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<1>
Accession Number
615112835
Title
A pilot study using preoperative cerebral tissue oxygen saturation to
stratify cardiovascular risk in major non-cardiac surgery.
Source
Anaesthesia and Intensive Care. 45 (2) (pp 202-209), 2017. Date of
Publication: March 2017.
Author
Wen S.Y.B.; Peng A.Z.Y.; Boyle S.; Cai S.; Pope L.; Tran M.T.; Short T.G.;
Aneman A.; Jaeger M.; Chuan A.
Institution
(Wen, Peng) South West Sydney Clinical School, University of NSW, Sydney,
NSW, Australia
(Boyle, Cai, Pope, Tran, Aneman, Chuan) Department of Anaesthesia,
Liverpool Hospital, Sydney, NSW, Australia
(Short) Department of Anaesthesia, Auckland City Hospital, New Zealand
(Jaeger) South Western Sydney Clinical School, University of NSW, Sydney,
NSW, Australia
Publisher
Australian Society of Anaesthetists (United States. E-mail:
claims@sagepub.com)
Abstract
This prospective pilot study evaluated whether low preoperative cerebral
tissue oxygen saturation is associated with unfavourable outcomes after
major elective non-cardiac surgery. Eighty-one patients over 60 years of
age, American Society of Anesthesiologists physical status 3 or 4, were
recruited. Resting cerebral tissue oxygen saturation was recorded on room
air, and after oxygen supplementation, using cerebral oximetry. The
primary outcome was 30-day major adverse event of combined mortality or
severe morbidity, and the secondary outcome was 30-day new disability.
Eleven patients (13.6%) suffered a major adverse event, and 28 patients
(34.6%) experienced new disability. Room air cerebral tissue oxygen
saturation was significantly different between patients who had a major
adverse event, 67% (95% confidence interval [CI] 65-70) versus unaffected,
71% (95% CI 70-72; P=0.04). No statistical difference was found between
patients for new disability (range 70%-74%; P=0.73). Room air cerebral
tissue oxygen saturation was significantly associated with major adverse
events (odds ratio 1.36 (95% CI 1.03-1.79), P=0.03). Saturation levels
=68% carried a positive likelihood ratio of 2.2 for death or severe
morbidity, P=0.04. A definitive trial is required to confirm if cerebral
oximetry can be used to stratify the cardiovascular risk of patients
presenting for non-cardiac surgery.

<2>
Accession Number
632741584
Title
3D printing in adult cardiovascular surgery and interventions: A
systematic review.
Source
Journal of Thoracic Disease. 12 (6) (pp 3227-3237), 2020. Date of
Publication: 01 Jun 2020.
Author
Wang C.; Zhang L.; Qin T.; Xi Z.; Sun L.; Wu H.; Li D.
Institution
(Wang, Zhang, Qin, Xi, Sun, Wu, Li) Department of Cardiovascular Surgery,
Jinling Hospital, Nanjing University, School Medicine, Nanjing 210002,
China
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
3D printing in adult cardiac and vascular surgery has been evaluated over
the last 10 years, and all of the available literature reports benefits
from the use of 3D models. In the present study, we analyzed the current
applications of 3D printing for adult cardiovascular disease treated with
surgical or catheter-based interventions, including the clinical medical
simulation of physiological or pathology conducted with 3D printing in
this field. A search of PubMed and MEDLINE databases were supplemented by
searching through bibliographies of key articles. Thereafter, data on
demographic, clinical scenarios and application, imaging modality,
purposes of using with 3D printing, outcomes and follow-up were extracted.
A total of 43 articles were deemed eligible and included. 296 patients
(mean age: 65.4+/-14.2 years; male, 58.2%) received 3D printing for
cardiac and vascular surgery or conditions [percutaneous left atrial
appendage occlusion (LAAO), TAVR, mitral valve disease, aortic valve
replacement, coronary artery abnormality, HOCM, aortic aneurysm and aortic
dissection, Kommerell's diverticulum, primary cardiac tumor and
ventricular aneurysm]. Eight papers reported the utility of 3D printing in
the medical simulator and training fields. Most studies were conducted
starting in 2014. Twenty-six was case report. The major scenario used with
3D printing technology was LAAO (50.3%) and followed by TAVR (17.6%). CT
and echocardiography were two main imaging techniques that were used to
generate 3D-printed heart models. All studies showed that 3D-printed
models were helpful for preoperative planning, orientation, and medical
teaching. The important finding is that 3D printing provides a unique
patient-specific method to assess complex anatomy and is helpful for
intraoperative orientation, decision-making, creating functional models,
and teaching adult cardiac and vascular surgery, including catheter-based
heart surgery.<br/>Copyright &#xa9; Journal of Thoracic Disease. All
rights reserved.

<3>
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
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.<br/>Copyright &#xa9; 2020 College of Physicians and Surgeons
Pakistan. All rights reserved.

<4>
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Accession Number
632567905
Title
Towards integrative neuromonitoring of the surgical newborn: A systematic
review.
Source
European Journal of Anaesthesiology. 37 (8) (pp 701-712), 2020. Date of
Publication: 01 Aug 2020.
Author
Costerus S.A.; Van Hoorn C.E.; Hendrikx D.; Kortenbout J.; Hunfeld M.;
Vlot J.; Naulaers G.; Tibboel D.; De Graaff J.C.
Institution
(Costerus, Hendrikx, Tibboel) Department of Pediatric Surgery and
Intensive Care, Sophia Children's Hospital, Erasmus MC, Dr Molewaterplein
60, Rotterdam 3000 CB, Netherlands
(Van Hoorn, De Graaff) Department of Anesthesiology, Erasmus University
Medical Center, Rotterdam, Netherlands
(Hunfeld) Department of Electrical Engineering, KU Leuven, Leuven, Belgium
(Kortenbout) Department of Biomedical Engineering, Erasmus University
Medical Center, Netherlands
(Vlot) Department of Pediatric Neurology, Erasmus University Medical
Center-Sophia Children's Hospital, Rotterdam, Netherlands
(Naulaers) Department of Neonatal Intensive Care Unit, University
Hospitals Leuven, Leuven, Belgium
Publisher
Lippincott Williams and Wilkins (E-mail: agents@lww.com)
Abstract
BACKGROUNDThe altered neurodevelopment of children operated on during the
neonatal period might be due to peri-operative changes in the homeostasis
of brain perfusion. Monitoring of vital signs is a standard of care, but
it does not usually include monitoring of the brain.OBJECTIVESTo evaluate
methods of monitoring the brain that might be of value. We also wanted to
clarify if there are specific risk factors that result in peri-operative
changes and how this might be evaluated.DESIGNSystematic review.DATA
SOURCESA structured literature search was performed in MEDLINE in Ovid,
Embase, Cochrane CENTRAL, Web of Science and Google Scholar.ELIGIBILITY
CRITERIAStudies in neonates who received peri-operative neuromonitoring
were eligible for inclusion; studies on neurosurgical procedures or
cardiac surgery with cardiopulmonary bypass and/or deep hypothermia
cardiac arrest were excluded.RESULTSNineteen of the 24 included studies,
totalling 374 infants, reported the use of near-infrared spectroscopy.
Baseline values of cerebral oxygenation greatly varied (mean 53 to 91%)
and consequently, no coherent results were found. Two studies found a
correlation between cerebral oxygenation and mean arterial blood pressure.
Five studies, with in total 388 infants, used (amplitude-integrated)
electro-encephalography to study peri-operative brain activity. Overall,
the brain activity decreased during anaesthesia and epileptic activity was
more frequent in the peri-operative phase. The association between
intra-operative cerebral saturation or activity and neuro-imaging
abnormalities and/or neurodevelopmental outcome was investigated in six
studies, but no association was found.CONCLUSIONNeuromonitoring with the
techniques currently used will neither help our understanding of the
altered neonatal pathophysiology, nor enable early detection of deviation
from the norm. The modalities lack specificity and are not related to
clinical (long-term) outcome or prognosis. Accordingly, we were unable to
draw up a monitoring guideline.<br/>Copyright &#xa9; 2020 Lippincott
Williams and Wilkins. All rights reserved.

<5>
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Accession Number
632567880
Title
Postoperative atrial fibrillation following emergency noncardiothoracic
surgery: A systematic review.
Source
European Journal of Anaesthesiology. 37 (8) (pp 671-679), 2020. Date of
Publication: 01 Aug 2020.
Author
Bjerrum E.; Wahlstroem K.L.; Gogenur I.; Burcharth J.; Ekeloef S.
Institution
(Bjerrum, Wahlstroem, Gogenur, Burcharth, Ekeloef) Center for Surgical
Science (CSS), Department of Surgery, Zealand University Hospital,
Lykkebaekvej 1, Koege 4600, Denmark
Publisher
Lippincott Williams and Wilkins (E-mail: agents@lww.com)
Abstract
BACKGROUNDPostoperative atrial fibrillation (POAF) occurs frequently
following cardiothoracic surgery and is associated with a higher mortality
and a longer hospital stay. The condition is less studied following
noncardiothoracic surgery as well as emergency surgery.OBJECTIVEThe aim of
this systematic review was to investigate the occurrence of atrial
fibrillation following emergency noncardiothoracic surgery and associated
risk factors and mortality.DESIGNWe conducted a systematic review
according to the Preferred Reporting Items for Systematic reviews and
Meta-Analyses guidelines. Observational studies and randomised controlled
trials were assessed for risk of bias using the Downs and Black checklist
and Cochrane Handbook for Systematic reviews of intervention.DATA SOURCESA
systematic literature search of PubMed, EMBASE and Scopus was carried out
in August 2019. No publication date- or source restrictions were
imposed.ELIGIBILITY CRITERIAObservational and randomised controlled trials
were included if data on POAF occurring after an emergency,
noncardiothoracic, surgical intervention on adult patients could be
extracted.RESULTSWe identified 15 studies eligible for inclusion covering
orthopaedic-, abdominal-, vascular-, neuro- and miscellaneous
noncardiothoracic surgery. The occurrence of POAF after emergency
noncardiothoracic surgery ranged from 1.5 to 12.2% depending on type of
surgery and intensity of cardiac monitoring. Studies that investigated
risk factors and associated mortality found emergency surgery and
increasing age to be associated with risk of POAF. Moreover, POAF was
generally associated with an increase in long-term and short-term
mortality.CONCLUSIONIn this study, atrial fibrillation occurred
frequently, especially following emergency orthopaedic, vascular and
neurosurgery. Emergency surgery and age were independent risk factors for
developing atrial fibrillation. POAF seems to be related to a higher risk
of postoperative complications and mortality, though further studies with
long-term follow-up are needed.TRIAL
REGISTRATIONCRD42019112090.<br/>Copyright &#xa9; 2020 Lippincott Williams
and Wilkins. All rights reserved.

<6>
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Accession Number
632434613
Title
Effects of Different Doses of Remote Ischemic Preconditioning on Kidney
Damage among Patients Undergoing Cardiac Surgery: A Single-Center
Mechanistic Randomized Controlled Trial.
Source
Critical Care Medicine. 48 (8) (pp E690-E697), 2020. Date of Publication:
01 Aug 2020.
Author
Meersch M.; Kullmar M.; Pavenstadt H.; Rossaint J.; Kellum J.A.; Martens
S.; Klausmeyer P.; Schmidt E.A.; Kerschke L.; Zarbock A.
Institution
(Meersch, Kullmar, Rossaint, Klausmeyer, Schmidt, Zarbock) Department of
Anaesthesiology, Intensive Care Medicine and Pain Medicine, University
Hospital Munster, Munster, Germany
(Pavenstadt) Department of Medicine, Division D, Nephrology, University
Hospital Munster, Munster, Germany
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, PA, United States
(Martens) Department of Cardiac Surgery, University of Munster, Munster,
Germany
(Kerschke) Institute of Biostatistics and Clinical Research, University of
Munster, Munster, Germany
Publisher
Lippincott Williams and Wilkins (E-mail: customerservice@lww.com)
Abstract
Objectives: We have previously shown that remote ischemic preconditioning
reduces acute kidney injury (acute kidney injury) in high-risk patients
undergoing cardiopulmonary bypass and that the protective effect is
confined to patients who exhibit an increased urinary tissue inhibitor of
metalloproteinases-2 and insulin-like growth factor-binding protein 7 in
response to remote ischemic preconditioning. The purpose of this study was
to determine the optimal intensity of remote ischemic preconditioning to
induce required [tissue inhibitor of metalloproteinases-2]*[insulin-like
growth factor-binding protein 7] changes and further explore mechanisms of
remote ischemic preconditioning. <br/>Design(s): Observational and
randomized controlled, double-blind clinical trial. <br/>Setting(s):
University Hospital of Muenster, Germany. <br/>Patient(s): High-risk
patients undergoing cardiac surgery as defined by the Cleveland Clinic
Foundation Score. <br/>Intervention(s): In the interventional part,
patients were randomized to receive either one of four different remote
ischemic preconditioning doses (3 x 5 min, 3 x 7 min, 3 x 10 min remote
ischemic preconditioning, or 3 x 5 min remote ischemic preconditioning + 2
x 10 min remote ischemic preconditioning in nonresponders) or sham-remote
ischemic preconditioning (control). <br/>Measurements and Main Results:
The primary endpoint of the interventional part was change in urinary
[tissue inhibitor of metalloproteinases-2]*[insulin-like growth
factor-binding protein 7] between pre- A nd postintervention. To examine
secondary objectives including acute kidney injury incidence, we included
an observational cohort. A total of 180 patients were included in the
trial (n = 80 observational and n = 100 randomized controlled part [20
patients/group]). The mean age was 69.3 years (10.5 yr), 119 were men
(66.1%). Absolute changes in [tissue inhibitor of
metalloproteinases-2]*[insulin-like growth factor-binding protein 7] were
significantly higher in all remote ischemic preconditioning groups when
compared with controls (p < 0.01). Although we did not observe a
dose-response relationship on absolute changes in [tissue inhibitor of
metalloproteinases-2]*[insulin-like growth factor-binding protein 7]
across the four different remote ischemic preconditioning groups, in the
15 patients failing to respond to the lowest dose, nine (60%) responded to
a subsequent treatment at a higher intensity. Compared with controls,
fewer patients receiving remote ischemic preconditioning developed acute
kidney injury within 72 hours after surgery as defined by both Kidney
Disease: Improving Global Outcomes criteria (30/80 [37.5%] vs 61/100
[61.0%]; p = 0.003). <br/>Conclusion(s): All doses of remote ischemic
preconditioning significantly increased [tissue inhibitor of
metalloproteinases-2]*[insulin-like growth factor-binding protein 7] and
significantly decreased acute kidney injury compared with controls.
High-dose remote ischemic preconditioning could stimulate [tissue
inhibitor of metalloproteinases-2]*[insulin-like growth factor-binding
protein 7] increases in patients refractory to low-dose remote ischemic
preconditioning.<br/>Copyright &#xa9; 2020 by the Society of Critical Care
Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

<7>
Accession Number
2005480963
Title
Cardiovascular Outcomes Post Percutaneous Coronary Intervention in
Patients with Obstructive Sleep Apnea and Type 2 Diabetes Mellitus: A
Systematic Review and Meta-Analysis.
Source
Diabetes Therapy. 11 (8) (pp 1795-1806), 2020. Date of Publication: 01 Aug
2020.
Author
Wang H.; Li X.; Tang Z.; Gong G.
Institution
(Wang, Li, Gong) Department of Cardiology, The People's Hospital of
Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
(Tang) Department of Cardiovascular Disease, Xiangya Hospital, Central
South University, Changsha, Hunan, China
Publisher
Adis
Abstract
Introduction: Type 2 diabetes mellitus (T2DM) is a major risk factor for
the occurrence of cardiovascular diseases. Similar to T2DM, obstructive
sleep apnea (OSA) is also known to be a risk factor for cardiovascular
diseases. In this analysis, we aimed to systematically compare the
post-interventional cardiovascular outcomes observed in patients with T2DM
with versus without OSA. <br/>Method(s): Electronic databases were
searched for relevant publications comparing the cardiovascular outcomes
following percutaneous coronary intervention (PCI) in patients with T2DM
with OSA. Cardiovascular outcomes were considered as the relevant
endpoints. The RevMan software 5.3 was used to carry out the statistical
analysis. Odds ratios (OR) with 95% confidence intervals (CI) were used to
represent the results following data assessment. <br/>Result(s): A total
of 1168 participants with T2DM were included in this analysis, of whom 614
had co-existing OSA. The time period of patients' enrollment varied from
year 2002 to 2017. Our current analysis showed that major adverse cardiac
events (MACEs) (OR 2.28, 95% CI 1.24-4.18; P = 0.008) and all-cause
mortality (OR 1.95, 95% CI 1.08-3.54; P = 0.03) were significantly higher
in the OSA subgroup. However, major adverse cerebrovascular and
cardiovascular (MACCEs) (OR 1.38, 95% CI 0.97-1.98; P = 0.07) and cardiac
death (OR 1.79, 95% CI 0.77-4.16; P = 0.18) were not significantly
different post PCI. In addition, hospitalization for heart failure (OR
1.99, 95% CI 0.43-9.25; P = 0.38), re-infarction (OR 1.52, 95% CI
0.85-2.70; P = 0.16), stroke (OR 1.81, 95% CI 0.81-4.08; P = 0.15), target
vessel revascularization (TVR) (OR 1.54, 95% CI 0.98-2.42; P = 0.06), and
target lesion revascularization (TLR) (OR 1.32, 95% CI 0.80-2.18; P =
0.28) were also not significantly different post PCI in the patients with
T2DM with versus without OSA. <br/>Conclusion(s): OSA was associated with
a significant increase in all-cause mortality and MACEs post PCI in these
patients with T2DM. Therefore, special care and continuous follow-up might
be required for patients with T2DM with associated OSA after PCI. However,
as a result of the limited number of participants, further larger studies
would be required to confirm these hypotheses.<br/>Copyright &#xa9; 2020,
The Author(s).

<8>
Accession Number
2004813092
Title
GENES and in-stent restenosis: Review.
Source
International Journal of Research in Pharmaceutical Sciences. 11 (3) (pp
3993-3998), 2020. Date of Publication: 09 Jul 2020.
Author
Abdelaziz T.A.; Mohamed R.H.; Balata G.F.; El-Azzazy O.Y.
Institution
(Abdelaziz) Department of Cardiology, Faculty of Medicine, Zagazig
University, Egypt
(Mohamed) Department of Medical Biochemistry, Faculty of Medicine, Zagazig
University, Egypt
(Balata) Department of Pharmaceutics, Faculty of Pharmacy, Zagazig
University, Egypt
(El-Azzazy) Department of Pharmacy Practice, Faculty of Pharmacy, Zagazig
University, Egypt
Publisher
J. K. Welfare and Pharmascope Foundation (E-mail: info@pharmascope.org)
Abstract
The initiation of coronary stents is a vast landmark in the practice of
interventional cardiology. The vascular injury sustained during the
percutaneous coronary intervention (PCI) leads to a complicated
inflammatory and repairing process. Therefore, stent restenosis arises.
Diabetes mellitus is the highest-risk clinical predictor of ISR. Genetics
has an important role in the development of ISR. There is a suggested
association between the appearance of stent restenosis and certain genetic
polymorphisms. Examples of these single nucleotide polymorphisms are
endothelial nitric oxide synthase gene (eNOS), the angiotensin converting
enzyme gene (ACE), the angiotensin II type 1 receptor gene (AT1R),
TGF-beta, and VEGF. CYP2C19 variants can help change the medical strategy
to a more individualized therapeutic regimen either by altering the
therapeutic dose depending on the genotype or using an alternative drug
that does not worsen the patient's case. However, eNOS polymorphism
produces gene expression alteration leading to ISR following stent
placement. In addition, the deletion-allele of the ACE genotype increases
the risk of ISR; however, the I allele decreases the risk. Moreover, the
D/I polymorphism is not an independent factor of ISR in patients
administering ACE inhibitors or angiotensin receptor antagonists.
Furthermore, studies on large sample sizes are required to decrease the
harmful adverse effects of stent restenosis by detecting these allele gene
polymorphisms.<br/>Copyright &#xa9; 2020 <br/> All rights reserved.

<9>
Accession Number
631779902
Title
Systematic review and meta-analysis of valve-in-valve transcatheter aortic
valve replacement in patients with failed bioprosthetic aortic valves.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
16 (7) (pp 539-548), 2020. Date of Publication: 18 Sep 2020.
Author
Mahmoud A.N.; Gad M.M.; Elgendy I.Y.; Mahmoud A.A.; Taha Y.; Elgendy A.Y.;
Ahuja K.R.; Saad A.M.; Simonato M.; McCabe J.M.; Reisman M.; Kapadia S.R.;
Dvir D.
Institution
(Mahmoud) Division of Cardiology, University of Washington, Seattle, WA,
USA
Publisher
NLM (Medline)
Abstract
AIMS: The aim of this meta-analysis was to evaluate the evidence regarding
the rates of procedural success and the incidence of adverse outcomes
following valve-in-valve (VIV) transcatheter aortic valve replacement
(TAVR) in patients with failed bioprosthetic aortic valves. METHODS AND
RESULTS: A systematic search of major electronic databases was conducted
for studies relevant to patients with failed bioprosthetic aortic valves
undergoing VIV-TAVR. The primary outcome was procedural success. A total
of 5,553 patients from 24 studies were included. The mean Society of
Thoracic Surgeons (STS) score was 7.84+/-5.14. The procedural success rate
was high (97%, 95% confidence interval [CI]: 94-98%). At 30 days,
all-cause mortality was 5% (95% CI: 3-6%), stroke 2% (95% CI: 1-2%),
myocardial infarction 1% (95% CI: 1-2%), permanent pacemaker placement 6%
(95% CI: 5-8%), and aortic regurgitation 7% (95% CI: 5-10%). At one year,
the incidence of all-cause mortality was 12% (95% CI: 10-14%), stroke 3%
(95% CI: 2-4%), myocardial infarction 1% (95% CI: 0-2%), and permanent
pacemaker placement 7% (95% CI: 5-11%). At three years, the incidence of
all-cause mortality was 29% (95% CI: 25-34%) and stroke 6% (95% CI: 5-9%).
<br/>CONCLUSION(S): VIV-TAVR appears to be associated with high procedural
success rates and low adverse outcomes during the short-term and midterm
follow-up period.

<10>
Accession Number
2007675853
Title
An evidence-based review of neuromodulation for the treatment and
management of refractory angina.
Source
Best Practice and Research: Clinical Anaesthesiology. 34 (3) (pp 517-528),
2020. Date of Publication: September 2020.
Author
Urits I.; Patel A.; Leider J.; Anya A.; Franscioni H.; Jung J.W.; Kassem
H.; Kaye A.D.; Viswanath O.
Institution
(Urits) Beth Israel Deaconess Medical Center, Department of Anesthesia,
Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA,
United States
(Patel, Leider, Anya, Franscioni, Jung) Georgetown University School of
Medicine, Washington, DC, United States
(Kassem) Mount Sinai Medical Center, Department of Anesthesiology, Miami
Beach, FL, United States
(Kaye, Viswanath) Louisiana State University Health Shreveport, Department
of Anesthesiology, Shreveport, LA, United States
(Viswanath) Valley Pain Consultants - Envision Physician Services,
Phoenix, AZ, United States
(Viswanath) Creighton University School of Medicine, Department of
Anesthesiology, Omaha, NE, United States
(Viswanath) University of Arizona College of Medicine-Phoenix, Department
of Anesthesiology, Phoenix, AZ, United States
Publisher
Bailliere Tindall Ltd
Abstract
Angina pectoris is defined as substernal chest pain that is typically
exacerbated by exertion, stress, or other exposures. There are various
methods of treatment for angina. Lifestyle modification and
pharmacological management are considered as conservative treatments. If
these medications do not result in the resolution of pain, more invasive
approaches are an option, like coronary revascularization. Refractory
angina (RA) is differentiated from acute or chronic angina based on the
persistence of symptoms despite conventional therapies. Overall, the
prevalence of RA is estimated to be 5%-15% in patients with coronary
artery disease, which can account for up to 1,500,000 current cases and
100,000 new cases in the United States per year. Spinal cord stimulation
treatment is a viable option for patients who are suffering from RA pain
and are either not candidates for revascularization surgery or are
currently not being well managed on more traditional treatments. Many
studies show a positive result.<br/>Copyright &#xa9; 2020

<11>
Accession Number
2007031160
Title
Efficacy of Ultrasound-Guided Transversus Thoracic Muscle Plane Block on
Postoperative Opioid Consumption After Cardiac Surgery: A Prospective,
Randomized, Double-Blind Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (11) (pp 2996-3003),
2020. Date of Publication: November 2020.
Author
Aydin M.E.; Ahiskalioglu A.; Ates I.; Tor I.H.; Borulu F.; Erguney O.D.;
Celik M.; Dogan N.
Institution
(Aydin, Ahiskalioglu, Ates, Erguney, Celik, Dogan) Department of
Anesthesiology and Reanimation, Ataturk University School of Medicine,
Erzurum, Turkey
(Aydin, Ahiskalioglu, Celik) Clinical Research, Development and Design
Application and Research Center, Ataturk University School of Medicine,
Erzurum, Turkey
(Tor) Department of Anesthesiology and Reanimation, University of Health
Sciences School of Medicine, Erzurum, Turkey
(Borulu) Department of Cardiovascular Surgery, Ataturk University School
of Medicine, Erzurum, Turkey
Publisher
W.B. Saunders
Abstract
Objectives: The postoperative analgesic efficacy of transversus thoracic
muscle plane block (TTMPB) has not yet been evaluated sufficiently. This
randomized controlled study evaluated the effect of TTMPB on postoperative
opioid consumption in patients undergoing cardiac surgery. <br/>Design(s):
Prospective, randomized, double-blind study. <br/>Setting(s): Single
institution, academic university hospital. <br/>Participant(s):
Forty-eight adult patients having cardiac surgery with median sternotomy.
<br/>Intervention(s): Patients were randomly assigned to receive
preoperative ultrasound-guided TTMPB with either 20 mL of 0.25%
bupivacaine or saline bilaterally. Postoperative analgesia was
administered intravenously in the 2 groups 4 times a day with 1000 mg of
paracetamol and patient-controlled analgesia with fentanyl.
<br/>Measurements and Main Results: The primary outcome was opioid
consumption in the first 24 hours. Secondary outcomes included
postoperative pain scores, first analgesic requirement time, rescue
analgesia, intensive care discharge time, and side effects. Compared with
the control group (median 465 micro&#32;g, interquartile range 415-585),
the transversus thoracic muscle plane (TTMP) group (median 255
micro&#32;g, interquartile range 235-305) had reduced postoperative
24-hour opioid consumption (p < 0.001). Pain scores were significantly
lower in the TTMP group compared with the control group up to 12 hours
after surgery both at rest and active movement (p < 0.001). Compared with
the TTMP group, the proportion of postoperative nausea and pruritus was
statistically higher in the control group (p < 0.001). <br/>Conclusion(s):
A single preoperative TTMPB provided effective analgesia and decreased
opioid requirements in patients undergoing cardiac surgery.<br/>Copyright
&#xa9; 2020 Elsevier Inc.

<12>
Accession Number
2005737728
Title
Clinical burden associated with postsurgical complications in major
cardiac surgeries in Asia-Oceania countries: A systematic review and
meta-analysis.
Source
Journal of Cardiac Surgery. 35 (10) (pp 2618-2626), 2020. Date of
Publication: 01 Oct 2020.
Author
Dhippayom T.; Dilokthornsakul P.; Laophokhin V.; Kitikannakorn N.;
Chaiyakunapruk N.
Institution
(Dhippayom) Faculty of Pharmaceutical Sciences, Naresuan University,
Phitsanulok, Thailand
(Dilokthornsakul) Department of Pharmacy Practice, Center of
Pharmaceutical Outcomes Research (CPOR), Faculty of Pharmaceutical
Sciences, Naresuan University, Phitsanulok, Thailand
(Laophokhin, Kitikannakorn) Department of Pharmaceutical Care, Centor for
Community of Drug System Research and Development (CDR), Faculty of
Pharmacy, Chiang Mai University, Chiang Mai, Thailand
(Chaiyakunapruk) Department of Pharmacotherapy, College of Pharmacy,
University of Utah, Salt Lake City, UT, United States
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: Evidence on the burden of postsurgical complications is mainly
from studies in western countries, and little is highlighted in the
Asia-Oceania region. This study aimed to identify and compare the burden
of postsurgical complications in major cardiac surgeries in Asia-Oceania
countries. <br/>Method(s): A systematic search was performed in PubMed,
Embase, and CENTRAL between January 2000 and July 2018. Inclusion criteria
were: (a) observational studies or randomized control trials; (b) studied
in coronary artery bypass graft (CABG) and/or heart valve procedures; (c)
measured postsurgical clinical outcomes; and (d) conducted in Asia-Oceania
countries. Pooled effects were calculated using a random-effects model.
<br/>Result(s): Of the 6032 articles screened, 472 studies with a total of
614 161 patients met the inclusion criteria. The pooled incidences (95%
confidence interval) of hospital mortality and 30-day mortality were
similar at 2.38% (2.16%-2.59%) and 2.33% (2.16%-2.50%), respectively.
Length of stay (LOS) was 14.07 days (13.44-14.71 days). The incidence for
atrial fibrillation (AF) and stroke/cerebrovascular accident (CVA) was
17.49% (15.99%-18.99%) and 1.64% (1.51%-1.78%), respectively. Below
outcomes tended to be better in studies on CABG compared to heart valve
procedures, including the incidence of hospital mortality
(1.97%[1.75%-2.18%] vs 3.97% [3.29%-4.65%]), AF (16.47% [14.85%-18.10%] vs
21.98% [17.41%-26.54%]), stoke/CVA (1.51% [1n 37%-1.65%] vs 2.55%
[2.07%-3.04%]), and mean LOS (days) (13.08 [12.51-13.65] vs 19.58
[16.72-22.45]). Similarly, all postsurgical complications tended to be
higher in studies involving high-risk patients vs non-high-risk patients.
<br/>Conclusion(s): There are opportunities to improve clinical outcomes
of patients with high surgical risks and those undertaking heart valve
procedures, as they tend to have poorer survival and higher risk in
developing postsurgical complications.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC

<13>
Accession Number
2005737713
Title
Local prolonged release of antibiotic for prevention of sternal wound
infections postcardiac surgery-A novel technology.
Source
Journal of Cardiac Surgery. 35 (10) (pp 2695-2703), 2020. Date of
Publication: 01 Oct 2020.
Author
Kachel E.; Moshkovitz Y.; Sternik L.; Sahar G.; Grosman-Rimon L.;
Belotserkovsky O.; Reichart M.; Stark Y.; Emanuel N.
Institution
(Kachel, Grosman-Rimon) Department of Cardiac Surgery, Poriya Medical
Center, Tiberias, Israel
(Kachel, Sternik) Department of Cardiac Surgery, Sheba Medical Centre, Tel
Hashomer, Israel
(Moshkovitz) Department of Cardiothoracic Surgery, Assuta Medical Center,
Tel Aviv, Israel
(Sahar) Department of Cardiothoracic Surgery, Soroka Medical Center, Beer
Sheva, Israel
(Belotserkovsky, Reichart, Stark, Emanuel) PolyPid Ltd, Petach-Tikva,
Israel
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Introduction: Sternal wound infection (SWI) is a devastating postcardiac
surgical complication. D-PLEX<inf>100</inf> (D-PLEX) is a localized
prolonged release compound applied as a prophylactic at the completion of
surgery to prevent SWI. The D-PLEX technology platform is built as a
matrix of alternating layers of polymers and lipids, entrapping an
antibiotic (doxycycline). The objective of this study was to assess the
safety profile and pharmacokinetics of D-PLEX in reducing SWI rates
postcardiac surgery. <br/>Method(s): Eighty-one patients were enrolled in
a prospective single-blind randomized controlled multicenter study. Sixty
patients were treated with both D-PLEX and standard of care (SOC) and 21
with SOC alone. Both groups were followed 6 months for safety endpoints.
SWI was assessed at 90 days. <br/>Result(s): No SWI-related serious
adverse events (SAEs) occurred in either group. The mean plasma
C<inf>max</inf> in patients treated with D-PLEX was about 10 times lower
than the value detected following the oral administration of doxycycline
hyclate with an equivalent overall dose, and followed by a very low plasma
concentration over the next 30 days. There were no sternal infections in
the D-PLEX group (0/60) while there was one patient with a sternal
infection in the control group (1/21, 4.8%). <br/>Conclusion(s): D-PLEX
was found to be safe for use in cardiac surgery patients. By providing
localized prophylactic prolonged release of broad-spectrum antibiotics,
D-PLEX has the potential to prevent SWI postcardiac surgery and long-term
postoperative hospitalization, reducing high-treatment costs, morbidity,
and mortality.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<14>
Accession Number
2005688347
Title
Sex-related differences in outcomes after coronary artery bypass surgery-A
patient-level pooled analysis of randomized controlled trials: rationale
and study protocol.
Source
Journal of Cardiac Surgery. 35 (10) (pp 2754-2758), 2020. Date of
Publication: 01 Oct 2020.
Author
Gaudino M.; Alexander J.H.; Egorova N.; Kurlansky P.; Lamy A.; Bakaeen F.;
Hameed I.; Di Franco A.; Demetres M.; Robinson N.B.; Chikwe J.; Lawton
J.S.; Devereaux P.J.; Taggart D.P.; Flather M.; Reents W.; Boening A.;
Diegeler A.; Girardi L.N.; Fremes S.E.; Benedetto U.
Institution
(Gaudino, Hameed, Di Franco, Robinson, Girardi) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Alexander) Department of Medicine, Duke Clinical Research Institute, Duke
University Medical Center, Durham, NC, United States
(Egorova) Department of Population Health Science and Policy, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Kurlansky) Department of Surgery, Center for Innovation and Outcomes
Research, Columbia University Medical Center, New York, NY, United States
(Lamy, Devereaux) Department of Surgery, Population Health Research
Institute, McMaster University, Hamilton, ON, Canada
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Chikwe) Department of Cardiac Surgery in the Smidt Heart Institute at
Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Lawton) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University School of Medicine, Baltimore, MD, United States
(Taggart) Nuffield Department of Surgical Sciences, John Radcliffe
Hospital, University of Oxford, Oxford, United Kingdom
(Flather) Research and Development Unit, Norfolk and Norwich University
Hospitals NHS Foundation Trust, Norwich, United Kingdom
(Reents, Diegeler) Department Cardiac Surgery, Cardiovascular Center Bad
Neustadt/Saale, Bad Neustadt, Saale, Germany
(Boening) Department of Cardiovascular Surgery, Justus-Liebig University
Giesen, Giesen, Germany
(Fremes) Department of Surgery, Schulich Heart Centre Sunnybrook Health
Sciences Centre, University of Toronto, Toronto, Canada
(Benedetto) Bristol Heart Institute, University of Bristol, Bristol,
United Kingdom
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Introduction: The impact of sex on the outcomes after coronary artery
bypass grafting (CABG) is controversial. The majority of CABG studies are
retrospectively collected clinical or registry data, women comprise only a
minority, and the reported findings represent the male predominated
cohort. This individual patient meta-analysis is aimed at evaluating
sex-related differences in outcomes after CABG using high quality data
from randomized controlled trials (RCTs). Methods and Analysis: A
systematic literature search will be performed to identify all CABG RCTs
(minimum follow-up: 5 years). Detailed specification for the minimum
deidentified patient records' data requirements will be provided to RCT
primary contact to request their deidentified data for pooling. The pooled
analysis will follow the prospective register of systematic reviews
(PROSPERO) and the preferred reporting items for systematic reviews and
meta-analyses for individual patient data systematic reviews (PRISMA-IPD)
recommendations and will compare sex-related outcomes after CABG. The main
hypothesis is that outcomes after CABG are worse in women than in men. We
will also test whether treatment effects for off-pump and the use of
multiple arterial grafts are present within each sex, and also, whether
there are differential treatment effects between sexes. The primary
endpoint will be a composite of all-cause mortality, myocardial
infarction, stroke, and repeat revascularization at long-term follow up.
Ethics and Dissemination: Ethics approval and participant consent for the
study will be obtained locally by each study team if needed. Data will be
disseminated and submitted to peer-reviewed scientific journals and
meetings irrespective of study outcome.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC

<15>
Accession Number
2005677011
Title
Prednisone and azathioprine in patients with inflammatory cardiomyopathy:
systematic review and meta-analysis.
Source
ESC Heart Failure. 7 (5) (pp 2278-2296), 2020. Date of Publication: 01 Oct
2020.
Author
Timmermans P.; Barradas-Pires A.; Ali O.; Henkens M.; Heymans S.; Negishi
K.
Institution
(Timmermans) Department of Cardiology, Jessa Hospital, Hasselt, Belgium
(Timmermans) University Hospital Gasthuisberg, Leuven, Belgium
(Barradas-Pires) Royal Brompton and Harefield NHS Foundation Trust,
London, United Kingdom
(Ali) Detroit Medical Center, Department of Cardiology, Wayne State
University School of Medicine, United States
(Henkens, Heymans) Department of Cardiology, CARIM School for
Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences,
Maastricht University, Maastricht, Netherlands
(Heymans) Department of Cardiovascular Sciences, Centre for Molecular and
Vascular Biology, Catholic University of Leuven, Leuven, Belgium
(Negishi) Menzies Institute for Medical Research, University of Tasmania,
Hobart, Australia
(Negishi) Nepean Clinical School, The University of Sydney, Kingswood,
Sydney, Australia
Publisher
Wiley-Blackwell (E-mail: info@wiley.com)
Abstract
Aims Chronic non-viral myocarditis, also called inflammatory
cardiomyopathy, can be treated with immune suppression on tops of optimal
medical therapy (OMT) for heart failure, using a combination of
prednisolone and azathioprine (IPA). However, there has been inconsistency
in the effects of immunosuppression treatment. This meta-analysis is the
first to evaluate all available data of the effect of this treatment on
left ventricular ejection fraction (LVEF) and the combined clinical
endpoint of cardiovascular mortality and/or heart transplantation-free
survival. Methods and results All trials with using IPA vs. OMT in this
syndrome were searched using OVID Medline and ClinicalTrials. gov,
following the PRISMA guidelines. Missing data were retrieved after
contacting the corresponding authors. All data was reviewed and analysed
using and standard meta-analysis methods. A random effect model was used
to pool the effect sizes. A total of four trials (three randomised
controlled trials and one propensity-matched retrospective registry)
including 369 patients were identified. IPA on top of OMT did not improve
LVEF [mean difference 9.9% (95% confidence interval -1.8, 21.7)] with
significant heterogeneity. When we limited our pooled estimate to the
published studies only, significant LVEF improvement by IPA was observed
[14% (1.4, 26.6)]. No cardiovascular mortality benefit was observed with
the intervention [risk ratio 0.34 (0.08, 1.51)]. Conclusions At the
moment, there is insufficient evidence supporting functional and
prognostic benefits of IPA added to OMT in virus negative inflammatory
positive cardiomyopathy. Further adequate-powered well-designed
prospective RCTs should be warranted to explore the potential effects of
adding immunosuppressive therapy to OMT.<br/>Copyright &#xa9; 2020 The
Heart Failure Association of the European Society of Cardiology / John
Wiley & Sons Ltd

<16>
Accession Number
632977441
Title
SABM 2020 Annual Meeting Abstracts.
Source
Anesthesia and Analgesia. Conference: 2020 Annual Meeting of the Society
for the Advancement of Blood Management, SABM 2020. United States. 131 (3
Supplement 1) (no pagination), 2020. Date of Publication: 2020.
Author
Anonymous
Publisher
Lippincott Williams and Wilkins
Abstract
The proceedings contain 29 papers. The topics discussed include:
identifying the rate of preoperative and postoperative anemia in patients
undergoing planned cesarean section at a tertiary care center; impact of
blood transfusion during cardiopulmonary bypass on clinical outcomes;
severe hypophosphatemia in patients with cancer following iv iron
treatment: results from a large randomized controlled trial; analysis of
blood conservation impacts on clinical outcome in ascending aortic
replacement (AAR) surgeries with deep hypothermic circulatory arrest
(DHCA); autotransfusion during postpartum hemorrhage following vaginal
delivery; cell saver blood infusion up to 24 hours post collection in
pediatric cardiac surgical patients does not increase incidence of
hospital acquired infections or mortality; and novel blood separation
device enables production of platelet-rich red blood cells and
convalescent plasma.

<17>
Accession Number
632977916
Title
Postoperative atrial fibrillation and long-term risk of stroke and death
following cardiac surgery: A systematic review and metaanalysis.
Source
BMC Proceedings. Conference: 9th International Conference for Healthcare
and Medical Students, ICHAMS 2020. Ireland. 14 (Supplement 3) (no
pagination), 2020. Date of Publication: 2020.
Author
Ali M.Z.; Chen P.; Meyre P.; Wang M.K.; McIntyre W.; Healey J.; Whitlock
R.; Lamy A.; Devereaux P.J.; Conen D.
Institution
(Ali) School of Medicine, Royal College of Surgeons in Ireland, Dublin,
Ireland
(Chen) University of British Columbia, Vancouver, Canada
(Meyre) Department of Cardiology and Cardiovascular Research Institute
Basel, University Hospital Basel, University of Basel, Basel, Switzerland
(Wang, McIntyre, Healey, Whitlock, Lamy, Devereaux, Conen) Department of
Medicine, McMaster University, Hamilton, Canada
(McIntyre, Healey, Lamy, Devereaux, Conen) Population Health Research
Institute, McMaster University, Hamilton, Canada
(Whitlock) Department of Surgery, McMaster University, Hamilton, Canada
Publisher
BioMed Central Ltd
Abstract
Introduction Postoperative atrial fibrillation (POAF) is a frequent
complication after cardiac surgery. Studies so far have shown variability
in terms of whether POAF is associated with higher risks of stroke or
death. To gain additional insights into this important issue, we performed
a systematic review and meta-analysis to investigate the long and
short-term risks of stroke and death in patients with POAF after cardiac
surgery. Methods We searched PubMed for studies that investigated the
association of stroke and death in patients with POAF after cardiac
surgery. Studies were included if they reported short (<30 days after
cardiac surgery) and long-term risks (>30 days after cardiac surgery) of
stroke or death, and had enrolled >=100 patients. Data were independently
abstracted by 2 reviewers and pooled using inverse variance random-effects
models. The primary outcome was stroke occurring >30 days after cardiac
surgery, and the secondary outcome was all-cause death occurring >30 days
after surgery. We presented data as risk ratios (RR). Results Of the 7131
citations screened, a total of 43 studies met the eligibility criteria.
Among the 332,577 participants, 69,205 developed POAF (20.8%). During a
mean follow-up of 22 months, patients with POAF had a significantly higher
long-term risk of stroke compared to those without POAF (RR, 1.46; 95%
confidence interval [CI], 1.29-1.66, I2= 71%). The risk of stroke was also
increased in the first 30 days after surgery (RR for <30 days, 2.63; 95%
CI, 2.05-3.38, I2=77%). Patients with POAF had an increased long-term risk
of death (RR, 1.67; 95% CI, 1.41-1.99, I2=90%). There was a trend for
increased risk of death during the first 30 days after surgery among
patients with POAF (RR for <30 days, 1.73; 95% CI, 0.99-3.02, I2=97%).
Discussion Patients with POAF after cardiac surgery have an increased
long-term risk of stroke and death.

<18>
Accession Number
2007958536
Title
Perioperative intravenous S-ketamine for acute postoperative pain in
adults: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 68 (no pagination), 2021. Article Number:
110071. Date of Publication: February 2021.
Author
Wang X.; Lin C.; Lan L.; Liu J.
Institution
(Wang, Lin, Lan, Liu) Department of Anesthesiology, the First Affiliated
Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
Publisher
Elsevier Inc. (E-mail: sinfo-f@elsevier.com)
Abstract
Study objective: To evaluate the effectiveness and safety of S-ketamine
for pain relief and analgesic consumption in surgical patients.
<br/>Design(s): Systematic review and meta-analysis of randomized
controlled trials (RCTs). <br/>Setting(s): Perioperative setting.
<br/>Patient(s): A total of 905 adult patients undergoing surgery using
general anesthesia: 504 patients in the S-ketamine group and 401 patients
in the placebo group. <br/>Intervention(s): Intravenous S-ketamine as an
adjuvant to general anesthesia compared with placebo. Measurements: The
primary outcomes were resting and movement pain scores (VAS/NRS 0-10) and
morphine consumption within 4, 12, 24 and 48 h after surgery. The
secondary outcomes included postoperative complications such as nausea,
vomiting, and psychotomimetic adverse events. We used the guidelines of
the Recommendation Assessment, Development, and Evaluation (GRADE) system
to evaluate the level of certainty for the main results. <br/>Main
Result(s): A total of 12 studies were included. The types of surgery
included abdominal surgery, thoracotomy, gynecologic surgery, arthroscopic
anterior cruciate ligament repair, cardiac surgery, laparoscopic
cholecystectomy, lumbar spinal fusion surgery, radical prostatectomy, and
hemorrhoidectomy. There were significant improvements in resting pain
scores at 4, 12 and 24 h with S-ketamine versus placebo [4 h: standardized
mean difference (SMD) -1.11; 95% confidence interval (CI): -1.53, -0.68, p
< 0.00001; GRADE = moderate; 12 h: SMD -0.88; 95%CI: -1.42, -0.34, p =
0.001; GRADE = moderate; 24 h: SMD -0.39; 95%CI: -0.73, -0.06, p = 0.02;
GRADE = moderate]. The incidence of pain scores at 48 h showed no
statistical difference between the two groups (SMD -0.27; 95%CI: -1.12,
0.58, p = 0.53, GRADE = moderate). The movement pain scores were not
significantly different between the two groups at each time point (4 h:
SMD -0.34; 95%CI: -0.73, 0.05, p = 0.09, GRADE = moderate; 12 h: SMD
-0.42; 95%CI: -1.46, 0.63, p = 0.44, GRADE = low; 24 h: SMD -0.58; 95%CI:
-1.25, 0.09, p = 0.09, GRADE = moderate; 48 h: SMD -0.49; 95%CI: -1.11,
0.14, p = 0.13, GRADE = low). At 4 and 12 h after surgery, the consumption
of morphine was significantly reduced in the S-ketamine group (4 h: SMD
-0.98; 95%CI: -1.37, -0.06, p < 0.00001, GRADE = moderate; 12 h: SMD
-1.36; 95%CI: -2.26, -0.46, p = 0.003, GRADE = low). There were no
significant differences in morphine use at 24 and 48 h between the two
groups (24 h: SMD -0.70; 95%CI: -1.42, 0.02, p = 0.06, GRADE = low; 48 h:
SMD -0.79; 95%CI: -2.26, 1.03, p = 0.39, GRADE = low). The risk for nausea
[relative risk (RR) = 1.04; 95%CI: 0.83, 1.30, p = 0.73], vomiting (RR =
1.07; 95%CI: 0.84, 1.38, p = 0.57), and psychotomimetic adverse events (RR
= 1.57; 95%CI: 0.82, 2.99, p = 0.17) showed no significant increase in the
S-ketamine group. <br/>Conclusion(s): Intravenous S-ketamine as an adjunct
to general anesthesia is effective for assisting analgesia and decreases
the intensity of pain and opioid requirements in a short period of time
after surgery, but it may increase the psychotomimetic adverse event rate.
Overall, the level of certainty is moderate to low.<br/>Copyright &#xa9;
2020 Elsevier Inc.

<19>
Accession Number
2007957209
Title
Is preoperative balloon aortic valvuloplasty of interest for severe aortic
stenosis in hip fracture surgery?.
Source
Injury. (no pagination), 2020. Date of Publication: 2020.
Author
Ferre F.; Viarnes M.; Martin C.; Bosch L.; Bouisset F.; Lhermusier T.;
Reina N.; Lairez O.; Minville V.
Institution
(Ferre, Viarnes, Martin, Bosch, Minville) Centre Hospitalier Universitaire
de Toulouse Purpan, Place du Dr Baylac, TSA 40 031, Toulouse 31059, France
(Bouisset, Lhermusier, Lairez) Cardiologie, Pole cardiovasculaire et
metabolique, CHU Rangueil, Toulouse, France
(Reina) Departement de chirurgie Orthopedique et Traumatologique, Hopital
Pierre-Paul Riquet, CHU Purpan, Toulouse, France
Publisher
Elsevier Ltd
Abstract
Purpose: In elderly patients, the discovery and management of a severe
aortic stenosis (AS) prior to emergency non-cardiac surgery is a frequent
and controversial issue. The objective of this study was to evaluate
preoperative balloon aortic valvuloplasty (BAV) for severe AS in hip
fracture surgery. <br/>Method(s): We conducted an observational,
monocentric, retrospective study from 2011 to 2018. Survival (30-day,
90-day and 180-day mortality) and the occurrence of perioperative
complications were analyzed and compared between control (i.e. no BAV
prior to surgery) and preoperative BAV groups in patients with hip
fracture surgery and a formal transthoracic echocardiographic diagnosis of
severe AS (aortic valve area < 1 cm2). Patients' allocation to the
intervention and control groups was after a discussion between
cardiologist, anesthesiologist and the surgeon. <br/>Result(s): Among the
8506 patients who underwent hip fracture surgery, 29 patients in the
control group and 30 patients in the BAV group were finally included.
Kaplan-Meier survival analysis demonstrated a significant decrease in
mortality in the BAV group (p=0.014) despite an increase in median time to
operation of about 48 hours (p<0.0001). Multivariate analysis (stepwise
logistic regression) showed that postoperative delirium (OR [95%CI]: 17.5
[1.8-168]; p=0.013) and postoperative acute congestive heart failure (OR
[95%CI]: 59.4 [5.0-711.1]; p=0.0013) were predictive factors of 30-day
mortality with an area under ROC curve of 0.90 (95%CI: 0.80-0.97;
p<0.0001). <br/>Conclusion(s): preoperative BAV for severe AS could reduce
the mortality of hip fracture patients despite an increase in time to
operation. This improved survival could be linked to the decrease in
cardiologic and neurologic adverse events. A larger prospective randomized
study is necessary before generalizing our results.<br/>Copyright &#xa9;
2020

<20>
Accession Number
2007950068
Title
Meta-Analysis of Complete versus Culprit-Only Revascularization in
Patients with ST-Segment Elevation Myocardial Infarction and Multivessel
Coronary Disease.
Source
American Journal of Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Levett J.Y.; Windle S.B.; Filion K.B.; Cabaussel J.; Eisenberg M.J.
Institution
(Levett, Windle, Filion, Cabaussel, Eisenberg) Center of Clinical
Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill
University, Montreal, QC, Canada
(Levett, Filion, Eisenberg) Faculty of Medicine, McGill University,
Montreal, QC, Canada
(Filion, Eisenberg) Department of Epidemiology, Biostatistics and
Occupational Health, McGill University, Montreal, QC, Canada
(Filion) Department of Medicine, McGill University, Montreal, QC, Canada
(Eisenberg) Division of Cardiology, Jewish General Hospital/McGill
University, Montreal, QC, Canada
Publisher
Elsevier Inc. (E-mail: sinfo-f@elsevier.com)
Abstract
Approximately half of patients with ST-segment elevation myocardial
infarction (STEMI) present with noninfarct related multivessel coronary
artery disease (CAD) during primary percutaneous coronary intervention
(PCI). However, questions remain concerning whether patients with STEMI
and multivessel CAD should routinely undergo complete revascularization.
Our objective was to compare the risks of major cardiovascular outcomes
and procedural complications in patients with STEMI and multivessel CAD
randomized to complete revascularization versus culprit-only PCI. We
conducted a systematic review and meta-analysis of randomized controlled
trials (RCTs) comparing complete revascularization to culprit-only PCI.
RCTs were identified via a systematic search of MEDLINE, Embase, and
Cochrane CENTRAL. Count data were pooled using DerSimonian and Laird
random-effects models with inverse variance weighting to obtain relative
risks (RRs) and 95% confidence intervals (CIs). A total of 9 RCTs (n =
6,751) were included, with mean/median follow-up times ranging from 6 to
36 months. Compared with culprit-only PCI, complete revascularization was
associated with a substantial reduction in major adverse cardiovascular
events (13.1% vs 22.1%; RR: 0.54; 95%CI: 0.43 to 0.66), repeat myocardial
infarction (4.9% vs 6.8%; RR: 0.64; 95%CI: 0.48 to 0.84), and repeat
revascularization (3.7% vs 12.3%; RR: 0.33; 95%CI: 0.25 to 0.44). Complete
revascularization may have beneficial effects on all-cause and
cardiovascular mortality, but 95%CIs were wide. Findings for stroke, major
bleeding, and contrast-induced acute kidney injury were inconclusive. In
conclusion, complete coronary artery revascularization appears to confer
benefit over culprit-only PCI in patients with STEMI and multivessel CAD,
and should be considered a first-line strategy in these
patients.<br/>Copyright &#xa9; 2020 The Author(s)

<21>
Accession Number
2006821220
Title
Acute aortic dissection during pregnancy: Trials and tribulations.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Rimmer L.; Heyward-Chaplin J.; South M.; Gouda M.; Bashir M.
Institution
(Rimmer, Heyward-Chaplin, South, Bashir) Vascular Surgery Department,
Blackburn Hospital, East Lancashire Hospitals NHS Trust, Blackburn, United
Kingdom
(Gouda) Department of Vascular and Endovascular Surgery, Mataria Teaching
Hospital, Cairo, Egypt
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: Type A acute aortic dissection (TAAD) during pregnancy is a
life-threatening event for both the mother and the unborn baby. Pregnancy
has been recognized as an independent risk factor for TAAD, postulated to
be due to physiological changes that cause hyperdynamic circulation. This
review seeks to outline the current controversies around this unique
group. <br/>Method(s): A comprehensive literature search was carried out
across large databases to assimilate relevant papers regarding acute
aortic dissection in pregnant women. <br/>Result(s): The presentation can
be atypical in many cases and further concern from clinicians of fetal
radiation exposure can result in missed or delayed diagnoses.
Investigation via the quickest form of imaging, whether computed
tomography, magnetic resonance imaging, or transesophageal
echocardiography, should be carried out promptly due to the high risk of
mortality. Surgical management of TAAD in pregnancy revolves primarily
around the decision to deliver the fetus concomitantly or to perform the
aortic repair with the fetus in utero. <br/>Conclusion(s): Management of
this group includes rapid and dynamic assessment without delay. From
conception to postpartum, there are multiple stages in which to manage
these women. Challenges in carrying out management in the form of
operative techniques and cardiopulmonary bypass place the fetus at risk
and must be approached with caution, particularly as there is little
evidence-base for many of these decisions. Further research into reducing
maternal and fetal mortality is necessary.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC

<22>
Accession Number
632989087
Title
Global longitudinal strain predicts survival and left ventricular function
after mitral valve surgery. A meta-analysis.
Source
Seminars in thoracic and cardiovascular surgery. (no pagination), 2020.
Date of Publication: 21 Sep 2020.
Author
Canessa M.; Thamman R.; Americo C.; Soca G.; Dayan V.
Institution
(Canessa, Americo, Soca) National Institute of Cardiac Surgery,
Montevideo, Uruguay
(Thamman) School of Medicine. University of Pittsburgh, Pittsburgh, United
States
(Dayan) National Institute of Cardiac Surgery, Montevideo, Uruguay; Centro
Cardiovascular Universitario, Montevideo, Uruguay
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The timing for surgical treatment in patients with primary
organic severe mitral valve regurgitation (MR) and preserved left
ventricular ejection fraction (LVEF) systolic is a challenge since it
depends upon LV end systolic dimension (LVESD) and LVEF which may be late
markers of LV dysfunction. Echocardiography is the most important tool in
the diagnosis of mechanisms, etiology, severity and hemodynamic
consequences of mitral regurgitation. The global longitudinal strain
(GLS), a new and sensitive method for the detection of LV dysfunction,
might be a useful method for the evaluation of preclinical systolic
dysfunction. Nevertheless, its role for predicting postoperative outcomes
is not well established. <br/>METHOD(S): A meta-analysis was performed to
address the role of GLS in patients with severe mitral regurgitation and
preserved LVEF who underwent mitral surgery. We included studies that
compared outcomes according to preoperative GLS in regard to survival and
postoperative LV function. <br/>RESULT(S): We included 2358 patients
enrolled in 8 studies. Patients with reduced GLS% had worse long term
survival after mitral valve surgery (HR=1.13, 95%CI: 1.02-1.26). Patients
with preoperatively reduced GLS% had lower LVEF after surgery (MD= -5.06%,
95%CI: -8.97%-1.16%) and additionally, patients who presented
postoperative LVEF dysfunction had worse preoperative GLS (MD=4.33, 95%CI:
3.89-4.76). <br/>CONCLUSION(S): In patients with primary mitral
regurgitation, preoperative GLS is a predictor for long term survival and
postoperative LVEF. It is a useful parameter to be included when
considering early surgery in patients with severe mitral regurgitation and
normal LVEF.<br/>Copyright &#xa9; 2020. Published by Elsevier Inc.

<23>
Accession Number
632988737
Title
Skeletonized or Pedicled harvesting of left internal mammary artery: a
systematic review and meta-analysis.
Source
Seminars in thoracic and cardiovascular surgery. (no pagination), 2020.
Date of Publication: 23 Sep 2020.
Author
Kusu-Orkar T.-E.; Kermali M.; Masharani K.; Noshirwani A.; MacCarthy-Ofosu
B.; Oguamanam N.; BinSaeid J.; Muir A.D.; Harky A.
Institution
(Kusu-Orkar) Department of Surgery, Pilgrim Hospital, Boston, United
Kingdom
(Kermali) Faculty of Medicine, University of London, St. George's, London,
United Kingdom
(Masharani, Noshirwani, MacCarthy-Ofosu, BinSaeid, Muir, Harky) Department
of cardiothoracic surgery, Liverpool Heart and Chest Hospital, Liverpool,
United Kingdom
(Oguamanam) Department of cardiothoracic surgery, Barts Heart Centre, St.
Bartholomew's Hospital, London, United Kingdom
Publisher
NLM (Medline)
Abstract
We sought to compare clinical outcomes in skeletonized versus pedicled
left internal mammary artery (LIMA) grafts in elective coronary artery
bypass grafting through a systematic review and meta-analysis. A
comprehensive electronic literature search of PubMed, Ovid, Embase and
Scopus was conducted from inception to January 2020. Only short-term (30
day) studies which compared both techniques have been included in our
analysis. Primary outcomes were post anastomosis flow rate and sternal
wound infection rate (SWI); secondary outcomes were conduit length, acute
myocardial infarction and 30-day mortality. Thirteen articles with a total
of 6,222 patients met the inclusion criteria. Except for the prevalence of
diabetes mellitus being significantly lower in the skeletonized cohort
(Odds Ratio (OR) 0.77 95% CI [0.61, 0.97], p=0.03), there were no
differences in the preoperative demographics between the two groups. The
skeletonized LIMA conduit was significantly longer when compared to the
pedicled conduit (Weighted Mean Difference (WMD) -2.64cm 95% CI [-3.71,
-1.56], p<0.0001). Sternal wound infection rates were not significantly
different in the skeletonized versus pedicled LIMA group (OR 0.71 95% CI
[0.47, 1.06], p=0.10). New onset of acute MI and 30-day mortality rate
were similar in the two groups (OR 1.04 and 0.97 respectively, p>0.05 in
both). The post-anastomoses flow rate was higher in skeletonized LIMA (WMD
-11.51ml/min 95% CI [-20.54, -2.49], p<0.01). Harvesting the LIMA using
the skeletonized technique is associated with higher post-anastomosis flow
rates and longer conduit lengths; with no difference in sternal wound
infection and mortality rates when compared to the pedicled technique. We
suggest that this technique should be adopted, particularly for BITA
harvesting. However, further research is needed to provide clearer
indications for both methods.<br/>Copyright &#xa9; 2020. Published by
Elsevier Inc.

<24>
Accession Number
632988129
Title
Effect of Retrograde Autologous Blood Priming of Cardiopulmonary Bypass on
Hemodynamic Parameters and Pulmonary Mechanics in Pediatric Cardiac
Surgery: A Randomized Clinical Study.
Source
Seminars in thoracic and cardiovascular surgery. (no pagination), 2020.
Date of Publication: 22 Sep 2020.
Author
Singab H.; Gamal M.A.; Refaey R.; Al-Taher W.
Institution
(Singab, Gamal, Refaey) Cardiothoracic Surgery Department, Ain Shams
University Faculty of Medicine, Ain Shams University Hospitals, Cairo,
Egypt
(Al-Taher) Anesthesia and Intensive Care Department, Ain Shams University
Faculty of Medicine, Ain Shams University Hospitals, Cairo, Egypt
Publisher
NLM (Medline)
Abstract
The present study aimed to assess the impact of retrograde autologous
priming (RAP) on hemodynamics and pulmonary mechanics in children
subjected to cardiothoracic surgery. This prospective randomized study
analyzed the clinical records of 124 children with Rachs-1 left to right
lesions subjected to cardiac surgery. They comprised 64 patients in RAP
group and 60 patients in the conventional priming group. The preoperative,
intraoperative and postoperative data of the studied patients were
reported. The outcome measures included hematocrit value, blood gases,
lung mechanics parameters, transfusion needs, ICU stay, postoperative
complications and mortality. Preoperatively, there were no significant
differences between the studied groups regarding the demographic data,
underlying lesions, laboratory data, blood gases and pulmonary mechanics
parameters. Intraoperatively, RAP group patients had significantly lower
amount of blood loss, less frequent need to packed RBCs transfusion and
better hematocrit values when compared with the control group.
Postoperatively, RAP group patients had significantly higher Hct % at ICU
arrival, significantly better pulmonary mechanics parameters and
significantly shorter duration on mechanical ventilation. Retrograde
autologous priming in children older than 12 months subjected to cardiac
surgery for Rachs-1 left to right lesions is associated with less
transfusion needs and better pulmonary mechanics.<br/>Copyright &#xa9;
2020. Published by Elsevier Inc.

<25>
Accession Number
632986297
Title
Corynebacterium Jeikeium Endocarditis: A Review of the Literature.
Source
Cardiology in review. (no pagination), 2020. Date of Publication: 21 Sep
2020.
Author
Gupta R.; Popli T.; Ranchal P.; Khosla J.; Aronow W.S.; Frishman W.H.; El
Khoury M.Y.
Institution
(Gupta, Ranchal, Khosla, Aronow, Frishman) Department of Medicine,
Westchester Medical Center and New York Medical College, Valhalla, NY
10595
(Popli, El Khoury) Division of Infectious Disease Westchester Medical
Center and New York Medical College, Valhalla, NY 10595
(Aronow, Frishman) Division of Cardiology, Westchester Medical Center and
New York Medical College, Valhalla, NY 10595
Publisher
NLM (Medline)
Abstract
Corynebacterium jeikeium is a gram-positive, aerobic, pleomorphic,
non-spore forming bacillus, commonly present on the skin surface.
Infective endocarditis secondary to C. jeikeium most commonly affects
left-sided heart valves and has a higher likelihood to require valve
replacement compared to other Corynebacterium endocarditis. C. jeikeium
endocarditis is extremely difficult to treat as it is characteristically
resistant to penicillin, cephalosporins and aminoglycosides, and
sensitivity to quinolones, macrolides, tetracyclines and rifampin is
variable. Despite treatment, mortality rates as high as 33% have been
reported. We hereby review the literature regarding the epidemiology,
diagnosis and treatment of this deadly microorganism.

<26>
Accession Number
2004639825
Title
Vasopressors and inotropes in acute myocardial infarction related
cardiogenic shock: A systematic review and meta-analysis.
Source
Journal of Clinical Medicine. 9 (7) (pp 1-12), 2020. Article Number: 2051.
Date of Publication: July 2020.
Author
Karami M.; Hemradj V.V.; Ouweneel D.M.; Den Uil C.A.; Limpens J.;
Otterspoor L.C.; Vlaar A.P.; Lagrand W.K.; Henriques J.P.S.
Institution
(Karami, Ouweneel, Henriques) Heart Center, Department of Interventional
Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University
of Amsterdam, Amsterdam 1105 AZ, Netherlands
(Hemradj) Department of Cardiology, Isala, Zwolle 8025 AB, Netherlands
(Den Uil) Departments of Cardiology and Intensive Care Medicine, Erasmus
MC, University Medical Center, Rotterdam 3015 GD, Netherlands
(Limpens) Medical Library, Amsterdam UMC, University of Amsterdam,
Amsterdam 1105 AZ, Netherlands
(Otterspoor) Heart Center Catharina Hospital, Eindhoven 5623 EJ,
Netherlands
(Vlaar, Lagrand) Department of Intensive Care, Amsterdam UMC, University
of Amsterdam, Amsterdam 1105 AZ, Netherlands
Publisher
MDPI AG (E-mail: diversity@mdpi.com)
Abstract
Vasopressors and inotropes are routinely used in acute myocardial
infarction (AMI) related cardiogenic shock (CS) to improve hemodynamics.
We aimed to investigate the effect of routinely used vasopressor and
inotropes on mortality in AMI related CS. A systematic search of MEDLINE,
EMBASE and CENTRAL was performed up to 20 February 2019. Randomized and
observational studies reporting mortality of AMI related CS patients were
included. At least one group should have received the vasopressor/inotrope
compared with a control group not exposed to the vasopressor/inotrope.
Exclusion criteria were case reports, correspondence and studies including
only post-cardiac surgery patients. In total, 19 studies (6 RCTs) were
included, comprising 2478 CS patients. The overall quality of evidence was
graded low. Treatment with adrenaline, noradrenaline, vasopressin,
milrinone, levosimendan, dobutamine or dopamine was not associated with a
difference in mortality between therapy and control group. We found a
trend toward better outcome with levosimendan, compared with control (RR
0.69, 95% CI 0.47-1.00). In conclusion, we found insufficient evidence
that routinely used vasopressors and inotropes are associated with reduced
mortality in patients with AMI related CS. Considering the limited
evidence, this study emphasizes the need for randomized trials with
appropriate endpoints and methodology.<br/>Copyright &#xa9; 2020 by the
authors. Licensee MDPI, Basel, Switzerland.

<27>
Accession Number
2003779007
Title
Effectiveness of Incentive Spirometry on Inspiratory Muscle Strength After
Coronary Artery Bypass Graft Surgery.
Source
Heart Lung and Circulation. 29 (8) (pp 1180-1186), 2020. Date of
Publication: August 2020.
Author
Manapunsopee S.; Thanakiatpinyo T.; Wongkornrat W.; Chuaychoo B.;
Thirapatarapong W.
Institution
(Manapunsopee, Thanakiatpinyo, Thirapatarapong) Department of
Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol
University, Bangkok, Thailand
(Wongkornrat) Cardiothoracic Division, Department of Surgery, Faculty of
Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
(Chuaychoo) Division of Respiratory Diseases and Tuberculosis, Department
of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok, Thailand
Publisher
Elsevier Ltd
Abstract
Background: Although the use of incentive spirometry with a deep breathing
exercise (DBE) is widely used in clinical practice in patients who have
undergone coronary artery bypass graft (CABG) surgery, the effect of this
combination therapy has not been conclusively elucidated. The aim of this
study was to investigate the effect of postoperative combined incentive
spirometry and DBE versus DBE alone on inspiratory muscle strength
following CABG. <br/>Method(s): This randomised clinical trial was
conducted in patients scheduled to undergo CABG surgery at Siriraj
Hospital, Bangkok Thailand. The study group received incentive spirometry
and DBE, and the control group received DBE only. Maximal inspiratory
pressure (MIP) before surgery and at day 4 after surgery was assessed by a
respiratory pressure meter. Secondary outcomes, including postoperative
pulmonary complication and duration of postoperative hospitalisation, were
obtained from the medical records. <br/>Result(s): Ninety (90) patients
were included, with 47 and 43 patients assigned to the study and control
groups, respectively. In both groups, there was a significant reduction in
MIP from preoperative baseline to postoperative day 4; however, the MIP in
the incentive spirometry group had a significantly smaller reduction in
MIP compared with the control group (33.0+/-23.2% vs 47.2+/-20.1%,
respectively; p=0.006, 95% confidence interval, 3.9-23.3). There was no
difference between groups regarding secondary outcomes.
<br/>Conclusion(s): Patients in the study group had significantly better
recovery of inspiratory muscle strength on day 4 post-CABG than patients
in the control group. There was no significant difference between groups
for either postoperative pulmonary complications or length of hospital
stay.<br/>Copyright &#xa9; 2019 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<28>
Accession Number
632857135
Title
Recommendations and Alerting for Delirium Alleviation in Real-Time
(RADAR): Protocol for a pilot randomized controlled trial.
Source
F1000Research. 8 (no pagination), 2020. Article Number: 1683. Date of
Publication: 2020.
Author
Vlisides P.E.; Ragheb J.W.; Leis A.; Schoettinger A.; Hickey K.; McKinney
A.; Brooks J.; Zierau M.; Norcott A.; Yang S.; Avidan M.S.; Min L.
Institution
(Vlisides, Ragheb, Leis, McKinney, Brooks, Zierau, Yang) Department of
Anesthesiology, University of Michigan Medical School, Ann Arbor, MI
48170, United States
(Vlisides) Center for Consciousness Science, University of Michigan
Medical School, Ann Arbor, MI 48109, United States
(Schoettinger) Department of Social Work, Michigan Medicine, Ann Arbor, MI
48109, United States
(Hickey) University of Michigan School of Nursing, Ann Arbor, MI 48109,
United States
(Norcott, Min) Department of Internal Medicine, Division of Geriatric and
Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI
48109, United States
(Norcott) Department of Internal Medicine, Division of Geriatric and
Palliative Medicine, Veterans Affairs Ann Arbor Healthcare System, Ann
Arbor, MI 48105, United States
(Avidan) Department of Anesthesiology, Washington University School of
Medicine, St. Louis, MO 63110, United States
(Min) Geriatric Research Education and Clinical Care, VA Ann Arbor
Healthcare System, Ann Arbor, MI 48105, United States
Publisher
F1000 Research Ltd
Abstract
Background: Delirium is a common and serious complication of major surgery
for older adults. Postoperative social and behavioral support (e.g., early
mobilization, mealtime assistance) may reduce the incidence and impact of
delirium, and these efforts are possible with proactive patient-care
programs. This pilot trial tests the hypothesis that a multicomponent
decision support system, which sends automated alerts and recommendations
to patient-care programs and family members for high-risk patients, will
improve the postoperative environment for neurocognitive and clinical
recovery. <br/>Method(s): This will be a randomized, controlled, factorial
pilot trial at a large academic medical center. High-risk, non-cardiac
surgery patients (>=70 years old) will be recruited. Patients will be
allocated to a usual care group (n=15), Hospital Elder Life Program
(HELP)-based paging system (n=15), family-based paging system (n=15), or
combined HELP- and family-based system (n=15). The primary outcome will be
the presence of delirium, defined by positive long-form Confusion
Assessment Method screening. Secondary outcomes will include additional
HELP- and family-based performance metrics along with various
neurocognitive and clinical recovery measures. Exploratory outcomes
include the incidence of positive family-based delirium assessments
post-discharge, 36-item Short Form Survey, PROMIS Cognitive Function
Abilities Subset 4a, and 30-day readmission rates. Ethics and
dissemination: This trial has received approval by the University of
Michigan Medical Institutional Review Board (IRBMED). Dissemination plans
include presentation at scientific conferences, publication in medical
journals, and distribution via educational and news media. Registration:
ClinicalTrials.gov Identifier NCT04007523, registered on
7/3/2019.<br/>Copyright &#xa9; 2020 Vlisides PE et al.

<29>
Accession Number
632726353
Title
A randomised comparison of the efficacy of a Coopdech bronchial blocker
and a double-lumen endotracheal tube for minimally invasive esophagectomy.
Source
Translational Cancer Research. 9 (8) (pp 4686-4692), 2020. Date of
Publication: 01 Aug 2020.
Author
Zhang T.-H.; Liu X.-Q.; Cao L.-H.; Fu J.-H.; Lin W.-Q.
Institution
(Zhang, Cao, Lin) Department of Anaesthesia, Sun Yat-Sen University,
Cancer Center, State Key Laboratory of Oncology in South China and
Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal
Cancer Institute, Guangzhou, China
(Liu) Department of Anesthesia, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen
University, Guangzhou, China
(Fu) Department of Thoracic Surgery, Sun Yat-Sen University, Cancer
Center, State Key Laboratory of Oncology in South China and Collaborative
Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer
Institute, Guangzhou, China
(Lin) Department of Blood Transfusion, Sun Yat-Sen University, Cancer
Center, State Key Laboratory of Oncology in South China and Collaborative
Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer
Institute, Guangzhou, China
Publisher
AME Publishing Company (E-mail: info@amepc.org)
Abstract
Background: Both a bronchial blocker (BB) and a double-lumen endotracheal
tube (DLT) can achieve lung collapse and one-lung ventilation (OLV) during
thoracic surgery. The purpose of this study was to compare these two
airway devices in terms of efficacy in video-assisted thoraco-laparoscopic
esophagectomy for cancer. <br/>Method(s): A total of 55 patients underwent
combined thoracoscopic and laparoscopic esophagectomy for cancer were
enrolled and divided into a Coopdech bronchial blocker group (CBB group,
n=27) or a DLT group (DLT group, n=28). The primary outcome was the lung
collapse scores at 1, 5, 10 minutes after the opening of the pleural and
assessed using a verbal analogue scale via a real-time video view.
Secondary outcomes including time for tube localization, incidence of tube
displacement, postoperative sore throats, and surgeons' satisfaction with
surgical manipulations were collected. <br/>Result(s): The patients in the
CBB group achieved better lung collapse scores at 5 minutes (7.4+/-1.3 vs.
6.4+/-0.9 minutes, P<0.01) and 10 minutes (8.9+/-0.8 vs. 7.1+/-0.9
minutes, P<0.01) after opening the pleura, and they had lower incidence of
postoperative sore throats [5 (18%) vs. 16 (57%), P<0.01] when compared
with patients in DLT group. However, the time for tube localization were
significantly longer in CBB group than in DLT group (210+/-120 vs.
125+/-60 s, P<0.05). There were no significant difference in tube
displacement, hypoxemia (SpO2 <90%) during OLV, and in surgeons'
satisfaction with surgical manipulations. <br/>Conclusion(s): CBB
technique can be a potential alternative to the conventional DLT strategy
for lung collapse and OLV during esophagectomy.<br/>Copyright &#xa9;
Translational Cancer Research. All rights reserved.

<30>
Accession Number
2006954376
Title
Lipoprotein(a) and calcific aortic valve stenosis: A systematic review.
Source
Progress in Cardiovascular Diseases. 63 (4) (pp 496-502), 2020. Date of
Publication: July - August 2020.
Author
Guddeti R.R.; Patil S.; Ahmed A.; Sharma A.; Aboeata A.; Lavie C.J.; Alla
V.M.
Institution
(Guddeti, Patil, Sharma, Aboeata, Alla) Division of Cardiovascular
Diseases, Creighton University School of Medicine, Omaha, NE, United
States
(Ahmed) Division of Internal Medicine, Creighton University School of
Medicine, Omaha, NE, United States
(Lavie) John Ochsner Heart and Vascular Institute, Ochsner Clinical
School, The University of Queensland School of Medicine, New Orleans, LA,
United States
Publisher
W.B. Saunders
Abstract
Calcific aortic valve stenosis (AS) is the most common form of acquired
valvular heart disease needing intervention and our understanding of this
disease has evolved from one of degenerative calcification to that of an
active process driven by the interplay of genetic factors and chronic
inflammation modulated by risk factors such as smoking, hypertension and
elevated cholesterol. Lipoprotein(a) [Lp (a)] is a cholesterol rich
particle secreted by the liver which functions as the major lipoprotein
carrier of phosphocholine-containing oxidized phospholipids. Lp(a) levels
are largely genetically determined by polymorphisms in the LPA gene. While
there is an extensive body of evidence linking Lp(a) to atherosclerotic
cardiovascular disease, emerging evidence now suggests a similar
association of Lp(a) to calcific AS. In this article, we performed a
systematic review of all published literature to assess the association
between Lp(a) and calcific aortic valve (AV) disease. In addition, we
review the potential mechanisms by which Lp(a) influences the progression
of valve disease. Our review identified a total of 21 studies, varying
from case-control studies, prospective or retrospective observational
cohort studies to Mendelian randomized studies that assessed the
association between Lp(a) and calcific AS. All but one of the above
studies demonstrated significant association between elevated Lp(a) and
calcific AS. We conclude that there is convincing evidence supporting a
causal association between elevated Lp(a) and calcific AS. In addition,
elevated Lp(a) predicts a faster hemodynamic progression of AS, and
increased risk of AV replacement, especially in younger patients. Further
research into the clinical utility of Lp(a) as a marker for predicting the
incidence, progression, and outcomes of sclerodegenerative AV disease is
needed.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<31>
Accession Number
2006170921
Title
Effects of antidiabetic medications on cardiovascular outcomes.
Source
Journal of Cardiac Surgery. 35 (10) (pp 2759-2767), 2020. Date of
Publication: 01 Oct 2020.
Author
Leung M.S.T.; Lin S.G.; Uthayanan L.; Harky A.
Institution
(Leung, Lin, Uthayanan) Department of Surgery, Faculty of Medicine,
University of London, St George's Hospital Medical School, London, United
Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Objectives: Hyperglycemia is associated with an increased risk of adverse
cardiovascular outcomes, such as heart failure, coronary heart disease,
stroke, and in-hospital mortality. For those receiving cardiac surgery, up
to half develop hyperglycemia while 30% have a diagnosis of diabetes,
which is defined by chronic hyperglycemia. Due to a prothrombic state and
endovascular damage, patients with diabetes have a twofold increased risk
of cardiovascular events. <br/>Method(s): Electronic literature search was
done to identify articles that have discussed antidiabetic medications and
how it is impacting the glycemia status as well as cardiovascular
outcomes. No limits were placed on timing of the publication or type of
the article. Key words and MeSH terms were used to conduct the search and
the results are summarized in a narrative manner within each relevant
section. <br/>Result(s): Antidiabetic medications play a key role in
lowering blood glucose levels to reduce adverse cardiovascular outcomes.
However, it is a challenge to assess their cardiovascular safety due to
confounding factors, such as age, obesity, smoking, hyperlipidemia, and
high blood pressure. Further research in this field is required to
understand this correlation closely. <br/>Conclusion(s): Optimizing blood
glucose level during the perioperative period with correct medication and
dose have a significant role in reducing morbidities. Measures should be
taken to provide a safe blood glucose level for optimum
outcomes.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<32>
Accession Number
2005875740
Title
Microplegia in cardiac surgery: Systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 35 (10) (pp 2737-2746), 2020. Date of
Publication: 01 Oct 2020.
Author
Owen C.M.; Asopa S.; Smart N.A.; King N.
Institution
(Owen, King) School of Biomedical Sciences, Faculty of Health, University
of Plymouth, Plymouth, United Kingdom
(Asopa) South West Cardiothoracic Centre, University Hospitals Plymouth,
Plymouth, United Kingdom
(Smart) Exercise Physiology, School of Science and Technology, University
of New England, Armidale, Australia
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: Consensus on the optimum choice of cardioplegia remains
elusive. One possibility that has been suggested to have beneficial
properties is microplegia, a cardioplegia of reduced crystalloid volume.
The aim of this meta-analysis is to comprehensively investigate
microplegia against a range of clinical outcomes. <br/>Method(s): To
identify potential studies, systematic searches were carried out in four
databases (eg, Pubmed, EMBASE). The search strategy included the key
concepts of "microplegia" OR "mini-cardioplegia" OR "miniplegia" AND
"cardiac surgery." This was followed by a meta-analysis investigating:
mortality, crystalloid volume; cardiopulmonary bypass time; cross-clamp
time; intra-aortic balloon pump use; spontaneous heartbeat recovery;
inotropic support; low cardiac output syndrome; myocardial infarction;
acute renal failure; atrial fibrillation, reoperation for bleeding;
creatine kinase myocardial band (CK-MB); intensive care unit (ICU) time
and hospital stay. <br/>Result(s): Eleven studies comprising 5798
participants were analyzed. Microplegia used a lower volume of
crystalloids and led to a higher spontaneous return of heartbeat, odds
ratio (OR) 4.271 (95% confidence intervals [CIs]: 1.935, 9.423;
I² = 76.57%; P <.001) and a lower requirement for inotropic
support, OR: 0.665 (95% CI: 0.47, 0.941; I² = 3.53%; P =.021).
Microplegia was also associated with a lower CK-MB release, mean
difference (MD) -6.448 ng/mL (95% CI: -9.386, -3.511; I² = 0%;
P <.001) and a shorter ICU stay, MD: -0.411 days (95% CI: -0.812, -0.009;
I² = 17.65%; P =.045). All other comparisons were
nonsignificant. <br/>Conclusion(s): Microplegia has similar effects to
other types of cardioplegia and is beneficial with regard to spontaneous
return of heartbeat, inotropic support, ICU stay, and CK-MB
release.<br/>Copyright &#xa9; 2020 The Authors. Journal of Cardiac Surgery
published by Wiley Periodicals LLC

<33>
Accession Number
2005875739
Title
Telemedicine in cardiovascular surgery during COVID-19 pandemic: A
systematic review and our experience.
Source
Journal of Cardiac Surgery. 35 (10) (pp 2773-2784), 2020. Date of
Publication: 01 Oct 2020.
Author
Ajibade A.; Younas H.; Pullan M.; Harky A.
Institution
(Ajibade) Birmingham Medical School, University of Birmingham, Birmingham,
United Kingdom
(Younas) St George's Medical School, University of London, London, United
Kingdom
(Pullan, Harky) Department of Cardiothoracic Surgery, Liverpool Heart and
Chest Hospital, Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Life Sciences,
University of Liverpool, Liverpool, United Kingdom
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Objective: The SAR-COV-2 pandemic has had an unprecedented effect on the
UK's healthcare systems. To reduce spread of the virus, elective
treatments and surgeries have been postponed or canceled. There has been a
rise in the use of telemedicine (TM) as an alternative way to carry
outpatient consultations. This systematic review aims to evaluate the
extent to which TM may be able to support cardiac and vascular surgery
patients in the COVID-19 era. <br/>Method(s): We looked into how TM can
support the management of patients via triaging, preoperative, and
postoperative care. Evaluations targeted the clinical effectiveness of
common TM methods and the feasibility of applying those methods in the UK
during this pandemic. <br/>Result(s): Several studies have published their
evidence on the benefit of TM and its benefit during COVID-19, the data
related to cardiovascular surgery and how this will impact future practice
of this speciality is emerging and yet larger studies with appropriate
timing of outcomes to be published. <br/>Conclusion(s): Overall, the use
of virtual consultations and remote monitoring is feasible and best placed
to support these patients via triaging and postoperative monitoring.
However, TM can be limited by the need of sophisticated technological
requirement and patients' educational and know-how computer literacy
level.<br/>Copyright &#xa9; 2020 The Authors. Journal of Cardiac Surgery
published by Wiley Periodicals LLC

<34>
Accession Number
2005840624
Title
Effects of pulmonary perfusion during cardiopulmonary bypass on lung
functions after cardiac operation.
Source
Journal of Cardiac Surgery. 35 (10) (pp 2469-2476), 2020. Date of
Publication: 01 Oct 2020.
Author
Karacalilar M.; Onan I.S.; Onan B.; Sen O.; Gonca S.; Solakoglu S.;
Yeniterzi M.
Institution
(Karacalilar, Onan, Onan, Sen, Yeniterzi) Department of Cardiovascular
Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery
Hospital, University of Health Sciences Turkey, Istanbul, Turkey
(Gonca) Department of Histology and Embryology, Faculty of Medicine,
Kocaeli University, Kocaeli, Turkey
(Solakoglu) Department of Histology and Embryology, Capa Faculty of
Medicine, Istanbul University, Istanbul, Turkey
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: Pulmonary artery perfusion during cardiopulmonary bypass (CPB)
is a known but rarely used technique in adult cardiac surgery. In this
study, we aimed to investigate biochemical and histopathological effects
of pulmonary artery perfusion during CPB on lung functions.
<br/>Method(s): Between May 2014 and August 2014, all patients (n = 24)
who gave informed consent for participating this study with inclusion
criteria were included. Patients undergoing isolated coronary artery
bypass grafting were sequentially randomized to conventional CPB (control
group, n = 12) and conventional CPB with selective pulmonary artery
perfusion (study group, n = 12). Lung functions were monitored using PF
ratio, alveolar-arterial oxygen gradient, and lactate levels. A small
sample tissue from the left lung was excised for histopathologic
examination. Immunocytochemistry analysis was performed using anti-rabbit
polyclonal vascular endothelial growth factor (VEGF), rabbit polyclonal
inducible nitric oxide synthase (i-NOS), and BCL-2 antibodies.
<br/>Result(s): Postoperative course of the patients were uneventful
without any clinical outcome differences in terms of cardiopulmonary
complications, ventilation time and hospital stay. Pulmonary perfusion
group had significantly better oxygenation values after extubation and at
postoperative 24-hour. Electron microscopy examinations revealed better
preservation of the alveolar wall integrity with pulmonary perfusion. The
intensity of VEGF, i-NOS, and BCL-2 antibody expressions in bronchial
epithelial cells were more prominent in the pulmonary perfusion group.
<br/>Conclusion(s): Pulmonary artery perfusion during aortic
cross-clamping provides better oxygenation and preservation of the wall
alveolar integrity after coronary artery bypass grafting surgery. This
technique can be used as a protective strategy to minimize CPB-induced
lung injury in adult cardiac surgery.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC

<35>
Accession Number
2005688417
Title
Publication of cardiac surgery research papers in top cardiovascular
journals.
Source
Journal of Cardiac Surgery. 35 (10) (pp 2734-2736), 2020. Date of
Publication: 01 Oct 2020.
Author
Gaudino M.; Morsi M.; Hameed I.; Naik A.; Robinson N.B.; Benedetto U.;
Ruel M.
Institution
(Gaudino, Morsi, Hameed, Naik, Robinson) Department of Cardiothoracic
Surgery, Weill Cornell Medicine, New York, NY, United States
(Benedetto) Bristol Heart Institute, University of Bristol, Bristol,
United Kingdom
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background and Aim: To evaluate the publication rate of articles related
to cardiac surgery in the four main cardiovascular journals over the last
5 years. <br/>Method(s): A bibliometric review of all full-length articles
published between January 2014 and March 2020 in the top four
cardiovascular journals (Circulation, European Heart Journal (EHJ),
Journal of the American College of Cardiology (JACC), and JAMA Cardiology)
was conducted. For each eligible article in the four journals, the journal
of publication, study design, area of interest, country of origin, and
type of intervention tested (for cardiac surgery and interventional
cardiology studies) were extracted. The affiliations of all editorial
board members were identified from journal websites or from online
searches and recorded as from cardiac surgery, cardiology, or another
discipline. Correlations between variables were evaluated. <br/>Result(s):
A total of 4835 articles were reviewed. Cardiac surgery studies amounted
to 6.2% (104) of total research publications in JACC, 4.4% (74) in
Circulation, 3.6% (13) in JAMA Cardiology, and 2.0% (22) in EHJ (P <.001).
The percentage of cardiac surgery publications was significantly less than
interventional cardiology publications (P <.001). <br/>Conclusion(s):
Cardiac surgery studies represent only a small minority of the articles
published in the top cardiovascular journals over the last 5 years, with
significant differences between individual journals. Cardiac surgery
studies were more often observational and this may constitute one
important reason for their under-representation.<br/>Copyright &#xa9; 2020
Wiley Periodicals LLC

<36>
Accession Number
2005643928
Title
FFR-guided versus coronary angiogram-guided CABG: A review and
meta-analysis of prospective randomized controlled trials.
Source
Journal of Cardiac Surgery. 35 (10) (pp 2785-2793), 2020. Date of
Publication: 01 Oct 2020.
Author
Timbadia D.; Ler A.; Sazzad F.; Alexiou C.; Kofidis T.
Institution
(Timbadia) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
(Timbadia, Ler, Sazzad, Kofidis) Department of Cardiac Thoracic and
Vascular Surgery, National University Heart Centre, Singapore
(Ler) School of Medicine, National University of Ireland, Galway, Ireland
(Sazzad, Kofidis) Department of Surgery, Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
(Sazzad, Kofidis) Cardiovascular Research Institute, National University
of Singapore, Singapore
(Alexiou) Department of Cardiac Surgery, Interbalkan European Medical
Centre, Thessaloniki, Greece
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: Fractional flow reserve (FFR) is a well-established method for
the evaluation of coronary artery stenosis before percutaneous coronary
intervention. However, whether FFR assessment should be routinely used
before coronary artery bypass graft surgery (CABG) remains unclear. A
meta-analysis of prospectively randomized controlled trials (PRCTs) was
carried out to compare the outcomes of FFR-guided CABG vs coronary
angiography (CAG)-guided CABG. <br/>Method(s): The meta-analysis adhered
to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines. Two PRCTs (the FARGO and GRAFFITI trials) were found and
included reporting data on 269 patients with 6 and 12 month follow-up.
Primary endpoints were rates of overall death, MACCE, target vessel
revascularization, and spontaneous myocardial infarction (MI). Secondary
endpoints were overall graft patency and patency of arterial and venous
grafts. <br/>Result(s): There were no significant differences between the
FFR-guided and CAG-guided groups in the rates of overall death, MACCE,
target vessel revascularization, spontaneous MI and graft patency.
Meta-analysis of FARGO and GRAFFITI PRCTs showed that FFR-guided CABG and
CAG-guided CABG produced similar clinical outcomes with similar graft
patency rates up to a year postoperatively. <br/>Conclusion(s): Currently
available PRCTs showes no sufficient evidence to support the use FFR in
CABG.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<37>
Accession Number
2005609370
Title
Mitral valve surgery combined with on-pump versus off-pump myocardial
revascularization: A prospective randomized analysis with midterm
follow-up.
Source
Journal of Cardiac Surgery. 35 (10) (pp 2649-2656), 2020. Date of
Publication: 01 Oct 2020.
Author
Zavolozhin A.; Shonbin A.; Bystrov D.; Enginoev S.
Institution
(Zavolozhin, Shonbin) Department of Surgery, Arkhangelsk State Medical
University, Arkhangelsk, Russian Federation
(Zavolozhin, Enginoev) Department of Cardiac Surgery, FSBI Federal Centre
for Cardiovascular Surgery of the Ministry of Health of the Russian
Federation, Astrakhan, Russian Federation
(Shonbin, Bystrov) Department of Cardiac Surgery, City Hospital No 1,
Arkhangelsk, Russian Federation
(Enginoev) Department of Cardiac Surgery, Astrakhan State Medical
University, Astrakhan, Russian Federation
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: The aim of the study was to compare results off-pump coronary
artery bypass (OPCAB) combined mitral valve reconstruction (MVR) with
standard on-pump approach. <br/>Method(s): From January 2014 to December
2017, a total of 53 patients received a combined myocardial
revascularization and MVR for multivessel coronary artery disease (CAD)
complicated by severe ischemic mitral regurgitation (IMR). All the
subjects were divided into two groups: group I: 27 patients, received
OPCAB + MVR, and group II (control group): 26 patients with on-pump
myocardial revascularization (ONCAB) + MVR. <br/>Result(s): The aortic
cross-clamp (ACC) and cardio-pulmonary bypass (CPB) times were longer in
group II, 47.0 (44.0; 55.0) vs 94.5 (89.75; 105.5) minutes, P <.05 and
70.0 (63.0; 77.0) vs 138.5 (127.0; 157.5) minutes, P <.05, respectively.
Evaluation of major clinical events showed that the implementation of the
off-pump stage of myocardial revascularization in patients with severe IMR
did not lead to significant changes in the mortality and postoperative
complications. Furthermore, its use did not affect the volume of blood
loss and need for blood transfusion, the duration of mechanical
ventilation, the need for inotropic therapy, as well as the duration of
the patient's resuscitation and the total duration of hospitalization,
with the one exception: the troponin-T level increase in the OPCAB + MVR
group was less than in the ONCAB + MVR group. <br/>Conclusion(s): OPCAB
combined MVR in patients with CAD and severe IMR can be performed with
shorter CPB and ACC times, and lower troponin-T level after surgery,
without reducing the risk of surgical complications.<br/>Copyright &#xa9;
2020 Wiley Periodicals LLC

<38>
Accession Number
631130951
Title
Mortality after drug-eluting stents vs. coronary artery bypass grafting
for left main coronary artery disease: a meta-analysis of randomized
controlled trials.
Source
European heart journal. 41 (34) (pp 3228-3235), 2020. Date of Publication:
07 Sep 2020.
Author
Ahmad Y.; Howard J.P.; Arnold A.D.; Cook C.M.; Prasad M.; Ali Z.A.; Parikh
M.A.; Kosmidou I.; Francis D.P.; Moses J.W.; Leon M.B.; Kirtane A.J.;
Stone G.W.; Karmpaliotis D.
Institution
(Ahmad, Prasad, Ali, Parikh, Kosmidou, Moses, Leon, Kirtane, Karmpaliotis)
Center for Interventional Vascular Therapy, Columbia University Medical
Center, NewYork-Presbyterian Hospital, 161 Fort Washington Avenue, NY, NY
10032, United States
(Ahmad, Howard, Arnold, Cook, Francis) National Heart and Lung Institute,
Imperial College London, Du Cane Road, London W12 0HS, United Kingdom
(Ali, Kosmidou, Moses, Leon, Kirtane, Stone) The Cardiovascular Research
Foundation, 1700 Broadway, New York, NY 10019, USA
(Stone) Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital1190
Fifth Avenue, NY, NY 10029, United States
Publisher
NLM (Medline)
Abstract
AIMS : The optimal method of revascularization for patients with left main
coronary artery disease (LMCAD) is controversial. Coronary artery bypass
graft surgery (CABG) has traditionally been considered the gold standard
therapy, and recent randomized trials comparing CABG with percutaneous
coronary intervention (PCI) with drug-eluting stents (DES) have reported
conflicting outcomes. We, therefore, performed a systematic review and
updated meta-analysis comparing CABG to PCI with DES for the treatment of
LMCAD. METHODS AND RESULTS : We systematically identified all randomized
trials comparing PCI with DES vs. CABG in patients with LMCAD. The primary
efficacy endpoint was all-cause mortality. Secondary endpoints included
cardiac death, myocardial infarction (MI), stroke, and unplanned
revascularization. All analyses were by intention-to-treat. There were
five eligible trials in which 4612 patients were randomized. The weighted
mean follow-up duration was 67.1months. There were no significant
differences between PCI and CABG for the risk of all-cause mortality
[relative risk (RR) 1.03, 95% confidence interval (CI) 0.81-1.32; P=0.779]
or cardiac death (RR 1.03, 95% CI 0.79-1.34; P=0.817). There were also no
significant differences in the risk of stroke (RR 0.74, 95% CI 0.35-1.50;
P=0.400) or MI (RR 1.22, 95% CI 0.96-1.56; P=0.110). Percutaneous coronary
intervention was associated with an increased risk of unplanned
revascularization (RR 1.73, 95% CI 1.49-2.02; P<0.001). CONCLUSION : The
totality of randomized clinical trial evidence demonstrated similar
long-term mortality after PCI with DES compared with CABG in patients with
LMCAD. Nor were there significant differences in cardiac death, stroke, or
MI between PCI and CABG. Unplanned revascularization procedures were less
common after CABG compared with PCI. These findings may inform clinical
decision-making between cardiologists, surgeons, and patients with
LMCAD.<br/>Copyright &#xa9; The Author(s) 2020. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<39>
Accession Number
632956936
Title
Dexmedetomidine Improves Lung Function by Promoting Inflammation
Resolution in Patients Undergoing Totally Thoracoscopic Cardiac Surgery.
Source
Oxidative medicine and cellular longevity. 2020 (pp 8638301), 2020. Date
of Publication: 2020.
Author
Cui J.; Gao M.; Huang H.; Huang X.; Zeng Q.
Institution
(Cui, Gao, Huang, Zeng) Department of Anesthesiology, Cardiovascular
Institute of Guangdong Province, Guangdong Provincial People's Hospital,
Guangzhou, Guangdong 510030, China
(Cui, Gao, Huang, Zeng) Department of Anesthesiology, Guangdong Provincial
People's Hospital Zhuhai Hospital, Zhuhai Golden Bay Center Hospital,
Zhuhai, Guangdong 519000, China
(Huang) Department of Clinical Laboratory, Guangdong Provincial People's
Hospital Zhuhai Hospital, Zhuhai Golden Bay Center Hospital, Zhuhai,
Guangdong 519000, China
Publisher
NLM (Medline)
Abstract
Objective: Totally thoracoscopic cardiac surgery under cardiopulmonary
bypass combined with one-lung ventilation has been identified as the trend
in cardiac surgery. The aim of this study was to examine the effects of
the selective alpha2 adrenergic receptor agonist dexmedetomidine on the
pulmonary function of patients who underwent mitral valve surgery using
the totally thoracoscopic technique. <br/>Method(s): Fifty-seven patients
who underwent thoracoscopic mitral valve surgery between July 2019 and
December 2019 were selected. The patients were randomly divided into the
control (Con) group (n = 28) and the dexmedetomidine (DEX) group (n = 29)
using the random number table method. Arterial blood gas analyses were
performed, and the oxygenation (PaO2/FiO2) and respiratory indexes
(P(A-a)O/PaO2) were calculated 5min after tracheal intubation (T1), 2h
after operation (T2), 6h after operation (T3), and 24h after operation
(T4). Moreover, the serum cytokines interleukin-6 (IL-6), tumor necrosis
factor-alpha (TNF-alpha), and intercellular adhesion molecule-1 (ICAM-1)
were detected using the enzyme-linked immunosorbent method at all time
points. Chest radiography was performed 24h after surgery. Peripheral
blood samples were collected before and after the operation for a complete
hemogram. Additionally, the procalcitonin concentration was measured and
recorded when the patients were transported to the intensive care unit
(ICU). The postoperative extubation time, length of ICU stay, and
pulmonary infection rate were also recorded. <br/>Result(s): Inflammatory
reaction after surgery was evident. However, the inflammatory cytokines
IL-6, TNF-alpha, and ICAM-1 in the DEX group were lower than those in the
Con group after surgery (T2 to T4; P < 0.05). Neutrophil counts and
procalcitonin concentration were higher in the Con group than in the DEX
group (P < 0.05). In addition, in the DEX group, pulmonary exudation on
chest radiography was lower, and pulmonary function, as shown by an
increase in oxidation index and decrease in the respiratory index,
improved after surgery (P < 0.05). Moreover, the duration of mechanical
ventilation in the Con group was 3.4h longer than that in the DEX group.
<br/>Conclusion(s): Dexmedetomidine has a protective effect on pulmonary
function in patients undergoing mitral valve surgery using a totally
video-assisted thoracoscopic technique, which may be related to a
reduction in the concentration of inflammatory cytokines in the early
perioperative period.<br/>Copyright &#xa9; 2020 Junji Cui et al.

<40>
Accession Number
632971153
Title
Evolution of outcome and complications in TAVR: a meta-analysis of
observational and randomized studies.
Source
Scientific reports. 10 (1) (pp 15568), 2020. Date of Publication: 23 Sep
2020.
Author
Winter M.-P.; Bartko P.; Hofer F.; Zbiral M.; Burger A.; Ghanim B.;
Kastner J.; Lang I.M.; Mascherbauer J.; Hengstenberg C.; Goliasch G.
Institution
(Winter, Bartko, Hofer, Zbiral, Burger, Kastner, Lang, Mascherbauer,
Hengstenberg, Goliasch) Department of Internal Medicine II, Medical
University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
(Ghanim) Department of General and Thoracic Surgery, University Hospital
Krems, Karl Landsteiner University of Health Sciences, Krems an der Donau,
Austria
Publisher
NLM (Medline)
Abstract
Aim of the present analysis was to collect and pool all available data
currently in the literature regarding outcomes and complications of all
approved TAVR prosthesis and to assess the transition from first to next
generation TAVR devices by directly comparing both in regard of procedure
related complications. Transcatheter aortic valve replacement is a well
established treatment modality in patients with severe aortic stenosis
deemed to be inoperable or at unacceptable risk for open heart surgery.
First generation prostheses were associated with a high rate of
peri-procedural complications like paravalvular regurgitation, valve
malpositioning, vascular complications and conduction disorders.
Refinement of the available devices incorporate features to address the
limitations of the first-generation devices. A PRISMA checklist-guided
systematic review and meta-analysis of prospective observational studies,
national and device specific registries or randomized clinical trials was
conducted. Studies were identified by searching PUBMED, SCOPUS, Cochrane
Central Register of Controlled Trials and LILACs from January 2000 to
October 2017. We extracted and pooled data on both mortality and
complications from 273 studies for twelve different valves prostheses in a
total of 68,193 patients. In second generation prostheses as compared to
first generation devices, we observed a significant decrease in mortality
(1.47+/-1.73% vs. 5.41+/-4.35%; p<0.001), paravalvular regurgitation
(1.75+/-2.43vs. 12.39+/-9.38, p<0.001) and MACE. TAVR with contemporary
next generation devices has led to an impressive improvement in TAVR
safety driven by refined case selection, improved procedural techniques
and increased site experience.

<41>
Accession Number
632930532
Title
Transcatheter versus surgical aortic valve replacement in patients with
cardiac surgery: Meta-analysis and systematic review of the literature.
Source
Journal of Cardiovascular Development and Disease. 7 (3) (no pagination),
2020. Article Number: 36. Date of Publication: September 2020.
Author
Latif A.; Lateef N.; Ahsan M.J.; Kapoor V.; Usman R.M.; Cooper S.;
Andukuri V.; Mirza M.; Ashfaq M.Z.; Khouzam R.
Institution
(Latif, Lateef, Ahsan, Kapoor, Cooper, Andukuri, Mirza, Ashfaq) Department
of Internal Medicine, Creighton University, Omaha, NE 68124, United States
(Usman) Department of Internal Medicine, University of Tennessee, Memphis,
TN 38152, United States
(Khouzam) Department of Cardiology, University of Tennessee, Memphis, TN
38152, United States
Publisher
MDPI AG (E-mail: diversity@mdpi.com)
Abstract
The number of patients with severe aortic stenosis (AS) and a history of
prior cardiac surgery has increased. Prior cardiac surgery increases the
risk of adverse outcomes in patients undergoing aortic valve replacement.
To evaluate the impact of prior cardiac surgery on clinical endpoints in
patients undergoing transcatheter aortic valve replacement (TAVR) versus
surgical aortic valve replacement (SAVR), we performed a literature search
using PubMed, Embase, Google Scholar, and Scopus databases. The clinical
endpoints included in our study were 30-day mortality, 1-2-year mortality,
acute kidney injury (AKI), bleeding, stroke, procedural time, and duration
of hospital stay. Seven studies, which included a total of 8221 patients,
were selected. Our study found that TAVR was associated with a lower
incidence of stroke and bleeding complications. There was no significant
difference in terms of AKI, 30-day all-cause mortality, and 1-2-year
all-cause mortality between the two groups. The average procedure time and
duration of hospital stay were 170 min less (p <= 0.01) and 3.6 days
shorter (p < 0.01) in patients with TAVR, respectively. In patients with
prior coronary artery bypass graft and severe AS, both TAVR and SAVR are
reasonable options. However, TAVR may be associated with a lower incidence
of complications like stroke and perioperative bleeding, in addition to a
shorter length of stay.<br/>Copyright &#xa9; 2020 by the authors.

<42>
Accession Number
2007902358
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: 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, Guzon, Otero-Forero, Mataro, Sanchez-Espin, Porras,
Villaescusa, Melero-Tejedor) UGC Heart Area, Cardiovascular Surgery
Department, Hospital Universitario Virgen de la Victoria de Malaga,
Fundacion Publica Andaluza para la Investigacion de Malaga en Biomedicina
y Salud (FIMABIS), University of Malaga, 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,
Fundacion Publica Andaluza para la Investigacion de Malaga en Biomedicina
y Salud (FIMABIS), University of Malaga, CIBERCV Enfermedades
Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
Publisher
W.B. Saunders
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-center, 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 endpoint was a difference between
intervention groups of >=0.10 points in change from baseline quality of
life Questionnaire EuroQOL-index, measured at 1, 6, or 12 months.
Secondary endpoints were differences in change from other baseline
EuroQOL-index utilities, cardiac surgery-specific satisfaction
questionnaire (SATISCORE), a combined safety endpoint of 4 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 hours, 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% confidence interval 0.10-0.30, P <
0.001) and median difference +0.14 (95% confidence interval 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.<br/>Copyright &#xa9; 2020 Elsevier
Inc.

<43>
Accession Number
2006808738
Title
Topical versus low-dose systemic tranexamic acid in pediatric cardiac
surgery: A randomized clinical study.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Hatami F.; Valizadeh N.; Salehi F.; Hosseinzadeh Maleki M.
Institution
(Hatami, Valizadeh, Salehi) Department of Cardiology, Cardiovascular
Diseases Research Center, Birjand University of Medical Sciences, Birjand,
Iran, Islamic Republic of
(Hosseinzadeh Maleki) Department of Cardiac Surgery, Mashhad University of
Medical Sciences, Mashhad, Iran, Islamic Republic of
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Objectives: The current study aimed to compare the benefits of topical and
low-dose systemic tranexamic acid administration in pediatric cardiac
surgery. <br/>Method(s): A total of 117 children undergoing cardiac
surgery for congenital heart disease were assigned into three groups.
Patients in the systemic group received 20 mg/kg^-1 tranexamic
acid through the cardiopulmonary bypass followed by another dose of 20
mg/kg^-1 after cardiopulmonary bypass separation. Patients in
the topical group were administered with 50 mg/kg^-1 tranexamic
acid poured into the pericardium, while the control group received no
antifibrinolytics. The outcome measures of bleeding and blood products
transfusion were recorded over the first 48 h postoperatively.
<br/>Result(s): Chest tube drainage was significantly lower in both
topical and systemic groups than the control group, but it did not differ
between the case groups. Blood products requirement did not show a
difference between groups. Neurological or thromboembolic events did not
variate among the groups, and no deaths occurred in this study.
<br/>Conclusion(s): Topical or systemic tranexamic acid administration
reduced postoperative blood loss effectively without adding an extra
risk.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<44>
Accession Number
2006801919
Title
Costs of surgical ablation of atrial fibrillation in Ontario, Canada from
2006 to 2017.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Chow J.Y.; McClure G.; Belley-Cote E.P.; McIntyre W.F.; Singal R.K.;
Whitlock R.P.
Institution
(Chow, Belley-Cote, McIntyre) Department of Medicine, McMaster University,
Hamilton, ON, Canada
(McClure) Division of Vascular Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Belley-Cote, McIntyre, Whitlock) Population Health Research Institute,
Hamilton, ON, Canada
(Singal) CVT Associates, Vancouver Island Health Authority, Victoria, BC,
Canada
(Whitlock) Division of Cardiac Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: International guidelines currently recommend concomitant
surgical ablation of atrial fibrillation (AF) in patients with AF
undergoing cardiac surgery. However, a systematic review and meta-analysis
of 23 randomized controlled trials (RCTs) showed no significant difference
in mortality or stroke in patients who underwent surgical AF ablation
compared with those who did not (moderate-quality evidence).
<br/>Method(s): We estimated the Ontario-wide costs of surgical AF
ablation between 2006 and 2017 using data from a systematic review and
meta-analysis of RCTs, estimates of case volumes from Ontario Health
Insurance Plan fee codes, the ongoing left atrial appendage occlusion
study III trial (NCT01561651), institutional costs from large academic
centers in Ontario, as well as professional fees based on the Ontario fee
schedule. Device costs were obtained from Canadian industry data with
expert input. <br/>Result(s): We estimated the average extra cost of
surgical AF ablation at $4,287 CAD (95% CI $4,113-4,619) per patient.
Procedural costs (equipment costs and physician remuneration) comprise
82.2% of this, while smaller portions relate to the increased need for
pacemaker (3.9%) and additional hospital length of stay (13.9%).
Approximately 2,391 patients underwent surgical AF ablation between 2006
and 2017, corresponding to an estimated $10.2 million in incremental cost
during that time span. <br/>Conclusion(s): Ontario taxpayers spend
significant financial resources on surgical ablation of AF, a procedure
lacking high-quality evidence demonstrating benefit in reducing mortality
or stroke. Further large prospective studies examining clinically
important outcomes are needed to justify its routine use in patient care
and to guide allocation of healthcare funds.<br/>Copyright &#xa9; 2020
Wiley Periodicals LLC

<45>
Accession Number
2006799525
Title
Management of the aortic root in type A aortic dissection: A valve sparing
approach.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Mohamed Ahmed E.; Chen E.P.
Institution
(Mohamed Ahmed, Chen) Division of Cardiothoracic Surgery, Department of
Surgery, Emory School of Medicine, Atlanta, GA, United States
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: Type A acute aortic dissection (TAAAD) is rapidly fatal
without emergency repair. Surgical outcomes have improved over the years
with improvements in technique and postoperative care. Classically,
supracomissural aortic replacement has been the standard of care. However,
reintervention rates, particularly on the aortic root in certain groups of
patients, shifted the focus towards improving long-term results of
surgical repair. With regard to the aortic root, root replacement has been
the gold standard. However, the surgical community realized that valve
replacement in itself is a disease, and valve sparing aortic root
replacement (VSRR) took center stage in the care of these patients.
<br/>Method(s): We searched the Pubmed and EMBASE databases for articles
related to VSRR and composite valve conduit (CVC) root replacement, and
the long-term results of these techniques in TAAAD. <br/>Result(s):
Supracomissural repair is limited by reintervention, and CVC results are
affected by complications related to the prosthetic valve. Conversely,
VSRR is associated with good short-term outcomes, improvement in quality
of life, and it is durable. <br/>Conclusion(s): VSRR is a sound technique
in TAAAD in experienced hands.<br/>Copyright &#xa9; 2020 Wiley Periodicals
LLC

<46>
Accession Number
2007682982
Title
The effects of taurine supplementation on obesity, blood pressure and
lipid profile: A meta-analysis of randomized controlled trials.
Source
European Journal of Pharmacology. 885 (no pagination), 2020. Article
Number: 173533. Date of Publication: 15 October 2020.
Author
Guan L.; Miao P.
Institution
(Guan) Gastroenterology Department, The First Hospital of China Medical
University, No.155 North Nanjing Street Heping District, Shenyang,
Liaoning 110001, China
(Miao) General Surgery Department, The First Hospital of China Medical
University, No.155 North Nanjing Street Heping District, Shenyang,
Liaoning 110001, China
Publisher
Elsevier B.V. (Netherlands)
Abstract
Taurine plays a pivotal role in regulating glucose and lipid metabolism,
blood pressure homeostasis, and obesity largely due to its cytoprotective,
antioxidant, and anti-inflammatory actions. Despite promising data from
animal studies in this scenario, the efficacy of taurine supplementation
in human studies has been inconsistent. The main objective of this
meta-analysis was to appraise the effects of taurine supplementation on
liver markers and, secondarily, to explore anthropometric measures as
well. Pubmed, SCOPUS, Web of Science, and Google Scholar were searched
from inception to April 2020. There were 12 eligible peer-reviewed studies
meeting the inclusion criteria. Most studies were conducted in patients
with liver or metabolic dysregulation (diabetes, hepatitis, fatty liver,
obesity, cystic fibrosis, chronic alcoholism, and cardiac surgery). The
taurine dosage varied from 0.5 to 6 g/d for 15 days to 6 months. Pooled
effect sizes suggested a significant effect of taurine administration on
systolic blood pressure (weighted mean difference (WMD): -4.67 mm Hg;
95%CI, -9.10 to -0.25), diastolic blood pressure (WMD: -2.90 mm Hg; 95%CI,
-4.29 to -1.52), total cholesterol (WMD: -10.87 mg/dl; 95%CI, -16.96 to
-4.79), and triglycerides (WMD: -13.05 mg/dl; 95%CI, -25.88 to -0.22);
however, it had no effect on fasting blood glucose (WMD: 0.06 mg/dl),
HDL-C (WMD: 0.90 mg/dl), LDL-C (WMD: -6.17 mg/dl), as well as on body mass
index (WMD: -0.46 kg/m²) and body weight (WMD: -0.47 kg) as the
anthropometric measures. These findings indicate that, in patients with
liver dysregulation, taurine supplementation can lower blood pressure and
improve the lipid profile by reducing total cholesterol and triglyceride
levels.<br/>Copyright &#xa9; 2020 Elsevier B.V.

<47>
Accession Number
2007560653
Title
Meta-Analysis of the Effect of Percutaneous Coronary Intervention on Death
and Myocardial Infarction in Patients With Stable Coronary Artery Disease
and Inducible Myocardial Ischemia.
Source
American Journal of Cardiology. 133 (pp 171-174), 2020. Date of
Publication: 15 October 2020.
Author
Radaideh Q.; Osman M.; Kheiri B.; Al-Abdouh A.; Barbarawi M.; Bachuwa G.;
Tamis-Holland J.E.; Shammas N.W.; Boden W.E.
Institution
(Radaideh) Division of Internal Medicine, University of Iowa Hospitals and
Clinics, Iowa City, IA, United States
(Osman) Division of Cardiology, West Virginia University School of
Medicine, Morgantown, WV, United States
(Kheiri) Knight Cardiovascular Institute, Oregon Health & Science
University, Portland, OR, United States
(Al-Abdouh) Department of Medicine, Saint Agnes Hospital, Baltimore, MD,
United States
(Barbarawi, Bachuwa) Department of Internal Medicine, Hurley Medical
Center/Michigan State University, Flint, MI, United States
(Tamis-Holland) Division of Cardiology, Department of Medicine, Mount
Sinai Saint Luke's Hospital, New York, NY, United States
(Radaideh, Shammas) Midwest Cardiovascular Research Foundation, Davenport,
IA, United States
(Boden) VA New England Health Care System, Boston University School of
Medicine, Boston, MA, United States
Publisher
Elsevier Inc. (E-mail: sinfo-f@elsevier.com)
Abstract
Background. There has been a continuous debate about the survival benefit
of percutaneous coronary intervention (PCI) for the management of patients
with stable ischemic heart disease (SIHD) and moderate to severe ischemia.
In this study we aimed to summarize the currently available evidence from
randomized controlled trials (RCTs) on PCI versus medical therapy (MT) for
patients with SIHD.Methods. An electronic database search was conducted
for RCTs that compared PCI on top of MT versus MT alone. A random effects
model was used to calculate relative risk (RR) and 95% confidence
intervals (CIs).Results. A total of 7 RCTs with 10,043 patients with a
mean age of 62.54 +/- 1.56 years and a median follow up of 3.9 years were
identified. Among patients with SIHD and moderate to severe ischemia by
stress testing, PCI didn't show any benefit for the primary outcome of
all-cause mortality compared to MT(RR = 0.85; 95% CI 0.646-1.12; p =
0.639). There was also no benefit in cardiovascular (CV) death (RR = 0.88;
95% CI 0.71-1.09; p = 0.18) or myocardial infarction (MI) (RR = 0.271; 95%
CI 0.782-1.087; P = 0.327) in the PCI group as compared to MT.Conclusion.
Among patients with SIHD and evidence of moderate to severe ischemia by
stress testing, PCI on top of MT appears to add no mortality benefit as
compared to with MT alone.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<48>
Accession Number
2006117474
Title
Exercise echocardiography in aortic stenosis with preserved ejection
fraction.
Source
Anatolian Journal of Cardiology. 23 (6) (pp 312-317), 2020. Date of
Publication: June 2020.
Author
Postolache A.; Trung M.-L.N.; Tridetti J.; Sperlongano S.; Chitroceanu
A.M.; Dulgheru R.; Lancellotti P.
Institution
(Postolache, Trung, Tridetti, Dulgheru, Lancellotti) Department of
Cardiology and Cardiovascular Surgery, GIGA Cardiovascular Sciences, CHU
SartTilman, University of Liege Hospital, Liege, Belgium
(Sperlongano) Unit of Cardiology, Department of Translational Medical
Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital,
Naples, Italy
(Chitroceanu) Unit of Cardiovascular Research, University and Emergency
Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest,
Romania
(Lancellotti) Gruppo Villa Maria Care and Research, Maria Cecilia
Hospital, Cotignola, Anthea Hospital, Bari, Italy
Publisher
Turkish Society of Cardiology (E-mail: kareyayincilik@gmail.com)
Abstract
The appropriate timing of intervention and follow-up in asymptomatic
patients with aortic stenosis remains controversial. Risk stratification
is a key, especially with the use of a multimodality imaging approach,
including exercise stress echocardiography. This review focuses on the use
of exercise echocardiography in asymptomatic patients with moderate and
severe aortic stenosis with preserved left ventricular ejection fraction.
It describes the exercise echocardiography protocol, parameters to be
evaluated, and its role in guiding the timing of intervention and
follow-up in these patients.<br/>&#xa9; Copyright 2020 by Turkish Society
of Cardiology

<49>
Accession Number
632134775
Title
Comparing sedation vs. general anaesthesia in transoesophageal
echocardiography-guided percutaneous transcatheter mitral valve repair: A
meta-analysis.
Source
European Heart Journal Cardiovascular Imaging. 21 (5) (pp 511-521), 2020.
Date of Publication: 01 May 2020.
Author
Banga S.; Hafiz A.M.; Chami Y.; Gumm D.C.; Banga P.; Howard C.; Kim M.;
Sengupta P.P.
Institution
(Banga, Sengupta) Division of Cardiology, West Virginia University School
of Medicine, 1 Medical Center Drive, Morgantown, WV, United States
(Hafiz, Chami) Division of Cardiology, Southern Illinois University School
of Medicine, Springfield, IL, United States
(Gumm) Division of Cardiology, University of Illinois College of Medicine
at Peoria, OSF Saint Francis Medical Center, Peoria, IL, United States
(Banga) University of Illinois College of Medicine at Peoria, OSF Saint
Francis Medical Center, Peoria, IL, United States
(Howard) Library of the Health Sciences at Peoria, University of Illinois
at Chicago, Peoria, IL, United States
(Kim) Center of Outcomes Research, Department of Internal Medicine,
University of Illinois College of Medicine at Peoria, Peoria, IL, United
States
Publisher
Oxford University Press (E-mail: jnls.cust.serv@oupjournals.org)
Abstract
Aims: Transoesophageal echocardiography-guided percutaneous transcatheter
mitral valve repair (TOE-guided PMVR) using edge-to-edge leaflet plication
is typically performed under general anaesthesia (GA). Increasing evidence
supports the efficacy and safety of PMVR performed under conscious
sedation (CS) or deep sedation (DS). We performed a meta-analysis
comparing safety and efficacy of CS/DS vs. GA in PMVR. <br/>Methods and
Results: A comprehensive search was performed using PubMed, CINAHL, Ovid
MEDLINE, Embase, and the Cochrane Library. Study characteristics,
participant demographics, and procedural outcomes with both types of
anaesthesia were analysed. Out of 73 articles, five met inclusion
criteria. Overall, there was no significant difference in the primary
outcome of procedural success rate [odds ratio (OR) 0.75; 95% confidence
interval (CI) 0.30-1.88, I²= 0.0%, P = 0.538] or post-procedure
in-hospital mortality (OR 1.02; 95% CI 0.38-2.71, I²= 0.0%, P =
0.970) in the patients undergoing PMVR under CS/DS vs. GA. The secondary
endpoint of intensive care unit (ICU) length of stay (LOS) was
significantly shorter in patients under CS/DS vs. GA (standardized mean
difference, SMD = -0.97; 95% CI -1.75 to -0.20; P = 0.014), but the
hospital LOS (SMD = 0.36; 95% CI -0.77 to 0.04, P = 0.078) did not show a
statistically significant difference between the groups, although it was
shorter in the CS/DS group. No difference was observed between CS/DS and
GA in fluoroscopy time, procedure time, or complications, including
pneumonia, stroke/transient ischaemic attack, and major bleeding.
<br/>Conclusion(s): CS or DS has lower ICU LOS, but comparable procedural
success rate and in-hospital mortality, making it a potential alternative
to GA for TOE-guided PMVR.<br/>Copyright &#xa9; 2020 Published on behalf
of the European Society of Cardiology. All rights reserved.

<50>
Accession Number
632810945
Title
Effect of Intramyocardial Grafting Collagen Scaffold with Mesenchymal
Stromal Cells in Patients with Chronic Ischemic Heart Disease: A
Randomized Clinical Trial.
Source
JAMA Network Open. 3 (9) (no pagination), 2020. Article Number: e2016236.
Date of Publication: September 2020.
Author
He X.; Wang Q.; Zhao Y.; Zhang H.; Wang B.; Pan J.; Li J.; Yu H.; Wang L.;
Dai J.; Wang D.
Institution
(He, Wang, Zhang, Pan, Wang) Department of Thoracic and Cardiovascular
Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical
School, 321 Zhongshan Rd, Nanjing 210008, China
(Zhao, Dai) Key Laboratory of Molecular Developmental Biology, Institute
of Genetics and Developmental Biology, Chinese Academy of Sciences,
Beijing 100101, China
(Wang, Wang) Center for Clinical Stem Cell Research, Affiliated Drum Tower
Hospital of Nanjing University Medical School, Nanjing, China
(Li) Department of Cardiology, Affiliated Drum Tower Hospital of Nanjing
University Medical School, Nanjing, China
(Yu) Department of Radiology, Affiliated Drum Tower Hospital of Nanjing
University Medical School, Nanjing, China
Publisher
American Medical Association (E-mail: shirley.martin@ama-assn.org)
Abstract
Importance: Cell therapy may be helpful for cardiac disease but has been
fraught with poor cell retention and survival after transplantation.
<br/>Objective(s): To determine whether cell-laden hydrogel treatment is
safe and feasible for patients with chronic ischemic heart disease (CIHD).
<br/>Design, Setting, and Participant(s): This randomized, double-blind
clinical trial was conducted between March 1, 2016, and August 31, 2019,
at a single hospital in Nanjing, China. Among 115 eligible patients with
CIHD, 50 patients with left ventricular ejection fraction of 45% or less
were selected to receive elective coronary artery bypass grafting (CABG)
and additionally randomized to cell-plus-collagen treatment (collagen/cell
group), cell treatment alone (cell group), or a control group. Sixty-five
patients were excluded because of severe comorbidities or unwillingness to
participate. Forty-four participants (88%) completed the study. The last
patient completed 12 months of follow-up in August 2019. Analyses were
prespecified and included all patients with available data.
<br/>Intervention(s): During CABG, patients in the collagen/cell group
were treated with human umbilical cord-derived mesenchymal stromal cell
(hUC-MSC)-laden collagen hydrogel intramyocardial injection, and the cell
group was treated with hUC-MSCs alone. Patients in the control group
underwent CABG alone. <br/>Main Outcomes and Measures: The primary outcome
was safety of the cell-laden collagen hydrogel assessed by the incidence
of serious adverse events. The secondary end point was the efficacy of
treatment, according to cardiovascular magnetic resonance imaging-based
left ventricular ejection fraction and infarct size. <br/>Result(s): Fifty
patients (mean [SD] age, 62.6 [8.3] years; 38 men [76%]) were enrolled, of
whom 18 were randomized to the collagen/cell group, 17 to the cell group,
and 15 to the control group. Patient characteristics did not differ among
groups at baseline. For the primary end point, no significant differences
in serious adverse events, myocardial damage markers, and renal or liver
function were observed among all groups after treatment; the collagen/cell
and cell groups each had 1 case of hospitalization because of heart
failure, and no serious adverse events were seen in the control group. At
12 months after treatment, the mean infarct size percentage change
was-3.1% (95% CI,-6.20% to-0.02%; P =.05) in the collagen/cell group,
5.19% (-1.85% to 12.22%, P =.35) in the cell group, and 8.59% (-3.06% to
20.25%, P =.21) in the control group. <br/>Conclusions and Relevance: This
study provides, to our knowledge, the first clinical evidence that the use
of collagen hydrogel is safe and feasible for cell delivery. These
findings provide a basis for larger clinical studies. Trial Registration:
ClinicalTrials.gov Identifier: NCT02635464.<br/>Copyright &#xa9; 2020
American Medical Association. All rights reserved.

<51>
Accession Number
632514286
Title
Effect of dexmedetomidine on attenuation of hemodynamic response to
intubation, skin incision, and sternotomy in coronary artery bypass graft
patients: A double-blind randomized control trial.
Source
Journal of Anaesthesiology Clinical Pharmacology. 36 (2) (pp 255-260),
2020. Date of Publication: April-June 2020.
Author
Kamal M.; Agarwal D.; Singariya G.; Kumari K.; Paliwal B.; Ujwal S.
Institution
(Kamal, Agarwal, Kumari, Paliwal) Department of Anaesthesiology and
Critical Care, All India Institute of Medical Sciences, Jodhpur,
Rajasthan, India
(Singariya, Ujwal) Department of Anaesthesiology and Critical Care, Dr S N
Medical College, 123, Vaishali Avenue, Jhanwar Road, Jodhpur, Rajasthan
342008, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Coronary artery bypass grafting (CABG) surgery
involves various noxious stimuli resulting in stress response, which in
turn increases the risk of perioperative myocardial ischemia. The present
study was conducted to evaluate the effect of dexmedetomidine on the
attenuation of hemodynamic response to intubation, skin incision, and
sternotomy in CABG surgery. <br/>Material(s) and Method(s): Sixty patients
were randomized into two groups of 30 each. Group D patients received
dexmedetomidine 1 micro&#32;g/kg as loading dose over 10 min, followed by
continuous infusion of 0.5 micro&#32;g/kg/h. In group P, normal saline was
infused as loading and maintenance dose at similar rate. Hemodynamic
parameters, total induction dose of thiopentone, and adverse effects were
recorded. Statistical analysis was performed using SPSS version 20.0.
Chi-square test and ANNOVA test were used and P < 0.05 was considered
significant. <br/>Result(s): The percentage increase in heart rate was
significantly lesser in group D than group P after intubation (7.04% v/s
15.08%), skin incision (5.91% v/s 10.11%), and sternotomy (5.33% v/s
11.65%). Similarly increase in systolic, diastolic, and mean blood
pressure were significantly lesser in group D than group P after
intubation, skin incision, and sternotomy. There was a significant
reduction of mean total of thiopentone in group D in comparison to group
P. (1.16 mg/kg v/s 2.44 mg/kg) (P< 0.001). <br/>Conclusion(s):
Dexmedetomidine resulted in significant attenuation of hemodynamic
response to intubation, skin incision, and sternotomy in CABG surgery
without significant adverse effects. It also significantly reduced the
dose of thiopentone required for induction.<br/>Copyright &#xa9; 2020
Journal of Anaesthesiology Clinical Pharmacology <br/> Published by
Wolters Kluwer-Medknow.

<52>
Accession Number
2007885047
Title
Intraoperative Remifentanil Infusion and Postoperative Pain Outcomes After
Cardiac Surgery-Results from Secondary Analysis of a Randomized,
Open-Label Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Subramaniam K.; Ibarra A.; Ruppert K.; Mallikarjun K.; Orebaugh S.
Institution
(Subramaniam, Ibarra, Orebaugh) Department of Anaesthesiology and
Perioperative Medicine, University of Pittsburgh Medical Center,
Pittsburgh, United States
(Ruppert) Department of Epidemiology, Clinical and Translational Science
Institute, University of Pittsburgh, Pittsburgh, United States
(Mallikarjun) St Louis School of Medicine, Washington University, St
Louis, MO, United States
Publisher
W.B. Saunders
Abstract
Design: Report of secondary pain outcomes from a prospective, randomized,
open-label clinical trial that compared remifentanil and fentanyl on
perioperative hyperglycemic response in cardiac surgery. <br/>Setting(s):
Single institution, tertiary university hospital. <br/>Participant(s): The
study comprised 116 adult elective cardiac surgical patients.
<br/>Intervention(s): Participants were randomly assigned to receive
either intermittent fentanyl boluses (F) or continuous remifentanil
infusion (R) intraoperatively. <br/>Measurements and Main Results:
Postoperative pain was evaluated with pain scores every 6 hours for 48
hours. Pain threshold to mechanical stimuli was measured around the
sternotomy incision at 48 and 96 hours. The development of chronic pain
was assessed using the numeric rating scale at 1, 3, 6, and 12 months
after discharge. The final analysis included 106 patients. Pain scores and
wound hyperalgesia were not significantly different postoperatively
between the groups. The incidence of chronic pain at 3 months was
comparable in both groups (61% in group F v 58% in group R; p = 0.79).
Pain of more-than-mild degree was seen in 13 (32%) patients in group F and
8 (19%) in group R (p = 0.25) at 3 months. Median pain scores were not
significantly different between the groups at 1, 3, 6, and 12 months after
discharge from the hospital. <br/>Conclusion(s): The present study's
findings suggested that intraoperative remifentanil infusion does not
significantly worsen pain outcomes in patients undergoing elective cardiac
surgery.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<53>
Accession Number
2007884736
Title
Sugammadex for Fast-Track Surgery in Children Undergoing Cardiac Surgery:
A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Li L.; Jiang Y.; Zhang W.
Institution
(Li) Department of Anesthesiology, Wenzhou Central Hospital, Wenzhou,
China
(Jiang) Department of Anesthesiology, Shanghai Children's Hospital,
Shanghai Jiao Tong University, Shanghai, China
(Zhang) Department of Anesthesiology, Women and Children's Hospital of
Jiaxing University, Jiaxing, China
Publisher
W.B. Saunders
Abstract
Objective: The purpose of this study was to evaluate the safety and
efficacy of sugammadex for fast-track surgery in children undergoing
cardiac surgery. <br/>Design(s): This was a prospective, randomized,
controlled clinical study. <br/>Setting(s): University hospital.
<br/>Participant(s): The study comprised 60 children undergoing cardiac
surgery. <br/>Intervention(s): The children in group S received
sugammadex, 4 mg/kg, for reversal of neuromuscular block, and the children
in group N received neostigmine, 30 micro&#32;g/kg, and atropine, 15
micro&#32;g/kg. <br/>Measurements and Main Results: The recovery time to a
train-of-four of 0.9 and extubation time were significantly shorter in the
group S than in group N (3.4 +/- 1.2 min v 76.2 +/- 20.5 min and 31.0 +/-
6.4 min v 125.2 +/- 21.6 min, respectively; p < 0.01). The heart rate
after drug administration was higher in group S than in group N (102.7 +/-
9.4 beats/min v 96.9 +/- 8.5 beats/min; p = 0.03), whereas the mean
arterial pressure after drug administration was similar in both groups.
The length of hospital stay was shorter in group S (5.8 +/- 1.0 v 6.5 +/-
0.9 days; p = 0.03), and the hospitalization expenses were decreased in
group S compared with that of group N ($1,036 +/- $114 v $1,286 +/- $187;
p < 0.01). The incidence of postoperative atelectasis was less in group S
than in group N (0 v 20%; p = 0.024). <br/>Conclusion(s): Sugammadex can
shorten the extubation time and reduce the incidence of postoperative
atelectasis, with fewer adverse events, in children undergoing cardiac
surgery. It may be beneficial to use sugammadex for fast-track surgery in
children undergoing cardiac surgery.<br/>Copyright &#xa9; 2020 Elsevier
Inc.

<54>
Accession Number
632410246
Title
Coronary Subclavian Steal Syndrome: A Contemporary Review.
Source
Cardiology (Switzerland). 145 (9) (pp 601-607), 2020. Date of Publication:
01 Sep 2020.
Author
Lak H.M.; Shah R.; Verma B.R.; Roselli E.; Caputo F.; Xu B.
Institution
(Lak, Verma) Department of Medicine, Cleveland Clinic, Cleveland, OH,
United States
(Shah, Xu) Department of Cardiovascular Medicine Heart, Vascular and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Roselli) Department of Thoracic and Cardiovascular Surgery, Heart,
Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United
States
(Caputo) Department of Vascular Surgery, Heart, Vascular and Thoracic
Institute, Cleveland Clinic, Cleveland, OH, United States
(Xu) Section of Cardiovascular Imaging, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Miller Family
Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid
Avenue, Cleveland, OH 44195, United States
Publisher
S. Karger AG
Abstract
Coronary subclavian steal syndrome (CSSS) is a rare cause of angina. It
occurs in patients with prior coronary artery bypass grafting and,
specifically, a left internal mammary artery (LIMA) to left anterior
descending artery (LAD) graft and co-existent significant subclavian
artery stenosis. In this context, there is retrograde blood flow through
the LIMA to LAD graft to supply the subclavian artery beyond the
significant stenosis. This potentially occurs at the cost of compromising
coronary artery perfusion dependent on the LIMA graft. In this review, we
present a case of a middle-aged female who suffered from CSSS and review
the literature for the contemporary diagnosis and management of this
condition.<br/>Copyright &#xa9; 2020 S. Karger AG, Basel. All rights
reserved.

<55>
Accession Number
631984938
Title
Effect of Music Therapy on the Chronic Pain and Midterm Quality of Life of
Patients after Mechanical Valve Replacement.
Source
Annals of thoracic and cardiovascular surgery : official journal of the
Association of Thoracic and Cardiovascular Surgeons of Asia. 26 (4) (pp
196-201), 2020. Date of Publication: 20 Aug 2020.
Author
Lin Z.-W.; Huang S.-T.; Xu N.; Cao H.; Chen L.-W.; Chen Q.
Institution
(Lin, Huang, Xu, Cao, Chen) Department of Cardiac Surgery, Fujian
Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical
University, Fuzhou, China
(Lin, Huang, Xu, Chen, Chen) Department of Cardiovascular Surgery, Union
Hospital, Fujian Medical University, Fuzhou, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the effect of music therapy on the chronic pain and
midterm quality of life of patients after mechanical valve replacement.
<br/>METHOD(S): Patients were divided into two groups according to whether
or not they received music therapy. The patients in the music group
received 30 minutes of music therapy every day for 6 months after the
operation. The patients in the control group received standard treatment
and had 30 minutes of quiet rest time every day in the same period. The
short-form of McGill Pain Questionnaire (SF-MPQ) was used to evaluate the
degree of postoperative chronic pain, and the SF-36 was used to evaluate
the midterm quality of life of patients. <br/>RESULT(S): In terms of the
degree of postoperative chronic pain, the score of the pain rating index
(PRI) emotional item in the music group was significantly lower than that
in the control group. In the evaluation of the postoperative midterm
quality of life using the SF-36, the emotional function score in the music
group was significantly higher than that in the control group.
<br/>CONCLUSION(S): This study preliminarily showed that music therapy can
effectively reduce chronic pain and improve midterm quality of life after
surgery.

<56>
Accession Number
2006772498
Title
Transcatheter or surgical aortic valve implantation in chronic dialysis
patients: a German Aortic Valve Registry analysis.
Source
Clinical Research in Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Farber G.; Bleiziffer S.; Doenst T.; Bon D.; Boning A.; Weiler H.;
Herrmann E.; Frerker C.; Beckmann A.; Mollmann H.; Ensminger S.;
Bekeredjian R.; Walther T.; Harringer W.; Katus H.A.; Hamm C.W.;
Beyersdorf F.; Bauer T.; Fichtlscherer S.
Institution
(Farber, Doenst) Department of Cardiothoracic Surgery, Jena University
Hospital, Friedrich Schiller University of Jena, Jena, Germany
(Bleiziffer) Clinic for Thoracic and Cardiovascular Surgery, Heart and
Diabetes Centre North Rhine Westphalia, Bad Oeynhausen, Germany
(Bon, Herrmann) Institute of Biostatistics and Mathematical Modelling,
Goethe University Frankfurt, Frankfurt am Main, Germany
(Bon, Herrmann) German Center for Cardiovascular Research, DZHK, Partner
Site Rhein-Main, Frankfurt am Main, Germany
(Boning, Bauer) Department of Cardiology, University of Giessen, Giessen,
Germany
(Weiler, Fichtlscherer) Department of Cardiology, University Hospital
Frankfurt am Main, Frankfurt, Germany
(Frerker) Department of Internal Medicine III, University of Cologne,
Cologne, Germany
(Beckmann) German Society of Thoracic, Cardiac and Vascular Surgery
(Deutsche Gesellschaft fur Thorax-, Herz- und Gefaschirurgie, DGTHG),
Berlin, Germany
(Mollmann) Department of Cardiology, St.-Johannes-Hospital Dortmund,
Dortmund, Germany
(Ensminger) Department of Cardiac Surgery, University of Lubeck, Lubeck,
Germany
(Bekeredjian) Department of Cardiology, Robert-Bosch-Krankenhaus,
Stuttgart, Germany
(Walther) Department of Cardiothoracic Surgery, University Hospital
Frankfurt, Frankfurt, Germany
(Harringer) Clinic for Cardiac, Thoracic and Vascular Surgery, Klinikum
Braunschweig gGmbH, Brunswick, Germany
(Katus) Department of Cardiology, University Hospital Heidelberg,
Heidelberg, Germany
(Hamm) Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad
Nauheim, Germany
(Beyersdorf) Department of Cardiovascular Surgery, Faculty of Medicine,
Heart Centre Freiburg University, Freiburg, Germany
(Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University of Jena, Am Klinikum 1, Jena 07747, Germany
Publisher
Springer Science and Business Media Deutschland GmbH (E-mail:
info@springer-sbm.com)
Abstract
Objectives: The aim of this study was to compare outcomes of transcatheter
and surgical aortic valve implantation in chronic dialysis patients with
aortic valve stenosis (AS). <br/>Background(s): Chronic dialysis patients
undergoing heart valve surgery are at higher risk for morbidity and
mortality. Whether interventional techniques can reduce this risk is
unclear because dialysis patients have thus far been excluded from
randomized trials. <br/>Method(s): Chronic dialysis patients with AS
enrolled in the German Aortic Valve Registry (GARY) between 2012 and 2015
were analyzed to compare transcatheter aortic valve implantation (TAVI n =
661) with surgical aortic valve replacement (SAVR n = 457). Propensity
scores for inverse probability of treatment weighting (IPTW) were used to
adjust the comparison of the two treatment groups for potential
confounders. <br/>Result(s): TAVI patients were older (78 +/- 7.3 vs. 69
+/- 10.2 years, p < 0.01, unadjusted) and had more comorbidities.
Mortality at 1 year was the same (TAVI: 33.4% vs. SAVR 35.0%, p = 0.72,
IPTW-adjusted) while it was lower with TAVI at 30 days (8.6% vs. 15.0%, p
= 0.02, IPTW-adjusted). TAVI patients required more pacemaker implantation
and showed more aortic regurgitation. SAVR patients required more blood
transfusions and had longer hospital stay. Diabetes mellitus, atrial
fibrillation, previous PCI, urgent procedure and EuroSCORE were associated
with elevated 30-day mortality. Atrial fibrillation and older age were
independent risk factor of 1-year mortality in both groups.
<br/>Conclusion(s): Chronic dialysis patients with AS undergoing TAVI or
SAVR had the same 1-year mortality, although survival at 30 days was
better with TAVI. These results suggest that TAVI may improve
peri-procedural outcomes.<br/>Copyright &#xa9; 2020, Springer-Verlag GmbH
Germany, part of Springer Nature.

<57>
Accession Number
2006763491
Title
Comparison of postoperative outcomes following multidetector computed
tomography based vs transesophageal echocardiography based annulus sizing
for transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Echocardiography. (no pagination), 2020. Date of Publication: 2020.
Author
Tang G.; Lv Q.; He X.
Institution
(Tang, Lv, He) Department of Echocardiography, The Affiliated Hospital of
Qingdao University, Qingdao, China
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: The purpose of this paper was to evaluate the difference in
postoperative outcomes following multidetector computed tomography (MDCT)
and transesophageal echocardiography (TEE)-based annulus sizing for
transcatheter aortic valve replacement (TAVR). <br/>Method(s): Electronic
search of PubMed, Biomed Central, Scopus, and Google Scholar databases was
conducted until August 15, 2019. We included all types of studies
comparing MDCT-based annulus sizing with TEE-based annulus sizing and
assessing paravalvular regurgitation (PVR). Data were summarized using the
Mantel-Haenszel odds ratio (OR) with 95% confidence intervals (CI).
<br/>Result(s): A total of six studies were included. Pooled analysis of
431 participants in the MDCT group and 509 participants in the TEE group
demonstrated that MDCT-based annulus sizing is associated with a
significantly lower incidence of more than moderate PVR as compared to
2DTEE-based sizing (OR: 0.31, 95% CI: 0.18-0.54, P <.0001; I² =
0%). There was no statistical difference in annulus rupture (OR: 0.57, 95%
CI: 0.12-2.66, P =.91; I² = 0%), procedural mortality (OR:
0.97, 95% CI: 0.19-4.86, P =.97; I² = 0%), and 30-day mortality
(OR: 0.63, 95% CI: 0.26-1.50, P =.29; I² = 0%) with MDCT or
2DTEE-based annulus sizing. Compared with 3DTEE, the incidence of PVR in
the MDCT group was lower, but there was no statistical difference in
30-day mortality. <br/>Conclusion(s): Use of MDCT in comparison with 2DTEE
is associated with significantly lower incidence of more than moderate PVR
after TAVR. There seems to be no difference in annulus rupture and 30-day
mortality with either imaging modality.<br/>Copyright &#xa9; 2020 The
Authors. Echocardiography published by Wiley Periodicals LLC

<58>
Accession Number
632942474
Title
Radiofrequency ablation of left atrium in patients with mitral valve
replacement. the future of surgical treatment for atrial fibrillation in
mitral valve disease?.
Source
Europace. Conference: Annual Congress of the European Heart Rhythm
Association, EHRA 2020. Austria. 22 (SUPPL 1) (pp i408), 2020. Date of
Publication: June 2020.
Author
Utyasheva A.; Abdulyanov I.V.; Sungatullin M.A.; Vagizov I.I.
Institution
(Utyasheva, Abdulyanov) Kazan Mdical State Academy, Kazan, Russian
Federation
(Sungatullin, Vagizov) Interregional Clinico-Diagnostic Center, Kazan,
Russian Federation
Publisher
Oxford University Press
Abstract
Aims: The evaluation of sinus rhythm preservation after surgical treatment
of atrial fibrillation by left-atrial RFA in patients with mitral valve
prosthetics. <br/>Material(s) and Method(s): A prospective, randomized
study was performed in the interregional clinical and diagnostic center of
Kazan in 2011-2018 which were included 136 patients with mitral valve
pathology and persistent AF. The average age of patients was 57 +/- 5, the
gender division was dominated by female patients and made up 97 (58.4%).
All patients underwent either mitral valve prosthesis with mechanical
prosthesis Meding-2 which made up 96 (70.5%) or biological prosthesis
Carpantier-Edwards which made up 40 (29.4%). Radiofrequency isolation of
the left atrium and pulmonary veins was performed by standard procedure by
Cox-IV which doesn't include the right atrium tissue. Results and
discussion: In the early post surgical period, recovery of sinus rhythm
was observed in 111 (81.6%) patients. Cardiac Pacemaker Implantation was
performed in 1 (0.73%) case. The results of the study were assessed after
surgical treatment in 22 +/- 5 months, the sinus rhythm was preserved in
99 patients from the study group and made up 72.7%. <br/>Conclusion(s):
Radiofrequency ablation the left atrium provides long-term preservation of
sinus rhythm in the treatment of patients with atrial fibrillation and
mitral valve pathology.

<59>
Accession Number
2007931132
Title
Effect of acute normovolemic hemodilution on coronary artery bypass
grafting: A systematic review and meta-analysis of 22 randomized trials.
Source
International Journal of Surgery. 83 (pp 131-139), 2020. Date of
Publication: November 2020.
Author
Li S.; Liu Y.; Zhu Y.
Institution
(Li) Department of Anesthesiology, Jingzhou Central Hospital, Jingzhou
434020, China
(Liu, Zhu) Department of Anesthesia, Chongqing Emergency Medical Center
(Chongqing University Central Hospital), Chongqing 400014, China
Publisher
Elsevier Ltd
Abstract
Background: Efficacy of minimal acute normovolemic hemodilution (ANH) in
avoiding homologous blood transfusion during cardiovascular surgery
remains controversial. Postoperative bleeding and transfusion remain a
source of morbidity and cost after open heart operations. To better
understand the role of acute normovolemic hemodilution (ANH) in coronary
artery bypass grafting (CABG), we compared ANH with standard
intraoperative care in a systematic review including a standard pairwise
meta-analysis of randomized controlled trials (RCTs). <br/>Method(s): We
searched the Cochrane Library, PubMed, EMBASE, Web of Science and Chinese
National Knowledge Infrastructure (CNKI) up to April 1, 2020. The primary
outcome was to assess the incidence of ANH-related number of allogeneic
red blood cell units (ARBCu) transfused. Secondary outcomes included the
rate of allogeneic blood transfusion and estimated total blood loss.
<br/>Result(s): A total of 22 RCTs including 1688 patients were identified
for the present meta-analysis. Of these studies, 19 were about CABG with
on-pump and three with off-pump. Our pooled result indicated that patients
received ANH experienced fewer ARBCu transfusions, with a standardized
mean difference (SMD) of -0.60 (95%CI -0.96 to -0.24; P = 0.001). The rate
of allogeneic blood transfusion in ANH group was significant reduced when
compared with controls, with a relative risk (RR) of 0.65 (95%CI 0.52 to
0.82; P = 0.0002). In addition, less postoperative estimated total blood
loss was present, with a SMD of -0.53 (95%CI -0.88 to -0.17; P = 0.004).
<br/>Conclusion(s): The present meta-analysis indicated that ANH could
reduce the number of ARBCu transfused in the CABG surgery setting. In
addition, ANH could also reduce the rate of ARBCu transfusion and
estimated total blood loss for CABG patients.<br/>Copyright &#xa9; 2020
IJS Publishing Group Ltd

<60>
Accession Number
632958975
Title
Effects of different mean arterial pressure targets on plasma volume, ANP
and glycocalyx - A randomised trial.
Source
Acta anaesthesiologica Scandinavica. (no pagination), 2020. Date of
Publication: 23 Sep 2020.
Author
Damen T.; Saadati S.; Forssell-Aronsson E.; Hesse C.; Bentzer P.; Ricksten
S.-E.; Nygren A.
Institution
(Damen, Ricksten, Nygren) Department of Anaesthesiology and Intensive Care
Medicine, Institute of Clinical Sciences at the Sahlgrenska Academy,
University of Gothenburg, Sahlgrenska University Hospital, Section of
Cardiothoracic Anaesthesia and Intensive Care, Gothenburg, Sweden
(Saadati, Forssell-Aronsson) Department of Radiation Physics, Institute of
Clinical Sciences, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Forssell-Aronsson) Department of Medical Physics and Biomedical
Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
(Hesse) Department of Laboratory Medicine, Institute of Biomedicine,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Bentzer) Department of Anaesthesia and Intensive Care, Helsingborg
Hospital, Helsingborg and Lund University, Helsingborg, Sweden
(Bentzer) Department of Clinical Sciences, Anaesthesiology, Lund
University, Lund, Sweden
Publisher
NLM (Medline)
Abstract
BACKGROUND: Arterial haematocrit (Hct) has been shown to decrease after
anaesthesia induction, most probably because of an increased plasma volume
(PV). The primary objective was to quantify change in PV if mean arterial
pressure (MAP) was kept at baseline level or allowed to decrease to 60
mmHg. Our secondary objective was to evaluate underlying mechanisms of
this response. <br/>METHOD(S): Twenty-four coronary artery bypass patients
were randomised to a higher (90 mmHg, intervention group) or lower (60
mmHg, control group) MAP by titration of norepinephrine. During the
experimental procedure, no fluids were administered. Baseline PV was
measured by 125 I-albumin and the change in PV was calculated from the
change in Hct. Changes in MAP, plasma 125 I-albumin, colloid osmotic
pressure, albumin, Mid Regional-pro Atrial Natriuretic Peptide (MR-proANP)
and endothelial glycocalyx components were measured from baseline to 50
min after anaesthesia induction. <br/>RESULT(S): The MAP during the trial
was 93 +/- 9 mmHg in the intervention group and 62 +/- 5 mmHg in the
control group. PV increased with up to 420 +/- 180 ml in the control group
and 45 +/- 130 ml in the intervention group (p<0.001). Albumin and colloid
osmotic pressure decreased significantly more in the control group.
MR-proANP increased in the control group but no shedding of the glycocalyx
layer was detected in either of the groups. <br/>CONCLUSION(S): Allowing
mean arterial pressure to fall to 60 mmHg during anesthesia induction,
increases the plasma volume due to reabsorption of interstitial water,
with no ANP-induced degradation of the endothelial
glycocalyx.<br/>Copyright This article is protected by copyright. All
rights reserved.

<61>
Accession Number
632956813
Title
A Randomized Controlled Trial of Prasugrel for Prevention of Early
Saphenous Vein Graft Thrombosis.
Source
The Journal of invasive cardiology. (no pagination), 2020. Date of
Publication: 22 Sep 2020.
Author
Danek B.A.; Karatasakis A.; Abdullah K.; Iwnetu R.; Kalsaria P.; Shunk K.;
Zimmet J.; Vidovich M.; Bavry A.A.; Rangan B.V.; Roesle M.; Griza D.;
Stanley K.; Banerjee S.; Khalili H.; Brilakis E.S.; Abdullah S.M.
Institution
(Abdullah) Shuaib Abdullah, MD, Veterans Affairs North Texas Health Care
System, 4500 South Lancaster, 111A, Dallas, TX 75216 USA
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To test whether administration of prasugrel after coronary
artery bypass grafting (CABG) reduces saphenous vein graft (SVG)
thrombosis. Use of aspirin after CABG improves graft patency, but
administration of other antiplatelet agents has yielded equivocal results.
<br/>METHOD(S): We performed a double-blind trial randomizing patients to
prasugrel or placebo after CABG at four United States centers. Almost all
patients were receiving aspirin. Follow-up angiography, optical coherence
tomography (OCT), intravascular ultrasound (IVUS), and near-infrared
spectroscopy (NIRS) were performed at 12 months. The primary efficacy
endpoint was prevalence of OCT-detected SVG thrombus. The primary safety
endpoint was incidence of Global Utilization of Streptokinase and t-PA for
Occluded Coronary Arteries (GUSTO) severe bleeding. <br/>RESULT(S): The
study was stopped early due to slow enrollment after randomizing 84
patients. Mean age was 64 +/- 6 years; 98% of the patients were men.
Follow-up angiography was performed in 59 patients. IVUS was performed in
52 patients, OCT in 53 patients, and NIRS in 33 patients. Thrombus was
identified by OCT in 56% vs 50% of patients in the prasugrel vs placebo
groups, respectively (P=.78). Angiographic SVG failure occurred in 24% of
patients in the prasugrel arm vs 40% in the placebo arm (P=.19). The
1-year incidence of major adverse cardiovascular events was 14.3% vs 2.4%
in the prasugrel and placebo groups, respectively (P=.20), without
significant differences in GUSTO severe bleeding (P=.32).
<br/>CONCLUSION(S): Early SVG failure occurred in approximately one-third
of patients. Prasugrel did not decrease prevalence of SVG thrombus 12
months after CABG.

<62>
Accession Number
632955002
Title
Meta-analysis of Aspirin Monotherapy versus Dual Antiplatelet Therapy
after Transcatheter Aortic Valve Implantation.
Source
The American journal of cardiology. (no pagination), 2020. Date of
Publication: 19 Sep 2020.
Author
Osman M.; Syed M.; Balla S.; Kheiri B.; Golwala H.; Zahr F.
Institution
(Osman, Syed, Balla) Division of Cardiology, West Virginia University
School of Medicine, Morgantown, United States
(Kheiri, Golwala, Zahr) Knight Cardiovascular Institute, Oregon Health and
Science University, OR, Portland, United States
Publisher
NLM (Medline)

<63>
Accession Number
621548319
Title
Arginine vasopressin concentration and chest tube output post-fontan
palliation.
Source
World Journal for Pediatric and Congenital Hearth Surgery. Conference:
Cardiology 2018: 21st Update on Pediatric and Congenital Cardiovascular
Disease. United States. 9 (2) (pp NP65-NP66), 2018. Date of Publication:
March 2018.
Author
Bigelow A.; Ghanayem N.; Thompson N.; Scott J.; Cassidy L.; Hoffman G.
Institution
(Bigelow, Ghanayem, Thompson, Scott, Cassidy, Hoffman) Children's Hospital
of Wisconsin, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Treatments for preventing and managing low-cardiac output
syndrome after congenital heart surgery with car-diopulmonary bypass (CPB)
include preload augmentation, infu-sions of phosphodiesterase inhibitors
and catecholamines with primary goals of increasing systemic perfusion,
and with secondary effects on vasomotor tone. Vasopressin, a vasoactive
drug with efficacy in septic shock, has also been utilized to improve
postoperative hemodynamics after cardiac surgery in children. Vasopressin
is a neurohypopphyseal hormone with diverse actions on water balance,
vasomotor tone, and contractility. Vasopressin concentration and the use
of vasopressin infusion have been described in a number of studies in
various disease states. The aim of our study is to evaluate the impact of
vasopressin and AVP concentration on the early postoperative course in
patients undergoing the Fontan operation. <br/>Method(s): The
Institutional Review Board approved this double-blinded, randomized,
placebo-controlled study of vaso-pressin use in patients undergoing Fontan
palliation. Hemody-namic measures, urinary output, fluid balance, and
chest tube drainage were recorded hourly for 48 hours, and arginine
vaso-pressin (AVP) concentration was obtained at five different times.
Patients undergoing Fontan palliation at Children's Hos-pital of Wisconsin
since January 2017 have been screened for study eligibility. We herein
report preliminary findings of relationship of AVP concentrations to
hemodynamics and fluid balance in the first ten patients. Data are
expressed as median (IQR). <br/>Result(s): Patients were aged 1,121 (IQR
1,004, 1,485) days, weighed 14.6 kg (13, 15.3). CPB time was 61 (56, 86)
minutes at 35degreeC (34, 35). All patients were extubated prior to ICU
admission. Total chest tube drainage was 23 (17, 29) cm/kg on day 1, 9
(6,18) cm/kg on day 2, and 2 (1, 53) cm/kg on day 3. AVP levels rose from
1.7 (1.1, 4.3) pre-CPB to 74 (15, 200) post-CPB, 59 (27, 76) on day 1, 68
(30,82) on day 2, and 21 (17,36) on day 3. Total chest tube output was not
related to CVP, LAP, or AVP concentrations but was positively related to
both epinephrine and norepinephrine infusion doses. <br/>Conclusion(s):
These results suggest that chest tube drainage following Fontan palliation
is poorly responsive to standard hemodynamic management or total
vasopressin concentration. The role for exogenous vasopressin in managing
fluid balance and chest tube drainage remains unclear.

<64>
Accession Number
621548169
Title
Antiepileptic drug use and outcomes after stage i palliation of
hypoplastic left heart syndrome.
Source
World Journal for Pediatric and Congenital Hearth Surgery. Conference:
Cardiology 2018: 21st Update on Pediatric and Congenital Cardiovascular
Disease. United States. 9 (2) (pp NP34-NP35), 2018. Date of Publication:
March 2018.
Author
Salciccioli K.B.; Moffet B.S.; Cabrera A.G.
Institution
(Salciccioli, Moffet, Cabrera) Baylor College of Medicine, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Neurologic and neurodevelopmental morbidities are increasingly
recognized following congenital heart surgery. In infants with hypoplastic
left heart syndrome (HLHS), clinical seizures have been identified as a
risk factor for neurodevelopmental impairment. Furthermore, hospital
discharge with an antiepileptic drug (AED) has been associated with more
than a 10-fold increased relative risk of interstage mortality. Little is
known about whether AED use correlates with immediate postoperative
morbidity and mortality in this population. <br/>Method(s): Retrospective
review using the Pediatric Health Information System (PHIS) administrative
database identified infants with HLHS who underwent a Norwood operation
with placement of either a Blalock-Taussig or Sano shunt between January
1, 2004, and September 30, 2015. Patient demographics, length of hospital
stay (LOS), in-hospital mortality, readmission, use of extracorporeal
membrane oxygenation (ECMO), and use of AEDs were collected. Descriptive
statistics were used to characterize the population. Student's t-test,
Fisher's exact test, and multivariate logistic regression were used to
identify differences in patients who received AEDs compared to patients
who did not receive and AED. <br/>Result(s): A total of 2,825 infants with
HLHS who underwent a Norwood operation during the specified time interval
were identified, of which 1,752 (62%) were male. The majority were
Caucasian (n = 1,949, 69%). 445 (16%) patients required ECMO.
Cerebrovascular event was documented in 170 (6%) patients. AEDs were used
in 676 (24%) patients. Patients who received AEDs were significantly more
likely to suffer in-house mortality than those who did not (20% vs 15%,
respectively, P =.000). Length of stay was also significantly longer (P
<.001) in patients who received AEDs (53 + 51 days) compared to those who
did not (37 + 31 days). <br/>Conclusion(s): In infants with HLHS,
postoperative AED use after stage I palliation is associated with
increased in-hospital mortality and longer length of hospital stay. This
study demon-strates that patients who receive AEDs are a high-risk group
with regard to mortality and resources utilization. Further work is needed
to better understand the role of AEDs in these outcomes.

<65>
Accession Number
621548094
Title
Use of vasopressin following the fontan operation: A pilot study.
Source
World Journal for Pediatric and Congenital Hearth Surgery. Conference:
Cardiology 2018: 21st Update on Pediatric and Congenital Cardiovascular
Disease. United States. 9 (2) (pp NP32), 2018. Date of Publication: March
2018.
Author
Hernandez N.B.; Penk J.; Connolly J.; Li Y.
Institution
(Hernandez, Penk, Connolly, Li) Advocate Children's Hospital, United
States
Publisher
SAGE Publications Inc.
Abstract
Background: Prolonged pleural drainage remains one of the most significant
complications after the Fontan operation. It is associated with
considerable morbidity and significant resource utilization. Vasopressin
may target several mechanisms that led to prolonged chest tube drainage. A
retrospective report using historical controls of vasopressin utilization
after the Fontan operation demonstrated significant reduction in pleural
drainage and length of stay. This is a pilot study to evaluate
feasibility, safety, and effect size of vasopressin infusion after the
Fontan operation. <br/>Method(s): Randomized, double-blind,
placebo-control, pilot study. Inclusion criteria were age 1.5 to 7 years
undergoing a nonfenestrated, extracardiac Fontan. Patients were excluded
for planned arch reconstruction, re-do Fontan procedure, or evidence of
renal insufficiency. The vasopressin group received 0.4 mU/kg/min for 48
hours starting once the patient was off cardiopulmonary bypass. The
placebo group received normal saline at the same rate and timing as the
treatment group. The amount and duration of chest tube drainage and length
of hospital stay were compared between the two groups. <br/>Result(s):
Eleven patients were enrolled from March 2017 to October 2017. Six
patients were randomized to the vasopressin group and five to the placebo
group. One patient from the placebo group was withdrawn from the primary
analysis due to significantly prolonged chylous effusion. There were no
significant differences in demographics or preoperative risk factors
between the groups. Three patients in the vasopressin group received
cardioplegia whereas one patient in the placebo group did. There was no
significant difference between the vasopressin and placebo groups in chest
tube output (59 mL/kg versus 49 mL/kg total, respectively) and mean length
of hospital stay (6.8 days versus 6.7 days, respectively). Fluid balance
through chest tube removal was more negative in the vasopressin group with
a median of-24 mL/kg (-120 to 85 mL/kg) versus-6 mL/kg (-15 to+57 mL/kg),
but this was not statistically significant. There were no significant
complications related to vasopressin use. One patient in the placebo group
was readmitted ten days after discharge due to recurrent pleural effusion.
<br/>Conclusion(s): Vasopressin was well tolerated in children after the
Fontan operation. This study demonstrates feasibility of our protocol with
no significant associated side effects due to vasopressin in this patient
population. This pilot study adds useful preliminary data for a planned
multicenter trial to evaluate vasopressin efficacy in decreasing pleural
drainage and length of stay.

<66>
Accession Number
621547919
Title
Peritoneal dialysis versus standard diuretic regimen in children after
congenital cardiac surgery.
Source
World Journal for Pediatric and Congenital Hearth Surgery. Conference:
Cardiology 2018: 21st Update on Pediatric and Congenital Cardiovascular
Disease. United States. 9 (2) (pp NP52), 2018. Date of Publication: March
2018.
Author
Flores S.; Elhoff J.; Bronicki R.; Mery C.; Alsaied T.; Ahdab F.
Institution
(Flores, Elhoff, Bronicki, Mery, Alsaied, Ahdab) Texas Children's
Hospital, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Fluid management remains one of the central tasks following
congenital cardiac surgery. Some centers have reported improved outcomes
with the routine early application of peritoneal dialysis (PD). However,
it is not entirely clear if early implementation of PD is advantageous,
with recently published studies presenting conflicting findings. We
conducted a meta-analysis on the comparison of outcomes following
congenital cardiac surgery in patients who received PD compared to those
who received standard diuretic regimen (SDR). <br/>Method(s): A
comprehensive database search was conducted, including Medline, Embase,
Cochrane Central register of Controlled Trials, Cochrane Database of
Systematic Reviews, and Scopus through January 2017. Only studies that
made a direct comparison between PD and standard diuretic regimen were
included. Outcomes of interest were: negative fluid balance at day 1, 10%
fluid overload, hours to negative fluid balance, fluid balance by
post-operative day, mechanical ventilation days, delayed extubation,
cardiac intensive care unit length of stay (LOS), hospital LOS,
electrolyte abnormalities, number of electrolyte repletion, duration of
inotropic support, mortality, incidence of peritonitis with PD, incidence
of communication with chest tube with PD, incidence of low cardiac output
syndrome during PD, need for mechanical support, and time to delayed chest
closure. <br/>Result(s): Initial search identified 213 studies for title
and abstract screening. Following initial screening, 86 studies were
selected for full-text screening. Eleven studies were identified for data
extraction with a total of 209 patients receiving PD and 739 patients
receiving standard diuretic regimen. Only 1 of the 11 included studies
prospectively randomized patients to receive PD versus SDR. The mean age
for the PD group was 11 days (SD 14.4) and for the SDR group 9.4 days (SD
5.5). The mean RACHS-1 score for the PD group was 4.2 (SD 1.5) and for the
SDR group 4.8 days (SD 1.8). The mean baseline creatinine level for the PD
group was 0.8 mg/dL (SD 0.2) and for the SDR group 0.5 mg/dL (SD 0.2). The
utilization of peritoneal dialysis was associated with a 2.49 increased
odds of mortality in comparison to patients who received SDR (95% CI:
1.2-5.15). There was no statistical difference in negative fluid balance
after postoperative day 1, OR 1.9 (95% CI: 0.92-3.94), incidence of
peritonitis, OR 1.98 (95% CI: 0.31-12.83), or need for mechanical support,
OR 3.6 (95% CI: 0.29-44.46). <br/>Conclusion(s): Our findings suggest that
there are increased odds of mortality in children after congenital cardiac
surgery who received PD versus SDR. The meta-analysis did not identify
differences between groups related to negative fluid balance after
postoperative day 1, incidence or peritonitis, or need for mechanical
support. There is a need of prospective multi-center studies to establish
if PD utilization is beneficial in selected children after cardiac
surgery.

<67>
Accession Number
2006765650
Title
Incidence, predictors and outcomes of valve-in-valve TAVI: A systematic
review and meta-analysis.
Source
International Journal of Cardiology. 316 (pp 64-69), 2020. Date of
Publication: 1 October 2020.
Author
Giordana F.; Bruno F.; Conrotto F.; Saglietto A.; D'Ascenzo F.; Grosso
Marra W.; Dvir D.; Webb J.; D'Onofrio A.; Camboni D.; Grubitzsch H.;
Duncan A.; Kaneko T.; Toggweiler S.; Latib A.; Nerla R.; Salizzoni S.; La
Torre M.; Trompeo A.; D'Amico M.; Rinaldi M.; De Ferrari G.
Institution
(Giordana, Bruno, Conrotto, Saglietto, D'Ascenzo, Grosso Marra, D'Amico,
De Ferrari) Division of Cardiology, Cardiovascular and Thoracic
Department, Citta della Salute e della Scienza Hospital and University of
Turin, Italy
(Salizzoni, La Torre, Trompeo, Rinaldi) Division of Cardiosurgery,
Cardiovascular and Thoracic Department, Citta della Salute e della Scienza
Hospital and University of Turin, Italy
(Dvir) University of Washington, Seattle, WA, United States
(Webb) Centre for Heart Valve Innovation, St Paul's Hospital, University
of British Columbia, Vancouver, BC, Canada
(D'Onofrio) Division of Cardiology, Monaldi Hospital, Naples, Italy
(Camboni) Department of Cardio-Thoracic Surgery, University Medical Center
Regensburg, Germany
(Grubitzsch) Department of Cardiovascular Surgery, Charite
Universitatsmedizin Berlin, Chariteplatz 1, Berlin 10117, Germany
(Duncan) Royal Brompton Hospital, London, United Kingdom
(Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Toggweiler) Heart Center Lucerne, Luzerner Kantonsspital, Switzerland
(Latib) Interventional Cardiology Unit, San Raffaele Scientific Institute,
Milan, Italy
(Nerla) Cardiovascular Department, Humanities Gavazzeni, Bergamo, Italy
(Latib) Department of Cardiology, Montefiore Medical Centre, New York,
United States
Publisher
Elsevier Ireland Ltd
Abstract
Aims: Surgical aortic valve replacement has been the treatment of choice
for patients with aortic valve disease before the arrival of transcatheter
aortic valve replacement (TAVI), although limited by degeneration of the
bioprosthesis. "Redo" intervention itself is burdened by high risk of
complications and valve-in-valve (ViV) TAVI could be a valid strategy of
redo for patients with comorbidities. <br/>Methods and Results: Two
independent reviewers screened all studies investigating patients
undergoing ViV TAVI. Mortality at 30 days and at 1 year was the primary
end point. Of 286 studies identified, 26 articles were included in this
review with a total of 1448 patients. Median age was 78.8 years, 57.7%
male. Median STS score and Logistic EuroSCORE were 9.4% and 31.3%
respectively. Stenosis (45%) was the leading cause of prosthesis failure.
Transfemoral approach was preferred (76%), with a prevalence of balloon
expandable valves (73.3%). Mean follow up was 376 days. Overall and
cardiovascular mortality at 30 days was 6.5% and 5.5% respectively, while
at 1 year it was 14.5% and 8.9% respectively. At meta-regression analysis
study year (p <.001), Logistic EuroSCORE (p <.01) and valve diameter <= 21
mm (p <.05) at 30 days, and stenosis as reason for failure (p =.05) at 1
year were identified as possible predictors of survival.
<br/>Conclusion(s): ViV TAVI offers a valid strategy to treat high risk
patients with a failure of bioprosthesis with satisfying results in terms
of short and mid-term mortality. Future studies are needed to find
predictors of long term survival and outcomes in lower risk
patients.<br/>Copyright &#xa9; 2020 Elsevier B.V.

<68>
Accession Number
2005619680
Title
A comparison of figure-of-8-suture versus manual compression for venous
access closure after cardiac procedures: An updated meta-analysis.
Source
PACE - Pacing and Clinical Electrophysiology. 43 (8) (pp 856-865), 2020.
Date of Publication: 01 Aug 2020.
Author
Mujer M.T.; Al-Abcha A.; Flores J.; Saleh Y.; Robinson P.
Institution
(Mujer, Al-Abcha, Saleh) Department of Medicine, Michigan State
University, East Lansing, MI, United States
(Flores) University of the Philippines College of Medicine, Manila,
Philippines
(Robinson) Pat and Jim Calhoun Cardiology Center, University of
Connecticut, Farmington, CT, United States
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: Manual compression (MC) is the current standard to achieve
postprocedural hemostasis in patients who need venous vascular access
closure after cardiovascular procedures. Figure-of-8 (F8) suture for
venous access closure has been reported to be a safe and efficacious
alternative to MC. <br/>Method(s): A systematic search was done using
PubMed, Google Scholar, EMBASE, SCOPUS, and ClinicalTrials.gov without
language restriction up until April 15, 2020 for studies comparing F8
suture versus MC. Risk ratio (RR) and mean difference (MD) with 95%
confidence interval (CI) were calculated using a random effects model.
<br/>Result(s): Time to achieve hemostasis was significantly reduced in
the F8 arm [MD -21.04 min (95% CI: -35.66 to -6.42; P =.005)]. Access site
bleeding was significantly lower in the F8 group [RR 0.35 (95% CI: 0.18 to
0.66; P =.001)] along with a lower incidence of hematoma formation [RR
0.42 (95% CI: 0.26 to 0.67; P =.0003)]. There was no significant
difference in rates of fistula or pseudoaneurysm formation between the two
groups. Overall access site complications were lower in the F8 arm [RR
0.38 (95% CI: 0.26 to 0.55; P <.00001)] and the effect was more pronounced
for sheaths >=10 Fr [RR 0.33 (95% CI: 0.18 to 0.60; P =.0003)]. There was
lower postprocedural protamine use in the F8 group [RR 0.07 (95% CI: 0.01
to 0.36; P =.001)]. <br/>Conclusion(s): For large-bore venous access
closure, the F8 suture results in a shortened time to achieve hemostasis
along with a lower overall risk of access site complications and
postprocedural protamine use.<br/>Copyright &#xa9; 2020 Wiley Periodicals
LLC

<69>
Accession Number
2005572488
Title
Mitral valve repair with minimally invasive approaches vs sternotomy: A
meta-analysis of early and late results in randomized and matched
observational studies.
Source
Journal of Cardiac Surgery. 35 (9) (pp 2307-2323), 2020. Date of
Publication: 01 Sep 2020.
Author
Sa M.P.B.O.; Van den Eynde J.; Cavalcanti L.R.P.; Kadyraliev B.; Enginoev
S.; Zhigalov K.; Ruhparwar A.; Weymann A.; Dreyfus G.
Institution
(Sa, Cavalcanti) Division of Cardiovascular Surgery of Pronto Socorro
Cardiologico de Pernambuco, PROCAPE, University of Pernambuco, Recife,
Pernambuco, Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Kadyraliev) Department of Cardiac Surgery, S.G. Sukhanov Federal Center
of Cardiovascular Surgery, E.A. Vagner Perm State Medical University,
Perm, Russian Federation
(Enginoev) Department of Cardiac Surgery, Federal Center for
Cardiovascular Surgery, Astrakhan, Russian Federation
(Enginoev) Department of Cardiovascular Surgery, Astrakhan State Medical
University, Astrakhan, Russian Federation
(Zhigalov, Ruhparwar, Weymann) Department of Thoracic and Cardiovascular
Surgery, West German Heart and Vascular Center Essen, University Hospital
of Essen, University Duisburg-Essen, Essen, Germany
(Dreyfus) Department of Cardiac Surgery, Institut Montsouris, University
Pierre et Marie Curie, Paris, France
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background and Aim of the Study: Minimally invasive cardiac surgery (MICS)
for mitral valve repair (MVRp) has been increasingly used. This study
aimed to evaluate the early and late results of MICS for MVRp vs
conventional sternotomy. <br/>Material(s) and Method(s): A systematic
review of randomized controlled trials or observational studies (with
matched populations) comparing MICS and conventional MVRp reporting any of
the following outcomes: mortality, MVRp failure, complications, blood
transfusion, readmission within 30 days after discharge, long-term
reoperation for mitral regurgitation, operative times, mechanical
ventilation time, intensive care unit (ICU) stay, or hospital stay. The
pooled treatment effects were calculated using a random-effects model.
<br/>Result(s): Ten studies involving 6792 patients (MICS: 3396 patients;
Conventional: 3296 patients) met the eligibility criteria. In the pooled
analysis, MICS significantly reduced the risk for blood transfusion (odds
ratio [OR], 0.654; 95% confidence interval [CI] 0.462-0.928; P =.017) and
readmission within 30 days after discharge (OR, 0.615; 95% 0.456-0.829; P
=.001). MICS was associated with a significantly longer cross-clamp time
(mean difference 14 minutes; 95% CI, 7.4-21 minutes; P <.001), CPB time
(24 minutes; 95% CI, 14-35 minutes; P <.001), and total operative time
(36; 95% CI, 15-56 minutes; P <.001), but a significantly shorter ICU stay
(-8.5; 95% CI -15; -1.8; P =.013) and hospital stay (-1.3, 95% CI -2.1;
-0.45; P =.003). This meta-analysis found no significant difference
regarding the risk of in-hospital and long-term mortality, nor
complications. <br/>Conclusion(s): Despite longer operative times, MICS
for MVRp reduces ICU and hospital stay, as well as readmission rates and
the need for transfusion.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<70>
Accession Number
632526951
Title
Cardiovascular CT and MRI in 2019: Review of Key Articles.
Source
Radiology. 297 (1) (pp 17-30), 2020. Date of Publication: 01 Oct 2020.
Author
Dodd J.D.; Leipsic J.
Institution
(Dodd, Leipsic) From the Department of Radiology, St. Vincent's University
Hospital, Elm Park, Dublin D4, Ireland (J.D.D.); School of Medicine,
University College Dublin, Dublin, Ireland (J.D.D); and Department of
Radiology, University of British Columbia, St. Paul's Hospital, Vancouver,
Canada (J.L.)
Publisher
NLM (Medline)
Abstract
Cardiac imaging is becoming commonplace throughout radiology practices and
is increasingly important in large-cohort prospective cardiovascular
trials and in statements and guidelines. In this review, the authors
summarize some of the most important imaging findings relevant to clinical
practice in the past year. Key coronary CT angiography studies have
included rigorous meta-analysis of its diagnostic accuracy, prognostic
implications of adverse coronary plaque features, and sex differences. The
value of CT for catheter-delivered valve implantation (eg, transcatheter
aortic and mitral valve replacements) was further elucidated in
large-cohort outcome trials. Hypertrophic cardiomyopathy registries have
revealed distinct clinical and MRI phenotypes, highlighting different
underlying causes, while others clarified the prognostic usefulness of MRI
in hypertrophic cardiomyopathy and Fabry disease. Artificial intelligence
and/or machine learning was applied to many aspects of cardiovascular
imaging, while evidence of the benefits of both adenosine stress perfusion
cardiac MRI and coronary CT angiography-derived fractional flow reserve
from real-world trials has increased. Studies on vaping and vascular
endothelial function and the whole-body MRI depiction of metabolic
syndrome consequences were also noteworthy. Although this review focuses
on Radiology articles, key articles from high-impact clinical journals are
also included. Although not possible to detail all articles because of
space limitations, the authors attempted to highlight those with the most
pragmatic and scientific value.<br/>Copyright &#xa9; RSNA, 2020.

<71>
Accession Number
2005788323
Title
Cholesterol lowering with EVOLocumab to prevent cardiac allograft
Vasculopathy in De-novo heart transplant recipients: Design of the
randomized controlled EVOLVD trial.
Source
Clinical Transplantation. 34 (9) (no pagination), 2020. Article Number:
e13984. Date of Publication: 01 Sep 2020.
Author
Broch K.; Gude E.; Karason K.; Dellgren G.; Radegran G.; Gjesdal G.;
Gustafsson F.; Eiskjaer H.; Lommi J.; Pentikainen M.; Lemstrom K.B.;
Andreassen A.K.; Gullestad L.
Institution
(Broch, Gude, Andreassen, Gullestad) Department of Cardiology, Oslo
University Hospital, Rikshospitalet, Oslo, Norway
(Karason, Dellgren) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Radegran, Gjesdal) The Clinic for Heart Failure and Valvular Disease,
Skane University Hospital, Lund, Sweden
(Radegran) Lund University, Lund, Sweden
(Gustafsson) Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
(Eiskjaer) Department of Cardiology, Aarhus University Hospital, Aarhus,
Denmark
(Lommi, Pentikainen, Lemstrom) Helsinki University Hospital Heart and Lung
Center, Helsinki, Finland
(Lemstrom) University of Helsinki, Helsinki, Finland
(Gullestad) KG Jebsen Center for Cardiac Research, University of Oslo,
Norway and Center for Heart Failure Research, Oslo University Hospital,
Norway
Publisher
Blackwell Publishing Ltd (E-mail: info@royensoc.co.uk)
Abstract
Background: Cardiac allograft vasculopathy (CAV) is characterized by
diffuse thickening of the arterial intima. Statins reduce the incidence of
CAV, but despite the use of statins, CAV remains one of the leading causes
of long-term death after heart transplant. Inhibitors of proprotein
convertase subtilisin-kexin type 9 (PCSK9) substantially reduce
cholesterol levels but have not been tested in heart transplant
recipients. <br/>Method(s): The Cholesterol lowering with EVOLocumab to
prevent cardiac allograft Vasculopathy in De-novo heart transplant
recipients (EVOLVD) trial (ClinicalTrials.gov Identifier: NCT03734211) is
a randomized, double-blind trial designed to test the effect of the PCSK9
inhibitor evolocumab on coronary intima thickness in heart transplant
recipients. Adults who have received a cardiac transplant within the past
4-8 weeks are eligible. Exclusion criteria include an estimated glomerular
filtration rate ' 20 mL/min/1.73 m², renal replacement therapy,
or contraindications to coronary angiography with intravascular
ultrasound. 130 patients will be randomized (1:1) to 12-month treatment
with evolocumab or matching placebo. The primary endpoint is the coronary
artery intima thickness as measured by intravascular ultrasound.
<br/>Conclusion(s): The EVOLVD trial is a randomized clinical trial
designed to show whether treatment with the PCSK9 inhibitor evolocumab can
ameliorate CAV over the first year after heart transplant.<br/>Copyright
&#xa9; 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

<72>
Accession Number
628338623
Title
Higher arterial pressure during cardiopulmonary bypass may not reduce the
risk of acute kidney injury.
Source
Journal of cardiothoracic surgery. 14 (1) (pp 107), 2019. Date of
Publication: 13 Jun 2019.
Author
Kandler K.; Nilsson J.C.; Oturai P.; Jensen M.E.; Moller C.H.; Clemmesen
J.O.; Arendrup H.C.; Steinbruchel D.A.
Institution
(Kandler, Jensen, Moller, Arendrup, Steinbruchel) Department of
Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet,
Blegdamsvej 9, Copenhagen 2100, Denmark
(Nilsson) Department of Cardiothoracic Anaesthesiology, Copenhagen
University Hospital, Rigshospitalet, Copenhagen, Denmark
(Oturai) Department of Clinical Physiology, Nuclear Medicine and PET,
Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
(Clemmesen) Department of Hepatology, Copenhagen University Hospital,
Rigshospitalet, Copenhagen, Denmark
Publisher
NLM (Medline)
Abstract
BACKGROUND: Acute kidney injury after cardiac surgery is common and
associated with increased mortality. It is unknown whether an intended
higher arterial pressure during cardiopulmonary bypass reduces the
incidence of acute and chronic kidney injury. <br/>METHOD(S): Patients
were randomised either to a control group or a high pressure group
(arterial pressure>60mmHg). The inclusion criteria were age>70years,
combined cardiac surgery and serum creatinine <200mumol/L. Glomerular
filtration rate using the Cr-EDTA clearance method was measured the day
before surgery and 4 months postoperatively. The RIFLE criteria were used
to define the presence of acute kidney injury. In addition, the ratio
between urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) and
creatinine was measured. <br/>RESULT(S): Ninety patients were included.
Mean age was 76+/-4years and 76% were male. Mean arterial pressure was
47+/-5mmHg in the control group and 61+/-4mmHg in the high pressure group
(p<0.0001). The change in glomerular filtration rate at follow-up was
-9+/-12ml/min in the control group and-5+/-16ml/min in the high pressure
group (p=0.288, 95% CI -13 to 4). According to the RIFLE criteria 38% in
the control group and 46% in the high pressure group developed acute
kidney injury (p=0.447). The postoperative urinary NGAL/creatinine ratio
was comparable between the groups. <br/>CONCLUSION(S): An intended
increase in arterial pressure during cardiopulmonary bypass to >60mmHg did
not decrease the incidence of acute or chronic kidney injury after cardiac
surgery. TRIAL REGISTRATION: Clinicaltrials.gov, identifier: NCT01408420 .
Registered 3rd of August 2011.

<73>
Accession Number
628397837
Title
Study protocol: A randomized controlled trial assessing the avoidance of
endotracheal suction in cardiac surgical patients ventilated for <= 12 hr.
Source
Journal of advanced nursing. 75 (9) (pp 2006-2014), 2019. Date of
Publication: 01 Sep 2019.
Author
Gilder E.; Parke R.L.; McGuinness S.; Jull A.
Institution
(Gilder, Parke, McGuinness) Cardiothoracic and Vascular Intensive Care
Unit, Auckland City Hospital, Auckland, New Zealand
(Gilder, Parke, Jull) School of Nursing, Faculty of Medical and Health
Sciences, University of Auckland, Auckland, New Zealand
(Parke, McGuinness) FANZCA, Australian and New Zealand Intensive Care
Research Centre, Melbourne, Vic., Australia
(Parke, McGuinness) WellingtonNew Zealand
Publisher
NLM (Medline)
Abstract
AIMS: To assess the safety and efficacy of avoiding endotracheal suction
in postoperative cardiac surgical patients mechanically ventilated for <=
12 hr. DESIGN: A prospective, single centre, single blind,
non-inferiority, randomized controlled trial evaluating the safety and
efficacy of avoiding suction in uncomplicated, postoperative, adult
cardiac surgical patients mechanically ventilated for <= 12 hr.
<br/>METHOD(S): Randomization will be performed on return to intensive
care (ICU) with allocation to either usual postoperative care including
suction or to usual care with no suction (intervention arm). The primary
outcome is the ratio of partial pressure of oxygen (PaO2 ) to fraction of
inspired oxygen (FiO2 ) (P/F) 6 hr after extubation. Pain assessments will
be performed before, during and after endotracheal suction (ETS) and the
patient experience will be investigated with a brief interview the
following day. Ethics approval was received in October 2015. DISCUSSION:
Endotracheal suction is performed as part of airway management but has
potential complications and there is little robust evidence to guide
practice. This study will add to the evidence base about the need and
benefit of endotracheal suction in this patient cohort. IMPACT: As there
is currently no published evidence about the safety of avoiding
endotracheal suction. This study will provide the first evidence about
avoidance of endotracheal suction in patients ventilated for less than 1
day. If non-inferior, the results have the capacity to change nursing
practice by avoiding a potentially unnecessary procedure, it will build on
the body of knowledge about the patient experience.<br/>Copyright &#xa9;
2019 John Wiley & Sons Ltd.

<74>
Accession Number
2007889897
Title
Lung cancer risk in solid organ transplant recipients: A meta-analysis.
Source
Annals of Oncology. Conference: ESMO Virtual Congress 2020. 31 (Supplement
4) (pp S1080-S1081), 2020. Date of Publication: September 2020.
Author
Ge F.; Huo Z.; Wang R.; Liang W.; He J.
Institution
(Ge) The First Clinical College, Guangzhou Medical University, Guangzhou,
China
(Huo, Wang) Nanshan School, Guangzhou Medical University, Guangzhou, China
(Liang) Department of Thoracic Oncology and Surgery, the First Affiliated
Hospital of Guangzhou Medical University, Department of Thoracic Oncology
and Surgery, China State Key Laboratory of Respiratory Disease & National
Clinical Research Center for Respiratory Disease, the First Affiliated
Hospital of Guangzhou Medical University, Guangzhou, China
(He) Thoracic Surgery, State Key Laboratory of Respiratory Diseases - The
First Affiliated Hospital of Guangzhou Medical University, Guangzhou,
China
Publisher
Elsevier Ltd
Abstract
Background: Patients underwent solid organ transplantation are considered
to be associated with an increased risk of developing cancers. We
performed a meta-analysis to determine whether there was an increased risk
of lung cancer in solid organ transplant recipients. <br/>Method(s):
PubMed, Web of Science, EMBASE, Medline were searched. Random-effects
model meta-analyses were used to calculate standardized incidence ratios
(SIRs) for solid organ transplant recipients versus the general
population, stratified by types of transplantation. Subgroup analyses were
performed based on country/region of each study. <br/>Result(s): Based on
data from 531,377 patients with a total follow-up of 307,7669
patient-years, we identified a 5.97 -fold higher SIR [95% confidence
intervals (CI) 4.66-7.66, P<0.001] in lung transplantation recipients, a
2.61-fold higher SIR of lung cancer [95% CI 2.14-3.17, P=0.012] in
patients underwent heart transplantation, a 1.89-fold higher SIR [95% CI:
1.6-2.22, P=0.001] in patients following liver transplantation, and a
1.45-fold higher SIR [95% CI: 1.23-1.7, P<0.001] in renal transplantation
recipients, compared with the general population. In subgroup analyses, we
found that the order of lung cancer SIR after different transplantation
types (lung, heart, liver and kidney) was consistent among different
ethnic groups, and European and North American countries had the highest
SIRs compared with Asians and Oceania (Table). [Formula presented]
<br/>Conclusion(s): Our study demonstrated that solid transplant
recipients showed a significantly greater risk of lung cancer, which
varied among different transplantation types and ethnic groups. Such
association can provide guidance for clinicians in the detection of lung
cancer among solid organ transplantation recipients. Legal entity
responsible for the study: The authors. <br/>Funding(s): Has not received
any funding. Disclosure: All authors have declared no conflicts of
interest.<br/>Copyright &#xa9; 2020

<75>
Accession Number
632942380
Title
Abstracts from the British Cardiovascular Society Annual Conference 2020.
Source
Heart. Conference: 2020 Annual Conference of the British Cardiovascular
Society, BCS 2020. United Kingdom. 106 (SUPPL 2) (no pagination), 2020.
Date of Publication: July 2020.
Author
Anonymous
Publisher
BMJ Publishing Group
Abstract
The proceedings contain 139 papers. The topics discussed include: invasive
and non-invasive quantification of myocardial fibrosis in primary mitral
regurgitation: prognostic implications for post-operative remodeling,
symptom burden and exercise capacity; a prospective study of hypertrophic
cardiomyopathy and sleep disordered breathing; comparison of treatment
outcomes in very elderly patients (>85years) with severe symptomatic
aortic stenosis; assessment of post heart valve surgery outcomes in
tertiary center in Scotland; acceleration time and ratio of acceleration
time and ejection time in bicuspid aortic stenosis; a valid clinical
measure?; next-day discharge after transcatheter aortic valve
implantation; clinical outcomes and programming strategies of implantable
cardioverter defibrillator (ICD) devices during childhood in hypertrophic
cardiomyopathy: a UK national cohort study; impact of transthoracic versus
transoesophageal echocardiography measurement of vegetation length in
infective endocarditis on indications for surgery; and transcatheter
versus surgical approach for severe aortic stenosis with concomitant
coronary artery disease: a systematic review and meta-analysis of early
and mid-term outcomes.

<76>
Accession Number
632942218
Title
Systematic review and meta-analysis comparing bilateral versus single
internal thoracic artery grafts in patients with diabetes and obesity
undergoing coronary artery bypass graft surgery.
Source
Heart. Conference: 2020 Annual Conference of the British Cardiovascular
Society, BCS 2020. United Kingdom. 106 (SUPPL 2) (pp A102-A103), 2020.
Date of Publication: July 2020.
Author
Flather M.; Stefil M.; Gaudino M.; Benedetto U.; Gray A.; Gerry S.; Lees
B.; Krzych L.; Seevanayagam S.; Taggart D.
Institution
(Flather) University of East Anglia
(Stefil) Norwich Medical School, University of East Anglia, Norwich,
United Kingdom
(Gaudino) Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York,
United States
(Benedetto) School of Clinical Sciences, University of Bristol, Bristol
Royal Infirmary, Bristol, United Kingdom
(Gray) Health Economics Research Centre, University of Oxford, Oxford,
United Kingdom
(Gerry) Centre for Statistics in Medicine, University of Oxford, Oxford,
United Kingdom
(Lees, Taggart) Nuffield Department of Surgical Sciences, University of
Oxford, Oxford, United Kingdom
(Krzych) Department of Cardiac Surgery, Medical University of Silesia,
Katowice, Poland
(Seevanayagam) Department of Cardiac Surgery, Austin Health, University of
Melbourne, Melbourne, Australia
Publisher
BMJ Publishing Group
Abstract
Background Obesity and diabetes put patients are at higher risk of
mortality and other adverse outcomes following coronary artery bypass
grafting (CABG) and are becoming more common. The use of bilateral
internal thoracic arteries (BITA) can potentially offer survival benefit
in higher risk patients compared to single internal thoracic artery (SITA)
in patients undergoing CABG. Current evidence does not support the routine
use of BITA and this approach is associated with a higher risk of sternal
wound complications. Methods We conducted a systematic review of the
literature to identify observational studies and randomised controlled
trials (RCT) comparing efficacy (mortality) and safety (sternal wound
infection) of BITA and SITA in diabetic and obese patients. Results
Eighteen observational studies and one RCT (subgroup analysis) were
identified comparing BITA and SITA in 19,589 patients with diabetes. In
contrast there were just two observational studies and one RCT (subgroup
analysis) comparing BITA and SITA in 6972 obese patients. Pooled analysis
demonstrated significant mortality benefit of BITA compared to SITA in
diabetic patients (risk ratio [RR] 0.79; 95% confidence interval [CI]
0.70, 0.90; Z=3.62, p=0.0003; I2=88%) (Figure 1b). Pooled analysis in
obese patients found no significant difference in mortality rates between
BITA and SITA (RR 0.73, 95% CI 0.47, 1.12; Z=1.43, p=0.15; I2=78%),
although the overall effect was for a beneficial trend for BITA (Figure
1a). A significantly higher rate of sternal wound complications following
BITA was observed in diabetic (RR 1.53, 95% CI 1.23, 1.90; Z=3.86,
p=0.0001; I2=4%) and obese patients (RR 2.24, 95% CI 1.63, 3.07; Z=5.00,
p<0.00001; I2=0%). Conclusions In a pooled analysis, BITA is associated
with better long-term survival in diabetic patients, but most of the
supportive data comes from observational studies. The effects of BITA
grafting in patients who are obese is uncertain due to low numbers of
patients available for analysis. BITA is associated with higher rates of
sternal wound complications than SITA in both diabetic and obese patients.
Further studies are needed to understand the benefits and risks of
multiple arterial grafting in patients with diabetes and/or obesity.

<77>
Accession Number
632942206
Title
Influence of diabetes and obesity on mortality and sternal wound
complications after coronary artery bypass graft surgery: Ten-year
follow-up from the arterial revascularisation trial.
Source
Heart. Conference: 2020 Annual Conference of the British Cardiovascular
Society, BCS 2020. United Kingdom. 106 (SUPPL 2) (pp A101-A102), 2020.
Date of Publication: July 2020.
Author
Flather M.; Stefil M.; Taggart D.; Podesser B.; Benedetto U.; Gaudino M.;
Gerry S.; Gray A.; Lees B.; Krzych L.
Institution
(Flather) University of East Anglia
(Stefil) Norwich Medical School, University of East Anglia, Norwich,
United Kingdom
(Taggart, Lees) Nuffield Department of Surgical Sciences, University of
Oxford, Oxford, United Kingdom
(Podesser) Medical University of Vienna, Austria
(Benedetto) School of Clinical Sciences, University of Bristol, Bristol
Royal Infirmary, Bristol, United Kingdom
(Gaudino) Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York,
United States
(Gerry) Centre for Statistics in Medicine, University of Oxford, Oxford,
United Kingdom
(Gray) Health Economics Research Centre, University of Oxford, Oxford,
United Kingdom
(Krzych) Department of Cardiac Surgery, Medical University of Silesia,
Katowice, Poland
Publisher
BMJ Publishing Group
Abstract
Background Diabetes is associated with higher risk of mortality in
patients undergoing coronary artery bypass graft (CABG) but the effects of
obesity, and the interactions between diabetes and obesity in the context
of CABG, have not been fully explored. Methods The Arterial
Revascularisation Trial (ART) randomised patients to single- or bilateral
internal thoracic arterial graft plus other vein or arterial grafts as
needed and followed them for 10 years to compare mortality, clinical
outcomes and safety. In this analysis we explored the effects of diabetes
and obesity on mortality and risk (sternal wound complications). Diabetes
was defined according to clinical history at baseline and combined insulin
and non-insulin dependent patients, and obesity was defined as body mass
index (BMI) >=30kg/m2 at baseline. Results Data on diabetes, obesity and
ten-year mortality were available for 3094 patients who were included in
the analysis. Mean age was 64 years, 86% male, mean weight 82kg and BMI
28. Diabetes was documented in 24% and obesity in 30% and as expected
obese patients were more likely to be diabetic. The hazard ratios (95%
confidence intervals) for ten-year mortality using the no-diabetes,
non-obese group as a reference were 1.33 (1.08, 1.64) (diabetes,
non-obese), 0.93 (0.75, 1.16) (no diabetes, obese) and 1.18 (0.91, 1.54)
(diabetes, obese) groups (Figure). Similar patterns of risk were observed
whether patients were randomised to receive single or bilateral internal
thoracic arteries and diabetes appeared to be the main driver of elevated
risk of early sternal wound complications following CABG. Conclusions
Obesity and diabetes often occur in the same patients, but our analysis
shows that patterns of risk of death after CABG are not additive for these
characteristics, and obesity may actually be associated with lower death
rates in patients with and without diabetes. Sternal wound complications
appeared to be driven more by diabetes than obesity. Further analyses will
be presented to explore the possible mechanisms for these observations.

<78>
Accession Number
632942106
Title
Transcatheter versus surgical approach for severe aortic stenosis with
concomitant coronary artery disease: A systematic review and meta-analysis
of early and mid-term outcomes.
Source
Heart. Conference: 2020 Annual Conference of the British Cardiovascular
Society, BCS 2020. United Kingdom. 106 (SUPPL 2) (pp A9-A10), 2020. Date
of Publication: July 2020.
Author
Kotronias R.; Bray J.; Scarsini R.; Rajasundaram S.; Terentes-Printzios
D.; De Maria G.L.; Kharbanda R.; Mamas M.; Bagur R.; Bannning A.
Institution
(Kotronias, Bray, Scarsini, Rajasundaram, Terentes-Printzios, De Maria,
Kharbanda, Bannning) Heart Centre, Oxford University Hospitals NHS Trust
(Mamas) Heart Centre, Royal Stoke Hospital, University Hospital of North
Midlands Trust
(Bagur) Department of Epidemiology and Biostatistics, Schulich School of
Medicine and Dentistry, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction Coronary artery disease (CAD) is frequently encountered in
patients undergoing transcatheter aortic valve replacement (TAVR).
Contemporary recommendations advocate revascularisation of patients with
severe aortic stenosis (AS) and concomitant significant coronary artery
disease (CAD) by either a surgical or percutaneous approach. We undertook
a systematic review and meta-analysis to evaluate the early and mid-term
outcomes of patients who underwent surgical aortic valve replacement
(SAVR) and coronary artery bypass grafting (CABG) against patients who had
TAVR and percutaneous coronary intervention (PCI). Methods A search of
Medline and Embase was performed to identify studies comparing
transcatheter and surgical approaches. Our search was independently
screened by two investigators. Random effects meta-analyses with the
Mantel-Haenzsel method were performed to estimate the odds of adverse
outcomes. Analyses were performed with RevMan (Review Manager version
5.3.5, Nordic Cochrane Centre, Denmark). Results 1770 participants from
six studies (5 observational, 1 randomised) were included in the
meta-analysis (631 TAVR and PCI, 1139 SAVR and CABG). The mean age of
participants was 79.2 years and 58.9% were male. TAVR was performed via
both transapical/transaortic and transfemoral routes, using both
self-expandable and balloon expandable valve systems. PCI was conducted
either concomitant to TAVR or up to a year before. Risk of bias assessed
using the ROB-INS-I tool, identified 1 study at low risk and 4 studies at
high risk of bias, predominately due to selection bias. There were no
significant differences in effect estimates for early and mid-term
mortality (OR: 0.78; 95% CI, 0.50-1.20 and OR: 1.09; 95% CI, 0.80-1.49) or
myocardial infarction (OR: 0.52 95% CI, 0.20-1.33 and OR: 1.34; 95% CI,
0.67-2.65) No significant difference was noted in early cerebrovascular
accidents (OR: 0.80; 95% CI, 0.35-1.87). A transcatheter approach was
associated with a higher rate of new permanent pacemaker insertion (OR:
3.47; 95% CI, 1.98-6.06) and major vascular complications (OR: 14.44; 95%
CI, 4.42-47.16), but a lower rate of acute kidney injury (OR: 0.41; 95%
CI, 0.19-0.91). Conclusion These data suggest that in patients with severe
AS and CAD a transcatheter approach has comparable outcomes to a surgical
approach. Pending high level evidence, surgical risk assessment should
form the cornerstone of individualised decision making.

<79>
[Use Link to view the full text]
Accession Number
632932954
Title
Mis-estimation of coronary lesions and rectification by SYNTAX score
feedback for coronary revascularization appropriateness.
Source
Chinese Medical Journal. 133 (11) (pp 1276-1284), 2020. Date of
Publication: 05 Jun 2020.
Author
Lin S.; Zhang H.; Chen S.-P.; Rao C.-F.; Wu F.; Zhou F.-J.; Wang Y.; Yan
H.-B.; Dou K.-F.; Wu Y.-J.; Tang Y.-D.; Xie L.-H.; Guan C.-D.; Xu B.;
Zheng Z.
Institution
(Lin, Zhang, Rao, Wu, Zhou, Yan, Dou, Wu, Tang, Xie, Guan, Xu, Zheng)
National Clinical Research Center of Cardiovascular Diseases, State Key
Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing 100032, China
(Zhang, Rao, Zheng) Department of Cardiovascular Surgery, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing 100032, China
(Chen) Department of Information Center, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing 100032, China
(Wu, Zhou, Yan, Dou, Wu, Tang, Xie, Guan, Xu) Department of Cardiology,
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing
100032, China
(Wang) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
(Wang) Center for Outcomes Research and Evaluation, Yale-New Haven Health,
New Haven, CT, United States
Publisher
Lippincott Williams and Wilkins (E-mail: customerservice@lww.com)
Abstract
Background:Imprecise interpretation of coronary angiograms was reported
and resulted in inappropriate revascularization. Synergy Between
Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX)
score is a comprehensive system to evaluate the complexity of the overall
lesions. We hypothesized that a real-time SYNTAX score feedback from image
analysts may rectify the mis-estimation and improve revascularization
appropriateness in patients with stable coronary artery disease (CAD).
<br/>Method(s):In this single-center, historical control study, patients
with stable CAD with coronary lesion stenosis >=50% were consecutively
recruited. During the control period, SYNTAX scores were calculated by
treating cardiologists. During the intervention period, SYNTAX scores were
calculated by image analysts immediately after coronary angiography and
were provided to cardiologists in real-time to aid decision-making. The
primary outcome was revascularization deemed inappropriate by Chinese
appropriate use criteria for coronary revascularization. <br/>Result(s):A
total of 3245 patients were enrolled and assigned to the control group
(08/2016-03/2017, n = 1525) or the intervention group (03/2017-09/2017, n
= 1720). For SYNTAX score tertiles, 17.9% patients were overestimated and
4.3% were underestimated by cardiologists in the control group. After
adjustment, inappropriate revascularization significantly decreased in the
intervention group compared with the control group (adjusted odds ratio
[OR]: 0.83; 95% confidence interval [CI]: 0.73-0.95; P = 0.007). Both
inappropriate percutaneous coronary intervention (adjusted OR: 0.82; 95%
CI: 0.74-0.92; P < 0.001) and percutaneous coronary intervention
utilization (adjusted OR: 0.88; 95% CI: 0.79-0.98; P = 0.016) decreased
significantly in the intervention group. There was no significant
difference in 1-year adverse cardiac events between the control group and
the intervention group. <br/>Conclusion(s):Real-time SYNTAX score feedback
significantly reduced inappropriate coronary revascularization in stable
patients with CAD.Clinical trial registration:Nos. NCT03068858 and
NCT02880605; https://www.clinicaltrials.gov.<br/>Copyright &#xa9; 2020
Lippincott Williams and Wilkins. All rights reserved.

<80>
Accession Number
2006792915
Title
A systematic review of guidelines for dual antiplatelet therapy in
coronary artery bypass graft.
Source
European Journal of Clinical Investigation. (no pagination), 2020. Date of
Publication: 2020.
Author
Zhang Z.-Z.-P.; Zhang S.-Z.; Zhou H.-M.; Fan Y.-Q.; Liu M.-H.; Zhong
X.-B.; Yang D.-Y.; Guo Y.; Zhuang X.-D.; Liao X.-X.
Institution
(Zhang) Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou,
China
(Zhang, Zhou, Fan, Liu, Zhong, Yang, Guo, Zhuang, Liao) Cardiology
Department, First Affiliated Hospital of Sun Yat-Sen University,
Guangzhou, China
(Zhang, Zhou, Fan, Liu, Zhong, Yang, Guo, Zhuang, Liao) NHC Key Laboratory
of Assisted Circulation (Sun Yat-Sen University), Guangzhou, China
Publisher
Blackwell Publishing Ltd (E-mail: info@royensoc.co.uk)
Abstract
Background: In most situations, many patients undergoing coronary artery
bypass graft (CABG) are on dual antiplatelet therapy (DAPT), which is also
required after CABG. The adjustment of antiplatelet strategy remains
controversial. In this study, we systematically review current guidelines,
seeking consensus and controversies to facilitate clinical practice.
<br/>Methods and Results: Guidelines are searched in PubMed, Embase, ECRI
Guidelines Trust and websites of guidelines organizations and professional
society. Guidelines with recommendations of DAPT for patients undergo CABG
are included. Two reviewers appraised guidelines with the Appraisal of
Guidelines for Research and Evaluation II (AGREE II). Relevant
recommendations are extracted and summarized. A total of 14 guidelines
meeting inclusion criteria are selected, with average AGREE II scores from
44% to 86%. Most guidelines score high in domains other than
'applicability'. Many guidelines are not detailed enough in reporting
considerations behind recommendations. Current guidelines are consistent
on the management of antiplatelet strategy before elective CABG and using
DAPT after surgery for preventing graft vessel occlusion. Evidence is
still lacking in urgent CABG and resumption of the previous DAPT after
surgery. <br/>Conclusion(s): Current guidelines on DAPT in CABG are
generally satisfying. Suspending P2Y12 inhibitors while aspirin continued
before elective CABG is recommended, as well as 12 months of DAPT
following CABG. More evidence is needed to guide antiplatelet therapy in
urgent CABG and to prove the benefits of resuming previous
DAPT.<br/>Copyright &#xa9; 2020 Stichting European Society for Clinical
Investigation Journal Foundation. Published by John Wiley & Sons Ltd

<81>
Accession Number
632944068
Title
Clinical Burden and Unmet Need in Recurrent Pericarditis: A Systematic
Literature Review.
Source
Cardiology in review. (no pagination), 2020. Date of Publication: 18 Sep
2020.
Author
Klein A.; Cremer P.; Kontzias A.; Furqan M.; Forsythe A.; Crotty C.;
Lim-Watson M.; Magestro M.
Institution
(Klein, Cremer, Furqan) Center for the Diagnosis and Treatment of
Pericardial Diseases, Department of Cardiovascular Medicine, Heart,
Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
(Kontzias) Center of Autoinflammatory Diseases, State University of New
York Stonybrook, NY, NY
(Forsythe, Crotty) Purple Squirrel Economics, NY, NY
(Lim-Watson, Magestro) Value and Access, Kiniksa Pharmaceuticals Corp.,
MA, Lexington, United States
Publisher
NLM (Medline)
Abstract
Inflammation of the pericardium (pericarditis) is characterized by
excruciating chest pain. This systematic literature review summarizes
clinical, humanistic, and economic burdens in acute, especially recurrent,
pericarditis, with a secondary aim of understanding United States
treatment patterns and outcomes. Short-term clinical burden is well
characterized, but longer-term data are limited. Some studies report
healthcare resource utilization and economic impact; none measure
health-related quality-of-life. Pericarditis is associated with infrequent
but potentially life-threatening complications, including cardiac
tamponade (weighted average: 12.7% across 10 studies), constrictive
pericarditis (1.84%; nine studies), and pericardial effusion (54.7%; 16
studies). There are no approved pericarditis treatments; treatment
guidelines, when available, are inconsistent on treatment course or
duration. Most recommend first-line use of conventional treatments, e.g.,
non-steroidal anti-inflammatory drugs with or without colchicine; however,
15% to 30% of patients experience recurrence. Second-line therapy may
involve conventional therapies plus long-term utilization of
corticosteroids, despite safety issues and the difficulty of tapering or
discontinuation. Other exploratory therapies (e.g. azathioprine,
immunoglobulin, methotrexate, anakinra) present steroid-sparing options,
but none are supported by robust clinical evidence, and some present
tolerability challenges that may impact adherence. Pericardiectomy is
occasionally pursued in treatment-refractory patients, though data are
limited. This lack of an evidence-based treatment pathway for patients
with recurrent disease is reflected in readmission rates, e.g., 12.2% at
30 days in one US study. Patients with continued recurrence and inadequate
treatment response need approved, safe, accessible treatments to resolve
pericarditis symptoms and reduce recurrence risk without excessive
treatment burden.

<82>
Accession Number
632942075
Title
High Transaminases following Cardiac SurgeryA Narrative Review.
Source
Journal of Cardiac Critical Care. (no pagination), 2020. Date of
Publication: 2020.
Author
Omar A.S.; Taha A.; Al-Khulaifi A.
Institution
(Omar, Al-Khulaifi) Department of Cardiothoracic Surgery, Cardiac
Anesthesia and ICU, Heart Hospital, Hamad Medical Corporation, PO, 3050,
Doha, Qatar
(Omar) Department of Critical Care Medicine, Beni Suef University, Beni
Suef, Egypt
(Omar) Department of Clinical Medicine, Weill Cornell Medical College,
Qatar
(Taha) Department of Critical Care Medicine, King Khaled Specialized
Hospital, Dammam, KSA, Saudi Arabia
Publisher
Thieme India
Abstract
Elevation of liver enzymes after cardiac surgery is encountered
infrequently. Acute heart failure during and after surgery may be the
culprit responsible for liver dysfunction. However, it may create clinical
confusion whether acute liver dysfunction could induce some sort of
cardiac dysfunction through mechanisms similar to those encountered in
chronic liver disease. We searched through the Medline, Cochrane, and
Embase databases up to January 2018. We included review articles,
meta-analyses, and original trials on the elevation of liver enzymes after
cardiac surgery, and combined the following MESH terms: intensive care,
cardiac surgery, high liver enzymes, ischemia, left ventricular
dysfunction, and critical illness. Case reports were excluded. Language
restrictions were not applied. References were examined for other
potentially useful articles. We did not find any articles that supported
the cardiac decompensation phenomenon after acute liver injury. In
contrast, low-hepatic flow, hypoxemia, or pump-induced inflammation could
induce hepatic dysfunction in acute settings after cardiac surgery. In
conclusion, a rise in the transaminases following cardiac surgery would
favor an ischemic etiology for the condition. <br/>Copyright &#xa9; 2020
Official Publication of The Simulation Society (TSS), accredited by
International Society of Cardiovascular Ultrasound (ISCU).

<83>
Accession Number
632924435
Title
A Pilot Trial of Platelets Stored Cold versus at Room Temperature for
Complex Cardiothoracic Surgery.
Source
Anesthesiology. (no pagination), 2020. Date of Publication: 09 Sep 2020.
Author
Strandenes G.; Sivertsen J.; Bjerkvig C.K.; Fosse T.K.; Cap A.P.; Del
Junco D.J.; Kristoffersen E.K.; Haaverstad R.; Kvalheim V.; Braathen H.;
Lunde T.H.F.; Hervig T.; Hufthammer K.O.; Spinella P.C.; Apelseth T.O.
Publisher
NLM (Medline)
Abstract
BACKGROUND: This pilot trial focused on feasibility and safety to provide
preliminary data to evaluate the hemostatic potential of cold-stored
platelets (2degree to 6degreeC) compared with standard room
temperature-stored platelets (20degree to 24degreeC) in adult patients
undergoing complex cardiothoracic surgery. This study aimed to assess
feasibility and to provide information for future pivotal trials.
<br/>METHOD(S): A single center two-stage exploratory pilot study was
performed on adult patients undergoing elective or semiurgent complex
cardiothoracic surgery. In stage I, a two-armed randomized trial,
platelets stored up to 7 days in the cold were compared with those stored
at room temperature. In the subsequent single-arm stage II, cold storage
time was extended to 8 to 14 days. The primary outcome was clinical effect
measured by chest drain output. Secondary outcomes were platelet function
measured by multiple electrode impedance aggregometry, total blood usage,
immediate and long-term (28 days) adverse events, length of stay in
intensive care, and mortality. <br/>RESULT(S): In stage I, the median
chest drain output was 720 ml (quartiles 485 to 1,170, n = 25) in patients
transfused with room temperature-stored platelets and 645 ml (quartiles
460 to 800, n = 25) in patients transfused with cold-stored platelets. No
significant difference was observed. The difference in medians between the
room temperature- and cold-stored up to 7 days arm was 75 ml (95% CI,
-220, 425). In stage II, the median chest drain output was 690 ml (500 to
1,880, n = 15). The difference in medians between the room temperature arm
and the nonconcurrent cold-stored 8 to 14 days arm was 30 ml (95% CI,
-1,040, 355). Platelet aggregation in vitro increased after transfusion in
both the room temperature- and cold-stored platelet study arms. Total
blood usage, number of adverse events, length of stay in intensive care,
and mortality were comparable among patients receiving cold-stored and
room temperature-stored platelets. <br/>CONCLUSION(S): This pilot trial
supports the feasibility of platelets stored cold for up to 14 days and
provides critical guidance for future pivotal trials in high-risk
cardiothoracic bleeding patients.<br/>Copyright &#xa9; 2020, the American
Society of Anesthesiologists, Inc. All Rights Reserved.

<84>
Accession Number
2005609220
Title
Is carotid screening redundant for patients undergoing coronary artery
bypass grafting?.
Source
Journal of Cardiac Surgery. 35 (9) (pp 2297-2306), 2020. Date of
Publication: 01 Sep 2020.
Author
Volpi S.; Ali J.M.
Institution
(Volpi, Ali) Department of Cardiothoracic Surgery, Royal Papworth
Hospital, Cambridge Biomedical Campus, Cambridge, United Kingdom
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Objectives: Stroke is a devastating complication following coronary artery
bypass grafting, which thankfully occurs with low incidence. The role of
preoperative carotid ultrasound remains unclear. Whilst it is a cheap and
reliable way of diagnosing carotid stenosis (CS), it is unclear if and how
this knowledge should impact on subsequent patient management.
<br/>Method(s): A systematic review of the literature was performed using
the PRISMA guideline. A literature search was conducted on the MEDLINE
database from 1950 to May 2020 using the OVID interface. Fifteen papers
out of a total of 5931 were identified for inclusion. <br/>Result(s): The
evidence overall suggests that patients with severe CS are likely to have
an increased incidence of postoperative stroke-however, the prevalence of
severe CS is low, and even in this cohort of patients, the incidence is
not particularly high. <br/>Conclusion(s): In screened patients identified
to have severe CS, there appears to be a generally low appetite for
undertaking carotid intervention internationally either before or
concurrently with the coronary artery bypass grafting. Putting this all
together, the widespread screening of asymptomatic patients would appear
to not be justified.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<85>
Accession Number
2005541054
Title
Prospective randomized trial of endoscopic vs open radial artery harvest
for CABG: Clinical outcome, patient satisfaction, and midterm RA graft
patency.
Source
Journal of Cardiac Surgery. 35 (9) (pp 2147-2154), 2020. Date of
Publication: 01 Sep 2020.
Author
Tamim M.; Alexiou C.; Al-Hassan D.; Al-Faraidy K.
Institution
(Tamim, Alexiou) Department of Cardiac Surgery, King Fahd Military Medical
Complex, Dhahran, Saudi Arabia
(Al-Hassan) Department of Radiology, King Fahd Military Medical Complex,
Dhahran, Saudi Arabia
(Al-Faraidy) Department of Cardiology, King Fahd Military Medical Complex,
Dhahran, Saudi Arabia
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background and Aim: Endoscopic radial artery (RA) harvest (ERAH) is an
alternative to open RA harvest (ORAH) technique. Our aim was to ascertain
clinical outcomes, patent satisfaction, and 1-year angiographic patency
rates after ERAH and ORAH. <br/>Patients and Methods: A total of 50
patients undergoing coronary artery bypass grafting were prospectively
randomized to two groups. In the ERAH group (25 patients) the RA was
harvested endoscopically and in the ORAH group (25 patients) openly.
<br/>Result(s): There were not differences between the groups in
preoperative characteristics. Length of skin incision was shorter in ERAH
(P <.001) but there were not differences in the length of RA, harvest
time, blood flow, and pulsatility index after ERAH and ORAH. Wound healing
was uniformly smooth in ERAH and there were two hematomas and one
infection in ORAH. Postoperatively, major neuralgias were present in five
patients in ORAH and none in ERAH and minor neuralgias in 11 and 3
patients (P =.02) respectively. Twenty-four patients in ERAH and four in
ORAH graded their experience as excellent (P <.001). One-year angiographic
RA patency was 90% without intergroup difference. Target vessel stenosis
less than 90% adversely affected RA patency (P <.0001).
<br/>Conclusion(s): In expert center, ERAH does not appear to have
negative impact on the time harvest, the length, and quality of RA
conduit, the wound healing, and the occurrence of hand and forearm
complications. In addition, provides excellent cosmetic result and patient
satisfaction. RA graft patency is gratifying when placed to a target
coronary artery vessel with stenosis greater than 90%.<br/>Copyright
&#xa9; 2020 Wiley Periodicals LLC

<86>
Accession Number
2005540955
Title
Surgical vs transfemoral aortic valve replacement in low-risk patients: An
updated meta-analysis of trial and registry data.
Source
Journal of Cardiac Surgery. 35 (9) (pp 2264-2274), 2020. Date of
Publication: 01 Sep 2020.
Author
Luthra S.; Leiva-Juarez M.M.; Ohri S.K.
Institution
(Luthra, Ohri) Wessex Cardiothoracic Centre, Southampton University
Hospitals NHS Trust, Southampton, United Kingdom
(Leiva-Juarez) Department of Surgery, Brookdale University Hospital and
Medical Center, Brooklyn, NY, United States
Publisher
Blackwell Publishing Inc. (Postfach 10 11 61, 69451 Weinheim, Boschstrabe
12, 69469 Weinheim, Deutschland 69469, Germany. E-mail:
subscrip@blackwellpub.com)
Abstract
Background: Transfemoral aortic valve replacement (TAVR) has been studied
extensively in patients with improving safety and efficacy in high to
intermediate-risk patients with aortic stenosis. TAVR has been now
approved for patients with low surgical risk. <br/>Objective(s): The
purpose of this study is to integrate the evidence from randomized
controlled trials (RCT) and large registry data comparing TAVR to surgical
aortic valve repair (SAVR). <br/>Method(s): Seven studies (three RCTs, one
post hoc study of a RCT, and three registries) were included. Incidence
rate ratios (IRR) of outcomes of interest (overall mortality, 30-day
mortality, cardiovascular death, stroke, pacemaker implantation [PPMI],
myocardial infarction, moderate-severe paravalvular leak [PVL], and
re-intervention) were compared using a random-effects model.
<br/>Result(s): The pooled analysis included 24 819 patients (TAVR, 8227
and SAVR, 16 592). 2,952 (11.9%) patients were from RCTs and 21 867
(88.1%) were registry patients. Thirty-day mortality was lower in TAVR
(logIRR, -0.43; 95% CI. -0.61 to -0.25; P <.001), whereas the rate of
moderate-severe PVL (logIRR, 1.44; 95% CI, 0.58-2.3; P <.001) and PPMI
(logIRR, 1.13; 95% CI, 1.02-1.24; P <.001) were higher. There were no
significant differences in the rates of overall mortality, reintervention,
cardiovascular death, myocardial infarction, or stroke between SAVR and
TAVR. <br/>Conclusion(s): Early mortality is higher in SAVR while rates of
PVL and PPMI are substantially higher in TAVR. There is no significant
advantage with TAVR for overall survival, cardiovascular death, stroke,
MI, and re-intervention rates.<br/>Copyright &#xa9; 2020 Wiley Periodicals
LLC

<87>
Accession Number
632876468
Title
The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain
Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.
Source
Journal of Alzheimer's Disease. 75 (4) (pp 1319-1328), 2020. Date of
Publication: 2020.
Author
Vandusen K.W.; Eleswarpu S.; Moretti E.W.; Devinney M.J.; Crabtree D.M.;
Laskowitz D.T.; Woldorff M.G.; Roberts K.C.; Whittle J.; Browndyke J.N.;
Cooter M.; Rockhold F.W.; Anakwenze O.; Bolognesi M.P.; Easley M.E.;
Ferrandino M.N.; Jiranek W.A.; Berger M.; Adams S.B.; Amundsen C.L.;
Avasarala P.; Barber M.D.; Berchuck A.; Blazer Iii D.G.; Brassard R.;
Brigman B.E.; Cai V.; Christensen S.K.; Cox M.W.; Davidson B.A.; Deorio
J.K.; Erdmann D.; Erickson M.M.; Funk B.L.; Gadsden J.; Gage M.J.;
Gingrich J.R.; Greenup R.A.; Ha C.; Habib A.; Abi Hachem R.; Hall A.E.;
Hartwig M.G.; Havrilesky L.J.; Heflin M.T.; Holland C.; Hollenbeck S.T.;
Hopkins T.J.; Inman B.A.; Jang D.W.; Kahmke R.R.; Karikari I.; Kawasaki
A.; Klapper J.A.; Klifto C.S.; Klinger R.; Knechtle S.J.;
Lagoo-Deenadayalan S.A.; Lee W.T.; Levinson H.; Lewis B.D.; Lidsky M.E.;
Lipkin M.E.; Mantyh C.R.; McDonald S.R.; Migaly J.; Miller T.E.; Mithani
S.K.; Mosca P.J.; Moul J.W.; Novick T.L.; Olson S.A.; Pappas T.N.; Park
J.J.; Peterson A.C.; Phillips B.T.; Polascik T.J.; Potash P.; Preminger
G.M.; Previs R.A.; Robertson C.N.; Scales Jr C.D.; Shah K.N.; Scheri R.P.;
Siddiqui N.Y.; Smani S.; Southerland K.W.; Stang M.T.; Syed A.; Szydlowska
A.; Thacker J.K.M.; Terrando N.; Toulgoat-Dubois Y.; Visco A.G.; Weidner
A.C.; Yanamadala M.; Zani Jr S.; Price C.
Institution
(Vandusen, Eleswarpu, Moretti, Devinney, Whittle, Cooter, Berger,
Avasarala, Brassard, Cai, Christensen, Funk, Gadsden, Ha, Habib, Hall,
Holland, Hopkins, Lewis, Miller, Park, Potash, Smani, Syed, Szydlowska,
Terrando, Toulgoat-Dubois, Price) Department of Anesthesiology, Duke
University, Durham, NC, United States
(Crabtree) Duke Office of Clinical Research, Duke University, Durham, NC,
United States
(Laskowitz) Department of Neurology, Duke University, Durham, NC, United
States
(Woldorff, Browndyke) Department of Psychiatry and Behavioral Sciences,
Duke University Medical Center, Durham, NC, United States
(Woldorff) Department of Psychology and Neuroscience, Duke University,
Durham, NC, United States
(Roberts, Berger) Center for Cognitive Neuroscience, Duke University
Medical Center, Durham, NC, United States
(Rockhold) Duke Clinical Research Institute, Durham, NC, United States
(Anakwenze, Bolognesi, Easley, Adams, Brigman, Deorio, Erickson, Gage,
Klifto, Olson) Department of Orthopaedic Surgery, Duke University, Durham,
NC, United States
(Ferrandino, Jiranek, Blazer Iii, Cox, Erdmann, Gingrich, Greenup, Abi
Hachem, Hartwig, Hollenbeck, Inman, Jang, Kahmke, Klapper, Knechtle,
Lagoo-Deenadayalan, Lee, Levinson, Lidsky, Lipkin, Mantyh, Migaly,
Mithani, Mosca, Moul, Novick, Pappas, Peterson, Phillips, Polascik,
Preminger, Robertson, Scales Jr, Shah, Scheri, Southerland, Stang,
Thacker, Zani Jr) Department of Surgery, Duke University, Durham, NC,
United States
(Berger, Amundsen, Barber, Berchuck, Davidson, Havrilesky, Heflin,
Kawasaki, Previs, Siddiqui, Visco) Center for the Study of Aging and Human
Development, Duke University Medical Center, Durham, NC, United States
(Weidner) Department of Obstetrics and Gynecology, Duke University,
Durham, NC, United States
(Abi Hachem, Jang, Karikari) Department of Neurosurgery, Duke University,
Durham, NC, United States
(Heflin, Klinger, McDonald, Yanamadala) Department of Medicine, Duke
University, Durham, NC, United States
(Levinson) Department of Dermatology, Duke University, Durham, NC, United
States
(Levinson) Department of Pathology, Duke University, Durham, NC, United
States
(Scales Jr) Department of Population Health Sciences, Duke University,
Durham, NC, United States
(Zani Jr) Department of Mechanical Engineering and Materials Science, Duke
University, Durham, NC, United States
Publisher
IOS Press BV (E-mail: sales@iospress.com)
Abstract
Background: Perioperative neurocognitive disorders (PND) are common
complications in older adults associated with increased 1-year mortality
and long-term cognitive decline. One risk factor for worsened long-term
postoperative cognitive trajectory is the Alzheimer's disease (AD) genetic
risk factor APOE4. APOE4 is thought to elevate AD risk partly by
increasing neuroinflammation, which is also a theorized mechanism for PND.
Yet, it is unclear whether modulating apoE4 protein signaling in older
surgical patients would reduce PND risk or severity. <br/>Objective(s):
MARBLE is a randomized, blinded, placebo-controlled phase II sequential
dose escalation trial designed to evaluate perioperative administration of
an apoE mimetic peptide drug, CN-105, in older adults (age>=60 years). The
primary aim is evaluating the safety of CN-105 administration, as measured
by adverse event rates in CN-105 versus placebo-treated patients.
Secondary aims include assessing perioperative CN-105 administration
feasibility and its efficacy for reducing postoperative neuroinflammation
and PND severity. <br/>Method(s): 201 patients undergoing non-cardiac,
non-neurological surgery will be randomized to control or CN-105 treatment
groups and receive placebo or drug before and every six hours after
surgery, for up to three days after surgery. Chart reviews, pre-and
postoperative cognitive testing, delirium screening, and blood and CSF
analyses will be performed to examine effects of CN-105 on perioperative
adverse event rates, cognition, and neuroinflammation. Trial results will
be disseminated by presentations at conferences and peer-reviewed
publications. <br/>Conclusion(s): MARBLE is a transdisciplinary study
designed to measure CN-105 safety and efficacy for preventing PND in older
adults and to provide insight into the pathogenesis of these geriatric
syndromes.<br/>Copyright &#xa9; 2020-IOS Press and the authors. All rights
reserved.

<88>
Accession Number
632684490
Title
Endocarditis risk with bioprosthetic and mechanical valves: Systematic
review and meta-analysis.
Source
Heart. 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
BMJ Publishing Group (E-mail: support@bmj.com)
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. Methods 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. Results 13
comparison groups with 43 941 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 (I 2 =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. Conclusions 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.<br/>Copyright
&#xa9;

<89>
Accession Number
631759650
Title
Effect of Evolocumab on Type and Size of Subsequent Myocardial Infarction:
A Prespecified Analysis of the FOURIER Randomized Clinical Trial.
Source
JAMA Cardiology. 5 (7) (pp 787-793), 2020. Date of Publication: July 2020.
Author
Wiviott S.D.; Giugliano R.P.; Morrow D.A.; De Ferrari G.M.; Lewis B.S.;
Huber K.; Kuder J.F.; Murphy S.A.; Forni D.M.; Kurtz C.E.; Honarpour N.;
Keech A.C.; Sever P.S.; Pedersen T.R.; Sabatine M.S.
Institution
(Wiviott, Giugliano, Morrow, Murphy, Forni, Sabatine) Cardiovascular
Division, Brigham and Women's Hospital, Boston, MA, United States
(Giugliano, Kuder, Murphy, Sabatine) Thrombolysis in Myocardial Infarction
(TIMI) Study Group, Division of Cardiovascular Medicine, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA, United States
(De Ferrari) Department of Medical Sciences, University of Torino,
Cardiology Aou Citta della Salute e della Scienza, Torino, Italy
(Lewis) Lady Davis Carmel Medical Center, Haifa, Israel
(Huber) Wilhelminen Hospital, Vienna, Austria
(Kurtz, Honarpour) Amgen, Thousand Oaks, CA, United States
(Keech) Sydney Medical School, National Health and Medical Research
Council Clinical Trials Center, University of Sydney, Sydney, Australia
(Sever) National Heart and Lung Institute, Imperial College, London,
United Kingdom
(Pedersen) Oslo University Hospital, Ulleval and Medical Faculty,
Niversity of Oslo, Oslo, Norway
Publisher
American Medical Association (E-mail: shirley.martin@ama-assn.org)
Abstract
Importance: The PCSK9 inhibitor evolocumab reduced major vascular events
in the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in
Subjects With Elevated Risk (FOURIER) trial, yet the types and sizes of
myocardial outcomes in FOURIER have not been previously explored.
<br/>Objective(s): To assess the types and sizes of myocardial infarction
(MI) and the effect of evolocumab on MI by subtype. <br/>Design, Setting,
and Participant(s): A prespecified analysis of a multicenter double-blind
randomized clinical trial. Patients were randomized to evolocumab or
placebo and followed up for a median of 2.2 years. The study included
27564 patients with stable atherosclerotic disease receiving statin
therapy. Clinical end points were evaluated by the Thrombolysis in
Myocardial Infarction clinical events committee. Rates presented are
3-year Kaplan-Meier estimates. Data were collected from 2013 to 2016 and
analyzed from June 2017 to December 2019. <br/>Main Outcomes and Measures:
Myocardial infarction was defined based on the third universal MI
definition, and further classified according to MI type (universal MI
subclass, ST-segment elevation myocardial infarction [STEMI] vs non-STEMI)
and by MI size (determined by peak troponin level). <br/>Result(s): A
total of 27564 patients were randomized, with a mean (SD) age of 62.5
(9.0) years, and 20795 (75%) were male. Of these, 1107 patients
experienced a total of 1288 MIs. Most MIs (68%) were atherothrombotic
(type 1), with 15% from myocardial oxygen supply-demand mismatch (type 2)
and 15% percutaneous coronary intervention-related (type 4). Sudden death
(type 3) and coronary artery bypass grafting-related (type 5) accounted
for a total of 21 MIs (<2%). Evolocumab significantly reduced the risk of
first MI by 27% (4.4% vs 6.3%; hazard ratio [HR], 0.73; 95% CI, 0.65-0.82;
P <.001), type 1 by 32% (2.9% vs 4.5%; HR, 0.68; 95% CI, 0.59-0.79; P
<.001), and type 4 by 35% (0.8% vs 1.1%; HR, 0.65; 95% CI, 0.48-0.87; P
=.004), with no effect on type 2 (0.9% vs 0.8%; HR, 1.09; 95% CI,
0.82-1.45; P =.56). Most MIs (688 [59.8%]) had troponin levels greater
than or equal to 10 times the upper limit of normal. The benefit was
highly significant and consistent regardless of the size of MI with a 34%
reduction in MIs with troponin level greater than or equal to 10 times the
upper limit of normal (2.6% vs 3.7%; HR, 0.66; 95% CI, 0.56-0.77; P <.001)
and a 36% reduction in the risk of STEMI (1.0% vs 1.5%; HR, 0.64; 95% CI,
0.49-0.84; P <.001). <br/>Conclusions and Relevance: Low-density
lipoprotein cholesterol lowering with evolocumab was highly effective in
reducing the risk of MI. This reduction with evolocumab included benefit
across multiple subtypes of MI related to plaque rupture, smaller and
larger MIs, and both STEMI and non-STEMI. These data are consistent with
the known benefit of low-density lipoprotein cholesterol lowering and
underscore the reduction in clinically meaningful events. Trial
Registration: ClinicalTrials.gov Identifier: NCT01764633.<br/>Copyright
&#xa9; 2020 American Medical Association. All rights reserved.

<90>
Accession Number
2007883556
Title
Sublingual Sufentanil Tablet System Versus Continuous Morphine Infusion
for Postoperative Analgesia in Cardiac Surgery Patients.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Van Tittelboom V.; Poelaert R.; Malbrain M.L.N.G.; La Meir M.; Staessens
K.; Poelaert J.
Institution
(Van Tittelboom, Poelaert) Department of Anesthesiology and Perioperative
Medicine, UZ Brussels, Jette, Belgium
(Malbrain) Department of Intensive Care, UZ Brussels, Faculty of Medicine
and Pharmacy, Jette, Belgium
(La Meir) Department of Cardiac Surgery, UZ Brussels, Faculty of Medicine
and Pharmacy, Jette, Belgium
(Staessens) Department of Perfusion, UZ Brussels, Jette, Belgium
(Poelaert) Department of Anesthesiology and Perioperative Medicine, UZ
Brussels, Faculty of Medicine and Pharmacy, Jette, Belgium
Publisher
W.B. Saunders
Abstract
Objective(s): To assess the effectiveness and side effects of a
patient-controlled sublingual sufentanil tablet system for postoperative
analgesia after cardiac surgery and to compare it to a nurse-controlled
continuous morphine infusion. <br/>Design(s): Prospective, open-label,
randomized controlled trial. <br/>Setting(s): Single university academic
center. <br/>Participant(s): Adult patients undergoing cardiac surgery,
which included a sternotomy. <br/>Intervention(s): Sublingual sufentanil
tablet system versus nurse-controlled continuous morphine infusion.
<br/>Measurements and Main Results: A total of 483 cardiac surgery
patients were screened for eligibility, of whom 64 patients completed the
study. No statistically significant differences were found for baseline
characteristics between both groups. All mean numeric rating scale (NRS)
pain scores from after extubation until intensive care unit discharge were
<=3 in both groups. The cumulative mean NRS pain score from 24 hours after
extubation (primary outcome) (t = hours after extubation) was
significantly different in favor of the morphine group: (t = 0-24) (0.8
[0.7] v 1.3 [0.8]; p = 0.006). Later cumulative mean pain scores were also
in favor of the morphine group: (t = 24-48) (0.2 [0.3] v 0.6 [0.5]; p =
0.001) and (t = 48-63) (0.0 [0.0] v 0.1 [0.2]; p = 0.013). The cumulative
opioid dose (in milligrams intravenous morphine equivalents) was
significantly higher in the morphine group compared with the sublingual
sufentanil group (241.94 [218.73] v 39.84 [21.96]; p = 0.0001). No
differences were found for the incidences of postoperative nausea and
vomiting, sedation, hypoventilation, bradycardia, or hypotension between
both groups (secondary outcomes). <br/>Conclusion(s): Despite resulting in
statistically significantly higher pain scores, a patient-controlled
sublingual sufentanil tablet system offers adequate analgesia after
cardiac surgery and reduces opioid consumption when compared with
continuous morphine infusion.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<91>
Accession Number
2007883469
Title
Combined Cardiothoracic Surgery and Liver Transplantation Versus Isolated
Liver Transplantation.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Bui C.C.M.; Tanner C.; Nguyen-Buckley C.; Scovotti J.; Wray C.; Xia V.W.
Institution
(Bui, Tanner, Nguyen-Buckley, Scovotti, Wray, Xia) Department of
Anesthesiology and Perioperative Medicine, David Geffen School of Medicine
at UCLA, Los Angeles, CA, United States
Publisher
W.B. Saunders
Abstract
Objective: Combined cardiothoracic surgery and liver transplantation
(cCSLT) recently increasingly has been used. Despite that, liver
transplant immediately after cardiothoracic surgery has not been
well-characterized. The authors aimed to compare perioperative management
and postoperative outcomes between patients undergoing cCSLT and isolated
liver transplantation (iLT). <br/>Design(s): A retrospective study.
<br/>Setting(s): University tertiary medical center. <br/>Participant(s):
Twenty-five cCSLT patients and 1091 iLT patients at a single institution
from 2010 to 2017. <br/>Intervention(s): Twenty-five cCSLT patients were
compared with 100 randomly selected and 100 propensity-matched iLT
patients. <br/>Measurements and Main Results: All cCSLT patients underwent
comprehensive preoperative evaluation by a multidisciplinary team. Of 25
cardiothoracic surgeries, heart transplant (n = 9) was most common,
followed by coronary artery bypass grafting (n = 5) and lung transplant (n
= 3). Intraoperative management of cCSLT was provided by 2 separate teams,
one for cardiothoracic surgery and one for liver transplantation. Patients
undergoing cCSLT often required cardiopulmonary bypass, an intra-aortic
balloon pump, extracorporeal membrane oxygenation, or cardiac
pharmacologic therapies and, additionally, needed more interventions
including antifibrinolytic administration, venovenous bypass, massive
blood transfusion, and platelet transfusions compared with iLT patients.
Ninety-day survival rates were similar in the cCSLT (100%) and iLT groups
(random iLT 87% and matched iLT 93%, log-rank test p = 0.089).
<br/>Conclusion(s): Despite having end-stage liver disease and advanced
cardiothoracic disorders and experiencing a complex intraoperative course,
cCSLT patients had comparable 90-day survival to iLT patients.
Comprehensive planning before transplant, optimal patient/donor selection,
the multiple-team model, and meticulous intraoperative management are
critical to the success of cCSLT.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<92>
Accession Number
2006119034
Title
Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention
in Patients with Left Ventricular Systolic Dysfunction.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2020. Date of
Publication: 2020.
Author
Khan M.R.; Kayani W.T.; Pelton J.; Ansari A.; Paniagua D.; Khalid U.;
Denktas A.; Changezi H.U.; Munir A.; Jimenez E.; Alam M.; Jneid H.
Institution
(Khan, Changezi, Munir) Division of Cardiology, McLaren-Flint/Michigan
State University, Flint, MI, United States
(Kayani, Pelton, Ansari, Paniagua, Khalid, Denktas, Alam, Jneid) Section
of Cardiology, Department of Internal Medicine, Baylor College of
Medicine, Houston, TX 77030, United States
(Khalid, Jimenez, Jneid) Division of Cardiology, Michael E. DeBakey
Veterans Affairs Medical Center, Houston, TX 77030, United States
(Jimenez) Division of Cardiothoracic Surgery, Michael E. DeBakey Veterans
Affairs Medical Center, Houston, TX, United States
Publisher
Springer
Abstract
Purpose: There is a paucity of comparative data examining the optimal
revascularization strategy in patients with left ventricular systolic
dysfunction (LVD). <br/>Method(s): We performed an aggregate data
meta-analysis of clinical outcomes comparing percutaneous coronary
intervention (PCI) versus coronary artery bypass (CABG) in patients with
LVD (left ventricle ejection fraction (LVEF) of <= 40%), using the random
effects model. Effects size is reported as odds ratio (OR) and a 95%
confidence interval. Outcomes included all-cause mortality, myocardial
infarction, stroke, repeat revascularization, and a composite of major
adverse cardiac and cerebrovascular events (MACCE) at 30-day, 3-year, and
long-term (6.3 +/- 0.9 years) follow-ups. Seventeen studies (16
observational, 1 randomized) and 18,599 patients (CABG 9651; PCI 8948)
were included. <br/>Result(s): PCI and CABG had comparable all-cause
mortality at 30 days (OR 0.78, 95% CI 0.49-1.23) and 3 years (OR 1.05, 95%
CI 0.91-1.21); however, PCI was associated with increased long-term
morality after a mean follow-up of 6.3 +/- 0.9 years (31.6% vs. 24.3%, OR
1.41, 95% CI 1.21-1.64). A similar mortality trend was observed in the
subgroup of patients with EF <= 35%. PCI had a higher rate of repeat
revascularization at 3-year and long-term follow-ups. The long-term rates
of stroke and MI were comparable. PCI, on the other hand, had lower rates
of stroke at 30-day and 3-year follow-ups. <br/>Conclusion(s): CABG was
associated with lower rates of long-term mortality and revascularization
but higher rate of upfront stroke in patients with LVD. However, the data
included consisted predominantly of observational studies, highlighting
the paucity and need for randomized trials.<br/>Copyright &#xa9; 2020,
Springer Science+Business Media, LLC, part of Springer Nature.

<93>
Accession Number
2005253149
Title
Thromboelastometry and a hemostasis management system are most beneficial
for guiding hemostatic therapy in cardiac surgery patients with a
EuroSCORE II of >=1.83%: a randomized controlled two-step trial.
Source
Journal of Anesthesia. 34 (5) (pp 666-674), 2020. Date of Publication: 01
Oct 2020.
Author
Kodaka M.; Ichikawa J.; Ando K.; Komori M.
Institution
(Kodaka, Ichikawa, Ando, Komori) Department of Anesthesiology and
Intensive Care, Tokyo Women's Medical University Medical Center East,
Arakawa-ku, Tokyo 116-8567, Japan
Publisher
Springer Japan (E-mail: orders@springer.jp)
Abstract
Purpose: We evaluated the efficacy of hemostatic therapy based on
point-of-care (POC) testing in patients undergoing cardiac surgery.
<br/>Method(s): This was a single-institution, prospective, randomized,
double-blinded study. In step 1, 90 patients scheduled for elective
cardiac surgery underwent complete blood count and fibrinogen measurements
at baseline, after cardiopulmonary bypass (CPB) initiation (CPB start),
just after CPB end, and in the intensive care unit (ICU). In step 2, 72
patients scheduled for elective cardiac surgery underwent conventional
laboratory coagulation tests (control group) or POC coagulation tests (POC
group). Transfusions were prepared using the fibrinogen and platelet
values at mainly "CPB start" for the control group, and using the ROTEM
values at mainly "CPB end" for the POC group. Consequently, the step 2
patients were divided into high- and low-risk subgroups based on the
EuroSCORE II by logistic regression analysis; transfusion data and
bleeding volumes were compared between the control and POC groups within
the high- and low-risk subgroups. <br/>Result(s): In step 1, all blood
components were significantly decreased at CPB start compared with
baseline, and platelet and fibrinogen levels remained almost constant from
CPB start to end. In step 2, the transfusion rates and perioperative
bleeding volumes did not significantly differ between the control and POC
groups. Subgroup analysis suggested that only the high-risk subgroup
significantly differed regarding perioperative red blood cell transfusion
and total bleeding volume in the ICU. <br/>Conclusion(s): POC testing is
beneficial for cardiac surgery patients with a EuroSCORE II of
>=1.83%.<br/>Copyright &#xa9; 2020, Japanese Society of Anesthesiologists.

<94>
Accession Number
632908960
Title
Clinical performance of decellularized heart valves versus standard tissue
conduits: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 15 (1) (pp 260), 2020. Date of
Publication: 18 Sep 2020.
Author
Waqanivavalagi S.W.F.R.; Bhat S.; Ground M.B.; Milsom P.F.; Cornish J.
Institution
(Waqanivavalagi, Bhat, Ground, Cornish) Department of Medicine, Faculty of
Medical and Health Sciences, University of Auckland, Grafton, Auckland
1023, New Zealand
(Waqanivavalagi) Adult Emergency Department, Auckland City Hospital
,Auckland District Health Board, Grafton, Auckland 1023, New Zealand
(Bhat) Department of Surgery, Faculty of Medical and Health Sciences,
University of Auckland, Grafton, Auckland 1023, New Zealand
(Ground) Department of Medicine, Dunedin School of Medicine, University of
Otago, Dunedin 9054, New Zealand
(Milsom) Green Lane Cardiothoracic Surgical Unit, Auckland City Hospital
,Auckland District Health Board, Grafton, Auckland 1023, New Zealand
Publisher
NLM (Medline)
Abstract
BACKGROUND: Valve replacement surgery is the definitive management
strategy for patients with severe valvular disease. However, valvular
conduits currently in clinical use are associated with significant
limitations. Tissue-engineered (decellularized) heart valves are
alternative prostheses that have demonstrated promising early results. The
purpose of this systematic review and meta-analysis is to perform robust
evaluation of the clinical performance of decellularized heart valves
implanted in either outflow tract position, in comparison with standard
tissue conduits. <br/>METHOD(S): Systematic searches were conducted in the
PubMed, Scopus, and Web of Science databases for articles in which
outcomes between decellularized heart valves surgically implanted within
either outflow tract position of human subjects and standard tissue
conduits were compared. Primary endpoints included postoperative mortality
and reoperation rates. Meta-analysis was performed using a random-effects
model via the Mantel-Haenszel method. <br/>RESULT(S): Seventeen articles
were identified, of which 16 were included in the meta-analysis. In total,
1418 patients underwent outflow tract reconstructions with decellularized
heart valves and 2725 patients received standard tissue conduits.
Decellularized heart valves were produced from human pulmonary valves and
implanted within the right ventricular outflow tract in all cases. Lower
postoperative mortality (4.7% vs. 6.1%; RR 0.94, 95% CI: 0.60-1.47;
P=0.77) and reoperation rates (4.8% vs. 7.4%; RR 0.55, 95% CI: 0.36-0.84;
P=0.0057) were observed in patients with decellularized heart valves,
although only reoperation rates were statistically significant. There was
no statistically significant heterogeneity between the analyzed articles
(I2 =31%, P=0.13 and I2 =33%, P =0.10 respectively). <br/>CONCLUSION(S):
Decellularized heart valves implanted within the right ventricular outflow
tract have demonstrated significantly lower reoperation rates when
compared to standard tissue conduits. However, in order to allow for more
accurate conclusions about the clinical performance of decellularized
heart valves to be made, there need to be more high-quality studies with
greater consistency in the reporting of clinical outcomes.

<95>
Accession Number
628112487
Title
The Effect of Perioperative Iron Therapy in Acute Major Non-cardiac
Surgery on Allogenic Blood Transfusion and Postoperative Haemoglobin
Levels: A Systematic Review and Meta-analysis.
Source
World journal of surgery. 43 (7) (pp 1677-1691), 2019. Date of
Publication: 01 Jul 2019.
Author
Schack A.; Berkfors A.A.; Ekeloef S.; Gogenur I.; Burcharth J.
Institution
(Schack) Center for Surgical Science (CSS), Department of Surgery, Zealand
University Hospital & University of Copenhagen, Lykkebaekvej 1 4600,
Denmark
(Berkfors, Ekeloef, Gogenur, Burcharth) Center for Surgical Science (CSS),
Department of Surgery, Zealand University Hospital & University of
Copenhagen, Lykkebaekvej 1 4600, Denmark
Publisher
NLM (Medline)
Abstract
BACKGROUND: Perioperative anaemia in relation to surgery is associated
with adverse clinical outcomes. In an elective surgical setting, it is
possible to optimize patients prior to surgery, often by iron
supplementation with correction of anaemia. Possibilities for optimization
prior to and during acute surgical procedures are limited. This review
investigates whether iron treatment initiated perioperatively improves
outcomes in patients undergoing major acute non-cardiac surgery.
<br/>METHOD(S): This systematic review was performed using PubMed, EMBASE
(Ovid) and Scopus to identify current evidence on iron supplementation in
acute surgery. Primary outcomes were allogenic blood transfusion (ABT)
rate and changes in haemoglobin. Secondary outcomes were postoperative
mortality, length of stay (LOS), and postoperative complications. Iron was
administered at latest within 24 h after end of surgery. <br/>RESULT(S):
Of the 5413 studies screened, four randomized controlled trials and nine
observational cohort studies were included. Ten studies included patients
with hip fractures. A meta-analysis of seven studies showed a risk
reduction of transfusion (OR=0.35 CI 95% (0.20-0.63), p=0.0004, I2=66%).
No influence on plasma haemoglobin was found. Postoperative mortality was
reduced in the iron therapy group in a meta-analysis of four observational
studies (OR 0.50 (CI 95% 0.26-0.96) p=0.04). No effect was found on LOS,
but a reduction in postoperative infection was seen in four studies.
<br/>CONCLUSION(S): This review examined perioperative iron therapy in
acute major non-cardiac surgery. IV iron showed a lower 30-day mortality,
a reduction in postoperative infections and a reduction in ABT largely due
to the observational studies. The review primarily consisted of small
observational studies and does not have the power to formally recommend
this practice.

<96>
Accession Number
2007858934
Title
Clinical Outcome of Local Treatment in Synchronous Oligometastatic
Non-Small Cell Lung Cancer (NSCLC): A Preliminary Analysis of Prospective
Data.
Source
International Journal of Radiation Oncology Biology Physics. Conference:
Global Oncology:Radiation Therapy in a Changing WorldASTRO Annual Meeting.
108 (3 Supplement) (pp e138-e139), 2020. Date of Publication: 1 November
2020.
Author
Zhu X.; Li S.; Zheng Z.
Institution
(Zhu, Li, Zheng) Radiation Oncology Department, Zhujiang Hospital,
Southern Medical University, Guangzhou, China
Publisher
Elsevier Inc.
Abstract
Purpose/Objective(s): Advanced NSCLC is a heterogeneous disease, a large
number of retrospective studies suggested that patients with
oligometastases may achieve long-term survival from aggressive local
treatment. However, relevant prospective studies were limited. Therefore,
we prospectively evaluated the role of local treatment in synchronous
oligometastatic NSCLC. Materials/Methods: We prospectively identified 50
NSCLC patients newly diagnosed with synchronous oligometastases (<=5) in
two centers between 11/2017 and 12/2019, among whom there were 24 patients
from a randomized clinical trial NCT03119519. Patients were given
first-line systemic therapy according to the latest NCCN guidelines with
either local radiotherapy or surgery to thoracic primary tumor and/or
radiotherapy to metastases. They were divided into combined therapies
(Tx), systemic Tx and untreated groups. Kaplan Meier Survival analysis was
used to compare progression free survival (PFS) and overall survival (OS)
among the groups. <br/>Result(s): Median age of all patients was 61 years
old (range: 27-80 years) and median follow up was 5.7 months (range:
0.5-23.3 months). A total of 10 deaths were observed. In the combined Tx
group, 23 patients received radiotherapy, and 2 patients received primary
surgical resection. The median OS of the combined Tx group (n = 25), the
systemic Tx group (n = 19) and the untreated group (n = 6) was 18.47
months, not reached, 3.27 months, respectively. Compared with the
untreated group, the combined group and the systemic Tx group had better
OS (hazard ratio [HR] = 0.1047, p = 0.0001; HR = 0.1125, p = 0.0006).
However, the patients in the combined group did not show significant OS
advantage compared with those in the systemic Tx group (HR = 1.376, p =
0.667). In addition, we conducted an ITT analysis in clinical trial
NCT03119519, in which 8 progression events were observed. There was no
significant difference in PFS between the combined group (n = 13) and the
systemic Tx group (n = 11) (13.2 months vs. not reached, HR = 1.317, p =
0.7015; 1-year PFS: 74% vs. 54%, p = 0.7015, respectively).
<br/>Conclusion(s): Current analysis shows that the addition of local
treatment to first-line systemic Tx does not improve PFS and OS. More
samples, further updated data, and selection of potential benefiter are
necessary. <br/>Funding(s): 81972853, 81572279, 2016J004, LC2019ZD009,
2018CR033.<br/>Copyright &#xa9; 2020

<97>
Accession Number
2007856671
Title
Evaluation of Deep Learning-Based Auto-Segmentation of Target Volume and
Organs-at-Risk in Breast Cancer Patients.
Source
International Journal of Radiation Oncology Biology Physics. Conference:
Global Oncology:Radiation Therapy in a Changing WorldASTRO Annual Meeting.
108 (3 Supplement) (pp e779), 2020. Date of Publication: 1 November 2020.
Author
Chung S.Y.; Chang J.S.; Chang Y.; Choi B.S.; Chun J.; Kim J.S.; Kim Y.B.
Institution
(Chung, Chang, Choi, Chun, Kim, Kim) Department of Radiation Oncology,
Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South
Korea
(Chang) CorelineSoft, Co., Ltd, Seoul, South Korea
Publisher
Elsevier Inc.
Abstract
Purpose/Objective(s): In breast cancer patients receiving radiotherapy
(RT), lower radiation doses to the nearby normal organs can reduce
treatment-related toxicities. Also, the importance of meticulous target
delineation is increasing due to the advancement of RT modalities such as
intensity-modulated RT. Subsequently, accurate target volume and
organs-at-risk (OAR) segmentation has become imperative, adding
considerable amount of workload in the clinical field. Thus, deep
learning-based auto-segmentation can be an expedient tool for target and
OAR segmentation. Here, we evaluated the deep learning-based
auto-segmented contours compared to manually delineated contours in breast
cancer patients. Materials/Methods: Clinical target volumes (CTV) for
bilateral breasts and regional lymph node and OARs including heart, lung,
esophagus, spinal cord and thyroid were manually delineated on a planning
computed tomography scans of 61 breast cancer patients who received
breast-conserving surgery. In addition, cardiac substructures including
right coronary artery (RCA), left anterior descending artery (LAD),
atriums and ventricles were manually delineated. Afterwards, a two-stage
convolutional neural network (CNN) algorithm was conducted to effectively
segment the organs. Quantitative metrics, including dice similarity
coefficient (DSC) and Hausdorff distance (HD), and qualitative scoring by
expert and non-expert panel were used for analysis. Inter-observer
variability was also assessed for contours by three radiation oncologists
on a randomly selected case. <br/>Result(s): The correlation between the
auto-segmented and manual contours was good for OARs including heart,
lung, esophagus, spinal cord, thyroid and bilateral atriums and ventricles
with mean DSC higher than 0.80. In addition, CTVs also showed favorable
results with mean DSC higher than 0.70 for all breast and regional lymph
node CTVs. However, auto-segmented contours of RCA and LAD showed reduced
performance with mean DSC lower than 0.5 and mean HD higher than 20 mm.
Qualitative subjective scoring by physicians showed good results for all
CTV and OARs. As for inter-observer variability, only heart showed DSC of
0.91, whereas the other OARs showed DSCs lower than 0.80. For CTV,
although breast CTV showed an acceptable mean DSC of 0.85, other CTVs for
regional lymph nodes showed poor results with mean DSC ranging from 0.45
to 0.75. <br/>Conclusion(s): The feasibility of deep learning-based
auto-segmentation was shown in this study. Although deep learning-based
auto-segmentation cannot be a substitution for radiation oncologists, it
can be an expedient tool in clinic, by assisting radiation oncologists and
consequently enhancing the quality control of radiotherapy.<br/>Copyright
&#xa9; 2020

<98>
Accession Number
631989764
Title
Cardiac structural changes after transcatheter aortic valve replacement:
Systematic review and meta-analysis of cardiovascular magnetic resonance
studies.
Source
Journal of Cardiovascular Magnetic Resonance. 22 (1) (no pagination),
2020. Article Number: 41. Date of Publication: 01 Jun 2020.
Author
Mehdipoor G.; Chen S.; Chatterjee S.; Torkian P.; Ben-Yehuda O.; Leon
M.B.; Stone G.W.; Prince M.R.
Institution
(Mehdipoor, Chen, Ben-Yehuda, Leon, Stone) Cardiovascular Research
Foundation, New York, NY, United States
(Chen, Ben-Yehuda, Leon) Department of Cardiology, Columbia University
College of Physicians and Surgeons, New York, NY, United States
(Chatterjee) Hoffman Heart Institute, Saint Francis Hospital, University
of Connecticut, Hartford, CT, United States
(Torkian) Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Prince) Department of Radiology, Weill Cornell Medical Collegeand New
York Presbyterian Hospital, 416 East 55th Street, New York, NY 10022,
United States
(Prince) Department of Radiology, Columbia University College of
Physicians and Surgeons, New York, NY, United States
Publisher
BioMed Central Ltd ( United Kingdom. E-mail: info@biomedcentral.com)
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is increasingly
used to treat patients with severe aortic stenosis (AS). Cardiovascular
magnetic resonance imaging (CMR) provides reliable and reproducible
estimates for assessment of cardiac structure and function after TAVR. The
goal of this study was to conduct a systematic review and meta-analysis of
the literature to assess left ventricular (LV) volumes, mass and function
by CMR after TAVR. <br/>Method(s): Using Meta-analysis of Observational
Studies in Epidemiology (MOOSE) guidelines, we searched PubMed and Embase
for studies reporting CMR findings before and at least 1 month after TAVR.
Main factors of interest were LV end-diastolic volume index (LVEDVi), LV
end-systolic volume index (LVESVi), LV mass index (LVMi), and left
ventricular ejection fraction (LVEF). Standardized mean differences (SMD)
were pooled by random effects meta-analytic techniques. <br/>Result(s): Of
453 screened publications, 10 studies (published between 2012 and 2018)
were included. A total of 305 patients completed pre- and post-TAVR
follow-up CMR (mean age range 78.6-85.0 years, follow-up range 6-15
months). Random effects analysis showed TAVR resulted in reduced LVEDVi
(SMD: -0.25, 95% CI: - 0.43 to - 0.07, P = 0.006), LVESVi (SMD: -0.24, 95%
CI: - 0.44 to - 0.05, P = 0.01), LVMi (SMD: -0.82, 95% CI: - 1.0 to -
0.63, P < 0.001) and increased LVEF (SMD: 22, 95% CI: 6 to 38%, P =
0.006). Heterogeneity across studies was low (I2: 0%, Pheterogeneity >
0.05 for all). The median reduction was 4 ml/m2 (IQR: 3.1 to 8.2) for
LVEDVi, 5 ml/m2 (IQR: 3.0 to 6.0) for LVESVi, and 15.1 g/m2 (IQR: 11.8 to
18.3) for LVMi. The median increase for LVEF was 3.4% (IQR 1.0 to 4.6%).
<br/>Conclusion(s): CMR demonstrates reverse LV remodeling occurrs within
6-15 months after TAVR, with reductions in LVEDVi, LVESVi and LVMi, and
increased LVEF.<br/>Copyright &#xa9; 2020 The Author(s).

<99>
Accession Number
632921243
Title
Effects of different positive end-expiratory pressure titrating strategies
on oxygenation and respiratory mechanics during one- lung ventilation: a
randomized controlled trial.
Source
Annals of palliative medicine. (no pagination), 2020. Date of Publication:
15 Sep 2020.
Author
Xu D.; Wei W.; Chen L.; Li S.; Lian M.
Institution
(Xu) Department of Anesthesiology, Shanghai General Hospital of Nanjing
Medical University, Shanghai, China
(Wei, Chen, Lian) Department of Anesthesiology, Shanghai General Hospital,
Shanghai Jiao Tong University, Shanghai, China
(Li) Department of Anesthesiology, Shanghai General Hospital of Nanjing
Medical University, Shanghai, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Positive end-expiratory pressure (PEEP) is widely used to
reduce the risk of hypoxemia and atelectasis during one-lung ventilation
(OLV); however, the optimal strategy for PEEP titrating remains
unclear.The purpose of the study was to investigate the effects of
different PEEP titrating strategies on oxygenation and respiratory
mechanics during OLV. <br/>METHOD(S): Patients undergoing thoracic surgery
with general anesthesia were randomly allocated into five groups. In P0
group, PEEP was set to zero; in PLIP2 group, PEEP was set to 2 cmH2O plus
the pressure of lower inflection point (LIP) of pressure-volume (P-V)
curve; in PLIPS group, PEEP was titrated to achieve maximum static
compliance from the averaged LIP pressure value; in groups PSTAT and PDYN,
the incremental PEEP values were titrated to achieve maximum static
compliance or maximum dynamic compliance from 4 cmH2O. Hemodynamic
measurements, respiratory mechanics, and blood gas analyses were recorded
at the beginning of OLV, OLV 15 min, OLV 30 min, OLV 45 min, and OLV 60
min. Also, the intrapulmonary shunt (Qs/Qt), physiological dead space to
tidal volume ratio (VD/VT), and oxygenation index (OI) were calculated and
compared. <br/>RESULT(S): Seventy-five patients consented to participate
in this study. Dynamic compliance, peak inspiratory pressure (PIP), and
plateau inspiratory pressure (Pplat) increased after PEEP titration during
OLV. PIP, Qs/ Qt, and OI showed no differences among groups. Group PDYN
showed lower Pplat, lower driving pressure, and higher dynamic compliance
when compared with zero PEEP group. <br/>CONCLUSION(S): The PEEP titrating
strategy according to dynamic compliance can improve respiratory
mechanics, whereas it has no significant effects on oxygenation, dead
space ratio, and intrapulmonary shunt, suggesting that it is better during
OLV for thoracic surgery.

<100>
Accession Number
632919226
Title
Effect of Omega-3 Dosage on Cardiovascular Outcomes: An Updated
Meta-Analysis and Meta-Regression of Interventional Trials.
Source
Mayo Clinic proceedings. (no pagination), 2020. Date of Publication: 15
Sep 2020.
Author
Bernasconi A.A.; Wiest M.M.; Lavie C.J.; Milani R.V.; Laukkanen J.A.
Institution
(Bernasconi) Global Organization for EPA and DHA Omega-3s (GOED), UT.,
Salt Lake City, United States
(Wiest) Department of Statistical Science, University of Idaho, ID,
Moscow, Russian Federation
(Lavie, Milani) Department of Cardiovascular Diseases, John Ochsner Heart
and Vascular Institute, Ochsner Clinical School, University of Queensland
School of Medicine, LA, New Orleans, United States
(Laukkanen) Institute of Public Health and Clinical Nutrition, University
of Eastern Finland, Finland Faculty of Sport and Health Sciences,
University of Jyvaskyla, Finland Department of Medicine, Central Finland
Health Care District, Jyvaskyla, Kuopio, Finland
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To quantify the effect of eicosapentaenoic (EPA) and
docosahexaenoic (DHA) acids on cardiovascular disease (CVD) prevention and
the effect of dosage. <br/>METHOD(S): This study is designed as a random
effects meta-analysis and meta-regression of randomized control trials
with EPA/DHA supplementation. This is an update and expanded analysis of a
previously published meta-analysis which covers all randomized control
trials with EPA/DHA interventions and cardiovascular outcomes published
before August 2019. The outcomes included are myocardial infarction (MI),
coronary heart disease (CHD) events, CVD events (a composite of MI,
angina, stroke, heart failure, peripheral arterial disease, sudden death,
and non-scheduled cardiovascular surgical interventions), CHD mortality
and fatal MI. The strength of evidence was assessed using the Grading of
Recommendations Assessment, Development, and Evaluation framework.
<br/>RESULT(S): A total of 40 studies with a combined 135,267 participants
were included. Supplementation was associated with reduced risk of MI
(relative risk [RR], 0.87; 95% CI, 0.80 to 0.96), high certainty number
needed to treat (NNT) of 272; CHD events (RR, 0.90; 95% CI, 0.84 to 0.97),
high certainty NNT of 192; fatal MI (RR, 0.65; 95% CI, 0.46 to 0.91]),
moderate certainty NNT = 128; and CHD mortality (RR, 0.91; 95% CI, 0.85 to
0.98), low certainty NNT = 431, but not CVD events (RR, 0.95; 95% CI, 0.90
to 1.00). The effect is dose dependent for CVD events and MI.
<br/>CONCLUSION(S): Cardiovascular disease remains the leading cause of
death worldwide. Supplementation with EPA and DHA is an effective
lifestyle strategy for CVD prevention, and the protective effect probably
increases with dosage.<br/>Copyright &#xa9; 2020 Mayo Foundation for
Medical Education and Research. Published by Elsevier Inc. All rights
reserved.

<101>
Accession Number
632918522
Title
Aspirin-Free Prasugrel Monotherapy Following Coronary Artery Stenting in
Patients With Stable CAD: The ASET Pilot Study.
Source
JACC. Cardiovascular interventions. (no pagination), 2020. Date of
Publication: 11 Sep 2020.
Author
Kogame N.; Guimaraes P.O.; Modolo R.; De Martino F.; Tinoco J.; Ribeiro
E.E.; Kawashima H.; Ono M.; Hara H.; Wang R.; Cavalcante R.; Moulin B.;
Falcao B.A.A.; Leite R.S.; de Almeida Sampaio F.B.; Morais G.R.; Meireles
G.C.; Campos C.M.; Onuma Y.; Serruys P.W.; Lemos P.A.
Institution
(Kogame) Department of Cardiology, Amsterdam University Medical Center,
Amsterdam, the Netherlands; Department of Cardiology, Toho University
Medical Center Ohashi Hospital, Tokyo, Japan
(Guimaraes, Ribeiro) Heart Institute - InCor, University of Sao Paulo, Sao
Paulo, Brazil
(Modolo) Department of Cardiology, Amsterdam University Medical Center,
Amsterdam, the Netherlands; Department of Internal Medicine, Cardiology
Division, University of Campinas, Campinas, Brazil
(De Martino) Department of Internal Medicine, Discipline of Cardiology,
University of Triangulo Mineiro, Uberaba, Brazil
(Tinoco) Instituto Cardiovascular de Linhares LTDA - UNICOR, Linhares,
Brazil
(Kawashima, Ono, Hara) Department of Cardiology, Amsterdam University
Medical Center, Amsterdam, Netherlands
(Wang) Department of Cardiology, Radboud University, Nijmegen, Netherlands
(Cavalcante) Boston Scientific, Marlborough, Massachusetts
(Moulin) Vila VelhaBrazil
(Falcao) Hospital Dr. Carlos Alberto Studart Gomes de Messejana,
Fortaleza, Brazil
(Leite) Instituto de Cardiologia do Rio Grande do Sul/Fundacao
Universitaria de Cardiologia, Porto Alegre, Brazil
(de Almeida Sampaio) Instituto Nacional de Cardiologia, Rio de Janeiro,
Brazil
(Morais) Hospital Nossa Senhora das Neves, Joao Pessoa, Brazil
(Meireles) Hospital do Servidor Publico Estadual - IAMSPE, Sao Paulo,
Brazil
(Campos, Lemos) Heart Institute - InCor, University of Sao Paulo, Sao
Paulo, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Onuma) Department of Cardiology, National University of Ireland Galway,
Galway, Ireland
(Serruys) Department of Cardiology, National University of Ireland Galway,
Galway, Ireland; Imperial College London, London, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The aim of this study was to evaluate the hypothesis that
prasugrel monotherapy following successful everolimus-eluting stent
implantation is feasible and safe in patients with stable coronary artery
disease (CAD). BACKGROUND: Recent studies have suggested that short
dual-antiplatelet therapy strategies may provide an adequate balance
between ischemic and bleeding risks. However, the complete omission of
aspirin immediately after percutaneous coronary intervention (PCI) has not
been tested so far. <br/>METHOD(S): The study was a multicenter,
single-arm, open-label trial with a stopping rule based on the occurrence
of definite stent thrombosis (if >3, trial enrollment would be
terminated). Patients undergoing successful everolimus-eluting stent
implantation for stable CAD with SYNTAX (Synergy Between PCI With Taxus
and Cardiac Surgery) scores <23 were included. All participants were on
standard dual-antiplatelet therapy at the time of index PCI. Aspirin was
discontinued on the day of the index procedure but given prior to the
procedure; prasugrel was administered in the catheterization laboratory
immediately after the successful procedure, and aspirin-free prasugrel
became the therapy regimen from that moment. Patients were treated solely
with prasugrel for 3 months. The primary ischemic endpoint was the
composite of cardiac death, spontaneous target vessel myocardial
infarction, or definite stent thrombosis, and the primary bleeding
endpoint was Bleeding Academic Research Consortium types 3 and 5 bleeding
up to 3 months. <br/>RESULT(S): From February 22, 2018, to May 7, 2019,
201 patients were enrolled. All patients underwent PCI for stable CAD.
Overall, 98.5% of patients were adherent to prasugrel at 3-month
follow-up. The primary ischemic and bleeding endpoints occurred in 1
patient (0.5%). No stent thrombosis events occurred. <br/>CONCLUSION(S):
Aspirin-free prasugrel monotherapy following successful everolimus-eluting
stent implantation demonstrated feasibility and safety without any stent
thrombosis in selected low-risk patients with stable CAD. These findings
may help underpin larger randomized controlled studies to evaluate the
aspirin-free strategy compared with traditional dual-antiplatelet therapy
following PCI. (Acetyl Salicylic Elimination Trial: The ASET Pilot Study
[ASET]; NCT03469856).<br/>Copyright &#xa9; 2020. Published by Elsevier
Inc.

<102>
Accession Number
632915588
Title
A Single Prophylactic Dose of Ondansetron Given at Cessation of
Postoperative Propofol Sedation Decreases Postoperative Nausea and
Vomiting in Cardiac Surgery Patients: A Randomized Controlled Trial.
Source
Anesthesia and Analgesia. (pp 1164-1172), 2020. Date of Publication: 2020.
Author
Wang E.H.Z.; Sunderland S.; Edwards N.Y.; Chima N.S.; Yarnold C.H.;
Schwarz S.K.W.; Coley M.A.
Institution
(Wang) Pharmacy Department, St Paul's Hospital, Providence Health Care,
Vancouver, BC, Canada
(Wang) Faculty of Pharmaceutical Sciences
(Sunderland, Chima, Yarnold, Schwarz, Coley) Department of Anesthesiology,
Pharmacology and Therapeutics, University of British Columbia, Vancouver,
BC, Canada
(Edwards, Yarnold, Schwarz, Coley) Department of Anesthesia, St Paul's
Hospital, Providence Health Care, Vancouver, BC, Canada
Publisher
Lippincott Williams and Wilkins (E-mail: customerservice@lww.com)
Abstract
BACKGROUND: Postoperative nausea and vomiting (PONV) is a common
occurrence after cardiac surgery. However, in contrast to other surgical
populations, routine PONV prophylaxis is not a standard of care in cardiac
surgery. We hypothesized that routine administration of a single
prophylactic dose of ondansetron (4 mg) at the time of stopping
postoperative propofol sedation before extubation in the cardiac surgery
intensive care unit would decrease the incidence of PONV. <br/>METHOD(S):
With institutional human ethics board approval and written informed
consent, we conducted a randomized controlled trial in patients >=19 years
of age with no history of PONV undergoing elective or urgent cardiac
surgery procedures requiring cardiopulmonary bypass. The primary outcome
was the incidence of PONV in the first 24 hours postextubation, compared
by the chi2 test. Secondary outcomes included the incidence and times to
first dose of rescue antiemetic treatment administration, the incidence of
headaches, and the incidence of ventricular arrhythmias. <br/>RESULT(S):
PONV within the first 24 hours postextubation occurred in 33 of 77
patients (43%) in the ondansetron group versus 50 of 82 patients (61%) in
the placebo group (relative risk, 0.70 [95% confidence interval {CI},
0.51-0.95]; absolute risk difference, -18% [95% CI, -33 to -2]; number
needed to treat, 5.5 [95% CI, 3.0-58.4]; chi2 test, P =.022). Kaplan-Meier
"survival"analysis of the times to first rescue antiemetic treatment
administration over 24 hours indicated that patients in the ondansetron
group fared better than those in the placebo group (log-rank [Mantel-Cox]
test; P =.028). Overall, 32 of 77 patients (42%) in the ondansetron group
received rescue antiemetic treatment over the first 24 hours
postextubation versus 47 of 82 patients (57%) in the placebo group
(relative risk, 0.73 [95% CI, 0.52-1.00]; absolute risk difference, -16%
[95% CI, -31 to 1]); P =.047. There were no significant differences
between the groups in the incidence of postoperative headache (ondansetron
group, 5 of 77 patients [6%] versus placebo group, 4 of 82 patients [5%];
Fisher exact test; P =.740) or ventricular arrhythmias (ondansetron group,
2 of 77 patients [3%] versus placebo group, 4 of 82 patients [5%]; P
=.68). <br/>CONCLUSION(S): These findings support the routine
administration of ondansetron prophylaxis at the time of discontinuation
of postoperative propofol sedation before extubation in patients following
cardiac surgery. Further research is warranted to optimize PONV
prophylaxis in cardiac surgery patients. <br/>Copyright &#xa9; 2020
International Anesthesia Research Society.

<103>
Accession Number
632914311
Title
A Comprehensive Update on Aspirin Management during Noncardiac Surgery.
Source
Anesthesia and Analgesia. (pp 1111-1123), 2020. Date of Publication: 2020.
Author
Gerstein N.S.; Albrechtsen C.L.; Mercado N.; Cigarroa J.E.; Schulman P.M.
Institution
(Gerstein) Department of Anesthesiology and Critical Care Medicine,
University of New Mexico School of Medicine, Albuquerque, NM, United
States
(Albrechtsen) L. Burrell College of Osteopathic Medicine, Las Cruces, NM,
United States
(Mercado) Division of Cardiology, Department of Internal Medicine,
University of New Mexico School of Medicine, Albuquerque, NM, United
States
(Cigarroa) Division of Cardiology, Knight Cardiovascular Institute
(Schulman) Department of Anesthesiology and Perioperative Medicine, Oregon
Health and Science University, Portland, OR, United States
Publisher
Lippincott Williams and Wilkins (E-mail: customerservice@lww.com)
Abstract
Aspirin is considered critical lifelong therapy for patients with
established cardiovascular (CV) disease (including coronary artery,
cerebrovascular, and peripheral arterial diseases) and is consequently one
of the most widely used medications worldwide. However, the indications
for aspirin use continue to evolve and recent trials question its efficacy
for primary prevention. Although one third of patients undergoing
noncardiac surgery and at risk for a major adverse CV event receive
aspirin perioperatively, uncertainty still exists about how aspirin should
be optimally managed in this context, and significant practice variability
remains. Recent trials suggest that the risks of continuing aspirin during
the perioperative period outweigh the benefits in many cases, but data on
patients with high CV risk remain limited. We performed a comprehensive
PubMed and Medline literature search using the following keywords:
aspirin, aspirin withdrawal, perioperative, coronary artery disease,
cerebrovascular disease, peripheral artery disease, and CV disease; we
manually reviewed all relevant citations for inclusion. Patients taking
aspirin for the primary prevention of CV disease should likely discontinue
it during the perioperative period, especially when there is a high risk
of bleeding. Patients with established CV disease but without a coronary
stent should likely continue aspirin during the perioperative period
unless undergoing closed-space surgery. Patients with a history of
coronary stenting also likely need aspirin continuation throughout the
perioperative period for nonclosed space procedures. Perioperative
clinicians need to balance the risks of ceasing aspirin before surgery
against its continuation during the perioperative interval using a
patient-specific strategy. The guidance on decision-making with regard to
perioperative aspirin cessation or continuation using currently available
clinical data from studies in high-risk patients along with nonclinical
aspirin studies is conflicting and does not enable a simplified or unified
answer. However, pertinent guidelines on CV disease management provide a
basic framework for aspirin management, and large trial findings provide
some insight into the safety of perioperative aspirin cessation in some
contexts, although uncertainty on perioperative aspirin still exists. This
review provides an evidence-based update on perioperative aspirin
management in patients undergoing noncardiac surgery with a focus on
recommendations for perioperative clinicians on continuing versus holding
aspirin during this context. <br/>Copyright &#xa9; 2020 International
Anesthesia Research Society.

<104>
Accession Number
632911494
Title
Appropriate therapy for patients with stable ischemic heart disease: a
review of literature and the implication of the International Study of
Comparative Effectiveness with Medical and Invasive Approaches trial.
Source
Current opinion in cardiology. (no pagination), 2020. Date of Publication:
15 Sep 2020.
Author
Guo M.H.; Nantsios A.; Ruel M.
Institution
(Guo) Division of Cardiac Surgery, University of Ottawa Heart Institute,
Ottawa, ON, Canada
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: The aim of this review is to review the current
literature on the management of stable ischemic heart disease in light of
findings from the International Study of Comparative Effectiveness with
Medical and Invasive Approaches (ISCHEMIA) trial. RECENT FINDINGS:
Compared with optimal medical therapy, coronary artery bypass grafting
(CABG) has been shown to improve survival and incidence of myocardial
infarction in patients with stable ischemic heart disease whereas
percutaneous coronary intervention (PCI) has not. The ISCHEMIA trial
compared an initial conservative management strategy with optimal medical
therapy with an initial invasive strategy with coronary angiogram followed
by revascularization and found no difference in survival and myocardial
infarction between the two groups. However, the trial was conducted under
the assumption that patients would be referred to the most efficacious
revascularization therapy; it was apparent that CABG was underutilized in
many appropriate patients in the ISCHEMIA trial. The study highlighted the
importance of optimizing medical therapy in stable ischemic heart disease
(SIHD) patients but does not answer whether revascularization or
conservative management is better for patients with SIHD. SUMMARY: Optimal
medical therapy is an important element and should be included in the
Heart Team discussion, and also applied after revascularization from PCI
or CABG. Cardiac surgeons need to continue to advocate for the appropriate
use of CABG based on the current available evidence.

<105>
Accession Number
632910380
Title
Which preoperative screening tool should be applied to older patients
undergoing elective surgery to predict short-term postoperative outcomes?
Lessons from systematic reviews, meta-analyses and guidelines: heart and
non-cardiac surgery need a different approach?.
Source
Internal and emergency medicine. (no pagination), 2020. Date of
Publication: 17 Sep 2020.
Author
Rostagno C.
Institution
(Rostagno) Dipartimento Medicina Sperimentale e Clinica, Universita di
Firenze, Viale Morgagni 85, Firenze 50134, Italy
Publisher
NLM (Medline)