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<1>
Accession Number
631375377
Title
Polymer-based or polymer-free stents in patients at high bleeding risk.
Source
New England Journal of Medicine. 382 (13) (pp 1208-1218), 2020. Date of
Publication: 26 Mar 2020.
Author
Windecker S.; Latib A.; Kedhi E.; Kirtane A.J.; Kandzari D.E.; Mehran R.;
Price M.J.; Abizaid A.; Simon D.I.; Worthley S.G.; Zaman A.; Hudec M.;
Poliacikova P.; Abdul Ghapar A.K.; Selvaraj K.; Petrov I.; Mylotte D.;
Pinar E.; Moreno R.; Fabbiocchi F.; Pasupati S.; Kim H.-S.; Aminian A.;
Tie C.; Wlodarczak A.; Hur S.-H.; Marx S.O.; Jankovic I.; Brar S.;
Bousquette L.; Liu M.; Stone G.W.
Institution
(Windecker) Inselspital, Bern University Hospital, University of Bern,
Department of Cardiology, Freiburgstr., Bern CH-3010, Switzerland
(Latib) Montefiore Medical Center, New York, United States
(Kirtane, Marx) Columbia University Irving Medical Center-New
York-Presbyterian Hospital, New York, United States
(Kirtane, Marx, Jankovic, Stone) Cardiovascular Research Foundation, New
York, United States
(Mehran) Mount Sinai Medical Center, New York, United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, United States
(Kedhi) Isala Zwolle, Zwolle, Netherlands
(Kedhi, Wlodarczak) Medical University of Silesia, Katowice, Poland
(Kandzari) Piedmont Heart Institute, Atlanta, United States
(Price) Division of Cardiovascular Diseases, Scripps Clinic, San Diego,
CA, United States
(Brar, Bousquette, Liu) Medtronic, Santa Rosa, CA, United States
(Abizaid) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Simon) University Hospitals Cleveland Medical Center, Cleveland, United
States
(Worthley) GenesisCare Cardiology, Alexandria, NSW, Australia
(Tie) St. Andrew's Hospital, Adelaide, SA, Australia
(Zaman) Freeman Hospital and Newcastle University, Newcastle upon Tyne,
United Kingdom
(Hudec, Poliacikova) Stredoslovensky Ustav Srdcovych A Cievnych Chorob,
Banska Bystrica, Slovakia
(Abdul Ghapar, Selvaraj) Hospital Serdang, Kajang, Malaysia
(Petrov) Acibadem City Clinic, Sofia, Bulgaria
(Mylotte) Galway University Hospitals-University Hospital Galway, Galway,
Ireland
(Pinar) Hospital Clinico Universitario Virgen de la Arrixaca, El Palmar,
Spain
(Moreno) Hospital Universitario la Paz, Hospital la Paz Institute for
Health Research, Madrid, Spain
(Fabbiocchi) Centro Cardiologico Monzino IRCCS, Milan, Italy
(Pasupati) Waikato Hospital, Hamilton, New Zealand
(Kim) Seoul National University Hospital, Seoul, South Korea
(Hur) Keimyung University Dongsan Medical Center, Daegu, South Korea
(Aminian) Centre Hospitalier Universitaire Charleroi, Charleroi, Belgium
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Polymer-free drug-coated stents provide superior clinical
outcomes to bare-metal stents in patients at high bleeding risk who
undergo percutaneous coronary intervention (PCI) and are treated with 1
month of dual antiplatelet therapy. Data on the use of polymer-based
drug-eluting stents, as compared with polymer-free drug-coated stents, in
such patients are limited. METHODS In an international, randomized,
single-blind trial, we compared polymer-based zotarolimus-eluting stents
with polymer-free umirolimus-coated stents in patients at high bleeding
risk. After PCI, patients were treated with 1 month of dual antiplatelet
therapy, followed by single antiplatelet therapy. The primary outcome was
a safety composite of death from cardiac causes, myocardial infarction, or
stent thrombosis at 1 year. The principal secondary outcome was
target-lesion failure, an effectiveness composite of death from cardiac
causes, target-vessel myocardial infarction, or clinically indicated
target-lesion revascularization. Both outcomes were powered for
noninferiority. RESULTS A total of 1996 patients at high bleeding risk
were randomly assigned in a 1:1 ratio to receive zotarolimus-eluting
stents (1003 patients) or polymer-free drugcoated stents (993 patients).
At 1 year, the primary outcome was observed in 169 of 988 patients (17.1%)
in the zotarolimus-eluting stent group and in 164 of 969 (16.9%) in the
polymer-free drug-coated stent group (risk difference, 0.2 percentage
points; upper boundary of the one-sided 97.5% confidence interval [CI],
3.5; noninferiority margin, 4.1; P = 0.01 for noninferiority). The
principal secondary outcome was observed in 174 patients (17.6%) in the
zotarolimus-eluting stent group and in 169 (17.4%) in the polymer-free
drug-coated stent group (risk difference, 0.2 percentage points; upper
boundary of the one-sided 97.5% CI, 3.5; noninferiority margin, 4.4; P =
0.007 for noninferiority). CONCLUSIONS Among patients at high bleeding
risk who received 1 month of dual antiplatelet therapy after PCI, use of
polymer-based zotarolimus-eluting stents was noninferior to use of
polymer-free drug-coated stents with regard to safety and effectiveness
composite outcomes.<br/>Copyright &#xa9; 2020 Massachusetts Medical
Society.

<2>
Accession Number
631063112
Title
Omega-3 fatty acids for the primary and secondary prevention of
cardiovascular disease.
Source
Cochrane Database of Systematic Reviews. 2020 (3) (no pagination), 2020.
Article Number: CD003177. Date of Publication: 29 Feb 2020.
Author
Abdelhamid A.S.; Brown T.J.; Brainard J.S.; Biswas P.; Thorpe G.C.; Moore
H.J.; Deane K.H.O.; Summerbell C.D.; Worthington H.V.; Song F.; Hooper L.
Institution
(Abdelhamid, Brown, Brainard, Song, Hooper) University of East Anglia,
Norwich Medical School, Norwich Research Park, Norwich, Norfolk NR4 7TJ,
United Kingdom
(Biswas) University of East Anglia, MED/HSC, Norwich Research Park,
Norwich NR4 7TJ, United Kingdom
(Thorpe, Deane) University of East Anglia, School of Health Sciences,
Earlham Road, Norwich NR4 7TJ, United Kingdom
(Moore) Teesside University, School of Social Sciences, Humanities and
Law, Middlesborough TS1 3BA, United Kingdom
(Summerbell) Durham University, Department of Sport and Exercise Sciences,
42 Old Elvet, Durham DH13HN, United Kingdom
(Worthington) Division of Dentistry, School of Medical Sciences, Faculty
of Biology, Medicine and Health, The University of Manchester, Cochrane
Oral Health, Coupland Building 3, Oxford Road, Manchester M13 9PL, United
Kingdom
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Background: Omega-3 polyunsaturated fatty acids from oily fish (long-chain
omega-3 (LCn3)), including eicosapentaenoic acid (EPA) and docosahexaenoic
acid (DHA)), as well as from plants (alpha-linolenic acid (ALA)) may
benefit cardiovascular health. Guidelines recommend increasing
omega-3-rich foods, and sometimes supplementation, but recent trials have
not confirmed this. <br/>Objective(s): To assess the effects of increased
intake of fish- and plant-based omega-3 fats for all-cause mortality,
cardiovascular events, adiposity and lipids. <br/>Search Method(s): We
searched CENTRAL, MEDLINE and Embase to February 2019, plus
ClinicalTrials.gov and World Health Organization International Clinical
Trials Registry to August 2019, with no language restrictions. We
handsearched systematic review references and bibliographies and contacted
trial authors. <br/>Selection Criteria: We included randomised controlled
trials (RCTs) that lasted at least 12 months and compared supplementation
or advice to increase LCn3 or ALA intake, or both, versus usual or lower
intake. <br/>Data Collection and Analysis: Two review authors
independently assessed trials for inclusion, extracted data and assessed
validity. We performed separate random-effects meta-analysis for ALA and
LCn3 interventions, and assessed dose-response relationships through
meta-regression. <br/>Main Result(s): We included 86 RCTs (162,796
participants) in this review update and found that 28 were at low summary
risk of bias. Trials were of 12 to 88 months' duration and included adults
at varying cardiovascular risk, mainly in high-income countries. Most
trials assessed LCn3 supplementation with capsules, but some used LCn3- or
ALA-rich or enriched foods or dietary advice compared to placebo or usual
diet. LCn3 doses ranged from 0.5 g a day to more than 5 g a day (19 RCTs
gave at least 3 g LCn3 daily). Meta-analysis and sensitivity analyses
suggested little or no effect of increasing LCn3 on all-cause mortality
(risk ratio (RR) 0.97, 95% confidence interval (CI) 0.93 to 1.01; 143,693
participants; 11,297 deaths in 45 RCTs; high-certainty evidence),
cardiovascular mortality (RR 0.92, 95% CI 0.86 to 0.99; 117,837
participants; 5658 deaths in 29 RCTs; moderate-certainty evidence),
cardiovascular events (RR 0.96, 95% CI 0.92 to 1.01; 140,482 participants;
17,619 people experienced events in 43 RCTs; high-certainty evidence),
stroke (RR 1.02, 95% CI 0.94 to 1.12; 138,888 participants; 2850 strokes
in 31 RCTs; moderate-certainty evidence) or arrhythmia (RR 0.99, 95% CI
0.92 to 1.06; 77,990 participants; 4586 people experienced arrhythmia in
30 RCTs; low-certainty evidence). Increasing LCn3 may slightly reduce
coronary heart disease mortality (number needed to treat for an additional
beneficial outcome (NNTB) 334, RR 0.90, 95% CI 0.81 to 1.00; 127,378
participants; 3598 coronary heart disease deaths in 24 RCTs, low-certainty
evidence) and coronary heart disease events (NNTB 167, RR 0.91, 95% CI
0.85 to 0.97; 134,116 participants; 8791 people experienced coronary heart
disease events in 32 RCTs, low-certainty evidence). Overall, effects did
not differ by trial duration or LCn3 dose in pre-planned subgrouping or
meta-regression. There is little evidence of effects of eating fish.
Increasing ALA intake probably makes little or no difference to all-cause
mortality (RR 1.01, 95% CI 0.84 to 1.20; 19,327 participants; 459 deaths
in 5 RCTs, moderate-certainty evidence),cardiovascular mortality (RR 0.96,
95% CI 0.74 to 1.25; 18,619 participants; 219 cardiovascular deaths in 4
RCTs; moderate-certainty evidence), coronary heart disease mortality (RR
0.95, 95% CI 0.72 to 1.26; 18,353 participants; 193 coronary heart disease
deaths in 3 RCTs; moderate-certainty evidence) and coronary heart disease
events (RR 1.00, 95% CI 0.82 to 1.22; 19,061 participants; 397 coronary
heart disease events in 4 RCTs; low-certainty evidence). However,
increased ALA may slightly reduce risk of cardiovascular disease events
(NNTB 500, RR 0.95, 95% CI 0.83 to 1.07; but RR 0.91, 95% CI 0.79 to 1.04
in RCTs at low summary risk of bias; 19,327 participants; 884
cardiovascular disease events in 5 RCTs; low-certainty evidence), and
probably slightly reduces risk of arrhythmia (NNTB 91, RR 0.73, 95% CI
0.55 to 0.97; 4912 participants; 173 events in 2 RCTs; moderate-certainty
evidence). Effects on stroke are unclear. Increasing LCn3 and ALA had
little or no effect on serious adverse events, adiposity, lipids and blood
pressure, except increasing LCn3 reduced triglycerides by ~15% in a
dose-dependent way (high-certainty evidence). Authors' conclusions: This
is the most extensive systematic assessment of effects of omega-3 fats on
cardiovascular health to date. Moderate- and low-certainty evidence
suggests that increasing LCn3 slightly reduces risk of coronary heart
disease mortality and events, and reduces serum triglycerides (evidence
mainly from supplement trials). Increasing ALA slightly reduces risk of
cardiovascular events and arrhythmia.<br/>Copyright &#xa9; 2020 The
Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<3>
Accession Number
2004055079
Title
Early outcome of tricuspid valve repair using prosthetic ring annuloplasty
versus suture annuloplasty.
Source
Indian Journal of Public Health Research and Development. 10 (12) (pp
1526-1532), 2019. Date of Publication: December 2019.
Author
El-Zayadi M.M.; Mahmoud M.A.-D.; Osama A.; Helal A.
Institution
(El-Zayadi, Mahmoud, Osama, Helal) Cardiothoracic Surgery Department,
Faculty of Medicine, Cairo University, Egypt
Publisher
Indian Journal of Public Health Research and Development (Aster-06/603,
Supertech Emerald Court, Sector - 93 A, Expressway, NOIDA, UTTAR PRADESH
201 304, India)
Abstract
The purpose of this study is to compare the early outcome of tricuspid
valve repair using prosthetic ring annuloplasty versus suture
annuloplasty. <br/>Method(s): In the period between March 2016 and
September 2017, 40 patients with severe functional tricuspid regurgitation
(TR) secondary to rheumatic mitral with or without aortic valve pathology
divided into two equal groups underwent open heart surgery at Kasr Al-Aini
Hospitals, Cardiothoracic surgery department. Group (1) had tricuspid
valve repair using suture annuloplasty, while Group (2) had tricuspid
valve repair using prosthetic ring annuloplasty. All patients were
evaluated thoroughly preoperative, intra-operative, and post-operative.
Particular attention was paid to clinical and echocardiographic findings
of presence of tricuspid regurgitation (TR), its nature and degree,
postoperative intensive care unit (ICU) events, ICU stay, hospital stay
and follow up of the degree of TR post-operatively. <br/>Result(s):
Evaluation showed that there is no significant difference between results
of suture annuloplasty and prosthetic ring annuloplasty early
postoperative, while late postoperative studies had proven significantly
better outcomes with prosthetic ring annuloplasty than with suture
annuloplasty techniques concerning low rate of recurrent TR.
<br/>Conclusion(s): we concluded that using prosthetic ring for tricuspid
valve repair was better than suture annuloplasty techniques as it was
associated with less frequent rates of late postoperative recurrent
TR.<br/>Copyright &#xa9; 2019, Indian Journal of Public Health Research
and Development. All rights reserved.

<4>
Accession Number
2001724429
Title
Prognostic impact of light-chain and transthyretin-related categories in
cardiac amyloidosis: A systematic review and meta-analysis.
Source
Hellenic Journal of Cardiology. 60 (6) (pp 375-383), 2019. Date of
Publication: November - December 2019.
Author
Xin Y.; Hu W.; Chen X.; Hu J.; Sun Y.; Zhao Y.
Institution
(Xin, Hu, Hu, Sun) Department of Cardiology, The First Affiliated Hospital
of China Medical University, Shenyang, China
(Xin) Department of Cardiology, West China Hospital, Sichuan University,
Chengdu, China
(Chen) Department of Cardiology, Fuling Central Hospital, Chongqing, China
(Zhao) Department of Neurology, The First Affiliated Hospital of China
Medical University, Shenyang, China
Publisher
Hellenic Cardiological Society
Abstract
Objective: Light-chain amyloidosis and transthyretin-related amyloidosis
(wild-type and mutated) are three main types of systemic amyloidosis
associated with a clinically relevant cardiac involvement. In this study,
we compared prognosis in patients with different categories of cardiac
amyloidosis using meta-analysis and present a systematic review.
<br/>Method(s): A systematic literature search was performed through Jan
1, 2018, and two reviewers independently extracted data and assessed risk
of bias. We extracted MACE and death endpoint events and hazard ratios
from regression models and performed a meta-analysis of the multiple
prognosis association studies. <br/>Result(s): We observed that there were
significant MACE differences between patients diagnosed with transthyretin
amyloidosis and light-chain amyloidosis (OR: 2.09; 95% CI: 1.06-4.12; P =
0.03), and the same is true in the sub-comparison between AL and mATTR or
wtATTR (AL vs. mATTR: OR: 1.72; 95% CI: 1.06-2.82; P = 0.03; AL vs.
wtATTR: OR: 1.48; 95% CI: 0.85-2.58; P = 0.17). However, no significant
difference was observed between two transthyretin types (P = 0.17).
Overall death rate evaluated showed that compared with
transthyretin-related amyloidosis, light-chain type showed a significant
difference (P < 0.05). The prognostic analysis showed that types of
amyloidosis, LVEF, NYHA, restrictive filling pattern, E-wave deceleration
time, E/E' ratio, and low QRS voltage were predictors of cardiac-related
mortality. <br/>Conclusion(s): Patients diagnosed with light-chain
amyloidosis has a poor prognosis compared with transthyretin-related
amyloidosis, while no difference was proved in prognostic analysis between
wild-type and mutated TTR amyloidosis. Some clinical factors related to
the death prognosis, such as the LVEF, restrictive filling pattern, E-wave
deceleration time, and E/E' ratio are important prognostic
factors.<br/>Copyright &#xa9; 2019 Hellenic Society of Cardiology

<5>
Accession Number
631091089
Title
Comparing sedation vs. general anaesthesia in transoesophageal
echocardiography-guided percutaneous transcatheter mitral valve repair: a
meta-analysis.
Source
European heart journal cardiovascular Imaging. 21 (5) (pp 511-521), 2020.
Date of Publication: 01 May 2020.
Author
Banga S.; Hafiz A.M.; Chami Y.; Gumm D.C.; Banga P.; Howard C.; Kim M.;
Sengupta P.P.
Institution
(Banga, Sengupta) Division of Cardiology, West Virginia University School
of Medicine, 1 Medical Center Drive, Morgantown, United States
(Hafiz, Chami) Division of Cardiology, Southern Illinois University School
of Medicine, Springfield, United States
(Gumm) Division of Cardiology, University of Illinois College of Medicine
at Peoria, OSF Saint Francis Medical Center, Peoria, United States
(Banga) University of Illinois College of Medicine at Peoria, OSF Saint
Francis Medical Center, Peoria, United States
(Howard) Library of the Health Sciences at Peoria, University of Illinois
at Chicago, Peoria, United States
(Kim) Center of Outcomes Research, Department of Internal Medicine,
University of Illinois College of Medicine at Peoria, Peoria, United
States
Publisher
NLM (Medline)
Abstract
AIMS: Transoesophageal echocardiography-guided percutaneous transcatheter
mitral valve repair (TOE-guided PMVR) using edge-to-edge leaflet plication
is typically performed under general anaesthesia (GA). Increasing evidence
supports the efficacy and safety of PMVR performed under conscious
sedation (CS) or deep sedation (DS). We performed a meta-analysis
comparing safety and efficacy of CS/DS vs. GA in PMVR. METHODS AND
RESULTS: A comprehensive search was performed using PubMed, CINAHL, Ovid
MEDLINE, Embase, and the Cochrane Library. Study characteristics,
participant demographics, and procedural outcomes with both types of
anaesthesia were analysed. Out of 73 articles, five met inclusion
criteria. Overall, there was no significant difference in the primary
outcome of procedural success rate [odds ratio (OR) 0.75; 95% confidence
interval (CI) 0.30-1.88, I2= 0.0%, P=0.538] or post-procedure in-hospital
mortality (OR 1.02; 95% CI 0.38-2.71, I2= 0.0%, P=0.970) in the patients
undergoing PMVR under CS/DS vs. GA. The secondary endpoint of intensive
care unit (ICU) length of stay (LOS) was significantly shorter in patients
under CS/DS vs. GA (standardized mean difference, SMD = -0.97; 95% CI
-1.75 to -0.20; P=0.014), but the hospital LOS (SMD = 0.36; 95% CI -0.77
to 0.04, P=0.078) did not show a statistically significant difference
between the groups, although it was shorter in the CS/DS group. No
difference was observed between CS/DS and GA in fluoroscopy time,
procedure time, or complications, including pneumonia, stroke/transient
ischaemic attack, and major bleeding. <br/>CONCLUSION(S): CS or DS has
lower ICU LOS, but comparable procedural success rate and in-hospital
mortality, making it a potential alternative to GA for TOE-guided
PMVR.<br/>Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. &#xa9; The Author(s) 2020. For
permissions, please email: journals.permissions@oup.com.

<6>
Accession Number
2004697682
Title
Impact of renin-angiotensin system inhibitors on outcomes after
transcatheter aortic valve replacement: A meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2020.
Date of Publication: 2020.
Author
Sun Y.; Li J.; Li G.; Fan R.; Luo J.
Institution
(Sun, Li, Li, Luo) Department of Cardiology, Vascular Center, Guangdong
Cardiovascular Institute, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, China
(Fan) Department of Cardiovascular surgery, Vascular Center, Guangdong
Cardiovascular Institute, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, China
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objectives: We aimed to evaluate the impact of renin-angiotensin system
(RAS) inhibitors on outcomes after transcatheter aortic valve replacement
(TAVR). <br/>Background(s): The impact of RAS inhibitors on outcomes after
TAVR was unclear. <br/>Method(s): A systematic review of articles
comparing outcomes of patients using and not using RAS inhibitors after
TAVR was performed through PubMed, Embase, and Cochrane. Primary outcome
was midterm all-cause mortality. Risk ratios (RRs) were calculated with
the corresponding 95% confidence interval using random effect models.
<br/>Result(s): Five studies with 23,319 patients were included. Patients
treated with RAS inhibitors had lower midterm all-cause mortality after
TAVR than those without RAS inhibitors in both the unmatched (13.3 vs.
17.2%, RR 0.77, p =.005) and propensity score matched cohorts (13.5 vs
16.2%, RR 0.83, p <.001). Cardiovascular mortality (10.4 vs. 15.6%, RR
0.68, p <.001), rate of heart failure readmission (12.2 vs. 14.5%, RR
0.80, p =.006), and new-onset atrial fibrillation (14.0 vs. 23.7%, RR
0.73, p =.003) were also lower with RAS inhibitors. No difference was
found between two groups regarding cerebrovascular events, myocardial
infarction, major bleeding, major vascular complications, acute kidney
injury, permanent pacemaker implantation, and moderate/severe paravalvular
aortic regurgitation. <br/>Conclusion(s): RAS inhibitors were associated
with lower midterm all-cause mortality after TAVR.<br/>Copyright &#xa9;
2020 Wiley Periodicals, Inc.

<7>
Accession Number
2004239755
Title
Association of postoperative fluid overload with adverse outcomes after
congenital heart surgery: a systematic review and dose-response
meta-analysis.
Source
Pediatric Nephrology. 35 (6) (pp 1109-1119), 2020. Date of Publication: 01
Jun 2020.
Author
Bellos I.; Iliopoulos D.C.; Perrea D.N.
Institution
(Bellos, Iliopoulos, Perrea) Laboratory of Experimental Surgery and
Surgical Research N.S. Christeas, Athens University Medical School,
National and Kapodistrian University of Athens, Athens, Greece
Publisher
Springer
Abstract
Background: Pediatric cardiac surgery is commonly associated with acute
kidney injury (AKI) and significant fluid retention, which complicate
postoperative management and lead to increased rates of morbidity. This
meta-analysis aimed to accumulate current literature evidence and evaluate
the correlation of fluid overload degree with adverse outcome in patients
undergoing congenital heart surgery. <br/>Method(s): Medline, Scopus,
CENTRAL, Clinicaltrials.gov, and Google Scholar were systematically
searched from inception. All studies reporting the effects of fluid
overload on postoperative clinical outcomes were selected. A dose-response
meta-analytic method using restricted cubic splines was implemented in
R-3.6.1. <br/>Result(s): Twelve studies were included, with a total of
3111 pediatric patients. Qualitative synthesis indicated that fluid
overload was linked to significantly higher risk of mortality, AKI,
prolonged hospital, and intensive care unit (ICU) stay, as well as with
increased duration of mechanical ventilation, inotrope need, and infection
rate. Meta-analysis demonstrated a linear correlation between fluid
overload and the risk of mortality (chi² = 6.22, p value =
0.01) and AKI (chi² = 35.84, p value < 0.001), while a positive
curvilinear relationship was estimated for the outcomes of hospital
(chi² = 18.84, p value = 0.0001) and ICU stay (chi²
= 63.69, p value = 0.0001). <br/>Conclusion(s): The present meta-analysis
supports that postoperative fluid overload is significantly linked to
elevated risk of prolonged hospital stay, AKI development, and mortality
in pediatric patients undergoing cardiac surgery. These findings warrant
replication by future prospective studies, which should define the optimal
cutoff values and assess the effectiveness of therapeutic strategies to
limit fluid overload in the postoperative setting.<br/>Copyright &#xa9;
2020, IPNA.

<8>
Accession Number
2003824856
Title
Effect of exercise on endothelial function in heart transplant recipients:
systematic review and meta-analysis.
Source
Heart Failure Reviews. 25 (3) (pp 487-494), 2020. Date of Publication: 01
May 2020.
Author
de Souza J.A.F.; Araujo B.T.S.; de Lima G.H.C.; Dornelas de Andrade A.;
Campos S.L.; de Aguiar M.I.R.; Carneiro R.M.D.; Brandao D.C.
Institution
(de Souza, Araujo, de Lima, Dornelas de Andrade, Campos, de Aguiar,
Brandao) Physiotherapy Department, Federal University of Pernambuco
(UFPE), Av. Jornalista Anibal Fernandes, s/n, Cidade Universitaria, Recife
CEP 50740-560, Brazil
(Carneiro) Institute of Integral Medicine Professor Fernando Figueira
(IMIP), Recife, Brazil
Publisher
Springer
Abstract
Endothelial dysfunction is associated with increased cardiovascular risk
and death in heart transplant recipients (HTx). Although the measurement
of peripheral endothelial function is considered a significant predictor
of cardiovascular events in several populations, few studies have
investigated this outcome after therapeutic strategies, including
different exercise types, duration, and intensity. This systematic review
and meta-analysis aimed to investigate the effects of continuous moderate
exercise (CON) or high-intensity interval training (HIIT) to improve
endothelial function (EF) in HTx. The search was conducted in Cochrane
Central Registry of Controlled Trials (CENTRAL), MEDLINE (via PubMed), Web
of Science and Scopus/Elsevier, CINAHL/Ebsco, Physiotherapy Evidence
Database (PEDro), LILACS/BIREME, and SciELO databases. Quality of the
evidence was assessed using the Grading of Recommendations Assessment
Development and Evaluation (GRADE). The search strategy retrieved 5192
titles. A total of four articles met the inclusion criteria and were
included for the qualitative analysis. Meta-analysis showed that exercises
improved EF ([mean difference-MD] 3.48 95% CI - 0.29 to 7.25, p = 0.007)
when compared with the control. However, there was a poor quality of
evidence to demonstrate that CON or HIIT is better than usual care to
improve EF. Exercise training provides benefits to patients, but the poor
quality of evidence does not allow us to state that exercise is related to
endothelial function improvement in HTx.<br/>Copyright &#xa9; 2019,
Springer Science+Business Media, LLC, part of Springer Nature.

<9>
Accession Number
631561826
Title
Analysis of survival after coronary endarterectomy combined with coronary
artery bypass grafting compared with isolated coronary artery bypass
grafting: A meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 29 (3) (pp 393-401),
2019. Date of Publication: 01 Sep 2019.
Author
Wang C.; Chen J.; Gu C.; Li J.
Institution
(Wang, Gu, Li) Department of Cardiac Surgery, Beijing Anzhen Hospital,
Capital Medical University, 2 Anzhen Road, Chaoyang District, Beijing
100029, China
(Chen) People's Hospital of Deyang City, Sichuan, China
Publisher
Oxford University Press
Abstract
OBJECTIVES: The aim of this analysis was to compare survival outcomes of
coronary endarterectomy (CE) combined with coronary artery bypass grafting
(CABG) with those of conventional CABG. <br/>METHOD(S): Eight
observational studies were included in this analysis, including 10 529
different patients in Asia, Europe and North America, from 1985 to 2012,
among whom 1925 underwent CE + CAGB and 8604 underwent conventional CAGB.
The follow-up period ranged from 4 to 14 years. This meta-analysis was
performed with the fixed-effects model. <br/>RESULT(S): After rigorous
assessment of the quality of the studies included, this analysis showed
that CE + CABG had a statistically significant weaker short-term outcome,
with a higher risk of mortality [odds ratio (OR)] 1.61; P = 0.002].
Further, this phenomenon was exacerbated in the midterm. One-year and
2-year results indicated that death was, respectively, 163% (OR 2.63; P <
0.001) and 133% (OR 2.60; P < 0.001) more likely to occur in the CE + CABG
group. However, the long-term results indicated no difference between the
2 groups. The 4-year hazard ratio (1.13; P = 0.10) did not show
significant differences between the groups, and the Kaplan-Meier survival
curves had the same level and pattern. <br/>CONCLUSION(S): CE + CABG had a
significantly weaker short-term outcome than conventional CABG, and this
trend continued in the midterm. The survival rate had the largest gap in
the midterm. However, there was no significant difference between these 2
groups in the long run.<br/>Copyright &#xa9; 2019 The Author(s) 2019.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<10>
[Use Link to view the full text]
Accession Number
631586451
Title
Prognostic Value of Late Gadolinium Enhancement for the Prediction of
Cardiovascular Outcomes in Dilated Cardiomyopathy: An International,
Multi-Institutional Study of the MINICOR Group.
Source
Circulation. Cardiovascular imaging. 13 (4) (pp e010105), 2020. Date of
Publication: 01 Apr 2020.
Author
Alba A.C.; Gaztanaga J.; Foroutan F.; Thavendiranathan P.; Merlo M.;
Alonso-Rodriguez D.; Vallejo-Garcia V.; Vidal-Perez R.; Corros-Vicente C.;
Barreiro-Perez M.; Pazos-Lopez P.; Perez-David E.; Dykstra S.; Flewitt J.;
Perez-Rivera J.A.; Vazquez-Caamano M.; Katz S.D.; Sinagra G.; Kober L.;
Poole J.; Ross H.; Farkouh M.E.; White J.A.
Institution
(Alba, Foroutan, Thavendiranathan, Ross, Farkouh) Peter Munk Cardiac
Centre, Department of Medicine, Toronto General Hospital, University
Health Network, ON
(Gaztanaga) Division of Cardiology, Department of Medicine, NYU Winthrop
Hospital, Mineola, United States
(Merlo, Sinagra) Cardiovascular Department, Azienda Sanitaria
Universitaria Giuliano Isontina (ASUGI), Universita Degli Studi di
Trieste, Trieste, Italy
(Alonso-Rodriguez) Department of Cardiology, Complejo Asistencial
Universitario de Leon
(Vallejo-Garcia, Barreiro-Perez) Department of Cardiology, Hospital
Clinico Universitario de Salamanca
(Vidal-Perez) Department of Cardiology, Hospital Universitario Lucus
Augusti, Lugo, Italy
(Corros-Vicente) Department of Cardiology, Hospital Universitario Central
de Asturias, Oviedo, Dominican Republic
(Pazos-Lopez) Department of Cardiology, Complejo Hospitalario
Universitario de Vigo
(Perez-David) Department of Cardiology, Hospital General Universitario
Gregorio Maranon, Madrid, Spain
(Dykstra, Flewitt, White) Departments of Cardiac Sciences and Diagnostic
Imaging, Libin Cardiovascular Institute of Alberta, Calgary, Canada
(Perez-Rivera) Hospital Universitario de Burgos
(Vazquez-Caamano) Hospital Povisa, Vigo, Italy
(Katz) NYU Langone Health, Leon H. Charney Division of Cardiology
(Kober) Rigshospitalet, Copenhagen University Hospital
(Poole) Division of Cardiology, Department of Medicine, University of
Washington, Seattle, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Dilated cardiomyopathy is associated with increased risk of
major cardiovascular events. Late gadolinium enhancement (LGE) cardiac
magnetic resonance imaging is a unique tissue-based marker that, in
single-center studies, suggests strong prognostic value. We
retrospectively studied associations between LGE presence and adverse
cardiovascular events in patients with dilated cardiomyopathy in a
multicenter setting as part of an emerging global consortium (MINICOR
[Multi-Modal International Cardiovascular Outcomes Registry]).
<br/>METHOD(S): Consecutive patients with dilated cardiomyopathy referred
for cardiac magnetic resonance (2000-2017) at 12 institutions in 4
countries were studied. Using multivariable Cox proportional hazard and
semiparametric Fine and Gray models, we evaluated the association between
LGE and the composite primary end point of all-cause mortality, heart
transplantation, or left ventricular assist device implant and a secondary
arrhythmic end point of sudden cardiac death or appropriate implantable
cardioverter-defibrillator shock. <br/>RESULT(S): We studied 1672
patients, mean age 56+/-14 years (29% female), left ventricular ejection
fraction 33+/-11%, and 25% having New York Heart Association class III to
IV; 650 patients (39%) had LGE. During 2.3 years (interquartile range,
1.0-4.3) follow-up, 160 patients experienced the primary end point, and 88
experienced the arrhythmic end point. In multivariable analyses, LGE was
associated with 1.5-fold (hazard ratio, 1.45 [95% CI, 1.03-2.04]) risk of
the primary end point and 1.8-fold (hazard ratio, 1.82 [95% CI,
1.20-3.06]) risk of the arrhythmic end point. Primary end point risk was
increased in patients with multiple LGE patterns, although arrhythmic risk
was higher among patients receiving primary prevention implantable
cardioverter-defibrillator and widening QRS. <br/>CONCLUSION(S): In this
large multinational study of patients with dilated cardiomyopathy, the
presence of LGE showed strong prognostic value for identification of
high-risk patients. Randomized controlled trials evaluating LGE-based care
management strategies are warranted.

<11>
Accession Number
631584595
Title
Estimated oxygen extraction versus dynamic parameters of
fluid-responsiveness for perioperative hemodynamic optimization of
patients undergoing non-cardiac surgery: a non-inferiority randomized
controlled trial.
Source
BMC anesthesiology. 20 (1) (pp 87), 2020. Date of Publication: 18 Apr
2020.
Author
Carsetti A.; Amici M.; Bernacconi T.; Brancaleoni P.; Cerutti E.;
Chiarello M.; Cingolani D.; Cola L.; Corsi D.; Forlini G.; Giampieri M.;
Iuorio S.; Principi T.; Tappata G.; Tempesta M.; Adrario E.; Donati A.
Institution
(Carsetti, Adrario, Donati) Department of Biomedical Sciences and Public
Health, Universita Politecnica delle Marche, Ancona, Italy
(Carsetti, Adrario, Donati) Anesthesia and Intensive Care Unit, Azienda
Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
(Amici) Pediatric Anesthesia and Intensive Care Unit, Azienda Ospedaliero
Universitaria Ospedali Riuniti, Ancona, Italy
(Bernacconi) Anesthesia and Intensive Care Unit, ASUR Marche, area vasta
n. 2, Jesi, Italy
(Brancaleoni) Anesthesia and Intensive Care Unit, ASUR Marche, area vasta
n. 1, Urbino, Italy
(Cerutti) Anesthesia and Post-operative Intensive Care Unit, Azienda
Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy
(Chiarello) Anesthesia and Intensive Care Unit, ASUR Marche, area vasta n.
3, Camerino, Italy
(Cingolani) Anesthesia and Intensive Care Unit, ASUR Marche, area vasta n.
2, Senigallia, Italy
(Cola) Anesthesia and Intensive Care Unit, ASUR Marche, area vasta n. 4,
Fermo, Italy
(Corsi) Anesthesia and Intensive Care Unit, ASUR Marche, area vasta n. 3,
Civitanova Marche, Italy
(Forlini) Anesthesia and Intensive Care Unit, ASUR Marche, area vasta n.
5, Ascoli Piceno, Italy
(Giampieri) Anesthesia and Intensive Care Unit, IRCCS-INRCA, Ancona, Italy
(Iuorio) Anesthesia and Intensive Care Unit, IRCCS-INRCA, Osimo, Italy
(Principi) Anesthesia and Intensive Care Unit, ASUR Marche, area vasta n.
5, San Benedetto del Tronto, Italy
(Tappata) Anesthesia and Intensive Care Unit, ASUR Marche, area vasta n.
3, Macerata, Italy
(Tempesta) Anesthesia and Intensive Care Unit, Azienda Ospedaliera Marche
Nord, Pesaro, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Goal directed therapy (GDT) is able to improve mortality and
reduce complications in selected high-risk patients undergoing major
surgery. The aim of this study is to compare two different strategies of
perioperative hemodynamic optimization: one based on optimization of
preload using dynamic parameters of fluid-responsiveness and the other one
based on estimated oxygen extraction rate (O2ER) as target of hemodynamic
manipulation. <br/>METHOD(S): This is a multicenter randomized controlled
trial. Adult patients undergoing elective major open abdominal surgery
will be allocated to receive a protocol based on dynamic parameters of
fluid-responsiveness or a protocol based on estimated O2ER. The
hemodynamic optimization will be continued for 6h postoperatively. The
primary outcome is difference in overall postoperative complications rate
between the two protocol groups. Fluids administered, fluid balance,
utilization of vasoactive drugs, hospital length of stay and mortality at
28day will also be assessed. DISCUSSION: As a predefined target of cardiac
output (CO) or oxygen delivery (DO2) seems to be not adequate for every
patient, a personalized therapy is likely more appropriate. Following this
concept, dynamic parameters of fluid-responsiveness allow to titrate fluid
administration aiming CO increase but avoiding fluid overload. This
approach has the advantage of personalized fluid therapy, but it does not
consider if CO is adequate or not. A protocol based on O2ER considers this
second important aspect. Although positive effects of perioperative GDT
have been clearly demonstrated, currently studies comparing different
strategies of hemodynamic optimization are lacking. TRIAL REGISTRATION:
ClinicalTrials.gov, NCT04053595. Registered on 12/08/2019.

<12>
Accession Number
2005685110
Title
Effects of sugammadex on postoperative respiratory management in children
with congenital heart disease: a randomized controlled study.
Source
Biomedicine and Pharmacotherapy. 127 (no pagination), 2020. Article
Number: 110180. Date of Publication: July 2020.
Author
Xiaobing L.; Yan J.; Wangping Z.; Rufang Z.; Jia L.; Rong W.
Institution
(Xiaobing, Rufang, Jia) Department of Cardiothoracic Surgery, Shanghai
Children's Hospital, Shanghai JiaoTong University, Shanghai 200062, China
(Yan, Rong) Department of Anesthesiology, Shanghai Children's Hospital,
Shanghai JiaoTong University, Shanghai 200062, China
(Wangping) Department of Anesthesiology, Women and Children's Hospital of
Jiaxing University, Jiaxing 314000, China
Publisher
Elsevier Masson SAS (62 rue Camille Desmoulins, Issy les Moulineaux Cedex
92442, France)
Abstract
Background: Early extubation can reduce pulmonary complications in
children undergoing cardiac surgery. The aim of this study is to evaluate
the effects of sugammadex for postoperative respiratory management in
children with congenital heart disease. <br/>Method(s): Sixty children
with congenital heart disease undergoing elective cardiac surgery were
divided into group S and group C (30 children in each group). When post
tetanic twitches count (PTC) = 1-2 and train-of-four (TOF) = 0, the
children in group S received sugammadex4 mg/kg for reversal of
neuromuscular block at the end of surgery, and the children in group C
received the same volume of normal saline. The recovery time to TOF of
0.9, the mechanical ventilation and extubation times were recorded. On the
other side, the hemodynamic parameters before and 5 min after
administration, and side effects were also recorded. The levels of
C-reactive protein (CRP) and procalcitonin (PCT) before and 24 h after
surgery were measured. <br/>Result(s): The recovery time to TOF of 0.9 and
extubation time were significantly shorter in the group S than in the
group C (4.2 +/- 1.4 vs 108.2 +/- 26.7 min, 66.3 +/- 6.5 vs 171.6 +/- 23.1
min, respectively, P < 0.01). The CRP and PCT levels were found to be
increased in both groups at postoperative 24 h than before surgery.
Further, the levels of PCT and CRP at postoperative 24 h were lower in
group S when compared to group C (median, 7 vs 17.5 mg/ml, 1.76 vs 5.22
ng/ml, respectively, P < 0.05). There were no statistical differences
observed between the two groups (P> 0.05) with respect to side effects.
<br/>Conclusion(s): Sugammadex is rapid and effective in reversing
rocuronium-induced neuromuscular block, and significantly reduces the
extubation time and the release of postoperative CRP and PCT in children
with congenital heart diseases.<br/>Copyright &#xa9; 2020 The Author(s)

<13>
Accession Number
631561879
Title
Is microwave ablation more effective than radiofrequency ablation in
achieving local control for primary pulmonary malignancy?.
Source
Interactive Cardiovascular and Thoracic Surgery. 29 (2) (pp 283-286),
2019. Date of Publication: 01 Aug 2019.
Author
Tsakok M.T.; Jones D.; MacNeill A.; Gleeson F.V.
Institution
(Tsakok, Gleeson) Department of Radiology, Oxford University Hospitals NHS
Foundation Trust, Oxford, United Kingdom
(Tsakok, Jones, MacNeill) Medical Sciences Division, University of Oxford,
Oxford, United Kingdom
Publisher
Oxford University Press
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was 'Is microwave ablation
(MWA) more effective than radiofrequency ablation (RFA) in achieving local
control for primary lung cancer?'. Altogether, 439 papers were found, of
which 7 represented the best evidence to answer the clinical question. The
authors, journal, date and country of publication, patient group studied,
study type, relevant outcomes and results of these papers are tabulated.
Both are thermal ablative techniques, with microwave ablation (MWA) the
newer technique and radiofrequency ablation (RFA) with a longer track
record. Lack of consensus with regard to definitions of technical success
and efficacy and heterogeneity of study inclusions limits studies for
both. The only direct comparison study does not demonstrate a difference
with either technique in achieving local control. The quality of evidence
for MWA is very limited by retrospective nature and heterogeneity in
technique, power settings and tumour type. Tumour size and late-stage
cancer were shown to be associated with higher rates of local recurrence
in 1 MWA study. RFA studies were generally of a higher level of evidence
comprising prospective trials, systematic review and meta-analysis. The
recurrence rates for MWA and RFA overlapped, and for the included studies
ranged between 16% and 44% for MWA and 9% and 58% for RFA. The current
evidence, therefore, does not clearly demonstrate a benefit of MWA over
RFA in achieving local control in primary lung cancer.<br/>Copyright
&#xa9; 2019 The Author(s) 2019. Published by Oxford University Press on
behalf of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<14>
Accession Number
631561817
Title
Reported outcomes after aortic valve resuspension for acute type A aortic
dissection: A systematic review and meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 29 (3) (pp 331-338),
2019. Date of Publication: 01 Sep 2019.
Author
Chen S.-K.; Qiu Z.-H.; Fang G.-H.; Wu X.-J.; Chen L.-W.
Institution
(Chen, Qiu, Fang, Wu, Chen) Department of Cardiac Surgery, Union Hospital,
Fujian Medical University, 29 Xinquan Rd, Fuzhou, Fujian 350001, China
Publisher
Oxford University Press
Abstract
In the majority of patients presenting with acute type A aortic dissection
(AAD) complicated by aortic valve insufficiency, the aortic valve (AV) can
be preserved by AV resuspension. A meta-analysis was performed to
investigate the outcomes following AV resuspension for AAD. A systematic
literature search for publications reporting outcomes after AV
resuspension in AAD published between January 1998 and June 2018 was
conducted. Early outcome events and linearized occurrence rates for late
outcome events were derived. The retrieval process yielded 18 unique
studies involving 3295 patients with a total of 17 532 patient-years
(pt-yrs). Pooled early mortality was 15.5% [95% confidence interval (95%
CI) 11.5-19.4%, I² = 91.9%], and the linearized late mortality
rate was 3.21%/pt-yrs (95% CI 2.49-3.77, I² = 29%). The
linearized occurrence rates for aortic root reintervention was 1.4%/pt-yrs
(95% CI 0.88-1.79, I² = 48%); for recurrent significant aortic
valve insufficiency (>2+), it was 1.12%/pt-yrs (95% CI 0.79-1.45,
I² = 68%); and for endocarditis, it was 0.01%/pt-yrs (95% CI
0-0.04, I² = 7%). The composite rate of thromboembolism and
bleeding was 1.41%/pt-yrs (95% CI 0.18-2.63, I² = 82%). A more
recent surgical period was associated with a decreased hazard of
reoperation on the aortic root (P < 0.001). Requirement of AV resuspension
alone in AAD is a risk factor for mortality. The long-term durability of
AV resuspension is excellent, with low rates of endocarditis and
thromboembolism and bleeding. Root reoperation hazard has become
acceptable in recent years. Preoperative aortic valve insufficiency grade
exceeding 2+ is a predictor for root reoperation.<br/>Copyright &#xa9;
2019 The Author(s) 2019. Published by Oxford University Press on behalf of
the European Association for Cardio-Thoracic Surgery. All rights reserved.

<15>
Accession Number
631561764
Title
Tricuspid valve intervention at the time of mitral valve surgery: A
meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 29 (2) (pp 193-200),
2019. Date of Publication: 01 Aug 2019.
Author
Tam D.Y.; Tran A.; Mazine A.; Tang G.H.L.; Gaudino M.F.L.; Calafiore A.M.;
Friedrich J.O.; Fremes S.E.
Institution
(Tam, Tran, Mazine, Fremes) Division of Cardiac Surgery, Department of
Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Tam) Dalla Lana School of Public Health, Institute of Health Policy,
Management and Evaluation, University of Toronto, Toronto, ON, Canada
(Tang) Department of Cardiovascular Surgery, Mount Sinai Medical Center,
New York, NY, United States
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Calafiore) Department of Cardiovascular Disease, John Paul II Foundation,
Campobasso, Italy
(Friedrich) Department of Critical Care and Medicine, St. Michael's
Hospital, University of Toronto, Toronto, ON, Canada
Publisher
Oxford University Press
Abstract
OBJECTIVES: The surgical management of tricuspid regurgitation (TR) at the
time of mitral valve surgery remains controversial. Our objectives were to
determine the safety and efficacy of tricuspid valve (TV) repair during
mitral valve surgery in a meta-analysis. <br/>METHOD(S): MEDLINE and
EMBASE were searched from 1946 to 2017 for all studies comparing TV repair
to no intervention at the time of mitral valve surgery on early and late
mortality and late TR. A random-effects meta-analysis of all outcomes was
performed. <br/>RESULT(S): One thousand four hundred and seventeen studies
were retrieved and a total of 17 studies [2 randomized clinical trial (n =
211), 11 adjusted observational studies (n = 3848) and 4 unadjusted
observational studies (n = 67 010)] that compared TV repair (n = 11 787)
to no intervention (n = 56 027) at a mean follow-up of 6.0 +/- 0.64 years
were included. There was no difference in 30-day/in-hospital mortality
between repair and no repair [risk ratio (RR) 1.19, 95% confidence
interval (95% CI) 0.70-2.02; P = 0.52]. The incidence of new permanent
pacemaker implantation was higher in the TV repair group (RR 2.73, 95% CI
2.57-2.89; P < 0.01). TV repair was protective against late moderate or
greater TR [incident rate ratio (IRR) 0.28, 95% CI 0.17-0.47; P < 0.01]
and severe TR (IRR 0.38, 95% CI 0.17-0.84). There was a numerically lower
rate of late TV reoperation (IRR 0.39, 95% CI 0.12-1.25; P = 0.11) that
did not reach statistical significance. Overall, there was no difference
in late mortality between the 2 treatments (IRR 0.87, 95% CI 0.63-1.24; P
= 0.43). <br/>CONCLUSION(S): TV repair appears safe in the perioperative
period and may reduce future recurrent TR without any survival
benefit.<br/>Copyright &#xa9; 2019 The Author(s) 2019. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<16>
Accession Number
631561613
Title
Feasibility of planning coronary artery bypass grafting based only on
coronary computed tomography angiography and CT-derived fractional flow
reserve: A pilot survey of the surgeons involved in the randomized SYNTAX
III Revolution trial.
Source
Interactive Cardiovascular and Thoracic Surgery. 29 (2) (pp 209-216),
2019. Date of Publication: 01 Aug 2019.
Author
Sonck J.; Miyazaki Y.; Collet C.; Onuma Y.; Asano T.; Takahashi K.; Kogame
N.; Katagiri Y.; Modolo R.; Serruys P.W.; Bartorelli A.L.; Andreini D.;
Doenst T.; Maureira J.P.; Plass A.; La Meir M.; Pompillio G.
Institution
(Sonck, Collet, La Meir) Department of Cardiology and Cardiovascular
Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
(Sonck) Department of Advanced Biomedical Sciences, University of Naples
Federico II, Naples, Italy
(Miyazaki, Onuma) Department of Interventional Cardiology, Thoraxcenter,
Erasmus University Medical Center, Rotterdam, Netherlands
(Collet, Asano, Takahashi, Kogame, Katagiri, Modolo) Department of
Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam,
Netherlands
(Onuma, Serruys) Cardialysis BV, Rotterdam, Netherlands
(Serruys) Department of Cardiology, Imperial College of London, London,
United Kingdom
(Bartorelli) Department of Biomedical and Clinical Sciences Luigi Sacco,
University of Milan, Milan, Italy
(Bartorelli, Andreini, Pompillio) Centro Cardiologico Monzino, IRCCS,
Milan, Italy
(Andreini, Pompillio) Department of Clinical Sciences and Community
Health, University of Milan, Milan, Italy
(Doenst) Department of Cardiothoracic Surgery, Jena University Hospital,
Friedrich Schiller University of Jena, Jena, Germany
(Maureira) Department of Cardiovascular Surgery, CHRU Nancy, Nancy, France
(Plass) Division of Cardiovascular Surgery, University Hospital Zurich,
Zurich, Switzerland
Publisher
Oxford University Press
Abstract
OBJECTIVES: Invasive coronary angiography has been the preferred
diagnostic method to guide the decision-making process between coronary
artery bypass grafting (CABG) and percutaneous coronary intervention and
plan a surgical revascularization procedure. Guidelines recommend a heart
team approach and assessment of coronary artery disease (CAD) complexity,
objectively quantified by the anatomical SYNTAX score. Coronary computed
tomography angiography (CCTA) and CT-derived fractional flow reserve
(FFR<inf>CT</inf>) are emerging technologies in the diagnosis of stable
CAD. In this study, data from patients with left main or 3-vessel CAD who
underwent CABG were evaluated to assess the feasibility of developing a
surgical plan based on CCTA integrated with FFR<inf>CT</inf>. The primary
objective was to assess the theoretical feasibility of surgical
decision-making and treatment planning based only on non-invasive imaging.
<br/>METHOD(S): This study represents a survey of surgeons involved in the
SYNTAX III Revolution trial. In this trial, heart teams were randomized to
make treatment decisions using CTA. CCTAs and FFR<inf>CT</inf> results of
20 patients were presented to 5 cardiac surgeons. <br/>RESULT(S): Surgical
treatment decision-making based on CCTA with FFR<inf>CT</inf> was
considered feasible by a panel of surgeons in 84% of the cases with an
excellent agreement on the number of anastomoses to be made in each
patient (intraclass correlation coefficient 0.77, 95% confidence interval
0.35-0.96). <br/>CONCLUSION(S): Using non-invasive imaging only in
patients with left main or 3-vessel CAD, an excellent agreement on
treatment planning and the number of anastomoses was found among cardiac
surgeons. Thus, CABG planning based on non-invasive imaging appears
feasible. Further investigation is warranted to determine the safety and
feasibility in clinical practice.<br/>Copyright &#xa9; 2019 The Author(s)
2019. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<17>
Accession Number
631561280
Title
Bilateral internal thoracic artery versus single internal thoracic artery:
A meta-analysis of propensity score-matched observational studies.
Source
Interactive Cardiovascular and Thoracic Surgery. 29 (2) (pp 163-172),
2019. Date of Publication: 01 Aug 2019.
Author
Urso S.; Nogales E.; Gonzalez J.M.; Sadaba R.; Tena M.A.; Bellot R.; Rios
L.; Portela F.
Institution
(Urso, Tena, Bellot, Rios, Portela) Cardiac Surgery Department, Hospital
Universitario Dr. Negrin, Barranco de la Ballena, s/n, Las Palmas de Gran
Canaria 35010, Spain
(Nogales) Cardiology Department, Hospital Universitario Insular, Las
Palmas de Gran Canaria, Spain
(Gonzalez) Research Unit, Hospital Universitario Dr. Negrin, Las Palmas de
Gran Canaria, Spain
(Sadaba) Cardiac Surgery Department, Complejo Hospitalario de Navarra,
Pamplona, Spain
Publisher
Oxford University Press
Abstract
The lack of benefit in terms of mid-term survival and the increase in the
risk of sternal wound complications published in a recent randomized
controlled trial have raised concerns about the use of bilateral internal
thoracic artery (BITA) in myocardial revascularization surgery. For this
reason, we decided to explore the current evidence available on the
subject by carrying out a meta-analysis of propensity score-matched
studies comparing BITA versus single internal thoracic artery (SITA).
PubMed, EMBASE and Google Scholar were searched for propensity
score-matched studies comparing BITA versus SITA. The generic inverse
variance method was used to compute the combined hazard ratio (HR) of
long-term mortality. The DerSimonian and Laird method was used to compute
the combined risk ratio of 30-day mortality, deep sternal wound infection
and reoperation for bleeding. Forty-five BITA versus SITA matched
populations were included. Meta-analysis showed a significant benefit in
terms of long-term survival in favour of the BITA group [HR 0.78; 95%
confidence interval (CI) 0.71-0.86]. These results were consistent with
those obtained by a pooled analysis of the matched populations comprising
patients with diabetes (HR 0.65; 95% CI 0.43-0.99). When compared with the
use of SITA plus radial artery, BITA did not show any significant benefit
in terms of long-term survival (HR 0.86; 95% CI 0.69-1.07). No differences
between BITA and SITA groups were detected in terms of 30-day mortality or
in terms of reoperation for bleeding. Compared with the SITA group,
patients in the BITA group had a significantly higher risk of deep sternal
wound infection (risk ratio 1.66; 95% CI 1.41-1.95) even when the pooled
analysis was limited to matched populations in which BITA was harvested
according to the skeletonization technique (risk ratio 1.37; 95% CI
1.04-1.79). The use of BITA provided a long-term survival benefit compared
with the use of SITA at the expense of a higher risk of sternal deep wound
infection. The long-term survival advantage of BITA is undetectable when
compared with SITA plus radial artery.<br/>Copyright &#xa9; 2019 The
Author(s) 2019. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<18>
Accession Number
631588959
Title
The learning curve in transcatheter aortic valve implantation clinical
studies: A systematic review.
Source
International Journal of Technology Assessment in Health Care. (no
pagination), 2020. Date of Publication: 2020.
Author
Thivilliers A.-P.; Ladarre R.; Merabti O.; Francois C.; Fontenay S.; Van
Den Brink H.; Pineau J.; Prognon P.; Borget I.; Martelli N.
Institution
(Thivilliers, Ladarre, Merabti, Francois, Fontenay, Pineau, Prognon,
Martelli) Pharmacy Department, Georges Pompidou European Hospital, 20 Rue
Leblanc, Paris 75015, France
(Borget) Department of Health Economics, Gustave Roussy Institute, 114,
Rue Edouard-Vaillant, Villejuif 94805, France
(Van Den Brink, Borget, Martelli) Faculty of Pharmacy, University
Paris-Sud, GRADES, 5 Rue Jean-Baptiste Clement, Chatenay-Malabry 92290,
France
Publisher
Cambridge University Press (E-mail: Journals_subscriptions@cup.cam.ac.uk)
Abstract
BackgroundTranscatheter aortic-valve implantation (TAVI) has become an
essential alternative to surgical aortic-valve replacement in the
treatment of symptomatic severe aortic stenosis, and this procedure
requires technical expertise. The aim of this study was to identify
prospective studies on TAVI from the past 10 years, and then to analyze
the quality of information reported about the learning curve.Materials and
methodsA systematic review of articles published between 2007 and 2017 was
performed using PubMed and the EMBASE database. Prospective studies
regarding TAVI were included. The quality of information reported about
the learning curve was evaluated using the following criteria: mention of
the learning curve, the description of a roll-in phase, the involvement of
a proctor, and the number of patients suggested to maintain
skills.ResultsA total of sixty-eight studies met the selection criteria
and were suitable for analysis. The learning curve was addressed in
approximately half of the articles (n = 37, 54 percent). However, the
roll-in period was mentioned by only eight studies (12 percent) and with
very few details. Furthermore, a proctorship was disclosed in three
articles (4 percent) whereas twenty-five studies (37 percent) included
authors that were proctors for manufacturers of TAVI.ConclusionMany
prospective studies on TAVI over the past 10 years mention learning curves
as a core component of successful TAVI procedures. However, the quality of
information reported about the learning curve is relatively poor, and
uniform guidance on how to properly assess the learning curve is still
missing.<br/>Copyright &#xa9; Cambridge University Press 2020.

<19>
[Use Link to view the full text]
Accession Number
631588088
Title
Prevention of early postoperative decline: A randomized, controlled
feasibility trial of perioperative cognitive training.
Source
Anesthesia and Analgesia. (pp 586-595), 2020. Date of Publication: 2020.
Author
O'Gara B.P.; Mueller A.; Gasangwa D.V.I.; Patxot M.; Shaefi S.; Khabbaz
K.; Banner-Goodspeed V.; Pascal-Leone A.; Marcantonio E.R.; Subramaniam B.
Institution
(O'Gara, Mueller, Gasangwa, Patxot, Shaefi, Banner-Goodspeed, Subramaniam)
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel
Deaconess Medical Center, 1 Deaconess Rd, Rosenberg 470, Boston, MA 02215,
United States
(Khabbaz) Department of Surgery, Division of Cardiac Surgery, Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, MA, United
States
(Pascal-Leone) Department of Neurology, Division of Cognitive Neurology,
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(Pascal-Leone) Neurorehabilitation, Institut Guttman, Universitat Autonoma
Barcelona, Bellaterra, Spain
(Marcantonio) Department of Medicine, Division of General Medicine and
Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical
School, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
BACKGROUND: Postoperative delirium and postoperative cognitive dysfunction
(POCD) are common after cardiac surgery and contribute to an increased
risk of postoperative complications, longer length of stay, and increased
hospital mortality. Cognitive training (CT) may be able to durably improve
cognitive reserve in areas deficient in delirium and POCD and, therefore,
may potentially reduce the risk of these conditions. We sought to
determine the feasibility and potential efficacy of a perioperative CT
program to reduce the incidence of postoperative delirium and POCD in
older cardiac surgery patients. <br/>METHOD(S): Randomized controlled
trial at a single tertiary care center. Participants included 45 older
adults age 60-90 undergoing cardiac surgery at least 10 days from
enrollment. Participants were randomly assigned in a 1:1 fashion to either
perioperative CT via a mobile device or a usual care control. The primary
outcome of feasibility was evaluated by enrollment patterns and adherence
to protocol. Secondary outcomes of postoperative delirium and POCD were
assessed using the Confusion Assessment Method and the Montreal Cognitive
Assessment, respectively. Patient satisfaction was assessed via a
postoperative survey. <br/>RESULT(S): Sixty-five percent of eligible
patients were enrolled. Median (interquartile range [IQR]) adherence (as a
percentage of prescribed minutes played) was 39% (20%-68%), 6% (0%-37%),
and 19% (0%-56%) for the preoperative, immediate postoperative, and
postdischarge periods, respectively. Median (IQR) training times were 245
(136-536), 18 (0-40), and 122 (0-281) minutes for each period,
respectively. The incidence of postoperative delirium (CT group 5/20 [25%]
versus control 3/20 [15%]; P = .69) and POCD (CT group 53% versus control
37%; P = .33) was not significantly different between groups for either
outcome in this limited sample. CT participants reported a high level of
agreement (on a scale of 0-100) with statements that the program was easy
to use (median [IQR], 87 [75-97]) and enjoyable (85 [79-91]). CT
participants agreed significantly more than controls that their memory
(median [IQR], 75 [54-82] vs 51 [49-54]; P = .01) and thinking ability
(median [IQR], 78 [64-83] vs 50 [41-68]; P = .01) improved as a result of
their participation in the study. <br/>CONCLUSION(S): A CT program
designed for use in the preoperative period is an attractive target for
future investigations of cognitive prehabilitation in older cardiac
surgery patients. Changes in the functionality of the program and
enrichment techniques may improve adherence in future trials. Further
investigation is necessary to determine the potential efficacy of
cognitive prehabilitation to reduce the risk of postoperative delirium and
POCD.<br/>Copyright &#xa9; 2019 International Anesthesia Research Society

<20>
[Use Link to view the full text]
Accession Number
631587890
Title
Fibrinogen concentrate as an alternative to cryoprecipitate in a
postcardiopulmonary transfusion algorithm in infants undergoing cardiac
surgery: A prospective randomized controlled trial.
Source
Anesthesia and Analgesia. (pp 740-751), 2020. Date of Publication: 2020.
Author
Downey L.A.; Andrews J.; Hedlin H.; Kamra K.; McKenzie E.D.; Hanley F.L.;
Williams G.D.; Guzzetta N.A.
Institution
(Downey, Guzzetta) Department of Anesthesiology, Perioperative and Pain
Medicine, Emory University, Children's Healthcare of Atlanta, 1405 Clifton
Rd NE, Atlanta, GA 30322, United States
(Andrews) Department of Pathology, Microbiology, and Immunology,
Vanderbilt University Medical Center, Nashville, TN, United States
(Andrews) Department of Pediatrics, Vanderbilt University Medical Center,
Nashville, TN, United States
(Hedlin) Department of Quantitative Sciences Unit, Stanford University
School of Medicine, Palo Alto, CA, United States
(Kamra, Williams) Department of Anesthesiology, Stanford University School
of Medicine, Lucile Packard Children's Hospital, Palo Alto, CA, United
States
(McKenzie) Division of Congenital Heart Surgery, Department of Surgery,
Baylor College of Medicine, Texas Children's Hospital, Houston, TX, United
States
(Hanley) Department of Cardiovascular Surgery, Stanford University School
of Medicine, Lucile Packard Children's Hospital, Palo Alto, CA, United
States
(Hanley) Department of Pediatric Cardiac Surgery, Stanford University
School of Medicine, Lucile Packard Children's Hospital, Palo Alto, CA,
United States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
BACKGROUND: Infants undergoing cardiac surgery are at risk for bleeding
and massive transfusion due to an immature coagulation system, complex
surgeries, and cardiopulmonary bypass (CPB) effects. Hemodilution from CPB
promotes an acquired hypofibrinogenemia that results in impaired fibrin
formation, inadequate clot formation, and increased bleeding. In North
America, the current standard of care to supplement fibrinogen is
cryoprecipitate. An alternative option is the off-label use of fibrinogen
concentrate (FC; RiaSTAP; CSL Behring, Marburg, Germany), a purified
fibrinogen. Because perioperative allogenic transfusions are associated
with increased morbidity and mortality, we sought to determine whether FC
would be an acceptable alternative to cryoprecipitate in a post-CPB
transfusion algorithm in infants undergoing open-heart surgery.
<br/>METHOD(S): We randomized 60 infants (<12 months) undergoing
nonemergent cardiac surgery with CPB at 2 tertiary care children's
hospitals to receive either cryoprecipitate or FC in a post-CPB
transfusion algorithm. Infants underwent a stratified randomization based
on institution and surgical complexity. The primary outcome was the
difference in number of intraoperative allogenic blood product
transfusions. Secondary outcomes included 24-hour chest tube output (CTO),
mechanical ventilation time, adverse events (AEs), intensive care unit
(ICU) length of stay (LOS), hospital LOS, postoperative thrombosis, and
death within 30 days of surgery. The primary analysis followed the
intent-to-treat (ITT) principle and was performed using linear regression
adjusted for institution and complexity of surgery. A per-protocol (PP)
analysis was also performed. <br/>RESULT(S): Between June 2016 and January
2018, we enrolled 60 patients with complete data available for 25 patients
who received cryoprecipitate and 29 patients who received FC. Patients in
the cryoprecipitate group (median age: 4 months [2-6 months]) received 5.5
(4.0-7.0) allogeneic blood units in the ITT analysis and 6.0 units
(5.0-7.0 units) in the PP analysis. Patients in the FC group (median age:
4 months [2-5]) received 4 units (3.0-5.0 units) in the ITT analysis and
4.0 units (3.0-5.0 units) in the PP analysis. In the adjusted ITT
analysis, the FC group received 1.79 units (95% confidence interval [CI],
0.64-2.93; P = .003) less than the cryoprecipitate group. In the adjusted
PP analysis, the FC group received 2.67 units (95% CI, 1.75-3.59; P <
.001) less than the cryoprecipitate group. There were no significant
differences in secondary outcomes or AEs. <br/>CONCLUSION(S): Our findings
suggest that FC may be considered as an alternative to cryoprecipitate for
the treatment of hypofibrinogenemia in infants with bleeding after CPB.
Although we found no significant differences between secondary outcomes or
AEs, further studies are needed to assess safety.<br/>Copyright &#xa9;
2019 International Anesthesia Research Society

<21>
Accession Number
631587875
Title
Cerebrovascular events after transcatheter mitral valve interventions: A
systematic review and meta-analysis.
Source
Heart. (no pagination), 2020. Article Number: 2019-316331. Date of
Publication: 2020.
Author
Chateauneuf G.; Nazif T.M.; Beaupre F.; Kodali S.; Rodes-Cabau J.; Paradis
J.-M.
Institution
(Chateauneuf, Beaupre, Rodes-Cabau, Paradis) Cardiology, Quebec Heart and
Lung Institute, Quebec, QC, Canada
(Nazif, Kodali) Cardiology Columbia University Medical Center,
NewYork-Presbyterian Hospital and the Cardiovascular Research Foundation,
New York, NY, United States
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Objective: Current guidelines support the use of transcatheter mitral
valve interventions to treat some selected high-risk patients with
significant mitral valvulopathy. As with any other interventional cardiac
procedure, concerns have been raised about cerebrovascular event. The aim
of this systematic review and meta-analysis was to determine the incidence
of cerebrovascular events following (1) transcatheter mitral valve
edge-to-edge repair with mitral valve clip and (2) transcatheter mitral
valve replacement (TMVR). <br/>Method(s): We conducted a systematic review
of studies reporting the cerebrovascular adverse events after
transcatheter mitral valve edge-to-edge repair and TMVR procedures. The
primary endpoint was the incidence of cerebrovascular events as defined by
the Mitral Valve Academic Research Consortium. An event that occurred
within 30 days or during index hospitalisation was defined as
periprocedural; otherwise it was defined as non-periprocedural. This study
was designed in accordance with the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines. Aggregated study-level
data were pooled using a random effect model. The quality of each study
was appraised with the Hawker checklist, a method of systematically
reviewing research from different paradigms. <br/>Result(s): Sixty studies
totalling 28 155 patients undergoing edge-to-edge repair with mitral valve
clip were included in the analysis. Periprocedural stroke and
non-periprocedural stroke rates were 0.9% (95% CI 0.6 to 1.1) and 2.4%
(95% CI 1.6 to 3.2), respectively. For TMVR procedures, 26 studies
including 1910 patients were analysed. The estimated periprocedural stroke
incidence was 1% (95% CI 0.5 to 1.8) compared with 7% (95% CI 0.8 to 18.5)
for non-periprocedural stroke. <br/>Conclusion(s): Transcatheter mitral
valve interventions are associated with low rates of cerebrovascular
events. The exact mechanisms of these complications are still poorly
understood given the relative paucity of good quality data. Trial
registration number: CRD42019117257.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2020. No commercial re-use. See rights and permissions.
Published by BMJ.

<22>
[Use Link to view the full text]
Accession Number
631587225
Title
A Multinational Observational Study Exploring Adherence with the Kidney
Disease: Improving Global Outcomes Recommendations for Prevention of Acute
Kidney Injury after Cardiac Surgery.
Source
Anesthesia and Analgesia. (pp 910-916), 2020. Date of Publication: 2020.
Author
Kullmar M.; Weiss R.; Ostermann M.; Campos S.; Grau Novellas N.; Thomson
G.; Haffner M.; Arndt C.; Wulf H.; Irqsusi M.; Monaco F.; Di Prima A.L.;
Garcia-Alvarez M.; Italiano S.; Felipe Correoso M.; Kunst G.; Nair S.;
L'acqua C.; Hoste E.; Vandenberghe W.; Honore P.M.; Kellum J.A.; Forni L.;
Grieshaber P.; Wempe C.; Meersch M.; Zarbock A.
Institution
(Kullmar, Weis, Wempe, Meersch, Zarbock) Department of Anaesthesiology,
Intensive Care Medicine and Pain Medicine, University Hospital Munster,
Albert-Schweitzer-Campus 1, Gebaude A1, Munster 48149, Germany
(Ostermann, Campos, Grau Novellas, Thomson, Haffner) Department of
Critical Care, Guy's and St Thomas' NHS Foundation Hospital, London,
United Kingdom
(Arndt, Wulf) Department of Anaesthesiology and Intensive Care Medicine,
University Hospital Marburg, Marburg, Germany
(Irqsusi) Department of Cardiac Surgery, University Hospital Marburg,
Marburg, Germany
(Monaco, Di Prima) Department of Anesthesia and Intensive Care, IRCCS San
Raffaele Scientific Institute, Milan, Italy
(Garcia-Alvarez, Italiano, Felipe Correoso) Department of Anesthesiology,
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(Kunst, Nair) Department of Anaesthetics, King's College Hospital, Denmark
Hill, London, United Kingdom
(L'acqua) Centro Cardiologico Monzino IRCCS, Milan, Italy
(Hoste, Vandenberghe) Department of Intensive Care Medicine, University
Hospital Gent, Gent, Belgium
(Honore) Department of Intensive Care, CHU Brugmann University Hospital,
Brussel, Belgium
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, PA, United States
(Forni) Department of Intensive Care Medicine, Royal Surrey County
Hospital, Guildford, United Kingdom
(Grieshaber) Department of Cardiac Surgery, University Hospital Giessen,
Giessen, Germany
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
BACKGROUND: The Kidney Disease: Improving Global Outcomes (KDIGO)
guidelines recommend a bundle of different measures for patients at
increased risk of acute kidney injury (AKI). Prospective, single-center,
randomized controlled trials (RCTs) have shown that management in
accordance with the KDIGO recommendations was associated with a
significant reduction in the incidence of postoperative AKI in high-risk
patients. However, compliance with the KDIGO bundle in routine clinical
practice is unknown. <br/>METHOD(S): This observational prevalence study
was performed in conjunction with a prospective RCT investigating the role
of the KDIGO bundle in high-risk patients undergoing cardiac surgery. A
2-day observational prevalence study was performed in all participating
centers before the RCT to explore routine clinical practice. The
participating hospitals provided the following data: Demographics and
surgical characteristics, AKI rates, and compliance rates with the
individual components of the bundle. <br/>RESULT(S): Ninety-five patients
were enrolled in 12 participating hospitals. The incidence of AKI within
72 hours after cardiac surgery was 24.2%. In 5.3% of all patients,
clinical management was fully compliant with all 6 components of the
bundle. Nephrotoxic drugs were discontinued in 52.6% of patients, volume
optimization was performed in 70.5%, 52.6% of the patients underwent
functional hemodynamic monitoring, close monitoring of serum creatinine
and urine output was undertaken in 24.2% of patients, hyperglycemia was
avoided in 41.1% of patients, and no patient received radiocontrast
agents. The patients received on average 3.4 (standard deviation [SD]
+/-1.1) of 6 supportive measures as recommended by the KDIGO guidelines.
There was no significant difference in the number of applied measures
between AKI and non-AKI patients (3.2 [SD +/-1.1] vs 3.5 [SD +/-1.1]; P
=.347). <br/>CONCLUSION(S): In patients after cardiac surgery, compliance
with the KDIGO recommendations was low in routine clinical
practice.<br/>Copyright &#xa9; 2019 International Anesthesia Research
Society.

<23>
[Use Link to view the full text]
Accession Number
631584423
Title
Postoperative pain and analgesic requirements in the first year after
intraoperative methadone for complex spine and cardiac surgery.
Source
Anesthesiology. (pp 330-342), 2020. Date of Publication: 2020.
Author
Murphy G.S.; Avram M.J.; Greenberg S.B.; Shear T.D.; Deshur M.A.;
Dickerson D.; Bilimoria S.; Benson J.; Maher C.E.; Trenk G.J.; Teister
K.J.; Szokol J.W.
Institution
(Murphy, Greenberg, Shear, Deshur, Dickerson, Bilimoria, Benson, Maher,
Trenk, Teister, Szokol) Department of Anesthesiology, NorthShore
University HealthSystem, University of Chicago Pritzker, School of
Medicine, Evanston, IL, United States
(Avram) Department of Anesthesiology, Northwestern University Feinberg,
School of Medicine, Chicago, IL, United States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: Methadone is a long-acting opioid that has been reported to
reduce postoperative pain scores and analgesic requirements and may
attenuate development of chronic postsurgical pain. The aim of this
secondary analysis of two previous trials was to follow up with patients
who had received a single intraoperative dose of either methadone or
traditional opioids for complex spine or cardiac surgical procedures.
<br/>Method(s): Preplanned analyses of long-term outcomes were conducted
for spinal surgery patients randomized to receive 0.2 mg/kg methadone at
the start of surgery or 2 mg hydromorphone at surgical closure, and for
cardiac surgery patients randomized to receive 0.3 mg/kg methadone or 12
mug/kg fentanyl intraoperatively. A pain questionnaire assessing the
weekly frequency (the primary outcome) and intensity of pain was mailed to
subjects 1, 3, 6, and 12 months after surgery. Ordinal data were compared
with the Mann-Whitney U test, and nominal data were compared using the
chi-square test or Fisher exact probability test. The criterion for
rejection of the null hypothesis was P < 0.01. <br/>Result(s): Three
months after surgery, patients randomized to receive methadone for spine
procedures reported the weekly frequency of chronic pain was less (median
score 0 on a 0 to 4 scale [less than once a week] vs. 3 [daily] in the
hydromorphone group, P = 0.004). Patients randomized to receive methadone
for cardiac surgery reported the frequency of postsurgical pain was less
at 1 month (median score 0) than it was in patients randomized to receive
fentanyl (median score 2 [twice per week], P = 0.004). <br/>Conclusion(s):
Analgesic benefits of a single dose of intraoperative methadone were
observed during the first 3 months after spinal surgery (but not at 6 and
12 months), and during the first month after cardiac surgery, when the
intensity and frequency of pain were the greatest.<br/>Copyright &#xa9;
2020, the American Society of Anesthesiologists, Inc. All Rights Reserved.

<24>
Accession Number
631578938
Title
Prognostic significance of left ventricular noncompaction: Systematic
review and meta-analysis of observational studies.
Source
Circulation: Cardiovascular Imaging. (no pagination), 2020. Article
Number: e009712. Date of Publication: 2020.
Author
Aung N.; Doimo S.; Ricci F.; Sanghvi M.M.; Pedrosa C.; Woodbridge S.P.;
Al-Balah A.; Zemrak F.; Khanji M.Y.; Munroe P.B.; Naci H.; Petersen S.E.
Institution
(Aung, Sanghvi, Pedrosa, Woodbridge, Zemrak, Khanji, Munroe, Petersen)
William Harvey Research Institute, NIHR Cardiovascular Biomedical Research
Centre at Barts, Queen Mary University of London, Charterhouse Sq, London
EC1M 6BQ, United Kingdom
(Aung, Sanghvi, Zemrak, Khanji, Munroe, Petersen) Barts Heart Centre, St
Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London,
United Kingdom
(Doimo) Cardiovascular Department, Azienda Sanitaria Universitaria
Integrata, University of Trieste, Italy
(Ricci) Department of Neuroscience, Imaging and Clinical Sciences,
Institute of Advanced Biomedical Technologies, "G. d'Annunzio" University,
Chieti, Italy
(Al-Balah) Imperial College London, Kensington, United Kingdom
(Munroe) Clinical Pharmacology, William Harvey Research Institute, Barts
and The London School of Medicine and Dentistry, Queen Mary University of
London, United Kingdom
(Naci) Department of Health Policy, London School of Economics and
Political Science, United Kingdom
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
BACKGROUND: Although left ventricular noncompaction (LVNC) has been
associated with an increased risk of adverse cardiovascular events, the
accurate incidence of cardiovascular morbidity and mortality is unknown.
We, therefore, aimed to assess the incidence rate of LVNC-related
cardiovascular events. <br/>METHOD(S): We systematically searched
observational studies reporting the adverse outcomes related to LVNC. The
primary end point was cardiovascular mortality. <br/>RESULT(S): We
identified 28 eligible studies enrolling 2501 LVNC patients (mean age, 46
years; male/female ratio, 1.7). After a median follow-up of 2.9 years, the
pooled event rate for cardiovascular mortality was 1.92 (95% CI,
1.54-2.30) per 100 person-years. LVNC patients had a similar risk of
cardiovascular mortality compared with a dilated cardiomyopathy control
group (odds ratio, 1.10 [95% CI, 0.18-6.67]). The incidence rates of
all-cause mortality, stroke and systemic emboli, heart failure admission,
cardiac transplantation, ventricular arrhythmias, and cardiac device
implantation were 2.16, 1.54, 3.53, 1.24, 2.17, and 2.66, respectively,
per 100 person-years. Meta-regression and subgroup analyses revealed that
left ventricular ejection fraction, not the extent of left ventricular
trabeculation, had an important influence on the variability of incidence
rates. The risks of thromboembolism and ventricular arrhythmias in LVNC
patients were similar to dilated cardiomyopathy patients. However, LVNC
patients had a higher incidence of heart failure hospitalization than
dilated cardiomyopathy patients. <br/>CONCLUSION(S): Patients with LVNC
carry a similar cardiovascular risk when compared with dilated
cardiomyopathy patients. Left ventricular ejection fraction-a conventional
indicator of heart failure severity, not the extent of
trabeculation-appears to be an important determinant of adverse outcomes
in LVNC patients.<br/>Copyright &#xa9; 2020 The Authors. Circulation:
Cardiovascular Imaging is published on behalf of the American Heart
Association, Inc., by Wolters Kluwer Health, Inc. This is an open access
article under the terms of the Creative Commons Attribution License, which
permits use, distribution, and reproduction in any medium, provided that
the original work is properly cited.

<25>
Accession Number
2005625428
Title
Artificial Intelligence and Machine Learning in Cardiovascular Health
Care.
Source
Annals of Thoracic Surgery. 109 (5) (pp 1323-1329), 2020. Date of
Publication: May 2020.
Author
Kilic A.
Institution
(Kilic) Division of Cardiac Surgery, Department of Cardiothoracic Surgery,
University of Pittsburgh Medical Center, Pittsburgh, PA, United States
Publisher
Elsevier USA
Abstract
Background: This review article provides an overview of artificial
intelligence (AI) and machine learning (ML) as it relates to
cardiovascular health care. <br/>Method(s): An overview of the terminology
and algorithms used in ML as it relates to health care are provided by the
author. Articles published up to August 1, 2019, in the field of AI and ML
in cardiovascular medicine are also reviewed and placed in the context of
the potential role these approaches will have in clinical practice in the
future. <br/>Result(s): AI is a broader term referring to the ability of
machines to perform intelligent tasks, and ML is a subset of AI that
refers to the ability of machines to learn independently and make accurate
predictions. An expanding body of literature has been published using ML
in cardiovascular health care. Moreover, ML has been applied in the
settings of automated imaging interpretation, natural language processing
and data extraction from electronic health records, and predictive
analytics. Examples include automated interpretation of chest
roentgenograms, electrocardiograms, echocardiograms, and angiography;
identification of patients with early heart failure using clinical notes
evaluated by ML; and predicting mortality or complications following
percutaneous or surgical cardiovascular procedures. <br/>Conclusion(s):
Although there is an expanding body of literature on AI and ML in
cardiovascular medicine, the future these fields will have in clinical
practice remains to be paved. In particular, there is a promising role in
providing automated imaging interpretation, automated data extraction and
quality control, and clinical risk prediction, although these techniques
require further refinement and evaluation.<br/>Copyright &#xa9; 2020 The
Society of Thoracic Surgeons

<26>
Accession Number
2005614562
Title
Extracorporeal Hemadsorption versus Glucocorticoids during Cardiopulmonary
Bypass: A Prospective, Randomized, Controlled Trial.
Source
Cardiovascular Therapeutics. 2020 (no pagination), 2020. Article Number:
7834173. Date of Publication: 2020.
Author
Taleska Stupica G.; Sostaric M.; Bozhinovska M.; Rupert L.; Bosnic Z.;
Jerin A.; Ihan A.; Klokocovnik T.; Podbregar M.
Institution
(Taleska Stupica, Sostaric, Rupert, Podbregar) Clinical Department of
Anaesthesiology and Perioperative Intensive Therapy, University Medical
Centre Ljubljana, Ljubljana, Slovenia
(Bozhinovska) University of Ljubljana, Faculty of Medicine, Ljubljana,
Slovenia
(Bosnic) University of Ljubljana, Faculty of Computer and Information
Science, Ljubljana, Slovenia
(Jerin) Institute of Clinical Chemistry and Biochemistry, University
Medical Centre Ljubljana, Ljubljana, Slovenia
(Ihan) University of Ljubljana, Faculty of Medicine, Institute of
Microbiology and Immunology, Ljubljana, Slovenia
(Klokocovnik) Clinical Department of Cardio-Vascular Surgery, University
Medical Centre Ljubljana, Ljubljana, Slovenia
(Klokocovnik) Department of Internal Intensive Medicine, General and
Teaching Hospital, Celje, Slovenia
Publisher
Hindawi Limited (410 Park Avenue, 15th Floor, 287 pmb, New York NY 10022,
United States)
Abstract
Extracorporeal hemadsorption may reduce inflammatory reaction in
cardiopulmonary bypass (CPB) surgery. Glucocorticoids have been used
during open-heart surgery for alleviation of systemic inflammation after
CPB. We compared intraoperative hemadsorption and methylprednisolone, with
usual care, during complex cardiac surgery on CPB, for inflammatory
responses, hemodynamics, and perioperative course. Seventy-six patients
with prolonged CPB were recruited and randomized, with 60 included in
final analysis. Allocation was into three groups: Methylprednisolone (n =
20), Cytosorb (n = 20), and Control group (usual care, n = 20).
Proinflammatory (TNF-, IL-1beta, IL-6, and IL-8) and anti-inflammatory
(IL-10) cytokines which complement C5a, CD64, and CD163 expression by
immune cells were analyzed within the first five postoperative days, in
addition to hemodynamic and clinical outcome parameters.
Methylprednisolone group, compared to Cytosorb and Control had
significantly lower levels of TNF- (until the end of surgery, p<0.001),
IL-6 (until 48 h after surgery, p<0.001), and IL-8 (until 24 h after
surgery, p<0.016). CD64 expression on monocytes was the highest in the
Cytosorb group and lasted until the 5^th postoperative day
(p<0.016). IL-10 concentration (until the end of surgery) and CD163
expression on monocytes (until 48 h after surgery) were the highest in the
Methylprednisolone group (p<0.016, for all measurements between three
groups). No differences between groups in the cardiac index or clinical
outcome parameters were found. Methylprednisolone more effectively
ameliorates inflammatory responses after CPB surgery compared to
hemadsorption and usual care. Hemadsorption compared with usual care
causes higher prolonged expression of CD64 on monocytes but short lasting
expression of CD163 on granulocytes. Hemadsorption with CytoSorb was safe
and well tolerated. This trial is registered with clinicaltrials.gov
(NCT02666703).<br/>Copyright &#xa9; 2020 Gordana Taleska Stupica et al.

<27>
Accession Number
2005600988
Title
Regular drug-eluting stents versus dedicated bifurcation drug-eluting
BiOSS stents for coronary bifurcation treatment: Four-year results of the
randomised POLBOS i and POLBOS II clinical trials.
Source
EuroIntervention. 14 (16) (pp 1460-1463), 2020. Date of Publication: March
2020.
Author
Gil R.J.; Bil J.; Kern A.; Garcia L.A.I.; Formuszewicz R.; Dobrzycki S.;
Vassilev D.; Segiet A.
Institution
(Gil, Bil) Department of Invasive Cardiology, Centre of Postgraduate
Medical Education, Central Clinical Hospital of the Ministry of Interior
and Administration, Warsaw, Poland
(Gil) Mossakowski Medical Research Center, Polish Academy of Science,
Warsaw, Poland
(Kern) Department of Cardiology and Cardiosurgery, University of Warmia
and Masury, Olsztyn, Poland
(Garcia) Costa Del Sol Hospital, Marbella, Spain
(Formuszewicz) 10th Clinical Military Hospital, Bydgoszcz, Poland
(Dobrzycki) Department of Invasive Cardiology, Medical University in
Bialystok, Bialystok, Poland
(Vassilev) Alexandrovska University Hospital, Sofia, Bulgaria
(Segiet) Warsaw Medical University, Warsaw, Poland
Publisher
Europa Group

<28>
Accession Number
2005600974
Title
Stroke after transcatheter edge-to-edge mitral valve repair: A systematic
review and meta-analysis.
Source
EuroIntervention. 14 (16) (pp 1401-1408), 2020. Date of Publication: March
2020.
Author
Da Silva P.B.; Sousa J.P.; Oliveiros B.; Donato H.; Costa M.; Goncalves
L.; Teixeira R.
Institution
(Da Silva, Sousa, Oliveiros, Donato, Goncalves, Teixeira) Faculdade de
Medicina, Universidade de Coimbra, Coimbra, Portugal
(Donato) Servico de Documentacao, Centro Hospitalare Universitario de
Coimbra, Coimbra, Portugal
(Costa, Goncalves, Teixeira) Servico de Cardiologia, Centro Hospitalar e
Universitario de Coimbra, Coimbra, Portugal
Publisher
Europa Group
Abstract
Aims: The aim of this study was to assess the stroke rate after
transcatheter mitral valve repair (TMVR) with the MitraClip, comparing it
with surgical mitral valve repair (SMVR) and optimal medical treatment
(OMT). <br/>Methods and Results: In December 2018, we systematically
searched PubMed, Embase and Cochrane Controlled Register of Trials for
studies comparing TMVR with SMVR and/or OMT for the treatment of severe
mitral regurgitation. Random-effects and cumulative meta-analysis was
performed. Ten studies were included (seven of TMVR versus SMVR and three
of TMVR versus OMT), providing a total of 1,881 patients and 61 pooled
strokes (16 in TMVR versus SMVR and 45 in TMVR versus OMT). There was no
difference in stroke incidence between TMVR and SMVR (pooled OR 0.49
[0.17, 1.42], p=0.19). However, there was a trend towards a lower stroke
risk in TMVR. For TMVR versus OMT, no difference in stroke rate was
identified (pooled OR 1.09 [0.60, 1.97], p=0.79). Post-procedure de novo
atrial fibrillation was more frequent in SMVR when compared with TMVR.
<br/>Conclusion(s): Despite both a low number of pooled stroke events and
the failure to reach the pre-specified statistical significance, there was
a trend for a lower post-procedure stroke rate in TMVR when compared with
SMVR and a similar one between TMVR and OMT alone.<br/>Copyright &#xa9;
Europa Digital & Publishing 2020.

<29>
Accession Number
2005600967
Title
Major infections after bypass surgery and stenting for multivessel
coronary disease in the randomised SYNTAX trial.
Source
EuroIntervention. 15 (17) (pp 1520-15266), 2020. Date of Publication:
April 2020.
Author
Mancone M.; Cavalcante R.; Modolo R.; Falcone M.; Biondi-Zoccai G.; Frati
G.; Spitzer E.; Benedetto U.; Blackstone E.H.; Onuma Y.; Van Geuns R.-J.;
Diletti R.; Serruys P.W.
Institution
(Mancone) Department of Cardiovascular Respiratory Nephrology
Anesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome,
Italy
(Cavalcante, Spitzer, Onuma, Van Geuns, Diletti) Erasmus University
Medical Center, Rotterdam, Netherlands
(Cavalcante) Boston Scientific Corporation, Marlborough, MA, United States
(Modolo) Department of Cardiology, Amsterdam University Medical Center,
Amsterdam, Netherlands
(Modolo) Department OfInternal Medicine, University of Campinas, UNICAMP,
Campinas, Brazil
(Falcone) Department of Clinical and Experimental Medicine, University of
Pisa, Pisa, Italy
(Biondi-Zoccai, Frati) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Naples, Italy
(Frati) IRCCS Neuromed, Pozzilli, Italy
(Spitzer) Cardialysis B.V., Rotterdam, Netherlands
(Benedetto) Bristol Royal Infirmary, Bristol, United Kingdom
(Blackstone) Thoracic and Cardiovascular Surgery, ClevelandClinic,
Cleveland, OH, United States
(Serruys) Imperial College London, London, United Kingdom
(Serruys) Department of Cardiology, National University of Ireland,
University Road, Galway H91 TK33, Ireland
Publisher
Europa Group
Abstract
Aims: Incidence, associated risk factors and impact on mortality of
infections after bypass surgery (CABG) and stenting (PCI) for multivessel
coronary disease (MVD) have never been reported in a large randomised
trial. The aim of the present study was to evaluate, in patients with MVD,
the prevalence of major infections after PCI and CABG and to assess their
impact on mortality. <br/>Methods and Results: The SYNTAX trial randomised
1,800 MVD patients to either CABG or PCI. Patients were followed up to
five years. The primary endpoint of this post hoc analysis was the
occurrence of major infection. At five years of follow-up, the primary
endpoint had occurred in 142 (15.8%) patients in the CABG arm and 44
(4.9%) patients in the PCI arm (>=60 days HR - 7.9, 95% CI: 4.7 to 13.1;
p<0.001) (>60 days - HR 0.79, 95% CI: 0.44 to 1.44; p=0.45). Major
infections were independently associated with a higher risk of all-cause
mortality at five years (adjusted HR 2.6, 95% CI: 1.8 to 3.8, p<0.001).
<br/>Conclusion(s): CABG is associated with a higher incidence of
post-procedure major infections compared to PCI. Major infections are
independently associated with all-cause mortality.<br/>Copyright &#xa9;
Europa Digital & Publishing 2020.

<30>
Accession Number
2005600962
Title
Systematic review and meta-analysis of current risk models in predicting
short-term mortality after transcatheter aortic valve replacement.
Source
EuroIntervention. 15 (17) (pp 1497-1505), 2020. Date of Publication: April
2020.
Author
Siddiqi T.J.; Usman M.S.; Khan M.S.; Khan M.A.A.; Riaz H.; Khan S.U.;
Murad M.H.; Kavinsky C.J.; Doukky R.; Kalra A.; Desai M.Y.; Bhatt D.L.
Institution
(Siddiqi, Usman, Khan) Department of Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Khan, Doukky) Department of Medicine, John H. Stroger Jr. Hospital of
Cook County, Chicago, IL, United States
(Riaz, Kalra, Desai) Department of Cardiovascular Medicine, Cleveland
Clinic, Cleveland, OH, United States
(Khan) Department of Medicine, West Virginia University, Morgantown, WV,
United States
(Murad) Evidence-Based Practice Center, Mayo Clinic, Rochester, NY, United
States
(Kavinsky, Doukky) Division of Cardiology, Rush University Medical Center,
Chicago, IL, United States
(Bhatt) Department of Cardiovascular Medicine, Brigham and Women's
Hospital, Heart and Vascular Center, Boston, MA, United States
Publisher
Europa Group
Abstract
Aims: The aim of this study was to evaluate the performance of risk
stratification models (RSMs) in predicting short-term mortality after
transcatheter aortic valve replacement (TAVR). <br/>Methods and Results:
MEDLINE and Scopus were queried to identify studies which validated RSMs
designed to assess 30-day or in-hospital mortality after TAVR.
Discrimination and calibration were assessed using C-statistics and
observed/expected ratios (OERs), respectively. C-statistics were pooled
using a random- effects inverse-variance method, while OERs were pooled
using the Peto odds ratio. A good RSM is defined as one with a C-statistic
>0.7 and an OER close to 1.0. Twenty-four studies (n=68,215 patients)
testing 11 different RSMs were identified. Discrimination of all RSMs was
poor (C-statistic <0.7); however, certain TAVR-specific RSMs such as the
in-hospital STS/ACC TVT (C-statistic=0.65) and STT (C-statistic=0.66)
predicted individual mortality more reliably than surgical models
(C-statistic range=0.59-0.61). A good calibration was demonstrated by the
in-hospital STS/ACC TVT (OER=0.99), 30-day STS/ACC TVT (OER=1.08) and STS
(OER=1.01) models. Baseline dialysis (OER: 2.64 [1.88, 3.70]; p<0.001) was
the strongest predictor of mortality. <br/>Conclusion(s): This study
demonstrates that the STS/ACC TVT model (in-hospital and 30-day) and the
STS model have accurate calibration, making them useful for comparison of
centre-level risk-adjusted mortality. In contrast, the discriminative
ability of currently available models is limited.<br/>Copyright &#xa9;
Europa Digital & Publishing 2020.

<31>
Accession Number
631498925
Title
Echo-derived peak cardiac power output-to-left ventricular mass with
cardiopulmonary exercise testing predicts outcome in patients with heart
failure and depressed systolic function.
Source
European Heart Journal Cardiovascular Imaging. 20 (6) (pp 700-708), 2019.
Date of Publication: 01 Jun 2019.
Author
Pugliese N.R.; Fabiani I.; Mandoli G.E.; Guarini G.; Galeotti G.G.;
Miccoli M.; Lombardo A.; Simioniuc A.; Bigalli G.; Pedrinelli R.; Dini
F.L.
Institution
(Pugliese, Fabiani, Mandoli, Guarini, Galeotti, Lombardo, Simioniuc,
Bigalli, Pedrinelli, Dini) Cardiac Thoracic and Vascular Department,
University of Pisa, Azienda Universitaria-Ospedaliera Pisana, Via
Paradisa, 2, Pisa 56124, Italy
(Miccoli) Department of Clinical and Experimental Medicine, University of
Pisa, Via Paradisa, 2, Pisa 56124, Italy
Publisher
Oxford University Press
Abstract
Aims: Peak cardiac power output-to-mass (CPOM) represents a measure of the
rate at which cardiac work is delivered respect to the potential energy
stored in left ventricular (LV) mass. We studied the value of CPOM and
cardiopulmonary exercise test (CPET) in risk stratification of patients
with heart failure (HF). Materials and results: We studied 159 patients
with chronic HF (mean rest LV ejection fraction 30%) undergoing CPET and
exercise stress echocardiography. CPOM was calculated as the product of a
constant (K = 2.22 x 10^-1) with cardiac output (CO) and the
mean blood pressure (MBP), divided by LV mass (M), and expressed in the
unit of W/100 g: CPOM = [K x CO (L/min) x MBP (mmHg)]/LVM(g). Patients
were followed-up for the primary endpoint, including all-cause death,
ventricular assist device implantation, and heart transplantation, and the
secondary endpoint that comprised hospitalization for HF. In multivariate
Cox regression analyses, peak CPOM was selected as the most powerful
independent predictor of both primary and secondary endpoint [hazard ratio
(HR) 0.004, 95% confidence interval (CI) 0.004-0.3; P = 0.002 and HR 0.09,
95% CI 0.02-0.55; P = 0.009]. Sixty-month survival free from the combined
endpoint was 85% in those exhibiting oxygen consumption (VO<inf>2</inf>) >
14 mL/min/kg and peak CPOM > 0.6 W/100 g. Peak VO<inf>2</inf> <= 14
mL/min/kg provided incremental prognostic value over demographic and
clinical variables, brain natriuretic peptide, and resting
echocardiographic parameters (chi² from 58 to 64; P = 0.04),
that was further increased by peak CPOM <= 0.6 W/100 g (chi²
77; P < 0.001). <br/>Conclusion(s): Peak CPOM and peak VO<inf>2</inf>
showed independent and incremental prognostic values in patients with
chronic HF.<br/>Copyright &#xa9; 2018 Published on behalf of the European
Society of Cardiology. All rights reserved. &#xa9; The Author(s) 2018.

<32>
Accession Number
2005667775
Title
5-Year Outcomes After TAVR With Balloon-Expandable Versus Self-Expanding
Valves: Results From the CHOICE Randomized Clinical Trial.
Source
JACC: Cardiovascular Interventions. 13 (9) (pp 1071-1082), 2020. Date of
Publication: 11 May 2020.
Author
Abdel-Wahab M.; Landt M.; Neumann F.-J.; Massberg S.; Frerker C.; Kurz T.;
Kaur J.; Toelg R.; Sachse S.; Jochheim D.; Schafer U.; El-Mawardy M.;
Robinson D.R.; Richardt G.
Institution
(Abdel-Wahab) Heart Center Leipzig at the University of Leipzig, Leipzig,
Germany
(Landt, Kaur, Toelg, Sachse, Richardt) Heart Center, Segeberger Kliniken,
Bad Segeberg, Germany
(Neumann) University Heart Center Freiburg-Bad Krozingen, Bad Krozingen,
Germany
(Massberg, Jochheim) Munich University Clinic, Munich, Germany
(Frerker, Schafer) Cardiology Department, Asklepios Clinic St. Georg,
Hamburg, Germany
(Kurz) Cardiology Department, Lubeck University Hospital, Lubeck, Germany
(El-Mawardy) Cardiology Department, Vivantes Wenckebach Hospital, Berlin,
Germany
(Robinson) Mathematics Department, University of Sussex, Brighton,
England, United Kingdom
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The purpose of this study was to evaluate clinical and
echocardiographic outcome data of the CHOICE (Randomized Comparison of
Transcatheter Heart Valves in High Risk Patients with Severe Aortic
Stenosis: Medtronic CoreValve Versus Edwards SAPIEN XT) trial at 5 years.
<br/>Background(s): The CHOICE trial was designed to compare device
performance of a balloon-expandable (BE) transcatheter heart valve (THV)
versus a self-expanding (SE) THV. <br/>Method(s): The CHOICE trial is an
investigator-initiated trial that randomized 241 high-risk patients with
severe symptomatic aortic stenosis and an anatomy suitable for treatment
with both BE and SE THVs to transfemoral transcatheter aortic valve
replacement with either device. The primary endpoint was device success.
Patients were followed up to 5 years, with assessment of clinical
outcomes, and echocardiographic evaluation of valve function and THV
durability. <br/>Result(s): After 5 years, there were no statistically
significant differences between BE and SE valves in the cumulative
incidence of death from any cause (53.4% vs. 47.6%; p = 0.38), death from
cardiovascular causes (31.6% vs. 21.5%; p = 0.12), all strokes (17.5% vs.
16.5%; p = 0.73), and repeat hospitalization for heart failure (28.9% vs.
22.5%; p = 0.75). SE patients had larger prosthetic valve area (1.6 +/-
0.5 cm² vs. 1.9 +/- 0.5 cm²; p = 0.02) with a lower
mean transprosthetic gradient (12.2 +/- 8.7 mm Hg vs. 6.9 +/- 2.7 mm Hg; p
= 0.001) at 5 years. No differences were observed in the rates of
paravalvular regurgitation. Clinical valve thrombosis occurred in 7 BE
patients (7.3%) and 1 SE patient (0.8%; p = 0.06), and moderate or severe
structural valve deterioration in 6 BE patients (6.6%) and no SE patient
(0%; p = 0.018). The rate of bioprosthetic valve failure was low and not
significantly different between both groups (4.1% vs. 3.4%; p = 0.63).
<br/>Conclusion(s): Five-year follow-up of patients in the CHOICE trial
revealed clinical outcomes after transfemoral transcatheter aortic valve
replacement with early-generation BE and SE valves that were not
statistically significantly different, with limited statistical power.
Forward flow hemodynamics were significantly better with the SE valve.
Moderate or severe structural valve deterioration was uncommon but
occurred more frequently with the BE valve. (A Comparison of Transcatheter
Heart Valves in High Risk Patients With Severe Aortic Stenosis: The CHOICE
Trial [CHOICE]; NCT01645202)<br/>Copyright &#xa9; 2020 American College of
Cardiology Foundation

<33>
Accession Number
2005636838
Title
"Beta-blocker exposure for short-term outcomes following non-cardiac
surgery: A meta-analysis of observational studies" Int J Surg. 2020 Mar
10. pii: S1743-9191(20)30206-5. doi: 10.1016/j.ijsu.2020.02.041. [Epub
ahead of print].
Source
International Journal of Surgery. 78 (pp 46-47), 2020. Date of
Publication: June 2020.
Author
Baram A.
Institution
(Baram) Cardiovascular and Thoracic Surgery, Department of Surgery, School
of Medicine, Faculty of Medical Sciences, University of Sulaimani, Iraq
(Baram) Department of Thoracic and Cardiovascular Surgery, Sulaimani
Teaching Hospital, Al Sulaymaniyah 46001, Iraq
Publisher
Elsevier Ltd

<34>
Accession Number
2005587461
Title
Experience with porcine beating heart simulator for coronary artery bypass
surgery residency training.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Wu S.; Ling Y.-P.; Zhao H.
Institution
(Wu, Ling, Zhao) Cardiac Surgery Department, Peking University Third
Hospital, Beijing, China
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: To evaluate the effect of our uniquely designed beating heart
simulator for coronary artery bypass surgery residency training.
<br/>Method(s): The balloon of intra-aortic balloon pump (IABP) was
inserted into the left ventricle of an isolated porcine heart to form a
beating heart simulator. This model simulated off-pump coronary artery
bypass grafting (OPCABG), and the nonbeating heart model simulated the
on-pump coronary artery bypass grafting (ONCABG) for training of surgeons.
From 2017 to 2019, 60 trainees were randomly divided into nonbeating and
beating heart simulator training groups. The training period was 3 months.
The performance of anastomosis was evaluated at the beginning (after 1
month), midpoint (after 2 months), and at the end of the assessment (after
3 months). <br/>Result(s): Trainees improved their performance of coronary
artery anastomosis respectively after 3 months of training, whether they
were trained on beating heart simulator or nonbeating heart simulator (P <
.05). On both nonbeating and beating heart simulator test, trainees in the
beating group performed better than those in the nonbeating group in the
use of microsurgical instruments, anastomotic quality, and anastomotic
speed after 3 months of training (P < .05). <br/>Conclusion(s): The effect
of our uniquely developed beating heart simulator training was better than
those of nonbeating heart simulator for OPCABG and ONCABG training of
surgeons during residency.<br/>Copyright &#xa9; 2020 The American
Association for Thoracic Surgery

<35>
Accession Number
2005432654
Title
Validation of the long-term prognostic capability of the SYNTAX score II
in patients undergoing biodegradable polymer-based Sirolimus-eluting
stents: 2-year outcomes from the PANDA III trial.
Source
International Journal of Cardiology. 309 (pp 27-32), 2020. Date of
Publication: 15 June 2020.
Author
Song Y.; Guan C.; Cao X.; Qin L.; Li Y.; Li Z.; Nie S.; Hou S.; Zhang M.;
Gao R.; Yuan J.; Xu B.
Institution
(Song, Gao, Yuan) Fu Wai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, Beijing, China
(Guan, Xu) Catheterization Laboratories, Fu Wai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing,
China
(Cao) Chinese PLA 252 Hospital, Baoding, China
(Qin) Kaifeng Central Hospital, Kaifeng, China
(Li) Yunnan St. John's Hospital, Kunming, China
(Li) Liaoning Provincial People's Hospital, Shenyang, China
(Nie) Affiliated Anzhen Hospital of Capital Medical University, Beijing,
China
(Hou, Zhang) China Cardiovascular Research Foundation Inc, Beijing, China
Publisher
Elsevier Ireland Ltd
Abstract
Background: This study aimed to assess the prognostic ability of SYNTAX
(Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac
Surgery) Score II (SS-II) in LM and/or TVD patients undergoing
biodegradable polymer-based drug-eluting stents (BP-DES) in the
multi-central randomized PANDA III trial. <br/>Method(s): A total of 723
patients in PANDA III population were enrolled in this study. According to
SS-II tertiles, patients were stratified as follow: SS-II <= 23 (n = 224),
23 < SS II <= 31 (n = 255), SS II > 31 (n = 244). The predictive abilities
for 2-year cardiac death were compared between angiographic scores and
scores combining both angiographic and clinical variables. <br/>Result(s):
Mean anatomic SS was 20.6 +/- 9.4, SS-II for PCI was 28.7 +/- 8.6. During
2-year follow up, cardiac death (0.00% vs. 1.7% vs. 4.3%, p = 0.003) and
target lesion failure (5.9% vs. 9.1% vs. 13.6%, p = 0.020) was
significantly higher in the upper tertile group than in intermedian and
low tertile. At multivariate analysis, SS-II for PCI was an independent
risk factor of cardiac death (Hazard ratio: 2.41, 95%CI: 1.47-3.97, p <
0.005) and TLF (Hazard ratio: 1.29, 95%CI: 1.01-1.65, p = 0.040). The ROC
curve analysis showed that SS-II for PCI had better ability than other
SYNTAX scoring systems to predict cardiac death (AUC: 0.746,
95%CI:0.63-0.87, p = 0.010). <br/>Conclusion(s): The SS-II had superiority
than other SYNTAX scoring systems in predicting 2-year cardiac death in LM
and/or TVD patients undergoing PCI with biodegradable polymer drug-eluting
stents.<br/>Copyright &#xa9; 2020

<36>
Accession Number
2005408275
Title
Multi-omic analysis of the effects of low frequency ventilation during
cardiopulmonary bypass surgery.
Source
International Journal of Cardiology. 309 (pp 40-47), 2020. Date of
Publication: 15 June 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

<37>
Accession Number
2004701089
Title
Clinical application of a new ternary polymer, SEC-1 coatTM, for pediatric
cardiopulmonary bypass circuits: a prospective randomized pilot study.
Source
Perfusion (United Kingdom). (no pagination), 2020. Date of Publication:
2020.
Author
Hasegawa T.; Oshima Y.; Yokoyama S.; Akimoto A.; Misaka Y.; Akiyama S.
Institution
(Hasegawa) Department of Pediatric Critical Care Medicine, Hyogo
Prefectural Kobe Children's Hospital, Kobe, Japan
(Hasegawa, Oshima, Yokoyama, Akimoto, Misaka, Akiyama) Department of
Cardiovascular Surgery, Hyogo Prefectural Kobe Children's Hospital, Kobe,
Japan
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Objective: The use of biocompatible materials to reduce the systemic
activation of inflammation and coagulation pathways is expanding rapidly.
However, there have been few clinical studies of biocompatible circuits
for pediatric cardiopulmonary bypass. This pilot study aimed to
preliminarily evaluate the biocompatibility of SEC-1 coatTM (SEC) for
cardiopulmonary bypass circuits in pediatric cardiac surgery.
<br/>Method(s): Twenty infants undergoing cardiac surgery for isolated
ventricular septal defects at Kobe Children's Hospital were assigned
randomly to an SEC-coated (SEC group, n = 10) or heparin-coated (control
group, n = 10) circuit. Perioperative data and the following markers were
prospectively analyzed: platelet counts and interleukin-6, interleukin-8,
C3a, beta-thromboglobulin, and thrombin-antithrombin complex levels.
<br/>Result(s): Neither patient characteristics nor postoperative clinical
outcomes differed significantly between the SEC and control groups.
Platelet counts markedly decreased during cardiopulmonary bypass in both
groups, but were significantly better preserved in the SEC group. Fewer
patients needed postoperative platelet transfusions in the SEC group.
After cardiopulmonary bypass termination, serum levels of
beta-thromboglobulin and thrombin-antithrombin complex were significantly
lower in the SEC than in the control group. Although the differences were
not statistically significant, serum levels of interleukin-6,
interleukin-8, and C3a had a tendency toward being lower in the SEC group,
with good preservation of leukocyte counts, fibrinogen, and antithrombin
III. <br/>Conclusion(s): SEC-1 coatTM for cardiopulmonary bypass circuits
have good biocompatibility with regard to platelet preservation and in
terms of attenuating inflammatory reaction or coagulation activation
during pediatric cardiac surgery. It can be beneficial in pediatric as
well as adult cardiac surgery.<br/>Copyright &#xa9; The Author(s) 2020.

<38>
Accession Number
2004083783
Title
Inflammatory cardiomyopathies: short- and long-term outcomes after heart
transplantation-a protocol for a systematic review and meta-analysis.
Source
Heart Failure Reviews. 25 (3) (pp 481-485), 2020. Date of Publication: 01
May 2020.
Author
Bobbio E.; Lingbrant M.; Nwaru B.I.; Hessman E.; Lehtonen J.; Karason K.;
Bollano E.
Institution
(Bobbio, Lingbrant, Bollano) Department of Cardiology, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Nwaru) Krefting Research Centre, Institute of Medicine, University of
Gothenburg, Gothenburg, Sweden
(Hessman) University Library, University of Gothenburg, Gothenburg, Sweden
(Lehtonen) Heart and Lung Center, Helsinki University and Helsinki
University Hospital, Helsinki, Finland
(Karason) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Karason) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Bobbio, Lingbrant, Karason, Bollano) Institute of Medicine at Sahlgrenska
Academy, University of Gothenburg, Gothenburg, Sweden
Publisher
Springer
Abstract
Heart transplantation (HTx) for patients with "giant cell myocarditis"
(GCM) or "cardiac sarcoidosis" (CS) is still controversial. However, no
single center has accumulated enough experience to investigate post-HTx
outcome. The primary aim of this systematic review is to identify,
appraise, and synthesize existing literature investigating whether
patients who have undergone HTx because of GCM or CS have worse outcomes
as compared with patients transplanted because of other etiologies. A
systematic and comprehensive search will be performed using PubMed,
Scopus, Web of Science, EMBASE, and Google Scholar, for studies published
up to December 2019. Observational and interventional population-based
studies will be eligible for inclusion. The quality of observational
studies will be assessed using the Newcastle-Ottawa scale, while the
interventional studies will be assessed using the Cochrane Effective
Practice Organization of Care tool. The collected evidence will be
narratively synthesized; in addition, we will perform a meta-analysis to
pool estimates from studies considered to be homogenous. Reporting of the
systematic review and meta-analysis will be in accordance with the
Meta-analysis of Observational Studies in Epidemiology Preferred Reporting
Items for Systematic reviews and Meta-Analysis guidelines. To our
knowledge, this will be the first synthesis of outcomes, including
survival, acute cellular rejection, and disease recurrence, in patients
with either GCM or CS treated with HTx. Reviewing the suitability of HTx
in this population and highlighting areas for further research will
benefit both patients and healthcare providers. Trial registration:
CRD42019140574.<br/>Copyright &#xa9; 2020, The Author(s).

<39>
Accession Number
2003857232
Title
A systematic review of the cost-effectiveness of heart valve replacement
with a mechanical versus biological prosthesis in patients with heart
valvular disease.
Source
Heart Failure Reviews. 25 (3) (pp 495-503), 2020. Date of Publication: 01
May 2020.
Author
Azari S.; Rezapour A.; Omidi N.; Alipour V.; Tajdini M.; Sadeghian S.;
Bragazzi N.L.
Institution
(Azari) Department of Health Economics, School of Health Management and
Information Sciences, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Rezapour, Alipour) Health Management and Economics Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Omidi, Tajdini, Sadeghian) Department of Cardiology, Tehran Heart Center,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Bragazzi) Laboratory for industrial and applied mathematics (LIAM),
Department of mathematics and statistics, York university, Toronto, Canada
Publisher
Springer
Abstract
Heart valve disease (HVD) affects 2.5% of the US population and one
million individuals aged 65 years and older in the UK. Given its burden,
the aim of the present review was to assess the cost-effectiveness of
heart valve replacement with mechanical versus biological prosthesis in
HVD patients. We performed a systematic search in various electronic
databases from January 1990 to June 2019. Five out of 542 articles were
entered into the study, from which 2 papers were subsequently excluded not
meeting the minimum number of items of the CHEERS checklist.
Quality-Adjusted Life Year, Life Years Gained, and the Incremental
Cost-Effectiveness Ratio (ICER) regarding the type of replaced heart valve
were extracted and reported. Studies were conducted in three different
countries (Iran, France, and USA). ICER ranged from $1253 in Iran to
54,634 in France. Survival rate of mitral mechanical versus biological
valves at 10 and 20 years was 72.9% versus 76.0% and 51% versus 30%,
respectively. Survival rate at 20 years in patients undergoing atrial
valve replacement was 20%. Ten- and 20-year death rates for biological
valves were higher with respect to mechanical prosthesis (15.5% versus
8.4% at 10 years), with this difference becoming more relevant at 20 years
(36.9% versus 13.9%). Due to higher ICER, mortality rate, and lower
success rates in the long term for biological prostheses compared to
mechanical ones, these appear to be more suitable for older patients (aged
>= 70 years).<br/>Copyright &#xa9; 2019, Springer Science+Business Media,
LLC, part of Springer Nature.

<40>
Accession Number
2003720783
Title
The effects of a comprehensive rehabilitation and intensive education
program on anxiety, depression, quality of life, and major adverse cardiac
and cerebrovascular events in unprotected left main coronary artery
disease patients who underwent coronary artery bypass grafting.
Source
Irish Journal of Medical Science. 189 (2) (pp 477-488), 2020. Date of
Publication: 01 May 2020.
Author
Ma L.; Deng L.; Yu H.
Institution
(Ma, Deng, Yu) Department of Cardiovascular Surgery, The First Affiliated
Hospital of Harbin Medical University, 23 Youzheng Street, Harbin,
Heilongjiang 150001, China
Publisher
Springer
Abstract
Objective: This study aimed to explore the effect of a comprehensive
rehabilitation and intensive education (CRIE) program on anxiety,
depression, quality of life (QoL), and major adverse cardiac and
cerebrovascular events (MACCE) risk in unprotected left main coronary
artery disease (ULMCAD) patients who underwent coronary artery bypass
grafting (CABG). <br/>Method(s): In total, 300 ULMCAD patients who
underwent CABG were randomly assigned to the CRIE group or usual care (UC)
group in a 1:1 ratio. During a 12-month intervention, anxiety and
depression were evaluated by Hospital Anxiety and Depression Scale (HADS),
QoL was evaluated by 12-Item Short-Form Health Survey (SF-12), on
discharge day from hospital (M0), and at 3 months after the discharge
(M3), M6, and M12. All patients were further followed up until occurrence
of MACCE or for an additional 24 months, and MACCE accumulating occurrence
rate was calculated. <br/>Result(s): At M12, HADS-anxiety score and
anxiety prevalence (17.3% vs. 29.3%) were decreased in the CRIE group than
those in the UC group, meanwhile HADS-depression score and depression
prevalence (15.3% vs. 24.7%) were also reduced in the CRIE group than
those in the UC group. For QoL, SF-12 Physical Component Summary (PCS)
score at M6/M12, and SF-12 PCS score change (M12 - M0) were increased in
the CRIE group than those in the UC group; meanwhile, SF-12 Mental
Component Summary (MCS) score at M12 and SF-12 PCS score change (M12 - M0)
were increased in the CRIE group than those in the UC group as well.
Besides, MACCE accumulating occurrence rate was numerically lower in the
CRIE group compared with that in the UC group but without statistical
significance. <br/>Conclusion(s): CRIE is an effective approach in
improving anxiety, depression, and QoL in ULMCAD patients who underwent
CABG.<br/>Copyright &#xa9; 2019, Royal Academy of Medicine in Ireland.

<41>
Accession Number
605946015
Title
Meta-analysis of the association between preoperative anaemia and
mortality after surgery.
Source
British Journal of Surgery. 102 (11) (pp 1314-1324), 2015. Date of
Publication: 01 Oct 2015.
Author
Fowler A.J.; Ahmad T.; Phull M.K.; Allard S.; Gillies M.A.; Pearse R.M.
Institution
(Fowler, Ahmad, Pearse) Barts and the London School of Medicine and
Dentistry, Queen Mary University of London, London, United Kingdom
(Phull) Department of Anaesthesia, Royal London Hospital, Barts Health NHS
Trust, London, United Kingdom
(Allard) Department of Haematology, Royal London Hospital, Barts Health
NHS Trust, London, United Kingdom
(Gillies) Department of Anaesthesia, Critical Care and Pain Medicine,
Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Background Numerous published studies have explored associations between
anaemia and adverse outcomes after surgery. However, there are no evidence
syntheses describing the impact of preoperative anaemia on postoperative
outcomes. Methods A systematic review and meta-analysis of observational
studies exploring associations between preoperative anaemia and
postoperative outcomes was performed. Studies investigating trauma, burns,
transplant, paediatric and obstetric populations were excluded. The
primary outcome was 30-day or in-hospital mortality. Secondary outcomes
were acute kidney injury, stroke and myocardial infarction. Predefined
analyses were performed for the cardiac and non-cardiac surgery subgroups.
A post hoc analysis was undertaken to evaluate the relationship between
anaemia and infection. Data are presented as odds ratios (ORs) with 95 per
cent c.i. Results From 8973 records, 24 eligible studies including 949 445
patients were identified. Some 371 594 patients (39.1 per cent) were
anaemic. Anaemia was associated with increased mortality (OR 2.90, 2.30 to
3.68; I² = 97 per cent; P < 0.001), acute kidney injury (OR
3.75, 2.95 to 4.76; I² = 60 per cent; P < 0.001) and infection
(OR 1.93, 1.17 to 3.18; I² = 99 per cent; P = 0.01). Among
cardiac surgical patients, anaemia was associated with stroke (OR 1.28,
1.06 to 1.55; I² = 0 per cent; P = 0.009) but not myocardial
infarction (OR 1.11, 0.68 to 1.82; I² = 13 per cent; P = 0.67).
Anaemia was associated with an increased incidence of red cell transfusion
(OR 5.04, 4.12 to 6.17; I² = 96 per cent; P < 0.001). Similar
findings were observed in the cardiac and non-cardiac subgroups.
Conclusion Preoperative anaemia is associated with poor outcomes after
surgery, although heterogeneity between studies was significant. It
remains unclear whether anaemia is an independent risk factor for poor
outcome or simply a marker of underlying chronic disease. However, red
cell transfusion is much more frequent amongst anaemic
patients.<br/>Copyright &#xa9; 2015 BJS Society Ltd Published by John
Wiley & Sons Ltd.

<42>
Accession Number
601796531
Title
Systematic review of surgery and outcomes in patients with primary
aldosteronism.
Source
British Journal of Surgery. 102 (4) (pp 307-317 and e190), 2015. Date of
Publication: 01 Mar 2015.
Author
Muth A.; Ragnarsson O.; Johannsson G.; Wangberg B.
Institution
(Muth, Wangberg) Section for Endocrine Surgery and Abdominal Sarcoma,
Department of Surgery, Institute of Clinical Sciences, Gothenburg, Sweden
(Ragnarsson, Johannsson) Section for Endocrinology, Department of
Medicine, University of Gothenburg, Gothenburg, Sweden
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Background: Primary aldosteronism (PA) is the most common cause of
secondary hypertension. The main aims of this paper were to review outcome
after surgical versus medical treatment of PA and partial versus total
adrenalectomy in patients with PA. <br/>Method(s): Relevant medical
literature from PubMed, the Cochrane Library and Embase OvidSP from 1985
to June 2014 was reviewed. <br/>Result(s): Of 2036 records, 43 articles
were included in the final analysis. Twenty-one addressed surgical versus
medical treatment of PA, four considered partial versus total
adrenalectomy for unilateral PA, and 18 series reported on surgical
outcomes. Owing to the heterogeneity of protocols and reported outcomes,
only a qualitative analysis was performed. In six studies, surgical and
medical treatment had comparable outcomes concerning blood pressure,
whereas six showed better outcome after surgery. No differences were seen
in cardiovascular complications, but surgery was associated with the use
of fewer antihypertensive medications after surgery, improved quality of
life, and (possibly) lower all-cause mortality compared with medical
treatment. Randomized studies indicate a role for partial adrenalectomy in
PA, but the high rate of multiple adenomas or adenoma combined with
hyperplasia in localized disease is disconcerting. Surgery for unilateral
dominant PA normalized BP in a mean of 42 (range 20-72) per cent and the
biochemical profile in 96-100 per cent of patients. The mean complication
rate in 1056 patients was 4.7 per cent. <br/>Conclusion(s):
Recommendations for treatment of PA are hampered by the lack of randomized
trials, but support surgical resection of unilateral disease. Partial
adrenalectomy may be an option in selected patients.<br/>Copyright &#xa9;
2015 BJS Society Ltd.

<43>
Accession Number
631569643
Title
Outcomes of preexisting mechanical mitral valve after continuous-flow left
ventricular assist device implantation: A systematic review.
Source
Artificial Organs. Conference: 27th Annual Meeting of the International
Society for Mechanical Circulatory Support. Italy. 44 (3) (pp E101), 2020.
Date of Publication: March 2020.
Author
Gordon J.S.; Wood C.T.; Kalantri N.; Choi J.H.; Maynes E.J.; Morris R.J.;
Samuels L.E.; Massey H.T.; Tchantchaleishvili V.
Institution
(Gordon, Wood, Kalantri, Choi, Maynes, Morris, Samuels, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University Hospital, Philadelphia, PA, United States
Publisher
Blackwell Publishing Inc.
Abstract
Background/Purpose: A preexisting mechanical mitral valve (MMV) is thought
to be a thrombogenic risk factor after continuous-flow left ventricular
assist device (CF-LVAD) implantation despite obligatory anticoagulation
for the CF-LVAD. We sought to evaluate the management and outcomes of
preexisting MMVs in patients undergoing CF-LVAD implantation.
<br/>Method(s): An electronic search was performed to identify all studies
in the English literature examining the presence of an MMV at the time of
CF-LVAD implantation. Identified articles were systematically assessed for
inclusion and exclusion criteria. Of the 1168 studies identified, only 5
studies consisting of seven CF-LVAD patients met the inclusion criteria.
Patient-level data were extracted and analyzed. <br/>Result(s): The median
patient age was 54 years (IQR: 42-61) and 71.4% were male. Nonischemic
cardiomyopathy was the predominant etiology (83.3%), and
bridge-to-transplant the predominant indication (85.7%). Five patients
(71.4%) were implanted with HeartMate 2 LVAD and two with (28.6%)
BerlinHeart Incor. Median time from MMV to CF-LVAD placement was 6.0 years
(IQR: 1.3-15.0). None of the MMVs were replaced with a bioprosthetic valve
at the time of CF-LVAD placement. The median lower and upper INR range was
2.8 (IQR: 2.1-3.0) and 3.5 (IQR: 3.1-3.5), respectively. During the median
follow-up time of 120 days (IQR: 70-201) on CF-LVAD support, there was no
major GI bleed, none of the patients experienced thromboembolic
complications, and none had evidence of mitral valve thrombus. Although,
one patient (14.3%) had a thrombus that developed on a mechanical aortic
valve. In-hospital mortality rate was 14.3% (n = 1). Transplantation
occurred in 42.9% (n = 3) with a median time to transplantation of 219
days (IQR: 157-363). <br/>Conclusion(s): With adequate anticoagulation,
preexisting MMVs in CF-LVAD patients does not appear to result in major
thromboembolic adverse events.

<44>
Accession Number
631569564
Title
Right atrial vs right ventricular heartware HVAD placement in patients
with left-sided heartware hvad: A systematic review.
Source
Artificial Organs. Conference: 27th Annual Meeting of the International
Society for Mechanical Circulatory Support. Italy. 44 (3) (pp E73), 2020.
Date of Publication: March 2020.
Author
Maynes E.J.; Patel P.; Prochno K.W.; Choi J.H.; Morris R.J.; Entwistle
J.W.; Massey H.T.; Tchantchaleishvili V.; O'Malley T.J.
Institution
(Maynes, Patel, Prochno, Choi, Morris, Entwistle, Massey,
Tchantchaleishvili, O'Malley) Division of Cardiac Surgery, Thomas
Jefferson University, Philadelphia, PA, United States
Publisher
Blackwell Publishing Inc.
Abstract
Background/Purpose: In patients who develop refractory right heart failure
following HeartWare HVAD placement, off-label placement of a second
HeartWare HVAD has been described both in right ventricular (RV) and right
atrial (RA) positions. We sought to evaluate and compare the outcomes of
right-sided HeartWare HVAD using the RA vs RV approach. <br/>Method(s): An
electronic search was performed in the English literature to identify all
reports of left and right heart supports with HeartWare HVAD. Of the 1288
articles identified, 13 articles with 56 cases met inclusion criteria.
Patient-level data were extracted and analyzed. <br/>Result(s): Median
patient age was 52 years (IQR 33.0-59.0), and 40/50 (80.0%) were male.
Overall, 21/56 patients (37.5%) had an RA HVAD while 35/56 (62.5%) had an
RV HVAD. Most underwent concomitant HVAD placement [RA: 17/21 (81.0%) vs
RV: 31/35 (88.6%), P =.69]. In those who did not, the median time between
left and right HVAD was 10 days (IQR 7-14) for RA HVAD and 12 days (IQR
7.8-29.2) for RV HVAD (P =.77). Median time of support was 351 days (IQR
136-626) for RA HVAD as opposed to 135 days (IQR 61-244) for RV HVAD (P
=.02). Pump thrombosis occurred at a similar rate [RA: 3/10 (30.0%) vs RV:
6/20 (30.0%), P = 1], as did GI bleeding [RA: 10/35 (28.6%) vs RV: 5/21
(23.8%), P =.94]. Kaplan-Meier analysis showed higher survival with RA
HVAD compared to RV HVAD (P =.05), with an estimated survival at 1 year of
91.7% (95% CI 77.3-100.0) in RA HVAD vs 66.2% (95% CI 48.9-89.6) for RV
HVAD. Cox proportional hazard analysis showed comparable incidence of
heart transplant between the groups (Hazard Ratio 1.01, 95% CI 0.35-2.86).
<br/>Conclusion(s): RA HVAD appears to be a viable option for durable
right-sided support with outcomes at least comparable to RV HVAD.

<45>
Accession Number
631570610
Title
16th International Conference on Pediatric Mechanical Circulatory Support
Systems and Pediatric Cardiopulmonary Perfusion.
Source
Artificial Organs. Conference: 16th International Conference on Pediatric
Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary
Perfusion. United States. 44 (4) (no pagination), 2020. Date of
Publication: 2020.
Author
Anonymous
Publisher
Blackwell Publishing Inc.
Abstract
The proceedings contain 22 papers. The topics discussed include:
mechanical circulatory support on pediatric heart transplant candidates
with elevated pulmonary vascular resistance; novel use of cangrelor in
pediatrics: a case series demonstrating the use in ventricular assist
devices; durable ventricular assist device support for failing Glenn
physiology; stroke on mechanical support: similar survival but higher risk
of stroke posttransplant; is bivalirudin comparable to heparin
anticoagulation for pediatric extracorporeal life support? results from a
high-volume center; ovarian torsion in a teenager on ventricular assist
device therapy; nitric oxide added to the sweep gas of the oxygenator
during cardiopulmonary bypass in infants: a pilot randomized controlled
trial; and evaluation of an anti-hyperfibrinolysis regimen in pediatric
cardiac surgery.

<46>
Accession Number
631570594
Title
Nitric oxide added to the sweep gas of the oxygenator during
cardiopulmonary bypass in infants: A pilot randomized controlled trial.
Source
Artificial Organs. Conference: 16th International Conference on Pediatric
Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary
Perfusion. United States. 44 (4) (pp E185), 2020. Date of Publication:
2020.
Author
Niebler R.A.; Chiang-Ching H.; Daley K.; Janecke R.; Jobe S.M.; Mitchell
M.E.; Varner C.; Woods K.; Scott J.P.
Institution
(Niebler, Jobe, Woods, Scott) Department of Pediatrics, Medical College of
Wisconsin, Milwaukee, WI, United States
(Niebler, Daley, Mitchell, Varner, Scott) Herma Heart Institute,
Children's Wisconsin, Milwaukee, WI, United States
(Chiang-Ching) University of Wisconsin, Milwaukee, WI, United States
(Janecke, Jobe) Versiti Blood Research Institute, Milwaukee, WI, United
States
(Mitchell) Department of Cardiothoracic Surgery, Medical College of
Wisconsin, Milwaukee, WI, United States
(Scott) Department of Anesthesia, Medical College of Wisconsin, Milwaukee,
WI, United States
Publisher
Blackwell Publishing Inc.
Abstract
Objective: To assess the effect of nitric oxide added to the sweep gas of
the oxygenator during cardiopulmonary bypass (CPB) in infants on platelet
count, platelet function, clinical outcomes, and safety. <br/>Method(s):
Randomized, double-blinded, placebo-controlled clinical trial in infants
less than a year of age undergoing cardiac surgery requiring CPB. Nitric
oxide at a dose of 20 ppm was added to the sweep gas in the treatment
group. Blood was collected at baseline and prior to separation from CPB to
measure platelet count and function as determined by responsiveness to
specific agonists. Clinical outcomes were observed through hospital
discharge. Methemoglobin levels were measured preoperatively, at the
conclusion of CPB, and upon admission to the intensive care unit.
<br/>Result(s): Forty patients were consented and were randomized in the
trial. Eighteen patients were randomized to the treatment group and 22
were included in the placebo group. The groups were similar in terms of
age, weight, gender, and surgical complexity. No significant differences
were found in the measures of platelet count, platelet response to
agonist, or clinical outcomes (Table 1). Patients in the treatment group
had higher methemoglobin levels after receiving nitric oxide, but no
levels approached toxicity (maximum 2.4%). <br/>Conclusion(s): Nitric
oxide added to the sweep gas of the oxygenator during CPB in infants did
not have an appreciable effect on the preservation of platelet count,
platelet responsiveness to agonist, or clinical outcomes. Methemoglobin
levels were increased after receiving nitric oxide but were far below a
toxic level of 15%.

<47>
Accession Number
631581834
Title
Australian and New Zealand College of Anaesthetists Annual Scientific
Meeting.
Source
Anaesthesia and Intensive Care. Conference: Annual Scientific Meeting of
the Australian and New Zealand College of Anaesthetists. Australia. 46 (5)
(no pagination), 2018. Date of Publication: September 2018.
Author
Anonymous
Publisher
SAGE Publications Inc.
Abstract
The proceedings contain 22 papers. The topics discussed include: improving
the fidelity of cardiopulmonary exercise testing (CPET) for preoperative
risk assessment in major non-cardiac surgery; time-driven activity based
costing to model the utility of parallel induction room redesign in high
turnover surgical lists; costoclavicular vs paracoracoid approach to
infraclavicular brachial plexus block: a randomized controlled trial;
effect of adding clonidine to ropivacaine in transversus abdominis plane
blocks: a randomized pharmacokinetic study; skin-to-epidural space
distance in pregnancy: stronger association with body mass index than
abdominal subcutaneous fat thickness; pre-operative neurocognitive
impairment and delirium in the post-anesthesia care unit: an observational
study; and simulation to assess latent safety threats and operational
preparedness within anesthetic locations in a new children's hospital.

<48>
Accession Number
631582054
Title
Association of Cerebrovascular Autoregulation and Outcomes after Major
Non-Cardiac Surgery: A Single-Centre Prospective Observational Study.
Source
Anaesthesia and Intensive Care. Conference: 76th National Scientific
Congress of the Australian Society of Anaesthetists. Australia. 46 (1) (pp
120), 2018. Date of Publication: January 2018.
Author
Chuan A.; Short T.G.; Peng A.Z.Y.; Wen S.Y.B.; Sun A.X.; Ting T.H.; Wan
A.S.H.; Pope L.; Jaeger M.; Aneman A.
Institution
(Chuan, Wan, Pope, Aneman) Liverpool Hospital, Sydney, NSW, Australia
(Short) Auckland City Hospital, Auckland, New Zealand
(Peng, Wen, Sun, Ting) University of New South Wales, NSW, Australia
(Jaeger) Wollongong Hospital, Australia
Publisher
SAGE Publications Inc.
Abstract
Introduction: Impaired blood pressure autoregulation causing end organ
ischaemia has been associated with mortality and morbidity, including
acute kidney injury and stroke. Whether impaired cerebrovascular
autoregulation contributes to post-operative cognitive decline after
surgery is unclear, as current studies are equivocal. <br/>Aim(s): The
primary aim of this prospective single centre observational study was to
investigate whether cerebrovascular autoregulation is associated with
failure to recover to pre-operative baseline in the cognition domain of
the Postoperative Quality of Recovery Scale. A secondary aim was to
examine if impaired cerebrovascular autoregulation is associated with
mortality and major morbidity after major elective non-cardiac surgery.
<br/>Method(s): One hundred and forty patients in a single centre were
co-enrolled when recruited to the randomised, double-blinded BALANCED
study on the depth of anaesthesia and mortality and morbidity outcomes in
major noncardiac surgery. Near infrared spectroscopy was used to calculate
the tissue oxygenation index of dynamic autoregulation (TOx). Patients
were ASA physical status 3 or 4, aged >= 60 years, having non-cardiac
surgery >= 2 hours, and expected hospital stay of >= 2 days. The primary
endpoint was Day 3 cognitive recovery. The secondary endpoint was a
combined major adverse event of death, acute myocardial infarction,
cardiac arrest, stroke, pulmonary embolism, sepsis, and acute kidney
injury at Day 30. <br/>Result(s): One hundred and nineteen patients had
valid autoregulation and outcomes data for analysis. Higher optimal TOx
values, signifying impaired autoregulation, was associated with worse
outcomes. Patients who cognitively recovered at Day 3 had lower optimal
TOx values (TOxopt) than patients who did not recover: 0.06 (0.24) versus
0.18 (0.16) (mean [SD]), p = 0.02. Patients who did not suffer a major
adverse event had lower TOxopt than patients who did: 0.09 (0.21) versus
0.20 (0.27), p = 0.04. The mean arterial pressures at optimal
autoregulation (84 to 88 mmHg), and the mean intra-operative TOx values,
were not significantly different between patients for outcomes, all p >
0.18. TOxopt >= 0.1 correctly identified 72.7% of patients who did not
cognitively recover, OR 3.3 (1.1 - 9.9) (Odds ratio, [95% CI]), p = 0.03.
TOxopt >= 0.1 correctly identified 82.4% of patients who suffered a major
adverse event, OR 4.7 (1.3 - 17.2), p = 0.02. <br/>Conclusion(s): In older
and higher risk patients having major non-cardiac surgery, impaired
cerebrovascular autoregulation was associated with failure of cognitive
recovery in the early post-operative period, and with mortality and
morbidity at Day 30.

<49>
Accession Number
631582048
Title
Comparison of the effect of etomidate and thiopentone on left ventricular
strain and strain rate at the time of anesthesia induction in patients
undergoing elective coronary artery bypass grafting: A randomized double
blind controlled trial.
Source
Anaesthesia and Intensive Care. Conference: 76th National Scientific
Congress of the Australian Society of Anaesthetists. Australia. 46 (1) (pp
119), 2018. Date of Publication: January 2018.
Author
Choudhury M.
Institution
(Choudhury) Department of Cardiac Anesthesia, Cardiothoracic Sciences
Centre, All India Institute of Medical Sciences, India
Publisher
SAGE Publications Inc.
Abstract
Introduction: Hemodynamic disturbances and myocardial dysfunction due to
anesthetic during anesthesia induction has been largely overlooked because
induction phase is usually of short duration and there is a lack of easily
available evaluation tool for detection of real time impact of hypnotic
agent on myocardial performance. 2D Speckle tracking echocardiography
(STE) derived myocardial deformation parameters (strain and strain rate)
provides real time myocardial function, is a feasible and reliable tool
for assessment of myocardial performance perioperatively. <br/>Aim(s): To
evaluate and compare the effect of etomidate (E) and thiopentone(T) on
left ventricular strain and strain rate by 2 D STE at the time of
anesthesia induction in patient undergoing elective coronary artery bypass
grafting (CABG) in a randomized double blinded trial. <br/>Method(s):
After approval from ethical committee, and written informed consent we
randomized 98 patients preoperatively into two groups depending upon the
induction agent they received (Group E, N = 39 or Group T, N = 39). Serial
2 D transthoracic echocardiography was done and loops acquired before
(T0), and one min after injection of induction agents along with
hemodynamic recording at the same point of time. Three loops with three
different views (apical four chambers, apical two chambers and apical long
axis) were saved for offline speckle tracking analysis in the QLAB 7.0
workstation. Appropriate statistical tests were applied and a p value of <
0.05 was considered to be significant. <br/>Result(s): A total of 60
patients were analysed due to dropout. The groups had comparative
demographics and preoperative hemodynamic variables. In group T, a
significant decrease in index of contractility (ICON) (p=0.005) and
systemic vascular resistance index (SVRI) (p=0.002) from the base line was
occurred during post induction; whereas in group E, there was a decrease
in cardiac performance index CPI) and (p=0.032) and cardiac index (CI)
(p=0.027). The following table shows the echocardiographic parameters at
different time points. <br/>Conclusion(s): Most of the STE parameters were
suggestive of preserved myocardial function after etomidate injection.
After injection of thiopentone STE parameters revealed a significant
decrease in myocardial contractility and ICON value also supported the
same. A reduction in SVRI and increase in HR at the same time resulted in
maintained CI and unchanged CPI. This suggests that the depressive effect
of thiopentone on myocardium does not impair overall cardiovascular
function in patient with normal LV. This implies that both the induction
drugs relieve myocardial stress well at the time of induction and equally
safe in patients with preserved LV systolic function suffering from
ischemic heart disease.

<50>
Accession Number
631582045
Title
Cystatin C following Perioperative Dexmedetomidine Therapy in Patients
undergoing Valve Surgery - A Randomized Control Trial.
Source
Anaesthesia and Intensive Care. Conference: 76th National Scientific
Congress of the Australian Society of Anaesthetists. Australia. 46 (1) (pp
118-119), 2018. Date of Publication: January 2018.
Author
Das S.; Makhija N.; Airan B.; Lakshmy R.; Sharma G.
Institution
(Das, Makhija, Airan, Lakshmy, Sharma) All India Institute of Medical
Sciences, New Delhi, India
Publisher
SAGE Publications Inc.
Abstract
Introduction: Dexmedetomidine is used in anaesthesia practice for
sedation, induction of anesthesia and adjuvant to regional as well as
general analgesia and anesthesia. In addition, dexmedetomidine is now used
in cardiac anesthesia for attenuation of stress, inflammation,
tachyarrhythmia and delirium. Patients undergoing valve heart surgery are
with chronic heart failure, pulmonary, renal and hepatic congestion.
Cystatin C is an established biomarker of renal injury. We hypothesized
that dexmedetomidine, being a alpha2 agonist can protect the renal injury
resulting from cardiopulmonary bypass during valve surgery. <br/>Aim(s):
To evaluate the effect perioperative dexmedetomidine therapy on Cystatin C
level, as a marker of renal injury in patients undergoing valvular heart
surgery. <br/>Method(s): The study was designed as prospective randomized
controlled trial (RCT), double blind and single centre study. 110 patients
undergoing valve surgery were included and divided into control (Group-1;
n=55) and intervention or dexmedetomidine (group-2; n=55) group. The
intervention group was administered dexmedetomidine 0.5mug/kg slowly over
10 minutes as bolus before induction of anesthesia; followed by 0.5
mug/kg/hr throughout the surgery and in ICU till tracheal extubation. In
control group a similar bolus and infusion of normal saline was continued.
Blood samples were collected at before induction of anesthesia, 30min
after cardiopulmonary bypass and 24hr after surgery for estimation of
cystatin C level between two groups. Two groups were analysed and compared
with SPSS 20. P<0.05 was considered significant. <br/>Result(s): All the
110 patients completed the study. Demographic parameters, surgery and
cardiopulmonary bypass duration between the groups were comparable.
Cystatin C level between group1 and 2 were 1051.4+/- 227.9 vs
1090.6+/-204.2mug/L; p=0.471 at base line, 1048.6+/- 148.1 vs 848.4+/-
141.2 mug/L; p=0.001 at 30min after CPB and 1139 +/- 150.5 vs 838.5 +/-
162.2 mug/L; p=0.000 at 24h after surgery (table 1). The values of urea
and creatinine were significantly (p<0.05) less after 24h in
dexmedetomidine group. No patient in both groups developed acute renal
failure requiring renal replacement therapy. <br/>Conclusion(s):
Dexmedetomidine therapy reduces the rise in serum level of Cystatin C in
patients undergoing valvular heart surgery. Dexmedetomidine therapy is
safe and effective in protecting kidneys during cardiopulmonary bypass in
valve surgery.

<51>
Accession Number
631582006
Title
Hydroxycobalamin for Post-Cardiotomy Vasoplegia: Vitamin B12 to the
rescue.
Source
Anaesthesia and Intensive Care. Conference: 76th National Scientific
Congress of the Australian Society of Anaesthetists. Australia. 46 (1) (pp
111-112), 2018. Date of Publication: January 2018.
Author
Nelson J.; Armour S.; Armour T.
Institution
(Nelson, Armour, Armour) Mayo Clinic, Rochester, MN, United States
Publisher
SAGE Publications Inc.
Abstract
Introduction: Vasoplegic Syndrome (VS) is defined as hypotension
refractory to vasopressor administration in the setting of a normal
cardiac index, and adequate volume status. It remains a clinical diagnosis
and is quite common post cardiac surgery with an incidence of 9%-44%
depending on the population studied1,2. Mortality approaches 25% in
patients with vasoplegia resistant to catecholamine therapy for longer
than 36-48 hrs3. Typically treatment involves volume status optimization
and a combination of vasopressors and inotropes. One proposed mechanism is
activation of inducible nitric oxide synthase (NOS). This led to usage of
methylene blue (MB), a NOS inhibitor, as a "rescue medication" in patients
with catecholamine resistant VS. Although several studies have
demonstrated benefit with MB use in this population, concerns regarding
precipitation of serotonin syndrome, interference with pulse oximetry and
pulmonary hypertension remain. Hydroxocobalamin, which is thought to have
a similar mechanism of action4, has emerged as a possible alternative5,6.
We present an observational study assessing blood pressure as well as
vasopressor and inotropic support before and after hydroxocobalamin
administration. <br/>Aim(s): Assessment of hemodynamic response and
vasopressor requirement in patients receiving hydroxocobalamin with
post-cardiotomy VS. <br/>Method(s): Post cardiac surgical patients
received 5g of hydroxocobalamin if i) on at least two high dose
vasopressors and ii) experienced hypotension consistent with VS (defined
as a MAP < 65mmHg, SVRI dynes*sec*cm5/m2 and CI > 2.4L/min/m2).
Hemodynamically unstable patients who did not meet the stated criteria but
who were thought to have VS were also given hydroxocobalamin at the
discretion of the primary anesthesiologist. Pediatric patients or those
who received hydroxocobalamin while on mechanical circulatory support were
excluded. <br/>Result(s): Analysis of the first 10 patients was performed
with complete analysis to follow. Figure 1 shows average mean arterial
blood pressure and vasopressor doses of the 10 patient cohort in 30 minute
increments, 60 minutes prior through to 240 minutes post administration.
Mean blood pressure increased significantly from 60.1 (SD 5.2) mmHg 30
minutes prior to administration to 87.0 (SD 16.7) mmHg 30 minutes after
administration (p=0.0001). The increase in MAP was sustained but
diminished over 4 hours, consistent with the known duration of action of
hydroxocobalamin. Of note, norepinephrine requirements declined over the
same time period from a mean of 0.15 (SD 0.07) mcg/kg/min to 0.12 (SD
0.06) mcg/kg/min. <br/>Conclusion(s): Hydroxocobalamin for catecholamine
resistant vasoplegic syndrome may be a safe and effective therapeutic
option. Further study is warranted in larger randomized controlled trials.

<52>
Accession Number
631580324
Title
Evaluating the Therapeutic Efficacy and Safety of Landiolol Hydrochloride
for Management of Arrhythmia in Critical Settings: Review of the
Literature.
Source
Vascular health and risk management. 16 (pp 111-123), 2020. Date of
Publication: 2020.
Author
Matsuishi Y.; Mathis B.J.; Shimojo N.; Kawano S.; Inoue Y.
Institution
(Matsuishi, Shimojo, Kawano, Inoue) Department of Emergency and Critical
Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba,
Ibaraki, Japan
(Mathis) Medical English Communication Center, Faculty of Medicine,
University of Tsukuba, Tsukuba, Ibaraki, Japan
Publisher
NLM (Medline)
Abstract
Background: Landiolol hydrochloride, a highly cardio-selective beta-1
blocker with an ultra-short-acting half-life of 4 minutes, was originally
approved by Japan for treatment of intraoperative tachyarrhythmias. This
review aims to provide an integrated overview of the current state of
knowledge of landiolol hydrochloride in the management of arrhythmia in
critical settings. <br/>Method(s): We searched MEDLINE, EMBASE, and the
Cochrane Library to retrieve relevant articles with a total of 65 records
identified. <br/>Result(s): The high beta1 selectivity (beta1/beta2 ratio
of 255:1) of landiolol causes a more rapid heart rate (HR) decrease
compared to esmolol while avoiding decreases in mean arterial blood
pressure. Recently, it has been found useful in left ventricular
dysfunction patients and fatal arrhythmia requiring emergency treatment.
Recent random clinical trials (RCT) have revealed therapeutic and
prophylactic effects on arrhythmia, and very low-dose landiolol might be
effective for preventing postoperative atrial fibrillation (POAF) and
sinus tachycardia. Likewise, landiolol is an optimal choice for
perioperative tachycardia treatment during cardiac surgery. The high beta1
selectivity of landiolol is useful in heart failure patients as a
first-line therapy for tachycardia and arrhythmia as it avoids the typical
depression of cardiac function seen in other beta-blockers. Application in
cardiac injury after percutaneous coronary intervention (PCI), protection
for vital organs (lung, kidney, etc.) during sepsis, and stabilizing
hemodynamics in pediatric patients are becoming the new frontier of
landiolol use. <br/>Conclusion(s): Landiolol is useful as a first-line
therapy for the prevention of POAF after cardiac/non-cardiac surgery,
fatal arrhythmias in heart failure patients and during PCI. Moreover, the
potential therapeutic effect of landiolol for sepsis in pediatric patients
is currently being explored. As positive RCT results continue to be
published, new clinical uses and further clinical studies in various
settings by cardiologists, intensivists and pediatric cardiologists are
being conducted.<br/>Copyright &#xa9; 2020 Matsuishi et al.

<53>
Accession Number
631570898
Title
Dextran- versus crystalloid-based prime in cardiac surgery: A prospective
randomized pilot study.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 14 Apr 2020.
Author
Barbu M.; Kolsrud O.; Ricksten S.-E.; Dellgren G.; Zetterberg H.; Blennow
K.; Bjork K.; Thoren A.; Hansson C.; Jeppsson A.
Institution
(Barbu) Department of Cardiology, Blekinge Hospital, Karlskrona, Sweden;
Department of Molecular and Clinical Medicine, Institute of Medicine,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Kolsrud, Bjork, Hansson) Department of Cardiothoracic Surgery,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Ricksten) Department of Cardiothoracic Anaesthesia and Intensive Care,
Sahlgrenska University Hospital, Gothenburg, Sweden; Department of
Anesthesiology and Intensive Care, Institute of Clinical Sciences,
University of Gothenburg, Gothenburg, Sweden
(Dellgren, Jeppsson) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden; Department of Cardiothoracic Surgery, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Zetterberg, Blennow) Clinical Neurochemistry Laboratory, Sahlgrenska
University Hospital, Molndal, Sweden; Department of Psychiatry and
Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska
Academy, University of Gothenburg, Molndal, Sweden
(Thoren) Department of Cardiothoracic Anaesthesia and Intensive Care,
Sahlgrenska University Hospital, Gothenburg, Sweden
Publisher
NLM (Medline)
Abstract
BACKGROUND: The optimum priming fluid for the cardiopulmonary bypass (CPB)
circuit is still debated. We compared a new hyperoncotic priming solution
containing dextran 40, which has an electrolyte composition that mimics
extracellular fluid, with a standard crystalloid-based prime.
<br/>METHOD(S): Eighty cardiac surgery patients were included in this
double-blind randomized single-centre study. The patients were randomized
to either a dextran-based prime or a crystalloid prime containing Ringer
acetate and mannitol. The primary endpoint was colloid oncotic pressure
(COP) in serum during CPB. Secondary endpoints included fluid balance,
bleeding and transfusion requirements, pulmonary function, hemolysis,
systemic inflammation, and markers of renal, hepatic, myocardial, and
brain injury. Blood samples were collected before, during, and after CPB.
<br/>RESULT(S): COP was higher in the dextran group than in the
crystalloid prime group on CPB (18.8+/-2.9 vs. 16.4+/-2.9 mmHg, p<0.001)
and 10 min after CPB (19.2+/-2.7 vs. 16.8+/-2.9 mmHg, p<0.001). Patients
in the dextran group required less intravenous fluid during CPB
(1090+/-499 vs. 1437+/-543 ml; p=0.003) and net fluid balance was less
positive 12h after surgery (+1,431+/-741 vs. +1,901+/-922 ml; p=0.014).
Plasma free hemoglobin was significantly lower in the dextran group 2h
after CPB (0.18+/-0.11 vs 0.41+/-0.33, p=0.001). There were no significant
differences in bleeding, transfusion requirements, organ function,
systemic inflammation, or brain and myocardial injury markers between the
groups at any time point. <br/>CONCLUSION(S): Our results suggest that a
hyperoncotic dextran-based priming solution preserves intraoperative COP
compared to crystalloid prime. Larger studies with clinically valid
endpoints are necessary to evaluate hyperoncotic prime solutions
further.<br/>Copyright &#xa9; 2020. Published by Elsevier Inc.

<54>
Accession Number
2005667780
Title
Transcatheter Aortic Valve Replacement in Low-Risk Patients With
Symptomatic Severe Bicuspid Aortic Valve Stenosis.
Source
JACC: Cardiovascular Interventions. 13 (9) (pp 1019-1027), 2020. Date of
Publication: 11 May 2020.
Author
Waksman R.; Craig P.E.; Torguson R.; Asch F.M.; Weissman G.; Ruiz D.;
Gordon P.; Ehsan A.; Parikh P.; Bilfinger T.; Levitt R.; Hahn C.; Roberts
D.; Ingram M.; Hanna N.; Comas G.; Zhang C.; Ben-Dor I.; Satler L.F.;
Garcia-Garcia H.M.; Shults C.; Rogers T.
Institution
(Waksman, Craig, Torguson, Ruiz, Zhang, Ben-Dor, Satler, Garcia-Garcia,
Rogers) Section of Interventional Cardiology, MedStar Washington Hospital
Center, Washington, DC, United States
(Asch) MedStar Health Research Institute, MedStar Washington Hospital
Center, Washington, DC, United States
(Weissman) Department of Cardiology, MedStar Washington Hospital Center,
Washington, DC, United States
(Gordon) Division of Cardiology, The Miriam Hospital, Providence, RI,
United States
(Ehsan) Division of Cardiothoracic Surgery, Lifespan Cardiovascular
Institute, Providence, RI, United States
(Parikh) Department of Medicine, Stony Brook Hospital, Stony Brook, NY,
United States
(Bilfinger) Department of Surgery, Stony Brook Hospital, Stony Brook, NY,
United States
(Levitt) Department of Cardiology, Henrico Doctors' Hospital, Richmond,
VA, United States
(Hahn) Department of Cardiothoracic Surgery, Henrico Doctors' Hospital,
Richmond, VA, United States
(Roberts, Ingram) Sutter Medical Center, Sacramento, Sutter Heart and
Vascular Institute, Research, Sacramento, CA, United States
(Hanna) St. John Heart Institute Cardiovascular Consultants, St. John
Health System, Tulsa, OK, United States
(Comas) St. John Clinic Cardiovascular Surgery, St. John Heart Institute
Cardiovascular Consultants, St. John Health System, Tulsa, OK, United
States
(Shults) Department of Cardiac Surgery, MedStar Washington Hospital
Center, Washington, DC, United States
(Rogers) Cardiovascular Branch, Division of Intramural Research, National
Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda,
MD, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The aim of this study was to evaluate clinical outcomes and
transcatheter heart valve hemodynamic parameters after transcatheter
aortic valve replacement (TAVR) in low-risk patients with bicuspid aortic
stenosis (AS). <br/>Background(s): TAVR is approved for low-risk patients
in the United States. However, patients with bicuspid AS were excluded
from the randomized cohorts of the pivotal low-risk trials.
<br/>Method(s): The LRT (Low Risk TAVR) trial was an
investigator-initiated, prospective, multicenter study and was the first
and only U.S. Food and Drug Administration-approved investigational device
exemption trial to evaluate the feasibility of TAVR with either
balloon-expandable or self-expanding valves in low-risk patients with
bicuspid AS. The primary endpoint was all-cause mortality at 30 days.
Baseline and follow-up echocardiography and computed tomography to detect
leaflet thickening were analyzed in an independent core laboratory.
<br/>Result(s): Sixty-one low-risk patients with symptomatic, severe AS
and bicuspid aortic valves (78.3% Sievers type 1 morphology) underwent
TAVR at 6 centers from 2016 to 2019. The mean age was 68.6 years, and
42.6% were men. At 30 days, there was zero mortality and no disabling
strokes. The rate of new permanent pacemaker implantation was 13.1%; just
1 patient had a moderate paravalvular leak at 30 days. Hypoattenuated
leaflet thickening was observed in 10% of patients at 30 days.
<br/>Conclusion(s): TAVR appears to be safe in patients with bicuspid AS,
with short length of hospital stay, zero mortality, and no disabling
strokes at 30 days. Subclinical leaflet thrombosis was observed in a
minority of patients at 30 days but did not appear to be associated with
clinical events.<br/>Copyright &#xa9; 2020

<55>
Accession Number
2005685109
Title
Sugammadex versus neostigmine for reversal of rocuronium-induced
neuromuscular blockade: A randomized, double-blinded study of thoracic
surgical patients evaluating hypoxic episodes in the early postoperative
period.
Source
Journal of Clinical Anesthesia. 64 (no pagination), 2020. Article Number:
109804. Date of Publication: September 2020.
Author
Moon T.S.; Reznik S.; Pak T.; Jan K.; Pruszynski J.; Kim A.; Smith K.M.;
Lu R.; Chen J.; Gasanova I.; Fox P.E.; Ogunnaike B.
Institution
(Moon, Pak, Jan, Kim, Smith, Lu, Chen, Gasanova, Fox, Ogunnaike)
University of Texas Southwestern Medical Center, Department of
Anesthesiology and Pain, 5323 Harry Hines Boulevard, Dallas, TX 75390,
United States
(Reznik, Pruszynski) University of Texas Southwestern Medical Center,
Department of Cardiovascular and Thoracic Surgery, 5323 Harry Hines
Boulevard, Dallas, TX 75390, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Study objective: This objective of this study was to determine if reversal
of rocuronium-induced neuromuscular blockade with sugammadex versus
neostigmine results in a decreased number of hypoxic episodes in the early
postoperative period in patients undergoing thoracic surgery with single
lung ventilation. <br/>Design(s): Single-center, randomized, double-blind,
two-arm clinical trial. <br/>Setting(s): Operating room and postanesthesia
care unit. <br/>Patient(s): 92 subjects aged >=18, American Society of
Anesthesiologists physical status II-IV, and undergoing a thoracic
operation necessitating single lung ventilation. <br/>Intervention(s):
Subjects received either 2 mg/kg sugammadex or 50 mug/kg neostigmine with
8 mug/kg glycopyrrolate for reversal of moderate neuromuscular blockade.
Measurements: For the first 90 min postoperatively, all episodes of
hypoxia were recorded. Neuromuscular monitoring was performed with
acceleromyography (TOF-Watch SX) and the train of four (TOF) was recorded
at 2, 5, 10, and 15 min after administration of the neuromuscular reversal
agent. <br/>Main Result(s): Subjects who received neostigmine had a median
of 1 episode (interquartile range IQR: 0-2.2) of hypoxia versus subjects
who received sugammadex who had a median of 0 episodes (IQR: 0-1) (p =
0.009). The mean time to recovery of TOF >= 0.9 was significantly faster
with sugammadex at 10 min (95% confidence interval CI: 5-15) compared with
neostigmine at 40 min (95% CI: 15-53) (p < 0.001). <br/>Conclusion(s): In
thoracic surgical patients necessitating single lung ventilation,
sugammadex provides faster reversal of moderate neuromuscular blockade and
results in a decreased number of postoperative hypoxic episodes compared
with neostigmine.<br/>Copyright &#xa9; 2020

<56>
Accession Number
2005700310
Title
Safety and Haemodynamic Outcomes of Currently Available Suture-less Aortic
Valves in Patients With Aortic Stenosis: A Meta-analysis.
Source
Heart Lung and Circulation. (no pagination), 2020. Date of Publication:
2020.
Author
Amer M.; Al Jawad M.A.; Omar A.; Metwaly H.
Institution
(Amer) Mahala Cardiac Center, El Gharbeya, Egypt
(Al Jawad, Omar, Metwaly) Department of Cardio-Thoracic Surgery, Faculty
of Medicine, Ain Shams University, Cairo, Egypt
Publisher
Elsevier Ltd
Abstract
Background: Suture-less aortic valves aim to achieve better outcomes and
to aid and facilitate the minimally invasive aortic valve replacement
procedure by tackling the issue of cross-clamp time, which is an
independent predictor of postoperative outcomes, especially in patients
with serious comorbidities. By reducing the number of sutures, the time
for suture placement is reduced. Our meta-analysis tried to assess the
safety and haemodynamic performance of the suture-less aortic valve
prostheses to ascertain their benefits as a viable alternative to current
established measures. <br/>Method(s): From their inceptions to February
2017, six electronic databases were searched. Relevant studies using
commercially accessible suture-free valves to replace the aortic valve
have been recognised. Based on the predefined end points, data were
collected and analysed. <br/>Result(s): For incorporation in qualitative
and quantitative analyses, 24 studies were recognised, with a total number
of 5,073 patients undergoing suture-less aortic valve replacement.
Mortality incidence at the 30-day and 12-month follow-ups were 2.5% and
2.7%, respectively, while the incidences of thromboembolic events (1.6%)
and paravalvular leak (0.5%) were acceptable. <br/>Conclusion(s): Current
available evidence indicates that sutureless aortic valve replacement is a
safe operation showing low mortality and complication rates, with
satisfactory haemodynamic performance.<br/>Copyright &#xa9; 2020
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<57>
Accession Number
2004724161
Title
Differences in morbidity and mortality in Down syndrome are related to the
type of congenital heart defect.
Source
American Journal of Medical Genetics, Part A. (no pagination), 2020. Date
of Publication: 2020.
Author
Baban A.; Olivini N.; Cantarutti N.; Cali F.; Vitello C.; Valentini D.;
Adorisio R.; Calcagni G.; Alesi V.; Di Mambro C.; Villani A.; Dallapiccola
B.; Digilio M.C.; Marino B.; Carotti A.; Drago F.
Institution
(Baban, Olivini, Cantarutti, Cali, Vitello, Adorisio, Calcagni, Di Mambro,
Drago) Pediatric Cardiology and Cardiac Arrhythmias Unit, Department of
Pediatric Cardiology and Cardiac Surgery, Bambino Gesu Children's
Hospital, IRCCS, Rome, Italy
(Valentini, Villani) Pediatric and Infectious Disease Unit, Bambino Gesu
Children's Hospital, IRCCS, Rome, Italy
(Alesi, Digilio) Medical Genetics Unit, Medical Genetics Laboratory,
Pediatric Cardiology, Bambino Gesu Children's Hospital, IRCCS, Rome, Italy
(Dallapiccola) Scientific Directorate, Bambino Gesu Children's Hospital,
IRCCS, Rome, Italy
(Marino) Department of Pediatrics, Sapienza University of Rome, Rome,
Italy
(Carotti) Pediatric Cardiac Surgery Unit, Department of Pediatric
Cardiology and Cardiac Surgery, Bambino Gesu Children's Hospital, IRCCS,
Rome, Italy
Publisher
Wiley-Liss Inc. (E-mail: info@wiley.com)
Abstract
Morbidity and mortality in Down syndrome (DS) are mainly related to
congenital heart defects (CHDs). While CHDs with high prevalence in DS
(typical CHDs), such as endocardial cushion defects, have been extensively
described, little is known about the impact of less common CHDs (atypical
CHDs), such as aortic coarctation and univentricular hearts. In our
single-center study, we analyzed, in observational, retrospective manner,
data regarding cardiac features, surgical management, and outcomes of a
cohort of DS patients. Literature review was performed to investigate
previously reported studies on atypical CHDs in DS. Patients with CHDs
were subclassified as having typical or atypical CHDs. Statistical
analysis was performed for comparison between the groups. The study
population encompassed 859 DS patients, 72.2% with CHDs, of which 4.7%
were atypical. Statistical analysis showed a significant excess in
multiple surgeries, all-cause mortality and cardiac mortality in patients
with atypical CHDs (p =.0067, p =.0038, p =.0001, respectively). According
to the Kaplan-Meier method, survival at 10 and 40 years was significantly
higher in typical CHDs (99 and 98% vs. 91 and 84%, log rank <0.05). Among
atypical CHDs, it seems that particularly multiple complex defects in
univentricular physiology associate with a worse outcome. This may be due
to the surgical difficulty in managing univentricular hearts with multiple
defects concurring to the clinical picture or to the severity of
associated defects themselves. Further studies need to address this
specific issue, also considering the higher pulmonary pressures, infective
complications, and potential comorbidities in DS patients.<br/>Copyright
&#xa9; 2020 Wiley Periodicals, Inc.

<58>
Accession Number
2004700450
Title
Dexmedetomidine in the prevention of postoperative delirium in elderly
patients following non-cardiac surgery: A systematic review and
meta-analysis.
Source
Clinical and Experimental Pharmacology and Physiology. (no pagination),
2020. Date of Publication: 2020.
Author
Shen Q.-H.; Li H.-F.; Zhou X.-Y.; Yuan X.-Z.
Institution
(Shen, Zhou, Yuan) Department of Anesthesiology, The First Hospital of
Jiaxing, Affiliated Hospital of Jiaxing University, Zhejiang, China
(Li) Department of Gynecology, Tongxiang Maternal and Child Health Care
Hospital, Tongxiang, China
Publisher
Blackwell Publishing
Abstract
The efficacy of dexmedetomidine in the prevention of postoperative
delirium (POD) remains ambiguous, however, it has been used to reduce the
incidence of delirium in elderly patients. Here, we conducted a
meta-analysis study for assessing the effects of dexmedetomidine on POD
among elderly patients following non-cardiac surgery. A systematic
literature search was performed against the PubMed, EMBASE, Cochrane
Library, and Web of Science databases, and all relevant literature
published till November 30, 2019, were considered. Our analysis included
16 randomised controlled trials conducted with 4534 patients for exploring
the effects of dexmedetomidine on POD in elderly patients following
non-cardiac surgery. It was observed that the overall incidence of POD was
significantly lower in the dexmedetomidine group than in the control group
(risk ratio [RR] 0.51, 95% confidence interval [CI] 0.43-0.61, P <.01).
Similar results were obtained from subgroup analysis upon comparison of
the placebo (RR 0.52, 95% CI 0.41-0.66, P <.01, moderate quality of
evidence), propofol-treated (RR 0.55, 95% CI 0.38-0.78, P <.01, low
quality of evidence), and midazolam-treated (RR 0.38, 95% CI 0.20-0.71, P
<.01, low quality of evidence) groups. Trial sequential analysis revealed
that the cumulative z-value superseded the monitoring boundary and reached
the required information size. However, patients who received
dexmedetomidine had a higher incidence of bradycardia and hypotension. In
conclusion, the meta-analysis revealed that dexmedetomidine appears to
decrease the risk of POD in elderly patients following non-cardiac
surgery. However, as some of the studies were heterogeneous and of low
quality, high-quality trials are necessary for drawing more definitive
conclusions.<br/>Copyright &#xa9; 2020 John Wiley & Sons Australia, Ltd

<59>
Accession Number
631578039
Title
Major adverse cardiovascular events associated with postoperative atrial
fibrillation after noncardiac surgery a systematic review and
meta-analysis.
Source
Circulation: Arrhythmia and Electrophysiology. (no pagination), 2020.
Article Number: e007437. Date of Publication: 2020.
Author
AlTurki A.; Marafi M.; Proietti R.; Cardinale D.; Blackwell R.; Dorian P.;
Bessissow A.; Vieira L.; Greiss I.; Essebag V.; Healey J.S.; Huynh T.
Institution
(AlTurki, Essebag, Huynh) Division of Cardiology, McGill University Health
Center, Montreal, QC, Canada
(Bessissow) Division of General Internal Medicine, McGill University
Health Center, Montreal, QC, Canada
(Marafi, Vieira) Department of Neurology and Neurosurgery, Montreal
Neurological Institute, QC, Canada
(Proietti) Department of Cardiac, Thoracic and Vascular Sciences,
University of Padua, Italy
(Cardinale) Cardioncology Unit, European Institute of Oncology, I.R.C.C.S,
Milan, Italy
(Blackwell) Department of Urology, Loyola University Health Center,
Chicago, IL, United States
(Dorian) Division of Cardiology, St Michael's Hospital, University of
Toronto, ON, Canada
(Greiss) Division of Cardiology, Univerity of Montreal Health Centre, QC,
Canada
(Healey) Population Health Research Institute, McMaster University,
Hamilton, ON, Canada
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) is a frequent
occurrence after noncardiac surgery. It remains unclear whether POAF is
associated with an increased risk of major adverse events. We aimed to
elucidate the risk of stroke, myocardial infarction, and death associated
with POAF following noncardiac surgery by a meta-analysis of randomized
controlled studies and observational studies. <br/>METHOD(S): We searched
electronic databases from inception up to August 1, 2019 for all studies
that reported stroke or myocardial infarction in adult patients who
developed POAF following noncardiac surgery. We used random-effects models
to summarize the studies. <br/>RESULT(S): The final analyses included 28
studies enrolling 2612816 patients. At 1-month (10 studies), POAF was
associated with an =3-fold increase in the risk of stroke (weighted mean
2.1% versus 0.7%; odds ratio [OR], 2.82 [95% CI, 2.15-3.70]; P<0.001).
POAF was associated with =4-fold increase in the long-term risk of stroke
with (weighted mean, 2.0% versus 0.6%; OR, 4.12 [95% CI, 3.32-5.11];
P<=0.001) in 8 studies with >=12-month follow-up. There was a significant
overall increase in the risk of stroke and myocardial infarction
associated with POAF (weighted mean, 2.5% versus 0.9%; OR, 3.44 [95% CI,
2.38-4.98]; P<0.001) and (weighted mean, 12.6% versus 2.7%; OR, 4.02 [95%
CI, 3.08-5.24]; P<0.001), respectively. Furthermore, POAF was associated
with a 3-fold increase in all-cause mortality at 30 days (weighted mean,
15.0% versus 5.4%; OR, 3.36 [95% CI, 2.13-5.31]; P<0.001).
<br/>CONCLUSION(S): POAF was associated with markedly higher risk of
stroke, myocardial infarction, and all-cause mortality following
noncardiac surgery. Future studies are needed to evaluate the impact of
optimal cardiovascular pharmacotherapies to prevent POAF and to decrease
the risk of major adverse events in these high-risk patients. VISUAL
OVERVIEW: A visual overview is available for this article.<br/>Copyright
&#xa9; 2020 American Heart Association, Inc.

<60>
[Use Link to view the full text]
Accession Number
631571348
Title
Impact of induction immunosuppression on post-transplant outcomes of
patients bridged with contemporary left ventricular assist devices.
Source
ASAIO Journal. (pp 261-267), 2020. Date of Publication: 2020.
Author
Truby L.K.; Batra J.; Jennings D.L.; Takeda K.; Defilippis E.M.; Takayama
H.; Naka Y.; Farr M.A.; Topkara V.K.
Institution
(Truby) Division of Cardiology, Department of Medicine, Duke University
Medical Center, Durham, NC, United States
(Batra, Jennings, Defilippis, Farr, Topkara) Division of Cardiology,
Department of Medicine, Columbia University College of Physicians and
Surgeons, New York, NY, United States
(Takeda, Takayama, Naka) Division of Cardiothoracic Surgery, Department of
Surgery, Columbia University College of Physicians and Surgeons, New York,
NY, United States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
For patients bridged to transplant (BTT) with left ventricular assist
devices (LVAD), data regarding the use of induction immunosuppressive
therapy remain limited. The objectives of the current study were to
describe the current trends and clinical consequences of IT in patients
BTT with LVAD. The United Network of Organ Sharing database was queried to
identify adult, single-organ heart transplant recipients who were BTT with
LVAD between 2008 and 2018. Propensity score matching was then used to
balance clinical covariates between those patient who did and did not
receive IT. The primary outcomes of interest were graft survival,
hospitalization for rejection and infection, and freedom from transplant
coronary artery disease (TCAD). In the overall cohort, 49.1% (n = 3,978)
received IT, with basiliximab being the most commonly used agent followed
by antithymocyte globulin. After propensity score matching, 4,388 patients
(2,194 without induction and 2,194 with induction) were identified.
Between those who did and did not receive IT, there was no significant
difference in graft survival, freedom from hospitalization for rejection,
and freedom from hospitalization for infection. Patients who received IT
experienced increased freedom from TCAD (p = 0.004) with unadjusted hazard
ratio of 0.81 (95% Cardiac Index: 0.70-0.93). For freedom from TCAD,
antithymocyte globulin was associated with better outcomes than
basiliximab (80.2% vs. 73.1% at 5 years, log rank p value = 0.004). In a
sensitivity analysis, there was no significant increase in hospitalization
for infection in those patients with an infected LVAD before transplant.
Use of induction therapy in patients BTT with LVAD appears to be safe and
feasible, without a significant increase in the risk of infection or
rejection, even in those patients with pretransplant device-related
infections. IT, particularly antithymocyte globulin, was associated with
increased time to development of TCAD. Routine use of IT in patients BTT
with LVAD may be considered, and further randomized control trials are
warranted to further support these data.<br/>Copyright &#xa9; 2020 by the
ASAIO

<61>
Accession Number
631577896
Title
Everolimus initiation with early calcineurin inhibitor withdrawal in de
novo heart transplant recipients: Long-term Follow-up from the Randomized
SCHEDULE Study.
Source
Transplantation. (pp 154-164), 2019. Date of Publication: 2019.
Author
Gustafsson F.; Andreassen A.K.; Andersson B.; Eiskjaer H.; Radegran G.;
Gude E.; Jansson K.; Solbu D.; Karason K.; Arora S.; Dellgren G.;
Gullestad L.; Larsen L.; Sigurdardottir V.; Selimovic N.; Bollano E.;
Bartfay S.-E.; Roy S.D.; Rexius H.; Janssen A.; Rosenberg M.; Tram E.M.;
Molgard D.; Konrad L.; Mortensen B.; Persson L.; Koch M.; Kornhall B.;
Ekmehag B.; Reitan O.; Stueflotten W.; Bjorkelund E.; Relbo A.; Grov I.;
Erikstad I.; Solberg O.G.; Ragnarsson A.; Aakhus S.; Massey R.
Institution
(Gustafsson) Department of Cardiology, Rigshospitalet, 2142, 9
Blegdamsvej, Copenhagen DK-2100, Denmark
(Gustafsson) Department of Clinical Medicine, University of Copenhagen,
Denmark
(Andreassen, Gude, Arora, Gullestad) Department of Cardiology, Oslo
University Hospital Rikshospitalet, Oslo, Norway
(Andersson, Karason) Department of Cardiology, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Eiskjaer) Department of Cardiology, Aarhus University Hospital, Skejby,
Denmark
(Radegran) Section for Heart Failure and Valvular Disease, Skane
University Hospital, Department of Clinical Sciences, Cardiology, Lund
University, Lund, Sweden
(Jansson) Department of Cardiology, Heart and Medicine Center County
Council of Ostergotland and, Linkoping University, Linkoping, Sweden
(Solbu) Novartis Norge AS, Oslo, Norway
(Dellgren) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Gullestad) K.G. Jebsen Cardiac Research Center, Center for Heart Failure
Research, Faculty of Medicine, University of Oslo, Oslo, Norway
(Larsen) CopenhagenDenmark
(Sigurdardottir, Selimovic, Bollano, Bartfay, Roy, Rexius, Janssen,
Rosenberg) GoteborgSweden
(Tram, Molgard, Konrad, Mortensen) AarhusDenmark
(Persson, Koch, Kornhall, Ekmehag, Reitan) LundSweden
(Stueflotten, Bjorkelund, Relbo, Grov, Erikstad, Solberg, Ragnarsson,
Aakhus, Massey) OsloNorway
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background. A calcineurin inhibitor (CNI)-free immunosuppressive regimen
has been demonstrated to improve renal function early after heart
transplantation, but long-term outcome of such a strategy has not been
well described. Methods. In the randomized SCHEDULE trial, de novo heart
transplant recipients received (1) everolimus with reduced-exposure CNI
(cyclosporine) followed by CNI withdrawal at week 7-11 posttransplant or
(2) standard-exposure cyclosporine, both with mycophenolate mofetil and
corticosteroids; 95/115 randomized patients were followed up at 5-7 years
posttransplant. Results. Mean measured glomerular filtration rate was 74.7
mL/min and 62.4 mL/min with everolimus and CNI, respectively. The mean
difference was in favor of everolimus by 11.8 mL/min in the
intent-to-treat population (P = 0.004) and 17.2 mL/min in the per protocol
population (n = 75; P < 0.001). From transplantation to last follow-up,
the incidence of biopsy-proven acute rejection (BPAR) was 77% (37/48) and
66% (31/47) (P = 0.23) with treated BPAR in 50% and 23% (P < 0.01) in the
everolimus and CNI groups, respectively; no episode led to hemodynamic
compromise. Coronary allograft vasculopathy (CAV) assessed by coronary
intravascular ultrasound was present in 53% (19/36) and 74% (26/35) of
everolimus- and CNI-treated patients, respectively (P = 0.037). Graft
dimensions and function were similar between the groups. Late adverse
events were comparable. Conclusions. These results suggest that de novo
heart transplant patients randomized to everolimus and low-dose CNI
followed by CNI-free therapy maintain significantly better long-term renal
function as well as significantly reduced CAV than patients randomized to
standard CNI treatment. Increased BPAR in the everolimus group during year
1 did not impair long-term graft function.<br/>Copyright &#xa9; 2019
Wolters Kluwer Health, Inc. All rights reserved.

<62>
Accession Number
631485522
Title
Effects of nitroglycerin versus labetalol on peripheral perfusion during
deliberate hypotension for sinus endoscopic surgery: A randomized,
controlled, double-blinded trial.
Source
BMC Anesthesiology. 20 (1) (no pagination), 2020. Article Number: 85. Date
of Publication: 17 Apr 2020.
Author
Zayed M.; Nassar H.; Hasanin A.; Saleh A.H.; Hassan P.; Saad D.; Mahmoud
S.; Abo Bakr G.; Fouad E.; Saleh N.; Ismail M.; El-Hadi H.
Institution
(Zayed, Nassar, Hasanin, Saleh, Hassan, Fouad, Ismail) Department of
Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
(Zayed, Saad, Mahmoud, Abo Bakr, Saleh, El-Hadi) Department of Anesthesia
and Critical Care Medicine, Faculty of Medicine, Cairo University, 01
elsarayah street, Elmanyal, Cairo 11559, Egypt
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Deliberate hypotension is used to provide a bloodless field
during functional endoscopic sinus surgery; however, the impact of
controlled hypotension during anesthesia on peripheral tissue perfusion
has not been extensively evaluated. The aim of this study was to compare
the impact of nitroglycerin- versus labetalol-induced hypotension on
peripheral perfusion. <br/>Method(s): The present randomized,
double-blinded, controlled trial included adult patients undergoing
endoscopic sinus surgery. Patients were allocated to one of two groups
according to the drug received for induction of deliberate hypotension:
nitroglycerin (n = 20) or labetalol (n = 20). Mean arterial pressure was
maintained at 55-65 mmHg in both groups. Both study groups were compared
according to pulse oximeter-derived peripheral perfusion index (primary
outcome), serum lactate level, mean arterial pressure, heart rate,
surgical field score, and intraoperative blood loss. <br/>Result(s): Forty
patients were included in the final analysis. The nitroglycerin group
exhibited a higher peripheral perfusion index at nearly all records (p <
0.0001) and lower postoperative serum lactate levels (1.3 +/- 0.2 mmol/L
vs. 1.7 +/- 0.4 mmol/L; p = 0.001) than the labetalol group. The
peripheral perfusion index was higher in the nitroglycerin group than at
baseline at most intraoperative readings. The median surgical field score
was modestly lower in the labetalol group than in the nitroglycerin group
in the first 20 min (2 [interquartile range (IQR) 2-2.5] versus 1.5 [IQR
1-2]; p = 0.001). Both groups demonstrated comparable and acceptable
surgical field scores in all subsequent readings. <br/>Conclusion(s):
Nitroglycerin-induced deliberate hypotension was accompanied by higher
peripheral perfusion index and lower serum lactate levels than
labetalol-induced deliberate hypotension during sinus endoscopic surgery.
Trial registration: The study was registered at clinicaltrials registry
system with trial number: NCT03809065. Registered at 19 January 2019. This
study adheres to CONSORT guidelines.<br/>Copyright &#xa9; 2020 The
Author(s).

<63>
Accession Number
2005641024
Title
Atorvastatin Reduces First and Subsequent Vascular Events Across Vascular
Territories: The SPARCL Trial.
Source
Journal of the American College of Cardiology. 75 (17) (pp 2110-2118),
2020. Date of Publication: 5 May 2020.
Author
Szarek M.; Amarenco P.; Callahan A.; DeMicco D.; Fayyad R.; Goldstein
L.B.; Laskey R.; Sillesen H.; Welch K.M.
Institution
(Szarek) SUNY Downstate Health Sciences University, Brooklyn, NY, United
States
(Amarenco) Paris University, Paris, France
(Callahan) Meharry Medical College, Nashville, TN, United States
(DeMicco, Fayyad, Laskey) Pfizer, New York, NY, United States
(Goldstein) University of Kentucky, Lexington, KY, United States
(Sillesen) University of Copenhagen, Copenhagen, Denmark
(Welch) Rosalind Franklin University, North Chicago, IL, United States
Publisher
Elsevier USA
Abstract
Background: In the SPARCL (Stroke Prevention by Aggressive Reduction in
Cholesterol Levels) trial, atorvastatin was compared with placebo in 4,731
participants with recent stroke or transient ischemic attack and no known
coronary heart disease. Atorvastatin reduced the first occurrence of
stroke and the first occurrence of a composite of vascular events.
<br/>Objective(s): The aim of this post hoc analysis was to assess the
occurrence of all (first and subsequent) vascular events and the effect of
atorvastatin to reduce these events by vascular territory
(cerebrovascular, coronary, or peripheral) in SPARCL. <br/>Method(s):
Treatment effects on total adjudicated vascular events, overall and by
vascular territory, were summarized by marginal proportional hazards
models. Vascular event rates were estimated for each treatment group with
cumulative incidence functions. <br/>Result(s): The placebo group had an
estimated 41.2 first and 62.7 total vascular events per 100 participants
over 6 years. There were 164 fewer first and 390 fewer total vascular
events in the atorvastatin group (total events hazard ratio: 0.68; 95%
confidence interval: 0.60 to 0.77). The total events reduction included
177 fewer cerebrovascular, 170 fewer coronary, and 43 fewer peripheral
events. Over 6 years, an estimated 20 vascular events per 100 participants
were avoided with atorvastatin treatment. <br/>Conclusion(s): In
participants with recent stroke or transient ischemic attack, the total
number of vascular events prevented with atorvastatin was more than twice
the number of first events prevented. Total event reduction provides a
comprehensive metric to capture the totality of atorvastatin clinical
efficacy in reducing disease burden after stroke or transient ischemic
attack. (Lipitor in the Prevention of Stroke, for Patients Who Have Had a
Previous Stroke [SPARCL]; NCT00147602)<br/>Copyright &#xa9; 2020 American
College of Cardiology Foundation

<64>
Accession Number
2005605317
Title
Evaluation of a Powered Vascular Stapler in Video-Assisted Thoracic
Surgery Lobectomy.
Source
Journal of Surgical Research. 253 (pp 26-33), 2020. Date of Publication:
September 2020.
Author
Molins L.; Lanuti M.; Force S.; Woolley S.; Krantz S.; Creedon E.E.;
Schwiers M.L.; Singleton D.W.; Waggoner J.R.; Fryrear R.; Licht P.
Institution
(Molins) Department of Thoracic Surgery, Barcelona University, Barcelona,
Spain
(Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Force) Department of Surgery, The Emory Clinic, Atlanta, GA, United
States
(Woolley) Consultant Thoracic Surgeon, Liverpool Heart & Chest Hospital,
Liverpool, United Kingdom
(Krantz) Division of Thoracic Surgery, Northshore University Health
System, Evanston, IL, United States
(Creedon, Schwiers, Singleton, Waggoner, Fryrear) Ethicon Endo-Surgery,
Inc., Cincinnati, OH, United States
(Licht) Department of Cardiothoracic Surgery, Odense University Hospital,
Odense, Denmark
Publisher
Academic Press Inc. (E-mail: apjcs@harcourt.com)
Abstract
Background: A narrow-profile powered vascular stapler (PVS) was developed
to provide superior access and precise staple placement in thoracic
procedures. The objective of this study was to determine if the PVS would
yield an equivalent rate of hemostatic interventions compared with
standard of care (SOC) staplers in video-assisted thoracoscopic surgery
lobectomy. <br/>Material(s) and Method(s): A randomized, controlled,
multicenter study was conducted comparing PVS with SOC staplers in
lobectomies performed for non-small cell lung cancer. The primary
performance endpoint was the incidence of intraoperative hemostatic
interventions, and the primary safety endpoint was the frequency of
postoperative bleeding-related interventions. <br/>Result(s): A total of
98 subjects participated in the SOC group and 103 in the PVS group. Rates
of intraoperative hemostatic interventions were 5.3% and 8.3% for the SOC
and PVS groups, respectively. These rates were not statistically different
(P = 0.137), although the upper bound of the 95% confidence interval for
the difference in intervention rates between PVC and SOC exceeded a
predefined 3% criterion for equivalence. Simple compressions were
performed more frequently in the PVS subjects, which accounted for the
higher intervention rate in this group. Postoperative interventions for
bleeding were required in one SOC subject (1.0%) and one subject from the
PVS group (0.9%). Procedure-related adverse events occurred in 21 (21.9%)
SOC subjects and 23 (21.9%) PVS subjects, with no adverse events related
to use of the study devices. <br/>Conclusion(s): The PVS exhibited similar
overall safety and effectiveness to SOC staplers in video-assisted
thoracoscopic surgery lobectomy.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<65>
Accession Number
2004435855
Title
The effect of colchicine on the echocardiographic constrictive physiology
after coronary artery bypass graft surgery.
Source
Echocardiography. 37 (3) (pp 399-403), 2020. Date of Publication: 01 Mar
2020.
Author
Shojaeifard M.; Pakbaz M.; Beheshti R.; Noohi Bezanjani F.; Ahangar H.;
Gohari S.; Dehghani Mohammad Abadi H.; Erami S.
Institution
(Shojaeifard) Echocardiography Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Pakbaz) Department of Cardiovascular Disease, Hazrat-e Rasool General
Hospital, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Beheshti, Noohi Bezanjani) Department of Cardiology, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Ahangar) Department of Cardiology, Mousavi Hospital, School of Medicine,
Zanjan University of Medical Sciences, Zanjan, Iran, Islamic Republic of
(Gohari) School of Medicine, Zanjan University of Medical Sciences,
Zanjan, Iran, Islamic Republic of
(Dehghani Mohammad Abadi) Shahid Sadoughi Hospital, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Erami) School of Medicine, Shahid Sadoughi University of Medical
Sciences, Yazd, Iran, Islamic Republic of
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Constrictive physiology is a transitory condition that could
lead to constrictive pericarditis, which is a rare complication after
open-heart surgery. Anti-inflammatory drugs like colchicine are
recommended for prevention of constrictive pericarditis; however, there is
no evidence about the effect of colchicine on constrictive pericarditis.
Thus, the aim of this study is to evaluate the preventive effect of
colchicine on the incidence of echocardiographic constrictive physiology
after open-heart surgery. <br/>Method(s): This was a parallel randomized,
double-blind trial. Patients were randomly assigned to receive 1 mg
colchicine once-daily from 48 hours before and 0.5 mg twice daily for 5
days after surgery. Primary outcome was the incidence of the constrictive
physiology after primary endpoint (1 week after the surgery). The
secondary outcome was the primary outcome after secondary endpoint (4
weeks after surgery) plus the new cases of constrictive physiology between
the primary and secondary endpoints. <br/>Result(s): Out of 160
participating patients, the primary outcome occurred in 19 patients (23%)
in placebo and 11 (13%) in intervention groups. There was no significant
difference between two groups (P =.106). After 4 weeks of follow-up, 19
patients (23%) in placebo and 9 (11%) in intervention groups had
constrictive physiology whereas 2 out of 11 patients (18.2%) were
recovered. The difference was significant (P =.038). No new case of
constrictive physiology occurred between primary and secondary endpoints.
<br/>Conclusion(s): Short-term use of colchicine has a preventive effect
on reducing constrictive physiology after 1 month of open-heart surgery
but not a week after that.<br/>Copyright &#xa9; 2020 Wiley Periodicals,
Inc.

<66>
Accession Number
630818435
Title
Shared decision making in older patients with symptomatic severe aortic
stenosis: a systematic review.
Source
Heart. 106 (9) (pp 647-655), 2020. Date of Publication: 01 May 2020.
Author
Van Beek-Peeters J.J.A.M.; Van Noort E.H.M.; Faes M.C.; De Vos A.J.B.M.;
Van Geldorp M.W.A.; Minkman M.M.N.; Van Der Meer N.J.M.
Institution
(Van Beek-Peeters, Van Geldorp) Department of Cardiothoracic Surgery,
Amphia Hospital, Breda 4800 RK, Netherlands
(Van Noort, Faes) Department of Geriatrics, Amphia Hospital, Breda,
Netherlands
(De Vos) Nursing Council, Amphia Hospital, Breda, Netherlands
(Minkman, Van Der Meer) TIAS, School for Business and Society, Tilburg
University, Tilburg, Netherlands
(Minkman) Vilans, Centre of Expertise for Long-term Care, Utrecht,
Netherlands
(Van Der Meer) Department of Anesthesiology, Amphia Hospital, Breda,
Netherlands
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
This review provides an overview of the status of shared decision making
(SDM) in older patients regarding treatment of symptomatic severe aortic
stenosis (SSAS). The databases Embase, Medline Ovid, Cinahl and Cochrane
Dare were searched for relevant studies from January 2002 to May 2018
regarding perspectives of professionals, patients and caregivers; aspects
of decision making; type of decision making; application of the six
domains of SDM; barriers to and facilitators of SDM. The systematic search
yielded 1842 articles, 15 studies were included. Experiences of
professionals and informal caregivers with SDM were scarcely found.
Patient refusal was a frequently reported result of decision making, but
often no insight was given into the decision process. Most studies
investigated the ' decision' and ' option' domains of SDM, yet no study
took all six domains into account. Problem analysis, personalised
treatment aims, use of decision aids and integrating patient goals in
decisions lacked in all studies. Barriers to and facilitators of SDM were
' individualised formal and informal information support' and ' patients'
opportunity to use their own knowledge about their health condition and
preferences for SDM'. In conclusion, SDM is not yet common practice in the
decision making process of older patients with SSAS. Moreover, the six
domains of SDM are not often applied in this process. More knowledge is
needed about the implementation of SDM in the context of SSAS treatment
and how to involve patients, professionals and informal
caregivers.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2020.

<67>
Accession Number
627811904
Title
The impact of pre-existing peripheral artery disease on transcatheter
aortic valve implantation outcomes: A systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 95 (5) (pp 993-1000),
2020. Date of Publication: 01 Apr 2020.
Author
Ueshima D.; Barioli A.; Nai Fovino L.; D'Amico G.; Fabris T.; Brener S.J.;
Tarantini G.
Institution
(Ueshima, Barioli, Nai Fovino, D'Amico, Fabris, Tarantini) Cardiology
Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of
Padua Medical School, Padua, Italy
(Brener) Department of Medicine, Cardiac Catheterization Laboratory, New
York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, United States
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background: Peripheral arterial disease (PAD) plays a decisive role in the
preinterventional selection process of the optimal vascular access site in
patients undergoing transcatheter aortic valve implantation (TAVI).
However, the impact of PAD on mortality and vascular complications (VCs)
in TAVI-treated patients remains unclear. Accordingly, we aimed to assess
the outcomes of patients with and without PAD undergoing TAVI, by
performing a meta-regression analysis. <br/>Method(s): Studies published
between January 2002 and March 2018 and reporting outcomes according to
the presence of PAD in TAVI patients were identified. Outcome measures
analyzed were short-, mid- and long-term mortality, and peri-procedural
VC. The interaction between sheath size and PAD on outcomes was also
assessed. <br/>Result(s): A total of 26 studies (68,581 TAVI patients, of
whom 17,326 with preprocedural PAD) were included in the analysis.
Patients with PAD had higher risk of mortality at short- (HR 1.36, 95%
confidence interval [CI] 1.13-1.63, p =.0009), mid- (HR 1.18, 95% CI
1.08-1.30, p =.0005), and long-term (HR 1.36, 95% CI 1.24-1.48, p <.0001)
follow-up, and higher risk of VC (RR 1.55, 95% CI 1.27; 1.89, p <.0001).
Moreover, the adoption of smaller sheaths during TAVI procedures was
associated with fewer VC both in PAD and non-PAD patients, but the latter
group had a more pronounced benefit. <br/>Conclusion(s): Patients with
pre-existent PAD are at increased risk of all-cause mortality and VC after
TAVI. The adoption of smaller sheaths during the procedure seems to be
associated with fewer peri-procedural VC both in PAD and non-PAD
patients.<br/>Copyright &#xa9; 2019 Wiley Periodicals, Inc.

<68>
Accession Number
2003394705
Title
Carotid to subclavian bypass and Amplatzer vascular plug subclavian
endovascular occlusion before thoracic open or endovascular repair.
Source
Journal of Vascular Surgery. 71 (5) (pp 1480-1488.e1), 2020. Date of
Publication: May 2020.
Author
Bertoglio L.; Salvati S.; Fittipaldi A.; Melloni A.; Kahlberg A.;
Cambiaghi T.; Melissano G.; Chiesa R.
Institution
(Bertoglio, Salvati, Fittipaldi, Melloni, Kahlberg, Melissano, Chiesa)
Division of Vascular Surgery, "Vita - Salute" University, Scientific
Institute H. San Raffaele, Milano, Italy
(Cambiaghi) Department of Cardiothoracic and Vascular Surgery, McGovern
Medical School at The University of Texas Health Science Center at Houston
(UTHealth) and Memorial Hermann Hospital, Houston, Tex
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: The aim of this study was to evaluate the safety and
effectiveness of endovascular occlusion of the prevertebral subclavian
artery (SA) using an Amplatzer vascular plug after prophylactic
revascularization with carotid-subclavian bypass (CSB) in the setting of
endovascular thoracic stent grafting or open arch repair with frozen
elephant trunk. <br/>Method(s): All patients who underwent SA plug
embolization (SAPE) and CSB from September 2009 to December 2018 were
enrolled in a registered study (SAPE study: clinicaltrials.gov
NCT03620006). The primary end point was technical success, defined as
complete occlusion of the origin of the SA, and how it was influenced by
SA anatomy. The secondary end points were access vessel complications,
cerebrovascular events, and CSB patency. <br/>Result(s): The 101 SAPE
procedures were performed using a type I (35 patients) or a type II (66
patients) Amplatzer vascular plug. A percutaneous ipsilateral upper
extremity access was used in 66% of patients and a radial artery access
was used in 50% of procedures. The 30-day primary technical success rate
was 95% (five patients received an additional plug during the index); five
type IC endoleaks were observed and successfully treated either with
surgical ligation (in open arch repair procedures) or secondary
embolization procedure (thoracic endovascular aneurysm repair group).
Three access vessel complications (3%) were recorded with percutaneous
brachial approach. At a median follow-up time of 11 months (range, 2-19
months), no new-onset type IC endoleak was observed, and the CSB patency
rate was 97%. <br/>Conclusion(s): SAPE after CSB is feasible and safe, and
has low incidence of type IC endoleaks. Further device developments are
needed to better adapt to the subclavian anatomy.<br/>Copyright &#xa9;
2019 Society for Vascular Surgery

<69>
Accession Number
631485597
Title
Hypotheses, rationale, design, and methods for prognostic evaluation of a
randomized comparison between patients with coronary artery disease
associated with ischemic cardiomyopathy who undergo medical or surgical
treatment: MASS-VI (HF).
Source
Trials. 21 (1) (no pagination), 2020. Article Number: 337. Date of
Publication: 16 Apr 2020.
Author
Rezende P.C.; Hueb W.; Bocchi E.A.; Farkouh M.; Junior C.V.S.; Lima E.G.;
Silva E.E.R.; Dallan L.A.O.; Gaiotto F.A.; Garzillo C.L.; Rochitte C.E.;
Nomura C.H.; Scudeler T.L.; Soares P.R.; Jatene F.B.; Ramires J.A.F.;
Filho R.K.
Institution
(Rezende, Hueb, Bocchi, Junior, Lima, Silva, Dallan, Gaiotto, Garzillo,
Rochitte, Nomura, Scudeler, Soares, Jatene, Ramires, Filho) Instituto Do
Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina,
Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, Sao Paulo
05403-000, Brazil
(Farkouh) Toronto General Hospital Research Institute (TGHRI), Toronto,
ON, Canada
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Ischemic cardiomyopathy and severe left ventricular
dysfunction are well established to represent the main determinants of
poor survival and premature death compared with preserved ventricular
function. However, the role of myocardial revascularization as a
therapeutic alternative is not known to improve the long-term prognosis in
this group of patients. This study will investigate whether myocardial
revascularization contributes to a better prognosis for patients compared
with those treated with drugs alone and followed over the long term.
<br/>Method(s): The study will include 600 patients with coronary artery
disease associated with ischemic cardiomyopathy. The surgical or drug
therapy option will be randomized, and the events considered for analysis
will be all-cause mortality, nonfatal infarction, unstable angina
requiring additional revascularization, and stroke. The events will be
analyzed according to the intent-to-treat principle. Patients with
multivessel coronary disease and left ventricular ejection fraction
measurements of less than 35% will be included. In addition, myocardial
ischemia will be documented by myocardial scintigraphy. Markers of
myocardial necrosis will be checked at admission and after the procedure.
<br/>Discussion(s): The role of myocardial revascularization (CABG) in the
treatment of patients with coronary artery disease and heart failure is
not clearly established. The surgical option of revascularizing the
myocardium is a procedure designed to reduce the load of myocardial
hibernation in patients with heart failure caused by coronary artery
disease. On the other hand, the assessment of myocardial viability is
frequently used to identify patients with left ventricular ischemic
dysfunction in which CABG may add survival benefit. However, the
effectiveness of this option is uncertain. The great difficulty in
establishing the efficacy of surgical intervention is based on the
understanding of viability without ischemia. Thus, this study will include
only patients with viable and truly ischemic myocardium to correct this
anomaly. Trial registration: Evaluation of a randomized comparison between
patients with coronary artery disease associated with ischemic
cardiomyopathy submitted to medical or surgical treatment: MASS-VI (HF),
ISRCTN77449548, Oct 10th, 2019 (retrospectively registered).<br/>Copyright
&#xa9; 2020 The Author(s).

<70>
Accession Number
631475474
Title
Serum trace elements in coronary artery bypass graft surgery: The
relationship between trace element supplementation and period of
mechanical ventilation in a randomized double-blind placebo-controlled
trial.
Source
Jundishapur Journal of Natural Pharmaceutical Products. 14 (4) (no
pagination), 2019. Article Number: 68735. Date of Publication: 01 Nov
2019.
Author
Amirizadeh M.; Salehifar E.; Habibi M.; Shokrzadeh M.; Soleimani A.;
Charati J.Y.; Ghaffari R.; Habibi V.; Eslami G.
Institution
(Amirizadeh, Salehifar) Department of Clinical Pharmacy, Pharmaceutical
Sciences Research Center, Faculty of Pharmacy, Mazandaran University of
Medical Sciences, Sari, Iran, Islamic Republic of
(Habibi, Soleimani) Department of Anesthesiology, Faculty of Medicine,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Shokrzadeh) Department of Toxicology, Faculty of Pharmacy, Mazandaran
University of Medical Sciences, Sari, Iran, Islamic Republic of
(Charati) Department of Biostatics, Health Sciences Research Center,
Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran,
Islamic Republic of
(Ghaffari, Habibi) Department of Cardiac Surgery, Faculty of Medicine,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Eslami) Department of Clinical Pharmacy, Faculty of Pharmacy,
Cardiovascular Research Center, Mazandaran University of Medical Sciences,
Sari, Iran, Islamic Republic of
Publisher
Kowsar Medical Publishing Company (E-mail: library@kowsarpub.com)
Abstract
Background: Coronary artery bypass graft surgery (CABG) may cause a
substantial decrease in trace elements of whole blood during the
operation, as well as increased oxidative stress and result in lung
damage. <br/>Objective(s): This study aimed to evaluate the effect of
Addamel, as a complete mixture of trace elements, in reducing the period
of mechanical ventilation following the cardiac surgery. <br/>Method(s):
In this randomized, double-blind, placebo-controlled trial, two hundred
patients receiving CABG were randomized to receive three doses of either
Addamel or normal saline. Selenium, zinc, copper, ferrous, and manganese
serum levels were measured before the operation, on days one and two in
all groups. Besides, the effects of Addamel on the mechanical ventilation
period were evaluated. <br/>Result(s): The mean length of stay on the
mechanical ventilator was lower in the supplemented patients (21.98 +/-
8.4 days) than the control patients (25.16 +/- 8.44 days), and the
difference was statistically significant (P = 0.009). <br/>Conclusion(s):
A substantial number of patients undergoing CABG may benefit from
supplementation with Addamel, as a source of trace elements.<br/>Copyright
&#xa9; 2019, Jundishapur Journal of Natural Pharmaceutical Products. This
is an open-access article distributed under the terms of the Creative
Commons Attribution-NonCommercial 4.0 International License
(http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and
redistribute the material just in noncommercial usages, provided the
original work is properly cited.

<71>
Accession Number
2005565898
Title
Differential outcomes with edetate disodium-based treatment among stable
post anterior vs. non-anterior myocardial infarction patients.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Lewis E.F.; Ujueta F.; Lamas G.A.; Roberts R.S.; Mark D.B.; Nahin R.L.;
Goertz C.; Stylianou M.; Lee K.L.
Institution
(Lewis) Brigham and Women's Hospital and Harvard Medical School, Boston,
MA (E.F.L.), United States
(Ujueta, Lamas) Columbia University Division of Cardiology at Mount Sinai
Medical Center, Miami Beach, FL (G.A.L.), United States
(Roberts) Remarque Systems, Durham, NC (R.S.R), United States
(Mark, Stylianou) National Heart, Lung, and Blood Institute, Bethesda, MD
(M.S.), United States
(Lee) Duke Clinical Research Institute, Durham, NC (D.B.M., K.L.L.),
United States
(Goertz) Duke Department of Orthopaedic Surgery, Durham, NC (C.G.), United
States
(Nahin) The National Center for Complementary and Integrative Health,
Bethesda, MD (R.L.N.), United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: The Trial to Assess Chelation Therapy (TACT) found that
chelation therapy significantly reduced clinical events in patients with a
history of myocardial infarction (MI). The initial report of TACT included
the observation of an interaction between edetate disodium infusions and
MI location, as well as diabetes. Thus, we examined in greater detail the
effect of edetate disodium chelation therapy as a function of MI location
and diabetes. <br/>Method(s): Patients (n = 1708) at least 6 weeks post-MI
and age >= 50 were randomized to receive 40 infusions of a 500 mL
chelation solution or placebo (median follow-up 55 months). The effect of
edetate disodium on the primary outcome (all-cause mortality, MI, stroke,
hospitalization for angina, or coronary revascularization) was assessed as
a function of MI location using log-rank test and Cox regression model,
adjusting for other prognostic variables. <br/>Result(s): Among patients
with post anterior MI (n = 674), chelation was associated with a lower
risk of the primary endpoint (HR 0.63, 95% CI 0.47-0.86, p = 0.003) among
anterior MI patients, but not in post non-anterior MI (n = 1034) patients
(HR 0.96, 95% CI 0.77-1.20, p = 0.702) (p-for-interaction = 0.032). The
point estimates for each component of the primary endpoint favored
chelation therapy. The differing treatment effect in patients with post
anterior vs. non-anterior MI was consistent among patients with or without
diabetes and remained significant after adjusting for other prognostic
variables (p < 0.01). <br/>Conclusion(s): Edetate disodium infusions
reduced the risk of cardiovascular events among patients with a prior
anterior MI. Future studies should focus on replicating these results and
understanding the mechanisms of benefit.<br/>Copyright &#xa9; 2020

<72>
Accession Number
2004479112
Title
Melatonin and its analogues for the prevention of postoperative delirium:
A systematic review and meta-analysis.
Source
Journal of Pineal Research. 68 (4) (no pagination), 2020. Article Number:
e12644. Date of Publication: 01 May 2020.
Author
Han Y.; Wu J.; Qin Z.; Fu W.; Zhao B.; Li X.; Wang W.; Sha T.; Sun M.; Li
J.; Zeng Z.; Chen Z.
Institution
(Han, Qin, Zhao) Department of Anaesthesiology, Nanfang Hospital, Southern
Medical University, Guangzhou, China
(Wu, Fu, Wang, Sha, Sun, Li, Zeng, Chen) Department of Critical Care
Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
(Li) Department of Anaesthesiology, People's Hospital of Ningxia Hui
Autonomous Region, Northwest University for Nationalities, Yinchuan, China
Publisher
Blackwell Publishing Ltd
Abstract
It remains unclear whether melatonin and its analogues prevent
postoperative delirium (POD). Therefore, we conducted a systematic review
and meta-analysis to evaluate the effect of melatonin and its analogues on
POD prevention. PubMed, Cochrane Library, Web of Science, Embase and
CINAHL databases were searched. Primary outcome was the incidence of POD.
Six randomized controlled trials, 2 cohort studies and 1 case-control
study were included in this meta-analysis. Results showed that melatonin
and its analogue ramelteon decreased the incidence of POD in the entire
adult surgical population (odds ratio [OR] = 0.45, 95% confidence interval
[CI] 0.24-0.84, P =.01). When administered at a higher dose (5 mg),
melatonin was effective in reducing the POD incidence (OR = 0.32, 95% CI
0.20-0.52, P <.00001). Melatonin administered less than 5 elimination
half-lives before the surgery significantly reduced the POD incidence (OR
= 0.31, 95% CI 0.19-0.49, P <.00001). Current literature supports the
effectiveness of melatonin and its analogue ramelteon in POD prevention.
However, the present study was limited by the significant heterogeneity of
the included studies. More studies are needed to ascertain the preventive
effect of melatonin and its analogues on the incidence of delirium after
cardiac and noncardiac surgeries.<br/>Copyright &#xa9; 2020 John Wiley &
Sons A/S. Published by John Wiley & Sons Ltd

<73>
Accession Number
2004421235
Title
The effect of restrictive versus liberal transfusion strategies on
longer-term outcomes after cardiac surgery: a systematic review and
meta-analysis with trial sequential analysis.
Source
Canadian Journal of Anesthesia. 67 (5) (pp 577-587), 2020. Date of
Publication: 01 May 2020.
Author
Kashani H.H.; Lodewyks C.; Kavosh M.S.; Jeyaraman M.M.; Neilson C.; Okoli
G.; Rabbani R.; Abou-Setta A.M.; Zarychanski R.; Grocott H.P.
Institution
(Kashani, Kavosh, Grocott) Department of Anesthesiology, Perioperative and
Pain Medicine, St. Boniface Hospital, University of Manitoba, CR3008-369
Tache Ave, Winnipeg, MB R2H 2A6, Canada
(Lodewyks) Section of Cardiac Surgery, Department of Surgery, University
of Manitoba, Winnipeg, MB, Canada
(Jeyaraman, Okoli, Rabbani, Abou-Setta) The George & Fay Yee Center for
Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada
(Jeyaraman, Okoli, Rabbani, Abou-Setta, Zarychanski) Department of
Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
(Neilson) Neil John Maclean Health Sciences Library, University of
Manitoba, Winnipeg, MB, Canada
(Zarychanski) Department of Internal Medicine, University of Manitoba,
Winnipeg, MB, Canada
(Zarychanski) Department of Medical Oncology and Hematology, Cancer Care
Manitoba, Winnipeg, MB, Canada
Publisher
Springer
Abstract
Purpose: Blood transfusions are frequently administered in cardiac
surgery. Despite a large number of published studies comparing a
"restrictive" strategy with a "liberal" strategy, no clear consensus has
emerged to guide blood transfusion practice in cardiac surgery patients.
The purpose of this study was to identify, critically appraise, and
summarize the evidence on the overall effect of restrictive transfusion
strategies compared with liberal transfusion strategies on mortality,
other clinical outcomes, and transfusion-related outcomes in adult
patients undergoing cardiac surgery. Source: We searched MEDLINE (OvidSP),
EMBASE (OvidSP) and Cochrane CENTRAL (Wiley) from inception to 1 December
2017 and queried clinical trial registries and conference proceedings for
randomized-controlled trials of liberal vs restrictive transfusion
strategies in cardiac surgery. Principal findings: From 7,908 citations,
we included ten trials (9,101 patients) and eight companion publications.
Overall, we found no significant difference in mortality between
restrictive and liberal transfusion strategies (risk ratio [RR], 1.08; 95%
confidence interval [CI], 0.76 to 1.54; I² = 33%; seven trials;
8,661 patients). The use of a restrictive transfusion strategy did not
appear to adversely impact any of the secondary clinical outcomes. As
expected, the proportion of patients who received red blood cells (RBCs)
in the restrictive group was significantly lower than in the liberal group
(RR, 0.68; 95% CI, 0.64 to 0.73; I² = 56%; 5 trials; 8,534
patients). Among transfused patients, a restrictive transfusion strategy
was associated with fewer transfused RBC units per patient than a liberal
transfusion strategy. <br/>Conclusion(s): In adult patients undergoing
cardiac surgery, a restrictive transfusion strategy reduces RBC
transfusion without impacting mortality rate or the incidence of other
perioperative complications. Nevertheless, further large trials in
subgroups of patients, potentially of differing age, are needed to
establish firm evidence to guide transfusion in cardiac surgery. Trial
registration: PROSPERO (CRD42017071440); registered 20 April,
2018.<br/>Copyright &#xa9; 2020, Canadian Anesthesiologists' Society.

<74>
Accession Number
2004117251
Title
Impact of Physician Race on Patient Decision-Making and Ratings of
Physicians: a Randomized Experiment Using Video Vignettes.
Source
Journal of General Internal Medicine. 35 (4) (pp 1084-1091), 2020. Date of
Publication: 01 Apr 2020.
Author
Saha S.; Beach M.C.
Institution
(Saha) Section of General Internal Medicine, VA Portland Health Care
System, 3710 SW U.S. Veterans Hospital Rd. (P3HSRD), Portland, OR, United
States
(Saha) Division of General Internal Medicine & Geriatrics, Oregon Health
and Science University, Portland, OR, United States
(Beach) Department of Medicine, Johns Hopkins University, Baltimore, MD,
United States
Publisher
Springer
Abstract
Background: Studies suggest that black patients have better interactions,
on average, with physicians of their own race. Whether this reflects
greater "cultural competence" in race-concordant relationships, or other
effects of race unrelated to physician behavior, is unclear. It is also
unclear if physician race influences patient decision-making.
<br/>Objective(s): To determine whether physician race affects patients'
ratings of physicians and decision-making, independent of physician
behavior. <br/>Design(s): Randomized study using standardized video
vignettes. <br/>Participant(s): Primary care patients with coronary risk
factors or disease. <br/>Intervention(s): Each participant viewed one of
16 vignettes depicting a physician reviewing cardiac catheterization
results and recommending coronary artery bypass graft (CABG) surgery.
Vignettes varied only in terms of physicians' race, gender, age, and
communication style (high vs. low patient-centeredness). Main Measures:
Participants rated the video physician's communication, interpersonal
style, competence, trustworthiness, likability, and overall performance
(0-4 Likert scales). They also rated the necessity of CABG (0-5 scale) and
whether they would undergo CABG or obtain a second opinion if they were
the video patient (0-3 scales). Key Results: Participants included 107
black and 131 white patients (72% participation rate). Black participants
viewing a black (vs. white) video physician gave higher ratings on all
physician attributes (e.g., overall rating 3.22 vs. 2.34, p < 0.001) and
were more likely to perceive CABG as necessary (4.05 vs. 3.72, p = 0.03)
and say they would undergo CABG if they were the video patient (2.43 vs.
2.09, p = 0.004). Patient-centered communication style reduced, but did
not eliminate, the impact of race concordance. Physician race was not
associated with any outcomes among white patients. <br/>Conclusion(s):
Black patients viewed the doctor in a scripted vignette more positively,
and were more receptive to the same recommendation, communicated in the
same way, with a black vs. white physician. Patient-centered communication
reduced but did not eliminate the effect of physician race.<br/>Copyright
&#xa9; 2020, Society of General Internal Medicine (This is a U.S.
government work and not under copyright protection in the U.S.; foreign
copyright protection may apply).

<75>
Accession Number
2003422642
Title
Moderate ischemic mitral incompetence: does it worth more ischemic time?.
Source
General Thoracic and Cardiovascular Surgery. 68 (5) (pp 492-498), 2020.
Date of Publication: 01 May 2020.
Author
El-Hag-Aly M.A.; El swaf Y.F.; Elkassas M.H.; Hagag M.G.; Allam H.K.
Institution
(El-Hag-Aly, Hagag) Cardiothoracic Surgery Department, Faculty of
Medicine, Menoufia University, Yassin Abdel Ghaffar Street, Shebin El-Kom,
Menoufia 32511, Egypt
(El swaf) Cardiothoracic Surgery Department, Mahalla Cardiac Institute,
Mahalla, Gharbia, Egypt
(Elkassas) Cardiothoracic Surgery Department, Faculty of Medicine, Suez
Canal University, Suez, Egypt
(Allam) Public Health and Community Medicine Department, Faculty of
Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt
Publisher
Springer
Abstract
Objectives: Ischemic mitral regurgitation (IMR) is a common finding
following myocardial infarction or ischemia. Management of moderate IMR is
still a hot topic. Adding mitral valve repair (MVr) to coronary artery
bypass grafting (CABG) is questionable. The goal of this study was to
assess and compare short-term clinical and echocardiographic results of
moderate IMR treated by CABG alone versus another group of patients
treated by CABG plus MVr. <br/>Method(s): Eighty consecutive patients with
ischemic heart disease (IHD) and moderate IMR were divided randomly into
two equal groups: group I (40) had only CABG and group II (40) had CABG
plus MVr. Patients were evaluated at 1-week, 3-months and 1-year intervals
postoperatively. <br/>Result(s): After 1-year follow-up, our study
revealed statistically significant improvement in the grade of mitral
regurgitation (MR) in group II than group I. The mean value for effective
regurgitant orifice area (EROA) was 0.22 +/- 0.13 for group I versus 0.03
+/- 0.03 for group II (P = 0.001) and for vena contracta (VC), it was 3.8
+/- 2.24 for group I versus 0.4 +/- 0.49 for group II (P = 0.000). There
was also a significant reduction in the New York Heart Association (NYHA)
functional class in both groups. <br/>Conclusion(s): MVr can be performed
safely and concomitantly with CABG in patients having moderate IMR, and
its addition to CABG have significant short-term impact on clinical or
echocardiographic outcome of patients.<br/>Copyright &#xa9; 2019, The
Japanese Association for Thoracic Surgery.

<76>
Accession Number
2002365716
Title
Epicardial Application of Hydrogel with Amiodarone for Prevention of
Postoperative Atrial Fibrillation in Patients After Coronary Artery Bypass
Grafting.
Source
Journal of Cardiovascular Translational Research. 13 (2) (pp 191-198),
2020. Date of Publication: 01 Apr 2020.
Author
Bockeria O.L.; Kanametov T.N.; Shvartz V.A.; Sokolskaya M.A.; Zhuginisov
D.S.; Sanakoev M.K.; Bockeria L.A.
Institution
(Bockeria, Kanametov, Shvartz, Sokolskaya, Zhuginisov, Sanakoev, Bockeria)
Bakulev National Medical Research Center for Cardiovascular Surgery,
Moscow, Russian Federation
(Bockeria, Kanametov, Shvartz, Sokolskaya, Zhuginisov, Sanakoev, Bockeria)
Department of Surgical Treatment for Interactive Pathology, Bakulev
National Medical Research Center for Cardiovascular Surgery, Moscow,
Russian Federation
Publisher
Springer
Abstract
The objective of this study was to assess the safety and efficacy of local
epicardial application of amiodarone-releasing hydrogel for prevention of
postoperative atrial fibrillation (POAF) in patients after coronary artery
bypass grafting. Patients were randomized into two groups: with the
application of amiodarone-releasing hydrogel and the control group. It
included 60 patients (47 males, 13 females) (mean age of 62 +/- 8.5). POAF
incidence differences were statistically significant between two groups:
in the study group, the POAF incidence was 3.3%, while in the control
group, the POAF incidence was 37% (p < 0.001). Statistically significant
differences were revealed in the PQ interval duration. The risk of POAF
incidence was calculated using the Cox regression model: the age and the
application of amiodarone-releasing hydrogel application were
statistically significant. Hospital length of stay in two groups was also
different (p < 0.001). The age and the application of amiodarone-releasing
hydrogel were statistically significant for POAF incidence.<br/>Copyright
&#xa9; 2019, Springer Science+Business Media, LLC, part of Springer
Nature.

<77>
Accession Number
2001845758
Title
Combined profiles derived from cardiovascular risk factors,
health-promoting lifestyle, and post-traumatic stress disorder symptoms.
Source
Clinical Epidemiology and Global Health. 8 (1) (pp 49-52), 2020. Date of
Publication: March 2020.
Author
Ahmadi M.; Komasi S.
Institution
(Ahmadi) Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah
University of Medical Sciences, Kermanshah, Iran, Islamic Republic of
(Komasi) Clinical Research Development Center, Imam Reza Hospital,
Kermanshah University of Medical Sciences, Kermanshah, Iran, Islamic
Republic of
Publisher
Elsevier B.V.
Abstract
Background: Obviously, determining and organizing patients' health profile
is important after a cardiac event or procedure. Therefore, the present
study was conducted with the aim of cluster analysis of the post-traumatic
stress disorder (PTSD) symptoms, illness risk factors, and
health-promoting lifestyle profile (HPLP) in patients with heart disease.
<br/>Method(s): This cross-sectional study was conducted on 201 patients
with established heart disease in a hospital in the west of Iran. The
participants were randomly selected during January-May 2017. The
self-report checklist for demographics and cardiovascular risk factors,
the Health-Promoting Lifestyle Profile II (HPLP-II), and the NSESSS-PTSD
were the measurement tools. The results were analyzed using two-stage
cluster analysis (TSCA), one-way ANOVA, and Bonferroni post hoc test.
<br/>Result(s): The mean age of patients (50.2% female) was 53.4 +/- 11.9
years old. TSCA provided the three clusters: (A) samples with poor
lifestyle/high PTSD (36.3%); (B) samples with a relatively poor
lifestyle/moderate PTSD (20.9%); and (C) samples with a relatively good
lifestyle/mild PTSD (42.8%). In most variables, there is a significant
difference between clusters A and C (p < 0.05). <br/>Conclusion(s): The
profiles of risk factors, lifestyle, and experienced PTSD symptoms are not
the same for all patients with heart disease. So, specialists should focus
on high-risk groups through the design and delivery of appropriate
interventions and cardiac rehabilitation programs tailored to the unique
Profiles.<br/>Copyright &#xa9; 2019

<78>
Accession Number
2005667793
Title
Surgery Versus TAVR for Bicuspid Aortic Valve Disease: The Time Has Come
for a Randomized Study.
Source
JACC: Cardiovascular Interventions. 13 (9) (pp 1028-1029), 2020. Date of
Publication: 11 May 2020.
Author
Colombo A.; Mangieri A.
Institution
(Colombo, Mangieri) GVM Care and Research, Maria Cecilia Hospital,
Cotignola, Ravenna, Italy
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)

<79>
Accession Number
2005667080
Title
Continuous postoperative pericardial flushing method versus standard care
for wound drainage after adult cardiac surgery: A randomized controlled
trial.
Source
EBioMedicine. 55 (no pagination), 2020. Article Number: 102744. Date of
Publication: May 2020.
Author
Diephuis E.; de Borgie C.; Tomsic A.; Winkelman J.; van Boven W.J.; Bouma
B.; Eberl S.; Juffermans N.; Schultz M.; Henriques J.P.; Koolbergen D.
Institution
(Diephuis, Winkelman, van Boven, Koolbergen) Department of Cardiothoracic
Surgery, Amsterdam University Medical Center, Location AMC, Meibergdreef
9, Amsterdam, AZ 1105, Netherlands
(Tomsic, Koolbergen) Department of Cardiothoracic Surgery, Leiden
University Medical Center (LUMC), Leiden, Netherlands
(de Borgie) Clinical Research Unit, Amsterdam University Medical Center,
Location AMC, Amsterdam, Netherlands
(Bouma, Henriques) Department of Cardiology, Amsterdam University Medical
Center, Location AMC, Amsterdam, Netherlands
(Eberl) Department of Anesthesiology, Amsterdam University Medical Center,
Location AMC, Amsterdam, Netherlands
(Juffermans, Schultz) Department of Intensive Care Medicine, Amsterdam
University Medical Center, Location AMC, Amsterdam, Netherlands
Publisher
Elsevier B.V.
Abstract
Background: Excessive bleeding, incomplete wound drainage, and subsequent
accumulation of blood and clots in the pericardium have been associated
with a broad spectrum of bleeding-related complications after cardiac
surgery. We developed and studied the continuous postoperative pericardial
flushing (CPPF) method to improve wound drainage and reduce blood loss and
bleeding-related complications. <br/>Method(s): We conducted a
single-center, open-label, ITT, randomized controlled trial at the
Academic Medical Center Amstserdam. Adults undergoing cardiac surgery for
non-emergent valvular or congenital heart disease (CHD) were randomly
assigned (1:1) to receive CPPF method or standard care. The primary
outcome was actual blood loss after 12-hour stay in the intensive care
unit (ICU). Secondary outcomes included bleeding-related complications and
clinical outcome after six months follow-up. <br/>Finding(s): Between May
2013 and February 2016, 170 patients were randomly allocated to CPPF
method (study group; n = 80) or to standard care (control group; n = 90).
CPPF significantly reduced blood loss after 12-hour stay in the ICU (-41%)
when compared to standard care (median differences -155 ml, 95% confidence
interval (CI) -310 to 0; p=<=0.001). Cardiac tamponade and reoperation for
bleeding did not occur in the study group versus one and three in the
control group, respectively. At discharge from hospital, patients in the
study group were less likely to have pleural effusion in a surgically
opened pleural cavity (22% vs. 36%; p = 0.043). <br/>Interpretation(s):
Our study results indicate that CPPF is a safe and effective method to
improve chest tube patency and reduce blood loss after cardiac surgery.
Larger trials are needed to draw final conclusions concerning the
effectiveness of CPPF on clinically relevant outcomes.<br/>Copyright
&#xa9; 2020 The Author(s)

<80>
Accession Number
2004184271
Title
RNAs and gene expression predicting postoperative atrial fibrillation in
cardiac surgery patients undergoing coronary artery bypass grafting.
Source
Journal of Clinical Medicine. 9 (4) (no pagination), 2020. Article Number:
1139. Date of Publication: April 2020.
Author
Khan M.S.; Yamashita K.; Sharma V.; Ranjan R.; Dosdall D.J.
Institution
(Khan, Yamashita, Ranjan, Dosdall) Nora Eccles Harrison Cardiovascular
Research and Training Institute, The University of Utah, Salt Lake City,
UT 84112, United States
(Yamashita, Ranjan, Dosdall) Division of Cardiovascular Medicine, The
University of Utah-Health, Salt Lake City, UT 84132, United States
(Sharma, Dosdall) Division of Cardiothoracic Surgery, The University of
Utah-Health, Salt Lake City, UT 84132, United States
(Ranjan, Dosdall) Department of Biomedical Engineering, The University of
Utah, Salt Lake City, UT 84112, United States
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: rasetti@mdpi.com)
Abstract
Postoperative atrial fibrillation (POAF) is linked with increased
morbidity, mortality rate and financial liability. About 20-50% of
patients experience POAF after coronary artery bypass graft (CABG)
surgery. Numerous review articles and meta-analyses have investigated
links between patient clinical risk factors, demographic conditions, and
pre-, peri-and post-operative biomarkers to forecast POAF incidence in
CABG patients. This narrative review, for the first time, summarize the
role of micro-RNAs, circular-RNAs and other gene expressions that have
shown experimental evidence to accurately predict the POAF incidence in
cardiac surgery patients after CABG. We envisage that identifying specific
genomic markers for predicting POAF might be a significant step for the
prevention and effective management of this type of post-operative
complication and may provide critical perspective into arrhythmogenic
substrate responsible for POAF.<br/>Copyright &#xa9; 2020 by the authors.
Licensee MDPI, Basel, Switzerland.

<81>
Accession Number
2004214604
Title
Investigation of impact of trinitroglycerin conjugated cardioplegia on
myocardial protection of patients with coronary artery bypass grafting.
Source
Acta Medica Iranica. 57 (10) (pp 586-591), 2019. Date of Publication:
2019.
Author
Nemati M.H.; Badie H.; Jannati M.
Institution
(Nemati, Badie, Jannati) Department of Cardiovascular Surgery, Faghihi
Hospital, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
Publisher
Medical Sciences University of Teheran
Abstract
Pharmacologic-conjugated-cardioplegia is one of the strategies against
ischemia and reperfusion. The aim of this study was to investigate the
impact of nitroglycerin on myocardial protection and postoperative
outcomes. This was a case-control study performed on 91 patients
undergoing coronary artery bypass grafting in Faghihi Hospital, Shiraz
University of Medical Sciences. Patients were randomly divided into case
and control groups. Trinitroglycerin Conjugated Cardioplegia on Myocardial
Protection of Patients with Coronary Artery Bypass Grafting. As a result
of nitroglycerin, the number of patients requiring inotrope administration
was increased. No other significant alteration was observed between two
groups in neither of ischemic features nor postoperative outcomes. In
conclusion, nitroglycerin conjugated cardioplegia, with the condition of
this study, demonstrated a negative inotrope requirement without
improvement in myocardium protection.<br/>Copyright &#xa9; 2019 Tehran
University of Medical Sciences. All rights reserved.

<82>
Accession Number
2004700352
Title
Continuous-flow left ventricular assist device implantation in patients
with preexisting mechanical mitral valves: a systematic review.
Source
Expert Review of Medical Devices. (no pagination), 2020. Date of
Publication: 2020.
Author
Gordon J.S.; O'Malley T.J.; Maynes E.J.; Wood C.T.; Kalantri N.; Morris
R.J.; Samuels L.E.; Massey H.T.; Tchantchaleishvili V.
Institution
(Gordon, O'Malley, Maynes, Wood, Kalantri, Morris, Samuels, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
Publisher
Taylor and Francis Ltd
Abstract
Introduction: A preexisting mechanical mitral valve (MMV) is thought to be
a thrombogenic risk factor after continuous-flow left ventricular assist
device (CF-LVAD) implantation. We sought to evaluate the management and
outcomes of preexisting MMVs in patients following CF-LVAD implantation.
Areas covered: An electronic search was performed to identify the presence
of an MMV at the time of CF-LVAD implantation. Of the 1,168 studies
identified, only five studies consisting of seven CF-LVAD patients met the
inclusion criteria. Patient-level data were extracted and analyzed. Expert
opinion: The median patient age was 54 (IQR: 42-61) years and 71.4% (5/7)
were male. Non-ischemic cardiomyopathy was the predominant etiology
(83.3%, 5/6) of heart failure, and bridge-to-transplant the predominant
indication (85.7%, 6/7) for CF-LVAD. Aortic valve prosthesis was present
in 42.9% (3/7) of patients. Median time from MMV to CF-LVAD placement was
6.0 years (IQR: 1.3-15.0). The median lower limit of the INR range was 2.8
(IQR: 2.1-3.0) and upper limit of the INR range was 3.5 (IQR: 3.1-3.5).
During a median follow-up time of 120 (IQR: 70-201) days, there were no
major GI bleeds or clinically significant thromboembolic complications.
With adequate anticoagulation, preexisting MMVs in CF-LVAD patients did
not result in clinically significant thromboembolic events.<br/>Copyright
&#xa9; 2020, &#xa9; 2020 Informa UK Limited, trading as Taylor & Francis
Group.

<83>
[Use Link to view the full text]
Accession Number
631566234
Title
High-sensitivity cardiac troponin and the universal definition of
myocardial infarction.
Source
Circulation. (pp 161-171), 2020. Date of Publication: 2020.
Author
Chapman A.R.; Adamson P.D.; Shah A.S.V.; Anand A.; Strachan F.E.; Ferry
A.V.; Lee K.K.; Berry C.; Findlay I.; Cruikshank A.; Reid A.; Gray A.;
Collinson P.O.; Apple F.; McAllister D.A.; Maguire D.; Fox K.A.A.;
Vallejos C.A.; Keerie C.; Weir C.J.; Newby D.E.; Mills N.L.
Institution
(Chapman, Adamson, Shah, Anand, Strachan, Ferry, Lee, Fox, Keerie, Newby,
Mills) BHF Centre for Cardiovascular Science, University of Edinburgh,
United Kingdom
(Weir) Edinburgh Clinical Trials Unit, University of Edinburgh, United
Kingdom
(Vallejos) MRC Human Genetics Unit, University of Edinburgh, United
Kingdom
(Weir, Mills) Usher Institute of Population Health Sciences and
Informatics, University of Edinburgh, United Kingdom
(Adamson) Christchurch Heart Institute, University of Otago, New Zealand
(Berry) Institute of Cardiovascular and Medical Sciences, University of
Glasgow, United Kingdom
(McAllister) Institute of Health and Wellbeing, University of Glasgow,
United Kingdom
(Findlay) Department of Cardiology, Royal Alexandra Hospital, Paisley,
United Kingdom
(Cruikshank, Reid) Department of Biochemistry, Queen Elizabeth University
Hospital, Glasgow, United Kingdom
(Gray) Emergency Medicine Research Group Edinburgh, Royal Infirmary of
Edinburgh, United Kingdom
(Collinson) Departments of Clinical Blood Sciences and Cardiology, St
George's University Hospitals NHS Trust, St George's University of London,
United Kingdom
(Apple) Department of Laboratory Medicine and Pathology, Hennepin
Healthcare/Hennepin County Medical Center, University of Minnesota,
Minneapolis, United States
(Maguire) Emergency Medicine Department, Glasgow Royal Infirmary, United
Kingdom
(Vallejos) Alan Turing Institute, London, United Kingdom
(Chapman, Adamson, Shah, Anand, Strachan, Ferry, Lee, Fox, Newby, Mills)
BHF Centre for Cardiovascular Science, University of Edinburgh, United
Kingdom
(Weir) Edinburgh Clinical Trials Unit, University of Edinburgh, United
Kingdom
(Vallejos) MRC Human Genetics Unit, University of Edinburgh, United
Kingdom
(Weir, Mills) Usher Institute of Population Health Sciences and
Informatics, University of Edinburgh, United Kingdom
(Adamson) Christchurch Heart Institute, University of Otago, New Zealand
(Berry) Institute of Cardiovascular and Medical Sciences, University of
Glasgow, United Kingdom
(McAllister) Institute of Health and Wellbeing, University of Glasgow,
United Kingdom
(Findlay) Department of Cardiology, Royal Alexandra Hospital, Paisley,
United Kingdom
(Cruikshank, Reid) Department of Biochemistry, Queen Elizabeth University
Hospital, Glasgow, United Kingdom
(Gray) Emergency Medicine Research Group Edinburgh, Royal Infirmary of
Edinburgh, United Kingdom
(Collinson) Departments of Clinical Blood Sciences and Cardiology, St
George's, University Hospitals NHS Trust, St George's University of
London, United Kingdom
(Apple) Department of Laboratory Medicine and Pathology, Hennepin
Healthcare/Hennepin County Medical Center, University of Minnesota,
Minneapolis, United States
(Maguire) Emergency Medicine Department, Glasgow Royal Infirmary, United
Kingdom
(Vallejos) Alan Turing Institute, London, United Kingdom
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: The introduction of more sensitive cardiac troponin assays has
led to increased recognition of myocardial injury in acute illnesses other
than acute coronary syndrome. The Universal Definition of Myocardial
Infarction recommends high-sensitivity cardiac troponin testing and
classification of patients with myocardial injury based on pathogenesis,
but the clinical implications of implementing this guideline are not well
understood. <br/>Method(s): In a stepped-wedge cluster randomized,
controlled trial, we implemented a high-sensitivity cardiac troponin assay
and the recommendations of the Universal Definition in 48 282 consecutive
patients with suspected acute coronary syndrome. In a prespecified
secondary analysis, we compared the primary outcome of myocardial
infarction or cardiovascular death and secondary outcome of
noncardiovascular death at 1 year across diagnostic categories.
<br/>Result(s): Implementation increased the diagnosis of type 1
myocardial infarction by 11% (510/4471), type 2 myocardial infarction by
22% (205/916), and acute and chronic myocardial injury by 36% (443/1233)
and 43% (389/898), respectively. Compared with those without myocardial
injury, the rate of the primary outcome was highest in those with type 1
myocardial infarction (cause-specific hazard ratio [HR] 5.64 [95% CI,
5.12-6.22]), but was similar across diagnostic categories, whereas
noncardiovascular deaths were highest in those with acute myocardial
injury (cause specific HR 2.65 [95% CI, 2.33-3.01]). Despite modest
increases in antiplatelet therapy and coronary revascularization after
implementation in patients with type 1 myocardial infarction, the primary
outcome was unchanged (cause specific HR 1.00 [95% CI, 0.82-1.21]).
Increased recognition of type 2 myocardial infarction and myocardial
injury did not lead to changes in investigation, treatment or outcomes.
<br/>Conclusion(s): Implementation of high-sensitivity cardiac troponin
assays and the recommendations of the Universal Definition of Myocardial
Infarction identified patients at high-risk of cardiovascular and
noncardiovascular events but was not associated with consistent increases
in treatment or improved outcomes. Trials of secondary prevention are
urgently required to determine whether this risk is modifiable in patients
without type 1 myocardial infarction. Clinical Trial Registration:
https://www.clinicaltrials.gov. Unique identifier:
NCT01852123.<br/>Copyright &#xa9; 2019 Wolters Kluwer Health, Inc. All
rights reserved.

<84>
Accession Number
2004502243
Title
Can we reduce conduction disturbances following transcatheter aortic valve
replacement?.
Source
Expert Review of Medical Devices. 17 (4) (pp 309-322), 2020. Date of
Publication: 02 Apr 2020.
Author
Alperi Garcia A.; Muntane-Carol G.; Junquera L.; del Val D.; Faroux L.;
Philippon F.; Rodes-Cabau J.
Institution
(Alperi Garcia, Muntane-Carol, Junquera, del Val, Faroux, Philippon,
Rodes-Cabau) Quebec Heart & Lung Institute, Laval University, Quebec City,
QC, Canada
Publisher
Taylor and Francis Ltd
Abstract
Introduction: Transcatheter aortic valve replacement (TAVR) has been
demonstrated to be a good alternative to surgery for treating severe
aortic stenosis (AS) across the whole range of surgical risk patients.
Whereas most periprocedural TAVR complications have significantly
decreased over time, conduction disturbances remain high. Approaches to
decrease this shortcoming are under continuous investigation. Areas
covered: Overview of the actual evidence regarding conduction disturbances
in the TAVR setting, focusing on modifiable factors. PubMed and Embase
databases were used for literature search. Expert opinion: Several factors
have been associated with an increased risk of conduction disturbances
post-TAVR, and some of them may be modifiable. While some transcatheter
valve systems have been associated with higher rates of conduction
disturbances, additional randomized data are needed to draw definite
conclusions about newer generation transcatheter valve systems. Nowadays,
good hemodynamic valve function can be obtained without excessive valve
oversizing, which has been associated with an increased risk of conduction
disturbances in some studies. Also, contemporary data regarding valve
implantation depth and new anatomical landmarks such as membranous septum
length have provided valuable insights for procedural planning. Finally,
homogenization of the management of conduction abnormalities post-TAVR
should be emphasized to allow a better understanding and generalization of
available evidence.<br/>Copyright &#xa9; 2020, &#xa9; 2020 Informa UK
Limited, trading as Taylor & Francis Group.

<85>
Accession Number
2003429932
Title
Effects of high-dose vitamin D supplementation on the occurrence of
post-operative atrial fibrillation after coronary artery bypass grafting:
randomized controlled trial.
Source
General Thoracic and Cardiovascular Surgery. 68 (5) (pp 477-484), 2020.
Date of Publication: 01 May 2020.
Author
Kara H.; Yasim A.
Institution
(Kara) Department of Cardiovascular Surgery, Giresun Ada Hospital,
Giresun, Turkey
(Yasim) Department of Cardiovascular Surgery, Kahramanmaras Sutcu Imam
University, Kahramanmaras, Turkey
Publisher
Springer
Abstract
Objective: This study aimed to investigate the preventive effects of a
high-dose vitamin D administered preoperatively on the post-operative
atrial fibrillation (POAF) occurrence in patients with insufficient or
deficient serum vitamin D levels who underwent coronary artery bypass
grafting (CABG) surgery. <br/>Method(s): The study was a randomized
controlled, blinded and parallel-arm trial conducted on 116 who had
vitamin D deficiency or insufficiency during the pre-operative evaluation
were included in the study conducted between January 2018 and January
2019. Patients were divided into those who received oral vitamin D
(treatment group; n = 58) and those who did not (control group; n = 58) 48
h before CABG surgery. In the treatment group, patients with vitamin D
deficiency were administered 300.000 IU vitamin D orally and those with
vitamin D insufficiency 150.000 IU 48 h preoperatively. Patients were
followed up during hospitalisation process with respect to POAF.
<br/>Result(s): Both groups showed no significant differences with regard
to age, gender, body mass index, creatine level, left atrial diameter,
pre-operative drug use, calcium level, ejection fraction, diabetes
mellitus and hypertension. The ratio of POAF occurrence found in the
treatment and control groups were 12.07% and 27.59%, respectively. Vitamin
D treatment was found to reduce the risk of POAF development by 0.24 times
(p = 0.034). <br/>Conclusion(s): In this study with sufficient sample
size, preoperative short-term high-dose vitamin D supplementation was
found to be significantly preventive to the occurrence of POAF in patients
with vitamin D insufficiency and deficiency who underwent CABG
surgery.<br/>Copyright &#xa9; 2019, The Japanese Association for Thoracic
Surgery.

<86>
Accession Number
2005646449
Title
Testosterone concentrations and risk of cardiovascular events in
androgen-deficient men with atherosclerotic cardiovascular disease.
Source
American Heart Journal. 224 (pp 65-76), 2020. Date of Publication: June
2020.
Author
Boden W.E.; Miller M.G.; McBride R.; Harvey C.; Snabes M.C.; Schmidt J.;
McGovern M.E.; Fleg J.L.; Desvigne-Nickens P.; Anderson T.; Kashyap M.;
Probstfield J.L.
Institution
(Boden, McGovern) VA Boston Healthcare System, Boston University School of
Medicine, Boston, MA, United States
(Miller, Snabes, Schmidt) AbbVie, Chicago, IL, United States
(McBride, Harvey, Desvigne-Nickens) Axio Research, LLC, Seattle, WA,
United States
(Fleg) National Heart, Lung and Blood Institute, National Institutes of
Health, Bethesda, MD, United States
(Anderson) Libin Cardiovascular Institute, University of Calgary, Calgary,
Alberta, Canada
(Kashyap) Long Beach VA Healthcare System, Los Angeles, CA, United States
(Probstfield) University of Washington, Seattle, WA, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Whether androgen deficiency among men increases the risk of
cardiovascular (CV) events or is merely a disease marker remains a subject
of intense scientific interest. <br/>Objective(s): Among male subjects in
the AIM-HIGH Trial with metabolic syndrome and low baseline levels of
high-density lipoprotein (HDL)-cholesterol who were randomized to niacin
or placebo plus simvastatin, we examined the relationship between low
baseline testosterone (T) concentrations and subsequent CV outcomes during
a mean 3-year follow-up. <br/>Method(s): In this post hoc analysis of men
with available baseline plasma T concentrations, we examined the
relationship between clinical/demographic characteristics and T
concentrations both as a continuous and dichotomous variable (<300 ng/dL
["low T"] vs. >=300 ng/dL ["normal T"]) on rates of pre-specified CV
outcomes, using Cox proportional hazards models. <br/>Result(s): Among
2118 male participants in whom T concentrations were measured, 643 (30%)
had low T and 1475 had normal T concentrations at baseline. The low T
group had higher rates of diabetes mellitus, hypertension, elevated body
mass index, metabolic syndrome, higher blood glucose, hemoglobin A1c, and
triglyceride levels, but lower levels of both low-density lipoprotein and
HDL-cholesterol, and a lower rate of prior myocardial infarction (MI). Men
with low T had a higher risk of the primary composite outcome of coronary
heart disease (CHD) death, MI, stroke, hospitalization for acute coronary
syndrome, or coronary or cerebral revascularization (20.1%) compared with
the normal T group (15.2%); final adjusted HR 1.23, P = .07, and a higher
risk of the CHD death, MI, and stroke composite endpoint (11.8% vs. 8.2%;
final adjusted HR 1.37, P = .04), respectively. <br/>Conclusion(s): In
this post hoc analysis, there was an association between low baseline
testosterone concentrations and increased risk of subsequent CV events in
androgen-deficient men with established CV disease and metabolic syndrome,
particularly for the composite secondary endpoint of CHD death, MI, and
stroke. Condensed Abstract: In this AIM-HIGH Trial post hoc analysis of
2118 men with metabolic syndrome and low HDL-cholesterol with available
baseline plasma testosterone (T) samples, 643 males (30%) had low T (mean:
229 ng/dL) and 1475 (70%) had normal T (mean: 444 ng/dL) concentrations.
The "low T" group had a 24% higher risk of the primary 5-component
endpoint (20.1%) compared with the normal T group (15.2%); final adjusted
HR 1.23, P = .07). There was also a 31% higher risk of the secondary
composite endpoint: coronary heart disease death, myocardial infarction,
and stroke (11.8% vs. 8.2%, final adjusted HR 1.37, P = .04) in the low
vs. normal T group, respectively.<br/>Copyright &#xa9; 2020

<87>
Accession Number
2005641032
Title
Health Status Changes and Outcomes in Patients With Heart Failure and
Mitral Regurgitation: COAPT Trial.
Source
Journal of the American College of Cardiology. 75 (17) (pp 2099-2106),
2020. Date of Publication: 5 May 2020.
Author
Arnold S.V.; Stone G.W.; Mack M.J.; Chhatriwalla A.K.; Austin B.A.; Zhang
Z.; Ben-Yehuda O.; Kar S.; Lim D.S.; Lindenfeld J.; Abraham W.T.; Cohen
D.J.
Institution
(Arnold, Chhatriwalla, Austin) Saint Luke's Mid America Heart Institute,
Kansas City, MO, United States
(Arnold, Chhatriwalla, Austin, Cohen) University of Missouri-Kansas City,
Kansas City, MO, United States
(Stone, Zhang, Ben-Yehuda) Clinical Trials Center, Cardiovascular Research
Foundation, New York, NY, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Ben-Yehuda) NewYork-Presbyterian Hospital/Columbia University Medical
Center, New York, NY, United States
(Kar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville, VA,
United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, Nashville, TN,
United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
Publisher
Elsevier USA
Abstract
Background: In the COAPT (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation) trial, transcatheter mitral valve repair (TMVr) with
the MitraClip rapidly improved health status and reduced the long-term
risks for death and heart failure (HF) hospitalization in patients with HF
and severe secondary mitral regurgitation who remained symptomatic despite
maximally tolerated guideline-directed medical therapy (GDMT).
<br/>Objective(s): The aim of this study was to examine if early health
status changes were associated with long-term clinical outcomes in the
COAPT population. <br/>Method(s): The association between change in health
status (Kansas City Cardiomyopathy Questionnaire overall summary score
[KCCQ-OS]) from baseline to 1 month and the composite rate of death or HF
hospitalization between 1 month and 2 years in the COAPT trial were
evaluated, and whether treatment (TMVr or GDMT alone) modified this
association was tested. <br/>Result(s): Among 551 patients with HF and
severe secondary mitral regurgitation who were alive at 1 month, those
randomized to TMVr were more likely than those randomized to GDMT alone to
achieve a >=10-point improvement in KCCQ-OS from baseline to 1 month
(TMVr, 58%; GDMT alone, 26%). Early improvement in KCCQ-OS was inversely
associated with the risk for death or HF hospitalization between 1 month
and 2 years (p < 0.001). When analyzed as a continuous variable, a
10-point increase in KCCQ-OS was associated with a 14% lower risk for
death or HF hospitalization (hazard ratio: 0.86; 95% confidence interval:
0.81 to 0.92; p < 0.001), with no significant interaction with treatment
group (p<inf>interaction</inf> = 0.17). After adjusting for demographic
and clinical factors, the association between change in KCCQ-OS and
outcomes was strengthened (hazard ratio: 0.79; 95% confidence interval:
0.73 to 0.86; p < 0.001). <br/>Conclusion(s): In patients with HF and
severe secondary mitral regurgitation, a short-term change in
disease-specific health status was strongly associated with the subsequent
long-term risk for death or HF hospitalization. These findings reinforce
the prognostic utility of serial KCCQ-OS assessments to identify patients
at risk for poor long-term clinical outcomes in this population.
(Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy
for Heart Failure Patients With Functional Mitral Regurgitation [The COAPT
Trial]; NCT01626079)<br/>Copyright &#xa9; 2020 American College of
Cardiology Foundation

<88>
Accession Number
2005654958
Title
Managing Otolaryngologic Complications in Cardiothoracic Surgery.
Source
Annals of Thoracic Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Huston M.N.; Naunheim K.S.; Naunheim M.R.
Institution
(Huston) Department of Otolaryngology-Head and Neck Surgery, Washington
University School of Medicine in Saint Louis, St Louis, MO, United States
(Naunheim) Division of Cardiothoracic Surgery, Department of Surgery,
Saint Louis University, St Louis, MO, United States
(Naunheim) Division of Laryngology, Department of Otolaryngology-Head and
Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, United
States
Publisher
Elsevier USA
Abstract
Background: Cardiothoracic procedures are often lifesaving operations, and
because of their complexity they are not without complications. Although
major complications are often recognized and treated immediately, there
are many less commonly identified complications that can and frequently
should be addressed by otolaryngology colleagues during a patient's
hospital course. <br/>Method(s): This comprehensive review describes
otolaryngologic complications of cardiac and thoracic surgery.
<br/>Result(s): Dysphonia, dysphagia, stridor, tracheotomy hemorrhage, and
pharyngeal tear are all complications of cardiothoracic procedures.
Indications for treatment and treatment options are reviewed. The impact
on quality of life and long-term morbidity is also discussed.
<br/>Conclusion(s): Otolaryngologic complications are common after
cardiothoracic procedures. An otolaryngologist should be asked to evaluate
a patient with dysphonia, dysphagia, or stridor while the patient is an
inpatient. Patients experiencing persistent or nonacute problems should be
referred to otolaryngologists to discuss more long-term
interventions.<br/>Copyright &#xa9; 2020

<89>
Accession Number
2005645066
Title
Long-term atrial arrhythmias incidence after heart transplantation.
Source
International Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Anselmino M.; Matta M.; Saglietto A.; Gallo C.; Gaita F.; Marchetto G.;
Rinaldi M.; De Ferrari G.M.; Boffini M.
Institution
(Anselmino, Saglietto, Gallo, De Ferrari) Division of Cardiology,
Department of Medical Sciences, "Citta della Salute e della Scienza di
Torino" Hospital, University of Turin, Turin, Italy
(Matta) Division of Cardiology, Sant'Andrea Hospital, Vercelli, Italy
(Gaita) Cardiovascular Department, Clinica Pinna Pintor, Policlinico di
Monza, Turin, Italy
(Marchetto, Rinaldi, Boffini) Division of Cardiac Surgery, Department of
Surgical Sciences, Citta della Salute e della Scienza, University of
Turin, Turin, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: Atrial arrhythmias after heart transplantation have rarely
been investigated. The aim of this study is to assess incidence, type and
predictors of atrial arrhythmias during a long-term follow-up in a large
population of heart-transplanted patients. <br/>Method(s): Consecutive
patients undergone to heart transplantation at our Centre from 1990 to
2017 were enrolled. All documented atrial arrhythmias were systematically
reviewed during a long-term follow-up after heart transplantation. Atrial
fibrillation (AF), atrial flutter and tachycardias were defined according
to current guidelines. <br/>Result(s): Overall, 364 patients were included
and followed for 120 +/- 70 months. During the follow-up period 108
(29.7%) patients died and 3 (0.8%) underwent re-transplantation. Sinus
rhythm was present in 355 (97.5%) patients. Nine patients had persistent
atrial arrhythmias: 8 (2.2%) presented atypical flutter and one (0.3%)
patient AF. Paroxysmal sustained arrhythmias were detected in 42 (11.5%)
patients, always atrial flutters. At univariate analysis several
echocardiographic (left ventricular end-diastolic diameter, TEI index,
mitral and tricuspid regurgitation grade) hemodynamic (systolic and
diastolic pulmonary pressure, capillary wedge pressure) and clinical
(dyslipidaemia, weight, pacemaker implantation) parameters related to
higher incidence of atrial arrhythmias. <br/>Conclusion(s): Persistent
atrial arrhythmias, and most of all AF, are rare among heart
transplantation carriers, despite substantial comorbidities resulting in
significant mortality. It can be speculated that the lesion set provided
by the surgical technique, a complete and transmural electrical isolation
of the posterior left atrium wall, represents an effective lesion set to
prevent persistent AF.<br/>Copyright &#xa9; 2018

<90>
Accession Number
631553852
Title
Robotic assisted thoracic surgery for lung cancer: A meta-analysis.
Source
Annals of Surgical Oncology. Conference: Society of Surgical Oncology SSO
2020 - International Conference on Surgical Cancer Care. United States. 27
(Supplement 1) (pp S212), 2020. Date of Publication: 2020.
Author
Rahouma M.; Baudo M.; Ghaly G.; Kamel M.; Mohamed A.
Institution
(Rahouma, Ghaly, Kamel, Mohamed) National Cancer Institute, Cairo
University, Egypt
(Baudo) Spedali Civili di Brescia, Milano, Italy
Publisher
Springer
Abstract
Objectives: Robotic assisted thoracic surgery (RATS) has been increasingly
utilized for lobectomy. Other than small institutional series, little data
exits comparing current VATS techniques with RATS in regard to
perioperative outcomes. In this analysis we sought to compare both RATS
vs. VATS in lung cancer patients who underwent lobectomy. <br/>Method(s):
Pubmed, ScienceDirect, and Embase databases were queried and we included
only reported RATS vs. VATS lobectomy for primary lung cancer. The primary
endpoint was in-hospital/30-day ortality. Secondary endpoints were
operative time, conversion to open, tumor size, clinical and pathological
non-stage I, lymph node (LN) retrieval, LN stations retrieved, air leak >
5 days, estimated blood loss (EBL), length of stay (LOS), and complication
rate. The odds ratio and standard mean differences (OR and SMD) were the
summary statistic using the random model. Leave-one-out analysis was done.
<br/>Result(s): Among 1,312 articles, 9 were eligible with 39,696 patients
included (7,271 RATS and 32,424 VATS). Pooled analysis indicated that
there was no difference in the rate of conversion to open thoracotomy,
tumor size, clinical and pathological non-stage I, LN numbers retrieved,
number of LN stations retrieved. Prolonged air leaks (>5days) were similar
between both groups as well as LOS, complication rates and in hospital/30
days mortality. On meta-regression, age, sex, smoking and FEV1 had no
effect on perioperative mortality. Although RATS was associated with a
longer OR-time (SMD= 0.82, 95%CI=0.55-1.09, P<0.0001) there was a trend
towards less EBL (SMD= -0.36, 95%CI=-0.73 - 0.01, P=0.06).
<br/>Conclusion(s): This current analysis demonstrates that both RATS and
VATS can be performed safely with comparable peri-operative outcomes.
Randomized clinical trials comparing both approaches are required to
elucidate possible RATS advantages.

<91>
Accession Number
631555213
Title
A case series of Left Impella-device as bridge from acute mitral
regurgitation to MitraClip-procedure: A novel implementation of
percutaneous mechanical circulatory support.
Source
Acta Clinica Belgica. Conference: 39th Annual Congress of the Belgian
Society of Cardiology. Belgium. 75 (Supplement 1) (pp 26-27), 2020. Date
of Publication: 2020.
Author
Vandenbriele C.; Wilson J.; Adriaenssens T.; Balthazar T.; Caetano F.;
Davies S.; Dubois C.; Goetschalckx K.; Janssens S.; Ledot S.; Meyns B.;
Price S.; Smith R.
Institution
(Vandenbriele, Adriaenssens, Balthazar, Dubois, Goetschalckx, Janssens,
Meyns) University Hospital Leuven
(Wilson, Caetano, Davies, Ledot, Price, Smith) Royal Brompton Hospital
Publisher
Taylor and Francis Ltd.
Abstract
Background: Acute mitral regurgitation (MR) is a medical and mostly
surgical emergency. Severe acute MR presenting with hemodynamic collapse
is usually related to an exceedingly rare mechanical complication such as
papillary muscle rupture after AMI or chordae tendinae rupture, resulting
in flail mitral leaflets. Preoperative stabilization is complex due to
concomitant hemodynamic collapse and hypoxic respiratory failure. Finding
the right balance between both preload and inotropic support is very
challenging. Nowadays, when patients are too sick for immediate surgical
intervention, mechanical circulatory support should be considered because
of its decreasing effect on afterload and cardiac work while increasing
coronary perfusion and cardiac output. Nevertheless, even after initial
stabilization, the surgical risk remains high in critically ill acute
severe MR patients and other technical modalities reducing the MR-such as
MitraClip - should be explored. <br/>Method(s): Between August 2017 and
September 2019, patients presenting with acute, moderate-to-severe or
severe mitral regurgitation and considered too ill for immediate surgical
intervention (EURO-II score >11,2% plus pulmonary edema necessitating
mechanical ventilation and/or hemodynamic instability), were selected for
an Impella-assisted ventricular unloading technique as bridge to
MitraClip-procedure. Five patients were selected for the combined left
Impella/ MitraClip-procedure in two tertiary cardiac intensive care units.
<br/>Result(s): The mean age was 72 years. The cause of MR was ischemic in
20% of all cases and all patients presented in cardiogenic shock state,
necessitating mechanical ventilation. Only one patient was in multiple
organ failure (late referral) at presentation. The overall cardiac
operative risk assessment (Euro-II) score represented a 35% chance of
in-hospital mortality after surgery. Cardiac output was severely impaired
(mean LVOT VTI 8,2 cm; forward failure). All patients were on inotropic
support and supported by an Impella-CP pVAD (mean flow 2,5 Liter per
minute; mean 6,3 days of support). In all cases, we managed to reduce the
LVEDP below 15mmHg using medical therapy (afterload reduction, inotropes),
mechanical ventilation and pVAD-therapy. The MR could be successfully
reduced by a MitraClip-procedure in each patient. The overall survival at
discharge was 80%. One patient with late referral and multiple organ
failure at presentation deceased due to refractory cardiogenic shock.
Overall, severe MR was reduced to grade 1+ and all four patients survived
6 months after discharge with only one readmission for decompensated heart
failure. <br/>Conclusion(s): We identify the combined
Impella/MitraClip-strategy (Figure) as an interesting and feasible
alternative for patients presenting with acute, severe MR and unable to
wean from mechanical ventilatory support due to therapy resistant
pulmonary edema despite pVAD-support. pVAD-support should be initiated
early. We realize the limitations of our study; the patient sample size is
small (rare pathology) and the study non-randomized. Therefore, this
strategy should be further explored in a randomized, multicenter way.

<92>
Accession Number
631471259
Title
Topical Use of Tranexamic Acid in Cardiac Surgery: A Meta-Analysis.
Source
Thoracic and Cardiovascular Surgeon. 68 (3) (pp 212-218), 2020. Date of
Publication: 01 Apr 2020.
Author
Habbab L.M.; Semelhago L.; Lamy A.
Institution
(Habbab, Semelhago, Lamy) Division of Cardiac Surgery, Hamilton General
Hospital, McMaster University, McMaster Clinic, 237 Barton Street East,
Hamilton, ON L8L 22, Canada
Publisher
Georg Thieme Verlag (E-mail: iaorl@iaorl.org)
Abstract
Background This meta-analysis was conducted to investigate the evidence
for the efficacy and safety of intrapericardial tranexamic acid (TXA) in
cardiac surgery. Methods We searched MEDLINE from 2000 to 2017 for
randomized controlled trials that compared intrapericardial TXA to
placebo. We performed a meta-analysis for the eligible trials that focused
on chest tube drainage measured during the first 24 hours after surgery as
a primary outcome. We also examined the secondary outcome measures of
these trials such as the incidence of transfusion requirements following
surgery and the evidence for any increase in complication rates. Results
A total of seven randomized controlled trials (six on-pump and one
off-pump) comparing topical application of TXA to placebo in 692 patients
were eligible for the blood loss outcome data. These trials randomized 372
patients to receive TXA and 320 patients as controls. The use of
intrapericardial TXA was associated with a considerable reduction in
24-hour blood loss in all seven studies and a weighted mean difference of
-343.56 mL (95% confidence interval: -316.41, -370.72) significantly
differed from zero (p = 0.005) with a heterogeneity of I ² =
0%. The incidence of packed RBC transfusion in TXA patients was
significantly lower in one study and was not significant but with trend in
favor of TXA in five out of the six studies in which it was reported. In
one trial, TXA was not detected in any patient and in another the studied
groups were similar in postoperative complications, such as graft patency,
myocardial infarction, cerebral infarction, atrial fibrillation, seizures,
and infections. Conclusions Findings from this meta-analysis suggest that
intrapericardial use of TXA in patients undergoing cardiac surgery can
decrease postoperative bleeding without increasing the risk of
postoperative seizures. Future large randomized, double-blind, controlled
clinical trials are needed to confirm these promising
findings.<br/>Copyright &#xa9; 2020 EDP Sciences. All rights reserved.

<93>
Accession Number
2004685462
Title
Derivation and Validation of a Risk Stratification System for Predicting
Postoperative Cognitive Impairment.
Source
Journal of Investigative Surgery. (no pagination), 2020. Date of
Publication: 2020.
Author
Liao Y.; Su X.; Ouyang W.; Li L.; Chen S.; Chou J.; Le Y.
Institution
(Liao, Su, Ouyang, Li, Chen, Chou, Le) Department of Anesthesiology, The
Third Xiangya Hospital, Central South University, Changsha, China
Publisher
Taylor and Francis Ltd
Abstract
Background: To establish and validate a risk stratification scoring system
(we name it as PreOp-BFS, which represents Pre-Operative Brain Fragility
Score) for postoperative cognitive impairment containing postoperative
cognitive dysfunction (POCD) and postoperative delirium (POD) in elderly
patients undergoing non-cardiac surgery. <br/>Method(s): We searched for
relevant literatures and reviews reported in PubMed and ScienceDirect
databases from January 1994 to December 2017. We performed a preoperative
risk factor for cognitive impairment in elderly patients (age >= 60 years)
who underwent non-cardiac surgery, and finally constructed a risk scoring
system to predict postoperative cognitive impairment. <br/>Result(s): The
test data included 49 patients with postoperative cognitive impairment and
31 patients without postoperative cognitive impairment. The postoperative
risk scale score ranged from 0 to 8 points. The incidence of postoperative
cognitive impairment was 16.2%, 62.9% and 96.2% in the low (0-2 scores),
medium (3-4 scores) and high (5-8 scores) risk groups, respectively. In
addition, the risk of postoperative cognitive impairment was significantly
higher in high and medium risk groups than in low risk group. Receiver
operating characteristic (ROC) analysis showed that the area under the
curve (AUC) of the risk scoring system was 0.862 [95% CI 0.784-0.941].
<br/>Conclusion(s): The preoperative risk stratification scoring system
(PreOp-BFS) established in this study had a good prediction effect, which
was helpful for rapid identification and screening of high-risk
susceptible patients with early postoperative cognitive impairment, and
for performing targeted perioperative prevention.<br/>Copyright &#xa9;
2020, &#xa9; 2020 Taylor & Francis Group, LLC.

<94>
Accession Number
2004659832
Title
Could fluorescence-guided surgery be an efficient and sustainable option?
A SICE (Italian Society of Endoscopic Surgery) health technology
assessment summary.
Source
Surgical Endoscopy. (no pagination), 2020. Date of Publication: 2020.
Author
Vettoretto N.; Foglia E.; Ferrario L.; Gerardi C.; Molteni B.; Nocco U.;
Lettieri E.; Molfino S.; Baiocchi G.L.; Elmore U.; Rosati R.; Curro G.;
Cassinotti E.; Boni L.; Cirocchi R.; Marano A.; Petz W.L.; Arezzo A.;
Bonino M.A.; Davini F.; Biondi A.; Anania G.; Agresta F.; Silecchia G.
Institution
(Vettoretto) Chirurgia Montichiari, Azienda Socio Sanitaria Territoriale
Degli Spedali Civili, V.le Ciotti 154, Montichiari, Brescia 25018, Italy
(Foglia, Ferrario) LIUC - Universita Cattaneo, Castellanza, VA, Italy
(Gerardi) Centro di Politiche Regolatorie, Istituto di Ricerche
Farmacologiche "Mario Negri" IRCCS, Milan, Italy
(Molteni, Molfino, Baiocchi) Department of Clinical and Experimental
Surgery, University of Brescia, Brescia, Italy
(Nocco) Ingegneria Clinica, Azienda Socio Sanitaria Territoriale dei Sette
Laghi, Varese, Italy
(Lettieri) School of Management, Department of Management, Economics and
Industrial Engineering, Politecnico, Milano, Italy
(Elmore, Rosati) Department of Gastrointestinal Surgery, IRCCS San
Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan,
Italy
(Curro) Department of Human Pathology of Adult and Evolutive Age,
University Hospital of Messina, Messina, Italy
(Cassinotti, Boni) Chirurgia Generale, Fondazione IRCCS - Ca' Granda -
Ospedale Maggiore Policlinico - University of Milan, Milan, Italy
(Cirocchi) Department of Surgical Sciences, University of Perugia,
Perugia, Italy
(Marano) Chirurgia Generale ed Oncologica, Azienda Ospedaliera S. Croce e
Carle, Cuneo, Italy
(Petz) Chirurgia, IEO, European Institute of Oncology IRCCS, Milan, Italy
(Arezzo, Bonino) Department of Surgical Sciences, University of Torino,
Turin, Italy
(Davini) Centro multidisciplinare Chirurgia Robotica, Chirurgia Toracica
mini-invasiva e Robotica, Azienda Ospedaliero-Universitaria Pisana, Pisa,
Italy
(Biondi) Chirurgia Generale, Fondazione Policlinico Universitario A.
Gemelli IRCSS, Rome, Italy
(Anania) Chirurgia Generale, University of Ferrara, Ferrara, Italy
(Agresta) Chirurgia Generale, Azienda ULSS 5 "Polesana", Hospital of
Adria, Adria, RO, Italy
(Silecchia) Department of Medical-Surgical Sciences and Biotechnologies,
Sapienza University of Rome-Polo Pontino, Rome, Italy
Publisher
Springer
Abstract
Background: Indocyanine green fluorescence vision is an upcoming
technology in surgery. It can be used in three ways: angiographic and
biliary tree visualization and lymphatic spreading studies. The present
paper shows the most outstanding results from an health technology
assessment study design, conducted on fluorescence-guided compared with
standard vision surgery. <br/>Method(s): A health technology assessment
approach was implemented to investigate the economic, social, ethical, and
organizational implications related to the adoption of the innovative
fluorescence-guided view, with a focus on minimally invasive approach.
With the support of a multidisciplinary team, qualitative and quantitative
data were collected, by means of literature evidence, validated
questionnaires and self-reported interviews, considering the dimensions
resulting from the EUnetHTA Core Model. <br/>Result(s): From a systematic
search of literature, we retrieved the following studies: 6 on hepatic, 1
on pancreatic, 4 on biliary, 2 on bariatric, 4 on endocrine, 2 on
thoracic, 11 on colorectal, 7 on urology, 11 on gynecology, 2 on gastric
surgery. Fluorescence guide has shown advantages on the length of
hospitalization particularly in colorectal surgery, with a reduction of
the rate of leakages and re-do anastomoses, in spite of a slight increase
in operating time, and is confirmed to be a safe, efficacious, and
sustainable vision technology. Clinical applications are still presenting
a low evidence in the literature. <br/>Conclusion(s): The present paper,
under the patronage of Italian Society of Endoscopic Surgery, based on an
HTA approach, sustains the use of fluorescence-guided vision in minimally
invasive surgery, in the fields of general, gynecologic, urologic, and
thoracic surgery, as an efficient and economically sustainable
technology.<br/>Copyright &#xa9; 2020, Springer Science+Business Media,
LLC, part of Springer Nature.

<95>
[Use Link to view the full text]
Accession Number
631535683
Title
Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve
Replacement: A Propensity-Matched Comparison from the FRANCE-TAVI
Registry.
Source
Circulation. (pp 243-259), 2020. Date of Publication: 2020.
Author
Van Belle E.; Vincent F.; Labreuche J.; Auffret V.; Debry N.; Lefevre T.;
Eltchaninoff H.; Manigold T.; Gilard M.; Verhoye J.-P.; Himbert D.; Koning
R.; Collet J.-P.; Leprince P.; Teiger E.; Duhamel A.; Cosenza A.; Schurtz
G.; Porouchani S.; Lattuca B.; Robin E.; Coisne A.; Modine T.; Richardson
M.; Joly P.; Rioufol G.; Ghostine S.; Bar O.; Amabile N.; Champagnac D.;
Ohlmann P.; Meneveau N.; Lhermusier T.; Leroux L.; Leclercq F.; Gandet T.;
Pinaud F.; Cuisset T.; Motreff P.; Souteyrand G.; Iung B.; Folliguet T.;
Commeau P.; Cayla G.; Bayet G.; Darremont O.; Spaulding C.; Le Breton H.;
Delhaye C.
Institution
(Van Belle, Vincent, Debry, Cosenza, Schurtz, Porouchani, Robin, Coisne,
Modine, Richardson, Delhaye) Department of Cardiology, Institut Coeur
Poumon, Centre Hospitalier Universitaire de Lille, Lille Cedex 59037,
France
(Labreuche, Duhamel) Department of Biostatistics, EA 2694-Sante Publique:
Epidemiologie et Qualite des Soins, France
(Auffret, Verhoye, Le Breton) CHU de Lille, Universite de Lille, France
(Auffret, Verhoye, Le Breton) CHU Pontchaillou, Service de Cardiologie et
Maladies Vasculaires, CIC-IT 804, Universite de Rennes 1, Laboratoire de
Traitement du Signal et de l'Image, Inserm, Rennes U1099, France
(Lefevre) Institut Cardiovasculaire Paris-Sud, Hopital Prive
Jacques-Cartier, Massy, France
(Eltchaninoff) CHU Rouen-Charles-Nicolle, Service de Cardiologie, Inserm
U644, Rouen, France
(Manigold) CHU Guillaume et Rene Laennec, Institut du Thorax, Service de
Cardiologie, Nantes, France
(Gilard, Iung) CHU la Cavale Blanche, Departement de Cardiologie,
Optimisation des Regulations Physiologiques, UFR Sciences et Techniques,
Brest, France
(Himbert) AP-HP, Hopital Bichat, Departement de Cardiologie, Universite
Paris-Diderot, France
(Koning) Clinique Saint-Hilaire, Service de Cardiologie, Rouen, France
(Collet, Leprince) AP-HP, CHU la Pitie-Salpetriere, Service de
Cardiologie, Paris, France
(Teiger, Cayla) Hopital Henri-Mondor Assistance Publique Hopitaux de
Paris, Departement de Cardiologie, Creteil, France
(Lattuca) CHU Nimes, Cardiologie, Universite Montpellier, Nimes, France
(Joly) Hopital Saint-Joseph, Federation de Cardiologie, Marseille, France
(Rioufol) CHU Louis Pradel, Division de Cardiologie, Centre
d'Investigation Clinique de Lyon (CIC), Bron, France
(Ghostine) Centre Marie Lannelongue, Departement de Cardiologie, Le
Plessis Robinson, France
(Bar) Clinique Saint Gatien, Service de Cardiologie, Tours, France
(Amabile) Institut Mutualiste Montsouris, Departement de Cardiologie,
Paris, France
(Champagnac) Clinique du Tonkin, Service de Cardiologie, Villeurbanne,
France
(Ohlmann) CHU de Strasbourg, Nouvel Hopital Civil, Departement de
Cardiologie, Universite de Strasbourg, France
(Meneveau) CHU Besancon, Cardiologie, Hopital Jean Minjoz, Besancon,
France
(Lhermusier) CHU de Toulouse, Departement de Cardiologie, Inserm U1048,
Universite de Toulouse 3, France
(Leroux) Hopital Cardiologique du Haut-Leveque, Departement de Cardiologie
Interventionnelle, Universite de Bordeaux, Pessac, France
(Leclercq, Gandet) CHU Arnaud de Villeneuve, Service de Cardiologie,
Montpellier, France
(Pinaud) CHU d'Angers, Service de Chirurgie Cardiaque, CNRS UMR 6214,
INSERM 1083, Universite d'Angers, France
(Cuisset) CHU la Timone Assistance Publique Hopitaux de Marseille,
Departement de Cardiologie, Inserm UMR1062, INRA UMR 1260, Universite
d'Aix-Marseille, France
(Motreff, Souteyrand) CHU Gabriel Montpied, Departement de Cardiologie,
ISIT, CaVITI, CNRS (UMR-6284), Universite d'Auvergne, Clermont-Ferrand,
France
(Folliguet) CHU de Nancy, Service de Chirurgie Cardiovasculaire,
Vandoeuvre-les-Nancy, France
(Commeau) Polyclinique les Fleurs, Cardiologie, Ollioules, France
(Bayet) Hopital Prive Clairval, Service de Cardiologie, Marseille, France
(Darremont) Clinique Saint Augustin, Service de Cardiologie, Bordeaux,
France
(Spaulding) Hopital Europeen Georges Pompidou, Paris, France
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: No randomized study powered to compare balloon expandable (BE)
with self expanding (SE) transcatheter heart valves (THVs) on individual
end points after transcatheter aortic valve replacement has been conducted
to date. <br/>Method(s): From January 2013 to December 2015, the
FRANCE-TAVI nationwide registry (Registry of Aortic Valve Bioprostheses
Established by Catheter) included 12 141 patients undergoing BE-THV
(Edwards, n=8038) or SE-THV (Medtronic, n=4103) for treatment of native
aortic stenosis. Long term mortality status was available in all patients
(median 20 months; interquartile range, 14 to 30). Patients treated with
BE-THV (n=3910) were successfully matched 1:1 with 3910 patients treated
with SE-THV by using propensity score (25 clinical, anatomical, and
procedural variables) and by date of the procedure (within 3 months). The
first coprimary outcome was >= moderate occurrence of paravalvular
regurgitation or in-hospital mortality, or both. The second coprimary
outcome was 2-year all-cause mortality. <br/>Result(s): In
propensity-matched analyses, the incidence of the first coprimary outcome
was higher with SE-THV (19.8%) compared with BE-THV (11.9%; relative risk,
1.68 [95% CI, 1.46-1.91]; P<0.0001). Each component of the outcome was
also higher in patients receiving SE-THV: >= moderate paravalvular
regurgitation (15.5% versus 8.3%; relative risk, 1.90 [95% CI, 1.63-2.22];
P<0.0001) and in hospital mortality (5.6% versus 4.2%; relative risk, 1.34
[95% CI, 1.07-1.66]; P=0.01). During follow up, all cause mortality
occurred in 899 patients treated with SE-THV (2-year mortality, 29.8%) and
in 801 patients treated with BE-THV (2-year mortality, 26.6%; hazard
ratio, 1.17 [95% CI, 1.06-1.29]; P=0.003). Similar results were found
using inverse probability of treatment weighting using propensity score
analysis. <br/>Conclusion(s): The present study suggests that use of
SE-THV was associated with a higher risk of paravalvular regurgitation and
higher in-hospital and 2-year mortality compared with use of BE-THV. These
data strongly support the need for a randomized trial sufficiently powered
to compare the latest generation of SE-THV and BE-THV. Clinical Trial
Registration: https://www.clinicaltrials.gov. Unique identifier:
NCT01777828.<br/>Copyright &#xa9; 2019 American Heart Association, Inc.

<96>
Accession Number
2005600963
Title
Treatment of Severe TRIcuspid regurgitation in patients with advanced
heart failure with caval vein implantation of the edwards sapien XT valve
(TRICAVAL): A randomised controlled trial.
Source
EuroIntervention. 15 (17) (pp 1506-1513), 2020. Date of Publication: April
2020.
Author
Dreger H.; Mattig I.; Hewing B.; Knebel F.; Lauten A.; Lembcke A.; Thoenes
M.; Roehle R.; Stangl V.; Landmesser U.; Grubitzsch H.; Stangl K.; Laule
M.
Institution
(Dreger, Mattig, Hewing, Knebel, Stangl, Stangl, Laule) Medizinische
Klinik fur Kardiologie und Angiologie, Campus Charite Mitte, Charite -
Universitatsmedizin Berlin, Chariteplatz 1, Berlin D-10117, Germany
(Dreger, Hewing, Knebel, Stangl, Landmesser, Stangl) DZHK (German Centre
for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
(Hewing, Knebel, Roehle, Landmesser, Laule) Berlin Institute of Health
(BIH), Berlin, Germany
(Lauten, Landmesser) Medizinische Klinik fur Kardiologie, Campus Benjamin
Franklin, Charite - Universitatsmedizin Berlin, Berlin, Germany
(Lembcke) Institut fur Radiologie, Campus Charite Mitte, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Thoenes) Edwards Lifesciences, Nyon, Switzerland
(Roehle) Coordinating Center for Clinical Studies, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Roehle) Institute of Biometry and Clinical Epidemiology, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Grubitzsch) Klinik fur Kardiovaskulare Chirurgie, Charite -
Universitatsmedizin Berlin, Berlin, Germany
Publisher
Europa Group
Abstract
Aims: The aim of our study was to compare the impact of implantation of a
balloon-expandable transcatheter valve into the inferior vena cava (CAVI)
on exercise capacity with optimal medical therapy (OMT) in patients with
severe tricuspid regurgitation (TR) and high surgical risk. <br/>Methods
and Results: Twenty-eight patients were randomised to OMT (n=14) or CAVI
(n=14). The primary endpoint was maximal oxygen uptake at the three-month
follow-up. Secondary endpoints included six-minute walk test, NYHA class,
NT-proBNP levels, right heart function, unscheduled heart failure
hospitalisation, and quality of life as assessed by the Minnesota Living
with Heart Failure Questionnaire (MLHFQ). Patients underwent follow-up
examinations one, three, six, and twelve months after randomisation.
Maximal oxygen uptake did not change significantly in either group after
three months and there was no difference between the OMT and CAVI groups
(-0.1+/-1.8 ml kg-1 min-1 vs -1.0+/-1.6 ml kg-1 min-1, p=0.4995). Compared
to baseline, CAVI improved NYHA class, dyspnoea, and quality of life after
three months. However, there were no statistically significant differences
in the secondary endpoints between the groups. Four periprocedural
complications occurred after CAVI, resulting in open heart surgery. Four
patients in the OMT group and eight patients (including four after
conversion to surgery) in the CAVI group died from right heart failure,
sepsis or haemorrhage. <br/>Conclusion(s): CAVI did not result in a
superior functional outcome compared to OMT. Due to an unexpectedly high
rate of valve dislocations, the study was stopped for safety
reasons.<br/>Copyright &#xa9; Europa Digital & Publishing 2020.

<97>
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. 125 (10) (pp 1558-1565), 2020. Date of
Publication: 15 May 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

<98>
Accession Number
2004253870
Title
The prognostic value of late gadolinium enhancement in myocarditis and
clinically suspected myocarditis: systematic review and meta-analysis.
Source
European Radiology. 30 (5) (pp 2616-2626), 2020. Date of Publication: 01
May 2020.
Author
Yang F.; Wang J.; Li W.; Xu Y.; Wan K.; Zeng R.; Chen Y.
Institution
(Yang, Wang, Li, Xu, Zeng, Chen) Department of Cardiology, West China
Hospital, Sichuan University, Guoxue Xiang No. 37, Chengdu, Sichuan
610041, China
(Wan) Department of Geriatrics, West China Hospital, Sichuan University,
Chengdu, Sichuan Province 610041, China
(Chen) Center of Rare diseases, West China Hospital, Sichuan University,
Chengdu, Sichuan Province 610041, China
Publisher
Springer
Abstract
Objective: To evaluate the prognostic value of late gadolinium enhancement
(LGE) in myocarditis and clinically suspected myocarditis. <br/>Method(s):
The study was registered in PROSPERO (CRD42019144976). A systematic search
of PubMed, Ovid Medline, Embase, Web of Science and the Cochrane Central
Register of Controlled Trials was completed. Major adverse cardiac event
(MACE) was defined as the combination of all-cause mortality or
cardiovascular death, resuscitated cardiac arrest, heart transplantation,
appropriate implantable cardioverter-defibrillator shock,
rehospitalisation following a cardiac event and recurrent acute
myocarditis. Combined outcome was defined as the combination of all
adverse events. Pooled odds ratios (ORs) and 95% confidence intervals
(CIs) were calculated to evaluate the prognostic value of LGE.
<br/>Result(s): Eight articles including 1319 patients (mean age, 38.8 +/-
12.9 years) were included in the meta-analysis. The study showed that
positive LGE was strongly associated with an increased risk of combined
outcome (pooled OR, 5.85; 95% CI, 2.88 to 11.86; p < 0.001) and of MACE
(pooled OR, 4.57; 95% CI, 2.18 to 9.59; p < 0.001). Additionally, in a
subgroup analysis with mean ejection fraction (EF) point of 50%, the
pooled ORs for the combined outcome were 6.46 for left ventricular EF
(LVEF) > 50% and 7.90 for LVEF <= 50%, and the pooled ORs for MACE were
9.03 and 3.45, respectively. After 3 years of follow-up, the worse
outcomes occurred mainly in patients with positive LGE.
<br/>Conclusion(s): Positive LGE is a powerful prognosticator of adverse
outcome in myocarditis and clinically suspected myocarditis, irrespective
of LVEF. Key Points: * Forty-four percent to 100% of myocarditis patients
have positive late gadolinium enhancement. * Positive LGE was a powerful
prognosticator of adverse outcome in myocarditis and clinically suspected
myocarditis, irrespective of LVEF. * LGE-CMR is important tool for risk
stratification in myocarditis and clinically suspected
myocarditis.<br/>Copyright &#xa9; 2020, European Society of Radiology.

<99>
Accession Number
2005551168
Title
Viscoelastic haemostatic assays in the perioperative period of surgical
procedures: Systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 64 (no pagination), 2020. Article Number:
109809. Date of Publication: September 2020.
Author
Santos A.S.; Oliveira A.J.F.; Barbosa M.C.L.; Nogueira J.L.D.S.
Institution
(Santos, Oliveira, Barbosa, Nogueira) Centre for Health Technology
Assessment of the UFMG Teaching Hospital (NATS-HC/UFMG), Universidade
Federal de Minas Gerais, Av. Alfredo Balena, 110, Santa Efigenia, Belo
Horizonte 30.130-100, Brazil
(Santos) Department of Economical Sciences, School of Economics,
Universidade Federal de Minas Gerais, Av. Presidente Antonio Carlos, 6627,
Pampulha, Belo Horizonte 31.270-901, Brazil
(Oliveira) Department of Health Management, School of Nursing,
Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, Santa
Efigenia, Belo Horizonte 30.130-100, Brazil
(Barbosa) Collegy of Pharmacy, Universidade Federal de Minas Gerais, Av.
Presidente Antonio Carlos, 6627, Pampulha, Belo Horizonte 31.270-901,
Brazil
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objective: The aim of this study is to evaluate the safety and efficacy of
Viscoelastic Haemostatic Assays (VHA) to guide transfusions in patients
undergoing surgical procedures. <br/>Design(s): Systematic review with
meta-analysis of randomized controlled trials up until June 5, 2019.
<br/>Setting(s): Hospitalized patients. <br/>Intervention(s): VHAs
compared to the Standard-Of-Care (SOC), which are represented by standard
laboratory tests and/or clinical decisions. Measurements: Primary - Risk
of death, acute kidney injury, thrombotic events and reoperation for
bleeding; Secondary - Risk of use of red blood cells (RBC), platelets,
fresh frozen plasma (FFP), fibrinogen, factor VIIa, prothrombin complex,
volume of RBC, platelets and FFP, length of hospital stay, and length of
ICU stay. <br/>Result(s): VHAs were associated to a statistically
significant reduction in mortality (7.3% vs. 12.1%; RR = 0.64, p-value =
0.03), risk of acute kidney injury (10.5% vs. 17.6%; RR = 0.53, p-value =
0.005), volume of red blood cells (RBCs) transfused (MD = -1.63 U, p-value
= 0.02), risk of platelet transfusion (23.9% vs. 27.3%; RR = 0.74, p-value
= 0.006), risk of fresh frozen plasma (FFP) transfusion (RR = 0.57,
p-value = 0.001), and volume of FFP transfused (MD = -0.90, p-value =
0.0003). No significant differences were observed in terms of thrombotic
events, reexploration for bleeding, RBC transfusion, volume of platelets
transfused, use of fibrinogen, prothrombin complex, or factor VIIa, length
of hospitalization and length of ICU stay. <br/>Conclusion(s):
Viscoelastic haemostatic assays are safe and efficacious for coagulation
control in patients undergoing surgical procedures, therefore it should be
considered for use in practice.<br/>Copyright &#xa9; 2020 Elsevier Inc.