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<1>
Accession Number
2007254811
Title
Registration of attentional function as a predictor of incident delirium
(the RAPID study).
Source
Alzheimer's and Dementia: Translational Research and Clinical
Interventions. 6 (1) (no pagination), 2020. Article Number: e12031. Date
of Publication: 2020.
Author
van Zuylen M.L.; Hermanides J.; ten Hoope W.; Preckel B.; van de Beek D.;
van Gool W.A.; Schoenmaker N.
Institution
(van Zuylen, Hermanides, ten Hoope, Preckel) Department of Anesthesiology,
Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(ten Hoope) Department of Anesthesiology, Rijnstate Hospital, Arnhem,
Netherlands
(van de Beek, van Gool) Department of Neurology, Amsterdam UMC, University
of Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
(Schoenmaker) Department of Neurology, Isala, Zwolle, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Older adults undergoing elective surgery have a high risk of
developing postoperative delirium (POD). Validated models predicting POD
are scarce. This study investigated whether preoperative impairment of
attentional function predicts POD in older adults without previously
diagnosed cognitive impairment. <br/>Method(s): In this prospective cohort
study we recruited patients aged >=70 years preceding major elective
surgery. Preoperatively a visual vigilance test was administered to
determine intra-individual reaction-time variability. Postoperatively,
presence of delirium was screened daily. <br/>Result(s): We recruited 152
patients, 25 (16.4%) developed POD. Intra-individual reaction-time
variability was not significantly different between patients with or
without POD (0.18 +/- 0.08 ms vs 0.22 +/- 0.11 ms; P = 0.087). Receiver
operating characteristic analyses indicated a poor accuracy for POD (area
under the curve 0.609 +/- 0.63). Except for surgery duration, no
clinically significant between-group differences were found for secondary
outcome parameters. <br/>Discussion(s): Preoperative intra-individual
reaction time variability does not predict the incidence of POD in older
patients undergoing major elective surgery.<br/>Copyright &#xa9; 2020 The
Authors. Alzheimer's & Dementia: Translational Research & Clinical
Interventions published by Wiley Periodicals LLC on behalf of Alzheimer's
Association

<2>
Accession Number
2006925551
Title
Transesophageal Echocardiography - Dysphagia Risk in Acute Stroke
(TEDRAS): a prospective, blind, randomized and controlled clinical trial.
Source
European Journal of Neurology. 28 (1) (pp 172-181), 2021. Date of
Publication: January 2021.
Author
Hamzic S.; Braun T.; Butz M.; Khilan H.; Weber S.; Yeniguen M.; Gerriets
T.; Schramm P.; Juenemann M.
Institution
(Hamzic, Braun, Butz, Khilan, Yeniguen, Gerriets, Juenemann) Department of
Neurology, University Hospital Giessen and Marburg GmbH,
Justus-Liebig-University, Giessen, Germany
(Hamzic, Braun, Butz, Yeniguen, Gerriets, Schramm, Juenemann) Heart and
Brain Research Group, Heart-, Lung-, Vascular- and Rheumatic Centre Bad
Nauheim, Kerckhoff Clinic GmbH, Bad Nauheim, Germany
(Khilan, Weber, Gerriets) Department of Neurology/Stroke Unit,
Gesundheitszentrum Wetterau, Friedberg, Hesse, Germany
(Schramm) Department of Anaesthesiology, University Medical Centre of the
Johannes Gutenberg-University, Mainz, Germany
Publisher
Blackwell Publishing Ltd
Abstract
Background and purpose: Dysphagia is common in acute stroke and leads to
worse overall outcome. Transesophageal echocardiography (TEE) is used in
the diagnostic evaluation of stroke with regard to its etiology and is a
known cause of postoperative dysphagia in cardiac surgery. The prevalence
of dysphagia in acute stroke patients undergoing TEE remains unknown. The
aim of the Transesophageal Echocardiography - Dysphagia Risk in Acute
Stroke (TEDRAS) study was to assess the influence of TEE on swallowing
among patients who have experienced acute stroke. <br/>Method(s): The
TEDRAS study was a prospective, blind, randomized, controlled trial that
included two groups of patients with acute stroke. Simple unrestricted
randomization was performed, and examiners were blinded to each other's
results. Swallowing was tested using flexible endoscopic evaluation of
swallowing (FEES) at three different time points in the intervention group
(24 h before, immediately after and 24 h after TEE) and in the control
group (FEES on three consecutive days and TEE earliest after the third
FEES). Validated scales were used to assess dysphagia severity for all
time points as primary outcome measures. <br/>Result(s): A total of 34
patients were randomized: 19 to the intervention group and 15 to the
control group. The key findings of the repeated-measures between-group
comparisons were significant increases in the intervention group for the
following dysphagia measures: (1) secretion severity score (immediately
after TEE: P < 0.001; 24 h after TEE: P < 0.001) and (2)
Penetration-Aspiration Scale score for saliva (immediately after TEE: P <
0.001; 24 h after TEE: P = 0.007), for small (immediately after TEE: P =
0.009) and large liquid boli (immediately after TEE: P = 0.009; 24 h after
TEE: P = 0.025). <br/>Conclusion(s): The results indicate a negative
influence of TEE on swallowing in acute stroke patients for at least 24
hours.<br/>Copyright &#xa9; 2020 The Authors. European Journal of
Neurology published by John Wiley & Sons Ltd on behalf of European Academy
of Neurology

<3>
Accession Number
633551512
Title
Findings of a feasibility study of pre-operative pulmonary rehabilitation
to reduce post-operative pulmonary complications in people with chronic
obstructive pulmonary disease scheduled for major abdominal surgery.
Source
F1000Research. 9 (no pagination), 2020. Article Number: 172. Date of
Publication: 2020.
Author
Pattinson K.T.S.; Marlow L.L.; Lee A.H.Y.; Hedley E.; Grocott M.P.;
Steiner M.C.; Young J.D.; Rahman N.M.; Snowden C.P.
Institution
(Pattinson, Marlow, Lee, Young) Nuffield Division of Anaesthetics,
Nuffield Department of Clinical Neurosciences, University of Oxford,
Oxford, United Kingdom
(Marlow) Warwick Medical School, The University of Warwick, Coventry,
United Kingdom
(Hedley, Rahman) Division of Experimental Medicine, Nuffield Department of
Medicine, University of Oxford, Oxford, United Kingdom
(Grocott) Clinical and Experimental Sciences, Faculty of Medicine,
University of Southampton, Southampton, United Kingdom
(Grocott) Anaesthesia Perioperative and Critical Care Research Group,
Southampton National Institute of Health Research (NIHR) Biomedical
Research Centre, University Hospital Southampton, Southampton, United
Kingdom
(Steiner) Leicester Respiratory Biomedical Research Centre, Department of
Respiratory Sciences, University of Leicester, Leicester, United Kingdom
(Snowden) The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman
Hospital, Newcastle University, Newcastle upon Tyne, United Kingdom
Publisher
F1000 Research Ltd
Abstract
Background: Patients with chronic obstructive pulmonary disease (COPD) are
at increased risk of complications and death following surgery. Pulmonary
complications are particularly prominent. Pulmonary rehabilitation is a
course of physical exercise and education that helps people with COPD
manage their condition. Although proven to improve health outcomes in
patients with stable COPD, it has never been formally tested as a
pre-surgical intervention in patients scheduled for non-cardiothoracic
surgery. If a beneficial effect were to be demonstrated, pulmonary
rehabilitation for pre-surgical patients with COPD might be rapidly
implemented across the National Health Service, as pulmonary
rehabilitation courses are already well established across much of the
United Kingdom (UK). <br/>Method(s): We performed a feasibility study to
test study procedures and barriers to identification and recruitment to a
randomised controlled trial testing whether pulmonary rehabilitation,
delivered before major abdominal surgery in a population of people with
COPD, would reduce the incidence of post-operative pulmonary
complications. This study was run in two UK centres (Oxford and Newcastle
upon Tyne). <br/>Result(s): We determined that a full randomised
controlled trial would not be feasible, due to failure to identify and
recruit participants. We identified an unmet need to identify more
effectively patients with COPD earlier in the surgical pathway. Service
evaluations suggested that barriers to identification and recruitment
would likely be the same across other UK hospitals. <br/>Conclusion(s):
Although pulmonary rehabilitation is a potentially beneficial intervention
to prevent post-operative pulmonary complications, a randomised controlled
trial is unlikely to recruit sufficient participants to answer our study
question conclusively at the present time, when spirometry is not
automatically conducted in all patients planned for surgery. As pulmonary
rehabilitation is a recommended treatment for all people with COPD,
alternative study methods combined with earlier identification of
candidate patients in the surgical pathway should be considered. Trial
registration: ISRCTN29696295, 31/08/2017<br/>Copyright &#xa9; 2020 Marlow
LL et al.

<4>
Accession Number
2006126609
Title
A 3 year post-intervention follow-up on mortality in advanced heart
failure (EVITA vitamin D supplementation trial).
Source
ESC Heart Failure. 7 (6) (pp 3754-3761), 2020. Date of Publication:
December 2020.
Author
Zittermann A.; Ernst J.B.; Prokop S.; Fuchs U.; Berthold H.K.;
Gouni-Berthold I.; Gummert J.F.; Pilz S.
Institution
(Zittermann, Ernst, Prokop, Fuchs, Gummert) Clinic for Thoracic and
Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr University
Bochum, Georgstrase 11, Bad Oeynhausen D-32545, Germany
(Berthold) Department of Internal Medicine and Geriatrics, Bethel Clinic
(EvKB), Bielefeld, Germany
(Gouni-Berthold) Polyclinic for Endocrinology, Diabetes and Preventive
Medicine (PEDP), University of Cologne, Cologne, Germany
(Pilz) Division of Endocrinology and Diabetology, Department of Internal
Medicine, Medical University of Graz, Graz, Austria
Publisher
Wiley-Blackwell
Abstract
Aims: Vitamin D supplementation is widely used in the clinical setting,
but its effects on mortality and cardiovascular outcomes in patients with
heart failure are unclear. This paper reports outcome data that were
collected during follow-up of 3 years after closure of the EVITA trial (a
3 year randomized, placebo-controlled, intervention study with 4000 IU
vitamin D daily in patients with advanced heart failure), to capture
potential latency effects of vitamin D supplementation on clinical
outcomes. <br/>Methods and Results: The prespecified primary endpoint was
overall mortality. Secondary endpoints included hospitalization,
mechanical circulatory support implantation, high urgent listing for heart
transplantation, and heart transplantation. For group comparisons, we used
Cox regression models with a time-dependent categorical covariate. The
calculated net difference in circulating 25-hydroxyvitamin D between the
vitamin D and placebo groups dropped from 60.9 nmol/L at the end of the
active study period to 3.2 nmol/L at the end of the post-intervention
period. During the entire 6 year period, 73 patients (36.5%) died in the
placebo group and 76 (38.8%) in the vitamin D group. Out of these 149
patients, 36 and 39 died during the first 3 years, and 37 and 37 during
the second 3 years, respectively. The hazard ratio (HR) for mortality in
the vitamin D versus the placebo group was 1.06 [95% confidence interval
(CI): 0.68-1.66] for the first 3 years and 1.07 (95% CI: 0.68-1.70) for
the 3 year post-intervention follow-up. Compared with the placebo group,
the HRs for hospitalization and for mechanical circulatory support implant
were significantly higher in the vitamin D group during vitamin D
supplementation (HR = 1.31, 95% CI: 1.01-1.68 and HR = 2.01, 95% CI:
1.08-3.76, respectively) but not after vitamin D discontinuation (HR =
1.10, 95% CI: 0.62-1.94 and HR = 0.99, 95% CI: 0.38-2.56, respectively).
There was no significant time-dependent effect on the risk of high urgent
listing for heart transplantation and heart transplantation.
<br/>Conclusion(s): No beneficial latency effects of vitamin D
supplementation on overall mortality could be demonstrated. Instead, the
disappearance of unfavourable findings in the vitamin D group (higher HRs
for hospitalization and for mechanical circulatory support implant) after
vitamin D discontinuation supports the assumption of adverse vitamin D
effects on the cardiovascular system at doses of 4000 IU
daily.<br/>Copyright &#xa9; 2020 The Authors. ESC Heart Failure published
by John Wiley & Sons Ltd on behalf of the European Society of Cardiology

<5>
Accession Number
633718089
Title
Percutaneous mitral valve repair with mitraclip device in hemodynamically
unstable patients: A systematic review.
Source
Heart. Conference: Irish Cardiac Society Annual Scientific Meeting and
AGM. United States. 106 (SUPPL 4) (pp A19-A20), 2020. Date of Publication:
October 2020.
Author
McInerney A.; Martinez-Gomez E.; Triado-Contre G.; Nombela-Franco L.
Institution
(McInerney, Martinez-Gomez, Triado-Contre, Nombela-Franco) Hospital
Clinico San Carlos, Madrid, Spain
Publisher
BMJ Publishing Group
Abstract
Background Percutaneous mitral valve edge-to-edge repair (PMVr) with the
MitraClip device has been reserved as an alternative treatment for chronic
mitral regurgitation (MR) in high surgical risk patients. Acute
significant MR has been reported to complicate 12% of myocardial
infarctions and is present in 5 to 12% of patients in cardiogenic shock.
The use of MitraClip in hemodynamically unstable patients, who are of high
surgical risk, is therefore increasing. However, there is a paucity of
specific outcome data in this important clinical setting as these patients
are generally not included in clinical trials. Objectives The aim of the
present study was to perform a systematic review of published data, and
provide further insight into the baseline characteristics, management and
clinical outcomes of unstable patients undergoing PMVr with MitraClip.
Methods We conducted a systematic review of the published data on
MitraClip from its first use in 2003 to February 2020. Pubmed search terms
included 'Acute' and 'MitraClip', and later 'MitraClip' and 'cardiogenic
shock'. Studies referring to critically ill patients in cardiogenic shock
or acute pulmonary edema were included. Studies referring to stable
patients were excluded. Results A total of 27 publications including 155
patients with significant MR (grade 4 in 91%) were included. Mean age was
70+/-12 years with median Euroscore II and STS of 15.7 (IQRdoi 10.5-27.6)
and 18.1 (IQR 7.6-23.9), respectively. Clinical presentation was with
cardiogenic shock in 77.5% of patients. The most frequent etiology of MR
was ischemia (77%). Median time between hospital admission and Mitra-Clip
implantation was 22 (IQR 8-45) days. Hemodynamic support was required in
the majority of the patients (87.1%), with vasoactive drugs and
ventricular support in 101 patients (65.2%) and 67 patients (43.2%),
respectively. MR was quantified as severe (grade 4) in 91.3% of the
patients, with 15.9% related to a papillary muscle rupture in the context
of acute STEMI. Left ventricular ejection fraction (LVEF) was
moderate-to-severely depressed (34.2 +/- 15.6%). Device success was
achieved in 147 (95%) patients with a significant reduction in MR (grade2
in 94%, p<0.001). The weaning time from the procedure, to discontinuation
of circulatory or respiratory support, was 2.5 (IQR 1.0-6.8) days, with an
inhospital mortality and non-fatal complication rate of 9% and 5.2%,
respectively. At 6-month follow-up, mortality rate was 21.5%, with
persistent reduction in MR severity for survivors (grade2 in 83%) and one
case of mitral valve reintervention.Conclusions Percutaneous mitral valve
repair with MitraClip device is a safe and viable management option in
high-risk patients with cardiogenic shock or refractory pulmonary edema
and concomitant moderate-severe MR. Prospective trials are required to
confirm these findings, and definitively determine the value of MitraClip
in hemodynamically unstable patients.

<6>
Accession Number
633717745
Title
Irish Cardiac Society Annual Scientific Meeting and AGM.
Source
Heart. Conference: Irish Cardiac Society Annual Scientific Meeting and
AGM. United States. 106 (SUPPL 4) (no pagination), 2020. Date of
Publication: October 2020.
Author
Anonymous
Publisher
BMJ Publishing Group
Abstract
The proceedings contain 62 papers. The topics discussed include: long term
outcomes after deferral of revascularization for instent restenosis using
physiological assessment ; the clinical utility of PET-CT in the
management of infective endocarditis; incidence, clinical impact and
predictors of thrombocytopenia after aortic valve replacement with
transcatheter or sutureless heart valves; the role of ablation index on
repeat pulmonary vein isolation procedures in persistent atrial
fibrillation: a short term outcome; drug-coated balloon angioplasty versus
drug-eluting stent implantation for the treatment of bare-metal and
drug-eluting stent restenosis: results from the daedalus study; left
atrial function by echocardiography is independent of degree of left
atrial electrical scar; and antithrombotic therapy with or without aspirin
after percutaneous coronary intervention or acute coronary syndrome in
patients taking oral anticoagulation: a meta-analysis and network analysis
of randomized controlled trials.

<7>
Accession Number
633716278
Title
Comparison of Rocuronium and Vecuronium in Patients Undergoing Elective
Ultrafast-Track Off-Pump Coronary Artery Bypass Surgery.
Source
Journal of Cardiac Critical Care. 3 (2) (pp 68-76), 2019. Article Number:
JCCC320001. Date of Publication: 01 Dec 2019.
Author
Shah K.S.; Kulshrestha A.
Institution
(Shah, Kulshrestha) Department of Anaesthesia, Breach Candy Hospital,
Mumbai, Maharashtra, India
Publisher
Thieme India
Abstract
Background Neuromuscular blocking drugs are necessary in cardiac surgery
to facilitate smooth intubation and ventilation conditions, avoid patient
movement, reduce oxygen consumption, and prevent shivering. Hemodynamic
stability is very essential in cardiac surgery because the coronary
reserve is below normal in such patients. Aims This study was conducted
with the objective of comparing rocuronium, the near-ideal muscle relaxant
with vecuronium, an already established neuromuscular blocking agent in
patients undergoing elective ultrafast-track off-pump coronary artery
bypass surgery (CABG). Settings and Design This prospective, randomized
comparative study included 60 patients scheduled for elective off-pump
CABG procedures under general anesthesia in the period between May 2015
and March 2016. Materials and Methods Patients were randomized in equal
numbers to either the rocuronium group or the vecuronium group, and
intubating conditions and various hemodynamic parameters were observed at
different time points. Statistical Analysis Used Categorical variables
were evaluated using the chi-square test, whereas the Student t -test or
Mann-Whitney test were used for continuous variables. Results Pulse rate
in the rocuronium group was lesser (79.97 +/- 7.42) (p < 0.05) at the time
of intubation as compared with the vecuronium group (92.33 +/- 8.93).
Systolic blood pressure was higher in the vecuronium group (150.70 +/-
14.05) at the time of intubation as compared with the rocuronium group
(130.27 +/- 9.95) (p < 0.05). Intubating conditions, mean arterial
pressure, and diastolic blood pressure changes were similar in both
groups. Conclusions Rocuronium provides good-to-excellent intubating
conditions and is devoid of any significant cardiovascular changes causing
hemodynamic instability when compared with vecuronium in patients
undergoing elective ultrafast-track off-pump CABG.<br/>Copyright &#xa9;
2019 Thieme India. All rights reserved.

<8>
Accession Number
2007651176
Title
Investigation of myocardial protection during pediatric CPB: Practical
experience in 100 Chinese hospitals.
Source
Perfusion (United Kingdom). (no pagination), 2020. Date of Publication:
2020.
Author
Zhang P.; Liu J.; Tong Y.; Guo S.; Bai L.; Jin Y.; Feng Z.; Zhao J.; Li Y.
Institution
(Zhang, Liu, Tong, Guo, Bai, Jin, Feng, Zhao, Li) State Key Laboratory of
Cardiovascular Disease, Department of Cardiopulmonary Bypass, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
Publisher
SAGE Publications Ltd
Abstract
Many measures have been proposed for myocardial protection in pediatric
congenital heart surgeries, but little data is available for China. This
study investigates myocardial protection strategies in pediatric
cardiopulmonary bypass (CPB) throughout China. Online questionnaires were
delivered to 100 hospitals in 27 provinces. The number of yearly on-pump
pediatric cardiovascular surgeries in these hospitals varied greatly.
About 91.0% of respondents believe that each surgery should have at least
two perfusionists, while only 64.0% of hospitals actually met this
requirement. For pediatric patients, crystalloid cardioplegia was more
prevalent than blood-based cardioplegia.
Histidine-tryptophan-ketoglutarate solution and St. Thomas crystalloid
solution were dominant among crystalloid cardioplegia. Del Nido
cardioplegia and St. Thomas blood-based cardioplegia ranked the top two in
the popularity of blood-based cardioplegia. Dosages varied among different
kinds of cardioplegia. In the choice of different cardioplegia,
perfusionists mainly focused on myocardial protective effect and cost.
Hypothermia of cardioplegia solution was maintained by ice buckets in 3/4
of the hospitals in this survey. In conclusion, the essence of myocardial
protection management during pediatric CPB was cardiac arrest induced by
cardioplegia under systemic hypothermia. However, there is no uniform
standard for the type of cardioplegia, or dosages. Therefore,
well-designed multicenter randomized controlled trials are warranted to
provide tangible evidence for myocardial protection of cardioplegia in
pediatric CPB.<br/>Copyright &#xa9; The Author(s) 2020.

<9>
Accession Number
633725343
Title
Myocardial Injury After Balloon Predilatation Versus Direct Transcatheter
Aortic Valve Replacement: Insights From the DIRECTAVI Trial.
Source
Journal of the American Heart Association. (pp e018405), 2020. Date of
Publication: 10 Dec 2020.
Author
Akodad M.; Roubille F.; Marin G.; Lattuca B.; Macia J.-C.; Delseny D.;
Gandet T.; Robert P.; Schmutz L.; Piot C.; Maupas E.; Robert G.; Targosz
F.; Albat B.; Cayla G.; Leclercq F.
Institution
(Akodad, Roubille, Macia, Delseny, Robert, Leclercq) Department of
Cardiology Montpellier University Hospital Montpellier France
(Akodad, Roubille) PhyMedExp INSERM U1046CNRS UMR 9214 Montpellier France
(Marin) Department of Medical Information Montpellier University Hospital
Montpellier France
(Lattuca, Schmutz, Cayla) Department of Cardiology CHU NimesMontpellier
University Nimes France
(Gandet, Albat) Department of Cardiovascular Surgery University Hospital
of Montpellier France
(Piot) Millenaire Clinic Montpellier France
(Maupas) Franciscaines Clinic Nimes France
(Robert) St Pierre Clinic Perpignan France
(Targosz) Perpignan Hospital Perpignan France
Publisher
NLM (Medline)
Abstract
Background Myocardial injury is associated with higher mortality after
transcatheter aortic valve replacement (TAVR) and might be increased by
prior balloon aortic valvuloplasty (BAV). We aimed to evaluate the impact
of prior BAV versus direct prosthesis implantation on myocardial injury
occurring after (TAVR) with balloon-expandable prostheses. Methods and
Results The DIRECTAVI (Direct Transcatheter Aortic Valve Implantation)
trial, an open-label randomized study, demonstrated noninferiority of TAVR
without BAV (direct TAVR group) compared with systematic BAV (BAV group)
with the Edwards SAPIEN 3 valve. High-sensitivity troponin was assessed
before and the day after the procedure. Incidence of myocardial injury
after the procedure (high-sensitivity troponin elevation >15x the upper
reference limit [14 ng/L]) was the main end point. Impact of myocardial
injury on 1-month adverse events (all-cause mortality, stroke, major
bleeding, major vascular complications, transfusion, acute kidney injury,
heart failure, pacemaker implantation, and aortic regurgitation) was
evaluated. Preprocedure and postprocedure high-sensitivity troponin levels
were available in 211 patients. The mean age of patients was 83 years
(78-87 years), with 129 men (61.1%). Mean postprocedure high-sensitivity
troponin was 124.9+/-81.4 ng/L in the direct TAVR group versus
170.4+/-127.7 ng/L in the BAV group (P=0.007). Myocardial injury occurred
in 42 patients (19.9%), including 13 patients (12.2%) in the direct TAVR
group and 29 (27.9%) in the BAV group (P=0.004). BAV increased by 2.8-fold
(95% CI, 1.4-5.8) myocardial injury probability. Myocardial injury was
associated with 1-month adverse events (P=0.03). Conclusions BAV increased
the incidence and magnitude of myocardial injury after TAVR with
new-generation balloon-expandable valves. Myocardial injury was associated
with 1-month adverse events. These results argue in favor of direct SAPIEN
3 valve implantation. Registration URL: https://www.Clinicaltrials.gov;
Unique identifier: NCT02729519.

<10>
Accession Number
633714669
Title
Individualized, Intraoperative Dosing of Fibrinogen Concentrate for the
Prevention of Bleeding in Neonatal and Infant Cardiac Surgery Using
Cardiopulmonary Bypass (FIBCON): A Phase 1b/2a Randomized Controlled
Trial.
Source
Circulation: Cardiovascular Interventions. (pp 325-333), 2020. Article
Number: 009465. Date of Publication: 2020.
Author
Siemens K.; Hunt B.J.; Harris J.; Nyman A.G.; Parmar K.; Tibby S.M.
Institution
(Siemens, Harris, Nyman, Tibby) Department of Paediatric Intensive Care,
Evelina London Children's Hospital, United Kingdom
(Hunt, Parmar) Department of Haematology, St Thomas' Hospital, London,
United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Mediastinal bleeding is common following pediatric
cardiopulmonary bypass surgery for congenital heart disease. Fibrinogen
concentrate (FC) represents a potential therapy for preventing bleeding.
<br/>Method(s): We performed a single-center, phase 1b/2a, randomized
controlled trial on infants 2.5 to 12 kg undergoing cardiopulmonary bypass
surgery, aimed at (1) demonstrating the feasibility of an intraoperative
point-of-care test, rotational thromboelastometry, to screen out patients
at low risk of postoperative bleeding and then guide individualized FC
dosing in high-risk patients and (2) determining the dose, safety, and
efficacy of intraoperative FC supplementation. Screening occurred
intraoperatively 1-hour before bypass separation using the rotational
thromboelastometry variable fibrinogen thromboelastometry maximum clot
firmness (FibTEM-MCF; fibrinogen contribution to clot firmness). If
FibTEM-MCF >=7 mm, patients entered the monitoring cohort. If FibTEM-MCF
<=6 mm, patients were randomized to receive FC/placebo (2:1 ratio).
Individualized FC dose calculation included weight, bypass circuit volume,
hematocrit, and intraoperative measured and desired FibTEM-MCF. The
coprimary outcomes, measured 5 minutes post-FC administration were
FibTEM-MCF (desired range, 8-13 mm) and fibrinogen levels (desired range,
1.5-2.5 g/L). Secondary outcomes were thrombosis and thrombosis-related
major complications and postoperative 24-hour mediastinal blood loss.
<br/>Result(s): We enrolled 111 patients (cohort, n=21; FC, n=60; placebo,
n=30); mean (SD) age, 6.4 months (5.8); weight, 5.9 kg (2.0).
Intraoperative rotational thromboelastometry screening effectively
excluded low-risk patients, in that none in the cohort arm (FibTEM-MCF,
>=7 mm) demonstrated clinically significant early postoperative bleeding
(>10 mL/kg per 4 hours). Among randomized patients, the median (range) FC
administered dose was 114 mg/kg (51-218). Fibrinogen levels increased from
a mean (SD) of 0.91 (0.22) to 1.7 g/L (0.41). The postdose fibrinogen
range was 1.2 to 3.3 g/L (72% within the desired range). The corresponding
FibTEM-MCF values were as follows: pre-dose, 5.3 mm (1.9); post-dose, 13
mm (3.2). Ten patients (8 FC and 2 placebo) exhibited 12 possible
thromboses; none were clearly related to FC. There was an overall
difference in mean (SD) 24-hour mediastinal drain loss: cohort, 12.6 mL/kg
(6.4); FC, 11.6 mL/kg (5.2); placebo, 17.1 mL/kg (14.3; ANOVA P=0.02).
<br/>Conclusion(s): Intraoperative, individualized dosing of FC appears
feasible. The need for individualized dosing is supported by the finding
that a 4-fold variation in FC dose is required to achieve therapeutic
fibrinogen levels. Registration: URL: https://eudract.ema.europa.eu/;
Unique identifier: 2013-003532-68. URL: https://www.isrctn.com/; Unique
identifier: 50553029.<br/>Copyright &#xa9; 2020 Lippincott Williams and
Wilkins. All rights reserved.

<11>
Accession Number
2004831397
Title
Translating evidence from clonal hematopoiesis to cardiovascular disease:
A systematic review.
Source
Journal of Clinical Medicine. 9 (8) (pp 1-20), 2020. Article Number: 2480.
Date of Publication: August 2020.
Author
Papa V.; Marracino L.; Fortini F.; Rizzo P.; Campo G.; Vaccarezza M.;
Dalla Sega F.V.
Institution
(Papa) Department of Motor Sciences and Wellness (DiSMeB), Universita
Degli Studi di Napoli "Parthenope, Napoli " 80133, Italy
(Papa) FAPAB Research Center, Avola, SR 96012, Italy
(Marracino, Rizzo, Vaccarezza) Department of Morphology, Surgery and
Experimental Medicine, Laboratory for Technologies of Advanced Therapies
(LTTA), University of Ferrara, Via Fossato di Mortara 64/B, Ferrara 44121,
Italy
(Fortini, Rizzo, Campo, Dalla Sega) Translational Research Center, Maria
Cecilia Hospital, GVM Care & Research, Cotignola, Ravenna 44124, Italy
(Campo) Department of Medical Sciences, Cardiovascular Institute, Azienda
Ospedaliero-Universitaria of Ferrara, University of Ferrara, Cona 30010,
Italy
(Vaccarezza) School of Pharmacy and Biomedical Sciences, Faculty of Health
Sciences, Curtin University, Curtin Perth Campus, Bentley, Perth, WA 6102,
Australia
Publisher
MDPI AG
Abstract
Some random mutations can confer a selective advantage to a hematopoietic
stem cell. As a result, mutated hematopoietic stem cells can give rise to
a significant proportion of mutated clones of blood cells. This event is
known as "clonal hematopoiesis." Clonal hematopoiesis is closely
associated with age, and carriers show an increased risk of developing
blood cancers. Clonal hematopoiesis of indeterminate potential is defined
by the presence of clones carrying a mutation associated with a blood
neoplasm without obvious hematological malignancies. Unexpectedly, in
recent years, it has emerged that clonal hematopoiesis of indeterminate
potential carriers also have an increased risk of developing
cardiovascular disease. Mechanisms linking clonal hematopoiesis of
indeterminate potential to cardiovascular disease are only partially
known. Findings in animal models indicate that clonal hematopoiesis of
indeterminate potential-related mutations amplify inflammatory responses.
Consistently, clinical studies have revealed that clonal hematopoiesis of
indeterminate potential carriers display increased levels of inflammatory
markers. In this review, we describe progress in our understanding of
clonal hematopoiesis in the context of cancer, and we discuss the most
recent findings linking clonal hematopoiesis of indeterminate potential
and cardiovascular diseases.<br/>Copyright &#xa9; 2020 by the authors.
Licensee MDPI, Basel, Switzerland.

<12>
Accession Number
632723721
Title
Comparison of efficacy and safety of drug-eluting versus uncoated balloon
angioplasty for femoropopliteal arterial occlusive disease: A
meta-analysis.
Source
BMC Cardiovascular Disorders. 20 (1) (no pagination), 2020. Article
Number: 395. Date of Publication: 31 Aug 2020.
Author
Feng H.; Chen X.; Guo X.; Zhang Z.; Liu B.; Lian L.
Institution
(Feng, Chen, Guo, Zhang, Zhang, Liu, Lian) Department of Vascular Surgery,
Beijing Friendship Hospital, Capital Medical University, Beijing 100050,
China
Publisher
BioMed Central Ltd
Abstract
Background: This quantitative meta-analysis was conducted to evaluate the
efficacy and safety of drug-eluting balloon (DEB) vs. uncoated balloon
(UCB) in patients with femoropopliteal arterial occlusive disease.
<br/>Method(s): Electronic databases were searched to identify randomized
controlled trials (RCTs) that compared DEB and UCB till November 2018. The
random-effects model was used for conducting pooled analyses.
<br/>Result(s): Seventeen RCTs with 2706 patients were included in the
final meta-analysis. Patients who received DEB had higher levels of
minimal luminal diameter (MLD) at 6 (WMD: 0.77; 95%CI: 0.53 to 1.02; P <
0.001) and 12 months (WMD: 1.33; 95%CI: 0.93 to 1.73; P < 0.001) than
those who received UCB. DEB reduced the late lumen loss (LLL) levels after
6 (WMD: -0.57; 95%CI: - 1.07 to - 0.06; P = 0.029) and 12 months (WMD:
-0.95; 95%CI: - 1.28 to - 0.62; P < 0.001). DEB was found not superior
over UCB on primary patency after 6 months (RR: 1.44; 95%CI: 0.88-2.35; P
= 0.149), whereas DEB increased the primary patency after 12 (RR: 1.51;
95%CI: 1.25-1.83; P < 0.001) and 24 months (RR: 1.51; 95%CI: 1.30-1.77; P
< 0.001). Patients who received DEB had reduced the risk of restenosis
after 6 (RR: 0.47; 95%CI: 0.33-0.67; P < 0.001) and 12 months (RR: 0.55;
95%CI: 0.35-0.85; P = 0.008). DEB reduced the risk of major adverse events
after 6 (RR: 0.30; 95%CI: 0.14-0.61; P = 0.001), 12 (RR: 0.49; 95%CI:
0.32-0.76; P = 0.001) and 24 months (RR: 0.62; 95%CI: 0.41-0.92; P =
0.018). <br/>Conclusion(s): DEB yielded additional benefits on MLD, LLL,
primary patency, restenosis, TLR, and major adverse events than UCB in
patients with femoropopliteal arterial occlusive disease.<br/>Copyright
&#xa9; 2020 The Author(s).

<13>
Accession Number
2010370575
Title
Large-vessel vasculitis affecting the aorta and its branches in relapsing
polychondritis: Case series and systematic review of the literature.
Source
Journal of Rheumatology. 47 (12) (pp 1780-1784), 2020. Date of
Publication: 01 Dec 2020.
Author
Tomelleri A.; Campochiaro C.; Sartorelli S.; Papa M.; De Luca G.; Cavalli
G.; Baldissera E.; Dagna L.
Institution
(Tomelleri, Campochiaro, Sartorelli, De Luca, Cavalli, Baldissera, Dagna)
Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San
Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
(Papa) Department of Radiology, IRCCS San Raffaele Hospital, Italy
Publisher
Journal of Rheumatology
Abstract
Objective. To describe the features of large-vessel vasculitis (LVV) as it
affects the aorta and its branches in patients with relapsing
polychondritis (RP). Methods. Retrospective data and systematic literature
review. Results. Twenty-one patients were identified. LVV diagnosis was
subsequent to RP and associated with extrachondral involvement in the
majority of patients. Supraaortic vessels were more frequently involved
(82%). Fourteen patients (67%) were treated with a conventional synthetic
disease-modifying antirheumatic drug (csDMARD) and 7 (33%) with a
biological DMARD (bDMARD). Vascular interventional procedures were
performed in 10 patients (48%). Premature death due to cardiovascular
complications was reported in 3 cases (14%). Conclusion. Extraaortic LVV
is a serious and overlooked RP manifestation. All patients with RP should
be investigated for LVV.<br/>Copyright &#xa9; 2020. All rights reserved.

<14>
Accession Number
2008461055
Title
Meta-Analysis of Cerebral Embolic Protection During Transcatheter Aortic
Valve Replacement.
Source
American Journal of Cardiology. 139 (pp 138-139), 2021. Date of
Publication: 15 Jan 2021.
Author
Nazir S.; Zafrullah F.; Virk H.U.H.; Sandhu C.S.; Ameen M.; Ahuja K.R.
Institution
(Nazir, Zafrullah) Division of Cardiology, University of Toledo Medical
Center, Toledo, OH, United States
(Virk) Division of Cardiology, Case Western Reserve University/University
Hospitals Cleveland Medical Center, Cleveland, OH, United States
(Sandhu, Ameen, Ahuja) Division of Cardiology, Reading Hospital-Tower
Health System, West Reading, United States
Publisher
Elsevier Inc.

<15>
Accession Number
2008574731
Title
Meta-analysis Comparing Early Outcomes Following Transcatheter Aortic
Valve Implantation With the Evolut Versus Sapien 3 Valves.
Source
American Journal of Cardiology. 139 (pp 87-96), 2021. Date of Publication:
15 Jan 2021.
Author
Alperi A.; Faroux L.; Muntane-Carol G.; Rodes-Cabau J.
Institution
(Alperi, Faroux, Muntane-Carol, Rodes-Cabau) Quebec Heart & Lung
Institute, Laval University, Quebec City, QC, Canada
Publisher
Elsevier Inc.
Abstract
We aimed to compare the early (in-hospital/30-day) outcomes (major
periprocedural complications, device success/valve performance, and
mortality) following transcatheter aortic valve implantation with the
Sapien 3 versus Evolut transcatheter valve systems. This was a systematic
review from PubMed and EMBASE databases for studies reporting raw data or
estimates. The outcomes analyzed were (1) in-hospital/30-day major
periprocedural complications, (2) device success and valve performance,
and (3) mortality. The outcomes were defined according to VARC-2 criteria.
A total of 24,628 transcatheter aortic valve implantation patients from 9
studies (1 randomized, 8 observational [5 case- or propensity-matched
analyses]) were included: 12,411 and 12,217 patients had Sapien 3 and
Evolut valve implantation, respectively. There were no differences between
devices regarding in-hospital/30-day stroke (risk ratio [RR] 0.95, 95%
confidence interval [CI] 0.34 to 2.66), major vascular complications (RR
1.03, 95% CI 0.63 to 1.68), acute kidney injury (RR 1.17, 95% CI 0.78 to
1.77), device success (RR 1.00, 95% CI 0.97 to 1.04) and moderate-severe
residual aortic regurgitation (RR 0.49, 95% CI 0.20 to 1.17). Sapien 3
recipients exhibited lower risk of permanent pacemaker implantation (RR
0.66, 95% CI 0.55 to 0.80), a higher risk of life-threatening bleeding (RR
1.82, 95% CI 1.18 to 2.80), and higher residual transvalvular gradients
(mean difference 3.95 mmHg, 95% CI 3.37 to 4.56). A lower risk of
in-hospital/30-day mortality was observed for Sapien 3 (RR 0.79, 95% CI
0.69 to 0.90). In conclusion, the similarities in device success rate and
major periprocedural complications (except for a higher and lower risk of
permanent pacemaker implantation and life-threatening bleeding,
respectively, with the Evolut system) support the lack of a valve type
effect accounting for the increased mortality risk observed with the
Evolut valve.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<16>
Accession Number
2008363359
Title
Meta-Analysis Comparing Culprit-Only Versus Complete Multivessel
Percutaneous Coronary Intervention in Patients With ST-Elevation
Myocardial Infarction.
Source
American Journal of Cardiology. 139 (pp 34-39), 2021. Date of Publication:
15 Jan 2021.
Author
Ullah W.; Zahid S.; Nadeem N.; Gowda S.; Munir S.; Saleem S.; Alraies
M.C.; Alam M.; Fischman D.L.
Institution
(Ullah, Nadeem, Munir) Abington Jefferson Health, Abington, PA, United
States
(Zahid) Rochester General Hospital, Rochester, NY, United States
(Gowda) University of South Dakota, Vermillion, SD, United States
(Saleem) University of Kentucky, Bowling Green, KY, United States
(Alraies) Detroit Medical Center, Detroit, MI, United States
(Alam) Baylor College of Medicine, Houston, TX, United States
(Fischman) Thomas Jefferson University, Philadelphia, PA, United States
Publisher
Elsevier Inc.
Abstract
ST-segment elevation myocardial infarction (STEMI) in patients with
concomitant multivessel coronary artery disease is associated with poor
prognosis. We sought to determine the merits of percutaneous coronary
intervention of the culprit-only revascularization (COR) compared with
multivessel revascularization (MVR) approach. Multiple databases were
queried to identify relevant articles. Data were analyzed using a
random-effect model to calculate unadjusted odds ratio (OR) and relative
risk. A total of 28 studies comprising 26,892 patients, 18,377 in the COR
and 8,515 in the MVR group were included. The mean age of patients was 63
years, comprising 72% of male patients. The baseline characteristics of
the 2 treatment groups were comparable. On a median follow-up of 1-year,
COR was associated with a significantly higher odds of major adverse
cardiovascular events (MACE; OR 1.36, 95% confidence interval [CI] 1.10 to
1.70, p = 0.005), angina (OR 2.28, 95% CI 1.83 to 2.85, p <= 0.00001) and
revascularization (OR 1.76, 95% CI 1.22 to 2.54, p = 0.002) compared with
patients undergoing MVR for STEMI. The all-cause mortality (OR 1.18, 95%
CI 0.91 to 1.53, p = 0.22), cardiovascular mortality (OR 1.30, 95% CI 0.98
to 1.72, p = 0.07), rate of heart failure (OR 1.17, 95% CI 0.86 to 1.59, p
= 0.31), need for coronary artery bypass graft (CABG) (OR 1.47, 95% CI
0.82 to 2.64, p = 0.19), repeat myocardial infarction (MI) events (OR
1.23, 95% CI 0.93 to 1.64, p = 0.15) and risk of stroke (OR 1.27 95% CI
0.68 to 2.34, p = 0.45%) were similar between the two groups. A subgroup
analysis based on follow-up duration and study design mostly followed the
results of the pooled analysis except that the risk of repeat MI events
were significantly lower in the MVR group across RCTs (OR 1.46, 95% CI
1.10 to 1.94, p = 0.009). In contrast to the culprit-only approach, MVR in
patients with STEMI is associated with a significant reduction in MACE,
angina and need for revascularization.<br/>Copyright &#xa9; 2020 Elsevier
Inc.

<17>
Accession Number
2005565898
Title
Differential Outcomes With Edetate Disodium-Based Treatment Among Stable
Post Anterior vs. Non-Anterior Myocardial Infarction Patients.
Source
Cardiovascular Revascularization Medicine. 21 (11) (pp 1389-1395), 2020.
Date of Publication: November 2020.
Author
Lewis E.F.; Ujueta F.; Lamas G.A.; Roberts R.S.; Mark D.B.; Nahin R.L.;
Goertz C.; Stylianou M.; Lee K.L.
Institution
(Lewis) Brigham and Women's Hospital and Harvard Medical School, Boston,
MA (E.F.L.), United States
(Ujueta, Lamas) Columbia University Division of Cardiology at Mount Sinai
Medical Center, Miami Beach, FL (G.A.L.), United States
(Roberts) Remarque Systems, Durham, NC (R.S.R), United States
(Mark, Stylianou) National Heart, Lung, and Blood Institute, Bethesda, MD
(M.S.), United States
(Lee) Duke Clinical Research Institute, Durham, NC (D.B.M., K.L.L.),
United States
(Goertz) Duke Department of Orthopaedic Surgery, Durham, NC (C.G.), United
States
(Nahin) The National Center for Complementary and Integrative Health,
Bethesda, MD (R.L.N.), United States
Publisher
Elsevier Inc.
Abstract
Background: The Trial to Assess Chelation Therapy (TACT) found that
chelation therapy significantly reduced clinical events in patients with a
history of myocardial infarction (MI). The initial report of TACT included
the observation of an interaction between edetate disodium infusions and
MI location, as well as diabetes. Thus, we examined in greater detail the
effect of edetate disodium chelation therapy as a function of MI location
and diabetes. <br/>Method(s): Patients (n = 1708) at least 6 weeks post-MI
and age >= 50 were randomized to receive 40 infusions of a 500 mL
chelation solution or placebo (median follow-up 55 months). The effect of
edetate disodium on the primary outcome (all-cause mortality, MI, stroke,
hospitalization for angina, or coronary revascularization) was assessed as
a function of MI location using log-rank test and Cox regression model,
adjusting for other prognostic variables. <br/>Result(s): Among patients
with post anterior MI (n = 674), chelation was associated with a lower
risk of the primary endpoint (HR 0.63, 95% CI 0.47-0.86, p = 0.003) among
anterior MI patients, but not in post non-anterior MI (n = 1034) patients
(HR 0.96, 95% CI 0.77-1.20, p = 0.702) (p-for-interaction = 0.032). The
point estimates for each component of the primary endpoint favored
chelation therapy. The differing treatment effect in patients with post
anterior vs. non-anterior MI was consistent among patients with or without
diabetes and remained significant after adjusting for other prognostic
variables (p < 0.01). <br/>Conclusion(s): Edetate disodium infusions
reduced the risk of cardiovascular events among patients with a prior
anterior MI. Future studies should focus on replicating these results and
understanding the mechanisms of benefit.<br/>Copyright &#xa9; 2020

<18>
Accession Number
52123572
Title
Gentamicin collagen sponges for the prevention of sternal wound infection:
A meta-analysis of randomized controlled trials.
Source
Journal of Thoracic and Cardiovascular Surgery. 144 (5) (pp 1235-1240),
2012. Date of Publication: November 2012.
Author
Mavros M.N.; Mitsikostas P.K.; Alexiou V.G.; Peppas G.; Falagas M.E.
Institution
(Mavros, Mitsikostas, Alexiou, Peppas, Falagas) Alfa Institute of
Biomedical Sciences, Athens, Greece
(Alexiou) Department of Surgery, Kettering General Hospital, Kettering,
United Kingdom
(Peppas) Department of Medicine and Infectious Diseases, Mitera General
Hospital, Hygeia Group, Athens, Greece
(Falagas) Department of Medicine, Henry Dunant Hospital, Athens, Greece
(Falagas) Department of Medicine, Tufts University School of Medicine,
Boston, Mass, United States
Publisher
Mosby Inc.
Abstract
Objective: The study objective was to determine whether the application of
gentamicin collagen sponges reduces sternal wound infections in patients
undergoing cardiac surgery. <br/>Method(s): A meta-analysis of randomized
controlled trials was performed. <br/>Result(s): Four randomized
controlled trials were eligible for inclusion. By pooling data from 4
randomized controlled trials (4672 per-protocol patients), gentamicin
collagen sponges reduced deep sternal wound infections (risk ratio, 0.62;
95% confidence interval, 0.39-0.97) and any sternal wound infections (risk
ratio, 0.61; confidence interval, 0.39-0.98). In contrast, no benefit was
demonstrated regarding superficial sternal wound infections (4 randomized
controlled trials [4672 patients]; risk ratio, 0.65; 95% confidence
interval, 0.34-1.25) and all-cause mortality (3 randomized controlled
trials [3994 patients]; risk ratio, 0.90; 95% confidence interval,
0.57-1.42). On the basis of data from 2 randomized controlled trials (3410
patients), gentamicin collagen sponges also seemed to reduce surgically
treated sternal wound infections (risk ratio, 0.59; 95% confidence
interval, 0.41-0.86). The most commonly isolated pathogens were
coagulase-negative Staphylococcus spp (43%) and Staphylococcus aureus
(28%). <br/>Conclusion(s): Gentamicin collagen sponges seem to reduce the
sternal wound infection rate in patients undergoing cardiac surgery. The
statistical heterogeneity among the existing trials underlines the need
for additional large, high-quality randomized controlled
trials.<br/>Copyright &#xa9; 2020

<19>
Accession Number
2010057237
Title
Clevidipine for the treatment of severe hypertension in adults.
Source
Clinical Therapeutics. 32 (1) (pp 11-23), 2010. Date of Publication:
January 2010.
Author
Nguyen H.M.; Ma K.; Pham D.Q.
Institution
(Nguyen, Pham) College of Pharmacy, Western University of Health Sciences,
Pomona, California, United States
(Ma) Department of Pharmacy, New York-Presbyterian Hospital, New York, New
York, United States
Publisher
Excerpta Medica Inc.
Abstract
Background: Intravenous antihypertensive agents are used when immediate
control of blood pressure (BP) is required, including during the
perioperative cardiac surgery period. Controlling postoperative BP is
challenging because of the need to adequately reduce BP while maintaining
appropriate end-organ perfusion. Clevidipine is an intravenous,
ultra-short-acting, third-generation dihydropyridine calcium channel
antagonist with selectivity for arteriolar vasodilatation. It is approved
by the US Food and Drug Administration for the treatment of severe
hypertension. <br/>Objective(s): This paper reviews the clinical
pharmacology, pharmacokinetic and pharmacodynamic properties,
tolerability, and clinical efficacy of clevidipine. <br/>Method(s): To
minimize selection bias, each author conducted an independent search for
English-language publications indexed on MEDLINE and International
Pharmaceutical Abstracts through January 2010 using the term clevidipine.
All identified prospective, randomized and nonrandomized Phase III trials
were included in the review. <br/>Result(s): Seven Phase III trials were
identified in which clevidipine was compared with baseline, placebo, or
other intravenous antihypertensive agents in the settings of severe
hypertension (1 study), preoperative cardiac surgery (1), perioperative
cardiac surgery (1), and postoperative cardiac surgery (4). In a
multicenter, randomized, double-blind, placebo-controlled study of the
efficacy of clevidipine in treating preoperative hypertension, the mean
reduction from baseline in mean arterial pressure was 31.2% with
clevidipine and 11.2% with placebo (P < 0.001). In a randomized,
open-label, prospective study involving separate comparisons of
clevidipine with nitroglycerin, sodium nitroprusside, and nicardipine, the
median total AUC for digression in systolic BP from the predetermined
target range differed significantly between clevidipine and nitroglycerin
(4.14 vs 8.87 mm Hg . min/h; respectively, P < 0.001) and between
clevidipine and sodium nitroprusside (4.37 vs 10.5 mm Hg . min/h; P =
0.003), but not between clevidipine and nicardipine (1.76 and 1.69 mm Hg .
min/h). Another study found no significant difference in efficacy in
controlling BP during the 3-hour study period between clevidipine and
sodium nitroprusside (AUC for mean [SD] arterial pressure, 106 [25] and
101 [28] mm Hg . min/h, respectively). Adverse events in these studies
included atrial fibrillation (13.0%-36.1% clevidipine vs 12.0% placebo),
nausea (5.0%-21.0% vs 12.0%, respectively), fever (19.0% vs 13.7%),
insomnia (12.0% vs 6.1%), and acute renal failure (9.0% vs 2.0%). In the
studies reviewed, only 1 case of chest discomfort in the setting of severe
hypertension was considered a serious adverse event related to clevidipine
therapy. <br/>Conclusion(s): In the Phase III trials reviewed, clevidipine
was effective in controlling BP in the settings of perioperative cardiac
surgery and severe hypertension and was associated with minimal adverse
effects.<br/>Copyright &#xa9; 2010 Excerpta Medica Inc.

<20>
Accession Number
2010403630
Title
Myocardial Protection in Adult Cardiac Surgery with del Nido versus Blood
Cardioplegia: A Systematic Review and Meta-analysis.
Source
Heart Lung and Circulation. (no pagination), 2020. Date of Publication:
2020.
Author
Misra S.; Srinivasan A.; Jena S.S.; Bellapukonda S.
Institution
(Misra, Jena, Bellapukonda) Department of Anesthesiology and Critical
Care, All India Institute of Medical Sciences (AIIMS), Bhubaneswar,
Odisha, India
(Srinivasan) Department of Pharmacology, All India Institute of Medical
Sciences (AIIMS), Bhubaneswar, Odisha, India
Publisher
Elsevier Ltd
Abstract
Background: Myocardial protection in adult cardiac surgery is commonly
achieved with either multidose blood cardioplegia or single-dose del Nido
crystalloid cardioplegia. <br/>Aim(s): The aim of this systematic review
and meta-analysis was to compare the outcomes of del Nido cardioplegia
versus blood cardioplegia in adult cardiac surgery. <br/>Method(s): All
English-language articles were searched in MEDLINE (PubMed), the Cochrane
Central Register of Controlled Trials (CENTRAL), and Google Scholar up to
March 2020, to identify randomised control trials, prospective
observational studies, and retrospective analyses (with or without
propensity matching) reporting any or all of the primary and secondary
endpoints. The primary endpoint was all-cause mortality. Secondary
endpoints included cardiopulmonary bypass (CPB) and aortic cross-clamp
(AoX) time; cardioplegia volume; need for defibrillation after AoX
release; intraoperative glucose; postoperative myocardial enzyme release;
postoperative left ventricular ejection fraction (LVEF); incidence of
postoperative acute kidney injury (AKI), atrial fibrillation (AF), stroke,
and low cardiac output syndrome (LCOS); postoperative blood transfusion;
duration of mechanical ventilation; and length of Intensive Care Unit
(ICU) and hospital stay. <br/>Result(s): Twenty-nine (29) studies were
included. There was no difference in the primary outcome of mortality
between the two groups (odds ratio [OR], 1.18; 95% confidence interval
[CI], 0.82-1.72 [p=0.37]). del Nido cardioplegia was associated with
significantly shorter CPB (mean difference [MD], -7.42 minutes; 95% CI,
-12.53 to -2.31 [p=0.004]) and AoX times (MD, -6.39 minutes; 95% CI,
-10.30 to -2.48 [p=0.001]), and lower cardioplegia volumes. Significantly
fewer patients required defibrillation after AoX release in the del Nido
group. Intraoperative glucose homeostasis was better preserved in the del
Nido group. Postoperative cardiac troponin T release and the number of
patients needing transfusions were less in the del Nido group. No
differences were seen in postoperative LVEF, or in the incidence of AKI,
stroke, AF, and LCOS. Duration of mechanical ventilation, and length of
ICU and hospital stay were similar. <br/>Conclusion(s): Although this
meta-analysis failed to find any mortality benefits with del Nido
cardioplegia, significant benefits were seen in a number of intraoperative
and postoperative variables. del Nido cardioplegia is a safe and
favourable alternative to blood cardioplegia in adult cardiac
surgery.<br/>Copyright &#xa9; 2020 Australian and New Zealand Society of
Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<21>
Accession Number
2010392950
Title
Recruitment maneuvers to reduce pulmonary atelectasis after cardiac
surgery: A meta-analysis of randomized trials.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Hu M.-C.; Yang Y.-L.; Chen T.-T.; Lee C.-I.; Tam K.-W.
Institution
(Hu, Chen) Graduate Institute of Clinical Medicine, College of Medicine,
Taipei Medical University, Taipei, Taiwan (Republic of China)
(Yang) School of Respiratory Therapy, College of Medicine, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Yang) Department of Respiratory Therapy, Landseed International Hospital,
Taoyuan, Taiwan (Republic of China)
(Chen) Division of Pulmonary Medicine, Department of Internal Medicine,
Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
(Republic of China)
(Lee) Division of Cardiovascular Surgery, Department of Surgery, Shuang Ho
Hospital, Taipei Medical University, New Taipei City, Taiwan (Republic of
China)
(Tam) Division of General Surgery, Department of Surgery, Shuang Ho
Hospital, Taipei Medical University, New Taipei City, Taiwan (Republic of
China)
(Tam) Division of General Surgery, Department of Surgery, School of
Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
(Republic of China)
(Tam) Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan (Republic
of China)
Publisher
Mosby Inc.
Abstract
Background: Pulmonary atelectasis is a common postoperative complication
that may lead to intrapulmonary shunt, refractory hypoxemia, and
respiratory distress. Recruitment maneuvers may relieve pulmonary
atelectasis in patients undergoing cardiac surgery. We conducted a
meta-analysis of randomized controlled trials to evaluate the
effectiveness of recruitment maneuvers in these patients. <br/>Method(s):
We conducted a search in PubMed, Embase, Cochrane Library, and the
ClinicalTrials.gov registry for trials published before March 2020.
Individual effect sizes were standardized, and a meta-analysis was
performed to calculate a pooled effect size by using random-effects
models. Pulmonary atelectasis was assessed postoperatively. Secondary
outcomes included hypoxic events, arterial oxygen tension
(PaO<inf>2</inf>)/inspired oxygen fraction (FIO<inf>2</inf>) ratio,
cardiac index, mean arterial pressure, and postoperative complications
including pneumothorax and pneumonia. <br/>Result(s): We reviewed 16
trials involving 1455 patients. Patients receiving recruitment maneuvers
had a reduced incidence of pulmonary atelectasis (group with recruited
pressure >40 cmH<inf>2</inf>O: risk ratio [RR], 0.20; 95% confidence
interval [CI], 0.07-0.57; group with recruited pressure <40
cmH<inf>2</inf>O: RR, 0.54; 95% CI, 0.33-0.89), reduced incidence of
hypoxic events (RR, 0.23; 95% CI, 0.14-0.37), reduced incidence of
pneumonia (RR, 0.42; 95% CI, 0.18-0.95), and improved
PaO<inf>2</inf>/FIO<inf>2</inf> ratio (weighted mean difference [WMD];
58.87, 95% CI, 31.24-86.50) without disturbing the cardiac index (WMD,
0.22; 95% CI, -0.18 to 0.61) or mean arterial pressure (WMD, -0.30, 95%
CI, -3.19 to 2.59) as compared with those who received conventional
mechanical ventilation. The incidence of pneumothorax was nonsignificant
between the groups. <br/>Conclusion(s): Recruitment maneuvers may reduce
postoperative pulmonary atelectasis, hypoxic events, and pneumonia and
improve PaO<inf>2</inf>/FIO<inf>2</inf> ratios without hemodynamic
disturbance in patients undergoing cardiac surgery.<br/>Copyright &#xa9;
2020 The American Association for Thoracic Surgery

<22>
Accession Number
2007560582
Title
Multiple versus single arterial grafting in coronary artery bypass
grafting: A meta-analysis of randomized controlled trials and propensity
score studies.
Source
International Journal of Cardiology. 320 (pp 55-63), 2020. Date of
Publication: 01 Dec 2020.
Author
Saraiva F.A.; Leite-Moreira J.P.; Barros A.S.; Lourenco A.P.; Benedetto
U.; Leite-Moreira A.F.
Institution
(Saraiva, Leite-Moreira, Barros, Lourenco, Leite-Moreira) Cardiovascular
Research and Development Center, Department of Surgery and Physiology,
Faculty of Medicine of the University of Porto, Porto, Portugal
(Lourenco) Department of Anaesthesiology, Centro Hospitalar Universitario
Sao Joao, Porto, Portugal
(Benedetto) Bristol Heart Institute, School of Clinical Sciences,
University of Bristol, Bristol, United Kingdom
(Leite-Moreira) Department of Cardiothoracic Surgery, Centro Hospitalar
Universitario Sao Joao, Porto, Portugal
Publisher
Elsevier Ireland Ltd
Abstract
Objectives: We conducted a meta-analysis of randomized controlled trials
(RCTs) and propensity score (PS) studies comparing survival and major
adverse cardiac and cerebrovascular events (MACCEs) of patients who
underwent coronary artery bypass grafting (CABG) with multiple (MAG)
versus single arterial grafting (SAG). <br/>Method(s): MEDLINE, Web of
Science and Cochrane Library were used to find relevant literature
(1960-2018). Survival at a follow-up >=1 year, MACCEs and early outcomes
were evaluated. Time-to-event outcomes were collected through hazard ratio
(HR) along with their variance, and the other endpoints using frequencies
from matched sample or adjusted odds ratios. Random effect models were
used to compute combined statistical measures and 95% confidence intervals
(CI) through generic inverse variance method (time-to-event) or
Mantel-Haenszel method (binary events). <br/>Result(s): Twenty-nine PS
cohorts and 8 RCTs comprising 122,832 patients (52,178 MAG and 70,654 SAG)
were included in this meta-analysis. MAG was associated with lower early
mortality (OR: 0.82, 95%CI: 0.71-0.95, p = .007), long-term mortality (HR:
0.76, 95%CI: 0.73-0.78, p < .001) and MACCEs (HR: 0.85, 95%CI: 0.79-0.91,
p < .001). Increased risk of sternal wound complications (SWC) was only
observed when the bilateral internal mammary artery configuration was used
for MAG (OR MAG BIMA: 1.96, 95%CI: 1.37-2.81, p < .001).
<br/>Conclusion(s): Although the BIMA configuration increases the risk of
SWC, MAG improves both early and long-term survival as well as MACCEs in
CABG.<br/>Copyright &#xa9; 2020

<23>
Accession Number
2010355406
Title
A systematic review and meta-analysis of carotid artery stenting using the
transcervical approach.
Source
International Angiology. 39 (5) (pp 372-380), 2020. Date of Publication:
October 2020.
Author
Nana P.N.; Brotis A.G.; Spanos K.T.; Kouvelos G.N.; Matsagkas M.I.;
Giannoukas A.D.
Institution
(Nana, Spanos, Kouvelos, Matsagkas, Giannoukas) Department of Vascular
Surgery, Faculty of Medicine, School of Health Sciences, University
Hospital of Larissa, University of Thessaly, Larissa, Greece
(Brotis) Department of Neurosurgery, Faculty of Medicine, School of Health
Sciences, University Hospital of Larissa, University of Thessaly, Larissa,
Greece
Publisher
Edizioni Minerva Medica
Abstract
Introduction: Carotid artery stenting (CAS) via a transcarotid
revascularization (TCAR) approach has emerged as an alternative when
carotid endarterectomy or conventional CAS is contraindicated. The present
study was conducted to assess the feasibility and safety of TCAR in
patients with carotid artery stenosis. <br/>Evidence Acquisition: A
systematic review of the literature was performed, according to PRISMA
guidelines (Preferred Reporting Items for Systematic reviews and
Meta-Analyses), using PubMed, EMBASE and CENTRAL databases. The primary
outcomes included technical success, perioperative neurological event,
myocardial ischemic events, death and their composite. Operational
duration, flow reversal time and any local procedure related complication
(carotid dissection and cranial nerve injury) were also recorded.
<br/>Evidence Synthesis: Twenty-three studies were included, reporting on
3130 patients, undergoing TCAR. Thirty-five per cent of them were
symptomatic. Technical success was 98% (95% CI: 0.97-0.99; P=0.11,
I²=32%). Early (30-day) new neurological event rate was
estimated at 2% (95% CI: 0.01-0.02; P=1.0, I²=0%, respectively)
while early death rate was 1% (95% CI: 0.00-0.01; P=1.0,
I²=0%). Myocardial ischemic (MI) event rate was 1% (95% CI,
0.00-0.01, P=0.97, I²=6.6%). The composite outcome of
neurological event/MI/death at 30-day follow-up was 2% (95% CI: 0.01-0.02,
P=0.79, I²=14%). Carotid dissection rate during the
intervention was 2% (95% CI: 0.01-0.03, P=0.58, I²=2.9%) while
the post-operatively detected cranial nerve injury rate was 1% (95% CI,
0.00-0.01, P=1.0, I²=0%). Regarding the technical aspects of
the procedures, operational and flow reversal time were at 73.8 min and
13.7 min, respectively (95% CI: 68.2-79.3, P=0.18, I2=37.6% and 95% CI:
11.3-16.1, P=0.48, I²=0%, respectively). <br/>Conclusion(s):
TCAR is feasible with high technical success rate. The procedure presents
low incidence of local complications, neurological events, myocardial
complications and mortality during the early postoperative period and
should be considered an acceptable alternative for patients treated for
carotid artery stenosis.<br/>Copyright &#xa9; 2020 EDIZIONI MINERVA MEDICA

<24>
Accession Number
2006151257
Title
Transcatheter vs surgical aortic valve replacement in low to intermediate
surgical risk aortic stenosis patients: A systematic review and
meta-analysis of randomized controlled trials.
Source
Clinical Cardiology. 43 (12) (pp 1414-1422), 2020. Date of Publication:
December 2020.
Author
Zhang D.; Mao X.; Liu D.; Zhang J.; Luo G.; Luo L.
Institution
(Zhang, Mao, Liu, Zhang, Luo, Luo) Department of Cardiovascular Surgery,
The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is regarded as
the most superior alternative treatment approach for patients with aortic
stenosis (AS) who are associated with high surgical risk, whereas the
effectiveness of TAVR vs surgical aortic valve replacement (SAVR) in low
to intermediate surgical risk patients remained inconclusive. This study
aimed to determine the best treatment strategies for AS with low to
intermediate surgical risk based on published randomized controlled trials
(RCTs). Hypothesis and Methods: RCTs that compared TAVR vs SAVR in AS
patients with low to intermediate surgical risk were identified by PubMed,
EmBase, and the Cochrane library from inception till April 2019. The
pooled relative risks (RRs) with 95% confidence intervals (CIs) were
calculated for the data collected using random-effects models.
<br/>Result(s): Seven RCTs with a total of 6929 AS patients were enrolled.
We noted that TAVR significantly increased the risk of transient ischemic
attack (TIA) (RR: 1.43; 95%CI: 1.04-1.96; P =.029), and permanent
pacemaker implantation (RR: 3.00; 95%CI: 1.70-5.30; P <.001). However,
TAVR was associated with lower risk of post-procedural bleeding (RR: 0.57;
95%CI: 0.33-0.98; P =.042), new-onset or worsening of atrial fibrillation
(RR: 0.32; 95%CI: 0.23-0.45; P <.001), acute kidney injury (RR: 0.40;
95%CI: 0.25-0.63; P <.001), and cardiogenic shock (RR: 0.34; 95%CI:
0.19-0.59; P <.001). The risk of aortic-valve reintervention at 1- (RR:
2.63; 95%CI: 1.34-5.15; P =.005), and 2 years (RR: 3.19; 95%CI: 1.63-6.24;
P =.001) in low to intermediate surgical risk patients who received TAVR
was significantly increased than those who received SAVR.
<br/>Conclusion(s): These findings indicated that low to intermediate
surgical risk patients who received TAVR had low risk of complications,
whereas the risk of TIA, permanent pacemaker implantation, and
aortic-valve reintervention was increased.<br/>Copyright &#xa9; 2020 The
Authors. Clinical Cardiology published by Wiley Periodicals LLC.

<25>
Accession Number
2005838628
Title
Population Pharmacokinetic Models of Tacrolimus in Adult Transplant
Recipients: A Systematic Review.
Source
Clinical Pharmacokinetics. 59 (11) (pp 1357-1392), 2020. Date of
Publication: November 2020.
Author
Kirubakaran R.; Stocker S.L.; Hennig S.; Day R.O.; Carland J.E.
Institution
(Kirubakaran, Stocker, Day, Carland) St Vincent's Clinical School, Faculty
of Medicine, University of New South Wales, Sydney, NSW, Australia
(Kirubakaran, Stocker, Day, Carland) Department of Clinical Pharmacology
and Toxicology, St Vincent's Hospital, Sydney, NSW, Australia
(Kirubakaran) Ministry of Health, Putrajaya, Malaysia
(Hennig) Certara Inc., Princeton, NJ, United States
(Hennig) School of Clinical Sciences, Faculty of Health, Queensland
University of Technology, Brisbane, QLD, Australia
Publisher
Adis
Abstract
Background and Objectives: Numerous population pharmacokinetic (PK) models
of tacrolimus in adult transplant recipients have been published to
characterize tacrolimus PK and facilitate dose individualization. This
study aimed to (1) investigate clinical determinants influencing
tacrolimus PK, and (2) identify areas requiring additional research to
facilitate the use of population PK models to guide tacrolimus dosing
decisions. <br/>Method(s): The MEDLINE and EMBASE databases, as well as
the reference lists of all articles, were searched to identify population
PK models of tacrolimus developed from adult transplant recipients
published from the inception of the databases to 29 February 2020.
<br/>Result(s): Of the 69 studies identified, 55% were developed from
kidney transplant recipients and 30% from liver transplant recipients.
Most studies (91%) investigated the oral immediate-release formulation of
tacrolimus. Few studies (17%) explained the effect of drug-drug
interactions on tacrolimus PK. Only 35% of the studies performed an
external evaluation to assess the generalizability of the models. Studies
related variability in tacrolimus whole blood clearance among transplant
recipients to either cytochrome P450 (CYP) 3A5 genotype (41%), days
post-transplant (30%), or hematocrit (29%). Variability in the central
volume of distribution was mainly explained by body weight (20% of
studies). <br/>Conclusion(s): The effect of clinically significant
drug-drug interactions and different formulations and brands of tacrolimus
should be considered for any future tacrolimus population PK model
development. Further work is required to assess the generalizability of
existing models and identify key factors that influence both initial and
maintenance doses of tacrolimus, particularly in heart and lung transplant
recipients.<br/>Copyright &#xa9; 2020, Springer Nature Switzerland AG.

<26>
Accession Number
2005654330
Title
Endovascular treatment of ischemic large-vessel stroke due to infective
endocarditis: case series and review of the literature.
Source
Neurological Sciences. 41 (12) (pp 3517-3525), 2020. Date of Publication:
December 2020.
Author
D'Anna L.
Institution
(D'Anna) Department of Stroke and Neurosciences, Charing Cross Hospital,
Imperial College London NHS Healthcare Trust, Fulham Palace Road, London
W6 8RF, United Kingdom
(D'Anna) Division of Brain Sciences, Imperial College London, London,
United Kingdom
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Background: Mechanical thrombectomy is the standard of care, in selected
patients, for acute ischemic stroke with large vessel occlusion but its
use in patients with stroke secondary to infective endocarditis is
controversial. We report three cases of acute ischemic stroke treated by
mechanical thrombectomy and we propose an extensive review of the
literature to evaluate the clinical safety and efficacy of thrombectomy in
patients with stroke secondary to infective endocarditis. <br/>Method(s):
A comprehensive literature search was performed following a pre-specified
protocol of the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses statement. Case reports, cases series, cross-sectional
studies, case control studies, randomized controlled trials or
nonrandomized controlled trials were considered that included
endocarditis-related acute ischemic stroke patients who underwent
mechanical thrombectomy. <br/>Result(s): The database search yielded 431
relevant records published until January 2020. Nineteen articles fulfilled
the eligibility criteria that described thirty patients. After the
thrombectomy, 13.3% of the patients experienced intracranial haemorrhage.
After the procedure, the median National Institutes of Health Stroke Scale
score dropped from 15 (IQR 7) to 2.5 (IQR 5.75). At 90 days, mortality was
23.3% while 46.7% of the patients were functionally independent (mRS <=
2). <br/>Discussion(s): Based on our review, the use of mechanical
thrombectomy in patients with large vessel occlusion due to
endocarditis-associated stroke might improve patient outcome but it should
be considered on a case by case base as the safety has not been well
established yet. Further research on risk stratification is needed to
drive clinician during the decision-making process.<br/>Copyright &#xa9;
2020, The Author(s).

<27>
Accession Number
633050606
Title
Aspirin with or without clopidogrel after transcatheter aortic-valve
implantation.
Source
New England Journal of Medicine. 383 (15) (pp 1447-1457), 2020. Date of
Publication: 08 Oct 2020.
Author
Brouwer J.; Nijenhuis V.J.; Delewi R.; Hermanides R.S.; Holvoet W.; Dubois
C.L.F.; Frambach P.; de Bruyne B.; van Houwelingen G.K.; van der Heyden
J.A.S.; Tousek P.; van der Kley F.; Buysschaert I.; Schotborgh C.E.;
Ferdinande B.; van der Harst P.; Roosen J.; Peper J.; Thielen F.W.F.;
Veenstra L.; Chan Pin Yin D.R.P.P.; Swaans M.J.; Rensing B.J.W.M.; van't
Hof A.W.J.; Timmers L.; Kelder J.C.; Stella P.R.; Baan J.; ten Berg J.M.
Institution
(Brouwer, Nijenhuis, Delewi, Hermanides, Holvoet, Dubois, Frambach, de
Bruyne, van Houwelingen, van der Heyden, Tousek, van der Kley,
Buysschaert, Schotborgh, Ferdinande, van der Harst, Roosen, Peper,
Thielen, Veenstra, Chan Pin Yin, Swaans, Rensing, van't Hof, Timmers,
Kelder, Stella, Baan, ten Berg) St. Antonius Hospital, Koekoekslaan 1,
Nieuwegein 3435CM, Netherlands
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND The effect of single as compared with dual antiplatelet
treatment on bleeding and thromboembolic events after transcatheter
aortic-valve implantation (TAVI) in patients who do not have an indication
for long-term anticoagulation has not been well studied. METHODS In a
randomized, controlled trial, we assigned a subgroup of patients who were
undergoing TAVI and did not have an indication for long-term
anticoagulation, in a 1:1 ratio, to receive aspirin alone or aspirin plus
clopidogrel for 3 months. The two primary outcomes were all bleeding
(including minor, major, and life-threatening or disabling bleeding) and
non-procedure-related bleeding over a period of 12 months. Most bleeding
at the TAVI puncture site was counted as non-procedure-related. The two
secondary outcomes were a composite of death from cardiovascular causes,
non-procedure-related bleeding, stroke, or myocardial infarction
(secondary composite 1) and a composite of death from cardiovascular
causes, ischemic stroke, or myocardial infarction (secondary composite 2)
at 1 year, with both outcomes tested sequentially for noninferiority
(noninferiority margin, 7.5 percentage points) and superiority. RESULTS A
total of 331 patients were assigned to receive aspirin alone and 334 were
assigned to receive aspirin plus clopidogrel. A bleeding event occurred in
50 patients (15.1%) receiving aspirin alone and in 89 (26.6%) receiving
aspirin plus clopidogrel (risk ratio, 0.57; 95% confidence interval [CI],
0.42 to 0.77; P=0.001). Non-procedure-related bleeding occurred in 50
patients (15.1%) and 83 patients (24.9%), respectively (risk ratio, 0.61;
95% CI, 0.44 to 0.83; P=0.005). A secondary composite 1 event occurred in
76 patients (23.0%) receiving aspirin alone and in 104 (31.1%) receiving
aspirin plus clopidogrel (difference, -8.2 percentage points; 95% CI for
noninferiority, -14.9 to -1.5; P<0.001; risk ratio, 0.74; 95% CI for
superiority, 0.57 to 0.95; P=0.04). A secondary composite 2 event occurred
in 32 patients (9.7%) and 33 patients (9.9%), respectively (difference,
-0.2 percentage points; 95% CI for noninferiority, -4.7 to 4.3; P=0.004;
risk ratio, 0.98; 95% CI for superiority, 0.62 to 1.55; P=0.93). A total
of 44 patients (13.3%) and 32 (9.6%), respectively, received oral
anticoagulation during the trial. CONCLUSIONS Among patients undergoing
TAVI who did not have an indication for oral anticoagulation, the
incidence of bleeding and the composite of bleeding or thromboembolic
events at 1 year were significantly less frequent with aspirin than with
aspirin plus clopidogrel administered for 3 months.<br/>Copyright &#xa9;
2020 Massachusetts Medical Society.

<28>
Accession Number
633698745
Title
Benefits of icosapent ethyl across a range of baseline renal function in
patients with established cardiovascular disease or diabetes: Results of
reduce-it renal.
Source
Journal of the American Society of Nephrology. Conference: Kidney Week
2020. United States. 31 (pp 21), 2020. Date of Publication: 2020.
Author
Majithia A.; Bhatt D.L.; Friedman A.N.; Miller M.; Steg P.G.; Brinton
E.A.; Jacobson T.A.; Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.;
Granowitz C.B.; Budoff M.J.; Mason P.; Tardif J.-C.; Boden W.E.;
Ballantyne C.
Institution
(Majithia, Bhatt, Mason) Brigham and Women's Hospital, Boston, MA, United
States
(Friedman) Indiana University, School of Medicine, Indianapolis, IN,
United States
(Miller) University of Maryland, School of Medicine, Baltimore, MD, United
States
(Steg) Hopital Bichat - Claude-Bernard, Paris, France
(Budoff) University of California Los Angeles, Los Angeles, CA, United
States
(Ballantyne) Baylor College of Medicine, Houston, TX, United States
(Brinton) Utah Lipid Center, Salt Lake City, UT, United States
(Boden) VA Boston Healthcare System, West Roxbury, MA, United States
(Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma Inc, Bridgewater,
NJ, United States
(Tardif) Institut De Cardiologie de Montreal, Montreal, QC, Canada
(Jacobson) Emory University School of Medicine, Atlanta, GA, United States
Publisher
American Society of Nephrology
Abstract
Background: Chronic kidney disease is associated with adverse outcomes
among patients with established cardiovascular disease (CVD) or diabetes.
Medications for treatment of CVD among patients with low estimated
glomerular filtration rate (eGFR) may be ineffective. <br/>Method(s): The
Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial
(REDUCE-IT) randomized patients with CVD or diabetes and one additional
risk factor to treatment with icosapent ethyl or placebo. Patients from
REDUCE-IT were categorized by prespecified eGFR categories for analysis of
the effect of icosapent ethyl (IPE) on the primary endpoint (composite of
cardiovascular (CV) death, nonfatal myocardial infarction (MI), nonfatal
stroke, coronary revascularization, or unstable angina) and key secondary
endpoint (a composite of CV death, nonfatal MI, or nonfatal stroke). In
post hoc analysis, patients were categorized by additional eGFR cutoffs
consistent with current medical guidelines. <br/>Result(s): Among the 8179
REDUCE-IT patients, median baseline eGFR was 75 mL/ min/1.73m²
(range: 17 to 123 mL/min/1.73m²). There were no meaningful
changes in median eGFR for IPE versus placebo across study visits. IPE
benefit was consistent across baseline eGFR for the primary (Figure) and
key secondary endpoints. The numerical reduction in CV death was greatest
in the eGFR <60 mL/min/1.73m² group (IPE: 7.6%; placebo: 10.6%;
HR 0.70, 95%CI 0.51, 0.95, p=0.02). The rate of microalbuminuria in
adverse event reporting was lower among IPE-treated patients (0.1% versus
0.3%, p=0.01). <br/>Conclusion(s): In REDUCE-IT, icosapent ethyl reduced
fatal and nonfatal ischemic events across the broad range of baseline eGFR
categories. (Figure Presented).

<29>
Accession Number
633700243
Title
Long-term renal outcomes in children who had surgical repair of congenital
heart disease.
Source
Journal of the American Society of Nephrology. Conference: Kidney Week
2017. United States. 28 (pp 83-84), 2017. Date of Publication: October
2017.
Author
Parikh C.R.; Greenberg J.H.; McArthur E.; Philbrook H.T.; Wald R.;
Zappitelli M.; Chanchlani R.; Garg A.X.
Institution
(McArthur) Institute for Clinical Evaluative Sciences, London, ON, Canada
(Garg) London Health Sciences Centre, London, ON, Canada
(Zappitelli) McGill University Health Centre, Montreal Children's
Hospital, Montreal, QC, Canada
(Chanchlani) HamiltonONCanada
(Wald) St. Michael's Hospital, Toronto, ON, Canada
(Greenberg, Philbrook) Yale University, New Haven, CT, United States
(Parikh) Yale University and VAMC, New Haven, CT, United States
Publisher
American Society of Nephrology
Abstract
Background: The risk of mortality in children who require surgery for
congenital heart disease (S-CHD) has markedly reduced in recent years due
to advances in pediatric and surgical care. However, there are limited
data on long-term kidney outcomes in children after S-CHD compared with
the general population of children. <br/>Method(s): A registry-based,
matched-cohort study was conducted across 7 administrative Canadian
databases. Children were included if they were born between April 1, 2002
and March 31, 2015 and underwent surgery for CHD. Follow-up and
comorbidity data were collected until March 2015. Children serving as
controls (10 controls for each patient with S-CHD), were matched for age,
sex, neighborhood income quintile, and county, and were randomly selected
from the general population. Survival analyses were performed with Cox
proportional hazards models. <br/>Result(s): Of the 3600 patients with a
diagnosis of S-CHD, 1595 were female (44.3%). Median age at first surgery
was 150 (IQR, 40-252) days and 21.8% of the children were low birthweight
(<2500 grams). The median (IQR) follow-up time was 5.9 (2.9-9.0) years. 52
(1.4%) children reached ESRD in follow-up. The 10-year cumulative
incidences of hypertension and CKD were 12.9% and 2.1%, respectively. The
hazard ratios for renal outcomes and mortality in children with S-CHD
compared with controls were significantly higher (Table). According to
RACHS-1 severity classifications, the group of patients with the most
severe complex defects (RACHS-1 category 4) had the highest risk for death
and renal outcomes. Trends in relative increase in risk of renal outcomes
and mortality were also seen associated with younger age at surgery (<150
days), but not with income quintile or preterm status at birth.
<br/>Conclusion(s): Despite dramatic recent improvements in outcomes after
S-CHD, the incidence of long-term hypertension, CKD, ESRD and mortality
remains high in these patients compared to matched controls. Further
interventions aimed at improving renal outcomes in this vulnerable group
are required. (Figure Presented).

<30>
Accession Number
633701093
Title
The association of beta-blockers and all-cause mortality by EGFR in
patients with heart failure.
Source
Journal of the American Society of Nephrology. Conference: Kidney Week
2017. United States. 28 (pp 39), 2017. Date of Publication: October 2017.
Author
Molnar A.O.; Garg A.X.; Sood M.M.
Institution
(Garg) London Health Sciences Centre, London, ON, Canada
(Molnar) McMaster University, Hamilton, ON, Canada
(Sood) Ottawa Hospital Research Institute, Ottawa, ON, Canada
Publisher
American Society of Nephrology
Abstract
Background: Congestive heart failure (CHF) and CKD are strongly
interrelated and when occurring concurrently, are associated with very
high mortality, especially in the elderly. Whether the mortality benefit
of beta-blockers (BB) extends to patients with CHF and lower levels of
eGFR remains unknown. <br/>Method(s): A population-level administrative
database study using linked datasets in Ontario, Canada. Incident CHF
cases age > 66 years from April 2002 to March 2014 were included. The date
of the first prescription for a BB was the date of inclusion (index date).
Patients without evidence of a BB prescription were randomly assigned an
index date based on the distribution of index dates for those prescribed a
BB. Individuals without an eGFR measure within 1 year prior to the index
date, or a prior history of kidney or heart transplant or chronic dialysis
were excluded. We matched BB users to non-users (1:1) based on age, sex,
eGFR grouping, and a high dimensional propensity score. We examined
all-cause mortality using Cox proportional hazards models with BB
prescription at baseline and as a time-varying covariate. <br/>Result(s):
Results: After matching, a total of 3,574 pairs were identified. By eGFR
category, the number of all-cause mortality events in the BB versus the no
beta-blocker (NBB) groups were eGFR > 90: BB 44 (12.7%) vs. NBB 188
(38.6%), eGFR 60-90, BB 357 (14.0%) vs. NBB 1352 (22.2%), eGFR 30-60, BB
274 (19.0%) vs NBB 917 (47.7%), eGFR < 30 BB 47 (20.4%) vs. NBB 166 (53%).
Examining baseline BB use, there was no mortality benefit with BB usage in
lower eGFR categories [eGFR >90: HR 0.67 (0.48-0.94), eGFR 60-90: HR 0.96
(0.85-1.08), eGFR 30-60: HR 0.96 (0.88-1.05), eGFR <30: HR 0.87
(0.68-1.13), eGFR category X BB interaction p=0.225]. When examining
timevarying BB use, it was associated with a similar reduction in
all-cause mortality across all eGFR categories [eGFR 90: HR 0.56
(0.39-0.79), eGFR 60-90: HR 0.63 (0.55-0.73), eGFR 30-60: HR 0.59
(0.52-0.66), eGFR <30: HR 0.47 (0.33-0.66), eGFR category X beta-blocker
interaction p=0.458]. <br/>Conclusion(s): In elderly patients with CHF, BB
use was associated with a similar reduction in mortality across all eGFR
categories. Our findings suggest that mortality benefits of BB's observed
in CHF patients included in randomized trials could be extended to
patients with eGFR < 30 not on dialysis.

<31>
Accession Number
633701363
Title
Effect of spontaneous donor hypothermia on graft outcome in organ
transplantation.
Source
Journal of the American Society of Nephrology. Conference: Kidney Week
2017. United States. 28 (pp 674-675), 2017. Date of Publication: October
2017.
Author
Kramer B.K.; Benck U.; Schnuelle P.
Institution
(Kramer) Vth Department of Medicine, University Hospital Mannheim,
Mannheim, Germany
(Benck, Schnuelle) University Medicine Mannheim, Mannheim, Germany
(Schnuelle) Nierenzentrum, Weinheim, Germany
Publisher
American Society of Nephrology
Abstract
Background: A previous controlled donor intervention trial found that
therapeutic hypothermia reduced delayed graft function (DGF) after kidney
transplantation. <br/>Method(s): This retrospective cohort study nested in
the randomized dopamine trial (ClinicalTrials.gov identifier:
NCT000115115) investigates the effects of spontaneous donor hypothermia on
initial kidney graft function, and evaluates graft survival including
heart and liver transplants. All 264 donors who met the eligibility
criteria for enrollment in the randomized dopamine trial were grouped by
occurrence of spontaneous hypothermia. Hypothermia was defined by a core
body temperature of less than 36.0degreeC before organ procurement.
Accordingly, we assigned 54 donors to the hypothermia group and the
remaining 210 donors served as controls. <br/>Result(s): Hypothermia was
associated with less DGF after kidney transplantation (OR 0.56, 95%CI
0.34-0.91). The benefit was greater when need for more than a single
posttransplant dialysis session was analyzed (OR 0.48, 95%CI 0.28-0.82).
Donor dopamine ameliorated dialysis requirement independently from
hypothermia in a time-relationship with exposure (OR 0.93; 95%CI
0.87-0.98, per hour). Hypothermia did not alter kidney graft survival (HR
0.83, 95%CI 0.54-1.27), while dopamine treatment was associated with
improved long-term outcome (HR 0.95, 95%CI 0.91-0.99 per hour).
Stratifiedanalyses of non-renal organs in tertiles of the donor's core
body temperature disclosed negative effects on heart allograft survival
(HR 1.89, 95%CI 1.09-3.27). <br/>Conclusion(s): Spontaneous donor
hypothermia is associated with less DGF but does not appear to affect
long-term outcome of the kidney graft. Our data raise safety concerns
against therapeutic hypothermia in multi-organ donors when a thoracic
transplantation is considered.

<32>
Accession Number
633699344
Title
Initial application of electronic alert for AKI among high-risk wards.
Source
Journal of the American Society of Nephrology. Conference: Kidney Week
2017. United States. 28 (pp 415-416), 2017. Date of Publication: October
2017.
Author
Wu Y.; Chen Y.; Dong W.; Liang X.
Institution
(Wu, Chen, Dong, Liang) Guangdong General Hospital, Guangdong Academy of
Medical Sciences, Guangzhou, China
Publisher
American Society of Nephrology
Abstract
Background: The effectiveness of acute kidney injury alert might differ in
different care settings. We aimed to investigate the value of electronic
alert for acute kidney injury among high-risk wards. <br/>Method(s): A
prospective, randomized, controlled study was conducted. We developed an
electronic alert for AKI and ran the system in intensive care units and
cardiovascular departments. Eligible participants were adults aged 18
years or older who were in hospital with acute kidney injury as defined by
Kidney Disease Improving Global Outcomes creatinine-based criteria.
Exclusion criteria were initial hospital creatinine 353.6mumol/L or
greater, end-stage renal disease, renal replacement therapy before
randomization, kidney transplantation and amputation. The primary outcomes
were AKI and expanded AKI diagnosis rates, nephrology consultation,
dialysis, recovery of renal function and death. Patients were randomly
assigned to alert group and non-alert group. Alert group could receive
popup messages. This study is registered with ClinicalTrials.gov, number
NCT02793167. <br/>Result(s): Between Mar.1 2016 and Jul.31 2016, 5535
patients were screened.318 eligible participants were assigned to the
alert group and 623 were assigned to the non-alert group. The diagnosis
rate of AKI in alert group was higher than non-alert group(5.6% vs.
2.1%,P=0.004). The expanded AKI (AKI and multiple organ dysfunction
syndrome) diagnosis rate was also higher in alert group (11.2% vs.
4.5%,P<0.001). Patients were stratified according to the severity of AKI
and different wards. At AKI stage 1, the AKI and expanded AKI diagnosis
rates in alert group were higher than non-alert group (AKI: 2.8% vs.
0.8%,P=0.037; expanded AKI: 4.7% and 1.3%, P=0.011). There was no
difference at AKI stage 2 and stage 3. Among the different wards, the AKI
alert had greater impact on AKI and expanded AKI diagnosis rates in
cardiovascular surgery wards(AKI:3.9% vs. 1.2%,P=0.077; expanded AKI:9.0%
vs. 2.9%, P=0.003). There was not significantly different in nephrology
consultation, dialysis, recovery of renal function or death in the two
groups. <br/>Conclusion(s): Electronic warning system could reduce the
misdiagnosis rates of AKI and expanded AKI in high-risk wards. Standard
diagnosis rate of AKI was still very low. The electronic alert system for
AKI did not improve clinical outcomes in these wards.

<33>
Accession Number
633703653
Title
Daring discourse: Should the ESP block be renamed RIP II block?.
Source
Regional Anesthesia and Pain Medicine. 46 (1) (pp 57-60), 2021. Date of
Publication: 01 Jan 2021.
Author
Lonnqvist P.A.; Karmakar M.K.; Richardson J.; Moriggl B.
Institution
(Lonnqvist) Physiology and Pharmacology, Karolinska Institute, Stockholm,
Sweden
(Karmakar) Department of Anesthesia and Intensive Care, The Chinese
University of Hong Kong, Shatin, Hong Kong
(Richardson) Department of Anaesthetics and Pain Medicine, Bradford Royal
Infirmary, Bradford, United Kingdom
(Moriggl) Anatomy, Histology and Embryology, Medical University of
Innsbruck, Innsbruck, Austria
Publisher
BMJ Publishing Group
Abstract
During the time period 1984 to the turn of the millennium, interpleural
nerve blockade was touted as a very useful regional anesthetic nerve
blockade for most procedures or conditions that involved the trunk and was
widely practiced despite the lack of proper evidence-based support.
However, as an adequate evidence base developed, the interest for this
type of nerve block dwindled and very few centers currently use it -
thereby to us representing the rest in peace (RIP) I block. Unfortunately,
we get a deja-vu sensation when we observe the current fascination with
the erector spinae plane block (ESPB), which since 2019 has generated as
many as 98 PubMed items. This daring discourse point out the lack of a
proper evidence base of the ESPB compared with other established nerve
blocking techniques as well as the lack of a proven mechanism of action
that explains how this nerve block technique can be effective regarding
surgical procedures performed on the front of the trunk. Emerging
meta-analysis data also raise concern and give cause to healthy skepticism
regarding the use of ESPB for major thoracic or abdominal surgery. Against
this background, we foresee that ESPB (and variations on this theme) will
end up in a similar fashion as interpleural nerve blockade, thereby soon
to be renamed the RIP II block. <br/>Copyright &#xa9; 2021 BMJ Publishing
Group. All rights reserved.

<34>
Accession Number
633652880
Title
A novel method to interpret early phase trials shows how the narrowing of
the coronary sinus concordantly improves symptoms, functional status and
quality of life in refractory angina.
Source
Heart. 107 (1) (pp 41-46), 2021. Date of Publication: 01 Jan 2021.
Author
Jolicoeur E.M.; Verheye S.; Henry T.D.; Joseph L.; Doucet S.; White C.J.;
Edelman E.; Banai S.
Institution
(Jolicoeur, Doucet) Department of Medicine, Interventional Cardiology,
Montreal Heart Institute, Montreal, QC, Canada
(Verheye) Antwerp Cardiovascular Institute, ZNA Middelheim Hospital,
Antwerpen, Belgium
(Henry) The Carl and Edyth Lindner Center for Research and Education, The
Christ Hospital, Cincinnati, OH, United States
(Joseph) Department of Epidemiology and Biostatistics, McGill University,
Montreal, QC, Canada
(White) The John Ochsner Heart and Vascular Institute, Ochsner Clinical
School, University of Queensland, New Orleans, LA, United States
(Edelman) Institute for Medical Engineering and Science, Cambridge, MA,
United States
(Edelman) Cardiovascular Division, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Banai) The Tel Aviv Medical Center, The Tel Aviv University Medical
School, Tel Aviv, Israel
Publisher
BMJ Publishing Group
Abstract
Background Reduction of the coronary sinus was shown to improve angina in
patients unsuitable for revascularisation. We assessed whether a
percutaneous device that reduces the diameter of the coronary sinus
improved outcomes across multiple endpoints in a phase II trial. Methods
We conducted a novel analysis performed as a post hoc efficacy analysis of
the COSIRA (Coronary Sinus Reducer for Treatment of Refractory Angina)
trial, which enrolled patients with Canadian Cardiovascular Society (CCS)
class 3-4 refractory angina. We used four domains: symptoms (CCS Angina
Scale), functionality (total exercise duration), ischaemia (imaging) and
health-related quality of life. For all domains, we specified a meaningful
threshold for change. The primary endpoint was defined as a probability of
>=80% that the reducer exceeded the meaningful threshold on two or more
domains (group-level analysis) or that the average efficacy score in the
reducer group exceeded the sham control group by at least two points
(patient-level analysis). Results We randomised 104 participants to either
a device that narrows to coronary sinus (n=52) or a sham implantation
(n=52). The reducer group met the prespecified criteria for concordance at
the group level and demonstrated improvement in symptoms (0.59 CCS grade,
95% credible interval (CrI)=0.22 to 0.95), total exercise duration
(+27.9%, 95% CrI=2.8% to 59.8%) and quality of life (stability +11.2
points, 95% CrI=3.3 to 19.1; perception +11.0, 95% CrI=3.3 to 18.7).
Conclusions The reducer concordantly improved symptoms, functionality and
quality of life compared with a sham intervention in patients with angina
unsuitable for coronary revascularisation. Concordant analysis such as
this one can help interpret early phase trials and guide the decision to
pursue a clinical programme into a larger confirmatory trial. Trail
registration number ClinicalTrials.gov identifier: NCT01205893.
<br/>Copyright &#xa9; 2021 BMJ Publishing Group. All rights reserved.

<35>
Accession Number
633653081
Title
Goal-directed perfusion to reduce acute kidney injury after paediatric
cardiac surgery (GDP-AKIp): Study protocol for a prospective randomised
controlled trial.
Source
BMJ Open. 10 (12) (no pagination), 2020. Article Number: 039385. Date of
Publication: 10 Dec 2020.
Author
Zhang Y.; Zhou X.; Wang B.; Guo L.; Zhou R.
Institution
(Zhang, Zhou, Wang, Guo, Zhou) Anesthesiology, West China Hospital of
Sichuan University, Chengdu, China
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiac surgery-associated acute kidney injury (CS-AKI)
occurs in up to 40%~60% of paediatric patients and increases postoperative
morbidity and mortality. A goal-directed perfusion (GDP) strategy aimed at
maintaining indexed oxygen delivery (DO 2 i) above the critical threshold
(reported to be 260~300 mL/min/m 2 in adults) during cardiopulmonary
bypass (CPB), is effective in reducing the incidence of CS-AKI. However,
no clear standards of paediatric critical DO 2 i exist. Our prior
prospective cohort study exploring the critical DO 2 i threshold during
paediatric CPB has found the nadir DO 2 i <353 mL/min/m 2 was an
independent risk predictor of CS-AKI. Based on this background, this trial
is designed to further determine whether the implementation of the GDP
initiative aimed at maintaining DO 2 i >=360 mL/min/m 2 would reduce the
rate of CS-AKI in paediatrics and improve clinical outcome. Methods and
analysis This is a prospective, single-centre, randomised controlled
trial. In total, 166 paediatric patients undergoing cardiac surgery will
be randomly allocated to the GDP group or control group. Patients in the
GDP arm will be treated with a GDP strategy during CPB aimed to maintain
DO 2 i at >=360 mL/min/m 2 (to ensure safely above the risk DO 2 i
threshold we found). The perfusion strategy for patients in the control
arm will be factored on body surface area and temperature. The primary
outcome is the rate of postoperative CS-AKI (it is defined according to
paediatric Risk, Injury, Failure, Loss of renal function and End-stage
renal disease criteria). The secondary end points include: (1) the other
oxygen metabolism parameters during CPB; (2) major complication and
all-cause mortality (in-hospital or within 30 days postoperatively); (3)
short-term clinical outcomes (ie, time to extubation, mechanical
ventilation time, hospital stay). Ethics and dissemination The study has
been approved by the Biomedical Research Ethics committee of West China
Hospital of Sichuan University (approval number: 2019(863)). Results will
be disseminated through peer-reviewed publications and conferences. Trial
registration number ChiCTR2000029232. <br/>Copyright &#xa9;

<36>
Accession Number
358102025
Title
Omega-3 polyunsaturated fatty acids: A necessity for a comprehensive
secondary prevention strategy.
Source
Vascular Health and Risk Management. 5 (pp 801-810), 2009. Date of
Publication: 2009.
Author
Patel J.V.; Tracey I.; Hughes E.A.; Lip G.Y.H.
Institution
(Patel, Tracey, Hughes, Lip) Haemostasis, Thrombosis and Vascular Biology
Unit, University of Birmingham Centre for Cardiovascular Sciences, City
Hospital, Birmingham, United Kingdom
Publisher
Dove Medical Press Ltd
Abstract
Long-chain omega-3 polyunsaturated fatty acid (PUFA) supplementation has
been used for the secondary prevention of fatal and nonfatal myocardial
infarction (MI). However, the benefit of this therapy is frequently
confused with other established treatments in the therapeutic strategy
among such patients. We review the data on omega-3 PUFA use in secondary
care and consider indications for its use which include post-MI and raised
triglycerides. We suggest that the available evidence supports the use of
omega-3 supplementation as part of the comprehensive secondary care
package for post-MI patients. &#xa9; 2009 Patel et al, publisher and
licensee Dove Medical Press Ltd.

<37>
Accession Number
2007027010
Title
Prosthesis-patient mismatch after mitral valve replacement: A pooled
meta-analysis of Kaplan-Meier-derived individual patient data.
Source
Journal of Cardiac Surgery. 35 (12) (pp 3477-3485), 2020. Date of
Publication: December 2020.
Author
Tomsic A.; Arabkhani B.; Schoones J.W.; Etnel J.R.G.; Marsan N.A.; Klautz
R.J.M.; Palmen M.
Institution
(Tomsic, Arabkhani, Klautz, Palmen) Department of Cardiothoracic Surgery,
Leiden University Medical Centre, Leiden, Netherlands
(Schoones) Walaeus Library, Leiden University Medical Centre, Leiden,
Netherlands
(Etnel) Department of Cardiothoracic Surgery, Erasmus University Medical
Centre, Rotterdam, Netherlands
(Marsan) Department of Cardiology, Leiden University Medical Centre,
Leiden, Netherlands
Publisher
Blackwell Publishing Inc.
Abstract
Objective: The hemodynamic effect and early and late survival impact of
prosthesis-patient mismatch (PPM) after mitral valve replacement remains
insufficiently explored. <br/>Method(s): Pubmed, Embase, Web of Science,
and Cochrane Library databases were searched for English language original
publications. The search yielded 791 potentially relevant studies. The
final review and analysis included 19 studies compromising 11,675
patients. <br/>Result(s): Prosthetic effective orifice area was calculated
with the continuity equation method in 7 (37%), pressure half-time method
in 2 (10%), and partially or fully obtained from referenced values in 10
(53%) studies. Risk factors for PPM included gender (male), diabetes
mellitus, chronic renal disease, and the use of bioprostheses. When
pooling unadjusted data, PPM was associated with higher perioperative
(odds ratio [OR]: 1.66; 95% confidence interval [CI]: 1.32-2.10; p <.001)
and late mortality (hazard ratio [HR]: 1.46; 95% CI: 1.21-1.77; p <.001).
Moreover, PPM was associated with higher late mortality when Cox
proportional-hazards regression (HR: 1.97; 95% CI: 1.57-2.47; p <.001) and
propensity score (HR: 1.99; 95% CI: 1.34-2.95; p <.001) adjusted data were
pooled. Contrarily, moderate (HR: 1.01; 95% CI: 0.84-1.22; p =.88) or
severe (HR: 1.19; 95% CI: 0.89-1.58; p =.24) PPM were not related to
higher late mortality when adjusted data were pooled individually. PPM was
associated with higher systolic pulmonary pressures (mean difference: 7.88
mmHg; 95% CI: 4.72-11.05; p <.001) and less pulmonary hypertension
regression (OR: 5.78; 95% CI: 3.33-10.05; p <.001) late after surgery.
<br/>Conclusion(s): Mitral valve PPM is associated with higher
postoperative pulmonary artery pressure and might impair perioperative and
overall survival. The relation should be further assessed in properly
designed studies.<br/>Copyright &#xa9; 2020 The Authors. Journal of
Cardiac Surgery published by Wiley Periodicals LLC

<38>
Accession Number
2008411169
Title
Anatomy versus physiology-guided ablation for persistent atrial
fibrillation.
Source
Journal of Atrial Fibrillation. 12 (6) (no pagination), 2020. Date of
Publication: 2020.
Author
Deshmukh A.; Zhong L.; Slusser J.; Xiao P.; Zhang P.; Hodge D.; Hocini M.;
McLeod C.; Bradley D.; Munger T.; Packer D.; Cha Y.-M.
Institution
(Deshmukh, Zhong, Xiao, Zhang, McLeod, Bradley, Munger, Packer, Cha)
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United
States
(Hocini) Bordeaux University Hospital, LIRYC Institute, Pessac, France
(Slusser, Hodge) Department of Health Sciences Research, Mayo Clinic,
Rochester, MN, United States
Publisher
CardioFront LLC
Abstract
Background: Pulmonary vein isolation remains the cornerstone of atrial
fibrillation (AF) ablation. However, due to high recurrence rates,
especially in patients with persistent AF, PV antral isolation,
complemented by linear ablation, autonomic modulation, and ablation of
complex fractionated electrograms, have been attempted to increase the
odds of success. However, the optimum approach for a complementary
strategy in addition to PVI for persistent AF is unknown. <br/>Method(s):
We performed a prospective randomized trial by assigning 92 patients with
persistent AF in 1:1 ratio to pulmonary-vein isolation plus ablation of
electrograms showing complex fractionated activity (45 patients), or
pulmonary-vein isolation plus additional linear ablation across the left
atrial roof and mitral valve isthmus (47 patients). The duration of
follow-up was five years. The primary endpoint was freedom from any
documented recurrence of atrial fibrillation after a single ablation
procedure. <br/>Result(s): At a 12-month follow-up, 9 (23%) patients had
AF recurrence in the linear ablation and 8 (21%) patients in the CFAE
groups. At a mean follow-up duration of 59+/-36 months, 48.3% of patients
in the linear ablation group and 44.6% of patients in the CFAE group were
free from AF (p=0.403). There were no significant differences between the
two groups for independent predictors of freedom from AF. The overall
procedure time and radiation exposure were higher in the PVI+linear
ablation group. There were five adverse events noted, two in the linear
group (pericardial effusion not requiring drain) and 3 in the CFAE group
(1 pseudoaneurysm, one effusion requiring pericardiocentesis and one
effusion nor requiring drain). <br/>Conclusion(s): Among patients with
persistent atrial fibrillation, we found no difference in maintenance of
sinus rhythm in either linear ablation or ablation of complex fractionated
electrograms was performed in addition to pulmonary vein isolation in
short- and long-term follow-up.<br/>Copyright &#xa9; 2020 CardioFront LLC.
All rights reserved.

<39>
Accession Number
2010329284
Title
Carotid plaque vulnerability on magnetic resonance imaging and risk of
future ischemic events: A systematic review and meta-analysis.
Source
Journal of Neurosurgical Sciences. 64 (5) (pp 480-486), 2020. Date of
Publication: October 2020.
Author
Rizvi A.; Seyedsaadat S.M.; Alzuabi M.; Murad M.H.; Huston J.; Lehman
V.T.; Lanzino G.; Saba L.; Brinjikji W.
Institution
(Rizvi, Seyedsaadat, Huston, Lehman, Brinjikji) Department of Radiology,
Mayo Clinic, Rochester, MN, United States
(Rizvi) Department of Medicine, University of Texas Medical Branch at
Galveston, Galveston, TX, United States
(Alzuabi, Murad) Evidence-based Practice Center, Mayo Clinic, Rochester,
MN, United States
(Lanzino) Department of Neurologic Surgery, Mayo Clinic, Rochester, MN,
United States
(Saba) Department of Radiology, University of Cagliari, Cagliari, Italy
(Brinjikji) Joint Department of Medical Imaging, Toronto Western Hospital,
Toronto, ON, Canada
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Magnetic resonance imaging (MRI) can characterize carotid
plaque features, including intraplaque hemorrhage (IPH), lipid-rich
necrotic core (LRNC), and thin/ruptured fibrous cap (TRFC), that have
increased tendency to cause future cerebrovascular ischemic events. We
performed a systematic review and meta-analysis of studies evaluating
association of MRI-identified high-risk plaque features, including IPH,
LRNC, and TRFC, with risks of subsequent ischemic events of stroke,
transient ischemic attack (TIA), or amaurosis fugax (AF) over follow-up
duration of >=3 months. EVIDENCE ACQUISITION: Multiple databases were
searched for relevant publications between January 2000 and March 2020.
Studies reporting outcomes of future ischemic events of stroke, TIA, or AF
for individual MRI-identified high-risk carotid plaque features over
follow-up duration of >=3 months were included. Random effects
meta-analysis was performed to estimate odds ratios (OR) and 95%
confidence intervals (CI) comparing outcomes between MRI-positive and
MRI-negative groups. EVIDENCE SYNTHESIS: Fifteen studies including 2350
patients were included. The annual rate of future ischemic events was
11.9% for MRI-positive IPH, 5.4% for LRNC, and 5.7% for TRFC. IPH, LRNC,
and TRFC were associated with increased risk of future ischemic events (OR
6.37; 95% CI, 3.96 to 10.24), (OR 4.34; 95% CI, 1.65 to 11.42), and (OR
10.60, 95% CI 3.56 to 31.58), respectively. <br/>CONCLUSION(S): The
current study findings strengthen the assertion that MRI-positive
"high-risk" or "vulnerable" plaque features, including IPH, LRNC, and/or
TRFC can predict risks of future ischemic events of stroke, TIA, or
AF.<br/>Copyright &#xa9; 2020 EDIZIONI MINERVA MEDICA.

<40>
Accession Number
2006052512
Title
Peri-procedural novel oral anticoagulants dosing strategy during atrial
fibrillation ablation: A meta-analysis.
Source
PACE - Pacing and Clinical Electrophysiology. 43 (10) (pp 1104-1114),
2020. Date of Publication: 01 Oct 2020.
Author
Mao Y.-J.; Wang H.; Huang P.-F.
Institution
(Mao, Wang, Huang) Department of Pharmacy, First Affiliated Hospital of
Fujian Medical University, Fuzhou, China
Publisher
Blackwell Publishing Inc.
Abstract
Background: This study aimed at determining whether uninterrupted novel
oral anticoagulant (UI-NOAC) would have similar rates of bleeding and
thromboembolic events as minimally interrupted NOAC (MI-NOAC) at the time
of ablation for atrial fibrillation (AF) as relevant studies are scarce.
<br/>Method(s): We searched through the PubMed, EMBASE, and Cochrane
Library databases for prospective observational studies (POSs) or
randomised controlled trials (RCTs) comparing UI-NOAC versus MI-NOAC from
their establishment to January 2020. Odds ratios (ORs) with 95% confidence
intervals (CIs) were calculated to compare the pooled treatment effect.
<br/>Result(s): Nine studies (three POSs and six RCTs) with 2578 patients
were included in the final analysis (55% patients received MI-NOAC). No
significant difference was found regarding the risk of major bleeding (OR
0.92, 95% CI 0.43-2.00, P =.84, I²= 0%). Both groups were
comparable in all subgroups ([Asians: OR 1.00, 95% CI 0.43-2.36, P =.99,
I²= 0%], [non-Asians: OR 0.64, 95% CI 0.11-3.88, P =.63,
I²= 0%], [RCTs: OR 0.85, 95% CI 0.37-1.97, P =.71,
I²= 0%], and [POSs: OR 0.52, 95% CI 0.19-12.01, P =.69,
I²= 0%]). The risk of minor bleeding (P =.88) or stroke (P
=.69) was comparable between the groups. UI-NOAC resulted in a significant
reduction in silent stroke (SS) (OR 0.44, 95% CI 0.23-0.83, P =.01,
I²= 72%). No significant difference was found in SS between
once-daily and twice-daily NOACs (OR 0.91, 95% CI 0.63-1.33, P =.64,
I²= 0%) in the MI-NOAC group. <br/>Conclusion(s): UI-NOAC, as a
peri-procedural anticoagulation strategy for catheter ablation in AF, had
similar safety compared with MI-NOAC, but was advantageous in terms of
SS.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<41>
Accession Number
2007521386
Title
Efficacy and safety of one-month DAPT followed by 23-month ticagrelor
monotherapy in patients undergoing proximal LAD stenting: Insights from
the GLOBAL LEADERS trial.
Source
International Journal of Cardiology. 320 (pp 27-34), 2020. Date of
Publication: 01 Dec 2020.
Author
Takahashi K.; Wang R.; Kawashima H.; Tomaniak M.; Gao C.; Ono M.; Hara H.;
Wykrzykowska J.J.; de Winter R.J.; Werner N.; Teiger E.; Almeida M.;
Barraud P.; Lantelme P.; Barlis P.; Garg S.; Hamm C.; Steg P.G.; Onuma Y.;
Vranckx P.; Windecker S.; Valgimigli M.; Serruys P.W.
Institution
(Takahashi, Kawashima, Ono, Hara, Wykrzykowska, de Winter) Department of
Cardiology, Amsterdam Universities Medical Centers, Location Academic
Medical Center, University of Amsterdam, Amsterdam, Netherlands
(Wang, Gao) Depatment of Cardiology, Radboud University, Nijmegen,
Netherlands
(Tomaniak) Department of Cardiology, Erasmus Medical University Center,
Thorax Centre, Rotterdam, Netherlands
(Werner) Department of Medicine II, Heart Center, University Hospital
Bonn, Bonn, Germany
(Teiger) University Hospital Henri Mondor, Creteil, France
(Almeida) Hospital de Santa Cruz, Lisbon, Portugal
(Barraud) Clinique des Domes, Clermont-Ferrand, France
(Lantelme) Hopital de la Croix-Rousse, Lyon, France
(Barlis) Northern Hospital, Epping, Australia
(Barlis) St. Vincent's Heart Centre, Fitzroy, Australia
(Garg) Royal Blackburn Hospital, Blackburn, United Kingdom
(Hamm) University of Giessen, Kerckhoff Heartand Thorax Center, Bad
Nauheim, Germany
(Steg) FACT (French Alliance for Cardiovascular Trials), Universite
Paris-Diderot, Paris, France
(Onuma, Serruys) Department of Cardiology, National University of Ireland,
Galway (NUIG), Galway, Ireland
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa, Ziekenhuis, Hasselt, Belgium, Faculty of Medicine and Life
Sciences, University of Hasselt, Hasselt, Belgium
(Windecker, Valgimigli) Department of Cardiology, Inselspital, Bern
University Hospital, University of Bern, Bern, Switzerland
Publisher
Elsevier Ireland Ltd
Abstract
Backgrounds: Data on optimal antiplatelet therapy in patients undergoing
stenting of the proximal left anterior descending artery (LAD) are
limited. <br/>Method(s): This is a post-hoc analysis of the GLOBAL LEADERS
trial, a prospective, multi-center, randomized controlled trial, comparing
the experimental strategy (1-month dual anti-platelet therapy [DAPT]
followed by 23-month ticagrelor monotherapy) with the reference regimen
(12-month DAPT followed by 12-month aspirin monotherapy) in relation to
stenting of the proximal LAD. The primary endpoint was the composite of
all-cause death or new Q-wave myocardial infarction (MI) and key secondary
safety endpoint was Bleeding Academic Research Consortium (BARC) type 3 or
5 bleeding at two years. <br/>Result(s): Among 15,845 patients included in
the analysis, 3823 (23.9%) patients underwent stenting of the proximal
LAD, while 12,022 (75.2%) did not. In the proximal LAD stenting group,
there was no significant difference in the risk of the primary endpoint
between the two antiplatelet strategies (3.38% vs. 3.93%; hazard ratio
[HR]:0.86; 95% CI:0.62-1.20; P<inf>interaction</inf> = 0.951). However,
the risk of any MI (2.63% vs. 3.88%; HR:0.68; 95% CI:0.47-0.97;
P<inf>interaction</inf> = 0.015) and any revascularization (7.84% vs.
9.94%; HR:0.78; 95% CI:0.63-0.97; P<inf>interaction</inf> = 0.058) was
significantly lower in the experimental strategy group, while
demonstrating a similar risk of BARC type 3 or 5 bleeding between the two
antiplatelet strategies (1.93% vs. 1.99%; HR:0.98; 95% CI:0.62-1.54;
P<inf>interaction</inf> = 0.981). <br/>Conclusion(s): The present study
showed patients having stenting to the proximal LAD could potentially
benefit from the experimental strategy with lower ischaemic events without
a trade-off in major bleeding at two years.<br/>Copyright &#xa9; 2020
Elsevier B.V.

<42>
Accession Number
2008493607
Title
Intraoperative thermal insulation in off-pump coronary artery bypass
grafting surgery: a prospective, double blind, randomized controlled,
single-center study.
Source
Annals of Translational Medicine. 8 (19) (no pagination), 2020. Article
Number: 21037. Date of Publication: October 2020.
Author
Jin L.; Han X.; Yu Y.; Xu L.; Wang H.; Guo K.
Institution
(Jin, Han, Yu, Xu, Wang, Guo) Department of Anesthesia, Zhongshan
Hospital, Fudan University, Shanghai, China
Publisher
AME Publishing Company
Abstract
Background: About 50% patients who underwent off-pump coronary artery
bypass grafting (OPCAB) experienced perioperative hypothermia. Pre-warming
and intraoperative infusion of amino acid injection are the most popular
perioperative insulation measures in recent years, but neither of them can
completely prevent intraoperative hypothermia. The objective is to
investigate the effect of preoperative warming and/ or intraoperative
infusion of amino acid injection on body temperature in patients
undergoing OPCAB. <br/>Method(s): A prospective, double blind, randomized
controlled, single-center study. Seventy-two patients were randomly
divided into 4 groups: control group, pre-warming group, amino-acid group
and multi-mode group. Pre-warming and multi-mode group were pre-heated
with warming blankets and forced-air warming system before induction.
After that, amino-acid and multi-mode group were infused with 18-amino
acid solution. The perioperative temperature and complications were
monitored. <br/>Result(s): The temperature of control and amino-acid group
decreased significantly, but amino-acid group recovered to preoperative
level faster. The temperature of pre-warming group was stable, and that in
multi-mode group increased at 60 min after the start of surgery. There was
a significant difference in temperature at each time, and no difference in
the incidence of complications between the groups. <br/>Conclusion(s):
Preoperative warming and/or intraoperative infusion of amino acid
injection can effectively reduce hypothermia in OPCAB surgery. Pre-warming
before anesthesia is more effective, and the combination of the two
methods has the best effect.<br/>Copyright &#xa9; Annals of Translational
Medicine. All rights reserved.

<43>
Accession Number
633256425
Title
Angiographic control versus ischaemia-driven management of patients
undergoing percutaneous revascularisation of the unprotected left main
coronary artery with second-generation drug-eluting stents: Rationale and
design of the PULSE trial.
Source
Open Heart. 7 (2) (no pagination), 2020. Article Number: e001253. Date of
Publication: 29 Oct 2020.
Author
De Filippo O.; Bianco M.; Tebaldi M.; Iannaccone M.; Gaido L.; Guiducci
V.; Santarelli A.; Zaccaro L.; Depaoli A.; Vaudano P.; Quadri G.; Gagnor
A.; Boccuzzi G.; Solitro F.; Cortese G.; Guarnaccia C.; Tore D.; Veltri
A.; Franchin L.; Angelini F.; Garbo R.; Giammaria M.; Varbella F.;
Marchisio F.; Fonio P.; De Ferrari G.M.; Cerrato E.; Campo G.; D'Ascenzo
F.
Institution
(De Filippo, Zaccaro, Franchin, Angelini, De Ferrari, D'Ascenzo)
Department of Medical Sciences, Division of Cardiology, Azienda
Ospedaliero Universitaria Citta della Salute e della Scienza di Torino,
Torino, Italy
(Bianco) Division of Cardiology, San Luigi Gonzaga University Hospital,
Orbassano, Italy
(Tebaldi) Cardiovascular Institute, Azienda Ospedaliero Universitaria di
Ferrara, Ferrara, Italy
(Iannaccone, Boccuzzi, Garbo) Department of Cardiology, San Giovanni Bosco
Hospital, Asl Citta di Torino, Turin, Italy
(Gaido, Gagnor, Giammaria) Division of Cardiology, Maria Vittoria
Hospital, Turin, Italy
(Guiducci) Cardiology Unit, Azienda USL-IRCCS Reggio Emilia, S. Maria
Nuova Hospital, Reggio Emilia, Italy
(Santarelli) Division of Cardiology, Department of Cardiovascular
Diseases, Ausl Romagna, Degli Infermi Hospital, Rimini, Italy
(Depaoli, Guarnaccia, Tore, Fonio) University Radiodiagnostic Unit, A.O.U.
Citta della Salute e della Scienza di Torino, Turin, Italy
(Vaudano) Radiology Unit, San Giovanni Bosco Hospital, Turin, Italy
(Quadri, Varbella) Cardiology Unit, Infermi Hospital, Rivoli, Italy
(Solitro) Department of Radiology, San Luigi Gonzaga Hospital, University
of Turin, Orbassano, Italy
(Cortese) Department of Radiology, Maria Vittoria Hospital, Turin, Italy
(Veltri) Radiology Unit, San Luigi Gonzaga University Hospital, Orbassano,
Italy
(Marchisio) Radiology Unit, Infermi Hospital, Rivoli, Italy
(Cerrato) Interventional Cardiology Unit, San Luigi Gonzaga University
Hospital, Orbassano and Rivoli Infermi Hospital, RIvoli, Italy
(Campo) Division of Cardiology, Azienda Ospedaliero-Universitaria di
Ferrara, University of Ferrara, Ferrara, Italy
Publisher
BMJ Publishing Group
Abstract
Background The role of planned angiographic control (PAC) over a
conservative management driven by symptoms and ischaemia following
percutaneous coronary intervention (PCI) of the unprotected left main
(ULM) with second-generation drug-eluting stents remains controversial.
PAC may timely detect intrastent restenosis, but it is still unclear if
this translated into improved prognosis. Methods and analysis PULSE is a
prospective, multicentre, open-label, randomised controlled trial.
Consecutive patients treated with PCI on ULM will be included, and after
the index revascularisation patients will be randomised to PAC strategy
performed with CT coronary after 6 months versus a conservative symptoms
and ischaemia-driven follow-up management. Follow-up will be for at least
18 months from randomisation. Major adverse cardiovascular events at 18
months (a composite endpoint including death, cardiovascular death,
myocardial infarction (MI) (excluding periprocedural MI), unstable angina,
stent thrombosis) will be the primary efficacy outcome. Secondary outcomes
will include any unplanned target lesion revascularisation (TLR) and TLR
driven by PAC. Safety endpoints embrace worsening of renal failure and
bleeding events. A sample size of 550 patients (275 per group) is required
to have a 80% chance of detecting, as significant at the 5% level, a 7.5%
relative reduction in the primary outcome.<br/>Copyright &#xa9; 2020
Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<44>
Accession Number
2004925503
Title
Systematic Review: Treatment for Addictive Disorder in Transplant
Patients.
Source
American Journal on Addictions. 29 (6) (pp 445-462), 2020. Date of
Publication: November 2020.
Author
Luchsinger W.; Zimbrean P.
Institution
(Luchsinger, Zimbrean) Yale University School of Medicine, New Haven, CT,
United States
(Zimbrean) Yale New Haven Hospital, New Haven, CT, United States
Publisher
Wiley Blackwell
Abstract
Background and Objectives: The number of patients with substance use
disorders in need for organ transplantation is expected to increase.
Patients with addictive disorders are considered a higher risk of negative
outcomes after organ transplantation due to the impact of substance use
upon medical status and adherence with treatment. The goal of this
systematic review was to assess the current literature on treatment for
addiction transplant candidates and recipients. <br/>Method(s): We
conducted a literature search within four databases PubMed, MEDLINE,
EMBASE, and PsycINFO for publications dated 1/1/1988 to 12/31/2018.
<br/>Result(s): Out of 3108 articles identified through database
screening, 39 were included in the qualitative synthesis. Sixteen studies
described addiction treatment in groups over five patients. All the
articles included liver transplant patients, with only two studies
including patients who needed a kidney or a heart transplant. Nine
articles described treatment of alcohol use disorder exclusively, five
focused on treatment of opioid use disorders. Although 9 of 16 studies
were prospective, the variability of the treatment intervention, outcome
measures, and control group when applicable prohibited a meaningful
meta-analysis of the results. Eight articles that described the case
reports are analyzed separately. Discussion and <br/>Conclusion(s):
Promising treatment options for alcohol use disorder have been reported
but more studies are needed to confirm their effectiveness and their
feasibility. Methadone appears effective for opioid disorder in transplant
patients. Scientific Significance: To the best of our knowledge, this is
the first systematic review on the treatment of addictive disorders in
transplant patients. (Am J Addict 2020;29:445-462).<br/>Copyright &#xa9;
2020 American Academy of Addiction Psychiatry

<45>
Accession Number
2008451067
Title
Factors influencing physical activity after cardiac surgery: An
integrative review.
Source
Heart and Lung. 50 (1) (pp 136-145), 2021. Date of Publication: 01 Jan
2021.
Author
Lee S.; Collins E.G.
Institution
(Lee, Collins) University of Illinois at Chicago, College of Nursing, 845
S. Damen Ave., Chicago, IL 60612, United States
Publisher
Mosby Inc.
Abstract
Background: Physical activity can optimize patient outcomes after cardiac
surgery, but postoperative patients' physical activity generally has been
inadequate. No review studies have focused on factors influencing cardiac
patients' postoperative physical activity. <br/>Objective(s): To identify
factors influencing physical activity in patients after cardiac surgery.
<br/>Method(s): This study was conducted following Whittemore and Knafl's
methodology. CINAHL, MEDLINE, PsychINFO, Scopus, and Embase were searched
and selected studies were analyzed using the Matrix Method.
<br/>Result(s): In 12 studies, factors facilitating physical activity
included personal, socio-environmental, and intervention-related factors.
Barriers to physical activity included personal, socio-environmental, and
cardiac rehabilitation program-related factors. The most common predictor
of physical activity was male sex, and the most frequent barrier was
comorbidities. <br/>Conclusion(s): This study revealed facilitators and
barriers that significantly influenced physical activity after cardiac
surgery. Healthcare providers and exercise guideline developers should
consider our findings when devising physical activity strategies for
postoperative cardiac patients.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<46>
Accession Number
2007806824
Title
Oxygen Management During Cardiopulmonary Bypass: A Single-Center, 8-Year
Retrospective Cohort Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (1) (pp 100-105),
2021. Date of Publication: January 2021.
Author
Grocott B.B.; Kashani H.H.; Maakamedi H.; Dutta V.; Hiebert B.; Rakar M.;
Grocott H.P.
Institution
(Grocott, Kashani, Dutta, Grocott) Department of Anesthesiology,
Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB,
Canada
(Maakamedi) Department of Anaesthesiology, University of Pretoria, South
Africa, South Africa
(Hiebert, Rakar) Cardiac Sciences Program, Winnipeg Regional Health
Authority, Winnipeg, MB, Canada
Publisher
W.B. Saunders
Abstract
Objective: To characterize the institutional oxygen management practices
during cardiopulmonary bypass (CPB) in patients undergoing cardiac
surgery, including any potential changes during an 8-year study period.
<br/>Design(s): A retrospective cohort study. <br/>Setting(s): A tertiary
care cardiac surgical program. <br/>Participant(s): Patients who underwent
cardiac surgery involving CPB, with or without hypothermic circulatory
arrest (HCA), between January 1, 2010, and December 31, 2017.
<br/>Measurements and Main Results: In addition to baseline patient
characteristics, the authors recorded the partial pressures of arterial
oxygen (PaO<inf>2</inf>), fraction of inspired oxygen, and mixed venous
oxygen saturation during CPB of 696 randomly selected patients during an
8-year study period. The overall mean PaO<inf>2</inf> was 255 +/- 48 mmHg,
without any significant change during the 8-year study period (p = 0.30).
The mean PaO<inf>2</inf> of HCA patients was significantly higher than in
patients without HCA (327 +/- 93 mmHg v 252 +/- 45 mmHg, respectively; p <
0.001). <br/>Conclusion(s): The current approach to oxygen management
during CPB at the authors' institution is within the range of hyperoxemic
levels, and these practices have not changed over time. The impact of
these practices on patients' outcomes is not fully understood, and
additional studies are needed to establish firm evidence to guide optimal
oxygen management practice during CPB.<br/>Copyright &#xa9; 2020 Elsevier
Inc.

<47>
Accession Number
2007794871
Title
The Shaggy Aorta Syndrome: An Updated Review.
Source
Annals of Vascular Surgery. 70 (pp 528-541), 2021. Date of Publication:
January 2021.
Author
Serra R.; Bracale U.M.; Jiritano F.; Ielapi N.; Licastro N.; Provenzano
M.; Andreucci M.; Pingitore A.; de Franciscis S.; Mastroroberto P.;
Serraino G.F.
Institution
(Serra, Ielapi, de Franciscis) Interuniversity Center of Phlebolymphology
(CIFL). International Research and Educational Program in Clinical and
Experimental Biotechnology" at the Department of Medical and Surgical
Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
(Serra, Licastro, de Franciscis) Department of Medical and Surgical
Sciences, University of Catanzaro, Catanzaro, Italy
(Bracale, Licastro) Department of Public Health, University of Naples
"Federico II", Naples, Italy
(Jiritano, Mastroroberto, Serraino) Department of Experimental and
Clinical Medicine, University of Catanzaro, Catanzaro, Italy
(Ielapi) Sapienza" University of Rome, Department of Public Health and
Infectious Disease, Roma, Italy
(Provenzano, Andreucci) Department of Health Sciences, University of
Catanzaro, Catanzaro, Italy
(Pingitore) Department of Radiology, Pugliese-Ciaccio Hospital of
Catanzaro, Catanzaro, Italy
Publisher
Elsevier Inc.
Abstract
Background: Shaggy aorta (SA) depicts the severe aortic surface
degeneration, extremely friable, and likely to cause spontaneous
peripheral and visceral embolization or during catheterization, aortic
manipulation, surgery, or minimally invasive procedures. This study aims
to provide the most accurate and up-to-date information on this disease.
<br/>Method(s): Potentially eligible studies to be included were
identified by searching the following databases: CENTRAL Library,
ClinicalTrials.gov, MEDLINE, and CINAHL, using a combination of subject
headings and text words to identify relevant studies: (Shaggy aorta) OR
(aortic embolization) OR (aortic embolism) OR (aortic thrombus) OR (aortic
plaque). From a total of 29,111 abstracts, and after applying inclusion
and exclusion criteria, we considered 60 studies for inclusion in this
review. <br/>Result(s): Appropriate measurement and assessment of the
aortic wall are pivotal in the modern era, in particular when percutaneous
procedures are performed, as SA has been identified as an independent risk
factor for spinal cord injury, mesenteric embolization, and cerebral
infarction after endovascular aortic repair. Furthermore, SA increases the
rate of cerebral complications during transcatheter aortic valve
implantation. <br/>Conclusion(s): In conclusion, prompt diagnosis of SA
syndrome and appropriate guidelines on the management of these conditions
may help physicians to better assess the patient risk and to minimize the
dreadful-related complications.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<48>
Accession Number
2007316250
Title
Does Tweeting Improve Citations? One-Year Results From the TSSMN
Prospective Randomized Trial.
Source
Annals of Thoracic Surgery. 111 (1) (pp 296-300), 2021. Date of
Publication: January 2021.
Author
Luc J.G.Y.; Archer M.A.; Arora R.C.; Bender E.M.; Blitz A.; Cooke D.T.;
Hlci T.N.; Kidane B.; Ouzounian M.; Varghese T.K.; Antonoff M.B.
Institution
(Luc) Division of Cardiovascular Surgery, Department of Surgery,
University of British Columbia, Vancouver, BC, Canada
(Archer) Division of Thoracic Surgery, Department of Surgery, SUNY-Upstate
Medical University, Syracuse, NY, United States
(Arora) Section of Cardiac Surgery, Department of Surgery, Max Rady
College of Medicine, University of Manitoba, St Boniface Hospital,
Winnipeg, MB, Canada
(Bender) Department of Cardiothoracic Surgery, Stanford University, Palo
Alto, CA, United States
(Blitz) Division of Cardiac Surgery, University of Cincinnati Medical
Center, Cincinnati, OH, United States
(Cooke) Section of General Thoracic Surgery, UC Davis Health, Sacramento,
CA, United States
(Hlci) Department of Cardiothoracic Surgery, Morriston Hospital, ABMU,
Swansea, United Kingdom
(Kidane) Section of Thoracic Surgery, Department of Surgery, University of
Manitoba, Winnipeg, MB, Canada
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, University of Toronto, Toronto, ON, Canada
(Varghese) Division of Cardiothoracic Surgery, Department of Surgery,
University of Utah, Salt Lake City, UT, United States
(Antonoff) Department of Thoracic and Cardiovascular Surgery, MD Anderson
Cancer Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: The Thoracic Surgery Social Media Network (TSSMN) is a
collaborative effort of leading journals in cardiothoracic surgery to
highlight publications via social media. This study aims to evaluate the
1-year results of a prospective randomized social media trial to determine
the effect of tweeting on subsequent citations and nontraditional
bibliometrics. <br/>Method(s): A total of 112 representative original
articles were randomized 1:1 to be tweeted via TSSMN or a control
(non-tweeted) group. Measured endpoints included citations at 1 year
compared with baseline, as well as article-level metrics (Altmetric score)
and Twitter analytics. Independent predictors of citations were identified
through univariable and multivariable regression analyses. <br/>Result(s):
When compared with control articles, tweeted articles achieved
significantly greater increase in Altmetric scores (Tweeted 9.4 +/- 5.8 vs
Non-tweeted 1.0 +/- 1.8, P < .001), Altmetric score percentiles relative
to articles of similar age from each respective journal (Tweeted 76.0 +/-
9.1 percentile vs Non-tweeted 13.8 +/- 22.7 percentile, P < .001), with
greater change in citations at 1 year (Tweeted +3.1 +/- 2.4 vs Non-Tweeted
+0.7 +/- 1.3, P < .001). Multivariable analysis showed that independent
predictors of citations were randomization to tweeting (odds ratio [OR]
9.50; 95% confidence interval [CI] 3.30-27.35, P < .001), Altmetric score
(OR 1.32; 95% CI 1.15-1.50, P < .001), open-access status (OR 1.56; 95% CI
1.21-1.78, P < .001), and exposure to a larger number of Twitter followers
as quantified by impressions (OR 1.30, 95% CI 1.10-1.49, P < .001).
<br/>Conclusion(s): One-year follow-up of this TSSMN prospective
randomized trial importantly demonstrates that tweeting results in
significantly more article citations over time, highlighting the durable
scholarly impact of social media activity.<br/>Copyright &#xa9; 2021 The
Society of Thoracic Surgeons

<49>
Accession Number
2007982278
Title
IL-8 and CRP moderate the effects of preoperative psychological
interventions on postoperative long-term outcomes 6 months after CABG
surgery - The randomized controlled PSY-HEART trial.
Source
Brain, Behavior, and Immunity. 91 (pp 202-211), 2021. Date of Publication:
January 2021.
Author
Salzmann S.; Euteneuer F.; Laferton J.A.C.; Shedden-Mora M.C.; Schedlowski
M.; Moosdorf R.; Rief W.
Institution
(Salzmann, Euteneuer, Laferton, Rief) Department of Clinical Psychology
and Psychotherapy, Philipps University of Marburg, Marburg, Germany
(Euteneuer) Clinical Psychology and Psychotherapy, Medical School Berlin,
Berlin, Germany
(Laferton) Department of Clinical Psychology and Psychotherapy,
Psychologische Hochschule Berlin, Berlin, Germany
(Shedden-Mora) Department of Psychosomatic Medicine and Psychotherapy,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Schedlowski) Institute of Medical Psychology and Behavioral
Immunobiology, University Clinic Essen, Essen, Germany
(Schedlowski) Department of Clinical Neuroscience, Osher Center for
Integrative Medicine, Karolinska Institute, Stockholm 17177, Sweden
(Moosdorf) Department for Cardiovascular Surgery, Heart Center, Philipps
University of Marburg, Marburg, Germany
Publisher
Academic Press Inc.
Abstract
Introduction: Inflammation has been related to several somatic and
psychological disorders and may moderate effects of psychological
interventions. In the PSY-HEART trial patients benefitted from
preoperative psychological interventions before undergoing coronary artery
bypass graft surgery (CABG) and, if necessary, concomitant valvular
surgery, compared to standard medical care. In this study we examined
whether patients' baseline inflammatory status moderated the intervention
effects. <br/>Material(s) and Method(s): In a prospective three-arm
randomized clinical trial with 6-months follow-up, 124 patients scheduled
for CABG surgery alone or concomitant with valvular surgery were
randomized to (i) standard medical care only (SMC) or two preoperative
psychological interventions: (ii) CBT-based optimizing expectations
(EXPECT) and an (iii) an active control group focusing on emotional
support (SUPPORT). Available baseline CRP- (n = 79), IL-6- (n = 78), IL-8-
(n = 78) and TNF-alpha-(n = 80) parameters were considered as potential
moderators (CRP as a categorical and continuous moderator). Linear mixed
model analyses were calculated to test whether baseline inflammatory
levels moderated intervention effects on disability, mental and physical
quality of life at 6 months after surgery. <br/>Result(s): IL-8 moderated
intervention effects on patients' disability and categorical CRP moderated
intervention effects on mental quality of life. Follow-up tests indicated
that EXPECT (and in part SUPPORT) led to lower postoperative disability
and higher mental quality of life compared to SMC in patients with low
baseline inflammatory markers. EXPECT indicated higher mental quality of
life compared to SUPPORT in the high CRP subgroup. Patients in the SMC
group had higher mental quality of life in the high CRP subgroup compared
to the low CRP subgroup. <br/>Conclusion(s): Especially for patients with
a lower inflammatory baseline status preoperative psychological
interventions might be helpful to optimize long-term CABG surgery
outcomes.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<50>
Accession Number
2007377488
Title
Transcatheter Mitral Valve-in-Ring Implantation in the Flexible Adjustable
Attune Annuloplasty Ring.
Source
Cardiovascular Revascularization Medicine. 21 (11 Supplement) (pp 54-59),
2020. Date of Publication: November 2020.
Author
Oestreich B.; Mbai M.; Sievert K.; Schnelle N.; Carpenter L.; Sievert H.;
Soule M.; Kelly R.F.; Sharma A.; Bertog S.
Institution
(Oestreich, Mbai, Soule, Kelly, Sharma, Bertog) University of Minnesota,
Minneapolis, MN, United States
(Mbai, Soule, Kelly, Sharma, Bertog) Minneapolis Veterans Affairs Medical
Center, Minneapolis, MN, United States
(Sievert, Schnelle, Sievert, Bertog) CardioVascular Center Frankfurt,
Frankfurt, Germany
(Carpenter) Abbott, Chicago, IL, United States
Publisher
Elsevier Inc.
Abstract
Transcatheter mitral valve-in-ring implantation (TMViR) poses unique
challenges when compared to valve-in-valve implantation due to the large
variation in the different annuloplasty rings used. Annuloplasty rings are
often classified according to whether they are complete or incomplete,
rigid, semi-rigid, or flexible, and whether their three-dimensional
geometry is saddle-shaped or flat. A limited number of annuloplasty rings
are available which are adjustable allowing the surgeon to increase or
decrease the size of the ring once it has been sutured in place. To our
knowledge there has been no description of TMViR in such adjustable
complete rings and recommendations on THV sizing and implantation are not
available on the Valve-in-Valve application. Here we report a case of
TMViR in an adjustable annuloplasty ring (Attune ring, Abbott, Chicago,
IL, USA) and review the literature on TMViR.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<51>
Accession Number
2005859666
Title
Effects of Protective Controlled Coronary Reperfusion on Left Ventricular
Remodeling in Dogs With Acute Myocardial Infarction: A Pilot Study.
Source
Cardiovascular Revascularization Medicine. 21 (12) (pp 1579-1584), 2020.
Date of Publication: December 2020.
Author
Reshef E.; Sabbah H.N.; Nussinovitch U.
Institution
(Reshef, Nussinovitch) InVatin Technologies, Ltd., Kazrin, Israel
(Sabbah) Department of Medicine, Division of Cardiovascular Medicine,
Henry Ford Hospital, Detroit, MI, United States
(Nussinovitch) Applicative Cardiovascular Research Center (ACRC) and
Department of Cardiology, Meir Medical Center, Kfar Saba, Israel
(Nussinovitch) Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv,
Israel
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery obstruction causes ischemia of cardiac tissue,
leading to acute myocardial infarction (AMI). The treatment of choice for
reducing acute myocardial ischemic injury is early, effective vascular
reperfusion using thrombolytic therapy or primary percutaneous coronary
intervention. However, reperfusion can cause cardiomyocyte injury.
Currently, there is no effective therapy to prevent cardiac
reperfusion-related tissue damage. This study evaluated whether Protective
Controlled Coronary Reperfusion (PCCR), selectively delivered to ischemic
tissue, is associated with decreased myocardial scarring, contractile
deterioration and reperfusion-associated myocardial edema. <br/>Method(s):
Three hours of cardiac ischemia was induced in 10 mongrel dogs, and
followed by either 30-minute PCCR or sham treatment. Cardiac performance
was evaluated 2, 4 and 6 months later. Trichrome staining was used to
distinguish collagen from viable myocardial tissue and to evaluate mean
scar area. <br/>Result(s): One hour following reperfusion, PCCR
significantly attenuated the relative increase (edema) in left ventricular
end diastolic posterior wall thickness compared with sham treatment. At 6
months follow-up, the PCCR group showed a modest corrected increase in
left ventricular ejection fraction (cLVEF) in comparison to the sham group
where it deteriorated (2.3 +/- 10.5% vs. -16.4 +/- 10.3%, respectively, p
= 0.043). Histomorphometric assessments of the hearts showed the PCCR
group had smaller area of scarring, as compared to sham-treated animals
(9.0 +/- 2.4% vs. 14.0 +/- 3.3%, p = 0.047). <br/>Conclusion(s): In this
pilot study, PCCR reduced myocardial edema, modestly increased in cLVEF
and resulted in a smaller scar area. Further studies are needed to fully
ascertain the mechanisms that underlie the potential benefits of PCCR
therapy prior to initiating clinical trials in human subjects with
AMI.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<52>
Accession Number
2006753629
Title
Prosthetic Valve Endocarditis in Patients Undergoing TAVR Compared to
SAVR: A Systematic Review and Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 21 (12) (pp 1567-1572), 2020.
Date of Publication: December 2020.
Author
Ullah W.; Khan M.S.; Gowda S.N.; Alraies M.C.; Fischman D.L.
Institution
(Ullah) Abington Jefferson Health, Abington, United States
(Khan) Mercy Saint Vincent Medical Center, Toledo, OH, United States
(Gowda) University of South Dakota, Sioux Falls, United States
(Alraies) Detroit Medical Center, DMC Heart Hospital, Detroit, MI, United
States
(Fischman) Thomas Jefferson University, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: The risk of prosthetic valve endocarditis (PVE) in patients
who underwent transcatheter aortic valve replacement (TAVR) is presumed to
be high. <br/>Method(s): Electronic databases were searched to identify
articles comparing the rate of PVE in post-TAVR and post-surgical aortic
valve replacement (SAVR) patients. Pooled adjusted odds ratio (OR) was
computed using a random-effects model. <br/>Result(s): A total of 19
studies consisting of 84,288 patients, were identified. There was no
significant difference in the odds of PVE between patients undergoing TAVR
and SAVR, at 30-day (OR 0.62, 95% confidence interval (CI) 0.20-1.92, p =
0.41), 1-year (OR 0.99 95% CI 0.89-1.11, p = 0.84), 2-year (OR 1.02 95% CI
0.68-1.54, p = 0.92) and 5-year (OR 1.03 95% CI 0.80-1.33, p = 0.81). A
subgroup sensitivity analysis also showed no significant inter-group
differences in the rate of PVE at all time points, when stratified by the
study design (clinical trial vs. observational), type of TAVR valves used
(self-expanding bioprosthetic valves vs. balloon expanded bioprosthetic
valves) and surgical risk of patients (high vs. intermediate vs. low).
There was no heterogeneity (I2 = 0%) in the outcomes of the included
studies at 30-day, 1-year and 2-year, while the heterogeneity in studies
at 5-year was minimal (I2 = 22%). <br/>Conclusion(s): In comparison to
SAVR, both short and long-term risk of prosthetic valve endocarditis
appears to be identical in patients undergoing TAVR. This risk is
unaffected by the type of valve, duration of follow-up, study design and
surgical risk of the patients.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<53>
Accession Number
2010066828
Title
The 5% Lidocaine Patch for Decreasing Postoperative Pain and Rescue Opioid
Use in Sternotomy: A Prospective, Randomized, Double-blind Trial.
Source
Clinical Therapeutics. 42 (12) (pp 2311-2320), 2020. Date of Publication:
December 2020.
Author
Nahm F.S.; Han W.K.; Park S.; Han S.; Park K.-H.; Lim C.
Institution
(Park) Division of Intensive Care, Sheikh Khalifa Specialty Hospital, Ras
Al Khaimah, United Arab Emirates
(Nahm, Han, Park, Han) Department of Anesthesiology and Pain Medicine,
Seoul National University Bundang Hospital, Seongnam, South Korea
(Nahm, Han) Department of Anesthesiology and Pain Medicine, Seoul National
University College of Medicine, Seoul, South Korea
(Park, Lim) Department of Thoracic and Cardiovascular Surgery, Seoul
National University College of Medicine, Seoul, South Korea
Publisher
Excerpta Medica Inc.
Abstract
Purpose: Poststernotomy pain (PSP), a primary concern after sternotomy,
can negatively affect patients' satisfaction with surgery and quality of
life. Many clinical trials have been conducted to examine the usefulness
of lidocaine patches (LPs) for postoperative pain control for multiple
types of surgery; however, the results of these trials are inconsistent.
In addition, little is known about the use of LPs after cardiac procedures
that require sternotomy. This prospective, double-blind,
placebo-controlled trial aimed to determine the efficacy of the 5% LP
application at the sternotomy site for reducing PSP and rescue opioid
consumption. <br/>Method(s): The patients were randomly assigned to
receive either the 5% LP or the placebo patch on each side of the incision
site immediately after the surgery. The intensity of pain at 6, 12, 24,
and 48 h after the patch application; the total dose of rescue opioids;
incidence of nausea, vomiting, and sleep disturbance; and use of
antiemetics were compared between the 2 groups. <br/>Finding(s):
Fifty-seven (31 in the LP group and 26 in the placebo group) patients were
included. The pain intensity was significantly lower in the LP group at
each time point (66%-68% pain reduction, P < 0.001, interaction of time x
treatment P = 0.69). In addition, the total dose of rescue opioids used
for 48 h was significantly lower in the L group (27.2% reduction, P =
0.008). No significant differences were found in other outcome variables
between the 2 groups. Implications: The application of a 5% LP on each
side of the sternotomy site can reduce PSP and additional opioid use
without significant adverse effects in patients undergoing sternotomy.
Thus, it can be considered as a standard and routine modality along with
other analgesic medications for the management of PSP. Clinical Trial
Registry in South Korea identifier: KCT0000476.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<54>
Accession Number
633684528
Title
Driveline damage and repair in continuous flow-left ventricular assist
devices: A systematic review.
Source
ASAIO Journal. Conference: 66th Annual Conference of the American Society
for Artificial Internal Organs, ASAIO 2020. United States. 66 (SUPPL 2)
(pp 97), 2020. Date of Publication: June 2020.
Author
D'Antonio N.D.; Prochno K.W.; O'Malley T.J.; Maynes E.J.; Saxena A.D.;
Maltais S.; Samuels L.E.; Morris R.J.; Massey H.T.; Tchantchaleishvili V.
Institution
(D'Antonio, Prochno, O'Malley, Maynes, Saxena, Samuels, Morris, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Maltais) Division of Cardiac Surgery, Centre Hospitalie De l'Universite
De Montreal, Montreal, QC, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Study: With mounting time on continuous-flow left ventricular assist
device (CF-LVAD) support, patients may sustain damage to the device
driveline. Outcomes associated with external and internal driveline damage
remain poorly documented. We sought to combine the existing evidence in a
systematic review. <br/>Method(s): Electronic search was performed to
identify all relevant studies published. 15 studies were selected for
analysis comprising 55 patients who suffered CF-LVAD dysfunction due to
driveline damage. Patient-level data were extracted and pooled for
systematic review. <br/>Result(s): Median patient age was 51 years [IQR
42, 60] and 85.5% (47/55) were male. One patient was supported on
HeartWare HVAD, while the remaining patients (54/55) were supported on
HeartMate II LVAD. Driveline damage was more commonly reported at an
internal location as opposed to an external location [69.1% (38/55) versus
30.9% (17/55), P < .01]. Median time to driveline damage was 1.9 years
[IQR 1.0, 2.5]. The majority of patients presented with some form of
CF-LVAD alarm [94.5% (52/55)]. Initially, 14.5% of patients (8/55)
underwent an external repair of the driveline and 5.5% (3/55) were treated
with rescue tape. 5.5% of patients (3/55) were placed on an ungrounded
cable, indicating a short-to-shield event occurred. Furthermore, 49.1% of
patients (27/55) underwent CF-LVAD exchange, 5.5% (3/55) were weaned off
the CF-LVAD to explantation, and 5.5% (3/55) underwent heart
transplantation. The median length of hospital stay was 12 days [IQR 7,
12]. The 30-day mortality rate was 14.5% (8/55). There was no significant
difference in the 30-day mortality rate between patients who experienced
external versus internal damage [11.8% (2/17) versus 15.8% (6/38), P >
.99]. Driveline damage was more commonly reported at an internal location
as opposed to an external location. Despite being a well-recognized
complication, mortality still appears high.

<55>
Accession Number
633683572
Title
Recruitment in the teammate trial: Observed vs. expected.
Source
World Journal for Pediatric and Congenital Heart Surgery. Conference: 23rd
Annual Update on Pediatric and Congenital Cardiovascular Disease. United
States. 11 (2) (pp NP52-NP53), 2020. Date of Publication: 2020.
Author
Sleeper L.; Daly K.; Addonizio L.; Alejos J.; Auerbach S.; Bock M.; Butto
A.; Carlo W.; Castleberry C.; Dreyer W.; Feingold B.; Lamour J.;
Friedland-Little J.; Hollander S.; Klein G.; Lal A.; Pahl E.; Peng D.;
Rossano J.; Almond C.
Institution
(Sleeper, Daly, Addonizio, Alejos, Auerbach, Bock, Butto, Carlo,
Castleberry, Dreyer, Feingold, Lamour, Friedland-Little, Hollander, Klein,
Lal, Pahl, Peng, Rossano, Almond) Boston Children-s Hospital, Morgan
Stanley Children-s Hospital, Mattel Children-s Hospital
Publisher
SAGE Publications Inc.
Abstract
Background: The TEAMMATE (Tacrolimus/Everolimusvs. Tacrolimus/MMF in
Pediatric Heart Transplant Recipients using the MATE Score) network of
investigators represents the first multicenter effort to address key
scientificquestions in the field of pediatric heart transplant using
arandomized trial design. TEAMMATE has 26 participatingstudy sites in the
United States. Six-month heart transplantsurvivors are randomized in a 1:1
ratio to everolimus/lowdose tacrolimus (EVL/LDTAC) or
tacrolimus/mycophenolate mofetil (TAC/MMF) and are followed for 30
months.Given that pediatric trials present unique challenges with respect
to enrollment, we sought to examine our screeningpatterns, recruitment
performance, and the characteristics ofour resultant randomized cohort.
<br/>Method(s): Patient screening and recruitment began in February2018
and will be completed by spring 2020. The TEAMMATETrial Coordinating
Centers (Clinical: Stanford/Lucile PackardHospital Data: Harvard/Boston
Children-s Hospital) developedseveral tools including a public website
(http://med.stanford.edu/teammate.html) and an informed consent video in
two languages, approved by a central IRB. The target sample size is210
patients. Original design assumptions were 85% eligibilityand 80% consent,
for a yield of 68% of total screened. <br/>Result(s): As of June 11, 2019,
a total of 485 patients werescreened for trial eligibility. Of these, 56%
were potentially eligible and approached for consent. The consent rate was
65% and158 were randomized (33% of total screened). The most commonreasons
(not mutually exclusive) for the 205 screen failures were(a) inability to
return to study site for study visits (n = 50, 24%);(b) prior qualifying
rejection (n = 33, 16%); (c) past reaction tomycophenolate mofetil (n =
31, 15%); (d) history of nonadherence to immunosuppression regimen (n =
31, 15%); and (e)participation in a concurrent pediatric heart transplant
trial (n =18, 9%). The randomized cohort (n = 80 EVL/LDTAC, n = 78TAC/MMF
to date) is age 7.9 +/- 6.2 years (17% infants). Onehalf (47%) had a
cardiomyopathy diagnosis and 46% had congenital heart disease (n = 60
single ventricle and n = 12 twoventricle). Nearly half (49%) are insured
by Medicare/Medicaid/CHIP. One quarter (25%) experienced rejection prior
to trialenrollment (15% grade 1R and 7% grade 2R acute cellular rejection;
1% grade 1 and 2% grades 2-3 antibody-mediatedrejection).
<br/>Conclusion(s): Actual eligibility and informed consent rates forthe
TEAMMATE trial were lower than expected for multiplereasons, but
innovative trial tools and close collaboration haveled to successful
albeit longer duration of recruitment in thismedically complex population.
The randomized cohort willprovide unique information on the safety and
relative efficacyof EVL/LDTAC with respect to long-term complications
ofheart transplant in children.

<56>
Accession Number
633685375
Title
Improvement in health-related quality of life after total ankle
arthroplasty compares well to other successful orthopaedic and
nonorthopaedic procedures.
Source
Foot and Ankle International. Conference: Annual Meeting of the American
Orthopaedic Foot and Ankle Society, AOFAS 2018. United States. 39 (2
SUPPL) (pp 96S-97S), 2018. Date of Publication: 2018.
Author
Lachman J.; Adams S.; Deorio J.; Easley M.
Publisher
SAGE Publications Inc.
Abstract
Introduction/Purpose: End-Stage arthritis is one of the leading causes of
chronic disability in the United States. Improvement in Health-Related
Quality of Life(HRQOL) after total ankle arthroplasty(TAA) has been
demonstrated in the literature. This improvement has not been compared to
that of other common Orthopaedic and non-Orthopaedic procedures including
Anterior Cervical Discectomy and Fusion(ACDF), Total Knee
Arthroplasty(TKA), Coronary Artery Bypass Grafting(CABG), and Orthotopic
Liver Transplant(OLT). Although TAA is noted to be effective in
eliminating symptoms in end-stage arthritis, it is difficult to gauge the
impact of TAA relative to other meaningful procedures that have been shown
to have great impact on HRQOL improvement. The purpose of this study was
to compare changes in HRQOL between TAA and other common procedures with
large impacts on this outcomes measure. <br/>Method(s): Five hundred
consecutive patients with minimum of two-years follow-up after TAA were
prospectively evaluated with the Short Form-36(SF-36) outcome instrument
preoperatively, at six months, one year and two years post-operatively. An
exhaustive literature review was conducted identifying studies with
comparatively sample sizes comparing preoperative and postoperative SF-36
scores after ACDF, TKA, CABG, and OLT. The SF-36 Physical and Mental
component scores were included in each cohort and compared for magnitude
of improvement and significant differences between them. <br/>Result(s):
Patients in all cohorts had preoperative SF-36 mental and physical
function scores significantly lower than the general population scores.
The preoperative physical function scores were lowest in the TKA group
(average 31.1 +/-9.7) followed by TAA group (average 40.6 +/-16.3), ACDF
group (average 41.5 +/-21.6), OLT group (average 51.9 +/-23.6) and CABG
groups (57.8 +/-21.3), respectively. Improvement after surgery was
greatest in the ACDF group (Mental +31.5, Physical +22.9), followed by the
TAA group (Mental +13.9, Physical +26.8), TKA group (Mental +14.3,
Physical +22.4), CABG group (Mental +7.6, Physical +15.4) and OLT group
(Mental-4.47, Physical +9.8), respectively. The greatest improvement in
physical function score occurred in the TAA group (see attached table).
<br/>Conclusion(s): The mental and physical disability associated with
end-stage ankle arthritis is as severe as that associated with many other
Orthopaedic and non-Orthopaedic conditions. The improvement in HRQOL after
TAA is greater than that obtained after TKA, CABG, and OLT but not as
great as the improvement seen after ACDF; however, the improvement in
physical function score was greatest in the TAA cohort. The HRQOL benefits
of TAA are comparable to the benefits achieved after several other
relatively common and successful surgical procedures.

<57>
Accession Number
2010361300
Title
Cardiac veins, an anatomical review.
Source
Translational Research in Anatomy. 23 (no pagination), 2021. Article
Number: 100096. Date of Publication: June 2021.
Author
Kassem M.W.; Lake S.; Roberts W.; Salandy S.; Loukas M.
Institution
(Kassem) Mercy Health Neuroscience Institute, St. Vincent Medical Centre,
Toledo, OH, United States
(Lake, Loukas) Department of Anatomical Sciences, School of Medicine, St.
George's University, West Indies, Grenada
(Roberts) Surgery Department, Grenada General Hospital, West Indies,
Grenada
(Salandy) Pediatrics Department, Bronx-Lebanon Hospital Center, Bronx, NY,
United States
(Loukas) Department of Anatomy, Warmia and Mazury, Olsztyn, Poland
Publisher
Elsevier GmbH
Abstract
Background: The detailed investigations of the coronary arteries
overshadow the anatomy and clinical relevance of the coronary venous tree.
Many recent advances in diagnostic and therapeutic interventional cardiac
procedures now involve manipulations of the coronary veins.
<br/>Purpose(s): The aim of this paper is to provide a review of the
coronary venous tree to assist in enhancing the clinical knowledge on the
anatomy of the coronary veins. <br/>Method(s): A literature search was
conducted using google scholar, and pubmed NCBI data basem in search of
peer-reviewed literature with keyword search including history of cardiac
veins, coronary vein anatomy, and cardiac veins. <br/>Conclusion(s):
Cardiac procedures such as ablations and retrograde cardioplegia depends
on the ability to of the clinician to accurately identify critical cardiac
venous structures from imaging studies and while during procedures. These
advances demand that clinicians have a deeper understanding of the
coronary venous tree as it relates to their anatomy and
variants.<br/>Copyright &#xa9; 2020

<58>
Accession Number
2010329719
Title
Surgical interventions for pediatric unilateral vocal fold paralysis: A
systematic review and meta-analysis.
Source
International Journal of Pediatric Otorhinolaryngology. 141 (no
pagination), 2021. Article Number: 110553. Date of Publication: February
2021.
Author
Aires M.M.; Marinho C.B.; Vasconcelos S.J.D.
Institution
(Aires, Marinho, Vasconcelos) Department of Otolaryngology-Head and Neck
Surgery of Hospital Das Clinicas da Universidade Federal de Pernambuco,
Recife, Pernambuco, Brazil
Publisher
Elsevier Ireland Ltd
Abstract
Objective: To evaluate outcomes of injection laryngoplasty (IL) and
laryngeal reinnervation for the treatment of pediatric Unilateral Vocal
Fold Paralysis (UVFP), especially on swallowing and quality of voice.
<br/>Method(s): A literature review was performed in Medline/PubMed and
Cochrane Library, following PRISMA guidelines, with no constraints on
publication date. We included studies in English, Portuguese or Spanish
about surgical treatment for UVFP on the pediatric population (0-21 years)
that documented outcomes for one of the following techniques: IL or
laryngeal reinnervation. Study characteristics, patient demographics,
technical aspects of each procedure, complications, and outcomes for voice
and swallowing were extracted. A meta-analysis with inverse variance,
random-effects model was performed. <br/>Result(s): The PRISMA approach
yielded 22 studies, totaling 267 patients. Seven reinnervation articles
were included in meta-analysis for maximum phonation time (MPT) and
quality of voice measured by Grade, Roughness, Breathiness, Asthenia and
Strain (GRBAS) scale. Cardiac surgery had caused UVFP in 62.8% (142/226)
of the cases. The main indication for IL was aspiration and for
reinnervation was dysphonia. For IL, there was an improvement of 84.5%
(confidence interval [CI] 82.6-88.4%) in swallowing and 81.4% (CI
74.6-88.1%) in voice. For reinnervation, there was an improvement of 91.6%
(CI 88.2-94.9%) in swallowing and 96.8% (CI 95.5-98.0%) in voice. We found
an increase of 6.19 s (CI 1.00 to 11.38) in MPT and a mean difference in
GRBAS sum of -3.53 points (CI -6.15 to -0.91) after reinnervation.
<br/>Conclusion(s): Retrospective cohort studies suggest that injection
laryngoplasty and reinnervation are both effective in improving swallowing
and voice in children with UVFP. There was clinical evidence of
improvement in the MPT and GRBAS scale meta-analysis in patients
undergoing reinnervation.<br/>Copyright &#xa9; 2020 Elsevier B.V.

<59>
Accession Number
2005605020
Title
The effect of erythropoietin administration on the serum level of ykl-40,
pro-bnp and il-6 in coronary surgery patients.
Source
Iranian Journal of Pharmaceutical Research. 19 (3) (pp 430-439), 2020.
Date of Publication: 2020.
Author
Foroughi M.; Mohammadi Z.; Tehrani M.M.; Bakhtiari M.; Dabbagh A.;
Molahoseini M.H.
Institution
(Foroughi, Mohammadi, Tehrani) Cardiovascular Research Center, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Bakhtiari) Clinical Research and Development Center, Shahid Modarres
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Dabbagh) Anesthesiology Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Molahoseini) Department of Immunology, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Iranian Journal of Pharmaceutical Research
Abstract
Cardiopulmonary bypass and aortic clamping evokes the obligatory global
myocardial ischemia and dysfunction with a significant inflammatory
response. The discrepancy about cardioprotective effects of erythropoietin
still exist. The aim of this study was to assess the clinical
immunomodulatory effects of Erythropoietin (EPO) on serum inflammatory
biomarkers (YKL-40, IL-6) and cardiac biomarkers, (pro-BNP, CK-MB and
troponin). In this randomized double blind clinical trial, 132 patients
admitted for elective coronary surgery with Cardiopulmonary Bypass (CPB)
were randomly assigned in one of three groups: 1-group EPO-A (n = 35)
infusion of 300 IU/Kg EPO after anesthesia induction and before undergoing
CPB; 2-group EPO-CPB (n = 31) the same intervention during CPB; 3-placebo
group (n = 66) saline infusion in the same volume. Cardiac enzymes and
serum biomarkers were measured at intervals. There was a sharp increase in
serum YKL-40 with a 24 h delay after CPB in all groups without significant
difference. The increase in serum IL-6 was significant in EPO-CPB group
compared with both other groups (p = 0.001 and p = 0.001, respectively).
Serum pro-BNP reached maximum level 24 h after operation in all groups; in
group A significantly less than others (p = 0.008). CK-MB increased
significantly in all groups (p < 0.001), less prominently in CPB-A group
(p = 0.03). EPO administration before induced ischemia may be
cardioprotective in terms of cardiac biomarkers in patients undergoing
CABG with CPB.<br/>Copyright &#xa9; 2020, Iranian Journal of
Pharmaceutical Research. All rights reserved.

<60>
Accession Number
2010403664
Title
Assessment of prognostic value of intraoperative oliguria for
postoperative acute kidney injury: a retrospective cohort study.
Source
British Journal of Anaesthesia. (no pagination), 2020. Date of
Publication: 2020.
Author
Zhao B.-C.; Lei S.-H.; Yang X.; Zhang Y.; Qiu S.-D.; Liu W.-F.; Li C.; Liu
K.-X.
Institution
(Zhao, Lei, Yang, Zhang, Qiu, Liu, Li, Liu) Department of Anaesthesiology,
Nanfang Hospital, Southern Medical University, Guangzhou, China
Publisher
Elsevier Ltd
Abstract
Background: Oliguria is often viewed as a sign of renal hypoperfusion and
an indicator for volume expansion during surgery. However, the prognostic
association and the predictive utility of intraoperative oliguria for
postoperative acute kidney injury (AKI) are unclear. <br/>Method(s): We
conducted a retrospective cohort study on patients undergoing major
thoracic surgery in an academic hospital to assess the association of
intraoperative oliguria with postoperative AKI and its predictive value.
To contextualise our findings, we included our results in a meta-analysis
of observational studies on the importance of oliguria during noncardiac
surgery. <br/>Result(s): In our cohort study, 3862 patients were included;
205 (5.3%) developed AKI after surgery. Intraoperative urine output of 0.3
ml kg^-1 h^-1 was the optimal threshold for oliguria
in multivariable analysis. Patients with oliguria had an increased risk of
AKI (adjusted odds ratio: 2.60; 95% confidence interval: 1.24-5.05).
However, intraoperative oliguria had a sensitivity of 5.9%, specificity of
98%, positive likelihood ratio of 2.74, and negative likelihood ratio of
0.96, suggesting poor predictive ability. Moreover, it did not improve
upon the predictive performance of a multivariable model, based on
discrimination and reclassification indices. Our findings were generally
consistent with the results of a systematic review and meta-analysis,
including six additional studies. <br/>Conclusion(s): Intraoperative
oliguria has moderate association with, but poor predictive ability for,
postoperative AKI. It remains of clinical interest as a risk factor
potentially modifiable to interventions.<br/>Copyright &#xa9; 2020 British
Journal of Anaesthesia

<61>
Accession Number
2010392475
Title
Investigating the Effect of Acupressure on the Patients' Anxiety Before
Open-Heart Surgery: A Randomized Clinical Trial.
Source
JAMS Journal of Acupuncture and Meridian Studies. (no pagination), 2020.
Date of Publication: 2020.
Author
Khoram B.; Yoosefinejad A.K.; Rivaz M.; Najafi S.S.
Institution
(Khoram) Student Research Committee, School of Nursing and Midwifery,
Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Yoosefinejad) Physical Therapy Department, School of Rehabilitation
Sciences, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Rivaz, Najafi) Department of Medical Surgical Nursing, School of Nursing
and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran,
Islamic Republic of
Publisher
Korean Pharmacopuncture Institute
Abstract
Background: Anxiety is a common complaint of patients before diagnostic or
therapeutic invasive procedures, especially before open-heart surgery. The
most well-known method to reduce anxiety is the use of sedatives, which
have pronounced side effects. <br/>Objective(s): The purpose of this study
was to determine the effect of acupressure on anxiety in patients
undergoing open-heart surgery. <br/>Method(s): This is a randomized
clinical trial study conducted on 90 patients who were candidates for
open-heart surgery. The patients were randomly assigned into either
intervention or control groups. Acupressure intervention was applied at
three real acupoints over two consecutive days in the intervention group.
The control group received acupressure on sham points. We used Spielberger
State-Trait Anxiety Inventory to assess anxiety in our study.
<br/>Result(s): The results showed that before acupressure, there was no
statistically significant difference between state anxiety scores and
intergroup traits (p-value > 0.05), and this difference was only
significant in state anxiety after the second intervention. State and
trait anxiety were significant before and after the intervention in the
test group (p-value<0.05), but these changes in the control group did not
show a statistically significant difference (p-value > 0.05). After
completing the second phase of the intervention at the actual sites,
systolic blood pressure (p-value = 0.007) and heart rate (p-value = 0.001)
decreased significantly. However, acupressure did not have a significant
effect on diastolic blood pressure in any of the groups (p-value >0.05).
<br/>Conclusion(s): Based on the results of this study, the application of
acupressure in patients who are candidates for open-heart surgery can
reduce their state anxiety.<br/>Copyright &#xa9; 2020

<62>
Accession Number
2010379991
Title
Short-Term Effects of Alfacalcidol on Hospital Length of Stay in Patients
Undergoing Valve Replacement Surgery: A Randomized Clinical Trial.
Source
Clinical Therapeutics. (no pagination), 2020. Date of Publication: 2020.
Author
Naguib S.N.; Sabry N.A.; Farid S.F.; Alansary A.M.
Institution
(Naguib, Sabry, Farid) Department of Clinical Pharmacy, Faculty of
Pharmacy, Cairo University, Cairo, Egypt
(Alansary) Department of Anesthesiology and Critical Care, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
Publisher
Excerpta Medica Inc.
Abstract
Purpose: Vitamin D deficiency is highly prevalent in critically ill
patients, and has been associated with more prolonged length of hospital
stay and poor prognosis. Patients undergoing open-heart surgery are at
higher risk due to the associated life-threatening postoperative
complications. This study investigated the effect of alfacalcidol
treatment on the length of hospital stay in patients undergoing
valve-replacement surgery. <br/>Method(s): This single-center, randomized,
open-label, controlled trial was conducted at El-Demerdash Cardiac Academy
Hospital (Cairo, Egypt), from April 2017 to January 2018. This study
included adult patients undergoing valve-replacement surgery who were
randomized to the intervention group (n = 47; alfacalcidol 2 mug/d started
48 h before surgery and continued throughout the hospital stay) or to the
control group (n = 42). The primary end points were lengths of stay (LOS)
in the intensive care unit (ICU) and in the hospital. Secondary end points
were the prevalence of postoperative hospital-acquired infections, cardiac
complications, and in-hospital mortality. <br/>Finding(s): A total of 86
patients were included in the final analysis, with 51 (59.3%) being
vitamin D deficient on hospital admission. Treatment with alfacalcidol was
associated with a statistically significant decrease in ICU LOS (hazard
ratio = 1.61; 95% CI, 1.77-2.81; P = 0.041) and hospital LOS (hazard ratio
= 1.63; 95% CI, 1.04-2.55; P = 0.034). Treated patients had a
significantly lower postoperative infection rate than did the control
group (35.5% vs 56.1%; P = 0.017). The median epinephrine dose was lower
in the intervention group compared to that in the control group (5.9 vs
8.2 mg; P = 0.019). The rate of in-hospital mortality was not
significantly different between the 2 groups. Implications: Early
treatment with 2 mug of alfacalcidol in patients undergoing
valve-replacement surgery is promising and well tolerated. This effect may
be attributed to its immunomodulatory and cardioprotective mechanisms.
ClinicalTrials.gov identifier: NCT04085770.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<63>
Accession Number
2010331795
Title
Mitral regurgitation following PASCAL mitral valve repair system: A single
arm meta-analysis.
Source
Indian Heart Journal. (no pagination), 2020. Date of Publication: 2020.
Author
Kansara T.; Kumar A.; Majmundar M.; Basman C.
Institution
(Kansara, Majmundar) Department of Internal Medicine, New York Medical
College - Metropolitan Hospital Center, New York, NY, United States
(Kumar) Department of Cardiovascular Research, Cleveland Clinic, Akron,
OH, United States
(Basman) Department of Cardiology, Lenox Hill Hospital, New York, NY,
United States
Publisher
Elsevier B.V.
Abstract
Major consequences of untreated severe mitral regurgitation (MR) includes
heart failure, ventricular remodeling and pulmonary hypertension leading
to significant morbidity and mortality. MitraClip is the most widely used
device for treatment of severe MR. To overcome some of the shortcomings of
MitraClip, novel devices like PASCAL mitral valve repair system are
developed. We performed a single arm meta-analysis for patients with
severe mitral regurgitation (MR) undergoing PASCAL mitral valve repair
system. The results showed that 93.8% patients had reduction in MR grade,
with an average operative time of 88 min and an average increase of 86.33
m in 6-min walk test.<br/>Copyright &#xa9; 2020 Cardiological Society of
India

<64>
Accession Number
2010318801
Title
Surgical Atrial Fibrillation Ablation With and Without Left Atrium
Reduction for Patients Scheduled for Mitral Valve Surgery: A Prospective
Randomised Study.
Source
Heart Lung and Circulation. (no pagination), 2020. Date of Publication:
2020.
Author
Bogachev-Prokophiev A.V.; Ovcharov M.A.; Lavinykov S.O.; Pivkin A.N.;
Sharifulin R.M.; Afanasyev A.V.; Sapegin A.V.; Zheleznev S.I.
Institution
(Bogachev-Prokophiev, Ovcharov, Lavinykov, Pivkin, Sharifulin, Afanasyev,
Sapegin, Zheleznev) Heart Valves Surgery Department, E. Meshalkin National
Medical Research Center, Novosibirsk, Russian Federation
Publisher
Elsevier Ltd
Abstract
Background: The influence of left atrium (LA) enlargement on atrial
arrhythmia recurrence (AAR) after surgical ablation in patients with
mitral valve (MV) disease remains unresolved. <br/>Objective(s): Left
atrial size is critical to the success of concomitant atrial fibrillation
(AF) ablation in patients scheduled for MV surgery. However, a large LA
should not be a limiting factor when evaluating surgical candidates with
AF if they receive appropriate treatment during concomitant ablation. This
randomised study assessed whether adding LA reduction (LAR) to the maze
procedure for MV surgery patients can improve freedom from AAR.
<br/>Method(s): From September 2014 to September 2017, 140 patients were
randomly assigned into two groups. The maze group underwent MV surgery
with concomitant surgical AF ablation (n=70). The maze + LA reduction
group underwent MV surgery with concomitant AF ablation and LA reduction
procedure (n=70). Rhythm outcomes were estimated by Holter monitoring,
according to Heart Rhythm Society guidelines. <br/>Result(s): The
concomitant LA reduction procedure did not increase early mortality and
complications rates. Significant differences in freedom from AAR were
observed at 24 months (maze, 78.4%; maze + LAR group, 92.3%; p=0.025). A
significant difference in LA volume was detected at discharge (p<0.0001);
however, it was not significantly different at 24 months (p=0.182).
<br/>Conclusion(s): Adding LA reduction to the maze procedure led to
improvements in freedom from AAR for patients with AF and LA enlargement
scheduled for MV surgery. A concomitant LA reduction procedure did not
increase mortality and perioperative risk.<br/>Copyright &#xa9; 2020
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<65>
Accession Number
2007629343
Title
A rare case of late-onset ticagrelor-induced sinus arrest.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2020. Date of
Publication: 2020.
Author
Aranganathan P.; Wilson B.; Rangan A.; Boopathi A.; Balasundaram R.
Institution
(Aranganathan, Wilson, Rangan, Boopathi, Balasundaram) Department of
Cardiology, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, India
Publisher
SAGE Publications Inc.
Abstract
Ticagrelor is a potent reversible P2Y12 inhibitor with proven superiority
over clopidogrel. Ticagrelor increases the tissue concentration of
adenosine, thereby leading to bradyarrhythmia. This complication is
reported to occur very early after initiating the drug. A randomized
controlled trial reported that ticagrelor-induced pauses have an early
onset without much clinical impact. However, our patient developed
ticagrelor-induced hemodynamically significant sinus arrest 10 months
after coronary artery stenting, which improved after stopping the drug.
Ticagrelor should be considered as one of the uncommon reasons for
late-onset sinus pause or bradyarrhythmia.<br/>Copyright &#xa9; The
Author(s) 2020.

<66>
Accession Number
2007629295
Title
Pedicled versus skeletonized internal thoracic artery grafts: a randomized
trial.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2020. Date of
Publication: 2020.
Author
Dreifaldt M.; Samano N.; Geijer H.; Liden M.; Bodin L.; Souza D.
Institution
(Dreifaldt, Souza) Department of Cardiovascular and Thoracic Surgery,
School of Medical Sciences, Orebro University, Orebro, Sweden
(Samano) Department of Cardiothoracic and Vascular Surgery, and University
Health Care Research Center, Faculty of Medicine and Health, Orebro
University, Orebro, Sweden
(Geijer, Liden) Department of Radiology, School of Medical Sciences,
Orebro University, Orebro, Sweden
(Bodin) Institute of Environmental Medicine, Unit of Intervention and
Implementation Research, Karolinska Institute, Stockholm, Sweden
Publisher
SAGE Publications Inc.
Abstract
Objective: Concerns have been raised regarding whether skeletonization of
the internal thoracic artery could damage the graft and thereby reduces
its patency. The objective of this study was to compare patency rates at
mid- and long-term follow-up between pedicled and skeletonized left
internal thoracic artery grafts. <br/>Method(s): This randomized
controlled trial included 109 patients undergoing coronary artery bypass
surgery. The patients were assigned to receive either one pedicled or one
skeletonized left internal thoracic artery graft to the left anterior
descending artery. Follow-up was performed at 3 years with conventional
angiography, and at 8 years with computed tomography angiography.
Differences between patency rates were analyzed with Fisher's exact test
and a generalized linear model. <br/>Result(s): The patency rates for
pedicled and skeletonized left internal thoracic artery grafts were 46/48
(95.8%) versus 47/52 (90.4%), p = 0.44 at 3 years, and 40/43 (93.0%)
versus 37/41 (90.2%), p = 0.71 at 8 years, respectively. The difference in
patency rates for pedicled and skeletonized grafts was 5.4% (95%
confidence interval: -4.2-14.5) at 3 years and 2.8% (95% confidence
interval: -9.9-14.1) at 8 years. All failed grafts, except for one with a
localized stenosis, were anastomosed to native coronary arteries with a
stenosis less than 70%. Three patients suffered sternal wound infections
(two in the pedicled group, one in the skeletonized group).
<br/>Conclusion(s): The skeletonization technique can be used without
jeopardizing the patency of the left internal thoracic artery. The most
important factor in graft failure was target artery stenosis below
70%.<br/>Copyright &#xa9; The Author(s) 2020.

<67>
Accession Number
2007627575
Title
Veno-Arterial Extracorporeal Life Support in Heart Transplant and
Ventricle Assist Device Centres. Meta-analysis.
Source
ESC Heart Failure. (no pagination), 2020. Date of Publication: 2020.
Author
Kowalewski M.; Zielinski K.; Gozdek M.; Raffa G.M.; Pilato M.; Alanazi M.;
Gilbers M.; Heuts S.; Natour E.; Bidar E.; Schreurs R.; Delnoij T.;
Driessen R.; Sels J.W.; van de Poll M.; Roekaerts P.; Pasierski M.; Meani
P.; Maessen J.; Suwalski P.; Lorusso R.
Institution
(Kowalewski, Pasierski, Suwalski) Department of Cardiac Surgery, Central
Clinical Hospital of the Ministry of Interior, Centre of Postgraduate
Medical Education, Woloska 137 Str, Warsaw 02-507, Poland
(Kowalewski, Alanazi, Gilbers, Heuts, Natour, Bidar, Schreurs, Maessen,
Lorusso) Cardio-Thoracic Surgery Department, Maastricht University Medical
Centre, Maastricht, Netherlands
(Kowalewski, Gozdek) Thoracic Research Centre, Collegium Medicum, Nicolaus
Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
(Zielinski) Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
(Gozdek) Department of Cardiology and Internal Medicine, Collegium
Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Raffa, Pilato) Department for the Treatment and Study of Cardiothoracic
Diseases and Cardiothoracic Transplantation, ISMETT-IRCCS, Palermo, Italy
(Delnoij, Driessen, Sels, Meani) Cardiology Department, Maastricht
University Medical Centre, Maastricht, Netherlands
(Delnoij, Driessen, Sels, van de Poll, Roekaerts, Meani) Department of
Intensive Care, Maastricht University Medical Centre, Maastricht,
Netherlands
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM), University
of Maastricht, Maastricht, Netherlands
Publisher
Wiley-Blackwell
Abstract
Aims: Because reported mortality on veno-arterial (V-A) extracorporeal
life support (ECLS) substantially varies between centres, the aim of the
current analysis was to assess the outcomes between units performing heart
transplantation and/or implanting ventricular assist device (HTx/VAD) vs.
non-HTx/VAD units in patients undergoing V-A ECLS for cardiogenic shock.
<br/>Methods and Results: Systematic search according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses was performed
using PubMed/MEDLINE databases until 30 November 2019. Articles reporting
in-hospital/30-day mortality and centre's HTx/VAD status were included.
In-hospital outcomes and long-term survival were analysed in subgroup
meta-analysis. A total of 174 studies enrolling n = 13 308 patients were
included with 20 series performed in non-HTx/VAD centres (1016 patients,
7.8%). Majority of patients underwent V-A ECLS for post-cardiotomy shock
(44.2%) and acute myocardial infarction (20.7%). Estimated overall
in-hospital mortality was 57.2% (54.9-59.4%). Mortality rates were higher
in non-HTx/VAD [65.5% (59.8-70.8%)] as compared with HTx/VAD centres
[55.8% (53.3-58.2%)], P < 0.001. Estimated late survival was 61.8%
(55.7-67.9%) without differences between non-HTx/VAD and HTx/VAD centres:
66.5% (30.3-1.02%) vs. 61.7% (55.5-67.8%), respectively (P = 0.797). No
differences were seen with respect to ECLS duration, limb complications,
and reoperations for bleeding, kidney injury, and sepsis. Yet, weaning
rates were higher in HTx/VAD vs. non-HTx/VAD centres: 58.7% (56.2-61.1%)
vs. 48.9% (42.0-55.9%), P = 0.010. Estimated rate of bridge to heart
transplant was 6.6% (5.2-8.3%) with numerical, yet not statistically
significant, difference between non-HTx/VAD [2.7% (0.8-8.3%)] as compared
with HTx/VAD [6.7% (5.3-8.6%)] (P = 0.131). <br/>Conclusion(s): Survival
after V-A ECLS differed according to centre's HTx/VAD status. Potentially
different risk profiles of patients must be taken account for before
definite conclusions are drawn.<br/>Copyright &#xa9; 2020 The Authors. ESC
Heart Failure published by John Wiley & Sons Ltd on behalf of the European
Society of Cardiology.

<68>
Accession Number
2007626899
Title
Patient survival in severe low-flow, low-gradient aortic stenosis after
aortic valve replacement or conservative management.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Micali L.R.; Algargoosh S.; Parise O.; Parise G.; Matteucci F.; de Jong
M.; Ioanna Moula A.; Tetta C.; Gelsomino S.
Institution
(Micali, Algargoosh, Parise, Parise, Matteucci, de Jong, Ioanna Moula,
Tetta, Gelsomino) Department of Cardiothoracic Surgery, Cardiovascular
Research Institute Maastricht University, Maastricht, Netherlands
Publisher
Blackwell Publishing Inc.
Abstract
Background and aim: Classical and paradoxical low-flow, low-gradient
(LFLG) aortic stenosis (AS) are the most challenging subtypes of AS. The
current therapeutic options are aortic valve replacement (AVR) and
conservative management: AVR promotes long-term survival but is invasive,
while conservative management yields a poor prognosis but is noninvasive
since it uses no aortic valve replacement (noAVR). The present
meta-analysis investigated the rate of survival of patients with LFLG AS
undergoing either AVR or noAVR interventions. <br/>Method(s): The
meta-analysis compared the outcomes of AVR with those of noAVR in terms of
patient survival. In both groups, a meta-regression was conducted to
investigate the impact on patient survival of the left ventricular
ejection fraction (LVEF), either preserved (paradoxical LFLG AS) or
reduced (classical LFLG AS). <br/>Result(s): The relative risk of survival
between the AVR and noAVR groups was 1.99 [1.40, 2.82] (p =.0001),
suggesting that survival tends to be better in AVR patients than in noAVR
patients. The meta-regression revealed that a reduced LVEF may be related
to a higher survival in AVR patients when compared to a preserved LVEF (p
=.04). Finally, the analysis indicated that LVEF seems not to be
prognostic of survival in noAVR patients (p =.18). <br/>Conclusion(s):
Patients with LFLG AS have better survival if they undergo AVR. In AVR
patients, reduced LVEF rather than preserved LVEF is related to better
survival, whereas there seems to be no difference in prognostic value
between reduced and preserved LVEF in noAVR patients.<br/>Copyright &#xa9;
2020 The Authors. Journal of Renal Care published by Wiley Periodicals LLC

<69>
Accession Number
625374244
Title
Outcomes of Patients with Significant Obesity Undergoing TAVR or SAVR in
the Randomized PARTNER 2A Trial.
Source
Structural Heart. 2 (6) (pp 500-511), 2018. Date of Publication: 02 Nov
2018.
Author
Chen S.; Redfors B.; Ben-Yehuda O.; Crowley A.; Dvir D.; Hahn R.T.;
Pibarot P.; Jaber W.A.; Webb J.G.; Yoon S.-H.; Makkar R.R.; Alu M.C.;
Thourani V.H.; Tuzcu E.M.; Mack M.J.; George I.; Nazif T.; Kodali S.K.;
Leon M.B.
Institution
(Chen, Redfors, Ben-Yehuda, Crowley, Leon) Cardiovascular Research
Foundation, New York, NY, United States
(Dvir) Division of Cardiology, University of Washington, Seattle, WA,
United States
(Hahn, Alu, George, Nazif, Kodali, Leon) Structural Heart & Valve Center,
Columbia University Irving Medical Center, New York, NY, United States
(Pibarot) Quebec Heart & Lung Institute, Laval University, QC, Canada
(Jaber, Tuzcu) Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH,
United States
(Webb) Centre for Heart Valve Innovation, St. Paul's Hospital, Vancouver,
BC, Canada
(Yoon, Makkar) Department of Medicine, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Thourani) Medstar Heart & Vascular Institute, Washington Hospital Center,
Washington, DC, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Patients with severe aortic stenosis (AS) at intermediate
surgical risk, treated with transcatheter aortic valve replacement (TAVR)
or surgical aortic valve replacement (SAVR) have similar 2-year survival.
Significant obesity (SigOb), defined as body mass index (BMI) >= 35
kg/m², has been associated with increased surgical risk and
post-operative complications. There are no data comparing clinical
outcomes after SAVR versus TAVR in patients with SigOb. <br/>Method(s): In
the PARTNER 2A trial, 2032 patients with severe AS and intermediate
surgical risk were randomized to TAVR with the SAPIEN XT valve or SAVR.
After excluding 32 patients who had very low BMI < 18.5 kg/m²,
the remaining 2000 patients were categorized based on BMI at baseline to
SigOb or not SigOb, and compared in regards to 2-year risk of adverse
cardiovascular events. <br/>Result(s): A total of 250 patients (12.5%)
were SigOb and were younger, more often female, and more frequently
diabetic. The 30-day and 2-year rates of the primary composite endpoint
death and disabling stroke as well as the risks of its components, were
similar for patients with versus without SigOb. However, the 2-year
relative risk of cardiovascular death was lower with TAVR versus SAVR for
SigOb patients (5.7% vs 15.4%, p = 0.02; HR 0.36, 95% CI 0.15-0.88) but
not for not SigOb patients (10.6% vs 10.7%, p = 0.91; HR 0.98, 95% CI
0.73-1.32; p<inf>interaction</inf> = 0.03). These results remained
consistent after multivariable adjustment. <br/>Conclusion(s): In the
PARTNER 2A Trial, intermediate-risk patients with severe AS and BMI >= 35
kg/m² undergoing TAVR experienced significantly lower
cardiovascular mortality than similar patients undergoing
SAVR.<br/>Copyright &#xa9; 2018, &#xa9; 2018 Cardiovascular Research
Foundation.

<70>
Accession Number
623935711
Title
Outcomes after Transcatheter and Surgical Aortic Valve Replacement in
Intermediate Risk Patients with Preoperative Mitral Regurgitation:
Analysis of PARTNER II Randomized Cohort.
Source
Structural Heart. 2 (4) (pp 336-343), 2018. Date of Publication: 04 Jul
2018.
Author
Malaisrie S.C.; Hodson R.W.; McAndrew T.C.; Davidson C.; Swanson J.; Hahn
R.T.; Pibarot P.; Jaber W.A.; Quader N.; Zajarias A.; Svensson L.; George
I.; Trento A.; Thourani V.H.; Szeto W.Y.; Dewey T.; Smith C.R.; Leon M.B.;
Webb J.G.
Institution
(Malaisrie, Davidson) Division of Cardiac Surgery, Northwestern
University, Bluhm Cardiovascular Institute, Chicago, IL, United States
(Hodson, Swanson) Providence Valve Center, Providence St. Vincent Medical
Center, Portland, OR, United States
(McAndrew, Leon) Cardiovascular Research Foundation, New York, NY, United
States
(Hahn, George, Smith, Leon) Columbia University Medical Center, New York,
NY, United States
(Pibarot) Department of Medicine, Laval University, Quebec, QC, Canada
(Jaber, Svensson) Cleveland Clinic, Cleveland, OH, United States
(Quader, Zajarias) Washington University School of Medicine, St. Louis,
MI, United States
(Trento) Cedars Sinai Medical Center, Los Angeles, CA, United States
(Thourani) Medstar Washington Hospital Center, Washington, DC, United
States
(Szeto) University of Pennsylvania, Philadelphia, PA, United States
(Dewey) Medical City Dallas Hospital, Dallas, TX, United States
(Webb) Centre for Heart Valve Innovation, St. Paul's Hospital, Vancouver,
BC, Canada
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Preoperative mitral regurgitation (MR) in patients undergoing
transcatheter (TAVR) and surgical aortic valve replacement (SAVR) has been
studied in high-risk cohorts. This study examines the outcomes of
preoperative MR (>= moderate) in a larger, intermediate-risk cohort.
<br/>Method(s): The Placement of Aortic Transcatheter Valves (PARTNER) 2A
Trial randomized 2032 intermediate-risk patients with severe, symptomatic
aortic stenosis to TAVR or SAVR. An ad-hoc analysis was performed on 1738
patients with baseline MR echocardiographic data. Patients were analyzed
according to the degree of preoperative MR (>= moderate versus <= mild).
<br/>Result(s): At baseline, >= moderate MR was reported in 300 patients
(17%). At 30 days, >= moderate MR had improved in 47% to <= mild.
Thirty-day mortality was higher in SAVR patients with >= moderate MR (8.0
versus 3.5%; p = 0.01), but this difference was not seen in TAVR (2.7 vs.
3.1%; p = 0.78). At 2-years, the combined outcome of death (20.5 vs.
16.3%; p = 0.07), stroke (12.9 vs. 9.0%; p = 0.06), and rehospitalization
(22.0 versus 17.4%; p = 0.06) was higher in the >= moderate MR (40.4 vs.
32.6%; p = 0.009), and similar between SAVR and TAVR (39.8 vs. 41.0%; p =
0.89). <br/>Conclusion(s): Significant MR is prevalent in patients with
severe AS and affects clinical outcomes after both TAVR and SAVR. SAVR
patients with MR have high early risk, but the increased risk of
death/stroke/rehospitalization becomes similar in both groups over time.
Improvement in MR is common, especially in patients with lower ejection
fraction and larger left-ventricular dimensions.<br/>Copyright &#xa9;
2018, &#xa9; 2018 Cardiovascular Research Foundation.

<71>
Accession Number
2006074502
Title
STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage:
Protocol for a randomised controlled trial.
Source
European Stroke Journal. 5 (4) (pp 414-422), 2020. Date of Publication:
December 2020.
Author
Larsen K.T.; Forfang E.; Pennlert J.; Glader E.-L.; Kruuse C.; Wester P.;
Ihle-Hansen H.; Carlsson M.; Berge E.; Al-Shahi Salman R.; Bruun Wyller
T.; Ronning O.M.
Institution
(Larsen, Berge, Bruun Wyller) Department of Geriatric Medicine, Oslo
University Hospital, Oslo, Norway
(Larsen, Forfang, Ihle-Hansen, Bruun Wyller, Ronning) University of Oslo,
Institute of Clinical Medicine, Oslo, Norway
(Pennlert, Glader, Wester) Department of Public Health and Clinical
Medicine, Umea University Hospital, Umea, Sweden
(Kruuse) Herlev Gentofte Hospital and University of Copenhagen, Herlev,
Denmark
(Wester) Department of Clinical Sciences, Karolinska Institute, Danderyds
Hospital, Stockholm, Sweden
(Ihle-Hansen) Department of Neurology, Oslo University Hospital, Oslo,
Norway
(Carlsson) Department of Neurology, Nordland Hospital Trust, Bodo, Norway
(Carlsson) Department of Clinical Medicine, UiT The Arctic University of
Norway, Tromso, Norway
(Al-Shahi Salman) Centre for Clinical Brain Sciences, University of
Edinburgh, Edinburgh, United Kingdom
(Ronning) Department of Neurology, Akershus University Hospital,
Lorenskog, Norway
Publisher
SAGE Publications Ltd
Abstract
Background and aims: Many patients with prior intracerebral haemorrhage
have indications for antithrombotic treatment with antiplatelet or
anticoagulant drugs for prevention of ischaemic events, but it is
uncertain whether such treatment is beneficial after intracerebral
haemorrhage. STudy of Antithrombotic Treatment after IntraCerebral
Haemorrhage will assess (i) the effects of long-term antithrombotic
treatment on the risk of recurrent intracerebral haemorrhage and occlusive
vascular events after intracerebral haemorrhage and (ii) whether imaging
findings, like cerebral microbleeds, modify these effects. <br/>Method(s):
STudy of Antithrombotic Treatment after IntraCerebral Haemorrhage is a
multicentre, randomised controlled, open trial of starting versus avoiding
antithrombotic treatment after non-traumatic intracerebral haemorrhage, in
patients with an indication for antithrombotic treatment. Participants
with vascular disease as an indication for antiplatelet treatment are
randomly allocated to antiplatelet treatment or no antithrombotic
treatment. Participants with atrial fibrillation as an indication for
anticoagulant treatment are randomly allocated to anticoagulant treatment
or no anticoagulant treatment. Cerebral CT or MRI is performed before
randomisation. Duration of follow-up is at least two years. The primary
outcome is recurrent intracerebral haemorrhage. Secondary outcomes include
occlusive vascular events and death. Assessment of clinical outcomes is
performed blinded to treatment allocation. Target recruitment is 500
participants. Trial status: Recruitment to STudy of Antithrombotic
Treatment after IntraCerebral Haemorrhage is on-going. On 30 April 2020,
44 participants had been enrolled in 31 participating hospitals. An
individual patient-data meta-analysis is planned with similar randomised
trials.<br/>Copyright &#xa9; European Stroke Organisation 2020.

<72>
Accession Number
2003388374
Title
Early Emotional, Behavioural and Social Development of Infants and Young
Children with Congenital Heart Disease: A Systematic Review.
Source
Journal of Clinical Psychology in Medical Settings. 27 (4) (pp 686-703),
2020. Date of Publication: 01 Dec 2020.
Author
Clancy T.; Jordan B.; de Weerth C.; Muscara F.
Institution
(Clancy) Department of Pediatrics, University of Melbourne, Melbourne,
Australia
(Jordan, Muscara) Brain and Mind, Murdoch Children's Research Institute,
Melbourne, Australia
(Jordan, Muscara) The Royal Children's Hospital, Melbourne, Australia
(de Weerth) Donders Institute for Brain, Cognition and Behaviour, Radboud
University Medical Center, Nijmegen, Netherlands
Publisher
Springer
Abstract
The experiences of diagnosis of congenital heart disease (CHD), cardiac
surgery and hospitalisation(s) are distressing and represent a significant
stressor for a child and family, which may impact psychosocial
development. This systematic review provides a synthesis of psychosocial
outcomes of infants and young children with congenital heart disease who
had cardiac surgery early in life. Twenty-eight studies related to infant
and young children's psychosocial development, specifically emotional,
social and behavioural functioning were identified. Variability was
related to methodological factors including differences in study design,
varying measurement tools and heterogeneous samples. Despite these
limitations, the majority of studies were of high quality. The most common
finding was a high prevalence of low-severity emotional and behavioural
dysregulation. Young children with severe CHD or comorbid conditions
experienced greater impairment, with higher rates of externalising
behaviour problems, although internalising behaviour problems were also
evident. This review integrates findings from literature in the past 28
years on the psychosocial well-being of infants and young children with
CHD and demonstrates a risk for emotional, social and behavioural
development difficulty, and, importantly, that symptoms of psychosocial
impairment are detectable very early in infancy. We advocate for
assessment and monitoring of emotional and behavioural regulation and
social development to be routinely conducted from infancy to enable
prevention and early intervention.<br/>Copyright &#xa9; 2019, Springer
Science+Business Media, LLC, part of Springer Nature.

<73>
Accession Number
2006792915
Title
A systematic review of guidelines for dual antiplatelet therapy in
coronary artery bypass graft.
Source
European Journal of Clinical Investigation. 51 (1) (no pagination), 2021.
Article Number: e13405. Date of Publication: January 2021.
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
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

<74>
Accession Number
2005576609
Title
Investigation of the safety and feasibility of AAV1/SERCA2a gene transfer
in patients with chronic heart failure supported with a left ventricular
assist device - the SERCA-LVAD TRIAL.
Source
Gene Therapy. 27 (12) (pp 579-590), 2020. Date of Publication: December
2020.
Author
Lyon A.R.; Babalis D.; Morley-Smith A.C.; Hedger M.; Suarez Barrientos A.;
Foldes G.; Couch L.S.; Chowdhury R.A.; Tzortzis K.N.; Peters N.S.;
Rog-Zielinska E.A.; Yang H.-Y.; Welch S.; Bowles C.T.; Rahman Haley S.;
Bell A.R.; Rice A.; Sasikaran T.; Johnson N.A.; Falaschetti E.;
Parameshwar J.; Lewis C.; Tsui S.; Simon A.; Pepper J.; Rudy J.J.; Zsebo
K.M.; Macleod K.T.; Terracciano C.M.; Hajjar R.J.; Banner N.; Harding S.E.
Institution
(Lyon, Morley-Smith, Foldes, Couch, Chowdhury, Tzortzis, Peters,
Rog-Zielinska, Yang, Welch, Simon, Pepper, Macleod, Terracciano, Harding)
National Heart and Lung Institute, Imperial College London, London, United
Kingdom
(Lyon, Morley-Smith, Hedger, Suarez Barrientos, Welch, Bowles, Rahman
Haley, Simon, Pepper, Banner) NIHR Cardiovascular Biomedical Research
Unit, Royal Brompton and Harefield Hospitals NHS Trust, London, United
Kingdom
(Babalis, Sasikaran, Johnson, Falaschetti) Imperial Clinical Trials Unit
(ICTU), School of Public Health, Imperial College London, London, United
Kingdom
(Rog-Zielinska) Institute for Experimental Cardiovascular Medicine,
University Heart Center, Medical Center, University of Freiburg, Freiburg,
Germany
(Bell, Rice) Department of Histopathology, Royal Brompton and Harefield
Hospitals NHS Trust, Freiburg, Germany
(Parameshwar, Lewis, Tsui) Royal Papworth Hospital NHS Trust, Cambridge,
United Kingdom
(Rudy, Zsebo) Celladon Corporation, San Diego, CA, United States
(Hajjar) Phospholamban Foundation, Amsterdam, Netherlands
Publisher
Springer Nature
Abstract
The SERCA-LVAD trial was a phase 2a trial assessing the safety and
feasibility of delivering an adeno-associated vector 1 carrying the
cardiac isoform of the sarcoplasmic reticulum calcium ATPase
(AAV1/SERCA2a) to adult chronic heart failure patients implanted with a
left ventricular assist device. The SERCA-LVAD trial was one of a program
of AAV1/SERCA2a cardiac gene therapy trials including CUPID1, CUPID 2 and
AGENT trials. Enroled subjects were randomised to receive a single
intracoronary infusion of 1 x 10¹³ DNase-resistant AAV1/SERCA2a
particles or a placebo solution in a double-blinded design, stratified by
presence of neutralising antibodies to AAV. Elective endomyocardial biopsy
was performed at 6 months unless the subject had undergone cardiac
transplantation, with myocardial samples assessed for the presence of
exogenous viral DNA from the treatment vector. Safety assessments
including ELISPOT were serially performed. Although designed as a 24
subject trial, recruitment was stopped after five subjects had been
randomised and received infusion due to the neutral result from the CUPID
2 trial. Here we describe the results from the 5 patients at 3 years
follow up, which confirmed that viral DNA was delivered to the failing
human heart in 2 patients receiving gene therapy with vector detectable at
follow up endomyocardial biopsy or cardiac transplantation. Absolute
levels of detectable transgene DNA were low, and no functional benefit was
observed. There were no safety concerns in this small cohort. This trial
identified some of the challenges of performing gene therapy trials in
this LVAD patient cohort which may help guide future trial
design.<br/>Copyright &#xa9; 2020, The Author(s).

<75>
[Use Link to view the full text]
Accession Number
2007624116
Title
Outcomes of cardiac surgery in Jehovah's Witness patients: A review.
Source
Perfusion (United Kingdom). (no pagination), 2020. Date of Publication:
2020.
Author
Chambault A.-L.; Brown L.J.; Mellor S.; Harky A.
Institution
(Chambault, Brown, Mellor) Medical School, College of Medical and Dental
Sciences, University of Birmingham, Birmingham, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Life Sciences,
University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
(Harky) Department of Cardiac Surgery, Alder Hey Children Hospital,
Liverpool, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: To review current literature evidence on outcomes of cardiac
surgery in Jehovah's Witness patients. <br/>Method(s): A comprehensive
electronic literature search was done from 2010 to 20th August 2020
identifying articles that discussed optimisation/outcomes of cardiac
surgery in Jehovah's Witness either as a solo cohort or as comparative to
non-Jehovah's Witnesses. No limit was placed on place of publication and
the evidence has been summarised in a narrative manner within the
manuscript. <br/>Result(s): The outcomes of cardiac surgery in Jehovah's
Witness patients has been described, and also compared, to non-Witness
patients within a number of case reports, case series and comparative
cohort studies. Many of these studies note no significant differences
between outcomes of the two groups for a number of variables, including
mortality. Pre-, intra and post-operative optimisation of the patients by
a multidisciplinary team is important to achieve good outcomes.
<br/>Conclusion(s): The use of a bloodless protocol for Jehovah's
Witnesses does not appear to significantly impact upon clinical outcomes
when compared to non-Witness patients, and it has even been suggested that
a bloodless approach could provide advantages to all patients undergoing
cardiac surgery. Larger cohorts and research across multiple centres into
the long term outcomes of these patients is required.<br/>Copyright &#xa9;
The Author(s) 2020.

<76>
Accession Number
2007616701
Title
Evidence-based indications of platelet-rich plasma therapy.
Source
Expert Review of Hematology. (no pagination), 2020. Date of Publication:
2020.
Author
Gupta S.; Paliczak A.; Delgado D.
Institution
(Gupta) Department of Medicine, Queen's University, Kingston, ON, Canada
(Paliczak) Vita Medical Aesthetics Center, Toronto, ON, Canada
(Delgado) University of Toronto, Toronto, ON, Canada
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Platelet-rich plasma (PRP) is an autologous blood-derived
product that contains platelet concentrations at least 2/3 times above the
normal level and includes platelet-related growth factors. The concept of
PRP began in the 1970s in the field of hematology to treat patients with
thrombocytopenia. In the 1980s and 1990s, PRP began to be used in surgical
procedures such as maxillofacial surgery and plastic surgery. Since then,
PRP had been used in orthopedic procedures, cardiac surgery, sports
injuries, plastic surgery, gynecology, urology, and more recently in
medical esthetics. Areas covered: This review analyzes the mechanisms of
action, current indications, clinical evidence, safety and future
directions of PRP in the management of various medical conditions. The
literature search methodology included using medical subject headings
terms to search in PubMed. Articles used were screened and critically
appraised by the coauthors of this review. Expert Opinion: Platelet-rich
plasma is a therapeutic option used to treat many medical conditions. PRP
could be used alone or in combination with other procedures. The
effectiveness and safety of PRP has been demonstrated in many medical
scenarios, however there is limited availability of large randomized
clinical trials.<br/>Copyright &#xa9; 2020 Informa UK Limited, trading as
Taylor & Francis Group.

<77>
Accession Number
2007612399
Title
American Society of ExtraCorporeal Technology: Development of Standards
and Guidelines for Pediatric and Congenital Perfusion Practice (2019).
Source
World Journal for Pediatric and Congenital Heart Surgery. (no pagination),
2020. Date of Publication: 2020.
Author
Oldeen M.E.; Angona R.E.; Hodge A.; Klein T.
Institution
(Oldeen) Division of Cardiovascular-Thoracic Surgery, Ann Robert H. Lurie
Children's Hospital of Chicago, IL, United States
(Angona) University of Rochester Medical Center, Strong Memorial Hospital,
Rochester, NY, United States
(Hodge) Cardiothoracic Surgery, The Heart Center, Nationwide Children's
Hospital, Columbus, OH, United States
(Klein) Cincinnati Children's Hospital Medical Center, OH, United States
Publisher
SAGE Publications Inc.
Abstract
The development of standards and guidelines by professional societies
offers clinicians guidance toward providing evidence-based care. The
ultimate goals of standards and guidelines are to standardize care and
improve patient safety and outcomes while also minimizing risk. The
American Society of ExtraCorporeal Technology (AmSECT) currently offers
perfusionists several clinical resources, primarily the Standards and
Guidelines for Perfusion Practice; however, no document exists specific to
pediatric perfusion. Historically, the development of a pediatric-specific
document has been limited by available scientific evidence due to smaller
patient populations, sample sizes, and variable techniques among
congenital perfusionists. In the current setting of evolving clinical
practices and increasingly complex cardiac operations, a subcommittee of
pediatric perfusionists developed the Standards and Guidelines for
Pediatric and Congenital Perfusion Practice. The development process
included a comprehensive literature review for supporting evidence to
justify new recommendations or updates to the existing AmSECT Adult
Standards and Guidelines document. Multiple revisions incorporating
feedback from the community led to a finalized document accepted by the
AmSECT membership and made available electronically in May 2019. The
Standards and Guidelines for Pediatric and Congenital Perfusion Practice
is an essential tool for pediatric perfusionists and serves as the
backbone for institutionally based protocols, promotes improved
decision-making, and identifies opportunities for future research and
collaboration with other disciplines. The purpose of this manuscript is to
summarize the process of development, the content, and recommended
utilization of AmSECT's Standards and Guidelines for Pediatric and
Congenital Perfusion Practice.<br/>Copyright &#xa9; The Author(s) 2020.