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<1>
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Accession Number
632383421
Title
Outcome of Flow-Gradient Patterns of Aortic Stenosis After Aortic Valve
Replacement: An Analysis of the PARTNER 2 Trial and Registry.
Source
Circulation. Cardiovascular interventions. 13 (7) (pp e008792), 2020. Date
of Publication: 01 Jul 2020.
Author
Salaun E.; Clavel M.-A.; Hahn R.T.; Jaber W.A.; Asch F.M.; Rodriguez L.;
Weissman N.J.; Gertz Z.M.; Herrmann H.C.; Dahou A.; Annabi M.-S.; Toubal
O.; Bernier M.; Beaudoin J.; Leipsic J.; Blanke P.; Ridard C.; Ong G.;
Rodes-Cabau J.; Webb J.G.; Zhang Y.; Alu M.C.; Douglas P.S.; Makkar R.;
Miller D.C.; Lindman B.R.; Thourani V.H.; Leon M.B.; Pibarot P.
Institution
(Salaun, Clavel, Dahou, Annabi, Toubal, Bernier, Beaudoin, Ridard, Ong,
Rodes-Cabau, Pibarot) Institut Universitaire de Cardiologie et de
Pneumologie de Quebec/Quebec Heart and Lung Institute, Laval University,
M.-A.C., A.D., M.-S.A., M.B., C.R., G.O., J.R.-C.
(Hahn, Dahou, Zhang, Alu, Leon) Columbia University Medical Center/New
York- Presbyterian Hospital (R.T.H., A.D., M.C.A.
(Hahn, Zhang, Alu, Leon) Cardiovascular Research Foundation, M.C.A., NY
(Jaber, Rodriguez) Heart and Vascular Institute, Cleveland Clinic
(Asch, Weissman, Thourani) MedStar Health Research Institute at Washington
Hospital Center
(Gertz) Division of Cardiology, Virginia Commonwealth University
(Herrmann) University of Pennsylvania Medical Center
(Leipsic, Blanke, Webb) St Paul's Hospital, Vancouver, BC, Canada
(Ong) Division of Cardiology, St Michael's Hospital, ON, Toronto, United
States
(Douglas) Duke University Medical Center and Duke Clinical Research
Institute, Durham
(Makkar) Cedars-Sinai Heart Institute, Los Angeles, Mexico
(Miller) Division of Cardiovascular Medicine, Department of Medicine,
Stanford University School of Medicine
(Lindman) Vanderbilt University Medical Center, Nashville, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although aortic valve replacement is associated with a major
benefit in high-gradient (HG) severe aortic stenosis (AS), the results in
low-gradient (LG, mean gradient <40 mm Hg) AS are conflicting. LG severe
AS may be subdivided in classical low-flow (left ventricular ejection
fraction <50%) and LG (CLF-LG); paradoxical low-flow (left ventricular
ejection fraction >=50% but stroke volume index <35 mL/m2) and LG; and
normal-flow (left ventricular ejection fraction >=50% and stroke volume
index >=35 mL/m2) and LG. The primary objective is to determine in the
PARTNER 2 trial (The Placement of Aortic Transcatheter Valves) and
registry the outcomes after aortic valve replacement of the 4
flow-gradient groups. <br/>METHOD(S): A total of 3511 patients from the
PARTNER 2 Cohort A randomized trial (n=1910) and SAPIEN 3 registry
(n=1601) were included. The flow-gradient pattern was determined at
baseline transthoracic echocardiography and classified as follows: (1) HG;
(2) CLF-LG; (3) paradoxical low-flow-LG; and (4) normal-flow-LG. The
primary end point for this analysis was the composite of (1) death; (2)
rehospitalization for heart failure symptoms and valve prosthesis
complication; or (3) stroke. <br/>RESULT(S): The distribution was HG, 2229
patients (63.5%); CLF-LG, 689 patients (19.6%); paradoxical low-flow-LG,
247 patients (7.0%); and normal-flow-LG, 346 patients (9.9%). The 2-year
rate of primary end point was higher in CLF-LG (38.8%) versus HG: 31.8%
(P=0.002) and normal-flow-LG: 32.1% (P=0.05) but was not statistically
different from paradoxical low-flow-LG: 33.6% (P=0.18). There was no
significant difference in the 2-year rates of clinical events between
transcatheter aortic valve replacement versus surgical aortic valve
replacement in the whole cohort and within each flow-gradient group.
<br/>CONCLUSION(S): The LG AS pattern was highly prevalent (36.5%) in the
PARTNER 2 trial and registry. CLF-LG was the most common pattern of LG AS
and was associated with higher rates of death, rehospitalization, or
stroke at 2 years compared with the HG group. Clinical outcomes were as
good in the LG AS groups with preserved left ventricular ejection fraction
compared with the HG group.

<2>
Accession Number
632380536
Title
Accelerated rehabilitation combined with enteral nutrition in the
management of lung cancer surgery patients.
Source
Asia Pacific journal of clinical nutrition. 29 (2) (pp 274-279), 2020.
Date of Publication: 2020.
Author
Ding Q.; Chen W.; Gu Y.; Qi Z.-Y.; Chen Y.-H.; Chen J.; Jiang L.
Institution
(Ding, Chen, Gu, Qi, Chen) Nutrition Department, Shanghai Pulmonary
Hospital Affiliated to Tongji University, Shanghai, China
(Chen) Thoracic Surgery Department, Shanghai Pulmonary Hospital Affiliated
to Tongji University, Shanghai, China
(Jiang) Thoracic Surgery Department, Shanghai Pulmonary Hospital
Affiliated to Tongji University, Shanghai, China
Publisher
NLM (Medline)
Abstract
BACKGROUND AND OBJECTIVES: To investigate the effect of accelerated
rehabilitation combined with enteral nutrition on surgically treated lung
cancer patients. METHODS AND STUDY DESIGN: In total, 150 lung cancer
patients treated in our hospital from January 2017 to January 2018 were
retrospectively analysed. Sixty-six patients were randomly divided into a
control group with conventional nutrition (Con group) and an accelerated
rehabilitation combined with enteral nutrition group (EN group).
Postoperative drainage; total hospitalization time; total hospitalization
expenses; and albumin, haemoglobin and total lymphocyte counts (TLC)
before and after treatment were compared. <br/>RESULT(S): The serum
albumin, prealbumin and haemoglobin in both groups were decreased after
operation and were significantly higher in the EN group (p<0.05) than in
the Con group. The TLC decreased in both groups after operation and were
significantly higher in the EN group than in the con group. The
postoperative drainage volume, total hospitalization time and total
hospitalization expenses were significantly lower in the EN group than in
the Con group (p<0.05). <br/>CONCLUSION(S): The effect of accelerated
rehabilitation combined with enteral nutrition in lung cancer surgery
patients is clear. Surgery leads to stress, which enhances catabolism and
reduces the synthesis of carbohydrates, protein, and fat, increasing
patients' nutritional risk. Nutritional support combined with fast-track
minimally invasive thoracic surgery for at-risk lung cancer patients who
undergo preoperative nutritional screening and assessment can reduce
postoperative complications and hospitalization time and improve
nutritional indicators, immunity, respiratory function recovery and
clinical outcomes, leading to socioeconomic benefits.

<3>
Accession Number
632368868
Title
Effects of Supervised Early Resistance Training versus standard care on
cognitive recovery following cardiac surgery via median sternotomy (the
SEcReT study): protocol for a randomised controlled pilot study.
Source
Trials. 21 (1) (pp 649), 2020. Date of Publication: 15 Jul 2020.
Author
Pengelly J.M.S.; Royse A.G.; Bryant A.L.; Williams G.P.; Tivendale L.J.;
Dettmann T.J.; Canty D.J.; Royse C.F.; El-Ansary D.A.
Institution
(Pengelly, El-Ansary) Department of Nursing and Allied Health, Swinburne
University of Technology, Hawthorn, Melbourne, Victoria, Australia
(Royse, Canty, Royse, El-Ansary) Department of Surgery, University of
Melbourne, Melbourne, VIC, Australia
(Royse, Tivendale) Department of Cardiothoracic Surgery, Royal Melbourne
Hospital, Parkville, VIC, Australia
(Bryant, Williams) Department of Physiotherapy, University of Melbourne,
Parkville, VIC, Australia
(Dettmann) South Melbourne, VIC, Australia
(Canty) Department of Medicine, Monash University, Clayton, VIC, Australia
(Canty) Department of Anaesthesia and Perioperative Medicine, Monash
Health, Clayton, VIC, Australia
(Royse) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Parkville, VIC, Australia
(Royse) Outcomes Research Consortium Cleveland Clinic, Cleveland, OH,
United States
(El-Ansary) Clinical Research Institute, Westmead Private Hospital, NSW,
Westmead, Sydney, Australia
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Mild cognitive impairment is considered a precursor to
dementia and significantly impacts upon quality of life. The prevalence of
mild cognitive impairment is higher in the post-surgical cardiac
population than in the general population, with older age and
comorbidities further increasing the risk of cognitive decline. Exercise
improves neurogenesis, synaptic plasticity and inflammatory and
neurotrophic factor pathways, which may help to augment the effects of
cognitive decline. However, the effects of resistance training on
cognitive, functional and overall patient-reported recovery have not been
investigated in the surgical cardiac population. This study aims to
determine the effect of early moderate-intensity resistance training,
compared to standard care, on cognitive recovery following cardiac surgery
via a median sternotomy. The safety, feasibility and effect on functional
recovery will also be examined. <br/>METHOD(S): This study will be a
prospective, pragmatic, pilot randomised controlled trial comparing a
standard care group (low-intensity aerobic exercise) and a
moderate-intensity resistance training group. Participants aged 18years
and older with coronary artery and/or valve disease requiring surgical
intervention will be recruited pre-operatively and randomised 1:1 to
either the resistance training or standard care group post-operatively.
The primary outcome, cognitive function, will be assessed using the
Alzheimer's Disease Assessment Scale and cognitive subscale. Secondary
measures include safety, feasibility, muscular strength, physical
function, multiple-domain quality of recovery, dynamic balance and patient
satisfaction. Assessments will be conducted at baseline (pre-operatively)
and post-operatively at 2weeks, 8weeks, 14weeks and 6months. DISCUSSION:
The results of this pilot study will be used to determine the feasibility
of a future large-scale randomised controlled trial that promotes the
integration of early resistance training into existing aerobic-based
cardiac rehabilitation programs in Australia. TRIAL REGISTRATION:
Australian New Zealand Clinical Trials Registry (ANZCTR)
ACTRN12617001430325p . Registered on 9 October 2017. Universal Trial
Number (UTN): U1111-1203-2131.

<4>
Accession Number
2006910091
Title
Evaluating the cardiovascular safety of sclerostin inhibition using
evidence from meta-analysis of clinical trials and human genetics.
Source
Science Translational Medicine. 12 (549) (no pagination), 2020. Article
Number: eaay6570. Date of Publication: 24 Jun 2020.
Author
Bovijn J.; Krebs K.; Chen C.-Y.; Boxall R.; Censin J.C.; Ferreira T.;
Pulit S.L.; Glastonbury C.A.; Laber S.; Millwood I.Y.; Lin K.; Li L.; Chen
Z.; Milani L.; Smith G.D.; Walters R.G.; Magi R.; Neale B.M.; Lindgren
C.M.; Holmes M.V.
Institution
(Bovijn, Censin, Ferreira, Pulit, Glastonbury, Laber, Lindgren, Holmes)
Big Data Institute, Li Ka Shing Centre for Health Information and
Discovery, University of Oxford, Oxford OX3 7FZ, United Kingdom
(Bovijn, Censin, Laber, Lindgren) Wellcome Centre for Human Genetics,
University of Oxford, Oxford OX3 7BN, United Kingdom
(Krebs, Milani, Magi) Estonian Genome Center, Institute of Genomics,
University of Tartu, Tartu 51010, Estonia
(Chen, Neale) Analytic and Translational Genetics Unit, Massachusetts
General Hospital, Boston, MA 02114, United States
(Chen) Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts
General Hospital, Boston, MA 02114, United States
(Chen, Neale) Stanley Center for Psychiatric Research, Broad Institute of
mit and Harvard, Cambridge, MA 02142, United States
(Boxall, Millwood, Lin, Chen, Walters, Holmes) Clinical Trial Service Unit
and Epidemiological Studies Unit (CTSU), Nuffield Department of Population
Health, University of Oxford, Oxford OX3 7LF, United Kingdom
(Boxall, Millwood, Walters, Holmes) Medical Research Council Population
Health Research Unit (MRC PHRU), Nuffield Department of Population Health,
University of Oxford, Oxford OX3 7LF, United Kingdom
(Pulit, Lindgren) Program in Medical and Population Genetics, Broad
Institute, Cambridge, MA 02142, United States
(Pulit) Department of Genetics, University Medical Center Utrecht, Utrecht
3584 CX, Netherlands
(Li) Department of Epidemiology and Biostatistics, Peking University
Health Science Centre, Peking University, Beijing 100191, China
(Smith) Medical Research Council Integrative Epidemiology Unit, University
of Bristol, Bristol BS8 2BN, United Kingdom
(Smith) Population Health Sciences, Bristol Medical School, University of
Bristol, Barley House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
(Lindgren, Holmes) National Institute for Health Research Oxford
Biomedical Research Centre, Oxford University Hospitals NHS Foundation
Trust, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
(Chen) Biogen, Cambridge, MA 02142, United States
(Pulit) Vertex Pharmaceuticals, Abingdon OX14 4RW, United Kingdom
(Glastonbury) BenevolentAI, London W1T 5HD, United Kingdom
Publisher
American Association for the Advancement of Science
Abstract
Inhibition of sclerostin is a therapeutic approach to lowering fracture
risk in patients with osteoporosis. However, data from phase 3 randomized
controlled trials (RCTs) of romosozumab, a first-in-class monoclonal
antibody that inhibits sclerostin, suggest an imbalance of serious
cardiovascular events, and regulatory agencies have issued marketing
authorizations with warnings of cardiovascular disease. Here, we
meta-analyze published and unpublished cardiovascular outcome trial data
of romosozumab and investigate whether genetic variants that mimic
therapeutic inhibition of sclerostin are associated with higher risk of
cardiovascular disease. Meta-analysis of up to three RCTs indicated a
probable higher risk of cardiovascular events with romosozumab. Scaled to
the equivalent dose of romosozumab (210 milligrams per month; 0.09 grams
per square centimeter of higher bone mineral density), the SOST genetic
variants were associated with lower risk of fracture and osteoporosis
(commensurate with the therapeutic effect of romosozumab) and with a
higher risk of myocardial infarction and/or coronary revascularization and
major adverse cardiovascular events. The same variants were also
associated with increased risk of type 2 diabetes mellitus and higher
systolic blood pressure and central adiposity. Together, our findings
indicate that inhibition of sclerostin may elevate cardiovascular risk,
warranting a rigorous evaluation of the cardiovascular safety of
romosozumab and other sclerostin inhibitors.<br/>Copyright &#xa9; 2020 The
Authors, some rights reserved; exclusive licensee American Association for
the Advancement of Science. No claim to original U.S. Government Works.

<5>
Accession Number
2006805991
Title
Mitral valve replacement using subvalvular apparatus: A systematic review
and meta-analysis.
Source
Heart Surgery Forum. 23 (3) (pp E385-E392), 2020. Date of Publication: May
2020.
Author
Hsieh W.C.; Aboud A.; Henry B.M.; Kan C.D.; Omara M.; Lindner J.
Institution
(Hsieh) First Faculty of Medicine, Charles University, Prague, Czechia
(Hsieh, Lindner) 2nd Department of Cardiovascular Surgery, First Faculty
of Medicine, Charles University, General University Hospital in Prague,
Prague, Czechia
(Aboud) Department of Cardiac and Thoracic Vascular Surgery, University of
Schleswig-Holstein, Lubeck Campus, Lubeck, Germany
(Henry) Division of Cardiology, Cincinnati Children's Hospital Medical
Center, Cincinnati, OH, United States
(Kan) Division of Cardiovascular Surgery, Department of Surgery, National
Cheng Kung University Hospital, Tainan, Taiwan (Republic of China)
(Omara) Department of Thoracic and Cardiovascular Surgery, Research
Institute, Cleveland Clinic, Cleveland, OH, United States
Publisher
Forum Multimedia Publishing LLC (E-mail: motis@cjp.com)
Abstract
Background: To assess clinical outcomes among participants undergoing
mitral valve replacement with preservation of subvalvular apparatus.
<br/>Method(s): Electronic databases, including PubMed, Embase, Science
Direct, World of Science, Scopus, Biosis, SciElo and Cochrane library,
were probed using an extensive search strategy. Studies that reported at
least one clinical outcome, such as morbidity, mortality, early 30-day
mortality, myocardial failure, survival, late cerebrovascular events,
length of stay, or major operative complications (stroke, prolonged
ventilation, and reoperation for bleeding, renal failure, and sternal
infection) were considered for inclusion. Data was extracted and pooled
into a meta-analysis in RevMan (version 5.3) using a random-effects model.
<br/>Result(s): A total of 21 studies with 5,106 participants (age range:
27.3-69.2 years) were included in this meta-analysis. Preservation of the
subvalvular apparatus during MVR significantly reduces the risk of
long-term mortality (OR: 0.46; 95% CI: 0.33-0.64), but not early mortality
(OR: 0.76; 95% CI: 0.12-4.93). No significant difference ejection fraction
was observed (SMD: 0.10; 95% CI: -0.44-0.64). Similarly, there was no
significant difference in the risk of stroke, renal failure, and pneumonia
between C-MVR and in the control group. <br/>Conclusion(s): MVR with the
preservation of subvalvular apparatus improves clinical outcomes, such as
long-term mortality, hospital length of stay, pneumonia, and bleeding.
There is no significant difference in the risk of stroke, renal failure,
or ICU length of stay. However, there is very limited data available with
respect to bleeding, sepsis, and nosocomial infections.<br/>Copyright
&#xa9; 2020 Forum Multimedia Publishing, LLC.

<6>
Accession Number
2006731266
Title
Efficacy of different doses of omega-3 fatty acids on cardiovascular
outcomes: Rationale and design of a network meta-analysis.
Source
Minerva Cardioangiologica. 68 (1) (pp 47-50), 2020. Date of Publication:
February 2020.
Author
Lombardi M.; Chiabrando J.G.; Vescovo G.M.; Bressi E.; Del Buono M.G.;
Carbone S.; Koenig R.; van Tassell B.W.; Dixon D.L.; Abbate A.; Biondi
Zoccai G.
Institution
(Lombardi, Bressi, Del Buono, Carbone, van Tassell, Abbate) VCU Pauley
Heart Center, Division of Cardiology, Department of Internal Medicine,
Virginia Commonwealth University, Richmond, VA, United States
(Lombardi, Del Buono) Department of Cardiovascular and Thoracic Sciences,
Sacred Heart Catholic University, Rome, Italy
(Chiabrando) Interventional Cardiology Service, Hospital Italiano de
Buenos Aires, Buenos Aires, Argentina
(Chiabrando) Health Science Statistics Applied Laboratory (LEACS),
Department of Pharmacology and Toxicology, University of Buenos Aires,
Buenos Aires, Argentina
(Vescovo) Department of Cardiac Thoracic, Vascular Sciences and Public
Health, University of Padua, Padua, Italy
(Carbone) Department of Kinesiology and Health Sciences, College of
Humanities and Sciences, Virginia Commonwealth University, Richmond, VA,
United States
(Koenig) Tompkins-McCaw Library for the Health Sciences, VCU Libraries
Virginia Commonwealth University, Richmond, VA, United States
(van Tassell, Dixon) Department of Pharmacotherapy and Outcomes Science,
Virginia Commonwealth University, Richmond, VA, United States
(Biondi Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University, Latina, Italy
(Biondi Zoccai) Mediterranea Cardiocentro, Naples, Italy
Publisher
Edizioni Minerva Medica (E-mail: subscriptions.dept@minervamedica.it)
Abstract
INTRODUCTION: The impact of omega-3 fatty acids (O3FA) supplementation on
cardiovascular risk is still in debate, largely due to the heterogeneity
of population enrolled and variable dose and composition of the
formulations used in the previous studies. Yet, O3FA may favorably impact
on cardiovascular risk by reducing major cardiovascular events (including
cardiac death and ischemic events). EVIDENCE ACQUISITION: We aim to
perform a comprehensive review of the topic of O3FA for cardiovascular
prevention, stemming from a systematic review, to pairwise meta-analysis
and network meta-analysis, limiting our inclusion only to randomized
clinical trials comparing low dose (LD) (<1 g per day) O3FA and high dose
(HD) (>1 g per day) O3FA versus placebo. The efficacy outcomes of interest
are total death, cardiac death, sudden cardiac death, myocardial
infarction, stroke, coronary revascularization, unstable angina and major
vascular events. Safety outcomes of interest are bleeding,
gastrointestinal disturbances and atrial fibrillation events. EVIDENCE
SYNTHESIS: This meta-analysis is expected to include several important
studies on cardiovascular primary and secondary prevention and detail on
important cardiovascular outcomes. Furthermore, we intend to highlight
safety outcomes related to O3FA supplementation. <br/>CONCLUSION(S): The
present network meta-analysis results will aid physicians in the decision
to prescribe O3FA in patients with or at risk of cardiovascular events. In
particular, it will be able to solve controversies emerged from previous
randomized clinical trials and meta-analyses regarding the benefit of
different doses of O3FA supplementation in the cardiovascular
prevention.<br/>Copyright &#xa9; 2019 EDIZIONI MINERVA MEDICA

<7>
Accession Number
632280674
Title
A controlled trial of rivaroxaban after transcatheter Aortic-valve
replacement.
Source
New England Journal of Medicine. 383 (2) (pp E81), 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
Massachussetts Medical Society

<8>
Accession Number
632280613
Title
Impact of beta blockers on patients undergoing transcatheter aortic valve
replacement: The OCEAN-TAVI registry.
Source
Open Heart. 7 (2) (no pagination), 2020. Article Number: 001269. Date of
Publication: 07 Jul 2020.
Author
Saito T.; Yoshijima N.; Hase H.; Yashima F.; Tsuruta H.; Shimizu H.;
Fukuda K.; Naganuma T.; Mizutani K.; Araki M.; Tada N.; Yamanaka F.;
Shirai S.; Tabata M.; Ueno H.; Takagi K.; Higashimori A.; Watanabe Y.;
Yamamoto M.; Hayashida K.
Institution
(Saito, Yoshijima, Hase, Tsuruta, Fukuda, Hayashida) Cardiology, Keio
University School of Medicine, Shinjuku-ku, Tokyo, Japan
(Yashima) Cardiology, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi,
Japan
(Shimizu) Cardiovascular Surgery, Keio University School of Medicine,
Shinjuku-ku, Tokyo, Japan
(Naganuma) Cardiology, New Tokyo Hospital, Matsudo, Chiba, Japan
(Mizutani) Cardiovascular Medicine, Osaka City General Hospital, Osaka,
Osaka, Japan
(Araki) Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama,
Kanagawa, Japan
(Tada) Cardiology, Sendai Kosei Hospital, Sendai, Miyagi, Japan
(Yamanaka) Cardiology, Shonan Kamakura General Hospital, Kamakura,
Kanagawa, Japan
(Shirai) Cardiology, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan
(Tabata) Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Iryo Center,
Urayasu, Chiba, Japan
(Ueno) Cardiology, Toyama University School of Medicine, Toyama, Toyama,
Japan
(Takagi) Cardiology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
(Higashimori) Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Osaka,
Japan
(Watanabe) Cardiology, Teikyo University School of Medicine, Itabashi-ku,
Tokyo, Japan
(Yamamoto) Cardiology, Toyohashi Heart Center, Toyohashi, Aichi, Japan
(Yamamoto) Cardiology, Nagoya Heart Center, Nagoya, Aichi, Japan
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Objective There is paucity of data on optimal medical treatment, including
use of beta blockers for patients undergoing transcatheter aortic valve
replacement (TAVR). The study aimed to investigate the association of beta
blockers and clinical outcomes following TAVR. Methods We examined data of
2563 patients who underwent TAVR between October 2013 and May 2017
obtained from a prospective multicentre cohort registry, the optimised
catheter valvular intervention-TAVI registry. We compared the 2-year
cardiovascular and non-cardiovascular mortality and in-hospital outcomes
between patients with and without preprocedural beta-blocker
administration by propensity score matching (PSM). Results Preprocedural
beta blockers were prescribed in 867 patients (33.8%). After PSM, the
incidence of in-hospital congestive heart failure was significantly lower
in patients with preprocedural beta blocker (p=0.046). No differences were
found in 2-year cardiovascular and non-cardiovascular mortality. In the
subgroup analyses, beta-blocker administration was associated with a lower
cardiovascular mortality within 2 years in patients with a history of
coronary artery bypass grafting (CABG; log-rank p=0.017), presence of
peripheral artery disease (PAD; log-rank p=0.003) and brain natriuretic
peptide (BNP) >=400 pg/mL (log-rank p=0.003). When stratified by
postprocedural left ventricular ejection fraction (post-LVEF),
beta-blocker administration was associated with a lower cardiovascular
mortality among patients with post-LVEF <50% (log-rank p=0.024).
Conclusions Preprocedural beta-blocker administration was not associated
with 2-year cardiovascular and non-cardiovascular mortality in overall,
but was associated with a lower 2-year cardiovascular mortality in
patients with a history of CABG, presence of PAD, BNP >=400 pg/mL and
post-LVEF <50%. The findings must be validated using randomised trials.
<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2020. Re-use
permitted under CC BY. Published by BMJ.

<9>
Accession Number
2006782239
Title
ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural
mesothelioma.
Source
European Respiratory Journal. 55 (6) (no pagination), 2020. Article
Number: 1900953. Date of Publication: 01 Jun 2020.
Author
Scherpereel A.; Opitz I.; Berghmans T.; Psallidas I.; Glatzer M.; Rigau
D.; Astoul P.; Bolukbas S.; Boyd J.; Coolen J.; De Bondt C.; De Ruysscher
D.; Durieux V.; Faivre-Finn C.; Fennell D.; Galateau-Salle F.; Greillier
L.; Hoda M.A.; Klepetko W.; Lacourt A.; McElnay P.; Maskell N.A.; Mutti
L.; Pairon J.-C.; Van Schil P.; Van Meerbeeck J.P.; Waller D.; Weder W.;
Cardillo G.; Putora P.M.
Institution
(Scherpereel) Pulmonary and Thoracic Oncology, Univ. Lille, CHU Lille,
INSERM U1189, OncoThAI, Lille, France
(Scherpereel) French National Network of Clinical Expert Centers,
Malignant Pleural Mesothelioma Management (Mesoclin), Lille, France
(Opitz, Weder) Dept of Thoracic Surgery, University Hospital Zurich,
Zurich, Switzerland
(Berghmans) Thoracic Oncology Clinic, Institut Jules Bordet, Brussels,
Belgium
(Psallidas) Oxford Centre for Respiratory Medicine, Oxford University
Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Glatzer, Putora) Dept of Radiation Oncology, Kantonsspital St Gallen, St
Gallen, Switzerland
(Rigau) Iberoamerican Cochrane Center, Barcelona, Spain
(Astoul) Dept of Thoracic Oncology, Pleural Diseases and Interventional
Pulmonology, Hopital Nord, Aix-Marseille University, Marseille, France
(Bolukbas) Dept of Thoracic Surgery, Evang, Kliniken Essen-Mitte, Essen,
Germany
(Boyd) European Lung Foundation, Sheffield, United Kingdom
(Coolen) Dept of Imaging and Pathology, KU Leuven, Leuven, Belgium
(De Bondt, Van Meerbeeck) Dept of Pulmonology and Thoracic Oncology,
Antwerp University, Antwerp University Hospital, Antwerp, Belgium
(De Ruysscher) Dept of Radiation Oncology, Maastro Clinic, Maastricht
University Medical Center+, GROW Research Institute, Maastricht,
Netherlands
(Durieux) Bibliotheque des Sciences de la Sante, Universite libre de
Bruxelles (ULB), Brussels, Belgium
(Faivre-Finn) Christie NHS Foundation Trust, University of Manchester,
Manchester, United Kingdom
(Fennell) Leicester Cancer Research Centre, University of Leicester,
University of Leicester Hospitals NHS Trust, Leicester, United Kingdom
(Galateau-Salle) National Reference Center for Pleural Malignant
Mesothelioma and Rare Peritoneal Tumors MESOPATH, Dept of Biopathology,
Centre Leon Berard, Lyon, France
(Greillier) Aix Marseille University, Assistance Publique Hopitaux de
Marseille, INSERM UMR1068, CNRS UMR7258, Dept of Multidisciplinary
Oncology and Therapeutic Innovations, Marseille, France
(Hoda, Klepetko) Dept of Thoracic Surgery, Medical University of Vienna,
Vienna, Austria
(Lacourt) Univ. Bordeaux, INSERM, Bordeaux Population Health Research
Center, EPICENE, UMR 1219, Bordeaux, France
(McElnay) Newcastle University, Newcastle upon Tyne, United Kingdom
(Maskell) Academic Respiratory Unit, Bristol Medical School, University of
Bristol, Bristol, United Kingdom
(Mutti) Teaching Hosp. Vercelli, Gruppo Italiano Mesotelioma, Italy
(Pairon) INSERM U955, Equipe 4, Universite Paris-Est Creteil, Service de
Pathologies professionnelles et de l'Environnement, Institut Sante-Travail
Paris-Est, CHI Creteil, Creteil, France
(Van Schil) Dept Thoracic and Vascular Surgery, Antwerp University,
Antwerp University Hospital, Antwerp, Belgium
(Waller) Barts Thorax Centre, St Bartholomew's Hospital, London, United
Kingdom
(Cardillo) Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo
Forlanini, Rome, Italy
(Putora) Dept of Radiation Oncology, University of Bern, Bern, Switzerland
Publisher
European Respiratory Society (E-mail: info@ersnet.org)
Abstract
The European Respiratory Society (ERS)/European Society of Thoracic
Surgeons (ESTS)/European Association for Cardio-Thoracic Surgery
(EACTS)/European Society for Radiotherapy and Oncology (ESTRO) task force
brought together experts to update previous 2009 ERS/ESTS guidelines on
management of malignant pleural mesothelioma (MPM), a rare cancer with
globally poor outcome, after a systematic review of the 2009-2018
literature. The evidence was appraised using the Grading of
Recommendations, Assessment, Development and Evaluation approach. The
evidence syntheses were discussed and recommendations formulated by this
multidisciplinary group of experts. Diagnosis: pleural biopsies remain the
gold standard to confirm the diagnosis, usually obtained by thoracoscopy
but occasionally via image-guided percutaneous needle biopsy in cases of
pleural symphysis or poor performance status. Pathology: standard staining
procedures are insufficient in ~10% of cases, justifying the use of
specific markers, including BAP-1 and CDKN2A (p16) for the separation of
atypical mesothelial proliferation from MPM. Staging: in the absence of a
uniform, robust and validated staging system, we advise using the most
recent 2016 8th TNM (tumour, node, metastasis) classification, with an
algorithm for pre-therapeutic assessment. Monitoring: patient's
performance status, histological subtype and tumour volume are the main
prognostic factors of clinical importance in routine MPM management. Other
potential parameters should be recorded at baseline and reported in
clinical trials. Treatment: (chemo)therapy has limited efficacy in MPM
patients and only selected patients are candidates for radical surgery.
New promising targeted therapies, immunotherapies and strategies have been
reviewed. Because of limited data on the best combination treatment, we
emphasise that patients who are considered candidates for a multimodal
approach, including radical surgery, should be treated as part of clinical
trials in MPM-dedicated centres.<br/>Copyright &#xa9; 2020 European
Association for Cardio-Thoracic Surgery.

<10>
Accession Number
2004724537
Title
The safety and efficacy of ultrasound-guided serratus anterior plane block
(Sapb) combined with dexmedetomidine for patients undergoing
video-assisted thoracic surgery (vats): A randomized controlled trial.
Source
Journal of Pain Research. 13 (pp 1785-1795), 2020. Date of Publication:
2020.
Author
Li X.; Liu Y.; Zhao J.; Xiang Z.; Ren C.; Qiao K.
Institution
(Li, Xiang, Qiao) Department of Anesthesiology, The First People's
Hospital of Tianmen, Tianmen, Hubei, China
(Liu, Zhao, Ren) Department of Anesthesiology, Liaocheng People's
Hospital, Liaocheng, Shandong, China
Publisher
Dove Medical Press Ltd. (PO Box 300-008, Albany, Auckland, New Zealand)
Abstract
Background: Although video-assisted thoracic surgery (VATS) can
significantly reduce postoperative pain, the incidence is as high as
30-50%. The purpose of this study was to explore the safety and efficacy
of ultrasound-guided serratus anterior plane block (SAPB) combined with
dexmedetomidine (Dex) for patients undergoing VATS. <br/>Method(s): Eighty
patients were randomized into two groups (20 mL 0.5% ropivacaine plus 0.5
micro&#32;g/kg or 1 micro&#32;g/kg Dex). Primary outcome was the visual
analog scale of pain while coughing (VASc) score at 24 h after surgery.
Secondary outcomes included hemodynamics, sufentanil consumption, number
of patients needing rescue analgesia, time to first rescue analgesic,
total dose of rescue analgesic, satisfaction scores of patients and
surgeons, time of chest tube removal, length of hospital stay, adverse
effects, the prevalence of chronic pain and quality of life.
<br/>Result(s): Compared with D1 group, visual analog scale of pain at
rest (VASr) was significantly lower during the first 24 h after surgery,
while VASc was significantly lower during the first 48 h after surgery
(P<0.05). Mean arterial pressure was significantly decreased from T2 to
T8, and heart rate was significantly decreased from T2 to T7 in the D2
group (P<0.05). Consumption of sevoflurane, remifentanil, DEX and the
recovery time were significantly reduced in the D2 group (P <0.05).
Consumption of sufentanil 8-72 h after surgery was significantly lower in
the D2 group (P<0.05). Additionally, the number of patients who required
rescue analgesia, the time to the first dose of rescue analgesia, and the
total dose of rescue analgesia was significantly lower in the D2 group
(P<0.05). <br/>Conclusion(s): The results of this study show that 1
micro&#32;g/kg DEX is a beneficial adjuvant to ropivacaine for
single-injection SAPB in VATS patients while stable hemodynamics were
maintained.<br/>Copyright &#xa9; 2020 Li et al.

<11>
Accession Number
2007092305
Title
Rationale and design of PROACT Xa: A randomized, multicenter, open-label,
clinical trial to evaluate the efficacy and safety of apixaban versus
warfarin in patients with a mechanical On-X Aortic Heart Valve.
Source
American Heart Journal. 227 (pp 91-99), 2020. Date of Publication:
September 2020.
Author
Jawitz O.K.; Wang T.Y.; Lopes R.D.; Chavez A.; Boyer B.; Kim H.; Anstrom
K.J.; Becker R.C.; Blackstone E.; Ruel M.; Thourani V.H.; Puskas J.D.;
Gerdisch M.W.; Johnston D.; Capps S.; Alexander J.H.; Svensson L.G.
Institution
(Jawitz, Wang, Lopes, Chavez, Kim, Anstrom, Alexander) Duke Clinical
Research Institute, Durham, NC, United States
(Jawitz) Department of Surgery, Duke University Medical Center, Durham,
NC, United States
(Boyer, Capps) CryoLife, Inc., Kennesaw, GA, United States
(Becker) Division of Cardiovascular Health and Diseases, University of
Cincinnati Heart, Lung & Vascular Institute, Cincinnati, OH, United States
(Blackstone, Johnston, Svensson) Department of Thoracic and Cardiovascular
Surgery, Cleveland Clinic, Cleveland, OH, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa, Ottawa, ON,
Canada
(Thourani) Piedmont Heart Institute, Atlanta, GA, United States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai St. Luke's, New
York, NY, United States
(Gerdisch) Department of Cardiothoracic Surgery, Franciscan Hospital,
Indianapolis, IN, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Vitamin K antagonists are the only approved oral anticoagulants for
long-term prophylaxis against valve thrombosis and thromboembolism in
patients with a mechanical heart valve. Despite the proven efficacy and
safety of anticoagulation with the oral direct factor Xa inhibitor
apixaban compared with warfarin in high-risk populations including
subjects with atrial fibrillation or with venous thromboembolism, it
remains unknown whether patients with a mechanical heart valve can be
safely managed with apixaban. The On-X Aortic Heart Valve and On-X
Ascending Aortic Prosthesis with the Vascutek Gelweave Valsalva Graft may
have lower rates of valve thrombosis and thromboembolism than conventional
bileaflet and tilting disc valves due its unique pyrolytic carbon
composition and flared inlet design. <br/>Design(s): PROACT Xa is a
randomized, multicenter, open-label, active-controlled trial comparing
apixaban with warfarin in patients with an On-X Aortic Heart Valve or On-X
Ascending Aortic Prosthesis with the Vascutek Gelweave Valsalva Graft. The
study will randomize approximately 1,000 patients from approximately 60
sites in North America who underwent aortic valve replacement at least 3
months prior. Patients will be randomized 1:1 to receiving apixaban 5 mg
twice daily or warfarin with a target international normalized ratio of
2.0-3.0. The last randomized participant will be followed for at least 2
years. The primary efficacy outcome is the composite of valve thrombosis
and valve-related thromboembolism, and the primary safety outcome is major
bleeding. Assuming the primary outcome occurs in warfarin-anticoagulated
patients at a rate of 1.75%/patient-year, the study has more than 90%
power to assess noninferiority of apixaban treatment with an absolute
noninferiority margin of 1.75%/patient-year. A second co-primary analysis
is to compare the hazard rate for the apixaban arm to twice the objective
performance criterion for thromboembolism and valve thrombosis, that is,
3.4%/patient-year. PROACT Xa will determine whether patients with an On-X
Aortic Heart Valve can be anticoagulated with apixaban as an alternative
to warfarin.<br/>Copyright &#xa9; 2020 The Authors

<12>
Accession Number
2004569049
Title
The comparison of direct laryngoscopy and video laryngoscopy in pediatric
airways management for congenital heart surgery: A randomized clinical
trial.
Source
Anesthesiology and Pain Medicine. 10 (3) (pp 1-6), 2020. Article Number:
e99827. Date of Publication: June 2020.
Author
Javaherforooshzadeh F.; Gharacheh L.
Institution
(Javaherforooshzadeh) Department of Anesthesia, Ahvaz Anesthesiology and
Pain Research Center, Ahvaz Jundishapur University of Medical Sciences,
Ahvaz, Iran, Islamic Republic of
(Gharacheh) Student Research Center, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Gharacheh) Student Research Center, Ahvaz Jundishapur University of
Medical Sciences, Ahvaz, Iran, Islamic Republic of
Publisher
Kowsar Medical Publishing Company (E-mail: library@kowsarpub.com)
Abstract
Background: Airway management in patients with hereditary heart disease is
an important therapeutic intervention. <br/>Objective(s): The purpose of
this study was to compare direct laryngoscopy (DL) with video laryngoscopy
(VL) in pediatric airways management for congenital heart surgery.
<br/>Method(s): This study was designed as a prospective randomized
clinical trial. Two consecutive groups of 30 patients undergoing elective
noncyanotic congenital heart surgery. The patients were divided into
direct laryngoscopy versus video laryngoscopy for intubation of the
trachea. The main outcomes were the number of success rate in the first
attempt, and the secondary outcomes were the duration of successful
intubation and complications, such as desaturation and bradycardia.
<br/>Result(s): Intubation procedure time was measured as 51.13 +/- 17.88
seconds for the group with direct laryngoscopy and 59.66 +/- 45.91 seconds
for group with VL that was significant (P = 0.006). In DL group, 22
patients were intubated on the first attempt, 8 patients on the second
attempt, and 6 patients on the third attempt, compared to 24, 6, and 2
respectively, in VL group. The differences were significant only in the
third attempt between groups (P = 0.033). The important difference
established in heart rate (HR) and SpaO<inf>2</inf> amounts between the
two groups at any time (P < 0.05). <br/>Conclusion(s): VL can produce
better visualization for intubation of trachea in congenital heart
disease, but this is time-consuming. Indeed, training in the use of the VL
should be increased to reduce the time required for performance. Moreover,
further studies are recommended to approve these helpful
findings.<br/>Copyright &#xa9; 2020, Author(s).

<13>
Accession Number
2006087520
Title
Graft patency after FFR-guided versus angiography-guided coronary artery
bypass grafting: The GRAFFITI trial.
Source
EuroIntervention. 15 (11) (pp E999-E1005), 2019. Date of Publication:
December 2019.
Author
Toth G.G.; de Bruyne B.; Kala P.; Ribichini F.; Casselman F.; Ramos R.;
Piroth Z.; Fournier S.; Piccoli A.; van Mieghem C.; Penicka M.; Mates M.;
Nemec P.; van Praet F.; Stockman B.; Degriek I.; Barbato E.
Institution
(Toth) University Heart Center Graz, Division of Cardiology, Department of
Medicine, Medical University Graz, Graz, Austria
(Toth, de Bruyne, Casselman, Fournier, van Mieghem, Penicka, van Praet,
Stockman, Degriek, Barbato) Cardiovascular Research Center Aalst, OLV
Clinic, Aalst, Belgium
(Kala) Department of Cardiology and Internal Medicine, University Hospital
Brno, Medical Faculty, Masaryk University, Brno, Czechia
(Ribichini, Piccoli) Division of Cardiology, Department of Medicine,
University of Verona, Verona, Italy
(Ramos) Hospital Santa Marta, Centro Hospitalar Lisboa Central, Lisbon,
Portugal
(Piroth) Hungarian Institute of Cardiology, Budapest, Hungary
(Mates) Cardiovascular Center, Na Homolce Hospital, Prague, Czechia
(Nemec) Centre of Cardiovascular and Transplant Surgery, Brno, Czechia
(Barbato) Department of Advanced Biomedical Sciences, Federico II
University, Naples, Italy
Publisher
Europa Group
Abstract
Aims: The aim of this study was to assess prospectively the clinical
benefits of fractional flow reserve (FFR) in guiding coronary artery
bypass grafting (CABG). <br/>Methods and Results: GRAFFITI is a
single-blinded, prospective, multicentre, randomised controlled trial of
FFR-guided versus angiography-guided CABG. We enrolled patients undergoing
coronary angiography, having a significantly diseased left anterior
descending artery or left main stem and at least one more major coronary
artery with intermediate stenosis, assessed by FFR. Surgical strategy was
defined based on angiography, blinded to FFR values prior to
randomisation. After randomisation, patients were operated on either
following the angiography-based strategy (angiography-guided group) or
according to FFR, i.e., with an FFR <=0.80 as cut-off for grafting
(FFR-guided group). The primary endpoint was graft patency at 12 months.
Between March 2012 and December 2016, 172 patients were randomised either
to the angiography-guided group (84 patients) or to the FFR-guided group
(88 patients). The patients had a median of three [3; 4] lesions; diameter
stenosis was 65% (50%; 80%), FFR was 0.72 (0.50; 0.82). Compared to the
angiography-guided group, the FFR-guided group received fewer anastomoses
(3 [3; 3] vs 2 [2; 3], respectively; p=0.004). One-year angiographic
follow-up showed no difference in overall graft patency (126 [80%] vs 113
[81%], respectively; p=0.885). One-year clinical follow-up, available in
98% of patients, showed no difference in the composite of death,
myocardial infarction, target vessel revascularisation and stroke.
<br/>Conclusion(s): FFR guidance of CABG has no impact on one-year graft
patency, but it is associated with a simplified surgical
procedure.<br/>Copyright &#xa9; Europa Digital & Publishing 2019. All
rights reserved.

<14>
Accession Number
2005530625
Title
Meta-analysis of two different surgical treatments of ischaemic mitral
regurgitation with the same outcome: mitral valve repair vs mitral valve
replacement.
Source
Acta Cardiologica. 71 (5) (pp 573-580), 2016. Date of Publication: 01 Oct
2016.
Author
Zhang H.; Liu Y.; Bin J.; Qiu S.; Chen F.
Institution
(Zhang, Liu) Department of Medical Ultrasound, Second Affiliated Hospital
of Guangzhou Medical University, Guangzhou, Guangdong, China
(Bin) Southern Medical University, Guangzhou, Guangdong, China
(Qiu, Chen) Department of Cardiology, Nanfang Hospital of Southern Medical
University, Guangzhou, Guangdong, China
Publisher
Taylor and Francis Ltd. (E-mail: michael.wagreich@univie.ac.at)
Abstract
Background Mitral valve replacement (MVR) and mitral valve repair (MVP)
are the most common clinical treatment for ischaemic mitral insufficiency
(IMR). But controversy exists on the optimal surgical strategy for IMR.
Methods A literature search was performed in OvidSP, PubMed and Cochrane
Library to find articles comparing MVP versus MVR for the treatment of
IMR. A meta-analysis was performed for the differences in short- and
long-term survival. Secondary outcomes analysed the postoperative left
ventricular diastolic diameter (LVDD), left ventricular ejection fraction
(LVEF) and the New York Heart Association (NYHA) class. Results Out of the
584 studies, we only included 12 articles. A total of 2953 patients were
enrolled, including 1731 patients in the MVP group and 1222 patients in
the MVR group. The total number of bioprosthesis valves was 1.2 times
(631/535) the number of mechanical valves. After surgery, LVDD and LVEF
had improved and the proportion of NYHA III-IV class declined, but the
differences between the two groups were not significant (P >0.05).
Shortterm survival in the MVP group was higher than that in the MVR group
(odds ratio [OR], 0.44; 95% confidence interval [CI] 0.32-0.60; P<
0.00001). Long-term survival was similar in both two groups (hazard ratio
[HR], 0.86; 95% CI 0.68-1.10, P= 0.24). Conclusion Both MVP and MVR can
play a role in reducing IMR and improving left ventricular function. The
short-term survival of MVP is better than MVR but long-term survival is
similar. Further exploration is needed to install optimal treatment of IMR
and individualized therapy.<br/>Copyright &#xa9; 2016, &#xa9; 2016 Taylor
and Francis Group LLC.

<15>
Accession Number
632384241
Title
Neutrophil Gelatinase-Associated Lipocalin Measured on Clinical Laboratory
Platforms for the Prediction of Acute Kidney Injury and the Associated
Need for Dialysis Therapy: A Systematic Review and Meta-analysis.
Source
American journal of kidney diseases : the official journal of the National
Kidney Foundation. (no pagination), 2020. Date of Publication: 14 Jul
2020.
Author
Albert C.; Zapf A.; Haase M.; Rover C.; Pickering J.W.; Albert A.; Bellomo
R.; Breidthardt T.; Camou F.; Chen Z.; Chocron S.; Cruz D.; de Geus H.R.;
Devarajan P.; Di Somma S.; Doi K.; Endre Z.H.; Garcia-Alvarez M.; Hjortrup
P.B.; Hur M.; Karaolanis G.; Kavalci C.; Kim H.; Lentini P.; Liebetrau C.;
Lipcsey M.; Martensson J.; Muller C.; Nanas S.; Nickolas T.L.; Pipili C.;
Ronco C.; Rosa-Diez G.J.; Ralib A.; Soto K.; Braun-Dullaeus R.C.; Heinz
J.; Haase-Fielitz A.
Institution
(Albert) University Clinic for Cardiology and Angiology, Medical Faculty,
Otto-von-Guericke University
(Zapf) Department of Medical Biometry and Epidemiology, University Medical
Center Hamburg-Eppendorf, Germany
(Haase) Faculty of Medicine, Otto-von-Guericke University, Magdeburg,
Leipziger Str. 44, 39120 Magdeburg, Germany; Diaverum Renal Services
Germany, MVZ Am Neuen Garten, 14469, Potsdam, Germanydst
(Rover, Heinz) Department of Medical Statistics, University Medical Center
Gottingen, D-37073 Gottingen, Humboldtallee 32, Germany
(Pickering) Department of Medicine, University of Otago Christchurch,
Emergency Department, Christchurch Hospital, Christchurch, New Zealand
(Albert) Department for Nephrology and Endocrinology, Klinikum Ernst von
Bergmann, Potsdam, Germany; Diaverum Renal Services Germany, MVZ Am Neuen
Garten, 14469, Potsdam, Germany
(Bellomo) Department of Intensive Care, Austin Hospital, Centre for
Integrated Critical Care, University of Melbourne, Melbourne, Australia
(Breidthardt, Muller) Departments of Internal Medicine, Nephrology and
Cardiology, University Hospital Basel, Switzerland
(Camou) Service de reanimation medicale, hopital Saint-Andre, CHU de
Bordeaux, France
(Chen) Department of Critical Care Medicine, Nanfang Hospital, Southern
Medical University, 1838 Guangzhou Avenue North, Guangzhou, Guangdong
510515, China
(Chocron) Department of Thoracic and Cardio-Vascular Surgery, EA3920,
University Hospital Jean Minjoz, Blvd Fleming, 25000 Besancon
(Cruz) Division of Nephrology-Hypertension, University of California, San
Diego, CA, USA
(de Geus) Department of Intensive Care, Erasmus University Medical Center,
Rotterdam, Netherlands
(Devarajan) Division of Nephrology and Hypertension, Cincinnati Children's
Hospital, University of Cincinnati, United States
(Di Somma) Emergency Medicine, Department of Medical-Surgery Sciences and
Translational Medicine, Sapienza' University of Rome S. Andrea Hospital,
Rome 00189, Italy
(Doi) Department of Emergency and Critical Care Medicine, University of
Tokyo, Bunkyo, 7-3-1 Hongo, Tokyo 113-8655, Japan
(Endre) Department of Nephrology, Prince of Wales Hospital and Clinical
School, University of New South Wales, High Street, Randwick, Sydney
(Garcia-Alvarez) Department of Anesthesiology, Hospital de la Santa Creu i
Sant Pau, Barcelona, Spain
(Hjortrup) Department of Intensive Care, Copenhagen University Hospital,
Rigshospitalet Blegdamsvej 9, Copenhagen 2100, Denmark
(Hur, Kim) Department of Laboratory Medicine, Konkuk University School of
Medicine, Seoul, South Korea
(Karaolanis) Vascular Unit, First Department of Surgery, "Laiko" General
Hospital, Medical School, National and Kapodistrian University of Athens,
Athens, Greece
(Kavalci) Emergency Department, Baskent University Faculty of Medicine,
Ankara, Turkey
(Lentini) Department of Nephrology and Dialysis, San Bassiano Hospital,
Via Dei Lotti
(Liebetrau) Department of Cardiology, Kerckhoff Clinic, Benekestrase 2-8,
Bad Nauheim 61231, Germany
(Lipcsey) Hedenstierna laboratory, Anaesthesiology and Intensive care,
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
(Martensson) Section of Anaesthesia and Intensive Care Medicine,
Department of Physiology and Pharmacology, Karolinska Institutet
Stockholm, Sweden
(Nanas, Pipili) First Critical Care Department, 'Evangelismos' General
Hospital, National and Kapodistrian University of Athens, Ypsilantou
45-47, Athens 10675, Greece
(Nickolas) Columbia University Vagelos College of Physicians and Surgeons,
630 West 168th Street, NY 10032
(Ronco) University of Padova; Director Dep. Nephrology Dialysis &
Transplantation, AULSS8, Regione Veneto, Vicenza, Italy; International
Renal Research Institute (IRRIV), San Bortolo Hospital, Vicenza, Italy
(Rosa-Diez) Department of Nephrology, Dialysis and Transplantation,
Hospital Italiano de Buenos Aires, Peron 4190, Buenos Aires 1181,
Argentina
(Ralib) Department of Anaesthesiology and Intensive Care, International
Islamic University Malaysia, Kuantan, Pahang, Malaysia
(Soto) Department of Nephrology, Hospital Fernando Fonseca, Centro de
Estatistica e Aplicacoes da Universidade de Lisboa, Lisbon, Portugal
(Braun-Dullaeus) University Clinic for Cardiology and Angiology, Medical
Faculty, Otto-von-Guericke University, Leipziger Str. 44, Magdeburg 39120,
Germany
(Haase-Fielitz) Department of Cardiology, Heart Center Brandenburg,
Brandenburg Medical School Theodor Fontane (MHB), Faculty of Health
Sciences, University of Potsdam, Germany
Publisher
NLM (Medline)
Abstract
RATIONALE & OBJECTIVE: The usefulness of measures of neutrophil
gelatinase-associated lipocalin in urine or plasma (u/pNGAL) obtained on
clinical laboratory platforms for predicting acute kidney injury (AKI) and
severe AKI requiring kidney dialysis (AKI-D) has not been fully evaluated.
We sought to quantitatively summarize published data to evaluate the value
of urinary and plasma NGAL for prediction. STUDY DESIGN: Literature-based
meta-analysis and individual-study-data meta-analysis of diagnostic
studies following PRISMA-IPD guidelines. SETTING & STUDY POPULATIONS:
Studies of adults investigating AKI, severe AKI, and AKI-D in the setting
of cardiac surgery, intensive care, or emergency department care using
either urine or plasma NGAL measured on clinical laboratory platforms.
SELECTION CRITERIA FOR STUDIES: PubMed, Web of Science, Cochrane Library,
Scopus and congress abstracts ever published through February 2020
reporting diagnostic test studies of NGAL measured on clinical laboratory
platforms to predict AKI. DATA EXTRACTION: Individual-study-data
meta-analysis was accomplished by providing authors data specifications
tailored to their studies and requesting standardized patient-level data
analysis. ANALYTICAL APPROACH: Individual-study-data meta-analysis
utilized a bivariate time-to-event model for interval-censored data from
which discriminative ability (area under the receiver operating
characteristic curve (AUC)) was characterized. NGAL cutoff concentrations
at 95% sensitivity, 95% specificity, as well as optimal sensitivity and
specificity were also estimated. Models incorporated as confounders
clinical setting and use versus non-use of urine output as a criterion for
AKI. A literature-based meta-analysis was also performed for all published
studies including those studies for which the authors were unable to
provide individual study data analyses. <br/>RESULT(S): We included 52
observational studies involving 13,040 patients. We analyzed 30 datasets
for the individual-study-data meta-analysis with 837 AKI events, 304
severe AKI events, and 103 severe AKI-D events for analyses of urine NGAL
and 705 AKI events, 271 severe AKI events, and 178 AKI-D events for
analyses of plasma NGAL. Discriminative performance was similar in
individual-study-data meta-analysis and literature-based meta-analysis.
Individual-study-data meta-analysis AUCs for uNGAL were 0.75 (95% CI
0.73-0.76) and 0.80 (0.79-0.81) for severe AKI and AKI-D, respectively;
for pNGAL, the corresponding values were 0.80 (0.79-0.81) and 0.86
(0.84-0.86). Cut-off-concentrations at 95% specificity for uNGAL were >580
ng/mL with 27% sensitivity for severe AKI and >589 ng/mL with 24%
sensitivity for AKI-D. Corresponding cut-offs for pNGAL were >364 ng/mL
with 44% sensitivity and >546 ng/mL with 26% sensitivity, respectively.
LIMITATIONS: Practice variability on initiation of acute dialysis.
Imperfect harmonization of data across studies. <br/>CONCLUSION(S):
Urinary and plasma NGAL concentrations may identify patients at high risk
for AKI in clinical research and practice. The reported cut-off
concentrations in this study require prospective evaluation.<br/>Copyright
&#xa9; 2020. Published by Elsevier Inc.

<16>
Accession Number
632381308
Title
A Comprehensive Update on Aspirin Management During Noncardiac Surgery.
Source
Anesthesia and analgesia. (no pagination), 2020. Date of Publication: 14
Jul 2020.
Author
Gerstein N.S.; Albrechtsen C.L.; Mercado N.; Cigarroa J.E.; Schulman P.M.
Institution
(Gerstein) From the Department of Anesthesiology and Critical Care
Medicine, University of New Mexico School of Medicine, Albuquerque, NM,
United States
(Albrechtsen) L. Burrell College of Osteopathic Medicine, Las Cruces, NM,
Mexico
(Mercado) Division of Cardiology, Department of Internal Medicine,
University of New Mexico School of Medicine, Albuquerque, NM, United
States
(Cigarroa) Division of Cardiology, Knight Cardiovascular Institute
(Schulman) Department of Anesthesiology and Perioperative Medicine, Oregon
Health & Science University, Portland, Oregon
Publisher
NLM (Medline)
Abstract
Aspirin is considered critical lifelong therapy for patients with
established cardiovascular (CV) disease (including coronary artery,
cerebrovascular, and peripheral arterial diseases) and is consequently one
of the most widely used medications worldwide. However, the indications
for aspirin use continue to evolve and recent trials question its efficacy
for primary prevention. Although one third of patients undergoing
noncardiac surgery and at risk for a major adverse CV event receive
aspirin perioperatively, uncertainty still exists about how aspirin should
be optimally managed in this context, and significant practice variability
remains. Recent trials suggest that the risks of continuing aspirin during
the perioperative period outweigh the benefits in many cases, but data on
patients with high CV risk remain limited. We performed a comprehensive
PubMed and Medline literature search using the following keywords:
aspirin, aspirin withdrawal, perioperative, coronary artery disease,
cerebrovascular disease, peripheral artery disease, and CV disease; we
manually reviewed all relevant citations for inclusion. Patients taking
aspirin for the primary prevention of CV disease should likely discontinue
it during the perioperative period, especially when there is a high risk
of bleeding. Patients with established CV disease but without a coronary
stent should likely continue aspirin during the perioperative period
unless undergoing closed-space surgery. Patients with a history of
coronary stenting also likely need aspirin continuation throughout the
perioperative period for nonclosed space procedures. Perioperative
clinicians need to balance the risks of ceasing aspirin before surgery
against its continuation during the perioperative interval using a
patient-specific strategy. The guidance on decisionmaking with regard to
perioperative aspirin cessation or continuation using currently available
clinical data from studies in high-risk patients along with nonclinical
aspirin studies is conflicting and does not enable a simplified or unified
answer. However, pertinent guidelines on CV disease management provide a
basic framework for aspirin management, and large trial findings provide
some insight into the safety of perioperative aspirin cessation in some
contexts, although uncertainty on perioperative aspirin still exists. This
review provides an evidence-based update on perioperative aspirin
management in patients undergoing noncardiac surgery with a focus on
recommendations for perioperative clinicians on continuing versus holding
aspirin during this context.

<17>
Accession Number
2007114271
Title
Cardiac resynchronization therapy for the failing systemic right
ventricle: A systematic review.
Source
International Journal of Cardiology. (no pagination), 2020. Date of
Publication: 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, de Groot) Department of Cardiology, Erasmus MC, University
Medical Center, Rotterdam, Netherlands
(Kharbanda, Taverne, Bogers) Department of Cardiothoracic Surgery, Erasmus
MC, University Medical Center, Rotterdam, Netherlands
(Moore) Ahmanson/UCLA Adult Congenital Heart Disease Center, California,
Los Angeles, United States
(Taverne) Department of Anatomy, ERCATHAN, Erasmus MC, university Medical
Center, Rotterdam, Netherlands
(Bramer) Medical library Erasmus MC, University Medical Center, Rotterdam,
Netherlands
Publisher
Elsevier Ireland Ltd
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 The Authors

<18>
Accession Number
2007103936
Title
Feasibility of Perioperative eHealth Interventions for Older Surgical
Patients: A Systematic Review.
Source
Journal of the American Medical Directors Association. (no pagination),
2020. Date of Publication: 2020.
Author
Jonker L.T.; Haveman M.E.; de Bock G.H.; van Leeuwen B.L.; Lahr M.M.H.
Institution
(Jonker, Haveman, van Leeuwen) Department of Surgery, University of
Groningen, University Medical Center Groningen, Groningen, Netherlands
(Jonker, de Bock, Lahr) Department of Epidemiology, University of
Groningen, University Medical Center Groningen, Groningen, Netherlands
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: EHealth interventions are increasingly being applied in
perioperative care but have not been adequately studied for older surgical
patients who could potentially benefit from them. Therefore, we evaluated
the feasibility of perioperative eHealth interventions for this
population. <br/>Design(s): A systematic review of prospective
observational and interventional studies was conducted. Three electronic
databases (PubMed, EMBASE, CINAHL) were searched between January 1999 and
July 2019. Study quality was assessed by Methodological Index for
Non-Randomized Studies (MINORS) with and without control group. Setting
and Participants: Studies of surgical patients with an average age >=65
years undergoing any perioperative eHealth intervention with active
patient participation (with the exception of telerehabilitation following
orthopedic surgery) were included. Measures: The main outcome measure was
feasibility, defined as a patient's perceptions of usability,
satisfaction, and/or acceptability of the intervention. Other outcomes
included compliance and study completion rate. <br/>Result(s): Screening
of 1569 titles and abstracts yielded 7 single-center prospective studies
with 223 patients (range n = 9-69 per study, average age 66-74 years)
undergoing oncological, cardiovascular, or orthopedic surgery. The median
MINORS scores were 13.5 of 16 for 6 studies without control group, and 14
of 24 for 1 study with a control group. Telemonitoring interventions were
rated as "easy to use" by 89% to 95% of participants in 3 studies.
Patients in 3 studies were satisfied with the eHealth intervention and
would recommend it to others. Acceptability (derived from consent rate)
ranged from 71% to 89%, compliance from 53% to 86%, and completion of
study follow-up from 54% to 95%. Conclusions and Implications: Results of
7 studies involving perioperative eHealth interventions suggest their
feasibility and encourage further development of technologies for older
surgical patients. Future feasibility studies require clear definitions of
appropriate feasibility outcome measures and a comprehensive description
of patient characteristics such as functional performance, level of
education, and socioeconomic status.<br/>Copyright &#xa9; 2020 AMDA - The
Society for Post-Acute and Long-Term Care Medicine

<19>
Accession Number
2005619457
Title
Impact of minimal invasive extracorporeal circulation on atrial
fibrillation after coronary artery bypass surgery.
Source
Artificial Organs. (no pagination), 2020. Date of Publication: 2020.
Author
Ellam S.; Hartikainen J.; Korvenoja P.; Pitkanen O.; Tyrvainen E.; Valtola
A.; Halonen J.
Institution
(Ellam, Pitkanen, Tyrvainen) Department of Anesthesiology and Operative
Services, Kuopio University Hospital, Kuopio, Finland
(Hartikainen, Valtola, Halonen) Heart Center, Kuopio University Hospital,
and School of Medicine, University of Eastern Finland, Kuopio, Finland
(Korvenoja) Acute Care, South Karelia Central Hospital, Lappeenranta,
Finland
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Postoperative atrial fibrillation (POAF) is the most common arrhythmia
after cardiac surgery with an incidence between 15% and 50% and
pathophysiology not fully known. By choosing the method of extracorporeal
circulation with focus on the reduction of systemic inflammatory response,
one can potentially decrease the risk of POAF. In this prospective,
randomized trial, we compared minimal invasive extracorporeal circulation
(MiECC) with conventional extracorporeal circulation (CECC) in the
prevention of POAF after coronary artery bypass surgery (CABG). A total of
240 patients who were scheduled for their first on-pump CABG, were
randomized to MiECC or CECC. The primary outcome measure was the incidence
of first POAF during the first 84 hours after surgery. POAF occurred in
42/120 (35.0%) MiECC patients and 43/120 (35.8%) CECC patients with
nonsignificant difference between the groups (OR 1.043, 95% CI
0.591-1.843, P =.884). The first postoperative creatine kinase-MB mass
(CK-MBm) value was lower in the MiECC group, 13.95 [10.5-16.7] (median
[IQR]) than in the CECC group, 15.30 [11.4-18.9] (P =.036), whereas the
use of perioperative dobutamine was higher in the MiECC group, 18/120
(15.0%), than in the CECC group 8/120 (6.7%) (P =.038). The incidence of a
stroke, perioperative myocardial infarction, and resternotomy caused by
bleeding did not differ in the MiECC and CECC groups. Age (OR 1.08, 95% CI
1.04-1.13, P =.000) and peak postoperative CK-MBm (OR 1.57, 95% CI
1.06-2.37, P =.026) were independent predictors of POAF. MiECC compared to
CECC was not effective in reducing the incidence of POAF in patients
undergoing CABG.<br/>Copyright &#xa9; 2020 International Center for
Artificial Organs and Transplantation and Wiley Periodicals LLC.

<20>
Accession Number
2005609370
Title
Mitral valve surgery combined with on-pump versus off-pump myocardial
revascularization: A prospective randomized analysis with midterm
follow-up.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Zavolozhin A.; Shonbin A.; Bystrov D.; Enginoev S.
Institution
(Zavolozhin, Shonbin) Department of Surgery, Arkhangelsk State Medical
University, Arkhangelsk, Russian Federation
(Zavolozhin, Enginoev) Department of Cardiac Surgery, FSBI Federal Centre
for Cardiovascular Surgery of the Ministry of Health of the Russian
Federation, Astrakhan, Russian Federation
(Shonbin, Bystrov) Department of Cardiac Surgery, City Hospital No 1,
Arkhangelsk, Russian Federation
(Enginoev) Department of Cardiac Surgery, Astrakhan State Medical
University, Astrakhan, Russian Federation
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: The aim of the study was to compare results off-pump coronary
artery bypass (OPCAB) combined mitral valve reconstruction (MVR) with
standard on-pump approach. <br/>Method(s): From January 2014 to December
2017, a total of 53 patients received a combined myocardial
revascularization and MVR for multivessel coronary artery disease (CAD)
complicated by severe ischemic mitral regurgitation (IMR). All the
subjects were divided into two groups: group I: 27 patients, received
OPCAB + MVR, and group II (control group): 26 patients with on-pump
myocardial revascularization (ONCAB) + MVR. <br/>Result(s): The aortic
cross-clamp (ACC) and cardio-pulmonary bypass (CPB) times were longer in
group II, 47.0 (44.0; 55.0) vs 94.5 (89.75; 105.5) minutes, P <.05 and
70.0 (63.0; 77.0) vs 138.5 (127.0; 157.5) minutes, P <.05, respectively.
Evaluation of major clinical events showed that the implementation of the
off-pump stage of myocardial revascularization in patients with severe IMR
did not lead to significant changes in the mortality and postoperative
complications. Furthermore, its use did not affect the volume of blood
loss and need for blood transfusion, the duration of mechanical
ventilation, the need for inotropic therapy, as well as the duration of
the patient's resuscitation and the total duration of hospitalization,
with the one exception: the troponin-T level increase in the OPCAB + MVR
group was less than in the ONCAB + MVR group. <br/>Conclusion(s): OPCAB
combined MVR in patients with CAD and severe IMR can be performed with
shorter CPB and ACC times, and lower troponin-T level after surgery,
without reducing the risk of surgical complications.<br/>Copyright &#xa9;
2020 Wiley Periodicals LLC

<21>
Accession Number
2005609285
Title
A European consensus statement on the use of four-factor prothrombin
complex concentrate for cardiac and non-cardiac surgical patients.
Source
Anaesthesia. (no pagination), 2020. Date of Publication: 2020.
Author
Erdoes G.; Koster A.; Ortmann E.; Meesters M.I.; Bolliger D.; Baryshnikova
E.; Martinez Lopez De B.; Ahmed A.; Lance M.D.; Ranucci M.; von Heymann
C.; Agarwal S.; Ravn H.B.
Institution
(Erdoes) Department of Anaesthesiology and Pain Medicine, Inselspital,
Bern University Hospital, University of Bern, Switzerland
(Koster) Institute for Anaesthesiology, Heart and Diabetes Centre NRW,
Ruhr-University Bochum, Bad Oeynhausen, Germany
(Ortmann) Department of Anaesthesia, Kerckhoff Heart and Lung Centre, Bad
Nauheim, Germany
(Meesters) Department of Anaesthesiology, University Medical Centre
Utrecht, Netherlands
(Bolliger) Department of Anaesthesia, Prehospital Emergency Medicine, and
Pain Therapy, University Hospital Basel, Switzerland
(Baryshnikova, Ranucci) Department of Cardiovascular Anaesthesia and
Intensive Care Unit, IRCCS Policlinico San Donato, San Donato Milanese,
Milan, Italy
(Martinez Lopez De) Department of Cardiac Anaesthesia and Intensive Care,
Ca`Foncello Hospital of Treviso, Treviso, Italy
(Ahmed) Department of Anaesthesia, University Hospitals of Leicester NHS
Trust, United Kingdom
(Ahmed) Department of Cardiovascular Sciences, University of Leicester,
United Kingdom
(Lance) Hamad Medical Corporation, HMC, Anaesthesiology, ICU and
Peri-operative Medicine, Doha, Qatar
(von Heymann) Department of Anaesthesia, Intensive Care Medicine,
Emergency Medicine and Pain Therapy, Vivantes Klinikum im Friedrichshain,
Berlin, Germany
(Agarwal) Department of Anaesthesia, Manchester University Hospitals,
Manchester, United Kingdom
(Ravn) Department of Cardiothoracic Anaesthesiology, Rigshospitalet,
Copenhagen University, Copenhagen, Denmark
Publisher
Blackwell Publishing Ltd
Abstract
Modern four-factor prothrombin complex concentrate was designed originally
for rapid targeted replacement of the coagulation factors II, VII, IX and
X. Dosing strategies for the approved indication of vitamin K
antagonist-related bleeding vary greatly. They include INR and
bodyweight-related protocols as well as fixed dose regimens. Particularly
in the massively bleeding trauma and cardiac surgery patient, four-factor
prothrombin complex concentrate is used increasingly for haemostatic
resuscitation. Members of the Transfusion and Haemostasis Subcommittee of
the European Association of Cardiothoracic Anaesthesiology performed a
systematic literature review on four-factor prothrombin complex
concentrate. The available evidence has been summarised for dosing,
efficacy, drug safety and monitoring strategies in different scenarios.
Whereas there is evidence for the efficacy of four-factor prothrombin
concentrate for a variety of bleeding scenarios, convincing safety data
are clearly missing. In the massively bleeding patient with coagulopathy,
our group recommends the administration of an initial bolus of 25
IU.kg^-1. This applies for: the acute reversal of vitamin K
antagonist therapy; haemostatic resuscitation, particularly in trauma; and
the reversal of direct oral anticoagulants when no specific antidote is
available. In patients with a high risk for thromboembolic complications,
e.g. cardiac surgery, the administration of an initial half-dose bolus
(12.5 IU.kg^-1) should be considered. A second bolus may be
indicated if coagulopathy and microvascular bleeding persists and other
reasons for bleeding are largely ruled out. Tissue-factor-activated,
factor VII-dependent and heparin insensitive point-of-care tests may be
used for peri-operative monitoring and guiding of prothrombin complex
concentrate therapy.<br/>Copyright &#xa9; 2020 Association of
Anaesthetists

<22>
Accession Number
2005609220
Title
Is carotid screening redundant for patients undergoing coronary artery
bypass grafting?.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Volpi S.; Ali J.M.
Institution
(Volpi, Ali) Department of Cardiothoracic Surgery, Royal Papworth
Hospital, Cambridge Biomedical Campus, Cambridge, United Kingdom
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Objectives: Stroke is a devastating complication following coronary artery
bypass grafting, which thankfully occurs with low incidence. The role of
preoperative carotid ultrasound remains unclear. Whilst it is a cheap and
reliable way of diagnosing carotid stenosis (CS), it is unclear if and how
this knowledge should impact on subsequent patient management.
<br/>Method(s): A systematic review of the literature was performed using
the PRISMA guideline. A literature search was conducted on the MEDLINE
database from 1950 to May 2020 using the OVID interface. Fifteen papers
out of a total of 5931 were identified for inclusion. <br/>Result(s): The
evidence overall suggests that patients with severe CS are likely to have
an increased incidence of postoperative stroke-however, the prevalence of
severe CS is low, and even in this cohort of patients, the incidence is
not particularly high. <br/>Conclusion(s): In screened patients identified
to have severe CS, there appears to be a generally low appetite for
undertaking carotid intervention internationally either before or
concurrently with the coronary artery bypass grafting. Putting this all
together, the widespread screening of asymptomatic patients would appear
to not be justified.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<23>
Accession Number
2005609049
Title
Catheter ablation of atrial tachycardias after mitral valve surgery: A
systematic review and meta-analysis.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2020. Date
of Publication: 2020.
Author
Marazzato J.; Cappabianca G.; Angeli F.; Crippa M.; Golino M.; Ferrarese
S.; Beghi C.; De Ponti R.
Institution
(Marazzato, Cappabianca, Angeli, Crippa, Golino, Ferrarese, Beghi, De
Ponti) Department of Medicine and Surgery, Ospedale di Circolo, University
of Insubria, Varese, Italy
(Angeli) Department of Medicine and Cardiopulmonary Rehabilitation,
Maugeri Care and Research Institutes, IRCCS Tradate, Varese, Italy
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Introduction: Data regarding catheter ablation (CA) of atrial tachycardias
(ATs) occurring after mitral valve surgery (MVS) are scarce. The aim of
this study was to assess the safety and efficacy of CA of ATs in this
surgical population through a systematic review of the literature and
meta-analysis. <br/>Method(s): A systematic search on PubMed/MEDLINE,
EMBASE, and Web of Science was performed considering patients undergoing
CA for ATs occurring after MVS. Periprocedural thromboembolic and
hemorrhagic complications were assessed. The acute success and maintenance
of sinus rhythm (SR) at a mid (<24 months) and long-term follow-up (FU)
after CA were investigated along with the burden of arrhythmic recurrence
at FU. <br/>Result(s): Fourteen studies for a total of 227 patients were
considered. Three-dimensional (3D) mapping systems were used in all
studies. Only two major bleedings were recorded with a pooled estimate of
periprocedural major complications of 0%. The acute success after CA was
95% with a clear improvement over time. Although maintenance of SR was 71%
at a midterm FU, long-term efficacy was as low as 47% due to an increased
burden of atrial fibrillation (AF) recurrence despite multiple
procedures/patient. <br/>Conclusion(s): In this meta-analysis, CA of
postsurgical ATs after MVS proved safe and effective but with still a
significant burden of AF recurrence at more than 24 months of FU due to a
progressive atrial substrate deterioration. The improvement of procedural
success over time might suggest a learning curve in optimizing the use of
3D mapping systems.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<24>
Accession Number
632376315
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. (no pagination), 2020. Date of Publication: 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, Houston, TX, United States
(Villarreal) Tecnologico de Monterrey, Escuela de Medicina y Ciencias de
la Salud, Nuevo Leon, Monterrey, Mexico
(Aiello, Loomba) Chicago Medical School/Rosalind Franklin University of
Medicine and Science, North Chicago, IL, United States
(Loomba) Advocate Children's Hospital, Oak Lawn, IL, United States
Publisher
Cambridge University Press (E-mail: Journals_subscriptions@cup.cam.ac.uk)
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. <br/>Copyright &#xa9;
The Author(s), 2020. Published by Cambridge University Press.

<25>
Accession Number
632366180
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: 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, 9500 Euclid Ave, Cleveland, OH 44195, 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 and Lung Institute, Universite de Laval, Quebec,
QC, Canada
(Riesmeyer, Ruotolo) Eli Lilly, Indianapolis, IN, United States
(Nicholls) MonashHeart, Department of Cardiology, Monash University,
Clayton, VIC, Australia
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
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.<br/>Copyright &#xa9; 2020 American Medical Association. All
rights reserved.

<26>
Accession Number
2006816013
Title
Melatonin and organ transplantation: What is the relationship?.
Source
Revista da Associacao Medica Brasileira. 66 (3) (pp 353-358), 2020. Date
of Publication: March 2020.
Author
Haddad C.F.; Haddad J.M.; de Arruda Veiga E.C.; Sorpreso I.C.E.; Simoes
R.S.; Baracat E.C.; Soares-Junior J.M.
Institution
(Haddad, Haddad, de Arruda Veiga, Sorpreso, Simoes, Baracat,
Soares-Junior) Departamento de Obstetricia e Ginecologia, Hospital das
Clinicas, Faculdade de Medicina da Universidade, Sao Paulo, Brazil
Publisher
Associacao Medica Brasileira
Abstract
Melatonin has anti-inflammatory and antioxidant properties that can
influence tissue growth and apoptosis. This aspect may influence the
success of organ transplantation. <br/>OBJECTIVE(S): To evaluate the
relationship between melatonin and organ transplantation. <br/>METHOD(S):
A systematic review was performed in PubMed databases using the search
terms: "melatonin physiology" or "melatonin therapy" and "transplant
pharmacology" or "transplant physiology" or "transplant therapy" or
"Transplant therapy". Experiments on the organs of the reproductive system
were not included. After analysis, five articles were selected after
reading the title and abstract of 50 manuscripts. The works were divided
into two aspects: a) analysis of the influence of the organ
transplantation procedure on melatonin production; b) action of melatonin
on organ transplantation. <br/>RESULT(S): The cardiac transplantation
surgical procedure, immunosuppression, and graft did not influence
melatonin secretion in rodents, but there was a significant reduction of
melatonin in the renal transplantation procedure in patients with renal
insufficiency. Melatonin administration in experimental models decreased
rejection and improved transplant success. <br/>CONCLUSION(S): Studies
show that melatonin can reduce organ and species dependence, and the use
of melatonin decreases graft rejection.<br/>Copyright &#xa9; 2020
Associacao Medica Brasileira. All rights reserved.

<27>
Accession Number
2005552925
Title
Medical thoracoscopy in the diagnosis of pleural disease: a guide for the
clinician.
Source
Expert Review of Respiratory Medicine. (pp 1-14), 2020. Date of
Publication: 2020.
Author
Shaikh F.; Lentz R.J.; Feller-Kopman D.; Maldonado F.
Institution
(Shaikh) Division of Pulmonary and Critical Care Medicine, David Geffen
School of Medicine, University of Los Angeles, Los Angeles, CA, United
States
(Lentz, Maldonado) Division of Allergy, Pulmonary, and Critical Care
Medicine, Vanderbilt University Interventional Pulmonology, Nashville, TN,
United States
(Feller-Kopman) Division of Pulmonary, Critical Care, and Sleep Medicine,
Johns Hopkins Hospital, Baltimore, MD, United States
Publisher
Taylor and Francis Ltd
Abstract
Introduction: Developing a feasible and accurate means of evaluating
pleural pathology has been an ongoing effort for over 150 years. Pleural
fluid cellular and biomarker analyses are simple ways of characterizing
and uncovering pathologic entities of pleural disease. However, obtaining
samples of pleural tissue has become increasingly important. In cases of
suspected malignancy and certain infections histopathology, culture, and
molecular testing are necessary to profile diseases more effectively. The
pleura is sampled via several techniques including blind transthoracic
biopsy, image-guided biopsy, and surgical thoracotomy. Given the
heterogeneity of pleural disease, low diagnostic yields, or invasiveness
no procedural gold standard has been established in pleural diagnostics.
Areas covered: Herein, we provide a review of the literature on medical
thoracoscopy (MT), its development, technical approach, indications,
risks, current and future role in the evaluation of thoracic disease.
Pubmed was searched for articles published on MT, awake thoracoscopy, and
pleuroscopy with a focus on reviewing literature published in the past 5
years. Expert opinion: As the proficiency and number of interventional
pulmonologists continues to grow, MT is ideally positioned to become a
front-line diagnostic tool in pleural disease and play an increasingly
prominent role in the treatment algorithm of various pleural
pathologies.<br/>Copyright &#xa9; 2020, &#xa9; 2020 Informa UK Limited,
trading as Taylor & Francis Group.

<28>
Accession Number
2004716890
Title
Antithrombotic treatment in diabetes mellitus: A review of the literature
about antiplatelet and anticoagulation strategies used for diabetic
patients in primary and secondary prevention.
Source
Current Pharmaceutical Design. 26 (23) (pp 2780-2788), 2020. Date of
Publication: 2020.
Author
Siasos G.; Skotsimara G.; Oikonomou E.; Sagris M.; Vasilikichara M.;
Bletsa E.; Stampouloglou P.; Theofilis P.; Charalampous G.; Tousoulis D.
Institution
(Siasos, Skotsimara, Oikonomou, Sagris, Vasilikichara, Bletsa,
Stampouloglou, Theofilis, Charalampous, Tousoulis) First Department of
Cardiology, Hippokration Hospital, Athens Medical School, 114 Vas. Sofias
avenue, Athens 11527, Greece
Publisher
Bentham Science Publishers (P.O. Box 294, Bussum 1400 AG, Netherlands)
Abstract
Background: Diabetes mellitus (DM) is on the rise globally. Its prevalence
has nearly doubled during the last two decades and it is estimated to
affect 8.8% of the global population. Cardiovascular disease (CVD) is the
leading cause of death in the diabetic population and despite modern
anti-inflammatory and cardioprotective therapeutic strategies, diabetic
patients have at least a twice fold risk of cardiovascular events. The
prothrombotic state in DM is associated with multiple determinants such as
platelet alterations, oxidative stress, endothelial changes, circulating
mediators. Thus, proper antithrombotic strategies to reduce the risk of
CVD in this population are critical. <br/>Method(s): This article reviews
the current antiplatelet and anticoagulant agents in the aspect of primary
and secondary prevention of CVD in the diabetic population.
<br/>Result(s): The use of aspirin may be considered only at high-risk
patients in the absence of contraindications. Cangrelor was not inferior
to clopidogrel in preventing the composite outcome of CV death, myocardial
infarction and revascularization without increasing major bleeding. Triple
therapy in the subpopulation with DM significantly reduced the composite
primary outcome of CV death, myocardial infarction or repeat target lesion
revascularization. That was not the case for stent thrombosis, which was
similar in both groups. Importantly, triple therapy did not result in
increased bleeding complications, which were similar in both groups.
However, cilostazol is linked to various adverse effects (e.g., headache,
palpitations, and gastrointestinal disturbances) that drive many patients
to withdrawal. <br/>Conclusion(s): In conclusion, DM is a rapidly growing
disease that increases the risk of CVD, AF, and CV mortality. Proper
antithrombotic strategies to reduce CVD risk in DM are a necessity.
Moreover, new antithrombotic treatments and combination therapies may play
a critical role to overcome antiplatelet resistance in DM patients and
reduce morbidity and mortality attributed to CVD.<br/>Copyright &#xa9;
2020 Bentham Science Publishers.

<29>
Accession Number
632325727
Title
Intra-procedural arrhythmia during cardiac catheterization: A systematic
review of literature.
Source
World Journal of Cardiology. 12 (6) (pp 269-284), 2020. Date of
Publication: 26 Jun 2020.
Author
Shaik F.A.; Slotwiner D.J.; Gustafson G.M.; Dai X.
Institution
(Shaik, Slotwiner, Gustafson, Dai) Division of Cardiology, New York
Presbyterian Queens Hospital, Flushing, NY 11355, United States
Publisher
Baishideng Publishing Group Co (7901 Stoneridge Drive, Suite 501,
Pleasanton, California 94588, United States. E-mail: bpg@baishideng.com)
Abstract
BACKGROUND Cardiac catheterization is among the most performed medical
procedures in the modern era. There were sporadic reports indicating that
cardiac arrhythmias are common during cardiac catheterization, and there
are risks of developing serious and potentially life-threatening
arrhythmias, such as sustained ventricular tachycardia (VT), ventricular
fibrillation (VF) and high-grade conduction disturbances such as complete
heart block (CHB), requiring immediate interventions. However, there is
lack of systematic overview of these conditions. AIM To systematically
review existing literature and gain better understanding of the incidence
of cardiac arrhythmias during cardiac catheterization, and their impact on
outcomes, as well as potential approaches to minimize this risk. METHODS
We applied a combination of terms potentially used in reports describing
various cardiac arrhythmias during common cardiac catheterization
procedures to systematically search PubMed, EMBASE and Cochrane databases,
as well as references of full-length articles. RESULTS During right heart
catheterization (RHC), the incidence of atrial arrhythmias (premature
atrial complexes, atrial fibrillation and flutter) was low (< 1%); these
arrhythmias were usually transient and self-limited. RHC associated with
the development of a new RBBB at a rate of 0.1%-0.3% in individuals with
normal conduction system but up to 6.3% in individuals with pre-existing
left bundle branch block. These patients may require temporary pacing due
to transient CHB. Isolated premature ventricular complexes or
non-sustained VT are common during RHC (up to 20% of cases). Sustained
ventricular arrhythmias (VT and/or VF) requiring either withdrawal of
catheter or cardioversion occurred infrequently (1%-1.3%). During left
heart catheterizations (LHC), the incidence of ventricular arrhythmias has
declined significantly over the last few decades, from 1.1% historically
to 0.1% currently. The overall reported rate of VT/VF in diagnostic LHC
and coronary angiography is 0.8%. The risk of VT/VF was higher during
percutaneous coronary interventions for stable coronary artery disease
(1.1%) and even higher for patients with acute myocardial infarctions
(4.1%-4.3%). Intravenous adenosine and papaverine bolus for fractional
flow reserve measurement, as well as intracoronary imaging using optical
coherence tomography have been reported to induce VF. Although uncommon,
LHC and coronary angiography were also reported to induce conduction
disturbances including CHB. CONCLUSION Cardiac arrhythmias are common and
potentially serious complications of cardiac catheterization procedures,
and it demands constant vigilance and readiness to intervene during
procedures.<br/>Copyright &#xa9; The Author(s) 2020. Published by
Baishideng Publishing Group Inc. All rights reserved.

<30>
Accession Number
2005593270
Title
A meta-analysis comparing transaxillary and transaortic transcatheter
aortic valve replacement.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2020. Date
of Publication: 2020.
Author
Zhan Y.; Lofftus S.; Kawabori M.; Soin A.; Chen F.Y.
Institution
(Zhan, Lofftus, Kawabori, Soin, Chen) Division of Cardiac Surgery, Tufts
Medical Center, Tufts University School of Medicine, 800 Washington
Street, #266, Boston, MA 02111, United States
Publisher
Springer
Abstract
Background: The alternative access route of choice for transcatheter
aortic valve replacement (TAVR) remains to be elucidated due to lack of
evidences. We performed a meta-analysis comparing the outcomes of two
common alternative access routes, transaxillary (TAx) and transaortic
(TAo) approaches. <br/>Method(s): The PubMed/MEDLINE, Embase, and Cochrane
library from inception to December 2018 were searched to identify the
articles reporting data on both TAx-TAVR and TAo-TAVR. Patients' baseline
characteristics, procedural outcomes, and clinical outcomes were extracted
from the articles and pooled for analysis. <br/>Result(s): Four studies, a
total of 750 (374 TAo and 376 TAx) patients were included in the study.
The two groups were similar in patients' baseline characteristics,
although the TAx group comprised few female patients. The two groups
differ in outcomes including 30-day mortality, rates of pacemaker implant
and acute kidney injury, and length of hospital stay. There were no
differences between the two groups with regard to device success,
paravalvular leak, stroke, vascular complications, and 1-year mortality.
<br/>Conclusion(s): Compared with the TAo approach, the TAx approach is
associated with favorable short-term mortality, lower incidence of acute
kidney injury, and shorter length of hospital stay, but increased
pacemaker requirement. TAx could be considered over TAo as the preferred
alternative access for TAVR.<br/>Copyright &#xa9; 2020, The Japanese
Association for Thoracic Surgery.

<31>
Accession Number
2005586369
Title
Impact of Different Doses of Omega-3 Fatty Acids on Cardiovascular
Outcomes: a Pairwise and Network Meta-analysis.
Source
Current Atherosclerosis Reports. 22 (9) (no pagination), 2020. Article
Number: 45. Date of Publication: 01 Sep 2020.
Author
Lombardi M.; Chiabrando J.G.; Vescovo G.M.; Bressi E.; Del Buono M.G.;
Carbone S.; Koenig R.A.; Van Tassell B.W.; Abbate A.; Biondi-Zoccai G.;
Dixon D.L.
Institution
(Lombardi, Bressi, Del Buono, Carbone, Van Tassell, Abbate, Dixon) VCU
Pauley Heart Center, Virginia Commonwealth University, Richmond, VA,
United States
(Lombardi, Del Buono) Department of Cardiovascular and Thoracic Sciences,
Catholic University of the Sacred Heart, Rome, Italy
(Chiabrando) Interventional Cardiology Service, Hospital Italiano de
Buenos Aires, Buenos Aires, Argentina
(Chiabrando) Health Science Statistics Applied Laboratory (LEACS),
Pharmacology and Toxicology Department, School of Medicine, University of
Buenos Aires, Buenos Aires, Argentina
(Vescovo) Department of Cardiac Thoracic, Vascular Sciences and Public
Health, University of Padua, Padua, Italy
(Bressi) Division of Cardiology, Policlinico Casilino, Rome, Italy
(Carbone) Department of Kinesiology & Health Sciences, College of
Humanities & Sciences, Virginia Commonwealth University, Richmond, VA,
United States
(Koenig) Tompkins-McCaw Library for the Health Sciences, VCU Libraries
Virginia Commonwealth University, Richmond, VA, United States
(Van Tassell, Dixon) Department of Pharmacotherapy & Outcomes Science,
Virginia Commonwealth University, Richmond, VA, United States
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Napoli, Italy
Publisher
Springer
Abstract
Purpose of Review: Omega-3 fatty acid (O3FA) supplementation has shown
conflicting evidence regarding its benefit in cardiovascular events. We
performed a pairwise and network meta-analysis to elucidate the benefit of
different doses of O3FA supplementation in cardiovascular prevention.
Recent Findings: Fourteen studies were identified providing data on
125,763 patients. A prespecified cut-off value of < 1 g per day was set
for low-dose (LD) O3FA and > 1 g per day for high-dose (HD) O3FA. The
efficacy outcomes of interest were total death, cardiac death, sudden
cardiac death, myocardial infarction, stroke, coronary revascularization,
unstable angina, and major vascular events. Safety outcomes of interest
were bleeding, gastrointestinal disturbances, and atrial fibrillation
events. HD treatment was associated with a lower risk of cardiac death
(IRR 0.79, 95% CI [0.65-0.96], p = 0.03 versus control), myocardial
infarction (0.71 [0.62-0.82], p < 0.0001 versus control and 0.79
[0.67-0.92], p = 0.003 versus LD), coronary revascularization (0.74
[0.66-0.83], p < 0.0001 versus control and 0.74 [0.66-0.84], p < 0.0001
versus LD), unstable angina (0.73 [0.62-0.86], p = 0.0001 versus control
and 0.74 [0.62-0.89], p = 0.002 versus LD), and major vascular events
(0.78 [0.71-0.85], p < 0.0001 versus control and 0.79 [0.72-0.88], p <
0.0001 versus LD). HD treatment was associated with increased risk for
bleeding events (1.49 [1.2-1.84], p = 0.0002 versus control and 1.63
[1.16-2.3], p = 0.005 versus LD) and increased atrial fibrillation events
compared to control (1.35 [1.1-1.66], p = 0.004). <br/>Summary: HD O3FA
treatment was associated with lower cardiovascular events compared to LD
and to control, but increased risk for bleeding and atrial fibrillation
events.<br/>Copyright &#xa9; 2020, Springer Science+Business Media, LLC,
part of Springer Nature.

<32>
Accession Number
2005576609
Title
Investigation of the safety and feasibility of AAV1/SERCA2a gene transfer
in patients with chronic heart failure supported with a left ventricular
assist device - the SERCA-LVAD TRIAL.
Source
Gene Therapy. (no pagination), 2020. Date of Publication: 2020.
Author
Lyon A.R.; Babalis D.; Morley-Smith A.C.; Hedger M.; Suarez Barrientos A.;
Foldes G.; Couch L.S.; Chowdhury R.A.; Tzortzis K.N.; Peters N.S.;
Rog-Zielinska E.A.; Yang H.-Y.; Welch S.; Bowles C.T.; Rahman Haley S.;
Bell A.R.; Rice A.; Sasikaran T.; Johnson N.A.; Falaschetti E.;
Parameshwar J.; Lewis C.; Tsui S.; Simon A.; Pepper J.; Rudy J.J.; Zsebo
K.M.; Macleod K.T.; Terracciano C.M.; Hajjar R.J.; Banner N.; Harding S.E.
Institution
(Lyon, Morley-Smith, Foldes, Couch, Chowdhury, Tzortzis, Peters,
Rog-Zielinska, Yang, Welch, Simon, Pepper, Macleod, Terracciano, Harding)
National Heart and Lung Institute, Imperial College London, London, United
Kingdom
(Lyon, Morley-Smith, Hedger, Suarez Barrientos, Welch, Bowles, Rahman
Haley, Simon, Pepper, Banner) NIHR Cardiovascular Biomedical Research
Unit, Royal Brompton and Harefield Hospitals NHS Trust, London, United
Kingdom
(Babalis, Sasikaran, Johnson, Falaschetti) Imperial Clinical Trials Unit
(ICTU), School of Public Health, Imperial College London, London, United
Kingdom
(Rog-Zielinska) Institute for Experimental Cardiovascular Medicine,
University Heart Center, Medical Center, University of Freiburg, Freiburg,
Germany
(Bell, Rice) Department of Histopathology, Royal Brompton and Harefield
Hospitals NHS Trust, Freiburg, Germany
(Parameshwar, Lewis, Tsui) Royal Papworth Hospital NHS Trust, Cambridge,
United Kingdom
(Rudy, Zsebo) Celladon Corporation, San Diego, CA, United States
(Hajjar) Phospholamban Foundation, Amsterdam, Netherlands
Publisher
Springer Nature
Abstract
The SERCA-LVAD trial was a phase 2a trial assessing the safety and
feasibility of delivering an adeno-associated vector 1 carrying the
cardiac isoform of the sarcoplasmic reticulum calcium ATPase
(AAV1/SERCA2a) to adult chronic heart failure patients implanted with a
left ventricular assist device. The SERCA-LVAD trial was one of a program
of AAV1/SERCA2a cardiac gene therapy trials including CUPID1, CUPID 2 and
AGENT trials. Enroled subjects were randomised to receive a single
intracoronary infusion of 1 x 10¹³ DNase-resistant AAV1/SERCA2a
particles or a placebo solution in a double-blinded design, stratified by
presence of neutralising antibodies to AAV. Elective endomyocardial biopsy
was performed at 6 months unless the subject had undergone cardiac
transplantation, with myocardial samples assessed for the presence of
exogenous viral DNA from the treatment vector. Safety assessments
including ELISPOT were serially performed. Although designed as a 24
subject trial, recruitment was stopped after five subjects had been
randomised and received infusion due to the neutral result from the CUPID
2 trial. Here we describe the results from the 5 patients at 3 years
follow up, which confirmed that viral DNA was delivered to the failing
human heart in 2 patients receiving gene therapy with vector detectable at
follow up endomyocardial biopsy or cardiac transplantation. Absolute
levels of detectable transgene DNA were low, and no functional benefit was
observed. There were no safety concerns in this small cohort. This trial
identified some of the challenges of performing gene therapy trials in
this LVAD patient cohort which may help guide future trial
design.<br/>Copyright &#xa9; 2020, The Author(s).

<33>
Accession Number
2005572488
Title
Mitral valve repair with minimally invasive approaches vs sternotomy: A
meta-analysis of early and late results in randomized and matched
observational studies.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Sa M.P.B.O.; Van den Eynde J.; Cavalcanti L.R.P.; Kadyraliev B.; Enginoev
S.; Zhigalov K.; Ruhparwar A.; Weymann A.; Dreyfus G.
Institution
(Sa, Cavalcanti) Division of Cardiovascular Surgery of Pronto Socorro
Cardiologico de Pernambuco, PROCAPE, University of Pernambuco, Recife,
Pernambuco, Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Kadyraliev) Department of Cardiac Surgery, S.G. Sukhanov Federal Center
of Cardiovascular Surgery, E.A. Vagner Perm State Medical University,
Perm, Russian Federation
(Enginoev) Department of Cardiac Surgery, Federal Center for
Cardiovascular Surgery, Astrakhan, Russian Federation
(Enginoev) Department of Cardiovascular Surgery, Astrakhan State Medical
University, Astrakhan, Russian Federation
(Zhigalov, Ruhparwar, Weymann) Department of Thoracic and Cardiovascular
Surgery, West German Heart and Vascular Center Essen, University Hospital
of Essen, University Duisburg-Essen, Essen, Germany
(Dreyfus) Department of Cardiac Surgery, Institut Montsouris, University
Pierre et Marie Curie, Paris, France
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background and Aim of the Study: Minimally invasive cardiac surgery (MICS)
for mitral valve repair (MVRp) has been increasingly used. This study
aimed to evaluate the early and late results of MICS for MVRp vs
conventional sternotomy. <br/>Material(s) and Method(s): A systematic
review of randomized controlled trials or observational studies (with
matched populations) comparing MICS and conventional MVRp reporting any of
the following outcomes: mortality, MVRp failure, complications, blood
transfusion, readmission within 30 days after discharge, long-term
reoperation for mitral regurgitation, operative times, mechanical
ventilation time, intensive care unit (ICU) stay, or hospital stay. The
pooled treatment effects were calculated using a random-effects model.
<br/>Result(s): Ten studies involving 6792 patients (MICS: 3396 patients;
Conventional: 3296 patients) met the eligibility criteria. In the pooled
analysis, MICS significantly reduced the risk for blood transfusion (odds
ratio [OR], 0.654; 95% confidence interval [CI] 0.462-0.928; P =.017) and
readmission within 30 days after discharge (OR, 0.615; 95% 0.456-0.829; P
=.001). MICS was associated with a significantly longer cross-clamp time
(mean difference 14 minutes; 95% CI, 7.4-21 minutes; P <.001), CPB time
(24 minutes; 95% CI, 14-35 minutes; P <.001), and total operative time
(36; 95% CI, 15-56 minutes; P <.001), but a significantly shorter ICU stay
(-8.5; 95% CI -15; -1.8; P =.013) and hospital stay (-1.3, 95% CI -2.1;
-0.45; P =.003). This meta-analysis found no significant difference
regarding the risk of in-hospital and long-term mortality, nor
complications. <br/>Conclusion(s): Despite longer operative times, MICS
for MVRp reduces ICU and hospital stay, as well as readmission rates and
the need for transfusion.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<34>
Accession Number
2004786683
Title
Efficacy of quadruple treatment on different types of pre-operative
anaemia: secondary analysis of a randomised controlled trial.
Source
Anaesthesia. 75 (8) (pp 1039-1049), 2020. Date of Publication: 01 Aug
2020.
Author
Rossler J.; Hegemann I.; Schoenrath F.; Seifert B.; Kaserer A.; Spahn
G.H.; Falk V.; Spahn D.R.
Institution
(Rossler, Kaserer, Spahn, Spahn) Institute of Anesthesiology, University
of Zurich and University Hospital Zurich, Zurich, Switzerland
(Hegemann) Department of Medical Oncology and Haematology, University of
Zurich and University Hospital Zurich, Zurich, Switzerland
(Schoenrath, Falk) Department of Cardiothoracic and Vascular Surgery,
German Heart Centre Berlin, German Centre for Cardiovascular Research,
Berlin, Germany
(Seifert) Department of Biostatistics, Epidemiology, Biostatistics and
Prevention Institute, University of Zurich, Switzerland
(Falk) Department of Cardiothoracic Surgery, Charite - Universitatsmedizin
Berlin, Germany
(Falk) Department of Health Science and Technology, Swiss Federal
Institute of Technology, Zurich, Switzerland
Publisher
Blackwell Publishing Ltd
Abstract
In patients with pre-operative anaemia undergoing cardiac surgery,
combination treatment with intravenous iron, subcutaneous erythropoietin
alpha, vitamin B12 and oral folic acid reduces allogeneic blood product
transfusions. It is unclear if certain types of anaemia particularly
benefit from this treatment. We performed a post-hoc analysis of anaemic
patients from a randomised trial on the 'Effect of ultra-short-term
treatment of patients with iron deficiency or anaemia undergoing cardiac
surgery'. We used linear regression analyses to examine the efficacy of a
combination anaemia treatment compared with placebo on the following
deficiencies, each representing a part of the combination treatment:
ferritin and transferrin saturation; endogenous erythropoietin;
holotranscobalamine; and folic acid in erythrocytes. Efficacy was defined
as change in reticulocyte count from baseline to the first, third and
fifth postoperative days and represented erythropoietic activity in the
immediate peri-operative recovery phase. In all 253 anaemic patients, iron
deficiency was the most common cause of anaemia. Treatment significantly
increased reticulocyte count in all regression analyses on postoperative
days 1, 3 and 5 (all p < 0.001). Baseline ferritin and endogenous
erythropoietin were negatively associated with change in reticulocyte
count on postoperative day 5, with an unstandardised regression
coefficient B of -0.08 (95%CI -0.14 to -0.02) and -0.14 (95%CI -0.23 to
-0.06), respectively. Quadruple anaemia treatment was effective regardless
of the cause of anaemia and its effect manifested early in the
peri-operative recovery phase. The more pronounced a deficiency was, the
stronger the subsequent boost to erythropoiesis may have
been.<br/>Copyright &#xa9; 2020 Association of Anaesthetists

<35>
Accession Number
2007017677
Title
Rationale and design of the RIGHT trial: A multicenter, randomized,
double-blind, placebo-controlled trial of anticoagulation prolongation
versus no anticoagulation after primary percutaneous coronary intervention
for ST-segment elevation myocardial infarction.
Source
American Heart Journal. 227 (pp 19-30), 2020. Date of Publication:
September 2020.
Author
Yan Y.; Wang X.; Guo J.; Li Y.; Ai H.; Gong W.; Que B.; Zhen L.; Lu J.; Ma
C.; Montalescot G.; Nie S.
Institution
(Yan, Wang, Ai, Gong, Que, Zhen, Nie) Emergency & Critical Care Center,
Beijing Anzhen Hospital, Capital Medical University, Beijing, China
(Yan, Wang, Ai, Gong, Que, Zhen, Nie) Beijing Institute of Heart, Lung,
and Blood Vessel Diseases, Beijing, China
(Guo) Beijing Luhe Hospital, Capital Medical University, Beijing, China
(Li) The Second Hospital of Hebei Medical University, Shijiazhuang, China
(Lu) National Clinical Research Center of Cardiovascular Diseases, State
Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing, China
(Ma) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Montalescot) Sorbonne University, France
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Current guidelines recommend anticoagulation therapy during
primary percutaneous coronary intervention (pPCI) for ST-segment elevation
myocardial infarction (STEMI). However, whether anticoagulation should be
continued after pPCI has not been well investigated. Methods/Design: The
RIGHT trial is a prospective, multicenter, randomized, double-blind,
placebo-controlled trial in STEMI patients treated with pPCI evaluating
the prolongation of anticoagulation after the procedure. Patients are
randomized in a 1:1 fashion to receive either prolonged anticoagulant or
matching placebo (no anticoagulation) for at least 48 hours after the
procedure. When randomized to anticoagulation prolongation, the patient is
assigned to intravenous unfractionated heparin (UFH) or subcutaneous
enoxaparin or intravenous bivalirudin (same drug and same regimen at each
center). The primary efficacy endpoint is the composite of all-cause
death, non-fatal myocardial infarction, non-fatal stroke, stent thrombosis
(definite) or urgent revascularization (any vessel) at 30 days. The
primary safety endpoint is major bleeding (BARC 3-5) at 30 days. Based on
a superiority design and assuming a 35% relative risk reduction (from 7%
to 4.5%), 2856 patients will be enrolled, accounting for a 5% drop-out
rate (alpha = 0.05 and power = 80%). <br/>Conclusion(s): The RIGHT trial
tests the hypothesis that post-procedural anticoagulation is superior to
no anticoagulation in reducing ischemic events in STEMI patients
undergoing pPCI.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<36>
Accession Number
2007060841
Title
Dexmedetomidine for reduction of atrial fibrillation and delirium after
cardiac surgery (DECADE): a randomised placebo-controlled trial.
Source
The Lancet. 396 (10245) (pp 177-185), 2020. Date of Publication: 18 - 24
July 2020.
Author
Turan A.; Duncan A.; Leung S.; Karimi N.; Fang J.; Mao G.; Hargrave J.;
Gillinov M.; Trombetta C.; Ayad S.; Hassan M.; Feider A.; Howard-Quijano
K.; Ruetzler K.; Sessler D.I.; Bergese S.; De Oliveira G.; Honar H.; Niazi
A.; Elliott K.; Hamadnalla H.; Chodavarapu P.; Bajracharya G.; Fitzgerald
P.; Cuko E.; Akhtar Z.; Lokhande C.; Khan M.Z.; Khoshknabi D.; Riter Q.;
Hutcherson M.; Yagar S.; Glosse L.; Saha P.; Raza S.
Institution
(Turan, Fang, Mao, Ruetzler, Sessler) Department of Outcomes Research,
Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, United States
(Ayad, Hassan) Department of Regional Practice, Cleveland Clinic,
Cleveland, OH, United States
(Turan, Ayad, Ruetzler) Department of General Anesthesiology, Cleveland
Clinic, Cleveland, OH, United States
(Duncan, Hargrave, Trombetta) Department of Cardiovascular Anesthesiology,
Cleveland Clinic, Cleveland, OH, United States
(Mao) Department of Quantitative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Leung) Department of Radiology, Metrohealth Hospital, Cleveland, OH,
United States
(Karimi) Department of Anesthesiology, University of Rochester, Rochester,
NY, United States
(Feider) Department of Anesthesia, University of Iowa Hospitals and
Clinics, Iowa City, IA, United States
(Howard-Quijano) Department of Anesthesiology and Perioperative Medicine,
University of Pittsburgh School of Medicine and University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
Publisher
Lancet Publishing Group (E-mail: cususerv@lancet.com)
Abstract
Background: Atrial fibrillation and delirium are common consequences of
cardiac surgery. Dexmedetomidine has unique properties as sedative agent
and might reduce the risk of each complication. This study coprimarily
aimed to establish whether dexmedetomidine reduces the incidence of
new-onset atrial fibrillation and the incidence of delirium.
<br/>Method(s): A randomised, placebo-controlled trial was done at six
academic hospitals in the USA. Patients who had had cardiac surgery with
cardiopulmonary bypass were enrolled. Patients were randomly assigned 1:1,
stratified by site, to dexmedetomidine or normal saline placebo.
Randomisation was computer generated with random permuted block size 2 and
4, and allocation was concealed by a web-based system. Patients,
caregivers, and evaluators were all masked to treatment. The study drug
was prepared by the pharmacy or an otherwise uninvolved research associate
so that investigators and clinicians were fully masked to allocation.
Participants were given either dexmedetomidine infusion or saline placebo
started before the surgical incision at a rate of 0.1 mug/kg per h then
increased to 0.2 mug/kg per h at the end of bypass, and postoperatively
increased to 0.4 mug/kg per h, which was maintained until 24 h. The
coprimary outcomes were atrial fibrillation and delirium occurring between
intensive care unit admission and the earlier of postoperative day 5 or
hospital discharge. All analyses were intention-to-treat. The trial is
registered with ClinicalTrials.gov, NCT02004613 and is closed.
<br/>Finding(s): 798 patients of 3357 screened were enrolled from April
17, 2013, to Dec 6, 2018. The trial was stopped per protocol after the
last designated interim analysis. Among 798 patients randomly assigned,
794 were analysed, with 400 assigned to dexmedetomidine and 398 assigned
to placebo. The incidence of atrial fibrillation was 121 (30%) in 397
patients given dexmedetomidine and 134 (34%) in 395 patients given
placebo, a difference that was not significant: relative risk 0.90 (97.8%
CI 0.72, 1.15; p=0.34). The incidence of delirium was non-significantly
increased from 12% in patients given placebo to 17% in those given
dexmedetomidine: 1.48 (97.8% CI 0.99-2.23). Safety outcomes were
clinically important bradycardia (requiring treatment) and hypotension,
myocardial infarction, stroke, surgical site infection, pulmonary
embolism, deep venous thrombosis, and death. 21 (5%) of 394 patients given
dexmedetomidine and 8 (2%) of 396 patients given placebo, had a serious
adverse event as determined by clinicians. 1 (<1%) of 391 patients given
dexmedetomidine and 1 (<1%) of 387 patients given placebo died.
<br/>Interpretation(s): Dexmedetomidine infusion, initiated at anaesthetic
induction and continued for 24 h, did not decrease postoperative atrial
arrhythmias or delirium in patients recovering from cardiac surgery.
Dexmedetomidine should not be infused to reduce atrial fibrillation or
delirium in patients having cardiac surgery. <br/>Funding(s): Hospira
Pharmaceuticals.<br/>Copyright &#xa9; 2020 Elsevier Ltd

<37>
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

<38>
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.

<39>
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.

<40>
Accession Number
2005746073
Title
Meta-analysis of prognostic impact of peripheral arterial disease on
mortality after transcatheter aortic valve implantation.
Source
Journal of Cardiovascular Surgery. 60 (6) (pp 723-732), 2019. Date of
Publication: December 2019.
Author
Takagi H.; Hari Y.; Nakashima K.; Kuno T.; Ando T.
Institution
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Kuno) Department of Medicine, Mount Sinai Beth Israel Medical Center, New
York, NY, United States
(Ando) Department of Cardiology, Detroit Medical Center, Detroit, MI,
United States
Publisher
Edizioni Minerva Medica (E-mail: subscriptions.dept@minervamedica.it)
Abstract
INTRODUCTION: The aim of this study was to determine whether peripheral
arterial disease (PAD) is an independent predictor of mortality in
patients who undergo transcatheter aortic valve implantation (TAVI) and we
performed meta-analysis of currently available studies. EVIDENCE
ACQUISITION: MEDLINE and EMBASE were searched through June 2018 using
Web-based search engines (PubMed and OVID). We included comparative
studies of patients with PAD versus those without PAD and cohort studies
which investigated PAD as one of prognostic factors of mortality, which
used the multivariable analysis and reported an adjusted odds and hazard
ratio (OR/HR) for early (30-day or in-hospital) and late (including early)
mortality after TAVI. Study-specific estimates were combined using inverse
variance-weighted averages of logarithmic ORs/HRs in the random-effects
model. EVIDENCE SYNTHESIS: The primary meta-analysis which pooled all the
ORs/HRs demonstrated that PAD was associated with a statistically
significant increase in both early (OR, 1.21; P=0.02) and midterm (1-year
to 7-year) mortality (HR, 1.31; P<0.00001). The secondary metaanalysis
which exclusively pooled approach-adjusted/stratified ORs/HRs demonstrated
that PAD was associated with a strong trend toward (though statistically
non-significant) an increase in early mortality (OR, 1.18; P=0.07) and a
still statistically significant increase in midterm mortality (OR, 1.24;
P=0.0001). Meta-regression coefficients for the proportion of patients who
underwent transfemoral TAVI were not statistically significant (P for
early/midterm mortality =0.24/0.52). <br/>CONCLUSION(S): The present
meta-analysis clearly highlighted that PAD was an independent predictor of
both early and midterm mortality in patients who underwent
TAVI.<br/>Copyright &#xa9; 2019 EDIZIONI MINERVA MEDICA Online version at
http://www.minervamedica.it

<41>
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.

<42>
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.

<43>
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

<44>
Accession Number
2005841149
Title
Hemostatis analyzer-supported hemotherapy algorithm in cardiac surgery:
Protocol for a randomized controlled monocentric trial.
Source
Journal of Medical Internet Research. 22 (4) (no pagination), 2020.
Article Number: e17206. Date of Publication: April 2020.
Author
Michel S.; Piekarski F.; Fischer J.-H.; Hettler V.; Adam E.H.; Holzer L.;
Lotz G.; Walther T.; Zacharowski K.; Raimann F.J.
Institution
(Michel, Piekarski, Fischer, Hettler, Adam, Holzer, Lotz, Walther,
Zacharowski, Raimann) Department of Anaesthesiology, Intensive Care
Medicine and Pain Therapy, University Hospital Frankfurt, Goethe
University, Frankfurt am Main, Germany
Publisher
Journal of Medical Internet Research
Abstract
Background: Point of care devices for performing targeted coagulation
substitution in patients who are bleeding have become increasingly
important in recent years. New on the market is the Quantra. It is a
device that uses sonorheometry, a sonic estimation of elasticity via
resonance, which is a novel ultrasound-based technology that measures
viscoelastic properties of whole blood. Several studies have already shown
the comparability of the Quantra with devices already established on the
market, such as the rotational thromboelastometry (ROTEM) device.
<br/>Objective(s): In contrast to existing studies, this study is the
first prospective interventional study using this new system in a cardiac
surgical patient cohort. We will investigate the noninferiority between an
already existing coagulation algorithm based on the ROTEM/Multiplate
system and a new algorithm based on the Quantra system for the treatment
of coagulopathic cardiac surgical patients. <br/>Method(s): The study is
divided into two phases. In an initial observation phase, whole blood
samples of 20 patients obtained at three defined time points (prior to
surgery, after completion of cardiopulmonary bypass, and on arrival in the
intensive care unit) will be analyzed using both the ROTEM/Multiplate and
Quantra systems. The obtained threshold values will be used to develop a
novel algorithm for hemotherapy. In a second intervention phase, the new
algorithm will be tested for noninferiority against an algorithm used
routinely for years in our department. <br/>Result(s): The main objective
of the examination is the cumulative loss of blood within 24 hours after
surgery. Statistical calculations based on the literature and in-house
data suggest that the new algorithm is not inferior if the difference in
cumulative blood loss is <150 mL/24 hours. <br/>Conclusion(s): Because of
the comparability of the Quantra sonorheometry system with the ROTEM
measurement methods, the existing hemotherapy treatment algorithm can be
adapted to the Quantra device with proof of noninferiority.<br/>Copyright
&#xa9; Sophie Michel, Florian Piekarski, Jan-Hendrik Fischer, Vanessa
Hettler, Elisabeth Hannah Adam, Lars Holzer, Gosta Lotz, Thomas Walther,
Kai Zacharowski, Florian Jurgen Raimann.

<45>
Accession Number
2005572145
Title
Coronary revascularization during treatment of severe aortic stenosis: A
meta-analysis of the complete percutaneous approach (PCI plus TAVR) versus
the complete surgical approach (CABG plus SAVR).
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Tarus A.; Tinica G.; Bacusca A.; Artene B.; Popa I.V.; Burlacu A.
Institution
(Tarus, Tinica, Bacusca) Department of Cardiovascular Surgery,
Cardiovascular Diseases Institute, Iasi, Romania
(Tinica, Popa, Burlacu) Grigore T. Popa University of Medicine and
Pharmacy, Iasi, Romania
(Artene, Burlacu) Department of Interventional Cardiology, Cardiovascular
Diseases Institute, Iasi, Romania
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: The management of patients with coexisting severe aortic
stenosis (AS) and coronary artery disease (CAD) is still facing a great
deal of uncertainty when it comes to choosing between the entire surgical
versus the complete percutaneous approaches, after accurately balancing
risks versus outcomes. <br/>Aim(s): To evaluate clinical outcomes and
mortality of transcatheter aortic valve replacement (TAVR) plus
percutaneous coronary intervention (PCI) compared with surgical aortic
valve replacement (SAVR) plus coronary arteries bypass grafting (CABG)
procedures in patients with concomitant AS and CAD. <br/>Method(s):
Electronic databases of PubMed, EMBASE, and SCOPUS were searched for
relevant articles assessing outcome parameters of interest. The study
endpoints were the rate of overall myocardial infarction and stroke within
30 days and the rate of 30-day mortality and 2-year mortality between
patients with TAVR/PCI and those with SAVR/CABG. <br/>Result(s):
Random-effect meta-analysis did not reveal any significant difference
between 30-day safety outcomes: myocardial infarction (TAVR/PCI vs
SAVR/CABG: odds ratio [OR]: 0.52; 95% confidence interval [CI]: 0.20-1.33;
I² = 0%), stroke (TAVR/PCI vs SAVR/CABG: OR: 0.88; 95% CI:
0.45-1.73; I² = 0%). No significant difference in 30-day
mortality (OR: 0.72; 95% CI: 0.43-1.21; I² = 0%) and 2-year
mortality (OR: 1.50; 95% CI: 0.77-2.94; I² = 81%) rate was
noted between patients with TAVR/PCI and those with SAVR/CABG.
<br/>Conclusion(s): When comparing the total percutaneous and total
surgical treatment, no significant difference in short-term safety
outcomes or early and late mortality was observed. More evidence is needed
to guide the clinical decision.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC

<46>
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.

<47>
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

<48>
Accession Number
2004555956
Title
Understanding and addressing variation in health care-associated
infections after durable ventricular assist device therapy: Protocol for a
mixed methods study.
Source
Journal of Medical Internet Research. 22 (1) (no pagination), 2020.
Article Number: e14701. Date of Publication: 2020.
Author
Chandanabhumma P.P.; Fetters M.D.; Pagani F.D.; Malani P.N.; Hollingsworth
J.M.; Funk R.J.; Aaronson K.D.; Zhang M.; Kormos R.L.; Chenoweth C.E.;
Shore S.; Watt T.M.F.; Cabrera L.; Likosky D.
Institution
(Chandanabhumma, Fetters) Mixed Methods Program, Department of Family
Medicine, University of Michigan, Ann Arbor, MI, United States
(Pagani, Watt, Cabrera, Likosky) Department of Cardiac Surgery, University
of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, United States
(Malani, Chenoweth) Division of Infectious Diseases, Department of
Internal Medicine, University of Michigan, Ann Arbor, MI, United States
(Hollingsworth) Department of Urology, University of Michigan, Ann Arbor,
MI, United States
(Funk) Department of Strategic Management and Entrepreneurship, Carlson
School of Management, University of Minnesota, Minneapolis, MN, United
States
(Aaronson, Shore) Division of Cardiovascular Medicine, Department of
Internal Medicine, University of Michigan, Ann Arbor, MI, United States
(Zhang) Department of Biostatistics, School of Public Health, University
of Michigan, Ann Arbor, MI, United States
(Kormos) Department of Cardiothoracic Surgery, University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
Publisher
Journal of Medical Internet Research
Abstract
Background: Durable ventricular assist device (VAD) therapy is reserved
for patients with advanced heart failure who have a poor estimated 1-year
survival. However, despite highly protocolized management processes,
patients are at a unique risk for developing a health care-associated
infection (HAI). Few studies have examined optimal strategies for HAI
prevention after durable VAD implantation, despite variability in rates
across centers and their impact on short- and long-term outcomes.
<br/>Objective(s): The objective of this study is to develop
recommendations for preventing the most significant HAIs after durable VAD
implantation. The study has 3 specific aims: (1) identify determinants of
center-level variability in HAI rates, (2) develop comprehensive
understanding of barriers and facilitators for achieving low center-level
HAI rates, and (3) develop and disseminate a best practices toolkit for
preventing HAIs that accommodates various center contexts. <br/>Method(s):
This is a sequential mixed methods study starting with a cross-sectional
assessment of current practices. To address aim 1, we will conduct (1) a
systematic review of HAI prevention studies and (2) in-depth quantitative
analyses using administrative claims, in-depth clinical data, and
organizational surveys of VAD centers. For aim 2, we will apply a mixed
methods patient tracer assessment framework to conduct semistructured
interviews, field observations, and document analysis informed by findings
from aim 1 at 5 high-performing (ie, low HAIs) and 5 low-performing (ie,
high HAI) centers, which will be examined using a mixed methods case
series analysis. For aim 3, we will build upon the findings from the
previous aims to develop and field test an HAI preventive toolkit, acquire
stakeholder input at an annual cardiac surgical conference, disseminate
the final version to VAD centers nationwide, and conduct follow-up surveys
to assess the toolkit's adoption. <br/>Result(s): The project was funded
by the Agency for Healthcare Research and Quality in 2018 and enrollment
for the overall project is ongoing. Data analysis is currently under way
and the first results are expected to be submitted for publication in
2019. <br/>Conclusion(s): This mixed methods study seeks to quantitatively
assess the determinants of HAIs across clinical centers and qualitatively
identify the context-specific facilitators and barriers for attaining low
HAI rates. The mixed data findings will be used to develop and disseminate
a stakeholder-acceptable toolkit of evidence-based HAI prevention
recommendations that will accommodate the specific contexts and needs of
VAD centers.<br/>Copyright &#xa9; 2020 Journal of Medical Internet
Research. All rights reserved.

<49>
Accession Number
632356857
Title
Association of Radial Artery Graft vs Saphenous Vein Graft With Long-term
Cardiovascular Outcomes Among Patients Undergoing Coronary Artery Bypass
Grafting: A Systematic Review and Meta-analysis.
Source
JAMA. 324 (2) (pp 179-187), 2020. Date of Publication: 14 Jul 2020.
Author
Gaudino M.; Benedetto U.; Fremes S.; Ballman K.; Biondi-Zoccai G.;
Sedrakyan A.; Nasso G.; Raman J.; Buxton B.; Hayward P.A.; Moat N.;
Collins P.; Webb C.; Peric M.; Petrovic I.; Yoo K.J.; Hameed I.; Di Franco
A.; Moscarelli M.; Speziale G.; Puskas J.D.; Girardi L.N.; Hare D.L.;
Taggart D.P.
Institution
(Gaudino, Hameed, Di Franco, Girardi) Department of Cardiothoracic
Surgery, Weill Cornell Medicine, NY
(Benedetto) Department of Cardiac Surgery, Bristol Heart Institute,
Bristol, United Kingdom
(Fremes) Department of Surgery, Schulich Heart Centre, Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, Canada
(Ballman, Sedrakyan) Department of Healthcare Policy and Research, Weill
Cornell Medicine, NY
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University, Rome, Italy
(Biondi-Zoccai) NaplesItaly
(Nasso, Moscarelli, Speziale) Cardiothoracic and Vascular Department,
Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA), Italy
(Raman) Austin Hospital, Melbourne, VIC, Australia
(Raman, Buxton, Hayward) Department of Surgery, University of Melbourne,
Melbourne, VIC, Australia
(Moat, Collins, Webb) NHLI, Imperial College London, Royal Brompton and
Harefield NHS Foundation Trust, London, United Kingdom
(Peric, Petrovic) Dedinje Cardiovascular Institute and Belgrade University
School of Medicine, Belgrade, Serbia
(Yoo) Yonsei University College of Medicine, Seoul, South Korea
(Puskas) Department of Cardiovascular Surgery, Mount Sinai St. Luke's, NY
(Hare) Faculty of Medicine, Dentistry and Health Sciences, University of
Melbourne, Melbourne, VIC, Australia
(Hare) Department of Cardiology, Austin Health, Melbourne, VIC, Australia
(Taggart) Nuffield Department of Surgical Sciences, University of Oxford,
Oxford, United Kingdom
Publisher
NLM (Medline)
Abstract
Importance: Observational studies have suggested that the use of radial
artery grafts for coronary artery bypass grafting may improve clinical
outcomes compared with the use of saphenous vein grafts, but this has not
been confirmed in randomized trials. <br/>Objective(s): To compare
clinical outcomes between patients receiving radial artery vs saphenous
vein grafts for coronary artery bypass grafting after long-term follow-up.
<br/>Design, Setting, and Participant(s): Patient-level pooled analysis
comparing radial artery vs saphenous vein graft in adult patients
undergoing isolated coronary artery bypass grafting from 5 countries
(Australia, Italy, Serbia, South Korea, and the United Kingdom), with
enrollment from 1997 to 2009 and follow-up completed in 2019.
<br/>Intervention(s): Patients were randomized to undergo either radial
artery (n=534) or saphenous vein (n=502) grafts for coronary artery bypass
grafting. <br/>Main Outcomes and Measures: The primary outcome was a
composite of death, myocardial infarction, or repeat revascularization and
the secondary outcome was a composite of death or myocardial infarction.
<br/>Result(s): A total of 1036 patients were randomized (mean age, 66.6
years in the radial artery group vs 67.1 years in the saphenous vein
group; 376 [70.4%] men in the radial artery group vs 351 [69.9%] in the
saphenous vein group); 942 (90.9%) of the originally randomized patients
completed 10 years of follow-up (510 in the radial artery group). At a
median (interquartile range) follow-up of 10 (10-11) years, the use of the
radial artery, compared with the saphenous vein, in coronary artery bypass
grafting was associated with a statistically significant reduction in the
incidence of the composite outcome of death, myocardial infarction, or
repeat revascularization (220 vs 237 total events; 41 vs 47 events per
1000 patient-years; hazard ratio, 0.73 [95% CI, 0.61-0.88]; P<.001) and of
the composite of death or myocardial infarction (188 vs 193 total events;
35 vs 38 events per 1000 patient-years; hazard ratio, 0.77 [95% CI,
0.63-0.94]; P=.01). <br/>Conclusions and Relevance: In this individual
participant data meta-analysis with a median follow-up of 10 years, among
patients undergoing coronary artery bypass grafting, the use of the radial
artery compared with the saphenous vein was associated with a lower risk
of a composite of cardiovascular outcomes.

<50>
Accession Number
631966561
Title
Bayesian Interpretation of the EXCEL Trial and Other Randomized Clinical
Trials of Left Main Coronary Artery Revascularization.
Source
JAMA Internal Medicine. 180 (7) (pp 986-992), 2020. Date of Publication:
July 2020.
Author
Brophy J.M.
Institution
(Brophy) McGill University Health Center, 1001 Decarie Blvd, Montreal, QC
H4A 3J1, Canada
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
Importance: Patients with left main coronary artery disease have improved
outcomes with coronary revascularization compared with medical therapy,
but the choice of optimal revascularization technique is unresolved.
<br/>Objective(s): To use bayesian methods to analyze the risk differences
for patients with left main coronary artery disease randomized to
treatment with coronary artery bypass surgery (CABG) compared with those
randomized to percutaneous coronary intervention (PCI) in recent
randomized clinical trials (RCTs). <br/>Design, Setting, and
Participant(s): A systematic review using the PubMed database with the
query string "(left main disease) and (PCI or CABG) and (5-year follow-up)
and (clinical trial)" identified all RCTs from January 1996 to January
2020 comparing CABG to PCI for treatment of patients with left main
coronary artery disease and with 5-year follow-up data. With the use of
bayesian methods, the largest and most publicized RCT (EXCEL; Evaluation
of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left
Main Revascularization; 2019) was reanalyzed (1) as an isolated entity
using noninformative priors and (2) in the context of previous knowledge
using informative priors derived from similar trials. Published aggregate
data were used with assignments from each trial following the original
intention-to-treat principle. Combining EXCEL data with varying levels of
prior information using Bayes theorem provided final (posterior)
probability distributions for primary and secondary outcomes. <br/>Main
Outcomes and Measures: A composite end point of death, nonfatal myocardial
infarction, and stroke was the primary EXCEL outcome and was accordingly
the primary outcome for this reanalysis. Secondary analyses were performed
for isolated all-cause mortality and for the composite outcome along with
repeated revascularization procedures. <br/>Result(s): When EXCEL data
were analyzed using the originally stated noninferiority design, the
5-year primary outcome difference reported (2.8%; 95% CI, -0.9% to 6.5%)
exceeded the predefined 4.2% noninferiority margin; thus, the null
hypothesis of PCI inferiority could not be rejected. By contrast, the
present bayesian analysis of the EXCEL primary outcome estimated 95%
probability that the 5-year primary outcome difference was increased with
PCI compared with CABG and 87% probability that this difference was
greater than 1 extra event per 100 patients treated. Bayesian analyses
also suggested 99% probability that EXCEL total mortality was increased
with PCI and 94% probability that this absolute difference exceeded 1
extra deaths per 100 treated. A systematic review identified 3 other RCTs
that studied the same question. The incorporation of this prior knowledge
reduced the estimated probability of any excess mortality with PCI to 85%.
For the secondary composite end point, which also included repeated
revascularizations, there were estimated probabilities of 98% for at least
4 extra events and of 90% for at least 5 extra events per 100 patients
treated with PCI. <br/>Conclusions and Relevance: Bayesian analysis
assisted in RCT data interpretation and specifically suggested, whether
based on EXCEL results alone or on the totality of available evidence,
that PCI was associated with inferior long-term results for all events,
including mortality, compared with CABG for patients with left main
coronary artery disease.<br/>Copyright &#xa9; 2020 American Medical
Association. All rights reserved.

<51>
Accession Number
631949896
Title
Characteristics of Contemporary Randomized Clinical Trials and Their
Association with the Trial Funding Source in Invasive Cardiovascular
Interventions.
Source
JAMA Internal Medicine. 180 (7) (pp 993-1001), 2020. Date of Publication:
July 2020.
Author
Gaudino M.; Hameed I.; Rahouma M.; Khan F.M.; Tam D.Y.; Biondi-Zoccai G.;
Demetres M.; Charlson M.E.; Ruel M.; Crea F.; Falk V.; Girardi L.N.;
Fremes S.; Chikwe J.
Institution
(Gaudino, Hameed, Rahouma, Khan, Girardi) Department of Cardiothoracic
Surgery, Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, United
States
(Tam, Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Rome, Italy
(Biondi-Zoccai) IRCCS Neuromed, Pozzilli, Italy
(Demetres) Samuel J. Wood Library, C. V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
(Charlson) Division of General Internal Medicine, Weill Cornell Medical
College, New York, NY, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Crea) Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
(Crea) Department of Cardiovascular and Thoracic Sciences, Universita
Cattolica de Sacro Cuore, Roma, Italy
(Falk) Department of Cardiovascular Surgery, Charite, Berlin, Germany
(Falk) Department of Cardiothoracic and Vascular Surgery, German Heart
Center Berlin, Berlin, Germany
(Falk) German Center for Cardiovascular Research, Berlin, Germany
(Falk) Department of Health Science and Technology, Swiss Federal
Institute of Technology, Zurich, Switzerland
(Chikwe) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA, United States
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
Importance: Changes in evidence-based practice and guideline
recommendations depend on high-quality randomized clinical trials (RCTs).
Commercial device and pharmaceutical manufacturers are frequently involved
in the funding, design, conduct, and reporting of trials, the implications
of which have not been recently analyzed. <br/>Objective(s): To evaluate
the design, outcomes, and reporting of contemporary randomized clinical
trials of invasive cardiovascular interventions and their association with
the funding source. <br/>Design, Setting, and Participant(s): This
cross-sectional study analyzed published RCTs between January 1, 2008, to
May 31, 2019. The trials included those involving coronary, vascular and
structural interventional cardiology, and vascular and cardiac surgical
procedures. <br/>Main Outcomes and Measures: We assessed (1) trial
characteristics, (2) finding of a statistically significant difference in
the primary end point favoring the experimental intervention, (3)
reporting of implied treatment advantage in trials without significant
differences in primary end point, (4) existence of major discrepancies
between registered and published primary outcomes, (5) number of patients
whose outcomes would need to switch from a nonevent to an event to convert
a significant difference in primary end point to nonsignificant, and (6)
association with funding source. <br/>Result(s): Of the 216 RCTs analyzed,
115 (53.2%) reported having commercial sponsorship. Most trials had 80%
power to detect an estimated treatment effect of 30%, and 128 trials
(59.3%) used composite primary end points. The median (interquartile range
[IQR]) sample size was 502 (204-1702) patients, and the median (IQR)
follow-up duration was 12 (1.0-14.4) months. Overall, 123 trials (57.0%)
reported a statistically significant difference in the primary outcome
favoring the experimental intervention; reporting strategies that implied
an advantage were identified in 55 (65.5%) of 84 trials that reported
nonsignificant differences. Commercial sponsorship was associated with a
statistically significantly greater likelihood of favorable outcomes
reporting (exponent of regression coefficient beta, 2.80; 95% CI,
1.09-7.18; P =.03) and with the reporting of findings that are
inconsistent with the trial results. Discrepancies between the registered
and published primary outcomes were found in 82 trials (38.0%), without
differences in trial sponsorship. A median (IQR) number of 5 (2.8-12.5)
patients experiencing a different outcome would have change statistically
significant results to nonsignificant. Commercial sponsorship was
associated with a greater number of patients (exponent of regression
coefficient beta, 1.29; 95% CI, 1.00-1.66; P =.04). <br/>Conclusions and
Relevance: These results suggest that contemporary RCTs of invasive
cardiovascular interventions are relatively small and fragile, have short
follow-up, and have limited power to detect large treatment effects.
Commercial support appeared to be associated with differences in trial
design, results, and reporting.<br/>Copyright &#xa9; 2020 American Medical
Association. All rights reserved.

<52>
Accession Number
632117941
Title
Spironolactone improves event-free survival in heart transplant
recipients: Single centre prospective study.
Source
Transplant International. Conference: 19th Congress of the European
Society for Organ Transplantation. Denmark. 32 (Supplement 2) (pp 35),
2019. Date of Publication: October 2019.
Author
Shevchenko A.; Kwan V.; Kachanova J.; Koloskova N.; Gautier S.
Institution
(Shevchenko, Kwan, Kachanova, Koloskova, Gautier) Shumakov National
Research Center of Transplantology and Artificial Organs
Publisher
Blackwell Publishing Ltd
Abstract
Objectives: To evaluate the effects of aldosterone inhibitor
spironolactone in heart transplant recipients. <br/>Patients and Methods:
Patients who received a heart transplant between January 2013 and April
2016 in Shumakov National Research Centre of Transplantology (Moscow) and
met inclusion criteria were randomly assigned to receive spironolactone
(12.5-25 mg o.d.) in a 1:4 ratio. We included patients who survived 14
days after transplantation without severe renal dysfunction or
hyperkalemia. Eligible participants continued to receive conventional
immunosuppressive therapy and other treatments. The primary outcome was a
composite of death from any cause or retransplantation. <br/>Result(s):
Out of 478 heart recipients, 398 patients (mean age 45.7+/-2.4 years, 53
females and 345 males) enrolled in the study. Eighty patients were
assigned receive spironolactone, 318 included to the control group. The
mean follow-up was 728.9+/-52.7 (95% CI = 573.3-1095.0). Nine (11.3%)
patients in the spironolactone group and 19 (5.9%) in the placebo group -
discontinued study participation due to the development of renal failure
and were not included in the outcome's analysis (intergroup comparison p =
0.09). Treatment with spironolactone was associated with increased serum
creatinine and potassium levels, but no significant differences in
tacrolimus levels, rejection episodes or any other surrogate indices were
observed. Patients receiving spironolactone had significantly better
event-free survival than the control group (log-rank p = 0.04).
<br/>Conclusion(s): In heart transplant recipients survived 14 day after
cardiac transplantation without severe renal failure and hyperkaliemia,
treatment with aldosterone inhibitor spironolactone significantly improves
composite outcome.

<53>
Accession Number
632364434
Title
Effect of intraoperative dexmedetomidine infusion on delirium in adult
patients following cardiac valve surgery: a protocol of a randomized,
double-blinded, and placebo-controlled study.
Source
Trials. 21 (1) (pp 645), 2020. Date of Publication: 14 Jul 2020.
Author
Wang H.-B.; Zhang L.; Zhang Z.; Yuan S.; Yan F.-X.; Luo Q.-P.
Institution
(Wang, Zhang, Yan, Luo) Department of Anesthesiology, Fuwai Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College, No.
167 North Lishi Road, Xicheng District, Beijing, China
(Zhang) Department of Anesthesiology, Chongqing Traditional Chinese
Medicine Hospital, No. 6 ,7 Branch Road, Chongqing, China
(Yuan) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Sciences and Peking Union Medical College, No. 167 North Lishi
Road, Xicheng District, Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Delirium is an acute status of brain dysfunction that commonly
occurs in patients who have undergone cardiac surgery, and increases
morbidity and mortality. It is associated with risk factors, such as older
age, use of narcotics, cardiopulmonary bypass, and hypothermia.
Dexmedetomidine infusion might exert a neuroprotective effect. However,
the effect of perioperative administration of dexmedetomidine on the
incidence of postoperative delirium (POD) in patients undergoing cardiac
or non-cardiac surgery is yet controversial. The present study aimed to
reveal the effect of intraoperative dexmedetomidine administration on the
incidence of delirium in adult patients following cardiac surgery.
<br/>METHOD(S): This single-center, randomized, double-blinded, and
placebo-controlled trial consisted of 652 patients randomly divided into
two groups: dexmedetomidine and placebo. 0.6mug/kg dexmedetomidine will be
infused 10min after central vein catheterization, followed by a continuous
infusion at a speed of 0.4mug/kg/h until the end of surgery in the
dexmedetomidine group, while normal saline will be administered at the
same rate in the placebo group. The primary outcome is the incidence of
POD during the first 7days post-surgery. The secondary outcomes include
duration of mechanical ventilation after surgery, duration of stay in the
intensive care unit and the hospital after surgery, incidence of
hypotension during or after dexmedetomidine infusion, acute kidney injury
and sudden arrhythmia during the hospital stay postoperatively, and
all-cause mortality in 30 and 90days after surgery, respectively.
DISCUSSION: This study was approved by the Ethics Committee of the Chinese
Academy of Medical Sciences Fuwai Hospital on 6 March 2019 (2019-1180).
The results will be disseminated at academic conferences and submitted to
peer-reviewed publications. Either positive or negative results will
provide guidance for clinical practice. TRIAL REGISTRATION: The Chinese
Clinical Trial Registry ( http://www.chictr.org.cn ) ChiCTR1900022583.
Registered on 17 April 2019.

<54>
[Use Link to view the full text]
Accession Number
632360756
Title
The myocardial protective effect of monosodium phosphate cardioplegia in
cardiopulmonary bypass in infants with an atrial septal defect.
Source
Medicine. 99 (28) (pp e20934), 2020. Date of Publication: 10 Jul 2020.
Author
Yang F.; Wang J.; Zhai B.
Publisher
NLM (Medline)
Abstract
This study aimed to investigate the myocardial protective effect of liquid
sodium phosphocreatine cardiac arrest in extracorporeal circulation
surgery treating infants with atrial septal defects.Eighty-four infants
with atrial septal defects who required extracorporeal circulation surgery
treatment at our hospital from January 2016 to June 2018 were divided into
an observation group and a control group through a digitally randomized
method, with 42 cases in each group. The control group adopted the
conventional modified St Thomas II high potassium cold liquid crystal
cardiac arrest, while the observation group adopted the liquid sodium
phosphocreatine cardiac arrest.The myocardial enzyme indexes of the 2
groups 3, 6, 12, and 24 hours postoperatively were higher than before
establishing the cardiopulmonary bypass and the enzyme indexes of the
control group at the same time were higher than that of the observation
group; adenosine triphosphate, adenosine diphosphate, and other energy
levels and the postoperative recovery rate energy levels of the
observation group were higher than those in the control group, the
difference was statistically significant (P < .05).Liquid sodium
phosphocreatine cardiac arrest used in extracorporeal circulation surgery
treating infants with atrial septal defects can reduce myocardial
ischemia-reperfusion injury, maintain energy supply during ischemia,
strengthen the St Thomas II effect, and aid postoperative cardiac function
recovery of high potassium cold liquid crystal cardiac arrest used in
infants with atrial septal defects and treated with extracorporeal
circulation surgery.

<55>
Accession Number
2007084995
Title
Synthetic mRNA Encoding VEGF-A in Patients Undergoing Coronary Artery
Bypass Grafting: Design of a Phase 2a Clinical Trial.
Source
Molecular Therapy - Methods and Clinical Development. 18 (pp 464-472),
2020. Date of Publication: 11 September 2020.
Author
Anttila V.; Saraste A.; Knuuti J.; Jaakkola P.; Hedman M.; Svedlund S.;
Lagerstrom-Fermer M.; Kjaer M.; Jeppsson A.; Gan L.-M.
Institution
(Anttila, Saraste) Heart Center, Turku University Hospital and University
of Turku, Turku, Finland
(Saraste, Knuuti) Turku PET Center, Turku University Hospital and
University of Turku, Turku, Finland
(Jaakkola, Hedman) Heart Center, Kuopio University Hospital, Kuopio,
Finland
(Svedlund) Department of Clinical Physiology, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Svedlund, Jeppsson, Gan) Department of Molecular and Clinical Medicine,
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Lagerstrom-Fermer, Gan) Research and Early Development, Cardiovascular,
Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg,
Sweden
(Kjaer) Early Biometrics and Statistical Innovation, Data Science & AI,
BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
(Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Gan) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
Cell Press (E-mail: subs@cell.com)
Abstract
Therapeutic angiogenesis may improve outcomes in patients with coronary
artery disease undergoing surgical revascularization. Angiogenic factors
may promote blood vessel growth and regenerate regions of ischemic but
viable myocardium. Previous clinical trials of vascular endothelial growth
factor A (VEGF-A) gene therapy with DNA or viral vectors demonstrated
safety but not efficacy. AZD8601 is VEGF-A<inf>165</inf> mRNA formulated
in biocompatible citrate-buffered saline and optimized for high-efficiency
VEGF-A expression with minimal innate immune response. EPICCURE is an
ongoing randomized, double-blind, placebo-controlled study of the safety
of AZD8601 in patients with moderately decreased left ventricular function
(ejection fraction 30%-50%) undergoing elective coronary artery bypass
surgery. AZD8601 3 mg, 30 mg, or placebo is administered as 30 epicardial
injections in a 10-min extension of cardioplegia. Injections are targeted
to ischemic but viable myocardial regions in each patient using
quantitative ¹⁵O-water positron emission tomography (PET)
imaging (stress myocardial blood flow < 2.3 mL/g/min; resting myocardial
blood flow > 0.6 mL/g/min). Improvement in regional and global myocardial
blood flow quantified with ¹⁵O-water PET is an exploratory
efficacy outcome, together with echocardiographic, clinical, functional,
and biomarker measures. EPICCURE combines high-efficiency delivery with
quantitative targeting and follow-up for robust assessment of the safety
and exploratory efficacy of VEGF-A mRNA angiogenesis (ClinicalTrials.gov:
NCT03370887).
In the EPICCURE study, patients undergoing coronary artery bypass grafting
receive epicardial injections of synthetic mRNA encoding vascular
endothelial growth factor A or placebo. Imaging of myocardial blood flow
with ¹⁵O-water PET is used to target injections to ischemic but
viable regions in each participant and to monitor potential
improvement.<br/>Copyright &#xa9; 2020 The Authors

<56>
Accession Number
2007022014
Title
A meta-analysis of 1-year outcomes of transcatheter versus surgical aortic
valve replacement in low-risk patients with severe aortic stenosis.
Source
Journal of Geriatric Cardiology. 17 (1) (pp 43-50), 2020. Date of
Publication: 2020.
Author
Malik A.H.; Zaid S.; Ahmad H.; Goldberg J.; Dutta T.; Undemir C.; Cohen
M.; Aronow W.S.; Lansman S.L.
Institution
(Malik) Department of Medicine, Westchester Medical Center, New York
Medical College, Valhalla, NY, United States
(Zaid, Ahmad, Dutta, Cohen, Aronow) Department of Cardiology, Westchester
Medical Center, New York Medical College, Valhalla, NY, United States
(Goldberg, Undemir, Lansman) Section of Cardiothoracic Surgery, Department
of Surgery, Westchester Medical Center, Valhalla, NY, United States
Publisher
Science Press (E-mail: wangjing@neigae.ac.cn)
Abstract
Background Transcatheter aortic valve replacement (TAVR) for the treatment
symptomatic severe aortic stenosis (AS) is indicated in patients with
intermediate or higher surgical risk. Latest trials showed TAVR, and
surgical aortic valve replacement (SAVR) perform similarly at 1-year for
the composite outcomes of mortality, stroke and rehospitalization. We
performed a comprehensive meta-analysis to compare individual outcomes at
1-year for TAVR compared to SAVR in low-risk patients. Methods PubMed,
Embase, and Cochrane central were searched for all the randomized
controlled trials (RCTs) that reported 1-year comparative outcomes of TAVR
and surgical aortic valve replacement (SAVR). Our conclusions are based
upon the random-effects model using DerSimonian-Laird estimator. Results
Data from 4 trials and 2887 randomized patients showed that TAVR had lower
rates of all-cause mortality, cardiovascular mortality, and atrial
fibrillation compared to SAVR at 1-year follow-up (P < 0.05 for all).
Also, TAVR was also associated with a significantly higher risk of
permanent pacemaker implantation and moderate-severe paravalvular leak (P
< 0.05). Conclusions The latest randomised trial data demonstrates that in
short-term, TAVR is safe and effective in reducing all-cause mortality or
stroke. Longer follow-up of RCTs is needed to determine the durability of
clinical benefits in TAVR over SAVR in low-risk patients.<br/>Copyright
&#xa9; 2020 JGC All rights reserved

<57>
Accession Number
632354359
Title
Association of Statin Use with All-Cause and Cardiovascular Mortality in
US Veterans 75 Years and Older.
Source
JAMA - Journal of the American Medical Association. 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, and Clinical
Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
(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,
United States
(Orkaby, Driver, Gaziano, Cho, Djousse) Division of Aging, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(Lu, Vassy) Department of Medicine, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Forman) Section of Geriatric Cardiology, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
(Forman) Geriatric Research, Education, and Clinical Center, VA Pittsburgh
Healthcare System, Pittsburgh, PA, United States
(Gagnon) Department of Biostatistics, Boston University School of Public
Health, Boston, MA, United States
(Wilson) Atlanta VA Medical Center, Decatur, GA, United States
(Wilson) Division of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
(Wilson) Department of Epidemiology, Rollins School of Public Health,
Emory University, Atlanta, GA, United States
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
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..<br/>Copyright &#xa9; 2020 American Medical
Association. All rights reserved.

<58>
Accession Number
632268440
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) (no pagination), 2020. Article
Number: 328. 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
BioMed Central (E-mail: info@biomedcentral.com)
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 20 years 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.<br/>Copyright &#xa9; 2020 The Author(s).

<59>
Accession Number
632067315
Title
Comparison of newer generation self-expandable vs. balloon-expandable
valves in transcatheter aortic valve implantation: The randomized
SOLVE-TAVI trial.
Source
European Heart Journal. 41 (20) (pp 1890-1899), 2020. Date of Publication:
21 May 2020.
Author
Thiele H.; Kurz T.; Feistritzer H.-J.; Stachel G.; Hartung P.; Eitel I.;
Marquetand C.; Nef H.; Doerr O.; Lauten A.; Landmesser U.; Abdel-Wahab M.;
Sandri M.; Holzhey D.; Borger M.; Ince H.; Oner A.; Meyer-Saraei R.;
Wienbergen H.; Fach A.; Frey N.; Konig I.R.; Vonthein R.; Ruckert Y.;
Funkat A.-K.; De Waha-Thiele S.; Desch S.
Institution
(Thiele, Feistritzer, Stachel, Hartung, Abdel-Wahab, Sandri, Holzhey,
Borger, Desch) Heart Center Leipzig, University of Leipzig, Strumpellstr.
39, Leipzig 04289, Germany
(Thiele, Feistritzer, Stachel, Hartung, Abdel-Wahab, Sandri, Holzhey,
Borger, Ruckert, Funkat, Desch) Leipzig Heart Institute, Russenstrase 69a,
Leipzig D-04289, Germany
(Kurz, Eitel, Marquetand, Meyer-Saraei, De Waha-Thiele) University Clinic
Schleswig-Holstein, University Heart Center Lubeck, Ratzeburger Allee 160,
Lubeck D-23538, Germany
(Kurz, Eitel, Marquetand, Lauten, Landmesser, Meyer-Saraei, Frey, Konig,
De Waha-Thiele, Desch) German Center for Cardiovascular Research (DZHK),
Ratzeburger Allee 160, Lubeck D-23538, Germany
(Nef, Doerr) Medizinische Klinik i, Abteilung fur Kardiologie,
Universitatsklinikum Marburg/Giesen, Klinikstr. 33, Giesen D-35392,
Germany
(Lauten, Landmesser) Universitatsklinikum Charite, Campus Benjamin
Franklin, Hindenburgdamm 30, Berlin D-12200, Germany
(Ince, Oner) Medizinische Klinik i im Zentrum fur Innere Medizin (ZIM),
Universitatsklinikum Rostock, Ernst-Heydemann-Str. 6, Rostock D-18057,
Germany
(Wienbergen, Fach) Klinikum Links der Weser, Herzzentrum Bremen,
Senator-Wessling-Str. 1, Bremen D-28277, Germany
(Frey) Department of Cardiology, University Clinic Schleswig-Holstein,
Campus Kiel, Schittenhelmstr. 12, Kiel D-24105, Germany
(Konig, Vonthein) Institut fur Medizinische Biometrie und Statistik,
Universitat zu Lubeck, Universitatsklinikum Schleswig-Holstein, Campus
Lubeck, Ratzeburger Allee 160, Lubeck D-23562, Germany
Publisher
Oxford University Press
Abstract
Aims: Transcatheter aortic valve implantation (TAVI) has emerged as
established treatment option in patients with symptomatic aortic stenosis.
Technical developments in valve design have addressed previous limitations
such as suboptimal deployment, conduction disturbances, and paravalvular
leakage. However, there are only limited data available for the comparison
of newer generation self-expandable valve (SEV) and balloon-expandable
valve (BEV). <br/>Methods and Results: SOLVE-TAVI is a multicentre,
open-label, 2 x 2 factorial, randomized trial of 447 patients with aortic
stenosis undergoing transfemoral TAVI comparing SEV (Evolut R, Medtronic
Inc., Minneapolis, MN, USA) with BEV (Sapien 3, Edwards Lifesciences,
Irvine, CA, USA). The primary efficacy composite endpoint of all-cause
mortality, stroke, moderate/severe prosthetic valve regurgitation, and
permanent pacemaker implantation at 30 days was powered for equivalence
(equivalence margin 10% with significance level 0.05). The primary
composite endpoint occurred in 28.4% of SEV patients and 26.1% of BEV
patients meeting the prespecified criteria of equivalence [rate difference
-2.39 (90% confidence interval, CI -9.45 to 4.66); P<inf>equivalence</inf>
= 0.04]. Event rates for the individual components were as follows:
all-cause mortality 3.2% vs. 2.3% [rate difference -0.93 (90% CI -4.78 to
2.92); P<inf>equivalence</inf> < 0.001], stroke 0.5% vs. 4.7% [rate
difference 4.20 (90% CI 0.12 to 8.27); P<inf>equivalence</inf> = 0.003],
moderate/severe paravalvular leak 3.4% vs. 1.5% [rate difference -1.89
(90% CI -5.86 to 2.08); P<inf>equivalence</inf> = 0.0001], and permanent
pacemaker implantation 23.0% vs. 19.2% [rate difference -3.85 (90% CI
-10.41 to 2.72) in SEV vs. BEV patients; P<inf>equivalence</inf> = 0.06].
<br/>Conclusion(s): In patients with aortic stenosis undergoing
transfemoral TAVI, newer generation SEV and BEV are equivalent for the
primary valve-related efficacy endpoint. These findings support the safe
application of these newer generation percutaneous valves in the majority
of patients with some specific preferences based on individual valve
anatomy.<br/>Copyright &#xa9; 2020 Published on behalf of the European
Society of Cardiology. All rights reserved. &#xa9; The Author(s) 2020.

<60>
Accession Number
2004983460
Title
Dose-response analysis between hemoglobin A1c and risk of atrial
fibrillation in patients with and without known diabetes.
Source
PLoS ONE. 15 (2) (no pagination), 2020. Article Number: e0227262. Date of
Publication: 2020.
Author
Zhao H.; Liu M.; Chen Z.; Mei K.; Yu P.; Xie L.
Institution
(Zhao) Department of Anesthesiology, Third Hospital of Nanchang, Nanchang,
Jiangxi, China
(Liu) Department of Cardiology, Seventh People's Hospital, Zhengzhou,
Henan, China
(Chen) Fuzhou University of International Studies and Trade, Fuzhou,
Fujian, China
(Mei) Department of Anesthesiology, Shangrao People's Hospital, Shangrao,
Jiangxi, China
(Yu) Department of Endocrinology, Second Affiliated Hospital of Nanchang
University, Nanchang, Jiangxi, China
(Xie) Department of Respiratory and Critical Care Medicine, Second
Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background The relationship between serum hemoglobin A1c (HbA1c) and
atrial fibrillation (AF) or postoperative AF (POAF) in coronary artery
bypass (CABG) patients is still under debate. It is also unclear whether
there is a dose-response relationship between circulating HbA1c and the
risk of AF or POAF. Methods and results The Cochrane Library, PubMed, and
EMBASE databases were searched. A robust-error meta-regression method was
used to summarize the shape of the dose-response relationship. The RR and
95%CI were using a random-effects model. In total, 14 studies were
included, totaling 17,914 AF cases among 352,325 participants. The summary
RR per 1% increase in HbA1c was 1.16 (95% CI: 1.07-1.27). In the subgroup
analysis, the summary RR was 1.13 (95% CI: 1.08-1.19) or 1.12 (95% CI:
1.05-1.20) for patients with diabetes or without known diabetes,
respectively. The nonlinear analysis showed a nonlinear
(P<inf>nonlinear</inf> = 0.04) relationship between HbA1c and AF, with a
significantly increased risk of AF if HbA1c was over 6.3%. However, HbA1c
(per 1% increase) was not associated with POAF in patients with diabetes
(RR: 1.13, P = 0.34) or without known diabetes (RR: 0.91, P = 0.37) among
patients undergoing CABG. Conclusion Our results suggest that higher HbA1c
was associated with an increased risk of AF, both in diabetes and in
without diabetes or with unknown diabetes. However, no association was
found between HbA1c and POAF in patients undergoing CABG. Further
prospective studies with larger population sizes are needed to explore the
association between serum HbA1c level and the risk of POAF.<br/>Copyright
&#xa9; 2020 Zhao et al. This is an open access article distributed under
the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<61>
Accession Number
2004670444
Title
Infective endocarditis post-transcatheter aortic valve implantation
(TAVI), microbiological profile and clinical outcomes: A systematic
review.
Source
PLoS ONE. 15 (1) (no pagination), 2020. Article Number: e0225077. Date of
Publication: 2020.
Author
Khan A.; Aslam A.; Satti K.N.; Ashiq S.
Institution
(Khan, Aslam, Ashiq) Sharif Medical and Dental College, Lahore, Pakistan
(Satti) Senior Registrar Rawalpindi Institute of Cardiology, Rawalpindi,
Pakistan
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background The data on infective endocarditis after transcatheter aortic
valve implantation (TAVI) is scarce and limited to case reports and case
series in the literature. It is the need of the hour to analyze the
available data on post-TAVI infective endocarditis from the available
literature. The objectives of this systematic review were to evaluate the
incidence of infective endocarditis after transcatheter aortic valve
implantation, its microbiological profile and clinical outcomes. It will
help us to improve the antibiotic prophylaxis strategies and treatment
options for infective endocarditis in the context of TAVI. Methods EMBASE,
Medline and the CENTRAL trials registry of the Cochrane Collaboration were
searched for articles on infective endocarditis in post-TAVI patients till
October 2018. Eleven articles were included in the systematic review. The
outcomes assessed werethe incidence of infective endocarditis, its
microbiological profile andclinical outcomes including major adverse
cardiac event (MACE), net adverse clinical event (NACE), surgical
intervention and valve-in-valve procedure. Results The incidence of
infective endocarditis varied from 0%-14.3% in the included studies, the
mean was3.25%. The average duration of follow-up was 474 days (1.3 years).
Enterococci were the most common causative organism isolated from 25.9% of
cases followed by Staphylococcus aureus (16.1%) and coagulase-negative
Staphylococcus species (14.7%). The mean in-hospital mortality and
mortality at follow-up was 29.5% and 29.9%, respectively. The cumulative
incidence of heart failure, stroke and major bleeding were 37.1%, 5.3% and
11.3%,respectively. Only a single study by Martinez-Selles et al. reported
arrhythmias in 20% cases. The septic shock occurred in 10% and 27.7%
post-TAVI infective endocarditis patients according to 2 studies. The
surgical intervention and valve-in-valve procedure were reported in 11.4%
and 6.4% cases, respectively. Conclusion The incidence of post-TAVI
infective endocarditis is low being 3.25% but it is associated with high
mortality and complications. The most common complication is heart failure
with a cumulative incidence of 37.1%. Enterococciare the most common
causative organism isolated from 25.9% of cases followed by Staphylococcus
aureus in 16.1% of cases. Appropriate measures should be taken to prevent
infective endocarditis in post-TAVI patients including adequate
antibiotics prophylaxis directed specifically against these
organisms.<br/>Copyright &#xa9; 2020 Khan et al.

<62>
Accession Number
2003581529
Title
Volatile anesthetics versus total intravenous anesthesia in patients
undergoing coronary artery bypass grafting: An updated metaanalysis and
trial sequential analysis of randomized controlled trials.
Source
PLoS ONE. 14 (10) (no pagination), 2019. Article Number: e0224562. Date of
Publication: 2019.
Author
Jiao X.-F.; Lin X.-M.; Ni X.-F.; Li H.-L.; Zhang C.; Yang C.-S.; Song
H.-X.; Yi Q.-S.; Zhang L.-L.
Institution
(Jiao, Ni, Li, Zhang, Yang, Song, Yi, Zhang) Department of Pharmacy, West
China Second University Hospital, Sichuan University, Sichuan, China
(Jiao, Ni, Li, Zhang, Yang, Song, Yi, Zhang) Evidence-Based Pharmacy
Center, West China Second University Hospital, Sichuan University,
Sichuan, China
(Jiao, Lin, Ni, Li, Zhang, Yang, Song, Yi, Zhang) Key Laboratory of Birth
Defects and Related Diseases of Women and Children, Sichuan University,
Ministry of Education, Sichuan, China
(Jiao, Ni, Yi) West China School of Medicine, Sichuan University, Sichuan,
China
(Lin) Department of Anesthesiology, West China Second University Hospital,
Sichuan University, Sichuan, China
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background The benefits of volatile anesthetics in coronary artery bypass
grafting (CABG) patients remain controversial. We aimed to conduct an
updated meta-analysis to assess whether the use of volatile anesthetics
during CABG could reduce mortality and other outcomes. Methods We searched
eight databases from inception to June 2019 and included randomized
controlled trials (RCTs) comparing the effects of volatile anesthetics
versus total intravenous anesthesia (TIVA) in CABG patients. The primary
outcomes were operative mortality and one-year mortality. The secondary
outcomes included the length of stay in the intensive care unit (ICU) and
hospital and postoperative safety outcomes (myocardial infarction, heart
failure, arrhythmia, stroke, delirium, postoperative cognitive impairment,
acute kidney injury, and the use of intra-aortic balloon pump (IABP) or
other mechanical circulatory support). Trial sequential analysis (TSA) was
performed to control for random errors. Results A total of 89 RCTs
comprising 14,387 patients were included. There were no significant
differences between the volatile anesthetics and TIVA groups in operative
mortality (relative risk (RR) = 0.92, 95% confidence interval (CI):
0.68-1.24, p = 0.59, I2 = 0%), one-year mortality (RR = 0.64, 95% CI:
0.32-1.26, p = 0.19, I2 = 51%), or any of the postoperative safety
outcomes. The lengths of stay in the ICU and hospital were shorter in the
volatile anesthetics group than in the TIVA group. TSA revealed that the
results for operative mortality, one-year mortality, length of stay in the
ICU, heart failure, stroke, and the use of IABP were inconclusive.
Conclusions Conventional meta-analysis suggests that the use of volatile
anesthetics during CABG is not associated with reduced risk of mortality
or other postoperative safety outcomes when compared with TIVA. TSA shows
that the current evidence is insufficient and inconclusive. Thus, future
large RCTs are required to clarify this issue.<br/>Copyright &#xa9; 2019
Jiao et al. This is an open access article distributed under the terms of
the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author
and source are credited.

<63>
Accession Number
2003581491
Title
The use of prophylactic intra-aortic balloon pump in high-risk patients
undergoing coronary artery bypass grafting.
Source
PLoS ONE. 14 (10) (no pagination), 2019. Article Number: e0224273. Date of
Publication: 2019.
Author
Nakamura K.; Hamasaki A.; Uchida T.; Kobayashi K.; Sho R.; Kim C.; Uchino
H.; Shimanuki T.; Sadahiro M.
Institution
(Nakamura, Kobayashi, Kim, Uchino, Shimanuki) Division of Cardiovascular
Surgery, Nihonkai General Hospital, Sakata, Japan
(Hamasaki, Uchida, Sadahiro) Second Department of Surgery, Yamagata
University, Faculty of Medicine, Yamagata, Japan
(Sho) Department of Public Health, Yamagata University, Faculty of
Medicine, Yamagata, Japan
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Objective Intra-aortic balloon pump (IABP) is one of the most commonly
used mechanical circulatory assist devices for high-risk patients
undergoing cardiac surgery. In an effort to validate previously reported
clinical outcomes, we describe the preoperative characteristics and
outcomes of patients who underwent prophylactic IABP in high-risk patients
undergoing coronary artery bypass grafting (CABG). Design A prospective
observational study Methods From 2005 to 2017, 471 patients underwent
either isolated or combined CABG at our institution. Of those, 393
patients underwent isolated CABG and were included for the analysis.
Eighty-five patients (22%) were considered high-risk and underwent
prophylactic IABP, with subsequent review of surgical morbidity and
mortality rates. Results The 30-day postoperative mortality (prophylactic
IABP group vs non prophylactic IABP group: 0% vs 1.6%, p = 0.589) and
major adverse cardiac or cerebrovascular events (5.9% vs 3.3%, p = 0.333)
were not significantly different between the two groups. Prolonged
mechanical ventilation (>72 hours) (12.5% vs 4.2%, p = 0.014) occurred
more frequently in the prophylactic IABP group. Conclusions No
IABP-related complications were noted, emphasizing that the use of
prophylactic IABP in high-risk patients undergoing CABG is an acceptable
option.<br/>Copyright &#xa9; 2019 Nakamura et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<64>
Accession Number
2002958743
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement in patients at low and intermediate risk: A risk specific
meta-analysis of randomized controlled trials.
Source
PLoS ONE. 14 (9) (no pagination), 2019. Article Number: e0221922. Date of
Publication: 2019.
Author
Fang F.; Tang J.; Zhao Y.; He J.; Xu P.; Faramand A.
Institution
(Fang, Zhao, He) West China Hospital, Sichuan University, Chengdu,
Sichuan, China
(Tang) Chinese University of Hong Kong, Shenzhen, Guangdong, China
(Xu) Sichuan University Library, Chengdu, Sichuan, China
(Faramand) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background Transcatheter aortic valve implantation (TAVI) is an option for
treatment for patients with severe aortic stenosis who are at high risk
for death with surgical aortic valve replacement (SAVR). It is unknown
whether TAVI can be safely introduced to intermediate-and low-risk
patients. Objective To compare the efficacy and safety of TAVI and SAVR in
patients with intermediate-and low-surgical risk. Data sources Medline,
Embase, and the Cochrane Central Register of Controlled Trials were
searched from inception to April 15, 2019. Study selection We included
randomized controlled trials comparing TAVI with SAVR in patients with
intermediate-and low-surgical risk. Data extraction Meta-analyses were
conducted using random-effects models to calculate risk ratios (RR) with
corresponding 95% confidence interval (CI). Two independent reviewers
completed citation screening, data abstraction, and risk assessment.
Primary outcome was a composite of all-cause mortality or disabling stroke
at 12 months. Data Synthesis A total of 5 trials randomizing 6390 patients
were included. In patients with low risk, TAVI was associated with a
significant reduction in the composite of all-cause mortality or disabling
stroke compared with SAVR (RR, 0.56; 95%CI, 0.40-0.79; I² =
0%). This benefit was not replicated in patients with intermediate risk
(RR, 0.96; 95% CI, 0.80-1.15; I² = 0%). Similar results were
seen separately in all-cause mortality and disabling stroke when TAVI was
compared with SAVR. Conclusion For patients with severe aortic stenosis
who were at low risk for death from surgery, TAVI achieved superior
clinical outcomes compared to SAVR; however, these benefits were not seen
in those with intermediate risk. This information may inform discussions
about deciding between SAVR and TAVI for patients with low to intermediate
risk separately.<br/>Copyright &#xa9; 2019 Fang et al.

<65>
Accession Number
2002842475
Title
Costs of clinical events in type 2 diabetes mellitus patients in the
Netherlands: A systematic review.
Source
PLoS ONE. 14 (9) (no pagination), 2019. Article Number: e0221856. Date of
Publication: 2019.
Author
Van Schoonhoven A.V.; Gout-Zwart J.J.; De Vries M.J.S.; Van Asselt A.D.I.;
Dvortsin E.; Vemer P.; Van Boven J.F.M.; Postma M.J.
Institution
(Van Schoonhoven, De Vries, Vemer, Postma) Unit of PharmacoTherapy,
Epidemiology and Economics (PTE2), Department of Pharmacy, University of
Groningen, Groningen, Netherlands
(Gout-Zwart, Dvortsin) Asc Academics, Groningen, Netherlands
(Gout-Zwart) Department of Nephrology, University of Groningen, University
Medical Centre Groningen (UMCG), Groningen, Netherlands
(Van Asselt, Vemer) Department of Epidemiology, University Medical Centre
Groningen, Groningen, Netherlands
(Van Asselt, Postma) Department of Health Sciences, University of
Groningen, University Medical Centre Groningen (UMCG), Groningen,
Netherlands
(Van Boven) Department of General Practice and Elderly Care, University of
Groningen, University Medical Center Groningen (UMCG), Groningen,
Netherlands
(Van Boven) Department of Clinical Pharmacy and Pharmacology, University
of Groningen, University Medical Centre Groningen (UMCG), Groningen,
Netherlands
(Postma) Department of Economics, Econometrics and Finance, University of
Groningen, Faculty of Economics and Business, Groningen, Netherlands
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background Type 2 diabetes mellitus (T2DM) is an established risk factor
for cardiovascular and nephropathic events. In the Netherlands, prevalence
of T2DM is expected to be as high as 8% by 2025. This will result in
significant clinical and economic impact, highlighting the need for
well-informed reimbursement decisions for new treatments. However,
availability and consistent use of costing methodologies is limited.
Objective We aimed to systematically review recent costing data for
T2DM-related cardiovascular and nephropathic events in the Netherlands.
Methods A systematic literature review in PubMed and Embase was conducted
to identify available Dutch cost data for T2DM-related events, published
in the last decade. Information extracted included costs, source, study
population, and costing perspective. Finally, papers were evaluated using
the Consolidated Health Economic Evaluation Reporting Standards (CHEERS).
Results Out of initially 570 papers, 36 agreed with the inclusion
criteria. From these studies, 150 cost estimates for T2DM-related clinical
events were identified. In total, 29 cost estimates were reported for
myocardial infarction (range: 196-27,038), 61 for stroke (495-54,678),
fifteen for heart failure (325-16,561), 24 for renal failure
(2,438-91,503), and seventeen for revascularisation (3,000-37,071). Only
four estimates for transient ischaemic attack were available, ranging from
587 to 2,470. Adherence to CHEERS was generally high. Conclusions The most
expensive clinical events were related to renal failure, while TIA was the
least expensive event. Generally, there was substantial variation in
reported cost estimates for T2DM-related events. Costing of clinical
events should be improved and preferably standardised, as accurate and
consistent results in economic models are desired.<br/>Copyright &#xa9;
2019 van Schoonhoven et al. This is an open access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<66>
Accession Number
2002662559
Title
Heart rate recovery and morbidity after noncardiac surgery: Planned
secondary analysis of two prospective, multi-centre, blinded observational
studies.
Source
PLoS ONE. 14 (8) (no pagination), 2019. Article Number: e0221277. Date of
Publication: 2019.
Author
Ackland G.L.; Abbott T.E.F.; Minto G.; Clark M.; Owen T.; Prabhu P.; May
S.M.; Reynolds J.A.; Cuthbertson B.H.; Wijesundera D.; Pearse R.M.
Institution
(Ackland, Abbott, May, Reynolds, Pearse) William Harvey Research
Institute, Queen Mary University of London, London, United Kingdom
(Minto) Department of Anaesthesia, Derriford Hospital, Plymouth Hospitals
NHS Trust, Peninsula Schools of Medicine and Dentistry, Plymouth
University, Plymouth, United Kingdom
(Clark) Department of Anaesthesia, Royal Bournemouth Hospital,
Bournemouth, United Kingdom
(Owen) Department of Anaesthesia, Royal Preston Hospital, Lancashire
Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
(Prabhu) Department of Anaesthesia, Royal Surrey County Hospital,
Guildford, United Kingdom
(Cuthbertson, Wijesundera) Department of Critical Care Medicine,
Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Cuthbertson, Wijesundera) Department of Anesthesia, University of
Toronto, Toronto, ON, Canada
(Wijesundera) Li Ka Shing Knowledge Institute, St. Michael's Hospital,
Toronto, ON, Canada
(Wijesundera) Department of Anesthesia and Pain Management, Toronto
General Hospital, Toronto, ON, Canada
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background Impaired cardiac vagal function, quantified preoperatively as
slower heart rate recovery (HRR) after exercise, is independently
associated with perioperative myocardial injury. Parasympathetic (vagal)
dysfunction may also promote (extra-cardiac) multi-organ dysfunction,
although perioperative data are lacking. Assuming that cardiac vagal
activity, and therefore heart rate recovery response, is a marker of
brainstem parasympathetic dysfunction, we hypothesized that impaired HRR
would be associated with a higher incidence of morbidity after noncardiac
surgery. Methods In two prospective, blinded, observational cohort
studies, we established the definition of impaired vagal function in terms
of the HRR threshold that is associated with perioperative myocardial
injury (HRR 12 beats min^-1 (bpm), 60 seconds after cessation of
cardiopulmonary exercise testing. The primary outcome of this secondary
analysis was all-cause morbidity three and five days after surgery,
defined using the Post-Operative Morbidity Survey. Secondary outcomes of
this analysis were type of morbidity and time to become morbidity-free.
Logistic regression and Cox regression tested for the association between
HRR and morbidity. Results are presented as odds/hazard ratios [OR or HR;
(95% confidence intervals). Results 882/1941 (45.4%) patients had
HRR12bpm. All-cause morbidity within 5 days of surgery was more common in
585/822 (71.2%) patients with HRR12bpm, compared to 718/1119 (64.2%)
patients with HRR>12bpm (OR:1.38 (1.14-1.67); p = 0.001). HRR12bpm was
associated with more frequent episodes of pulmonary (OR:1.31 (1.05-1.62);p
= 0.02)), infective (OR:1.38 (1.10-1.72); p = 0.006), renal (OR:1.91
(1.30-2.79); p = 0.02)), cardiovascular (OR:1.39 (1.15-1.69); p<0.001)),
neurological (OR:1.73 (1.11-2.70); p = 0.02)) and pain morbidity (OR:1.38
(1.14-1.68); p = 0.001) within 5 days of surgery. Conclusions Multi-organ
dysfunction is more common in surgical patients with cardiac vagal
dysfunction, defined as HRR 12 bpm after preoperative cardiopulmonary
exercise testing.<br/>Copyright &#xa9; 2019 Ackland et al. This is an open
access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<67>
Accession Number
2002560975
Title
Comparison of early and delayed invasive strategies in short-medium term
among patients with non-ST segment elevation acute coronary syndrome: A
systematic review and meta-analysis.
Source
PLoS ONE. 14 (8) (no pagination), 2019. Article Number: e0220847. Date of
Publication: 2019.
Author
Zhang M.-B.; Guo C.; Li M.; Lv Y.-H.; Fan Y.-D.; Wang Z.-L.
Institution
(Zhang, Guo, Li, Lv, Wang) First Medical Clinical College of Lanzhou
University, Lanzhou, China
(Fan) Department of Cardiology, Emergency General Hospital, Beijing, China
(Wang) Department of Cardiology, First Hospital of Lanzhou University,
Lanzhou, China
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background and objectives An invasive approach is recommended as the
treatment of patients with non-ST elevated acute coronary syndromes
(NSTE-ACS). However, it remains unclear that the optimal time of
angiography and intervention for patients with NSTE-ACS at present. This
study was designed to compare the effect of early and delayed invasive
strategies on short-medium term prognosis in patients with those. Methods
Pubmed, Cochrane Library and Embase were searched up to Dec-30-2018.
Randomized clinical trials comparing an early versus a delayed invasive
strategy in patients with NSTEACS were included. The primary endpoint
(all-cause death and recurrent myocardial infarction) and secondary
endpoint (major bleeding and recurrent revascularization), as well as
composite endpoint were assessed by random or fixed effected meta-analysis
with software RevMan 5.3 version after short-medium term follow up. Result
A total of six randomized clinical trials involving 4,277 early or delayed
invasive strategies patients with NSTE-ACS were included in the
meta-analysis. Time to coronary angiography varied from 0.5 to 24 h in the
early invasive strategy and from 18.6 to 72 h in the delayed invasive
strategy. There was a statistical difference in the primary endpoint of
all-cause death among patients with NSTE-ACS between early and delayed
invasive strategies (4.6% vs 6%; OR:0.76; 95% CI:0.58 to 1.00; P = 0.05;
I2 = 0%), but not for recurrent myocardial infarction (6.0% vs 6.3%; OR:
0.94; 95% CI: 0.55 to 1.61; P = 0.82; I2 = 60%). The major bleeding in
patients with NSTE-ACS was similar between both invasive strategies (2.7%
vs 3.1%; OR:0.88; 95% CI:0.59 to 1.31; P = 0.54; I2 = 0%). However, the
composite endpoint in the early invasive strategy patients with NSTE-ACS
was significantly lower than that of the delayed invasive strategy (10.9%
vs 13.9%; OR:0.76; 95% CI:0.63 to 0.92; P = 0.006; I2 = 0%), and the
recurrent revascularization between both strategies was just the opposite
(8.7% vs 5.9%; OR:1.5; 95%CI:1.15 to 1.97; P = 0.003; I2 = 0%). Conclusion
The systematic review and meta-analysis demonstrated that the early
invasive strategy had a beneficial trend on all-cause death and
significantly reduced the composite endpoint in patients with NSTE-ACS,
but increased the rate of revascularization. These data could provide a
solution for patients with those.<br/>Copyright &#xa9; 2019 Zhang et al.

<68>
Accession Number
623954593
Title
Radiologist initiated specialty referral for patients suspected of having
a thoracic malignancy.
Source
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine. 1 (4)
(pp 180-185), 2017. Date of Publication: 02 Oct 2017.
Author
Tremblay A.; Strilchuk N.; Taghizadeh N.; Fortin M.; Burrowes P.; Hampton
L.; Chee A.; MacEachern P.; Koetzler R.; McFadden S.
Institution
(Tremblay, Strilchuk, Taghizadeh, Fortin, Hampton, Chee, MacEachern,
Koetzler) Division of Respiratory Medicine, University of Calgary and
Alberta Thoracic Oncology Program, Calgary, AB, Canada
(Burrowes) Department of Diagnostic Imaging, Alberta Health Services,
Calgary, AB, Canada
(McFadden) Division of Thoracic Surgery, University of Calgary and Alberta
Thoracic Oncology Program, Calgary, AB, Canada
Publisher
Taylor and Francis Inc. (E-mail: customerservice@taylorandfrancis.com)
Abstract
RATIONALE: The time interval between detection of a lesion suspicious for
thoracic malignancy on imaging and referral to specialty care can be too
long. <br/>OBJECTIVE(S): We aimed to evaluate an expedited referral
process in which a radiologist could trigger a referral to specialty care
at the time of CT interpretation. <br/>METHOD(S): Prospective
observational non-randomized study of two groups of patients referred to
the Alberta Thoracic Oncology Program-South (ATOP-S). Group 1: Subjects
referred through a radiologist referral at the time of interpretation.
Group 2: Subjects referred through another health care provider. The time
interval between dates of first suspicious CT scan to acceptance of
referral (CT-R), first specialty appointment date (CT-A), and treatment
decision (CT-D) were compared between both groups. MEASUREMENTS AND MAIN
RESULTS: Seventy-five cases met study criteria for group 1 and 836 for
group 2. The median (75^th, 90^th percentile) CT-R was
4 (8, 13) days in group 1 and 8 (19, 37) days in group 2. For CT-A, the
time intervals were 14 (19, 26) days in group 1 and 20 (32, 52) days in
group 2 and for CT-D 26 (40, 63) days in group 1 and 32 (49, 71) days in
group 2. Subjects in group 1 had a significantly shorter CT-R, CT-A, and
CT-D intervals compared to subjects in group 2 (P-values < 0.001, < 0.001
and 0.004, respectively). <br/>CONCLUSION(S): A radiologist initiated
referral program significantly reduced the interval between first CT scan
suggestive of a lung malignancy to receipt of referral to a specialist,
first specialty appointment date and treatment decision. RESUME
JUSTIFICATION: L'intervalle de temps entre la detection d'une lesion
suspecte de malignite thoracique par imagerie et la reference en soins
specialises peut etre trop long. OBJECTIFS: Nous voulions evaluer un
processus de reference accelere dans le cadre duquel un radiologue pouvait
declencher une reference en soins specialises au moment de
l'interpretation de la tomodensitometrie. METHODES: Etude observationnelle
prospective non randomisee de deux groupes de patients referes au
Programme d'oncologie thoracique de l'Alberta-Sud (ATOP-S). Groupe 1:
Sujets referes par le biais d'une reference du radiologue au moment de
l'interpretation. Groupe 2: Sujets referes par le biais d'un autre
prestataire de soins. L'intervalle de temps entre la date de la premiere
tomographie suspecte et la date de l'acception de la reference (CT-R), la
date du premier rendez-vous en soins specialises (CT-A) et la date
decision de traitement (CT-D) a ete compare entre les deux groupes.
MESURES ET PRINCIPAUX RESULTATS: Soixante-quinze cas repondaient aux
criteres de l'etude pour le groupe 1 et 836 pour le groupe 2. Le CT-R
median (75^e, 90^e percentile) etait de 4 (8, 13)
jours pour le groupe 1 et de 8 (19, 37) jours pour le groupe 2. Pour le
CT-A, les intervalles de temps ont ete de 14 (19, 26) jours pour le groupe
1 et de 20 (32, 52) jours pour le groupe 2, tandis que pour le CT-D, ils
ont ete de 26 (40, 63) jours pour le groupe 1 et de 32 (49, 71) jours pour
le groupe 2. Les sujets du groupe 1 avaient des intervalles de CT-R, de
CT-A et de CT-D significativement plus courts comparativement aux sujets
du groupe 2 (valeurs p < 0,001, < 0,001 et 0,004, respectivement).
<br/>CONCLUSION(S): Un programme de reference initiee par le radiologue
reduit de maniere significative l'intervalle entre la premiere
tomodensitometrie evocatrice d'une malignite pulmonaire et la reception de
la reference par un specialiste, le premier rendez-vous en soins
specialises et la decision de traitement.<br/>Copyright &#xa9; 2017,
&#xa9; 2017 Canadian Thoracic Society.

<69>
Accession Number
359716823
Title
Cost-effectiveness of lowering blood pressure with a fixed combination of
perindopril and indapamide in type 2 diabetes mellitus: An ADVANCE
trial-based analysis.
Source
Medical Journal of Australia. 193 (6) (pp 320-324), 2010. Date of
Publication: 20 Sep 2010.
Author
Glasziou P.P.; Clarke P.; Alexander J.; Rajmokan M.; Beller E.; Woodward
M.; Chalmers J.; Poulter N.; Patel A.
Institution
(Glasziou) Clinical Epidemiology and Biostatistics, Bond University, Gold
Coast, QLD, Australia
(Clarke) Department of Public Health, University of Sydney, Sydney, NSW,
Australia
(Alexander, Beller) Queensland Clinical Trials Centre, University of
Queensland, Brisbane, QLD, Australia
(Rajmokan) Centre for Healthcare Related Infection Surveillance and
Prevention, Queensland Health, Brisbane, QLD, Australia
(Woodward, Patel) Cardiovascular Division, George Institute for
International Health, Sydney, NSW, Australia
(Poulter) Department of Preventive Cardiovascular Medicine, Imperial
College London, London, United Kingdom
(Woodward) Department of Biostatistics, University of Sydney, Sydney, NSW,
Australia
(Chalmers) Department of Medicine, University of Sydney, Sydney, NSW,
Australia
(Chalmers) George Institute for International Health, Sydney, NSW,
Australia
Publisher
Australasian Medical Publishing Co. Ltd (P.O.Box 18667, Newark NJ
07191-8667, United States)
Abstract
Objective: To determine the cost-effectiveness of routine administration,
irrespective of blood pressure (BP), of a fixed-dose combination of
perindopril and indapamide to patients with type 2 diabetes mellitus.
Design, setting and participants: Prospective cost-effectiveness analysis
within the Action in Diabetes and Vascular Disease: Preterax and
Diamicron-MR Controlled Evaluation (ADVANCE) trial, an international,
multicentre, randomised controlled trial of 11 140 participants with type
2 diabetes randomly allocated to receive perindopril plus indapamide
(4mg-1.25mg/day) or placebo. <br/>Main Outcome Measure(s): Health-related
quality-of-life measured by the EuroQol-5D, resource utilisation, and
cost-effectiveness (cost per death averted at 4.3 years' average
follow-up, and estimated cost per life-year gained, by extrapolation).
<br/>Result(s): The mean health-related quality-of-life score of survivors
was 0.80 (on a 0-1 scale [death to full health]), with no difference
between treatment groups. Active treatment reduced hospital admissions for
coronary heart disease and coronary revascularisation by 5%. For the
Australian participants, perindopril-indapamide cost A$1368 per patient
during the trial period, but reduced total hospitalisation costs by A$410
and other medication costs (mainly other BP-lowering drugs) by A$332. The
absolute reduction in all-cause mortality for the active treatment group
was 1.1%, giving a cost per life saved of A$49 200. Lifetime extrapolation
gave an estimated cost per life-year saved of A$10 040 (discounted at 5%
per year). <br/>Conclusion(s): The combination of perindopril and
indapamide in patients with type 2 diabetes appears to be cost-effective.
Trial registration: United States National Library of Medicine
NCT00145925.

<70>
Accession Number
2006805970
Title
Results of surgical coronary revascularization alone versus combined
surgical revascularization and mitral valve repair in patients with
moderate ischemic mitral regurgitation.
Source
Heart Surgery Forum. 23 (3) (pp E270-E275), 2020. Date of Publication: May
2020.
Author
Khallaf A.; Elzayadi M.; Alkady H.; Elnaggar A.
Institution
(Khallaf, Elzayadi) Department of Cardiothoracic Surgery, Fayoum
University, Fayoum, Egypt
(Alkady, Elnaggar) Department of Cardiothoracic Surgery, Cairo University,
Egypt
Publisher
Forum Multimedia Publishing LLC (E-mail: motis@cjp.com)
Abstract
Background: This is a prospective randomized-controlled study aiming to
determine whether the optimal surgical management of moderate ischemic
mitral regurgitation is to revascularize the heart through performing
coronary artery bypass grafting alone or together with repairing the
mitral valve. <br/>Method(s): Between April 2014 and November 2014, 40
patients with ischemic heart disease associated with moderate ischemic
mitral regurgitation at our University hospitals were divided into 2
matched groups. Group 1 received both coronary artery bypass grafting
surgery together with mitral valve repair, while Group 2 underwent
coronary artery bypass grafting surgery alone. <br/>Result(s): No
statistically significant difference was found between both study groups,
in terms of operative data, except for cardiopulmonary bypass time and
aortic cross-clamp time, which were significantly longer in Group 1 (P <
.001). Only one case died in the study in Group 1 on the third
postoperative day, due to severe low cardiac output syndrome. During the
follow up, NYHA class improved in Group 1 from 2.6 to 1.35 (P < .004), but
in Group 2 NYHA class improved from 2.55 to 1.72 (P = .07). The degree of
MR improved in 19 patients (95%) in Group 1 compared with 15 (75%)
patients in Group 2 (P < .0001). <br/>Conclusion(s): Our study showed
meaningful advantages of adding mitral-valve repair to CABG in patients
with ischemic heart disease and moderate ischemic mitral regurgitation,
regarding the degree of MR and functional NYHA class. On the other hand,
there was no statistically significant difference between both groups in
postoperative coarse and in-hospital mortality.<br/>Copyright &#xa9; 2020
Forum Multimedia Publishing, LLC.

<71>
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.

<72>
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.

<73>
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.

<74>
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

<75>
Accession Number
2004711389
Title
Assessment of mortality and factors affecting outcome of use of
paclitaxel-coated stents and bare metal stents in femoropopliteal pad.
Source
Journal of Clinical Medicine. 9 (7) (pp 1-11), 2020. Article Number: 2221.
Date of Publication: July 2020.
Author
Falkowski A.; Bogacki H.; Szemitko M.
Institution
(Falkowski, Bogacki, Szemitko) Department of Interventional Radiology,
Pomeranian Medical University, Szczecin 70-111, Poland
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: rasetti@mdpi.com)
Abstract
The use of drug-coated devices in intravascular therapy is aimed at
preventing neointimal hyperplasia caused by excessive proliferation of
vascular smooth muscle and thereby restenosis. Although its use seemed
initially promising, a recent publication has shown an increased risk of
mortality with paclitaxel-coated devices, and there is an urgent need to
reaffirm assessments of drug-eluting stents (DES). <br/>Objective(s): The
aim of the study was to compare mortality and effectiveness of
paclitaxel-coated stents and bare-metal stents (BMS) in the treatment of
peripheral arterial disease (PAD) with long-term follow-up.
<br/>Material(s) and Method(s): In a single center randomized study, 256
patients with PAD were treated intravascularly with stent implantation.
Patients were randomized into two groups: the first (n = 126) were treated
with DES, and the second (n = 130) were treated with BMS. The study
included evaluation after the procedure, after about 6 months and 36
months. Co-morbidities, with risks for atherosclerosis, were analyzed in
all patients. Patients were evaluated for clinical outcome, restenosis
frequency, and safety (complications and total mortality). <br/>Result(s):
Clinical benefit at the end of the investigation was statistically
significantly better in the DES group compared with the BMS group: 85.7%
versus 66.2% (p = 0.0003), respectively. Restenosis occurred significantly
less frequently in patients with DES: 16.0% versus BMS: 35.0%, p = 0.012.
There was no significant effect of comorbidities on the frequency of
restenoses. There were no differences in all-cause mortality over the
three years with paclitaxel and no-paclitaxel stents cohorts (8.7% versus
7.1%; long-rank p = 0.575). No association was found with mortality and
treatment with DES or BMS. <br/>Conclusion(s): The use of
paclitaxel-coated stents gave good clinical benefit and caused a
significantly lower frequency of restenosis compared to bare-metal stents.
The use of paclitaxel-coated stents did not increase
mortality.<br/>Copyright &#xa9; 2020 by the authors. Licensee MDPI, Basel,
Switzerland.

<76>
Accession Number
2005726977
Title
Impact of the time interval between diagnosis and symptoms on survival of
surgical patients with left-sided infective endocarditis: A propensity
score analysis.
Source
Medicina Clinica. (no pagination), 2020. Date of Publication: 2020.
Author
Urso S.; Tena M.A.; Gonzalez-Barbeito M.; Paredes F.; Quevedo V.; Portela
F.
Institution
(Urso, Tena, Gonzalez-Barbeito, Paredes, Portela) Cardiac Surgery
Department, Hospital Universitario Dr. Negrin, Las Palmas de Gran Canaria,
Spain
(Quevedo) Cardiology Department, Hospital Universitario Dr. Negrin, Las
Palmas de Gran Canaria, Spain
Publisher
Ediciones Doyma, S.L.
Abstract
Objectives: We aimed to explore the impact of the time interval between
symptoms and diagnosis on post-operative infective endocarditis (IE)
survival. <br/>Method(s): From 2014 to 2019, data from 93 consecutive
patients undergoing cardiac surgery due to left-sided +/- right-sided IE
were prospectively recorded in our specific electronic database. Patients
were classified into 2 groups according to time interval between first
clinical symptoms and definitive endocarditis diagnosis: patients with
early diagnosis (<=8 days) and patients with late diagnosis (>8 days).
Follow-up was 100% complete, and follow-up mean time was 471 days.
<br/>Result(s): Among the 93 patients undergoing cardiac surgery due to
definite left-sided IE, 48 (51.6%) had early-diagnosed IE whereas 45
(48.4%) presented with a late-diagnosed IE. Unadjusted and propensity
score adjusted mid-term survival Kaplan-Meier analysis showed
significantly worse survival of patients belonging to the early-diagnosis
group (p .019 and .049 respectively). Multivariable Cox regression
analysis identified only one predictor of mid-term mortality: EuroSCORE II
(Hazard ratio 1.03, 95% CI 1.01-1.05, p .0008). <br/>Conclusion(s): The
association in the Kaplan-Meier analysis between "early-diagnosis group"
and mortality suggests that this group of patients presents clinical
characteristics of severity that, on the one hand, speed up the diagnostic
process and on the other, converge in the determination of a higher
euroSCORE II value, which is the only independent predictor of mid-term
mortality according to our analysis.<br/>Copyright &#xa9; 2020 Elsevier
Espana, S.L.U.

<77>
Accession Number
2002368801
Title
Pre-operative stress testing in the evaluation of patients undergoing
non-cardiac surgery: A systematic review and meta-analysis.
Source
PLoS ONE. 14 (7) (no pagination), 2019. Article Number: e0219145. Date of
Publication: 2019.
Author
Kalesan B.; Nicewarner H.; Intwala S.; Leung C.; Balady G.J.
Institution
(Kalesan) Department of Medicine and Community Health Sciences, Boston
University, School of Medicine and Public Health, Boston, MA, United
States
(Nicewarner, Intwala, Leung, Balady) Department of Medicine, Boston
Medical Center, Boston University Medical Campus, Boston, MA, United
States
Publisher
Public Library of Science (E-mail: plos@plos.org)
Abstract
Background Pre-operative stress testing is widely used to evaluate
patients for non-cardiac surgeries. However, its value in predicting
peri-operative mortality is uncertain. The objective of this study is to
assess the type and quality of available evidence in a comprehensive and
statistically rigorous evaluation regarding the effectiveness of
pre-operative stress testing in reducing 30-day post -operative mortality
following non -cardiac surgery. Methods The databases of MEDLINE, EMBASE,
and CENTRAL databases (from inception to January 27, 2016) were searched
for all studies in English. We included studies with pre-operative stress
testing prior to 10 different non-cardiac surgery among adults and
excluded studies with sample size<15. The data on study characteristics,
methodology and outcomes were extracted independently by two observers and
checked by two other observers. The primary outcome was 30-day mortality.
We performed random effects meta-analysis to estimate relative risk (RR)
and 95% confidence intervals (95% CI) in two-group comparison and pooled
the rates for stress test alone. Heterogeneity was assessed using I2 and
methodological quality of studies using Newcastle-Ottawa Quality
Assessment Scale. The predefined protocol was registered in PROSPERO
#CRD42016049212. Results From 1807 abstracts, 79 studies were eligible
(297,534 patients): 40 had information on 30- day mortality, of which 6
studies compared stress test versus no stress test. The risk of 30- day
mortality was not significant in the comparison of stress testing versus
none (RR: 0.79, 95% CI = 0.35-1.80) along with weak evidence for
heterogeneity. For the studies that evaluated stress testing without a
comparison group, the pooled rates are 1.98% (95% CI = 1.25- 2.85) with a
high heterogeneity. There was evidence of potential publication bias and
small study effects. Conclusions Despite substantial interest and research
over the past 40 years to predict 30-day mortality risk among patients
undergoing non-cardiac surgery, the current body of evidence is
insufficient to derive a definitive conclusion as to whether stress
testing leads to reduced perioperative mortality.<br/>Copyright &#xa9;
2019 Kalesan et al. This is an open access article distributed under the
terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<78>
Accession Number
632344607
Title
Comparison of complete blood counts of stable COPD patients at two
different altitude in Turkey.
Source
Turkish Thoracic Journal. Conference: 22nd Turkish Thoracic Society Annual
Congress. Turkey. 20 (Supplement 1) (pp S225), 2019. Date of Publication:
April 2019.
Author
Perincek G.; Avci S.; Yilmam I.
Institution
(Perincek) Clinic of Pulmonology, Kars Harakani State Hospital, Kars,
Turkey
(Avci) Department of Emergency Medicine, Amasya University Sabuncuoglu
Serefeddin Research and Training Hospital, Amasya, Turkey
(Yilmam) Clinicof Pulmonology, Samsun Chest Diseases and Thoracic Surgery
Hospital, Samsun, Turkey
Publisher
S. Karger AG
Abstract
Objectives: The aim of this study was to evaluate how altitude difference
affects complete blood count (CBC) in patients with stable Chronic
Obstructive Pulmonary Disease (COPD). <br/>Method(s): Study Design:
Cross-sectional study. Place and Duration of Study: Department of
Pulmonology, Kars Harakani State Hospital (Group 1) and Samsun Chest
Diseases and Thoracic Surgery Hospital (Group 2), Turkey, from March to
September 2018. A total of 400 patients (200 female, 200 male) with stable
COPD were included. For each group, 100 female and 100 male patients were
randomly selected from hospitals. Age, BMI (kg/m2), comorbidity, smoking
status, CBC were evaluated. Hemoglobin, hematocrit, WBC, MPV, platelet,
lymphocyte count and percentage, platelet/lymphocyte rate (PLR),
neutrophil count and percentage, neutrophil/lymphocyte rate (NLR),
eosinophil count and percentage, PDW, PCT were recorded. <br/>Result(s):
Patients living at high altitude were significantly older, had lower
weight and had lower FEV1 levels. COPD stages of Group 1 patients were
more severe (p<0.001). There were no moderate COPD patients in this group
and the patients had fewer comorbidities (43%). Hemoglobin, hematocrit,
MPV, WBC, neutrophil count and percentage, NLR and PLR were significantly
higher in Group 1 (p<0.001). PDW, PCT, lymphocyte count and percentage,
eosinophil count and percentage were significantly higher in Group 2
patients (p<0.001). <br/>Conclusion(s): Hemoglobin, hematocrit, MPV, WBC,
neutrophil count and percentage, NLR and PLR were higher in patients
living at high altitude. PDW, PCT, lymphocyte count and percentage,
eosinophil count and percentage were significantly higher in patients
living at low altitude.

<79>
Accession Number
632344214
Title
Safety assessment of omeprazole use: A systematic review.
Source
Pharmacy Practice. Conference: 1st International Conference FIP Pharmacy
Practice Research: Postgraduate Students, Postdoctoral Fellows and
Supervisors Symposium. Portugal. 16 (Supplement 1) (no pagination), 2018.
Date of Publication: 2018.
Author
Forgerini M.; Mieli S.; Mastroianni P.C.
Publisher
Grupo de Investigacion en Atencion Farmaceutica
Abstract
Background Proton pump inhibitors (PPIs), such as omeprazole, are one of
the most widely prescribed classes at worldwide. However, there are
studies reporting the risks of hospital admission for adverse drug
reactions and drug interactions related to the use of omeprazole. In
addition, the safety of a drug can be modified over time due to increased
use and patient characteristics, and risk assessment is required. Purpose
Therefore, the guiding question sought what are adverse events and how
effective omeprazole treatment is, Methods Propose to evaluate the safety
of the use of omeprazole and a Systematic review of studies was conducted.
PubMed, SCOPUS, LILACS, SciELO, EMBASE and EBSCO databases were searched
through September/2016. Clinical, cohort, and case-control trials,
cross-sectional and quasi-experimental studies, which reported outcomes
ineffectiveness and/or safety about omeprazole use, were screened. The
risk of bias of the different outcomes were assessed. 62 articles were
included. Results 50 studies reported adverse drug events [39 adverse drug
reaction, five drug interactions, six ineffectiveness]. 14 adverse drug
reaction are not described in the literature: spontaneous abortion(1);
proliferative changes(1); chills(1); myocardial infarction(6); heart
failure leading(1); stroke(2), thrombosis(2); eczematous eruption(1);
among others. Severe adverse reaction occurred in patients who underwent
heart-related surgeries or drug interventions, or in the concomitant use
of such medications, with inhibition of the antiplatelet effects of drugs
such as clopidogrel, increasing the risk of developing cardiac problems
and decreased absorption of mycophenolate mofetil, leading to rejection of
transplanted organs. All indications for the use of omeprazole were
approved, therefore, there was no evidence of safety of omeprazole use in
polymedicated patients. Conclusions The use of omeprazole should be
monitored primarily in patients with heart disorders using antiplatelet
agents concomitantly and in newly transplanted patients using mycophenolic
acid, in order to avoid serious adverse reactions.

<80>
Accession Number
2007078614
Title
A prospective controlled randomized multicenter study to evaluate the
severity of compensatory sweating after one-stage bilateral thoracic
sympathectomy versus unilateral thoracic sympathectomy in the dominant
side.
Source
Contemporary Clinical Trials Communications. 19 (no pagination), 2020.
Article Number: 100618. Date of Publication: September 2020.
Author
Hamilton N.N.; Tedde M.L.; Wolosker N.; Aguiar W.W.S.; Ferreira H.P.D.C.;
Oliveira H.A.D.; Lima A.M.R.; Westphal F.L.; Oliveira M.V.B.D.; Riuto
F.D.O.; Pereira S.T.L.F.; Rezende G.C.; Valero C.E.B.; Pego-Fernandes P.M.
Institution
(Hamilton, Tedde, Pego-Fernandes) Heart Institute (InCor) Hospital das
Clinicas, University of Sao Paulo, R. Dr. Eneas de Carvalho Aguiar, 44,
Sao Paulo, SP 05403-900, Brazil
(Wolosker) Hospital das Clinicas, University of Sao Paulo, R. Dr. Eneas de
Carvalho Aguiar, 255, Sao Paulo, SP 05403-000, Brazil
(Hamilton, Tedde) Hospital Alemao Oswaldo Cruz, Rua Treze de Maio, 1815,
Sao Paulo, SP 01327-001, Brazil
(Aguiar) Hospital Universitario Oswaldo Cruz, R. Arnobio Marques, 310,
Recife, PE 50100-130, Brazil
(Ferreira) Hospital Liga Norte Riograndense Contra o Cancer, Av. Miguel
Castro, 1355, Natal, RN 59075-740, Brazil
(Oliveira) Hospital de Base, SMHS, Area Especial, Q. 101, Brasilia, DF
70330-150, Brazil
(Lima) Hospital Geral Dr. Cesar Cals, Av. Imperador, 545, Fortaleza, CE
60015-152, Brazil
(Westphal) Hospital da Universidade Federal do Amazonas, Av. Gen. Rodrigo
Octavio, 6200, Manaus, AM 69080-900, Brazil
(Oliveira) Hospital das Clinicas da Universidade Federal de Minas Gerais,
Av. Prof. Alfredo Balena, 110, Belo Horizonte, MG 30130-100, Brazil
(Riuto) Hospital da Universidade Federal da Grande Dourados, R. Ivo Alves
da Rocha, 558, Dourados, MS 79823-501, Brazil
(Pereira) Hospital Santa Isabel, Praca Conselheiro Almeida Couto, 500,
Salvador, BA 40050-410, Brazil
(Rezende) Hospital Universitario de Brasilia, Setor de Grandes Areas
Norte, 605, Brasilia, DF 70840-040, Brazil
(Valero) Empresa Brasileira de Servicos Hospitalares, SCS, Quadra 9, Ed
Parque Cidade Corporate, Brasilia, DF 70308-200, Brazil
Publisher
Elsevier Inc
Abstract
Objective: To evaluate the contribution that unilateral thoracic
sympathectomy in dominant side or two-stage bilateral thoracic
sympathectomy can have as strategies to reduce the incidence of
compensatory sweating after sympathectomy for palmar hyperhidrosis.
<br/>Method(s): This is a prospective, controlled, randomized multicenter
trial of 200 participants with palmar hyperhidrosis, which will be
randomized into two arms: (a) one-stage bilateral thoracic sympathectomy
(control arm); or (b) unilateral thoracic sympathectomy in dominant side
(intervention arm). At six months the participants submitted to unilateral
procedure can make the contralateral surgery if they wanted it, creating a
third group called two-stage bilateral sympathectomy. Participants will be
evaluated for the degree of sweating by the Hyperhidrosis Disease Severity
Scale (HDSS) and of quality of life questionnaires. <br/>Result(s): 96
participants out of the 200 proposed have been included so far, with 48
participants randomized to each arm. From the sample 61 (63.5%) are
female, with a mean age of 24 (20-32) years. There were exclusive palmar
hiperhydrosis in 14 cases (14.5%), palmar and plantar hyperhidrosis in 36
(37.5%) cases, palmar and axillar hyperhidrosis in 12 (12,5%) cases and
palmar-axillary-plantar hyperhidrosis in 34 (35,4%) cases. The age at the
beginning of the disease was childhood (78%), with mean of time of disease
15 (11-22) years. <br/>Conclusion(s): If one or both hypothesis: (a)
unilateral sympathectomy in dominant hand is a satisfactory treatment; b)
two-stage bilateral sympathectomy causes less compensatory sweating than
in one stage are confirmed there is a chance that surgical therapy for
palmar hyperhidrosis can be changed for better.<br/>Copyright &#xa9; 2020

<81>
Accession Number
2007070235
Title
Effects of erector spinae plane block on postoperative pain and
side-effects in adult patients underwent surgery: A systematic review and
meta-analysis of randomized controlled trials.
Source
International Journal of Surgery. 80 (pp 107-116), 2020. Date of
Publication: August 2020.
Author
Cai Q.; Liu G.-Q.; Huang L.-S.; Yang Z.-X.; Gao M.-L.; Jing R.; Liu Z.;
Pan L.-H.
Institution
(Cai, Jing, Liu, Pan) Department of Anesthesiology, Guangxi Medical
University Cancer Hospital, Nanning, Guangxi 530021, China
(Liu, Yang) School of Basic Medicine at Guangxi Medical University,
Nanning, Guangxi 530021, China
(Huang) Department of Hepatobiliary Surgery, Taihe Hospital, Hubei
University of Medicine, Shiyan, Hubei 442000, China
(Gao) Department of Anesthesiology, Taihe Hospital, Hubei University of
Medicine, Shiyan, Hubei 442000, China
Publisher
Elsevier Ltd
Abstract
Background: Recently, the effects of erector spinae plane block on
postoperative pain have become increasingly controversial. This
meta-analysis compared the effects of ESP block versus placebo on
postoperative analgesia and side effects to determine whether the new
technique is a reliable alternative for pain management. <br/>Method(s):
PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure
(CNKI), and Wanfang Database were searched for clinical studies
investigating the analgesic effect of ESP block versus placebo. The
primary outcomes included the visual analogue scale (VAS) at rest and
during movement, as well as the postoperative morphine consumption in 24
h, and the secondary outcome was the rate of postoperative nausea and
vomiting (PONV). The choice of using the fixed or random-effects model
depended on whether the heterogeneity tested by I² statistic
was more than 50%. Seeking sources of heterogeneity and exploring the
effect of clinical details on the final result were performed by subgroup
analysis. Additionally, the test for stability of the pooled result was
realized by sensitivity analysis. Finally, we evaluated the quality of the
evidence for the outcomes. STATA 13.0 software was selected as the main
analysis software in the meta-analysis. <br/>Result(s): Eighteen
randomized controlled trials (RCTs) comprising 1041 patients were
reviewed. This meta-analysis showed that ESP block could significantly
reduce patients' pain scores at 1 h, 6 h, 12 h, and 24 h after surgery at
rest or during movement; 24-h postoperative morphine consumption; and the
incidence of PONV. <br/>Conclusion(s): ESP block as a novel technique
exhibited superior postoperative analgesic effects, reducing the
postoperative complications in spinal, thoracic, and abdominal surgeries
during the early postoperative period. However, as a new nerve block
technique, numerous large-sized RCTs are needed for further
research.<br/>Copyright &#xa9; 2020 IJS Publishing Group Ltd

<82>
[Use Link to view the full text]
Accession Number
2007032207
Title
A meta-analysis of >=5-year mortality after transcatheter versus surgical
aortic valve replacement.
Source
Journal of Cardiovascular Surgery. 61 (1) (pp 107-116), 2020. Date of
Publication: February 2020.
Author
Takagi H.; Hari Y.; Nakashima K.; Kuno T.; Ando T.
Institution
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Kuno) Department of Medicine, Mount Sinai Beth Israel Medical Center, New
York, NY, United States
(Ando) Department of Cardiology, Detroit Medical Center, Detroit, MI,
United States
Publisher
Edizioni Minerva Medica (E-mail: subscriptions.dept@minervamedica.it)
Abstract
INTRODUCTION: It remains unclear whether long-term survival is superior
following transcatheter aortic valve implantation (TAVI) than following
surgical aortic valve replacement (SAVR). We performed a meta-analysis of
mortality with >=5-year follow-up in randomized controlled trials (RCTs)
and propensity-score matched (PSM) studies of TAVI versus SAVR. EVIDENCE
ACQUISITION: MEDLINE, EMBASE, and the Cochrane Central Register of
Controlled Trials were searched through March 2019. Eligible studies were
RCTs or PSM studies of TAVI versus SAVR enrolling patients with severe
aortic stenosis and reporting all-cause mortality with >=5-year follow-up
as an outcome. A hazard ratio of mortality for TAVI versus SAVR was
extracted from each individual study. EVIDENCE SYNTHESIS: Our search
identified 3 RCTs and 7 PSM studies enrolling 5498 patients. A pooled
analysis of all 10 studies demonstrated a statistically significant 38%
increase in mortality with TAVI relative to SAVR. A subgroup meta-analysis
showed no statistically significant difference between TAVI and AVR in
RCTs and a statistically significant 68% increase with TAVI relative to
SAVR in PSM studies. <br/>CONCLUSION(S): On the basis of a meta-analysis
of 7 PSM studies, TAVI is associated with greater all-cause mortality with
>=5-year follow-up than SAVR. However, another meta-analysis of 3 RCTs
suggests no difference in mortality between TAVI and SAVR.<br/>Copyright
&#xa9; 2019 EDIZIONI MINERVA MEDICA

<83>
[Use Link to view the full text]
Accession Number
2007032206
Title
Meta-analysis of impact of troponins on mortality after transcatheter
aortic valve implantation.
Source
Journal of Cardiovascular Surgery. 61 (1) (pp 98-106), 2020. Date of
Publication: February 2020.
Author
Takagi H.; Hari Y.; Nakashima K.; Kuno T.; Ando T.
Institution
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Kuno) Department of Medicine, Mount Sinai Beth Israel Medical Center, New
York, NY, United States
(Ando) Department of Cardiology, Detroit Medical Center, Detroit, MI,
United States
Publisher
Edizioni Minerva Medica (E-mail: subscriptions.dept@minervamedica.it)
Abstract
INTRODUCTION: To determine whether troponin (Tn) can predict mortality
after transcatheter aortic valve implantation (TAVI), we performed a
meta-analysis of currently available studies investigating impact of
baseline and postprocedural Tn. EVIDENCE ACQUISITION: MEDLINE and EMBASE
were searched through April 2019 using PubMed and OVID. Studies considered
for inclusion met the following criteria: the study investigating impact
of baseline and postprocedural Tn on mortality; the study population was
patients undergoing TAVI for aortic stenosis (AS); outcomes included early
(30-day or in-hospital)/late (including early) mortality. For each study,
data regarding early/late mortality in both high and low (defined in each
study) level of baseline/postprocedural Tn groups were used to generate
odds ratios (ORs) and 95% confidence intervals (CIs), or reported ORs and
hazard ratios (HRs) with 95% CIs were directly extracted. Study-specific
estimates were combined using inverse variance-weighted averages of
logarithmic ORs/HRs in the random-effects model. EVIDENCE SYNTHESIS: We
identified 19 eligible studies including a total of 7555 patients
undergoing TAVI. Pooled analyses demonstrated associations of high levels
of baseline Tn with statistically significant increases in both 30-day
(P=0.002) and midterm mortality (P<0.00001), no correlation of high
postprocedural Tn with 30-day mortality (P=0.13), and an association of
high postprocedural Tn with a statistically significant increase in
midterm mortality (P=0.002). High levels of baseline/postprocedural TnT
predicted statistically significant increases in both 30-day
(P=0.002/<0.0001) and midterm mortality (P<0.00001/0.0003).
<br/>CONCLUSION(S): Both baseline and postprocedural Tn, especially TnT,
may predict mortality after TAVI for AS.<br/>Copyright &#xa9; 2019
EDIZIONI MINERVA MEDICA

<84>
Accession Number
2004717212
Title
Long-term outcomes of patients with unprotected left main coronary artery
disease treated with percutaneous angioplasty versus bypass grafting: A
meta-analysis of randomized controlled trials.
Source
Journal of Clinical Medicine. 9 (7) (pp 1-10), 2020. Article Number: 2231.
Date of Publication: July 2020.
Author
Bajraktari G.; Zhubi-bakija F.; Ndrepepa G.; Alfonso F.; Elezi S.; Rexhaj
Z.; Bytyci I.; Bajraktari A.; Poniku A.; Henein M.Y.
Institution
(Bajraktari, Bytyci, Bajraktari, Henein) Department of Public Health and
Clinical Medicine, Umea University, Umea 90737, Sweden
(Bajraktari, Zhubi-bakija, Rexhaj, Bytyci, Poniku) Clinic of Cardiology,
University Clinical Centre of Kosova, Pristina 10000, Serbia
(Bajraktari, Elezi, Poniku) Medical Faculty, University of Prishtina
"Hasan Prishtina", Pristina 10000, Serbia
(Ndrepepa) Deutsches Herzzentrum Munchen, Technische Universitat, Munich
80636, Germany
(Alfonso) Cardiac Department, La Princesa University Hospital, Institute
of Health Research, IIS-IP, CIBER-CV University Autonoma of Madrid, Madrid
28029, Spain
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: rasetti@mdpi.com)
Abstract
Background and Aim: Treatment of patients with left main coronary artery
disease (LMCA) with percutaneous coronary intervention (PCI) or coronary
artery bypass grafting (CABG) remains controversial. The aim of this
meta-analysis was to compare the long-term clinical outcomes of patients
with unprotected LMCA treated randomly by PCI or CABG. <br/>Method(s):
PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL and
ClinicalTrials.gov database searches identified five randomized trials
(RCTs) including 4499 patients with unprotected LMCA comparing PCI (n =
2249) vs. CABG (n = 2250), with a minimum clinical follow-up of five
years. Random effect risk ratios were used for efficacy and safety
outcomes. The study was registered in PROSPERO. The primary outcome was
major adverse cardiac events (MACE), defined as a composite of death from
any cause, myocardial infarction or stroke. <br/>Result(s): Compared to
CABG, patients assigned to PCI had a similar rate of MACE (risk ratio
(RR): 1.13; 95% CI: 0.94 to 1.36; p = 0.19), myocardial infarction (RR:
1.48; 95% CI: 0.97 to 2.25; p = 0.07) and stroke (RR: 0.87; 95% CI: 0.62
to 1.23; p = 0.42). Additionally, all-cause mortality (RR: 1.07; 95% CI:
0.89 to 1.28; p = 0.48) and cardiovascular (CV) mortality (RR: 1.13; 95%
CI: 0.89 to 1.43; p = 0.31) were not different. However, the risk of any
repeat revascularization (RR: 1.70; 95% CI: 1.34 to 2.15; p < 0.00001) was
higher in patients assigned to PCI. <br/>Conclusion(s): The findings of
this meta-analysis suggest that the long-term survival and MACE of
patients who underwent PCI for unprotected LMCA stenosis were comparable
to those receiving CABG, despite a higher rate of repeat
revascularization.<br/>Copyright &#xa9; 2020 by the authors. Licensee
MDPI, Basel, Switzerland.

<85>
Accession Number
2005562546
Title
How valvular calcification can affect the outcomes of transcatheter aortic
valve implantation.
Source
Expert Review of Medical Devices. (pp 1-12), 2020. Date of Publication:
2020.
Author
Milhorini Pio S.; Bax J.; Delgado V.
Institution
(Milhorini Pio, Bax, Delgado) Department of Cardiology, Leiden University
Medical Center, Leiden, Netherlands
Publisher
Taylor and Francis Ltd
Abstract
Introduction: In transcatheter aortic valve implantation (TAVI),
assessment of aortic valve calcification is not as standardized as aortic
annulus measurement. Aortic valve calcification is important for stable
anchoring of the prosthesis to the aortic annulus. However, excessive
aortic valve calcification is related to procedural complications. Areas
covered: This review covers the methods to assess aortic valve
calcification and the implications of aortic valve calcium burden for TAVI
outcomes. We performed a systematic review of the literature in Pubmed and
secondary sources. Furthermore, future perspectives on how to integrate
aortic valve calcification assessment in the management of patients with
aortic stenosis is discussed. Expert opinion: Thorough assessment of the
aortic valve and aortic root components including aortic valve
calcification is key in the planning of TAVI. Aortic valve calcification
load, location and extension are important contributors to paravalvular
regurgitation. Asymmetric calcification burden with greater calcification
of the left-coronary cusp related to higher need of permanent pacemaker
implantation. Patients with moderate and severe left ventricular outflow
tract/subannular calcification are more susceptible to aortic annular
rupture. Periprocedural dislodgement of calcium form cusps and commissures
is one of the main reasons of coronary artery ostial occlusion during
transcatheter aortic valve implantation. Abbreviations: Ao, aorta; LA,
left atrium; LAA, left atrial appendage; LV, left ventricle; LVOT, left
ventricular outflow tract; THV, transcatheter heart valve.<br/>Copyright
&#xa9; 2020, &#xa9; 2020 The Author(s). Published by Informa UK Limited,
trading as Taylor & Francis Group.

<86>
Accession Number
2005257951
Title
Disorders of the Aorta and Aortic Valve in Connective Tissue Diseases.
Source
Current Cardiology Reports. 22 (8) (no pagination), 2020. Article Number:
70. Date of Publication: 01 Aug 2020.
Author
Grygiel-Gorniak B.; Oduah M.-T.; Olagunju A.; Klokner M.
Institution
(Grygiel-Gorniak, Oduah, Olagunju, Klokner) Department of Rheumatology and
Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
Publisher
Springer
Abstract
Purpose of Review: The incidence of aortic valve disease in inherited
connective tissue disorders is well documented; however, recent studies
have only begun to unravel the pathology behind this association. In this
review, we aim to describe the etiology, clinical manifestations,
management, and prognosis of aortic and aortic valvular disorders that
co-exist in a variety of connective tissue diseases. An extensive
literature review was performed in PubMed. Articles from 2008 to 2018 were
included for review. Predetermined search terms used in PubMed include
"aortic manifestation of connective tissue diseases" and "aortic valve
disorders in rheumatologic disease." Recent Findings: Manifestations of
aortic valve disease in the context of connective tissue disorders include
valvular stenosis, regurgitation, and/or thoracic aortic aneurysms. Both
inherited and inflammatory connective tissue disorders contribute to
aortic valve damage with increased susceptibility associated with specific
gene variants. <br/>Summary: Anti-inflammatory and immunosuppressive
therapies have demonstrated beneficial results in Marfan's syndrome,
Behcet disease, rheumatoid arthritis, ankylosing spondylitis, and systemic
sclerosis, often leading to remission. Yet, such therapy is less effective
in other disorders compared to alternative treatments such as surgical
intervention. Additionally, regular echocardiographic studies should be
recommended to those suffering from these disorders, especially those at
higher risk for cardiovascular involvement. Given the rates of relapse
with immunosuppressants, even following aortic valve replacement, further
studies are needed to determine if certain dosing and/or combinations of
immunosuppressants could be given to those diagnosed with connective
tissue diseases to prevent progression of aortic valve
involvement.<br/>Copyright &#xa9; 2020, The Author(s).

<87>
Accession Number
2007088346
Title
Anesthetic management of neonates undergoing diagnostic and therapeutic
cardiac catheterization: a systematic literature review.
Source
Brazilian Journal of Anesthesiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Valencia-Arango L.M.; Fajardo-Escolar A.P.; Segura-Salguero J.C.;
Saenz-Quispe S.; Rincon-Restrepo C.; Posada A.; Ronderos V.; Perea-Bello
A.H.
Institution
(Valencia-Arango, Fajardo-Escolar, Segura-Salguero, Saenz-Quispe,
Rincon-Restrepo, Perea-Bello) Hospital Universitario San Ignacio.
Universidad Javeriana, Facultad de Medicina, Bogota, Colombia
(Posada, Ronderos) Universidad Javeriana. Facultad de Medicina, Bogota,
Colombia
Publisher
Elsevier Editora Ltda
Abstract
Background: Several interventional cardiology procedures are required in
neonates with congenital heart disease. Interventional cardiology
procedures have a higher risk of cardiac arrest compared to other
interventions. At present, there is great heterogeneity in the
perioperative management of congenital heart disease neonates undergoing
diagnostic cardiac catheterization or therapeutic cardiac catheterization.
Study objectives: Primary aim: Provide a systematic review of the most
effective and/or safe anesthetic and perioperative management in neonates
with congenital heart disease who undergo diagnostic cardiac
catheterization or therapeutic cardiac catheterization. Secondary aim:
Identify the medications, monitoring parameters and airway management used
in the same population. <br/>Design(s): Systematic literature review.
<br/>Setting(s): Catheterization laboratory. <br/>Method(s): Literature
was searched (December 2017) in electronic databases Medline, EMBASE,
ScienceDirect, BIREME-Lilacs-Biblioteca Virtual de la Salud, Cochrane
Database of Systematic Reviews, Database of Abstracts of Reviews of
Effects and Health Technology Assessment Database. <br/>Main Result(s):
From 130 records identified, four studies met inclusion criteria and
quality assessment. None of the studies were relevant to the primary
objective. Regarding the secondary objectives, one study compared the
efficacy and adverse effects of racemic ketamine and its S(+) ketamine
enantiomer, one study reported the efficacy of subarachnoid anesthesia for
high-risk children undergoing diagnostic cardiac catheterization, one
study identified the factors associated to high severity adverse events
related to sedation, anesthesia and airway, and one study retrospectively
analyzed cardiac catheterization procedures in neonates weighing less than
2.5 kg. <br/>Conclusion(s): There are no evidence-based recommendations
available for congenital heart disease neonates undergoing cardiac
catheterization. More studies are required to evaluate the ideal
anesthetic and perioperative management in this population.<br/>Copyright
&#xa9; 2020

<88>
Accession Number
2006954716
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 (United States). (no pagination), 2020. Date of Publication: 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, Newcastle upon Tyne, Tyne and Wear, United
Kingdom
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)

<89>
Accession Number
2006942265
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 (United States). (no pagination), 2020. Date of Publication: 2020.
Author
Dunlop D.; Kyriacou E.; Jones J.R.A.; Boden I.; Berlowitz D.J.
Institution
(Dunlop, Kyriacou, Jones, Berlowitz) Physiotherapy Department, Austin
Health, Heidelberg, Vic, Australia
(Jones, Boden, Berlowitz) Department of Physiotherapy, The University of
Melbourne, Parkville, Vic, Australia
(Jones, Berlowitz) Institute for Breathing and Sleep, Heidelberg, Vic,
Australia
(Boden) Physiotherapy Department, Launceston General Hospital, Tas,
Australia
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)

<90>
Accession Number
632340241
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. Article Number: thoraxjnl-2019-214019. Date
of Publication: 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, Normandie, Rouen, France
(Gravier, Bonnevie) ADIR Association, Bois Guillaume, 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 and Respiratory Intensive Care Department, CHU Rouen,
Normandie, Rouen, France
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
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.

<91>
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.

<92>
Accession Number
632229675
Title
Psychological interventions for depression and anxiety in patients with
coronary heart disease, heart failure or atrial fibrillation.
Source
Cochrane Database of Systematic Reviews. 2020 (7) (no pagination), 2020.
Article Number: CD013508. Date of Publication: 06 Jul 2020.
Author
Ski C.F.; Taylor R.S.; McGuigan K.; Lambert J.D.; Richards S.H.; Thompson
D.R.
Institution
(Ski, McGuigan, Thompson) School of Nursing and Midwifery, Queen's
University Belfast, Belfast, United Kingdom
(Taylor) MRC/CSO Social and Public Health Sciences Unit & Robertson Centre
for Biostatistics, Institute of Health and Well Being, University of
Glasgow, Glasgow, United Kingdom
(Lambert) College of Medicine and Health, University of Exeter, Exeter,
United Kingdom
(Richards) Leeds Institute of Health Sciences, University of Leeds, Leeds,
United Kingdom
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. To assess the efficacy and costs of
psychological interventions (alone, or with CR or pharmacotherapy, or
both) in adults who have a diagnosis of CHD, HF or AF compared to no
intervention, or treatment as usual, on psychological and clinical
outcomes.<br/>Copyright &#xa9; 2020 The Cochrane Collaboration. Published
by John Wiley & Sons, Ltd.

<93>
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 (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).

<94>
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).

<95>
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.

<96>
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

<97>
[Use Link to view the full text]
Accession Number
630982471
Title
Electrical Stimulation of the Greater Auricular Nerve to Reduce
Postoperative Atrial Fibrillation.
Source
Circulation: Arrhythmia and Electrophysiology. 12 (10) (no pagination),
2019. Article Number: e007711. Date of Publication: 01 Oct 2019.
Author
Andreas M.; Arzl P.; Mitterbauer A.; Ballarini N.M.; Kainz F.-M.; Kocher
A.; Laufer G.; Wolzt M.
Institution
(Andreas, Arzl, Mitterbauer, Kainz, Kocher, Laufer) Department of Cardiac
Surgery, Medical University of Vienna, Austria
(Ballarini) Center for Medical Statistics, Informatics, and Intelligence
Systems (CeMSIIS), Medical University of Vienna, Austria
(Wolzt) Section for Medical Statistics, Department of Clinical
Pharmacology, Medical University of Vienna, Austria
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: Postoperative atrial fibrillation (POAF) occurs in up to 40%
of patients undergoing cardiac surgery. Invasive stimulation of the vagal
nerve previously demonstrated a reduced risk of POAF. Therefore, we
examined the antiarrhythmic and anti-inflammatory effects of noninvasive
low-level transcutaneous electrical stimulation (LLTS) of the greater
auricular nerve in a pilot trial including patients undergoing cardiac
surgery. <br/>Method(s): Patients were randomized into a sham (n=20) or a
treatment group (n=20) for LLTS. After cardiac surgery, electrodes were
applied in the triangular fossa of the ear. Stimulation (amplitude 1 mA,
frequency 1 Hz for 40 minutes, followed by a 20 minutes break) was
performed for up to 2 weeks after cardiac surgery. Heart rhythm was
recorded continuously using an ECG during the observation period. CRP
(C-reactive protein) and IL (interleukin)-6 plasma concentrations were
measured immediately after surgery as well as on day 2 and 7 postsurgery.
<br/>Result(s): Patients receiving LLTS had a significantly reduced
occurrence of POAF (4 of 20) when compared with controls (11 of 20,
P=0.022) during a similar mean Holter recording period. The median
duration of POAF was comparable between the treatment and the control
group (878 [249; 1660] minutes versus 489 [148; 1775] minutes; P=0.661).
No effect of LLTS on CRP or IL-6 levels was detectable.
<br/>Conclusion(s): LLTS of the greater auricular nerve may be a potential
therapy for POAF. We demonstrated the feasibility to conduct a randomized
trial of neurostimulation as an outlay for a multisite clinical
trial.<br/>Copyright &#xa9; 2019 Lippincott Williams and Wilkins. All
rights reserved.

<98>
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)

<99>
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

<100>
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.

<101>
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.

<102>
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.

<103>
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

<104>
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

<105>
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

<106>
Accession Number
2004716370
Title
The effect of vitamin C supplementation on cardiac enzymes after coronary
artery bypass graft: A double-blind randomized control trial.
Source
Current Nutrition and Food Science. 16 (5) (pp 833-838), 2020. Date of
Publication: 2020.
Author
Moludi J.; Alizadeh M.; Jafari-Vayghyan H.; Foroumandi E.; Maleki V.;
Ebrahimi B.; Sadeghpour A.; Alizadehasl A.; Tabaee A.S.
Institution
(Moludi, Foroumandi, Maleki) Student Research Committee, Faculty of
Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
(Moludi, Alizadeh) Nutrition Research Center, Faculty of Nutrition, Tabriz
University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Jafari-Vayghyan) School of Health, Arak University of Medical Sciences,
Arak, Iran, Islamic Republic of
(Ebrahimi) Department of Food Science and Technology, Maragheh University
of Medical Science, Maragheh, Iran, Islamic Republic of
(Sadeghpour, Alizadehasl) Echocardiography Research Center, Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Tabaee) Rajaie Cardiovascular Medi cal and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Bentham Science Publishers (P.O. Box 294, Bussum 1400 AG, Netherlands)
Abstract
Background: Coronary artery bypass graft (CABG) is associated with
oxidative stress and tissue damage. Vitamin C, as an antioxidant agent,
has an important role in attenuating the oxidative stress damage and might
have cardio-protective effects after CABG. We aimed to evaluate the
probable roles of vitamin C supplementation in cardiac biomarkers after
CABG. <br/>Method(s): In this randomized control trial, 122 patients
undergoing CABG were randomly assigned to the intervention (n=54) and
control group (n=68) and received vitamin C (2 g intravenously) or
placebo, respectively. The surgical methods of the patients in the two
groups were identical. The primary efficacy endpoint of this trial is the
difference in the levels of CK-MB, Troponin and Total Antioxidant Capacity
(TAC) were measured at study entry and 24 hrs after surgery between the
two groups. <br/>Result(s): The two groups were not significantly
different in terms of basic variables. Within-group comparison showed
significant rises in the level of troponin (P < 0.001) and CK-MB (P <
0.001) over time. However, between-group comparison showed no significant
difference between the two groups in terms of CK-MB (P=0.826) and troponin
(P=0.821). As a whole, the correlation between cardiac enzymes and
surgical characteristic was not seen. <br/>Conclusion(s): The results
showed that pretreatment with vitamin C could not reduce cardiac marker
following CABG. After the intervention, TAC did not differ between and
within the intervention and the control groups. Pretreatment with vitamin
C as an antioxidant agent could not reduce ischemicreperfusion resulting
in CABG.<br/>Copyright &#xa9; 2020 Bentham Science Publishers.

<107>
Accession Number
2005530569
Title
Heart transplantation in patients with previous malignancy. An overview.
Source
Acta Cardiologica. 70 (2) (pp 123-130), 2015. Date of Publication: 01 Apr
2015.
Author
Peter Mistiaen W.
Institution
(Peter Mistiaen) Faculty of Medicine and Health Sciences, University of
Antwerp, Antwerp, Belgium, Dept. of Healthcare Sciences, Artesis-Plantijn
University College of Antwerp, and, Antwerp, Belgium
Publisher
Taylor and Francis Ltd. (E-mail: michael.wagreich@univie.ac.at)
Abstract
Introduction A history of malignancy has been considered as a
contraindication for heart transplantation. The number of patients with
prior malignancy needing transplantation is increasing due to improved
survival and to cardiotoxic cancer treatment. However, this reluctance for
transplantation can be challenged by the already available results.
Methods A systematic literature search was performed in electronic
databases. After exclusion of cardiac sarcomas, three case reports,
thirteen series of which three are paediatric, two database searches and
one article with specifi c design have been found. The larger series are
of more recent origin. The study design of the manuscripts diff ered to
some degree. Results The preoperative profi le and the postoperative
results are reviewed. The preoperative profi le includes demographics,
interval between treatment of malignancy and transplantation, indication
of transplantation and diff erences between patients with and without
prior malignancy. An important observation is the increase of
transplantation in patients with chemotherapy-related cardiomyopathy over
time. The postoperative results show that hospital mortality and long-term
survival do not diff er signifi cantly between patients with and without
pre-transplant malignancy. This seems also to be true for post-transplant
recurrence. The disease-free pre-transplant interval has a major eff ect
on both outcomes. Patients with haematologic malignancies and after
splenectomy have a worse prognosis. Use of LVAD (left ventricular assist
device) as bridge-to-transplant and rapamycin as immune suppression, holds
some promises. Conclusions This review has some limitations since the
published series are not comparable. It seems that transplantation in
patients with prior malignancy can be justifi ed in some cases, especially
when the interval between malignancy and transplantation exceeds fi ve
years.<br/>Copyright &#xa9; 2015, &#xa9; 2015 Taylor and Francis Group
LLC.

<108>
Accession Number
632332614
Title
Clinical outcomes of leadless pacemaker: a systematic review.
Source
Minerva cardioangiologica. (no pagination), 2020. Date of Publication: 10
Jul 2020.
Author
Oliveira S.F.; Carvalho M.M.; Adao L.; Nunes J.P.
Institution
(Oliveira) Faculdade de Medicina da Universidade do Porto, Porto, Portugal
(Carvalho, Nunes) Faculdade de Medicina da Universidade do Porto, Porto,
Portugal
(Carvalho, Adao, Nunes) Centro Hospitalar Universitario Sao Joao, Porto,
Portugal
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Transvenous pacemakers are associated with a significant
amount of complications. Leadless pacemakers (LP) are emerging as an
alternative to conventional devices. This article provides a systematic
review of patient eligibility, safety and clinical outcomes of the LP
devices. EVIDENCE ACQUISITION: A systematic search for articles describing
the use of LP was conducted. Out of two databases, 24 articles were
included in the qualitative analysis. These articles comprised a total of
4739 patients, with follow up times of 1-38 months. Further information
was obtained from 10 more studies. EVIDENCE SYNTHESIS: From a population
of 4739 patients included in the qualitative analysis, 4670 LP were
implanted with success (98.5%). A total of 248 complications were
described (5.23%) during the follow-up. The most common were pacing issues
such as elevated thresholds, dislodgements or battery failure (68
patients), events at the femoral access site such as hemorrhage, hematoma
or pseudoaneurysms (64 patients) and procedure related cardiac injuries
such as cardiac perforation, tamponade or pericardial effusion (47
patients). There were 360 deaths during the follow-up and 11 were
described as procedure or device related. Four studies presented the
strategy of using a combined approach of atrioventricular node ablation
(AVNA) and LP implantation. <br/>CONCLUSION(S): Leadless pacemakers seem
to have a relatively low complication rate. These devices may be a good
option in patients with an indication for single-chamber pacing, in
patients with conditions precluding conventional transvenous pacemaker
implantations. Studies directly comparing LP and transvenous pacemakers
and data on longer follow-up periods are needed.

<109>
Accession Number
632331785
Title
Association of Factor V Leiden with Subsequent Atherothrombotic Events: A
GENIUS-CHD Study of Individual Participant Data.
Source
Circulation. (no pagination), 2020. Date of Publication: 13 Jul 2020.
Author
Mahmoodi B.K.; Tragante V.; Kleber M.E.; Holmes M.V.; Schmidt A.F.;
McCubrey R.O.; Howe L.J.; Direk K.; Allayee H.; Baranova E.V.; Braund
P.S.; Delgado G.E.; Eriksson N.; Gijsberts C.M.; Gong Y.; Hartiala J.;
Heydarpour M.; Pasterkamp G.; Kotti S.; Kuukasjarvi P.; Lenzini P.A.;
Levin D.; Lyytikainen L.-P.; Muehlschlegel J.D.; Nelson C.P.; Nikus K.;
Pilbrow A.P.; Tang W.H.W.; van der Laan S.W.; van Setten J.; Vilmundarson
R.O.; Deanfield J.; Deloukas P.; Dudbridge F.; James S.; Mordi I.R.; Teren
A.; Bergmeijer T.O.; Body S.C.; Bots M.; Burkhardt R.; Cooper-DeHoff R.M.;
Cresci S.; Danchin N.; Doughty R.N.; Grobbee D.E.; Hagstrom E.; Hazen
S.L.; Held C.; Hoefer I.E.; Hovingh G.K.; Johnson J.A.; Kaczor M.P.;
Kahonen M.; Klungel O.H.; Laurikka J.O.; Lehtimaki T.; Maitland-van der
Zee A.H.; McPherson R.; Palmer C.N.; Kraaijeveld A.O.; Pepine C.J.; Sanak
M.; Sattar N.; Scholz M.; Simon T.; Spertus J.A.; Stewart A.F.R.;
Szczeklik W.; Thiery J.; Visseren F.L.J.; Waltenberger J.; Richards A.M.;
Lang C.C.; Cameron V.A.; Akerblom A.; Pare G.; Marz W.; Samani N.J.;
Hingorani A.D.; Ten Berg J.M.; Wallentin L.; Asselbergs F.W.; Patel R.
Institution
(Mahmoodi) St. Antonius Hospital, department of Cardiology, Koekoekslaan
1, 3435CM, Nieuwegein, the Netherlands; Division of Hemostasis and
Thrombosis, Department of Hematology, UMC Groningen, University of
Groningen, Groningen, the Netherlands
(Tragante, van Setten, Kraaijeveld, Asselbergs) Department of Cardiology,
Division Heart and Lungs, UMC Utrecht, Utrecht University, Utrecht,
Netherlands
(Kleber, Delgado) Vth Department of Medicine, Medical Faculty Mannheim,
Heidelberg University, Theodor-KutzerUfer 1-3, Germany
(Holmes) Clinical Trial Service Unit and Epidemiological Studies Unit,
Nuffield Department of Population Health, University of Oxford, Oxford,
UK; Medical Research Council Population Health Research Unit at the
University of Oxford, Oxford, UK; National Institute for Health Research
Oxford Biomedical Research Centre, Oxford University Hospital, Oxford, UK
(Schmidt) Department of Cardiology, Division Heart and Lungs, UMC Utrecht,
Utrecht University, Utrecht, the Netherlands; Institute of Cardiovascular
Science and UCL BHF Research Accelerator, Faculty of Population Health
Science, University College London, London, UK
(McCubrey) Intermountain Heart Institute, UT, Intermountain Medical
Center, Salt Lake City, United States
(Howe, Direk, Deanfield, Hingorani) Institute of Cardiovascular Science
and UCL BHF Research Accelerator, Faculty of Population Health Science,
University College London, London, United Kingdom
(Allayee) Departments of Preventive Medicine and Biochemistry and
Molecular Medicine, Keck School of Medicine of USC, Los Angeles, CA
(Baranova, Klungel) Division of Pharmacoepidemiology and Clinical
Pharmacology, Utrecht University, Utrecht, Netherlands
(Braund, Nelson, Samani) Department of Cardiovascular Sciences, University
of Leicester, BHF Cardiovascular Research Centre, Glenfield Hospital,
Leicester, UK; NIHR Leicester Biomedical Research Centre, Glenfield
Hospital, Groby Road, Leicester, LE3 9QP, UK
(Eriksson) Uppsala Clinical Research Center, Uppsala, Sweden
(Gijsberts) Laboratory of Experimental Cardiology, UMC Utrecht, Utrecht,
Netherlands
(Gong) University of Florida, Department of Pharmacotherapy and
Translational Research and Center for Pharmacogenomics, FL, 1333 Center
Drive, Gainesville, United States
(Hartiala) Departments of Preventive Medicine and Biochemistry and
Molecular Medicine, Keck School of Medicine of USC, Los Angeles, CA;
Institute for Genetic Medicine, Keck School of Medicine of USC, Los
Angeles, CA
(Heydarpour, Muehlschlegel) Department of Anesthesiology, Perioperative
and Pain Medicine, Brigham and Women's Hospital, Boston, MA; Harvard
Medical School, Harvard University, Boston, MA
(Pasterkamp) Department of Clinical Chemistry, UMC Utrecht, Utrecht
University, Utrecht, Netherlands
(Kotti) Department of Clinical Pharmacology, Assistance Publique-Hopitaux
de Paris (APHP)Platform of Clinical Research of East Paris
(URCEST-CRCEST-CRB HUEP-UPMC), Paris, France
(Kuukasjarvi) Department of Cardio-Thoracic Surgery, Finnish
Cardiovascular Research Center - Tampere, Faculty of Medicine and Health
Techonology, Tampere University, Tampere 33014, Finland
(Lenzini) Washington University School of Medicine, Department of
Genetics, Statistical Genomics Division, MO, Saint Louis, Seychelles
(Levin, Mordi, Lang) Division of Molecular and Clinical Medicine, School
of Medicine, University of Dundee, Dundee DD1 9SY, United Kingdom
(Lyytikainen, Lehtimaki) Department of Clinical Chemistry, Fimlab
Laboratories, Arvo Ylpon katu 34, Tampere 33014, Finland; Department of
Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere,
Faculty of Medicine and Health Techonology, Tampere University, Tampere
33014, Finland
(Nikus) Department of Cardiology, Heart Center, Tampere University
Hospital, Ensitie 4, 33520 Tampere, Finland; Department of Cardiology,
Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and
Health Technology, Tampere University, Tampere 33014, Finland
(Pilbrow, Cameron) Christchurch Heart Institute, University of Otago
Christchurch, PO Box 4345, New Zealand
(Tang) Department of Cardiovascular and Metabolic Sciences, Lerner
Research Institue, Cleveland Clinic, Cleveland, OH; Department of
Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic,
Cleveland, OH
(van der Laan) Central Diagnostics Laboratory, Division Laboratories,
Pharmacy, Biomedical Genetics, UMC Utrecht, Utrecht University, Utrecht,
Netherlands
(Vilmundarson, Stewart) Ruddy Canadian Cardiovascular Genetics Centre,
University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Department
of Biochemistry, Microbiology and Immunology, University of Ottawa,
Ontario, Canada
(Deloukas) William Harvey Research Institute, Barts and the London Medical
School, Queen Mary University of London, London, UK; Centre for Genomic
Health, Queen Mary University of London, London, UK
(Dudbridge) Department of Health Sciences, University of Leicester,
Leicester, United Kingdom
(James, Held, Akerblom, Wallentin) Uppsala Clinical Research Center,
Uppsala, Sweden; Department of Medical Sciences, Cardiology, Uppsala
University, Uppsala, Sweden
(Teren) Heart Center Leipzig, Leipzig, Germany; LIFE Research Center for
Civilization Diseases, University of Leipzig, Leipzig, Germany
(Bergmeijer, Ten Berg) St. Antonius Hospital, department of Cardiology,
Koekoekslaan 1, Nieuwegein 3435CM, Netherlands
(Body) Department of Anaesthesiology, Boston University School of
Medicine, 750 Albany St, MA, Boston
(Bots, Grobbee) Julius Center for Health Sciences and Primary Care,
University Medical Center Utrecht and Utrecht University, Utrecht,
Netherlands
(Burkhardt) Institute of Clinical Chemistry and Laboratory Medicine,
University Hospital Regensburg, Regensburg, Germany; LIFE Research Center
for Civilization Diseases, University of Leipzig, Leipzig, Germany
(Cooper-DeHoff, Johnson) University of Florida, Department of
Pharmacotherapy and Translational Research and Center for
Pharmacogenomics, 1333 Center Drive, Gainesville, FL; College of Medicine,
Division of Cardiovascular Medicine, University of Florida, 1600 SW Archer
Road/Box 100277, Gainesville, FL
(Cresci) Washington University School of Medicine, Department of Medicine,
Cardiovascular Division, Saint Louis, MO; Washington University School of
Medicine, Department of Genetics, Statistical Genomics Division, Saint
Louis, MO
(Danchin) Assistance Publique-Hopitaux de Paris (APHP), Department of
Cardiology, Hopital Europeen Georges Pompidou, 75015 Paris, France; FACT
(french Alliance for cardiovascular trials); Universite Paris Descartes,
Paris, France; Universite Paris-Descartes, Paris, France
(Doughty) Heart Health Research Group, University of Auckland, Private Bag
92019, Auckland 1142, New Zealand
(Hagstrom) Uppsala University, Dept of Cardiology, Uppsala, Sweden and
Uppsala Clinical Research Center, Uppsala, Sweden; Department of Medical
Sciences, Cardiology, Uppsala University, Uppsala, Sweden
(Hazen) Department of Cardiovascular and Metabolic Sciences, Lerner
Research Institue, Cleveland Clinic, Cleveland, OH; Department of
Cardiovascular Medicine, Heart and Vascular Institute, and Center for
Microbiome and Human Health, Cleveland Clinic, Cleveland, OH
(Hoefer) Department of Clinical Chemistry and Hematology, UMC Utrecht,
Utrecht University, Utrecht, Netherlands
(Hovingh) Department of Vascular Medicine, Academic Medical Center,
Amsterdam, Netherlands
(Kaczor, Sanak, Szczeklik) Department of Internal Medicine, Jagiellonian
University Medical College, 8 Skawinska Str, 31-066 Krakow, Poland
(Kahonen) Department of Clinical Physiology, Tampere University Hospital,
FM1 3rd floor, Tampere 33521, Finland; Department of Clinical Physiology,
Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and
Health Techonology, Tampere University, Tampere 33014, Finland
(Laurikka) Department of Cardio-Thoracic Surgery, Heart Center, Tampere
University Hospital, Arvo Ylpon katu 6, Tampere 33521, Finland; Department
of Cardio-Thoracic Surgery, Finnish Cardiovascular Research Center -
Tampere, Faculty of Medicine and Health Techonology, Tampere University,
Tampere 33014, Finland
(Maitland-van der Zee) Department of Respiratory Medicine, Academic
Medical Center, University of Amsterdam, Amsterdam, The Netherlands;
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht
University, Utrecht, the Netherlands
(McPherson) Ruddy Canadian Cardiovascular Genetics Centre, University of
Ottawa Heart Institute, Ottawa, Ontario, Canada; Departments of Medicine
and Biochemistry, Microbiology and Immunology, University of Ottawa,
Ontario, Canada
(Palmer) Pat Macpherson Centre for Pharmacogenetics and Pharmacogenomics,
Division of Molecular and Clinical Medicine, Ninewells Hospital and
Medical School, Level 5, Dundee, United Kingdom
(Pepine) College of Medicine, Division of Cardiovascular Medicine,
University of Florida, 1600 SW Archer Road/Box 100277, FL, Gainesville,
United States
(Sattar) Institute of Cardiovascular and Medical Sciences, University of
Glasgow, Glasgow, United Kingdom
(Scholz) Institute for Medical Informatics, Statistics and Epidemiology,
University of Leipzig, Leipzig, Germany; LIFE Research Center for
Civilization Diseases, University of Leipzig, Leipzig, Germany
(Simon) Assistance Publique-Hopitaux de Paris (APHP), Department of
Clinical Pharmacology, Platform of Clinical Research of East Paris
(URCEST-CRCEST-CRB HUEP-UPMC), FACT (French Alliance for Cardiovascular
trials); Sorbonne Universite, Paris-06, France; Paris-Sorbonne University,
UPMC-Site St Antoine, 27 Rue Chaligny, 75012, Paris, France
(Spertus) University of Missouri-Kansas City, Kansas City, MO; Saint
Luke's Mid America Heart Institute, 4401 Wornall Road, 9th Floor, Kansas
City, MO
(Thiery) Institute of Laboratory Medicine, Clinical Chemistry and
Molecular Diagnostics, University Hospital, Leipzig, Germany; LIFE
Research Center for Civilization Diseases, University of Leipzig, Leipzig,
Germany
(Visseren) Department of Vascular Medicine, University Medical Center
Utrecht and Utrecht University, Utrecht, Netherlands
(Waltenberger) Department of Cardiovascular Medicine, University of
Munster, Munster, Germany
(Richards) The Christchurch Heart Institute, University of Otago
Christchurch, PO Box 4345, Christchurch 8140, New Zealand; Cardiovascular
Research Institute, National University of Singapore, 1 E Kent Ridge Road,
Singapore
(Pare) McMaster University, Department of Pathology and Molecular
Medicine, Hamilton, Canada; Population Health Research Institute,
Hamilton, ON L8L 2X2, Canada
(Marz) Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg
University, Theodor-KutzerUfer 1-3, 68167 Mannheim, Germany; Synlab
Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany; Clinical
Institute of Medical and Chemical Laboratory Diagnostics, Medical
University of Graz, Graz, Austria
(Patel) Institute of Cardiovascular Science and UCL BHF Research
Accelerator, Faculty of Population Health Science, University College
London, London, UK; Bart's Heart Centre, St Bartholomew's Hospital,
London, EC1A2DA, UK
Publisher
NLM (Medline)
Abstract
Background: Studies examining the role of factor V Leiden among patients
at higher risk of atherothrombotic events, such as those with established
coronary heart disease (CHD) are lacking. Given that coagulation is
involved in the thrombus formation stage upon atherosclerotic plaque
rupture, we hypothesized that factor V Leiden may be a stronger risk
factor for atherothrombotic events in patients with established CHD.
<br/>Method(s): We performed an individual-level meta-analysis including
25 prospective studies (18 cohorts, 3 case-cohorts, 4 randomized trials)
from the GENIUS-CHD consortium involving patients with established CHD at
baseline. Participating studies genotyped factor V Leiden status and
shared risk estimates for the outcomes of interest using a centrally
developed statistical code with harmonized definitions across studies.
Cox-regression models were used to obtain age and sex adjusted estimates.
The obtained estimates were pooled using fixed-effect meta-analysis. The
primary outcome was composite of myocardial infarction and CHD death.
Secondary outcomes included any stroke, ischemic stroke, coronary
revascularization, cardiovascular mortality and all-cause mortality.
<br/>Result(s): The studies included 69,681 individuals of whom 3,190
(4.6%) were either heterozygous or homozygous (n=47) carriers of factor V
Leiden. Median follow-up per study ranged from 1.0 to 10.6 years. A total
of 20 studies with 61,147 participants and 6,849 events contributed to
analyses of the primary outcome. Factor V Leiden was not associated with
the combined outcome of myocardial infarction and CHD death (hazard ratio,
1.03; 95% CI, 0.92 - 1.16; I2 = 28%; P-heterogeneity = 0.12). Subgroup
analysis according to baseline characteristics or strata of traditional
cardiovascular risk factors did not show relevant differences. Similarly,
risk estimates for the secondary outcomes including stroke, coronary
revascularization, cardiovascular mortality and all-cause mortality were
close to identity. <br/>Conclusion(s): Factor V Leiden was not associated
with increased risk of subsequent atherothrombotic events and mortality in
high-risk participants with established and treated CHD. Routine
assessment of factor V Leiden status is unlikely to improve
atherothrombotic events risk stratification in this population.