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<1>
Accession Number
628249912
Title
Effects of programmed intermittent thoracic paravertebral bolus of
levobupivacaine on the spread of sensory block: A randomized, controlled,
double-blind study.
Source
Regional Anesthesia and Pain Medicine. 44 (3) (pp 326-332), 2019. Date of
Publication: 01 Mar 2019.
Author
Hida K.; Murata H.; Ichinomiya T.; Inoue H.; Sato S.; Hara T.
Institution
(Hida, Murata, Ichinomiya, Inoue, Hara) Department of Anesthesiology,
Nagasaki University, School of Medicine, Nagasaki 852-8501, Japan
(Sato) Clinical Research Center, Nagasaki University Hospital, Nagasaki,
Japan
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Background and objectives This randomized, controlled, double-blind trial
compared the effectiveness of levobupivacaine delivery of a programmed
intermittent paravertebral bolus with a continuous paravertebral infusion.
Methods Thirty-two consecutively enrolled patients who underwent
unilateral video-assisted thoracic surgery were randomized to receive
either a programmed intermittent paravertebral bolus of 10 mL of 0.2%
levobupivacaine every 2 hours (Bolus group, n=16) or a continuous
paravertebral infusion of 0.2% levobupivacaine at 5 mL/hour (Infusion
group, n=16) after the operation. Postoperatively, after injection of 20
mL of 0.25% levobupivacaine through the paravertebral catheter, a
mechanical infusion pump was set depending on the assigned group. The
primary efficacy outcome was the number of anesthetized dermatomes 24
hours after the initial bolus of levobupivacaine. The secondary efficacy
outcomes included the number of anesthetized dermatomes at other time
points, pain at rest and coughing, additional analgesic use and patient
acceptance of the analgesic technique. Arterial levobupivacaine
concentration was measured to ensure safety. P<0.05 was considered
statistically significant. Results The mean (95% CI) number of
anesthetized dermatomes 24 hours after the initial bolus of
levobupivacaine was significantly larger among subjects receiving
programmed intermittent bolus (n=16) compared with those receiving
continuous infusion (n=16; 6.8 (5.7-7.9) vs 3.1 (2.0-4.2); p<0.001). The
arterial levobupivacaine concentration did not reach a toxic level.
Conclusions The programmed intermittent paravertebral bolus of
levobupivacaine provided a wider dermatomal spread of sensory block than
continuous paravertebral infusion with an identical hourly dose of
levobupivacaine. Trial registration number UMIN000022532.<br/>Copyright
&#xa9; 2019 American Society of Regional Anesthesia & Pain Medicine.

<2>
Accession Number
2006728911
Title
Meta-Analysis of Optimal Revascularization Strategy for Patients With
ST-Segment Elevation Myocardial Infarction and Multi-Vessel Coronary
Artery Disease.
Source
American Journal of Cardiology. 129 (pp 19-24), 2020. Date of Publication:
15 August 2020.
Author
Shah R.; Nayyar M.; Le F.K.; Labroo A.; Davis D.A.; Brilakis E.S.;
Kandzari D.E.
Institution
(Shah, Le, Labroo, Davis) Alabama College of Osteopathic Medicine, Dothan,
AL, United States
(Shah, Le, Labroo, Davis) Gulf Coast Medical center, Panama City, FL,
United States
(Nayyar) University of Tennessee, Memphis, TN, United States
(Brilakis) Minneapolis Heart Institute, Minneapolis, MN, United States
(Kandzari) Piedmont Heart Institute, Atlanta, Georgia, Georgia
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Several clinical trials have shown that complete revascularization (CR)
lowers the risks of revascularization and nonfatal myocardial infarction
(MI) in patients with ST-segment elevation myocardial infarction (STEMI)
and multivessel coronary artery disease compared with infarct-related
artery-only revascularization (IRA-OR). However, individual trials have
been underpowered for hard outcomes such as cardiovascular (CV) mortality.
Therefore, we conducted an updated meta-analysis representing the largest
sample size to date inclusive of contemporary studies comparing CR versus
IRA-OR. Pooled risk ratios (RRs) were calculated using random effects
model. Data from 11 RCTs involving 7,343 patients showed that compared
with IRA-OR, CR was associated with lower CV mortality (RR 0.75; 95%
confidence interval [CI] 0.57 to 0.99; p = 0.04), MI (RR 0.70; 95% CI 0.53
to 0.93), and recurrent revascularization (RR 0.38; 95% CI 0.27 to 0.54),
but similar all-cause mortality (RR 0.85; 95% CI 0.70 to 1.05). In
conclusion, in patients with STEMI and multivessel coronary artery
disease, compared with IRA-OR, CR was associated with lower risk for CV
mortality, MI, and recurrent revascularization, suggesting that CR should
be the standard of care for STEMI patients.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<3>
Accession Number
2005977768
Title
Reduced Fractionation in Lung Cancer Patients Treated with Curative-intent
Radiotherapy during the COVID-19 Pandemic.
Source
Clinical Oncology. 32 (8) (pp 481-489), 2020. Date of Publication: August
2020.
Author
Faivre-Finn C.; Fenwick J.D.; Franks K.N.; Harrow S.; Hatton M.Q.F.; Hiley
C.; McAleese J.J.; McDonald F.; O'Hare J.; Peedell C.; Pope T.; Powell C.;
Rulach R.; Toy E.
Institution
(Faivre-Finn) The Christie NHS Foundation Trust, Manchester, United
Kingdom
(Faivre-Finn) The University of Manchester, Manchester, United Kingdom
(Fenwick) Department of Molecular and Clinical Cancer Medicine, Institute
of Translational Medicine, University of Liverpool, Liverpool, United
Kingdom
(Fenwick) Department of Physics, Clatterbridge Cancer Centre, Bebington,
Wirral, United Kingdom
(Franks) Leeds Cancer Centre, St James's University Hospital, Leeds,
United Kingdom
(Franks) University of Leeds, Leeds, United Kingdom
(Harrow, Rulach) Beatson West of Scotland Cancer Centre, Glasgow, United
Kingdom
(Harrow, Rulach) University of Glasgow, Glasgow, United Kingdom
(Hatton) Weston Park Hospital, Broomhall, Sheffield, United Kingdom
(Hiley) CRUK Lung Cancer Centre of Excellence, University College London,
London, United Kingdom
(Hiley) Department of Clinical Oncology, University College London
Hospitals NHS Foundation Trust, London, United Kingdom
(McAleese, O'Hare) Northern Ireland Cancer Centre, Belfast City Hospital,
Belfast, United Kingdom
(McDonald) The Royal Marsden NHS Foundation Trust, London, United Kingdom
(Peedell) James Cook University Hospital, Middlesbrough, United Kingdom
(Powell) South West Wales Cancer Centre, Singleton Hospital, Swansea,
United Kingdom
(Powell) Velindre Cancer Centre, Cardiff, United Kingdom
(Pope) Clatterbridge Cancer Centre, Bebington, Wirral, United Kingdom
(Toy) Royal Devon and Exeter NHS Foundation Trust, Exeter Hospital,
Exeter, United Kingdom
Publisher
Elsevier Ltd
Abstract
Patients treated with curative-intent lung radiotherapy are in the group
at highest risk of severe complications and death from COVID-19. There is
therefore an urgent need to reduce the risks associated with multiple
hospital visits and their anti-cancer treatment. One recommendation is to
consider alternative dose-fractionation schedules or radiotherapy
techniques. This would also increase radiotherapy service capacity for
operable patients with stage I-III lung cancer, who might be unable to
have surgery during the pandemic. Here we identify reduced-fractionation
for curative-intent radiotherapy regimes in lung cancer, from a literature
search carried out between 20/03/2020 and 30/03/2020 as well as published
and unpublished audits of hypofractionated regimes from UK centres.
Evidence, practical considerations and limitations are discussed for
early-stage NSCLC, stage III NSCLC, early-stage and locally advanced SCLC.
We recommend discussion of this guidance document with other specialist
lung MDT members to disseminate the potential changes to radiotherapy
practices that could be made to reduce pressure on other departments such
as thoracic surgery. It is also a crucial part of the consent process to
ensure that the risks and benefits of undergoing cancer treatment during
the COVID-19 pandemic and the uncertainties surrounding toxicity from
reduced fractionation have been adequately discussed with patients.
Furthermore, centres should document all deviations from standard
protocols, and we urge all colleagues, where possible, to join
national/international data collection initiatives (such as COVID-RT Lung)
aimed at recording the impact of the COVID-19 pandemic on lung cancer
treatment and outcomes.<br/>Copyright &#xa9; 2020 The Royal College of
Radiologists

<4>
[Use Link to view the full text]
Accession Number
2007032209
Title
Comparison of automated fastener device Cor-Knot versus manually-tied knot
in minimally-invasive isolated aortic valve replacement surgery.
Source
Journal of Cardiovascular Surgery. 61 (1) (pp 123-128), 2020. Date of
Publication: February 2020.
Author
Morhant M.-C.; Malapert H.; Petrosyan A.; Pujos C.; Jazayeri S.; Bouchot
O.
Institution
(Morhant, Malapert, Petrosyan, Pujos, Jazayeri, Bouchot) Department of
Cardiovascular and Thoracic Surgery, Dijon University Hospital, Dijon,
France
Publisher
Edizioni Minerva Medica (E-mail: subscriptions.dept@minervamedica.it)
Abstract
BACKHROUND: The aim of our prospective study was to evaluate the efficacy
and the safety of the Cor-Knot device in isolated aortic valve replacement
by right anterior minithoracotomy. <br/>METHOD(S): A single-center,
prospective study was conducted between September 2009 and June 2018. Four
hundred and forty patients were operated on for aortic valve replacement
by right anterior minithoracotomy. Of these patients, 221 underwent
isolated AVR surgery with stented prosthesis. Sutures were secured using
the Cor-Knot titanium fastener in 63 patients (28.5%) and knots were
hand-tied in 158 (71.5%). Statistical analyses were done using a
propensity score with 1:1 matching for the automatically tied (AT) and
manually tied (MT) patients. <br/>RESULT(S): The aortic cross-clamping and
cardiopulmonary bypass times were significantly decreased in the AT group
(74+/-13.8 minutes vs. 90.4+/-23.7 minutes, P<0.0001, and 100.8+/-20.6
minutes vs. 117.6+/-33.1 minutes, P<0.0001), compared with the MT group.
Clinical outcomes were similar in the two groups, whether in the analysis
of non-matched or matched groups. There was no difference in 30
day-mortality (1.2% vs. 0%, P=0.37), and the stroke and transient ischemic
attack rates were comparable (2.5% vs. 1.6%; P=0.67). There was no
significant increase in pacemaker implantation in the AT group (1.3% vs.
0%, P=0.36), and the rate of aortic regurgitation >= 2 was lower (3.9% vs.
0%; P=0.11) but not statistically significant. <br/>CONCLUSION(S): The
automated Cor-Knot fastener is an easy-to-use, time-saving device which
does not increase perioperative morbidity and mortality in patients
undergoing aortic valve replacement by right anterior
minithoracotomy.<br/>Copyright &#xa9; 2019 EDIZIONI MINERVA MEDICA

<5>
[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

<6>
[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

<7>
Accession Number
2007255406
Title
Long-term outcomes of left main coronary artery disease treated with
drug-eluting stent vs coronary artery bypass grafting: A meta-analysis and
systematic review.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Al-abcha A.; Saleh Y.; Mujer M.; Herzallah K.; Abela G.S.
Institution
(Al-abcha, Mujer) Department of Internal Medicine, Michigan State
University, East Lansing, MI, United States
(Saleh) Department of Cardiology, Houston Methodist Hospital, Houston, TX,
United States
(Herzallah) Department of Cardiology, Tufts Medical Center, Boston, MA,
United States
(Abela) Department of Internal Medicine, Division of Cardiology, Michigan
State University, East Lansing, MI, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Currently, DES is a reasonable treatment option for LMCA
disease but CABG continues to be first-line treatment. Multiple randomized
clinical trials (RCTs) have compared outcomes between these two treatment
modalities. Recently, these trials published their long-term results with
conflicting findings. <br/>Method(s): We conducted a systematic review and
meta-analysis of RCTs that compared DES vs CABG in patients with LMCA
disease. We only included trials with follow up duration of at least 5
years. The primary outcome was all-cause mortality. Secondary outcomes
included risk of cardiac death, myocardial infarction (MI), stroke and
repeat revascularization. <br/>Result(s): We included a total of 4 RCTs.
The median-weighted follow up period was 6.5 years. There was no
significant difference between DES and CABG in all-cause mortality (Risk
ratio (RR) 1.10; 95% confidence interval (CI) 0.92 to 1.31; p = 0.28),
risk of cardiac death (RR of 1.08, 95% CI 0.84 to 1.38; p = 0.56), total
MI (RR of 1.22, 95% CI 0.96 to 1.56; p = 0.11), and stroke (RR of 0.85,
95% CI 0.46 to 1.57; p = 0.60). The risk of repeat revascularization (RR
of 1.75, 95% CI 1.50 to 2.03; p < 0.00001), and non-periprocedural MI (RR
of 2.13, 95% CI 1.53 to 2.97; p < 0.00001) were significantly higher in
the DES arm. <br/>Conclusion(s): DES has similar long-term outcomes
compared to CABG in terms of all-cause mortality, cardiac death, total MI
and stroke; but was associated with a higher risk of repeat
revascularization, and non-periprocedural MI.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<8>
Accession Number
2007244173
Title
Transcatheter Versus Surgical Aortic Valve Replacement: An Updated
Systematic Review and Meta-Analysis With a Focus on Outcomes by Sex.
Source
Heart Lung and Circulation. (no pagination), 2020. Date of Publication:
2020.
Author
Dagan M.; Yeung T.; Stehli J.; Stub D.; Walton A.S.; Duffy S.J.
Institution
(Dagan, Yeung, Stehli, Stub, Walton, Duffy) Department of Cardiology, The
Alfred Hospital, Melbourne, Vic, Australia
(Stub, Walton, Duffy) Baker IDI Heart and Diabetes Institute, Melbourne,
Vic, Australia
(Stub, Duffy) Centre of Cardiovascular Research and Education in
Therapeutics, Department of Epidemiology and Preventive Medicine, Monash
University, Melbourne, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Background and Aims: Women at increased surgical risk have been shown to
have better outcomes with transcatheter aortic valve implantation (TAVI)
as compared to surgical valve replacement (SAVR). With the scope of TAVI
moving into low-surgical risk patients, we aimed to update the current
literature to include the new low-risk randomised controlled trial (RCT)
data in investigating outcomes by sex. <br/>Method(s): We systematically
searched MEDLINE (Ovid), PubMed, Cochrane Central Register of Controlled
Trials (CENTRAL), ClinicalTrials.gov and reference lists for relevant RCTs
comparing TAVI to SAVR published prior to 4 May 2020. Data extraction was
performed by two independent authors and included trial design details,
baseline characteristics and outcome data stratified by sex. Risk of bias
was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Quantitative
synthesis of pooled data was performed using Mantel-Haenszel fixed or
random effects model. Q-statistic and the I² test were used for
assessment of heterogeneity. <br/>Result(s): Our search yielded eight RCTs
included in the final quantitative synthesis. The overall pooled cohort
was 8,040, of whom 41.4% were female. Women had significantly lower rates
of one-year all-cause mortality (12.2% vs 17.7%, pooled OR 0.59, 95% CI
0.40-0.86) and one-year composite endpoint (9.7% vs 12.4%, pooled OR 0.73,
95% CI 0.58-0.92) with TAVI as compared to SAVR. The selective mortality
benefit with TAVI over SAVR in women did not persist to 5 years (pooled HR
1.01, 95% CI 0.87-1.17). At 30 days, women demonstrated lower rates of
major bleeding and acute kidney injury following TAVI compared to SAVR.
For men, these outcomes were similar regardless of type of intervention.
Both sexes were at increased risk of major vascular complications with
TAVI as compared to SAVR, however women demonstrated nearly double the
odds of major vascular complication with TAVI compared to men.
<br/>Conclusion(s): Our updated meta-analysis demonstrates that at
one-year women undergoing TAVI have significantly lower mortality and
better safety outcomes compared to those undergoing SAVR. These benefits
are not seen in men. In the new low-risk era, these results are ever more
important for guiding appropriate patient selection.<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)

<9>
Accession Number
2005737801
Title
Myocardial protection in cardiac surgery: how limited are the options? A
comprehensive literature review.
Source
Perfusion (United Kingdom). (no pagination), 2020. Date of Publication:
2020.
Author
Whittaker A.; Aboughdir M.; Mahbub S.; Ahmed A.; Harky A.
Institution
(Whittaker, Aboughdir, Mahbub) Department of Medicine, St George's,
University of London, London, United Kingdom
(Aboughdir, Ahmed) Department of Medicine, Imperial College London,
London, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
For patients undergoing cardiopulmonary bypass, myocardial protection is a
key for successful recovery and improved outcomes following cardiac
surgery that requires cardiac arrest. Different solutions, components and
modes of delivery have evolved over the last few decades to optimise
myocardial protection. These include cold and warm and blood and
crystalloid solution through antegrade, retrograde or combined
cardioplegia delivery approach. However, each method has its own
advantages and disadvantages, posing a challenge to establish a
gold-standard cardioplegic solution with an optimised mode of delivery for
enhanced myocardial protection during cardiac surgery. The aim of this
review is to provide a brief history of the development of cardioplegia,
explain the electrophysiological concepts behind myocardial protection in
cardioplegia, analyse the current literature and summarise existing
evidence that warrants the use of varying cardioplegic techniques. We
provide a comprehensive and comparative overview of the effectiveness of
each technique in achieving optimal cardioprotection and propose novel
techniques for optimising myocardial protection in the
future.<br/>Copyright &#xa9; The Author(s) 2020.

<10>
Accession Number
632492007
Title
Nasal decolonization of Staphylococcus aureus and the risk of surgical
site infection after surgery: a meta-analysis.
Source
Annals of clinical microbiology and antimicrobials. 19 (1) (pp 33), 2020.
Date of Publication: 30 Jul 2020.
Author
Tang J.; Hui J.; Ma J.; Mingquan C.
Institution
(Tang) Department of Infectious Diseases and Hepatology, Huashan Hospital,
Fudan University, Shanghai 200040, China
(Hui) Department of Infectious Diseases, First Affiliated Hospital of
Zhejiang University, Hangzhou 310003, China
(Ma) Department of Endocrinology and Metabolism, Gansu Provincial
Hospital, Lanzhou 730000, China
(Mingquan) Department of Infectious Diseases and Hepatology, Huashan
Hospital, Fudan University, Shanghai 200040, China
(Mingquan) Department of Emergency, Huashan Hospital, Fudan University,
Shanghai 200040, China
Publisher
NLM (Medline)
Abstract
AIM: To assess the effects of nasal decontamination on preventing surgical
site infections (SSIs) in people who are Staphylococcus aureus carriers
undergoing different types of surgeries and diverse measures of
decolonization. <br/>METHOD(S): Relevant randomized controlled trials
(RCTs) were identified through systematic searches of the PubMed, Embase,
Web of science, and the Cochrane Library databases. The risk ratios (RRs)
and 95% confidence intervals (CIs) were calculated and the effects model
was chosen according to the heterogeneity. Subgroup analyses were
performed according to different types of surgeries and measures of
decolonization that Staphylococcus aureus carriers were applied.
<br/>RESULT(S): Twenty RCTs published between 1996 and 2019 involving
10,526 patients were included. Pooled results showed that the overall SSIs
and pulmonary surgery SSIs presented with a statistical difference in
measures of nasal decontamination (RR=0.59 and 0.47, respectively, both
p<0.01). However, the associations between nasal decolonization and
increased risks of SSIs in orthopedics surgery or cardiovascular surgery
remained insignificant in studies. As for the diverse measures of nasal
decontamination, 50% used mupirocin, 15% used chlorhexidine, 30% used
different types of antimicrobial drugs, and 5% use others. The SSIs rate
were decreased after chlorhexidine (RR=0.474, 95% CI 0.259-0.864), while
no significant difference was shown in the use of mupirocin (RR=0.871, 95%
CI 0.544-1.394). <br/>CONCLUSION(S): It seems that nasal decolonization of
Staphylococcus aureus may be associated with a reduction of SSIs in these
patients, especially in patients who have been administered by pulmonary
surgeries or treated with chlorhexidine.

<11>
Accession Number
632134775
Title
Comparing sedation vs. general anaesthesia in transoesophageal
echocardiography-guided percutaneous transcatheter mitral valve repair: A
meta-analysis.
Source
European Heart Journal Cardiovascular Imaging. 21 (5) (pp 511-521), 2020.
Date of Publication: 01 May 2020.
Author
Banga S.; Hafiz A.M.; Chami Y.; Gumm D.C.; Banga P.; Howard C.; Kim M.;
Sengupta P.P.
Institution
(Banga, Sengupta) Division of Cardiology, West Virginia University School
of Medicine, 1 Medical Center Drive, Morgantown, WV, United States
(Hafiz, Chami) Division of Cardiology, Southern Illinois University School
of Medicine, Springfield, IL, United States
(Gumm) Division of Cardiology, University of Illinois College of Medicine
at Peoria, OSF Saint Francis Medical Center, Peoria, IL, United States
(Banga) University of Illinois College of Medicine at Peoria, OSF Saint
Francis Medical Center, Peoria, IL, United States
(Howard) Library of the Health Sciences at Peoria, University of Illinois
at Chicago, Peoria, IL, United States
(Kim) Center of Outcomes Research, Department of Internal Medicine,
University of Illinois College of Medicine at Peoria, Peoria, IL, United
States
Publisher
Oxford University Press
Abstract
Aims: Transoesophageal echocardiography-guided percutaneous transcatheter
mitral valve repair (TOE-guided PMVR) using edge-to-edge leaflet plication
is typically performed under general anaesthesia (GA). Increasing evidence
supports the efficacy and safety of PMVR performed under conscious
sedation (CS) or deep sedation (DS). We performed a meta-analysis
comparing safety and efficacy of CS/DS vs. GA in PMVR. <br/>Methods and
Results: A comprehensive search was performed using PubMed, CINAHL, Ovid
MEDLINE, Embase, and the Cochrane Library. Study characteristics,
participant demographics, and procedural outcomes with both types of
anaesthesia were analysed. Out of 73 articles, five met inclusion
criteria. Overall, there was no significant difference in the primary
outcome of procedural success rate [odds ratio (OR) 0.75; 95% confidence
interval (CI) 0.30-1.88, I²= 0.0%, P = 0.538] or post-procedure
in-hospital mortality (OR 1.02; 95% CI 0.38-2.71, I²= 0.0%, P =
0.970) in the patients undergoing PMVR under CS/DS vs. GA. The secondary
endpoint of intensive care unit (ICU) length of stay (LOS) was
significantly shorter in patients under CS/DS vs. GA (standardized mean
difference, SMD = -0.97; 95% CI -1.75 to -0.20; P = 0.014), but the
hospital LOS (SMD = 0.36; 95% CI -0.77 to 0.04, P = 0.078) did not show a
statistically significant difference between the groups, although it was
shorter in the CS/DS group. No difference was observed between CS/DS and
GA in fluoroscopy time, procedure time, or complications, including
pneumonia, stroke/transient ischaemic attack, and major bleeding.
<br/>Conclusion(s): CS or DS has lower ICU LOS, but comparable procedural
success rate and in-hospital mortality, making it a potential alternative
to GA for TOE-guided PMVR.<br/>Copyright &#xa9; 2020 Published on behalf
of the European Society of Cardiology. All rights reserved.

<12>
Accession Number
632067339
Title
Long-term ticagrelor for secondary prevention in patients with prior
myocardial infarction and no history of coronary stenting: Insights from
PEGASUS-TIMI 54.
Source
European Heart Journal. 41 (17) (pp 1625-1632), 2020. Date of Publication:
01 May 2020.
Author
Furtado R.H.M.; Nicolau J.C.; Magnani G.; Im K.; Bhatt D.L.; Storey R.F.;
Steg P.G.; Spinar J.; Budaj A.; Kontny F.; Corbalan R.; Kiss R.G.; Abola
M.T.; Johanson P.; Jensen E.C.; Braunwald E.; Sabatine M.S.; Bonaca M.P.
Institution
(Furtado, Im, Bhatt, Braunwald, Sabatine, Bonaca) TIMI Study Group,
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical
School, Boston, United States
(Furtado, Nicolau) Instituto Do Coracao (InCor), Hospital das Clinicas,
Faculdade de Medicina, Universidade de Sao Paulo, Av Dr Eneas de Carvalho
Aguiar 44, Sao Paulo 05403, Brazil
(Magnani) University Hospital of Parma, Via Gramsci, 14, Parma PR 43126,
Italy
(Storey) University of Sheffield, Western Bank, Sheffield S102TN, United
Kingdom
(Steg) Assistance Publique-Hopitaux de Paris, 3 Avenue Victoria, Paris
75004, France
(Spinar) University Hospital Brno, 20 Jihlavska, Brno, Czechia
(Budaj) Centre of Postgraduate Medical Education, Grochowski Hospital,
Grenadierow 51/59, Warsaw 04-073, Poland
(Kontny) Department of Cardiology, Stavanger University Hospital, Gerd
Ragna Bloch Thorsens gate 8, Stavanger, Norway
(Kontny) Drammen Heart Center, Dronninggata 28, Drammen 3004, Norway
(Corbalan) Cardiovascular Division, Faculty of Medicine, Pontificia
Universidad Catolica de Chile, Lira 40, Santiago, Chile
(Kiss) Department of Cardiology, Military Hospital, Robert Karoly krt.,
Budapest 1134, Hungary
(Abola) College of Medicine, University of the Philippines, Philippine
Heart Center, Quezon City, Metro Manila, Philippines
(Johanson, Jensen) AstraZeneca, Molndal 43153, Sweden
(Bonaca) CPC Clinical Research, University of Colorado School of Medicine,
13199 E Montview Blvd Suite 200, Aurora, CO, United States
Publisher
Oxford University Press
Abstract
Aims: PEGASUS-TIMI 54 demonstrated that long-term dual antiplatelet
therapy (DAPT) with aspirin and ticagrelor reduced the risk of major
adverse cardiovascular events (MACE), with an acceptable increase in
bleeding, in patients with prior myocardial infarction (MI). While much of
the discussion around prolonged DAPT has been focused on stented patients,
patients with prior MI without prior coronary stenting comprise a
clinically important subgroup. <br/>Methods and Results: This was a
pre-specified analysis from PEGASUS-TIMI 54, which randomized 21 162
patients with prior MI (1-3 years) and additional high-risk features to
ticagrelor 60 mg, 90 mg, or placebo twice daily in addition to aspirin. A
total of 4199 patients had no history of coronary stenting at baseline.
The primary efficacy outcome (MACE) was the composite of cardiovascular
death, MI, or stroke. Patients without history of coronary stenting had
higher baseline risk of MACE [13.2% vs. 8.0%, adjusted hazard ratio (HR)
1.41, 95% confidence interval (CI) 1.15-1.73, in the placebo arm]. The
relative risk reduction in MACE with ticagrelor (pooled doses) was similar
in patients without (HR 0.82, 95% CI 0.68-0.99) and with prior stenting
(HR 0.85, 95% CI 0.75-0.96; P for interaction = 0.76). <br/>Conclusion(s):
Long-term ticagrelor reduces thrombotic events in patients with prior MI
regardless of whether they had prior coronary stenting. These data
highlight the benefits of DAPT in prevention of spontaneous
atherothrombotic events and indicate that long-term ticagrelor may be
considered in high-risk patients with prior MI even if they have not been
treated with stenting. ClinicalTrials.gov Identifier:
NCT01225562.<br/>Copyright &#xa9; 2019 Published on behalf of the European
Society of Cardiology. All rights reserved. &#xa9; 2019 The Author(s).

<13>
Accession Number
2007299561
Title
Robotic segmentectomy: Indication and technique.
Source
Journal of Thoracic Disease. 12 (6) (pp 3404-3410), 2020. Date of
Publication: June 2020.
Author
Perroni G.; Veronesi G.
Institution
(Perroni) Department of Thoracic Surgery, Tor Vergata University, Rome,
Italy
(Veronesi) Faculty of Medicine and Surgery, Vita-Salute San Raffaele
University, Milan, Italy
(Veronesi) Division of Thoracic Surgery, IRCCS San Raffaele Scientific
Institute, Milan, Italy
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Use of low-dose CT scan allows detection of lung cancer at early stages,
enabling a more conservative surgery and a better long-term survival in
those patients. In this scenario, intentional anatomical segmentectomy is
gaining consent over standard lobectomy among surgeons. A minimally
invasive approach such as VATS reduced invasiveness and complication rate
compared to open surgery, but this technique comes also with some
disadvantages in terms of dexterity and intuitiveness. Robotic surgery
allows to overcome those limitations, making segmentectomies easier and
safer to perform. In addition, it offers the possibility to utilize
intravenous indocyanine green to define the intersegmental plane, allowing
a more precise surgery. We reviewed the literature and describe the
technique of the robot assisted segmentectomy with a focus on the new
technologies available nowadays.<br/>Copyright &#xa9; 2020 AME Publishing
Company. All rights reserved.

<14>
Accession Number
2004582268
Title
Perioperative management of wilms' tumor with intracardiac extension:
Report of two cases with review of literature.
Source
Journal of the Saudi Heart Association. 32 (1) (pp 106-109), 2020. Article
Number: 19. Date of Publication: 2020.
Author
Altwaeel H.; Kabbani M.S.; Shammari A.A.; Al-Namshan M.; Alghamdi A.A.
Institution
(Altwaeel, Kabbani) Section of Pediatric Cardiac Intensive Care,
Department of Cardiac Sciences, King Abdulaziz Medical City, Riyadh, Saudi
Arabia
(Alghamdi) Department of Cardiac Sciences, King Abdulaziz Medical City,
Riyadh, Saudi Arabia
(Shammari) Department of Surgery, King Abdulaziz Medical City. Riyadh,
Saudi Arabia
(Al-Namshan) Children Hospital, Riyadh, Saudi Arabia
(Kabbani, Shammari, Al-Namshan, Alghamdi) King Saud Bin AbdulAziz
University for Health Sciences, Riyadh, Saudi Arabia
Publisher
Saudi Heart Association
Abstract
Wilms' tumor (WT) is one of the solid tumor that affects children. It
involves the kidney and may extend to the lungs and liver. WT conquers the
adjacent blood vessels such as renal veins and inferior vena cava (IVC);
its extension to IVC and right-sided heart chambers is unusual.
Furthermore, when the tumor extends to heart chambers, its surgical
management becomes challenging and demands multidisciplinary medical and
surgical specialties including pediatric cardiac surgery. In this report,
we discuss the surgical management and perioperative treatment of two
unusual cases of WT with IVC and intracardiac extension.<br/>Copyright
&#xa9; 2020 Saudi Heart Association.

<15>
Accession Number
2007305878
Title
Rationale and design of a prospective, randomized, controlled, multicenter
study to evaluate the safety and efficacy of transcatheter heart valve
replacement in female patients with severe symptomatic aortic stenosis
requiring aortic valve intervention (Randomized researcH in womEn all
comers wIth Aortic stenosis [RHEIA] trial).
Source
American Heart Journal. 228 (pp 27-35), 2020. Date of Publication: October
2020.
Author
Eltchaninoff H.; Bonaros N.; Prendergast B.; Nietlispach F.; Vasa-Nicotera
M.; Chieffo A.; Pibarot P.; Bramlage P.; Sykorova L.; Kurucova J.; Bax
J.J.; Windecker S.; Dumonteil N.; Tchetche D.
Institution
(Eltchaninoff) Department of Cardiology, Rouen University Hospital, FHU
REMOD-VHF, Rouen, France
(Bonaros) Department of Cardiac Surgery, Medical University of Innsbruck,
Innsbruck, Austria
(Prendergast) St. Thomas' Hospital, London, United Kingdom
(Nietlispach) CardioVascularCenter, Hirslanden Klinik Im Park, Zurich,
Switzerland
(Vasa-Nicotera) University Heart Center Frankfurt, Frankfurt, Germany
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Pibarot) Department of Cardiology, Quebec Heart & Lung Institute, Laval
University, Quebec City, QC, Canada
(Bramlage) Institute for Pharmacology and Preventive Medicine,
Cloppenburg, Germany
(Sykorova, Kurucova) Edwards Lifesciences, Prague, Czechia
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Windecker) Department of Cardiology, Bern University Hospital, Bern,
Switzerland
(Dumonteil, Tchetche) Groupe Cardiovasculaire Interventionnel, clinique
Pasteur Toulouse, France
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Limited data suggest that transcatheter (TAVR) as compared
with surgical aortic valve replacement (SAVR) may be more effective in
female than male patients. To date, most evidence is derived from subgroup
analyses of large trials, and a dedicated randomized trial evaluating
whether there is a difference in outcomes between these interventions in
women is warranted. The RHEIA trial will compare the safety and efficacy
of TAVR with SAVR in women with severe symptomatic aortic stenosis
requiring aortic valve intervention, irrespective of surgical risk.
Methods/Design: The RHEIA trial is a prospective, randomized, controlled
study that will enroll up to 440 patients across 35 sites in Europe. Women
with severe symptomatic aortic stenosis, with any but prohibitive surgical
risk status, will be randomized 1:1 to undergo aortic valve intervention
with either transfemoral TAVR with the SAPIEN 3 or SAPIEN 3 Ultra device
or SAVR and followed up for 1 year. The objective is to determine whether
TAVR is non-inferior to SAVR in this patient population and, if this is
fulfilled whether TAVR is actually superior to SAVR. The primary
safety/efficacy endpoint is a composite of all-cause mortality, all
stroke, and re-hospitalization (for valve or procedure-related symptoms or
worsening congestive heart failure) at 1 year post-procedure. Other
outcomes (assessed at 30 days and/or 1 year) include all-cause mortality;
bleeding, vascular, cardiac, cerebrovascular and renal complications;
aortic valve prosthesis and left ventricular function; cognitive function,
health status, and quality of life. <br/>Discussion(s): The RHEIA study
has been designed to evaluate the safety and efficacy of TAVR compared
with SAVR specifically in women with severe symptomatic aortic stenosis,
irrespective of the level of surgical risk. The results will be the first
to provide specific randomized evidence to guide treatment selection in
female patients with severe symptomatic aortic stenosis. Trial
registration: clinicaltrials.gov: NCT04160130<br/>Copyright &#xa9; 2020
Elsevier Inc.

<16>
Accession Number
2007303760
Title
Smartphone-based application to improve medication adherence in patients
after surgical coronary revascularization.
Source
American Heart Journal. 228 (pp 17-26), 2020. Date of Publication: October
2020.
Author
Yu C.; Liu C.; Du J.; Liu H.; Zhang H.; Zhao Y.; Yang L.; Li X.; Li J.;
Wang J.; Wang H.; Liu Z.; Rao C.; Zheng Z.
Institution
(Yu, Liu, Du, Liu, Zhang, Zhao, Li, Li, Rao, Zheng) 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
(Liu, Zhang, Yang, Li, Rao, Zheng) Department of Cardiovascular Surgery,
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
(Wang) Department of Thoracic and Cardiovascular Surgery, The First
Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang,
China
(Wang) General Hospital of Shenyang Military Region, Shenyang, Liaoning,
China
(Liu) Department of Cardiovascular Surgery, TEDA International
Cardiovascular Hospital, Peking Union Medical College and Chinese Academy
of Medical Science, Tianjin, China
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Secondary preventive therapies play a key role in the
prevention of adverse events after coronary artery bypass grafting (CABG).
However, adherence to secondary preventive drugs after CABG is often poor.
With the increasing penetration of smartphones, health-related smartphone
applications might provide an opportunity to improve medication adherence.
We aimed to evaluate the effectiveness and feasibility of using a
smartphone-based application to improve medication adherence in patients
after CABG. <br/>Method(s): The Measurement and Improvement Studies of
Surgical coronary revascularizatION: medication adherence (MISSION-2)
study is a multicenter randomized controlled trial that planned to enroll
over 1000 patients who underwent isolated CABG at one of four large
teaching hospitals in China; all enrolled participants had access to a
smartphone and were able to operate at least three smartphone
applications. The investigators randomly assigned the participants to one
of two groups: (1) the intervention group with an advanced smartphone
application for 6 months which was designed specifically for this trial
and did not exist before. Participants could receive medication reminders
and cardiac health education by the smartphone application or (2) the
control group with usual care. The primary outcome was CABG secondary
preventive medication adherence as measured by the translated Chinese
version of the 8-item Morisky Medication Adherence Scale (MMAS-8) at 6
months after randomization. The secondary outcomes were mortality, major
adverse cardiovascular and cerebrovascular events (MACCE), cardiovascular
rehospitalization, self-reported secondary preventive medication use after
6 months of follow-up, blood pressure (BP), body mass index (BMI), and
self-reported smoking status. All analyses were conducted using the
intention-to-treat principle. <br/>Result(s): A total of 1000 patients
(mean age, 57.28 [SD, 9.09] years; 85.5% male) with coronary heart disease
after CABG were enrolled between September 2015 and September 2016 and
were randomly assigned to the intervention (n = 501) or control group (n =
499). At 6 months, the proportion of low-adherence participants,
categorized by MMAS-8 scores, was 11.8% in the intervention group and
11.7% in the control group (RR = 1.005, 95% CI 0.682 to 1.480, P = 1.000).
Similar results were found in sensitivity analyses that considered
participants who withdrew from the study, or were lost to follow-up as
nonadherent. There were no significant differences in the secondary
clinical outcome measures, and there were no significant differences in
the primary outcome across the subgroups tested. In the intervention
group, the proportion of participants who used and operated the
application during the first month after CABG was 88.1%; however, the use
rate decreased sharply from 42.5% in the second month to 9.2% by the end
of the study (6 months). <br/>Conclusion(s): A smartphone-based
application supporting secondary prevention among patients after CABG did
not lead to a greater adherence to secondary preventive medications. The
limited room for improvement in medication adherence and the low
participants' engagement with the smartphone applications might account
for these non-significant outcomes.<br/>Copyright &#xa9; 2020 Elsevier
Inc.

<17>
Accession Number
2004830932
Title
Effects of comprehensive nursing care on recovery of respiratory function
after thoracic surgery.
Source
International Journal of Clinical and Experimental Medicine. 13 (7) (pp
5328-5334), 2020. Article Number: IJCEM0111872. Date of Publication: 2020.
Author
Jiao J.; Fan X.; Dang H.; Zhang J.; Yin J.; Wang Q.; Zhang G.; Fu J.
Institution
(Jiao, Fan, Yin, Wang, Zhang, Fu) Department of Thoracic Surgery 1 Ward,
The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi
Province, China
(Dang) Department of Dermatology, The First Affiliated Hospital of Xi'an
Jiaotong University, Xi'an, Shaanxi Province, China
(Zhang) Thoracic Surgery 2 Ward, The First Affiliated Hospital of Xi'an
Jiaotong University, Xi'an, Shaanxi Province, China
Publisher
E-Century Publishing Corporation (40 White Oaks Lane, Madison WI 53711,
United States)
Abstract
Objective: To explore the effects of comprehensive nursing care on
recovery of respiratory function after thoracic surgery. <br/>Method(s): A
total of 86 patients with esophageal cancer (EC) who underwent thoracic
surgery were recruited and randomly allocated into a control group (n=43)
and an observation group (n=43). Patients in the control group received
conventional care, and those in the observation group received
comprehensive nursing care additionally, including preoperative
psychological nursing, respiratory function training, pain expression
guidance, sputum elimination guidance, postoperative nursing, as well as
dietary guidance. Related indices between the two groups were compared
after nursing. <br/>Result(s): In the observation group, postoperative
pulmonary function and arte-rial blood gas (ABG) were improved than those
in the control group (P<0.05). Besides, lower St George's Respiratory
Questionnaire (SGRQ) score, shorter duration of chest tube indwelling,
higher nursing satisfaction, and decreased complication rate were also
demonstrated in the observation group (P<0.05). <br/>Conclusion(s):
Comprehensive nursing care has a favorable clinical impact on the recovery
of respiratory function after thoracic surgery. It speeds up the
rehabilitation and improves the prognosis of patients, thus achieving
positive nursing feedback.<br/>Copyright &#xa9; 2020, E-Century Publishing
Corporation. All rights reserved.

<18>
Accession Number
2007316250
Title
Does Tweeting Improve Citations? One-Year Results from the TSSMN
Prospective Randomized Trial.
Source
Annals of Thoracic Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Luc J.G.Y.; Archer M.A.; Arora R.C.; Bender E.M.; Blitz A.; Cooke D.T.;
Hlci T.N.; Kidane B.; Ouzounian M.; Varghese T.K.; Antonoff M.B.
Institution
(Luc) Division of Cardiovascular Surgery, Department of Surgery,
University of British Columbia, Vancouver, BC, Canada
(Archer) Division of Thoracic Surgery, Department of Surgery, SUNY-Upstate
Medical University, Syracuse, NY, United States
(Arora) Section of Cardiac Surgery, Department of Surgery, Max Rady
College of Medicine, University of Manitoba, St Boniface Hospital,
Winnipeg, MB, Canada
(Bender) Department of Cardiothoracic Surgery, Stanford University, Palo
Alto, CA, United States
(Blitz) Division of Cardiac Surgery, University of Cincinnati Medical
Center, Cincinnati, OH, United States
(Cooke) Section of General Thoracic Surgery, UC Davis Health, Sacramento,
CA, United States
(Hlci) Department of Cardiothoracic Surgery, Morriston Hospital, ABMU,
Swansea, United Kingdom
(Kidane) Section of Thoracic Surgery, Department of Surgery, University of
Manitoba, Winnipeg, MB, Canada
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, University of Toronto, Toronto, ON, Canada
(Varghese) Division of Cardiothoracic Surgery, Department of Surgery,
University of Utah, Salt Lake City, UT, United States
(Antonoff) Department of Thoracic and Cardiovascular Surgery, MD Anderson
Cancer Center, Houston, TX, United States
Publisher
Elsevier USA
Abstract
Background: The Thoracic Surgery Social Media Network (TSSMN) is a
collaborative effort of leading journals in cardiothoracic surgery to
highlight publications via social media. This study aims to evaluate the
1-year results of a prospective randomized social media trial to determine
the effect of tweeting on subsequent citations and nontraditional
bibliometrics. <br/>Method(s): A total of 112 representative original
articles were randomized 1:1 to be tweeted via TSSMN or a control
(non-tweeted) group. Measured endpoints included citations at 1 year
compared with baseline, as well as article-level metrics (Altmetric score)
and Twitter analytics. Independent predictors of citations were identified
through univariable and multivariable regression analyses. <br/>Result(s):
When compared with control articles, tweeted articles achieved
significantly greater increase in Altmetric scores (Tweeted 9.4 +/- 5.8 vs
Non-tweeted 1.0 +/- 1.8, P < .001), Altmetric score percentiles relative
to articles of similar age from each respective journal (Tweeted 76.0 +/-
9.1 percentile vs Non-tweeted 13.8 +/- 22.7 percentile, P < .001), with
greater change in citations at 1 year (Tweeted +3.1 +/- 2.4 vs Non-Tweeted
+0.7 +/- 1.3, P < .001). Multivariable analysis showed that independent
predictors of citations were randomization to tweeting (odds ratio [OR]
9.50; 95% confidence interval [CI] 3.30-27.35, P < .001), Altmetric score
(OR 1.32; 95% CI 1.15-1.50, P < .001), open-access status (OR 1.56; 95% CI
1.21-1.78, P < .001), and exposure to a larger number of Twitter followers
as quantified by impressions (OR 1.30, 95% CI 1.10-1.49, P < .001).
<br/>Conclusion(s): One-year follow-up of this TSSMN prospective
randomized trial importantly demonstrates that tweeting results in
significantly more article citations over time, highlighting the durable
scholarly impact of social media activity.<br/>Copyright &#xa9; 2020

<19>
Accession Number
2007316070
Title
Impact of Aortic Annulus Enlargement on the Outcomes of Aortic Valve
Replacement: A Meta-analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Sa M.P.B.O.; Zhigalov K.; Cavalcanti L.R.P.; Escorel Neto A.C.; Rayol
S.C.; Weymann A.; Ruhparwar A.; Lima R.C.
Institution
(Sa, Cavalcanti, Escorel Neto, Rayol, Lima) Division of Cardiovascular
Surgery of Pronto Socorro Cardiologico de Pernambuco - PROCAPE, Recife,
Brazil
(Sa, Cavalcanti, Escorel Neto, Rayol, Lima) University of Pernambuco -
UPE, Recife, Brazil
(Sa, Lima) Nucleus of Postgraduate and Research in Health Sciences of
Faculty of Medical Sciences and Biological Sciences Instituite - FCM/ICB,
Recife, Brazil
(Zhigalov, Weymann, Ruhparwar) Department of Thoracic and Cardiovascular
Surgery, West German Heart and Vascular Center Essen, University Hospital
of Essen, University Duisburg-Essen, Essen, Germany
Publisher
W.B. Saunders
Abstract
We sought to evaluate the impact of surgical aortic annulus enlargement
(ARE) on the perioperative outcomes of surgical aortic valve replacement.
Databases were searched for articles published by October 2019 in order to
carry out a systematic review followed by meta-analysis. Thirteen studies
with 40,447 patients (aortic valve replacement [AVR] with aortic annulus
enlargement [AAE]: 4686 patients; AVR without AAE: 35,761 patients) were
included. The total rate of AAE was 11.6%, ranging from 4.1%-28.1%. The
overall unadjusted odds ratio (OR) (95% confidence interval [CI]) for
operative mortality showed a statistically significant difference between
the groups, with higher risk in the "AVR with AAE" group (OR 1.388; 95% CI
1.049-1.836, P < 0.001), but not for isolated AVR+AAE (OR 1.341; 95% CI
0.920-1.956, P = 0.127) and also not in matched populations (OR 1.003; 95%
CI 0.773-1.300, P = 0.984). The "AVR with AAE" group showed an overall
lower risk of significant patient-prosthesis mismatch (PPM) (OR 0.567; 95%
CI 0.376-0.854, P = 0.007) and a higher overall difference in means of
indexed effective orifice area (iEOA) (random effect model: 0.058
cm²/m²; 95% CI 0.024-0.092, P < 0.001). The overall
ORs for myocardial infarction, stroke, complete heart block/permanent
pacemaker implantation and reoperation for bleeding showed no
statistically significant difference between the groups. AAE is a useful
adjunct to AVR, but the benefit of reduced PPM must be balanced against a
possibly higher risk of perioperative mortality.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<20>
Accession Number
2007302182
Title
Autograft remodeling after the Ross procedure by cardiovascular magnetic
resonance imaging: Aortic stenosis versus insufficiency.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Lenoir M.; Emmott A.; Bouhout I.; Poirier N.; Tousch M.; El-Hamamsy I.;
Mongeon F.-P.
Institution
(Lenoir, Emmott, Bouhout, Poirier, Tousch, El-Hamamsy) Department of
Surgery, Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(El-Hamamsy) Division of Cardiac Surgery, Sacre-Coeur Hospital, Universite
de Montreal, Montreal, QC, Canada
(Poirier) Division of Cardiac Surgery, Sainte-Justine University Hospital
Center, Universite de Montreal, Montreal, QC, Canada
(Mongeon) Divison of Noninvasive Cardiology, Department of Specialized
Medicine, Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Studies suggest that patients undergoing the Ross procedure
for aortic insufficiency are at greater risk of autograft dilatation than
those with aortic stenosis. By using a tailored Ross technique to mitigate
autograft dilatation in patients with aortic insufficiency, we aimed to
compare the biomechanical and morphologic remodeling of the autograft at 1
year between patients with aortic insufficiency and patients with aortic
stenosis. <br/>Method(s): A total of 210 patients underwent a Ross
procedure (2011-2016). Of those, 86 patients (mean age 43 +/- 13 years;
32% were female) completed preoperative and postoperative cardiovascular
magnetic resonance imaging. A total of 71 studies were suitable for
analysis: 41 patients with aortic stenosis and 30 patients with aortic
insufficiency. Nine healthy adults were used as controls. Autograft root
dimensions, individual sinus volumes, and distensibility were measured
using cardiovascular magnetic resonance. <br/>Result(s): At 1 year, there
was no difference in autograft root dimensions between patients with
aortic stenosis (mean annulus 25.1 +/- 3.1 mm and sinus diameters 35 +/-
4.1 mm) and patients with aortic insufficiency (26.6 +/- 3 mm and 37.1 +/-
3.5 mm; P =.12 and.06, respectively). Relative sinus of Valsalva volumes
were symmetrical in the aortic stenosis (right 34.8% +/- 4%, left 33.7%
+/- 3.5%, noncoronary 31.4% +/- 3.2%) and aortic insufficiency groups
(34.8% +/- 3.9%, 33.8% +/- 2.8%, 31.3% +/- 3.7%, P =.85,.92, and.82), and
similar to those of healthy adults. Aortic root distensibility was reduced
in both groups compared with healthy adults (P =.003), but was similar
between aortic stenosis (3.12 +/- 1.58 x 10^-3 mm
Hg^-1) and aortic insufficiency (3.04 +/- 1.15 x 10^-3
mm Hg^-1; P =.9). <br/>Conclusion(s): Using a tailored
technique, there were no differences in the morphologic or biomechanical
remodeling of the autograft root 1 year after the Ross procedure between
patients with aortic stenosis and patients with aortic insufficiency.
However, autograft roots are stiffer than native aortic
roots.<br/>Copyright &#xa9; 2020 The American Association for Thoracic
Surgery

<21>
Accession Number
2005755017
Title
Effect of Desmopressin on Platelet Dysfunction During Antiplatelet
Therapy: A Systematic Review.
Source
Neurocritical Care. (no pagination), 2020. Date of Publication: 2020.
Author
Andersen L.K.; Hvas A.-M.; Hvas C.L.
Institution
(Andersen, Hvas) Thrombosis and Hemostasis Research Unit, Department of
Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
(Hvas) Department of Anaesthesiology and Intensive Care, Aarhus University
Hospital, Aarhus, Denmark
Publisher
Springer
Abstract
Background and Objective: An increasing number of patients receive
antiplatelet therapy. Patients exposed to surgery while receiving platelet
inhibitors hold an increased bleeding risk. Especially in neurosurgery and
neurocritical care patients, bleeding and hematoma expansion are feared
complications as even minor bleedings may be hazardous. The objective of
this systematic review was to investigate the effect of desmopressin
(1-deamino-8-d-arginine vasopressin, DDAVP) on platelet function during
antiplatelet therapy in patients undergoing non-cardiac surgery, patients
who experience spontaneous or traumatic hemorrhage, healthy individuals
and in animals. <br/>Method(s): Studies were identified through a
systematic literature search in PubMed and EMBASE on August 19, 2019, with
an update on May 2, 2020, and from reference lists of the included
studies. Data on clinical and biochemical effect of DDAVP were extracted
from included studies for a qualitative data synthesis. <br/>Result(s): In
total, 22 studies were included: 18 human studies and four animal studies.
Overall, DDAVP improved bleeding time and increased platelet aggregation
in patients undergoing non-cardiac surgery, patients suffering
intracerebral or subarachnoid hemorrhage while receiving antiplatelet
therapy as well as in healthy individuals and animals exposed to
antiplatelet therapy. Observational data indicate that DDAVP may mitigate
hematoma expansion in patients with intracerebral hemorrhage or traumatic
brain injury. <br/>Conclusion(s): The present data hold biochemical
evidence that DDAVP improves platelet function during antiplatelet therapy
in humans and animals. The need for randomized trials is evident in order
to evaluate the potential clinical effect of DDAVP in management of
patients with spontaneous or traumatic hemorrhage, or undergoing
neurosurgery, while receiving antiplatelet therapy.<br/>Copyright &#xa9;
2020, Springer Science+Business Media, LLC, part of Springer Nature and
Neurocritical Care Society.

<22>
Accession Number
632498077
Title
Nitric Oxide Added to the Sweep Gas of the Oxygenator during
Cardiopulmonary Bypass in Infants: A Pilot Randomized Controlled Trial.
Source
Artificial organs. (no pagination), 2020. Date of Publication: 01 Aug
2020.
Author
Niebler R.A.; Chiang-Ching H.; Daley K.; Janecke R.; Jobe S.M.; Mitchell
M.E.; Varner C.; Woods K.; Scott J.P.
Institution
(Niebler, Jobe, Woods, Scott) Medical College of Wisconsin, Departments of
Pediatrics, WI, Milwaukee, United States
(Niebler, Daley, Mitchell, Varner, Scott) WI, Milwaukee, United States
(Chiang-Ching) University of Wisconsin, WI, Milwaukee, United States
(Janecke, Jobe) Versiti Blood Research Institute, WI, Milwaukee, United
States
(Mitchell) Cardiothoracic Surgery, Medical College of Wisconsin, WI,
Milwaukee, United States
(Scott) Anesthesia, WI, Milwaukee, United States
Publisher
NLM (Medline)
Abstract
Our objective was to assess the effect of nitric oxide added to the sweep
gas of the oxygenator during cardiopulmonary bypass (CPB) in infants on
platelet count, platelet function, clinical outcomes, and safety. A
randomized, double blinded, placebo controlled clinical trial in infants
less than a year of age undergoing cardiac surgery requiring CPB was
undertaken. Nitric oxide at a dose of 20 ppm was added to the sweep gas in
the treatment group. Blood was collected at baseline and prior to
separation from CPB to measure platelet count and function as determined
by responsiveness to specific agonists. Clinical outcomes were observed
through hospital discharge. Methemoglobin levels were measured
pre-operatively, at the conclusion of CPB, and upon admission to the ICU.
Forty patients consented and were randomized in the trial. Eighteen
patients were randomized to the treatment group and twenty-two were
included in the placebo group. The groups were similar in terms of age,
weight, gender, and surgical complexity. No significant differences were
found in measures of platelet count, platelet response to agonist, or
clinical outcomes. Patients in the treatment group had higher
methemoglobin levels after receiving nitric oxide, but no levels
approached toxicity (maximum 2.4%). Nitric oxide added to the sweep gas of
the oxygenator during CPB in infants did not have an appreciable effect on
preservation of platelet count, platelet responsiveness to agonist, or
clinical outcomes. Methemoglobin levels were increased after receiving
nitric oxide but were far below a toxic level of 15%.<br/>Copyright This
article is protected by copyright. All rights reserved.

<23>
Accession Number
632496435
Title
The Rationale, Indications, Safety, and Use of Statins in the Pediatric
Population.
Source
The Canadian journal of cardiology. (no pagination), 2020. Date of
Publication: 05 Apr 2020.
Author
Khoury M.; McCrindle B.W.
Institution
(Khoury) Division of Pediatric Cardiology, Department of Pediatrics,
University of Alberta, Edmonton, AB, Canada
(McCrindle) Labatt Family Heart Center, Department of Pediatrics, Hospital
for Sick Children, University of Toronto, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
Together with heart-healthy lifestyle habits, statins serve as the
cornerstone of primary and secondary prevention of atherosclerotic
cardiovascular disease in adults. Several conditions, most notably
familial hypercholesterolemia (FH), cause early dyslipidemia and vascular
disease, contributing to the development and progression of
atherosclerosis from childhood and increased cardiovascular risk. In
recent decades, studies increasingly have evaluated the safety and
efficacy of statins in such high-risk youth. The strongest evidence for
pediatric statin use is for the heterozygous FH population, whereby statin
use has been shown to lower low-density lipoprotein cholesterol
effectively, slow the progression of atherosclerosis and vascular
dysfunction, and significantly reduce cardiovascular risk in early
adulthood. Numerous meta-analyses and Cochrane reviews have demonstrated
that attributed adverse effects, including liver toxicity, myositis, and
rhabdomyolysis, occur no more frequently in youth receiving statins than
placebos, with no impact on growth or development. However, further
studies evaluating the long-term safety of pediatric statin use are
required. In the current review, we summarize the pediatric experience of
statin use to date, focusing on its utility for FH, Kawasaki disease,
post-heart transplantation, and other at-risk populations. Current
guidelines and indications for use are summarized, and the short- and
medium-term safety experience is reviewed. Finally, a clinical approach to
the indications, initiation, and monitoring of statins in youth is
provided.<br/>Copyright &#xa9; 2020 Canadian Cardiovascular Society.
Published by Elsevier Inc. All rights reserved.

<24>
Accession Number
632489500
Title
Association of Gender and Race with Allocation of Advanced Heart Failure
Therapies.
Source
JAMA Network Open. (no pagination), 2020. Date of Publication: 2020.
Author
Breathett K.; Yee E.; Pool N.; Hebdon M.; Crist J.D.; Yee R.H.; Knapp
S.M.; Solola S.; Luy L.; Herrera-Theut K.; Zabala L.; Stone J.; McEwen
M.M.; Calhoun E.; Sweitzer N.K.
Institution
(Breathett, Sweitzer) Sarver Heart Center, Division of Cardiology,
Department of Medicine, University of Arizona, 1501 N Campbell Ave,
Tucson, AZ 85724, United States
(Yee, Yee) Sarver Heart Center, Clinical Research Office, University of
Arizona, Tucson, United States
(Pool, Crist, McEwen) College of Nursing, University of Arizona, Tucson,
United States
(Hebdon) College of Nursing, University of Utah, Salt Lake City, United
States
(Knapp) Statistics Consulting Lab, Bio5 Institute, University of Arizona,
Tucson, United States
(Solola) Department of Medicine, University of Arizona, Tucson, United
States
(Luy) University of Rochester, New York, United States
(Herrera-Theut) University of Arizona Medical School, Tucson, United
States
(Zabala) Department of Medicine, University of California, Los Angeles,
United States
(Stone) Department of Psychology, University of Arizona, Tucson, United
States
(Calhoun) Center for Population Health Sciences, University of Arizona,
Tucson, United States
Publisher
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
Abstract
Importance: Racial bias is associated with the allocation of advanced
heart failure therapies, heart transplants, and ventricular assist
devices. It is unknown whether gender and racial biases are associated
with the allocation of advanced therapies among women. <br/>Objective(s):
To determine whether the intersection of patient gender and race is
associated with the decision-making of clinicians during the allocation of
advanced heart failure therapies. <br/>Design, Setting, and
Participant(s): In this qualitative study, 46 US clinicians attending a
conference for an international heart transplant organization in April
2019 were interviewed on the allocation of advanced heart failure
therapies. Participants were randomized to examine clinical vignettes that
varied 1:1 by patient race (African American to white) and 20:3 by gender
(women to men) to purposefully target vignettes of women patients to
compare with a prior study of vignettes of men patients. Participants were
interviewed about their decision-making process using the think-aloud
technique and provided supplemental surveys. Interviews were analyzed
using grounded theory methodology, and surveys were analyzed with Wilcoxon
tests. Exposure: Randomization to clinical vignettes. <br/>Main Outcomes
and Measures: Thematic differences in allocation of advanced therapies by
patient race and gender. <br/>Result(s): Among 46 participants (24 [52%]
women, 20 [43%] racial minority), participants were randomized to the
vignette of a white woman (20 participants [43%]), an African American
woman (20 participants [43%]), a white man (3 participants [7%]), and an
African American man (3 participants [7%]). Allocation differences
centered on 5 themes. First, clinicians critiqued the appearance of the
women more harshly than the men as part of their overall impressions.
Second, the African American man was perceived as experiencing more severe
illness than individuals from other racial and gender groups. Third, there
was more concern regarding appropriateness of prior care of the African
American woman compared with the white woman. Fourth, there were greater
concerns about adequacy of social support for the women than for the men.
Children were perceived as liabilities for women, particularly the African
American woman. Family dynamics and finances were perceived to be greater
concerns for the African American woman than for individuals in the other
vignettes; spouses were deemed inadequate support for women. Last,
participants recommended ventricular assist devices over transplantation
for all racial and gender groups. Surveys revealed no statistically
significant differences in allocation recommendations for African American
and white women patients. <br/>Conclusions and Relevance: This national
study of health care professionals randomized to clinical vignettes that
varied only by gender and race found evidence of gender and race bias in
the decision-making process for offering advanced therapies for heart
failure, particularly for African American women patients, who were judged
more harshly by appearance and adequacy of social support. There was no
associated between patient gender and race and final recommendations for
allocation of advanced therapies. However, it is possible that bias may
contribute to delayed allocation and ultimately inequity in the allocation
of advanced therapies in a clinical setting.<br/>Copyright &#xa9; 2020 S.
Karger AG. All rights reserved.

<25>
Accession Number
2005781133
Title
Treatment of lower limb arterial disease by Dardik graft: It takes one to
know one.
Source
JMV-Journal de Medecine Vasculaire. 45 (4) (pp 214-220), 2020. Date of
Publication: July 2020.
Author
Borghese O.; Pisani A.; Sapienza P.
Institution
(Borghese) Department of Vascular Surgery, Foch Hospital, Suresnes, France
(Pisani) Department of Cardiovascular Surgery, Bichat-Claude-Bernard
Hospital, Paris, France
(Sapienza) Department of Surgery Pietro-Valdoni, Policlinico-Umberto I,
Rome, Italy
Publisher
Elsevier Masson SAS (62 rue Camille Desmoulins, Issy les Moulineaux Cedex
92442, France)
Abstract
Objective: To perform a comprehensive literature review on outcomes
achieved with the historical Dardik graft, illustrated with a case report
of a patient with 13-years primary patency and limb salvage.
<br/>Method(s): A comprehensive literature review was performed through
MedLine (PubMed.gov, U.S. National Library of Medicine, National Institute
of Health) from 1976 to 2018 using search terms (Umbilical Vein Graft),
(Dardik graft), (Glutaraldehyde stabilized human umbilical vein [HUV]) and
(HUV) to collected data on clinical use of HUV. Only papers in English and
reporting adequate information about indication for surgery, short- and
long-term patency and complication rate were included. <br/>Result(s):
Data about a total of 899 patients (977 limbs) were available. Overall,
45% of patients (438 limbs) underwent HUV implantation for critical limb
ischemia (rest pain or tissue loss) or for disabling claudication in 12.2%
of cases (120 limbs). Others indication for surgery were acute onset limb
ischemia, popliteal aneurysms or aneurysmal degeneration of a previously
implanted synthetic graft. At a mean follow-up of 4.3 years (range 3-6
years), primary patency and secondary patency were 61.3% and 61%,
respectively. Aneurisms formation was detected in 3% of cases (21 limbs),
graft's infection in 24.4% of cases (31 limbs) and graft's thrombosis in
25.5% of cases (193 limbs). <br/>Conclusion(s): This article provide a
historical review of the use, outcomes and complications of HUV. Even
though it is no longer commercially available, the knowledge of this type
of substitute still remains inspirational for the development of
innovative vascular conduits and fundamental for the new generations of
physician both in diagnostics and in the management of
complications.<br/>Copyright &#xa9; 2020 Elsevier Masson SAS

<26>
Accession Number
2007104410
Title
Comparison by real-time hemodynamic and cardiac efficiency monitoring of
sufentanil-midazolam and sevoflurane for anesthesia induction in children
undergoing cardiac surgery: A prospective randomized study.
Source
Heart Surgery Forum. 22 (1) (pp E38-E44), 2019. Date of Publication:
February 2019.
Author
Han D.; Liu Y.-G.; Pan S.-D.; Luo Y.; Li J.; Ou-Yang C.
Institution
(Han, Pan, Ou-Yang) Departments of Anesthesia
(Luo) Cardiac Surgery
(Li) Clinical Physiology Laboratory, Capital Institute, Pediatrics
Affiliated Children's Hospital, Beijing, China
(Han, Liu, Ou-Yang) Anesthesia Center, Capital Medical University
Affiliated Beijing Anzhen Hospital, Beijing, China
Publisher
Forum Multimedia Publishing LLC (E-mail: motis@cjp.com)
Abstract
Background: Intravenous sufentanil-midazolam and inhalational sevoflurane
are widely used for anesthetic induction in children undergoing cardiac
surgery. However, knowledge about their effects on hemodynamics and
cardiac efficiency remains limited due largely to the lack of direct
monitoring method. We used a minimally invasive technique, the pressure
recording analytical method (PRAM), to directly monitor hemodynamics and
cardiac efficiency, and compared the effects of the two anesthetic
regimens in children undergoing ventricular septal defect repair.
<br/>Method(s): Forty-four children (2.3 +/- 0.9 years) were randomized
into two groups to receive either intravenous sufentanil (1 mug/kg) and
midazolam (0.2 mg/kg) (Group SM) or 2.0 MAC sevoflurane (Group S) to
complete induction after sedation was obtained with 2.0 MAC sevoflurane.
Systemic hemodynamic data recorded by PRAM included heart rate (HR),
systolic (SBP) and mean (MBP) blood pressure, stroke volume index (SVI),
cardiac index (CI), systemic vascular resistance index (SVRI), the maximal
slope of systolic upstroke (dp/dt<inf>max</inf>) and cardiac cycle
efficiency (CCE) after sedation obtained; 1, 2, and 5 minutes after
induction achieved; 1, 2, 5, and 10 minutes after intubation.
<br/>Result(s): HR and SVRI showed a decrease in Group SM but an increase
in Group S (P<inf>time*group</inf> < 0.0001) in the study period. SVI and
CCE showed an increase in Group SM but a decrease in Group S
(P<inf>time*group</inf> < 0.0001). SBP, MBP, and CI were related to time
after polynomial transformation, showing an increase after intubation in
Group SM but a decrease in Group S (P<inf>time2*group</inf> < 0.0001).
<br/>Conclusion(s): PRAM provides meaningful and direct monitoring of
hemodynamic parameters as well as cardiac efficiency during the dynamic
period of anesthetic induction in children undergoing cardiac surgery. As
compared to inhalational sevoflurane, intravenous sufentanil-midazolam
exerts more favorable effects on systemic hemodynamics and cardiac
efficiency during anesthetic induction in this group of
patients.<br/>Copyright &#xa9; 2019 Forum Multimedia Publishing, LLC

<27>
Accession Number
623825596
Title
Health-related quality of life in adult heart-transplant recipients-a
systematic review.
Source
Herz. 45 (5) (pp 475-482), 2020. Date of Publication: 01 Aug 2020.
Author
Tackmann E.; Dettmer S.
Institution
(Tackmann, Dettmer) Institute of Medical Sociology and Rehabilitation
Science, Charite - Universitatsmedizin Berlin, Chariteplatz 1, Berlin
10117, Germany
Publisher
Springer Medizin (E-mail: kundenservice@springermedizin.de)
Abstract
Background: Health-related quality of life is a multidimensional concept
to assess the impact of medical interventions from an individual
perspective. This concept is important to evaluate benefits of heart
transplantation. This systematic review was conducted to determine (1)
posttransplant health-related quality of life in heart transplantation
patients and (2) influencing factors of health-related quality of life.
<br/>Method(s): A systematic review of cross-sectional, prospective and
mixed methods studies published from November 2007 to November 2017 was
conducted on PsycINFO, PSYNDEX and PubMed using a combination of the
keywords heart transplantation, heart transplantation patient, quality of
life, and health-related quality of life. <br/>Result(s): A total of 14
studies with a cross-sectional design, 6 studies with a prospective design
and 2 mixed-methods studies were identified. The stability of
health-related quality of life up to 10 years after transplantation has
been reported. Most often generic scales, such as SF-36 (8) and
WHOQoL-BREF (7) were used for data collection. Demoralization, depression,
pain, gastrointestinal symptoms, sexual dysfunction, and poor oral health
influence health-related quality of life negatively, whereas social and
family support have a positive impact. <br/>Conclusion(s): Although
health-related quality of life is positively influenced by
transplantation, further research regarding gender differences is needed.
Disease-specific scales were rarely used.<br/>Copyright &#xa9; 2018,
Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

<28>
Accession Number
2007236979
Title
Sutureless versus transcatheter aortic valves in elderly patients with
aortic stenosis at intermediate risk: A multi-institutional study.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Muneretto C.; Solinas M.; Folliguet T.; Di Bartolomeo R.; Repossini A.;
Laborde F.; Rambaldini M.; Santarpino G.; Di Bacco L.; Fischlein T.
Institution
(Muneretto, Repossini, Di Bacco) University of Brescia, Brescia, Italy
(Solinas) Monasterio Foundation Heart Hospital, Massa, Italy
(Folliguet) Centre Hospitalo-universitaire Brabois ILCV, Vandoeuvre les
Nancy, France
(Di Bartolomeo) University of Bologna, Bologna, Italy
(Laborde) Institut Mutualiste Montsouris, Paris, France
(Rambaldini) Carlo Poma Hospital of Mantova, Mantova, Italy
(Santarpino, Fischlein) Universitatsklinik der Paracelsus Medizinischen
Privatuniversitat, Nuremberg, Germany
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: This multi-institutional study compares the long-term outcome
of elderly patients with severe aortic stenosis and an intermediate risk
profile undergoing sutureless versus transcatheter aortic valve
implantation. <br/>Method(s): From 2008 to 2015, 967 elderly patients (>75
years) with intermediate risk (Society of Thoracic Surgeons score 4%-8%)
and isolated aortic stenosis were included in the study (sutureless valve
= 481; transcatheter aortic valve implantation = 486). After propensity
score matching, 2 matched groups of 291 patients were obtained.
Transcatheter valves implanted in patients were the CoreValve (Medtronic,
Minneapolis, Minn), Edwards SAPIEN-XT (Edwards Lifesciences, Irvine,
Calif), and Acurate-TA (Symetis, Lausanne, Switzerland). Primary end
points included all-cause death at 30 days and 5 years. Secondary end
points included early and 5-year incidence of composite adverse events
(major adverse cardiovascular events: all-cause death, stroke, pacemaker
implant, myocardial infarction, paravalvular leak >=II, and reoperation).
<br/>Result(s): After matching, there were no substantial differences
between groups. The 30-day mortality was significantly lower in the
sutureless valve group (sutureless valve = 1.7% vs transcatheter aortic
valve implantation = 5.5%; P =.024) and the rate of permanent pacemaker
implantation (sutureless valve = 5.5% vs transcatheter aortic valve
implantation = 10.7%, P =.032). Stroke/transient ischemic attack
cumulative incidence at 5 years was 1.4% in the sutureless valve group and
5.3% in the transcatheter aortic valve implantation group (P =.010). The
incidence of perivalvular leak grade II or greater was 1.3% in the
sutureless valve group and 9.8% in the transcatheter aortic valve
implantation group (P <.001). At 60 months follow-up, the all-cause death
rate was lower in the sutureless valve group than in the transcatheter
aortic valve implantation group (sutureless valve = 16.1% +/- 4.1% vs
transcatheter aortic valve implantation = 28.9% +/- 5.3%, P =.006), and
the major adverse cardiovascular event rate was lower in the sutureless
valve group (sutureless valve = 23.5% +/- 4.1% vs transcatheter aortic
valve implantation = 39.0% +/- 5.6%, P =.002). Multivariable Cox
regression identified transcatheter aortic valve implantation as an
independent predictor for 5-year mortality and major adverse
cardiovascular events (hazard ratio, 1.86; confidence interval, 1.09-3.18;
P =.022) (hazard ratio, 1.73; confidence interval, 1.13-2.73; P =.010).
<br/>Conclusion(s): Sutureless valves improved the outcomes of aortic
stenosis in elderly patients with an intermediate risk profile when
compared with transcatheter aortic valve implantation. The use of
transcatheter aortic valve implantation in this subset population should
be evaluated in further controlled randomized trials with sutureless valve
use in a comparative cohort.<br/>Copyright &#xa9; 2020 The American
Association for Thoracic Surgery

<29>
Accession Number
2005720677
Title
Clinical risk model for predicting 1-year mortality after transcatheter
aortic valve replacement.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2020.
Date of Publication: 2020.
Author
Yamamoto M.; Otsuka T.; Shimura T.; Yamaguchi R.; Adachi Y.; Kagase A.;
Tokuda T.; Yashima F.; Watanabe Y.; Tada N.; Naganuma T.; Araki M.;
Yamanaka F.; Mizutani K.; Tabata M.; Watanabe S.; Sato Y.; Ueno H.; Takagi
K.; Higashimori A.; Shirai S.; Hayashida K.
Institution
(Yamamoto, Shimura, Yamaguchi, Adachi) Department of Cardiology, Toyohashi
Heart Center, Toyohashi, Japan
(Yamamoto, Kagase, Tokuda) Department of Cardiology, Nagoya Heart Center,
Nagoya, Japan
(Otsuka) Department of Hygiene and Public Health, Nippon Medical School,
Tokyo, Japan
(Otsuka) Center for Clinical Research, Nippon Medical School Hospital,
Tokyo, Japan
(Yashima) Department of Cardiology, Saiseikai Utsunomiya Hospital,
Tochigi, Japan
(Yashima, Hayashida) Department of Cardiology, Keio University School of
Medicine, Tokyo, Japan
(Watanabe) Department of Cardiology, Teikyo University School of Medicine,
Tokyo, Japan
(Tada) Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan
(Naganuma) Department of Cardiology, New Tokyo Hospital, Chiba, Japan
(Araki) Department of Cardiology, Saiseikai Yokohama City Eastern
Hospital, Yokohama, Japan
(Yamanaka) Department of Cardiology, Syonan Kamakura General Hospital,
Kamakura, Kanagawa, Japan
(Mizutani) Department of Cardiovascular Medicine, Osaka City University
Graduate School of Medicine, Osaka, Japan
(Tabata, Watanabe) Department of Cardiovascular Surgery, Tokyo Bay
Urayasu-Ichikawa Medical Center, Chiba, Japan
(Sato) Department of Preventive Medicine and Public Health, Keio
University, Minato, Japan
(Ueno) Department of Cardiology, Toyama University Hospital, Toyama, Japan
(Takagi) Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan
(Higashimori) Department of Cardiology, Kishiwada Tokushukai Hospital,
Osaka, Japan
(Shirai) Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objectives: Estimating 1-year life expectancy is an essential factor when
evaluating appropriate indicators for transcatheter aortic valve
replacement (TAVR). <br/>Background(s): It is clinically useful in
developing a reliable risk model for predicting 1-year mortality after
TAVR. <br/>Method(s): We evaluated 2,588 patients who underwent TAVR using
data from the Optimized CathEter vAlvular iNtervention (OCEAN) Japanese
multicenter registry from October 2013 to May 2017. The 1-year clinical
follow-up was achieved by 99.5% of the entire population (n = 2,575).
Patients were randomly divided into two cohorts: the derivation cohort (n
= 1,931, 75% of the study population) and the validation cohort (n = 644).
Considerable clinical variables including individual patient's
comorbidities and frailty markers were used for predicting 1-year
mortality following TAVR. <br/>Result(s): In the derivation cohort, a
multivariate logistic regression analysis demonstrated that sex, body mass
index, Clinical Frailty Scale, atrial fibrillation, peripheral artery
disease, prior cardiac surgery, serum albumin, renal function as estimated
glomerular filtration rate, and presence of pulmonary disease were
independent predictors of 1-year mortality after TAVR. Using these
variables, a risk prediction model was constructed to estimate the 1-year
risk of mortality after TAVR. In the validation cohort, the risk
prediction model revealed high discrimination ability and acceptable
calibration with area under the curve of 0.763 (95% confidence interval,
0.728-0.795, p <.001) in the receiver operating characteristics curve
analysis and a Hosmer-Lemeshow chi² statistic of 5.96 (p =.65).
<br/>Conclusion(s): This risk prediction model for 1-year mortality may be
a reliable tool for risk stratification and identification of adequate
candidates in patients undergoing TAVR.<br/>Copyright &#xa9; 2020 The
Authors. Catheterization and Cardiovascular Interventions published by
Wiley Periodicals LLC.

<30>
Accession Number
2005484465
Title
Systematic review of viscoelastic testing (TEG/ROTEM) in obstetrics and
recommendations from the women's SSC of the ISTH.
Source
Journal of Thrombosis and Haemostasis. 18 (8) (pp 1813-1838), 2020. Date
of Publication: 01 Aug 2020.
Author
Amgalan A.; Allen T.; Othman M.; Ahmadzia H.K.
Institution
(Amgalan) Georgetown University School of Medicine, Washington, DC, United
States
(Allen) Department of Anesthesiology, Duke University Hospital, Durham,
NC, United States
(Othman) Department of Biomedical and Molecular Sciences, School of
Medicine, Queen's University, Kingston, ON, Canada
(Othman) School of Baccalaureate Nursing, St. Lawrence College, Kingston,
ON, Canada
(Ahmadzia) Department of Obstetrics and Gynecology, Division of Maternal
Fetal Medicine, The George Washington University School of Medicine and
Health Sciences, Washington, DC, United States
Publisher
Blackwell Publishing Ltd
Abstract
Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are
point-of-care viscoelastic devices that use whole blood samples to assess
coagulation and fibrinolysis. These devices have been studied extensively
in cardiac surgery, but there is limited robust evidence supporting its
use in obstetrics. The hesitancy toward its routine use in obstetrics may
be due to the current lack of randomized controlled trials and large
observational studies. The study aims to systematically review studies
that investigated TEG/ROTEM use in pregnancy or peripartum, and to provide
recommendations for future studies to fill current research gaps. We
performed a systematic review of studies on viscoelastic testing in
obstetrics. Included studies were original research, used TEG or ROTEM
during pregnancy or peripartum, and published in English. Ninety-three
studies, spanning 31 years from 1989 to 2020 and with a total of 32,817
participants, were included. Sixty-two (66.7%) of the studies used TEG and
31 (33.3%) used ROTEM. To date, there are a total of two randomized
controlled trials on TEG/ROTEM use in obstetrics. ROTEM may be used to
guide transfusion therapy for postpartum hemorrhage. TEG and ROTEM can
detect the hypercoagulable changes associated with pregnancy. Variability
between study protocols and results suggests the need for future large
prospective high-quality studies with standardized protocols to
investigate the utility of TEG/ROTEM in assessing risk for thrombosis and
hemorrhage as well as in guiding prophylaxis and treatment in obstetric
patients. This review identifies the gaps and provides concrete
recommendations for future studies to fill those gaps.<br/>Copyright
&#xa9; 2020 International Society on Thrombosis and Haemostasis

<31>
Accession Number
2004388861
Title
Concomitant atrial fibrillation ablation in patients undergoing coronary
artery bypass and cardiac valve surgery.
Source
Journal of Cardiovascular Electrophysiology. 31 (8) (pp 2172-2178), 2020.
Date of Publication: 01 Aug 2020.
Author
Churyla A.; Desai A.; Kruse J.; Cox J.; McCarthy P.
Institution
(Churyla, Desai, Kruse, Cox, McCarthy) Division of Cardiac Surgery,
Department of Surgery, Northwestern Medicine Bluhm Cardiovascular
Institute, Northwestern Memorial Hospital, Chicago, IL, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Surgical ablation of atrial fibrillation (AF) in conjunction with other
cardiac surgery is now a class I guideline recommendation. Multiple
studies have demonstrated that the concomitant surgical ablation of AF can
be performed safely and effectively during valve and coronary artery
bypass grafting (CABG) resulting in a return to sinus rhythm
postoperatively and improved long-term results. However, the surgical
ablation of AF at the time of other cardiac surgery is performed less
often than it should be, especially in patients undergoing CABG and aortic
valve surgery. Randomized-controlled trials designed to determine the
effect of treating AF concomitantly with other cardiac surgical procedures
have lacked long-term follow up, but multiple, large observational studies
have demonstrated an improved quality of life, a decrease in long-term
strokes, and improved late survival in patients who undergo AF ablation.
However, the potential survival benefit of concomitant AF ablation was not
addressed by either the Society of Thoracic Surgery or American
Association for Thoracic Surgery guideline committees. Left atrial
appendage closure is an important part of the surgical ablation of AF as
it significantly reduces the long-term risk of stroke following cardiac
surgery and improves the success of AF treatment. In this study, we update
the electrophysiology and surgical community on the recommended surgical
techniques for AF ablation and its effect on perioperative morbidity,
perioperative mortality, as well as its long-term effects on stroke,
quality of life, and survival.<br/>Copyright &#xa9; 2020 Wiley
Periodicals, Inc.

<32>
Accession Number
632488374
Title
Quality of life measured by EQ-5D at different treatment time points for
coronary artery disease: protocol for a systematic review and
meta-analysis.
Source
BMJ open. 10 (7) (pp e039311), 2020. Date of Publication: 29 Jul 2020.
Author
Lum E.; McCreanor V.; Luo N.; Graves N.
Institution
(Lum, Graves) Health Services & Systems Research, Duke-NUS Medical School,
Singapore
(Lum) School of Clinical Sciences, Queensland University of Technology,
Brisbane, QLD, Australia
(McCreanor) Metro North Hospital and Health Service, Royal Brisbane and
Women's Hospital, Brisbane, QLD, Australia
(McCreanor) Australian Centre for Health Services Innovation, Queensland
University of Technology, Brisbane, QLD, Australia
(Luo) Saw Swee Hock School of Public Health, National University of
Singapore, Singapore
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Cardiovascular disease is estimated to affect 423million
people globally. It caused 18million deaths in 2017 and is projected to
cost US$1trillion by 2030 worldwide. Coronary artery disease (CAD) is the
most common type of cardiovascular disease; CAD treatments can affect
patients' quality of life. Valuations of quality of life or health
utilities are important for economic evaluations to ascertain relative
health benefit when comparing treatments, and can be expected to change
for individuals over time. The purpose of this systematic review is to
estimate the quality of life of patients with CAD reported through the
EuroQol 5 Dimension (EQ-5D) questionnaire, from short to longer term time
points following different treatments. METHODS AND ANALYSIS: PubMed,
Embase, Web of Science, the Cochrane Database of Systematic Reviews and
the EuroQol website will be systematically searched from January
2003-March 2020. Published, peer-reviewed, English language studies
assessing quality of life of patients with CAD using the EQ-5D will be
included. One researcher will conduct the search; two researchers will
independently screen titles and abstracts for potential inclusion. Full
texts of potentially eligible studies will be retrieved for a second round
of independent screening against inclusion and exclusion criteria by two
researchers. The final list of included studies will be assessed for risk
of bias using the RoB 2 and Risk Of Bias In Non-randomized Studies - of
Interventions (ROBINS-I) tools for randomised and non-randomised studies,
respectively. Data extraction will be done by one researcher, with data
extraction for a random 10% of included studies checked by a second
researcher. Mean utility weights for individual studies will be combined
using random effects model meta-analyses. A model will be run separately
for each time point and treatment. Treatment time points of interest
include baseline, 30 days, 6 months, 12-24 months and more than 24 months.
Subgroup analysis of patients with diabetes who received interventional
treatments-coronary artery bypass graft or percutaneous coronary
intervention with or without stents, will be conducted for the same
selected time points. ETHICS AND DISSEMINATION: Ethics approval is not
required for systematic reviews. Results of the review will be
disseminated via publication in a peer-reviewed journal.<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.

<33>
Accession Number
632485643
Title
The Effect of Different Types of Mechanical Circulatory Support on
Mortality of Patients after Adult Cardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
The heart surgery forum. 23 (4) (pp E537-E545), 2020. Date of Publication:
27 Jul 2020.
Author
Guan Z.; Guan X.; Gu K.; Li Y.; Lin J.; Zhou W.; Xu M.; Song C.; Zhang Z.;
Wan F.
Institution
(Guan) Peking University Third Hospital, Beijing, China
(Guan) Peking University, Beijing, China
(Gu, Lin, Zhou, Zhang) Peking University Third Hospital, Beijing, China
(Li) Beijing University of Technology, Beijing, China
(Xu) Department of Cardiology, Peking University Third Hospital, NHC Key
Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides,
Beijing, China
(Song) Department of Orthopedics, Peking University Third Hospital,
Beijing, China
(Wan) Shanghai East Hospital, Tongji University, Shanghai, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Sample size may limit the ability of individual studies to
detect differences in clinical outcomes between extracorporeal membrane
oxygenation (ECMO) alone and ECMO plus intra-aortic balloon pump (IABP)
after adult cardiac surgery. Therefore, we undertook a meta-analysis of
the best evidence available on the comparison of clinical outcomes of ECMO
alone and ECMO plus IABP after adult cardiac surgery. <br/>METHOD(S):
PubMed, EMBASE, Web of Science, and Cochrane Center Registry of Controlled
Trials were searched for studies comparing the use of ECMO alone and ECMO
plus IABP after adult cardiac surgery. A meta-analysis and a sensitivity
analysis were conducted. <br/>RESULT(S): Among the 472 screened articles,
24 studies (1302 cases of ECMO plus IABP and 1603 cases of ECMO) were
included. A significant relationship between patient risk profile and
benefits from IABP plus ECMO was found in terms of the 30-day mortality
(odds ratio [OR] 0.75; 95% confidence interval [CI] 0.62 to 0.91; P =
.004) with postcardiotomy shock (PCS). However, ECMO alone was associated
with lower in-hospital mortality (OR 1.75; 95% CI 1.06 to 3.01; Z = 2.19;
P = .03) compared with ECMO plus IABP without PCS. <br/>CONCLUSION(S):
Pooled data show that patients receiving IABP plus ECMO with PCS have
lower 30-day mortality than those receiving ECMO also, which in turn show
higher 30-day mortality in patients with IABP plus ECMO without PCS.
Further randomized studies are warranted to corroborate these
observational data.

<34>
Accession Number
2007321127
Title
A systematic review of radiological and histological findings of septic
myocardial calcifications.
Source
Journal of Forensic and Legal Medicine. 74 (no pagination), 2020. Article
Number: 102026. Date of Publication: August 2020.
Author
Cappelletti S.; Piacentino D.; Ciallella C.
Institution
(Cappelletti, Ciallella) Department of Anatomical, Histological, Forensic
Medicine and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
(Cappelletti) State Police Health Service Department, Ministry of
Interior, Rome, Italy
(Piacentino) Department of Psychiatry, Central Hospital, Sanitary Agency
of South Tyrol, Bolzano-Bozen, Italy
Publisher
Churchill Livingstone
Abstract
Myocardial calcification is a life-threatening condition that is a
recognised complication of ischaemic heart disease, cardiac surgery,
rheumatic fever, myocarditis and sepsis. Only sparse data, reporting the
clinical symptoms, the anatomo-pathological findings, the imaging findings
have been published and no exhaustive analysis of all these factors exists
in literature. To date, there have been 26 published cases in the medical
literature in which myocardial calcifications is the consequence of a
septic status. In this review, we will describe the main imaging and
histological findings, with particular attention to the known and
hypothesized mechanisms of myocardial calcifications. The results of this
study may help clinicians and forensic pathologists to identify possible
unrecognized cases and inspire the development of an international
registry by which to coordinate further research.<br/>Copyright &#xa9;
2020 Elsevier Ltd and Faculty of Forensic and Legal Medicine

<35>
Accession Number
2007294820
Title
Extended antiplatelet therapy with clopidogrel alone versus clopidogrel
plus aspirin after completion of 9- to 12-month dual antiplatelet therapy
for acute coronary syndrome patients with both high bleeding and ischemic
risk. Rationale and design of the OPT-BIRISK double-blinded,
placebo-controlled randomized trial.
Source
American Heart Journal. 228 (pp 1-7), 2020. Date of Publication: October
2020.
Author
Li Y.; Jing Q.; Wang B.; Wang X.; Li J.; Qiao S.; Chen S.; Angiolillo
D.J.; Han Y.
Institution
(Li, Jing, Wang, Wang, Li, Han) Department of Cardiology, General Hospital
of Northern Theater Command, Shenyang, China
(Qiao) Fu Wai Hospital of Chinese Academy of Medical Science, Beijing,
China
(Chen) Nanjing First Hospital of Nanjing Medical University, Nanjing,
China
(Angiolillo) University of Florida College of Medicine-Jacksonville,
Jacksonville, FL, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor
is the cornerstone for prevention ischemic events in patients with acute
coronary syndromes (ACS) and undergoing percutaneous coronary
intervention. However, the optimal antiplatelet strategy for ACS patients
with both high bleeding and high ischemic risks is unclear. Study design:
The OPT-BIRISK trial is a multicenter, double-blinded, placebo-controlled
randomized study designed to test the superiority of extended antiplatelet
therapy with clopidogrel monotherapy compared with aspirin and clopidogrel
for reduction of bleeding events in ACS patients with both high bleeding
and high ischemic risks ("bi-risk"). A total of 7,700 patients who
completed 9- to 12-month dual antiplatelet therapy after new-generation
drug-eluting stent implantation for the treatment of ACS will be
randomized to receive clopidogrel monotherapy or aspirin plus clopidogrel
for 9 months followed by aspirin monotherapy for 3 months. The primary end
point is Bleeding Academic Research Consortium type 2, 3, or 5 bleedings
at 9 months after randomization. The key secondary end point is major
adverse cardiac and cerebral events at 9 months after randomization,
defined as a composite of all-cause death, myocardial infarction, stroke,
or coronary artery revascularization. <br/>Conclusion(s): OPT-BIRISK is
the first large-scale randomized trial aimed to explore the optimal
antiplatelet strategy for bi-risk ACS patients after percutaneous coronary
intervention in current clinical practice. The results will add evidence
regarding de-escalation antiplatelet therapy for patients at special
risk.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<36>
Accession Number
2007156612
Title
Efficacy of tolvaptan for fluid management after cardiovascular surgery: A
systematic review and meta-analysis of randomized control trials.
Source
Experimental and Therapeutic Medicine. 20 (3) (pp 2585-2592), 2020. Date
of Publication: September 2020.
Author
Jiang W.; Li X.; Meng Z.; Chen H.; Li J.; Wang J.; Zhao X.
Institution
(Chen, Jiang, Li, Li, Wang, Zhao) Department of Cardiology, Third Xiangya
Hospital of Central South University, 138 Tongzipo Road, Changsha, Hunan
410013, China
(Meng, Chen) Department of Cardiology, First Affiliated Hospital of
Kunming Medical University, Kunming, Yunnan 660034, China
Publisher
Spandidos Publications (10 Vriaxidos Street, Athens 116 10, Greece.
E-mail: subscriptions@spandidos-publications.com)
Abstract
The purpose of this study was to systematically search the literature and
analyze evidence from randomized controlled trials (RCTs) comparing
tolvaptan with conventional diuretics for postoperative fluid management
in cardiac surgery patients. An electronic search of PubMed, Scopus,
BioMed Central, CENTRAL (Cochrane Central Register of Controlled Trials)
and Google scholar databases was carried out up to 1st December 2019. Four
RCTs were included. Tolvaptan was co-administered with conventional
diuretics in all the studies. The mean postoperative urine output was
significantly greater in patients receiving tolvaptan as compared to
controls (MD=0.39; 95% CI: 0.17 to 0.61; P=0.006, I²=48%). Body
weight of patients on tolvaptan returned to pre-operative levels
significantly earlier (MD=-1.57; 95% CI: -2.48 to -0.66; P=0.007,
I²=50%). There was statistical significant difference in the
highest postoperative serum sodium levels (MD=2.34; 95% CI: -1.65 to 3.03;
p < 0.00001, I²=0%), lowest serum sodium levels (MD=2.05; 95%
CI: 1.41 to 2.68; p<0.00001, I²=0%) and mean serum sodium
levels (MD=1.69; 95% CI: 0.98 to 2.40; p<0.00001, I²=0%)
between the tolvaptan and control groups. Lowest serum potassium was
significantly higher with tolvaptan as compared to the control group
(MD=0.10; 95% CI: 0.01 to 0.18; P=0.03, I²=19%). There was no
significant difference in the length of ICU stay or incidence of
arrhythmias between the two groups. The quality of the included studies
was not high. Within the limitations of our study, our results indicate
that co-administration of tolvaptan with low dose of conventional
diuretics significantly increases urine output while maintaining
electrolyte balance in postoperative cardiac surgery patients. Faster
return of body weight to pre-operative levels is evident with tolvaptan.
Further high-quality RCTs are required to confirm this
evidence.<br/>Copyright &#xa9; 2020 Spandidos Publications. All rights
reserved.

<37>
Accession Number
2007012664
Title
Developing appropriateness criteria for pediatric vascular access.
Source
Pediatrics. 145 (pp S233-S242), 2020. Article Number: e20193474G. Date of
Publication: 01 Jun 2020.
Author
Ullman A.J.; Chopra V.; Brown E.; Kleidon T.; Cooke M.; Rickard C.M.;
Bernstein S.J.
Institution
(Ullman, Brown, Kleidon, Cooke, Rickard) Alliance for Vascular Access
Teaching and Research, Menzies Health Institute Queensland, Australia
(Ullman, Cooke, Rickard) School of Nursing and Midwifery, Griffith
University, Nathan, QLD, Australia
(Ullman, Kleidon) Queensland Children's Hospital, Brisbane, QLD, Australia
(Chopra) Divisions of Hospital Medicine, University of Michigan, Ann
Arbor, MI, United States
(Bernstein) General Medicine, Department of Internal Medicine, Medical
School, University of Michigan, Ann Arbor, MI, United States
(Chopra, Bernstein) Patient Safety Enhancement Program, Center for
Clinical Management Research, Veterans Affair Ann Arbor Healthcare System,
Ann Arbor, MI, United States
(Brown) Child Health Research Centre, Faculty of Medicine, University of
Queensland, Brisbane, QLD, Australia
Publisher
American Academy of Pediatrics (141 Northwest Point Blvd, P.O. Box 927,
Elk Grove Village IL 60007-1098, United States)
Abstract
OBJECTIVES: To describe the methodology undertaken to provide guidance on
the appropriateness, as well as inappropriateness, of vascular access
device selection, characteristics, and insertion technique for pediatric
patients. <br/>METHOD(S): The RAND Corporation-University of California,
Los Angeles Appropriateness Method was used. After definition of key terms
and scope, a systematic review of the pediatric vascular access literature
was undertaken. Clinical scenarios were developed to reflect the common
indications for vascular access across pediatric health care. These were
sectioned according to (1) device selection, (2) device characteristics,
and (3) insertion technique. An interdisciplinary panel of experts (N =
14) consisting of leading experts representing diverse pediatric clinical
disciplines including anesthesiology, cardiology and cardiac surgery,
critical care and emergency, general surgery, hematology and oncology,
hospital medicine, infectious disease, interventional radiology,
pharmacology, regional pediatric hospitalist, and vascular access nursing
specialties was convened. The scenarios were rated for appropriateness by
the panel over 2 rounds (1 [highly inappropriate] to 9 [highly
appropriate]). Round 1 ratings were completed anonymously and
independently by panel members and classified into 3 levels of
appropriateness: appropriate, uncertain, and inappropriate, or
disagreement. For round 2, panelists met in-person to discuss the round 1
ratings and independently rerated the indications. All indications were
reclassified into 3 levels of appropriateness or disagreement.
<br/>CONCLUSION(S): The RAND Corporation-University of California, Los
Angeles Appropriateness Method provides a rigorous, in-depth and
transparent methodology to develop the first appropriateness criteria for
the selection of pediatric vascular access devices in a range of patient
groups.<br/>Copyright DOI: https://doi.org/10.1542/peds.2019-3474G

<38>
Accession Number
2007327871
Title
Impact of advanced clinical fellowship training on future research
productivity and career advancement in adult cardiac surgery.
Source
Surgery (United States). (no pagination), 2020. Date of Publication: 2020.
Author
Wang H.; Bajaj S.S.; Williams K.M.; Pickering J.M.; Heiler J.C.;
Manjunatha K.; O'Donnell C.T.; Sanchez M.; Boyd J.H.
Institution
(Wang, Bajaj, Williams, Pickering, Heiler, Manjunatha, O'Donnell, Sanchez,
Boyd) Department of Cardiothoracic Surgery, Stanford University, Stanford,
CA, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Advanced clinical fellowships are important for training
surgeons with a niche expertise. Whether this additional training impacts
future academic achievement, however, remains unknown. Here, we
investigated the impact of advanced fellowship training on research
productivity and career advancement among active, academic cardiac
surgeons. We hypothesized that advanced fellowships do not significantly
boost future academic achievement. <br/>Method(s): Using online sources
(eg, department webpages, CTSNet, Scopus, Grantome), we studied adult
cardiac surgeons who are current faculty at accredited United States
cardiothoracic surgery training programs, and who have practiced only at
United States academic centers since 1986 (n = 227). Publicly available
data regarding career advancement, research productivity, and grant
funding were collected. Data are expressed as counts or medians.
<br/>Result(s): In our study, 78 (34.4%) surgeons completed an advanced
clinical fellowship, and 149 (65.6%) did not. Surgeons who pursued an
advanced fellowship spent more time focused on surgical training (P
<.0001), and those who did not were more likely to have completed a
dedicated research fellowship (P =.0482). Both groups exhibited similar
cumulative total publications (P =.6862), H-index (P =.6232), frequency of
National Institutes of Health grant funding (P =.8708), and time to
achieve full professor rank (P =.7099). After stratification by current
academic rank, or by whether surgeons pursued a dedicated research
fellowship, completion of an advanced clinical fellowship was not
associated with increased research productivity or accelerated career
advancement. <br/>Conclusion(s): Academic adult cardiac surgeons who
pursue advanced clinical fellowships exhibit similar research productivity
and similar career advancement as those who do not pursue additional
clinical training.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<39>
Accession Number
632487141
Title
Effects of Remote Ischemic Pre-Conditioning to Prevent Contrast-Induced
Nephropathy after Intravenous Contrast Medium Injection: A Randomized
Controlled Trial.
Source
Korean journal of radiology. (no pagination), 2020. Date of Publication:
27 Jul 2020.
Author
Belabbas D.; Koch C.; Chaudru S.; Lederlin M.; Laviolle B.; Le Pabic E.;
Boulmier D.; Heautot J.F.; Mahe G.
Institution
(Belabbas, Chaudru, Lederlin, Laviolle, Le Pabic, Boulmier, Heautot, Mahe)
Vascular Medicine Unit, Department of Radiology, University Hospital
Pontchaillou, Rennes, France
(Koch) Department of Radiodology, Toulouse University Hospital, Toulouse,
France
Publisher
NLM (Medline)
Abstract
OBJECTIVE: We aimed to assess the effects of remote ischemic
pre-conditioning (RIPC) on the incidence of contrast-induced nephropathy
(CIN) after an intravenous (IV) or intra-arterial injection of contrast
medium (CM) in patient and control groups. MATERIALS AND METHODS: This
prospective, randomized, single-blinded, controlled trial included 26
patients who were hospitalized for the evaluation of the feasibility of
transcatheter aortic valve implantation and underwent investigations
including contrast-enhanced computed tomography (CT), with Mehran risk
scores greater than or equal to six. All the patients underwent four
cycles of five minute-blood pressure cuff inflation followed by five
minutes of total deflation. In the RIPC group (n = 13), the cuff was
inflated to 50 mm Hg above the patient's systolic blood pressure (SBP); in
the control group (n = 13), it was inflated to 10 mm Hg below the
patient's SBP. The primary endpoint was the occurrence of CIN.
Additionally, variation in the serum levels of cystatin C was assessed.
<br/>RESULT(S): One case of CIN was observed in the control group, whereas
no cases were detected in the RIPC group (p = 0.48, analysis of 25
patients). Mean creatinine values at the baseline, 24 hours after
injection of CM, and 48 hours after injection of CM were 88 +/- 32
mumol/L, 91 +/- 28 mumol/L and 82 +/- 29 mumol/L, respectively (p = 0.73)
in the RIPC group, whereas in the control group, they were 100 +/- 36
mumol/L, 110 +/- 36 mumol/L, and 105 +/- 34 mumol/L, respectively (p =
0.78). Cystatin C values (median [Q1, Q3]) at the baseline, 24 hours after
injection of CM, and 48 hours after injection of CM were 1.10 [1.08, 1.18]
mg/L, 1.17 [0.97, 1.35] mg/L, and 1.12 [0.99, 1.24] mg/L, respectively (p
= 0.88) in the RIPC group, whereas they were 1.11 [0.97, 1.28] mg/L, 1.13
[1.08, 1.25] mg/L, and 1.16 [1.03, 1.31] mg/L, respectively (p = 0.93), in
the control group. <br/>CONCLUSION(S): The risk of CIN after an IV
injection of CM is very low in patients with Mehran risk score greater
than or equal to six and even in the patients who are unable to receive
preventive hyperhydration. Hence, the Mehran risk score may not be an
appropriate method for the estimation of the risk of CIN after IV CM
injection.<br/>Copyright &#xa9; 2020 The Korean Society of Radiology.

<40>
Accession Number
2007155751
Title
Analgesic efficacy of ultrasound guided bilateral transversus thoracis
muscle plane block in pediatric cardiac surgery: a randomized,
double-blind, controlled study.
Source
Journal of Clinical Anesthesia. 67 (no pagination), 2020. Article Number:
110002. Date of Publication: December 2020.
Author
Abdelbaser I.I.; Mageed N.A.
Institution
(Abdelbaser, Mageed) Department of Anesthesiology and Surgical Intensive
Care, Faculty of Medicine, Mansoura University, 2 El-Gomhouria St,
Mansoura 35516, Egypt
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Study objective: Adequate perioperative pain control in children
undergoing cardiac surgery is mandatory. Intravenous opioids and neuraxial
anesthetic techniques have been used but didn't gained any popularity. The
aim of the current study was to evaluate the analgesic efficacy of
transversus thoracis plane (TTP) block in pediatric cardiac surgery.
<br/>Design(s): Superiority, randomized, double-blind, controlled study.
<br/>Setting(s): Intraoperative and postoperative in intensive care unit
(ICU), Mansoura university children hospital, Egypt. <br/>Patient(s):
Eighty pediatric patients aged 2-12 years, undergoing cardiac surgery via
median sternotomy, were randomly allocated into 2 equal groups, the
control group and TTP block group. <br/>Intervention(s): Controlled group
received only fentanyl for perioperative analgesia, while TTP block was
performed in the intervention group (TTP group). Measurements: The primary
outcome measure was the total dose of fentanyl in the first postoperative
24 h after extubation, while the secondary outcome measures were
postoperative pain score, intraoperative fentanyl consumption, time to
extubation and ICU length of stay. <br/>Main Result(s): During the first
postoperative 24 h, total fentanyl consumption was significantly lower (P
< 0.05) in the TTP block group (9.892 +/- 3.397 mug/kg) than the control
group (18.500 +/- 3.401 mug/kg) and modified objective pain score was
significantly (P < 0.05) lower in TTP block group than the control group
all over the time. Total intraoperative fentanyl requirement was
significantly (P < 0.05) lower in TTP block group (8.27 +/- 1.170 mug/kg)
than the control group (13.72 +/- 1.186 mug/kg). <br/>Conclusion(s): The
use of TTP block decreased perioperative fentanyl consumption and reduced
postoperative pain intensity.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<41>
Accession Number
2005638997
Title
Safety and Benefit of Transesophageal Echocardiography in Liver Transplant
Surgery: A Position Paper From the Society for the Advancement of
Transplant Anesthesia (SATA).
Source
Liver Transplantation. 26 (8) (pp 1019-1029), 2020. Date of Publication:
01 Aug 2020.
Author
De Marchi L.; Wang C.J.; Skubas N.J.; Kothari R.; Zerillo J.; Subramaniam
K.; Efune G.E.; Braunfeld M.Y.C.; Mandel S.
Institution
(De Marchi) Department of Anesthesiology, MedStar-Georgetown University
Hospital, Washington, DC, United States
(Wang) US Anesthesia Partners - Washington, Seattle, WA, United States
(Wang) Swedish Heart and Vascular Institute, Seattle, WA, United States
(Skubas) Cardiothoracic Anesthesiology, Anesthesiology Institute Cleveland
Clinic, Cleveland, OH, United States
(Kothari) Department of Anesthesia and Perioperative Care, University of
California San Francisco, San Francisco, CA, United States
(Zerillo) Department of Anesthesiology, Perioperative and Pain Medicine,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Subramaniam) Department of Anesthesiology, University of Pittsburgh
School of Medicine, Pittsburgh, PA, United States
(Efune) Department of Anesthesiology and Pain Management, University of
Texas Southwestern Medical Center, Dallas, TX, United States
(Braunfeld) Department of Anesthesiology & Perioperative Medicine,
University of California Los Angeles, Los Angeles, CA, United States
(Mandel) Department of Anesthesia, University of Colorado, Aurora, CO,
United States
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
More anesthesiologists are routinely using transesophageal
echocardiography (TEE) during liver transplant surgery, but the effects on
patient outcome are unknown. Transplant anesthesiologists are therefore
uncertain if they should undergo additional training and adopt TEE. In
response to these clinical questions, the Society for the Advancement of
Transplant Anesthesia appointed experts in liver transplantation and who
are certified in TEE to evaluate all available published evidence on the
topic. The aim was to produce a summary with greater explanatory power
than individual reports to guide transplant anesthesiologists in their
decision to use TEE. An exhaustive search recovered 51 articles of
uncontrolled clinical observations. Topics chosen for this study were
effectiveness and safety because they were a major or minor topic in all
articles. The pattern of clinical use was a common topic and was included
to provide contextual information. Summarized observations showed
effectiveness as the ability to make a new and unexpected diagnosis and to
direct the choice of clinical management. These were reported in each
stage of liver transplant surgery. There were observations that TEE
facilitated rapid diagnosis of life-threatening conditions difficult to
identify with other types of monitoring commonly used in the operating
room. Real-time diagnosis by TEE images made anesthesiologists confident
in their choice of interventions, especially those with a high risk of
complications such as use of anticoagulants for intracardiac thrombosis.
The summarized observations in this systematic review suggest that TEE is
an effective form of monitoring with a safety profile similar to that in
cardiac surgery patients.<br/>Copyright &#xa9; 2020 by the American
Association for the Study of Liver Diseases.

<42>
Accession Number
2007179587
Title
Propensity-Matched Comparison of Evolut-R Transcatheter Aortic Valve
Implantation With Surgery in Intermediate-Risk Patients (from the SURTAVI
Trial).
Source
American Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Yakubov S.J.; Van Mieghem N.M.; Reardon M.J.; Serruys P.W.; Gada H.;
Mumtaz M.; Deeb G.M.; Kodali S.; George I.; Windecker S.; Kleiman N.;
Chetcuti S.J.; Sanchez C.; Dauerman H.L.; Li S.; Popma J.J.
Institution
(Yakubov, Sanchez) Riverside Methodist - Ohio Health, Columbus, OH, United
States
(Van Mieghem) Erasmus University Medical Center, Rotterdam, Netherlands
(Reardon, Kleiman) Houston-Methodist-Debakey Heart and Vascular Center,
Houston, TX, United States
(Serruys) International Centre for Circulatory Health, NHLI, Imperial
College London, London, United Kingdom
(Gada, Mumtaz) University of Pittsburgh Medical Center Pinnacle Heath,
Harrisburg, PA, United States
(Deeb, Chetcuti) University of Michigan Hospitals, Ann Arbor, MI, United
States
(Kodali, George) Structural Heart and Valve Center, Columbia University
Medical Center, New York, NY, United States
(Windecker) University Hospital Bern, Bern, Switzerland
(Dauerman) University of Vermont Medical Center, Burlington, VT, United
States
(Li) Medtronic, Minneapolis, MN, United States
(Popma) Beth Israel Deaconess Medical Center, Boston, MA, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
The SURTAVI trial demonstrated the noninferiority of transcatheter aortic
valve implantation (TAVI) to surgical aortic valve replacement (SAVR) in
patients with severe, symptomatic aortic stenosis at intermediate surgical
risk. Most TAVI patients received an early generation device which is no
longer commercially available. This analysis compares TAVI outcomes in
patients that received the Evolut R valve to those of similar patients
randomized to SAVR in the SURTAVI trial. The continued access study of
SURTAVI (CAS) enrolled 290 patients. Of them, 252 were implanted with the
23, 26, or 29 mm Evolut R device. Propensity-score matching between this
group and SURTAVI SAVR patients with annular diameter of 26 mm or less was
based on 22 clinical characteristics, resulting in 197 matched pairs for
analysis. The primary end point for comparison was the rate of all-cause
mortality or disabling stroke at 1-year. The mean age for TAVI and SAVR
patients in the propensity-score matched population was 79.1 years and
STS-PROM was 4.0 +/- 1.5% for TAVI and 3.9% +/- 1.3% for SAVR. The rate of
all-cause mortality or disabling stroke at 30-days significantly favored
TAVI (0.5% vs 5.1%; p = 0.006). At 1-year TAVI was numerically favored
(4.1% vs 8.2%; p = 0.082). In conclusion, compared with SAVR, TAVI using
Evolut R had a favorable 30-day safety profile, significantly better
hemodynamic performance, and a comparable 1-year rate of all-cause
mortality or disabling stroke, suggesting this may be a preferred
treatment for patients with severe, symptomatic aortic stenosis at
intermediate surgical risk.<br/>Copyright &#xa9; 2020

<43>
Accession Number
2007179403
Title
Drug eluting stents versus bare-metal stents in large coronary artery
revascularization; systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Changal K.H.; Mir T.; Khan S.; Nazir S.; Elzanatey A.; Meenakshisundaram
C.; Syed M.; Sheikh M.A.
Institution
(Changal, Nazir, Syed) Cardiovascular Medicine, University of Toledo
Health Sciences, United States
(Mir) Internal Medicine, Detroit Medical Center, Wayne State University,
United States
(Khan) Internal Medicine, Mercy St. Vincent medical Center, Toledo, OH,
United States
(Elzanatey, Meenakshisundaram) Internal Medicine, University of Toledo
Health Sciences, United States
(Sheikh) Cardiovascular Medicine and Interventional Cardiology, Promedica
Toledo Hospital, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: We aim to determine if drug eluting stents (DES) are better
than bare-metal stents (BMS) in large coronary artery (diameter >= 3 mm)
percutaneous coronary intervention (PCI). <br/>Background(s): DES have
become the standard of care for PCI in coronary artery disease (CAD).
However, the superiority of DES over BMS in large vessel CAD is not clear
and previous studies have shown conflicting results. <br/>Method(s):
Randomized controlled trials (RCTs) comparing outcomes of PCI with BMS and
DES for large vessel CAD were identified from the year 2000 to August
2019. The outcomes were studied individually and included all-cause
mortality, myocardial infarction (MI), target lesion revascularization
(TLR), and stent thrombosis. Aggregated odds ratio and 95% CI were
calculated using a random-effects model. <br/>Result(s): Eight RCTs were
included (4 with data for second-generation DES and 5 had data on
first-generation trials). Compared to BMS, second generation DES had a
significantly lower rate of all-cause mortality (2.4% vs. 3.9%, OR 0.74,
95% CI 0.56-0.98, P 0.04), TLR (3.5% vs. 8.6% OR 0.38 95% CI 0.28-0.53, P
< 0.001), and MI (2.1% vs. 2.9% OR 0.73 95% CI 0.53-1.0, P 0.05). The
difference in all-cause mortality was not seen with first-generation DES.
<br/>Conclusion(s): Newer DES are associated with a lower mortality, TLR,
and MI and thus should be preferred over BMS for large coronary artery
PCI.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<44>
Accession Number
2007179384
Title
Incidence and Prognostic Impact of Incomplete Revascularization Documented
by Coronary Angiography 1 Year After Coronary Artery Bypass Grafting.
Source
American Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Hattler B.; Grover F.L.; Wagner T.; Hawkins R.B.; Quin J.A.; Collins J.F.;
Bishawi M.; Almassi H.; Shroyer A.L.
Institution
(Hattler) Department of Medicine, Rocky Mountain Regional Veterans Affairs
Medical Center, Aurora, United States
(Hattler) Department of Medicine, University of Colorado School of
Medicine, Aurora, United States
(Grover) Department of Surgery, University of Colorado School of Medicine,
Aurora, United States
(Grover) Department of Surgery, Rocky Mountain Regional Veterans Affairs
Medical Center, Aurora, United States
(Wagner) Department of Veterans Affairs Palo Alto Health Economics
Resource Center, Palo Alto, United States
(Wagner) Department of Surgery, Stanford University, Stanford, United
States
(Hawkins) Department of Surgery, University of Virginia, Charlottesville,
United States
(Quin) Department of Surgery, Veterans Affairs Boston Healthcare System,
West Roxbury, United States
(Collins) Cooperative Studies Program Coordinating Center, Perry Point
Veterans Affairs Medical Center, Perry Point, United States
(Bishawi, Shroyer) Research and Development Office, Northport Veterans
Affairs Medical Center, Northport, United States
(Bishawi) Department of Surgery, Duke University, Durham, United States
(Almassi) Department of Surgery, Clement J. Zablocki Veterans Affairs
Medical Center, Milwaukee, United States
(Almassi) Department of Surgery, Medical College of Wisconsin, Milwaukee,
United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Complete revascularization (CR) at the time of coronary artery bypass
graft (CABG) surgery improves long-term cardiac outcomes. No studies have
previously reported angiographically confirmed CR rates post-CABG. This
study's aim was to assess the impact upon long-term outcomes of CR versus
incomplete revascularization (IR), confirmed by coronary angiography 1
year after CABG. Randomized On/Off Bypass Study patients who returned for
protocol-specified 1-year post-CABG coronary angiograms were included.
Patients with a widely patent graft supplying the major diseased artery
within each diseased coronary territory were considered to have CR.
Outcomes were all-cause mortality and major adverse cardiovascular events
(MACE; all-cause mortality, nonfatal myocardial infarction, repeat
revascularization) over the 4 years after angiography. Of the 1,276
patients, 756 (59%) had CR and 520 (41%) had IR. MACE was 13% CR versus
26% IR, p <0.001. This difference was driven by fewer repeat
revascularizations (5% CR vs 18% IR; p <0.001). There were no differences
in mortality (7.1% CR vs 8.1% IR, p = 0.13) or myocardial infarction (4%
in both). Adjusted multivariable models confirmed CR was associated with
reduced MACE (odds ratio 0.44, 95% confidence interval 0.33 to 0.58, p
<0.01), but had no impact on mortality. In conclusion, CR confirmed by
post-CABG angiography was associated with improved MACE but not mortality.
Repeat revascularization of patients with IR, driven by knowledge of the
research angiography results, may have ameliorated potential mortality
differences.<br/>Copyright &#xa9; 2020

<45>
Accession Number
2007179352
Title
Nitric oxide delivery during cardiopulmonary bypass reduces acute kidney
injury: A randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Kamenshchikov N.O.; Anfinogenova Y.J.; Kozlov B.N.; Svirko Y.S.; Pekarskiy
S.E.; Evtushenko V.V.; Lugovsky V.A.; Shipulin V.M.; Lomivorotov V.V.;
Podoksenov Y.K.
Institution
(Kamenshchikov, Anfinogenova, Kozlov, Svirko, Pekarskiy, Evtushenko,
Lugovsky, Shipulin, Podoksenov) Cardiology Research Institute, Tomsk
National Research Medical Center, Russian Academy of Sciences, Tomsk,
Russian Federation
(Kozlov, Svirko, Shipulin, Podoksenov) Department of Cardiovascular
Surgery, Siberian State Medical University, Tomsk, Russian Federation
(Lomivorotov) Department of Anesthesiology and Critical Care, Meshalkin
National Medical Research Center, Novosibirsk, Russian Federation
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: Acute kidney injury (AKI) is a serious complication of cardiac
surgery with cardiopulmonary bypass (CPB). The aim of this study was to
evaluate the effects of nitric oxide (NO) supplementation to the CPB
circuit on the development of cardiac surgery-associated AKI.
<br/>Method(s): This prospective randomized controlled study included 96
patients with moderate risk of renal complications who underwent elective
cardiac surgery with CPB. The study protocol was registered at
ClinicalTrials.gov (identifier NCT03527381). Patients were randomly
allocated to either NO supplementation to the CPB bypass circuit (NO
treatment group; n = 48) or usual care (control group; n = 48). In the NO
treatment group, 40-ppm NO was administered during the entire CPB period.
The primary outcome was the incidence of AKI. <br/>Result(s): NO treatment
was associated with a significant decrease in AKI incidence (10 cases
[20.8%] vs 20 cases [41.6%] in the control group; relative risk, 0.5; 95%
confidence interval, 0.26-0.95; P =.023) and a higher median urine output
during CPB (2.6 mL/kg/h [interquartile range (IQR), 2.1-5.08 mL/kg/h] vs
1.7 mL/kg/h [IQR, 0.80-2.50 mL/kg/h]; P =.0002). The median urinary
neutrophil gelatinase-associated lipocalin level at 4 hours after surgery
was significantly lower in the NO treatment group (1.12 ng/mL [IQR,
0.75-5.8 ng/mL] vs 4.62 ng/mL [IQR, 2.02-34.55 ng/mL]; P =.005). In the NO
treatment group, concentrations of NO metabolites were significantly
increased at 5 minutes postclamping, at 5 minutes after declamping, and at
the end of the operation. Concentrations of proinflammatory and
anti-inflammatory mediators and free plasma hemoglobin did not differ
significantly between the 2 groups. <br/>Conclusion(s): NO administration
in patients at moderate risk of renal complications undergoing elective
cardiac surgery with CPB was associated with a lower incidence of
AKI.<br/>Copyright &#xa9; 2020 The American Association for Thoracic
Surgery

<46>
Accession Number
2007179300
Title
Meta-analysis Comparing Transradial Versus Transfemoral Secondary Access
in Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Jhand A.; Apala D.R.; Dhawan R.; Katta N.; Aronow H.D.; Daniels M.J.;
Porter T.R.; Altin E.; Goldsweig A.M.
Institution
(Jhand, Dhawan, Katta, Porter, Goldsweig) Division of Cardiovascular
Medicine, University of Nebraska Medical Center, Omaha, NE, United States
(Apala) Department of Internal Medicine, Creighton University School of
Medicine, Omaha, NE, United States
(Aronow) Warren Alpert Medical School, Brown University, Lifespan
Cardiovascular Institute, Providence, RI, United States
(Daniels) Manchester Heart Centre, Manchester Royal Infirmary, Manchester
University NHS Foundation Trust, Manchester, United Kingdom
(Altin) Division of Cardiovascular Medicine, Yale University School of
Medicine, New Haven, CT, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Up to a quarter of vascular complications during transcatheter aortic
valve implantation (TAVI) result from secondary access via the femoral
artery (FA). The radial artery (RA) is increasingly used as an alternative
to the FA for secondary access in TAVI. Limited data exist on the outcomes
of RA secondary access versus FA secondary access. We therefore conducted
a systematic review and meta-analysis comparing secondary access sites.
PubMed, EMBASE, Scopus, Cochrane library and CINAHL were searched
systematically for studies comparing RA and FA as secondary access sites
for TAVI. Primary outcomes of interest were vascular complications and
major bleeding. Secondary outcomes included all-cause mortality, stroke
and myocardial infarction (MI). Risk ratio (RR), standardized mean
difference and corresponding 95% confidence intervals (CI) were calculated
using a random effects model. Six observational studies comprising 6,373
patients (RA: 1,514, FA: 4,859) met inclusion criteria. Secondary access
was utilized for aortography during valve deployment and to manage primary
access site complications. Procedural characteristics were similar in both
groups. RA was associated with a lower risk of major bleeding (RR: 0.51,
95% CI: 0.40 to 0.64, p <0.00001). No statistically significant difference
was observed in the incidence of overall vascular complications, however,
the risk of major vascular complications was lower with RA (RR: 0.45, 95%
CI: 0.32 to 0.63, p <0.00001). The incidence of stroke and all-cause
mortality was lower in RA, whereas no difference was observed in the risk
of MI. In conclusion, our meta-analysis suggests that RA secondary access
is associated with better outcomes for TAVI than FA.<br/>Copyright &#xa9;
2020 Elsevier Inc.

<47>
Accession Number
2007179215
Title
Prevalence and Cost of Managing Paediatric Cardiac Disease in Queensland.
Source
Heart Lung and Circulation. (no pagination), 2020. Date of Publication:
2020.
Author
Strange G.A.; Veerappan S.; Alphonso N.; Refeld S.; Simon S.; Justo R.
Institution
(Strange) School of Medicine, University of Notre Dame, Freemantle, WA,
Australia
(Strange) Department of Cardiology, Royal Prince Alfred Hospital, Sydney,
NSW, Australia
(Veerappan, Alphonso, Refeld, Justo) Queensland Children's Hospital,
Brisbane, Qld, Australia
(Veerappan, Alphonso, Justo) School of Medicine, University of Queensland,
Brisbane, Qld, Australia
(Simon) Hatter Institute for Cardiovascular Research in Africa, University
of Cape Town, Cape Town, South Africa
(Simon) Torrens University Australia, Adelaide, SA, Australia
Publisher
Elsevier Ltd
Abstract
Background: There is a paucity of contemporary information regarding the
prevalence and related health care expenditure of the most common cardiac
conditions in Australian children, including congenital heart disease
(CHD). <br/>Method(s): The 10 most common cardiac conditions managed by
Queensland Paediatric Cardiac Service during 2014-2015 were identified
from an electronic database: ventricular septal defect (VSD), pulmonary
stenosis, aortic stenosis, tetralogy of Fallot, atrioventricular septal
defect, transposition, Ebstein's anomaly, long QT syndrome, dilated
cardiomyopathy, and rheumatic carditis. Demographic data, clinic
attendance, investigational procedures, and therapeutic interventions were
extracted from the electronic health records to derive indicative
population estimates and direct health care expenditure relating to CHD.
<br/>Result(s): A total of 2,519 patients diagnosed with the 10 target
conditions were being actively managed, including 456 (18.1%) new-born and
787 prevalent cases (2.5/1,000 population) aged <5 years. A total of
12,180 (4.8/case) investigations were performed (6,169 echocardiographic
and 279 cardiac catheterisation procedures) costing $2.25 million/annum. A
further 5,326 clinic visits (2.1/case, 22% regional) were conducted at a
cost of $550,000/annum. A combined total of 804 catheter-based
interventions and surgical procedures were performed in 300 cases (11.9%)
at a cost of $13.6 million/annum. VSD (38.6% of cases) was the single
greatest contributor ($5.1 million/annum) to total combined direct
healthcare costs of $13.6 million/annum for the 2,519 patients.
<br/>Conclusion(s): These pilot data indicate a significant patient
population and health care burden imposed by CHD in Queensland. Future
initiatives to better quantify this burden, from an individual to health
system perspective, are urgently needed.<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)

<48>
Accession Number
2005711157
Title
Infective Endocarditis After Transcatheter Versus Surgical Aortic Valve
Replacement: A Meta-Analysis.
Source
Angiology. (no pagination), 2020. Date of Publication: 2020.
Author
Wang J.; Wang X.; Hou F.; Yuan W.; Dong R.; Wang L.; Shen H.; Zhou Y.
Institution
(Wang, Dong) Department of Cardiac Surgery, Beijing Anzhen Hospital
Capital Medical University, Beijing, China
(Wang, Yuan) Center for Cardiac Intensive Care, Beijing Anzhen Hospital
Capital Medical University, Beijing, China
(Wang, Shen, Zhou) Department of Cardiology, Beijing Anzhen Hospital,
Capital Medical University, Beijing, China
(Wang) Department of General Surgery, Chinese PLA general hospital,
Beijing, China
(Hou) Department of Cardiology, Qingdao Municipal Hospital, Qingdao, China
(Wang) Department of Epidemiology, Beijing Anzhen Hospital, Beijing
Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical
University, Beijing, China
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
We determined the incidence, clinical characteristics, and risk factors of
post-transcatheter aortic valve replacement (TAVR)-associated infective
endocarditis (IE). We compared the incidence of IE after TAVR versus after
surgical aortic valve replacement (SAVR). The incidence rate of IE 1-year
post-TAVR was 0.9% (95% confidence interval [CI]: 0.8-1.0). Transcatheter
aortic valve replacement was associated with significantly reduced IE
incidence (incidence rate ratio: 0.69, 95% CI: 0.52-0.92, P =.011)
compared with SAVR. In patients with TAVR IE, the pooled in-hospital
mortality was 37.8% (95% CI: 32.4-43.3, I² = 54.9%). Pooled
adjusted hazard ratio (HR) revealed that peri-procedural peripheral artery
disease (HR: 4.02, 95% CI: 2.28-7.10, P <.0001), moderate or severe
residual aortic regurgitation (HR: 2.34, 95% CI: 1.53-3.59, P <.0001),
orotracheal intubation (HR: 2.13, 95% CI: 1.19-3.82, P =.011), and male
gender (HR: 1.70, 95% CI: 1.47-1.97, P <.0001) were risk factors for
post-TAVR IE. Post-TAVR IE is a life-threatening complication often
resulting in in-hospital mortality. The current evidence-based
meta-analysis to identify risk factors may lead to the development of
effective preventive and therapeutic strategies for post-TAVR IE to
ultimately improve patient outcomes.<br/>Copyright &#xa9; The Author(s)
2020.

<49>
Accession Number
2005688398
Title
Discontinuation of anticoagulants after successful surgical ablation of
atrial fibrillation.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Lauritzen D.J.; Vodstrup H.J.; Christensen T.D.; Hald M.O.; Christensen
R.; Heiberg J.
Institution
(Lauritzen, Vodstrup, Christensen, Hald, Christensen, Heiberg) Department
of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Aarhus,
Denmark
(Lauritzen, Vodstrup, Christensen, Hald, Heiberg) Department of Clinical
Medicine, Aarhus University, Aarhus, Denmark
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: The decision of whether to continue oral anticoagulation
therapy (OAT) after successful surgical ablation of atrial fibrillation is
challenging, and current guidelines provide no specific recommendations on
whether or not it is safe to terminate OAT. Therefore, the aim of this
study was to assess long-term outcomes in patients who either did or did
not, receive OAT after surgical ablation of atrial fibrillation.
<br/>Method(s): In a prospective follow-up study, patients were included
if surgical ablation of atrial fibrillation concomitantly with other
cardiac surgery was done, between 2004 and 2018 at Aarhus University
Hospital, Denmark. After 12 months, OAT was discontinued if: (a) sinus
rhythm was documented by electrocardiogram, (b) atrial fibrillation was
absent on 5-day Holter monitoring, (c) CHADS<inf>2</inf> score <=2, and
(d) no other indications for OAT were present. Follow-up was ended in
April 2019. <br/>Result(s): A total of 560 patients underwent surgical
ablation of which 436 patients reached the baseline at 12 months; 286
patients received OAT, and 150 had OAT discontinued. Survival analysis
revealed no differences between the two groups (P =.723). Mean survival
time in the group receiving OAT was 5.3 +/- 3.3 years, compared to 5.1 +/-
3.0 years in the group where OAT was discontinued (P =.784). There was no
difference in major adverse cardiac and cerebrovascular events between the
two groups (P =.846). <br/>Conclusion(s): Discontinuation of OAT is safe
in patients with a CHADS<inf>2</inf> score <=2 following successful
surgical ablation and left atrial appendage occlusion. This conclusion
needs to be confirmed in randomized trials.<br/>Copyright &#xa9; 2020
Wiley Periodicals LLC

<50>
Accession Number
2005688347
Title
Sex-related differences in outcomes after coronary artery bypass surgery-A
patient-level pooled analysis of randomized controlled trials: rationale
and study protocol.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Gaudino M.; Alexander J.H.; Egorova N.; Kurlansky P.; Lamy A.; Bakaeen F.;
Hameed I.; Di Franco A.; Demetres M.; Robinson N.B.; Chikwe J.; Lawton
J.S.; Devereaux P.J.; Taggart D.P.; Flather M.; Reents W.; Boening A.;
Diegeler A.; Girardi L.N.; Fremes S.E.; Benedetto U.
Institution
(Gaudino, Hameed, Di Franco, Robinson, Girardi) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Alexander) Department of Medicine, Duke Clinical Research Institute, Duke
University Medical Center, Durham, NC, United States
(Egorova) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Kurlansky) Department of Surgery, Center for Innovation and Outcomes
Research, Columbia University Medical Center, New York, NY, United States
(Lamy, Devereaux) Department of Surgery, Population Health Research
Institute, McMaster University, Hamilton, ON, Canada
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Chikwe) Department of Cardiac Surgery in the Smidt Heart Institute at
Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Lawton) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University School of Medicine, Baltimore, MD, United States
(Taggart) Nuffield Department of Surgical Sciences, John Radcliffe
Hospital, University of Oxford, Oxford, United Kingdom
(Flather) Research and Development Unit, Norfolk and Norwich University
Hospitals NHS Foundation Trust, Norwich, United Kingdom
(Reents, Diegeler) Department Cardiac Surgery, Cardiovascular Center Bad
Neustadt/Saale, Bad Neustadt, Saale, Germany
(Boening) Department of Cardiovascular Surgery, Justus-Liebig University
Giesen, Giesen, Germany
(Fremes) Department of Surgery, Schulich Heart Centre Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, Canada
(Benedetto) Bristol Heart Institute, University of Bristol, Bristol,
United Kingdom
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Introduction: The impact of sex on the outcomes after coronary artery
bypass grafting (CABG) is controversial. The majority of CABG studies are
retrospectively collected clinical or registry data, women comprise only a
minority, and the reported findings represent the male predominated
cohort. This individual patient meta-analysis is aimed at evaluating
sex-related differences in outcomes after CABG using high quality data
from randomized controlled trials (RCTs). Methods and Analysis: A
systematic literature search will be performed to identify all CABG RCTs
(minimum follow-up: 5 years). Detailed specification for the minimum
deidentified patient records' data requirements will be provided to RCT
primary contact to request their deidentified data for pooling. The pooled
analysis will follow the prospective register of systematic reviews
(PROSPERO) and the preferred reporting items for systematic reviews and
meta-analyses for individual patient data systematic reviews (PRISMA-IPD)
recommendations and will compare sex-related outcomes after CABG. The main
hypothesis is that outcomes after CABG are worse in women than in men. We
will also test whether treatment effects for off-pump and the use of
multiple arterial grafts are present within each sex, and also, whether
there are differential treatment effects between sexes. The primary
endpoint will be a composite of all-cause mortality, myocardial
infarction, stroke, and repeat revascularization at long-term follow up.
Ethics and Dissemination: Ethics approval and participant consent for the
study will be obtained locally by each study team if needed. Data will be
disseminated and submitted to peer-reviewed scientific journals and
meetings irrespective of study outcome.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC

<51>
Accession Number
2005686839
Title
Comparison of colloid and crystalloid using goal-directed fluid therapy
protocol in non-cardiac surgery: a meta-analysis of randomized controlled
trials.
Source
Journal of Anesthesia. (no pagination), 2020. Date of Publication: 2020.
Author
Tyagi A.; Maitra S.; Bhattacharjee S.
Institution
(Tyagi, Maitra, Bhattacharjee) Department of Anaesthesiology, Pain
Medicine and Critical Care, All India Institute of Medical Sciences, Room
No: 5013, 5th Floor Teaching Block, New Delhi 110029, India
Publisher
Springer
Abstract
Purpose: A few randomized controlled trials (RCTs) have compared
crystalloid-based goal-directed fluid therapy (GDFT) with starch-based
GDFT in patients undergoing major surgical procedures with conflicting
results. In this meta-analysis, colloid-based GDFT was compared with
crystalloid-based GDFT. <br/>Method(s): In this meta-analysis, RCTs
comparing colloid- and crystalloid-based GDFT in patients undergoing
non-cardiac surgery were included. Binary outcomes were reported as risk
ratio (RR) and continuous outcomes were reported as mean difference (MD)
with 95% confidence interval (95% CI). PubMed, PubMed central, The
Cochrane Library database and EMBASE were searched for potentially
eligible trials from inception to 28 February 2020. <br/>Result(s): Data
of 2392 patients from nine RCTs were included in this meta-analysis.
Mortality at the longest available follow-up [RR (95% CI) 1.44 (0.88,
2.34); p = 0.15], postoperative kidney dysfunction [RR (95% CI) 1.07
(0.72, 1.60); p = 0.73], postoperative length of hospital stay [MD (95%
CI) - 0.29 (- 1.25, 0.66) d; p = 0.55], cardiovascular complications [RR
(95% CI) 1.20 (0.50, 2.88); p = 0.68], wound complications [RR (95% CI)
1.08 (0.76, 1.54); p = 0.66], pulmonary complications [RR (95% CI) 0.90
(0.71, 1.140); p = 0.40] and bleeding [RR (95% CI) 1.24 (0.77, 1.99); p =
0.37] were similar in both the groups. Postoperative major complications
were also similar between patients who received colloid and crystalloid
[RR (95% CI) 0.79 (0.48, 1.29); p = 0.34]. <br/>Conclusion(s): Colloids in
goal-directed fluid therapy protocol does not offer any benefit over
crystalloid-based goal-directed fluid therapy protocol in patients
undergoing major non-cardiac surgical procedure.<br/>Copyright &#xa9;
2020, Japanese Society of Anesthesiologists.

<52>
Accession Number
2005045412
Title
Percutaneous mitral valve repair for secondary mitral valve regurgitation:
A systematic review and meta-analysis.
Source
European Journal of Internal Medicine. 78 (pp 107-112), 2020. Date of
Publication: August 2020.
Author
Kumar A.; Al-khafaji J.; Shariff M.; Vaz I.P.; Adalja D.; Doshi R.
Institution
(Kumar, Shariff) Department of Critical Care, St John's Medical college
hospital, Bengaluru, Karnataka, India
(Al-khafaji, Doshi) Department of Internal Medicine, University of Nevada
Reno School of Medicine, Reno, NV, United States
(Vaz) Department of internal medicine, Jackson Memorial
Hospital/University of Miami, Florida, United States
(Adalja) GMERS Gotri Medical College, Gotri Medical Education and Research
Center, Vadodara, Gujarat, India
Publisher
Elsevier B.V.
Abstract
Background: The first two randomized control trials (RCTs) studying the
role of MitraClip in patients with secondary mitral regurgitation (MR) had
antagonizing results. We, therefore, performed an updated meta-analysis of
RCTs and propensity score-matched observational studies investigating the
role of MitraClips in patients with secondary MR. A novel method of Kaplan
Meier Curve reconstruction from derived individual patient data will be
used to compare the survival probability of control groups in COAPT and
MITRA HF trail, and hence, access inter-study heterogeneity.
<br/>Method(s): Medline and Cochrane databases was used for systematic
search. We used the Mantel-Haenszel method with a random-effect model to
calculate risk ratio (RR) with 95% confidence interval (CI) and inverse
variance method with a random-effect model to calculate the mean
difference (MD) with 95% confidence interval (CI). We used a fixed-effect
approach for meta-regression. <br/>Result(s): MitraClip reduced the risk
of all-cause mortality [RR: 0.72, CI: 0.55-0.95, P value = 0.02, I2 = 55%,
chi²P-value = 0.08] and readmission [RR: 0.62, CI: 0.42-0.92, P
value = 0.02, I² = 90%, chi²P-value<0.01] at two
years follow-up. There was no effect of MitraClip on change in
cardiovascular mortality and 6 m walking distance at 12 months follow-up.
Meta-regression indicated left ventricular end diastolic volume and age
among the factors affecting outcomes. Reconstructed Kaplan Meier curves
confirmed considerable heterogeneity among patients randomized in MITRA HF
and COAPT trial. <br/>Conclusion(s): The present meta-analysis confirms
the beneficial role of percutaneous mitral valve repair in patients with
secondary MR. However, all the results were associated with considerable
heterogeneity.<br/>Copyright &#xa9; 2020 European Federation of Internal
Medicine

<53>
Accession Number
2004744527
Title
Percutaneous Aortic Valve Intervention in Patients Scheduled for
Noncardiac Surgery: A Japanese Multicenter Study.
Source
Cardiovascular Revascularization Medicine. 21 (5) (pp 621-628), 2020. Date
of Publication: May 2020.
Author
Yamamoto M.; Kagase A.; Shimura T.; Koyama Y.; Tsujimoto S.; Kano S.;
Hosoba S.; Tada N.; Yamanaka F.; Naganuma T.; Araki M.; Shirai S.;
Mizutani K.; Tabata M.; Ueno H.; Takagi K.; Higashimori A.; Watanabe Y.;
Hayashida K.
Institution
(Yamamoto, Kagase, Koyama, Tsujimoto) Department of Cardiology, Nagoya
Heart Canter, Nagoya, Japan
(Yamamoto, Shimura, Kano, Hosoba) Department of Cardiology, Toyohashi
Heart Canter, Toyohashi, Japan
(Tada) Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan
(Yamanaka) Department of Cardiology, Syonan Kamakura General Hospital,
Kanagawa, Japan
(Naganuma) Department of Cardiology, New Tokyo Hospital, Chiba, Japan
(Araki) Department of cardiology, Saiseikai Yokohama City Eastern
Hospital, Yokohama, Japan
(Shirai) Department of cardiology, Kokura Memorial Hospital, Kokura, Japan
(Mizutani) Department of Cardiology, Osaka City General Hospital, Osaka,
Japan
(Tabata) Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa
Medical Center, Chiba, Japan
(Ueno) Toyama University Hospital, Toyama, Japan
(Takagi) Ogaki Municipal Hospital, Gifu, Japan
(Higashimori) Kishiwada Tokushukai Hospital, Osaka, Japan
(Watanabe) Department of cardiology, Teikyo University School of Medicine,
Tokyo, Japan
(Hayashida) Department of cardiology, Keio University School of Medicine,
Tokyo, Japan
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: The optimal management of preexisting severe aortic stenosis
(AS) in patients undergoing noncardiac surgery (non-CS) remains uncertain.
This study aimed to investigate the safety and effectiveness of
percutaneous aortic valve intervention (PAVI) in patients with AS before
non-CS. <br/>Method(s): We analyzed pooled data within a multicenter
Japanese registry from 118 patients with severe AS who underwent PAVI
before non-CS. Sixty patients underwent percutaneous balloon aortic
valvuloplasty (BAV) and 58 patients underwent transcatheter aortic valve
replacement (TAVR). The groups' baseline characteristics, perioperative
complications, and 30-day mortality and midterm mortality after non-CS
were compared. <br/>Result(s): The postprocedural mean pressure gradient
was higher in the BAV group than in the TAVR group (35.0 +/- 11.5 mmHg vs.
11.5 +/- 4.8 mmHg, p < 0.001). The non-CS operation risk did not differ
between the groups (p = 0.69). One patient in each group experienced a
noncardiac death (p = 0.74), and the 30-day mortality rate after non-CS
was 1.7%. Heart failure occurred in 2 patients in each group (p = 0.68).
One patient in the TAVR group experienced a non-disabling stroke, and no
myocardial infarctions occurred. Consequently, the combined adverse events
were 5.0% and 6.9% in the 2 groups (p = 0.48). The bleeding rates during
the non-CS were similar in both groups (33.3% vs. 25.9%, p = 0.25). There
were no differences between the groups regarding midterm mortality (p =
0.60), whereas 53.3% of the patients in the BAV group required invasive
treatment of their AS during follow-up. <br/>Conclusion(s): Among patients
with severe AS, PAVI before non-CS reduces the AS severity and may
contribute to procedural safety during non-CS.<br/>Copyright &#xa9; 2019
Elsevier Inc.

<54>
Accession Number
632475637
Title
Effect of Low-dose ColchiciNe on the InciDence of Atrial Fibrillation in
Open Heart Surgery Patients: END-AF Low Dose Trial.
Source
The Journal of international medical research. 48 (7) (pp
300060520939832), 2020. Date of Publication: 01 Jul 2020.
Author
Tabbalat R.A.; Alhaddad I.; Hammoudeh A.; Khader Y.S.; Khalaf H.A.;
Obaidat M.; Barakat J.
Institution
(Tabbalat, Khalaf, Obaidat) Abdali Clemenceau Hospital, Amman, Jordan
(Alhaddad) Jordan Hospital, Amman, Jordan
(Hammoudeh) Istishari Hospital, Amman, Jordan
(Khader) Jordan University of Science and Technology, Irbid, Jordan
(Barakat) Al Khalidi Hospital and Medical Center, Amman, Jordan
Publisher
NLM (Medline)
Abstract
BACKGROUND: Studies using 1 mg of colchicine to prevent postoperative
atrial fibrillation (POAF) reported conflicting results. Moreover,
colchicine was associated with significant gastrointestinal (GI) side
effects. This study examined whether low-dose colchicine effectively
prevents POAF and whether low-dose therapy is associated with lower rates
of colchicine-induced GI side effects. <br/>METHOD(S): In this
prospective, randomized, double-blind, placebo-controlled study,
consecutive adult patients admitted for elective cardiac surgeries
randomly received a 1-mg dose of colchicine (n=81) or placebo (n=71)
orally 12 to 24 hours before surgery followed by a daily dose of 0.5 mg
until hospital discharge. The primary efficacy endpoint was the
development of at least one episode of POAF of >=5 minutes. The primary
safety endpoint was the development of adverse events, especially
diarrhea. <br/>RESULT(S): The in-hospital mortality rate was 3.9%. POAF
occurred in 13 patients (16.1%) in the colchicine group and 13 patients
(18.3%) in the placebo group (odds ratio 0.85 [95% Confidence
Interval=0.37-1.99]). Diarrhea occurred in two patients in each group and
necessitated treatment discontinuation in one patient in each group.
<br/>CONCLUSION(S): Low-dose colchicine did not prevent POAF in patients
undergoing cardiac surgery. These results should be interpreted cautiously
because of the small sample size and early study
termination.ClinicalTrials.gov Unique Identifier number: NCT03015831.

<55>
Accession Number
2004807998
Title
The effects of dexmedetomidine prescription in paediatric patients with
pulmonary hypertension under congenital heart surgery.
Source
Acta Medica Iranica. 58 (4) (pp 171-176), 2020. Date of Publication: 2020.
Author
Ghasemzadeh B.; Azizi B.; Azemati S.; Bagherinasab M.
Institution
(Ghasemzadeh) Department of Cardiac Surgery, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Azizi) Department of Anesthesia, Division of Perfusion Technology, School
of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Azemati) Department of Anesthesia, School of Medicine, Shiraz University
of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Bagherinasab) Department of Anesthesia, School of Medicine, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Medical Sciences University of Teheran
Abstract
Anesthetized patient management for pediatric patients with pulmonary
arterial hypertension (PAH) is a major challenge. The aim of this study
was to evaluate the ability of dexmedetomidine to reduce pulmonary
arterial hypertension in patients with pulmonary arterial hypertension
undergoing cardiac surgery. Sixty-six patients with pulmonary arterial
hypertension underwent the study. Patients were randomly divided into two
groups: group D received a dexmedetomidine injection in a dose of 1 mug/kg
in the first hour and then decreased to 0.5 mug/kg/hr, injection continued
after surgery until extubation in the post-anesthetic care unit (PACU).
Group C received normal saline 0.9% in a similar volume. Pulmonary artery
systolic pressure (PASP) and systemic systolic blood pressure (SSBP) were
recorded during and after the surgery in the post-anesthetic care unit.
Needing vasodilators, sedatives, extubation time, and the length of ICU
stay were recorded for all patients. Patients in the dexmedetomidine group
showed a significant reduction in Pulmonary artery systolic pressure and
Pulmonary artery systolic pressure/systemic systolic blood pressure rates
during surgery and during the first 24 hours in the post-anesthetic care
unit (P<0.001). The dexmedetomidine group, in comparison with the control
group, needed a significantly lower dose of a vasodilator (P<0.001) and a
lower dose of sedation (P<0.001). It is concluded that the use of
dexmedetomidine during the surgery in children with pulmonary hypertension
reduces pulmonary artery systolic pressure during and after the
surgery.<br/>Copyright &#xa9; 2020 Tehran University of Medical Sciences.

<56>
Accession Number
2005739612
Title
Effectiveness of prothrombin complex concentrate for the treatment of
bleeding: A systematic review and meta-analysis.
Source
Journal of Thrombosis and Haemostasis. (no pagination), 2020. Date of
Publication: 2020.
Author
van den Brink D.P.; Wirtz M.R.; Neto A.S.; Schochl H.; Viersen V.;
Binnekade J.; Juffermans N.P.
Institution
(van den Brink, Wirtz, Neto, Binnekade, Juffermans) Department of
Intensive Care Medicine, Amsterdam UMC, Amsterdam, Netherlands
(van den Brink, Wirtz, Juffermans) Laboratory of Experimental Intensive
Care and Anesthesiology, Amsterdam UMC, Amsterdam, Netherlands
(Wirtz) Department of Trauma Surgery, Amsterdam UMC, Amsterdam,
Netherlands
(Neto) Department of Critical Care Medicine, Hospital Israelita Albert
Einstein, Salphao Paulo, Brazil
(Schochl) Department of Anesthesiology and Intensive Care Medicine, AUVA
Trauma Centre Salzburg, Academic Teaching Hospital of the Paracelsus
Medical University, Salzburg, Austria
(Schochl) Institute for Experimental and Clinical Traumatology, AUVA
Research Centre, Vienna, Austria
(Viersen) Department of Anesthesiology, Amsterdam UMC, Amsterdam,
Netherlands
(Juffermans) Department of Intensive Care Medicine, OLVG Hospital,
Amsterdam, Netherlands
Publisher
Blackwell Publishing Ltd
Abstract
Prothrombin complex concentrate (PCC) is increasingly being used as a
treatment for major bleeding in patients who are not taking
anticoagulants. The aim of this systematic review and meta-analysis is to
evaluate the effectiveness of PCC administration for the treatment of
bleeding in patients not taking anticoagulants. Studies investigating the
effectivity of PCC to treat bleeding in adult patients and providing data
on either mortality or blood loss were eligible. Data were pooled using
Mantel-Haenszel random effects meta-analysis or inverse variance random
effects meta-analysis. From 4668 identified studies, 17 observational
studies were included. In all patient groups combined, PCC administration
was not associated with mortality (odds ratio = 0.83; 95% confidence
interval [CI], 0.66-1.06; P =.13; I² = 0%). However, in trauma
patients, PCC administration, in addition to fresh frozen plasma, was
associated with reduced mortality (odds ratio = 0.64; CI, 0.46-0.88; P
=.007; I² = 0%). PCC administration was associated with a
reduction in blood loss in cardiac surgery patients (mean difference:
-384; CI, -640 to -128, P =.003, I² = 81%) and a decreased need
for red blood cell transfusions when compared with standard care across a
wide range of bleeding patients not taking anticoagulants (mean
difference: -1.80; CI, -3.22 to -0.38; P =.01; I² = 92%). In
conclusion, PCC administration was not associated with reduced mortality
in the whole cohort but did reduce mortality in trauma patients. In
bleeding patients, PCC reduced the need for red blood cell transfusions
when compared with treatment strategies not involving PCC. In bleeding
cardiac surgery patients, PCC administration reduced blood
loss.<br/>Copyright &#xa9; 2020 The Authors. Journal of Thrombosis and
Haemostasis published by Wiley Periodicals LLC on behalf of International
Society on Thrombosis and Haemostasis

<57>
Accession Number
632478673
Title
Cardiac Surgery and Small Island States: A Bridge Too Far?.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 25 Jul 2020.
Author
Vervoort D.; Vinck E.E.; Tiwari K.K.; Tapaua N.
Institution
(Vervoort) Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,
United States
(Vinck) Department of Surgery, El Bosque University, Bogota, Colombia; Dr.
Horacio Oduber Hospitaal, Oranjestad, Aruba
(Tiwari) ADK Hospital, Male, Maldives
(Tapaua) University of Papua New Guinea, Papua New Guinea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Small Island Developing States (SIDS) make up nearly one
percent of the world's population with 65 million people across 58
countries. SIDS have some of the highest rates of rheumatic heart disease,
in addition to a substantial burden of congenital heart defects and a
growing burden of ischemic heart disease. Here, we present an overview of
cardiac surgical services in SIDS, with a focus on Papua New Guinea, the
Maldives, and Aruba. <br/>METHOD(S): A literature review was performed
using the PubMed/MEDLINE and Google Scholar databases to identify articles
describing cardiac surgery services in SIDS. Case studies of the history
and current state of cardiac surgery in Papua New Guinea, the Maldives,
and Aruba were developed and informed by local clinical experience.
<br/>RESULT(S): Nine SIDS have independent cardiac surgical centers, and
five SIDS have local centers supported by visiting teams. Papua New Guinea
started cardiac surgery in 1993 and is served by a public center,
performing nearly 100 cardiac surgeries per year. The Maldives introduced
cardiac surgery services in 2018, with one local cardiac surgeon supported
by Nepalese cardiac surgeons, performing 33 cardiac surgeries in 15
months. In Aruba, no local cardiac center exists and over 150 patients are
sent abroad for cardiac surgery, representing 12% of total health
spending. <br/>CONCLUSION(S): SIDS have limited availability of cardiac
surgery but pressing clinical needs. Independent cardiac centers exist
with acceptable outcomes and lower costs than foreign treatment,
suggesting the need to strengthen regionalization models to deliver
cardiac surgical care in SIDS.<br/>Copyright &#xa9; 2020. Published by
Elsevier Inc.

<58>
Accession Number
632476609
Title
A novel method to interpret early phase trials shows how the narrowing of
the coronary sinus concordantly improves symptoms, functional status and
quality of life in refractory angina.
Source
Heart (British Cardiac Society). (no pagination), 2020. Date of
Publication: 21 Jul 2020.
Author
Jolicoeur E.M.; Verheye S.; Henry T.D.; Joseph L.; Doucet S.; White C.J.;
Edelman E.; Banai S.
Institution
(Jolicoeur, Doucet) Department of Medicine, Interventional Cardiology,
Montreal Heart Institute, Montreal, QC, Canada
(Verheye) Antwerp Cardiovascular Institute, ZNA Middelheim Hospital,
Antwerpen, Belgium
(Henry) Carl and Edyth Lindner Center for Research and Education, Christ
Hospital, Cincinnati, OH, United States
(Joseph) Department of Epidemiology and Biostatistics, McGill University,
Montreal, QC, Canada
(White) John Ochsner Heart & Vascular Institute, Ochsner Clinical School,
University of Queensland, New Orleans, LA, United States
(Edelman) Institute for Medical Engineering and Science, Cambridge, MA,
United States
(Edelman) Cardiovascular Division, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Banai) Tel Aviv Medical Center, Tel Aviv University Medical School, Tel
Aviv, Israel
Publisher
NLM (Medline)
Abstract
BACKGROUND: Reduction of the coronary sinus was shown to improve angina in
patients unsuitable for revascularisation. We assessed whether a
percutaneous device that reduces the diameter of the coronary sinus
improved outcomes across multiple endpoints in a phase II trial.
<br/>METHOD(S): We conducted a novel analysis performed as a post hoc
efficacy analysis of the COSIRA (Coronary Sinus Reducer for Treatment of
Refractory Angina) trial, which enrolled patients with Canadian
Cardiovascular Society (CCS) class 3-4 refractory angina. We used four
domains: symptoms (CCS Angina Scale), functionality (total exercise
duration), ischaemia (imaging) and health-related quality of life. For all
domains, we specified a meaningful threshold for change. The primary
endpoint was defined as a probability of >=80% that the reducer exceeded
the meaningful threshold on two or more domains (group-level analysis) or
that the average efficacy score in the reducer group exceeded the sham
control group by at least two points (patient-level analysis).
<br/>RESULT(S): We randomised 104 participants to either a device that
narrows to coronary sinus (n=52) or a sham implantation (n=52). The
reducer group met the prespecified criteria for concordance at the group
level and demonstrated improvement in symptoms (0.59 CCS grade, 95%
credible interval (CrI)=0.22to 0.95), total exercise duration (+27.9%, 95%
CrI=2.8%to 59.8%) and quality of life (stability +11.2 points, 95%
CrI=3.3to 19.1; perception +11.0, 95% CrI=3.3to 18.7). <br/>CONCLUSION(S):
The reducer concordantly improved symptoms, functionality and quality of
life compared with a sham intervention in patients with angina unsuitable
for coronary revascularisation. Concordant analysis such as this one can
help interpret early phase trials and guide the decision to pursue a
clinical programme into a larger confirmatory trial. TRAIL REGISTRATION
NUMBER: ClinicalTrials.gov identifier: NCT01205893.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2020. No commercial re-use. See rights
and permissions. Published by BMJ.

<59>
Accession Number
632475281
Title
Critical Coarctation of the Aorta in Selective Fetal Growth Restriction
and the Role of Coronary Stent Implantation.
Source
Fetal diagnosis and therapy. (pp 1-9), 2020. Date of Publication: 27 Jul
2020.
Author
Gijtenbeek M.; Haak M.C.; Ten Harkel A.D.J.; Bokenkamp R.; Eyskens B.;
Ortibus E.; Meyns B.; Gewillig M.; Lewi L.
Institution
(Gijtenbeek, Haak) Division of Fetal Medicine, Department of Obstetrics,
Leiden University Medical Center, Leiden, Netherlands
(Ten Harkel, Bokenkamp) Department of Pediatric Cardiology, Leiden
University Medical Center, Leiden, Netherlands
(Eyskens, Gewillig) Department of Pediatrics, Pediatric Cardiology,
University Hospitals Leuven, Leuven, Belgium
(Eyskens, Ortibus, Gewillig) Department of Development and Regeneration,
Biomedical Sciences, KU Leuven, Leuven, Belgium
(Ortibus) Department of Pediatrics, Pediatric Neurology, University
Hospitals Leuven, Leuven, Belgium
(Meyns) Department of Cardiac Surgery, University Hospitals Leuven,
Leuven, Belgium
(Meyns) Department of Cardiovascular Sciences, Biomedical Sciences, KU
Leuven, Leuven, Belgium
(Lewi) Department of Development and Regeneration, Biomedical Sciences, KU
Leuven, Leuven, Belgium
(Lewi) Department of Obstetrics and Gynecology, Obstetrics, University
Hospitals Leuven, Leuven, Belgium
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Monochorionic twins are at increased risk of congenital
heart defects (CHDs). Up to 26% have a birth weight <1,500 g, a CHD
requiring neonatal surgery, therefore, poses particular challenges.
<br/>OBJECTIVE(S): The aim of the study was to describe pregnancy
characteristics, perinatal management, and outcome of monochorionic twins
diagnosed with critical coarctation of the aorta (CoA). <br/>METHOD(S): We
included monochorionic twins diagnosed with critical CoA (2010-2019) at 2
tertiary referral centers, and we systematically reviewed the literature
regarding CoA in monochorionic twins. <br/>RESULT(S): Seven neonates were
included. All were the smaller twin of pregnancies complicated by
selective fetal growth restriction. The median gestational age at birth
was 32 weeks (28-34). Birth weight of affected twins ranged as 670-1,800
g. One neonate underwent coarctectomy at the age of 1 month (2,330 g). Six
underwent stent implantation, performed between day 8 and 40, followed by
definitive coarctectomy between 4 and 9 months in 4. All 7 developed
normally, except for 1 child with neurodevelopmental delay. Three co-twins
had pulmonary stenosis, of whom 1 required balloon valvuloplasty. The
literature review revealed 10 cases of CoA, all in the smaller twin. Six
cases detected in the first weeks after birth were treated with
prostaglandins alone, by repeated transcatheter angioplasty or by surgical
repair, with good outcome in 2 out of 6. <br/>CONCLUSION(S): CoA
specifically affects the smaller twin of growth discordant monochorionic
twin pairs. Stent implantation is a feasible bridging therapy to surgery
in these low birth weight neonates.<br/>Copyright &#xa9; 2020 S. Karger
AG, Basel.

<60>
Accession Number
632475186
Title
Have we learnt all from Improve-It? Part I. Core results and subanalyses
on the effects of ezetimibe added to statin therapy related to age, gender
and selected chronic diseases (kidney disease, diabetes mellitus and non-
alcoholic fatty liver disease).
Source
Current vascular pharmacology. (no pagination), 2020. Date of Publication:
27 Jul 2020.
Author
Fras Z.; Mikhailidis D.P.
Institution
(Fras) Centre for Preventive Cardiology, Department of Vascular Medicine,
Division of Medicine, University Medical Centre Ljubljana. Slovenia
(Mikhailidis) Department of Clinical Biochemistry, Royal Free Hospital
Campus, University College Medical School, University College London,
London. United Kingdom
Publisher
NLM (Medline)
Abstract
IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International
Trial) was a randomized clini- cal trial (18,144 patients) that evaluated
the efficacy of the combination of ezetimibe with simvastatin vs
simvastatin mono- therapy in patients with acute coronary syndrome (ACS)
and moderately increased low-density lipoprotein cholesterol (LDL-C)
levels (of up to 2.6-3.2 mmol/L; 100-120 mg/dL). After 7 years of
follow-up, combination therapy resulted in an additional LDL-C decrease
[1.8 mmol/L, or 70 mg/dL, within the simvastatin (40 mg/day) monotherapy
arm and 1.4 mmol/L, or 53 mg/dL for simvastatin (40 mg/day) + ezetimibe
(10 mg/day)] and showed an incremental clinical benefit (composite of
cardiovascular death, nonfatal myocardial infarction, unstable angina
requiring rehospitalization, coronary re- vascularization (>=30 days after
randomization), or nonfatal stroke; hazard ratio (HR) of 0.936, and 95% CI
0.887-0.996, p=0.016). Therefore, for very high cardiovascular risk
patients "even lower is even better" regarding LDL-C, independently of the
LDL-C reducing strategy. These findings confirm ezetimibe as an option to
treat very-high-risk patients who cannot achieve LDL-C targets with statin
monotherapy. Additional analyses of the IMPROVE-IT (both prespecified and
post-hoc) include specific very-high-risk subgroups of patients (those
with previous acute events and/or coronary revascularization, older than
75 years, as well as patients with diabetes mellitus, chronic kidney
disease or non-alcoholic fatty liver disease). The data from IMPROVE-IT
also provide reassurance regarding longer-term safety and efficacy of the
intensification of li- pid-lowering therapy in very-high-risk patients
resulting in very low LDL-C levels. We comment on the results of several
(sub) analyses of IMPROVE-IT.<br/>Copyright&#xa9; Bentham Science
Publishers; For any queries, please email at epub@benthamscience.net.

<61>
Accession Number
632474574
Title
Systematic reviews and meta-analyses in cardiac surgery: rules of the road
- 1.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 24 Jul 2020.
Author
Gaudino M.; Fremes S.; Bagiella E.; Bangalore S.; Demetres M.; D'Ascenzo
F.; Biondi-Zoccai G.; Di Franco A.
Institution
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
NY, NY, United States
(Fremes) Division of Cardiac Surgery, Schulich Heart Centre, Sunnybrook
Health Sciences Centre, University of Toronto, Toronto, ON, Canada
(Bagiella) Department of Population Health Science and Policy, Icahn
School of Medicine at Mount Sinai, NY, NY, United States
(Bangalore) New York University Grossman School of Medicine, NY, NY,
United States
(Demetres) Weill Cornell Medicine, Samuel J. Wood Library & C.V. Starr
Biomedical Information Center, NY, NY, United States
(D'Ascenzo) Division of Cardiology, "Citta della scienza e della Salute",
University of Turin, Turin, Italy
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University, Rome, Italy; Mediterranea
Cardiocentro, Naples, Italy
(Di Franco) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
NY, NY, United States
Publisher
NLM (Medline)
Abstract
The number of cardiac surgical meta-analyses and systematic reviews
published in the last decades has constantly increased, paralleling the
exponential growth observed in virtually all other medical fields.
However, meta-analyses are open to methodological flaws if best practices
are not strictly followed. Assessment of the appropriateness of the
research question is a crucial first step. Once a protocol has been
developed, this should be registered before the work is initiated. The
cornerstone of any systematic review or meta-analysis is a rigorous,
comprehensive, and most of all reproducible search which follows a
prespecified and clear strategy. Eligibility criteria must be discussed
and agreed upon in advance to guide final study selection, which
ultimately lays the foundation for subsequent data extraction. In case of
missing or partially reported data, the authors of the original paper
should be contacted. Adherence to rigorous methodological rules at each of
these stages will warrant availability of good quality data for formal
statistical analyses. The aim of the first part of this expert review is
to discuss the limits and pitfalls of the meta-analytic approach and
provide guidance on how to perform trial level meta-analyses, with
particular reference to the identification of an appropriate research
question, the definition and registration of the protocol, the search
strategy, the study selection and the data abstraction.<br/>Copyright
&#xa9; 2020. Published by Elsevier Inc.

<62>
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.

<63>
Accession Number
2004046557
Title
The effects of Hegu point ice massage on post-sternotomy pain in patients
undergoing coronary artery bypass grafting: A single-blind, randomized,
clinical trial.
Source
Advances in Integrative Medicine. 7 (2) (pp 73-78), 2020. Date of
Publication: May 2020.
Author
Taherian T.; Shorofi S.A.; Zeydi A.E.; Charati J.Y.; Pouresmail Z.; Jafari
H.
Institution
(Taherian) School of Nursing and Midwifery, Student Research Committee,
Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic of
(Shorofi, Jafari) Traditional and Complementary Medicine Research Center,
Addiction Institute, Mazandaran University of Medical Sciences, Sari,
Iran, Islamic Republic of
(Shorofi) Adjunct Research Fellow, Flinders University, Adelaide,
Australia
(Zeydi) School of Nursing and Midwifery, Mazandaran University of Medical
Sciences, Sari, Iran, Islamic Republic of
(Charati) School of Health Sciences, Mazandaran University of Medical
Sciences, Sari, Iran, Islamic Republic of
(Pouresmail) School of Nursing and Midwifery, Shahid Beheshti University
of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Elsevier Australia
Abstract
Background and purpose: Pain is considered as one of the most common
problems among patients undergoing open heart surgery. We aimed to
evaluate the effects of Hegu point ice massage on the level of pain
experienced after coronary artery bypass grafting <br/>Material(s) and
Method(s): This is a single-blind, randomized, clinical trial, conducted
on 80 patients who were recruited via convenience sampling method. The
sample was randomly divided into two groups. In the experimental group,
ice massage was performed at the Hegu point on the left hand by applying a
medium pressure for 10 min (2 min massage, 15 s rest) in postoperative day
1 and 2. In the control group, glass marbles were applied at the Hegu
point on the left hand with no pressure and massage for 10 min. Pain
intensity was measured in both groups before the intervention and at 30,
60, and 120 min following the intervention. <br/>Result(s): Following the
intervention on the postoperative day 1, the mean pain score for the
experimental and control groups was 2.97 +/- 1.40 and 3.64 +/- 1.56,
respectively. For the experimental and control groups on postoperative day
2, the mean pain score was 2.35 +/- 1.12 versus 3.03 +/- 1.40,
respectively. Following the intervention on postoperative day 1, the mean
pain score was 2.97 +/- 1.40 and 3.64 +/- 1.56 in the experimental and
control groups, respectively. The mean pain score for the experimental
group was 2.35 +/- 1.12 compared with 3.03 +/- 1.40 for the control group
after the intervention on the second postoperative day. Statistically
significant differences were revealed for the mean pain score between the
two groups after the intervention on the first (p = 0.04) and second (p =
0.02) postoperative days. <br/>Conclusion(s): Hegu point ice massage is an
effective method for relieving pain associated with coronary artery bypass
grafting in specific patients.<br/>Copyright &#xa9; 2019 Elsevier Ltd

<64>
Accession Number
632410684
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 - Journal of the American Medical Association. 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, 525 E 68th St, New York, NY 10065, United
States
(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, New York, NY, United States
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University, Rome, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Naples, Italy
(Nasso, Moscarelli, Speziale) Cardiothoracic and Vascular Department,
Maria Cecilia Hospital, GVM Care and 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, 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, New
York, NY, United States
(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
American Medical Association (E-mail: smcleod@itsa.ucsf.edu)
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.<br/>Copyright
&#xa9; 2020 American Medical Association. All rights reserved.

<65>
Accession Number
632408563
Title
Beta-blockers for congestive heart failure in children.
Source
Cochrane Database of Systematic Reviews. 2020 (7) (no pagination), 2020.
Article Number: CD007037. Date of Publication: 23 Jul 2020.
Author
Alabed S.; Sabouni A.; Al Dakhoul S.; Bdaiwi Y.
Institution
(Alabed) Academic Unit of Radiology, University of Sheffield, Sheffield,
United Kingdom
(Sabouni) KasrAlAiny School of Medicine, Cairo University, Cairo, Egypt
(Al Dakhoul) Department of Medicine, The Wirral University Teaching
Hospitals, Upton, Wirral, United Kingdom
(Bdaiwi) Faculty of Medicine, Damascus University, Damascus, Syrian Arab
Republic
Publisher
John Wiley and Sons Ltd (Southern Gate, Chichester, West Sussex PO19 8SQ,
United Kingdom. E-mail: vgorayska@wiley.com)
Abstract
Background: Beta-blockers are an essential part of standard therapy in
adult congestive heart failure and therefore, are expected to be
beneficial in children. However, congestive heart failure in children
differs from that in adults in terms of characteristics, aetiology, and
drug clearance. Therefore, paediatric needs must be specifically
investigated. This is an update of a Cochrane review previously published
in 2009. <br/>Objective(s): To assess the effect of
beta-adrenoceptor-blockers (beta-blockers) in children with congestive
heart failure. <br/>Search Method(s): We searched the Cochrane Central
Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE,
EMBASE, and LILACS up to November 2015. Bibliographies of identified
studies were checked. No language restrictions were applied.
<br/>Selection Criteria: Randomised, controlled, clinical trials
investigating the effect of beta-blocker therapy on paediatric congestive
heart failure. <br/>Data Collection and Analysis: Two review authors
independently extracted and assessed data from the included trials.
<br/>Main Result(s): We identified four new studies for the review update;
the review now includes seven studies with 420 participants. Four small
studies with 20 to 30 children each, and two larger studies of 80 children
each, showed an improvement of congestive heart failure with beta-blocker
therapy. A larger study with 161 participants showed no evidence of
benefit over placebo in a composite measure of heart failure outcomes. The
included studies showed no significant difference in mortality or heart
transplantation rates between the beta-blocker and control groups. No
significant adverse events were reported with beta-blockers, apart from
one episode of complete heart block. A meta-analysis of left ventricular
ejection fraction (LVEF) and fractional shortening (LVFS) data showed a
very small improvement with beta-blockers. However, there were vast
differences in the age, age range, and health of the participants
(aetiology and severity of heart failure; heterogeneity of diagnoses and
co-morbidities); there was a range of treatments across studies (choice of
beta-blocker, dosing, duration of treatment); and a lack of standardised
methods and outcome measures. Therefore, the primary outcomes could not be
pooled in meta-analyses. Authors' conclusions: There is not enough
evidence to support or discourage the use of beta-blockers in children
with congestive heart failure, or to propose a paediatric dosing scheme.
However, the sparse data available suggested that children with congestive
heart failure might benefit from beta-blocker treatment. Further
investigations in clearly defined populations with standardised
methodology are required to establish guidelines for therapy.
Pharmacokinetic investigations of beta-blockers in children are also
required to provide effective dosing in future trials.<br/>Copyright
&#xa9; 2020 The Cochrane Collaboration. Published by John Wiley & Sons,
Ltd.

<66>
Accession Number
632162318
Title
Comparative efficacy and safety of antithrombotic therapy for
transcatheter aortic valve replacement: A systematic review and network
meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 57 (5) (pp 965-976), 2020.
Date of Publication: 01 May 2020.
Author
Zhu Y.; Zou Z.; Huang Y.; Zhang L.; Chen H.; Li Y.; Liu C.; Li X.; Xu D.;
Zeng Q.
Institution
(Zhu, Zou, Huang, Zhang, Chen, Li, Li, Xu, Zeng) First Clinical Medical
College, State Key Laboratory of Organ Failure Research, Nanfang Hospital,
Southern Medical University, Guangzhou, China
(Zhu, Huang, Xu, Zeng) Guangzhou Regenerative Medicine and Health
Guangdong Laboratory, Guangzhou, China
(Liu) Department of Cardiology, Guangzhou First People's Hospital, School
of Medicine, South China University of Technology, Guangzhou, China
Publisher
European Association for Cardio-Thoracic Surgery (E-mail:
info@eacts.co.uk)
Abstract
OBJECTIVES: We sought to determine the optimal antithrombotic therapy
after transcatheter aortic valve replacement. <br/>METHOD(S): Related
scientific databases were searched until December 2018. We conducted a
pairwise and a network meta-analysis within a frequentist framework,
measuring 30-day bleeding, stroke and all-cause mortality. The surface
under the cumulative ranking (SUCRA) curve was estimated to rank the
therapies. The Grading of Recommendations Assessment, Development and
Evaluation (GRADE) approach was performed. The protocol was registered
with PROSPERO (CRD42018111163). <br/>RESULT(S): Eight studies comprising
2173 patients were analysed. The risk of 30-day bleeding was higher for
dual antiplatelet therapy (DAPT) than single antiplatelet therapy (SAPT)
[odds ratio (OR) 1.90 (1.10-3.28); P = 0.02], whereas there was no
difference in the risk of 30-day stroke [OR 1.27 (0.38-4.20); P = 0.69]
and mortality [OR 1.46 (0.67-3.22); P = 0.34] between DAPT and SAPT. In
the network meta-analysis, DAPT + oral anticoagulant (OAC) increased the
risk of 30-day bleeding compared with SAPT [OR 6.21 (1.74-22.17); P =
0.005], DAPT [OR 3.27 (1.04-10.32); P = 0.043], SAPT + OAC [OR 4.87
(2.51-9.45); P < 0.001] and OAC [OR 14.4 (1.3-154.7); P = 0.028].
Additionally, patients receiving DAPT + OAC had the highest risks for
30-day bleeding (SUCRA 1.0%). OAC seemed to be superior to SAPT and DAPT
in terms of 30-day bleeding (SUCRA OAC: 86.3%, SAPT: 72.3%, DAPT: 32.3%)
and stroke (SUCRA 54.2%, 47.4%, 40.5%), but not mortality (SUCRA 69.6%,
74.1%, 43.4%). <br/>CONCLUSION(S): There is a trend towards less bleeding
with the application of SAPT, but no mortality benefit with the
application of DAPT is shown. The comparison of SAPT, DAPT and OAC shows
that OAC may improve the balance between stroke and bleeding, which can
reduce the risk of mortality. In addition, the application of DAPT + OAC
was ranked the worst amongst all treatment modalities and should be
avoided due to an increased risk of bleeding. Clinical trial registration
number: PROSPERO (International Prospective Register of Systematic
Reviews, CRD42018111163).<br/>Copyright &#xa9; 2019 The Author(s).

<67>
Accession Number
2006826503
Title
Comparison of the effect of ultrasound-guided thoracic paravertebral nerve
block and intercostal nerve block for video-assisted thoracic surgery
under spontaneous-ventilating anesthesia.
Source
Revista da Associacao Medica Brasileira. 66 (4) (pp 452-457), 2020. Date
of Publication: April 2020.
Author
Zheng Y.; Wang H.; Ma X.; Cheng Z.; Cao W.; Shao D.
Institution
(Zheng, Wang, Ma, Cheng, Cao, Shao) Department of Anesthesiology,
Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu
212002, China
Publisher
Associacao Medica Brasileira
Abstract
Objective: The aim of the current study was to compare the efficacy of two
different techniques for blocking chest nerves during video-assisted
thoracic surgery (VATS) under spontaneous-ventilating anesthesia.
<br/>Method(s): One hundred patients were recruited in this study and
divided into two groups. The first, P group, underwent the TPVB approach;
the second, I group, underwent the ICNB approach. Then, the rate of
clinical efficacy, duration of the block procedure, and its complications
were recorded for comparison of the effect of the two approaches.
<br/>Result(s): No difference was found in the clinical effect of chest
nerve blocks between the two groups. Two patients in the ICNB group were
converted to general anesthesia due to severe mediastinal flutter (grade
three). The number of patients who had grade one mediastinal flutter in
the TPVB group was significantly higher than in the ICNB group. Vascular
puncture was detected in four patients in the ICNB group and in one
patient in the TPVB group. No other complications were observed.
<br/>Conclusion(s): No difference was found regarding the clinical
efficacy in the two groups. However, ultrasound-guided TPVB was superior
to ultrasound-guided ICBN during VATS for pulmonary lobectomy under
spontaneous-ventilating anesthesia. Additionally, vascular puncture should
receive more attention.<br/>Copyright &#xa9; 2020 Associacao Medica
Brasileira. All rights reserved.

<68>
Accession Number
2004734713
Title
Mapping clinical outcomes to generic preference-based outcome measures:
Development and comparison of methods.
Source
Health Technology Assessment. 24 (34) (pp 1-94), 2020. Date of
Publication: 2020.
Author
Wailoo A.; Pudney S.; Gray L.; Manca A.; Alava M.H.
Institution
(Wailoo, Pudney, Gray, Alava) School of Health and Related Research
(ScHARR), University of Sheffield, Sheffield, United Kingdom
(Manca) Centre for Health Economics, University of York, York, United
Kingdom
Publisher
NIHR Journals Library (NETSCCAlpha HouseUniversity of Southampton, Science
Park, Southampton SO167NS, United Kingdom)
Abstract
Background: Cost-effectiveness analysis using quality-adjusted life-years
as the measure of health benefit is commonly used to aid decision-makers.
Clinical studies often do not include preference-based measures that allow
the calculation of quality-adjusted life-years, or the data are
insufficient. 'Mapping' can bridge this evidence gap; it entails
estimating the relationship between outcomes measured in clinical studies
and the required preference-based measures using a different data set.
However, many methods for mapping yield biased results, distorting
cost-effectiveness estimates. <br/>Objective(s): Develop existing and new
methods for mapping; test their performance in case studies spanning
different preference-based measures; and develop methods for mapping
between preference-based measures. Data sources: Fifteen data sets for
mapping from non-preference-based measures to preference-based measures
for patients with head injury, breast cancer, asthma, heart disease, knee
surgery and varicose veins were used. Four preference-based measures were
covered: the EuroQoL-5 Dimensions, three-level version (n = 11), EuroQoL-5
Dimensions, five-level version (n = 2), Short Form questionnaire-6
Dimensions (n = 1) and Health Utility Index Mark 3 (n = 1). Sample sizes
ranged from 852 to 136,327. For mapping between generic preference-based
measures, data from FORWARD, the National Databank for Rheumatic Diseases
(which includes the EuroQoL-5 Dimensions, three-level version, and
EuroQoL-5 Dimensions, five-level version, in its 2011 wave), were used.
Main methods developed: Mixture-model-based approaches for direct mapping,
in which the dependent variable is the health utility value, including
adaptations of methods developed to model the EuroQoL-5 Dimensions,
three-level version, and beta regression mixtures, were developed, as were
indirect methods, in which responses to the descriptive systems are
modelled, for consistent multidirectional mapping between preference-based
measures. A highly flexible approach was designed, using copulas to
specify the bivariate distribution of each pair of EuroQoL-5 Dimensions,
three-level version, and EuroQoL-5 Dimensions, five-level version,
responses. <br/>Result(s): A range of criteria for assessing model
performance is proposed. Theoretically, linear regression is inappropriate
for mapping. Case studies confirm this. Flexible, direct mapping methods,
based on different variants of mixture models with appropriate underlying
distributions, perform very well for all preference-based measures. The
precise form is important. Case studies show that a minimum of three
components are required. Covariates representing disease severity are
required as predictors of component membership. Beta-based mixtures
perform similarly to the bespoke mixture approaches but necessitate
detailed consideration of the number and location of probability masses.
The flexible, bi-directional indirect approach performs well for testing
differences between preference-based measures. <br/>Limitation(s): Case
studies drew heavily on EuroQoL-5 Dimensions. Indirect methods could not
be undertaken for several case studies because of a lack of coverage.
These methods will often be unfeasible for preference-based measures with
complex descriptive systems. <br/>Conclusion(s): Mapping requires
appropriate methods to yield reliable results. Evidence shows that widely
used methods such as linear regression are inappropriate. More flexible
methods developed specifically for mapping show that close-fitting results
can be achieved. Approaches based on mixture models are appropriate for
all preference-based measures. Some features are universally required
(such as the minimum number of components) but others must be assessed on
a case-by-case basis (such as the location and number of probability mass
points).<br/>Copyright &#xa9; Queen's Printer and Controller of HMSO 2020.

<69>
Accession Number
2005726961
Title
Volatile Anesthesia Versus Total Intravenous Anesthesia During
Cardiopulmonary Bypass: A Narrative Review on the Technical Challenges and
Considerations.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (8) (pp 2181-2188),
2020. Date of Publication: August 2020.
Author
Yeoh C.J.; Hwang N.C.
Institution
(Yeoh, Hwang) Department of Anaesthesiology, Singapore General Hospital,
Singapore
(Yeoh, Hwang) Department of Cardiothoracic Anaesthesia, National Heart
Centre, Singapore
Publisher
W.B. Saunders
Abstract
The Mortality in Cardiac Surgery Randomized Controlled Trial of Volatile
Anesthetics (MYRIAD) demonstrated that cardiac surgery with either
volatile anesthesia or intravenous anesthesia techniques can be comparable
with respect to morbidity and mortality. Maintaining anesthesia during
cardiopulmonary bypass (CPB) with either approach requires appreciation of
the nuances that are unique to each. This narrative review addresses these
technical challenges and other considerations.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<70>
Accession Number
2005884132
Title
Selected 2019 Highlights in Congenital Cardiac Anesthesia.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (8) (pp 2022-2027),
2020. Date of Publication: August 2020.
Author
Ross F.J.; Vu E.L.; Fang Z.A.; Resheidat A.; Mossad E.B.; Mittnacht A.J.C.
Institution
(Ross) Department of Anesthesiology, Seattle Children's Hospital,
University of Washington, Seattle, WA, United States
(Vu) Department of Anesthesiology, Lurie Children's Hospital, Northwestern
University Feinberg School of Medicine, Chicago, IL, United States
(Fang) Department of Anesthesia and Pain Medicine, Hospital for Sick
Children Toronto, Ontario, Canada
(Resheidat, Mossad) Division of Pediatric Cardiovascular Anesthesia,
Baylor College of Medicine, Texas Children's Hospital, Houston, TX, United
States
(Mittnacht) Department of Anesthesiology, Westchester Medical Center, New
York Medical College, Valhalla, NY, United States
Publisher
W.B. Saunders
Abstract
This article is a review of the highlights of pertinent literature
published in 2019, which is of interest to the pediatric cardiac
anesthesiologist. After a search of the United States National Library of
Medicine PubMed database, several topics emerged in which significant
contributions were made in 2019. The authors of this manuscript considered
the following topics noteworthy and were included in this review: advances
in pediatric heart transplantation, blood management in pediatric cardiac
surgery, the impact of nutrition on outcomes in congenital heart surgery,
and the use of vasopressin in patients after Fontan
palliation.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<71>
Accession Number
2005737728
Title
Clinical burden associated with postsurgical complications in major
cardiac surgeries in Asia-Oceania countries: A systematic review and
meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Dhippayom T.; Dilokthornsakul P.; Laophokhin V.; Kitikannakorn N.;
Chaiyakunapruk N.
Institution
(Dhippayom) Faculty of Pharmaceutical Sciences, Naresuan University,
Phitsanulok, Thailand
(Dilokthornsakul) Department of Pharmacy Practice, Center of
Pharmaceutical Outcomes Research (CPOR), Faculty of Pharmaceutical
Sciences, Naresuan University, Phitsanulok, Thailand
(Laophokhin, Kitikannakorn) Department of Pharmaceutical Care, Centor for
Community of Drug System Research and Development (CDR), Faculty of
Pharmacy, Chiang Mai University, Chiang Mai, Thailand
(Chaiyakunapruk) Department of Pharmacotherapy, College of Pharmacy,
University of Utah, Salt Lake City, UT, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Evidence on the burden of postsurgical complications is mainly
from studies in western countries, and little is highlighted in the
Asia-Oceania region. This study aimed to identify and compare the burden
of postsurgical complications in major cardiac surgeries in Asia-Oceania
countries. <br/>Method(s): A systematic search was performed in PubMed,
Embase, and CENTRAL between January 2000 and July 2018. Inclusion criteria
were: (a) observational studies or randomized control trials; (b) studied
in coronary artery bypass graft (CABG) and/or heart valve procedures; (c)
measured postsurgical clinical outcomes; and (d) conducted in Asia-Oceania
countries. Pooled effects were calculated using a random-effects model.
<br/>Result(s): Of the 6032 articles screened, 472 studies with a total of
614 161 patients met the inclusion criteria. The pooled incidences (95%
confidence interval) of hospital mortality and 30-day mortality were
similar at 2.38% (2.16%-2.59%) and 2.33% (2.16%-2.50%), respectively.
Length of stay (LOS) was 14.07 days (13.44-14.71 days). The incidence for
atrial fibrillation (AF) and stroke/cerebrovascular accident (CVA) was
17.49% (15.99%-18.99%) and 1.64% (1.51%-1.78%), respectively. Below
outcomes tended to be better in studies on CABG compared to heart valve
procedures, including the incidence of hospital mortality
(1.97%[1.75%-2.18%] vs 3.97% [3.29%-4.65%]), AF (16.47% [14.85%-18.10%] vs
21.98% [17.41%-26.54%]), stoke/CVA (1.51% [1n 37%-1.65%] vs 2.55%
[2.07%-3.04%]), and mean LOS (days) (13.08 [12.51-13.65] vs 19.58
[16.72-22.45]). Similarly, all postsurgical complications tended to be
higher in studies involving high-risk patients vs non-high-risk patients.
<br/>Conclusion(s): There are opportunities to improve clinical outcomes
of patients with high surgical risks and those undertaking heart valve
procedures, as they tend to have poorer survival and higher risk in
developing postsurgical complications.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC

<72>
Accession Number
2005737713
Title
Local prolonged release of antibiotic for prevention of sternal wound
infections postcardiac surgery-A novel technology.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Kachel E.; Moshkovitz Y.; Sternik L.; Sahar G.; Grosman-Rimon L.;
Belotserkovsky O.; Reichart M.; Stark Y.; Emanuel N.
Institution
(Kachel, Grosman-Rimon) Department of Cardiac Surgery, Poriya Medical
Center, Tiberias, Israel
(Kachel, Sternik) Department of Cardiac Surgery, Sheba Medical Centre, Tel
Hashomer, Israel
(Moshkovitz) Department of Cardiothoracic Surgery, Assuta Medical Center,
Tel Aviv, Israel
(Sahar) Department of Cardiothoracic Surgery, Soroka Medical Center, Beer
Sheva, Israel
(Belotserkovsky, Reichart, Stark, Emanuel) PolyPid Ltd, Petach-Tikva,
Israel
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Introduction: Sternal wound infection (SWI) is a devastating postcardiac
surgical complication. D-PLEX<inf>100</inf> (D-PLEX) is a localized
prolonged release compound applied as a prophylactic at the completion of
surgery to prevent SWI. The D-PLEX technology platform is built as a
matrix of alternating layers of polymers and lipids, entrapping an
antibiotic (doxycycline). The objective of this study was to assess the
safety profile and pharmacokinetics of D-PLEX in reducing SWI rates
postcardiac surgery. <br/>Method(s): Eighty-one patients were enrolled in
a prospective single-blind randomized controlled multicenter study. Sixty
patients were treated with both D-PLEX and standard of care (SOC) and 21
with SOC alone. Both groups were followed 6 months for safety endpoints.
SWI was assessed at 90 days. <br/>Result(s): No SWI-related serious
adverse events (SAEs) occurred in either group. The mean plasma
C<inf>max</inf> in patients treated with D-PLEX was about 10 times lower
than the value detected following the oral administration of doxycycline
hyclate with an equivalent overall dose, and followed by a very low plasma
concentration over the next 30 days. There were no sternal infections in
the D-PLEX group (0/60) while there was one patient with a sternal
infection in the control group (1/21, 4.8%). <br/>Conclusion(s): D-PLEX
was found to be safe for use in cardiac surgery patients. By providing
localized prophylactic prolonged release of broad-spectrum antibiotics,
D-PLEX has the potential to prevent SWI postcardiac surgery and long-term
postoperative hospitalization, reducing high-treatment costs, morbidity,
and mortality.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<73>
Accession Number
2005737701
Title
Anticoagulation following mitral valve repair.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Watt T.M.F.; Murray S.L.; Brescia A.A.; Burn D.A.; Wisniewski A.; Khan
S.P.; Romano M.A.; Bolling S.F.; The M.
Institution
(Watt, Murray, Brescia, Romano, Bolling) Department of Cardiac Surgery,
University of Michigan, Ann Arbor, MI, United States
(Burn) Department of Mathematics, Quinnipiac University, Hamden, CT,
United States
(Wisniewski) University of Toledo College of Medicine, Toledo, OH, United
States
(Khan) Department of Internal Medicine, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background and Aim: Anticoagulation after mitral valve repair is
controversial and guidelines are not well-established. This study
evaluated the association between postoperative warfarin use and
complications after mitral valve repair, including bleeding and
thromboembolic incidents, readmission, and mortality. <br/>Method(s): This
retrospective study investigated 1097 patients who underwent elective
mitral valve repair between April 2003 and March 2017, and was naive to
atrial fibrillation or prior cardiac surgery. This cohort had no other
indication for or against anticoagulation. About 775 patients were placed
on warfarin with international normalized ratio goal 2.5 and 322 patients
were not anticoagulated. The association between anticoagulation and
complications was assessed with univariate comparisons between groups and
multiple logistic regression. <br/>Result(s): Postoperative warfarin use
was associated with a reduced composite of bleeding and thromboembolic
complications (pulmonary embolism, TIA, stroke, pericardial effusion or
cardiac tamponade, gastrointestinal bleeding, and reoperation for
bleeding) with an odds ratio of 0.29 (95% confidence interval, 0.13-0.64,
P =.003). There was no difference in 30-day or 6-month mortality or
readmission rate between groups. Long-term survival estimates were
superior in the warfarin group (10-year: 92% vs 85%; log-rank P <.001).
<br/>Conclusion(s): Our analysis showed that postoperative warfarin use
was associated with an overall reduced composite of bleeding and
thromboembolic incidents and superior long-term survival. These findings
suggest that anticoagulation with warfarin following mitral valve repair
may be a safe and effective means for avoiding postoperative complications
and that a large prospective randomized clinical trial is
warranted.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<74>
[Use Link to view the full text]
Accession Number
2007085467
Title
The Impact of Coexistence of Smoking and Diabetes on the Coronary Artery
Severity and Outcomes following Percutaneous Coronary Intervention:
Results from the 1^STJordanian PCI Registry.
Source
International Journal of Vascular Medicine. 2020 (no pagination), 2020.
Article Number: 7624158. Date of Publication: 2020.
Author
Jarrah M.I.; Al-Khatib S.; Khader Y.; Alkharabsheh H.N.; Hammoudeh A.;
Alzoubi K.H.; Alrabadi N.
Institution
(Jarrah) Department of Internal Medicine, Faculty of Medicine, Jordan
University of Science and Technology, Irbid, Jordan
(Al-Khatib, Alkharabsheh) Department of Physiology, Faculty of Medicine,
Jordan University of Science and Technology, Irbid, Jordan
(Khader) Department of Public Health, Faculty of Medicine, Jordan
University of Science and Technology, Irbid 22110, Jordan
(Hammoudeh) Cardiology Department, Istishari Hospital, Amman, Jordan
(Alzoubi) Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan
University of Science and Technology, Irbid, Jordan
(Alrabadi) Department of Pharmacology, Faculty of Medicine, Jordan
University of Science and Technology, Irbid 22110, Jordan
Publisher
Hindawi Limited (410 Park Avenue, 15th Floor, 287 pmb, New York NY 10022,
United States)
Abstract
Introduction. Diabetes mellitus (DM) and smoking are highly prevalent
among Middle Eastern patients admitted with acute coronary syndrome (ACS)
or who undergo percutaneous coronary intervention (PCI). Methods. This
study used the analysis of the data from the first Jordanian PCI registry
(JoPCR1) to determine the impact of coexistence of smoking and diabetes
mellitus on the coronary artery severity and outcome following
percutaneous coronary intervention in Middle Eastern patients. Results. Of
2426 patients enrolled, 1300 (53.6%) and 1055 (43.5%) were diabetics and
smokers, respectively. The patients' age was 59.0+/-10.1 and ranged
between 24 and 95 years. Males comprised 79.4% of all patients. The
patients were divided into four groups: nondiabetic-nonsmokers (22.2%),
diabetic-nonsmokers (34.3%), nondiabetic-smokers (24.2%), and
diabetic-smokers (19.2%). Compared with the other three groups, patients
in the diabetic-nonsmoker group were older, more likely to be females, and
having a higher prevalence of hypertension, dyslipidemia, chronic renal
disease, and history of CVD and revascularization. Consequently, the
diabetic-nonsmoker patients (but not the diabetic-smokers) had a higher
prevalence of multivessel CAD and PCI than the other three groups,
highlighting the importance of other risk factors (age, gender, metabolic
syndrome, and comorbidities) and not only smoking in predisposing for CAD.
Furthermore, those patients had a higher incidence of ACS as an indication
for PCI than the stable coronary disease (73% vs 27%) and the highest
CRUSADE bleeding risk score (63.9%) among other groups. The in-hospital
events including in-stent thrombosis and emergency CABG events did not
significantly differ among groups (p=0.5 and 0.22). Heart failure and
major bleeding events occurred significantly higher among
diabetic-nonsmokers compared to other groups. In-hospital deaths occurred
significantly more among diabetic-nonsmokers. Moreover, the one-month and
one-year follow-up outcome events (the mortality rate, in-stent
thrombosis, readmission for ACS, coronary revascularization, and major
bleedings) occurred more frequently in the diabetic-nonsmoker group.
However, the difference was statistically significant only for major
bleeding incidences. Conclusions. In this analysis of a completed
prospective Middle Eastern PCI registry, the majority of the
diabetic-nonsmoker (and not the diabetic-smokers) patients (73%) presented
with ACS. This group was the highest at risk for in-hospital PCI
complications as well as the worst in outcomes after one year of
follow-up. Those patients were more likely to be older, female, and have
the worst cardiovascular baseline features, highlighting the importance of
other risk factors (age, gender, metabolic syndrome, and comorbidities)
and not only smoking in predisposing for CAD. Thus, more sufficient
education about controlling CVD risk factors should be implemented in the
Middle Eastern region.<br/>Copyright &#xa9; 2020 Mohamad I. Jarrah et al.

<75>
Accession Number
2006790386
Title
Persistent pain in intensive care survivors: a systematic review.
Source
British Journal of Anaesthesia. 125 (2) (pp 149-158), 2020. Date of
Publication: August 2020.
Author
Makinen O.J.; Backlund M.E.; Liisanantti J.; Peltomaa M.; Karlsson S.;
Kalliomaki M.-L.
Institution
(Makinen) Faculty of Medicine and Life Sciences, Tampere University,
Tampere, Finland
(Backlund) Department of Intensive Care, Helsinki University Hospital,
Helsinki, Finland
(Liisanantti) Oulu University Hospital, Oulu, Finland
(Peltomaa, Karlsson) Department of Intensive Care, Tampere University
Hospital, Tampere, Finland
(Kalliomaki) Department of Anaesthesiology, Tampere University Hospital,
Tampere, Finland
Publisher
Elsevier Ltd
Abstract
Background: According to earlier studies where the main aim has been
quality of life, there is growing evidence of increased levels of
persistent pain in survivors of critical illness. The cause of admission
and several factors during intensive care may have associated risk factors
for pain persistence. This systematic review aims to determine the
incidence or prevalence of persistent pain after critical illness and to
identify risk factors for it. <br/>Method(s): Six databases were searched,
and eventually nine studies were included in the final systematic process.
The validity of observational and cross-sectional studies was analysed
using the National Institute of Health 'Quality Assessment Tool for
Observational Cohort and Cross-Sectional Studies'. <br/>Result(s): The
incidence of persistent pain after intensive care varied from 28% to 77%.
Risk factors for persistent pain were acute pain at discharge from ICU,
higher thoracic trauma score, surgery, pre-existing pain, organ failure,
longer length of ventilator or hospital stay, and sepsis. No difference in
incidence between medical and surgical patients was found.
<br/>Conclusion(s): New systematic, observational studies are warranted to
identify persistent pain-related factors in intensive care to improve pain
management protocols and thereby diminish the risk of persistent pain
after ICU stay.<br/>Copyright &#xa9; 2020 British Journal of Anaesthesia

<76>
Accession Number
2006777705
Title
Residual SYNTAX Score and One-Year Outcome in Elderly Patients With Acute
Coronary Syndrome.
Source
CJC Open. 2 (4) (pp 236-243), 2020. Date of Publication: July 2020.
Author
Morici N.; Alicandro G.; Ferri L.A.; Piatti L.; Grosseto D.; Sganzerla P.;
Tortorella G.; Ferrario M.; Crimi G.; Bossi I.; Tondi S.; Petronio A.S.;
Mariani M.; Toso A.; Ravera A.; Corrada E.; Cao D.; Di Ascenzo L.; La
Vecchia C.; De Servi S.; Savonitto S.
Institution
(Morici) Unita di Cure Intensive Cardiologiche and De Gasperis
Cardio-Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
(Morici, Alicandro, La Vecchia) Department of Clinical Sciences and
Community Health, Universita degli Studi di Milano, Milano, Italy
(Alicandro) Italian National Institute of Statistics, Rome, Italy
(Ferri) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Piatti, Savonitto) Division of Cardiology, Ospedale Manzoni, Lecco, Italy
(Grosseto) Division of Cardiology, Ospedale Infermi, Rimini, Italy
(Sganzerla) Division of Cardiology, ASST Bergamo ovest-ospedale di
Treviglio, Treviglio, Italy
(Tortorella) Division of Cardiology, IRCCS Arcispedale S. Maria Nuova,
Reggio Emilia, Italy
(Ferrario) Division of Cardiology, Fondazione IRCCS Policlinico S. Matteo,
Pavia, Italy
(Crimi) Interventional Cardiology Unit, Cardio Thoraco Vascular Department
(DICATOV), IRCCS Policlinico San Martino, Genova, Italy
(Bossi) Interventional Cardiology Division and De Gasperis Cardio-Center,
ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
(Tondi) Division of Cardiology, Ospedale Baggiovara, Modena, Italy
(Petronio) Cardiothoracic and Vascular Department, Cardiac Catheterization
Laboratory, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
(Mariani) Division of Cardiology, Ospedale Civile, Legnano, Italy
(Toso) Division of Cardiology, Ospedale S. Stefano, Prato, Italy
(Ravera) Division of Cardiology, Ospedale Ruggi D' Aragona, Salerno, Italy
(Corrada, Cao) Cardiovascular Department, Humanitas Research Hospital,
Rozzano, Italy
(Di Ascenzo) Division of Cardiology - Azienda ULSS "Veneto Orientale," San
Dona di Piave, Venezia, Italy
(De Servi) University of Pavia, Italy, Milan, Italy
Publisher
Elsevier Inc
Abstract
Background: The residual burden of coronary artery disease after
percutaneous coronary intervention (PCI) has been associated with worse
ischemic outcome. However, data are conflicting in elderly patients. The
aim of our study was to verify the incremental value of the residual
Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac
Surgery (SYNTAX) score (rSS) over clinical variables and baseline SYNTAX
score (bSS) in predicting 1-year mortality or cardiovascular events.
<br/>Method(s): A post hoc analysis of data collected in the Elderly-ACS 2
multicenter randomized trial was performed. We included 630 patients aged
> 75 years with multivessel coronary disease undergoing PCI for acute
coronary syndrome (ACS). The primary outcome was a composite of death,
recurrent myocardial infarction, and stroke at 1-year follow up. Change in
c-statistic and standardized net benefit were used to evaluate the
incremental value of the rSS. <br/>Result(s): Event rates were
significantly higher in patients with incomplete revascularization (rSS >
8). When the rSS was included in a core Cox regression model containing
age, previous myocardial infarction, and ACS type, the hazard ratio for
patients with score values > 8 was 2.47 (95% confidence interval,
1.51-4.06). However, the core model with rSS did not increase the
c-statistic compared with the core model with the bSS (from 0.69 to 0.70)
and gave little incremental value in the standardized net benefit.
<br/>Conclusion(s): In elderly patients with ACS with multivessel disease
undergoing PCI, incomplete revascularization was associated with worse
outcome at 1-year follow-up. However, there was no clear incremental value
of the rSS in the prediction of 1-year adverse outcome compared with a
model including clinical variables and bSS.<br/>Copyright &#xa9; 2020
Canadian Cardiovascular Society

<77>
Accession Number
2006171850
Title
Meta-analysis Comparing Outcomes of Self-Expanding Versus
Balloon-Expandable Valves for Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 128 (pp 202-209), 2020. Date of
Publication: 1 August 2020.
Author
Elgendy I.Y.; Gad M.M.; Mahmoud A.N.; Dvir D.; Kapadia S.R.; Alfonso F.;
Capodanno D.
Institution
(Elgendy) Division of Cardiology Massachusetts General Hospital and
Harvard Medical School, Boston, MA, United States
(Gad, Kapadia) Heart and Vascular Institute, Department of Cardiovascular
Medicine, Cleveland Clinic Foundation, Cleveland, OH, United States
(Mahmoud, Dvir) Division of Cardiology, University of Washington, Seattle,
WA, United States
(Alfonso) Department of Cardiology, Hospital Universitario de La Princesa,
CIBER-CV, Universidad Autonoma de Madrid, Madrid, Spain
(Capodanno) Division of Cardiology, A.O.U. "Policlinico-Vittorio Emanuele,
University of Catania, Catania, Italy
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
There are two commercially available transcatheter heart valve systems:
balloon expandable valves (BEV) and self-expanding valves (SEV). However,
there is a paucity of randomized trials comparing both systems. Electronic
databases (Medline, the Cochrane Library, Web of Science, and
clinicaltrials.gov) and major conference proceedings were searched for
randomized trials of patients with symptomatic severe aortic stenosis and
received transcatheter aortic valve implantation (TAVI) with a SEV or BEV
or surgical aortic valve replacement. The main efficacy outcomes were
all-cause mortality and stroke at the longest available follow-up. The
main analysis was performed using a random-effects network meta-analysis
complemented by several subgroup and sensitivity analyses. Ten trials with
9,439 patients (mostly undergoing transfemoral TAVI) were included. At a
median of 27 months, there was no difference between BEV and SEV valves in
terms of all-cause mortality (odds ratio [OR] 1.05, 95% confidence
interval [CI] 0.79 to 1.42). The incidence of any stroke was higher with
BEV (OR 1.51, 95% CI 1.01 to 2.26), but there was no difference in the
incidence of disabling stroke. At 30-days, BEV valves were associated with
lower incidence of new permanent pacemaker placement (OR 0.50, 95% CI 0.32
to 0.79) and moderate/severe paravalvular regurgitation (OR 0.39, 95% CI
0.22 to 0.68). In conclusion, in patients with severe symptomatic aortic
stenosis undergoing transfemoral TAVI, SEV and BEV were associated with
similar all-cause mortality. BEV were associated with a higher incidence
of any stroke driven by nondisabling strokes, but lower incidence of new
permanent pacemaker placement and moderate/severe paravalvular
regurgitation compared with SEV.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<78>
Accession Number
2005978425
Title
Growth of cardiac infants with post-surgical chylothorax can be supported
using modified fat breast milk with proactive nutrient-enrichment and
advancement feeding protocols; an open-label trial.
Source
Clinical Nutrition ESPEN. 38 (pp 19-27), 2020. Date of Publication: August
2020.
Author
DiLauro S.; Russell J.; McCrindle B.W.; Tomlinson C.; Unger S.; O'Connor
D.L.
Institution
(DiLauro, McCrindle, Tomlinson, Unger, O'Connor) Department of Nutritional
Sciences, University of Toronto, Medical Sciences Building, 5th Floor,
Room 5253, 1 King's College Circle, Toronto M5S 1A8, Canada
(DiLauro, Russell, McCrindle) Labatt Family Heart Centre, The Hospital for
Sick Children, 555 University Avenue, Toronto M5G 1X8, Canada
(DiLauro, O'Connor) Translational Medicine Program, The Hospital for Sick
Children, 686 Bay Street, Toronto M5G 0A4, Canada
(Russell, McCrindle, Tomlinson) Department of Pediatrics, Faculty of
Medicine, University of Toronto, Toronto M5G 1X8, Canada
(Tomlinson, Unger) Department of Neonatology, The Hospital for Sick
Children, 555 University Avenue, Toronto M5G 1X8, Canada
(Unger, O'Connor) Rogers Hixon Ontario Human Milk Bank, Mount Sinai
Hospital, 600 University Ave, Toronto M5G 1X5, Canada
(Unger, O'Connor) Department of Pediatrics, Mount Sinai Hospital, 600
University Avenue, Toronto M5G 1X5, Canada
Publisher
Elsevier Ltd
Abstract
Background & aim: Previously we showed that modified fat breast milk
(MFBM) facilitated resolution of post-surgical chylothorax in cardiac
infants, but their weight-for-age and length-for-age z-scores declined
over the >=6-week treatment duration. Our aim was to evaluate the growth
of infants diagnosed with post-surgical chylothorax and fed according to
one of two proactive feeding protocols using MFBM or a high medium
triglyceride (MCT)-containing formula (standard of care). <br/>Method(s):
In this open-label trial, infants who were receiving >50% of their enteral
feeds as breast milk prior to chylothorax diagnosis were randomized to
receive their enteral feeds according to one of two proactive MFBM
protocols: Target Fortification (n = 8), where the protein concentration
of defatted breast milk was measured weekly and multi- and single-nutrient
modulars were added to provide 3.5 g/kg/day of protein; or Higher Initial
Concentration (n = 8), where defatted breast milk was initially fortified
to an energy and nutrient level higher than that of unmodified breast milk
(80kcal/100 ml; 2.2 g/100 ml protein). A third nonrandomized group of
infants (n = 8) received high MCT formula (68kcal/100 ml; 2.3 g/100 ml
protein). The intervention lasted for a minimum of 6-weeks after chest
tube removal and continued after discharge. Weekly weight, length and head
circumference (HC) measurements were completed. <br/>Result(s): At
enrolment, there was no statistically significant differences in mean
(+/-SD) weight-for-age (-1.6 +/- 0.9, n = 24), length-for-age (-1.3 +/-
0.8), or HC-for-age (-0.9 +/- 1.0) z-scores among groups. Changes in mean
weight- (-0.3 +/- 0.9, n = 23), length- (0.1 +/- 0.6) and HC-for-age (0.2
+/- 0.6) z-scores did not differ among groups over the treatment period.
There was no difference in duration or volume of chest tube drainage
across groups. <br/>Conclusion(s): Use of proactive MFBM feeding protocols
both resolve chylothorax and support growth in infants following
cardiothoracic surgery. Trial registration: ClinicalTrials.gov
(NCT02577419).<br/>Copyright &#xa9; 2020 The Authors

<79>
Accession Number
2005950418
Title
Possible differential benefits of edetate disodium in post-myocardial
infarction patients with diabetes treated with different hypoglycemic
strategies in the Trial to Assess Chelation Therapy (TACT).
Source
Journal of Diabetes and its Complications. 34 (8) (no pagination), 2020.
Article Number: 107616. Date of Publication: August 2020.
Author
Escolar E.; Ujueta F.; Kim H.; Mark D.B.; Boineau R.; Nahin R.L.; Goertz
C.; Lee K.L.; Anstrom K.J.; Lamas G.A.
Institution
(Escolar, Ujueta, Lamas) Columbia University Division of Cardiology at
Mount Sinai Medical Center, Miami, FL, United States
(Kim, Mark, Lee, Anstrom) Duke Clinical Research Institute, Duke
University Medical Center, Durham, NC, United States
(Kim, Mark, Lee, Anstrom) Duke University, Durham, NC, United States
(Boineau, Nahin) National Heart, Lung, and Blood Institute, Bethesda, MD,
United States
(Goertz) Duke Department of Orthopaedic Surgery, Duke University, Durham,
NC, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: The NIH-funded Trial to Assess Chelation Therapy (TACT)
randomized 1708 stable patients age >=50 who were >=6 months post
myocardial infarction to 40 infusions of an edetate disodium-based regimen
or placebo. In 633 patients with diabetes, edetate disodium significantly
reduced the primary composite endpoint of mortality, recurrent myocardial
infarction, stroke, coronary revascularization, or hospitalization for
angina (hazard ratio [HR] 0.59, 95% confidence interval [CI] 0.44-0.79, p
< 0.001). The principal secondary endpoint of a composite of
cardiovascular death, myocardial infarction, or stroke was also reduced
(HR 0.60, 95% CI 0.39-0.91, p = 0.017). It is unknown if the treatment
effect differs by diabetes therapy. <br/>Method(s): We grouped the subset
of 633 patients with diabetes according to glucose-lowering therapy at
time of randomization. The log-rank test was used to compare active
therapy versus placebo. All treatment comparisons were performed using
2-sided significance tests at the significance level of 0.05 and were as
randomized. Relative risks were expressed as HR with associated 95% CI,
calculated using the Cox proportional hazards model. <br/>Result(s): There
were 162 (25.7%) patients treated with insulin; 301 (47.5%) with oral
hypoglycemics only; and 170 (26.8%) receiving no pharmacologic treatment
for diabetes. Patients on insulin reached the primary endpoint more
frequently than patients on no pharmacologic treatment [61 (38%) vs 49
(29%) (HR 1.56, 95% CI 1.07-2.27, p = 0.022)] or oral hypoglycemics [61
(38%) vs 87 (29%) (HR 1.46, 1.05-2.03, p = 0.024)]. The primary endpoint
occurred less frequently with edetate disodium based therapy versus
placebo in patients on insulin [19 (26%) vs 42 (48%) (HR 0.42, 95% CI
0.25-0.74, log-rank p = 0.002)], marginally in patients on oral
hypoglycemics [38 (25%) vs 49 (34%) (HR 0.66, 95% CI 0.43-1.01, log-rank p
= 0.041)], and no significant difference in patients not treated with a
pharmacologic therapy [23 (25%) vs 26 (34%) (HR 0.69, 95% CI 0.39-1.20,
log-rank p = 0.225)]. The interaction between randomized intravenous
treatment and type of diabetes therapy was not statistically significant
(p = 0.203). <br/>Conclusion(s): Edetate disodium treatment in stable,
post-myocardial infarction patients with diabetes suggests that patients
on insulin therapy at baseline may accrue the greatest benefit. Clinical
Trial Registration: clinicaltrials.gov identifier:
http://clinicaltrials.gov/ct2/show/NCT00044213?term=TACT&rank=7 identifier
Trial to Assess Chelation Therapy (TACT), NCT00044213.<br/>Copyright
&#xa9; 2020 Elsevier Inc.

<80>
Accession Number
2005760512
Title
The Optimal Length of Insertion for Central Venous Catheters Via the Right
Internal Jugular Vein in Pediatric Cardiac Surgical Patients.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (9) (pp 2386-2391),
2020. Date of Publication: September 2020.
Author
Maddali M.M.; Al-Shamsi F.; Arora N.R.; Panchatcharam S.M.
Institution
(Maddali) Department of Cardiac Anesthesia, National Heart Center, Royal
Hospital, Muscat, Oman
(Al-Shamsi) Anesthesia Residency Training Program, Oman Medical Specialty
Board, Muscat, Oman
(Arora) Department of Cardiac Anesthesia, National Heart Center, Royal
Hospital, Muscat, Oman
(Panchatcharam) Department of Studies and Research, Oman Medical Specialty
Board, Muscat, Oman
Publisher
W.B. Saunders
Abstract
Objectives: The primary objective was to identify the best among 4
techniques that could predict the length of central venous catheter
insertion through the right internal jugular vein, which, in turn, would
ensure the ideal placement of the catheter tip in pediatric cardiac
surgical patients. The techniques evaluated were those based on operator
experience, topography/landmark methods, and one that relied on a
patient's height-related formula. Based on the outcome of the study, the
possibility of arriving at a formula was investigated that would predict
with reasonable certainty the ideal length of catheter to be inserted for
the correct catheter placement through the right internal jugular vein in
pediatric cardiac surgical patients belonging to the authors' geographic
area. <br/>Design(s): A prospective observational study. <br/>Setting(s):
Tertiary care cardiac center. <br/>Participant(s): Children younger than 5
years of age undergoing cardiac surgery. <br/>Intervention(s): Right
internal jugular vein cannulation by the Seldinger technique method.
<br/>Measurements and Main Results: A total of 120 children aged younger
than 5 years undergoing cardiac surgery were included in the study. The
participants were randomized to 4 groups: group 1 (n = 30), the length of
the central venous catheter was determined empirically by the operator
based on clinical experience; group 2 (n = 30), the depth of insertion of
the catheter was determined by the distance from the site of skin puncture
to the second intercostal space; group 3 (n = 30), the depth of insertion
of the catheter was determined by the distance from the skin puncture site
to the third intercostal space; and group 4 (n = 30), the length of
catheter was determined by a height-based formula that was followed
routinely at the authors' institution. Central venous catheterization
through the right internal jugular vein was performed according to
out-of-plane ultrasound guidance in all patients. The ideal catheter tip
location was assumed to be at the level of the carina or within 1.5 cm
proximal to it. The number of patients who had ideal catheter tip
placement were recorded from postoperative chest radiograph in all groups.
Any relationship between acceptable catheter tip and demographic data
(mean ranks of age, height, weight, and body surface area) of the patients
were studied. <br/>Result(s): The central vein catheter tip was at the
level of the carina or within 1.5 cm in more patients in group 2 (39%, p =
0.02) compared with the other groups. This was followed by group 4 (40%),
group 3 (30%), and group 1 (23%). There was a statistically significant
difference in the mean distance between catheter tip and carina, with
group 2 patients having the tip closest to the carina (p = 0.03). There
was a significant correlation between acceptable catheter tip positioning
and a patient's height (p = 0.04). A new formula was developed based on
this correlation. <br/>Conclusion(s): A landmark-based topographic method
in which the length of insertion of the catheter was determined by the
distance from the skin puncture site to the second intercostal space for
achieving correct placement of the catheter tip was found to be more
reliable compared with other techniques. Height-based formula has the
disadvantage of being affected by the skin puncture site. Assuming that a
skin puncture at the midpoint between the right mastoid process and
clavicular insertion of sternocleidomastoid muscle insertion is ensured, a
new formula based on height has been proposed.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<81>
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. 35 (8) (pp 2009-2016), 2020. Date of
Publication: 01 Aug 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

<82>
Accession Number
2005565438
Title
Biatrial Versus Bicaval Orthotopic Heart Transplantation: A Systematic
Review and Meta-Analysis.
Source
Annals of Thoracic Surgery. 110 (2) (pp 684-691), 2020. Date of
Publication: August 2020.
Author
Zijderhand C.F.; Veen K.M.; Caliskan K.; Schoonen T.; Mokhles M.M.;
Bekkers J.A.; Manintveld O.C.; Constantinescu A.A.; Brugts J.J.; Bogers
A.J.J.C.; Takkenberg J.J.M.
Institution
(Zijderhand, Veen, Schoonen, Mokhles, Bekkers, Bogers, Takkenberg)
Department of Cardiothoracic Surgery, Erasmus University Medical Center,
Rotterdam, Netherlands
(Caliskan, Manintveld, Constantinescu, Brugts) Department of Cardiology,
Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier USA
Abstract
Background: Orthotopic heart transplantation (OHT) is the gold standard
treatment in end-stage heart disease. Controversy remains whether bicaval
OHT is superior to biatrial OHT in both early and late outcomes. This
study aimed to provide an overview of the early and late outcomes in
patients who underwent a bicaval or biatrial OHT. <br/>Method(s): A
systematic literature search was performed for articles published before
December 2017. Studies comparing adult patients undergoing biatrial OHT
and bicaval OHT were included. Early outcomes were pooled in odds ratios
and late outcomes were pooled in rate ratios. Late survival was visualized
by a pooled Kaplan-Meier curve. <br/>Result(s): A total of 36 publications
were included in the meta-analysis, counting 3555 patients undergoing
biatrial OHT and 3208 patients undergoing bicaval OHT. Early outcomes in
mortality, tricuspid regurgitation, mitral regurgitation, and permanent
pacemaker implantation differed significantly in favor of the bicaval OHT
patients. Long-term survival was significantly better in patients
undergoing bicaval vs biatrial OHT (hazard ratio, 1.32; 95% confidence
interval, 1.1-1.6; P =.008). Also, late tricuspid regurgitation was less
frequently seen in the bicaval OHT patients (rate ratio, 2.14; 95% CI,
1.17-3.94; P =.014). Conclusions. This systematic review with
meta-analysis shows that bicaval OHT results in more favorable early and
late outcomes for patients undergoing a bicaval OHT compared with a
biatrial OHT. Therefore, bicaval OHT should be considered as preferable
technique for OHT.<br/>Copyright &#xa9; 2020 The Society of Thoracic
Surgeons

<83>
Accession Number
2005520785
Title
On-pump beating-heart coronary artery bypass grafting in high-risk
patients: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 35 (8) (pp 1958-1978), 2020. Date of
Publication: 01 Aug 2020.
Author
Dominici C.; Salsano A.; Nenna A.; Spadaccio C.; Mariscalco G.; Santini
F.; Chello M.
Institution
(Dominici, Nenna, Chello) Department of Cardiovascular Surgery, Universita
Campus Bio-Medico di Roma, Rome, Italy
(Salsano, Santini) Department of Cardiac Surgery, University of Genoa,
Genoa, Italy
(Spadaccio) Department of Cardiac Surgery, Golden Jubilee National
Hospital, Glasgow, United Kingdom
(Mariscalco) Department of Cardiac Surgery, Glenfield Hospital, University
Hospitals of Leicester, Leicester, United Kingdom
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Background: Operative technique for surgical myocardial revascularization
in high-risk patients remains an argument of debate. On-pump coronary
artery bypass graft (CABG) with cardioplegic arrest and off-pump CABG have
intrinsic limitations. The hybrid approach of on-pump beating-heart CABG
(OPBHC) has been proposed over the years with conflicting results. This
systematic review and meta-analysis intends to summarize the contemporary
literature. <br/>Method(s): A literature search was conducted through
major electronic databases. The systematic review provided a total of 279
articles, of those 17 studies were included in the present study.
<br/>Result(s): Compared with on-pump CABG, OPBHC patients showed a
preoperative higher risk profile but had reduced early mortality (risk
ratio [RR], 0.59, 95% CI, 0.36-0.97) and reduced postoperative stroke (RR,
0.60, 95% CI, 0.39-0.91). Also, interesting trends towards reduced
postoperative intra-aortic balloon pump use (RR, 0.56, 95% CI, 0.31-1.01)
and myocardial infarction (RR, 0.48, 95% CI, 0.22-1.07) were observed.
Baseline characteristics and postoperative complications were similar
between OPBHC and off-pump CABG, but limited data are available. The risk
of incomplete revascularization in OPBHC is lower than off-pump CABG (RR,
0.53, 95% CI, 0.33-0.87) but higher than conventional on-pump CABG (RR,
1.71, 95% CI, 1.23-2.39). <br/>Conclusion(s): OPBHC is an effective
technique to perform surgical revascularization in high-risk patients as
preventing haemodynamic deterioration and guaranteeing adequate end-organ
perfusion. OPBHC represents an alternative technique to on-pump and
off-pump CABG, in those cases in which complications deriving from
cardioplegic arrest or manipulation of the heart are more likely. For
these reasons, OPBHC might be useful in patients with recent myocardial
infarction or with left ventricular dysfunction.<br/>Copyright &#xa9; 2020
Wiley Periodicals LLC

<84>
Accession Number
2005471520
Title
Supplemental Cardioplegia During Donor Heart Implantation: A Systematic
Review and Meta-Analysis.
Source
Annals of Thoracic Surgery. 110 (2) (pp 545-552), 2020. Date of
Publication: August 2020.
Author
Ribeiro R.V.P.; Friedrich J.O.; Ouzounian M.; Yau T.; Lee J.; Yanagawa B.
Institution
(Ribeiro, Ouzounian, Yau) Division of Cardiovascular Surgery, Peter Munk
Cardiac Centre, Toronto General Hospital, University Health Network,
Toronto, ON, Canada
(Ribeiro, Yau) Institute of Medical Science, University of Toronto,
Toronto, ON, Canada
(Friedrich) Critical Care and Medicine Departments and Li Ka Shing
Knowledge Institute, St. Michael's Hospital, Department of Medicine and
Interdepartmental Division of Critical Care, University of Toronto,
Toronto, ON, Canada
(Lee, Yanagawa) Division of Cardiovascular Surgery, St. Michael's
Hospital, Toronto, ON, Canada
Publisher
Elsevier USA
Abstract
Background: The optimal donor heart preservation and management strategy
during heart transplantation remains controversial. We report the results
of a systematic review and meta-analysis of the effect of supplemental
cardioplegia administration during donor heart implant for
transplantation. <br/>Method(s): We searched MEDLINE and Embase databases
until February 2019 for studies comparing patients who received
transplants with the donor heart given supplemental cardioplegia or not.
Data were extracted by 2 independent investigators. The main outcomes were
early morbidity and mortality. <br/>Result(s): Included were 7
retrospective observational studies (4 comparing to historical controls)
and 3 randomized controlled trials enrolling 1125 patients. Supplemental
cardioplegia included crystalloid and blood cardioplegia given continuous
retrograde or as terminal "hot shots." Supplemental cardioplegia was
associated with improved early mortality (risk ratio [RR], 0.55; 95%
confidence interval [CI], 0.35-0.87; P <.01), greater rates of spontaneous
return of sinus rhythm (RR, 2.62; 95% CI, 1.50-4.56; P <.01), shorter
intensive care stay (mean difference, -3.4 days; 95% CI, -5.1 to -1.6; P
<.01), and lower incidence of ischemic changes seen on endomyocardial
biopsy specimens (RR, 0.49; 95% CI, 0.35-0.69; P <.01) compared with
controls. Midterm mortality was not different between groups (incident
rate ratio, 0.80; 95% CI, 0.51-1.26; P =.34). <br/>Conclusion(s):
Administration of supplemental cardioplegia may be associated with a
reduction in organ ischemic injury and shorter intensive care stay as well
as improvement in early survival after transplantation. This strategy may
be a simple and cost-effective adjunct to improve outcomes of heart
transplantation, especially in an era of increasing use of marginal donor
organs. Further investigation will be needed to confirm the findings of
this hypothesis-generating study.<br/>Copyright &#xa9; 2020 The Society of
Thoracic Surgeons

<85>
Accession Number
2005416313
Title
The use of extracorporeal membrane oxygenation postcardiotomy-A systematic
review.
Source
Journal of Cardiac Surgery. 35 (8) (pp 1941-1953), 2020. Date of
Publication: 01 Aug 2020.
Author
Harahwa T.; Chor C.Y.T.; Harky A.
Institution
(Harahwa, Chor) School of Medicine, St George's, University of London,
London, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Objectives: The use of extracorporeal membrane oxygenation (ECMO) in
cardiac surgery has been established in cases of postcardiotomy
cardiogenic shock, which is refractory to conventional therapy with
inotropes and intra-aortic balloon pulsation support. We sought to examine
the literature in a systematic review manner on the outcomes of using ECMO
postcardiac surgery. <br/>Method(s): A comprehensive electronic literature
search was done to identify all the articles that have discussed the use
of ECMO postcardiac surgery. The keywords and medical subject headings
terms were used to identify the relevant articles. Studies have been
screened according to the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses guidelines. <br/>Result(s): The identified studies have
been summarized in each relevant section of this study. Cardiogenic shock
postcardiac surgery can benefit from ECMO to varying degrees and the
survival for this; otherwise, fatal condition has been shown to be
improving through the use of ECMO. However, the decision and timing to
initiate ECMO therapy remains selective and is dependent on a range of
factors such as patient factor, clinician's judgment, meaning there is no
consistent and solid ground regarding the timing of ECMO initiation.
<br/>Conclusion(s): Current evidence suggests that the circulatory support
provided by ECMO improves survival rates for postcardiac surgery
cardiogenic shock patients who are refractory to inotropic management,
without such ECMO support patient mortality rates would be much
greater.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<86>
Accession Number
2005189601
Title
Efficacy of Bilateral Transversus Thoracis Muscle Plane Block in Pediatric
Patients Undergoing Open Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (9) (pp 2430-2434),
2020. Date of Publication: September 2020.
Author
Zhang Y.; Chen S.; Gong H.; Zhan B.
Institution
(Zhang, Chen, Gong) Department of Anesthesiology, First Affiliated
Hospital of Nanchang University, Nanchang, China
(Zhan) Department of Cardiology, The Second Affiliated Hospital of
Nanchang University, Jiangxi, China
Publisher
W.B. Saunders
Abstract
Objectives: Adequate pain management is crucial for pediatric patients
undergoing open cardiac surgery. The aim of the present study was to
investigate the effect of a bilateral transversus thoracis muscle plane
(TTP) block on open cardiac surgery outcomes. <br/>Setting(s): First
Affiliated Hospital of Nanchang University. <br/>Participant(s): Patients
ages 6 to 60 months undergoing cardiac surgical procedures were included.
<br/>Intervention(s): A group of 100 children were randomly allocated to
receive either bilateral TTP block (TTP group) or no nerve block.
<br/>Measurements and Main Results: The primary endpoint was postoperative
pain, which was measured with the Modified Objective Pain Score. The
secondary outcome measures included intraoperative and postoperative
fentanyl consumption; time to extubation; time to first feces; length of
stay in the intensive care unit; length of hospital stay; and possible
complications such as ropivacaine allergy, pneumothorax, hematomas,
infections, and injuries to the internal mammary artery and vein. The TTP
group had a significantly lower Modified Objective Pain Score until 24
hours after extubation than the no nerve block group. The TTP group
reported significantly less fentanyl consumption. Time to extubation and
lengths of stay in the intensive care unit and hospital were significantly
decreased in the TTP group. <br/>Conclusion(s): Bilateral TTP blocks
provide effective analgesia and accelerate recovery in pediatric
patients.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<87>
Accession Number
2005098681
Title
Heparin Dose and Point-of-Care Measurements of Hemostasis in Cardiac
Surgery-Results of a Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (9) (pp 2362-2368),
2020. Date of Publication: September 2020.
Author
Lax M.; Pesonen E.; Hiippala S.; Schramko A.; Lassila R.; Raivio P.
Institution
(Lax, Pesonen, Hiippala, Schramko) Division of Anesthesiology, Department
of Anesthesiology, Intensive Care and Pain Medicine, University of
Helsinki and Helsinki University Hospital, Helsinki, Finland
(Lassila) Coagulation Disorders Unit, Laboratory Services, Department of
Hematology and Comprehensive Cancer Center, Helsinki University Hospital,
Helsinki, Finland
(Raivio) Department of Cardiac Surgery, Heart, and Lung Center, University
of Helsinki and Helsinki University Hospital, Helsinki, Finland
Publisher
W.B. Saunders
Abstract
Objective: High heparin doses during cardiopulmonary bypass (CPB) have
been suggested to reduce thrombin activation and consumption coagulopathy
and consequently bleeding complications. The authors investigated the
effect of a high heparin dose during CPB on point-of-care measurements of
coagulation. The authors hypothesized that during CPB a high heparin dose
compared with a lower heparin dose would reduce thrombin generation and
platelet activation and tested whether this would be reflected in the
results of rotational thromboelastometry (TEM) and platelet aggregation,
measured with multiple electrode aggregometry (MEA). <br/>Design(s):
Prospective, randomized, controlled, open single-center study.
<br/>Setting(s): University teaching hospital. <br/>Participant(s):
Sixty-three consecutive patients undergoing elective coronary artery
bypass grafting with CPB were enrolled. <br/>Intervention(s): Patients
were randomly assigned to receive either a high (600 IU/kg, n = 32) or a
low (300 IU/kg, n = 31) initial dose of heparin. Target levels of
activated clotting time during CPB were >600 seconds in the high heparin
dose group and >400 seconds in the low heparin dose group.
<br/>Measurements and Main Results: Blood samples were collected (1)
preoperatively after induction of anesthesia, (2) 10 minutes after aortic
declamping, (3) 30 minutes after protamine administration, and (4) 3 hours
after protamine administration. TEM and MEA were then measured. There was
no difference in blood loss up to 18 hours postoperatively (median 735 mL
for high dose v 610 mL for low dose; p < 0.056) or transfusions between
the groups. Total median heparin dose (54,300 IU v 27,000 IU; p = 0.001)
and median antifactor Xa levels during CPB (9.38 U/mL v 5.04 U/mL; p =
0.001) were greater in the high than in the low heparin dose group.
However, neither TEM nor MEA results differed significantly between the
groups. <br/>Conclusion(s): Compared with a lower dose of heparin during
CPB, a high dose of heparin had little effect on the point-of-care
measurements of hemostasis, TEM, and MEA. Based on the similarity of
platelet and coagulation activity assessments, the higher heparin dose
does not appear to offer benefit during CPB.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<88>
Accession Number
2004671053
Title
Industry compensation and self-reported financial conflicts of interest
among authors of highly cited peripheral artery disease studies.
Source
Journal of Vascular Surgery. 72 (2) (pp 673-684), 2020. Date of
Publication: August 2020.
Author
Bellomo T.R.; Hwang C.; Spector-Bagdady K.; Stanley J.C.; Corriere M.A.
Institution
(Bellomo, Hwang, Stanley, Corriere) Department of Surgery, Section of
Vascular Surgery, University of Michigan, Ann Arbor, Mich, United States
(Spector-Bagdady, Corriere) Center for Bioethics and Social Sciences in
Medicine, University of Michigan, Ann Arbor, Mich, United States
(Spector-Bagdady) Department of Obstetrics and Gynecology, University of
Michigan, Ann Arbor, Mich, United States
(Corriere) Center for Health Outcomes and Policy, University of Michigan,
Ann Arbor, Mich, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: Industry compensation to authors may influence the
interpretation of study results. Scientific journals often require author
disclosure of a relevant financial conflict of interest (FCOI) but seldom
quantify compensation and leave reporting up to the author's discretion.
Professional and public concerns related to potential bias introduced into
medical research by FCOI have arisen, especially when physician
compensation from manufacturers is not disclosed. Little is known,
however, about the prevalence of industry compensation to authors of
related publications, payment amounts, or how this information compares
with self-reported FCOI. The objective of this study was to compare
industry compensation and disclosed FCOI among highly referenced
publications related to treatment of peripheral artery disease, a disease
that affects approximately 8.5 million Americans and is often treated with
medications and devices. <br/>Method(s): "Peripheral artery disease" was
used as a Web of Science search term to identify publications from 2013 to
2016, excluding review articles, conference proceedings, book chapters,
abstract publications, and non-English language publications. The top 99
most cited publications were abstracted for self-reported FCOI by author.
Industry compensation to authors was queried using a ProPublica Dollars
for Docs custom data set based on Centers for Medicare and Medicaid
Services Open Payments data. Providers practicing in the United States in
any of the following specialties were included: cardiology, cardiothoracic
surgery, vascular and interventional radiology, or vascular surgery.
Payment transactions were matched to physician authors on the basis of
provider name, specialty, and geographic location. Statistical analysis
included descriptive statistics and categorical tests. Descriptive
statistics are reported as frequency (percentage) or median (interquartile
range). <br/>Result(s): Among 1008 vascular specialist authors identified,
218 (22%) self-reported FCOI. Fifty-six physician authors had compensation
reported to the Centers for Medicare and Medicaid Services by industry
during the study period. Among those identified as recipients of industry
compensation, 28 (50%) self-reported FCOI. Industry payments to the 56
authors totaled $11,139,987, with a median total payment of $18,827
(interquartile range, $152,084) per author. Food and beverage was the most
frequently identified nature of payment (n = 8981 [74%]), promotional
speaking involved the largest total amount of payments ($3,256,431), and
royalty or license was the highest median payment ($51,431 [$72,215]).
Physicians reporting FCOI received a total of $9,435,340 during the study
period vs $1,706,647 for those who did not report any FCOI. Median total
payments were higher among authors reporting FCOI vs not ($81,224
[$324,171] vs $9494 [$43,448]; P <.001). <br/>Conclusion(s): Nondisclosed
author compensation from industry is relatively uncommon among highly
cited peripheral artery disease research studies but may be associated
with substantial payments. These results suggest that self-reported FCOI
does not provide a comprehensive overview of industry compensation.
Reporting all payments rather than only those deemed relevant by the
author might provide a more complete and transparent report of potential
FCOI, allowing independent assessment of relevance in interpreting study
findings.<br/>Copyright &#xa9; 2019 Society for Vascular Surgery

<89>
Accession Number
2003701251
Title
Impact of patient blood management guidelines on blood transfusions and
patient outcomes during cardiac surgery.
Source
Journal of Thoracic and Cardiovascular Surgery. 160 (2) (pp 437-445.e20),
2020. Date of Publication: August 2020.
Author
Irving A.H.; Harris A.; Petrie D.; Higgins A.; Smith J.; McQuilten Z.K.
Institution
(Irving, Harris, Petrie) Centre for Health Economics, Monash University,
Melbourne, Australia
(Higgins, McQuilten) Australian and New Zealand Intensive Care Research
Centre, School of Public Health and Preventive Medicine, Monash
University, Melbourne, Australia
(Smith) Department of Surgery, School of Clinical Sciences at Monash
Health, Monash University, Melbourne, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Melbourne,
Australia
(McQuilten) Department of Haematology, Monash Health, Melbourne, Australia
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: In March 2012, Australia's National Blood Authority published
national patient blood-management guidelines for perioperative care
developed by a systematic review and clinical expert opinion. This study
assesses how blood transfusions and patient outcomes in cardiac surgery
changed after the guidelines were published. <br/>Method(s): Blood
transfusions and patient outcomes in cardiac surgery were compared before
and after implementation of the guidelines using an interrupted time
series analysis. The evaluation included red blood cells, platelets,
cryoprecipitate, fresh-frozen plasma, 30-day mortality, 30-day
readmissions, and hospital and intensive care length of stay. Patient
characteristics were controlled for along with hospital characteristics
using fixed effects. Different responses across institutional settings
were assessed with an expanded difference-in-differences model.
<br/>Result(s): After the guidelines were published, our model found a
significant reduction in red blood cell, platelet, and fresh-frozen plasma
transfusions. There was also a significant reduction in hospital length of
stay but no significant impact on cryoprecipitate, 30-day mortality,
30-day readmissions, or intensive care unit length of stay. The subgroup
analyses found no differences with regards to institutional settings.
<br/>Conclusion(s): Following the publication of the guidelines, there was
a measurable reduction in perioperative blood transfusions in cardiac
surgery with an associated reduction in hospital length of stay but no
detectable differences in other patient outcomes.<br/>Copyright &#xa9;
2019 The American Association for Thoracic Surgery

<90>
Accession Number
2003570830
Title
Low-Risk Transcatheter Versus Surgical Aortic Valve Replacement - An
Updated Meta-Analysis of Randomized Controlled Trials.
Source
Cardiovascular Revascularization Medicine. 21 (4) (pp 441-452), 2020. Date
of Publication: April 2020.
Author
Anantha-Narayanan M.; Kandasamy V.V.; Reddy Y.N.; Megaly M.; Baskaran J.;
Pershad A.; Suri R.M.; Garcia S.
Institution
(Anantha-Narayanan) University of Minnesota Medical Center, United States
(Kandasamy) University of Louisville Medical Center, United States
(Reddy) Mayo Clinic, United States
(Megaly, Garcia) Minneapolis Heart Institute, United States
(Baskaran) CHI Health Creighton University Medical Center, United States
(Pershad) University of Arizona, Banner, United States
(Suri) Cleveland Clinic, Abu Dhabi, United Arab Emirates
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Objectives: To perform a meta-analysis including all available randomized
controlled trials (RCTs) to date comparing transcatheter aortic valve
replacement (TAVR) to surgical aortic valve replacement (SAVR) in patients
with severe aortic stenosis (AS) and low surgical risk.
<br/>Background(s): Current guidelines recommend SAVR for patients with
severe symptomatic AS and low surgical risk. A few RCTs have evaluated
TAVR in low surgical risk patients but equipoise exists related to TAVR
valve durability, paravalvular leak (PVL) and role of TAVR in younger, low
surgical risk patients. <br/>Method(s): Five databases were analyzed from
January-2000 to March-2019 for RCTs comparing SAVR to TAVR in low-risk
severe AS patients. <br/>Result(s): Four RCTs on low-risk TAVR patients
with 2887 patients were included. Mean follow-up was ~24.1 +/- 24 months.
Early mortality was lower with TAVR compared to SAVR (RR: 0.44, 95% CI:
0.20-0.95, P = 0.038) whereas long-term mortality was similar (RR: 0.67,
95% CI: 0.39-1.14, P = 0.141). Both early and long-term stroke rates were
similar. TAVR was associated with lower risk of atrial fibrillation, major
bleeding, acute kidney injury (AKI) and rehospitalization, but higher
rates of permanent pacemaker implantation (PPM) and moderate or severe
PVL. There was no difference in major vascular complications, myocardial
infarction, endocarditis, aortic valve gradients and valve area at
follow-up. <br/>Conclusion(s): In low-risk patients with severe AS, TAVR
has a lower early mortality compared to SAVR with no difference in
long-term mortality. Although complication rates varied between TAVR and
SAVR, our study findings suggest that transfemoral-TAVR is an appropriate
treatment option for severe symptomatic AS in patients with low surgical
risk.<br/>Copyright &#xa9; 2019 Elsevier Inc.

<91>
Accession Number
632451738
Title
Radial artery harvesting in coronary artery bypass grafting
surgery-Endoscopic or open method? A meta-analysis.
Source
PloS one. 15 (7) (pp e0236499), 2020. Date of Publication: 2020.
Author
Huang T.-Y.; Huang T.-S.; Cheng Y.-T.; Wang Y.-C.; Chen T.-P.; Yin S.-Y.;
Yeh C.-H.
Institution
(Huang, Wang, Chen, Yin, Yeh) Department of Thoracic and Cardiovascular
Surgery Chang Gung Memorial Hospital at Keelung, Chiayi, Taiwan (Republic
of China)
(Huang) Department of Biomedical Engineering, National Taiwan University,
Taipei, Taiwan (Republic of China)
(Huang) Department of General Surgery, Keelung Chang Gung Memorial
Hospital, Taoyuan City, Taiwan (Republic of China)
(Huang, Yeh) Community Medicine Research Center, Keelung Chang Gung
Memorial Hospital, Taoyuan City, Taiwan (Republic of China)
(Huang, Yeh) Department of Chinese Medicine, College of Medicine, Chang
Gung University, Taoyuan City, Taiwan (Republic of China)
(Cheng, Yeh) Department of Thoracic and Cardiovascular Surgery, Chang Gung
Memorial Hospital at Linkou, Taoyuan City, Taiwan (Republic of China)
(Yeh) College of Medicine, Chang Gung University, Taoyuan City, Taiwan
(Republic of China)
Publisher
NLM (Medline)
Abstract
We analyzed the clinical outcomes of open radial artery harvesting (OAH)
and endoscopic radial artery harvesting (EAH) undergoing coronary artery
bypass grafting (CABG). We designed this meta-analysis conducted using
Pubmed, Medline, the Cochrane Library, and EMBASE. Articles with
comparisons of OAH and EAH undergoing CABG were included. Primary outcomes
included the wound infection rate, the wound complication rate,
neurological complications of the forearm, in-hospital mortality,
long-term survival, and the patency rate. The results of our study
included six randomized controlled trials (RCTs), two non-randomized
controlled trials (NRCTs) with matching, and 10 NRCTs. In total, 2919
patients were included in 18 studies, while 1187 (40.7%) and 1732 (59.3%)
patients received EAH and OAH, respectively. EAH was associated with a
lower incidence of wound infection (RR = 0.29, 95% confidence interval
(CI) = 0.14 to 0.60, p = 0.03), and neurological complications over the
harvesting site (RR = 0.41, 95% CI = 0.27 to 0.62, p < 0.0001). There was
no significant difference in 30-day mortality, long-term survival (over
one year), and the graft patency rate. According to our analysis,
endoscopic radial artery harvesting can improve the outcome of the
harvesting site, without affecting the mortality, long-term survival, and
graft patency.

<92>
Accession Number
2007164367
Title
Three-dimensional geometry of coronary arteries after arterial switch
operation for transposition of the great arteries and late coronary
events.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Batteux C.; Abakka S.; Gaudin R.; Vouhe P.; Raisky O.; Bonnet D.
Institution
(Batteux, Abakka, Gaudin, Vouhe, Raisky, Bonnet) Department of Congenital
and Pediatric Cardiology, Centre de Reference Malformations Cardiaques
Congenitales Complexes, Hopital Necker-Enfants Malades, Assistance
Publique-Hopitaux de Paris, Paris, France
(Vouhe, Raisky, Bonnet) Universite de Paris, Paris, France
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Objective: Using 3-dimensional (3D) modeling to predict late coronary
events after the arterial switch operation (ASO) for transposition of the
great arteries (TGA). <br/>Method(s): We reviewed 100 coronary computed
tomography scans performed after ASO randomly selected from
free-from-coronary-event patients and 21 coronary computed tomography
scans from patients who had a coronary event later than 3 years after ASO.
Using 3D modeling software, we defined and measured 6 geometric criteria
for each coronary artery: Clockwise position of coronary ostium, First
centimeter angle defined as the angle between of the coronary artery
ostium and the first centimeter of the vessel, Minimal 3D angle between
the coronary first centimeter and the aortic wall, ostium height defined
as the distance between the ostium and the aortic valve, distance between
the coronary ostium and the pulmonary artery, and distance between the
coronary first centimeter and the pulmonary artery. <br/>Result(s): None
of the right ostium geometric parameters were associated with coronary
events. Four out of 6 criteria of left coronary artery geometry were
associated to coronary events: Clockwise position of the left ostium
>67degree (P < .001), First centimeter angle >62degree (P < .01), minimal
3D angle <39degree (P = .003), distance between the coronary ostium and
the pulmonary artery <1 mm/mm (P = .03). The association of first
centimeter angle >62degree and minimal angle in 3D <39degree had a 88%
sensitivity and a 81% specificity to predict coronary events (receiver
operator characteristics curve, 0.847; 95% confidence interval,
0.745-0.949; P < .001). <br/>Conclusion(s): The acquired geometric
characteristics of the transferred left coronary artery are associated
with coronary events. Imaging coronary arteries after ASO might be useful
to select patients at higher risk of coronary events and to tailor
surveillance.<br/>Copyright &#xa9; 2020 The American Association for
Thoracic Surgery

<93>
Accession Number
2007164350
Title
Treatment options for ischemic mitral regurgitation: A meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Nappi F.; Antoniou G.A.; Nenna A.; Michler R.; Benedetto U.; Avtaar Singh
S.S.; Gambardella I.C.; Chello M.
Institution
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord de
Saint-Denis, Paris, France
(Antoniou) Department of Vascular and Endovascular Surgery, The Royal
Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, United
Kingdom
(Antoniou) Division of Cardiovascular Sciences, School of Medical
Sciences, University of Manchester, Manchester, United Kingdom
(Nenna, Chello) Department of Cardiovascular Surgery, University Campus
Bio-Medico of Rome, Rome, Italy
(Michler) Department of Surgery and Cardiothoracic and Vascular Surgery,
Montefiore Medical Center, Albert Einstein College of Medicine, New York,
NY, United States
(Benedetto) Department of Cardiothoracic Surgery, Bristol Heart Institute,
University of Bristol, Bristol, United Kingdom
(Avtaar Singh) Department of Cardiac Surgery, Golden Jubilee National
Hospital, Glasgow, United Kingdom
(Gambardella) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York, NY, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: Treatment of ischemic mitral regurgitation (IMR) is in
evolution, as percutaneous procedures and complex surgical repair have
been recently investigated in randomized clinical trials and matched
studies. This study aims to review and compare the current treatment
options for IMR. <br/>Method(s): A comprehensive literature search was
conducted using electronic databases. The primary outcome was all-cause
long-term mortality. The secondary outcomes were perioperative mortality,
unplanned rehospitalization, reoperation, and composite end points as
defined in the original articles. <br/>Result(s): A total of 12 articles
met the inclusion criteria and were included in the final meta-analysis.
The MitraClip procedure did not confer a significant benefit in mortality
and repeated hospitalization compared with medical therapy alone. In
patients with moderate IMR, the adjunct of mitral procedure over coronary
artery bypass graft is not associated with clinical improvements. When
evaluating mitral valve (MV) replacement versus repair, hospital mortality
was greater among patients undergoing replacement (odds ratio [OR], 1.91;
P =.009), but both reoperation and readmission rates were lower (OR, 0.60,
P =.05; and OR, 0.45, P <.02, respectively). Comparing restrictive
annuloplasty alone with adjunctive subvalvular repair, subvalvular
procedures resulted in fewer readmissions (OR, 0.50; P =.06) and adverse
composite end points (P =.009). <br/>Conclusion(s): MitraClip procedure is
not associated with improved outcomes compared with medical therapy. MV
replacement is associated with increased early mortality but reduced
reoperation rate and readmission rate compared with MV repair using
annuloplasty in moderate-to-severe IMR. Despite no significant benefit in
isolated outcomes comparing annular and adjunct subvalvular procedures,
the adjunct of subvalvular procedures reduces the risk of major
postoperative adverse events.<br/>Copyright &#xa9; 2020 The American
Association for Thoracic Surgery

<94>
Accession Number
2007164302
Title
Five-year outcomes comparing percutaneous coronary intervention with
drug-eluting stents versus coronary artery bypass grafting in patients
with left main coronary artery disease: A systematic review and
meta-analysis.
Source
Atherosclerosis. (no pagination), 2020. Date of Publication: 2020.
Author
Zhang J.; Jiang T.; Hou Y.; Chen F.; Yang K.; Sang W.; Wu H.; Ma Y.; Xu
F.; Chen Y.
Institution
(Zhang, Jiang, Hou, Yang, Sang, Wu, Ma, Xu, Chen) Department of Emergency
Medicine, Qilu Hospital of Shandong University, Jinan, China
(Zhang, Jiang, Hou, Yang, Sang, Wu, Ma, Xu, Chen) Shandong Provincial
Clinical Research Center for Emergency and Critical Care Medicine,
Institute of Emergency and Critical Care Medicine of Shandong University,
Qilu Hospital of Shandong University, Jinan, China
(Zhang, Jiang, Hou, Yang, Sang, Wu, Ma, Xu, Chen) Key Laboratory of
Emergency and Critical Care Medicine of Shandong Province, Key Laboratory
of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province,
Shandong Provincial Engineering Laboratory for Emergency and Critical Care
Medicine, Qilu Hospital of Shandong University, Jinan, China
(Zhang, Jiang, Hou, Yang, Sang, Wu, Ma, Xu, Chen) The Key Laboratory of
Cardiovascular Remodeling and Function Research, Chinese Ministry of
Education, Chinese Ministry of Health and Chinese Academy of Medical
Sciences, The State and Shandong Province Joint Key Laboratory of
Translational Cardiovascular Medicine, Qilu Hospital of Shandong
University, Jinan, China
(Chen) Emergency Department, The Affiliated Hospital of Inner Mongolia
Medical University, Huhhot, China
Publisher
Elsevier Ireland Ltd
Abstract
Background and aims: In patients with left main coronary artery disease
(LMCAD), long-term outcomes after percutaneous coronary intervention (PCI)
with drug-eluting stents (DES) compared with coronary artery bypass
grafting (CABG) remain controversial. We conducted a meta-analysis to
compare the efficacy and safety of PCI with DES and CABG in LMCAD
patients. <br/>Method(s): We comprehensively searched in Web of Science,
EMBASE, PubMed, and Cochrane databases for eligible randomised controlled
trials (RCTs) comparing the 5-year clinical outcomes between PCI with DES
and CABG in LMCAD patients. Random-effect models were applied to analyse
risk ratios (RRs) and hazard ratios (HRs) across studies, and
I² to assess heterogeneity. <br/>Result(s): We screened 4 RCTs
including 4394 patients distributed randomly into PCI (n = 2197) and CABG
(n = 2197) groups. In comparison to CABG, PCI showed non-inferiority
concerning a composite of death, myocardial infarction, and stroke (HR
1.22, 95% confident interval [CI] 0.84-1.75), death (HR 1.06, 95% CI
0.81-1.40) and stroke (HR 0.80, 95% CI 0.42-1.53). Regarding major adverse
cardiac or cerebrovascular events (MACCE) rate, both strategies show
clinical equipoise in patients with a low-to-intermediate Synergy Between
PCI with TAXUS and Cardiac Surgery (SYNTAX) score (HR 1.20, 95% CI
0.85-1.70), while CABG had an advantage over PCI in those with a high
SYNTAX score (HR 1.64, 95% CI 1.20-2.24). <br/>Conclusion(s): CABG showed
advantage over PCI with DES for LMCAD patients in MACCE. PCI and CABG
showed equivalent 5-year clinical risk of a composite of all-cause
mortality, myocardial infarction, and stroke, but the former had higher
risk of repeat revascularization.<br/>Copyright &#xa9; 2020 Elsevier B.V.

<95>
Accession Number
2007151997
Title
Performance and Safety of Transfemoral TAVI With SAPIEN XT in Australian
Patients With Severe Aortic Stenosis at Intermediate Surgical Risk:
SOLACE-AU Trial.
Source
Heart Lung and Circulation. (no pagination), 2020. Date of Publication:
2020.
Author
Yong G.; Walton T.; Ng M.; Gurvitch R.; Worthley S.; Whitbourn R.; Jepson
N.; Bhindi R.; Shang K.; Sinhal A.
Institution
(Yong) Fiona Stanley Hospital, Perth, WA, Australia
(Walton) Alfred Health, Melbourne, Vic, Australia
(Ng) Royal Prince Alfred Hospital, Sydney, NSW, Australia
(Gurvitch) Royal Melbourne Hospital, Melbourne, Vic, Australia
(Worthley) GenesisCare Cardiology, Sydney, NSW, Australia
(Whitbourn) St Vincent's Hospital Melbourne & Melbourne University,
Melbourne, Vic, Australia
(Jepson) Prince of Wales Public Hospital and Eastern Heart Clinic, Sydney,
NSW, Australia; University of NSW, Sydney, NSW, Australia
(Bhindi) North Shore Private Hospital, Sydney, NSW, Australia
(Shang) Edwards Lifesciences, Irvine, CA, United States
(Sinhal) Flinders Medical Centre, Flinders University, Adelaide, SA,
Australia
Publisher
Elsevier Ltd
Abstract
Background: To determine the safety and performance of the SAPIEN XT
transcatheter heart valve (THV) in Australian patients with severe aortic
stenosis (AS) and intermediate surgical risk. <br/>Method(s): Eligible
patients in this multi-centre, prospective, consecutively enrolled,
non-randomised, clinical trial, received transcatheter aortic valve
replacement via femoral artery access. Follow-up visits were at discharge,
30 days, and 6, 12, and 24 months. The primary endpoint was Valve Academic
Research Consortium-2 composite safety at 30 days: all-cause mortality,
all stroke, life-threatening bleeding, acute kidney injury-Stage 3,
coronary artery obstruction requiring intervention, major vascular
complication, and valve-related dysfunction requiring repeat procedure.
Other endpoints were device success (successful vascular access, delivery,
and deployment; correct position; intended performance mean aortic valve
gradient <20 mmHg, mild or less paravalvular aortic regurgitation [PAR];
and only one valve implanted) and New York Heart Association functional
class (NYHA). Kaplan-Meier (KM) estimates were calculated for the primary
endpoint. <br/>Result(s): At baseline, mean patient (N=199) age was 85.5
years, mean Society of Thoracic Surgeon score was 5.9, and 78.4% were in
NYHA class III/IV. The primary composite endpoint KM estimate was 12.1%.
Device success was 88.8%. SAPIEN XT was implanted in the proper location
in 98.5% (n=2: valve-in-valve procedures, n=1: no implant due to left main
coronary artery occlusion). No device malfunctions were reported. The post
procedure PAR was mild or less in 93.8% of patients. Mean aortic gradient
decreased from baseline (50.0 mmHg) to 2 years (10.3 mmHg). Most patients
(90.9%) were in NYHA class I/II at 30 days. New permanent pacemaker rate
was 8.1%. Stroke at 30 days was 3.5% (1.5% disabling). <br/>Conclusion(s):
SAPIEN XT was safe and improved heart failure symptoms and valve
haemodynamics in this cohort of Australian patients.<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)

<96>
Accession Number
613995063
Title
Efficacy of N-Acetylcysteine in Preventing Acute Kidney Injury After
Cardiac Surgery: A Meta-Analysis Study.
Source
Journal of Investigative Surgery. 31 (1) (pp 14-23), 2018. Date of
Publication: 02 Jan 2018.
Author
Mei M.; Zhao H.-W.; Pan Q.-G.; Pu Y.-M.; Tang M.-Z.; Shen B.-B.
Institution
(Mei, Zhao, Pan, Pu, Tang, Shen) Department of Kidney, Southwest Hospital,
Third Military Medical University, Chongqing 400038, China
Publisher
Taylor and Francis Ltd
Abstract
Purpose: To evaluate whether perioperative N-acetylcysteine (NAC)
administration reduces the risk of cardiac surgery associated acute kidney
injury (CSA-AKI). <br/>Material(s) and Method(s): A systematic literature
review (Medline, PubMed, Cochrane, Biomedical central, Google Scholar)
identified 10 studies (1391 patients; 695 NAC and 696 placebo) that
compared the efficacy and adverse effects of perioperative NAC
administration for CSA-AKI prevention in adults undergoing elective
cardiac surgery. Meta-analysis was performed using Comprehensive
Meta-Analysis statistical software. <br/>Result(s): Patients in the
NAC-treated and placebo groups had similar rate of CSA-AKI occurrence,
change in creatinine levels, as well as the in-hospital mortality rate (RR
= 0.841, 95% CI = 0.691 to 1.023, p = 0.083; pooled difference in means =
-0.328, 95% CI = -0.712 to 0.056, p = 0.094; RR = 0.741, 95% CI = 0.388 to
1.418, p = 0.366, respectively). <br/>Conclusion(s): Our study does not
support perioperative NAC administration as a mean to reduce the risk of
CSA-AKI.<br/>&#xa9; Copyright &#xa9; 2017 Taylor & Francis Group, LLC.

<97>
Accession Number
632460892
Title
Clinical Outcomes of TAVI or SAVR in Men and Women with Aortic Stenosis at
Intermediate Operative Risk: a post hoc analysis of the randomized SURTAVI
trial.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2020. Date of Publication: 21 Jul 2020.
Author
Van Mieghem N.M.; Reardon M.J.; Yakubov S.J.; Heiser J.; Merhi W.;
Windecker S.; Makkar R.R.; Cheng W.; Robbins M.; Fail P.; Feinberg E.;
Stoler R.C.; Hebeler R.; Serruys P.W.; Popma J.J.
Institution
(Van Mieghem) Department of Interventional Cardiology, Erasmus University
Medical Center, Rotterdam, Netherlands
Publisher
NLM (Medline)
Abstract
AIMS: In patients with aortic stenosis randomized to transcatheter aortic
valve implantation (TAVI) or surgical aortic valve replacement (SAVR),
sex-specific differences in complication rates are unclear in
intermediate-risk patients. METHODS AND RESULTS: 1,660 intermediate-risk
patients underwent TAVI with a supra-annular, self-expanding bioprosthesis
or SAVR. The population was stratified by sex and treatment modality
(female TAVI=366, male TAVI=498, female SAVR=358, male SAVR=438). The
primary endpoint was a composite of all-cause mortality or disabling
stroke at two years. Compared to males, females had a smaller body surface
area, a higher Society of Thoracic Surgeons score (4.7+/-1.6% vs.
4.3+/-1.6%, p&lt;0.01) and more frailty. Men required more concomitant
revascularization (23% vs. 16%). All-cause mortality or disabling stroke
at two years was similar between TAVI and SAVR for females (10.2% vs.
10.5%, p=0.90) and males (14.5% vs. 14.4%, p=0.99); the difference between
females and males was 10.2% vs. 14.5%, for TAVI (p=0.08) and 10.5% vs.
14.4%, SAVR (p=0.13). Functional status improvement was more pronounced
after TAVI for females than males. <br/>CONCLUSION(S): Aortic valve
replacement, either by surgical or transcatheter approach, appears
similarly effective and safe for males and females at intermediate
surgical risk. Functional status appears to improve most in females after
TAVI.