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<1>
Accession Number
2010440751
Title
Erdheim-Chester Disease With Extensive Pericardial Involvement: A Case
Report and Systematic Review.
Source
Cardiology Research. 11 (2) (pp 118-128), 2020. Date of Publication: 2020.
Author
Sanchez-Nadales A.; Anampa-Guzman A.; Navarro-Motta J.
Institution
(Sanchez-Nadales, Navarro-Motta) Department of Medicine, Advocate Illinois
Masonic Medical Center, Chicago, IL, United States
(Anampa-Guzman) Sociedad Cientifica de San Fernando, Faculty of Medicine,
Universidad Na- cional Mayor de San Marcos, Lima, Peru
(Sanchez-Nadales) Alejandro Sanchez-Nadales, Department of Medicine,
Advocate Illinois Masonic Medical Center, Chicago, IL, United States
Publisher
Elmer Press
Abstract
Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis
characterized by systemic xanthogranulomatous infiltration. We described
the case of a female adult presenting with pericardial effusion.
Pericardial infiltration is the most frequent cardiac manifestation of ECD
and is the one discussed in this article. We found that the majority of
patients with pericardial infiltration needed a cardiovascular procedure.

<2>
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Accession Number
2007636779
Title
Misplacement of transjugular intrahepatic portosystemic shunts: A surgical
challenge for liver transplantation?.
Source
Surgery (United States). 169 (2) (pp 447-454), 2021. Date of Publication:
February 2021.
Author
Addeo P.; Schaaf C.; Faitot F.; Terrone A.; Julliard O.; Besch C.; Serfaty
L.; Bachellier P.
Institution
(Addeo, Schaaf, Faitot, Terrone, Julliard, Bachellier)
Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pole des
Pathologies Digestives, Hepatiques et de la Transplantation, Hopital de
Hautepierre-Hopitaux Universitaires de Strasbourg, Universite de
Strasbourg, France
(Besch, Serfaty) Hepatology Department, Pole des Pathologies Digestives,
Hepatiques et de la Transplantation, Hopital de Hautepierre-Hopitaux
Universitaires de Strasbourg, Universite de Strasbourg, France
Publisher
Mosby Inc.
Abstract
Background: The impact of transjugular intrahepatic portosystemic shunt
misplacement on outcomes of liver transplantation remains controversial.
We systematically reviewed the literature on the outcomes of liver
transplantation with transjugular intrahepatic portosystemic shunt
misplacement. <br/>Method(s): This systematic review was conducted
according to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines. The Cochrane library, PubMed, and Embase were
searched (January 1990-April 2020) for studies reporting patients
undergoing liver transplantation with transjugular intrahepatic
portosystemic shunt misplacement. <br/>Result(s): Thirty-six studies
reporting 181 patients who underwent liver transplantation with
transjugular intrahepatic portosystemic shunt misplacement were
identified. Transjugular intrahepatic portosystemic shunt was misplaced
with a variable degree of extension toward the inferior vena cava/right
heart in 63 patients (34%), the spleno/portal/superior mesenteric venous
confluence in 105 patients (58%), and both in 15 patients (8%).
Transjugular intrahepatic portosystemic shunt thrombosis was also present
in 21 cases (12%). The median interval between transjugular intrahepatic
portosystemic shunt placement and liver transplantation ranged from 1 day
to 6 years. Complete transjugular intrahepatic portosystemic shunt removal
was successfully performed in all but 12 (7%) patients in whom part of the
transjugular intrahepatic portosystemic shunt was left in situ. Cardiac
surgery under cardiopulmonary bypass was necessary to remove transjugular
intrahepatic portosystemic shunt from the right heart in 4 patients (2%),
and a venous graft interposition was necessary for a portal anastomosis in
5 patients (3%). Postoperative mortality (90 days) was 1.1% (2 patients),
and portal vein thrombosis developed postoperatively in 4 patients (2%).
<br/>Conclusion(s): Misplaced transjugular intrahepatic portosystemic
shunt removal is possible in most cases during liver transplantation with
extremely low mortality and good postoperative outcomes. Preoperative
surgical strategy and intraoperative tailored surgical technique reduces
the potential consequences of transjugular intrahepatic portosystemic
shunt misplacement.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<3>
Accession Number
2010480029
Title
The Effects of Volatile Anesthetics on Lung Ischemia-Reperfusion Injury:
Basic to Clinical Studies.
Source
Journal of Surgical Research. 260 (pp 325-344), 2021. Date of Publication:
April 2021.
Author
Oshima Y.; Otsuki A.; Endo R.; Nakasone M.; Harada T.; Takahashi S.;
Inagaki Y.
Institution
(Oshima) Department of Anesthesiology, Yonago Medical Center, Yonago,
Tottori, Japan
(Otsuki, Endo, Nakasone, Harada, Takahashi, Inagaki) Division of
Anesthesiology and Critical Care Medicine, Department of Surgery, Tottori
University Faculty of Medicine, Yonago, Tottori, Japan
Publisher
Academic Press Inc.
Abstract
Case reports from as early as the 1970s have shown that intravenous
injection of even a small dose of volatile anesthetics result in fatal
lung injury. Direct contact between volatile anesthetics and pulmonary
vasculature triggers chemical damage in the vessel walls. A wide variety
of factors are involved in lung ischemia-reperfusion injury (LIRI), such
as pulmonary endothelial cells, alveolar epithelial cells, alveolar
macrophages, neutrophils, mast cells, platelets, proinflammatory
cytokines, and surfactant. With a constellation of factors involved, the
assessment of the protective effect of volatile anesthetics in LIRI is
difficult. Multiple animal studies have reported that with regards to
LIRI, sevoflurane demonstrates an anti-inflammatory effect in
immunocompetent cells and an anti-apoptotic effect on lung tissue.
Scattered studies have dismissed a protective effect of desflurane against
LIRI. While a single-center randomized controlled trial (RCT) found that
volatile anesthetics including desflurane demonstrated a lung-protective
effect in thoracic surgery, a multicenter RCT did not demonstrate a
lung-protective effect of desflurane. LIRI is common in lung
transplantation. One study, although limited due to its small sample size,
found that the use of volatile anesthetics in organ procurement surgery
involving "death by neurologic criteria" donors did not improve lung graft
survival. Future studies on the protective effect of volatile anesthetics
against LIRI must examine not only the mechanism of the protective effect
but also differences in the effects of different types of volatile
anesthetics, their optimal dosage, and the appropriateness of their use in
the event of marked alveolar capillary barrier damage.<br/>Copyright
&#xa9; 2020 The Author(s)

<4>
Accession Number
633570379
Title
What are the endovascular options and outcomes for repair of ascending
aortic or aortic arch pathology?.
Source
Interactive cardiovascular and thoracic surgery. 32 (1) (pp 106-110),
2021. Date of Publication: 01 Jan 2021.
Author
Sharma V.J.; Prakash M.; Lin Z.; Lo C.
Institution
(Sharma, Prakash, Lin, Lo) Department of Cardiothoracic Surgery, Waikato
District Health Board, Hamilton, New Zealand
(Sharma, Prakash, Lin, Lo) Waikato Institute of Surgery Education and
Research (WISER), Hamilton, New Zealand
Publisher
NLM (Medline)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was 'in patients with
ascending aortic or aortic arch disease what are the outcomes with
endovascular repair in terms of survival, complications and
reintervention?' Altogether 585 papers were found using the reported
search, of which 9 represented the best evidence to answer the clinical
question. The authors, journal, date and country of publication, patient
group studied, study type, relevant outcomes and results of these papers
are tabulated. We found that the endovascular operative techniques with
the greatest evidence were ascending aortic chimney grafts (AACs),
branched thoracic endovascular aortic repair (bTEVAR) aortic grafts and
fenestrated TEVAR (fTEVAR) aortic grafts. The best evidence available were
small case-series or retrospective cohort studies (n<100), with 1
systematic review, at a short follow-up period (range 0-5years).
Intraoperatively, these techniques have a high technical success rate
(84-100%). We found rates of endoleak comparable between AAC (7.4-16%) and
bTEVAR/fenestrated TEVAR (11.1-21.4%). Stroke rates are higher in bTEVAR
(3.1-42% vs 1-26% in AACs), attributed to more proximal pathology and
technically challenging procedures. Following the immediate postoperative
period, the 30-day mortality is 0-10.8% and patency is 97-100%. Stroke and
reintervention rates remain higher in the bTEVAR group (3.1-42.0% and
0.5-33.3%) compared to the AAC group (1.0-11.1% and 6.7-16.7%). The 3- and
5-year survival ranges from 59% to 90%, but is driven by non-aortic
pathology in a high-risk population; 3-year freedom from aortic death is
93-97%. Patency is 97-100% at up to 3years, conformation and supra-aortic
occlusions thereafter remain unknown. We conclude that AACs, bTEVARs and
fenestrated TEVARs are safe endovascular options in high-risk elective
patients, with results comparable to open or hybrid repair. They remain
unverified in acute settings or in patients fit for open
intervention.<br/>Copyright &#xa9; The Author(s) 2020. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<5>
Accession Number
633475533
Title
Does metformin improve the efficacy of standard epidermal growth factor
receptor-tyrosine kinase inhibitor treatment for patients with advanced
non-small-cell lung cancer?.
Source
Interactive cardiovascular and thoracic surgery. 32 (1) (pp 73-76), 2021.
Date of Publication: 01 Jan 2021.
Author
Lin Z.; Li G.; Xu X.; Mei J.
Institution
(Lin, Li, Xu, Mei) West China School of Medicine, Sichuan University,
Chengdu, China
(Lin, Mei) Department of Thoracic Surgery, West China Hospital, Sichuan
University, Chengdu, China
(Mei) Sichuan University, Western China Collaborative Innovation Center
for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Chengdu,
China
Publisher
NLM (Medline)
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was whether metformin improved
the efficacy of standard epidermal growth factor receptor-tyrosine kinase
inhibitor (EGFR-TKI) treatment for patients with epidermal growth factor
receptor (EGFR)-mutated advanced non-small-cell lung cancer. A total of 99
papers were found using the reported search, of which 4 represented the
best evidence to answer this clinical question. The authors, journal,
publication date, country, study type, treatment regimen, relevant
outcomes and results of these papers are tabulated. We concluded that the
addition of metformin to EGFR-TKI might improve the survival of patients
with EGFR-mutated non-small-cell lung cancer and diabetes mellitus type 2.
However, for non-diabetic non-small-cell lung cancer patients with EGFR
mutation, the efficiency of additional metformin in EGFR-TKI treatment
remains unclear because of the conflicting results of only 2 available
studies.<br/>Copyright &#xa9; The Author(s) 2020. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<6>
Accession Number
2005675663
Title
Preoperative carbohydrate loading on outcomes after cardiac surgery: A
flawed meta-analysis. comment on: "The effect of preoperative carbohydrate
loading on clinical and biochemical outcomes after cardiac surgery: A
systematic review and meta-analysis of randomized trials". Nutrients 2020,
12, 3105.
Source
Nutrients. 12 (12) (pp 1-3), 2020. Article Number: 3904. Date of
Publication: December 2020.
Author
Lobo D.N.; Joshi G.P.
Institution
(Lobo) Gastrointestinal Surgery, Nottingham Digestive Diseases Centre,
National Institute for Health Research (NIHR) Nottingham Biomedical
Research Centre, Nottingham University Hospitals NHS Trust and University
of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom
(Lobo) MRC Versus Arthritis Centre for Musculoskeletal Ageing Research,
School of Life Sciences, University of Nottingham, Queen's Medical Centre,
Nottingham NG7 2UH, United Kingdom
(Joshi) Department of Anesthesiology and Pain Management, University of
Texas Southwestern Medical Center, Dallas, TX 75390-9068, United States
Publisher
MDPI AG

<7>
Accession Number
2005675662
Title
Reply to: "preoperative carbohydrate loading on outcomes after cardiac
surgery: A flawed meta-analysis. comment on: The effect of preoperative
carbohydrate loading on clinical and biochemical outcomes after cardiac
surgery: A systematic review and meta-analysis of randomized trials.
nutrients 2020, 12, 3904".
Source
Nutrients. 12 (12) (pp 1-3), 2020. Article Number: 3905. Date of
Publication: December 2020.
Author
Kotfis K.; Jamiol-Milc D.; Skonieczna-zydecka K.; Folwarski M.; Stachowska
E.
Institution
(Kotfis) Department of Anesthesiology, Intensive Therapy and Acute
Intoxications, Pomeranian Medical University, Szczecin 70-111, Poland
(Jamiol-Milc, Skonieczna-zydecka, Stachowska) Department of Human
Nutrition and Metabolomics, Pomeranian Medical University in Szczecin,
Szczecin 71-460, Poland
(Folwarski) Department of Clinical Nutrition and Dietetics, Medical
University of Gdansk, Gdansk 80-210, Poland
(Folwarski) Home Enteral and Parenteral Nutrition Unit, General Surgery,
Nicolaus Copernicus Hospital, Gdansk 80-210, Poland
Publisher
MDPI AG

<8>
Accession Number
633774961
Title
Exercise training modalities for heart transplant recipients: A systematic
review and network meta-analysis protocol.
Source
BMJ Open. 10 (12) (no pagination), 2020. Article Number: e044975. Date of
Publication: 29 Dec 2020.
Author
De Lima J.B.; Soares D.D.S.; Ferrari F.; Carvas N.; Carvalho G.; Tobar
Leitao S.A.; Goldraich L.A.; Clausell N.; Stein R.
Institution
(De Lima, Soares, Ferrari, Tobar Leitao, Clausell, Stein) Graduate Program
in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio
Grande do Sul, Hospital das Clinicas de Porto Alegre, Porto Alegre, RS,
Brazil
(De Lima, Ferrari, Carvalho, Stein) Exercise Cardiology Research Group,
Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto
Alegre, Porto Alegre, RS, Brazil
(De Lima, Soares, Ferrari, Tobar Leitao, Goldraich, Clausell, Stein)
Interdisciplinary Research Group in Translational Cardiology, Clinical
Research Center, Hospital das Clinicas de Porto Alegre, Porto Alegre, RS,
Brazil
(Carvas) Department of Evidence-Based Health, Brazilian Cochrane Center,
Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
(Goldraich, Clausell) Heart Failure and Cardiac Transplant Unit,
Cardiology Division, Hospital das Clinicas de Porto Alegre, Porto Alegre,
Rio Grande do Sul, Brazil
(Clausell, Stein) School of Medicine, Universidade Federal do Rio Grande
do Sul, Porto Alegre, RS, Brazil
Publisher
BMJ Publishing Group
Abstract
Introduction Heart transplantation is the gold standard treatment for
selected patients with end-stage heart failure. Although this procedure
can improve quality and prolong life expectancy, several of these patients
persist with decreased exercise tolerance. Evidence suggests that exercise
training can bring multifactorial benefits to heart transplant (HTx)
recipients. However, it is unclear that exercise modality should be
preferred. Therefore, the aim of this systematic review and network
meta-analysis is to compare the efficacy and safety of different training
modalities in HTx recipients. Methods and analysis We will perform a
comprehensive literature search in PubMed/MEDLINE, Embase, The Cochrane
Library, CINAHL, Scopus, SportDISCUS, Web of Science Core Collection and
PEDro from inception until November 2020. Two registries
(ClinicalTrials.gov and REBEC) will also be searched for potential results
in unpublished studies. There will be no restriction on language, date of
publication, publication status or sample size. We will include randomised
controlled trials enrolling adult HTx recipients with the presence of at
least one exercise training group, which might be compared with another
training modality and/or a non-exercise control group for a minimum of 4
weeks of intervention. The primary outcomes will be peak oxygen
consumption and occurrence of adverse events. As secondary outcomes, the
interaction between pulmonary ventilation, pulmonary perfusion and cardiac
output, oxygen uptake efficiency slope, heart rate response, oxygen pulse,
peak blood pressure and peak subjective perception of effort. In addition,
we will evaluate the 6 min walking distance, health-related quality of
life, endothelial function, muscle strength, body fat percentage and lean
mass. Risk of bias will be assessed using the Cochrane RoB V.2.0 tool, and
we plan to use the Confidence in Network Meta-Analysis tool to assess
confidence in the results. All materials (raw data, processed data,
statistical code and outputs) will be shared in a public repository.
Ethics and dissemination Given the nature of this study, no ethical
approval will be required. We believe that the findings of this study may
show which is the most efficacious and safe physical training modality for
HTx recipients. The completed systematic review and network meta-analysis
will be submitted to a peer-reviewed journal. PROSPERO registration number
CRD42020191192.<br/>Copyright &#xa9; 2020 Author(s) (or their
employer(s)).

<9>
Accession Number
633739389
Title
Multimodal prehabilitation as strategy for reduction of postoperative
complications after cardiac surgery: A randomised controlled trial
protocol.
Source
BMJ Open. 10 (12) (no pagination), 2020. Article Number: e039885. Date of
Publication: 22 Dec 2020.
Author
Coca-Martinez M.; Lopez-Hernandez A.; Montane-Muntane M.; Arguis M.J.;
Gimeno-Santos E.; Navarro-Ripoll R.; Perdomo J.; Lopez-Baamonde M.; Rios
J.; Moises J.; Sanz De La Garza M.; Sandoval E.; Romano B.; Sebio R.; Dana
F.; Martinez-Palli G.
Institution
(Coca-Martinez, Lopez-Hernandez, Montane-Muntane, Arguis, Navarro-Ripoll,
Perdomo, Lopez-Baamonde, Martinez-Palli) Anaesthesiology and Intensive
Care, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
(Arguis, Gimeno-Santos, Rios, Martinez-Palli) August Pi i Sunyer
Biomedical Research Institute (IDIBAPS), Barcelona, Catalunya, Spain
(Gimeno-Santos, Sebio, Dana) Prehabilitation Unit, Hospital Clinic de
Barcelona, Barcelona, Catalunya, Spain
(Rios) Biostatistics Unit, Universitat Autonoma de Barcelona, Facultat de
Medicina, Bellaterra, Catalunya, Spain
(Moises) Respiratory Medicine, Hospital Clinic de Barcelona, Barcelona,
Catalunya, Spain
(Sanz De La Garza) Department of Cardiology, Cardiovascular Institute,
Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
(Sandoval) Department of Cardiac Surgery, Cardiovascular Institute,
Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
(Romano) Nutrition and Clinical Dietetics, Hospital Clinic de Barcelona,
Barcelona, Catalunya, Spain
Publisher
BMJ Publishing Group
Abstract
Introduction Prehabilitation programmes that combine exercise training,
nutritional support and emotional reinforcement (multimodal
prehabilitation) have demonstrated efficacy reducing postoperative
complications in the context of abdominal surgery. However, such
programmes have seldom been studied in cardiac surgery, one of the
surgeries associated with higher postoperative morbidity and mortality.
This trial will assess the feasibility and efficacy in terms of reduction
of postoperative complications and cost-effectiveness of a multimodal
prehabilitation programme comparing to the standard of care in cardiac
surgical patients. Methods and analysis This is a single-centre,
randomised, open-label, controlled trial with a 1:1 ratio. Consecutive 160
elective valve replacement and/or coronary revascularisation surgical
patients will be randomised to either standard of care or 4-6 weeks of
multimodal prehabilitation that will consist in (1) two times/week
supervised endurance and strength exercise training sessions, (2)
promotion of physical activity and healthy lifestyle, (3) respiratory
physiotherapy, (4) nutrition counselling and supplementation if needed,
and (5) weekly mindfulness sessions. Baseline, preoperative and 3-month
postoperative data will be collected by an independent blinded evaluator.
The primary outcome of this study will be the incidence of postoperative
complications. Ethics and dissemination This study has been approved by
the Ethics Committee of Clinical investigation of Hospital Clinic de
Barcelona (HCB/2017/0708). The results will be disseminated in a
peer-reviewed journal.<br/>Copyright &#xa9; 2020 Author(s). Published by
BMJ.

<10>
Accession Number
633739322
Title
A key role for comprehensive geriatric assessment in aortic valve
replacement.
Source
BMJ Case Reports. 13 (12) (no pagination), 2020. Article Number: e237031.
Date of Publication: 22 Dec 2020.
Author
El-Shakankery K.H.; Mieiro L.
Institution
(El-Shakankery, Mieiro) Department of Medicine for Elderly People, Whipps
Cross Hospital, Barts Health NHS Trust, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
As our population ages, the demand for surgical services in older people
is increasing exponentially. Shown to be indispensable in the care of
medical patients, use of the comprehensive geriatric assessment (CGA) is
also growing in the perioperative setting. We present the case of a
previously independent 82-year-old man who underwent a standard
preoperative assessment and surgical aortic valve replacement. In the 7
months that followed, prior to his death, he suffered a rapid functional
decline contributed to by slow postoperative recovery, delirium and
recurrent falls. Post-mortem revealed cardiac amyloid deposition and
extensive small vessel disease in the brain. This case highlights the
importance of the CGA in the perioperative management of older patients,
especially in identification and optimisation of geriatric syndromes and
consideration of less-invasive alternative treatments. We review the
existing literature on CGA use in cardiothoracic and vascular surgical
settings, drawing on experiences learnt from the above case.<br/>Copyright
&#xa9; 2020 BMJ Publishing Group Limited. Published by BMJ.

<11>
Accession Number
633342941
Title
Pulmonary function and quality of life after aortic valve replacement
through ministernotomy: a prospective randomized study.
Source
Kardiologia polska. 78 (12) (pp 1278-1280), 2020. Date of Publication: 23
Dec 2020.
Author
Gofus J.; Vobornik M.; Koblizek V.; Smolak P.; Myjavec A.; Vojacek J.;
Pojar M.
Publisher
NLM (Medline)

<12>
Accession Number
633896913
Title
Clinical characteristics of systemic lupus erythematosus with chylothorax
and/or chylous ascites: An analysis of 15 cases in China.
Source
Medicine. 99 (51) (pp e23661), 2020. Date of Publication: 18 Dec 2020.
Author
Zhang G.-H.; Zhang L.-L.; Wang Y.-H.; Shen W.-B.
Institution
(Zhang, Zhang, Wang) Department of Rheumatology
(Shen) Department of Lymph Surgery, Beijing Shijitan Hospital, Capital
Medical University, Beijing, China
Publisher
NLM (Medline)
Abstract
ABSTRACT: This analysis of clinical data from systemic lupus erythematosus
(SLE) patients with chylothorax and/or chylous ascites was conducted to
guide further clinical work.From June 2008 to June 2019, 15 SLE patients
(14 females and 1 male) with chylothorax and/or chylous ascites were
hospitalized at the Beijing Shijitan Hospital. Sixty SLE patients without
chylothorax and chylous ascites were randomly selected as controls.
Patients', clinical data was investigated.The mean age of onset of
chylothorax and/or chylous ascites in patients with SLE was 35.7 +/- 3.7
years (range, 15-69 years). The mean disease duration of chylothorax
and/or chylous ascites in patients with SLE was 13.7 +/- 3.4 months
(range, 1-48 months). Patients with chylothorax and/or chylous ascites
were always diagnosed at later stages of SLE compared with the controls.
Among cases, glomerulonephritis and hematologic system involvement were
the most common complications. Anti-Sjogren's syndrome antigen A antibody
was positive in 7 cases (46.7%). Among cases, direct lymphangiography was
performed in 13 patients, indicating thoracic duct outlet obstruction or a
poor backflow at the terminal of the thoracic duct. Subsequently, 13
patients were treated with corticosteroids, combined with
immunosuppressants in 11 patients and thoracic duct surgery in 6 patients.
Eleven patients were followed up for 0.5 to 7.0 years. One patient died of
infection. Eight patients (53.3%) achieved remission.Chylothorax and/or
chylous ascites are rare complications of SLE. An early diagnosis and
timely initiation of glucocorticoids, immunosuppressants, and surgery are
critical to relieve symptoms and to improve prognosis.<br/>Copyright
&#xa9; 2020 the Author(s). Published by Wolters Kluwer Health, Inc.

<13>
Accession Number
633838884
Title
Magnetic Non-invasive Auricular Acupuncture During Eye-Exam for
Retinopathy of Prematurity in Preterm Infants: A Multicentre Randomized
Controlled Trial.
Source
Frontiers in Pediatrics. 8 (no pagination), 2020. Article Number: 615008.
Date of Publication: 23 Dec 2020.
Author
Gan K.M.L.; Oei J.-L.; Quah-Smith I.; Kamar A.A.; Lordudass A.A.D.; Liem
K.D.; Lindrea K.B.; Daly M.; Gaunker N.; Mangat A.K.; Yaskina M.;
Schmolzer G.M.
Institution
(Gan) Faculty of Medicine, University of New South Wales, Kensington, NSW,
Australia
(Gan, Oei, Quah-Smith) School of Women's and Children's Health, University
of New South Wales, Kensington, NSW, Australia
(Oei, Lindrea, Daly, Gaunker) Department of Newborn Care, The Royal
Hospital for Women, Randwick, NSW, Australia
(Quah-Smith) Roseville Wellness Group, Roseville, NSW, Australia
(Kamar, Lordudass) Neonatology Unit, University of Malaya Medical Centre,
Kuala Lumpur, Malaysia
(Liem) Department of Neonatology, Radboudumc Amalia Children's Hospital,
Nijmegen, Netherlands
(Mangat, Schmolzer) Neonatal Research Unit, Centre for the Studies of
Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, AB, Canada
(Mangat, Schmolzer) Department of Paediatrics, University of Alberta,
Edmonton, AB, Canada
(Yaskina) Women and Children's Health Research Institute (WCHRI),
University of Alberta, Edmonton, AB, Canada
Publisher
Frontiers Media S.A.
Abstract
Background: Eye exam for Retinopathy of prematurity (ROP) is a painful
procedure and pharmacological analgesia might be ineffective. We
hypothesized that magnetic auricular acupuncture (MAA) compared to placebo
will decrease pain during ROP exam in preterm infants. <br/>Method(s):
Multicentre randomized controlled trial conducted in three hospitals
(Australia, Canada, and Malaysia). Eligibility: >32 weeks, ROP exam, not
sedated, and parental consent. A total of 100 infants were randomized
(1:1) to MAA (n = 50) or placebo (n = 50). MAA stickers or placebo were
placed on both ears by an unblinded investigator. Pain was assessed using
the Premature Infant Pain Profile. Primary analyses were by
intention-to-treat. ClinicalTrials.gov:NCT03650621. <br/>Finding(s): The
mean (standard deviation, SD) gestation, birthweight, and postnatal age
were (MAA 28(3) vs. placebo 28(2) weeks; MAA 1,057(455) vs. placebo
952(273) g; MAA 7(3) vs. placebo 7(3) weeks. Placebo infants had
significantly higher PIPP scores during [mean difference 1.6 points (95%CI
0.1-3.1)] and 1 h mean difference 1.5 points (95%CI 0.7-2.2) after the
procedure (p < 0.03). Heart rate was lower (173(22) vs. 184(18)/min) and
oxygen saturations were higher (93.8(6.2) vs. 91.7(6.1)%, p = 0.05) in MAA
infants. No adverse effects. <br/>Interpretation(s): MAA may reduce
physiological pain responses during and after ROP exam in preterm infants.
Assessment of long-term effects are warranted. Clinical trial
registration: www.ClinicalTrials.gov, identifier: NCT03650621.<br/>&#xa9;
Copyright &#xa9; 2020 Gan, Oei, Quah-Smith, Kamar, Lordudass, Liem,
Lindrea, Daly, Gaunker, Mangat, Yaskina and Schmolzer.

<14>
Accession Number
2010586256
Title
Dual Antiplatelet Therapy before Coronary Artery Bypass Grafting; a
Systematic Review andMeta-Analysis.
Source
Archives of Academic Emergency Medicine. 8 (1) (pp 1-15), 2020. Date of
Publication: January 2020.
Author
Sadeghi R.; Babahajian A.; Sarveazad A.; Kachoueian N.; Bahardoust M.
Institution
(Sadeghi) Department of cardiovascular Medicine, School of Medicine,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Sadeghi) Cardiovascular Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Babahajian) Liver and Digestive Research Center, Research Institute for
Health Development, Kurdistan University of Medical Sciences, Sanandaj,
Iran, Islamic Republic of
(Sarveazad, Bahardoust) Colorectal Research Center, Iran University
ofMedical Sciences, Tehran, Iran, Islamic Republic of
(Sarveazad) Nursing Care Research center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Kachoueian) Department of Cardiac Surgery, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Bahardoust) Department of Epidemiology, School of Public Health, Iran
University ofMedical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Shaheed Beheshti University of Medical Sciences and Health Services
Abstract
Introduction: Currently, the basis of acute coronary syndrome (ACS)
therapy is dual antiplatelet therapy (DAPT) with Aspirin as a nonsteroidal
anti-inflammatory drug and clopidogrel as adenosine diphosphate receptor
antagonists. Therefore, the aim of the present systematic review is to
answer that should DAPT with Aspirin and clopidogrel be continued until
coronary artery bypass grafting (CABG) in patients who have ACS?Methods:
The search for relevant studies in the present meta-analysis is based on
three approaches: A) systematic searches in electronic databases, B)
manual searches in Google and Google Scholar, and C) screening of
bibliography of related original and review articles. The endpoints
included mortality rate, myocardial infarction (MI), cerebrovascular
accident (CVA), reoperation, re-exploration, other cardiac events, renal
failure, length of ICU and hospital stay, chest tube drainage and blood
product transfusion after CABG. <br/>Result(s): After the initial
screening, 41 articles were studied in detail, and finally the data of 15
studies were included in the meta-analysis. DAPT before CABG in patients
with ACS does not increase the rate of mortality, CVA, renal failure, MI,
and other cardiac events, but increases reoperation, re-exploration,
length of ICU, and hospital stay. Chest tube drainage and blood product
transfusion rate significantly increased in the DAPT group compared to the
control group (non-antiplatelet or Aspirin alone). Increase in chest tube
drainage and blood product transfusion rate indicates an increase in
bleeding, so increase in reoperation, re-exploration to control bleeding,
and, subsequently, increase in the length of ICU and hospital stay are
expected. <br/>Conclusion(s): DAPT with Aspirin and clopidogrel before
CABG in patients with ACS does not increase the rate of mortality, CVA,
renal failure, MI, and other cardiac events despite more bleedings, and it
may be suggested before CABG for better graft patency.<br/>Copyright
&#xa9; 2020, Archives of Academic Emergency Medicine. All Rights Reserved.

<15>
Accession Number
2010619115
Title
A Risk Score for Adults With Congenital Heart Disease Undergoing Heart
Transplantation.
Source
Annals of Thoracic Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Seese L.; Morell V.O.; Viegas M.; Keebler M.; Hickey G.; Wang Y.; Kilic A.
Institution
(Seese, Wang, Kilic) Division of Cardiac Surgery, University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
(Morell, Viegas) Division of Congenital Heart Surgery, Children's Hospital
of Pittsburgh, Pittsburgh, PA, United States
(Keebler, Hickey) Division of Cardiology, University of Pittsburgh Medical
Center, Pittsburgh, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: This study derived and validated a risk score for 1-year
mortality in patients with adult congenital heart disease (ACHD)
undergoing orthotopic heart transplantation (OHT). <br/>Method(s): The
United Network for Organ Sharing registry identified patients with ACHD
(>=18 years of age) who underwent OHT between 1987 and 2018. The primary
outcome was 1-year mortality. Associated covariates (univariate P < .2)
were entered into a multivariable logistic regression model. Variable
inclusion in the model was assessed by improvement in the McFadden
pseudo-R², likelihood ratio test, and C-index. A risk score was
created using the absolute magnitude of the odds ratios from the
derivation cohort, and its ability to predict 1-year mortality was tested
in the validation cohort. <br/>Result(s): A total of 1388 recipients were
randomly divided into derivation (66.7%, n = 950) and validation (33.3%, n
= 438) cohorts. A 13-point risk score incorporating 4 pretransplant
variables (age, dialysis dependence, serum bilirubin level, and mechanical
ventilation) was created. The predicted 1-year mortality ranged from 14.6%
(0 points) to 49.9% (13 points) (P < .001). In weighted regression
analysis, there was a strong correlation between predicted 1-year
mortality and observed 1-year mortality in the validation cohort (r =
0.85, P < .001). Logistic regression also demonstrated a significant
association (odds ratio, 1.18; 95% confidence interval, 1.1-1.3; P =
.004). The Brier score of the composite score in the validation cohort was
0.14. Kaplan-Meier analysis demonstrated that risk scores of 4 points or
higher portended worse survival at 1-year posttransplant (P < .001).
<br/>Conclusion(s): This 13-point risk score for ACHD is predictive of
mortality within 1 year after OHT and has potential utilization in
improving recipient selection for OHT in adult patients with
CHD.<br/>Copyright &#xa9; 2020

<16>
Accession Number
2010583967
Title
Impact of Myocardial Scar on Prognostic Implication of Secondary Mitral
Regurgitation in Heart Failure.
Source
JACC: Cardiovascular Imaging. (no pagination), 2021. Date of Publication:
2021.
Author
Tayal B.; Debs D.; Nabi F.; Malahfji M.; Little S.H.; Reardon M.; Zoghbi
W.; Kleiman N.; Shah D.J.
Institution
(Tayal, Debs, Nabi, Malahfji, Little, Reardon, Zoghbi, Kleiman, Shah)
Houston Methodist DeBakey Heart and Vascular Center, Division of
Cardiovascular Imaging, Houston, TX, United States
(Tayal) Aalborg University Hospital, Department of Cardiology, Aalborg,
Denmark
Publisher
Elsevier Inc.
Abstract
Objectives: The objective of the present study was to use cardiovascular
magnetic resonance (CMR) to examine the natural history of secondary MR
severity and the implication of left ventricular (LV) scar on its
prognostic significance. <br/>Background(s): There is a need for further
understanding of the prognostic implication of secondary mitral
regurgitation (MR) given the heterogeneous findings of the 2 recent
randomized trials on percutaneous mitral intervention in patients with
secondary MR. <br/>Method(s): Patients with heart failure were enrolled
into a prospective observational registry between 2008 and 2019. Outcomes
were a composite of all-cause death, heart transplantation, or LV assist
device implantation at follow-up. CMR was used to quantify the mitral
regurgitation volume and mitral regurgitation fraction (MRF) along with
scar burden utilizing late gadolinium enhancement. Patients were
categorized into 4 subgroups based on presence and tertiles of scar
extent: no scar, limited scar (scar burden 1% to 4%), intermediate scar
(scar burden 5% to 20%), and extensive scar (scar burden >20%).
<br/>Result(s): Among patients (n = 441) included in the study (age 59 +/-
14 years, 43% with ischemic etiology), 85 (19%) experienced an adverse
event. MRF >=30% was associated with increased risk of events among the
study group (hazard ratio: 1.74; 95% confidence interval: 1.10 to 2.76; p
= 0.02). When stratified by presence or absence of scar, MRF >=30% was
associated with events only among patients with scar (hazard ratio: 1.67;
95% confidence interval: 1.02 to 2.76; p = 0.04) but not among patients
without scar. On further classification of patients with scar, the
prognostic significance of secondary MR was observed primarily among
patients with intermediate scar burden. <br/>Conclusion(s): The natural
history of secondary MR is complex, and outcomes are affected by severity
of MR and vary depending upon the extent of scar. (DeBakey Cardiovascular
Magnetic Resonance Study [DEBAKEY-CMR]; NCT04281823)<br/>Copyright &#xa9;
2020 American College of Cardiology Foundation

<17>
Accession Number
2010583880
Title
Paravalvular Regurgitation According to Transcatheter Aortic Valve
Prosthesis Type: Insights From the Randomized SOLVE-TAVI Trial.
Source
JACC: Cardiovascular Imaging. (no pagination), 2021. Date of Publication:
2021.
Author
Stachel G.; Abdel-Wahab M.; de Waha-Thiele S.; Desch S.; Feistritzer
H.-J.; Kitamura M.; Eitel I.; Kurz T.; Thiele H.
Publisher
Elsevier Inc.

<18>
Accession Number
633895095
Title
Driveline Damage and Repair in Continuous-Flow Left Ventricular Assist
Devices: A Systematic Review.
Source
Artificial organs. (no pagination), 2020. Date of Publication: 29 Dec
2020.
Author
D'Antonio N.D.; Maynes E.J.; Tatum R.T.; Prochno K.W.; Saxena A.; Maltais
S.; Samuels L.E.; Morris R.J.; Massey H.T.; Tchantchaleishvili V.
Institution
(D'Antonio, Maynes, Tatum, Prochno, 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, QC, Montreal, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: With mounting time on continuous-flow left ventricular assist
device (CF-LVAD) support, patients occasionally sustain damage to the
device driveline. Outcomes associated with external and internal driveline
damage and repair are currently not well documented. We sought to evaluate
outcomes of driveline damage and its repair. <br/>METHOD(S): Electronic
search was performed to identify all relevant studies published over the
past 20 years. 15 studies were selected for analysis comprising 55
patients with CF-LVAD dysfunction due to driveline damage. Demographic and
perioperative variables along with outcomes including survival rates were
extracted and pooled for systematic review. <br/>RESULT(S): Most patients
(53/55) were supported on HeartMate II LVAD (Abbott Laboratories, Abbott
Park, IL). Internal damage was more commonly reported than external damage
[69.1% (38/55) versus 30.9% (17/55), P=0.01]. Median time to driveline
damage was 1.9 years [IQR 1.0, 2.5]. Most patients presented with a
CF-LVAD alarm [94.5% (52/55)] and patients with internal driveline damage
had a significantly higher rate of alarm activation compared to that
observed for those with external damage [38/38 (100%) versus 14/17
(82.4%), P=0.04]. Patients with internal driveline dysfunction were more
likely to experience component wear compared to those with external
driveline dysfunction [10/38 (26.3%) versus 0/17 (0%), P=0.05]; 14.5% of
patients (8/55) underwent external repair of the driveline, 5.5% (3/55)
were treated with rescue tape, and 5.5% (3/55) were placed on an
ungrounded cable, indicating a short-to-shield event had occurred. 49.1%
of patients (27/55) underwent CF-LVAD exchange, 5.5% (3/55) were weaned
off the CF-LVAD to explant, and 5.5% (3/55) underwent emergent heart
transplantation. The median length of hospital stay was 12 days [IQR 7,
12] and 30-day mortality rate was 14.5% (8/55). <br/>CONCLUSION(S):
Driveline damage was more commonly reported at an internal location and
despite being a well-recognized complication, mortality still appears
high.<br/>Copyright This article is protected by copyright. All rights
reserved.

<19>
Accession Number
633892342
Title
Higher Mortality in Women after Coronary Artery Bypass: Meta-analysis &
Bias Analysis of Confounding.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 26 Dec 2020.
Author
Shi D.; Zhang B.; Motamed M.; Lee S.; Wang P.; McLaren C.; Petsikas D.;
Brogly S.
Institution
(Shi, Motamed, Wang, McLaren) Queen's University, K7L 3N6. School of
Medicine, 99 University Avenue
(Zhang) McMaster University, L8S 4L8. School of Medicine, 1280 Main Street
West
(Lee) McMaster University, L8S 4L8. Faculty of Health Sciences, 1280 Main
Street West
(Petsikas, Brogly) Queen's University, K7L 3N6. Department of Surgery, 99
University Avenue
Publisher
NLM (Medline)
Abstract
BACKGROUND: Some studies suggest the observed higher mortality in women
than men after coronary artery bypass grafting (CABG) is due to
confounding. Our meta-analysis aimed to 1) summarize the effect of sex on
mortality following CABG and 2) identify whether unmeasured confounding
likely explains the apparent higher mortality in women. <br/>METHOD(S):
MEDLINE, Embase, and CENTRAL databases were searched for studies examining
sex and 30-day mortality following CABG. We used random-effects
meta-analysis to estimate the summary odds ratio (OR) of mortality in
women versus men using 1) unadjusted study results and 2) adjusted study
results. Available confounders data from included studies was identified.
Using the OR of measured confounders and the risk of death to inform
unmeasured confounding effects, we performed bias analysis simulation to
correct potential unmeasured confounding in our summary OR.
<br/>RESULT(S): From 7138 retrieved studies, 112 were included
(N=5,008,262 patients), 25 studies reported adjusted OR (N=770,450
patients). The overall 30-day mortality was 4.9% in women vs. 3.3% in men.
The unadjusted summary OR (1.81, 95% CI 1.72 to 1.91) and adjusted summary
OR (1.40, 95% CI 1.35 to 1.45) demonstrated that women had an increased
risk of 30-day mortality compared to men. Simulations correcting for
unmeasured confounding that mostly ranged from 1.05 to 1.80, supporting a
higher risk of death in women after CABG. <br/>CONCLUSION(S): The findings
of this review suggest confounding is unlikely to account for the
increased risk of mortality in women after CABG and that biological
factors have a casual effect.<br/>Copyright &#xa9; 2020. Published by
Elsevier Inc.

<20>
Accession Number
633887632
Title
A Mortality Risk Score for Septuagenarians undergoing Orthotopic Heart
Transplantation.
Source
Clinical transplantation. (pp e14202), 2020. Date of Publication: 24 Dec
2020.
Author
Diaz-Castrillon C.E.; Seese L.; Hong Y.; Dufendach K.; Hickey G.; Sultan
I.; Kilic A.
Institution
(Diaz-Castrillon, Seese, Hong, Dufendach, Sultan, Kilic) Department of
Cardiothoracic Surgery, Division of Cardiac Surgery, United States
(Hickey) Division of Cardiology, United States
(Hickey, Sultan, Kilic) eart and Vascular Institute, University of
Pittsburgh Medical Center, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: With septuagenarians undergoing orthotopic heart
transplantation (OHT) more frequently, we aimed to develop a risk score
for 1-year mortality in this population. <br/>METHOD(S): Septuagenarian
OHT recipients were identified from the UNOS registry between 1987 and
2018. The primary outcome was 1-year post-OHT mortality. Patients were
randomly divided into derivation and validation cohorts. Associated
covariates were entered into a multivariable logistic regression model. A
risk score was created using the magnitudes of the odds ratios from the
derivation cohort, and its 1-year post-OHT mortality prediction capacity
was tested in the validation cohort. <br/>RESULT(S): A total of 1,156
septuagenarians were included, and they were randomly divided into
derivation (66.7%, n=771) and validation (33.3%, n=385) cohorts. An
11-point risk score incorporating 4 variables was created, which included
mechanical ventilation, serum bilirubin, serum creatinine, and donor age.
The predicted 1-year mortality ranged from 4.2% (0 points) to 48.1%
(11-points) (p<0.001). After cross-validation, the c-index was 0.67 with a
Brier score of 0.10. Risk scores above 3 points portended a survival
disadvantage at 1-year follow-up (p<0.001). <br/>CONCLUSION(S): This
11-point risk score for septuagenarians is predictive of mortality within
1-year of OHT and has potential utilization in improving recipient
evaluation and selection of elderly patients.<br/>Copyright This article
is protected by copyright. All rights reserved.

<21>
Accession Number
2010439088
Title
A systematic review of the infectious complications of colchicine and the
use of colchicine to treat infections.
Source
Seminars in Arthritis and Rheumatism. 51 (1) (pp 101-112), 2021. Date of
Publication: February 2021.
Author
McEwan T.; Robinson P.C.
Institution
(McEwan, Robinson) University of Queensland School of Clinical Medicine,
Queensland, Australia
Publisher
W.B. Saunders
Abstract
Objective: Colchicine has been used historically as an anti-inflammatory
agent for a wide range of diseases. Little is known regarding the
relationship between colchicine use and infectious disease outcomes. The
objective of this study was to systematically examine infectious adverse
events associated with colchicine usage and the clinical use of colchicine
for infectious diseases. <br/>Method(s): A systematic review was conducted
in accordance with PRISMA methodology. PubMed, EMBASE, Scopus and Cochrane
Library databases were searched (up to 12^th October, 2020) for
interventional and observational studies that included colchicine usage
associated with infectious adverse events or infectious disease outcomes.
<br/>Result(s): A total of 9,237 studies were initially identified and
after exclusions, 36 articles comprising 21 interventional studies and 15
observational studies were included in this systematic review. There were
19 studies that reported infectious adverse events and 17 studies that
examined the efficacy of colchicine in treating infectious disease. Only
two out of six studies reported a significant benefit using colchicine in
the management of viral liver disease. There was some evidence colchicine
is beneficial in managing COVID-19 by reducing time to deterioration,
length of stay in hospital and mortality. Colchicine had some benefit in
managing malaria, condyloma accuminata and verruca vulgaris, viral
myocarditis and erythema nodosum leprosum based on case-series or small,
pilot clinical studies. Two of the clinical trials and five of the
observational studies reported significant associations between infections
adverse events and colchicine usage. Risk of pneumonia was found in three
studies and post-operative infections were reported in two studies. Risks
of urinary tract infections, H. pylori and C.difficile were only reported
by one study each. <br/>Conclusion(s): There is a current lack of clinical
evidence that colchicine has a role in treating or managing infectious
diseases. Preliminary studies have demonstrated a possible role in the
management of COVID-19 but results from more clinical trials are needed.
There is inconclusive evidence that suggests colchicine is associated with
increased risk of infections, particularly pneumonia.<br/>Copyright &#xa9;
2020 Elsevier Inc.

<22>
[Use Link to view the full text]
Accession Number
2010317997
Title
Pediatric/Congenital Cardiac Catheterization Quality: An Analysis of
Existing Metrics.
Source
JACC: Cardiovascular Interventions. 13 (24) (pp 2853-2864), 2020. Date of
Publication: 28 Dec 2020.
Author
O'Byrne M.L.; Huang J.; Asztalos I.; Smith C.L.; Dori Y.; Gillespie M.J.;
Rome J.J.; Glatz A.C.
Institution
(O'Byrne, Huang, Asztalos, Smith, Dori, Gillespie, Rome, Glatz) Division
of Cardiology, The Children's Hospital of Philadelphia, Department of
Pediatrics, Perelman School of Medicine at the University of Pennsylvania,
Philadelphia, PA, United States
(O'Byrne, Glatz) Center for Pediatric Clinical Effectiveness, The
Children's Hospital of Philadelphia, Department of Pediatrics, Perelman
School of Medicine at the University of Pennsylvania, Philadelphia, PA,
United States
(O'Byrne) Leonard Davis Institute, Perelman School of Medicine at the
University of Pennsylvania, Philadelphia, PA, United States
(O'Byrne) Center for Cardiovascular Outcomes, Quality, and Evaluative
Research, Perelman School of Medicine at the University of Pennsylvania,
Philadelphia, PA, United States
(Huang) Department of Biostatistics Center for Clinical Epidemiology and
Biostatistics, Perelman School of Medicine at the University of
Pennsylvania Philadelphia, PA, United States
(Huang) Department of Biomedical and Health Informatics, Data Science and
Biostatistics Unit, The Children's Hospital of Philadelphia, Philadelphia,
PA, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to enumerate and categorize quality
metrics relevant to the pediatric/congenital cardiac catheterization
laboratory (PCCL). <br/>Background(s): Diagnostic and interventional
catheterization procedures are an increasingly important part of the care
of young patients with cardiac disease. Measurement of the performance of
PCCL programs in a stringent and consistent fashion is a crucial step
toward improving outcomes. To the best of our knowledge, a systematic
evaluation of current quality metrics in PCCL has not been performed
previously. <br/>Method(s): Potential metrics were evaluated by: 1) a
systematic review of peer-reviewed research; 2) a review of metrics from
organizations interested in quality improvement, patient safety, and/or
PCCL programs; and 3) a survey of U.S. PCCL cardiologists. Collected
metrics were grouped on 2 dimensions: 1) Institute of Medicine domains;
and 2) the Donabedian structure/process/outcome framework. Survey
responses were dichotomized between favorable and unfavorable responses
and then compared within and between categories. <br/>Result(s): In the
systematic review, 6 metrics were identified (from 9 publications), all
focused on safety either as an outcome (adverse events [AEs], mortality,
and failure to rescue along with radiation exposure) or as a structure
(procedure volume or operator experience). Four organizations measure
quality metrics of PCCL programs, of which only 1 publicly reports data.
For the survey, 229 cardiologists from 118 hospital programs responded
(66% of individuals and 72% of hospital programs). The highest favorable
ratings were for safety metrics (p < 0.001), of which major AEs, failure
to rescue, and procedure-specific AEs had the highest ratings. Of
respondents, 67% stated that current risk adjustment were not effective.
Favorability ratings for hospital characteristics, PCCL characteristics,
and quality improvement processes were significantly lower than for safety
and less consistent within categories. <br/>Conclusion(s): There is a
limited number of PCCL quality metrics, primarily focused on safety.
Confidence in current risk adjustment methodology is low. The knowledge
gaps identified should guide future research in the development of new
quality metrics.<br/>Copyright &#xa9; 2020 American College of Cardiology
Foundation

<23>
Accession Number
2005976376
Title
Perioperative probiotic treatment decreased the incidence of postoperative
cognitive impairment in elderly patients following non-cardiac surgery: A
randomised double-blind and placebo-controlled trial.
Source
Clinical Nutrition. 40 (1) (pp 64-71), 2021. Date of Publication: January
2021.
Author
Wang P.; Yin X.; Chen G.; Li L.; Le Y.; Xie Z.; Ouyang W.; Tong J.
Institution
(Wang, Yin, Chen, Li, Le, Ouyang, Tong) Department of Anesthesiology, The
Third Xiangya Hospital of Central South University, Changsha, Hunan, China
(Wang, Tong) Hunan Province Key Laboratory of Brain Homeostasis, Third
Xiangya Hospital, Central South University, Changsha, Hunan, China
(Tong) Center for Experimental Medicine, Third Xiangya Hospital, Central
South University, Changsha, Hunan, China
(Xie) Geriatric Anesthesia Research Unit, Department of Anesthesia,
Critical Care and Pain Medicine, Massachusetts General Hospital and
Harvard Medical School, Charlestown, United States
Publisher
Churchill Livingstone
Abstract
Background: Given that population aging is a global health challenge, the
high prevalence of postoperative neurocognitive impairment in elderly
patients necessitates the development of novel simple and effective
prevention methods. <br/>Objective(s): To evaluate the effects of
perioperative application of oral probiotic as a prophylaxis for cognitive
impairment in elderly patients following non-cardiac surgery.
<br/>Method(s): This randomised double-blind and placebo-controlled trial
included 120 elderly patients (in a modified intention-to-treat analysis)
scheduled for elective orthopaedic or colorectal surgery. Patients were
assigned to receive either probiotics or a placebo from hospital admission
until discharge. The primary endpoint was the incidence of postoperative
cognitive impairment, defined as a decrease of >=3 points in the
Mini-Mental State Examination (MMSE) scores from admission baseline to the
7th day post-surgery. Secondary endpoints included changes in plasma
interleukin-6 (IL-6) and cortisol, postoperative pain intensity,
postoperative sleep quality, gastrointestinal function recovery, and
faecal microbiota composition. <br/>Result(s): The incidence of
postoperative cognitive impairment in the probiotic group was
significantly lower than in the control group (3 of 59 patients [5.1%] vs.
10 of 61 patients [16.4%], P = 0.046). In addition, compared to
pre-surgery, the levels of plasma IL-6 and cortisol in the probiotic group
decreased more than in the control group 5-7 days after surgery (IL-6:
-117.90 +/- 49.15 vs. -14.93 +/- 15.21, P = 0.044; cortisol: -158.70 +/-
53.52 vs. 40.98 +/- 72.48, P = 0.010). Relative abundance at the genus
level in the faeces of the probiotic group also changed more than in that
of the control group during the perioperative period. In contrast,
postoperative pain intensity, sleep quality, and gastrointestinal function
recovery did not differ significantly between the two groups.
<br/>Conclusion(s): Perioperative application of oral probiotic prevents
postoperative cognitive impairment in elderly patients following
non-cardiac surgery, possibly via the limitation of peripheral
inflammation and the stress response.<br/>Copyright &#xa9; 2020 Elsevier
Ltd and European Society for Clinical Nutrition and Metabolism

<24>
Accession Number
2007606035
Title
The Association of Cerebral Desaturation During One-Lung Ventilation and
Postoperative Recovery: A Prospective Observational Cohort Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (2) (pp 542-550),
2021. Date of Publication: February 2021.
Author
Roberts M.L.; Lin H.-M.; Tinuoye E.; Cohen E.; Flores R.M.; Fischer G.W.;
Weiner M.M.
Institution
(Roberts) Department of Anesthesia and Critical Care, Hospital of
University of Pennsylvania, Philadelphia, PA, United States
(Lin) Department of Population Health Science and Policy, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Tinuoye) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Cohen, Weiner) Department of Anesthesiology, Perioperative and Pain
Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Flores) Department of Thoracic Surgery, Icahn School of Medicine at Mount
Sinai, Mount Sinai Health System, New York, NY, United States
(Fischer) Department of Anesthesiology and Critical Care Medicine,
Memorial Sloan Kettering Cancer Center, New York, NY, United States
Publisher
W.B. Saunders
Abstract
Objectives: This study was designed to investigate whether cerebral oxygen
desaturations during thoracic surgery are predictive of patients' quality
of recovery. As a secondary aim, the authors investigated the relationship
among cerebral desaturations and postoperative delirium and hospital
length of stay. <br/>Design(s): This study was a prospective observational
cohort study. <br/>Setting(s): A single tertiary-care medical center from
September 2012 through March 2014. <br/>Patient(s): Adult patients
scheduled for elective pulmonary surgery requiring one-lung ventilation.
<br/>Intervention(s): All patients were monitored with the ForeSight
cerebral oximeter. <br/>Measurements and Main Results: The primary
assessment tool was the Postoperative Quality of Recovery Scale. Delirium
was assessed using the Confusion Assessment Method. Of the 117 patients
analyzed in the study, 60 of the patients desaturated below a cerebral
oximetry level of 65% for a minimum of 3 minutes (51.3%). Patients who
desaturated were significantly less likely to have cognitive recovery in
the immediate postoperative period (p = 0.012), which did not persist in
the postoperative period beyond day 0. Patients who desaturated also were
more likely to have delirium (p = 0.048, odds ratio 2.81 [95% CI
1.01-7.79]) and longer length of stay (relative duration 1.35, 95% CI
1.05-1.73; p = 0.020). <br/>Conclusion(s): Intraoperative cerebral oxygen
desaturations, frequent during one-lung ventilation, are associated
significantly with worse early cognitive recovery, high risk of
postoperative delirium, and prolonged length of stay. Large interventional
studies on cerebral oximetry in the thoracic operating room are
warranted.<br/>Copyright &#xa9; 2020

<25>
Accession Number
2010558820
Title
interventional procedures versus medical therapy alone: outcome of cardiac
patient management - A systematic review.
Source
Minerva Cardioangiologica. 68 (6) (pp 586-591), 2020. Date of Publication:
December 2020.
Author
Abuosa A.; Elshiekh A.; Kinsara A.J.
Institution
(Abuosa, Elshiekh, Kinsara) Ministry of National Guard Health Affair, King
Abdullah International Medical Research Center, King Saud Bin Abdulaziz
University for Health Sciences, COM-WR, Jeddah, Saudi Arabia
Publisher
Edizioni Minerva Medica
Abstract
Cardiac patients are managed medically or with an intervention. This
review aimed to explore the survival benefit of each approach in the
management of cardiac patients. We reviewed updated evidence of survival
benefit from the most recent trials and guidelines. Patients with
ST-segment-elevation myocardial infarction (STEMI) have a mortality
benefit when a primary cardiac intervention is implemented. No similar
benefit has been shown in chronic stable coronary artery disease. Heart
failure patients show a mortality benefit using medication and similarly,
mild or moderate valve disease patients do not require an intervention. In
atrial fibrillation, the CABANA trial using ablation therapy, had no
mortality benefit. Hypertension drug therapy showed a significant
mortality benefit, a similar benefit was noted with drug therapy for the
treatment of dyslipidemia, when achieving the target lipid goal. not all
interventional procedures result in a mortality benefit. Medical therapy
alone increases survival in many cardiac diseases.<br/>Copyright &#xa9;
2020 ediZioni Minerva MediCa

<26>
Accession Number
2010552196
Title
Comparison of Custodiol and modified St. Thomas cardioplegia for
myocardial protection in coronary artery bypass grafting.
Source
Vojnosanitetski Pregled. 77 (11) (pp 1126-1134), 2020. Date of
Publication: 2020.
Author
Cvetkovic D.; Kocica M.; Soskic L.; Vucicevic F.; Petrovic O.; Jovanovic
I.; Jovicic S.; Trifkovic J.; Kostovski S.; Milicic B.; Karadzic M.;
Ristic A.; Savic D.
Institution
(Cvetkovic, Kocica, Soskic, Vucicevic, Kostovski, Karadzic) Clinical
Centre of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia
(Petrovic, Jovanovic, Ristic) Clinical Centre of Serbia, Clinic for
Cardiology, Belgrade, Serbia
(Jovicic) Clinical Centre of Serbia, Center for Medical Biochemistry,
Belgrade, Serbia
(Savic) Clinical Centre of Serbia, Pacemaker Center, Belgrade, Serbia
(Trifkovic) University of Belgarde, Faculty of Chemistry, Faculty of
Dentistry, Belgrade, Serbia
(Milicic) Department of Medical Statistics and Informatics, Belgrade,
Serbia
Publisher
Inst. Sci. inf., Univ. Defence in Belgrade
Abstract
Background/Aim. Custodiol is a hyperpolarizing cardio-plegic solution
which has been used in our national cardiac surgical practice exclusively
for the heart transplant surgery. Owing to its numerous advantages over
the standard depo-larizing solutions, Custodiol became cardioplegic
solution of choice for all other cardiac surgical procedures in many
cardio-surgical centers. This study evaluated myocardial pro-tection by
Custodiol compared to modified St. Thomas cardioplegic solution in
coronary artery bypass surgery. Methods. In a prospective four-month
study, 110 consecu-tive adult patients who underwent primary isolated
elective on-pump coronary artery bypass grafting (CABG) were randomized
into the Custodiol group (n = 54) and the St. Thomas groupa (n = 50),
based on the type of administered cardioplegia; six patients were
excluded. Cardiac protection was achieved as antegrade cold crystalloid
cardioplegia by one of the solutions. Myocardial preservation was assessed
through following outcomes: spontaneous rhythm restora-tion post
cross-clamp, and postpoperative cardiac specific enzymes level, ejection
fraction (EF) change, inotropic sup-port, myocardial infarction (MI),
atrial fibrillation (AF), and death. Results. Preoperative and
intraoperative characteris-tics of patients in both groups were similar
except for a considerably longer cross-clamp time in the Custodiol group
(49.1 +/- 19.0 vs. 41.0 +/- 12.9 minutes; p = 0.022). The Custodiol group
exhibited a higher rate of return to spon-taneous rhythm compared to the
St. Thomas group (31.5% vs. 20.0%, respectively; p = 0.267), lower rates
of AF (20.4% vs. 28%, respectively; p = 0.496), MI (1.8% vs. 10.0%,
respectively; p = 0.075) and inotropic support (9.0% vs. 12.0%,
respectively; p = 0.651), albeit not statistically significant. There was
an insignificant difference in peak value of troponin I between the
Custodiol and Thee St. Thomas group (5.0 +/- 3.92 mug/L vs. 4.5 +/- 3.39
mug/L, re-spectively; p = 0.755) and creatine kinase-MB (26.9 +/- 15.4
mug/L vs. 28.5 +/- 24.2 mug/L, respectively; p = 0.646) 6 hours
post-surgery. EF reduction was comparable (0.81% vs. 1.26%; p = 0.891).
There were no deaths in both groups. Conclusions. Custodiol and modified
St. Thomas cardio-plegic solution have comparable cardioprotective effects
in CABG surgery. The trends of less frequent MI, AF and ino-tropic
support, despite the longer cross-clamp time in the Custodiol group may
suggest that its benefits could be as-certained in a larger
study.<br/>Copyright &#xa9; 2020 Inst. Sci. inf., Univ. Defence in
Belgrade. All rights reserved.

<27>
Accession Number
2003547838
Title
Keeping up to date: a current review of wearable cardioverter
defibrillator use.
Source
Acta Cardiologica. 75 (8) (pp 695-704), 2020. Date of Publication: 2020.
Author
Ashraf S.; Ilyas S.; Siddiqui F.; Ando T.; Shokr M.; Panaich S.;
Briasoulis A.; Afonso L.; Khan M.
Institution
(Ashraf, Siddiqui, Ando, Shokr, Panaich, Briasoulis, Afonso, Khan)
Division of Cardiology, Detroit Medical Center/Wayne State University,
Detroit, MI, United States
(Ilyas) Department of Medicine, The Warren Alpert Medical School of Brown
University, Providence, RI, United States
Publisher
Taylor and Francis Ltd.
Abstract
The introduction of wearable cardioverter defibrillators (WCD) provides a
novel means of protection in select patients at high risk for sudden
cardiac death. The WCD can safely record and terminate life-threatening
arrhythmias. In this review, we explore the data behind indications for
WCD use and discuss its limitations. We searched PubMed, Google Scholar
and Cochrane Central Register of controlled trials for relevant studies.
The VEST trial, the first randomised controlled trial on WCD use, did not
show statistical significance in utility of the WCD in post-myocardial
infarction patients with low ejection fraction. While the use of WCD in
this select patient population showed no benefit, the findings of the
trial merit closer inspection. Various other indications of WCD use still
exist and others require exploration. Select subsets of patients who stand
to benefit for other indications include severely decreased left
ventricular function post-revascularization with high arrhythmic burden,
severe non-ischaemic cardiomyopathy, patients awaiting heart transplant
and patients who have had their implantable cardioverter device
temporarily removed. The role of the WCD is also being explored in
children, peripartum cardiomyopathy, haemodialysis patients, and in
syncope secondary to high-risk arrhythmias.<br/>Copyright &#xa9; 2019
Belgian Society of Cardiology.

<28>
Accession Number
633213402
Title
Perioperative Sleep Disturbances and Postoperative Delirium in Adult
Patients: A Systematic Review and Meta-Analysis of Clinical Trials.
Source
Frontiers in Psychiatry. 11 (no pagination), 2020. Article Number: 570362.
Date of Publication: 14 Oct 2020.
Author
Wang H.; Zhang L.; Zhang Z.; Li Y.; Luo Q.; Yuan S.; Yan F.
Institution
(Wang, Zhang, Li, Luo, Yuan, Yan) Department of Anesthesiology, Chinese
Academy of Medical Sciences and Peking Union Medical College, Fuwai
Hospital, Beijing, China
(Zhang) Department of Anesthesiology, Chongqing Traditional Chinese
Medicine Hospital, Chongqing, China
Publisher
Frontiers Media S.A.
Abstract
Background: The aim of this systematic review and meta-analysis of
clinical trials was to investigate the effects of perioperative sleep
disturbances on postoperative delirium (POD). <br/>Method(s): Authors
searched for studies (until May 12, 2020) reporting POD in patients with
sleep disturbances following the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) guidelines. <br/>Result(s): We
identified 29 relevant trials including 55,907 patients. We divided these
trials into three groups according to study design: Seven retrospective
observational trials, 12 prospective observational trials, and 10
randomized controlled trials. The results demonstrated that perioperative
sleep disturbances were significantly associated with POD occurrence in
observational groups [retrospective: OR = 0.56, 95% CI: [0.33, 0.93],
I² = 91%, p for effect = 0.03; prospective: OR = 0.27, 95% CI:
[0.20, 0.36], I² = 25%, p for effect < 0.001], but not in the
randomized controlled trial group [OR = 0.58, 95% CI: [0.34, 1.01],
I² = 68%, p for effect = 0.05]. Publication bias was assessed
using Egger's test. We used a one-by-one literature exclusion method to
address high heterogeneity. <br/>Conclusion(s): Perioperative sleep
disturbances were potential risk factors for POD in observational trials,
but not in randomized controlled trials.<br/>&#xa9; Copyright &#xa9; 2020
Wang, Zhang, Zhang, Li, Luo, Yuan and Yan.

<29>
Accession Number
2007014708
Title
Effects of physical exercise on the autonomic nervous system in patients
with coronary artery disease: a systematic review.
Source
Expert Review of Cardiovascular Therapy. 18 (11) (pp 749-759), 2020. Date
of Publication: 2020.
Author
Figueiredo T.D.G.; de Souza H.C.M.; Neves V.R.; do Rego Barros A.E.V.;
Dornelas de Andrade A.D.F.; Brandao D.C.
Institution
(Figueiredo, do Rego Barros) Physical Therapy, Federal University of
Pernambuco, Recife, Brazil
(de Souza) Clinical Hospital, Federal University of Pernambuco,
Pernambuco, Brazil
(Neves) Department of Physical Therapy, University of Pernambuco,
Pernambuco, Brazil
(Dornelas de Andrade, Brandao) Department of Physical Therapy, Federal
University of Pernambuco, Recife, Brazil
Publisher
Taylor and Francis Ltd.
Abstract
Background: Imbalance in autonomic modulation can occur after a cardiac
event, which can lead to deleterious consequences. Exercise has proven to
be a therapy which affects this modulation and can be assessed through
heart rate variability (HRV). Areas covered: The objective of this
systematic review was to investigate the effects of physical exercise on
heart rate variability in individuals with coronary artery disease (CAD).
The PubMed, PEDro, Scielo, Lilacs and Cochrane databases were
systematically searched, for articles which performed supervised exercises
in phase II of cardiac rehabilitation in patients with CAD. Expert
opinion: Given the differences between studies on interventions and
population characteristics, it is difficult to justify similarities or
divergences in terms of results. In addition to the variation in sample
size, intervention duration, carrying out an additional program at home,
and patients with different clinical presentations, it can be inferred
that responses to exercise may vary for certain types/clinical profile of
individuals with CAD. Thus, it is necessary to carry out more studies with
greater methodological rigor, greater standardization of the variables
studied and the evaluation forms, in order to increase the veracity of the
results and the consequent clinical relevance and therapeutic
application.<br/>Copyright &#xa9; 2020 Informa UK Limited, trading as
Taylor & Francis Group.

<30>
Accession Number
2010573233
Title
Outpatient Versus Inpatient Percutaneous Coronary Intervention in Patients
With Left Main Disease (from the EXCEL Trial).
Source
American Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Gaba P.; Serruys P.W.; Karmpaliotis D.; Lembo N.J.; Banning A.P.; Zhang
Z.; Morice M.-C.; Kandzari D.E.; Gershlick A.H.; Ben-Yehuda O.; Sabik
J.F.; Kappetein A.P.; Stone G.W.
Institution
(Gaba, Karmpaliotis, Lembo, Ben-Yehuda) NewYork-Presbyterian
Hospital/Columbia University Irving Medical Center, New York, NY, United
States
(Serruys) Department of Cardiology, National University of Ireland Galway
(NUIG), Galway, Ireland
(Serruys) Department of Cardiology, Imperial College of London, London,
United Kingdom
(Karmpaliotis, Lembo, Zhang, Ben-Yehuda, Stone) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Banning) John Radcliffe Hospital, Oxford, United Kingdom
(Morice) Hopital Prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Kandzari) Piedmont Heart Institute, Atlanta, Georgia, Georgia
(Gershlick) University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
(Kappetein) Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Prior studies in patients with noncomplex coronary artery disease have
demonstrated the safety of percutaneous coronary intervention (PCI) in the
outpatient setting. We sought to examine the outcomes of outpatient PCI in
patients with unprotected left main coronary artery disease (LMCAD). In
the EXCEL trial, 1905 patients with LMCAD and site-assessed low or
intermediate SYNTAX scores were randomized to PCI with everolimus-eluting
stents versus coronary artery bypass grafting. The primary end point was
major adverse cardiovascular events (MACE; the composite of death, stroke,
or myocardial infarction). In this sub-analysis, outcomes at 30 days and 5
years were analyzed according to whether PCI was performed in the
outpatient versus inpatient setting. Among 948 patients with LMCAD
assigned to PCI, 935 patients underwent PCI as their first procedure,
including 100 (10.7%) performed in the outpatient setting. Patients who
underwent outpatient compared with inpatient PCI were less likely to have
experienced recent myocardial infarction. Distal left main bifurcation
disease involvement and SYNTAX scores were similar between the groups.
Comparing outpatient to inpatient PCI, there were no significant
differences in MACE at 30 days (4.0% vs 5.0% respectively, adjusted OR
0.52 95% CI 0.12 to 2.22; p = 0.38) or 5 years (20.6% vs 22.1%
respectively, adjusted OR 0.72, 95% CI 0.40 to 1.29; p = 0.27). Similar
results were observed in patients with distal left main bifurcation
lesions. In conclusion, in the EXCEL trial, outpatient PCI of patients
with LMCAD was not associated with an excess early or late hazard of MACE.
These data suggest that outpatient PCI may be safely performed in select
patients with LMCAD.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<31>
Accession Number
2010564282
Title
Renin-angiotensin system inhibition and outcome after coronary artery
bypass grafting: A population-based study from the SWEDEHEART registry.
Source
International Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Martinsson A.; Nielsen S.J.; Bjorklund E.; Pivodic A.; Malm C.J.; Hansson
E.C.; Jeppsson A.
Institution
(Martinsson) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Martinsson, Nielsen, Bjorklund, Malm, Hansson, Jeppsson) Department of
Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg
University, Sweden
(Nielsen, Malm, Hansson, Jeppsson) Department of Cardiothoracic Surgery,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Bjorklund) Department of Medicine, South Alvsborg Hospital, Boras, Sweden
(Pivodic) Statistiska konsultgruppen, Gothenburg, Sweden
(Pivodic) Department of Ophthalmology, Institute of Neuroscience and
Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
Publisher
Elsevier Ireland Ltd
Abstract
Background: Renin-angiotensin system (RAS) inhibitors are recommended
postoperatively to coronary artery bypass grafting (CABG) patients with
reduced left ventricular function, diabetes, hypertension or previous
myocardial infarction, but not to remaining patients. The aim of the study
was to assess the long-term utilization of RAS inhibitors after CABG in
patients with and without indication for treatment, and its association
with outcome. <br/>Method(s): All patients (n = 28,782) not meeting
exclusion criterion in Sweden who underwent isolated first time CABG from
2006 to 2015 were included using nationwide registries. The association
between treatment and outcome was assessed using adjusted Cox regression
models with time-updated data on medications. The primary outcome was
major adverse cardiovascular events (MACE), defined as all-cause
mortality, stroke and/or myocardial infarction. <br/>Result(s): At
baseline 26,284 (91.3%) of the patients had at least one indication for
RAS inhibition while 2498 (8.7%) had not. RAS inhibitors were dispensed to
77.0% and 29.7% of patients with and without indication respectively.
Dispense declined over time. RAS inhibition was associated with a
reduction in MACE in the whole study population (adjusted hazard ratio
(aHR) 0.88, 95% confidence interval (95% CI) 0.83-0.93, p < 0.0001), and
in patients with (aHR 0.87 95% CI: 0.82-0.93, p < 0.0001) and without
indication (aHR 0.75, 95% CI: 0.58-0.98, p = 0.034). <br/>Conclusion(s):
RAS inhibition is underutilized after CABG. The use of RAS inhibitors was
associated with a reduction in MACE, both in patients with and without
indication for treatment. The results suggest that RAS inhibition is
beneficial for all CABG patients. Randomized controlled trials are
necessary to confirm this hypothesis.<br/>Copyright &#xa9; 2021 The
Authors

<32>
[Use Link to view the full text]
Accession Number
2007481878
Title
Sitagliptin for the prevention and treatment of perioperative
hyperglycaemia in patients with type 2 diabetes undergoing cardiac
surgery: A randomized controlled trial.
Source
Diabetes, Obesity and Metabolism. 23 (2) (pp 480-488), 2021. Date of
Publication: February 2021.
Author
Cardona S.; Tsegka K.; Pasquel F.J.; Jacobs S.; Halkos M.; Keeling W.B.;
Davis G.M.; Fayfman M.; Albury B.; Urrutia M.A.; Galindo R.J.; Migdal
A.L.; Macheers S.; Guyton R.A.; Vellanki P.; Peng L.; Umpierrez G.E.
Institution
(Cardona, Tsegka, Pasquel, Jacobs, Davis, Fayfman, Albury, Urrutia,
Galindo, Migdal, Vellanki, Umpierrez) Department of Medicine, Emory
University, Atlanta, GA, United States
(Halkos, Keeling, Macheers, Guyton) Joseph B. Whitehead Department of
Surgery, Emory University, Atlanta, GA, United States
(Peng) Rollins School of Public Health, Emory University, Atlanta, GA,
United States
Publisher
Blackwell Publishing Ltd
Abstract
Aim: To assess whether treatment with sitagliptin, starting before surgery
and continued during the hospital stay, can prevent and reduce the
severity of perioperative hyperglycaemia in patients with type 2 diabetes
undergoing coronary artery bypass graft (CABG) surgery. <br/>Material(s)
and Method(s): We conducted a double-blinded, placebo-controlled trial in
adults with type 2 diabetes randomly assigned to receive sitagliptin or
matching placebo starting 1 day prior to surgery and continued during the
hospital stay. The primary outcome was difference in the proportion of
patients with postoperative hyperglycaemia (blood glucose [BG] > 10 mmol/L
[>180 mg/dL]) in the intensive care unit (ICU). Secondary endpoints
included differences in mean daily BG in the ICU and after transition to
regular wards, hypoglycaemia, hospital complications, length of stay and
need of insulin therapy. <br/>Result(s): We included 182 participants
randomized to receive sitagliptin or placebo (91 per group, age 64 +/- 9
years, HbA1c 7.6% +/- 1.5% and diabetes duration 10 +/- 9 years). There
were no differences in the number of patients with postoperative BG
greater than 10 mmol/L, mean daily BG in the ICU or after transition to
regular wards, hypoglycaemia, hospital complications or length of stay.
There were no differences in insulin requirements in the ICU; however,
sitagliptin therapy was associated with lower mean daily insulin
requirements (21.1 +/- 18.4 vs. 32.5 +/- 26.3 units, P =.007) after
transition to a regular ward compared with placebo. <br/>Conclusion(s):
The administration of sitagliptin prior to surgery and during the hospital
stay did not prevent perioperative hyperglycaemia or complications after
CABG. Sitagliptin therapy was associated with lower mean daily insulin
requirements after transition to regular wards.<br/>Copyright &#xa9; 2020
John Wiley & Sons Ltd

<33>
Accession Number
2006876233
Title
Effects of different mean arterial pressure targets on plasma volume, ANP
and glycocalyx-A randomized trial.
Source
Acta Anaesthesiologica Scandinavica. 65 (2) (pp 220-227), 2021. Date of
Publication: February 2021.
Author
Damen T.; Saadati S.; Forssell-Aronsson E.; Hesse C.; Bentzer P.; Ricksten
S.-E.; Nygren A.
Institution
(Damen, Ricksten, Nygren) Department of Anaesthesiology and Intensive Care
Medicine, Institute of Clinical Sciences at the Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
(Damen, Ricksten, Nygren) Section of Cardiothoracic Anaesthesia and
Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
(Saadati, Forssell-Aronsson) Department of Radiation Physics, Institute of
Clinical Sciences, Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden
(Forssell-Aronsson) Department of Medical Physics and Biomedical
Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
(Hesse) Department of Laboratory Medicine, Institute of Biomedicine,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Bentzer) Department of Anaesthesia and Intensive Care, Helsingborg
Hospital, Helsingborg and Lund University, Helsingborg, Sweden
(Bentzer) Department of Clinical Sciences, Anaesthesiology, Lund
University, Lund, Sweden
Publisher
Blackwell Munksgaard
Abstract
Background: Arterial haematocrit (Hct) has been shown to decrease after
anaesthesia induction, most probably because of an increased plasma volume
(PV). The primary objective was to quantify change in PV if mean arterial
pressure (MAP) was kept at baseline level or allowed to decrease to 60 mm
Hg. Our secondary objective was to evaluate underlying mechanisms of this
response. <br/>Method(s): Twenty-four coronary artery bypass patients were
randomized to a higher (90 mm Hg, intervention group) or lower (60 mm Hg,
control group) MAP by titration of norepinephrine. During the experimental
procedure, no fluids were administered. Baseline PV was measured by
¹²⁵I-albumin and the change in PV was calculated from the
change in Hct. Changes in MAP, plasma ¹²⁵I-albumin, colloid
osmotic pressure, albumin, Mid Regional-pro Atrial Natriuretic Peptide
(MR-proANP) and endothelial glycocalyx components were measured from
baseline to 50 minutes after anaesthesia induction. <br/>Result(s): The
MAP during the trial was 93 +/- 9 mm Hg in the intervention group and 62
+/- 5 mm Hg in the control group. PV increased with up to 420 +/- 180 mL
in the control group and 45 +/- 130 mL in the intervention group (P
<.001). Albumin and colloid osmotic pressure decreased significantly more
in the control group. MR-proANP increased in the control group but no
shedding of the glycocalyx layer was detected in either of the groups.
<br/>Conclusion(s): Allowing mean arterial pressure to fall to 60 mm Hg
during anaesthesia induction, increases the plasma volume due to
reabsorption of interstitial water, with no ANP-induced degradation of the
endothelial glycocalyx.<br/>Copyright &#xa9; 2020 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation

<34>
Accession Number
2007701128
Title
Transcatheter versus surgical aortic valve replacement in patients with
chronic obstructive pulmonary disease.
Source
Scandinavian Cardiovascular Journal. (no pagination), 2020. Date of
Publication: 2020.
Author
Takagi H.; Kuno T.; Hari Y.; Nakashima K.; Yokoyama Y.; Ueyama H.; Ando T.
Institution
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Kuno, Ueyama) Department of Medicine, Mount Sinai Beth Israel Medical
Center, New York, NY, United States
(Yokoyama) Department of Surgery, Easton Hospital, Easton, PA, United
States
(Ando) Division of Interventional Cardiology, Department of Cardiology,
New York Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: Although a number of studies compared mortality after
transcatheter aortic valve implantation (TAVI) with that after surgical
aortic replacement (SAVR) in patients with chronic obstructive pulmonary
disease (COPD), no meta-analysis of them has been conducted to date. To
determine whether TAVI or SAVR is associated with better postprocedural
survival in patients with COPD, a meta-analysis of all studies currently
available was performed. Design. To identify all comparative studies of
TAVI with SAVR in patients with COPD, PubMed and Web of Science were
searched through January 2020. Studies meeting the following criteria were
included in the present meta-analysis: the design was an observational
comparative study or a randomized controlled trial; the study population
was patients with COPD; patients were assigned to TAVI versus SAVR; and
outcomes included all-cause mortality. Adjusted (if unavailable,
unadjusted) odds or hazard ratios with their confidence intervals (CIs) of
mortality for TAVI versus SAVR were extracted from each study.
Study-specific estimates were combined in the random-effects model.
Results. Six eligible studies with a total of 4771 patients with COPD were
identified and included in the present meta-analysis. The meta-analysis
indicated significantly lower early (in-hospital or 30-day) mortality
after TAVI than after SAVR (odds ratio, 0.69; 95% CI, 0.53-0.90; p =.006)
but no significant difference in midterm (1-year to 5-year) mortality
between TAVI and SAVR (hazard ratio, 1.07; 95% CI, 0.79-1.44; p =.68).
Conclusions. In patients with COPD, TAVI was associated with reduced early
mortality, while midterm mortality appeared similar, as compared with
SAVR.<br/>Copyright &#xa9; 2020 Informa UK Limited, trading as Taylor &
Francis Group.

<35>
Accession Number
2007674554
Title
New or Worsened Mitral Regurgitation After Surgical Aortic Valve
Replacement: A Systematic Review.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Kumar N.; Kumar J.E.; Hussain N.; Gorelik L.; Essandoh M.K.; Whitson B.A.;
Bhatt A.M.; Flores A.S.; Hachem A.; Sawyer T.R.; Iyer M.H.
Institution
(Kumar, Kumar, Hussain, Gorelik, Essandoh, Bhatt, Flores, Iyer) Department
of Anesthesiology, The Ohio State University Wexner Medical Center,
Columbus, OH, United States
(Kumar) The Ohio State University College of Medicine, Columbus, OH,
United States
(Whitson) Division of Cardiac Surgery, Department of Surgery, The Ohio
State University Wexner Medical Center, OH, United States
(Hachem, Sawyer) Central Michigan University College of Medicine, Mt.
Pleasant, MI, United States
Publisher
SAGE Publications Inc.
Abstract
Background: New or worsened mitral regurgitation (MR) is an uncommon yet
serious complication after surgical aortic valve replacement (SAVR). While
there have been numerous reports of its occurrence, there is little
consensus regarding its presentation and management. This systematic
review summarizes the evidence in the current literature surrounding new
or worsened MR after SAVR and analyzes its potential implications.
<br/>Method(s): Databases were examined for all articles and abstracts
reporting on new or worsened MR after SAVR. Data collected included number
of patients studied; patient characteristics; incidences of new or
worsened MR; timing of diagnosis; and treatment. <br/>Result(s):
Thirty-six full-text citations were included in this review. The
prevalence of new or worsened MR after SAVR was 8.4%. Sixteen percent of
new MR occurrences were from an organic etiology, and 83% of new MR
occurrences were that of a functional etiology. Most diagnoses were made
in the late or unspecified postoperative period using echocardiography
(range: 0 minutes to 18 years postoperatively). While no patients died
from this complication, 7.7% of patients (16 out of 207) required emergent
procedural re-intervention. <br/>Conclusion(s): This systematic review
underscores the importance of identifying new or worsened MR following
SAVR and accurate scoring of MR severity to guide treatment. It also
outlines the associated clinical measures commonly documented following
this complication, and the usefulness of transesophageal echocardiography
for the detection of significant MR. These results reflect the current,
limited state of the literature on this topic and warrant further
investigation into MR detection and management strategies in SAVR
patients.<br/>Copyright &#xa9; The Author(s) 2020.

<36>
Accession Number
2007668844
Title
Effect of Preoperative Infusion of Levosimendan on Biomarkers of
Myocardial Injury and Haemodynamics After Paediatric Cardiac Surgery: A
Randomised Controlled Trial.
Source
Drugs in R and D. (no pagination), 2020. Date of Publication: 2020.
Author
Abril-Molina A.; Gomez-Luque J.M.; Perin F.; Esteban-Molina M.;
Ferreiro-Marzal A.; Fernandez-Guerrero C.; Ocete-Hita E.
Institution
(Abril-Molina, Gomez-Luque, Ocete-Hita) Pediatric Intensive Care Unit,
Hospital Universitario Virgen de las Nieves, University of Granada,
Granada, Spain
(Perin) Paediatric Cardiology Unit, Hospital Universitario Virgen de las
Nieves, Granada, Spain
(Esteban-Molina, Ferreiro-Marzal) Paediatric Cardiac Surgery Unit,
Hospital Universitario Virgen de las Nieves, Granada, Spain
(Fernandez-Guerrero) Pediatric Anesthesia Unit, Hospital Universitario
Virgen de las Nieves, Granada, Spain
Publisher
Adis
Abstract
Objective: The aim was to test the hypothesis that preoperative infusion
of levosimendan would decrease patients' cardiac biomarker profiles during
the immediate postoperative stage (troponin I and B-type natriuretic
peptide levels) more efficiently than placebo after cardiopulmonary
bypass. <br/>Method(s): In a randomised, placebo-controlled,
double-blinded study, 30 paediatric patients were scheduled for congenital
heart disease surgery. 15 patients (50%) received prophylactic
levosimendan and 15 patients (50%) received placebo from 12 h before
cardiopulmonary bypass to 24 h after surgery. <br/>Result(s): Troponin I
levels were higher in the placebo group at 0, 12, and 24 h after
cardiopulmonary bypass, although the mean differences between the study
groups and the 95% confidence intervals (CIs) for troponin I levels did
not present statistically significant differences at any of the three time
points considered (mean differences [95% CIs] - 3.32 pg/ml [- 19.34 to
12.70], - 2.42 pg/ml [- 19.78 to 13.95], and - 79.94 pg/ml [- 266.99 to
16.39] at 0, 12, and 24 h, respectively). A similar lack of statistically
significant difference was observed for B-type natriuretic peptide (mean
differences [95% CIs] 36.86 pg/dl [- 134.16 to 225.64], - 350.79 pg/dl [-
1459.67 to 557.45], and - 310.35 pg/dl [- 1505.76 to 509.82]). Lactic acid
levels were significantly lower with levosimendan; the mean differences
between the study groups and the 95% CIs for lactate levels present
statistically significant differences at 0 h (- 1.52 mmol/l [- 3.19 to -
0.25]) and 12 h (- 1.20 mmol/l [- 2.53 to - 0.10]) after cardiopulmonary
bypass. Oxygen delivery (DO<inf>2</inf>) was significantly higher at 12 h
and 24 h after surgery (mean difference [95% CI] 627.70
ml/min/m² [122.34-1162.67] and 832.35 ml/min/m²
[58.15 to 1651.38], respectively). <br/>Conclusion(s): Levosimendan does
not significantly improve patients' postoperative troponin I and B-type
natriuretic peptide profiles during the immediate postoperative stage in
comparison with placebo, although both were numerically higher with
placebo. Levosimendan, however, significantly reduced lactic acid levels
and improved patients' DO<inf>2</inf> profiles. These results highlight
the importance of this new drug and its possible benefit with regard to
myocardial injury; however, evaluation in larger, adequately powered
trials is needed to determine the efficacy of levosimendan. Trial registry
number: EudraCT 2012-005310-19.<br/>Copyright &#xa9; 2020, The Author(s).

<37>
Accession Number
2007661084
Title
Antithrombotic therapy with or without clopidogrel after transcatheter
aortic valve replacement. A meta-analysis of randomized controlled trials.
Source
Clinical Research in Cardiology. (no pagination), 2020. Date of
Publication: 2020.
Author
Pellegrini C.; Xhepa E.; Ndrepepa G.; Alvarez-Covarrubias H.; Kufner S.;
Lahmann A.L.; Rheude T.; Rai H.; Mayr N.P.; Schunkert H.; Kastrati A.;
Joner M.; Cassese S.
Institution
(Pellegrini, Xhepa, Ndrepepa, Alvarez-Covarrubias, Kufner, Lahmann,
Rheude, Rai, Schunkert, Kastrati, Joner, Cassese) Klinik Fur Herz- und
Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technische
Universitat Munchen, Lazarettstrasse, 36, Munich, Germany
(Schunkert, Kastrati, Joner) German Center for Cardiovascular Research
(DZHK), Partner Site Munich Heart Alliance, Munich, Germany
(Alvarez-Covarrubias) Hospital de Cardiologia, IMSS, Centro Medico
Nacional Siglo XXI, Mexico City, Cd. de Mexico, Mexico
(Lahmann) Facharztliche Praxis, Kardiologie Im Herzen Munchens, Tal 21,
Munich, Germany
(Mayr) Institut fur Anasthesiologie, Deutsches Herzzentrum Munchen,
Technische Universitat Munchen, Munich, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aims: To investigate the clinical outcomes associated with an
antithrombotic therapy with or without clopidogrel after transcatheter
aortic valve replacement (TAVR). <br/>Methods and Results: This is a
study-level meta-analysis including all randomized trials investigating
antithrombotic regimens after TAVR. The protocol was registered with
PROSPERO (CRD42020191036). We searched electronic scientific databases for
eligible studies. The primary outcome was all-cause death. Main secondary
outcome was major bleeding. Other outcomes were life-threatening (or
disabling) bleeding, myocardial infarction (MI) and stroke. Six eligible
trials randomly allocated 3056 TAVR patients to aspirin or oral
anticoagulation (OAC) with clopidogrel (n = 1525) versus aspirin and/or
OAC without clopidogrel (n = 1531). In the overall estimates, an
antithrombotic therapy with clopidogrel versus without displayed a
comparable risk of all-cause death [Risk Ratio-RR = 0.83, 95% Confidence
intervals-CI (0.57-1.20); P = 0.25] and major bleeding [RR = 1.33, 95% CI
(0.61-2.92); P = 0.39]. However, the combination of aspirin or OAC with
clopidogrel doubled the risk of major bleeding as compared to aspirin or
OAC without clopidogrel [RR = 2.08, 95% CI (1.27-3.42); P = 0.015, P for
interaction = 0.021]. Treatment strategies did not differ with respect to
the risk of life-threatening bleeding, MI and stroke. <br/>Conclusion(s):
In patients receiving TAVR, a therapeutic strategy of aspirin or OAC with
clopidogrel significantly increases the risk of major bleeding without
impact on mortality and ischemic outcomes compared to aspirin or OAC
without clopidogrel. The performance of different antithrombotic regimens
in terms of long-term clinical outcomes and bioprosthesis valve function
requires further investigation. Graphic abstract: Forest plots from
pairwise and network meta-analyses associated with an antithrombotic
therapy with or without clopidogrel Risk ratio for all outcomes of
interest calculated with the pairwise meta-analysis (left side) and for
main outcomes calculated with the network meta-analysis (right side) in
patients allocated to an antithrombotic therapy with clopidogrel or
without. The diamonds indicate the point estimate and the left and the
right ends of the lines the [95% CI]. CI: Confidence intervals; OAC; oral
anticoagulation. [Figure not available: see fulltext.]<br/>Copyright
&#xa9; 2020, The Author(s).

<38>
Accession Number
633747644
Title
Combination of InnoSEAL plus TR band compared with TR band alone for
radial artery outcomes in patients undergoing transradial coronary
intervention (InnoSEAL-II): An open-label randomised controlled trial
(protocol).
Source
BMJ Open. 10 (12) (no pagination), 2020. Article Number: e042101. Date of
Publication: 23 Dec 2020.
Author
Aijaz S.; Sheikh S.; Pathan A.
Institution
(Aijaz, Pathan) Department of Cardiology, Tabba Heart Institute, Karachi,
Sindh, Pakistan
(Sheikh) Clinical Research Department, Tabba Heart Institute, Karachi,
Sindh, Pakistan
Publisher
BMJ Publishing Group
Abstract
Introduction About 2%-30% of cardiac catheterisation procedures get
complicated by radial artery occlusion (RAO). Ensuring patent haemostasis
appears to be an important factor in reducing RAO. Currently employed
method is a radial compression device (RCD) such as transradial band (TRB)
that take hours to achieve haemostasis and cause discomfort to the
patients. Haemostatic pads offer an alternative to RCD with reduced time
to achieve haemostasis. Our trial aims to determine the non-inferiority of
the catecholamine chitosan-based pad (InnoSEAL haemostatic pad) used in
conjunction with TRB (InnoSEAL +TRB) when compared with the TRB alone in
reducing composite adverse access site outcomes. Methods and analysis It
will be an open-label, parallel, randomised controlled trial on 714 adult
patients (325 in each arm) undergoing coronary procedure using transradial
approach at a cardiac health facility over 7 months duration. InnoSEAL
patch along with TRB will be used to control bleeding in intervention arm
and TRB alone in control arm, which is the standard practice. Study
primary outcomes include RAO and haematoma; secondary outcomes are
compression time, patient discomfort, time to discharge and ease of use of
the intervention technique by the healthcare staff. chi 2 test will be
used to compare the categorical outcomes between two arms and student's
t-test for continuous outcomes. A p value of <0.05 will be considered
significant. Ethics and dissemination Ethical approval for the study has
been obtained from the Institutional Review Board of Tabba Heart Institute
number IORG0007863. Findings will be disseminated through seminars and
scientific publications. Trial registration number NCT04380883;
Pre-results. <br/>Copyright &#xa9;

<39>
Accession Number
633845895
Title
Effects of psychological behaviour management programme on dental fear and
anxiety in children: A randomised controlled clinical trial.
Source
European journal of paediatric dentistry. 21 (4) (pp 287-291), 2020. Date
of Publication: 01 Dec 2020.
Author
Song J.-S.; Chung H.-C.; Sohn S.; Kim Y.-J.
Institution
(Song) DDS, Assistant professor of the department of Paediatric Dentistry,
Dental Research Institute, School of Dentistry, Seoul National University,
Seoul, South Korea
(Chung) MS, Computer scientist in the Culture Technology, Korea Advanced
Institute of Science and Technology, Daejeon, South Korea
(Sohn) MA, Computer-mediated communication researcher in graduate school
of Communication and Arts, Yonsei University, Seoul, South Korea
(Kim) DDS, Professor and Chair of the department of Paediatric Dentistry,
Dental Research Institute, School of Dentistry, Seoul National University,
Seoul, South Korea
Publisher
NLM (Medline)
Abstract
AIM: A psychological behaviour management programme with information and
communications technology was developed that includes symbolic modelling,
tell-show-do, positive reinforcement and distraction, and provides
real-time treatment information. We hypothesised that the programme would
help patients feel less stressed and show less uncooperative behaviours
and subjective pain. MATERIALS AND METHODS: Forty-eight paediatric
patients were recruited from May 2016 to January 2017, and randomly
divided into a control group and an experimental group. In the control,
patients watched cartoon animations during the first and second
treatments. The experimental group watched cartoon animations during the
first treatment, and they used the programme during the second treatment.
To measure stress, uncooperative behaviour and subjective pain, we
recorded the heart rate, Procedure Behaviour Checklist (PBCL) and Wong and
Baker's Faces Pain Rating Scale (FPRS). <br/>RESULT(S): The experimental
group resulted in a significantly lower mean heart rate, uncooperative
behaviour and subjective pain in the second treatment than did the control
group (p<0.001). The differences in heart rate and uncooperative behaviour
between the treatments were also significantly greater in the experimental
group than in the control group (p<0.001). <br/>CONCLUSION(S): The
programme was effective in relieving fear and anxiety as well as learning
cooperative behaviour.

<40>
Accession Number
633865980
Title
Efficacy of citrulline supplementation to decrease the risk of pulmonary
hypertension after congenital heart disease surgery. A local experience.
Source
Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina). 77 (4)
(pp 249-253), 2020. Date of Publication: 01 Dec 2020.
Author
Silvera Ruiz S.; Grosso C.L.; Tablada M.; Cabrera M.; Dodelson de Kremer
R.; Juaneda E.; Larovere L.E.
Institution
(Silvera Ruiz) Centro de Estudio de las Metabolopatias Congenitas
(CEMECO), Hospital de Ninos de la Santisima Trinidad, Facultad de Ciencias
Medicas. Universidad Nacional de Cordoba, Cordoba, Argentina
(Grosso) Universidad Nacional de Cordoba. Facultad de Ciencias Medicas.
Ministerio de Salud de la Provincia de Cordoba. Hospital de Ninos de la
Santisima Trinidad. Centro de Estudio de las Metabolopatias Congenitas
(CEMECO). Cordoba, Argentina. 3 Universidad Nacional de Cordoba. Facultad
de Ciencias Medicas. Catedra de Clinica Pediatrica. Cordoba, Argentina
(Tablada) Universidad Nacional de Cordoba. Facultad de Ciencias
Agropecuarias. Catedra de Estadistica y Biometria. Cordoba, Argentina
(Cabrera, Juaneda) Ministerio de Salud de la Provincia de Cordoba.
Hospital de Ninos de la Santisima Trinidad. Servicio de Cardiologia.
Cordoba, Argentina
(Dodelson de Kremer) Universidad Nacional de Cordoba. Facultad de Ciencias
Medicas. Ministerio de Salud de la Provincia de Cordoba. Hospital de Ninos
de la Santisima Trinidad. Centro de Estudio de las Metabolopatias
Congenitas (CEMECO). Cordoba, Argentina. 3 Universidad Nacional de
Cordoba. Facultad de Ciencias Medicas. Catedra de Clinica Pediatrica.
Cordoba, Argentina
(Larovere) Universidad Nacional de Cordoba. Facultad de Ciencias Medicas.
Ministerio de Salud de la Provincia de Cordoba. Hospital de Ninos de la
Santisima Trinidad. Centro de Estudio de las Metabolopatias Congenitas
(CEMECO). Cordoba, Argentina. 2 Consejo Nacional de Investigacion
Cientifica y Tecnica (CONICET), Ministerio de Ciencia, Tecnologia e
Innovacion. Argentina. 3 Universidad Nacional de Cordoba. Facultad de
Ciencias Medicas. Catedra de Clinica Pediatrica. Cordoba, Argentina
Publisher
NLM (Medline)
Abstract
Introduction: Pulmonary hypertension (PH) is a major cause of
morbi-mortality among patients with congenital heart disease (CHD) and
also a potentially severe complication after surgical repair. Oral
citrulline, a precursor to NO synthesis, is safe and efficacious for
decreasing the risk of postoperative PH. <br/>Objective(s): Objetive: The
aim of the present study was to investigate in pediatric patients the
changes of plasma citrulline, arginine, homocysteine and nitric oxide (NO)
metabolites and pulmonary artery pressures (PAP) pre-post cardiac surgery
in order to describe our population status with regard to the risk of
pulmonary hypertension and look for potential biomarkers for early
detection and treatment. Main results/Discussion: 16 Argentine pediatric
patients with CHD undergoing cardiopulmonary bypass were randomized in two
groups: (A) with and (B) without perioperative citrulline supplementation.
We found that plasma citrulline median levels before surgery were lower in
both groups respect to referential values, probably due to the poor
nutritional status of our patients; only group A surpassed post-surgery
the minimum recommended level to avoid PH. Furthermore, none of the
patients in group A showed mean PAP higher than 20 mmHg, whereas in group
B, 67% of the measurements were >= than the reference level.
<br/>Conclusion(s): We reaffirm that citrulline supplementation it is
effective in reducing postoperative pulmonary hypertension and biomarkers
could evidence patient status as a translational medicine
application.<br/>Copyright Universidad Nacional de Cordoba.

<41>
Accession Number
2010470434
Title
Propofol plus low dose dexmedetomidine infusion and postoperative delirium
in older patients undergoing cardiac surgery.
Source
British Journal of Anaesthesia. (no pagination), 2020. Date of
Publication: 2020.
Author
Momeni M.; Khalifa C.; Lemaire G.; Watremez C.; Tircoveanu R.; Van Dyck
M.; Kahn D.; Rosal Martins M.; Mastrobuoni S.; De Kerchove L.; Zango S.H.;
Jacquet L.-M.
Institution
(Momeni, Khalifa, Lemaire, Watremez, Tircoveanu, Van Dyck, Kahn, Rosal
Martins) Department of Anaesthesiology;, Cliniques Universitaires Saint
Luc, Universite Cathlique de Louvain, Institut de Recherche Experimentale
et Clinique (IREC), Brussels, Belgium
(Mastrobuoni, De Kerchove) Department of Cardiac Surgery;, Cliniques
Universitaires Saint Luc, Universite Cathlique de Louvain, Institut de
Recherche Experimentale et Clinique (IREC), Brussels, Belgium
(Zango) Department of Epidemiology and Statistics;, Cliniques
Universitaires Saint Luc, Universite Cathlique de Louvain, Institut de
Recherche Experimentale et Clinique (IREC), Brussels, Belgium
(Jacquet) Department of Intensive Care Unit;, Cliniques Universitaires
Saint Luc, Universite Cathlique de Louvain, Institut de Recherche
Experimentale et Clinique (IREC), Brussels, Belgium
Publisher
Elsevier Ltd
Abstract
Background: Postoperative delirium (POD) is a frequent complication in
older patients. Dexmedetomidine might be effective in decreasing the
incidence of POD. We hypothesised that adding low dose rate
dexmedetomidine infusion to a propofol sedation regimen would have fewer
side-effects and would counteract the possible delirium producing
properties of propofol, resulting in a lower risk of POD than propofol
with placebo. <br/>Method(s): In this double-blind placebo-controlled
trial, patients >=60 yr old undergoing on-pump cardiac surgery were
randomised 1:1 to the following postoperative sedative regimens: a
propofol infusion and dexmedetomidine (0.4 mug kg^-1
h^-1) or a propofol infusion and saline 0.9% (placebo group).
The study drug was started at chest closure and continued for 10 h. The
primary endpoint was in-hospital POD, assessed using the Confusion
Assessment Method and chart review method. <br/>Result(s): POD over the
course of hospital stay occurred in 31/177 (18%) and 33/172 (19%) patients
in the dexmedetomidine and placebo arm, respectively (P=0.687; odds
ratio=0.89; 95% confidence interval, 0.52-1.54). The incidence of POD in
the intensive care alone, or on the ward alone, was also not significantly
different between the groups. Subjects in the dexmedetomidine group spent
less median time in a delirious state (P=0.026). Median administered
postoperative norepinephrine was significantly higher in the
dexmedetomidine group (P<0.001). One patient in the dexmedetomidine group
and 10 patients in the placebo group died in the hospital.
<br/>Conclusion(s): Adding low dose rate dexmedetomidine to a sedative
regimen based on propofol did not result in a different risk of
in-hospital delirium in older patients undergoing cardiac surgery. With a
suggestion of both harm and benefit in secondary outcomes, supplementing
postoperative propofol with dexmedetomidine cannot be recommended based on
this study. Clinical trial registration: NCT03388541.<br/>Copyright &#xa9;
2020 British Journal of Anaesthesia

<42>
Accession Number
2005781545
Title
Sarcopenia in Patients Undergoing Transcatheter Aortic Valve Implantation
(TAVI): A Systematic Review of the Literature.
Source
Journal of Nutrition, Health and Aging. (no pagination), 2020. Date of
Publication: 2020.
Author
Bertschi D.; Kiss C.M.; Schoenenberger A.W.; Stuck A.E.; Kressig R.W.
Institution
(Bertschi, Kiss, Kressig) University Department of Geriatric Medicine
FELIX PLATTER, Burgfelderstrasse 101, Basel 4055, Switzerland
(Bertschi, Schoenenberger, Stuck) Department of Geriatrics, Inselspital,
Bern University Hospital, University of Bern, Bern, Switzerland
Publisher
Serdi-Editions
Abstract
Background: In older patients, sarcopenia is a prevalent disease
associated with negative outcomes. Sarcopenia has been investigated in
patients undergoing transcatheter aortic valve implantation (TAVI), but
the criteria for diagnosis of the disease are heterogeneous. This
systematic review of the current literature aims to evaluate the
prevalence of sarcopenia in patients undergoing TAVI and to analyse the
impact of sarcopenia on clinical outcomes. <br/>Method(s): A comprehensive
search of the literature has been performed in electronic databases from
the date of initiation until March 2020. Using a pre-defined search
strategy, we identified studies assessing skeletal muscle mass, muscle
quality and muscle function as measures for sarcopenia in patients
undergoing TAVI. We evaluated how sarcopenia affects the outcomes
mortality at >=1 year, prolonged length of hospital stay, and functional
decline. <br/>Result(s): We identified 18 observational studies, enrolling
a total number of 9'513 patients. For assessment of skeletal muscle mass,
all included studies used data from computed tomography. Cutoff points for
definition of low muscle mass were heterogeneous, and prevalence of
sarcopenia varied between 21.0% and 70.2%. In uni- or multivariate
regression analysis of different studies, low muscle mass was found to be
a significant predictor of mortality, prolonged length of hospital stay,
and functional decline. No interventional study was identified measuring
the effect of nutritional or physiotherapy interventions on sarcopenia in
TAVI patients. <br/>Conclusion(s): Sarcopenia is highly prevalent among
patients undergoing TAVI, and negatively affects important outcomes. Early
diagnosis of this condition might allow a timely start of nutritional and
physiotherapy interventions to prevent negative outcomes in TAVI
patients.<br/>Copyright &#xa9; 2020, Serdi and Springer-Verlag
International SAS, part of Springer Nature.

<43>
Accession Number
2010152247
Title
Regional anaesthesia quality indicators for adult patients undergoing
non-cardiac surgery: a systematic review.
Source
Anaesthesia. 76 (S1) (pp 89-99), 2021. Date of Publication: January 2021.
Author
Hamilton G.M.; MacMillan Y.; Benson P.; Memtsoudis S.; McCartney C.J.L.
Institution
(Hamilton, McCartney) Department of Anaesthesiology and Pain Medicine,
University of Ottawa, ON, Canada
(MacMillan, Benson) Department of Medicine, University of Ottawa, ON,
Canada
(Memtsoudis) Department of Anaesthesiology, Hospital for Special Surgery,
Weill Cornell Medical College, New York, NY, United States
Publisher
Blackwell Publishing Ltd
Abstract
Improvement in healthcare delivery depends on the ability to measure
outcomes that can direct changes in the system. An overview of quality
indicators within the field of regional anaesthesia is lacking. This
systematic review aims to synthesise available quality indicators, as per
the Donabedian framework, and provide a concise overview of evidence-based
quality indicators within regional anaesthesia. A systematic literature
search was conducted using the databases MEDLINE, Embase, CINAHL and
Cochrane from 2003 to present, and a prespecified search of regional
anaesthesia society websites and healthcare quality agencies. The quality
indicators relevant to regional anaesthesia were subdivided into
peri-operative structure, process and outcome indicators as per the
Donabedian framework. The methodological quality of the indicators was
determined as per the Oxford Centre for Evidence-Based Medicine's
framework. Twenty manuscripts met our inclusion criteria and, in total, 68
unique quality indicators were identified. There were 4 (6%) structure, 12
(18%) process and 52 (76%) outcome indicators. Most of the indicators were
related to the safety (57%) and effectiveness (19%) of regional
anaesthesia and were general in nature (60%). In addition, most indicators
(84%) were based on low levels of evidence. Our study is an important
first step towards describing quality indicators for the provision of
regional anaesthesia. Future research should focus on the development of
structure and process quality indicators and improving the methodological
quality and usability of these indicators.<br/>Copyright &#xa9; 2021
Association of Anaesthetists

<44>
Accession Number
633877836
Title
Safety and Efficacy of Using Tranexamic Acid at the Beginning of
Robotic-Assisted Radical Prostatectomy in a Double-Blind Prospective
Randomized Pilot Study.
Source
Acta medica (Hradec Kralove). 63 (4) (pp 176-182), 2020. Date of
Publication: 2020.
Author
Balik M.; Kosina J.; Husek P.; Brodak M.; Cecka F.
Institution
(Balik, Kosina, Husek, Brodak) Department of Urology, Faculty of Medicine
and University Hospital Hradec Kralove, Czechia
(Cecka) Department of Surgery, Faculty of Medicine and University Hospital
Hradec Kralove, Czechia
Publisher
NLM (Medline)
Abstract
BACKGROUND: The prophylactic administration of tranexamic acid has been
shown to be appropriate for procedures with a high risk of perioperative
bleeding in cardiac surgery and orthopaedics. In urology the ambiguous
results have been reported. Our goal was to evaluate the effect of
tranexamic acid administration in robotic-assisted radical prostatectomy
(RARP). A pilot, prospective, double-blind, randomized study was conducted
to evaluate this effect. <br/>METHOD(S): The study included 100 patients
who received RARP in the period from April 2017 to January 2018. The
patients were randomly assigned to study and control groups of 50 patients
each. <br/>RESULT(S): The median follow-up was 6 months. Lower haemoglobin
level drop weighted for gram of operated prostate was observed in the
study group when treating the dorsal vein complex (DVC) at the beginning
of the procedure (p = 0.004 after 3 hours and p < 0.001 after 24 hours).
There was no evidence of any serious side effect of tranexamic acid.
<br/>CONCLUSION(S): We demonstrated the safety of tranexamic acid at RARP.
In addition, we showed that administration of tranexamic acid at the
beginning of RARP significantly reduces the decrease in haemoglobin after
the procedure when treating the DVC at the beginning of the procedure.

<45>
Accession Number
2010150957
Title
Expanding enhanced recovery protocols for cardiac surgery to include the
patient voice: a scoping review protocol.
Source
Systematic Reviews. 10 (1) (no pagination), 2021. Article Number: 22. Date
of Publication: December 2021.
Author
Oravec N.; Arora R.C.; Bjorklund B.; Gregora A.; Monnin C.; Duhamel T.A.;
Kent D.E.; Schultz A.S.H.; Chudyk A.M.
Institution
(Oravec, Arora) Department of Surgery, Rady Faculty of Health Sciences,
Max Rady College of Medicine, University of Manitoba, AE101-820 Sherbrook
Street, Winnipeg, MB R3A 1R9, Canada
(Arora, Kent) Cardiac Sciences Program, CR 1005-St. Boniface Hospital, 369
Tache Avenue, Winnipeg, MB R2H 2A6, Canada
(Bjorklund, Gregora) Enhanced Recovery Protocols for Cardiac Surgery
Patient Researcher Group, St. Boniface Hospital, 369 Tache Avenue,
Winnipeg, MB R2H 2A6, Canada
(Monnin) Neil John Maclean Health Sciences Library, University of
Manitoba, 727 McDermot Avenue, Winnipeg R3E 3P5, Canada
(Duhamel) Faculty of Kinesiology and Recreation Management, 208 Active
Living Centre, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
(Duhamel) Institute of Cardiovascular Sciences, St. Boniface General
Hospital Albrechtsen Research Centre, 351 Tache Avenue, Winnipeg, MB R2H
2A6, Canada
(Schultz) College of Nursing, Rady Faculty of Health Sciences, University
of Manitoba, 89 Curry Place, Winnipeg, MB R3T 2 N2, Canada
(Schultz, Chudyk) Health Services & Structural Determinants of Health
Research, St. Boniface Research Centre, Winnipeg, Canada
(Chudyk) Department of Family Medicine, Rady Faculty of Health Sciences,
University of Manitoba, 454-6 - 753 McDermot Avenue, Winnipeg, MB R3E 0
T6, Canada
Publisher
BioMed Central Ltd
Abstract
Background: Cardiac surgery is becoming increasingly common in older, more
vulnerable adults. A focus on timely and complete medical and functional
recovery has led to the development of enhanced recovery protocols (ERPs)
for a number of surgical procedures and subspecialties, including cardiac
surgery (ERAS Cardiac). An element that is often overlooked in the
development and implementation of ERPs is the involvement of key
stakeholder groups, including surgery patients and caregivers (e.g.,
family and/or friends). The aim of this study is to describe a protocol
for a scoping review of cardiac patient and caregiver preferences and
outcomes relevant to cardiac surgery ERPs. <br/>Method(s): Using Arksey
and O'Malley's et al six-stage framework for scoping review methodologies
with adaptions from Levac et al. (Represent Interv: 1-18, 2012), a scoping
review of existing literature describing patient- and caregiver-identified
preferences and outcomes as they relate to care received in the
perioperative period of cardiac surgery will be undertaken. The search for
relevant articles will be conducted using electronic databases (i.e., the
Cochrane Library, Medline, PsycINFO, Scopus, and Embase), as well as
through a search of the grey literature (e.g., CPG Infobase, Heart and
Stroke Foundation, ProQuest Theses and Dissertations, Google Advanced, and
Prospero). Published and unpublished full-text articles written in
English, published after the year 2000, and that relate to the research
question will be included. Central to the design of this scoping review is
our collaboration with two patient partners who possess lived experience
as cardiac surgery patients. <br/>Discussion(s): This review will identify
strategies that can be integrated into ERPs for cardiac surgery which
align with patient- and caregiver-defined values. Broadly, it is our goal
to demonstrate the added value of patient engagement in research to aid in
the success of system change processes.<br/>Copyright &#xa9; 2021, The
Author(s).

<46>
Accession Number
2010153038
Title
Does the clinical effectiveness of Mitraclip compare with surgical repair
for mitral regurgitation?.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Khader A.A.; Allaf M.; Lu O.W.; Lazopoulos G.; Moscarelli M.; Kendall S.;
Salmasi M.Y.; Athanasiou T.
Institution
(Khader, Allaf) Department of Medicine, Imperial College London, London,
United Kingdom
(Lu) Division of Biosciences, University College London, London, United
Kingdom
(Lu) Faculty of Medicine, Dentistry and Health Sciences, Melbourne Medical
School, University of Melbourne, Melbourne, VIC, Australia
(Lazopoulos) Department of Cardio-thoracic Surgery, University Hospital of
Heraklion, Crete, Greece
(Moscarelli) Department of Cardiovascular Surgery, GVM Care and Research,
Lugo, Ravenna, Italy
(Kendall) Deparment of Cardiothoracic Surgery, James Cook University
Hospital, Middlesbrough, United Kingdom
(Salmasi, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
Publisher
Blackwell Publishing Inc.
Abstract
Background: Surgical repair of the mitral valve has long been the
established therapy for degenerative mitral regurgitation (MR). Newer
transcatheter methods over the last decade, such as the MitraClip, serve
to restore mitral function with reduced procedural burden and enhanced
recovery. This study aims to compare the shortterm and midterm outcomes of
MitraClip insertion with surgical repair for MR. <br/>Method(s): A
systematic review of the literature was conducted for studies comparing
outcomes between surgical repair and MitraClip. The initial search
returned 1850 titles, from which 12 studies satisfied the inclusion
criteria (one randomized controlled trial and 11 retrospective studies).
<br/>Result(s): The final analysis comprised 4219 patients (MitraClip
1210; surgery 3009). Operative mortality was not different between the
groups (odds ratio [OR] = 1.63, 95% confidence interval [CI]: [0.63-4.23];
p =.317). Length of hospital stay was significantly shorter in the
MitraClip group (standardized mean difference [SMD] = 0.882, 95% CI:
[0.77-0.99]; p <.001) with considerable heterogeneity (I² >
90%; p <.001). The rate of reoperation on the mitral valve was lower in
the surgical group (OR = 0.392; 95% CI: [0.188-0.817]; p =.012) as was the
rate of MR recurrence grade moderate or above (OR = 0.29; 95% CI:
[0.19-0.46]; p <.001) during midterm follow up. Long term survival (4-5
years) was also similar between both groups (hazard ratio = 0.70; 95% CI:
[0.35-1.41]; p =.323). <br/>Conclusion(s): This study highlights the
superior midterm durability of surgical valve repair for MR compared with
the MitraClip.<br/>Copyright &#xa9; 2021 The Authors. Journal of Cardiac
Surgery published by Wiley Periodicals LLC

<47>
Accession Number
633884405
Title
Long-term and short-term outcomes of robot- versus video-assisted anatomic
lung resection in lung cancer: a systematic review and meta-analysis.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2020.
Date of Publication: 23 Dec 2020.
Author
Wu H.; Jin R.; Yang S.; Park B.J.; Li H.
Institution
(Wu, Jin, Yang, Li) Department of Thoracic Surgery, Ruijin Hospital,
Shanghai Jiaotong University School of Medicine, Shanghai, China
(Park) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, NY, NY, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Minimally invasive thoracic surgery has evolved with the
introduction of robotic platforms. This study aimed to compare the
long-term and short-term outcomes of the robot-assisted thoracic surgery
(RATS) and video-assisted thoracic surgery (VATS) for anatomic lung
resection. <br/>METHOD(S): We searched published studies that investigated
RATS and VATS in anatomic lung resection. Long-term outcomes (disease-free
survival and overall survival) and short-term outcomes (30-day mortality,
postoperative complications, conversion rate to open surgery and lymph
node upstaging) were extracted. The features were compared and tested as
hazard ratios (HRs) and odds ratios (ORs) at a 95% confidence interval
(CI). <br/>RESULT(S): Twenty-five studies with 50 404 patients (7135 for
RATS and 43 269 for VATS) were included. The RATS group had a longer
disease-free survival than the VATS group (HR: 0.76; 95% CI: 0.59-0.97;
P=0.03), and the overall survival showed a similar trend but was not
statistically significant (HR: 0.77; 95% CI: 0.57-1.05; P=0.10). The RATS
group showed a significantly lower 30-day mortality (OR: 0.55; 95% CI:
0.38-0.81; P=0.002). No significant difference was found in postoperative
complications (OR: 1.01; 95% CI: 0.87-1.16; P=0.94), the conversion rate
to open surgery (OR: 0.92; 95% CI: 0.56-1.52; P=0.75) and lymph node
upstaging (OR: 0.89; 95% CI: 0.52-1.54; P=0.68). <br/>CONCLUSION(S): RATS
has comparable short-term outcomes and potential long-term survival
benefits for anatomic lung resection compared with VATS.<br/>Copyright
&#xa9; The Author(s) 2020. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<48>
Accession Number
633884353
Title
Post-operative pain following cardiac implantable electronic device
implantation: insights from the BRUISE CONTROL trials.
Source
Europace : European pacing, arrhythmias, and cardiac electrophysiology :
journal of the working groups on cardiac pacing, arrhythmias, and cardiac
cellular electrophysiology of the European Society of Cardiology. (no
pagination), 2020. Date of Publication: 28 Dec 2020.
Author
Nair G.M.; Birnie D.H.; Sumner G.L.; Krahn A.D.; Healey J.S.; Nery P.B.;
Kalfon E.; Verma A.; Ayala-Paredes F.; Coutu B.; Becker G.; Philippon F.;
Eikelboom J.; Sandhu R.K.; Sapp J.; Leather R.; Yung D.; Thibault B.;
Simpson C.S.; Ahmad K.; Sturmer M.; Kavanagh K.; Crystal E.; Wells G.A.;
Essebag V.
Institution
(Nair, Birnie, Nery, Wells) Arrhythmia Service, Division of Cardiology,
University of Ottawa Heart Institute, Ottawa ON K1Y 4W7, Canada
(Sumner, Sandhu, Kavanagh) Department of Medicine, University of Calgary,
Libin Cardiovascular Institute, AB, Calgary, Canada
(Krahn) Department of Medicine, University of British Columbia, Vancouver,
Canada
(Healey, Eikelboom) Division of Cardiology, Department of Medicine,
McMaster University, Hamilton Health Sciences, Population Health Research
Institute, ON, Hamilton, Canada
(Kalfon) Department of Medicine, Galilee Medical Center, Israel
(Verma) Department of Medicine, Southlake Regional Health Center,
University of Toronto, ON, Toronto, Canada
(Ayala-Paredes) Department of Medicine, Universite de Sherbrooke, QC,
Sherbrooke, Canada
(Coutu) Department of Medicine, Centre Hospitalier de l'Universite de
Montreal, Hopital Hotel-Dieu, QC, Montreal, Canada
(Becker) Department of Medicine, McGill University Health Center, QC,
Montreal, Canada
(Philippon) Department of Medicine, Quebec Heart Institute, Sainte-Foy,
QC, Canada
(Sapp) Department of Medicine, QEII Health Sciences Centre, Halifax, NS,
Canada
(Leather, Yung) Scarborough Health Network, University of Toronto, ON,
Toronto, Canada
(Thibault) Division of Cardiology, Department of Medicine, QC, Canada
(Simpson) Department of Medicine, Queen's University, ON, Kingston, Canada
(Ahmad) Department of Medicine, University of Toronto, ON, Toronto, Canada
(Sturmer, Essebag) Division of Cardiology, Department of Medicine,
University of Calgary, Libin Cardiovascular Institute, AB, Calgary, Canada
(Crystal) Department of Medicine, Sunnybrook Health Sciences Center,
University of Toronto, ON, Toronto, Canada
Publisher
NLM (Medline)
Abstract
AIMS : Post-operative pain following cardiac implantable electronic device
(CIED) insertion is associated with patient dissatisfaction, emotional
distress, and emergency department visits. We sought to identify factors
associated with post-operative pain and develop a prediction score for
post-operative pain. METHODS AND RESULTS : All patients from the BRUISE
CONTROL-1 and 2 trials were included in this analysis. A validated Visual
Analogue Scale (VAS) was used to assess the severity of pain related to
CIED implant procedures. Patients were asked to grade the most severe
post-operative pain, average post-operative pain, and pain on the day of
the first post-operative clinic. Multivariable regression analyses were
performed to identify predictors of significant post-operative pain and to
develop a pain-prediction score. A total of 1308 patients were included.
Multivariable regression analysis found that the presence of
post-operative clinically significant haematoma {CSH; P value < 0.001;
odds ratio (OR) 3.82 [95% confidence interval (CI): 2.37-6.16]}, de novo
CIED implantation [P value < 0.001; OR 1.90 (95% CI: 1.47-2.46)], female
sex [P value < 0.001; OR 1.61 (95% CI: 1.22-2.12)], younger age [<65years;
P value < 0.001; OR 1.54 (95% CI: 1.14-2.10)], and lower body mass index
[<20kg/m2; P value < 0.05; OR 2.05 (95% CI: 0.98-4.28)] demonstrated
strong and independent associations with increased post-operative pain. An
11-point post-operative pain prediction score was developed using the
data. CONCLUSION : Our study has identified multiple predictors of
post-operative pain after CIED insertion. We have developed a prediction
score for post-operative pain that can be used to identify individuals at
risk of experiencing significant post-operative pain.<br/>Copyright
Published on behalf of the European Society of Cardiology. All rights
reserved. &#xa9; The Author(s) 2020. For permissions, please email:
journals.permissions@oup.com.

<49>
Accession Number
633881855
Title
Suture- or Plug-Based Large-Bore Arteriotomy Closure: A Pilot Randomized
Controlled Trial.
Source
JACC. Cardiovascular interventions. (no pagination), 2020. Date of
Publication: 16 Dec 2020.
Author
van Wiechen M.P.; Tchetche D.; Ooms J.F.; Hokken T.W.; Kroon H.; Ziviello
F.; Ghattas A.; Siddiqui S.; Laperche C.; Spitzer E.; Daemen J.; de
Jaegere P.P.; Dumonteil N.; Van Mieghem N.M.
Institution
(van Wiechen, Ooms, Hokken, Kroon, Ziviello, Spitzer, Daemen, de Jaegere)
Department of Cardiology, Erasmus University Medical Center, Rotterdam,
Netherlands
(Tchetche, Ghattas, Siddiqui, Laperche, Dumonteil) Department of
Cardiology, Clinique Pasteur, Toulouse, France
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The authors sought to test the superiority in terms of
efficacy and safety of a dedicated plug-based vascular closure device
(VCD) during transcatheter aortic valve replacement (TAVR) over a
suture-based VCD. BACKGROUND: Vascular complications after TAVR are
relevant and often associated with VCD failure. <br/>METHOD(S): The MASH
trial (MANTA vs. Suture-based vascular closure after transcatHeter aortic
valve replacement) is an international, 2-center pilot randomized
controlled trial comparing the MANTA VCD (Teleflex, Wayne, Pennsylvania)
versus 2 ProGlides (Abbott Vascular, Abbott Park, Illinois). The primary
composite endpoint consisted of access site-related major or minor
vascular complications at 30-days' follow-up. Secondary endpoints included
clinically relevant access site bleeding, time to hemostasis, and modified
VCD failure (defined as failure to achieve hemostasis within 5 min or
requiring additional endovascular maneuvers such as endovascular stenting,
surgical techniques, or additional closure devices). Adverse events were
adjudicated by an independent clinical events committee according to the
VARC-2 definitions. <br/>RESULT(S): A total of 210 TAVR patients were
included between October 2018 and January 2020. Median age was 81 years,
54% were male, and the median STS score was 2.7%. There was no significant
difference in the primary endpoint of access site-related vascular
complications between MANTA and ProGlide (10% vs. 4%; p = 0.16).
Clinically significant access site bleedings were similar with both
closure techniques (9% vs. 6%; p = 0.57). Modified VCD failure occurred
less frequently in MANTA versus ProGlide (20% vs. 40%; p < 0.01).
Suture-based closure required more often additional closure devices,
whereas MANTA numerically needed more covered stents and surgical
bailouts. <br/>CONCLUSION(S): Plug-based large-bore arteriotomy closure
was not superior to suture-based closure. Plug-based closure required
fewer, but a different kind of bailout maneuvers.<br/>Copyright &#xa9;
2020 American College of Cardiology Foundation. Published by Elsevier Inc.
All rights reserved.

<50>
Accession Number
633881844
Title
Coronary Artery Bypass Grafting Transit-Time Flow Measurement: Graft
Patency and Clinical Outcomes.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 22 Dec 2020.
Author
Quin J.A.; Noubani M.; Rove J.Y.; Krstacic J.E.; Hattler B.; Collins J.F.;
Grover F.L.; Almassi G.H.; Shroyer A.L.
Institution
(Quin) VA Boston Healthcare System, West Roxbury MA; Harvard Medical
School, Boston MA
(Noubani, Krstacic, Shroyer) Northport VA Medical Center, Northport, NY;
Stony Brook University, Stony Brook, NY
(Rove, Grover) Rocky Mountain Regional VA Medical Center, Aurora, CO;
Division of Cardiothoracic Surgery, Department of Surgery, University of
Colorado School of Medicine, Aurora, CO
(Hattler) Rocky Mountain Regional VA Medical Center, Aurora, CO; Division
of Cardiology, Department of Medicine, University of Colorado School of
Medicine, Aurora, CO
(Collins) VA Cooperative Studies Program, Perry Point MD
(Almassi) Clement J. Zablocki VA Medical Center, Milwaukee, WI; Medical
College of Wisconsin, Milwaukee, WI
Publisher
NLM (Medline)
Abstract
BACKGROUND: This Randomized On-Off Bypass (ROOBY) Trial sub-analysis
examined transit time flow measurement (TTFM) use and its impact on graft
patency and long-term clinical outcomes after coronary artery bypass
grafting (CABG). <br/>METHOD(S): TTFM use for ROOBY centers and surgeons
was assessed. Comparative patient outcomes, based on TTFM use, included
1-year graft patency and 1-year and 5-year major adverse cardiac events
(MACE): all-cause mortality, non-fatal myocardial infarction (MI), and
revascularization (percutaneous coronary intervention (PCI) or repeat
CABG). <br/>RESULT(S): TTFM was used in 1,067 patients (TTFM group) and
not used in 501 patients (non-TTFM group); of the TTFM group, median
percentage TTFM use was 82% (IQR 53-98%) among 18 VA centers and 78% (IQR
9.2-97%) among 44 surgeons. Patients were comparable in age (63 +/-8.5
TTFM vs. 62 +/-8.0 non-TTFM; p=0.30) and estimated 30-day mortality risk
(1.8+/-1.7 TTFM vs. 1.9 non-TTFM, p=0.53). One-year Fitzgibbon A patency
was 83 % (1600/1988 grafts) for TTFM assessed grafts and 78% (629/803) for
non-TTFM assessed grafts (p<0.01). Fewer TTFM patients had an occluded
graft (29% vs. 38% non- TTFM, p=0.01). Comparing TTFM to non-TTFM
patients, five-year MACE rates were 30% vs. 25%, p = 0.06. Individual
component rates were 14% vs. 11% for death (p=0.06), 12% vs. 8.8% for MI
(p=0.07), and 13% vs. 12% for revascularization (p=0.62).
<br/>CONCLUSION(S): The association of TTFM use with graft patency and
clinical outcome is uncertain. Future, randomized studies which account
for patient risk factors and practice variation would help address this
knowledge gap.<br/>Copyright &#xa9; 2020. Published by Elsevier Inc.

<51>
Accession Number
633881375
Title
Bariatric Surgery in Patients with Obesity and Ventricular Assist Devices
Considered for Heart Transplantation: Systematic Review and Individual
Participant Data Meta-analysis.
Source
Journal of cardiac failure. (no pagination), 2020. Date of Publication: 21
Dec 2020.
Author
deAbreu A.D.; Alhafez B.A.; Curbelo-Pena Y.; Lavie C.J.; Ventura H.O.;
Loro-Ferrer J.F.; Mandras S.A.
Institution
(deAbreu) John Ochsner Heart and Vascular Institute, Ochsner Clinic
Foundation, New Orleans, LA, USA; The University of Queensland Ochsner
Clinical School, New Orleans, LA, USA; Doctoral School, Universidad de Las
Palmas de Gran Canaria, Las Palmas, Spain. Electronic address:
adrianjdasilva@gmail.com
(Alhafez) Department of Internal Medicine, The Ohio State University,
Columbus, OH, USA
(Curbelo-Pena) Service of General Surgery, Consorci Sanitari de l'Alt
Penedes i Garraf, Barcelona, Spain
(Lavie, Ventura, Mandras) John Ochsner Heart and Vascular Institute,
Ochsner Clinic Foundation, New Orleans, LA, USA; The University of
Queensland Ochsner Clinical School, New Orleans, LA, USA
(Loro-Ferrer) Doctoral School, Universidad de Las Palmas de Gran Canaria,
Las Palmas, Spain
Publisher
NLM (Medline)
Abstract
BACKGROUND: Class II obesity (>= 35 kg/m2) is a contraindication for heart
transplantation (HT). Although few single-center studies (case
reports/series and small cohorts) have reported promising outcomes of
bariatric surgery (BS) in patients with obesity and ventricular assist
devices (VADs), low sample sizes have made their analysis and
interpretation challenging. <br/>METHOD(S): We conducted a systematic
search in ClinicalTrials.gov, Cochrane, Embase, PubMed, Google Scholar,
and most relevant bariatric and heart failure journals. We extracted
baseline and outcome individual participant data for every VAD patient
undergoing BS with reported postoperative BMI and their respective
timepoints when BMI data were measured. <br/>RESULT(S): Fourteen
references with 29 patients were included. The mean age was 41.9 (+/-
12.2) years, 82.8% underwent laparoscopic sleeve gastrectomy, and 39.3%
had reported perioperative adverse events. Mean pre-BS BMI was 45.5 (+/-
6.6) kg/m2 and decrease significantly during follow-up (rho -0.671; p <
0.00001). Among 23 patients with documented listing status, 78.3% got
listed for HT. Thirteen (46.4%) of 28 patients underwent HT at 14.4 (+/-
7) months. There were no reported deaths for the HT-free 1-year period.
Median follow-up was 24 (12-30) months. Twenty-two (78.6%) of 28 patients
achieved the composite outcome (BMI < 35 kg/m2/HT/listing for
HT/myocardial recovery) at 11 (3-17) months. Patients with non-ischemic
cardiomyopathy or BMI < 45 kg/m2 had higher chances of achieving the
composite outcome (p values < 0.05). <br/>CONCLUSION(S): Bariatric surgery
may help patients with obesity and VADs to lose significant amount of
weight and improve their candidacy for HT or even achieve myocardial
recovery.<br/>Copyright &#xa9; 2020. Published by Elsevier Inc.

<52>
Accession Number
633880540
Title
Transcatheter Aortic Valve Implantation in Bicuspid Aortic Valve with
Aortic Stenosis: a Meta-Analysis and Trial Sequential Analysis.
Source
Brazilian journal of cardiovascular surgery. (no pagination), 2020. Date
of Publication: 23 Dec 2020.
Author
Chan J.S.K.; Singh S.; Eriksen P.; Ultimos P.; Tsui L.H.; Harky A.
Institution
(Chan) Division of Cardiology, Department of Medicine and Therapeutics,
Prince of Wales Hospital, Shatin, New Territories, Hong Kong
(Chan, Singh) Faculty of Medicine, The Chinese University of Hong Kong,
Shatin, New Territories, Hong Kong
(Eriksen) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
(Ultimos) Afiliacao
(Tsui) Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, United Kingdom
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Bicuspid aortic valve (BAV) is an important aetiology of
aortic stenosis and the use of transcatheter aortic valve implantation
(TAVI) has not been fully explored in this cohort. This systematic review
and meta-analysis compared the outcomes of TAVI in stenotic BAV against
tricuspid aortic valve (TAV). <br/>METHOD(S): An electronic literature
search was performed in PubMed, MEDLINE, EMBASE, and Scopus to identify
all studies comparing TAVI in stenotic BAV versus TAV. Only studies
comparing TAVI in BAV versus TAV were included, without any limit on the
study date. Primary endpoints were 30-day and 1-year mortality, while
secondary endpoints were postoperative rates of stroke, acute kidney
injury (AKI), and permanent pacemaker (PPM) requirement. A trial
sequential analysis (TSA) was performed for all endpoints to understand
their significance. <br/>RESULT(S): Thirteen studies met the inclusion
criteria (917 BAV and 3079 TAV patients). The BAV cohort was younger
(76.8+/-7.43 years vs. 78.5+/-7.12 years, P=0.02), had a higher
trans-aortic valve gradient (P=0.02), and larger ascending aortic
diameters (P<0.0001). No significant difference was shown for primary
(30-day mortality [P=0.45] and 1-year mortality [P=0.41]) and secondary
endpoints (postoperative stroke [P=0.49], AKI [P=0.14], and PPM
requirement [P=0.86]). The BAV group had a higher rate of significant
postoperative aortic regurgitation (P=0.002). TSA showed that there was
sufficient evidence to conclude the lack of difference in PPM
requirements, and 30-day and 1-year mortality between the two cohorts.
<br/>CONCLUSION(S): TAVI gives satisfactory outcomes for treating stenotic
BAV and should be considered clinically.

<53>
Accession Number
633876046
Title
Incidence and prevalence of pressure injury in adult cardiac patients
admitted to intensive care: A systematic review and meta-analysis.
Source
International journal of nursing studies. 114 (pp 103826), 2020. Date of
Publication: 15 Nov 2020.
Author
Fulbrook P.; Mbuzi V.; Miles S.
Institution
(Fulbrook) Nursing Research and Practice Development Centre, The Prince
Charles Hospital, Level 5 Clinical Sciences Building, Chermside, Brisbane,
Queensland 4032, Australia; School of Nursing, Midwifery and Paramedicine,
Australian Catholic University, Brisbane, Australia; Faculty of Health
Sciences, University of the Witwatersrand, Johannesburg, South Africa
(Mbuzi) Nursing Research and Practice Development Centre, The Prince
Charles Hospital, Level 5 Clinical Sciences Building, Chermside, Brisbane,
Queensland 4032, Australia; Adult Intensive Care Services, The Prince
Charles Hospital, Brisbane, Australia
(Miles) Nursing Research and Practice Development Centre, The Prince
Charles Hospital, Level 5 Clinical Sciences Building, Chermside, Brisbane,
Queensland 4032, Australia; School of Nursing, Midwifery and Paramedicine,
Australian Catholic University, Brisbane, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Pressure injury is recognised as an adverse event occurring in
healthcare settings. Patients in intensive care are at high risk of
developing a pressure injury. Cardiac patients are also among those at
higher risk. <br/>OBJECTIVE(S): To systematically assess the incidence and
prevalence of pressure injury in adult cardiac patients admitted to
intensive care. DESIGN: Systematic review and meta-analysis of incidence
and prevalence REVIEW METHODS: Articles published in English between 2009
and 2018, reporting pressure injury as a primary outcome were selected
based on inclusion criteria. Two authors assessed study bias and extracted
data, with a third reviewer as arbitrator. A random effects meta-analysis
was conducted. Sub-group meta-analyses were conducted to investigate
potential causes of heterogeneity. <br/>RESULT(S): Fifteen studies met the
criteria for inclusion in the systematic review, of which 14 were
incidence studies. Heterogeneity was significant and there was large
observed variance between studies. The 95% confidence interval of
cumulative incidence across all 14 studies, with an overall sample size of
6371, was 9.8-25.6%. In 11 studies that included all-stage pressure injury
the 95% confidence interval was 8.3-28.3%. In seven studies in which Stage
1 pressure injury was excluded, the 95% confidence interval was 5.8-22.7%.
In the single prevalence study included, which excluded Stage 1 pressure
injury, prevalence was 8.8%. <br/>CONCLUSION(S): The incidence of pressure
injury in cardiac intensive care patients was similar to that found in
general intensive care patients. However, our results suggest that the
incidence may be significantly higher in cardiac surgical patients
admitted to intensive care. There were significant differences across the
various studies in the ways in which data were collected and reported.
Further well-designed studies are required to better understand incidence
in this population, using standardised methods of data collection and
reporting.<br/>Copyright &#xa9; 2020. Published by Elsevier Ltd.

<54>
Accession Number
2007334265
Title
Association of Adenosine Diphosphate-Induced Platelet Maximum Amplitude
With Postoperative Bleeding and Blood Transfusions in Patients Undergoing
Coronary Artery Bypass Grafting.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (2) (pp 421-428),
2021. Date of Publication: February 2021.
Author
Tian L.; Gao X.; Yang J.; Yao Y.; Ji H.
Institution
(Tian, Yang, Yao, Ji) Department of Anesthesiology, State Key Laboratory
of Cardiovascular Disease, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Gao, Ji) Department of Transfusion Medicine, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
Publisher
W.B. Saunders
Abstract
Objectives: To investigate the association of adenosine diphosphate
(ADP)-induced platelet maximum amplitude (MA<inf>ADP</inf>) with
postoperative bleeding and blood product transfusions in patients
undergoing coronary artery bypass grafting (CABG) with cardiopulmonary
bypass (CPB). <br/>Design(s): This single-center observational study
recruited 200 patients who underwent elective, first-time, isolated CABG
with CPB. A rapid thromboelastography with platelet mapping test was
conducted for all patients before the surgery. Patients were categorized
by the preoperative MA<inf>ADP</inf> into <=50 mm (MA<inf>ADP</inf> <=50
group [n = 87]) and MA<inf>ADP</inf> >50 mm (MA<inf>ADP</inf> >50 group [n
= 113]). The primary outcome was postoperative bleeding at 6 and 24 hours
as measured by chest tube drainage volume. The perioperative blood product
transfusions, postoperative complications, postoperative time course, and
in-hospital mortality also were evaluated. <br/>Setting(s): University
hospital. <br/>Participant(s): Adult patients scheduled to undergo
isolated primary CABG with CPB. <br/>Intervention(s): None.
<br/>Measurements and Main Results: The study included 200 patients who
underwent CABG with CPB. MA<inf>ADP</inf> was >50 mm in 113 (56.5%)
patients (MA<inf>ADP</inf> >50 group). Compared with the MA<inf>ADP</inf>
>50 group, the postoperative chest tube drainage volume at 6 and 24 hours
was significantly greater in the patients with MA<inf>ADP</inf> <=50 mm
(476.90 +/- 156.36 mL v 403.36 +/- 133.24 mL; p < 0.001 and 935.86 +/-
318.43 mL v 667.21 +/- 222.75 mL; p < 0.001, respectively). The
consumption of blood products in patients with MA<inf>ADP</inf> <=50 mm
was significantly more than those with MA<inf>ADP</inf> >50 mm. The
durations of intensive care unit stay and length of postoperative hospital
stay were markedly longer in the MA<inf>ADP</inf> <=50 group than in the
MA<inf>ADP</inf> >50 group (p = 0.001 and p = 0.005; respectively). There
were no significant differences in adverse outcomes between the 2 groups
except for the postoperative atrial fibrillation, which occurred more in
the MA<inf>ADP</inf> <=50 group than in the MA<inf>ADP</inf> >50 group
(8.05% v 1.77%; p = 0.043). MA<inf>ADP</inf> (area under the receiver
operating characteristic curve of 0.767; p < 0.001) was demonstrated to
have significant ability to predict bleeding tendency, with a sensitivity
of 76.2% and a specificity of 69.0%. <br/>Conclusion(s): Preoperative
MA<inf>ADP</inf> may play a potential role in the prediction of
postoperative bleeding and allogeneic blood transfusions and guide
clinicians in perioperative management of patients undergoing CABG with
CPB.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<55>
Accession Number
2005485541
Title
Perioperative Dexmedetomidine Supplement Decreases Delirium Incidence
After Adult Cardiac Surgery: A Randomized, Double-Blind, Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (2) (pp 449-457),
2021. Date of Publication: February 2021.
Author
Likhvantsev V.V.; Landoni G.; Grebenchikov O.A.; Ovezov A.M.; Skripkin
Y.V.; Lembo R.; Gaevskiy D.I.; Tereshina A.A.; Yavorovskiy A.G.
Institution
(Likhvantsev, Grebenchikov, Ovezov, Skripkin, Gaevskiy, Tereshina) Moscow
Regional Research and Clinical Institute, Moscow, Russian Federation
(Likhvantsev, Yavorovskiy) IM Sechenov First Moscow State Medical
University of the Ministry of Health of the Russian Federation (Sechenov
University), Moscow, Russian Federation
(Landoni) Vita-Salute San Raffaele University, Milan, Italy
(Landoni, Lembo) Department of Anesthesia and Intensive Care, IRCCS San
Raffaele Scientific Institute, Milan, Italy
(Grebenchikov) VA Negovsky Research Institute of General Reanimatology,
Federal Research and Clinical Center of Intensive Care Medicine and
Rehabilitology, Moscow, Russian Federation
Publisher
W.B. Saunders
Abstract
Objective: Conflicting data exist on the effect of dexmedetomidine on
delirium. For the present study, a randomized trial was performed to
investigate the effect of perioperative dexmedetomidine on the rate of
postoperative delirium after cardiac surgery. <br/>Design(s): A randomized
controlled trial. <br/>Setting(s): University hospital.
<br/>Participant(s): Patients (n = 169) undergoing elective cardiac
surgery (coronary artery bypass graft surgery, valve surgery, or combined
surgery) with cardiopulmonary bypass. <br/>Intervention(s): Patients
received a sevoflurane-based general anesthesia and were randomly assigned
1:1 to receive a dexmedetomidine infusion that started in the operating
room (0.7 mug/kg/h) and continued into the intensive care unit (0.4
mug/kg/h) or an equivolume infusion of placebo. <br/>Measurements and Main
Results: A decrease in the rate of delirium in the dexmedetomidine group
compared with the placebo group was demonstrated (6 of 84 [7.1%] v 16 of
85 [18.8%]; p = 0.02; odds ratio [OR] 0.33 [95% confidence interval {CI}
0.12-0.90]). Reduced intensive care unit and hospital lengths of stay also
were observed (18 [18-22] hours v 22 [18-39] hours; p = 0.002 and 17
[7-20] days v 19 [8-21] days; p = 0.04, respectively). Mortality at 30
days was 2 (2.4%) in both groups. On multivariate analysis, only
dexmedetomidine administration (OR 0.24 [95% CI 0.08-0.74]) and
cardiopulmonary bypass time (OR 1.02 [95% CI 1.01-1.03] for increases of 1
min) were independent predictors of delirium development.
<br/>Conclusion(s): Dexmedetomidine administered during and after general
anesthesia for cardiac surgery with cardiopulmonary bypass decreased the
rate of postoperative delirium and intensive care unit and hospital
lengths of stay.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<56>
Accession Number
633796191
Title
Association Between Perioperative Glycemic Control Strategy and Mortality
in Patients With Diabetes Undergoing Cardiac Surgery: A Systematic Review
and Meta-Analysis.
Source
Frontiers in Endocrinology. 11 (no pagination), 2020. Article Number:
513073. Date of Publication: 17 Dec 2020.
Author
Jin X.; Ma Y.; Li X.; An P.; Wang J.; Mao W.; Mu Y.; Chen Y.; Chen K.
Institution
(Jin, Wang, Li, An, Wang, Mao, Mu, Chen) Department of Endocrinology,
Chinese PLA General Hospital, Beijing, China
(Jin) Department of Endocrinology and Nephrology, Hainan Hospital of
Chinese PLA General Hospital, Sanya, China
(Jin) Hainan Academician Team Innovation Center, Sanya, China
(Wang) Department of Endocrinology, Fifth Medical Center of Chinese, PLA
General Hospital, Beijing, China
(Ma, Chen) Evidence-Based Medicine Center, School of Basic Medical
Sciences, Lanzhou University, Lanzhou, China
(Ma, Chen) WHO Collaborating Center for Guideline Implementation and
Knowledge Translation, Lanzhou, China
(Ma, Chen) Chinese GRADE Center, Lanzhou, China
(Li) Department of Gerontology, First Affiliated Hospital of Kunming
Medical University, Kunming, China
(Wang, Mao) School of Medicine, Nankai University, Tianjin, China
Publisher
Frontiers Media S.A.
Abstract
Objective: To analyze association between different perioperative glycemic
control strategies and postoperative outcomes in patients with diabetes
undergoing cardiac surgery. <br/>Method(s): MEDLINE, Cochrane Library, Web
of Science, EMBASE, Wanfang Data, China National Knowledge Infrastructure
(CNKI) and China Biology Medicine (CBM) databases were searched from
inception to January 31, 2019. Two researchers independently screened the
literature, extracted data, and evaluated the risk of bias of included
studies, and consensus was reached by discussion with a third researcher.
<br/>Result(s): Six RCTs were included in the meta-analysis. We analyzed
the effect of liberal (>180 mg/dl or 10.0 mmol/L), moderate (140-180 mg/dl
or 7.8-10.0 mmol/L) and strict (<140 mg/dl or 7.8 mmol/L) glycemic control
strategies in patients with diabetes undergoing cardiac surgery. The
pooled results showed that strict glycemic control strategy was associated
with a significant reduction in the risk of atrial fibrillation [OR =
0.48, 95%CI (0.32, 0.72), P < 0.001] and sternal wound infection [OR =
0.28, 95%CI (0.14, 0.54), P < 0.001], while there was no significant
differences in postoperative mortality, stroke, and hypoglycemic episodes
when compared with moderate control. In addition, there is no significant
difference between moderate and liberal glycemic control strategies in
postoperative mortality. However, moderate control was beneficial in
reducing atrial fibrillation [OR = 0.28, 95%CI (0.13, 0.60), P = 0.001]
compared with the liberal glycemic control strategy. <br/>Conclusion(s):
This meta-analysis showed when compared with moderate glycemic control
strategy in patients with diabetes undergoing cardiac surgery, maintained
strict glycemic control was associated with lower risk of atrial
fibrillation and sternal wound infection. No benefit was found with
liberal glycemic control strategy, so it could be a poor glycemic control
strategy.<br/>&#xa9; Copyright &#xa9; 2020 Jin, Wang, Ma, Li, An, Wang,
Mao, Mu, Chen and Chen.

<57>
Accession Number
633679979
Title
Fibrin-Coated Collagen Fleece Seems to Prevent Sternal Instability after
Cardiac Surgery: A Matched Pair Data Analysis.
Source
Thoracic and Cardiovascular Surgeon. 68 (8) (pp 737-742), 2020. Date of
Publication: 01 Dec 2020.
Author
Roth P.; Stella J.; Niemann B.; Grieshaber P.; Roehrig R.; Boning A.
Institution
(Roth, Stella, Niemann, Grieshaber, Boning) Department of Adult and
Pediatric Cardiovascular Surgery, Giessen University Hospital, Giessen,
Germany
(Roehrig) Department of Medical Informatics, Carl von Ossietzky University
Oldenburg, Oldenburg, Germany
Publisher
Georg Thieme Verlag
Abstract
Background To examine if fibrin-coated collagen fleece (Tachosil)
interferes with bone and wound healing when it is used on the cut surface
of the sternum after median sternotomy. Methods A total of 25 patients
with osteoporotic sternal disorders were treated with fibrin-coated
collagen fleece at the cut surface of the sternum after median sternotomy
(therapy group). We compared the occurrence of impaired wound healing and
sternal instability, reoperation rate, and 30-day mortality with a control
group of 25 case-matched patients. After matching for age, gender, and
risk factors for sternal instability (diabetes mellitus, osteoporosis,
body mass index, nicotine consumption), both groups were comparable.
Results Sternal instability occurred in one (4%) patient in the study
group and in five (20%) patients in the control group. Impaired wound
healing occurred in one (4%) patient in the therapy group and two (8%)
patients in the control group. Reoperation was necessary in four (16%)
patients in the therapy group and 6 (24%) patients in the control group.
The 30-day mortality occurred in six (24%) patients in the therapy group
and four (16%) patients in the control group. Conclusions The use of
fibrin-coated collagen fleece on the cut surface of the sternum in
patients with osteoporosis does not impair bone and wound healing.
Furthermore, it seems to result in less sternal instability. A larger
prospective study is necessary to verify the results of this explorative
study.<br/>Copyright &#xa9; 2020 Royal Society of Chemistry. All rights
reserved.

<58>
Accession Number
2006129743
Title
Prasugrel vs Ticagrelor for DAPT in Patients with ACS Undergoing PCI: A
Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Source
Cardiovascular Revascularization Medicine. 21 (12) (pp 1613-1618), 2020.
Date of Publication: December 2020.
Author
Al-Abdouh A.; Barbarawi M.; Abusnina W.; Amr M.; Zhao D.; Savji N.; Hasan
R.K.; Michos E.D.
Institution
(Al-Abdouh, Amr) Department of Medicine, Saint Agnes Hospital, Baltimore,
MD, United States
(Barbarawi) Department of Medicine, Hurley Medical Center, Flint, MI,
United States
(Abusnina) Advanced Cardiac Imaging Department, University of Kentucky,
Lexington, KY, United States
(Zhao) Department of Epidemiology, Johns Hopkins School of Medicine,
Baltimore, MD, United States
(Savji, Michos) The Ciccarone Center for the Prevention of Cardiovascular
Disease, Johns Hopkins School of Medicine, Baltimore, MD, United States
(Savji, Hasan, Michos) Division of Cardiology, Johns Hopkins School of
Medicine, Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
Introduction: Dual antiplatelet therapy (DAPT) with a P2Y12 inhibitor
added to aspirin is considered the standard of care for patients with
acute coronary syndrome (ACS) undergoing percutaneous intervention (PCI).
Prasugrel and ticagrelor are commonly used P2Y12 inhibitors, and a few
head-to-head randomized control trials (RCTs) have been performed. We
performed a systematic review and meta-analysis of these RCTs to compare
the efficacy and adverse effects between these two agents when used in
patients with ACS undergoing PCI. <br/>Method(s): We searched
PubMed/MEDLINE and Cochrane library for RCTs comparing prasugrel to
ticagrelor in ACS. The primary endpoint was major adverse cardiovascular
events (MACE). Secondary outcomes were all-cause mortality, cardiovascular
mortality, myocardial infarction (MI), stent thrombosis, major bleeding,
and all bleeding event. Estimates were calculated as random effects risk
ratios (RRs) with 95% confidence intervals (CI). <br/>Result(s): Six
trials with 6807 patients were included. There were no significant
difference of MACE (RR 0.93; 95% CI [0.72-1.20]; p = 0.59; I² =
26%), all-cause mortality (RR 0.92; 95% CI [0.73-1.17]; p = 0.51;
I² = 0%), cardiovascular mortality (RR 0.99; 95% CI
[0.75-1.31]; p = 0.96; I² = 0%), MI (RR 0.87; 95% CI
[0.60-1.27]; p = 0.48; I² = 27%), stent thrombosis (RR 0.64;
95% CI [0.39-1.04]; p = 0.07; I² = 0%), major bleeding (RR
0.94; 95% CI [0.70-1.26]; p = 0.68; I² = 6%), and all bleeding
event (RR 0.92; 95% CI [0.77-1.09]; p = 0.32; I² = 0%) for
prasugrel compared with ticagrelor. <br/>Conclusion(s): There are no
significant difference of MACE, all-cause mortality, cardiovascular
mortality, MI, stent thrombosis, and bleeding between prasugrel and
ticagrelor when added to aspirin among patients with ACS undergoing
PCI.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<59>
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.

<60>
[Use Link to view the full text]
Accession Number
2007099315
Title
Early recognition and response to increases in surgical site infections
using optimized statistical process control charts-the Early 2RIS Trial: a
multicenter cluster randomized controlled trial with stepped wedge design.
Source
Trials. 21 (1) (no pagination), 2020. Article Number: 894. Date of
Publication: 01 Dec 2020.
Author
Anderson D.J.; Ilies I.; Foy K.; Nehls N.; Benneyan J.C.; Lokhnygina Y.;
Baker A.W.
Institution
(Anderson, Foy, Baker) Duke Center for Antimicrobial Stewardship and
Infection Prevention, Durham, NC, United States
(Ilies, Nehls, Benneyan) Healthcare Systems Engineering Institute,
Northeastern University, Boston, MA, United States
(Lokhnygina) Department of Biostatistics, Duke University School of
Medicine, Durham, NC, United States
Publisher
BioMed Central Ltd
Abstract
Background: Surgical site infections (SSIs) cause significant patient
suffering. Surveillance and feedback of SSI rates is an evidence-based
strategy to reduce SSIs, but traditional surveillance methods are slow and
prone to bias. The objective of this cluster randomized controlled trial
(RCT) is to determine if using optimized statistical process control (SPC)
charts for SSI surveillance and feedback lead to a reduction in SSI rates
compared to traditional surveillance. <br/>Method(s): The Early 2RIS Trial
is a prospective, multicenter cluster RCT using a stepped wedge design.
The trial will be performed in 29 hospitals in the Duke Infection Control
Outreach Network (DICON) and 105 clusters over 4 years, from March 2016
through February 2020; year one represents a baseline period; thereafter,
8-9 clusters will be randomized to intervention every 3 months over a
3-year period using a stepped wedge randomization design. All patients who
undergo one of 13 targeted procedures at study hospitals will be included
in the analysis; these procedures will be included in one of six clusters:
cardiac, orthopedic, gastrointestinal, OB-GYN, vascular, and spinal. All
clusters will undergo traditional surveillance for SSIs; once randomized
to intervention, clusters will also undergo surveillance and feedback
using optimized SPC charts. Feedback on surveillance data will be provided
to all clusters, regardless of allocation or type of surveillance. The
primary endpoint is the difference in rates of SSI between the SPC
intervention compared to traditional surveillance and feedback alone.
<br/>Discussion(s): The traditional approach for SSI surveillance and
feedback has several major deficiencies because SSIs are rare events.
First, traditional statistical methods require aggregation of measurements
over time, which delays analysis until enough data accumulate. Second,
traditional statistical tests and resulting p values are difficult to
interpret. Third, analyses based on average SSI rates during predefined
time periods have limited ability to rapidly identify important, real-time
trends. Thus, standard analytic methods that compare average SSI rates
between arbitrarily designated time intervals may not identify an
important SSI rate increase on time unless the "signal" is very strong.
Therefore, novel strategies for early identification and investigation of
SSI rate increases are needed to decrease SSI rates. While SPC charts are
used throughout industry and healthcare to improve and optimize processes,
including other types of healthcare-associated infections, they have not
been evaluated as a tool for SSI surveillance and feedback in a randomized
trial. Trial registration: ClinicalTrials.govNCT03075813, Registered March
9, 2017.<br/>Copyright &#xa9; 2020, The Author(s).

<61>
Accession Number
2005631348
Title
Effect of obstructive sleep apnea and CPAP treatment on cardiovascular
outcomes in acute coronary syndrome in the RICCADSA trial.
Source
Journal of Clinical Medicine. 9 (12) (pp 1-12), 2020. Article Number:
4051. Date of Publication: December 2020.
Author
Peker Y.; Thunstrom E.; Glantz H.; Eulenburg C.
Institution
(Peker) Department of Pulmonary Medicine, Koc University School of
Medicine, Istanbul TR 34010, Turkey
(Peker, Thunstrom) Department of Molecular and Clinical Medicine,
Sahlgrenska Academy, University of Gothenburg, Gothenburg SE 40530, Sweden
(Peker) Department of Clinical Sciences, Respiratory Medicine and
Allergology, Faculty of Medicine, Lund University, Lund SE 22185, Sweden
(Peker) Division of Pulmonary, Allergy, and Critical Care Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United
States
(Thunstrom) Department of Cardiology, Sahlgrenska University
Hospital/Ostra, Gothenburg 41345, Sweden
(Glantz) Department of Internal Medicine, Skaraborg Hospital, Lidkoping SE
53185, Sweden
(Eulenburg) Department for Epidemiology, University of Groningen,
Groningen 9712 CP, Netherlands
Publisher
MDPI AG
Abstract
We aimed to address the impact of OSA and its treatment with continuous
positive airway pressure (CPAP) on major adverse cardiovascular and
cerebrovascular events (MACCE) in patients with acute coronary syndrome
(ACS). In this current analysis of the revascularized ACS subgroup (n =
353) of the Randomized Intervention with CPAP in Coronary Artery Disease
and Obstructive Sleep Apnea (RICCADSA) trial (Trial Registry:
ClinicalTrials.gov; No: NCT 00519597), participants with non-sleepy OSA
(apnea-hypopnea-index [AHI] >= 15 events/h on a home sleep apnea testing,
and Epworth Sleepiness Scale [ESS] score < 10; n = 171) were randomized to
CPAP (n = 86) or no-CPAP (n = 85). The sleepy OSA patients (AHI >= 15
events/h and ESS >= 10) who were offered CPAP, and the ones with no-OSA
(AHI < 5 events/h) were included in the observational arm. A post-hoc
analysis was done to compare untreated OSA (no-CPAP; n = 78) and
nonadherent sleepy/non-sleepy OSA (n = 96) with the reference group
without OSA (n = 81). The primary endpoint (the first event of repeat
revascularization, myocardial infarction, stroke or cardiovascular
mortality) during a median 4.7-year follow-up was evaluated in
time-dependent Cox proportional hazards models adjusted for confounding
factors. The incidence of MACCE did not differ significantly in
intention-to-treat population. On-treatment analysis showed a significant
risk reduction in those who used CPAP for >=4 vs. <4 h/day or did not
receive treatment (adjusted hazard ratio [HR] 0.17; 95% confidence
interval [CI] 0.03-0.81; p = 0.03). Compared with the reference group,
nonadherent/untreated OSA was associated with an increased cardiovascular
risk (adjusted HR 1.97, 95% CI 1.03-3.77; p = 0.04). We conclude that OSA
is an independent risk factor for adverse cardiovascular outcomes in
patients with ACS. CPAP treatment may reduce this risk, if the device is
used at least 4 h/day.<br/>Copyright &#xa9; 2020 by the authors. Licensee
MDPI, Basel, Switzerland.

<62>
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.

<63>
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.

<64>
Accession Number
2010165473
Title
Single Anti-platelet Versus Dual Anti-platelet Therapy After Transcatheter
Aortic Valve Implantation: A Meta-Analysis of Randomized Trials.
Source
American Journal of Cardiology. 140 (pp 152-154), 2021. Date of
Publication: 01 Feb 2021.
Author
Elbadawi A.; Thakker R.; Abuzaid A.A.; Khalife W.; Goel S.S.; Gilani S.;
Alasnag M.; Elgendy I.Y.
Institution
(Elbadawi, Khalife, Gilani) Department of Cardiovascular Medicine,
University of Texas Medical Branch, Galveston, TX, United States
(Thakker) Division of Internal Medicine, University of Texas Medical
Branch, Galveston, TX, United States
(Abuzaid) Division of Cardiology, University of California San Francisco,
San Francisco, CA, United States
(Goel) Department of Cardiology, Houston Methodist DeBakey Heart and
Vascular Center, Houston, TX, United States
(Alasnag) Cardiac Center-King Fahd Armed Forces Hospital, Jeddah, Saudi
Arabia
(Elgendy) Division of Cardiology, Weill Cornell Medicine-Qatar, Doha,
Qatar
Publisher
Elsevier Inc.

<65>
Accession Number
632224786
Title
Virtual reality-assisted conscious sedation during transcatheter aortic
valve implantation: a randomised pilot study.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
16 (12) (pp e1014-e1020), 2020. Date of Publication: 18 Dec 2020.
Author
Bruno R.R.; Lin Y.; Wolff G.; Polzin A.; Veulemans V.; Klein K.;
Westenfeld R.; Zeus T.; Kelm M.; Jung C.
Institution
(Bruno) Division of Cardiology, Pulmonology, Vascular Medicine, Medical
Faculty, University Hospital Dusseldorf, Dusseldorf, Germany
Publisher
NLM (Medline)
Abstract
AIMS: Virtual reality (VR) has been used successfully in different
clinical settings to treat anxiety. This prospective, randomised pilot
study aimed to investigate the feasibility and safety of VR in patients
undergoing conscious sedation during transfemoral transcatheter aortic
valve implantation (TAVI). METHODS AND RESULTS: Thirty-two patients were
included and randomised to VR intervention (n=16) or control (n=16). In
the intervention group, patient-selected relaxing 3D videos were projected
during the TAVI procedure; pain and anxiety before and after TAVI were
measured using visual analogue scales (VAS; 0-10). The median age was 83
years (IQR 78.25-87). Patients' baseline characteristics did not differ
significantly between the groups. During TAVI under conscious sedation,
the median duration of VR intervention was 30.5 minutes (IQR 23.5-46);
81.3% of the patients watched the videos until device implantation, 37.5%
during the whole procedure. The VR intervention group reported
significantly less anxiety after the procedure (VAS 2 [IQR 0-3.75] vs 5
[IQR 2-8], p=0.04) than patients randomised to control. In the
intervention group, 93.8% would use VR during TAVI again. Nausea and
vomiting did not occur more frequently compared to control.
<br/>CONCLUSION(S): VR interventions during TAVI to assist conscious
sedation are safe and feasible, even in very old and frail patients. In
this small cohort, there was a significant reduction in periprocedural
anxiety.

<66>
Accession Number
633870598
Title
Postoperative anemia is associated with nonfatal myocardial infarction and
all-cause mortality.
Source
Swiss Medical Weekly. Conference: Annual Congress of Swiss Society for
Anaesthesiology and Resuscitation, SGAR-SSAR 2020. 150 (SUPPL 246) (pp
9S-10S), 2020. Date of Publication: October 2020.
Author
Kurt R.; Eva R.; Cohen B.; Alparslan T.
Institution
(Kurt, Eva, Cohen, Alparslan) Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, United States
Publisher
EMH Swiss Medical Publishers Ltd.
Abstract
Background: Myocardial infarction is a major postoperative complica-tion
and is probably mostly consequent to myocardial oxygen supply-demand
mismatch. Perioperative anemia is common and strongly asso-ciated with
postoperative complications and mortality. We therefore aimed to test the
hypothesis that the lowest in-hospital postoperative he-moglobin
concentration is associated with a composite of nonfatal myo-cardial
infarction and all-cause mortality within the first 30 days after
non-cardiac surgery. <br/>Method(s): With IRB approval we conducted a
retrospective cohort study as a sub-study from the POISE-2 multicenter
trial. In the POISE-2 trial 10.010 non-cardiac surgical patients >45 years
old at risk for cardiovas-cular disease were factorially randomized to
aspirin versus placebo and to clonidine versus placebo from 2010 to 2013.
All POISE-2 patients were enrolled. We excluded 1817 patients in whom
postoperative hemo-globin concentrations were not available and 950
POISE-2 patients who were recruited from Cleveland Clinic sites since they
were included in the companion analysis. Patients were stratified into
four groups based on hemoglobin levels for data presentation: <8 g/dL,
8-11 g/dL, 11-13 g/dL and >13 g/dL. We assessed the association between
the lowest hemoglobin concentration during the initial hospitalization and
a compo-site of non-fatal myocardial infarction and all-cause mortality
during the initial 30-days, using a multivariable logistic regression
model. Potential confounders were adjusted. <br/>Result(s): 7243 patients
analyzed. The overall incidence of non-fatal my-ocardial infarction and
all-cause mortality was 8.9%, ranging from 21% amongst patients with
lowest haemoglobin concentrations <8 g/dL, to 2.1% in those with
hemoglobin concentrations >13 g/dL. After adjusting for baseline factors,
in patients with a lowest hemoglobin concentration <11 g/dL, each one g/dL
reduction in lowest hemoglobin concentration was associated with a 1.51
(95% CI: 1.41, 1.61; P <0.001) increase in the odds of the composite
outcome. In contrast, there was no significant relationship amongst
patients with a lowest hemoglobin concentration that exceeded 11 g/dL (OR
= 1.00, 95% CI: 0.90, 1.11; P = 0.95). <br/>Conclusion(s): Postoperative
hemoglobin concentration is an additional modifiable risk factor for
nonfatal myocardial infarction and all-cause mortality, especially in
patients with or at risk of cardiovascular disease.

<67>
Accession Number
633870593
Title
Glucose-Insulin-Potassium (GIK) morbidity and mortality effects in cardiac
surgery: A systematic review and meta-analysis of randomized trials.
Source
Swiss Medical Weekly. Conference: Annual Congress of Swiss Society for
Anaesthesiology and Resuscitation, SGAR-SSAR 2020. 150 (SUPPL 246) (pp
8S), 2020. Date of Publication: October 2020.
Author
Schorer R.; Putzu A.; Keli-Barcelos G.; Licker M.J.
Institution
(Schorer, Putzu, Keli-Barcelos, Licker) Service d'Anesthesie, Departement
De Medecine Aigue, Hopitaux Universitaires De Geneve, Geneve, Switzerland
Publisher
EMH Swiss Medical Publishers Ltd.
Abstract
Background: Although experimental studies strongly support the
cardi-oprotective effects of glucose'insulin'potassium (GIK) infusion,
clini-cal trials have yielded mixed results due to the heterogeneity of
patient populations as well as varying GIK administration patterns. An
updated systematic review and meta-analysis were conducted to assess the
im-pact of GIK treatment on postoperative complications in patients
under-going on- or off-pump cardiac surgery. <br/>Method(s): We searched
MEDLINE, Embase and the Cochrane Central Register without language
restrictions for studies from inception to March, 2020. We included
randomized controlled trials that compared GIK infusion as
cardioprotective measure to conventional treatment or placebo in adults
undergoing on- or off-pump cardiac surgery. Postoper-ative myocardial
infarct (PMI) was the main study endpoint; secondary outcomes were
in-hospital mortality, postoperative complications, as well as duration of
mechanical ventilation, intensive care stay and hospital stay.
Postoperative glycemia and cardiac index were also examined. The study was
registered with PROSPERO (Ndegree CRD42019117728). We computed risk ratios
(RR) or mean differences (MD) with 95% confidence intervals (CI) and
heterogeneity was estimated using I2 statistic. <br/>Result(s): From 47
studies, 5'872 participants were pooled for meta-anal-ysis. The incidence
of PMI was 5.9% and 8.3% in the GIK and Control groups, respectively (n =
20, RR [95% CI] = 0.83 [0.65 to 1.04] I2 = 0). Compared to control
treatment, GIK infusion was associated with lower hospital mortality (n =
19, RR [95%CI] = 0.64 [0.43 to 0.97], I2 = 0), re-duced acute kidney
injury (n = 6, RR [95%CI] = 0.59 [0.4 to 0.87, I2 = 0), fewer atrial
fibrillation (n = 23, RR [95%CI] = 0.75 [0.6 to 0.94], I2 = 0.58), as well
as a shorter duration of mechanical ventilation (n = 14, MD [95%CI] =
-1.77 [-3.04 to -0.49] hours, I2 = 0.96), shorter stay in intensive care
(n = 20, MD [95%CI] = -5.39 [-9.34 to -1.44] hours, I2 = 0.99) and faster
hospital discharge (n = 19, MD [95%CI] = -0.84 [-1.6 to -0.08] days, I2 =
0.95). <br/>Conclusion(s): Perioperative administration of GIK was
associated with improved postoperative clinical outcomes as reflected by
lower in-hospi-tal mortality and morbidity as well as lesser utilization
of hospital re-sources. Further clinical studies are warranted to
ascertain the effective-ness of GIK in minimizing myocardial injuries and
to explore the specific dosage and timing of GIK infusion.

<68>
Accession Number
633857045
Title
Rationale and design of the ADAPT-TAVR trial: A randomised comparison of
edoxaban and dual antiplatelet therapy for prevention of leaflet
thrombosis and cerebral embolisation after transcatheter aortic valve
replacement.
Source
BMJ Open. 11 (1) (no pagination), 2021. Article Number: 042587. Date of
Publication: 05 Jan 2021.
Author
Park H.; Kang D.-Y.; Ahn J.-M.; Kim K.W.; Wong A.Y.T.; Lam S.C.C.; Yin
W.-H.; Wei J.; Lee Y.-T.; Kao H.-L.; Lin M.-S.; Ko T.-Y.; Kim W.-J.; Kang
S.H.; Ko E.; Kim D.-H.; Koo H.J.; Yang D.H.; Kang J.-W.; Jung S.C.; Lee
J.-H.; Yun S.-C.; Park S.-J.; Park D.-W.
Institution
(Park, Kang, Ahn, Ko, Kim, Park, Park) Division of Cardiology, Asan
Medical Center, Songpa-gu, Seoul, South Korea
(Kim) Asan Image Metrics, Clinical Trial Center, Asan Institute for Life
Sciences, Asan Medical Center, Songpa-gu, Seoul, South Korea
(Kim, Koo, Yang, Kang, Jung) Department of Radiology and Research
Institute of Radiology, Asan Medical Center, Songpa-gu, Seoul, South Korea
(Wong, Lam) Division of Cardiology, Department of Medicine, Queen Mary
Hospital, Pok Fu Lam, Hong Kong
(Yin, Wei) Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan
(Republic of China)
(Lee, Kao, Lin) Division of Cardiology, Department of Internal Medicine,
National Taiwan University Hospital, Taipei, Taiwan (Republic of China)
(Ko) Division of Cardiology, Department of Internal Medicine, Hsin-Chu
Branch, National Taiwan University Hospital, Hsin-Chu, Taiwan (Republic of
China)
(Kim, Kang) Department of Cardiology, CHA Bundang Medical Center,
Seongnam, Gyeonggi-do, South Korea
(Lee) Department of Neurology, Asan Medical Center, Songpa-gu, Seoul,
South Korea
(Yun) Department of Biostatistics, Asan Medical Center, Songpa-gu, Seoul,
South Korea
Publisher
BMJ Publishing Group
Abstract
Introduction Optimal antithrombotic strategy following transcatheter
aortic valve replacement (TAVR) is still unknown. We hypothesised that the
direct factor Xa inhibitor edoxaban can potentially prevent subclinical
leaflet thrombosis and cerebral embolisation compared with conventional
dual antiplatelet therapy (DAPT) in patients undergoing TAVR. Methods and
analysis The ADAPT-TAVR trial is an international, multicentre,
randomised, open-label, superiority trial comparing edoxaban-based
strategy and DAPT strategy in patients without an indication for oral
anticoagulation who underwent successful TAVR. A total of 220 patients are
randomised (1:1 ratio), 1-7 days after successful TAVR, to receive either
edoxaban (60 mg daily or 30 mg daily if patients had dose-reduction
criteria) or DAPT using aspirin (100 mg daily) plus clopidogrel (75 mg
daily) for 6 months. The primary endpoint was an incidence of leaflet
thrombosis on four-dimensional, volume-rendered cardiac CT imaging at 6
months post-TAVR. The key secondary endpoints were the number of new
lesions and new lesion volume on brain diffusion-weighted MRI and the
changes in neurological and neurocognitive function assessment between
immediate post-TAVR and 6 months of study drug administration. Detailed
clinical information on thromboembolic and bleeding events were also
assessed. Ethics and dissemination Ethic approval has been obtained from
the Ethics Committee/Institutional Review Board of Asan Medical Center
(approval number: 2017-1317) and this trial is also approved by National
Institute of Food and Drug Safety Evaluation of Republic of Korea
(approval number: 31511). Results of this study will be disseminated in
scientific publication in reputed journals. Trial registration number
NCT03284827. <br/>Copyright &#xa9;

<69>
Accession Number
2005753246
Title
Open kidney cancer surgery and perioperative cardiac arrhythmias.
Source
Central European Journal of Urology. 73 (4) (pp 1-8), 2020. Date of
Publication: 2020.
Author
Dobronska K.; Jureczko L.; Kowalczyk R.; Dobronski P.; Trzebicki J.
Institution
(Dobronska, Jureczko, Kowalczyk, Trzebicki) First Department of
Anesthesiology and Intensive Care, Medical University of Warsaw, Warsaw,
Poland
(Dobronski) Department of Urology, Medical University of Warsaw, Warsaw,
Poland
Publisher
Polish Urological Association
Abstract
Introduction Although cardiac arrhythmias during anesthesia are often
observed, the literature focuses mainly on cardio-thoracic surgery. We
aimed to evaluate the incidence of arrhythmias appearing in the
perioperative period in patients undergoing urological surgery and
furthermore to define whether combining general with epidural anesthesia
prevents them. Material and methods The study included 50 adults, without
a prior cardiac or arrhythmia history, undergoing an open kidney cancer
surgery, who were randomly allocated to receive either general or combined
epidural/general anesthesia. A Holter monitor was applied the evening
before the surgery, tracing continuously for a period of 24 hours
(7PM-7PM). ClinicalTrials.gov NCT02988219 Results There was no statistical
difference in the arrhythmia occurrence between the randomization groups.
Among 65.21% the following arrhythmias were observed: 27 - bradycardia, 4
- sinus pause, 6 - ventricular extrasystoles (>1000/24 hours), 3 -
supraventricular extrasystoles (>200/24 hours). The patients with
arrhythmia were older and often with hypertension (p <0.01). A longer
surgery duration predisposed to arrhythmia appearance (122.5 vs. 99
minutes), (p <0.01). The temperature measured at the beginning and at the
end of the surgery was significantly lower among the participants with
arrhythmia (p = 0.02, p = 0.01). The gender, body mass index (BMI),
laboratory tests and the intake of intravenous fluids did not influence
the occurrence of arrhythmia. Conclusions Perioperative cardiac
arrhythmias (usually sinus arrhythmias) are common during an open kidney
surgery and occur regardless of the anesthetic technique and usually do
not require any treatment. Age, hypertension, long operation time or low
body temperature predispose the patient to perioperative cardiac
arrhythmias during surgery.<br/>Copyright &#xa9; 2020, Polish Urological
Association. All rights reserved.

<70>
Accession Number
2010449457
Title
Meta-analysis of Direct Oral Anticoagulants in Patients With Atrial
Fibrillation and Bioprosthetic Valves.
Source
American Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Kheiri B.; Przybylowicz R.; Simpson T.F.; Alhamoud H.; Osman M.; Dalouk
K.; Nazer B.; Henrikson C.A.; Stecker E.
Institution
(Kheiri, Przybylowicz, Simpson, Dalouk, Nazer, Henrikson, Stecker) Knight
Cardiovascular Institute, Oregon Health & Science University, Portland,
OR, United States
(Alhamoud, Osman) Division of Cardiology, West Virginia University School
of Medicine, Morgantown, WV, United States
Publisher
Elsevier Inc.

<71>
[Use Link to view the full text]
Accession Number
2010149718
Title
A review of indications and comorbidities in which warfarin may be the
preferred oral anticoagulant.
Source
Journal of Clinical Pharmacy and Therapeutics. (no pagination), 2021. Date
of Publication: 2021.
Author
Wadsworth D.; Sullivan E.; Jacky T.; Sprague T.; Feinman H.; Kim J.
Institution
(Wadsworth, Sullivan, Jacky, Sprague, Feinman) The University of North
Carolina Eshelman School of Pharmacy, Chapel Hill, NC, United States
(Kim) Cone Health Department of Internal Medicine, Greensboro, NC, United
States
Publisher
Blackwell Publishing Ltd
Abstract
What is known and objective: Direct oral anticoagulants (DOACs) are
increasingly prescribed instead of warfarin for chronic anticoagulation
for ease of dosing, fewer interactions, and less stringent monitoring.
However, it is important to consider indications and comorbidities for
which warfarin is still the preferred anticoagulant. This review aims to
capture these clinical scenarios in which warfarin may still be preferred
over DOACs. <br/>Method(s): We undertook a comprehensive literature search
using the PubMed database. Key search terms were based on DOAC clinical
trial exclusion criteria, as well as indications and conditions in which
the use of DOACs for anticoagulation has suggested harm. Society
guidelines and tertiary literature were used to inform expert opinion
where necessary. Studies were included if they investigated the use of
DOACs or warfarin in the identified indications or conditions. Results and
Discussion: Currently, evidence for the use of warfarin over DOACs for
anticoagulation is strongest for patients with prosthetic valves,
antiphospholipid syndrome, or a high risk of gastrointestinal bleeding.
For several clinical situations, including mitral stenosis, obesity,
altered gastrointestinal anatomy, pulmonary arterial hypertension, renal
or hepatic impairment, and left ventricular thrombus, evidence is lacking
but may eventually support the use of DOACs. Depending on indication and
condition, appropriateness of DOAC use may vary by agent. What is new and
conclusion: New evidence continues to support new indications and
conditions in which DOACs may be appropriate to use for anticoagulation.
There are key clinical scenarios, however, in which emerging literature
continues to support warfarin as the preferred
anticoagulant.<br/>Copyright &#xa9; 2021 John Wiley & Sons Ltd

<72>
Accession Number
2010387266
Title
Impact of chronic total occlusion and revascularization strategy in
patients with infarct-related cardiogenic shock: A subanalysis of the
culprit-shock trial.
Source
American Heart Journal. 232 (pp 185-193), 2021. Date of Publication:
February 2021.
Author
Braik N.; Guedeney P.; Behnes M.; Desch S.; Barthelemy O.; Sandri M.; de
Waha-Thiele S.; Fuernau G.; Rouanet S.; Hauguel-Moreau M.; Zeitouni M.;
Overtchouk P.; Ouarrak T.; Schneider S.; Zeymer U.; Thiele H.; Montalescot
G.; Akin I.
Institution
(Braik, Guedeney, Barthelemy, Hauguel-Moreau, Zeitouni, Overtchouk,
Montalescot) Sorbonne Universite, ACTION Study Group, INSERM UMRS_1166
Institut de cardiologie, Pitie Salpetriere (AP-HP), Paris, France
(Behnes, Akin) First Department of Medicine-Cardiology, University Medical
Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
(Desch, Sandri, Thiele) Heart Center Leipzig at University of Leipzig and
Leipzig Heart Institute, Leipzig, Germany
(de Waha-Thiele, Fuernau) Medical Clinic II, University Heart Center
Luebeck, Luebeck, Germany
(Rouanet) Statistician unit, StatEthic, ACTION Study group
Levallois-Perret, France
(Ouarrak, Schneider, Zeymer) Institut fur Herzinfarktforschung,
Ludwigshafen, Germany
Publisher
Mosby Inc.
Abstract
Background: The impact of coronary artery chronic total occlusion (CTO)
and its management with percutaneous coronary intervention (PCI) in the
setting of myocardial infarction (MI) related cardiogenic shock (CS)
remains unclear. <br/>Method(s): This is a pre-specified analysis from the
culprit-lesion-only PCI vs multivessel PCI in CS (CULPRIT-SHOCK) trial
which randomized patients presenting with MI and multivessel disease
complicated by CS to a culprit-lesion-only or immediate multivessel PCI
strategy. CTO was defined by central core-laboratory evaluation. The
independent associations between the presence of CTO and adverse outcomes
at 30 days and 1 year were assessed using multivariate logistics models.
<br/>Result(s): A noninfarct related CTO was present in 157 of 667 (23.5%)
analyzed patients. Patients presenting with CTO had more frequent diabetes
mellitus or prior PCI but less frequently presented with ST segment
elevation MI as index event. The presence of CTO was associated with
higher rate of death at 30 days (adjusted Odds ratio 1.63; 95% confidence
interval [CI] 1.01-2.60). Rate of death at 1 year was also increased but
did not reach statistical significance (adjusted Odds ratio 1.62; 95%CI
0.99-2.66). Compare to immediate multivessel PCI, a strategy of
culprit-lesion-only PCI was associated with lower rates of death or renal
replacement therapy at 30 days in patients with and without CTO (Odds
ratio 0.79 95%CI 0.42-1.49 and Odds ratio 0.67 95%CI 0.48-0.96,
respectively), without significant interaction (P =.68).
<br/>Conclusion(s): In patients with MI-related CS and multivessel
disease, the presence of CTO is associated with adverse outcomes while a
strategy of culprit-lesion-only PCI seems beneficial regardless of the
presence of CTO.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<73>
Accession Number
2008467634
Title
A randomized clinical trial to evaluate the efficacy and safety of
rivaroxaban in patients with bioprosthetic mitral valve and atrial
fibrillation or flutter: Rationale and design of the RIVER trial: RIVER
Trial: Rationale and Design.
Source
American Heart Journal. 231 (pp 128-136), 2021. Date of Publication:
January 2021.
Author
Guimaraes H.P.; de Barros e Silva P.G.M.; Liporace I.L.; Sampaio R.O.;
Tarasoutchi F.; Paixao M.; Hoffmann-Filho C.R.; Patriota R.; Leiria
T.L.L.; Lamprea D.; Precoma D.B.; Atik F.A.; Silveira F.S.; Farias F.R.;
Barreto D.O.; Almeida A.P.; Zilli A.C.; de Souza Neto J.D.; Cavalcante
M.A.; Figueira F.A.M.S.; Junior R.A.; Moises V.A.; Mesas C.E.; Ardito
R.V.; Kalil P.S.A.; Paiva M.S.M.O.; Maldonado J.G.A.; de Lima C.E.B.;
D'Oliveira Vieira R.; Laranjeira L.; Kojima F.; Damiani L.; Nakagawa R.H.;
dos Santos J.R.Y.; Sampaio B.S.; Campos V.B.; Saraiva J.F.K.; Fonseca
F.H.; Pinto I.M.; Magalhaes C.C.; Ferreira J.F.M.; Lopes R.D.; Pavanello
R.; Cavalcanti A.B.; Berwanger O.
Institution
(Guimaraes, de Barros e Silva, Laranjeira, Kojima, Damiani, Nakagawa, dos
Santos, Sampaio, Campos, Pavanello, Cavalcanti, Berwanger) Research
Institute - Heart Hospital (HCor), Sao Paulo, Brazil
(Guimaraes, Berwanger) Hospital Israelita Albert Einstein, Sao Paulo, SP,
Brazil
(Liporace) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Sampaio, Tarasoutchi, Paixao, Ferreira) Incor - Instituto do Coracao do
HCFMUSP, Sao Paulo, Brazil
(Hoffmann-Filho) Hospital Regional Hans Dieter Schmidt - Joinvile, Brazil
(Patriota) Hospital Metropolitano Sul Dom Helder Camara, Cabo de Santo
Agostinho, Brazil
(Leiria) Instituto de Cardiologia do Rio Grande do Sul (FUC), Porto
Alegre, Brazil
(Lamprea) Procape, Recife, Brazil
(Precoma) Sociedade Hospitalar Angelina Caron, Campina Grande do Sul,
Brazil
(Atik) Instituto de Cardiologia do Distrito Federal, Brasilia, Brazil
(Silveira) Clinica do Coracao Sergipe - Aracaju, Brazil
(Farias) Quanta Diagnostico e Terapia, Curitiba, Brazil
(Barreto) Hospital Evangelico de Vila Velha, Vila Velha, Brazil
(Almeida) Unidade Medico Cirurgica - Unimec, Vitoria da Conquista, Brazil
(Zilli) Hospital de Caridade Sao Vicente de Paulo, Jundiai, Brazil
(de Souza Neto) Hospital Messejana, Ceara, Brazil
(Cavalcante) Hospital Regional de Presidente Prudente, Presidente
Prudente, Brazil
(Figueira) IMIP - Instituto de Medicina Integral Professor Fernando
Figueira, Recife, Brazil
(Junior) HUPES-Hospital Universitario Prof Edgard Santos, Salvador, Brazil
(Moises, Fonseca) UNIFESP, Sao Paulo, Brazil
(Mesas) Hospital de Universidade Estadual de Londrina, Londrina, Brazil
(Ardito) IMC - Instituto de Molestias Cardiovasculares, Sao Jose do Rio
Preto, Brazil
(Kalil) Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
(Paiva) Eurolatino Natal Center, Natal, Brazil
(Maldonado) Servico de Eletrofisiologia e Marca-Passo do Hospital
Universitario Francisca Mendes (HUFM)-Manaus, Brazil
(de Lima) Cardiolima Piaui, Teresina, Brazil
(D'Oliveira Vieira) Hospital e Clinica Sao Roque, Ipiau, Brazil
(Saraiva) Instituto de Pesquisa Clinica de Campinas, Campinas, Brazil
(Saraiva, Fonseca, Pinto, Magalhaes, Ferreira, Pavanello, Berwanger)
Sociedade de Cardiologia do Estado de Sao Paulo (SOCESP), Sao Paulo,
Brazil
(Lopes) Duke Clinical Research Institute (DCRI), Durham, NC, United States
Publisher
Mosby Inc.
Abstract
The efficacy and safety of rivaroxaban in patients with bioprosthetic
mitral valves and atrial fibrillation or flutter remain uncertain.
<br/>Design(s): RIVER was an academic-led, multicenter, open-label,
randomized, non-inferiority trial with blinded outcome adjudication that
enrolled 1005 patients from 49 sites in Brazil. Patients with a
bioprosthetic mitral valve and atrial fibrillation or flutter were
randomly assigned (1:1) to rivaroxaban 20 mg once daily (15 mg in those
with creatinine clearance <50 mL/min) or dose-adjusted warfarin (target
international normalized ratio 2.0-30.); the follow-up period was 12
months. The primary outcome was a composite of all-cause mortality,
stroke, transient ischemic attack, major bleeding, valve thrombosis,
systemic embolism, or hospitalization for heart failure. Secondary
outcomes included individual components of the primary composite outcome,
bleeding events, and venous thromboembolism. RIVER represents the largest
trial specifically designed to assess the efficacy and safety of a direct
oral anticoagulant in patients with bioprosthetic mitral valves and atrial
fibrillation or flutter. The results of this trial can inform clinical
practice and international guidelines.<br/>Copyright &#xa9; 2020 Elsevier
Inc.

<74>
Accession Number
2008460715
Title
Transcatheter Mitral Valve Repair in Cardiogenic Shock and Mitral
Regurgitation: A Patient-Level, Multicenter Analysis.
Source
JACC: Cardiovascular Interventions. 14 (1) (pp 1-11), 2021. Date of
Publication: 11 Jan 2021.
Author
Jung R.G.; Simard T.; Kovach C.; Flint K.; Don C.; Di Santo P.; Adamo M.;
Branca L.; Valentini F.; Benito-Gonzalez T.; Fernandez-Vazquez F.;
Estevez-Loureiro R.; Berardini A.; Conti N.; Rapezzi C.; Biagini E.;
Parlow S.; Shorr R.; Levi A.; Manovel A.; Cardenal-Piris R.; Diaz
Fernandez J.; Shuvy M.; Haberman D.; Sala A.; Alkhouli M.A.; Marini C.;
Bargagna M.; Schiavi D.; Denti P.; Markovic S.; Buzzatti N.; Chan V.;
Hynes M.; Mesana T.; Labinaz M.; Pappalardo F.; Taramasso M.; Hibbert B.
Institution
(Jung, Simard, Di Santo, Parlow, Levi, Labinaz, Hibbert) CAPITAL Research
Group, University of Ottawa Heart Institute, Ottawa, ON, Canada
(Jung, Simard, Hibbert) Department of Cellular and Molecular Medicine,
University of Ottawa, Ottawa, ON, Canada
(Simard, Di Santo, Parlow, Levi, Labinaz, Hibbert) Division of Cardiology,
University of Ottawa Heart Institute, Ottawa, ON, Canada
(Kovach, Flint) Division of Cardiology, University of Colorado School of
Medicine, Aurora, CO, United States
(Kovach, Don) Division of Cardiology, University of Washington, Seattle,
WA, United States
(Flint) Rocky Mountain Regional VA Medical Center, Medicine Services,
Cardiology, Aurora, CO, United States
(Adamo, Branca, Valentini) Catheterization Laboratory, Cardiothoracic
Department, Spedali Civili, Brescia, Italy
(Benito-Gonzalez, Fernandez-Vazquez) Department of Cardiology, University
Hospital of Leon, Leon, Spain
(Estevez-Loureiro) Department of Cardiology, Alvaro Cunqueiro Hospital,
Vigo, Spain
(Berardini, Conti, Biagini) Cardiology Unit, Cardio-Thoracic-Vascular
Department, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna,
Italy
(Rapezzi) Cardiological Center, Universitario di Ferrara, University of
Ferrara, Italy
(Rapezzi) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
(Shorr) University of Ottawa Health Sciences Library, Ottawa, ON, Canada
(Manovel, Cardenal-Piris, Diaz Fernandez) Juan Ramon Jimenez University
Hospital, Huelva, Spain
(Shuvy) Cardiovascular Research Centre, Heart Institute, Hadassah-Hebrew
University Medical Centre, Jerusalem, Israel
(Haberman) Heart Center, Kaplan Medical Center, Hebrew University of
Jerusalem, Jerusalem, Israel
(Sala) Department of Cardiovascular Anesthesia and Intensive Care, San
Raffaele Scientific Institute, Milan, Italy
(Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Marini, Bargagna, Denti, Buzzatti, Taramasso) Department of Cardiac
Surgery, San Raffaele Scientific Institute, Milan, Italy
(Schiavi) Alfieri Heart Foundation, Milan, Italy
(Markovic) Department of Internal Medicine II, University of Ulm, Ulm,
Germany
(Chan, Mesana) Division of Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Hynes) Department of Anesthesiology, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Pappalardo) Department of Anesthesia and Intensive Care, IRCCS ISMETT,
Palermo, Italy
(Taramasso) University Heart Center Zurich, University Hospital of Zurich,
Zurich, Switzerland
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to evaluate the outcome of
transcatheter mitral valve repair (TMVr) in patients with cardiogenic
shock and significant mitral regurgitation (MR). <br/>Background(s):
Patients in cardiogenic shock with severe MR have a poor prognosis in the
setting of conventional medical therapy. Because of its favorable safety
profile, TMVr is being increasingly used as an acute therapy in this
population, though its efficacy remains unknown. <br/>Method(s): A
multicenter, collaborative, patient-level analysis was conducted. Patients
with cardiogenic shock and moderate to severe (3+) or severe (4+) MR who
were not surgical candidates were treated with TMVr. The primary outcome
was in-hospital mortality. Secondary outcomes included 90-day mortality,
heart failure (HF) hospitalization, and the combined event rate of 90-day
mortality and HF hospitalization following dichotomization by TMVr device
success. <br/>Result(s): Between January 2011 and February 2019, 141
patients across 14 institutions met the inclusion criteria. In-hospital
mortality occurred in 22 patients (15.6%), at 90 days in 38 patients
(29.5%), and at one year in 55 patients (42.6%). Median length of hospital
stay following TMVr was 10 days (interquartile range: 6 to 20 days). HF
hospitalization occurred in 26 patients (18.4%) at a median of 73 days
(interquartile range: 26 to 546 days). When stratified by TMVr procedural
results, successful TMVr reduced rates of in-hospital mortality (hazard
ratio [HR]: 0.36; 95% confidence interval [CI]: 0.13 to 0.98; p = 0.04),
90-day mortality (HR: 0.36; 95% CI: 0.16 to 0.78; p = 0.01), and the
composite of 90-day mortality and HF hospitalization (HR: 0.41; 95% CI:
0.19 to 0.90; p = 0.03). <br/>Conclusion(s): TMVr may improve short- and
intermediate-term mortality in high-risk patients with cardiogenic shock
and moderate to severe MR. Randomized studies are needed to definitively
establish MR as a therapeutic target in patients with cardiogenic
shock.<br/>Copyright &#xa9; 2021 The Authors

<75>
Accession Number
2005844445
Title
A Comparison of Different Remifentanil Effect-Site Concentrations to Allow
for Early Extubation After Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (2) (pp 470-481),
2021. Date of Publication: February 2021.
Author
Khidr A.M.; Khalil M.A.; Abdulfattah D.; El Tahan M.R.
Institution
(Khidr, El Tahan) King Fahd Hospital of the University, College of
Medicine, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia
(Khalil) King Fahd Hospital of the Imam Abdulrahman Bin Faisal University,
Al Khobar, Saudi Arabia
(Khalil) Faculty of Medicine, Cairo University, Cairo, Egypt
(Abdulfattah) Clinical Nursing Supervisor Operating Room, Day Surgery,
CSSD, Hemodialysis, and PDU, King Fahd Hospital of the Imam Abdulrahman
Bin Faisal University, Al Khobar, Saudi Arabia
Publisher
W.B. Saunders
Abstract
Objectives: Assess different remifentanil effect-site concentrations (Ce)
for readiness for extubation time after cardiac surgery. <br/>Design(s):
Prospective, randomized, blinded, controlled study. <br/>Design(s): Single
university hospital. <br/>Participant(s): Seventy-three patients scheduled
for cardiac surgery. <br/>Intervention(s): After ethical approval,
patients scheduled for cardiac surgery with target-controlled propofol
infusion were randomly assigned to receive remifentanil effect-site
concentrations (Ce) of 1, 2, or 3 ng/mL (n = 25, 25, and 23,
respectively). <br/>Measurements and Main Results: The primary endpoint
was readiness for extubation. Secondary outcomes were also recorded,
including the cumulative doses and number of changes of propofol and
remifentanil, hemodynamic variables, time to spontaneous eye opening and
breathing, actual extubation, incidences of light anesthesia and
myocardial ischemia, need for vasopressors and inotropes, and intensive
care unit (ICU) and hospital stays. There was no difference in the time to
readiness for extubation in any of the groups (0.1 ng/mL: 11.5 min (5-37);
0.2 ng/mL: 22 min (10-35); and 0.3 ng/mL: 21 min (10-49), p < 0.532);
however, there was a significant difference among the 3 groups regarding
the cumulative remifentanil doses (p < 0.001). Time to spontaneous eye
opening and breathing, actual extubation, use of vasopressors and
inotropes, incidences of light anesthesia and myocardial ischemia, and
length of ICU and hospital stay were similar for all groups. Forty-six of
the 73 patients were extubated on-table. <br/>Conclusion(s): Remifentanil
Ce 1, 2, and 3 ng/mL produced comparative effects on time to extubation
and hemodynamic responses to cardiac surgery. The 3 Ce resulted in
immediate on-table extubation in 50% of patients.<br/>Copyright &#xa9;
2020 Elsevier Inc.

<76>
Accession Number
633811883
Title
Donors after circulatory death heart trial.
Source
Future Cardiology. 17 (1) (pp 11-17), 2021. Date of Publication: January
2021.
Author
Shudo Y.; Benjamin-Addy R.; Koyano T.K.; Hiesinger W.; Macarthur J.W.; Woo
Y.J.
Institution
(Shudo, Benjamin-Addy, Koyano, Hiesinger, Macarthur, Woo) Department of
Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford,
CA 94305-5407, United States
Publisher
Future Medicine Ltd.
Abstract
Orthotopic heart transplantation is the gold standard treatment for
end-stage heart failure. However, the persistent shortage of available
donor organs has resulted in an ever-increasing waitlist and longer
waiting periods for transplantation. On the contrary, increasing the
number of heart transplants by preserving extended criteria donors and
donation after circulatory death hearts with the Organ Care SystemTM (OCS)
Heart System has the potential to provide the gold standard, life-saving
treatment to patients with end-stage heart failure. The objective of the
Donation After Circulatory Death Heart Trial is to evaluate the
effectiveness of the OCS Heart System to preserve and assess hearts
donated after circulatory death for transplantation to increase the pool
of donor hearts available for transplantation, which can potentially
provide patients with end-stage heart failure with the life-saving
treatment. Clinical Trial Registration: NCT03831048
(ClinicalTrials.gov.<br/>Copyright &#xa9; 2020

<77>
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

<78>
Accession Number
2007027352
Title
Effect of Albumin Addition to Cardiopulmonary Bypass Prime on Outcomes in
Children Undergoing Open-Heart Surgery (EACPO Study)-A Randomized
Controlled Trial.
Source
World Journal for Pediatric and Congenital Heart Surgery. 12 (1) (pp
61-69), 2021. Date of Publication: January 2021.
Author
Rauf A.; Joshi R.K.; Aggarwal N.; Agarwal M.; Kumar M.; Dinand V.; Joshi
R.
Institution
(Rauf, Joshi) Department of Pediatric Intensive Care, Sir Ganga Ram
Hospital, New Delhi, Delhi, India
(Joshi, Aggarwal, Agarwal, Kumar) Department of Pediatric Cardiac
Sciences, Sir Ganga Ram Hospital, New Delhi, Delhi, India
(Dinand) Department of Research, Sir Ganga Ram Hospital, New Delhi, Delhi,
India
Publisher
SAGE Publications Inc.
Abstract
Background: There is a paucity of literature regarding the association of
high oncotic priming solutions for pediatric cardiopulmonary bypass (CPB)
and outcomes, and no consensus exists regarding the composition of optimal
CPB priming solution. This study aimed to examine the impact of high
oncotic pressure priming by the addition of 20% human albumin on outcomes.
<br/>Method(s): Double-blinded, randomized controlled study was done in
the pediatric cardiac intensive care unit of a tertiary care hospital.
Consecutive children with congenital heart diseases admitted for
open-heart surgery were randomized into two groups, where the study group
received an additional 20% albumin to conventional blood prime before CPB
initiation. <br/>Result(s): We enrolled 39 children in the high oncotic
prime (added albumin) group and 37 children in the conventional prime
group. In the first 24-hour postoperative period, children in the albumin
group had significantly lower occurrence of hypotension (28.2% vs 54%, P
=.02), requirement of fluid boluses (25.6% vs 54%, P =.006), and lactate
clearance time (6 vs 9 hours, P <.001). Albumin group also had
significantly higher platelet count (x10³/microL) at 24 hours
(112 vs 91, P =.02). There was no significant difference in intra-CPB
hemodynamic parameters and incidence of acute kidney injury. In subgroup
analysis based on risk category, significantly decreased intensive care
unit stay (4 vs 5 days, P =.04) and hospital stay (5 vs 7 days, P =.002)
were found in the albumin group in low-risk category. <br/>Conclusion(s):
High oncotic pressure CPB prime using albumin addition might be beneficial
over conventional blood prime, and our study does provide a rationale for
further studies.<br/>Copyright &#xa9; The Author(s) 2020.

<79>
Accession Number
2006974761
Title
Evaluating the Impact of Medical Student Inclusion Into Hands-On Surgical
Simulation in Congenital Heart Surgery.
Source
Journal of Surgical Education. 78 (1) (pp 207-213), 2021. Date of
Publication: 01 Jan 2021.
Author
Hon N.W.L.; Hussein N.; Honjo O.; Yoo S.-J.
Institution
(Hon) The Center for Image Guided Innovation and Therapeutic Intervention,
Hospital for Sick Children, Toronto, ON, Canada
(Hussein, Honjo) Division of Cardiology, Department of Paediatrics,
Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
(Hussein, Honjo) Division of Cardiovascular Surgery, Department of
Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON,
Canada
(Yoo) Department of Diagnostic Imaging, Division of Cardiology, Hospital
for Sick Children, University of Toronto, Toronto, ON, Canada
(Yoo) Department of Pediatrics, Hospital for Sick Children, University of
Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Objective: Over the last decade medical students' interest in pursuing
surgery as a career has declined. This is more apparent in
high-specialized specialities such as congenital heart surgery (CHS).
Early hands-on simulation has shown to have a positive impact on medical
students' interest in pursuing surgery, however, its incorporation into
medical school curricula is lacking. This study aimed to evaluate the
impact of incorporating medical students as surgical assistants during the
Hands On Surgical Training course in CHS. <br/>Method(s): Local
preclinical medical students were invited to participate as surgical
assistants during the 5th annual Hands On Surgical Training course in CHS.
Among those who responded to the invitation, students were randomly
selected and allocated to assist a congenital heart surgeon. All selected
students attended an assistants' session prior to the course to
familiarize themselves with assisting and to practice basic surgical
skills. At the end of both courses students completed a questionnaire
based on Likert 5-point scale to evaluate the courses' usefulness.
<br/>Result(s): Fifteen medical students completed the questionnaires. All
reported a beginner level of understanding of congenital heart disease.
All students were highly satisfied with using 3D-printed models to help
their understanding of congenital heart disease (4.80 +/- 0.41) and agreed
that the sessions improved their assisting skills (4.93 +/- 0.26). All
expressed a desire to attend similar sessions in the future and agreed
that surgical simulation inclusion into medical school curricula would
enhance learning (5.00 +/- 0.00). Interest in pursuing a career in CHS
increased from 33% (5) to 87% (13) by the end of the course.
<br/>Conclusion(s): Integration of preclinical medical students into
surgical simulation increases interest in pursuing highly specialised
surgical specialities such as CHS. Early exposure and the incorporation of
such simulation programs into medical school curricula will likely improve
surgical skill acquisition and may enable students to be better informed
when selecting future career choices.<br/>Copyright &#xa9; 2020

<80>
Accession Number
2006857515
Title
Comparison of transhiatal esophagectomy using a mediastinoscope with
transhiatal esophagectomy by the classic method.
Source
Asian Cardiovascular and Thoracic Annals. 29 (1) (pp 33-37), 2021. Date of
Publication: January 2021.
Author
Rezaei R.; Masuom S.H.F.; Soroush N.; Zehi V.
Institution
(Rezaei, Masuom, Soroush) Endoscopic and Minimally Invasive Surgery
Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,
Islamic Republic of
(Zehi) General Surgery, Torbat-e- Heydariyeh University of Medical
Sciences, Torbat-e-Heydariyeh, Iran, Islamic Republic of
Publisher
SAGE Publications Inc.
Abstract
Background: This study aimed to evaluate the results of transhiatal
esophagectomy using a mediastinoscope in comparison with conventional
transhiatal esophagectomy. <br/>Method(s): Sixty-two esophageal cancer
patients who were referred to our thoracic surgery clinic between April
2015 and March 2017, and met the inclusion criteria, were randomly divided
into two groups of 31 each. In the first group, patients were operated on
by conventional transhiatal esophagectomy. In the second group, only
release of the thoracic esophagus through a neck incision (mediastinal
esophagolysis) was performed using a mediastinoscope. The other surgical
procedures were similar to those in the first group. <br/>Result(s): The
mean age of the patients was almost the same in both groups (57.7 years in
the first group versus 56.7 years in the second group). There was no
significant difference in sex ratio. The mean volume of blood loss during
the operation, mean operative time, and intensive care unit stay as well
as cardiopulmonary complications and early postoperative complications
were lower in the group that had esophagectomy using a mediastinoscope,
and the number of resected mediastinal lymph nodes was greater.
<br/>Conclusion(s): Based on the results of this study, it can be expected
that use of a video mediastinoscope for esophagolysis of the thoracic
esophagus in a transhiatal esophagectomy procedure is safe and it will
reduce the morbidity and mortality in these patients.<br/>Copyright &#xa9;
The Author(s) 2020.

<81>
Accession Number
2006119769
Title
Surgical repair of anomalous aortic origin of coronary artery in adults.
Source
Asian Cardiovascular and Thoracic Annals. 29 (1) (pp 51-58), 2021. Date of
Publication: January 2021.
Author
Karangelis D.; Mylonas K.S.; Loggos S.; Adreanides E.; Tzifa A.;
Mitropoulos F.
Institution
(Karangelis, Loggos, Mitropoulos) Department of Cardiac Surgery, Mitera
Hospital, Athens, Greece
(Mylonas, Tzifa) Department of Congenital Cardiology, Mitera Hospital,
Athens, Greece
(Adreanides) Department of Cardiology, Medical Institution Military
Shareholder Fund, Athens, Greece
Publisher
SAGE Publications Inc.
Abstract
Anomalous aortic origin of a coronary artery is a congenital abnormality
of the origin or course of a coronary artery that arises from the aorta.
The surgical treatment of this anomaly is highly variable and
controversial and is achieved by implementing elaborate techniques of
anatomic repair or by simple coronary artery bypass grafting. This review
was conducted in accordance with the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses guidelines. Two independent reviewers
determined whether studies met the inclusion criteria. Eligible papers
were published in English, clinical studies describing surgical repair of
anomalous aortic origin of a coronary artery including coronary artery
bypass in adults, and enrolled >5 patients. In the absence of multicentre
trials, 7 single-center retrospective series were included, which
demonstrated comparable short- and midterm outcomes of anatomic repair and
coronary artery bypass in adults with anomalous aortic origin of a
coronary artery. Coronary unroofing was the preferred technique when the
anomalous artery has an intramural component, but there is a risk of
aortic insufficiency. Anatomic repair is technically demanding and should
be carried out in experienced centers. Coronary artery bypass with
internal thoracic artery or vein grafts is technically straightforward
with low operative risk and comparable midterm outcomes, however,
long-term outcomes are unknown. Coronary artery bypass grafting is the
technique of choice for older patients, in those with concomitant coronary
artery disease, as a bailout procedure for failed anatomic repair, or in
centers without experience in anatomic repair for anomalous aortic origin
of a coronary artery.<br/>Copyright &#xa9; The Author(s) 2020.

<82>
Accession Number
2008363299
Title
Systematic review and consensus definitions for the Standardized Endpoints
in Perioperative Medicine (StEP) initiative: cardiovascular outcomes.
Source
British Journal of Anaesthesia. 126 (1) (pp 56-66), 2021. Date of
Publication: January 2021.
Author
Beattie W.S.; Lalu M.; Bocock M.; Feng S.; Wijeysundera D.N.; Nagele P.;
Fleisher L.A.; Kurz A.; Biccard B.; Leslie K.; Howell S.; Grocott H.; Lamy
A.; Richards T.; Myles P.; Gan T.J.; Peyton P.; Sessler D.; Tramer M.;
Cyna A.; De Oliveira G.S.; Wu C.; Jensen M.; Kehlet H.; Botti M.; Boney
O.; Haller G.; Grocott M.; Cook T.; Fleisher L.; Neuman M.; Story D.;
Gruen R.; Bampoe S.; Evered L.; Scott D.; Silbert B.; van Dijk D.; Kalkman
C.; Chan M.; Eckenhoff R.; Rasmussen L.; Eriksson L.; Beattie S.;
Wijeysundera D.; Landoni G.; Bartlett R.J.; McMonnies R.; Gerstl J.; Jay
M.; Kishlyansky D.; Machina M.; Bobcock M.; Pearse R.; Mythen M.; Canet
J.; Moller A.; Gin T.; Schultz M.; Pelosi P.; Gabreu M.; Futier E.;
Creagh-Brown B.; Abbott T.; Klein A.; Corcoran T.; Cooper D.J.; Dieleman
S.; Diouf E.; McIlroy D.; Bellomo R.; Shaw A.; Prowle J.; Karkouti K.;
Billings J.; Mazer D.; Jayarajah M.; Murphy M.; Bartoszko J.; Sneyd R.;
Morris S.; George R.; Moonesinghe R.; Shulman M.; Lane-Fall M.; Nilsson
U.; Stevenson N.; Cooper J.D.; van Klei W.; Cabrini L.; Miller T.; Pace
N.; Jackson S.; Buggy D.; Short T.; Riedel B.; Gottumukkala V.; Alkhaffaf
B.; Johnson M.
Institution
(Beattie) Cardiovascular Anesthesia, University Health Network, University
of Toronto, Toronto, ON, Canada
(Lalu, Bocock, Feng) Department of Anesthesia, University of Ottawa,
Ottawa, ON, Canada
(Wijeysundera) Li Ka Shing Knowledge Institute, St Michaels Hospital,
University of Toronto, Toronto, ON, Canada
(Nagele) Department of Anesthesia and Critical Care, University of
Chicago, Chicago, IL, United States
(Fleisher) Department of Anesthesiology and Critical Care, University of
Pennsylvania Health System, Philadelphia, PA, United States
(Kurz) Outcomes Research, Cleveland Clinic, Cleveland, OH, United States
(Biccard) Department of Anesthesia and Perioperative Medicine, University
of Cape Town, Cape Town, South Africa
(Leslie) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, Vic., Australia
(Howell) University of Leeds School of Medicine, Leeds, United Kingdom
(Landoni) Center for Intensive Care and Anesthesiology, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Grocott) Department of Anesthesia and Perioperative Medicine, University
of Manitoba, Winnipeg, MB, Canada
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
(Richards) University of Western Australia, Perth, Australia
(Myles) Alfred Health and Monash University Department of Anaesthesia and
Perioperative Medicine, Melbourne, Vic., Australia
Publisher
Elsevier Ltd
Abstract
Background: Adverse cardiovascular events are a leading cause of
perioperative morbidity and mortality. The definitions of perioperative
cardiovascular adverse events are heterogeneous. As part of the
international Standardized Endpoints in Perioperative Medicine initiative,
this study aimed to find consensus amongst clinical trialists on a set of
standardised and valid cardiovascular outcomes for use in future
perioperative clinical trials. <br/>Method(s): We identified currently
used perioperative cardiovascular outcomes by a systematic review of the
anaesthesia and perioperative medicine literature (PubMed/Ovid, Embase,
and Cochrane Library). We performed a three-stage Delphi consensus-gaining
process that involved 55 clinician researchers worldwide. Cardiovascular
outcomes were first shortlisted and the most suitable definitions
determined. These cardiovascular outcomes were then assessed for validity,
reliability, feasibility, and clarity. <br/>Result(s): We identified 18
cardiovascular outcomes. Participation in the three Delphi rounds was 100%
(n=19), 71% (n=55), and 89% (n=17), respectively. A final list of nine
cardiovascular outcomes was elicited from the consensus: myocardial
infarction, myocardial injury, cardiovascular death, non-fatal cardiac
arrest, coronary revascularisation, major adverse cardiac events,
pulmonary embolism, deep vein thrombosis, and atrial fibrillation. These
nine cardiovascular outcomes were rated by the majority of experts as
valid, reliable, feasible, and clearly defined. <br/>Conclusion(s): These
nine consensus cardiovascular outcomes can be confidently used as
endpoints in clinical trials designed to evaluate perioperative
interventions with the goal of improving perioperative
outcomes.<br/>Copyright &#xa9; 2020 British Journal of Anaesthesia

<83>
Accession Number
2007522911
Title
Pharmacological interventions for the prevention of renal injury in
surgical patients: a systematic literature review and meta-analysis.
Source
British Journal of Anaesthesia. 126 (1) (pp 131-138), 2021. Date of
Publication: January 2021.
Author
Pathak S.; Olivieri G.; Mohamed W.; Abbasciano R.; Roman M.; Tomassini S.;
Lai F.; Wozniak M.; Murphy G.J.
Institution
(Pathak, Olivieri, Mohamed, Abbasciano, Roman, Tomassini, Lai, Wozniak,
Murphy) Department of Cardiovascular Sciences, National Institute for
Health Research Leicester Biomedical Research Unit in Cardiovascular
Medicine, University of Leicester, Leicester, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: The aim of this systematic review was to summarise the results
of randomised controlled trials (RCTs) that have evaluated pharmacological
interventions for renoprotection in people undergoing surgery.
<br/>Method(s): Searches were conducted to update a previous review using
the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE to
August 23, 2019. RCTs evaluating the use of pharmacological interventions
for renal protection in the perioperative period were included. The
co-primary outcome measures were 30-day mortality and acute kidney injury
(AKI). Pooled effect estimates were expressed as risk ratios (RRs) (95%
confidence intervals). <br/>Result(s): We included 228 trials enrolling 56
047 patients. Twenty-three trials were considered to be at low risk of
bias across all domains. Atrial natriuretic peptides (14 trials; n=2207)
reduced 30-day mortality (RR: 0.63 [0.41, 0.97]) and AKI events (RR: 0.43
[0.33, 0.56]) without heterogeneity. These effects were consistent across
cardiac surgery and vascular surgery subgroups, and in sensitivity
analyses restricted to studies at low risk of bias. Inodilators (13
trials; n=2941) reduced mortality (RR: 0.71 [0.53, 0.94]) and AKI events
(RR: 0.65 [0.50, 0.85]) in the primary analysis and in cardiac surgery
cohorts. Vasopressors (4 trials; n=1047) reduced AKI (RR: 0.56 [0.36,
0.86]). Nitric oxide donors, alpha-2-agonists, and calcium channel
blockers reduced AKI in primary analyses, but not after exclusion of
studies at risk of bias. Overall, assessment of the certainty of the
effect estimates was low. <br/>Conclusion(s): There are multiple effective
pharmacological renoprotective interventions for people undergoing
surgery.<br/>Copyright &#xa9; 2020 The Authors

<84>
Accession Number
632561674
Title
The effects of foot reflexology on agitation and extubation time in male
patients following coronary artery bypass surgery: A randomized controlled
clinical trial.
Source
Complementary therapies in clinical practice. 40 (pp 101201), 2020. Date
of Publication: 01 Aug 2020.
Author
Allahbakhhsian A.; Gholizadeh L.; Allahbakhshian M.; Sarbakhsh P.;
Abbaszadeh Y.
Institution
(Allahbakhhsian, Abbaszadeh) Faculty of Nursing and Midwifery, Tabriz
University of Medical Sciences, Tabriz, Iran, Islamic Republic of
(Gholizadeh) Faculty of Health, University of Technology Sydney, Sydney,
Australia
(Allahbakhshian) Faculty of Nursing and Midwifery, Shahid Beheshti
University of Medical Sciences. Tehran, Iran, Islamic Republic of
(Sarbakhsh) Faculty of Public Health, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
BACKGROUND AND PURPOSE: This study examined the effects of foot
reflexology on agitation and extubation time of male patients following
coronary artery bypass graft surgery. MATERIALS AND METHODS: In this
randomized three-arm controlled clinical trial, participants (n = 120)
were randomly assigned to the intervention, placebo, or control groups.
The intervention group received foot reflexology massage for 15 min.
Agitation was assessed using the Richmond Agitation- Sedation Scale before
the intervention (Time 1) and immediately (Time 2) and 10 min after the
intervention (Time 3). Extubation time was measured as the time from
gaining full consciousness to endotracheal extubation. <br/>RESULT(S):
Agitation reduced in all groups from Time 1 to Time 3 (p < 0.05); however,
the intervention group showed a significantly higher reduction at Time 2
(p < 0.001) and Time 3 (p < 0.001). Also, extubation time was
significantly shorter in the intervention group (p < 0.01).
<br/>CONCLUSION(S): Foot reflexology may be introduced as a nursing
intervention to facilitate the weaning process in the cardiac
ICUs.<br/>Copyright &#xa9; 2020 Elsevier Ltd. All rights reserved.

<85>
Accession Number
632795406
Title
The effect of aromatherapy with peppermint essential oil on nausea and
vomiting after cardiac surgery: A randomized clinical trial.
Source
Complementary therapies in clinical practice. 40 (pp 101199), 2020. Date
of Publication: 01 Aug 2020.
Author
Afazel M.R.; Azizi-Fini I.; Maghami M.
Institution
(Maghami, Afazel) Trauma Nursing Research Center, Faculty of Nursing and
Midwifery, Kashan University of Medical Sciences, Iran, Islamic Republic
of
(Azizi-Fini) Trauma Nursing Research Center, Faculty of Nursing and
Midwifery, Kashan University of Medical Sciences, Iran, Islamic Republic
of
(Maghami) Department of Biostatistics and Epidemiology, School of Health,
Isfahan university of Medical sciences, Isfahan, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
Background Postoperative nausea and vomiting are common in patients who
underwent cardiac surgery. This study aimed to examine the effect of
peppermint essential oil inhalation on the postoperative nausea and
vomiting after cardiac surgery. Methods In this clinical trial study, 60
cardiac surgery patients were divided into control and intervention
groups. The intervention group underwent nebulizer aromatherapy with
peppermint essential oil before the endotracheal tube was removed after
surgery. Patients' nausea and vomiting were then assessed through a
checklist. The independent-samples t-test, chi-square, and Generalized
estimating equation were used for data analysis. Results Totally 85.7% of
the patients undergone coronary artery bypass graft surgery. The two
groups did not significantly differ in terms of their baseline demographic
and clinical variables (P > 0.05). Significant differences were found
between the intervention and control groups in terms of the frequency of
nausea (0.63 +/- 0.81 vs. 1.46 +/- 1.21), its duration (3.78 +/- 5.09 vs.
7.97 +/- 5.55 min), and severity (2.43 +/- 2.84 vs. 4.61 +/- 2.85), and in
the frequency of vomiting episodes (0.17 +/-.46 vs. 0.73 +/-.60) in the
first four hours after extubation (P < 0.05). <br/>Conclusion(s):
Peppermint essential oil inhalation has beneficial effects on reducing
nausea and vomiting after open-heart surgery. Using peppermint essential
oil inhalation for managing postoperative nausea and vomiting is
recommended.<br/>Copyright &#xa9; 2020 Elsevier Ltd. All rights reserved.

<86>
Accession Number
633183839
Title
Precision implementation of early ambulation in elderly patients
undergoing off-pump coronary artery bypass graft surgery: a
randomized-controlled clinical trial.
Source
BMC geriatrics. 20 (1) (pp 404), 2020. Date of Publication: 14 Oct 2020.
Author
Cui Z.; Li N.; Gao C.; Fan Y.; Zhuang X.; Liu J.; Zhang J.; Tan Q.
Institution
(Cui, Zhuang, Liu, Zhang) Intensive Care Unit (ICU), Department of Cardiac
Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical
University, Jinan, Shandong 250021, China
(Li) Department of Gynecology, Shandong Provincial Hospital Affiliated to
Shandong First Medical University, Jinan, Shandong 250021, China
(Gao) Department of Biostatistics, School of Public Health, Cheeloo
College of Medicine, Shandong University, Jinan, Shandong 250012, China
(Fan) Department of Toxicological and Functional Test, Centers for Disease
Control and Prevention of Shandong, Jinan 250014, China
(Tan) Intensive Care Unit (ICU), Department of Cardiac Surgery, Shandong
Provincial Hospital Affiliated to Shandong First Medical University,
Jinan, Shandong 250021, China
(Tan) Intensive Care Unit (ICU), Department of Cardiac Surgery, Shandong
Provincial Hospital, Cheeloo College of Medicine, Shandong University,
Jinan, Shandong 250021, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although early ambulation (EA) is associated with improved
outcomes in post-operative patients, implementation of EA in elderly
patients is still a challenge. In this study, we aimed to design and
assess a precision early ambulation program for cardiac rehabilitation.
<br/>METHOD(S): We conducted a single-center, randomized and controlled
clinical trial in elderly patients aged over 60years after off-pump
coronary artery bypass graft (OPCABG) surgery. Patients were randomly
assigned to a precision early ambulation (PEA) group or a routine
ambulation (Control) group. Age-predicted maximal heart rate (APMHR) and
maximal oxygen uptake (VO2max) were used as a reference to formulate and
monitor the PEA regimen. The primary end-point was the postoperative
length of stay in hospital (PLOS). The secondary end-points included
90-day mortality, incidence of early discharge, laboratory tests, length
of ICU stay, the incidence of multiple organ complications and
post-traumatic stress disorder (PTSD). Ambulation outcomes were also
recorded. <br/>RESULT(S): In total, 178 patients were enrolled (n=89 per
group). In the intent-to-treat analysis, PLOS in the PEA group was shorter
than that in the Control group (9.04+/-3.08 versus 10.09+/-3.32days,
respectively. Mean difference 1.045days; 95% confidence interval [CI]
0.098-1.992; P=0.031 in the unadjusted model; mean difference 0.957days;
CI 0.007-1.907; P=0.048 in adjusted model). The incidence of early
discharge differed significantly between the PEA and control groups
(41[46.1%] versus 24[27.0%] patients, respectively. Odds ratio [OR] 0.432;
CI 0.231-0.809; P=0.009 in unadjusted model; OR 0.466; CI 0.244-0.889,
P=0.02 in adjusted model). The time of first bowel movement, partial
pressure O2 and post-traumatic stress disorder score in the PEA group were
better than those in the Control group. Participants walked much longer
distances on day 3 in the PEA group than those in the Control group
(76.12+/-29.02 versus 56.80+/-24.40m, respectively, P < 0.001).
<br/>CONCLUSION(S): APMHR and VO2max are valuable for implementation of
PEA according to an established security threshold. PEA after OPCAPG
surgery is safe and reliable for elderly patients, not only reducing the
hospital stay, but also improving their physiological and psychological
symptoms. TRIAL REGISTRATION: This study is a component of a protocol
retrospectively registered: Application of ERAS in cardiovascular surgery.
TRIAL REGISTRATION NUMBER: ChiCTR1800018167 . Date of registration: 3rd
September, 2018. URL of trial registry record:
http://www.chictr.org.cn/index.aspx.

<87>
Accession Number
2010427472
Title
MAGGIC, STS, and EuroSCORE II Risk Score Comparison After Aortic and
Mitral Valve Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Zhuo D.X.; Bilchick K.C.; Shah K.P.; Mehta N.K.; Mwansa H.; Nkanza-Kabaso
K.; Kwon Y.; Breathett K.K.; Hilton-Buchholz E.J.; Mazimba S.
Institution
(Zhuo, Bilchick, Shah, Mehta, Mazimba) University of Virginia Health
System, Department of Medicine, Division of Cardiovascular Medicine,
Charlottesville, VA, United States
(Mwansa) OSF Saint Francis Medical Center, Peoria, IL, United States
(Nkanza-Kabaso) University of Cape Town, Groote Schuur Hospital, Cape
Town, South Africa
(Kwon) University of Washington Medical Center, University of Washington
Division of Cardiology, Harborview Medical Center, Seattle, WA, United
States
(Breathett) University of Arizona College of Medicine, Division of
Cardiology/Sarver Heart Center, Tucson, AZ, United States
(Hilton-Buchholz) University of Virginia Health System, Department of
Anesthesiology, Charlottesville, VA, United States
Publisher
W.B. Saunders
Abstract
Objectives: To compare the Meta-Analysis Global Group in Chronic Heart
Failure (MAGGIC) risk score with the established Society of Thoracic
Surgeons (STS) and EuroSCORE II risk prediction models regarding mortality
discrimination after aortic and mitral valve surgery. <br/>Design(s):
Retrospective cohort study. <br/>Setting(s): Single tertiary academic
medical center. <br/>Participant(s): A total of 259 patients who underwent
open aortic valve replacement or open mitral valve repair/replacement from
2009-2014. <br/>Intervention(s): Retrospective chart review.
<br/>Measurements and Main Results: MAGGIC, STS, and EuroSCORE II risk
scores for each patient were studied using binary logistic regression and
receiver operating characteristic analysis for the primary endpoint of
one-year mortality and secondary endpoint of 30-day mortality. One-year
mortality C-statistics were similar across risk scores (STS 0.709, 95%
confidence interval [CI] 0.578-0.841; MAGGIC 0.673, 95% CI 0.547-0.799;
EuroSCORE II 0.642, 95% CI 0.521-0.762; p = 0.56 between STS and MAGGIC; p
= 0.20 between STS and EuroSCORE II; and p = 0.69 between MAGGIC and
EuroSCORE II). Thirty-day mortality C-statistics also were similar between
STS (0.797, 95% CI 0.655-0.939; p < 0.0001 v null hypothesis), MAGGIC
(0.721, 95% CI 0.581-0.860; p = 0.33 v STS), and EuroSCORE II (0.688, 95%
CI 0.557-0.818; p = 0.06 v STS; p = 0.68 v MAGGIC). <br/>Conclusion(s):
The MAGGIC risk score performs similarly to STS and EuroSCORE II risk
models in mortality discrimination after aortic and mitral valve surgery,
albeit in a small sample size. This finding has important implications in
establishing MAGGIC as a viable prognostic model in this population
subset, with fewer variables and ease of use representing key advantages
over STS and EuroSCORE II.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<88>
Accession Number
633361723
Title
Inotropic agents and vasodilator strategies for the treatment of
cardiogenic shock or low cardiac output syndrome.
Source
The Cochrane database of systematic reviews. 11 (pp CD009669), 2020. Date
of Publication: 05 Nov 2020.
Author
Uhlig K.; Efremov L.; Tongers J.; Frantz S.; Mikolajczyk R.; Sedding D.;
Schumann J.
Institution
(Uhlig, Schumann) Department of Anaesthesiology and Surgical Intensive
Care, Martin-Luther-University Halle-Wittenberg ,Halle/Saale, Germany
(Efremov, Mikolajczyk) Institute for Medical Epidemiology, Biometrics and
Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical
School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale),
Germany
(Tongers, Sedding) Cardiology, Angiology and Intensive Care Medicine,
University Hospital Halle (Saale), Halle (Saale), Germany
(Frantz) Department of Internal Medicine I, University Hospital Wurzburg,
Wurzburg, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiogenic shock (CS) and low cardiac output syndrome (LCOS)
are potentially life-threatening complications of acute myocardial
infarction (AMI), heart failure (HF) or cardiac surgery. While there is
solid evidence for the treatment of other cardiovascular diseases of acute
onset, treatment strategies in haemodynamic instability due to CS and LCOS
remains less robustly supported by the given scientific literature.
Therefore, we have analysed the current body of evidence for the treatment
of CS or LCOS with inotropic and/or vasodilating agents. This is the
second update of a Cochrane review originally published in 2014.
<br/>OBJECTIVE(S): Assessment of efficacy and safety of cardiac care with
positive inotropic agents and vasodilator agents in CS or LCOS due to AMI,
HF or after cardiac surgery. <br/>SEARCH METHOD(S): We conducted a search
in CENTRAL, MEDLINE, Embase and CPCI-S Web of Science in October 2019. We
also searched four registers of ongoing trials and scanned reference lists
and contacted experts in the field to obtain further information. No
language restrictions were applied. SELECTION CRITERIA: Randomised
controlled trials (RCTs) enrolling patients with AMI, HF or cardiac
surgery complicated by CS or LCOS. DATA COLLECTION AND ANALYSIS: We used
standard methodological procedures according to Cochrane standards. MAIN
RESULTS: We identified 19 eligible studies including 2385 individuals
(mean or median age range 56 to 73 years) and three ongoing studies. We
categorised studies into 11 comparisons, all against standard cardiac care
and additional other drugs or placebo. These comparisons investigated the
efficacy of levosimendan versus dobutamine, enoximone or placebo;
enoximone versus dobutamine, piroximone or epinephrine-nitroglycerine;
epinephrine versus norepinephrine or norepinephrine-dobutamine; dopexamine
versus dopamine; milrinone versus dobutamine and dopamine-milrinone versus
dopamine-dobutamine. All trials were published in peer-reviewed journals,
and analyses were done by the intention-to-treat (ITT) principle. Eighteen
of 19 trials were small with only a few included participants. An
acknowledgement of funding by the pharmaceutical industry or missing
conflict of interest statements occurred in nine of 19 trials. In general,
confidence in the results of analysed studies was reduced due to relevant
study limitations (risk of bias), imprecision or indirectness. Domains of
concern, which showed a high risk in more than 50% of included studies,
encompassed performance bias (blinding of participants and personnel) and
bias affecting the quality of evidence on adverse events. All comparisons
revealed uncertainty on the effect of inotropic/vasodilating drugs on
all-cause mortality with a low to very low quality of evidence. In detail,
the findings were: levosimendan versus dobutamine (short-term mortality:
RR 0.60, 95% CI 0.36 to 1.03; participants = 1701; low-quality evidence;
long-term mortality: RR 0.84, 95% CI 0.63 to 1.13; participants = 1591;
low-quality evidence); levosimendan versus placebo (short-term mortality:
no data available; long-term mortality: RR 0.55, 95% CI 0.16 to 1.90;
participants = 55; very low-quality evidence); levosimendan versus
enoximone (short-term mortality: RR 0.50, 0.22 to 1.14; participants = 32;
very low-quality evidence; long-term mortality: no data available);
epinephrine versus norepinephrine-dobutamine (short-term mortality: RR
1.25; 95% CI 0.41 to 3.77; participants = 30; very low-quality evidence;
long-term mortality: no data available); dopexamine versus dopamine
(short-term mortality: no deaths in either intervention arm; participants
= 70; very low-quality evidence; long-term mortality: no data available);
enoximone versus dobutamine (short-term mortality RR 0.21; 95% CI 0.01 to
4.11; participants = 27; very low-quality evidence; long-term mortality:
no data available); epinephrine versus norepinephrine (short-term
mortality: RR 1.81, 0.89 to 3.68; participants = 57; very low-quality
evidence; long-term mortality: no data available); and dopamine-milrinone
versus dopamine-dobutamine (short-term mortality: RR 1.0, 95% CI 0.34 to
2.93; participants = 20; very low-quality evidence; long-term mortality:
no data available). No information regarding all-cause mortality were
available for the comparisons milrinone versus dobutamine, enoximone
versus piroximone and enoximone versus epinephrine-nitroglycerine.
AUTHORS' <br/>CONCLUSION(S): At present, there are no convincing data
supporting any specific inotropic or vasodilating therapy to reduce
mortality in haemodynamically unstable patients with CS or LCOS.
Considering the limited evidence derived from the present data due to a
high risk of bias and imprecision, it should be emphasised that there is
an unmet need for large-scale, well-designed randomised trials on this
topic to close the gap between daily practice in critical care of
cardiovascular patients and the available evidence. In light of the
uncertainties in the field, partially due to the underlying methodological
flaws in existing studies, future RCTs should be carefully designed to
potentially overcome given limitations and ultimately define the role of
inotropic agents and vasodilator strategies in CS and LCOS.<br/>Copyright
&#xa9; 2020 The Cochrane Collaboration. Published by John Wiley & Sons,
Ltd.

<89>
Accession Number
631415431
Title
A randomized trial comparing the effects of sternal band and plate
fixation of the sternum with that of figure-of-8 wires on sternal edge
motion and quality of recovery after cardiac surgery.
Source
Interactive cardiovascular and thoracic surgery. 30 (6) (pp 863-870),
2020. Date of Publication: 01 Jun 2020.
Author
Royse A.G.; El-Ansary D.; Hoang W.; Lui E.; McCusker M.; Tivendale L.;
Yang Y.; Canty D.J.; Royse C.F.
Institution
(Royse, El-Ansary, Tivendale, Yang, Canty, Royse) Department of Surgery,
The University of Melbourne, Parkville, VIC, Australia
(Royse, El-Ansary, Hoang, Tivendale, Royse) Department of Surgery, The
Royal Melbourne Hospital, Melbourne, VIC, Australia
(Royse, El-Ansary, Royse) Department of Health Professions, Faculty of
Art, Design and Health, Swinburne University of Technology, Melbourne,
VIC, Australia
(Lui, McCusker) Department of Radiology, The University of Melbourne,
Parkville, VIC, Australia
(Yang) Department of Intensive Care, Western Hospital, Melbourne, VIC,
Australia
(Canty) Department of Anaesthesia and Pain Management, Monash Medical
Centre, Melbourne, VIC, Australia
(Royse) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Royse) Outcomes Research Consortium, The Cleveland Clinic, Cleveland, OH,
USA
Publisher
NLM (Medline)
Abstract
OBJECTIVES: We sought to compare the effects of conventional wire cerclage
with that of the band and plate fixation of the sternum. <br/>METHOD(S): A
parallel randomized open-label trial with 1:1 allocation ratio compared
healing after adult cardiac surgery using 'figure-of-8' stainless steel
wire cerclage or a band and plate system (plates). The primary end point
was maximal sternal edge displacement during active coughing of >=2mm in
>=2 of 4 sites measured with ultrasound by 2 assessors blinded to the
other at 6weeks postoperatively. Secondary end points at 12weeks included
ultrasound assessment, computed tomography (CT) scan and multidimensional
assessment of quality of recovery using the Postoperative Quality of
Recovery Scale. <br/>RESULT(S): Of 50 patients, 26 received plates and 24
wires. Two patients died and 1 withdrew consent leaving 25 plates and 22
wires for primary end point analysis. Operations included 37 coronary, 5
valve and 8 combined coronary and valve procedures. At 6weeks, less
sternal movement was observed in patients with plates than those with
wires, 4% (1/25) vs 32% (7/22), P=0.018. Agreement between observers was
high, kappa=0.850. At 12weeks, less ultrasound motion was seen in patients
with plates, 0% (0/23) than those with wires, 25% (5/20), P=0.014.
Recovery from pain was higher for patients with plates 92% (22/24) than
those with wires 67% (14/21), P=0.004. CT bone edge separation was less
for plates 38% (9/24) than wires 71% (15/21), P=0.036. CT mild bone
synthesis or greater was similar between patients with plates 21% (5/24)
and wires 14% (3/21), P=0.71. <br/>CONCLUSION(S): Patients receiving the
band and plate system had significantly less sternal edge motion than
those receiving wires, 6 and 12weeks after cardiac surgery and experienced
less pain. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov
NCT03282578.<br/>Copyright &#xa9; The Author(s) 2020. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<90>
Accession Number
2010591079
Title
Ischemic heart disease and risk of development of cognitive disorders or
dementia (review).
Source
Journal of Cardiovascular Disease Research. 11 (4) (pp 87-90), 2020. Date
of Publication: October 2020.
Author
Osipova O.A.; Golovin A.I.; Shevtsov R.Y.; Zhernakova N.I.; Bocharova
K.A.; Chefranova Z.Y.
Institution
(Osipova, Golovin, Shevtsov, Zhernakova, Bocharova, Chefranova) Belgorod
State University, 85, Pobedy St, Belgorod 308015, Russian Federation
Publisher
EManuscript Technologies
Abstract
An increase in life expectancy in Europe and Russia leads to an increase
in the number of patients of older age groups with Cardiovascular diseases
(CVD). The incidence of coronary heart disease (CHD) and the presence of
cognitive impairment (CI) and dementia (DM) increase with age and have
common risk factors. It should be noted that atherosclerosis and CHD are
associated with brain ischemia and specific lesions. Research interest in
the relationship between cardiovascular disease and dementia has more
often focused on cerebrovascular disease than on CHD. It is important to
note that it is the studies in middleaged and CHD patients, as well as the
links with cognitive impairment that are important. Since more often,
coronary heart disease manifests itself in middle age. This literature
review presents data from studies aimed at studying the relationship of
coronary heart disease and cognitive impairment, new research on the
relationship between coronary artery disease, the prevalence of the
disease and poor cognitive status. Studies are presented on the study of a
cohort of patients of middle, elderly and senile age. The research data on
the study of the dependence of atherosclerosis, age, various forms of
coronary heart disease (stable coronary heart disease, acute myocardial
infarction, revascularization by percutaneous coronary intervention and
coronary artery bypass grafting) with the course and clinical
manifestations of cognitive impairment and dementia, complications and
severity of cognitive impairment are described. Studies aimed at linking
coronary heart disease and cognitive impairment require further study to
determine the mechanisms of their development and progression and identify
new strategies in preventive medicine.<br/>Copyright &#xa9; 2020
EManuscript Technologies. All rights reserved.

<91>
Accession Number
2010546797
Title
Aortic Valve Replacement in Low-Risk Patients With Severe Aortic Stenosis
Outside Randomized Trials.
Source
Journal of the American College of Cardiology. 77 (2) (pp 111-123), 2021.
Date of Publication: 19 Jan 2021.
Author
Alperi A.; Voisine P.; Kalavrouziotis D.; Dumont E.; Dagenais F.; Perron
J.; Silva I.; Bernardi F.; Mohammadi S.; Rodes-Cabau J.
Institution
(Alperi, Voisine, Kalavrouziotis, Dumont, Dagenais, Perron, Silva,
Bernardi, Mohammadi, Rodes-Cabau) Quebec Heart & Lung Institute, Laval
University, Quebec City, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Recent randomized trials including low-risk patients showed
positive results for transcatheter aortic valve replacement (TAVR)
compared to surgical aortic valve replacement (SAVR), but patients with
non-tricuspid aortic valve (NTAV), severe coronary artery disease
(SevCAD), and those requiring concomitant mitral/tricuspid valve (CMTV) or
concomitant ascending aorta replacement (CAAR) interventions were
excluded. <br/>Objective(s): This study sought to evaluate the presence
and impact of the main clinical variables not evaluated in TAVR versus
SAVR trials (NTAV, SevCAD, and CMTV or CAAR intervention) in a large
series of consecutive low-risk patients with severe aortic stenosis (SAS)
undergoing SAVR. <br/>Method(s): Single-center study including consecutive
patients with SAS and low surgical risk (Society of Thoracic Surgeons
score of <4%) undergoing SAVR. Baseline, procedural characteristics, and
30-day outcomes were prospectively collected. <br/>Result(s): Of 6,772
patients with SAS who underwent SAVR between 2000 and 2019, 5,310 (78.4%)
exhibited a low surgical risk (mean Society of Thoracic Surgeons score:
1.94 +/- 0.87%). Of these, 2,165 patients (40.8%) had at least 1 of the
following: NTAV (n = 1,468, 27.6%), SevCAD (n = 307, 5.8%), CMTV (n = 306,
5.8%), and CAAR (n = 560, 10.5%). The 30-day mortality and stroke rates
for the overall low-risk SAS cohort were 1.9% and 2.4%, respectively. The
mortality rate was similar in the SevCAD (2.6%) and CAAR (2.1%) groups
versus the rest of the cohort (odds ratio [OR]: 1.79; 95% confidence
interval [CI]: 0.85 to 3.75, and OR: 1.64; 95% CI: 0.88 to 3.05,
respectively), lower in the NTAV group (0.9%; OR: 0.42; 95% CI: 0.22 to
0.81), and higher in the CMTV group (5.9%; OR: 2.61; 95% CI: 1.51 to 4.5).
<br/>Conclusion(s): In a real-world setting, close to one-half of the
low-risk patients with SAS undergoing SAVR exhibited at least 1 major
criterion not evaluated in TAVR versus SAVR randomized trials. Clinical
outcomes were better than or similar to those predicted by surgical scores
in all groups but those patients requiring CMTV intervention. These
results may help determine the impact of implementing the results of
TAVR-SAVR trials in real practice and may inform future trials in specific
groups.<br/>Copyright &#xa9; 2021 American College of Cardiology
Foundation

<92>
Accession Number
2010145067
Title
Efficacy of Valerian Extract on Sleep Quality after Coronary Artery bypass
Graft Surgery: A Triple-Blind Randomized Controlled Trial.
Source
Chinese Journal of Integrative Medicine. 27 (1) (pp 7-15), 2021. Date of
Publication: January 2021.
Author
Zare Elmi H.; Gholami M.; Saki M.; Ebrahimzadeh F.
Institution
(Zare Elmi) Student Research Committee, Lorestan University of Medical
Sciences, Khorramabad 6814993165, Iran, Islamic Republic of
(Gholami) School of Nursing and Midwifery, Lorestan University of Medical
Sciences, Khorramabad 6814993165, Iran, Islamic Republic of
(Saki) Social Determinants of Health Research Center, Lorestan University
of Medical Sciences, Khorramabad 6814993165, Iran, Islamic Republic of
(Ebrahimzadeh) Department of Biostatistics and Epidemiology, School of
Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad
6814993165, Iran, Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To assess the effect of valerian root extract on the sleep
quality of patients after coronary artery bypass graft (CABG) surgery.
<br/>Method(s): The patients who participated in this triple-blind
clinical trial were selected by permuted block randomization. The
participants were assigned to the valerian (n=36) and placebo (n=36)
groups. The valerian group received 530 mg of valerian capsules for 30
nights after CABG surgery, and the placebo group received 530 mg of the
placebo capsules containing wheat flour. The Pittsburgh Sleep Quality
Index (PSQI), the prothrombin time (PT) and partial thromboplastin time
(PTT) were assessed on four occasions, including the baseline, the 3rd,
14th and 30th days following intervention. <br/>Result(s): The odds ratio
of worsened sleep quality significantly varied over time (the interaction
of time and group) in the valerian group compared to the placebo group in
various dimensions including total sleep quality (P=0.001), sleep latency
(P<0.01), sleep duration (P=0.020), sleep efficiency (P=0.001) and daytime
dysfunction (P=0.025). No significant difference was observed in the
alterations of the odds ratio of PT in the two groups over time.
(P=0.371). <br/>Conclusion(s): The consumption of oral valerian root
extract over 30 nights could significantly improve the patients' sleep
quality safely after CABG surgery.<br/>Copyright &#xa9; 2020, The Chinese
Journal of Integrated Traditional and Western Medicine Press and
Springer-Verlag GmbH Germany, part of Springer Nature.

<93>
Accession Number
2010133649
Title
Effects of intraoperative goal-directed fluid therapy and restrictive
fluid therapy combined with enhanced recovery after surgery protocol on
complications after thoracoscopic lobectomy in high-risk patients: study
protocol for a prospective randomized controlled trial.
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 36. Date of
Publication: December 2021.
Author
Guan Z.; Gao Y.; Qiao Q.; Wang Q.; Liu J.
Institution
(Guan, Gao, Qiao, Wang) Department of Anesthesiology, the First Affiliated
Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
(Liu) Department of Neurology, the Second Affiliated Hospital of Xi'an
Jiaotong University, Xi'an, Shaanxi, China
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is a common complication after
thoracoscopic lobectomy in high-risk patients due to insufficient
intraoperative infusion. Goal-directed fluid therapy (GDFT) is an
individualized fluid infusion strategy; the fluid infusion strategy is
adjusted according to the patient's fluid response. GDFT during operation
can reduce the incidence of AKI after major surgery. Enhanced recovery
after surgery (ERAS) protocol optimizes perioperative interventions to
decrease the postoperative complications after surgery. In ERAS protocol
of lobectomy, intraoperative restrictive fluid therapy is recommended. In
this study, we will compare the effects of intraoperative GDFT with
restrictive fluid therapy combined with an ERAS protocol on the incidence
of AKI after thoracoscopic lobectomy in high-risk patients.
Methods/design: This is a prospective single-center single-blind
randomized controlled trial. Two hundred seventy-six patients scheduled
for thoracoscopic lobectomy are randomly allocated to receive either GDFT
or restrictive fluid therapy combined with an ERAS protocol at a 1:1
ratio. The primary outcome is the incidence of AKI after operation. The
secondary outcomes include (1) the incidence of renal replacement therapy,
(2) the length of intensive care unit stay after operation, (3) the length
of hospital stay after operation, and (4) the incidence of other
complications including infection, acute lung injury, pneumonia,
arrhythmia, heart failure, myocardial injury after noncardiac surgery, and
cardiac infarction. <br/>Discussion(s): This is the first study to compare
intraoperative GDFT with restrictive fluid therapy combined with an ERAS
protocol on the incidence of AKI after thoracoscopic lobectomy in
high-risk patients. The hypothesis is that the restrictive fluid therapy
is noninferior to GDFT in reducing the incidence of AKI, but restrictive
fluid therapy is simpler to apply than GDFT. Trial registration:
ClinicalTrials.govNCT04302467. Registered on 26 February
2020<br/>Copyright &#xa9; 2021, The Author(s).

<94>
Accession Number
2010128408
Title
Non-surgical treatment of tetanus infection associated with breast cancer
skin ulcer: a case report and literature review.
Source
BMC Infectious Diseases. 21 (1) (no pagination), 2021. Article Number: 37.
Date of Publication: December 2021.
Author
Nomura K.; Sakawaki E.; Sakawaki S.; Yamaoka A.; Aisaka W.; Okamoto H.;
Takeyama Y.; Uemura S.; Narimatsu E.
Institution
(Nomura, Aisaka, Uemura, Narimatsu) Department of Emergency Medicine,
Sapporo Medical University, Minami 1-jo, Nishi 16-chome, 291, Chuo-ku,
Sapporo-shi, Hokkaido 060-8543, Japan
(Sakawaki, Sakawaki, Takeyama) Department of Emergency Medicine, Hakodate
Municipal Hospital, 1-chome 10-1, Minato-cho, Hakodate-shi, Hokkaido
041-8680, Japan
(Yamaoka) Department of Neurosurgery, Sunagawa City Medical Center,
3-chome1-1 Nishi 4-jo Kita, Sunagawa-shi, Hokkaido 073-0196, Japan
(Okamoto) Department of Emergency Medicine, Teine Keijinkai Hospital,
12-chome 1-40, Maeda 1-jo, Teine-ku, Sapporo-shi, Hokkaido 006-0811, Japan
Publisher
BioMed Central Ltd
Abstract
Background: Previous studies have reported poor prognosis in cases of
tetanus that develops after bacteria enters via breast cancer-related skin
ulcers that are not treated with surgical debridement. Herein, we review
the literature concerning this presentation and report the first case of
complete remission from tetanus without surgical debridement of the skin
ulcer. Case presentation: An Asian woman aged over 60 years had a history
of skin ulcer caused by breast cancer. She was diagnosed with tetanus due
to trismus and opisthotonus. Based on the suspicion that the skin ulcer
was the portal of entry for tetanus bacteria, we considered several
debridement and thoracic surgical options for tetanus treatment. However,
debridement was not performed as the surgery was considered high risk and
the patient did not consent to it. The patient received treatment with
anti-tetanus globulin and metronidazole; sound insulation and shielding
were also performed in a dark room. Subsequently, the patient's symptoms
improved, and sound insulation and deep sedation management were completed
on 19th day of hospitalization. With no symptom recurrence, the patient
was discharged on Day 54. To date, over 3 years after treatment, no
evidence of tetanus recurrence has been observed. The case was
characterized by a lack of autonomic hyperactivity. The tetanus severity
was likely representative of the low amount of toxin that the patient was
exposed to. <br/>Conclusion(s): This case involved moderate severity
tetanus originating from a chronic skin ulcer related to breast cancer.
The patient survived without undergoing extensive debridement. No evidence
of tetanus relapse was observed during the follow-up period, likely due to
vaccination that might have restored the patient's active immunity.
Debridement is not always necessary for tetanus complicated by breast
cancer skin ulcers. Furthermore, appropriate toxoid vaccination is
critical for preventing the onset and recurrence of tetanus in these
patients.<br/>Copyright &#xa9; 2021, The Author(s).

<95>
Accession Number
2010123132
Title
Timing of renal replacement therapy initiation for acute kidney injury in
critically ill patients: a systematic review of randomized clinical trials
with meta-analysis and trial sequential analysis.
Source
Critical Care. 25 (1) (no pagination), 2021. Article Number: 15. Date of
Publication: December 2021.
Author
Li X.; Liu C.; Mao Z.; Li Q.; Zhou F.
Institution
(Li, Mao, Li, Zhou) Department of Critical Care Medicine, the First
Medical Centre, Chinese People's Liberation Army General Hospital, 28
Fu-Xing Road, Beijing 100853, China
(Li, Liu) Medical School of Chinese PLA, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is a common serious complication in
critically ill patients. AKI occurs in up to 50% patients in intensive
care unit (ICU), with poor clinical prognosis. Renal replacement therapy
(RRT) has been widely used in critically ill patients with AKI. However,
in patients without urgent indications such as acute pulmonary edema,
severe acidosis, and severe hyperkalemia, the optimal timing of RRT
initiation is still under debate. We conducted this systematic review of
randomized clinical trials (RCTs) with meta-analysis and trial sequential
analysis (TSA) to compare the effects of early RRT initiation versus
delayed RRT initiation. <br/>Method(s): We searched databases (PubMed,
EMBASE and Cochrane Library) from inception through to July 20, 2020, to
identify eligible RCTs. The primary outcome was 28-day mortality. Two
authors extracted the data independently. When the I² values <
25%, we used fixed-effect mode. Otherwise, the random effects model was
used as appropriate. TSA was performed to control the risk of random
errors and assess whether the results in our meta-analysis were
conclusive. <br/>Result(s): Eleven studies involving 5086 patients were
identified. Two studies included patients with sepsis, one study included
patients with shock after cardiac surgery, and eight others included mixed
populations. The criteria for the initiation of RRT, the definition of
AKI, and RRT modalities existed great variations among the studies. The
median time of RRT initiation across studies ranged from 2 to 7.6 h in the
early RRT group and 21 to 57 h in the delayed RRT group. The pooled
results showed that early initiation of RRT could not decrease 28-day
all-cause mortality compared with delayed RRT (RR 1.01; 95% CI 0.94-1.09;
P = 0.77; I² = 0%). TSA result showed that the required
information size was 2949. The cumulative Z curve crossed the futility
boundary and reached the required information size. In addition, early
initiation of RRT could lead to unnecessary RRT exposure in some patients
and was associated with a higher incidence of hypotension (RR 1.42; 95% CI
1.23-1.63; P < 0.00001; I² = 8%) and RRT-associated infection
events (RR 1.34; 95% CI 1.01-1.78; P = 0.04; I² = 0%).
<br/>Conclusion(s): This meta-analysis suggested that early initiation of
RRT was not associated with survival benefit in critically ill patients
with AKI. In addition, early initiation of RRT could lead to unnecessary
RRT exposure in some patients, resulting in a waste of health resources
and a higher incidence of RRT-associated adverse events. Maybe, only
critically ill patients with a clear and hard indication, such as severe
acidosis, pulmonary edema, and hyperkalemia, could benefit from early
initiation of RRT.<br/>Copyright &#xa9; 2021, The Author(s).

<96>
Accession Number
2010555053
Title
Landiolol for managing atrial fibrillation in post-cardiac surgery.
Source
European Heart Journal, Supplement. 20 (pp A4-A9), 2021. Date of
Publication: 2021.
Author
Fellahi J.-L.; Heringlake M.; Knotzer J.; Fornier W.; Cazenave L.;
Guarracino F.
Institution
(Fellahi, Fornier, Cazenave) Service d'Anestheasie-ReAanimation, Hospital
Cardiologique Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel,
Lyon Cedex 03 69394, France
(Heringlake) Department of Anesthesiology and Intensive Care Medicine,
University of Lubeck, Ratzeburger Allee 160, Lubeck 23538, Germany
(Knotzer) Klinikum Wels-Grieskirchen, Institut fur Anasthesiologie und
Intensivmedizin II, Grieskirchner Str. 42, Wels 4600, Austria
(Guarracino) Department of Anaesthesia and Critical Care Medicine,
Cardiothoracic and Vascular Anaesthesia and Intensive Care, Azienda
Ospedaliero Universitaria Pisana, Via Roma n. 67, Pisa 56126, Italy
Publisher
Oxford University Press
Abstract
Landiolol is an intravenous ultra-short acting beta-blocker which has been
used in Japan for many years to prevent and/or to treat post-operative
atrial fibrillation following cardiac surgery. The drug is now available
in Europe. This article is a systematic review of literature regarding the
use of landiolol in that specific surgical setting.<br/>Copyright &#xa9;
2018 Oxford University Press. All rights reserved.

<97>
Accession Number
2010573225
Title
A Randomized Comparison of Positional Stability: The EZ-Blocker Versus
Left-Sided Double-Lumen Endobronchial Tubes in Adult Patients Undergoing
Thoracic Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Morris B.N.; Fernando R.J.; Garner C.R.; Johnson S.D.; Gardner J.C.;
Marchant B.E.; Johnson K.N.; Harris H.M.; Russell G.B.; Wudel L.J.;
Templeton T.W.
Institution
(Morris, Fernando, Garner, Johnson, Gardner, Marchant, Johnson, Harris,
Russell, Templeton) Department of Anesthesiology, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Wudel) Department of Cardiothoracic Surgery, Wake Forest School of
Medicine, Winston-Salem, NC, United States
(Russell) Division of Public Health Sciences\Department of Biostatistics
and Data Science
Publisher
W.B. Saunders
Abstract
Objective: To assess if there is a difference in the repositioning rate of
the EZ-Blocker versus a left-sided double-lumen endobronchial tube (DLT)
in patients undergoing thoracic surgery and one-lung ventilation.
<br/>Design(s): Prospective, randomized. <br/>Setting(s): Single center,
university hospital. <br/>Participant(s): One hundred sixty-three thoracic
surgery patients. <br/>Intervention(s): Patients were randomized to either
EZ-Blocker or a DLT. <br/>Measurements and Main Results: The primary
outcome was positional stability of either the EZ-Blocker or a left-sided
double-lumen endobronchial tube, defined as the number of repositionings
per hour of surgery and one-lung ventilation. Secondary outcomes included
an ordinal isolation score from 1 to 3, in which 1 was poor, up to 3,
which represented excellent isolation, and a visual analog postoperative
sore throat score (0-100) on postoperative days (POD) one and two. Rate of
repositionings per hour during one-lung ventilation and surgical
manipulation in left-sided cases was similar between the two devices: 0.08
+/- 0.15 v 0.11 +/- 0.3 (p = 0.57). In right-sided cases, the rate of
repositioning was higher in the EZ-Blocker group compared with DLT: 0.38
+/- 0.65 v 0.09 +/- 0.21 (p = 0.01). Overall, mean isolation scores for
the EZ-Blocker versus the DLT were 2.64 v 2.86 (p = 0.001) in left-sided
cases and 2.61 v 2.81(p = 0.01) in right-sided cases. Median sore throat
scores were 0 v 5 (p = 0.13) POD one and 0 v 5 (p = 0.006) POD two for the
EZ-Blocker and left-sided DLT, respectively. <br/>Conclusion(s): For
right-sided procedures, the positional stability of the EZ-Blocker is
inferior to a DLT. In left-sided cases, the rate of repositioning for the
EZ-Blocker and DLT are not statistically different.<br/>Copyright &#xa9;
2020 Elsevier Inc.

<98>
Accession Number
2010564076
Title
Congenital aortic stenosis: A treatment under debate.
Source
Cirugia Cardiovascular. (no pagination), 2021. Date of Publication: 2021.
Author
Bellot R.; Rios L.; Portela F.
Institution
(Bellot, Rios, Portela) Servicio de Cirugia Cardiaca Infantil, Hospital
Materno-Infantil, Las Palmas de Gran Canaria, Spain
Publisher
Elsevier Doyma
Abstract
Congenital aortic valve stenosis is a common and long-term heart disease
during the life of the patient, knowing that when it begins at an early
age it will often require reoperation. There are two treatment modalities:
percutaneous balloon valvuloplasty and surgical valvuloplasty, both
applicable from the neonatal period. The unfavorable results of surgery in
the first series led to the adoption of a preference for percutaneous
treatment, which offered similar management of the aortic valve in a less
invasive way and with less morbidity and mortality. However, advances in
perioperative care and, above all, in surgical techniques currently used
have allowed an improvement in these results, with recent series showing a
benefit of surgical treatment over percutaneous treatment. This benefit is
mainly based on the ability to perform a directed opening of the
commissures under direct vision, in addition to being able to act on the
leaflets. Current mortality rates are comparable with both treatments, but
the greater durability of the repair justifies a more invasive treatment.
The role of percutaneous valvuloplasty will continue to be critical in
selected groups of patients, such as those with ventricular dysfunction.
This article will describe a case of congenital aortic stenosis operated
on in the neonatal period in our center as a starting point for a review
of the current literature and open the debate on the best management of
this pathology: balloon or scalpel?<br/>Copyright &#xa9; 2020 Sociedad
Espanola de Cirugia Cardiovascular y Endovascular

<99>
Accession Number
2010544203
Title
Long-term outcomes of postoperative atrial fibrillation following non
cardiac surgery: A systematic review and metanalysis.
Source
European Journal of Internal Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Albini A.; Malavasi V.L.; Vitolo M.; Imberti J.F.; Marietta M.; Lip
G.Y.H.; Boriani G.
Institution
(Albini, Malavasi, Vitolo, Imberti, Boriani) Cardiology Division,
Department of Biomedical, Metabolic and Neural Sciences, University of
Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
(Vitolo, Lip) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
(Marietta) Department of Oncology and Haematology, University Hospital,
Modena, Italy
(Lip) Aalborg Thrombosis Research Unit, Department of Clinical Medicine,
Aalborg University, Aalborg, Denmark
Publisher
Elsevier B.V.
Abstract
Background: New-onset atrial fibrillation (AF) in non-cardiac
postoperative setting is common and is associated with a high risk of
in-hospital mortality and morbidity. The long-term risks of stroke,
mortality and AF recurrence rate in patients with postoperative AF (POAF)
are unclear. <br/>Method(s): We performed a systematic literature review
in electronic databases from inception to March 5th, 2020 of studies
reporting the incidence of stroke, mortality and AF recurrence in patients
with POAF. We confined our analysis to studies with a cohort of at least
150 patients with POAF and with a median follow-up of 12 months as a
minimum. Odds Ratios (OR) were pooled using a random-effects model.
<br/>Result(s): Qualitative analysis included 8 studies (7 observational
cohort studies and 1 randomized controlled trial) enrolling 3,718,587
patients. Six studies underwent metanalysis comprising 17,684
postoperative patients with POAF and 2,169,248 postoperative patients
without POAF. The development of POAF conferred a four-fold increased risk
of stroke in the long-term [OR 4.05; 95% confidence interval (CI)
2.91-5.62]. Mortality in the two studies reporting long-term data was
higher in patients with POAF compared to those without POAF (OR 3.59; CI
95% 2.84-4.53). Data about recurrence were too heterogeneous to undergo
metanalysis. <br/>Conclusion(s): POAF is associated with a greater risk of
stroke and mortality over the long-term period. Studies focusing on AF
recurrence are needed to address the perception of POAF as a benign
transient entity. The increased mortality risk following POAF should
encourage systematic detection and prevention of this
arrhythmia.<br/>Copyright &#xa9; 2020

<100>
Accession Number
633864720
Title
Current and Future Applications of Virtual, Augmented, and Mixed Reality
in Cardiothoracic Surgery.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 18 Dec 2020.
Author
Sadeghi A.H.; Mathari S.E.; Abjigitova D.; Maat A.P.W.M.; Taverne
Y.J.H.J.; Bogers A.J.J.C.; Mahtab E.A.F.
Institution
(Sadeghi, Mathari, Abjigitova, Maat, Taverne, Bogers, Mahtab) Department
of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam,
Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: This review aims to examine the existing literature to address
currently used virtual, augmented, and mixed reality modalities in the
areas of preoperative surgical planning, intraoperative guidance, and
postoperative management in the field of cardiothoracic surgery. In
addition, this innovative technology provides future perspectives and
potential benefits for cardiothoracic surgeons, trainees, and patients.
<br/>METHOD(S): A targeted, non-systematic literature assessment was
performed within the Medline and Google Scholar databases to help identify
current trends and to provide better understanding of the current
state-of-the-art extended reality (XR) modalities in cardiothoracic
surgery. Related articles published up to July 2020, are included in the
review. <br/>RESULT(S): XR is a novel technique gaining increasing
application in cardiothoracic surgery. It provides a three-dimensional
(3D) and realistic view of structures and environments and offers the user
the ability to interact with digital projections of surgical targets.
Recent studies showed the validity and benefits of XR applications in
cardiothoracic surgery. Examples include XR-guided pre-operative planning,
intraoperative guidance and navigation, post-operative pain and
rehabilitation management, surgical simulation, and patient education.
<br/>CONCLUSION(S): XR is gaining interest in the field of cardiothoracic
surgery. In particular, there are promising roles for XR applications in
televirtuality, surgical planning, surgical simulation, and perioperative
management. However, future refinement and research is needed to further
implement XR in the aforementioned settings within cardiothoracic
surgery.<br/>Copyright &#xa9; 2020. Published by Elsevier Inc.

<101>
Accession Number
2010387260
Title
Continuous positive airway pressure treatment and anxiety in adults with
coronary artery disease and nonsleepy obstructive sleep apnea in the
RICCADSA trial.
Source
Sleep Medicine. 77 (pp 96-103), 2021. Date of Publication: January 2021.
Author
Celik Y.; Thunstrom E.; Strollo P.J.; Peker Y.
Institution
(Celik, Peker) Koc University Research Center for Translational Medicine
(KUTTAM), Istanbul, Turkey
(Thunstrom, Peker) Dept. of Molecular and Clinical Medicine/Cardiology,
Sahlgrenska Academy, University of Gothenburg, Sweden
(Strollo, Peker) Dept of Clinical Sciences, Respiratory Medicine and
Allergology, Faculty of Medicine, Lund University, Lund, Sweden
(Peker) Division of Pulmonary, Allergy, and Critical Care Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Publisher
Elsevier B.V.
Abstract
Background: Anxiety and obstructive sleep apnea (OSA) coexist among adults
with coronary artery disease (CAD) following revascularization. Continuous
positive airway pressure (CPAP) is the first line treatment of OSA
patients with daytime sleepiness. The current study evaluated the effect
of CPAP on anxiety in CAD patients with nonsleepy OSA. <br/>Method(s): Two
hundred forty-four revascularized CAD patients with nonsleepy OSA
(apnea-hypopnea index >=15/h, Epworth Sleepiness Scale score <10) were
randomly assigned to CPAP or no-CPAP between 2005 and 2010. Zung
Self-rating Anxiety Scale (SAS) was administered at baseline and after 3
and 12 months with higher scores suggesting more anxiety. <br/>Result(s):
A total of 208 patients with complete SAS scores at baseline and 12-month
follow-up were included (CPAP, n = 103; no-CPAP, n = 105). In the
intention-to-treat analysis, CPAP had no significant effect on the SAS
scores. On-treatment analysis revealed a significant increase in the
median of delta SAS score (+3.75) after three months among the
participants using the device 2.8 h/day or more while there was a decline
in the median of delta SAS score (-1.25) in the non-adherent or no-CPAP
group (p = 0.031). The increase in the SAS score (+1.25) in the adherent
group, and the decline (-1.25 points) in the non-adherent/no-CPAP group
remained significant after one year (p = 0.011). Baseline SAS score
predicted non-adherence [adjusted odds ratio 1.11; 95% confidence interval
(CI) 1.04-1.18; p = 0.003], and there was an association between the
increase in the SAS scores and accumulated CPAP hours/day [standardized
beta = 0.144 (95% CI 0.005-0.695), p = 0.047]. <br/>Conclusion(s): Our
results suggest that anxiety should be considered in the management of CAD
patients with nonsleepy OSA following revascularization. Clinical trial
registration: NCT00519597.<br/>Copyright &#xa9; 2020 Elsevier B.V.

<102>
Accession Number
364511873
Title
Beta-blocker management in high-risk patients presenting for non-cardiac
surgery: Before and after the POISE Trial.
Source
Anaesthesia and Intensive Care. 40 (2) (pp 319-327), 2012. Date of
Publication: March 2012.
Author
Leslie K.; Myles P.S.; Halliwell R.; Paech M.J.; Short T.G.; Walker S.
Institution
(Leslie) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Leslie) Department of Pharmacology, University of Melbourne, Melbourne,
VIC, Australia
(Leslie) Department of Epidemiology and Preventive Medicine, Monash
University, Melbourne, VIC, Australia
(Myles) Department of Anaesthesia and Perioperative Medicine, Alfred
Hospital, Melbourne, VIC, Australia
(Myles) Academic Board of Anaesthesia and Perioperative Medicine, Monash
University, Melbourne, VIC, Australia
(Myles) National Health and Medical Research Council, Canberra, ACT,
Australia
(Halliwell) Department of Anaesthesia, Westmead Hospital, Sydney, NSW,
Australia
(Paech) School of Medicine and Pharmacology, University of Western
Australia, Perth, WA, Australia
(Paech) Department of Anaesthesia and Pain Medicine, King Edward Memorial
Hospital for Women, Perth, WA, Australia
(Short) Department of Anaesthesia, Auckland City Hospital, Auckland, New
Zealand
(Walker) Department of Anaesthesia, Middlemore Hospital, Auckland, New
Zealand
Publisher
Australian Society of Anaesthetists
Abstract
The POISE Trial was a randomised, placebo-controlled, double-blind study
of the effectiveness of perioperative beta-blockade in preventing cardiac
events including death in 8351 patients. Our hypothesis was that knowledge
of the results of the POISE Trial would either increase or decrease the
use of effective perioperative beta-blockade, depending on the result.
Patients presenting for non-cardiac surgery and at risk of perioperative
cardiac events were recruited in two cohorts before and after the release
of the POISE Trial results. Effective perioperative beta-blockade was
defined as heart rate <65 beats per minute for at least 80% of the
perioperative period in patients prescribed beta-blockers. Effective
perioperative beta-blockade was achieved in 22 (11.5%) of 191 patients
prescribed perioperative beta-blockade in the first cohort (n=392) and
seven (6%) of 118 patients in the second cohort (n=241) (P=0.10).
Effective heart rate control was achieved in 29 (9%) patients prescribed
perioperative beta-blockers compared with 10 (3%) patients not prescribed
perioperative beta-blockers (P=0.001). The rate of implementation of
effective beta-blockade was low before POISE and this did not change
significantly after publication. Our finding does not provide reliable
evidence of a change in practice as a result of the POISE Trial.

<103>
Accession Number
2005676178
Title
Antiplatelet strategy in primary and secondary prevention of
cardiovascular disease in patients with type 2 diabetes mellitus: A
perspective from the guideline appraisal.
Source
Journal of Diabetes Investigation. 12 (1) (pp 99-108), 2021. Date of
Publication: January 2021.
Author
Liu M.; Zhuang X.; Chen X.; Zhang S.; Yang D.; Zhong X.; Xiong Z.; Lin Y.;
Zhou H.; Fan Y.; Xie P.; Huang Y.; Wang L.; Liao X.
Institution
(Liu, Zhuang, Zhang, Yang, Zhong, Xiong, Lin, Zhou, Fan, Huang, Wang,
Liao) Department of Cardiology, The First Affiliated Hospital of Sun
Yat-Sen University, Guangzhou, China
(Liu, Zhuang, Zhang, Yang, Zhong, Xiong, Lin, Zhou, Fan, Huang, Wang,
Liao) NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University),
Guangzhou, China
(Chen) Department of Otorhinolaryngology, The Third Affiliated Hospital of
Sun Yat-Sen University, Guangzhou, China
(Xie) Department of Ultrasonography, The First Affiliated Hospital of Sun
Yat-Sen University, Guangzhou, China
Publisher
Blackwell Publishing
Abstract
Aims/Introduction: To appraise guidelines on the antiplatelet strategy of
prevention of cardiovascular disease (CVD) in patients with type 2
diabetes mellitus, and highlight the consensuses and controversies to aid
clinician decision-making. <br/>Material(s) and Method(s): A systematic
search was carried out for guidelines regarding CVD prevention or focusing
on type 2 diabetes patients. Appraisal of Guidelines for Research and
Evaluation II instrument was utilized to appraise the quality of included
guidelines. <br/>Result(s): Of the 15 guidelines with discrepant Appraisal
of Guidelines for Research and Evaluation II scores (66%; interquartile
range 51-71%), 10 were defined as "strongly recommended" guidelines. For
secondary prevention, >60% of guidelines advocated that the dual
antiplatelet therapy was used within 12 months when the type 2 diabetes
patients experienced acute coronary syndrome and/or post-percutaneous
coronary intervention or coronary artery bypass grafting, with subsequent
long-term aspirin use. For primary prevention, 80% of guidelines supported
that aspirin should not be routinely used by patients with type 2
diabetes. No consensus on whether to prolong dual antiplatelet therapy in
secondary prevention, and whether to use aspirin in type 2 diabetes
patients with high CVD risk exists in current guidelines.
<br/>Conclusion(s): Physicians should use the recommendations from
"strongly recommended" guidelines to make informed decisions and know the
consensuses of current guidelines. Dual antiplatelet therapy should be
used within 12 months when type 2 diabetes patients experience acute
coronary syndrome and/or percutaneous coronary intervention/coronary
artery bypass grafting, with subsequent long-term aspirin use. In primary
prevention, aspirin should not be routinely used by individuals with type
2 diabetes, but might be considered for those with high CVD
risk.<br/>Copyright &#xa9; 2020 The Authors. Journal of Diabetes
Investigation published by Asian Association for the Study of Diabetes
(AASD) and John Wiley & Sons Australia, Ltd

<104>
Accession Number
2005593270
Title
A meta-analysis comparing transaxillary and transaortic transcatheter
aortic valve replacement.
Source
General Thoracic and Cardiovascular Surgery. 69 (1) (pp 19-26), 2021. Date
of Publication: January 2021.
Author
Zhan Y.; Lofftus S.; Kawabori M.; Soin A.; Chen F.Y.
Institution
(Zhan, Lofftus, Kawabori, Soin, Chen) Division of Cardiac Surgery, Tufts
Medical Center, Tufts University School of Medicine, 800 Washington
Street, #266, Boston, MA 02111, United States
Publisher
Springer Japan
Abstract
Background: The alternative access route of choice for transcatheter
aortic valve replacement (TAVR) remains to be elucidated due to lack of
evidences. We performed a meta-analysis comparing the outcomes of two
common alternative access routes, transaxillary (TAx) and transaortic
(TAo) approaches. <br/>Method(s): The PubMed/MEDLINE, Embase, and Cochrane
library from inception to December 2018 were searched to identify the
articles reporting data on both TAx-TAVR and TAo-TAVR. Patients' baseline
characteristics, procedural outcomes, and clinical outcomes were extracted
from the articles and pooled for analysis. <br/>Result(s): Four studies, a
total of 750 (374 TAo and 376 TAx) patients were included in the study.
The two groups were similar in patients' baseline characteristics,
although the TAx group comprised few female patients. The two groups
differ in outcomes including 30-day mortality, rates of pacemaker implant
and acute kidney injury, and length of hospital stay. There were no
differences between the two groups with regard to device success,
paravalvular leak, stroke, vascular complications, and 1-year mortality.
<br/>Conclusion(s): Compared with the TAo approach, the TAx approach is
associated with favorable short-term mortality, lower incidence of acute
kidney injury, and shorter length of hospital stay, but increased
pacemaker requirement. TAx could be considered over TAo as the preferred
alternative access for TAVR.<br/>Copyright &#xa9; 2020, The Japanese
Association for Thoracic Surgery.

<105>
Accession Number
2005546378
Title
Development of a new risk model for a prognostic prediction after
transcatheter aortic valve replacement.
Source
General Thoracic and Cardiovascular Surgery. 69 (1) (pp 44-50), 2021. Date
of Publication: January 2021.
Author
Maeda K.; Kuratani T.; Pak K.; Shimamura K.; Mizote I.; Miyagawa S.; Toda
K.; Sakata Y.; Sawa Y.
Institution
(Maeda, Kuratani, Shimamura, Miyagawa, Toda, Sawa) Department of
Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2
Yamada-oka, Suita, Osaka 565-0871, Japan
(Pak, Sakata) Division of Biostatistics, Center for Clinical Research,
National Center for Child Health and Development, Setagaya, Japan
(Mizote) Department of Cardiology, Osaka University Graduate School of
Medicine, Suita, Japan
Publisher
Springer Japan
Abstract
Background: Current guidelines for transcatheter aortic valve replacement
(TAVR) recommend that TAVR should be performed in patients with a life
expectancy > 1 year. However, it is challenging to estimate the patients'
life expectancy because it is related to various factors, including
frailty and nutritional status. Hypothesis: A new risk model can estimate
the prognosis of patients after TAVR. <br/>Method(s): We randomly divided
388 patients with aortic stenosis (AS) undergoing TAVR from October 2009
to August 2016 into two groups (2:1 ratio; training cohort, 259;
validation cohort, 129). Using 94 baseline factors in the training cohort,
we developed possible scoring models by the Cox proportional hazard
regression model with the overall survival as the endpoint. Then,
cross-validated 5-year C-statistics were calculated to assess the accuracy
of the model. <br/>Result(s): Of 94 baseline factors, 12 factors were
finally identified (5-year C-statistics in the training cohort:
0.709)-age, gender, body mass index, left ventricular ejection fraction, %
vital capacity, forced expiratory volume 1.0 (s) %, albumin, hemoglobin,
creatine, platelet, creatine kinase, and prothrombin time-international
normalized ratio. The cross-validated 1-, 3-, and 5-year C-statistics in
the validation cohort were 0.792, 0.758, and 0.778, respectively.
Furthermore, calibration plots in the validation cohort revealed that
5-year survival is well predicted (r = 0.962). <br/>Conclusion(s): The new
survival prediction model after TAVR could provide appropriate guidance
during decision making regarding the TAVR implementation.<br/>Copyright
&#xa9; 2020, The Japanese Association for Thoracic Surgery.

<106>
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.

<107>
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.

<108>
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

<109>
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

<110>
Accession Number
633843767
Title
Effect of Hypertensive Disorders of Pregnancy on Clinical Outcomes in
Peripartum Cardiomyopathy.
Source
Obstetrics and Gynecology. Conference: 67th Annual Clinical and Scientific
Meeting of the American College of Obstetricians and Gynecologists. United
States. 133 (SUPPL 1) (no pagination), 2019. Date of Publication: May
2019.
Author
Sangtani A.; Alrahmani L.; Parikh P.
Institution
(Sangtani, Alrahmani, Parikh) Mayo Clinic, Rochester, MN, United States
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION: The influence of concurrent hypertensive disorders of
pregnancy (HDP) on clinical outcomes of patients with peripartum
cardiomyopathy (PPCM) remains incompletely characterized, with authors
describing harmful and beneficial relationships with regards to maternal
mortality or requirement for cardiac transplantation. <br/>METHOD(S): Ovid
Medline, EMBASE, CENTRAL and Scopus were searched for combinations of the
following terminology: hypertension, preeclampsia, cardiomyopathy,
peripartum, postpartum or puerperium. Eligibility criteria included all
articles addressing mortality rates of PPCM with and without HDP using a
combination of the European Society of Cardiology 2010 and the National
Heart Lung Blood Institute 2000 diagnostic criteria. Two independent
reviewers analyzed abstracts and article text to determine eligibility and
risk of bias. Risk of bias was determined using the Newcastle-Ottawa scale
and a Peto fixed effects model was used to combine odds ratios in a
meta-analytic fashion due to the relatively rare frequency of these
events. <br/>RESULT(S): 1838 articles were identified using the search
strategy; 148 full text articles were reviewed for eligibility, with 10
observational studies meeting criteria. There was substantial agreement
between the two raters for selection (K: 0.799) and for risk of bias (K:
0.851). An overall protective effect was identified [0.565 (95% CI 0.327,
0.974)], with a low degree of heterogeneity (I2 17.66%). No significant
differences were found between subgroups-chronic hypertension, access to
social medicine, high-income countries and post-diagnosis duration of care
greater than 12 months. <br/>CONCLUSION(S): Although the strength of
association is weak, concurrent HDP appears to be protective against
mortality and need for cardiac transplantation in PPCM.

<111>
Accession Number
633844323
Title
Perioperative Administration of Tranexamic Acid for Placenta Previa and
Accreta Study (TAPPAS): A Randomized Trial.
Source
Obstetrics and Gynecology. Conference: 67th Annual Clinical and Scientific
Meeting of the American College of Obstetricians and Gynecologists. United
States. 133 (SUPPL 1) (no pagination), 2019. Date of Publication: May
2019.
Author
Kremer M.; Cortez C.
Institution
(Kremer, Cortez) University of Washington, Department of OB GYN, Seattle,
WA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
INTRODUCTION: Intravenous tranexamic acid (TXA) is routinely used in
orthopedic and cardiac surgery to reduce blood loss. There is growing
evidence supporting off-label use in obstetrical hemorrhage, yet no prior
studies have investigated TXA for deliveries complicated by placenta
previa and/or accreta. <br/>METHOD(S): This was a single site, randomized,
placebo-controlled, double blind pilot study from 11/2016 to 7/2018.
Eligible participants were women with suspicion of morbidly adherent
placenta (accreta) on imaging, or women with placenta previa and two or
more cesareans (CS). Subjects were randomized to receive 1 gram of IV TXA
vs placebo at cord clamping during their cesarean or cesarean hysterectomy
(CH). <br/>RESULT(S): The TXA (n=6) and placebo (n=5) groups were well
matched for age, parity and number of prior cesareans. Mean gestational
age was 35w0d in the TXA group and 34w2d for placebo. The TXA group had 2
CH for accreta and 4 CS for previa, while the placebo group had 4 CH and 1
CS. Mean estimated blood loss (EBL) was 3,116 cc (SD 3,947) in the TXA
group and 9,420 cc (SD 12,474) in the placebo group (P>.3). The mean pRBCs
units given intraoperatively was 5.2 (SD 8) in TXA group and 17.6 (SD 25)
for placebo. In all study participants, no thrombotic events occurred.
<br/>CONCLUSION(S): The sample size was insufficient to evaluate the
primary endpoint of EBL. However, no complications attributable to giving
TXA at cord clamping were encountered. Power analysis suggests n=36 in
both groups would be sufficient in future studies to detect a difference
in EBL.

<112>
Accession Number
2010445353
Title
Continuous postoperative pericardial flushing reduces postoperative
bleeding after coronary artery bypass grafting: A randomized trial.
Source
EClinicalMedicine. 31 (no pagination), 2021. Article Number: 100661. Date
of Publication: January 2021.
Author
Diephuis E.C.; de Borgie C.A.; Zwinderman A.; Winkelman J.A.; van Boven
W.-J.P.; Henriques J.P.S.; Eberl S.; Juffermans N.P.; Schultz M.J.; Klautz
R.J.M.; Koolbergen D.R.
Institution
(Diephuis, Winkelman, van Boven, Klautz, Koolbergen) Department of
Cardiothoracic Surgery, Amsterdam University Medical Center, location AMC,
Meibergdreef 9, Amsterdam, AZ 1105, Netherlands
(Klautz, Koolbergen) Department of Cardiothoracic Surgery, Leiden
University Medical Center (LUMC), Leiden, Netherlands
(Henriques) Department of Cardiology, Amsterdam University Medical Center,
location AMC, Amsterdam, Netherlands
(de Borgie, Zwinderman) Clinical Research Unit, University of Amsterdam,
Amsterdam, Netherlands
(Eberl) Department of anesthesiology, Amsterdam University Medical Center,
location AMC, Amsterdam, Netherlands
(Juffermans, Schultz) Department of Intensive Care, Amsterdam University
Medical Center, location AMC, Amsterdam, Netherlands
(Schultz) Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol
University, Bangkok, Thailand
(Schultz) Nuffield Department of Medicine, University of Oxford, Oxford,
United Kingdom
Publisher
Lancet Publishing Group
Abstract
Background: Prolonged or excessive bleeding after cardiac surgery can lead
to a broad spectrum of secondary complications. One of the underlying
causes is incomplete wound drainage, with subsequent accumulation of blood
and clots in the pericardium. We developed the continuous postoperative
pericardial flushing (CPPF) therapy to improve wound drainage and reduce
postoperative blood loss and bleeding-related complications after cardiac
surgery. This study compared CPPF to standard care in patients after
coronary artery bypass grafting (CABG). <br/>Method(s): This is a single
center, open label, randomized trial that enrolled patients at the
Amsterdam UMC, location AMC, Amsterdam, the Netherlands. The study was
registered at the 'Netherlands Trial Register', study identifier NTR5200
[1]. Adults undergoing CABG were randomly assigned to receive CPPF therapy
or standard care, participants and investigators were not masked to group
assignment. The primary end point was postoperative blood loss in the
first 12-hours after surgery. <br/>Finding(s): Between the January 15,
2014 and the March 13, 2017, 169 patients were enrolled and assigned to
CPPF therapy (study group; n = 83) or standard care (control group; n =
86). CPPF reduced postoperative blood loss when compared to standard care
(median differences -385 ml, reduction 76% p=<=0.001), with the remark
that these results are overestimated due to a measurement error in part of
the study group. None of patients in the study group required reoperation
for non-surgical bleeding versus 3 (4%, 95% CI -0.4% to 7.0%) in the
control group. None of the patients in the study group suffered from
cardiac tamponade, versus 3 (4%, 95% CI -0,4% to 7.0%) in the control
group. The incremental cost-effectiveness ratio was 116.513 (95% bootstrap
CI -882.068 to +897.278). <br/>Interpretation(s): The use of CPPF therapy
after CABG seems to reduce bleeding and bleeding related complications.
With comparable costs and no improvement in Qualty of Life (QoL), cost
consideration for the implementation of CPPF is not relevant. None of the
patients in the study group required re-interventions for non-surgical
bleeding or acute cardiac tamponade, which underlines the proof of concept
of this novel therapy. <br/>Funding(s): This study was funded by ZonMw,
the Netherlands organization for health research and development (project
837001405).<br/>Copyright &#xa9; 2020 The Authors

<113>
Accession Number
2010123141
Title
Effect of sevoflurane on the inflammatory response during cardiopulmonary
bypass in cardiac surgery: the study protocol for a randomized controlled
trial.
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 25. Date of
Publication: December 2021.
Author
Cardoso T.A.A.M.; Kunst G.; Neto C.N.; de Ribamar Costa Junior J.; Silva
C.G.S.; Bastos G.M.; Borges J.B.; Hirata M.H.
Institution
(Cardoso, Neto, Silva) Department of Surgery and Anesthesia, Dante
Pazzanese Institute of Cardiology, Captain Pinto Ferreira Street, 62, ap
92, Jardim Paulista, Sao Paulo 01423-020, Brazil
(Kunst) Department of Anaesthetics, Intensive Care Medicine and Pain
Therapy, King's College Hospital NHS Foundation Trust, Denmark Hill,
London, United Kingdom
(de Ribamar Costa Junior) Department of Interventional Cardiology, Dante
Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Bastos, Borges) Molecular Cardiology Research Laboratory, Dante Pazzanese
Institute of Cardiology, Sao Paulo, Brazil
(Hirata) Department of Clinical and Toxicological Analysis, School of
Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
Publisher
BioMed Central Ltd
Abstract
Background: Recent experimental evidence shows that sevoflurane can reduce
the inflammatory response during cardiac surgery with cardiopulmonary
bypass. However, this observation so far has not been assessed in an
adequately powered randomized controlled trial. <br/>Method(s): We plan to
include one hundred patients undergoing elective coronary artery bypass
graft with cardiopulmonary bypass who will be randomized to receive either
volatile anesthetics during cardiopulmonary bypass or total intravenous
anesthesia. The primary endpoint of the study is to assess the
inflammatory response during cardiopulmonary bypass by measuring
PMN-elastase serum levels. Secondary endpoints include serum levels of
other pro-inflammatory markers (IL-1beta, IL-6, IL-8, TNFalpha),
anti-inflammatory cytokines (TGFbeta and IL-10), and microRNA expression
in peripheral blood to achieve possible epigenetic mechanisms in this
process. In addition clinical endpoints such as presence of major
complications in the postoperative period and length of hospital and
intensive care unit stay will be assessed. <br/>Discussion(s): The trial
may determine whether adding volatile anesthetic during cardiopulmonary
bypass will attenuate the inflammatory response. Trial registration:
ClinicalTrials.gov NCT02672345. Registered on February 2016 and updated on
June 2020.<br/>Copyright &#xa9; 2021, The Author(s).

<114>
Accession Number
2010571273
Title
Effect of Evolocumab on Complex Coronary Disease Requiring
Revascularization.
Source
Journal of the American College of Cardiology. 77 (3) (pp 259-267), 2021.
Date of Publication: 26 Jan 2021.
Author
Oyama K.; Furtado R.H.M.; Fagundes A.; Zelniker T.A.; Tang M.; Kuder J.;
Murphy S.A.; Hamer A.; Wang H.; Keech A.C.; Giugliano R.P.; Sabatine M.S.;
Bergmark B.A.
Institution
(Oyama, Furtado, Fagundes, Zelniker, Tang, Kuder, Murphy, Giugliano,
Sabatine, Bergmark) TIMI Study Group, Division of Cardiovascular Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Oyama) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Furtado) Hospital Israelita Albert Einsteinand Instituto do Coracao da
Faculdade de Medicina da USP, Sao Paulo, Brazil
(Zelniker) Division of Cardiology, Vienna General Hospital and Medical
University of Vienna, Vienna, Austria
(Hamer, Wang) Amgen, Thousand Oaks, CA, United States
(Keech) National Health and Medical Research Council Clinical Trials
Centre, Sydney Medical School, University of Sydney, Sydney, New South
Wales, Australia
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to evaluate the ability of the proprotein
convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab to reduce
the risk of complex coronary atherosclerosis requiring revascularization.
<br/>Background(s): PCSK9 inhibitors induce plaque regression and reduce
the risk of coronary revascularization overall. <br/>Method(s): FOURIER
(Further Cardiovascular Outcomes Research with PCSK9 Inhibition in
Subjects with Elevated Risk) was a randomized trial of the PCSK9 inhibitor
evolocumab versus placebo in 27,564 patients with stable atherosclerotic
cardiovascular disease on statin therapy followed for a median of 2.2
years. Clinical documentation of revascularization events was blindly
reviewed to assess coronary anatomy and procedural characteristics.
Complex revascularization was the composite of complex percutaneous
coronary intervention (PCI) (as per previous analyses, >=1 of: multivessel
PCI, >=3 stents, >=3 lesions treated, bifurcation PCI, or total stent
length >60 mm) or coronary artery bypass grafting surgery (CABG).
<br/>Result(s): In this study, 1,724 patients underwent coronary
revascularization, including 1,482 who underwent PCI, 296 who underwent
CABG, and 54 who underwent both. Complex revascularization was performed
in 632 (37%) patients. Evolocumab reduced the risk of any coronary
revascularization by 22% (hazard ratio [HR]: 0.78; 95% CI: 0.71 to 0.86; p
< 0.001), simple PCI by 22% (HR: 0.78; 95% CI: 0.70 to 0.88; p < 0.001),
complex PCI by 33% (HR: 0.67; 95% CI: 0.54 to 0.84; p < 0.001), CABG by
24% (HR: 0.76; 95% CI: 0.60 to 0.96; p = 0.019), and complex
revascularization by 29% (HR: 0.71; 95% CI: 0.61 to 0.84; p < 0.001). The
magnitude of the risk reduction with evolocumab in complex
revascularization tended to increase over time (20%, 36%, and 41% risk
reductions in the first, second, and beyond second years).
<br/>Conclusion(s): Adding evolocumab to statin therapy significantly
reduced the risk of developing complex coronary disease requiring
revascularization, including complex PCI and CABG individually. (Further
Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with
Elevated Risk (FOURIER); NCT01764633.)<br/>Copyright &#xa9; 2021 American
College of Cardiology Foundation

<115>
Accession Number
2010560307
Title
Higher versus lower mean arterial pressure target management in older
patients having non-cardiothoracic surgery: A prospective randomized
controlled trial.
Source
Journal of Clinical Anesthesia. 69 (no pagination), 2021. Article Number:
110150. Date of Publication: May 2021.
Author
Hu A.-M.; Qiu Y.; Zhang P.; Zhao R.; Li S.-T.; Zhang Y.-X.; Zheng Z.-H.;
Hu B.-L.; Yang Y.-L.; Zhang Z.-J.
Institution
(Hu, Zhang, Zheng, Zhang) Department of Anesthesiology, Shenzhen People's
Hospital, Shenzhen, China
(Hu, Zhang, Zheng, Zhang) The Second Clinical Medical College, Jinan
University, Shenzhen, China
(Hu, Zhang, Zheng, Zhang) First Affiliated Hospital, Southern University
of Science and Technology, Shenzhen, China
(Qiu) Department of Anesthesiology and Translational Neuroscience Center,
West China Hospital, Sichuan University, Chengdu, China
(Zhang) Department of Anesthesiology, Sichuan Provincial People's
Hospital, Chengdu, China
(Zhao) Department of Anesthesiology, Kunming Children's Hospital, Kunming,
China
(Li) Department of Anesthesiology, Jinan University-affiliated Shenzhen
Baoan Women's and Children's Hospital, Shenzhen, China
(Hu) Department of Anesthesiology, Affiliated Hospital of Guizhou Medical
University, Guiyang, China
(Yang) Department of Anesthesiology, Henan Provincial People's Hospital,
Zhengzhou University, Zhengzhou, China
Publisher
Elsevier Inc.
Abstract
Study objective: This study aimed to evaluate the effects of low versus
high mean arterial pressure (MAP) levels on the incidence of postoperative
delirium during non-cardiothoracic surgery in older patients.
<br/>Design(s): Multicenter, randomized, parallel-controlled, open-label,
and assessor-blinded clinical trial. <br/>Setting(s): University hospital.
<br/>Patient(s): Three hundred twenty-two patients aged >=65 with an
American Society of Anesthesiologists physical status of I-II who
underwent non-cardiothoracic surgery with general anaesthesia.
<br/>Intervention(s): Participants were randomly assigned into a low-level
MAP (60-70 mmHg) or high-level MAP (90-100 mmHg) group during general
anaesthesia. The study was conducted from November 2016 to February 2020.
Participants were older patients having non-cardiothoracic surgery. The
follow-up period ranged from 1 to 7 days after surgery. The primary
outcome was the incidence of postoperative delirium. <br/>Main Result(s):
In total, 322 patients were included and randomized; 298 completed
in-hospital delirium assessments [median (interquartile range) age, 73
(68-77) years; 173 (58.1%) women]. Fifty-four (18.1%) patients total,
including 36 (24.5%) and 18 (11.9%) in the low-level and high-level MAP
groups [relative risk (RR) 0.48, 95% confidence interval (CI) 0.25 to
0.87, P = 0.02], respectively, experienced postoperative delirium. The
adjusted RR was 0.34 (95% CI 0.16 to 0.70, P < 0.01) in the multiple
regression analysis. High-level MAP was associated with a shorter delirium
span and a higher intraoperative urine volume than low-level MAP.
<br/>Conclusion(s): In older patients during non-cardiothoracic surgery,
high-level blood pressure management might help reduce the incidence of
postoperative delirium.<br/>Copyright &#xa9; 2020

<116>
Accession Number
2007745324
Title
Effects of intravenous and transdermal photobiomodulation on the
postoperative complications of coronary artery bypass grafting surgery: a
randomized, controlled clinical trial.
Source
Lasers in Medical Science. (no pagination), 2021. Date of Publication:
2021.
Author
Kazemikhoo N.; Kyavar M.; Razzaghi Z.; Ansari F.; Maleki M.; Ghavidel
A.A.; Gholampour M.; Ghaffarinejad M.H.
Institution
(Kazemikhoo) Skin and Stem Cell Research Center, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Kazemikhoo) Department of Dermatology at St George Hospital, University
of NSW, Sydney, Australia
(Kyavar, Maleki, Ghavidel, Gholampour, Ghaffarinejad) Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Razzaghi) Laser Application in Medical Sciences Research Center, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ansari) Research Center for Evidence-Based Medicine, Health Management
and Safety Promotion Research Institute, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Ansari) Razi Vaccine and Serum Research Institute, Agricultural Research,
Education and Extension Organization (AREEO), Tehran, Iran, Islamic
Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Although coronary artery bypass graft (CABG) surgery is one of the most
worldwide commonly performed cardiac surgeries to enhance myocardial
perfusion in high-grade myocardial occlusion, it remains a high-risk
procedure. Photobiomodulation (PBM) is one of the methods which have been
shown to have positive effects on the healing process after CABG and
postoperative complications. The aim of this study was to evaluate the
efficacy of PBM in patients who underwent a coronary artery bypass graft
(CABG). Ths study was conducted with 192 volunteers who electively
submitted to CABG. The volunteers were randomly allocated into two groups:
laser-treated (transdermal: 980 nm, 200 mW, continuous, average energy
fluency of 6 J/cm² and intravenous: 405 nm, 1.5 mW, continuous
for 30 min) and standard treatment and control group (standard treatment
only). Intravenous laser was illuminated the day before the surgery,
immediately after transferring the patient to CCU post-operation and IV
laser in addition to transdermal laser was applied every day after surgery
for 6 days. A total of 170 out of 192 participants completed the study, 82
(48.2%) in the PBM group and 88 (51.8%) in the control group. Level of LDH
and CPK was significantly lower in the PBM group (P < 0.05) in the 4th day
postoperatively. The PBM group also showed significantly lower
post-surgery complications, including pericardial effusion, ejection
fraction, pathologic ST changes, pathologic Q, rehospitalization, heart
failure, and mediastinitis (P < 0.05). Likewise, the VAS pain score after
surgery was significantly lower in patients in the laser group (P < 0.05).
PBM seems a promising, safe, cost-benefit therapeutic modality to reduce
postoperative complications of CABG. Trial registration number:
IRCT2016052926069N4.<br/>Copyright &#xa9; 2021, The Author(s), under
exclusive licence to Springer-Verlag London Ltd. part of Springer Nature.

<117>
Accession Number
633846674
Title
Non-Autologous Grafts in Coronary Artery Bypass Surgery: A Systematic
Review.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 16 Dec 2020.
Author
Lampridis S.; George S.J.
Institution
(Lampridis, George) Bristol Medical School, University of Bristol, United
Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Suitable autologous conduits may be lacking when performing
coronary artery bypass grafting (CABG). The aim of this review is to
determine the status of non-autologous grafts in CABG. <br/>METHOD(S): We
conducted a literature search on MEDLINE All, Embase Classic and Embase
through Ovid from 1960 to April 2020. <br/>RESULT(S): Of the 1579 records
identified, 21 studies were included in the review. The following grafts
were assessed for patency: 109 homologous saphenous veins (patency rates
ranged from 66.7% at a median follow-up of 8.5 months to 0% at 6-12 and
7-18 months, respectively), 29 expanded polytetrafluoroethylene (ePTFE)
grafts (from 80% at a median follow-up of 5 months to 14.3% at 45 months),
12 human umbilical veins (50% at a median follow-up of 6 months), 50
Bioflow bovine internal mammary arteries (from 15.8% to 0% at a mean
follow-up of 9.5 and 19 months, respectively), 39 Perma-Flow grafts (80%
and 76.9% at 1-3 and 12 months, respectively), 20 No-React bovine internal
mammary arteries (57.1% at a median follow-up of 28 months and 23.1% at a
mean follow-up of 7 months), 40 autologous venous endothelial cell-seeded
ePTFE grafts (94.7% and 81% at a mean follow-up of 27 and 60 months,
respectively) and 12 autologous venous endothelial cell-seeded
cryopreserved homologous veins (83.3% at a mean follow-up of 8.5 months).
<br/>CONCLUSION(S): The goal of an alternative conduit with patency and
attributes that match those of autografts remains elusive. Autologous
endothelial cell-seeded synthetic grafts have demonstrated promising
results but require further investigation.<br/>Copyright &#xa9; 2020.
Published by Elsevier Inc.

<118>
Accession Number
633846552
Title
Postoperative atrial fibrillation after cardiac surgery: a meta-analysis.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 16 Dec 2020.
Author
Woldendorp K.; Farag J.; Khadra S.; Black D.; Robinson B.; Bannon P.
Institution
(Woldendorp, Bannon) Faculty of Health and Medicine, University of Sydney,
Sydney, Australia; Cardiothoracic Surgical Department, Royal Prince Alfred
Hospital, Sydney, Australia; Baird Institute of Applied Heart and Lung
Research, Sydney, Australia
(Farag) Faculty of Health and Medicine, University of Sydney, Sydney,
Australia; Cardiothoracic Surgical Department, Royal Prince Alfred
Hospital, Sydney, Australia
(Khadra) Faculty of Health and Medicine, University of Sydney, Sydney,
Australia
(Black) Faculty of Health and Medicine, University of Sydney, Sydney,
Australia; Baird Institute of Applied Heart and Lung Research, Sydney,
Australia
(Robinson) Cardiothoracic Surgical Department, Royal Prince Alfred
Hospital, Sydney, Australia; Baird Institute of Applied Heart and Lung
Research, Sydney, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) is common after
cardiac surgery and linked to poorer short- and long-term outcomes.,
however conflicting evidence exists on stroke risk and how the index
procedure affects outcomes. This study aims to provide a comprehensive
review of the published outcomes of POAF after cardiac surgery, examined
as a whole and by index procedure. <br/>METHOD(S): A systematic review of
POAF after cardiac surgery was conducted. Outcomes related to POAF were
analysed in a meta-analysis and aggregate survival data was derived to
examine long-term survival. <br/>RESULT(S): Sixty-one studies with 239,018
patients were identified, the majority (78.7%) undergoing coronary
surgery. POAF occurred in 25.5% of patients and was associated with
significantly higher rates of early mortality and stroke (OR 1.74, p
<0.001; OR 2.21, p <0.001, respectively) along with longer intensive care
and overall hospital length of stay (mean difference 0.8 days, p = 0.008;
mean difference 2.8 days, p <0.001, respectively). After a median of
6.6yrs (range 0.5-20), mortality and stroke remained significantly higher
for those with POAF (OR 1.57, p <0.001; OR 1.81, p = 0.001). Pooled hazard
ratio for long-term mortality was significantly higher for patients who
underwent coronary surgery compared to isolated valve surgery.
<br/>CONCLUSION(S): POAF is common after cardiac surgery and is associated
with significantly higher rates of both short- and long-term stroke and
mortality as well as increased hospital stay. Differences in hazard for
long-term survival may be due to the underlying pathophysiological risk
factors for POAF which differ by surgical procedure.<br/>Copyright &#xa9;
2020. Published by Elsevier Inc.

<119>
Accession Number
633850367
Title
Does routine topical antimicrobial administration prevent sternal wound
infection after cardiac surgery?.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2020.
Date of Publication: 21 Dec 2020.
Author
Magro P.L.; Sousa Uva M.
Institution
(Magro, Sousa Uva) Department of Cardio-thoracic Surgery, Hospital de
Santa Cruz, Carnaxide, Portugal
Publisher
NLM (Medline)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was 'Does routine topical
antimicrobial administration prevent sternal wound infection (SWI) after
cardiac surgery? Altogether >238 papers were found using the reported
search, of which 11 represented the best evidence to answer the clinical
question. The authors, journal, date and country of publication, patient
group studied, study type, relevant outcomes and results of these papers
are tabulated. Several different antimicrobial agents, dosages and
application protocols were found in the literature. Regarding topical
vancomycin use, a meta-analysis by Kowalewski et al. demonstrated a 76%
risk reduction in any SWI. Collagen-gentamicin sponge application was
associated with a 38% risk reduction in SWI in another meta-analysis by
Kowalewski et al., which included 4 randomized control trials and >23 000
patients. Lower evidence observational studies found benefit in the use of
different regimes, including: combination of vancomycin paste and
subcutaneous gentamycin; combined cefazoline and gentamicin spray;
isolated cefazolin; bacitracin ointment; and rifampicin irrigation. We
conclude that, in light of the body of evidence available, topical
antibiotic application prevents SWI, including both superficial and deep
SWI. The strongest evidence, derived from 2 meta-analyses, is related to
the use of gentamicin-collagen sponges and topical vancomycin.
Heterogeneity throughout studies regarding antibiotic agents, dosages,
application protocols and SWI definition makes providing general
recommendations challenging.<br/>Copyright &#xa9; The Author(s) 2020.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.