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<1>
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. 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. 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. 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. 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. Copyright © 2020

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

<3>
Accession Number
600795991
Title
Diagnostic efficacy value in terms of sensitivity and specificity of
imaging modalities in detecting the abdominal aortic aneurysm: A
systematic review.
Source
7 (1) (pp 15-35), 2015. Date of Publication: 01 Jan 2015.
Author
Alamoudi A.O.; Haque S.; Srinivasan S.; Mital D.P.
Institution
(Alamoudi, Haque, Srinivasan, Mital) Department of Health Informatics,
School of Health Related Professions, University of Medicine and Dentistry
of New Jersey, Newark, NJ 07107-3001, United States
Publisher
Inderscience Publishers
Abstract
The purpose of this study was to examine whether duplex ultrasonography
(DUS) or MR angiography (MRA) or CT angiography (CTA) is more applicable
to use as alternative modality in terms of sensitivity and specificity for
detection of abdominal aortic aneurysm (AAA). A search of the medical
databases was performed for describing AAA evaluation and detection.
Twenty eight studies were found and met the selection criteria. Diameter
of aneurysms was categorised by size: <= 2.5 cm of the aneurysm diameter.
For aneurisms <= 2.5 cm, the mean reported sensitivities and specificities
were DUS: 81% and 91.1%; CTA: 84.3% and 98.4%; MRA: 95.8% and 95.8%,
respectively compared DSA as gold standard. MRA has the highest
sensitivity and CTA has the highest specificity reported diagnostic
accuracy in detecting the aneurysm <= 2.5 cm of AAA diameter and they
could be used as a reliable alternative modality to invasive
DSA. Copyright © 2015 Inderscience Enterprises Ltd.

<4>
Accession Number
2006071707
Title
Xinyue Capsule in patients with stable coronary artery disease after
percutaneous coronary intervention: a multicenter, randomized,
placebo-controlled trial.
Source
Pharmacological Research. 158 (no pagination), 2020. Article Number:
104883. Date of Publication: August 2020.
Author
Guo M.; Wang P.; Du J.; Fu C.; Yang Q.; Gao Z.; Zhu M.; Lv S.; Deng Y.; Li
T.; Shi D.; Working Group F.T.X.
Institution
(Guo, Wang, Du, Fu, Yang, Gao, Shi, Working Group) Xiyuan Hospital, China
Academy of Chinese Medical Sciences, Beijing 100091, China
(Zhu) The First Affiliated Hospital of the Henan University of Chinese
Medicine, Henan 450046, China
(Lv) Beijing Anzhen Hospital, Beijing Institute of Respiratory Medicine,
Capital Medical University, Beijing 10029, China
(Deng) The First Affiliated Hospital of Jilin University of Traditional
Chinese Medicine, Changchun 130021, China
(Li) Naval General Hospital, Beijing 100048, China
Publisher
Academic Press
Abstract
Background: Xinyue capsule, a patented Chinese herbal medicine, has been
used to manage coronary artery disease (CAD) for over a decade in China,
but whether it can further reduce risk of cardiovascular events beyond
conventional treatment is unknown. Method(s): In this multicenter,
randomized, placebo-controlled trial, we randomly assigned patients with
stable CAD who underwent percutaneous coronary intervention (PCI) within
the preceding 3-12 months to receive Xinyue capsule (100 mg panax
quinquefolius saponins, three times a day) or placebo for 24 weeks in
addition to conventional treatment. The primary endpoint was a composite
that included cardiac death, nonfatal myocardial infarction and urgent
revascularization with either PCI or coronary artery bypass grafting. The
secondary composite endpoints included stroke, re-hospitalization due to
acute coronary syndrome (ACS), pulmonary embolism, peripheral vascular
events and all-cause mortality. Quality of life was assessed using a
36-item Short-Form Health Survey (SF-36). Result(s): A total of 1054
participants were included in the analyses. The median follow up was 1
year. The primary endpoint events occurred in 16 patients (3.02%) in the
Xinyue group and 34 patients (6.49%) in the placebo group (hazard ratio
[HR] 0.455, 95% confidence interval [CI] 0.25 to 0.825; P = 0.009).
Secondary end-point events occurred in 5.47% of patients in the Xinyue
group and 10.31% in the placebo group (HR 0.515, 95% CI 0.328 to 0.809; P
= 0.004). SF-36 subscale scores at 12 months were significantly higher in
the Xinyue group than placebo group for general health (P = 0.048) and
vitality (P = 0.008). Conclusion(s): In patients with stable CAD
after PCI within the preceding 3 to 12 months, Xinyue capsule added on
conventional treatment reduced the incidence of primary composite endpoint
(cardiac death, nonfatal myocardial infarction and urgent
revascularization). Copyright © 2020 Elsevier Ltd

<5>
Accession Number
2005953142
Title
Challenges in addressing the knowledge gap on endomyocardial fibrosis
through community-based studies.
Source
Cardiovascular Diagnosis and Therapy. 10 (2) (pp 279-288), 2020. Date of
Publication: 01 Apr 2020.
Author
Mbanze J.; Cumbane B.; Jive R.; Mocumbi A.
Institution
(Mbanze, Cumbane, Jive) Mozambique Institute for Health Education and
Research, Maputo, Mozambique
(Mocumbi) Instituto Nacional de Saude, Maputo, Mozambique
(Mocumbi) Universidade Eduardo Mondlane, Maputo, Mozambique
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Endomyocardial fibrosis (EMF) is a poverty-related disease of unknown
origin that afflicts predominantly young people of certain rural areas in
low-income countries and can be used to expose global disparities in
cardiovascular research. Despite affecting predominantly young people and
causing high morbidity and mortality, efforts to understand its mechanisms
and natural history have been hampered by the incapacity to detect the
early stages of the disease in endemic areas. Dietary, environmental and
infectious factors seem to combine in susceptible individuals to give rise
to an inflammatory process that leads to endomyocardial damage and scar
formation. Lack of awareness by health professionals and low access to
health care determine late diagnosis, when complications such as chronic
heart failure, thromboembolism and arrhythmia are already present.
Open-heart surgery to detach the endocardial fibrous tissue and repair the
atrioventricular valve, remains the last resource to prolong patients'
survival. Community-based research is therefore needed to understand the
epidemiology of EMF, detect early disease, uncover its pathogenesis and
explore new therapeutic targets. Our research has shown that
echocardiographic screening using standard criteria adds sensitivity and
precision to the diagnosis, particularly in asymptomatic disease,
providing an opportunity for longitudinal community-based research.
However, researchers face major constraints in rural settings where EMF is
endemic, including socioeconomic, cultural, geographical and
administrative barriers. In presenting our experience we aim to describe
the challenges and discuss the lessons learned while implementing
community-based research in a highly endemic area in southern Mozambique,
one of the poorest countries in the world. Additionally, we discuss how
recent advances in medicine-such as use of point-of-care diagnostics,
heart failure biomarkers and new imaging techniques-may open new
possibilities for high quality research through collaborative partnerships
and regional initiatives. Copyright © Cardiovascular Diagnosis
and Therapy. All rights reserved.

<6>
Accession Number
631982316
Title
Additional treatment prolonged survival of pulmonary artery sarcoma after
surgical resection.
Source
Translational Cancer Research. 9 (4) (pp 2618-2626), 2020. Date of
Publication: 01 Apr 2020.
Author
Xu L.; Lu W.; Li J.; Wang C.
Institution
(Xu, Lu, Li, Wang) Department of Thoracic Tumor Surgery, Zhejiang Cancer
Hospital, Hangzhou 310008, China
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Background: Pulmonary artery sarcoma is too rare for a randomized
controlled trial or cohort study. We aimed to perform a retrospective
analysis on the therapeutic effect of adjuvant therapy on postoperative
survival time. Method(s): Medline and EMBASE database were searched
for articles on pulmonary artery sarcoma published between 1923 and 2018.
Age, gender, postoperative overall survival, therapeutic approach, tumor
extension, tumor localization, status of resection margins, metastasis,
surgical method were extracted as parameters to analyze postoperative
overall survival. Result(s): A total of 162 articles and 275 cases
are included in analysis. Median postoperative overall survival time was
31 months. Patients who received adjuvant and/or neo-adjuvant therapy were
associated with improved survival [hazard ratio (HR) =0.64, P=0.017, 95%
confidence interval (CI): 0.45-0.92]. Patients with complete resection or
without metastasis had longer postoperative overall survival compared with
incomplete resection (HR =0.55, P=0.002, 95% CI: 0.37-0.79) or with
metastasis (HR =6.01, P=0.000, 95% CI: 3.33-10.67). Subgroup analysis
suggested chemotherapy was related with longer postoperative overall
survival (HR =0.63, P=0.015, 95% CI: 0.43-0.91), especially for patients
with incomplete resection (HR =0.53, P=0.025, 95% CI: 0.31-0.92) and
metastasis (HR =0.44, P=0.000, 95% CI: 0.28-0.68). Conclusion(s):
Radical surgery offers the only chance to cure pulmonary artery sarcoma.
Palliative and aggressive surgery can relieve the symptoms and extend the
life expectance. Patients can benefit from adjuvant and/or neo-adjuvant
chemotherapy, especially those who have metastasis or undergo incomplete
resection. Copyright © Translational Cancer Research. All rights
reserved.

<7>
Accession Number
631195253
Title
The Effect of Drug-Eluting Stents on Target Lesion Revascularization in
Native Coronary Arteries: Results from the NORSTENT Randomized Study.
Source
Cardiology (Switzerland). 145 (6) (pp 333-341), 2020. Date of Publication:
01 Jun 2020.
Author
Molstad P.; Nordrehaug J.E.; Steigen T.; Giil L.M.; Wilsgaard T.; Wiseth
R.; Bonaa K.H.
Institution
(Molstad) Department of Cardiology, LHL Clinics Gardermoen, Jessheim
NO-2067, Norway
(Nordrehaug) Department of Clinical Science, University of Bergen, Bergen,
Norway
(Steigen) University Hospital of North Norway, UiT the Arctic University
of Norway, Tromso, Norway
(Giil) Department of Internal Medicine, Haraldsplass Deaconess Hospital,
Bergen, Norway
(Wilsgaard) Department of Community Medicine, UiT the Arctic University of
Norway, Tromso, Norway
(Wiseth, Bonaa) Clinic of Cardiology, St. Olav's University Hospital,
Trondheim, Norway
(Wiseth, Bonaa) Department of Circulation and Medical Imaging, Faculty of
Medicine and Health Sciences, Norwegian University of Science and
Technology, Trondheim, Norway
Publisher
S. Karger AG
Abstract
Background: The NORSTENT trial randomized 9,013 patients to percutaneous
coronary intervention (PCI) with a drug-eluting stent (DES) or bare-metal
stent (BMS) with 5-year follow-up. No difference was found in the
composite primary outcome of death from any cause and nonfatal spontaneous
myocardial infarction after a median of 5 years of follow-up. Secondary
outcomes included repeat revascularizations, which were reduced by DES. We
report the occurrence of target lesion revascularization (TLR) in time and
across demographic and clinical subgroups in patients with lesions in
native coronary arteries (n = 8,782). Result(s): Clinically driven
TLR was performed on 488 (5.6%) of the 8,782 patients during 5 years of
follow-up. Male gender, older age, visible thrombus in the lesion, and
larger stent diameter were associated with less TLR; multivessel disease
and longer stents were associated with a higher risk of TLR. There was a
substantial and highly significant reduction of the risk of any TLR after
5 years in the DES group (hazard ratio [HR] 0.44, 95% confidence interval
[CI] 0.36-0.52], p < 0.001). The effect of DES on TLR was limited in time
to the first 2 years in the study with no evidence of a later rebound
effect. The reduction in TLR after DES insertion was consistent across
subgroups defined by gender, age, diabetes status, renal function, and
lesion and stent characteristics. The number needed to treat with DES (vs.
BMS) to prevent 1 TLR ranged from 4 to 110 across clinically relevant
subgroups. Conclusion(s): DES have a time-limited effect on the rate
of TLR, but with a substantial and highly significant reduction in the
first 2 years after the procedure. This effect was found to be consistent
across all important clinical subgroups. © 2020 S. Karger AG,
Basel. Copyright: All rights reserved.

<8>
Accession Number
631887149
Title
ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural
mesothelioma.
Source
The European respiratory journal. 55 (6) (no pagination), 2020. Date of
Publication: 01 Jun 2020.
Author
Scherpereel A.; Opitz I.; Berghmans T.; Psallidas I.; Glatzer M.; Rigau
D.; Astoul P.; Bolukbas S.; Boyd J.; Coolen J.; De Bondt C.; De Ruysscher
D.; Durieux V.; Faivre-Finn C.; Fennell D.; Galateau-Salle F.; Greillier
L.; Hoda M.A.; Klepetko W.; Lacourt A.; McElnay P.; Maskell N.A.; Mutti
L.; Pairon J.-C.; Van Schil P.; van Meerbeeck J.P.; Waller D.; Weder W.;
Cardillo G.; Putora P.M.
Institution
(Scherpereel) Pulmonary and Thoracic Oncology, Univ. Lille, INSERM U1189,
OncoThAI, CHU Lille, Lille, France
(Scherpereel) French National Network of Clinical Expert Centers for
Malignant Pleural Mesothelioma Management (Mesoclin), Lille, France
(Opitz, Weder) Dept of Thoracic Surgery, University Hospital Zurich,
Zurich, Switzerland
(Berghmans) Thoracic Oncology Clinic, Institut Jules Bordet, Brussels,
Belgium
(Psallidas) Oxford Centre for Respiratory Medicine, Oxford University
Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Glatzer, Putora) Dept of Radiation Oncology, Kantonsspital St Gallen, St
Gallen, Switzerland
(Rigau) Iberoamerican Cochrane Center, Barcelona, Spain
(Astoul) Dept of Thoracic Oncology, Pleural Diseases and Interventional
Pulmonology, Aix-Marseille University, Hopital Nord, Marseille, France
(Bolukbas) Dept of Thoracic Surgery, Kliniken Essen-Mitte, Essen, Germany
(Boyd) European Lung Foundation, Sheffield, United Kingdom
(Coolen) Dept of Imaging and Pathology, KU Leuven, Leuven, Belgium
(De Bondt, van Meerbeeck) Dept of Pulmonology and Thoracic Oncology,
Antwerp University and Antwerp University Hospital, Antwerp, Belgium
(De Ruysscher) Dept of Radiation Oncology (Maastro Clinic), Maastricht
University Medical Center+, GROW Research Institute, Maastricht,
Netherlands
(Durieux) Bibliotheque des Sciences de la Sante, Universite libre de
Bruxelles (ULB), Brussels, Belgium
(Faivre-Finn) Christie NHS Foundation Trust, University of Manchester,
Manchester, United Kingdom
(Fennell) Leicester Cancer Research Centre, University of Leicester and
University of Leicester Hospitals NHS Trust, Leicester, United Kingdom
(Galateau-Salle) National Reference Center for Pleural Malignant
Mesothelioma and Rare Peritoneal Tumors MESOPATH, Dept of Biopathology,
Centre Leon Berard, Lyon, France
(Greillier) Aix Marseille University, Assistance Publique Hopitaux de
Marseille, Inserm UMR1068, CNRS UMR7258, Dept of Multidisciplinary
Oncology and Therapeutic Innovations, Marseille, France
(Hoda, Klepetko) Dept of Thoracic Surgery, Medical University of Vienna,
Vienna, Austria
(Lacourt) Univ. Bordeaux, INSERM, Bordeaux Population Health Research
Center, Bordeaux, France
(McElnay) Newcastle University, Newcastle upon Tyne, United Kingdom
(Maskell) Academic Respiratory Unit, Bristol Medical School, University of
Bristol, Bristol, United Kingdom
(Mutti) Teaching Hosp. Vercelli/Gruppo Italiano Mesotelioma, Italy
(Pairon) Universite Paris-Est Creteil, Service de Pathologies
professionnelles et de l'Environnement, CHI Creteil, Equipe 4, Creteil
INSERM U955, France
(Van Schil) Dept Thoracic and Vascular Surgery, Antwerp University and
Antwerp University Hospital, Antwerp, Belgium
(Waller) Barts Thorax Centre, St Bartholomew's Hospital, London, United
Kingdom
(Cardillo) Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo
Forlanini, Rome, Italy
(Putora) Dept of Radiation Oncology, University of Bern, Bern, Switzerland
Publisher
NLM (Medline)
Abstract
The European Respiratory Society (ERS)/European Society of Thoracic
Surgeons (ESTS)/European Association for Cardio-Thoracic Surgery
(EACTS)/European Society for Radiotherapy and Oncology (ESTRO) task force
brought together experts to update previous 2009 ERS/ESTS guidelines on
management of malignant pleural mesothelioma (MPM), a rare cancer with
globally poor outcome, after a systematic review of the 2009-2018
literature. The evidence was appraised using the Grading of
Recommendations, Assessment, Development and Evaluation approach. The
evidence syntheses were discussed and recommendations formulated by this
multidisciplinary group of experts. Diagnosis: pleural biopsies remain the
gold standard to confirm the diagnosis, usually obtained by thoracoscopy
but occasionally via image-guided percutaneous needle biopsy in cases of
pleural symphysis or poor performance status. Pathology: standard staining
procedures are insufficient in ~10% of cases, justifying the use of
specific markers, including BAP-1 and CDKN2A (p16) for the separation of
atypical mesothelial proliferation from MPM. Staging: in the absence of a
uniform, robust and validated staging system, we advise using the most
recent 2016 8th TNM (tumour, node, metastasis) classification, with an
algorithm for pre-therapeutic assessment. Monitoring: patient's
performance status, histological subtype and tumour volume are the main
prognostic factors of clinical importance in routine MPM management. Other
potential parameters should be recorded at baseline and reported in
clinical trials. Treatment: (chemo)therapy has limited efficacy in MPM
patients and only selected patients are candidates for radical surgery.
New promising targeted therapies, immunotherapies and strategies have been
reviewed. Because of limited data on the best combination treatment, we
emphasise that patients who are considered candidates for a multimodal
approach, including radical surgery, should be treated as part of clinical
trials in MPM-dedicated centres. Copyright The article has been
co-published with permission in the European Respiratory Journal and the
European Journal of Cardio-Thoracic Surgery. All rights reserved in
respect of European Respiratory Journal, © European Respiratory
Society 2020 and European Journal of Cardio-Thoracic Surgery, ©
European Association for Cardio-Thoracic Surgery 2020. The articles are
identical except for minor stylistic

<9>
Accession Number
632020232
Title
Hemodynamic outcome at 5y of the perceval sutureless valve: Results from
an international prospective trial.
Source
Structural Heart. Conference: 6th Annual Scientific Meeting of the Heart
Valve Society, HVS 2020. . 4 (Supplement 1) (pp 162), 2020. Date of
Publication: 2020.
Author
Meuris B.; Fishlein T.; Folliguet T.; Hakim-Meibodi H.; Misfeld M.; Carrel
T.; Zembala M.; Cerutti E.; Madonna F.; Haverich A.
Institution
(Meuris) KU Leuven, Leuven, Belgium
(Fishlein) Klinikum Nurnberg, Nurnberg, Germany
(Folliguet) Institute Mutualiste Montsouris, Paris, France
(Hakim-Meibodi) Herz-und Diabeteszentrum NRW, Bad Oeynhausen, Germany
(Misfeld) Klinik fur Herzchirurgie, Leipzig, Germany
(Carrel) Inselspital, Bern, Switzerland
(Zembala) Silesian Center for Heart Diseases, Zabrze, Poland
(Cerutti) Sorin Group, Saluggia, Italy
(Madonna) Hospital Cardiologique Du Haut-Leveque, Pessac, France
(Haverich) Hannover Medical School, Hannover, Germany
Publisher
Taylor and Francis Inc.
Abstract
Objective: To report the 5-year hemodynamic and clinical outcomes in
intermediate risk patients implanted with the Perceval sutureless aortic
valve. Method(s): During 2010-2013, 658 patients were enrolled at 25
European institutions in the prospective not-randomized CAVALIER Trial,
aimed to demonstrate early and mid-term safety and effectiveness of the
Perceval valve. All serious adverse events were adjudicated by an
independent Clinical Events Committee and hemodynamic data were assessed
by an independent Echo Core-lab at discharge, 1 year and then annually.
Five-year follow-up was 100% complete; mean follow-up was 3.8 years, late
cumulative follow-up was 2352.2 patient-years (pt-yrs). Result(s):
Patient mean age was 78.3+/-5.6 years old and 40% (n=263) were
octogenarian, mean STS-PROM was 7.2. Cardiac concomitant procedures were
performed in 30% (n=197) of cases, mainly CABG (n=154). Overall survival
at 1, 2 and 5 years was 91.6%, 88.5% and 72.7%. Late rates of stroke,
major bleeding and endocarditis were 0.8% (18 events) 1.6% (38 events) and
0.7% (17 events) per pt-yrs. In 13 patients (0.6% per pts-yr) a structural
valve degeneration requiring reintervention occurred, treated in 7 cases
with explant and in 6 cases with a transcatheter valve-in-valve procedure.
The hemodynamic data are reported in Table 1. The reduction of pressure
gradients and the increase in the valve area following implantation were
maintained stable to 5 years. Significant regression in left ventricular
mass was observed, not affected by the increase of greater than mild
central aortic regurgitation. Conclusion(s): This series represents
the longest follow-up with the Perceval valve in a prospective,
multi-center study. The good and stable hemodynamic performance during
follow-up with low mortality and morbidity rates demonstrates that
Perceval represents an important option for the treatment of aortic valve
stenosis both isolated and combined procedures.

<10>
Accession Number
632020227
Title
Heart Valve Society 6th Annual Meeting Including Abstracts of the ICTEHV
Satellite Symposium.
Source
Structural Heart. Conference: 6th Annual Scientific Meeting of the Heart
Valve Society, HVS 2020. . 4 (Supplement 1) (no pagination), 2020. Date of
Publication: 2020.
Author
Anonymous
Publisher
Taylor and Francis Inc.
Abstract
The proceedings contain 148 papers. The topics discussed include:
pulmonary valve replacement with the biopulmonic injectable self-expanding
stented valve: report of 29 patients; early experience with the INSPIRIS
RESILIA valve in pulmonary valve replacement for congenital heart disease;
results of pulmonary valve replacement with a newly introduced
bioprosthesis in children and young adults with congenital heart disease;
management of dilated aortic root in patients undergoing repair of acute
type-a aortic dissection; challenges in the management of rheumatic
valvular heart disease in the West African subregion; surgeon experience
modifies postoperative pacemaker implantation rate in sutureless
prostheses; annular dynamics, and not diameter, predict later tricuspid
regurgitation after mitral valve surgery: results from a prospective
randomized trial; and incidence of tricuspid valve thrombosis after
mechanical tricuspid valve replacement.

<11>
Accession Number
632020192
Title
A systematic review and meta-analysis of tavi in bicuspid vs tricuspid
aortic valve patients.
Source
Structural Heart. Conference: 6th Annual Scientific Meeting of the Heart
Valve Society, HVS 2020. . 4 (Supplement 1) (pp 39), 2020. Date of
Publication: 2020.
Author
Harky A.; Chan J.; Eriksen P.; Singh S.; Field M.
Institution
(Harky, Chan, Eriksen, Singh, Field) Liverpool Heart and Chest Hospital,
Liverpool, United Kingdom
Publisher
Taylor and Francis Inc.
Abstract
Objective: Bicuspid aortic valve (BAV) is an important etiology of aortic
stenosis. Currently, there is controversy regarding using transcatheter
aortic valve implantation (TAVI) in such cohort. This systematic review
and meta-analysis aimed to compare the outcomes of TAVI in stenotic BAV to
that in tricuspid aortic valve (TAV). Method(s): Electronic searches
were performed on PubMed, Ovid, EMBASE, and Scopus to identify all studies
comparing TAVI in stenotic BAV vs TAV. Primary outcome was postoperative
rate of stroke while secondary outcomes were acute kidney injury (AKI),
permanent pacemaker (PPM) requirement, 30-day mortality, and late (>30
day) mortality. Result(s): Thirteen studies with 1,077 stenotic BAV
and 4,165 stenotic TAV patients were analyzed. The TAV cohort had more
patients with diabetes mellitus (31% in TAV versus 24% in BAV, p=0.04),
peripheral arterial disease (25% in TAV versus 22% in BAV, p=0.045), and
they were older (80.8+/-7 years in TAV versus 77.1+/-11 years in BAV,
p=0.0002). All reported outcomes were not significantly different,
including postoperative stroke (odds ratio (OR) 0.76 [0.45, 1.27],
p=0.29), AKI (OR 0.90 [0.50, 1.62], p=0.72), PPM requirement (OR 0.94
[0.74, 1.21], p=0.64), 30-day mortality (OR 0.74 [0.51, 1.07], p=0.11),
and late mortality (OR 1.04 [0.40, 2.67], p=0.94). Other outcomes were
also not significantly different, including mean transvalvular gradient
(p=0.87), significant aortic regurgitation (p=0.12), bleeding (p=0.09),
conversion to open surgery (p=0.55), and vascular complications (p=0.08).
 Conclusion(s): Reported outcomes in TAVI for stenotic BAV are not
inferior to TAV patients. The clinical usage of TAVI in BAV patients
should be explored formally through larger studies and trials.

<12>
Accession Number
632020181
Title
Systematic review of valve sparing aortic root surgery in acute type a
aortic dissection.
Source
Structural Heart. Conference: 6th Annual Scientific Meeting of the Heart
Valve Society, HVS 2020. . 4 (Supplement 1) (pp 15), 2020. Date of
Publication: 2020.
Author
Harky A.; Kusu-Orkar T.-E.; Chaplin G.; Syziu A.; Khan A.; Sokal P.;
Nawaytou O.; Mark F.
Institution
(Harky, Kusu-Orkar, Chaplin, Syziu, Khan, Sokal, Nawaytou, Mark) Liverpool
Heart and Chest Hospital, Liverpool, United Kingdom
Publisher
Taylor and Francis Inc.
Abstract
Objective: To establish the benefit of performing valve sparing aortic
root repair (VSRR) in patients with acute type A aortic dissection (ATAAD)
through a systematic review. Method(s): An electronic database search
was performed from inception to Jan 2019. The primary outcomes were 30-day
mortality and stroke rate, secondary outcomes were operative times and
requirement for aortic valve re-intervention at follow up time. No limit
on language or publication were placed, however, only articles that
reported the practice and outcomes of VSRR in acute type A aortic
dissection were included. Result(s): A total of 31 observational
studies with 3,862 patients were included in this quantitative analysis.
Mean age was 57 +/-11.8 years. Bicuspid aortic valve was present in 4%
while a further 4% of them had previous cardiac surgery. Mean
cardiopulmonary bypass time was 201+/-59 mins, aortic cross clamp time of
140+/-37 and deep hypothermic circulatory arrest of 65+/-24 mins. AV
resuspension was performed in 58% of them while 36% had re-implantation
and 11% had remodelling procedures. Stroke rate reported as 5%,
re-operation of bleeding was 6% and 30-day mortality reported as 15%. Mean
follow-up was 5.1+/-3 years, rate of aortic valve reintervention at
follow-up was 5%. Regression analysis demonstrated that hypertension and
diabetes were the strongest predictors of 30-day mortality.
 Conclusion(s): Valve sparing aortic root repair is a relatively safe
and feasible technique in patients with acute type A aortic dissection.
Patients should be selected carefully bearing in mind the future
requirement for aortic valve re-intervention.

<13>
Accession Number
632020178
Title
A systematic review and meta-analysis of transeptal vs left atrial
approach for mitral valve surgery.
Source
Structural Heart. Conference: 6th Annual Scientific Meeting of the Heart
Valve Society, HVS 2020. . 4 (Supplement 1) (pp 121-122), 2020. Date of
Publication: 2020.
Author
Harky A.; Noshirwani A.; Pousios D.; Muir A.D.
Institution
(Harky, Noshirwani, Pousios, Muir) Liverpool Heart and Chest Hospital,
Liverpool, United Kingdom
Publisher
Taylor and Francis Inc.
Abstract
Objective: We sought to compare the clinical outcomes of mitral valve
surgery through conventional left atriotomy [LA] and transeptal approach
[TS]. Method(s): Electronic database search was performed from
inception to March 2019. Only articles including both approaches were
included. Primary outcomes were operative times and secondary outcomes
were new onset of atrial fibrillation, re-operation for bleeding,
permanent pacemaker need and operative mortality. Result(s): Fifteen
articlesmet the inclusion criteria. A total of 4,457 patients were
included (n=3,025 LA and n=1,432 TS). There were no differences in
preoperative patient demographics.Mitral valve replacement took place in
67%. No differences were noted in operative mortality (OR=0.92, 95% CI
[0.60, 1.40], p=0.69), rate of concomitant procedures (66%vs 55%, OR=0.85,
95% CI [0.51, 1.42], p=0.54), rate of new onset atrial fibrillation
(OR=0.82, 95% CI [0.62, 1.07], p=0.15), and reoperation for bleeding
(OR=0.95, 95% CI [0.58, 1.53], p=0.82). Cardiopulmonary bypass and aortic
cross clamp times were longer with TS (130+/-32 vs 113+/-31 mins, p=0.03;
88+/-23 vs 75+/-23 mins, p=0.0007), and permanent pacemaker was higher
with TS (5% vs 3%, OR 0.61, 95% CI [0.43, 0.87], p=0.006).
 Conclusion(s): Transeptal approach for mitral valve surgery is
associated with longer operative times and higher postoperative pacemaker
requirement; however, no significant differences in other outcomes are
evident. A randomized controlled trial is required to confirm those
findings.

<14>
Accession Number
632020175
Title
Early results of aortic valve neocuspidization (Ozaki Procedure):
Azerbaijan experience.
Source
Structural Heart. Conference: 6th Annual Scientific Meeting of the Heart
Valve Society, HVS 2020. . 4 (Supplement 1) (pp 58), 2020. Date of
Publication: 2020.
Author
Musayev K.; Ahmadov K.; Kazimzade N.
Institution
(Musayev, Ahmadov, Kazimzade) Central Clinic, Baku, Azerbaijan
Publisher
Taylor and Francis Inc.
Abstract
Objective: We evaluated early results of Ozaki procedures performed first
time in Azerbaijan at our institution. Method(s): Between August 2018
and August 2019, Ozaki procedure was performed in 11 patients (7 males and
4 females). Mean age was 62.1 +/- 7.3 years. Surgical technique is based
on replacement of aortic cusps with neocusps trimmed from glutaraldehyde
treated autologous pericardium as described by Ozaki and colleagues.
 Result(s): Patients were suffering from aortic stenosis (AS, n = 6),
or combination of aortic stenosis and aortic regurgitation (AS/ AR, n =
5). On preoperative echocardiography, average peak and mean pressure
gradients were measured 79.1 +/- 34.6 and 49.1 +/- 23 mmHg, respectively.
On postoperative echocardiography average peak pressure gradient was 12.7
+/- 2.6 mmHg. Mean cross-clamp time was 97.9 +/- 18.1 minutes and bypass
time was 126.7 +/- 17 minutes. Mean postoperative coaptation line was 16.4
+/- 2.5 mm. Mean ICU stay was 1.8 +/- 0.4 days. There was no conversion to
prosthetic valve replacement. There was no inhospital mortality. No
pacemaker had to be implanted. The median follow-up period was 7.3 +/- 3.5
months. No patient presented with aortic stenosis. Aortic regurgitation
was trivial or mild in all cases. No reoperation was required.
 Conclusion(s): Early results of aortic neocuspidization are promising
with aortic regurgitation no more than mild in all patients, no
reoperation or endocarditis. However, randomized trials are needed to
verify advantages and limits of this method in comparison to standard
techniques in the long-term follow-up.

<15>
Accession Number
632020081
Title
Pedicled or skeletonized internal mammary artery in elective coronary
artery bypass? a systematic review and meta-analysis.
Source
Structural Heart. Conference: 6th Annual Scientific Meeting of the Heart
Valve Society, HVS 2020. . 4 (Supplement 1) (pp 85-86), 2020. Date of
Publication: 2020.
Author
Harky A.; Eriksen P.; Oguamana N.; Carthy-Ofosu B.M.; Muir A.D.
Institution
(Harky, Eriksen, Oguamana, Carthy-Ofosu, Muir) Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
Publisher
Taylor and Francis Inc.
Abstract
Objective: We sought to compare the clinical outcomes of harvesting
internal mammary artery through pedicled or skeletonized approach in
patients undergoing elective coronary artery bypass surgery.
 Method(s): Electronic database search performed from inception to
July 2019. Only articles that directly compared the outcomes using both
techniques were included. Primary outcome was sternal wound infection.
Secondary outcomes were 30-day mortality and flow rate post anastomosis.
 Result(s): Nineteen articles met the inclusion criteria. A total of
8,567 patients were included. Total of 4,494 patients were in pedicled
group and n=4,073 in skeletonized internal mammary harvesting. There were
no differences in preoperative patient demographics of hypertension or
COPD, but diabetes mellitus was higher in skeletonized cohort (23% vs 17%,
0.77 [95% CI 0.61, 0.97], p=0.03. There was no difference in the rate of
using LIMA, RIMA or BIMA in in either technique. Skeletonized IMA were
longer in length against pedicled ones (18+/-3.1 cm vs 15+/-2.3, -2.37
[95% CI -3.57, -1.17], p=0.0001). Sternal wound infection was much lower
in skeletonized IMA (3.5% vs 2%, 1.95 [95% CI 1.36, 2.78], p=0.0002). New
onset of acute MI and 30-day mortality rate was equal in both cohorts
(p>0.05). The flow rate post anastomosis was higher in skeletonized IMA
over Pedicled IMA (51+/-16 vs 39+/-12 mls/mins, -11.51 [95% CI -20.54,
-2.49], p=0.01). Conclusion(s): Harvesting IMA with skeletonized
technique is associated with lower SWI rates and higher post-anastomosis
flow rate. However, there are significant confounding factors and
heterogeneity in the included studies, therefore the results should be
interpreted carefully.

<16>
Accession Number
632020077
Title
Annular dynamics, and not diameter, predict later tricuspid regurgitation
after mitral valve surgery: Results from a prospective randomized trial.
Source
Structural Heart. Conference: 6th Annual Scientific Meeting of the Heart
Valve Society, HVS 2020. . 4 (Supplement 1) (pp 6), 2020. Date of
Publication: 2020.
Author
Pettinari M.; De Kerchove L.; Van Dyck M.; Pasquet A.; Gerber B.;
El-Khoury G.; Vanoverschelde J.-L.
Institution
(Pettinari) Ziekenhuis Oost Limburg, Genk, Belgium
(De Kerchove, Van Dyck, Pasquet, Gerber, El-Khoury, Vanoverschelde)
Cliniques Universitaires Saint-Luc, Brussels, Belgium
Publisher
Taylor and Francis Inc.
Abstract
Objective: Current guidelines advise prophylactic tricuspid valve
annuloplasty during mitral valve surgery in the presence of annular
diameter enlargement. However, several retrospective studies and a
prospective randomized study from our department could not confirm
diameter enlargement as a predictor of late regurgitation. We examined
whether two and three dimension echocardiographic and clinical
characteristics could identify those who will develop moderate/ severe
recurrent tricuspid regurgitation. Method(s): Among the 53 patients
with less than severe functional tricuspid regurgitation (FTR), who were
randomized to not receive a tricuspid annuloplasty, eleven were excluded
because the 3D echocardiographic analysis was not possible. Logistic
regression was used to estimate model-based probabilities of
moderate/severe FTR (vena contracta>=3mm) and FTR regression using valve
dimensions (annulus area, diameters, and perimeter; non-planar angle;
sphericity index), dynamics (annulus contraction, annulus displacement and
displacement velocity) and clinical parameters as possible predictors.
 Result(s): At a median follow up of 3.8 years (range 3.0-5.6 years),
12 patients had moderate/severe FTR and 16 had FTR regression. Our models
identify annular displacement for FTR recurrence and non-planar angle for
FTR regression as significant predictors. Conclusion(s): Annular
dynamics, but not dimensions, predict recurrence and regression of FTR;
annular contraction, possible surrogate of the right ventricle function,
should be systematically investigated to decide whether to
prophylactically treat tricuspid valve.

<17>
Accession Number
632020073
Title
Challenges in the management of rheumatic valvular heart disease in the
West African sub-region.
Source
Structural Heart. Conference: 6th Annual Scientific Meeting of the Heart
Valve Society, HVS 2020. . 4 (Supplement 1) (pp 4), 2020. Date of
Publication: 2020.
Author
Abubakar U.; Ismail S.; Hayatu U.; Usman M.Z.; Abdullahi I.
Institution
(Abubakar, Ismail, Hayatu, Usman, Abdullahi) Usmanu Danfodiyo University,
Teaching Hospital, Sokoto, Nigeria
Publisher
Taylor and Francis Inc.
Abstract
Objective: It is estimated that 12 million people worldwide are affected
by rheumatic fever and rheumatic heart disease and two-thirds of these are
children between ages of five and fifteen, with 79% of cases from
developing countries particularly those in the African continent. Despite
the burden of rheumatic heart diseases in this sub-region, the region is
faced with multiple challenges like misdiagnosis of rheumatic valvular
heart disease and lack of centers that can either repair or replace these
diseased valves within the sub-region. The aim of this study is to
highlight these challenges and proffer solutions. Method(s): A
literature search was conducted in medical databases Pubmed and Google
Scholar using the following combination of keywords: 'rheumatic heart
disease', 'mitral valve repair', 'mitral valve replacement', 'developing
countries', 'anticoagulation', 'West Africa', 'Nigeria'. Only articles
that were published in English and French languages were considered. A
total of 51 papers were finally analyzed. Result(s): A total of 51
articles were analyzed. It is clear from the articles that in developing
countries, social determinants of rheumatic fever and rheumatic heart
diseases such as adequate housing, access to primary health care,
education and availability of cardiologic diagnostic tools and cardiac
surgery are still a major challenge. There are very few centers in the
region that can operate on these teeming population of patients. Few of
these patients were able to travel outside the region for valve
replacement. Most of those that had valve replacement had mechanical valve
implanted, afterward there were a lot of challenges in managing their
anticoagulation. Conclusion(s): There is high burden of rheumatic
valvular heart diseases in West African sub-region with very few centers
to cater to these patients. There is an urgent need for a concerted effort
by the Heart Valve Society to assist in taking care of these patients.

<18>
Accession Number
632019784
Title
Comparative study to evaluate role of modified ultrafiltration (MUF) in
complex cardiac surgeries in adults.
Source
Structural Heart. Conference: Heart Valve Society Annual Scientific
Meeting, HVS 2019. Spain. 3 (Supplement 1) (pp 39), 2019. Date of
Publication: 2019.
Author
Narang S.
Institution
(Narang) Savodaya Hospital and Research Centre, Faridabad, India
Publisher
Taylor and Francis Inc.
Abstract
Methods: All adult patients undergoing complex cardiac surgery (triple or
more combined procedures) in Sarvodaya Hospital and Research Centre sector
8 Faridabad, Haryana, India during period between December 2013 till
August 2018 were included. Patients were alternately randomized to Group A
(using MUF) and Group B (not using MUF). MUF was done during cardiac
surgery by adding hemodialysis filter in cardio pulmonary bypass (CPB)
circuit. Result(s): Total of 68 patients, age ranged between 24 and
78 years, were included in study, with 34 patients each in Group A and
Group B. All patients underwent complex cardiac surgery (triple or more
combined procedure) including valvular, ascending aortic and coronary
artery bypass procedures in various combinations. Age, NYHA status, EURO
score and clinical profile were comparable in both groups. Mean cross
clamp time, CPB time and operating time were 2.8 vs 2.7 hours, 3.6 vs 3.7
hours and 5.2 vs 5.4 hours respectively in Group A vs Group B. Average ICU
stay, ventilatory support duration and total hospital stay in Group A vs
Group B were 3.7 vs 5.4, 1.8 vs 2.4 and 7.4 vs 9.6 respectively. Renal
failure, sepsis and mortality were 2 vs 5, 3 vs 6 and 2 vs 5 respectively
in Group A vs Group B. Conclusion(s): Use of modified ultrafiltration
(MUF) in complex cardiac surgeries in adults is associated with less
morbidity and mortality and better recovery, so it should be used in all
such patients.

<19>
Accession Number
632019754
Title
Effectiveness of prosthesis valve replacement in patients with aortic
stenosis: A systematic review and meta-analysis.
Source
Structural Heart. Conference: Heart Valve Society Annual Scientific
Meeting, HVS 2019. Spain. 3 (Supplement 1) (pp 162), 2019. Date of
Publication: 2019.
Author
Salahia S.I.; Obaida S.O.; Mohamed S.M.; Nour A.N.; Raed D.R.; Basel A.B.;
Hassaballa A.S.
Institution
(Salahia, Obaida, Nour, Raed) Ain Shams University, Faculty of Medicine,
Cairo, Egypt
(Mohamed) Zagazig University, Faculty of Medicine, Zagazig, Egypt
(Basel) Al- Basel University, Hospital For Cardiology and Cardiac Surgery,
Aleppo, Syrian Arab Republic
(Hassaballa) Lecturer of Cardiothoracic Surgery, Ain Shams University.,
Cairo, Egypt
Publisher
Taylor and Francis Inc.
Abstract
Objective: Cardiothoracic surgeons are facing a big challenge regarding
decision of the best valve replacement type that can be used in patients
with Aortic Stenosis. It's still under debate to assess the most effective
valve specially with old patients while different studies are comparing
valves. The aim of this systematic review and Meta-analysis was to assess
the efficacy and safety while comparing variable protheses after aortic
valve replacement. Method(s): We searched PubMed, MEDLINE in Process,
Scopus and Web of Science (previously ISI) for relevant studies, published
up to January 2018. We included randomized controlled trials (RCTs) that
compared different types of prostheses valves. Data were pooled as odds
ratios (OR) or mean differences (MD) with their 95% confidence intervals
(CI) between compared groups in a random metaanalysis model. Subgroup and
sensitivity analysis were conducted. We assessed heterogeneity by a Chi
square test and I2 statistic. Result(s): From a total of 2828 entries
identified, 29 RCTs were appropriate for inclusion into the final
analysis. Regarding efficacy outcomes, Fractional shortening was
significantly higher in Toronto than Cryolife O'Brien (MD= 6.00 mmhg, 95%
CI [0.37, 11.63]).The effect estimate showed that EOA at 1 year was
significantly higher in Edwards Perimount Magna than MM (MD= 0.29, 95% CI
[0.17, 0.41]), higher in Cryolife O'Brien than Toronto (MD= 0.51, 95% CI
[0.31, 0.71]), and higher in ROSS than MIRA (MD= 0.69, 95% CI [0.40,
0.98]). Regarding safety outcomes, the pooled effect estimate showed no
significant difference between any compared prostheses in terms of LVMI
and ICU stay. Conclusion(s): Our findings showed that Fractional
shortening was significantly higher in Toronto than Cryolife O'Brien, EOA
at 1 year was significantly higher in Edwards Perimount Magna than MM,
higher in Cryolife O'Brien than Toronto, and higher in ROSS compared to
MIRA.

<20>
Accession Number
632019735
Title
Efficacy and safety of triiodothyronine in patients undergoing cardiac
surgery: A systematic review and meta-analysis.
Source
Structural Heart. Conference: Heart Valve Society Annual Scientific
Meeting, HVS 2019. Spain. 3 (Supplement 1) (pp 100), 2019. Date of
Publication: 2019.
Author
Salahia S.I.; Alrefai M.A.; Salahia H.; Rachid A.; Dewair K.; Hassaballa
A.S.
Institution
(Salahia, Alrefai, Salahia, Rachid, Dewair, Hassaballa) Ain Shams
University, Cairo, Egypt
Publisher
Taylor and Francis Inc.
Abstract
Objective: The hemodynamic effects of thyroid hormones include effects on
contractility, heart rate, and oxygen consumption of myocardium. Cardiac
surgery under cardiopulmonary bypass (CPB) is positively associated by a
low thyroid hormone level. Multiple RCTs investigated the effect of
Triiodothyronine (T3) in patients undergoing cardiac surgery. Our aim from
this study was to systematically review and conduct a meta-analysis of
Randomized controlled trials investigating the impact of Triiodothyronine
in patients undergoing Cardiac Surgery. Method(s): We searched
PubMed, Scopus, Cochrane Central Register of Controlled Trials (Central),
Web of Science, and Ovid for relevant studies, published up to August
2018. We included RCTs that compared Triiodothyronine with other
interventions in terms of efficacy and adverse events. Result(s):
From a total of 694 entries identified, 10 RCTs were appropriate for
inclusion into the final analysis. The metaanalysis indicated that heart
rate was significantly lower in T3 compared to Control for 12 hours (MD=
-6.71, 95% CI [-29.51, 16.08], p<0.0001, fig. A). The pooled estimate
showed that pulmonary artery diastolic pressure was significantly lower in
T3 compared to Control (MD= -1.00, 95% CI [-1.22, -0.78], p<0.0001, fig.
B). Also, Systemic vascular resistance index (SVRI) was significantly
lower in T3 than Control (MD= -195.06, 95% CI [-240.05, -150.07],
p<0.0001, fig. C). Regarding safety, the pooled estimate showed that
stroke was significantly lower in T3 than Control (MD= 3.00, 95% CI [2.64,
3.36], p<0.0001, fig. D). T3 had a significantly lower risk of side
effects than control (RR= 0.47, 95% CI [0.33, 0.67], p<0.0001). The pooled
RR for individual adverse events showed that T3 had lower risk of
infection/sepsis (RR= 0.32, 95% CI [0.14, 0.73]). There was no significant
difference in terms of death/mortality (RR=0.44, 95% CI [0.18,1.09]), fig
E). Conclusion(s): This meta-analysis showed that Triiodothyronine
was effective in patients undergoing cardiac surgery.

<21>
Accession Number
632019712
Title
Ross procedure in neonate and infant populations: A meta-analysis review.
Source
Structural Heart. Conference: Heart Valve Society Annual Scientific
Meeting, HVS 2019. Spain. 3 (Supplement 1) (pp 116-117), 2019. Date of
Publication: 2019.
Author
Tohme S.; Jiang S.; Shah A.; Freud L.; Ferrari G.; Bacha E.; Kalfa D.
Institution
(Tohme) New York Medical College, Valhalla, NY, United States
(Jiang) Columbia University, Mailman School of Public Health, New York,
NY, United States
(Shah, Freud, Ferrari, Bacha, Kalfa) Columbia University, College of
Physicians and Surgeons New York, Presbyterian Morgan Stanley Children's
Hospital, New York, NY, United States
Publisher
Taylor and Francis Inc.
Abstract
Objective: The Ross procedure is considered to be the gold standard for
aortic valve replacement in neonates/infants; however, there are few
studies reporting outcomes of the Ross procedure in large cohorts of this
population. We performed a meta-analysis to compare early and late
outcomes in neonate/infant patients who undergo a Ross/Ross-Konno
procedure in the current era. Method(s): In accordance with PRISMA
and MOOSE guidelines, we systematically searched Ovid versions of MEDLINE
and PubMed using ('Ross'OR'Autograft') AND ('Aortic Valve Replacement')
AND ('Neonate and Infant'OR'Infant'OR'Neonate'). Included were
Englishwritten observational studies presenting outcomes of the
Ross/Ross-Konno procedure in neonates/infants including early mortality,
late mortality, autograft and/or homograft reinterventions. Figure 1 shows
the PRISMA flow chart. Meta-analysis was undertaken in MetaXL add-in for
Microsoft Excel using random-effect model combined with double arscine
transformation. A point estimate of a pooled prevalence along with its
95%CI was calculated. Result(s): 24 studies were included in the
metanalysis. The outcomes of 603 neonates/infants having a Ross/Ross-
Konno were extracted and analyzed. Follow-up range was 5 days-23 years. 22
studies reported 104 cases of early mortality out of 567 neonates/infants
and 39 cases of late mortality out of 418 neonates/infants. The estimated
early mortality prevalence was 18.28% (95%Cl:13.55%-23.54%). The late
mortality prevalence was 9.67% (95%CI:5.85%- 14.27%). 17 studies reported
that 74 out of 380 neonates/ infants presented with autograft failure,
defined as greater than moderate stenosis or regurgitation. The estimated
autograft reintervention is 20.27% (95%CI:7.74%-36.40%). The estimated
prevalence of homograft reintervention is 32.03% (95%CI:20.98%-44.18%).
 Conclusion(s): A neonatal or infant Ross procedure still carries a
significant risk of mortality in the current era. Studies of
neonatal/infant Ross patients with longer followup are warranted to
investigate the rate of autograft reintervention and the impact of the
Ross on long-term survival. (Figure Presented).

<22>
Accession Number
632019682
Title
Long-term outcomes of small-size heart valve bioprostheses: Comparative
study between mitroflow and magna pericardial xenografts.
Source
Structural Heart. Conference: Heart Valve Society Annual Scientific
Meeting, HVS 2019. Spain. 3 (Supplement 1) (pp 111-112), 2019. Date of
Publication: 2019.
Author
Alhamwy Z.; Baluja A.; Souaf S.; Adrio B.; Sierra J.; Duran D.; Garcia J.;
Fernandez Gonzalez A.L.
Institution
(Alhamwy, Baluja, Souaf, Adrio, Sierra, Duran, Garcia, Fernandez Gonzalez)
University of Santiago de Compostela, Santiago de Compostela, Spain
Publisher
Taylor and Francis Inc.
Abstract
Objective: The small-size Mitroflow prosthetic xenograft has been widely
used in high risk older patients because of its satisfactory hemodynamic
characteristics and easy implantation technique. However, early structural
valve deterioration has been described after Mitroflow valve implantation.
There is a limited number of studies comparing the performance of the
Mitroflow prosthesis with other small-size aortic bioprosthesis in the
same population. The objective of this retrospective study is to evaluate
the clinical profile, long term survival and reoperation in a group of
older patients who received small size aortic bioprosthesis.
 Patient(s): From January 2008 until December 2012, 166 consecutive
19-mm and 21-mm Mitroflow aortic valves; 93 consecutive 19-mm and 21-mm
Magna aortic valves. Method(s): Same surgical team. Patients randomly
assigned to a surgeon. Free choice of the prosthesis according to
surgeon's preference. Same surgical technique: supra-anular placement with
2-0 pledgeted interrupted sutures. Postoperative echocardiography and
clinical follow-up at regular intervals. Patient Prostheses Mismatch
defined as: Moderate: effective orifice index area 0.65-0.85 cm2/m2;
Severe: EOIA <= 0.65 cm2/m2. Result(s): Overall survival is depicted
in the Figure. Conclusion(s): No significant differences could be
demonstrated between the small-size numbers of the Mitroflow and the
Carpentier Magna xenografts in the medium-term. However, there are higher
rates of overall mortality and reoperation in the longterm of patients who
received a small-size Mitroflow prosthetic heart valve. The Mitroflow
prosthesis should be used cautiously in patients with long life
expectancy. (Figure Presented).

<23>
Accession Number
632064312
Title
Primary repair of transposition of the great arteries with an interrupted
aortic arch: a case report and literature review.
Source
Journal of cardiothoracic surgery. 15 (1) (pp 136), 2020. Date of
Publication: 11 Jun 2020.
Author
Xu Q.; Duan S.; Xing P.; Chen R.
Institution
(Xu, Duan, Xing, Chen) Heart Center, Qingdao Women and Children's
Hospital, Qingdao University, 6 tongfu Road, Qingdao, Shandong, China
Publisher
NLM (Medline)
Abstract
Transposition of the great arteries (TGA) and interruption of the aortic
arch (IAA) are uncommon congenital heart diseases. The association between
TGA and IAA is rare. The aim of this study is to present a case with
combined TGA and IAA, who underwent the primary repair and review the
literature with similar cases. The one-month-old patient was admitted with
tachypnea and cyanosis. Delayed diagnosis was caused due to the absence of
prenatal examination. Echocardiography and computed tomography angiography
confirmed TGA with anterior-posterior-oriented great arteries, wide patent
ductus arteriosus, type B IAA, ventricular septal defect (VSD) and
pulmonary arterial hypertension. The patient underwent a single-stage
primary surgical repair process leading to VSD closure, reconstruction of
the aortic arch and arterial switch operation in October 2019. The patient
is doing well at a 3-month follow-up post-surgery. The echocardiogram
suggests a normal systolic function of the ventricles and trivial
regurgitation for both aortic and pulmonary valves. CONCLUSION(S):
The single-stage repair with VSD closure, reconstruction of aortic arch
and arterial switch operation might be an applicable approach for most of
the patients with combined TGA and IAA. Long term follow-up is required as
a high re-intervention rate for recurrent coarctation, supravalvular
aortic stenosis, neoaortic valve regurgitation, obstruction of the right
heart system and coronary stenosis has been reported.

<24>
Accession Number
2006145398
Title
Subclinical Leaflet Thrombosis in Transcatheter and Surgical Bioprosthetic
Valves: PARTNER 3 Cardiac Computed Tomography Substudy.
Source
Journal of the American College of Cardiology. 75 (24) (pp 3003-3015),
2020. Date of Publication: 23 June 2020.
Author
Makkar R.R.; Blanke P.; Leipsic J.; Thourani V.; Chakravarty T.; Brown D.;
Trento A.; Guyton R.; Babaliaros V.; Williams M.; Jilaihawi H.; Kodali S.;
George I.; Lu M.; McCabe J.M.; Friedman J.; Smalling R.; Wong S.C.;
Yazdani S.; Bhatt D.L.; Bax J.; Kapadia S.; Herrmann H.C.; Mack M.; Leon
M.B.
Institution
(Makkar, Chakravarty, Trento, Friedman) Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Blanke, Leipsic) St. Paul's Hospital, University of British Columbia,
Vancouver, British Columbia, Canada
(Thourani) Piedmont Heart Institute, Atlanta, Georgia, Georgia
(Brown, Mack) Baylor Scott and White Healthcare, Plano, TX, United States
(Guyton, Babaliaros) Emory University, Atlanta, Georgia, Georgia
(Williams, Jilaihawi) New York University Langone Medical Center, New
York, NY, United States
(Kodali, George, Leon) Columbia University Medical
Center/NewYork-Presbyterian Hospital, New York, NY, United States
(Lu) Department of Biostatistics, Edwards Lifesciences, Irvine, CA, United
States
(McCabe) University of Washington, Seattle, WA, United States
(Smalling) The University of Texas Health Science Center at Houston,
Houston, TX, United States
(Wong) Cornell University New York, New York, NY, United States
(Yazdani) Inova Heart and Vascular Institute (Fairfax Inova), Falls
Church, VA, United States
(Bhatt) Brigham and Women's Hospital Heart and Vascular Center and Harvard
Medical School, Boston, MA, United States
(Bax) Leiden University Medical Centre, Leiden, Netherlands
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Herrmann) University of Pennsylvania, Philadelphia, PA, United States
Publisher
Elsevier USA
Abstract
Background: Subclinical leaflet thrombosis, characterized by
hypoattenuated leaflet thickening (HALT) and reduced leaflet motion
observed on 4-dimensional computed tomography (CT), may represent a form
of bioprosthetic valve dysfunction. Objective(s): The U.S. Food and
Drug Administration mandated CT studies to understand the natural history
of this finding, differences between transcatheter and surgical valves,
and its association with valve hemodynamics and clinical outcomes.
 Method(s): The PARTNER 3 (The Safety and Effectiveness of the SAPIEN
3 Transcatheter Heart Valve in Low-Risk Patients With Aortic Stenosis) CT
substudy randomized 435 patients with low-surgical-risk aortic stenosis to
undergo transcatheter aortic valve replacement (n = 221) or surgery (n =
214). Serial 4-dimensional CTs were performed at 30 days and 1 year and
were analyzed independently by a core laboratory. Result(s): The
incidence of HALT increased from 10% at 30 days to 24% at 1 year.
Spontaneous resolution of 30-day HALT occurred in 54% of patients at 1
year, whereas new HALT appeared in 21% of patients at 1 year. HALT was
more frequent in transcatheter versus surgical valves at 30 days (13% vs.
5%; p = 0.03), but not at 1 year (28% vs. 20%; p = 0.19). The presence of
HALT did not significantly affect aortic valve mean gradients at 30 days
or 1 year. Patients with HALT at both 30 days and 1 year, compared with
those with no HALT at 30 days and 1 year, had significantly increased
aortic valve gradients at 1 year (17.8 +/- 2.2 mm Hg vs. 12.7. +/- 0.3 mm
Hg; p = 0.04). Conclusion(s): Subclinical leaflet thrombosis was more
frequent in transcatheter compared with surgical valves at 30 days, but
not at 1 year. The impact of HALT on thromboembolic complications and
structural valve degeneration needs further assessment. Copyright
© 2020 The Authors

<25>
Accession Number
2004467058
Title
Incentive spirometry inspiratory capacity changes and predictors after
open heart surgery: A 5-day prospective study.
Source
Medical Journal of Malaysia. 75 (3) (pp 226-234), 2020. Date of
Publication: May 2020.
Author
Narayanan L.T.; Syed Hamid S.R.G.
Institution
(Narayanan) School of Biomedical Engineering and Health Science, Faculty
of Engineering, Universiti Teknologi Malaysia, Skudai, Johor, Malaysia
(Syed Hamid) Cardiothoracic Surgery Department, Hospital Sultanah Aminah,
Johor Bahru, Johor, Malaysia
Publisher
Malaysian Medical Association
Abstract
Introduction: Incentive spirometry (IS) is commonly used for increasing
postoperative IS inspiratory capacity (ISIC) after open heart surgery
(OHS). However, little is known about the serial changes in ISIC and their
predictive factors. Objective(s): The aim of this study is to
identify the postoperative ISIC changes relative to preoperative ISIC
after OHS, and determine their predictors, including patient
characteristics factors and IS performance parameters such as inspiration
volumes (ISv) and frequencies (ISf). Method(s): This is a prospective
study with blinding procedures involving 95 OHS patients, aged 52.8+/-11.5
years, whose ISIC was measured preoperatively (PreopISIC) until fifth
postoperative day (POD), while ISv and ISf monitored with an electronic
device from POD1-POD4. Regression models were used to identify predictors
of POD1 ISIC, POD2- POD5 ISIC increments, and the odds of attaining
PreopISIC by POD5. Result(s): The ISIC reduced to 41% on POD1,
increasing thereafter to 57%, 75%, 91%, and 106% from POD2-POD5
respectively. Higher PreopISIC (B=-0.01) significantly predicted lower
POD1 ISIC, and, together with hyperlipedemia (B=11.52), which
significantly predicted higher POD1 ISIC, explained 13% of variance. ISv
at relative percentages of PreopISIC from POD1-POD4 (BPOD1=0.60,
BPOD2=0.56, BPOD3=0.49, BPOD4=0.50) significantly predicted ISIC of
subsequent PODs with variances at 23%, 24%, 17% and 25% respectively, but
no association was elicited for ISf. IS performance findings facilitated
proposal of a postoperative IS therapy target guideline. Higher ISv
(B=0.05) also increased odds of patients recovering to preoperative ISIC
on POD5 while higher PreopISIC (B=- 0.002), pain (B=-0.72) and being of
Indian race (B=-1.73) decreased its odds. Conclusion(s): ISv appears
integral to IS therapy efficacy after OHS and the proposed therapy targets
need further verification through randomized controlled
trials. Copyright © 2020, Malaysian Medical Association. All
rights reserved.

<26>
Accession Number
2004539222
Title
Prevention of pulmonary and venous thromboembolism post coronary artery
bypass graft surgery - literature review.
Source
Brazilian Journal of Cardiovascular Surgery. 35 (3) (pp 368-374), 2020.
Date of Publication: May-June 2020.
Author
Jannati M.; Ardecani A.A.
Institution
(Jannati, Ardecani) Department of Cardiovascular Surgery, Faghihi
Hospital, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular (E-mail:
revista@sbccv.org.br)
Abstract
Objective: The current review evaluates recent literature on the different
aspects of prophylaxis in postoperative pulmonary and venous
thromboembolism and their main risk factors. Method(s): The
literature survey was carried out based on the PubMed data using the
keywords "coronary artery bypass graft" and "venous thromboembolism" as
components of the search field title. Result(s): Studies reported
several risk factors for postoperative thromboembolism including advanced
age, postoperative immobilization, type of thromboprophylaxis, obesity,
and location of the surgery. Conclusion(s): According to the studies,
tailored prophylaxis could be easily adapted to decrease the intensity and
duration of postoperative thromboembolism in a patient with several
disorders and comorbidities, especially in cardiovascular
disease. Copyright © 2020, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<27>
Accession Number
2006171850
Title
Meta-analysis Comparing Outcomes of Self-Expanding Versus
Balloon-Expandable Valves for Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Elgendy I.Y.; Gad M.M.; Mahmoud A.N.; Dvir D.; Kapadia S.R.; Alfonso F.;
Capodanno D.
Institution
(Elgendy) Division of Cardiology Massachusetts General Hospital and
Harvard Medical School, Boston, MA, United States
(Gad, Kapadia) Heart and Vascular Institute, Department of Cardiovascular
Medicine, Cleveland Clinic Foundation, Cleveland, OH, United States
(Mahmoud, Dvir) Division of Cardiology, University of Washington, Seattle,
WA, United States
(Alfonso) Department of Cardiology, Hospital Universitario de La Princesa,
CIBER-CV, Universidad Autonoma de Madrid, Madrid, Spain
(Capodanno) Division of Cardiology, A.O.U. "Policlinico-Vittorio Emanuele,
University of Catania, Catania, Italy
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
There are two commercially available transcatheter heart valve systems:
balloon expandable valves (BEV) and self-expanding valves (SEV). However,
there is a paucity of randomized trials comparing both systems. Electronic
databases (Medline, the Cochrane Library, Web of Science, and
clinicaltrials.gov) and major conference proceedings were searched for
randomized trials of patients with symptomatic severe aortic stenosis and
received transcatheter aortic valve implantation (TAVI) with a SEV or BEV
or surgical aortic valve replacement. The main efficacy outcomes were
all-cause mortality and stroke at the longest available follow-up. The
main analysis was performed using a random-effects network meta-analysis
complemented by several subgroup and sensitivity analyses. Ten trials with
9,439 patients (mostly undergoing transfemoral TAVI) were included. At a
median of 27 months, there was no difference between BEV and SEV valves in
terms of all-cause mortality (odds ratio [OR] 1.05, 95% confidence
interval [CI] 0.79 to 1.42). The incidence of any stroke was higher with
BEV (OR 1.51, 95% CI 1.01 to 2.26), but there was no difference in the
incidence of disabling stroke. At 30-days, BEV valves were associated with
lower incidence of new permanent pacemaker placement (OR 0.50, 95% CI 0.32
to 0.79) and moderate/severe paravalvular regurgitation (OR 0.39, 95% CI
0.22 to 0.68). In conclusion, in patients with severe symptomatic aortic
stenosis undergoing transfemoral TAVI, SEV and BEV were associated with
similar all-cause mortality. BEV were associated with a higher incidence
of any stroke driven by nondisabling strokes, but lower incidence of new
permanent pacemaker placement and moderate/severe paravalvular
regurgitation compared with SEV. Copyright © 2020 Elsevier Inc.

<28>
Accession Number
2006161023
Title
Left Atrial or Transeptal Approach for Mitral Valve Surgery: A Systematic
Review and Meta-analysis.
Source
Current Problems in Cardiology. (no pagination), 2020. Article Number:
100602. Date of Publication: 2020.
Author
Harky A.; Kusu-Orkar T.-E.; Chan J.S.K.; Noshirwani A.; Savarimuthu S.;
Pousios D.; Muir A.D.
Institution
(Harky, Kusu-Orkar, Noshirwani, Pousios, Muir) Department of
cardiothoracic surgery, Liverpool Heart and Chest Hospital, Liverpool,
United Kingdom
(Harky) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
(Chan) Division of Cardiology, Department of Medicine and Therapeutics,
Prince of Wales Hospital, Hong Kong
(Chan) Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
(Savarimuthu) Department of cardiothoracic surgery, Barts Heart Centre,
St. Bartholomew's Hospital, London, United Kingdom
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
To compare outcomes of mitral valve surgery through conventional left
atriotomy and transeptal approach (TS). Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines were followed. Primary
outcomes were operative mortality and permanent pacemaker (PPM)
implantation; secondary outcomes were new onset of atrial fibrillation
(AF), stroke and operative times. Sixteen articles met the inclusion
criteria with 4537 patients. Cardiopulmonary bypass was longer with TS
(weighted mean differences - 16.44 minutes [-29.53, -3.36], P = 0.01).
Rates of PPM implantation (risk ratio 0.65 [0.47, 0.89], P = 0.007) and
new onset AF (risk ratio 0.87 [0.78, 0.97], P = 0.02) were higher with TS.
Subgroup analysis of isolated mitral valve surgery cohort showed no
difference in operative times, mortality, new onset of AF, stroke, and PPM
implantation. There is equal outcomes between both approaches during
isolated mitral valve surgery; however, TS was associated with longer
operative times and higher postoperative AF and PPM rates when pooling
combined procedures. A large randomized controlled trial is required to
confirm those findings. Copyright © 2020 Elsevier Inc.

<29>
Accession Number
2005221502
Title
Intravenous regular insulin is an efficient and safe procedure for
obtaining high-quality cardiac 18F-FDG PET images: an
open-label, single-center, randomized controlled prospective trial.
Source
Journal of Nuclear Cardiology. (no pagination), 2020. Date of Publication:
2020.
Author
Chen Y.C.; Wang Q.Q.; Wang Y.H.; Zhuo H.L.; Dai R.Z.
Institution
(Chen, Wang, Wang) Department of Nuclear Medicine, Quanzhou First Hospital
Affiliated to Fujian Medical University, Quanzhou 362000, China
(Chen) Medical College, Huaqiao University, South Anji Road 1028#, Fengze
District, Quanzhou 362000, China
(Zhuo, Dai) Department of Cardiology, Quanzhou First Hospital Affiliated
to Fujian Medical University, Quanzhou 362000, China
Publisher
Springer
Abstract
Background: An open-label, single-center, randomized controlled
prospective trial was performed to assess the efficiency and safety of an
insulin loading procedure to obtain high-quality cardiac
18F-FDG PET/CT images for patients with coronary artery disease
(CAD). Method(s): Between November 22, 2018 and August 15, 2019, 60
patients with CAD scheduled for cardiac 18F-FDG PET/CT imaging
in our department were randomly allocated in a 1:1 ratio to receive an
insulin or standardized glucose loading procedure for cardiac
18F-FDG imaging. The primary outcome was the ratio of
interpretable images (high-quality images defined as myocardium-to-liver
ratios >= 1). The secondary outcome was the patient preparation time (time
interval between administration of insulin/glucose and 18F-FDG
injection). Hypoglycemia events were recorded. Result(s): The ratio
of interpretable cardiac PET images in the insulin loading group surpassed
the glucose loading group (30/30 vs. 25/30, P = 0.026). Preparation time
was 71+/-2 min shorter for the insulin loading group than for the glucose
loading group (P < 0.01). Two and six hypoglycemia cases occurred in the
insulin and glucose loading groups, respectively. Conclusion(s): The
insulin loading protocol was a quicker, more efficient, and safer
preparation for gaining high-quality cardiac 18F-FDG
images. Copyright © 2020, American Society of Nuclear Cardiology.

<30>
Accession Number
2005181241
Title
Hypertonic saline for fluid resuscitation in ICU patients post-cardiac
surgery (HERACLES): a double-blind randomized controlled clinical trial.
Source
Intensive Care Medicine. (no pagination), 2020. Date of Publication: 2020.
Author
Pfortmueller C.A.; Kindler M.; Schenk N.; Messmer A.S.; Hess B.; Jakob L.;
Wenger S.; Waskowski J.; Zuercher P.; Stoehr F.; Jakob S.M.; Englberger
L.; Schefold J.C.
Institution
(Pfortmueller, Kindler, Schenk, Messmer, Hess, Jakob, Wenger, Waskowski,
Zuercher, Stoehr, Jakob, Schefold) Department of Intensive Care Medicine,
Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse
18, Bern 3010, Switzerland
(Englberger) Department of Cardiovascular Surgery, Inselspital, Bern
University Hospital, University of Bern, Bern, Switzerland
Publisher
Springer
Abstract
Purpose: Recent evidence questions a liberal approach to fluid
resuscitation in intensive care unit (ICU) patients. Here, we assess
whether use of hypertonic saline applied as single infusion at ICU
admission after cardiac surgery can reduce cumulative perioperative fluid
volume. Method(s): Prospective randomized double-blind single-center
clinical trial investigates effects of a single infusion of hypertonic
saline (HS) versus normal saline (comparator). Primary endpoint was the
cumulative amount of fluid administered in patients in the hypertonic
saline versus the 0.9% saline groups (during ICU stay). Upon ICU
admission, patients received a single infusion of 5 ml/kg body weight of
7.3% NaCl (or 0.9% NaCl) over 60 min. Patients undergoing cardiac surgery
for elective valvular and/or coronary heart disease were included.
Patients with advanced organ dysfunction, infection, and/or patients on
chronic steroid medication were excluded. Result(s): A total of 101
patients were randomized to receive the study intervention (HS n = 53, NS
n = 48). Cumulative fluid intake on the ICU (primary endpoint) did not
differ between the HS and the NS groups [median 3193 ml (IQR 2052-4333 ml)
vs. 3345 ml (IQR 2332-5043 ml)]. Postoperative urinary output until ICU
discharge was increased in HS-treated patients [median 2250 ml (IQR
1640-2690 ml) vs. 1545 ml (IQR 1087-1976 ml)], and ICU fluid balance was
lower in the HS group when compared to the NS group [296 ml (IQR - 441 to
1412 ml) vs. 1137 ml (IQR 322-2660 ml)]. Conclusion(s): In a
monocentric prospective double-blind randomized clinical trial, we
observed that hypertonic saline did not reduce the total fluid volume
administered on the ICU in critically ill cardiac surgery patients.
Hypertonic saline infusion was associated with timely increase in urinary
output. Variations in electrolyte and acid-base homeostasis were
transient, but substantial in all patients. Copyright © 2020,
Springer-Verlag GmbH Germany, part of Springer Nature.

<31>
Accession Number
632061733
Title
Lipoprotein(a) and calcific aortic valve stenosis: A systematic review.
Source
Progress in cardiovascular diseases. (no pagination), 2020. Date of
Publication: 08 Jun 2020.
Author
Guddeti R.R.; Patil S.; Ahmed A.; Sharma A.; Aboeata A.; Lavie C.J.; Alla
V.M.
Institution
(Guddeti, Patil, Sharma, Aboeata, Alla) Division of Cardiovascular
Diseases, Creighton University School of Medicine, Omaha, NE, USA
(Ahmed) Division of Internal Medicine, Creighton University School of
Medicine, Omaha, NE, USA
(Lavie) John Ochsner Heart and Vascular Institute, Ochsner Clinical
School, University of Queensland School of Medicine, LA, New Orleans,
United States
Publisher
NLM (Medline)
Abstract
Calcific aortic valve stenosis (AS) is the most common form of acquired
valvular heart disease needing intervention and our understanding of this
disease has evolved from one of degenerative calcification to that of an
active process driven by the interplay of genetic factors and chronic
inflammation modulated by risk factors such as smoking, hypertension and
elevated cholesterol. Lipoprotein(a) [Lp (a)] is a cholesterol rich
particle secreted by the liver which functions as the major lipoprotein
carrier of phosphocholine-containing oxidized phospholipids. Lp(a) levels
are largely genetically determined by polymorphisms in the LPA gene. While
there is an extensive body of evidence linking Lp(a) to atherosclerotic
cardiovascular disease, emerging evidence now suggests a similar
association of Lp(a) to calcific AS. In this article, we performed a
systematic review of all published literature to assess the association
between Lp(a) and calcific aortic valve (AV) disease. In addition, we
review the potential mechanisms by which Lp(a) influences the progression
of valve disease. Our review identified a total of 21 studies, varying
from case-control studies, prospective or retrospective observational
cohort studies to Mendelian randomized studies that assessed the
association between Lp(a) and calcific AS. All but one of the above
studies demonstrated significant association between elevated Lp(a) and
calcific AS. We conclude that there is convincing evidence supporting a
causal association between elevated Lp(a) and calcific AS. In addition,
elevated Lp(a) predicts a faster hemodynamic progression of AS, and
increased risk of AV replacement, especially in younger patients. Further
research into the clinical utility of Lp(a) as a marker for predicting the
incidence, progression, and outcomes of sclerodegenerative AV disease is
needed. Copyright © 2020. Published by Elsevier Inc.

<32>
Accession Number
632051075
Title
Results of Surgical Coronary Revascularization Alone Versus Combined
Surgical Revascularization and Mitral Valve Repair in Patients With
Moderate Ischemic Mitral Regurgitation.
Source
The heart surgery forum. 23 (3) (pp E270-E275), 2020. Date of Publication:
05 May 2020.
Author
Khallaf A.; Elzayadi M.; Alkady H.; El Naggar A.
Institution
(Khallaf, Elzayadi) Department of Cardiothoracic Surgery, Fayoum
University, Egypt
(Alkady, El Naggar) Department of Cardiothoracic Surgery, Cairo
University, Egypt
Publisher
NLM (Medline)
Abstract
BACKGROUND: This is a prospective randomized-controlled study aiming to
determine whether the optimal surgical management of moderate ischemic
mitral regurgitation is to revascularize the heart through performing
coronary artery bypass grafting alone or together with repairing the
mitral valve. METHOD(S): Between April 2014 and November 2014, 40
patients with ischemic heart disease associated with moderate ischemic
mitral regurgitation at our University hospitals were divided into 2
matched groups. Group 1 received both coronary artery bypass grafting
surgery together with mitral valve repair, while Group 2 underwent
coronary artery bypass grafting surgery alone. RESULT(S): No
statistically significant difference was found between both study groups,
in terms of operative data, except for cardiopulmonary bypass time and
aortic cross-clamp time, which were significantly longer in Group 1 (P <
.001). Only one case died in the study in Group 1 on the third
postoperative day, due to severe low cardiac output syndrome. During the
follow up, NYHA class improved in Group 1 from 2.6 to 1.35 (P < .004), but
in Group 2 NYHA class improved from 2.55 to 1.72 (P = .07). The degree of
MR improved in 19 patients (95%) in Group 1 compared with 15 (75%)
patients in Group 2 (P < .0001). CONCLUSION(S): Our study showed
meaningful advantages of adding mitral-valve repair to CABG in patients
with ischemic heart disease and moderate ischemic mitral regurgitation,
regarding the degree of MR and functional NYHA class. On the other hand,
there was no statistically significant difference between both groups in
postoperative coarse and in-hospital mortality.

<33>
Accession Number
632049349
Title
Preoperative Vitamin D Level is Associated with Postoperative Delirium
After Cardiac Surgery in Patients Over 65 Years of Age.
Source
The heart surgery forum. 23 (3) (pp E264-E269), 2020. Date of Publication:
05 May 2020.
Author
Tumer N.B.; Tekeli Kunt A.; Gunaydin S.; Ozisik K.
Institution
(Tumer, Gunaydin, Ozisik) SBU Ankara City Hospital, Department of
Cardiovascular Surgery, Ankara, Turkey
(Tekeli Kunt) Kirikkale University Faculty of Medicine, Department of
Cardiovascular Surgery, Kirikkale, Turkey
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Delirium after cardiac surgery is a devastating and
important complication. Delirium is defined as "disturbance in attention
(i.e., reduced ability to direct, focus, sustain, and shift attention) and
awareness (reduced orientation to the environment)." In this study, we
analyzed the association of preoperative vitamin D levels and
postoperative delirium after cardiac surgery in patients over 65 years.
MATERIALS AND METHODS: We retrospectively reviewed the data of 212 adult
patients above 65 years of age who underwent isolated coronary artery
bypass graft surgery from January 2016 to January 2018. The mean age for
Group I was 69.7 +/- 7.4 and Group II was 70.6 +/- 4.8 years. There were
112 female patients in Group I and 46 female patients in Group II. The
patient population was divided into 2 groups based on preoperative serum
vitamin D (25-hydroxyvitamin D [25-OHD]) levels (normal range of
25-75nmol/L). Group I included patients with preoperative serum 25-OHD
level<25nmol/L. Group II included patients with preoperative serum 25-OHD
level >=25nmol/L. RESULT(S): The incidence of delirium in this study
was 30.2%. In this study, 138 patients (65.1%) had preoperative serum
25-OHD levels <25 nmol/L, and 74 patients (34.9%) had preoperative serum
25-OHD levels >=25 nmol/L. Preoperative serum 25-OHD levels were
associated with postoperative delirium after coronary artery bypass graft
surgery. Our retrospective study illustrated that a lower preoperative
serum level of 25-OHD was associated with postoperative delirium. Our
results showed that 65.1% of patients had preoperative serum 25-OHD levels
<25 nmol/L, and this was associated with postoperative delirium.
 CONCLUSION(S): Vitamin D deficiency exacerbates delirium after
coronary artery bypass surgery with cardiopulmonary bypass. Whether the
effects of vitamin D deficiency during this event represent separate or
interrelated activities with cardiopulmonary bypass is an important
question to address and prospective randomized studies are necessary to
confirm these results.

<34>
Accession Number
632049335
Title
Mitral Valve Replacement Using Subvalvular Apparatus: A Systematic Review
and Meta-Analysis.
Source
The heart surgery forum. 23 (3) (pp E385-E392), 2020. Date of Publication:
01 Jun 2020.
Author
Hsieh W.C.; Aboud A.; Henry B.M.; Kan C.D.; Omara M.; Lindner J.; Kolesova
H.
Institution
(Hsieh) First Faculty of Medicine, Charles University, Prague, Czech
Republic; 2nd Department of Cardiovascular Surgery, First Faculty of
Medicine, Charles University and General University Hospital in Prague,
Prague, Czech Republic
(Aboud) Department of Cardiac and Thoracic Vascular Surgery, University of
Schleswig-Holstein, Lubeck Campus, Lubeck, Germany
(Henry) Division of Cardiology, Cincinnati Children's Hospital Medical
Center, Cincinnati, OH, United States
(Kan) Division of Cardiovascular Surgery, Department of Surgery, National
Cheng Kung University Hospital, Tainan, Taiwan (Republic of China)
(Omara) Department of Thoracic and Cardiovascular Surgery, Research
Institute, Cleveland Clinic, Cleveland, OH, United States
(Lindner) 2nd Department of Cardiovascular Surgery, First Faculty of
Medicine, Charles University and General University Hospital in Prague,
Prague, Czechia
(Kolesova) Institute of Anatomy, First Faculty of Medicine, Charles
University
Publisher
NLM (Medline)
Abstract
BACKGROUND: To assess clinical outcomes among participants undergoing
mitral valve replacement with preservation of subvalvular apparatus.
 METHOD(S): Electronic databases, including PubMed, Embase, Science
Direct, World of Science, Scopus, Biosis, SciElo and Cochrane library,
were probed using an extensive search strategy. Studies that reported at
least one clinical outcome, such as morbidity, mortality, early 30-day
mortality, myocardial failure, survival, late cerebrovascular events,
length of stay, or major operative complications (stroke, prolonged
ventilation, and reoperation for bleeding, renal failure, and sternal
infection) were considered for inclusion. Data was extracted and pooled
into a meta-analysis in RevMan (version 5.3) using a random-effects model.
 RESULT(S): A total of 21 studies with 5,106 participants (age range:
27.3-69.2 years) were included in this meta-analysis. Preservation of the
subvalvular apparatus during MVR significantly reduces the risk of
long-term mortality (OR: 0.46; 95% CI: 0.33-0.64), but not early mortality
(OR: 0.76; 95% CI: 0.12-4.93). No significant difference ejection fraction
was observed (SMD: 0.10; 95% CI: -0.44-0.64). Similarly, there was no
significant difference in the risk of stroke, renal failure, and pneumonia
between C-MVR and in the control group. CONCLUSION(S): MVR with the
preservation of subvalvular apparatus improves clinical outcomes, such as
long-term mortality, hospital length of stay, pneumonia, and bleeding.
There is no significant difference in the risk of stroke, renal failure,
or ICU length of stay. However, there is very limited data available with
respect to bleeding, sepsis, and nosocomial infections.

<35>
Accession Number
632047133
Title
Melatonin and organ transplantation: what is the relationship?.
Source
Revista da Associacao Medica Brasileira (1992). 66 (3) (pp 353-358), 2020.
Date of Publication: 01 Mar 2020.
Author
Haddad C.F.; Haddad J.M.; Veiga E.C.A.; Sorpreso I.C.E.; Simoes R.S.;
Baracat E.C.; Soares Junior J.M.
Institution
(Haddad, Haddad, Veiga, Sorpreso, Simoes, Baracat, Soares Junior)
Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia,
Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo.
Brasil
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Melatonin has anti-inflammatory and antioxidant properties that
can influence tissue growth and apoptosis. This aspect may influence the
success of organ transplantation. To evaluate the relationship between
melatonin and organ transplantation. METHOD(S): A systematic review
was performed in PubMed databases using the search terms: "melatonin
physiology" or "melatonin therapy" and "transplant pharmacology" or
"transplant physiology" or "transplant therapy" or "Transplant therapy".
Experiments on the organs of the reproductive system were not included.
After analysis, five articles were selected after reading the title and
abstract of 50 manuscripts. The works were divided into two aspects: a)
analysis of the influence of the organ transplantation procedure on
melatonin production; b) action of melatonin on organ transplantation.
 RESULT(S): The cardiac transplantation surgical procedure,
immunosuppression, and graft did not influence melatonin secretion in
rodents, but there was a significant reduction of melatonin in the renal
transplantation procedure in patients with renal insufficiency. Melatonin
administration in experimental models decreased rejection and improved
transplant success. CONCLUSION(S): Studies show that melatonin can
reduce organ and species dependence, and the use of melatonin decreases
graft rejection.

<36>
Accession Number
631988204
Title
Mechanical assist devices for acute cardiogenic shock.
Source
Cochrane Database of Systematic Reviews. 2020 (6) (no pagination), 2020.
Article Number: CD013002. Date of Publication: 04 Jun 2020.
Author
Ni hIci T.; Boardman H.M.P.; Baig K.; Stafford J.L.; Cernei C.; Bodger O.;
Westaby S.
Institution
(Ni hIci) Cardiothoracic Surgery, Morriston Hospital, Swansea, United
Kingdom
(Boardman) Radcliffe Department of Medicine, John Radcliffe Hospital,
Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Baig) Department of Cardiac Surgery, Guy's and St Thomas' NHS Foundation
Trust, London, United Kingdom
(Stafford) Perfusion/Cardiothoracic Surgery, University Hospital of Wales,
Cardiff, United Kingdom
(Cernei, Bodger) Swansea University Medical School, Swansea University,
Swansea, United Kingdom
(Westaby) Cardiothoracic Surgery, John Radcliffe Hospital, Oxford
University Hospitals NHS Foundation Trust, Oxford, United Kingdom
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Background: Cardiogenic shock (CS) is a state of critical end-organ
hypoperfusion due to a primary cardiac disorder. For people with
refractory CS despite maximal vasopressors, inotropic support and
intra-aortic balloon pump, mortality approaches 100%. Mechanical assist
devices provide mechanical circulatory support (MCS) which has the ability
to maintain vital organ perfusion, to unload the failing ventricle thus
reduce intracardiac filling pressures which reduces pulmonary congestion,
myocardial wall stress and myocardial oxygen consumption. This has been
hypothesised to allow time for myocardial recovery (bridge to recovery) or
allow time to come to a decision as to whether the person is a candidate
for a longer-term ventricular assist device (VAD) either as a bridge to
heart transplantation or as a destination therapy with a long-term VAD.
 Objective(s): To assess whether mechanical assist devices improve
survival in people with acute cardiogenic shock. Search Method(s): We
searched CENTRAL, MEDLINE (Ovid), Embase (Ovid) and Web of Science Core
Collection in November 2019. In addition, we searched three trials
registers in August 2019. We scanned reference lists and contacted experts
in the field to obtain further information. There were no language
restrictions. Selection Criteria: Randomised controlled trials on
people with acute CS comparing mechanical assist devices with best current
intensive care management, including intra-aortic balloon pump and
inotropic support. Data Collection and Analysis: We performed data
collection and analysis according to the published protocol. Primary
outcomes were survival to discharge, 30 days, 1 year and secondary
outcomes included, quality of life, major adverse cardiovascular events
(30 days/end of follow-up), dialysis-dependent (30 days/end of follow-up),
length of hospital stay and length of intensive care unit stay and major
adverse events. We used the five GRADE considerations (study limitations,
consistency of effect, imprecision, indirectness, and publication bias) to
assess the quality of a body of evidence as it relates to the studies
which contribute data to the meta-analyses for the prespecified outcomes.
Summary statistics for the primary endpoints were risk ratios (RR), hazard
ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs).
 Main Result(s): The search identified five studies from 4534 original
citations reviewed. Two studies included acute CS of all causes randomised
to treatment using TandemHeart percutaneous VAD and three studies included
people with CS secondary to acute myocardial infarction who were
randomised to Impella CP or best medical management. Meta-analysis was
performed only to assess the 30-day survival as there were insufficient
data to perform any further meta-analyses. The results from the five
studies with 162 participants showed mechanical assist devices may have
little or no effect on 30-day survival (RR of 1.01 95% CI 0.76 to 1.35)
but the evidence is very uncertain. Complications such as sepsis,
thromboembolic phenomena, bleeding and major adverse cardiovascular events
were not infrequent in both the MAD and control group across the studies,
but these could not be pooled due to inconsistencies in adverse event
definitions and reporting. We identified four randomised control trials
assessing mechanical assist devices in acute CS that are currently
ongoing. Authors' conclusions: There is no evidence from this review of a
benefit from MCS in improving survival for people with acute CS. Further
use of the technology, risk stratification and optimising the use
protocols have been highlighted as potential reasons for lack of benefit
and are being addressed in the current ongoing clinical
trials. Copyright © 2020 The Cochrane Collaboration. Published by
John Wiley & Sons, Ltd.

<37>
Accession Number
632048032
Title
Effects of Different Doses of Remote Ischemic Preconditioning on Kidney
Damage Among Patients Undergoing Cardiac Surgery: A Single-Center
Mechanistic Randomized Controlled Trial.
Source
Critical care medicine. (no pagination), 2020. Date of Publication: 08 Jun
2020.
Author
Meersch M.; Kullmar M.; Pavenstadt H.; Rossaint J.; Kellum J.A.; Martens
S.; Klausmeyer P.; Schmidt E.A.; Kerschke L.; Zarbock A.
Institution
(Meersch, Kullmar, Rossaint, Klausmeyer, Schmidt, Zarbock) Department of
Anaesthesiology, Intensive Care Medicine and Pain Medicine, University
Hospital Munster, Munster, Germany
(Pavenstadt) Department of Medicine, Division D, Nephrology, University
Hospital Munster, Munster, Germany
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, United States
(Martens) Department of Cardiac Surgery, University of Munster, Munster,
Germany
(Kerschke) Institute of Biostatistics and Clinical Research, University of
Munster, Munster, Germany
Publisher
NLM (Medline)
Abstract
OBJECTIVES: We have previously shown that remote ischemic preconditioning
reduces acute kidney injury (acute kidney injury) in high-risk patients
undergoing cardiopulmonary bypass and that the protective effect is
confined to patients who exhibit an increased urinary tissue inhibitor of
metalloproteinases-2 and insulin-like growth factor-binding protein 7 in
response to remote ischemic preconditioning. The purpose of this study was
to determine the optimal intensity of remote ischemic preconditioning to
induce required [tissue inhibitor of metalloproteinases-2]*[insulin-like
growth factor-binding protein 7] changes and further explore mechanisms of
remote ischemic preconditioning. DESIGN: Observational and randomized
controlled, double-blind clinical trial. SETTING: University Hospital of
Muenster, Germany. PATIENTS: High-risk patients undergoing cardiac surgery
as defined by the Cleveland Clinic Foundation Score. INTERVENTIONS: In the
interventional part, patients were randomized to receive either one of
four different remote ischemic preconditioning doses (3 x 5 min, 3 x 7
min, 3 x 10 min remote ischemic preconditioning, or 3 x 5 min remote
ischemic preconditioning + 2 x 10 min remote ischemic preconditioning in
nonresponders) or sham-remote ischemic preconditioning (control).
MEASUREMENTS AND MAIN RESULTS: The primary endpoint of the interventional
part was change in urinary [tissue inhibitor of
metalloproteinases-2]*[insulin-like growth factor-binding protein 7]
between pre- and postintervention. To examine secondary objectives
including acute kidney injury incidence, we included an observational
cohort. A total of 180 patients were included in the trial (n = 80
observational and n = 100 randomized controlled part [20 patients/group]).
The mean age was 69.3 years (10.5 yr), 119 were men (66.1%). Absolute
changes in [tissue inhibitor of metalloproteinases-2]*[insulin-like growth
factor-binding protein 7] were significantly higher in all remote ischemic
preconditioning groups when compared with controls (p < 0.01). Although we
did not observe a dose-response relationship on absolute changes in
[tissue inhibitor of metalloproteinases-2]*[insulin-like growth
factor-binding protein 7] across the four different remote ischemic
preconditioning groups, in the 15 patients failing to respond to the
lowest dose, nine (60%) responded to a subsequent treatment at a higher
intensity. Compared with controls, fewer patients receiving remote
ischemic preconditioning developed acute kidney injury within 72 hours
after surgery as defined by both Kidney Disease: Improving Global Outcomes
criteria (30/80 [37.5%] vs 61/100 [61.0%]; p = 0.003). CONCLUSION(S):
All doses of remote ischemic preconditioning significantly increased
[tissue inhibitor of metalloproteinases-2]*[insulin-like growth
factor-binding protein 7] and significantly decreased acute kidney injury
compared with controls. High-dose remote ischemic preconditioning could
stimulate [tissue inhibitor of metalloproteinases-2]*[insulin-like growth
factor-binding protein 7] increases in patients refractory to low-dose
remote ischemic preconditioning.

<38>
Accession Number
632047029
Title
Epidemiology of infective endocarditis in transcatheter aortic valve
replacement: systemic review and meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). (no pagination),
2020. Date of Publication: 08 Jun 2020.
Author
Prasitlumkum N.; Vutthikraivit W.; Thangjui S.; Leesutipornchai T.;
Kewcharoen J.; Riangwiwat T.; Dworkin J.
Institution
(Prasitlumkum, Kewcharoen, Dworkin) Department of Internal Medicine,
University of Hawaii Internal Medicine Residency Program, Honolulu, HI,
United States
(Vutthikraivit) Department of Internal Medicine, Texas Tech University
Health Sciences Center, Lubbock, TX, United States
(Thangjui, Leesutipornchai) Department of Internal Medicine, Faculty of
Medicine, Chulalongkorn University, Bangkok, Thailand
(Riangwiwat) Cardiology Department, Geisinger Medical Center, Danville,
PA, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Infective endocarditis following transcatheter aortic valve
replacement (TAVR) is an emerging problem, with a high rate of morbidity
and mortality. However, little is known about the burden of disease, and
data on infective endocarditis incidence are scarce. This study aimed to
evaluate the incidence of infective endocarditis in TAVR by performing a
systematic review and meta-analysis of the literature. METHOD(S): We
comprehensively searched the databases of MEDLINE and EMBASE from
inception to October 2019. Included studies were prospective or
retrospective cohort studies that reported the event rate of infective
endocarditis in patients who underwent TAVR. Data from each study were
combined using the random-effects method to calculate pooled incidence
with 95% confidence intervals (CIs). RESULT(S): A total of 30 studies
consisting of 73 780 patients undergoing TAVR were included in this
meta-analysis. Overall, the pooled estimated incidence of infective
endocarditis following TAVR was 7 in 1000 patients (95% CI: 0.5-1%). For
early infective endocarditis, the pooled estimated incidence was 8 per
1000 patients (95% CI: 0.5-1.1%). For late infective endocarditis, the
pooled estimated incidence was 2 in 1000 patients (95% CI: 0.1-0.4%).
Significantly, the overall pooled infective endocarditis mortality rate
was 39% (95% CI: 28.7-49.4%). CONCLUSION(S): The current study
demonstrates the incidence of overall, early, and late infective
endocarditis following TAVR, ranging from 2 to 8 per 1000 patients.
Although it remains a rare event, infective endocarditis following TAVR is
associated with high mortality.

<39>
Accession Number
632045759
Title
High-Flow Nasal Cannula vs Conventional Oxygen Therapy for
Postcardiothoracic Surgery.
Source
Respiratory care. (no pagination), 2020. Date of Publication: 09 Jun 2020.
Author
Wang Y.; Huang D.; Ni Y.; Liang Z.
Institution
(Wang, Huang, Ni, Liang) Department of Respiratory and Critical Care
Medicine, West China School of Medicine and West China Hospital, Sichuan
University, Chengdu, Sichuan, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: High-flow nasal cannula (HFNC) oxygen therapy is widely used
in extubated patients. We aim to evaluate the effect of HFNC compared with
conventional oxygen therapy in adults after cardiothoracic surgery.
 METHOD(S): We conducted a literature search in PubMed, Embase, and
ClinicalTrials for randomized controlled trials that compared HFNC with
conventional oxygen therapy in extubated patients after cardiothoracic
surgery. RESULT(S): Eight studies with 1,086 subjects were included.
Compared with conventional oxygen therapy, HFNC was associated with a
significant reduction in the need for escalation of respiratory support
(risk ratio 0.40, 95% CI 0.26-0.61, P < .001), re-intubation rate (risk
ratio 0.35, 95% CI 0.13-0.96, P = .04), and length of hospital stay (mean
difference -0.48, 95% CI -0.95 to -0.01, P = .05). No significant
differences were found for the length of ICU stay (mean difference -0.09,
95% CI -0.21 to -0.04, P = .18), pulmonary complications (risk ratio 0.85,
95% CI 0.48-1.48, P = .56), or mortality rate (risk ratio 0.54, 95% CI
0.12-2.53, P = .44). CONCLUSION(S): HFNC may significantly reduce the
need for the escalation of respiratory support and re-intubation rate, and
might reduce the hospital stay. More high-quality randomized controlled
trials are needed to further validate our results. Copyright ©
2020 by Daedalus Enterprises.

<40>
Accession Number
632045316
Title
Prognostic Assessment of Right Ventricular Systolic Dysfunction on
Post-Transcatheter Aortic Valve Replacement Short-Term Outcomes:
Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. (pp e014463), 2020. Date of
Publication: 10 Jun 2020.
Author
Grevious S.N.; Fernandes M.F.; Annor A.K.; Ibrahim M.; Saint Croix G.R.;
de Marchena E.; G Cohen M.; Alfonso C.E.
Institution
(Grevious, Ibrahim, Alfonso) Cardiovascular Division Department of
Medicine Boston University School of Medicine Boston MA
(Fernandes, Alfonso) Cardiovascular Division Department of Medicine Emory
University School of Medicine Atlanta GA
(Annor) Department of Medicine Baylor College of Medicine Houston TX
(Saint Croix, de Marchena, G Cohen) Department of Medicine University of
Miami Miller School of Medicine Miami FL
(de Marchena, G Cohen) Cardiovascular Division Department of Medicine
University of Miami Miller School of Medicine Miami FL
Publisher
NLM (Medline)
Abstract
Background Right ventricular systolic dysfunction (RVSD) is a known risk
factor for adverse outcome in surgical aortic valve replacement.
Transcatheter aortic valve replacement (TAVR), on the other hand, has been
shown to be either beneficial or have no effect on right ventricular
systolic function. However, the prognostic significance of RVSD on TAVR
has not been clearly determined. We conducted a systematic review and
meta-analysis to define the impact of RVSD on outcomes in terms of 1-year
mortality in patients with severe aortic stenosis undergoing TAVR. Methods
and Results An extensive literature review was performed, with an aim to
identify clinical studies that focused on the prognosis and short-term
mortality of patients with severe symptomatic aortic stenosis who
underwent TAVR. A total of 3166 patients from 8 selected studies were
included. RVSD, as assessed with tricuspid annular plane systolic
excursion, fractional area change or ejection fraction, was found to be a
predictor of adverse procedural outcome after TAVR (hazard ratio, 1.31;
95% CI, 1.1-1.55; P=0.002). Overall, we found that RVSD did affect
post-TAVR prognosis in 1-year mortality rate. Conclusions Patients with
severe, symptomatic aortic stenosis and concomitant severe RVSD have a
poor 1-year post-TAVR prognosis when compared with patients without RVSD.
Right ventricular dilation and severe tricuspid regurgitation were
associated with increased 1-year morality post-TAVR and should be
considered as independent risk factors. Further evaluations of long-term
morbidity, mortality, as well as sustained improvement in functional class
and symptoms need to be conducted to determine the long-term effects.

<41>
Accession Number
2004243557
Title
Impact of left ventricular ejection fraction on clinical outcomes after
left main coronary artery revascularization: results from the randomized
EXCEL trial.
Source
European Journal of Heart Failure. 22 (5) (pp 871-879), 2020. Date of
Publication: 01 May 2020.
Author
Thuijs D.J.F.M.; Milojevic M.; Stone G.W.; Puskas J.D.; Serruys P.W.;
Sabik J.F.; Dressler O.; Crowley A.; Head S.J.; Kappetein A.P.
Institution
(Thuijs, Milojevic, Head, Kappetein) Department of Cardiothoracic Surgery,
Erasmus MC, University Medical Centre, Rotterdam, Netherlands
(Stone) Division of Cardiology, New York-Presbyterian Hospital/Columbia
University Medical Center, New York, NY, United States
(Stone, Dressler, Crowley) Clinical Trials Center, Cardiovascular Research
Foundation, New York, NY, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Heart at Mount
Saint Luke's, New York, NY, United States
(Serruys) Department of Cardiology, Imperial College London, London,
United Kingdom
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Aim: To evaluate the impact of left ventricular ejection fraction (LVEF)
on 3-year outcomes in patients with left main coronary artery disease
(LMCAD) undergoing percutaneous coronary intervention (PCI) or coronary
artery bypass grafting (CABG) in the EXCEL trial. Methods and
Results: The EXCEL trial randomized patients with LMCAD to PCI with
everolimus-eluting stents (n = 948) or CABG (n = 957). Among 1804 patients
with known baseline LVEF, 74 (4.1%) had LVEF <40% [heart failure with
reduced ejection fraction (HFrEF)], 152 (8.4%) LVEF 40-49% [heart failure
with mid-range ejection fraction (HFmrEF)] and 1578 (87.5%) LVEF >=50%
(heart failure with preserved ejection fraction). Patients with HFrEF vs.
HFmrEF vs. preserved LVEF experienced a longer postoperative hospital stay
(9.0 vs. 7.0 vs. 6.0 days, P = 0.02) with greater peri-procedural
complications after CABG, while hospital stay after PCI was unaffected by
LVEF (1.5 vs. 2.0 vs. 1.0 days, P = 0.20). The composite primary endpoint
of death, stroke, or myocardial infarction at 3 years was 29.3% (PCI) vs.
27.6% (CABG) in patients with HFrEF, 16.2% vs. 15.0% in patients with
HFmrEF, and 14.5% vs. 14.6% in those with preserved LVEF, respectively
(P<inf>interaction</inf> = 0.90). Smoothing spline analysis demonstrated
that the 3-year risk of all-cause death increased when LVEF decreased,
both in patients undergoing CABG and PCI. Conclusion(s): In the EXCEL
trial, the composite rate of death, stroke or myocardial infarction at 3
years was significantly higher in patients with HFrEF compared with HFmrEF
or preserved LVEF, driven by an increased rate of all-cause death. No
significant differences after PCI vs. CABG were observed among patients
with HFrEF, HFmrEF and preserved LVEF. Longer-term follow-up could provide
important insights on differences in clinical outcomes that might emerge
over time. Clinical Trial Registration: ClinicalTrials.gov Identifier
NCT01205776. Copyright © 2020 The Authors. European Journal of
Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<42>
Accession Number
631987033
Title
Effects of non-invasive ventilation in subjects undergoing cardiac surgery
on length of hospital stay and cardiac-pulmonary complications: A
systematic review and meta-analysis.
Source
Journal of Thoracic Disease. 12 (4) (pp 1507-1519), 2020. Date of
Publication: 01 Apr 2020.
Author
Wu Q.; Xiang G.; Song J.; Xie L.; Hao S.; Wu X.; Liu Z.; Li S.
Institution
(Wu, Xiang, Song, Xie, Wu, Hao, Wu, Liu, Li) Department of Pulmonary
Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Rd., Shanghai
200032, China
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Background: Cardiac surgery often leads to pulmonary complications.
Non-invasive ventilation (NIV) is a mechanical ventilation modality that
may help to prevent the pulmonary complications, and the role of the
prophylactic use of NIV in patients after cardiac surgery remains
controversial. Method(s): We searched PubMed, Embase, Web of Science
and Cochrane Central for randomized controlled trials comparing the use of
NIV (continues positive airway pressure or bi-level positive airway
pressure) with standard treatment in post-cardiac surgery subjects without
language restriction. Two investigators screened the eligible studies up
to July, 2019. Meta-analysis using random effect model or fixed effect
model was conducted for pulmonary complications, mortality, rate of
reintubation and cardiac complications, and mean difference (MD) or
standard mean difference for length of hospital stay and length of ICU
stay. Result(s): We included nine randomized controlled trails with
830 subjects. The use of NIV failed to reduce the risk of pulmonary
complications, including atelectasis [risk rate (RR) 0.60; 95% confidence
interval (CI): 0.28 to 1.28, P=0.19] and pneumonia (RR 0.27; 95% CI: 0.05
to 1.64, P=0.16). However, it has shortened the length of ICU stay (MD
-1.00 h, 95% CI: -1.38 to -0.63, P<0.00001) and the length of hospital
stay (MD -1.00 d, 95% CI: -1.12 to -0.87, P<0.00001). NIV also failed to
reduce the rate of reintubation (RR 0.68; 95% CI: 0.21 to 2.26, P=0.53) or
the risk of cardiac complications (RR 0.81; 95% CI: 0.59 to 1.13, P=0.22).
 Conclusion(s): The prophylactic use of NIV immediately in
post-cardiac subjects who underwent cardiac surgery might be able to
shorten the length of hospital stay and the length of ICU stay, but it has
no significant effect on pulmonary complications, rate of reintubation or
cardiac complications. Copyright © 2020 Journal of Thoracic
Disease.

<43>
Accession Number
2006092822
Title
Balloon-expandable versus self-expanding transcatheter aortic valve
replacement for bioprosthetic dysfunction: A systematic review and
meta-analysis.
Source
PLoS ONE. 15 (6) (no pagination), 2020. Article Number: e0233894. Date of
Publication: 01 Jun 2020.
Author
Lee H.-A.; Chou A.-H.; Wu V.C.-C.; Chen D.-Y.; Lee H.-F.; Lee K.-T.; Chu
P.-H.; Cheng Y.-T.; Chang S.-H.; Chen S.-W.
Institution
(Lee, Cheng, Chen) Division of Thoracic and Cardiovascular Surgery,
Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical
Center, Chang Gung University, Taoyuan City, Taiwan (Republic of China)
(Lee) Division of Cardiovascular Surgery, Department of Surgery, Chang
Bing Show Chwan Memorial Hospital, Changhua, Taiwan (Republic of China)
(Chou) Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou
Medical Center, Chang Gung University, Taoyuan City, Taiwan (Republic of
China)
(Wu, Chen, Lee, Lee, Chu, Chang) Department of Cardiology, Chang Gung
Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan
City, Taiwan (Republic of China)
(Chen) Center for Big Data Analytics and Statistics, Chang Gung Memorial
Hospital, Linkou Medical Center, Taoyuan City, Taiwan (Republic of China)
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background Transcatheter aortic valve-in-valve (VIV) procedure is a safe
alternative to conventional reoperation for bioprosthetic dysfunction.
Balloon-expandable valve (BEV) and self-expanding valve (SEV) are the 2
major types of devices used. Evidence regarding the comparison of the 2
valves remains scarce. Methods A systematic review and meta-analysis was
conducted to compare the outcomes of BEV and SEV in transcatheter VIV for
aortic bioprostheses dysfunction. A computerized search of Medline,
PubMed, Embase, and Cochrane databases was performed. English-language
journal articles reporting SEV or BEV outcomes of at least 10 patients
were included. Results In total, 27 studies were included, with 2,269 and
1,671 patients in the BEV and SEV groups, respectively. Rates of 30-day
mortality and stroke did not differ significantly between the 2 groups.
However, BEV was associated with significantly lower rates of
postprocedural permanent pacemaker implantation (3.8% vs. 12%; P < 0.001).
Regarding echocardiographic parameters, SEV was associated with larger
postprocedural effective orifice area at 30 days (1.53 cm2 vs.
1.23 cm2; P < 0.001) and 1 year (1.55 cm2 vs. 1.22
cm2; P < 0.001). Conclusions For patients who underwent
transcatheter aortic VIV, SEV was associated with larger postprocedural
effective orifice area but higher rates of permanent pacemaker
implantation. These findings provide valuable information for optimizing
device selection for transcatheter aortic VIV. Copyright © 2020
Lee et al. This is an open access article distributed under the terms of
the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author
and source are credited.

<44>
Accession Number
2005953128
Title
Comparison of surgical versus transcatheter aortic valve replacement for
patients with aortic stenosis at low-intermediate risk.
Source
Cardiovascular Diagnosis and Therapy. 10 (2) (pp 135-144), 2020. Date of
Publication: 01 Apr 2020.
Author
Khan M.R.; Kayani W.T.; Manan M.; Munir A.; Hamzeh I.; Virani S.S.;
Birnbaum Y.; Jneid H.; Alam M.
Institution
(Khan, Munir) Division of Cardiology, McLaren-Flint/Michigan State
University, Flint, MI, United States
(Kayani, Hamzeh, Virani, Birnbaum, Jneid, Alam) Section of Cardiology,
Department of Internal Medicine, Baylor College of Medicine, Houston, TX,
United States
(Manan) King Edward Medical University, Lahore, Pakistan
(Virani, Jneid) Section of Cardiology, Michael E. DeBakey Veterans Affairs
Medical Center, Houston, TX, United States
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Background: To compare safety and efficacy of transcatheter aortic valve
replacement (TAVR) with surgical aortic valve replacement (SAVR) in
patients at low-intermediate risk, given the paucity of robust data.
 Method(s): We performed an aggregate data meta-analysis of 7
randomized controlled trials (RCTs) and 6,778 patients comparing TAVR with
SAVR for aortic stenosis (AS) in low-intermediate risk patients (Society
of Thoracic Surgeons risk-score <=8%) using the random-effects model.
Primary outcome was all-cause mortality at 30-day, 1-year and 2-year of
follow-up. Secondary outcomes included cardiac-mortality, stroke, acute
kidney injury (AKI), atrial fibrillation (AF), permanent pacemaker (PPM)
implantation, major-bleeding, moderate-severe paravalvular regurgitation
(PVR) and rehospitalization. Result(s): All-cause mortality,
cardiac-mortality and stroke were comparable between the two groups. AF
was higher with SAVR at 30-day [odds ratio (OR) 0.17, 95% confidence
intervals (CI): 0.12-0.24] thorough to 2-year (OR 0.34, 95% CI:
0.21-0.55), while PPM implantation was higher with TAVR (30-day: OR 3.31,
95% CI: 1.64-6.66, 2-year: OR 3.17, 95% CI: 1.02-9.86). Moderate-severe
PVR was more prevalent with TAVR at all follow-ups. On inter-group
comparison, patients in the low-risk group had an even lower risk of AF,
but a higher risk of PPM implantation as compared to the patients in the
intermediate-risk group undergoing TAVR. Conclusion(s): Compared to
SAVR, TAVR had comparable all-cause mortality and stroke, lower-risk of
AF, but was associated with a higher risk of PPM implantation and
moderate-severe PVR in low-intermediate-risk patients. Thus, highlighting
the need for longer-term follow-up before robust inferences are
drawn. Copyright © Cardiovascular Diagnosis and Therapy. All
rights reserved.

<45>
Accession Number
2004441040
Title
Slow positive end-expiratory pressure titration during general anesthesia
with muscle paralysis improves lung function without compromising
hemodynamic stability in preschool children: A randomized control clinical
trial.
Source
Iranian Journal of Pediatrics. 29 (6) (no pagination), 2019. Article
Number: e92269. Date of Publication: 2019.
Author
Mandras A.D.; Soldatovic I.; Sujica M.; Stevanovic V.; Markovic D.;
Paunovic Z.; Minic P.
Institution
(Mandras, Sujica, Stevanovic) Department of Anesthesiology and Intensive
Care Therapy, Institute for Mother and Child Health Care, Belgrade, Serbia
(Soldatovic) Institute for Medical Statistics and Informatics, Medical
Faculty, University of Belgrade, Belgrade, Serbia
(Markovic) Department of Anesthesiology, Clinic for Cardiovascular
Surgery, Clinical Center of Serbia, Belgrade, Serbia
(Paunovic) Department of Orthopedics, Institute for Mother and Child
Health Care, Belgrade, Serbia
(Minic) Depratment of Pulmonolgy, Institute for Mother and Child Health
Care, Belgrade, Serbia
Publisher
Kowsar Medical Publishing Company (E-mail: library@kowsarpub.com)
Abstract
Background: Mechanical ventilation impairs oxygenation and increases
intrapulmonary shunt. Positive end-expiratory pressure (PEEP) slows
derecruitment, improves lung function but can compromise hemodynamics.
 Objective(s): To asses slow PEEP titration effect on intrapulmonary
shunt, oxygenation and hemodynamics in preschool children on mechanical
ventilation under general anesthesia. Method(s): This was a single
tertiary care center an open-label, randomized parallel group controlled
clinical trial. Study included 70 children, 3-7 years, ASA I and II, under
general anesthesia for non-cardiothoracic surgery. Children were randomly
allocated either to receive PEEP titration 5-11 cmH<inf>2</inf>O 20
minutes before the end of anesthesia (intervention group) or to be
ventilated until the end of anesthesia with constant positive
end-expiratory pressure of 3 cmH<inf>2</inf>O (control group). Main
outcome measures were changes in oxygenation index
(PaO<inf>2</inf>/FiO<inf>2</inf>) and alveolar-arterial gradient
(P(A-a)O<inf>2</inf>) between and within groups and changes in systolic
blood pressure (SBP), mean arterial pressure (MAP) and heart rate (HR) in
interventional group during PEEP trial. Result(s): Seventy children
were recruited and analyzed. P(A-a)O<inf>2</inf> and
PaO<inf>2</inf>/FiO<inf>2</inf> improved in interventional group comparing
to control as consequence of PEEP titration
(PaO<inf>2</inf>/FiO<inf>2</inf>-30.3 vs. 0.52; P < 0.001;
P(A-a)O<inf>2</inf> 6.7 vs.-1.0; P < 0.001) and within interven-tional
group before and after PEEP titration (PaO<inf>2</inf>/FiO<inf>2</inf>
522.0 vs. 552.3; P < 0.01; P(A-a)O<inf>2</inf> 20.1 vs. 13.3; P < 0.001).
Hypotension and bradycardia were not documented. Conclusion(s): Slow
PEEP titration up to 11 cmH<inf>2</inf>O improves oxygenation, reduces
intrapulmonary shunt without causing hemodynamic instability in preschool
children during general anesthesia. Copyright © 2019, Author(s).

<46>
Accession Number
2006141430
Title
Evolution of Transcatheter Aortic Valve Replacement , Review of
Literature.
Source
Current Problems in Cardiology. (no pagination), 2020. Article Number:
100600. Date of Publication: 2020.
Author
Jiang T.; Hasan S.M.; Faluk M.; Patel J.
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Aortic valve stenosis is the most common primary valvular heart disease
leading to either surgical or transcatheter valve replacement in the
United States with its prevalence on the rise due to the elderly
population. Over the recent years, the rise of transcatheter aortic valve
replacement has been exponential due to technologic developments and
randomized control trials. In this review article, we aim to review
current literature on transcatheter aortic valve
replacements. Copyright © 2020 Elsevier Inc.

<47>
Accession Number
2005198278
Title
Clinical outcomes associated with retrograde arterial perfusion in
minimally invasive mitral valve surgery: a systematic review.
Source
Perfusion (United Kingdom). (no pagination), 2020. Date of Publication:
2020.
Author
Burns D.J.P.; Birla R.; Vohra H.A.
Institution
(Burns) Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland,
OH, United States
(Birla) Cardiac Surgery, Freeman Hospital, Newcastle upon Tyne, United
Kingdom
(Vohra) Cardiac Surgery, University Hospitals Bristol NHS Foundation
Trust, Bristol, United Kingdom
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Introduction: Given several reports of an increased neurologic risk with
retrograde arterial perfusion in minimally invasive mitral valve surgery,
we sought to identify and synthesize the best available evidence on the
influence of perfusion strategy on post-operative clinical outcomes in
this population. Method(s): A systematic search of PubMed, EMBASE,
MEDLINE, and Cochrane library databases was performed to identify
publications comparing clinical outcomes associated with antegrade and
retrograde arterial perfusion in minimally invasive mitral valve surgery.
Pre-specified outcomes of interest were neurologic events, mortality, and
renal failure. The search was performed by two independent reviewers, with
data abstraction following. Result(s): Seven observational studies
were included in this review, with a total patient population of 5,385.
Six were retrospective cohort in design, with a single small prospective
cohort study identified. When available, adjusted publication-specific
risk estimates were abstracted and included preferentially over unadjusted
or reviewer-derived risk estimates. Meta-analysis was felt to be heavily
flawed in the context of few small studies identified and was not
performed. In adjusted estimates, there appeared to be an increased risk
of neurologic complications with retrograde arterial perfusion. There was
a null pattern apparent between arterial perfusion strategy and each of
30-day mortality and renal failure. Conclusion(s): Retrograde
arterial perfusion in minimally invasive mitral valve surgery may be
associated with an increased risk of neurologic events, without affecting
the risk of 30-day mortality or renal failure. Although these patterns
were identified, an overall paucity of evidence justifies further
study. Copyright © The Author(s) 2020.

<48>
Accession Number
2004562035
Title
Combined non-intubated anaesthesia and paravertebral nerve block in
comparison with intubated anaesthesia in children undergoing
video-assisted thoracic surgery.
Source
Acta Anaesthesiologica Scandinavica. 64 (6) (pp 810-818), 2020. Date of
Publication: 01 Jul 2020.
Author
Wei W.; Fan Y.; Liu W.; Zhao T.; Tian H.; Xu Y.; Tan Y.; Song X.; Ma D.
Institution
(Wei, Fan, Zhao, Tian, Xu, Tan, Song) Department of Anaesthesiology,
Guangzhou Women and Children's Medical Center, Guangzhou Medical
University, Guangzhou, China
(Liu) Department of Thoracic Surgery, Guangzhou Women and Children's
Medical Center, Guangzhou Medical University, Guangzhou, China
(Ma) Anaethetics, Pain Medicine and Intensive Care, Department of Surgery
and Cancer, Faculty of Medicine, Imperial College London, Chelsea and
Westminster Hospital, London, United Kingdom
Publisher
Blackwell Munksgaard (E-mail: info@mks.blackwellpublising.com)
Abstract
Background: This study is to investigate if non-intubated anaesthesia
combined with paravertebral nerve block (PVNB) can enhance recovery in
children undergoing video-assisted thoracic surgery (VATS).
 Method(s): A randomized controlled trial including 60 patients aged 3
to 8 years old who underwent elective VATS was performed. They were
randomly assigned to receive non-intubated anaesthesia combined with PVNB
or general anaesthesia with tracheal intubation (1:1 ratio). The primary
outcome was the length of postoperative in-hospital stay. The secondary
outcomes included emergence time, the incidence of emergence delirium,
time to first feeding, time to first out-of-bed activity, pain score and
in-hospital complications. Result(s): The non-intubated group had
shorter postoperative in-hospital stay than the control group (4 days
[IQR, 4-6] vs 5 days [IQR, 5-8], 95% CI 0-2; P =.013). When compared to
the control group, the incidence of emergence delirium (odds ratio [OR]
3.39, 95% CI 1.01-11.41; P =.043), emergence time, duration in the PACU,
time to first eating food, first out-of-bed activity, pain score and
consumption of sufentanil (at 6 and 12 hours after surgery) were decreased
in the intervention group. In contrast, the incidence of airway
complications was higher in the control than the intervention group (27.6%
vs 6.9%, P =.037). There was no statistical significance in the occurrence
of PONV, pneumothorax and other complications between the two groups.
 Conclusion(s): Non-intubated anaesthesia combined with PVNB enhances
recovery in paediatric patients for video-assisted thoracic surgery
although further multi-centre study is needed. Copyright © 2020
The Acta Anaesthesiologica Scandinavica Foundation. Published by John
Wiley & Sons Ltd

<49>
Accession Number
631793030
Title
A Randomized Trial to Compare Serratus Anterior Plane Block and Erector
Spinae Plane Block for Pain Management Following Thoracoscopic Surgery.
Source
Pain medicine (Malden, Mass.). 21 (6) (pp 1248-1254), 2020. Date of
Publication: 01 Jun 2020.
Author
Ekinci M.; Ciftci B.; Golboyu B.E.; Demiraran Y.; Bayrak Y.; Tulgar S.
Institution
(Ekinci, Ciftci, Demiraran) Department of Anesthesiology and Reanimation,
Istanbul Medipol University, School of Medicine, Mega Medipol University
Hospital, Istanbul, Turkey
(Golboyu) Department of Anesthesiology and Reanimation, Manisa State
Hospital, Manisa, Turkey
(Bayrak) Department of Thoracic Surgery, Istanbul Medipol University, Mega
Medipol University Hospital, Istanbul, Turkey
(Tulgar) Department of Anesthesiology, Faculty of Medicine, Maltepe
University, Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Comparison of ultrasound (US)-guided erector spinae plane block
(ESPB) and serratus anterior plane block (SAPB) in video-assisted thoracic
surgery (VATS) patients. The primary outcome was to compare perioperative
and postoperative (48 hours) opioid consumption. METHOD(S): A total
of 60 patients were randomized into two groups (N=30): an ESPB group and
an SAPB group. All the patients received intravenous patient-controlled
postoperative analgesia and ibuprofen 400mg intravenously every eight
hours. Visual analog scale (VAS) scores, opioid consumption, and adverse
events were recorded. RESULT(S): Intraoperative and postoperative
opioid consumption at 0-8, 8-16, and 16-24hours and rescue analgesic use
were significantly lower in the ESPB group (P<0.05). Static/dynamic VAS
scores were significantly lower in the ESPB group (P<0.05). There was no
significant difference between static VAS scores at the fourth hour. There
were no differences between adverse effects. Block procedure time and
one-time puncture success were similar between groups (P >0.05 each).
 CONCLUSION(S): US-guided ESPB may provide better pain control than
SAPB after VATS. QUESTION: Even though there are studies about analgesia
management after VATS, clinicians want to perform the technique that is
both less invasive and more effective. FINDINGS: This randomized trial
showed that US-guided ESPB provides effective analgesia compared with
SAPB. MEANING: Performing single-injection ESPB reduces VAS scores and
opioid consumption compared with SAPB. Copyright © 2020 American
Academy of Pain Medicine. All rights reserved. For permissions, please
e-mail: journals.permissions@oup.com.

<50>
Accession Number
2006705743
Title
FOLLICULAR VARIANT OF PAPILLARY THYROID CARCINOMA: STERNAL RESECTION TO
TREAT RECURRENT AGGRESSIVE BONE METASTASIS.
Source
Chest. Conference: CHEST Congress 2020. Italy. 157 (6 Supplement) (pp
A35), 2020. Date of Publication: June 2020.
Author
Thobani H.; Abbas M.; Pervez M.; Fatimi S.
Institution
(Thobani) Aga Khan University Medical College, Department Of Surgery,
Karachi, Pakistan
(Abbas) Aga Khan University, Medical College, Karachi, Pakistan
(Pervez, Fatimi) Aga Khan University, Cardiothoracic Surgery, Karachi,
Pakistan
Publisher
Elsevier Inc.
Abstract
TYPE: Case Report Publication TOPIC: Cardiothoracic Surgery INTRODUCTION:
Follicular Variant of Papillary Thyroid Carcinoma (FV-PTC) is a type of
differentiated thyroid carcinoma. Bony metastasis is extremely rare, with
greatly increased morbidity and mortality, and debulking/resection is
often the best treatment. CASE PRESENTATION: We report a case of a 55 y/o
female presenting with a bony mass in her anterior chest since 1.5 years,
associated with 1 month history of dysphagia and 4 months of left arm
stiffness. History revealed she had a thyroid lobectomy 20 years prior due
to goiter (reason unknown). She was clinically euthyroid. Bone-scan showed
osteolytic lesions in the sternum, manubrium and left proximal humerus.
Thyroid-scan showed remnants of thyroid glandular tissue with ectopic
growth at the sites mentioned above. CT scan revealed a large
heterogeneous soft tissue mass with a central necrotic focus involving the
entire sternum. TSH and T4 were normal but thyroglobulin was >6000ng/ml. A
complete thyroidectomy and concomitant complete sternectomy with
reconstruction using polypropylene mesh was performed under
general-anesthesia. Histopathology revealed FV-PTC. Further treatment with
Radio-Active Iodine therapy and EBRT for palliation. Patient is alive and
well on 1 year follow-up. Bone-scan showed no recurrence of sternal
lesion, however lesion at humerus was persisting. DISCUSSION: Review of
Literature identified 16 cases of Thyroid CA metastasis to sternum, of
which only 1 (ours) was identified as FV-PTC. We discuss an updated table
on the reconstruction methods used for sternectomies due to Thyroid CA -
Modified from Yanagawa et al. Journal of Thoracic Oncology. 2009;4:1022-5
 CONCLUSION(S): Sternal resection is a useful therapy for FV-PTC
sternal metastasis. DISCLOSURE: No significant relationships. KEYWORDS:
Thyroid Carcinoma, Sternum, Bone metastasis Copyright © 2020
American College of Chest Physicians

<51>
Accession Number
2006705546
Title
PREOPERATIVE EXERCISE TRAINING TO PREVENT POSTOPERATIVE PULMONARY
COMPLICATIONS IN ADULTS UNDERGOING MAJOR SURGERY: A SYSTEMATIC REVIEW AND
META-ANALYSIS WITH TRIAL SEQUENTIAL ANALYSIS.
Source
Chest. Conference: CHEST Congress 2020. Italy. 157 (6 Supplement) (pp
A389), 2020. Date of Publication: June 2020.
Author
Licker M.; Assouline B.; Schorer R.
Institution
(Licker, Assouline, Schorer) University Hospital Geneva, Anesthesiology,
Pharmacology, Intensive Care, Geneva, Switzerland
Publisher
Elsevier Inc.
Abstract
TYPE: Abstract Publication TOPIC: Pulmonary Rehabilitation PURPOSE: Poor
physical fitness and respiratory muscle weakness are risk factors of
postoperative pulmonary complications (PPCs) and preoperative exercise
training programs may reduce the risk of PPCs. METHOD(S): We searched
MEDLINE, Web of Science, Embase, Pedro, and the Cochrane Central Register,
until September 2019, for RCTs comparing exercise training with usual care
before cardiac, lung, oesophageal or abdominal surgery. The main outcome
was occurrence of PPCs; secondary outcomes were preoperative functional
changes. The study was registered with PROSPERO (Ndegree CRD42018096956).
 RESULT(S): From 28 RCTs, 2'044 patients were pooled for
meta-analysis. Compared with controls, preoperative exercise training was
associated with a lower incidence of PPCs (22 RCTs, 1'838 patients, odds
ratio [OR] 0.43; 95% CI 0.31-0.59); TSA provided evidence of the
effectiveness of exercise training to reduce PPCs by > 30%. Prevention of
PPCs was effective in patients undergoing cardiac surgery (OR 0.44, 95% CI
0.29-0.67) and lung surgery (OR, 0.33, 95% CI 0.21-0.51) and when patients
were pretreated with endurance training (OR 0.39, 95%CI 0.24-0.65) or
combined endurance and respiratory training modalities (OR 0.27, 95%CI
0.16-0.45). Exercise training was associated with increased peak oxygen
uptake (mean weight difference [WMD] +2.1 ml/kg/min, 99%CI 0.2-4.0) and
higher maximal inspiratory pressure (WMD +12.9 cmH20, 99%CI 7.2-18.7).
 CONCLUSION(S): Short-term exercise training improves patient physical
fitness and reduces the risk to develop PPCs. CLINICAL IMPLICATIONS:
Preoperative exercise training is a simple and low cost intervention to
reduce the risk of PPCs. This information is important for healthcare
providers involved in the clinical pathway of patients undergoing major
surgery. DISCLOSURE: No significant relationships. KEYWORD: respiratory
muscle, aerobic capacity Copyright © 2020 American College of
Chest Physicians

<52>
Accession Number
632017165
Title
Structural durability of early-generation Transcatheter aortic valve
replacement valves compared with surgical aortic valve replacement valves
in heart valve surgery: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 15 (1) (pp 127), 2020. Date of
Publication: 08 Jun 2020.
Author
Ler A.; Ying Y.J.; Sazzad F.; Choong A.M.T.L.; Kofidis T.
Institution
(Ler, Ying, Sazzad, Choong, Kofidis) Department of Cardiac, Thoracic and
Vascular Surgery, National University Heart Centre, 9th Floor ,Tower Block
,1E Kent Ridge Road 119228, Singapore
(Ler) School of Medicine, National University of Ireland, Galway, Ireland
(Ying) School of Medicine, Queen's University Belfast, Belfast, United
Kingdom
(Sazzad, Choong, Kofidis) Department of Surgery, Yong Loo Lin School of
Medicine, National University of Singapore, Kent Ridge Road, Singapore
(Sazzad, Choong, Kofidis) National University Health System (NUHS), 5
Lower Kent Ridge Road ,Kent Ridge Road 119228, Singapore
(Choong, Kofidis) Cardiovascular Research Institute, National University
of Singapore, 14 Medical Drive 117599, Singapore
Publisher
NLM (Medline)
Abstract
BACKGROUND: The current treatment for aortic stenosis includes open
surgical aortic valve replacement (SAVR) as well as endovascular
transcatheter aortic valve replacement (TAVR). This study aims to compare
the 1-year, 2-3year and 5-year structural durability of TAVR valves with
that of SAVR valves. METHOD(S): A systematic literature search was
conducted in July 2019 on Medline (via PubMed), Embase and Cochrane
electronic databases according to the PRISMA guidelines. RESULT(S):
Thirteen randomized controlled trials were included. From the
meta-analysis, we observed higher rates of 1-year (OR: 7.65, CI: 4.57 to
12.79, p<0.00001), 2-3-year (OR: 13.49, CI: 5.66 to 32.16, p<0.00001) and
5-year paravalvular regurgitation (OR: 14.51, CI: 4.47 to 47.09,
p<0.00001) associated with the TAVR valves than the SAVR valves. There
were also higher rates of 1-year (OR: 5.00, CI: 3.27 to 7.67, p<0.00001),
2-3-year (OR: 8.14, CI: 3.58 to 18.50, p<0.00001) and 5-year moderate or
severe aortic regurgitation (MD: 14.65, CI: 4.55 to 47.19, p<0.00001), and
higher rates of 1-year (OR: 3.55, CI: 1.86 to 6.77, p=0.0001), 2-3-year
(OR: 3.55, CI: 1.86 to 6.77, p=0.0001) and 5-year reintervention (OR:
3.55, CI: 1.22 to 10.38, p=0.02) in the TAVR valves as compared to SAVR
valves. CONCLUSION(S): TAVR valves appear to be more susceptible to
structural valve deterioration and thus potentially less structurally
durable than SAVR valves, given that they may be associated with higher
rates of moderate or severe aortic regurgitation, paravalvular
regurgitation and reintervention in the 1-year-, 2-3year, and 5-year
period.

<53>
Accession Number
632004661
Title
Effects of dexmedetomidine on stress hormones in patients undergoing
cardiac valve replacement: a randomized controlled trial.
Source
BMC anesthesiology. 20 (1) (pp 142), 2020. Date of Publication: 06 Jun
2020.
Author
Wu H.; Tang J.; Pan J.; Han M.; Cai H.; Zhang H.
Institution
(Wu, Pan, Han, Cai) Department of Anesthesiology, Affiliated Hospital of
Zunyi Medical University, Guizhou Province, No. 149 Dalian Road, Zunyi
563003, China
(Tang) Department of Anesthesiology, Third Affiliated Hospital of Zunyi
Medical University, Guizhou Province, Zunyi 563003, China
(Zhang) Department of Anesthesiology, Affiliated Hospital of Zunyi Medical
University, Guizhou Province, No. 149 Dalian Road, Zunyi 563003, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Stress response always occurs in cardiac valve replacement
patients undergoing cardiopulmonary bypass (CPB). METHOD(S): 60
patients undergoing cardiac valve replacement were recruited and
randomized into control and Dex groups. Dex group received 1.0mug.kg-1 of
Dex for 10min intravenously before anesthesia, followed by 0.5mug.kg-1.h-1
of Dex, steadily administered throughout the procedure. And controlled
group received the identical velocity of saline as Dex group. Plasma level
of cortisol (Cor), epinephrine (E), norepinephrine (NE), and serotonin
(5-HT) were evaluated at four timepoints: Before administration (T0), sawn
sternum (T1), end of extracorporeal circulation (T2), and 24h post
operation (T3). General data of operation and recovery such as heart rate
(HR), mean arterial pressure (MAP), intraoperative bispectral index (BIS),
and hospitalization time in the intensive care unit (ICU) were also
compared. RESULT(S): Increase of Cor, E, NE, and 5-HT for the Dex
group was significant lesser than that in the control group (P<0.05), and
ICU hospitalization time and ventilator support time was significantly
shorter in the Dex group. The proportion of patients discharged from the
hospital with better prognosis was significantly higher than that in the
control group, while there were no significant differences in
hospitalization costs and vasoactive drugs use between the two groups.
 CONCLUSION(S): Dex reduces plasma Cor, E and NE elevations in
patients after CPB, alleviates the stress reaction of the body, shortens
the hospitalization time and ventilator support time in ICU, and plays a
positive role in the rehabilitation of patients undergoing cardiac valve
replacement. TRIAL REGISTRATION: China Clinical Trial Registry (No.
ChiCTR-IPR-17010954) March 22rd, 2017.

<54>
Accession Number
632003088
Title
Diagnosis of Infective Endocarditis by Subtype Using
18F-Fluorodeoxyglucose Positron Emission Tomography/Computed
Tomography: A Contemporary Meta-Analysis.
Source
Circulation. Cardiovascular imaging. 13 (6) (pp e010600), 2020. Date of
Publication: 01 Jun 2020.
Author
Wang T.K.M.; Sanchez-Nadales A.; Igbinomwanhia E.; Cremer P.; Griffin B.;
Xu B.
Institution
(Wang, Cremer, Griffin, Xu) Section of Cardiovascular Imaging, Robert and
Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold
Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic,
P.C., B.G.
(Sanchez-Nadales, Igbinomwanhia) Department of Medicine, Advocate Illinois
Masonic Medical Center
Publisher
NLM (Medline)
Abstract
Background Infective endocarditis (IE) remains a difficult to diagnose
condition associated with high mortality. 18F-fluorodeoxyglucose positron
emission tomography/computed tomography (18F-FDG PET/CT) has recently
emerged as another IE imaging modality, although diagnostic accuracy
varies across observational studies and types of IE. This meta-analysis
assessed the diagnostic performance of 18F-FDG PET/CT for IE and its
subtypes. Methods We searched Pubmed, Cochrane, and Embase from January
1980 to September 2019 for studies reporting both sensitivity and
specificity of 18F-FDG PET/CT for IE. Meta-Disc 1.4 was used to pool data
for all cases of IE and its subgroups of native valve IE, prosthetic valve
IE, and cardiac implantable electronic devices IE. Results We screened
2566 records from the search, assessed 52 full-text articles, and included
26 studies totaling 1358 patients (509 IE cases). Pooled sensitivity and
specificity (95% CI, inconsistency I-square statistic) were 0.74
(0.70-0.77, 71.5%) and 0.88 (0.86-0.91, 78.5%) for all cases of
endocarditis. Corresponding parameters for native valve IE were
sensitivity 0.31 (0.21-0.41, 29.4%) and specificity 0.98 (0.95-0.99,
34.4%); for prosthetic valve IE: sensitivity 0.86 (0.81-0.89, 60.0%) and
specificity 0.84 (0.79-0.88, 75.2%); and for cardiac implantable
electronic devices IE: sensitivity 0.72 (0.61-0.81, 76.2%) and specificity
0.83 (0.75-0.89, 83.6%). Pooled sensitivities and specificities were
higher for the 17 studies since 2015 than the 9 studies published before
2015. Conclusions 18F-FDG PET/CT had high specificity for all IE subtypes;
however, sensitivity was markedly lower for native valve IE than
prosthetic valve IE and cardiac implantable electronic devices IE. It is,
therefore, a useful adjunct modality for assessing endocarditis,
especially in the challenging scenarios of prosthetic valve IE and cardiac
implantable electronic devices IE, with improving performance over time,
related to advances in 18F-FDG PET/CT techniques.

<55>
Accession Number
632042469
Title
Cardiac tamponade after thrombolysis for acute ischemic stroke a case with
an excellent outcome.
Source
European Journal of Case Reports in Internal Medicine. 7 (4) (no
pagination), 2020. Date of Publication: 2020.
Author
Vera-Cruz A.; Cerol M.; Pereira M.M.; Canadas S.; Mortagua J.;
Gherbovetchi I.; Andrade J.P.
Institution
(Vera-Cruz, Cerol, Pereira) Medicine Department, Internal Medicine
Service, District Hospital of Santarem, Santarem, Portugal
(Canadas) Medicine Department, Internal Medicine Service, Hospital Sousa
Martins, Guarda, Portugal
(Mortagua, Gherbovetchi, Andrade) Emergency Department, Intermediate Care
Unit, District Hospital of Santarem, Santarem, Portugal
Publisher
SMC Media Srl (E-mail: ejcrim@smc-media.eu)
Abstract
Intravenous thrombolysis with recombinant tissue plasminogen activator
(rtPA) is the established treatment for acute ischemic stroke and has been
highly effective in reducing the neurological deficit. Serious adverse
events are not uncommon, with hemorrhage being the major complication. We
describe the case of a patient with acute ischemic stroke that also
presented with vague cardiac symptoms and was treated with rtPA, which was
complicated by a hemopericardium causing cardiac tamponade.
Pericardiocentesis was promptly performed, which resulted in rapid
resolution of the cardiogenic shock. The patient recovered consciousness
within a few minutes. A search of the MEDLINE database shows that this is
the first report of cardiac tamponade after rtPA thrombolysis occurring in
a patient with no history of recent myocardial infarction or aortic
dissection. Copyright © EFIM 2019.

<56>
Accession Number
632022763
Title
Association of Neurodevelopmental Outcomes with Environmental Exposure to
Cyclohexanone during Neonatal Congenital Cardiac Operations: A Secondary
Analysis of a Randomized Clinical Trial.
Source
JAMA Network Open. 3 (5) (no pagination), 2020. Article Number: e204070.
Date of Publication: May 2020.
Author
Everett A.D.; Buckley J.P.; Ellis G.; Yang J.; Graham D.; Griffiths M.;
Bembea M.; Graham E.M.
Institution
(Everett, Yang, Griffiths) Division of Pediatric Cardiology, Department of
Pediatrics, Johns Hopkins University, 1800 Orleans St, Room M2303,
Baltimore, MD 21287, United States
(Buckley) Johns Hopkins Bloomberg School of Public Health, Department of
Environmental Health and Engineering, Johns Hopkins University, Baltimore,
MD, United States
(Graham, Bembea) Department of Anesthesia and Critical Care Medicine,
Johns Hopkins University, Baltimore, MD, United States
(Ellis, Graham) Molecular Determinants Core, Johns Hopkins All Children's
Hospital, St Petersburg, FL, United States
(Graham) Department of Pediatrics, Division of Cardiology, Medical
University of South Carolina, Charleston, United States
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
Importance: Cyclohexanone is an industrial solvent used as a coupling
agent in medical plastics. Perioperative exposure to cyclohexanone could
play a role in lower scores on measures of neurodevelopmental outcomes
after neonatal cardiac operations. Objective(s): To examine the
presence and association of serum cyclohexanone level with neonatal
cardiac operations and neurodevelopmental outcomes. Design, Setting,
and Participant(s): This ad hoc secondary analysis used data from the
Corticosteroid Therapy in Neonates Undergoing Cardiopulmonary Bypass
randomized clinical trial. The cohort included neonates younger than 31
days and with at least 37 weeks postgestational age at surgical treatment
who were enrolled at a single center between June 1, 2012, and October 31,
2016, and who had completed a neurodevelopmental assessment at age 12
months. Data were analyzed from July 8 to August 20, 2019. Exposures:
Serum cyclohexanone and its metabolites were measured preoperatively
(prior to skin incision), postoperatively (immediately after the surgical
procedure was completed), and 12 hours postoperatively. Cyclohexanone and
the molar sum of its metabolites were examined at each point and as a
geometric mean of all 3 points. Main Outcomes and Measures:
Neurodevelopment was assessed at age 12 months with the Bayley Scales of
Infant and Toddler Development III, assessing cognitive, language, and
motor function composite scores standardized to a population mean (SD) of
100 (15). Linear regression models were used to determine
covariate-adjusted differences in 12-month cognitive, language, and motor
composite scores per interquartile range increase in cyclohexanone level
or summed metabolite molar concentrations. Result(s): Among 85
included neonates, mean (SD) age at surgical treatment was 9.7 (5.3) days,
49 (58%) were boys, and 54 (64%) underwent corrective repair. Mean (SD)
Bayley Scales of Infant and Toddler Development III composite scores were
108.2 (12.2) for cognitive function, 104.7 (11.0) for language function,
and 94.7 (15.7) for motor function. Median (interquartile range)
cyclohexanone levels increased approximately 3-fold from immediately prior
to surgical treatment to immediately after surgical treatment (572
[389-974] vs 1744 [1469-2291] mug/L; P =.001). In adjusted analyses,
higher geometric mean cyclohexanone levels were associated with
significantly lower composite scores for cognitive (-4.23; 95% CI,-7.39
to-1.06; P =.01) and language (-3.65; 95% CI,-6.41 to-0.88; P =.01)
function. The difference in composite scores for motor function among
infants with higher geometric mean cyclohexanone levels was not
statistically significant(-3.93, 95% CI:-8.19 to 0.33, P =.07).
 Conclusions and Relevance: The findings of this secondary analysis of
a randomized clinical trial suggest that infants who underwent neonatal
cardiac surgical treatment with cardiopulmonary bypass had substantial
cyclohexanone levels, which were associated with adverse
neurodevelopmental function at age 12 months. Copyright © 2020
Everett AD et al.

<57>
Accession Number
2005018472
Title
Long-term and short-term duration of thienopyridine therapy after coronary
stenting in patients with chronic kidney disease a meta-analysis of
literature studies.
Source
Platelets. 31 (4) (pp 483-489), 2020. Date of Publication: 18 May 2020.
Author
Wu Y.; Song Y.; Pan Y.; Gong Y.; Zhou Y.
Institution
(Wu, Gong, Zhou) Department of Nephrology, Beijing Tiantan hospital,
Capital Medical University, Beijing, China
(Song) School of Economics, Central University of Finance and Economics,
Beijing, China
(Pan) Department of Epidemiology and Health Statistics, School of Public
Health, Capital Medical University, Beijing, China
(Pan) China National Clinical Research Center for Neurological Diseases
(NCRC-ND), Beijing, China
Publisher
Taylor and Francis Ltd
Abstract
The study aimed to compare the efficacy and safety outcome associated with
a short and a prolonged duration of thienopyridine therapy in patients
with chronic kidney disease (CKD) after coronary stenting. We
systematically searched PubMed, EMBASE and the Cochrane Library from their
inception to 1 January 2019 for studies comparing short and prolonged
thienopyridine therapy in patients with CKD. Ischemic and bleeding events
were considered as the clinical endpoints in this analysis. Odds Ratios
(OR) with 95% confidence intervals (CIs) were used as estimates of effect
size in random-effect models. Seven studies comprising a total of 17,628
CKD patients were included in the evaluation. Prolonged duration of
thienopyridine use, when compared to short-term thienopyridine, was
associated with reduced risk of all-cause mortality (odds ratio 0.75, 95%
confidence interval: 0.70-0.81, P<.001) and stent thrombosis (OR: 0.54,
95% CI 0.32 to 0.89; P<.001), but the odds of myocardial infarction (OR:
0.91, 95% CI: 0.77-1.07; P =.23) and stroke (OR: 0.91, 95% CI 0.73 to
1.13; P =.38) did not differ according to different duration of
thienopyridine. As for bleeding events, long-term thienopyridine therapy
did not significantly increase the bleeding (OR: 0.95, 95% CI 0.79 to
1.14; P =.58). In these patients with CKD following PCI, prolonged
thienopyridine therapy compared with short-term therapy, was associated
with reduced all-cause mortality and stent thrombosis, without any
significant difference in myocardial infarction, stroke, and bleeding.
Thienopyridine prolongation decisions for CKD patients should be
individualized after careful consideration of the benefit-risk
balance. Copyright © 2019, © 2019 Taylor & Francis Group,
LLC.

<58>
Accession Number
2004533018
Title
Better approach to optimize perioperative care for high risk older
patients undergoing non cardiac surgeries: A narrative review.
Source
Australasian Medical Journal. 13 (5) (pp 163-173), 2020. Date of
Publication: 2020.
Author
Iddagoda M.T.; Karunanayaka A.
Institution
(Iddagoda, Karunanayaka) Perioperative Service, Royal Perth Hospital,
Australia
Publisher
Australasian Medical Journal Pty Ltd (12 Lancett Crt, Sorrento, WA 6020
WA, Australia)
Abstract
Background As the population is aging, an associated rise in
co-morbidities augment perioperative mortality and morbidity. Evidence is
emerging to improve perioperative care for high-risk patients in view of
better postoperative outcomes. Aims While there are number of
international guidelines describing preoperative evaluation of such
patients, a comprehensive review of a high-risk older patient's journey
through non-cardiac surgery is lacking in the literature. The aim of this
review is to recapitulate current evidence for management approaches of
high-risk patients undergoing non-cardiac surgeries. Methods In this
review, literature search was conducted through East Metropolitan Health
library service for studies and guidelines published on high risk older
patients undergoing non cardiac surgeries. Priority was given to the
evidence on preoperative risk stratification, investigation and management
of chronic medical conditions and postoperative care. Conclusion The
available evidence should be used to optimize perioperative outcomes of
high and intermediate risk older patients undergoing non-cardiac
surgeries. Copyright © 2020, Australasian Medical Journal Pty
Ltd. All rights reserved.

<59>
Accession Number
2004519665
Title
Effectiveness of an educational program on nurses' knowledge and practices
regarding nursing interventions of chest tube drainage system in ibn
alnafees teaching hospital.
Source
Indian Journal of Public Health Research and Development. 11 (4) (pp
1809-1814), 2020. Date of Publication: April 2020.
Author
Hamel O.L.; Ahmed S.A.
Institution
(Hamel, Ahmed) Adult Nursing Department, College of Nursing, University of
Baghdad, Iraq
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
This study aims to evaluate the effectiveness of an educational program on
nurses' knowledge and practices regarding nursing interventions of chest
tube drainage system in Ibn Alnafees teaching hospital. As well also aims
to assess nurses' knowledge and practices regarding these interventions,
and to find out the relationships between nurses' knowledge and practices.
A quasi-experimental design was used in the present study with the
application of a pre-test/post-test approach for the study group and
control group. Data collection was done at two times: baseline data
(before any intervention was provided to the study group) and 21 days
after giving the educational program (in the study group). The period of
the study was from 15th December, 2018 to 11th February, 2019. A
non-probability purposive sample was randomly selected from nurses who
were working in surgical units, intensive care unit, thoracic operating
room, and open heart operating room. The results of this study shows that
there is a highly significant differences related to nurses' knowledge and
practices regarding nursing interventions for chest drainage system;
between pre & post-test in the study group, while there is a trivial or no
differences between pre & post-test in the control group. Copyright
© 2020, Indian Journal of Public Health Research and Development. All
rights reserved.

<60>
Accession Number
2005978229
Title
American Society of Hematology 2018 guidelines for management of venous
thromboembolism: Heparin-induced thrombocytopenia.
Source
Blood Advances. 2 (22) (pp 3360-3392), 2018. Date of Publication: 27 Nov
2018.
Author
Cuker A.; Arepally G.M.; Chong B.H.; Cines D.B.; Greinacher A.; Gruel Y.;
Linkins L.A.; Rodner S.B.; Selleng S.; Warkentin T.E.; Wex A.; Mustafa
R.A.; Morgan R.L.; Santesso N.
Institution
(Cuker, Cines) Department of Medicine, University of Pennsylvania,
Philadelphia, PA, United States
(Cuker, Cines) Department of Pathology and Laboratory Medicine, Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA, United
States
(Arepally) Department of Medicine, Duke University Medical Center, Durham,
NC, United States
(Chong) Department of Haematology, University of New South Wales, Sydney,
NSW, Australia
(Greinacher) Institute of Immunology and Transfusion Medicine, University
of Greifswald, Greifswald, Germany
(Gruel) Department of Haematology-Haemostasis, Trousseau Hospital, Tours,
France
(Linkins, Warkentin) Department of Medicine, McMaster University,
Hamilton, ON, Canada
(Rodner) New YorkNYUnited States
(Selleng) Department of Anaesthesiology, University of Greifswald,
Greifswald, Germany
(Warkentin) Department of Pathology and Molecular Medicine, McMaster
University, Hamilton, ON, Canada
(Wex) ColumbusOHUnited States
(Mustafa, Morgan, Santesso) Department of Health Research Methods,
Evidence and Impact, McMaster University, Hamilton, ON, Canada
(Mustafa) Department of Medicine, University of Missouri-Kansas City,
Kansas City, MO, United States
Publisher
American Society of Hematology (E-mail: publishing@hematology.org)
Abstract
Background: Heparin-induced thrombocytopenia (HIT) is an adverse drug
reaction mediated by platelet-activating antibodies that target complexes
of platelet factor 4 and heparin. Patients are at markedly increased risk
of thromboembolism. Objective(s): These evidence-based guidelines of
the American Society of Hematology (ASH) are intended to support patients,
clinicians, and other health care professionals in their decisions about
diagnosis and management of HIT. Method(s): ASH formed a
multidisciplinary guideline panel balanced to minimize potential bias from
conflicts of interest. The McMaster University GRADE Centre supported the
guideline development process, including updating or performing systematic
evidence reviews. The panel prioritized clinical questions and outcomes
according to their importance for clinicians and patients. The Grading of
Recommendations Assessment, Development and Evaluation (GRADE) approach
was used to assess evidence and make recommendations, which were subject
to public comment. Result(s): The panel agreed on 33 recommendations.
The recommendations address screening of asymptomatic patients for HIT,
diagnosis and initial management of patients with suspected HIT, treatment
of acute HIT, and special situations in patients with acute HIT or a
history of HIT, including cardiovascular surgery, percutaneous
cardiovascular intervention, renal replacement therapy, and venous
thromboembolism prophylaxis. Conclusion(s): Strong recommendations
include use of the 4Ts score rather than a gestalt approach for estimating
the pretest probability of HIT and avoidance of HIT laboratory testing and
empiric treatment of HIT in patients with a low-probability 4Ts score.
Conditional recommendations include the choice among non-heparin
anticoagulants (argatroban, bivalirudin, danaparoid, fondaparinux, direct
oral anticoagulants) for treatment of acute HIT. Copyright © 2018
by The American Society of Hematology.

<61>
Accession Number
2005220797
Title
Impact of inferior caval valve implantation on severity of tricuspid
regurgitation and right heart function.
Source
Echocardiography. (no pagination), 2020. Date of Publication: 2020.
Author
Mattig I.; Knebel F.; Hewing B.; Stangl V.; Stangl K.; Laule M.; Dreger H.
Institution
(Mattig, Knebel, Hewing, Stangl, Stangl, Laule, Dreger) Medizinische
Klinik mit Schwerpunkt Kardiologie und Angiologie, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Knebel, Hewing, Laule) Berlin Institute of Health (BIH), Berlin, Germany
(Knebel, Hewing, Stangl, Stangl, Dreger) DZHK (German Centre for
Cardiovascular Research), Berlin, Germany
(Hewing) Department of Cardiology III - Adult Congenital and Valvular
Heart Disease, University Hospital Muenster, Muenster, Germany
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Aims: Severe tricuspid regurgitation (TR) is a common finding in heart
failure patients and associated with increased mortality. New
interventional therapeutic options are needed as many heart failure
patients are unfit for surgery. The TRICAVAL study compared valve
implantation into the inferior vena cava (CAVI) with optimal medical
therapy (OMT) in patients with severe TR. Here, we report details on the
impact of CAVI on TR severity as well as right heart function and
morphology. Methods and Results: We randomized 28 patients with
severe TR to CAVI (n = 14) with transfemoral implantation of an Edwards
Sapien XT valve into the inferior vena cava or OMT (n = 14). Inclusion and
exclusion criteria were based on anatomical and clinical parameters.
Echocardiographic measurements were performed at baseline, at the first
postoperative day and one, three, and twelve months after randomization.
As proof of concept of an effective sealing of the inferior vena cava, we
detected a significant decrease in systolic hepatic vein reflux volume
(11.0 [6.2-21.9] mL vs 3.5 [0.6-8.5] mL, P =.016) and hepatic vein
diameter (11.5 [10.0-14.8] mm vs 10.0 [9.3-11.8] mm, P =.034) at
thirty-day follow-up. However, CAVI had no significant impact on TR,
cardiac function, and morphology. Conclusion(s): Caval valve
implantation significantly reduced systolic reflux into the hepatic veins
but was not associated with an improvement in cardiac function,
morphology, or TR severity. Copyright © 2020 The Authors.
Echocardiography published by Wiley Periodicals LLC

<62>
Accession Number
632035808
Title
A Comprehensive Systemic Literature review of Pericardial Decompression
Syndrome: Often Unrecognized and Potentially Fatal Syndrome.
Source
Current cardiology reviews. (no pagination), 2020. Date of Publication: 07
Jun 2020.
Author
Amro A.; Mansoor K.; Amro M.; Sobeih A.; Suliman M.; Okoro K.; El-Hamdani
Ms R.; Vilchez D.; El-Hamdani M.; Shweihat Y.R.
Institution
(Amro, Mansoor, Suliman, Okoro, El-Hamdani Ms, Vilchez, El-Hamdani,
Shweihat) Internal Medicine Department, Joan C. Edwards School of
Medicine, Marshall University, WV. United States, Huntington, United
States
(Amro) School of medicine, Misr University of Science and Technology
(Sobeih) School of medicine, AL-Najah University, Nablus. Palestinian
Territory
Publisher
NLM (Medline)
Abstract
BACKGROUND: Pericardial Decompression Syndrome (PDS) is defined as
paradoxical hemodynamic deterioration and/or pulmonary edema, commonly
associated with ventricular dysfunction. This phenomenon was first
described by Vandyke in 1983. PDS is a rare but formidable complication of
pericardiocentesis which if not managed appropriately is fatal. PDS as an
entity has dispersed literature; this review is to understand its
epidemiology, presentation, and management. METHODOLOGY: Medline: Science
Direct and Google Scholar databases were utilized to do a systemic
literature search. PRISMA protocol was employed. Abstracts, case reports,
case series and clinical studies were identified since 1983 to 2019. A
total of 6508 articles were reviewed out of which 210 were short listed,
after removal of duplicates 49 manuscripts were included in this review.
For Statistical analysis, patient data was tabulated in SPSS version 20.
Cases were divided into two categories surgical and percutaneous groups. T
test was done for continuous variable and chi square test was done for
categorical data was used for analysis. RESULT(S): A total of 42 full
length case reports, 2 poster abstracts, 3 case series of 2 patients , 1
case series of 4 patient s and 1 case series of 5 patients were included
in the study. A total of 59 cases were included in this manuscript. Our
data had 45.8% (n=27) males and 54.2% (n=32) females. The mean age of
patients was 48.04 +/- 17 years. Pericardiocentesis was performed in 52.5%
(n=31) cases, Pericardiostomy was performed in 45.8% (n=27). The most
common identifiable cause pericardial effusion was found to be malignancy
in 35.6% (n=21). 23 cases reported pre-procedural ejection fraction which
ranged from 20%-75% with a mean of 55.8 +/- 14.6%, while 26 cases reported
post procedural ejection fraction which ranged from 10%-65% with a mean of
30% +/- 15.1%. Data was further divided into two categories namely,
pericardiocentesis and pericardiostomy. The outcome as death was
significant in the pericardiostomy arm with a p-value of < 0.00. Use of
inotropic agents for the treatment of PDS was more common in needle
pericardiocentesis with a p-value of 0.04. Lastly, the computed recovery
time did not yield any significance with a p-value of 0.275.
 CONCLUSION(S): Pericardial decompression syndrome is a rare condition
with high mortality. Operators performing pericardial drainage should be
aware of this complication following drainage of cardiac tamponade, since
early recognition and expeditious supportive care are the only therapeutic
modalities available for adequate management of this
complication. Copyright© Bentham Science Publishers; For any
queries, please email at epub@benthamscience.net.

<63>
Accession Number
632029991
Title
Exercise Electrocardiography and Computed Tomography Coronary Angiography
for Patients with Suspected Stable Angina Pectoris: A Post Hoc Analysis of
the Randomized SCOT-HEART Trial.
Source
JAMA Cardiology. (no pagination), 2020. Date of Publication: 2020.
Author
Singh T.; Bing R.; Dweck M.R.; Van Beek E.J.R.; Mills N.L.; Williams M.C.;
Villines T.C.; Newby D.E.; Adamson P.D.
Institution
(Singh, Bing, Dweck, Van Beek, Mills, Williams, Newby, Adamson) British
Heart Foundation Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, United Kingdom
(Villines) Division of Cardiovascular Medicine, University of Virginia,
Charlottesville, United States
(Adamson) Christchurch Heart Institute, University of Otago, Christchurch,
New Zealand
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
Importance: Recent European guidance supports a diminished role for
exercise electrocardiography (ECG) in the assessment of suspected stable
angina. Objective(s): To evaluate the utility of exercise ECG in
contemporary practice and assess the value of combined functional and
anatomical testing. Design, Setting, and Participant(s): This is a
post hoc analysis of the Scottish Computed Tomography of the Heart
(SCOT-HEART) open-label randomized clinical trial, conducted in 12
cardiology chest pain clinics across Scotland for patients with suspected
angina secondary to coronary heart disease. Between November 18, 2010, and
September 24, 2014, 4146 patients aged 18 to 75 years with stable angina
underwent clinical evaluation and 1417 of 1651 (86%) underwent exercise
ECG prior to randomization. Statistical analysis was conducted from
October 10 to November 5, 2019. Intervention(s): Patients were
randomized in a 1:1 ratio to receive standard care plus coronary computed
tomography (CT) angiography or to receive standard care alone. The present
analysis was limited to the 3283 patients who underwent exercise ECG alone
or in combination with coronary CT angiography. Main Outcomes and
Measures: The primary clinical end point was death from coronary heart
disease or nonfatal myocardial infarction at 5 years. Result(s):
Among the 3283 patients (1889 men; median age, 57.0 years [interquartile
range, 50.0-64.0 years]), exercise ECG had a sensitivity of 39% and a
specificity of 91% for detecting any obstructive coronary artery disease
in those who underwent subsequent invasive angiography. Abnormal results
of exercise ECG were associated with a 14.47-fold (95% CI, 10.00-20.41; P
<.001) increase in coronary revascularization at 1 year and a 2.57-fold
(95% CI, 1.38-4.63; P <.001) increase in mortality from coronary heart
disease death at 5 years or in cases of nonfatal myocardial infarction at
5 years. Compared with exercise ECG alone, results of coronary CT
angiography had a stronger association with 5-year coronary heart disease
death or nonfatal myocardial infarction (hazard ratio, 10.63; 95% CI,
2.32-48.70; P =.002). The greatest numerical difference in outcome with CT
angiography compared with exercise ECG alone was observed for those with
inconclusive results of exercise ECG (6 of 283 [2%] vs 18 of 283 [6%]),
although this was not statistically significant (log-rank P =.05).
 Conclusions and Relevance: This study suggests that abnormal results
of exercise ECG are associated with coronary revascularization and the
future risk of adverse coronary events. However, coronary CT angiography
more accurately detects coronary artery disease and is more strongly
associated with future risk compared with exercise ECG. Trial
Registration: ClinicalTrials.gov Identifier: NCT01149590. Copyright
© 2020 American Medical Association. All rights reserved.

<64>
Accession Number
632004182
Title
Does Tweeting Improve Citations? One-Year Results from the TSSMN
Prospective Randomized Trial.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 03 Jun 2020.
Author
Luc J.G.Y.; Archer M.A.; Arora R.C.; Bender E.M.; Blitz A.; Cooke D.T.;
Hlci T.N.; Kidane B.; Ouzounian M.; Varghese T.K.; Antonoff M.B.
Institution
(Luc) Division of Cardiovascular Surgery, Department of Surgery,
University of British Columbia, Vancouver, BC, Canada
(Archer) Department of Thoracic Surgery, Vanderbilt University Medical
Center, TN, Nashville, United States
(Arora) Section of Cardiac Surgery, Department of Surgery, Max Rady
College of Medicine, University of Manitoba, St. Boniface Hospital,
Winnipeg, MB, Canada
(Bender) Department of Cardiothoracic Surgery, Stanford University, Palo
Alto, CA, United States
(Blitz) Division of Cardiac Surgery, University of Cincinnati Medical
Center, Cincinnati, OH, USA
(Cooke) Section of General Thoracic Surgery, UC Davis Health, Sacramento,
CA, USA
(Hlci) Department of Cardiothoracic Surgery, Morriston Hospital, ABMU,
Swansea, United Kingdom
(Kidane) Section of Thoracic Surgery, Department of Surgery, University of
Manitoba, Winnipeg, MB, Canada
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, University of Toronto, Toronto, ON, Canada
(Varghese) Division of Cardiothoracic Surgery, Department of Surgery,
University of Utah, UT, Salt Lake City, United States
(Antonoff) Department of Thoracic and Cardiovascular Surgery, UT MD
Anderson Cancer Center, TX, Houston, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The Thoracic Surgery Social Media Network (TSSMN) is a
collaborative effort of leading journals in cardiothoracic surgery to
highlight publications via social media. This study aims to evaluate the
1-year results of a prospective randomized social media trial to determine
the effect of tweeting on subsequent citations and non-traditional
bibliometrics. METHOD(S): A total of 112 representative original
articles were randomized 1:1 to be tweeted via TSSMN or a control
(non-tweeted) group. Measured endpoints included citations at 1-year
compared to baseline, as well as article-level metrics (Altmetric score)
and Twitter analytics. Independent predictors of citations were identified
through univariable and multivariable regression analyses. RESULT(S):
When compared to control articles, tweeted articles achieved significantly
greater increase in Altmetric scores (Tweeted 9.4+/-5.8 vs. Non-Tweeted
1.0+/-1.8, p<0.001), Altmetric score percentiles relative to articles of
similar age from each respective journal (Tweeted 76.0+/-9.1%ile vs.
Non-Tweeted 13.8+/-22.7%ile, p<0.001), with greater change in citations at
1 year (Tweeted +3.1+/-2.4 vs. Non-Tweeted +0.7+/-1.3, p<0.001).
Multivariable analysis showed that independent predictors of citations
were randomization to tweeting (OR 9.50; 95%CI 3.30-27.35, p<0.001),
Altmetric score (OR 1.32; 95%CI 1.15-1.50, p<0.001), open-access status
(OR 1.56; 95%CI 1.21-1.78, p<0.001), and exposure to a larger number of
Twitter followers as quantified by impressions (OR 1.30, 95%CI 1.10-1.49,
p<0.001). CONCLUSION(S): One-year follow-up of this TSSMN prospective
randomized trial importantly demonstrates that tweeting results in
significantly more article citations over time, highlighting the durable
scholarly impact of social media activity. Copyright © 2020.
Published by Elsevier Inc.

<65>
Accession Number
632002629
Title
Preoperative Statin Therapy for Atrial Fibrillation and Renal Failure
after Cardiac Surgery.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2020. Date of
Publication: 07 Jun 2020.
Author
Kuhn E.W.; Liakopoulos O.J.; Choi Y.-H.; Rahmanian P.; Eghbalzadeh K.;
Slottosch I.; Deppe A.C.; Wahlers T.C.W.
Institution
(Kuhn, Liakopoulos, Choi, Rahmanian, Eghbalzadeh, Slottosch, Deppe,
Wahlers) Department of Cardiothoracic Surgery, Heart Center of the
University Hospital of Cologne, Cologne, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Performing cardiac surgery in patients with cardiovascular
risk factors incorporates a steady risk for the development of
postoperative complications. Perioperative statin intake was associated
with an improvement of perioperative outcomes in these patients. However,
the European Association for Cardio-Thoracic Surgery guidelines regarding
the perioperative statin treatment were changed recently due to large
studies reporting about relevant adverse effects related to statin
therapy. METHOD(S): All relevant databases were searched including
the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and
the metaRegister of Controlled Trials. Various registries were screened
(National Research Register, the ClinicalTrials.gov, and gray literature)
with search on online conference indices of relevant scientific meetings.
No language restrictions were applied. RESULT(S): We identified 10
randomized controlled studies summarizing 3,468 participants undergoing
various kinds of cardiac surgical procedures. All included studies
presented with marked differences regarding study design. Pooled analysis
indicated that statin pretreatment was associated with a formally reduced
incidence of postoperative atrial fibrillation (AF) (odds ratio [OR] 0.63,
95% confidence interval [CI] 0.39-1.00; p=0.05) but with an increased
incidence of renal failure (OR 1.20, 95% CI 1.01-1.44; p=0.04) compared
with control. Substantial heterogeneity was observed among studies
reporting about AF. CONCLUSION(S): Current but sparse evidence
reveals that statin pretreatment is associated with a higher rate of
postoperative renal failure compared with control therapy but is
ineffective to substantially reduce postoperative AF. Given the relevant
heterogeneity among included studies, statin pretreatment cannot be
generally recommended. Copyright Georg Thieme Verlag KG Stuttgart .
New York.

<66>
Accession Number
2004449445
Title
Comparative study between effects of epidural magnesium sulphate on
intraoperative and postoperative analgesic requirements in cancer thoracic
surgery: A randomized controlled trial.
Source
Indian Journal of Public Health Research and Development. 11 (3) (pp
1404-1410), 2020. Date of Publication: March 2020.
Author
Hussein A.A.; Ghobrial H.Z.; Kamel M.A.; Saied A.M.A.; Khattab M.;
Mohammed A.T.; Elhalwagy A.M.A.
Institution
(Hussein) Department of Anesthesiology, ICU,and Pain Management, Faculty
of Medicine, Cairo University, Cairo, Egypt
(Ghobrial, Khattab, Mohammed) Department of Anesthesiology, ICU and Pain
Management, Faculty of Medicine, Al Azhar University for Boys, Cairo,
Egypt
(Kamel, Saied, Elhalwagy) Department of Anesthesiology, ICU and Pain
Management, Faculty of Medicine, Sohag University, Sohag, 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
Background: The epidural infusion of local anesthetic and opioid achieves
effective postoperative analgesia in thoracic surgery patients.
Nevertheless, high dose of opioids my induce dose-dependent undesired
effects. Recent reports showed that adjuvantepidural magnesium
administration significantly improve intra and postoperative analgesic
outcomes.T he present randomized trial aimed to assess the intra and
postoperative analgesic effect of continuousepidural infusion of magnesium
sulphate in patients undergoing elective cancer thoracic surgery.
 Method(s): Sixty ASA III patients undergoing elective cancer thoracic
surgery were randomized in 1:1 ratio to receive adjuvant epidural
magnesium sulphate or 0.9% sodium chloride solution. The primary outcomes
in the present study were intra and postoperative analgesic requirements,
and postoperative pain score. Result(s): The magnesium sulphate group
showed a statistically significant lower number of required fenanyl doses
than the control group (74.3% needed two or more doses in magnesium
sulphate group versus 94.4% in the control group, p =0.026). A similar
findings was observed for need for ketorolac 30mg (p =0.017). The
postoperative VAS was significantly lower inmagnesium sulphate groupfrom
the 12th hour (p =0.033) to the 48th hour
postoperatively (p <0.001). The magnesium sulphate group showed more
stable hemodynamics. No major side-effects were observed in any of the
study groups. Conclusion(s): Epidural magnesium sulphate is a potent
adjuvant analgesic thatreduced opioid consumption and postoperative pain
in patients undergoing thoracic surgery. Copyright © 2020, Indian
Journal of Public Health Research and Development. All rights reserved.

<67>
Accession Number
2004270080
Title
High-dose nitroglycerin administered during rewarming preserves
erythrocyte deformability in cardiac surgery with cardiopulmonary bypass.
Source
Microcirculation. 27 (4) (no pagination), 2020. Article Number: e12608.
Date of Publication: 01 May 2020.
Author
Tai Y.-H.; Chu Y.-H.; Wu H.-L.; Lin S.-M.; Tsou M.-Y.; Huang C.-H.; Chang
H.-H.; Lu C.-C.
Institution
(Tai, Chu, Wu, Lin, Tsou, Lu) Department of Anesthesiology, Taipei
Veterans General Hospital, Taipei, Taiwan (Republic of China)
(Tai, Wu, Lin, Tsou, Huang) School of Medicine, National Yang-Ming
University, Taipei, Taiwan (Republic of China)
(Tai) Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical
University, New Taipei City, Taiwan (Republic of China)
(Tai) Department of Anesthesiology, School of Medicine, College of
Medicine, Taipei Medical University, Taipei, Taiwan (Republic of China)
(Chu, Lu) Graduate Institute of Life Sciences, National Defense Medical
Center, Taipei, Taiwan (Republic of China)
(Huang, Chang) Division of Cardiovascular Surgery, Department of Surgery,
Taipei Veterans General Hospital, Taipei, Taiwan (Republic of China)
(Lu) Institute of Aerospace Medicine, National Defense Medical Center,
Taipei, Taiwan (Republic of China)
Publisher
Wiley Blackwell (E-mail: info@wiley.com)
Abstract
Objective: We aimed to determine whether high-dose nitroglycerin, a nitric
oxide donor, preserves erythrocyte deformability during cardiopulmonary
bypass and examines the signaling pathway of nitric oxide in erythrocytes.
 Method(s): In a randomized and controlled fashion, forty-two patients
undergoing cardiac surgery with hypothermic cardiopulmonary bypass were
allocated to high-dose (N = 21) and low-dose groups (N = 21). During
rewarming period, patients were given intravenous nitroglycerin with an
infusion rate 5 and 1 micro g.kg-1.min-1 in
high-dose and low-dose groups, respectively. Tyrosine phosphorylation
level of non-muscle myosin IIA in erythrocyte membrane was used as an
index of erythrocyte deformability and analyzed using immunoblotting.
 Result(s): Tyrosine phosphorylation of non-muscle myosin IIA was
significantly enhanced after bypass in high-dose group (3.729 +/- 1.700
folds, P =.011) but not low-dose group (1.545 +/- 0.595 folds, P =.076).
Phosphorylation of aquaporin 1, vasodilator-stimulated phosphoprotein, and
focal adhesion kinase in erythrocyte membrane was also upregulated in
high-dose group after bypass. Besides, plasma nitric oxide level was
highly correlated with fold change of non-muscle myosin IIA
phosphorylation (Pearson's correlation coefficient.871).
 Conclusion(s): High-dose nitroglycerin administered during
cardiopulmonary bypass improves erythrocyte deformability through
activating phosphorylation of aquaporin 1, vasodilator-stimulated
phosphoprotein, and focal adhesion kinase in erythrocytes. Copyright
© 2020 John Wiley & Sons Ltd

<68>
Accession Number
2003912045
Title
Bone marrow-derived mesenchymal stromal cell treatment in patients with
ischaemic heart failure: final 4-year follow-up of the MSC-HF trial.
Source
European Journal of Heart Failure. 22 (5) (pp 884-892), 2020. Date of
Publication: 01 May 2020.
Author
Mathiasen A.B.; Qayyum A.A.; Jorgensen E.; Helqvist S.; Kofoed K.F.;
Haack-Sorensen M.; Ekblond A.; Kastrup J.
Institution
(Mathiasen, Qayyum, Jorgensen, Helqvist, Kofoed, Kastrup) Department of
Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen,
Copenhagen, Denmark
(Haack-Sorensen, Ekblond) Cardiac Stem Cell Centre, The Heart Centre,
Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Aims: The study assessed 4-year outcomes of intramyocardial injections of
autologous bone marrow-derived mesenchymal stromal cells (MSCs) in
patients with ischaemic heart failure. Methods and Results: The
MSC-HF trial was a randomized, double-blind, placebo-controlled trial.
Patients were randomized 2:1 to intramyocardial injections of MSCs or
placebo. The primary endpoint was change in left ventricular end-systolic
volume (LVESV), measured by magnetic resonance imaging or computed
tomography. Sixty patients aged 30-80 years with ischaemic heart failure,
New York Heart Association class II-III, left ventricular ejection
fraction (LVEF) <45% and no further treatment options were randomized.
Patients were followed clinically for 12 months and in addition 4-year
data of hospitalizations and survival were retrieved. After 12 months,
LVESV was significantly reduced in the MSC group and not in the placebo
group, with difference between groups of 17.0 +/- 16.2 mL (95% confidence
interval 8.3-25.7, P = 0.0002). There were also significant improvements
in LVEF of 6.2% (P < 0.0001), stroke volume of 16.1 mL (P < 0.0001) and
myocardial mass (P = 0.009) between groups. A significant dose-response
effect was also observed. Moreover, a significant reduction in the amount
of scar tissue and quality of life score in the MSC group but not in the
placebo group was observed. After 4 years, there were significantly fewer
hospitalizations for angina in the MSC group and otherwise no differences
in hospitalizations or survival. No side effects were identified.
 Conclusion(s): Intramyocardial injections of autologous bone
marrow-derived MSCs improved myocardial function and myocardial mass in
patients with ischaemic heart failure. Copyright © 2019 European
Society of Cardiology

<69>
Accession Number
2003637598
Title
Dexmedetomidine Reduces Atrial Fibrillation After Adult Cardiac Surgery: A
Meta-Analysis of Randomized Controlled Trials.
Source
American Journal of Cardiovascular Drugs. 20 (3) (pp 271-281), 2020. Date
of Publication: 01 Jun 2020.
Author
Liu Y.; Zhang L.; Wang S.; Lu F.; Zhen J.; Chen W.
Institution
(Liu, Wang, Lu, Zhen, Chen) Department of Intensive Care Unit, Beijing
Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Haidian
District, Beijing 100038, China
(Zhang) Department of anesthesiology, Beijing Daxing Maternal and Child
Care Hospital, Beijing, China
Publisher
Adis
Abstract
Background: Dexmedetomidine has been shown to have antiarrhythmic effects
by exhibiting sympatholytic properties and activating the vagus nerve in
preclinical studies. Results from clinical trials of dexmedetomidine on
atrial fibrillation (AF) following adult cardiac surgery are
controversial. Material(s) and Method(s): We searched EMBASE, PubMed
and Cochrane CENTRAL databases for randomized controlled trials (RCTs)
comparing the antiarrhythmic effect of dexmedetomidine versus placebo or
other anesthetic drugs in adult patients undergoing cardiac surgery. The
primary outcome was the incidence of AF. The secondary outcomes were
ventricular arrhythmias [ventricular fibrillation (VF), ventricular
tachycardia (VT)], mechanical ventilation (MV) duration, intensive care
unit (ICU) length of stay, and hospital length of stay, and all-cause
mortality. Result(s): Thirteen trials with a total of 1684 study
patients were selected. Compared with controls, dexmedetomidine
significantly reduced the incidence of postoperative AF [odds ratio (OR)
0.75; 95% confidence interval (CI) 0.58-0.97; P = 0.03] and VT (OR 0.23;
95% CI 0.11-0.48; P < 0.0001). No significant difference for the incidence
of VF existed (OR 0.80; 95% CI 0.21-3.03; P = 0.74). There was no
significant difference between groups in MV duration [weighted mean
difference (WMD) - 0.10; 95% CI - 0.42 to 0.21; P = 0.52], postoperative
ICU stay (WMD - 0.49; 95% CI - 2.64 to 1.66; P = 0.65), hospital stay (WMD
- 0.01; 95% CI - 0.16 to 0.13; P = 0.88) and mortality (OR 0.59; 95% CI
0.15-2.37; P = 0.46). Conclusion(s): Perioperative administration of
dexmedetomidine in adult patients undergoing cardiac surgery reduced the
incidence of postoperative AF and VT. But there was no significant
difference in incidence of VF, MV duration, ICU stay, hospital stay and
mortality. Copyright © 2019, Springer Nature Switzerland AG.

<70>
Accession Number
631940689
Title
Safety and efficacy of direct Cardiac Shockwave Therapy in patients with
ischemic cardiomyopathy undergoing coronary artery bypass grafting (the
CAST-HF trial): Study protocol for a randomized controlled trial.
Source
Trials. 21 (1) (no pagination), 2020. Article Number: 447. Date of
Publication: 30 May 2020.
Author
Polzl L.; Nagele F.; Graber M.; Hirsch J.; Lobenwein D.; Mitrovic M.; Mayr
A.; Theurl M.; Schreinlechner M.; Pamminger M.; Dorfmuller C.; Grimm M.;
Gollmann-Tepekoylu C.; Holfeld J.
Institution
(Polzl, Nagele, Graber, Hirsch, Lobenwein, Grimm, Gollmann-Tepekoylu,
Holfeld) University Clinic of Cardiac Surgery, Medical University of
Innsbruck, Innsbruck, Austria
(Mitrovic) Clinical Trial Center, Medical University of Innsbruck, Innrain
52, Innsbruck 6020, Austria
(Mayr, Pamminger) University Clinic of Radiology, Medical University of
Innsbruck, Innsbruck, Austria
(Theurl, Schreinlechner) University Clinic of Internal Medicine III,
Medical University of Innsbruck, Innsbruck, Austria
(Dorfmuller) Heart Regeneration Technologies GmbH, Innsbruck, Austria
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Coronary artery diseases (CAD) remains a severe socio-economic
burden in the Western world. Coronary obstruction and subsequent
myocardial ischemia result in progressive replacement of contractile
myocardium with dysfunctional, fibrotic scar tissue. Post-infarctional
remodeling is causal for the concomitant decline of left-ventricular
function and the fatal syndrome of heart failure. Available neurohumoral
treatment strategies aim at the improvement of symptoms. Despite extensive
research, therapeutic options for myocardial regeneration, including
(stem)-cell therapy, gene therapy, cellular reprogramming or tissue
engineering, remain purely experimental. Thus, there is an urgent clinical
need for novel treatment options for inducing myocardial regeneration and
improving left-ventricular function in ischemic cardiomyopathy. Shockwave
Therapy (SWT) is a well-established regenerative tool that is effective
for the treatment of chronic tendonitis, long-bone non-union and
wound-healing disorders. In preclinical trials, SWT regenerated ischemic
myocardium via the induction of angiogenesis and the reduction of fibrotic
scar tissue, resulting in improved left-ventricular function.
Methods/design: In this prospective, randomized controlled, single-blind,
monocentric study, 80 patients with reduced left-ventricular ejection
fraction (LVEF<= 40%) are subjected to coronary-artery bypass-graft
surgery (CABG) surgery and randomized in a 1:1 ratio to receive additional
cardiac SWT (intervention group; 40 patients) or CABG surgery with sham
treatment (control group; 40 patients). This study aims to evaluate (1)
the safety and (2) the efficacy of cardiac SWT as adjunctive treatment
during CABG surgery for the regeneration of ischemic myocardium. The
primary endpoints of the study represent (1) major cardiac events and (2)
changes in left-ventricular function 12 months after treatment. Secondary
endpoints include 6-min Walk Test distance, improvement of symptoms and
assessment of quality of life. Discussion(s): This study aims to
investigate the safety and efficacy of cardiac SWT during CABG surgery for
myocardial regeneration. The induction of angiogenesis, decrease of
fibrotic scar tissue formation and, thus, improvement of left-ventricular
function could lead to improved quality of life and prognosis for patients
with ischemic heart failure. Thus, it could become the first clinically
available treatment strategy for the regeneration of ischemic myocardium
alleviating the socio-economic burden of heart failure. Trial
registration: ClinicalTrials.gov, ID: NCT03859466. Registered on 1 March
2019. Copyright © 2020 The Author(s).

<71>
Accession Number
631934264
Title
Comparing transcatheter aortic valve replacement (AVR) with surgical AVR
in lower risk patients: A comprehensive meta-analysis and systematic
review.
Source
Cardiology Research. 11 (3) (pp 168-178), 2020. Article Number: 1046. Date
of Publication: 01 Jun 2020.
Author
Khan M.S.; Mir T.; Ullah W.; Ali Z.; Idris O.; Khan G.; Ur Rashid M.;
Salman; Mehmood M.; Ali S.S.
Institution
(Khan, Salman) Department of Internal Medicine, Mercy St Vincent Medical
Center, Toledo, OH 43608, United States
(Mir) Department of Internal Medicine, Detroit Medical Center, Wayne State
University, Detroit, MI 48201, United States
(Ullah, Ali) Department of Internal Medicine, Abington Jefferson Health,
Abington, PA 19001, United States
(Idris, Mehmood, Ali) Department of Cardiology, Mercy Saint Vincent
Medical Center, Toledo, OH 43608, United States
(Khan) University of Missouri, Kansas City, MO 64110, United States
(Ur Rashid) Department of Internal Medicine, Advent Health, Orlando, FL
32803, United States
(Khan) Department of Internal Medicine, Mercy Saint Vincent Medical
Center, Toledo, OH 43608, United States
Publisher
Elmer Press (E-mail: production@elmerpress.com)
Abstract
Background: Transcutaneous aortic valve replacement (TAVR) is a novel
percutaneous procedure for severe aortic stenosis and has been recently
approved by Food and Drug Administration in lower risk patients. We
performed the first ever meta-analysis and literature review of clinical
trials comparing both 30-day and 1-year outcomes in lower risk patients
undergoing TAVR vs. surgical aortic valve replacement (SAVR, having
Society of Thoracic Surgeons score < 4% or equivalent). Method(s):
Using predefined selection criteria as above, 68 articles were identified.
Seven eligible articles were selected after extensive review. Primary
effect outcomes were 30-day and 1-year all-cause mortality using risk
ratio (RR) with significant P value of < 0.05. Result(s): A total of
4,859 subjects were included. Risk of 30-day all-cause mortality was 40.1%
less in TAVR group, RR 0.59 (95% confidence interval (CI): 0.38-0.92, P =
0.02) with no significant heterogeneity. Six studies except Schymik et al
also reported 1-year risk. This was, however, not statistically
significant with a 21% decrease in the TAVR group, RR 0.79 (95% CI:
0.57-1.09, P = 0.15). Six studies reported 30-day risk of secondary
outcomes. The risk of 30-day stroke was 36% less in TAVR group, although
this was not statistically significant, RR 0.64 (95% CI: 0.38-1.9, P =
0.10). The risk of acute kidney injury (AKI) stage 2 and above was 56%
less in post-TAVR patients, RR 0.43 (95% CI: 0.35-0.54, P < 0.001) with no
heterogeneity. For vascular complications, RR was high in TAVR group 4.62
(95% CI: 1.42-15.18, P = 0.01). Significant heterogeneity was demonstrated
though (I2 = 81). The risks for permanent pacemaker (PPM) were also higher
in the TAVR group, RR 3.30 (95% CI: 2.04-5.33, P < 0.001) and significant
heterogeneity was observed. After removing Thyregod et al and Partner 3
trial from the analysis, heterogeneity was removed, but the RR was still
high 3.21 (95% CI: 2.54-4.068, P < 0.001). Post-operative incidence of
endocarditis among TAVR patients was low but not statistically
significant. The 30-day risk for infective endocarditis was RR 0.67 (95%
CI: 0.13-3.48, P = 0.63). The 1-year risk was similarly low but not
significant, RR 0.73 (95% CI: 0.28-1.92, P = 0.53). Conclusion(s):
Among low risk patients, TAVR was found to be superior in short-term
all-cause mortality and 1-year stroke, a result that was statistically
significant for TAVR and close to significance for stroke. TAVR patients
were also less likely to have post-operative bleeding and AKI stage 2 and
beyond. Post-operative incidence of endocarditis among TAVR patients was
low but not statistically significant. However, the rates of PPM and
vascular complications are higher in TAVR patients. The results of TAVR in
low risk population are thus extremely encouraging. However, the issue of
long-term valve durability in this group needs further studies. Also,
caution needs to be exercised while extending the indications to extremely
young patients due to lack of enough studies. Copyright © The
authors.

<72>
Accession Number
2006116483
Title
Evidence-based thoracic epidural nerve block: A systematic review.
Source
International Journal of Surgery Open. 24 (pp 151-155), 2020. Date of
Publication: 2020.
Author
Chekol W.B.; Melesse D.Y.; Denu Z.A.; Tawuye H.Y.
Institution
(Chekol, Melesse, Denu, Tawuye) Department of Anesthesia, College of
Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Publisher
Elsevier Ltd
Abstract
Background: Thoracic epidural nerve block (TENB) is a technique in which
analgesia is produced by injecting local anesthetic agent by itself or
combined with additives or alone into the epidural space. This systematic
review was designed to improve the quality of pain management and to form
a common consensus for TENB based on the current evidences.
 Method(s): PubMed through HINARI was used to get access for current
and updated evidences on TENB for cardio-thoracic and major abdominal
surgeries. The flow diagram was used to show the filtration methods of
suitable literature. Discussion(s): TENB should be started after
checking baseline vital signs and after preparation of emergent
phenomenon. The prominent part of C7, T3 scapular spine and the inferior
border of T7 are used to localize the intended segment during performing
the procedures. Skin infiltration with aseptic technique of 2-3 ml of 2%
lidocaine, test dose of 3 ml of lidocaine with 1:200,000 epinephrine, and
loading dose of 3-5 ml of 0.25-0.5% bupivacaine are recommended for TENB.
The maintenance dose is 3-5 ml of 0.1-0.25% of bupivacaine. The thoracic
epidural catheter will not stay for more than 4 days. Post-procedural care
and monitoring should be performed for patients on thoracic epidural
catheter. Conclusion(s): Generally, appropriate preoperative patient
evaluation, pre-procedural preparation of the necessary materials, and
consideration of the possible options should be mandatory. Anesthetists
should be familiar with the landmark techniques, troubleshooting,
administration of safe doses of the drug, and post-epidural catheter
insertion care. Copyright © 2020 The Author(s)

<73>
Accession Number
2005033913
Title
Degenerative Severe Aortic Stenosis and Concomitant Coronary Artery
Disease: What Is Changing in the Era of the "Transcatheter Revolution"?.
Source
Current Atherosclerosis Reports. 22 (5) (no pagination), 2020. Article
Number: 17. Date of Publication: 01 May 2020.
Author
Pepe M.; Larosa C.; Rosa I.; Biondi-Zoccai G.; Nestola P.L.; Di Cillo O.;
Bortone A.S.; Giordano A.; Favale S.
Institution
(Pepe, Nestola, Favale) Division of Cardiology, Department of Emergency
and Organ Transplantation, University of Bari, Bari, Italy
(Larosa) Division of Cardiology, Lorenzo Bonomo Hospital, Andria, BT,
Italy
(Rosa) Division of Cardiology, Vittorio Emanuele II Hospital, Bisceglie,
BT, Italy
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Naples, Italy
(Di Cillo) Chest Pain Unit, Cardiology Emergency, University of Bari,
Bari, Italy
(Bortone) Division of Heart Surgery, Department of Emergency and Organ
Transplantation, University of Bari, Bari, Italy
(Giordano) Invasive Cardiology Unit, "Pineta Grande" Hospital, Castel
Volturno, Caserta, Italy
Publisher
Springer
Abstract
Purpose of Review: To summarize epidemiology, pathophysiology, prognostic
relevance, and treatment options of coronary artery disease (CAD) when
coupled with severe aortic stenosis (SAS). In regard to treatment options,
we focused on the most recently adopted therapeutic approaches and on the
future perspectives in light of the latest percutaneous and surgical
technical improvements in the field of both CAD and SAS management. Recent
Findings: Nowadays, SAS is the most common valve disease requiring
intervention, either surgical or percutaneous. On the other side, CAD is
one of the leading causes of death in the developed countries. CAD and
degenerative SAS share several predisposing factors and are often
concurrently found in clinical practice. Despite in the last years the
transcatheter aortic valve replacement (TAVR) has been deeply changing the
therapeutic approach to SAS, the correct management of patients with
concomitant CAD remains controversial due to limited and heterogeneous
data in the literature. Summary: Coronary revascularization is often
performed in patients with concomitant CAD and SAS. Complete surgical
approach is still the standard of care according to international
guidelines. However, in light of the recent results of TAVR trials, the
therapeutic approach is expected to change. To date, percutaneous coronary
intervention performed before TAVR is safe and feasible even if the
optimal timing for revascularization remains debated. Due to the great
complexity of the patients affected by SAS and CAD and until
unquestionable truths will come from large randomized trials, the role of
the Heart Team in the decision-making process is of primary importance to
guarantee the best tailored therapeutic strategy for the single
patient. Copyright © 2020, Springer Science+Business Media, LLC,
part of Springer Nature.

<74>
Accession Number
2004750697
Title
Meta-analysis of randomised trials compares mortality after transcatheter
versus surgical aortic valve replacement.
Source
Netherlands Heart Journal. 28 (6) (pp 309-311), 2020. Date of Publication:
01 Jun 2020.
Author
Vendrik J.; BaanJr J.
Institution
(Vendrik, Baan Jr) Heart Centre, Amsterdam University Medical Centres
(location AMC), Amsterdam, Netherlands
Publisher
Bohn Stafleu van Loghum (E-mail: e.smid@ntvg.nl)

<75>
Accession Number
2004562105
Title
Pharmacokinetics of an intravenous bolus dose of clonidine in children
undergoing surgery.
Source
Paediatric Anaesthesia. 30 (5) (pp 607-613), 2020. Date of Publication: 01
May 2020.
Author
Nielsen B.N.; Anderson B.J.; Falcon L.; Henneberg S.W.; Lauritsen T.;
Lomstein E.; Ydemann M.; Afshari A.
Institution
(Nielsen, Falcon, Henneberg, Lauritsen, Afshari) Department of
Anaesthesia, The Juliane Marie Centre, Copenhagen University Hospital
Rigshospitalet, Copenhagen, Denmark
(Anderson) Department of Anaesthesiology, University of Auckland,
Auckland, New Zealand
(Lomstein) Center for Laboratory, Food and Environmental Technology, The
Business Academy Aarhus, Aarhus, Denmark
(Ydemann) Department of Neuroanaethestesiology, Copenhagen University
Hospital, Copenhagen, Denmark
Publisher
Blackwell Publishing Ltd
Abstract
Background: Clonidine is used off-label in children but only limited
pediatric pharmacokinetic data are available for intravenously
administered clonidine. Objective(s): To determine pharmacokinetic
parameter estimates of clonidine in healthy children undergoing surgery
and to investigate age-related differences. Furthermore, to investigate
possible pharmacokinetic differences of clonidine between this group of
children and a cohort with cardiac diseases. Method(s): In a
randomized placebo-controlled trial (The PREVENT AGITATION trial), blood
samples for clonidine pharmacokinetic analysis were collected in a
proportion of the enrolled patients. Healthy children with ASA score 1-2
in the age-groups 1 to <2 years and 2-5 years were randomized for blood
sampling. Clonidine was administered as a single intravenous bolus of 3
micro g/kg intraoperatively. Blood samples were drawn at baseline, 5,
10, 15, 30, 60 minutes after dosing and additionally every hour until
discharge from the PACU. Clonidine analysis was performed on liquid
chromatography-mass spectrometry. Result(s): Data form eighteen
children were available for pharmacokinetic analysis (ASA I; male/female:
17/1; age: 1-5 years; weight 8.7-24 kg). Population parameter estimates
for the 2-compartment model were similar to previous published data for
children who underwent cardiac surgery. A pooled analysis including data
from 59 children indicated clearance of 14.4 L h-1 70
kg-1 and volume of distribution of 192.6 L 70 kg-1.
No age-related pharmacokinetic differences and no difference in time from
administration of study medication to awakening were found. Children 1 to
<2 years had a shorter PACU stay than children 2-5 years (mean difference
17% 95% CI:3%-34%, P =.02). Conclusion(s): Pharmacokinetic parameter
estimates were similar for children undergoing general surgery and cardiac
surgery given a single dose of intravenous clonidine. These results
indicated that no dose reduction is needed in children aged 1 to <2 years
compared with those 2-5 years, which was supported by pharmacodynamic
observations. Copyright © 2020 John Wiley & Sons Ltd

<76>
Accession Number
2006006205
Title
TicagRelor Or Clopidogrel in severe or terminal chronic kidney patients
Undergoing PERcutaneous coronary intervention for acute coronary syndrome:
The TROUPER trial.
Source
American Heart Journal. 225 (pp 19-26), 2020. Date of Publication: July
2020.
Author
Laine M.; Lemesle G.; Burtey S.; Cayla G.; Range G.; Quaino G.; Canault
M.; Pankert M.; Paganelli F.; Puymirat E.; Bonello L.
Institution
(Laine, Paganelli, Bonello) Aix-Marseille Univ, Intensive cardiac care
unit, Assistance Publique-Hopitaux de Marseille, Hopital Nord, Marseille,
France
(Laine, Paganelli, Bonello) Mediterranean Association for Research and
Studies in Cardiology (MARS Cardio), Marseille, France
(Laine, Burtey, Canault, Bonello) Aix Marseille Univ, INSERM, INRA, C2VN,
Marseille, France
(Lemesle) Institut Coeur et Poumon, CHRU de Lille, Faculte de Medecine de
l'Universite de Lille, Unite INSERM UMR 1011, Lille, France
(Burtey) Service de Nephrologie, Hopital de la Conception, Assistance
Publique des Hopitaux de Marseille, Aix Marseille Universite, France
(Cayla) Departement de Cardiologie, CHU Nimes, Nimes, France
(Range) Departement de Cardiologie, CHU Chartres, Chartres, France
(Quaino) Service de Cardiologie, Centre Hospitalier Toulon, Toulon, France
(Pankert) Service de Cardiologie, Centre Hospitalier d'Avignon, Avignon,
France
(Puymirat) Departement de Cardiologie, Hopital Europeen Georges Pompidou,
Assistance Publique des Hopitaux de Paris, Universite Paris Descartes,
INSERM U-970, Paris, France
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Chronic kidney disease (CKD) is associated with an increased risk of acute
coronary syndrome (ACS) and cardiovascular death. CKD patients suffering
from ACS are exposed to an increased risk of thrombotic recurrences and a
higher bleeding rate than patients with normal renal function. However,
CKD patients are excluded or underrepresented in clinical trials.
Therefore, determining the optimal antiplatelet strategy in this
population is of utmost importance. We designed the TicagRelor Or
Clopidogrel in severe or terminal chronic kidney patients Undergoing
PERcutaneous coronary intervention for acute coronary syndrome (TROUPER)
trial: a prospective, controlled, multicenter, randomized trial to
investigate the optimal P2Y12 antagonist in CKD patients with ACS.
Patients with stage >=3b CKD are eligible if the diagnosis of ACS is made
and invasive strategy scheduled. Patients are randomized 1:1 between a
control group with a 600-mg loading dose of clopidogrel followed by a
75-mg/d maintenance dose for 1 year and an experimental group with a
180-mg loading dose of ticagrelor followed by a 90-mg twice daily
maintenance dose for the same duration. The primary end point is defined
by the rate of major adverse cardiovascular events, including death,
myocardial infarction, urgent revascularization, and stroke at 1 year.
Safety will be evaluated by the bleeding rate (Bleeding Academic Research
Consortium). To demonstrate the superiority of ticagrelor on major adverse
cardiovascular events, we calculated that 508 patients are required. The
aim of the TROUPER trial is to compare the efficacy of ticagrelor and
clopidogrel in stage >3b CKD patients presenting with ACS and scheduled
for an invasive strategy. RCT# NCT03357874 Copyright © 2020
Elsevier Inc.

<77>
Accession Number
2004416980
Title
Mortality after transcatheter versus surgical aortic valve replacement: an
updated meta-analysis of randomised trials.
Source
Netherlands Heart Journal. 28 (6) (pp 320-333), 2020. Date of Publication:
01 Jun 2020.
Author
Takagi H.; Hari Y.; Nakashima K.; Kuno T.; Ando T.
Institution
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Kuno) Department of Medicine, Mount Sinai Beth Israel Medical Center, New
York, NY, United States
(Ando) Division of Interventional Cardiology, Department of Cardiology,
New York Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
Publisher
Bohn Stafleu van Loghum (E-mail: e.smid@ntvg.nl)
Abstract
Background: To determine whether transcatheter aortic valve implantation
(TAVI) improves early (30-day) and midterm (1-year) mortality compared
with surgical aortic valve replacement (SAVR), we performed an updated
meta-analysis of all the currently available randomised controlled trials
(RCTs). Method(s): To identify all RCTs providing both 30-day and
1-year mortality after TAVI versus SAVR, PubMed and ClinicalTrials.gov
were searched up to and including July 2019. A risk difference (RD) and
its 95% confidence interval were generated using data of prespecified
outcomes in both the TAVI and SAVR groups. Study-specific estimates were
pooled using inverse variance-weighted averages of RDs in the
random-effects model. Result(s): We identified seven eligible
high-quality RCTs including a total of 7631 as-treated patients. Pooled
analyses demonstrated significantly lower 30-day (RD -0.60%; p= 0.046) and
1-year all-cause mortality (RD -1.12%; p= 0.03) after TAVI than after
SAVR. No funnel plot asymmetry was detected for 30-day and 1-year
mortality. Meta-regression analyses indicated that RDs of 30-day and
1-year mortality between TAVI and SAVR were not modulated by mean Society
of Thoracic Surgeons Predicted Risk of Mortality score. Bleeding
complications at 30 days and 1 year and stage 2/3 acute kidney injury at
30 days were significantly less frequent after TAVI than after SAVR,
whereas major vascular complications and new permanent pacemaker
implantation at 30 days and 1 year were significantly more frequent after
TAVI than after SAVR. Conclusion(s): The best evidence from the
present meta-analysis of all the currently available RCTs suggests that
TAVI may reduce 30-day and 1-year all-cause mortality compared with
SAVR. Copyright © 2020, The Author(s).

<78>
Accession Number
2003514036
Title
Systematic review of cardiac rehabilitation guidelines: Quality and scope.
Source
European Journal of Preventive Cardiology. 27 (9) (pp 912-928), 2020. Date
of Publication: 01 Jun 2020.
Author
Mehra V.M.; Gaalema D.E.; Pakosh M.; Grace S.L.
Institution
(Mehra, Grace) Faculty of Health, York University, Canada
(Gaalema) Vermont Center on Behavior and Health, University of Vermont,
United States
(Pakosh) Library and Information Services, Toronto Rehabilitation
Institute, Canada
(Grace) KITE-Toronto Rehabilitation Institute, University Health Network,
University of Toronto, Canada
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Cardiac rehabilitation is a comprehensive model of secondary prevention
proven to reduce mortality and morbidity. The World Health Organization is
developing a Package of Rehabilitation Interventions for implementation by
ministries of health as part of universal healthcare across the continuum.
Through a systematic review, we sought to identify the best-quality
cardiac rehabilitation guidelines, and extract their recommendations for
implementation by member states. A systematic search was undertaken of
academic databases and guideline repositories, among other sources,
through to April 2019, for English-language cardiac rehabilitation
guidelines from the last 10 years, free from conflicts, and with strength
of recommendations. Two authors independently considered all citations.
Potentially eligible guidelines were rated for quality using the Appraisal
of Guidelines for Research and Evaluation tool, and for other
characteristics such as being multi-professional, comprehensive and
international in perspective; the latter criteria were used to inform
selection of 3-5 guidelines meeting inclusion criteria. Equity
considerations were also extracted. Altogether, 2076 unique citations were
identified. Thirteen passed title and abstract screening, with six
guidelines potentially eligible for inclusion in the Package of
Rehabilitation Interventions and rated for quality; for two guidelines the
Appraisal of Guidelines for Research and Evaluation tool ratings did not
meet World Health Organization minimums. Of the four eligible guidelines,
three were selected: the International Council of Cardiovascular
Prevention and Rehabilitation (2016), National Institute for Health and
Care Excellence (#172; 2013) and Scottish Intercollegiate Guideline
Network (#150; 2017). Extracted recommendations were comprehensive, but
psychosocial recommendations were contradictory and diet recommendations
were inconsistent. A development group of the World Health Organization
will review and refine the recommendations which will then undergo peer
review, before open source dissemination for implementation. Copyright
© The European Society of Cardiology 2019.

<79>
[Use Link to view the full text]
Accession Number
631982000
Title
Red Meat Allergies after Lone Star Tick (Amblyomma americanum) Bites.
Source
Southern Medical Journal. 113 (6) (pp 267-274), 2020. Date of Publication:
01 Jun 2020.
Author
Diaz J.H.
Institution
(Diaz) School of Public Health, Environmental, and Occupational Health
Sciences, Louisiana State University Health Sciences Center, 2020 Gravier
St, New Orleans, LA 70112, United States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Red meat allergies have followed tick bites on every continent except
Antarctica. The sensitizing antigen is galactose-alpha-1,3-galactose
(alpha-gal), an oligosaccharide constituent of nonprimate blood and meat,
acquired by ticks during animal bloodfeeding. Because red meat allergy
after tick bites is a worldwide phenomenon, the objectives of this review
were to describe the global epidemiology of red meat allergy after tick
bites and its immunological mechanisms; to identify the human risk factors
for red meat allergy after tick bites; to identify the most common tick
vectors of red meat allergy worldwide; to describe the clinical
manifestations, diagnostic confirmation, and management of patients with
red meat allergy after tick bites; and to recommend strategies for the
prevention of tick bites. To meet these objectives, Internet search
engines were queried with keywords to select scientific articles for
review. The keywords included ticks, tick bites, allergy, anaphylaxis, and
meat allergy. The study period was defined as 1980-2019. The major risk
factors for red meat allergy after tick bites included male sex, non-B
blood type, systemic mastocytosis, a bioprosthetic (bovine or porcine)
heart valve, and preexisting allergies to gelatin or animal dander.
Following confirmation by challenge testing, patients with red meat
allergies should avoid red meats, foods containing gelatin, and
intravenous immunotherapy with monoclonal antibodies such as cetuximab and
infliximab produced in SP2/0 mouse cell lines. Red meat allergy after tick
bites represents an emerging threat from tick bites in addition to
infectious diseases. Copyright © Lippincott Williams & Wilkins.

<80>
Accession Number
2006130020
Title
The efficacy of early postoperative enteral immunonutrition on
T-lymphocyte count: A randomised control study in low-risk cardiac surgery
patients.
Source
Clinical Nutrition. (no pagination), 2020. Date of Publication: 2020.
Author
Svetikiene M.; Ringaitiene D.; Vezeliene J.; Isajevas V.; Trybe D.; Vicka
V.; Malickaite R.; Jurgauskiene L.; Norkuniene J.; Serpytis M.; Sipylaite
J.
Institution
(Svetikiene, Ringaitiene, Isajevas, Serpytis, Sipylaite) Department of
Anaesthesiology and Intensive Care, Institute of Clinical Medicine,
Faculty of Medicine, Vilnius University, Lithuania
(Svetikiene, Ringaitiene, Vezeliene, Isajevas, Vicka, Serpytis, Sipylaite)
Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
(Trybe, Vicka) Faculty of Medicine, Vilnius University, Vilnius, Lithuania
(Malickaite, Jurgauskiene) Clinic of Cardiac and Vascular Diseases,
Institute of Clinical Medicine, Faculty of Medicine, Vilnius University,
Vilnius, Lithuania
(Norkuniene) Department of Mathematical Statistics, Faculty of Fundamental
Sciences, Vilnius Gediminas Technical University, Vilnius, Lithuania
Publisher
Churchill Livingstone
Abstract
Background: Patients undergoing cardiac surgery have a pronounced immune
response that leads to a reduction in cellular immunity. Immune-modulating
nutritional supplements are considered to be beneficial for patients
undergoing major surgery. However, due to the lack of studies in the
cardiac surgery population, the effect of immunonutrition remains unclear
in this patient group. Objective(s): Our purpose was to research the
efficacy of early postoperative enteral immunonutrition on T-lymphocyte
count in the cardiac surgery population. Method(s): This was a
randomised control study of low operative risk adult patients, who
underwent elective cardiac surgery. These patients were randomised into
immunonutrition and control groups. The immunonutrition group was
supplemented with immune nutrients for five postoperative days. The counts
of T-lymphocytes, as well as the counts for the CD4+ and CD8+ cell
subpopulations were determined on the day of surgery and on the sixth
postoperative day. Result(s): Fifty-five patients were enrolled in
the study, the mean age was 69.7 +/- 6.3 years, 28 (50.9%) of them were
males, the median operative risk was 1.75%. Twenty-seven (49.1%) were
randomised into the immunonutrition group. The control and the
immunonutrition groups were similar before the intervention. The counts of
the CD3+ T cells and CD4+ T cells on the sixth postoperative day were
significantly higher in the immunonutrition group compared to the control
group with 1.42 +/- 0.49 vs. 1.12 +/- 0.56 (*109/l), p = 0.035
and 1.02 +/- 0.36 vs. 0.80 +/- 0.43 (*109/l), p = 0.048,
respectively. Regression analysis was performed to determine the efficacy
of the immunonutrition on the counts of the CD3+ and CD4+ T cells; CD3+ T
and CD4+ T cell counts were increased to 0.264 (*109/l), p =
0.039 and 0.232 (*109/l), p = 0.021, respectively.
 Conclusion(s): Early postoperative immunonutrition increases the
count of the CD3+ and CD4+ T cells in cardiac surgical patients. Clinical
trials identifier number: NCT04047095 Copyright © 2020 Elsevier
Ltd and European Society for Clinical Nutrition and Metabolism

<81>
Accession Number
2004378853
Title
Active chest tube clearance after aortic valve surgery did not influence
amount residual pericardial fluid after aortic valve replacement in a
randomised trial.
Source
Scandinavian Cardiovascular Journal. 54 (3) (pp 200-205), 2020. Date of
Publication: 03 May 2020.
Author
Malgerud L.; Maret E.; Reitan C.; Ivert T.
Institution
(Malgerud, Ivert) Department of Cardiothoracic Surgery, Karolinska
University Hospital, Stockholm, Sweden
(Malgerud) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
(Maret) Department of Clinical Physiology, Karolinska University Hospital,
and Karolinska Institutet, Stockholm, Sweden
(Reitan) Department of Cardiothoracic Surgery, Karolinska University
Hospital, Stockholm and Department of Cardiology, Lund University, Lund,
Sweden
Publisher
Taylor and Francis Ltd
Abstract
Objective. Evaluate if the use of active clearance of chest tubes after
aortic valve surgery influenced bleeding and reduced postoperative
residual pericardial effusion. Design. Prospective randomised trial
comparing PleuraFlow 32 F chest tube with FlowGlideTM active
clearance to a standard Argyle 32 F chest tube in 100 patients
undergoing aortic valve surgery. Chest tube outputs and pericardial
effusion measurements assessed by two-dimensional transthoracic
echocardiography were recorded before hospital discharge. Results.
Postoperative chest tube outputs per hour did not differ between the two
groups. The median chest tube output was 400 mL for patients who had a
PleuraFlow chest tube vs. 490 mL for patients with an
Argyle chest tube (p =.08). Pericardial effusions >= 2 mm were
detected in 76% vs. 68% of the patients (p =.50) and postoperative atrial
fibrillation occurred in 42% vs. 34% (p =.54), respectively. Conclusions.
Use of active clearance chest tubes, compared to standard chest tubes
after aortic valve surgery did not differ significantly regarding
postoperative bleeding or degree of pericardial effusion as measured by
echocardiography prior to hospital discharge. Copyright © 2020,
© 2020 The Author(s). Published by Informa UK Limited, trading as
Taylor & Francis Group.

<82>
Accession Number
630522047
Title
Comparative efficacy of continuous infusion of bupivacaine/fentanyl and
ropivacaine/fentanyl for paediatric pain control after the Ravitch
procedure and thoracotomy. A prospective randomized study.
Source
Biomedical papers of the Medical Faculty of the University Palacky,
Olomouc, Czechoslovakia. 163 (4) (pp 366-373), 2019. Date of Publication:
01 Dec 2019.
Author
Tomaszek L.; Fenikowski D.; Gawron D.; Komotajtys H.
Institution
(Tomaszek, Fenikowski, Gawron, Komotajtys) Department of Thoracic Surgery,
Institute for Tuberculosis and Lung Diseases, Pediatric Division, Poland
Publisher
NLM (Medline)
Abstract
AIMS: (1) To compare the efficacy of bupivacaine/fentanyl and
ropivacaine/fentanyl for postoperative pain control (2). To identify the
predictors of acute post-operative pain at rest, during deep breathing and
coughing. METHOD(S): The study was performed in patients aged 6-18
years after thoracic surgery. The subjects were randomized to the
bupivacaine 0.125%/fentanyl 5.0 mug/mL (n=46) or ropivacaine 0.2%/fentanyl
5.0 mug/mL (n=48) group; analgesic mixtures were administered through
epidural catheter. All the patients received paracetamol and non-steroidal
anti-inflammatory drugs. The observation period after surgery lasted 72 h.
Pain intensity was assessed at rest, during deep breathing and coughing
and was based on the Numerical Rating Scale and the FLACC scale (range
0-10). If the pain was above 2/10, the analgesia was modified.
 RESULT(S): Median pain scores at rest (0.4 vs. 0.5), during deep
breathing (0.3 vs. 0.3) and coughing (0.6 vs. 0.6) were comparable in BF
and RF group. The intensity of pain at rest was associated with the number
of drains inserted into the thorax (beta=0.39), the number of pain
intensity measurements (beta=0.36) and the number of nursing interventions
undertaken to relieve pain (beta=0.16). Pain intensity at rest determined
the intensity of pain during deep breathing (beta=0.60), which in turn
decided on the severity of pain during coughing (beta=0.80). The intensity
of pain was increased by age. CONCLUSION(S): Thoracic epidural
bupivacaine/fentanyl provided adequate pain relief and similar analgesia
to ropivacaine/fentanyl. The effectiveness of analgesia depended on the
number of pain measurements and interventions by nurses to relieve the
pain. TRIAL REGISTRATION: ClinicalTrials.gov; Multimodal Analgesia in
Children and Adolescents After the Ravitch Procedure and Thoracotomy;
NCT03444636; https://clinicaltrials.gov/ct2/show/NCT03444636.

<83>
Accession Number
604220767
Title
RIPC remains a promising technique for protection of the myocardium during
open cardiac surgery: A meta-analysis and systematic review.
Source
Heart Surgery Forum. 18 (2) (no pagination), 2015. Date of Publication:
2015.
Author
Payne R.E.; Aldwinckle J.; Storrow J.; Kong R.S.; Lewis M.E.
Institution
(Payne) Department of Trauma and Orthopaedic Surgery, University Hospital
Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, United
Kingdom
(Aldwinckle) Department of Cardiology, University Hospital Coventry and
Warwickshire, Coventry, United Kingdom
(Storrow) Department of Intensive Care, Heartlands Hospital, Birmingham,
United Kingdom
(Kong, Lewis) Department of Cardiac Surgery, Royal Sussex County Hospital,
Brighton, United Kingdom
Publisher
Carden Jennings Publishing Co. Ltd (E-mail: motis@cjp.com)
Abstract
Background: Remote ischemic preconditioning (RIPC) is the process of
inducing brief ischemia in a tissue to prevent ischemic damage in another.
This preconditioning can be induced simply by inflating a blood pressure
cuff on a limb. Previous randomized controlled trials (RCT) have suggested
that RIPC may infer myocardial protection during open cardiac surgery. One
method of assessing the degree of myocardial damage incurred in these
studies is to assay troponin concentration. Troponin is a cardiac enzyme
released by damaged myocardiocytes. With the recent publication of several
large RCTs in this area, a meta-analysis of the evidence was undertaken.
 Method(s): A systematic search of PubMed, EMBASE, and
clinicaltrials.gov.uk was conducted using MeSH terms "ischaemic
preconditioning" and "cardiac surgery." RCTs that examined post-surgery
troponin concentrations were included in this review. The primary outcome
investigated was troponin levels at six hours post-cardiac surgery.
Secondary outcomes included six to eight hour and twenty-four hour
troponin release. Result(s): Thirteen RCTs, comprising 1398
participants, were identified for inclusion in this meta-analysis. Twelve
hour postoperative troponin was significantly reduced by RIPC,
standardized mean difference 1.29 (95% CI 0.34-2.24). Six to eight and
twenty-four hour troponin were also significantly reduced, standardized
mean differences 1.23 (95% CI 0.62-1.84) and 1.25 (95% CI 0.31-2.19)
respectively. Conclusion(s): The reduction in troponin concentration
suggests that RIPC reduces myocardial damage during open cardiac surgery,
however, the degree of bias in the studies assessed may have had a
significant impact on this result. Copyright © 2015 Forum
Multimedia Publishing, LLC.

<84>
Accession Number
2005714677
Title
Long-Term Outcomes With Drug-Eluting Stents or Coronary Artery Bypass
Surgery for Unprotected Left Main Coronary Disease: A Meta-Analysis and
Trial Sequential Analysis of Randomized Trials.
Source
American Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Elgendy I.Y.; Mahmoud A.N.; Gad M.; Elgendy A.Y.; Bhatt D.L.
Institution
(Elgendy) Division of Cardiology, Massachusetts General Hospital and
Harvard Medical School, Boston, MA, United States
(Mahmoud) Division of Cardiology, University of Washington, Seattle, WA,
United States
(Gad) Department of Medicine, Cleveland Clinic Foundation, Cleveland, OH,
United States
(Elgendy) Division of Cardiovascular Medicine, University of Florida,
Gainesville, FL, United States
(Bhatt) Brigham and Women's Hospital Heart & Vascular Center, Harvard
Medical School, Boston, MA, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)

<85>
Accession Number
2005145452
Title
Transcatheter aortic valve replacement in patients with a history of
cancer: Periprocedural and long-term outcomes.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2020.
Date of Publication: 2020.
Author
Murphy A.C.; Koshy A.N.; Cameron W.; Horrigan M.; Kearney L.; Yeo B.;
Farouque O.; Yudi M.B.
Institution
(Murphy, Koshy, Cameron, Horrigan, Kearney, Farouque, Yudi) Department of
Cardiology, Austin Health, Melbourne, VIC, Australia
(Murphy, Koshy, Kearney, Farouque, Yudi) Department of Medicine, The
University of Melbourne, Melbourne, VIC, Australia
(Yeo) Department of Oncology, The Olivia Newton-John Cancer and Wellness
Centre, Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background: A history of cancer is incorporated into the surgical risk
assessment of patients undergoing surgical aortic valve replacement
through the Society for Thoracic Surgeons score. However, the prognostic
significance of cancer in patients treated with transcatheter aortic valve
replacement (TAVR) is unclear. As the cancer survivorship population
increases, it is imperative to establish the efficacy and safety of TAVR
in patients with severe symptomatic aortic stenosis (AS) and a history of
malignancy. Objective(s): The primary goal of this study was to
assess the periprocedural outcomes and long-term mortality in patients
with a history of cancer undergoing TAVR. Method(s): A systematic
review of PubMed, MEDLINE, and EMBASE was conducted to identify studies
reporting outcomes in patients with a history of malignancy undergoing
TAVR. A meta-analysis was performed using a random-effects model with a
primary outcome of all-cause mortality and cardiac mortality at the
longest follow-up. On secondary analyses, procedural safety was assessed.
 Result(s): A total of 13 observational studies with 10,916 patients
were identified in the systematic review. Seven studies including 6,323
patients were included in the quantitative analysis. Short-term mortality
(relative risk [RR] 0.61, 95%CI 0.36-1.01; p =.06) and long-term all-cause
mortality (RR 1.24, 95%CI 0.95-1.63; p =.11) were not significantly
different when comparing patients with and without a history of cancer. No
significant difference in the rate of periprocedural complications
including stroke, bleeding, acute kidney injury, and pacemaker
implantation was noted. Conclusion(s): In patients with severe AS
undergoing TAVR, a history of cancer was not associated with adverse short
or long-term survival. Based on these findings, TAVR should be considered
in all patients with severe symptomatic AS, irrespective of their history
of malignancy. Copyright © 2020 Wiley Periodicals LLC.

<86>
Accession Number
631753911
Title
Hypertension in cardiac transplant recipients: tackling a new face of an
old foe.
Source
Current opinion in cardiology. 35 (4) (pp 368-375), 2020. Date of
Publication: 01 Jul 2020.
Author
Campbell P.T.; Krim S.R.
Institution
(Campbell) Division of Cardiology, Baptist Health Medical Center, Little
Rock, AR
(Krim) Division of Cardiology, John Ochsner Heart and Vascular Institute
(Krim) Section of Cardiomyopathy and Heart Transplantation, John Ochsner
Heart and Vascular Institute, Ochsner Clinic Foundation
(Krim) University of Queensland School of Medicine, Ochsner Clinical
School, New Orleans, LA, United States
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: Systemic hypertension (HTN) is a common complication
arising in the heart transplant recipient. This article aims to review the
most current literature and update readers on the epidemiology,
pathophysiology and management of HTN in heart transplant patients. RECENT
FINDINGS: In contrast to the general nontransplant hypertensive patient
population, traditional risk factors, including family history of HTN,
obesity and diabetes, play a minor role in the genesis of posttransplant
HTN. Dysregulation in sodium and water balance, vascular stiffness,
endothelial dysfunction, abnormal cardiorenal neural reflexes resulting
from immunosuppression and cardiac denervation seem to be the predominant
factors leading to postheart transplant HTN. Calcineurin inhibitors
induced nephrotoxicity and steroid use further contributes to
posttransplant HTN. SUMMARY: Owing to the paucity of data, particularly
randomized controlled trials to guide the evaluation and management of HTN
in the cardiac transplant patients, much of the available data come from
the renal transplant population. The choice of antihypertensive should be
based on timing related to transplantation and patient's comorbidities.
Although calcium channel blockers and loop diuretics are the preferred
agents in the early postheart transplant period,
angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers
may be beneficial in the late postheart transplant period especially in
the setting of diabetes and in the presence of proteinuria.

<87>
Accession Number
631593388
Title
Comparison of third generation balloon-expandable Edwards Sapien 3 versus
self-expandable Evolut R in transcatheter aortic valve implantation: a
meta-analysis.
Source
Annals of palliative medicine. 9 (3) (pp 700-708), 2020. Date of
Publication: 01 May 2020.
Author
Li Y.-M.; Tsauo J.-Y.; Liao Y.-B.; Zhao Z.-G.; Chen M.
Institution
(Li, Tsauo, Liao, Zhao, Chen) Department of Cardiology, West China
Hospital, Sichuan University, Chengdu 610041, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The 3rd generations of transcatheter heart valve system,
including Edwards SAPIEN S3 (ES3) and Medtronic's Evolut R, has been
developed to specifically improve the safety of transcatheter aortic valve
implantation (TAVI). The aim of this work was to provide a summary effect
estimate of the peri-procedural characteristics and clinical outcome of
patients treated with ES3 versus the Evolut R. METHOD(S): We
conducted a literature search of PubMed, Ovid and EMBASE (2002 to 2018).
Two authors extracted the data independently. The safety and feasibility
of Sapien 3 and Evolut R were compared by odds ratios (ORs) with 95%
confidence intervals (CIs) in inverse variance method. RESULT(S):
After a multi-step assessment, a total 6 studies were finally included,
yielding 1,664 patients, of which, 768 (46%) used ES3 and 896 (54%) used
Evolut R. There was no statistical difference with device success rate (OR
1.15, 95% CI: 0.70-1.91, I2 =0%), 30-day mortality [OR: 0.72 (0.33-1.57),
I2 =0%], pre-dilation rate, 30-day stroke, bleeding complication (BC)
(major and life-threating), major vascular complication (VC), and
paravalvular leakage between the two groups. However, the ES3 group was
associated with a higher risk of acute kidney injury (AKI), higher mean
aortic valve gradient and better mean left ventricular ejection fraction
(LVEF) after TAVR procedure. Moreover, the Evolut R group had a higher
rate of post-dilation and new permanent pacemaker implantation (PPMI).
 CONCLUSION(S): Both devices had demonstrated excellent procedural
success rate and short-term safety. At 30-day follow-up, both devices
shared similar rates of mortality, BC, VC, stroke, and paravalvular
leakage (PVL). However, the rate of AKI was higher in the ES3 group, and
the rate of PPM was higher in the Evolut R group.

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