EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
612299461
Title
Long-term outcomes of mitral valve repair versus replacement for
degenerative disease: A systematic review.
Source
Current Cardiology Reviews. 11 (2) (pp 157-162), 2015. Date of
Publication: 01 Jan 2015.
Author
McNeely C.A.; Vassileva C.M.
Institution
(McNeely, Vassileva) Department of Cardiothoracic Surgery, Southern
Illinois University School of Medicine, Springfield, IL, United States
Publisher
Bentham Science Publishers (P.O. Box 294, Bussum 1400 AG, Netherlands)
Abstract
The short-term advantage of mitral valve repair versus replacement for
degenerative disease has been extensively documented. These advantages
include lower operative mortality, improved survival, better preservation
of leftventricular function, shorter post-operative hospital stay, lower
total costs, and fewer valve-related complications, including
thromboembolism, anticoagulation-related bleeding events and late
prosthetic dysfunction. More recent written data are available indicating
the long-term advantage of repair versus replacement. While at some
institutions, the repair rate for degenerative disease may exceed 90%, the
national average in 2007 was only 69%. Making direct comparisons between
mitral valve repair and replacement using the available studies does
present some challenges however, as there are often differences in
baseline characteristics between patient groups as well as other
dissimilarities between studies. The purpose of this review is to
systematically summarize the long-term survival and reoperation data of
mitral valve repair versus replacement for degenerative disease. A PubMed
search was done and resulted in 12 studies that met our study criteria for
comparing mitral valve repair versus replacement for degenerative disease.
A systematic review was then conducted abstracting survival and
reoperation data.<br/>Copyright &#xa9; 2015 Bentham Science Publishers.

<2>
Accession Number
2006835263
Title
Gut microbiota-dependent trimethylamine N-oxide and all-cause mortality:
Findings from an updated systematic review and meta-analysis.
Source
Nutrition. 78 (no pagination), 2020. Article Number: 110856. Date of
Publication: October 2020.
Author
Farhangi M.A.
Institution
(Farhangi) Research Center for Evidence Based Medicine, Health Management
and Safety Promotion Research Institute, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
The gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) has
been regarded as one of the potent risk factors for cardiovascular events
and diabetes. In the current meta-analysis we quantitatively summarized
and updated the results of studies regarding the association between TMAO
and mortality. A systematic search was performed from PubMed, ProQuest,
Scopus, and Embase. All of the studies that evaluated the association
between TMAO and mortality were included in the systematic review and
meta-analysis. Subgroup analysis and meta-regression were performed to
identify the source of heterogeneity. There were 31 230 participants
included and the results showed that being in the highest category of TMAO
increased the hazard ratio (HR) of mortality by 47%. Moreover, there was a
non-linear association between increased TMAO concentrations and HR of
mortality. In the current dose-response meta-analysis, we revealed a
positive association between TMAO and mortality risk among an adult
population.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<3>
Accession Number
2004700450
Title
Dexmedetomidine in the prevention of postoperative delirium in elderly
patients following non-cardiac surgery: A systematic review and
meta-analysis.
Source
Clinical and Experimental Pharmacology and Physiology. 47 (8) (pp
1333-1341), 2020. Date of Publication: 01 Aug 2020.
Author
Shen Q.-H.; Li H.-F.; Zhou X.-Y.; Yuan X.-Z.
Institution
(Shen, Zhou, Yuan) Department of Anesthesiology, The First Hospital of
Jiaxing, Affiliated Hospital of Jiaxing University, Zhejiang, China
(Li) Department of Gynecology, Tongxiang Maternal and Child Health Care
Hospital, Tongxiang, China
Publisher
Blackwell Publishing
Abstract
The efficacy of dexmedetomidine in the prevention of postoperative
delirium (POD) remains ambiguous, however, it has been used to reduce the
incidence of delirium in elderly patients. Here, we conducted a
meta-analysis study for assessing the effects of dexmedetomidine on POD
among elderly patients following non-cardiac surgery. A systematic
literature search was performed against the PubMed, EMBASE, Cochrane
Library, and Web of Science databases, and all relevant literature
published till November 30, 2019, were considered. Our analysis included
16 randomised controlled trials conducted with 4534 patients for exploring
the effects of dexmedetomidine on POD in elderly patients following
non-cardiac surgery. It was observed that the overall incidence of POD was
significantly lower in the dexmedetomidine group than in the control group
(risk ratio [RR] 0.51, 95% confidence interval [CI] 0.43-0.61, P <.01).
Similar results were obtained from subgroup analysis upon comparison of
the placebo (RR 0.52, 95% CI 0.41-0.66, P <.01, moderate quality of
evidence), propofol-treated (RR 0.55, 95% CI 0.38-0.78, P <.01, low
quality of evidence), and midazolam-treated (RR 0.38, 95% CI 0.20-0.71, P
<.01, low quality of evidence) groups. Trial sequential analysis revealed
that the cumulative z-value superseded the monitoring boundary and reached
the required information size. However, patients who received
dexmedetomidine had a higher incidence of bradycardia and hypotension. In
conclusion, the meta-analysis revealed that dexmedetomidine appears to
decrease the risk of POD in elderly patients following non-cardiac
surgery. However, as some of the studies were heterogeneous and of low
quality, high-quality trials are necessary for drawing more definitive
conclusions.<br/>Copyright &#xa9; 2020 John Wiley & Sons Australia, Ltd

<4>
Accession Number
632245525
Title
Safety and Effectiveness of Early Oral Hydration in Patients After
Cardiothoracic Surgery.
Source
American journal of critical care : an official publication, American
Association of Critical-Care Nurses. 29 (4) (pp 292-300), 2020. Date of
Publication: 01 Jul 2020.
Author
Ford C.; McCormick D.; Parkosewich J.; Derycke-Chapman K.; Marshall J.;
Mancarella J.; Chepulis A.
Institution
(Ford, McCormick, Parkosewich, Derycke-Chapman, Marshall, Mancarella,
Chepulis) About the Authors: Catherine Ford and Donna McCormick are
clinical nurses; Katrien Derycke-Chapman, Judith Marshall, Jessica
Mancarella, and Anne Chepulis are former clinical nurses in the
cardiothoracic intensive care unit, Heart and Vascular Center, Yale New
Haven Hospital, New Haven, Connecticut
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients fast after cardiothoracic surgery because of concerns
for nausea, vomiting, dysphagia, and aspiration pneumonia; fasting,
however, causes thirst, a distressing symptom. To our knowledge, no
studies exist to guide hydration practices in this population.
<br/>OBJECTIVE(S): To determine the effect of early oral hydration on
adverse events and thirst in patients after cardiothoracic surgery.
<br/>METHOD(S): This study applied a prospective 2-group design in which
149 patients from an 18-bed cardiothoracic intensive care unit were
randomized to either usual care (a 6-hour fast) or early oral hydration
after extubation. The research protocol involved nurses evaluating
patients' readiness for oral hydration and then offering them ice chips.
If patients tolerated the ice chips, they were allowed to drink water 1
hour later. <br/>RESULT(S): Most patients (91.3%) had undergone coronary
artery or valve surgery, or both. Demographic and clinical variables were
similar in both groups. No significant between-group differences were
found for the incidence of nausea, vomiting, or dysphagia, and no
aspiration pneumonia occurred. Significantly more patients with a high
thirst level were in the usual care group (81.2%) than in the early oral
hydration group (56.5%; P = .002, r2 test). After adjustment for
demographic and clinical variables by using logistic regression, early
oral hydration was independently and negatively associated with a high
thirst level (odds ratio, 0.30 [95% CI, 0.13-0.69]; P = .004).
<br/>CONCLUSION(S): This research provides new evidence that oral
hydration (ice chips and water) soon after extubation is safe and
significantly reduces thirst in particular patients.<br/>Copyright &#xa9;
2020 American Association of Critical-Care Nurses.

<5>
Accession Number
632241283
Title
Congenital heart disease diagnosed with echocardiogram in newborns with
asymptomatic cardiac murmurs: a systematic review.
Source
BMC pediatrics. 20 (1) (pp 322), 2020. Date of Publication: 30 Jun 2020.
Author
Yoon S.A.; Hong W.H.; Cho H.J.
Institution
(Yoon) Department of Pediatrics, Chungbuk National University Hospital,
(28644) 1 Chungdae-ro ,Seowon-gu ,Cheongju-si ,Chungcheongbuk-do, South
Korea
(Hong) College of Medicine, Medical Research Information Center, Chungbuk
National University, (28644) 1 Chungdae-ro ,Seowon-gu ,Cheongju-si
,Chungcheongbuk-do, South Korea
(Cho) Department of Pathology, Inje University Busan Paik Hospital,
(47392) 75 Bokji-ro ,Busanjin-gu, Busan, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: More than 50% of newborns with congenital heart disease (CHD)
are unrecognized at birth; however, the use of echocardiogram (Echo) for
diagnosing CHD in newborns with asymptomatic, non-syndromic cardiac
murmurs (ANCM), has not been systematically reviewed yet. We aimed to
identify the incidence of CHD diagnosed with Echo and systematically
review whether Echo should be recommended in this patient group.
<br/>METHOD(S): The methodology utilized in this systematic review adhered
to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
framework. Using the MEDLINE, EMBASE, Web of Science, and Cochrane Library
databases, we performed a systematic review of publications reporting CHD
diagnosed with Echo in newborns with cardiac murmurs. The quality of the
included studies was evaluated using the Study Quality Assessment Tools
developed by the National Institutes of Health. <br/>RESULT(S): Of the 630
studies screened, six cohort studies, four cross-sectional studies, and
two case reports were included in this review. The incidence of cardiac
murmurs ranged from 0.6-8.6%. Among the 1928 newborns with ANCM, 719
(37.3%) were diagnosed with Echo as having CHD, and ventricular septal
defect was the most common congenital malformation. More than 50% of the
newborns showed moderate CHD necessitating outpatient cardiology
follow-up, and 2.5% had severe CHD requiring immediate interventions, such
as cardiac catheterization and heart surgery. <br/>CONCLUSION(S): In this
systematic review, a high incidence of CHD in newborns with ANCM was
detected using Echo. This indicates that the use of Echo for diagnosing
CHD in healthy newborns with cardiac murmurs could be helpful in earlier
detection of CHD, thereby improving clinical outcomes for newborns with
severe CHD.

<6>
Accession Number
632241203
Title
Coronary Stent Thrombosis- Predictors and Prevention.
Source
Deutsches Arzteblatt international. 117 (18) (pp 320-326), 2020. Date of
Publication: 01 May 2020.
Author
Ullrich H.; Munzel T.; Gori T.
Institution
(Ullrich) Cardiology Center, Cardiology I, Universitiy Medical Center,
Johannes Gutenberg University Mainz, German Center of Cardiovascular
Research (Deutsches Zentrum fur Herz-Kreislauf-Forschung, Rhine-Main
Publisher
NLM (Medline)
Abstract
BACKGROUND: Stent thrombosis (ST) is a dreaded complication after stent
implantation and is associated with a mortality between 5% and 45%. The
mechanisms by which ST arises are complex. Because of the seriousness of
this situation, all phy - sicians should have at least basic knowledge of
it. In this article, we present the risk factors for ST and discuss some
innovative approaches to its treatment. <br/>METHOD(S): This review is
based on pertinent articles retrieved by a selective search in PubMed, and
on current international guidelines and expert recommendations.
<br/>RESULT(S): The frequency of ST has been markedly lowered by technical
advances in coronary stenting and by the implementation of modern
implantation techniques, including the introduction of coverage with dual
antiplatelet therapy (DAPT). Both patient-related risk factors and
procedural aspects can elevate the risk of ST. The independent risk
factors for ST include premature termination of DAPT (hazard ratio [HR]
26.8; 95% confidence interval [8.4; 85.4]; p <0.0001), malignant disease
(odds ratio [OR]: 17.45; [4.67; 65.26]; p <0.0001), and diabetes mellitus
(OR: 3.14; [1.33; 7.45]; p = 0.0093). In comparison to angiographically
guided procedures, the use of intracoronary imaging techniques in patients
with acute coronary syndrome lowers the frequency of ST (0.6% versus 1.2%;
p = 0.005). These techniques enable the detection of many findings in the
coronary arteries that are associated with the development of ST. In such
cases, countermeasures such as secondary stent dilatation or prolongation
of DAPT can help prevent ST. <br/>CONCLUSION(S): As the pathophysiology of
ST is multifactorial, research in this area presents a special challenge.
Prospective clinical trials will be needed to determine whether the
systematic use of imaging techniques can lower the frequency of ST.

<7>
Accession Number
2006737556
Title
Coronary Revascularization Reduces Postoperative Cardiac Events and
Improves Survival of Vascular Surgery Patients Compared With Best Medical
Therapy.
Source
Journal of Vascular Surgery. Conference: 2020 Vascular Annual Meeting.
Metro Toronto Convention Centre, Canada. 72 (1) (pp e44-e45), 2020. Date
of Publication: July 2020.
Author
Krievins D.; Zellans E.; Latkovskis G.; Rumba R.; Jegere S.; Kumsars I.;
Zarins C.
Institution
(Krievins, Zellans, Latkovskis, Rumba, Jegere, Kumsars) Stradins
University Hospital, Riga, Latvia
(Zarins) HeartFlow, Inc., Riga, Latvia
Publisher
Mosby Inc.
Abstract
Objective: Vascular surgery patients have increased risk of postoperative
death/myocardial infarction (MI), but randomized trials show no survival
benefit from preoperative coronary revascularization. A new noninvasive
test, coronary computed tomography angiography (CTA)-derived fractional
flow reserve (FFRCT), can identify patients with coronary ischemia and
guide coronary revascularization. We sought to determine whether
FFRCT-guided coronary revascularization can reduce preoperative cardiac
events and improve survival compared with best medical management.
<br/>Method(s): We compared 2-year outcomes of patients undergoing lower
extremity revascularization in two consecutive Institutional Review
Board-approved trials at our institution: group I, patients with no
cardiac symptoms having preoperative FFRCT to detect silent ischemia with
selective postoperative coronary revascularization; and group II, patients
enrolled in the randomized, double-blind study of postoperative medical
care +/- rivaroxaban (VOYAGER trial) with exclusion of patients with
history of MI or prior coronary revascularization. In group I,
lesion-specific coronary ischemia was defined as FFRCT <=0.80, with FFRCT
<=0.75 indicating severe ischemia. The primary end point was major adverse
cardiovascular events (cardiac death, MI, or unplanned coronary
revascularization); secondary end points were MI, cardiovascular death,
stroke, and survival at 1 year and 2 years. <br/>Result(s): Group I (n =
77) and group II (n = 76) were similar with regard to age (66 +/- 9 years
vs 66 +/- 8 years), sex (79/78% male), comorbidities, medications,
preoperative ankle-brachial index, and indications for surgery (critical
limb-threatening ischemia in >80%). Coronary CTA in group I showed
extensive calcification (Agatston score, 1229 +/- 1096) with >=50%
stenosis in 52 patients (68%). FFRCT revealed silent coronary ischemia in
69%, with severe ischemia in 56%, multivessel ischemia in 43%, and left
main in 8%. Vascular surgery was performed in all patients with no
cardiovascular events. After recovery from surgery, coronary angiography
was performed in 43 patients (56%) with coronary revascularization in 29
patients (38%). Group II had no coronary revascularization.
Postoperatively, both groups had guideline-directed medical care +/-
rivaroxaban in group II. At 1 year, compared with group II, cardiac deaths
were reduced in group I (0% vs 7.9%; P =.014), as were MIs (2.6% vs 11.8%;
P =.03). During 2 years of follow-up, group I showed a reduction in major
adverse cardiovascular events (2.6% vs 11.8%; P =.03; Fig 1) and improved
survival (98.7% vs 86.8%; P =.007, Kaplan-Meier, log-rank test; Fig 2).
<br/>Conclusion(s): Preoperative diagnosis of silent coronary ischemia
using CTA-FFRCT with selective postoperative coronary revascularization
reduced postoperative cardiac death and MI and improved 2-year survival
compared with standard coronary care with best medical therapy.
Prospective controlled studies are needed to further define the role of
coronary revascularization in patients undergoing peripheral vascular
surgery. [Formula presented] [Formula presented]<br/>Copyright &#xa9; 2020

<8>
Accession Number
2006965521
Title
The Hybrid Coronary Approach for Optimal Revascularization: JACC Review
Topic of the Week.
Source
Journal of the American College of Cardiology. 76 (3) (pp 321-333), 2020.
Date of Publication: 21 July 2020.
Author
Moreno P.R.; Stone G.W.; Gonzalez-Lengua C.A.; Puskas J.D.
Institution
(Moreno, Stone, Gonzalez-Lengua, Puskas) Mount Sinai Heart, Mount Sinai
Hospital, Mount Sinai Morningside Hospital, New York, NY, United States
(Moreno, Stone, Gonzalez-Lengua, Puskas) Icahn School of Medicine at Mount
Sinai, New York, NY, United States
Publisher
Elsevier USA
Abstract
Coronary revascularization is accomplished either by percutaneous coronary
intervention (PCI), with low risk of immediate complications, or coronary
artery bypass graft (CABG), with improved long-term, event-free survival
attributable to use of the left internal mammary artery graft. Hybrid
coronary revascularization (HCR) combines both. The left internal mammary
artery graft is done by sternal-sparing approaches or by robotic-assisted,
endoscopic surgery. HCR reduces bleeding, ventilator time, and length of
stay compared with traditional CABG. Compared with PCI, HCR offers the
durability and survival advantages of the left internal mammary artery.
The large-scale National Heart, Lung, and Blood Institute-sponsored,
randomized Hybrid Trial (Hybrid Coronary Revascularization Trial) was
initiated to examine whether HCR is superior to multivessel PCI. However,
enrollment was suboptimal, triggering premature study discontinuation. HCR
integrates the positive features of both PCI and CABG, albeit requiring 2
procedures rather than 1. Adequately powered randomized trials are
required to evaluate the outcomes and cost-effectiveness of HCR compared
with CABG and multivessel PCI alone.<br/>Copyright &#xa9; 2020 American
College of Cardiology Foundation

<9>
Accession Number
2005473385
Title
Meta-analysis of right ventricular function in patients with aortic
stenosis after transfemoral aortic valve replacement or surgical aortic
valve replacement.
Source
Therapeutic Advances in Chronic Disease. 11 (no pagination), 2020. Date of
Publication: 2020.
Author
Cao Y.; Singh V.; Wang A.; Zhang L.; He T.; Su H.; Wei R.; Duan Y.; Jiang
K.; Wu W.; Huang Y.; Elmariah S.; Qi G.; Su X.; Zhang Y.; Zhang M.
Institution
(Cao) Department of Cardiology, Gansu Provincial Hospital, No. 204,
Donggang West RoadChengguan District, Lanzhou, Gansu 730000, China
(Singh) Division of Cardiovascular Medicine, University of Louisville
School of Medicine, Louisville, KY, United States
(Wang, Su, Wei, Huang) Department of Cardiology, Gansu Provincial
Hospital, Lanzhou, China
(Zhang, He, Jiang, Su) Clinical Medicine School, Gansu University of
Chinese Medicine, Lanzhou, China
(Duan, Wu) School of Clinical Medicine, Ningxia Medical University,
Ningxia, China
(Elmariah) Cardiology Division, Department of Medicine, Massachusetts
General Hospital, Harvard Medical School Boston, MA, United States
(Qi) Pulmonary and Critical Care Division, Tufts Medical Center, Boston,
MA, United States
(Zhang) Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin
International Joint Research and Development Center of Ophthalmology and
Vision Science, Eye Institute and School of Optometry, Tianjin Medical
University Eye Hospital, No. 251, Fukang RoadNankai District, Tianjin,
China
(Zhang) Department of Pathology, Gansu Provincial Hospital, No.204,
Donggang West RoadChengguan District, Lanzhou, Gansu 730000, China
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Background: Right ventricular function (RVF) is an independent predictor
of prognosis for patients undergoing aortic valve replacement:
transcatheter aortic valve replacement (TAVR) or surgical aortic valve
replacement (SAVR). The effect of transfemoral aortic valve replacement
(TF-TAVR) on RVF is uncertain. We aimed to perform a meta-analysis of the
effect of TF-TAVR on RVF in patients with aortic stenosis (AS) and compare
the effect of TF-TAVR with SAVR. <br/>Method(s): We searched relevant
studies from PubMed, Embase, Cochrane Library databases, and Web of
Science. Furthermore, two reviewers (Wang AQ and Cao YS) extracted all
relevant data, which were then double checked by another two reviewers
(Zhang M and Qi GM). We used the forest plot to present results. Tricuspid
annular plane systolic excursion (TAPSE) was the primary outcome.
<br/>Result(s): This meta-analysis included 11 studies. There were 353
patients who underwent TF-TAVR, and 358 patients who were subjected to
SAVR. There was no significant difference in TAPSE at 1 week and 6 months
as well as right ventricular ejection fraction (RVEF) at <2 weeks and 6
months after TF-TAVR. For the SAVR group, TAPSE at 1 week and 3 months as
well as fractional area change (FAC) at 3 months post procedure were
significantly aggravated, while RVEF did not change significantly.
Moreover, TAPSE post-TF-TAVR was significantly improved as compared with
post-SAVR. The TAPSE, the difference between TAPSE post-procedure and
TAPSE prior to procedure, was also significantly better in the TF-TAVR
group than in the SAVR group. <br/>Conclusion(s): RVF was maintained post
TF-TAVR. For SAVR, discrepancy in the measured parameters exists, as
reduced TAPSE indicates compromised longitudinal RVF, while insignificant
changes in RVEF implicate maintained RVF post procedure. Collectively, our
study suggests that the baseline RV dysfunction and the effect of TF-TAVR
versus SAVR on longitudinal RVF may influence the selection of aortic
valve intervention.<br/>Copyright &#xa9; The Author(s), 2020.

<10>
Accession Number
632076524
Title
Videolaryngoscopy versus direct laryngoscopy for double-lumen endotracheal
tube intubation in thoracic surgery - A randomised controlled clinical
trial.
Source
BMC Anesthesiology. 20 (1) (no pagination), 2020. Article Number: 150.
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, Baldingerstrase, Marburg 35033, Germany
(Kirschbaum) Visceral, Thoracic and Vascular Surgery Clinic, University
Hospital Giessen and Marburg GmbH, Baldingerstrase, Marburg 35033, Germany
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
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.
<br/>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. <br/>Result(s): 65 patients were
included (DL group [n = 31], GVL group [n = 34]). Median intubation time
(25th-75th percentiles) in GVL group was 93 s (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.
<br/>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. <br/>Copyright
&#xa9; 2020 The Author(s).

<11>
Accession Number
2006953918
Title
Network Meta-analysis of Surgical Aortic Valve Replacement and Different
Transcatheter Heart Valve Systems for Symptomatic Severe Aortic Stenosis.
Source
Canadian Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Ueyama H.; Kuno T.; Ando T.; Hayashida K.; Takagi H.
Institution
(Ueyama, Kuno) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Beth Israel, New York, NY, United States
(Ando) Center for Interventional Vascular Therapy, Division of Cardiology,
New York-Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
(Hayashida) Division of Cardiology, Keio University School of Medicine,
Tokyo, Japan
(Takagi) Division of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Although different transcatheter heart valve (THV) systems
have been introduced to overcome transcatheter aortic valve replacement
(TAVR)-specific complications, head-to-head comparisons of these THV
systems are scarce. The aim of this study was to compare different THV
systems and surgical aortic valve replacement (SAVR) by conducting a
network meta-analysis. <br/>Method(s): PubMed and EMBASE were searched
through November 2019 for studies comparing safety and efficacy of
balloon-expandable valve (BEV), self-expanding valve (SEV), mechanically
expandable valve (MEV), and SAVR for symptomatic severe aortic stenosis.
End points in the short term at 30 days or discharge and the long term up
to 2 years were assessed. <br/>Result(s): We identified 11 randomized
controlled trials with a total of 10,300 patients eligible for inclusion
in our study. There were no significant differences in all-cause death
among different THV systems and SAVR in both short and long terms.
Disabling stroke was significantly lower with MEV vs BEV and SAVR (hazard
ratios [HRs] 0.31 [95% confidence interval [CI] 0.12-0.77] and 0.33 [95%
CI 0.14-0.76], respectively) in the long term. MEV was associated with an
increased risk of new permanent pacemaker implantation compared with BEV,
SEV, and SAVR (HRs 3.82 [95% CI 1.83-7.97], 1.85 [95% CI 1.02-3.36], and
5.23 [95% CI 2.61-10.47], respectively) in the long term.
<br/>Conclusion(s): In patients with symptomatic severe aortic stenosis
undergoing intervention, there were no significant differences in
all-cause death among different THV systems and SAVR. MEV had low
frequency of disabling stroke compared with BEV and SAVR, but an increased
frequency of permanent pacemaker implantation compared with other
interventions.<br/>Copyright &#xa9; 2020 Canadian Cardiovascular Society

<12>
Accession Number
2005453638
Title
Comparison of the Efficacy and Safety of Direct Oral Anticoagulants and
Warfarin After Bioprosthetic Valve Replacements.
Source
Clinical Drug Investigation. (no pagination), 2020. Date of Publication:
2020.
Author
Pasciolla S.; Zizza L.F.; Le T.; Wright K.
Institution
(Pasciolla, Zizza, Le, Wright) Department of Pharmacy, ChristianaCare,
Newark, DE, United States
(Pasciolla) Philadelphia College of Pharmacy, University of the Sciences,
Philadelphia, PA, United States
Publisher
Adis
Abstract
Background and Objective: Current guidelines recommend anticoagulation
with a vitamin K antagonist (warfarin) after a bioprosthetic valve
replacement. There is minimal literature evaluating direct oral
anticoagulants (DOACs) in patients who have just received a bioprosthetic
aortic valve replacement (AVR) or mitral valve replacement (MVR). The
purpose of this study was to investigate any differences in efficacy and
safety for patients taking a DOAC, compared with warfarin, after a
bioprosthetic AVR or MVR. <br/>Method(s): A retrospective cohort study was
performed to evaluate anticoagulation in patients who received
bioprosthetic valve replacements at a large teaching hospital from 2014 to
2018. Patients included in this study received either warfarin or a DOAC
following bioprosthetic AVR or MVR, and were maintained on the same agent
throughout the 6-month follow-up period. The primary efficacy outcome was
the incidence of thromboembolic complications and the primary safety
outcome was the incidence of major bleeding within 6 months following
surgery. The rate of readmission was assessed as a secondary endpoint.
<br/>Result(s): A total of 197 patients were included; 70 patients
received warfarin and 127 patients received a DOAC (apixaban, n = 86;
rivaroxaban, n = 40; dabigatran, n = 1). Three patients experienced
thromboembolic events, all of which occurred in the DOAC group (0% vs.
2.4%; p = 0.20). Major bleeding occurred in 11 patients-two in the
warfarin group and nine in the DOAC group (2.9% vs. 7.1%; p = 0.22).
Sixty-one patients were readmitted within the 6-month time frame, with 26
readmissions in the warfarin group and 35 readmissions in the DOAC group
(37% vs. 27%; p = 0.16). <br/>Conclusion(s): This small, exploratory study
found similar rates of thromboembolic complications and major bleeding
events in patients who received a DOAC versus warfarin after a recent
bioprosthetic AVR or MVR. This study was limited by its retrospective
nature and its sample size. Larger, randomized controlled trials are
needed to further determine the efficacy and safety of DOACs in this
patient population.<br/>Copyright &#xa9; 2020, Springer Nature Switzerland
AG.

<13>
Accession Number
632237880
Title
Incidence and risk factors for new-onset atrial fibrillation following
coronary artery bypass grafting: A systematic review and meta-analysis.
Source
Intensive & critical care nursing. (pp 102897), 2020. Date of Publication:
26 Jun 2020.
Author
Higgs M.; Sim J.; Traynor V.
Institution
(Higgs) School of Nursing, Faculty of Science, Medicine and Health,
University of Wollongong, NSW, Wollongong, Australia
(Sim, Traynor) School of Nursing, Faculty of Science, Medicine and Health,
University of Wollongong, NSW, Wollongong, Australia
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To estimate the incidence of new-onset post-operative atrial
fibrillation after isolated coronary artery bypass surgery and summarise
the evidence on risk factors that predispose people to developing the
complication. STUDY DESIGN/METHODS: A systematic review was conducted to
identify studies from the CINAHL, MEDLINE and Cochrane databases. A title
and abstract review was conducted by one reviewer. Full text review and
quality assessment processes were conducted by two reviewers. Incidence
data was combined in meta-analysis using the 'metaprop' routine in Stata
and risk factor data were synthesised in narrative and table format.
<br/>RESULT(S): Ten studies, including 6173 participants, were included in
the review. The estimated pooled incidence of post-operative atrial
fibrillation was 25% (CI 0.19-0.30). In a secondary meta-analysis
including studies that only included first time bypass surgery recipients
the estimated pooled incidence was 26% (CI 0.14-0.41). Due to high levels
of heterogeneity these results should be interpreted with caution. Risk
factors with the strongest associations to post-operative atrial
fibrillation were chronic obstructive pulmonary disease, decreased partial
pressure of oxygen on air, congestive heart failure, right coronary artery
disease, male gender, prolonged cross clamp time and port-operative
inotropic exposure. <br/>CONCLUSION(S): Further prospective studies are
needed to strengthen the current evidence base.<br/>Copyright &#xa9; 2020
Elsevier Ltd. All rights reserved.

<14>
Accession Number
632236963
Title
The effect of a structured patient education intervention on the quality
of life for coronary artery bypass grafting patients: A prospective
randomised controlled study.
Source
Journal of perioperative practice. (pp 1750458920936915), 2020. Date of
Publication: 30 Jun 2020.
Author
Ozdemir B.; Onler E.
Institution
(Ozdemir, Onler) School of Health, Nursing Division, Department of
Surgical Nursing, Tekirdag Namik Kemal University, Tekirdag, Turkey
Publisher
NLM (Medline)
Abstract
This study aimed to determine the effectiveness of structured patient
education on the quality of life for coronary artery bypass grafting
patients. The research included 80 patients (40 control, 40 experimental)
who underwent coronary artery bypass graft surgery at the cardiovascular
surgery ward of a university hospital in Western Turkey and met the
criteria to be included in the sample. The following documents were used
to collect data: Patient Information Form, Knowledge Level Form and SF36
Quality of Life Scale. It was determined that the structured planned
patient education for coronary artery bypass grafting patients effectively
improved the patients' knowledge level and quality of life.

<15>
Accession Number
631336317
Title
Association of FADS1/2 Locus Variants and Polyunsaturated Fatty Acids with
Aortic Stenosis.
Source
JAMA Cardiology. 5 (6) (pp 694-702), 2020. Date of Publication: June 2020.
Author
Chen H.Y.; Cairns B.J.; Small A.M.; Burr H.A.; Ambikkumar A.; Martinsson
A.; Theriault S.; Munter H.M.; Steffen B.; Zhang R.; Levinson R.T.;
Shaffer C.M.; Rong J.; Sonestedt E.; Dufresne L.; Ljungberg J.; Naslund
U.; Johansson B.; Ranatunga D.K.; Whitmer R.A.; Budoff M.J.; Nguyen A.;
Vasan R.S.; Larson M.G.; Harris W.S.; Damrauer S.M.; Stark K.D.; Boekholdt
S.M.; Wareham N.J.; Pibarot P.; Arsenault B.J.; Mathieu P.; Gudnason V.;
O'Donnell C.J.; Rotter J.I.; Tsai M.Y.; Post W.S.; Clarke R.; Soderberg
S.; Bosse Y.; Wells Q.S.; Smith J.G.; Rader D.J.; Lathrop M.; Engert J.C.;
Thanassoulis G.
Institution
(Chen, Burr, Engert, Thanassoulis) Division of Experimental Medicine,
McGill University, Montreal, QC, Canada
(Chen, Burr, Ambikkumar, Zhang, Dufresne, Nguyen, Engert, Thanassoulis)
Preventive and Genomic Cardiology, McGill University Health Centre,
Research Institute, 1001 Decarie Blvd, Room D05.5120, Montreal, QC H4A
3J1, Canada
(Cairns, Clarke) MRC (Medical Research Council), Population Health
Research Unit, Nuffield Department of Population Health, University of
Oxford, Oxford, United Kingdom
(Cairns, Clarke) Clinical Trial Service Unit, Nuffield Department of
Population Health, University of Oxford, Oxford, United Kingdom
(Cairns, Clarke) Epidemiological Studies Unit, Nuffield Department of
Population Health, University of Oxford, Oxford, United Kingdom
(Small) Department of Medicine, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, United States
(Martinsson) Department of Cardiology, Clinical Sciences, Lund University,
Lund, Sweden
(Martinsson, Smith) Department of Cardiology, Skane University Hospital,
Lund, Sweden
(Theriault, Pibarot, Arsenault, Mathieu, Bosse) Quebec Heart and Lung
Institute, Laval University, Quebec City, QC, Canada
(Munter, Lathrop) McGill University, Genome Quebec Innovation Centre,
Montreal, QC, Canada
(Steffen, Tsai) Department of Laboratory Medicine and Pathology,
University of Minnesota, Minneapolis, MN, United States
(Levinson, Shaffer, Wells) Vanderbilt Translational and Clinical
Cardiovascular Research Center, Vanderbilt University Medical Center,
Nashville, TN, United States
(Rong, Vasan, Larson, O'Donnell) National Heart, Lung, and Blood
Institute, Bethesda, MD, United States
(Rong, Vasan, Larson, O'Donnell) Boston University's Framingham Heart
Study, Boston, MA, United States
(Sonestedt) Nutritional Epidemiology, Department of Clinical Sciences
Malmo, Lund University, Malmo, Sweden
(Ljungberg, Naslund, Johansson, Soderberg) Department of Public Health and
Clinical Medicine, Umea University, Umea, Sweden
(Ranatunga) Division of Research, Kaiser Permanente of Northern
California, Oakland, United States
(Whitmer) Department of Public Health Sciences, University of California,
Davis, United States
(Budoff, Rotter) Los Angeles Biomedical Research Institute, Torrance, CA,
United States
(Budoff, Rotter) Departments of Pediatrics and Medicine, Harbor-UCLA
(University of California Los Angeles), Medical Center, Torrance, United
States
(Harris) Department of Medicine, Sanford School of Medicine, University of
South Dakota, Sioux Falls, SD, United States
(Harris) OmegaQuant Analytics LLC, Sioux Falls, SD, United States
(Damrauer) Department of Surgery, Perelman School of Medicine, University
of Pennsylvania, Philadelphia, United States
(Stark) Department of Kinesiology, University of Waterloo, Waterloo, ON,
Canada
(Boekholdt) Department of Cardiology, Amsterdam University Medical Center,
University of Amsterdam, Amsterdam, Netherlands
(Wareham) MRC Epidemiology Unit, University of Cambridge, Cambridge,
United Kingdom
(Gudnason) Faculty of Medicine, University of Iceland, Reykjavik, Iceland
(Post) Division of Cardiology, Department of Medicine, Johns Hopkins
University, School of Medicine, Baltimore, MD, United States
(Smith) Wallenberg Center for Molecular Medicine, Lund University, Lund,
Sweden
(Smith) Lund University Diabetes Center, Lund University, Lund, Sweden
(Rader) Department of Genetics, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, United States
(Lathrop, Engert) Department of Human Genetics, McGill University,
Montreal, QC, Canada
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
Importance: Aortic stenosis (AS) has no approved medical treatment.
Identifying etiological pathways for AS could identify pharmacological
targets. <br/>Objective(s): To identify novel genetic loci and pathways
associated with AS. <br/>Design, Setting, and Participant(s): This
genome-wide association study used a case-control design to evaluate 44703
participants (3469 cases of AS) of self-reported European ancestry from
the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort
(from January 1, 1996, to December 31, 2015). Replication was performed in
7 other cohorts totaling 256926 participants (5926 cases of AS), with
additional analyses performed in 6942 participants from the Cohorts for
Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium.
Follow-up biomarker analyses with aortic valve calcium (AVC) were also
performed. Data were analyzed from May 1, 2017, to December 5, 2019.
Exposures: Genetic variants (615643 variants) and polyunsaturated fatty
acids (omega-6 and omega-3) measured in blood samples. <br/>Main Outcomes
and Measures: Aortic stenosis and aortic valve replacement defined by
electronic health records, surgical records, or echocardiography and the
presence of AVC measured by computed tomography. <br/>Result(s): The mean
(SD) age of the 44703 GERA participants was 69.7 (8.4) years, and 22019
(49.3%) were men. The rs174547 variant at the FADS1/2 locus was associated
with AS (odds ratio [OR] per C allele, 0.88; 95% CI, 0.83-0.93; P = 3.0 x
10^-6), with genome-wide significance after meta-analysis with 7
replication cohorts totaling 312118 individuals (9395 cases of AS) (OR,
0.91; 95% CI, 0.88-0.94; P = 2.5 x 10^-8). A consistent
association with AVC was also observed (OR, 0.91; 95% CI, 0.83-0.99; P
=.03). A higher ratio of arachidonic acid to linoleic acid was associated
with AVC (OR per SD of the natural logarithm, 1.19; 95% CI, 1.09-1.30; P =
6.6 x 10^-5). In mendelian randomization, increased FADS1 liver
expression and arachidonic acid were associated with AS (OR per unit of
normalized expression, 1.31 [95% CI, 1.17-1.48; P = 7.4 x
10^-6]; OR per 5-percentage point increase in arachidonic acid
for AVC, 1.23 [95% CI, 1.01-1.49; P =.04]; OR per 5-percentage point
increase in arachidonic acid for AS, 1.08 [95% CI, 1.04-1.13; P = 4.1 x
10^-4]). <br/>Conclusions and Relevance: Variation at the
FADS1/2 locus was associated with AS and AVC. Findings from biomarker
measurements and mendelian randomization appear to link omega-6 fatty acid
biosynthesis to AS, which may represent a therapeutic
target.<br/>Copyright &#xa9; 2020 American Medical Association. All rights
reserved.

<16>
Accession Number
2006865641
Title
Multivessel Versus Culprit-Only Revascularization in STEMI and Multivessel
Coronary Artery Disease: Meta-Analysis of Randomized Trials.
Source
JACC: Cardiovascular Interventions. 13 (13) (pp 1571-1582), 2020. Date of
Publication: 13 July 2020.
Author
Atti V.; Gwon Y.; Narayanan M.A.; Garcia S.; Sandoval Y.; Brilakis E.S.;
Basir M.B.; Turagam M.K.; Khandelwal A.; Mena-Hurtado C.; Mamas M.A.;
Abbott J.D.; Bhatt D.L.; Velagapudi P.
Institution
(Atti) Department of Internal Medicine, Michigan State University,
Lansing, MI, United States
(Gwon, Velagapudi) Division of Cardiology, University of Nebraska Medical
Center, Omaha, NE, United States
(Narayanan, Mena-Hurtado) Division of Cardiology, Yale-New Haven Hospital,
Hartford, CT, United States
(Garcia, Brilakis) Division of Cardiology, Minneapolis Heart Institute,
Minneapolis, MN, United States
(Sandoval) Division of Cardiology, Mayo Clinic, Rochester, MN, United
States
(Basir, Khandelwal) Division of Cardiology, Henry Ford Hospital, Detroit,
MI, United States
(Turagam) Division of Cardiology, The Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Mamas) Division of Cardiology, Keele University, New Castle, United
Kingdom
(Abbott) Division of Cardiology, Brown University, Providence, RI, United
States
(Bhatt) Division of Cardiology, Brigham and Women's Hospital Heart and
Vascular Center, Harvard Medical School, Boston, MA, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The goal of this systematic review and meta-analysis was to
provide a comprehensive evaluation of contemporary randomized trials
addressing the efficacy and safety of multivessel versus culprit
vessel-only percutaneous coronary intervention (PCI) among patients
presenting with ST-segment elevation myocardial infarction and multivessel
coronary artery disease. <br/>Background(s): Multivessel coronary artery
disease is present in about one-half of patients with ST-segment elevation
myocardial infarction. Randomized controlled trials comparing multivessel
and culprit vessel-only PCI produced conflicting results regarding the
benefits of a multivessel PCI strategy. <br/>Method(s): A comprehensive
search for published randomized controlled trials comparing multivessel
PCI with culprit vessel-only PCI was conducted on ClinicalTrials.gov,
PubMed, Web of Science, EBSCO Services, the Cochrane Central Register of
Controlled Trials, Google Scholar, and scientific conference sessions from
inception to September 15, 2019. A meta-analysis was performed using a
random-effects model to calculate the risk ratio (RR) and 95% confidence
interval (CI). Primary efficacy outcomes were all-cause mortality and
reinfarction. <br/>Result(s): Ten randomized controlled trials were
included, representing 7,030 patients: 3,426 underwent multivessel PCI and
3,604 received culprit vessel-only PCI. Compared with culprit vessel-only
PCI, multivessel PCI was associated with no significant difference in
all-cause mortality (RR: 0.85; 95% CI: 0.68 to 1.05) and lower risk for
reinfarction (RR: 0.69; 95% CI: 0.50 to 0.95), cardiovascular mortality
(RR: 0.71; 95% CI: 0.50 to 1.00), and repeat revascularization (RR: 0.34;
95% CI: 0.25 to 0.44). Major bleeding (RR: 0.92; 95% CI: 0.50 to 1.67),
stroke (RR: 1.15; 95% CI: 0.65 to 2.01), and contrast-induced nephropathy
(RR: 1.25; 95% CI: 0.80 to 1.95) were not significantly different between
the 2 groups. <br/>Conclusion(s): Multivessel PCI was associated with a
lower risk for reinfarction, without any difference in all-cause
mortality, compared with culprit vessel-only PCI in patients with
ST-segment elevation myocardial infarction.<br/>Copyright &#xa9; 2020
American College of Cardiology Foundation

<17>
Accession Number
2006860329
Title
Complete Revascularization in Patients With STEMI and Multi-Vessel
Disease: A Meta-Analysis of Randomized Controlled Trials.
Source
Cardiovascular Revascularization Medicine. 21 (5) (pp 684-691), 2020. Date
of Publication: May 2020.
Author
Al-Abdouh A.; Barbarawi M.; Bizanti A.; Abudaya I.; Upadhrasta S.; Elias
H.; Zhao D.; Savji N.; Lakshman H.; Hasan R.; Michos E.D.
Institution
(Al-Abdouh, Bizanti, Abudaya, Upadhrasta) Department of Medicine, Saint
Agnes Hospital, Baltimore, MD, United States
(Barbarawi, Lakshman) Department of Medicine, Hurley Medical Center,
Michigan State University, Flint, MI, United States
(Elias) Department of Cardiology, Geisenger Medical Center, PA, United
States
(Zhao, Michos) Department of Epidemiology, Johns Hopkins University,
Baltimore, MD, United States
(Savji, Hasan, Michos) Division of Cardiology, Johns Hopkins School of
Medicine, Baltimore, MD, United States
(Michos) The Ciccarone Center for the Prevention of Cardiovascular
Disease, Johns Hopkins School of Medicine, Baltimore, MD, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Percutaneous coronary intervention (PCI) is the treatment of
choice for ST-elevation myocardial infarction (STEMI). However, efficacy
of complete vs culprit only revascularization in patients with STEMI and
multivessel disease remains unclear. <br/>Method(s): We searched
PubMed/MEDLINE, and Cochrane library. The primary endpoint was major
adverse cardiovascular events (MACE). Secondary outcomes were all-cause
mortality, cardiovascular mortality, myocardial infarction (MI), repeat
revascularization, stroke, major bleeding, and contrast induced
nephropathy. Estimates were calculated as random effects hazard ratios
(HRs) with 95% confidence intervals (CI). <br/>Result(s): Twelve trials
with 7592 patients were included. There was a significantly lower risk of
MACE [HR 0.61; 95% CI (0.43-0.60); p = 0.0009; I² = 72%],
cardiovascular mortality [HR 0.74; 95% CI (0.56-0.99); p = 0.04;
I² = 2%], and repeat revascularization [HR 0.43; 95% CI
(0.31-0.59); p < 0.00001; I² = 67%] in patients treated with
complete compared with culprit-only revascularization. There was no
statistically significant difference in MI [HR 0.77; 95% CI (0.52-1.12); p
= 0.17; I² = 49%], all-cause mortality [HR 0.86; 95% CI
(0.65-1.13); p = 0.28; I² = 14%], heart failure [HR 0.82 95% CI
(0.51-1.32); p = 0.42; I² = 26%], major bleeding [HR 1.07; 95%
CI (0.66-1.75); p = 0.78; I² = 25%], stroke [HR 0.67; 95% CI
(0.24-1.89); p = 0.45; I² = 54%], or contrast induced
nephropathy, although higher contrast volumes were used in the complete
revascularization group [HR 1.22; 95% CI (0.78-1.92); p = 0.39;
I² = 0%]. <br/>Conclusion(s): Complete revascularization was
associated with a significantly lower risk of MACE, cardiovascular
mortality, and repeat revascularization compared with culprit-only
revascularization. These results suggest complete revascularization with
PCI following STEMI and multivessel disease should be
considered.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<18>
Accession Number
2004443186
Title
Minimally Invasive Surgery vs Device Closure for Atrial Septal Defects: A
Systematic Review and Meta-analysis.
Source
Pediatric Cardiology. 41 (5) (pp 853-861), 2020. Date of Publication: 01
Jun 2020.
Author
Mylonas K.S.; Ziogas I.A.; Evangeliou A.; Hemmati P.; Schizas D.; Sfyridis
P.G.; Economopoulos K.P.; Bakoyiannis C.; Kapelouzou A.; Tzifa A.;
Avgerinos D.V.
Institution
(Mylonas, Sfyridis) Department of Pediatric Cardiac Surgery, Mitera
Children's Hospital, HYGEIA Group, Athens, Greece
(Mylonas, Schizas) First Department of Surgery, Laiko General Hospital,
National and Kapodistrian University of Athens, Athens 11527, Greece
(Ziogas) Department of Surgery, Vanderbilt Medical Center, Nashville, TN,
United States
(Ziogas, Evangeliou, Economopoulos) Surgery Working Group, Society of
Junior Doctors, Athens, Greece
(Hemmati) Department of Surgery, Mayo Clinic, Rochester, MN, United States
(Economopoulos) Department of Surgery, Duke University Medical Center,
Durham, NC, United States
(Bakoyiannis) Division of Vascular Surgery, Laikon General Hospital,
National and Kapodistrian University of Athens, Athens, Greece
(Kapelouzou) Clinical, Experimental Surgery & Translational Research,
Biomedical Research Foundation Academy of Athens, Athens, Greece
(Tzifa) Department of Pediatric Cardiology and Adult Congenital Heart
Disease, Mitera Children's Hospital, HYGEIA Group, Athens, Greece
(Avgerinos) Department of Cardiothoracic Surgery, New York Presbyterian
Hospital, Weill Cornell Medicine, New York City, NY, United States
Publisher
Springer
Abstract
Device closure is the first-line treatment for most atrial septal defects
(ASDs). Minimally invasive cardiac surgery (MICS) has been found safe and
effective for ASD closure with comparable mortality/morbidity and superior
cosmetic results compared to conventional median sternotomy. Our goal was
to compare percutaneous versus MICS of ASDs. A systematic review was
performed using PubMed and the Cochrane Library (end-of-search date on May
22, 2019). Meta-analyses were conducted using fixed and random effects
models. In the present systematic review, we analyzed six studies
including 1577 patients with ASDs who underwent either MICS (n = 642) or
device closure (n = 935). Treatment efficacy was significantly higher in
the MICS (99.8%; 95% CI 98.9-99.9) compared to the device closure group
(97.3%; 95% CI 95.6-98.2), (OR 0.1; 95% CI 0.02-0.6). Surgical patients
experienced significantly more complications (16.2%; 95% CI 13.0-19.9)
compared to those that were treated with a percutaneous approach (7.1%;
95% CI 5.0-9.8), (OR 2.0; 95% CI 1.2-3.2). Surgery was associated with
significantly longer length of hospital stay (5.6 +/- 1.7 days) compared
to device closure (1.3 +/- 1.4 days), (OR 4.8; 95% CI 1.1-20.5). Residual
shunts were more common with the transcatheter (3.9%; 95% CI 2.7-5.5)
compared to the surgical approach (0.95%; 95% CI 0.3-2.4), (OR 0.1; 95% CI
0.06-0.5). There was no difference between the two techniques in terms of
major bleeding, hematoma formation, transfusion requirements, cardiac
tamponade, new-onset atrial fibrillation, permanent pacemaker placement,
and reoperation rates. MICS for ASD is a safe procedure and compares
favorably to transcatheter closure. Despite longer hospitalization
requirements, the MICS approach is feasible irrespective of ASD anatomy
and may lead to a more effective and durable repair.<br/>Copyright &#xa9;
2020, Springer Science+Business Media, LLC, part of Springer Nature.

<19>
[Use Link to view the full text]
Accession Number
2004197902
Title
Multicenter Assessment of Grafts in Coronaries: Midterm Evaluation of the
C-Port Device (the MAGIC Study).
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 13 (4) (pp 273-281), 2018. Date of Publication: 01 Jul 2018.
Author
Balkhy H.H.; Patel N.C.; Ramshandani M.; Kitahara H.; Subramanian V.A.;
Augelli N.V.; Tobler G.; Cai T.H.
Institution
(Balkhy, Kitahara) Division of Cardiothoracic Surgery, The University of
Chicago Medicine, Chicago, IL, United States
(Patel, Subramanian) Department of Cardiac Surgery, Lenox Hill Hospital,
New York, NY, United States
(Ramshandani) Department of Cardiothoracic Surgery, Houston Methodist
Hospital, Houston, TX, United States
(Augelli) Department of Cardiac Surgery, ThedaCare Regional Medical
Center, Appleton, WI, United States
(Tobler) Department of Cardiothoracic Surgery, John L. McClellan Veterans
Administration Medical Center, Little Rock, AR, United States
(Cai) Department of Cardiothoracic Surgery, CRSTI Heart Hospital, Plano,
TX, United States
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Objective: The commercially available C-Port distal anastomotic device
(Food and Drug Administration cleared in 2007) is an automated miniature
vascular stapler that performs the coronary anastomosis. This prospective
multicenter registry sought to evaluate midterm patency using this device
compared with hand-sewn grafts. <br/>Method(s): Patients receiving at
least one C-Port anastomosis during coronary artery bypass grafting
surgery were enrolled at eight sites. Of the 117 patients enrolled, 78
patients (67%) with 104 C-Port vein grafts completed the study to patency
assessment via computed tomography angiography. Clinical follow-up and
index graft patency (Gated 64-slice computed tomography scan) were
performed at least 12 months postoperatively. The primary efficacy
endpoint was patency compared with the peer-reviewed results from the
PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT IV)
trial. <br/>Result(s): The patient population was consistent with the
PREVENT IV placebo cohort. The mortality at 12 months was 0.85% (1/117).
The major cardiac morbidity rate was 3.4% (4/117). The C-Port vein graft
occlusion rate was 16.3% (17/104) compared with 26.6% (597/2242) in the
PREVENT IV trial (P = 0.011). Within this study, C-Port graft occlusion
rates were not significantly different from the hand-sewn grafts (P =
0.821). <br/>Conclusion(s): The C-Port device is safe and effective in
creating the distal anastomosis with equivalent patency rates to hand-sewn
grafts at 12 months. When compared with hand-sewn anastomoses from a
recent large prospective trial, the C-Port device demonstrated a
statistically significant reduction in midterm graft occlusion. Further
studies are required to evaluate its effect in less invasive coronary
surgery.<br/>Copyright &#xa9; 2018 International Society for Minimally
Invasive Cardiothoracic Surgery.

<20>
Accession Number
631599532
Title
The Effect of Acupressure on Acute Pain During Venipuncture in Children:
Implications for Evidence-Based Practice.
Source
Worldviews on evidence-based nursing. 17 (3) (pp 221-228), 2020. Date of
Publication: 01 Jun 2020.
Author
Koc Ozkan T.; Balci S.
Institution
(Koc Ozkan) Midwifery Department, Adiyaman University Faculty of Health
Sciences, Adiyaman, Turkey
(Balci) Department of Child Health and Diseases Nursing, Florence
Nightingale Faculty of Nursing, Istanbul University, Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
AIMS: The study was conducted as a randomized controlled trial in order to
determine the effects of acupressure on acute pain during venipuncture in
children. <br/>METHOD(S): The population of the study consisted of
children, aged between 9 and 12 years, who received venipuncture between
September 2015 and June 2016 at a university hospital in Istanbul. The
sample consisted of a total of 90 children, including 45 children in the
acupressure group and 45 children in the control group, who met the sample
inclusion criteria. The results of the study were obtained by using an
information form, the State Anxiety Inventory for Children (STAIC), the
visual analog scale (VAS), and the Faces Pain Scale-Revised (FPS-R).
Acupressure was applied to the children in the acupressure group for 10
min before the venipuncture procedure. Pain, heart rate, and oxygen
saturation levels of the children in the acupressure and control groups
were evaluated both before and after the venipuncture procedure.
<br/>RESULT(S): The children in the acupressure and control groups were
found to be similar in terms of age, gender, parents' educational levels
and working status, number of venipuncture procedures, and mean anxiety
scores. In the evaluation that was conducted before the venipuncture
procedure, no statistically significant differences were observed between
the heat rates, oxygen saturation levels, and expected pain scores from
the venipuncture procedure in the children in the acupressure and control
groups. On the other hand, it was observed that the children in the
acupressure group (VAS: 19.51 +/- 4.98; FPS-R: 2.08 +/- 0.41) experienced
less pain than the children in the control group (VAS: 47.37 +/- 9.89;
FPS-R: 4.84 +/- 1.08), and there was a significant difference between the
two groups (p< .000). LINKING EVIDENCE TO ACTION: Acupressure
administration is effective in reducing the pain that is experienced by
children during a venipuncture procedure.<br/>Copyright &#xa9; 2020 Sigma
Theta Tau International.

<21>
Accession Number
2005437250
Title
Optimizing outcomes in infective endocarditis: A comprehensive literature
review.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Harky A.; Zaim S.; Mallya A.; George J.J.
Institution
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky, Zaim, Mallya, George) Department of Medicine, School of Medicine,
University of Liverpool, Liverpool, United Kingdom
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Despite being rare, infective endocarditis (IE) is a
life-threatening disease with poor prognosis. New diagnostic and
therapeutic strategies are emerging; however, predisposing factors and
microbiology of the disease are also changing with time. Because of this,
there has been a lack of reduction in the disease's incidence and new
challenges for clinicians have arisen such as an increasingly aging
population and growing antimicrobial resistance. <br/>Aim(s): In this
paper, we aim to provide an overview of the changing trends in IE, current
diagnosis, and management strategies, as well as the emerging role of the
infective endocarditis teams in the care of patients with this disease.
<br/>Material(s) and Method(s): A comprehensive electronic search was done
utilizing PubMed, Ovid, SCOPUS, Embase and google scholar. The search
terms included 'Endocarditis', 'IE', 'Infection', 'Vegetation', 'Duke
criteria', 'native valve infection', 'prosthetic valve', 'valve
infection', 'endocarditis outcome' and 'endocarditis bacteriology'. The
references of the identified articles were then searched for any potential
articles that can be included. The inclusion criteria were any article
that discussed the evidence behind incidence and management of IE
including the role of endocarditis team. The exclusion criteria were case
reports, expert opinion, and editorials. <br/>Result(s): All the relevant
findings are summarized in specified tables and within appropriate
sections. <br/>Discussion(s): It is vital to determine the current trends
in the epidemiology and microbiology of the condition so that the
diagnostic threshold can be adapted, to identify new at-risk groups and
achieve an accelerated evaluation strategy that allows for earlier
diagnosis and treatment. <br/>Conclusion(s): Management of IE can benefit
from the input of different specialties, such as cardiology,
cardiothoracic surgery, infectious disease, and microbiology. Therefore,
adopting a multidisciplinary approach towards treatment is crucial to
reduce morbidity and mortality from preventable complications of this
pathology.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<22>
Accession Number
2005416313
Title
The use of extracorporeal membrane oxygenation postcardiotomy-A systematic
review.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Harahwa T.; Chor C.Y.T.; Harky A.
Institution
(Harahwa, Chor) School of Medicine, St George's, University of London,
London, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Objectives: The use of extracorporeal membrane oxygenation (ECMO) in
cardiac surgery has been established in cases of postcardiotomy
cardiogenic shock, which is refractory to conventional therapy with
inotropes and intra-aortic balloon pulsation support. We sought to examine
the literature in a systematic review manner on the outcomes of using ECMO
postcardiac surgery. <br/>Method(s): A comprehensive electronic literature
search was done to identify all the articles that have discussed the use
of ECMO postcardiac surgery. The keywords and medical subject headings
terms were used to identify the relevant articles. Studies have been
screened according to the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses guidelines. <br/>Result(s): The identified studies have
been summarized in each relevant section of this study. Cardiogenic shock
postcardiac surgery can benefit from ECMO to varying degrees and the
survival for this; otherwise, fatal condition has been shown to be
improving through the use of ECMO. However, the decision and timing to
initiate ECMO therapy remains selective and is dependent on a range of
factors such as patient factor, clinician's judgment, meaning there is no
consistent and solid ground regarding the timing of ECMO initiation.
<br/>Conclusion(s): Current evidence suggests that the circulatory support
provided by ECMO improves survival rates for postcardiac surgery
cardiogenic shock patients who are refractory to inotropic management,
without such ECMO support patient mortality rates would be much
greater.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<23>
Accession Number
632220159
Title
Influence of final kissing balloon inflation on long-term outcomes after
PCI of distal left main bifurcation lesions in the EXCEL trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
16 (3) (pp 218-224), 2020. Date of Publication: 25 Jun 2020.
Author
Kini A.S.; Dangas G.D.; Baber U.; Vengrenyuk Y.; Kandzari D.E.; Leon M.B.;
Morice M.-C.; Serruys P.W.; Kappetein A.P.; Sabik J.F.; Dressler O.;
Mehran R.; Sharma S.K.; Stone G.W.
Institution
(Kini) Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai,
NY, NY, United States
Publisher
NLM (Medline)
Abstract
AIMS: The impact of final kissing balloon inflation (FKBI) after
percutaneous coronary intervention (PCI) of bifurcation lesions on
long-term clinical outcomes remains controversial. We sought to determine
the impact of FKBI on four-year outcomes after PCI of distal left main
(LM) bifurcation lesions. METHODS AND RESULTS: The EXCEL trial compared
PCI with everolimus-eluting stents and coronary artery bypass graft
surgery (CABG) in patients with left main (LM) disease. We examined
four-year clinical outcomes after PCI of distal LM bifurcation lesions
according to use of FKBI. The primary endpoint was the composite rate of
death, myocardial infarction (MI), or stroke. The major secondary endpoint
was the composite rate of death, MI, stroke, or ischaemia-driven
revascularisation (IDR). Among 948 patients randomised to PCI, 759 had
distal LM lesions treated, 430 of which were treated with one stent and
329 of which were treated with two or more stents. The four-year rates of
the primary and major secondary endpoints were similar with versus without
FKBI in both the one-stent and >=2-stent groups in both unadjusted and
adjusted analyses. <br/>CONCLUSION(S): In the EXCEL trial, the performance
of FKBI after PCI of distal LM bifurcation lesions was not associated with
improved four-year clinical outcomes regardless of whether one stent or
>=2 stents were implanted.

<24>
Accession Number
2006948379
Title
Percutaneous coronary intervention or coronary artery bypass graft surgery
for left main coronary artery disease: A meta-analysis of randomized
trials.
Source
American Heart Journal. 227 (pp 9-10), 2020. Date of Publication:
September 2020.
Author
Kuno T.; Ueyama H.; Rao S.V.; Cohen M.G.; Tamis-Holland J.E.; Thompson C.;
Takagi H.; Bangalore S.
Institution
(Kuno, Ueyama) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Beth Israel, New York, NY, United States
(Rao) Duke Clinical Research Institute, Durham, NC, United States
(Cohen) Cardiovascular Division, University of Miami Miller School of
Medicine, Miami, FL, United States
(Tamis-Holland) Mount Sinai Saint Luke's Hospital, New York, NY, United
States
(Thompson, Bangalore) Division of Cardiovascular Medicine, New York
University School of Medicine, New York, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
We aimed to investigate long-term (>=5 years) outcomes of percutaneous
coronary intervention (PCI) versus coronary artery bypass grafting (CABG)
for left main coronary artery disease (LMCAD) using a meta-analysis from
updated published randomized trials. Our data showed that the risk of
all-cause death as well as cardiovascular death, myocardial infarction,
and stroke was similar between PCI and CABG, whereas PCI had significantly
higher rates of repeat revascularization compared to CABG. Decisions for
PCI versus CABG for LMCAD should be based on weighing the upfront
morbidity and mortality risk of CABG with late risk of repeat
revascularization with PCI and taking into consideration patient
preference.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<25>
Accession Number
2006942348
Title
Blood transfusion and ischaemic outcomes according to anemia and bleeding
in patients with non-ST-segment elevation acute coronary syndromes:
Insights from the TAO randomized clinical trial.
Source
International Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Deharo P.; Ducrocq G.; Bode C.; Cohen M.; Cuisset T.; Mehta S.R.; Pollack
C.V.; Wiviott S.D.; Rao S.V.; Jukema J.W.; Erglis A.; Moccetti T.; Elbez
Y.; Steg P.G.
Institution
(Deharo, Cuisset) Departement de Cardiologie, CHU Timone, Marseille
F-13385, France
(Deharo) Aix Marseille Univ, Inserm, Inra, C2VN, Marseille, France
(Deharo) Aix-Marseille Universite, Faculte de Medecine, Marseille F-13385,
France
(Ducrocq, Elbez, Steg) Hopital Bichat, Assistance Publique-Hopitaux de
Paris, Paris, France
(Ducrocq, Elbez, Steg) Universite Paris-Diderot, Departement
Hospitalo-Universitaire FIRE, Sorbonne-Paris Cite, Paris, France
(Ducrocq, Elbez, Steg) FACT (French Alliance for Cardiovascular clinical
Trials), an F-CRIN network,l: NHLI, Royal Brompton Hospital, Imperial
College, London, United Kingdom
(Bode) Heart Center Freiburg University, Cardiology and Angiology I,
Faculty of Medicine, Freiburg, Germany
(Cohen) Newark Beth Israel Medical Center, Rutgers-New Jersey Medical
School, Newark, NJ, United States
(Mehta) McMaster University and the Population Health Research Institute,
Hamilton Health Sciences, Hamilton, ON, Canada
(Pollack) Department of Emergency Medicine, Thomas Jefferson University,
Philadelphia, PA, United States
(Wiviott) TIMI Study Group, Division of Cardiovascular Medicine, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA, United States
(Rao) Department of Cardiology, Duke Clinical Research Institute, Durham,
NC, United States
(Jukema) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Erglis) Latvian Centre of Cardiology, Pauls Stradins Clinical University
Hospital, University of Latvia, Pilsonu Street 13, Riga, Latvia
(Moccetti) Electrophysiology Unit, Department of Cardiology, Fondazione
Cardiocentro Ticino, via Tesserete 48, Lugano 6900, Switzerland
Publisher
Elsevier Ireland Ltd
Abstract
Background: The benefits and risks of blood transfusion in patients with
acute myocardial infarction who are anemic or who experience bleeding are
debated. We sought to study the association between blood transfusion and
ischemic outcomes according to haemoglobin nadir and bleeding status in
patients with NST-elevation myocardial infarction (NSTEMI).
<br/>Method(s): The TAO trial randomized patients with NSTEMI and coronary
angiogram scheduled within 72h to heparin plus eptifibatide versus
otamixaban. After exclusion of patients who underwent coronary artery
bypass surgery, patients were categorized according to transfusion status
considering transfusion as a time-varying covariate. The primary ischemic
outcome was the composite of all-cause death or MI within 180 days of
randomization. Subgroup analyses were performed according to
pre-transfusion hemoglobin nadir and bleeding status. <br/>Result(s):
12,547 patients were enrolled. Among these, blood transfusion was used in
489 (3.9%) patients. Patients who received transfusion had a higher rate
of death or MI (29.9% vs. 8.1%, p<0.01). This excess risk persisted after
adjustment on GRACE score and nadir of hemoglobin (HR 3.36 95%CI 2.63-4.29
p<0.01). Subgroup analyses showed that blood transfusion was associated
with a higher risk in patients without overt bleeding (adjusted HR 6.25
vs. 2.85; p-interaction 0.001) as well as in those with hemoglobin nadir >
9.0 g/dl (HR 4.01; p-interaction<0.0001). <br/>Conclusion(s): In patients
with NSTEMI, blood transfusion was associated with an overall increased
risk of ischaemic events. However, this was mainly driven by patients
without overt bleeding and those hemoglobin nadir > 9.0g/dl. This suggests
possible harm of transfusion in those groups.<br/>Copyright &#xa9; 2020
Elsevier B.V.

<26>
Accession Number
628857899
Title
The low accuracy of the non-ST-elevation myocardial infarction
electrocardiograph criteria of the fourth universal definition of
myocardial infarction.
Source
Hong Kong Journal of Emergency Medicine. 27 (4) (pp 229-235), 2020. Date
of Publication: 01 Jul 2020.
Author
Morris N.; Reynard C.; Body R.
Institution
(Morris, Reynard, Body) Division of Cardiovascular Sciences, The
University of Manchester, Manchester, United Kingdom
(Morris) Emergency Department, Manchester Royal Infirmary, Manchester,
United Kingdom
(Morris, Reynard, Body) Manchester University Foundation Hospital NHS
Trust, Manchester Academic Health Science Centre, Manchester, United
Kingdom
(Body) Manchester Metropolitan University, Manchester, United Kingdom
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Background: The electrocardiograph has been integral to the diagnosis of
acute coronary syndromes since the mid-20th Century and is an important
initial investigation that chest pain patients undergo on presentation to
the Emergency Department. The Fourth Universal Definition of Myocardial
Infarction recommends using dichotomous cut-offs to identify ischaemic
electrocardiographs. <br/>Objective(s): We aimed to summarise the existing
knowledge to inform emergency clinicians about the diagnostic accuracy of
the new guidelines. <br/>Method(s): We performed a systematic review and a
narrative analysis due to the heterogeneity of the studies.
<br/>Result(s): We were able to obtain diagnostic characteristics for 10
papers. The ST-depression criteria were highly specific but poorly
sensitive in five papers, with a specificity of 97.2%-99.3% and a
sensitivity of 16.6%-20.0%. The remaining papers reported a higher
sensitivity of 25.7%-58.6% but a lower specificity of 86.0%-91.2%. T wave
inversion demonstrated poor specificity; the papers that looked at 0.1 mV
T wave inversion demonstrated a sensitivity of 26.9%-46.8% and a
specificity of 68.6%-86.4%. <br/>Conclusion(s): The heterogeneous evidence
database demonstrates that the Fourth universal definition's diagnostic
performance varies wildly. Apart from two outlying papers, ST-depression
has suboptimal sensitivity but high specificity. T wave inversion appears
to be more sensitive yet less specific.<br/>Copyright &#xa9; The Author(s)
2019.

<27>
Accession Number
600795991
Title
Diagnostic efficacy value in terms of sensitivity and specificity of
imaging modalities in detecting the abdominal aortic aneurysm: A
systematic review.
Source
International Journal of Medical Engineering and Informatics. 7 (1) (pp
15-35), 2015. Date of Publication: 01 Jan 2015.
Author
Alamoudi A.O.; Haque S.; Srinivasan S.; Mital D.P.
Institution
(Alamoudi, Haque, Srinivasan, Mital) Department of Health Informatics,
School of Health Related Professions, University of Medicine and Dentistry
of New Jersey, Newark, NJ 07107-3001, United States
Publisher
Inderscience Publishers
Abstract
The purpose of this study was to examine whether duplex ultrasonography
(DUS) or MR angiography (MRA) or CT angiography (CTA) is more applicable
to use as alternative modality in terms of sensitivity and specificity for
detection of abdominal aortic aneurysm (AAA). A search of the medical
databases was performed for describing AAA evaluation and detection.
Twenty eight studies were found and met the selection criteria. Diameter
of aneurysms was categorised by size: <= 2.5 cm of the aneurysm diameter.
For aneurisms <= 2.5 cm, the mean reported sensitivities and specificities
were DUS: 81% and 91.1%; CTA: 84.3% and 98.4%; MRA: 95.8% and 95.8%,
respectively compared DSA as gold standard. MRA has the highest
sensitivity and CTA has the highest specificity reported diagnostic
accuracy in detecting the aneurysm <= 2.5 cm of AAA diameter and they
could be used as a reliable alternative modality to invasive
DSA.<br/>Copyright &#xa9; 2015 Inderscience Enterprises Ltd.

<28>
Accession Number
632080755
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) (no pagination), 2020. Article Number: e034264. 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, Mainz, Rheinland-Pfalz, Germany
(Anadol, Munzel, Gori) DZHK, Standort Rhein-Mainz, Universitatsmedizin
Mainz, Mainz, Rheinland-Pfalz, Germany
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
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 6 months after
discharge. A clinical, angiographic and intracoronary imaging control at 6
months 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)<br/>Copyright &#xa9; Author(s)
(or their employer(s)) 2020. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<29>
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. <br/>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.
<br/>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.
<br/>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.<br/>Copyright &#xa9; 2020 The
Author(s).

<30>
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). <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2020 The
Author(s).

<31>
Accession Number
631728437
Title
A comparison of different antibiotic regimens for the treatment of
infective endocarditis.
Source
Cochrane Database of Systematic Reviews. 2020 (5) (no pagination), 2020.
Article Number: CD009880. Date of Publication: 14 May 2020.
Author
Marti-Carvajal A.J.; Dayer M.; Conterno L.O.; Gonzalez Garay A.G.;
Marti-Amarista C.E.
Institution
(Marti-Carvajal) Facultad de Ciencias de la Salud Eugenio Espejo,
Universidad UTE (Cochrane Ecuador), Quito, Ecuador
(Dayer) Department of Cardiology, Taunton and Somerset NHS Trust, Taunton,
United Kingdom
(Conterno) Medical School, Department of Internal Medicine, Infectious
Diseases Division, State University of Campinas (UNICAMP), Campinas,
Brazil
(Gonzalez Garay) Methodology Research Unit, Instituto Nacional de
Pediatria, Mexico City, Mexico
(Marti-Amarista) Department of Family Medicine, Northwell Health Southside
Hospital, Bay Shore, NY, United States
(Marti-Carvajal) School of Medicine, Universidad Francisco de Vitoria
(Cochrane Madrid), Madrid, Spain
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Background: Infective endocarditis is a microbial infection of the
endocardial surface of the heart. Antibiotics are the cornerstone of
treatment, but due to the differences in presentation, populations
affected, and the wide variety of micro-organisms that can be responsible,
their use is not standardised. This is an update of a review previously
published in 2016. <br/>Objective(s): To assess the existing evidence
about the clinical benefits and harms of different antibiotics regimens
used to treat people with infective endocarditis. <br/>Search Method(s):
We searched the Cochrane Central Register of Controlled Trials (CENTRAL),
MEDLINE, Embase Classic and Embase, LILACS, CINAHL, and the Conference
Proceedings Citation Index - Science on 6 January 2020. We also searched
three trials registers and handsearched the reference lists of included
papers. We applied no language restrictions. <br/>Selection Criteria: We
included randomised controlled trials (RCTs) assessing the effects of
antibiotic regimens for treating definitive infective endocarditis
diagnosed according to modified Duke's criteria. We considered all-cause
mortality, cure rates, and adverse events as the primary outcomes. We
excluded people with possible infective endocarditis and pregnant women.
<br/>Data Collection and Analysis: Two review authors independently
performed study selection, 'Risk of bias' assessment, and data extraction
in duplicate. We constructed 'Summary of findings' tables and used GRADE
methodology to assess the quality of the evidence. We described the
included studies narratively. <br/>Main Result(s): Six small RCTs
involving 1143 allocated/632 analysed participants met the inclusion
criteria of this first update. The included trials had a high risk of
bias. Three trials were sponsored by drug companies. Due to heterogeneity
in outcome definitions and different antibiotics used data could not be
pooled. The included trials compared miscellaneous antibiotic schedules
having uncertain effects for all of the prespecified outcomes in this
review. Evidence was either low or very low quality due to high risk of
bias and very low number of events and small sample size. The results for
all-cause mortality were as follows: one trial compared quinolone
(levofloxacin) plus standard treatment (antistaphylococcal penicillin
(cloxacillin or dicloxacillin), aminoglycoside (tobramycin or netilmicin),
and rifampicin) versus standard treatment alone and reported 8/31 (26%)
with levofloxacin plus standard treatment versus 9/39 (23%) with standard
treatment alone; risk ratio (RR) 1.12, 95% confidence interval (CI) 0.49
to 2.56. One trial compared fosfomycin plus imipenem 3/4 (75%) versus
vancomycin 0/4 (0%) (RR 7.00, 95% CI 0.47 to 103.27), and one trial
compared partial oral treatment 7/201 (3.5%) versus conventional
intravenous treatment 13/199 (6.53%) (RR 0.53, 95% CI 0.22 to 1.31). The
results for rates of cure with or without surgery were as follows: one
trial compared daptomycin versus low-dose gentamicin plus an
antistaphylococcal penicillin (nafcillin, oxacillin, or flucloxacillin) or
vancomycin and reported 9/28 (32.1%) with daptomycin versus 9/25 (36%)
with low-dose gentamicin plus antistaphylococcal penicillin or vancomycin;
RR 0.89, 95% CI 0.42 to 1.89. One trial compared glycopeptide (vancomycin
or teicoplanin) plus gentamicin with cloxacillin plus gentamicin (13/23
(56%) versus 11/11 (100%); RR 0.59, 95% CI 0.40 to 0.85). One trial
compared ceftriaxone plus gentamicin versus ceftriaxone alone (15/34 (44%)
versus 21/33 (64%); RR 0.69, 95% CI 0.44 to 1.10), and one trial compared
fosfomycin plus imipenem versus vancomycin (1/4 (25%) versus 2/4 (50%); RR
0.50, 95% CI 0.07 to 3.55). The included trials reported adverse events,
the need for cardiac surgical interventions, and rates of uncontrolled
infection, congestive heart failure, relapse of endocarditis, and septic
emboli, and found no conclusive differences between groups (very
low-quality evidence). No trials assessed quality of life. Authors'
conclusions: This first update confirms the findings of the original
version of the review. Limited and low to very low-quality evidence
suggests that the comparative effects of different antibiotic regimens in
terms of cure rates or other relevant clinical outcomes are uncertain. The
conclusions of this updated Cochrane Review were based on few RCTs with a
high risk of bias. Accordingly, current evidence does not support or
reject any regimen of antibiotic therapy for the treatment of infective
endocarditis.<br/>Copyright &#xa9; 2020 The Cochrane Collaboration.
Published by John Wiley & Sons, Ltd.

<32>
Accession Number
2004029015
Title
Contemporary Status of Percutaneous Transcatheter Edge-to-Edge Repair: Is
It a Complement or Replacement to Mitral Surgery?.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 15 (1) (pp 26-35), 2020. Date of Publication: 01 Feb 2020.
Author
Shim H.; Percy E.; Hirji S.; Kaneko T.
Institution
(Shim, Percy, Hirji, Kaneko) Division of Cardiac Surgery, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Percy) Division of Cardiovascular Surgery, University of British
Columbia, Vancouver, Canada
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Transcatheter mitral valve repair devices borrow from the concept of
surgical edge-to-edge approximation and are becoming increasingly used in
patients with both primary and functional mitral regurgitation. The
application of these new devices is expanding globally; however, debates
between which patients are amenable to surgery vs. percutaneous approaches
are ongoing. As new trials and regulatory approvals have evolved, the
indications for transcatheter approaches have expanded, in a way that is
complementaty to existing indications for surgical repair. In general, the
treatment of mitral regurgitation should be stratified based on underlying
pathophysiology and anatomy by a multidisciplinary team including cardiac
surgeons and interventional cardiologists. This review aims to provide
practical approaches to patient selection and treatment strategies for
mitral regurgitation based on historical data and recently published
trials, with a focus on the distinction between surgical and transcatheter
mitral therapies.<br/>Copyright &#xa9; The Author(s) 2019.

<33>
Accession Number
2006855370
Title
Prognostic Value of Coronary CTA in Stable Chest Pain: CAD-RADS, CAC, and
Cardiovascular Events in PROMISE.
Source
JACC: Cardiovascular Imaging. 13 (7) (pp 1534-1545), 2020. Date of
Publication: July 2020.
Author
Bittner D.O.; Mayrhofer T.; Budoff M.; Szilveszter B.; Foldyna B.; Hallett
T.R.; Ivanov A.; Janjua S.; Meyersohn N.M.; Staziaki P.V.; Achenbach S.;
Ferencik M.; Douglas P.S.; Hoffmann U.; Lu M.T.
Institution
(Bittner, Mayrhofer, Szilveszter, Foldyna, Hallett, Ivanov, Janjua,
Meyersohn, Staziaki, Ferencik, Hoffmann, Lu) Massachusetts General
Hospital, Harvard Medical School, Boston, MA, United States
(Bittner, Achenbach) Friedrich-Alexander University Erlangen-Nurnberg
(FAU), Department of Cardiology, Erlangen, Germany
(Mayrhofer) School of Business Studies, Stralsund University of Applied
Sciences, Stralsund, Germany
(Budoff) Los Angeles Biomedical Research Institute, Torrance, CA, United
States
(Szilveszter) MTA-SE Lendulet Cardiovascular Imaging Research Group, Heart
and Vascular Centre, Semmelweis University, Budapest, Hungary
(Ferencik) Knight Cardiovascular Institute, Oregon Health and Science
University, Portland, OR, United States
(Douglas) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, NC, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The purpose of this study was to compare Coronary Artery
Disease Reporting and Data System (CAD-RADS) to traditional stenosis
categories and the coronary artery calcium score (CACS) for predicting
cardiovascular events in patients with stable chest pain and suspected
coronary artery disease (CAD). <br/>Background(s): The 2016 CAD-RADS has
been established to standardize the reporting of CAD on coronary CT
angiography (CTA). <br/>Method(s): PROMISE (Prospective Multicenter
Imaging Study for Evaluation of Chest Pain) trial participants' CTAs were
assessed by a central CT core laboratory for CACS, traditional
stenosis-based categories, and modified CAD-RADS grade including high-risk
coronary plaque (HRP) features. Traditional stenosis categories and
CAD-RADS grade were compared for the prediction of the composite endpoint
of death, myocardial infarction, or hospitalization for unstable angina
over a median follow-up of 25 months. Incremental prognostic value over
traditional risk factors and CACS was assessed. <br/>Result(s): In 3,840
eligible patients (mean age: 60.4 +/- 8.2 years; 49% men), 3.0% (115)
experienced events. CAD-RADS (concordance statistic [C-statistic] 0.747)
had significantly higher discriminatory value than traditional
stenosis-based assessments (C-statistic 0.698 to 0.717; all p for
comparison <=0.001). With no plaque (CAD-RADS 0) as the baseline, the
hazard ratio (HR) for an event increased from 2.43 (95% confidence
interval [CI]: 1.16 to 5.08) for CAD-RADS 1 to 21.84 (95% CI: 8.63 to
55.26) for CAD-RADS 4b and 5. In stepwise nested models, CAD-RADS added
incremental prognostic value beyond ASCVD risk score and CACS (C-statistic
0.776 vs. 0.682; p < 0.001), and added incremental value persisted in all
CACS strata. <br/>Conclusion(s): These data from a large representative
contemporary cohort of patients undergoing coronary CTA for stable chest
pain support the prognostic value of CAD-RADS as a standard reporting
system for coronary CTA.<br/>Copyright &#xa9; 2020 American College of
Cardiology Foundation

<34>
Accession Number
2004560481
Title
Improved Survival and Cardiovascular Outcomes with Renin-Angiotensin
Inhibitor Use After Transcatheter Aortic Valve Replacement.
Source
Cardiovascular Revascularization Medicine. 21 (5) (pp 694-695), 2020. Date
of Publication: May 2020.
Author
Malik A.H.; Yandrapalli S.; Shetty S.; Kirtane A.J.; Aronow W.S.
Institution
(Malik) Department of Medicine, Westchester Medical Center and New York
Medical College, Valhalla, NY, United States
(Yandrapalli, Aronow) Department of Cardiology, Westchester Medical Center
and New York Medical College, Valhalla, NY, United States
(Shetty) Department of Medicine, University of Iowa Hospitals and Clinics,
Iowa City, IA, United States
(Kirtane) Division of Cardiology, Columbia University Medical Center, New
York, NY, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)

<35>
Accession Number
631946250
Title
Will urinary biomarkers provide a breakthrough in diagnosing cardiac
surgery-associated AKI? - A systematic review.
Source
Biomarkers : biochemical indicators of exposure, response, and
susceptibility to chemicals. 25 (5) (pp 375-383), 2020. Date of
Publication: 01 Jul 2020.
Author
Hussain M.L.; Hamid P.F.; Chakane N.
Institution
(Hussain, Hamid, Chakane) Medical Research, California Institute of
Behavioural Neurosciences and Psychology, Fairfield, CA, USA
Publisher
NLM (Medline)
Abstract
Introduction: Acute kidney injury following cardiac surgery is a dreaded
complication contributing to early mortality. Diagnosing AKI using serum
creatinine usually results in a delay. To combat this, certain kidney
damage specific biomarkers were investigated to identify if they can serve
as early predictors of cardiac surgery-associated AKI (CSA-AKI). This
study systematically reviews three such biomarkers; NGAL, tissue inhibitor
of matrix metalloproteinase-2 (TIMP-2) and insulin-like growth factor
binding protein-7 (IGFBP7) to identify if they can serve as early
predictors of CSA-AKI. <br/>Method(s): Systematic search was carried out
on literature reporting the diagnostic ability of the three biomarkers
from databases in accordance with PRISMA guidelines. <br/>Result(s): We
found 43 articles reporting urinary-NGAL levels (n=34 in adults, n=9 in
children) and 10 studies reporting TIMP-2 and IGFBP7 levels among adults.
Interestingly, NGAL showed high diagnostic value in predicting AKI in
children (seven among nine studies with AUROC>0.8). The cell cycle arrest
biomarkers, namely TIMP-2 and IGFBP7, showed high diagnostic value in
predicting AKI in adults (five among ten studies with AUROC>0.8).
<br/>Conclusion(s): In predicting CSA-AKI; the diagnostic value of NGAL is
high in the paediatric population while the diagnostic value of TIMP-2 and
IGFBP7 is high in adults.

<36>
Accession Number
631766863
Title
Long-term outcome of perioperative low cardiac output syndrome in cardiac
surgery: 1-year results of a multicenter randomized trial.
Source
Journal of critical care. 58 (pp 89-95), 2020. Date of Publication: 01 Aug
2020.
Author
Zangrillo A.; Lomivorotov V.V.; Pisano A.; Calabro M.G.; Belletti A.;
Brazzi L.; Grigoryev E.V.; Guarracino F.; Monaco F.; Garofalo E.;
Crivellari M.; Likhvantsev V.V.; Fominskiy E.V.; Paternoster G.;
Yavorovskiy A.; Pasyuga V.V.; Oriani A.; Lembo R.; Bianchi A.; Scandroglio
A.M.; Abubakirov M.N.; Di Tomasso N.; Landoni G.
Institution
(Zangrillo, Landoni) Department of Anesthesia and Intensive Care, IRCCS
San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele
University, Milan, Italy
(Lomivorotov) Department of Anesthesiology and Intensive Care, E.
Meshalkin National Medical Research Center, Novosibirsk, Russia;
Novosibirsk State University, Novosibirsk, Russia
(Pisano) Division of Cardiac Anesthesia and Intensive Care Unit, AORN dei
Colli - Monaldi Hospital, Naples, Italy
(Calabro, Belletti, Monaco, Crivellari, Fominskiy, Oriani, Lembo,
Scandroglio, Di Tomasso) Department of Anesthesia and Intensive Care,
IRCCS San Raffaele Scientific Institute, Milan, Italy
(Brazzi) Department of Anesthesia, Intensive Care and Emergency, Citta
della Salute e della Scienza Hospital, Turin, Italy; Department of
Surgical Sciences, University of Turin, Turin, Italy
(Grigoryev) Intensive Care Unit, Scientific Research Institute for Complex
Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
(Guarracino) Division of Cardiothoracic Anesthesia and Intensive Care,
Department of Anesthesia and Critical Care Medicine, AOU Pisana, Pisa,
Italy
(Garofalo) Department of Anesthesia and Intensive Care, AOU Mater Domini
Germaneto, Catanzaro, Italy
(Likhvantsev) Department of Anesthesiology and Intensive Care, First
Moscow State Medical University, Moscow, Russia; V. Negovsky Reanimatology
Research Institute, Moscow, Russia
(Paternoster) Department of Anesthesia and Intensive Care, San Carlo
Hospital, Potenza, Italy
(Yavorovskiy) Department of Anesthesiology and Intensive Care, First
Moscow State Medical University, Moscow, Russian Federation
(Pasyuga) Department of Anesthesiology and Intensive Care, Federal Center
for Cardiovascular Surgery Astrakhan, Astrakhan, Russian Federation
(Bianchi) Department of Cardiovascular Anesthesia and Intensive Care, AO
Ordine Mauriziano, Turin, Italy
(Abubakirov) Department of Anesthesiology and Intensive Care, E. Meshalkin
National Medical Research Center, Novosibirsk, Russian Federation
Publisher
NLM (Medline)
Abstract
PURPOSE: Perioperative myocardial dysfunction occurs frequently in cardiac
surgery, and is a risk factor for morbidity and mortality. Levosimendan
has been suggested to reduce mortality of patients with perioperative
myocardial dysfunction. However, long-term outcome data on its efficacy in
cardiac surgery are lacking. MATERIALS AND METHODS: Cardiac surgery
patients with perioperative myocardial dysfunction were randomized to
levosimendan or placebo, in addition to standard inotropic care. One-year
mortality data were collected. <br/>RESULT(S): We randomized 506 patients
(248 to levosimendan 258 to placebo). At 1-year follow-up, 41 patients
(16.5%) died in the levosimendan group, while 47 (18.3%) died in the
placebo group (absolute risk difference -1.8; 95% CI -8.4 to 4.9; P=.60).
Female sex, history of chronic obstructive pulmonary disease, previous
myocardial infarction, serum creatinine, hematocrit, mean arterial
pressure, and duration of cardiopulmonary bypass were independently
associated with 1-year mortality. <br/>CONCLUSION(S): Levosimendan
administration does not improve 1-year survival in cardiac surgery
patients with perioperative myocardial dysfunction. One-year mortality in
these patients is 17%. Six predictive factors for long-term mortality were
identified. STUDY REGISTRATION NUMBER: NCT00994825
(ClinicalTrials.gov).<br/>Copyright &#xa9; 2020 Elsevier Inc. All rights
reserved.

<37>
[Use Link to view the full text]
Accession Number
624600525
Title
Randomized Controlled Trial of Surgical Versus Catheter Ablation for
Paroxysmal and Early Persistent Atrial Fibrillation.
Source
Circulation. Arrhythmia and electrophysiology. 11 (10) (pp e006182), 2018.
Date of Publication: 01 Oct 2018.
Author
Adiyaman A.; Buist T.J.; Beukema R.J.; Smit J.J.J.; Delnoy P.P.H.M.;
Hemels M.E.W.; Sie H.T.; Ramdat Misier A.R.; Elvan A.
Institution
(Adiyaman, Buist, Beukema, Smit, Delnoy, Hemels, Ramdat Misier, Elvan)
Department of Cardiology, Isala Heart Centre, Zwolle, Netherlands
(Sie) Department of Cardiothoracic Surgery, Isala Heart Centre, Zwolle,
Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: Current guidelines recommend both percutaneous catheter
ablation (CA) and surgical ablation in the treatment of atrial
fibrillation, with different levels of evidence. No direct comparison has
been made between minimally invasive thoracoscopic pulmonary vein
isolation with left atrial appendage ligation (surgical MIPI) versus
percutaneous CA comprising of pulmonary vein isolation as primary
treatment of atrial fibrillation. We, therefore, conducted a randomized
controlled trial comparing the safety and efficacy of these 2 treatment
modalities. <br/>METHOD(S): Eighty patients were enrolled in the study and
underwent implantable loop recorder implantation. Twenty-eight patients
did not reach randomization criteria. A total of 52 patients with
symptomatic paroxysmal or early persistent atrial fibrillation were
randomized, 26 to CA and 26 to surgical MIPI. The primary end point was
defined as freedom of atrial tachyarrhythmias, without the use of
antiarrhythmic drugs. The safety end point was freedom of complications.
<br/>RESULT(S): Median age was 57 years (range, 37-75), and 78% were men.
Paroxysmal atrial fibrillation was present in 74%. Follow-up duration was
>=2 years in all patients. CA was noninferior to MIPI in terms of
single-procedure arrhythmia-free survival after 2 years of follow-up
(56.0% versus 29.2%; HR, 0.56; 95% CI, 0.26-1.20; log-rank P=0.059).
Procedure-related major adverse events occurred significantly more often
in MIPI than CA (20.8% versus 0%; P=0.029). <br/>CONCLUSION(S):
Percutaneous pulmonary vein isolation was noninferior to MIPI in terms of
efficacy and resulted in less complications. CLINICAL TRIAL REGISTRATION:
URL: https://www.clinicaltrials.gov . Unique identifier: NCT00703157.

<38>
Accession Number
632194859
Title
Disseminated Mycobacterium chimaera Following Open-Heart Surgery, the
Heater-Cooler Unit Worldwide Outbreak: Case Report and Minireview.
Source
Frontiers in Medicine. 7 (no pagination), 2020. Article Number: 243. Date
of Publication: 16 Jun 2020.
Author
Lecorche E.; Pean de Ponfilly G.; Mougari F.; Benmansour H.; Poisnel E.;
Janvier F.; Cambau E.
Institution
(Lecorche, Mougari, Benmansour, Cambau) Universite de Paris, IAME, INSERM,
UMR1137, UFR de Medecine, Paris, France
(Lecorche, Mougari, Benmansour, Cambau) CNR-MyRMA, Centre National de
Reference pour les Mycobacteries et les Antituberculeux, APHP, Paris,
France
(Lecorche, Pean de Ponfilly, Mougari, Benmansour, Cambau) APHP, Hopital
Lariboisiere, Service de Microbiologie, Paris, France
(Poisnel) Service de Medecine Interne, Hopital d'Instruction, Armees
Sainte Anne, Toulon, France
(Janvier) Service de microbiologie, Hopital d'Instruction, Armees Sainte
Anne, Toulon, France
(Janvier) Ecole du Val-de-Grace, Paris, France
Publisher
Frontiers Media S.A. (E-mail: info@frontiersin.org)
Abstract
Invasive cardiovascular infections by Mycobacterium chimaera associated
with open-heart surgery have been reported worldwide since 2013. Here, we
report a case of a 61 year old man, without any other particular medical
background, who underwent cardiac surgery for replacing part of the
ascending aorta by a bio-prosthetic graft. Eighteen months later, the
patient was painful at the lower back with fever. A pyogenic vertebral
osteomyelitis due to M. chimaera associated to graft infection was
diagnosed after 6 months of sub-acute infection. The patient presented a
disseminated disease with cerebral lesions, chorioretinitis, and chronic
renal failure. Despite adequate antimicrobial treatment and graft
explantation, the patient died after 6 years. We reviewed the literature
on M. chimaera infections associated with open-heart surgery. The
worldwide outbreak has been explained by airborne bioaerosol generated by
the 3T heater-cooler unit (HCU) used during cardiac by-pass surgical
procedures. These infections are difficult to diagnose because of a long
latency period (up to several years), with no specific symptoms and a
highly specialized microbiological diagnosis. The treatment is based on
antibiotics and surgery. These infections are also difficult to treat,
since the mortality rate is high around 50%. Prevention is necessary by
modifying the use of HCUs in operating rooms.<br/>&#xa9; Copyright &#xa9;
2020 Lecorche, Pean de Ponfilly, Mougari, Benmansour, Poisnel, Janvier and
Cambau.

<39>
Accession Number
2006954376
Title
Lipoprotein(a) and calcific aortic valve stenosis: A systematic review.
Source
Progress in Cardiovascular Diseases. (no pagination), 2020. Date of
Publication: 2020.
Author
Guddeti R.R.; Patil S.; Ahmed A.; Sharma A.; Aboeata A.; Lavie C.J.; Alla
V.M.
Institution
(Guddeti, Patil, Sharma, Aboeata, Alla) Division of Cardiovascular
Diseases, Creighton University School of Medicine, Omaha, NE, United
States
(Ahmed) Division of Internal Medicine, Creighton University School of
Medicine, Omaha, NE, United States
(Lavie) John Ochsner Heart and Vascular Institute, Ochsner Clinical
School, The University of Queensland School of Medicine, New Orleans, LA,
United States
Publisher
W.B. Saunders
Abstract
Calcific aortic valve stenosis (AS) is the most common form of acquired
valvular heart disease needing intervention and our understanding of this
disease has evolved from one of degenerative calcification to that of an
active process driven by the interplay of genetic factors and chronic
inflammation modulated by risk factors such as smoking, hypertension and
elevated cholesterol. Lipoprotein(a) [Lp (a)] is a cholesterol rich
particle secreted by the liver which functions as the major lipoprotein
carrier of phosphocholine-containing oxidized phospholipids. Lp(a) levels
are largely genetically determined by polymorphisms in the LPA gene. While
there is an extensive body of evidence linking Lp(a) to atherosclerotic
cardiovascular disease, emerging evidence now suggests a similar
association of Lp(a) to calcific AS. In this article, we performed a
systematic review of all published literature to assess the association
between Lp(a) and calcific aortic valve (AV) disease. In addition, we
review the potential mechanisms by which Lp(a) influences the progression
of valve disease. Our review identified a total of 21 studies, varying
from case-control studies, prospective or retrospective observational
cohort studies to Mendelian randomized studies that assessed the
association between Lp(a) and calcific AS. All but one of the above
studies demonstrated significant association between elevated Lp(a) and
calcific AS. We conclude that there is convincing evidence supporting a
causal association between elevated Lp(a) and calcific AS. In addition,
elevated Lp(a) predicts a faster hemodynamic progression of AS, and
increased risk of AV replacement, especially in younger patients. Further
research into the clinical utility of Lp(a) as a marker for predicting the
incidence, progression, and outcomes of sclerodegenerative AV disease is
needed.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<40>
Accession Number
2006915539
Title
Fibrin and Thrombin Sealants in Vascular and Cardiac Surgery: A Systematic
Review and Meta-analysis.
Source
European Journal of Vascular and Endovascular Surgery. (no pagination),
2020. Date of Publication: 2020.
Author
Daud S.A.; Kaur B.; McClure G.R.; Belley-Cote E.P.; Harlock J.; Crowther
M.; Whitlock R.P.
Institution
(Daud) Faculty of Medicine, University of Toronto, Toronto, Canada
(Kaur, McClure, Whitlock) Department of Clinical Epidemiology and
Biostatistics, McMaster University, Hamilton, ON, Canada
(McClure, Harlock) Division of Vascular Surgery, Department of Surgery,
McMaster University, Hamilton, ON, Canada
(Belley-Cote, Crowther) Department of Medicine, McMaster University and St
Joseph's Hospital, Hamilton, ON, Canada
(Belley-Cote, Whitlock) Population Health Research Institute, Hamilton,
ON, Canada
(Whitlock) Division of Cardiac Surgery, McMaster University, Hamilton, ON,
Canada
Publisher
W.B. Saunders Ltd
Abstract
Objective: In vascular and cardiac surgery, the ability to maintain
haemostasis and seal haemorrhagic tissues is key. Fibrin and thrombin
based sealants were introduced as a means to prevent or halt bleeding
during surgery. Whether fibrin and thrombin sealants affect surgical
outcomes is poorly established. A systematic review and meta-analysis was
performed to examine the impact of fibrin or thrombin sealants on patient
outcomes in vascular and cardiac surgery. Data sources: Cochrane CENTRAL,
Embase, and MEDLINE, as well as trial registries, conference abstracts,
and reference lists of included articles were searched from inception to
December 2019. Review methods: Studies comparing the use of fibrin or
thrombin sealant with either an active (other haemostatic methods) or
standard surgical haemostatic control in vascular and cardiac surgery were
searched for. The Cochrane risk of bias tool and the ROBINS-I tool (Risk
Of Bias In Non-randomised Studies - of Interventions) were used to assess
the risk of bias of the included randomised and non-randomised studies;
quality of evidence was assessed by the Grading of Recommendations
Assessment, Development and Evaluation (GRADE) framework. Two reviewers
screened studies, assessed risk of bias, and extracted data independently
and in duplicate. Data from included trials were pooled using a random
effects model. <br/>Result(s): Twenty-one studies (n = 7 622 patients)
were included: 13 randomised controlled trials (RCTs), five retrospective,
and three prospective cohort studies. Meta-analysis of the RCTs showed a
statistically significant decrease in the volume of blood lost (mean
difference 120.7 mL, in favour of sealant use [95% confidence interval
{CI} -150.6 - -90.7; p < .001], moderate quality). Time to haemostasis was
also shown to be reduced in patients receiving sealant (mean difference
-2.5 minutes [95% CI -4.0 - -1.1; p < .001], low quality). Post-operative
blood transfusions, re-operation due to bleeding, and 30 day mortality
were not significantly different for either RCTs or observational data.
<br/>Conclusion(s): The use of fibrin and thrombin sealants confers a
statistically significant but clinically small reduction in blood loss and
time to haemostasis; it does not reduce blood transfusion. These Results
may support selective rather than routine use of fibrin and thrombin
sealants in vascular and cardiac surgery.<br/>Copyright &#xa9; 2020
European Society for Vascular Surgery

<41>
Accession Number
2005430186
Title
Perioperative outcomes of robot-assisted vs video-assisted and traditional
open thoracic surgery for lung cancer: A systematic review and network
meta-analysis.
Source
International Journal of Medical Robotics and Computer Assisted Surgery.
(no pagination), 2020. Date of Publication: 2020.
Author
Hu J.; Chen Y.; Dai J.; Zhu X.; Gonzalez-Rivas D.; Jiang G.; Li H.; Zhang
P.
Institution
(Hu, Chen, Dai, Zhu, Gonzalez-Rivas, Jiang, Zhang) Department of Thoracic
Surgery, Shanghai Pulmonary Hospital, Tongji University School of
Medicine, Shanghai, China
(Gonzalez-Rivas) Department of Thoracic Surgery, Coruna University
Hospital, Coruna, Spain
(Li) Department of Anesthesiology, Shanghai Pulmonary Hospital, Tongji
University School of Medicine, Shanghai, China
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Background: The superiority of robot-assisted thoracic surgery (RATS) over
video-assisted thoracic surgery (VATS) and thoracotomy remains
controversial for lung cancer. <br/>Method(s): A network meta-analysis
(NMA) and pairwise meta-analysis (PMA) were performed to evaluate the
perioperative outcomes using five databases. <br/>Result(s): Thirty-two
studies involving 6593 patients were included for analysis. The NMA showed
that RATS had similar operative time, conversion rate to thoracotomy,
number of lymph node, postoperative morbidity, and length of hospital stay
with VATS, except for lower 30-day mortality. Compared with thoracotomy,
longer operative time and shorter hospital stay were observed in RATS, but
no significant difference was observed in number of lymph node,
postoperative morbidity, and 30-day mortality in both NMA and PMA. In
lobectomy/segmentectomy subgroup, all outcomes, except for operative time
of RATS vs VATS and number of lymph node, were similar with overall
analyses. <br/>Conclusion(s): RATS had comparable perioperative outcomes
with VATS and open surgery.<br/>Copyright &#xa9; 2020 John Wiley & Sons,
Ltd

<42>
Accession Number
632224786
Title
Virtual reality assisted conscious sedation during transcatheter aortic
valve implantation - a randomized pilot study.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2020. Date of Publication: 30 Jun 2020.
Author
Bruno R.R.; Lin Y.; Wolff G.; Polzin A.; Veulemans V.; Klein K.;
Westenfeld R.; Zeus T.; Kelm M.; Jung C.
Institution
(Bruno) Division of Cardiology, Pulmonology, Vascular Medicine, Medical
Faculty, University Hospital Dusseldorf, Dusseldorf, Germany
Publisher
NLM (Medline)
Abstract
AIMS: Virtual Reality (VR) has been used successfully in different
clinical settings to treat anxiety. This prospective, randomized pilot
study investigates the feasibility and safety of VR in patients undergoing
conscious sedation during transfemoral transcatheter aortic valve
implantation (TAVI). METHODS AND RESULTS: Thirty-two patients were
included and randomized to VR intervention (n=16) or control (n=16). In
the intervention group, patient-selected relaxing 3D-Videos were projected
during the TAVI procedure; pain and anxiety before and after TAVI were
measured using visual analog scales (VAS, 0-10). The median age was 83
years (IQR 78.25-87). Patients' baseline characteristics did not differ
significantly between groups. During TAVI under conscious sedation, the
median duration of VR intervention was 30.5 minutes (IQR 23.5-46). 81.3%
of the patients watched the videos until device implantation, 37.5% during
the whole procedure. The VR-intervention group reported significantly less
anxiety after the procedure (VAS 2 (IQR 0-3.75) vs. 5 (IQR 2-8), p=0.04)
than patients randomized to control. 93.8% of the intervention group would
use VR during TAVI again. Nausea and vomiting did not occur more
frequently compared to control. <br/>CONCLUSION(S): VR-interventions
during TAVI to assist conscious sedation are safe and feasible, even in
very old and frail patients. In this small cohort, there was a significant
reduction in anxiety.

<43>
Accession Number
632223879
Title
How valvular calcification can affect the outcomes of transcatheter aortic
valve implantation.
Source
Expert review of medical devices. (no pagination), 2020. Date of
Publication: 29 Jun 2020.
Author
Milhorini Pio S.; Bax J.; Delgado V.
Institution
(Milhorini Pio, Bax, Delgado) Department of Cardiology, Leiden University
Medical Center, Leiden, Netherlands
Publisher
NLM (Medline)
Abstract
INTRODUCTION: In transcatheter aortic valve implantation (TAVI),
assessment of aortic valve calcification is not as standardized as aortic
annulus measurement. Aortic valve calcification is important for stable
anchoring of the prosthesis to the aortic annulus. However, excessive
aortic valve calcification is related to procedural complications. AREAS
COVERED: This review covers the methods to assess aortic valve
calcification and the implications of aortic valve calcium burden for TAVI
outcomes. We performed a systematic review of the literature in Pubmed and
secondary sources. Furthermore, future perspectives on how to integrate
aortic valve calcification assessment in the management of patients with
aortic stenosis is discussed. EXPERT OPINION: Thorough assessment of the
aortic valve and aortic root components including aortic valve
calcification is key in the planning of TAVI. Aortic valve calcification
load, location and extension are important contributors to paravalvular
regurgitation. Asymmetric calcification burden with greater calcification
of the left-coronary cusp related to higher need of permanent pacemaker
implantation. Patients with moderate and severe left ventricular outflow
tract/subannular calcification are more susceptible to aortic annular
rupture. Periprocedural dislodgement of calcium form cusps and commissures
is one of the main reasons of coronary artery ostial occlusion during
transcatheter aortic valve implantation.

<44>
Accession Number
632222692
Title
The tenets of intrathoracic packing during damage control thoracic surgery
for trauma patients: a systematic review.
Source
European journal of trauma and emergency surgery : official publication of
the European Trauma Society. (no pagination), 2020. Date of Publication:
28 Jun 2020.
Author
Manzano-Nunez R.; Chica J.; Gomez A.; Naranjo M.P.; Chaves H.; Munoz L.E.;
Rengifo J.E.; Caicedo-Holguin I.; Puyana J.C.; Garcia A.F.
Institution
(Manzano-Nunez, Chica, Gomez, Naranjo) Clinical Research Center, Fundacion
Valle del Lili, Cali, Colombia
(Manzano-Nunez, Chica, Garcia) Department of Surgery, Fundacion Valle del
Lili, Cali, Colombia
(Chaves, Munoz, Garcia) Department of Surgery, Universidad del Valle,
Cali, Colombia
(Rengifo) Department of Radiology, Universidad Autonoma de Bucaramanga,
Bucaramanga, Colombia
(Caicedo-Holguin) Facultad de Medicina, Universidad del Rosario, Bogota,
Colombia
(Puyana) Department of Surgery, University of Pittsburgh, Pittsburgh,
United States
Publisher
NLM (Medline)
Abstract
PURPOSE: Although Damage Control Thoracic Surgery (DCTS) has become a
provocative alternative to treat patients with chest injuries who are
critically ill and physiologically depleted, the management approaches of
chest-packing and the measurement of clinically relevant outcomes are not
well established. In this paper, we systematically reviewed the available
knowledge and evidence about intra-thoracic packing during DCTS for trauma
patients. We furthermore inform on the management approaches, surgical
strategies, and mortality associated with this intervention.
<br/>METHOD(S): We identified articles in MEDLINE and SCOPUS. We reviewed
all studies that included trauma patients with chest injuries and managed
with intrathoracic packing during DCTS. Studies were eligible if the use
of intrathoracic packing in trauma populations was reported.
<br/>RESULT(S): We identified 14 studies with a total of 211 patients.
Overall, intrathoracic packing was used in 131 trauma patients. Packing
was most commonly used to arrest persistent coagulopathic bleeding or
oozing either from raw surfaces or repaired structures and in conjunction
with other operative techniques. Pneumonectomy was a deadly intervention;
however, one study reported survivors when pneumonectomy was deferred.
<br/>CONCLUSION(S): Packing is a feasible, reliable and potentially
effective complementary method for hemorrhage control. Therefore, we
recommend that packing can be used liberally as a complement to rapid
lung-sparing techniques.

<45>
Accession Number
632221496
Title
Self-expanding intra-annular versus commercially available transcatheter
heart valves in high and extreme risk patients with severe aortic stenosis
(PORTICO IDE): a randomised, controlled, non-inferiority trial.
Source
Lancet (London, England). (no pagination), 2020. Date of Publication: 25
Jun 2020.
Author
Makkar R.R.; Cheng W.; Waksman R.; Satler L.F.; Chakravarty T.; Groh M.;
Abernethy W.; Russo M.J.; Heimansohn D.; Hermiller J.; Worthley S.; Chehab
B.; Cunningham M.; Matthews R.; Ramana R.K.; Yong G.; Ruiz C.E.; Chen C.;
Asch F.M.; Nakamura M.; Jilaihawi H.; Sharma R.; Yoon S.-H.; Pichard A.D.;
Kapadia S.; Reardon M.J.; Bhatt D.L.; Fontana G.P.
Institution
(Makkar, Cheng, Chakravarty, Nakamura, Yoon) Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA, USA
(Waksman, Satler) DC, Washington Hospital Center, WA, United States
(Groh, Abernethy) Mission Health and Hospitals, Asheville, United States
(Russo) Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ,
USA; Newark Beth Israel Medical Center, Newark, NY, USA
(Heimansohn, Hermiller) St Vincent Heart Center, IN, Indianapolis, United
States
(Worthley) Royal Adelaide Hospital, Adelaide, SA, Australia; Genesis Care,
Sydney, NSW, Australia
(Chehab) Cardiovascular Research Institute of Kansas, Ascension Via
Christi Hospital, Wichita, United States
(Cunningham, Matthews) University of Southern California, Los Angeles, CA,
USA
(Ramana) Advocate Christ Medical Center, Oak Lawn, IL, USA; Heart Care
Centers of Illinois, Palos Park, IL, USA
(Yong) Fiona Stanley Hospital, Murdoch, WA, Australia
(Ruiz) Hackensack University Medical Center, Hackensack, United States
(Chen) Newark Beth Israel Medical Center, Newark, NY, USA
(Asch) MedStar Health Research Institute, DC, WA, United States
(Jilaihawi) NYU Langone Health, NY, NY, United States
(Sharma) Stanford University Medical Center, Stanford, CA, USA
(Pichard) Abbott Park, Abbott, United States
(Kapadia) Cleveland Clinic, Cleveland, OH, USA
(Reardon) Houston Methodist Hospital, TX, Houston, United States
(Bhatt) Brigham and Women's Hospital, Harvard Medical School, MA, Boston,
United States
(Fontana) Cardiovascular Institute, Los Robles Regional Medical Center,
Thousand Oaks, CA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Randomised trial data assessing the safety and efficacy of the
self-expanding intra-annular Portico transcatheter aortic valve system
(Abbott Structural Heart, St Paul, MN, USA) compared with any commercially
available valves are needed to compare performance among designs.
<br/>METHOD(S): In this prospective, multicentre, non-inferiority,
randomised controlled trial (the Portico Re-sheathable Transcatheter
Aortic Valve System US Investigational Device Exemption trial [PORTICO
IDE]), high and extreme risk patients with severe symptomatic aortic
stenosis were recruited from 52 medical centres experienced in performing
transcatheter aortic valve replacement in the USA and Australia. Patients
were eligible if they were aged 21 years or older, in New York Heart
Association functional class II or higher, and had severe native aortic
stenosis. Eligible patients were randomly assigned (1:1) using permuted
block randomisation (block sizes of 2 and 4) and stratified by clinical
investigational site, surgical risk cohort, and vascular access method, to
transcatheter aortic valve replacement with the first generation Portico
valve and delivery system or a commercially available valve (either an
intra-annular balloon-expandable Edwards-SAPIEN, SAPIEN XT, or SAPIEN 3
valve [Edwards LifeSciences, Irvine, CA, USA]; or a supra-annular
self-expanding CoreValve, Evolut-R, or Evolut-PRO valve [Medtronic,
Minneapolis, MN, USA]). Investigational site staff, implanting physician,
and study participant were unmasked to treatment assignment. Core
laboratories and clinical event assessors were masked to treatment
allocation. The primary safety endpoint was a composite of all-cause
mortality, disabling stroke, life-threatening bleeding requiring
transfusion, acute kidney injury requiring dialysis, or major vascular
complication at 30 days. The primary efficacy endpoint was all-cause
mortality or disabling stroke at 1 year. Clinical outcomes and valve
performance were assessed up to 2 years after the procedure. Primary
analyses were by intention to treat and the Kaplan-Meier method to
estimate event rates. The non-inferiority margin was 8.5% for primary
safety and 8.0% for primary efficacy endpoints. This study is registered
with ClinicalTrials.gov, NCT02000115, and is ongoing. FINDINGS: Between
May 30 and Sept 12, 2014, and between Aug 21, 2015, and Oct 10, 2017, with
recruitment paused for 11 months by the funder, we recruited 1034
patients, of whom 750 were eligible and randomly assigned to the Portico
valve group (n=381) or commercially available valve group (n=369). Mean
age was 83 years (SD 7) and 395 (52.7%) patients were female. For the
primary safety endpoint at 30 days, the event rate was higher in the
Portico valve group than in the commercial valve group (52 [13.8%] vs 35
[9.6%]; absolute difference 4.2, 95% CI -0.4 to 8.8 [upper confidence
bound {UCB} 8.1%]; pnon-inferiority=0.034, psuperiority=0.071). At 1 year,
the rates of the primary efficacy endpoint were similar between the groups
(55 [14.8%] in the Portico group vs 48 [13.4%] in the commercial valve
group; difference 1.5%, 95% CI -3.6 to 6.5 [UCB 5.7%];
pnon-inferiority=0.0058, psuperiority=0.50). At 2 years, rates of death
(80 [22.3%] vs 70 [20.2%]; p=0.40) or disabling stroke (10 [3.1%] vs 16
[5.0%]; p=0.23) were similar between groups. INTERPRETATION: The Portico
valve was associated with similar rates of death or disabling stroke at 2
years compared with commercial valves, but was associated with higher
rates of the primary composite safety endpoint including death at 30 days.
The first-generation Portico valve and delivery system did not offer
advantages over other commercially available valves.Abbott.<br/>Copyright
&#xa9; 2020 Elsevier Ltd. All rights reserved.

<46>
Accession Number
2006732683
Title
Left Atrial Appendage Closure Versus Direct Oral Anticoagulants in
High-Risk Patients With Atrial Fibrillation.
Source
Journal of the American College of Cardiology. 75 (25) (pp 3122-3135),
2020. Date of Publication: 30 June 2020.
Author
Osmancik P.; Herman D.; Neuzil P.; Hala P.; Taborsky M.; Kala P.; Poloczek
M.; Stasek J.; Haman L.; Branny M.; Chovancik J.; Cervinka P.; Holy J.;
Kovarnik T.; Zemanek D.; Havranek S.; Vancura V.; Opatrny J.; Peichl P.;
Tousek P.; Lekesova V.; Jarkovsky J.; Novackova M.; Benesova K.; Widimsky
P.; Reddy V.Y.
Institution
(Osmancik, Herman, Tousek, Widimsky) Cardiocenter, Third Faculty of
Medicine, Charles University Prague and University Hospital Kralovske
Vinohrady, Prague, Czechia
(Neuzil, Hala, Lekesova, Reddy) Cardiocenter, Department of Cardiology, Na
Homolce Hospital, Prague, Czechia
(Taborsky) Cardiocenter, Department of Cardiology, University Hospital
Olomouc, Olomouc, Czechia
(Kala, Poloczek) Clinic of Cardiology, Masaryk University and University
Hospital Brno, Brno, Czechia
(Stasek, Haman) First Department of Internal Medicine, Faculty of
Medicine, University Hospital Hradec Kralove, Charles University Prague,
Prague, Czechia
(Branny, Chovancik) Department of Cardiology, Cardiocenter, Hospital
Podlesi a.s., Trinec, Czechia
(Cervinka, Holy) Department of Cardiology, Krajska zdravotni a.s., Masaryk
Hospital and J.E.Purkyne University, Usti nad Labem, Czechia
(Kovarnik, Zemanek, Havranek) Cardiocenter, Second Internal
Clinic-Cardiology and Angiology, Charles University, General Faculty
Hospital, Prague, Czechia
(Vancura, Opatrny) Department of Cardiology, University Hospital and
Faculty of Medicine Pilsen, Pilsen, Czechia
(Peichl) Cardiocenter, Institute of Clinical and Experimental Medicine,
Prague, Czechia
(Jarkovsky, Novackova, Benesova) Masaryk University, Institute of
Biostatistics and Analyses, Brno, Czechia
(Reddy) Helmsley Electrophysiology Center, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
Publisher
Elsevier USA
Abstract
Background: Percutaneous left atrial appendage closure (LAAC) is
noninferior to vitamin K antagonists (VKAs) for preventing atrial
fibrillation (AF)-related stroke. However, direct oral anticoagulants
(DOACs) have an improved safety profile over VKAs, and their effect on
cardiovascular and neurological outcomes relative to LAAC is unknown.
<br/>Objective(s): This study sought to compare DOACs with LAAC in
high-risk patients with AF. <br/>Method(s): Left Atrial Appendage Closure
vs. Novel Anticoagulation Agents in Atrial Fibrillation (PRAGUE-17) was a
multicenter, randomized, noninferiority trial comparing LAAC with DOACs.
Patients were eligible to be enrolled if they had nonvalvular AF; were
indicated for oral anticoagulation (OAC); and had a history of bleeding
requiring intervention or hospitalization, a history of a cardioembolic
event while taking an OAC, and/or a CHA<inf>2</inf>DS<inf>2</inf>-VASc of
>=3 and HAS-BLED of >2. Patients were randomized to receive LAAC or DOAC.
The primary composite outcome was stroke, transient ischemic attack,
systemic embolism, cardiovascular death, major or nonmajor clinically
relevant bleeding, or procedure-/device-related complications. The primary
analysis was by modified intention to treat. <br/>Result(s): A high-risk
patient cohort (CHA<inf>2</inf>DS<inf>2</inf>-VASc: 4.7 +/- 1.5) was
randomized to receive LAAC (n = 201) or DOAC (n = 201). LAAC was
successful in 181 of 201 (90.0%) patients. In the DOAC group, apixaban was
most frequently used (192 of 201; 95.5%). At a median 19.9 months of
follow-up, the annual rates of the primary outcome were 10.99% with LAAC
and 13.42% with DOAC (subdistribution hazard ratio [sHR]: 0.84; 95%
confidence interval [CI]: 0.53 to 1.31; p = 0.44; p = 0.004 for
noninferiority). There were no differences between groups for the
components of the composite endpoint: all-stroke/TIA (sHR: 1.00; 95% CI:
0.40 to 2.51), clinically significant bleeding (sHR: 0.81; 95% CI: 0.44 to
1.52), and cardiovascular death (sHR: 0.75; 95% CI: 0.34 to 1.62). Major
LAAC-related complications occurred in 9 (4.5%) patients.
<br/>Conclusion(s): Among patients at high risk for stroke and increased
risk of bleeding, LAAC was noninferior to DOAC in preventing major
AF-related cardiovascular, neurological, and bleeding events. (Left Atrial
Appendage Closure vs. Novel Anticoagulation Agents in Atrial Fibrillation
[PRAGUE-17]; NCT02426944)<br/>Copyright &#xa9; 2020 American College of
Cardiology Foundation

<47>
Accession Number
2003884929
Title
Effects of a person-centred telephone support on fatigue in people with
chronic heart failure: Subgroup analysis of a randomised controlled trial.
Source
European Journal of Cardiovascular Nursing. 19 (5) (pp 393-400), 2020.
Date of Publication: 01 Jun 2020.
Author
Wallstrom S.; Ali L.; Ekman I.; Swedberg K.; Fors A.
Institution
(Wallstrom, Ali, Ekman, Fors) Institute of Health and Care Sciences,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Wallstrom, Ali, Ekman, Swedberg, Fors) Centre for Person-Centred Care
(GPCC), University of Gothenburg, Gothenburg, Sweden
(Ali) Psychiatric Department, Sahlgrenska University Hospital, Gothenburg,
Sweden
(Swedberg) Department of Molecular and Clinical Medicine, Sahlgrenska
Academy, University of Gothenburg, Gothenburg, Sweden
(Swedberg) National Heart and Lung Institute, Imperial College, London,
United Kingdom
(Fors) Narhalsan Research and Development Primary Health Care, Region
Vastra Gotaland, Sweden
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Introduction: Fatigue is a prevalent symptom that is associated with
various conditions. In patients with chronic heart failure (CHF), fatigue
is one of the most commonly reported and distressing symptoms and it is
associated with disease progression. Person-centred care (PCC) is a
fruitful approach to increase the patient's ability to handle their
illness. <br/>Aim(s): The aim of this study was to evaluate the effects of
PCC in the form of structured telephone support on self-reported fatigue
in patients with CHF. <br/>Method(s): This study reports a subgroup
analysis of a secondary outcome measure from the Care4Ourselves randomised
intervention. Patients (n=77) that were at least 50 years old who had been
hospitalized due to worsening CHF received either usual care (n=38) or
usual care and PCC in the form of structured telephone support (n=39).
Participants in the intervention group created a health plan in
partnership with a registered nurse. The plan was followed up and
evaluated by telephone. Self-reported fatigue was assessed using the
Multidimensional Fatigue Inventory 20 (MFI-20) at baseline and at 6
months. Linear regression was used to analyse the change in MFI-20 score
between the groups. <br/>Result(s): The intervention group improved
significantly from baseline to the 6-month follow-up compared with the
control group regarding the 'reduced motivation' dimension of the MFI-20
(DELTA -1.41 versus 0.38, p=0.046). <br/>Conclusion(s): PCC in the form of
structured telephone support shows promise in supporting patients with CHF
in their rehabilitation, improve health-related quality of life and reduce
adverse events. Trial registration: ISRCTN.com
ISRCTN55562827.<br/>Copyright &#xa9; The European Society of Cardiology
2019.

<48>
Accession Number
2002604858
Title
Left main percutaneous coronary intervention-Radial versus femoral access:
A systematic analysis.
Source
Catheterization and Cardiovascular Interventions. 95 (7) (pp E201-E213),
2020. Date of Publication: 01 Jun 2020.
Author
Goel S.; Pasam R.T.; Raheja H.; Gotesman J.; Gidwani U.; Ahuja K.R.; Reed
G.; Puri R.; Khatri J.K.; Kapadia S.R.
Institution
(Goel, Pasam, Raheja, Gotesman) Department of Cardiology, Maimonides
Medical Center, Brooklyn, NY, United States
(Gidwani) Department of Cardiology, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Ahuja, Reed, Puri, Khatri, Kapadia) Department of Cardiology, Heart and
Vascular Institute, Cleveland Clinic, Cleveland, OH, United States
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background: Debate still occurs of the benefits of transradial access
(TRA) versus transfemoral access (TFA), especially for complex
percutaneous coronary interventions. Recent data has shown equivalent
efficacy and improved safety outcomes with TRA. <br/>Objective(s): To
systematically review and perform a meta-analysis comparing procedural
characteristics and clinical outcomes of TRA versus TFA in patients who
underwent percutaneous coronary intervention (PCI) for left main (LM)
disease. <br/>Method(s): We conducted an electronic database search of all
published data for studies that compared TRA with TFA in patients
undergoing PCI of LM disease. Event rates were compared using the odds
ratio (OR) as a measure of effect size. Random-effects models were used to
account for interstudy heterogeneity. <br/>Result(s): A total of 12
observational studies including 17,258 patients (TRA n = 7,971; TFA n =
9,287) were included. Compared to TFA, TRA was associated with a
significant reduction in access site bleeding (OR = 0.11; 95% confidence
interval [CI] = 0.04-0.26; I² = 0%; p <.0001), major bleeding
(OR = 0.44; 95% CI = 0.27-0.69; I² = 0%; p =.0005) or any
bleeding episode (OR = 0.43; 95% CI = 0.27-0.69; I² = 12%; p
=.0004). Rates of access site or vascular complications (OR = 0.26; 95% CI
= 0.17-0.40; I² = 0%; p <.00001) and in-hospital mortality (OR
= 0.49; 95% CI = 0.31-0.79: I² = 11%; p =.004) were also lower
in the TRA group. There were no significant differences in procedural
outcomes between TRA and TFA except for a significant reduction in the
rate of long-term target vessel revascularization (TVR) in the TRA group
(OR = 0.62; 95% CI = 0.41-0.94: I² = 0%: p =.02). We further
performed a subgroup analysis for unprotected left main PCI only, which
showed a significant reduction in rates of any bleeding episode, lower
access site or vascular complications, and in-hospital mortality with TRA
as compared to TFA. <br/>Conclusion(s): Patients undergoing PCI for LM
disease via TRA have with less bleeding, reduced access site or vascular
complications, reduced in-hospital mortality, comparable procedural
success, and possibly better long-term clinical efficacy when compared to
those undergoing the procedure via TFA.<br/>Copyright &#xa9; 2019 Wiley
Periodicals, Inc.

<49>
Accession Number
2005109621
Title
Children's heart and COVID-19: Up-to-date evidence in the form of a
systematic review.
Source
European Journal of Pediatrics. 179 (7) (pp 1079-1087), 2020. Date of
Publication: 01 Jul 2020.
Author
Sanna G.; Serrau G.; Bassareo P.P.; Neroni P.; Fanos V.; Marcialis M.A.
Institution
(Sanna, Serrau, Neroni, Fanos, Marcialis) Neonatal Intensive Care Unit,
University of Cagliari, Cagliari, Italy
(Bassareo) Mater Misericordiae University Hospital and Our Lady's
Children's Hospital Crumlin, University College of Dublin, Dublin, Ireland
(Bassareo) Mater Misericordiae University Hospital, University College of
Dublin, Eccles St, Inns Quay, Dublin D07 R2WY, Ireland
Publisher
Springer
Abstract
The new coronavirus disease outbreak in 2019 (COVID-19) represents a
dramatic challenge for healthcare systems worldwide. As to viral tropism,
lungs are not the only COVID-19 target but also the heart may be involved
in a not negligible percentage of the infected patients.
Myocarditis-related cardiac dysfunction and potentially life-threatening
arrhythmias are the main aftermaths. A few studies showed that myocardial
injury in adult patients is often linked with a fatal outcome. Conversely,
scientific evidence in children is sparse, although several reports were
published with the description of a cardiac involvement in COVID-19
paediatric patients. In these young subjects, a background of surgically
treated congenital heart disease seems to be a predisposing factor.
<br/>Conclusion(s): This systematic review is aimed at summarizing all
COVID-19 cases with a cardiac involvement published in paediatric age and
trying to explain the underlying mechanisms responsible for
COVID-19-related myocardial damage.What is Known:* Coronaviruses proved to
be able to jump from animals to humans.* The outbreak of COVID-19 started
from China (Dec 2019) and became pandemic.What is New:* Even in childhood,
COVID-19 is not without the risk of cardiac involvement.* Myocarditis,
heart failure, and arrhythmias are among the possible
manifestations.<br/>Copyright &#xa9; 2020, Springer-Verlag GmbH Germany,
part of Springer Nature.

<50>
Accession Number
2005094972
Title
Defining the MIS-TLIF: A Systematic Review of Techniques and Technologies
Used by Surgeons Worldwide.
Source
Global Spine Journal. 10 (2_suppl) (pp 151S-167S), 2020. Date of
Publication: 01 Apr 2020.
Author
Lener S.; Wipplinger C.; Hernandez R.N.; Hussain I.; Kirnaz S.;
Navarro-Ramirez R.; Schmidt F.A.; Kim E.; Hartl R.
Institution
(Lener, Wipplinger, Hernandez, Hussain, Kirnaz, Navarro-Ramirez, Schmidt,
Kim, Hartl) Weill Cornell Brain and Spine Center, Weill Cornell Medicine,
New York, NY, United States
(Lener, Wipplinger) Medical University of Innsbruck, Innsbruck, Austria
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Study Design: Systematic review. <br/>Objective(s): To date there is no
consensus among surgeons as to what defines an MIS-TLIF (transforaminal
lumbar interbody fusion using minimally invasive spine surgery) compared
to an open or mini-open TLIF. This systematic review aimed to examine the
MIS-TLIF techniques reported in the recent body of literature to help
provide a definition of what constitutes the MIS-TLIF, based on the
consensus of the majority of surgeons. <br/>Method(s): We created a
database of articles published about MIS-TLIF between 2010 and 2018. We
evaluated the technical components of the MIS-TLIF including instruments
and incisions used as well the order in which key steps are performed.
<br/>Result(s): We could identify several patterns for MIS-TLIF
performance that seemed agreed upon by the majority of MIS surgeons: use
of paramedian incisions; use of a tubular retractor to perform a total
facetectomy, decompression, and interbody cage implantation; and
percutaneous insertion of the pedicle-screw rod constructs with
intraoperative imaging. <br/>Conclusion(s): Based on this review of the
literature, the key features used by surgeons performing MIS TLIF include
the use of nonexpandable or expandable tubular retractors, a paramedian or
lateral incision, and the use of a microscope or endoscope for
visualization. Approaches using expandable nontubular retractors, those
that require extensive subperiosteal dissection from the midline
laterally, or specular-based retractors with wide pedicle to pedicle
exposure are far less likely to be promoted as an MIS-based approach. A
definition is necessary to improve the communication among spine surgeons
in research as well as patient education.<br/>Copyright &#xa9; The
Author(s) 2019.

<51>
Accession Number
2004909887
Title
Evaluation of Serratus Anterior Plane Block for Pain Relief in Patients
Undergoing MIDCAB Surgery.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 15 (2) (pp 148-154), 2020. Date of Publication: 01 Mar 2020.
Author
Gautam S.; Pande S.; Agarwal A.; Agarwal S.K.; Rastogi A.; Shamshery C.;
Singh A.
Institution
(Gautam, Agarwal, Rastogi, Shamshery, Singh) Department of Anesthesiology,
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
(Pande, Agarwal) Department of Cardiovascular and Thoracic Surgery, Sanjay
Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Objective: The minimally invasive direct coronary artery bypass (MIDCAB)
surgery is associated with severe chest pain in the first 2 to 3
postoperative days; this may delay the patient recovery. In this
randomized controlled trial we evaluated the role of serratus anterior
plane (SAP) block for postoperative pain relief in patients undergoing
MIDCAB surgery. <br/>Method(s): Patients undergoing MIDCAB surgery were
randomized into 2 groups of 25 each; SAP group received 20 mL of 0.2%
ropivacaine with 1 mug/mL fentanyl as bolus followed by infusion at 8
mL/h; control group received saline for both bolus and infusion. Primary
outcome measure was postoperative pain when supine, and during deep
inspiration, coughing, and patient movement; secondary outcome measures
were requirement of postoperative intravenous fentanyl and opioid-related
side effects. All patients were followed at 6-hourly intervals for 48
hours in the postoperative period. Results were analyzed by the Student's
t -test, chi² test, Mann-Whitney U-test and Kruskall-Wallis
test. A P-value <0.05 was considered significant. <br/>Result(s): The 2
groups were similar with respect to patient characteristics. Static and
dynamic pain visual analog scale scores were significantly reduced in the
SAP group as compared to the control group at most of the time points of
assessment (P < 0.05). Patient-controlled fentanyl requirements were
reduced in the SAP group as compared to control group on the second
postoperative day (P < 0.05). <br/>Conclusion(s): SAP block reduced the
postoperative pain scores and opioid requirements in patients undergoing
MIDCAB surgery.<br/>Copyright &#xa9; The Author(s) 2020.

<52>
Accession Number
2004441896
Title
Single-arm meta-analysis of Argentine studies reporting 30-day mortality
after transcatheter aortic valve implantation in intermediate-risk
patients.
Source
Revista Argentina de Cardiologia. 88 (2) (pp 111-117), 2020. Date of
Publication: 2020.
Author
Borracci R.A.; Amrein E.; Higa C.C.
Institution
(Borracci) School of Biomedical Sciences, Universidad Austral, Argentina
(Amrein, Higa) Cardiology Service, Herzzentrum, Hospital Aleman, Buenos
Aires, Argentina
Publisher
Sociedad Argentina de Cardiologia (E-mail: info@sac.org.ar)
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has proved to
be beneficial in intermediate-risk patients; however, there is no analysis
reporting overall TAVI results in our country. <br/>Objective(s): The aim
of this investigation was to conduct a meta-analysis of single-arm local
studies reporting in-hospital TAVI outcomes in intermediate-risk patients
in Argentina. <br/>Method(s): A systematic review was performed including
observational TAVI studies identified in MEDLINE, Embase, SCOPUS and
Cochrane to August 2019. <br/>Result(s): Among 59 articles identified
through the database search, only 4 local observational studies reported
30-day mortality and complications after TAVI in moderate-risk patients,
with Society of Thoracic Surgeons (STS) score ranging between 4% and 7%.
In 494 patients, 30-day mortality was 4.8%. Weighted pooled estimates of
the studies were: stroke 2.7%, myocardial infarction 1.0%, need for
definitive pacemaker 24.8%, moderate or severe periprosthetic leak 16.7%,
and major bleeding 5.5%. <br/>Conclusion(s): The proven efficacy of TAVI
is expanding its indication to intermediate and low-risk patients.
However, this shift should be supported by local evidence of its benefit
over traditional valve surgery. This single-arm meta-analysis of Argentine
studies presents 30-day mortality and complications after TAVI in
intermediate-risk patients. The updated information of local TAVI outcomes
will serve as a standard in our setting.<br/>Copyright &#xa9; 2020,
Sociedad Argentina de Cardiologia. All rights reserved.

<53>
Accession Number
2006842729
Title
Machine-learning-based in-hospital mortality prediction for transcatheter
mitral valve repair in the United States.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Hernandez-Suarez D.F.; Ranka S.; Kim Y.; Latib A.; Wiley J.;
Lopez-Candales A.; Pinto D.S.; Gonzalez M.C.; Ramakrishna H.; Sanina C.;
Nieves-Rodriguez B.G.; Rodriguez-Maldonado J.; Feliu Maldonado R.;
Rodriguez-Ruiz I.J.; da Luz Sant'Ana I.; Wiley K.A.; Cox-Alomar P.;
Villablanca P.A.; Roche-Lima A.
Institution
(Hernandez-Suarez) Division of Cardiovascular Medicine, Department of
Medicine, University of Puerto Rico School of Medicine, San Juan, PR,
United States
(Ranka) Division of Cardiovascular Medicine, Department of Medicine,
University of Kansas School of Medicine, Kansas City, KS, United States
(Kim) Division of Cardiovascular Medicine, Department of Medicine, Yale
University School of Medicine, New Haven, CT, United States
(Latib, Wiley, Gonzalez, Sanina) Division of Cardiology, Department of
Medicine, Montefiore Medical Center/Albert Einstein College of Medicine,
New York, NY, United States
(Lopez-Candales) Division of Cardiology, Department of Medicine,
University of Arkansas for Medical Sciences, Little Rock, AR, United
States
(Pinto) Beth Israel Deaconess Medical Center, Harvard Medical School,
Boston, MA, United States
(Ramakrishna) Division of Cardiovascular and Thoracic Anesthesiology, Mayo
Clinic, Rochester, MN, United States
(Nieves-Rodriguez, Rodriguez-Maldonado, Feliu Maldonado, Rodriguez-Ruiz,
da Luz Sant'Ana, Roche-Lima) Center for Collaborative Research in Health
Disparities, University of Puerto Rico School of Medicine, San Juan, PR,
United States
(Wiley) College of Agriculture and Life Sciences, Cornell University,
Ithaca, NY, United States
(Cox-Alomar) Division of Cardiology, Department of Medicine, Louisiana
State University, New Orleans, LA, United States
(Villablanca) Division of Cardiovascular Medicine, Department of Medicine,
Henry Ford Hospital, Detroit, MI, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Transcatheter mitral valve repair utilization has increased
significantly in the United States over the last years. Yet, a
risk-prediction tool for adverse events has not been developed. We aimed
to generate a machine-learning-based algorithm to predict in-hospital
mortality after TMVR. <br/>Method(s): Patients who underwent TMVR from
2012 through 2015 were identified using the National Inpatient Sample
database. The study population was randomly divided into a training set (n
= 636) and a testing set (n = 213). Prediction models for in-hospital
mortality were obtained using five supervised machine-learning
classifiers. <br/>Result(s): A total of 849 TMVRs were analyzed in our
study. The overall in-hospital mortality was 3.1%. A naive Bayes (NB)
model had the best discrimination for fifteen variables, with an area
under the receiver-operating curve (AUC) of 0.83 (95% CI, 0.80-0.87),
compared to 0.77 for logistic regression (95% CI, 0.58-0.95), 0.73 for an
artificial neural network (95% CI, 0.55-0.91), and 0.67 for both a random
forest and a support-vector machine (95% CI, 0.47-0.87). History of
coronary artery disease, of chronic kidney disease, and smoking were the
three most significant predictors of in-hospital mortality.
<br/>Conclusion(s): We developed a robust machine-learning-derived model
to predict in-hospital mortality in patients undergoing TMVR. This model
is promising for decision-making and deserves further clinical
validation.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<54>
Accession Number
2005416289
Title
Access site related vascular complications with third generation
transcatheter heart valve systems.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2020.
Date of Publication: 2020.
Author
Ruge H.; Burri M.; Erlebach M.; Lange R.
Institution
(Ruge, Burri, Erlebach, Lange) Department of Cardiovascular Surgery,
German Heart Center, TUM, INSURE (Institute for Translational Cardiac
Surgery), Munich, Germany
(Ruge, Burri, Erlebach, Lange) Department of Cardiovascular Surgery,
German Heart Center Munich, TUM, Munich, Germany
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objectives: This study examines the impact of anatomical and procedural
factors on Valve Academic Research Consortium-2-defined vascular
complications at the femoral access site in transcatheter aortic valve
replacement (TAVR) with third generation transcatheter heart valve
(THV)-systems. <br/>Background(s): Randomized clinical trials reported on
vascular complications with current THV-systems. However, clinical
presentation and consequences of these events are not well studied.
<br/>Method(s): All patients who underwent a transfemoral TAVR using an
Edwards Sapien3/Sapien3ultra or a Medtronic Evolut-R/Evolut-PRO have been
identified from our institutional database. Only procedures utilizing the
PerClose-ProGlide vascular closure device were included. Risk factors for
vascular complications were analyzed with a logistic regression model.
Preoperative and procedural data were collected. The postoperative course
of patients with and without vascular complications was compared.
<br/>Result(s): A total of 878 patients met the inclusion criteria. Of
these, 152 patients (17.3%) had an access-site related vascular
complication (87 major complications, 9.9%).
Sheath-to-femoral-artery-ratio (SFAR) (OR per 0.1 increase = 1.35, p
<.001) and more than 2 vessel entries with large bore sheaths (OR = 1.76,
p =.029) were independent risk factors for vascular complications. Female
gender (OR = 1.44, p =.07) and two vessel entries with large bore sheaths
(OR = 1.2, p =.53) increased the risk, although no statistical
significance was shown. Age (OR = 1.07, p =.62), body mass index (OR = 1.1
per 5 points, p =.32) and vessel wall calcification at puncture site (OR =
0.93, p =.7) had no influence on vascular complications. Patients with
vascular complications had a higher need for blood transfusion (p <.001)
and a higher in-hospital mortality (2.6 vs. 0.4%, p =.019).
<br/>Conclusion(s): Procedural risk assessment should include SFAR
calculation and consider the need for large bore sheath exchange. This
might reduce the vascular trauma, lower vascular complication rates and
improve the clinical outcome after TAVR.<br/>Copyright &#xa9; 2020 The
Authors. Catheterization and Cardiovascular Interventions published by
Wiley Periodicals LLC.

<55>
Accession Number
632198755
Title
Randomised controlled trial comparing efficacy and safety of high versus
low Low-Molecular Weight Heparin dosages in hospitalized patients with
severe COVID-19 pneumonia and coagulopathy not requiring invasive
mechanical ventilation (COVID-19 HD): a structured summary of a study
protocol.
Source
Trials. 21 (1) (pp 574), 2020. Date of Publication: 26 Jun 2020.
Author
Marietta M.; Vandelli P.; Mighali P.; Vicini R.; Coluccio V.; D'Amico R.
Institution
(Marietta, Coluccio) Dipartimento Oncologia ed Ematologia, Azienda
Ospedaliero-Universitaria di Modena, Ospedale Policlinico, Modena, Italy
(Vandelli, Mighali, Vicini, D'Amico) Servizio Formazione, Ricerca e
Innovazione, Azienda Ospedaliero-Universitaria di Modena, Ospedale
Policlinico, Modena, Italy
(D'Amico) Cattedra di Statistica Medica, Dipartimento di Scienze Mediche e
Chirurgiche Materno-Infantili e dell'Adulto, Universita di Modena e Reggio
Emilia, Modena, Italy
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To assess whether high doses of Low Molecular Weight Heparin
(LMWH) (i.e. Enoxaparin 70 IU/kg twice daily) compared to standard
prophylactic dose (i.e., Enoxaparin 4000 IU once day), in hospitalized
patients with COVID19 not requiring Invasive Mechanical Ventilation [IMV],
are: a)more effective in preventing clinical worsening, defined as the
occurrence of at least one of the following events, whichever comes first:
1.Death2.Acute Myocardial Infarction [AMI]3.Objectively confirmed,
symptomatic arterial or venous thromboembolism [TE]4.Need of either:
a.Continuous Positive Airway Pressure (Cpap) or Non-Invasive Ventilation
(NIV) orb.IMV in patients who at randomisation were receiving standard
oxygen therapy5.IMV in patients who at randomisation were receiving
non-invasive mechanical ventilationb)Similar in terms of major bleeding
risk TRIAL DESIGN: Multicentre, randomised controlled, superiority, open
label, parallel group, two arms (1:1 ratio), in-hospital study.
PARTICIPANTS: Inpatients will be recruited from 7 Italian Academic and
non-Academic Internal Medicine Units, 2 Infectious Disease Units and 1
Respiratory Disease Unit. INCLUSION CRITERIA (ALL REQUIRED): 1. Age > 18
and < 80 years 2. Positive SARS-CoV-2 diagnostic (on pharyngeal swab of
deep airways material) 3. Severe pneumonia defined by the presence of at
least one of the following criteria: a.Respiratory Rate >=25 breaths
/minb.Arterial oxygen saturation<=93% at rest on ambient airc.PaO2/FiO2
<=300 mmHg 4. Coagulopathy, defined by the presence of at least one of the
following criteria: a.D-dimer >4 times the upper level of normal reference
rangeb.Sepsis-Induced Coagulopathy (SIC) score >4 5. No need of IMV
EXCLUSION CRITERIA: 1. Age <18 and >80 years 2. IMV 3. Thrombocytopenia
(platelet count < 80.000 mm3) 4. Coagulopathy: INR >1.5, aPTT ratio > 1.4
5. Impaired renal function (eGFR calculated by CKD-EPI Creatinine equation
< 30 ml/min) 6. Known hypersensitivity to enoxaparin 7. History of heparin
induced thrombocytopenia 8. Presence of an active bleeding or a pathology
susceptible of bleeding in presence of anticoagulation (e.g. recent
haemorrhagic stroke, peptic ulcer, malignant cancer at high risk of
haemorrhage, recent neurosurgery or ophthalmic surgery, vascular
aneurysms, arteriovenous malformations) 9. Concomitant anticoagulant
treatment for other indications (e.g. atrial fibrillation, venous
thromboembolism, prosthetic heart valves) 10. Concomitant double
antiplatelet therapy 11. Administration of therapeutic doses of LMWH,
fondaparinux, or unfractionated heparin (UFH) for more than 72 hours
before randomization; prophylactic doses are allowed 12. Pregnancy or
breastfeeding or positive pregnancy test 13. Presence of other severe
diseases impairing life expectancy (e.g. patients are not expected to
survive 28 days given their pre-existing medical condition) 14. Lack or
withdrawal of informed consent INTERVENTION AND COMPARATOR: Control Group
(Low-Dose LMWH): patients in this group will be administered Enoxaparin
(Inhixa) at standard prophylactic dose (i.e., 4000 UI subcutaneously once
day). Intervention Group (High-Dose LMWH): patients in this group will be
administered Enoxaparin (Inhixa) at dose of 70 IU/kg every 12 hours, as
reported in the following table. This dose is commonly used in Italy when
a bridging strategy is required for the management of surgery or invasive
procedures in patients taking anti-vitamin K oral anticoagulants Body
Weight (kg)Enoxaparin dose every 12 hours
(IU)<50200050-69400070-89600090-1108000>11010000 The treatment with
Enoxaparin will be initiated soon after randomization (maximum allowed
starting time 12h after randomization). The treatment will be administered
every 12 hours in the intervention group and every 24 hours in the control
group. Treatments will be administered in the two arms until hospital
discharge or the primary outcomes detailed below occur. MAIN OUTCOMES:
Primary Efficacy Endpoint: Clinical worsening, defined as the occurrence
of at least one of the following events, whichever comes first:
1.Death2.Acute Myocardial Infarction [AMI]3.Objectively confirmed,
symptomatic arterial or venous thromboembolism [TE]4.Need of either:
a.Continuous Positive Airway Pressure (Cpap) or Non-Invasive Ventilation
(NIV) orb.IMV in patients who at randomisation were in standard oxygen
therapy by delivery interfaces5.Need for IMV, in patients who at
randomisation were in Cpap or NIV Time to the occurrence of each of these
events will be recorded. Clinical worsening will be analysed as a binary
outcome as well as a time-to-event one. Secondary Efficacy Endpoints: Any
of the following events occurring within the hospital stay 1.Death2.Acute
Myocardial Infarction [AMI]3.Objectively confirmed, symptomatic arterial
or venous thromboembolism [TE]4.Need of either: a.Continuous Positive
Airway Pressure (Cpap) or Non-Invasive Ventilation (NIV) orb.IMV in
patients who at randomisation were in standard oxygen therapy by delivery
interfaces5.Need for IMV in patients who at randomisation were in Cpap or
NIV6.Improvement of laboratory parameters of disease severity, including:
o D-dimer levelo Plasma fibrinogen levelso Mean Platelet Volumeo
Lymphocyte/Neutrophil ratioo IL-6 plasma levels MORTALITY AT 30 DAYS:
Information about patients' status will be sought in those who are
discharged before 30 days on Day 30 from randomisation. Time to the
occurrence of each of these events will be recorded. Each of these events
will be analysed as a binary outcome and as a time-to-event one. Primary
safety endpoint: Major bleeding, defined as an acute clinically overt
bleeding associated with one or more of the following: Decrease in
haemoglobin of 2 g/dl or more;Transfusion of 2 or more units of packed red
blood cells;Bleeding that occurs in at least one of the following critical
sites [intracranial, intraspinal, intraocular (within the corpus of the
eye; thus, a conjunctival bleed is not an intraocular bleed), pericardial,
intra-articular, intramuscular with compartment syndrome, or
retroperitoneal];Bleeding that is fatal (defined as a bleeding event that
was the primary cause of death or contributed directly to death);Bleeding
that necessitates surgical intervention Time to the occurrence of each of
these events will be recorded. Each of these events will be analysed as a
binary outcome and as a time-to-event one. Secondary safety endpoint:
Clinically Relevant non-major bleeding, defined as an acute clinically
overt bleeding that does not meet the criteria for major and consists of:
1.Any bleeding compromising hemodynamic2.Spontaneous hematoma larger than
25 cm2, or 100 cm2 if there was a traumatic cause3.Intramuscular hematoma
documented by ultrasonography4.Epistaxis or gingival bleeding requiring
tamponade or other medical intervention5.Bleeding from venipuncture for >5
minutes6.Haematuria that was macroscopic and was spontaneous or lasted for
more than 24 hours after invasive procedures7.Haemoptysis, hematemesis or
spontaneous rectal bleeding requiring endoscopy or other medical
intervention8.Any other bleeding requiring temporary cessation of a study
drug. Time to the occurrence of each of these events will be recorded.
Each of these events will be analysed as a binary outcome and as a
time-to-event one. RANDOMISATION: Randomisation (with a 1:1 randomisation
ratio) will be centrally performed by using a secure, web-based system,
which will be developed by the Methodological and Statistical Unit at the
Azienda Ospedaliero-Universitaria of Modena. Randomisation stratified by 4
factors: 1) Gender (M/F); 2) Age (<75/>=75 years); 3) BMI (<30/>=30); 4)
Comorbidities (0-1/>2) with random variable block sizes will be generated
by STATA software. The web-based system will guarantee the allocation
concealment. Blinding (masking) The study is conceived as open-label:
patients and all health-care personnel involved in the study will be aware
of the assigned group. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): The target
sample size is based on the hypothesis that LMWH administered at high
doses versus low doses will significantly reduce the risk of clinical
worsening. The overall sample size in this study is expected to be 300
with 150 in the Low-Dose LMWH control group and 150 in the High-Dose LMWH
intervention group, recruited over 10-11 months. Assuming an alpha of 5%
(two tailed) and a percentage of patients who experience clinical
worsening in the control group being between 25% and 30%, the study will
have 80% power to detect at least 50% relative reduction in the risk of
death between low and high doses of heparin. TRIAL STATUS: Protocol
version 1.2 of 11/05/2020. Recruitment start (expected): 08/06/2020
Recruitment finish (expected): 30/04/2021 Trial registration EudraCT
2020-001972-13, registered on April 17th, 2020 Full protocol The full
protocol is attached as an additional file, accessible from the Trials
website (Additional file 1). In the interest in expediting dissemination
of this material, the familiar formatting has been eliminated; this Letter
serves as a summary of the key elements of the full protocol.

<56>
Accession Number
632196787
Title
Efficacy and safety outcomes in novel oral anticoagulants versus vitamin-K
antagonist on post-TAVI patients: a meta-analysis.
Source
BMC cardiovascular disorders. 20 (1) (pp 307), 2020. Date of Publication:
26 Jun 2020.
Author
Liang H.; He Q.; Zhang Q.; Liu X.; Cui K.; Chen G.; Xiu J.
Institution
(Liang, Zhang, Liu, Cui, Chen, Xiu) Department of Cardiology, Nanfang
Hospital, Southern Medical University, Guangzhou, Guangdong, China
(He) Pediatric Cardiac Surgery Center, National Center for Cardiovascular
Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking
Union Medical College, Beijing, China
(He) Faculty of Medicine, International School, Jinan University,
Guangzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been a
favored option for the patient who suffered from symptomatic aortic
stenosis. However, the efficacy and safety outcomes in novel oral
anticoagulants (NOACs) versus Vitamin-K antagonist (VKA) for post-TAVI
patients are still controversial. This meta-analysis aims at comparing the
clinical outcome and safety of NOACs and VKA in the patients after
receiving TAVI. <br/>METHOD(S): We searched literature articles in all
reachable databases, and observational study as well as randomized
controlled trial would be included in order to perform a comprehensive
analysis. All-cause mortality, major or life-threatening bleeding,
disabling or nondisabling stroke were main pooled outcome measures.
Subgroup analysis and meta-regression were adopted to explore
heterogeneity. Assessment of bias was performed under the suggestion of
Cochrane's Collaboration Tool. <br/>RESULT(S): We collected 3841
non-duplicate citations from PubMed, Embase, Cochrane and
ClinicalTrials.gov, and eventually 7 studies were included for this
meta-analysis. As a result, VKA showed priority against NOACs in the field
of anti-thromboembolism (4435 participants, RR:1.44, 95% CI: 1.05 to 1.99,
I2 =0%, P=0.02). <br/>CONCLUSION(S): With corroborative analysis of severe
complications, VKA is shown to be more protective on post-TAVI patients in
disabling or nondisabling stroke scenario but not in mortality or bleeding
event.

<57>
Accession Number
2005422128
Title
A prospective multicenter study of direct comparison of feasibility and
safety of pulmonary vein isolation using the minimally interrupted
apixaban between second-generation cryoballoon and radiofrequency ablation
of paroxysmal atrial fibrillation: J-HIT apixaban.
Source
Journal of Arrhythmia. (no pagination), 2020. Date of Publication: 2020.
Author
Yagishita A.; Goya M.; Iesaka Y.; Nitta J.; Takahashi A.; Nagata Y.;
Hachiya H.; Inaba O.; Inamura Y.; Tanaka Y.; Watanabe K.; Tao S.; Shirai
Y.; Yamamoto T.; Shiohira S.; Akiyoshi K.; Sekigawa M.; Maeda S.; Sasaki
T.; Takahashi Y.; Kawabata M.; Hirao K.
Institution
(Yagishita, Goya, Tao, Shirai, Yamamoto, Shiohira, Akiyoshi, Sekigawa,
Sasaki, Kawabata, Hirao) Department of Cardiovascular Medicine/Heart
Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan
(Iesaka, Hachiya) Cardiovascular Center, Tsuchiura Kyodo Hospital,
Tsuchiura, Japan
(Nitta, Inaba, Inamura) Department of Cardiology, Saitama Red Cross
Hospital, Saitama, Japan
(Takahashi, Tanaka) Cardiovascular Center, Yokosuka Kyosai Hospital,
Yokosuka, Japan
(Nagata, Watanabe) Division of Cardiology, Musashino Red Cross Hospital,
Tokyo, Japan
(Maeda, Takahashi) Department of Advanced Arrhythmia Research, Tokyo
Medical and Dental University, Tokyo, Japan
Publisher
Wiley-Blackwell (E-mail: info@wiley.com)
Abstract
Background: The feasibility and safety of pulmonary vein isolation (PVI)
using cryoballoon (CB) for paroxysmal atrial fibrillation (PAF) with
minimally interrupted apixaban has not fully explored. <br/>Method(s): In
this multicenter, randomized prospective study, we enrolled patients with
PAF undergoing CB or radiofrequency (RF) ablation with interrupted
(holding 1 dose) apixaban. The primary composite end point consisted of
bleeding events, including pericardial effusion and major bleeding
requiring blood transfusion, or thromboembolic events at 4 weeks after
ablation; secondary end points included early recurrence of AF and
procedural duration. <br/>Result(s): A total of 250 patients underwent PVI
(125 assigned to the RF ablation and 125 assigned to the CB ablation). The
primary end point occurred in 1 patient in the CB ablation group (0.8%;
90% confidence interval [CI], 0.04 to 3.70) and 3 patients in the RF group
(2.4%, P =.622; risk ratio, 0333; 90% CI, 0.05 to 2.20). All events were
pericardial effusion, all of whom recovered after pericardiocentesis.
Early recurrence of AF occurred in 4 patients (3.2%) in the RF group and
in 6 patients (4.8%) in the CB group (P =.749). The procedural duration
was shorter in the CB group than that in the RF group (136.5 +/- 39.9 vs
179.5 +/- 44.8 min, P <.001). <br/>Conclusion(s): CB ablation with
minimally interrupted apixaban was feasible and safe in patients with PAF
undergoing PVI, which was equivalent to RF ablation.<br/>Copyright &#xa9;
2020 The Authors. Journal of Arrhythmia published by John Wiley & Sons
Australia, Ltd on behalf of Japanese Heart Rhythm Society

<58>
Accession Number
2005419677
Title
Long-term effects of high-intensity training vs moderate intensity
training in heart transplant recipients: A 3-year follow-up study of the
randomized-controlled HITTS study.
Source
American Journal of Transplantation. (no pagination), 2020. Date of
Publication: 2020.
Author
Rolid K.; Andreassen A.K.; Yardley M.; Gude E.; Bjorkelund E.; Authen
A.R.; Grov I.; Broch K.; Gullestad L.; Nytroen K.
Institution
(Rolid, Andreassen, Yardley, Gude, Bjorkelund, Authen, Grov, Broch,
Gullestad, Nytroen) Department of Cardiology, Oslo University Hospital
Rikshospitalet, Oslo, Norway
(Rolid, Andreassen, Yardley, Gullestad, Nytroen) Institute of Clinical
Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
(Rolid, Yardley) The Norwegian Health Association, Oslo, Norway
(Rolid, Broch, Gullestad, Nytroen) KG Jebsen Center for Cardiac Research,
University of Oslo, Norway and the Center for Heart Failure Research, Oslo
University Hospital, Oslo, Norway
Publisher
Blackwell Publishing Ltd
Abstract
The randomized controlled High-Intensity Interval Training in De Novo
Heart Transplant Recipients in Scandinavia (HITTS) study compared 9 months
of high-intensity interval training (HIT) with moderate intensity
continuous training in de novo heart transplant recipients. In our 3-year
follow-up study, we aimed to determine whether the effect of early
initiation of HIT on peak oxygen consumption (VO<inf>2peak</inf>)
persisted for 2 years postintervention. The study's primary end point was
the change in VO<inf>2peak</inf> (mL/kg/min). The secondary end points
were muscle strength, body composition, heart rate response,
health-related quality of life, daily physical activity, biomarkers, and
heart function. Of 78 patients who completed the 1-year HITTS trial, 65
entered our study and 62 completed the study tests. VO<inf>2peak</inf>
increased from baseline to 1 year and leveled off thereafter. During the
intervention period, the increase in VO<inf>2peak</inf> was larger in the
HIT arm; however, 2 years later, there was no significant between-group
difference in VO<inf>2peak</inf>. However, the mean change in the
anaerobic threshold and extensor muscle endurance remained significantly
higher in the HIT group. Early initiation of HIT after heart
transplantation appears to have some sustainable long-term effects.
Clinical trial registration number: NCT01796379.<br/>Copyright &#xa9; 2020
The Authors. American Journal of Transplantation published by Wiley
Periodicals LLC on behalf of The American Society of Transplantation and
the American Society of Transplant Surgeons

<59>
Accession Number
2005419632
Title
Association between surgical risk and 30-day stroke after transcatheter
versus surgical aortic valve replacement: a systematic review and
meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2020.
Date of Publication: 2020.
Author
Matsuda Y.; Nai Fovino L.; Giacoppo D.; Scotti A.; Massussi M.; Ueshima
D.; Sasano T.; Fabris T.; Tarantini G.
Institution
(Matsuda, Nai Fovino, Giacoppo, Scotti, Massussi, Ueshima, Fabris,
Tarantini) Department of Cardiac, Thoracic, Vascular Sciences and Public
Health, University of Padua Medical School, Padua, Italy
(Matsuda, Sasano) Department of Cardiovascular Medicine, Graduate School
of General Medical and Dental Science, Tokyo Medical and Dental
University, Tokyo, Japan
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background: Stroke is a feared complication of transcatheter aortic valve
replacement (TAVR) and surgical aortic valve replacement (SAVR).
<br/>Objective(s): With this meta-analysis we aimed to evaluate the
incidence of 30-day stroke with TAVR and SAVR focusing on its possible
correlation with surgical risk. <br/>Method(s): Major electronic databases
were searched for studies published between January 2002 and October 2019
reporting the rates of 30-day stroke after TAVR and SAVR. Data were pooled
using fixed- and random-effects models. The primary outcome of the study
was stroke rate within 30-day from TAVR or SAVR. Results were stratified
according to surgical risk score (high, intermediate and low).
<br/>Result(s): A total of 23 studies were identified (TAVR: 14,589
patients; SAVR: 11,681 patients). Regardless of the model used, in the
overall population TAVR was associated with a significant reduction in the
risk of stroke compared with SAVR (fixed effect: OR 0.78, 95% CI
0.66-0.92, p =.003; random-effects: OR 0.80, 95% CI 0.64-1.00, p =.045).
Rates of 30-day stroke after TAVR and SAVR were not significantly
different in the high- (OR 1.01, 95% CI 0.44-1.98, p =.105) and
intermediate-risk groups (OR 0.92, 95% CI 0.63-1.36, p =.319), while
low-risk patients had a lower rate of 30-day stroke after TAVR than SAVR
(OR 0.65, 95% CI 0.50-0.83, p <.001). Meta-regression showed a significant
association between surgical risk score and 30-day stroke rate (p =.007).
<br/>Conclusion(s): TAVR is associated with a lower risk of 30-day stroke
compared with SAVR, mainly as a result of the significant advantage
observed in patients at low surgical risk.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC.

<60>
Accession Number
2005418980
Title
Comparison of preincisional and postincisional parasternal intercostal
block on postoperative pain in cardiac surgery.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Padala S.R.A.N.; Badhe A.S.; Parida S.; Jha A.K.
Institution
(Padala, Badhe, Parida, Jha) Department of Anaesthesiology and Critical
Care, Jawaharlal Institute of Postgraduate Medical Education and Research,
Puducherry, India
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: The optimum cardiac surgical pain management has known to
maintain hemodynamic stability and, reduces respiratory and cardiovascular
complications. Postoperative parasternal intercostal block has shown to
reduce postoperative analgesic consumption after cardiac surgery.
Therefore, this study sought to investigate the effectiveness of the
preoperative ultrasound guided parasternal block in reducing postoperative
pain after cardiac surgery. <br/>Method(s): This was a randomized,
prospective, interventional, single blind study comprised of 90 adult
patients scheduled for cardiac surgery involving sternotomy.
Preoperatively and postoperatively, 0.25% bupivacaine administered in 4 mL
aliquots into the anterior (2nd-6th) intercostal spaces on each side about
2 cm lateral to the sternal edge with a total volume of 40 mL under
ultrasound guidance and direct vision, respectively. Postoperative pain
was rated according to visual analogue scale. Secondary outcomes included
intraoperative and postoperative fentanyl consumptions, dosages of rescue
medications, and time to extubation. <br/>Main Result(s): There was no
significant differences in visual analogue score visual analogue score at
all time points till 24 hours postoperatively. Intraoperative fentanyl
requirements (microgram/kg) before cardiopulmonary bypass was
significantly lower in pre-incisional group than the post-incisional group
(0.16 +/- 0.43 vs 0.68 +/- 0.72; P =.0001). Furthermore, there were no
significant difference in total fentanyl requirement (7.20 +/- 2.66 vs
8.37 +/- 3.13; P =.06) and tramadol requirement (0.02 +/- 0.15 vs 0.07 +/-
0.26; P =.28) within first 24 hours. However, time to extubation was
significantly higher in the preoperative group (P =.02).
<br/>Conclusion(s): Preoperative and postoperative parasternal intercostal
block provide comparable pain relief during the postoperative
period.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<61>
Accession Number
632204602
Title
Long-Axis In-Plane Approach Versus Short-Axis Out-of-Plane Approach for
Ultrasound-Guided Central Venous Catheterization in Pediatric Patients: A
Randomized Controlled Trial.
Source
Pediatric critical care medicine : a journal of the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies. (no pagination), 2020. Date of Publication: 25 Jun 2020.
Author
Takeshita J.; Tachibana K.; Nakajima Y.; Nagai G.; Fujiwara A.; Hamaba H.;
Matsuura H.; Yamashita T.; Shime N.
Institution
(Takeshita, Tachibana, Nagai, Fujiwara, Hamaba, Matsuura, Yamashita)
Department of Anesthesiology, Osaka Prefectural Hospital Organization,
Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
(Takeshita, Nakajima) Department of Anesthesiology, Kansai Medical
University Hospital, Hirakata, Osaka, Japan
(Shime) Department of Emergency and Critical Care Medicine, Institute of
Biomedical & Health Sciences, Hiroshima University, Minami-ku, Hiroshima,
Japan
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The aim of this study was to compare the occurrence of
posterior wall puncture between the long-axis in-plane and the short-axis
out-of-plane approaches in a randomized controlled trial of pediatric
patients who underwent cardiovascular surgery under general anesthesia.
DESIGN: Prospective randomized controlled trial. SETTING: Operating room
of Osaka Women's and Children's Hospital. PATIENTS: Pediatric patients
less than 5 years old who underwent cardiovascular surgery. INTERVENTIONS:
Ultrasound-guided central venous catheterization using the long-axis
in-plane approach and short-axis out-of-plane approach. MEASUREMENTS AND
MAIN RESULTS: The occurrence of posterior wall puncture was compared
between the long-axis in-plane and short-axis out-of-plane approaches for
ultrasound-guided central venous catheterization. Patients were randomly
allocated to a long-axis group or a short-axis group and underwent
ultrasound-guided central venous catheterization in the internal jugular
vein using either the long-axis in-plane approach (long-axis group) or the
short-axis out-of-plane approach (short-axis group). After exclusion, 97
patients were allocated to the long-axis (n = 49) or short-axis (n = 48)
groups. Posterior wall puncture rates were 8.2% (4/49) and 39.6% (19/48)
in the long-axis and short-axis groups, respectively (relative risk, 0.21;
95% CI, 0.076-0.56; p = 0.0003). First attempt success rates were 67.3%
(33/49) and 64.6% (31/48) in the long-axis and short-axis groups,
respectively (relative risk, 1.04; 95% CI, 0.78-1.39; p = 0.77). Overall
success rates within 20 minutes were 93.9% (46/49) and 93.8% (45/48) in
the long-axis and short-axis groups, respectively (relative risk, 0.99;
95% CI, 0.90-1.11; p = 0.98). <br/>CONCLUSION(S): The long-axis in-plane
approach for ultrasound-guided central venous catheterization is a useful
technique for avoiding posterior wall puncture in pediatric patients,
compared with the short-axis out-of-plane approach.

<62>
Accession Number
632203308
Title
Cardiac Surgery 2019 Reviewed.
Source
The Thoracic and cardiovascular surgeon. (no pagination), 2020. Date of
Publication: 27 Jun 2020.
Author
Doenst T.; Bargenda S.; Kirov H.; Moschovas A.; Tkebuchava S.; Safarov R.;
Velichkov I.; Diab M.
Institution
(Doenst, Bargenda, Kirov, Moschovas, Tkebuchava, Safarov, Velichkov, Diab)
Department of Cardiothoracic Surgery, Friedrich-Schiller University of
Jena, Jena, Germany
Publisher
NLM (Medline)
Abstract
For the year 2019, almost 25,000 published references can be found in
PubMed when entering the search term "cardiac surgery." We used the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
approach for article selection and reviewed the main fields of adult
cardiac surgery (i.e., coronary, valve, aortic, and heart failure
surgery). The past decade has experienced an enormous development of
interventional techniques that compete more and more with classic surgery.
This contest was broadly visible in 2019. It peaked over the
interpretation of the EXCEL trial data, where percutaneous coronary
intervention and coronary artery bypass grafting (CABG) for left main
disease were compared. A novel pathomechanism for CABG was proposed,
potentially answering open questions in the field. In aortic valve
surgery, two low-risk trials comparing transcatheter aortic valve
implantation (TAVI) to classic aortic valve replacement (surgical aortic
valve replacement) received attention for showing equal or superior
short-term outcomes for TAVI. Longer follow-up information from recent
trials became available presenting results emphasizing the need for joint
decision making. While publications addressing surgery on the aorta and
the mitral and tricuspid valves were less abundant, there was substantial
activity regarding left ventricular assist device support and heart
transplantation. This article attempts to summarize the most pertinent
publications. It does not expect to be complete and cannot be free of
individual interpretation. We aimed to provide a condensed summary of
2019s publications with a stimulus for in-depth reading and a basis
supporting patient information.<br/>Copyright Georg Thieme Verlag KG
Stuttgart . New York.

<63>
Accession Number
632200259
Title
Clinical and conceptual approaches to interpreting the findings of
systematic review and meta-analysis of mortality after drug-eluting stents
vs. coronary artery bypass grafting for left main coronary artery disease.
Source
European heart journal. (no pagination), 2020. Date of Publication: 26 Jun
2020.
Author
Jayaraj R.; Kumaraswamy C.; Shaw P.
Institution
(Jayaraj) Northern Territory Medical Program (NTMP), College of Medicine
and Public Health, Flinders University, CDU Campus ,Ellengowan Drive,
Darwin, NT 0909, Australia
(Jayaraj, Shaw) Department of Artificial Intelligence, Nanjing University
of Information Science and Technology (NUIST), Jiangsu, China
(Kumaraswamy) School of Public Health, University of Adelaide, North
Terrace Campus, Adelaide SA 5005, Australia
Publisher
NLM (Medline)

<64>
Accession Number
632196506
Title
Platelet Transfusion in Cardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 22 Jun 2020.
Author
Yanagawa B.; Ribeiro R.; Lee J.; Mazer C.D.; Cheng D.; Martin J.; Verma
S.; Friedrich J.O.
Institution
(Yanagawa, Ribeiro, Lee, Verma) Divisions of Cardiac Surgery
(Mazer) Departments of Anesthesia; Critical Care and Medicine, St
Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
(Cheng, Martin) Department of Anesthesia & Perioperative Medicine, MEDICI
Centre, University of Western Ontario
(Friedrich) Critical Care and Medicine, St Michael's Hospital, University
of Toronto, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Blood transfusion is a well-established independent risk
factor for mortality in patients undergoing cardiac surgery but the impact
of platelet transfusion is less clear. We performed a systematic review
and meta-analysis of observational studies comparing outcomes of patients
who received platelet transfusion following cardiac surgery.
<br/>METHOD(S): We searched MEDLINE and EMBASE databases to January 2019
for studies comparing peri-operative outcomes in patients undergoing
cardiac surgery with and without platelet transfusion. <br/>RESULT(S):
There were 9 observational studies reporting on 101,511 patients: 12% with
and 88% without platelet transfusion. In unmatched/unadjusted studies,
patients who received platelet transfusion were older with greater
incidence of renal, peripheral and cerebrovascular disease, myocardial
infarction, left ventricular dysfunction, and anemia. They were more
likely to have non-elective, combined surgery; pre-operative hemodynamic
instability and endocarditis; and more likely to be on clopidogrel
preoperatively. Perioperative complications were significantly increased
without adjusting for these baseline differences. After pooling only
matched/adjusted data, differences were not found in patients who did vs
did not receive platelets for operative mortality (risk ratio [RR] 1.26,
95%CI:0.69-2.32, p=0.46, 5 studies), stroke (RR 0.94, 95%CI:0.62-1.45,
p=0.79, 5 studies), myocardial infarction (RR1.29, 95%CI:0.95-1.77,
p=0.11, 3 studies), reoperation for bleeding (RR1.20, 95%CI:0.46-3.18,
p=0.71, 3 studies), infection (RR1.02, 95%CI:0.86-1.20, p=0.85, 6
studies), and peri-operative dialysis (RR0.91, 95%CI:0.63-1.32, p=0.62, 3
studies). <br/>CONCLUSION(S): After accounting for baseline differences,
platelet transfusion was not linked with perioperative complications in
cardiac surgery patients. Given the small number of observational studies,
these findings should be considered hypothesis generating.<br/>Copyright
&#xa9; 2020. Published by Elsevier Inc.