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<1>
Accession Number
361756160
Title
A single dose of aprotinin prevents platelet hyporeactivity after coronary
artery bypass graft surgery.
Source
Polskie Archiwum Medycyny Wewnetrznej. 120 (9) (pp 321-327), 2010. Date of
Publication: 2010.
Author
Szczeklik W.; Morawski W.; Sanak M.; Jakiela B.; Bolkowski M.; Cisowski
M.; Szczeklik M.; Bochenek A.; Musial J.
Institution
(Szczeklik, Sanak, Jakiela, Musial) 2nd Department of Medicine,
Jagiellonian University Medical Collage, Krakow, Poland
(Morawski, Bolkowski, Cisowski, Szczeklik, Bochenek) 1St Department of
Cardiac Surgery, Medical University of Silesia, Katowice, Poland
Publisher
Medycyna Praktyczna Cholerzyn
Abstract
INTRODUCTION: Bleeding after coronary artery bypass graft (CABG) surgery
is associated with a significant increase in mortality. Even though
aprotinin significantly reduces bleeding in patients undergoing cardiac
surgery, its use has been recently substantially limited because of
serious cardiovascular complications. The exact mechanism of its action,
particularly its effect on platelet function, remains unclear.
<br/>OBJECTIVE(S): The aim of the study was to assess the effect of
aprotinin on platelet function in patients undergoing CABG. <br/>PATIENTS
AND METHODS: In a randomized placebo-controlled double-blind study, we
investigated the effect of a single dose of aprotinin on platelet function
in 24 patients who underwent CABG between 2005 and 2006. Before surgery
and in the postoperative period, we measured platelet activation markers
(P-selectin and activated form of glycoprotein IIb/IIIa) at baseline and
following in vitro platelet activation with adenosine diphosphate (ADP) or
protease-activated receptor 1 (PAR-1) agonist - thrombin receptor
activator for peptide 6 (TRAP-6). Perioperative bleeding and urinary
metabolites of thromboxane A<inf>2</inf> were also determined.
<br/>RESULT(S): Aprotinin reduced perioperative bleeding by 26% (P <0.01)
and prevented a decrease in platelet sensitivity to ADP immediately after
CABG. In vitro platelet reactivity to TRAP-6 remained unchanged. Aprotinin
did not affect blood platelet count or urinary thromboxane A2 metabolite
excretion after CABG. <br/>CONCLUSION(S): Our results indicate that
aprotinin may reduce perioperative bleeding by its interference with ADP
pathway of platelet activation, thereby preventing postoperative
hyporeactivity of platelets to ADP. Platelet reactivity to PAR-1 receptor
agonist was not affected by aprotinin. Copyright by Medycyna Praktyczna,
2010.

<2>
Accession Number
2005609136
Title
Systematic review of the treatment options for pericardial effusions in
dogs.
Source
Veterinary Surgery. 50 (1) (pp 20-28), 2021. Date of Publication: January
2021.
Author
Scheuermann L.M.; Gordon-Evans W.J.; Nault A.J.
Institution
(Scheuermann, Gordon-Evans) Veterinary Clinical Sciences, College of
Veterinary Medicine, University of Minnesota, Saint Paul, MN, United
States
(Nault) Veterinary Medical Library, University of Minnesota, Saint Paul,
MN, United States
Publisher
Blackwell Publishing Inc.
Abstract
Objective: To evaluate the evidence for the conservative and surgical
management of pericardial effusions for neoplastic and idiopathic
etiologies in dogs. Study design: Systematic review. Sample population:
Peer-reviewed English-language articles describing the treatment and
outcome of naturally occurring pericardial effusion in domestic dogs.
<br/>Method(s): A literature search was performed with PubMed, Cab
Abstracts, Scopus, and Agricola in August 2019 for articles describing
pericardial effusion treatment in dogs. Inclusion criteria were applied,
and articles were evaluated for reported outcome and level of evidence by
using The Oxford 2011 Levels of Evidence, a previously described
hierarchical system, and GRADE (Grading of Recommendations, Assessment,
Development and Evaluation). <br/>Result(s): One hundred eight of the 641
unique articles that were identified and evaluated met inclusion criteria.
Most articles included were case studies (68.2%) or retrospective case
series (25.2%), with all articles providing a low level of evidence. The
articles had inconsistent inclusion criteria, outcome measures, and
follow-up, making comparison of outcomes difficult. <br/>Conclusion(s):
Because of the low quality of evidence of the studies included in this
systematic review and the variability of the outcomes, there is not
sufficient evidence to recommend one treatment option rather than another.
Clinical significance: There is a requirement for higher quality evidence
such as randomized controlled trials and prospective comparative cohort
studies. Standardization of outcome measures reported for each treatment
option and disease process studied will allow for better comparison of
outcomes between studies.<br/>Copyright &#xa9; 2020 The American College
of Veterinary Surgeons

<3>
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)).

<4>
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.

<5>
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.

<6>
Accession Number
2010404732
Title
Intramyocardial Transplantation of Umbilical Cord Mesenchymal Stromal
Cells in Chronic Ischemic Cardiomyopathy: A Controlled, Randomized
Clinical Trial (HUC-HEART Trial).
Source
International Journal of Stem Cells. 13 (3) (pp 364-376), 2020. Date of
Publication: November 2020.
Author
Ulus A.T.; Mungan C.; Kurtoglu M.; Celikkan F.T.; Akyol M.; Sucu M.; Toru
M.; Gul S.S.; Cinar O.; Can A.
Institution
(Ulus) Department of Cardiovascular Surgery, Hacettepe University Faculty
of Medicine, Ankara, Turkey
(Mungan, Sucu) Ankara University Biotechnology Institute and Sisbiyotek,
Ankara, Turkey
(Kurtoglu) Cardiovascular Surgery Division, Ankara Guven Hospital, Ankara,
Turkey
(Celikkan, Cinar, Can) Department of Histology and Embryology, Laboratory
for Stem Cells and Reproductive Cell Biology, Ankara University School of
Medicine, Ankara, Turkey
(Akyol) Department of Biostatistics, Ankara Yildirim Beyazit University,
Ankara, Turkey
(Toru) Radiology Division, Ankara Liv Hospital, Ankara, Turkey
(Gul) Visart Medical Imaging Center, Ankara, Turkey
Publisher
Sungkyunkwan University
Abstract
Background and Objectives: The HUC-HEART Trial (ClinicalTrials.gov
Identifier: NCT02323477) was a controlled, prospective, phase I/II,
multicenter, single-blind, three-arm randomized study of intramyocardial
delivery of human umbilical cord-derived mesenchymal stromal cells
(HUC-MSCs) combined with coronary artery bypass-grafting (CABG) in
patients with chronic ischemic cardiomyopathy (CIC). The trial aimed to
assess (i) the safety and the efficacy of cell transplantation during
one-year follow-up, (ii) to compare the efficacy of HUC-MSCs with
autologous bone-marrow- derived mononuclear cells (BM-MNCs) in the same
clinical settings. <br/>Methods and Results: Fifty-four patients who were
randomized to receive HUC-MSCs (23x106) (n=26) or BM-MNCs (70x107) (n=12)
in combination with CABG surgery. The control patients (n=16) received no
cells/vehicles but CABG intervention. All patients were screened at
baseline and 1, 3, 6, 12 months after transplantation. Forty-six (85%)
patients completed 12 months follow-up. No short/mid-term adverse events
were encountered. Decline in NT-proBNP (baseline~ 6 months) in both
cell-treated groups; an increase in left ventricular ejection fraction
(LVEF) (5.4%) and stroke volume (19.7%) were noted (baseline~6 or 12
months) only in the HUC-MSC group. Decreases were also detected in
necrotic myocardium as 2.3% in the control, 4.5% in BM-MNC, and 7.7% in
the HUC-MSC groups. The 6-min walking test revealed an increase in the
control (14.4%) and HUC-MSC (23.1%) groups. <br/>Conclusion(s):
Significant findings directly related to the intramyocardial delivery of
HUC-MSCs justified their efficacy in CIC. Stricter patient selection
criteria with precisely aligned cell dose and delivery intervals, rigorous
follow-up by detailed diagnostic approaches would further help to clarify
the responsiveness to the therapy.<br/>Copyright &#xa9; 2020 2020 by the
Korean Society for Stem Cell Research This is an Open Access article
distributed under the terms of the Creative Commons Attribution
Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/)
which permits unrestricted non-commercial use, distribution, and
reproduction in any medium, provided the original work is properly cited.

<7>
Accession Number
2010715984
Title
A systematic evaluation on reporting quality of modern studies on
pulmonary heart valve implantation in large animals.
Source
Interactive Cardiovascular and Thoracic Surgery. 31 (4) (pp 437-445),
2020. Date of Publication: 01 Oct 2020.
Author
Uiterwijk M.; Vis A.; De Brouwer I.; Van Urk D.; Kluin J.
Institution
(Uiterwijk, Vis, De Brouwer, Van Urk, Kluin) Department of Cardiothoracic
Surgery, Amsterdam University Medical Center, University of Amsterdam,
Heart Center, Amsterdam, Netherlands
Publisher
Oxford University Press
Abstract
OBJECTIVES: Before new heart valves can be implanted safely in humans,
animal experiments have to be performed. These animal experiments have to
be clearly designed, analysed and reported to assess the accuracy and
importance of the findings. We aimed to provide an overview of the
reporting and methodological quality of preclinical heart valve research.
<br/>METHOD(S): We conducted a systematic literature search on biological
and mechanical pulmonary valve implantations in large animals. We used the
Animals in Research: Reporting In Vivo Experiments (ARRIVE) guidelines to
score the quality of reporting in each article. We compared the scores
before and after the introduction of the ARRIVE guidelines (2010).
<br/>RESULT(S): We screened 348 articles, of which 31 articles were
included. The included articles reported a mean of 54.7% adequately scored
ARRIVE items (95% confidence interval 52.2-57.3%). We did not identify a
difference in reporting quality (54.7% vs 54.8%) between articles
published before and after 2010. We found an unclear (lack of description)
risk of selection bias, performance bias and detection bias.
<br/>CONCLUSION(S): The reporting quality of studies that implanted
bioprosthetic or mechanical valves in the pulmonary position in the large
animal model is not on the desired level. The introduction of the ARRIVE
guidelines in 2010 did not improve the reporting quality in this field of
research. Hereby, we want to emphasize the importance of clearly
describing the methods and transparently reporting the results in animal
experiments. This is of great importance for the safe translation of new
heart valves to the clinic. Clinical trial registration number: PROSPERO
(CRD42019147895). <br/>Copyright &#xa9; 2020 The Author(s) 2020. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<8>
Accession Number
2010671838
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.
Institution
(Gofus, Vobornik, Smolak, Myjavec, Vojacek, Pojar) Department of Cardiac
Surgery, Charles University, Faculty of Medicine, University Hospital in
Hradec Kralove, Hradec Kralove, Czechia
(Koblizek) Department of Pulmology, Charles University, Faculty of
Medicine, University Hospital in Hradec Kralove, Hradec Kralove, Czechia
Publisher
Medycyna Praktyczna Cholerzyn

<9>
Accession Number
2005778977
Title
Cervical arthroplasty in the treatment of cervical angina: Case report and
review of the literature.
Source
Neurospine. 17 (4) (pp 929-938), 2020. Date of Publication: December 2020.
Author
Al Jammal O.M.; Diaz-Aguilar L.D.; Srinivas S.; Plonsker J.; Sahyouni R.;
Pham M.H.
Institution
(Al Jammal, Diaz-Aguilar, Srinivas, Plonsker, Sahyouni, Pham) Department
of Neurosurgery, University of California San Diego School of Medicine,
San Diego, CA, United States
Publisher
Korean Spinal Neurosurgery Society
Abstract
Cervical angina is an often-overlooked etiology of noncardiac chest pain
that may mimic true angina pectoris but is due to cervical spine disease.
Diagnosis can be difficult, and treatment ranges from conservative therapy
to surgical management. However, of patient's refractory to conservative
therapy, approximately ninety percent experience postoperative relief of
angina symptoms. Here, we present a case report on cervical angina and
performed a systematic review of the literature. A 34-year-old male with
prior surgery for thoracic outlet syndrome presented with persistent
anterior neck and chest pain as well as posterior left scapular and upper
lateral arm pain. The pain was refractory to 12 months of conservative
therapy. Cardiac workup was negative and cervical spine imaging revealed a
C6-7 herniation with neuroforaminal stenosis. A systematic literature
search was conducted in PubMed, Web of Science, and Cochrane databases
from database inception to April 2020. Studies reporting cervical level,
average symptom duration, location of pain, and postoperative pain
improvement were included. The patient's atypical symptoms were completely
resolved after C6-7 anterior cervical discectomy and arthroplasty. To our
knowledge, this is the first study which reports on the use of
arthroplasty in the treatment of cervical angina. The systematic review
included 11 articles from 1989-2020 consisting of 1, 186 total patients
and 109 patients (age range, 36-84 years; 60.7% male) meeting inclusion
criteria. Symptom duration range was 2 days to 90 months, with the most
common location of pain being localized to the anterior chest wall (66. 7%
of patients). All patients (100%) had postoperative resolution of their
pain symptoms. The most common herniation level was C6-7 (87. 3% of
patients). We conclude that a broad and multidisciplinary approach is
necessary for the diagnosis and management of noncardiac chest pain. When
cervical disease is identified as the underlying cause for the angina-like
pain, conservative therapy should be sought. Refractory cases should be
treated surgically depending on the cervical pathology.<br/>Copyright
&#xa9; 2020 by the Korean Spinal Neurosurgery Society.

<10>
Accession Number
2010715983
Title
Short-term outcome of the intuity rapid deployment prosthesis: A
systematic review and meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 31 (4) (pp 427-436),
2020. Date of Publication: 01 Oct 2020.
Author
Klop I.D.G.; Kougioumtzoglou A.M.; Kloppenburg G.T.L.; Van Putte B.P.;
Sprangers M.A.G.; Klein P.; Nieuwkerk P.T.
Institution
(Klop, Kloppenburg, Van Putte, Klein) Department of Cardiothoracic
Surgery, St. Antonius Ziekenhuis, Nieuwegein, Netherlands
(Kougioumtzoglou, Van Putte) Department of Cardiothoracic Surgery,
Amsterdam University Medical Centers, Academic Medical Center, Amsterdam,
Netherlands
(Sprangers, Nieuwkerk) Department of Psychology, Amsterdam University
Medical Centers, Academic Medical Center, University of Amsterdam,
Amsterdam Public Health Research Institute, Amsterdam, Netherlands
Publisher
Oxford University Press
Abstract
OBJECTIVES: Limited access aortic valve replacement is an alternative
approach for the treatment of calcified aortic valve disease. To
facilitate limited access aortic valve replacement, rapid deployment valve
prostheses have been developed aiming to reduce surgical impact. This
systematic review gives an overview of current literature regarding the
INTUITY or INTUITY Elite rapid deployment biological valve prosthesis.
<br/>Method(s): Cochrane, Embase and MEDLINE were searched to identify
relevant studies. All studies reporting on patients who underwent isolated
or combined surgical aortic valve replacement with the INTUITY or INTUITY
Elite valve prosthesis were considered eligible. Primary end points were
technical success rate, 30-day mortality, cerebrovascular accident,
paravalvular leak and permanent pacemaker implantation. Secondary end
points included procedural data such as aortic cross-clamping time,
cardiopulmonary bypass time and procedural approach. <br/>Result(s): A
total of 16 articles fulfilled the inclusion and exclusion criteria and
comprised 4.184 patients. Thirty-day mortality was 2.7% (1.9-3.7%),
cerebrovascular accident 2.6% (1.4-4.7%), permanent pacemaker implantation
7.9% (6.6-9.5%) and severe postoperative paravalvular leak requiring a
reintervention 3.3% (1.7-6.1%). Technical success rate varied between
93.9% and 100%. Conventional median sternotomy was most commonly
performed, ranging from 21.7% to 89.6%. Upper hemi-sternotomy was
performed more often than anterior right thoracotomy, ranging from 10.4%
to 63.3% and 2.2% to 26.1%. The mean transvalvular pressure gradient
ranged between 9.0 and 10.3 mmHg at 1 year postoperatively.
<br/>Conclusion(s): This review demonstrates that the technical success
rate of the INTUITY or INTUITY Elite rapid deployment valve system is
high, also in limited access aortic valve replacement. Mortality and
cerebrovascular accident rates are low, but the need for postoperative
permanent pacemaker implantation and reintervention rate for paravalvular
leakage is increased. <br/>Copyright &#xa9; 2020 The Author(s) 2020.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<11>
Accession Number
633925836
Title
Comparison between video-assisted thoracoscopic lung cancer resection and
robot-assisted lung cancer resection Protocol for a systematic review and
meta-analysis.
Source
Medicine (United States). 98 (11) (no pagination), 2019. Article Number:
e14790. Date of Publication: 2019.
Author
Chai T.; Lin Y.; Shen Z.; Chen S.; Zhang Z.; Lin W.; Zhang P.; Kang M.;
Lin J.
Institution
(Chai, Shen, Chen, Zhang, Lin, Zhang, Kang, Lin) Department of Thoracic
Surgery, Fujian Medical University Union Hospital, Fuzhou, China
(Chai, Shen, Zhang) The Graduate School of Fujian Medical University,
Fuzhou, China
(Lin) School of Stomatology, Fujian Medical University, Fuzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Video-assisted thoracoscopic surgery (VATS) has developed
rapidly and a variety of feasible technical methods have been formed. VATS
is the main way of lung cancer resection nowadays with minor surgical
incision and less bleeding. Robotassisted thoracic surgery (RATS) is a
revolution in surgical procedures and robotic pulmonary resection has been
put to use by an increasing quantity of hospitals around the world.
However, the widespread adoption of robot-assisted lung cancer resection
is controversial. We aimed to evaluate quality metrics of these 2
different approaches of operation by this review and meta-analysis.
Methods and Analysis: We will search Medline, Embase, Pubmed, Google
Scholar, and the Cochrane Central Register of Controlled Trials for
related literature published in any language before February 28, 2019.
Propensity score matched comparative studies, prospective cohort studies;
randomized controlled trials (RCTs) will be included. If sufficient data
are available, we will perform subgroup analysis in different operative
types of lung cancer resection. <br/>Result(s): The results of this study
will be published in a peer-reviewed journal. <br/>Conclusion(s): To our
knowledge, this will be the first time to use meta-analysis to assess
quality metrics of video-assisted thoracoscopic lung cancer resection and
robot-assisted lung cancer resection. The results of this study will
provide more proofs for researchers, clinicians, and patients with lung
cancer to choose a suitable surgical procedure. There is not enough
high-quality evidence of RCTs to be included, due to the characteristics
of interventions. We will try to include some non-randomized controlled
trials, small sample trails. Although our team has experience in carrying
out a systematic review and meta-analysis, there may be high heterogeneity
and low reliability of evidence, which is the limitation of this study.
Abbreviations: CI = confidence interval, PRISMA = Preferred Reporting
Items for Systematic Reviews and Meta-Analyses, RATS = robot-assisted
thoracic surgery, RCTs = randomized controlled trials, VATS =
video-assisted thoracoscopic surgery.<br/>Copyright &#xa9; 2019 Lippincott
Williams and Wilkins. All rights reserved.

<12>
Accession Number
2010179069
Title
Aspergillus flavus costochondritis following coronary artery bypass
grafting: a case report and a brief review of literature.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2021. Date of
Publication: 2021.
Author
Mohammad A.; Benjamin S.R.; Mallampati S.; Gnanamuthu B.R.; Prabhu A.J.;
Ninan M.M.
Institution
(Mohammad, Benjamin, Mallampati, Gnanamuthu) Department of Cardiothoracic
Surgery, The Christian Medical College, Vellore, India
(Prabhu) Department of Pathology, The Christian Medical College, Vellore,
India
(Ninan) Department of Microbiology, The Christian Medical College,
Vellore, India
Publisher
SAGE Publications Inc.
Abstract
Bacterial sternal wound infections following cardiac surgery are not
uncommon. However, sternal wound infection by a fungus is a rarity, and it
warrants a correct diagnosis followed by specific treatment. We report a
case of Aspergillus sternal wound infection with costochondritis following
cardiac surgery, and briefly review the relevant literature.<br/>Copyright
&#xa9; The Author(s) 2021.

<13>
Accession Number
606042374
Title
Evaluation of early interventional treatment opportunity of the elderly &
high-risk patients with non-ST segment elevation acute myocardial
infarction.
Source
Pakistan Journal of Medical Sciences. 31 (5) (no pagination), 2015. Date
of Publication: 2015.
Author
Liu Z.; Zhao L.; Li Y.; Wang Z.; Liu L.; Zhang F.
Institution
(Liu, Zhao, Li, Wang, Liu, Zhang) Department of Cardiology, Xinxiang
Central Hospital, Xinxiang 453000, China
Publisher
Professional Medical Publications
Abstract
Objective: To investigate the effect of treatment on prognosis of patients
with different timing of early interventional treatment for non-ST segment
elevation acute myocardial infarction (NSTEMI). <br/>Method(s): Forty two
cases above 75 years old, diagnosed with high-risk on NSTEMI, were
selected in cardiology department of Xinxiang central hospital. They were
randomly divided into two groups: 22 in group A and 20 in group B. Group A
was performed PCI surgery within 12 hours after the onset while group B
from 12 to 24 hour after the onset. Major adverse cardiovascular events
(including death, heart failure readmission rates after ischemia,
malignant arrhythmias, again target vessel revascularization) and bleeding
data were recorded at the three terms of hospitalization, one month after
the onset and six months after the onset. <br/>Result(s): Angina,
malignant arrhythmia and heart failure during hospitalization can be
reduced after interventional treatment carried out within 12 hours after
the onset. Readmission rates after ischemia, heart failure and the
incidence of death can be significantly reduced after interventional
treatment carried out during 1-6 month after the onset with no significant
increase in bleeding rate. <br/>Conclusion(s): In the treatment of elderly
patients with NSTEMI, early interventional treatment is safe and
effective.<br/>Copyright &#xa9; 2015, Professional Medical Publications.
All rights reserved.

<14>
Accession Number
2007697880
Title
Prospective Evaluation of Malignancy in 17,708 Patients Randomized to
Ezetimibe Versus Placebo: Analysis From IMPROVE-IT.
Source
JACC: CardioOncology. 2 (3) (pp 385-396), 2020. Date of Publication:
September 2020.
Author
Giugliano R.P.; Gencer B.; Wiviott S.D.; Park J.-G.; Fuchs C.S.; Goessling
W.; Musliner T.A.; Tershakovec A.M.; Blazing M.A.; Califf R.; Cannon C.P.;
Braunwald E.
Institution
(Giugliano, Gencer, Wiviott, Park, Cannon, Braunwald) TIMI Study Group,
Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Department of Medicine, Harvard Medical School, Boston, MA, United States
(Fuchs) Smilow Cancer Hospital at Yale New Haven, New Haven, CT, United
States
(Goessling) Division of Gastroenterology, Massachusetts General Hospital,
Boston, MA, United States
(Musliner, Tershakovec) Merck, Kenilworth, NJ, United States
(Blazing) Duke Clinical Research Institute, Durham, NC, United States
(Califf) Verily Life Sciences and Google Health, South San Francisco,
California, United States
Publisher
Elsevier Inc.
Abstract
Background: An increased risk of malignancy was reported with
simvastatin/ezetimibe in 1,873 patients in the SEAS (Simvastatin and
Ezetimibe in Aortic Stenosis) trial. <br/>Objective(s): The purpose of
this study was to clarify this unexpected finding in a larger sample size
of patients stabilized after acute coronary syndrome, we conducted a
prospective systematic analysis of malignancy events in IMPROVE-IT
(Improved Reduction of Outcomes: Vytorin Efficacy International Trial).
<br/>Method(s): Within IMPROVE-IT, 17,708 patients post-acute coronary
syndrome were randomized to either ezetimibe 10 mg or matching placebo on
a background of simvastatin 40 mg who took >=1 dose of the study drug.
Suspected tumors (benign and malignant) reported by investigators or
identified from a review of adverse events were adjudicated by oncologists
without knowledge of drug assignment. The primary malignancy endpoint
included new, relapsing, or progressive malignancies (excluding
nonmelanotic skin malignancies). The secondary endpoint was death due to
malignancy. <br/>Result(s): In this trial, 1,470 patients developed the
primary malignancy endpoint during a median 6 years of follow-up. The most
common malignancy locations were prostate (18.9%), lung (16.8%), and
bladder (8.8%) with no differences by treatment group (p > 0.05 for each
location). Kaplan-Meier 7-year rates of malignancies were similar with
ezetimibe and placebo (10.2% vs. 10.3%; hazard ratio: 1.03; 95% confidence
interval: 0.93 to 1.14; p = 0.56), as were the rates for malignancy death
(3.8% vs. 3.6%; hazard ratio: 1.04; 95% confidence interval: 0.88 to 1.23;
p = 0.68). <br/>Conclusion(s): Among 17,708 patients receiving simvastatin
40 mg daily, those randomized to ezetimibe 10 mg daily had a similar
incidence of malignancy and deaths due to malignancy compared with those
receiving placebo during a median follow-up of 6 years (96,377
patient-years). (IMPROVE-IT: Examining Outcomes in Subjects With Acute
Coronary Syndrome: Vytorin [Ezetimibe/Simvastatin] vs Simvastatin
[P04103]; NCT00202878)<br/>Copyright &#xa9; 2020 The Authors

<15>
Accession Number
2005169767
Title
Cardiovascular Safety of Degarelix Versus Leuprolide for Advanced Prostate
Cancer: The PRONOUNCE Trial Study Design.
Source
JACC: CardioOncology. 2 (1) (pp 70-81), 2020. Date of Publication: March
2020.
Author
Melloni C.; Slovin S.F.; Blemings A.; Goodman S.G.; Evans C.P.; Nilsson
J.; Bhatt D.L.; Zubovskiy K.; Olesen T.K.; Dugi K.; Clarke N.W.; Higano
C.S.; Roe M.T.
Institution
(Melloni, Roe) Department of Medicine, Division of Cardiology, Duke
Clinical Research Institute, Duke University Medical Center, Durham, NC,
United States
(Slovin) Department of Medicine, Division of Medical Oncology, Memorial
Sloan Kettering Cancer Center, New York, NY, United States
(Blemings) Ferring Pharmaceuticals A/S, Copenhagen, Denmark
(Goodman) Department of Medicine, Division of Cardiology, St. Michael's
Hospital, University of Toronto, Toronto, Ontario, Canada
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton,
Alberta, Canada
(Evans) Department of Urologic Surgery, University of California, Davis,
Sacramento, California, United States
(Nilsson) Department of Clinical Sciences Malmo, Lund University, Lund,
Sweden
(Bhatt) Division of Cardiovascular Medicine, Brigham and Women's Hospital
Heart and Vascular Center, Harvard Medical School, Boston, MA, United
States
(Zubovskiy, Olesen) Ferring Pharmaceuticals A/S, Parsippany, NJ, United
States
(Dugi) Ferring Pharmaceuticals A/S, Saint-Prex, Switzerland
(Clarke) Division of Urology, Institute of Cancer Sciences, University of
Manchester, United Kingdom
(Higano) Division of Medical Oncology, University of Washington and Fred
Hutchinson Cancer Research Center, Seattle, Washington, United States
Publisher
Elsevier Inc.
Abstract
Objectives: This study will compare the incidence of major adverse
cardiovascular events (MACEs) with androgen deprivation therapy (ADT)
among men with advanced prostate cancer who are being treated with a
gonadotropin-releasing hormone (GnRH) antagonist versus a GnRH agonist.
<br/>Background(s): Treatment of advanced prostate cancer with ADT might
increase the risk of subsequent cardiovascular events among men with known
atherosclerotic cardiovascular disease (ASCVD), but a recent meta-analysis
suggested that this risk might be lower with ADT using a GnRH antagonist
versus a GnRH agonist. <br/>Method(s): PRONOUNCE is a multicenter,
prospective, randomized, open, blinded endpoint trial that will enroll
approximately 900 patients with advanced prostate cancer and pre-existing
ASCVD who will be treated with ADT. Participants will be randomized to
receive the GnRH antagonist degarelix or the GnRH agonist leuprolide as
ADT for 12 months. The primary endpoint is time from randomization to
first confirmed, adjudicated occurrence of a MACE, which is defined as a
composite of all-cause death, nonfatal myocardial infarction, or nonfatal
stroke through 12 months of ADT treatment. Baseline cardiovascular
biomarkers (high-sensitivity C-reactive protein, high-sensitivity troponin
T, and N-terminal pro-brain natriuretic peptide), as well as serial
inflammatory and immune biomarkers, will be evaluated in exploratory
analyses. <br/>Result(s): As of October 1, 2019, a total of 364 patients
have been enrolled. The mean age is 74 years, 90% are white, 80% have
hypertension or dyslipidemia, 30% diabetes mellitus, 40% have had a
previous myocardial infarction, and 65% have had previous
revascularization. Regarding prostate cancer features at randomization,
48% of the patients had localized disease, 23% had locally advanced
disease, and 18% had metastatic disease. <br/>Conclusion(s): PRONOUNCE is
the first prospective cardiovascular outcomes trial in advanced prostate
cancer that will delineate whether the risk of subsequent cardiovascular
events associated with ADT is lower with a GnRH antagonist versus a GnRH
agonist for men with pre-existing ASCVD. (A Trial Comparing Cardiovascular
Safety of Degarelix Versus Leuprolide in Patients With Advanced Prostate
Cancer and Cardiovascular Disease [PRONOUNCE]; NCT02663908)<br/>Copyright
&#xa9; 2020 The Authors

<16>
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;

<17>
Accession Number
633280354
Title
Efficacy of Adherence-Enhancing Interventions for Immunosuppressive
Therapy in Solid Organ Transplant Recipients: A Systematic Review and
Meta-Analysis Based on Randomized Controlled Trials.
Source
Frontiers in Pharmacology. 11 (no pagination), 2020. Article Number:
578887. Date of Publication: 20 Oct 2020.
Author
Shi Y.-X.; Liu C.-X.; Liu F.; Zhang H.-M.; Yu M.-M.; Jin Y.-H.; Shang
S.-M.; Fu Y.-X.
Institution
(Shi, Yu, Shang) School of Nursing, Peking University, Beijing, China
(Liu) Department of Urinary Surgery, Peking University Third Hospital,
Beijing, China
(Liu) School of Public Health, Peking University, Beijing, China
(Zhang) Liver Transplantation Center, Clinical Center for Pediatric Liver
Transplantation, National Clinical Research Center for Digestive Diseases,
Beijing, China
(Jin) Center for Evidence-Based and Translational Medicine, Zhongnan
Hospital of Wuhan University, Wuhan, China
(Jin) Center for Evidence-Based and Translational Medicine, Wuhan
University, Wuhan, China
(Fu) Department of Kidney Transplantation, Tianjin First Center Hospital,
Tianjin, China
Publisher
Frontiers Media S.A.
Abstract
Background: Immunosuppressant non-adherence is a widespread problem among
solid organ recipients. With the newly published clinical trials, the
randomized controlled trials (RCTs) based systematic review of
adherence-enhancing interventions on immunosuppressant adherence in solid
organ recipients has not been completed. In this systematic review and
meta-analysis, we compared the efficacy of adherence-enhancing
interventions versus routine intervention, as performed with RCTs, on
immunosuppressant adherence in solid organ transplantation recipients.
<br/>Method(s): PubMed, Embase, Cochrane Library, CINAHL full text, and
PsycINFO were searched from database inception to December 2019. This
review was conducted following the PRISMA's reporting guidelines and
according to the principles recommended by Cochrane Handbook for
Systematic Review. <br/>Result(s): The search yielded 10,479 articles. A
total of 27 articles (26 studies) with 715 participants were included in
our analysis. Results from the meta-analysis revealed that as compared
with that of the routine intervention group, the rates of overall
adherence, dosing adherence, and timing adherence were significantly
increased within the adherence-enhancing intervention group, with the
pooled risk ratio (RR) of overall adherence = 1.17, [95% confidence
interval (CI): 1.07 to 1.28; p = 0.0006]; RR of dosing adherence = 1.21
(95% CI: 1.08 to 1.36, p = 0.001); RR of timing adherence = 1.16 (95% CI:
1.03 to 1.29, p = 0.01). There was a significantly increased adherence
score in the adherence-enhancing intervention group; however, no
statistical significance on the immunosuppressant blood concentration was
found between the two study groups. Results obtained from a subgroup
analysis shown interventions led by a multidisciplinary team, both the
assessment time at 6 months and 12 months demonstrated a significantly
increased adherence rate in the intervention group compared with the
control group. <br/>Conclusion(s): The findings of this report indicate
that clinicians (doctors and nurses) should maintain a long-term
intervention protocol to ensure immunosuppressant adherence within solid
organ transplant recipients. To accomplish this goal, we recommend a
multidisciplinary team-led, comprehensive intervention approach combined
with mobile health monitoring for the administration of an effective
immunosuppressive therapy regimen.<br/>&#xa9; Copyright &#xa9; 2020 Shi,
Liu, Liu, Zhang, Yu, Jin, Shang and Fu.

<18>
Accession Number
2006925551
Title
Transesophageal Echocardiography - Dysphagia Risk in Acute Stroke
(TEDRAS): a prospective, blind, randomized and controlled clinical trial.
Source
European Journal of Neurology. 28 (1) (pp 172-181), 2021. Date of
Publication: January 2021.
Author
Hamzic S.; Braun T.; Butz M.; Khilan H.; Weber S.; Yeniguen M.; Gerriets
T.; Schramm P.; Juenemann M.
Institution
(Hamzic, Braun, Butz, Khilan, Yeniguen, Gerriets, Juenemann) Department of
Neurology, University Hospital Giessen and Marburg GmbH,
Justus-Liebig-University, Giessen, Germany
(Hamzic, Braun, Butz, Yeniguen, Gerriets, Schramm, Juenemann) Heart and
Brain Research Group, Heart-, Lung-, Vascular- and Rheumatic Centre Bad
Nauheim, Kerckhoff Clinic GmbH, Bad Nauheim, Germany
(Khilan, Weber, Gerriets) Department of Neurology/Stroke Unit,
Gesundheitszentrum Wetterau, Friedberg, Hesse, Germany
(Schramm) Department of Anaesthesiology, University Medical Centre of the
Johannes Gutenberg-University, Mainz, Germany
Publisher
Blackwell Publishing Ltd
Abstract
Background and purpose: Dysphagia is common in acute stroke and leads to
worse overall outcome. Transesophageal echocardiography (TEE) is used in
the diagnostic evaluation of stroke with regard to its etiology and is a
known cause of postoperative dysphagia in cardiac surgery. The prevalence
of dysphagia in acute stroke patients undergoing TEE remains unknown. The
aim of the Transesophageal Echocardiography - Dysphagia Risk in Acute
Stroke (TEDRAS) study was to assess the influence of TEE on swallowing
among patients who have experienced acute stroke. <br/>Method(s): The
TEDRAS study was a prospective, blind, randomized, controlled trial that
included two groups of patients with acute stroke. Simple unrestricted
randomization was performed, and examiners were blinded to each other's
results. Swallowing was tested using flexible endoscopic evaluation of
swallowing (FEES) at three different time points in the intervention group
(24 h before, immediately after and 24 h after TEE) and in the control
group (FEES on three consecutive days and TEE earliest after the third
FEES). Validated scales were used to assess dysphagia severity for all
time points as primary outcome measures. <br/>Result(s): A total of 34
patients were randomized: 19 to the intervention group and 15 to the
control group. The key findings of the repeated-measures between-group
comparisons were significant increases in the intervention group for the
following dysphagia measures: (1) secretion severity score (immediately
after TEE: P < 0.001; 24 h after TEE: P < 0.001) and (2)
Penetration-Aspiration Scale score for saliva (immediately after TEE: P <
0.001; 24 h after TEE: P = 0.007), for small (immediately after TEE: P =
0.009) and large liquid boli (immediately after TEE: P = 0.009; 24 h after
TEE: P = 0.025). <br/>Conclusion(s): The results indicate a negative
influence of TEE on swallowing in acute stroke patients for at least 24
hours.<br/>Copyright &#xa9; 2020 The Authors. European Journal of
Neurology published by John Wiley & Sons Ltd on behalf of European Academy
of Neurology

<19>
Accession Number
2005851225
Title
A Systematic Review of Antibiotic Prophylaxis for Delayed Sternal Closure
in Children.
Source
World Journal for Pediatric and Congenital Heart Surgery. 12 (1) (pp
93-102), 2021. Date of Publication: January 2021.
Author
Kennedy J.T.; DiLeonardo O.; Hurtado C.G.; Nelson J.S.
Institution
(Kennedy, Hurtado, Nelson) University of Central Florida College of
Medicine, Orlando, FL, United States
(Kennedy) Department of Surgery, University of Cincinnati College of
Medicine, Cincinnati, OH, United States
(DiLeonardo) Department of Medical Education, Nemours Children's Hospital,
Orlando, FL, United States
(DiLeonardo) Nemours Children's Hospital Medical Library, Orlando, FL,
United States
(Nelson) Department of Cardiovascular Services, Nemours Children's
Hospital, Orlando, FL, United States
Publisher
SAGE Publications Inc.
Abstract
Antibiotic prophylaxis following delayed sternal closure in pediatric
cardiac surgery is not standardized. We systematically reviewed relevant
literature published between 1990 and 2019 to aid future trial design.
Patient characteristics, antimicrobial prophylaxis regimens, and
postoperative incidence of infection were collected. Twenty-eight studies
described 36 different regimens in over 3,000 patients. There were 11
single-drug regimens and 25 multidrug regimens. Cefazolin-only was the
most common regimen (9/36, 25%). The overall incidence of surgical site
infection was 7.5% (217/2,910 patients) and bloodstream infection was 7.4%
(123/1,667 patients). In the 2010s, multidrug regimens were associated
with a significantly lower incidence of both surgical site infections
(4.6% vs. 20%, P <.001) and bloodstream infections (6.0% vs. 50%, P <.001)
compared to single-drug regimens.<br/>Copyright &#xa9; The Author(s) 2020.

<20>
[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

<21>
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).

<22>
Accession Number
2010397828
Title
Transradial vs transfemoral secondary access outcomes in transcatheter
aortic valve implantation: A systematic review and meta-analysis.
Source
World Journal of Cardiology. 12 (11) (pp 571-583), 2020. Date of
Publication: 26 Nov 2020.
Author
Radhakrishnan S.L.; Ho K.K.L.
Institution
(Radhakrishnan) Division of General Medicine, Department of Medicine, Beth
Israel Deaconess Medical Center, Boston, MA 02215, United States
(Ho) Division of Cardiovascular Medicine, Department of Medicine, Beth
Israel Deaconess Medical Center, Boston, MA 02215, United States
Publisher
Baishideng Publishing Group Co
Abstract
BACKGROUND Complications of transcatheter aortic valve implantation (TAVI)
procedures include bleeding, vascular complications, and strokes. These
complications are often associated with the type of access used. The two
types of access in TAVI procedures are primary and secondary. The main use
of the primary access is for valve delivery, while secondary access is
used for angiography and hemodynamic monitoring. While there are many
options for primary access, those for secondary access are transfemoral
and transradial. AIM To compare outcomes between transradial vs
transfemoral secondary access (TFSA). METHODS A systematic search was
conducted using major databases (EMBASE, PubMed, Cochrane Central, Google
Scholar), which resulted in 5 studies that met the criteria for study
selection. Outcomes of interest were 30-d rates each of
major/life-threatening bleeding, vascular complications, strokes, and
mortality. All 5 studies were observational. Only adjusted or matched data
were used when available in this meta-analysis. RESULTS A total of 5065
patients underwent TAVI, with 1453 patients (28.7%) having undergone
transradial secondary access (TRSA) and 3612 patients (71.3%) TFSA.
Irrespective of the site of primary access, the odds of having major or
life-threatening bleeding were 60% lower in the TRSA group than the TFSA
group (P < 0.00001). The odds of having major vascular complications were
52% lower in the TRSA group (P < 0.0001) with no difference in minor
vascular complications between the 2 groups. Similarly, the odds of
mortality in 30-d after the procedure were 41% lower (P = 0.006) and the
odds of stroke were 54% lower (P = 0.001) in the TRSA group than the TFSA
group. CONCLUSION The transradial secondary approach appears to be a safer
alternative to the transfemoral secondary approach in TAVI
procedures.<br/>Copyright &#xa9; The Author(s) 2020. Published by
Baishideng Publishing Group Inc. All rights reserved.

<23>
Accession Number
2008335116
Title
Allogeneic Mesenchymal Cell Therapy in Anthracycline-Induced
Cardiomyopathy Heart Failure Patients: The CCTRN SENECA Trial.
Source
JACC: CardioOncology. 2 (4) (pp 581-595), 2020. Date of Publication:
November 2020.
Author
Bolli R.; Perin E.C.; Willerson J.T.; Yang P.C.; Traverse J.H.; Henry
T.D.; Pepine C.J.; Mitrani R.D.; Hare J.M.; Murphy M.P.; March K.L.; Ikram
S.; Lee D.P.; O'Brien C.; Durand J.-B.; Miller K.; Lima J.A.; Ostovaneh
M.R.; Ambale-Venkatesh B.; Gee A.P.; Richman S.; Taylor D.A.; Sayre S.L.;
Bettencourt J.; Vojvodic R.W.; Cohen M.L.; Simpson L.M.; Lai D.; Aguilar
D.; Loghin C.; Moye L.; Ebert R.F.; Davis B.R.; Simari R.D.
Institution
(Bolli, Ikram) Department of Medicine, Division of Cardiovascular
Medicine, University of Louisville, School of Medicine, Louisville, KY,
United States
(Perin, Willerson) Division of Cardiology Research, Texas Heart Institute,
CHI St. Luke's Health Baylor College of Medicine Medical Center, Houston,
TX, United States
(Yang, Lee, O'Brien) Department of Medicine and Cardiovascular Institute,
Division of Cardiovascular Medicine, Stanford University School of
Medicine, Stanford, CA, United States
(Traverse) Department of Medicine, Cardiovascular Division, Minneapolis
Heart Institute Foundation at Abbott Northwestern Hospital, and University
of Minnesota School of Medicine, Minneapolis, MN, United States
(Henry) The Carl and Edyth Lindner Center for Research and Education, The
Christ Hospital, Cincinnati, OH, United States
(Pepine, March) Department of Medicine, Division of Cardiovascular
Medicine, University of Florida College of Medicine, Gainesville, United
States
(Mitrani) Department of Medicine, Cardiovascular Division, University of
Miami, Miller School of Medicine, Miami, FL, United States
(Hare) Department of Molecular and Cellular Pharmacology, Division of
Cardiology, University of Miami, Miller School of Medicine, Miami, FL,
United States
(Murphy) Department of Surgery, Division of Vascular Surgery, Indiana
University School of Medicine, Indianapolis, IN, United States
(Durand) Department of Cardiology, Division of Internal Medicine, M.D.
Anderson Cancer Center, Houston, TX, United States
(Miller) Department of Medicine, Division of Hematology/Oncology, Indiana
University School of Medicine, Indianapolis, IN, United States
(Lima, Ostovaneh, Ambale-Venkatesh) Department of Medicine, Cardiology
Division, Johns Hopkins University, Baltimore, MD, United States
(Gee, Richman) Department of Pediatrics, Division of Hematology and
Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine,
Houston, TX, United States
(Taylor) Department of Regenerative Medicine Research, Texas Heart
Institute, CHI St. Luke's Health Baylor College of Medicine Medical
Center, Houston, TX, United States
(Sayre, Bettencourt, Vojvodic, Cohen, Simpson, Lai, Moye, Davis)
Department of Biostatistics & Data Science, UTHealth University of Texas
Health Science Center at Houston School of Public Health, Houston, TX,
United States
(Aguilar) Department of Epidemiology, Human Genetics and Environmental
Sciences, UTHealth University of Texas Health Science Center at Houston
School of Public Health, Houston, TX, United States
(Loghin) Department of Medicine, Division of Cardiovascular Medicine,
UTHealth University of Texas Health Science Center at Houston McGovern
Medical School, Houston, TX, United States
(Ebert) Division of Cardiovascular Sciences, Basic & Early Translational
Research Program, National Institutes of Health, National Heart, Lung, and
Blood Institute, Washington, DC, United States
(Simari) Division of Cardiovascular Diseases, University of Kansas School
of Medicine, Kansas City, KS, United States
Publisher
Elsevier Inc.
Abstract
Background: Anthracycline-induced cardiomyopathy (AIC) may be irreversible
with a poor prognosis, disproportionately affecting women and young
adults. Administration of allogeneic bone marrow-derived mesenchymal
stromal cells (allo-MSCs) is a promising approach to heart failure (HF)
treatment. <br/>Objective(s): SENECA (Stem Cell Injection in Cancer
Survivors) was a phase 1 study of allo-MSCs in AIC. <br/>Method(s): Cancer
survivors with chronic AIC (mean age 56.6 years; 68% women; NT-proBNP
1,426 pg/ml; 6 enrolled in an open-label, lead-in phase and 31 subjects
randomized 1:1) received 1 x 10⁸ allo-MSCs or vehicle
transendocardially. Primary objectives were safety and feasibility.
Secondary efficacy measures included cardiac function and structure
measured by cardiac magnetic resonance imaging (CMR), functional capacity,
quality of life (Minnesota Living with Heart Failure Questionnaire), and
biomarkers. <br/>Result(s): A total of 97% of subjects underwent
successful study product injections; all allo-MSC-assigned subjects
received the target dose of cells. Follow-up visits were well-attended
(92%) with successful collection of endpoints in 94% at the 1-year visit.
Although 58% of subjects had non-CMR compatible devices, CMR endpoints
were successfully collected in 84% of subjects imaged at 1 year. No new
tumors were reported. There were no significant differences between
allo-MSC and vehicle groups with regard to clinical outcomes. Secondary
measures included 6-min walk test (p = 0.056) and Minnesota Living with
Heart Failure Questionnaire score (p = 0.048), which tended to favor the
allo-MSC group. <br/>Conclusion(s): In this first-in-human study of cell
therapy in patients with AIC, transendocardial administration of allo-MSCs
appears safe and feasible, and CMR was successfully performed in the
majority of the HF patients with devices. This study lays the groundwork
for phase 2 trials aimed at assessing efficacy of cell therapy in patients
with AIC. (Stem Cell Injection in Cancer Survivors [SENECA];
NCT02509156)<br/>Copyright &#xa9; 2020 The Authors

<24>
Accession Number
2004551269
Title
Three contemporary thin-strut drug-eluting stents implanted in severely
calcified coronary lesions of participants in a randomized all-comers
trial.
Source
Catheterization and Cardiovascular Interventions. 96 (5) (pp E508-E515),
2020. Date of Publication: 01 Nov 2020.
Author
Buiten R.A.; Ploumen E.H.; Zocca P.; Doggen C.J.M.; van Houwelingen K.G.;
Danse P.W.; Schotborgh C.E.; Stoel M.G.; Scholte M.; Linssen G.C.M.; de
Man F.H.A.F.; von Birgelen C.
Institution
(Buiten, Ploumen, Zocca, van Houwelingen, Stoel, de Man, von Birgelen)
Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente,
Enschede, Netherlands
(Buiten, Ploumen, Zocca, Doggen, von Birgelen) Department of Health
Technology and Services Research, Faculty BMS, Technical Medical Centre,
University of Twente, Enschede, Netherlands
(Danse) Department of Cardiology, Rijnstate Hospital, Arnhem, Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Scholte) Department of Cardiology, Albert Schweitzer Hospital, Dordrecht,
Netherlands
(Linssen) Department of Cardiology, Hospital Group Twente, Almelo and
Hengelo, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Objective: The objective was to assess the 2-year clinical performance of
three drug-eluting stents in all-comer patients with severely calcified
coronary lesions. <br/>Background(s): Severe lesion calcification
increases cardiovascular event risk after coronary stenting, but there is
a lack of data on the clinical outcome of all-comers with severely
calcified lesions who were treated with more recently introduced
drug-eluting stents. <br/>Method(s): The BIO-RESORT trial
(clinicaltrials.gov: NCT01674803) randomly assigned 3,514 all-comer
patients to biodegradable polymer Synergy everolimus-eluting stents (EES)
or Orsiro sirolimus-eluting stents (SES), versus durable polymer Resolute
Integrity zotarolimus-eluting stents (ZES). In a post hoc analysis, we
assessed 783 patients (22.3%) with at least one severely calcified target
lesion. <br/>Result(s): At 2-year follow-up (available in 99% of
patients), the main composite endpoint target vessel failure occurred in
19/252 (7.6%) of the EES and in 33/265 (12.6%) of the ZES-treated patients
(p =.07). Target vessel failure occurred in 24/266 (9.1%) of the
SES-treated patients (vs. ZES: p =.21). There was a difference in target
vessel revascularization, which was required in EES in 6/252 (2.4%)
patients and in ZES in 20/265 (7.7%) patients (p =.01); the target vessel
revascularization rate in SES was 9/266 (3.4%, vs. ZES: p =.04).
Multivariate analysis showed that implantation of EES, but not SES, was
independently associated with lower target vessel revascularization rates
than in ZES. <br/>Conclusion(s): In BIO-RESORT participants with severely
calcified target lesions, treatment with EES was associated with a lower
2-year target vessel revascularization rate than treatment with
ZES.<br/>Copyright &#xa9; 2020 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals, Inc.

<25>
Accession Number
633716278
Title
Comparison of Rocuronium and Vecuronium in Patients Undergoing Elective
Ultrafast-Track Off-Pump Coronary Artery Bypass Surgery.
Source
Journal of Cardiac Critical Care. 3 (2) (pp 68-76), 2019. Article Number:
JCCC320001. Date of Publication: 01 Dec 2019.
Author
Shah K.S.; Kulshrestha A.
Institution
(Shah, Kulshrestha) Department of Anaesthesia, Breach Candy Hospital,
Mumbai, Maharashtra, India
Publisher
Thieme India
Abstract
Background Neuromuscular blocking drugs are necessary in cardiac surgery
to facilitate smooth intubation and ventilation conditions, avoid patient
movement, reduce oxygen consumption, and prevent shivering. Hemodynamic
stability is very essential in cardiac surgery because the coronary
reserve is below normal in such patients. Aims This study was conducted
with the objective of comparing rocuronium, the near-ideal muscle relaxant
with vecuronium, an already established neuromuscular blocking agent in
patients undergoing elective ultrafast-track off-pump coronary artery
bypass surgery (CABG). Settings and Design This prospective, randomized
comparative study included 60 patients scheduled for elective off-pump
CABG procedures under general anesthesia in the period between May 2015
and March 2016. Materials and Methods Patients were randomized in equal
numbers to either the rocuronium group or the vecuronium group, and
intubating conditions and various hemodynamic parameters were observed at
different time points. Statistical Analysis Used Categorical variables
were evaluated using the chi-square test, whereas the Student t -test or
Mann-Whitney test were used for continuous variables. Results Pulse rate
in the rocuronium group was lesser (79.97 +/- 7.42) (p < 0.05) at the time
of intubation as compared with the vecuronium group (92.33 +/- 8.93).
Systolic blood pressure was higher in the vecuronium group (150.70 +/-
14.05) at the time of intubation as compared with the rocuronium group
(130.27 +/- 9.95) (p < 0.05). Intubating conditions, mean arterial
pressure, and diastolic blood pressure changes were similar in both
groups. Conclusions Rocuronium provides good-to-excellent intubating
conditions and is devoid of any significant cardiovascular changes causing
hemodynamic instability when compared with vecuronium in patients
undergoing elective ultrafast-track off-pump CABG.<br/>Copyright &#xa9;
2019 Thieme India. All rights reserved.

<26>
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

<27>
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;

<28>
[Use Link to view the full text]
Accession Number
633823550
Title
Efficacy and safety of corticosteroids prophylaxis in cardiac surgery: A
protocol for systematic review and meta-analysis.
Source
Medicine. 99 (50) (pp e23240), 2020. Date of Publication: 11 Dec 2020.
Author
He J.; Zhang Y.; Qiu Z.; Chai T.; Fang G.; Hu Y.; Xu F.; Huang Q.; Zheng
H.; Zhou H.; Tian M.; Chen L.W.
Institution
(He, Zhang, Qiu, Chai, Fang, Hu, Xu, Huang, Zheng, Zhou, Chen) Department
of Cardiac Surgery, Fujian Medical University Union Hospital, Fuzhou,
China
(Tian) School of Nursing, Xuzhou Medical University, Xuzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although corticosteroid prophylaxis in adult cardiac surgery
has been studied extensively for 40 years, its role remains controversial,
and the optimal dose remains uncertain. The objective of this
meta-analysis was to estimate the clinical benefits and risks of
corticosteroid use in cardiopulmonary bypass. <br/>METHOD(S): We will
search Pubmed, Web of Science, Embase, Clinical Trials, and Cochrane
Central Register of Controlled Trials for relevant clinical trials
published in any language before August 1, 2020. Randomized controlled
trials (RCTs) of interest which meet inclusion criteria published or
unpublished will be included. We will divide the included studies into
child and adult groups for analysis. If sufficient data are available, the
included trials will be divided into 4 subgroups: <=20 mg/kg (low dose),
20-40 mg/kg (slightly high dose), 40-100 mg/kg (high dose), and >100 mg/kg
(ultra high dose) based on the equivalent hydrocortisone dose. INPLASY
registration number: INPLASY2020100044. <br/>RESULT(S): The results of
this study will be published in a peer-reviewed journal.
<br/>CONCLUSION(S): This study will compare the efficacy of tprophylactic
corticosteroids for adults and children undergoing cardiac surgery with
CPB. Due to the nature of the disease and intervention methods, randomized
controlled trials may be inadequate, and we will carefully consider
inclusion in high-quality, non-randomized controlled trials, but this may
result in high heterogeneity and affect the reliability of the results.

<29>
[Use Link to view the full text]
Accession Number
633823439
Title
Anaesthesia and ICU sedation with sevoflurane do not reduce myocardial
injury in patients undergoing cardiac surgery: A randomized prospective
study.
Source
Medicine. 99 (50) (pp e23253), 2020. Date of Publication: 11 Dec 2020.
Author
Guinot P.-G.; Ellouze O.; Grosjean S.; Berthoud V.; Constandache T.;
Radhouani M.; Anciaux J.-B.; Aho-Glele S.; Morgant M.-C.; Girard C.;
Nguyen M.; Bouhemad B.
Institution
(Guinot, Ellouze, Grosjean, Berthoud, Constandache, Radhouani, Anciaux,
Girard, Nguyen, Bouhemad) Department of Anesthesiology and Critical Care
Medicine, Dijon University Medical Center
(Guinot) Universite[Combining Acute Accent] Bourgogne
Franche-Comte[Combining Acute Accent], LNC UMR866
(Aho-Glele) Departement of epidemiology
(Morgant) Department of Cardiac Surgery, Dijon University Medical Center,
Dijon, France
Publisher
NLM (Medline)
Abstract
BACKGROUND: To evaluate the effect of anaesthesia and ICU sedation with
sevoflurane to protect the myocardium against ischemia-reperfusion injury
associated to cardiac surgery assessed by troponin release.
<br/>METHOD(S): We performed a prospective, open-label, randomized study
in cardiac surgery with cardiopulmonary bypass. Patients were randomized
to an algorithm-based intervention group and a control group. The main
outcome was the perioperative kinetic of cardiac troponin I (cTnI). The
secondary outcomes included composite endpoint, GDF-15 (macrophage
inhibitory cytokine-1) value, arterial lactate levels, and the length of
stay (LOS) in the ICU. <br/>RESULT(S): Of 82 included patients, 81 were
analyzed on an intention-to-treat basis (intervention group: n = 42;
control group: n = 39). On inclusion, the intervention and control groups
did not differ significantly in terms of demographic and surgical data.
The postoperative kinetics of cTnI did not differ significantly between
groups: the mean difference was 0.44 +/- 1.09 mug/ml, P = .69. Incidence
of composite endpoint and GDF-15 values were higher in the sevoflurane
group than in propofol group. The intervention and control groups did not
differ significantly in terms of ICU stay and hospital stay.
<br/>CONCLUSION(S): The use of an anaesthesia and ICU sedation with
sevoflurane was not associated with a lower incidence of myocardial injury
assessed by cTnI. Sevoflurane administration was associated with higher
prevalence of acute renal failure and higher GDF-15 values.

<30>
Accession Number
633831896
Title
Association of Sickle Cell Trait with Incidence of Coronary Heart Disease
among African American Individuals.
Source
JAMA Network Open. (no pagination), 2021. Article Number: e2030435. Date
of Publication: 2021.
Author
Hyacinth H.I.; Franceschini N.; Seals S.R.; Irvin M.R.; Chaudhary N.; Naik
R.P.; Alonso A.; Carty C.L.; Burke G.L.; Zakai N.A.; Winkler C.A.; David
V.A.; Kopp J.B.; Judd S.E.; Adams R.J.; Gee B.E.; Longstreth W.T.; Egede
L.; Lackland D.T.; Greenberg C.S.; Taylor H.; Manson J.E.; Key N.S.;
Derebail V.K.; Kshirsagar A.V.; Folsom A.R.; Konety S.H.; Howard V.;
Allison M.; Wilson J.G.; Correa A.; Zhi D.; Arnett D.K.; Howard G.; Reiner
A.P.; Cushman M.; Safford M.M.
Institution
(Hyacinth, Gee) Aflac Cancer and Blood Disorder Center, Department of
Pediatrics, Emory University, School of Medicine, 2015 Uppergate Dr,
Atlanta, GA 30322, United States
(Franceschini) Department of Epidemiology, University of North Carolina,
Chapel Hill, United States
(Seals) Department of Mathematics and Statistics, University of West
Florida, Pensacola, United States
(Irvin, Chaudhary, Judd) School of Public Health, University of Alabama at
Birmingham, Birmingham, United States
(Naik) Division of Hematology, Department of Medicine, Johns Hopkins
University, Baltimore, MD, United States
(Alonso) Department of Epidemiology, Rollins School of Public Health,
Emory University, Atlanta, GA, United States
(Carty) Fred Hutchinson Cancer Research Center, Seattle, WA, United States
(Burke) Department of Public Health Sciences, Wake Forest University,
Winston-Salem, NC, United States
(Zakai, Cushman) Department of Medicine and Pathology and Laboratory
Medicine, University of Vermont, Burlington, United States
(Winkler, David) Basic Science Laboratory, National Cancer Institute,
Frederick National Laboratory, Leidos Biomedical Research, Frederick, MD,
United States
(Kopp) National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Bethesda, MD, United States
(Adams, Lackland) Stroke Center, Department of Neurology, Medical
University of South Carolina, Charleston, United States
(Longstreth) Department of Neurology, University of Washington, Seattle,
United States
(Longstreth) Department of Epidemiology, University of Washington,
Seattle, United States
(Egede) Division of General Internal Medicine, Medical College of
Wisconsin, Milwaukee, United States
(Greenberg) Division of Hematology-Oncology, Medical University of South
Carolina, Charleston, United States
(Taylor) Cardiovascular Research Institute, Morehouse School of Medicine,
Atlanta, GA, United States
(Manson) Department of Medicine, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Key) Division of Hematology/Oncology, University of North Carolina at
Chapel Hill, Chapel Hill, United States
(Derebail, Kshirsagar) University of North Carolina Kidney Center,
University of North Carolina at Chapel Hill, Chapel Hill, United States
(Folsom) Division of Epidemiology and Community Health, University of
Minnesota, School of Public Health, Minneapolis, United States
(Konety) Division of Cardiology, University of Minnesota Medical Center,
Minneapolis, United States
(Howard) Department of Epidemiology, School of Public Health, University
of Alabama at Birmingham, Birmingham, United States
(Allison) Department of Family Medicine and Public Health, University of
California San Diego, San Diego, United States
(Wilson) Department of Physiology and Biophysics, University of
Mississippi Medical Center, Jackson, United States
(Correa) Jackson Heart Study, University of Mississippi Medical Center,
Jackson, United States
(Zhi) Department of Biostatistics, School of Public Health, University of
Alabama at Birmingham, Birmingham, United States
(Arnett) College of Public Health, University of Kentucky, Lexington,
United States
(Howard) Department of Biostatistics, School of Public Health, University
of Alabama at Birmingham, Birmingham, United States
(Reiner) University of Washington, Fred Hutchinson Cancer Research Center,
Seattle, United States
(Safford) Division of General Internal Medicine, Weill Cornell Medicine,
New York, NY, United States
Publisher
American Medical Association
Abstract
Importance: The incidence of and mortality from coronary heart disease
(CHD) are substantially higher among African American individuals compared
with non-Hispanic White individuals, even after adjusting for traditional
factors associated with CHD. The unexplained excess risk might be due to
genetic factors related to African ancestry that are associated with a
higher risk of CHD, such as the heterozygous state for the sickle cell
variant or sickle cell trait (SCT). <br/>Objective(s): To evaluate whether
there is an association between SCT and the incidence of myocardial
infarction (MI) or composite CHD outcomes in African American individuals.
<br/>Design, Setting, and Participant(s): This cohort study included 5
large, prospective, population-based cohorts of African American
individuals in the Women's Health Initiative (WHI) study, the Reasons for
Geographic and Racial Differences in Stroke (REGARDS) study, the
Multi-Ethnic Study of Atherosclerosis (MESA), the Jackson Heart Study
(JHS), and the Atherosclerosis Risk in Communities (ARIC) study. The
follow-up periods included in this study were 1993 and 1998 to 2014 for
the WHI study, 2003 to 2014 for the REGARDS study, 2002 to 2016 for the
MESA, 2002 to 2015 for the JHS, and 1987 to 2016 for the ARIC study. Data
analysis began in October 2013 and was completed in October 2020.
Exposures: Sickle cell trait status was evaluated by either direct
genotyping or high-quality imputation of rs334 (the sickle cell variant).
Participants with sickle cell disease and those with a history of CHD were
excluded from the analyses. <br/>Main Outcomes and Measures: Incident MI,
defined as adjudicated nonfatal or fatal MI, and incident CHD, defined as
adjudicated nonfatal MI, fatal MI, coronary revascularization procedures,
or death due to CHD. Cox proportional hazards regression models were used
to estimate the hazard ratio for incident MI or CHD comparing SCT carriers
with noncarriers. Models were adjusted for age, sex (except for the WHI
study), study site or region of residence, hypertension status or systolic
blood pressure, type 1 or 2 diabetes, serum high-density lipoprotein
level, total cholesterol level, and global ancestry (estimated from
principal components analysis). <br/>Result(s): A total of 23197 African
American men (29.8%) and women (70.2%) were included in the combined
sample, of whom 1781 had SCT (7.7% prevalence). Mean (SD) ages at baseline
were 61.2 (6.9) years in the WHI study (n = 5904), 64.0 (9.3) years in the
REGARDS study (n = 10714), 62.0 (10.0) years in the MESA (n = 1556), 50.3
(12.0) years in the JHS (n = 2175), and 53.2 (5.8) years in the ARIC study
(n = 2848). There were no significant differences in the distribution of
traditional factors associated with cardiovascular disease by SCT status
within cohorts. A combined total of 1034 participants (76 with SCT) had
incident MI, and 1714 (137 with SCT) had the composite CHD outcome. The
meta-analyzed crude incidence rate of MI did not differ by SCT status and
was 3.8 per 1000 person-years (95% CI, 3.3-4.5 per 1000 person-years)
among those with SCT and 3.6 per 1000 person-years (95% CI, 2.7-5.1 per
1000 person-years) among those without SCT. For the composite CHD outcome,
these rates were 7.3 per 1000 person-years (95% CI, 5.5-9.7 per 1000
person-years) among those with SCT and 6.0 per 1000 person-years (95% CI,
4.9-7.4 per 1000 person-years) among those without SCT. Meta-analysis of
the 5 study results showed that SCT status was not significantly
associated with MI (hazard ratio, 1.03; 95% CI, 0.81-1.32) or the
composite CHD outcome (hazard ratio, 1.16; 95% CI, 0.92-1.47).
<br/>Conclusions and Relevance: In this cohort study, there was not an
association between SCT and increased risk of MI or CHD in African
American individuals. These disorders may not be associated with sickle
cell trait-related sudden death in this population..<br/>Copyright &#xa9;
2021 Thieme Medical Publishers, Inc.. All rights reserved.

<31>
Accession Number
632795623
Title
Catheter-based treatment of the dissected ascending aorta: a systematic
review.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 59 (1) (pp 80-91), 2021.
Date of Publication: 04 Jan 2021.
Author
Wang C.; von Segesser L.K.; Maisano F.; Ferrari E.
Institution
(Wang) Department of Cardiovascular Surgery. Jinling Hospital, Nanjing
University, School Medicine, Nanjing, China
(von Segesser) Department of Surgery and Anesthesiology, Cardiovascular
Research Unit, University Hospital of Lausanne, Lausanne, Switzerland
(Maisano, Ferrari) Department of Cardiovascular Surgery, University
Hospital of Zurich, Zurich, Switzerland
(Ferrari) Department of Cardiac Surgery, Cardiocentro Ticino Foundation,
Lugano, Switzerland
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Type A aortic dissection requires immediate surgical repair.
Despite improvements in surgery and anaesthesia, there is still a
considerable risk when high-risk patients are concerned. Less invasive
endovascular treatments are under evaluation. We investigated the current
status of catheter-based treatment for type A aortic dissection with the
entry tear located in the ascending aorta. <br/>METHOD(S): A PubMed search
was supplemented by searching through bibliographies and key articles.
Demographics, risk score, stent graft detail, access route, mortality,
cause of death, complications, reinterventions and follow-up data were
extracted and analysed. <br/>RESULT(S): Thirty-one articles (7
retrospective reports; 24 case reports/series) were included in the study.
In total, 104 patients (mean age 71+/-14years) received endovascular
treatment for acute (63) or chronic (41) type A dissection. A history of a
major cardiac or aortic operation was present in 29 patients. The mean
EuroSCORE II was 30+/-20 in 4 reports. A total of 114 stent grafts were
implanted: 'off-the-shelf', 65/114; custom made, 12/114; and modified,
7/114. Hospital complications included intraprocedural conversion to open
surgery (2/104), stroke (2/104), coronary stenting (2/104), early endoleak
(9/104) and repeat aortic endovascular treatment for endoleak (5/104).
Hospital mortality was 10% (intraoperative death 2/104). Mean duration of
follow-up time was 21+/-21months (range 1-81months); follow-up data were
available for 86 patients: 10 patients died of non-aortic-related causes;
reintervention for aortic disease (endovascular repair or open surgery)
was performed in 8 patients. <br/>CONCLUSION(S): Catheter-based ascending
aorta repair for type A aortic dissection with the entry tear in the
ascending aorta can be considered in carefully selected high-risk
patients. Further analysis and specifically designed devices are
required.<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.

<32>
Accession Number
2007789947
Title
Ischemic functional mitral regurgitation: from pathophysiological concepts
to current treatment options. A systemic review for optimal strategy.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2021. Date
of Publication: 2021.
Author
Nappi F.; Nenna A.; Mihos C.; Spadaccio C.; Gentile F.; Chello M.; Matzui
Y.
Institution
(Nappi) Cardiac Surgery, Centre Cardiologique du Nord, 36 Rue des Moulins
Gemeaux, Saint-Denis 93200, France
(Nenna, Chello) Cardiovascular Surgery, Universita Campus Bio-Medico di
Roma, Rome, Italy
(Mihos) Echocardiography Laboratory, Columbia University, Mount Sinai
Heart Institute, Miami, United States
(Spadaccio) Cardiothoracic Surgery, Golden Jubilee National Hospital,
Glasgow, United Kingdom
(Gentile) Cardiovascular Disease Diagnostic Medical Center, Naples, Italy
(Matzui) Cardiovascular and Thoracic Surgery, Hokkaido University Graduate
School of Medicine, Sapporo, Japan
Publisher
Springer Japan
Abstract
Objective: The current treatment of ischemic functional mitral
regurgitation (FMR) remains debated due to differences in inclusion
criteria of randomized studies and baseline characteristics. Also, the
role of left ventricular pathophysiology and the role of subvalvular
apparatus have not been thoroughly investigated in recent literature.
<br/>Method(s): A literature search was performed from PubMed inception to
June 2020. <br/>Result(s): Novel concepts of pathophysiology, such as the
proportionate/disproportionate conceptual framework, the role of papillary
muscles and left ventricular dysfunction, the impact of myocardial
ischemia and revascularization, left ventricular remodeling, and the
effect of restrictive annuloplasty or subvalvular procedures have been
reviewed. <br/>Conclusion(s): The clinical benefits associated with the
use of MitraClip is more evident in patients with disproportionate FMR
with greater and sustained left ventricular reverse remodeling.
Importantly, in the absence of myocardial revascularization, expansion of
myocardial scar tissue and non-perfused areas of ischemic myocardium occur
with time, and this impact on outcomes with a longer follow-up period
cannot be quantified. In advanced phases of FMR, neither mitral ring
annuloplasty nor percutaneous therapies could significantly modify the
established pathoanatomic alterations.<br/>Copyright &#xa9; 2021, The
Japanese Association for Thoracic Surgery.

<33>
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.

<34>
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. 25 (1) (pp 64-70), 2021. Date of
Publication: January 2021.
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, and 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.

<35>
Accession Number
2004735583
Title
Inadvertent aortocoronary arteriovenous fistula after CABG: Systematic
review of case reports.
Source
Catheterization and Cardiovascular Interventions. 97 (1) (pp E19-E25),
2021. Date of Publication: 01 Jan 2021.
Author
Chen K.; Scridon T.; Chait R.
Institution
(Chen) Division of Internal Medicine, University of Miami/JFK Medical
Center, Atlantis, FL, United States
(Scridon) Division of Cardiology, Florida State University College of
Medicine, Tallahassee, FL, United States
(Chait) Division of Cardiology, University of Miami/JFK Medical Center,
Atlantis, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: To summarize published case reports of aortocoronary
arteriovenous fistula (ACAVF) after coronary artery bypass grafting
surgery (CABG). <br/>Background(s): Inadvertent ACAVF is a rare
complication following CABG. However, the incidence continues to rise, and
its management details and clinical outcomes have not been well described.
<br/>Method(s): To identify all published cases of ACAVF following CABG,
PubMed, EMBASE, and Scopus were searched through November 2019. We defined
ACAVF as inadvertent attachment of the grafting vessel onto a cardiac vein
instead of targeted coronary artery. A systematic review was performed to
identify the incidence, clinical features, and management outcomes.
<br/>Result(s): A total of 48 post-CABG ACAVF cases were gathered. Among
these patients, the mean age was 61.9 years and 79.2% were men. Most
common presenting symptoms were chest pain (60.4%) and dyspnea (27.1%).
The average onset of symptoms was 3 years; however, 54.2% of patients
developed symptoms within the first year. The majority of cases reported
targeted native vessel LAD during CABG (62.5%). Of these cases, 9 (18.8%)
were managed conservatively, 8 (16.7%) chose to undergo surgery including
ligation of fistula and repeat CABG, and 27 (56.3%) underwent percutaneous
closure. Among these patients 13 cases (27.1%) were managed with coil
embolization, 5 (10.4%) with balloon embolization, 5 (10.4%) were treated
with a covered stent, and 4 (8.3%) used a vascular plug. There were no
reported complications following treatment in this group.
<br/>Conclusion(s): Inadvertent ACAVF are rare following CABG.
Percutaneous closure was feasible and safe in treating these
patients.<br/>Copyright &#xa9; 2020 Wiley Periodicals, Inc.

<36>
Accession Number
2004697682
Title
Impact of renin-angiotensin system inhibitors on outcomes after
transcatheter aortic valve replacement: A meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 97 (1) (pp E88-E94),
2021. Date of Publication: 01 Jan 2021.
Author
Sun Y.; Li J.; Li G.; Fan R.; Luo J.
Institution
(Sun, Li, Li, Luo) Department of Cardiology, Vascular Center, Guangdong
Cardiovascular Institute, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, China
(Fan) Department of Cardiovascular surgery, Vascular Center, Guangdong
Cardiovascular Institute, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: We aimed to evaluate the impact of renin-angiotensin system
(RAS) inhibitors on outcomes after transcatheter aortic valve replacement
(TAVR). <br/>Background(s): The impact of RAS inhibitors on outcomes after
TAVR was unclear. <br/>Method(s): A systematic review of articles
comparing outcomes of patients using and not using RAS inhibitors after
TAVR was performed through PubMed, Embase, and Cochrane. Primary outcome
was midterm all-cause mortality. Risk ratios (RRs) were calculated with
the corresponding 95% confidence interval using random effect models.
<br/>Result(s): Five studies with 23,319 patients were included. Patients
treated with RAS inhibitors had lower midterm all-cause mortality after
TAVR than those without RAS inhibitors in both the unmatched (13.3 vs.
17.2%, RR 0.77, p =.005) and propensity score matched cohorts (13.5 vs
16.2%, RR 0.83, p <.001). Cardiovascular mortality (10.4 vs. 15.6%, RR
0.68, p <.001), rate of heart failure readmission (12.2 vs. 14.5%, RR
0.80, p =.006), and new-onset atrial fibrillation (14.0 vs. 23.7%, RR
0.73, p =.003) were also lower with RAS inhibitors. No difference was
found between two groups regarding cerebrovascular events, myocardial
infarction, major bleeding, major vascular complications, acute kidney
injury, permanent pacemaker implantation, and moderate/severe paravalvular
aortic regurgitation. <br/>Conclusion(s): RAS inhibitors were associated
with lower midterm all-cause mortality after TAVR.<br/>Copyright &#xa9;
2020 Wiley Periodicals, Inc.

<37>
Accession Number
2003791079
Title
Left internal mammary artery side branch intervention in the management of
coronary steal syndrome following coronary artery bypass grafting.
Source
Catheterization and Cardiovascular Interventions. 97 (1) (pp 97-104),
2021. Date of Publication: 01 Jan 2021.
Author
Mangels D.; Penny W.; Reeves R.
Institution
(Mangels, Reeves) Department of Cardiovascular Medicine, University of
California, San Diego, CA, United States
(Penny) Division of Cardiovascular Medicine, VA Medical Center, University
of California, San Diego, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: The objective of this qualitative review is to summarize the
pathophysiological and clinical data behind the clinical entity of left
internal mammary artery (LIMA) side branch coronary steal as well as the
potential diagnostic and therapeutic modalities available.
<br/>Background(s): The presence of persistent unligated LIMA side
branches following coronary artery bypass grafting has previously been
associated with stable angina and acute coronary syndromes. However,
despite numerous attempts to objectively demonstrate a coronary steal
phenomenon, the pathophysiology of LIMA side branch flow diversion remains
elusive and the clinical utility of intervention is not well elucidated.
<br/>Method(s): A review of literature and available data including case
reports, case series, and investigational studies was performed.
<br/>Result(s): Therapeutic closure of LIMA side branches has been
reported in at least 44 patients and in at least 31 publications since
1990 and is associated with an 87.5% rate of freedom from angina amongst
technically successful initial interventions. In all patients with pre-
and post- stress testing, intervention was associated with an improvement
and/or resolution of previously observed reversible ischemia.
<br/>Conclusion(s): LIMA side branch coronary steal should remain an
ongoing consideration in symptomatic patients with large unligated side
branches on angiography, particularly when there is clear evidence of
reversible ischemic on perfusion imaging.<br/>Copyright &#xa9; 2019 Wiley
Periodicals, Inc.

<38>
[Use Link to view the full text]
Accession Number
633823342
Title
Family nursing with the assistance of network improves clinical outcome
and life quality in patients underwent coronary artery bypass grafting: A
consolidated standards of reporting trials-compliant randomized controlled
trial.
Source
Medicine. 99 (50) (pp e23488), 2020. Date of Publication: 11 Dec 2020.
Author
Jin L.; Pan R.; Huang L.; Zhang H.; Jiang M.; Zhao H.
Institution
(Jin) Department of Cardiac Surgery, First Hospital of Jilin University,
Changchun, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Family nursing with the assistance of network (FNAN) improves
nurses' practice and provides family/community-oriented nursing care. This
study aimed to explore the effects of FNAN on the clinical outcome and
life quality of coronary atherosclerotic heart disease (CHD) patients
underwent coronary artery bypass grafting (CABG). TRIAL DESIGN: This study
is a randomized, placebo-controlled and double-blind trial.
<br/>METHOD(S): One-hundred and twelve patients underwent CABG were
randomly divided into control group (CG, routine family nursing care) and
experimental group (EG, FNAN) and the allocation ratio was 1:1. The
situation of anxiety and depression were analyzed using the Hamilton
Anxiety Scale (HAMA) scale and Hamilton Depression Scale (HAMD). Sleep
quality was measured by using Pittsburgh Sleep Quality Index (PSQI). Lung
function parameters were measured, including minute ventilation (MVV),
partial pressure of oxygen (PaO2), partial pressure of arterial carbon
dioxide (PaCO2), oxygen saturation measurement by pulse oximetry (SpO2),
forced expiratory volume in 1 second (FEV1) and forced vital capacity
(FVC). Life quality was measured by using Chronic Obstructive Pulmonary
Disease Assessment Test (CAT). <br/>RESULT(S): After a 3-month
intervention, 10 and 6 patients were lost in the CG and EG groups,
respectively. The scores of HAMA, HAMD, PSQI and CAT were reduced in the
EG group when compared with the CG group (P < .05). The values of MVV,
PaO2, SpO2, FEV1 and FVC in the EG group was higher than those in the CG
group whereas the levels of PaCO2 in the EG group was lower than those in
the CG group (P < .05). PSQI score had a strong relationship with the
values of MVV, PaO2, PaCO2, SpO2, FEV1, and FVC. <br/>CONCLUSION(S): FNAN
improves the clinical outcome and life quality in the patients underwent
CABG.

<39>
Accession Number
633933984
Title
Efficacy and Safety of Nonvitamin K Oral Anticoagulants following Cardiac
Valve Replacement.
Source
Southern medical journal. 114 (1) (pp 46-50), 2021. Date of Publication:
01 Jan 2021.
Author
Stuart M.K.; Blackwell S.B.; Holder H.B.; Wood E.L.; Starr J.A.
Institution
(Stuart, Blackwell, Holder, Wood, Starr) From the Department of Pharmacy
Services, Princeton Baptist Medical Center, Birmingham, Alabama, the
Department of Pharmacy Services, Vanderbilt Wilson County Hospital,
Lebanon, Tennessee, and the Department of Pharmacy Practice, Harrison
School of Pharmacy, Auburn University, Auburn, Alabama
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To compare the efficacy and safety of nonvitamin K oral
anticoagulants (NOACs) and vitamin K antagonists (VKAs) following
bioprosthetic cardiac valve replacement. <br/>METHOD(S): This was a
retrospective analysis conducted at a community teaching hospital in the
southeastern United States between August 2015 and August 2018. Patients
18 years of age and older who underwent cardiac valve replacement and were
prescribed oral anticoagulation were screened for inclusion. Patients were
excluded if they had a mechanical valve replacement, experienced a venous
thromboembolism, cerebrovascular accident, or acute coronary syndrome
within 1 month before valve replacement, changed oral anticoagulation
during the study period, were lost to follow-up, or declined to
participate in the follow-up survey. The primary outcome was a composite
of thromboembolic events within 90 days following bioprosthetic cardiac
valve replacement. The safety outcome was major bleeding within 180 days
of bioprosthetic cardiac valve replacement. <br/>RESULT(S): The primary
outcome of a composite of thromboembolic events within 90 days following
bioprosthetic cardiac valve replacement occurred in 1 patient (4.3%) in
the VKA group and 4 patients (7.4%) in the NOAC group. Major bleeding
occurred in 2 patients (8.7%) in the VKA group and 0 patients in the NOAC
group. <br/>CONCLUSION(S): Our study is the first to report the efficacy
and safety of NOACs compared with VKA therapy following bioprosthetic
cardiac valve replacement irrespective of an atrial fibrillation
diagnosis. Notably, two of the thromboembolic events in the NOAC group
occurred while therapy was held or inappropriately dosed; when these
events are removed, the rate of thromboembolism is 3.8%. This rate is
consistent with the VKA group. Our study adds to a small pool of
literature regarding the use of NOACs following bioprosthetic cardiac
valve replacement and suggests that NOACs may have similar efficacy and
improved safety as compared with VKA therapy. Large randomized controlled
trials are warranted to confirm our observations.

<40>
Accession Number
2010701998
Title
Comparing quality of life and postoperative pain after limited access and
conventional aortic valve replacement: Design and rationale of the LImited
access aortic valve replacement (LIAR) trial.
Source
Contemporary Clinical Trials Communications. 21 (no pagination), 2021.
Article Number: 100700. Date of Publication: March 2021.
Author
Klop I.D.G.; van Putte B.P.; Kloppenburg G.T.L.; Sprangers M.A.G.;
Nieuwkerk P.T.; Klein P.
Institution
(Klop, van Putte, Kloppenburg, Klein) Department of Cardiothoracic
Surgery, St. Antonius Hospital, Nieuwegein, Netherlands
(van Putte) Department of Cardiothoracic Surgery, AMC Heart Centre,
Amsterdam University Medical Center, Amsterdam, Netherlands
(Sprangers, Nieuwkerk) Department of Medical Psychology, Amsterdam
University Medical Center/University of Amsterdam, Amsterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Surgical aortic valve replacement (SAVR) via limited access
approaches ('mini-AVR') have proven to be safe alternative for the
surgical treatment of aortic valve disease. However, it remains unclear
whether these less invasive approaches are associated with improved
quality of life and/or reduced postoperative pain when compared to
conventional SAVR via full median sternotomy (FMS). Study design: The
LImited access Aortic valve Replacement (LIAR) trial is a single-center,
single blind randomized controlled clinical trial comparing 2 arms of 80
patients undergoing limited access SAVR via J-shaped upper hemi-sternotomy
(UHS) or conventional SAVR through FMS. In all randomized patients, the
diseased native aortic valve is planned to be replaced with a rapid
deployment stented bioprosthesis. Patients unwilling or unable to
participate in the randomized trial will be treated conventionally via
SAVR via FMS and with implantation of a sutured valve prosthesis. These
patients will participate in a prospective registry. Study methods:
Primary outcome is improvement in cardiac-specific quality of life,
measured by two domains of the Kansas City Cardiomyopathy Questionnaire up
to one year after surgery. Secondary outcomes include, but are not limited
to: generic quality of life measured with the Short Form-36, postoperative
pain, perioperative (technical success rate, operating time) and
postoperative outcomes (30-day and one-year mortality), complication rate
and hospital length of stay. <br/>Conclusion(s): The LIAR trial is
designed to determine whether a limited access approach for SAVR
('mini-AVR') is associated with improved quality of life and/or reduced
postoperative pain compared with conventional SAVR through FMS. The study
is registered at ClinicalTrials.gov, number NCT04012060.<br/>Copyright
&#xa9; 2021

<41>
Accession Number
2010173236
Title
Cardiovascular events in patients undergoing hip fracture surgery treated
with remote ischaemic preconditioning: 1-year follow-up of a randomised
clinical trial.
Source
Anaesthesia. (no pagination), 2021. Date of Publication: 2021.
Author
Ekeloef S.; Koyuncu S.; Holst-Knudsen J.; Gundel O.; Meyhoff C.S.;
Homilius M.; Stilling M.; Ekeloef P.; Munster A.M.B.; Mathiesen O.;
Gogenur I.
Institution
(Ekeloef, Gogenur) Center for Surgical Science, Department of Surgery,
Zealand University Hospital, Koege, Denmark
(Koyuncu, Holst-Knudsen, Mathiesen) Centre for Anaesthesiological
Research, Department of Anaesthesiology, Zealand University Hospital,
Koege, Denmark
(Gundel, Meyhoff) Department of Anaesthesia and Intensive Care, Bispebjerg
and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
(Homilius, Stilling) Department of Orthopaedic Surgery, University Clinic
for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Holstebro,
Denmark
(Ekeloef) Department of Anaesthesiology, Regional Hospital West Jutland,
Holstebro, Denmark
(Munster) Unit for Thrombosis Research, Department of Clinical
Biochemistry, Hospital of South West Denmark, Esbjerg, Denmark
Publisher
Blackwell Publishing Ltd
Abstract
Remote ischaemic preconditioning reduces the risk of myocardial injury
within 4 days of hip fracture surgery. We aimed to investigate the effect
of remote ischaemic preconditioning on the incidence of major adverse
cardiovascular events 1 year after hip fracture surgery. We performed a
phase-2, multicentre, randomised, observer-blinded, clinical trial between
February 2015 and September 2017. We studied patients aged >= 45 years
with a hip fracture and a minimum of one cardiovascular risk factor.
Patients were allocated randomly to remote ischaemic preconditioning
applied just before surgery or no treatment (control group). Remote
ischaemic preconditioning was performed on the upper arm with a tourniquet
in four cycles of 5 min ischaemia and 5 min reperfusion. Primary outcome
was the occurrence of major adverse cardiovascular events within 1 year of
surgery. A total of 316 patients were allocated randomly to the remote
ischaemic preconditioning group and 309 patients to the control group.
Major adverse cardiovascular events occurred in 43 patients (13.6%) in the
remote ischaemic preconditioning group compared with 51 patients (16.5%)
in the control group (adjusted hazard ratio (95%CI) 0.83 (0.55-1.25); p =
0.37). Fewer patients in the remote ischaemic preconditioning group had a
myocardial infarction (11 (3.5%) vs. 22 (7.1%); hazard ratio (95%CI) 0.48
(CI 0.23-1.00); p = 0.04). Remote ischaemic preconditioning did not reduce
the occurrence of major adverse cardiovascular events within 1 year of hip
fracture surgery. The effect of remote ischaemic preconditioning on
clinical cardiovascular outcomes in non-cardiac surgery needs confirmation
in appropriately powered randomised clinical trials.<br/>Copyright &#xa9;
2021 Association of Anaesthetists

<42>
Accession Number
2010173210
Title
Midterm outcomes of transaortic and transapical TAVI in patients with
unsuitable vascular anatomy for femoral access: A propensity score inverse
probability weight study.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Casado A.P.; Barili F.; D'Auria F.; Raviola E.; Parolari A.; Le Houerou
D.; Romano M.
Institution
(Casado, Barili) Department of Cardiovascular Surgery, A. O. Santa Croce e
Carle, Cuneo, Italy
(Casado, Raviola, Le Houerou) Department of Cardiovascular Surgery,
Hopital Prive Jacques Cartier, Massy, France
(D'Auria) Department of Cardiovascular Surgery, A. O. Maggiore della
Carita, Novara, Italy
(Raviola) Department of Cardiac Surgery, GVM Care & Research, Maria
Cecilia Hospital, Cotignola, Italy
(Parolari, Romano) Department of Cardiac Surgery, Policlinico S. Donato
IRCCS, University of Milan, Milan, Italy
Publisher
Blackwell Publishing Inc.
Abstract
Aims: Transaortic (TAo) and transapical (TA) implantation can be used in
transcatheter aortic valve implantation (TAVI) when the transfemoral (TF)
approach is precluded. We compare the safety and efficacy of these
alternative techniques. <br/>Method(s): From October 2007 to February
2016, TAo and TA patients' data were collected. Propensity score inverse
probability of treatment weight (IPTW) method was employed to minimize the
impact of no-randomization bias. <br/>Result(s): From our single-center
non-TF-TAVI registry, 282 patients were included: 235 (83.3%) underwent
TAo and 47 (16.7%) TA. Differences in baseline characteristics were
statistically significant in age, sex, risk profile according to
logistic-EuroSCORE, and previous cardiac surgery. No difference in
hospital morbidity and mortality, but lower stroke-rate in TAo (1.27% vs.
8.5% p <.01) was observed. This was confirmed at logistic regression after
IPTW adjustment (odds ratio [OR]: 0.16, 95% CI 0.03-0.71, p =.01),
together with reduced risk of the paravalvular leak (PVL) (OR: 0.14, 95%
confidence interval [CI]: 0.02-0.81, p =.02). Kaplan-Meier estimates did
not demonstrate differences in long-term mortality among access routes
(logrank test p =.13). At the IPTW-Cox regression model, long-term
mortality was related to New York Heart Association III-IV (hazard ratio
[HR]: 2.92, 95% CI: 1.15-7.40, p =.026), chronic renal failure (HR: 3.25;
95% CI: 1.02-10.32 p =.046), previous transient ischemic attack/stroke
(HR: 2.29, 95% CI: 1.25-4.20 p =.007). Sapien-3 device resulted to be a
protective factor, reducing long-term mortality (HR: 0.18, 95% CI 0.04-
0.90 p =.03). <br/>Conclusion(s): TAo is safe and feasible in case of
contraindication to femoral approach demonstrating comparable midterm
outcomes to TA, thus representing a central access alternative, to
increase the overall safety of high-risk TAVI procedures.<br/>Copyright
&#xa9; 2021 Wiley Periodicals LLC

<43>
Accession Number
2010173164
Title
Parental experiences of their infant's hospital admission undergoing
cardiac surgery: A systematic review.
Source
Acta Paediatrica, International Journal of Paediatrics. (no pagination),
2021. Date of Publication: 2021.
Author
de Man M.A.C.P.; Segers E.W.; Schappin R.; van der Leeden K.; Wosten-van
Asperen R.M.; Breur H.; de Weerth C.; van den Hoogen A.
Institution
(de Man, Segers, van der Leeden, Wosten-van Asperen, Breur, van den
Hoogen) Wilhelmina Children's Hospital, University Medical Centre Utrecht,
Utrecht, Netherlands
(Schappin) Department of Development and Education of Youth in Diverse
Societies, Utrecht University, Utrecht, Netherlands
(de Weerth) Donders Institute for Brain, Cognition and Behaviour, Radboud
University Medical Center, Nijmegen, Netherlands
Publisher
Blackwell Publishing Ltd
Abstract
Aim: To explore parents' experiences of parenting a child hospitalised
with congenital heart disease (CHD) and undergoing surgery.
<br/>Method(s): Five electronic databases were systematically searched for
articles describing the experiences of parents with a child with a CHD. A
thematic analysis approach was used to identify the most common themes.
<br/>Result(s): A total of 188 articles were identified. Eight studies
were included in the review. Four themes emerged, including balancing the
parental role, experiencing anticipatory grief, decreasing parental stress
using coping strategies and professional support. <br/>Conclusion(s):
Having a child with CHD undergoing heart surgery is a stressful experience
due to, among other things, the different situation-related parenting role
during the hospital stay and feelings of anticipatory grief. Healthcare
professionals in the PICU have an essential role in supporting parents and
understanding the needs that are crucial for the parents in order to
provide better support and reduce stress and anxiety. More qualitative
research regarding the pathway from the prenatal diagnosis through the
early childhood period is warranted.<br/>Copyright &#xa9; 2021 The
Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of
Foundation Acta Paediatrica

<44>
Accession Number
2010162465
Title
Results of surgical ventricular reconstruction in a specialized center and
in comparison to the STICH trial: Rationale and study protocol for a
patient-level pooled analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Gaudino M.; Castelvecchio S.; Rahouma M.; Robinson N.B.; Audisio K.;
Soletti G.J.; Garatti A.; Benedetto U.; Girardi L.N.; Menicanti L.
Institution
(Gaudino, Rahouma, Robinson, Audisio, Soletti, Girardi) Department of
Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United
States
(Castelvecchio, Garatti, Menicanti) Department Cardiac Surgery, IRCCS
Policlinico San Donato, Milan, Italy
(Benedetto) Bristol Heart Institute, University of Bristol, Bristol,
United Kingdom
Publisher
Blackwell Publishing Inc.
Abstract
Introduction: Post-infarction left ventricular remodeling is associated
with increased mortality in patients with ischemic heart disease. Surgical
ventricular reconstruction (SVR) in addition to coronary artery bypass
grafting (CABG) has been proposed to reduce left ventricular volume and
improve clinical outcomes. The Surgical Treatment for Ischemic Heart
Failure (STICH) trial found that the addition of SVR to CABG did not
reduce the rates of death or rehospitalization in the 5 years after
surgery compared to CABG alone. Like all randomized trials, STICH has
limitations and it has been hypothesized that it may have underestimated
the treatment effect of SVR. The aim of this study is to evaluate the
results of SVR in one of the largest contemporary single-center series and
to compare the results with those of the STICH trial using individual
patient's data. Methods and Analysis: Individual data of patients who
underwent SVR with or without CABG will be obtained from San Donato
University Hospital in Milan. Using multivariable Cox regression analysis,
significant prognostic indicators in this cohort will be identified. We
will then compare the San Donato cohort to individual patient's data from
the SVR arm of Hypothesis 2 of the STICH trial and from both arms of the
STICH Extended Study (STICHES). To reduce confounders, propensity score
adjustment will be used for this comparison. The primary endpoint will be
all-cause mortality. Data will be merged and analyzed independently at
Weill Cornell Medicine in New York.<br/>Copyright &#xa9; 2021 Wiley
Periodicals LLC

<45>
Accession Number
633936304
Title
Protective effect of sevoflurane on vascular endothelial glycocalyx in
patients undergoing heart valve surgery under cardiopulmonary bypass: A
randomised controlled trial.
Source
European journal of anaesthesiology. Publish Ahead of Print (no
pagination), 2021. Date of Publication: 04 Jan 2021.
Author
Fang F.-Q.; Sun J.-H.; Wu Q.-L.; Feng L.-Y.; Fan Y.-X.; Ye J.-X.; Gao W.;
He G.-L.; Wang W.-J.
Institution
(Fang) From the The First Affiliated Hospital, Zhejiang University School
of Medicine, Hangzhou (FQ-F) and The First Affiliated Hospital of Wenzhou
Medical University, China (JH-S, Wenzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The glycocalyx plays an important physiological role and may
be damaged during cardiopulmonary bypass. Sevoflurane can protect the
glycocalyx; however, its relevance in a clinical setting is unknown.
<br/>OBJECTIVE(S): Glycocalyx degradation during cardiopulmonary bypass in
patients was investigated. On the basis of the available experimental
data, we hypothesised that sevoflurane-based anaesthesia would confer
additional protection against cardiopulmonary bypass-induced glycocalyx
damage. DESIGN: Randomised controlled study. SETTING: Clinical study at
The First Affiliated Hospital of Wenzhou Medical University between June
2018 and March 2019. PATIENTS: Fifty-one patients. INTERVENTIONS: After
intubation and mechanical ventilation, patients undergoing elective heart
valve surgery were maintained under general anaesthesia with either
propofol or sevoflurane during surgery. MAIN OUTCOME MEASURES: Glycocalyx
markers (such as syndecan-1, heparan sulphate and hyaluronan), sheddases
responsible for the degradation of the endothelial glycocalyx (such as
matrix metalloproteinase-9 and cathepsin-B), urine albumin-to-creatinine
ratio and levels of lactic acid and myocardial enzymes were all measured.
Postoperative mechanical ventilation time and length of stay in the
cardiac care unit and hospital were also measured. Morbidity and mortality
after 30 days and 1 year were evaluated. <br/>RESULT(S): The vascular
endothelial glycocalyx was damaged during cardiopulmonary bypass. The
glycocalyx damage in the sevoflurane group was less extensive than that in
the propofol group. The urine albumin-to-creatinine ratio increased in
both groups but was lower in the sevoflurane group. Enzymes including
matrix metalloproteinase-9 and cathepsin-B were positively correlated with
glycocalyx marker concentrations. After operation, the sevoflurane group
showed lower levels of lactic acid and myocardial enzyme, as well as
shorter duration of postoperative mechanical ventilation than the propofol
group. <br/>CONCLUSION(S): Sevoflurane can decrease glycocalyx degradation
in patients undergoing heart valve surgery under cardiopulmonary bypass.
TRIAL REGISTRATION: Chinese Clinical Trial Registry, chictr.org.cn,
identifier: ChiCTR1800016367.<br/>Copyright &#xa9; 2021 European Society
of Anaesthesiology.

<46>
Accession Number
2010642803
Title
Outcomes of transcarotid versus trans-subclavian transcatheter aortic
valve replacement: A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Amer M.R.; Mosleh W.; Megaly M.; Shah T.; Ooi Y.S.; McKay R.G.
Institution
(Amer, Ooi) Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Mosleh) University of Connecticut, Farmington, CT, United States
(Megaly) Banner University Medical Center- UA College of Medicine,
Phoenix, AZ, United States
(Shah) St. Vincent's Hospital, Worcester, MA, United States
(McKay) Heart and Vascular Institute, Hartford Hospital, Hartford, CT,
United States
Publisher
Elsevier Inc.
Abstract
Objectives: This study aimed to perform the first meta-analysis of studies
comparing transcarotid (TC) and trans-subclavian (TSc) transcatheter
aortic valve replacement (TAVR). <br/>Background(s): The safety and
feasibility of a TC and a TSc approach for performing TAVR in patients
with prohibitive femoral anatomy have been well described. The potential
advantage of one approach over the other is yet to be ascertained.
<br/>Method(s): A computerized literature search of key medical databases
through September 2020 was performed. Randomized controlled trials (RCTs)
and observational studies comparing TC and TSc TAVR with reported 30-day
outcomes were considered. The primary endpoint was a composite of
all-cause mortality, stroke, life-threatening, and/or major bleeding or
major vascular complications. Statistical analysis using random-effects
models to report the odds ratio (OR) with 95% confidence interval (CI) was
performed. <br/>Result(s): A total of 5 observational studies inclusive of
4164 patients (TC = 1788 and TSc = 2376) met the eligibility criteria. The
average age of patients was 81.1 years. There was no difference in the
occurrence of the composite endpoint between the groups at 30-days. A
statistically insignificant trend towards higher rates of major vascular
complications (OR 1.65; 95% CI 0.94-2.89; P = 0.08; I² = 0%)
and the need for permanent pacemaker placement was observed with the TSc
approach. <br/>Conclusion(s): This meta-analysis of studies comparing TC
and TSc TAVR showed similar 30-day outcomes between the 2 approaches. A
notable trend towards higher rates of major vascular complications and the
need for permanent pacemaker placement was observed with the TSc
approach.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<47>
Accession Number
366105675
Title
Fractional flow reserve-guided PCI reduced urgent revascularization at 7
months in coronary artery disease.
Source
Annals of Internal Medicine. 157 (10) (pp JC5-9), 2012. Date of
Publication: 20 Nov 2012.
Author
de Bruyne B.
Institution
(de Bruyne) OLV-Clinic, Aalst, Belgium
Publisher
American College of Physicians

<48>
Accession Number
629175204
Title
The Effect of Continuous Ventilation on Thiol-Disulphide Homeostasis and
Albumin-Adjusted Ischemia-Modified Albumin During Cardiopulmonary Bypass.
Source
Brazilian journal of cardiovascular surgery. 34 (4) (pp 436-443), 2019.
Date of Publication: 27 Aug 2019.
Author
Ozgunay S.E.; Ozsin K.K.; Ustundag Y.; Karasu D.; Ozyaprak B.; Balci B.;
Erel O.; Yavuz S.
Institution
(Ozgunay, Karasu, Ozyaprak) University of Health Sciences Bursa Yuksek
Ihtisas Training and Research Hospital Department of Anesthesiology Bursa
Turkey Department of Anesthesiology, University of Health Sciences, Bursa
Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
(Ozsin, Balci, Yavuz) University of Health Sciences Bursa Yuksek Ihtisas
Training and Research Hospital Department of Cardiovascular Surgery Bursa
Turkey Department of Cardiovascular Surgery, University of Health
Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa,
Turkey
(Ustundag) University of Health Sciences Bursa Yuksek Ihtisas Training and
Research Hospital Department of Medical Biochemistry Bursa Turkey
Department of Medical Biochemistry, University of Health Sciences, Bursa
Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
(Erel) University of Health Sciences Ankara Diskapi Yildirim Beyazit
Research and Education Hospital Department of Medical Biochemistry Ankara
Turkey Department of Medical Biochemistry, University of Health Sciences,
Ankara Diskapi Yildirim Beyazit Research and Education Hospital, Ankara,
Turkey
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To investigate the effect of continuous lung ventilation with
low tidal volume on oxidation parameters, such as thiol/disulphide
homeostasis and albumin-adjusted ischemia-modified albumin (AAIMA), during
cardiopulmonary bypass (CBP) in coronary artery bypass grafting (CABG).
<br/>METHOD(S): Seventy-four patients who underwent elective CABG with CPB
were included in the study. Blood samples were taken in the preoperative
period, 10 minutes after CPB, and six and 24 hours postoperatively.
Patients were assigned to the continuous ventilation group (Group 1, n=37)
and the non-ventilated group (Group 2, n=37). The clinical
characteristics, thiol/disulphide homeostasis, ischemia-modified albumin
(IMA), and AAIMA levels of the patients were compared. <br/>RESULT(S): A
significant difference was found between the groups regarding native
thiol, total thiol, and IMA levels at the postoperative 24th hour
(P=0.030, P=0.031, and P=0.004, respectively). There was no difference
between the groups in terms of AAIMA. AAIMA levels returned to
preoperative levels in Groups 1 and 2, at the 6th and 24th postoperative
hours, respectively. Length of hospital stay was significantly shorter in
Group 1 (P<0.001) than in Group 2. <br/>CONCLUSION(S): Continuous
ventilation during CPB caused an increase in native and total thiol
levels, an earlier return of AAIMA levels, and shorter hospital stay.
Continuous ventilation may reduce the negative effects of CPB on
myocardium (Table 2, Figure 1, and Reference 31).

<49>
Accession Number
629174979
Title
Coronary Artery Bypass Graft Surgery Improves Survival Without Increasing
the Risk of Stroke in Patients with Ischemic Heart Failure in Comparison
to Percutaneous Coronary Intervention: A Meta-Analysis With 54,173
Patients.
Source
Brazilian journal of cardiovascular surgery. 34 (4) (pp 396-405), 2019.
Date of Publication: 27 Aug 2019.
Author
Sa M.P.B.O.; Perazzo AM.; Saragiotto F.A.S.; Cavalcanti L.R.P.; Almeida
A.C.E.; Campos J.C.S.; Braga P.G.B.; Rayol S.D.C.; Diniz R.G.S.; Sa
F.B.C.A.; Lima R.C.
Institution
(Sa, Perazzo, Saragiotto, Cavalcanti, Almeida, Campos, Braga, Rayol,
Diniz, Sa, Lima) Pronto Socorro Cardiologico de Pernambuco - PROCAPE
Division of Cardiovascular Surgery Recife Pernambuco Brazil Division of
Cardiovascular Surgery, Pronto Socorro Cardiologico de Pernambuco -
PROCAPE, Recife, Pernambuco, Brazil
(Sa, Perazzo, Saragiotto, Cavalcanti, Almeida, Campos, Braga, Rayol,
Diniz, Sa, Lima) University of Pernambuco - UPE Recife Pernambuco Brazil
University of Pernambuco - UPE, Recife, Pernambuco, Brazil
(Sa, Lima) Faculty of Medical Sciences and Biological Sciences Institute -
FCM/ICB Nucleus of Postgraduate and Research in Health Sciences Recife
Pernambuco Brazil Nucleus of Postgraduate and Research in Health Sciences,
Faculty of Medical Sciences and Biological Sciences Institute - FCM/ICB,
Recife, Pernambuco, Brazil
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate whether there is any difference on the results of
patients treated with coronary artery bypass grafting (CABG) or
percutaneous coronary intervention (PCI) in the setting of ischemic heart
failure (HF). <br/>METHOD(S): Databases (MEDLINE, Embase, Cochrane
Controlled Trials Register [CENTRAL/CCTR], ClinicalTrials.gov, Scientific
Electronic Library Online [SciELO], Literatura Latino-americana e do
Caribe em Ciencias da Saude [LILACS], and Google Scholar) were searched
for studies published until February 2019. Main outcomes of interest were
mortality, myocardial infarction, repeat revascularization, and stroke.
<br/>RESULT(S): The search yielded 5,775 studies for inclusion. Of these,
20 articles were analyzed, and their data were extracted. The total number
of patients included was 54,173, and those underwent CABG (N=29,075) or
PCI (N=25098). The hazard ratios (HRs) for mortality (HR 0.763; 95%
confidence interval [CI] 0.678-0.859; P<0.001), myocardial infarction (HR
0.481; 95% CI 0.365-0.633; P<0.001), and repeat revascularization (HR
0.321; 95% CI 0.241-0.428; P<0.001) were lower in the CABG group than in
the PCI group. The HR for stroke showed no statistically significant
difference between the groups (random effect model: HR 0.879; 95% CI
0.625-1.237; P=0.459). <br/>CONCLUSION(S): This meta-analysis found that
CABG surgery remains the best option for patients with ischemic HF,
without increase in the risk of stroke.

<50>
Accession Number
629157895
Title
Effect of dental treatment before cardiac valve surgery: Systematic review
and meta-analysis.
Source
Journal of the American Dental Association (1939). 150 (9) (pp 739-747),
2019. Date of Publication: 01 Sep 2019.
Author
Lockhart P.B.; DeLong H.R.; Lipman R.D.; Abt E.; Baddour L.M.; Colvin M.;
Miller C.S.; Sollecito T.; O'Brien K.; Estrich C.G.; Araujo M.W.B.;
Carrasco-Labra A.
Publisher
NLM (Medline)
Abstract
BACKGROUND: The purpose of this systematic review was to determine the
potential effect of dental treatment before cardiac valve surgery (CVS) or
left ventricular assist device (LVAD) implantation on morbidity and
mortality. TYPES OF STUDIES REVIEWED: The authors included relevant
studies from MEDLINE, Embase, and the Cochrane Central Register of
Controlled Trials, including randomized controlled trials and cohort
studies, published from 1998 through 2019 and involving adults who
received dental treatment before CVS or LVAD implantation. The authors
assessed bias by using the Newcastle-Ottawa Quality Assessment Scale and
evidence certainty by using the Grading of Recommendations Assessment,
Development and Evaluation approach. The authors used a meta-analysis with
a random-effects model to estimate dichotomous and continuous outcomes,
expressed as relative risk (RR) and weighted mean difference.
<br/>RESULT(S): Six studies met the inclusion criteria for CVS but none
for LVAD implantation. Very low certainty in the evidence suggested
uncertainty as to whether health outcomes for patients undergoing dental
treatment before CVS differed from those who did not. Postsurgical
outcomes included all-cause mortality (RR, 1.00; 95% confidence interval
[CI], 0.53 to 1.91), infective endocarditis (RR, 1.30; 95% CI, 0.51 to
3.35), postsurgical infection (RR, 1.01; 95% CI, 0.76 to 1.33), and length
of stay in the hospital (weighted mean difference, 2.9; 95% CI, -2.3 to
8.1). CONCLUSIONS AND PRACTICAL IMPLICATIONS: From the available evidence,
it is unclear whether postoperative outcomes differ in patients receiving
dental treatment before CVS compared with outcomes in those who do not.
Dentists and medical care professionals should collaborate on an
appropriate course of action for each patient, weighing any potentially
relevant care considerations.<br/>Copyright &#xa9; 2019 American Dental
Association. Published by Elsevier Inc. All rights reserved.

<51>
Accession Number
2010462409
Title
Frailty is highly prevalent in specific cardiovascular diseases and
females, but significantly worsens prognosis in all affected patients: A
systematic review.
Source
Ageing Research Reviews. 66 (no pagination), 2021. Article Number: 101233.
Date of Publication: March 2021.
Author
Marinus N.; Vigorito C.; Giallauria F.; Haenen L.; Jansegers T.; Dendale
P.; Feys P.; Meesen R.; Timmermans A.; Spildooren J.; Hansen D.
Institution
(Marinus, Haenen, Jansegers, Dendale, Feys, Meesen, Timmermans,
Spildooren, Hansen) REVAL, Rehabilitation Research Center, Faculty of
Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
(Dendale, Hansen) Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
(Marinus, Feys, Hansen) BIOMED, Biomedical Research Center, Hasselt
University, Diepenbeek, Belgium
(Vigorito, Giallauria) Department of Translational Medical Sciences,
Federico II University of Naples, Naples, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Cardiologists are more often confronted with older (>60 years)
cardiovascular disease (CVD) patients. These patients have particular
needs in clinical care because, for example, of frailty. However, it
remains to be established what is the prevalence of frailty in different
CVD's and how it relates to mortality. In this systematic review studies
were included if they: (i) examined subjects (men and women) aged >=60
years who suffered from any CVD with or without cardiac surgery, (ii.)
examined the presence of frailty with a well-defined frailty tool and
(iii.) reported prevalence rates of frailty. From thirty studies
comprising 96.841 participants, it is found that 1. Frailty is highly
common in older patients with CVD (in particular in females (approximately
1.6 times more than in males), in heart failure (up to 80 % of patients)
and aortic valve disease (up to 74 % of patients)), and 2. Frailty is
related to a 2.5-3.5-fold elevated mortality risk, even in patients with
less severe CVD (e.g. percutaneous coronary intervention). Moreover, there
is a lack of consistency on how to assess frailty as up to 20 different
tools/assessment batteries are currently used. It is concluded that
frailty should be assessed in all older CVD patients in a uniform manner
to enhance clinical care and outcomes.<br/>Copyright &#xa9; 2020 Elsevier
B.V.

<52>
Accession Number
2006953918
Title
Network Meta-analysis of Surgical Aortic Valve Replacement and Different
Transcatheter Heart Valve Systems for Symptomatic Severe Aortic Stenosis.
Source
Canadian Journal of Cardiology. 37 (1) (pp 27-36), 2021. Date of
Publication: January 2021.
Author
Ueyama H.; Kuno T.; Ando T.; Hayashida K.; Takagi H.
Institution
(Ueyama, Kuno) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Beth Israel, New York, NY, United States
(Ando) Center for Interventional Vascular Therapy, Division of Cardiology,
New York-Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
(Hayashida) Division of Cardiology, Keio University School of Medicine,
Tokyo, Japan
(Takagi) Division of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
Publisher
Elsevier Inc.
Abstract
Background: Although different transcatheter heart valve (THV) systems
have been introduced to overcome transcatheter aortic valve replacement
(TAVR)-specific complications, head-to-head comparisons of these THV
systems are scarce. The aim of this study was to compare different THV
systems and surgical aortic valve replacement (SAVR) by conducting a
network meta-analysis. <br/>Method(s): PubMed and EMBASE were searched
through November 2019 for studies comparing safety and efficacy of
balloon-expandable valve (BEV), self-expanding valve (SEV), mechanically
expandable valve (MEV), and SAVR for symptomatic severe aortic stenosis.
End points in the short term at 30 days or discharge and the long term up
to 2 years were assessed. <br/>Result(s): We identified 11 randomized
controlled trials with a total of 10,300 patients eligible for inclusion
in our study. There were no significant differences in all-cause death
among different THV systems and SAVR in both short and long terms.
Disabling stroke was significantly lower with MEV vs BEV and SAVR (hazard
ratios [HRs] 0.31 [95% confidence interval [CI] 0.12-0.77] and 0.33 [95%
CI 0.14-0.76], respectively) in the long term. MEV was associated with an
increased risk of new permanent pacemaker implantation compared with BEV,
SEV, and SAVR (HRs 3.82 [95% CI 1.83-7.97], 1.85 [95% CI 1.02-3.36], and
5.23 [95% CI 2.61-10.47], respectively) in the long term.
<br/>Conclusion(s): In patients with symptomatic severe aortic stenosis
undergoing intervention, there were no significant differences in
all-cause death among different THV systems and SAVR. MEV had low
frequency of disabling stroke compared with BEV and SAVR, but an increased
frequency of permanent pacemaker implantation compared with other
interventions.<br/>Copyright &#xa9; 2020 Canadian Cardiovascular Society

<53>
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).

<54>
Accession Number
2007466883
Title
Cardiac Rehabilitation Programs for Chronic Heart Disease: A Bayesian
Network Meta-analysis.
Source
Canadian Journal of Cardiology. 37 (1) (pp 162-171), 2021. Date of
Publication: January 2021.
Author
Huang R.; Palmer S.C.; Cao Y.; Zhang H.; Sun Y.; Su W.; Liang L.; Wang S.;
Wang Y.; Xu Y.; Melgiri N.D.; Jiang L.; Strippoli G.F.M.; Li X.
Institution
(Huang, Li) Department of Gerontology, the Second Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Palmer) Department of Medicine, University of Otago - Christchurch,
Christchurch, New Zealand
(Cao, Jiang) Department of Cardiothoracic Surgery, the First People's
Hospital of Yunnan Province, Kunming, Yunnan Province, China
(Zhang, Su, Liang) Department of Cardiology, the First People's Hospital
of Yunnan Province, Kunming, Yunnan Province, China
(Sun) Institute of Ultrasound Imaging, the Second Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Wang, Wang) Department of Rehabilitation Medicine, the Second Affiliated
Hospital of Chongqing Medical University, Chongqing, China
(Xu) Statistical Laboratory, Chuang Xu Institute of Lifesciences,
Chongqing, China
(Melgiri) Impactys Foundation for Biomedical Research, San Diego, CA,
United States
(Strippoli) Department of Emergency and Organ Transplantation, University
of Bari, Bari, Italy
Publisher
Elsevier Inc.
Abstract
Background: Cardiac rehabilitation is a medically supervised program after
coronary events that involves exercise and dietary modification. We
evaluated the comparative benefits and harms of cardiac rehabilitation
strategies via a network meta-analysis. <br/>Method(s): We followed a
pre-specified protocol (PROSPERO: CRD42018094998). We searched Embase,
MEDLINE, and Cochrane Central Register of Randomized Trials databases for
randomized controlled trials that evaluated cardiac rehabilitation vs a
second form of rehabilitation or standard/usual care in adults after
myocardial infarction, coronary artery bypass grafting, percutaneous
coronary intervention, or angiography. Risk of bias and evidence quality
was evaluated using the Cochrane tool and Grading of Recommendations
Assessment, Development and Evaluation (GRADE), respectively. Pairwise and
Bayesian network meta-analyses were performed for 11 clinical outcomes.
<br/>Result(s): We included 134 randomized controlled trials involving
62,322 participants. Compared with standard care, exercise-only cardiac
rehabilitation reduced the odds of cardiovascular mortality (odds ratio
[OR], 0.70; 95% credibility interval [CrI], 0.51-0.96; moderate-quality
evidence), major adverse cardiovascular events (OR, 0.57; 95% CrI,
0.40-0.78; low-quality evidence), nonfatal myocardial infarction (OR,
0.71; 95% CrI, 0.54-0.93; moderate-quality evidence), all-cause
hospitalization (OR, 0.74; 95% CrI, 0.54-0.98; moderate-quality evidence),
and cardiovascular hospitalization (OR, 0.69; 95% CrI, 0.51-0.88;
moderate-quality evidence). Exercise-only cardiac rehabilitation was
associated with lower cardiovascular hospitalization risk relative to
cardiac rehabilitation without exercise (OR, 0.68; 95% CrI, 0.48-0.97;
moderate-quality evidence). <br/>Conclusion(s): Cardiac rehabilitation
programs containing exercise might provide broader cardiovascular benefits
compared with those without exercise.<br/>Copyright &#xa9; 2020 Canadian
Cardiovascular Society

<55>
Accession Number
2010397827
Title
Rapid right ventricular pacing for balloon valvuloplasty in congenital
aortic stenosis: A systematic review.
Source
World Journal of Cardiology. 12 (11) (pp 540-549), 2020. Date of
Publication: 26 Nov 2020.
Author
Mylonas K.S.; Ziogas I.A.; Mylona C.S.; Avgerinos D.V.; Bakoyiannis C.;
Mitropoulos F.; Tzifa A.
Institution
(Mylonas) Department of Cardiothoracic Surgery, Yale New Haven Hospital,
New Haven, CT 06510, United States
(Ziogas) Medical School, Aristotle University of Thessaloniki,
Thessaloniki 54124, Greece
(Mylona) Department of Pediatrics, Trikala General Hospital, Trikala
42100, Greece
(Avgerinos) Department of Cardiothoracic Surgery, New York Presbyterian
Hospital, New York, NY 10065, United States
(Bakoyiannis) Division of Vascular Surgery, First Department of Surgery,
Laiko General Hospital, National and Kapodistrian University of Athens,
Athens 11527, Greece
(Mitropoulos) Department of Pediatric Cardiac Surgery, Mitera Children's
Hospital, Athens 15123, Greece
(Tzifa) Department of Pediatric Cardiology and Adult Congenital Heart
Disease, Mitera Children's Hospital, Athens 15123, Greece
Publisher
Baishideng Publishing Group Co
Abstract
BACKGROUND Balloon aortic valvuloplasty (BAV) is a well-established
treatment modality for congenital aortic valve stenosis. AIM To evaluate
the role of rapid right ventricular pacing (RRVP) in balloon stabilization
during BAV on aortic regurgitation (AR) in pediatric patients. METHODS A
systematic review of the MEDLINE, Cochrane Library, and Scopus databases
was conducted according to the PRISMA guidelines (end-of-search date: July
8, 2020). The National Heart, Lung, and Blood Institute and
Newcastle-Ottawa scales was utilized for quality assessment. RESULTS Five
studies reporting on 72 patients were included. The studies investigated
the use of RRVP-assisted BAV in infants (> 1 mo) and older children, but
not in neonates. Ten (13.9%) patients had a history of some type of aortic
valve surgical or catheterization procedure. Before BAV, 58 (84.0%), 7
(10.1%), 4 (5.9%) patients had AR grade 0 (none), 1 (trivial), 2 (mild),
respectively. After BAV, 34 (49.3%), 6 (8.7%), 26 (37.7%), 3 (4.3%),
patients had AR grade 0, 1, 2, and 3 (moderate), respectively. No patient
developed severe AR after RRVP. One (1.4%) developed ventricular
fibrillation and was defibrillated successfully. No additional arrhythmias
or complications occurred during RRVP. CONCLUSION RRVP can be safely used
to achieve balloon stability during pediatric BAV, which could potentially
decrease AR rates.<br/>Copyright &#xa9; The Author(s) 2020. Published by
Baishideng Publishing Group Inc. All rights reserved.

<56>
Accession Number
2003783139
Title
Outcomes with retrograde versus antegrade chronic total occlusion
revascularization.
Source
Catheterization and Cardiovascular Interventions. 96 (5) (pp 1037-1043),
2020. Date of Publication: 01 Nov 2020.
Author
Megaly M.; Ali A.; Saad M.; Omer M.; Xenogiannis I.; Werner G.S.;
Karmpaliotis D.; Russo J.J.; Yamane M.; Garbo R.; Gagnor A.; Ungi I.;
Rinfret S.; Pershad A.; Wojcik J.; Garcia S.; Mashayekhi K.; Sianos G.;
Galassi A.R.; Burke M.N.; Brilakis E.S.
Institution
(Megaly, Omer, Xenogiannis, Garcia, Burke, Brilakis) Minneapolis Heart
Institute, Abbott Northwestern Hospital, Minneapolis, MN, United States
(Megaly, Omer) Department of Cardiovascular Medicine, Hennepin Healthcare,
Minneapolis, MN, United States
(Ali) Department of Medicine, Mercy Hospital and Medical Center, Chicago,
IL, United States
(Saad) Division of Cardiovascular Medicine, The Warren Alpert School of
Medicine at Brown University, Providence, RI, United States
(Saad) Department of Cardiovascular Medicine, Ain Shams University
Hospitals, Cairo, Egypt
(Werner) Medizinische Klinik I (Cardiology and Intensive Care), Klinikum
Darmstadt GmbH, Darmstadt, Germany
(Karmpaliotis, Russo) Department of Cardiology, Columbia University, New
York, NY, United States
(Yamane) Department of Cardiology, Sayama Hospital, Saitama, Japan
(Garbo) Department of Invasive Cardiology, San Giovanni Bosco Hospital,
Turin, Italy
(Gagnor) Department of Invasive Cardiology, Maria Vittoria Hospital,
Turin, Italy
(Ungi) Division of Invasive Cardiology, University of Szeged, Second
Department of Internal Medicine and Cardiology Center, Szeged, Hungary
(Rinfret) Division of Interventional Cardiology, McGill University Health
Centre, Montreal, Canada
(Pershad) Division of Cardiology, Banner-University Medical Center,
Phoenix, AZ, United States
(Wojcik) Department of Cardiology, Hospital of Invasive Cardiology
IKARDIA, Naleczow, Poland
(Mashayekhi) Division of Cardiology and Angiology II, University Heart
Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
(Sianos) First Department of Cardiology, AHEPA University Hospital,
Thessaloniki, Greece
(Galassi) Department of Clinical and Experimental Medicine,
Catheterization Laboratory and Cardiovascular Interventional Unit,
Cannizzaro Hospital, University of Catania, Catania, Italy
Publisher
John Wiley and Sons Inc
Abstract
Objectives: The aim of the study was to evaluate the outcomes of
retrograde versus antegrade approach in chronic total occlusion (CTO)
percutaneous coronary intervention (PCI). <br/>Background(s): The
retrograde approach has increased the success rate of CTO PCI but has been
associated with a higher risk for complications. <br/>Method(s): We
conducted a meta-analysis of studies published between 2000 and August
2019 comparing the in-hospital and long-term outcomes with retrograde
versus antegrade CTO PCI. <br/>Result(s): Twelve observational studies
(10,240 patients) met our inclusion criteria (retrograde approach 2,789
patients, antegrade approach 7,451 patients). Lesions treated with the
retrograde approach had higher J-CTO score (2.8 vs. 1.9, p <.001).
Retrograde CTO PCI was associated with a lower success rate (80.9% vs.
87.4%, p <.001). Both approaches had similar in-hospital mortality, urgent
revascularization, and cerebrovascular events. Retrograde CTO PCI was
associated with higher risk of in-hospital myocardial infarction (MI; odds
ratio [OR] 2.37, 95% confidence intervals [CI] 1.7, 3.32, p <.001), urgent
pericardiocentesis (OR 2.53, 95% CI 1.41-4.51, p =.002), and
contrast-induced nephropathy (OR 2.12, 95% CI 1.47-3.08; p <.001). During
a mean follow-up of 48 +/- 31 months retrograde crossing had similar
mortality (OR 1.79, 95% CI 0.84-3.81, p =.13), but a higher incidence of
MI (OR 2.07, 95% CI 1.1-3.88, p =.02), target vessel revascularization (OR
1.92, 95% CI 1.49-2.46, p <.001), and target lesion revascularization (OR
2.08, 95% CI 1.33-3.28, p =.001). <br/>Conclusion(s): Compared with
antegrade CTO PCI, retrograde CTO PCI is performed in more complex lesions
and is associated with a higher risk for acute and long-term adverse
events.<br/>Copyright &#xa9; 2019 Wiley Periodicals, Inc.

<57>
Accession Number
2008411115
Title
Comparison of isoflurane, sevoflurane, and desflurane as inhalant
anesthetics in prairie rattlesnakes (Crotalus viridis).
Source
Journal of the American Veterinary Medical Association. 257 (9) (pp
945-949), 2020. Date of Publication: 01 Nov 2020.
Author
Kane L.P.; Chinnadurai S.K.; Vivirito K.; Strahl-Heldreth D.; Allender
M.C.
Institution
(Kane, Vivirito, Strahl-Heldreth, Allender) Department of Veterinary
Clinical Medicine, University of Illinois, College of Veterinary Medicine,
Urbana, IL 61802, United States
(Chinnadurai) Chicago Zoological Society, Brookfield Zoo, Brookfield, IL
60513, United States
Publisher
American Veterinary Medical Association
Abstract
OBJECTIVE To characterize induction and recovery characteristics of 3
commonly used inhalant anesthetics in prairie rattlesnakes (Crotalus
viridis): isoflurane, sevoflurane, and desflurane. ANIMALS 12 healthy
adult prairie rattlesnakes. PROCEDURES In a randomized crossover design,
snakes underwent anesthetic induction with 5% isoflurane, 8% sevoflurane,
or 18% desflurane, with a washout period of >= 7 days between anesthetic
events. Anesthetic depth parameters were recorded throughout induction and
recovery, including time to loss and return of righting reflex, muscle
tone, ability to intubate, response to pressure, and time to return to
spontaneous respiration. Every 5 minutes throughout the anesthetic
procedures, heart rate, respiratory rate, and percentage expired
anesthetic gas were recorded. RESULTS No snakes died during the study.
Sevoflurane anesthesia resulted in anesthetic gas avoidance behavior in
snakes during induction and had the significantly longest recovery time to
extubation and time to return of pressure response, compared with the
other inhalant anesthetics. Anesthesia with isoflurane resulted in a
significantly longer time to return of righting reflex, compared with
sevoflurane or desflurane. No significant difference was noted in time to
loss of pressure response among the 3 anesthetic gases. Desflurane
anesthesia resulted in the significantly quickest loss of righting reflex
among the anesthetic protocols; despite this, 4 of 12 desflurane
anesthetized snakes did not achieve an anesthetic plane deep enough for
intubation. CONCLUSIONS AND CLINICAL RELEVANCE Isoflurane and sevoflurane,
but not desflurane, inhalation anesthesia resulted in consistent and
predictable loss of righting reflex and induction of anesthesia deep
enough to allow intubation in snakes.<br/>Copyright &#xa9; 2020 American
Veterinary Medical Association. All rights reserved.

<58>
Accession Number
2005561570
Title
Transcatheter aortic valve replacement and percutaneous coronary
intervention versus surgical aortic valve replacement and coronary artery
bypass grafting in patients with severe aortic stenosis and concomitant
coronary artery disease: A systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 96 (5) (pp 1113-1125),
2020. Date of Publication: 01 Nov 2020.
Author
Kotronias R.A.; Bray J.H.; Scarsini R.; Rajasundaram S.;
Terentes-Printzios D.; De Maria G.L.; Kharbanda R.K.; Mamas M.A.; Bagur
R.; Banning A.P.
Institution
(Kotronias, Bray, Scarsini, Rajasundaram, Terentes-Printzios, De Maria,
Kharbanda, Banning) Oxford Heart Centre, Oxford University Hospitals NHS
Foundation Trust, Oxford, Oxfordshire, United Kingdom
(Kotronias) Department of Cardiovascular Medicine, University of Oxford,
Oxford, Oxfordshire, United Kingdom
(Scarsini) Department of Medicine, Division of Cardiology, University of
Verona, Verona, Italy
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, UK and Heart Centre, Thomas Jefferson
University, Philadelphia, United States
(Bagur) Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, Western University, London, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Objectives: We performed a systematic review and meta-analysis to evaluate
the early and midterm outcomes of patients who underwent surgical aortic
valve replacement (SAVR) and coronary artery bypass grafting (CABG)
against patients who had transcatheter aortic valve replacement (TAVR) and
percutaneous coronary intervention (PCI). <br/>Background(s): Contemporary
guidelines suggest that surgical or percutaneous revascularization of
significant coronary artery disease (CAD) in patients with severe aortic
stenosis (AS) is a reasonable strategy. <br/>Method(s): We conducted a
comprehensive search of Medline and Embase to identify studies comparing a
percutaneous transcatheter versus a surgical approach. Random effects
meta-analyses using the Mantel-Haenszel method were performed to estimate
the effect of percutaneous compared surgical strategies using aggregate
data. <br/>Result(s): Six studies reporting on 1770 participants were
included in the meta-analysis. There were no significant differences in
effect estimates for early and midterm mortality (OR: 0.78; 95% CI,
0.50-1.20 and OR: 1.09; 95% CI, 0.80-1.49, respectively) or myocardial
infarction (OR: 0.52; 95% CI, 0.20-1.33 and OR: 1.34; 95% CI, 0.67-2.65,
respectively). No significant difference was shown for peri-procedural
stroke (OR: 0.80; 95% CI, 0.35-1.87). A transcatheter approach had a
higher rate of major vascular complications (OR: 14.44; 95% CI,
4.42-47.16), but a lower rate of acute kidney injury (OR: 0.41; 95% CI,
0.19-0.91). <br/>Conclusion(s): Our analysis suggests that a percutaneous
transcatheter approach confers similar outcomes compared to a surgical
approach in patients with severe AS and CAD. However, our findings are
based on low quality studies and should serve as hypothesis generating. In
the absence of adequately powered studies yielding high level evidence,
individualized decision making should be based on surgical risk
assessment.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC.

<59>
Accession Number
2004163815
Title
The no-touch saphenous vein is an excellent alternative conduit to the
radial artery 8 years after coronary artery bypass grafting: A randomized
trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 161 (2) (pp 624-630),
2021. Date of Publication: February 2021.
Author
Dreifaldt M.; Mannion J.D.; Geijer H.; Liden M.; Bodin L.; Souza D.
Institution
(Dreifaldt, Souza) Faculty of Medicine and Health, Department of
Cardiothoracic and Vascular Surgery and University Health Care Research
Center, Orebro University, Orebro, Sweden
(Mannion) Department of Surgery, Bayhealth Medical Center, Dover, Del,
United States
(Geijer, Liden) Faculty of Medicine and Health, Department of Radiology,
Orebro University, Orebro, Sweden
(Bodin) Unit of Intervention and Implementation Research, Institute of
Environmental Medicine, Karolinska Institute, Stockholm, Sweden
Publisher
Mosby Inc.
Abstract
Background: In 2004, a prospective randomized trial demonstrated that
after 3 years, saphenous veins (SVs) harvested with a no touch (NT)
technique had a greater patency than radial grafts for coronary bypass
surgery. Here we report the 8-year follow-up data of this trial.
<br/>Method(s): The trial included 108 patients undergoing coronary artery
bypass grafting (CABG). Each patient was assigned to receive 1 NT SV and 1
radial artery (RA) graft to either the left or right coronary territory to
complement the left internal thoracic artery (LITA). Sequential grafting
was common, so overall graft patency as well as the patency of each
anastomosis were assessed. <br/>Result(s): Angiography was performed in 84
patients (78%) at mean of 97 months postoperatively. Graft patency were
high and similar for both NT and RA: 86% for NT versus 79% for RA (P
=.22). The patency of coronary anastomoses was significantly higher with
the NT SV grafts (91% vs 81%; P =.046). The NT grafts also had excellent
patency in coronary arteries with <90% stenosis (93% patency) and in
coronary arteries of small diameter (87% patency) or with mild
calcification (88% patency). Patency for the LITA was 92%.
<br/>Conclusion(s): NT SV grafts have excellent patency similar to that of
RA grafts after 8 years. In addition, NT SV grafts can be used in
situations that are not ideal for RA grafts.<br/>Copyright &#xa9; 2019 The
American Association for Thoracic Surgery

<60>
Accession Number
633220994
Title
Transcatheter Aortic Valve Replacement in Low-risk Patients with Bicuspid
Aortic Valve Stenosis.
Source
JAMA Cardiology. 6 (1) (pp 50-57), 2021. Date of Publication: January
2021.
Author
Forrest J.K.; Ramlawi B.; Deeb G.M.; Zahr F.; Song H.K.; Kleiman N.S.;
Chetcuti S.J.; Michelena H.I.; Mangi A.A.; Skiles J.A.; Huang J.; Popma
J.J.; Reardon M.J.
Institution
(Forrest, Mangi) Departments of Internal Medicine (Cardiology), Yale
University, School of Medicine, Dana 3 Cardiology Section, 789 Howard Ave,
New Haven, CT 06519, United States
(Ramlawi, Skiles) Department of Cardiothoracic Surgery and Cardiology,
Valley Health System, Winchester, VA, United States
(Deeb, Chetcuti) Departments of Cardiac Surgery and Interventional
Cardiology, University of Michigan Hospitals, Ann Arbor, United States
(Zahr, Song) Departments of Interventional Cardiology and Cardiothoracic
Surgery, Oregon Health and Science University, Portland, United States
(Kleiman, Reardon) Departments of Interventional Cardiology and
Cardiothoracic Surgery, Houston Methodist DeBakey Heart and Vascular
Institute, Houston, TX, United States
(Michelena) Division of Cardiovascular Ultrasound, Mayo Clinic, Rochester,
MN, United States
(Huang) Department of Statistics, Medtronic, Minneapolis, MN, United
States
(Popma) Department of Interventional Cardiology, Beth Israel Deaconess
Medical Center, Boston, MA, United States
Publisher
American Medical Association
Abstract
Importance: The outcomes of transcatheter aortic valve replacement (TAVR)
in low-risk patients with bicuspid aortic valve stenosis have not been
studied in a large scale, multicentered, prospective fashion.
<br/>Objective(s): To evaluate the procedural safety, efficacy, and 30-day
outcomes of TAVR in patients with bicuspid aortic stenosis at low surgical
risk. <br/>Design, Setting, and Participant(s): The Low Risk Bicuspid
Study is a prospective, single-arm trial study with inclusion/exclusion
criteria developed from the Evolut Low Risk Randomized Trial. Follow-up is
planned for 10 years. Patients underwent TAVR at 25 centers in the United
States who were also participating in the Evolut Low Risk Randomized Trial
from December 2018 to October 2019. Eligible patients had severe bicuspid
aortic valve stenosis and met American Heart Association/American College
of Cardiology guideline indications for aortic valve replacement.
<br/>Intervention(s): Patients underwent attempted implant of an Evolut or
Evolut PRO transcatheter aortic valve, with valve size based on annular
measurements. <br/>Main Outcomes and Measures: The prespecified primary
end point was the incidence of all-cause mortality or disabling stroke at
30 days. The prespecified primary efficacy end point was device success
defined as the absence of procedural mortality, the correct position of 1
bioprosthetic heart valve in the proper anatomical location, and the
absence of more than mild aortic regurgitation postprocedure.
<br/>Result(s): A total of 150 patients underwent an attempted implant.
Baseline characteristics include mean age of 70.3 (5.5) years, 48.0%
female (n = 72), and a mean Society of Thoracic Surgeons score of 1.4
(0.6%). Most patients (136; 90.7%) had Sievers type I valve morphology.
The incidence of all-cause mortality or disabling stroke was 1.3% (95% CI,
0.3%-5.3%) at 30 days. The device success rate was 95.3% (95% CI,
90.5%-98.1%). At 30 days, the mean (SD) AV gradient was 7.6 (3.7) mm Hg
and effective orifice area was 2.3 (0.7) cm². A new permanent
pacemaker was implanted in 22 patients (15.1%). No patients had greater
than mild paravalvular leak. <br/>Conclusions and Relevance: Transcatheter
aortic valve replacement in low-surgical risk patients with bicuspid
aortic valve stenosis achieved favorable 30-day results, with low rates of
death and stroke and high device success rate. Trial Registration:
ClinicalTrials.gov Identifier: NCT03635424.<br/>Copyright &#xa9; 2021
American Medical Association. All rights reserved.

<61>
Accession Number
2007560869
Title
Diagnosis and management of silent coronary ischemia in patients
undergoing carotid endarterectomy.
Source
Journal of Vascular Surgery. 73 (2) (pp 533-541), 2021. Date of
Publication: February 2021.
Author
Krievins D.; Zellans E.; Latkovskis G.; Jegere S.; Kumsars I.; Kaufmanis
K.; Erglis A.; Zarins C.K.
Institution
(Krievins, Zellans, Latkovskis, Jegere, Kumsars, Erglis) Department of
Vascular Surgery, Pauls Stradins Clinical University Hospital, Riga,
Latvia
(Krievins, Zellans, Latkovskis, Jegere, Kumsars, Kaufmanis, Erglis)
Faculty of Medicine, University of Latvia, Riga, Latvia
(Zarins) HeartFlow, Inc, Redwood City, Calif, United States
Publisher
Mosby Inc.
Abstract
Background: Coronary artery disease is the primary cause of death in
patients with carotid artery disease and silent ischemia is a marker for
adverse coronary events. A new noninvasive cardiac diagnostic test,
coronary computed tomography-derived fractional flow reserve
(FFR<inf>CT</inf>) can reliably identify ischemia-producing coronary
stenosis in patients with coronary artery disease and help to select
patients for coronary revascularization. The purpose of this study is to
determine the prevalence of silent coronary ischemia in patients
undergoing carotid endarterectomy (CEA) and to evaluate the usefulness of
FFR<inf>CT</inf> in selecting patients for coronary revascularization to
decrease cardiac events and improve survival. <br/>Method(s): Patients
with no cardiac history or symptoms admitted for elective CEA were
enrolled in a prospective, open-label, institutional review board-approved
study and underwent preoperative coronary computed tomography angiography
(CTA) and FFR<inf>CT</inf> with results available to physicians for
patient management. Lesion-specific coronary ischemia was defined as
FFR<inf>CT</inf> of 0.80 or less distal to a focal coronary stenosis with
an FFR<inf>CT</inf> of 0.75 or less, indicating severe ischemia. Primary
end point was incidence of major adverse cardiovascular events (MACE;
defined as cardiovascular death, myocardial infarction, or stroke) at 30
days and 1 year. <br/>Result(s): Coronary CTA and FFR<inf>CT</inf> was
performed in 90 CEA patients (age 67 +/- 8 years; male 66%).
Lesion-specific coronary ischemia was found in 51 patients (57%) with a
mean FFR<inf>CT</inf> of 0.71 +/- 0.14. Severe coronary ischemia was
present in 39 patients (43%), 26 patients had multivessel ischemia, and 5
had left main disease. CEA was performed as scheduled in all patients with
no postoperative deaths or myocardial infarctions. There were no MACE
events at 30 days. After recovery from surgery, 36 patients with
significant lesion-specific ischemia underwent coronary angiography with
coronary revascularization (percutaneous coronary intervention or coronary
artery bypass grafting) in 30 patients (33%). Survival at 1 year was 100%
and freedom from MACE was 98%. <br/>Conclusion(s): Patients undergoing CEA
have a high prevalence of unsuspected (silent) coronary ischemia, which
may place them at risk for coronary events. Preoperative diagnosis of
silent ischemia using CTA and FFR<inf>CT</inf> can identify high-risk
patients and help to guide patient management. Selective postoperative
coronary revascularization of patients with significant ischemia may
decrease the risk of cardiac events and improve survival, but longer
follow-up is needed and prospective, controlled trials are
indicated.<br/>Copyright &#xa9; 2020 The Authors

<62>
[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

<63>
Accession Number
2008575544
Title
Meta-analysis Evaluating the Utility of Colchicine in Secondary Prevention
of Coronary Artery Disease.
Source
American Journal of Cardiology. 140 (pp 33-38), 2021. Date of Publication:
01 Feb 2021.
Author
Xia M.; Yang X.; Qian C.
Institution
(Xia, Qian) Department of Cardiology, The Affiliated Hospital of Southwest
Medical University, Luzhou, Sichuan Province, China
(Yang) Department of Medical Records, The Central Hospital of Enshi
Autonomous Prefecture, Enshi, Hubei Province, China
Publisher
Elsevier Inc.
Abstract
Colchicine has shown potential therapeutic benefits in cardiovascular
conditions owing to its broad anti-inflammatory properties. Here, we
performed a meta-analysis to determine the efficacy and safety of
colchicine in patients with coronary artery disease (CAD). A systematical
search in electronic databases of PubMed, The Cochrane Library, and Scopus
were carried out to identify eligible studies. Only randomized controlled
trials evaluating the cardiovascular effects of colchicine in CAD patients
were included. Study-level data of cardiovascular outcomes or adverse
events were pooled using random-effect models. We finally included 5
randomized controlled trials with follow-up duration >=6 months,
comprising a total of 11,790 patients with CAD. Compared with placebo or
no treatment, colchicine administration was associated with a
significantly lower incidence of major adverse cardiovascular events
(relative risk [RR] 0.65, 95% confidence interval [CI] 0.52 to 0.82). Such
a benefit was not modified by the clinical phenotype of CAD (p for
interaction = 0.34). Colchicine treatment also decreased the risk of
myocardial infarction (RR 0.73, 95% CI 0.55 to 0.98), coronary
revascularization (RR 0.61, 95% CI 0.42 to 0.89) and stroke (RR 0.47, 95%
CI 0.28 to 0.81) in CAD patients, but with no impact on cardiovascular
mortality. In addition, the rates of common adverse events were generally
similar between colchicine and control groups, including noncardiovascular
deaths (RR 1.50, 95% CI 0.93 to 2.40) and gastrointestinal symptoms (RR
1.05, 95% CI 0.91 to 1.22). In conclusion, the results of our
meta-analysis demonstrated that colchicine treatment may reduce the risk
of future cardiovascular events in CAD patients.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<64>
Accession Number
2008396493
Title
Revascularization versus medical therapy for the treatment of stable
coronary artery disease: A meta-analysis of contemporary randomized
controlled trials.
Source
International Journal of Cardiology. 324 (pp 13-21), 2021. Date of
Publication: 01 Feb 2021.
Author
Laukkanen J.A.; Kunutsor S.K.
Institution
(Laukkanen) Institute of Clinical Medicine, Department of Medicine,
University of Eastern Finland, Kuopio, Finland
(Laukkanen) Central Finland Health Care District, Department of Medicine,
Jyvaskyla, Finland
(Laukkanen) Institute of Public Health and Clinical Nutrition, University
of Eastern Finland, Kuopio, Finland
(Kunutsor) National Institute for Health Research Bristol Biomedical
Research Centre, University Hospitals Bristol and Weston NHS Foundation
Trust and the University of Bristol, Bristol, United Kingdom
(Kunutsor) Translational Health Sciences, Bristol Medical School,
University of Bristol, Southmead Hospital, Learning & Research Building
(Level 1), Bristol, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: We conducted a systematic review and meta-analysis of
contemporary randomized controlled trials (RCTs) to compare clinical
outcomes among stable coronary artery disease (CAD) patients treated with
revascularization [percutaneous coronary intervention (PCI),
coronary-artery bypass grafting (CABG) or both] plus medical therapy (MT)
versus MT alone. <br/>Method(s): Prospective RCTs were sought from
MEDLINE, Embase, The Cochrane Library, and Web of Science up to April
2020. Data was extracted on study characteristics, methods, and outcomes.
Relative risks (RRs) with 95% confidence intervals (CIs) were pooled for
the composite of all-cause mortality, myocardial infarction (MI),
revascularizations, rehospitalizations, or stroke; its individual
components and other cardiovascular endpoints. <br/>Result(s): Twelve
unique RCTs comprising of 15,774 patients were included. There was no
significant difference in all-cause mortality risk (0.95, 95% CI:
0.86-1.06); however, revascularization plus MT reduced the risk of the
composite outcome of all-cause mortality, MI, revascularizations,
rehospitalizations, or stroke (0.69, 95% CI: 0.55-0.87); unplanned
revascularization (0.53, 95% CI: 0.40-0.71); and fatal MI (0.65, 95% CI:
0.49-0.84). Revascularization plus MT reduced the risk of stroke at 1 year
(0.44, 95% CI: 0.30-0.65) and unplanned revascularization and the
composite outcome of all-cause mortality, MI, revascularizations,
rehospitalizations, or stroke at 2-5 years. <br/>Conclusion(s):
Revascularization plus MT does not confer survival advantage beyond that
of MT among patients with stable CAD. However, revascularization plus MT
may reduce the overall risk of the combined outcome of mortality, MI,
revascularizations, rehospitalizations, or stroke, which could be driven
by a decrease in the risk of unplanned revascularizations or fatal
MI.<br/>Copyright &#xa9; 2020 Elsevier B.V.

<65>
Accession Number
2008368781
Title
Pulmonary lobectomy for cancer: Systematic review and network
meta-analysis comparing open, video-assisted thoracic surgery, and robotic
approach.
Source
Surgery (United States). 169 (2) (pp 436-446), 2021. Date of Publication:
February 2021.
Author
Aiolfi A.; Nosotti M.; Micheletto G.; Khor D.; Bonitta G.; Perali C.;
Marin J.; Biraghi T.; Bona D.
Institution
(Aiolfi, Bonitta, Perali, Marin, Biraghi, Bona) Department of Biomedical
Science for Health, Division of General Surgery, University of Milan,
Istitituto Clinico Sant'Ambrogio, Milan, Italy
(Nosotti) Department of Pathophysiology and Transplantation, Thoracic
Surgery and Lung Transplant Unit Fondazione IRCCS Ca' Granda - Ospedale
Maggiore Policlinico, Milan, Italy
(Micheletto) Department of Pathophysiology and Transplantation, INCO and
Department of General Surgery, University of Milan, Istituto Clinico
Sant'Ambrogio, Milan, Italy
(Khor) University of Maryland Medical Center, Baltimore, MD, United States
Publisher
Mosby Inc.
Abstract
Background: Although minimally invasive lobectomy has gained worldwide
interest, there has been debate on perioperative and oncological outcomes.
The purpose of this study was to compare outcomes among open lobectomy,
video-assisted thoracic surgery lobectomy, and robotic lobectomy.
<br/>Method(s): PubMed, EMBASE, and Web of Science databases were
consulted. A fully Bayesian network meta-analysis was performed.
<br/>Result(s): Thirty-four studies (183,426 patients) were included;
88,865 (48.4%) underwent open lobectomy, 79,171 (43.2%) video-assisted
thoracic surgery lobectomy, and 15,390 (8.4%) robotic lobectomy. Compared
with open lobectomy, video-assisted thoracic surgery, lobectomy and
robotic lobectomy had significantly reduced 30-day mortality (risk ratio =
0.53; 95% credible intervals, 0.40-0.66 and risk ratio = 0.51; 95%
credible intervals, 0.36-0.71), pulmonary complications (risk ratio =
0.70; 95% credible intervals, 0.51-0.92 and risk ratio = 0.69; 95%
credible intervals, 0.51-0.88), and overall complications (risk ratio =
0.77; 95% credible intervals, 0.68-0.85 and risk ratio = 0.79; 95%
credible intervals, 0.67-0.91). Compared with video-assisted thoracic
surgery lobectomy, open lobectomy, and robotic lobectomy had a
significantly higher total number of harvested lymph nodes (mean
difference = 1.46; 95% credible intervals, 0.30, 2.64 and mean difference
= 2.18; 95% credible intervals, 0.52-3.92) and lymph nodes stations (mean
difference = 0.37; 95% credible intervals, 0.08-0.65 and mean difference =
0.93; 95% credible intervals, 0.47-1.40). Positive resection margin and
5-year overall survival were similar across treatments. Intraoperative
blood loss, postoperative transfusion, hospital length of stay, and 30-day
readmission were significantly reduced for minimally invasive approaches.
<br/>Conclusion(s): Compared with open lobectomy, video-assisted thoracic
surgery lobectomy, and robotic lobectomy seem safer with reduced 30-day
mortality, pulmonary, and overall complications with equivalent oncologic
outcomes and 5-year overall survival. Minimally invasive techniques may
improve outcomes and surgeons should be encouraged, when feasible, to
adopt video-assisted thoracic surgery lobectomy, or robotic lobectomy in
the treatment of lung cancer.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<66>
Accession Number
2008362882
Title
Remote ischemic preconditioning in isolated valve intervention. A pooled
meta-analysis.
Source
International Journal of Cardiology. 324 (pp 146-151), 2021. Date of
Publication: 01 Feb 2021.
Author
Moscarelli M.; Angelini G.D.; Emanueli C.; Suleiman S.; Pepe M.;
Contegiacomo G.; Punjabi P.P.
Institution
(Moscarelli, Emanueli, Punjabi) Imperial College London, National Heart
Lung Institute, United Kingdom
(Angelini, Suleiman) Clinical Sciences, Bristol Heart Institute, Bristol
Royal Infirmary, Bristol, United Kingdom
(Contegiacomo) Dept of Cardiovascular surgery, GVM Care&Research, Bari,
Italy
(Pepe) Cardiology Unit, Department of Emergency and Organ Transplantation,
University of Bari Aldo Moro, Bari, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Objective: Recent studies have shown no benefits from remote ischemic
preconditioning (RIPC) in patients undergoing coronary artery bypass
surgery. One possible explanation is that given previous exposure to
angina and ischemia/reperfusion injury these patients, may be already
'naturally preconditioned'. The role of RIPC in a context of isolated
valve intervention, both surgical and particularly transcatheter is less
clear and remains under investigated, with few high-quality studies.
<br/>Method(s): A systematic literature review identified 8 candidate
studies that met the meta-analysis criteria. We analyzed outcomes of 610
subjects (312 RIPC and 298 SHAM) with random effects modeling. Each study
was assessed for heterogeneity. The primary outcome was the extent of
periprocedural myocardial injury, as reflected by the area under the curve
for serum troponin concentration. Secondary endpoints included relevant
intra- and post-operative outcomes; sensitivity and high-quality subgroup
analysis was also carried out. <br/>Result(s): Six and two studies
reported the effect of RIPC in surgical and transcatheter valve
intervention. There was a significant difference between-group in terms of
periprocedural Troponin release (standardized mean difference (SMD: 0.74
[95% CI: 0.52; 0.95], p = 0.02) with no heterogeneity (chi²
2.40, I² 0%, p = 0.88). RIPC was not associated with any
improvement in post-operative outcomes. No serious adverse RIPC related
events were reported. <br/>Conclusion(s): RIPC seems to elicit overall
periprocedural cardioprotection in patients undergoing valvular
intervention, yet with no benefit on early clinical
outcomes.<br/>Copyright &#xa9; 2020 Elsevier B.V.

<67>
Accession Number
52110553
Title
Aprotinin revisited.
Source
Journal of Thoracic and Cardiovascular Surgery. 144 (5) (pp 998-1002),
2012. Date of Publication: November 2012.
Author
DeAnda A.; Spiess B.D.
Institution
(DeAnda) Department of Cardiothoracic Surgery, NYU-Langone Medical Center,
New York, NY, United States
(Spiess) Department of Anesthesiology, Virginia Commonwealth University
Medical Center, Richmond, Va
Publisher
Mosby Inc.
Abstract
In 2008, we saw the withdrawal of aprotinin from the US markets after
preliminary results from a large, randomized clinical trial in Canada.
This drug, a potent antifibrinolytic, was used primarily in complex and/or
redo cardiac surgery as an adjunct to decrease postoperative bleeding and
complications. The Canadian study raised questions previously brought up
in similar studies-does aprotinin increase the risk of mortality and renal
failure after cardiac surgery? Recently, a re-review of the Canadian data
noted flaws in the study, as well as in the interpretation of the results.
The present review revisits the aprotinin controversy.<br/>Copyright
&#xa9; 2020

<68>
Accession Number
633930349
Title
A case series of left Impella-device as bridge from acute mitral
regurgitation to MitraClipprocedure: A novel implementation of
percutaneous mechanical circulatory support.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: Acute
Cardiovascular Care Congress 2020. Greece. 9 (2 SUPPL) (pp 136-137), 2020.
Date of Publication: August 2020.
Author
Vandenbriele C.; Wilson J.; Adriaenssens T.; Balthazar T.; Davies S.;
Dubois C.; Caetano A.F.; Goetschalckx K.; Janssens S.; Ledot S.; Meyns B.;
Smith R.; Voigt J.U.; Price S.
Institution
(Vandenbriele, Adriaenssens, Balthazar, Dubois, Janssens, Meyns, Voigt)
University Hospitals (UZ) Leuven, Leuven, Belgium
(Wilson, Caetano, Ledot, Price) Royal Brompton and Harefield NHS
Foundation Trust, Adult Intensive Care, London, United Kingdom
(Davies, Goetschalckx, Smith) Royal Brompton and Harefield NHS Foundation
Trust, Cardiology, London, United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Background: Acute mitral regurgitation (MR) is a medical and mostly
surgical emergency. Severe acute MR presenting with hemodynamic collapse
is usually related to an exceedingly rare mechanical complication such as
papillary muscle rupture after AMI or chordae tendinae rupture, resulting
in flail mitral leaflets. Preoperative stabilization is complex due to
concomitant hemodynamic collapse and hypoxic respiratory failure. Finding
the right balance between both preload and inotropic support is very
challenging. Nowadays, when patients are too sick for immediate surgical
intervention, mechanical circulatory support should be considered because
of its decreasing effect on afterload and cardiac work while increasing
coronary perfusion and cardiac output. Nevertheless, even after initial
stabilization, the surgical risk remains high in critically ill acute
severe MR patients and other technical modalities reducing the MR - such
as MitraClip - should be explored. <br/>Method(s): Between August 2017 and
September 2019, five patients on 2 tertiary ICUs presenting with acute,
moderate-to-severe or severe MR and considered too ill for immediate
surgical intervention (EURO-II score > 11,2%, pulmonary edema
necessitating mechanical ventilation and/ or hemodynamic instability),
were selected for Impellaassisted ventricular unloading as bridge to
MitraClip. <br/>Result(s): The mean age was 72 years. The cause of MR was
ischemic in 20% and all patients presented in cardiogenic shock state,
necessitating mechanical ventilation. Only one patient was in multiple
organ failure (late referral) at presentation. The overall cardiac
operative risk assessment (Euro-II) score represented a 35% chance of
in-hospital mortality after surgery. Cardiac output was severely impaired
(mean LVOT VTI 8,2 cm). All patients were on inotropic support and
supported by an Impella- CP pVAD (mean flow 2,5 Liter per minute; mean 6,3
days of support). In all cases, we managed reducing the LVEDP below 15
mmHg using medical therapy (afterload reduction, inotropes), mechanical
ventilation and pVADtherapy. The MR could be successfully reduced by a
MitraClip-procedure in each patient. The overall survival at discharge was
80%. One patient with late referral and multiple organ failure at
presentation deceased due to refractory cardiogenic shock. All four
patients survived 6 months after discharge. <br/>Conclusion(s): A combined
strategy of Impella and MitraClip appears to be a novel, feasible
alternative for patients presenting with acute, severe MR unable to
proceed to a corrective procedure at presentation due to cardiogenic shock
requiring mechanical circulatory support. In these cases, the initiation
of pVAD-support early is essential to reduce the risk of development of
irreversible end organs damage and dysfunction. Given the limitations of
this small, non-randomised case series, further exploration in a larger,
randomised population is warranted to investigate this strategy further.

<69>
Accession Number
633930341
Title
Sex-specific management in patients with acute myocardial infarction and
cardiogenic shock Supported by a grant agreement (602202) from the
European Union Seventh Framework Program and by the German Heart Research
Foundation Impact of Levosimendan use on the success of weaning and
survival of patients.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: Acute
Cardiovascular Care Congress 2020. Greece. 9 (2 SUPPL) (pp 101), 2020.
Date of Publication: August 2020.
Author
Rubini Gimenez M.; Zeymer U.; Desch S.; De Waha-Thiele S.; Poess J.;
Fuernau G.; Stepinska J.; Huber K.; Thiele H.
Institution
(Rubini Gimenez, Desch, Thiele) Heart Center of Leipzig, Leipzig, Germany
(Zeymer) Klinikum Ludwigshafen, Ludwigshafen, Germany
(De Waha-Thiele, Poess, Fuernau) University Heart Center, Luebeck, Germany
(Stepinska) Institute of Cardiology, Warsaw, Poland
(Huber) Medical University of Vienna, Vienna, Austria
Publisher
SAGE Publications Inc.
Abstract
Background: Women are more likely to suffer and die from cardiogenic shock
(CS) as the most severe complication of acute myocardial infarction (AMI).
Data concerning optimal management for women with CS are scarce. Aim of
this study was therefore to better define characteristics of women
suffering CS and to investigate the influence of sex on different
treatment strategies including coronary revascularization. <br/>Method(s):
In the CULPRIT-SHOCK trial, patients with CS complicating AMI and
multivessel coronary artery disease were randomly assigned to one of the
following coronary revascularization strategies: either percutaneous
coronary intervention (PCI) of the culpritlesion- only or immediate
multivessel PCI. Primary endpoint was a composite of death from any cause
or severe renal failure leading to renal replacement therapy within 30
days after randomization. We investigated sex-specific differences in
general and according to the revascularization strategies. <br/>Result(s):
Among all 686 randomized patients included in the analysis 24% were
female. Women were older, had more often diabetes mellitus and known renal
insufficiency, whereas they had less often a history of previous AMI and
smoking. After 30 days, the primary clinical endpoint was not
significantly different between groups (56% women versus 49% men, OR 1.29;
95% CI 0.91 -1.84; p=0.15). There was no interaction between sex and
coronary revascularization strategy regarding mortality and renal failure
(pinteraction=0.11), the primary endpoint occurred in 56% of women treated
by the culprit-lesion-only strategy vs. 42% men, whereas 55% of women and
of men in the multivessel PCI group experienced the primary endpoint.
<br/>Conclusion(s): Although women presented with a different risk
profile, mortality and renal replacement after 30 days were similar to
men. Sex did not influence mortality and renal failure according to the
different coronary revascularization strategies. These data suggest that
women and men presenting with CS complicating AMI and multivessel coronary
artery disease should be treated equally.

<70>
Accession Number
633930179
Title
The effect of myocardial inflammation on subpopulation of macrophages in
virus-positive patients with ADHF.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: Acute
Cardiovascular Care Congress 2020. Greece. 9 (2 SUPPL) (pp 5), 2020. Date
of Publication: August 2020.
Author
Kruchinkina E.; Rogovskaya Y.V.; Batalov R.E.; Ryabov V.V.
Institution
(Kruchinkina, Batalov) Cardiology Research Institute Tomsk National
Research Medical Center Russian Academy of Sciences, Tomsk, Russian
Federation
(Rogovskaya) National Research Tomsk State University, Tomsk, Russian
Federation
(Ryabov) Siberian State Medical University, Tomsk, Russian Federation
Publisher
SAGE Publications Inc.
Abstract
Background: Macrophages play a key role in the inflammatory cascade and
are the main source of both pro- and anti-inflammatory cytokines than
underlies the pathogenesis of heart failure. <br/>Aim(s): To study the
subpopulation of macrophages depending on myocardial inflammation in
virus-positive patients with acute decompensation of ischemic heart
failure (ADHF). <br/>Method(s): This open-label, nonrandomized,
single-center, prospective trial was registered at clinicaltrials.gov
(#NCT02649517). This trial included 25 patients (84% men, left ventricular
ejection fraction of 29.17+/-9.4%) with ADHF, ischemic systolic
dysfunction, and the presence of cardiotropic viruses (human herpes virus
type 1, 2, and 6; adenovirus; enterovirus; Epstein-Barr virus; and
parvovirus B19). Inclusion criteria were ADHF not earlier than six months
after optimal surgery (percutaneous coronary intervention or/and coronary
artery bypass graft) and optimal drug treatment for ADHF according to ESC
guidelines. All patients underwent invasive angiography and endomyocardial
biopsy with immunohistochemistry (n=25) and by double immunofluorescent
analysis (n=21). Immunohistochemical criteria of myocarditis were at least
14 leukocytes per sq. mm in the myocardium including up to 4 monocytes and
7 or more CD3+ T lymphocytes per sq. mm. We used CD68 as a marker of the
cells of the macrophage lineage; CD80 was considered a biomarker of
M1-like macrophages; CD163, CD206, and stabilin-1 were considered
biomarkers of M2-like macrophages. <br/>Result(s): Based on data of
immunohistochemical analysis, viruses in myocardial tissue were detected
in 14 cases. After all these patients were divided into two groups: group
1 enrolled virus-positive patients with the signs of viral inflammation
43% (n=9), and group 2 enrolled virus-positive patients without signs of
myocardial inflammation 22% (n=5). CD163+CD206-, CD163- CD206+,
CD163+CD206+, CD68-CD 163+, CD68+CD 163-, CD68+ CD163+, CD 68+CD80-,
CD68-CD80+, CD68+CD80+, CD68+CD stabilin-1-, CD68+CD stabilin-1+, CD 68-
CD stabilin-1-, CD 68- CD 206+, CD68+CD206+, CD68+CD206- of M2-like
macrophages in patients with ADHF were identified. In group 1 there was an
increasing tendency in a number of CD68-CD80+ macrophages among other
subpopulations in group 1 (59.50[24.00;74.00], p=0.0562). Whereas, in
group 2 there was an increasing tendency in a number of CD68+CD163-
macrophages (66.00[56.50;68.50], p=0.5254). In addition, an increased
number of macrophages CD68+CD163+ was observed (19.00[10.00;26.00]) in
group 1 compared to group 2 (11.00[7.50; 20.50]) by 63% (p=0.0421).
<br/>Conclusion(s): We observed a regular tendency to increase M1-like
macrophages in group 1 and M2-like macrophages in group 2 in this study.
In support of this, a significant increase in the number of M2-like
macrophages (CD68 + CD163 +) was observed in patients with viral
inflammation that can indicate the stage of recovery of the myocardium.

<71>
Accession Number
633915750
Title
The use of spinal cord stimulation to treat truncal CRPS with subsequent
relief of nausea.
Source
Neuromodulation. Conference: 23rd Annual Meeting of the North American
Neuromodulation Society's. United States. 23 (3) (pp e154), 2020. Date of
Publication: April 2020.
Author
Feldheim T.; Craig T.; Herrera J.M.; McNeil A.
Publisher
Blackwell Publishing Inc.
Abstract
Introduction: Spinal Cord Stimulation (SCS) therapy has been utilized to
treat a myriad of different chronic pain pathologies, including complex
regional pain syndrome (CRPS), a painful affliction that severely limits
the quality of life of the patient. Despite CRPS being very well described
in medical literature and having extensive criterion for diagnosis, the
pathophysiology is still poorly understood. Most of these patients pain
distributions are in the extremities, but a growing number of CRPS
diagnosis are being made for truncal pain. We present a rare case of a
patient with truncal CRPS with successful treatment using SCS therapy and
secondary benefit of treatment of patient's intractable nausea. Case
Description: We present a case of a female who developed CRPS over the
left anterior chest and the left upper abdominal quadrant, secondary to
complications from a perforated Roux-en-Y gastric bypass anastomosis
during an upper endoscopy which subsequently required multiple abdominal
and thoracic surgical interventions and drain placements. She also had
severe nausea non-responsive to medical treatment. After years of failed
conservative therapy, the patient underwent a successful dorsal column SCS
trial with two linear leads (T2-3 midline; T3-4 left of midline), using a
high density (1000 Hz) waveform that provided 95% relief of pain.
Thereafter, she had a permanent implant placed with 100% pain reduction
from baseline, return of functionality and endorsed complete resolution of
nausea after activation of SCS. <br/>Discussion(s): On review of the
literature, SCS has been proven to be an effective therapy for the
treatment of pain and decreased functionality caused by CRPS in several
case reports, studies, and meta-analysis. However, only a handful of case
reports describe its utilization for truncal CRPS. While it was
interesting that our patient had improvement of pain and functionality
with SCS placement, it was also fascinating to find complete resolution of
her nausea. On further review of the literature, there has never been a
reported case with SCS implantation improving nausea, with one case report
showing that SCS therapy can actually induce nausea. <br/>Conclusion(s):
SCS therapy has proven successful in treating several chronic pain
pathologies and their side effect profiles, though only a few cases
reported for truncal CRPS, with the complete resolution of nausea yet to
be reported in the literature. More research is needed into the use of
neuromodulation for truncal CRPS, as well as the possible other benefits
in other organs of our body.

<72>
Accession Number
2010596137
Title
Valve-in-Valve Transcatheter Aortic Valve Replacement Versus Redo Surgical
Aortic Valve Replacement: An Updated Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 14 (2) (pp 211-220), 2021. Date of
Publication: 25 Jan 2021.
Author
Sa M.P.B.O.; Van den Eynde J.; Simonato M.; Cavalcanti L.R.P.; Doulamis
I.P.; Weixler V.; Kampaktsis P.N.; Gallo M.; Laforgia P.L.; Zhigalov K.;
Ruhparwar A.; Weymann A.; Pibarot P.; Clavel M.-A.
Institution
(Sa, Cavalcanti) Division of Cardiovascular Surgery of Pronto Socorro
Cardiologico de Pernambuco-PROCAPE, University of Pernambuco-UPE, Recife,
Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Research Unit of
Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Simonato) Division of Cardiac Surgery, Escola Paulista de
Medicina-UNIFESP, Sao Paulo, Brazil
(Doulamis) Department of Cardiac Surgery, Boston Children's Hospital,
Harvard Medical School, Boston, MA, United States
(Weixler) German Heart Center, Berlin, Germany
(Kampaktsis) NYU Langone Medical Center, New York, NY, United States
(Gallo) Department of Cardiac Surgery, Cardiocentro Ticino, Lugano,
Switzerland
(Laforgia) I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan,
Italy
(Zhigalov, Ruhparwar, Weymann) Department of Thoracic and Cardiovascular
Surgery, West German Heart and Vascular Center Essen, University Hospital
of Essen, University Duisburg-Essen, Essen, Germany
(Pibarot, Clavel) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Pibarot, Clavel) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to evaluate early results of
valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) versus
redo surgical aortic valve replacement (SAVR) for structural valve
degeneration (SVD). <br/>Background(s): ViV TAVR has been increasingly
used for SVD, but it remains unknown whether it produces better or at
least comparable results as redo SAVR. <br/>Method(s): Observational
studies comparing ViV TAVR and redo SAVR were identified in a systematic
search of published research. Random-effects meta-analysis was performed,
comparing clinical outcomes between the 2 groups. <br/>Result(s): Twelve
publications including a total of 16,207 patients (ViV TAVR, n = 8,048;
redo SAVR, n = 8,159) were included from studies published from 2015 to
2020. In the pooled analysis, ViV TAVR was associated with lower rates of
30-day mortality overall (odds ratio [OR]: 0.53; 95% confidence interval
[CI]: 0.32 to 0.87; p = 0.017) and for matched populations (OR: 0.419; 95%
CI: 0.278 to 0.632; p = 0.003), stroke (OR: 0.65; 95% CI: 0.55 to 0.76; p
< 0.001), permanent pacemaker implantation (OR: 0.73; 95% CI: 0.22 to
2.43; p = 0.536), and major bleeding (OR: 0.49; 95% CI: 0.26 to 0.93; p =
0.034), as well as with shorter hospital stay (OR: -3.30; 95% CI: -4.52 to
-2.08; p < 0.001). In contrast, ViV TAVR was associated with higher rates
of myocardial infarction (OR: 1.50; 95% CI: 1.01 to 2.23; p = 0.045) and
severe patient-prosthesis mismatch (OR: 4.63; 95% CI: 3.05 to 7.03; p <
0.001). The search revealed an important lack of comparative studies with
long-term results. <br/>Conclusion(s): ViV TAVR is a valuable option in
the treatment of patients with SVD because of its lower incidence of
post-operative complications and better early survival compared with redo
SAVR. However, ViV TAVR is associated with higher rates of myocardial
infarction and severe patient-prosthesis mismatch.<br/>Copyright &#xa9;
2021 American College of Cardiology Foundation

<73>
Accession Number
2010583834
Title
Suture- or Plug-Based Large-Bore Arteriotomy Closure: A Pilot Randomized
Controlled Trial.
Source
JACC: Cardiovascular Interventions. 14 (2) (pp 149-157), 2021. Date of
Publication: 25 Jan 2021.
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,
Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Tchetche, Ghattas, Siddiqui, Laperche, Dumonteil) Department of
Cardiology, Clinique Pasteur, Toulouse, France
Publisher
Elsevier Inc.
Abstract
Objectives: This study 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.
<br/>Background(s): Vascular complications after TAVR are relevant and
often associated with VCD failure. <br/>Method(s): The MASH (MANTA vs.
Suture-based vascular closure after transcatHeter aortic valve
replacement) trial 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;
2021 American College of Cardiology Foundation

<74>
Accession Number
2010148029
Title
A mortality risk score for septuagenarians undergoing orthotopic heart
transplantation.
Source
Clinical Transplantation. (no pagination), 2021. Date of Publication:
2021.
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) Division of
Cardiac Surgery, Department of Cardiothoracic Surgery, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Hickey) Division of Cardiology, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Hickey, Sultan, Kilic) Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
Publisher
Blackwell Publishing Ltd
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 1156
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 <.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 <.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 &#xa9; 2021
John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

<75>
Accession Number
2010154591
Title
Clinical outcomes in nonagenarians undergoing transcatheter aortic valve
implantation: a systematic review and meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. (no pagination), 2021. Date
of Publication: 2021.
Author
Noguchi M.; Ueyama H.; Ando T.; Takagi H.; Toshiki K.
Institution
(Noguchi) Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical
Center, Uyarasu, Japan
(Ueyama, Toshiki) Department of Medicine, Icahn School of Medicine at
Mount Sinai, Mount Sinai Beth Israel, New York, NY, United States
(Ando) Department of Cardiology, Kawasaki Saiwai Hospital, Kawasaki, Japan
(Takagi) Division of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
Publisher
Springer Japan
Abstract
To compare the risk of procedural complications and mortality after
transcatheter aortic valve implantation (TAVI) in nonagenarians (age >= 90
years) compared to younger patients (< 90 years). Although TAVI could be
considered as a treatment option in nonagenarians, several previous
studies have shown conflicting outcomes between nonagenarians and younger
patients who underwent TAVI. We conducted a comprehensive literature
search through PubMed and EMBASE to investigate the clinical outcomes of
nonagenarians after TAVI. The outcomes of interest were short- and
long-term mortality and procedural complications. Our study identified 16
observational studies including a total of 179,565 patients (21,674
nonagenarian patients and 157,891 younger patients. Nonagenarians had a
significantly higher rate of short- (hazard ratio [HR], 95% confidence
interval [CI]: 1.48, 1.38-1.59; P < 0.001) and long-term mortality (HR,
95% CI: 1.34, 1.24-1.44; P < 0.001) than younger patients after TAVI.
Furthermore, there were significant differences in major and/or
life-threatening bleeding (risk ratio [RR], 95% CI: 1.21, 1.05-1.39; P =
0.008), stroke (HR, 95% CI: 1.24, 1.11-1.40; P < 0.001), and major
vascular complication (RR, 95% CI: 2.15, 1.35-3.42; P = 0.001) between
nonagenarians and younger patients after TAVI. Minor vascular
complication, myocardial infarction and permanent pacemaker implantation
rate were similar between the two groups. Nonagenarians had significantly
higher rate of short- and long-term mortality, major and/or
life-threatening bleeding, stroke, and major vascular complication after
TAVI. Although TAVI is a treatment option in nonagenarians, careful and
appropriate selection of patients is essential to improve clinical
outcomes.<br/>Copyright &#xa9; 2021, Japanese Association of
Cardiovascular Intervention and Therapeutics.

<76>
[Use Link to view the full text]
Accession Number
2010671704
Title
Perioperative Spinal Cord Ischemia After Cardiac Surgery Not Involving the
Aorta: A Review of the Literature.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Wanat-Hawthorne A.; Akorede R.; Floyd T.
Institution
(Wanat-Hawthorne, Akorede, Floyd) Department of Anesthesiology and Pain
Management, UT Southwestern, Dallas, TX, United States
Publisher
W.B. Saunders
Abstract
Spinal cord ischemia (SCI) associated with aortic surgery is
well-described; however, SCI after cardiac surgery not involving the aorta
is an unusual and underappreciated phenomenon. The authors reviewed the
literature and found 54 case reports of perioperative spinal cord ischemia
in nonaortic surgery. The severity of its implications is evidenced by the
fact that 14 patients died, 22 had no recovery, and seven had only partial
recovery. Various types of cardiac surgery have reported this complication
including coronary artery bypass grafting (CABG), off-pump CABG, valve
surgeries, combination valve and CABG surgeries, and transcatheter aortic
valve procedures. Patient comorbidities, such as high blood pressure,
hypercholesterolemia, diabetes, and peripheral vascular disease, also may
play a role in the development of this adverse outcome. The authors review
the literature to define further possible mechanisms, surgical techniques,
and patient factors that could contribute to the risk of perioperative SCI
after cardiac surgery.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<77>
Accession Number
2010583877
Title
2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart
Disease: Executive Summary: A Report of the American College of
Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines.
Source
Journal of the American College of Cardiology. (no pagination), 2021. Date
of Publication: 2021.
Author
Otto C.M.; Nishimura R.A.; Bonow R.O.; Carabello B.A.; Erwin J.P.; Gentile
F.; Jneid H.; Krieger E.V.; Mack M.; McLeod C.; O'Gara P.T.; Rigolin V.H.;
Sundt T.M.; Thompson A.; Toly C.
Publisher
Elsevier Inc.
Abstract
Aim: This executive summary of the valvular heart disease guideline
provides recommendations for clinicians to diagnose and manage valvular
heart disease as well as supporting documentation to encourage their use.
<br/>Method(s): A comprehensive literature search was conducted from
January 1, 2010, to March 1, 2020, encompassing studies, reviews, and
other evidence conducted on human subjects that were published in English
from PubMed, EMBASE, Cochrane, Agency for Healthcare Research and Quality
Reports, and other selected database relevant to this guideline.
Structure: Many recommendations from the earlier valvular heart disease
guidelines have been updated with new evidence and provides newer options
for diagnosis and treatment of valvular heart disease. This summary
includes only the recommendations from the full guideline which focus on
diagnostic work-up, the timing and choice of surgical and catheter
interventions, and recommendations for medical therapy. The reader is
referred to the full guideline for graphical flow charts, text, and tables
with additional details about the rationale for and implementation of each
recommendation, and the evidence tables detailing the data considered in
developing these guidelines.<br/>Copyright &#xa9; 2020 American College of
Cardiology Foundation and the American Heart Association, Inc.

<78>
Accession Number
2010177224
Title
Update in carcinoid heart disease - the heart of the matter.
Source
Reviews in Endocrine and Metabolic Disorders. (no pagination), 2021. Date
of Publication: 2021.
Author
Oleinikov K.; Korach A.; Planer D.; Gilon D.; Grozinsky-Glasberg S.
Institution
(Oleinikov, Grozinsky-Glasberg) Neuroendocrine Tumor Unit, Endocrinology
and Metabolism Department, Division of Medicine, Hadassah-Hebrew
University Medical Center, P.O.B. 12000, Jerusalem 91120, Israel
(Oleinikov, Korach, Planer, Gilon, Grozinsky-Glasberg) ENETS Center of
Excellence, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
(Korach) Department of Cardiothoracic Surgery, Hadassah-Hebrew University
Medical Center, Jerusalem, Israel
(Planer, Gilon) Department of Cardiology, Hadassah-Hebrew University
Medical Center, Jerusalem, Israel
Publisher
Springer
Abstract
Carcinoid heart disease (CHD) is a paraneoplastic cardiac manifestation
occurring in patients with carcinoid syndrome (CS) and advanced
neuroendocrine malignancy. In about 20-40% of patients with CS, chronic
exposure to tumor-released circulating vasoactive peptides typically
results in right-sided valvular fibrosis leading to valve dysfunction and
right heart failure. CHD remains a significant cause of morbidity and
mortality. The management of patients with CHD is complex, as both the
systemic malignant disease and the heart involvement have to be addressed.
Early diagnosis and timely surgical intervention in selected patients are
of utmost importance and offer a survival benefit. In patients with
advanced carcinoid heart disease, valve replacement surgery is the most
effective option to alleviate cardiac symptoms and contribute to survival
outcomes. A collaboration of a multidisciplinary team in centers with
experience is required to provide optimal patient management. Here, we
review the current literature regarding CHD presentation, pathophysiology,
diagnostic tools, and available treatment strategies.<br/>Copyright &#xa9;
2021, The Author(s), under exclusive licence to Springer Science+Business
Media, LLC part of Springer Nature.

<79>
Accession Number
2007442422
Title
Valve-in-valve transcatheter aortic valve replacement to treat multijet
paravalvular regurgitation: A case series and review.
Source
Clinical Cardiology. 44 (1) (pp 13-19), 2021. Date of Publication: January
2021.
Author
Randall M.H.; Lewandowski T.J.; Choi C.; Beaver T.M.
Institution
(Randall, Lewandowski) Department of Medicine, Division of Cardiovascular
Medicine, University of Florida, Gainesville, FL, United States
(Choi) North Florida/South Georgia Veterans Health System, Medical
Service, Cardiology Section Gainesville, Gainesville, FL, United States
(Beaver) Department of Surgery, Division of Thoracic and Cardiovascular
Surgery, University of Florida, Gainesville, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Treatment advances for severe symptomatic aortic stenosis including
transcatheter and open surgical valve replacement have improved patient
survival, length of stay, and speed to recovery. However, paravalvular
regurgitation (PVR) is occasionally seen and when moderate or greater in
severity is associated with an at least 2-fold increase in 1 year
mortality. While several treatment approaches focused on single-jet PVR
have been described in the literature, few reports describe multijet PVR.
Multijet PVR can successfully be treated with a variety of catheter-based
options including valve-in-valve (ViV) transcatheter aortic valve
replacement (TAVR). We present two patients with at least moderate PVR
following aortic valve replacement who were successfully treated with ViV
TAVR along with a review of literature highlighting our rationale for
utilizing each management approach. Multijet PVR can be treated
successfully with ViV TAVR, but additional options such as self-expanding
occluder devices and bioprosthetic valve fracture have a role as
adjunctive treatments to achieve optimal results. The etiology of multijet
PVR can differ between patients, this heterogeneity underscores the
paucity of data to guide treatment strategies. Therefore, successful
treatment of multijet PVR requires familiarity with available therapeutic
options to achieve optimal results and, by extension, decrease patient
mortality.<br/>Copyright &#xa9; 2020 The Authors. Clinical Cardiology
published by Wiley Periodicals LLC.

<80>
Accession Number
633351216
Title
Reduction in Revascularization With Icosapent Ethyl: Insights From
REDUCE-IT Revascularization Analyses.
Source
Circulation. 143 (1) (pp 33-44), 2021. Date of Publication: 05 Jan 2021.
Author
Peterson B.E.; Bhatt D.L.; Steg P.G.; Miller M.; Brinton E.A.; Jacobson
T.A.; Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.; Granowitz C.;
Gibson C.M.; Pinto D.; Giugliano R.P.; Budoff M.J.; Tardif J.-C.; Verma
S.; Ballantyne C.M.
Institution
(Peterson, Bhatt, Giugliano) Brigham and Women's Hospital Heart and
Vascular Center, Harvard Medical School, D.L.B., Boston
(Steg) Universite de Paris, AP-HP (Assistance Publique-Hopitaux de Paris),
Hopital Bichat, FACT (French Alliance for Cardiovascular Trials), INSERM
U-1148
(Miller) Department of Medicine, University of Maryland School of Medicine
(Brinton) Utah Lipid Center
(Jacobson) Office of Health Promotion and Disease Prevention, Department
of Medicine, Emory University School of Medicine, Atlanta, United States
(Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma, Inc (Amarin),
R.A.J., L.J., R.T.D., Bridgewater, United States
(Gibson, Pinto) Baim Clinical Research Institute, Boston
(Budoff) David Geffen School of Medicine, Torrance
(Tardif) Montreal Heart Institute, QC, Universite de Montreal, Montreal,
France
(Verma) Division of Cardiac Surgery, St Michael's Hospital, University of
Toronto, ON
(Ballantyne) Department of Medicine, Baylor College of Medicine, Center
for Cardiovascular Disease Prevention, Methodist DeBakey Heart and
Vascular Center, Houston
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients with elevated triglycerides despite statin therapy
have increased risk for ischemic events, including coronary
revascularizations. <br/>METHOD(S): REDUCE-IT (The Reduction of
Cardiovascular Events with Icosapent Ethyl-Intervention Trial), a
multicenter, double-blind, placebo-controlled trial, randomly assigned
statin-treated patients with elevated triglycerides (135-499 mg/dL),
controlled low-density lipoprotein (41-100 mg/dL), and either established
cardiovascular disease or diabetes plus other risk factors to receive
icosapent ethyl 4 g/d or placebo. The primary and key secondary composite
end points were significantly reduced. Prespecified analyses examined all
coronary revascularizations, recurrent revascularizations, and
revascularization subtypes. <br/>RESULT(S): A total of 8179 randomly
assigned patients were followed for 4.9 years (median). First
revascularizations were reduced to 9.2% (22.5/1000 patient-years) with
icosapent ethyl versus 13.3% (33.7/1000 patient-years) with placebo
(hazard ratio, 0.66 [95% CI, 0.58-0.76]; P<0.0001; number needed to treat
for 4.9 years=24); similar reductions were observed in total (first and
subsequent) revascularizations (negative binomial rate ratio, 0.64 [95%
CI, 0.56-0.74]; P<0.0001), and across elective, urgent, and emergent
revascularizations. Icosapent ethyl significantly reduced percutaneous
coronary intervention (hazard ratio, 0.68 [95% CI, 0.59-0.79]; P<0.0001)
and coronary artery bypass grafting (hazard ratio, 0.61 [95% CI,
0.45-0.81]; P=0.0005). <br/>CONCLUSION(S): Icosapent ethyl reduced the
need for first and subsequent coronary revascularizations in
statin-treated patients with elevated triglycerides and increased
cardiovascular risk. To our knowledge, icosapent ethyl is the first
non-low-density lipoprotein-lowering treatment that has been shown to
reduce coronary artery bypass grafting in a blinded, randomized trial.
Registration: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT01492361.

<81>
Accession Number
633423510
Title
The effect of immediate postoperative Boussignac CPAP on adverse pulmonary
events after thoracic surgery: A multicentre, randomised controlled trial.
Source
European journal of anaesthesiology. 38 (2) (pp 164-170), 2021. Date of
Publication: 01 Feb 2021.
Author
Puente-Maestu L.; Lopez E.; Sayas J.; Alday E.; Planas A.; Parise D.J.;
Martinez-Borja M.; Garutti I.
Institution
(Puente-Maestu) From the Servicio de Neumologia Hospital General
Universitario Gregorio Maranon (LP-M), Instituto de Investigacion
Sanitaria Gregorio Maranon (IiSGM) (LP-M, Facultad de Medicina Universidad
Complutense de Madrid (UCM) (LP-M, Servicio de Anestesia Hospital General
Universitario Gregorio Maranon (IG), Servicio de Anestesia Hospital
General Universitario 12 de Octubre (EL), Instituto de Investigacion
Sanitaria 12 de Octubre (I+12) (EL, Servicio de Neumologia Hospital
General Universitario 12 de Octubre (JS), Servicio de Anestesia Hospital
General Universitario La Princesa (EA, Instituto de Investigacion
Sanitaria del Hospital de la Princesa (IIS La Princea) (EA, Facultad de
Medicina Universidad Autonoma de Madrid (UAM) (EA, Servicio de Anestesia
Hospital General Universitario Ramon y Cajal (DJP, Instituto de
Investigacion Sanitaria Hospital Ramon y Cajal (IRICYS) (DJP, Facultad de
Medicina Universidad de Alcala de Henares (UAH), Madrid, Spain
Publisher
NLM (Medline)
Abstract
BACKGROUND: The effectiveness of prophylactic continuous positive pressure
ventilation (CPAP) after thoracic surgery is not clearly established.
<br/>OBJECTIVE(S): The aim of this study was to assess the effectiveness
of CPAP immediately after lung resection either by thoracotomy or
thoracoscopy in preventing atelectasis and pneumonia. DESIGN: A
multicentre, randomised, controlled, open-label trial. SETTINGS: Four
large University hospitals at Madrid (Spain) from March 2014 to December
2016. PATIENTS: Immunocompetent patients scheduled for lung resection,
without previous diagnosis of sleep-apnoea syndrome or severe bullous
emphysema. Four hundred and sixty-four patients were assessed, 426 were
randomised and 422 were finally analysed. INTERVENTION: Six hours of
continuous CPAP through a Boussignac system versus standard care. MAIN
OUTCOME MEASURES: Primary outcome: incidence of the composite endpoint
'atelectasis + pneumonia'. Secondary outcome: incidence of the composite
endpoint 'persistent air leak + pneumothorax'. <br/>RESULT(S): The primary
outcome occurred in 35 patients (17%) of the CPAP group and in 58 (27%) of
the control group [adjusted relative risk (ARR) 0.53, 95% CI 0.30 to
0.93]. The secondary outcome occurred in 33 patients (16%) of the CPAP
group and in 29 (14%) of the control group [ARR 0.92, 95% CI 0.51 to
1.65]. <br/>CONCLUSION(S): Prophylactic CPAP decreased the incidence of
the composite endpoint 'postoperative atelectasis + pneumonia' without
increasing the incidence of the endpoint 'postoperative persistent air
leaks + pneumothorax'.<br/>Copyright &#xa9; 2020 European Society of
Anaesthesiology and Intensive Care. Unauthorized reproduction of this
article is prohibited.

<82>
Accession Number
632749674
Title
Safety and effectiveness of strategies to reduce radiation exposure to
proceduralists performing cardiac catheterization procedures: a systematic
review.
Source
JBI evidence synthesis. 19 (1) (pp 4-33), 2020. Date of Publication: 24
Sep 2020.
Author
Fernandez R.; Ellwood L.; Barrett D.; Weaver J.
Institution
(Fernandez, Ellwood) Centre for Evidence Based Initiatives in Health Care:
A JBI Centre of Excellence, NSW, Wollongong, Australia
(Fernandez, Ellwood) Centre for Research in Nursing and Health, St George
Hospital, NSW, Sydney, Australia
(Fernandez) School of Nursing, University of Wollongong, NSW, Sydney,
Australia
(Barrett) Interventional Cardiology, St Andrews Private Hospital, Ipswich,
Australia
(Weaver) Cardiology Department, Royal Prince Alfred Hospital, NSW, Sydney,
Australia
(Weaver) School of Medicine, University of New South Wales, NSW, Sydney,
Australia
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The objective of this systematic review was to synthesize the
best available evidence on the effect of various radiation protection
strategies on radiation dose received by proceduralists performing cardiac
catheterization procedures involving fluoroscopy. INTRODUCTION: Cardiac
catheterization procedures under fluoroscopy are the gold standard
diagnostic and treatment method for patients with coronary artery disease.
The growing demand of procedures means that proceduralists are being
exposed to increasing amounts of radiation, resulting in an increased risk
of deterministic and stochastic effects. Standard protective strategies
and equipment such as lead garments reduce radiation exposure; however,
the evidence surrounding additional equipment is contradictory. INCLUSION
CRITERIA: Randomized controlled trials that compared the use of an
additional radiation protection strategy with conventional radiation
protection methods were considered for inclusion. The primary outcome of
interest was the radiation dose received by the proceduralist during
cardiac catheterization procedures. <br/>METHOD(S): A three-step search
was conducted in MEDLINE, CINAHL, Embase, and the Cochrane Library
(CENTRAL). Trials published in the English language with adult
participants were included. Trials published from database inception until
July 2019 were eligible for inclusion. The methodological quality of the
included studies was assessed using the JBI critical appraisal checklist
for randomized controlled trials. Quantitative data were extracted from
the included papers using the JBI data extraction tool. Results that could
not be pooled in meta-analysis were reported in a narrative form.
<br/>RESULT(S): Fifteen randomized controlled trials were included in the
review. Six radiation protection strategies were assessed: leaded and
unleaded pelvic or arm drapes, transradial protection board, remotely
controlled mechanical contrast injector, extension tubing for contrast
injection, real-time radiation monitor, and a reduction in frame rate to
7.5 frames per second. Pooled data from two trials demonstrated a
statistically significant decrease in the mean radiation dose (P <
0.00001) received by proceduralists performing transfemoral cardiac
catheterization on patients who received a leaded pelvic drape compared to
standard protection. One trial that compared the use of unleaded pelvic
drapes placed on patients compared to standard protection reported a
statistically significant decrease (P = 0.004) in the mean radiation dose
received by proceduralists.Compared to standard protection, two trials
that used unleaded arm drapes for patients, one trial that used a remotely
controlled mechanical contrast injector, and one trial that used a
transradial protection board demonstrated a statistically significant
reduction in the radiation dose received by proceduralists.Similarly,
using a frame rate of 7.5 versus 15 frames per second and monitoring
radiation dose in real-time radiation significantly lowered the radiation
dose received by the proceduralist. One trial demonstrated no
statistically significant difference in proceduralist radiation dose among
those who used the extension tubing compared to standard protection (P =
1). <br/>CONCLUSION(S): This review provides evidence to support the use
of leaded pelvic drapes for patients as an additional radiation protection
strategy for proceduralists performing transradial or transfemoral cardiac
catheterization. Further studies on the effectiveness of using a lower
fluoroscopy frame rate, real-time radiation monitor, and transradial
protection board are needed.<br/>Copyright &#xa9; 2021 JBI.

<83>
Accession Number
633796619
Title
Guided relaxation-based virtual reality versus distraction-based virtual
reality or passive control for postoperative pain management in children
and adolescents undergoing Nuss repair of pectus excavatum: Protocol for a
prospective, randomised, controlled trial (FOREVR Peds trial).
Source
BMJ Open. 10 (12) (no pagination), 2020. Article Number: e040295. Date of
Publication: 30 Dec 2020.
Author
Olbrecht V.A.; Williams S.E.; O'Conor K.T.; Boehmer C.O.; Marchant G.W.;
Glynn S.M.; Geisler K.J.; Ding L.; Yang G.; King C.D.
Institution
(Olbrecht, O'Conor, Boehmer, Marchant, Glynn, Geisler) Department of
Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati,
OH, United States
(Williams, King) Division of Behavioral Medicine and Clinical Psychology,
Department of Pediatrics, Cincinnati Children's Hospital Medical Center,
Cincinnati, OH, United States
(Ding, Yang) Divsion of Biostatistics and Epidemiology, Department of
Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH,
United States
Publisher
BMJ Publishing Group
Abstract
Introduction Virtual reality (VR) offers an innovative method to deliver
non-pharmacological pain management. Distraction-based VR (VR-D) using
immersive games to redirect attention has shown short-term pain reductions
in various settings. To create lasting pain reduction, VR-based strategies
must go beyond distraction. Guided relaxation-based VR (VR-GR) integrates
pain-relieving mind-body based guided relaxation with VR, a novel therapy
delivery mechanism. The primary aim of this study is to assess the impact
of daily VR-GR, VR-D and 360 video (passive control) on pain intensity. We
will also assess the impact of these interventions on pain unpleasantness,
anxiety and opioid and benzodiazepine consumption. The secondary aim of
this study will assess the impact of psychological factors (anxiety
sensitivity and pain catastrophising) on pain following VR. Methods and
analysis This is a single centre, prospective, randomised, clinical trial.
Ninety children/adolescents, aged 8-18 years, presenting for Nuss repair
of pectus excavatum will be randomised to 1 of 3 study arms (VR-GR, VR-D
and 360 video). Patients will use the Starlight Xperience (Google
Daydream) VR suite for 10 min. Patients randomised to VR-GR (n=30) will
engage in guided relaxation/mindfulness with the Aurora application.
Patients randomised to VR-D (n=30) will play 1 of 3 distraction-based
games, and those randomised to the 360 video (n=30) will watch the Aurora
application without audio instructions or sound. Primary outcome is pain
intensity. Secondary outcomes include pain unpleasantness, anxiety and
opioid and benzodiazepine consumption. Ethics and dissemination This study
follows Standard Protocol Items: Recommendations for Interventional Trials
guidelines. The protocol was approved by the Cincinnati Children's
Hospital Medical Center's institutional review board. Patient recruitment
began in July 2020. Written informed consent will be obtained for all
participants. All information acquired will be disseminated via scientific
meetings and published in peer-reviewed journals. Trial registration
number NCT04351776.<br/>Copyright &#xa9; 2020 BMJ Publishing Group. All
rights reserved.

<84>
Accession Number
2010511356
Title
Anesthetic Induction With Etomidate in Cardiac Surgical Patients: A
PRISMA-Compliant Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Yao Y.-T.; He L.-X.; Fang N.-X.; Ma J.
Institution
(Yao, He, Fang) Department of Anesthesiology, Fuwai Hospital, National
Center for Cardiovascular Diseases, Peking Union Medical College and
Chinese Academy of Medical Sciences, Beijing, China
(Ma) Department of Pharmacy, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Publisher
W.B. Saunders
Abstract
Objective: This meta-analysis aimed to systematically review the effects
of etomidate (ETM) during anesthetic induction on patients undergoing
cardiac surgery. <br/>Design(s): Systematic review and meta-analysis.
<br/>Setting(s): Operating room. <br/>Participant(s): Patients undergoing
cardiac surgery. <br/>Intervention(s): ETM or control drugs.
<br/>Measurements and Main Results: PubMed, Cochrane Library, OVID, and
EMBASE were searched through August 31, 2020. Primary outcomes included
hemodynamic profiles and stress responses. Secondary outcomes included
morbidity, mortality, and postoperative recovery. For
continuous/dichotomous variables, treatment effects were calculated as
weighted mean difference (WMD)/odds ratio (OR) and 95% confidence interval
(CI). A database search yielded 18 randomized controlled trials including
1,241 patients. The present meta-analysis demonstrated that
ETM-anesthetized patients had lower heart rates (WMD, -3.31; 95% CI -5.43
to -1.19; p = 0.002), higher blood pressures (systolic blood pressure:
WMD, 12.02; 95% CI 6.24 to 17.80; p < 0.0001; diastolic blood pressure:
WMD, 5.23; 95% CI 2.39 to 8.08; p = 0.0003; mean arterial pressure (MAP):
WMD, 8.64; 95% CI 5.85 to 11.43; p < 0.00001), less requirement for
vasopressor (OR, 0.26; 95% CI 0.15 to 0.44; p < 0.00001), and more
nitroglycerin usage (OR, 14.89; 95% CI 4.92 to 45.08; p < 0.00001) during
anesthetic induction. Current meta-analysis also demonstrated that
single-dose ETM lowered cortisol levels transiently and did not have a
significant effect on endogenous norepinephrine and epinephrine levels and
was not associated with increased postoperative inotrope and/or
vasopressor requirement. Additionally, the meta-analysis suggested that
ETM anesthesia was associated with neither increased mortality nor
morbidity, except a higher incidence of transient adrenal insufficiency in
ETM recipients. <br/>Conclusion(s): The present meta-analysis suggested
that single-dose ETM during anesthetic induction could be associated with
more stable hemodynamics, transient and reversible lower cortisol levels,
and a higher adrenal insufficiency incidence, but not worse outcomes in
cardiac surgical patients.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<85>
Accession Number
633900443
Title
A comparison of cryoprecipitate versus fibrinogen concentrate on
fibrinogen measurements using TEGA functional fibrinogen and Clauss
fibrinogen levels in infants undergoing cardiac surgery.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. Conference: 2020
Annual Meeting of the Congenital Cardiac Anesthesia Society, CCAS 2020.
Bahamas. 24 (3) (pp 250-251), 2020. Date of Publication: 2020.
Author
Fiedorek M.; Downey L.; Miller K.
Institution
(Fiedorek, Downey, Miller) Emory University, Atlanta, GA, United States
Publisher
SAGE Publications Inc.
Abstract
Introduction: Acquired hypofibrinogenemia after cardiopulmonary bypass
(CPB) and a dysfunctional form of fibrinogen increase the proclivity of
bleeding in infants during cardiac surgery. The Thromboelastogram
Functional Fibrinogen assay (TEG-FF; TEGA, Haemonetics Corporation,
Braintree, MA) has been used to estimate fibrinogen levels and clot
strength to guide transfusions in adult cardiac patients. Few studies have
examined its utility in assessing fibrinogen deficiencies in infants
undergoing cardiac surgery. While cryoprecipitate (cryo) has been used to
supplement fibrinogen in infants; fibrinogen concentrate (FC; Riastap, CSL
Behring, Kankakee, IL), a blood product alternative, may have advantages
that mitigate transfusion risks. In this study, we examine the
correlations between TEG-FF parameters and plasma fibrinogen (PFib) before
and after CPB in infants undergoing cardiac surgery who received
fibrinogen replacement with either cryo or FC. <br/>Method(s): After IRB
approval and parental consent, infants were randomized to receive either
cryo or FC. A post-transfusion PFib level of 300 mg/dL was targeted. PFib
and TEG-FF assays were drawn at two points: Before CPB (baseline) and
post-CPB after transfusion (PT). We compared the correlations of PFib and
TEG-FF parameters (MA-FF and FLEV) between the two groups using the
Pearson correlation coefficient. <br/>Result(s): A total of 33 patients
were included in the study (15 cryo; 18 FC). There were no significant
differences between groups, including fibrinogen levels, platelet
transfusion, and chest tube output (Table 1). Linear correlation
coefficients between FLEV and PFib in all patients were R = 0.404 (p =
0.03) at baseline and R = 0.722 (p 0.001) PT. Although PFib were not
statistically different between groups, linear correlation coefficients
between FLEV and PFib PT were greater in the cryo group (R = 0.88; p
0.001) than the FC group (R = 0.488; p = 0.07). Correlations between PFib
and MA-FF were similar to those seen with FLEV (Table 2).
<br/>Discussion(s): FLEV correlated linearly with PFib levels before CPB
and improved PT. The stronger correlation PT may reflect replacement with
adult fibrinogen or greater platelet inhibition after CPB. The correlation
between FLEV and PFib was higher in the cryo group despite similar PFib
values which may suggest in vivo qualitative differences in hemostasis
between cryo and FC. <br/>Conclusion(s): While these findings warrant
further investigation, our findings suggest TEG-FF assay may provide a
point-of-care test to assess the quantitative and qualitative fibrinogen
deficiencies for infants undergoing cardiac surgery to enable
goal-directed transfusions.

<86>
Accession Number
633905971
Title
Bras for Breast Support After Sternotomy: Patient Satisfaction and Wear
Compliance.
Source
American journal of critical care : an official publication, American
Association of Critical-Care Nurses. 30 (1) (pp 21-26), 2021. Date of
Publication: 01 Jan 2021.
Author
Bolling K.; Long T.; Jennings C.D.; Dane F.C.; Carter K.F.
Institution
(Bolling) Carilion Roanoke Memorial Hospital, Kimberly Bolling is a
registered nurse in the cardiac surgery intensive care unit, Roanoke, VA,
United States
(Long) Carilion Roanoke Memorial Hospital, Takako Long is a registered
nurse in the cardiovascular progressive care unit, Roanoke, VA, United
States
(Jennings) Carilion Roanoke Memorial Hospital, Cathy D. Jennings is a
clinical nurse specialist
(Dane) Francis C. Dane is a professor of psychology, Radford University,
Radford, Virginia, and a professor of interprofessionalism, Virginia Tech
Carilion School of Medicine, Roanoke, Virginia
(Carter) nursing research, Carilion Clinic, Kimberly Ferren Carter is
senior director, Roanoke, VA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: For women undergoing median sternotomy, especially those with
a bra cup size C or larger, breast support can reduce pain, wound
breakdown, and infection. This study addressed a gap in research,
identifying the best bra after sternotomy in terms of patient satisfaction
and wear compliance. <br/>OBJECTIVE(S): To evaluate larger-breasted
women's satisfaction and compliance with wearing 3 commercially available
front-closure bras-with a hook-loop closure (the hospital's standard of
care), a zipper closure, or a hook-eye closure-after cardiac surgery.
<br/>METHOD(S): This study used a posttest-only, 3-group randomized
controlled design. A convenience sample of participants were sized and
randomly assigned a product that was placed immediately postoperatively.
Participants agreed to wear the bra at least 20 h/d until the provider
cleared them for less wear. At inpatient day 5 or discharge, and at the
follow-up outpatient visit, subjects completed investigator-developed
surveys. Data were analyzed from 60 participants by using the chi2 test
and Kruskal-Wallis analysis of variance; also, patterns were identified
within written comments. <br/>RESULT(S): Participants were most satisfied
with the hook-eye front-closure product before (P = .05) and after (P =
.02) discharge. Participants recommended the hook-eye and zipper products
over the hook-loop bra (H = 8.39, P = .02). Wear compliance was strongest
in the group wearing the hook-eye bra. <br/>CONCLUSION(S): The hook-eye
closure product had the most satisfaction and greatest wear compliance,
and it received the highest recommendation. A practice change was made to
fit and place the hook-eye bra in the operating room immediately after
surgery.<br/>Copyright &#xa9;2021 American Association of Critical-Care
Nurses.

<87>
Accession Number
2010157957
Title
Risk factors for unplanned reintubation caused by acute airway compromise
after general anesthesia: a case-control study.
Source
BMC Anesthesiology. 21 (1) (no pagination), 2021. Article Number: 17. Date
of Publication: December 2021.
Author
Chen S.; Zhang Y.; Che L.; Shen L.; Huang Y.
Institution
(Chen, Che, Shen, Huang) Department of Anesthesiology, Peking Union
Medical College Hospital, Chinese Academy of Medical Science & Peking
Union Medical College, Beijing 100730, China
(Zhang) Medical Research Center, Peking Union Medical College Hospital,
Chinese Academy of Medical Science & Peking Union Medical College, Beijing
100730, China
Publisher
BioMed Central Ltd
Abstract
Background: This study aimed to identify the risk factors and evaluate the
prognosis of unplanned reintubation caused by acute airway compromise
(AAC) after general anesthesia. <br/>Method(s): This case-control study
included surgical patients who underwent unplanned reintubation in the
operating room and postanesthesia care unit after general anesthesia
between January 1, 2014, and December 31, 2018. Cases due to AAC were
matched 1:4 with randomly selected controls. <br/>Result(s): A total of
123,068 patients were included, and reintubation due to AAC was performed
in 36 patients (approximate incidence 0.03%). Univariable analysis
revealed that male sex, age > 65, ASA physical status 3, sepsis, heart
disease history, cerebral infarction history, Cormack Lehane grade,
surgery type, fresh frozen plasma infusion, increased intubation duration,
white blood cell count, and creatinine clearance rate were related to
AAC-caused unplanned reintubation. Multivariable analysis revealed that
age > 65 (OR = 7.50, 95% CI 2.47-22.81, P < 0.001), ASA physical status 3
(OR = 6.51, 95% CI 1.18-35.92, P = 0.032), head-neck surgery (OR = 4.94,
95% CI 1.33-18.36, P = 0.017) or thoracic surgery (OR = 12.56, 95% CI
2.93-53.90, P < 0.001) and a high fluid load (OR = 3.04, 95% CI 1.16-7.99,
P = 0.024) were associated with AAC-caused unplanned reintubation.
AAC-caused unplanned reintubation patients had longer postoperative
hospital (OR = 5.26, 95% CI 1.57-8.95, P < 0.001) and intensive care unit
days (OR = 3.94, 95% CI 1.69-6.18, P < 0.001). <br/>Conclusion(s): Age >
65, ASA physical status 3, head-neck or thoracic surgery and high fluid
load were found to be associated with AAC-caused unplanned
reintubation.<br/>Copyright &#xa9; 2021, The Author(s).

<88>
[Use Link to view the full text]
Accession Number
2010627466
Title
Automated closed-loop versus standard manual oxygen administration after
major abdominal or thoracic surgery: An international multicentre
randomised controlled study.
Source
European Respiratory Journal. 57 (1) (no pagination), 2021. Article
Number: 2000182. Date of Publication: 01 Jan 2021.
Author
L Her E.; Jaber S.; Verzilli D.; Jacob C.; Huiban B.; Futier E.; Kerforne
T.; Pateau V.; Bouchard P.-A.; Consigny M.; Lellouche F.
Institution
(L Her) Medical Intensive Care, Chru de Brest la Cavale Blanche, Brest,
France
(L Her, Pateau) Latim Inserm Umr 1101, Fhu Techsan, Universite de Bretagne
Occidentale, Brest, France
(Jaber, Verzilli) Intensive Care Unit, Dept of Anaesthesiology B, Dar B
Chu de Montpellier, Hopital Saint Eloi, Universite Montpellier 1,
Montpellier, France
(Jacob, Huiban) Anaesthesiology Dept, Chru de Brest la Cavale Blanche,
Brest, France
(Futier) Anaesthesiology Dept, Hopital Estaing, Centre Hospitalier
Universitaire Clermont-Ferrand, Clermont-Ferrand, France
(Kerforne) Anaesthesiology Dept, Chu de Poitiers, Cedex, France
(Pateau) Oxynov Inc., Technopole Brest Iroise, Plouzane, France
(Bouchard, Lellouche) Centre de Recherche de L Institut de Cardiologie et
de Pneumologie de Quebec, QC, Canada
(Consigny) Centre D Investigation Clinique Cic Inserm 1412, Chru Brest la
Cavale Blanche, Brest, France
Publisher
European Respiratory Society
Abstract
Introduction: Hypoxaemia and hyperoxaemia may occur after surgery, with
related complications. This multicentre randomised trial evaluated the
impact of automated closed-loop oxygen administration after high-risk
abdominal or thoracic surgeries in terms of optimising the oxygen
saturation measured by pulse oximetry time within target range.
<br/>Method(s): After extubation, patients with an intermediate to high
risk of post-operative pulmonary complications were randomised to
"standard" or "automated" closed-loop oxygen administration. The primary
outcome was the percentage of time within the oxygenation range, during a
3-day frame. The secondary outcomes were the time with hypoxaemia and
hyperoxaemia under oxygen. <br/>Result(s): Among the 200 patients, time
within range was higher in the automated group, both initially (3 h;
91.4+/-13.7% versus 40.2+/-35.1% of time, difference +51.0% (95%
CI-42.8-59.2%); p0.0001) and during the 3-day period (94.0+/-11.3% versus
62.1+/-23.3% of time, difference +31.9% (95% CI 26.3-37.4%); p0.0001).
Periods of hypoxaemia were reduced in the automated group (3 days;
32.6+/-57.8 min (1.2+/-1.9%) versus 370.5+/-594.3 min (5.0+/-11.2%),
difference-10.2% (95% CI-13.9-6.6%); p0.0001), as well as hyperoxaemia
under oxygen (3 days; 5.1+/-10.9 min (4.8+/-11.2%) versus 177.9+/-277.2
min (27.0+/-23.8%), difference-22.0% (95% CI-27.6-16.4%); p0.0001).
Kaplan-Meier analysis depicted a significant difference in terms of
hypoxaemia (p=0.01) and severe hypoxaemia (p=0.0003) occurrence between
groups in favour of the automated group. 25 patients experienced
hypoxaemia for 10% of the entire monitoring time during the 3 days within
the standard group, as compared to the automated group (p0.0001).
<br/>Conclusion(s): Automated closed-loop oxygen administration promotes
greater time within the oxygenation target, as compared to standard manual
administration, thus reducing the occurrence of hypoxaemia and
hyperoxaemia.<br/>Copyright &#xa9; 2021 European Respiratory Society. All
rights reserved.

<89>
Accession Number
633903969
Title
Multivariable risk scores for predicting short term outcomes for emergency
department patients with unexplained syncope: a systematic review.
Source
Academic emergency medicine : official journal of the Society for Academic
Emergency Medicine. (no pagination), 2020. Date of Publication: 31 Dec
2020.
Author
Sweanor R.A.; Redelmeier R.J.; Simel D.L.; Albassam O.T.; Shadowitz S.;
Etchells E.E.
Institution
(Sweanor, Redelmeier, Albassam, Shadowitz, Etchells) Department of
Medicine, University of Toronto, Toronto, ON, Canada
(Redelmeier, Albassam, Shadowitz, Etchells) Department of Medicine
Sunnybrook Health Science Centre, University of Toronto, Toronto, ON,
Canada
(Simel) Division of General Internal Medicine, Duke Veterans Affairs
Medical Center, Durham, NC, United States
(Simel) Duke University, Durham, NC, United States
(Albassam) Division of Cardiology, King Abdulaziz University Hospital,
King Abdulaziz University, Jeddah, Saudi Arabia
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Emergency department patients with unexplained syncope are at
risk of experiencing an adverse event within 30 days. Our objective was to
systematically review the accuracy of multivariate risk stratification
scores for identifying adult syncope patients at high and low risk of an
adverse event over the next 30 days. <br/>METHOD(S): We conducted a
systematic review of electronic databases (MEDLINE, Cochrane, Embase and
CINAHL) from database creation until May 2020. We sought studies
evaluating prediction scores of adults presenting to an emergency
department with syncope. We included studies that followed patients for up
to 30 days to identify adverse events such as death, myocardial
infarction, stroke, or cardiac surgery. We only included studies with a
blinded comparison between baseline clinical features and adverse events.
We calculated likelihood ratios and confidence intervals. <br/>RESULT(S):
We screened 13,788 abstracts. We included 17 studies evaluating nine risk
stratification scores on 24,234 patient visits, where 7.5% (95% CI
5.3-10%) experienced an adverse event. A Canadian Syncope Risk Score of 4
or more was associated with a high likelihood of an adverse event (LR
score=4 or more 11 [95% CI 8.9-14). A Canadian Syncope Risk Score of 0 or
less (LR Score = 0 or less 0.10 [95% CI 0.07-0.20]) was associated with a
low likelihood of an adverse event. Other risk scores were not validated
on an independent sample, had low positive likelihood ratios for
identifying patients at high risk, or had high negative likelihood ratios
for identifying patients at low risk. <br/>CONCLUSION(S): Many risk
stratification scores are not validated or not sufficiently accurate for
clinical use. The Canadian Syncope Risk Score is an accurate validated
prediction score for emergency department patients with unexplained
syncope. Its impact on clinical decision making, admission rates, cost or
outcomes of care is not known.<br/>Copyright This article is protected by
copyright. All rights reserved.

<90>
Accession Number
633902916
Title
Pulmonary Valve Replacement in Tetralogy of Fallot: An Updated
Meta-Analysis.
Source
The Annals of thoracic surgery. (no pagination), 2020. Date of
Publication: 27 Dec 2020.
Author
Van den Eynde J.; Sa M.P.B.O.; Vervoort D.; Roever L.; Meyns B.; Budts W.;
Gewillig M.; Ruhparwar A.; Zhigalov K.; Weymann A.
Institution
(Van den Eynde, Meyns) Department of Cardiovascular Diseases, Unit of
Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
(Sa) Division of Cardiovascular Surgery of Pronto Socorro Cardiologico de
Pernambuco, PROCAPE, University of Pernambuco, Recife, Pernambuco, Brazil
(Vervoort) Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,
United States
(Roever) Department of Clinical Research, Federal University of
Uberlandia, Brazil
(Budts) Congenital and Structural Cardiology University Hospitals Leuven &
Department of Cardiovascular Sciences, Catholic University Leuven, Leuven,
Belgium
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Ruhparwar, Zhigalov, Weymann) Department of Thoracic and Cardiovascular
Surgery, West German Heart and Vascular Center, Essen, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: The benefits of pulmonary valve replacement (PVR) for
pulmonary insufficiency in patients with repaired tetralogy of Fallot
(TOF) are still incompletely understood, and optimal timing remains
challenging. <br/>METHOD(S): We systematically reviewed databases
(PubMed/MEDLINE, EMBASE, CENTRAL/CCTR, ClinicalTrials.gov, SciELO, LILACS,
Google Scholar) and reference lists of relevant articles for studies about
PVR in repaired TOF patients that reported any of the following outcomes:
mortality and redo-PVR rates, right (RV) and left ventricular (LV)
measures, QRS duration, cardiopulmonary exercise test (CPET) results, or
brain natriuretic peptide (BNP). In addition to calculating the pooled
treatment effects using a random effects meta-analysis, we evaluated the
effect of pre-operative measures on PVR outcomes using meta-regressions.
<br/>RESULT(S): Eighty-four studies involving 7,544 patients met the
eligibility criteria. Pooled mortality at 30 days, 5 year, and 10 year
after PVR was 0.87% (80 studies; 63 of 7,253 patients), 2.7% (37 studies;
132 of 4,952 patients), and 6.2% (15 studies; 510 of 2,765 patients),
respectively. Pooled 5 and 10 year re-PVR were 3.7% (23 studies; 141 of
3,755 patients) and 16.8% (16 studies; 172 of 3,035 patients),
respectively. The results of the previous meta-analysis could be
confirmed. In addition, it could be demonstrated that after PVR: 1) QRS
duration, CPET results, and RV and LV longitudinal strain do not
significantly change; 2) BNP decreases; and 3) greater indexed RV
end-diastolic and end-systolic volumes are associated with lower chances
of RV volume normalization after PVR. <br/>CONCLUSION(S): This updated
meta-analysis provides evidence about the benefits of PVR.<br/>Copyright
&#xa9; 2020. Published by Elsevier Inc.