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<1>
Accession Number
2006889886
Title
10-Year Outcomes From a Randomized Trial of Polymer-Free Versus Durable
Polymer Drug-Eluting Coronary Stents.
Source
Journal of the American College of Cardiology. 76 (2) (pp 146-158), 2020.
Date of Publication: 14 July 2020.
Author
Kufner S.; Ernst M.; Cassese S.; Joner M.; Mayer K.; Colleran R.; Koppara
T.; Xhepa E.; Koch T.; Wiebe J.; Ibrahim T.; Fusaro M.; Laugwitz K.-L.;
Schunkert H.; Kastrati A.; Byrne R.A.
Institution
(Kufner, Ernst, Cassese, Joner, Mayer, Colleran, Xhepa, Koch, Wiebe,
Fusaro, Schunkert, Kastrati) Deutsches Herzzentrum Munchen, Technische
Universitat Munchen, Munich, Germany
(Joner, Laugwitz, Schunkert, Kastrati) German Center for Cardiovascular
Research, partner site Munich Heart Alliance, Munich, Germany
(Koppara, Ibrahim, Laugwitz) Klinik und Poliklinik Innere Medizin I
(Kardiologie, Angiologie und Pneumologie), Klinikum rechts der Isar,
Technische Universitat Munchen, Munich, Germany
(Byrne) Dublin Cardiovascular Research Institute, Mater Private Hospital,
Dublin, Ireland
(Byrne) School of Pharmacy and Biomolecular Sciences, Royal College of
Surgeons in Ireland, Dublin, Ireland
Publisher
Elsevier USA
Abstract
Background: Outcome data after extended long-term follow-up of patients
with coronary artery disease treated with drug-eluting stents (DES) in
randomized clinical trials are scant. <br/>Objective(s): Performance
differences among devices may be expected to emerge over time depending on
whether stenting is done with polymer-free or durable polymer DES. This
study assessed the 10-year outcomes of patients enrolled in the
ISAR-TEST-5 (Test Efficacy of Sirolimus- and Probucol-Eluting Versus
Zotarolimus-Eluting Stents) trial. <br/>Method(s): A total of 3,002
patients were randomized to treatment with either polymer-free sirolimus-
and probucol-eluting stents (n = 2,002) or durable polymer
zotarolimus-eluting stents (n = 1,000). The primary endpoint was the
composite of cardiac death, target vessel-related myocardial infarction,
or target lesion revascularization (a device-oriented composite endpoint
[DOCE]). Additional endpoints of interest were the patient-oriented
composite endpoint (POCE), including all-cause death, any myocardial
infarction, or any revascularization; individual components of the
composite endpoints; and definite or probable stent thrombosis.
<br/>Result(s): The median age of the patients at randomization was 67.8
years. At 10 years, 63.9% of patients were alive. The rates of DOCE and
POCE were high in both groups with no difference in the incidence between
polymer-free sirolimus- and probucol-eluting stents and durable polymer
zotarolimus-eluting stents (DOCE: 43.8% vs. 43.0%, respectively; hazard
ratio: 1.01; 95% confidence interval [CI]: 0.89 to 1.14; p = 0.90; POCE:
66.2% vs. 67.7%, respectively; hazard ratio: 0.94; 95% CI: 0.86 to 1.04; p
= 0.22). The rates of the individual components of the composite endpoints
were comparable in both groups. The incidence of definite/probable stent
thrombosis over 10 years was low and comparable in both groups (1.6% vs.
1.9%; hazard ratio: 0.85; 95% CI: 0.46 to 1.54; p = 0.58).
<br/>Conclusion(s): At 10 years, there were no measurable differences in
outcomes between patients treated with polymer-free versus durable polymer
DES. The incidence of stent thrombosis was low and comparable in both
groups. High overall adverse clinical event rates were observed during
extended follow-up. (Test Efficacy of Sirolimus- and Probucol-Eluting
Versus Zotarolimus-Eluting Stents [ISAR-TEST-5];
NCT00598533)<br/>Copyright &#xa9; 2020 The Authors

<2>
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

<3>
Accession Number
613799386
Title
Impact of incomplete percutaneous revascularization in patients with
multivessel coronary artery disease: A systematic review and
meta-analysis.
Source
Journal of the American Heart Association. 5 (12) (no pagination), 2016.
Article Number: e004598. Date of Publication: 2016.
Author
Nagaraja V.; Ooi S.-Y.; Nolan J.; Large A.; De Belder M.; Ludman P.; Bagur
R.; Curzen N.; Matsukage T.; Yoshimachi F.; Kwok C.S.; Berry C.; Mamas
M.A.
Institution
(Nagaraja, Ooi) Department of Cardiology, Prince of Wales Hospital,
Sydney, NSW, Australia
(Nolan, Large, Kwok, Mamas) Royal Stoke University Hospital, University
Hospitals of North Midlands, Stoke-on-Trent, United Kingdom
(Nolan, Kwok, Mamas) Keele Cardiovascular Research Group, Institute of
Science and Technology in Medicine, University of Keele, Stoke-on-Trent,
United Kingdom
(De Belder) The James Cook University Hospital, Middlesbrough, United
Kingdom
(Ludman) Queen Elizabeth Hospital, Birmingham, United Kingdom
(Bagur) Division of Cardiology, Department of Medicine and Department of
Epidemiology and Biostatistics, London Health Sciences Centre, Western
University, London, ON, Canada
(Curzen) University Hospital Southampton and Faculty of Medicine,
University of Southampton, United Kingdom
(Matsukage, Yoshimachi) Division of Cardiology, Tokai University School of
Medicine, Isehara, Japan
(Berry) Institute of Cardiovascular and Medical Sciences, University of
Glasgow, United Kingdom
Publisher
John Wiley and Sons Inc.
Abstract
Background-Up to half of patients undergoing percutaneous coronary
intervention have multivessel coronary artery disease (MVD) with
conflicting data regarding optimal revascularization strategy in such
patients. This paper assesses the evidence for complete revascularization
(CR) versus incomplete revascularization in patients undergoing
percutaneous coronary intervention, and its prognostic impact using
meta-analysis. Methods and Results-A search of PubMed, EMBASE, MEDLINE,
Current Contents Connect, Google Scholar, Cochrane library, Science
Direct, and Web of Science was conducted to identify the association of CR
in patients with multivessel coronary artery disease undergoing
percutaneous coronary intervention with major adverse cardiac events and
mortality. Random-effects metaanalysis was used to estimate the odds of
adverse outcomes. Meta-regression analysis was conducted to assess the
relationship with continuous variables and outcomes. Thirty-eight
publications that included 156 240 patients were identified. Odds of death
(OR 0.69, 95% CI 0.61-0.78), repeat revascularization (OR 0.60, 95% CI
0.45-0.80), myocardial infarction (OR 0.64, 95% CI 0.50- 0.81), and major
adverse cardiac events (OR 0.63, 95% CI 0.50-0.79) were significantly
lower in the patients who underwent CR. These outcomes were unchanged on
subgroup analysis regardless of the definition of CR. Similar findings
were recorded when CR was studied in the chronic total occlusion (CTO)
subgroup (OR 0.65, 95% CI 0.53-0.80). A meta-regression analysis revealed
a negative relationship between the OR for mortality and the percentage of
CR. Conclusion-CR is associated with reduced risk of mortality and major
adverse cardiac events, irrespective of whether an anatomical or a
score-based definition of incomplete revascularization is used, and this
magnitude of risk relates to degree of CR. These results have important
implications for the interventional management of patients with
multivessel coronary artery disease.<br/>Copyright &#xa9; 2016 The
Authors.

<4>
Accession Number
613430248
Title
Isolated human pulmonary artery structure and function pre -and
post-cardiopulmonary bypass surgery.
Source
Journal of the American Heart Association. 5 (2) (no pagination), 2016.
Article Number: e002822. Date of Publication: 2016.
Author
Dora K.A.; Stanley C.P.; Jaaly E.A.; Fiorentino F.; Ascione R.; Reeves
B.C.; Angelini G.D.
Institution
(Dora, Stanley) Department of Pharmacology, University of Oxford, United
Kingdom
(Jaaly, Fiorentino, Angelini) Department of Cardiothoracic Surgery,
Hammersmith Hospital, Imperial College London, London, United Kingdom
(Ascione, Reeves, Angelini) Bristol Heart Institute, Bristol Royal
Infirmary, University of Bristol, United Kingdom
(Stanley) The Victor Chang Cardiac Research Institute, Sydney, Australia
Publisher
John Wiley and Sons Inc.
Abstract
Background-Pulmonary dysfunction is a known complication after cardiac
surgery using cardiopulmonary bypass, ranging from subclinical functional
changes to prolonged postoperative ventilation, acute lung injury, and
acute respiratory distress syndrome. Whether human pulmonary arterial
function is compromised is unknown. The aim of the present study was to
compare the structure and function of isolated and cannulated human
pulmonary arteries obtained from lung biopsies after the chest was opened
(pre-cardiopulmonary bypass) to those obtained at the end of
cardiopulmonary bypass (post-cardiopulmonary bypass) from patients
undergoing coronary artery bypass graft surgery. Methods and
Results-Pre-and post-cardiopulmonary bypass lung biopsies were received
from 12 patients undergoing elective surgery. Intralobular small arteries
were dissected, cannulated, pressurized, and imaged using confocal
microscopy. Functionally, the thromboxane mimetic U46619 produced
concentration-dependent vasoconstriction in 100% and 75% of pre-and
post-cardiopulmonary bypass arteries, respectively. The
endothelium-dependent agonist bradykinin stimulated vasodilation in 45%
and 33% of arteries pre-and post-cardiopulmonary bypass, respectively.
Structurally, in most arteries smooth muscle cells aligned
circumferentially; live cell viability revealed that although 100% of
smooth muscle and 90% of endothelial cells from pre -cardiopulmonary
bypass biopsies had intact membranes and were considered viable, only 60%
and 58%, respectively, were viable from post-cardiopulmonary bypass
biopsies. Conclusions-We successfully investigated isolated pulmonary
artery structure and function in fresh lung biopsies from patients
undergoing heart surgery. Pulmonary artery contractile tone and
endothelium-dependent dilation were significantly reduced in
post-cardiopulmonary bypass biopsies. The decreased functional responses
were associated with reduced cell viability. Clinical Trial
Registration--URL: http://www.isrctn.com/ISRCTN34428459.<br/>Copyright
&#xa9; 2016 The Authors.

<5>
Accession Number
610819058
Title
Impact of valve morphology on the prevalence of coronary artery disease: A
systematic review and meta-analysis.
Source
Journal of the American Heart Association. 5 (5) (no pagination), 2016.
Article Number: e003200. Date of Publication: 2016.
Author
Poggio P.; Cavallotti L.; Songia P.; Di Minno A.; Ambrosino P.; Mammana
L.; Parolari A.; Alamanni F.; Tremoli E.; Di Minno M.N.D.
Institution
(Poggio, Cavallotti, Songia, Di Minno, Mammana, Alamanni, Tremoli, Di
Minno) Centro Cardiologico Monzino IRCCS, Milan, Italy
(Cavallotti, Mammana, Alamanni) Dipartimento di Medicina e Chirurgia,
University of Milan, Italy
(Songia, Tremoli) Department of Pharmacological and Biomolecular Sciences,
University of Milan, Italy
(Parolari) Department of Biomedical Sciences for Health, University of
Milan, Italy
(Ambrosino, Di Minno) Division of Cardiology, Department of Advanced
Biomedical Sciences, Federico II University, Naples, Italy
(Parolari) Unita Operativa di Cardiochirurgia e Ricerca Traslazionale, San
Donato IRCCS, San Donato Milanese, Italy
Publisher
John Wiley and Sons Inc.
Abstract
Background-Literature studies suggested a lower prevalence of coronary
artery disease (CAD) in bicuspid aortic valve (BAV) than in tricuspid
aortic valve (TAV) patients. However, this finding has been challenged. We
performed a meta-analysis to assess whether aortic valve morphology has a
different association with CAD, concomitant coronary artery bypass
grafting (CABG), and postoperative mortality. Methods and Results-Detailed
search was conducted according to the PRISMA (Preferred Reporting Items
for Systematic reviews and Meta-Analyses) guideline to identify all
patients with BAV or TAV and presence of CAD, concomitant myocardial
surgical revascularization, and the postoperative mortality. Thirty-one
studies on 3017 BAV and 4586 TAV patients undergoing aortic valve surgery
were included. BAV patients showed a lower prevalence of CAD (odds ratio
[OR]: 0.33; 95% CI: 0.17, 0.65), concomitant CABG (OR, 0.45; 95% CI: 0.35,
0.59), and postoperative mortality (OR, 0.62; 95% CI: 0.40, 0.97) than
TAV. However, BAV subjects were significantly younger than TAV (mean
difference: -7.29; 95% CI: -11.17, -3.41) were more frequently males (OR,
1.61; 95% CI: 1.33, 1.94) and exhibited a lower prevalence of hypertension
(OR, 0.58; 95% CI: 0.39, 0.87) and diabetes (OR, 0.71; 95% CI: 0.54,
0.93). Interestingly, a metaregression analysis showed that younger age
and lower prevalence of diabetes were associated with lower prevalence of
CAD (Z value: -3.03; P=0.002 and Z value: -3.10; P=0.002, respectively)
and CABG (Z value: -2.69; P=0.007 and Z value: -3.36; P=0.001,
respectively) documented in BAV patients. Conclusions-Analysis of raw data
suggested an association of aortic valve morphology with prevalence of
CAD, concomitant CABG, and postoperative mortality. Interestingly, the
differences in age and diabetes have a profound impact on prevalence of
CAD between BAV and TAV. In conclusion, our meta-analysis suggests that
the presence of CAD is independent of aortic valve
morphology.<br/>Copyright &#xa9; 2016 The Authors.

<6>
Accession Number
610471206
Title
Cerebrovascular events after no-touch off-pump coronary artery bypass
grafting, conventional side-clamp off-pump coronary artery bypass, and
proximal anastomotic devices: A meta-analysis.
Source
Journal of the American Heart Association. 5 (2) (no pagination), 2016.
Article Number: e002802. Date of Publication: 2016.
Author
Pawliszak W.; Kowalewski M.; Raffa G.M.; Malvindi P.G.; Kowalkowska M.E.;
Szwed K.A.; Borkowska A.; Kowalewski J.; Anisimowicz L.
Institution
(Pawliszak, Kowalewski, Anisimowicz) Department of Cardiac Surgery, Dr
Antoni Jurasz Memorial University Hospital, Bydgoszcz, Poland
(Kowalewski) Division of Ergonomics and Physical Effort, Department of
Hygiene, Epidemiology and Ergonomics, Collegium Medicum UMK, Bydgoszcz,
Poland
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, IRCCS-ISMETT (Istituto Mediterraneo
per I Trapianti e Terapie ad alta specializzazione), Palermo, Italy
(Malvindi) Wessex Cardiothoracic Centre, University Hospital Southampton
NHS Foundation Trust, Southampton, United Kingdom
(Kowalkowska) Department and Clinic of Obstetrics, Gynecology, and
Oncological Gynecology, Collegium Medicum, Bydgoszcz, Poland
(Szwed, Borkowska) Department of Clinical Neuropsychology, Collegium
Medicum, Bydgoszcz, Poland
(Szwed, Borkowska) Nicolaus Copernicus University, Torun, Poland
(Kowalewski) Lung Cancer and Thoracic Surgery Department, Collegium
Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
Publisher
John Wiley and Sons Inc.
Abstract
Background--Off-pump coronary artery bypass (OPCAB) has been shown to
reduce the risk of neurologic complications as compared to coronary artery
bypass grafting performed with cardiopulmonary bypass. Side-clamping of
the aorta while constructing proximal anastomoses, however, still carries
substantial risk of cerebral embolization. We aimed to perform a
comprehensive meta-analysis of studies assessing 2 clampless techniques:
aortic "no-touch" and proximal anastomosis devices (PAD) for OPCAB.
Methods and Results--PubMed, CINAHL, CENTRAL, and Google Scholar databases
were screened for randomized controlled trials and observational studies
comparing "no-touch" and/or PAD with side-clamp OPCAB and reporting
short-term (=30 days) outcomes: cerebrovascular accident and all-cause
mortality. A total of 18 studies (3 randomized controlled trials)
enrolling 25 163 patients were included. Aortic "no-touch" was associated
with statistically lower risk of cerebrovascular accident as compared to
side-clamp OPCAB: risk ratio 95% CI: 0.41 (0.27-0.61); P<0.01; I2=0%.
Event rates were 0.36% and 1.28% for "no-touch" and sideclamp OPCAB,
respectively. No difference was seen between PAD and side-clamp OPCAB:
0.71 (0.33-1.55); P=0.39; I2=39%. A trend towards increased 30-day
all-cause mortality with PAD and no difference with "no-touch" were
observed when compared to side-clamp OPCAB. In a subset analysis,
"no-touch" consistently reduced the risk of cerebrovascular accident
regardless of patients' baseline risk characteristics. A benefit with PAD
was observed in low-risk patients. Conclusions--Aortic "no-touch"
technique was associated with nearly 60% lower risk of postoperative
cerebrovascular events as compared to conventional side-clamp OPCAB with
effect consistent across patients at different risk.<br/>Copyright &#xa9;
2016 The Authors.

<7>
Accession Number
623185619
Title
Ubiquinol (Reduced Coenzyme Q10) and Cellular Oxygen Consumption in
Patients Undergoing Coronary Artery Bypass Grafting.
Source
Journal of Intensive Care Medicine. 35 (8) (pp 797-804), 2020. Date of
Publication: 01 Aug 2020.
Author
Holmberg M.J.; Uber A.; Stankovic N.; Chen C.Y.O.; Grossestreuer A.V.;
Donnino M.W.; Andersen L.W.; Liu X.
Institution
(Holmberg, Uber, Stankovic, Grossestreuer, Donnino, Andersen, Liu)
Department of Emergency Medicine, Center for Resuscitation Science, Beth
Israel Deaconess Medical Center, Boston, MA, United States
(Holmberg, Stankovic, Andersen) Department of Clinical Medicine, Research
Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark
(Chen) Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts
University, Boston, MA, United States
(Donnino) Division of Pulmonary and Critical Care, Department of Internal
Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Ubiquinol is a fundamental component of cellular metabolism. Low ubiquinol
levels have been associated with mortality. This was a substudy of a
randomized trial in patients undergoing coronary artery bypass grafting.
We drew blood before and after surgery. Ubiquinol or placebo was added to
peripheral blood mononuclear cells for oxygen consumption (OCR)
measurements. In vivo ubiquinol levels were lower postsurgery compared to
presurgery (0.16 mumol/L [quartiles: 0.02-0.39], P =.01), although the
difference disappeared when adjusting for hemoglobin levels (P =.30).
There was no difference in presurgical basal (1.0 mL/min/mg [95%
confidence interval [CI]: -0.9 to 2.2], P =.08) and maximal (0.5 mL/min/mg
[95% CI: -4.3 to 7.3], P =.56) OCR in cells receiving ubiquinol or
placebo. There was a difference in postsurgical basal (1.1 mL/min/mg [95%
CI: 0.9-1.6], P <.001) and maximal (4.2 mL/min/mg [95% CI: 0.3-7.0], P
=.01) OCR between the groups. We found no association between ubiquinol
and OCR levels (all P >.05).<br/>Copyright &#xa9; The Author(s) 2018.

<8>
Accession Number
2005418980
Title
Comparison of preincisional and postincisional parasternal intercostal
block on postoperative pain in cardiac surgery.
Source
Journal of Cardiac Surgery. 35 (7) (pp 1525-1530), 2020. Date of
Publication: 01 Jul 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

<9>
Accession Number
2004379158
Title
Addition of magnesium sulfate to intraperitoneal ropivacaine for
perioperative analgesia in canine ovariohysterectomy.
Source
Journal of Veterinary Pharmacology and Therapeutics. 43 (4) (pp 355-363),
2020. Date of Publication: 01 Jul 2020.
Author
Gomes D.R.; Nicacio I.P.G.A.; Cerazo L.M.L.; Dourado L.; Teixeira-Neto
F.J.; Cassu R.N.
Institution
(Gomes, Nicacio, Cerazo, Dourado, Cassu) Department of Veterinary Surgery
and Anesthesiology, Faculdade de Medicina Veterinaria, Universidade do
Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
(Teixeira-Neto) Department of Veterinary Surgery and Animal Reproduction,
Faculdade de Medicina Veterinaria e Zootecnia, Universidade Estadual
Paulista (UNESP), Botucatu, Brazil
Publisher
Blackwell Publishing Ltd
Abstract
Magnesium may be used as an adjunctive analgesic for perioperative pain
management because of its antinociceptive properties. This study
investigated the analgesic efficacy of intraperitoneal ropivacaine
combined with magnesium sulfate in canine ovariohysterectomy. Forty-five
dogs sedated with acepromazine/meperidine and anesthetized with
propofol/isoflurane were randomly distributed into three treatments,
administered intraperitoneally (n = 15 per group): saline solution (group
S), 0.25% ropivacaine (3 mg/kg) alone (group R), or in combination with
magnesium sulfate (20 mg/kg, group R-Mg). Intravenous fentanyl was given
to control cardiovascular responses to surgical stimulation. Postoperative
pain was assessed using an Interactive Visual Analog Scale (IVAS), the
short form of the Glasgow Composite Pain Scale, and mechanical nociceptive
thresholds. Morphine/meloxicam was administered as rescue analgesia.
Intraoperatively, the R-Mg group required less fentanyl (p =.02) and
exhibited higher incidence of hypotension (systolic arterial pressure <90
mm Hg, p =.006) compared with the S group. Lower IVAS pain scores were
recorded during the first hour in the R-Mg group than the other groups (p
=.007-.045). Postoperative rescue analgesia did not differ between groups.
Intraperitoneal magnesium sulfate administration, in spite of decreasing
intraoperative opioid requirements, increased the incidence of hypotension
with minimal evidence of postoperative analgesic benefits.<br/>Copyright
&#xa9; 2020 John Wiley & Sons Ltd

<10>
Accession Number
2003666397
Title
Comparative effectiveness of torasemide versus furosemide in symptomatic
therapy in heart failure patients: Preliminary results from the randomized
tornado trial.
Source
Cardiology Journal. 26 (6) (pp 661-668), 2019. Date of Publication: 2019.
Author
Balsam P.; Ozieranski K.; Marchel M.; Gawalko M.; Niedziela L.; Tyminska
A.; Sieradzki B.; Sieradzki M.; Fojt A.; Bakula E.; Glowczynska R.; Peller
M.; Markulis M.; Bednarski J.; Kowalik R.; Cacko A.; Niewinski G.;
Filipiak K.J.; Opolski G.; Grabowski M.
Institution
(Balsam, Ozieranski, Marchel, Gawalko, Niedziela, Tyminska, Sieradzki,
Sieradzki, Fojt, Glowczynska, Peller, Markulis, Kowalik, Cacko, Filipiak,
Opolski, Grabowski) Department of Cardiology, Medical University of
Warsaw, Poland
(Bakula, Bednarski) Cardiology Unit, John Paul II Western Hospital,
Grodzisk Mazowiecki, Poland
(Niewinski) Department of Anesthesiology and Intensive Care, Medical
University of Warsaw, Poland
(Balsam, Ozieranski, Marchel, Gawalko, Niedziela, Tyminska, Sieradzki,
Sieradzki, Fojt, Glowczynska, Peller, Markulis, Kowalik, Cacko, Filipiak,
Opolski, Grabowski) st Department of Cardiology, Medical University of
Warsaw, ul. Banacha 1a, Warszawa 02-097, Poland
Publisher
Via Medica (Ul. Swietokrzyska 73, Gdansk 80-180, Poland. E-mail:
elzbieta.zabrocka@viamedica.pl)
Abstract
Background: Recent reports suggest that torasemide might be more
beneficial than furosemide in patients with symptomatic heart failure
(HF). The aim was to compare the effects of torasemide and furosemide on
clinical outcomes in HF patients. <br/>Method(s): This study pilot
consisted of data from the ongoing multicenter, randomized, unblinded
endpoint phase IV TORNADO (NCT01942109) study. HF patients in New York
Heart Association (NYHA) II-IV class with a stable dose of furosemide were
randomized to treatment with equipoten-tial dose of torasemide (4:1) or
continuation of unchanged dose of furosemide. On enrollment and control
visit (3 months after enrollment) clinical examination, 6-minute walk test
(6MWT) and assessment of fluid retention by ZOE Fluid Status Monitor were
performed. The primary endpoint was a composite of improvement of NYHA
class, improvement of at least 50 m during 6MWT and decrease in fluid
retention of at least 0.5 W after 3-months follow-up. <br/>Result(s): The
study group included 40 patients (median age 66 years; 77.5% male). During
follow-up 7 patients were hospitalized for HF worsening (3 in torasemide
and 4 in furosemide-treated patients). The primary endpoint reached 15
(94%) and 14 (58%) patients on torasemide and furosemide, respectively (p
= 0.03). <br/>Conclusion(s): In HF patients treated with torasemide fluid
overload and symptoms improved more than in the furosemide group. This
positive effect occurred already within 3-month observation.<br/>Copyright
&#xa9; 2019 Via Medica.

<11>
Accession Number
2006988157
Title
Clinical safety profile of transendocardial catheter injection systems: A
plea for uniform reporting.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Raval A.N.; Pepine C.J.
Institution
(Raval) Department of Medicine and Biomedical Engineering, University of
Wisconsin School of Medicine and Public Health, Madison, WI, United States
(Pepine) Division of Cardiovascular Medicine, University of Florida,
Gainsville, FL, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: The aim of this study was to characterize the clinical safety
profile of transendocardial injection catheters (TIC) reported in the
published literature. <br/>Background(s): Transendocardial delivery is a
minimally invasive approach to deliver potential therapeutic agents
directly into the myocardium. The rate of adverse events across TIC is
uncertain. <br/>Method(s): A systematic search was performed for trial
publications using TIC. Procedure-associated adverse event data were
abstracted, pooled and compared across catheters for active treatment and
placebo injected patients. The transendocardial injection associated
serious adverse events (TEI-SAE) was defined as the composite of death,
myocardial infarction, stroke or transient ischemic attack within 30 days
and cardiac perforation causing death or requiring evacuation, serious
intraprocedural arrhythmias and serious coronary artery or peripheral
vascular complications. <br/>Result(s): The search identified 4 TIC
systems: a helical needle (HN), an electro-anatomically tracked straight
needle (EAM-SN), a straight needle without tracking elements (SN), and a
curved needle (CN). Of 1789 patients who underwent transendocardial
injections, the combined TEI-SAE was 3.5% across all catheters, and 1.4%,
3.3%, 7.1%, and 8.3% for HN, EAM-SN, SN and CN, respectively. However, TIC
procedure duration and post procedural cardiac biomarker levels were
reported in only 24% and 36% of published trials, respectively.
<br/>Conclusion(s): Transendocardial injection is associated with varied
TEI-SAE but the data are very limited. The HN catheter appeared to be
associated with lower TEI-SAE, versus other catheters. Procedure duration
and post procedure cardiac biomarker levels were under-reported. Clearly,
standardized, procedure-related event reporting for trials involving
transcatheter delivery would improve our understanding of complications
across different systems.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<12>
Accession Number
2006974761
Title
Evaluating the Impact of Medical Student Inclusion Into Hands-On Surgical
Simulation in Congenital Heart Surgery.
Source
Journal of Surgical Education. (no pagination), 2020. Date of Publication:
2020.
Author
Hon N.W.L.; Hussein N.; Honjo O.; Yoo S.-J.
Institution
(Hon) The Center for Image Guided Innovation and Therapeutic Intervention,
Hospital for Sick Children, Toronto, ON, Canada
(Hussein, Honjo) Division of Cardiology, Department of Paediatrics,
Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
(Hussein, Honjo) Division of Cardiovascular Surgery, Department of
Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON,
Canada
(Yoo) Department of Diagnostic Imaging, Division of Cardiology, Hospital
for Sick Children, University of Toronto, Toronto, ON, Canada
(Yoo) Department of Pediatrics, Hospital for Sick Children, University of
Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objective: Over the last decade medical students' interest in pursuing
surgery as a career has declined. This is more apparent in
high-specialized specialities such as congenital heart surgery (CHS).
Early hands-on simulation has shown to have a positive impact on medical
students' interest in pursuing surgery, however, its incorporation into
medical school curricula is lacking. This study aimed to evaluate the
impact of incorporating medical students as surgical assistants during the
Hands On Surgical Training course in CHS. <br/>Method(s): Local
preclinical medical students were invited to participate as surgical
assistants during the 5th annual Hands On Surgical Training course in CHS.
Among those who responded to the invitation, students were randomly
selected and allocated to assist a congenital heart surgeon. All selected
students attended an assistants' session prior to the course to
familiarize themselves with assisting and to practice basic surgical
skills. At the end of both courses students completed a questionnaire
based on Likert 5-point scale to evaluate the courses' usefulness.
<br/>Result(s): Fifteen medical students completed the questionnaires. All
reported a beginner level of understanding of congenital heart disease.
All students were highly satisfied with using 3D-printed models to help
their understanding of congenital heart disease (4.80 +/- 0.41) and agreed
that the sessions improved their assisting skills (4.93 +/- 0.26). All
expressed a desire to attend similar sessions in the future and agreed
that surgical simulation inclusion into medical school curricula would
enhance learning (5.00 +/- 0.00). Interest in pursuing a career in CHS
increased from 33% (5) to 87% (13) by the end of the course.
<br/>Conclusion(s): Integration of preclinical medical students into
surgical simulation increases interest in pursuing highly specialised
surgical specialities such as CHS. Early exposure and the incorporation of
such simulation programs into medical school curricula will likely improve
surgical skill acquisition and may enable students to be better informed
when selecting future career choices.<br/>Copyright &#xa9; 2020

<13>
Accession Number
2005533885
Title
Incidence and Risk Factors for Silent Brain Infarction After On-Pump
Cardiac Surgery: A Meta-analysis and Meta-regression of 29 Prospective
Cohort Studies.
Source
Neurocritical Care. (no pagination), 2020. Date of Publication: 2020.
Author
Guo J.; Zhou C.; Yue L.; Yan F.; Shi J.
Institution
(Guo, Zhou, Yue, Yan, Shi) Department of Anesthesiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, No. 167 Beilishi Street,
Xicheng District, Beijing 100037, China
Publisher
Springer
Abstract
Background: Silent brain infarction (SBI) happens at a considerable rate
after on-pump cardiac surgery. Though termed silent, SBI is related to
unfavorable clinical outcomes including higher incidence of future stroke
and neurocognitive impairment in the general population. The risk factors
of SBI have not been fully identified in both individual studies and
several meta-analyses addressing the topic. In this meta-analysis, we
aimed to conduct meta-regression analysis for the first time to explore
risk factors for SBI after on-pump cardiac surgery. <br/>Method(s): This
meta-analysis was conducted following the Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) guidelines. Medline, Embase,
Central, Web of Science, and Wiley databases were searched for relevant
studies. Preoperative patient baseline characteristics and intraoperative
surgical parameters were extracted from included studies. For
meta-regression, a P value of less than 0.1 was considered statistically
significant in both univariable and multivariable analyses.
<br/>Result(s): Twenty-nine studies with 1478 patients were included in
this meta-analysis. The summarized SBI rate after on-pump cardiac surgery
was 37% (95% CI 0.27-0.47, P < 0.0001). Heterogeneity between studies was
significant (I² = 94.9%, P < 0.0001). In multivariable
meta-regression, we found that age (coefficient 0.014, 95% CI 0.001-0.029,
P = 0.043), diabetes (coefficient 0.006, 95% CI - 0.001 to 0.013, P =
0.075), and proportion of CABG (coefficient - 0.001, 95% CI - 0.003 to
0.0003, P = 0.096) were significantly associated with SBI incidence.
<br/>Conclusion(s): From the meta-regression, we concluded that advanced
age and diabetes were related to increased SBI incidence after on-pump
cardiac surgery, while CABG procedure alone was associated with less SBI
onset. Studies with more accurate diagnoses of SBI are required to add
more conclusive evidence to the field.<br/>Copyright &#xa9; 2020, Springer
Science+Business Media, LLC, part of Springer Nature and Neurocritical
Care Society.

<14>
Accession Number
2005529620
Title
Comparison of Mitral Valve Replacement and Repair for Degenerative Mitral
Regurgitation: a Meta-analysis and Implications for Transcatheter Mitral
Procedures.
Source
Current Cardiology Reports. 22 (9) (no pagination), 2020. Article Number:
79. Date of Publication: 01 Sep 2020.
Author
Overtchouk P.; Ben-Ali W.; Prendergast B.; Conradi L.; Hahn R.; Granada
J.; Modine T.
Institution
(Overtchouk, Ben-Ali, Modine) Structural Valve Program, CHRU-Lille, Lille,
France
(Ben-Ali) Department of Cardiac Surgery, Montreal Heart Institute,
Montreal, QC, Canada
(Prendergast) Department of Cardiology, St Thomas' Hospital, London,
United Kingdom
(Conradi) Department of Cardiovascular Surgery, University Heart Center
Hamburg, Hamburg, Germany
(Hahn) Division of Cardiology, New York-Presbyterian Hospital, Columbia
University Medical Center, New York, NY, United States
(Granada) Cardiovascular Research Foundation, CRF Skirball Center for
Innovation, Columbia University Medical Center, New York, NY, United
States
(Modine) Interventional Cardiology and Cardiovascular Surgery, Centre
Hospitalier Regional Universitaire de Lille (CHRU de Lille), 2 Avenue
Oscar Lambret, Lille 59037, France
Publisher
Springer
Abstract
Purpose of Review: Surgical mitral valve repair is considered superior to
replacement to treat primary mitral regurgitation. However, the
heterogeneity of cohorts and the lack of consideration of confounding in
the published literature raise potential biases. The aim of this study was
to pool all available matched data comparing outcomes of mitral valve
repair and replacement in the setting of primary mitral regurgitation.
Recent Findings: We searched Medline, Embase and the Cochrane Library
Central Register of Controlled Trials to identify propensity-matched
studies or reports with multivariable adjustment comparing repair and
replacement in patients with primary mitral regurgitation. The primary
outcome was all-cause mortality. DerSimonian and Laird random effects were
used to perform the meta-analysis. Eight observational studies were
selected including 4599 patients (3064 mitral repairs and 1535
replacements). Mean age ranged from 62 to 69 years, and the mean follow-up
duration ranged between 3 and 9 years. Replacement was associated with an
increased risk of long-term all-cause mortality compared to repair (HR of
1.68, 95% confidence interval 1.35-2.09, p < 0.001, tau² =
0.03). Surgical era and atrial fibrillation impacted the risk of mortality
but not mitral anatomy. Neither repair nor replacement impacted
significantly on the risk of re-operation after mitral surgery (HR 1.18,
95% CI 0.85-1.63, p = 0.33, tau² < 0.01). <br/>Summary: Mitral
valve replacement is possibly associated with higher long-term mortality
than mitral valve repair in primary mitral regurgitation but often used as
a bailout option in more complex anatomy. Despite this observation, both
techniques have similar risk of re-operation.<br/>Copyright &#xa9; 2020,
Springer Science+Business Media, LLC, part of Springer Nature.

<15>
Accession Number
2005518661
Title
Efficacy of Nitric Oxide Administration in Attenuating
Ischemia/Reperfusion Injury During Neonatal Cardiopulmonary Bypass.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11 (4) (pp
417-423), 2020. Date of Publication: 01 Jul 2020.
Author
Elzein C.; Urbas C.; Hughes B.; Li Y.; Lefaiver C.; Ilbawi M.; Vricella L.
Institution
(Elzein, Ilbawi, Vricella) Division of Pediatric Cardiothoracic Surgery,
Advocate Children's Hospital Heart Institute, Advocate Children's
Hospital, Oak Lawn, IL, United States
(Urbas) Advocate Children's Hospital Heart Institute, Advocate Children's
Hospital, Oak Lawn, IL, United States
(Hughes) Advocate Center for Pediatric Research, Advocate Children's
Hospital Heart Institute, Advocate Children's Hospital, Oak Lawn, IL,
United States
(Li) Patient-Centered Outcomes Research, Advocate Center for Pediatric
Research, Research Institute, Advocate Children's Hospital, Oak Lawn, IL,
United States
(Lefaiver) Advocate Center for Pediatric Research, Advocate Children's
Hospital, Oak Lawn, IL, United States
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Objective: Nitric oxide (NO) plays several protective roles in
ischemia/reperfusion (I/R) injury. Neonates undergoing the Norwood
procedure are subject to develop I/R injury due to the immaturity of their
organs and the potential need to interrupt or decrease systemic flow
during surgery. We hypothesized that NO administration during
cardiopulmonary bypass (CPB) ameliorates the I/R and could help the
postoperative recovery after the Norwood procedure. <br/>Method(s):
Twenty-four neonates who underwent a Norwood procedure were enrolled in a
prospective randomized blinded controlled trial to receive NO (12
patients) or placebo (12 patients) into the oxygenator of the CPB circuit
during the Norwood procedure. Markers of I/R injury were collected at
baseline (T0), after weaning from CPB before modified ultrafiltration
(T1), after modified ultrafiltration (T2), and at 12 hours (T3) and 24
hours (T4) after surgery, and they were compared between both groups, as
well as other postoperative clinical variables. <br/>Result(s): There was
no difference in age, weight, anatomical diagnosis, CPB, and aortic
cross-clamp time between both groups. Troponin levels were lower in the
study group at T1 (0.62 +/- 58 ng/mL vs 0.87 +/- 0.58 ng/mL, P =.31) and
became significantly lower at T2 (0.36 +/- 0.32 ng/mL vs 0.97 +/- 0.48
ng/mL, P =.009).There were no significant differences between both groups
for all other markers. Despite a lower troponin level, there was no
difference in inotropic scores or ventricular function between both
groups. Time to start diuresis, time to sternal closure and extubation,
and intensive care unit and hospital stay were not different between both
groups. <br/>Conclusion(s): Systemic administration of NO during the
Norwood procedure has myocardial protective effects (lower Troponin
levels) but we observed no effect on postoperative recovery. Larger sample
size may be needed to show clinical differences.<br/>Copyright &#xa9; The
Author(s) 2020.

<16>
Accession Number
2005518659
Title
Randomized Pilot Trial of Acute Normovolemic Hemodilution in Pediatric
Cardiac Surgery Patients.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11 (4) (pp
452-458), 2020. Date of Publication: 01 Jul 2020.
Author
Harris W.M.; Treggiari M.M.; LeBlanc A.; Giacomuzzi C.; You J.J.;
Muralidaran A.; Shen I.
Institution
(Harris, Treggiari) Department of Anesthesiology and Perioperative
Medicine, Oregon Health Science University, Portland, OR, United States
(Treggiari) Department of Anesthesiology, Yale University, New Haven, CT,
United States
(LeBlanc, Giacomuzzi, You) Department of Pediatric Perfusion and ECMO
Services, Oregon Health Science University, Portland, OR, United States
(Muralidaran, Shen) Department of Cardiothoracic Surgery, Oregon Health
Science University, Portland, OR, United States
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Background: Due to the substantial improvement in survival among pediatric
patients undergoing congenital heart surgery, reducing early and long-term
morbidity is becoming the major focus of care. Blood transfusion is
associated with worse postoperative outcomes after cardiac surgery. Acute
normovolemic hemodilution (ANH) is a blood conservation strategy that aims
to reduce allogenic blood transfusion during cardiac surgery. However,
there are scant data regarding its efficacy for pediatric cardiac surgery
patients. <br/>Method(s): We designed a single-center, controlled,
randomized, pilot trial in patients between 6 and 36 months old undergoing
pediatric heart surgery. Patients were equally assigned to undergo ANH
prior to initiation of cardiopulmonary bypass or to be managed per usual
care. The primary end point was the amount of blood product transfused
perioperatively. Secondary end points were markers of morbidity:
postoperative bleeding, hematocrit, inotropic agents use, intensive care
unit, and hospital stay. The analysis was by intention-to-treat. Estimates
of differences between groups are presented with 95% CIs. <br/>Result(s):
Twelve pediatric heart surgery patients were randomized to each group, ANH
and usual care. Baseline characteristics were similar between groups.
Acute normovolemic hemodilution implementation did not result in a
reduction in the administration of blood product transfused (difference
between ANH and usual care among patients transfused = -1.4 mL [-29.4 to
26.6], P =.92). Secondary end points were not different between groups.
<br/>Conclusion(s): In this small trial of pediatric cardiac surgery
patients, ANH as a strategy to reduce blood component therapy was safe;
however, the study failed to show a reduction in perioperative transfusion
or other postoperative outcomes.<br/>Copyright &#xa9; The Author(s) 2020.

<17>
Accession Number
2005001732
Title
Novel, digital, chest drainage system in cardiac surgery.
Source
Journal of Cardiac Surgery. 35 (7) (pp 1492-1497), 2020. Date of
Publication: 01 Jul 2020.
Author
Barozzi L.; Biagio L.S.; Meneguzzi M.; Courvoisier D.S.; Walpoth B.H.;
Faggian G.
Institution
(Barozzi, Biagio, Meneguzzi, Faggian) Division of Cardiac Surgery,
University of Verona, Verona, Italy
(Courvoisier) Quality of Care Unit, University Hospital, Geneva,
Switzerland
(Walpoth) Department of Cardiovascular Surgery, University Hospital,
Geneva, Switzerland
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: A new, self-contained, digital, continuous pump-driven chest
drainage system is compared in a randomized control trial to a traditional
wall-suction system in cardiac surgery. <br/>Method(s): One hundred and
twenty adult elective cardiac patients undergoing coronary artery bypass
graft and/or valve surgery were randomized to the study or control group.
Both groups had similar pre/intra-operative demographics: age 67.8 vs 67.0
years, Euroscore 2.3 vs 2.2, and body surface area 1.92 vs 1.91
m². Additionally, a satisfaction assessment score (0-10) was
performed by 52 staff members. <br/>Result(s): Given homogenous
intra-operative variables, total chest-tube drainage was comparable among
groups (566 vs 640 mL; ns), but the study group showed more efficient
fluid collection during the early postoperative phase due to continuous
suction (P =.01). Blood, cell saver transfusions and postoperative
hemoglobin values were similar in both groups. The study group experienced
drain removal after 29.8 vs 38.4 hours in the control group (ns). Seven
crossovers from the Study to the Control group were registered but no
patient had drain-related complications. The Personnel Satisfaction
Assessment scored above 5 for all questions asked. <br/>Conclusion(s): The
new, digital, chest drainage system showed better early drainage of the
chest cavity and was as reliable as conventional systems. Quicker drain
removal might impact on intensive care unit (ICU) stay and reduce costs.
Additional advantages are portable size, battery operation, patient
mobility, noiseless function, digital indications and alarms. The
satisfaction assessment of the new system by the staff revealed a higher
score when compared to the traditional wall suction chest drainage
system.<br/>Copyright &#xa9; 2020 The Authors. Journal of Cardiac Surgery
published by Wiley Periodicals LLC

<18>
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) 1Department of Anesthesiology, Osaka Prefectural Hospital
Organization, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.
2Department of Anesthesiology, Kansai Medical University Hospital,
Hirakata, Osaka, Japan. 3Department 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.

<19>
[Use Link to view the full text]
Accession Number
629726679
Title
A Novel Patient-Specific Model for Predicting Severe Oliguria; Development
and Comparison With Kidney Disease: Improving Global Outcomes Acute Kidney
Injury Classification.
Source
Critical care medicine. 48 (1) (pp e18-e25), 2020. Date of Publication: 01
Jan 2020.
Author
Howitt S.H.; Oakley J.; Caiado C.; Goldstein M.; Malagon I.; McCollum C.;
Grant S.W.
Institution
(Howitt, Oakley, Malagon, McCollum, Grant) Division of Cardiovascular
Sciences, University of Manchester, ERC, Manchester University Hospitals
Foundation Trust, Manchester, United Kingdom
(Howitt, Malagon) Department of Cardiothoracic Anaesthesia and Critical
Care, Wythenshawe Hospital, Manchester University Hospitals Foundation
Trust, Manchester, United Kingdom
(Oakley, Caiado, Goldstein) Department of Mathematical Sciences, Durham
University, Durham, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The Kidney Disease: Improving Global Outcomes urine output
criteria for acute kidney injury lack specificity for identifying patients
at risk of adverse renal outcomes. The objective was to develop a model
that analyses hourly urine output values in real time to identify those at
risk of developing severe oliguria. DESIGN: This was a retrospective
cohort study utilizing prospectively collected data. SETTING: A cardiac
ICU in the United Kingdom. PATIENTS: Patients undergoing cardiac surgery
between January 2013 and November 2017.None. MEASUREMENT AND MAIN RESULTS:
Patients were randomly assigned to development (n = 981) and validation (n
= 2,389) datasets. A patient-specific, dynamic Bayesian model was
developed to predict future urine output on an hourly basis. Model
discrimination and calibration for predicting severe oliguria (<
0.3mL/kg/hr for 6hr) occurring within the next 12 hours were tested in the
validation dataset at multiple time points. Patients with a high risk of
severe oliguria (p > 0.8) were identified and their outcomes were compared
with those for low-risk patients and for patients who met the Kidney
Disease: Improving Global Outcomes urine output criterion for acute kidney
injury. Model discrimination was excellent at all time points (area under
the curve > 0.9 for all). Calibration of the model's predictions was also
excellent. After adjustment using multivariable logistic regression,
patients in the high-risk group were more likely to require renal
replacement therapy (odds ratio, 10.4; 95% CI, 5.9-18.1), suffer prolonged
hospital stay (odds ratio, 4.4; 95% CI, 3.0-6.4), and die in hospital
(odds ratio, 6.4; 95% CI, 2.8-14.0) (p < 0.001 for all). Outcomes for
those identified as high risk by the model were significantly worse than
for patients who met the Kidney Disease: Improving Global Outcomes urine
output criterion. <br/>CONCLUSION(S): This novel, patient-specific model
identifies patients at increased risk of severe oliguria. Classification
according to model predictions outperformed the Kidney Disease: Improving
Global Outcomes urine output criterion. As the new model identifies
patients at risk before severe oliguria develops it could potentially
facilitate intervention to improve patient outcomes.

<20>
Accession Number
629736512
Title
Usefulness of combining clinical and biochemical parameters for prediction
of postoperative pulmonary complications after lung resection surgery.
Source
Journal of clinical monitoring and computing. 33 (6) (pp 1043-1054), 2019.
Date of Publication: 01 Dec 2019.
Author
Garutti I.; De la Gala F.; Pineiro P.; Rancan L.; Vara E.; Reyes A.;
Puente-Maestu L.; Bellon J.M.; Simon C.
Institution
(Garutti, De la Gala, Pineiro, Reyes) Department Anaesthesia, Hospital
General Maranon (HGUGM), Madrid 28009, Spain
(Garutti) Department Pharmacology, School of Medicine, UCM, Madrid 28040,
Spain
(Rancan, Vara) Department Biochemistry, School of Medicine, Universidad
Complutense de Madrid (UCM), Madrid 28040, Spain
(Puente-Maestu) Department Pneumology, Madrid 28009, Spain
(Bellon) Department Statistics, HGUGM Biomedical Research Foundation,
Madrid 28009, Spain
(Simon) Department Thoracic Surgery, Madrid 28009, Spain
Publisher
NLM (Medline)
Abstract
Early detection of patients with a high risk of postoperative pulmonary
complications (PPCs) could improve postoperative strategies. We
investigated the role of monitoring systemic and lung inflammatory
biomarkers during surgery and the early postoperative period to detect
patients at high risk of PPCs after lung resection surgery (LRS). This is
a substudy of a randomized control trial on the inflammatory effects of
anaesthetic drugs during LRS. We classified patients into two groups,
depending on whether or not they developed PPCs. We constructed three
multivariate logistic regression models to analyse the power of the
biomarkers to predict PPCs. Model 1 only included the usual clinical
variables; Model 2 included lung and systemic inflammatory biomarkers; and
Model 3 combined Models 1 and 2. Comparisons between mathematical models
were based on the area under the receiver operating characteristic curve
(AUROC) and tests of integrated discrimination improvement (IDI).
Statistical significance was set at p<0.05. PPCs were detected in 37
(21.3%) patients during admission. The AUROC for Models 1, 2, and 3 was
0.79 (95% CI 0.71-0.87), 0.80 (95% CI 0.72-0.88), and 0.93 (95% CI
0.88-0.97), respectively. Comparison of the AUROC between Models 1 and 2
did not reveal statistically significant values (p=0.79). However, Model 3
was superior to Model 1 (p<0.001). Model 3 had had an IDI of 0.29
(p<0.001) and a net reclassification index of 0.28 (p=0.007). A
mathematical model combining inflammation biomarkers with clinical
variables predicts PPCs after LRS better than a model that includes only
clinical data. Clinical registration number Clinical Trial Registration
NCT02168751; EudraCT 2011-002294-29.

<21>
Accession Number
632317629
Title
Cardiopulmonary bypass and internal thoracic artery: Can roller or
centrifugal pumps change vascular reactivity of the graft? The IPITA
study: A randomized controlled clinical trial.
Source
PloS one. 15 (7) (pp e0235604), 2020. Date of Publication: 2020.
Author
Fouquet O.; Dang Van S.; Baudry A.; Meisnerowski P.; Robert P.; Pinaud F.;
Binuani P.; Chretien J.-M.; Henrion D.; Baufreton C.; Loufrani L.
Institution
(Fouquet, Dang Van, Baudry, Meisnerowski, Pinaud, Binuani, Baufreton)
Department of Thoracic and Cardiovascular Surgery, University Hospital,
Angers, France
(Fouquet, Dang Van, Baudry, Meisnerowski, Robert, Pinaud, Binuani,
Henrion, Baufreton, Loufrani) MITOVASC Institute CNRS UMR 6214, INSERM
U1083, University of Angers, Angers, France
(Chretien) Clinical Research Department, University Hospital, Angers,
France
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiopulmonary bypass (CPB) induces a systemic inflammatory
response (SIRS) and affects the organ vascular bed. Experimentally, the
lack of pulsatility alters myogenic tone of resistance arteries and
increases the parietal inflammatory response. The purpose of this study
was to compare the vascular reactivity of the internal thoracic arteries
(ITAs) due to the inflammatory response between patients undergoing
coronary artery bypass grafting (CABG) under CPB with a roller pump or
with a centrifugal pump. <br/>METHOD(S): Eighty elective male patients
undergoing CABG were selected using one or two internal thoracic arteries
under CPB with a roller pump (RP group) or centrifugal pump (CFP group).
ITA samples were collected before starting CPB (Time 1) and before the
last coronary anastomosis during aortic cross clamping (Time 2). The
primary endpoint was the endothelium-dependent relaxation of ITAs
investigated using wire-myography. The secondary endpoint was the parietal
inflammatory response of arteries defined by the measurements of
superoxide levels, leukocytes and lymphocytes rate and gene expression of
inflammatory proteins using. Terminal complement complex activation
(SC5b-9) and neutrophil activation (elastase) analysis were performed on
arterial blood at the same times. <br/>RESULT(S): Exposure time of ITAs to
the pump flow was respectively 43.3 minutes in the RP group and 45.7
minutes in the CFP group. Acetylcholine-dependent relaxation was conserved
in the two groups whatever the time. Gene expression of C3 and C4a in the
artery wall decreased from Time 1 to Time 2. No oxidative stress was
observed in the graft. There was no difference between the groups
concerning the leukocytes and lymphocytes rate. SC5b-9 and elastase
increased between Time 1 and Time 2. <br/>CONCLUSION(S):
Endothelium-dependent relaxation of the internal thoracic arteries was
preserved during CPB whatever the type of pump used. The inflammatory
response observed in the blood was not found in the graft wall within this
time frame. TRIAL REGISTRATION: Name of trial study protocol: IPITA
Registration number (ClinicalTrials.gov): NCT04168853.

<22>
Accession Number
2004710998
Title
Effects of two different levels of positive end-expiratory pressure on the
duration of intubation in patients undergoing coronary artery bypass graft
surgery.
Source
Iranian Heart Journal. 21 (3) (pp 55-63), 2020. Date of Publication: 2020.
Author
Moradi B.; Yarahmadi S.; Ansari R.; Teymouri H.; Khademi M.; Abdi M.
Institution
(Moradi) Department of Emergency Medicine, Faculty of Paramedical
Sciences, Lorestan University of Medical Sciences, Khorramabad, Iran,
Islamic Republic of
(Yarahmadi, Khademi) Department of Nursing, Faculty of Nursing and
Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran,
Islamic Republic of
(Ansari) Department of ENT Surgery, Faculty of Medicine, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Teymouri) Department of Anesthesiology, Faculty of Medicine, Lorestan
University of Medical Sciences, Khorramabad, Iran, Islamic Republic of
(Abdi) Department of Nursing, Faculty of Nursing, Lorestan University of
Medical Sciences, Aligudarz, Iran, Islamic Republic of
Publisher
Iranian Heart Association (E-mail: iha@iha.org.ir)
Abstract
Background: Several factors affect the duration of mechanical ventilation
in open-heart surgery patients. The purpose of this study was to determine
the effects of positive end-expiratory pressure (PEEP) levels of 5 and 10
cmH<inf>2</inf>O on the duration of intubation in patients undergoing
coronary artery bypass graft surgery. <br/>Method(s): This study was a
clinical trial with a sample size of 90 patients. The patients were
classified into 2 groups of control (PEEP = 5 cmH<inf>2</inf>O) and
intervention (PEEP = 10 cmH<inf>2</inf>O) via the
stratified-block-randomized method, and then the duration of intubation
and the duration of hospitalization were calculated and recorded per
patient. <br/>Result(s): Each group comprised 25 (55.6%) men and 20
(44.4%) women. The 2 groups had no statistically significant difference in
terms of the duration of intubation (P = 0.9). <br/>Conclusion(s): The use
of physiological and therapeutic levels of PEEP (5 and 10
cmH<inf>2</inf>O) did not lead to complications such as pneumothorax and a
decrease in cardiac output and can, thus, be used by physicians to correct
and improve the condition of oxygenation in patients on mechanical
ventilation. However, the use of these PEEP levels is not recommended for
decreasing the duration of intubation and hospitalization.<br/>Copyright
&#xa9; 2020, Iranian Heart Association. All rights reserved.

<23>
Accession Number
2007031167
Title
Meta-Analysis Comparing Multiple Arterial Grafts Versus Single Arterial
Graft for Coronary-Artery Bypass Grafting.
Source
American Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Changal K.; Masroor S.; Elzanaty A.; Patel M.; Mir T.; Khan S.; Nazir S.;
Soni R.; Oostra C.; Khuder S.; Eltahawy E.
Institution
(Changal, Nazir, Soni, Oostra) Cardiovascular Medicine, University of
Toledo Health Sciences, OH, United States
(Masroor) Cardiothoracic Surgery, University of Toledo Health Sciences,
OH, United States
(Elzanaty, Patel) Department of Medicine, University of Toledo Health
Sciences, OH, United States
(Mir) Department of Medicine, Wayne State University Detroit, MI, United
States
(Khan) Department of Medicine, St. Vincent's Hospital, Toledo, OH, United
States
(Khuder) University of Toledo Health Sciences, OH, United States
(Eltahawy) Cardiovascular Medicine, University of Toledo Health Sciences,
OH, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Observational studies and randomized controlled trials (RCTs) have shown
conflicting outcomes for multiple arterial graft (MAG) coronary artery
bypass graft surgery compared with single arterial grafts (SAGs). The
predominant evidence supporting the use of MAGs is observational. The aim
of this meta-analysis of RCTs is to compare outcomes following MAG and
SAG. We searched multiple databases for RCTs comparing MAG versus SAG. The
clinical outcomes studied were all-cause mortality, cardiac mortality,
myocardial infarction (MI), revascularization, stroke, sternal wound
complications, and major bleeding. We used hazard ratio (HR), relative
risk (RR), and corresponding 95% confidence interval (CI) for measuring
outcomes. Ten RCTs (6392 patients) were included. The average follow-up in
the studies was 4.2 years. The average age of the patients in the studies
ranged from 56.3 years to 74.6. No significant difference was seen between
MAG and SAG groups for all-cause mortality (11.8% vs 12.7%, HR 0.94, 95%
CI 0.81 to 1.09, p 0.36), cardiac mortality (4.1% vs 4.5%, HR 0.96 95% CI
0.74 to 1.26, p 0.77), MI (3.5% vs 5.1%, HR 0.87 95% CI 0.67 to 1.12, p
0.28), and major bleeding (3.3% vs 4.9%, RR 0.85 95% CI 0.64 to 1.13, p
0.26). Repeat revascularization in MAG showed a lower RR than SAG when one
of the confounding studies was excluded (RR 0.63, 95% CI 0.4 to 0.99, p
0.04). The incidence of stroke was lower in MAG than SAG (2.9% vs 3.9%, RR
0.74 95% CI 0.56 to 0.98, p 0.03). MAG had higher incidence of sternal
wound complications than SAG (2.9% vs 1.7%, RR 1.75 95% CI 1.19 to 2.55, p
0.004). In conclusion, MAG does not have a survival advantage compared
with SAG but is better in revascularization and risk of stroke. This
benefit may be set off by a higher incidence of sternal wound
complications in MAG.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<24>
Accession Number
2005561570
Title
Transcatheter aortic valve replacement and percutaneous coronary
intervention versus surgical aortic valve replacement and coronary artery
bypass grafting in patients with severe aortic stenosis and concomitant
coronary artery disease: A systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2020.
Date of Publication: 2020.
Author
Kotronias R.A.; Bray J.H.; Scarsini R.; Rajasundaram S.;
Terentes-Printzios D.; De Maria G.L.; Kharbanda R.K.; Mamas M.A.; Bagur
R.; Banning A.P.
Institution
(Kotronias, Bray, Scarsini, Rajasundaram, Terentes-Printzios, De Maria,
Kharbanda, Banning) Oxford Heart Centre, Oxford University Hospitals NHS
Foundation Trust, Oxford, Oxfordshire, United Kingdom
(Kotronias) Department of Cardiovascular Medicine, University of Oxford,
Oxford, Oxfordshire, United Kingdom
(Scarsini) Department of Medicine, Division of Cardiology, University of
Verona, Verona, Italy
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, UK and Heart Centre, Thomas Jefferson
University, Philadelphia, United States
(Bagur) Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, Western University, London, ON, Canada
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objectives: We performed a systematic review and meta-analysis to evaluate
the early and midterm outcomes of patients who underwent surgical aortic
valve replacement (SAVR) and coronary artery bypass grafting (CABG)
against patients who had transcatheter aortic valve replacement (TAVR) and
percutaneous coronary intervention (PCI). <br/>Background(s): Contemporary
guidelines suggest that surgical or percutaneous revascularization of
significant coronary artery disease (CAD) in patients with severe aortic
stenosis (AS) is a reasonable strategy. <br/>Method(s): We conducted a
comprehensive search of Medline and Embase to identify studies comparing a
percutaneous transcatheter versus a surgical approach. Random effects
meta-analyses using the Mantel-Haenszel method were performed to estimate
the effect of percutaneous compared surgical strategies using aggregate
data. <br/>Result(s): Six studies reporting on 1770 participants were
included in the meta-analysis. There were no significant differences in
effect estimates for early and midterm mortality (OR: 0.78; 95% CI,
0.50-1.20 and OR: 1.09; 95% CI, 0.80-1.49, respectively) or myocardial
infarction (OR: 0.52; 95% CI, 0.20-1.33 and OR: 1.34; 95% CI, 0.67-2.65,
respectively). No significant difference was shown for peri-procedural
stroke (OR: 0.80; 95% CI, 0.35-1.87). A transcatheter approach had a
higher rate of major vascular complications (OR: 14.44; 95% CI,
4.42-47.16), but a lower rate of acute kidney injury (OR: 0.41; 95% CI,
0.19-0.91). <br/>Conclusion(s): Our analysis suggests that a percutaneous
transcatheter approach confers similar outcomes compared to a surgical
approach in patients with severe AS and CAD. However, our findings are
based on low quality studies and should serve as hypothesis generating. In
the absence of adequately powered studies yielding high level evidence,
individualized decision making should be based on surgical risk
assessment.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC.

<25>
Accession Number
2005558074
Title
Parental mobile health adherence to symptom home monitoring for infants
with congenital heart disease during the single ventricle interstage
period: A concept analysis.
Source
Journal for Specialists in Pediatric Nursing. (no pagination), 2020. Date
of Publication: 2020.
Author
Erickson L.A.; Emerson A.; Russell C.L.
Institution
(Erickson) Ward Family Heart Center, Children's Mercy Hospital, Kansas
City, MO, United States
(Emerson, Russell) School of Nursing, University of Missouri-Kansas City,
Kansas City, MO, United States
Publisher
Blackwell Publishing Ltd
Abstract
Purpose: Single ventricle heart disease is fraught with risk for infant
mortality and morbidity. During the interstage period, or the time between
palliative cardiac surgeries, mobile health (mHealth) technology improves
the ability of registered nurse coordinators to monitor infant symptoms
through parental monitoring and reporting. The concept of parental mHealth
adherence to symptom home monitoring of infants with single ventricle
congenital heart disease has not been defined, despite increasing use of
mHealth technology. <br/>Method(s): Rodger's concept analysis method was
used to derive a unified definition of parental mHealth adherence to
symptom home monitoring of infants with congenital heart disease during
the single ventricle interstage period. A literature review included a
search of databases for studies that addressed interstage home mHealth
monitoring. Thematic analysis was applied to selected articles to derive a
unified definition based on attributes, antecedents, consequences, related
terms, and an illustrative case example. Sixteen publications were
selected. Attributes, antecedents, and consequences of the concept were
derived from the literature leading to a definition of parental mHealth
adherence for infants with congenital heart disease during the single
ventricle interstage period. The definition is the degree of adherence to
which parents' transfer mHealth data for their infant meet healthcare
providers' recommendations for symptom home monitoring. Consequences were
improved infant symptom home monitoring through parental mHealth adherence
measured by initiation, implementation, and discontinuation.
<br/>Conclusion(s): The unified definition of the concept will provide a
firmer ground for research in mHealth and interstage pediatric care and a
guide for clinicians in developing new mHealth interventions for symptom
home monitoring. Practice Implications: This concept analysis hypothesizes
that infants with a single ventricle during the interstage period, whose
parents are mHealth symptom home monitoring adherent, will have timelier
symptom identification with resultant superior outcomes compared with
infants with a single ventricle during the interstage period whose parents
are not mHealth adherent.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<26>
Accession Number
2005543468
Title
Sleeve Gastrectomy in Patients with Continuous-Flow Left Ventricular
Assist Devices: a Systematic Review and Meta-Analysis.
Source
Obesity Surgery. (no pagination), 2020. Date of Publication: 2020.
Author
Challapalli J.; Maynes E.J.; O'Malley T.J.; Cross D.E.; Weber M.P.; Choi
J.H.; Aggarwal R.; Boyle A.J.; Whellan D.J.; Entwistle J.W.; Massey H.T.;
Morris R.J.; Tchantchaleishvili V.
Institution
(Challapalli) Drexel University College of Medicine, Philadelphia, PA,
United States
(Maynes, O'Malley, Cross, Weber, Choi, Entwistle, Massey, Morris,
Tchantchaleishvili) Division of Cardiac Surgery, Department of Surgery,
Thomas Jefferson University, Philadelphia, PA, United States
(Aggarwal) Division of Minimally Invasive, Metabolic, and Bariatric
Surgery, Thomas Jefferson University, Philadelphia, PA, United States
(Boyle, Whellan) Division of Cardiology, Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
Springer
Abstract
Purpose: A body mass index (BMI) > 35 kg/m² is a relative
contraindication to heart transplantation in patients with end-stage heart
failure. Bariatric surgery can be considered either concomitantly with
continuous-flow left ventricular assist device (CF-LVAD) placement, or
staged after CF-LVAD has been placed. We sought to evaluate the outcomes
of these approaches. <br/>Material(s) and Method(s): An electronic search
was performed to identify all relevant studies. After assessment for
inclusion and exclusion criteria, eight studies were pooled for systematic
review and metaanalysis. <br/>Result(s): Overall, of 59 patients, 22 (37%)
underwent simultaneous sleeve gastrectomy with CF-LVAD implantation while
37 (63%) underwent staged sleeve gastrectomy after CF-LVAD. The mean age
of patients was 46 years (95% CI: 39-53) with 40% females. Mean BMI at
most recent follow-up (33.4 kg/m², 95% CI: 30.2-36.6) was
significantly lower compared with mean preoperative BMI (46.7
kg/m², 95% CI: 42.9-50.6) (p < 0.01). There was no significant
difference in total incidence of postoperative complications
(simultaneous, 16% (95% CI: 1-87%) versus staged, 23% (95% CI: 7-53%)) or
in overall survival (simultaneous, 93% (95% CI: 72-99%) versus staged, 79%
(95% CI: 60-90%), p = 0.17) for average follow-up time of 12.7 months.
Bariatric surgery resulted in 66% of patients (95% CI: 51-79) to be listed
for heart transplantation, including 33% (95% CI: 22-47) who were
transplanted. <br/>Conclusion(s): Both simultaneous and staged bariatric
surgeries with CF-LVAD placement have comparable outcomes and
significantly reduce BMI. This can allow previously ineligible patients to
undergo heart transplantation.<br/>Copyright &#xa9; 2020, Springer
Science+Business Media, LLC, part of Springer Nature.

<27>
Accession Number
632323281
Title
Performance at stair-climbing test is associated with postoperative
complications after lung resection: a systematic review and meta-analysis.
Source
Thorax. (no pagination), 2020. Date of Publication: 10 Jul 2020.
Author
Boujibar F.; Gillibert A.; Gravier F.E.; Gillot T.; Bonnevie T.; Cuvelier
A.; Baste J.-M.
Institution
(Boujibar, Baste) Department of General and Thoracic Surgery, CHU Rouen,
Rouen, France
(Boujibar, Baste) Normandie University UNIROUEN, INSERM U1096, Rouen,
France
(Gillibert) Biostatistics Unit, CHU Rouen, Rouen, Normandie, France
(Gravier, Bonnevie) ADIR Association, France
(Gravier, Bonnevie, Cuvelier) Normandie University, UNIROUEN, UPRES EA
3830, Rouen University Hospital, Haute Normandie Research and Biomedical
Innovation, Rouen, France
(Gillot) CETAPS EA 3832, Mont Saint Aignan, France
(Gillot) ERFPS, CHU Rouen, Rouen, France
(Cuvelier) Pulmonary & Respiratory Intensive Care Department, CHU Rouen,
Rouen, Normandie, France
Publisher
NLM (Medline)
Abstract
BACKGROUND: Thoracic surgery is the optimal treatment for early-stage lung
cancer, but there is a high risk of postoperative morbidity. Therefore, it
is necessary to evaluate patients' preoperative general condition and
cardiorespiratory capacity to determine the risk of postoperative
complications. The objective of this study was to assess whether the
stair-climbing test could be used in the preoperative evaluation of lung
resection patients to predict postoperative morbidity following thoracic
surgery. <br/>METHOD(S): We performed a systematic review and a
meta-analysis on the association between stair-climbing test result and
morbidity/mortality after thoracic surgery. We analysed all articles
published until May 2020 in the following databases: Pubmed/Medline,
Pedro, The Cochrane library, Embase and CINAHL. The risk of bias was
assessed using the Quality in Prognosis Studies tool. This meta-analysis
is registered as PROSPERO CRD42019121348. <br/>RESULT(S): 13 articles were
included in the systematic review for a total of 2038 patients and 6 in
the meta-analysis. There were multiple test evaluation criteria: rise
time, height, desaturation and heart rate change. For the meta-analysis,
we were able to pool data on the height of rise at a variable threshold:
risk ratio 2.34 (95% CI 1.59 to 3.43) with I2=53% (p=0.06). The threshold
for occurrence of complications was estimated at a 10 m climb.
<br/>CONCLUSION(S): Our results indicate that the stair-climbing test
could be used as a first-line functional screening test to predict
postoperative morbidity following thoracic surgery and that patients with
a poor test result (<10 m) should be referred to formal cardiopulmonary
exercise testing.<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.

<28>
Accession Number
632317806
Title
Cardiac resynchronization therapy for the failing systemic right
ventricle: A systematic review.
Source
International journal of cardiology. (no pagination), 2020. Date of
Publication: 06 Jul 2020.
Author
Kharbanda R.K.; Moore J.P.; Taverne Y.J.H.J.; Bramer W.M.; Bogers
A.J.J.C.; de Groot N.M.S.
Institution
(Kharbanda) Department of Cardiology, Erasmus MC, University Medical
Center, Rotterdam, the Netherlands; Department of Cardiothoracic Surgery,
Erasmus MC, University Medical Center, Rotterdam, the Netherlands
(Moore) Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles,
CA, United States
(Taverne) Department of Cardiothoracic Surgery, Erasmus MC, University
Medical Center, Rotterdam, the Netherlands; Department of Anatomy,
ERCATHAN, Erasmus MC, university Medical Center, Rotterdam, the
Netherlands
(Bramer) Medical library Erasmus MC, University Medical Center, Rotterdam,
Netherlands
(Bogers) Department of Cardiothoracic Surgery, Erasmus MC, University
Medical Center, Rotterdam, Netherlands
(de Groot) Department of Cardiology, Erasmus MC, University Medical
Center, Rotterdam, Netherlands
Publisher
NLM (Medline)
Abstract
Patients with a systemic right ventricle (SRV) are at high risk for
development of heart failure early in life. An SRV is encountered in
patients with congenitally corrected transposition of the great arteries
(CCTGA) or dextro-transposition of the great arteries (DTGA) with previous
atrial switch repair (Mustard or Senning procedure). Progressive heart
failure is one of the leading cause of mortality in these patients.
Therefore, cardiac resynchronization therapy (CRT) has gained increasing
momentum for use in this challenging congenital heart disease (CHD)
population. However, current guidelines differ in recommendations for CRT
in patients with an SRV as evidence supporting CRT has thus far only been
described in case reports and retrospectively in relatively small study
populations. In fact, the European Society of Cardiology Guideline for the
management of grown-up congenital heart disease consider CRT to be
'experimental' in this population. This systematic review critically
summarizes current literature on CRT in SRV patients and provides future
perspectives for further research in this challenging and growing CHD
population.<br/>Copyright &#xa9; 2020. Published by Elsevier B.V.

<29>
Accession Number
632317155
Title
The cost-effectiveness of transcatheter aortic valve replacement in low
surgical risk patients with severe aortic stenosis.
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2020. Date of Publication: 09 Jul 2020.
Author
Tam D.Y.; Azizi P.M.; Fremes S.E.; Chikwe J.; Gaudino M.; Wijeysundera
H.C.
Institution
(Tam, Fremes) Division of Cardiac Surgery, Department of Surgery, Schulich
Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto,
Toronto, Canada
(Tam, Azizi, Fremes, Wijeysundera) Institute of Health Policy, Management
and Evaluation, University of Toronto, Toronto, Canada
(Chikwe) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, USA
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
NewYork - Presbyterian Hospital, NY, NY, United States
(Wijeysundera) Division of Cardiology, Department of Medicine, Schulich
Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto,
Toronto, Canada
Publisher
NLM (Medline)
Abstract
AIMS: The economic value of transcatheter aortic valve replacement (TAVR)
in low surgical risk patients with severe, symptomatic aortic stenosis is
not known. Our objective was to determine the cost-effectiveness of
balloon-expandable TAVR and self-expandable TAVR relative to surgical
aortic valve replacement (SAVR) in low risk patients. METHODS/RESULTS: A
fully probabilistic Markov cohort model was constructed to estimate
differences in costs and effectiveness (quality-adjusted life years
[QALYs]) over the patient's life-time time from the third party payer's
perspective. Clinical outcomes modeled were: alive/well (no
complications), permanent stroke, >=moderate paravalvular leak, new
pacemaker, rehospitalization, and death. A network meta-analysis of the
PARTNER 3 and Evolut Low Risk trial was performed to compare
balloon-expandable TAVR, self-expandable TAVR, and SAVR for the efficacy
inputs. Incremental-cost effectiveness ratios (ICER) were calculated.The
total lifetime costs in the balloon-expandable TAVR, self-expandable-TAVR,
and SAVR arms were $37,330+/-4,724, $39,660+/-4,862, and $34,583+/-6,731
respectively and total lifetime QALYs gained were 9.15+/-3.23,
9.13+/-3.23, and 9.05+/-3.20 respectively. The ICERs for
balloon-expandable TAVR and self-expandable TAVR against SAVR were
$27,196/QALY and $59,641/QALY respectively. Balloon-expandable TAVR was
less costly and more effective than self-expandable TAVR. There was
substantial uncertainty, with 53% and 58% of model iterations showing
balloon-expandable TAVR to be the preferred option at willingness-to-pay
thresholds of $50,000/QALY and $100,000/QALY respectively.
<br/>CONCLUSION(S): Compared to SAVR, TAVR, particularly with
balloon-expandable prostheses may be a cost-effective option for patients
with severe aortic stenosis at low surgical risk.<br/>Copyright Published
on behalf of the European Society of Cardiology. All rights reserved.
&#xa9; The Author(s) 2020. For permissions please email:
journals.permissions@oup.com.

<30>
Accession Number
2005684581
Title
Effects of bisoprolol transdermal patches for prevention of perioperative
myocardial injury in high-risk patients undergoing non-cardiac surgery -
multicenter randomized controlled study -.
Source
Circulation Journal. 84 (4) (pp 642-649), 2020. Date of Publication: 2020.
Author
Toda H.; Nakamura K.; Shimizu K.; Ejiri K.; Iwano T.; Miyoshi T.; Nakagawa
K.; Yoshida M.; Watanabe A.; Nishii N.; Hikasa Y.; Hayashi M.; Morita H.;
Morimatsu H.; Ito H.
Institution
(Toda, Nakamura, Ejiri, Iwano, Miyoshi, Nakagawa, Yoshida, Watanabe,
Nishii, Morita, Ito) Department of Cardiovascular Medicine, Okayama
University, Graduate School of Medicine, Dentistry and Pharmaceutical
Sciences, Okayama, Japan
(Shimizu, Hikasa, Hayashi, Morimatsu) Department of Anesthesiology,
Okayama University, Graduate School of Medicine, Dentistry and
Pharmaceutical Sciences, Okayama, Japan
(Morita) Department of Cardiovascular Therapeutics, Okayama University,
Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,
Okayama, Japan
Publisher
Japanese Circulation Society
Abstract
Background: The aim of this study was to evaluate the efficacy and safety
of transdermal beta-blocker patches, which offer stable blood
concentration and easy availability during operation, for prevention of
perioperative myocardial injury (PMI) in high-risk patients. <br/>Methods
and Results: In this randomized controlled trial, patients aged >60 years
with hypertension and high revised cardiac risk index (>=2) undergoing
non-cardiac surgery were randomly assigned to a bisoprolol patch or
control group. Primary efficacy outcome was incidence of PMI, defined as
postoperative high-sensitivity cardiac troponin T (hs-cTnT) >0.014ng/mL
and relative hs-cTnT change >=20%. Secondary efficacy outcomes were number
of cardiovascular events and 30-day mortality. From November 2014 to
February 2019, 240 patients from 5 hospitals were enrolled in this study.
The incidence of PMI was 35.7% in the bisoprolol patch group and 44.5% in
the control group (P=0.18). Incidence of major adverse cardiac events
including non-critical myocardial infarction, strokes, decompensated heart
failure and tachyarrhythmia was similar between the 2 groups.
Tachyarrhythmia tended to be higher in the control group. There were no
significant differences in safety outcomes including significant
hypotension and bradycardia requiring any treatment between the 2 groups.
<br/>Conclusion(s): Bisoprolol patches do not influence the incidence of
PMI and cardiovascular events in high-risk patients undergoing non-cardiac
surgery, but perioperative use of these patches is safe.<br/>Copyright
&#xa9; 2020 Japanese Circulation Society. All rights reserved.

<31>
Accession Number
2004497104
Title
D-dimer as a thrombus biomarker for predicting 2-year mortality after
percutaneous coronary intervention.
Source
Therapeutic Advances in Chronic Disease. 11 (no pagination), 2020. Date of
Publication: 2020.
Author
Zhao X.; Li J.; Tang X.; Jiang L.; Chen J.; Qiao S.; Yang Y.; Gao R.; Xu
B.; Yuan J.
Institution
(Zhao, Li, Tang, Jiang, Chen, Qiao, Yang, Gao) Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Xu, Yuan) State Key Laboratory of Cardiovascular Disease, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, No. 167 Beilishi Road,Xicheng
District, Beijing 100037, China
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Background: D-dimer has predictive value for mortality in some diseases.
This study aimed to evaluate the correlation between D-dimer and mortality
in patients undergoing percutaneous coronary intervention (PCI).
<br/>Method(s): We examined 10,724 consecutive patients who underwent PCI
between January 2013 and December 2013. The primary endpoint was all-cause
mortality, and the secondary endpoint was cardiac mortality. Patients were
divided according to the median D-dimer level of 0.28 mug/ml.
Multivariable model were including age, sex, and risk factors after
stepwise selection. <br/>Result(s): After a 2-year follow up, 8565
patients with D-dimer data were analyzed. There were 116 (1.35%) all-cause
deaths and 64 (0.75%) cardiac deaths. D-dimer levels were significantly
higher in the all-cause mortality group [0.42 (0.29, 0.68) mug/ml] and
cardiac mortality group [0.48 (0.30, 0.81) mug/ml] than in the survival
group [0.28 (0.20, 0.41) mug/ml] (both p < 0.001). Multivariate-adjusted
Cox hazard analysis showed that high D-dimer levels (0.28 mug/ml) were
significantly associated with all-cause mortality in the total population
[hazard ratio (HR): 2.35, 95% confidence interval (CI): 1.44-3.84, p =
0.001], acute coronary syndrome (ACS) subgroup (HR: 1.91, 95% CI:
1.08-3.38, p = 0.027), and stable coronary artery disease (SCAD) subgroup
(HR: 3.82, 95% CI: 1.45-10.10, p = 0.007). High D-dimer levels were
significantly associated with cardiac mortality in the total population
(HR: 3.44, 95% CI: 1.61-7.36, p = 0.001) and the ACS subgroup (HR: 3.33,
95% CI: 1.38-8.03, p = 0.007), but not in the SCAD subgroup (HR: 3.68, 95%
CI: 0.80-16.91, p = 0.094). <br/>Conclusion(s): D-dimer levels are
independently associated with 2-year all-cause mortality and cardiac
mortality in patients undergoing PCI.<br/>Copyright &#xa9; The Author(s),
2020.

<32>
Accession Number
2004154947
Title
Need for pacing in patients who qualify for an implantable
cardioverter-defibrillator: Clinical implications for the subcutaneous
ICD.
Source
Annals of Noninvasive Electrocardiology. 25 (4) (no pagination), 2020.
Article Number: e12744. Date of Publication: 01 Jul 2020.
Author
Kutyifa V.; Rosero S.Z.; McNitt S.; Polonsky B.; Brown M.W.; Zareba W.;
Goldenberg I.
Institution
(Kutyifa, Rosero, McNitt, Polonsky, Brown, Zareba, Goldenberg) Heart
Research Follow-Up Program, University of Rochester Medical Center,
Rochester, NY, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Implantation of the subcutaneous implantable
cardioverter-defibrillator (S-ICD) is spreading and has been shown to be
safe and effective; however, it does not provide brady-pacing. Currently,
data on the need for brady-pacing and cardiac resynchronization therapy
(CRT) implantation in patients with ICD indication are limited.
<br/>Method(s): The Multicenter Automatic Defibrillator Implantation Trial
(MADIT)-II enrolled post-MI patients with reduced ejection fraction (EF <=
35%), randomized to either an implantable cardioverter-defibrillator (ICD)
or conventional medical therapy. Kaplan-Meier analyses and multivariate
Cox models were performed to assess the incidence and predictors of
pacemaker (PM), or CRT implantation in the conventional arm of MADIT-II,
after excluding 32 patients (6.5%) with a previously implanted PM.
<br/>Result(s): During the median follow-up of 20 months, 24 of 458
patients (5.2%) were implanted with a PM or a CRT (19 PM, 5 CRT).
Symptomatic sinus bradycardia was the primary indication for PM
implantation (n = 9, 37%), followed by AV block (n = 5, 21%), tachy-brady
syndrome (n = 4, 17%), and carotid sinus hypersensitivity (n = 1, 4%).
Baseline PR interval >200 ms (HR = 3.07, 95% CI: 1.24-7.57, p =.02), and
CABG before enrollment (HR = 6.88, 95% CI: 1.58-29.84, p =.01) predicted
subsequent PM/CRT implantation. Patients with PM/CRT implantation had a
significantly higher risk for heart failure (HR = 2.67, 95% CI =
1.38-5.14, p =.003), but no increased mortality risk (HR = 1.06, 95% CI =
0.46-2.46, p =.89). <br/>Conclusion(s): The short-term need for
ventricular pacing or CRT implantation in patients with MADIT-II ICD
indication was low, especially in those with a normal baseline PR
interval, and such patients are appropriate candidates for the
subcutaneous ICD.<br/>Copyright &#xa9; 2020 The Authors. Annals of
Noninvasive Electrocardiology published by Wiley Periodicals, Inc.

<33>
Accession Number
2004143085
Title
A randomized controlled trial comparing novel triple-cuffed double-lumen
endobronchial tubes with conventional double-lumen endobronchial tubes for
lung isolation.
Source
Journal of Clinical Medicine. 9 (4) (no pagination), 2020. Article Number:
977. Date of Publication: April 2020.
Author
Kim N.; Byon H.-J.; Kim G.E.; Park C.; Joe Y.E.; Suh S.M.; Oh Y.J.
Institution
(Kim, Byon, Kim, Joe, Suh, Oh) Department of Anesthesiology and Pain
Medicine, Anesthesia and Pain Research Institute, Yonsei University
College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South
Korea
(Park) Department of Anesthesiology and Pain Medicine, Gil Medical Center,
Gachon University College of Medicine, 21 Namdong-daero 774 beon-gil,
Namdong-gu, Incheon 21565, South Korea
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: rasetti@mdpi.com)
Abstract
Placing a double-lumen endobronchial tube (DLT) in an appropriate position
to facilitate lung isolation is essential for thoracic procedures. The
novel ANKOR DLT is a DLT developed with three cuffs with a newly added
carinal cuff designed to prevent further advancement by being blocked by
the carina when the cuff is inflated. In this prospective study, the
direction and depth of initial placement of ANKOR DLT were compared with
those of conventional DLT. Patients undergoing thoracic surgery (n = 190)
with one-lung ventilation (OLV) were randomly allocated into either
left-sided conventional DLT group (n = 95) or left-sided ANKOR DLT group
(n = 95). The direction and depth of DLT position were compared via
fiberoptic bronchoscopy (FOB) after endobronchial intubation between the
groups. There was no significant difference in the number of right
mainstem endobronchial intubations between the two groups (p = 0.468). The
difference between the initial depth of DLT placement and the target depth
confirmed by FOB was significantly lower in the ANKOR DLT group than in
the conventional DLT group (1.8 +/- 1.8 vs. 12.9 +/- 9.7 mm; p < 0.001).
In conclusion, the ANKOR DLT facilitated its initial positioning at the
optimal depth compared to the conventional DLT.<br/>Copyright &#xa9; 2020
by the authors. Licensee MDPI, Basel, Switzerland.

<34>
Accession Number
2004096284
Title
Prevalence of depression in coronary artery bypass surgery: A systematic
review and meta-analysis.
Source
Journal of Clinical Medicine. 9 (4) (no pagination), 2020. Article Number:
909. Date of Publication: April 2020.
Author
Correa-Rodriguez M.; Ejheisheh M.A.; Suleiman-Martos N.; Membrive-Jimenez
M.J.; Velando-Soriano A.; Schmidt-Riovalle J.; Gomez-Urquiza J.L.
Institution
(Correa-Rodriguez, Ejheisheh, Schmidt-Riovalle, Gomez-Urquiza) Faculty of
Health Sciences, University of Granada, Avenida de la Ilustracion N. 60,
Granada 18016, Spain
(Correa-Rodriguez) Instituto de Investigacion Biosanitaria, IBS, Granada
18012, Spain
(Suleiman-Martos) Faculty of Health Sciences, University of Granada,
Campus Universitario de Ceuta, C/Cortadura del Valle s/n, Ceuta 51001,
Spain
(Membrive-Jimenez) University Hospital of Ceuta, Institute of Health
Management, C/Colmenar s/n, Ceuta 51003, Spain
(Velando-Soriano) University Hospital Virgen de las Nieves, Andalusian
Health Service, Av. de las Fuerzas Armadas 2, Granada 18014, Spain
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: rasetti@mdpi.com)
Abstract
Coronary artery bypass graft surgery (CABG) might adversely affect the
health status of the patients, producing cognitive deterioration, with
depression being the most common symptom. The aim of this study is to
analyse the prevalence of depression in patients before and after coronary
artery bypass surgery. A systematic review and meta-analysis was carried
out, involving a study of the past 10 years of the following databases:
CINAHL, LILACS, MEDLINE, PsycINFO, SciELO, Scopus, and Web of Science. The
total sample comprised n = 16,501 patients. The total number of items was
n = 65, with n = 29 included in the meta-analysis. Based on the different
measurement tools used, the prevalence of depression pre-CABG ranges from
19-37%, and post-CABG from 15- 33%. There is a considerable presence of
depression in this type of patient, but this varies according to the
measurement tool used and the quality of the study. Systematically
detecting depression prior to cardiac surgery could identify patients at
potential risk.<br/>Copyright &#xa9; 2020 by the authors. Licensee MDPI,
Basel, Switzerland.

<35>
[Use Link to view the full text]
Accession Number
2004197949
Title
Comparison of Automated Titanium Fasteners to Hand-Tied Knots in Open
Aortic Valve Replacement.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 13 (1) (pp 29-34), 2018. Date of Publication: 01 Jan 2018.
Author
Lee C.Y.; Johnson C.A.; Siordia J.A.; Lehoux J.M.; Knight P.A.
Institution
(Lee, Johnson, Siordia, Lehoux, Knight) Division of Cardiac Surgery,
University of Rochester Medical Center, Rochester, NY, United States
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Objective: Aortic cross-clamp and cardiopulmonary bypass times are
independent predictors of postoperative morbidity and mortality. Reducing
ischemic times with automated titanium fasteners may improve surgical
outcomes. This study compared operative times and costs of titanium
fasteners versus hand-tied knots for prosthesis securement in open aortic
valve replacement. <br/>Method(s): A randomized control trial was
conducted during a 16-month period at a single university medical center.
Patients undergoing elective aortic valve replacement were randomized to
the titanium fastener (n = 37) or hand-tied groups (n = 36). Knotting,
aortic cross-clamp, cardiopulmonary bypass, and total operating room times
were recorded. Hospital charges were also calculated for these procedures.
<br/>Result(s): Baseline characteristics, concomitant procedures,
prosthetic valve size, and sutures were similar between groups. The
titanium fastener group had significantly reduced knotting (7.4 vs. 13.0
minutes, P < 0.001), aortic cross-clamp (69 vs. 90 minutes, P < 0.05),
cardiopulmonary bypass (86 vs. 114 minutes, P < 0.05), and total operating
room times (234 vs. 266 minutes, P < 0.05). Intraoperative complications
occurred more frequently in the hand-tied group compared with the titanium
fastener group. Postoperative complications were similar between groups.
Operating room costs were significantly higher in the titanium fastener
group (US $10,428 vs. US $9671, P = 0.01). Hospitalization costs did not
differ significantly between the titanium fastener and hand-tied group (US
$23,987 vs. US $21,068, P = 0.12). <br/>Conclusion(s): Titanium fastener
use was associated with shorter knotting, aortic cross-clamp,
cardiopulmonary bypass, and operating room times and fewer intraoperative
complications in open aortic valve replacement, without significantly
increasing hospitalization cost.<br/>Copyright &#xa9; 2018 International
Society for Minimally Invasive Cardiothoracic Surgery.

<36>
[Use Link to view the full text]
Accession Number
2004197918
Title
Stented versus Stentless Aortic Valve Replacement in Patients with Small
Aortic Root: A Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 13 (6) (pp 404-416), 2018. Date of Publication: 01 Nov 2018.
Author
Harky A.; Wong C.H.M.; Hof A.; Froghi S.; Ahmad M.U.; Howard C.; Rimmer
L.; Bashir M.
Institution
(Harky) Department of Vascular Surgery, Countess of Chester Hospital,
Chester, United Kingdom
(Wong) Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
(Hof) Department of Cardiovascular Surgery, Heinrich-Heine-University,
Medical Faculty, Dusseldrof, Germany
(Froghi) Department of Surgery, Imperial College NHS Trust, Hammersmith,
London, United Kingdom
(Ahmad, Howard, Rimmer) School of Medicine, University of Liverpool,
Liverpool, United Kingdom
(Bashir) Manchester Royal Infirmary, Manchester, United Kingdom
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Objective: The aim of the study was to compare hemodynamic and
perioperative outcomes of stented against stentless aortic valve
replacement in patients with small aortic root (21 mm or less).
<br/>Method(s): A comprehensive search was undertaken among the four major
databases (PubMed, Embase, Scopus, and Ovid) to identify all randomized
and nonrandomized controlled trials comparing stentless to stented
bioprosthetic valves in small aortic root patients. Odds ratios, weighted
mean differences, or standardized mean differences and their 95%
confidence intervals were analyzed. <br/>Result(s): A total of seven
studies with a total of 965 patients fulfilled the inclusion criteria.
There was no significant difference in preoperative baselines including
mean age between both groups (P = 0.08), peak aortic valve gradient (P =
0.06), and effective orifice area (P = 0.28), whereas higher mean aortic
valve gradient in the stented group (P = 0.007). No difference in
cardiopulmonary bypass time (P = 0.74), aortic cross-clamp times (P =
0.88), intensive care unit stay (P = 0.13), and stroke rate (P = 0.56)
were noted. However, stented group of patients showed higher rate of
patient prosthesis mismatch (P = 0.0001) and longer total hospital stay (P
= 0.002). Postoperatively, stentless group showed lower peak and mean
aortic valve gradient (P = 0.003 and P = 0.008, respectively) with a
better effective orifice area (P < 0.00001) at 6 months of follow-up.
Mortality rates while in-hospital and at 1 year were similar in both
groups (P = 0.94 and P = 0.86, respectively). <br/>Conclusion(s):
Stentless aortic valves offer superior short-term hemodynamic outcomes in
patients with small aortic root when compared with stented aortic valves.
Although both groups have similar perioperative complications rates,
stentless valves bring about a shorter hospital stay. A further large
multicenter randomized controlled trial should address the longer-term
benefit of stentless aortic valve over stented valve.<br/>Copyright &#xa9;
2018 International Society for Minimally Invasive Cardiothoracic Surgery.

<37>
Accession Number
626128441
Title
Hammock Mitral Valve Repair in Infancy: Operative Steps Toward a
Customized Reconstruction After Preoperative Planning.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11 (4) (pp
NP213-NP216), 2020. Date of Publication: 01 Jul 2020.
Author
VanLoozen D.; Jensen M.A.; Lutin W.A.; Polimenakos A.C.
Institution
(VanLoozen, Lutin) Department of Pediatric Cardiology, Children's Hospital
of Georgia, Augusta University, Augusta, GA, United States
(Jensen) Department of Medical Illustration, College of Allied Health,
Augusta University, Augusta, GA, United States
(Polimenakos) Department of Pediatric Cardiothoracic Surgery, Children's
Hospital of Georgia, Augusta University, Augusta, GA, United States
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Hammock mitral valve (MV) repair is historically technically difficult
with a guarded prognosis. Surgical experience is extremely limited and
variable outcomes are reported. The perioperative strategy and technical
details of hammock MV repair in an infant who presented with severe mitral
stenosis are described and review of the existing literature was
undertaken.<br/>Copyright &#xa9; The Author(s) 2019.

<38>
Accession Number
2005520785
Title
On-pump beating-heart coronary artery bypass grafting in high-risk
patients: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Dominici C.; Salsano A.; Nenna A.; Spadaccio C.; Mariscalco G.; Santini
F.; Chello M.
Institution
(Dominici, Nenna, Chello) Department of Cardiovascular Surgery, Universita
Campus Bio-Medico di Roma, Rome, Italy
(Salsano, Santini) Department of Cardiac Surgery, University of Genoa,
Genoa, Italy
(Spadaccio) Department of Cardiac Surgery, Golden Jubilee National
Hospital, Glasgow, United Kingdom
(Mariscalco) Department of Cardiac Surgery, Glenfield Hospital, University
Hospitals of Leicester, Leicester, United Kingdom
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Operative technique for surgical myocardial revascularization
in high-risk patients remains an argument of debate. On-pump coronary
artery bypass graft (CABG) with cardioplegic arrest and off-pump CABG have
intrinsic limitations. The hybrid approach of on-pump beating-heart CABG
(OPBHC) has been proposed over the years with conflicting results. This
systematic review and meta-analysis intends to summarize the contemporary
literature. <br/>Method(s): A literature search was conducted through
major electronic databases. The systematic review provided a total of 279
articles, of those 17 studies were included in the present study.
<br/>Result(s): Compared with on-pump CABG, OPBHC patients showed a
preoperative higher risk profile but had reduced early mortality (risk
ratio [RR], 0.59, 95% CI, 0.36-0.97) and reduced postoperative stroke (RR,
0.60, 95% CI, 0.39-0.91). Also, interesting trends towards reduced
postoperative intra-aortic balloon pump use (RR, 0.56, 95% CI, 0.31-1.01)
and myocardial infarction (RR, 0.48, 95% CI, 0.22-1.07) were observed.
Baseline characteristics and postoperative complications were similar
between OPBHC and off-pump CABG, but limited data are available. The risk
of incomplete revascularization in OPBHC is lower than off-pump CABG (RR,
0.53, 95% CI, 0.33-0.87) but higher than conventional on-pump CABG (RR,
1.71, 95% CI, 1.23-2.39). <br/>Conclusion(s): OPBHC is an effective
technique to perform surgical revascularization in high-risk patients as
preventing haemodynamic deterioration and guaranteeing adequate end-organ
perfusion. OPBHC represents an alternative technique to on-pump and
off-pump CABG, in those cases in which complications deriving from
cardioplegic arrest or manipulation of the heart are more likely. For
these reasons, OPBHC might be useful in patients with recent myocardial
infarction or with left ventricular dysfunction.<br/>Copyright &#xa9; 2020
Wiley Periodicals LLC

<39>
Accession Number
2004958511
Title
Direct vs preimplantation balloon valvuloplasty in transcatheter aortic
valve replacement-Systematic review and meta-analysis of randomized
controlled trials and prospective-matched cohorts.
Source
Journal of Cardiac Surgery. 35 (7) (pp 1498-1507), 2020. Date of
Publication: 01 Jul 2020.
Author
Pranata R.; Vania R.; Alkatiri A.A.; Firman D.
Institution
(Pranata, Vania) Department of Medicine, Faculty of Medicine, Universitas
Pelita Harapan, Tangerang, Indonesia
(Alkatiri, Firman) Department of Cardiology and Vascular Medicine, Faculty
of Medicine, National Cardiovascular Center Harapan Kita, Universitas
Indonesia, Jakarta, Indonesia
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: This systematic review and meta-analysis aimed to evaluate the
efficacy and safety of direct vs preimplantation balloon valvuloplasty
(predilatation) before transcatheter aortic valve replacement (TAVR).
<br/>Method(s): We performed a systematic literature search up until March
2020 from PubMed, SCOPUS, EuropePMC, Cochrane Central Database, ProQuest,
and ClinicalTrials.gov. We included randomized controlled trial (RCT) and
prospective-matched cohorts that compared direct TAVR and preimplantation
balloon valvuloplasty before TAVR. The primary outcome was the device
success as defined by Valve Academic Research Consortium 2. The secondary
outcome was a patient-prosthesis mismatch, the need for balloon
postdilatation, composite adverse events, and 1-year mortality.
<br/>Result(s): There were a total of 3078 patients from eight studies.
This meta-analysis showed that direct TAVR has a similar device success
rate (P =.63), the need for postdilatation (P =.82), and composite adverse
events (P =.98) compared with preimplantation balloon valvuloplasty.
Subgroup analysis for balloon-expandable valves showed lower need for
balloon postdilatation (risk ratio [RR], 0.63 [0.47, 0.84]; P =.002;
I², 0%) in direct TAVR group but higher incidence of acute
kidney injury (RR, 3.23 [1.25, 8.40]; P =.02; I², 0%) and
major/life-threatening bleeding (RR, 1.54 [1.17, 2.02]; P =.002;
I², 0%). Subgroup analysis for the RCTs alone and RCTs +
propensity-matched cohorts showed similar device success and composite
adverse events in both groups. However, pooled RCTs showed a higher need
for balloon postdilatation in direct TAVR (RR, 1.83 [1.03, 3.24]; P =.04;
I², 0%). <br/>Conclusion(s): Direct TAVR has similar efficacy
and safety to preimplantation balloon valvuloplasty. However,
better-designed RCTs are required before drawing a definite
conclusion.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<40>
Accession Number
2003517936
Title
Transcatheter aortic valve replacement versus surgical aortic valve
replacement in low-surgical-risk patients: An updated meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 96 (1) (pp 169-178),
2020. Date of Publication: 01 Jul 2020.
Author
Goel S.; Pasam R.T.; Wats K.; Patel J.; Chava S.; Gotesman J.; Malik B.A.;
Frankel R.; Shani J.; Gidwani U.
Institution
(Goel, Pasam, Wats, Patel, Chava, Gotesman, Malik, Frankel, Shani)
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
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objective: The purpose of this meta-analysis is to compare the safety and
efficacy of transcatheter aortic-valve replacement (TAVR) to surgical
aortic valve replacement (SAVR) in low-surgical-risk patients.
<br/>Background(s): TAVR is proven to be safe and effective in patients
with high- and intermediate-risk aortic stenosis. However, there is
limited data on the safety and efficacy of TAVR in patients with low
surgical risk. <br/>Method(s): We conducted an electronic database search
of all published data for studies that compared TAVR to SAVR in
low-surgical-risk patients (mean society for thoracic surgery [STS] score
<4% and/or logistic EuroScore <10%) and reported on subsequent all-cause
mortality, cardiac mortality, stroke rates, and other outcomes of
interest. Event rates were compared with a forest plot of odds ratio using
a random-effects model assuming interstudy heterogeneity. <br/>Result(s):
A total of seven studies (n = 6,293 patients; TAVR = 2,912; and SAVR =
3,381) were included in the final analysis. There was no significant
difference between TAVR and SAVR in terms of all-cause mortality (OR 0.82;
95% CI 0.50-1.36, I² = 51%), cardiac mortality (OR 0.57; 95% CI
0.32-1.02, I² = 0%), new pacemaker implantation (OR = 3.11; 95%
CI 0.58-16.60, I² = 89%), moderate/severe paravalvular leak
(PVL; OR 3.50; 95% CI 0.64-19.10, I² = 54%) and rate of stroke
(OR 0.63; 95% CI 0.34-1.15, I² = 39%) at 1-year follow-up. TAVR
was found to have a significantly lower incidence of atrial fibrillation
(AF; OR 0.15, 95% CI 0.10-0.24, I² = 38%) as compared to SAVR.
<br/>Conclusion(s): The results of our meta-analysis demonstrate similar
rates of all-cause mortality, cardiac mortality, and stroke at 1-year
follow-up in patients undergoing TAVR and SAVR. TAVR is associated with a
lower incidence of AF relative to SAVR. However, there was a significantly
higher incidence of PVL with TAVR compared to SAVR.<br/>Copyright &#xa9;
2019 Wiley Periodicals, Inc.

<41>
Accession Number
2003507920
Title
Transcatheter aortic valve replacement versus surgery for symptomatic
severe aortic stenosis: A reconstructed individual patient data
meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 96 (1) (pp 158-166),
2020. Date of Publication: 01 Jul 2020.
Author
Dowling C.; Kondapally Seshasai S.R.; Firoozi S.; Brecker S.J.
Institution
(Dowling, Kondapally Seshasai, Firoozi, Brecker) Cardiology Clinical
Academic Group, St. George's, University of London and St. George's
University Hospitals NHS Foundation Trust, London, United Kingdom
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objectives: We wished to undertake a reconstructed individual patient data
meta-analysis of randomized clinical trials comparing transcatheter aortic
valve replacement (TAVR) and surgery for patients with severe symptomatic
aortic stenosis. <br/>Background(s): TAVR and surgery are both
well-established methods for treating patients with symptomatic severe
aortic stenosis who are at low, intermediate, and high risk for surgery.
<br/>Method(s): Data were identified by searches of Medline, Embase,
CENTRAL and ClinicalTrials.gov for all randomized clinical trials, which
compared TAVR and surgery that had published at least 1 year of follow-up.
Individual patient data were reconstructed from Kaplan-Meier curves.
<br/>Result(s): A total of 7,770 patients from seven randomized clinical
trials were included in this meta-analysis. At 1 year, TAVR was associated
with a lower risk of death from any cause (hazard ratio [HR], 0.85, 95%
confidence interval [CI], 0.73-0.98; p =.03), disabling stroke (HR, 0.71;
95% CI, 0.54-0.93; p =.01) and the composite end point of death or
disabling stroke (HR, 0.79; 95% CI, 0.67-0.92; p =.002). Significant
interactions were found for access suitability, with TAVR associated with
a lower risk of these end points in patients suitable for transfemoral
access. TAVR was associated with a lower risk of periprocedural events,
whereas the risk of late events was similar between TAVR and surgery.
<br/>Conclusion(s): At 1 year, TAVR was associated with a lower risk of
death, disabling stroke and the composite end point, when compared with
surgery. These associations were strongest within the subgroup of patients
in whom transfemoral access was feasible.<br/>Copyright &#xa9; 2019 Wiley
Periodicals, Inc.

<42>
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.

<43>
Accession Number
2005543068
Title
Transcatheter versus surgical aortic valve replacement in the digital era:
Meta-analysis based on the reconstruction of time-to-event individual
patient data.
Source
Catheterization and Cardiovascular Interventions. 96 (1) (pp 167-168),
2020. Date of Publication: 01 Jul 2020.
Author
Tarantini G.; Giacoppo D.
Institution
(Tarantini, Giacoppo) Department of Cardiac-Vascular-Thoracic Sciences,
University of Padova, Padova, Italy
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Clinical benefits of transcatheter aortic valve replacement (TAVR) over
surgery emerge soon after intervention and show durable, consistent trends
within 1 year. TAVR by transfemoral access is associated with improved
outcomes compared with TAVR by transthoracic access. Reconstructing
time-to-event individual patient data is advantageous and allows higher
flexibility in terms of meta-analysis design and modeling of
data.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC.

<44>
Accession Number
632310852
Title
Interventions with Music in PECTus excavatum treatment (IMPECT trial): a
study protocol for a randomised controlled trial investigating the
clinical effects of perioperative music interventions.
Source
BMJ open. 10 (7) (pp e036380), 2020. Date of Publication: 08 Jul 2020.
Author
Billar R.J.; Kuhlmann A.Y.R.; Schnater J.M.; Vlot J.; Tomas J.J.P.; Zijp
G.W.; Rad M.; de Beer S.A.; Stevens M.F.; Poley M.J.; van Rosmalen J.;
Jeekel J.F.; Wijnen R.M.H.
Institution
(Billar, Schnater, Vlot, Poley, Wijnen) Pediatric Surgery, Erasmus MC
Sophia Children's Hospital, Rotterdam, Netherlands
(Kuhlmann) Anaesthesiology, Saint Antonius Hospital, Nieuwegein, Utrecht,
Netherlands
(Tomas) Anaesthesiology, Erasmus MC Sophia Children's Hospital, Rotterdam,
Netherlands
(Zijp) Paediatric Surgery, Haga Hospital Juliana Children's Hospital, Den
Haag, Netherlands
(Rad) Anaesthesiology, Haga Hospital Juliana Children's Hospital, Den
Haag, Netherlands
(de Beer) Paediatric Surgery, Emma Children's Hospital AMC, Amsterdam,
North Holland, Netherlands
(Stevens) Anaesthesiology, Emma Children's Hospital AMC, Amsterdam, North
Holland, Netherlands
(Poley) Institute for Medical Technology Assessment, Erasmus University
Rotterdam, Rotterdam, Netherlands
(van Rosmalen) Biostatistics, Erasmus MC, Rotterdam, Netherlands
(Jeekel) Neuroscience, Erasmus MC, Rotterdam, Netherlands
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Pectus excavatum repair is associated with substantial
postoperative pain, despite the use of epidural analgesia and other
analgesic regimens. Perioperative recorded music interventions have been
shown to alleviate pain and anxiety in adults, but evidence for children
and adolescents is still lacking. This study protocol describes a
randomised controlled trial that evaluates the effects of recorded music
interventions on postoperative pain relief in children and adolescents
after pectus excavatum repair. <br/>METHOD(S): A multicentre randomised
controlled trial was set up comparing the effects of perioperative
recorded music interventions in addition to standard care with those of
standard care only in patients undergoing a Nuss procedure for pectus
excavatum repair. One hundred and seventy subjects (12-18 years of age)
will be included in three centres in the Netherlands. Patient inclusion
has started in November 2018, and is ongoing. The primary outcome is
self-reported perceived pain measured on the visual analogue scale.
Secondary outcomes are anxiety level, analgesics consumption, vital
parameters such as heart rate, blood pressure and respiratory rate, length
of hospital stay, postoperative complications, quality of life and
cost-effectiveness. ETHICS AND DISSEMINATION: This study is being
conducted in accordance with the Declaration of Helsinki. The Medical
Ethics Review Board of Erasmus University Medical Centre Rotterdam, The
Netherlands, has approved this protocol. Results will be disseminated via
peer-reviewed scientific journals and conference
presentations.NL6863.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

<45>
Accession Number
632310494
Title
The effect of milrinone on mortality in adult patients who underwent CABG
surgery: a systematic review of randomized clinical trials with a
meta-analysis and trial sequential analysis.
Source
BMC cardiovascular disorders. 20 (1) (pp 328), 2020. Date of Publication:
08 Jul 2020.
Author
Ren Y.-S.; Li L.-F.; Peng T.; Tan Y.-J.; Sun Y.; Cheng G.-L.; Zhang G.-M.;
Li J.
Institution
(Ren, Li, Peng, Tan, Sun, Cheng, Zhang, Li) Shandong New Time
Pharmaceutical Co, Ltd., Linyi, China
(Ren, Tan, Zhang, Li) National Engineering and Technology Research Center
of Chirality Pharmaceutica, Lunan Pharmaceutical Group Co, Ltd., Linyi,
China
(Ren, Li, Peng, Tan, Sun, Cheng, Zhang, Li) State Key Laboratory of
Generic Manufacture Technology of Chinese Traditional Medicine, Lunan
Pharmaceutical Group Co, Ltd., Linyi, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: As an inodilator, milrinone is commonly used for patients who
undergo coronary artery bypass graft (CABG) surgery because of its
effectiveness in decreasing the cardiac index and mitral regurgitation.
The aim of this study was to perform a systematic review and meta-analysis
of existing studies from the past 20years to evaluate the impact of
milrinone on mortality in patients who undergo CABG surgery.
<br/>METHOD(S): We performed a systematic literature search on the
application of milrinone in patients who underwent CABG surgery in studies
published between 1997 and 2017 in BioMed Central, PubMed, EMBASE, and the
Cochrane Central Register. The included studies evaluated milrinone groups
compared to groups receiving either placebo or standard treatment and
further compared the systemic administration. <br/>RESULT(S): The network
meta-analysis included 723 patients from 16 randomized clinical trials.
Overall, there was no significant difference in mortality between the
milrinone group and the placebo/standard care group when patients
underwent CABG surgery. In addition, 9 trials (with 440 randomized
patients), 4 trials (with 212 randomized patients), and 10 trials (with
470 randomized patients) reported that the occurrence of myocardial
infarction (MI), myocardial ischemia, and arrhythmia was lower in the
milrinone group than in the placebo/standard care group. Between the
milrinone treatment and placebo/standard care groups, the occurrence of
myocardial infarction, myocardial ischemia, and arrhythmia was
significantly different. However, the occurrence of stroke and renal
failure, the duration of inotropic support (h), the need for an
intra-aortic balloon pump (IABP), and mechanical ventilation (h) between
these two groups showed no differences. <br/>CONCLUSION(S): Based on the
current results, compared with placebo, milrinone might be unable to
decrease mortality in adult CABG surgical patients but can significantly
ameliorate the occurrence of MI, myocardial ischemia, and arrhythmia.
These results provide evidence for the further clinical application of
milrinone and of therapeutic strategies for CABG surgery. However, along
with milrinone application in clinical use, sufficient data from
randomized clinical trials need to be collected, and the potential
benefits and adverse effects should be analyzed and reevaluated.

<46>
Accession Number
632309664
Title
A Controlled Trial of Rivaroxaban after Transcatheter Aortic-Valve
Replacement.
Source
The New England journal of medicine. 383 (2) (pp e8), 2020. Date of
Publication: 09 Jul 2020.
Author
Yahagi K.; Sato Y.; Virmani R.
Institution
(Yahagi) Mitsui Memorial Hospital, Tokyo, Japan
(Sato) CVPath Institute, MD, Gaithersburg, United States
(Virmani) CVPath Institute, MD, Gaithersburg, United States
Publisher
NLM (Medline)

<47>
Accession Number
632309561
Title
A Controlled Trial of Rivaroxaban after Transcatheter Aortic-Valve
Replacement.
Source
The New England journal of medicine. 383 (2) (pp e8), 2020. Date of
Publication: 09 Jul 2020.
Author
Alghamry A.; Murdoch D.J.
Institution
(Alghamry) Prince Charles Hospital, Brisbane, Australia
(Murdoch) Prince Charles Hospital, Brisbane, Australia
Publisher
NLM (Medline)

<48>
Accession Number
632309558
Title
A Controlled Trial of Rivaroxaban after Transcatheter Aortic-Valve
Replacement. Reply.
Source
The New England journal of medicine. 383 (2) (pp e8), 2020. Date of
Publication: 09 Jul 2020.
Author
Dangas G.D.; De Backer O.; Windecker S.
Institution
(Dangas) Mount Sinai Hospital, NY, NY
(De Backer) Rigshospitalet, Copenhagen, Denmark
(Windecker) Inselspital Bern University Hospital, Bern, Switzerland
Publisher
NLM (Medline)

<49>
Accession Number
632309503
Title
A Controlled Trial of Rivaroxaban after Transcatheter Aortic-Valve
Replacement.
Source
The New England journal of medicine. 383 (2) (pp e8), 2020. Date of
Publication: 09 Jul 2020.
Author
Martin A.-C.; Smadja D.M.; Karam N.
Institution
(Martin) European Hospital Georges Pompidou, Paris, France
(Smadja) INSERM UMR-S 1140, Paris, France
(Karam) University of Paris, Paris, France
Publisher
NLM (Medline)

<50>
Accession Number
632309287
Title
A Controlled Trial of Rivaroxaban after Transcatheter Aortic-Valve
Replacement.
Source
The New England journal of medicine. 383 (2) (pp e8), 2020. Date of
Publication: 09 Jul 2020.
Author
Stojkovic S.; Sulzgruber P.; Niessner A.
Institution
(Stojkovic) Medical University of Vienna, Vienna, Austria
(Sulzgruber, Niessner) Medical University of Vienna, Vienna, Austria
Publisher
NLM (Medline)

<51>
Accession Number
2005518676
Title
Homozygous Familial Hypercholesterolemia: Anesthetic Challenges and Review
of Literature.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11 (4) (pp
NP83-NP87), 2020. Date of Publication: 01 Jul 2020.
Author
Ladha S.; Makhija N.; Kiran U.; Aarav S.K.
Institution
(Ladha, Makhija, Kiran) Department of Cardiac Anesthesia, Cardiothoracic
Centre, All India Institute of Medical Sciences, New Delhi, India
(Aarav) Department of Pathology, All India Institute of Medical Sciences,
New Delhi, India
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Homozygous familial hypercholesterolemia (HoFH; Fredrickson IIa) is a rare
autosomal dominant hereditary disease associated with increased
low-density lipoprotein cholesterol. We hereby report anesthetic
challenges in a rare case of HoFH having severe progressive aortic
stenosis, mitral regurgitation, diffuse aortic and carotid vessel
involvement, and severe left ventricular dysfunction. The patient
underwent a Konno aortoventriculoplasty with mechanical prosthesis along
with mitral valve repair.<br/>Copyright &#xa9; The Author(s) 2017.

<52>
Accession Number
2007039676
Title
China Tongxinluo Study for myocardial protection in patients with Acute
Myocardial Infarction (CTS-AMI): Rationale and design of a randomized,
double-blind, placebo-controlled, multicenter clinical trial.
Source
American Heart Journal. 227 (pp 47-55), 2020. Date of Publication:
September 2020.
Author
Xu Y.; Li X.; Zhang H.; Wu Y.; Zhang J.; Li J.; Dou K.; Yan H.; You S.;
Liang Y.; Xu L.; Gao X.; Liu C.; Dong Q.; Zhang W.; Song G.; Zhang T.;
Jiang L.; Chen G.; Tang R.; Jin C.; Yang J.; Yao C.; Xian Y.; Peterson
E.D.; Gao R.; Yang Y.
Institution
(Xu, Li, Zhang, Wu, Zhang, Li, Dou, Yan, You, Yang, Liang, Xu, Gao, Liu,
Dong, Zhang, Song, Zhang, Jiang, Chen, Tang, Jin, Yang, Gao, Yang) Fuwai
Hospital, National Center of Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
(Yao) Peking University Clinical Research Institute, Peking University,
Beijing, China
(Xian, Peterson) Duke Clinical Research Institute, Duke University Medical
Center, Durham, NC, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Acute ST-segment elevation myocardial infarction (STEMI) remains a serious
life-threatening event. Despite coronary revascularization, patients might
still suffer from poor outcomes caused by myocardial no-reflow and
ischemic/reperfusion injury. Tongxinluo (TXL), a traditional Chinese
medicine, has been preliminarily demonstrated to reduce myocardial
no-reflow and ischemic/reperfusion injury. We further hypothesize that TXL
treatment is also effective in reducing clinical end points for the
patients with STEMI. <br/>Methods and Results: The CTS-AMI trial is a
prospective, randomized, double-blind, placebo-controlled, multicenter
clinical study in China. An estimated 3,796 eligible patients with STEMI
from about 120 centers are randomized 1:1 ratio to TXL or placebo groups.
All enrolled patients are orally administrated a loading dose of 8
capsules of TXL or placebo together with dual antiplatelet agents on
admission followed by 4 capsules 3 times a day until 12 months. The
primary end point is 30-day major adverse cardiovascular and
cerebrovascular events, a composite of cardiac death, myocardial
reinfarction, emergency coronary revascularization, and stroke. Secondary
end points include each component of the primary end point, 1-year major
adverse cardiovascular and cerebrovascular events, and other efficacy and
safety parameters. <br/>Conclusion(s): Results of CTS-AMI trial will
determine the clinical efficacy and safety of traditional Chinese medicine
TXL capsule in the treatment of STEMI patients in the reperfusion
era.<br/>Copyright &#xa9; 2020 The Authors

<53>
Accession Number
2007038473
Title
Individualized PEEP ventilation between tumor resection and dural suture
in craniotomy.
Source
Clinical Neurology and Neurosurgery. 196 (no pagination), 2020. Article
Number: 106027. Date of Publication: September 2020.
Author
Liu H.; Wu X.; Li J.; Liu Y.; Huang Y.; Zhang M.; Zhu J.; Chen P.; Xie H.;
Dong J.
Institution
(Liu, Wu, Li, Liu, Huang, Zhu, Chen, Xie) Department of Anesthesiology,
The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road,
Suzhou 215004, China
(Zhang) Department of Infection Control, The Second Affiliated Hospital of
Soochow University, 1055 Sanxiang Road, Suzhou 215004, China
(Dong) Department of Neurosurgery, The Second Affiliated Hospital of
Soochow University, 1055 Sanxiang Road, Suzhou 215004, China
Publisher
Elsevier B.V.
Abstract
Objective: Atelectasis, which affects oxygenation, is always occurred
after craniotomy under general anesthesia. The commonly used protective
ventilation strategy, which includes recruitment maneuver and higher level
of positive end-expiratory pressure (PEEP), can effectively reduce
atelectasis after heart and abdominal surgery, but increase intracranial
pressure and reduce cerebral perfusion in patients undergoing craniotomy.
We hypothesized individualized PEEP ventilation between tumor resection
and dural suture in craniotomy could effectively reduce postoperative
atelectasis, improve PaO<inf>2</inf>/FiO<inf>2</inf> ratio, and without
reducing the regional cerebral oxygen saturation (rScO<inf>2</inf>).
<br/>Patients and Methods: 96 patients underwent tumor craniotomy in
supine position were randomized into the control group (C group) and
individualized PEEP group (P group). In the C group, the tidal volume (VT)
was set at 8 mL/kg of predicted body weight, but PEEP were not used. In
the P group, VT was set at 6 mL/kg of predicted body weight combined with
individualized PEEP between tumor resection and dural suture, while in
other periods of general anesthesia, VT was set at 8 mL/kg of predicted
body weight. PaO<inf>2</inf>/FiO<inf>2</inf> ratio, lung ultrasound score
(LUS) and rScO<inf>2</inf> were measured before induction, 1 h and 24 h
after extubation. <br/>Result(s): Individual PEEP in the P group was 7.0
(4.0-9.0). The PaO<inf>2</inf>/FiO<inf>2</inf> ratio and rScO<inf>2</inf>
in the P group were significantly higher than that of the C group (395 +/-
62 vs. 344 +/- 40, 67 +/- 5 vs. 61 +/- 4, respectively, p < 0.05) and the
LUS of the experimental group was significantly lower than that of the C
group [7.5 (5.3-8.3) vs. 10.0 (9.0-12.0), p < 0.05] 1 h after extubation.
<br/>Conclusion(s): Mechanical ventilation with individualized PEEP
between tumor resection and dural suture in craniotomy can reduce
atelectasis, improve PaO<inf>2</inf>/FiO<inf>2</inf> ratio and
rScO<inf>2</inf> 1 h after extubation.<br/>Copyright &#xa9; 2020 Elsevier
B.V.

<54>
Accession Number
2007031160
Title
Efficacy of Ultrasound-Guided Transversus Thoracic Muscle Plane Block on
Postoperative Opioid Consumption After Cardiac Surgery: A Prospective,
Randomized, Double-Blind Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Aydin M.E.; Ahiskalioglu A.; Ates I.; Tor I.H.; Borulu F.; Erguney O.D.;
Celik M.; Dogan N.
Institution
(Aydin, Ahiskalioglu, Ates, Erguney, Celik, Dogan) Department of
Anesthesiology and Reanimation, Ataturk University School of Medicine,
Erzurum, Turkey
(Aydin, Ahiskalioglu, Celik) Clinical Research, Development and Design
Application and Research Center, Ataturk University School of Medicine,
Erzurum, Turkey
(Tor) Department of Anesthesiology and Reanimation, University of Health
Sciences School of Medicine, Erzurum, Turkey
(Borulu) Department of Cardiovascular Surgery, Ataturk University School
of Medicine, Erzurum, Turkey
Publisher
W.B. Saunders
Abstract
Objectives: The postoperative analgesic efficacy of transversus thoracic
muscle plane block (TTMPB) has not yet been evaluated sufficiently. This
randomized controlled study evaluated the effect of TTMPB on postoperative
opioid consumption in patients undergoing cardiac surgery. <br/>Design(s):
Prospective, randomized, double-blind study. <br/>Setting(s): Single
institution, academic university hospital. <br/>Participant(s):
Forty-eight adult patients having cardiac surgery with median sternotomy.
<br/>Intervention(s): Patients were randomly assigned to receive
preoperative ultrasound-guided TTMPB with either 20 mL of 0.25%
bupivacaine or saline bilaterally. Postoperative analgesia was
administered intravenously in the 2 groups 4 times a day with 1000 mg of
paracetamol and patient-controlled analgesia with fentanyl.
<br/>Measurements and Main Results: The primary outcome was opioid
consumption in the first 24 hours. Secondary outcomes included
postoperative pain scores, first analgesic requirement time, rescue
analgesia, intensive care discharge time, and side effects. Compared with
the control group (median 465 micro&#32;g, interquartile range 415-585),
the transversus thoracic muscle plane (TTMP) group (median 255
micro&#32;g, interquartile range 235-305) had reduced postoperative
24-hour opioid consumption (p < 0.001). Pain scores were significantly
lower in the TTMP group compared with the control group up to 12 hours
after surgery both at rest and active movement (p < 0.001). Compared with
the TTMP group, the proportion of postoperative nausea and pruritus was
statistically higher in the control group (p < 0.001). <br/>Conclusion(s):
A single preoperative TTMPB provided effective analgesia and decreased
opioid requirements in patients undergoing cardiac surgery.<br/>Copyright
&#xa9; 2020 Elsevier Inc.

<55>
Accession Number
2007030669
Title
Comparing erector spinae plane block with serratus anterior plane block
for minimally invasive thoracic surgery: a randomised clinical trial.
Source
British Journal of Anaesthesia. (no pagination), 2020. Date of
Publication: 2020.
Author
Finnerty D.T.; McMahon A.; McNamara J.R.; Hartigan S.D.; Griffin M.; Buggy
D.J.
Institution
(Finnerty, McMahon, McNamara, Hartigan, Griffin, Buggy) Division of
Anaesthesiology, Mater Misericordiae University Hospital, Dublin, Ireland
(Finnerty, Buggy) School of Medicine, University College Dublin, Dublin,
Ireland
(Finnerty, Buggy) EU COST Action 15204 Euro-Periscope, Brussels, Belgium
(Buggy) Outcomes Research, Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Ltd
Abstract
Background: Minimally invasive thoracic surgery causes significant
postoperative pain. Erector spinae plane (ESP) block and serratus anterior
plane (SAP) block promise effective thoracic analgesia compared with
systemically administered opioids, but have never been compared in terms
of terms of quality of recovery and overall morbidity after minimally
invasive thoracic surgery. <br/>Method(s): Sixty adult patients undergoing
minimally invasive thoracic surgery were randomly assigned to receive
either single-shot ESP or SAP block before surgery using levobupivacaine
0.25%, 30 ml. The primary outcome was quality of patient recovery at 24 h,
using the Quality of Recovery-15 (QoR-15) scale. Secondary outcomes
included area under the curve (AUC) of pain verbal rating scale (VRS) over
time, time to first opioid analgesia, postoperative 24 h opioid
consumption, in-hospital comprehensive complication index (CCI) score and
hospital stay. <br/>Result(s): The QoR-15 score was higher among ESP
patients compared with those in the SAP group, mean (standard deviation):
114 (16) vs 102 (22) (P=0.02). Time (min) to first i.v. opioid analgesia
in recovery was 32.6 (20.6) in ESP vs 12.7 (9.5) in SAP (P=0.003). AUC at
rest was 92 (31) mm h^-1 vs 112 (35) in ESP and SAP (P=0.03),
respectively, whereas AUC on deep inspiration was 107 mm h^-1
(32) vs 129 (32) in ESP and SAP (P=0.01), respectively. VRS pain on
movement in ESP and SAP at 24 h was, median (25-75% range): 4 (2-4) vs 5
(3-6) (P=0.04), respectively. Opioid consumption at 24 h postoperatively
was 29 (31) vs 39 (34) (P=0.37). Median (25-75%) CCI in ESP and SAP was 1
(0-2) vs 4 (0-26) (P=0.03), whereas hospital stay was 3 (2-6) vs 6 (3-9)
days (P=0.17), respectively. <br/>Conclusion(s): Compared with SAP, ESP
provides superior quality of recovery at 24 h, lower morbidity, and better
analgesia after minimally invasive thoracic surgery. Clinical trial
registration: NCT 03862612.<br/>Copyright &#xa9; 2020 British Journal of
Anaesthesia

<56>
Accession Number
2005546378
Title
Development of a new risk model for a prognostic prediction after
transcatheter aortic valve replacement.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2020. Date
of Publication: 2020.
Author
Maeda K.; Kuratani T.; Pak K.; Shimamura K.; Mizote I.; Miyagawa S.; Toda
K.; Sakata Y.; Sawa Y.
Institution
(Maeda, Kuratani, Shimamura, Miyagawa, Toda, Sawa) Department of
Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2
Yamada-oka, Suita, Osaka 565-0871, Japan
(Pak, Sakata) Division of Biostatistics, Center for Clinical Research,
National Center for Child Health and Development, Setagaya, Japan
(Mizote) Department of Cardiology, Osaka University Graduate School of
Medicine, Suita, Japan
Publisher
Springer
Abstract
Background: Current guidelines for transcatheter aortic valve replacement
(TAVR) recommend that TAVR should be performed in patients with a life
expectancy > 1 year. However, it is challenging to estimate the patients'
life expectancy because it is related to various factors, including
frailty and nutritional status. Hypothesis: A new risk model can estimate
the prognosis of patients after TAVR. <br/>Method(s): We randomly divided
388 patients with aortic stenosis (AS) undergoing TAVR from October 2009
to August 2016 into two groups (2:1 ratio; training cohort, 259;
validation cohort, 129). Using 94 baseline factors in the training cohort,
we developed possible scoring models by the Cox proportional hazard
regression model with the overall survival as the endpoint. Then,
cross-validated 5-year C-statistics were calculated to assess the accuracy
of the model. <br/>Result(s): Of 94 baseline factors, 12 factors were
finally identified (5-year C-statistics in the training cohort:
0.709)-age, gender, body mass index, left ventricular ejection fraction, %
vital capacity, forced expiratory volume 1.0 (s) %, albumin, hemoglobin,
creatine, platelet, creatine kinase, and prothrombin time-international
normalized ratio. The cross-validated 1-, 3-, and 5-year C-statistics in
the validation cohort were 0.792, 0.758, and 0.778, respectively.
Furthermore, calibration plots in the validation cohort revealed that
5-year survival is well predicted (r = 0.962). <br/>Conclusion(s): The new
survival prediction model after TAVR could provide appropriate guidance
during decision making regarding the TAVR implementation.<br/>Copyright
&#xa9; 2020, The Japanese Association for Thoracic Surgery.

<57>
Accession Number
632312429
Title
Increased incidence of serious late adverse events with drug-eluting
stents when compared with coronary artery bypass surgery: a cause of
concern.
Source
Future cardiology. (no pagination), 2020. Date of Publication: 09 Jul
2020.
Author
Mieres J.; Alfredo E Rodriguez; Fernandez-Pereira C.; Ascarrunz-Cattoretti
D.
Institution
(Mieres, Alfredo E Rodriguez, Fernandez-Pereira, Ascarrunz-Cattoretti)
Cardiac Unit Otamendi Hospital Cardiovascular Research Center (CECI)
Azcuenaga 870, Buenos Aires, Argentina
Publisher
NLM (Medline)
Abstract
Percutaneous coronary intervention (PCI) and coronary artery bypass graft
(CABG) in pre-drug-eluting stents (DESs) era, randomized trials and
meta-analysis showed that the extension of coronary artery disease was not
associated with a better survival with CABG, and only diabetic patients
had an inferior survival with PCI. After the introduction of DES, we would
expect a substantial improvement in PCI results compared with CABG,
narrowing the gap between both revascularization strategies, However, on
the contrary, most randomized studies between DES and CABG showed that
rate of recurrences remained and there is an unexpected increased of late
serious adverse events including spontaneous myocardial infarction and
death. In this review, we try to described each of these problems and find
out explanations for these new findings searching for potential solutions.

<58>
Accession Number
632311479
Title
Non-invasive cardiovascular imaging for myocardial necrosis, viability,
stunning and hibernation: evidence from an umbrella review encompassing 12
systematic reviews, 286 studies, and 201,680 patients.
Source
Minerva cardioangiologica. (no pagination), 2020. Date of Publication: 08
Jul 2020.
Author
Nudi F.; Iskandrian A.E.; Schillaci O.; Nudi A.; Di Belardino N.; Frati
G.; Biondi-Zoccai G.
Institution
(Nudi, Nudi) Service of Hybrid Cardio Imaging, Madonna della Fiducia
Clinic, Rome, Italy
(Nudi) RomeItaly
(Iskandrian) Division of Cardiovascular Diseases, Department of Medicine,
University of Alabama at Birmingham, Birmingham, AL, USA
(Schillaci) Department of Biomedicine and Prevention, Tor Vergata
University, Rome, Italy
(Di Belardino) Unita Operativa Complessa di Cardiologia, Ospedali Riuniti
di Anzio-Nettuno, Anzio, Rome, Italy
(Frati) Department of Medico-Surgical Sciences and Biotechnologies,
Sapienza University of Rome, Latina, Italy
(Frati) IRCCS Neuromed, Pozzilli, Naples, Italy
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) NaplesItaly
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The concomitant presence of myocardial necrosis with
myocardial ischemia, stunning and hibernation may complicate appraisal of
left ventricular (LV) function and patient management. Several imaging
modalities have been proposed for the accurate assessment of myocardial
necrosis, viability, stunning and hibernation, with mixed results. We
aimed to review the evidence base on myocardial necrosis, stunning and
hibernation by conducting an umbrella review (i.e. overview of systematic
reviews). EVIDENCE ACQUISITION: We searched PubMed and The Cochrane
Library for meta-analyses focusing on the diagnostic, prognostic, or
management appraisal of myocardial necrosis, viability, stunning and
hibernation. Diagnostic test accuracy, prognostic yield, and clinical
outcomes were systematically abstracted from shortlisted reviews. EVIDENCE
SYNTHESIS: From an initial set of 6069 citations, 12 systematic reviews
were finally included, encompassing 286 studies and 201,680 patients.
Cardiac magnetic resonance imaging (CMR) had favorable results in 4
reviews that focused on the diagnosis of myocardial stunning or
hibernation in patients followed-up for 6+/-4 months after coronary
revascularization (sensitivity 96% and specificity 91%). Positron emission
tomography (PET), single photon emission tomography (SPECT) and CMR in 6
meta-analyses had each a significant and independent prognostic role for
the prediction of fatal and non-fatal cardiovascular events in patients
with follow-up of 2.8+/-1.7 years. Finally, 2 reviews with 2.3+/-1.1 years
of follow-up showed moderate quality evidence in favor of coronary
revascularization in patients with objective signs of myocardial
viability. <br/>CONCLUSION(S): The appraisal of myocardial necrosis and
residual viability remains a cornerstone of the modern management of
patients with CAD. Current imaging modalities, (echocardiography, PET,
SPECT and CMR) are widely used. Further trials using contemporary methods
are warranted to further clarify the impact of viability assessment on
patient management, and the cumulative risk of morbidity and mortality.

<59>
Accession Number
632310979
Title
Intravenous iron therapy for patients with preoperative iron deficiency or
anaemia undergoing cardiac surgery reduces blood transfusions: a
systematic review and meta-analysis.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2020.
Date of Publication: 09 Jul 2020.
Author
Gupta S.; Panchal P.; Gilotra K.; Wilfred A.M.; Hou W.; Siegal D.;
Whitlock R.P.; Belley-Cote E.P.
Institution
(Gupta, Whitlock) Department of Surgery, McMaster University, ON,
Hamilton, Canada
(Gupta, Whitlock) Department of Health Research Methods, McMaster
University, ON, Hamilton, Canada
(Panchal, Gilotra, Wilfred, Hou) Faculty of Health Sciences, McMaster
University, ON, Hamilton, Canada
(Siegal, Belley-Cote) Department of Medicine, McMaster University, ON,
Hamilton, Canada
(Siegal, Whitlock, Belley-Cote) Population Health Research Institute, ON,
Hamilton, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The benefits of preoperative intravenous (IV) iron treatment
in cardiac surgery patients with preoperative anaemia or iron deficiency
have not been well-established. We performed a systematic review and
meta-analysis to determine the effects of treating preoperative anaemia or
iron deficiency with IV iron in adult cardiac surgery patients.
<br/>METHOD(S): We searched Cochrane Central Register of Controlled
Trials, Medical Literature Analysis and Retrieval Systems Online and
Excerpta Medica Database for randomized controlled trials (RCTs) and
observational studies comparing IV iron to oral iron or no iron. We
performed title and abstract, full-text screening, data extraction and
risk of bias assessment independently and in duplicate. We pooled data
using a random effects model and evaluated the overall quality of
evidence. <br/>RESULT(S): We identified 4 RCTs and 7 observational
studies. Pooled data from observational studies suggested a benefit of IV
iron compared to no iron on mortality [relative risk 0.39, 95% confidence
interval (CI) 0.23-0.65; P<0.001, very low quality], units transfused per
patient (mean difference -1.22, 95% CI -1.85 to -0.60; P<0.001, very low
quality), renal injury (relative risk 0.50, 95% CI 0.36-0.69; P<0.001,
very low quality) and hospital length of stay (mean difference -4.24days,
95% CI -6.86 to -1.63; P=0.001, very low quality). Pooled data from RCTs
demonstrated a reduction in the number of patients transfused with IV iron
compared to oral or no iron (relative risk 0.81, 95% CI 0.70-0.94;
P=0.005, moderate quality). The pooled estimates of effect from RCTs for
mortality, hospital length of stay, units transfused per patient and renal
injury were consistent in direction with observational studies.
<br/>CONCLUSION(S): This meta-analysis suggests that IV iron improves
postoperative morbidity in adult cardiac surgery patients with
preoperative anaemia or iron deficiency. A large, rigorous,
placebo-controlled, double-blinded, multicentre trial is needed to clarify
the role of IV iron in this patient population. CLINICAL TRIAL
REGISTRATION: International prospective register of systematic reviews ID
Number CRD42019122844.<br/>Copyright &#xa9; The Author(s) 2020. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<60>
Accession Number
632304998
Title
Lipoprotein-associated phospholipase A2 activity, genetics and calcific
aortic valve stenosis in humans.
Source
Heart. (no pagination), 2020. Date of Publication: 2020.
Author
Perrot N.; Theriault S.; Rigade S.; Chen H.Y.; Dina C.; Martinsson A.;
Boekholdt S.M.; Capoulade R.; Le Tourneau T.; Messika-Zeitoun D.; Engert
J.C.; Wareham N.J.; Clavel M.-A.; Pibarot P.; Smith J.G.; Schott J.J.;
Mathieu P.; Bosse Y.; Thanassoulis G.; Arsenault B.J.
Institution
(Perrot, Theriault, Clavel, Pibarot, Mathieu, Bosse, Arsenault) Centre de
Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec city, QC, Canada
(Perrot, Clavel, Pibarot, Arsenault) Department of Medicine, Faculty of
Medicine, Universite Laval, Quebec City, QC G1V 4G5, Canada
(Theriault) Department of Molecular Biology, Medical Biochemistry and
Pathology, Faculty of Medicine, Universite Laval, Quebec City, QC, Canada
(Rigade, Dina, Capoulade, Schott) Institut du Thorax, INSERM, CNRS, UNIV
Nantes, CHU Nantes, Nantes, France
(Chen, Engert, Thanassoulis) McGill University Health Center Research
Institute, Montreal, QC, Canada
(Martinsson, Smith) Department of Cardiology, Clinical Sciences, Lund
University, Lund, Sweden
(Martinsson) Department of Cardiology, Sahlgrenska Universitetssjukhuset,
Goteborg, Sweden
(Boekholdt) Department of Cardiology, Amsterdam UMC, University of
Amsterdam, Amsterdam, Netherlands
(Le Tourneau) Ultrasound and Cardiology Departments, University Hospital,
Institut du Thorax, Nantes, France
(Messika-Zeitoun) University of Ottawa Heart Institute, APHP, Bichat
Hospital, Ottawa, ON, Canada
(Wareham) Department of Public Health and Primary Care, University of
Cambridge, Cambridge, United Kingdom
(Smith) Wallenberg Center for Molecular Medicine, Lund University Diabetes
Center, Lund University, Lund, Sweden
(Mathieu) Department of Surgery, Faculty of Medicine, Universite Laval,
Quebec City, QC, Canada
(Bosse) Department of Molecular Medicine, Faculty of Medicine, Universite
Laval, Quebec City, QC, Canada
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity has
been shown to predict calcific aortic valve stenosis (CAVS) outcomes. Our
objective was to test the association between plasma Lp-PLA2 activity and
genetically elevated Lp-PLA2 mass/activity with CAVS in humans.
<br/>Methods and Results: Lp-PLA2 activity was measured in 890 patients
undergoing cardiac surgery, including 476 patients undergoing aortic valve
replacement for CAVS and 414 control patients undergoing coronary artery
bypass grafting. After multivariable adjustment, Lp-PLA2 activity was
positively associated with the presence of CAVS (OR=1.21 (95% CI 1.04 to
1.41) per SD increment). We selected four single nucleotide polymorphisms
(SNPs) at the PLA2G7 locus associated with either Lp-PLA2 mass or activity
(rs7756935, rs1421368, rs1805017 and rs4498351). Genetic association
studies were performed in eight cohorts: Quebec-CAVS (1009 cases/1017
controls), UK Biobank (1350 cases/349 043 controls), European Prospective
Investigation into Cancer and Nutrition-Norfolk (504 cases/20 307
controls), Genetic Epidemiology Research on Aging (3469 cases/51 723
controls), Malmo Diet and Cancer Study (682 cases/5963 controls) and three
French cohorts (3123 cases/6532 controls), totalling 10 137 CAVS cases and
434 585 controls. A fixed-effect meta-analysis using the inverse-variance
weighted method revealed that none of the four SNPs was associated with
CAVS (OR=0.99 (95% CI 0.96 to 1.02, p=0.55) for rs7756935, 0.97 (95% CI
0.93 to 1.01, p=0.11) for rs1421368, 1.00 (95% CI 1.00 to 1.01, p=0.29)
for rs1805017, and 1.00 (95% CI 0.97 to 1.04, p=0.87) for rs4498351).
<br/>Conclusion(s): Higher Lp-PLA2 activity is significantly associated
with the presence of CAVS and might represent a biomarker of CAVS in
patients with heart disease. Results of our genetic association study
suggest that Lp-PLA2 is however unlikely to represent a causal risk factor
or therapeutic target for CAVS. <br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2020. No commercial re-use. See rights and permissions.
Published by BMJ.

<61>
Accession Number
2004859189
Title
Angiographic Restenosis in Coronary Bifurcations Treatment with Regular
Drug Eluting Stents and Dedicated Bifurcation Drug-Eluting BiOSS Stents:
Analysis Based on Randomized POLBOS i and POLBOS II Studies.
Source
Cardiovascular Therapeutics. 2020 (no pagination), 2020. Article Number:
6760205. Date of Publication: 2020.
Author
Gil R.J.; Bil J.; Kern A.; Inigo-Garcia L.A.; Formuszewicz R.; Dobrzycki
S.; Vassilev D.; Mehran R.
Institution
(Gil, Bil) Department of Invasive Cardiology, Centre of Postgraduate
Medical Education, Central Clinical Hospital, Ministry of Interior and
Administration, Warsaw, Poland
(Kern) Department of Cardiology and Cardiosurgery, University of Varmia
and Masuria, Olsztyn, Poland
(Inigo-Garcia) Costa Del Sol Hospital, Marbella, Spain
(Formuszewicz) 10th Clinical Military Hospital, Bydgoszcz, Poland
(Dobrzycki) Department of Invasive Cardiology, Medical University in
Bialystok, Bialystok, Poland
(Vassilev) Alexandrovska University Hospital, Sofia, Bulgaria
(Mehran) Cardiovascular Institute, Mount Sinai Medical Center, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Hindawi Limited (410 Park Avenue, 15th Floor, 287 pmb, New York NY 10022,
United States)
Abstract
Aim. The marked variation in bifurcation anatomy has brought about an
ongoing search for stents specifically constructed for coronary
bifurcations. This study aimed to analyze the angiographic restenosis
prevalence and patterns and predictors of different patterns in dedicated
bifurcation BiOSS vs. current generation drug-eluting stents implanted in
coronary bifurcation lesions based on data from two clinical trials POLBOS
I and II. Methods. Dedicated bifurcation BiOSS stents were compared with
drug-eluting stents (DES) in patients with stable coronary artery disease
(CAD) or nonST elevation acute coronary syndrome (NSTE-ACS) (POLBOS I:
paclitaxel eluting BiOSS Expert vs. DES; POLBOS II: sirolimus eluting
BiOSS LIM vs. DES). Provisional T-stenting was the default treatment.
Morphological pattern of in-stent restenosis according to the modified
Mehran classification adopted for bifurcation lesions was assessed with
bifurcation dedicated quantitative coronary angiographic software (CAAS
5.11, Pie Medical Imaging BV, the Netherlands). Results. In total, 445
patients (222 patients in BiOSS group and 223 patients in DES group) were
included into the analysis. In BiOSS group 24 cases of angiographic
restenosis (10.8%) were recorded, and in DES group - 17 cases (7.6%) at 12
months follow-up (angiographic control rate at follow-up - 90.3%). In the
BiOSS group most frequent medina classification in restenotic cases was
0.0.1 (25%), whereas in DES - 0.0.1 and 0.1.1 (23.5% each). In
multivariate regression analysis proximal optimization technique was
associated with the lowest chance for restenosis (OR 0.15, 95% CI
0.06-0.33), whereas diabetes on insulin was associated with the highest
risk of restenosis (OR 4.21, 95% CI 1.48-11.44). Conclusions. The
angiographic restenosis pattern and rate was similar between BiOSS stents
and DES in coronary bifurcation lesions.<br/>Copyright &#xa9; 2020 Robert
J. Gil et al.

<62>
Accession Number
2004483066
Title
Effects of adding dexmedetomidine to local infiltration of bupivacaine on
postoperative pain in pediatric herniorrhaphy: A randomized clinical
trial.
Source
Korean Journal of Anesthesiology. 73 (3) (pp 212-218), 2020. Date of
Publication: June 2020.
Author
Azemati S.; Pourali A.; Aghazadeh S.
Institution
(Azemati, Pourali, Aghazadeh) Department of Anesthesiology and Intensive
Care Unit, Medical College, Shiraz University of Medical Sciences, Shiraz,
Iran, Islamic Republic of
Publisher
Korean Society of Anesthesiologists
Abstract
Background: Postoperative pain is a major problem, especially in children,
as their toler-ance level is lower and several drugs are contraindicated
in childhood. This study aimed to compare the effect of dexmedetomidine
added to local infiltration of bupivacaine for postoperative pain relief
in children undergoing inguinal herniorrhaphy. <br/>Method(s): This
double-blind, randomized clinical trial included 60 children aged 6-72
months undergoing unilateral herniorrhaphy at selected hospitals in
Shiraz, Iran, ran-domly allocated into two groups, 30 in each group. One
group received 1 micro&#32;g/kg dexme-detomidine plus local infiltration
of 0.2 ml/kg bupivacaine 0.5% at the incision site before surgery (BD),
and the other group received bupivacaine and normal saline (BO). Analgesic
requirements, emergence time, and nausea/vomiting, postoperative pain and
sedation scores were assessed for 4 h after the operation. Heart rate
(HR), systolic blood pressure (SBP), and oxygen saturation
(SaO<inf>2</inf>) were recorded at baseline, and at 10 and 20 min after
injection. <br/>Result(s): Eighty percent were boy in each group; mean age
was 22.75 +/- 18.63 months. SaO<inf>2</inf> and SBP were not different
between the groups, while HR was significantly lower in the Group BD at 10
and 20 min after injection (P < 0.05). Group BD had a lower pain score at
1 and 2 h after the operation, a higher sedation score at the first three
time inter-vals, and longer emergence time than Group BO (all P < 0.001).
Group BD had a lower pain score at 1 and 2 h after the operation (P <
0.001, P < 0.047 respectively). <br/>Conclusion(s): Addition of
dexmedetomidine to local infiltration of bupivacaine in children
undergoing herniorrhaphy significantly reduced postoperative pain and
increased sedation.<br/>Copyright &#xa9; The Korean Society of
Anesthesiologists, 2020.

<63>
Accession Number
2004453509
Title
Fragmented QRS is associated with intraventricular dyssynchrony and
independently predicts nonresponse to cardiac resynchronization
therapy-Systematic review and meta-analysis.
Source
Annals of Noninvasive Electrocardiology. 25 (4) (no pagination), 2020.
Article Number: e12750. Date of Publication: 01 Jul 2020.
Author
Pranata R.; Yonas E.; Vania R.; Tondas A.E.; Yuniadi Y.
Institution
(Pranata, Vania) Faculty of Medicine, Universitas Pelita Harapan,
Tangerang, Indonesia
(Yonas) Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia
(Tondas) Department of Cardiology and Vascular Medicine, Faculty of
Medicine Universitas Sriwijaya, Dr. Mohammad Hoesin General Hospital,
Palembang, Indonesia
(Yuniadi) Department of Cardiology and Vascular Medicine Faculty of
Medicine Universitas Indonesia, National Cardiovascular Center Harapan
Kita, Jakarta, Indonesia
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Fragmented QRS (fQRS) is postulated to be associated with
ventricular dyssynchrony and might be able to predict a nonresponse to
cardiac resynchronization therapy (CRT) implantation. In this systematic
review and meta-analysis, we aim to assess whether fQRS can be a marker of
intraventricular dyssynchronies in patients with ischemic and nonischemic
cardiomyopathy and whether it is an independent predictor of nonresponse
in patients receiving CRT. <br/>Method(s): We performed a comprehensive
search on topics that assesses fQRS and its association with
intraventricular dyssynchrony and nonresponse to CRT up until September
2019. <br/>Result(s): Fragmented QRS is associated with intraventricular
dyssynchrony (OR 10.34 [3.39, 31.54], p <.001; I²: 80% with
sensitivity 76.8%, specificity 77%, LR+ 3.3, and LR- 0.3). Subgroup
analysis showed that fQRS is associated with intraventricular dyssynchrony
in patients with narrow QRS complex (OR 20.92 [12.24, 35.73], p <.001;
I²: 0%) and nonischemic cardiomyopathy (OR of 19.97 [12.12,
32.92], p <.001; I²: 0%). Fragmented QRS was also associated
with a higher time-to-peak myocardial sustained systolic (Ts-SD) (OR 15.19
[12.58, 17.80], p <.001; I²: 0% and positive Yu index (OR 15.61
[9.07, 26.86], p <.001; I²: 0%). Fragmented QRS has a pooled
adjusted OR of OR of 1.70 [1.35, 2.14], p <.001; I²: 62% for
association with a nonresponse to CRT. QRS duration is found to be higher
in nonresponders group mean difference -8.54 [-13.38, -3.70], p <.001;
I²: 70%. <br/>Conclusion(s): Fragmented QRS is associated with
intraventricular dyssynchrony and is independently associated with
nonresponse to cardiac resynchronization therapy.<br/>Copyright &#xa9;
2020 The Authors. Annals of Noninvasive Electrocardiology published by
Wiley Periodicals, Inc.

<64>
[Use Link to view the full text]
Accession Number
631093453
Title
Bioresorbable Scaffolds: Unfulfilled Prophecies.
Source
Circulation. 140 (23) (pp 1917-1920), 2019. Date of Publication: 03 Dec
2019.
Author
Raber L.; Ueki Y.
Institution
(Raber, Ueki) Department of Cardiology, Bern University Hospital,
University of Bern, Bern 3010, Switzerland
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)

<65>
[Use Link to view the full text]
Accession Number
631093208
Title
Clinically Significant Bleeding with Ticagrelor Versus Clopidogrel in
Korean Patients with Acute Coronary Syndromes Intended for Invasive
Management: A Randomized Clinical Trial.
Source
Circulation. 140 (23) (pp 1865-1877), 2019. Date of Publication: 03 Dec
2019.
Author
Park D.-W.; Kwon O.; Jang J.-S.; Yun S.-C.; Park H.; Kang D.-Y.; Ahn
J.-M.; Lee P.H.; Lee S.-W.; Park S.-W.; Choi S.W.; Lee S.-G.; Yoon H.-J.;
Ahn T.; Kim M.H.; Nah D.Y.; Lee S.Y.; Chae J.K.; Park S.-J.
Institution
(Park, Park, Kang, Ahn, Lee, Lee, Park, Park) Division of Cardiology, Asan
Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro
43-gil, Songpa-gu, Seoul 05505, South Korea
(Kwon) Division of Cardiology, Department of Internal Medicine, Catholic
University of Korea, Eunpyeong St. Mary's Hospital, Seoul, South Korea
(Jang) Inje University, Busan Paik Hospital, Busan, South Korea
(Yun) Division of Biostatistics, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
(Choi) Chungnam National University Hospital, Daejeon, South Korea
(Lee) Ulsan University Hospital, Ulsan, South Korea
(Yoon) Keimyung University, Dongsan Medical Center, Daegu, South Korea
(Ahn) Gachon University Gil Hospital, Incheon, South Korea
(Kim) Dong-A University Medical Center, Busan, South Korea
(Nah) Dongguk University Gyeongju Hospital, Gyeongju, South Korea
(Lee) Inje University, Ilsan Paik Hospital, Ilsan, South Korea
(Chae) Chonbuk National University Hospital, Jeonju, South Korea
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: Owing to the differential propensity for bleeding and ischemic
events with response to antiplatelet therapy, the safety and effectiveness
of potent P2Y12 inhibitor ticagrelor in East Asian populations remain
uncertain. <br/>Method(s): In this multicenter trial, 800 Korean patients
hospitalized for acute coronary syndromes with or without ST elevation and
intended for invasive management were randomly assigned to receive, in a
1:1 ratio, ticagrelor (180 mg loading dose, 90 mg twice daily thereafter)
or clopidogrel (600 mg loading dose, 75 mg daily thereafter). The primary
safety outcome was clinically significant bleeding (a composite of major
bleeding or minor bleeding according to PLATO (Platelet Inhibition and
Patient Outcomes) criteria at 12 months. <br/>Result(s): At 12 months, the
incidence of clinically significant bleeding was significantly higher in
the ticagrelor group than in the clopidogrel group (11.7% [45/400] vs 5.3%
[21/400]; hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.34 to
3.79; P=0.002). The incidences of major bleeding (7.5% [29/400] vs 4.1%
[16/400], P=0.04) and fatal bleeding (1% [4/400] vs 0%, P=0.04) were also
higher in the ticagrelor group. The incidence of death from cardiovascular
causes, myocardial infarction, or stroke was not significantly different
between the ticagrelor group and the clopidogrel group (9.2% [36/400] vs
5.8% [23/400]; HR, 1.62; 95% CI, 0.96 to 2.74; P=0.07). Overall safety and
effectiveness findings were similar with the use of several different
analytic methods and in multiple subgroups. <br/>Conclusion(s): In Korean
acute coronary syndrome patients intended to receive early invasive
management, standard-dose ticagrelor as compared with clopidogrel was
associated with a higher incidence of clinically significant bleeding. The
numerically higher incidence of ischemic events should be interpreted with
caution, given the present trial was underpowered to draw any conclusion
regarding efficacy.<br/>Copyright &#xa9; 2019 American Heart Association,
Inc.

<66>
[Use Link to view the full text]
Accession Number
630982117
Title
Comparison of a complete percutaneous versus surgical approach to aortic
valve replacement and revascularization in patients at intermediate
surgical risk results from the randomized SURTAVI trial.
Source
Circulation. 140 (16) (pp 1296-1305), 2019. Date of Publication: 15 Oct
2019.
Author
Sondergaard L.; Popma J.J.; Reardon M.J.; Van Mieghem N.M.; Deeb G.M.;
Kodali S.; George I.; Williams M.R.; Yakubov S.J.; Kappetein A.P.; Serruys
P.W.; Grube E.; Schiltgen M.B.; Chang Y.; Engstrom T.
Institution
(Sondergaard, Engstrom) Department of Cardiology, Heart Centre,
Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Popma) Department of Internal Medicine, Beth Israel Deaconess Medical
Center, Boston, MA, United States
(Reardon) Department of Cardiovascular Surgery, Methodist DeBakey Heart
and Vascular Center, Houston, TX, United States
(Van Mieghem, Kappetein) Departments of Cardiology and Cardiothoracic
Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands
(Deeb) Department of Cardiac Surgery, University of Michigan, Ann Arbor,
United States
(Kodali, George) Department of Surgery, Columbia University Medical
Center, New York, United States
(Williams) Departments of Medicine (Cardiology) and Cardiothoracic
Surgery, NYU-Langone Medical Center, NY, United States
(Yakubov) Department of Cardiology, OhioHealth Riverside Methodist
Hospital, Columbus, United States
(Serruys) International Centre for Circulatory Health, NHLI, Imperial
College London, London, United Kingdom
(Grube) Department of Medicine II, Heart Center Bonn, Bonn, Germany
(Kappetein, Schiltgen, Chang) Structural Heart, Medtronic Plc,
Minneapolis, MN, United States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
BACKGROUND: For patients with severe aortic stenosis and coronary artery
disease, the completely percutaneous approach to aortic valve replacement
and revascularization has not been compared with the standard surgical
approach. <br/>METHOD(S): The prospective SURTAVI trial (Safety and
Efficiency Study of the Medtronic CoreValve System in the Treatment of
Severe, Symptomatic Aortic Stenosis in Intermediate Risk Subjects Who Need
Aortic Valve Replacement) enrolled intermediate-risk patients with severe
aortic stenosis from 87 centers in the United States, Canada, and Europe
between June 2012 and June 2016. Complex coronary artery disease with
SYNTAX score (Synergy Between PCI with Taxus and Cardiac Surgery Trial)
>22 was an exclusion criterion. Patients were stratified according to the
need for revascularization and then randomly assigned to treatment with
transcatheter aortic valve replacement (TAVR) or surgical aortic valve
replacement (SAVR). Patients assigned to revascularization in the TAVR
group underwent percutaneous coronary intervention, whereas those in the
SAVR group had coronary artery bypass grafting. The primary end point was
the rate of all-cause mortality or disabling stroke at 2 years.
<br/>RESULT(S): Of 1660 subjects with attempted aortic valve implants, 332
(20%) were assigned to revascularization. They had a higher Society of
Thoracic Surgeons risk score for mortality (4.8+/-1.7% versus 4.4+/-1.5%;
P<0.01) and were more likely to be male (65.1% versus 54.2%; P<0.01) than
the 1328 patients not assigned to revascularization. After randomization
to treatment, there were 169 patients undergoing TAVR and percutaneous
coronary intervention, 163 patients undergoing SAVR and coronary artery
bypass grafting, 695 patients undergoing TAVR, and 633 patients undergoing
SAVR. No significant difference in the rate of the primary end point was
found between TAVR and percutaneous coronary intervention and SAVR and
coronary artery bypass grafting (16.0%; 95% CI, 11.1-22.9 versus 14.0%;
95% CI, 9.2-21.1; P=0.62), or between TAVR and SAVR (11.9%; 95% CI,
9.5-14.7 versus 12.3%; 95% CI, 9.8-15.4; P=0.76). <br/>CONCLUSION(S): For
patients at intermediate surgical risk with severe aortic stenosis and
noncomplex coronary artery disease (SYNTAX score <=22), a complete
percutaneous approach of TAVR and percutaneous coronary intervention is a
reasonable alternative to SAVR and coronary artery bypass
grafting.<br/>Copyright &#xa9; 2019 American Heart Association, Inc.

<67>
[Use Link to view the full text]
Accession Number
631999963
Title
In-hospital outcomes of chronic total occlusion percutaneous coronary
intervention in patients with and without prior coronary artery bypass
graft: A protocol for systematic review and meta analysis.
Source
Medicine. 99 (23) (pp e19977), 2020. Date of Publication: 05 Jun 2020.
Author
Liu M.-J.; Chen C.-F.; Gao X.-F.; Liu X.-H.; Xu Y.-Z.
Institution
(Liu) Department of Cardiology, Affiliated Hangzhou First People's
Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang,
China
Publisher
NLM (Medline)
Abstract
The clinical outcomes of chronic total occlusion (CTO) percutaneous
coronary intervention (PCI) in prior coronary artery bypass graft (pCABG)
patients have been investigated; however, the results are inconsistent.The
present meta-analysis compared the clinical outcomes of CTO PCI in
patients with and without prior CABG (nCABG). The endpoints included
technical success, procedural success, all-cause mortality, myocardial
infarction (MI), major bleeding, coronary perforation, pericardial
tamponade, emergency CABG, and vascular access complication.A total of 7
studies comprising of 11099 patients were included in this meta-analysis.
The results showed that compared to nCABG patents, pCABG patients were
associated with lower technical success (82.3% versus 87.8%; OR, 0.60; 95%
CI, 0.53-0.68; P < .00001; I = 0%) and procedural success (80.4% versus
86.2%; OR, 0.61; 95% CI, 0.53-0.70; P < .00001; I = 10%); a higher risk of
all-cause mortality (OR, 2.95; 95% CI, 1.56-5.57; P = 0.0008; I = 0%), MI
(OR, 2.30; 95% CI, 1.40-3.80; P = .001; I = 5%), and coronary perforation
(OR, 2.16; 95% CI, 1.51-3.08; P < 0.0001; I = 52%). On the other hand, the
risk of pericardial tamponade (OR, 0.42; 95% CI, 0.15-1.18; P = .10; I =
21%), major bleeding (OR, 1.51; 95% CI, 0.90-2.53; P = .11; I = 0%),
vascular access complication (OR, 1.50; 95% CI, 0.93-2.41; P = .10; I =
0%), and emergency CABG (OR, 0.99; 95% CI, 0.25-3.91; P = .99; I = 0%) was
similar in both groups.Compared to nCABG patients, pCABG patients had
lower CTO PCI success rates, higher rates of in-hospital mortality, MI,
and coronary perforation, and similar risk of pericardial tamponade and
vascular complication rates.

<68>
Accession Number
631452205
Title
Structural Valve Deterioration after Transcatheter Aortic Valve
Implantation Using J-Valve: A Long-Term Follow-Up.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 26 (3) (pp
158-165), 2020. Date of Publication: 20 Jun 2020.
Author
Li F.; Wang Y.; Xu F.; Wang X.; Li X.; Wang W.
Institution
(Li, Wang, Wang, Li, Wang) Department of Structural Heart Disease, Fuwai
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, State Key Laboratory of Cardiovascular Disease, Beijing, China
(Xu, Wang) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
Publisher
NLM (Medline)
Abstract
PURPOSE: Our study aimed to investigate the structural valve deterioration
(SVD) after transcatheter aortic valve implantation (TAVI) using J-Valve.
<br/>METHOD(S): In all, 14 patients with aortic stenosis (AS) and 4
patients with pure aortic regurgitation (PAR) were available in the study.
Four-year follow-up was performed in all patients, and the clinical data
and echocardiographic findings were recorded and analyzed. <br/>RESULT(S):
All patients survived at the 4-year follow-up. There was no evidence of
morphological SVD or prosthetic valve thrombosis in enrolled patients.
None of the hemodynamic SVD occurred in patients with PAR. Mean gradients
decreased from 61.93 +/- 15.42 mm Hg (pre-TAVI) to 19.64 +/- 9.16 mm Hg
(discharge) in patients with AS (p <0.001); subsequently, a slight
increase was observed in the mean trans-aortic gradient throughout
follow-up (p = 0.967). Overall, in patients with AS, six individuals
suffered moderate (3/14, 21.4%) or severe (3/14, 21.4%) hemodynamic SVD at
4-year follow-up. <br/>CONCLUSION(S): The limited number of cases provides
a preliminary indication of the long-term efficacy of TAVI using J-Valve
in patients with PAR. In patients with AS, although the higher rate of SVD
was observed, the overall transcatheter heart valve (THV) hemodynamics
remained stable over time after prosthetic valve implantation and the
long-term durability of J-Valve was convincing.

<69>
Accession Number
2004886305
Title
Resource utilization associated with hospital and office-based insertion
of a miniaturized insertable cardiac monitor: results from the RIO 2
randomized US study.
Source
Journal of Medical Economics. 23 (7) (pp 706-713), 2020. Date of
Publication: 02 Jul 2020.
Author
Rogers J.D.; Piorkowski C.; Sohail M.R.; Anand R.; Kowalski M.; Rosemas
S.; Stromberg K.; Sanders P.
Institution
(Rogers) Department of Cardiology, Scripps Green Hospital, La Jolla, CA,
United States
(Piorkowski) Department of Electrophysiology, Herzzentrum Dresden,
Dresden, Germany
(Sohail) Divisions of Infectious Diseases and Cardiovascular Diseases,
Mayo Clinic College of Medicine, Rochester, MN, United States
(Anand) Electrophysiology Laboratory, Holy Cross Hospital, Fort
Lauderdale, FL, United States
(Kowalski) Division of Electrophysiology, Department of Cardiology, Staten
Island University Hospital and Northwell Health System, Manhasset, NY,
United States
(Rosemas, Stromberg) Cardiac Rhythm and Heart Failure, Medtronic, Inc,
Mounds View, MN, United States
(Sanders) Department of Cardiology, Royal Adelaide Hospital, Centre for
Heart Rhythm Disorders, University of Adelaide, Adelaide, Australia
Publisher
Taylor and Francis Ltd
Abstract
Background: Previous studies support operational benefits when moving
insertable cardiac monitor (ICM) insertions outside the cardiac
catheterization/electrophysiology laboratories, but this has not been
directly assessed in a randomized trial or when the procedure is
specifically moved to the office setting. To gain insight, the RIO 2 US
study collected resource utilization and procedure time intervals for ICM
insertion in-office and in-hospital and these data were used to calculate
costs associated with staff time and supply use in each setting.
<br/>Methods and Results: The Reveal LINQ In-Office 2 US study (randomized
[1:1], multicenter, unblinded) included 482 patients to undergo insertion
of the ICM in-hospital (in an operating room or CATH/EP laboratory) (n =
231) or in-office (n = 251). Detailed information on resource utilization
was collected prospectively by the study and used to compare resource
utilization and procedure time intervals during ICM insertion procedures
performed in-office vs. in-hospital. In addition, costs associated with
staff time and supply use in each setting were calculated retrospectively.
Total visit duration (check-in to discharge) was 107 min shorter in-office
vs. in-hospital (95% CI = 97-116 min; p < 0.001). Patient preparation and
education in-office were more likely to occur in the same room as the
procedure, compared with in-hospital (91.6% vs. 34.2%, p < 0.001 and 87.3%
vs. 22.1%, p < 0.001, respectively). There was a reduction in registered
nurse and cardiovascular/operating room technologist involvement
in-office, accompanied by higher physician and medical assistant
participation. Overall staff time spent per case was 75% higher
in-hospital, leading to 50% higher staffing costs compared to in-office.
<br/>Conclusion(s): ICM insertion in a physician's office vs. a hospital
setting resulted in reduced patient visit time and reduced overall staff
time, with a consequent reduction in staffing costs. Clinical trial
registration: ClinicalTrials.gov NCT02395536.<br/>Copyright &#xa9; 2020,
&#xa9; 2020 The Author(s). Published by Informa UK Limited, trading as
Taylor & Francis Group.

<70>
Accession Number
632283713
Title
Association of Statin Use With All-Cause and Cardiovascular Mortality in
US Veterans 75 Years and Older.
Source
JAMA. 324 (1) (pp 68-78), 2020. Date of Publication: 07 Jul 2020.
Author
Orkaby A.R.; Driver J.A.; Ho Y.-L.; Lu B.; Costa L.; Honerlaw J.; Galloway
A.; Vassy J.L.; Forman D.E.; Gaziano J.M.; Gagnon D.R.; Wilson P.W.F.; Cho
K.; Djousse L.
Institution
(Orkaby, Driver) New England Geriatric Research, Education, Clinical
Center (GRECC), VA Boston Healthcare System, Boston, MA
(Orkaby, Driver, Ho, Lu, Costa, Honerlaw, Galloway, Vassy, Gaziano,
Gagnon, Cho, Djousse) Massachusetts Veterans Epidemiology Research and
Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA
(Orkaby, Driver, Gaziano, Cho, Djousse) Division of Aging, Brigham &
Women's Hospital, Harvard Medical School, Boston, MA
(Lu, Vassy) Department of Medicine, Brigham & Women's Hospital, Harvard
Medical School, Boston, MA
(Forman) Section of Geriatric Cardiology, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
(Forman) Geriatric Research, Education, Clinical Center, VA Pittsburgh
Healthcare System, Pittsburgh, PA, United States
(Gagnon) Department of Biostatistics, Boston University School of Public
Health, Boston, MA
(Wilson) Atlanta VA Medical Center, Decatur, Georgia
(Wilson) Division of Cardiology, Emory University School of Medicine,
Atlanta, Georgia
(Wilson) Department of Epidemiology, Rollins School of Public Health,
Emory University, Atlanta, Georgia
Publisher
NLM (Medline)
Abstract
Importance: Data are limited regarding statin therapy for primary
prevention of atherosclerotic cardiovascular disease (ASCVD) in adults 75
years and older. <br/>Objective(s): To evaluate the role of statin use for
mortality and primary prevention of ASCVD in veterans 75 years and older.
<br/>Design, Setting, and Participant(s): Retrospective cohort study that
used Veterans Health Administration (VHA) data on adults 75 years and
older, free of ASCVD, and with a clinical visit in 2002-2012. Follow-up
continued through December 31, 2016. All data were linked to Medicare and
Medicaid claims and pharmaceutical data. A new-user design was used,
excluding those with any prior statin use. Cox proportional hazards models
were fit to evaluate the association of statin use with outcomes. Analyses
were conducted using propensity score overlap weighting to balance
baseline characteristics. Exposures: Any new statin prescription.
<br/>Main Outcomes and Measures: The primary outcomes were all-cause and
cardiovascular mortality. Secondary outcomes included a composite of ASCVD
events (myocardial infarction, ischemic stroke, and revascularization with
coronary artery bypass graft surgery or percutaneous coronary
intervention). <br/>Result(s): Of 326981 eligible veterans (mean [SD] age,
81.1 [4.1] years; 97% men; 91% white), 57178 (17.5%) newly initiated
statins during the study period. During a mean follow-up of 6.8 (SD, 3.9)
years, a total 206902 deaths occurred including 53296 cardiovascular
deaths, with 78.7 and 98.2 total deaths/1000 person-years among statin
users and nonusers, respectively (weighted incidence rate difference
[IRD]/1000 person-years, -19.5 [95% CI, -20.4 to -18.5]). There were 22.6
and 25.7 cardiovascular deaths per 1000 person-years among statin users
and nonusers, respectively (weighted IRD/1000 person-years, -3.1 [95 CI,
-3.6 to -2.6]). For the composite ASCVD outcome there were 123379 events,
with 66.3 and 70.4 events/1000 person-years among statin users and
nonusers, respectively (weighted IRD/1000 person-years, -4.1 [95% CI, -5.1
to -3.0]). After propensity score overlap weighting was applied, the
hazard ratio was 0.75 (95% CI, 0.74-0.76) for all-cause mortality, 0.80
(95% CI, 0.78-0.81) for cardiovascular mortality, and 0.92 (95% CI,
0.91-0.94) for a composite of ASCVD events when comparing statin users
with nonusers. <br/>Conclusions and Relevance: Among US veterans 75 years
and older and free of ASCVD at baseline, new statin use was significantly
associated with a lower risk of all-cause and cardiovascular mortality.
Further research, including from randomized clinical trials, is needed to
more definitively determine the role of statin therapy in older adults for
primary prevention of ASCVD.

<71>
Accession Number
632296899
Title
Homozygous Familial Hypercholesterolemia: Anesthetic Challenges and Review
of Literature.
Source
World journal for pediatric & congenital heart surgery. 11 (4) (pp
NP83-NP87), 2020. Date of Publication: 01 Jul 2020.
Author
Ladha S.; Makhija N.; Kiran U.; Aarav S.K.
Institution
(Ladha, Makhija, Kiran) Department of Cardiac Anesthesia, Cardiothoracic
Centre, All India Institute of Medical Sciences, New Delhi, India
(Aarav) Department of Pathology, All India Institute of Medical Sciences,
New Delhi, India
Publisher
NLM (Medline)
Abstract
Homozygous familial hypercholesterolemia (HoFH; Fredrickson IIa) is a rare
autosomal dominant hereditary disease associated with increased
low-density lipoprotein cholesterol. We hereby report anesthetic
challenges in a rare case of HoFH having severe progressive aortic
stenosis, mitral regurgitation, diffuse aortic and carotid vessel
involvement, and severe left ventricular dysfunction. The patient
underwent a Konno aortoventriculoplasty with mechanical prosthesis along
with mitral valve repair.

<72>
Accession Number
632295606
Title
Heart rupture repair during huge mediastinal mass resection - case report.
Source
Journal of cardiothoracic surgery. 15 (1) (pp 164), 2020. Date of
Publication: 06 Jul 2020.
Author
Abdel Jail R.; Abou Chaar M.K.; Al-Qudah O.; Abu Zahra K.; Al-Hussaini M.;
Gharaibeh A.
Institution
(Abdel Jail) Department of Thoracic Oncology, King Hussein Cancer Center,
Amman, Jordan
(Abou Chaar, Abu Zahra) Department of Surgery, King Hussein Cancer Center,
Amman, Jordan
(Al-Qudah) Department of Thoracic Oncology, King Hussein Cancer Center,
Amman, Jordan
(Al-Hussaini) Department of Pathology and Laboratory Medicine, King
Hussein Cancer Center, Amman, Jordan
(Gharaibeh) Department of Radiology, King Hussein Cancer Center, Amman,
Jordan
Publisher
NLM (Medline)
Abstract
BACKGROUND: Ventricular rupture is rarely described in the literature
outside the context of myocardial infarction, infection or neoplasm. It is
associated with a high mortality rate due to late presentation and delayed
surgical intervention, which involves sutureless or sutured techniques.
Comprehensive literature review failed to identify any case of
intra-operative right ventricular heart rupture followed by myocardial
repair and a complete recovery after a prolonged intensive care unit (ICU)
stay. CASE PRESENTATION: A 57-year-old previously healthy gentleman
presented complaining of a new onset shortness of breath for 2 months. A
large mediastinal mass was found on chest imaging and biopsy revealed a
thymoma. Patient received a neoadjuvant
Cisplatin/Doxorubicin/Cyclophosphamide (CAP) regimen chemotherapy then
sternotomy and thymectomy en bloc with anterior pericardium.
Post-thymectomy, the patient continued to be hypotensive in recovery
despite aggressive fluid resuscitation. He was sent back to theatre,
aggressive fluid resuscitation continued, surgical site exploration was
done by reopening the sternum, and the bleeding source was identified and
controlled, but intraoperative asystole developed. During internal cardiac
massage, the right ventricle ruptured with a 3cm defect which was
successfully repaired using a pericardial patch without a bypass machine
due to unavailability at our cancer center. The patient remained dependent
on mechanical ventilation through tracheostomy for a total of 2 months due
to bilateral phrenic nerve paralysis, was discharged from ICU to the
surgical floor 66days after the operation and weaned off ventilator
support after 85days, adequate respiratory and physical rehabilitation
followed. Patient is doing very well now with excellent performance, and
free of tumor recurrence 30months after surgery. <br/>CONCLUSION(S): Right
ventricular rupture is rarely described outside the context of myocardial
infarction and valvular heart disease. Tumor proximity to the heart and
neoadjuvant cardiotoxic chemotherapy are the proposed causes for
precipitating the cardiac rupture in our case. Post-surgical patients who
receive early physical rehabilitation and respiratory physiotherapy have
improved survival and outcome.

<73>
Accession Number
2007029029
Title
Accelerated treatment of endocarditis-The POET II trial: Rationale and
design of a randomized controlled trial: Design and rationale of the POET
II trial.
Source
American Heart Journal. 227 (pp 40-46), 2020. Date of Publication:
September 2020.
Author
Ostergaard L.; Pries-Heje M.M.; Hasselbalch R.B.; Rasmussen M.; Akesson
P.; Horvath R.; Povlsen J.; Gill S.; Bruun N.E.; Mullertz K.; Tuxen C.D.;
Ihlemann N.; Helweg-Larsen J.; Moser C.; Fosbol E.L.; Bundgaard H.;
Iversen K.
Institution
(Ostergaard, Pries-Heje, Ihlemann, Fosbol, Bundgaard) The Heart Center,
Rigshospitalet, Copenhagen, Denmark
(Hasselbalch, Iversen) Department of Cardiology, Herlev-Gentofte Hospital,
Copenhagen, Denmark
(Rasmussen, Akesson) Department of Infectious Diseases, Skane University
Hospital, Lund, Sweden
(Horvath) Department of Infectious Diseases, The Prince Charles Hospital,
Brisbane, Australia
(Povlsen) Department of Cardiology, Aarhus University Hospital, Aarhus,
Denmark
(Gill) Department of Cardiology, Odense University Hospital, Odense,
Denmark
(Bruun) Department of Cardiology, Zealand University Hospital, Roskilde,
Denmark
(Mullertz) Department of Cardiology, Nordsjaellands Hospital, Hillerod,
Denmark
(Tuxen) Department of Cardiology, Bispebjerg-Frederiksberg Hospital,
Copenhagen, Denmark
(Helweg-Larsen) Department of Infectious Diseases, Rigshospitalet,
Copenhagen, Denmark
(Moser) Department of Clinical Microbiology, Rigshospitalet, Copenhagen,
Denmark
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: The optimal antibiotic treatment length for infective
endocarditis (IE) is uncertain. International guidelines recommend
treatment duration of up to 6 weeks for patients with left-sided IE but
are primarily based on historical data and expert opinion. Efficacies of
modern therapies, fast recovery seen in many patients with IE, and
complications to long hospital stays challenge the rationale for fixed
treatment durations in all patients. <br/>Objective(s): The objective was
to conduct a noninferiority randomized controlled trial (acronym POET II)
investigating the safety of accelerated (shortened) antibiotic therapy as
compared to standard duration in patients with left-sided IE.
<br/>Method(s): The POET II trial is a multicenter, multinational,
open-label, noninferiority randomized controlled trial. Patients with
definite left-sided IE due to Streptococcus spp, Staphylococcus aureus, or
Enterococcus faecalis will be eligible for enrolment. Each patient will be
randomized to accelerated antibiotic treatment or standard-length
treatment (1:1) following clinical stabilization as defined by clinical
parameters, laboratory values, and transesophageal echocardiography
findings. Accelerated treatment will be between 2 and 4 weeks, whereas
standard-length treatment will be between 4 and 6 weeks, depending on
microbiologic etiology, complications, need for valve surgery, and
prosthetic versus native valve endocarditis. The primary outcome is a
composite of all-cause mortality, unplanned cardiac surgery, relapse of
bacteremia, or embolization within 6 months of randomization.
<br/>Conclusion(s): The POET II trial will investigate the safety of
accelerated antibiotic therapy for patients with left-sided IE caused by
Streptococcus spp, Staphylococcus aureus, or Enterococcus faecalis. The
results of the POET II trial will improve the evidence base of treatment
recommendations, and clinical practice may be altered.<br/>Copyright
&#xa9; 2020 Elsevier Inc.

<74>
Accession Number
2005541583
Title
Mini-sternotomy vs right anterior thoracotomy for aortic valve
replacement.
Source
Journal of Cardiac Surgery. 35 (7) (pp 1570-1582), 2020. Date of
Publication: 01 Jul 2020.
Author
Yousuf Salmasi M.; Hamilton H.; Rahman I.; Chien L.; Rival P.; Benedetto
U.; Young C.; Caputo M.; Angelini G.D.; Vohra H.A.
Institution
(Yousuf Salmasi, Chien) Department of Surgery, Imperial College London,
London, United Kingdom
(Hamilton, Rahman) University of Bristol Medical School, Bristol, United
Kingdom
(Rival, Benedetto, Caputo, Angelini, Vohra) Department of Cardiac Surgery,
Bristol Heart Institute, Bristol, United Kingdom
(Young) Department of Cardiac Surgery, St Thomas' Hospital, London, United
Kingdom
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: While minimally invasive techniques for aortic valve
replacement (AVR) have been shown to be safe, limited data exist comparing
the varying approaches. This study aimed to compare the outcomes between
two minimally invasive approaches for AVR: mini-sternotomy (MS) and right
anterior thoracotomy (RAT). <br/>Material(s) and Method(s): A systematic
search of MEDLINE, EMBASE, and OVID was conducted for the period
1990-2019. Nine observational studies (n = 2926 patients) met the
inclusion criteria. <br/>Result(s): There was no difference in operative
mortality between MS and RAT (odds ratio [OR]: 0.87, 95% confidence
interval [CI]: 0.41-1.85; P =.709). Meta-analyses favored MS over RAT in
reoperation for bleeding (OR: 0.42, 95% CI: 0.28-0.63; P <.001), aortic
cross-clamp time (standardized mean difference [SMD]: -0.12, 95% CI: -0.20
to 0.029; P =.009), and the rate of conversion to sternotomy (OR: 0.32,
95% CI: 0.11-0.93; P =.036). The rate of permanent pacemaker insertion
approached borderline significance in favor of MS (OR: 0.54, 95% CI:
0.26-1.12; P =.097). In-hospital outcomes of stroke, atrial fibrillation,
and surgical site infection were similar between the two groups. The
length of hospital stay was shorter for RAT (SMD: 0.12, 95% CI:
0.027-0.22; P =.012) and the length of postoperative ventilation was
borderline significant in favor of RAT (SMD: 0.16, 95% CI: -0.027 to 0.34;
P =.095). <br/>Conclusion(s): This study highlights important differences
in short-term outcomes between MS and RAT as approaches for AVR. This has
important implications for patient selection, especially in the elderly,
where such approaches are becoming more common-place.<br/>Copyright &#xa9;
2020 The Authors. Journal of Cardiac Surgery published by Wiley
Periodicals LLC

<75>
Accession Number
2005541054
Title
Prospective randomized trial of endoscopic vs open radial artery harvest
for CABG: Clinical outcome, patient satisfaction, and midterm RA graft
patency.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Tamim M.; Alexiou C.; Al-Hassan D.; Al-Faraidy K.
Institution
(Tamim, Alexiou) Department of Cardiac Surgery, King Fahd Military Medical
Complex, Dhahran, Saudi Arabia
(Al-Hassan) Department of Radiology, King Fahd Military Medical Complex,
Dhahran, Saudi Arabia
(Al-Faraidy) Department of Cardiology, King Fahd Military Medical Complex,
Dhahran, Saudi Arabia
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background and Aim: Endoscopic radial artery (RA) harvest (ERAH) is an
alternative to open RA harvest (ORAH) technique. Our aim was to ascertain
clinical outcomes, patent satisfaction, and 1-year angiographic patency
rates after ERAH and ORAH. <br/>Patients and Methods: A total of 50
patients undergoing coronary artery bypass grafting were prospectively
randomized to two groups. In the ERAH group (25 patients) the RA was
harvested endoscopically and in the ORAH group (25 patients) openly.
<br/>Result(s): There were not differences between the groups in
preoperative characteristics. Length of skin incision was shorter in ERAH
(P <.001) but there were not differences in the length of RA, harvest
time, blood flow, and pulsatility index after ERAH and ORAH. Wound healing
was uniformly smooth in ERAH and there were two hematomas and one
infection in ORAH. Postoperatively, major neuralgias were present in five
patients in ORAH and none in ERAH and minor neuralgias in 11 and 3
patients (P =.02) respectively. Twenty-four patients in ERAH and four in
ORAH graded their experience as excellent (P <.001). One-year angiographic
RA patency was 90% without intergroup difference. Target vessel stenosis
less than 90% adversely affected RA patency (P <.0001).
<br/>Conclusion(s): In expert center, ERAH does not appear to have
negative impact on the time harvest, the length, and quality of RA
conduit, the wound healing, and the occurrence of hand and forearm
complications. In addition, provides excellent cosmetic result and patient
satisfaction. RA graft patency is gratifying when placed to a target
coronary artery vessel with stenosis greater than 90%.<br/>Copyright
&#xa9; 2020 Wiley Periodicals LLC

<76>
Accession Number
2005540996
Title
Tricuspid annuloplasty: Too many, too few? Virtue may be in the middle!.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Antunes M.J.
Institution
(Antunes) Clinic of Cardiothoracic Surgery, Faculty of Medicine,
University of Coimbra, Coimbra, Portugal
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Significant secondary tricuspid regurgitation, often
accompanied by right ventricular dilation and dysfunction, occurs in a
significant proportion of patients submitted to surgery for severe mitral
valve disease. It appears a vicious circle that is not interrupted by the
treatment of the left heart valve alone, hence it requires concomitant
intervention on the tricuspid valve. <br/>Aim(s): In this commentary I
will discuss a paper published in this issue of the Journal by Calafiore
et al from Riyadh - Saudi Arabia, reporting a retrospective study that
evaluated the influence of preoperative right ventricular and tricuspid
valve (TV) remodeling on the fate of tricuspid annuloplasty (TA) and RV in
423 patients undergoing TA for functional TR operated on from May 2009 to
December 2015 at their institution. <br/>Material(s) and Method(s):
Current guidelines and other consensus documents recommend that tricuspid
valve surgeryshould be considered (class IIa) in patients with
mild/moderate secondary regurgitation and/or significant annular
dilatation. However, rates of tricuspid annuloplasty performed during
operations to left-heart valves are very variable, depending also on the
etiology of the mitral disease. Results & Discussion: Different methods of
annuloplasty are used by the surgical community - suture, rings, bands -
with widely variable results with regard to the recurrence of
regurgitation and long-term survival. Not all these techniques are
standardised and this may also be a cause for the disparate results.
<br/>Conclusion(s): In the absence of randomized studies, which are highly
unlikely to be undertaken in this situation, more information is required
from large series with longer follow-ups.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC

<77>
Accession Number
2005540955
Title
Surgical vs transfemoral aortic valve replacement in low-risk patients: An
updated meta-analysis of trial and registry data.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Luthra S.; Leiva-Juarez M.M.; Ohri S.K.
Institution
(Luthra, Ohri) Wessex Cardiothoracic Centre, Southampton University
Hospitals NHS Trust, Southampton, United Kingdom
(Leiva-Juarez) Department of Surgery, Brookdale University Hospital and
Medical Center, Brooklyn, NY, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Transfemoral aortic valve replacement (TAVR) has been studied
extensively in patients with improving safety and efficacy in high to
intermediate-risk patients with aortic stenosis. TAVR has been now
approved for patients with low surgical risk. <br/>Objective(s): The
purpose of this study is to integrate the evidence from randomized
controlled trials (RCT) and large registry data comparing TAVR to surgical
aortic valve repair (SAVR). <br/>Method(s): Seven studies (three RCTs, one
post hoc study of a RCT, and three registries) were included. Incidence
rate ratios (IRR) of outcomes of interest (overall mortality, 30-day
mortality, cardiovascular death, stroke, pacemaker implantation [PPMI],
myocardial infarction, moderate-severe paravalvular leak [PVL], and
re-intervention) were compared using a random-effects model.
<br/>Result(s): The pooled analysis included 24 819 patients (TAVR, 8227
and SAVR, 16 592). 2,952 (11.9%) patients were from RCTs and 21 867
(88.1%) were registry patients. Thirty-day mortality was lower in TAVR
(logIRR, -0.43; 95% CI. -0.61 to -0.25; P <.001), whereas the rate of
moderate-severe PVL (logIRR, 1.44; 95% CI, 0.58-2.3; P <.001) and PPMI
(logIRR, 1.13; 95% CI, 1.02-1.24; P <.001) were higher. There were no
significant differences in the rates of overall mortality, reintervention,
cardiovascular death, myocardial infarction, or stroke between SAVR and
TAVR. <br/>Conclusion(s): Early mortality is higher in SAVR while rates of
PVL and PPMI are substantially higher in TAVR. There is no significant
advantage with TAVR for overall survival, cardiovascular death, stroke,
MI, and re-intervention rates.<br/>Copyright &#xa9; 2020 Wiley Periodicals
LLC

<78>
Accession Number
632302650
Title
Effectiveness of prothrombin complex concentrate for the treatment of
bleeding: A systematic review and meta-analysis.
Source
Journal of thrombosis and haemostasis : JTH. (no pagination), 2020. Date
of Publication: 08 Jul 2020.
Author
van den Brink D.P.; Wirtz M.R.; Neto A.S.; Schochl H.; Viersen V.;
Binnekade J.; Juffermans N.P.
Institution
(van den Brink, Wirtz, Neto, Binnekade, Juffermans) Department of
Intensive Care Medicine, Amsterdam, Netherlands
(van den Brink, Wirtz, Juffermans) Laboratory of Experimental Intensive
Care and Anesthesiology, Netherlands
(Wirtz) Department of Trauma Surgery, Amsterdam, Netherlands
(Neto) Department of Critical Care Medicine, Hospital Israelita Albert
Einstein, Brazil
(Schochl) Department of Anesthesiology and Intensive Care Medicine, AUVA
Trauma Centre Salzburg, Academic Teaching Hospital of the Paracelsus
Medical University, Salzburg, Austria
(Schochl) Institute for Experimental and Clinical Traumatology, AUVA
Research Centre, Vienna, Austria
(Viersen) Department of Anesthesiology, Netherlands
Publisher
NLM (Medline)
Abstract
Prothrombin complex concentrate(PCC) is increasingly being used as a
treatment for major bleeding in patients who are not taking
anticoagulants. The aim of this systematic review and meta-analysis is to
evaluate the effectiveness of PCC administration for the treatment of
bleeding in patients not taking anticoagulants. Studies investigating the
effectivity of PCC to treat bleeding in adult patients and providing data
on either mortality or blood loss were eligible. Data were pooled using
Mantel-Haenszel random effects meta-analysis or inverse variance random
effects meta-analysis. From 4668 identified studies, 17 observational
studies were included. In all patient groups combined, PCC administration
was not associated with mortality (odds ratio=0.83; confidence interval
=0.66 - 1.06; p=0.13; I2=0%). However, in trauma patients, PCC
administration, in addition to fresh frozen plasma, was associated with
reduced mortality (odds ratio=0.64; confidence interval=0.46-0.88;
p=0.007; I2=0%). PCC administration was associated with a reduction in
blood loss in cardiac surgery patients(mean difference: -384; confidence
interval =-640 - -128, p=0.003, I2=81%) and a decreased need for red blood
cell transfusions when compared to standard care across a wide range of
bleeding patients not taking anticoagulants (mean difference: -1.80;
confidence interval =-3.22 - -0.38; p=0.01; I2=92%. In conclusion, PCC
administration was not associated with reduced mortality in the whole
cohort but did reduce mortality in trauma patients. In bleeding patients,
PCC reduced the need for RBC transfusions when compared to treatment
strategies not involving PCC. In bleeding cardiac surgery patients, PCC
administration reduced blood loss.<br/>Copyright This article is protected
by copyright. All rights reserved.

<79>
Accession Number
632302361
Title
Effect of C-Reactive Protein on Lipoprotein(a)-Associated Cardiovascular
Risk in Optimally Treated Patients With High-Risk Vascular Disease: A
Prespecified Secondary Analysis of the ACCELERATE Trial.
Source
JAMA cardiology. (no pagination), 2020. Date of Publication: 08 Jul 2020.
Author
Puri R.; Nissen S.E.; Arsenault B.J.; St John J.; Riesmeyer J.S.; Ruotolo
G.; McErlean E.; Menon V.; Cho L.; Wolski K.; Lincoff A.M.; Nicholls S.J.
Institution
(Puri, Nissen, Menon, Cho, Lincoff) Department of Cardiovascular Medicine,
Cleveland Clinic, Cleveland, OH, United States
(Puri, Nissen, St John, McErlean, Menon, Wolski, Lincoff) Cleveland Clinic
Coordinating Center for Clinical Research, Cleveland Clinic, Cleveland,
OH, United States
(Arsenault) Quebec Heart & Lung Institute, Universite de Laval, Quebec,
Canada
(Riesmeyer, Ruotolo) Eli Lilly, Indianapolis, IN, United States
(Nicholls) MonashHeart, Department of Cardiology, Monash University,
Clayton, VIC, Australia
Publisher
NLM (Medline)
Abstract
Importance: Although lipoprotein(a) (Lp[a]) is a causal genetic risk
factor for atherosclerotic cardiovascular disease, it remains unclear
which patients with established atherosclerotic cardiovascular disease
stand to benefit the most from Lp(a) lowering. Whether inflammation can
modulate Lp(a)-associated cardiovascular (CV) risk during secondary
prevention is unknown. <br/>Objective(s): To examine whether
Lp(a)-associated CV risk is modulated by systemic inflammation in
optimally treated patients at high risk of CV disease. <br/>Design,
Setting, and Participant(s): A prespecified secondary post hoc analysis of
the double-blind, multicenter randomized clinical Assessment of Clinical
Effects of Cholesteryl Ester Transfer Protein Inhibition With Evacetrapib
in Patients at a High Risk for Vascular Outcomes (ACCELERATE) trial was
conducted between October 1, 2012, and December 31, 2013; the study was
terminated October 12, 2015. The study was conducted at 543 academic and
community hospitals in 36 countries among 12 092 patients at high risk of
CV disease (acute coronary syndrome, stroke, peripheral arterial disease,
or type 2 diabetes with coronary artery disease) with measurable Lp(a) and
high-sensitivity C-reactive protein (hsCRP) levels during treatment.
Statistical analysis for this post hoc analysis was performed from
September 26, 2018, to March 28, 2020. <br/>Intervention(s): Participants
received evacetrapib, 130 mg/d, or matching placebo. <br/>Main Outcomes
and Measures: The ACCELERATE trial found no significant benefit or harm of
evacetrapib on 30-month major adverse cardiovascular events (CV death,
myocardial infarction [MI], stroke, coronary revascularization, or
hospitalization for unstable angina). This secondary analysis evaluated
rates of CV death, MI, and stroke across levels of Lp(a). <br/>Result(s):
High-sensitivity C-reactive protein and Lp(a) levels were measured in 10
503 patients (8135 men; 8561 white; 10 134 received concurrent statins;
mean [SD] age, 64.6 [9.4] years). In fully adjusted analyses, in patients
with hsCRP of 2 mg/L or more but not less than 2 mg/L, increasing
quintiles of Lp(a) were significantly associated with greater rates of
death, MI, and stroke (P=.006 for interaction). Each unit increase in log
Lp(a) levels was associated with a 13% increased risk of CV death,
nonfatal MI, or stroke only in those with hsCRP levels of 2 mg/L or more
(P=.008 for interaction). There was also a significant stepwise
relationship between increasing Lp(a) quintiles and time to first CV
death, MI, or stroke (log-rank P<.001) when hsCRP levels were 2 mg/L or
more but not less than 2 mg/L. Sensitivity analyses in the ACCELERATE
placebo-treated group yielded similar significant associations exclusively
in the group with hsCRP of 2 mg/L or more. <br/>Conclusions and Relevance:
Elevated Lp(a) levels during treatment are related to CV death, MI, and
stroke when hsCRP levels are 2 mg/L or more but not less than 2mg/L. This
finding suggests a potential benefit of lowering Lp(a) in patients with
residual systemic inflammation despite receipt of optimal medical therapy.
Trial Registration: ClinicalTrials.gov Identifier: NCT01687998.

<80>
Accession Number
632302225
Title
Effects of inhaled nitric oxide on haemodynamics and gas exchange in
children after having undergone cardiac surgery utilising cardiopulmonary
bypass.
Source
Cardiology in the young. (pp 1-6), 2020. Date of Publication: 23 Jun 2020.
Author
Villarreal E.G.; Aiello S.; Evey L.W.; Flores S.; Loomba R.S.
Institution
(Villarreal, Evey, Flores) Texas Children's Hospital/Baylor School of
Medicine, TX, Houston, United States
(Villarreal) Tecnologico de Monterrey, Escuela de Medicina y Ciencias de
la Salud, Monterrey, Nuevo Leon, Mexico
(Aiello, Loomba) Chicago Medical School/Rosalind Franklin University of
Medicine and Science, North Chicago, United States
(Loomba) Advocate Children's Hospital, Oak Lawn, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: For CHD patients undergoing corrective surgery utilising
cardiopulmonary bypass, post-operative inhaled nitric oxide has been
administered to alleviate pulmonary hypertension. We performed a
systematic review and meta-analyses to determine the effect of inhaled
nitric oxide on haemodynamics, gas exchange, and hospitalisation
characteristics in children immediately after cardiopulmonary bypass.
MATERIALS AND METHODS: A systematic review of the literature was performed
to identify full-text manuscripts in English. PubMed, EMBASE, and the
Cochrane databases were queried. Once manuscripts were identified for
inclusion, a list of all the endpoints in each manuscript was created.
Endpoints with data present from two or more studies were then kept for
pooled analyses. All endpoints included were continuous variables and so
mean and standard deviation were utilised as the effect data for
comparison. <br/>RESULT(S): A total of eight studies were deemed
appropriate for inclusion. There were significant differences with
decreases in mean pulmonary artery pressure of -6.82 mmHg, left atrial
pressure of -1.16 mmHg, arteriovenous oxygen difference of -1.63, arterial
carbon dioxide concentration of -2.41 mmHg, mechanical ventilation
duration of -8.56 hours, and length of cardiac ICU stay duration of -0.91
days. All significant variables achieved p < 0.001. <br/>CONCLUSION(S):
Inhaled nitric oxide in children immediately after cardiopulmonary bypass
decreases mean pulmonary artery pressure significantly and decreases the
arterial carbon dioxide concentration significantly without significantly
altering other haemodynamic parameters. This results in a statistically
shorter duration of mechanical ventilation and cardiac ICU length of stay
without altering overall hospital length of stay.

<81>
Accession Number
632302218
Title
A comparison of figure-of-8-suture vs manual compression for venous access
closure after cardiac procedures: An updated meta-analysis.
Source
Pacing and clinical electrophysiology : PACE. (no pagination), 2020. Date
of Publication: 08 Jul 2020.
Author
Mujer M.T.; Al-Abcha A.; Flores J.; Saleh Y.; Robinson P.
Institution
(Mujer, Al-Abcha, Saleh) Department of Medicine, Michigan State
University, MI, East Lansing, United States
(Flores) University of the Philippines College of Medicine, Manila,
Philippines
(Robinson) Pat and Jim Calhoun Cardiology Center, University of
Connecticut, CT, Farmington, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Manual compression (MC) is the current standard to achieve
post-procedural hemostasis in patients who need venous vascular access
closure after cardiovascular procedures. Figure-of-8 (F8) suture for
venous access closure has been reported to be a safe and efficacious
alternative to MC. <br/>METHOD(S): A systematic search was done using
PubMed, Google Scholar, EMBASE, SCOPUS and ClinicalTrials.gov without
language restriction up until April 15, 2020 for studies comparing F8
suture vs MC. Risk ratio (RR) and mean difference (MD) with 95% confidence
interval (CI) were calculated using a random effects model.
<br/>RESULT(S): Time to achieve hemostasis was significantly reduced in
the F8 arm [MD -21.04 mins (95% CI: -35.66 to -6.42; p = .005)]. Access
site bleeding was significantly lower in the F8 group [RR 0.35 (95% CI:
0.18 to 0.66; p = 0.001)] along with a lower incidence of hematoma
formation [RR 0.42 (95% CI 0.26 to 0.67; p = 0.0003)]. There was no
significant difference in rates of fistula or pseudoaneurysm formation
between the two groups. Overall access site complications were lower in
the F8 arm [RR 0.38 (95% CI: 0.26 to 0.55; p<0.00001)] and the effect was
more pronounced for sheaths >=10 Fr [RR 0.33 (95% CI: 0.18 to 0.60; p =
0.0003)]. There was lower post-procedural protamine use in the F8 group
[RR 0.07 (95% CI:0.01 to 0.36; p = 0.001)]. <br/>CONCLUSION(S): For
large-bore venous access closure, the F8 suture results in a shortened
time to achieve hemostasis along with a lower overall risk of access site
complications and post-procedural protamine use. This article is protected
by copyright. All rights reserved.

<82>
Accession Number
632300114
Title
Re: "Critical appraisal on the impact of preoperative rehabilitation and
outcomes after major abdominal and cardiothoracic surgery: A systematic
review and meta-analysis"-Counting rules are critical.
Source
Surgery. (no pagination), 2020. Date of Publication: 04 Jul 2020.
Author
Bundred J.R.; Kamarajah S.K.
Institution
(Bundred) Leeds Teaching Hospitals National Health Service Trust, Beckett
Street, Leeds, United Kingdom
(Kamarajah) Department of Hepatobiliary, Pancreatic and Transplant
Surgery, Freeman Hospital, Tyne and Wear, Newcastle upon Tyne, United
Kingdom
Publisher
NLM (Medline)

<83>
Accession Number
632300095
Title
Lipoprotein-associated phospholipase A2 activity, genetics and calcific
aortic valve stenosis in humans.
Source
Heart (British Cardiac Society). (no pagination), 2020. Date of
Publication: 07 Jul 2020.
Author
Perrot N.; Theriault S.; Rigade S.; Chen H.Y.; Dina C.; Martinsson A.;
Boekholdt S.M.; Capoulade R.; Le Tourneau T.; Messika-Zeitoun D.; Engert
J.C.; Wareham N.J.; Clavel M.-A.; Pibarot P.; Smith J.G.; Schott J.J.;
Mathieu P.; Bosse Y.; Thanassoulis G.; Arsenault B.J.
Institution
(Perrot, Theriault, Clavel, Pibarot, Mathieu, Bosse, Arsenault) Centre de
recherche de l'Institut universitaire de cardiologie et de pneumologie de
Quebec, Quebec city, Quebec, Canada
(Perrot, Clavel, Pibarot, Arsenault) Department of Medicine, Faculty of
Medicine, Universite Laval, Quebec City, Quebec, Canada
(Theriault) Department of Molecular Biology, Medical Biochemistry and
Pathology, Faculty of Medicine, Universite Laval, Quebec City, Quebec,
Canada
(Rigade, Dina, Capoulade, Schott) l'institut du thorax, INSERM, CNRS, UNIV
Nantes, CHU Nantes, Nantes, France
(Chen, Engert, Thanassoulis) McGill University Health Center Research
Institute, Montreal, QC, Canada
(Martinsson, Smith) Department of Cardiology, Clinical Sciences, Lund
University, Lund, Sweden
(Martinsson) Department of Cardiology, Sahlgrenska universitetssjukhuset,
Goteborg, Sweden
(Boekholdt) Department of Cardiology, University of Amsterdam, Amsterdam,
Netherlands
(Le Tourneau) Ultrasound and Cardiology Departments, University Hospital,
Institut du Thorax, Nantes, France
(Messika-Zeitoun) University of Ottawa Heart Institute, APHP, Bichat
Hospital, Ottawa, ON, Canada
(Wareham) Department of Public Health and Primary Care, University of
Cambridge, Cambridge, United Kingdom
(Smith) Wallenberg Center for Molecular Medicine and Lund University
Diabetes Center, Lund University, Lund, Sweden
(Mathieu) Department of Surgery, Faculty of Medicine, Universite Laval,
Quebec City, QC, Canada
(Bosse) Department of Molecular Medicine, Faculty of Medicine, Universite
Laval, Quebec City, QC, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity has
been shown to predict calcific aortic valve stenosis (CAVS) outcomes. Our
objective was to test the association between plasma Lp-PLA2 activity and
genetically elevated Lp-PLA2 mass/activity with CAVS in humans. METHODS
AND RESULTS: Lp-PLA2 activity was measured in 890 patients undergoing
cardiac surgery, including 476 patients undergoing aortic valve
replacement for CAVS and 414 control patients undergoing coronary artery
bypass grafting. After multivariable adjustment, Lp-PLA2 activity was
positively associated with the presence of CAVS (OR=1.21 (95% CI 1.04 to
1.41) per SD increment). We selected four single nucleotide polymorphisms
(SNPs) at the PLA2G7 locus associated with either Lp-PLA2 mass or activity
(rs7756935, rs1421368, rs1805017 and rs4498351). Genetic association
studies were performed in eight cohorts: Quebec-CAVS (1009 cases/1017
controls), UK Biobank (1350 cases/349 043 controls), European Prospective
Investigation into Cancer and Nutrition-Norfolk (504 cases/20 307
controls), Genetic Epidemiology Research on Aging (3469 cases/51 723
controls), Malmo Diet and Cancer Study (682 cases/5963 controls) and three
French cohorts (3123 cases/6532 controls), totalling 10 137 CAVS cases and
434585 controls. A fixed-effect meta-analysis using the inverse-variance
weighted method revealed that none of the four SNPs was associated with
CAVS (OR=0.99 (95% CI 0.96 to 1.02, p=0.55) for rs7756935, 0.97 (95% CI
0.93 to 1.01, p=0.11) for rs1421368, 1.00 (95% CI 1.00 to 1.01, p=0.29)
for rs1805017, and 1.00 (95% CI 0.97 to 1.04, p=0.87) for rs4498351).
<br/>CONCLUSION(S): Higher Lp-PLA2 activity is significantly associated
with the presence of CAVS and might represent a biomarker of CAVS in
patients with heart disease. Results of our genetic association study
suggest that Lp-PLA2 is however unlikely to represent a causal risk factor
or therapeutic target for CAVS.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2020. No commercial re-use. See rights and permissions.
Published by BMJ.

<84>
Accession Number
617220467
Title
66th Annual Scientific Session of the American College of Cardiology and
i2 Summit: Innovation in Intervention, ACC.17.
Source
Journal of the American College of Cardiology. Conference: 66th Annual
Scientific Session of the American College of Cardiology and i2 Summit:
Innovation in Intervention, ACC.17. United States. 69 (11 Supplement 1)
(no pagination), 2017. Date of Publication: 21 Mar 2017.
Author
Anonymous
Publisher
Elsevier USA

<85>
Accession Number
358925635
Title
Effect of gabapentin on pain after cardiac surgery: A randomised,
double-blind, placebo-controlled trial.
Source
Anaesthesia and Intensive Care. 38 (3) (pp 445-451), 2010. Date of
Publication: May 2010.
Author
Rapchuk I.L.; O'Connell L.; Liessmann C.D.; Cornelissen H.R.; Fraser J.F.
Institution
(Rapchuk, O'Connell, Liessmann, Cornelissen, Fraser) Departments of
Anaesthesia, Critical Care Research Group, Prince Charles Hospital,
Chermside, QLD, Australia
Publisher
Australian Society of Anaesthetists
Abstract
This study evaluated whether perioperative administration of gabapentin in
cardiac surgery patients could reduce postoperative opioid consumption,
postoperative sleep or perceived quality of recovery. This randomised
controlled trial assigned 60 patients undergoing cardiac surgery to
receive 1200 mg of gabapentin or placebo two hours preoperatively, and
then 600 mg of gabapentin or placebo twice a day for the next two
postoperative days. Postoperative opioid use was measured by the amount of
fentanyl used in the first 48 hours postoperatively. Pain at rest and with
movement at 12, 24, 48 and 72 hours after surgery, sleep scores on
postoperative days two and three and patient-perceived quality of recovery
were also assessed. Fentanyl use, visual analog pain scores, sleep scores,
adjunctive pain medication use and number of anti-emetics given were not
significantly different between the gabapentin and placebo groups. The
incidence of side-effects was similar between the gabapentin and placebo
groups, and no difference was found between groups in relation to quality
of recovery. These findings indicate that preoperative use of gabapentin
followed by postoperative dosing for two days did not significantly affect
the postoperative pain, sleep, opioid consumption or patient-perceived
quality of recovery for patients undergoing cardiac surgery.

<86>
Accession Number
632132808
Title
Dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 receptor
agonists and sodium-glucose co-transporter-2 inhibitors for people with
cardiovascular disease: a network meta-analysis.
Source
Cochrane Database of Systematic Reviews. 2020 (6) (no pagination), 2020.
Article Number: CD013650. Date of Publication: 24 Jun 2020.
Author
Kanie T.; Mizuno A.; Yoneoka D.; Tam W.W.S.; Morze J.; Rynkiewicz A.; Xin
Y.; Wu O.; Kwong J.S.W.
Institution
(Kanie, Mizuno) Department of Cardiology, St. Luke's International
Hospital, Tokyo, Japan
(Yoneoka) Division of Biostatistics and Bioinformatics, Graduate School of
Public Health, St. Luke's International University, Tokyo, Japan
(Tam) Alice Lee Centre for Nursing Studies, National University of
Singapore, National University Health System, Singapore, Singapore
(Morze) Department of Human Nutrition, University of Warmia and Mazury,
Olsztyn, Poland
(Rynkiewicz) Department of Cardiology and Cardiosurgery, School of
Medicine, University of Warmia and Mazury, Olsztyn, Poland
(Xin, Wu) Health Economics and Health Technology Assessment (HEHTA),
Institute of Health and Wellbeing, University of Glasgow, Glasgow, United
Kingdom
(Kwong) Global Health Nursing, Graduate School of Nursing Science, St.
Luke's International University, Tokyo, Japan
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. To systematically review the available
evidence on the effects (benefits and harms) of DPP-4 inhibitors, GLP-1
receptor agonists, and SGLT-2 inhibitors in people with established CVD,
using network meta-analysis.<br/>Copyright &#xa9; 2020 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<87>
Accession Number
2006965518
Title
Ramipril in High-Risk Patients With COVID-19.
Source
Journal of the American College of Cardiology. 76 (3) (pp 268-276), 2020.
Date of Publication: 21 July 2020.
Author
Amat-Santos I.J.; Santos-Martinez S.; Lopez-Otero D.; Nombela-Franco L.;
Gutierrez-Ibanes E.; Del Valle R.; Munoz-Garcia E.; Jimenez-Diaz V.A.;
Regueiro A.; Gonzalez-Ferreiro R.; Benito T.; Sanmartin-Pena X.C.; Catala
P.; Rodriguez-Gabella T.; Delgado-Arana J.R.; Carrasco-Moraleja M.; Ibanez
B.; San Roman J.A.
Institution
(Amat-Santos, Santos-Martinez, Catala, Rodriguez-Gabella, Delgado-Arana,
Carrasco-Moraleja, San Roman) Cardiology Department, Centro de
Investigacion Biomedica en Red Enfermedades Cardiovaculares (CIBERCV),
Hospital Clinico Universitario, Valladolid, Spain
(Lopez-Otero, Sanmartin-Pena) CIBERCV, Hospital Clinico Universitario de
Santiago, Santiago de Compostela, Spain
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos, El
Instituto de Investigacion Sanitaria San Carlos, Madrid, Spain
(Gutierrez-Ibanes) CIBERCV, Hospital General Gregorio Maranon and
Universidad Carlos III, Madrid, Spain
(Del Valle) Hospital Universitario Central de Asturias, Oviedo, Spain
(Munoz-Garcia) CIBERCV, Hospital Virgen de la Victoria, Malaga, Spain
(Jimenez-Diaz) Hospital Universitario de Vigo, Vigo, Spain
(Regueiro) Hospital Clinic Univeristari, Barcelona, Spain
(Gonzalez-Ferreiro) Hospital Clinico Universitario, Salamanca, Spain
(Benito) Hospital Universitario de Leon, Leon, Spain
(Ibanez) CIBERCV, Centro Nacional de Investigaciones Cardiovasculares,
IIS-Hospital Fundacion Jimenez Diaz, Madrid, Spain
Publisher
Elsevier USA
Abstract
Background: Coronavirus disease-2019 (COVID-19) is caused by severe acute
respiratory-syndrome coronavirus-2 that interfaces with the
renin-angiotensin-aldosterone system (RAAS) through angiotensin-converting
enzyme 2. This interaction has been proposed as a potential risk factor in
patients treated with RAAS inhibitors. <br/>Objective(s): This study
analyzed whether RAAS inhibitors modify the risk for COVID-19.
<br/>Method(s): The RASTAVI (Renin-Angiotensin System Blockade Benefits in
Clinical Evolution and Ventricular Remodeling After Transcatheter Aortic
Valve Implantation) trial is an ongoing randomized clinical trial randomly
allocating subjects to ramipril or control groups after successful
transcatheter aortic valve replacement at 14 centers in Spain. A
non-pre-specified interim analysis was performed to evaluate ramipril's
impact on COVID-19 risk in this vulnerable population. <br/>Result(s): As
of April 1, 2020, 102 patients (50 in the ramipril group and 52 in the
control group) were included in the trial. Mean age was 82.3 +/- 6.1
years, 56.9% of the participants were male. Median time of ramipril
treatment was 6 months (interquartile range: 2.9 to 11.4 months). Eleven
patients (10.8%) have been diagnosed with COVID-19 (6 in control group and
5 receiving ramipril; hazard ratio: 1.150; 95% confidence interval: 0.351
to 3.768). The risk of COVID-19 was increased in older patients (p =
0.019) and those with atrial fibrillation (p = 0.066), lower hematocrit (p
= 0.084), and more comorbidities according to Society of Thoracic Surgeons
score (p = 0.065). Admission and oxygen supply was required in 4.9% of
patients (2 in the ramipril group and 3 in the control group), and 4 of
them died (2 in each randomized group). A higher body mass index was the
only factor increasing the mortality rate (p = 0.039). <br/>Conclusion(s):
In a high-risk population of older patients with cardiovascular disease,
randomization to ramipril had no impact on the incidence or severity of
COVID-19. This analysis supports the maintenance of RAAS inhibitor
treatment during the COVID-19 crisis. (Renin-Angiotensin System Blockade
Benefits in Clinical Evolution and Ventricular Remodeling After
Transcatheter Aortic Valve Implantation [RASTAVI];
NCT03201185)<br/>Copyright &#xa9; 2020 American College of Cardiology
Foundation

<88>
Accession Number
2006955114
Title
Dexmedetomidine pretreatment attenuates myocardial ischemia reperfusion
induced acute kidney injury and endoplasmic reticulum stress in human and
rat.
Source
Life Sciences. 257 (no pagination), 2020. Article Number: 118004. Date of
Publication: 15 September 2020.
Author
Tang C.; Hu Y.; Gao J.; Jiang J.; Shi S.; Wang J.; Geng Q.; Liang X.; Chai
X.
Institution
(Tang, Wang, Geng, Chai) Department of Anesthesiology, The First
Affiliated Hospital of USTC, Division of Life Sciences and Medicine,
University of Science and Technology of China, Hefei, Anhui 230001, China
(Hu, Shi) Department of Anesthesiology, Renmin Hospital of Wuhan
University, Wuhan, Hubei 430060, China
(Gao) Department of Anesthesia, Critical Care & Pain Medicine,
Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144,
United States
(Jiang) Department of Emergency, Huashan Hospital North, Fudan University,
Shanghai 201907, China
(Liang) Department of Clinical Laboratory, The First Affiliated Hospital
of USTC, Division of Life Sciences and Medicine, University of Science and
Technology of China, Hefei, Anhui 230000, China
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Patients undergoing cardiopulmonary bypass (CPB) often develop
acute kidney injury (AKI) caused by myocardial ischemia reperfusion
(MI/R), and this renal injury can be resolved notably by dexmedetomidine.
Endoplasmic reticulum (ER) stress was reported to get involved in organ
injury including AKI. <br/>Objective(s): The current study aimed to
address the correlation between MI/R induced AKI with ER stress and to
assess the effects of dexmedetomidine pretreatment on AKI protection.
<br/>Method(s): Patients selected for heart valve replacement surgery were
randomly assigned to NS group (pre-anesthesia with 0.9% NaCl) and DEX
group (pre-anesthesia with dexmedetomidine). Rat MI/R model was induced by
occluding coronary artery for 30 min followed by 48-hour reperfusion. Rats
were randomized into Sham (0.9% NaCl), I/R (MI/R + 0.9% NaCl) and I/R +
DEX (MI/R + dexmedetomidine). Organ function and ER stress condition were
evaluated by blood chemistry, pathology, and molecular test.
<br/>Result(s): Clinical data indicated dexmedetomidine pretreatment
attenuated AKI and oxidative stress as well as postischemic myocardial
injury in patients. Accordingly animal results suggested dexmedetomidine
reduced cellular injury and improved postischemic myocardial and renal
function. Dexmedetomidine also reduced myocardial and renal cells
apoptosis and down-regulated ER stress. <br/>Conclusion(s): These results
suggested that dexmedetomidine pretreatment attenuates MI/R injury-induced
AKI by relieving the ER stress.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<89>
Accession Number
629590694
Title
Stable Hemodynamics within "No-Touch" Saphenous Vein Graft.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 26 (2) (pp
88-94), 2020. Date of Publication: 20 Apr 2020.
Author
Jiang Q.; Yang Y.; Sun H.; Tang Y.; Lv F.; Hu S.
Institution
(Jiang) Department of Cardiac Surgery, Sichuan Provincial People's
Hospital; Affiliated Hospital of University of Electronic Science and
Technology, Chengdu, China
(Jiang, Yang, Sun, Tang, Lv, Hu) Department of Cardiac Surgery, Fuwai
Hospital, National Center for Cardiovascular Disease, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
Publisher
NLM (Medline)
Abstract
PURPOSE: To investigate the hemodynamics characteristics of the "no-touch"
saphenous vein graft (SVG) conduits by nicardipine intraluminal
administration in vivo experiment. <br/>METHOD(S): A total of 59
consecutive patients were enrolled and underwent a sequential SVG to three
non-left anterior descending (LAD) targets with the average runoff <=2 mm,
30 with "no-touch" harvest technique (group A) and 29 with conventional
preparation (group B). The patients were subject to nicardipine
intraluminal injection during off-pump coronary artery bypass grafting
(CABG) procedure. The intraoperative flow was measured with the ultrasonic
transit time flow meter (TTFM), and the graft patency testified by
multi-detector computed tomography (MDCT) angiography, respectively.
<br/>RESULT(S): The baseline blood flow was higher in group A than that in
group B (p <0.05). However, the increases in blood flow of SVG conduits in
group A were lower than those in group B with 19.7 +/- 5.9 vs. 35.4 +/-
9.2 mL/min, 14.8 +/- 5.6 vs. 23.1 +/- 6.8 mL/min, 6.6 +/- 2.1 vs. 11.2 +/-
4.3 mL/min before the first, second, and third anastomose after
nicardipine intraluminal administration, respectively (all p <0.01).
<br/>CONCLUSION(S): No-touch SVGs were associated with higher baseline
blood flow and less rises after nicardipine intraluminal administration
during off-pump CABG procedure compared with conventional preparation. The
no-touch SVGs seemed to be less spastic and well-tolerated on flow
dilatation.

<90>
Accession Number
2003620547
Title
Are segmentectomy and lobectomy comparable in terms of curative intent for
early stage non-small cell lung cancer?.
Source
General Thoracic and Cardiovascular Surgery. 68 (7) (pp 703-706), 2020.
Date of Publication: 01 Jul 2020.
Author
Mimae T.; Okada M.
Institution
(Mimae, Okada) Department of Surgical Oncology, Hiroshima University,
1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
Publisher
Springer
Abstract
In 1995, Ginsberg et al. compared lobectomy with limited resection
including segmentectomy and wide-wedge resection for stage I lung cancer
in a randomized controlled trial and found that limited resection should
not be applied to otherwise healthy patients with clinical stage IA lung
cancer who can tolerate lobectomy. However, recent advances in diagnostic
technology have improved the precision of detecting early-stage and small
lung cancers. Therefore, whether radical segmentectomy, anatomical
segmentectomy with hilar and mediastinal lymph node dissection (that is
more valuable than wedge resection in terms of oncological aspects) and
lobectomy are comparable in terms of curative intent for patients with
early-stage non-small cell lung cancer (NSCLC) remains controversial. The
role of segmentectomy differs according to tumor or patient
characteristics. High resolution computed tomography findings of tumor
size, location, and the presence or ratio of a ground glass opacity (GGO)
component and the maximum of standardized uptake value on
fluorine-18-2-deoxy-d-glucose positron emission tomography are important
for selecting surgical procedures because the malignant potential of even
early-stage NSCLC is variable. The ongoing JCOG0802/WJOG4607L, JCOG1211,
and CALGB140503 trials will disclose the influence of segmentectomy for
patients with early-staged NSCLCs that are small peripheral tumors based
on preoperative high-resolution computed tomography findings about
preserved pulmonary function and long-term prognosis. Segmentectomy is a
key surgical procedure that general thoracic surgeons will need to master
considering that it can be converted to lobectomy if the surgical margin
is insufficient or lymph node metastasis is intraoperatively
confirmed.<br/>Copyright &#xa9; 2019, The Japanese Association for
Thoracic Surgery.

<91>
Accession Number
629881499
Title
Transcatheter versus surgical aortic valve replacement in low-risk
surgical patients: A meta-analysis of randomized clinical trials.
Source
Cardiovascular revascularization medicine : including molecular
interventions. 20 (10) (pp 838-842), 2019. Date of Publication: 01 Oct
2019.
Author
Kheiri B.; Osman M.; Abubakar H.; Subahi A.; Chahine A.; Ahmed S.; Bachuwa
G.; Alkotob M.L.; Hassan M.; Bhatt D.L.
Institution
(Kheiri, Chahine, Ahmed, Bachuwa) Department of Internal Medicine, Hurley
Medical Center, Michigan State University, MI, Flint, United States
(Osman) Division of Cardiology, West Virginia University School of
Medicine, Morgantown, United States
(Abubakar, Subahi) Department of Internal Medicine, Wayne State
University, MI, Detroit, United States
(Alkotob, Hassan) Division of Cardiology, Hurley Medical Center, Michigan
State University, MI, Flint, United States
(Bhatt) Brigham and Women's Hospital Heart & Vascular Center, Harvard
Medical School, MA, Boston, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a valid
option for patients with high or intermediate surgical risk. However,
clinical outcomes of TAVR in low-risk patients are lacking. Our aim was to
evaluate the efficacy and safety of TAVR versus surgical aortic valve
replacement (SAVR) in low-surgical-risk patients. <br/>METHOD(S):
Electronic database review was conducted for all randomized clinical
trials (RCTs) that compared TAVR versus SAVR in low-risk patients. We
calculated risk ratios (RRs) and 95% confidence intervals (CIs) using a
random-effects model. <br/>RESULT(S): We included 3 RCTs totaling 604
patients (310 TAVR and 294 SAVR). Our results showed no significant
difference in mortality between TAVR compared with SAVR (RR=0.71; 95%
CI=0.22-2.30; P=0.56), however, there was a significantly increased risk
of pacemaker implantation (RR=7.28; 95% CI=3.94-13.42; P<0.01) and
moderate/severe paravalvular leakage (PVL) (RR=6.74; 95% CI=1.31-34.65;
P=0.02) with TAVR. Nevertheless, TAVR demonstrated a significantly reduced
risk of post-procedural bleeding (RR=0.40; 95% CI=0.30-0.54; P<0.01) and
new-onset atrial fibrillation (RR=0.36; 95% CI=0.27-0.47; P<0.01). Other
clinical outcomes were not significantly different between the groups and
included cardiovascular mortality, stroke, transient ischemic attack, and
myocardial infarction. <br/>CONCLUSION(S): Among low-risk patients, TAVR
offered comparable efficacy outcomes and fewer bleeding events compared
with SAVR. There were increased risks of pacemaker implantation and PVL
associated with TAVR, though lower atrial fibrillation
risks.<br/>Copyright &#xa9; 2018 Elsevier Inc. All rights reserved.

<92>
Accession Number
2005518876
Title
Comparison of the proximal and distal approaches for axillary vein
catheterization under ultrasound guidance (PANDA) in cardiac surgery
patients susceptible to bleeding: a randomized controlled trial.
Source
Annals of Intensive Care. 10 (1) (no pagination), 2020. Article Number:
90. Date of Publication: 01 Dec 2020.
Author
Su Y.; Hou J.-Y.; Ma G.-G.; Hao G.-W.; Luo J.-C.; Yu S.-J.; Liu K.; Zheng
J.-L.; Xue Y.; Luo Z.; Tu G.-W.
Institution
(Su, Hou, Ma, Hao, Luo, Yu, Liu, Luo, Tu) Department of Critical Care
Medicine, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road,
Xuhui District, Shanghai 200032, China
(Zheng, Xue) Department of Nursing, Zhongshan Hospital, Fudan University,
No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China
(Luo) Department of Critical Care Medicine, Xiamen Branch, Zhongshan
Hospital, Fudan University, No. 668 Jinghu Road, Huli District, Xiamen
361015, China
Publisher
Springer
Abstract
Background: The present study aimed at comparing the success rate and
safety of proximal versus distal approach for ultrasound (US)-guided
axillary vein catheterization (AVC) in cardiac surgery patients
susceptible to bleeding. <br/>Method(s): In this single-center randomized
controlled trial, cardiac surgery patients susceptible to bleeding and
requiring AVC were randomized to either the proximal or distal approach
group for US-guided AVC. Patients susceptible to bleeding were defined as
those who received oral antiplatelet drugs or anticoagulants for at least
3 days. Success rate, catheterization time, number of attempts, and
mechanical complications within 24 h were recorded for each procedure.
<br/>Result(s): A total of 198 patients underwent randomization: 99
patients each to the proximal and distal groups. The proximal group had
the higher first puncture success rate (75.8% vs. 51.5%, p < 0.001) and
site success rate (93.9% vs. 83.8%, p = 0.04) than the distal group.
However, the overall success rates between the two groups were similar
(99.0% vs. 99.0%; p = 1.00). Moreover, the proximal group had fewer
average number of attempts (p < 0.01), less access time (p < 0.001), and
less successful cannulation time (p < 0.001). There was no significant
difference in complications between the two groups, such as major
bleeding, minor bleeding, arterial puncture, pneumothorax, nerve injuries,
and catheter misplacements. <br/>Conclusion(s): For cardiac surgery
patients susceptible to bleeding, both proximal and distal approaches for
US-guided AVC can be considered as feasible and safe methods of central
venous cannulation. In terms of the first puncture success rate and
cannulation time, the proximal approach is superior to the distal
approach. Trial registration Clinicaltrials.gov, NCT03395691. Registered
January 10, 2018,
https://clinicaltrials.gov/ct2/show/NCT03395691?cond=NCT03395691&draw=1&ra
nk=1.<br/>Copyright &#xa9; 2020, The Author(s).

<93>
Accession Number
2005474174
Title
Will urinary biomarkers provide a breakthrough in diagnosing cardiac
surgery-associated AKI?-A systematic review.
Source
Biomarkers. 25 (5) (pp 375-383), 2020. Date of Publication: 03 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, United States
Publisher
Taylor and Francis Ltd
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.<br/>Copyright &#xa9; 2020, &#xa9; 2020 Informa
UK Limited, trading as Taylor & Francis Group.

<94>
Accession Number
2007001446
Title
Assessment of Disease Progression in Patients With Repaired Tetralogy of
Fallot Using Cardiac Magnetic Resonance Imaging: A Systematic Review.
Source
Heart Lung and Circulation. (no pagination), 2020. Date of Publication:
2020.
Author
Mohamed I.; Stamm R.; Keenan R.; Lowe B.; Coffey S.
Institution
(Mohamed, Stamm, Coffey) Department of Medicine - HeartOtago, Dunedin
School of Medicine, University of Otago, Dunedin, New Zealand
(Keenan) Pacific Radiology Group, Christchurch, New Zealand
(Keenan) Department of Radiology, University of Otago, Christchurch, New
Zealand
(Lowe) Auckland District Health Board, Auckland, New Zealand
Publisher
Elsevier Ltd
Abstract
Aims: Tetralogy of Fallot (ToF) is the most common cyanotic congenital
heart disease with a growing population of adult survivors. Late pulmonary
outflow tract and pulmonary valve postoperative complications are
frequent, leading to long-term risks such as right heart failure and
sudden death secondary to arrhythmias. Cardiac magnetic resonance imaging
(CMR) is the gold standard for assessment of cardiac function in patients
with repaired ToF. We aimed to determine the most useful CMR predictors of
disease progression and the optimal frequency of CMR. <br/>Methods and
Results: We systematically reviewed PubMed from inception until 29 April
2019 for longitudinal studies assessing the relationship between CMR
features and disease progression in repaired ToF. Fourteen (14) studies
were identified. Multiple studies showed that impaired right and left
ventricular function predict subsequent disease progression. Right
ventricular end diastolic volume, while being associated with disease
progression when analysed alone, was generally not associated with disease
progression on multivariate analysis. Severity of tricuspid regurgitation
and pulmonary regurgitant likewise did not show a consistent association
with subsequent events. A number of non-CMR factors were also identified
as being associated with disease progression, in particular QRS duration
and older age at repair. Restrictive right ventricular physiology was not
consistently an independent predictor of events. <br/>Conclusion(s):
Impaired right and left ventricular function are the most consistent
independent predictors of disease progression in repaired ToF. The optimal
timing of repeat cardiac imaging remains controversial. Large scale
prospective studies will provide important information to guide clinical
decision making in this area.<br/>Copyright &#xa9; 2020 Australian and New
Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac
Society of Australia and New Zealand (CSANZ)

<95>
Accession Number
2007001317
Title
Durable circulatory support with a paracorporeal device as an option for
pediatric and adult heart failure patients.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Bartfay S.-E.; Dellgren G.; Hallhagen S.; Wahlander H.; Dahlberg P.;
Redfors B.; Ekelund J.; Karason K.
Institution
(Bartfay, Dahlberg, Karason) Department of Cardiology, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Bartfay, Dellgren, Dahlberg, Karason) Institute of Medicine, Sahlgrenska
Academy, University of Gothenburg, Gothenburg, Sweden
(Dellgren) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Dellgren, Karason) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Hallhagen, Wahlander) Department of Pediatric Cardiology, Queen Silvia
Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
(Hallhagen, Wahlander, Redfors) Institute of Clinical Sciences,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Redfors) Department of Cardiothoracic Anesthesia and Intensive Care,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Ekelund) Centre of Registers Vastra Gotaland, Sahlgrenska University
Hospital, Gothenburg, Sweden
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objectives: Not all patients in need of durable mechanical circulatory
support are suitable for a continuous-flow left ventricular assist device.
We describe patient populations who were treated with the paracorporeal
EXCOR, including children with small body sizes, adolescents with complex
congenital heart diseases, and adults with biventricular failure.
<br/>Method(s): Information on clinical data, echocardiography, invasive
hemodynamic measurements, and surgical procedures were collected
retrospectively. Differences between various groups were compared.
<br/>Result(s): Between 2008 and 2018, a total of 50 patients (21 children
and 29 adults) received an EXCOR as bridge to heart transplantation or
myocardial recovery. The majority of patients had heart failure compatible
with Interagency Registry for Mechanically Assisted Circulatory Support
profile 1. At year 5, the overall survival probability for children was
90%, and for adults 75% (P = .3). After we pooled data from children and
adults, the survival probability between patients supported by a
biventricular assist device was similar to those treated with a left
ventricular assist device/ right ventricular assist device (94% vs 75%,
respectively, P = .2). Patients with dilated cardiomyopathy had a trend
toward better survival than those with other heart failure etiologies (92%
vs 70%, P = .05) and a greater survival free from stroke (92% vs 64%, P =
.01). Pump house exchange was performed in nine patients due to chamber
thrombosis (n = 7) and partial membrane rupture (n = 2). There were 14
cases of stroke in eleven patients. <br/>Conclusion(s): Despite severe
illness, patient survival on EXCOR was high, and the long-term overall
survival probability following heart transplantation and recovery was
advantageous. Treatment safety was satisfactory, although still hampered
by thromboembolism, mechanical problems, and infections.<br/>Copyright
&#xa9; 2020 The American Association for Thoracic Surgery

<96>
Accession Number
2005499667
Title
Effects of thoracic nerve block on perioperative lung injury, immune
function, and recovery after thoracic surgery.
Source
Clinical and Translational Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Zhang W.; Cong X.; Zhang L.; Sun M.; Li B.; Geng H.; Gu J.; Zhang J.
Institution
(Zhang, Cong, Zhang, Sun, Li, Geng, Zhang) Department of Anesthesiology
and Perioperative Medicine, Center for Clinical Single Cell Biomedicine,
Henan Provincial People's Hospital, People's Hospital of Zhengzhou
University, Zhengzhou, Henan, China
(Gu) Department of General Medicine, Henan Provincial People's Hospital,
People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Background: To investigate the effects of thoracic nerve block on
perioperative lung injury, immune function, and recovery after thoracic
surgery. <br/>Method(s): A total of 120 patients with lung cancer were
randomly allocated into three groups: general anesthesia group (GAL
group), thoracic paravertebral nerve block (TPVB) combined with general
anesthesia (TPL group), and TPVB (with paravertebral dexmedetomidine)
combined with general anesthesia group (TDL group); 120 patients with
esophageal cancer were randomly allocated into three groups: general
anesthesia group (GAE group), TPVB combined with general anesthesia group
(TPE group), and thoracic epidural block combined with general anesthesia
group (TEE group). Lung injury and immune function were evaluated.
Hemodynamic changes, early recovery in post-anesthesia care unit, pain,
6-min walking test (6MWT), drug consumption, and life quality were also
observed. The duration in the PACU of patients was retrospectively
analyzed. The effect of dexmedetomidine on lung injury was established in
vitro. <br/>Result(s): The lung injury, including injury scores,
apoptosis, and inflammation, were decreased in the TDL group compared with
the GAL group and TPL group. The ratio of CD4⁺/CD8⁺
cells at the end of surgery was higher in the TPE group than in the GAE
group. More stable hemodynamic was found in TPL group and TPE group. Acute
pain was alleviated and the 6MWT was enhanced by TPVB with or without
dexmedetomidine. Anesthetic consumption was decreased by thoracic nerve
block. <br/>Conclusion(s): Thoracic nerve block, especially TPVB with or
without paravertebral dexmedetomidine, can enhance recovery after thoracic
surgery. Protection against independent lung injury and cellular immune
dysfunction may be a potential mechanism.<br/>Copyright &#xa9; 2020 The
Authors. Clinical and Translational Medicine published by John Wiley &
Sons Australia, Ltd on behalf of Shanghai Institute of Clinical
Bioinformatics

<97>
Accession Number
2005489713
Title
Clinical Outcomes and Serologic Response in Solid Organ Transplant
Recipients with COVID-19: A Case Series from the United States.
Source
American Journal of Transplantation. (no pagination), 2020. Date of
Publication: 2020.
Author
Fung M.; Chiu C.Y.; DeVoe C.; Doernberg S.B.; Schwartz B.S.; Langelier C.;
Henrich T.J.; Yokoe D.; Davis J.; Hays S.R.; Chandran S.; Kukreja J.; Ng
D.; Prostko J.; Taylor R.; Reyes K.; Bainbridge E.; Bond A.; Chin-Hong P.;
Babik J.M.
Institution
(Fung, Chiu, DeVoe, Doernberg, Schwartz, Langelier, Henrich, Yokoe, Davis,
Bainbridge, Bond, Chin-Hong, Babik) Division of Infectious Disease,
Department of Medicine, University of California San Francisco, San
Francisco, United States
(Chiu, Ng, Reyes) Department of Laboratory Medicine, University of
California, San Francisco, CA, United States
(Chiu) UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco,
CA, United States
(Langelier) Chan Zuckerberg Biohub, San Francisco, United States
(Henrich) Division of Experimental Medicine, University of California San
Francisco, San Francisco, United States
(Hays) Division of Pulmonary, Critical Care, Allergy and Sleep Medicine,
Department of Medicine, University of California San Francisco, San
Francisco, United States
(Chandran) Division of Nephrology, Department of Medicine, University of
California San Francisco, San Francisco, United States
(Kukreja) Division of Adult Cardiothoracic Surgery, Department of Surgery,
University of California San Francisco, San Francisco, United States
(Prostko, Taylor) Abbott Laboratories, Inc, Abbott Park, IL, United States
Publisher
Blackwell Publishing Ltd
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by SARS
coronavirus 2 (SARS-CoV-2) has caused significant morbidity and mortality
for patients and stressed healthcare systems worldwide. The clinical
features, disease course, and serologic response of COVID-19 among
immunosuppressed patients such as solid organ transplant (SOT) recipients,
who are at presumed risk for more severe disease, are not well
characterized. We describe our institutional experience with COVID-19
among ten SOT patients, including the clinical presentation, treatment
modalities, and outcomes of seven renal transplant recipients, one liver
transplant recipient, one heart transplant recipient, and one lung
transplant recipient. In addition, we report the serologic response in SOT
recipients, documenting a positive IgG response in all seven hospitalized
patients. We also review the existing literature on COVID-19 in SOT
recipients to consolidate the current knowledge on COVID-19 in the SOT
population for the transplant community.<br/>Copyright This article is
protected by copyright. All rights reserved.

<98>
Accession Number
2005484465
Title
Systematic review of viscoelastic testing (TEG/ROTEM) in obstetrics and
recommendations from the women's SSC of the ISTH.
Source
Journal of Thrombosis and Haemostasis. (no pagination), 2020. Date of
Publication: 2020.
Author
Amgalan A.; Allen T.; Othman M.; Ahmadzia H.K.
Institution
(Amgalan) Georgetown University School of Medicine, Washington, DC, United
States
(Allen) Department of Anesthesiology, Duke University Hospital, Durham,
NC, United States
(Othman) Department of Biomedical and Molecular Sciences, School of
Medicine, Queen's University, Kingston, ON, Canada
(Othman) School of Baccalaureate Nursing, St. Lawrence College, Kingston,
ON, Canada
(Ahmadzia) Department of Obstetrics and Gynecology, Division of Maternal
Fetal Medicine, The George Washington University School of Medicine and
Health Sciences, Washington, DC, United States
Publisher
Blackwell Publishing Ltd
Abstract
Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are
point-of-care viscoelastic devices that use whole blood samples to assess
coagulation and fibrinolysis. These devices have been studied extensively
in cardiac surgery, but there is limited robust evidence supporting its
use in obstetrics. The hesitancy toward its routine use in obstetrics may
be due to the current lack of randomized controlled trials and large
observational studies. The study aims to systematically review studies
that investigated TEG/ROTEM use in pregnancy or peripartum, and to provide
recommendations for future studies to fill current research gaps. We
performed a systematic review of studies on viscoelastic testing in
obstetrics. Included studies were original research, used TEG or ROTEM
during pregnancy or peripartum, and published in English. Ninety-three
studies, spanning 31 years from 1989 to 2020 and with a total of 32,817
participants, were included. Sixty-two (66.7%) of the studies used TEG and
31 (33.3%) used ROTEM. To date, there are a total of two randomized
controlled trials on TEG/ROTEM use in obstetrics. ROTEM may be used to
guide transfusion therapy for postpartum hemorrhage. TEG and ROTEM can
detect the hypercoagulable changes associated with pregnancy. Variability
between study protocols and results suggests the need for future large
prospective high-quality studies with standardized protocols to
investigate the utility of TEG/ROTEM in assessing risk for thrombosis and
hemorrhage as well as in guiding prophylaxis and treatment in obstetric
patients. This review identifies the gaps and provides concrete
recommendations for future studies to fill those gaps.<br/>Copyright
&#xa9; 2020 International Society on Thrombosis and Haemostasis

<99>
Accession Number
2006809651
Title
Baroreflex Activation Therapy in Patients With Heart Failure With Reduced
Ejection Fraction.
Source
Journal of the American College of Cardiology. 76 (1) (pp 1-13), 2020.
Date of Publication: 7 July 2020.
Author
Zile M.R.; Lindenfeld J.; Weaver F.A.; Zannad F.; Galle E.; Rogers T.;
Abraham W.T.
Institution
(Zile) Medical University of South Carolina, Charleston, SC, United States
(Zile) Ralph H. Johnson Department of Veterans Affairs Medical Center,
Charleston, SC, United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, Nashville, TN,
United States
(Weaver) Division of Vascular Surgery and Endovascular Therapy, Keck
School of Medicine, University of Southern California, Los Angeles, CA,
United States
(Zannad) Inserm Centre d'Investigation, CHU de Nancy, Institute Lorrain du
Coeur et des Vaisseaux, Universite de Lorraine, Nancy, France
(Galle) CVRx, Inc., Minneapolis, MN, United States
(Rogers) NAMSA, Inc., Minneapolis, Minneapolis, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
Publisher
Elsevier USA
Abstract
Background: This study demonstrated the safety and effectiveness of
baroreflex activation therapy (BAT) in patients with heart failure with
reduced ejection fraction (HFrEF). <br/>Objective(s): The BeAT-HF
(Baroreflex Activation Therapy for Heart Failure) trial was a multicenter,
prospective, randomized, controlled trial; subjects were randomized 1:1 to
receive either BAT plus optimal medical management (BAT group) or optimal
medical management alone (control group). <br/>Method(s): Four patient
cohorts were created from 408 randomized patients with HFrEF using the
following enrollment criteria: current New York Heart Association (NYHA)
functional class III or functional class II (patients who had a recent
history of NYHA functional class III); ejection fraction <=35%; stable
medical management for >=4 weeks; and no Class I indication for cardiac
resynchronization therapy. Effectiveness endpoints were the change from
baseline to 6 months in 6-min hall walk distance (6MHW), Minnesota Living
with HF Questionnaire quality-of-life (QOL) score, and N-terminal
pro-B-type natriuretic peptide (NT-proBNP) levels. The safety endpoint
included the major adverse neurological or cardiovascular system or
procedure-related event rate (MANCE). <br/>Result(s): Results from,
timeline and rationale for, cohorts A, B, and C are presented in detail in
the text. Cohort D, which represented the intended use population that
reflected the U.S. Food and Drug Administration-approved instructions for
use (enrollment criteria plus NT-proBNP <1,600 pg/ml), consisted of 245
patients followed-up for 6 months (120 in the BAT group and 125 in the
control group). BAT was safe and significantly improved QOL, 6MHW, and
NT-proBNP. In the BAT group versus the control group, QOL score decreased
(DELTA = -14.1; 95% confidence interval [CI]: -19 to -9; p < 0.001), 6MHW
distance increased (DELTA = 60 m; 95% CI: 40 to 80 m; p < 0.001),
NT-proBNP decreased (DELTA = -25%; 95% CI: -38% to -9%; p = 0.004), and
the MANCE free rate was 97% (95% CI: 93% to 100%; p < 0.001).
<br/>Conclusion(s): BAT was safe and significantly improved QOL, exercise
capacity, and NT-proBNP. (Baroreflex Activation Therapy for Heart Failure
[BeAT-HF]; NCT02627196)<br/>Copyright &#xa9; 2020 The Authors

<100>
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).

<101>
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.

<102>
Accession Number
2005116112
Title
Impact of age on clinical outcomes of antihypertensive therapy in patients
with hypertension and coronary artery disease: A sub-analysis of the Heart
Institute of Japan Candesartan Randomized Trial for Evaluation in Coronary
Artery Disease.
Source
Journal of Clinical Hypertension. 22 (6) (pp 1070-1079), 2020. Date of
Publication: 01 Jun 2020.
Author
Kikuchi N.; Ogawa H.; Kawada-Watanabe E.; Arashi H.; Jujo K.; Sekiguchi
H.; Yamaguchi J.; Hagiwara N.
Institution
(Kikuchi, Ogawa, Kawada-Watanabe, Arashi, Jujo, Sekiguchi, Yamaguchi,
Hagiwara) Department of Cardiology, The Heart Institute of Japan, Tokyo
Women's Medical University, Tokyo, Japan
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
This study aimed to determine whether different systolic blood pressure
(SBP) measurements achieved with antihypertensive therapy impact clinical
outcomes by age in patients with hypertension and coronary artery disease
(CAD). This post hoc analysis from the Heart Institute of Japan
Candesartan Randomized Trial for Evaluation in Coronary Heart Disease
(HIJ-CREATE) trial included 2048 patients with hypertension and
angiographically documented CAD. Participants were divided into three
groups based on age at enrollment: middle-aged (<60 years, n = 570),
pre-elderly (>=60-<70 years, n = 730), and elderly (>=70 years, n = 748).
Among the 2,048 patients, 1695 (82.7%) underwent percutaneous coronary
intervention. The primary end point was the time to first occurrence of a
major adverse cardiac event (MACE). During a median follow-up of 4.2
years, the MACE rate was 19.8%, 28.1%, and 31.1% in the middle-aged,
pre-elderly, and elderly groups, respectively. Achieved BP was defined as
the mean BP during scheduled visits. Patients with higher achieved SBP had
a higher occurrence of MACE in all age groups. An unadjusted quadratic
proportional hazard model was used to evaluate the relationship between
achieved BP during follow-up and risk for MACE. In each age group,
participants were divided into quartiles based on the achieved BP during
follow-up. The relationship between achieved SBP and the incidence of MACE
did not follow a J-shaped curve in any age group. In conclusion, in the
contemporary era of aggressive coronary revascularization, a lower SBP
target may be appropriate even in elderly patients with hypertension and
CAD.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<103>
[Use Link to view the full text]
Accession Number
631868547
Title
Perioperative use of novel oral anticoagulants in orthopaedic surgery: A
critical analysis review.
Source
JBJS Reviews. 7 (7) (no pagination), 2019. Article Number: 00148. Date of
Publication: 2019.
Author
Eliasberg C.D.; Levack A.E.; Gausden E.B.; Garvin S.; Russell L.A.; Kelly
A.M.
Institution
(Eliasberg, Levack, Gausden, Kelly) Departments of Orthopaedic Surgery,
Hospital for Special Surgery, New York, NY, United States
(Garvin) Departments of Anesthesiology, Hospital for Special Surgery, New
York, NY, United States
(Russell) Departments of Medicine, Hospital for Special Surgery, New York,
NY, United States
Publisher
Journal of Bone and Joint Surgery Inc.
Abstract
The use of novel oral anticoagulants (NOACs) in the perioperative setting
is an important issue that is particularly relevant to orthopaedic
procedures, but no official recommendations currently exist for NOACs in
orthopaedic surgery. Given the lack of a current consensus in the
orthopaedic literature, a standardized approach is essential in order to
help minimize both the duration of time without chronic anticoagulation
and complications that can arise from excessive bleeding. We propose a
combined profile assessment that takes into account the type of
anticoagulant as well as both patient-specific and procedure-specific risk
factors and provide an algorithm to help guide periprocedural NOAC
use.<br/>Copyright &#xa9; 2019 BY THE JOURNAL OF BONE AND JOINT SURGERY,
INCORPORATED.

<104>
Accession Number
616903783
Title
Predictors and outcome of acute kidney injury after transcatheter aortic
valve implantation: A systematic review and meta-analysis.
Source
EuroIntervention. 12 (17) (pp 2067-2074), 2017. Date of Publication: April
2017.
Author
Liao Y.-B.; Deng X.-X.; Meng Y.; Zhao Z.-G.; Xiong T.-Y.; Meng X.-J.; Zuo
Z.-L.; Li Y.-J.; Cao J.-Y.; Xu Y.-N.; Chen M.; Feng Y.
Institution
(Liao, Zhao, Xiong, Zuo, Li, Cao, Xu, Chen, Feng) Department of
Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street,
Chengdu 610041, China
(Deng) Department of General Family Medicine, West China Hospital, Sichuan
University, Chengdu, China
(Meng) Department of Urology Surgery, West China Hospital, Sichuan
University, Chengdu, China
(Meng) Department of Gastrointestinal Surgery, West China Hospital,
Sichuan University, Chengdu, China
Publisher
Europa Group
Abstract
Aims: The aim of this systematic review and meta-analysis was to
investigate the predictors and outcome of acute kidney injury (AKI) after
transcatheter aortic valve implantation (TAVI). <br/>Methods and Results:
There were 35 articles recruiting 13,256 patients included in our study.
Hypertension (odds ratio [OR] 1.92, 95% CI: 1.44 to 2.56), diabetes
mellitus (OR 1.33, 95% CI: 1.20 to 1.47), peripheral artery disease (OR
1.28, 95% CI: 1.14 to 1.45) and a left ventricular ejection fraction <40%
(OR 1.50, 95% CI: 1.19 to 1.88) were identified as significant independent
predictors of AKI. In addition to the aforementioned comorbidities,
procedure-related/post-TAVI factors such as transapical access (OR 1.68,
95% CI: 1.44 to 1.97), major bleeding (OR 1.82, 95% CI: 1.37 to 2.40) and
transfusion (OR 1.30, 95% CI: 1.12 to 1.51) were also associated with a
higher risk of AKI. Importantly, the risk of short-term all-cause death
increased progressively with the aggravating severity of AKI (OR, 30 days:
stage 1: 3.41; stage 2: 4.0; stage 3: 11.02; one year: stage 1: 1.95;
stage 2: 2.82; stage 3: 7.34), as determined by a univariate analysis.
After eliminating confounders, AKI remained linked to a higher risk for
both short-term (30 days: HR 2.12, 95% CI: 1.59 to 2.83) and long-term (>3
years: HR 1.37, 95% CI: 1.27 to 1.48) all-cause mortality.
<br/>Conclusion(s): The reason for the occurrence of AKI was
multifactorial, including baseline characteristics, procedure-related and
post-TAVI factors. It appeared that even stage 1 AKI exerted detrimental
effects on survival within one year, and AKI was also independently linked
to mortality beyond three years.<br/>Copyright &#xa9; Europa Digital &
Publishing 2017. All rights reserved.

<105>
Accession Number
615012430
Title
Non-invasive Heart Team assessment of multivessel coronary disease with
coronary computed tomography angiography based on SYNTAX score II
treatment recommendations: Design and rationale of the randomised SYNTAX
III Revolution trial.
Source
EuroIntervention. 12 (16) (pp 2001-2008), 2017. Date of Publication: March
2017.
Author
Cavalcante R.; Onuma Y.; Sotomi Y.; Collet C.; Thomsen B.; Rogers C.; Zeng
Y.; Tenekecioglu E.; Asano T.; Miyasaki Y.; Abdelghani M.; Morel M.-A.;
Serruys P.W.
Institution
(Cavalcante, Onuma, Zeng, Tenekecioglu, Miyasaki, Serruys) Erasmus
University Medical Center, Rotterdam, Netherlands
(Cavalcante) Heart Institute (InCor), University of Sao Paulo Medical
School, Sao Paulo, Brazil
(Onuma, Morel) Cardialysis BV, Rotterdam, Netherlands
(Sotomi, Collet, Asano, Abdelghani) Academic Medical Center, Amsterdam,
Netherlands
(Thomsen) GE Healthcare, Waukesha, WI, United States
(Rogers) Heartflow Inc., Redwood City, CA, United States
(Serruys) Cardiovascular Science Division of the NHLI, Imperial College of
Science, Technology and Medicine, South Kensington Campus, London SW7 2AZ,
United Kingdom
Publisher
Europa Group
Abstract
Aims: The aim of this study was to investigate whether a Heart Team
decision-making process regarding the choice of revascularisation strategy
based on non-invasive coronary multislice computed tomography angiography
(MSCT) assessment of coronary artery disease (CAD) is equivalent to the
standard-of-care invasive angiography-based assessment in patients with
multivessel CAD. <br/>Methods and Results: The SYNTAX III Revolution trial
is a prospective, multicentre, all-comers randomised trial that will
randomise two Heart Teams to select between surgical and percutaneous
treatment according to either an invasive conventional angiography or a
non-invasive MSCT angiography assessment in patients with multivessel CAD.
The treatment selection by each Heart Team will be guided by the SYNTAX
score II calculation. The primary endpoint is the level of agreement
according to kappa of the initial decision by the Heart Teams on the
modality of the revascularisation based on MSCT and angiography
assessments. Secondary endpoints include agreement on the number of
vessels requiring treatment and the coronary segments in need of
revascularisation. <br/>Conclusion(s): The SYNTAX III Revolution trial
will provide valuable information regarding the ability of a purely
non-invasive coronary anatomy assessment to select accurately the most
appropriate revascularisation strategy for patients with multivessel
CAD.<br/>Copyright &#xa9; Europa Digital & Publishing 2017. All rights
reserved.

<106>
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

<107>
[Use Link to view the full text]
Accession Number
632257476
Title
Late atrial arrhythmias after lung transplantation: a meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). 21 (8) (pp 577-582),
2020. Date of Publication: 01 Aug 2020.
Author
Saglietto A.; Matta M.; Gaita F.; De Ferrari G.M.; Anselmino M.
Institution
(Saglietto, De Ferrari, Anselmino) Division of Cardiology, Department of
Medical Sciences, 'Citta della Salute e della Scienza di Torino' Hospital,
University of Turin, Turin, United States
(Matta) Division of Cardiology, Sant'Andrea Hospital, Vercelli, Italy
(Gaita) Cardiovascular Department, Clinica Pinna Pintor, Policlinico di
Monza, Turin, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Atrial arrhythmias are common following noncardiac thoracic
surgery. In particular, early postoperative atrial arrhythmias after lung
transplantation are very frequent, especially atrial fibrillation (AFib).
Late atrial arrhythmia occurrence following lung transplantation, instead,
has been less commonly reported. <br/>METHOD(S): The aim of the present
systematic review and meta-analysis is to analyse the incidence rate of
late atrial arrhythmia and AFib in lung transplantation patients, with a
special focus on double lung transplant (DLT), also to assess potential
predictors of AFib occurrence. After bibliographic search (PUBMED/Medline
and Embase databases), a random-effect model meta-analysis was performed:
seven studies were finally included, including 2068 lung transplantation
patients. <br/>RESULT(S): The pooled incidence rate of late atrial
arrhythmia was 4.3%/year [95% confidence interval (CI) 2.8-6.1%/year, I =
69%], whereas late AFib incidence rate was 1.5%/year (95% CI
0.7-2.6%/year, I = 87%). In patients undergoing DLT, the pooled incidence
rate of late atrial arrhythmia was 4.1%/year (95% CI 2.5-6.0%/year, I =
67%), while the AFib incidence rate was 0.9%/year (95% CI 0.1-2.4%/year, I
= 92%). A longer follow-up duration significantly related to the reduced
incidence rate of AFib (P = 0.02). History of AFib (hazard ratio 11.2, 95%
CI 5.9-21.3) and early postoperative AFib (hazard ratio 10.3, 95% CI
5.9-18.0) emerged, instead, as relevant predictors of AFib occurrence.
<br/>CONCLUSION(S): Late atrial arrhythmia occurrence is not infrequent in
lung transplantation patients; however, late Afib incidence was rare and
showed a time-dependent decrease, particularly in DLT patients, suggesting
that a transmural pulmonary veins isolation, the mainstay of transcatheter
ablation, is effective in decreasing the likelihood of experiencing AFib.

<108>
[Use Link to view the full text]
Accession Number
632097868
Title
Incidence, predictors, and outcome of prosthesis-patient mismatch after
transcatheter aortic valve replacement: A meta-analysis.
Source
Medicine. 99 (24) (pp e20717), 2020. Date of Publication: 12 Jun 2020.
Author
He S.; Fang Z.
Institution
(He) Department of Cardiology, Second Xiangya Hospital of Central South
University, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Prosthesis-patient mismatch (PPM) following transcatheter
aortic valve replacement (TAVR) is common, but the incidence, predictors
and outcome of PPM are still controversial. <br/>METHOD(S): A total of 18
articles incorporating 72,016 patients were identified form PubMed and
Embase online database. <br/>RESULT(S): The pooled incidences of overall,
and severe PPM following TAVR were 32.0% and 10.0% separately. Comparing
to surgical aortic valve replacement (SAVR), TAVR had lower incidence of
overall (OR, 0.31, 95% CI, 0.20-0.50) and severe PPM (OR, 0.38, 95% CI,
0.28-0.52). PPM was associated with a larger body surface area (BSA),
larger body mass index (BMI) and previous myocardial infarction in
comparison with those patients without PPM. Although PPM was not rare
after TAVR, no significant differences were observed both in short- and
mid-term all-cause mortality (30 day: OR: 1.51, 95% CI, 0.79-2.87, 1 year:
OR: 1.02, 95% CI, 0.96-1.08, and 2 years: OR: 0.99, 95% CI, 0.79-1.24)
between patients with PPM and those without PPM. <br/>CONCLUSION(S):
Despite the fact that the incidence of PPM was lower than that of SAVR,
PPM was not seen to have an impact on short- and mid-term survival.

<109>
Accession Number
631976063
Title
Vasopressor use in cardiogenic shock.
Source
Current opinion in critical care. 26 (4) (pp 411-416), 2020. Date of
Publication: 01 Aug 2020.
Author
Levy B.; Klein T.; Kimmoun A.
Institution
(Levy, Klein, Kimmoun) Service de Reanimation Medicale Brabois, CHRU Nancy
(Levy, Klein, Kimmoun) INSERM U1116, Vandoeuvre-les-Nancy, Faculte de
Medecine
(Levy, Klein, Kimmoun) Universite de Lorraine, Nancy, France
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: Data and interventional trials on vasopressor use
during cardiogenic shock are scarce. Their use is limited by their
side-effects and the lack of solid evidence regarding their effectiveness
in improving outcomes. In the present article, we review the current use
of vasopressor therapy during cardiogenic shock. RECENT FINDINGS: Two
recent Cochrane analyses concluded that there was insufficient evidence to
prove that any one vasopressor was superior to others in terms of
mortality. A recent RCT and a meta-analysis on individual data suggested
that norepinephrine may be preferred over epinephrine in patients with
cardiogenic shock, in particular, after myocardial infarction. In patients
with right ventricular failure and pulmonary hypertension, the use of
vasopressin may be advocated under advanced monitoring. SUMMARY: When
blood pressure needs to be restored, norepinephrine is a reasonable
first-line agent. Information regarding comparative effective outcomes is
sparse and their use should be limited to a temporary measure as a bridge
to recovery, mechanical circulatory support or heart transplantation.

<110>
Accession Number
631870907
Title
Cardiogenic shock: role of invasive cardiology.
Source
Current opinion in critical care. 26 (4) (pp 398-402), 2020. Date of
Publication: 01 Aug 2020.
Author
Feistritzer H.-J.; Thiele H.; Desch S.
Institution
(Feistritzer) Department of Internal Medicine/Cardiology, Heart Center
Leipzig at the University of Leipzig and Leipzig Heart Institute, Leipzig,
Germany
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: Early revascularization significantly improved the
outcome of patients with cardiogenic shock following acute myocardial
infarction (AMI). Nevertheless, the mortality remains substantial, ranging
between 40 and 50% after 30 days. The present review summarizes the
current evidence regarding revascularization strategies, vascular access
site and concomitant antiplatelet and antithrombotic treatment in
infarct-related cardiogenic shock. RECENT FINDINGS: On the basis of the
SHOCK trial, early revascularization is the most relevant procedure to
improve the outcome of patients with infarct-related cardiogenic shock.
The majority of these patients present with multivessel coronary disease.
The randomized CULPRIT-SHOCK trial showed that in the emergency setting,
percutaneous coronary intervention (PCI) should be confined to the culprit
lesion. Regarding vascular access site, no data derived from randomized
controlled trials in cardiogenic shock are available. Emergency coronary
artery bypass grafting (CABG) is nowadays rarely performed in cardiogenic
shock with rates less than 5% but is still a treatment option if coronary
anatomy is not amenable to PCI. Regarding antiplatelet treatment, a
randomized trial testing the intravenous P2Y12 inhibitor cangrelor versus
an oral P2Y12 inhibitor in infarct-related cardiogenic shock is currently
being performed. SUMMARY: Early revascularization is the cornerstone of
treatment of infarct-related cardiogenic shock and should be confined to
the culprit lesion in the emergency setting.

<111>
Accession Number
632252170
Title
Reliability and Influence on Decision Making of fully-automated vs.
semi-automated Software Packages for Procedural Planning in TAVI.
Source
Scientific reports. 10 (1) (pp 10746), 2020. Date of Publication: 01 Jul
2020.
Author
Meyer A.; Kofler M.; Montagner M.; Unbehaun A.; Sundermann S.; Buz S.;
Klein C.; Stamm C.; Solowjowa N.; Emmert M.Y.; Falk V.; Kempfert J.
Institution
(Meyer, Kofler, Montagner, Unbehaun, Sundermann, Buz, Stamm, Solowjowa,
Emmert, Falk, Kempfert) Department of Cardiothoracic and Vascular Surgery,
German Heart Center, Berlin, Germany
(Meyer, Stamm, Emmert, Falk, Kempfert) DZHK (German Centre for
Cardiovascular Research), partner site, Berlin, Germany
(Meyer, Unbehaun) Berlin Institute of Health (BIH), Berlin, Germany
(Kofler) Department of Cardiac Surgery, Medical University of Innsbruck,
Innsbruck, Austria
(Sundermann, Emmert, Falk) Department of Cardiovascular Surgery, Charite -
Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin,
Berlin Institute of Health, Humboldt-Universitat zu Berlin, Berlin,
Germany
(Klein) Department of Cardiology, German Heart Center, Berlin, Germany
(Falk) Translational Cardiovascular Technologies, Institute of
Translational Medicine, Department of Health Sciences and Technology,
Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland
Publisher
NLM (Medline)
Abstract
Precise procedural planning is crucial to achieve excellent results in
patients undergoing Transcatheter aortic valve implantation (TAVI). The
aim of this study was to compare the semi-automated 3mensio (3m) software
to the fully-automated HeartNavigator3 (HN) software. We randomly selected
100 patients from our in-house TAVI-registry and compared aortic annulus
and perimeter as well as coronary distances between 3m-measurements and
post-hoc HN-measurements. Finally, we retrospectively simulated prosthesis
choice based on HN-measurements and analyzed the differences compared to
routinely used 3m based strategy. We observed significant differences
between the two software packages regarding area (3m 464+/-88mm2, HN
482+/-96mm2, p<0.001), perimeter (3m 77+/-7mm, HN 79+/-8mm, p<0.001) and
coronary distances (LCA: 3m 13+/-3mm, HN 12+/-3mm, p<0.001; RCA: 3m
16+/-3mm, HN 15+/-3mm, p<0.001). Prosthesis choice simulation based on
newly obtained HN-measurements would have led to a decision change in 18%
of patients, with a further reduction to 4% following manual adjustment of
HN-measurements. The fully-automatic HN-software provides higher values
for annular metrics and lower annulus-to-coronary-ostia distances compared
to 3m-software. Measurement differences did not influence clinical
outcome. Both, the HN-software and the 3m-software are sophisticated,
reliable and easy to use for the clinician. Manual adjustment of
HN-measurements may increase precision in complex aortic annulus anatomy.

<112>
Accession Number
632195510
Title
Congenital heart disease diagnosed with echocardiogram in newborns with
asymptomatic cardiac murmurs: a systematic review.
Source
BMC Pediatrics. 20 (1) (no pagination), 2020. Article Number: 322. 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, 1
Chungdae-ro, Seowon-gu, Cheongju-si Chungcheongbuk-do 28644, South Korea
(Hong) College of Medicine, Medical Research Information Center, Chungbuk
National University, 1 Chungdae-ro, Seowon-gu, Cheongju-si
Chungcheongbuk-do 28644, South Korea
(Cho) Department of Pathology, Inje University Busan Paik Hospital, 75
Bokji-ro, Busanjin-gu Busan 47392, South Korea
Publisher
BioMed Central Ltd. (E-mail: info@biomedcentral.com)
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. <br/>Copyright &#xa9; 2020 The Author(s).

<113>
Accession Number
632265158
Title
Cardiovascular mortality and morbidity in patients undergoing percutaneous
coronary intervention after out-of-hospital cardiac arrest: a systematic
review and meta-analysis.
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: 07 Jul 2020.
Author
Spirito A.; Gargiulo G.; Siontis G.C.M.; Mitsis A.; Billinger M.;
Windecker S.; Valgimigli M.
Institution
(Spirito) Department of Cardiology, Inselspital, Bern University Hospital,
Bern, Switzerland
Publisher
NLM (Medline)
Abstract
AIMS: To appraise the burden of cardiovascular mortality and morbidity
among patients undergoing percutaneous coronary interventions (PCI) after
out-of-hospital cardiac arrest (OHCA). METHODS AND RESULTS: Meta-analysis
of studies assessing the cardiovascular mortality or at least one other
pre-defined outcomes in OHCA patients undergoing PCI. Forty-nine studies
of 301,902 patients (73,634 OHCA and 228,268 non-OHCA patients) were
included. Compared to non-OHCA patients, all-cause mortality was higher
(29% vs 4%). The cause of 39% of deaths among OHCA patients was
cardiovascular; PCI was more frequently unsuccessful (9.2% vs. 7.6%) and
there were higher rates of stent thrombosis (2.9% vs. 0.8%), myocardial
infarction (1.7% vs. 1.4%), relevant bleeding (10.2% vs. 2.1%) and stroke
(1.7% vs. 0.5%). OHCA patients compared to non-OHCA patients had a higher
risk of all-cause mortality (risk ratio 6.4, 95%CI, 5.5-7.4),
cardiovascular death (4.6, 1.1-19), unsuccessful coronary
revascularization (1.4, 1.1-1.7), stent thrombosis (3.8, 0.6-22.7),
myocardial infarction (1.4, 1.1-1.7), relevant bleeding (3.2, 2.5-4.1) and
stroke (3.1, 2.3-4.3). <br/>CONCLUSION(S): Almost one third of OHCA
patients undergoing PCI die and more than one third of the fatalities are
attributable to cardiovascular causes. The burden of ischemic and bleeding
complications was consistently higher and the success rates of PCI lower
among OHCA as compared to non-OHCA patients.

<114>
Accession Number
632264196
Title
Diagnosis and management of silent coronary ischemia in patients
undergoing carotid endarterectomy.
Source
Journal of vascular surgery. (no pagination), 2020. Date of Publication:
02 Jul 2020.
Author
Krievins D.; Zellans E.; Latkovskis G.; Jegere S.; Kumsars I.; Kaufmanis
K.; Erglis A.; Zarins C.K.
Institution
(Krievins, Zellans, Latkovskis, Jegere, Kumsars, Erglis) Pauls Stradins
Clinical University Hospital, Riga, Latvia; University of Latvia, Riga,
Latvia
(Kaufmanis) University of Latvia, Riga, Latvia
(Zarins) HeartFlow, Inc. Redwood City, CA
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Coronary artery disease (CAD) is the primary cause of death
in patients with carotid artery disease and silent ischemia is a marker
for adverse coronary events. A new non-invasive cardiac diagnostic test,
coronary CT-derived fractional flow reserve (FFRCT) can reliably identify
ischemia-producing coronary stenosis in patients with CAD and help select
patients for coronary revascularization. The purpose of this study is to
determine the prevalence of silent coronary ischemia in patients
undergoing carotid endarterectomy (CEA) and to evaluate the usefulness of
FFRCT in selecting patients for coronary revascularization in order to
reduce cardiac events and improve survival. <br/>METHOD(S): Patients with
no cardiac history or symptoms admitted for elective CEA were enrolled in
a prospective, open-label, IRB-approved study and underwent pre-op
coronary CT angiography (CTA) and FFRCT with results available to
physicians for patient management. Lesion-specific coronary ischemia was
defined as FFRCT <=0.80 distal to a focal coronary stenosis with FFRCT
<=0.75 indicating severe ischemia. Primary endpoint was incidence of major
adverse cardiovascular (CV) events (MACE, defined as CV death, MI, stroke)
at 30 days and 1 year. <br/>RESULT(S): Coronary CTA and FFRCT was
performed in 90 CEA patients (age 67+/-8 years, male 66%). Lesion-specific
coronary ischemia was found in 51 patients (57%) with mean FFRCT
0.71+/-0.14. Severe coronary ischemia was present in 39 patients (43%), 26
patients had multivessel ischemia and 5 had left main disease. CEA was
performed as scheduled in all patients with no post-operative deaths or
MIs. There were no MACE events at 30 days. After recovery from surgery, 36
patients with significant lesion-specific ischemia underwent coronary
angiography with coronary revascularization (PCI or CABG) in 30 patients
(33%). Survival at one year was 100% and freedom from MACE was 98%.
<br/>CONCLUSION(S): Patients undergoing CEA have a high prevalence of
unsuspected (silent) coronary ischemia which may place them at risk for
coronary events. Pre-operative diagnosis of silent ischemia using CTA and
FFRCT can identify high risk patients and help guide patient management.
Selective post-op coronary revascularization of patients with significant
ischemia may reduce risk of cardiac events and improve survival, but
longer follow up is needed and prospective, controlled trials are
indicated.<br/>Copyright &#xa9; 2020. Published by Elsevier Inc.

<115>
Accession Number
632262721
Title
A Frailty Screening Tool for Patients undergoing Orthotopic Heart
Transplant.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 02 Jul 2020.
Author
Seese L.; Hirji S.; Sultan I.; Gleason T.; Kilic A.
Institution
(Seese, Sultan, Gleason, Kilic) Division of Cardiac Surgery, University of
Pittsburgh Medical Center, Pittsburgh, United States
(Hirji) Division of Cardiac Surgery, Brigham and Women's Hospital, MA,
Boston
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although frailty has been previously shown to negatively
influence post-operative outcomes, frailty measurements remain undefined
and underutilized for patients undergoing orthotopic heart transplantation
(OHT). This study aims to derive and validate an OHT frailty screening
tool. <br/>METHOD(S): The UNOS database was queried for adults undergoing
OHT between 2000 and 2018. The total population was randomly divided into
derivation (80%) and validation (20%) cohorts. The primary outcome was
mortality. Secondary outcomes included rates of major morbidities and
hospital length of stay (LOS). Variables that were constructs within
pre-existing frailty tools and that were predictive of a composite frailty
outcome within the derivation cohort were incorporated into a
multivariable regression model (exploratory, p<0.2). Independent
predictors of frailty were included in the OHT frailty screening tool.
<br/>RESULT(S): 36,790 OHT recipients met criteria for inclusion. Twelve
variables were identified as independent predictors of frailty and
included as OHT frailty screening tool constructs. Recipients in the
validation cohort were stratified as non-frail (72.9%, n=5,363), pre-frail
(24.4%, n=1,795), and frail (2.7%, n=200). Frail patients had
significantly higher rates of post-transplant stroke, renal failure, and
mortality at all time intervals as well as longer LOS (all p<0.001). The
risk model's predictive rates of mortality strongly correlated with the
observed rates of mortality (r2=0.97, p<0.001). The c-index of the OHT
frailty score was 0.74. <br/>CONCLUSION(S): The OHT frailty screening tool
is highly predictive of adverse post-transplant outcomes. This screening
tool may provide a framework to improve enhance existing risk
stratification tools and improve overall resource
utilization.<br/>Copyright &#xa9; 2020. Published by Elsevier Inc.

<116>
Accession Number
632261202
Title
Impact of aortic annulus enlargement on the outcomes of aortic valve
replacement: a meta-analysis.
Source
Seminars in thoracic and cardiovascular surgery. (no pagination), 2020.
Date of Publication: 01 Jul 2020.
Author
Sa M.P.B.O.; Zhigalov K.; Cavalcanti L.R.P.; Escorel Neto A.C.; Rayol
S.C.; Weymann A.; Ruhparwar A.; Lima R.C.
Institution
(Sa) Division of Cardiovascular Surgery of Pronto Socorro Cardiologico de
Pernambuco - PROCAPE, Recife, Brazil; University of Pernambuco - UPE,
Recife, Brazil; Nucleus of Postgraduate and Research in Health Sciences of
Faculty of Medical Sciences and Biological Sciences Instituite - FCM/ICB,
Recife, Brazil. Electronic address: michel_pompeu@yahoo.com.br
(Zhigalov, Weymann, Ruhparwar) Department of Thoracic and Cardiovascular
Surgery, West German Heart and Vascular Center Essen, University Hospital
of Essen, University Duisburg-Essen, Essen, Germany
(Cavalcanti, Escorel Neto, Rayol) Division of Cardiovascular Surgery of
Pronto Socorro Cardiologico de Pernambuco - PROCAPE, Recife, Brazil;
University of Pernambuco - UPE, Recife, Brazil
(Lima) Division of Cardiovascular Surgery of Pronto Socorro Cardiologico
de Pernambuco - PROCAPE, Recife, Brazil; University of Pernambuco - UPE,
Recife, Brazil; Nucleus of Postgraduate and Research in Health Sciences of
Faculty of Medical Sciences and Biological Sciences Instituite - FCM/ICB,
Recife, Brazil
Publisher
NLM (Medline)
Abstract
We sought to evaluate the impact of surgical aortic annulus enlargement
(ARE) on the perioperative outcomes of surgical aortic valve replacement
(SAVR). Databases were searched for for articles published by October 2019
in order to carry out a systematic review followed by meta-analysis.
Thirteen studies with 40,447 patients (AVR with AAE: 4,686 patients; AVR
without AAE: 35,761 patients) were included. The total rate of AAE was
11.6%, ranging from from 4.1 to 28.1%. The overall unadjusted OR (95%CI)
for operative mortality showed a statistically significant difference
between the groups, with higher risk in the "AVR with AAE" group (OR
1.388; 95%CI 1.049-1.836, P<0.001), but not for isolated AVR+AAE (OR
1.341; 95%CI 0.920-1.956, P=0.127) and also not in matched populations (OR
1.003; 95%CI 0.773-1.300, P=0.984). The "AVR with AAE" group showed an
overall lower risk of significant patient-prosthesis mismatch (PPM) (OR
0.567; 95%CI 0.376-0.854, P=0.007) and a higher overall difference in
means of indexed effective orifice area (iEOA) (random effect model: 0.058
cm2/m2; 95%CI 0.024-0.092, P<0.001). The overall ORs for myocardial
infarction, stroke, complete heart block/permanent pacemaker implantation
and reoperation for bleeding showed no statistically significant
difference between the groups. AAE is a useful adjunct to AVR, but the
benefit of reduced PPM must be balanced against a possibly higher risk of
perioperative mortality.<br/>Copyright &#xa9; 2020. Published by Elsevier
Inc.

<117>
Accession Number
632256751
Title
Postoperative atrial fibrillation following emergency noncardiothoracic
surgery: A systematic review.
Source
European journal of anaesthesiology. (no pagination), 2020. Date of
Publication: 30 Jun 2020.
Author
Bjerrum E.; Wahlstroem K.L.; Gogenur I.; Burcharth J.; Ekeloef S.
Institution
(Bjerrum) From the Center for Surgical Science (CSS), Department of
Surgery, Zealand University Hospital, Lykkebaekvej 1, IG, Slovenia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) occurs frequently
following cardiothoracic surgery and is associated with a higher mortality
and a longer hospital stay. The condition is less studied following
noncardiothoracic surgery as well as emergency surgery. <br/>OBJECTIVE(S):
The aim of this systematic review was to investigate the occurrence of
atrial fibrillation following emergency noncardiothoracic surgery and
associated risk factors and mortality. DESIGN: We conducted a systematic
review according to the Preferred Reporting Items for Systematic reviews
and Meta-Analyses guidelines. Observational studies and randomised
controlled trials were assessed for risk of bias using the Downs and Black
checklist and Cochrane Handbook for Systematic reviews of intervention.
DATA SOURCES: A systematic literature search of PubMed, EMBASE and Scopus
was carried out in August 2019. No publication date- or source
restrictions were imposed. ELIGIBILITY CRITERIA: Observational and
randomised controlled trials were included if data on POAF occurring after
an emergency, noncardiothoracic, surgical intervention on adult patients
could be extracted. <br/>RESULT(S): We identified 15 studies eligible for
inclusion covering orthopaedic-, abdominal-, vascular-, neuro- and
miscellaneous noncardiothoracic surgery. The occurrence of POAF after
emergency noncardiothoracic surgery ranged from 1.5 to 12.2% depending on
type of surgery and intensity of cardiac monitoring. Studies that
investigated risk factors and associated mortality found emergency surgery
and increasing age to be associated with risk of POAF. Moreover, POAF was
generally associated with an increase in long-term and short-term
mortality. <br/>CONCLUSION(S): In this study, atrial fibrillation occurred
frequently, especially following emergency orthopaedic, vascular and
neurosurgery. Emergency surgery and age were independent risk factors for
developing atrial fibrillation. POAF seems to be related to a higher risk
of postoperative complications and mortality, though further studies with
long-term follow-up are needed. TRIAL REGISTRATION: CRD42019112090.

<118>
Accession Number
632251941
Title
High flow nasal cannula in the immediate post-operative period: a
systematic review and meta-analysis.
Source
Chest. (no pagination), 2020. Date of Publication: 29 Jun 2020.
Author
Chaudhuri D.; Granton D.; Wang D.X.; Burns K.E.A.; Helviz Y.; Einav S.;
Trivedi V.; Mauri T.; Ricard J.-D.; Mancebo J.; Frat J.-P.; Jog S.;
Hernandez G.; Maggiore S.M.; Mbuagbaw L.; Hodgson C.L.; Jaber S.; Goligher
E.; Brochard L.; Rochwerg B.
Institution
(Chaudhuri, Granton) Department of Medicine, McMaster University,
Hamilton, Ontario, Canada
(Wang) Schulich School of Medicine, Western University, London, ON, Canada
(Burns, Trivedi, Jaber) Department of Anaesthesiology and Critical Care
Medicine B (DAR B), Saint-Eloi Teaching Hospital, PhyMed Exp, INSERM
U1046, University of Montpellier, 80 avenue Augustin Fliche, Montpellier
34295, France
(Helviz) General Intensive Care Unit, Shaare Zedek Medical Center,
Jerusalem, Israel
(Einav) General Intensive Care Unit, Shaare Zedek Medical Center,
Jerusalem, Israel; Faculty of Medicine, Hebrew University, Jerusalem,
Israel
(Mauri) Dipartimento di fisopatologia medico-chirurgica e dei trapianti,
Universita degli Studi di Milano, Milan, Italy; Department of Anesthesia,
Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore
Policlinico, University of Milan, Milan, Italy
(Ricard) Assistance Publique-Hopital de Paris, Service de Reanimation
Medico-chirurgicale, Hopital Louis Mourier, Colombes, France; Universite
de Paris, INSERM, IAME, UMR 1137, Paris, France
(Mancebo) Servei de Medicina Intensiva, Hospital Universitari Sant Pau,
Barcelona, Spain
(Frat) CHU de Poitiers, Medecine Intensive Reanimation, Poitiers, France;
INSERM, CIC-1402, equipe ALIVE, Poitiers, France; Universite de Poitiers,
Faculte de Medecine et de Pharmacie de Poitiers, Poitiers, France
(Jog) Department of Intensive Care Medicine, Deenanath Mangeshkar Hospital
and Research Centre. Pune, India
(Hernandez) University Hospital Virgen de la Salud, Toledo, Spain
(Maggiore) Department of Medical, Oral and Biotechnological Sciences,
Gabriele d'Annunzio University of Chieti-Pescara, Department of
Anesthesiology and Critical Care, SS. Annunziata Hospital, Chieti, Italy
(Mbuagbaw) Department of Health Research Methods, Evidence and Impact,
McMaster University, Hamilton, Ontario, Canada
(Hodgson) Australian and New Zealand Intensive Care Research Centre,
Department of Epidemiology and Preventive Medicine, Monash University
(Goligher) Interdepartmental Division of Critical Care Medicine,
University of Toronto, Toronto, ON, Canada
(Brochard) Interdepartmental Division of Critical Care Medicine,
University of Toronto, Toronto, Ontario, Canada; Keenan research centre,
Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto
(Rochwerg) Department of Medicine, McMaster University, Hamilton, Ontario,
Canada; Department of Health Research Methods, Evidence and Impact,
McMaster University, Hamilton, Ontario, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Recent studies have demonstrated that high flow nasal cannula
(HFNC) prevents intubation in acute hypoxic respiratory failure when
compared to conventional oxygen therapy (COT). However, the data examining
routine HFNC use in the immediate post-operative period is less clear.
RESEARCH QUESTION: Is routine HFNC use superior to COT or non-invasive
ventilation (NIV) in preventing intubation in post-operative patients?
STUDY DESIGN: and Methods: We comprehensively searched databases (MEDLINE,
EMBASE, Web of Science) to identify randomized controlled trials (RCTs)
that compared the effect of HFNC use to COT or NIV in the immediate
post-operative period on reintubation, escalation of respiratory support,
hospital mortality, ICU and hospital length of stay, post-operative
hypoxemia and treatment complications. We assessed individual study risk
of bias using the revised Cochrane ROB 2 tool and rated certainty in
outcomes using GRADE framework. <br/>RESULT(S): We included 11 RCTs
enrolling 2201 patients. Ten compared HFNC to COT and one to NIV. Compared
to COT, HFNC use in the post-operative period was associated with a lower
reintubation rate (RR 0.32, 95% CI 0.12 to 0.88, 2.9% absolute risk
reduction (ARR), moderate certainty) and decreased escalation of
respiratory support (RR 0.54, 95% CI 0.31 to 0.94, ARR 5.8%, very low
certainty). Post-hoc subgroup analysis suggested that this effect was
driven by obese and/or high risk patients (subgroup differences, p 0.06).
We did not find differences in any of the other stated outcomes between
HFNC and COT. HFNC was also no different from NIV in reintubation rate,
respiratory therapy failure or ICU LOS. INTERPRETATION: With moderate
certainty evidence, prophylactic HFNC reduces reintubation and escalation
of respiratory support compared to COT in the immediate post-operative
period following cardiothoracic surgery. This effect is likely driven by
high risk and/or obese patients. These findings support post-op
prophylactic HFNC use in the high risk/obese cardiothoracic
patients.<br/>Copyright &#xa9; 2020. Published by Elsevier Inc.

<119>
Accession Number
632267170
Title
The Impact of Robotic-Assisted Surgery on Team Performance: A Systematic
Mixed Studies Review.
Source
Human factors. (pp 18720820928624), 2020. Date of Publication: 02 Jul
2020.
Author
Gillespie B.M.; Gillespie J.; Boorman R.J.; Granqvist K.; Stranne J.;
Erichsen-Andersson A.
Institution
(Gillespie, Boorman) School of Nursing & Midwifery & Menzies Institute of
Health, Brisbane, Australia
(Gillespie) Gold Coast Hospital and Health Service, Australia
(Gillespie) Services Australia, Brisbane, Australia
(Granqvist, Erichsen-Andersson) Institute of Health & Caring Sciences,
University of Gothenburg, Sweden
(Stranne) Sahlgrenska University Hospital, Gothenburg, Sweden
(Stranne) 3570 University of Gothenburg, Sweden
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The aim of this study is to describe the impact of
robotic-assisted surgery on team performance in the operating room.
BACKGROUND: The introduction of surgical robots has improved the technical
performance of surgical procedures but has also contributed to unexpected
interactions in surgical teams, leading to new types of errors.
<br/>METHOD(S): A systematic literature search of Cumulative Index to
Nursing and Allied Health Literature, PubMed, ProQuest, Cochrane, Web of
Science, PsycINFO, and Scopus databases using key words and MeSH terms was
conducted. Screening identified studies employing qualitative and
quantitative methods published between January 2000 and September 2019.
Two reviewers independently appraised the methodological quality of the
articles using the Mixed Methods Appraisal Tool (2018). Discussions were
held among authors to examine quality scores of the studies and emergent
themes, and agreement was reached through consensus. Themes were derived
using inductive content analysis. <br/>RESULT(S): Combined searches
identified 1,065 citations. Of these, 19 articles, 16 quantitative and 3
qualitative, were included. Robotic-assisted surgeries included urology,
gynecology, cardiac, and general procedures involving surgeons,
anesthetists, nurses, and technicians. Three themes emerged: Negotiating
the altered physical environs and adapting team communications to manage
task and technology; managing the robotic system to optimize workflow
efficiency; and technical proficiency depends on experience, team
familiarity, and case complexity. <br/>CONCLUSION(S): Inclusion of a robot
as a team member adds further complexity to the work of surgery.
APPLICATION: These review findings will inform training programs
specifically designed to optimize teamwork, workflow efficiency, and
learning needs.

<120>
Accession Number
632266443
Title
Critical appraisal on the impact of preoperative rehabilitation and
outcomes after major abdominal and cardiothoracic surgery: A systematic
review and meta-analysis: Counting rules are critical.
Source
Surgery. (no pagination), 2020. Date of Publication: 02 Jul 2020.
Author
Dunlop D.; Kyriacou E.; Jones J.R.A.; Boden I.; Berlowitz D.J.
Institution
(Dunlop, Kyriacou) Physiotherapy Department, Austin Health, Heidelberg,
Vic, Australia
(Jones) Physiotherapy Department, Austin Health, Heidelberg, Vic,
Australia; Department of Physiotherapy, The University of Melbourne,
Parkville, Vic, Australia; Institute for Breathing and Sleep, Heidelberg,
Vic, Australia
(Boden) Physiotherapy Department, Launceston General Hospital, Tas,
Australia; Department of Physiotherapy, The University of Melbourne,
Parkville, Vic, Australia
(Berlowitz) Physiotherapy Department, Austin Health, Heidelberg, Vic,
Australia; Department of Physiotherapy, The University of Melbourne,
Parkville, Vic, Australia; Institute for Breathing and Sleep, Heidelberg,
Vic, Australia. Electronic address: djberl@unimelb.edu.au
Publisher
NLM (Medline)