EPICORE Embase Updates: EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 76

Results Generated From:
Embase <1980 to 2020 Week 36>
Embase (updates since 2020-08-28)

<1>
Accession Number
2006003911
Title
Aortic Valve Intervention During Aortic Root Surgery in Children: A
Systematic Review.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11 (5) (pp
611-618), 2020. Date of Publication: 01 Sep 2020.
Author
Rodriguez M.; Malvea A.; McNally D.; Bijelic V.; Guo M.; Momoli F.;
Boodhwani M.
Institution
(Rodriguez) Division of Cardiovascular Surgery, Children's Hospital of
Eastern Ontario, Ottawa, ON, Canada
(Rodriguez, Malvea, Guo, Momoli, Boodhwani) University of Ottawa, Ottawa,
ON, Canada
(McNally) Pediatric Intensive Care Unit, Children's Hospital of Eastern
Ontario, Ottawa, ON, Canada
(Bijelic) Clinical Research Unit, Children's Hospital of Eastern Ontario,
Ottawa, ON, Canada
(Guo, Boodhwani) Division of Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, Canada
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Background: Pediatric aortic root dilatation is a life-threatening
condition that lacks guidelines for surgical management. We aimed to
analyze the data on aortic valve interventions during root surgery to
guide decision-making. Method(s): A search was performed of MEDLINE,
Embase, CENTRAL, ClinicalTrials.gov, and WHO ICTRP. Citations were
screened in duplicate and independently to identify randomized controlled
trials, cohorts, and case series involving populations aged 0 to 18 years,
who received valve-sparing and valve-replacing aortic root surgeries
between 1999 and 2019. Outcomes considered included mortality
(perioperative, one year, five year), reintervention rates.
 Result(s): After duplicate removal, 689 citations were screened
through abstract and full text review, identifying five eligible studies.
All five were observational studies evaluating valve-sparing procedures.
There were 81 patients with a mean study age range of 9.9 to 13.9 years.
Both reimplantation (74%) and remodeling (26%) subtypes were done. Range
of mean duration of follow-up was 1.2 to 4.4 years. There was no mortality
reported until the one-year follow-up period. The long-term mortality rate
was calculated as 0.02 per patient-year (95% CI: 0.01-0.05). The long-term
reintervention rate was 0.08 per patient-year (95% CI: 0.05-0.13).
 Conclusion(s): There is limited experience on aortic valve
intervention during aortic root surgery in children. Single-arm studies on
valve-sparing surgeries show excellent survival up to one year. Mortality
and reintervention rates increase in the longer term. The small sample
size and lack of controlled studies do not allow for direct comparisons
between procedure types. Copyright © The Author(s) 2020.

<2>
Accession Number
2006003902
Title
Monocusp Valves Do Not Improve Early Operative Mortality in Tetralogy of
Fallot: A Meta-Analysis.
Source
World Journal for Pediatric and Congenital Heart Surgery. 11 (5) (pp
619-624), 2020. Date of Publication: 01 Sep 2020.
Author
Awori M.N.; Awori J.A.; Mehta N.P.; Makori O.
Institution
(Awori, Mehta, Makori) Department of Surgery, School of Medicine,
University of Nairobi, Kenyatta National Hospital, Nairobi, Kenya
(Awori) Department of Pediatrics, Seattle Children's Hospital, Seattle,
WA, United States
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Monocusp valves are thought to reduce early operative mortality and
morbidity associated with pediatric tetralogy of Fallot repair. As there
are no published randomized clinical trials comparing outcomes with and
without a monocusp valve, we performed a meta-analysis of observational
studies in accordance with established protocols. After systematically
searching PubMed, the Cochrane Library, and Google Scholar, 12 studies
were included. The operative mortality was compared in 695 patients, and
we found no difference between patients with and patients without a
monocusp valve. Monocusp valves may not improve operative mortality of
tetralogy of Fallot repair in pediatric patients. Copyright © The
Author(s) 2020.

<3>
Accession Number
2007488762
Title
Predictors of Clinical Response to Transcatheter Reduction of Secondary
Mitral Regurgitation: The COAPT Trial.
Source
Journal of the American College of Cardiology. 76 (9) (pp 1007-1014),
2020. Date of Publication: 1 September 2020.
Author
Grayburn P.A.; Sannino A.; Cohen D.J.; Kar S.; Lim D.S.; Mishell J.M.;
Whisenant B.K.; Rinaldi M.J.; Kapadia S.R.; Rajagopal V.; Crowley A.;
Kotinkaduwa L.N.; Lindenfeld J.; Abraham W.T.; Mack M.J.; Stone G.W.
Institution
(Grayburn, Sannino, Mack) Baylor Heart and Vascular Institute, Baylor
University Medical Center, Dallas, TX, United States
(Cohen) University of Missouri-Kansas City School of Medicine, Kansas
City, MO, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville, VA,
United States
(Mishell) Kaiser Permanente-San Francisco Hospital, San Francisco, CA,
United States
(Whisenant) Intermountain Heart Center, Salt Lake City, UT, United States
(Rinaldi) Sanger Heart & Vascular Institute/Atrium Health, Charlotte, NC,
United States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Rajagopal) Piedmont Hospital, Atlanta, Georgia, Georgia
(Crowley, Kotinkaduwa, Stone) Clinical Trials Center, Cardiovascular
Research Foundation, New York, NY, United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, Nashville, TN,
United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, New York, United States
Publisher
Elsevier USA
Abstract
Background: Transcatheter mitral valve repair with the MitraClip results
in marked clinical improvement in some but not all patients with secondary
mitral regurgitation (MR) and heart failure (HF). Objective(s): This
study sought to evaluate the clinical predictors of a major response to
treatment in the COAPT trial. Method(s): Patients with HF and severe
MR who were symptomatic on maximally tolerated guideline-directed medical
therapy (GDMT) were randomly assigned to MitraClip plus GDMT or GDMT
alone. Super-responders were defined as those alive without HF
hospitalization and with >=20-point improvement in the Kansas City
Cardiomyopathy Questionnaire overall summary (KCCQ-OS) score at 12 months.
Responders were defined as those alive without HF hospitalization and with
a 5 to <20-point KCCQ-OS improvement at 12 months. Nonresponders were
those who either died, were hospitalized for HF, or had <5-point
improvement in KCCQ-OS at 12 months. Result(s): Among 614 enrolled
patients, 41 (6.7%) had missing KCCQ-OS data and could not be classified.
At 12 months, there were 79 super-responders (27.2%), 55 responders
(19.0%), and 156 nonresponders (53.8%) in the MitraClip arm compared with
29 super-responders (10.2%), 46 responders (16.3%), and 208 nonresponders
(73.5%) in the GDMT-alone arm (overall p < 0.0001). Independent baseline
predictors of clinical responder status were lower serum creatinine and
KCCQ-OS scores and treatment assignment to MitraClip. MR grade and
estimated right ventricular systolic pressure at 30 days were improved to
a greater degree in super-responders and responders but not in
nonresponders. Conclusion(s): Baseline predictors of clinical
super-responders in patients with HF and severe secondary MR in the COAPT
trial were lower serum creatinine, KCCQ-OS score and MitraClip treatment.
Improved MR severity and reduced right ventricular systolic pressure at 30
days are associated with a long-term favorable clinical response after
transcatheter mitral valve repair. (Cardiovascular Outcomes Assessment of
the MitraClip Percutaneous Therapy for Heart Failure Patients With
Functional Mitral Regurgitation [COAPT]; NCT01626079) Copyright ©
2020 American College of Cardiology Foundation

<4>
Accession Number
632721402
Title
Automated closed-loop versus standard manual oxygen administration after
major abdominal or thoracic surgery: an international multicentre
randomised controlled study.
Source
The European respiratory journal. (no pagination), 2020. Date of
Publication: 27 Aug 2020.
Author
L'Her E.; Jaber S.; Verzilli D.; Jacob C.; Huiban B.; Futier E.; Kerforne
T.; Pateau V.; Bouchard P.-A.; Consigny M.; Lellouche F.
Institution
(L'Her) Medical Intensive Care, CHRU de Brest - La Cavale Blanche, France
(L'Her, Pateau) LATIM INSERM UMR 1101, Universite de Bretagne Occidentale,
Brest, France
(Jaber, Verzilli) Intensive Care Unit, Department of Anaesthesiology B,
DAR B CHU de Montpellier, Hopital Saint Eloi, Universite Montpellier 1,
Montpellier, France
(Jacob, Huiban) Anaesthesiology Department, CHRU de Brest - La Cavale
Blanche, France
(Futier) Anaesthesiology Department, Hopital Estaing, Centre Hospitalier
Universitaire Clermont-Ferrand, Clermont-Ferrand, France
(Kerforne) Anaesthesiology Department, Cedex, CHU de Poitiers, France
(Pateau) Technopole Brest Iroise, Plouzane, France
(Bouchard, Lellouche) Centre de recherche de l'Institut de Cardiologie et
de Pneumologie de Quebec, Quebec, Canada
(Consigny) Centre d'Investigation Clinique CIC INSERM 1412, France
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Hypoxaemia and hyperoxaemia may occur after surgery, with
related complications. This multicentre and randomised trial evaluated the
impact of automated closed-loop oxygen administration after high-risk
abdominal or thoracic surgeries in terms of optimising the SpO2 time
within target range. METHOD(S): After extubation, patients with an
intermediate to high risk for postoperative pulmonary complications were
randomised to Standard or Automated closed-loop oxygen administration. The
primary outcome was the percentage of time within the oxygenation range,
during a 3-day frame. The secondary outcomes were the time with hypoxaemia
and hyperoxaemia under oxygen. RESULT(S): Among the 200 patients,
time within range was higher in the Automated group, both initially
(<=3-h; 91.4+/-13.7 versus 40.2+/-35.1% of time; difference +51.0% [CI95%
-42.8;59.2]; p<0.0001) and during the 3-day period (94.0+/-11.3 versus
62.1+/-23.3% of time; difference +31.9% [CI95% 26.3;37.4]; p<0.0001).
Periods of hypoxaemia were reduced in the Automated group (<=3 days;
32.6+/-57.8 [1.2+/-1.9%] versus 370.5+/-594.3 min [5.0+/-11.2%];
difference -10.2% [CI95% -13.9;-6.6]; p<0.0001), as well as hyperoxaemia
under oxygen (<=3 days; 5.1+/-10.9 [4.8+/-11.2%] versus 177.9+/-277.2 min
[27.0+/-23.8%]; difference -22.0% [CI95% -27.6;-16.4]; p<0.0001).
Kaplan-Meier analysis depicted a significant difference in terms of
hypoxaemia (p=0.01) and severe hypoxaemia (p=0.0003) occurrence between
groups in favour of the Automated group. Twenty-five patients experienced
hypoxaemia for more than 10% of the entire monitoring time during the 3
days within the Standard group, as compared to the Automated group
(p<0.0001). CONCLUSION(S): Automated closed-loop oxygen
administration promotes greater time within the oxygenation target, as
compared to Standard manual administration, thus reducing the occurrence
of hypoxaemia and hyperoxaemia. Copyright ©ERS 2020.

<5>
Accession Number
632718157
Title
Quality of life after ministernotomy versus full sternotomy aortic valve
replacement.
Source
Seminars in thoracic and cardiovascular surgery. (no pagination), 2020.
Date of Publication: 24 Aug 2020.
Author
Rodriguez-Caulo E.A.; Guijarro-Contreras A.; Guzon A.; Otero-Forero J.;
Mataro M.J.; Sanchez-Espin G.; Porras C.; Villaescusa J.M.; Melero-Tejedor
J.M.; Jimenez-Navarro M.
Institution
(Rodriguez-Caulo) UGC Heart Area. Cardiovascular Surgery Dept., Hospital
Universitario Virgen de la Victoria de Malaga, Spain. Fundacion Publica
Andaluza para la Investigacion de Malaga en Biomedicina y Salud (FIMABIS),
University of Malaga. Spain. CIBERCV Enfermedades Cardiovasculares,
Instituto de Salud Carlos III, Madrid, Spain
(Guijarro-Contreras, Jimenez-Navarro) UGC Heart Area. Cardiology
Department, Hospital Universitario Virgen de la Victoria de Malaga, Spain.
Fundacion Publica Andaluza para la Investigacion de Malaga en Biomedicina
y Salud (FIMABIS), University of Malaga. Spain. CIBERCV Enfermedades
Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
(Guzon, Otero-Forero, Mataro, Sanchez-Espin, Porras, Villaescusa,
Melero-Tejedor) UGC Heart Area. Cardiovascular Surgery Dept., Hospital
Universitario Virgen de la Victoria de Malaga, Spain. Fundacion Publica
Andaluza para la Investigacion de Malaga en Biomedicina y Salud (FIMABIS),
University of Malaga. Spain. CIBERCV Enfermedades Cardiovasculares,
Instituto de Salud Carlos III, Madrid, Spain
Publisher
NLM (Medline)
Abstract
Quality of life and patient satisfaction after ministernotomy have never
been compared to conventional full sternotomy in randomized trials. The
QUALITY-AVR trial is a single-blind, single-centre, independent,
randomized clinical trial comparing ministernotomy to full sternotomy in
patients with isolated severe aortic stenosis scheduled for elective
aortic valve replacement. One hundred patients were randomized in a 1:1
computational fashion. The primary end point was a difference between
intervention groups of >= 0.10 points in change from baseline quality of
life Questionnaire EuroQOL-index (EQ-5D-5L), measured at 1, 6 or 12
months. Secondary endpoints were differences in change from other baseline
EQ-5D-5L utilities, cardiac surgery specific satisfaction questionnaire
(SATISCORE), a combined safety endpoint of four major adverse
complications at 1 month (all-cause mortality, acute myocardial
infarction, neurologic events and acute renal failure), bleeding through
drains within the first 24 h, intubation time, and other minor endpoints.
Clinical follow up was scheduled at baseline, 1, 6, and 12 months after
randomization. Change from baseline mean difference EQ-5D-index was +0.20
points (95%CI 0.10-0.30, p<0.001) and median difference +0.14 (95%CI
0.06-0.22, p<0.001), favoring the ministernotomy group at 1 month. Patient
satisfaction was also better at 1 month (Satiscore 83 +/-9 vs 77+/- 13
points; p=0,010). The ministernotomy group had significantly less bleeding
in the first 24 hours (299 +/- 140 vs 509 +/- 251 ml, p=0.001).
Ministernotomy provides a faster recovery with improved quality of life
and satisfaction at 1 month compared to full sternotomy. Copyright
© 2020. Published by Elsevier Inc.

<6>
Accession Number
632722144
Title
Clinical Implications of Physical Function and Resilience in Patients
Undergoing Transcatheter Aortic Valve Replacement.
Source
Journal of the American Heart Association. (pp e017075), 2020. Date of
Publication: 28 Aug 2020.
Author
Goel K.; O'Leary J.M.; Barker C.M.; Levack M.; Rajagopal V.; Makkar R.R.;
Bajwa T.; Kleiman N.; Linke A.; Kereiakes D.J.; Waksman R.; Allocco D.J.;
Rizik D.G.; Reardon M.J.; Lindman B.R.
Institution
(Goel, O'Leary, Barker, Levack, Lindman) Structural Heart and Valve Center
Vanderbilt University Medical Center Nashville TN
(Goel, O'Leary, Barker, Lindman) Cardiovascular Medicine Division
Vanderbilt University Medical Center Nashville TN
(Levack) Cardiac Surgery Department Vanderbilt University Medical Center
Nashville TN
(Rajagopal) Marcus Heart Valve Center Piedmont Heart Institute Atlanta GA
(Makkar) Cedars - Sinai Heart Institute Los Angeles CA
(Bajwa) Aurora Cardiovascular Services Aurora Sinai/Aurora St. Luke's
Medical Centers Milwaukee WI
(Kleiman, Reardon) Department of Cardiovascular Surgery Houston Methodist
DeBakey Heart and Vascular Center Houston TX
(Linke) Department of Internal Medicine and Cardiology Heart Center
Dresden Technical University of Dresden Germany
(Kereiakes) The Christ Hospital Heart and Vascular Center Lindner Research
Center Cincinnati OH
(Waksman) Section of Interventional Cardiology MedStar Washington Hospital
Center Washington DC
(Allocco) Clinical Sciences Boston Scientific Corp Marlborough MA
(Rizik) HonorHealth and the Scottsdale-Lincoln Health Network Scottsdale
AZ
Publisher
NLM (Medline)
Abstract
Background Gait speed is a reliable measure of physical function and
frailty in patients with aortic stenosis undergoing transcatheter aortic
valve replacement (TAVR). Slow gait speed pre-TAVR predicts worse clinical
outcomes post-TAVR. The consequences of improved versus worsened physical
function post-TAVR are unknown. Methods and Results The REPRISE III
(Repositionable Percutaneous Replacement of Stenotic Aortic Valve Through
Implantation of Lotus Valve System-Randomized Clinical Evaluation) trial
randomized high/extreme risk patients to receive a mechanically-expanded
or self-expanding transcatheter heart valve. Of 874 patients who underwent
TAVR, 576 with complete data at baseline and 1 year were included in this
analysis. Slow gait speed in the 5-m walk test was defined as <0.83 m/s. A
clinically meaningful improvement (>=0.1 m/s) in gait speed 1 year after
TAVR occurred in 39% of patients, 35% exhibited no change, and 26%
declined (>=0.1 m/s). Among groups defined by baseline/1-year post-TAVR
gait speeds, 1- to 2-year mortality or hospitalization rates were as
follows: 6.6% (normal/normal), 8.0% (slow/normal), 20.9% (normal/slow),
and 21.5% (slow/slow). After adjustment, slow gait speed at 1 year
(regardless of baseline speed) was associated with a 3.5-fold increase in
death/hospitalization between 1 and 2 years compared with those with
normal baseline/1-year gait speed. Patients whose slow gait speed
normalized at 1 year had no increased risk. One-year, but not baseline,
gait speed was associated with death or hospitalization between 1 and 2
years (adjusted hazard ratio, 0.83 per 0.1 m/s faster gait; 95% CI,
0.74-0.93, P=0.001). Conclusions Marked heterogeneity exists in the
trajectory of physical function after TAVR and this, more than baseline
function, has clinical consequences. Identifying and optimizing factors
associated with physical resilience after TAVR may improve outcomes.
Registration URL: https://www.clinicaltrials.gov; Unique identifier:
NCT02202434.

<7>
Accession Number
2004892679
Title
Effect of intravenous injection of vitamin c on postoperative pulmonary
complications in patients undergoing cardiac surgery: A double-blind,
randomized trial.
Source
Drug Design, Development and Therapy. 14 (pp 3263-3270), 2020. Date of
Publication: 2020.
Author
Wang D.; Wang M.; Zhang H.; Zhu H.; Zhang N.; Liu J.
Institution
(Wang, Wang, Zhang, Zhu, Zhang) Jiangsu Province Key Laboratory of
Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
(Liu) Department of Anesthesiology, The Affiliated Hospital of Xuzhou
Medical University, Xuzhou, Jiangsu, China
Publisher
Dove Medical Press Ltd. (PO Box 300-008, Albany, Auckland, New Zealand)
Abstract
Purpose: In this study, the effect of intravenous vitamin C during surgery
on the incidence of postoperative pulmonary complications (PPCs) in
patients undergoing cardiopulmonary bypass and cardiac surgery was
observed, and its protective effect on the lungs was evaluated to provide
a reference for clinical medication. Patients and Methods: Patients
undergoing cardiac surgery under cardiopulmonary bypass (CPB) were
selected. The patients were divided into group A and group C by random
sequence. Patients in group A received intravenous vitamin C 1 g 10
minutes after induction of anesthesia, 10 minutes before cardiac
reanimation and at the moment of sternal closure. Patients in group C were
intravenously injected with the same volume of saline at the same time.
The primary outcome was the postoperative pulmonary complication severity
score. Other outcomes were the incidence of PPCs, awakening time,
extubation time, length of ICU stay, length of hospital stay, adverse
events, oxygenation index (PaO<inf>2</inf>/FiO<inf>2</inf>), alveolar
arterial oxygen partial pressure difference (A-aDO<inf>2</inf>), dynamic
lung compliance (Cd) and static lung compliance (Cs). Result(s):
Seventy patients completed the study. Compared to group C, the
postoperative pulmonary complication score [2(2-3) vs 2(1-2); P=0.009] and
the incidence of postoperative pulmonary complications (32.43% vs 12.12%;
P =0.043) were lower in group A. There were no significant differences in
awakening time, extubation time, length of ICU stay, length of hospital
stay, adverse events, PaO<inf>2</inf>/FiO<inf>2</inf>, A-aDO<inf>2</inf>,
Cs, and Cd between the two groups (P>0.05). Conclusion(s): In
summary, this small randomized trial including low-risk cardiac surgery
patients shows that intravenous vitamin C may safely be administered and
may be helpful to prevent PPCs after cardiac surgery. Copyright ©
2020 Wang et al.

<8>
Accession Number
2004158068
Title
Selenoprotein P as biomarker of selenium status in clinical trials with
therapeutic dosages of selenite.
Source
Nutrients. 12 (4) (no pagination), 2020. Article Number: 1067. Date of
Publication: April 2020.
Author
Brodin O.; Hackler J.; Misra S.; Wendt S.; Sun Q.; Laaf E.; Stoppe C.;
Bjornstedt M.; Schomburg L.
Institution
(Brodin, Misra, Bjornstedt) Department of Laboratory Medicine, Division of
Pathology F46, Karolinska Institutet, Karolinska University Hospital
Huddinge, Stockholm SE-141 86, Sweden
(Brodin) Department of Head and Neck, Lung and Skin Cancer, Karolinska
University Hospital, Stockholm SE-17176, Sweden
(Hackler, Sun, Schomburg) Institute for Experimental Endocrinology,
Charite-Universitatsmedizin Berlin, Corporate Member of Freie Universitat
Berlin, Humboldt-Universitat zu Berlin, Berlin Institute of Health,
Augustenburger Platz 1, CVK, Berlin D-13353, Germany
(Wendt, Laaf, Stoppe) Department of Intensive Care Medicine, RWTH Aachen
University, Aachen D-52074, Germany
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: rasetti@mdpi.com)
Abstract
Selenoprotein P (SELENOP) is an established biomarker of selenium (Se)
status. Serum SELENOP becomes saturated with increasing Se intake,
reaching maximal concentrations of 5-7 mg SELENOP/L at intakes of ca.
100-150 micro g Se/d. A biomarker for higher Se intake is missing. We
hypothesized that SELENOP may also reflect Se status in clinical
applications of therapeutic dosages of selenite. To this end, blood
samples from two supplementation studies employing intravenous application
of selenite at dosages >1 mg/d were analyzed. Total Se was quantified by
spectroscopy, and SELENOP by a validated ELISA. The high dosage selenite
infusions increased SELENOP in parallel to elevated Se concentrations
relatively fast to final values partly exceeding 10 mg SELENOP/L. Age or
sex were not related to the SELENOP increase. Western blot analyses of
SELENOP verified the results obtained by ELISA, and indicated an unchanged
pattern of immunoreactive protein isoforms. We conclude that the
saturation of SELENOP concentrations observed in prior studies with
moderate Se dosages (<400 micro g/d) may reflect an intermediate
plateau of expression, rather than an absolute upper limit. Circulating
SELENOP seems to be a suitable biomarker for therapeutic applications of
selenite exceeding the recommended upper intake levels. Whether SELENOP is
also capable of reflecting other supplemental selenocompounds in high
dosage therapeutic applications remains to be investigated. Copyright
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.

<9>
Accession Number
2007229087
Title
Rationale and design for the study Apixaban versus ClopidoGRel on a
background of aspirin in patients undergoing InfraPoPliteal angioplasty
for critical limb ischemia: AGRIPPA trial.
Source
American Heart Journal. 227 (pp 100-106), 2020. Date of Publication:
September 2020.
Author
Biagioni R.B.; Lopes R.D.; Agati L.B.; Sacilotto R.; Wolosker N.; Sobreira
M.L.; de Freitas Soares B.L.; Joviliano E.E.; Bernardi W.H.; Junior V.C.;
Caffaro R.A.; Fioranelli A.; Van Bellen B.; Casella I.B.; Fidelis R.J.R.;
Flumignan R.L.G.; Comerota A.J.; Ramacciotti E.
Institution
(Biagioni, Sacilotto) Sao Paulo State Public Servant Hospital, Sao Paulo,
Brazil
(Lopes) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, NC, United States
(Agati) Science Valley Research Institute, Sao Paulo, Santo Andre, Brazil
(Wolosker) Albert Einstein Hospital, Sao Paulo, Brazil
(Sobreira) Universidade Estadual Paulista (UNESP), Botucatu, Brazil
(de Freitas Soares) Santa Casa de Maceio, Maceio, Alagoas, Brazil
(Joviliano) Hospital das Clinicas de Ribeirao Preto, Sao Paulo University
Medical School (USP), Sao Paulo, Ribeirao Preto, Brazil
(Bernardi, Junior, Caffaro, Fioranelli, Ramacciotti) Santa Casa de Sao
Paulo School of Medical Sciences, Sao Paulo, Brazil
(Van Bellen) Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil
(Wolosker, Casella) Hospital das Clinicas de Sao Paulo, Sao Paulo
University, Sao Paulo, Brazil
(Fidelis) Vascular and Endovascular Surgery-Federal University of Bahia
(Flumignan) Federal University of Sao Paulo, Sao Paulo, Brazil
(Comerota) Inova Heart and Vascular Institute, Falls Church, VA, United
States
(Ramacciotti) Hemostasis & Thrombosis Research Laboratories at Loyola
University Medical Center, Maywood, IL, United States
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: New antithrombotic strategies that reduce primary thrombosis
and restenosis might improve vascular outcomes in patients with peripheral
artery disease (PAD) undergoing arterial angioplasty. The study objective
is to evaluate the potential benefit of apixaban plus aspirin compared
with standard of care dual antiplatelet therapy (DAPT) in reducing
thrombotic restenosis and artery re-occlusion in patients undergoing
endovascular infrapopliteal revascularization. Study design: This
multicenter, parallel-group, prospective, randomized, open-label,
blinded-endpoint adjudication, proof-of-concept, exploratory trial aims to
randomize 200 patients 72 hours after successful infrapopliteal
angioplasty for critical limb ischemia (CLI). Patients will be randomly
assigned in a 1:1 ratio to receive oral apixaban (2.5 mg twice daily) plus
aspirin (100 mg once daily) for 12 months or clopidogrel (75 mg daily) for
at least 3 months on a background of aspirin (100 mg once daily) for 12
months. The primary endpoint is the composite of target lesion
revascularization (TLR), major amputation, or restenosis/occlusion (RAS)
in addition to major adverse cardiovascular events - MACE (myocardial
infarction, stroke or cardiovascular death) at 12 months. The primary
safety endpoint is the composite of major bleeding or clinically relevant
non-major bleeding at 12 months. This study will evaluate the efficacy and
safety of apixaban 2.5 mg twice daily plus aspirin compared with DAPT
(clopidogrel plus aspirin) in patients with CLI undergoing endovascular
infrapopliteal revascularization and might prove the concept of an
alternative antithrombotic regimen for these patients to be tested in a
future large randomized clinical trial. Copyright © 2020 Elsevier
Inc.

<10>
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. 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. 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. Copyright © 2020 The Society of Thoracic
Surgeons

<11>
Accession Number
2007465319
Title
Rectal diclofenac administration for prevention of post-endoscopic
retrograde cholangio-pancreatography (ERCP) acute pancreatitis. Randomized
prospective study.
Source
Clinica Terapeutica. 170 (5) (pp E332-E336), 2019. Date of Publication:
2019.
Author
Geraci G.; Palumbo V.D.; D'Orazio B.; Maffongelli A.; Fazzotta S.; Lo
Monte A.I.
Institution
(Geraci, Palumbo, D'Orazio, Maffongelli, Fazzotta, Lo Monte) University
Teaching Hospital "Paolo Giaccone" of Palermo, Section of General and
Thoracic Surgery, Palermo, Italy
Publisher
Societa Editrice Universo (E-mail: annali@seu-roma.it)
Abstract
Introduction. Post-Endoscopic Retrograde Cholangio-Pancreatography
pancreatitis (PEP) is a relevant (1-4%) complication of biliopancreatic
operative endoscopy. Rectal nonsteroidal anti-inflammatory drugs
(specifically, 100 mg of diclofenac) have shown promising prophylactic
activity in PEP. The aim of our prospective study is to report whether
prophylactic oral versus rectal suppository versus intramuscular
diclofenac versus placebo are able to reduce the incidence and the
severity of ERCP-induced pancreatitis. Materials and Methods. in this
randomized, double-blinded, prospective study, 100 patients (49 male, 51
female), similar with regard to indication for ERCP, were enrolled between
January 2016 and November 2017 to undergo ERCP in the Section of General
and Thoracic Surgery of University Hospital of Palermo. They were
randomized into five groups, respectively 20 patients with placebo by
mouth; 20 patients with 50 mg diclofenac sodium enteric-coated capsules by
mouth; 20 with 100 mg rectal suppository diclofenac, 20 with 75 mg/3 ml
intramuscular diclofenac sodium, 20 with 75 mg/3 ml intramuscular
diclofenac sodium and 20 with 75 mg/3 ml intravenous diclofenac. All drugs
were administered 30 to 90 minutes before ERCP. All clinical data were
collected one day before and 2, 12 and 24 hour after ERCP. Results. data
were prospectively collected and to demonstrate the preventive effect of
rectal diclofenac on PEP, a two-by-two table and chi-square test with
Yates correction were used: the incidence of PEP was significantly lower
(p < 0.001) in the rectal diclofenac group respect to other groups and, in
the same way, the incidence of post-ERCP pain was significantly lower in
the rectal diclofenac group than in the other groups (p = 0.001) and
patients discharge was consequently earlier (p < 0.01). Conclusions. 100
mg dose rectal diclofenac administered 30-60 minutes before ERCP can
effectively prevent PEP. Copyright © Societa Editrice Universo
(SEU).

<12>
Accession Number
631935536
Title
Endocarditis risk with bioprosthetic and mechanical valves: systematic
review and meta-analysis.
Source
Heart (British Cardiac Society). 106 (18) (pp 1413-1419), 2020. Date of
Publication: 01 Sep 2020.
Author
Anantha-Narayanan M.; Reddy Y.N.V.; Sundaram V.; Murad M.H.; Erwin P.J.;
Baddour L.M.; Schaff H.V.; Nishimura R.A.
Institution
(Anantha-Narayanan) Section of Cardiovascular Diseases, Yale-New Haven
Hospital, New Haven, CT, United States
(Reddy, Erwin, Nishimura) Division of Cardiovascular Diseases, Mayo Clinic
College of Medicine, Rochester, MN, United States
(Sundaram) Harrington Heart and Vascular Institute, University Hospitals
Case Medical Center, Cleveland, OH, United States
(Sundaram) Division of Population Science, National Heart and Lung
Institute, London, United Kingdom
(Murad) Knowledge and Evaluation Research, Mayo Clinic, Rochester, MN,
United States
(Baddour) Division of Infectious Diseases, Mayo Clinic Department of
Health Sciences Research, Rochester, MN, United States
(Schaff) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN,
United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Bioprosthetic valves are being used with increased frequency
for valve replacement, with controversy regarding risk:benefit ratio
compared with mechanical valves in younger patients. However, prior
studies have been too small to provide comparative estimates of less
common but serious adverse events such as infective endocarditis. We aimed
to compare the incidence of infective endocarditis between bioprosthetic
valves and mechanical valves. METHOD(S): We searched PubMed,
Cochrane, EMBASE, Scopus and Web of Science from inception to April 2018
for studies comparing left-sided aortic and mitral bioprosthetic to
mechanical valves for randomised trials or observational studies with
propensity matching. We used random-effects model for our meta-analysis.
Our primary outcome of interest was the rate of infective endocarditis at
follow-up. RESULT(S): 13 comparison groups with 43941 patients were
included. Mean age was 59+/-7 years with a mean follow-up of 10.4+/-5.0
years. Patients with bioprosthetic valves had a higher risk of infective
endocarditis compared with patients receiving mechanical valves (OR 1.59,
95%CI 1.35 to 1.88, p<0.001) with an absolute risk reduction of 9 per 1000
(95% CI 6 to 14). Heterogeneity within the included studies was low
(I2=0%). Exclusion of the study with maximum weight did not change the
results of the analysis (OR 1.57, 95%CI 1.14 to 2.17, p=0.006). A
meta-regression of follow-up time on incidence of infective endocarditis
was not statistically significant (p=0.788) indicating difference in
follow-up times did not alter the pooled risk of infective endocarditis.
 CONCLUSION(S): Bioprosthetic valves may be associated with a higher
risk of infective endocarditis. These data should help guide the
discussion when deciding between bioprosthetic and mechanical valves in
individual patients. Copyright © Author(s) (or their employer(s))
2020. No commercial re-use. See rights and permissions. Published by BMJ.

<13>
Accession Number
2005973364
Title
Desflurane and sevoflurane concentrations in blood passing through the
oxygenator during cardiopulmonary bypass: a randomized prospective pilot
study.
Source
Journal of Anesthesia. (no pagination), 2020. Date of Publication: 2020.
Author
Tamura T.; Mori A.; Ishii A.; Ando M.; Kubo Y.; Nishiwaki K.
Institution
(Tamura, Nishiwaki) Department of Anesthesiology, Nagoya University
Graduate School of Medicine, 65 Tsurumai-cho, Showa-Ku, Nagoya 466-8550,
Japan
(Mori) Department of Perioperative Management System, Nagoya University
Graduate School of Medicine, Nagoya, Japan
(Ishii) Department of Legal Medicine and Bioethics, Nagoya University
Graduate School of Medicine, Nagoya, Japan
(Ando) Center for Advanced Medicine and Clinical Research, Nagoya
University Hospital, Nagoya, Japan
(Kubo) Department of Preventive Medicine, Nagoya University Graduate
School of Medicine, Nagoya, Japan
Publisher
Springer
Abstract
Purpose: Volatile anesthetics (VAs) protect myocardial cells in
cardiovascular surgery. A recent clinical trial of cardiopulmonary bypass
(CPB) surgery reported no significant difference in mortality rates
between the use of VAs and total intravenous anesthetics at 1 year
postoperatively. However, oxygenator function may affect the VA
pharmacokinetics. Thus, we measured the VA blood concentrations during CPB
in patients managed with four different microporous polypropylene hollow
fiber membrane oxygenators. Method(s): Twenty-four patients scheduled
for elective CPB were randomly allocated to one of the two VA groups
(desflurane and sevoflurane groups) and, then, randomly divided into one
of four oxygenator groups: Terumo, LivaNova, Medtronic, and Senko (n = 3).
Additionally, in each VA group, three patients were randomly selected and
redundantly allocated to the human lung group (for control blood VA
concentration without oxygenator). Blood samples collected 20 min after
starting 6.0 vol% desflurane or 1.7 vol% sevoflurane were analyzed using
gas chromatography. Oxygenator-related complications and structural
changes in the membrane surface of each oxygenator after surgery were
evaluated. Result(s): The mean (standard deviation) concentrations of
desflurane and sevoflurane in the human lung were 182.4 (23.2) and 54.0
(9.6) mug/ml, respectively; not significantly different from those in the
four oxygenator groups. No oxygenator-related complications occurred.
Structural changes in membrane fibers did not occur after clinical use,
except for difficulty in image acquisition with Senko products.
 Conclusion(s): Our results demonstrated that the blood concentrations
of desflurane and sevoflurane passing through oxygenators used during CPB
were similar to those in the human lung control. Copyright ©
2020, Japanese Society of Anesthesiologists.

<14>
Accession Number
628621846
Title
The Effect of Levosimendan Versus Milrinone on the Occurrence Rate of
Acute Kidney Injury Following Congenital Heart Surgery in Infants: A
Randomized Clinical Trial.
Source
Pediatric critical care medicine : a journal of the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies. 20 (10) (pp 947-956), 2019. Date of Publication: 01 Oct
2019.
Author
Thorlacius E.M.; Suominen P.K.; Wahlander H.; Keski-Nisula J.; Vistnes M.;
Ricksten S.-E.; Synnergren M.; Romlin B.S.; Castellheim A.
Institution
(Thorlacius, Ricksten, Romlin, Castellheim) Department of Anesthesiology
and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg
and Queen Silvia Children's Hospital, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Suominen, Keski-Nisula) Department of Anesthesia and Intensive Care,
Children's Hospital, Helsinki University Central Hospital, Helsinki,
Finland
(Wahlander) Department of Pediatric Cardiology, Sahlgrenska Academy,
University of Gothenburg and Queen Silvia Children's Hospital, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Vistnes) Department of Internal Medicine, Diakonhjemmet Hospital and
Institute for Experimental Medical Research, Oslo University Hospital and
University of Oslo, Oslo, Norway
(Synnergren) Department of Pediatric Thoracic Surgery, Queen Silvia
Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
Publisher
NLM (Medline)
Abstract
OBJECTIVES: It has been shown that, in contrast to other inotropic agents,
levosimendan improves glomerular filtration rate after adult cardiac
surgery. The aim of this study was to investigate the efficacy of
levosimendan, compared with milrinone, in preventing acute kidney
dysfunction in infants after open-heart surgery with cardiopulmonary
bypass. DESIGN: Two-center, double-blinded, prospective, randomized
clinical trial. SETTING: The study was performed in two tertiary pediatric
centers, one in Sweden (Gothenburg) and one in Finland (Helsinki).
PATIENTS: Infants between 1 and 12 months old, diagnosed with Tetralogy of
Fallot, complete atrioventricular septal defect or nonrestrictive
ventricular septal defect, undergoing total corrective cardiac surgery
with cardiopulmonary bypass. INTERVENTIONS: Seventy-two infants were
randomized to receive a perioperative infusion of levosimendan (0.1
micro g/kg/min) or milrinone (0.4 micro g/kg/min). The infusion
was initiated at the start of cardiopulmonary bypass and continued for 26
hours. MEASUREMENTS AND MAIN RESULTS: The primary outcome variable was the
absolute value of serum creatinine data on postoperative day 1. Secondary
outcomes included the following: 1) acute kidney injury according to the
serum creatinine criteria of the Kidney Diseases: Improving Global
Outcomes; 2) acute kidney injury with serum creatinine corrected for fluid
balance; 3) plasma neutrophil gelatinase-associated lipocalin; 4) cystatin
C; 5) urea; 6) lactate; 7) hemodynamic variables; 8) use of diuretics in
the PICU; 9) need of dialysis; 10) length of ventilator therapy; and 11)
length of PICU stays. There was no significant difference in postoperative
serum creatinine between the treatment groups over time (p = 0.65). The
occurrence rate of acute kidney injury within 48 hours was 46.9% in the
levosimendan group and 39.5% in the milrinone group (p = 0.70). There were
no significant differences in other secondary outcome variables between
the groups. CONCLUSION(S): Levosimendan compared with milrinone did
not reduce the occurrence rate of acute kidney injury in infants after
total corrective heart surgery for atrioventricular septal defect,
ventricular septal defect, or Tetralogy of Fallot.

<15>
Accession Number
628401133
Title
Plasma Neutrophil Gelatinase-Associated Lipocalin Is Associated With Acute
Kidney Injury and Clinical Outcomes in Neonates Undergoing Cardiopulmonary
Bypass.
Source
Pediatric critical care medicine : a journal of the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies. 20 (10) (pp 957-962), 2019. Date of Publication: 01 Oct
2019.
Author
Schroeder L.W.; Buckley J.R.; Stroud R.E.; Martin R.H.; Nadeau E.K.; Barrs
R.; Graham E.M.
Institution
(Schroeder, Buckley, Graham) Division of Cardiology, Department of
Pediatrics, Medical University of South Carolina, SC, Charleston, United
States
(Stroud, Nadeau, Barrs) Department of Surgery, Medical University of South
Carolina, SC, Charleston, United States
(Martin) Department of Public Health Sciences, Medical University of South
Carolina, SC, Charleston, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Acute kidney injury is a frequent complication following
neonatal cardiac surgery and is associated with significant morbidity and
mortality. The objectives of this study were to determine if plasma
neutrophil gelatinase-associated lipocalin levels were associated with
acute kidney injury and clinical outcomes in neonates with congenital
heart disease undergoing cardiopulmonary bypass. DESIGN: Retrospective
single-center observational study. SETTING: A pediatric cardiac ICU within
a tertiary-care academic hospital. PATIENTS: Patients age less than 30
days undergoing cardiac surgery requiring cardiopulmonary bypass.None.
MEASUREMENTS AND MAIN RESULTS: Plasma neutrophil gelatinase-associated
lipocalin peaked at 12 hours postcardiopulmonary bypass and more than
doubled compared with preoperative levels. Higher preoperative and 24-hour
postoperative neutrophil gelatinase-associated lipocalin levels were
associated with acute kidney injury (r = 0.30, r = 0.49), longer duration
of mechanical ventilation (r = 0.40, r = 0.51), ICU (r = 0.32, r = 0.33)
and hospital lengths of stay (r = 0.28, r = 0.32), and total hospital
charges (r = 0.35, r = 0.30; all p values < 0.05). CONCLUSION(S):
Both preoperative and 24-hour postoperative plasma neutrophil
gelatinase-associated lipocalin levels are associated with acute kidney
injury and worse clinical outcomes in neonates undergoing cardiac surgery.
Plasma neutrophil gelatinase-associated lipocalin levels may have a role
in risk stratification for predicting postoperative renal dysfunction as
well as providing a potential clinical trajectory in the postoperative
period.

<16>
Accession Number
628113088
Title
Spontaneous Breathing Trial for Prediction of Extubation Success in
Pediatric Patients Following Congenital Heart Surgery: A Randomized
Controlled Trial.
Source
Pediatric critical care medicine : a journal of the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies. 20 (10) (pp 940-946), 2019. Date of Publication: 01 Oct
2019.
Author
Ferreira F.V.; Sugo E.K.; Aragon D.C.; Carmona F.; Carlotti A.P.C.P.
Institution
(Ferreira) All authors: Department of Pediatrics, Division of Pediatric
Critical Care, Ribeirao Preto Medical School, University of Sao Paulo,
Ribeirao Preto, Brazil
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To evaluate the usefulness of a spontaneous breathing trial
for predicting extubation success in pediatric patients in the
postoperative period after cardiac surgery compared with a physician-led
weaning. STUDY DESIGN: Randomized, controlled trial. SETTING: PICU of a
tertiary-care university hospital. PATIENTS: A population of pediatric
patients following cardiac surgery for congenital heart disease.
INTERVENTIONS: Patients on mechanical ventilation for more than 12 hours
after surgery who were considered ready for weaning were randomized to the
spontaneous breathing trial group or the control group. The spontaneous
breathing trial was performed on continuous positive airway pressure with
the pressure support of 10 cmH2O, the positive end-expiratory pressure of
5 cmH2O, and the fraction of inspired oxygen less than or equal to 0.5 for
2 hours. Patients in the control group underwent ventilator weaning
according to clinical judgment. MEASUREMENTS AND MAIN RESULTS: The primary
endpoint was extubation success defined as no need for reintubation within
48 hours after extubation. Secondary outcomes were PICU length of stay,
hospital length of stay, occurrence rate of ventilator-associated
pneumonia, and mortality. One hundred and ten patients with the median age
of 8 months were included in the study: 56 were assigned to the
spontaneous breathing trial group and 54 were assigned to the control
group. Demographic and clinical data and Risk Adjustment for Congenital
Heart Surgery-1 classification were similar in both groups. Patients
undergoing the spontaneous breathing trial had greater extubation success
(83% vs 68%, p = 0.02) and shorter PICU length of stay (median 85 vs
367hr, p < 0.0001) compared with the control group, respectively. There
was no significant difference between groups in hospital length of stay,
occurrence rate of ventilator-associated pneumonia, and mortality.
 CONCLUSION(S): Pediatric patients with congenital heart disease
undergoing the spontaneous breathing trial postoperatively had greater
extubation success and shorter PICU length of stay compared with those
weaned according to clinical judgment.

<17>
Accession Number
632710687
Title
Cardiac papillary fibroelastoma originating from the coumadin ridge and
review of literature.
Source
BMJ case reports. 13 (8) (no pagination), 2020. Date of Publication: 26
Aug 2020.
Author
Lak H.M.; Kerndt C.C.; Unai S.; Maroo A.
Institution
(Lak) Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH,
United States
(Kerndt) Internal Medicine, Spectrum Health, Grand Rapids, MI, United
States
(Unai) Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland,
OH, United States
(Maroo) Cardiovascular Medicine, Fairview Hospital, Cleveland, OH, United
States
Publisher
NLM (Medline)
Abstract
Papillary fibroelastomas represent the second most common benign cardiac
tumour, secondary only to cardiac myxoma. A majority of patients are
asymptomatic on presentation. The most common clinical manifestations
include stroke, transient ischaemic attack, myocardial infarction and
angina. Echocardiography remains the primary imaging modality for
identification of these tumours. The majority of papillary fibroelastomas
arise from the valves. Simple surgical excision is the mainstay of
treatment, carrying an excellent prognosis. We present an unusual case of
cardiac papillary fibroelastoma originating from the coumadin ridge (CR)
in a 70-year-old woman. The patient exhibited increasing paroxysms of her
atrial fibrillation and was pursuing a MAZE procedure. Preoperatively, a
transesophageal echocardiogram revealed a 0.7x1cm intracardiac mass that
had echocardiographic appearance of a fibroelastoma. Surgical resection
and MAZE procedures were performed. The gross specimen and histopathology
findings were consistent with papillary fibroelastoma. This case reports
the seventh documented case of fibroelastoma originating from the
CR. Copyright © BMJ Publishing Group Limited 2020. No commercial
re-use. See rights and permissions. Published by BMJ.

<18>
Accession Number
2004997555
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. 21 (11) (pp 1230-1238), 2020. Date of
Publication: Nov 2020.
Author
Belabbas D.; Koch C.; Chaudru S.; Lederlin M.; Laviolle B.; Pabic E.L.;
Boulmier D.; Heautot J.-F.; Mahe G.
Institution
(Belabbas, Chaudru, Lederlin, Laviolle, 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
Korean Radiological Society (E-mail: office@radiology.or.kr)
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. Material(s) and Method(s):
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.
 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
micro mol/L, 91 +/- 28 micro mol/L and 82 +/- 29 micro mol/L,
respectively (p = 0.73) in the RIPC group, whereas in the control group,
they were 100 +/- 36 micro mol/L, 110 +/- 36 micro mol/L, and 105
+/- 34 micro mol/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.
 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. Copyright ©
2020 The Korean Society of Radiology.

<19>
Accession Number
632343690
Title
Nebulized dexmedetomidine improves pulmonary shunt and lung mechanics
during one-lung ventilation: a randomized clinical controlled trial.
Source
PeerJ. 2020 (6) (no pagination), 2020. Article Number: e9247. Date of
Publication: 2020.
Author
Xu B.; Gao H.; Li D.; Hu C.; Yang J.
Institution
(Xu, Yang) Department of Anesthesiology, First Affiliated Hospital of
Soochow University, Suzhou, Jiangsu, China
(Xu, Gao, Li, Hu) Department of Anesthesiology, Affiliated Wuxi People's
Hospital of Nanjing Medical University, Wuxi, Jiangsu, China
Publisher
PeerJ Inc. (E-mail: pete@peerj.com)
Abstract
Background. Dexmedetomidine (Dex), a selective a<inf>2</inf>-adrenergic
receptor agonist, has been previously reported to attenuate intrapulmonary
shunt during one-lung ventilation (OLV) and to alleviate
bronchoconstriction. However, the therapeutic effects of nebulized Dex on
pulmonary shunt and lung mechanics during OLV have not been evaluated.
Here we determine whether nebulized dexmedetomidine improved pulmonary
shunt and lung mechanics in patients undergoing elective thoracic surgery
in a prospective randomized controlled clinical trial. Methods. One
hundred and twenty-eight patients undergoing elective thoracoscopic
surgery were included in this study and randomly divided into four groups:
0.9% saline (Placebo group), 0.5 micro g/kg (Dex<inf>0.5</inf> group),
1 micro g/kg (Dex<inf>1</inf> group) and 2 micro g/kg
(Dex<inf>2</inf> group) dexmedetomidine. After bronchial intubation,
patients received different nebulized doses of dexmedetomidine (0.5
micro g/kg, 1 micro g/kg and 2 micro g/kg) or 0.9% saline
placebo during two-lung ventilation(TLV). OLV was initiated 15 min after
bronchial intubation. Anesthesia was maintained with intravenous infusion
of cisatracurium and propofol. Bispectral Index values were maintained
within 40-50 by adjusting the infusion of propofol in all groups. Arterial
blood gas samples and central venous blood gas samples were taken as
follows: 15 min after bronchial intubation during two-lung ventilation
(TLV<inf>15</inf>), after 30 and 60 min of OLV (OLV<inf>30</inf> and
OLV<inf>60</inf>, respectively) and 15 min after reinstitution of TLV
(ReTLV). Dynamic compliance was also calculated at TLV<inf>15</inf>,
OLV<inf>30</inf>, OLV<inf>60</inf> and ReTLV. Results. Dex decreased the
requirement of propofol in a dose-dependent manner(P = 0.000). Heart rate
(HR) and mean arterial pressure (MAP) displayed no significant difference
among groups (P = 0.397 and 0.863). Compared with the placebo group, Dex
administered between 0.5 and 2 micro g/kg increased partial pressure
of oxygen (P<inf>a</inf>O<inf>2</inf>) significantly at OLV<inf>30</inf>
and OLV<inf>60</inf> (P = 0.000); however, Dex administered between 1 and
2 micro g/kg decreased pulmonary shunt fraction
(Q<inf>s</inf>/Q<inf>t</inf>) at OLV<inf>30</inf> and OLV<inf>60</inf>(P =
0.000). Compared with the placebo group, there were significant increases
with dynamic compliance (Cdyn) after OLV in Dex<inf>0.5</inf>,
Dex<inf>1</inf> and Dex<inf>2</inf> group(P = 0.000). Conclusions.
Nebulized dexmedetomidine improved oxygenation not only by decreasing
pulmonary shunt but also by improving lung compliance during OLV, which
may be effective in managing OLV. Copyright 2020 Xu et al.

<20>
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.
 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. 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. 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. Copyright © 2018,
Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

<21>
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. 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.
 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. Copyright DOI: https://doi.org/10.1542/peds.2019-3474G

<22>
Accession Number
2004654418
Title
Comparison of stability and sternum healing rate in clinical and
ultrasonography (USG) between stainless steel wire and polydioxanone yarn
in children heart surgery operation.
Source
Indian Journal of Forensic Medicine and Toxicology. 14 (2) (pp 1846-1852),
2020. Date of Publication: April-June 2020.
Author
Hayuningrat P.K.; Soebroto H.; Rahardjo P.
Institution
(Hayuningrat, Soebroto) Thoracic Surgery, Cardiovascular and Vascular,
Dr.Soetomo General Hospital, Universitas Airlangga, Surabaya 60285,
Indonesia
(Rahardjo) Department of Radiology, Faculty of Medicine, Dr.Soetomo
General Hospital, Universitas Airlangga, Surabaya 60285, Indonesia
Publisher
Indian Journal of Forensic Medicine and Toxicology (E-mail:
ijfmt@hotmail.com)
Abstract
Background: The closing of the sternum bone is often used today by using
stainless steel wire material and Polydioxanone yarn continuous suture. To
objectives to be achieved for sternal healing after heart surgery without
complications resulting from the failure of sternal healing. The bone
healing process itself is influenced by mechanical stress and movement.
 Objective(s): To compare the effects of sternum closure techniques on
surgical patients The heart of the child uses Polydioxanone and Stainless
Steel Wire threads against clinical stability and rate of healing which
are evaluated clinically and Ultrasonography. Method(s): Performed
sternal closure of pediatric patients after cardiac surgery with sternal
wire (n = 8) and PDS (n = 8). Performed sternal pain and stability
evaluation with the physical examination. Further sternum
ultrasonographyund was performed to assess displacement, gap and callus
picture. Evaluations were performed at weeks 6, 9 and 12 postoperatively.
 Result(s): Week 6 and 9 degrees of pain were higher in sternal wire
compared with polydioxanone (p = 0.03 and p = 0.01). The 12th week of
sternal wire and polydioxanone did not find any difference in pain (p =
1,000). Week 6, 9 and 12 there was no clinical stability difference
between wire and PDS (p = 0.143, p = 0.264, p = 0.063). 9th, 9th and 12th
Sternum ultrasonography of examination appears to be displacement in
polydioxanone (p = 0.025, p = 0.009, p = 0.009). The gap increased
significantly from 6th to 9th weeks in the polydioxanone group, while the
addition at week 9 to 12 was statistically insignificant but it appears
that polydioxanone had a wider gap addition range than the sternal wire.
Week 9 and 12 callus were seen more often in sternal wire patients but not
significant (P = 0.602, p = 0.333) Conclusion(s): Clinically, sternal
steal wire stability is proportional to polydioxanone. Radiologically, the
stability of sternal wire is better than polydioxanone. The rate of
sternal cure in polydioxanone is proportional to the sternal
wire. Copyright © 2020, Indian Journal of Forensic Medicine and
Toxicology. All rights reserved.

<23>
Accession Number
2005987890
Title
Asymmetric dimethylarginine predicts perioperative cardiovascular
complications in patients undergoing medium-to-high risk non-cardiac
surgery.
Source
Journal of International Medical Research. 48 (8) (no pagination), 2020.
Date of Publication: 2020.
Author
Appel D.; Boger R.; Windolph J.; Heinze G.; Goetz A.E.; Hannemann J.
Institution
(Appel, Heinze, Goetz) University Medical Center Hamburg-Eppendorf,
Department of Anesthesiology, Hamburg, DE, Germany
(Boger, Windolph, Hannemann) University Medical Center Hamburg-Eppendorf,
Institute of Clinical Pharmacology and Toxicology, Hamburg, DE, Germany
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Objectives: Perioperative cardiovascular events remain an important factor
that affects surgery outcome. We assessed if asymmetric dimethylarginine
(ADMA), an endogenous inhibitor of nitric oxide synthesis, predicts
perioperative risk, and if pre-operative supplementation with
L-arginine/L-citrulline improves the plasma L-arginine/ADMA ratio.
 Method(s): In this prospective study, planned thoracic and/or
abdominal surgery patients were randomized to receive
L-arginine/L-citrulline (5 g/day) or placebo 1 to 5 days before surgery.
We measured perioperative plasma ADMA and L-arginine levels. The primary
outcome was a 30-day combined cardiovascular endpoint. Result(s):
Among 269 patients, 23 (8.6%) experienced a major adverse cardiovascular
event. ADMA and C-reactive protein were significantly associated with the
incidence of cardiovascular complications in the multivariable-adjusted
analysis. The L-arginine plasma concentration was significantly higher on
the day of surgery with L-arginine/L-citrulline supplementation compared
with placebo. In patients with high pre-operative ADMA, there was a
non-significant trend towards reduced incidence of the primary endpoint
with L-arginine/L-citrulline supplementation (six vs. nine events).
 Conclusion(s): ADMA is a predictor of major adverse cardiovascular
complications in the perioperative period for patients who are undergoing
major abdominal and/or thoracic surgery. Supplementation with
L-arginine/L-citrulline increased the L-arginine plasma concentration,
enhanced the L-arginine/ADMA ratio, and induced a trend towards fewer
perioperative events. Copyright © The Author(s) 2020.

<24>
Accession Number
2005960674
Title
The long-term effects of prolonged intensive care stay postcardiac
surgery.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Mackie-Savage U.F.; Lathlean J.
Institution
(Mackie-Savage, Lathlean) School of Health Sciences, Faculty of
Environmental and Life Sciences, University of Southampton, Southampton,
United Kingdom
(Mackie-Savage) Specialist Surgery Division, University College London
Hospital, University College London Hospitals NHS Trust, London, United
Kingdom
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Objectives: Short-term outcomes for those with a prolonged length of stay
(LOS) in intensive care (ITU) following cardiac surgery are poor, with
higher rates of in-hospital mortality and morbidity. Consequently,
discharge from hospital has been considered the key measure of success.
However, there has been a shift towards long-term outcomes, functional
recovery and quality of life (QoL) as measures of surgical quality. The
aim of this review is to compare and critique the findings of multiple
studies to determine the long-term effects of prolonged ITU stay
postcardiac surgery. Method(s): A computerized literature search of
CINAHL, EMBASE and Google Scholar databases, based on keywords "long-term
effects," "prolonged ITU stay," "cardiac surgery," with rigorous CASP
critique was undertaken. Result(s): The search yielded 12 papers
meeting the inclusion criteria, with eight retrospective and four
prospective studies. Eight of these 12 papers identified inferior
long-term survival or higher mortality rates for those who had prolonged
LOS in ITU in comparison to "normal" LOS or a control. The greatest burden
of mortality was 6 months to 1 year postdischarge. Three papers found that
quality of life was adversely affected or worse for those who had
experienced prolonged LOS in ITU. Conclusion(s): Further research is
required to provide better quality evidence into QoL, following prolonged
stay in ICU postcardiac surgery. The evidence reviewed suggests that the
risk of mortality in this demographic of patients is higher, especially
within the first year and, therefore, more frequent medical surveillance
of these patients is recommended. Copyright © 2020 The Authors.
Journal of Cardiac Surgery published by Wiley Periodicals LLC

<25>
Accession Number
632600299
Title
Levosimendan in the treatment of patients with acute cardiac conditions:
an expert opinion of the Association of Intensive Cardiac Care of the
Polish Cardiac Society.
Source
Kardiologia polska. 78 (7-8) (pp 825-834), 2020. Date of Publication: 25
Aug 2020.
Author
Tycinska A.; Gierlotka M.; Bugajski J.; Deja M.; Depukat R.; Gruchala M.;
Grzesk G.; Kasprzak J.D.; Kubica J.; Kucewicz-Czech E.; Leszek P.; Plonka
J.; Sobkowicz B.; Straburzynska-Migaj E.; Wilk K.; Zawislak B.; Zymlinski
R.; Stepinska J.
Publisher
NLM (Medline)
Abstract
Levosimendan is a new inodilator which involves 3 main mechanisms:
increases the calcium sensitivity of cardiomyocytes, acts as a vasodilator
due to the opening of potassium channels, and has a cardioprotective
effect. Levosimendan is mainly used in the treatment of acute
decompensated heart failure (class IIb recommendation according to the
European Society of Cardiology guidelines). However, numerous clinical
trials indicate the validity of repeated infusions of levosimendan in
patients with stable heart failure as a bridge therapy to heart
transplantation, and in patients with accompanying right ventricular heart
failure and pulmonary hypertension. Due to the complex mechanism of
action, including the cardioprotective and anti- -aggregating effect, the
use of levosimendan may be particularly beneficial in acute coronary
syndromes, preventing the occurrence of acute heart failure. There are
data indicating that levosimendan administered prior to cardiac surgery
may improve outcomes in patients with severely impaired left ventricular
function. The multidirectional mechanism of action also affects other
organs and systems. The positive effect of levosimendan in the treatment
of cardiorenal and cardiohepatic syndromes has been shown. It has a safe
and predictable profile of action, does not induce tolerance, and shows no
adverse effects affecting patients survival or prognosis. However, with
inconclusive results of previous studies, there is aneed for
awell-designed multicenter randomized placebo--controlled study, including
an adequately large group of outpatients with chronic advanced systolic
heart failure.

<26>
Accession Number
632545168
Title
Three-year outcomes of bioresorbable vascular scaffolds versus
second-generation drug-eluting stents: Meta-analysis of randomized trials.
Source
Medicine. 99 (31) (pp e21554), 2020. Date of Publication: 31 Jul 2020.
Author
Ke J.; Zhang H.; Huang J.; Lv P.; Chen Y.; Xu K.; Yang W.; Tu B.
Institution
(Ke, Zhang, Huang, Lv, Chen, Xu, Tu) Department of Cardiology, First
Affiliated Hospital of Nanchang University, Nanchang, China
(Yang) Department of Cardiology, Yuexi County Hospital, Anqing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Bioresorbable vascular scaffolds (BVS) completely resorb
within 3 years after placement into the coronary artery. The safety and
effectiveness of bioabsorbable scaffolds are of critical importance during
this 3-year period. OBJECTIVE(S): We performed a meta-analysis to
compare the safety and efficacy of BVS and second-generation drug-eluting
stents (DES) at 3 years after implantation. METHOD(S): Published
randomized trials comparing BVS to second-generation DES for the treatment
of coronary artery disease were identified within PubMed, EMBASE, Cochrane
Library, Web of Science, and relevant Web sites with publication dates
through June 2019. The primary efficacy endpoint was target lesion
failure. The primary safety endpoint was definite/probable stent/scaffold
thrombosis. Secondary outcomes were cardiac death, target vessel
myocardial infarction, ischemia-driven target lesion revascularization,
and a patient-oriented composite end point. RESULT(S): Six randomized
controlled trials, with a total of 5,412 patients (BVS n = 3,177; DES n =
2,235), were included. At 3 years, BVS was associated with higher rates of
target lesion failure (OR = 1.33, 95%CI: 1.10-1.60, P = 0.003) and
definite/probable stent/scaffold thrombosis (OR = 3.75, 95% CI: 2.22-6.35,
P < .00001)compared with DES. The incidence of target vessel myocardial
infarction (OR = 1.68, 95% CI: 1.30-2.17, P < .0001), ischemia-driven
target lesion revascularization (OR = 1.46, 95% CI: 1.14-1.86, P = .003),
and the patient-oriented composite end point(OR = 1.20, 95% CI: 1.04-1.39,
P = .01) were higher for those treated with BVS compared with DES.
However, there was no significant difference in risk of cardiac death (OR
= 0.94, 95%CI: 0.61-1.45, P = .79) between treatment groups.
 CONCLUSION(S): At the 3-year follow-up, BVS was inferior to
second-generation DES in both safety and efficacy.

<27>
Accession Number
631046994
Title
Letter to the editor for the article entitled Comparison of
ultrasound-guided erector spinae plane block and thoracic paravertebral
block for postoperative analgesia after video-assisted thoracic surgery: A
randomized controlled non-inferiority clinical trial'.
Source
Regional Anesthesia and Pain Medicine. 45 (9) (pp 752-753), 2020. Date of
Publication: 01 Sep 2020.
Author
Wang K.; An N.; Jiang X.; Yuan H.
Institution
(Wang, An, Jiang, Yuan) Department of Anesthesiology, Changzheng Hospital,
Shanghai, China
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)

<28>
Accession Number
2007648761
Title
Outcomes of individualized goal-directed therapy based on cerebral oxygen
balance in high-risk patients undergoing cardiac surgery: A randomized
controlled trial.
Source
Journal of Clinical Anesthesia. 67 (no pagination), 2020. Article Number:
110032. Date of Publication: December 2020.
Author
Cheng X.-Q.; Zhang J.-Y.; Wu H.; Zuo Y.-M.; Tang L.-L.; Zhao Q.; Gu E.-W.
Institution
(Cheng, Wu, Zuo, Tang, Zhao, Gu) Department of Anesthesiology, First
Affiliated Hospital of Anhui Medical University, Hefei 230022, China
(Zhang) Department of Pharmacology, Anhui Medical University, Hefei
230032, China
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Study objective: To investigate whether optimizing individualized
goal-directed therapy (GDT) based on cerebral oxygen balance in high-risk
surgical patients would reduce postoperative morbidity. Design(s):
This was a prospective, randomized, controlled study. Setting(s): The
study was performed in the First Affiliated Hospital of Anhui Medical
University, Hefei, China, from April 2017 to July 2018. Patient(s):
146 high-risk adult patients undergoing valve replacements or coronary
artery bypass surgery with cardiopulmonary bypass (CPB) were enrolled.
 Intervention(s): Patients were randomized to an individualized GDT
group or usual care group. Individualized GDT was targeted to achieve the
following goals: A less than 20% decline in the regional cerebral oxygen
saturation (rScO<inf>2</inf>) level from baseline; a less than 20% decline
in the mean arterial pressure (MAP) from baseline, as well as a bispectral
index (BIS) of 45-60 before and after CPB and 40-45 during CPB.
Measurements: The primary outcome was a composite endpoint of 30-day
mortality and major postoperative complications. Main Result(s): 128
completed the trial and were included in the modified intention-to-treat
analysis. Early morbidity was similar between the GDT (25 [39%] of 65
patients) and usual care groups (33 [53%] of 63 patients) (relative risk
0.73, 95% CI 0.50-1.08; P = 0.15). Secondary analysis showed that 75 (59%)
of 128 patients achieved individual targets (irrespective of intervention)
and sustained less morbidity (relative risk 3.41, 95% CI 2.19-5.31; P <
0.001). Conclusion(s): In high-risk patients undergoing cardiac
surgery, individualized GDT therapy did not yield better outcomes,
however, the achievement of preoperative individual targets may be
associated with less morbidity. Trial registration: Clinicaltrials.gov
identifier: NCT03103633. Registered on 1 April 2017. Copyright ©
2020 Elsevier Inc.

<29>
[Use Link to view the full text]
Accession Number
2007636779
Title
Misplacement of transjugular intrahepatic portosystemic shunts: A surgical
challenge for liver transplantation?.
Source
Surgery (United States). (no pagination), 2020. Date of Publication: 2020.
Author
Addeo P.; Schaaf C.; Faitot F.; Terrone A.; Julliard O.; Besch C.; Serfaty
L.; Bachellier P.
Institution
(Addeo, Schaaf, Faitot, Terrone, Julliard, Bachellier)
Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pole des
Pathologies Digestives, Hepatiques et de la Transplantation, Hopital de
Hautepierre-Hopitaux Universitaires de Strasbourg, Universite de
Strasbourg, France
(Besch, Serfaty) Hepatology Department, Pole des Pathologies Digestives,
Hepatiques et de la Transplantation, Hopital de Hautepierre-Hopitaux
Universitaires de Strasbourg, Universite de Strasbourg, France
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Background: The impact of transjugular intrahepatic portosystemic shunt
misplacement on outcomes of liver transplantation remains controversial.
We systematically reviewed the literature on the outcomes of liver
transplantation with transjugular intrahepatic portosystemic shunt
misplacement. Method(s): This systematic review was conducted
according to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines. The Cochrane library, PubMed, and Embase were
searched (January 1990-April 2020) for studies reporting patients
undergoing liver transplantation with transjugular intrahepatic
portosystemic shunt misplacement. Result(s): Thirty-six studies
reporting 181 patients who underwent liver transplantation with
transjugular intrahepatic portosystemic shunt misplacement were
identified. Transjugular intrahepatic portosystemic shunt was misplaced
with a variable degree of extension toward the inferior vena cava/right
heart in 63 patients (34%), the spleno/portal/superior mesenteric venous
confluence in 105 patients (58%), and both in 15 patients (8%).
Transjugular intrahepatic portosystemic shunt thrombosis was also present
in 21 cases (12%). The median interval between transjugular intrahepatic
portosystemic shunt placement and liver transplantation ranged from 1 day
to 6 years. Complete transjugular intrahepatic portosystemic shunt removal
was successfully performed in all but 12 (7%) patients in whom part of the
transjugular intrahepatic portosystemic shunt was left in situ. Cardiac
surgery under cardiopulmonary bypass was necessary to remove transjugular
intrahepatic portosystemic shunt from the right heart in 4 patients (2%),
and a venous graft interposition was necessary for a portal anastomosis in
5 patients (3%). Postoperative mortality (90 days) was 1.1% (2 patients),
and portal vein thrombosis developed postoperatively in 4 patients (2%).
 Conclusion(s): Misplaced transjugular intrahepatic portosystemic
shunt removal is possible in most cases during liver transplantation with
extremely low mortality and good postoperative outcomes. Preoperative
surgical strategy and intraoperative tailored surgical technique reduces
the potential consequences of transjugular intrahepatic portosystemic
shunt misplacement. Copyright © 2020 Elsevier Inc.

<30>
Accession Number
632702591
Title
Postoperative outcomes of kidney transplant recipients undergoing
non-transplant-related elective surgery: a systematic review and
meta-analysis.
Source
BMC nephrology. 21 (1) (pp 365), 2020. Date of Publication: 25 Aug 2020.
Author
Palamuthusingam D.; Kunarajah K.; Pascoe E.M.; Johnson D.W.; Hawley C.M.;
Fahim M.
Institution
(Palamuthusingam) Logan Hospital, Metro South Integrated Nephrology and
Transplant ServicesArmstrong Road & Loganlea Road, Meadowbrook, QLD 4131,
Australia
(Palamuthusingam, Johnson, Hawley, Fahim) Faculty of Medicine, University
of Queensland, St Lucia, QLD 4072, Australia
(Palamuthusingam) School of Medicine, Griffith University, Mount Gravatt,
QLD, Australia
(Kunarajah) Department of Medicine, Sunshine Coast University Hospital,
Doherty St, QLD 4575, Australia
(Pascoe) Centre for Health Services Research, University of Queensland, St
Lucia, QLD 4072, Australia
(Johnson, Hawley, Fahim) Princess Alexandra Hospital, Metro South
Integrated Nephrology and Transplant Services199 Ipswich Road
,Woolloongabba, QLD 4074, Australia
(Johnson) Translational Research Institute, Brisbane, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Reliable estimates of the absolute and relative risks of
postoperative complications in kidney transplant recipients undergoing
elective surgery are needed to inform clinical practice. This systematic
review and meta-analysis aimed to estimate the odds of both fatal and
non-fatal postoperative outcomes in kidney transplant recipients following
elective surgery compared to non-transplanted patients. METHOD(S):
Systematic searches were performed through Embase and MEDLINE databases to
identify relevant studies from inception to January 2020. Risk of bias was
assessed by the Newcastle Ottawa Scale and quality of evidence was
summarised in accordance with GRADE methodology (grading of
recommendations, assessment, development and evaluation). Random effects
meta-analysis was performed to derive summary risk estimates of outcomes.
Meta-regression and sensitivity analyses were performed to explore
heterogeneity. RESULT(S): Fourteen studies involving 14,427 kidney
transplant patients were eligible for inclusion. Kidney transplant
recipients had increased odds of postoperative mortality; cardiac surgery
(OR 2.2, 95%CI 1.9-2.5), general surgery (OR 2.2, 95% CI 1.3-4.0) compared
to non-transplanted patients. The magnitude of the mortality odds was
increased in the presence of diabetes mellitus. Acute kidney injury was
the most frequently reported non-fatal complication whereby kidney
transplant recipients had increased odds compared to their
non-transplanted counterparts. The odds for acute kidney injury was
highest following orthopaedic surgery (OR 15.3, 95% CI 3.9-59.4). However,
there was no difference in the odds of stroke and pneumonia.
 CONCLUSION(S): Kidney transplant recipients are at increased odds for
postoperative mortality and acute kidney injury following elective
surgery. This review also highlights the urgent need for further studies
to better inform perioperative risk assessment to assist in planning
perioperative care.

<31>
[Use Link to view the full text]
Accession Number
2007051570
Title
Is ischemia a disease or syndrome, the cause of angina, and now even a
trial?.
Source
Heart and Metabolism. (81) (pp 36-39), 2020. Date of Publication: 2020.
Author
Boden W.E.
Institution
(Boden) VA New England Healthcare System, Boston University School of
Medicine, Harvard Medical School, Boston, MA, United States
Publisher
Les Laboratoires Seriver (50 Rue Carnot, F-92284, Suresnes Cedex, France)
Abstract
The clinical manifestations of myocardial ischemia are protean in nature
and include a variable combination of typical or atypical angina symptoms,
electrocardiographic changes, noninvasive findings of regional wall motion
abnormalities, and reversible scintigraphic perfusion defects-the changes
of which, importantly, may or may not be of epicardial coronary origin.
Thus, mounting evidence indicates that the presence or absence of
atherosclerotic coronary artery disease (CAD) should no longer be
considered a surrogate marker for myocardial ischemia, as suggested by the
high prevalence of minor or absent coronary obstruction among patients
with proven myocardial ischemia. Whereas the management of CAD has been
largely predicated on the plausible assumption that flow-limiting
obstructions of the epicardial coronary arteries are the proximate cause
of both angina and myocardial ischemia, there is scant evidence from many
randomized trials and several meta-analyses that treating epicardial
coronary obstructions in patients with stable CAD, particularly with
percutaneous coronary intervention (PCI), reduces mortality and morbidity,
as compared with optimal medical therapy (OMT). A crucial scientific
question for which evidence has been lacking is whether more severe and
extensive myocardial ischemia is the driver of adverse cardiovascular
outcomes and whether an invasive strategy with myocardial
revascularization would be superior to OMT alone in such patients. The
results of the recent ISCHEMIA trial (International Study of Comparative
Health Effectiveness with Medical and Invasive Approaches), however, have
failed to show-even in this higher-risk CAD subset-any incremental
clinical benefit of revascularization as compared with OMT alone on
cardiac event reduction. Copyright © 2020 Les Laboratoires
Seriver. All rights reserved.

<32>
Accession Number
2005273642
Title
Perioperative Bridging/Cessation of Antiplatelet Agents: 2020 Update.
Source
Current Anesthesiology Reports. 10 (3) (pp 273-281), 2020. Date of
Publication: 01 Sep 2020.
Author
Cha S.; Hensley N.B.
Institution
(Cha, Hensley) Department of Anesthesiology & Critical Care Medicine,
Johns Hopkins University School of Medicine, Baltimore, MD, United States
Publisher
Springer
Abstract
Purpose of Review: Perioperative management of patients receiving
antiplatelet therapy is common and must carefully balance the risk of
ischemia or thrombosis with bleeding. Here we describe pathways of
platelet aggregation unique to the perioperative period and mechanisms of
commonly encountered antiplatelet medications, and review current
literature evaluating strategies for antiplatelet management surrounding
elective noncardiac and cardiac surgery. Recent Findings: Antiplatelet
therapies demonstrate unique risk profiles for stent thrombosis and
bleeding that may be dependent on individual genetic polymorphisms. Use of
scoring systems or point-of-care platelet function assays may identify
patients especially vulnerable to alterations in perioperative
antiplatelet management, and guide timing of surgery. Prior guidelines,
which recommend a minimum 6-month delay in elective surgery for patients
receiving dual-antiplatelet therapy following percutaneous coronary
intervention (PCI), may be amended to 3 months in certain cases in which
newer generation antiplatelet therapies are administered. While use of
intravenous bridging agents may reduce platelet reactivity during cardiac
surgery, there is no single antiplatelet strategy which consistently
reduces rates of major bleeding or cardiovascular events. Summary:
There is insufficient evidence to support any specific perioperative
antiplatelet strategy. Cases should be individualized to balance the risks
of stent thrombosis and bleeding. Current recommendations may be modified
if the risk of delaying surgery outweighs the risk of stent thrombosis. It
is reasonable to guide management by utilizing scoring systems and
point-of-care platelet function assays. Copyright © 2020,
Springer Science+Business Media, LLC, part of Springer Nature.

<33>
Accession Number
2004989352
Title
The role of acupuncture in cardiac anesthesia: A meta-analysis.
Source
International Journal of Clinical and Experimental Medicine. 13 (8) (pp
5673-5689), 2020. Date of Publication: 2020.
Author
Wang H.; Xie X.; Zhao G.; Yang S.; Li J.
Institution
(Wang, Xie, Zhao, Li) Department of Anesthesiology, Guangdong Provincial
Hospital of Chinese Medicine, Guangzhou, Guangdong 510120, China
(Yang) Health Management Department of Traditional Chinese Medicine,
Guangzhou 11th People's Hospital, Guangzhou, Guangdong 510000, China
Publisher
E-Century Publishing Corporation (40 White Oaks Lane, Madison WI 53711,
United States)
Abstract
Objective: To explore the role of acupuncture in cardiac anesthesia.
 Method(s): We searched MeSH terms including "acupuncture", "electric
acupuncture", "anesthesia", "heart surgery", "open chest surgery" in
PubMed, CNKI, Wanfang Data, China Journal Net, Vipnet, Longyuan Journal
Net and Springer Database. Randomized clinical trials regarding comparison
between acupuncture-assisted anesthesia (AAA) and general anesthesia (GA)
from January 1979 to January 2020 were obtained. The data quality of the
enrolled studies was evaluated following Cochrane handbook with Review
Manager 5.1.0 as the analysis tool. Result(s): Nine randomized,
controlled studies were included. AAA was superior to GA in the following
outcomes: elevated SpO<inf>2</inf> (Z = 17.13, P < 0.00001), longer length
of stay in resuscitation room (Z = 80.81, P < 0.0001), higher mean
arterial pressure (Z = 18.26, P <0.0001) and Prince-Henry scores (Z =
40.23, P < 0.0001), reduced consumption of inhalation anesthetics (Z =
94.34, P <0.0001) and intravenous anesthesia (Z = 130.86, P < 0.0001),
lower postoperative VAS score (Z = 39.15, P < 0.0001), incidence of low
blood pressure (Z = 3.31, P = 0.0009), postoperative nausea and vomiting
(Z = 4.49, P <0.0001), chills (Z = 3.31, P = 0.0009) and dysphoria (Z =
3.44, P = 0.006), and shortened extubation time in patients undergoing
thoracotomy (Z = 66.87, P < 0.0001). Conclusion(s): Meta-analysis
shows that AAA has beneficial clinical effects in open heart surgery. It
can improve respiratory and circulatory functions, reduce the consumption
of anesthetic drugs, extubation time, recovery time, pain intensity and
adverse reactions in the early stage of anes-thesia, which is suitable for
thoracotomy. Copyright © 2020, E-Century Publishing Corporation.
All rights reserved.

<34>
Accession Number
632705013
Title
Avoidance of Routine Endotracheal Suction in Subjects Ventilated for <= 12
h Following Elective Cardiac Surgery.
Source
Respiratory care. (no pagination), 2020. Date of Publication: 25 Aug 2020.
Author
Gilder E.; McGuinness S.P.; Cavadino A.; Jull A.; Parke R.L.
Institution
(Gilder, McGuinness, Parke) Cardiothoracic and Vascular Intensive Care
Unit, Auckland City Hospital, Grafton, Auckland, New Zealand
(Gilder, Jull, Parke) School of Nursing, Faculty of Medical and Health
Sciences, University of Auckland, Grafton, Auckland, New Zealand
(McGuinness, Parke) Australian and New Zealand Intensive Care Research
Centre, Monash University, Melbourne, VIC, Australia
(McGuinness, Parke) Medical Research Institute of New Zealand, Wellington
Hospital, Newtown, Wellington, New Zealand
(Cavadino) School of Population Health, University of Auckland, Grafton,
Auckland, New Zealand
Publisher
NLM (Medline)
Abstract
BACKGROUND: Mechanical ventilation requires an endotracheal tube. Airway
management includes endotracheal suctioning, a frequent procedure for
patients in the ICU. Associated risks of endotracheal suctioning include
hypoxia, atelectasis, and infection. There is currently no evidence about
the safety of avoiding endotracheal suction. We aimed to assess the safety
of avoiding endotracheal suction, including at extubation, in cardiac
surgical patients who were mechanically ventilated for <= 12 h.
 METHOD(S): We conducted a single-center, noninferiority, randomized
controlled trial in a cardiac ICU in a metropolitan tertiary teaching
hospital. Subjects were assigned to either avoidance of endotracheal
suction or to usual care including endotracheal suctioning during
mechanical ventilation. In total, we screened 468 patients and randomized
249 subjects (usual care, n = 125; intervention, n = 124). Subjects were
elective cardiac surgical patients anticipated to receive <= 12 h of
mechanical ventilation. The primary outcome was the PaO2 /FIO2 on room air
6 h after extubation, with a noninferiority margin of 10% (lower bound of
one-sided 95% CI to be < 30). RESULT(S): There were no differences in
group characteristics at baseline. The primary analysis was a per-protocol
analysis performed on 154 subjects. The median PaO2 /FIO2 was 323 for the
intervention group and 311 for the standard care group (median difference
= 12, one-sided 95% CI -14.3). The results were consistent when using an
intention-to-treat analysis and a 97.5% CI. There were no differences
between groups in complications or safety measures, including the
escalation of oxygen therapy. CONCLUSION(S): Endotracheal suctioning
can be safely minimized or avoided in low-risk patients who have had
cardiac surgery and are expected to be ventilated for < 12 h after
surgery. Copyright © 2020 by Daedalus Enterprises.

<35>
Accession Number
632704125
Title
Improvement of ejection fraction and mortality in ischaemic heart failure.
Source
Heart (British Cardiac Society). (no pagination), 2020. Date of
Publication: 25 Aug 2020.
Author
Perry A.S.; Mann D.L.; Brown D.L.
Institution
(Perry) University of Washington School of Medicine, Seattle, WA, United
States
(Mann, Brown) Cardiovascular Division, Washington University in St. Louis,
St. Louis, MO, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The frequency and predictors of improvement in left ventricular
ejection fraction (LVEF) in ischaemic cardiomyopathy and its association
with mortality is poorly understood. We sought to assess the predictors of
LVEF improvement >=10%and its effect on mortality. METHOD(S): We
compared characteristics of patients enrolled in The Surgical Treatment
for Ischaemic Heart Failure (STICH) trial with and without improvement of
LVEF >=10% at 24 months. A logistic regression model was constructed to
determine the independent predictors of LVEF improvement. A Cox
proportional hazards model was created to assess the independent
association of improvement in LVEF >=10% with mortality. RESULT(S):
Of the 1212 patients enrolled in STICH, 618 underwent echocardiographic
assessment of LVEF at baseline and 24 months. Of the patients randomised
to medical therapy plus coronary artery bypass graft surgery (CABG), 58
(19%) had an improvement in LVEF >10% compared with 51 (16%) patients
assigned to medical therapy alone (p=0.30). Independent predictors of LVEF
improvement >10% included prior myocardial infarction (OR 0.44, 95%CI:
0.28 to 0.71, p=0.001) and lower baseline LVEF (OR 0.94, 95%CI: 0.91 to
0.97, p<0.001). Improvement in LVEF >10% (HR 0.61, 95%CI: 0.44 to 0.84,
p=0.004) and randomisation to CABG (HR 0.72, 95%CI: 0.57 to 0.90, p=0.004)
were independently associated with a reduced hazard of mortality.
 CONCLUSION(S): Improvement of LVEF >=10% at 24 months was uncommon in
patients with ischaemic cardiomyopathy, did not differ between patients
assigned to CABG and medical therapy or medical therapy alone and was
independently associated with reduced mortality. TRIAL REGISTRATION
NUMBER: NCT00023595. Copyright © Author(s) (or their employer(s))
2020. No commercial re-use. See rights and permissions. Published by BMJ.

<36>
Accession Number
632699395
Title
Left ventricular mass reduction and hypertrophy regression following renal
artery revascularization: a meta-analysis.
Source
Journal of hypertension. (no pagination), 2020. Date of Publication: 21
Aug 2020.
Author
Cuspidi C.; Tadic M.; Sala C.; Quarti-Trevan F.; Gherbesi E.; Mancia G.;
Grassi G.
Institution
(Cuspidi, Quarti-Trevan, Mancia, Grassi) Department of Medicine and
Surgery, University of Milano-Bicocca
(Cuspidi) Clinical Research Unit, Istituto Auxologico Italiano, Milan,
Italy
(Tadic) Department of Cardiology, University Hospital 'Dr Dragisa Misovic
- Dedinje', Belgrade, Serbia
(Sala, Gherbesi) Department of Clinical Sciences and Community Health,
University of Milano and Fondazione Ospedale Maggiore IRCCS Policlinico di
Milano, Milan, Italy
Publisher
NLM (Medline)
Abstract
AIM: Few echocardiographic studies have focused on regression of left
ventricular hypertrophy (LVH) in patients with renal artery stenosis after
revascularization, with inconsistent results. We performed a systematic
meta-analysis of these studies in order to offer a comprehensive
information on this topic. METHOD(S): The PubMed, OVID-MEDLINE, and
Cochrane library databases were analyzed to search English-language
articles published from 1 January 1990 up to 31 March 2020. Studies were
identified by crossing the following terms: 'renal artery stenosis',
'renovascular hypertension', 'fibromuscular dysplasia', 'renal artery
stenting', 'renal artery surgery' with 'cardiac damage', 'hypertensive
heart disease' 'left ventricular mass', 'left ventricular hypertrophy',
'echocardiography'. RESULT(S): A total of 726 hypertensive patients
with renal artery stenosis (mean age 61 years, 64% men, 98% treated, 10%
with fibromuscular dysplasia) were included in 13 studies. Baseline and
postintervention pooled mean LVM values were 220 +/- 15 and 203 +/- 19 g,
respectively (SMD -0.24 +/- 0.06, CI -0.37 to -0.21, P<0.0001);
corresponding values for LV mass index were 129.0 +/- 6 and 115 +/- 7 g/m,
respectively (SMD -0.28 +/- 0.04, CI -0.36 to 0.21, P < 0.0001). Renal
revascularization was associated with a 40% lower risk of LVH. This trend
was accompanied by a reduction in the number of antihypertensive drugs
(SMD -0.27 +/- 0.04, CI -0.37 to 0.17, P < 0.0001). CONCLUSION(S):
The present meta-analysis suggests that renal artery revascularization
added to antihypertensive therapy promotes a favourable effect on LV
structure, as reflected by a significant decrease in absolute and indexed
LV mass index as well by a lower risk of LVH. Limitations include: high
prevalence of modest renal artery stenosis (>=50%); small sample of
fibromuscular dysplasia; lack of randomized design of most studies.

<37>
Accession Number
632692819
Title
Perioperative ADministration of Dexamethasone And blood Glucose
concentrations in patients undergoing elective non-cardiac surgery - the
randomised controlled PADDAG trial.
Source
European journal of anaesthesiology. (no pagination), 2020. Date of
Publication: 21 Aug 2020.
Author
Corcoran T.B.; O'Loughlin E.; Chan M.T.V.; Ho K.M.
Institution
(Corcoran) From the Department of Anaesthesia and Pain Medicine, Royal
Perth Hospital (TBC), School of Medicine and Pharmacology, University of
Western Australia, Perth, Western Australia (TBC, EOL), Department of
Epidemiology and Preventive Medicine, Monash University, Melbourne,
Victoria (TBC), Department of Anaesthesia and Pain Medicine, Fiona Stanley
Hospital, Perth, Western Australia, Australia (EOL), Department of
Anaesthesia and Intensive Care, The Chinese University of Hong Kong,
Shatin, New Territories, Hong Kong Special Administrative Region, China
(MAC), Department of Intensive Care Medicine, Royal Perth Hospital (KMH),
Medical School, University of Western Australia (KMH) and School of
Veterinary & Life Sciences, Murdoch University, Perth, Western Australia,
Australia (KMH)
Publisher
NLM (Medline)
Abstract
BACKGROUND: The hyperglycaemic effect of dexamethasone in diabetic and
nondiabetic patients in the peri-operative period is unknown.
 OBJECTIVE(S): To assess the effect of a single dose of
intra-operative dexamethasone on peri-operative blood glucose. DESIGN:
Multicentre, stratified, randomised trial. SETTING: University hospitals
in Australia and Hong Kong. PATIENTS: A total of 302 adults scheduled for
elective, noncardiac and nonobstetric surgical procedures under general
anaesthesia, stratified by diabetes mellitus status, were randomised to
receive placebo, 4 or 8 mg dexamethasone administered intravenously after
induction of anaesthesia. MAIN OUTCOME MEASURES: Maximum blood glucose
within 24 h of surgery, and the interaction between glycated haemoglobin
(HbA1c) and dexamethasone were the primary and secondary outcomes.
 RESULT(S): The median [IQR] baseline blood glucose in the nondiabetes
stratum in the placebo (n=81), 4 mg (n=81) and 8 mg dexamethasone (n=77)
trial arms were respectively 5.3 [4.6 to 5.8], 5.0 [4.7 to 5.4] and 5.0
[4.2 to 5.9] mmol l. In the diabetes stratum these values were 6.6 [6.0 to
8.3]; (n=22), 6.1 [5.5 to 10.4]; (n=22) and 6.7 [5.6 to 8.3]; (n=19) mmol
l. The median [IQR] maximum peri-operative blood glucose values in the
nondiabetes stratum were 6.0 [5.3 to 6.8], 6.3 [5.5 to 7.3] and 6.3 [5.8
to 7.4] mmol l in the control, dexamethasone 4 mg and dexamethasone 8 mg
arms, respectively. In the diabetes stratum these values were 10.3 [8.1 to
12.4], 12.6 [10.3 to 18.3] and 13.6 [11.2 to 0.1] mmol l. There was a
significant interaction between pre-operative HbA1c value and 8 mg
dexamethasone: every 1% increment in HbA1c produced a 4.0 mmol l elevation
in maximal peri-operative glucose concentration. CONCLUSION(S):
Dexamethasone four or 8 mg did not induce greater hyperglycaemia compared
with placebo for nondiabetic and well controlled diabetic patients.
Maximal peri-operative blood glucose concentrations in patients with
diabetes were related to baseline HbA1c values in a
concentration-dependent fashion after 8 mg of dexamethasone. TRIAL
REGISTRATION: Australia and New Zealand Clinical Trials Registry
(ACTRN12614001145695): URL:
https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367272.

<38>
Accession Number
632692350
Title
Blood pressure and brain injury in cardiac surgery: a secondary analysis
of a randomized trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2020.
Date of Publication: 25 Aug 2020.
Author
Vedel A.G.; Holmgaard F.; Danielsen E.R.; Langkilde A.; Paulson O.B.; Ravn
H.B.; Rasmussen L.S.; Nilsson J.C.
Institution
(Vedel, Holmgaard, Ravn, Nilsson) Department of Cardiothoracic
Anaesthesiology, Heart Center, Rigshospitalet, University of Copenhagen,
Copenhagen, Denmark
(Vedel, Rasmussen) Department of Anaesthesia, Center of Head and
Orthopedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Danielsen, Langkilde) Department of Radiology, Diagnostic Center,
Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Paulson) Neurobiology Research Unit, Neuroscience Center, Rigshospitalet,
University of Copenhagen, Copenhagen, Denmark
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Brain dysfunction is a serious complication after cardiac
surgery. In the Perfusion Pressure Cerebral Infarcts trial, we allocated
cardiac surgery patients to a mean arterial pressure of either 70-80 or
40-50mmHg during cardiopulmonary bypass (CPB). In this secondary analysis,
we compared selected cerebral metabolites using magnetic resonance
spectroscopy hypothesizing that a postoperative decrease in occipital grey
matter (GM) N-acetylaspartate-to-total-creatine ratio, indicative of
ischaemic injury, would be found in the high-target group. METHOD(S):
Of the 197 patients randomized in the Perfusion Pressure Cerebral Infarcts
trial, 55 and 42 patients had complete and useful data from GM and white
matter (WM), respectively. Spectroscopies were done preoperatively and on
postoperative days 3-6. Cognitive function was assessed prior to surgery,
at discharge and at 3months. We predefined the statistical significance
level to be 0.01. RESULT(S): A postoperative decrease was found in GM
N-acetylaspartate-to-total-creatine ratio in the high-target group [mean
difference -0.09 (95% confidence interval -0.14 to -0.04), P=0.014]. No
significant differences were found in other metabolite ratios investigated
in GM or WM. No significant association was found between changes in
metabolite ratios and new cerebral infarcts, WM lesion score or cognitive
dysfunction. CONCLUSION(S): A higher mean arterial pressure during
CPB was associated with signs of impaired cerebral metabolism, though not
at the predefined significance level of 0.01. No significant association
was found between metabolite ratio changes and neuroradiological pathology
or change in cognitive function. CLINICAL TRIAL REGISTRATION NUMBER:
Clinicaltrials.gov: NCT02185885. Copyright © The Author(s) 2020.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<39>
Accession Number
632690573
Title
Percutaneous coronary intervention compared to coronary artery bypass
graft surgery for patients with three-vessel disease.
Source
Journal of cardiovascular pharmacology. (no pagination), 2020. Date of
Publication: 19 Aug 2020.
Author
Zhao H.; Zhang D.
Institution
(Zhao) Affiliated Hospital of Shandong University of Traditional Chinese
Medicine, Jinan, Shandong, China
(Zhang) Department of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing 210006, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Previous investigations showed inconsistent results for
comparison in clinical outcomes between patients with three-vessel disease
(3VD) treated with percutaneous coronary intervention (PCI) and coronary
artery bypass graft (CABG) surgery. A systematic review and meta-analysis
is essential to compare the clinical outcomes of PCI to CABG surgery for
patients with 3VD. METHOD(S): We systematically searched on PubMed
and Web of Science for articles which compared PCI with CABG for patients
with 3VD and published from January 1989 to January 2020. We computed the
hazard ratios (HRs) and 95% confidence intervals (CIs) for individual
clinical outcomes. RESULT(S): The present study indicated that PCI
group was associated with a 1.51-fold higher risk of all-cause mortality
compared to CABG group in patients with 3VD (HR 1.51, 95% CI 1.38-1.65).
In addition, PCI group showed a 3.08-fold and 2.94-fold higher risk
compared to CABG group in risks of myocardial infarction (MI) and
target-vessel revascularization (TVR), respectively (MI: HR 3.08, 95% CI
2.61-3.63; TVR: HR 2.94, 95% CI 1.94-4.46). CONCLUSION(S): In
conclusion, in patients with 3VD, PCI was consistently associated with
higher rates of all-cause mortality, MI and TVR, compared to CABG.

<40>
Accession Number
632690566
Title
Clopidogrel drug interactions: a review of the evidence and clinical
implications.
Source
Expert opinion on drug metabolism & toxicology. (no pagination), 2020.
Date of Publication: 22 Aug 2020.
Author
Lee C.H.; Franchi F.; Angiolillo D.J.
Institution
(Lee, Franchi, Angiolillo) Division of Cardiology, University of Florida
College of Medicine-Jacksonville, FL, Jacksonville, United States
(Lee) Division of Cardiology, Department of Internal Medicine, Veterans
Health Service Medical Center, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Patients with cardiovascular disease are commonly affected
by a number of comorbidities leading to a high prevalence of polypharmacy.
Polypharmacy increases the probability of drug-drug interactions (DDIs).
Amongst these, DDIs involving clopidogrel, the most commonly utilized
platelet P2Y12 inhibitor, is a topic of potential clinical concern. AREAS
COVERED: This article reviews DDIs between clopidogrel and drugs which are
widely used in clinical practice. In particular, drugs shown to interfere
with the pharmacodynamic and pharmacokinetic effects of clopidogrel and
the clinical implications of these findings are reviewed. These drugs
include inhibitors of gastric acid secretion, statins, calcium channel
blockers, antidiabetic agents and antimicrobial agents. For the
references, we searched PubMed, EMBASE, or the Cochrane Library. EXPERT
OPINION: Clopidogrel-drug interactions are common. Most of these DDIs are
limited to laboratory findings showing an impact on clopidogrel-induced
antiplatelet effects. While variability in clopidogrel-induced
antiplatelet effects are known to affect clinical outcomes, with high
platelet reactivity being associated with thrombotic complications among
patients undergoing coronary stenting, most studies assessing the clinical
implications of clopidogrel-drug interactions have not shown to
significantly affect outcomes. However, awareness of these DDIs remain
important for optimizing the selection of concomitant therapies.

<41>
Accession Number
616834912
Title
Intraoperative dexamethasone does not increase the risk of postoperative
wound infection: A propensity score-matched post hoc analysis of the
ENIGMA-II trial (EnDEX).
Source
British Journal of Anaesthesia. 118 (2) (pp 190-199), 2017. Date of
Publication: 01 Feb 2017.
Author
Corcoran T.; Kasza J.; Short T.G.; O'Loughlin E.; Chan M.; Leslie K.;
Forbes A.; Paech M.; Myles P.; Wallace S.; Galagher W.; Farrington C.;
Ditoro A.; Peyton P.; Baulch S.; Sidiropoulos S.; Bulach R.; Bryant D.;
Mitteregger V.; Bolsin S.; Osborne C.; McRae R.; Backstrom M.; Cotter R.;
March S.; Silbert B.; Said S.; Halliwell R.; Cope J.; Fahlbusch D.; Crump
D.; Thompson G.; Jefferies A.; McCulloch T.; Reeves M.; Buckley N.; Tidyl
T.; Schricker T.; Lattermann R.; Iannuzzi D.; Beattie S.; Carroll J.;
Jacka M.; Bryden C.; Badner N.; Tsang M.; Cheng B.; Fong A.; Chu L.; Koo
E.; Mohd N.; Ming L.E.; Yin Wang C.; Campbell D.; McAllister D.; Walker
S.; Olliff S.; Kennedy R.; Eldawlatly A.; Alzahrani T.; Chua N.; Haller
G.; Pichon I.; Sneyd R.; McMillan H.; Parkinson I.; Rousseau G.; Brennan
A.; Balaji P.; Cupitt J.; Nightingale J.; Kunst G.; Dickinson M.; Saran
T.; Subramaniam B.; Banner-Godspeed V.; Sessler D.; Liu J.; Kurz A.;
Hesler B.; Fu A.; Egan C.; Fiffick A.; Hutcherson M.; Turan A.; Naylor A.;
Obal D.; Cooke E.
Institution
(Corcoran, Paech) Department of Anaesthesia and Pain Medicine, Royal Perth
Hospital, Perth, WA, Australia
(Corcoran, O'Loughlin, Paech) School of Medicine and Pharmacology,
University of Western Australia, Perth, WA, Australia
(Corcoran) Western Australia Health Department, Perth, WA, Australia
(Corcoran, Kasza, Leslie, Forbes, Myles) Department of Epidemiology and
Preventive Medicine, Monash University, Melbourne, VIC, Australia
(Short) Department of Anaesthesia, Auckland City Hospital, Park Road,
Grafton, Auckland, New Zealand
(O'Loughlin) Department of Anaesthesia and Pain Medicine, Fiona Stanley
Hospital, Perth, WA, Australia
(Chan) Department of Anaesthesia and Intensive Care, Chinese University of
Hong Kong, Hong Kong Special Administrative Region, Hong Kong
(Leslie) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Leslie) Anaesthesia Perioperative and Pain Medicine Unit, Department of
Pharmacology and Therapeutics, University of Melbourne, Melbourne, VIC,
Australia
(Myles) Department of Anaesthesia and Perioperative Medicine, Alfred
Hospital, Melbourne, VIC, Australia
(Wallace, Galagher, Farrington, Ditoro) AustinAustralia
(Peyton, Baulch, Sidiropoulos) DandenongAustralia
(Bulach, Bryant) Fremantle, Australia
(O'Loughlin, Mitteregger) Geelong Hospital, Australia
(Bolsin, Osborne) Monash Medical Centre, Australia
(McRae, Backstrom) Royal Melbourne Hospital, Australia
(Leslie, Cotter) Royal Perth Hospital, Australia
(Paech, March) St Vincent's Hospital, Australia
(Silbert, Said) Westmead Hospital, Australia
(Halliwell, Cope) Calvary WakefieldAustralia
(Fahlbusch, Crump) Peter MacCallum Cancer Centre, Australia
(Thompson) Western Hospital, Australia
(Jefferies) Royal Prince Alfred, Australia
(McCulloch) North West Regional Hosptial, Australia
(Reeves) McMaster University, Canada
(Buckley, Tidyl) Royal Victoria Hospital, Canada
(Schricker, Lattermann, Iannuzzi) Toronto General Hospital, Canada
(Beattie, Carroll) University of Alberta Hospital, Canada
(Jacka, Bryden) London Health Sciences, Canada
(Badner) Prince of Wales, Hong Kong
(Chan) ANZCA Trials Group Member, Hong Kong
(Tsang) Tuen Mun Hospital, Hong Kong
(Cheng, Fong) ACM Fong, Hong Kong
(Chu, Koo) Nethersole Eastern Hospital, Hong Kong
(Mohd, Ming) Hospital Kuala Lumpur, Malaysia
(Yin Wang) Malaya Medical Centre, Malaysia
(Campbell, McAllister) Auckland Hospital, New Zealand
(Walker, Olliff) Middlemore Hospital, New Zealand
(Kennedy) Christchurch Hospital, New Zealand
(Eldawlatly, Alzahrani) King Saud University Hospital, Saudi Arabia
(Chua) Tan Tock Seng Hospital, Singapore
(Haller, Pichon) Geneva University Hospital, Switzerland
(Sneyd, McMillan) Plymouth NHS Trust, France
(Parkinson) Royal Lancaster Infirmary, United Kingdom
(Rousseau) North Devon District Hospital, United Kingdom
(Brennan) Bradford Teaching Hospital, United Kingdom
(Balaji) Hull Royal Infirmary, United Kingdom
(Cupitt) Blackpool Victoria Hospital, United Kingdom
(Nightingale) Portsmouth Hospital, United Kingdom
(Kunst) King's College Hospital, United Kingdom
(Dickinson) Royal Surrey County Hospital, United Kingdom
(Saran) University Hospitals, Coventry and Warwickshire, United Kingdom
(Subramaniam, Banner-Godspeed) Beth Israel Deaconess Medical Center,
United States
(Sessler, Liu, Kurz, Hesler, Fu, Egan, Fiffick, Hutcherson, Turan, Naylor)
Cleveland Clinic, United States
(Obal, Cooke) Louisville Medical Centre, United States
Publisher
Elsevier Ltd
Abstract
Background. In a post hoc analysis of the ENIGMA-II trial, we sought to
determine whether intraoperative dexamethasone was associated with adverse
safety outcomes. Methods. Inverse probability weighting with estimated
propensity scores was used to determine the association of dexamethasone
administration with postoperative infection, quality of recovery, and
adverse safety outcomes for 5499 of the 7112 non-cardiac surgery subjects
enrolled in ENIGMA-II. Results. Dexamethasone was administered to 2178
(40%) of the 5499 subjects included in this analysis and was not
associated with wound infection [189 (8.7%) vs 275 (8.3%); propensity
score-adjusted relative risk (RR) 1.10; 95% confidence interval (CI)
0.89-1.34; P=0.38], severe postoperative nausea and vomiting on day 1 [242
(7.3%) vs 189 (8.7%); propensity score-adjusted RR 1.06; 95% CI 0.86-1.30;
P=0.59], quality of recovery score [median 14, interquartile range (IQR)
12-15, vs median 14, IQR 12-16, P=0.10), length of stay in the
postanaesthesia care unit [propensity score-adjusted median (IQR) 2.0
(1.3, 2.9) vs 1.9 (1.3, 3.1), P=0.60], or the primary outcome of the main
trial. Dexamethasone administration was associated with a decrease in
fever on days 1-3 [182 (8.4%) vs 488 (14.7%); RR 0.61; 95% CI 0.5-0.74;
P<0.001] and shorter lengths of stay in hospital [propensity
score-adjusted median (IQR) 5.0 (2.9, 8.2) vs 5.3 (3.1, 9.1), P<0.001].
Neither diabetes mellitus nor surgical wound contamination status altered
these outcomes. Conclusion. Dexamethasone administration to high-risk
non-cardiac surgical patients did not increase the risk of postoperative
wound infection or other adverse events up to day 30, and appears to be
safe in patients either with or without diabetes mellitus. Clinical trial
registration. NCT00430989. Copyright © 2017 The Author.

<42>
Accession Number
625742819
Title
The Accuracy of Urinary TIMP-2 and IGFBP7 for the Diagnosis of Cardiac
Surgery-Associated Acute Kidney Injury: A Systematic Review and
Meta-Analysis.
Source
Journal of Intensive Care Medicine. 35 (10) (pp 1013-1025), 2020. Date of
Publication: 01 Oct 2020.
Author
Tai Q.; Yi H.; Wei X.; Xie W.; Zeng O.; Zheng D.; Sun J.; Wang G.; Wang
S.; Liu G.
Institution
(Tai, Xie, Zheng, Sun, Wang, Wang, Liu) Intensive Care Unit, The First
Affiliated Hospital, Sun Yat-sen University, Guangdong Province, China
(Yi, Wei) Surgical Intensive Care Unit, The Third Affiliated Hospital of
Sun Yat-sen University, Guangdong Province, China
(Zeng) Department of Cardiology Intensive Care Unit, First People's
Hospital of Chenzhou, Hunan Province, China
Publisher
SAGE Publications Inc. (E-mail: claims@sagepub.com)
Abstract
Background: Tissue inhibitor of metalloproteinase 2 (TIMP-2) and
insulin-like growth factor binding protein 7 (IGFBP7) are recent promising
markers for identification of cardiac surgery-associated acute kidney
injury (CSA-AKI). The aim of this study was systematically and
quantitatively to evaluate the accuracy of urinary TIMP-2 and IGFBP7 for
the diagnosis of CSA-AKI. Method(s): Three databases including
PubMed, ISI web of knowledge, and Embase were systematically searched from
inception to March 2018. Two investigators conducted the processes of
literature search study selection, data extraction, and quality evaluation
independently. Meta-DiSc and STATA were used for all statistical analyses.
 Result(s): A total of 8 studies comprising 552 patients were included
in this meta-analysis. Pooled sensitivity and specificity with
corresponding 95% confidence intervals (CIs) were 0.79 (95% CI, 0.71-0.86,
I2 = 74.2%) and 0.76 (95% CI, 0.72-0.80, I2 =
80.8%), respectively. Pooled positive likelihood ratio (LR), negative LR,
and diagnostic odds ratio were 3.49 (95% CI, 2.44-5.00, I2 =
61.5%), 0.31(95% CI, 0.19-0.51, I2 = 51.8%), and 14.89 (95% CI,
7.31-30.32, I2 = 27.9%), respectively. The area under curve
estimated by summary receiver operating characteristic was 0.868 (standard
error [SE] 0.032) with a Q* value of 0.799 (SE 0.032). Sensitivity
analysis demonstrated that one study notably affected the stability of
pooled results. One of the subgroups investigated-AKI threshold-could
account for partial heterogeneity. Conclusion(s): Urinary TIMP-2 and
IGFBP7 is a helpful biomarker for early diagnosis of CSA-AKI. And, the
potential of this biomarker with a broader spectrum of clinical settings
may be the focus of future studies. Copyright © The Author(s)
2018.

<43>
Accession Number
2006823152
Title
Effect of oral glucose water administration 1 hour preoperatively in
children with cyanotic congenital heart disease: A randomized controlled
trial.
Source
Medical Science Monitor. 26 (no pagination), 2020. Article Number:
e922642. Date of Publication: 2020.
Author
Huang X.; Zhang H.; Lin Y.; Chen L.; Peng Y.; Jiang F.; Lin F.; Li S.; Lin
L.
Institution
(Huang, Lin, Chen, Peng, Jiang, Lin, Li) Heart Medicine Research Center,
Fujian Medical University Union Hospital, Fuzhou, Fujian, China
(Zhang) Fujian Medical University Union Clinical Medicine College, Fuzhou,
Fujian, China
(Lin) Department of Nursing, Fujian Medical University, Fuzhou, Fujian,
China
Publisher
International Scientific Information, Inc. (E-mail:
iza.pranga@isl-science.com)
Abstract
Background: Guidelines recommend a clear liquid fasting time of 2 h before
surgery, which is often exceeded, leading to adverse reactions (ARs) such
as discomfort, thirst, and dehydration. We assessed the gastric contents
and ARs after oral glucose water administration 1 h prior to surgery in
children with cyanotic congenital heart disease (CCHD). Material/Methods:
This was a non-inferiority randomized controlled trial of children with
CCHD enrolled at the Fujian Medical University Union Hospital from 09/2014
to 05/2017 and randomized to receive oral glucose water (10 g of glucose
in 100 ml of warm water, 5 ml/kg) 2 h (2-h group, n=174) or 1 h (1-h
group, n=170) before surgery. The primary endpoint was gastric volume.
Secondary endpoints included pH of gastric content, preoperative blood
glucose, and risk factors for aspiration pneumonia. Pre- and
intraoperative ARs were recorded. Result(s): The 1-h group showed
smaller gastric content volumes (0.34+/-0.35 (95% CI: 0.29-0.39) vs.
0.43+/-0.33 (95% CI: 0.38-0.48) ml/kg, t=2.55, P<0.05) and higher blood
glucose (6.21+/-0.78 (95% CI: 6.09-6.33) vs. 5.59+/-1.11 (95% CI:
5.43-5.76) mmol/L, t=-5.91, P<0.001). The 95% confidence interval of the
volume difference between the 2 groups was 0.017-0.163, the upper limit
value was 0.163 <d=0.2 (P<0.01). The non-inferiority hypothesis was
correct. The 1-h group showed lower incidence of crying, thirst and
hypoxia (all P<0.05 vs. 2-h group). There were no differences in ARs
between the 2 groups. Conclusion(s): A 1-h fast prior to surgery was
not inferior to a 2-h fast in terms of gastric residuals and ARs in
pediatric patients with CCHD. Copyright © Med Sci Monit

<44>
Accession Number
2004569049
Title
The comparison of direct laryngoscopy and video laryngoscopy in pediatric
airways management for congenital heart surgery: A randomized clinical
trial.
Source
Anesthesiology and Pain Medicine. 10 (3) (pp 1-6), 2020. Article Number:
e99827. Date of Publication: June 2020.
Author
Javaherforooshzadeh F.; Gharacheh L.
Institution
(Javaherforooshzadeh) Department of Anesthesia, Ahvaz Anesthesiology and
Pain Research Center, Ahvaz Jundishapur University of Medical Sciences,
Ahvaz, Iran, Islamic Republic of
(Gharacheh) Student Research Center, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Gharacheh) Student Research Center, Ahvaz Jundishapur University of
Medical Sciences, Ahvaz, Iran, Islamic Republic of
Publisher
Kowsar Medical Publishing Company (E-mail: library@kowsarpub.com)
Abstract
Background: Airway management in patients with hereditary heart disease is
an important therapeutic intervention. Objective(s): The purpose of
this study was to compare direct laryngoscopy (DL) with video laryngoscopy
(VL) in pediatric airways management for congenital heart surgery.
 Method(s): This study was designed as a prospective randomized
clinical trial. Two consecutive groups of 30 patients undergoing elective
noncyanotic congenital heart surgery. The patients were divided into
direct laryngoscopy versus video laryngoscopy for intubation of the
trachea. The main outcomes were the number of success rate in the first
attempt, and the secondary outcomes were the duration of successful
intubation and complications, such as desaturation and bradycardia.
 Result(s): Intubation procedure time was measured as 51.13 +/- 17.88
seconds for the group with direct laryngoscopy and 59.66 +/- 45.91 seconds
for group with VL that was significant (P = 0.006). In DL group, 22
patients were intubated on the first attempt, 8 patients on the second
attempt, and 6 patients on the third attempt, compared to 24, 6, and 2
respectively, in VL group. The differences were significant only in the
third attempt between groups (P = 0.033). The important difference
established in heart rate (HR) and SpaO<inf>2</inf> amounts between the
two groups at any time (P < 0.05). Conclusion(s): VL can produce
better visualization for intubation of trachea in congenital heart
disease, but this is time-consuming. Indeed, training in the use of the VL
should be increased to reduce the time required for performance. Moreover,
further studies are recommended to approve these helpful
findings. Copyright © 2020, Author(s).

<45>
Accession Number
2004921793
Title
Pcsk9 inhibitors, the most significant advance in lipilowering therapy
since statins? A literature review.
Source
Osteopathic Family Physician. 11 (4) (pp 24-30), 2019. Date of
Publication: July-August 2019.
Author
Wilson A.
Institution
(Wilson) Department of Medicine, San Antonio Uniformed Services Health
Education Consortium, Joint Base San Antonio, Fort Sam Houston, TX, United
States
Publisher
American College of Osteopathic Family Physicians (E-mail:
belindab@acofp.org)
Abstract
OBJECTIVE: The purpose of this study was to evaluate efficacy, safety and
cost of PCSK9 inhibitors. METHOD(S): PubMed was used to search for
literature regarding PCSK9 inhibitors up to May 1, 2018. Clinical trials,
systematic reviews, meta-analyses and prescribing information were
utilized for this review. Inclusion criteria was Phase II, III randomized
control trials (RCT) and review articles comparing treatment of
hypercholesterolemia in adults with and without PCSK9 inhibitors. All
studies were completed from 2012-2017 and were conducted primarily in
America. RESULT(S): Evolocumab and alirocumab are the only FDA
approved PCSK9 inhibitors and have been shown to reduce baseline LDL-C by
50-60% in multiple clinical trials. Although there is no proven all-cause
or cardiovascular mortality benefit associated with these drugs, there is
a significant reduction in myocardial infarction (MI), stroke and coronary
revascularization in treatment groups. DISCUSSION: Low-density lipoprotein
cholesterol (LDL-C) is a well characterized risk factor for cardiovascular
disease (CVD). While hypercholesterolemia is often well controlled with
statins, there remains a need for additional lipid lowering therapy in
select patients. PCSK9 inhibitors represent a novel approach to lowering
LDL-C in patients with familial hypercholesterolemia and clinical
atherosclerotic cardiovascular disease (ASCVD) alone or in combination
with other cholesterol lowering medications. PCSK9 inhibitors are well
tolerated, with the most common side effects being local injection site
reactions and flu-like symptoms. High cost remains the most significant
obstacle for widespread use. PCSK9 inhibitors have a valuable role in the
lipid lowering treatment algorithm with their full therapeutic potential
yet to be realized. Copyright © American College of Osteopathic
Family Physicians. All rights reserved.

<46>
Accession Number
632340241
Title
Performance at stair-climbing test is associated with postoperative
complications after lung resection: A systematic review and meta-analysis.
Source
Thorax. 75 (9) (pp 791-797), 2020. Date of Publication: 01 Sep 2020.
Author
Boujibar F.; Gillibert A.; Gravier F.E.; Gillot T.; Bonnevie T.; Cuvelier
A.; Baste J.-M.
Institution
(Boujibar, Baste) Department of General and Thoracic Surgery, Chu Rouen,
Rouen, France
(Boujibar, Baste) Normandie University Unirouen, Inserm U1096, Rouen,
France
(Gillibert) Biostatistics Unit, Chu Rouen, Rouen, Normandie, France
(Gravier, Bonnevie) Adir Association, Bois Guillaume, France
(Gravier, Bonnevie, Cuvelier) Normandie University, Unirouen Upres Ea
3830, Rouen University Hospital, Haute Normandie Research and Biomedical
Innovation, Rouen, France
(Gillot) Cetaps Ea 3832, Mont Saint Aignan, France
(Gillot) Erfps, Chu Rouen, Rouen, France
(Cuvelier) Pulmonary and Respiratory Intensive Care Department, Chu Rouen,
Rouen, Normandie, France
Publisher
BMJ Publishing Group (E-mail: subscriptions@bmjgroup.com)
Abstract
Background Thoracic surgery is the optimal treatment for early-stage lung
cancer, but there is a high risk of postoperative morbidity. Therefore, it
is necessary to evaluate patients' preoperative general condition and
cardiorespiratory capacity to determine the risk of postoperative
complications. The objective of this study was to assess whether the
stair-climbing test could be used in the preoperative evaluation of lung
resection patients to predict postoperative morbidity following thoracic
surgery. Methods We performed a systematic review and a meta-analysis on
the association between stair-climbing test result and morbidity/mortality
after thoracic surgery. We analysed all articles published until May 2020
in the following databases: Pubmed/Medline, Pedro, The Cochrane library,
Embase and CINAHL. The risk of bias was assessed using the Quality in
Prognosis Studies tool. This meta-analysis is registered as PROSPERO
CRD42019121348. Results 13 articles were included in the systematic review
for a total of 2038 patients and 6 in the meta-analysis. There were
multiple test evaluation criteria: rise time, height, desaturation and
heart rate change. For the meta-analysis, we were able to pool data on the
height of rise at a variable threshold: risk ratio 2.34 (95% CI 1.59 to
3.43) with I2=53% (p=0.06). The threshold for occurrence of complications
was estimated at a 10 m climb. Conclusions Our results indicate that the
stair-climbing test could be used as a first-line functional screening
test to predict postoperative morbidity following thoracic surgery and
that patients with a poor test result (<10 m) should be referred to formal
cardiopulmonary exercise testing. Copyright ©

<47>
Accession Number
2005453638
Title
Comparison of the Efficacy and Safety of Direct Oral Anticoagulants and
Warfarin After Bioprosthetic Valve Replacements.
Source
Clinical Drug Investigation. 40 (9) (pp 839-845), 2020. Date of
Publication: 01 Sep 2020.
Author
Pasciolla S.; Zizza L.F.; Le T.; Wright K.
Institution
(Pasciolla, Zizza, Le, Wright) Department of Pharmacy, ChristianaCare,
Newark, DE, United States
(Pasciolla) Philadelphia College of Pharmacy, University of the Sciences,
Philadelphia, PA, United States
Publisher
Adis
Abstract
Background and Objective: Current guidelines recommend anticoagulation
with a vitamin K antagonist (warfarin) after a bioprosthetic valve
replacement. There is minimal literature evaluating direct oral
anticoagulants (DOACs) in patients who have just received a bioprosthetic
aortic valve replacement (AVR) or mitral valve replacement (MVR). The
purpose of this study was to investigate any differences in efficacy and
safety for patients taking a DOAC, compared with warfarin, after a
bioprosthetic AVR or MVR. Method(s): A retrospective cohort study was
performed to evaluate anticoagulation in patients who received
bioprosthetic valve replacements at a large teaching hospital from 2014 to
2018. Patients included in this study received either warfarin or a DOAC
following bioprosthetic AVR or MVR, and were maintained on the same agent
throughout the 6-month follow-up period. The primary efficacy outcome was
the incidence of thromboembolic complications and the primary safety
outcome was the incidence of major bleeding within 6 months following
surgery. The rate of readmission was assessed as a secondary endpoint.
 Result(s): A total of 197 patients were included; 70 patients
received warfarin and 127 patients received a DOAC (apixaban, n = 86;
rivaroxaban, n = 40; dabigatran, n = 1). Three patients experienced
thromboembolic events, all of which occurred in the DOAC group (0% vs.
2.4%; p = 0.20). Major bleeding occurred in 11 patients-two in the
warfarin group and nine in the DOAC group (2.9% vs. 7.1%; p = 0.22).
Sixty-one patients were readmitted within the 6-month time frame, with 26
readmissions in the warfarin group and 35 readmissions in the DOAC group
(37% vs. 27%; p = 0.16). Conclusion(s): This small, exploratory study
found similar rates of thromboembolic complications and major bleeding
events in patients who received a DOAC versus warfarin after a recent
bioprosthetic AVR or MVR. This study was limited by its retrospective
nature and its sample size. Larger, randomized controlled trials are
needed to further determine the efficacy and safety of DOACs in this
patient population. Copyright © 2020, Springer Nature Switzerland
AG.

<48>
Accession Number
632573530
Title
A pilot randomized controlled trial to assess the effect of Islamic
spiritual intervention and of breathing technique with heart rate
variability feedback on anxiety, depression and psycho-physiologic
coherence in patients after coronary artery bypass surgery.
Source
Annals of General Psychiatry. 19 (1) (no pagination), 2020. Article
Number: 46. Date of Publication: 13 Aug 2020.
Author
Amjadian M.; Bahrami Ehsan H.; Saboni K.; Vahedi S.; Rostami R.; Roshani
D.
Institution
(Amjadian) Clinical Psychology Department, Kurdistan University of Medical
Sciences, Sanandaj, Iran, Islamic Republic of
(Bahrami Ehsan, Rostami) Psychology Department, University of Tehran,
Tehran, Iran, Islamic Republic of
(Saboni) Surgery Department, Medical Sciences University of Kurdistan,
Sanandaj, Iran, Islamic Republic of
(Vahedi) Cardiology Department, Kurdistan University of Medical Sciences,
Sanandaj, Iran, Islamic Republic of
(Roshani) Social Determinants of Health Research Center, Research
Institute for Health Development, Kurdistan University of Medical
Sciences, Sanandaj, Iran, Islamic Republic of
(Roshani) Department of Epidemiology and Biostatistics, Medical School,
Kurdistan University of Medical Sciences, Sanandaj, Iran, Islamic Republic
of
Publisher
BioMed Central (E-mail: info@biomedcentral.com)
Abstract
Background: This study investigated the effects of Islamic religious and
breathing techniques with heart rate variability (HRV) biofeedback
therapies on HRV and psycho-physiologic coherence (resonance frequency),
depression and anxiety in coronary artery bypass graft surgery (CABG)
patients. Method(s): Sixty CABG patients were chosen and randomly
assigned to religious, breathing techniques and control groups. The
experimental groups received 8 weeks of treatments; a 2-h session with
home works in each week. The control group received only their normal
hospital interventions. The groups' depression, anxiety, HRV and
psycho-physiologic coherence levels were assessed before and after the
interventions by DASS-21 for depression and anxiety, and em-wave desktop
software for HRV and psycho-physiologic coherence. The data were analyzed
using ANCOVA with Bonferroni Comparison test and descriptive tests in SPSS
software. Result(s): The findings showed that there were significant
differences in psycho-physiologic coherence (HRV), depression and anxiety
scores among the three groups in the post-tests. In fact, depression and
anxiety were reduced more in the religious group, while psycho-physiologic
coherence raised more in the breathing with the HRV feedback group.
 Conclusion(s): The results showed that both Islamic religious and
breathing techniques with HRV biofeedback therapies can be used in
rehabilitation programs for CABG patients in clinics and
hospitals. Copyright © 2020 The Author(s).

<49>
Accession Number
2006003957
Title
Coexisting Coronary and Carotid Artery Disease - Which Technique and in
Which Order? Case Report and Review of Literature.
Source
Clinical Medicine Insights: Cardiology. 14 (no pagination), 2020. Date of
Publication: 2020.
Author
Manthey S.; Spears J.; Goldberg S.
Institution
(Manthey, Spears) Department of Medicine, Pennsylvania Hospital,
University of Pennsylvania Health System, Philadelphia, PA, United States
(Goldberg) Department of Cardiology, Pennsylvania Hospital, University of
Pennsylvania Health System, Philadelphia, PA, United States
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Coexisting carotid artery stenosis and coronary artery disease is common
and there is currently no consensus in treatment guidelines on the timing,
sequence and methods of revascularization. We report a case of a patient
with symptomatic triple vessel coronary artery disease as well as
asymptomatic severe right internal carotid artery stenosis. Our patient
underwent myocardial revascularization first, because she presented with
unstable angina and was asymptomatic neurologically. This article
summarizes current literature about the approach to carotid and coronary
artery revascularization and addresses the decision-making process
regarding the timing and sequence of revascularization. Copyright
© The Author(s) 2020.

<50>
Accession Number
2005999532
Title
Lung protective ventilation in infants undergoing cardiopulmonary bypass
surgery for congenital heart disease: A prospective randomized controlled
trial.
Source
Paediatric Anaesthesia. 30 (7) (pp 814-822), 2020. Date of Publication: 01
Jul 2020.
Author
Sun Y.; Shen S.-E.; Deng X.-M.; Cai Y.; Du Y.
Institution
(Sun, Shen, Cai, Du) Department of Anesthesiology and Critical Care
Medicine, Xin Hua Hospital affiliated to Jiaotong University School of
Medicine, Shanghai, China
(Deng) Department of Anesthesiology and Intensive Care Medicine, Changhai
Hospital affiliated to The Second Military Medical University, Shanghai,
China
Publisher
Blackwell Publishing Ltd
Abstract
Background: Lung protective ventilation (LPV) has been applied to surgical
adults with normal pulmonary function for optimizing mechanical
ventilation and reducing postoperative pulmonary complications. Few
studies have reported the use of LPV in infants undergoing cardiac surgery
with cardiopulmonary bypass (CPB). Aim(s): To explore safety and
effectiveness of LPV in infants undergoing CPB surgery for congenital
heart disease (CHD). Method(s): Included in this study were 77
infants who underwent CPB surgery for CHD from November 2017 to September
2018. They were randomized into the LPV group and conventional ventilation
(CV) group. In the LPV group, small-tidal-volume (6-8 ml/kg) ventilation,
lung recruitment by PEEP increment to the maximum level of 15 cm
H<inf>2</inf>O after CPB, and individualized optimal PEEP titration were
applied. In the CV group, traditional tidal volume (10-12 ml/kg with zero
PEEP) was applied. The primary outcome was the ratio of arterial partial
pressure of oxygen to inspiratory oxygen fraction
(PaO<inf>2</inf>/FiO<inf>2</inf>). The secondary outcomes were respiratory
dynamic parameters, hypoxemia, prognostic indexes, and postoperative
pulmonary complications. Result(s): PaO<inf>2</inf>/FiO<inf>2</inf>
in the LPV group (416.86, 95%CI: 381.60-452.12) was significantly higher
than that in the CV group (263.37, 95%CI: 227.65-299.09) after
intervention (P <.001). There was a significant difference in the trend of
change in dynamic compliance, alveolar-arterial oxygen difference,
arterial-end-expired carbon dioxide difference, driving pressure, and
respiratory index between the two groups at different time points from
weaning from CPB to 2 hours after operation. There was no significant
difference in PaO<inf>2</inf>/FiO<inf>2</inf>, alveolar-arterial oxygen
difference, respiratory index, and dynamic compliance 2 hours
postoperative and in the incidence of postoperative pulmonary
complications, prognostic indexes between the two groups.
 Conclusion(s): LPV could be used safely in infants undergoing CPB in
that it can improve oxygenation, alveolar aeration, and dynamic
compliance, and reduce driving pressure, pulmonary shunting, and dead
space. Its effect on oxygenation, pulmonary gas exchange, and pulmonary
compliance was relatively short, and had less impact on postoperative
pulmonary complications and prognosis. Copyright © 2020 John
Wiley & Sons Ltd

<51>
Accession Number
2007621416
Title
Postoperative Pain Management and the Incidence of Ipsilateral Shoulder
Pain After Thoracic Surgery at an Australian Tertiary-Care Hospital: A
Prospective Audit.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Hodge A.; Rapchuk I.L.; Gurunathan U.
Institution
(Hodge) Department of Anaesthesia and Perioperative Medicine, Royal
Brisbane and Women's Hospital, Brisbane, Queensland, Australia
(Hodge, Rapchuk) University of Queensland
(Rapchuk, Gurunathan) Department of Anaesthesia and Perfusion Services,
The Prince Charles Hospital, Brisbane, Queensland, Australia
Publisher
W.B. Saunders
Abstract
Objectives: Ipsilateral shoulder pain (ISP) is a common but variably
occurring (42%-85%) complication after thoracic surgery. Multiple
potential treatments, including upper limb blocks, intrapleural local
anaesthetic infiltration, and systemic opioids, have undergone trials,
with limited efficacy. Phrenic nerve infiltration is a potential
intervention that may prevent ISP. The aim of this study was to assess the
incidence and severity of ISP after thoracic surgery at the authors'
institution, where phrenic nerve infiltration is commonly used.
 Design(s): Observational cohort study. Setting(s): A single-
center study in a tertiary referral center in Brisbane, Australia.
 Participant(s): This study comprised all adult patients undergoing
thoracic surgery at a tertiary- care referral center from May to July
2018. Measurements and Main Results: Surgical procedures were divided
into open thoracotomy, video-assisted thoracic surgery (VATS) and
VATS-guided mini-thoracotomy. The primary outcome was a comparison of
incidence of ISP among the 3 types of surgical procedures. Data were
analyzed using Stata (StataCorp), with significance testing by
Kruskal-Wallis equality of populations rank test. A p value of < 0.05 was
deemed significant. Sixty thoracic surgeries were performed during the
audit period. Nineteen patients had thoracotomies performed for lobectomy
or pneumonectomy, all of whom received phrenic nerve infiltration. The
incidence of moderate-to-severe ipsilateral shoulder pain among the
thoracoctomy cohort was 15.8% (3/19). Of the 36 VATS procedures audited, 7
patients (19.4%) received infiltration of their phrenic nerve, none of
whom reported postoperative ISP. Of the remaining twenty-nine patients who
did not receive phrenic nerve infiltration, there were 4 cases of
moderate-to-severe ipsilateral shoulder pain (11.1%). Four of the 5
patients (80%) who underwent VATS-guided mini-thoracotomies received
phrenic nerve infiltration intraoperatively. Three patients reported
moderate-to-severe ISP and of these 3 patients, 2 patients had phrenic
nerve infiltration, and 1 patient did not receive infiltration. Overall,
there were no statistically significant differences in rest or dynamic
pain scores across the surgical groups at any time point. Mann-Whitney
test revealed that the participants with ISP were significantly older than
those without ISP (p = 0.006). However, there were no significant
differences in sex or body mass index between those with and without ISP.
 Conclusion(s): The authors observed a lower (15.8%) incidence of
moderate-to-severe ISP among their thoracotomy patients than reported in
prior literature. Injection of local anesthetic into the phrenic nerve fat
pad at the level of the diaphragm appeared to be an effective and safe
surgical intervention that may eliminate a significant cause of ISP. None
of the VATS patients who received phrenic nerve infiltration experienced
ISP. Postoperative pain in VATS is expected to be reduced by avoiding the
use of a rib spreader, severing of the intercostal nerves, and division of
muscle tissue, which may account for the lower observed rates of ISP in
the VATS cohort who did not receive phrenic nerve infiltration. Further
randomized controlled trials are warranted to establish if patients
undergoing various VATS procedures benefit from this
intervention. Copyright © 2020 Elsevier Inc.

<52>
Accession Number
2007621164
Title
Peak Serum Chloride and Hyperchloremia in Patients Undergoing Cardiac
Surgery Is Not Explained by Chloride-Rich Intravenous Fluid Alone: A
Post-Hoc Analysis of the LICRA Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
McIlroy D.R.; Murphy D.; Shotwell M.S.; Bhatia D.
Institution
(McIlroy, Murphy, Bhatia) Alfred Hospital, Monash University, Melbourne,
Victoria, Australia
(McIlroy, Shotwell) Vanderbilt University Medical Center, Nashville, TN,
United States
Publisher
W.B. Saunders
Abstract
Objectives: With the exception of 0.9% saline, little is known about
factors that may contribute to increased serum chloride concentration
(S<inf>Cl</inf>-) in patients undergoing cardiac surgery. For
the present study, the authors sought to characterize the association
between administered chloride load from intravenous fluid and other
perioperative variables, with peak perioperative
S<inf>Cl</inf>-. Design(s): Secondary analysis of data
from a previously published controlled clinical trial in which patients
were assigned to a chloride-rich or chloride-limited perioperative fluid
strategy (NCT02020538). Setting(s): Academic medical center.
 Participant(s): The study comprised 1,056 adult patients with normal
preoperative S<inf>Cl</inf>- undergoing cardiac surgery.
 Intervention(s): None Measurements and Main Results: Peak
perioperative S<inf>Cl</inf>- and hyperchloremia, defined as
peak S<inf>Cl</inf>- >110 mmol/L, were selected as co-primary
endpoints. Regression modeling identified factors independently associated
with these endpoints. Mean (standard deviation) peak perioperative
S<inf>Cl</inf>- was 114 (5) mmol/L, and hyperchloremia occurred
in 824 (78.0%) of the cohort. In addition to administered volume of 0.9%
saline, multivariate linear and logistic regression modeling consistently
associated preoperative S<inf>Cl</inf>- (regression coefficient
0.5; 95% confidence interval [CI] 0.4-0.6 mmol/L; odds ratio 1.60; 95% CI
1.41-1.82 per 1 mmol/L increase) and cardiopulmonary bypass duration
(regression coefficient 0.1; 95% CI 0.1-0.2 mmol/L; odds ratio 1.12; 95%
CI 1.06-1.19 per 10 minutes) with both co-primary outcomes. Multivariate
modeling only explained approximately 50% of variability in peak
S<inf>Cl</inf>-. Conclusion(s): The present study's data
identified an association for both 0.9% saline administration and other
nonfluid variables with peak perioperative S<inf>Cl</inf>- and
hyperchloremia. Stand-alone strategies to limit administration of
chloride-rich intravenous fluid may have limited ability to prevent
hyperchloremia in this setting. Copyright © 2020 Elsevier Inc.

<53>
Accession Number
2007605810
Title
Pregnancy after Heart Transplantation.
Source
Journal of Cardiac Failure. (no pagination), 2020. Date of Publication:
2020.
Author
Defilippis E.M.; Kittleson M.M.
Institution
(Defilippis) Division of Cardiology, Columbia University Irving Medical
Center, New York, NY, United States
(Kittleson) Division of Cardiology, Smidt Heart Institute, Cedars-Sinai
Medical Center, Los Angeles, CA, United States
Publisher
Churchill Livingstone Inc.
Abstract
As post-transplant survival improves, many heart transplant (HT)
recipients are of, or are surviving to, childbearing age. Solid-organ
transplant recipients who become pregnant should be managed by a
multidisciplinary cardio-obstetrics team, including specialists in
maternal and fetal medicine, cardiology and transplant medicine, as well
as anesthesia, neonatology, psychology, genetics, and social services.
With careful patient selection, pregnancy after HT can been managed
safely. The purpose of this comprehensive review was to summarize the
current evidence and recommendations surrounding preconception counseling,
medical management and surveillance, maternal outcomes, breastfeeding, and
remaining gaps in knowledge. Copyright © 2020 Elsevier Inc.

<54>
Accession Number
2006000680
Title
Rheumatic heart disease anno 2020: Impacts of gender and migration on
epidemiology and management.
Source
European Journal of Clinical Investigation. (no pagination), 2020. Date of
Publication: 2020.
Author
Mutagaywa R.K.; Wind A.-M.; Kamuhabwa A.; Cramer M.J.; Chillo P.;
Chamuleau S.
Institution
(Mutagaywa, Chillo) School of Medicine, Muhimbili University of Health and
Allied Sciences, Dar Es Salaam, Tanzania
(Mutagaywa, Wind, Cramer, Chamuleau) Division of Heart and Lung,
Department of Cardiology, Faculty of Medicine, University Medical Centre
Utrecht, Utrecht, Netherlands
(Kamuhabwa) School of Pharmacy, Muhimbili University of Health and Allied
Sciences, Dar Es Salaam, Tanzania
(Chamuleau) Division of Heart and Lung, Department of Cardiology, Faculty
of Medicine, Amsterdam University Medical Centre, Amsterdam, Netherlands
Publisher
Blackwell Publishing Ltd
Abstract
Background: The epidemiology and management of diseases can be influenced
by social demographic factors. Gender and migration are among these
factors. Method(s): We aimed at reviewing the impacts of gender and
migration on rheumatic heart disease (RHD) epidemiology and management by
a nonsystematic literature review of published studies on RHD worldwide.
Our PubMed search terms included RHD pathophysiology, diagnosis,
complications, management or prevention, combined with words 'rheumatic
mitral stenosis (MS)', 'outcomes after percutaneous balloon mitral
valvuloplasty (PBMV)', 'gender or sex difference' and 'migration'. The
reporting of this study conforms to SANRA (the Scale for Assessment of
Narrative Review Articles) guidelines. Result(s): We retrieved eight
studies about the impact of sex on outcomes after PBMV. All of these
studies showed a female predominance for RHD. Two studies showed that
there is no impact, three studies showed female sex as a predictor of poor
outcomes, and the other three showed male sex a predictor of poor
outcomes. Although RHD is reported to be eradicated in the developed
countries, 2.1% of refugees recently screened for RHD in Italy were found
to have subclinical RHD. This prevalence is similar to those found in
India (2.0%), Cambodia (2.2%) and Mozambique (3%). Conclusion(s):
There are contradicting results for outcomes after PBMV between males and
females. It is not clear whether sex difference plays a role in
pathophysiology, diagnosis, management and prognosis of MS. Migration has
impacts on epidemiology and management of RHD. Further studies are
required in these two fields to explore their relationship to
RHD. Copyright © 2020 Stichting European Society for Clinical
Investigation Journal Foundation. Published by John Wiley & Sons Ltd

<55>
Accession Number
2005972998
Title
Characteristics and outcomes of gastrointestinal bleeding in patients with
continuous-flow left ventricular assist devices: A systematic review.
Source
Artificial Organs. (no pagination), 2020. Date of Publication: 2020.
Author
Carlson L.A.; Maynes E.J.; Choi J.H.; Hallett A.M.; Horan D.P.; Weber
M.P.; Deb A.K.; Patel S.; Samuels L.E.; Morris R.J.; Entwistle J.W.; Todd
Massey H.; Tchantchaleishvili V.
Institution
(Carlson, Maynes, Choi, Hallett, Horan, Weber, Patel, Samuels, Morris,
Entwistle, Todd Massey, Tchantchaleishvili) Division of Cardiac Surgery,
Thomas Jefferson University, Philadelphia, PA, United States
(Deb) Philadelphia College of Osteopathic Medicine, Philadelphia, PA,
United States
Publisher
Blackwell Publishing Inc. (E-mail: subscrip@blackwellpub.com)
Abstract
Gastrointestinal bleeding (GIB) is a common adverse event after
continuous-flow left ventricular assist device (CF-LVAD) implantation. We
sought to evaluate patterns of GIB development and related outcomes in
CF-LVAD recipients. An electronic search was performed to identify all
articles related to GIB in the setting of CF-LVAD implantation. A total of
34 studies involving 1087 patients were pooled for analysis. Mean patient
age was 60 years (95% CI 57-64) and 24% (95% CI 21-28%) were female. The
mean time from CF-LVAD implantation to the first GIB was 54 days (95% CI
24-84) with 40% (95% CI 34-45%) of patients having multiple episodes of
GIB. Anemia was present in 75% (95% CI 41-93%) and the most common
etiology of bleeding was arteriovenous malformations (36% [95% CI
24-50%]). The mean duration of follow-up was 14.6 months (95% CI 6.9-22.3)
during which the all-cause mortality rate was 21% (95% CI 12-36%) and the
mortality rate from GIB was 4% (95% CI 2-9%). Thromboembolic events
occurred in 32% (95% CI 22-44%) of patients with an ischemic stroke rate
of 16% (95% CI 3-51%) and a pump thrombosis rate of 8% (95%CI 3-22%).
Heart transplantation was performed in 31% (95% CI 18-47%) of patients,
after which 0% (95% CI 0-10%) experienced recurrent GIB. GIB is a major
source of morbidity among CF-LVAD recipients. While death due to GIB is
rare, cessation of anticoagulation during treatment increases the risk of
subsequent thrombotic events. Heart transplant in these patients appears
to reliably resolve the risk of future GIB. Copyright © 2020
International Center for Artificial Organs and Transplantation and Wiley
Periodicals, Inc.

<56>
Accession Number
632683350
Title
Outcome of Flow-Gradient Patterns of Aortic Stenosis after Aortic Valve
Replacement: An Analysis of the PARTNER 2 Trial and Registry.
Source
Circulation: Cardiovascular Interventions. (no pagination), 2020. Article
Number: e008792. Date of Publication: 2020.
Author
Salaun E.; Clavel M.-A.; Hahn R.T.; Jaber W.A.; Asch F.M.; Rodriguez L.;
Weissman N.J.; Gertz Z.M.; Herrmann H.C.; Dahou A.; Annabi M.-S.; Toubal
O.; Bernier M.; Beaudoin J.; Leipsic J.; Blanke P.; Ridard C.; Ong G.;
Rodes-Cabau J.; Webb J.G.; Zhang Y.; Alu M.C.; Douglas P.S.; Makkar R.;
Miller D.C.; Lindman B.R.; Thourani V.H.; Leon M.B.; Pibarot P.
Institution
(Salaun, Clavel, Dahou, Annabi, Toubal, Bernier, Beaudoin, Ridard, Ong,
Rodes-Cabau, Pibarot) Institut Universitaire de Cardiologie, Pneumologie
de Quebec/Quebec Heart and Lung Institute, Laval University, 2725 Chemin
Sainte-Foy No. A2075, Quebec, QC G1V-4G5, Canada
(Hahn, Zhang, Alu, Leon) Columbia University Medical Center, New York-
Presbyterian Hospital, New York, NY, United States
(Hahn, Zhang, Alu, Leon) Cardiovascular Research Foundation, New York, NY,
United States
(Jaber, Rodriguez) Heart and Vascular Institute, Cleveland Clinic, OH,
United States
(Asch, Weissman, Thourani) MedStar Health Research Institute, Washington
Hospital Center, DC, United States
(Gertz) Division of Cardiology, Virginia Commonwealth University,
Richmond, United States
(Herrmann) University of Pennsylvania Medical Center, Philadelphia, United
States
(Leipsic, Blanke, Webb) St Paul's Hospital, Vancouver, BC, Canada
(Ong) Division of Cardiology, St Michael's Hospital, Toronto, ON, Canada
(Douglas) Duke University Medical Center, Duke Clinical Research
Institute, Durham, NC, United States
(Makkar) Cedars-Sinai Heart Institute, Los Angeles, CA, United States
(Miller) Division of Cardiovascular Medicine, Department of Medicine,
Stanford University School of Medicine, CA, United States
(Lindman) Vanderbilt University Medical Center, Nashville, TN, United
States
Publisher
Lippincott Williams and Wilkins (E-mail: kathiest.clai@apta.org)
Abstract
Background: Although aortic valve replacement is associated with a major
benefit in high-gradient (HG) severe aortic stenosis (AS), the results in
low-gradient (LG, mean gradient <40 mm Hg) AS are conflicting. LG severe
AS may be subdivided in classical low-flow (left ventricular ejection
fraction <50%) and LG (CLF-LG); paradoxical low-flow (left ventricular
ejection fraction >=50% but stroke volume index <35 mL/m2) and LG; and
normal-flow (left ventricular ejection fraction >=50% and stroke volume
index >=35 mL/m2) and LG. The primary objective is to determine in the
PARTNER 2 trial (The Placement of Aortic Transcatheter Valves) and
registry the outcomes after aortic valve replacement of the 4
flow-gradient groups. Method(s): A total of 3511 patients from the
PARTNER 2 Cohort A randomized trial (n=1910) and SAPIEN 3 registry
(n=1601) were included. The flow-gradient pattern was determined at
baseline transthoracic echocardiography and classified as follows: (1) HG;
(2) CLF-LG; (3) paradoxical low-flow-LG; and (4) normal-flow-LG. The
primary end point for this analysis was the composite of (1) death; (2)
rehospitalization for heart failure symptoms and valve prosthesis
complication; or (3) stroke. Result(s): The distribution was HG, 2229
patients (63.5%); CLF-LG, 689 patients (19.6%); paradoxical low-flow-LG,
247 patients (7.0%); and normal-flow-LG, 346 patients (9.9%). The 2-year
rate of primary end point was higher in CLF-LG (38.8%) versus HG: 31.8%
(P=0.002) and normal-flow-LG: 32.1% (P=0.05) but was not statistically
different from paradoxical low-flow-LG: 33.6% (P=0.18). There was no
significant difference in the 2-year rates of clinical events between
transcatheter aortic valve replacement versus surgical aortic valve
replacement in the whole cohort and within each flow-gradient group.
 Conclusion(s): The LG AS pattern was highly prevalent (36.5%) in the
PARTNER 2 trial and registry. CLF-LG was the most common pattern of LG AS
and was associated with higher rates of death, rehospitalization, or
stroke at 2 years compared with the HG group. Clinical outcomes were as
good in the LG AS groups with preserved left ventricular ejection fraction
compared with the HG group. Copyright © 2020 American Heart
Association, Inc.

<57>
Accession Number
2005786485
Title
Osteopathic treatment leads to significantly greater reductions in chronic
thoracic pain after CABG surgery: A randomised controlled trial.
Source
Journal of Bodywork and Movement Therapies. 24 (3) (pp 202-211), 2020.
Date of Publication: July 2020.
Author
Roncada G.
Institution
(Roncada) Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium
(Roncada) Commission for Osteopathic Research, Practice and Promotion,
Mechelen, Belgium
Publisher
Churchill Livingstone
Abstract
Background: There are a number of long-term postoperative complications
after coronary artery bypass graft (CABG) surgery. Pulmonary function is
decreased by 12% and 30%-50% of the patients have chronic thoracic pain.
 Method(s): This randomised controlled trial with two parallel groups
aimed to explore the effectiveness of osteopathic treatments (OTs) on
these conditions. The standard care (SC) group and the and OT group
received a 12-week standard cardiac rehabilitation programme, which was
supplemented with four OTs for the OT group only. The outcome assessors
were blinded to the patients' allocation. Result(s): Eighty-two
patients with median sternotomy after CABG surgery were randomly allocated
in a 1:1 ratio (SC: n = 42, OT: n = 42). Slow vital capacity and pain
intensity were measured at baseline and at 12 weeks and 52 weeks after
surgery. Pain intensity was significantly lower in the OT group 12 weeks
after surgery (3.6-0.80 vs. 2.6 to 1.2, p = 0.030). One year after
surgery, there still was a significantly lower pain intensity in the OT
group (3.6-0.56, vs. 2.6 to 1.2, p = 0.014). No significant changes
between groups were found in pulmonary function. There were no adverse
events reported. Conclusion(s): From this study, it can be concluded
that the addition of OT to exercise-based cardiac rehabilitation may lead
to significantly greater reductions in thoracic pain after CABG surgery.
Trial registration: This study was registered on ClinicalTrials.gov
(NCT01714791). Copyright © 2020 Elsevier Ltd

<58>
Accession Number
2005698517
Title
Low-dose colchicine after MI reduced a composite ischemic cardiovascular
outcome vs placebo.
Source
Annals of Internal Medicine. 172 (8) (pp JC39), 2020. Date of Publication:
21 Apr 2020.
Author
Bach R.G.
Institution
(Bach) Washington University School of Medicine, St. Louis, MO, United
States
Publisher
American College of Physicians (190 N. Indenpence Mall West, Philadelphia
PA 19106-1572, United States)

<59>
Accession Number
2004931382
Title
Preoperative Anemia Management: What's New in 2020?.
Source
Current Anesthesiology Reports. 10 (2) (pp 166-175), 2020. Date of
Publication: 01 Jun 2020.
Author
Rubinger D.A.; Cahill C.; Ngo A.; Gloff M.; Refaai M.A.
Institution
(Rubinger, Gloff) Department of Anesthesia, University of Rochester
Medical Center, Rochester, NY, United States
(Cahill, Ngo, Refaai) Department of Pathology and Laboratory Medicine,
University of Rochester Medical Center, 601 Elmwood Avenue, Box-608,
Rochester, NY 14642, United States
Publisher
Springer
Abstract
Purpose of Review: The purpose of this article is to review the relevant
evidence regarding the clinical impact of preoperative anemia, current
methods of identifying anemia in the surgical population, and the current
and upcoming evidence for the treatment modalities targeting preoperative
anemia. Recent Findings: Preoperative anemia continues to be identified as
a contributor to poor outcomes in the surgical population. Identifying
anemia typically starts with hemoglobin and mean corpuscular volume.
Recent laboratories have also started using iron studies with serum
ferritin and transferrin saturation. Oral and IV iron have demonstrated
efficacy in treating preoperative anemia in terms of increasing hemoglobin
preoperatively and reducing allogeneic blood transfusions. However, few
studies have demonstrated an impact on patient outcomes, morbidity, and
mortality. Additionally, several meta-analyses have demonstrated the
benefit of adding erythropoietin-stimulating agents to improve anemia.
 Summary: Preoperative anemia is very common and is thought to be a
contributor to poor outcomes. IV iron is currently recommended by several
guidelines as the primary treatment modality for preoperative anemia. Two
ongoing studies hope to provide clarity on the effect of IV iron on
patient outcomes including morbidity and mortality in cardiac and
non-cardiac surgical populations. Copyright © 2020, Springer
Science+Business Media, LLC, part of Springer Nature.

<60>
Accession Number
2003836425
Title
Vitamin c for cardiac surgery patients: Several errors in a published
meta-analysis. comment on "effects of vitamin c on organ function in
cardiac surgery patients: A systematic review and meta-analysis. Nutrients
2019, 11, 2103".
Source
Nutrients. 12 (2) (no pagination), 2020. Article Number: 586. Date of
Publication: February 2020.
Author
Hemila H.; Chalker E.
Institution
(Hemila) Department of Public Health, University of Helsinki, POB 41,
Helsinki FI-00014, Finland
(Chalker) School of Public Health, University of Sydney, Sydney 2006,
Australia
Publisher
MDPI AG (Postfach, Basel CH-4005, Switzerland. E-mail: rasetti@mdpi.com)

<61>
Accession Number
2007513099
Title
Trifecta Versus Perimount Magna Ease Aortic Valve Prostheses.
Source
Annals of Thoracic Surgery. 110 (3) (pp 879-888), 2020. Date of
Publication: September 2020.
Author
Biancari F.; Valtola A.; Juvonen T.; Husso A.; Dahlbacka S.; Laakso T.;
Jalava M.P.; Tauriainen T.; Ahvenvaara T.; Kinnunen E.-M.; Niemela M.;
Makikallio T.; Eskola M.; Virtanen M.P.O.; Maaranen P.; Rosato S.; Anttila
V.; Vento A.; Airaksinen J.; Raivio P.
Institution
(Biancari, Jalava, Anttila) Heart Center, Turku University Hospital and
Department of Surgery, University of Turku, Turku, Finland
(Biancari, Tauriainen, Ahvenvaara, Airaksinen) Department of Surgery, Oulu
University Hospital and Research Unit of Surgery, Anesthesia and Intensive
Care, University of Oulu, Oulu, Finland
(Valtola, Husso) Heart Center, Kuopio University Hospital, Kuopio, Finland
(Juvonen, Dahlbacka, Laakso, Kinnunen, Vento, Raivio) Heart and Lung
Center, Helsinki University Hospital, Helsinki, Finland
(Niemela, Makikallio) Department of Internal Medicine, Oulu University
Hospital, Oulu, Finland
(Eskola, Virtanen, Maaranen) Heart Hospital, Tampere University Hospital,
Faculty of Medicine and Health Technology, University of Tampere, Tampere,
Finland
(Rosato) Istituto Superiore di Sanita, Rome, Italy
Publisher
Elsevier USA
Abstract
Background: Recent surgical bovine pericardial prostheses are widely used
despite limited data on their long-term durability. Method(s): This
is a comparative analysis of the outcome of the Trifecta (Abbott, Abbott
Park, IL) and Perimount Magna Ease (Edwards, Lifesciences Corp, Irvine,
CA) bioprostheses from the FinnValve registry, a Finnish nationwide
database including patients with aortic stenosis who underwent
transcatheter or surgical aortic valve replacement with a bioprosthesis
between 2008 and 2017. Result(s): Overall 2216 patients (mean age,
74.1 +/- 6.7 years; age <65 years, 8.9%; mean follow-up, 3.8 +/- 2.1
years) received the Trifecta (851 patients) or the Perimount Magna Ease
(1365 patients) bioprostheses. The rates of late mortality and prosthetic
valve endocarditis were comparable in the study cohorts. At 7 years the
Trifecta cohort had a significantly higher risk of repeat aortic valve
replacement for structural valve failure (3.3% vs 0%; adjusted
subdistribution hazard ratio, 2.224; 95% confidence interval,
1.044-4.737), repeat aortic valve replacement for any cause (3.6% vs 0.4%;
adjusted subdistribution hazard ratio, 3.210; 95% confidence interval,
1.286-8.013), and repeat aortic valve replacement and/or prosthetic valve
endocarditis (4.1% vs 0.9%; adjusted subdistribution hazard ratio, 3.210;
95% confidence interval, 1.286-8.013) compared with the Perimount Magna
Ease cohort. Among 772 propensity score-matched pairs, at 7 years the
Trifecta cohort had a higher risk of repeat aortic valve replacement for
structural valve failure (5.7% vs 0%, P = .009). Conclusion(s): The
Trifecta aortic bioprosthesis is associated with a higher occurrence of
repeat aortic valve replacement for structural valve failure compared with
the Perimount Magna Ease bioprosthesis. Further comparative studies with
echocardiographic data on structural valve deterioration and longer
follow-up are needed to confirm these findings. Copyright © 2020
The Society of Thoracic Surgeons

<62>
Accession Number
2007493029
Title
European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia
Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society
(LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use
the right tool for the right outcome, in the right population.
Source
Heart Rhythm. 17 (9) (pp e269-e316), 2020. Date of Publication: September
2020.
Author
Nielsen J.C.; Lin Y.-J.; de Oliveira Figueiredo M.J.; Sepehri Shamloo A.;
Alfie A.; Boveda S.; Dagres N.; Di Toro D.; Eckhardt L.L.; Ellenbogen K.;
Hardy C.; Ikeda T.; Jaswal A.; Kaufman E.; Krahn A.; Kusano K.; Kutyifa
V.; Lim H.S.; Lip G.Y.H.; Nava-Townsend S.; Pak H.-N.; Diez G.R.; Sauer
W.; Saxena A.; Svendsen J.H.; Vanegas D.; Vaseghi M.; Wilde A.; Bunch
T.J.; Buxton A.E.; Calvimontes G.; Chao T.-F.; Eckardt L.; Estner H.;
Gillis A.M.; Isa R.; Kautzner J.; Maury P.; Moss J.D.; Nam G.-B.;
Olshansky B.; Pava Molano L.F.; Pimentel M.; Prabhu M.; Tzou W.S.; Sommer
P.; Swampillai J.; Vidal A.; Deneke T.; Hindricks G.; Leclercq C.
Institution
(Nielsen) Department of Cardiology, Aarhus University Hospital, Skejby,
Denmark
(Lin, Chao) Division of Cardiology, Department of Medicine, Taipei
Veterans General Hospital, Taipei, Taiwan (Republic of China)
(de Oliveira Figueiredo) Department of Internal Medicine,
Electrophysiology Service, University of Campinas Hospital, Campinas,
Brazil
(Sepehri Shamloo, Dagres, Hindricks) Department of Electrophysiology,
Leipzig Heart Center at University of Leipzig, Leipzig, Germany
(Alfie) Division of Electrophysiology, Instituto Cardiovascular
Adventista, Clinica Bazterrica, Buenos Aires, Argentina
(Boveda) Department of Cardiology, Clinique Pasteur, Toulouse, France
(Di Toro) Department of Cardiology, Division of Electrophysiology,
Argerich Hospital and CEMIC, Buenos Aires, Argentina
(Eckhardt) Department of Medicine, University of Wisconsin-Madison,
Madison, WI, United States
(Ellenbogen) Division of Cardiology, Virginia Commonwealth University
School of Medicine, Richmond, Virginia, United States
(Hardy) Arrhythmia Unit, Heart Institute, University of Sao, Paulo Medical
School, Instituto do Coracao -InCor- Faculdade de Medicina de Sao, Paulo,
Sao Paulo, Brazil
(Ikeda) Department of Cardiovascular Medicine, Faculty of Medicine, Toho
University, Tokyo, Japan
(Jaswal, Saxena) Department of Cardiac Electrophysiology, Fortis Escorts
Heart Institute, Okhla Road, New Delhi, India
(Kaufman) The Heart and Vascular Research Center, Metrohealth Campus of
Case Western Reserve University, Cleveland, OH, United States
(Krahn) Division of Cardiology, Department of Medicine, University of
British Columbia, Vancouver, Canada
(Kusano) Division of Arrhythmia and Electrophysiology, Department of
Cardiovascular Medicine, National Cerebral and Cardiovascular Center,
Osaka, Japan
(Kutyifa) University of Rochester, Medical Center, Rochester, NY, United
States
(Kutyifa) Semmelweis University, Heart and Vascular Center, Budapest,
Hungary
(Lim) Department of Cardiology, Austin Health, Melbourne, VIC, Australia
(Lim) University of Melbourne, Melbourne, VIC, Australia
(Lip) Liverpool Centre for Cardiovascular Science, University of Liverpool
and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
(Lip) Aalborg Thrombosis Research Unit, Department of Clinical Medicine,
Aalborg University, Aalborg, Denmark
(Nava-Townsend) Department of Electrocardiology, National Institute of
Cardiology "Ignacio Chavez,", Mexico City, Mexico
(Pak) Division of Cardiology, Department of Internal Medicine, Yonsei
University Health System, Seoul, South Korea
(Diez) Department of Electrophysiology and Hemodynamic, Arrhytmias Unity,
CMN 20 de Noviembre, ISSSTE, Mexico City, Mexico
(Sauer) Cardiovascular Division, Brigham and Women's Hospital and Harvard
Medical School, Boston, MA, United States
(Svendsen) Department of Cardiology, Rigshospitalet, University of
Copenhagen, Copenhagen, Denmark
(Svendsen) Department of Clinical Medicine, Faculty of Health and Medical
Sciences, University of Copenhagen, Copenhagen, Denmark
(Vanegas) Hospital Militar Central, Fundarritmia, Bogota, Colombia
(Vaseghi) UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen
School of Medicine, at UCLA, Los Angeles, CA, United States
(Wilde) Amsterdam UMC, University of Amsterdam, Heart Center, Department
of Clinical and Experimental Cardiology, Amsterdam, Netherlands
(Bunch) Department of Medicine, Intermountain Heart Institute,
Intermountain Medical Center, Salt Lake City, UT, United States
(Buxton) Department of Medicine, The Richard A. and Susan F. Smith Center
for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Calvimontes) Asociacion Guatemalteca de Cardiologia, Guatemala, Guatemala
(Eckardt) Department for Cardiology, Electrophysiology, University
Hospital Munster, Munster, Germany
(Estner) Department of Medicine, I, University Hospital Munich,
Ludwig-Maximilians University, Munich, Germany
(Gillis) University of Calgary - Libin Cardiovascular Institute of
Alberta, Calgary, Canada
(Isa) Clinica RedSalud Vitacura and Hospital el Carmen de Maipu, Santiago,
Chile
(Kautzner) Institute for Clinical and Experimental Medicine, Prague,
Czechia
(Maury) Rangueil University Hospital, Toulouse, France
(Moss) Department of Cardiac Electrophysiology, University of California
San Francisco, San Francisco, CA, United States
(Nam) Division of Cardiology, Asan Medical Center, University of Ulsan,
College of Medicine, Seoul, South Korea
(Olshansky) University of Iowa Carver College of Medicine, Iowa City, IA,
United States
(Pava Molano) Fundacion Valle del Lili, Cali, Colombia
(Pimentel) Cardiology Division, Hospital de Clinicas de Porto Alegre,
Porto Alegre, RS, Brazil
(Prabhu) Department of Cardiology, Sree Chitra Tirunal Institute for
Medical Sciences and Technology, Trivandrum, India
(Tzou) Department of Cardiology/Cardiac Electrophysiology, University of
Colorado Anschutz Medical Campus, Aurora, CO, United States
(Sommer) Clinic for Electrophysiology, Herz- und Diabeteszentrum, Clinic
for Electrophysiology, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany
(Swampillai) Waikato Hospital, Hamilton, New Zealand
(Vidal) Division of Cardiology, McGill University Health Center, Montreal,
Canada
(Deneke) Clinic for Cardiology II (Interventional Electrophysiology),
Heart Center Bad Neustadt, Bad Neustadt a.d. Saale, Germany
(Leclercq) Univ Rennes, CHU Rennes, INSERM, Rennes, France
Publisher
Elsevier B.V.

<63>
Accession Number
632408231
Title
Does the Presence of Significant Mitral Regurgitation prior to
Transcatheter Aortic Valve Implantation for Aortic Stenosis Impact
Mortality? - Meta-Analysis and Systematic Review.
Source
Cardiology (Switzerland). 145 (7) (pp 428-438), 2020. Date of Publication:
01 Jul 2020.
Author
Sethi A.; Kodumuri V.; Prasad V.; Chaudhary A.; Coromilas J.; Kassotis J.
Institution
(Sethi, Chaudhary, Coromilas, Kassotis) Division of Cardiology, Rutgers
Robert Wood Johnson Medical School, New Brunswick, NJ, United States
(Kodumuri) John H. Stroger Hospital of Cook County, Chicago, IL, United
States
(Prasad) Division of Cardiology, Loma Linda University, Loma Linda, CA,
United States
Publisher
S. Karger AG
Abstract
Background: Mitral regurgitation (MR) is commonly encountered in patients
with severe aortic stenosis (AS). However, its independent impact on
mortality in patients undergoing transcatheter aortic valve implantation
(TAVI) has not been established. Method(s): We performed a systematic
search for studies reporting characteristics and outcome of patients with
and without significant MR and/or adjusted mortality associated with MR
post-TAVI. We conducted a meta-analysis of quantitative data.
 Result(s): Seventeen studies with 20,717 patients compared outcomes
and group characteristics. Twenty-one studies with 32,257 patients
reported adjusted odds of mortality associated with MR. Patients with MR
were older, had a higher Society of Thoracic Surgeons score, lower left
ventricular ejection fraction, a higher incidence of prior myocardial
infarction, atrial fibrillation, and a trend towards higher NYHA class
III/IV, but had similar mean gradient, gender, and chronic kidney disease.
The MR patients had a higher unadjusted short-term (RR = 1.46, 95% CI
1.30-1.65) and long-term mortality (RR = 1.40, 95% CI 1.18-1.65). However,
16 of 21 studies with 27,777 patients found no association between MR and
mortality after adjusting for baseline variables. In greater than half of
the patients (0.56, 95% CI 0.45-0.66) MR improved by at least one grade
following TAVI. Conclusion(s): The patients with MR undergoing TAVI
have a higher burden of risk factors which can independently impact
mortality. There is a lack of robust evidence supporting an increased
mortality in MR patients, after adjusting for other compounding variables.
MR tends to improve in the majority of patients post-TAVI. Copyright
© 2020

<64>
Accession Number
2007541500
Title
Anticoagulation with or without antiplatelet therapy following
transcatheter aortic valve replacement for patients with atrial
fibrillation: A meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2020. Date of
Publication: 2020.
Author
Yokoyama Y.; Briasoulis A.; Takagi H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Briasoulis) Division of Cardiology, Heart failure and Transplantation,
University of Iowa, IA, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, NY, United States
Publisher
Elsevier Inc. (E-mail: usjcs@elsevier.com)
Abstract
Background: Although current guidelines recommend oral anticoagulants
(OAC) with or without antiplatelet therapy (APT) following transcatheter
aortic valve replacement (TVAR) in patients with an indication for
long-term anticoagulation therapy, the optimal antithrombotic strategy
remains unknown in these population. Herein, we conducted a meta-analysis
comparing the outcome of OAC alone versus OAC with APT following TAVR in
patients with atrial fibrillation (AF). Method(s): MEDLINE and EMBASE
were searched through May 2020 to identify clinical trials that
investigated OAC alone versus OAC with APT following TAVR in patients with
AF. From each study, we extracted the hazard ratios (HRs) or risk ratios
of major or life threatening bleeding, stroke, all-cause mortality and
cardiovascular mortality. Result(s): 1 randomized controlled trial
and 3 observational studies were identified, which enrolled a total of
2032 patients with AF who underwent TAVR assigned to the OAC group (n =
722) or OAC with APT group (n = 1310). Pooled analyses demonstrated the
rate of major or life threatening bleeding was significantly lower in the
OAC group compared to the OAC with APT group (HR [95% Confidence Interval
[CI] = 0.54 [0.38-0.77], P = .0006]). However, the rate of stroke was
similar in both groups (HR [95% CI] = 1.22 [0.80-1.87], P = .36).
All-cause and cardiovascular mortalities were also similar in both groups.
 Conclusion(s): We observed that OAC with APT following TAVR in
patients with AF increased the risk of bleeding compared to OAC alone
without decreasing the risk of stroke. Copyright © 2020 Elsevier
Inc.

<65>
Accession Number
2007541471
Title
Surgical Strategy for Intravenous Cardiac Leiomyomatosis.
Source
Heart Lung and Circulation. (no pagination), 2020. Date of Publication:
2020.
Author
Deng Y.; Dong S.; Song B.
Institution
(Deng, Dong, Song) Department of Cardiovascular Surgery, The First
Hospital of Lanzhou University, Gansu Province, China
Publisher
Elsevier Ltd
Abstract
Intravenous-cardiac leiomyomatosis (IVCL) is a rare, histologically benign
but biologically aggressive tumour. Accurate diagnosis and appropriate
treatment choices are important for prognosis. The best surgical approach
remains unclear owing to limited evidence. This study aimed to assess
surgical strategies for treating IVCL and to propose individualised
surgical strategies. We searched PubMed, Web of Science, and the Cochrane
Library to identify case reports and case series published in English over
the last 10 years. Two (2) reviewers independently screened the literature
according to the inclusion and exclusion criteria, and subsequently
extracted data. One hundred and ten (110) cases were included. According
to our analysis, IV cardiac leiomyomatosis is most common in the fifth
decade, and the mean age at detection is 45.71+/-7.67 years. Most patients
had undergone previous hysterectomy/myomectomy, or had a co-existing
uterine leiomyoma when admitted. The most common clinical presentations
were dyspnoea, palpitation, pelvic mass, and leg oedema. More patients
benefited more from one-stage surgery. Seventy-eight per cent (78%) of
cases experienced a surgical approach of thoracic and abdominal incisions.
Extractions of IVCL were varied. Eighty-seven (87) patients experienced
cardiopulmonary bypass and deep hypothermic circulatory arrest was
performed on 64.4% of them. Total hysterectomy and bilateral oophorectomy,
together with pelvic leiomyoma excision, were done in 76.0% of patients.
Overall, surgical strategies for IVCL are varied; the optimal strategy
required consideration of multiple factors. Complete resection is
recommended for both single- and two-stage operations. Once complete
resection is achieved, recurrence is rare. Copyright © 2020
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<66>
Accession Number
2007522911
Title
Pharmacological interventions for the prevention of renal injury in
surgical patients: a systematic literature review and meta-analysis.
Source
British Journal of Anaesthesia. (no pagination), 2020. Date of
Publication: 2020.
Author
Pathak S.; Olivieri G.; Mohamed W.; Abbasciano R.; Roman M.; Tomassini S.;
Lai F.; Wozniak M.; Murphy G.J.
Institution
(Pathak, Olivieri, Mohamed, Abbasciano, Roman, Tomassini, Lai, Wozniak,
Murphy) Department of Cardiovascular Sciences, National Institute for
Health Research Leicester Biomedical Research Unit in Cardiovascular
Medicine, University of Leicester, Leicester, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: The aim of this systematic review was to summarise the results
of randomised controlled trials (RCTs) that have evaluated pharmacological
interventions for renoprotection in people undergoing surgery.
 Method(s): Searches were conducted to update a previous review using
the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE to
August 23, 2019. RCTs evaluating the use of pharmacological interventions
for renal protection in the perioperative period were included. The
co-primary outcome measures were 30-day mortality and acute kidney injury
(AKI). Pooled effect estimates were expressed as risk ratios (RRs) (95%
confidence intervals). Result(s): We included 228 trials enrolling 56
047 patients. Twenty-three trials were considered to be at low risk of
bias across all domains. Atrial natriuretic peptides (14 trials; n=2207)
reduced 30-day mortality (RR: 0.63 [0.41, 0.97]) and AKI events (RR: 0.43
[0.33, 0.56]) without heterogeneity. These effects were consistent across
cardiac surgery and vascular surgery subgroups, and in sensitivity
analyses restricted to studies at low risk of bias. Inodilators (13
trials; n=2941) reduced mortality (RR: 0.71 [0.53, 0.94]) and AKI events
(RR: 0.65 [0.50, 0.85]) in the primary analysis and in cardiac surgery
cohorts. Vasopressors (4 trials; n=1047) reduced AKI (RR: 0.56 [0.36,
0.86]). Nitric oxide donors, alpha-2-agonists, and calcium channel
blockers reduced AKI in primary analyses, but not after exclusion of
studies at risk of bias. Overall, assessment of the certainty of the
effect estimates was low. Conclusion(s): There are multiple effective
pharmacological renoprotective interventions for people undergoing
surgery. Copyright © 2020 The Authors

<67>
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. 131 (pp 82-90), 2020. Date of Publication:
15 September 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. Copyright © 2020

<68>
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. 131 (pp 7-11), 2020. Date of Publication:
15 September 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. Copyright © 2020

<69>
Accession Number
2007179300
Title
Meta-analysis Comparing Transradial Versus Transfemoral Secondary Access
in Transcatheter Aortic Valve Implantation.
Source
American Journal of Cardiology. 131 (pp 74-81), 2020. Date of Publication:
15 September 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. Copyright ©
2020 Elsevier Inc.

<70>
Accession Number
2007138006
Title
Supra annular sizing for TAVR in bicuspid aortic valve stenosis: A
meta-analysis.
Source
Indian Heart Journal. 72 (4) (pp 309-311), 2020. Date of Publication: July
- August 2020.
Author
Kumar A.; Doshi R.; Shariff M.; Adalja D.; Vallabhajosyula S.
Institution
(Kumar, Shariff) Department of Critical Care Medicine, St John's Medical
College Hospital, Bangalore, India
(Doshi) Department of Internal Medicine, University of Nevada Reno School
of Medicine, Reno, NV, United States
(Adalja) Department of Medicine, Gotri Medical Education and Research
Center, Vadodara, Gujrat, India
(Vallabhajosyula) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
Elsevier B.V.

<71>
Accession Number
632644453
Title
Transcatheter versus surgical aortic valve replacement in renal transplant
patients: A meta-analysis.
Source
Cardiology Research. 11 (5) (pp 280-285), 2020. Date of Publication: 2020.
Author
Mir T.; Darmoch F.; Ullah W.; Sattar Y.; Hakim Z.; Pacha H.M.; Fouad L.;
Gardi D.; Glazier J.J.; Zehr K.; Alraies M.C.
Institution
(Mir) Wayne State University/Detroit Medical Center, Detroit, MI, United
States
(Darmoch) Internal Medicine, Beth Israel Deaconess Medical Center/Harvard
School of Medicine, Boston, MA, United States
(Ullah) Internal Medicine, Abington Jefferson Health, 1200 Old York Road,
Abington, PA 19044, United States
(Sattar) Internal Medicine, Icahn School of Medicine, Mount Sinai Elmhurst
Hospital, New York, NY, United States
(Hakim, Gardi, Glazier, Zehr, Alraies) Cardiovascular Medicine, Detroit
Medical Center, Wayne State University, Detroit, MI, United States
(Pacha) University of Texas Health Science Center, McGovern Medical
School, Memorial Hermann Heart and Vascular Institute, Houston, TX, United
States
(Fouad) Detroit Medical Center, Heart Hospital, Detroit, MI, United States
Publisher
Elmer Press (E-mail: production@elmerpress.com)
Abstract
Background: The outcome of transcutaneous aortic valve replacement (TAVR)
in patients with kidney transplant is unknown, as majority of these
patients were excluded from the major TAVR clinical trials. We sought to
compare patients with severe aortic stenosis who underwent TAVR versus
surgical aortic valve replacement (SAVR) with a history of kidney
transplant. Method(s): PubMed, Google Scholar and Cochrane databases
were searched to identify relevant articles. The incidence of all-cause
mortality and acute kidney injury (AKI) was calculated using relative risk
on a random effect model. Result(s): A total of 1,538 patients (TAVR
328, SAVR 1,210) were included in the study. TAVR was associated with
lower mortality as compared with SAVR at 30 days from the index procedure
(odds ratio (OR) 0.48, 95% confidence interval (CI): 0.25-0.93; P = 0.03).
Oneyear mortality was studied in three studies and showed comparable
mortality in patients undergoing TAVR and SAVR (OR: 0.76, 95% CI:
0.10-5.51; P = 0.78). Compared to SAVR, TAVR carries an identical risk of
AKI (OR: 0.44, 95% CI: 0.10-1.90; P = 0.27). A sensitivity analysis
performed by exclusion of Voudris et al study showed a non-significant
difference in the mortality incidence of two groups at 30 days (OR: 0.72,
95% CI: 0.27-1.91; P = 0.51). Conclusion(s): In patients with a
history of kidney transplant, TAVR was associated with a comparable risk
of mortality and AKI compared to SAVR. Copyright © 2020 Elmer
Press.

<72>
Accession Number
632597555
Title
Post-cardiac surgery chylopericardium.
Source
Journal of the College of Physicians and Surgeons Pakistan. 30 (6) (pp
627-632), 2020. Date of Publication: June 2020.
Author
Yuan S.-M.
Institution
(Yuan) Department of Cardiothoracic Surgery, First Hospital of Putian,
Teaching Hospital, Fujian Medical University, Putian, Fujian Province
351100, China
Publisher
College of Physicians and Surgeons Pakistan (7th Central Street, Karachi
755000, Pakistan)
Abstract
Post-cardiac surgery chylopericardium is a rare complication. This
systematic review included 87 articles with 119 patients of post-cardiac
surgery chylopericardium. Chylopericardium developed after operations for
congenital heart defect more than those for acquired heart disease, and
more patients in whom post-cardiac surgery chylopericardium developed were
with complex than with simple congenital heart defects. Cardiac tamponade
occurred in 35 (29.4%) patients. The onset time of chylopericardium was
18.2 days earlier in patients operated for acquired than in those for
congenital heart defects. Post-cardiac surgery chylopericardium were
curable to conservative treatment in most patients. The recurrence of
post-cardiac surgery chylopericardium was on day 13.2 +/-18.2 after the
initial treatment. The overall early and late mortality rates were 1.7%
(2/119) and 1.7% (2/117), respectively. Most patients with post-cardiac
surgery chylopericardium were diagnosed by laboratory analysis of chylous
fluid. Patients with mild chylopericardium usually show good response to
conservative treatment. Whereas, patients with massive chylopericardium
and rapid accumulation, incurable to conservative treatment and recurrent
to either conservative or surgical treatment, warrant further surgical
treatment. Copyright © 2020 College of Physicians and Surgeons
Pakistan. All rights reserved.

<73>
Accession Number
2007104848
Title
Coronary stent thrombosis-predictors and prevention.
Source
Deutsches Arzteblatt International. 117 (18) (pp 320-326), 2020. Date of
Publication: 01 May 2020.
Author
Ullrich H.; Munzel T.; Gori T.
Institution
(Ullrich, Munzel, Gori) Cardiology Center, Cardiology I, Universitiy
Medical Center, Johannes Gutenberg University Mainz, German Center of
Cardiovascular Research (Deutsches Zentrum fur Herz-Kreislauf-Forschung,
DZHK), Rhine-Main, Germany
Publisher
Deutscher Arzte-Verlag GmbH (Dieselstrasse 2 (Postfach 0254), Cologne
50859, Germany)
Abstract
Background: Stent thrombosis (ST) is a dreaded complication after stent
implantation and is associated with a mortality between 5% and 45%. The
mechanisms by which ST arises are complex. Because of the seriousness of
this situation, all physicians should have at least basic knowledge of it.
In this article, we present the risk factors for ST and discuss some
innovative approaches to its treatment. Method(s): This review is
based on pertinent articles retrieved by a selective search in PubMed, and
on current international guidelines and expert recommendations.
 Result(s): The frequency of ST has been markedly lowered by technical
advances in coronary stenting and by the implementation of modern
implantation techniques, including the introduction of coverage with dual
antiplatelet therapy (DAPT). Both patient-related risk factors and
procedural aspects can elevate the risk of ST. The independent risk
factors for ST include premature termination of DAPT (hazard ratio [HR]
26.8; 95% confidence interval [8.4; 85.4]; p <0.0001), malignant disease
(odds ratio [OR]: 17.45; [4.67; 65.26]; p <0.0001), and diabetes mellitus
(OR: 3.14; [1.33; 7.45]; p = 0.0093). In comparison to angiographically
guided procedures, the use of intracoronary imaging techniques in patients
with acute coronary syndrome lowers the frequency of ST (0.6% versus 1.2%;
p = 0.005). These techniques enable the detection of many findings in the
coronary arteries that are associated with the development of ST. In such
cases, countermeasures such as secondary stent dilatation or prolongation
of DAPT can help prevent ST. Conclusion(s): As the pathophysiology of
ST is multifactorial, research in this area presents a special challenge.
Prospective clinical trials will be needed to determine whether the
systematic use of imaging techniques can lower the frequency of
ST. Copyright © 2020 Deutscher Arzte-Verlag GmbH. All rights
reserved.

<74>
Accession Number
2007593692
Title
Pectointercostal Fascial Block (PIFB) as a Novel Technique for
Postoperative Pain Management in Patients Undergoing Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Kumar A.K.; Chauhan S.; Bhoi D.; Kaushal B.
Institution
(Kumar, Chauhan, Kaushal) Department of Cardiac Anesthesiology, CN Center,
All India Institute of Medical Sciences, New Delhi, India
(Bhoi) Department of Anesthesiology, Pain Medicine and Critical Care, All
India Institute of Medical Sciences, New Delhi, India
Publisher
W.B. Saunders
Abstract
Objective: To determine the efficacy of pectointercostal fascial block in
relieving postoperative pain in patients undergoing cardiac surgery.
 Design(s): Single-blinded, prospective, randomized controlled trial.
 Setting(s): Single-center tertiary care teaching hospital.
 Participant(s): A total 40 participants undergoing cardiac surgery
aged 18 to 80 years. Intervention(s): Subjects were categorized into
2 groups of 20 each. In group 2 participants (interventional group),
bilateral pectointercostal fascial block was given using ropivacaine
injection 0.25% after completion of surgery, before shifting to the
intensive care unit. Measurements and Main Results: Postoperative
pain was measured after extubation at 0, 3, 6, and 12 hours, using a
numeric rating scale. Pain in group 2 was significantly less and lasted
for a longer duration than in group 1. Fentanyl requirement was
significantly higher in group 1 (1.06 +/- 0.12 micro /kg) than in
group 2 (0.82 +/- 0.19 micro /kg). Conclusion(s):
Pectointercostal fascial block is an easy and efficient technique to
reduce postoperative pain after cardiac surgery. Copyright © 2020
Elsevier Inc.

<75>
Accession Number
632678054
Title
Advancement of a standardised enteral feeding protocol in functional
single ventricle patients following stage I palliation using
cerebro-somatic near-infrared spectroscopy.
Source
Cardiology in the young. (pp 1-10), 2020. Date of Publication: 24 Aug
2020.
Author
Raymond T.T.; Valle S.; Garza J.; Yeramaneni S.; Wurtz E.; Sample B.;
Kozak N.; Stigall W.; Gatlin S.; Burton G.
Institution
(Raymond, Wurtz, Sample, Kozak, Burton) Department of Pediatrics, Cardiac
Intensive Care, Medical City Children's Hospital, TX, Dallas, United
States
(Valle, Yeramaneni) HCA Research Institute at Medical City Children's
Hospital, TX, Dallas, United States
(Garza) Children's Health, Division of Cardiology, TX, Dallas, United
States
(Stigall) Pediatric Critical Care, Cook Children's Hospital, TX, Fort
Worth, United States
(Gatlin) Department of Pediatrics, Division of Cardiology, Arkansas
Children's Hospital, Little Rock, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Infants with single ventricle following stage I palliation
are at risk for poor nutrition and growth failure. We hypothesise a
standardised enteral feeding protocol for these infants that will result
in a more rapid attainment of nutritional goals without an increased
incidence of gastrointestinal co-morbidities. MATERIALS AND METHODS:
Single-centre cardiac ICU, prospective case series with historical
comparisons. Feeding cohort consisted of consecutive patients with a
single ventricle admitted to cardiac ICU over 18 months following stage I
palliation (n = 33). Data were compared with a control cohort and admitted
to the cardiac ICU over 18 months before feeding protocol implementation
(n = 30). Feeding protocol patients were randomised: (1) protocol with
cerebro-somatic near-infrared spectroscopy feeding advancement criteria (n
= 17) or (2) protocol without cerebro-somatic near-infrared spectroscopy
feeding advancement criteria (n = 16). RESULT(S): Median time to
achieve goal enteral volume was significantly higher in the control
compared to feeding cohort. There were no significant differences in
enteral feeds being held for feeding intolerance or necrotising
enterocolitis between cohorts. Feeding cohort had significant improvements
in discharge nutritional status (weight, difference admit to discharge
weight, weight-for-age z score, volume, and caloric enteral nutrition) and
late mortality compared to the control cohort. No infants in the feeding
group with cerebro-somatic near-infrared spectroscopy developed
necrotising enterocolitis versus 4/16 (25%) in the feeding cohort without
cerebro-somatic near-infrared spectroscopy (p = 0.04). CONCLUSION(S):
A feeding protocol is a safe and effective means of initiating and
advancing enteral nutrition in infants following stage I palliation and
resulted in improved nutrition delivery, weight gain, and nourishment
status at discharge without increased incidence of gastrointestinal
co-morbidities.

<76>
Accession Number
632675175
Title
Randomized Controlled Trial of Working Memory Intervention in Congenital
Heart Disease.
Source
The Journal of pediatrics. (no pagination), 2020. Date of Publication: 19
Aug 2020.
Author
Calderon J.; Wypij D.; Rofeberg V.; Stopp C.; Roseman A.; Albers D.;
Newburger J.W.; Bellinger D.C.
Institution
(Calderon) Department of Psychiatry, Boston Children's Hospital, Boston,
MA; Department of Psychiatry, Harvard Medical School, Boston, MA
(Wypij) Department of Cardiology, Boston Children's Hospital, Boston, MA;
Department of Biostatistics. Harvard T.H. Chan School of Public Health,
Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA
(Rofeberg, Stopp, Roseman, Albers) Department of Cardiology, Boston
Children's Hospital, MA, Boston
(Newburger) Department of Cardiology, Boston Children's Hospital, Boston,
MA; Department of Pediatrics, Harvard Medical School, Boston, MA
(Bellinger) Department of Psychiatry, Boston Children's Hospital, Boston,
MA; Department of Psychiatry, Harvard Medical School, Boston, MA;
Department of Neurology, Boston Children's Hospital, Boston, MA;
Department of Neurology, Harvard Medical School, Boston, MA
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To evaluate the efficacy of Cogmed Working Memory Training
compared with the standard of care to improve executive function and
social outcomes in adolescents with congenital heart disease (CHD) who
underwent open-heart surgery in infancy and to identify factors associated
with changes in outcomes following the intervention. STUDY DESIGN: In a
single-center, randomized controlled trial, adolescents (13-16 years) with
CHD were randomly assigned to either Cogmed (home-based 45-minutes
sessions for 5-8 weeks) or to a control group. The primary outcome was
working memory. Secondary outcomes included inhibitory control and
cognitive flexibility as well as parent-reported executive function, ADHD
symptoms and social outcomes. All measures were assessed at baseline,
post-treatment (1-3 weeks post-training) and at 3-month follow-up. Data
were analyzed using an intention-to-treat approach. RESULT(S): Sixty
adolescents with CHD participated (28 assigned to Cogmed). No improvement
at the post-treatment or 3-month follow-up assessments was found for the
primary outcome measure of working memory. Compared with the control
group, participants assigned to the intervention demonstrated benefits in
inhibitory control and attention at the 3-month follow-up (p=0.02) and in
parent-reported cognitive regulatory skills at post-treatment and 3-month
follow-up (p=0.02 and p=0.04, respectively). Preterm birth, biventricular
CHD and history of ADHD diagnosis were associated with improved response
to the intervention. CONCLUSION(S): Cogmed intervention produced
improvements in the self-regulatory control abilities of adolescents with
CHD. The training did not enhance other areas of executive function or
behavioral outcomes. Further studies are needed to evaluate the
longer-term potential benefits to other domains. Copyright © 2020
Elsevier Inc. All rights reserved.

EPICORE Embase Updates

Saturday, September 5, 2020

EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

No comments:

Post a Comment

Followers

Blog Archive

About Me