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<1>
Accession Number
2005028704
Title
The effect of preoperative erector spinae plane vs. paravertebral blocks
on patient-controlled oxycodone consumption after video-assisted thoracic
surgery: A prospective randomized, blinded, non-inferiority study.
Source
Journal of Clinical Anesthesia. 62 (no pagination), 2020. Article Number:
109737. Date of Publication: June 2020.
Author
Zhao H.; Xin L.; Feng Y.
Institution
(Zhao, Xin, Feng) Department of Anesthesiology, Peking University People's
Hospital, China
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Study objective: To investigate the effective analgesia for video-assisted
thoracic surgery. <br/>Design(s): In this prospective non-inferiority
study, we evaluated the postoperative analgesic effect of preoperative
ultrasound-guided Erector Spinae Plane blocks (ESPB) on T4 and T6 levels
in patients undergoing video-assisted thoracic surgery in comparison with
paravertebral block (PVB) at the same intervertebral spaces.
<br/>Setting(s): A university hospital. <br/>Patient(s): 66 patients
scheduled to undergo video-assisted thoracic surgery under general
anesthesia were included. <br/>Intervention(s): Patients were randomly
allocated to receive ultrasound-guided ESP blocks on T4 and T6 levels
(Group ESPB, n = 33) or PVB (Group PVB, n = 33) with 30 mL 0.4%
ropivacaine 30 min before anesthesia induction. A continuous flurbiprofen
(8 mg/h) was infused postoperatively through a single-use infusion device
and intravenous oxycodone supplied as analgesic rescue if needed, with
bolus of oxycodone (1 mg) and lockout time being 10 min. Measurements: The
primary outcome was the postoperative oxycodone consumption at 48 h.
<br/>Main Result(s): Intraoperative use of sufentanil and remifentanil
were comparable between these two groups. Pain scores, oxycodone rescue
and Quality of Recovery (QoR) 15 on postoperative day 1 and 2 were
equivalent between these two groups. Postoperative oxycodone consumption
was 7.9 +/- 8.7 boluses in ESPB group and 6.9 +/- 6.3 boluses in PVB group
at 48 h. The cumulative 48 h difference i.e. Oxycodone boluses<inf>with
ESPB</inf> minus Oxycodone boluses<inf>with PVB</inf> was 2 (95% CI -1,
5.6). The lower limit of the 95% CI for this difference was -1, which was
within the predefined non-inferiority margin of -10 (DELTA).
<br/>Conclusion(s): Ultrasound-guided ESPB applied before video assisted
thoracic surgery was non-inferior in analgesic effect compared with PVB in
terms of pain score, analgesic rescue consumption and quality of recovery.
Brief summary statement: Preoperative Erector spinae plane blocks (ESPB),
when in combination with round-the-clock NSAIDs, offered equivalent
analgesia and quality of recovery after video assisted thoracic lung
surgery compared with paravertebral blocks. Patients who received ESP
blocks had similar consumption of oxycodone and length of hospital
stay.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<2>
Accession Number
2004983505
Title
Fluid-structure interaction modeling in cardiovascular medicine - A
systematic review 2017-2019.
Source
Medical Engineering and Physics. 78 (pp 1-13), 2020. Date of Publication:
April 2020.
Author
Hirschhorn M.; Tchantchaleishvili V.; Stevens R.; Rossano J.; Throckmorton
A.
Institution
(Hirschhorn, Throckmorton) BioCirc Research Laboratory, School of
Biomedical Engineering, Science, and Health Systems, Drexel University,
Philadelphia, PA, United States
(Tchantchaleishvili) Division of Cardiothoracic Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Stevens) St. Christopher's Hospital for Children, Tower Health Hospitals,
Philadelphia, PA, United States
(Stevens) Pediatrics, Drexel University College of Medicine, Philadelphia,
PA, United States
(Rossano) Division of Pediatric Cardiology, The Children's Hospital of
Philadelphia, Philadelphia, PA, United States
Publisher
Elsevier Ltd
Abstract
Finite element analysis (FEA) and computational fluid dynamics (CFD) are
generally insufficient independently to model the physics of the
cardiovascular system. Individually, they are unable to resolve the
interplay between the solid and fluid domains, and the interplay is
integral to the functioning of the system. The use of fluid-structure
interaction (FSI) methods overcomes these shortcomings by providing the
means to couple the fluid and structural domains. In the last decade, the
utilization of FSI has greatly increased in cardiovascular engineering. In
this study, we conducted a systematic review process of more than 1000
journal articles to investigate the implementation of One-Way and Two-Way
FSI for cardiovascular applications. We explored the utility of FSI to
study aneurysms, the hemodynamics of patient anatomies, native and
prosthetic heart valve dynamics, flow and hemodynamics of blood pumps, and
atherosclerosis. Computational resource requirements, implementation
strategies and future directions of FSI for cardiovascular applications
are also discussed.<br/>Copyright &#xa9; 2020

<3>
Accession Number
2002932867
Title
A Comparison of the Arterial Blood Concentration of Isoflurane During
Cardiopulmonary Bypass Between 2 Polypropylene Oxygenators.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (5) (pp 1184-1190),
2020. Date of Publication: May 2020.
Author
Alston R.P.; Kitchen C.; McKenzie C.; Homer N.
Institution
(Alston, McKenzie) Department of Anaesthesia, Critical Care and Pain
Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
(Kitchen) School of Medicine and Veterinary Medicine, University of
Edinburgh, Edinburgh, United Kingdom
(Homer) Clinical Research Facility Mass Spectrometry Core Centre for
Cardiovascular Research, Queens Medical Research Institute, University of
Edinburgh, Edinburgh, United Kingdom
Publisher
W.B. Saunders
Abstract
Objective: The primary objective was to compare arterial blood
concentration of isoflurane during cardiopulmonary bypass (CPB) between 2
polypropylene oxygenators of different designs. Secondary objectives were
to compare levels of Bispectral Index Score (BIS) during CPB between the 2
oxygenators and to examine the relationships between oxygenator exhaust
and arterial blood concentrations of isoflurane and BIS. <br/>Design(s):
Single, blinded, randomized control trial. <br/>Setting(s): Teaching
hospital. <br/>Participant(s): Twenty-five patients undergoing cardiac
surgery with CPB. <br/>Intervention(s): Subjects were randomly assigned
(1:1) to Inspire 8F (Sorin) or Affinity Fusion (Medtronic) oxygenators.
<br/>Measurements and Main Results: The mean arterial blood concentration
in the Inspire 8F (Sorin) group was 59 (standard deviation [SD] 23)
micro&#32;g/mL, compared with 53 (SD 17) micro&#32;g/mL in the Affinity
Fusion (Medtronic) group with a nonsignificant mean difference of 6 (95%
confidence interval = -11, 22) micro&#32;g/mL (t[23] = 0.676, p = 0.50).
No significant difference in BIS was found between the groups (p = 0.896).
Moderate and strong, negative correlations respectively, were found
between arterial and oxygenator exhaust correlations and BIS (r = -0.472,
p < 0.05; r = -0.812, p < 0.001). A strong, positive correlation was found
between arterial and exhaust isoflurane concentration (r = 0.810, p <
0.0005). <br/>Conclusion(s): No significant difference in arterial blood
concentration of isoflurane or BIS was found between the Inspire 8F
(Sorin) and Affinity Fusion (Medtronic) oxygenators. A significant
positive correlation was found between arterial blood and oxygenator
exhaust concentrations of isoflurane, as well as significant negative
correlations between both arterial and oxygenator exhaust concentrations
of isoflurane and BIS.<br/>Copyright &#xa9; 2019

<4>
Accession Number
2002561005
Title
Antibiotic Management for Delayed Sternal Closure Following Pediatric
Cardiac Surgery: A Systematic Review of Recent Literature.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (5) (pp 1333-1340),
2020. Date of Publication: May 2020.
Author
Silvetti S.; Landoni G.; Castagnola E.; Nuri H.; Pome G.; Moscatelli A.
Institution
(Silvetti, Moscatelli) Neonatal and Pediatric Intensive Care Unit,
Department of Surgery and Critical Care, IRCCS Istituto Giannina Gaslini,
Genova, Italy
(Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, University Vita-Salute San Raffaele, Milano, Italy
(Castagnola) Infectious Disease Unit, Department of Pediatrics, IRCCS
Istituto Giannina Gaslini, Genova, Italy
(Nuri, Pome) Cardiac Surgery Unit, Department of Surgery and Critical
Care, IRCCS Istituto Giannina Gaslini, Genova, Italy
Publisher
W.B. Saunders
Abstract
Delayed sternal closure after pediatric cardiac surgery is a management
option for the treatment of patients with severely impaired heart
function. The optimal antimicrobial treatment strategy for this condition
is unknown. The aim of this systematic review was to evaluate the current
antibiotic administration attitudes in pediatric cardiac surgery patients
needing an open chest in terms of infection with a focus on surgical site
infection rate. The authors performed a systematic review and
meta-analysis of all articles, which described the antibiotic
administration strategy and surgical site infection rate in pediatric
patients with an open chest after cardiac surgery. The authors performed a
subgroup analysis on "standard" versus "non-standard" (defined as any
antimicrobial drugs different from the adult guidelines recommendations)
therapy for one-proportion meta-analysis with a random effect model. The
authors identified 12 studies published from January 1, 2000 to July 1,
2019 including a total of 2,203 patients requiring an open chest after
cardiac surgery, 350 of whom (15.9%) developed infections and 182 (8.3%)
developed a surgical site infection. The surgical site infection rate in
patients with "non-standard" strategy was higher than in patients with
"standard" strategy: 8.8% (140 reported infections/1,582 patients) versus
6.8% (42 reported infections/621 patients), p = 0.001. The "standard"
antibiotic management proposed by guidelines for adult cardiac surgery
patients could be used an acceptable strategy to treat pediatric patients
with an open chest after cardiac surgery.<br/>Copyright &#xa9; 2019
Elsevier Inc.

<5>
Accession Number
2005395604
Title
Effects of bariatric surgery in early- And adult-onset obesity in the
prospective controlled Swedish Obese Subjects study.
Source
Diabetes Care. 43 (4) (pp 860-866), 2020. Date of Publication: 01 Apr
2020.
Author
Kristensson F.M.; Andersson-Assarsson J.C.; Svensson P.-A.; Carlsson B.;
Peltonen M.; Carlsson L.M.S.
Institution
(Kristensson, Andersson-Assarsson, Svensson, Carlsson, Carlsson) Institute
of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
(Svensson) Institute of Health and Care Sciences, Sahlgrenska Academy at
University of Gothenburg, Gothenburg, Sweden
(Carlsson) Research and Early Clinical Development, Cardiovascular, Renal
and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
(Peltonen) National Institute for Health and Welfare, Helsinki, Finland
Publisher
American Diabetes Association Inc. (E-mail: membership@diabetes.org)
Abstract
OBJECTIVE Bariatric surgery is an effective treatment for obesity, but it
is unknown if outcomes differ between adults with early- versus
adult-onset obesity. We investigated how obesity status at 20 years of age
affects outcomes after bariatric surgery later in life. RESEARCH DESIGN
AND METHODS The Swedish Obese Subjects study is a prospective matched
study performed at 25 surgical departments and 480 primary health care
centers. Participants aged 37-60 years with BMI ++34 kg/m²
(men) or ++38 kg/m² (women) were recruited between 1987 and
2001; 2,007 participants received bariatric surgery and 2,040 usual care.
Self-reported body weight at 20 years of age was used to stratify patients
into subgroups with normal BMI (<25 kg/m²), overweight (BMI
25-29.9 kg/m²), or obesity (BMI ++30 kg/m²). Body
weight, energy intake, and type 2 diabetes status were examined over 10
years, and incidence of cardiovascular and microvascular disease was
determined over up to 26 years using data from health registers. RESULTS
There were small but statistically significant differences in reduction of
body weight among the subgroups after bariatric surgery (interaction P 5
0.032), with the largest reductions among those with obesity aged 20
years. Bariatric surgery increased type 2 diabetes remission (odds ratios
4.51, 4.90, and 5.58 in subgroups with normal BMI, overweight, or obesity
at 20 years of age, respectively; interaction P 5 0.951), reduced type 2
diabetes incidence (odds ratios 0.15, 0.13, and 0.15, respectively;
interaction P 5 0.972), and reduced microvascular complications
independent of obesity status at 20 years of age (interaction P 5 0.650).
The association between bariatric surgery and cardiovascular disease was
similar in the subgroups (interaction P 5 0.674). Surgical complications
were similar in the subgroups. CONCLUSIONS The treatment benefits of
bariatric surgery in adults are similar regardless of obesity status at 20
years of age.<br/>Copyright &#xa9; 2020 by the American Diabetes
Association.

<6>
Accession Number
627954922
Title
Delirium is associated with higher mortality in transcatheter aortic valve
replacement: systemic review and meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. 35 (2) (pp 168-176), 2020.
Date of Publication: 01 Apr 2020.
Author
Prasitlumkum N.; Mekritthikrai R.; Kewcharoen J.; Kanitsoraphan C.; Mao
M.A.; Cheungpasitporn W.
Institution
(Prasitlumkum, Mekritthikrai, Kewcharoen, Kanitsoraphan) Internal Medicine
Residency Program, University of Hawaii, 1356 Lusitana St, Honolulu, HI
96813, United States
(Mao) Department of Internal Medicine, Mayo Clinic, Rochester, MN, United
States
(Cheungpasitporn) Department of Medicine, University of Mississippi
Medical Center, Jackson, MS, United States
Publisher
Springer
Abstract
Post-operative delirium (POD) has been recognized as an independent risk
factor for mortality. Recent studies suggest that POD is associated with
higher mortality rates in patients undergoing transcatheter aortic valve
replacement (TAVR). However, a systematic review and meta-analysis of the
literature has not been performed. This study assessed the association
between POD and TAVR by performing a systematic review and meta-analysis
of the literature. We comprehensively searched the databases of MEDLINE
and EMBASE from inception to April 2018. Included studies were prospective
or retrospective cohort studies that compared mortality among patients
undergoing TAVR both with and without POD. Data from each study were
combined using the random-effects, generic inverse variance method of
DerSimonian and Laird to calculate risk ratios and 95% confidence
intervals. Seven studies consisting of 20,086 subjects undergoing TAVR
(1517 with POD and 18,569 without POD) were included in this
meta-analysis. POD demonstrated a trend towards higher all-cause mortality
(pooled odd ratio 1.52, 95% confidence interval 0.98-2.37, p = 0.062,
I² = 72%). POD was associated with a significant increased
long-term mortality (pooled odd ratio 2.11, 95% confidence interval
1.21-3.68, p = 0.009, I² = 62.5%). POD was associated with an
increased risk of long-term all-cause mortality in patients undergoing
TAVR. Our study suggests POD could be a potential risk factor of mortality
among patients undergoing TAVR. Further studies implementing preventative
and treatment strategies against delirium and its effect on POD and its
associated mortality are needed.<br/>Copyright &#xa9; 2019, Japanese
Association of Cardiovascular Intervention and Therapeutics.

<7>
Accession Number
2003608464
Title
Efficacy and safety of dual antiplatelet therapy on graft patency after
coronary artery bypass graft surgery: A randomized controlled trial.
Source
Iranian Heart Journal. 21 (1) (pp 6-16), 2020. Date of Publication: 2020.
Author
Abdi S.; Momtahen M.; Bassiri H.-A.; Shafiei A.; Sadeghipour P.; Madani
M.; Bakhshandeh H.
Institution
(Abdi, Momtahen, Bassiri, Shafiei, Sadeghipour, Madani) Cardiovascular
Intervention Research Center, Rajaie Cardiovascular, Medical, and Research
Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Bakhshandeh) Rajaie Cardiovascular, Medical, and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Iranian Heart Association (E-mail: iha@iha.org.ir)
Abstract
Background: Early vein graft occlusion after coronary artery bypass
grafting (CABG) is one of the major problems after the surgery which
directly impacts its short-and long-term outcomes. One of the potential
explanations is aspirin resistance. The aim of this study was to evaluate
the efficacy and safety of dual antiplatelet therapy (DAPT) with
clopidogrel and aspirin compared with aspirin alone on the reduction of
early graft occ usion. <br/>Method(s): In a multicenter randomized
controlled trial with a parallel design, from 2012 to 2015 among 1165
patients, we compared 140 candidates for CABG: 71 in the DAPT group (300
mg c of clopidogrel and 80-325 mg of aspirin) and 69 in the aspirin group.
The primary outcome was graft patency assessed by coronary computed
tomography angiography performed at 6 months' follow-up. Bleeding
complications were considered the secondary outcome. <br/>Result(s):
Saphenous vein grafts were occluded in 10 (14.1%) patients in the DAPT and
11 (15.9%) in the control group (P = 0.758). After adjustments for study
centers, the associations remained unchanged (OR [95% CI]: 1.49
[0.59-3.74]). Bleeding endpoints were also similar in the 2 groups (P >
0.05). <br/>Conclusion(s): Our study did not demonstrate the superiority
of the DAPT regimen over aspirin monotherapy in patients undergoing
elective CABG. Larger multicenter studies may provide more
evidence.<br/>Copyright &#xa9; 2020, Iranian Heart Association. All rights
reserved.

<8>
Accession Number
2004593538
Title
Are Serum Potassium and Magnesium Levels Associated with Atrial
Fibrillation After Cardiac Surgery?.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (5) (pp 1152-1159),
2020. Date of Publication: May 2020.
Author
Howitt S.H.; Grant S.W.; Campbell N.G.; Malagon I.; McCollum C.
Institution
(Howitt, Grant, Campbell, Malagon, McCollum) Division of Cardiovascular
Sciences, University of Manchester, ERC, Manchester University Hospitals
Foundation Trust, Manchester, United Kingdom
(Malagon) Department of Cardiothoracic Anesthesia and Critical Care,
Wythenshawe Hospital, Manchester University Hospitals Foundation Trust,
Manchester, United Kingdom
Publisher
W.B. Saunders
Abstract
Objectives: Potassium and magnesium are frequently administered after
cardiac surgery to reduce the risk of atrial fibrillation (AF). The
evidence for this practice is unclear. This study was designed to evaluate
the relationship between serum potassium and magnesium levels and AF after
cardiac surgery. <br/>Design(s): Observational cohort study.
<br/>Setting(s): A cardiac intensive care unit in the United Kingdom.
<br/>Participant(s): Patients undergoing cardiac surgery between January
2013 and November 2017. <br/>Intervention(s): None. <br/>Measurements and
Main Results: Cardiac rhythm was assessed using continuous
electrocardiogram (ECG) monitoring in 3,068 patients on the cardiac
intensive care unit. Associations between serum potassium and magnesium
concentrations extracted from hospital databases and postoperative AF were
assessed using univariable and multivariable analyses. The association
between electrolyte supplementation therapy and AF was also analyzed. AF
developed within 72 hours of cardiac surgery in 545 (17.8%) of the 3,068
patients. After adjusting for logistic EuroSCORE, surgery type,
cardiopulmonary bypass time and age, mean serum potassium concentration
<4.5 mmol/L was associated with an increased risk of AF (odds ratio [OR]
1.43 (95% confidence interval (CI): 1.17-1.75), p < 0.001). Mean magnesium
concentration <1.0 mmol/L was not associated with an increased risk of AF
(OR 0.89, 0.71-1.13, p = 0.342), but the administration of magnesium was
associated with increased risk of developing AF (OR 1.61, 1.33-1.96, p <
0.001). <br/>Conclusion(s): Maintaining a serum potassium concentration
>=4.5 mmol/L after cardiac surgery may reduce the incidence of
postoperative AF. Magnesium supplementation was associated with an
increased risk of postoperative AF. Prospective randomized trials are
required to clarify these associations.<br/>Copyright &#xa9; 2019

<9>
Accession Number
2004534000
Title
Repair of ischemic ventricular septal defect with and without coronary
artery bypass grafting.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Horan D.P.; O'Malley T.J.; Weber M.P.; Maynes E.J.; Choi J.H.; Patel S.;
Challapalli J.; Luc J.G.Y.; Entwistle J.W.; Todd Massey H.; Morris R.J.;
Tchantchaleishvili V.
Institution
(Horan, O'Malley, Weber, Maynes, Choi, Patel, Challapalli, Luc, Entwistle,
Todd Massey, Morris, Tchantchaleishvili) Division of Cardiac Surgery,
Thomas Jefferson University, Philadelphia, PA, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background and Aim of the Study: Ventricular septal defect (VSD) following
myocardial infarction (MI) is a relatively infrequent complication with
high mortality. We sought to investigate the effect of concomitant
coronary artery bypass graft (CABG) on outcomes following post-MI VSD
repair. <br/>Method(s): Electronic search was performed to identify all
relevant studies published from 2000 to 2018. Sixty-seven studies were
selected for the analysis comprising 2174 patients with post-MI VSD.
Demographic information, perioperative variables, and outcomes including
survival data were extracted and pooled for systematic review and
meta-analysis. <br/>Result(s): Single-vessel disease was most common (47%,
95% confidence interval [CI], 42-52), left anterior descending coronary
artery was the most commonly involved vessel (55%, 95% CI, 46-63), and
anterior wall was the most commonly affected territory (57%, 95% CI,
51-63). Concomitant CABG was performed in 52% (95% CI, 46-57) of patients.
Of these, infarcted territory was re-vascularized in 54% (95% CI, 23-82).
A residual/recurrent shunt was present in 29% (95% CI, 24-34) of patients.
Of these, surgical repair was performed in 35% (95% CI, 28-41) and
transcatheter repair in 11% (95% CI, 6-21). Thirty-day mortality was 30%
(95% CI, 26-35) in patients who had preoperative coronary angiogram, and
58% (95% CI, 43-71) in those who did not (P <.01). No significant survival
difference observed between those who had concomitant CABG vs those
without CABG. <br/>Conclusion(s): Concomitant CABG did not have a
significant effect on survival following VSD repair. Revascularization
should be weighed against the risks associated with prolonged
cardiopulmonary bypass.<br/>Copyright &#xa9; 2020 Wiley Periodicals, Inc.

<10>
Accession Number
2004515077
Title
Opium use and cardiovascular diseases: a systematic review and
meta-analysis.
Source
Critical Reviews in Toxicology. (no pagination), 2020. Date of
Publication: 2020.
Author
Nakhaee S.; Amirabadizadeh A.; Qorbani M.; Lamarine R.J.; Mehrpour O.
Institution
(Nakhaee, Amirabadizadeh, Mehrpour) Medical Toxicology and Drug Abuse
Research Center (MTDRC), Birjand University of Medical Sciences, Birjand,
Iran, Islamic Republic of
(Qorbani) Department of Epidemiology, Non-Communicable Diseases Research
Center, Alborz, University of Medical Sciences, Karaj, Iran, Islamic
Republic of
(Qorbani) Chronic Diseases Research Center, Endocrinology and Metabolism
Population Sciences Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Lamarine) Department of Public Health, California State University Chico,
CA, United States
(Mehrpour) Rocky Mountain Poison and Drug Safety, Denver, CO, United
States
Publisher
Taylor and Francis Ltd
Abstract
The effects of opium on cardiovascular diseases (CVDs) have been
extensively studied. However, there are few studies that summarize this
research comprehensively; thus, this systematic review and meta-analysis
is a collection of the newest information combined with previous findings
to furthermore illuminate the effects of opium on CVDs. In this systematic
review, all observational studies were systematically searched using the
main international databases such as PubMed/Medline, Web of Sciences, and
Scopus until October 2018. After the quality assessment of the articles,
the fixed or random model meta-analysis was used to pool the results.
I-square test was used to assess the heterogeneity of the studies.
Overall, 41 studies were identified. Based on the random model, the pooled
odds ratio (OR) (95% confidence interval (CI)) of opium use and coronary
artery diseases (CAD) was estimated at 2.75 (95% CI = 2.04-3.75;
I²=47%). The pooled OR of opium use and CVD in-hospital
mortality was not statistically significant (OR: 1.44, 95% CI = 0.88-2.36,
I² = 51%). In the stratified analysis, in the patients who had
undergone heart surgery, the average of ejection fraction (EF) in the
opium users was significantly lower than those not using opium (mean
differences: -3.06, CI 95% = -4.40 to -1.71, I² = 60%) but in
the patients with acute myocardial infarction undergoing angiography, the
average EF was not significantly different in the opium users compared to
non-users (mean difference: 0.30, CI: -0. 55 to 1.15). The results of this
meta-analysis revealed that opium might be a risk factor for CAD and EF
but not in-hospital mortality.<br/>Copyright &#xa9; 2020, &#xa9; 2020
Informa UK Limited, trading as Taylor & Francis Group.

<11>
Accession Number
630762691
Title
Effects of cycle ergometer use in early mobilization following cardiac
surgery: a randomized controlled trial.
Source
Clinical rehabilitation. 34 (4) (pp 450-459), 2020. Date of Publication:
01 Apr 2020.
Author
Gama Lordello G.G.; Goncalves Gama G.G.; Lago Rosier G.; Viana P.A.D.C.;
Correia L.C.; Fonteles Ritt L.E.
Institution
(Gama Lordello, Goncalves Gama, Viana, Correia, Fonteles Ritt) Bahiana
School of Medicine and Public Health, Salvador, Brazil
(Gama Lordello, Lago Rosier, Viana) Hospital Santa Izabel, Santa Casa da
Bahia, Salvador, Brazil
(Goncalves Gama) Edgard Santos Teaching Hospital, Federal University of
Bahia, Salvador, Brazil
(Correia) Hospital Alianca, Salvador, Brazil
(Fonteles Ritt) Hospital Cardio Pulmonar, Salvador, Brazil
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the effect of early use of a cycle ergometer,
compared to a standard care protocol, in postoperatory in-hospital
mobility following cardiac surgery. DESIGN: A randomized controlled trial.
SETTING: Tertiary hospital in Salvador, Bahia, Brazil. SUBJECTS: Patients
submitted to elective cardiac surgery (valvular or coronary bypass surgery
by sternotomy). INTERVENTION: Patients were randomly allocated in two
groups: (1) cycle ergometer training group (10-minute session) and (2)
control group submitted standard physiotherapy protocol (10-minute
session). Training was provided twice a day, immediately following
extubation and until patient was discharged from the intensive care. MAIN
MEASURES: The primary outcome was the difference in the total number of
steps recorded on the pedometer over three days. Secondary outcomes were
mobility in different subgroups and the reasons that prevented individuals
from walking during early cardiac rehabilitation. <br/>RESULT(S): A total
of 228 participants completed the study. No significant difference was
found in the total number of steps between the groups after intervention:
2183 (range: 1729-2772) in the intervention group versus 2006 (1517-2657)
in the control group (P=0.167). However, self-reports indicated better
motivation in the intervention group (P=0.044). No adverse events occurred
during the study. <br/>CONCLUSION(S): As a strategy for early mobilization
following cardiac surgery, the use of a cycle ergometer failed to increase
independent physical activity compared to a standard care protocol.
Nevertheless, it was safe and could be an alternative to make
rehabilitation more attractive and motivational for this patient
population.

<12>
Accession Number
631380442
Title
Use of Coagulation Point-of-Care Tests in the Management of
Anticoagulation and Bleeding in Pediatric Cardiac Surgery: A Systematic
Review.
Source
Anesthesia and analgesia. (no pagination), 2019. Date of Publication: 28
Nov 2019.
Author
Bianchi P.; Beccaris C.; Norbert M.; Dunlop B.; Ranucci M.
Institution
(Bianchi) From the Department of Anesthesia and Intensive Care, Royal
Brompton and Harefield NHS Foundation Trust, London, United Kingdom
(Beccaris) Great Ormond Street Hospital NHS Foundation Trust, Cardiac
Intensive Care Unit, London, United Kingdom
(Norbert, Dunlop) Brunel University, London, United Kingdom
(Ranucci) Department of Cardiothoracic, Vascular Anesthesia and Intensive
Care, IRCCS Policlinico San Donato, Milan, Italy
Publisher
NLM (Medline)
Abstract
Bleeding and coagulation management are essential aspects in the
management of neonates and children undergoing cardiac surgery. The use of
point-of-care tests (POCTs) in a pediatric setting is not as widely used
as in the adult setting. This systematic review aims to summarize the
evidence showed by the literature regarding the use of POCTs in children
undergoing cardiac surgery. We included all studies examining the
pediatric population (<18 years old) undergoing cardiac surgery in which
the coagulation profile was assessed with POCTs. Three electronic
databases (PubMed, Embase, and the Cochrane Controlled Clinical Trials
register) were searched. Tests involved were heparin effect tests,
viscoelastic tests, and platelet function tests. Due to the wide
heterogeneity of the patients and tests studied, a formal meta-analysis
was impossible, and the results are therefore presented through a
systematic review. Eighty articles were found, of which 47 are presented
in this review. At present, literature data are too weak to define POCTs
as a "gold standard" for the treatment of perioperative bleeding in
pediatric cardiac surgery. Nevertheless, introduction of POCTs into
postoperative algorithms has shown to improve bleeding management, patient
outcome, and cost efficiency.

<13>
Accession Number
631404242
Title
Implementation of Appropriate Use Criteria for Cardiology Tests and
Procedures: a Systematic Review and Meta-analysis.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2020. Date of Publication: 31 Mar 2020.
Author
Winchester D.E.; Merritt J.; Waheed N.; Norton H.; Manja V.; Shah N.R.;
Helfrich C.D.
Institution
(Winchester) Malcom Randall VAMC Gainesville, FL
(Winchester, Merritt) University of Florida College of Medicine, Division
of Cardiovascular Medicine Gainesville, FL
(Waheed) University of Florida College of Medicine, Department of Internal
Medicine Gainesville, FL
(Norton) University of Florida College of Medicine, Health Science Center
Library Gainesville, FL
(Manja) University of California Davis, Department of Surgery
(Manja) VA Northern California Health Care System, Mather CA
(Shah) Providence VA Medical Center, Department of Medicine, Brown
University Warren Alpert Medical School, Providence, RI
(Shah) Department of Health Services, Policy & Practice, Brown University
School of Public Health
(Helfrich) Seattle-Denver Center for Innovation in Veteran-Centered &
Value-Driven Care
Publisher
NLM (Medline)
Abstract
AIMS: The American College of Cardiology appropriate use criteria (AUC)
provide clinicians with evidence-informed recommendations for cardiac
care. Adopting AUC into clinical workflows may present challenges, and
there may be specific implementation strategies that are effective in
promoting effective use of AUC. We sought to assess the effect of
implementing AUC in clinical practice. METHODS AND RESULTS: We conducted a
meta-analysis of studies found through a systematic search of the MEDLINE,
Web of Science, Cochrane, or CINAHL databases. Peer-reviewed manuscripts
published after 2005 that reported on the implementation of AUC for a
cardiovascular test or procedure were included. The main outcome was to
determine if AUC implementation was associated with a reduction in
inappropriate/rarely appropriate care. Of the 18 included studies, the
majority used pre/post cohort designs; few (n=3) were randomized trials.
Most studies used multiple strategies (n=12, 66.7%). Education was the
most common individual intervention strategy (n=13, 72.2%), followed by
audit & feedback (n=8, 44.4%) and computerized physician order entry
(CPOE) (n=6, 33.3%). No studies reported on formal use of stakeholder
engagement or "nudges". In meta-analysis, AUC implementation was
associated with a reduction in inappropriate/rarely appropriate care (odds
ratio 0.62, 95% confidence interval 0.49-0.78). Funnel plot suggests the
possibility of publication bias. <br/>CONCLUSION(S): We found most
published efforts to implement AUC observed reductions in
inappropriate/rarely appropriate care. Studies rarely explored how or why
the implementation strategy was effective. Because interventions were
infrequently tested in isolation, it is difficult to make observations
about their effectiveness as stand-alone strategies.<br/>Copyright
Published by Oxford University Press 2020.

<14>
Accession Number
631410552
Title
Bright light therapy for depressive symptoms in hospitalized cardiac
patients: A randomized controlled pilot trial.
Source
PloS one. 15 (3) (pp e0230839), 2020. Date of Publication: 2020.
Author
Eisenberg M.J.; Habib B.; Alcaraz M.; Thombs B.D.; Filion K.B.
Institution
(Eisenberg, Habib, Alcaraz, Thombs, Filion) Center for Clinical
Epidemiology, Jewish General Hospital, Lady Davis Institute, QC, Montreal,
Canada
(Eisenberg, Thombs, Filion) Department of Medicine, McGill University, QC,
Montreal, Canada
(Eisenberg, Thombs, Filion) Department of Epidemiology, Biostatistics and
Occupational Health, McGill University, QC, Montreal, Canada
(Eisenberg) Division of Cardiology, Jewish General Hospital/McGill
University, QC, Montreal, Canada
(Thombs) Departments of Psychiatry, of Psychology, of Educational and
Counselling Psychology, McGill University, QC, Montreal, Canada
Publisher
NLM (Medline)
Abstract
Depression is common among cardiac patients and associated with adverse
cardiovascular outcomes. Bright light therapy has emerged as a promising
treatment for depressive symptoms, however it has not yet been
investigated in this population. We conducted a double-blind, randomized,
placebo-controlled pilot trial to assess the feasibility of a larger-scale
trial testing bright light therapy for depressive symptoms in cardiac
patients. Patients hospitalized for an acute coronary syndrome or
undergoing cardiac surgery were randomized to either bright light (10,000
lux) or dim light placebo (500 lux) lamps for 30 minutes each day over 4
weeks, beginning in-hospital. Depression was quantified using the Patient
Health Questionnaire 9 (PHQ-9) and Depression Anxiety and Stress Scales
(DASS-21). The Short-Form Health Survey 36 (SF-36) was used to measure
quality of life. A total of 175 patients were screened and 15 were
randomized (8 treatment, 7 placebo) (8.6%) over 10 months. Despite
protocol amendments which broadened the inclusion criteria, the trial was
terminated early for infeasibility based on the rate of enrollment (1-2
participants/month), with 39.5% of the target sample (38 participants)
enrolled. Future trials should take into account the timing of the onset
of depressive symptoms in these patients, and consider a less conservative
approach to eligibility as well as ways to increase the acceptability of
bright light therapy in hospitalized cardiac patients. Once enrolled, our
findings suggest that most participants will adhere to the assigned
treatment and complete follow-up.

<15>
Accession Number
2005166502
Title
The role of Trimetazidine in prevention of contrast induced nephropathy in
diabetic patients with renal insufficiency undergoing cardiac
intervention.
Source
Systematic Reviews in Pharmacy. 11 (1) (pp 337-348), 2020. Date of
Publication: 2020.
Author
Rajeeb A.N.; Amber K.I.; Hadi N.R.; Alsalkhi H.A.; Muhammad-Baqir B.M.;
Ahmed M.H.
Institution
(Rajeeb) Kufa University Medical College, Consultant Cardiologist, Najaf
Cardiac Center
(Amber) Al Najaf Cardiac Center, Al-Najaf center for cardiac Surgery and,
Trans Catheter Therapy, Iraq
(Hadi) Department of Pharmacology and therapeutics, Faculty of Medicine,
University of Kufa, Iraq
(Alsalkhi) Department of Pediatric Cardiology, Faculty of Medicine,
University of Kufa, Iraq
(Muhammad-Baqir) Department of Clinical pharmacy, Faculty of Pharmacy,
University of Kufa, Iraq
(Ahmed) Al-Sader Teaching hospital / the specialist centre for Nephrology
and Kidney Transplantation, Iraq
Publisher
EManuscript Technologies (E-mail: journals@emanuscript.in)
Abstract
This study aims to assess the possible protective role of Trimetazidine in
the prevention of contrast induced nephropathy in patients with renal
impairment undergoing coronary angiography or percutaneous coronary
intervention. This was a randomized single-blind clinical trial study. A
total of 100 consecutive diabetic patients with symptomatic ischemic heart
disease and chronic kidney disease (CKD) were subjected to an elective
percutaneous coronary intervention, at ALSADR teaching hospital /Al-Najaf
Center for Cardiac surgery and Tran Catheter Therapy, Najaf, Iraq, in
period between May and December 2018. The Patients were divided into two
groups: Group l-Control Group (n=45) these patients with chronic kidney
disease and critical coronary stenosis and they were needed to be
subjected to coronary intervention. Group II- Treatment Group (n=44) also
these patients with chronic kidney disease and critical coronary stenosis
and they were need to be subjected to coronary intervention and treated
with 35 mg tablet /twice daily of Trimetazidine for the period of three
days. Trimetazidine significantly reduce the elevation in serum level of
monocyte chemo tactic proteinl, expression of Toll-like receptor 2 and the
urine levels of kidney injury molecule-1,F2-isoprostanes (p<0.05) while
insignificantly reduce the elevation in serum level of creatinine . (p >
0.05). Our study concluded that Trimetazidine reduce the acute kidney
injury response and systemic inflammatory response induced by contrast
administration after coronary intervention.<br/>Copyright &#xa9; Advanced
Scientific Research. All rights reserved

<16>
Accession Number
2005487044
Title
Impact of Cardiac Rehabilitation on Functional Capacity and Physical
Activity after Coronary Revascularization: A Scientific Review.
Source
Cardiology Research and Practice. 2020 (no pagination), 2020. Article
Number: 1236968. Date of Publication: 2020.
Author
Prabhu N.V.; Maiya A.G.; Prabhu N.S.
Institution
(Prabhu, Maiya, Prabhu) Department of Physiotherapy, Manipal College of
Health Professions, Manipal Academy of Higher Education, Manipal,
Karnataka 576104, India
Publisher
Hindawi Limited (410 Park Avenue, 15th Floor, 287 pmb, New York NY 10022,
United States)
Abstract
Background. Coronary revascularization procedures often cause lowered
exercise capacity and declining physical activity levels. These outcomes
are paramount in predicting morbidity and mortality after these
procedures. Cardiac rehabilitation (CR) focuses on incrementing
cardiovascular endurance, exercise capacity, muscle strength, levels of
physical activity, and quality of life through health education and
lifestyle modification in post-coronary revascularization patients.
Objective. To review the impact of cardiac rehabilitation on functional
capacity, levels of physical activity, and health related quality of life
in patients following coronary revascularization. Methods. A structured
literature search in PubMed, Scopus, CINAHL, and ProQuest for studies
focused on CR and its effects on functional capacity, physical activity,
and quality of life after coronary revascularization. Results. A total of
2,010 studies were retrieved. Deduplication and eligibility screening
included 190 studies after the application of filters. A sum of 21 studies
were considered for this review. Most studies reported that exercise and
physical activity programs were centre-based and home-based and via
telerehabilitation. Treadmill and cycle ergometry training with
callisthenics and flexibility exercises in phase 2 CR exhibited
significant improvement in functional capacity and physical activity
levels in patients after coronary revascularization procedures.
Conclusion. Although centre-based supervised CR programs do improve
functional capacity after coronary revascularization, home-based or
telerehabilitation-based CR programs are feasible, improve patient
compliance in improving physical activity, and thereby increase functional
capacity. Patient education improves levels of physical activity, health
related quality of life, and adherence to home- and centre-based CR
programs.<br/>Copyright &#xa9; 2020 Niramayee V. Prabhu et al.

<17>
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<br/>Copyright &#xa9; 2020 Elsevier Inc.

<18>
Accession Number
2004547235
Title
Upper gastrointestinal mucosal injury associated with ticagrelor plus
aspirin, ticagrelor alone, or aspirin alone at 1-year after coronary
artery bypass grafting.
Source
Journal of Gastroenterology and Hepatology (Australia). (no pagination),
2020. Date of Publication: 2020.
Author
Tang C.; Zhu Y.; Yang X.; Xu B.; Ye C.; Yang Y.; Zhong J.; Zhao Q.; Yu L.
Institution
(Tang, Xu, Zhong, Yu) Department of Gastroenterology, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Zhu, Ye, Yang, Zhao) Department of Cardiovascular Surgery, Shanghai Jiao
Tong University School of Medicine, Shanghai, China
(Yang) Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
Publisher
Blackwell Publishing
Abstract
Background and Aim: The presence and severity of upper gastrointestinal
mucosal lesions have not been evaluated using esophagogastroduodenoscopy
(EGD) in patients receiving ticagrelor plus aspirin or alone after
myocardial revascularization. We assessed upper gastrointestinal mucosal
injury and the use of proton pump inhibitors (PPIs) in patients receiving
1 year of antiplatelet therapy after coronary artery bypass grafting
(CABG). <br/>Method(s): In this single-center prospective substudy of a
randomized trial, 231 patients completing 1-year antiplatelet therapy
(ticagrelor 90 mg twice daily plus aspirin 100 mg once daily, ticagrelor
90 mg twice daily, or aspirin 100 mg once daily, in 81, 80, and 70
patients, respectively) after CABG underwent ¹³C urea breath
testing and EGD. Gastroduodenal lesions were assessed by modified Lanza
score, and reflux esophagitis was evaluated according to Los Angeles
classification. Additionally, at least one ulcer >= 5 mm was separately
analyzed. <br/>Result(s): Among 231 patients, EGD showed 28 (12.1%) with
ulcers >= 5 mm, which were detected in 13.6% (11/81) of ticagrelor plus
aspirin recipients, 8.8% (7/80) of ticagrelor recipients, and 14.3%
(10/70) of aspirin recipients, and 24 (10.4%) had reflux esophagitis.
Eighty-eight (38.1%) patients had a positive ¹³C urea breath
testing after 1 year of treatment, and one patient received eradication
therapy during follow up. Nineteen (8.2%) patients received a PPI for >= 6
months. <br/>Conclusion(s): Severe upper gastrointestinal mucosal lesions
were more frequently observed in patients treated with ticagrelor plus
aspirin and aspirin monotherapy than in patients treated with ticagrelor
monotherapy for 1 year post-CABG. Prophylactic use of PPIs might be
inadequate.<br/>Copyright &#xa9; 2020 Journal of Gastroenterology and
Hepatology Foundation and John Wiley & Sons Australia, Ltd

<19>
Accession Number
2004545445
Title
Pivotal Clinical Study to Evaluate the Safety and Effectiveness of the
MANTA Vascular Closure Device During Percutaneous EVAR and TEVAR
Procedures.
Source
Journal of Endovascular Therapy. (no pagination), 2020. Date of
Publication: 2020.
Author
Krajcer Z.; Wood D.A.; Strickman N.; Bernardo N.; Metzger C.; Aziz M.;
Bacharach J.M.; Nanjundappa A.; Campbell J.; Lee J.T.; Dake M.D.; Lumsden
A.; Nardone S.
Institution
(Krajcer, Strickman) Texas Heart Institute and Baylor St Luke's Hospital,
Houston, TX, United States
(Wood) Center for Cardiovascular Innovation, University of British
Columbia, Vancouver, BC, Canada
(Bernardo) MedStar Health, Washington, DC, United States
(Metzger, Aziz) Ballad CVA Heart Institution, Kingsport, TN, United States
(Bacharach) Avera Heart Hospital, Sioux Falls, SD, United States
(Nanjundappa, Campbell) Charleston Area Medical Center, Charleston, WV,
United States
(Lee, Dake) Stanford University Medical Center, Palo Alto, CA, United
States
(Lumsden) The Houston Methodist Hospital, Houston, TX, United States
(Nardone) Teleflex Inc, Exton, PA, United States
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Purpose: To evaluate the safety and effectiveness of the MANTA
percutaneous vascular closure device in patients undergoing percutaneous
endovascular aneurysm repair (PEVAR) or thoracic endovascular aortic
repair (TEVAR). <br/>Material(s) and Method(s): The SAFE MANTA Study
(ClinicalTrials.gov identifier NCT02908880) was a prospective, single-arm,
multicenter trial in patients undergoing endovascular interventions using
large-bore sheaths (transcatheter aortic valve replacement, PEVAR, or
TEVAR) at 20 sites in North America. Patient selection intended to test
the MANTA device in populations without morbid obesity, severe
calcification, or a severely scarred femoral access area. Of the 263
patients enrolled in the primary analysis cohort, 53 (20.2%) patients
(mean age 74.9+/-8.9 years; 41 men) underwent PEVAR (n=51) or TEVAR (n=2)
procedures and form the cohort for this subgroup analysis. Per protocol a
single MANTA device was deployed in all PEVAR/TEVAR cases. <br/>Result(s):
The mean time to hemostasis in the PEVAR/TEVAR cohort was 35+/-91 seconds,
with a median time of 19 seconds vs 24 seconds in the overall SAFE MANTA
population. The MANTA device met the definition for technical success in
52 (98%) of 53 PEVAR/TEVAR cases compared with 97.7% in the overall SAFE
MANTA population. One (1.9%) major complication (access-site stenosis)
occurred in this subgroup compared to 14 (5.3%) events in the SAFE
population. In the PEVAR/TEVAR group, 1 pseudoaneurysm was noted prior to
discharge, another at 30-day follow-up, and one at 60 days. One (1.9%) of
the 3 minor pseudoaneurysms was treated with ultrasound-guided compression
and the other 2 required no treatment. <br/>Conclusion(s): The MANTA
device demonstrated a short time to hemostasis and low complication rates
compared with published literature results of other percutaneous closure
devices. Time to hemostasis and complication rates were comparable between
the PEVAR/TEVAR patients and the full SAFE MANTA study cohort. The MANTA
device provides reliable closure with a single percutaneous device for
PEVAR/TEVAR procedures.<br/>Copyright &#xa9; The Author(s) 2020.

<20>
Accession Number
2003891890
Title
Risk prediction models for survival after heart transplantation: A
systematic review.
Source
American Journal of Transplantation. 20 (4) (pp 1137-1151), 2020. Date of
Publication: 01 Apr 2020.
Author
Aleksova N.; Alba A.C.; Molinero V.M.; Connolly K.; Orchanian-Cheff A.;
Badiwala M.; Ross H.J.; Duero Posada J.G.
Institution
(Aleksova, Alba, Molinero, Badiwala, Ross, Duero Posada) Peter Munk
Cardiac Centre, Toronto General Hospital-University Health Network,
Toronto, Canada
(Connolly) Hamilton Health Sciences, Hamilton, Canada
(Orchanian-Cheff) Library and Information Services, University Health
Network, Toronto, Canada
Publisher
Blackwell Publishing Ltd
Abstract
Risk prediction scores have been developed to predict survival following
heart transplantation (HT). Our objective was to systematically review the
model characteristics and performance for all available scores that
predict survival after HT. Ovid Medline and Epub Ahead of Print and
In-Process & Other Non-Indexed Citations, Ovid Embase, Cochrane Database
of Systematic Reviews, and Cochrane Central Register of Controlled
Clinical Trials were searched to December 2018. Eligible articles reported
a score to predict mortality following HT. Of the 5392 studies screened,
21 studies were included that derived and/or validated 16 scores. Seven
(44%) scores were validated in external cohorts and 8 (50%) assessed model
performance. Overall model discrimination ranged from poor to moderate
(C-statistic/area under the receiver operating characteristics 0.54-0.77).
The IMPACT score was the most widely validated, was well calibrated in two
large registries, and was best at discriminating 3-month survival
(C-statistic 0.76). Most scores did not perform particularly well in any
cohort in which they were assessed. This review shows that there are
insufficient data to recommend the use of one model over the others for
prediction of post-HT outcomes.<br/>Copyright &#xa9; 2019 The American
Society of Transplantation and the American Society of Transplant Surgeons

<21>
Accession Number
631398149
Title
Outcomes after surgery for functional tricuspid regurgitation: A
systematic review and meta-analysis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 6 (1) (pp
10-18), 2020. Date of Publication: 01 Jan 2020.
Author
Veen K.M.; Etnel J.R.G.; Quanjel T.J.M.; Mokhles M.M.; Huygens S.A.;
Rasheed M.; Oei F.B.S.; ten Cate F.J.; Bogers A.J.J.C.; Takkenberg J.J.M.
Institution
(Veen, Etnel, Quanjel, Mokhles, Huygens, Rasheed, Oei, Bogers, Takkenberg)
Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus MC,
University Medical Center Rotterdam, Dr Molewaterplein 40, Rotterdam 3015
GD, Netherlands
(ten Cate) Department of Cardiology, Thoraxcenter, Rg-619, Erasmus MC,
University Medical Center Rotterdam, Dr Molewaterplein 40, Rotterdam 3015
GD, Netherlands
Publisher
Oxford University Press
Abstract
Aims This study aims to provide a contemporary overview of outcomes after
tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR).
Methods The literature was systematically searched for papers published
between January 2005 and December 2017 report- and results ing on
clinical/echocardiographic outcomes after TV surgery for functional TR. A
random effects meta-analysis was conducted for outcome variables, and late
outcomes are visualized by pooled Kaplan-Meier curves. Subgroup analyses
were performed for studies with a within-study comparison of suture vs.
ring repair and flexible vs. rigid ring repair. Eighty-seven publications
were included, encompassing 13 184 patients (mean age: 62.1 +/- 11.8
years, 55% females). A mitral valve procedure was performed in 92% of
patients. Pooled mean follow-up was 4.0 +/- 2.8 years. Pooled early
mortality was 3.9% (95% CI: 3.2-4.6), and late mortality rate was
2.7%/year (95% CI: 2.0-3.5), of which approximately half was
cardiac-related 1.2%/year (95% CI: 0.8-1.9). Pooled risk of early
moderate-to-severe TR at discharge was 9.4% (95% CI: 7.0-12.1). Late
moderate-to-severe TR rate after discharge was 1.9%/year (95% CI:
1.0-3.5). Late reintervention rate was 0.3%/year (95% CI: 0.2-0.4).
Mortality and overall (early and late) TR rate were comparable between
suture vs. ring annuloplasty (14 studies), whereas overall TR rate was
higher after flexible ring vs. rigid ring annuloplasty (6 studies)
(7.5%/year vs. 3.9%/year, P = 0.002). Conclusion This study shows that
patients undergoing surgery for functional tricuspid regurgitation (FTR)
have an acceptable early and late mortality. However, TR remains prevalent
after surgery. The results of this study can be used to inform patients
and clinicians about the expected outcome after surgery for FTR and can
results serve as a benchmark for the performance of emerging transcatheter
TV interventions.<br/>Copyright Published on behalf of the European
Society of Cardiology. All rights reserved. VC The Author(s) 2019. For
permissions,

<22>
Accession Number
2005471520
Title
Supplemental Cardioplegia During Donor Heart Implantation: A Systematic
Review and Meta-Analysis.
Source
Annals of Thoracic Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Ribeiro R.V.P.; Friedrich J.O.; Ouzounian M.; Yau T.; Lee J.; Yanagawa B.
Institution
(Ribeiro, Ouzounian, Yau) Division of Cardiovascular Surgery, Peter Munk
Cardiac Centre, Toronto General Hospital, University Health Network,
Toronto, Ontario, Canada
(Ribeiro, Yau) Institute of Medical Science, University of Toronto,
Toronto, Ontario, Canada
(Friedrich) Critical Care and Medicine Departments and Li Ka Shing
Knowledge Institute, St. Michael's Hospital, and Department of Medicine
and Interdepartmental Division of Critical Care, University of Toronto,
Toronto, Ontario, Canada
(Lee, Yanagawa) Division of Cardiovascular Surgery, St. Michael's
Hospital, Toronto, Ontario, Canada
Publisher
Elsevier USA
Abstract
Background: The optimal donor heart preservation and management strategy
during heart transplantation remains controversial. We report the results
of a systematic review and meta-analysis of the effect of supplemental
cardioplegia administration during donor heart implant for
transplantation. <br/>Method(s): We searched MEDLINE and Embase databases
until February 2019 for studies comparing patients who received
transplants with the donor heart given supplemental cardioplegia or not.
Data were extracted by 2 independent investigators. The main outcomes were
early morbidity and mortality. <br/>Result(s): Included were 7
retrospective observational studies (4 comparing to historical controls)
and 3 randomized controlled trials enrolling 1125 patients. Supplemental
cardioplegia included crystalloid and blood cardioplegia given continuous
retrograde or as terminal "hot shots." Supplemental cardioplegia was
associated with improved early mortality (risk ratio [RR], 0.55; 95%
confidence interval [CI], 0.35-0.87; P < .01), greater rates of
spontaneous return of sinus rhythm (RR, 2.62; 95% CI, 1.50-4.56; P < .01),
shorter intensive care stay (mean difference, -3.4 days; 95% CI, -5.1 to
-1.6; P < .01), and lower incidence of ischemic changes seen on
endomyocardial biopsy specimens (RR, 0.49; 95% CI, 0.35-0.69; P < .01)
compared with controls. Midterm mortality was not different between groups
(incident rate ratio, 0.80; 95% CI, 0.51-1.26; P = .34).
<br/>Conclusion(s): Administration of supplemental cardioplegia may be
associated with a reduction in organ ischemic injury and shorter intensive
care stay as well as improvement in early survival after transplantation.
This strategy may be a simple and cost-effective adjunct to improve
outcomes of heart transplantation, especially in an era of increasing use
of marginal donor organs. Further investigation will be needed to confirm
the findings of this hypothesis-generating study.<br/>Copyright &#xa9;
2020

<23>
Accession Number
2005460097
Title
Remifentanil and perioperative glycaemic response in cardiac surgery: an
open-label randomised trial.
Source
British Journal of Anaesthesia. (no pagination), 2020. Date of
Publication: 2020.
Author
Subramaniam K.; Sciortino C.; Ruppert K.; Monroe A.; Esper S.; Boisen M.;
Marquez J.; Hayanga H.; Badhwar V.
Institution
(Subramaniam, Monroe, Esper, Boisen, Marquez) Department of Anesthesiology
and Perioperative Medicine, University of Pittsburgh School of Medicine,
Pittsburgh, PA, United States
(Sciortino) Department of Cardiothoracic Surgery, University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
(Ruppert) Department of Epidemiology, University of Pittsburgh,
Pittsburgh, PA, United States
(Hayanga, Badhwar) Department of Cardiovascular and Thoracic Surgery, West
Virginia University, Morgantown, WV, United States
Publisher
Elsevier Ltd
Abstract
Background: This study investigated whether remifentanil infusion
decreased intraoperative hyperglycaemia and insulin resistance compared
with intermittent fentanyl administration in patients undergoing elective
cardiac surgery. <br/>Method(s): This was a randomised, prospective,
open-label trial. Patients undergoing elective cardiac surgery (n=116)
were randomised to receive either continuous intravenous remifentanil
infusion or intermittent fentanyl boluses. Hourly blood glucose values
were obtained for 24 h starting from induction of anaesthesia. The
difference in percentage of patients with >=2 intraoperative blood glucose
concentrations >10 mM (180 mg dl^-1) between the groups was the
primary outcome measure. Secondary outcome measures included insulin
requirements, select stress hormone and inflammatory cytokine
concentrations, and safety events and adverse outcomes. <br/>Result(s):
The trial included 106 subjects in the final intention-to-treat analysis.
There were fewer patients with >=2 intraoperative blood glucose values >10
mM (180 mg dl^-1) in the remifentanil group (17 [31.5%])
compared with the fentanyl group (33 [63.5%]) (relative risk: 0.50; 95%
confidence interval [CI]: 0.32-0.77; P=0.001). The administered
intraoperative insulin was a median of 8.1 units (range: 0-46.7) in the
fentanyl group and 2.9 units (range: 0-35.1) in the remifentanil group
(median difference=5 units; 95% CI: 1-7; P=0.004). Cortisol and
adrenocorticotropic hormone were increased less in the remifentanil group
(P<0.001), but there was no relative decrease in this group in select
inflammatory cytokines. Postoperative measures of glycaemic control and
adverse clinical outcomes were not significantly different between groups.
<br/>Conclusion(s): Compared with patients treated with intermittent
fentanyl, patients receiving continuous remifentanil infusion had fewer
episodes of hyperglycaemia and less need for insulin administration during
the intraoperative period of cardiac surgery. Clinical trial registration:
NCT02349152.<br/>Copyright &#xa9; 2020 British Journal of Anaesthesia

<24>
Accession Number
2005459747
Title
Meta-analysis Comparing Valve-In-Valve Transcatheter Aortic Valve
Implantation With Self-Expanding Versus Balloon-Expandable Valves.
Source
American Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Hamilton G.W.; Koshy A.N.; Fulcher J.; Tang G.H.L.; Bapat V.; Murphy A.;
Horrigan M.; Farouque O.; Yudi M.B.
Institution
(Hamilton, Koshy, Fulcher, Murphy, Horrigan, Farouque, Yudi) Department of
Cardiology, Austin Health, Melbourne, Victoria, Australia
(Koshy, Farouque, Yudi) Department of Medicine, The University of
Melbourne, Victoria, Australia
(Tang) Department of Cardiovascular Surgery, Mount Sinai Health System,
New York, NY, United States
(Bapat) Department of Cardiothoracic Surgery, New York Presbyterian
Hospital, Columbia University Medical Centre, New York, NY, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) is an
alternative to redo-surgery in patients with failed surgical
bioprostheses. It remains unclear whether outcomes vary when using either
self-expanding (SE) or balloon-expandable (BE) valves. The aim of this
study was to compare outcomes between SE and BE transcatheter heart valves
when used for ViV TAVI. A systematic review of PubMed, MEDLINE, and EMBASE
was performed identifying studies reporting outcomes following ViV TAVI.
Event rates were pooled for meta-analysis using a random-effects model.
The primary outcome was all-cause mortality at 12 months. Secondary
outcomes included 30-day and 3-year mortality in addition to standard
safety outcomes after the procedure as per the Valve Academic Research
Consortium criteria. Nineteen studies reporting outcomes for 1,772
patients were included: 924 in the SE group and 848 patients in the BE
group. There was no significant difference in all-cause mortality at 12
months (SE 10.3% vs BE 12.6%, p = 0.165, I² = 0%), or 3 years
(SE 21.2% vs BE 31.2%, p = 0.407, I² = 63.79). SE valves had
lower transvalvular gradients after procedure and acute kidney injury, but
higher rates of pacemaker insertion, moderate or severe paravalvular
regurgitation and need for >=2 valves (all p < 0.05). There were no
differences in stroke, coronary obstruction, bleeding, or vascular
complications. Despite significant differences in key procedural outcomes
between SE and BE valves when used for ViV TAVI, we found no difference in
12-month mortality. Tailored device selection may further reduce the risk
of adverse procedural outcomes, particularly over the longer
term.<br/>Copyright &#xa9; 2020

<25>
Accession Number
2005451465
Title
Intravenous sildenafil citrate and post-cardiac surgery acute kidney
injury: a double-blind, randomised, placebo-controlled trial.
Source
British Journal of Anaesthesia. (no pagination), 2020. Date of
Publication: 2020.
Author
Kumar T.; Aujla H.; Wozniak M.; Dott W.; Sullo N.; Joel-David L.; Pais P.;
Smallwood D.; Miller D.; Eagle-Hemming B.; Di Paola A.S.; Barber S.;
Brookes C.; Brunskill N.J.; Murphy G.J.
Institution
(Kumar, Aujla, Wozniak, Dott, Sullo, Joel-David, Pais, Smallwood, Miller,
Eagle-Hemming, Murphy) Department of Cardiovascular Sciences and National
Institute for Health Research Leicester Biomedical Research Unit in
Cardiovascular Medicine, University of Leicester, Clinical Sciences Wing,
Glenfield General Hospital, Leicester, United Kingdom
(Sullo) University of Nottingham, Royal Derby Hospital, Derby, United
Kingdom
(Smallwood) School of Allied Health Sciences, De Montfort University,
Leicester, United Kingdom
(Di Paola, Barber, Brookes, Murphy) Leicester Clinical Trials Unit,
University of Leicester, Leicester, United Kingdom
(Brunskill) Department of Infection, Immunity and Inflammation, University
of Leicester, Leicester, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: This study assessed whether i.v. sildenafil citrate prevented
acute kidney injury in at-risk patients undergoing cardiac surgery with
cardiopulmonary bypass. <br/>Method(s): In a double-blind RCT, adults at
increased risk of acute kidney injury undergoing cardiac surgery in a
single UK tertiary centre were randomised to receive sildenafil citrate
12.5 mg kg^-1 i.v. over 150 min or dextrose 5% at the
commencement of surgery. The primary outcome was serum creatinine measured
at six post-randomisation time points. The primary analysis used a linear
mixed-effects model adjusted for the stratification variables, baseline
estimated glomerular filtration rate, and surgical procedure. Secondary
outcomes considered clinical events and potential disease mechanisms.
Effect estimates were expressed as mean differences (MDs) or odds ratios
with 95% confidence intervals. <br/>Result(s): The analysis population
comprised eligible randomised patients that underwent valve surgery or
combined coronary artery bypass graft and valve surgery, with
cardiopulmonary bypass, between May 2015 and June 2018. There were 60
subjects in the sildenafil group and 69 in the placebo control group. The
difference between groups in creatinine concentration was not
statistically significant (MD: 0.88 mumol L^-1 [-5.82, 7.59]).
There was a statistically significant increase in multiple organ
dysfunction scores in the sildenafil group (MD: 0.54 [0.02, 1.07];
P=0.044). Secondary outcomes, and biomarkers of kidney injury, endothelial
function, and inflammatory cell activation, were not significantly
different between the groups. <br/>Conclusion(s): These results do not
support the use of i.v. sildenafil citrate for kidney protection in adult
cardiac surgery. Clinical trial registration:
ISRCTN18386427.<br/>Copyright &#xa9; 2020 The Author(s)

<26>
Accession Number
631391575
Title
Role of advanced left ventricular imaging in adults with aortic stenosis.
Source
Heart. (no pagination), 2020. Date of Publication: 2020.
Author
Calin A.; Mateescu A.D.; Popescu A.C.; Bing R.; Dweck M.R.; Popescu B.A.
Institution
(Calin, Mateescu, Popescu, Popescu) Department of Cardiology, Euroecolab,
University of Medicine and Pharmacy Carol Davila, Emergency Institute for
Cardiovascular Diseases Prof Dr C C Iliescu, Sos. Fundeni 258, Bucharest
022328, Romania
(Calin, Mateescu, Popescu) Department of Cardiology, Emergency Institute
for Cardiovascular Diseases Prof Dr C C Iliescu, Bucharest, Romania
(Popescu) Department of Cardiology, Emergency University Hospital Elias,
Bucharest, Romania
(Bing, Dweck) BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh EH16 4SB, United Kingdom
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
This review focuses on the available data regarding the utility of
advanced left ventricular (LV) imaging in aortic stenosis (AS) and its
potential impact for optimising the timing of aortic valve replacement.
Ejection fraction is currently the only LV parameter recommended to guide
intervention in AS. The cut-off value of 50%, recommended for
decision-making in asymptomatic patients with AS, is currently under
debate. Several imaging parameters have emerged as predictors of disease
progression and clinical outcomes in this setting. Global longitudinal LV
strain by speckle tracking echocardiography is useful for risk
stratification of asymptomatic patients with severe AS and preserved LV
ejection fraction. Its prognostic value was demonstrated in these
patients, but further work is required to define the best thresholds to
aid the decision-making process. The assessment of myocardial fibrosis is
the most studied application of cardiac magnetic resonance in AS. The
detection of replacement fibrosis by late gadolinium enhancement offers
incremental prognostic information in these patients. Clinical
implementation of this technique to optimise the timing of aortic valve
intervention in asymptomatic patients is currently tested in a randomised
trial. The use of T1 mapping techniques can provide an assessment of
interstitial myocardial fibrosis and represents an expanding field of
interest. However, convincing data in patients with AS is still lacking.
All these imaging parameters have substantial potential to influence the
management decision in patients with AS in the future, but data from
randomised clinical trials are awaited to define their utility in daily
practice.<br/>Copyright &#xa9; 2020 Author(s) (or their employer(s)).
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<27>
Accession Number
359720142
Title
Twente study: The real-world endeavor resolute versus xience V
drug-eluting stent study in twente: Study design, rationale and
objectives.
Source
Netherlands Heart Journal. 18 (7) (pp 360-364), 2010. Date of Publication:
August 2010.
Author
Basalus M.W.Z.; Tandjung K.; van Houwelingen K.G.; Stoel M.G.; de Man
F.H.A.F.; Louwerenburg J.W.; Said S.A.M.; Linssen G.C.M.; Kleijne
M.A.W.J.; Van der Palen J.; Huisman J.; Verhorst P.M.J.; von Birgelen C.
Institution
(Basalus, Tandjung, van Houwelingen, Stoel, de Man, Louwerenburg, Huisman,
Verhorst) Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum
Twente, Enschede, Netherlands
(Said) Department of Cardiology, Hospital Group Twente, Hengelo,
Netherlands
(Linssen) Department of Cardiology, Hospital Group Twente, Almelo,
Netherlands
(Kleijne) Department of Cardiology, Streekziekenhuis Koningin Beatrix,
Winterswijk, Netherlands
(Van der Palen) Department of Epidemiology, Medisch Spectrum Twente,
Enschede and Department of Research Methodology, Measurement and Data
Analysis, University of Twente, Enschede, Netherlands
(von Birgelen) Department of Cardiology, Thoraxcentrum Twente, Medisch
Spectrum Twente, Enschede, and MIRA, Institute for Biomedical Technology
and Technical Medicine, University of Twente, Enschede, Netherlands
Publisher
Bohn Stafleu van Loghum (E-mail: e.smid@ntvg.nl)
Abstract
Background. New-generation drug-elutingstents (DES) may solve several
problems encountered with first-generation DES, but there is a lack of
prospective head-to-head comparisons between new-generation DES. In
addition, the outcome of regulatory trials may not perfectly reflect the
outcome in 'real world' patients. Objectives. To compare the efficacy and
safety of two new-generation DES in a 'real world' patient population.
Methods. A prospective, randomised, singleblinded clinical trial to
evaluate clinical outcome after Endeavor Resolute vs. Xience V stent
implantation. The primary endpoint is target vessel failure at one-year
follow-up. In addition, the study comprises a two-year and an open-label
five-year follow-up.

<28>
Accession Number
2005044540
Title
Meta-Analysis of Transcatheter Versus Surgical Aortic Valve Replacement in
Low Surgical Risk Patients.
Source
American Journal of Cardiology. 125 (8) (pp 1230-1238), 2020. Date of
Publication: 15 April 2020.
Author
Levett J.Y.; Windle S.B.; Filion K.B.; Brunetti V.C.; Eisenberg M.J.
Institution
(Levett, Windle, Filion, Brunetti, Eisenberg) Division of Clinical
Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill
University, Montreal, Quebec, Canada
(Levett, Filion, Eisenberg) Department of Medicine, McGill University,
Montreal, Quebec, Canada
(Filion, Brunetti, Eisenberg) Department of Epidemiology, Biostatistics
and Occupational Health, McGill University, Montreal, Quebec, Canada
(Eisenberg) Division of Cardiology, Jewish General Hospital/McGill
University, Montreal, Quebec, Canada
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Current guidelines recommend transcatheter aortic valve implantation
(TAVI) for patients with severe aortic stenosis at elevated surgical risk,
but not for patients at low surgical risk. Our objective is to compare
major clinical outcomes and procedural complications with TAVI versus
surgical aortic valve replacement in patients with severe aortic stenosis
at low surgical risk. We conducted a systematic review and meta-analysis
of randomized controlled trials, identified through a systematic search of
the MEDLINE, Embase, and Cochrane databases. Count data were pooled across
trials using random-effects models with inverse variance weighting to
obtain relative risks (RRs) and corresponding 95% confidence intervals
(CIs). Three randomized controlled trials (n = 2,629) were included. At 30
days, TAVI was associated with a substantial reduction in all-cause
mortality (RR: 0.45, 95%CI: 0.20 to 0.99), atrial fibrillation (RR: 0.27,
95%CI: 0.17 to 0.41), life threatening/disabling bleeding (RR: 0.29,
95%CI: 0.12 to 0.69), and acute kidney injury (RR: 0.28, 95%CI: 0.14 to
0.57). The reduction in atrial fibrillation persisted at 12 months (RR:
0.32, 95%CI: 0.21 to 0.49). However, TAVI patients had an increased risk
of permanent pacemaker implantation at both 30 days (RR: 3.13, 95%CI: 1.36
to 7.21) and 12 months (RR: 2.99, 95%CI: 1.19 to 7.51). Due to the low
absolute numbers of events, results were inconclusive at 30 days and 12
months for cardiovascular mortality, stroke, transient ischemic attack,
and myocardial infarction. In conclusion, while some outcomes remained
inconclusive, these data suggest that TAVI should be considered as a
first-line therapy for the treatment of severe aortic stenosis in low
surgical risk patients.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<29>
Accession Number
2003484329
Title
Impact of Perioperative Levosimendan Administration on Risk of Bleeding
After Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials.
Source
American Journal of Cardiovascular Drugs. 20 (2) (pp 149-160), 2020. Date
of Publication: 01 Apr 2020.
Author
Yan S.-B.; Wang X.-Y.; Shang G.-K.; Wang Z.-H.; Deng Q.-M.; Song J.-W.;
Sai W.-W.; Song M.; Zhong M.; Zhang W.
Institution
(Yan, Shang, Wang, Deng, Song, Sai, Song, Zhong, Zhang) The Key Laboratory
of Cardiovascular Remodeling and Function Research, Chinese Ministry of
Education, Chinese National Health Commission and Chinese Academy of
Medical Sciences, The State and Shandong Province Joint Key Laboratory of
Translational Cardiovascular Medicine, Department of Cardiology, Qilu
Hospital of Shandong University, No.107, Wen Hua Xi Road, Jinan 250012,
China
(Wang) Department of Pharmacy, Qilu Children's Hospital of Shandong
University, Children's Hospital of Jinan, Jinan, Shandong, China
(Wang) Department of Geriatric Medicine, Qilu Hospital of Shandong
University, Key Laboratory of Cardiovascular Proteomics of Shandong
Province, Jinan, Shandong, China
Publisher
Adis
Abstract
Background: Levosimendan, a calcium sensitizer and potassium channel
opener, has been demonstrated to improve myocardial function without
increasing oxygen consumption and to show protective effects in other
organs. Recently, a prospective, randomized controlled trial (RCT)
revealed an association between levosimendan use and a possible increased
risk of bleeding postoperatively. Levosimendan's anti-platelet effects
have been shown in in vitro studies. Current studies do not provide
sufficient data to support a relation between perioperative levosimendan
administration and increased bleeding risk. <br/>Purpose(s): Our goal was
to investigate the relation between perioperative levosimendan
administration and increased bleeding risk using a meta-analysis study
design. <br/>Method(s): The PubMed, Ovid, EMBASE and Cochrane Library
databases were searched for relevant RCTs before July 1, 2019. The outcome
parameters included reoperation secondary to increased bleeding in the
postoperative period, the amount of postoperative recorded blood loss, and
the need for transfusion of packed red blood cells (RBCs) and other blood
products. <br/>Result(s): A total of 1160 patients in nine RCTs (576 in
the levosimendan group and 584 in the control group) were included
according to our inclusion criteria. Analysis showed that perioperative
levosimendan administration neither increased the rate of reoperation
secondary to bleeding nor increased the amount of postoperative chest tube
drainage when compared with the control group. In terms of blood product
transfusion, levosimendan did not influence the requirement for RBC
transfusion, platelet transfusion nor fresh frozen plasma (FFP)
transfusion. Levosimendan also did not shorten or prolong the aortic
cross-clamp time or the cardiopulmonary bypass time. <br/>Conclusion(s):
The analyzed parameters, including reoperations due to bleeding,
postoperative chest drainage and the requirement for blood products,
revealed that levosimendan did not increase postoperative bleeding risk.
More studies with a larger sample size are needed to address a more
reliable conclusion due to study limitations.<br/>Copyright &#xa9; 2019,
Springer Nature Switzerland AG.

<30>
Accession Number
2005408275
Title
Multi-omic analysis of the effects of low frequency ventilation during
cardiopulmonary bypass surgery.
Source
International Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Durham A.L.; Al Jaaly E.; Graham R.; Brook P.O.; Bae J.H.; Heesom K.J.;
Postle A.D.; Lavender P.; Jazrawi E.; Reeves B.; Fiorentino F.; Mumby S.;
Angelini G.D.; Adcock I.M.
Institution
(Durham, Graham, Brook, Bae, Jazrawi, Mumby, Adcock) Airways Disease
Section, National Heart and Lung Institute, Imperial College London,
Dovehouse Street, London SW3 6LY, United Kingdom
(Al Jaaly, Reeves, Fiorentino, Angelini) Cardiothoracic Surgery, National
Heart and Lung Institute, Imperial College London, Hammersmith Hospital,
London, United Kingdom
(Heesom) University of Bristol, Proteomics Facility, BioMedical Sciences
Building, University Walk, Bristol, United Kingdom
(Postle) Faculty of Medicine, University of Southampton, Building 85, Life
Sciences Building, Highfield Campus, Southampton, United Kingdom
(Lavender) Department of Asthma, Allergy, and Respiratory Science, King's
College London, London, United Kingdom
(Angelini) Bristol Heart Institute, University of Bristol, Bristol Royal
Infirmary, Level 7, Marlborough Street, Bristol, United Kingdom
(Durham) Immunobiology, Blizard Institute, Barts and the London School of
Medicine and Dentistry, Queen Mary University of London, 4 Newark St,
London, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: Heart surgery with cardio-pulmonary bypass (CPB) is associated
with lung ischemia leading to injury and inflammation. It has been
suggested this is a result of the lungs being kept deflated throughout the
duration of CPB. Low frequency ventilation (LFV) during CPB has been
proposed to reduce lung dysfunction. <br/>Method(s): We used a semi-biased
multi-omic approach to analyse lung biopsies taken before and after CPB
from 37 patients undergoing coronary artery bypass surgery randomised to
both lungs left collapsed or using LFV for the duration of CPB. We also
examined inflammatory and oxidative stress markers from blood samples from
the same patients. <br/>Result(s): 30 genes were induced when the lungs
were left collapsed and 80 by LFV. Post-surgery 26 genes were
significantly higher in the LFV vs. lungs left collapsed, including genes
associated with inflammation (e.g. IL6 and IL8) and hypoxia/ischemia (e.g.
HIF1A, IER3 and FOS). Relatively few changes in protein levels were
detected, perhaps reflecting the early time point or the importance of
post-translational modifications. However, pathway analysis of proteomic
data indicated that LFV was associated with increased "cellular component
morphogenesis" and a decrease in "blood circulation". Lipidomic analysis
did not identify any lipids significantly altered by either intervention.
<br/>Discussion(s): Taken together these data indicate the keeping both
lungs collapsed during CPB significantly induces lung damage, oxidative
stress and inflammation. LFV during CPB increases these deleterious
effects, potentially through prolonged surgery time, further decreasing
blood flow to the lungs and enhancing hypoxia/ischemia.<br/>Copyright
&#xa9; 2020

<31>
Accession Number
2004367821
Title
Intraoperative Optimization of Both Depth of Anesthesia and Cerebral
Oxygenation in Elderly Patients Undergoing Coronary Artery Bypass Graft
Surgery-A Randomized Controlled Pilot Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (5) (pp 1172-1181),
2020. Date of Publication: May 2020.
Author
Kunst G.; Gauge N.; Salaunkey K.; Spazzapan M.; Amoako D.; Ferreira N.;
Green D.W.; Ballard C.
Institution
(Kunst, Salaunkey, Amoako, Ferreira, Green) Department of Anaesthetics and
Pain Medicine, King's College Hospital NHS Foundation Trust, London,
United Kingdom
(Kunst, Spazzapan) School of Cardiovascular Medicine and Sciences, King's
College London British Heart Foundation Centre of Excellence, Faculty of
Life Sciences and Medicine, London, United Kingdom
(Gauge, Ferreira, Ballard) Wolfson Centre for Age-Related Diseases,
Institute of Psychiatry, Psychology and Neuroscience, Kings College
London, London, United Kingdom
(Salaunkey) Royal Papworth Hospital, Cambridge, United Kingdom
(Ballard) University of Exeter Medical School, Exeter, United Kingdom
Publisher
W.B. Saunders
Abstract
Objectives: Does intraoperative optimization of both depth of anesthesia
and regional cerebral tissue oxygenation (rScO<inf>2</inf>) in elderly
patients reduce postoperative cognitive decline (primary outcome) or
delirium (secondary outcome)? Design: Prospective randomized controlled
single blind trial. <br/>Setting(s): A single major urban teaching and
university hospital and tertiary referral center. <br/>Participant(s):
Patients, 65 years of age and older, undergoing elective coronary artery
bypass graft surgery on cardiopulmonary bypass. <br/>Intervention(s):
Intraoperative depth of anesthesia bispectral index (BIS) values were
targeted at 50 +/- 10. Regional cerebral tissue desaturations of more than
15% of the pre-induction value, or below 50%, were avoided.
<br/>Measurements and Main Results: Eighty-two patients were included, and
mean depth of anesthesia values using BIS were significantly higher during
surgery in the intervention group with 40.6 (7.3) versus 35.4 (6.7) in the
control group, mean (standard deviation), p = 0.004. The cognitive
function was similar between the treatment and control groups at 6 weeks
postoperatively with a Mini Mental State Examination (MMSE) of 27 (26,29)
in the intervention group and an MMSE of 29 (27,29) in the control group,
median (interquartile range), with p = 0.12. The authors observed a
reduction in the incidence of delirium, occurring in 2.4% (n = 1) of
patients in the intervention group and in 20% (n = 8) in the control group
(p = 0.01). <br/>Conclusion(s): This pilot trial demonstrates that
noninvasive target-controlled depth of anesthesia monitoring is feasible.
Cognitive function at 6 weeks showed no difference between the treatment
and control groups; however, postoperative delirium was reduced in the
intervention group.<br/>Copyright &#xa9; 2019 The Authors

<32>
Accession Number
2002097221
Title
Interventions for Secondary Mitral Regurgitation in Patients With Heart
Failure: A Network Meta-Analysis of Randomized Controlled Comparisons of
Surgery, Medical Therapy and Transcatheter Intervention.
Source
Cardiovascular Revascularization Medicine. 21 (2) (pp 155-163), 2020. Date
of Publication: February 2020.
Author
Kheiri B.; Zayed Y.; Barbarawi M.; Osman M.; Chahine A.; Ahmed S.; Bachuwa
G.; Hassan M.; Alkhouli M.; Feldman T.; Bhatt D.L.
Institution
(Kheiri, Zayed, Barbarawi, Chahine, Ahmed, Bachuwa, Hassan) Department of
Internal Medicine, Hurley Medical Center/Michigan State University, Flint,
MI, United States
(Osman, Alkhouli) Division of Cardiology, West Virginia University School
of Medicine, Morgantown, WV, United States
(Feldman) Evanston Hospital, NorthShore University Health System,
Evanston, IL, United States
(Bhatt) Brigham and Women's Hospital Heart & Vascular Center, Harvard
Medical School, Boston, MA, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Mitral regurgitation (MR) in heart failure (HF) notoriously
carries a poor prognosis. While there are multiple interventional options
for treatment, the optimal intervention remains controversial. Therefore,
we aimed to evaluate the efficacy and safety of surgery, medical therapy,
and transcatheter intervention in secondary MR. <br/>Method(s): A
systematic database search was performed to identify all randomized
controlled trials (RCTs) that evaluate various interventions for secondary
MR. We performed a Bayesian network meta-analysis to calculate odd ratios
(ORs) and 95% credible intervals (CIs). The primary endpoint was all-cause
mortality. Secondary endpoints were moderate-severe MR,
HF-hospitalizations, and freedom from severe HF symptoms. <br/>Result(s):
We identified 12 RCTs (2316 total patients; age 67.6 +/- 11; 63% males,
and 74% with ischemic cardiomyopathy). There was a significant reduction
of mortality at 24-months with transcatheter leaflet repair compared with
medical therapy (OR = 0.57; 95% CI = 0.34-0.96). However, there were no
significant differences among the competing treatments in all-cause
mortality at the earlier time points of 30-days or 12-months (P > 0.05).
Recurrent moderate-severe MR was significantly less with valvular
interventions compared with medical therapy (P < 0.05), but there were no
differences in the rates of HF-hospitalizations or persistent severe HF
symptoms between the competing interventions (P > 0.05).
<br/>Conclusion(s): Among patients with HF and secondary MR, transcatheter
leaflet repair was associated with significantly reduced 24-month
mortality compared with medical therapy. Valvular interventions were
associated with lower rates of recurrent moderate-severe MR, but
non-significant improvements in clinical outcomes. Further long-term
studies are needed to identify the best route of intervention for
secondary MR.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<33>
Accession Number
631165456
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: 28 Mar 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
(Zi, Dong, Zhao, Li, Tan) Department of Cardiovascular Surgery, Shandong
Provincial Hospital Affiliated to Shandong University
(Fan) Department of Toxicological and Functional Test, Shandong Centers
for Disease Control and Prevention
Publisher
NLM (Medline)
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.

<34>
Accession Number
631368671
Title
Effect of peer support on patient anxiety during the coronary angiography
or percutaneous coronary intervention perioperative period: A protocol for
a systematic review and meta-analysis of randomised controlled trials.
Source
BMJ Open. 10 (3) (no pagination), 2020. Article Number: e031952. Date of
Publication: 25 Mar 2020.
Author
Qin S.; Gu Y.; Song T.
Institution
(Qin, Gu) College of Nursing, Hebei University of Chinese Medicine,
Shijiazhuang, Hebei, China
(Song) Faculty of Health and Medical Sciences, University of Adelaide,
Adelaide, SA, Australia
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Introduction The purpose of this study is to investigate the effect of
peer support on patient anxiety during the perioperative period of
coronary angiography or percutaneous coronary intervention (PCI). Methods
and analysis We will search the following databases (PubMed, Web of
Science, EMBASE, Cochrane Library, CINAHL, Clinicaltrials.gov, WHO
International Clinical Trials Registry Platform, Google Scholar, Chinese
National Knowledge Infrastructure, Chinese Science and Technology
Periodicals Database, Chinese BioMedical Database and Wanfang Data) from
the date of database inception to January 2019. Only randomised controlled
trials will be included. For the data analysis, we will use RevMan V.5.3.5
software to evaluate the risk of bias, and the heterogeneity will be
investigated using the Q statistic and P index. Additionally, the Grading
of Recommendations Assessment, Development and Evaluation system will be
used to assess the quality of evidence. Ethics and dissemination No ethics
approval will be required since this is a systematic review of published
studies. We aim to report information regarding the effects of peer
support on patient anxiety during the perioperative period of coronary
angiography or PCI. This systematic review and meta-analysis will be
submitted to a peer-reviewed journal for publication. PROSPERO
registration number CRD42019123290.<br/>Copyright &#xa9; 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.

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Accession Number
2004992972
Title
Meta-Analysis Comparing Percutaneous to Surgical Access in Trans-Femoral
Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 125 (8) (pp 1239-1248), 2020. Date of
Publication: 15 April 2020.
Author
Abdelaziz H.K.; Megaly M.; Debski M.; Rahbi H.; Kamal D.; Saad M.; Wiper
A.; More R.; Roberts D.H.
Institution
(Abdelaziz, Debski, Wiper, More, Roberts) Lancashire Cardiac Center,
Blackpool Victoria Hospital, Blackpool, United Kingdom
(Abdelaziz, Kamal, Saad) Department of Cardiovascular Medicine, Ain Shams
University, Cairo, Egypt
(Megaly) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Rahbi) Wiltshire Cardiac Center, Great Western Hospital, Swindon, United
Kingdom
(Saad) Cardiovascular Institute, The Warren Alpert Medical School of Brown
University and Lifespan Cardiovascular Institute, Providence, RI, United
States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
To compare the outcomes in trans-femoral transcatheter aortic valve
implantation (TF-TAVI) performed with percutaneous approach (PC) versus
surgical cut-down (SC). In 13 trials including 5,859 patients (PC = 3447,
SC = 2412), the outcomes based on Valve Academic Research Consortium
criteria were compared between PC and SC in TF-TAVI. Compared with SC, PC
was associated with similar major vascular complications (VCs) (8.7% vs
8.5%; odds ratio [OR] = 0.93, 95% confidence interval [CI] = 0.76 to 1.15,
p = 0.53), major bleeding (OR = 1.09, 95% CI = 0.66 to 1.8, p = 0.73),
perioperative mortality (5.7% vs 5.2%; OR = 1.13, 95% CI = 0.85 to 1.49, p
= 0.4), urgent surgical repair (OR = 1.27, 95% CI = 0.81 to 2.02, p =
0.3), stroke (3.3% vs 3.9%; OR = 0.85, 95% CI = 0.53 to 1.36, p = 0.5),
myocardial infarction (1.3% vs 1.1%; OR = 1.06, 95% CI = 0.53 to 2.12, p =
0.86), and renal failure (5.2% vs 5.9%; OR = 0.68, 95% CI = 0.38 to 1.22,
p = 0.2), but shorter hospital stay (9.1 +/- 8.5 vs 9.6 +/- 9.5 days; mean
difference = -1.07 day, 95% CI = -2.0 to -0.15, p = 0.02) and less blood
transfusion (18.5% vs 25.7%; OR = 0.61, 95% CI = 0.43-0.86, p = 0.005).
Minor VCs occurred more frequently in PC compared to SC (11.9% vs 6.9%; OR
= 1.67, 95% CI = 1.04-2.67, p = 0.03). In conclusion, in TF-TAVI, PC is a
safe and feasible alternative to SC, and adopting either approach depends
on operator experience after ensuring that vascular access could be safely
achieved with that specific technique.<br/>Copyright &#xa9; 2020 Elsevier
Inc.