASE
identified four randomised controlled trials (RCTs) in patients at low
surgical risk comparing TAVR to surgical aortic valve replacement (SAVR).
A meta-analysis was performed with a primary outcome of a composite of
all-cause mortality and stroke at longest available follow-up.
 Result(s): A total of four RCTs with 2,836 patients was included in
the final analysis. 1,363 patients were randomised to SAVR and 1,473 to
TAVR. The composite of all-cause mortality and stroke was significantly
lower in patients undergoing TAVR compared with SAVR (OR 0.59, 95%CI
0.37-0.95, p=0.03) with low heterogeneity (I2=31%). The
difference in the primary composite outcome was driven by a difference in
mortality (OR 0.66, 95%CI 0.44-0.98, p=0.04; I2=0%) without
significant differences in stroke (OR 0.75 95%CI 0.45-1.26, p=0.28;
I2=37%). Weighted absolute risk difference (ARD) of the primary
composite outcome also favoured TAVR (ARD -2.0% 95%CI -3.3 to -0.7%,
p=0.002) with a number needed to treat (NNT) of 50 to prevent one death or
stroke. Patients undergoing TAVR had a significantly higher risk of
permanent pacemaker implantation (OR 3.9, 95%CI 1.8-8.4, p<0.001,
I2=84%) and moderate or severe paravalvular leak (OR 5.0, 95%CI
1.6-15.7, p=0.01; I2=19%). Conclusion(s): In patients with severe AS
at low surgical risk, the rate of the composite of death and stroke was
significantly lower with TAVR than with SAVR. Longer-term follow-up with a
focus on the impact of permanent pacemaker (PPM) implantation,
paravalvular leak (PVL) and structural valve deterioration is essential
before the use of TAVR can be generalised to the broader population of
patients with AS. Copyright © 2020 Australian and New Zealand
Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society
of Australia and New Zealand (CSANZ)

<45>
Accession Number
2004902275
Title
The difficult balance between thrombosis and bleeding after transcatheter
aortic valve replacement: A translational review.
Source
Archives of Cardiovascular Diseases. 113 (4) (pp 263-275), 2020. Date of
Publication: April 2020.
Author
Trimaille A.; Marchandot B.; Park S.-H.; Schini-Kerth V.; Morel O.
Institution
(Trimaille, Marchandot, Morel) Pole d'Activite Medico-Chirurgicale
Cardio-Vasculaire, Nouvel Hopital Civil, Centre Hospitalier Universitaire,
Universite de Strasbourg, BP 426, Strasbourg 67091, France
(Park, Schini-Kerth, Morel) Regenerative NanoMedicine, UMR 1260, Inserm,
Universite de Strasbourg, Strasbourg 67085, France
Publisher
Elsevier Masson SAS (62 rue Camille Desmoulins, Issy les Moulineaux Cedex
92442, France)
Abstract
Transcatheter aortic valve replacement (TAVR) has emerged as the treatment
of choice for patients with severe aortic stenosis deemed at high or
intermediate risk for cardiac surgery. In light of the latest literature
advances, TAVR will undoubtedly concern a growing number of patients
because of the progressive extension of its indications. Whereas
significant efforts have been made to reduce the burden of periprocedural
complications, TAVR still exposes patients to a sizeable number of adverse
outcomes, including thrombotic and bleeding events. Although
contradictory, these two phenomena are closely related to
pathophysiological processes inherent to flow disturbances induced by
aortic stenosis itself, but also to a complex interaction between
bioprosthetic valves and native tissues in frail patients clustering
various co-morbidities. Reinforcing this paradigm, multiple TAVR studies
have emphasized the view that both thrombosis and bleeding events have a
deleterious effect on patient outcomes. Therefore, we sought to perform a
comprehensive translational review of the current literature addressing
the pathophysiological mechanisms leading to thrombosis and bleeding after
TAVR, and underline innovative strategies aimed at reducing these
complications. Copyright © 2020 Elsevier Masson SAS

<46>
Accession Number
2004435855
Title
The effect of colchicine on the echocardiographic constrictive physiology
after coronary artery bypass graft surgery.
Source
Echocardiography. 37 (3) (pp 399-403), 2020. Date of Publication: 01 Mar
2020.
Author
Shojaeifard M.; Pakbaz M.; Beheshti R.; Noohi Bezanjani F.; Ahangar H.;
Gohari S.; Dehghani Mohammad Abadi H.; Erami S.
Institution
(Shojaeifard) Echocardiography Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Pakbaz) Department of Cardiovascular Disease, Hazrat-e Rasool General
Hospital, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Beheshti, Noohi Bezanjani) Department of Cardiology, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Ahangar) Department of Cardiology, Mousavi Hospital, School of Medicine,
Zanjan University of Medical Sciences, Zanjan, Iran, Islamic Republic of
(Gohari) School of Medicine, Zanjan University of Medical Sciences,
Zanjan, Iran, Islamic Republic of
(Dehghani Mohammad Abadi) Shahid Sadoughi Hospital, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Erami) School of Medicine, Shahid Sadoughi University of Medical
Sciences, Yazd, Iran, Islamic Republic of
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Constrictive physiology is a transitory condition that could
lead to constrictive pericarditis, which is a rare complication after
open-heart surgery. Anti-inflammatory drugs like colchicine are
recommended for prevention of constrictive pericarditis; however, there is
no evidence about the effect of colchicine on constrictive pericarditis.
Thus, the aim of this study is to evaluate the preventive effect of
colchicine on the incidence of echocardiographic constrictive physiology
after open-heart surgery. Method(s): This was a parallel randomized,
double-blind trial. Patients were randomly assigned to receive 1 mg
colchicine once-daily from 48 hours before and 0.5 mg twice daily for 5
days after surgery. Primary outcome was the incidence of the constrictive
physiology after primary endpoint (1 week after the surgery). The
secondary outcome was the primary outcome after secondary endpoint (4
weeks after surgery) plus the new cases of constrictive physiology between
the primary and secondary endpoints. Result(s): Out of 160
participating patients, the primary outcome occurred in 19 patients (23%)
in placebo and 11 (13%) in intervention groups. There was no significant
difference between two groups (P =.106). After 4 weeks of follow-up, 19
patients (23%) in placebo and 9 (11%) in intervention groups had
constrictive physiology whereas 2 out of 11 patients (18.2%) were
recovered. The difference was significant (P =.038). No new case of
constrictive physiology occurred between primary and secondary endpoints.
 Conclusion(s): Short-term use of colchicine has a preventive effect
on reducing constrictive physiology after 1 month of open-heart surgery
but not a week after that. Copyright © 2020 Wiley Periodicals,
Inc.

<47>
Accession Number
2003394705
Title
Carotid to subclavian bypass and Amplatzer vascular plug subclavian
endovascular occlusion before thoracic open or endovascular repair.
Source
Journal of Vascular Surgery. 71 (5) (pp 1480-1488.e1), 2020. Date of
Publication: May 2020.
Author
Bertoglio L.; Salvati S.; Fittipaldi A.; Melloni A.; Kahlberg A.;
Cambiaghi T.; Melissano G.; Chiesa R.
Institution
(Bertoglio, Salvati, Fittipaldi, Melloni, Kahlberg, Melissano, Chiesa)
Division of Vascular Surgery, "Vita - Salute" University, Scientific
Institute H. San Raffaele, Milano, Italy
(Cambiaghi) Department of Cardiothoracic and Vascular Surgery, McGovern
Medical School at The University of Texas Health Science Center at Houston
(UTHealth) and Memorial Hermann Hospital, Houston, Tex
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: The aim of this study was to evaluate the safety and
effectiveness of endovascular occlusion of the prevertebral subclavian
artery (SA) using an Amplatzer vascular plug after prophylactic
revascularization with carotid-subclavian bypass (CSB) in the setting of
endovascular thoracic stent grafting or open arch repair with frozen
elephant trunk. Method(s): All patients who underwent SA plug
embolization (SAPE) and CSB from September 2009 to December 2018 were
enrolled in a registered study (SAPE study: clinicaltrials.gov
NCT03620006). The primary end point was technical success, defined as
complete occlusion of the origin of the SA, and how it was influenced by
SA anatomy. The secondary end points were access vessel complications,
cerebrovascular events, and CSB patency. Result(s): The 101 SAPE
procedures were performed using a type I (35 patients) or a type II (66
patients) Amplatzer vascular plug. A percutaneous ipsilateral upper
extremity access was used in 66% of patients and a radial artery access
was used in 50% of procedures. The 30-day primary technical success rate
was 95% (five patients received an additional plug during the index); five
type IC endoleaks were observed and successfully treated either with
surgical ligation (in open arch repair procedures) or secondary
embolization procedure (thoracic endovascular aneurysm repair group).
Three access vessel complications (3%) were recorded with percutaneous
brachial approach. At a median follow-up time of 11 months (range, 2-19
months), no new-onset type IC endoleak was observed, and the CSB patency
rate was 97%. Conclusion(s): SAPE after CSB is feasible and safe, and
has low incidence of type IC endoleaks. Further device developments are
needed to better adapt to the subclavian anatomy. Copyright ©
2019 Society for Vascular Surgery

<48>
Accession Number
631481731
Title
Agreement between the Schedule for the Evaluation of Individual Quality of
Life-Direct Weighting (SEIQoL-DW) interview and a paper-administered
adaption.
Source
BMC medical research methodology. 20 (1) (pp 80), 2020. Date of
Publication: 10 Apr 2020.
Author
Burckhardt M.; Fleischer S.; Berg A.
Institution
(Burckhardt, Fleischer, Berg) Institute of Health and Nursing Science,
Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale),
Germany
(Burckhardt) SRH University of Applied Health Sciences, Gera, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: The Schedule for the Evaluation of Individual Quality of
Life-Direct Weighting (SEIQoL-DW) is a prevalent face-to-face interview
method for measuring quality of life by integrating respondent-generated
dimensions. To apply this method in clinical trials, a paper-administered
alternative would be of interest. Therefore, our study aimed to analyze
the agreement between the SEIQoL-DW and a paper questionnaire version
(SEIQoL-PF/G). METHOD(S): In a crossover design, both measures were
completed in a random sequence. 104 patients at a heart surgery hospital
in Germany were randomly assigned to receive either the SEIQoL-DW or the
SEIQoL-PF/G as the first measurement in the sequence. Patients were
approached on their earliest stable day after surgery. The average time
between both measurements was 1 day (mean 1.3; SD 0.8). Agreement
regarding the indices, ratings, and weightings of nominated life areas
(cues) was explored using Bland-Altman plots with 95% limits of agreement
(LoA). Agreement of the SEIQoL indices was defined as acceptable if the
LoA did not exceed a threshold of 10 scale points. Data from n=99 patients
were included in the agreement analysis. RESULT(S): Both measures led
to similarly nominated cues. The most frequently nominated cues were
"physical health" and "family". In the Bland-Altman plot, the indices
showed a mean of differences of 2 points (95% CI, -1 to 6). The upper LoA
showed a difference of 36 points (95% CI, 30 to 42), and the lower LoA
showed a difference of -31 points (95% CI, -37 to -26). Thus, the LoAs and
confidence intervals exceeded the predefined threshold. The Bland-Altman
plots for the cue levels and cue weights showed similar results. The
SEIQoL-PF/G version showed a tendency for equal weighting of cues, while
the weighting procedure of the SEIQoL-DW led to greater variability.
 CONCLUSION(S): For cardiac surgery patients, use of the current
version of the SEIQoL-PF/G as a substitute for the SEIQoL-DW is not
recommended. The current questionnaire weighting method seems to be unable
to distinguish weighting for different cues. Therefore, the further design
of a weighting method without interviewer support as a paper-administered
measure of individual quality of life is desirable.

<49>
Accession Number
631481633
Title
A novel ECG-biomarker for cardiac arrest during hypothermia.
Source
Scandinavian journal of trauma, resuscitation and emergency medicine. 28
(1) (pp 27), 2020. Date of Publication: 10 Apr 2020.
Author
Dietrichs E.S.; Tveita T.; Myles R.; Smith G.
Institution
(Dietrichs) Experimental and Clinical Pharmacology Research Group,
Department of Medical Biology, UiT, Arctic University of Norway, Tromso
9037, Norway
(Dietrichs) Department of Clinical Pharmacology, Division of Diagnostic
Services, University Hospital of North Norway, Tromso 9038, Norway
(Tveita) Anesthesia and Critical Care Research Group, Department of
Clinical Medicine, UiT, Arctic University of Norway, Tromso 9037, Norway
(Tveita) Division of Surgical Medicine and Intensive Care, University
Hospital of North Norway, Tromso 9038, Norway
(Myles, Smith) Institute of Cardiovascular & Medical Sciences, University
of Glasgow, Glasgow, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Treatment of arrhythmias evoked by accidental or therapeutic
hypothermia and rewarming remains challenging. We aim to find an
ECG-biomarker that can predict ventricular arrhythmias at temperatures
occurring in therapeutic and accidental hypothermia. MAIN BODY: Evaluation
of ECG-data from accidental and therapeutic hypothermia patients and
experimental data on ECG and ventricular fibrillation (VF) threshold in
hypothermic New Zealand White Rabbits. VF threshold was measured in rabbit
hearts cooled to moderate (31degreeC) and severe (17degreeC) hypothermia.
QRS-interval divided by corrected QT-interval (QTc) was calculated at same
temperatures. Clinical QRS/QTc data were obtained after a systematic
literature review. Rabbit QRS/QTc values correlated with risk for VF
(correlation coefficient: 0.97). Human QRS/QTc values from hypothermic
patients, showed similar correlation with risk for ventricular
fibrillation in the experimental data (correlation coefficient: 1.00).
 CONCLUSION(S): These calculations indicate that QRS/QTc has potential
as novel biomarker for predicting risk of hypothermia-induced cardiac
arrest. Our findings apply both to victims of accidental hypothermia and
to patients undergoing therapeutic hypothermia during surgery or after
e.g. cardiac arrest.

<50>
Accession Number
631496443
Title
Emergence delirium following nasal surgery: A comparison of two different
doses of intravenous dexmedetomidine.
Source
Indian Journal of Anaesthesia. Conference: 67th Annual National Conference
of Indian Society of Anaesthesiologists, ISACON 2019. India. 64 (13
Supplement 1) (pp S32), 2020. Date of Publication: February 2020.
Author
Chandan N.; Sikora R.; Reddy K.R.; Reddy S.
Institution
(Chandan, Sikora, Reddy, Reddy) Manipal Hospitals, Bangalore, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & Aims: Emergence delirium is common after nasal surgery. We
compared the effectiveness of two different doses of intravenous
dexmedetomidine in reducing the incidence of emergence delirium after
nasal surgery. Method(s): After hospital ethical clearance, a
prospective double blinded randomised study was conducted on 72 ASA1 and 2
patients, aged between 18-60 years undergoing nasal surgery of < 90
minutes duration were randomly assigned to group A (0.5mcg/kg) and group B
(1.0mcg/kg). Patients with BMI >=30kg/m2, history of usage of
MAO inhibitors/adrenergic blocking drugs/anti psychotics and alcohol abuse
were excluded. Conduct of general anaesthesia was standardized for
induction and maintenance of anaesthesia. Study drug was infused at
induction of anaesthesia over 10 minutes. Incidence of emergence delirium,
hemodynamics, duration of emergence, intra operative analgesic
requirement, post operative pain and adverse effects were recorded.
Student T test and chi-square test were used . Result(s): Incidence
of emergence delirium was comparable between the two groups [28vs19%,
P=0.405]. Group B had lower systolic blood pressure at 15 and 30 min
interval after drug administration (P<=0.05). Time of emergence from
anaesthesia was shorter in group A compared to group B (P<=0.001). Mean
NRS scale for post operative pain was higher in group A than group B
(P<=0.001). Intra operative mean heart rate, incidence of
bradycardia/hypotension and requirement of intraoperative rescue analgesia
were comparable between the two groups. Conclusion(s): Administration
of low dose of IV dexmedetomidine (0.5mcg/kg) at induction of anaesthesia,
as a bolus over 10 minutes is as effective as high dose (1.0mcg/kg) in
reducing the incidence of emergence delirium.

<51>
Accession Number
631496270
Title
A prospective randomized control study on evaluation of effectiveness of
serratus anterior plane block for post-operative analgesia in modified
radical mastectomy surgeries.
Source
Indian Journal of Anaesthesia. Conference: 67th Annual National Conference
of Indian Society of Anaesthesiologists, ISACON 2019. India. 64 (13
Supplement 1) (pp S75-S76), 2020. Date of Publication: February 2020.
Author
Saravanan R.; Venkatraman R.; Yogalakshmi K.; Karthik K.
Institution
(Saravanan, Venkatraman, Yogalakshmi, Karthik) SRM Medical College and
Research Center, Chennai, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Ultrasound-guided Serratus Anterior Plane Block
(SAPB). SAPB is a novel analgesic technique usedfor breast and thoracic
wall surgeries. The primary objective of the study was to evaluate the
duration of postoperative analgesia with SAPB in Modified Radical
Mastectomy(MRM) surgeries. The secondary objectives were to assess the
total morphine consumption during first 24hrs, Visual Analogue
Scale(VAS)score post operatively. Method(s): After Institutional
Ethical Committee (1467/ IEC and CTRI/2019/01/017194) approval, forty
patients undergoing MRM surgeries under general anesthesia were taken for
the study with 20 patients in each group. At the end of surgery, the
patients in groupA were given ultrasound guided SAPB with 20 mL 0.25%
Ropivacaine with inj. Dexamethasone 8mg with patient in lateral position
while groupB patients received no block. Post operatively patients were
monitored continuously and assessed for VAS and vitals. PCA Morphine pump
was administered for post-operative analgesia with baseline infusion
0.1mg/ hr and bolus doses of 1mg with 10mins lock out interval time.
Duration of postoperative analgesia was taken as the time elapsed from the
administration of the block until the first dose of morphine bolus.
Post-operative Morphine consumption and adverse effects in first 24hrs
were recorded. Result(s): The average duration of analgesia was
prolonged in SAPB group (1455 Vs 144 mins) with reduced morphine
consumption (3.25 Vs 10.25mg). The average VAS scores were comparatively
lower in SAPB group. We observed no adverse effects related to the SAP
block. Conclusion(s): USG guided SAPB produces prolonged duration of
analgesia and reduces morphine consumption following MRM surgeries in
post-operative period with no complications. (Table Presented).

<52>
Accession Number
631496244
Title
To study effect of subcutaneous periradial administration of papaverine on
radial artery diameter using ultrasound in patients undergoing cardiac
surgery.
Source
Indian Journal of Anaesthesia. Conference: 67th Annual National Conference
of Indian Society of Anaesthesiologists, ISACON 2019. India. 64 (13
Supplement 1) (pp S6), 2020. Date of Publication: February 2020.
Author
Chavadi S.; Kashav R.C.; Kaur M.; Saraswat N.
Institution
(Chavadi, Kashav, Kaur, Saraswat) ABVIMS and DR.RML Hospital, New Delhi,
India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & aims: Radial artery cannulation is routinely done for
invasive BP monitoring in cardiac patients. Radial artery spasm is a known
complication following instrumentation. Various drugs including Papaverine
have been used to prevent spasm and to increase the artery diameter to
achieve higher success rate. In this study we aim to monitor the effect of
papaverine on radial artery diameter and hemodynamic stability following
subcutaneous administration. Method(s): Ethical committee approval
and written informed consent was obtained. The randomized comparative
study was conducted comprising of two groups with 30 patients in each
group of either sex belonging to NYHA class I-III, undergoing elective
cardiac surgery. Group C - received 2 ml of 1% lignocaine and 1ml of
saline. Group P - received 2ml of 1% lignocaine and 1ml of papaverine
(30mg/ml). Using ultrasound, baseline radial artery diameter and change in
diameter after drug administration if any were noted and compared.
 Result(s): With similar demographic profile in both groups, no
significant changes were noted with respect to SBP (P=0.293), DBP
(P=0.535), MBP (P=0.331) and HR (P=0.218) among both the groups. Compared
to group C, group P patients had comparable pre-drug administration
diameter (mm) (2.1 +/- 0.22 vs 2.15 +/- 0.25, P=0.448); significantly
higher post-drug administration diameter (mm) (2.63 +/- 0.26 vs. 2.16 +/-
0.25, P<0.0001); and significantly higher % increase in radial artery
diameter (mm) (1.06 vs. 25.39%). Conclusion(s): The use of
subcutaneous papaverine increases the radial artery diameter significantly
as compared to lignocaine alone with minimal effects on the hemodynamic
parameters.

<53>
Accession Number
631496225
Title
Effect on oxygenation with high flow nasal cannula (HFNC) vs conventional
oxygen therapy (Venturi mask) after extubation in patients undergoing
cardiac surgery.
Source
Indian Journal of Anaesthesia. Conference: 67th Annual National Conference
of Indian Society of Anaesthesiologists, ISACON 2019. India. 64 (13
Supplement 1) (pp S4), 2020. Date of Publication: February 2020.
Author
Devraj P.; Shrotey V.R.; Yogesh; Zanwar
Institution
(Devraj, Shrotey, Yogesh, Zanwar) GMC-SSH, Nagpur, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Postoperative pulmonary complications following
cardiac surgery leads to low PaO<inf>2</inf>, subsequently requiring
NIV,re-intubation.Technological improvements have enabled high flow
humidified oxygen therapy delivery through nasal cannula. Aim was to
Compare the effect on oxygenation of HFNC vs venturi mask after extubation
in patients undergoing cardiac surgery with midline sternotomy. Methods :
Randomized control study carried out on patients undergoing cardiac
surgery, stable hemodynamics. Patients preoperatively on NIV or requiring
postop ventilation for more than 24 hours excluded.After extubation
patients randomly assigned (computer generated random number table) at
FiO<inf>2</inf>(0.6):Group1oxygen with HFNC, Group2oxygen by venturi mask
PO<inf>2</inf>, PCO<inf>2</inf>, respiratory rate noted 6 hourly till 48
hours. Requirement of NIV,Re intubation,patient discomfort requiring
termination of therapy in 48 hrs noted Results: PO<inf>2</inf> at
different time intervals is significantly higher, patients more
comfortable with respiratory rate in HFNC.One in HFNC Vs four in Venturi
Mask group required NIV, two in Venturi Mask group Re-Intubated vs None
from HFNC group. Conclusion(s): HNFC provides better oxygenation than
Venturi mask after extubation in patients undergoing cardiac surgery with
midline sternotomy.

<54>
Accession Number
631496212
Title
Comparison of ultrasound guided unilateral thoracic paravertebral block
with ultrasound guided unilateral serratus anterior plane block in
perioperative pain management in patients undergoing minimally invasive
cardiac surgeries.
Source
Indian Journal of Anaesthesia. Conference: 67th Annual National Conference
of Indian Society of Anaesthesiologists, ISACON 2019. India. 64 (13
Supplement 1) (pp S2-S3), 2020. Date of Publication: February 2020.
Author
Ragavendran S.; Nagaraja P.S.; Singh N.G.; Arasu T.
Institution
(Ragavendran, Nagaraja, Singh, Arasu) Sri Jayadeva Institute of
Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background & aims: Minimally invasive cardiac surgery (MICS) requires
anterior or anterolateral mini-thoractomy. Traditional opioid based
anesthetic technique interferes with the elements of enhanced recovery
after surgery (ERAS) protocol. Neuraxial techniques have risk of neuraxial
hematoma in cardiac surgeries. Regional techniques like paravertebral
block (PVB) have provided post operative analgesia in MICS. Recently,
serratus anterior plane (SAP) block has been found to provide effective
analgesia in rib fractures, and video assisted thoracoscopic surgery
(VATS). The present study aimed to compare ultrasound guided (USG)
continuous PVB with SAP block in MICS. Method(s): It was a
prospective comparative clinical study enrolling 40 adult patients who
underwent elective MICS. Randomization was performed by open label method
into group A(PVB) and group B(SAP block) of 20 patients in each group.
Pain assessment at rest and deep breathing or cough was performed using
visual analog scale (VAS) till 48h postextubation. Rescue analgesics were
administered on patients request or VAS >4 at rest. Incentive spirometry,
oxygenation, duration of ventilation and hospital stay were reported as
outcome measures. Result(s): Intraoperative fentanyl consumption was
more in group B when compared to group A (p<0.05). VAS scores at rest and
during deep breathing, incentive spirometry, duration of mechanical
ventilation and hospital stay were comparable between the two groups.
PaO<inf>2</inf>/FiO<inf>2</inf> ratios were comparable at 0.5h, 3h, 6h,
12h, and 48h post-extubation between the two groups. However,
PaO<inf>2</inf>/FiO<inf>2</inf> ratios were significantly higher in group
B at 24h and 36h post-extubation when compared to group A (p<0.05).
 Conclusion(s): SAP block provided effective analgesia and could serve
as an alternative to thoracic PVB in perioperative pain management in
MICS.

<55>
Accession Number
631480743
Title
Indirect Comparison of the Efficacy and Safety of Alirocumab and
Evolocumab: A Systematic Review and Network Meta-Analysis.
Source
European heart journal. Cardiovascular pharmacotherapy. (no pagination),
2020. Date of Publication: 10 Apr 2020.
Author
Guedeney P.; Sorrentino S.; Giustino G.; Chapelle C.; Laporte S.; Claessen
B.E.; Ollier E.; Camaj A.; Kalkman D.N.; Vogel B.; De Rosa S.; Indolfi C.;
Lattuca B.; Zeitouni M.; Kerneis M.; Silvain J.; Collet J.-P.; Mehran R.;
Montalescot G.
Institution
(Guedeney, Vogel, Lattuca, Zeitouni, Kerneis, Silvain, Collet,
Montalescot) Sorbonne Universite, ACTION study group, Institut de
Cardiologie, Pitie Salpetriere Hospital (AP-HP), Paris, France
(Guedeney, Sorrentino, Giustino, Claessen, Camaj, Kalkman, Mehran) Zena
and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine
at Mount Sinai, Unites States, NY
(Sorrentino, De Rosa, Indolfi) Division of cardiology, Department of
Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy
(Chapelle, Laporte, Ollier) Unite de Recherche Clinique Innovation et
Pharmacologie CHU de Saint-Etienne, Saint-Etienne, France
(Kalkman) Amsterdam UMC, University of Amsterdam, Heart Center; Department
of Clinical and Experimental Cardiology, Amsterdam Cardiovascular
Sciences, Meibergdreef 9, Amsterdam, The Netherlands
Publisher
NLM (Medline)
Abstract
AIMS: Although alirocumab and evolocumab have both been associated with
improved outcomes in patients with dyslipidemia or established
atherosclerotic cardiovascular disease, data on their respective
performances are scarce. This study aimed at providing an indirect
comparison of the efficacy and safety of alirocumab versus evolocumab.
METHODS AND RESULTS: We conducted a systematic review and network
meta-analysis of randomized trials comparing alirocumab or evolocumab to
placebo with consistent background lipid lowering therapy up to November
2018. We estimated the relative risk and the 95% confidence intervals
using fixed effect model in a frequentist pairwise and network
meta-analytic approach. A total of 30 trials, enrolling 59,026 patients
were included. Eligibility criteria varied significantly across trials
evaluating alirocumab and evolocumab. Compared with evolocumab, alirocumab
was associated with a significant reduction in all-cause death (RR: 0.80;
95%CI: 0.66-0.97) but not in cardiovascular death (RR: 0.83; 95%CI:
0.65-1.05). This study did not find any significant differences in
myocardial infarction (RR: 1.15; 95%CI: 0.99-1.34), stroke (RR: 0.96;
95%CI: 0.71-1.28) or coronary revascularization (RR: 1.13; 95%CI:
0.99-1.29) between the two agents. Alirocumab was associated with a 27%
increased risk of injection site reaction compared to evolocumab; however,
no significant differences were found in terms of treatment
discontinuations, systemic allergic reaction, neurocognitive events,
ophthalmologic events, or new-onset of or worsening of pre-existing
diabetes. CONCLUSION(S): Alirocumab and evolocumab share a similar
safety profile except for injection site reaction. No significant
differences were observed across the efficacy endpoints, except for
all-cause death, which may be related to the heterogeneity of the studied
populations treated with the two drugs. Copyright © Published on
behalf of the European Society of Cardiology. All rights reserved. ©
The Author 2020. For permissions, please email:
journals.permissions@oup.com.

<56>
Accession Number
2005605317
Title
Evaluation of a Powered Vascular Stapler in Video-Assisted Thoracic
Surgery Lobectomy.
Source
Journal of Surgical Research. 253 (pp 26-33), 2020. Date of Publication:
September 2020.
Author
Molins L.; Lanuti M.; Force S.; Woolley S.; Krantz S.; Creedon E.E.;
Schwiers M.L.; Singleton D.W.; Waggoner J.R.; Fryrear R.; Licht P.
Institution
(Molins) Department of Thoracic Surgery, Barcelona University, Barcelona,
Spain
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Force) Department of Surgery, The Emory Clinic, Atlanta, GA, United
States
(Woolley) Consultant Thoracic Surgeon, Liverpool Heart & Chest Hospital,
Liverpool, United Kingdom
(Krantz) Division of Thoracic Surgery, Northshore University Health
System, Evanston, IL, United States
(Creedon, Schwiers, Singleton, Waggoner, Fryrear) Ethicon Endo-Surgery,
Inc., Cincinnati, OH, United States
(Licht) Department of Cardiothoracic Surgery, Odense University Hospital,
Odense, Denmark
Publisher
Academic Press Inc. (E-mail: apjcs@harcourt.com)
Abstract
Background: A narrow-profile powered vascular stapler (PVS) was developed
to provide superior access and precise staple placement in thoracic
procedures. The objective of this study was to determine if the PVS would
yield an equivalent rate of hemostatic interventions compared with
standard of care (SOC) staplers in video-assisted thoracoscopic surgery
lobectomy. Material(s) and Method(s): A randomized, controlled,
multicenter study was conducted comparing PVS with SOC staplers in
lobectomies performed for non-small cell lung cancer. The primary
performance endpoint was the incidence of intraoperative hemostatic
interventions, and the primary safety endpoint was the frequency of
postoperative bleeding-related interventions. Result(s): A total of
98 subjects participated in the SOC group and 103 in the PVS group. Rates
of intraoperative hemostatic interventions were 5.3% and 8.3% for the SOC
and PVS groups, respectively. These rates were not statistically different
(P = 0.137), although the upper bound of the 95% confidence interval for
the difference in intervention rates between PVC and SOC exceeded a
predefined 3% criterion for equivalence. Simple compressions were
performed more frequently in the PVS subjects, which accounted for the
higher intervention rate in this group. Postoperative interventions for
bleeding were required in one SOC subject (1.0%) and one subject from the
PVS group (0.9%). Procedure-related adverse events occurred in 21 (21.9%)
SOC subjects and 23 (21.9%) PVS subjects, with no adverse events related
to use of the study devices. Conclusion(s): The PVS exhibited similar
overall safety and effectiveness to SOC staplers in video-assisted
thoracoscopic surgery lobectomy. Copyright © 2020 Elsevier Inc.

<57>
Accession Number
2005594202
Title
Cardiac Surgery for Malignant Cardiac Neoplasms: "Futile" Surgery or
"Bridge-to-Life" Surgery? A Commentary on "Cardiac Tumors Prevalences and
Mortality: a Systematic Review and Meta-Analysis" [Int J Surg 76 (2020)
178-189].
Source
International Journal of Surgery. 78 (pp 13-14), 2020. Date of
Publication: June 2020.
Author
Bonacchi M.
Institution
(Bonacchi) Cardiac Surgery Unit, Experimental and Clinical Medicine
Department, University of Florence, Firenze, Italy
Publisher
Elsevier Ltd

<58>
Accession Number
2004096284
Title
Prevalence of depression in coronary artery bypass surgery: A systematic
review and meta-analysis.
Source
Journal of Clinical Medicine. 9 (4) (no pagination), 2020. Article Number:
909. Date of Publication: April 2020.
Author
Correa-Rodriguez M.; Ejheisheh M.A.; Suleiman-Martos N.; Membrive-Jimenez
M.J.; Velando-Soriano A.; Schmidt-Riovalle J.; Gomez-Urquiza J.L.
Institution
(Correa-Rodriguez, Ejheisheh, Schmidt-Riovalle, Gomez-Urquiza) Faculty of
Health Sciences, University of Granada, Avenida de la Ilustracion N. 60,
Granada 18016, Spain
(Correa-Rodriguez) Instituto de Investigacion Biosanitaria, IBS, Granada
18012, Spain
(Suleiman-Martos) Faculty of Health Sciences, University of Granada,
Campus Universitario de Ceuta, C/Cortadura del Valle s/n, Ceuta 51001,
Spain
(Membrive-Jimenez) University Hospital of Ceuta, Institute of Health
Management, C/Colmenar s/n, Ceuta 51003, Spain
(Velando-Soriano) University Hospital Virgen de las Nieves, Andalusian
Health Service, Av. de las Fuerzas Armadas 2, Granada 18014, Spain
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: rasetti@mdpi.com)
Abstract
Coronary artery bypass graft surgery (CABG) might adversely affect the
health status of the patients, producing cognitive deterioration, with
depression being the most common symptom. The aim of this study is to
analyse the prevalence of depression in patients before and after coronary
artery bypass surgery. A systematic review and meta-analysis was carried
out, involving a study of the past 10 years of the following databases:
CINAHL, LILACS, MEDLINE, PsycINFO, SciELO, Scopus, and Web of Science. The
total sample comprised n = 16,501 patients. The total number of items was
n = 65, with n = 29 included in the meta-analysis. Based on the different
measurement tools used, the prevalence of depression pre-CABG ranges from
19-37%, and post-CABG from 15- 33%. There is a considerable presence of
depression in this type of patient, but this varies according to the
measurement tool used and the quality of the study. Systematically
detecting depression prior to cardiac surgery could identify patients at
potential risk. Copyright © 2020 by the authors. Licensee MDPI,
Basel, Switzerland.

<59>
Accession Number
631422376
Title
Cardiac rehabilitation to improve health-related quality of life following
trans-catheter aortic valve implantation: A randomised controlled
feasibility study RECOVER-TAVI Pilot, ORCA 4, for the Optimal Restoration
of Cardiac Activity Group.
Source
Pilot and Feasibility Studies. 4 (1) (no pagination), 2018. Article
Number: 154. Date of Publication: 25 Apr 2018.
Author
Rogers P.; Al-Aidrous S.; Banya W.; Haley S.R.; Mittal T.; Kabir T.;
Panoulas V.; Raja S.; Bhudia S.; Probert H.; Prendergast C.; Spence M.S.;
Davies S.; Moat N.; Taylor R.S.; Dalby M.
Institution
(Rogers, Al-Aidrous, Banya, Haley, Mittal, Kabir, Panoulas, Raja, Bhudia,
Probert, Prendergast, Davies, Moat, Dalby) Royal Brompton and Harefield
NHS Foundation Trust London, Imperial College, London, United Kingdom
(Rogers, Al-Aidrous, Banya, Haley, Mittal, Kabir, Panoulas, Raja, Bhudia,
Probert, Prendergast, Spence, Davies, Moat, Dalby) Royal Victoria
Hospital, Belfast, United Kingdom
(Taylor) Institute of Health Research, University of Exeter Medical
School, Exeter and the School of Medicine Dentistry and Nursing,
University of Glasgow, Glasgow, United Kingdom
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Objectives: Transcatheter aortic valve implantation (TAVI) is often
undertaken in the oldest frailest cohort of patients undergoing cardiac
interventions. We plan to investigate the potential benefit of cardiac
rehabilitation (CR) in this vulnerable population. Design(s): We
undertook a pilot randomised trial of CR following TAVI to inform the
feasibility and design of a future randomised clinical trial (RCT).
 Participant(s): We screened patients undergoing TAVI at a single
institution between June 2016 and February 2017. Intervention(s):
Participants were randomised post-TAVI to standard of care (control group)
or standard of care plus exercise-based CR (intervention group).
 Outcome(s): We assessed recruitment and attrition rates, uptake of
CR, and explored changes in 6-min walk test, Nottingham Activities of
Daily Living, Fried and Edmonton Frailty scores and Hospital Anxiety and
Depression Score, from baseline (30 days post TAVI) to 3 and 6 months post
randomisation. We also undertook a parallel study to assess the use of the
Kansas City Cardiomyopathy Questionnaire (KCCQ) in the post-TAVI
population. Result(s): Of 82 patients screened, 52 met the inclusion
criteria and 27 were recruited (3 patients/month). In the intervention
group, 10/13 (77%) completed the prescribed course of 6 sessions of CR
(mean number of sessions attended 7.5, SD 4.25) over 6 weeks. At 6 months,
all participants were retained for follow-up. There was apparent
improvement in outcome scores at 3 and 6 months in control and CR groups.
There were no recorded adverse events associated with the intervention of
CR. The KCCQ was well accepted in 38 post-TAVI patients: Mean summary
score 72.6 (SD 22.6). Conclusion(s): We have demonstrated the
feasibility of recruiting post-TAVI patients into a randomised trial of
CR. We will use the findings of this pilot trial to design a fully powered
multicentre RCT to inform the provision of CR and support guideline
development to optimise health-related quality of life outcomes in this
vulnerable population. Copyright © The Author(s) 2018.

<60>
Accession Number
2005587461
Title
Experience with porcine beating heart simulator for coronary artery bypass
surgery residency training.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Wu S.; Ling Y.-P.; Zhao H.
Institution
(Wu, Ling, Zhao) Cardiac Surgery Department, Peking University Third
Hospital, Beijing, China
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: To evaluate the effect of our uniquely designed beating heart
simulator for coronary artery bypass surgery residency training.
 Method(s): The balloon of intra-aortic balloon pump (IABP) was
inserted into the left ventricle of an isolated porcine heart to form a
beating heart simulator. This model simulated off-pump coronary artery
bypass grafting (OPCABG), and the nonbeating heart model simulated the
on-pump coronary artery bypass grafting (ONCABG) for training of surgeons.
From 2017 to 2019, 60 trainees were randomly divided into nonbeating and
beating heart simulator training groups. The training period was 3 months.
The performance of anastomosis was evaluated at the beginning (after 1
month), midpoint (after 2 months), and at the end of the assessment (after
3 months). Result(s): Trainees improved their performance of coronary
artery anastomosis respectively after 3 months of training, whether they
were trained on beating heart simulator or nonbeating heart simulator (P <
.05). On both nonbeating and beating heart simulator test, trainees in the
beating group performed better than those in the nonbeating group in the
use of microsurgical instruments, anastomotic quality, and anastomotic
speed after 3 months of training (P < .05). Conclusion(s): The effect
of our uniquely developed beating heart simulator training was better than
those of nonbeating heart simulator for OPCABG and ONCABG training of
surgeons during residency. Copyright © 2020 The American
Association for Thoracic Surgery

<61>
Accession Number
2004641098
Title
The Moderate Alcohol and Cardiovascular Health Trial (MACH15): Design and
methods for a randomized trial of moderate alcohol consumption and
cardiometabolic risk.
Source
European Journal of Preventive Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Spiegelman D.; Lovato L.C.; Khudyakov P.; Wilkens T.L.; Adebamowo C.A.;
Adebamowo S.N.; Appel L.J.; Beulens J.W.J.; Coughlin J.W.; Dragsted L.O.;
Edenberg H.J.; Eriksen J.N.; Estruch R.; Grobbee D.E.; Gulayin P.E.;
Irazola V.; Krystal J.H.; Lazo M.; Murray M.M.; Rimm E.B.; Schrieks I.C.;
Williamson J.D.; Mukamal K.J.
Institution
(Spiegelman, Khudyakov, Rimm) Harvard TH Chan School of Public Health,
United States
(Lovato, Williamson) Wake Forest School of Medicine, United States
(Wilkens, Dragsted, Eriksen) University of Copenhagen, Denmark
(Adebamowo, Adebamowo) Department of Epidemiology and Public Health,
Greenebaum Comprehensive Cancer Center, University of Maryland, School of
Medicine, United States
(Appel, Coughlin, Lazo) Welch Center for Prevention, Epidemiology, and
Clinical Research, Johns Hopkins ProHealth Clinical Research Center,
United States
(Beulens) Amsterdam UMC - location VUmc, Amsterdam Cardiovascular Sciences
Research Institute, Netherlands
(Beulens) Julius Center for Health Sciences and Primary Care, University
Medical Center Utrecht, Netherlands
(Edenberg) Indiana University School of Medicine, United States
(Estruch) CIBER de Fisiopatologia de la Obesidad y la Nutricion
(CIBEROBN), Instituto de Salud Carlos III, Spain
(Lovato, Khudyakov, Estruch, Schrieks) Department of Internal Medicine,
Hospital Clinic, IDIBAPS August Pi i Sunyer Biomedical Research Institute,
University of Barcelona, Spain
(Grobbee, Gulayin, Irazola) Julius Clinical, Netherlands
(Krystal, Murray) Yale University School of Medicine, United States
(Rimm) National Institute on Alcohol Abuse and Alcoholism, U.S. National
Institutes of Health, United States
(Mukamal) Channing Laboratory, Brigham and Women's Hospital, Harvard
Medical School, United States
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Background: Observational studies have documented lower risks of coronary
heart disease and diabetes among moderate alcohol consumers relative to
abstainers, but only a randomized clinical trial can provide conclusive
evidence for or against these associations. Aim(s): The purpose of
this study was to describe the rationale and design of the Moderate
Alcohol and Cardiovascular Health Trial, aimed to assess the
cardiometabolic effects of one alcoholic drink daily over an average of
six years among adults 50 years or older. Method(s): This
multicenter, parallel-arm randomized trial was designed to compare the
effects of one standard serving (~11-15 g) daily of a preferred alcoholic
beverage to abstention. The trial aimed to enroll 7800 people at high risk
of cardiovascular disease. The primary composite endpoint comprised time
to the first occurrence of non-fatal myocardial infarction, non-fatal
ischemic stroke, hospitalized angina, coronary/carotid revascularization,
or total mortality. The trial was designed to provide >80% power to detect
a 15% reduction in the risk of the primary outcome. Secondary outcomes
included diabetes. Adverse effects of special interest included injuries,
congestive heart failure, alcohol use disorders, and cancer.
 Result(s): We describe the design, governance, masking issues, and
data handling. In three months of field center activity until termination
by the funder, the trial randomized 32 participants, successfully screened
another 70, and identified ~400 additional interested individuals.
 Conclusion(s): We describe a feasible design for a long-term
randomized trial of moderate alcohol consumption. Such a study will
provide the highest level of evidence for the effects of moderate alcohol
consumption on cardiovascular disease and diabetes, and will directly
inform clinical and public health guidelines. Copyright © The
European Society of Cardiology 2020.

<62>
Accession Number
631401808
Title
Isolated surgical tricuspid repair versus replacement: Meta-analysis of 15
069 patients.
Source
Open Heart. 7 (1) (no pagination), 2020. Article Number: e001227. Date of
Publication: 17 Mar 2020.
Author
Wang T.K.M.; Griffin B.P.; Miyasaka R.; Xu B.; Popovic Z.B.; Pettersson
G.B.; Gillinov A.M.; Desai M.Y.
Institution
(Wang, Griffin, Miyasaka, Xu, Popovic, Desai) Section of Cardiovascular
Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH,
United States
(Pettersson, Gillinov) Department of Thoracic and Cardiovascular Surgery,
Heart and Vascular Institute, Cleveland Clinic, Cleveland, United States
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Objectives: Tricuspid valve disease is increasingly encountered, but
surgery is rarely performed in isolation, in part because of a reported
higher operative risk than other single-valve operations. Although
guidelines recommend valve repair, there is sparse literature for the
optimal surgical approach in isolated tricuspid valve disease. We
performed a meta-analysis examining outcomes of isolated tricuspid valve
repair versus replacement. Method(s): We searched Pubmed, Embase,
Scopus and Cochrane from January 1980 to June 2019 for studies reporting
outcomes of both isolated tricuspid valve repair and replacement,
excluding congenital tricuspid aetiologies. Data were extracted and pooled
using random-effects models and Review Manager 5.3 software.
 Result(s): There were 811 article abstracts screened, from which 52
full-text articles reviewed and 16 studies included, totalling 6808
repairs and 8261 replacements. Mean age ranged from 36 to 68 years and
females made up 24%-92% of these studies. Pooled operative mortality rates
and odds ratios (95% confidence intervals) for isolated tricuspid repair
and replacement surgery were 8.4% vs 9.9%, 0.80 (0.64 to 1.00). Tricuspid
repair was also associated with lower in-hospital acute renal failure
12.4% vs 15.6%, 0.82 (0.72 to 0.93) and pacemaker implantation 9.4% vs
21.0%, 0.37 (0.24 to 0.58), but higher stroke rate 1.5% vs 0.9%, 1.63
(1.10 to 2.41). There were no differences in rates of prolonged
ventilation, mediastinitis, return to operating room or late mortality.
 Conclusion(s): Isolated tricuspid valve repair was associated with
significantly reduced in-hospital mortality, renal failure and pacemaker
implantation compared with replacement and is therefore recommended where
feasible for isolated tricuspid valve disease, although its higher stroke
rate warrants further research. Copyright © 2020 Author(s).

<63>
Accession Number
631179806
Title
Comparison of the efficacy of two doses of dexmedetomidine in attenuating
the hemodynamic response to intubation in patients undergoing elective
cardiac surgery: A randomized double-blinded study.
Source
Journal of Anaesthesiology Clinical Pharmacology. 36 (1) (pp 83-87), 2020.
Date of Publication: January-March 2020.
Author
Silpa A.R.; Koshy K.A.; Subramanian A.; Pradeep K.K.
Institution
(Silpa) Department of Anesthesia, Lourdes Hospital, Kochi, Kerala, India
(Koshy, Subramanian) Department of Cardiac Anesthesia, Lourdes Hospital,
Kochi, Kerala, India
(Pradeep) Department of Cardiac Surgery, Lourdes Hospital, Kochi, Kerala,
India
Publisher
Wolters Kluwer Medknow Publications (B9, Kanara Business Centre, off Link
Road, Ghatkopar (E), Mumbai 400 075, India)
Abstract
Background and Aims: Transient tachycardia and hypertension associated
with laryngoscopy and intubation may be hazardous to patients presenting
for cardiac surgery. The alpha 2 agonist dexmedetomidine may blunt this
stress response, but the optimal dose which will accomplish this without
causing hypotension and bradycardia is not well established. The primary
objective of this study was to compare the efficacy of two doses of
dexmedetomidine (0.5 and 1 mug/kg) as a 15 min infusion in attenuating the
hemodynamic stress response to laryngoscopy and endotracheal intubation in
elective cardiac surgery. Material(s) and Method(s): Seventy six
patients scheduled for elective cardiac surgery received a single
preoperative dose of dexmedetomidine of either 0.5 mug/kg (low dose) or 1
mug/kg (high dose) as a 15-min infusion prior to induction. The
hemodynamic response to laryngoscopy and endotracheal intubation (heart
rate, systolic blood pressure, mean arterial pressure, and diastolic blood
pressure) were recorded at different times. Independent sample t-test,
Chi-square test of association, and repeated measures analysis of variance
were used to analyze the collected data. Result(s): The incidence of
hypertension following intubation was significantly more in the low-dose
group. Administration of 1 mug/kg dexmedetomidine was not accompanied by
hypotension or bradycardia. Conclusion(s): Dexmedetomidine in a dose
of 1 mug/kg is more effective than 0.5 mug/kg for attenuation of
hemodynamic stress response to intubation in cardiac surgery. A more
graded increase in the dose of dexmedetomidine may lead to an optimum dose
in attenuating the hemodynamic response to intubation. Copyright
© 2020 Wolters Kluwer Medknow Publications. All rights reserved.

<64>
Accession Number
2005486433
Title
No-touch saphenous vein grafts in coronary artery surgery (SWEDEGRAFT):
Rationale and design of a multicenter, prospective, registry-based
randomized clinical trial.
Source
American Heart Journal. 224 (pp 17-24), 2020. Date of Publication: June
2020.
Author
Ragnarsson S.; Janiec M.; Modrau I.S.; Dreifaldt M.; Ericsson A.; Holmgren
A.; Hultkvist H.; Jeppsson A.; Sartipy U.; Ternstrom L.; Per Vikholm M.D.;
de Souza D.; James S.; Thelin S.
Institution
(Ragnarsson) Skane University Hospital and Lund University, Lund, Sweden
(Janiec, Per Vikholm, James, Thelin) Uppsala University Hospital, Uppsala,
Sweden
(Modrau) Aarhus University Hospital, Aarhus, Denmark
(Dreifaldt, de Souza) Orebro University Hospital, Orebro, Sweden
(Ericsson) Blekinge Hospital, Karlskrona, Sweden
(Holmgren) University Hospital of Umea, Umea, Sweden
(Hultkvist) Linkoping University Hospital, Linkoping, Sweden
(Jeppsson, Ternstrom) Sahlgrenska University Hospital, Gothenburg, Sweden
(Sartipy) Karolinska University Hospital, Stockholm, Sweden
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
The SWEDEGRAFT study (ClinicalTrials.gov Identifier: NCT03501303) tests
the hypothesis that saphenous vein grafts (SVGs) harvested with the
"no-touch" technique improves patency of coronary artery bypass grafts
compared with the conventional open skeletonized technique. This article
describes the rationale and design of the randomized trial and baseline
characteristics of the population enrolled during the first 9 months of
enrollment. The SWEDEGRAFT study is a prospective, binational multicenter,
open-label, registry-based trial in patients undergoing first isolated
nonemergent coronary artery bypass grafting (CABG), randomized 1:1 to
no-touch or conventional open skeletonized vein harvesting technique, with
a planned enrollment of 900 patients. The primary end point is the
proportion of patients with graft failure defined as SVGs occluded or
stenosed >50% on coronary computed tomography angiography at 2 years after
CABG, earlier clinically driven coronary angiography demonstrating an
occluded or stenosed >50% vein graft, or death within 2 years.
High-quality health registries and coronary computed tomography
angiography are used to assess the primary end point. The secondary end
points include wound healing in the vein graft sites and the composite
outcome of major adverse cardiac events during the first 2 years based on
registry data. Demographics of the first 200 patients enrolled in the
trial and other CABG patients operated in Sweden during the same time
period are comparable when the exclusion criteria are taken into
consideration. RCT# NCT03501303 Copyright © 2020 Elsevier Inc.

<65>
Accession Number
2004677595
Title
Advent of New perioperative care for fluid management after cardiovascular
surgery: A review of current evidence.
Source
Journal of Cardiology. 75 (6) (pp 606-613), 2020. Date of Publication:
June 2020.
Author
Nishi H.
Institution
(Nishi) Department of Cardiovascular Surgery, Osaka General Medical
Center, 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka 558-8558, Japan
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Fluid management with diuretics is a key factor for postoperative
management following cardiovascular surgery, and it is common to
administer intermittent doses of diuretics and fluids in the early
postoperative stage as primary therapy. Loop diuretics are usually given
as the first option, followed by an aldosterone blocker, mannitol, and
human atrial natriuretic peptide (hANP) or recombinant human B-type
natriuretic peptide infusion. Although the effects of tolvaptan, a new
type of diuretic with an aquaretic effect to increase urine volume without
increasing electrolyte excretion into urine by blocking the vasopressin V2
receptor, on congestive heart failure are well known, it has not been
established whether advantages may also be recognized in the volume
overload in early postoperative stage after cardiac surgery. In this
review, we clarified the efficacy of tolvaptan as the advent of new fluid
management after cardiovascular surgery. Tolvaptan has advantageous
effects for immediate body weight reduction in patients with positive
postoperative water balance following cardiac surgery. This immediate
volume reduction could help recovery of respiratory dysfunction due to
lung edema. Also, hypernatremia was rarely seen; therefore, it can be used
safely during postoperative period. With regard to the response of
tolvaptan, it seemed to have a beneficial effect in patients with
decreased renal function, increased body weight, and hypoalbuminemia.
Although long-term outcome is still unknown, tolvaptan treatment added to
conventional diuretics treatment in patients undergoing cardiovascular
surgery provides sufficient amount of fluid removal without affecting
renal function and serum sodium concentrations, and reduced the incidence
of worsening renal function. Copyright © 2020

<66>
Accession Number
2003829240
Title
Preemptive Anti-Stress Response Effects of Oxycodone Versus Sufentanil for
Patients Undergoing Cardiac Valve Replacement-A Randomized Controlled
Trial.
Source
Clinical Pharmacology in Drug Development. 9 (3) (pp 321-329), 2020. Date
of Publication: 01 Apr 2020.
Author
Zhang J.; Tu Q.; Gan J.; Miao S.; Zhou Y.; Li Q.; Zheng C.
Institution
(Zhang) Department of Anesthesiology, Sichuan Provincial Hospital for
Women and Children/Affiliated Women and Children's Hospital of Chengdu
Medical College, Chengdu, China
(Tu) Department of Anesthesiology, Shanghai General Hospital, Shanghai
Jiao Tong University School of Medicine, Shanghai, China
(Gan) Department of Anesthesiology, Tangshan People's Hospital, Tangshan,
China
(Miao) Department of Anesthesiology, Wuxi People's Hospital, Nanjing
Medical University, Wuxi, China
(Zhou, Li, Zheng) Department of Anesthesiology, the Third People's
Hospital of Chengdu, Southwest Jiao Tong University, Chengdu, China
Publisher
Blackwell Publishing Ltd
Abstract
Patients undergoing cardiac valve replacement may experience
cardiovascular adverse events during the preoperative period before
anesthesia. The study was to compare the preemptive anti-stress response
effects of oxycodone versus sufentanil for patients undergoing cardiac
valve replacement. Ninety-four patients were enrolled and assigned to
group Oxy, group Suf and group NS. Patients in group Oxy were
administrated with oxycodone 0.1 mg/kg, group Suf received sufentanil 0.1
mug/kg and group NS were given equivalent volume of normal saline. The
primary outcomes included serum levels of cortisol, norepinephrine, and
adrenaline. The secondary outcomes involved bispectral index value and the
observer's assessment of awareness/sedation grade, levels of mean arterial
pressure, heart rate, and the adverse reactions. Compared to group NS, the
serum levels of cortisol at T<inf>1</inf> to T<inf>5</inf> (P <.05), and
levels of norepinephrine and adrenaline at T<inf>3</inf> to T<inf>5</inf>
(P <.05) in group Oxy and Suf were lower. The bispectral index value and
observer's assessment of awareness/sedation grade T<inf>1</inf> to
T<inf>2</inf> (P <.05) in group Suf were lower than those in group Oxy and
NS. Compared with group NS, the levels of mean arterial pressure and heart
rate in group Oxy and Suf at T<inf>3</inf> to T<inf>5</inf> (P <.05) were
lower. The incidence of coughing was significantly higher in group Suf
(23.3%), but not in group NS (6.7%), than that in group Oxy (3.3%). The
preemptive analgesia of oxycodone may be used to inhibit the stress
response, without leading to excessive sedation and respiratory
depression, which may also help to stabilize hemodynamics during
preoperative period. Copyright © 2019, The American College of
Clinical Pharmacology

<67>
Accession Number
631467671
Title
Infra-Abdominal Muscles Activation Brings Benefits to the Pulmonary
Function of Patients with Sternal Instability after Cardiac Surgery.
Source
Brazilian journal of cardiovascular surgery. 35 (1) (pp 41-49), 2020. Date
of Publication: 01 May 2020.
Author
Nozawa E.; Goncalves C.D.; Almeida P.O.; Hajjar L.A.; Galas F.R.G.;
Feltrim M.I.Z.
Institution
(Nozawa, Goncalves, Almeida, Feltrim) Universidade de Sao Paulo Faculdade
de Medicina Hospital das Clinicas Sao Paulo SP Brazil Department of
Physiotherapy of the Instituto do Coracao do Hospital das Clinicas da
Faculdade de Medicina da Universidade de Sao Paulo (InCor/HC-FMUSP), Sao
Paulo, Brazil
(Hajjar) Universidade de Sao Paulo Faculdade de Medicina Hospital das
Clinicas Sao Paulo SP Brazil Department of Critical Patients of the
Instituto do Coracao do Hospital das Clinicas da Faculdade de Medicina da
Universidade de Sao Paulo (InCor/HC-FMUSP), Sao Paulo, Brazil
(Galas) Universidade de Sao Paulo Faculdade de Medicina Hospital das
Clinicas Sao Paulo SP Brazil Department of Anesthesia and Surgical
Intensive Care of the Instituto do Coracao do Hospital das Clinicas da
Faculdade de Medicina da Universidade de Sao Paulo (InCor/HC-FMUSP), Sao
Paulo, Brazil
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To compare physical therapy strategies involving abdominal
muscle stabilization, with and without upper limb movement, in patients
with sternal instability after heart surgery and during in-hospital care.
 METHOD(S): This prospective, longitudinal, randomized, and
comparative clinical study included 20 patients, which were divided into
two groups: ARM, the arm group (n=10), and LEG, the leg group (n=10). The
study involved the evaluation of scores of visual analog scales for
sternal instability, pain, discomfort, functional impairment, lung
function, and maximum inspiratory pressure (MIP) and maximum expiratory
pressure (MEP) before and after the interventions. Two protocols
consisting of abdominal exercises in both groups with upper limb movements
(ARM) and just abdominal activation with leg movements (LEG) were used for
three weeks. RESULT(S): There were statistically significant
(P<=0.01) improvements in pain, discomfort, and functional impairment
scores, and in MIP (P=0.04) and MEP (P<=0.01) after intervention in both
groups and just LEG showed improvement in forced vital capacity (P=0.043)
and forced expiratory volume in one second (P=0.011). CONCLUSION(S):
Both strategies promoted improvement in pain, discomfort, and functional
impairment scores and in the values of inspiratory and expiratory
pressures. Perhaps they were influenced by the time and resolution of the
infection process, although exercises with upper limb movements seem to be
safe in this population. The activation of the infra-abdominal muscles
through leg movements seems to bring more benefits to lung function.

<68>
Accession Number
631467463
Title
Should Doctors Know Their Patients' Attachment Style? A Psychological
Perspective and its Impact on Cardiac Surgery Outcomes.
Source
Brazilian journal of cardiovascular surgery. 35 (1) (pp 100-108), 2020.
Date of Publication: 01 May 2020.
Author
Bithas C.; Harky A.
Institution
(Bithas) University of Liverpool School of Medicine Liverpool UK School of
Medicine, University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Heart and Chest Hospital Department of Cardiothoracic
Surgery Liverpool UK Department of Cardiothoracic Surgery, Liverpool Heart
and Chest Hospital, Liverpool, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To increase our understanding of the psychological attachment
styles in order to develop a preventative strategy that could potentially
improve patients' perioperative outcomes. METHOD(S): A comprehensive
literature search was performed utilizing major electronic databases. The
search was done from inception to January 2019. All of the relevant papers
have been extracted and critically appraised in this review.
 RESULT(S): Understanding the psychological aspects of patients is
crucial for a satisfactory postoperative outcome. Depression and anxiety
have been shown to increase both mortality and morbidity after coronary
artery bypass graft surgery, independently of medical factors, although
the behavioural and biological mechanisms are poorly understood.
Psychosocial assessment is an important part of the pre-transplant
evaluation process. The majority of individuals undergoing a transplant
have significant psychosocial problems and can either be deferred or
denied the transplant until these psychosocial issues are approached and
managed. Psychological distress has been shown to affect long-term
prognosis of cardiac patients and as a result, it should be addressed
during follow-up of cardiac arrest survivors due to cardiac cause. Several
studies have considered different approaches and analyses of different
psychological attachments, and the understanding of such parameters
perioperatively could possibly minimise perioperatively complications.
 CONCLUSION(S): Since psychological distress affects long-term
prognosis of cardiac surgery patients, it should be addressed during
follow-up of cardiac arrest survivors due to cardiac cause.

<69>
Accession Number
631467411
Title
Does Prior Percutaneous Coronary Intervention Influence the Outcomes of
Coronary Artery Bypass Surgery?.
Source
Brazilian journal of cardiovascular surgery. 35 (1) (pp 1-8), 2020. Date
of Publication: 01 May 2020.
Author
Miguel G.S.V.; Sousa A.G.; Silva G.S.; Colosimo F.C.; Stolf N.A.G.
Institution
(Miguel) Clinica Girassol Cardiothoracic Surgeon Luanda Angola
Cardiothoracic Surgeon, Clinica Girassol, Luanda, Angola
(Sousa) Hospital Beneficencia Portuguesa Clinical Research Physician Sao
Paulo SP Brazil Clinical Research Physician, Hospital Beneficencia
Portuguesa, Sao Paulo, Brazil
(Silva, Colosimo) Hospital Beneficencia Portuguesa Center for Education
and Research Research Nurse Sao Paulo SP Brazil Research Nurse, Center for
Education and Research of the Hospital Beneficencia Portuguesa, Sao Paulo,
Brazil
(Stolf) University of Sao Paulo Medical School Sao Paulo SP Brazil
University of Sao Paulo Medical School, Sao Paulo, Brazil
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Percutaneous coronary intervention (PCI) has been
increasingly performed to treat coronary artery disease. The performance
of multiple PCI has also been increasing. Consequently, the percentage of
patients presenting for coronary artery bypass graft (CABG) surgery is
reported to vary from 13 to 40%. The influence of previous PCI on CABG
outcomes has been studied in single center, regional studies, registries
and meta-analyses. Some reports showed a negative effect on mortality and
morbidity in early or long-term follow-up, but others did not find this
influence. METHODS AND RESULTS: A cohort of 3007 patients consecutively
operated for CABG, 261 of them with previous PCI, were included in this
analysis. Comparison of the groups "previous PCI" and "primary CABG" was
made in the original cohort and in a propensity score matched cohort of
261 patients. There were some differences in preoperative clinical
characteristics in both types of cohort, even in the matched one. Outcomes
were compared at 30 days, 1 year and 5 years of follow-up. There were no
statistically significant differences in mortality in any period or
cohort. There were some differences in other outcomes as readmission and
composite events, including cardiovascular death at 1 and 5 years of
follow-up. These differences, neverthless, were not confirmed in
comparison with the matched cohort. CONCLUSION(S): Although there are
some limitations in this study, it was not found consistent negative
influence of previous PCI on CABG.

<70>
Accession Number
2005042675
Title
CLINICAL AND PROCEDURAL OUTCOMES IN TAVR FOR BICUSPID VERSUS TRICUSPID
AORTIC VALVE STENOSIS.
Source
Journal of the American College of Cardiology. Conference: ACC.20 Together
With World Congress of Cardiology. United States. 75 (11 Supplement 1) (pp
2185), 2020. Date of Publication: 24 March 2020.
Author
Garcia D.; Shurmur S.; Ansari M.
Institution
(Garcia, Shurmur, Ansari) Texas Tech University Health Sciences Center,
Lubbock, TX, United States
Publisher
Elsevier USA
Abstract
Background Transcatheter aortic valve replacement (TAVR) is considered
safe and feasible in high, intermediate and low risk patients with
tricuspid aortic valve (TAV) stenosis. Bicuspid aortic valve (BAV)
stenosis treated with TAVR might be challenging given anatomical
challenges. We aimed to evaluate the global experience with a
meta-analysis of all clinical studies comparing BAV to TAV. Methods Pub
Med and Cochrane databases were systematically searched for clinical
studies comparing clinical and procedural outcomes of patients with severe
BAV or TAV stenosis who underwent TAVR. Primary outcomes included >= 2
aortic insufficiency (AI) and 30 days mortality. Secondary outcomes
included pacemaker implantation, neurological events, major bleeding, AMI,
surgical replacement post-TAVR. We used fixed (I2 < 55%)
otherwise random effect analysis using the Cochrane Handbook of Systematic
Reviews, Results Nine studies were included and provided a total 45,000
patients (1,353=BAV and 43,647=TAV). First generation CoreValve was the
most commonly used in the BAV patients. Primary endpoints analysis showed
that BAV group had more >= 2 AI compared to TAV but not significantly
different (13% vs. 8%). There was no mortality difference between BAV and
TAV groups (5.3% vs. 4%; p=0.1). Secondary endpoint analysis showed a
trend towards more AMI in the BAV group (1.4%) compared to TAV group
(3.3%). There was no difference in pacemaker implantation, neurological
events, SAVR and major bleeding. Conclusion Our analysis suggested that
TAVR in patients with BAV stenosis is clinically safe although it might be
associated with higher procedural challenges given the less favorable
anatomy. The newer generation valves might improve with these challenges
although it is yet under investigated. Copyright © 2020 American
College of Cardiology Foundation

<71>
Accession Number
631469503
Title
Transcatheter versus surgical pulmonary valve replacement - A systemic
review and meta-analysis.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 05 Apr 2020.
Author
Ribeiro J.M.; Teixeira R.; Lopes J.; Costa M.; Pires A.; Goncalves L.
Institution
(Ribeiro, Lopes, Costa) Servico de Cardiologia, Centro Hospitalar e
Universitario de Coimbra, Coimbra, Portugal
(Teixeira, Goncalves) Servico de Cardiologia, Centro Hospitalar e
Universitario de Coimbra, Coimbra, Portugal; Faculdade de Medicina da
Universidade de Coimbra, Coimbra, Portugal
(Pires) Faculdade de Medicina da Universidade de Coimbra, Coimbra,
Portugal; Servico de Cardiologia Pediatrica, Centro Hospitalar e
Universitario de Coimbra, Coimbra, Portugal
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter pulmonary valve replacement (TPVR) has emerged
as an alternative to surgery in patients with pulmonary valve dysfunction.
 METHOD(S): We searched the MEDLINE and Cochrane databases since their
inception to January 2019, as well as references from articles, for all
publications comparing TPVR with surgical pulmonary valve replacement
(SPVR). Studies were considered for inclusion if they reported comparative
data regarding any of the study endpoints. The primary endpoint was early
mortality after pulmonary valve replacement. Secondary endpoints included
procedure-related complications, length of hospital stay, mortality during
follow-up, infective endocarditis (IE), need for re-intervention, post-PVR
transpulmonary peak systolic gradient and significant pulmonary
regurgitation (PR). RESULT(S): There were no differences in
peri-operative mortality between groups (0.2% vs 1.2%; pooled OR 0.56, 95%
CI 0.19-1.59, P=0.27, I2=0%). However, TPVR conferred a significant
reduction in procedure-related complications and length of hospital stay
compared to SPVR. Mid-term mortality and the need for repeat intervention
were similar with both techniques, but pooled IE was significantly more
frequent in the TPVR group (5.8 vs 2.7%, pooled OR 3.06, 95% CI 1.89-5.06,
P <0.001, I2 =0%). Significant PR during follow-up was less frequent after
TPVR, and there were no differences in the transpulmonary peak systolic
gradient. CONCLUSION(S): TPVR is a safe alternative to SPVR in
selected patients, and is associated with a shorter length of hospital
stay and fewer procedure-related complications. At mid-term follow-up,
TPVR was comparable to SPVR in terms of mortality and repeat intervention
but was associated with an increased risk of IE. Copyright ©
2020. Published by Elsevier Inc.

<72>
Accession Number
631469044
Title
Continuous-flow Left Ventricular Assist Device Implantation in Patients
with Pre-existing Mechanical Mitral Valves: A Systematic Review.
Source
Expert review of medical devices. (no pagination), 2020. Date of
Publication: 09 Apr 2020.
Author
Gordon J.S.; O'Malley T.J.; Maynes E.J.; Wood C.T.; Kalantri N.; Morris
R.J.; Samuels L.E.; Massey H.T.; Tchantchaleishvili V.
Institution
(Gordon, O'Malley, Maynes, Wood, Kalantri, Morris, Samuels, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
Publisher
NLM (Medline)
Abstract
Introduction: A pre-existing mechanical mitral valve (MMV) is thought to
be a thrombogenic risk factor after continuous-flow left ventricular
assist device (CF-LVAD) implantation. We sought to evaluate the management
and outcomes of pre-existing MMVs in patients following CF-LVAD
implantation.Areas Covered: An electronic search was performed to identify
the presence of an MMV at the time of CF-LVAD implantation. Of the 1,168
studies identified, only five studies consisting of seven CF-LVAD patients
met the inclusion criteria. Patient-level data were extracted and
analyzed.Expert Opinion: The median patient age was 54 (IQR: 42-61) years
and 71.4% (5/7) were male. Non-ischemic cardiomyopathy was the predominant
etiology (83.3%, 5/6) of heart failure, and bridge-to-transplant the
predominant indication (85.7%, 6/7) for CF-LVAD. Aortic valve prosthesis
was present in 42.9% (3/7) of patients. Median time from MMV to CF-LVAD
placement was 6.0 years (IQR: 1.3-15.0). The median lower limit of the INR
range was 2.8 (IQR: 2.1-3.0) and upper limit of the INR range was 3.5
(IQR: 3.1-3.5). During a median follow-up time of 120 (IQR: 70-201) days,
there were no major GI bleeds or clinically significant thromboembolic
complications. With adequate anticoagulation, pre-existing MMVs in CF-LVAD
patients did not result in clinically significant thromboembolic events.

<73>
Accession Number
631476567
Title
High thoracic epidural decreases perioperative myocardial ischemia and
improves left ventricle function in aortic valve replacement alone or in
addition to cabg surgery even with increased left ventricle mass index.
Source
Annals of cardiac anaesthesia. 23 (2) (pp 154-160), 2020. Date of
Publication: 01 Apr 2020.
Author
Elgebaly A.S.; Fathy S.M.; Elbarbary Y.; Sallam A.A.
Institution
(Elgebaly, Fathy) Department of Anesthesia, Surgical Intensive Care and
Pain Medicine, Faculty of Medicine, Tanta University, Egypt
(Elbarbary) Department of Cardiology, Faculty of Medicine, Tanta
University, Egypt
(Sallam) Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta
University, Egypt
Publisher
NLM (Medline)
Abstract
Introduction: High thoracic epidural (HTE) may reduce perioperative
tachyarrhythmias, respiratory complications and myocardial ischemia (MI)
and it may increase coronary perfusion and myocardial oxygen balance
through sympatholysis and pain control. The aim of this study is to
investigate the benefit of HTE in patients undergoing aortic valve
replacement (AVR) alone or in addition to coronary artery bypass graft
(CABG). Method(s): This prospective randomized controlled study was
conducted on 80 patients (40 with increased left ventricular mass index
(LVMI) and 40 with normal LVMI) who were equally randomised (n = 40) to
receive either GA with HTE (HTE group) or GA alone (GA group). Heart rate
(HR), mean arterial blood pressure (MAP) and the incidence of ischemic ECG
changes were recorded. LV functions (preoperative and postoperative by
transthoracic echocardiography and intraoperative by transoesophageal
echocardiography) were measured preoperative, intraoperative and till 48 H
postoperative. Result(s): There was no significant difference in the
baseline values of all measurements. HR and MAP were lower, and LV
functions were improved in HTE group intraoperatively and postoperatively.
Ischemic ECG changes were significantly lower in HTE group; with 42.9%
intraoperative risk reduction (95% CI: 0.195-0.943) and 46.6%
postoperative risk reduction (95% CI 0.227-0.952) as compared to GA group.
The risk of ischemia was significantly higher in patients with increased
LVMI in GA group (2.25 times compared to normal LVMI patients with 95% CI:
1.195-4.236), but it wasn't increased in HTE group. LV functions were
significantly improved from the induction to 48 H postoperative in HTE
group as compared to GA group. Conclusion(s): HTE reduced the
incidence of MI and improved the LV function, even with increased LVM, in
patients undergoing AVR alone or in addition to CABG.

<74>
Accession Number
631476535
Title
A randomized control trial to compare thoracic epidural with intercostal
block plus intravenous morphine infusion for postoperative analgesia in
patients undergoing elective thoracotomy.
Source
Annals of cardiac anaesthesia. 23 (2) (pp 127-133), 2020. Date of
Publication: 01 Apr 2020.
Author
Vilvanathan S.; Kuppuswamy B.; Sahajanandan R.
Institution
(Vilvanathan) Department of Cardiothoracic Anaesthesiology, Sree Chitra
Tirunal Institute for Medical Sciences, Trivandrum, Kerala, India
(Kuppuswamy, Sahajanandan) Department of Anaesthesiology, Christian
Medical College Hospital, Vellore, Tamil Nadu, India
Publisher
NLM (Medline)
Abstract
Objective: The objective of the study is to compare the efficacy of
Thoracic epidural with Intercostal block plus intravenous morphine
infusion for postoperative analgesia in patients undergoing elective
thoracotomy. Methodology and Design: This study is designed as a
prospective randomized clinical trial. Setting(s): Christian Medical
College Hospital, Vellore, India. Participant(s): Patients undergoing
elective thoracic surgery through posterolateral thoracotomy.
 Intervention(s): In Group A (TEA) patients epidural catheter was
inserted at T5-6 level before induction of GA and analgesia was activated
using 0.25% of bupivacaine towards the end of the surgery, before chest
closure and infusion of 0.1% bupivacaine with 2 mcg/ml of fentanyl was
started. In Group B (ICN) patients, an intercostal blockade of the 5
intercostal spaces was performed by the surgeon just before chest closure
using 0.25% bupivacaine and a continuous intravenous morphine infusion of
0.015-0.02 mg/kg/hr was started. Measurements: Assessment of resting and
dynamic pain intensity using Numerical rating scale and sedation using
Ramsay sedation scale was done and recorded at 1, 6,12,18,24 hours during
the first postoperative day. The other parameters that were measured
include side effects and the requirement of rescue analgesia.
 Result(s): Resting and Dynamic (NRS) pain scores were less in Group A
(TEA) than Group B (ICN). In the first 12 hours, the differences in both
the resting (P = 0.0505) and dynamic (P = 0.0307) pain scores were
statistically significant. By the end of the first postoperative day,
sedation scores were more or less similar in both groups. The incidence of
side effects and requirement of rescue analgesia were found to be similar
in both the groups. Conclusion(s): To summarize, though the results
show a slightly better quality of analgesia with the thoracic epidural,
the difference being clinically insignificant intercostal blockade could
be considered as a valid alternative.

<75>
Accession Number
631476509
Title
Comparision of upper thoracic epidural analgesia versus low thoracic
epidural analgesia in off-pump coronary artery bypass graft for
perioperative pain management and fast tracking.
Source
Annals of cardiac anaesthesia. 23 (2) (pp 183-188), 2020. Date of
Publication: 01 Apr 2020.
Author
Asai O.G.; Prabhakar V.; Manjunatha N.
Institution
(Asai, Prabhakar, Manjunatha) Department of Anaesthesiology, Sri Jayadeva
Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru,
Karnataka, India
Publisher
NLM (Medline)
Abstract
Background: Upper thoracic epidural analgesia (TEA) is compared with lower
thoracic epidural analgesia for the perioperative pain management and fast
tracking in patients undergoing off pump coronary artery bypass grafting
(OPCAB) surgery for the intraoperative hemodynamic, quality of analgesia,
incentive spirometry, time to awakening & extubation and intensive care
unit (ICU) duration. Material(s) and Method(s): A prospective,
randomized comparative clinical study was conducted with total of 60
patients randomized to either Group U: Upper TEA (n = 30) or Group L:
Lower TEA (n = 30). Visual analog scale (VAS) was recorded in both the
groups during rest and deep breathing at the various time intervals
postextubation. Both the groups were also compared for intraoperative
hemodynamics, incentive spirometry, time to awakening, and extubation and
ICU duration. Statistical analysis was performed using the independent
Student's t-test. A value of P < 0.05 was considered statistically
significant. Result(s): Postextubation VAS score at rest and deep
breathing at 0, 3, 6, 12, 24, 36, and 48 h were statistically significant
in both groups (P <= 0.05). Incentive spirometry, time to awakening and
extubation and duration of ICU stay were also statistically significant (P
<= 0.05) between the groups. Conclusion(s): Lower thoracic epidural
was better than upper thoracic epidural in perioperative pain management
and fast tracking in OPCAB surgery.

<76>
Accession Number
631476391
Title
Combined effect of left stellate ganglion blockade and topical
administration of papaverine on left internal thoracic artery blood flow
in patients undergoing coronary revascularization.
Source
Annals of cardiac anaesthesia. 23 (2) (pp 170-176), 2020. Date of
Publication: 01 Apr 2020.
Author
Chandran R.; Sreedhar R.; Gadhinglajkar S.; Dash P.; Karunakaran J.;
Pillai V.
Institution
(Chandran) Department of Cardiac Anaesthesia, Freeman Hospital, Newcastle
Upon Tyne, United Kingdom
(Sreedhar, Gadhinglajkar, Dash) Department of Anesthesia, Sree Chitra
Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala,
India
(Karunakaran, Pillai) Department of CVTS, Sree Chitra Tirunal Institute
for Medical Sciences and Technology, Trivandrum, Kerala, India
Publisher
NLM (Medline)
Abstract
Background: Left stellate ganglion blockade (LSGB) may have additive
effect to topical administration of papaverine on prevention of vasospasm
of left internal thoracic artery (LITA). Aim(s): This study aims to
compare LITA blood flow with topical application of papaverine alone or in
combination with LSGB. Setting(s): Tertiary care hospital.
 Design(s): Prospective randomized controlled study. Material(s)
and Method(s): A total of 100 patients operated for coronary
revascularization were randomly and equally allocated into two groups. In
control Group-C, papaverine was applied topically during the dissection of
LITA. In Group-S, the additional LSGB was performed. Blood flow was
measured from cut end of the LITA for 15 s. Primary objectives of the
evaluation were to observe differences in the LITA blood flow. Observing
incidence of radial-femoral arterial pressure difference after
cardiopulmonary bypass (CPB) was secondary objective. Statistical
Analysis: Student's unpaired t-test and Fisher's exact test to find out a
significant difference between the groups. Result(s): LITA flow in
Group-S was insignificantly more (49.28 +/- 7.88 ml/min) than Group-C
(47.12 +/- 7.24 ml/min), (P = 0.15). Radio-femoral arterial pressure
difference remained low for 40 min after termination of CPB in the Group-S
compared to the Group-C (-0.99 +/- 1.85 vs. -1.92 +/- 2.26).
 Conclusion(s): Combining LSGB with papaverine does not increase the
LITA blood flow compared to when the papaverine is used alone. However,
ganglion blockade reduces radial-femoral arterial pressure difference
after CPB. Blockade can be achieved successfully under the ultrasound
guidance without any complications.

<77>
Accession Number
631476384
Title
Cardioprotective effects of propofol-dexmedetomidine in open-heart
surgery: A prospective double-blind study.
Source
Annals of cardiac anaesthesia. 23 (2) (pp 134-141), 2020. Date of
Publication: 01 Apr 2020.
Author
Elgebaly A.S.; Fathy S.M.; Sallam A.A.; Elbarbary Y.
Institution
(Elgebaly, Fathy) Department of Anesthesia and PSICU, Faculty of Medicine,
Tanta University, Egypt
(Sallam) Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta
University, Egypt
(Elbarbary) Department of Cardiology, Faculty of Medicine, Tanta
University, Egypt
Publisher
NLM (Medline)
Abstract
Background: Myocardial protection in cardiac surgeries is a must and
requires multimodal approaches in perioperative period to decrease and
prevent the increase of myocardial oxygen demand and consumption that lead
to postoperative cardiac complications including myocardial ischemia,
dysfunction, and heart failure. Study Design: Prospective,
controlled, randomized, double-blinded study. Aim(s): This study aims
to study the effect of propofol-dexmedetomidine continuous infusion
cardioprotection during open-heart surgery in adult patients.
 Material(s) and Method(s): Sixty adult patients of both sexes aged
from 30 to 60 years old belonging to the American Society of
Anesthesiologists III or IV undergoing open-heart surgery were randomly
divided into two equal groups: Group P (control group) received continuous
infusion of propofol at a rate of 2 mg/kg/h and 50 cc 0.9% sodium chloride
solution infused at a rate of 0.4 mug/kg/h (used as a placebo) and Group
PD received continuous infusion of propofol at a rate of 2 mg/kg/h and
dexmedetomidine 200 mug diluted in 50 cc 0.9% sodium chloride solution
infused at a rate of 0.4 mug/kg/h. Infusion for all patients started
immediately preoperative till skin closure. Hemodynamic measurements of
heart rate (HR), invasive mean arterial pressure, and oxygen saturation
were recorded at baseline before induction of anesthesia, immediately
after intubation, at skin incision, at sternotomy and every 15 min in the
1st h then every 30 min during the prebypass period then every 15 min in
the 1st h then every 30 min after weaning from CPB till the end of the
surgery. Serum biomarkers; cardiac troponin (cTnI) and creatine
kinase-myocardial bound (CK-MB) samples were measured basally (T1), 15 min
after unclamping of the aorta (T2), immediate postoperative (T3), and 24 h
postoperative (T4). Intraoperative data were also recorded including the
number of coronary grafts, aortic cross-clamping duration, duration of
cardiopulmonary bypass (CPB), duration of surgery, and rhythm of
reperfusion. Fentanyl requirement, extubation time, and length of
intensive care unit (ICU) stay were also recorded for every case.
 Result(s): There was no statistically significant differences as
regard to demographic data between the studied two groups. HR and blood
pressure recorded was lower in the PD group than the control group, and
this difference was noted to be statistically significant. Furthermore,
the PD group showed lower levels of myocardial enzymes (cTnI and CK-MB),
decreased total fentanyl requirement, earlier postoperative extubation,
and shorter ICU stay than the P(control) group. Conclusion(s): The
use of propofol-dexmedetomidine in CPB surgeries offers more
cardioprotective effects than the use of propofol alone.

<78>
Accession Number
631476343
Title
A comparative study of the analgesic effects of intravenous ketorolac,
paracetamol, and morphine in patients undergoing video-assisted
thoracoscopic surgery: A double-blind, active-controlled, randomized
clinical trial.
Source
Annals of cardiac anaesthesia. 23 (2) (pp 177-182), 2020. Date of
Publication: 01 Apr 2020.
Author
Dastan F.; Langari Z.M.; Salamzadeh J.; Khalili A.; Aqajani S.;
Jahangirifard A.
Institution
(Dastan) Department of Clinical Pharmacy, School of Pharmacy, Shahid
Beheshti University of Medical Sciences; Chronic Respiratory Diseases
Research Center, National Research Institute of Tuberculosis and Lung
Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran,
Iran
(Langari) Department of Pharmacovigilance, National Research Institute of
Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Salamzadeh) Food Safety Research Center, School of Pharmacy, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Khalili) Anesthesiology Research Center, National Research Institute of
Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Aqajani) Department of Clinical Pharmacy, School of Pharmacy, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Jahangirifard) Chronic Respiratory Diseases Research Center, National
Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
Background: Opioids are traditionally used as the drug of choice for the
management of postoperative pain. However, their use is limited in
patients undergoing Video-assisted thoracic surgery (VATS), due to their
side effects, such as respiratory depression, nausea, and vomiting.
 Aim(s): In this double-blind active-controlled randomized study, we
have compared the analgesic effects of ketorolac and paracetamol to
morphine. Method(s): Patients were randomly chosen from a pool of
candidates who were undergoing VATS and were divided into three groups.
During the first 24 h postsurgery, patients in the control group received
a cumulative dose of morphine 20 mg, while patients in two treatment
groups received ketorolac 120 mg and paracetamol 4 g in total. Doses were
administered as bolus immediately after surgery and infusion during the
first 24 h. Patients' pain severity was evaluated by visual analogue scale
rating (VAS) at rest and during coughing episodes. Result(s): The
average pain score at recovery time was 2.29 +/- 2.13 and 2.26 +/- 2.16
for ketorolac and paracetamol, respectively, and it was significantly
lower than the morphine group with an average pain score of 3.87 (P =
0.003). Additionally, the VAS score during cough episodes was
significantly higher in the control group throughout the study period
compared to study groups. Comparison of mean morphine dose utilized as
liberation analgesic (in case of patients had VAS >3) between three groups
was not significantly different (P = 0.17). Conclusion(s): Our study
demonstrates the non-inferiority of ketorolac and paracetamol to morphine
in controlling post-VATS pain without causing any significant side
effects. We also show that ketorolac and paracetamol are superior to
morphine in controlling pain during 2 h postsurgery.

<79>
Accession Number
631476298
Title
Pain relief following sternotomy in conventional cardiac surgery: A review
of non neuraxial regional nerve blocks.
Source
Annals of cardiac anaesthesia. 23 (2) (pp 200-208), 2020. Date of
Publication: 01 Apr 2020.
Author
Kar P.; Ramachandran G.
Institution
(Kar, Ramachandran) Department of Anesthesia and Intensive Care, Nizams
Institute of Medical Sciences, Hyderabad, Telangana, India
Publisher
NLM (Medline)
Abstract
Acute post-operative pain following sternotomy in cardiac surgery should
be adequately managed so as to avoid adverse hemodynamic consequences and
pulmonary complications. In the era of fast tracking, adequate and
efficient technique of post-operative analgesia enables early extubation,
mobilization and discharge from intensive care unit. Due to increasing
expertise in ultrasound guided blocks there is a recent surge in trial of
bilateral nerve blocks for pain relief following sternotomy. The aim of
this article was to review non-neuraxial regional blocks for analgesia
following sternotomy in cardiac surgery. Due to the paucity of similar
studies and heterogeneity, the assessment of bias, systematic review or
pooled analysis/meta-analysis was not feasible. A total of 17 articles
were found to be directly related to the performance of non-neuraxial
regional nerve blocks across all study designs. Due to scarcity of
literature, comments cannot be made on the superiority of these blocks
over each other. However, most of the reviewed techniques were found to be
equally efficacious or better than conventional and established
techniques.

<80>
Accession Number
2005565898
Title
Differential outcomes with edetate disodium-based treatment among stable
post anterior vs. non-anterior myocardial infarction patients.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Lewis E.F.; Ujueta F.; Lamas G.A.; Roberts R.S.; Mark D.B.; Nahin R.L.;
Goertz C.; Stylianou M.; Lee K.L.
Institution
(Lewis) Brigham and Women's Hospital and Harvard Medical School, Boston,
MA (E.F.L.), United States
(Ujueta, Lamas) Columbia University Division of Cardiology at Mount Sinai
Medical Center, Miami Beach, FL (G.A.L.), United States
(Roberts) Remarque Systems, Durham, NC (R.S.R), United States
(Mark, Stylianou) National Heart, Lung, and Blood Institute, Bethesda, MD
(M.S.), United States
(Lee) Duke Clinical Research Institute, Durham, NC (D.B.M., K.L.L.),
United States
(Goertz) Duke Department of Orthopaedic Surgery, Durham, NC (C.G.), United
States
(Nahin) The National Center for Complementary and Integrative Health,
Bethesda, MD (R.L.N.), United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: The Trial to Assess Chelation Therapy (TACT) found that
chelation therapy significantly reduced clinical events in patients with a
history of myocardial infarction (MI). The initial report of TACT included
the observation of an interaction between edetate disodium infusions and
MI location, as well as diabetes. Thus, we examined in greater detail the
effect of edetate disodium chelation therapy as a function of MI location
and diabetes. Method(s): Patients (n = 1708) at least 6 weeks post-MI
and age >= 50 were randomized to receive 40 infusions of a 500 mL
chelation solution or placebo (median follow-up 55 months). The effect of
edetate disodium on the primary outcome (all-cause mortality, MI, stroke,
hospitalization for angina, or coronary revascularization) was assessed as
a function of MI location using log-rank test and Cox regression model,
adjusting for other prognostic variables. Result(s): Among patients
with post anterior MI (n = 674), chelation was associated with a lower
risk of the primary endpoint (HR 0.63, 95% CI 0.47-0.86, p = 0.003) among
anterior MI patients, but not in post non-anterior MI (n = 1034) patients
(HR 0.96, 95% CI 0.77-1.20, p = 0.702) (p-for-interaction = 0.032). The
point estimates for each component of the primary endpoint favored
chelation therapy. The differing treatment effect in patients with post
anterior vs. non-anterior MI was consistent among patients with or without
diabetes and remained significant after adjusting for other prognostic
variables (p < 0.01). Conclusion(s): Edetate disodium infusions
reduced the risk of cardiovascular events among patients with a prior
anterior MI. Future studies should focus on replicating these results and
understanding the mechanisms of benefit. Copyright © 2020

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