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<1>
Accession Number
2006132488
Title
Clinical Outcomes Following Coronary Bifurcation PCI Techniques: A
Systematic Review and Network Meta-Analysis Comprising 5,711 Patients.
Source
JACC: Cardiovascular Interventions. 13 (12) (pp 1432-1444), 2020. Date of
Publication: 22 June 2020.
Author
Di Gioia G.; Sonck J.; Ferenc M.; Chen S.-L.; Colaiori I.; Gallinoro E.;
Mizukami T.; Kodeboina M.; Nagumo S.; Franco D.; Bartunek J.; Vanderheyden
M.; Wyffels E.; De Bruyne B.; Lassen J.F.; Bennett J.; Vassilev D.;
Serruys P.W.; Stankovic G.; Louvard Y.; Barbato E.; Collet C.
Institution
(Di Gioia, Sonck, Colaiori, Gallinoro, Mizukami, Kodeboina, Nagumo,
Bartunek, Vanderheyden, Wyffels, De Bruyne, Collet) Cardiovascular Center
Aalst, OLV Clinic, Aalst, Belgium
(Di Gioia, Sonck, Kodeboina, Franco, Barbato) Department of Advance
Biomedical Sciences, Federico II University, Naples, Italy
(Ferenc) Division of Cardiology and Angiology II, University Heart Centre
Freiburg, Bad Krozingen, Bad Krozingen, Germany
(Chen) Division of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing, China
(Chen) Key Laboratory of Cardiovascular and Cerebrovascular Medicine,
School of Pharmacy, Nanjing Medical University, Nanjing, China
(Mizukami, Nagumo) Division of Cardiology, Showa University Fujigaoka
Hospital, Kanagawa, Japan
(Lassen) Department of Cardiology, Odense University Hospital & University
of Southern Denmark, Odense, Denmark, Denmark
(Bennett) Department of Cardiovascular Medicine, University Hospitals
Leuven, Leuven, Belgium
(Vassilev) "Alexandrovska" University Hospital, Sofia, Bulgaria
(Serruys) Department of Cardiology, National University of Ireland,
Galway, Ireland
(Stankovic) Department for Diagnostic and Catheterization Laboratories,
Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade,
Belgrade, Serbia
(Louvard) Department of Cardiology, Ramsay Generale de Sante, Institut
Cardiovasculaire Paris Sud, Hopital Prive Jacques Cartier, Massy, France
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The aim of this study was to compare clinical outcomes of
different bifurcation percutaneous coronary intervention (PCI) techniques.
 Background(s): Despite several randomized trials, the optimal PCI
technique for bifurcation lesions remains a matter of debate. Provisional
stenting has been recommended as the default technique for most
bifurcation lesions. Emerging data support double-kissing crush (DK-crush)
as a 2-stent technique. Method(s): PubMed and Scopus were searched
for randomized controlled trials comparing PCI bifurcation techniques for
coronary bifurcation lesions. Outcomes of interest were major adverse
cardiovascular events (MACE). Secondary outcomes of interest were cardiac
death, myocardial infarction, target vessel or lesion revascularization,
and stent thrombosis. Summary odds ratios (ORs) were estimated using
Bayesian network meta-analysis. Result(s): Twenty-one randomized
controlled trials including 5,711 patients treated using 5 bifurcation PCI
techniques were included. Investigated techniques were provisional
stenting, T stenting/T and protrusion, crush, culotte, and DK-crush.
Median follow-up duration was 12 months (interquartile range: 9 to 36
months). When all techniques were considered, patients treated using the
DK-crush technique had less occurrence of MACE (OR: 0.39; 95% credible
interval: 0.26 to 0.55) compared with those treated using provisional
stenting, driven by a reduction in target lesion revascularization (OR:
0.36; 95% credible interval: 0.22 to 0.57). No differences were found in
cardiac death, myocardial infarction, or stent thrombosis among analyzed
PCI techniques. No differences in MACE were observed among provisional
stenting, culotte, T stenting/T and protrusion, and crush. In non-left
main bifurcations, DK-crush reduced MACE (OR: 0.42; 95% credible interval:
0.24 to 0.66). Conclusion(s): In this network meta-analysis, DK-crush
was associated with fewer MACE, driven by lower rates of repeat
revascularization, whereas no significant differences among techniques
were observed for cardiac death, myocardial infarction, and stent
thrombosis. A clinical benefit of 2-stent techniques was observed over
provisional stenting in bifurcation with side branch lesion length >=10
mm. Copyright © 2020 American College of Cardiology Foundation

<2>
Accession Number
2004690334
Title
Comparison of outcomes between minimally invasive and median sternotomy
for double and triple valve surgery: A meta-analysis.
Source
Journal of Cardiac Surgery. 35 (6) (pp 1209-1219), 2020. Date of
Publication: 01 Jun 2020.
Author
Mohammed H.; Yousuf Salmasi M.; Caputo M.; Angelini G.D.; Vohra H.A.
Institution
(Mohammed) Faculty of Health Sciences, Bristol Medical School, University
of Bristol, Bristol, United Kingdom
(Yousuf Salmasi) Department of Surgery and Cancer, Imperial College,
London, United Kingdom
(Caputo, Angelini, Vohra) Department of Cardiovascular Sciences, Bristol
Heart Institute, University Hospitals Bristol, Bristol, United Kingdom
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Limited data exists demonstrating the efficacy of minimally
invasive surgery (MIS) compared to median sternotomy (MS) for multiple
valvular disease (MVD). This systematic review and meta-analysis aims to
compare operative and peri-operative outcomes of MIS vs MS in MVD.
 Method(s): PubMed, Ovid, and Embase were searched from inception
until August 2019 for randomized and observational studies comparing MIS
and MS in patients with MVD. Clinical outcomes of intra- and postoperative
times, reoperation for bleeding and surgical site infection were
evaluated. Result(s): Five observational studies comparing 340 MIS vs
414 MS patients were eligible for qualitative and quantitative review. The
quality of evidence assessed using the Newcastle-Ottawa scale was good for
all included studies. Meta-analysis demonstrated increased cardiopulmonary
bypass time for MIS patients (weighted mean difference [WMD], 0.487; 95%
confidence interval [CI], 0.365-0.608; P <.0001). Similarly, aortic
cross-clamp time was longer in patients undergoing MIS (WMD, 0.632; 95%
CI, 0.509-0.755; P <.0001). No differences were found in operative
mortality, reoperation for bleeding, surgical site infection, or hospital
stay. Conclusion(s): MIS for MVD have similar short-term outcomes
compared to MS. This adds value to the use of minimally invasive methods
for multivalvular surgery, despite conferring longer operative times.
However, the paucity in literature and learning curve associated with MIS
warrants further evidence, ideally randomized control trials, to support
these findings. Copyright © 2020 The Authors. Journal of Cardiac
Surgery published by Wiley Periodicals, Inc.

<3>
Accession Number
2004568811
Title
The clinical application of the ratio of transmitral early filling
velocity to early diastolic strain rate: a systematic review and
meta-analysis.
Source
Journal of Echocardiography. 18 (2) (pp 94-104), 2020. Date of
Publication: 01 Jun 2020.
Author
Lassen M.C.H.; Olsen F.J.; Skaarup K.G.; Tolstrup K.; Qasim A.N.; Gislason
G.; Biering-Sorensen T.
Institution
(Lassen, Olsen, Skaarup, Gislason, Biering-Sorensen) Department of
Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Niels
Andersens vej 65, Post 835, Copenhagen 2900, Denmark
(Lassen, Tolstrup, Qasim) Division of Cardiology, University of
California, San Francisco UCSF, San Francisco, United States
(Biering-Sorensen) Department of Biomedical Sciences, Faculty of Health
and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Publisher
Springer
Abstract
Background: The ratio of transmitral early filling velocity to early
diastolic strain rate (E/esr) has recently emerged as a novel and accurate
non-invasive measure of left ventricular (LV) filling pressure. This
systematic review and meta-analysis aimed to give an overview of the
possible clinical implications of E/esr. Method(s): We conducted a
systematic review and meta-analysis of all studies involving E/esr. Of 598
identified studies, 16 met our inclusion criteria. Studies involving E/esr
either investigated its prognostic value (n = 9) or its correlation with
invasively measured LV filling pressure (n = 7). Result(s): The
pooled meta-analysis showed a significant correlation between E/esr and
pulmonary capillary wedge pressure (PCWP) measured invasively across the
studies assessing this relationship (Cohen's d = 3.90 95% CI [2.38-6.39],
p < 0.001) and between E/esr and left ventricle end-diastolic pressure
(LVEDP) measured invasively across the studies assessing this relationship
(Cohen's d = 5.30 95% CI [2.83-9.96], p < 0.001). The pooled analysis of
the prognostic studies showed that E/esr was a significant predictor of
adverse outcomes after multivariable adjustment across the different study
populations in a random effects model (overall estimated HR: 1.58 95% CI
[1.28-1.96], p < 0.001, per 1 m increase). Conclusion(s): E/esr
correlates well with invasive measures of LV filling pressure. In
addition, E/esr provides significant prognostic information across various
patient populations. Further studies are needed to test if E/esr has an
advantage to E/e. Copyright © 2020, Japanese Society of
Echocardiography.

<4>
Accession Number
631391575
Title
Role of advanced left ventricular imaging in adults with aortic stenosis.
Source
Heart. 106 (13) (pp 962-969), 2020. Date of Publication: 01 Jul 2020.
Author
Calin A.; Mateescu A.D.; Popescu A.C.; Bing R.; Dweck M.R.; Popescu B.A.
Institution
(Calin, Mateescu, Popescu, Popescu) Department of Cardiology, Euroecolab,
University of Medicine and Pharmacy "carol Davila", Bucharest, Romania
(Calin, Mateescu, Popescu) Department of Cardiology, Emergency Institute
for Cardiovascular Diseases "prof Dr C C Iliescu", Bucharest, Romania
(Popescu) Department of Cardiology, Emergency University Hospital Elias,
Bucharest, Romania
(Bing, Dweck) BHF Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh EH16 4SB, United Kingdom
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
This review focuses on the available data regarding the utility of
advanced left ventricular (LV) imaging in aortic stenosis (AS) and its
potential impact for optimising the timing of aortic valve replacement.
Ejection fraction is currently the only LV parameter recommended to guide
intervention in AS. The cut-off value of 50%, recommended for
decision-making in asymptomatic patients with AS, is currently under
debate. Several imaging parameters have emerged as predictors of disease
progression and clinical outcomes in this setting. Global longitudinal LV
strain by speckle tracking echocardiography is useful for risk
stratification of asymptomatic patients with severe AS and preserved LV
ejection fraction. Its prognostic value was demonstrated in these
patients, but further work is required to define the best thresholds to
aid the decision-making process. The assessment of myocardial fibrosis is
the most studied application of cardiac magnetic resonance in AS. The
detection of replacement fibrosis by late gadolinium enhancement offers
incremental prognostic information in these patients. Clinical
implementation of this technique to optimise the timing of aortic valve
intervention in asymptomatic patients is currently tested in a randomised
trial. The use of T1 mapping techniques can provide an assessment of
interstitial myocardial fibrosis and represents an expanding field of
interest. However, convincing data in patients with AS is still lacking.
All these imaging parameters have substantial potential to influence the
management decision in patients with AS in the future, but data from
randomised clinical trials are awaited to define their utility in daily
practice. Copyright © Author(s) (or their employer(s)) 2020.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<5>
Accession Number
2006829157
Title
HEARTBiT: A Transcriptomic Signature for Excluding Acute Cellular
Rejection in Adult Heart Allograft Patients.
Source
Canadian Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Shannon C.P.; Hollander Z.; Dai D.L.Y.; Chen V.; Assadian S.; Lam K.K.;
McManus J.E.; Zarzycki M.; Kim Y.; Kim J.-Y.V.; Balshaw R.; Gidlof O.;
Ohman J.; Smith J.G.; Toma M.; Ignaszewski A.; Davies R.A.; Delgado D.;
Haddad H.; Isaac D.; Kim D.; Mui A.; Rajda M.; West L.; White M.; Zieroth
S.; Tebbutt S.J.; Keown P.A.; McMaster W.R.; Ng R.T.; McManus B.M.
Institution
(Shannon, Hollander, Dai, Chen, Assadian, Lam, McManus, Zarzycki, Kim,
Balshaw, Tebbutt, Ng, McManus) Prevention of Organ Failure (PROOF) Centre
of Excellence, Vancouver, BC, Canada
(Lam, McManus) Department of Pathology, University of British Columbia,
Vancouver, BC, Canada
(Zarzycki, Kim, Kim, Tebbutt, Keown, McMaster, Ng) Department of Medicine,
University of British Columbia, Vancouver, BC, Canada
(Kim, McMaster) Department of Medical Genetics, University of British
Columbia, Vancouver, BC, Canada
(Ng) Department of Computer Science, University of British Columbia,
Vancouver, BC, Canada
(Balshaw) Department of Statistics, University of British Columbia,
Vancouver, BC, Canada
(Gidlof, Ohman, Smith) Department of Cardiology, Skane University
Hospital, Lund University, Lund, Sweden
(Toma, Ignaszewski) Department of Cardiology, University of British
Columbia, Vancouver, BC, Canada
(Davies) Department of Medicine, University of Ottawa, Ottawa, ON, Canada
(Delgado) University Health Network/Mount Sinai Hospital, Toronto, ON,
Canada
(Haddad) Department of Medicine, University of Saskatchewan, Saskatoon,
SK, Canada
(Isaac, Kim) Department of Medicine, University of Alberta, Calgary,
Aberta, Canada
(Mui) Department of Surgery, University of British Columbia, Vancouver,
BC, Canada
(Rajda) Department of Medicine, Dalhousie University, Halifax, NS, Canada
(West) Department of Pediatrics, University of Alberta, Edmonton, AB,
Canada
(White) Institut de Cardiologie de Montreal, Montreal, Quebec, Canada
(Zieroth) Department of Medicine, University of Manitoba, Winnipeg, MB,
Canada
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Nine mRNA transcripts associated with acute cellular rejection
(ACR) in previous microarray studies were ported to the clinically
amenable NanoString nCounter platform. Here we report the diagnostic
performance of the resulting blood test to exclude ACR in heart allograft
recipients: HEARTBiT. Method(s): Blood samples for transcriptomic
profiling were collected during routine post-transplantation monitoring in
8 Canadian transplant centres participating in the Biomarkers in
Transplantation initiative, a large (n = 1622) prospective observational
study conducted between 2009 and 2014. All adult cardiac transplant
patients were invited to participate (median age = 56 [17 to 71]). The
reference standard for rejection status was histopathology grading of
tissue from endomyocardial biopsy (EMB). All locally graded ISHLT >= 2R
rejection samples were selected for analysis (n = 36). ISHLT 1R (n = 38)
and 0R (n = 86) samples were randomly selected to create a cohort
approximately matched for site, age, sex, and days post-transplantation,
with a focus on early time points (median days post-transplant = 42 [7 to
506]). Result(s): ISHLT >= 2R rejection was confirmed by EMB in 18
and excluded in 92 samples in the test set. HEARTBiT achieved 47%
specificity (95% confidence interval [CI], 36%-57%) given >= 90%
sensitivity, with a corresponding area under the receiver operating
characteristic curve of 0.69 (95% CI, 0.56-0.81). Conclusion(s):
HEARTBiT's diagnostic performance compares favourably to the only
currently approved minimally invasive diagnostic test to rule out ACR,
AlloMap (CareDx, Brisbane, CA) and may be used to inform care decisions in
the first 2 months post-transplantation, when AlloMap is not approved, and
most ACR episodes occur. Copyright © 2019 Canadian Cardiovascular
Society

<6>
Accession Number
2006753629
Title
Prosthetic valve endocarditis in patients undergoing TAVR compared to
SAVR: A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Ullah W.; Khan M.S.; Gowda S.N.; Alraies M.C.; Fischman D.L.
Institution
(Ullah) Abington Jefferson Health, Abington, United States
(Khan) Mercy Saint Vincent Medical Center, Toledo, OH, United States
(Gowda) University of South Dakota, Sioux Falls, United States
(Alraies) Detroit Medical Center, DMC Heart Hospital, Detroit, MI, United
States
(Fischman) Thomas Jefferson University, PA, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: The risk of prosthetic valve endocarditis (PVE) in patients
who underwent transcatheter aortic valve replacement (TAVR) is presumed to
be high. Method(s): Electronic databases were searched to identify
articles comparing the rate of PVE in post-TAVR and post-surgical aortic
valve replacement (SAVR) patients. Pooled adjusted odds ratio (OR) was
computed using a random-effects model. Result(s): A total of 19
studies consisting of 84,288 patients, were identified. There was no
significant difference in the odds of PVE between patients undergoing TAVR
and SAVR, at 30-day (OR 0.62, 95% confidence interval (CI) 0.20-1.92, p =
0.41), 1-year (OR 0.99 95% CI 0.89-1.11, p = 0.84), 2-year (OR 1.02 95% CI
0.68-1.54, p = 0.92) and 5-year (OR 1.03 95% CI 0.80-1.33, p = 0.81). A
subgroup sensitivity analysis also showed no significant inter-group
differences in the rate of PVE at all time points, when stratified by the
study design (clinical trial vs. observational), type of TAVR valves used
(self-expanding bioprosthetic valves vs. balloon expanded bioprosthetic
valves) and surgical risk of patients (high vs. intermediate vs. low).
There was no heterogeneity (I2 = 0%) in the outcomes of the included
studies at 30-day, 1-year and 2-year, while the heterogeneity in studies
at 5-year was minimal (I2 = 22%). Conclusion(s): In comparison to
SAVR, both short and long-term risk of prosthetic valve endocarditis
appears to be identical in patients undergoing TAVR. This risk is
unaffected by the type of valve, duration of follow-up, study design and
surgical risk of the patients. Copyright © 2020 Elsevier Inc.

<7>
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

<8>
Accession Number
2005253149
Title
Thromboelastometry and a hemostasis management system are most beneficial
for guiding hemostatic therapy in cardiac surgery patients with a
EuroSCORE II of >=1.83%: a randomized controlled two-step trial.
Source
Journal of Anesthesia. (no pagination), 2020. Date of Publication: 2020.
Author
Kodaka M.; Ichikawa J.; Ando K.; Komori M.
Institution
(Kodaka, Ichikawa, Ando, Komori) Department of Anesthesiology and
Intensive Care, Tokyo Women's Medical University Medical Center East,
Arakawa-ku, Tokyo 116-8567, Japan
Publisher
Springer
Abstract
Purpose: We evaluated the efficacy of hemostatic therapy based on
point-of-care (POC) testing in patients undergoing cardiac surgery.
 Method(s): This was a single-institution, prospective, randomized,
double-blinded study. In step 1, 90 patients scheduled for elective
cardiac surgery underwent complete blood count and fibrinogen measurements
at baseline, after cardiopulmonary bypass (CPB) initiation (CPB start),
just after CPB end, and in the intensive care unit (ICU). In step 2, 72
patients scheduled for elective cardiac surgery underwent conventional
laboratory coagulation tests (control group) or POC coagulation tests (POC
group). Transfusions were prepared using the fibrinogen and platelet
values at mainly "CPB start" for the control group, and using the ROTEM
values at mainly "CPB end" for the POC group. Consequently, the step 2
patients were divided into high- and low-risk subgroups based on the
EuroSCORE II by logistic regression analysis; transfusion data and
bleeding volumes were compared between the control and POC groups within
the high- and low-risk subgroups. Result(s): In step 1, all blood
components were significantly decreased at CPB start compared with
baseline, and platelet and fibrinogen levels remained almost constant from
CPB start to end. In step 2, the transfusion rates and perioperative
bleeding volumes did not significantly differ between the control and POC
groups. Subgroup analysis suggested that only the high-risk subgroup
significantly differed regarding perioperative red blood cell transfusion
and total bleeding volume in the ICU. Conclusion(s): POC testing is
beneficial for cardiac surgery patients with a EuroSCORE II of
>=1.83%. Copyright © 2020, Japanese Society of Anesthesiologists.

<9>
Accession Number
2005252851
Title
Device-related epistaxis risk: continuous-flow left ventricular assist
device-supported patients.
Source
European Archives of Oto-Rhino-Laryngology. (no pagination), 2020. Date of
Publication: 2020.
Author
Koycu A.; Vural O.; Bahcecitapar M.; Jafarov S.; Beyazpinar G.; Beyazpinar
D.S.
Institution
(Koycu, Vural, Jafarov, Beyazpinar) Department of Otolaryngology, Head and
Neck Surgery, Faculty of Medicine, Baskent University, Ankara 06490,
Turkey
(Bahcecitapar) Department of Statistics, Faculty of Science, Hacettepe
University, Ankara 06800, Turkey
(Beyazpinar) Department of Cardiovascular Surgery, Faculty of Medicine,
Baskent University, Ankara 06490, Turkey
Publisher
Springer
Abstract
Background: The aim of this study was to analyze the effect of
device-dependent factors on epistaxis episodes comparing patients
supported with a continuous-flow left ventricular assist device (CF-LVAD)
to patients under the same antithrombotic therapy. Method(s):
Patients who underwent CF-LVAD between 2012 and 2018 were reviewed
retrospectively from the institutionally adopted electronic database.
Patients who underwent mitral valve replacement (MVR) surgery receiving
the same anticoagulant and antiaggregant therapy were included as a
control group. Demographics, epistaxis episodes, and nonepistaxis bleeding
between the two groups were compared. Result(s): A total of 179
patients met the inclusion criteria (61 patients CF-LVAD group, 118
patients MVR group). The median (range) follow-up periods for the study
(CF-LVAD) and control (MVR) groups were 370 (2819) and 545.70 (2356) days,
respectively. There was a significant difference for frequency of bleeding
episodes per month between CF-LVAD and MVR groups (p = 0.003 < 0.05). The
most common site of bleeding was the anterior septum in both groups (90.9%
for the CF-MVR group and 100% for the MVR group). While 14 patients (23%)
had nonepistaxis bleeding in the CF-LVAD group, only two patients (1.7%)
had nonepistaxis bleeding in the MVR group. There were significant
differences in nonepistaxis bleeding rates between the CF-LVAD and MVR
groups (chi2=19.79, p < 0.001). Conclusion(s): Both
epistaxis and nonepistaxis bleeding rates were higher in the CF-LVAD group
than in the MVR group. This suggests that the use of CF-LVAD support could
directly increase the risk of hemorrhagic complications. Level of
Evidence: 2A (Etiology/Harm). Copyright © 2020, Springer-Verlag
GmbH Germany, part of Springer Nature.

<10>
Accession Number
2005088982
Title
Global cardiovascular care: an overview of high-level political
commitment.
Source
Asian Cardiovascular and Thoracic Annals. 28 (5) (pp 258-265), 2020. Date
of Publication: 01 Jun 2020.
Author
Vervoort D.; Parikh U.M.; Raj A.; Swain J.D.
Institution
(Vervoort) Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,
United States
(Parikh) Baylor College of Medicine, Houston, TX, United States
(Raj) Kasturba Medical College, Manipal, India
(Swain) Division of Cardiovascular Surgery, Department of Surgery,
Hospital of the University of Pennsylvania, Philadelphia, PA, United
States
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Background: Six billion people worldwide lack access to safe, timely, and
affordable cardiac surgical and interventional care when needed.
Cardiovascular diseases are the leading cause of mortality and morbidity
around the world, and include a significant surgical backlog of rheumatic
and congenital heart diseases. Here, we review the political commitment by
the WHO, the UN, and the World Bank to build and strengthen healthcare
services for cardiovascular diseases, with a particular focus on cardiac
surgical and interventional cardiology services around the world.
 Method(s): A literature search was performed in the WHO, UN, and
World Bank Governing Body databases to identify policy documents
mentioning curative cardiovascular disease care. The Governing Body
documentation, the Institutional Repository for Information Sharing
database of the WHO, and the Official Document System of the UN were used.
Documents only discussing prevention of cardiovascular diseases were
excluded. Result(s): Fifty-nine unique documents were identified,
including 56 from the WHO, 3 from the World Bank, and none from the UN; 12
(20.4%) documents mentioned cardiac surgery, and 6 (10.2%) contained some
actionable language to incorporate cardiac surgical services, but none was
explicitly dedicated to cardiac surgical services. Conclusion(s):
Although growing, high-level political commitment for curative
cardiovascular health services remains minimal. Increased awareness is
needed to develop comprehensive cardiovascular care that is necessary to
mitigate the increasing burden of premature morbidity and mortality from
cardiac disease, and to work towards the Sustainable Development Goals and
Universal Health Coverage. Copyright © The Author(s) 2020.

<11>
Accession Number
632127461
Title
Randomised, non-inferiority, controlled procedural outcomes TrIal
comParing reverse T And Protrusion versus double-kissing and crush
stenting: protocol of the TIP TAP I randomised trial.
Source
BMJ open. 10 (6) (pp e034264), 2020. Date of Publication: 16 Jun 2020.
Author
Rakhimov K.; Buono A.; Anadol R.; Ullrich H.; Knorr M.; Ahoopai M.; Munzel
T.; Gori T.
Institution
(Rakhimov, Buono, Anadol, Ullrich, Knorr, Ahoopai, Munzel, Gori)
Kardiologie I, Universitatsmedizin Mainz, Rheinland-Pfalz, Mainz, Germany
(Anadol, Munzel, Gori) DZHK, Standort Rhein-Mainz, Universitatsmedizin
Mainz, Rheinland-Pfalz, Mainz, Germany
Publisher
NLM (Medline)
Abstract
INTRODUCTION: To assess the impact of 'reverse T and Protrusion' (TAP)
technique on the outcome after stenting of true bifurcation lesions of the
left main (LM) or proximal epicardial vessels as compared with double
kissing (DK)-crush technique. METHODS AND ANALYSIS: 50 consecutive
patients with true coronary bifurcation lesion (Medina 1,1,1 or 0,1,1) of
the LM or the proximal main vessels, requiring a two-stent technique as
first-line strategy at University Medical Center Mainz, are randomised in
a 1:1 ratio to reverse TAP or DK-crush stenting. As recommended by best
clinical practice, final angiographic result is evaluated and optical
coherence tomographic (OCT) intracoronary imaging is performed to assess
and optimise the final result. The primary end point is defined as the
percentage of stent expansion in the side branch. Secondary end points
consist of angiographic and procedural success (assessed until patient's
discharge), procedural parameters (procedural time, fluoroscopy time, use
of devices, X-ray dose) and OCT parameters expressing expansion of the
stents. Safety parameters include all adverse events up to 6months after
discharge. A clinical, angiographic and intracoronary imaging control at
6months is planned. ETHICS AND DISSEMINATION: The protocol complies with
good clinical practice and the ethical principles described in the
Declaration of Helsinki and is approved by the local ethics committee. The
results of the trial will be published as original article(s) in medical
journals and/or as presentation at congresses. TRIAL REGISTRATION NUMBER:
ClinicalTrials.gov Registry (NCT03714750). Copyright © Author(s)
(or their employer(s)) 2020. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<12>
Accession Number
632076518
Title
Short-course antibiotic regimen compared to conventional antibiotic
treatment for gram-positive cocci infective endocarditis: Randomized
clinical trial (SATIE).
Source
BMC Infectious Diseases. 20 (1) (no pagination), 2020. Article Number:
417. Date of Publication: 16 Jun 2020.
Author
Olmos C.; Vilacosta I.; Lopez J.; Saez C.; Anguita M.; Garcia-Granja P.E.;
Sarria C.; Silva J.; Alvarez-Alvarez B.; Martinez-Monzonis M.A.; Castillo
J.C.; Seijas J.; Lopez-Picado A.; Peral V.; Maroto L.; San Roman J.A.
Institution
(Olmos, Vilacosta, Maroto) Instituto Cardiovascular, Hospital Clinico San
Carlos, Instituto de Investigacion Sanitaria Del Hospital Clinico San
Carlos (IdSSC), Prof. Martin Lagos s/n, Madrid 28040, Spain
(Lopez, Garcia-Granja, San Roman) Servicio de Cardiologia, Instituto de
Ciencias Del Corazon (ICICOR), CIBERCV, Valladolid, Spain
(Saez, Sarria) Servicio de Medicina Interna-Infecciosas, Instituto de
Investigacion Sanitaria Del Hospital, Universitario de la Princesa,
Madrid, Spain
(Anguita, Castillo) Servicio de Cardiologia, Hospital Universitario Reina
Sofia de Cordoba, Cordoba, Spain
(Silva) Servicio de Cirugia Cardiaca, Hospital Universitario Central de
Oviedo, Oviedo, Spain
(Alvarez-Alvarez, Martinez-Monzonis, Seijas) Servicio de Cardiologia y
Unidad Coronaria, Complejo Hospitalario Universitario de Santiago de
Compostela, Santiago de Compostela, Spain
(Lopez-Picado) Unidad de Investigacion y Ensayos Clinicos, Instituto de
Investigacion Sanitaria Del Hospital Clinico San Carlos (IdSSC), Madrid,
Spain
(Peral) Servicio de Cardiologia, Hospital Universitario de Son Espases,
Palma de Mallorca, Spain
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Most serious complications of infective endocarditis (IE)
appear in the so-called "critical phase"of the disease, which represents
the first days after diagnosis. The majority of patients overcoming the
acute phase has a favorable outcome, yet they remain hospitalized for a
long period of time mainly to complete antibiotic therapy. The major
hypothesis of this trial is that in patients with clinically stable IE and
adequate response to antibiotic treatment, without signs of persistent
infection, periannular complications or metastatic foci, a shorter
antibiotic time period would be as efficient and safe as the classic 4 to
6 weeks antibiotic regimen. Method(s): Multicenter, prospective,
randomized, controlled open-label, phase IV clinical trial with a
non-inferiority design to evaluate the efficacy of a short course (2
weeks) of parenteral antibiotic therapy compared with conventional
antibiotic therapy (4-6 weeks). Sample: patients with IE caused by
gram-positive cocci, having received at least 10 days of conventional
antibiotic treatment, and at least 7 days after surgery when indicated,
without clinical, analytical, microbiological or echocardiographic signs
of persistent infection. Estimated sample size: 298 patients.
 Intervention(s): Control group: standard duration antibiotic therapy,
(4 to 6 weeks) according to ESC guidelines recommendations. Experimental
group: short-course antibiotic therapy for 2 weeks. The incidence of the
primary composite endpoint of all-cause mortality, unplanned cardiac
surgery, symptomatic embolisms and relapses within 6 months after the
inclusion in the study will be prospectively registered and compared.
 Conclusion(s): SATIE will investigate whether a two weeks
short-course of intravenous antibiotics in patients with IE caused by
gram-positive cocci, without signs of persistent infection, is not
inferior in safety and efficacy to conventional antibiotic treatment (4-6
weeks). Trial registration: ClinicalTrials.gov Identifier: NCT04222257
(January 7, 2020). EudraCT 2019-003358-10. Copyright © 2020 The
Author(s).

<13>
Accession Number
2005272144
Title
Cardiogenic shock in autoimmune rheumatologic diseases: an insight on
etiologies, management, and treatment outcomes.
Source
Heart Failure Reviews. (no pagination), 2020. Date of Publication: 2020.
Author
Battisha A.; Sawalha K.; Altibi A.M.; Madoukh B.; Al-Akchar M.; Patel B.
Institution
(Battisha, Sawalha) University of Massachusetts Medical School - Baystate,
Springfield, MA, United States
(Altibi) Harvard T.H. Chan School of Public Health, Harvard University,
Boston, MA, United States
(Altibi) Henry Ford Health System (HFHS), Jackson, MI, United States
(Madoukh) Overland Park Regional Medical Center - HCA Midwest Health,
Kansas City, MO, United States
(Al-Akchar) Southern Illinois University School of Medicine, Springfield,
IL, United States
(Patel) Heart and Vascular Institute, West Virginian University, 1 Medical
Center Dr., Morgantown, WV 26505, United States
Publisher
Springer
Abstract
Autoimmune rheumatological disorders are known to have an increased risk
for cardiovascular diseases including coronary artery disease (CAD),
myocarditis, pericarditis, valvulopathy, and in consequence cardiogenic
shock. Data on cardiogenic shock in rheumatological diseases are scarce;
however, several reports have highlighted this specific entity. We sought
to review the available literature and highlight major outcomes and the
management approaches in each disease. Systematic literature search,
including PubMed, Ovid/Medline, Cochrane Library, and Web of Science, was
conducted between January 2000 and December 2009. We reviewed all cases
reporting cardiogenic shock with rheumatologic conditions, including
systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Takayasu's
arteritis (TA), granulomatosis with polyangiitis (GPA), giant cell
arteritis (GCA), and antiphospholipid syndrome (APS). We selected 45
papers reporting a total of 48 cases. Mean age was 39 +/- 7.3 years and
68.8% were females. Most common rheumatologic conditions associated with
cardiogenic shock were SLE (31%), GPA (23%), TA (14.6%), APA (10.4%), and
RA (8.3%). Cardiogenic shock was found to be caused by eosinophilic
myocarditis in 58% of cases, CAD in 19% of cases, and valvulopathy in 6%
of cases. Most patient required high-dose steroids and second
immunosuppressant therapy. Mechanical circulatory supported was required
in 23 cases, IABP in 16 cases, and ECMO in 12 cases. Complete recovery
occurred in 37 patients while 9 patients died and 2 required heart
transplant. Responsible for two-thirds of cases, eosinophilic myocarditis
should be suspected in young cardiogenic shock patients with underlying
rheumatologic conditions. Lupus and GPA are the two most common
conditions. Copyright © 2020, Springer Science+Business Media,
LLC, part of Springer Nature.

<14>
Accession Number
632120335
Title
Cooling as an Adjunctive Therapy to Percutaneous Intervention in Acute
Myocardial Infarction: COOL-MI InCor Trial.
Source
Therapeutic hypothermia and temperature management. (no pagination), 2020.
Date of Publication: 17 Jun 2020.
Author
Dallan L.A.P.; Giannetti N.S.; Rochitte C.E.; Polastri T.F.; San Martin
C.Y.B.; Hajjar L.A.; Nicolau J.C.; Oliveira M.T.; Dae M.; Ribeiro da Silva
E.E.; Kalil Filho R.; Lemos Neto P.A.; Timerman S.
Institution
(Dallan, Giannetti, Rochitte, Polastri, San Martin, Hajjar, Nicolau,
Oliveira, Ribeiro da Silva, Kalil Filho, Lemos Neto, Timerman) Department
of Cardiology, InCor, Heart Institute, School of Medicine, University of
Sao Paulo, Sao Paulo, Brazil
(Dae) Department of Radiology, UCSF, University of California, San
Francisco, CA, United States
Publisher
NLM (Medline)
Abstract
Endovascular Therapeutic hypothermia (ETH) reduces the damage caused by
postischemia reperfusion injury syndrome in cardiopulmonary arrest and has
already established its role in patients with sudden death; however, its
role in ST-segment elevation myocardial infarction (STEMI) remains
controversial. The objectives of this study were to investigate the
safety, feasibility, and 30-day efficacy of rapid induction of therapeutic
hypothermia as adjunctive therapy to percutaneous coronary intervention
(PCI) in patients with anterior and inferior STEMIs. This was a
prospective, controlled, randomized, two-arm, prospective, interventional
study of patients admitted to the emergency department within 6 hours of
angina onset, with anterior or inferior STEMI eligible for PCI. Subjects
were randomized to the hypothermia group (primary PCI+ETH) or to the
control group (primary PCI) at a 4:1 ratio. The ETH was induced by 1L cold
saline (1-4degreeC) associated with the ProteusTM System, by cooling for
at least 18 minutes before coronary reperfusion with a target temperature
of 32degreeC+/-1degreeC. Maintenance of ETH was conducted for 1-3 hours,
and active reheating was done at a rate of 1degreeC/h for 4 hours. Primary
safety outcomes were the feasibility of ETH in the absence of (1)
door-to-balloon (DTB) delay; (2) major adverse cardiac events (MACE)
within 30 days after randomization. The primary outcomes of effectiveness
were infarct size (IS) and left ventricular ejection fraction (LVEF) at 30
days. An as-treated statistical analysis was performed. Fifty patients
were included: 35 (70%) randomized to the hypothermia group and 15 (30%)
to the control group. The mean age was 58+/-12 years; 78% were men; and
associated diseases were 60% hypertension, 42% diabetes, and 72%
dyslipidemia. The compromised myocardial wall was anterior in 38% and
inferior in 62%, and the culprit vessels were left anterior descending
artery (LAD) (40%), right coronary artery (38%), and left circumflex
(18%). All 35 patients who attempted ETH (100%) had successful cooling,
with a mean endovascular coronary reperfusion temperature of
33.1degreeC+/-0.9degreeC. The mean ischemic time was 375+/-89.4 minutes in
the hypothermia group and 359.5+/-99.4 minutes in the control group. The
mean DTB was 92.1+/-20.5 minutes in the hypothermia group and 87+/-24.4
minutes in the control group. The absolute difference of 5.1 minutes was
not statistically significant (p=0.509). The MACE rates were similar
between both groups (21.7% vs. 20% respectively, p=0.237). In the
comparison between the hypothermia and control groups, no statistically
significant differences were observed at 30 days between mean IS
(13.9%+/-8% vs. 13.8%+/-10.8%, respectively, p=0.801) and mean final LVEF
(43.3%+/-11.2% vs. 48.3+/-10.9%, respectively; p=0.194). Hypothermia as an
adjunctive therapy to primary PCI in STEMI is feasible and can be
implemented without delay in coronary reperfusion. Hypothermia was safe
regarding the incidence of MACE at 30 days. However, there was a higher
incidence of arrhythmia and in-hospital infection in the hypothermia
group, with no increase in mortality. Regarding efficacy, there was no
difference in IS or LVEF at 30 days that would suggest additional
myocardial protection with ETH. ClinicalTrials.gov: NCT02664194.

<15>
Accession Number
2004690319
Title
Advantage of total arterial revascularization strategies: A meta-analysis.
Source
Journal of Cardiac Surgery. 35 (6) (pp 1393), 2020. Date of Publication:
01 Jun 2020.
Author
Kawada T.
Institution
(Kawada) Department of Hygiene and Public Health, Nippon Medical School,
Tokyo, Japan
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)

<16>
Accession Number
2004515077
Title
Opium use and cardiovascular diseases: a systematic review and
meta-analysis.
Source
Critical Reviews in Toxicology. 50 (3) (pp 201-212), 2020. Date of
Publication: 15 Mar 2020.
Author
Nakhaee S.; Amirabadizadeh A.; Qorbani M.; Lamarine R.J.; Mehrpour O.
Institution
(Nakhaee, Amirabadizadeh, Mehrpour) Medical Toxicology and Drug Abuse
Research Center (MTDRC), Birjand University of Medical Sciences, Birjand,
Iran, Islamic Republic of
(Qorbani) Department of Epidemiology, Non-Communicable Diseases Research
Center, Alborz, University of Medical Sciences, Karaj, Iran, Islamic
Republic of
(Qorbani) Chronic Diseases Research Center, Endocrinology and Metabolism
Population Sciences Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Lamarine) Department of Public Health, California State University Chico,
CA, United States
(Mehrpour) Rocky Mountain Poison and Drug Safety, Denver, CO, United
States
Publisher
Taylor and Francis Ltd
Abstract
The effects of opium on cardiovascular diseases (CVDs) have been
extensively studied. However, there are few studies that summarize this
research comprehensively; thus, this systematic review and meta-analysis
is a collection of the newest information combined with previous findings
to furthermore illuminate the effects of opium on CVDs. In this systematic
review, all observational studies were systematically searched using the
main international databases such as PubMed/Medline, Web of Sciences, and
Scopus until October 2018. After the quality assessment of the articles,
the fixed or random model meta-analysis was used to pool the results.
I-square test was used to assess the heterogeneity of the studies.
Overall, 41 studies were identified. Based on the random model, the pooled
odds ratio (OR) (95% confidence interval (CI)) of opium use and coronary
artery diseases (CAD) was estimated at 2.75 (95% CI = 2.04-3.75;
I2=47%). The pooled OR of opium use and CVD in-hospital
mortality was not statistically significant (OR: 1.44, 95% CI = 0.88-2.36,
I2 = 51%). In the stratified analysis, in the patients who had
undergone heart surgery, the average of ejection fraction (EF) in the
opium users was significantly lower than those not using opium (mean
differences: -3.06, CI 95% = -4.40 to -1.71, I2 = 60%) but in
the patients with acute myocardial infarction undergoing angiography, the
average EF was not significantly different in the opium users compared to
non-users (mean difference: 0.30, CI: -0. 55 to 1.15). The results of this
meta-analysis revealed that opium might be a risk factor for CAD and EF
but not in-hospital mortality. Copyright © 2020, © 2020
Informa UK Limited, trading as Taylor & Francis Group.

<17>
[Use Link to view the full text]
Accession Number
631945823
Title
The serratus anterior plane block for analgesia after thoracic surgery: A
meta-analysis of randomized controlled trails.
Source
Medicine. 99 (21) (pp e20286), 2020. Date of Publication: 22 May 2020.
Author
Liu X.; Song T.; Xu H.-Y.; Chen X.; Yin P.; Zhang J.
Institution
(Liu, Song, Xu) Department of Anesthesiology, First Hospital of Jilin
University, Changchun, Jilin, China
(Chen) Department of Anesthesiology, China-Japan Friendship Hospital,
Beijing, China
(Yin) Department of Anesthesiology, Second Hospital of Shanxi Medical
University, Taiyuan, China
(Zhang) Department of Ophthalmology, First Hospital of Jilin University,
Changchun, Jilin, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The serratus anterior plane (SAP) block is a newer method that
can be used in patients undergoing thoracic surgeries. The postoperative
analgesia efficacy of SAP blocks for thoracic surgery remains
controversial. We conduct a meta-analysis to evaluate the analgesia of SAP
blocks after thoracic surgery. METHOD(S): We searched PubMed, Embase,
EBSCO, the Cochrane Library, Web of Science, and CNKI for randomized
controlled trials (RCTs) regarding the postoperative pain control of a SAP
block on thoracic surgery. All of the dates were screened and evaluated by
two researchers and meta-analysis was performed using RevMan5.3 software.
 RESULT(S): A total of 8 RCTs involving 542 patients were included.
The meta-analysis showed statistically significant differences between the
two groups with respect to postoperative pain scores at 2 h (standardized
mean difference [Std.MD] = -1.26; 95% confidence interval [CI] = -1.66 to
-0.86; P < .0001); 6 h (SMD = -0.50; 95%CI = -0.88 to -0.11; P = .01); 12
h (SMD = -0.63; 95%CI = -1.10 to -0.16; P = .009); 24 h (SMD = -0.99;
95%CI = -1.44 to -0.51; P < .0001); postoperative opioid consumption at 24
h (SMD = -0.83; 95%CI = -1.10 to -0.56; P < .00001); and postoperative
nausea and vomiting (PONV) rates (RR = 0.39; 95% CI = 0.21-0.73; P =
.003). CONCLUSION(S): The SAP block can play an important role in the
management of pain after thoracic surgery by reducing both pain scores and
24-h postoperative opioids consumption. In addition, there is fewer
incidence of PONV in the SAP block group.

<18>
Accession Number
632000752
Title
Effect of high-intensity interval training in young heart transplant
recipients: Results from two randomized controlled trials.
Source
BMC Sports Science, Medicine and Rehabilitation. 12 (1) (no pagination),
2020. Article Number: 35. Date of Publication: 04 Jun 2020.
Author
Nytroen K.; Rolid K.; Yardley M.; Gullestad L.
Institution
(Nytroen, Rolid, Yardley, Gullestad) Department of Cardiology, Oslo
University Hospital, Rikshospitalet Nydalen, postbox 4950, Oslo 0424,
Norway
(Nytroen, Rolid, Gullestad) Faculty of Medicine, University of Oslo,
Postbox 1072, Blindern, Oslo 0316, Norway
(Nytroen, Rolid, Gullestad) KG Jebsen Center for Cardiac Research,
University of Oslo, Norway, Center for Heart Failure Research, Oslo
University Hospital, Oslo, Norway
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: Little is known about the effect of exercise in young heart
transplant recipients, and results on group level is lacking. This study
summarizes the findings of the youngest participants in two previous
randomized controlled trials. Method(s): This is a
hypothesis-generating study reporting the main results from the youngest
participants in two larger randomized controlled trials investigating the
effect of high-intensity interval training (HIT). The article summarizes
the main results from 28 young participants (< 40 year of age) who have
participated in two previous studies which evaluated the effect of HIT vs.
controls in adult heart transplant recipients. One of the studies included
de novo heart transplant recipients and the other included maintenance
heart transplant recipients. All study tests were performed in-hospital,
in the specialist health care setting, but the exercise intervention was
carried out locally, in cooperation with the primary health care. In both
studies the exercise intervention lasted for 9-12 months. In one study,
HIT (85-95% of peak effort) was compared to controls (no specific
intervention), and in the other study HIT was compared to moderate,
continuous exercise (MICT, 60-80% of peak effort). The main outcome
measure was peak oxygen uptake (VO2peak) and a secondary endpoint was
muscle strength. Result(s): The summarized findings from the youngest
heart transplant recipients in these two studies demonstrated mainly that
the improvement in peak oxygen uptake among the younger recipients (< 40
years) was much larger (4.7 vs. 1.2 ml/kg/min and 7.0 vs. 2.2 ml/kg/min)
compared to the improvement among the older recipients (>= 40 years), and
in accordance with results from adult heart transplant populations: HIT,
compared to MICT, induced the largest improvement in peak oxygen
consumption, also in the younger heart transplant recipients.
 Conclusion(s): These results suggest that young heart transplant
recipients have a greater effect of HIT than of MICT and may also suggest
that younger recipients benefit more from high-intensity interval training
than their older co-patients. However, larger randomized studies focusing
on the young heart transplant population is strongly needed to confirm
this hypothesis. Trial registration: Clinical trial registrations:
NCT01796379 and NCT01091194. Copyright © 2020 The Author(s).

<19>
Accession Number
632111175
Title
Effects of Lidocaine Oropharyngeal Spray Applied Before Endotracheal
Intubation on QT Dispersion in Patients Undergoing Coronary Artery Bypass
Grafting: A Prospective Randomized Controlled Study.
Source
Brazilian journal of cardiovascular surgery. 35 (3) (pp 291-298), 2020.
Date of Publication: 01 Jun 2020.
Author
Bilgi M.; Velioglu Y.; Yoldas H.; Cosgun M.; Yuksel A.; Karagoz I.; Yildiz
I.; Es A.; Caliskan D.; Erdem K.; Demirhan A.
Institution
(Bilgi, Velioglu, Yoldas, Cosgun, Yuksel, Karagoz, Yildiz, Caliskan,
Erdem, Demirhan) Abant Izzet Baysal University Medical School Bolu Turkey
Abant Izzet Baysal University Medical School, Bolu, Turkey
(Es) Abant Izzet Baysal University Faculty of Economics and Administrative
Sciences Bolu Turkey Abant Izzet Baysal University Faculty of Economics
and Administrative Sciences, Bolu, Turkey
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To investigate the effects of lidocaine oropharyngeal spray
applied before endotracheal intubation on hemodynamic responses and
electrocardiographic parameters in patients undergoing coronary artery
bypass grafting. METHOD(S): A total of 60 patients who underwent
coronary artery bypass grafting surgery were included in this prospective
randomized controlled study. Patients were randomly divided into two
groups, the topical lidocaine group (administration of 10% lidocaine
oropharyngeal spray, five minutes before laryngoscopy and endotracheal
intubation) and the control group. Both groups were compared with each
other in terms of main hemodynamic parameters including mean arterial
pressure and heart rate, as well as P and QT wave dispersion durations,
before and after endotracheal intubation. RESULT(S): The groups were
similar in terms of age, gender, and other demographics and basic clinical
characteristics. There was a statistically significant difference between
the groups in terms of QT dispersion durations after laryngoscopy and
endotracheal intubation. The increase in QT dispersion duration was not
statistically significant in the topical lidocaine group, whereas the
increase in QT dispersion duration was statistically significant in the
control group. When the groups were compared in terms of P wave dispersion
durations, there were significant decreases in both groups, but there was
no significant difference between the groups. CONCLUSION(S): Our
study revealed that the topical lidocaine administration before
endotracheal intubation prevented increase of QT dispersion duration in
patients undergoing coronary artery bypass grafting. TRIAL REGISTRATION:
NCT03304431.

<20>
Accession Number
632111050
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement for treatment of severe aortic stenosis: comparison of results
from randomized controlled trials and real-world data.
Source
Brazilian journal of cardiovascular surgery. 35 (3) (pp 346-367), 2020.
Date of Publication: 01 Jun 2020.
Author
Wang D.; Huang L.; Zhang Y.; Cheng Z.; Zhang X.; Ren P.; Hong Q.; Kang D.
Institution
(Wang, Huang, Zhang, Hong, Kang) Sichuan University West China Hospital
Department of Evidence-based Medicine and Clinical Epidemiology Chengdu
Sichuan China Department of Evidence-based Medicine and Clinical
Epidemiology, West China Hospital, Sichuan University, Chengdu, Sichuan,
China
(Cheng) Sichuan University West China Hospital Department of
Cardiovascular Surgery Chengdu Sichuan China Department of Cardiovascular
Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
(Zhang) West China Hospital, Sichuan University, Sichuan University West
China Hospital Department of Integrated Traditional Chinese and Western
Medicine China Department of Integrated Traditional Chinese and Western
Medicine
(Ren) Sichuan University West China Hospital Clinical Research Center for
Respiratory Diseases Chengdu Sichuan China Clinical Research Center for
Respiratory Diseases, West China Hospital, Sichuan University, Chengdu,
Sichuan, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Results from randomized controlled trials (RCTs) and real-world
study (RWS) appear to be discordant. We aimed to investigate whether data
derived from RCTs and RWS evaluating long-term all-cause mortality of
transcatheter aortic valve implantation (TAVI) versus surgical aortic
valve replacement (SAVR) in patients with severe aortic stenosis (AS) were
in agreement. METHOD(S): RCTs or RWS comparing TAVI and SAVR,
reporting longterm (>=2-year follow-up) all-cause mortality, were
identified. We also carried out subgroup analyses to access the effect in
different subgroups. A pre-designated data extraction form including 5
domains and 26 items was used to explore the relationship between RCTs and
RWS. Mortality and effect in different subgroups were evaluated using
random-effects meta-analyses. RESULT(S): Five RCTs (5421
participants, TAVI: 2759, SAVR: 2662) and 33 RWS (20839 participants;
TAVI: 6585, SAVR: 14254) were identified. Pooled RCT analysis showed no
difference in all-cause mortality between TAVI and SAVR (HR=0.97, 95% CI:
0.88-1.07; P=0.55). In RWS, TAVI was associated with an increased risk of
allcause mortality (HR=1.46, 95% CI: 1.26-1.69; P<0.001) compared to SAVR.
 CONCLUSION(S): These results highlight the inconsistencies between
RCTs and RWS in assessing long-term all-cause mortality in the treatment
of AS using TAVI or SAVR, which may be caused by interactions of clinical
characteristics or study design. RCTs as well as RWS are both developing
and improving; the advantages of one kind of design, measurement and
evaluation can and should be thoughtfully referred to the other.

<21>
Accession Number
632107692
Title
Videolaryngoscopy versus direct laryngoscopy for double-lumen endotracheal
tube intubation in thoracic surgery - a randomised controlled clinical
trial.
Source
BMC anesthesiology. 20 (1) (pp 150), 2020. Date of Publication: 16 Jun
2020.
Author
Risse J.; Schubert A.-K.; Wiesmann T.; Huelshoff A.; Stay D.; Zentgraf M.;
Kirschbaum A.; Wulf H.; Feldmann C.; Meggiolaro K.M.
Institution
(Risse) Center of Emergency Medicine, University Hospital Essen,
Hufelandstrasse 55, Essen 45122, Germany
(Risse, Schubert, Wiesmann, Huelshoff, Stay, Zentgraf, Wulf, Feldmann,
Meggiolaro) Department of Anesthesiology and Intensive Care Medicine,
Philipps-University Marburg, Marburg, Baldingerstrase 35033, Germany
(Kirschbaum) Visceral, Thoracic and Vascular Surgery Clinic, University
Hospital Giessen and Marburg GmbH, Marburg, Baldingerstrase 35033, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Double-lumen tube (DLT) intubation is necessary for thoracic
surgery and other operations with the need for lung separation. However,
DLT insertion is complex and might result in airway trauma. A new
videolaryngoscopy (GVL) with a thin blade might improve the intubation
time and reduce complexity as well as iatrogenic airway complications
compared to conventional direct laryngoscopy (DL) for DLT intubation.
 METHOD(S): A randomised, controlled trial was conducted in 70
patients undergoing elective thoracic surgery using DLT for lung
separation. Primary endpoint was time to successful intubation. The
secondary endpoints of this study were number of intubation attempts, the
assessment of difficulty, any complications during DLT intubation and the
incidence of objective trauma of the oropharynx and supraglottic space and
intubation-related subjective symptoms. RESULT(S): 65 patients were
included (DL group [n = 31], GVL group [n = 34]). Median intubation time
(25th-75th percentiles) in GVL group was 93s (63-160) versus 74 (58-94) in
DL group [p=0.044]. GVL resulted in significantly improved visualisation
of the larynx (Cormack and Lehane grade of 1 in GVL group was 97% vs. 74%
in DL Group [p=0.008]). Endoscopic examinations revealed significant
differences in GVL group compared to DL group showing less red-blooded
vocal cord [p=0.004], vocal cord haematoma [p=0.022] and vocal cord
haemorrhage [p=0.002]. No significant differences regarding the
postoperative subjective symptoms of airway were found.
 CONCLUSION(S): Videolaryngoscopy using the GlideScope-Titanium
shortly prolongs DLT intubation duration compared to direct laryngoscopy
but improves the view. Objective intubation trauma but not subjective
complaints are reduced. TRIAL REGISTRATION: German Clinical Trial Register
DRKS00020978, retrospectively registered on 09. March 2020.

<22>
Accession Number
632000575
Title
Effects of dexmedetomidine on stress hormones in patients undergoing
cardiac valve replacement: A randomized controlled trial.
Source
BMC Anesthesiology. 20 (1) (no pagination), 2020. Article Number: 142.
Date of Publication: 06 Jun 2020.
Author
Wu H.; Tang J.; Pan J.; Han M.; Cai H.; Zhang H.
Institution
(Wu, Pan, Han, Cai, Zhang) Department of Anesthesiology, Affiliated
Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan
District, Zunyi, Guizhou Province 563003, China
(Tang) Department of Anesthesiology, Third Affiliated Hospital of Zunyi
Medical University, Zunyi, Guizhou Province 563003, China
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
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 1.0 mug.kg-1 of
Dex for 10 min intravenously before anesthesia, followed by 0.5
mug.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 24 h
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. Copyright © 2020 The
Author(s).

<23>
Accession Number
2006790386
Title
Persistent pain in intensive care survivors: a systematic review.
Source
British Journal of Anaesthesia. (no pagination), 2020. Date of
Publication: 2020.
Author
Makinen O.J.; Backlund M.E.; Liisanantti J.; Peltomaa M.; Karlsson S.;
Kalliomaki M.-L.
Institution
(Makinen) Faculty of Medicine and Life Sciences, Tampere University,
Tampere, Finland
(Backlund) Department of Intensive Care, Helsinki University Hospital,
Helsinki, Finland
(Liisanantti) Oulu University Hospital, Oulu, Finland
(Peltomaa, Karlsson) Department of Intensive Care, Tampere University
Hospital, Tampere, Finland
(Kalliomaki) Department of Anaesthesiology, Tampere University Hospital,
Tampere, Finland
Publisher
Elsevier Ltd
Abstract
Background: According to earlier studies where the main aim has been
quality of life, there is growing evidence of increased levels of
persistent pain in survivors of critical illness. The cause of admission
and several factors during intensive care may have associated risk factors
for pain persistence. This systematic review aims to determine the
incidence or prevalence of persistent pain after critical illness and to
identify risk factors for it. Method(s): Six databases were searched,
and eventually nine studies were included in the final systematic process.
The validity of observational and cross-sectional studies was analysed
using the National Institute of Health 'Quality Assessment Tool for
Observational Cohort and Cross-Sectional Studies'. Result(s): The
incidence of persistent pain after intensive care varied from 28% to 77%.
Risk factors for persistent pain were acute pain at discharge from ICU,
higher thoracic trauma score, surgery, pre-existing pain, organ failure,
longer length of ventilator or hospital stay, and sepsis. No difference in
incidence between medical and surgical patients was found.
 Conclusion(s): New systematic, observational studies are warranted to
identify persistent pain-related factors in intensive care to improve pain
management protocols and thereby diminish the risk of persistent pain
after ICU stay. Copyright © 2020 British Journal of Anaesthesia

<24>
Accession Number
2005273642
Title
Perioperative Bridging/Cessation of Antiplatelet Agents: 2020 Update.
Source
Current Anesthesiology Reports. (no pagination), 2020. Date of
Publication: 2020.
Author
Cha S.; Hensley N.B.
Institution
(Cha, Hensley) Department of Anesthesiology & Critical Care Medicine,
Johns Hopkins University School of Medicine, Baltimore, MD, United States
Publisher
Springer
Abstract
Purpose of Review: Perioperative management of patients receiving
antiplatelet therapy is common and must carefully balance the risk of
ischemia or thrombosis with bleeding. Here we describe pathways of
platelet aggregation unique to the perioperative period and mechanisms of
commonly encountered antiplatelet medications, and review current
literature evaluating strategies for antiplatelet management surrounding
elective noncardiac and cardiac surgery. Recent Findings: Antiplatelet
therapies demonstrate unique risk profiles for stent thrombosis and
bleeding that may be dependent on individual genetic polymorphisms. Use of
scoring systems or point-of-care platelet function assays may identify
patients especially vulnerable to alterations in perioperative
antiplatelet management, and guide timing of surgery. Prior guidelines,
which recommend a minimum 6-month delay in elective surgery for patients
receiving dual-antiplatelet therapy following percutaneous coronary
intervention (PCI), may be amended to 3 months in certain cases in which
newer generation antiplatelet therapies are administered. While use of
intravenous bridging agents may reduce platelet reactivity during cardiac
surgery, there is no single antiplatelet strategy which consistently
reduces rates of major bleeding or cardiovascular events. Summary:
There is insufficient evidence to support any specific perioperative
antiplatelet strategy. Cases should be individualized to balance the risks
of stent thrombosis and bleeding. Current recommendations may be modified
if the risk of delaying surgery outweighs the risk of stent thrombosis. It
is reasonable to guide management by utilizing scoring systems and
point-of-care platelet function assays. Copyright © 2020,
Springer Science+Business Media, LLC, part of Springer Nature.

<25>
[Use Link to view the full text]
Accession Number
632112573
Title
Ten-Year Outcomes after Drug-Eluting Stents Versus Coronary Artery Bypass
Grafting for Left Main Coronary Disease: Extended Follow-Up of the
PRECOMBAT Trial.
Source
Circulation. (pp 1437-1446), 2020. Date of Publication: 2020.
Author
Park D.-W.; Ahn J.-M.; Park H.; Yun S.-C.; Kang D.-Y.; Lee P.H.; Kim
Y.-H.; Lim D.-S.; Rha S.-W.; Park G.-M.; Gwon H.-C.; Kim H.-S.; Chae
I.-H.; Jang Y.; Jeong M.-H.; Tahk S.-J.; Seung K.B.; Park S.-J.
Institution
(Park, Ahn, Park, Kang, Lee, Kim, Park) Department of Cardiology, Asan
Medical Center, Seoul, South Korea
(Yun) Division of Biostatistics, Asan Medical Center, Seoul, South Korea
(Lim) Korea University, Anam Hospital, Seoul, South Korea
(Rha) Korea University, Kuro Hospital, Seoul, South Korea
(Park) Ulsan University, Hospital, South Korea
(Gwon, Kim) Samsung Medical Center, Seoul, South Korea
(Kim) Seoul National University, Hospital, South Korea
(Chae) Seoul National University, Bundan Hospital, Seongnam, South Korea
(Jang) Yonsei University, Severance Hospital, Seoul, South Korea
(Jeong) Chonnam National University Hospital, Gwangju, South Korea
(Tahk) Ajou University, Medical Center, Suwon, South Korea
(Seung) Catholic University of Korea, St. Mary's Hospital, Seoul, South
Korea
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: Long-term comparative outcomes after percutaneous coronary
intervention (PCI) with drug-eluting stents and coronary-artery bypass
grafting (CABG) for left main coronary artery disease are highly debated.
 Method(s): In the PRECOMBAT trial (Premier of Randomized Comparison
of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in
Patients with Left Main Coronary Artery Disease), patients with
unprotected left main coronary artery disease were randomly assigned to
undergo PCI with sirolimus-eluting stents (n=300) or CABG (n=300) in 13
hospitals in Korea from April 2004 to August 2009. The follow-up was
extended to at least 10 years for all patients (median, 11.3 years). The
primary outcome was the incidence of major adverse cardiac or
cerebrovascular events (composite of death from any cause, myocardial
infarction, stroke, or ischemia-driven target-vessel revascularization).
 Result(s): At 10 years, a primary outcome event occurred in 29.8% of
the PCI group and in 24.7% of the CABG group (hazard ratio [HR] with PCI
vs CABG, 1.25 [95% CI, 0.93-1.69]). The 10-year incidence of the composite
of death, myocardial infarction, or stroke (18.2% vs 17.5%; HR 1.00 [95%
CI, 0.70-1.44]) and all-cause mortality (14.5% vs 13.8%; HR 1.13 [95% CI,
0.75-1.70]) were not significantly different between the PCI and CABG
groups. Ischemia-driven target-vessel revascularization was more frequent
after PCI than after CABG (16.1% vs 8.0%; HR 1.98 [95% CI, 1.21-3.21).
 Conclusion(s): Ten-year follow-up of the PRECOMBAT trial of patients
with left main coronary artery disease randomized to PCI or CABG did not
demonstrate significant difference in the incidence of major adverse
cardiac or cerebrovascular events. Because the study was underpowered, the
results should be considered hypothesis-generating, highlighting the need
for further research. Registration: URL: https://www.clinicaltrials.gov;
Unique identifiers: NCT03871127 and NCT00422968. Copyright © 2020
Lippincott Williams and Wilkins. All rights reserved.

<26>
Accession Number
632105542
Title
Prehabilitation in patients awaiting elective coronary artery bypass graft
surgery - effects on functional capacity and quality of life: a randomized
controlled trial.
Source
Clinical rehabilitation. (pp 269215520933950), 2020. Date of Publication:
16 Jun 2020.
Author
Steinmetz C.; Bjarnason-Wehrens B.; Baumgarten H.; Walther T.; Mengden T.;
Walther C.
Institution
(Steinmetz) Institute of Sport Science, Department of Training Science and
Kinesiology, University of Gottingen, Gottingen, Germany
(Bjarnason-Wehrens) Institute of Cardiology and Sports Medicine, German
Sport University Cologne, Cologne, Germany
(Baumgarten) Kerckhoff Heart Center, Department of Cardiothoracic Surgery,
Bad Nauheim, Germany
(Walther) Department of Cardiothoracic Surgery, University of Frankfurt,
Frankfurt am Main, Germany
(Mengden) Kerckhoff Heart Center, Department of Rehabilitation, Bad
Nauheim, Germany
(Walther) Department of Cardiology, University of Frankfurt, Frankfurt am
Main, Germany
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To determine the impact of an exercise-based prehabilitation
(EBPrehab) program on pre- and postoperative exercise capacity, functional
capacity (FC) and quality of life (QoL) in patients awaiting elective
coronary artery bypass graft surgery (CABG). DESIGN: A two-group
randomized controlled trail. SETTING: Ambulatory prehabilitation.
SUBJECTS: Overall 230 preoperative elective CABG-surgery patients were
randomly assigned to an intervention (IG, n=88; n=27 withdrew after
randomization) or control group (CG, n=115). INTERVENTION: IG: two-week
EBPrehab including supervised aerobic exercise. CG: usual care. MAIN
MEASURES: At baseline (T1), one day before surgery (T2), at the beginning
(T3) and at the end of cardiac rehabilitation (T4) the following
measurements were performed: cardiopulmonary exercise test, six-minute
walk test (6MWT), Timed-Up-and-Go Test (TUG) and QoL (MacNew
questionnaire). RESULT(S): A total of 171 patients (IG, n=81; CG,
n=90) completed the study. During EBPrehab no complications occurred.
Preoperatively FC (6MWTIG: 443.0+/-80.1m to 493.5+/-75.5m, P=0.003; TUGIG:
6.9+/-2.0s to 6.1+/-1.8s, P=0.018) and QoL (IG: 5.1+/-0.9 to 5.4+/-0.9,
P<0.001) improved significantly more in IG compared to CG. Similar effects
were observed postoperatively in FC (6MWDIG: DELTA-64.7m, pT1-T3=0.013;
DELTA+47.2m, pT1-T4<0.001; TUGIG: DELTA+1.4s, pT1-T3=0.003).
 CONCLUSION(S): A short-term EBPrehab is effective to improve
perioperative FC and preoperative QoL in patients with stable coronary
artery disease awaiting CABG-surgery. ID: NCT04111744 (
www.ClinicalTrials.gov ; Preoperative Exercise Training for Patients
Undergoing Coronary Artery Bypass Graft Surgery- A Prospective Randomized
Trial).

<27>
Accession Number
2004937653
Title
Author response to: Comment on: Postoperative pressure injuries in adults
having surgery under general anaesthesia: systematic review of
perioperative risk factors.
Source
British Journal of Surgery. 107 (8) (pp e273), 2020. Date of Publication:
01 Jul 2020.
Author
Haisley M.; Sorensen J.A.; Sollie M.
Institution
(Haisley, Sollie) Department of Plastic Surgery, Odense, Denmark
(Sorensen, Sollie) Research Unit for Plastic Surgery, Odense University
Hospital, Odense, Denmark
(Sorensen) Department of Clinical Research, University of Southern
Denmark, Odense, Denmark
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)

<28>
Accession Number
2006117408
Title
Per-vessel level analysis of fractional flow reserve and instantaneous
wave-free ratio discordance - insights from the AJIP registry -.
Source
Circulation Journal. 84 (6) (pp 1034-1038), 2020. Date of Publication:
2020.
Author
Warisawa T.; Cook C.M.; Seligman H.; Howard J.P.; Ahmad Y.; Rajkumar C.;
Doi S.; Nakayama M.; Tanigaki T.; Omori H.; Nakajima A.; Yamanaka F.; Goto
S.; Yakuta Y.; Karube K.; Uetani T.; Kikuta Y.; Shiono Y.; Kawase Y.;
Nishina H.; Nakamura S.; Escaned J.; Akashi Y.J.; Matsuo H.; Davies J.E.
Institution
(Warisawa, Cook, Seligman, Howard, Ahmad, Rajkumar, Davies) Cardiovascular
Science, Imperial College London, London, United Kingdom
(Warisawa) Department of Cardiovascular Medicine, St. Marianna University,
School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
(Doi, Akashi) Division of Cardiology, Department of Internal Medicine, St.
Marianna University, School of Medicine, Kawasaki, Japan
(Nakayama) Cardiovascular Center, Toda Central General Hospital, Toda,
Japan
(Nakayama) Tokyo Women's Medical University, Waseda University Joint
Institution for Advanced Biomedical Sciences, Tokyo, Japan
(Tanigaki, Omori, Kawase, Matsuo) Department of Cardiovascular Medicine,
Gifu Heart Center, Gifu, Japan
(Nakajima, Nakamura) Department of Cardiovascular Medicine, New Tokyo
Hospital, Matsudo, Japan
(Yamanaka) Department of Cardiovascular Medicine, Shonan Kamakura General
Hospital, Kamakura, Japan
(Goto, Escaned) Cardiovascular Institute, Hospital Clinico San Carlos,
Madrid, Spain
(Yakuta) Department of Cardiology, Kanazawa Cardiovascular Hospital,
Kanazawa, Japan
(Karube) Department of Cardiovascular Medicine, Okaya City Hospital,
Okaya, Japan
(Uetani) Department of Cardiology, Pulmonology, Hypertension and
Nephrology, Ehime University, Graduate School of Medicine, Toon, Japan
(Kikuta) Division of Cardiology, Fukuyama Cardiovascular Hospital,
Fukuyama, Japan
(Shiono) Department of Cardiovascular Medicine, Wakayama Medical
University, Wakayama, Japan
(Nishina) Department of Cardiology, Tsukuba Medical Center Hospital,
Tsukuba, Japan
Publisher
Japanese Circulation Society
Abstract
Background: The per-vessel level impact of physiological pattern of
disease on the discordance between fractional flow reserve (FFR) and
instantaneous wave-free ratio (iFR) has not been clarified. Methods
and Results: Using the AJIP registry, vessels with FFR/iFR discordance
(133/671 [19.8%]) were analyzed. In the left anterior descending artery
(LAD), physiologically diffuse disease, as assessed by pressure-wire
pullback, was associated with FFR-/ iFR+ (83.3% [40/48]), while
physiologically focal disease was associated with FFR+/iFR- (57.4%
[31/54]), significantly (P<0.0001). These differences were not significant
in non-LAD (P=0.17). Conclusion(s): The impact of physiological
pattern of disease on FFR/iFR discordance is more pronounced in the
LAD. Copyright © 2020 Japanese Circulation Society. All rights
reserved.

<29>
Accession Number
631625020
Title
Threat-related motivational disengagement: Integrating blunted
cardiovascular reactivity to stress into the biopsychosocial model of
challenge and threat.
Source
Anxiety, stress, and coping. 33 (4) (pp 355-369), 2020. Date of
Publication: 01 Jul 2020.
Author
Hase A.; Aan Het Rot M.; de Miranda Azevedo R.; Freeman P.
Institution
(Hase) Faculty Branch in Poznan, SWPS University of Social Sciences and
Humanities, Poznan, Poland
(Aan Het Rot) Department of Psychology, University of Groningen,
Groningen, Netherlands
(de Miranda Azevedo) Institute of Data Science, Maastricht University,
Maastricht, Netherlands
(Freeman) School of Sport, Rehabilitation and Exercise Sciences,
University of Essex, Colchester, United Kingdom
Publisher
NLM (Medline)
Abstract
Background: The biopsychosocial model of challenge and threat specifies a
challenge-threat continuum where favorable demand-resource evaluations,
efficient cardiovascular responses, and superior performance characterize
challenge; and maladaptive outcomes like clinical depression characterize
threat states. The model also specifies task engagement, operationalized
as heart rate and ventricular contractility increases, as a prerequisite
for challenge and threat states. The blunted cardiovascular reactivity to
stress literature describes reductions of these increases and associates
them with problems like clinical depression. Objective(s): To
determine whether blunted cardiovascular reactivity to stress has
implications for challenge and threat theory. Method(s): We review
and synthesize the literatures on blunted cardiovascular reactivity to
stress and the biopsychosocial model. Result(s): Blunted
cardiovascular reactivity appears not to reflect a physiological inability
to respond to stress. Rather, it reflects a contextually dependent
motivational dysregulation and reduced reactivity to stress consistent
with deficient task engagement in the biopsychosocial model.
 Conclusion(s): We argue that blunted cardiovascular reactivity
represents deficient task engagement, and more generally, motivational
disengagement due to threat states. Our biopsychosocial model-based
approach conceptualizes this motivational disengagement as a tendency to
avoid motivated performance situations. This tendency may represent a
defense mechanism against subsequent threat and might explain associations
with disorders like clinical depression.

<30>
Accession Number
2005235872
Title
Revascularization in cardiogenic shock.
Source
Herz. (no pagination), 2020. Date of Publication: 2020.
Author
Freund A.; Desch S.; Thiele H.
Institution
(Freund, Desch, Thiele) Department of Internal Medicine/Cardiology, Heart
Center Leipzig at University of Leipzig, Strumpellstr. 39, Leipzig 04289,
Germany
(Freund, Desch) German Center for Cardiovascular Research (DZHK), Berlin,
Germany
Publisher
Springer Medizin (E-mail: kundenservice@springermedizin.de)
Abstract
Approximately 10% of patients with acute myocardial infarction develop
cardiogenic shock. Randomized studies have shown a significant improvement
in survival with early revascularization, which now represents the most
important cornerstone in the treatment of infarct-related cardiogenic
shock. In the vast majority of cases, this is achieved by percutaneous
coronary intervention (PCI). In cases of complex coronary anatomy or
mechanical complications, the Heart Team should be consulted promptly. The
randomized CULPRIT-SHOCK study showed a survival advantage for patients
with multivessel coronary artery disease and a percutaneous
revascularization strategy who were treated by culprit-lesion-only PCI
compared with immediate multivessel PCI. There are currently few data on
anticoagulation and antiplatelet therapy in cardiogenic shock as well as
on active mechanical circulatory support in this setting. Copyright
© 2020, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

<31>
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.

<32>
Accession Number
627906111
Title
Does Hand Massage Have Sustained Effects on Pain Intensity and
Pain-Related Interference in the Cardiac Surgery Critically Ill? A
Randomized Controlled Trial.
Source
Pain management nursing : official journal of the American Society of Pain
Management Nurses. 20 (6) (pp 572-579), 2019. Date of Publication: 01 Dec
2019.
Author
Boitor M.; Martorella G.; Maheu C.; Laizner A.M.; Gelinas C.
Institution
(Boitor, Maheu, Laizner, Gelinas) Ingram School of Nursing, McGill
University, 680 Sherbrooke West, Montreal, Quebec, Canada
(Martorella) College of Nursing, Florida State University, Tallahassee,
FL, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Despite the promising short-term pain relief effect of
massage, little is known regarding its sustained effects on pain intensity
and pain-related interference with functioning. AIMS: To evaluate the
sustained effect of hand massage on the pain intensity and pain-related
interference with functioning of cardiac surgery patients. DESIGN: A
randomized controlled trial. SETTINGS: A medical-surgical intensive care
unit in Canada. PARTICIPANTS/SUBJECTS: Adult patients undergoing cardiac
surgery and at low risk for postoperative complications were eligible.
 METHOD(S): In the intensive care unit, patients were randomly
assigned to either 20-minute hand massage, hand holding, or rest. Pain
intensity and pain-related interference with functioning were assessed on
the second postoperative day. RESULT(S): A total of 60 patients were
randomly allocated and 46 completed data collection on the second
postoperative day. Although no significant differences were identified
across groups, the hand massage group reported a maximum pain intensity
(median 5.75, range: 2-10) that was lower than the hand-holding (median
6.50, range: 1-10) and standard care groups (median 6.25, range: 0-10).
The hand massage group could reach 0 pain intensity throughout a 24-hour
period (median 0, range: 0-7), contrary to the hand-holding (median 2,
range: 0-5) and standard care groups (median 2, range: 0-4.5). A trend for
statistical significance was noted for dichotomized ratings on pain
interference with walking (p = .176) and sleep (p = .050).
 CONCLUSION(S): Hand massage could help patients experience longer
periods without pain and lower levels of maximum pain intensity. When
coupled with recovery activities, hand massage could reduce pain-related
interference with functioning. Copyright © 2019 American Society
for Pain Management Nursing. Published by Elsevier Inc. All rights
reserved.

<33>
Accession Number
632099476
Title
Negative pressure wound therapy for surgical wounds healing by primary
closure.
Source
The Cochrane database of systematic reviews. 6 (pp CD009261), 2020. Date
of Publication: 15 Jun 2020.
Author
Norman G.; Goh E.L.; Dumville J.C.; Shi C.; Liu Z.; Chiverton L.;
Stankiewicz M.; Reid A.
Institution
(Norman, Dumville, Shi) Division of Nursing, Midwifery and Social Work,
School of Health Sciences, Faculty of Biology, Medicine and Health,
University of Manchester, Manchester Academic Health Science Centre,
Manchester, United Kingdom
(Goh) Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and
Musculoskeletal Sciences, Oxford, United Kingdom
(Liu) West China School of Public Health and West China Fourth Hospital,
Sichuan University, Chengdu, China
(Chiverton) NIHR Clinical Research Facility, Great Ormond Street Hospital,
London, United Kingdom
(Stankiewicz) Chermside Community Health Centre, Community and Oral Health
Directorate, Brisbane, Australia
(Reid) School of Biological Sciences, Faculty of Biology, Medicine &
Health, Manchester, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Indications for the use of negative pressure wound therapy
(NPWT) are broad and include prophylaxis for surgical site infections
(SSIs). Existing evidence for the effectiveness of NPWT on postoperative
wounds healing by primary closure remains uncertain. OBJECTIVE(S): To
assess the effects of NPWT for preventing SSI in wounds healing through
primary closure, and to assess the cost-effectiveness of NPWT in wounds
healing through primary closure. SEARCH METHOD(S): In June 2019, we
searched the Cochrane Wounds Specialised Register; the Cochrane Central
Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including
In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL
Plus. We also searched clinical trials registries and references of
included studies, systematic reviews and health technology reports. There
were no restrictions on language, publication date or study setting.
SELECTION CRITERIA: We included trials if they allocated participants to
treatment randomly and compared NPWT with any other type of wound
dressing, or compared one type of NPWT with another type of NPWT. DATA
COLLECTION AND ANALYSIS: At least two review authors independently
assessed trials using predetermined inclusion criteria. We carried out
data extraction, assessment using the Cochrane 'Risk of bias' tool, and
quality assessment according to Grading of Recommendations, Assessment,
Development and Evaluations methodology. MAIN RESULTS: In this third
update, we added 15 new randomised controlled trials (RCTs) and three new
economic studies, resulting in a total of 44 RCTs (7447 included
participants) and five economic studies. Studies evaluated NPWT in the
context of a wide range of surgeries including orthopaedic, obstetric,
vascular and general procedures. Economic studies assessed NPWT in
orthopaedic, obstetric and general surgical settings. All studies compared
NPWT with standard dressings. Most studies had unclear or high risk of
bias for at least one key domain. Primary outcomes Four studies (2107
participants) reported mortality. There is low-certainty evidence
(downgraded twice for imprecision) showing no clear difference in the risk
of death after surgery for people treated with NPWT (2.3%) compared with
standard dressings (2.7%) (risk ratio (RR) 0.86; 95% confidence interval
(CI) 0.50 to 1.47; I2 = 0%). Thirty-nine studies reported SSI; 31 of these
(6204 participants), were included in meta-analysis. There is
moderate-certainty evidence (downgraded once for risk of bias) that NPWT
probably results in fewer SSI (8.8% of participants) than treatment with
standard dressings (13.0% of participants) after surgery; RR 0.66 (95% CI
0.55 to 0.80 ; I2 = 23%). Eighteen studies reported dehiscence; 14 of
these (3809 participants) were included in meta-analysis. There is
low-certainty evidence (downgraded once for risk of bias and once for
imprecision) showing no clear difference in the risk of dehiscence after
surgery for NPWT (5.3% of participants) compared with standard dressings
(6.2% of participants) (RR 0.88, 95% CI 0.69 to 1.13; I2 = 0%). Secondary
outcomes There is low-certainty evidence showing no clear difference
between NPWT and standard treatment for the outcomes of reoperation and
incidence of seroma. For reoperation, the RR was 1.04 (95% CI 0.78 to
1.41; I2 = 13%; 12 trials; 3523 participants); for seroma, the RR was 0.72
(95% CI 0.50 to 1.05; I2 = 0%; seven trials; 729 participants). The effect
of NPWT on occurrence of haematoma or skin blisters is uncertain (very
low-certainty evidence); for haematoma, the RR was 0.67 (95% CI 0.28 to
1.59; I2 = 0%; nine trials; 1202 participants) and for blisters the RR was
2.64 (95% CI 0.65 to 10.68; I2 = 69%; seven trials; 796 participants). The
overall effect of NPWT on pain is uncertain (very low-certainty evidence
from seven trials (2218 participants) which reported disparate measures of
pain); but moderate-certainty evidence suggests there is probably little
difference between the groups in pain after three or six months following
surgery for lower limb fracture (one trial, 1549 participants). There is
also moderate-certainty evidence for women undergoing caesarean sections
(one trial, 876 participants) and people having surgery for lower limb
fractures (one trial, 1549 participants) that there is probably little
difference in quality of life scores at 30 days or 3 or 6 months,
respectively. Cost-effectiveness Five economic studies, based wholly or
partially on trials included in our review, assessed the
cost-effectiveness of NPWT compared with standard care. They considered
NPWT in four indications: caesarean sections in obese women; surgery for
lower limb fracture; knee/hip arthroplasty and coronary artery bypass
graft surgery. They calculated quality-adjusted life-years for treatment
groups and produced estimates of the treatments' relative
cost-effectiveness. The reporting quality was good but the grade of the
evidence varied from moderate to very low. There is moderate-certainty
evidence that NPWT in surgery for lower limb fracture was not
cost-effective at any threshold of willingness-to-pay and that NPWT is
probably cost-effective in obese women undergoing caesarean section. Other
studies found low or very low-certainty evidence indicating that NPWT may
be cost-effective for the indications assessed. AUTHORS'
 CONCLUSION(S): People experiencing primary wound closure of their
surgical wound and treated prophylactically with NPWT following surgery
probably experience fewer SSI than people treated with standard dressings
(moderate-certainty evidence). There is no clear difference in number of
deaths or wound dehiscence between people treated with NPWT and standard
dressings (low-certainty evidence). There are also no clear differences in
secondary outcomes where all evidence was low or very low-certainty. In
caesarean section in obese women and surgery for lower limb fracture,
there is probably little difference in quality of life scores
(moderate-certainty evidence). Most evidence on pain is very
low-certainty, but there is probably no difference in pain between NPWT
and standard dressings after surgery for lower limb fracture
(moderate-certainty evidence). Assessments of cost-effectiveness of NPWT
produced differing results in different indications. There is a large
number of ongoing studies, the results of which may change the findings of
this review. Decisions about use of NPWT should take into account surgical
indication and setting and consider evidence for all
outcomes. Copyright © 2020 The Authors. Cochrane Database of
Systematic Reviews published by John Wiley & Sons, Ltd. on behalf of The
Cochrane Collaboration.

<34>
[Use Link to view the full text]
Accession Number
632097868
Title
Incidence, predictors, and outcome of prosthesis-patient mismatch after
transcatheter aortic valve replacement: A meta-analysis.
Source
Medicine. 99 (24) (pp e20717), 2020. Date of Publication: 12 Jun 2020.
Author
He S.; Fang Z.
Institution
(He) Department of Cardiology, Second Xiangya Hospital of Central South
University, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Prosthesis-patient mismatch (PPM) following transcatheter
aortic valve replacement (TAVR) is common, but the incidence, predictors
and outcome of PPM are still controversial. METHOD(S): A total of 18
articles incorporating 72,016 patients were identified form PubMed and
Embase online database. RESULT(S): The pooled incidences of overall,
and severe PPM following TAVR were 32.0% and 10.0% separately. Comparing
to surgical aortic valve replacement (SAVR), TAVR had lower incidence of
overall (OR, 0.31, 95% CI, 0.20-0.50) and severe PPM (OR, 0.38, 95% CI,
0.28-0.52). PPM was associated with a larger body surface area (BSA),
larger body mass index (BMI) and previous myocardial infarction in
comparison with those patients without PPM. Although PPM was not rare
after TAVR, no significant differences were observed both in short- and
mid-term all-cause mortality (30 day: OR: 1.51, 95% CI, 0.79-2.87, 1 year:
OR: 1.02, 95% CI, 0.96-1.08, and 2 years: OR: 0.99, 95% CI, 0.79-1.24)
between patients with PPM and those without PPM. CONCLUSION(S):
Despite the fact that the incidence of PPM was lower than that of SAVR,
PPM was not seen to have an impact on short- and mid-term survival.

<35>
Accession Number
632091991
Title
Association of poor sleep quality with risk factors after coronary artery
bypass graft surgery-A prospective cohort study.
Source
Journal of vascular nursing : official publication of the Society for
Peripheral Vascular Nursing. 38 (2) (pp 83-92), 2020. Date of Publication:
01 Jun 2020.
Author
Muthukrishnan A.; Muralidharan T.R.; Subash J.; Lathamangeswari C.
Institution
(Muthukrishnan) School of Nursing, College of Pharmacy and Nursing,
University of Nizwa, Sultanate of Oman
(Muralidharan) Professor & Head, Department of Cardiology, Sri Ramachandra
Institute of Higher Education & Research (Deemed to be University),
Chennai, Tamil Nadu, India
(Subash) Principal, Rani Meyyammai College of Nursing, Annamalai
University, Chidambaram, Tamil Nadu, India
(Lathamangeswari) Principal, Jothi College of Management Science &
Technology, Bareilly, India
Publisher
NLM (Medline)
Abstract
Fragmented sleep is a daunting experience and a common health problem with
high prevalence among patients 3 months after coronary artery bypass
grafting (CABG). However, the potential predictors on poor seep quality
remains unexplored. The main purpose of this study was to determine the
predictors of poor sleep quality among patients 3 months after CABG. A
prospective cohort study is a part of the randomized controlled trial
between 2012 and 2013 in which 400 adult patients undergoing elective CABG
were being randomly sampled as per the inclusion criteria followed up at 3
months after CABG surgery in the cardiovascular outpatient clinic of a
tertiary-care hospital. The study was conducted according to the
Declaration of Helsinki and was approved by the institutional ethical
committee. All participants gave written informed consent on having
received detailed information on the study. Demographic and clinical data
were obtained from medical records at the time of CABG. The data on sleep
quality were collected by using the Pittsburgh Sleep Quality Index and
state anxiety was evaluated utilizing state-trait anxiety inventory
(STAI-YI fo3rm). Multivariable logistic regression examined the
association between the postoperative poor sleep quality and clinical,
preoperative state anxiety, and angina. The significant variables are
chosen based on the P-value associated with the significant level of model
that lies on alpha = 0.05. Logit determination and the correlation between
the variables are also discussed for further analysis. A total of 187
patients (mean age 55.6 +/- 12.05 years) completed the questionnaire. Most
patients (78%) reported poor sleep quality (4.23 +/- 1.24) (PQSI score of
less than 5). There was a strong relationship between PQSI and state
anxiety. The higher state anxiety among 68% of patients with the mean
score (53.51 +/- 9.55) had 6.42 (95% CI 3.04-9.61) times the odds of being
classified as high risk for sleep disturbance. There are 3 factors that
most significant of the 8 factors tested were identified as having
influence significantly on the poor sleep quality. These factors are
diabetes (OR 1.186, 95% CI 1.016-1.097, P > .01), body mass index > 30
kg/m2 (OR 2.36, 95% CI 1.041-1.172, P > .05), sedentary lifestyle (OR
1.091, 95% CI 1.016-1.159, P > .01), and preoperative state anxiety (OR
1.186, 95% CI 1.074-1.115, P > .01). Even though the body mass index>30
kg/m2, sedentary lifestyle, and diabetes were significantly associated
with sleep quality, the only factor with more significantly related to
poor sleep quality was preoperative state anxiety which is the strong
predictor of poor sleep quality. Hence, early recognition of predictors
and careful management of poor sleep quality is warranted. Copyright
© 2020 Society for Vascular Nursing. Published by Elsevier Inc. All
rights reserved.

<36>
Accession Number
632098208
Title
Postoperative Psychological Disorders Among Heart Transplant Recipients: A
Meta-Analysis and Meta-regression.
Source
Psychosomatic medicine. (no pagination), 2020. Date of Publication: 12 Jun
2020.
Author
Loh A.Z.H.; Tan J.S.Y.; Tam J.K.C.; Zhang M.W.; Ho C.S.H.; Ho R.C.
Institution
(Loh, Ho) Department of Psychological Medicine, Yong Loo Lin School of
Medicine, National University of Singapore 119228, Singapore
(Tan) Yong Loo Lin School of Medicine, National University of Singapore,
1E Kent Ridge Road Singapore 119228, Singapore
(Tam) Department of Cardiac, Thoracic and Vascular Surgery, National
University Heart Centre, Singapore
(Tam) Department of Surgery, Yong Loo Lin School of Medicine, National
University of Singapore
(Zhang) Institute of Mental Health, National Health Group, Buangkok Green
Medical Park, 10 Buangkok View 539747, Singapore
(Ho) Department of Psychological Medicine, National University Health
System 119228, Singapore
(Ho) Biomedical Institute for Global Health Research and Technology,
National University of Singapore
Publisher
NLM (Medline)
Abstract
OBJECTIVES: This meta-analysis evaluates the pooled prevalence of
depression, anxiety, adjustment disorder and Post-Traumatic Stress
Disorder (PTSD) among heart transplant recipients globally and determines
underlying moderators. METHOD(S): The authors searched PubMed,
Embase, PsychINFO, BIOSIS, Science Direct and Cochrane CENTRAL databases
from inception to 1 March 2019; and 1321 records, and 42 full-text
articles were selected and reviewed according to PRISMA guidelines. We
calculated the pooled prevalence proportion of depression, anxiety,
adjustment disorder and PTSD using random effects models. Meta-regression
was performed to identify important moderators which contribute to
heterogeneity. RESULT(S): Twenty studies met the inclusion criteria
and comprised 2,169 patients. The pooled prevalence of depression was
21.6% (95% CI=16.8%-27.3%), anxiety 11.1% (95% CI=3.8%-28.5%), adjustment
disorder 11.0% (95% CI=3.1%-32.1%) and PTSD 13.5% (95% CI=8%-21.8%). There
was significant heterogeneity. Meta-regression was conducted to account
for the heterogeneity of the prevalence proportion. Predisposing factors,
e.g. NYHA Class II, Class III/IV, steroid treatment and acute rejection of
transplant (<3 months) were associated with high prevalence of depression.
Protective factors, e.g. age and higher ejection fraction after transplant
of patients were associated with low prevalence of depression. Female sex,
single status and number of months since transplant were associated with
high prevalence of anxiety. Single status was associated with high
prevalence of both adjustment disorder and transplant-related PTSD.
 CONCLUSION(S): The prevalence of psychiatric conditions, particularly
depression, is high in heart transplant recipients. The identified
protective and risk factors may guide psychological interventions in heart
transplant recipients.

<37>
Accession Number
2006162229
Title
Cardiac magnetic resonance longitudinal strain analysis in acute
ST-segment elevation myocardial infarction: A comparison with
speckle-tracking echocardiography.
Source
IJC Heart and Vasculature. 29 (no pagination), 2020. Article Number:
100560. Date of Publication: August 2020.
Author
Valente F.; Gutierrez L.; Rodriguez-Eyras L.; Fernandez R.; Montano M.;
Sao-Aviles A.; Pineda V.; Guala A.; Cuellar H.; Evangelista A.;
Rodriguez-Palomares J.
Institution
(Valente, Gutierrez, Rodriguez-Eyras, Fernandez, Montano, Sao-Aviles,
Guala, Evangelista, Rodriguez-Palomares) Cardiology Department, Hospital
Universitari Vall d'Hebron, Barcelona, Spain
(Pineda, Cuellar) Radiology Department, Hospital Universitari Vall
d'Hebron, Barcelona, Spain
Publisher
Elsevier Ireland Ltd (P.O. Box 211, Amsterdam 1000 AE, Netherlands)
Abstract
Background: Strain analysis with speckle-tracking echocardiography (STE)
is considered superior to ejection fraction for ventricular function
assessment in different clinical scenarios. Feature tracking (FT) permits
cardiac magnetic resonance (CMR) strain analysis in routinely acquired
cine images. This study evaluated the feasibility of CMR-FT and its
agreement with STE in patients with acute ST-segment elevation myocardial
infarction (STEMI). Method(s): An echocardiogram and CMR were
performed in 128 patients who underwent primary percutaneous
revascularisation after a STEMI. Adequate strain analysis was obtained by
both techniques in 98 patients and peak systolic longitudinal strain (LS)
was assessed with STE and CMR-FT. Result(s): Of 1568 myocardial
segments, 97.2% were correctly tracked with STE and 97.7% with CMR-FT. For
global LS, STE showed a mean of -14.8 +/- 3.3% and CMR-FT -13.7 +/- 3.0%,
with good agreement between modalities [intraclass correlation coefficient
(ICC) 0.826; bias -1.09%; limits of agreement (LOA) +/- 4.2%]. On the
other hand, segmental LS agreement was only moderate, with an ICC of 0.678
(bias -1.14%; LOA +/- 11.76%) and the ICC ranged from 0.538 at the basal
antero-lateral segment to 0.815 at the apical lateral segment. Finally,
both STE and CMR-FT showed excellent intra- and inter-observer
reproducibility (ICC > 0.9). Conclusion(s): CMR-FT provides LS with
similar feasibility to STE and both techniques showed good agreement for
global LS, although agreement at segmental level was only moderate. CMR-FT
showed excellent reproducibility, strengthening its robustness and
potential for both research and clinical applications. Copyright
© 2020 The Authors

<38>
Accession Number
632067329
Title
Coronary artery bypass surgery versus medical therapy alone for ischaemic
heart disease.
Source
Cochrane Database of Systematic Reviews. 2020 (6) (no pagination), 2020.
Article Number: CD013645. Date of Publication: 10 Jun 2020.
Author
Zuo L.; Yue X.; Bian T.; Cai Y.; Zeng L.; He H.; Wang L.; Ioannou A.; Li
S.
Institution
(Zuo, Bian, Cai, Wang, Wang) Department of Cardiovascular Surgery,
Zhengzhou Seventh People's Hospital, Zhengzhou, China
(Yue) Department of Hemangioma Surgery, Henan Province People's Hospital,
Zhengzhou, China
(Zeng) Department of Respiratory Medicine, Mindong Hospital Affiliated to
Fujian Medical University, Fu'an City, China
(He) Statistical Medicine and Preventive Medicine, Basic Medical College
of Henan University, Kaifeng, China
(Ioannou) Royal Free London NHS Foundation Trust, London, United Kingdom
(Li) Zhengzhou Seventh People's Hospital, Zhengzhou, China
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. To assess the effects of coronary artery
bypass surgery versus medical therapy alone in people with ischaemic heart
disease. Copyright © 2020 The Cochrane Collaboration. Published
by John Wiley & Sons, Ltd.

<39>
Accession Number
2006112510
Title
Association of preoperative spirometry with cardiopulmonary fitness and
postoperative outcomes in surgical patients: A multicentre prospective
cohort study.
Source
EClinicalMedicine. 23 (no pagination), 2020. Article Number: 100396. Date
of Publication: June 2020.
Author
Sankar A.; Thorpe K.E.; Gershon A.S.; Granton J.T.; Wijeysundera D.N.
Institution
(Sankar, Wijeysundera) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Sankar, Gershon, Wijeysundera) Institute of Health Policy, Management and
Evaluation, University of Toronto, Toronto, ON, Canada
(Wijeysundera) Li Ka Shing Knowledge Institute, St Michael's Hospital,
Toronto, ON, Canada
(Thorpe) Applied Health Research Centre, St Michael's Hospital, Toronto,
ON, Canada
(Thorpe) Dalla Lana School of Public Health, University of Toronto,
Toronto, ON, Canada
(Gershon) Department of Medicine, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Gershon, Granton) Department of Medicine, University of Toronto, Toronto,
ON, Canada
(Gershon, Wijeysundera) ICES Central, Toronto, ON, Canada
(Granton) Department of Medicine, University Health Network, Toronto, ON,
Canada
(Granton) Department of Medicine, Sinai Health System, Toronto, ON, Canada
(Wijeysundera) Department of Anesthesia, St. Michael's Hospital, 30 Bond
Street, Toronto, ON M5B 1W8, Canada
Publisher
Lancet Publishing Group (E-mail: cususerv@lancet.com)
Abstract
Background: Preoperative spirometry and cardiopulmonary exercise testing
(CPET) may stratify risk for respiratory complications. This secondary
analysis of the Measurement of Exercise Tolerance before Surgery (METS)
study examined whether CPET performance (i.e., cardiopulmonary fitness)
confounds associations of spirometry with outcomes. Method(s): The
analysis included 1200 participants having major non-cardiac surgery at 25
hospitals in Canada, Australia, New Zealand and UK. Forced expiratory
volume in 1 s (FEV<inf>1</inf>), and ratio of FEV<inf>1</inf> to forced
vital capacity (FVC) were measured during preoperative spirometry, and
peak oxygen consumption and ventilatory efficiency during preoperative
CPET. Outcomes were respiratory morbidity (Postoperative Morbidity Survey)
and pulmonary complications (pneumonia or respiratory failure). We used
multivariable logistic regression models to estimate associations of
FEV<inf>1</inf> with outcomes after adjustment for risk factors and either
peak oxygen consumption or ventilatory efficiency. Finding(s): 128
participants (11%) developed respiratory morbidity, and 48 (4%) developed
pulmonary complications. There was no strong evidence that FEV<inf>1</inf>
predicted respiratory morbidity after adjustment for peak oxygen
consumption (p = 0.80) or ventilatory efficiency (p = 0.76), or
FEV<inf>1</inf> predicted pulmonary complications after adjustment for
ventilatory efficiency (p = 0.37). Peak oxygen consumption (odds ratio
0.66 per 5 mL/kg/min increase; 95% CI, 0.54-0.82) was associated with
respiratory morbidity. Ventilatory efficiency was associated with
respiratory morbidity (p = 0.04) and pulmonary complications (p = 0.02).
Peak oxygen consumption also confounded the association between
FEV<inf>1</inf> and respiratory morbidity. Interpretation(s): After
accounting for fitness and clinical factors, FEV<inf>1</inf> was not
strongly predictive of respiratory complications. Prior associations
between FEV<inf>1</inf> and respiratory morbidity may be explained by
confounding by peak oxygen consumption. Funding(s): Canadian
Institutes of Health Research, Heart and Stroke Foundation of Canada,
Ontario Ministry of Health and Long-Term Care, Ontario Ministry of
Research, Innovation and Science, UK National Institute of Academic
Anaesthesia, UK Clinical Research Collaboration, Australian and New
Zealand College of Anaesthetists, and Monash University. Copyright
© 2020 The Author(s)

<40>
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.

<41>
Accession Number
2004769897
Title
Predictive Value for Outcome and Evolution of Geriatric Parameters after
Transcatheter Aortic Valve Implantation.
Source
Journal of Nutrition, Health and Aging. 24 (6) (pp 598-605), 2020. Date of
Publication: 01 Jun 2020.
Author
Roca F.; Durand E.; Eltchaninoff H.; Chassagne P.
Institution
(Roca, Chassagne) Department of Geriatric medicine, Rouen University
Hospital, Rouen F 76000, France
(Durand, Eltchaninoff) Department of Cardiology, Rouen University
Hospital, FHU REMOD-VHF, Rouen F 76000, France
(Roca) Service de Medecine Geriatrique, CHU de Rouen, Rouen Cedex 76031,
France
Publisher
Serdi-Editions
Abstract
Objectives: To identify parameters of comprehensive geriatric assessment
(CGA) CGA including ABCDEF score, a multidomain frailty assessment,
associated with poor outcome after TAVI and to assess the evolution of CGA
parameters at 6-months follow-up. Design(s): One-year monocentric
prospective cohort study. Setting(s): Departments of geriatric
medicine and cardiology in Rouen University Hospital, Normandy, France.
 Participant(s): All patients over 70, selected for TAVI by a
multidisciplinary "heart team". Measurements: 8-areas CGA was performed
before TAVI and at 6-months follow-up. Poor outcome was defined as
decrease in 1 BADL or unplanned readmission at 6 months or death within
the first year after TAVI. Geriatric characteristics associated with poor
outcome were assessed by logistic regression with surgical scores as
bivariable. Geriatric characteristics were compared between baseline and
6-months follow-up. Result(s): 114 patients (mean age 85.8+/-5.3
years) were included. Mean EuroSCORE was 19.1+/-10.6%. Poor outcome
occurred in 57(50.0%) patients. Loss of one BADL (OR: 1.66,
95CI[1.11-2.48]), decrease in IADL (OR: 1.41, 95CI[1.14-1.74]), in
plasmatic albumin (OR: 1.10, 95CI[1.01-1.20]), in MMSe (OR: 1.13,
95CI[1.02-1.26]), low walking speed (OR: 1.53, 95CI[1.01-2.33]) and ABCDEF
score >=2 (OR: 1.63, 95CI[1.09-2.42]) were independently associated with
poor outcome. In survivors with complete follow-up (n=80), most geriatric
parameters were maintained 6 months after TAVI, but IADL decreased
(5.6+/-1.9 to 4.9+/-2.2, p<0.001). MMSe increased in patients with
previous cognitive impairments whereas it decreased in those without
(p<0.001). Conclusion(s): CGA parameters are independently associated
with poor outcome after TAVI. These parameters, but IADL, are maintained
at 6 months and course of the MMSe depends on previous cognitive
status. Copyright © 2020, Serdi and Springer-Verlag International
SAS, part of Springer Nature.

<42>
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.

<43>
Accession Number
2005408763
Title
Cardiac Imaging With 123I-meta-iodobenzylguanidine and
Analogous PET Tracers: Current Status and Future Perspectives.
Source
Seminars in Nuclear Medicine. (no pagination), 2020. Date of Publication:
2020.
Author
Wan N.; Travin M.I.
Institution
(Wan, Travin) Division of Nuclear Medicine, Department of Radiology, and
Division of Cardiology, Department of Medicine, Montefiore Medical Center
and The Albert Einstein College of Medicine, Bronx, NY, United States
Publisher
W.B. Saunders
Abstract
Autonomic innervation plays an important role in proper functioning of the
cardiovascular system. Altered cardiac sympathetic function is present in
a variety of diseases, and can be assessed with radionuclide imaging using
sympathetic neurotransmitter analogues. The most studied adrenergic
radiotracer is cardiac 123I-meta-iodobenzylguanidine
(123I-mIBG). Cardiac 123I-mIBG uptake can be
evaluated using both planar and tomographic imaging, thereby providing
insight into global and regional sympathetic innervation. Standardly
assessed imaging parameters are the heart-to-mediastinum ratio and washout
rate, customarily derived from planar images. Focal tracer deficits on
tomographic imaging also show prognostic utility, with some data
suggesting that the best approach to tomographic image interpretation may
differ from conventional methods. Cardiac 123I-mIBG image
findings strongly correlate with the severity and prognosis of many
cardiovascular diseases, especially heart failure and ventricular
arrhythmias. Cardiac 123I-mIBG imaging in heart failure is FDA
approved for prognostic purposes. With the robustly demonstrated ability
to predict occurrence of potentially fatal arrhythmias, cardiac
123I-mIBG imaging shows promise for better selecting patients
who will benefit from an implantable cardioverter defibrillator, but
clinical use has been hampered by lack of the randomized trial needed for
incorporation into societal guidelines. In patients with ischemic heart
disease, cardiac 123I-mIBG imaging aids in assessing the extent
of damage and in identifying arrhythmogenic regions. There have also been
studies using cardiac 123I-mIBG for other conditions, including
patients following heart transplantation, diabetic related cardiac
abnormalities and chemotherapy induced cardiotoxicity. Positron emission
tomographic adrenergic radiotracers, that improve image quality, have been
investigated, especially 11C-meta-hydroxyephedrine, and most
recently 18F-fluorbenguan. Cadmium-zinc-telluride cameras also
improve image quality. With better spatial resolution and quantification,
PET tracers and advanced camera technologies promise to expand the
clinical utility of cardiac sympathetic imaging. Copyright © 2020
Elsevier Inc.

<44>
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

<45>
Accession Number
2006780491
Title
A Prospective Study Investigating Blood Patch Pleurodesis for
Postoperative Air Leaks After Pulmonary Resection.
Source
Journal of Surgical Research. 255 (pp 240-246), 2020. Date of Publication:
November 2020.
Author
Ploenes T.; Kyritsis I.; Mardanzai K.; Muhmann D.; Langehegermann L.;
Slama A.; Hegedus B.; Aigner C.
Institution
(Ploenes, Kyritsis, Mardanzai, Muhmann, Langehegermann, Slama, Hegedus,
Aigner) Department of Thoracic Surgery and Thoracic Endoscopy,
Ruhrlandklinik, West German Lung Center, University Hospital Essen,
University Duisburg-Essen, Essen, Germany
Publisher
Academic Press Inc. (E-mail: apjcs@harcourt.com)
Abstract
Background: Prolonged air leaks (PALs) after lung resection are one of the
most common complications in thoracic surgery. Several options are
available to treat PALs. The autologous blood patch pleurodesis is
commonly used but has not been thoroughly investigated. Material(s)
and Method(s): We conducted a prospective randomized study including all
consecutive patients with PALs after pulmonary resections. Patients were
randomized to either having received pleurodesis by injecting 100 mL
autologous blood at d 5 and 6 (Group A) or being placed under observation
(Group B). Patients from either group undergoing revisions were further
investigated by a post hoc analysis and formed Group C. Result(s): A
total of 24 patients were included: 10 patients were randomized to group A
and 14 to group B. Six patients (3 from each group) underwent surgical
revision and were included in Group C. Groups A and B did not differ in
baseline characteristics. The median time to drainage removal was 9 d
(range: 5-23 d) in Group A; 9 d (range: 2-20 d) in Group B; and 6 d in
Group C (range: 3-10 d), (A/B versus C, P < 0.04; A versus B was not
significant). Conclusion(s): There is no evidence indicating a
benefit for blood patch pleurodeses in patients undergoing lung resections
and presenting with postoperative PALs for more than 5 d. An early
operative closure of postoperative air leakage seems to be more
effective. Copyright © 2020 Elsevier Inc.

<46>
Accession Number
2006777705
Title
Residual SYNTAX Score and One-Year Outcome in Elderly Patients With Acute
Coronary Syndrome.
Source
CJC Open. (no pagination), 2020. Date of Publication: 2020.
Author
Morici N.; Alicandro G.; Ferri L.A.; Piatti L.; Grosseto D.; Sganzerla P.;
Tortorella G.; Ferrario M.; Crimi G.; Bossi I.; Tondi S.; Petronio A.S.;
Mariani M.; Toso A.; Ravera A.; Corrada E.; Cao D.; Di Ascenzo L.; La
Vecchia C.; De Servi S.; Savonitto S.
Institution
(Morici) Unita di Cure Intensive Cardiologiche and De Gasperis
Cardio-Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
(Morici, Alicandro, La Vecchia) Department of Clinical Sciences and
Community Health, Universita degli Studi di Milano, Milano, Italy
(Alicandro) Italian National Institute of Statistics, Rome, Italy
(Ferri, Savonitto) Interventional Cardiology Unit, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Piatti) Division of Cardiology, Ospedale Manzoni, Lecco, Italy
(Grosseto) Division of Cardiology, Ospedale Infermi, Rimini, Italy
(Sganzerla) Division of Cardiology, ASST Bergamo ovest-ospedale di
Treviglio, Treviglio, Italy
(Tortorella) Division of Cardiology, IRCCS Arcispedale S. Maria Nuova,
Reggio Emilia, Italy
(Ferrario) Division of Cardiology, Fondazione IRCCS Policlinico S. Matteo,
Pavia, Italy
(Crimi) Interventional Cardiology Unit, Cardio Thoraco Vascular Department
(DICATOV), IRCCS Policlinico San Martino, Genova, Italy
(Bossi) Interventional Cardiology Division and De Gasperis Cardio-Center,
ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
(Tondi) Division of Cardiology, Ospedale Baggiovara, Modena, Italy
(Petronio) Cardiothoracic and Vascular Department, Cardiac Catheterization
Laboratory, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
(Mariani) Division of Cardiology, Ospedale Civile, Legnano, Italy
(Toso) Division of Cardiology, Ospedale S. Stefano, Prato, Italy
(Ravera) Division of Cardiology, Ospedale Ruggi D' Aragona, Salerno, Italy
(Corrada, Cao) Cardiovascular Department, Humanitas Research Hospital,
Rozzano, Italy
(Di Ascenzo) Division of Cardiology - Azienda ULSS "Veneto Orientale," San
Dona di Piave, Venezia, Italy
(De Servi) University of Pavia, Italy, Milan, Italy
Publisher
Elsevier Inc
Abstract
Background: The residual burden of coronary artery disease after
percutaneous coronary intervention (PCI) has been associated with worse
ischemic outcome. However, data are conflicting in elderly patients. The
aim of our study was to verify the incremental value of the residual
Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac
Surgery (SYNTAX) score (rSS) over clinical variables and baseline SYNTAX
score (bSS) in predicting 1-year mortality or cardiovascular events.
 Method(s): A post hoc analysis of data collected in the Elderly-ACS 2
multicenter randomized trial was performed. We included 630 patients aged
> 75 years with multivessel coronary disease undergoing PCI for acute
coronary syndrome (ACS). The primary outcome was a composite of death,
recurrent myocardial infarction, and stroke at 1-year follow up. Change in
c-statistic and standardized net benefit were used to evaluate the
incremental value of the rSS. Result(s): Event rates were
significantly higher in patients with incomplete revascularization (rSS >
8). When the rSS was included in a core Cox regression model containing
age, previous myocardial infarction, and ACS type, the hazard ratio for
patients with score values > 8 was 2.47 (95% confidence interval,
1.51-4.06). However, the core model with rSS did not increase the
c-statistic compared with the core model with the bSS (from 0.69 to 0.70)
and gave little incremental value in the standardized net benefit.
 Conclusion(s): In elderly patients with ACS with multivessel disease
undergoing PCI, incomplete revascularization was associated with worse
outcome at 1-year follow-up. However, there was no clear incremental value
of the rSS in the prediction of 1-year adverse outcome compared with a
model including clinical variables and bSS. Copyright © 2020
Canadian Cardiovascular Society

<47>
Accession Number
2006765650
Title
Incidence, predictors and outcomes of valve-in-valve TAVI: A systematic
review and meta-analysis.
Source
International Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Giordana F.; Bruno F.; Conrotto F.; Saglietto A.; D'Ascenzo F.; Grosso
Marra W.; Dvir D.; Webb J.; D'Onofrio A.; Camboni D.; Grubitzsch H.;
Duncan A.; Kaneko T.; Toggweiler S.; Latib A.; Nerla R.; Salizzoni S.; La
Torre M.; Trompeo A.; D'Amico M.; Rinaldi M.; De Ferrari G.
Institution
(Giordana, Bruno, Conrotto, Saglietto, D'Ascenzo, Grosso Marra, D'Amico,
De Ferrari) Division of Cardiology, Cardiovascular and Thoracic
Department, Citta della Salute e della Scienza Hospital and University of
Turin, Italy
(Salizzoni, La Torre, Trompeo, Rinaldi) Division of Cardiosurgery,
Cardiovascular and Thoracic Department, Citta della Salute e della Scienza
Hospital and University of Turin, Italy
(Dvir) University of Washington, Seattle, WA, United States
(Webb) Centre for Heart Valve Innovation, St Paul's Hospital, University
of British Columbia, Vancouver, BC, Canada
(D'Onofrio) Division of Cardiology, Monaldi Hospital, Naples, Italy
(Camboni) Department of Cardio-Thoracic Surgery, University Medical Center
Regensburg, Germany
(Grubitzsch) Department of Cardiovascular Surgery, Charite
Universitatsmedizin Berlin, Chariteplatz 1, Berlin 10117, Germany
(Duncan) Royal Brompton Hospital, London, United Kingdom
(Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Toggweiler) Heart Center Lucerne, Luzerner Kantonsspital, Switzerland
(Latib) Interventional Cardiology Unit, San Raffaele Scientific Institute,
Milan, Italy
(Nerla) Cardiovascular Department, Humanities Gavazzeni, Bergamo, Italy
(Latib) Department of Cardiology, Montefiore Medical Centre, New York,
United States
Publisher
Elsevier Ireland Ltd
Abstract
Aims: Surgical aortic valve replacement has been the treatment of choice
for patients with aortic valve disease before the arrival of transcatheter
aortic valve replacement (TAVI), although limited by degeneration of the
bioprosthesis. "Redo" intervention itself is burdened by high risk of
complications and valve-in-valve (ViV) TAVI could be a valid strategy of
redo for patients with comorbidities. Methods and Results: Two
independent reviewers screened all studies investigating patients
undergoing ViV TAVI. Mortality at 30 days and at 1 year was the primary
end point. Of 286 studies identified, 26 articles were included in this
review with a total of 1448 patients. Median age was 78.8 years, 57.7%
male. Median STS score and Logistic EuroSCORE were 9.4% and 31.3%
respectively. Stenosis (45%) was the leading cause of prosthesis failure.
Transfemoral approach was preferred (76%), with a prevalence of balloon
expandable valves (73.3%). Mean follow up was 376 days. Overall and
cardiovascular mortality at 30 days was 6.5% and 5.5% respectively, while
at 1 year it was 14.5% and 8.9% respectively. At meta-regression analysis
study year (p <.001), Logistic EuroSCORE (p <.01) and valve diameter <= 21
mm (p <.05) at 30 days, and stenosis as reason for failure (p =.05) at 1
year were identified as possible predictors of survival.
 Conclusion(s): ViV TAVI offers a valid strategy to treat high risk
patients with a failure of bioprosthesis with satisfying results in terms
of short and mid-term mortality. Future studies are needed to find
predictors of long term survival and outcomes in lower risk
patients. Copyright © 2020 Elsevier B.V.

<48>
Accession Number
2005685110
Title
Effects of sugammadex on postoperative respiratory management in children
with congenital heart disease: a randomized controlled study.
Source
Biomedicine and Pharmacotherapy. 127 (no pagination), 2020. Article
Number: 110180. Date of Publication: July 2020.
Author
Xiaobing L.; Yan J.; Wangping Z.; Rufang Z.; Jia L.; Rong W.
Institution
(Xiaobing, Rufang, Jia) Department of Cardiothoracic Surgery, Shanghai
Children's Hospital, Shanghai JiaoTong University, Shanghai 200062, China
(Yan, Rong) Department of Anesthesiology, Shanghai Children's Hospital,
Shanghai JiaoTong University, Shanghai 200062, China
(Wangping) Department of Anesthesiology, Women and Children's Hospital of
Jiaxing University, Jiaxing 314000, China
Publisher
Elsevier Masson SAS (62 rue Camille Desmoulins, Issy les Moulineaux Cedex
92442, France)
Abstract
Background: Early extubation can reduce pulmonary complications in
children undergoing cardiac surgery. The aim of this study is to evaluate
the effects of sugammadex for postoperative respiratory management in
children with congenital heart disease. Method(s): Sixty children
with congenital heart disease undergoing elective cardiac surgery were
divided into group S and group C (30 children in each group). When post
tetanic twitches count (PTC) = 1-2 and train-of-four (TOF) = 0, the
children in group S received sugammadex4 mg/kg for reversal of
neuromuscular block at the end of surgery, and the children in group C
received the same volume of normal saline. The recovery time to TOF of
0.9, the mechanical ventilation and extubation times were recorded. On the
other side, the hemodynamic parameters before and 5 min after
administration, and side effects were also recorded. The levels of
C-reactive protein (CRP) and procalcitonin (PCT) before and 24 h after
surgery were measured. Result(s): The recovery time to TOF of 0.9 and
extubation time were significantly shorter in the group S than in the
group C (4.2 +/- 1.4 vs 108.2 +/- 26.7 min, 66.3 +/- 6.5 vs 171.6 +/- 23.1
min, respectively, P < 0.01). The CRP and PCT levels were found to be
increased in both groups at postoperative 24 h than before surgery.
Further, the levels of PCT and CRP at postoperative 24 h were lower in
group S when compared to group C (median, 7 vs 17.5 mg/ml, 1.76 vs 5.22
ng/ml, respectively, P < 0.05). There were no statistical differences
observed between the two groups (P> 0.05) with respect to side effects.
 Conclusion(s): Sugammadex is rapid and effective in reversing
rocuronium-induced neuromuscular block, and significantly reduces the
extubation time and the release of postoperative CRP and PCT in children
with congenital heart diseases. Copyright © 2020 The Author(s)

<49>
Accession Number
2005127945
Title
The impact of negative pressure wound therapy for closed surgical
incisions on surgical site infection: A systematic review and
meta-analysis.
Source
Surgery (United States). 167 (6) (pp 1001-1009), 2020. Date of
Publication: June 2020.
Author
Shiroky J.; Lillie E.; Muaddi H.; Sevigny M.; Choi W.J.; Karanicolas P.J.
Institution
(Shiroky, Karanicolas) Division of General Surgery, Sunnybrook Health
Sciences Centre, Toronto, Canada
(Lillie, Karanicolas) Sunnybrook Research Institute, Sunnybrook Health
Sciences Centre, Toronto, Canada
(Muaddi, Sevigny, Choi, Karanicolas) Division of General Surgery,
Department of Surgery, University of Toronto, Canada
(Karanicolas) Institute of Health Policy, Management and Evaluation,
University of Toronto, Canada
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Surgical site infections cause substantial morbidity and
mortality. Negative pressure wound therapy may reduce the risk of surgical
site infections, but current evidence is unclear. The objective of this
study was to examine whether negative pressure wound therapy reduces the
risk of surgical site infections and other wound complications when
compared with conventional dressings in all patients with primarily closed
surgical wounds. Method(s): A comprehensive systematic review of
randomized controlled trials was conducted. Trials that compared a
negative pressure wound therapy system to any non-negative pressure wound
therapy dressing in surgical wound(s) intended to heal by primary
intention were eligible. Surgical site infection was the primary outcome,
and secondary outcomes included wound dehiscence, pain, seroma, healing
time, length of stay, device-related complications, cost-effectiveness,
and quality of life. Selection, extraction, and risk of bias steps were
done in duplicate, and data were synthesized using random effects
meta-analyses. A priori sensitivity and subgroup analyses of the primary
outcome were completed. The Grading of Recommendations, Assessment,
Development, and Evaluations framework was used to appraise the quality of
the evidence. Result(s): Forty-four randomized controlled trials with
N = 5,693 patients were included. Patients treated with negative pressure
wound therapy experienced nearly a 40% reduction in the risk of surgical
site infections relative to those with conventional dressings, which was
statistically significant: pooled risk ratio 0.61, 95% confidence interval
0.49-0.74, I2 = 26%. The effect remained consistent across
surgical specialties and brands of negative pressure wound therapy
devices. A statistically significant reduction in wound dehiscence and
seroma incidence was also observed. Conclusion(s): There is moderate
certainty that negative pressure wound therapy applied to closed surgical
incisions reduces the risk of surgical site infections across all surgical
procedures. Copyright © 2020 Elsevier Inc.

<50>
Accession Number
2004690337
Title
Cardiac involvement in COVID-19 patients: Risk factors, predictors, and
complications: A review.
Source
Journal of Cardiac Surgery. 35 (6) (pp 1302-1305), 2020. Date of
Publication: 01 Jun 2020.
Author
Aghagoli G.; Gallo Marin B.; Soliman L.B.; Sellke F.W.
Institution
(Aghagoli, Gallo Marin, Soliman, Sellke) Warren Alpert Medical School of
Brown University, Providence, RI, United States
(Sellke) Division of Cardiothoracic Surgery, Rhode Island Hospital,
Providence, RI, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Respiratory complications have been well remarked in the novel
coronavirus disease (SARS-CoV-2/COVID-19), yet an emerging body of
research indicates that cardiac involvement may be implicated in poor
outcomes for these patients. Aim(s): This review seeks to gather and
distill the existing body of literature that describes the cardiac
implications of COVID-19. Material(s) and Method(s): The English
literature was reviewed for papers dealing with the cardiac effects of
COVID-19. Result(s): Notably, COVID-19 patients with pre-existing
cardiovascular disease are counted in greater frequency in intensive care
unit settings, and ultimately suffer greater rates of mortality. Other
studies have noted cardiac presentations for COVID-19, rather than
respiratory, such as acute pericarditis and left ventricular dysfunction.
In some patients there has been evidence of acute myocardial injury, with
correspondingly increased serum troponin I levels. With regard to surgical
interventions, there is a dearth of data describing myocardial protection
during cardiac surgery for COVID-19 patients. Although some insights have
been garnered in the study of cardiovascular diseases for these patients,
these insights remain fragmented and have yet to cement clear guidelines
for actionable clinical practice. Conclusion(s): While some
information is available, further studies are imperative for a more
cohesive understanding of the cardiac pathophysiology in COVID-19 patients
to promote more informed treatment and, ultimately, better clinical
outcomes. Copyright © 2020 Wiley Periodicals, Inc.

<51>
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

<52>
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.

<53>
Accession Number
631555441
Title
Patient care without borders: A systematic review of medical and surgical
tourism.
Source
Journal of Travel Medicine. 26 (6) (no pagination), 2019. Date of
Publication: 2019.
Author
Foley B.M.; Haglin J.M.; Tanzer J.R.; Eltorai A.E.M.
Institution
(Foley, Haglin) Mayo Clinic Alix School of Medicine, Scottsdale, AZ 85054,
United States
(Tanzer) University of Rhode Island, United States
(Eltorai) Warren Alpert Medical School of Brown University, Providence, RI
02903, United States
Publisher
Oxford University Press
Abstract
Background: Medical tourism (MT) is an increasingly utilized modality for
acquiring medical treatment for patients globally. This review assimilates
the current literature regarding MT, with particular focus on the
applications, ethics and economics. Method(s): A systematic review of
MEDLINE and PubMed Central databases for publications relating to MT from
2005 to 2018 yielded 43 articles for this review. Result(s): Patients
seeking elective bariatric, cosmetic and orthopedic surgery abroad are
motivated by significantly lower costs, all-inclusive vacation packages
and reduced wait times. Complication rates as high as 56% include
infection, poor aesthetic and functional outcome and adverse
cardiovascular events. Cross-border reproductive care has steadily
increased due to less restrictive policies in select countries; however,
the depth of research on outcomes and quality of care is abysmal. Stem
cell therapy promise treatments that are often not well researched and
offer minimal evidence of efficacy, yet patients are drawn to treatment
through anecdotal advertisements and a last sense of hope. Transplant
surgery sought to decrease wait times carries many of the similar
aforementioned risks and may contribute to the practice of organ
trafficking in countries with high rates of poverty. Patients and
countries alike are motivated by a plethora of factors to engage in the MT
industry but may be doing so without accurate knowledge of the quality,
safety or potential for economic gain. Safety is of utmost importance to
prevent surgical complications and the spread of treatment-resistant
bacteria. Conclusion(s): MT is growing in popularity and complexity.
The lack of standardization in its definition and regulation leads to
difficulty in epidemiologic and economic analysis and ethical issues of
informed consent and health equity. The findings of this review may be
used by the stakeholders of MT, including patients and providers, to
enhance informed decision-making and quality of care. Copyright ©
2019 International Society of Travel Medicine 2019. Published by Oxford
University Press. All rights reserved.

<54>
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. 9 (12) (pp e014463), 2020. Date
of Publication: 16 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.

<55>
[Use Link to view the full text]
Accession Number
631366609
Title
Effect of sub-hypothermia blood purification technique in cardiac shock
after valvular disease surgery.
Source
Medicine. 99 (13) (pp e19476), 2020. Date of Publication: 01 Mar 2020.
Author
Fang J.; Xu M.; Liu B.; Wang B.; Ren H.; Yang H.; Dong Y.; Song L.; Xiao
H.
Institution
(Fang, Xu, Wang, Song) Department of Cardiac Surgery
(Liu, Ren) Department of Intensive Care Unit, Wuhan Asia Heart Hospital,
Wuhan, China
(Yang) Department of Urinary Surgery, Dongfeng Maojian Hospital, Shiyan,
China
(Dong) Department of Cardiology, Wuhan Asia Heart Hospital
(Xiao) Department of Intensive Care Unit, Asia Heart Hospital, Wuhan
University of Science and Technology, Wuhan, China
Publisher
NLM (Medline)
Abstract
To observe the effect of sub-hypothermia (HT) blood purification technique
in the treatment of cardiac shock after heart valve disease.The patients
were randomly divided into normothermic (NT) continuous blood purification
(CBP) group (NT group) and HT CBP group (HT group). Observe the cardiac
index (CI), the oxygen delivery (DO2) and oxygen consumption (VO2) ratio,
Acute Physiology and Chronic Health Evaluation III(APACHE III) score,
multiple organ dysfunction syndrome (MODS) score, dynamic monitoring of
electrocardiograph, blood loss with or without muscle tremors, intensive
care unit stay, mechanical ventilation time, CBP time, and the cases of
infection and mortality at 0 day, 1 day, 2 day, 3 day; all above
indicators were compared between 2 groups.Ninety-five patients were
randomly assigned into HT group (48 cases) and NT group (47 cases); there
were no significant differences between the 2 groups for age, gender,
pre-operative cardiac function, cardiothoracic ratio, and type of valve
replacement (P > .05). There were no significant differences among the 1
day, 2 day, 3 day after recruited for CI, DO2/VO2 ratio, APACHE III score,
MODS score (P > .05). But in HT group, DO2/VO2 ratio had been
significantly improved after treatment for 1 day (2.5 +/- 0.7 vs 1.8 +/-
0.4, P = .024), and CI (3.0 +/- 0.5 vs 1.9 +/- 0.7, P = .004), APACHE III
score (50.6 +/- 6.2 vs 77.5 +/- 5.5 P = .022), MODS score (6.0 +/- 1.5 vs
9.3 +/- 3.4, P = .013) also had been significantly improved after
treatment for 3 days. In clinical outcomes, there were no significant
differences between 2 groups for blood loss (617.0 +/- 60.7 ml vs 550.9
+/- 85.2 ml, P = .203), infection ratio (54.17% vs 53.19%, P = .341), the
incidence of ventricular arrhythmia (31.25% vs 36.17%, P = .237), and
muscle tremors (14.58% vs 8.51%, P = .346), while there were significant
differences between 2 groups for intensive care unit stay (6.9 +/- 3.4
days vs 12.5 +/- 3.5 days, P = .017,), mechanical ventilation time (4.2
+/- 1.3 days vs 7.5 +/- 2.7 days, P = .034,), CBP time (4.6 +/- 1.4 days
vs 10.5 +/- 4.0 days, P = .019), mortality (12.50% vs 23.40%, P = .024).
But the incidence of bradycardia in HT group was much higher than the NT
group (29.16% vs 14.89%, P = .029).HT blood purification is a safer and
more effective treatment than NT blood purification for patients who
suffered from cardiac shock after valve surgery.

<56>
[Use Link to view the full text]
Accession Number
631324383
Title
Retained Temporary Epicardial Pacing Wires: A Systematic Review and
Treatment Algorithm.
Source
Annals of plastic surgery. 85 (S1 Supplement 1) (pp S44-S49), 2020. Date
of Publication: 01 Jul 2020.
Author
Wald G.; Van Y.-V.R.; Pain K.J.; Otterburn D.M.
Institution
(Wald) From the Weill Cornell Medicine
(Van) New York Presbyterian Hospital, Weill Cornell and Columbia Plastic
Surgery Residency Programr
(Pain) Weill Cornell Medicine, Samuel J. Wood Library & C.V. Starr
Biomedical Information Center
(Otterburn) Weill Cornell Medicine, Division of Plastic Surgery, NY, NY
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Temporary epicardial pacing wires (TEPW) are used in the
immediate postoperative cardiac surgery period for the identification,
diagnosis, and treatment of acute arrhythmias. They are usually removed
before discharge, but are sometimes clipped and left to retract into the
skin and are thus retained. Rare complications from these retained wires
have been documented in numerous case reports. We describe a case of a
57-year-old man with chronically draining wounds due to infected retained
pacing wires. This case prompted a systematic review of these patients to
delineate complications and to create a novel treatment algorithm.
 METHOD(S): The authors conducted a systematic review of MEDLINE,
Embase, and the Cochrane Library databases and retrieved relevant,
English-language articles published between 1986 and 2018. Two reviewers
critically appraised the studies that met inclusion and exclusion
criteria. RESULT(S): Thirty-one articles met inclusion criteria with
a total of 35 patients included. The existing articles represent either
level IV or level V evidence. Mean +/- SD time of presentation from
initial TEPW placement was 4.9 +/- 5.9 years, with a range of 1 month to
24 years and 77% of patients were symptomatic. The TEPW wire migration
occurred in 74% of patients, with invasion into vasculature, visceral
organs, and subcutaneous tissue. Most of the patients who underwent wire
removal had complete recovery. The relevant literature suggests that there
is a wide range of complications, and migration is more often associated
with need for surgical intervention. CONCLUSION(S): In patients with
severe symptoms or evidence of migration, surgical intervention and
removal should be strongly considered to prevent potentially deadly
complications. We propose an algorithm to minimize these complications
based on a literature analysis in accordance with PRISMA guidelines.

<57>
Accession Number
632079140
Title
Adding blood to St Thomas solution does not improve mortality in pediatric
cardiac surgery: A Meta-analysis of a homogenous population.
Source
Annals of African Surgery. 17 (2) (pp 60-64), 2020. Date of Publication:
2020.
Author
Awori M.; Mehta N.; Kebba N.; Makori E.
Institution
(Awori, Mehta, Kebba, Makori) University of Nairobi, Kenya
Publisher
Surgical Society of Kenya (E-mail: hsaid2ke@yahoo.com)
Abstract
Background: Cardioplegia is the gold standard for providing ideal
operating conditions while effecting myocardial protection. Some studies
suggest that adding blood to St Thomas cardioplegia solution improves
efficacy; this is generally accepted as true. However, the few
meta-analyses conducted on children have pooled heterogeneous populations;
this raises concern about the validity of their conclusions.
 Method(s): PUBMED, the Cochrane Library and Google Scholar were
searched systematically until March 2019 using the search terms
"cardioplegia"; "myocardial protection"; "pediatric" "pediatric";
"children"; "infants"; "neonates". Full text articles were examined if
abstracts revealed that the studies possibly contained a blood
cardioplegia arm and a crystalloid cardioplegia arm. Studies were included
in the meta-analysis if they had a 4:1 blood cardioplegia arm and a St
Thomas solution arm. Meta-analysis was performed using Meta-Mar software.
 Result(s): The search retrieved 423 articles; 5 were included in the
meta-analysis, representing 324 patients. The risk ratio for operative
mortality was 0.77(95% CI 0.24-2.5; p=0.66). Little evidence was seen of
heterogeneity of the pooled patients. Conclusion(s): Adding blood to
St Thomas cardioplegia solution did not improve in-hospital operative
mortality; this may have implications for use of blood
cardioplegia. Copyright © 2020 Author.

<58>
[Use Link to view the full text]
Accession Number
632081757
Title
Transcatheter aortic valve implantation in the patients with chronic liver
disease: A mini-review and meta-analysis.
Source
Medicine. 99 (16) (pp e19766), 2020. Date of Publication: 01 Apr 2020.
Author
Ma X.; Zhao D.; Li J.; Wei D.; Zhang J.; Yuan P.; Kong X.; Ma J.; Ma H.;
Sun L.; Zhang Y.; Jiao Q.; Wang Z.; Zhang H.
Institution
(Ma, Zhao, Li, Wei, Sun, Wang, Zhang) Department of Cardiovascular
Surgery, Shandong Provincial Hospital Affiliated to Shandong University,
Shandong Provincial Hospital Affiliated to Shandong First Medical
University, No. 324 Jingwu Road, Jinan, Shandong 250021, China
(Zhao, Li, Wei, Zhang, Yuan) School of Medicine, Shandong University, No.
44 Wenhua West Road, Jinan, Shandong 250012, China
(Kong) Department of Vascular Surgery
(Ma) Department of Pathology
(Ma) Qingdao University Medical College, Qingdao University, 308 Ningxia
Road, Qingdao 266071, China
(Zhang) Emergency Center
(Jiao) Department of Anesthesiology, Shandong Provincial Hospital
Affiliated to Shandong University, No. 324 Jingwu Road, Jinan, Shandong
250021, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Chronic liver disease is traditionally conceived as a risk
factor for cardiovascular surgery. Transcatheter aortic valve implantation
(TAVI) has recently burgeoned to precede surgical aortic valve replacement
(SAVR) in patients with severe aortic stenosis at intermediate to high
surgical risk. The evidence regarding TAVI in the patients with chronic
liver disease is currently scarce. METHOD(S): This article aims to
assess the application of TAVI technique in the patients with chronic
liver disease. RESULT(S): TAVI in the patients with chronic liver
disease produced acceptable postoperative results. The post-TAVI outcomes
were comparable between the patients with or without chronic liver
disease, except for a lower rate of pacemaker implantation in the patients
with chronic liver disease (OR, 0.49[0.27-0.87], P = .02). In the patients
with chronic liver disease, compared to SAVR, TAVI led to a decrease in
the in-hospital mortality (OR, 0.43[0.22-0.86], P = .02) and need for
transfusion (OR, 0.39[0.25-0.62], P < .0001). The rest outcomes were
similar between the 2 groups. CONCLUSION(S): This systematic review
and meta-analysis supported that TAVI is a reliable therapeutic option for
treating severe aortic stenosis in the patients with chronic liver
disease. Future large-scale randomized controlled trials investigating the
mid-term and long-term prognosis are needed to further verify these
results.

<59>
Accession Number
632081107
Title
Short-duration triple antithrombotic therapy for atrial fibrillation
patients who require coronary stenting: results of the SAFE-A study.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
16 (2) (pp e164-e172), 2020. Date of Publication: 12 Jun 2020.
Author
Hoshi T.; Sato A.; Hiraya D.; Watabe H.; Takeyasu N.; Nogami A.; Ohigashi
T.; Gosho M.; Ieda M.; Aonuma K.
Institution
(Hoshi) Department of Cardiology, Faculty of Medicine, University of
Tsukuba, Ibaraki, Japan
Publisher
NLM (Medline)
Abstract
AIMS: We aimed to determine whether shortening the duration of P2Y12
inhibitor therapy can reduce the risk of bleeding without increasing the
risk of major adverse cardiovascular events following coronary stenting in
patients with atrial fibrillation (AF). METHODS AND RESULTS: The SAFE-A is
a randomised controlled trial that compared one-month and six-month P2Y12
inhibitor therapy, in combination with aspirin and apixaban for patients
with AF who require coronary stenting. The primary endpoint was the
incidence of any bleeding events, defined as Thrombolysis In Myocardial
Infarction major/minor bleeding, bleeding with various Bleeding Academic
Research Consortium grades, or bleeding requiring blood transfusion within
12 months after stenting. The study aimed to enrol 600 patients but
enrolment was slow. Enrolment was terminated prematurely after enrolling
210 patients (72.7+/-8.2 years; 81% male). The incidence of the primary
endpoint did not differ between the one-month and six-month groups (11.8%
vs 16.0%; hazard ratio [HR] 0.70, 95% confidence interval [CI]: 0.33-1.47;
p=0.35). CONCLUSION(S): The study evaluated the safety of withdrawing
the P2Y12 inhibitor from triple antithrombotic prescription one month
after coronary stenting. However, enrolment was prematurely terminated
because it was slow. Therefore, statistical power was not sufficient to
assess the differences in the primary endpoint.

<60>
Accession Number
623564491
Title
Effect of ulinastatin on interleukins and pulmonary function in bypass
patients: a meta-analysis of randomized controlled trials.
Source
Herz. 45 (4) (pp 335-346), 2020. Date of Publication: 01 Jun 2020.
Author
He G.; Li Q.; Li W.; Ruan Y.; Xiong X.; Song X.; Zeng F.
Institution
(He, Li, Ruan, Xiong, Song, Zeng) Department of Respiratory Medicine, The
First College of Clinical Medical Sciences, Yichang Central People's
Hospital, China Three Gorges University, Yiling Road 183, Yichang, Hubei
443000, China
(Li) Department of Cardiology, The First College of Clinical Medical
Sciences, Institute of Cardiovascular Diseases, China Three Gorges
University, Yichang, Hubei, China
(He, Li, Li, Ruan, Xiong, Song, Zeng) Institute of Evidence-Based and
Translational Medicine, China Three Gorges University, Yichang, Hubei,
China
Publisher
Springer Medizin (E-mail: kundenservice@springermedizin.de)
Abstract
Background: Our aim was to evaluate the effect of urinary trypsin
inhibitors (UTI) on interleukin, tumor necrosis factor-alpha (TNF-alpha),
and polymorphonuclear neutrophil elastase (PMNE) levels as well as on
pulmonary function in patients undergoing cardiopulmonary bypass.
 Material(s) and Method(s): We searched the following databases for
relevant studies: PubMed, Medline (Ovid SP), Cochrane Library, Wanfang
Data, China Biology Medicine Database, Chinese Periodical Database, China
Knowledge Resource Integrated Database, and Chinese Clinical Trial
Registry. Two investigators independently collected the data and assessed
the quality of each study. RevMan 5.3 was used for the meta-analysis.
 Result(s): In total, 15 randomized controlled trials (646 patients)
met the inclusion criteria. There was a significant decrease in TNF-alpha,
interleukin-6 (IL-6), IL-8, and PMNE levels at 6h and 24h after UTI
treatment and an increase in IL-10 levels; additionally, there was a
decrease in respiratory index and an improvement in the oxygenation index.
Nevertheless, UTI treatment did not affect the length of intensive care
unit stay, alveolar-arterial oxygen partial pressure difference, adverse
lung events, or hospital mortality. Because of the high heterogeneity of
the included trials, the results should be assessed carefully.
 Conclusion(s): UTI treatment can suppress proinflammatory cytokine
elevation and upregulate the release of anti-inflammatory mediators,
thereby reducing pulmonary injury and improving pulmonary function after
cardiopulmonary bypass. Copyright © 2018, Springer Medizin Verlag
GmbH, ein Teil von Springer Nature.

<61>
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.

<62>
Accession Number
631999076
Title
Preoperative individualized education intervention reduces delirium after
cardiac surgery: A randomized controlled study.
Source
Journal of Thoracic Disease. 12 (5) (pp 2188-2196), 2020. Date of
Publication: 01 May 2020.
Author
Xue X.; Pei W.; Jingjing W.; Li X.; Peng F.; Zhinong W.
Institution
(Xue, Pei, Jingjing, Li, Zhinong) Center for Comprehensive Treatment of
Atrial Fibrillation, Department of Cardiothoracic Surgery, Second Military
Medical University, Shanghai 200003, China
(Jingjing, Li, Peng) Department of Nursing, Changzheng Hospital, Second
Military Medical University, Shanghai 200003, China
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Background: Postoperative delirium dramatically increases the mortality
and morbidity of patients undergoing cardiac surgery. Preoperative
education has been proven to be effective in improving recovery and
reducing complications. However, there is rare evidence of individualized
education for the delirium. This study aimed to investigate the effect of
preoperative personalized education on postoperative delirium of patients
undergoing cardiac surgery. Method(s): A total of 133 adult patients
receiving cardiac surgery in a single center were enrolled in this study
and randomized into the experimental group (n=67) and the control group
(n=66), who were given the preoperative individualized education
intervention and routine care respectively. The primary endpoint of
delirium and other clinical outcomes were observed and compared.
 Result(s): All patients completed this trial without a significant
difference between the two groups in baseline characteristics. The
incidence of the delirium of the experimental group was significantly
lower than that of the control group (10.4% vs. 24.2%, P=0.038). There was
no statistical difference between two groups in hospital-stay and other
complications, while the mechanical ventilation time and ICU stay of the
experimental group was significantly lower (MV time: 13.7+/-7.6 vs.
18.6+/-9.8 h, P=0.002; ICU stay: 31.3+/-9.1 vs. 36.5+/-10.4 h, P=0.003).
 Conclusion(s): Preoperative individualized education intervention can
reduce the incidence of postoperative delirium and promote the recovery of
patients receiving cardiac surgery. Copyright © Journal of
Thoracic Disease. All rights reserved.

<63>
Accession Number
631998991
Title
Mitral regurgitation after transcatheter aortic valve replacement.
Source
Journal of Thoracic Disease. 12 (5) (pp 2926-2935), 2020. Date of
Publication: 01 May 2020.
Author
Nappi F.; Nenna A.; Timofeeva I.; Mihos C.; Gentile F.; Chello M.
Institution
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord de
Saint-Denis, Paris, France
(Nenna, Chello) Department of Cardiovascular Surgery, Universita Campus
Bio-Medico di Roma, Rome, Italy
(Timofeeva) Department of Imaging, Centre Cardiologique du Nord de
Saint-Denis, Paris, France
(Mihos) Division of Cardiology, Columbia University, Mount Sinai Heart
Institute, Miami Beach, FL, United States
(Gentile) Gentile Cardiovascular Medical Center, Naples, Italy
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Patients undergoing transcatheter aortic valve replacement (TAVR) might
have an associated significant MR that can potentially lead to left
ventricular (LV) failure after procedure. Considering the specific
alterations in the mitral valve in TAVR scenario and the widespread use of
TAVR in recent years, it appears important to know and understand the
anatomical, functional and clinical implications to develop adequate
strategies for the future. Patients with severe mitral regurgitation (MR)
have been generally excluded from randomized clinical trials, making poor
the impact that associated MR can have on clinical outcomes after TAVR.
Several factors must be considered whose presence influences the severity
of MR. For example, the elevated prevalence of coronary disease with
consequent ischemic MR may account for LV dilation observed at the end
stage of aortic stenosis. Evidence randomized studies and registries
suggests that the rate of concomitant moderate-to-severe MR in patients
undergoing TAVR oscillates between 2% and 33%, and patients with moderate
to severe MR may have hemodynamic frailty with clinical deterioration
during mechanical intervention. Short- and long-term outcomes, including
cardiac mortality, appear to be influenced by the existence of
preoperative moderate-to-severe MR or by the postprocedural worsening of
mild MR, generally due to adverse LV remodeling. The incidence and the
prognostic effect of concomitant MR in patients undergoing TAVR requires
specific attention as might trigger adjunctive strategy treatment which
should be carefully evaluated in clinical trials. Copyright ©
Journal of Thoracic Disease. All rights reserved.

<64>
Accession Number
631881073
Title
A meta-Analysis on the prevalence, associated factors and diagnostic
methods of mental stress induced myocardial ischemia.
Source
Journal of Translational Medicine. 18 (1) (no pagination), 2020. Article
Number: 218. Date of Publication: 29 May 2020.
Author
Zhang L.; Bao Y.; Wang X.; Zhou Y.; Tao S.; Xu W.; Liu M.
Institution
(Zhang, Wang, Tao, Xu, Liu) Cardiology Department, Beijing Anzhen
Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang
District, Beijing 100029, China
(Bao) National Institute on Drug Dependence, Peking University, No. 38,
Xueyuan Road, Haidian District, Beijing 10091, China
(Zhou) Department of Anatomy and Neurobiology, Boston University, Boston,
United States
(Tao) School of Basic Medical Sciences, Henan University, Kaifeng, China
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
Abstract
Background: The high prevalence of mental stress induced myocardial
ischemia (MSIMI) causes double risk of adverse cardiac events in patients
with MSIMI. However, multiple types of mental stress, diagnostic
techniques, and diagnostic measurements may increase the complexity and
heterogeneity in the assessment of MSIMI. Therefore, we performed this
meta-Analysis to assess the prevalence, associated factors, and diagnostic
methods of MSIMI. Method(s): We systematically searched PubMed,
EMBACE, Web of Science, CNKI, Wanfang through 1 Feb 2020 in English and
Chinese. Review Manager (RevMan) Version 5.3 and Stata 12.0 were used for
data analyses. Result(s): Twenty articles were enrolled. The pooled
estimates for the prevalence of MSIMI in CAD patients was 32%. Potential
associated factors of MSIMI involved history of post myocardial infarction
(MI), or coronary artery bypass graft (CABG) (RR: 1.29, 95% CI 1.00-1.66,
P = 0.05; RR: 1.59, 95% CI 1.00-2.52, P = 0.05). Evidence supported that
diagnostic methods could influence the prevalence of MSIMI. Significant
differences of MSIMI prevalence were found in different types of mental
stress (Public Speaking: 22%; Mental arithmetic: 26%; Anger recall: 34%;
Two types: 37%; Three or more than three types: 43%, P = 0.02), diagnostic
techniques (SPECT: 26%; RNV: 38%; ECG: 16%; Echocardiography: 41%; Two
types: 43%, P < 0.0001), and diagnostic measurements (LVEF decrease: 19%;
WMA: 51%; ST depression: 16%; MPD: 26%; Two or more than two measurements:
45%, P < 0.00001). Moreover, univariate meta-regression demonstrated that
MSIMI was linked with mental stress (exp(b): 1.0508, SE: 0.0201, P:
0.018). Conclusion(s): This meta-Analysis implicated that patients
with diabetes, post MI or CABG might be more vulnerable to MSIMI. However,
the prevalence of MSIMI could be influenced by diagnostic methods,
especially the adopted types of mental stress, diagnostic techniques and
measurements. Therefore, it is necessary to formulate a standard
diagnostic method for MSIMI, which should be adequate, assessable, and
affordable worldwide. Registration PROSPERO. Online Protocol:
CRD42020162822. Copyright © 2020 The Author(s).

<65>
Accession Number
2006032569
Title
The Use of Virtual Reality to Reduce Preoperative Anxiety in First-Time
Sternotomy Patients: A Randomized Controlled Pilot Trial.
Source
Mayo Clinic Proceedings. 95 (6) (pp 1148-1157), 2020. Date of Publication:
June 2020.
Author
Hendricks T.M.; Gutierrez C.N.; Stulak J.M.; Dearani J.A.; Miller J.D.
Institution
(Hendricks, Gutierrez) Mayo Clinic Alix School of Medicine, Mayo Clinic,
Rochester, MN, United States
(Stulak, Dearani, Miller) Department of Cardiovascular Surgery, Mayo
Clinic, Rochester, MN, United States
(Miller) Departments of Surgery and Physiology & Biomedical Engineering,
Mayo Clinic, Rochester, MN, United States
Publisher
Elsevier Ltd
Abstract
Objective: To report the first randomized controlled trial to investigate
if immersive virtual reality (VR) treatment can reduce patient perceptions
of anxiety compared with a tablet-based control treatment in adults
undergoing a first-time sternotomy. Method(s): Twenty first-time
sternotomy patients were prospectively randomized (blinded to
investigator) to a control or VR intervention. The VR intervention was a
game module "Bear Blast" (AppliedVR) displayed using a Samsung Gear Oculus
VR headset. The control intervention was a tablet-based game with
comparable audio, visual, and tactile components. The State-Trait Anxiety
Inventory was administered before and after the assigned intervention.
Self-reported anxiety measures between the control and VR groups were
evaluated using an unpaired t test. Changes in self-reported anxiety
measures pre- and post-intervention were evaluated with a paired t test
for both the control and VR groups. The study took place from May 1, 2017,
through January 1, 2019 (Institutional Review Board 16-009784).
 Result(s): Both control and VR groups were 90.0% male, with a mean
+/- SD age of 63.4 +/- 9.11 and 69.5 +/- 6.9 years, respectively. VR users
experienced significant reductions in feeling tense and strained, and
significant improvements in feeling calm when compared with tablet
controls (P<0.05). They also experienced significant reductions in feeling
strained, upset, and tense when compared with their own self-reported
anxiety measure pre- and post-intervention (P<0.05). Critically, control
patients had no change in these categories. Conclusion(s): Immersive
VR is an effective, nonpharmacologic approach to reducing preoperative
anxiety in adults undergoing cardiac surgery and shows the validity and
utility of this technology in adult patients. Copyright © 2020

<66>
Accession Number
2005000070
Title
Rise and fall of preoperative coronary revascularization.
Source
Expert Review of Cardiovascular Therapy. 18 (5) (pp 249-259), 2020. Date
of Publication: 03 May 2020.
Author
Raghunathan D.; Palaskas N.L.; Yusuf S.W.; Eagle K.A.
Institution
(Raghunathan) University of Texas Health Science Center at Houston, TX,
United States
(Palaskas, Yusuf) Department of Cardiology, University of Texas MD
Anderson Cancer Center, Houston, TX, United States
(Eagle) Department of Internal Medicine, Division of Cardiology, The
University of Michigan, Ann Arbor, MI, United States
Publisher
Taylor and Francis Ltd
Abstract
Introduction: About 234 million major surgical procedures are performed
each year worldwide, of which >60 million surgeries are performed in the
United States. Though postoperative major adverse cardiac complications
are relatively low, patients with postoperative myocardial infarction have
higher in-hospital mortality. Thus, comprehensive cardiac evaluations, and
in some cases, elective coronary revascularizations, are performed prior
to surgery with an intent to minimize these complications. In 2009,
approximately 4% of all elective percutaneous coronary interventions were
performed in preparation for noncardiac surgery. Areas covered: We discuss
relevant articles from the last 50 years regarding elective preoperative
coronary revascularization prior to noncardiac surgery. Expert opinion: In
the early years there was an interest in preemptive revascularization to
reduce postoperative cardiac events; however, subsequent studies in
patients with stable coronary artery disease have mostly shown that a
strategy of routine prophylactic coronary revascularization prior to
noncardiac surgery does not reduce postoperative cardiac
complications. Copyright © 2020, © 2020 Informa UK Limited,
trading as Taylor & Francis Group.

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