EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 75

Results Generated From:
Embase <1980 to 2021 Week 01>
Embase (updates since 2021-01-04)
Embase <1980 to 2021 Week 01>
Embase (updates since 2021-01-04)

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

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

<3>
Accession Number
633518089
Title
Open-label, single-centre, cluster-randomised controlled trial to Evaluate
the Potential Impact of Computerisedantimicrobial stewardship (EPIC) on
the antimicrobial use after cardiovascular surgeries: EPIC trial study
original protocol.
Source
BMJ Open. 10 (11) (no pagination), 2020. Article Number: e039717. Date of
Publication: 26 Nov 2020.
Author
Yuan X.; Chen K.; Zhao W.; Yu F.; Diao X.; Chen X.; Hu S.
Institution
(Yuan, Chen, Hu) State Key Laboratory of Cardiovascular Disease, National
Centre for Cardiovascular Diseases, Beijing, China
(Yuan, Chen, Hu) Department of Cardiovascular Surgery, Fuwai Hospital,
Chinese Academy of Medical Science and Peking Union Medical College,
Beijing, China
(Zhao, Yu, Diao) Information Centre, Fuwai Hospital, Chinese Academy of
Medical Science and Peking Union Medical College, Beijing, China
(Hu) National Clinical Research Centre of Cardiovascular Diseases, State
Key Lab. of Cardiovasc. Disease, Fuwai Hospital, National Centre for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Chen) Department of Pharmacy, Fuwai Hospital, Chinese Academy of Medical
Science and Peking Union Medical College, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Inappropriate antimicrobial use increases the prevalence of
antimicrobial-resistant bacteria. Surgeons are reluctant to implement
recommendations of guidelines in clinical practice. Antimicrobial
stewardship (AMS) is effective in antimicrobial management, but it remains
labour intensive. The computerised decision support system (CDSS) has been
identified as an effective way to enable key elements of AMS in clinical
settings. However, insufficient evidence is available to evaluate the
efficacy of computerised AMS in surgical settings. Methods and analysis
The Evaluate of the Potential Impact of Computerised AMS trial is an
open-label, single-centre, two-Arm, cluster-randomised, controlled trial,
which aims to determine whether a multicomponent CDSS intervention reduces
overall antimicrobial use after cardiovascular surgeries compared with
usual clinical care in a specialty hospital with a big volume of
cardiovascular surgeries. Eighteen cardiovascular surgical teams will be
randomised 1:1 to either the intervention or the control arm. The
intervention will consist of (1) re-evaluation alerts and decision support
for the duration of antimicrobial treatment decision, (2) re-evaluation
alerts and decision support for the choice of antimicrobial, (3) quality
control audit and feedback. The primary outcome will be the overall
systemic antimicrobial use measured in days of therapy (DOT) per admission
and DOT per 1000 patient-days over the whole intervention period (6
months). Secondary outcomes include a series of indices to evaluate
antimicrobial use, microbial resistance, perioperative infection outcomes,
patient safety, resource consumption, and user compliance and
satisfaction. Ethics and dissemination The Ethics Committee in Fuwai
Hospital approved this study (2020-1329). The results of the trial will be
submitted for publication in a peer-reviewed journal. Trial registration
number NCT04328090.<br/>Copyright &#xa9; 2020 BMJ. All rights reserved.

<4>
Accession Number
2010329719
Title
Surgical interventions for pediatric unilateral vocal fold paralysis: A
systematic review and meta-analysis.
Source
International Journal of Pediatric Otorhinolaryngology. 141 (no
pagination), 2021. Article Number: 110553. Date of Publication: February
2021.
Author
Aires M.M.; Marinho C.B.; Vasconcelos S.J.D.
Institution
(Aires, Marinho, Vasconcelos) Department of Otolaryngology-Head and Neck
Surgery of Hospital Das Clinicas da Universidade Federal de Pernambuco,
Recife, Pernambuco, Brazil
Publisher
Elsevier Ireland Ltd
Abstract
Objective: To evaluate outcomes of injection laryngoplasty (IL) and
laryngeal reinnervation for the treatment of pediatric Unilateral Vocal
Fold Paralysis (UVFP), especially on swallowing and quality of voice.
<br/>Method(s): A literature review was performed in Medline/PubMed and
Cochrane Library, following PRISMA guidelines, with no constraints on
publication date. We included studies in English, Portuguese or Spanish
about surgical treatment for UVFP on the pediatric population (0-21 years)
that documented outcomes for one of the following techniques: IL or
laryngeal reinnervation. Study characteristics, patient demographics,
technical aspects of each procedure, complications, and outcomes for voice
and swallowing were extracted. A meta-analysis with inverse variance,
random-effects model was performed. <br/>Result(s): The PRISMA approach
yielded 22 studies, totaling 267 patients. Seven reinnervation articles
were included in meta-analysis for maximum phonation time (MPT) and
quality of voice measured by Grade, Roughness, Breathiness, Asthenia and
Strain (GRBAS) scale. Cardiac surgery had caused UVFP in 62.8% (142/226)
of the cases. The main indication for IL was aspiration and for
reinnervation was dysphonia. For IL, there was an improvement of 84.5%
(confidence interval [CI] 82.6-88.4%) in swallowing and 81.4% (CI
74.6-88.1%) in voice. For reinnervation, there was an improvement of 91.6%
(CI 88.2-94.9%) in swallowing and 96.8% (CI 95.5-98.0%) in voice. We found
an increase of 6.19 s (CI 1.00 to 11.38) in MPT and a mean difference in
GRBAS sum of -3.53 points (CI -6.15 to -0.91) after reinnervation.
<br/>Conclusion(s): Retrospective cohort studies suggest that injection
laryngoplasty and reinnervation are both effective in improving swallowing
and voice in children with UVFP. There was clinical evidence of
improvement in the MPT and GRBAS scale meta-analysis in patients
undergoing reinnervation.<br/>Copyright &#xa9; 2020 Elsevier B.V.

<5>
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.

<6>
Accession Number
2007629343
Title
A rare case of late-onset ticagrelor-induced sinus arrest.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2020. Date of
Publication: 2020.
Author
Aranganathan P.; Wilson B.; Rangan A.; Boopathi A.; Balasundaram R.
Institution
(Aranganathan, Wilson, Rangan, Boopathi, Balasundaram) Department of
Cardiology, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, India
Publisher
SAGE Publications Inc.
Abstract
Ticagrelor is a potent reversible P2Y12 inhibitor with proven superiority
over clopidogrel. Ticagrelor increases the tissue concentration of
adenosine, thereby leading to bradyarrhythmia. This complication is
reported to occur very early after initiating the drug. A randomized
controlled trial reported that ticagrelor-induced pauses have an early
onset without much clinical impact. However, our patient developed
ticagrelor-induced hemodynamically significant sinus arrest 10 months
after coronary artery stenting, which improved after stopping the drug.
Ticagrelor should be considered as one of the uncommon reasons for
late-onset sinus pause or bradyarrhythmia.<br/>Copyright &#xa9; The
Author(s) 2020.

<7>
Accession Number
2007629295
Title
Pedicled versus skeletonized internal thoracic artery grafts: a randomized
trial.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2020. Date of
Publication: 2020.
Author
Dreifaldt M.; Samano N.; Geijer H.; Liden M.; Bodin L.; Souza D.
Institution
(Dreifaldt, Souza) Department of Cardiovascular and Thoracic Surgery,
School of Medical Sciences, Orebro University, Orebro, Sweden
(Samano) Department of Cardiothoracic and Vascular Surgery, and University
Health Care Research Center, Faculty of Medicine and Health, Orebro
University, Orebro, Sweden
(Geijer, Liden) Department of Radiology, School of Medical Sciences,
Orebro University, Orebro, Sweden
(Bodin) Institute of Environmental Medicine, Unit of Intervention and
Implementation Research, Karolinska Institute, Stockholm, Sweden
Publisher
SAGE Publications Inc.
Abstract
Objective: Concerns have been raised regarding whether skeletonization of
the internal thoracic artery could damage the graft and thereby reduces
its patency. The objective of this study was to compare patency rates at
mid- and long-term follow-up between pedicled and skeletonized left
internal thoracic artery grafts. <br/>Method(s): This randomized
controlled trial included 109 patients undergoing coronary artery bypass
surgery. The patients were assigned to receive either one pedicled or one
skeletonized left internal thoracic artery graft to the left anterior
descending artery. Follow-up was performed at 3 years with conventional
angiography, and at 8 years with computed tomography angiography.
Differences between patency rates were analyzed with Fisher's exact test
and a generalized linear model. <br/>Result(s): The patency rates for
pedicled and skeletonized left internal thoracic artery grafts were 46/48
(95.8%) versus 47/52 (90.4%), p = 0.44 at 3 years, and 40/43 (93.0%)
versus 37/41 (90.2%), p = 0.71 at 8 years, respectively. The difference in
patency rates for pedicled and skeletonized grafts was 5.4% (95%
confidence interval: -4.2-14.5) at 3 years and 2.8% (95% confidence
interval: -9.9-14.1) at 8 years. All failed grafts, except for one with a
localized stenosis, were anastomosed to native coronary arteries with a
stenosis less than 70%. Three patients suffered sternal wound infections
(two in the pedicled group, one in the skeletonized group).
<br/>Conclusion(s): The skeletonization technique can be used without
jeopardizing the patency of the left internal thoracic artery. The most
important factor in graft failure was target artery stenosis below
70%.<br/>Copyright &#xa9; The Author(s) 2020.

<8>
Accession Number
2007627575
Title
Veno-Arterial Extracorporeal Life Support in Heart Transplant and
Ventricle Assist Device Centres. Meta-analysis.
Source
ESC Heart Failure. (no pagination), 2020. Date of Publication: 2020.
Author
Kowalewski M.; Zielinski K.; Gozdek M.; Raffa G.M.; Pilato M.; Alanazi M.;
Gilbers M.; Heuts S.; Natour E.; Bidar E.; Schreurs R.; Delnoij T.;
Driessen R.; Sels J.W.; van de Poll M.; Roekaerts P.; Pasierski M.; Meani
P.; Maessen J.; Suwalski P.; Lorusso R.
Institution
(Kowalewski, Pasierski, Suwalski) Department of Cardiac Surgery, Central
Clinical Hospital of the Ministry of Interior, Centre of Postgraduate
Medical Education, Woloska 137 Str, Warsaw 02-507, Poland
(Kowalewski, Alanazi, Gilbers, Heuts, Natour, Bidar, Schreurs, Maessen,
Lorusso) Cardio-Thoracic Surgery Department, Maastricht University Medical
Centre, Maastricht, Netherlands
(Kowalewski, Gozdek) Thoracic Research Centre, Collegium Medicum, Nicolaus
Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
(Zielinski) Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
(Gozdek) Department of Cardiology and Internal Medicine, Collegium
Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Raffa, Pilato) Department for the Treatment and Study of Cardiothoracic
Diseases and Cardiothoracic Transplantation, ISMETT-IRCCS, Palermo, Italy
(Delnoij, Driessen, Sels, Meani) Cardiology Department, Maastricht
University Medical Centre, Maastricht, Netherlands
(Delnoij, Driessen, Sels, van de Poll, Roekaerts, Meani) Department of
Intensive Care, Maastricht University Medical Centre, Maastricht,
Netherlands
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM), University
of Maastricht, Maastricht, Netherlands
Publisher
Wiley-Blackwell
Abstract
Aims: Because reported mortality on veno-arterial (V-A) extracorporeal
life support (ECLS) substantially varies between centres, the aim of the
current analysis was to assess the outcomes between units performing heart
transplantation and/or implanting ventricular assist device (HTx/VAD) vs.
non-HTx/VAD units in patients undergoing V-A ECLS for cardiogenic shock.
<br/>Methods and Results: Systematic search according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses was performed
using PubMed/MEDLINE databases until 30 November 2019. Articles reporting
in-hospital/30-day mortality and centre's HTx/VAD status were included.
In-hospital outcomes and long-term survival were analysed in subgroup
meta-analysis. A total of 174 studies enrolling n = 13 308 patients were
included with 20 series performed in non-HTx/VAD centres (1016 patients,
7.8%). Majority of patients underwent V-A ECLS for post-cardiotomy shock
(44.2%) and acute myocardial infarction (20.7%). Estimated overall
in-hospital mortality was 57.2% (54.9-59.4%). Mortality rates were higher
in non-HTx/VAD [65.5% (59.8-70.8%)] as compared with HTx/VAD centres
[55.8% (53.3-58.2%)], P < 0.001. Estimated late survival was 61.8%
(55.7-67.9%) without differences between non-HTx/VAD and HTx/VAD centres:
66.5% (30.3-1.02%) vs. 61.7% (55.5-67.8%), respectively (P = 0.797). No
differences were seen with respect to ECLS duration, limb complications,
and reoperations for bleeding, kidney injury, and sepsis. Yet, weaning
rates were higher in HTx/VAD vs. non-HTx/VAD centres: 58.7% (56.2-61.1%)
vs. 48.9% (42.0-55.9%), P = 0.010. Estimated rate of bridge to heart
transplant was 6.6% (5.2-8.3%) with numerical, yet not statistically
significant, difference between non-HTx/VAD [2.7% (0.8-8.3%)] as compared
with HTx/VAD [6.7% (5.3-8.6%)] (P = 0.131). <br/>Conclusion(s): Survival
after V-A ECLS differed according to centre's HTx/VAD status. Potentially
different risk profiles of patients must be taken account for before
definite conclusions are drawn.<br/>Copyright &#xa9; 2020 The Authors. ESC
Heart Failure published by John Wiley & Sons Ltd on behalf of the European
Society of Cardiology.

<9>
Accession Number
2007626899
Title
Patient survival in severe low-flow, low-gradient aortic stenosis after
aortic valve replacement or conservative management.
Source
Journal of Cardiac Surgery. (no pagination), 2020. Date of Publication:
2020.
Author
Micali L.R.; Algargoosh S.; Parise O.; Parise G.; Matteucci F.; de Jong
M.; Ioanna Moula A.; Tetta C.; Gelsomino S.
Institution
(Micali, Algargoosh, Parise, Parise, Matteucci, de Jong, Ioanna Moula,
Tetta, Gelsomino) Department of Cardiothoracic Surgery, Cardiovascular
Research Institute Maastricht University, Maastricht, Netherlands
Publisher
Blackwell Publishing Inc.
Abstract
Background and aim: Classical and paradoxical low-flow, low-gradient
(LFLG) aortic stenosis (AS) are the most challenging subtypes of AS. The
current therapeutic options are aortic valve replacement (AVR) and
conservative management: AVR promotes long-term survival but is invasive,
while conservative management yields a poor prognosis but is noninvasive
since it uses no aortic valve replacement (noAVR). The present
meta-analysis investigated the rate of survival of patients with LFLG AS
undergoing either AVR or noAVR interventions. <br/>Method(s): The
meta-analysis compared the outcomes of AVR with those of noAVR in terms of
patient survival. In both groups, a meta-regression was conducted to
investigate the impact on patient survival of the left ventricular
ejection fraction (LVEF), either preserved (paradoxical LFLG AS) or
reduced (classical LFLG AS). <br/>Result(s): The relative risk of survival
between the AVR and noAVR groups was 1.99 [1.40, 2.82] (p =.0001),
suggesting that survival tends to be better in AVR patients than in noAVR
patients. The meta-regression revealed that a reduced LVEF may be related
to a higher survival in AVR patients when compared to a preserved LVEF (p
=.04). Finally, the analysis indicated that LVEF seems not to be
prognostic of survival in noAVR patients (p =.18). <br/>Conclusion(s):
Patients with LFLG AS have better survival if they undergo AVR. In AVR
patients, reduced LVEF rather than preserved LVEF is related to better
survival, whereas there seems to be no difference in prognostic value
between reduced and preserved LVEF in noAVR patients.<br/>Copyright &#xa9;
2020 The Authors. Journal of Renal Care published by Wiley Periodicals LLC

<10>
Accession Number
2003547838
Title
Keeping up to date: a current review of wearable cardioverter
defibrillator use.
Source
Acta Cardiologica. 75 (8) (pp 695-704), 2020. Date of Publication: 2020.
Author
Ashraf S.; Ilyas S.; Siddiqui F.; Ando T.; Shokr M.; Panaich S.;
Briasoulis A.; Afonso L.; Khan M.
Institution
(Ashraf, Siddiqui, Ando, Shokr, Panaich, Briasoulis, Afonso, Khan)
Division of Cardiology, Detroit Medical Center/Wayne State University,
Detroit, MI, United States
(Ilyas) Department of Medicine, The Warren Alpert Medical School of Brown
University, Providence, RI, United States
Publisher
Taylor and Francis Ltd.
Abstract
The introduction of wearable cardioverter defibrillators (WCD) provides a
novel means of protection in select patients at high risk for sudden
cardiac death. The WCD can safely record and terminate life-threatening
arrhythmias. In this review, we explore the data behind indications for
WCD use and discuss its limitations. We searched PubMed, Google Scholar
and Cochrane Central Register of controlled trials for relevant studies.
The VEST trial, the first randomised controlled trial on WCD use, did not
show statistical significance in utility of the WCD in post-myocardial
infarction patients with low ejection fraction. While the use of WCD in
this select patient population showed no benefit, the findings of the
trial merit closer inspection. Various other indications of WCD use still
exist and others require exploration. Select subsets of patients who stand
to benefit for other indications include severely decreased left
ventricular function post-revascularization with high arrhythmic burden,
severe non-ischaemic cardiomyopathy, patients awaiting heart transplant
and patients who have had their implantable cardioverter device
temporarily removed. The role of the WCD is also being explored in
children, peripartum cardiomyopathy, haemodialysis patients, and in
syncope secondary to high-risk arrhythmias.<br/>Copyright &#xa9; 2019
Belgian Society of Cardiology.

<11>
Accession Number
632971153
Title
Evolution of outcome and complications in TAVR: a meta-analysis of
observational and randomized studies.
Source
Scientific reports. 10 (1) (pp 15568), 2020. Date of Publication: 23 Sep
2020.
Author
Winter M.-P.; Bartko P.; Hofer F.; Zbiral M.; Burger A.; Ghanim B.;
Kastner J.; Lang I.M.; Mascherbauer J.; Hengstenberg C.; Goliasch G.
Institution
(Winter, Bartko, Hofer, Zbiral, Burger, Kastner, Lang, Mascherbauer,
Hengstenberg, Goliasch) Department of Internal Medicine II, Medical
University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria
(Ghanim) Department of General and Thoracic Surgery, University Hospital
Krems, Karl Landsteiner University of Health Sciences, Krems an der Donau,
Austria
Publisher
NLM (Medline)
Abstract
Aim of the present analysis was to collect and pool all available data
currently in the literature regarding outcomes and complications of all
approved TAVR prosthesis and to assess the transition from first to next
generation TAVR devices by directly comparing both in regard of procedure
related complications. Transcatheter aortic valve replacement is a well
established treatment modality in patients with severe aortic stenosis
deemed to be inoperable or at unacceptable risk for open heart surgery.
First generation prostheses were associated with a high rate of
peri-procedural complications like paravalvular regurgitation, valve
malpositioning, vascular complications and conduction disorders.
Refinement of the available devices incorporate features to address the
limitations of the first-generation devices. A PRISMA checklist-guided
systematic review and meta-analysis of prospective observational studies,
national and device specific registries or randomized clinical trials was
conducted. Studies were identified by searching PUBMED, SCOPUS, Cochrane
Central Register of Controlled Trials and LILACs from January 2000 to
October 2017. We extracted and pooled data on both mortality and
complications from 273 studies for twelve different valves prostheses in a
total of 68,193 patients. In second generation prostheses as compared to
first generation devices, we observed a significant decrease in mortality
(1.47+/-1.73% vs. 5.41+/-4.35%; p<0.001), paravalvular regurgitation
(1.75+/-2.43vs. 12.39+/-9.38, p<0.001) and MACE. TAVR with contemporary
next generation devices has led to an impressive improvement in TAVR
safety driven by refined case selection, improved procedural techniques
and increased site experience.

<12>
Accession Number
633828646
Title
Acupuncture history, expectations, and postoperative experience among
cardiac surgery patients: The ACU-heart pilot trial.
Source
Global Advances in Health and Medicine. Conference: International Congress
on Integrative Medicine and Health, ICIMH 2020. United States. 9 (pp
12-13), 2020. Date of Publication: 2020.
Author
Carroll A.; Moskowitz J.; Davidson C.; McCarthy P.; Ring M.; Feingold K.
Institution
(Carroll) Northwestern University, Feinberg School of Medicine, Chicago,
IL, United States
(Moskowitz) Northwestern University, Osher Center for Integrative
Medicine, Chicago, IL, United States
(Davidson, McCarthy, Ring, Feingold) Northwestern University, Chicago, IL,
United States
Publisher
SAGE Publications Ltd
Abstract
Purpose: Cardiac surgery patients suffer high rates of depression, somatic
sequelae, and medical complications (eg, atrial fibrillation). Although
acupuncture is an effective treatment for these conditions, no trials have
tested acupuncture among cardiac surgery patients. It is unknown whether
cardiac surgery patients would be receptive to acupuncture. In this study,
we assessed cardiac surgery patients' history of, expectations for, and
experience with acupuncture. <br/>Method(s): These data are part of a
randomized, controlled, feasibility trial of daily acupuncture (ACU) or
treatment as usual (TAU) following isolated valve surgery via sternotomy.
ACU patients received up to 6 acupuncture sessions duringhospitalization.
TAU patients had no intervention. Before randomization, all patients
reported history of and expectations for acupuncture. At follow-up
(3-months postsurgery), ACU patients reported their experience of
postoperative acupuncture. <br/>Result(s): In total, 100 patients were
randomized (51 ACU, 49 TAU), mostly males (71%), Caucasian (86%), and 59
years old on average (standard deviation [SD]=11 years). At baseline, 27%
of patients had previous experience with acupuncture, of which 82% had
only undergone 1 session. Patients' expectations for postoperative
acupuncture were neutral: most patients agreed "a little" or "moderately"
that acupuncture would help them with cardiac surgery (66%), postsurgical
symptoms (58%), and energy level (65%), all ACU vs TAU Ps>.20. During
hospitalization, ACU patients underwent 3.8 acupuncture sessions on
average (SD=1.1). Among ACU patients at follow-up, many reported
acupuncture was "extremely" or "very helpful" (33%), half reported it was
"somewhat" or "helpful" (51%), and few reported it was "not helpful" (8%).
<br/>Conclusion(s): One in 4 cardiac surgery patients had previous,
limited experience with acupuncture. Most patients had moderate
expectations that acupuncture would benefit them. Nonetheless, the
majority of patients who received acupuncture during postoperative
hospitalization found acupuncture to be helpful. Future analyses will
assess the impact of acupuncture on depressive symptoms, somatic sequelae,
and atrial fibrillation.

<13>
Accession Number
633830811
Title
Anesthetic Effect of Remifentanil Combined with Dexmedetomidine on
Hemodynamics in Cardiac Surgery Patients.
Source
Basic and Clinical Pharmacology and Toxicology. Conference: 2020
International Conference on Electronic Healthcare Technologies. Canada.
127 (SUPPL 1) (pp 138), 2020. Date of Publication: August 2020.
Author
Wang D.; Yu T.; Yao F.; Li Y.; Wang H.; Sun Y.
Institution
(Wang) Department of Anesthesiology, Weifang Medical College, Weifang City
261000, China
(Yu, Yao, Li) Affiliated Hospital of Weifang Medical College, Weifang City
261000, China
(Wang, Sun) Operating Room of Affiliated Hospital of Weifang Medical
College, Weifang city 261000, China
Publisher
Blackwell Publishing Ltd
Abstract
Objective: To investigate anesthetic effect of Remifentanil (REM) combined
with Dexmedetomidine (DEX) on hemodynamics in cardiac surgery patients.
<br/>Method(s): 100 patients who underwent heart operation at our hospital
from 2013 to 2015. They were randomly divided into two groups, anesthesia
I group (group I) and anesthesia II group (group II), each with 50 cases.
<br/>Result(s): There was no significant change in the levels of mean
arterial blood pressure (MABP), heart rate (HR), oxygen saturation (SpO2)
at different time periods in group II patients (P > 0.05). However, there
were statistically significant decreases in the levels of MABP, HR, and
SpO2 in group I patients (P < 0.05). Ramsay score was much higher for
group II patients than for group I patients (P < 0.05). There was no
statistically significant difference between the two groups for the amount
of time required for extubation, reviving, and recovering of spontaneous
breathing (P > 0.05). Anesthesia good rates of group II were much higher
than those of group I (P > 0.05). <br/>Conclusion(s): anesthetic effect of
REM combined with DEX can stabilize hemodynamics and improve sedative
effect without affecting the extubation, reviving, and spontaneous
breathing.

<14>
Accession Number
2010550761
Title
3-year outcomes with ex-vivo allograft perfusion for heart
transplantation: Comparison of Custodiol vs warm blood cardioplegia and
conditioning.
Source
Clinical and Experimental Surgery. 8 (3) (pp 27-31), 2021. Date of
Publication: 2021.
Author
Pya Yu.V.; Kaliyev R.B.; Bekbossynova M.S.; Lesbekov T.D.; Bekbossynov
S.T.; Kapyshev T.S.; Nurmykhametova Zh.A.; Novikova S.P.; Smagulov N.K.;
Faizov L.R.; Kuanyshbek A.S.; Andossova S.A.; Myrzakhmetova G.Sh.;
Turganbayeva G.M.
Institution
(Pya, Kaliyev, Bekbossynova, Lesbekov, Bekbossynov, Kapyshev,
Nurmykhametova, Novikova, Smagulov, Faizov, Kuanyshbek, Andossova,
Myrzakhmetova, Turganbayeva) National Research Center for Cardiac Surgery,
Nur-Sultan 010000, Kazakhstan
Publisher
Nutritec
Abstract
The Organ Care System (OCS) was introduced for more prolonged and reliable
ex-vivo organ management. We reviewed our institutional experience to
assess 3 year outcomes in patients of the standard Custodiol versus warm
blood cardioplegia groups. Material and methods. Between May 2014 and
September 2017, 43 patients after heart transplantation from single
institution were randomized depending on the way of cardioplegia
initiation. In 1st group (n=13) standard Custodiol solution was used to
arrest the donor heart before explant and implant; in 2nd group (n=30)
blood cardioplegia and conditioning were used for the same purpose. 3-year
survival, freedom from cardiac allograft vasculopathy (CAV), any-treated
rejection (ATR) and non-fatal major cardiac events (NF-MACE) in 3 years
were assessed. Results. Recipient demographic characteristics in each
group were similar. There was no significant difference in the 3-year
patient survival rate between the two groups (Standard Custodiol group 77%
vs Blood cardioplegia and conditioning group 67%, p=0.5). Similarly, there
was no difference in freedom from CAV, ATR, and NF-MACE. Mean ex vivo
perfusion time was 282.5+/-86.7 min in the blood cardioplegia group
compared to 247.4+/-88.4 min in the standard care group (p=0.87).
Conclusion. The outcome following heart transplantation after donor heart
preservation with the organ care system Custodiol vs warm blood
cardioplegia and conditioning represents a promising platform for donor
heart transportation with similar intermediate results.<br/>Copyright
&#xa9; 2020 GEOTAR Media. All rights reserved.

<15>
[Use Link to view the full text]
Accession Number
2010440234
Title
Efficacy of Allopurinol in Cardiovascular Diseases: A Systematic Review
and Meta-Analysis.
Source
Cardiology Research. 11 (14) (pp 226-232), 2020. Date of Publication:
August 2020.
Author
Khanal S.; Basyal B.; Munir S.; Minalyan A.; Khan R.; Alraies C.; Fischman
D.L.; Ullah W.
Institution
(Ullah, Khanal, Basyal, Munir, Minalyan) Abington Jefferson Health, United
States
(Khan) Medstar Union Memorial Hospital, Baltimore, United States
(Alraies) Detroit Medical Center, DMC Heart Hospital, United States
(Fischman) Thomas Jefferson University, Philadelphia, United States
(Ullah) Abington Jefferson Health, United States
Publisher
Elmer Press
Abstract
Background: Given current evidence, the use of allopurinol for the
prevention of major cardiovascular events (acute cardiovascular syndrome
(ACS) or cardiovascular mortality) in patients undergoing coronary artery
bypass graft (CABG), after index ACS or heart failure remains unknown.
<br/>Method(s): Multiple databases were queried to identify studies
comparing the efficacy of allopurinol in patients undergoing CABG, after
ACS or heart failure. The unadjusted odds ratio (OR) was calculated using
a random effect model. <br/>Result(s): A total of nine studies comprising
850 patients (allopurinol 480, control 370) were identified. The pooled OR
of periprocedural ACS (OR: 0.25, 95% confidence interval (CI): 0.06 -
0.96, P = 0.05) and cardiovascular mortality (OR: 0.22, 95% CI: 0.07 -
0.71, P = 0.01) was significantly lower in patients receiving allopurinol
during CABG compared to patients in the control group. The overall number
needed to treat (NNT) to prevent one ACS event was 11 (95% CI: 7 28),
while the NNT to prevent one death was 24 (95% CI: 13 - 247). By contrast,
the odds of cardiovascular mortality in the allopurinol group were not
significantly different from the control group in patients on long-term
allopurinol after ACS or heart failure (OR: 0.33, 95% CI: 0.01 - 8.21, P =
0.50) and (OR: 1.12, 95% CI: 0.39 - 3.20, P = 0.83), respectively.
Similarly, the use of allopurinol did not reduce the odds of recurrent ACS
events at 2 years (OR: 0.32, 95% CI: 0.03 - 3.18, P = 0.33).
<br/>Conclusion(s): Periprocedural use of allopurinol might be associated
with a significant reduction in the odds of ACS and cardiovascular
mortality in patients undergoing CABG. Allopurinol, however, offers no
long-term benefits in terms of secondary prevention of ACS or mortality.
Larger scale studies are needed to validate our findings.<br/>Copyright
&#xa9; The authors

<16>
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.

<17>
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.

<18>
Accession Number
633838012
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
Circulation. (pp CIR0000000000000932), 2020. Date of Publication: 17 Dec
2020.
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.
Institution
(O'Gara) ACC/AHA Joint Committee on Clinical Practice Guidelines Liaison
Publisher
NLM (Medline)
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.

<19>
Accession Number
633837245
Title
Phrenic Nerve Block at the Azygos Vein Level Versus Sham Block for
Ipsilateral Shoulder Pain After Video-Assisted Thoracoscopic Surgery: A
Randomized Controlled Trial.
Source
Anesthesia and analgesia. (no pagination), 2020. Date of Publication: 16
Dec 2020.
Author
Kimura Kuroiwa K.; Shiko Y.; Kawasaki Y.; Aoki Y.; Nishizawa M.; Ide S.;
Miura K.; Kobayashi N.; Sehmbi H.
Institution
(Kimura Kuroiwa, Nishizawa, Ide) From the Department of Anesthesia, Nagano
Red Cross Hospital, Nagano, Japan
(Shiko) Department of Biostatistics, Clinical Research Center, Chiba
University Hospital, Chiba, Japan
(Kawasaki) Department of Biostatistics of Japanese Red Cross College of
Nursing, Tokyo, Japan
(Aoki) Department of Anesthesiology and Intensive Care, Hamamatsu
University School of Medicine, Hamamatsu, Japan
(Miura, Kobayashi) Department of Thoracic Surgery, Nagano Red Cross
Hospital, Nagano, Japan
(Sehmbi) Department of Anesthesia & Perioperative Medicine, London Health
Sciences Centre, Western University, London, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Ipsilateral shoulder pain (ISP) is a common problem after
pulmonary surgery. We hypothesized that phrenic nerve block (PNB) at the
azygos vein level, near the location of the surgical operation, would be
effective for reducing ISP. Our primary aim was to assess the effect of
PNB on postoperative ISP, following video-assisted thoracic surgery
(VATS). <br/>METHOD(S): This prospective, randomized, patient-blinded,
single-institution trial was registered at the University Hospital Medical
Information Network (UMIN000030464). Enrolled patients had been scheduled
for VATS under general anesthesia with epidural analgesia. Patients were
randomly allocated to receive infiltration of the ipsilateral phrenic
nerve at the azygos vein level with either 10 mL of 0.375% ropivacaine
(PNB group) or 0.9% saline (control group) before chest closure.
Postoperative ISP was assessed using a numerical rating scale (NRS, 0-10)
at rest at 2, 4, 8, 16, and 24 hours. The incidence of ISP was defined as
the proportion of patients who reported an NRS score of >=1 at least once
within 24 hours after surgery. In the primary analysis, the proportion of
patients with ISP was compared between PNB and control groups using the
chi2 test. NRS values of ISP and postoperative incision pain within 24
hours were investigated, as was the frequency of postoperative analgesic
use. Incision pain was assessed using an NRS at the time of ISP
assessment. Finally, the incidence of postoperative nausea and vomiting
and shoulder movement disorders were also evaluated. <br/>RESULT(S):
Eighty-five patients were included, and their data were analyzed. These
patients were randomly assigned to either PNB group (n = 42) or control
group (n = 43). There were no clinically relevant differences in
demographic and surgical profiles between the groups. There was no
significant difference in the incidence of ISP (the control group 20/43
[46.5%] versus the PNB group 14/42 [33.3%]; P = .215). The severity of ISP
was lower in the PNB group than in the control group (linear mixed-effects
model, the main effect of treatment [groups]: P < .001). There were no
significant differences between groups in terms of postoperative incision
pain. The frequency of postoperative analgesic use was significantly
higher in the control group (Wilcoxon rank sum test, P < .001).
Postoperative nausea and vomiting did not significantly differ between the
2 groups. There were no changes in the range of shoulder joint movement.
<br/>CONCLUSION(S): Azygos vein level PNB did not significantly affect the
incidence of ISP after VATS.<br/>Copyright &#xa9; 2020 The Author(s).
Published by Wolters Kluwer Health, Inc. on behalf of the International
Anesthesia Research Society.

<20>
Accession Number
2007444401
Title
'Is totally endoscopic coronary artery bypass grafting compared with
minimally invasive direct coronary artery bypass grafting associated with
superior outcomes in patients with isolated left anterior descending
disease?'.
Source
Annals of Medicine and Surgery. 57 (pp 264-267), 2020. Date of
Publication: September 2020.
Author
Manuel L.; Fong L.S.; Wolfenden H.; Bassin L.
Institution
(Manuel, Bassin) Department of Cardiothoracic Surgery, Royal North Shore
Hospital, Sydney, Australia
(Manuel, Fong, Wolfenden, Bassin) Department of Cardiothoracic Surgery,
Prince of Wales Hospital, Sydney, Australia
Publisher
Elsevier Ltd
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was 'Is totally endoscopic
coronary artery bypass grafting compared with minimally invasive direct
coronary artery bypass grafting associated with superior outcomes in
patients with isolated left anterior descending disease?' Altogether more
than 118 papers were found using the reported search, of which 4
represented the best evidence to answer the clinical question, which
included 2 prospective cohort studies and 2 retrospective observational
studies. The authors, journal, date and country of publication, patient
group studied, study type, relevant outcomes and results of these papers
were tabulated. There is a significant variation within the MIDCAB and
TECAB techniques amongst the studies-including the experience of the
surgeon, use of cardiopulmonary bypass, patient selection, and target
vessel grafting strategies-highlighting the complexity of comparing these
two minimally invasive procedures. Operative times were comparable across
all studies, with TECAB patients having higher transfusions rates and
conversion rates to either a median sternotomy or MIDCAB procedure.
Overall safety was comparable between the two cohort groups, with similar
length of stay and 30-day mortality. However, the TECAB group were more
likely to require re-operation for bleeding and reintervention for early
revascularisation with greater total hospital costs than the MIDCAB
patients. Based on the available evidence, we conclude that TECAB is
associated with a higher rate of transfusions, conversion to median
sternotomy or MIDCAB, early graft failure and reintervention compared to
the MIDCAB approach. We advise caution in adopting a TECAB
approach.<br/>Copyright &#xa9; 2020 The Authors

<21>
Accession Number
633123223
Title
Longitudinal Course of Depressive, Anxiety, and Posttraumatic Stress
Disorder Symptoms After Heart Surgery: A Meta-Analysis of 94 Studies.
Source
Psychosomatic medicine. 83 (1) (pp 85-93), 2021. Date of Publication: 01
Jan 2021.
Author
Rosson S.; Monaco F.; Miola A.; Cascino G.; Stubbs B.; Correll C.U.; Firth
J.; Ermis C.; Perrotti A.; Marciello F.; Carvalho A.F.; Brunoni A.R.;
Fusar-Poli P.; Fornaro M.; Gentile G.; Granziol U.; Pigato G.; Favaro A.;
Solmi M.
Institution
(Rosson) From the Neurosciences Department (Rosson, Miola, Gentile,
Favaro, Solmi), University of Padua, Padua; Department of Mental Health
(Monaco), Residential Eating Disorder Unit "Mariconda," ASL Salerno;
Department of Medicine (Cascino, Marciello), Surgery and Dentistry "Scuola
Medica Salernitana," Section of Neurosciences, University of Salerno,
Salerno, Italy; Physiotherapy Department (Stubbs), South London and
Maudsley National Health Services Foundation Trust; Department of
Psychological Medicine (Stubbs), Institute of Psychiatry, Psychology, and
Neuroscience, King's College London, London, United Kingdom; Department of
Psychiatry (Correll), The Zucker Hillside Hospital, Northwell Health, Glen
Oaks; Department of Psychiatry and Molecular Medicine (Correll), Zucker
School of Medicine at Hofstra/Northwell, Hempstead; The Feinstein
Institute for Medical Research (Correll), Center for Psychiatric
Neuroscience, Manhasset, New York; Department of Child and Adolescent
Psychiatry (Correll), Charite Universitatsmedizin Berlin, Berlin, Germany;
Division of Psychology and Mental Health, Faculty of Biology, Medicine and
Health (Firth), University of Manchester, Manchester, United Kingdom; NICM
Health Research Institute, School of Science and Health (Firth),
University of Western Sydney, Sydney; Centre for Youth Mental Health,
University of Melbourne (Firth), Melbourne, Australia; Department of Child
and Adolescent Psychiatry (Ermis), Dokuz Eylul University, Izmir, Turkey
Publisher
NLM (Medline)
Abstract
OBJECTIVE: This study aimed to analyze the longitudinal course of
depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms in
patients with cardiac disease after heart surgery (HS). <br/>METHOD(S): We
conducted a systematic review and random-effects meta-analysis of cohort
studies in patients undergoing HS, measuring anxiety, depressive, and PTSD
symptoms before and at least 30 days thereafter. Subgroup and
meta-regression analyses, investigation of publication bias, and quality
assessment were undertaken. <br/>RESULT(S): We included 94 studies
relating to 15,561 patients. HS included coronary artery bypass graft
surgery, valve replacement, implantable cardioverter-defibrillator
placement, left ventricular assist device placement, heart
transplantation, and other types of HS. Across studies, symptoms of
depression (g = 0.32; 95% confidence interval [CI] = 0.25 to 0.39; p <
.001) and anxiety improved after HS (g = 0.52; 95% CI = 0.43 to 0.62; p <
.001), whereas PTSD symptoms worsened (g = -0.42; 95% CI = -0.80 to -0.04;
p = .032). The reduction of depression and anxiety levels was more
pronounced for patients with underlying coronary artery disease and heart
failure and persisted for 1 year after HS, whereas the increase in PTSD
symptoms returned to baseline after 6 months. Depression improvement was
inversely associated with older age, diabetes, hypertension, and
dyslipidemia and positively with baseline heart failure. No additional
clinical or demographic variables were associated with the course of
anxiety symptoms. Quality of included studies was low overall. Publication
bias was nonsignificant. <br/>CONCLUSION(S): Depressive and anxiety
symptoms improve for 1 year after HS, whereas PTSD symptoms might worsen.
Older patients and those with metabolic comorbidities, valve disease, or
ventricular arrhythmias are at higher risk for continued depressive and
anxiety symptoms and should be monitored closely.<br/>Copyright &#xa9;
2020 by the American Psychosomatic Society.

<22>
Accession Number
2010392475
Title
Investigating the Effect of Acupressure on the Patients' Anxiety Before
Open-Heart Surgery: A Randomized Clinical Trial.
Source
JAMS Journal of Acupuncture and Meridian Studies. 13 (6) (pp 169-173),
2020. Date of Publication: December 2020.
Author
Khoram B.; Yoosefinejad A.K.; Rivaz M.; Najafi S.S.
Institution
(Khoram) Student Research Committee, School of Nursing and Midwifery,
Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Yoosefinejad) Physical Therapy Department, School of Rehabilitation
Sciences, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Rivaz, Najafi) Department of Medical Surgical Nursing, School of Nursing
and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran,
Islamic Republic of
Publisher
Korean Pharmacopuncture Institute
Abstract
Background: Anxiety is a common complaint of patients before diagnostic or
therapeutic invasive procedures, especially before open-heart surgery. The
most well-known method to reduce anxiety is the use of sedatives, which
have pronounced side effects. <br/>Objective(s): The purpose of this study
was to determine the effect of acupressure on anxiety in patients
undergoing open-heart surgery. <br/>Method(s): This is a randomized
clinical trial study conducted on 90 patients who were candidates for
open-heart surgery. The patients were randomly assigned into either
intervention or control groups. Acupressure intervention was applied at
three real acupoints over two consecutive days in the intervention group.
The control group received acupressure on sham points. We used Spielberger
State-Trait Anxiety Inventory to assess anxiety in our study.
<br/>Result(s): The results showed that before acupressure, there was no
statistically significant difference between state anxiety scores and
intergroup traits, and this difference was only significant in state
anxiety after the second intervention. State and trait anxiety were
significant before and after the intervention in the test group,
respectively include (p < 0.001) (p = 0.01), but these changes in the
control group did not show a statistically significant difference. After
completing the second phase of the intervention at the actual sites,
systolic blood pressure (p = 0.007) and heart rate (p = 0.001) decreased
significantly. However, acupressure did not have a significant effect on
diastolic blood pressure in any of the groups. <br/>Conclusion(s): Based
on the results of this study, the application of acupressure in patients
who are candidates for open-heart surgery can reduce their state anxiety.
Further larger-scale and rigorous studies are warranted.<br/>Copyright
&#xa9; 2020

<23>
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.

<24>
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.

<25>
Accession Number
633823354
Title
Comparison of different transcatheter interventions for treatment of
mitral regurgitation: A protocol for a network meta-analysis.
Source
Medicine. 99 (50) (pp e23623), 2020. Date of Publication: 11 Dec 2020.
Author
Zhang B.; Li M.; Kang Y.; Xing L.; Zhang Y.
Institution
(Zhang) Department of Cardiothoracic Surgery, Wuwei People's Hospital,
Gansu, China
(Li) Second Clinical Medical College of Lanzhou University
(Kang, Xing) School of Basic Medical Sciences, Lanzhou University
(Zhang) Department of Thoracic Surgery, First Hospital of Lanzhou
University, Lanzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The arrival of transcatheter mitral valve therapies has
provided feasible and safe alternatives to medical and surgical treatments
for mitral regurgitation. The aim of this study is to estimate the
relative efficacy and safety of different transcatheter mitral valve
therapies for mitral regurgitation patients through network meta-analysis.
<br/>METHOD(S): A systematic search will be performed using PubMed,
EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical
Literature Database, and China National Knowledge Infrastructure to
include random controlled trials and nonrandom controlled trials comparing
the efficacy and safety of different transcatheter mitral valve
techniques. The risk of bias for the included nonrandom controlled studies
will be evaluated according to Risk of Bias in Non-randomized Studies - of
Interventions. For random controlled trials, we will use Cochrane Handbook
version 5.1.0 as the risk of bias tool. A Bayesian network meta-analysis
will be conducted using R-4.0.3 software. Grading of recommendations
assessment, development, and evaluation will be used to assess the quality
of evidence. <br/>RESULT(S): The results of this network meta-analysis
will be submitted to a peer-reviewed journal for publication.
<br/>CONCLUSION(S): This study will provide broad evidence of efficacy and
safety of different transcatheter mitral valve therapies for treatment of
mitral regurgitation and provide suggestions for clinical practice and
future research. PROTOCOL REGISTRATION NUMBER: INPLASY2020110034.

<26>
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.

<27>
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.

<28>
Accession Number
633796191
Title
Association Between Perioperative Glycemic Control Strategy and Mortality
in Patients With Diabetes Undergoing Cardiac Surgery: A Systematic Review
and Meta-Analysis.
Source
Frontiers in Endocrinology. 11 (no pagination), 2020. Article Number:
513073. Date of Publication: 17 Dec 2020.
Author
Jin X.; Ma Y.; Li X.; An P.; Wang J.; Mao W.; Mu Y.; Chen Y.; Chen K.
Institution
(Jin, Wang, Li, An, Wang, Mao, Mu, Chen) Department of Endocrinology,
Chinese PLA General Hospital, Beijing, China
(Jin) Department of Endocrinology and Nephrology, Hainan Hospital of
Chinese PLA General Hospital, Sanya, China
(Jin) Hainan Academician Team Innovation Center, Sanya, China
(Wang) Department of Endocrinology, Fifth Medical Center of Chinese, PLA
General Hospital, Beijing, China
(Ma, Chen) Evidence-Based Medicine Center, School of Basic Medical
Sciences, Lanzhou University, Lanzhou, China
(Ma, Chen) WHO Collaborating Center for Guideline Implementation and
Knowledge Translation, Lanzhou, China
(Ma, Chen) Chinese GRADE Center, Lanzhou, China
(Li) Department of Gerontology, First Affiliated Hospital of Kunming
Medical University, Kunming, China
(Wang, Mao) School of Medicine, Nankai University, Tianjin, China
Publisher
Frontiers Media S.A.
Abstract
Objective: To analyze association between different perioperative glycemic
control strategies and postoperative outcomes in patients with diabetes
undergoing cardiac surgery. <br/>Method(s): MEDLINE, Cochrane Library, Web
of Science, EMBASE, Wanfang Data, China National Knowledge Infrastructure
(CNKI) and China Biology Medicine (CBM) databases were searched from
inception to January 31, 2019. Two researchers independently screened the
literature, extracted data, and evaluated the risk of bias of included
studies, and consensus was reached by discussion with a third researcher.
<br/>Result(s): Six RCTs were included in the meta-analysis. We analyzed
the effect of liberal (>180 mg/dl or 10.0 mmol/L), moderate (140-180 mg/dl
or 7.8-10.0 mmol/L) and strict (<140 mg/dl or 7.8 mmol/L) glycemic control
strategies in patients with diabetes undergoing cardiac surgery. The
pooled results showed that strict glycemic control strategy was associated
with a significant reduction in the risk of atrial fibrillation [OR =
0.48, 95%CI (0.32, 0.72), P < 0.001] and sternal wound infection [OR =
0.28, 95%CI (0.14, 0.54), P < 0.001], while there was no significant
differences in postoperative mortality, stroke, and hypoglycemic episodes
when compared with moderate control. In addition, there is no significant
difference between moderate and liberal glycemic control strategies in
postoperative mortality. However, moderate control was beneficial in
reducing atrial fibrillation [OR = 0.28, 95%CI (0.13, 0.60), P = 0.001]
compared with the liberal glycemic control strategy. <br/>Conclusion(s):
This meta-analysis showed when compared with moderate glycemic control
strategy in patients with diabetes undergoing cardiac surgery, maintained
strict glycemic control was associated with lower risk of atrial
fibrillation and sternal wound infection. No benefit was found with
liberal glycemic control strategy, so it could be a poor glycemic control
strategy.<br/>&#xa9; Copyright &#xa9; 2020 Jin, Wang, Ma, Li, An, Wang,
Mao, Mu, Chen and Chen.

<29>
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)).

<30>
Accession Number
633826469
Title
Intraoperative Oxygen Concentration and Neurocognition after Cardiac
Surgery.
Source
Anesthesiology. (no pagination), 2020. Date of Publication: 16 Dec 2020.
Author
Shaefi S.; Shankar P.; Mueller A.L.; O'Gara B.P.; Spear K.; Khabbaz K.R.;
Bagchi A.; Chu L.M.; Banner-Goodspeed V.; Leaf D.E.; Talmor D.S.;
Marcantonio E.R.; Subramaniam B.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Despite evidence suggesting detrimental effects of
perioperative hyperoxia, hyperoxygenation remains commonplace in cardiac
surgery. Hyperoxygenation may increase oxidative damage and neuronal
injury leading to potential differences in postoperative neurocognition.
Therefore, this study tested the primary hypothesis that intraoperative
normoxia, as compared to hyperoxia, reduces postoperative cognitive
dysfunction in older patients having cardiac surgery. <br/>METHOD(S): A
randomized double-blind trial was conducted in patients aged 65 yr or
older having coronary artery bypass graft surgery with cardiopulmonary
bypass. A total of 100 patients were randomized to one of two
intraoperative oxygen delivery strategies. Normoxic patients (n = 50)
received a minimum fraction of inspired oxygen of 0.35 to maintain a Pao2
above 70 mmHg before and after cardiopulmonary bypass and between 100 and
150 mmHg during cardiopulmonary bypass. Hyperoxic patients (n = 50)
received a fraction of inspired oxygen of 1.0 throughout surgery,
irrespective of Pao2 levels. The primary outcome was neurocognitive
function measured on postoperative day 2 using the Telephonic Montreal
Cognitive Assessment. Secondary outcomes included neurocognitive function
at 1, 3, and 6 months, as well as postoperative delirium, mortality, and
durations of mechanical ventilation, intensive care unit stay, and
hospital stay. <br/>RESULT(S): The median age was 71 yr (interquartile
range, 68 to 75), and the median baseline neurocognitive score was 17 (16
to 19). The median intraoperative Pao2 was 309 (285 to 352) mmHg in the
hyperoxia group and 153 (133 to 168) mmHg in the normoxia group (P <
0.001). The median Telephonic Montreal Cognitive Assessment score on
postoperative day 2 was 18 (16 to 20) in the hyperoxia group and 18 (14 to
20) in the normoxia group (P = 0.42). Neurocognitive function at 1, 3, and
6 months, as well as secondary outcomes, were not statistically different
between groups. <br/>CONCLUSION(S): In this randomized controlled trial,
intraoperative normoxia did not reduce postoperative cognitive dysfunction
when compared to intraoperative hyperoxia in older patients having cardiac
surgery. Although the optimal intraoperative oxygenation strategy remains
uncertain, the results indicate that intraoperative hyperoxia does not
worsen postoperative cognition after cardiac surgery. Editor's
Perspective.<br/>Copyright &#xa9; 2020, the American Society of
Anesthesiologists, Inc. All Rights Reserved.

<31>
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.

<32>
Accession Number
2010470560
Title
Effect of Renin-Angiotensin System Inhibitors on Acute Kidney Injury Among
Patients Undergoing Cardiac Surgery: A Review and Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2020.
Date of Publication: 2020.
Author
Zhou H.; Xie J.; Zheng Z.; Ooi O.C.; Luo H.
Institution
(Zhou) School of Management, University of Science and Technology of
China, Hefei, China
(Xie) School of Management, Technical University of Munich, Heilbronn,
Germany
(Zheng) Lee Kong Chian School of Business, Singapore Management
University, Singapore
(Ooi, Luo) Department of Cardiac, Thoracic & Vascular Surgery, National
University Hospital, Singapore
Publisher
W.B. Saunders
Abstract
Acute kidney injury (AKI) is a frequent complication of cardiac surgery,
which can lead to higher mortality and long-term renal function
impairment. The effect of perioperative renin-angiotensin system
inhibitors (RASi) therapy on AKI incidence in patients undergoing cardiac
surgery remains controversial. We reviewed related studies in PubMed,
Scopus, and Cochrane Library from inception to February 2020. Two
randomized controlled trials and 21 cohort studies were included in the
meta-analysis, involving 76,321 participants. The pooled odds ratio and
95% confidence interval were calculated using the DerSimonian and Laird
random-effects model. The results showed no significant association
between perioperative RASi therapy and postoperative AKI in patients
undergoing cardiac surgery. We highlighted the limitations of existing
studies and called for well-designed large-scale randomized controlled
trials to verify the conclusion.<br/>Copyright &#xa9; 2020 Elsevier Inc.

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

<34>
Accession Number
2008588923
Title
How Do Type of Preoperative P2Y<inf>12</inf> Receptor Inhibitor and
Withdrawal Time Affect Bleeding?.
Source
Annals of Thoracic Surgery. 111 (1) (pp 77-84), 2021. Date of Publication:
January 2021.
Author
Voetsch A.; Pregartner G.; Berghold A.; Seitelberger R.; Schoerghuber M.;
Toller W.; Mahla E.
Institution
(Voetsch) Department of Cardiac Surgery, Medical University of Graz,
Austria
(Pregartner, Berghold) Institute for Medical Informatics, Statistics, and
Documentation, Medical University of Graz, Graz, Austria
(Voetsch, Seitelberger) Department of Cardiovascular and Endovascular
Surgery, Paracelsus Medical University, Salzburg, Austria
(Schoerghuber, Toller, Mahla) Division of Anesthesiology for
Cardiovascular Surgery and Intensive Care Medicine, Medical University of
Graz, Graz, Austria
Publisher
Elsevier Inc.
Abstract
Background: Despite recommendations for standardized preoperative waiting
of at least 3, 5, and 7 days for ticagrelor, clopidogrel, and prasugrel,
respectively, there is still substantial interinstitutional variation in
preoperative discontinuation of dual antiplatelet therapy in patients
needing coronary artery bypass grafting (CABG). <br/>Method(s): In 299
patients undergoing CABG with or without valve intervention less than 7
days after last P2Y<inf>12</inf> receptor inhibition, this study evaluated
calculated red blood cell loss and Bleeding Academic Research Consortium
type 4 (BARC-4) bleeding. <br/>Result(s): A total of 83% of patients
underwent CABG less than 48 hours after last drug intake. Calculated blood
loss was lower in patients taking clopidogrel as compared with prasugrel
or ticagrelor (1063 mL [690 to 1394 mL] vs 1351 mL [876 to 1829 mL] vs
1330 mL [994 to 1691 mL]; P < .001). Overall, 135 (45%) patients sustained
BARC-4 bleeding; the incidence differed among the groups (P = .015) and
was significantly higher in prasugrel-treated patients, as compared with
clopidogrel-treated patients. In multivariable linear regression analysis,
European System for Cardiac Operative Risk Evaluation II (EuroSCORE II),
aspirin dose, cardiopulmonary bypass time, drug withdrawal time, and type
of P2Y<inf>12</inf> receptor inhibitor were significantly associated with
red blood cell loss. Compared with 0 to 24 hours, a period of more than 48
hours of preoperative discontinuation substantially reduced calculated
blood loss by 37% to 48% and BARC-4 bleeding by 58% to 71%, depending on
the P2Y<inf>12</inf> receptor inhibitor. <br/>Conclusion(s): Exposure to
prasugrel and ticagrelor 24 hours or less before CABG increases both
calculated blood loss and BARC-4 bleeding as compared with clopidogrel.
Although discontinuation for longer than 48 hours substantially reduced
calculated blood loss and BARC-4 bleeding across all P2Y<inf>12</inf>
receptor inhibitors, our single-center data further support strict
adherence to the 2017 guidelines whenever justified by stable hemodynamics
and nonjeopardized myocardium.<br/>Copyright &#xa9; 2021 The Society of
Thoracic Surgeons

<35>
Accession Number
2007593473
Title
Circulating fatty-acid binding-protein 4 levels predict CV events in
patients after coronary interventions.
Source
Journal of the Formosan Medical Association. Part 3. 120 (1) (pp 728-736),
2021. Date of Publication: January 2021.
Author
Tsai H.-Y.; Wu Y.-W.; Tseng W.-K.; Leu H.-B.; Yin W.-H.; Lin T.-H.; Chang
K.-C.; Wang J.-H.; Wu C.-C.; Chen J.-W.; Yeh H.-I.
Institution
(Tsai, Wu) Cardiology Division of Cardiovascular Medical Center, Far
Eastern Memorial Hospital, New Taipei City, Taiwan (Republic of China)
(Wu) National Yang-Ming University School of Medicine, Taipei, Taiwan
(Republic of China)
(Tseng) Department of Medical Imaging and Radiological Sciences, I-Shou
University, Kaohsiung, Taiwan (Republic of China)
(Tseng) Division of Cardiology, Department of Internal Medicine, E-Da
Hospital, Kaohsiung, Taiwan (Republic of China)
(Leu, Chen) Institute of Clinical Medicine and Cardiovascular Research
Center, National Yang-Ming University, Taipei, Taiwan (Republic of China)
(Leu, Chen) Division of Cardiology, Department of Medicine, Taipei
Veterans General Hospital, Taipei, Taiwan (Republic of China)
(Yin) Division of Cardiology, Heart Center, Cheng-Hsin General Hospital,
School of Medicine, National Yang-Ming University, Taipei, Taiwan
(Republic of China)
(Lin) Division of Cardiology, Department of Internal Medicine, Kaohsiung
Medical University Hospital and Kaohsiung Medical University, Kaohsiung,
Taiwan (Republic of China)
(Chang) Division of Cardiology, Department of Internal Medicine, China
Medical University Hospital, Taichung, Taiwan (Republic of China)
(Chang) Graduate Institute of Biomedical Sciences, China Medical
University, Taichung, Taiwan (Republic of China)
(Wang) Department of Cardiology, Buddhist Tzu-Chi General Hospital,
Tzu-Chi University, Hualien, Taiwan (Republic of China)
(Yeh) Cardiovascular Division, Department of Internal Medicine, MacKay
Memorial Hospital, Mackay Medical College, New Taipei City, Taiwan
(Republic of China)
(Wu) Division of Cardiology, Department of Internal Medicine, National
Taiwan University Hospital and National Taiwan University College of
Medicine, Taipei, Taiwan (Republic of China)
(Wu) Graduate Institute of Medical Education & Bioethics, College of
Medicine, National Taiwan University, Taipei, Taiwan (Republic of China)
Publisher
Elsevier B.V.
Abstract
Background: Fatty-acid binding protein-4 (FABP4) has been associated with
the metabolic syndrome, diabetes mellitus, atherosclerosis, incident heart
failure, and the prognosis of coronary heart disease (CHD). However,
recent studies have not reported a significant correlation between FABP4
and cardiovascular (CV) mortality in high-risk patients or those with
documented CHD. The present study aimed to evaluate the association
between FABP4 and the prognosis in a cohort of patients with CHD who
received coronary interventions. <br/>Method(s): Serum FABP4 levels were
measured in 973 patients after a successful intervention for CHD, who were
then prospectively followed for 30 months. <br/>Result(s): During this
period, 223 patients experienced composite CV outcomes (22.92%), defined
as cardiovascular/cerebrovascular death, nonfatal myocardial infarction
(MI), nonfatal stroke, hospitalization for refractory or unstable angina,
hospitalization for heart failure, and peripheral artery occlusive
disease. Kaplan-Meier curves showed a significant association between
FABP4 levels at baseline (categorized in tertiles) and composite CV
outcomes during follow-up (log-rank test, p < 0.003). The patients with
the highest tertile of baseline FABP4 had an increased risk of composite
CV outcomes (hazard ratio (HR) 1.662; 95% confidence interval (CI),
1.2-2.302; p = 0.0022), which remained significant after multivariate
adjustments for traditional risk factors and hs-CRP (HR 1.596; 95% CI,
1.088-2.342; p = 0.0168). In contrast, FABP4 failed to show a significant
association with cardiovascular/cerebrovascular death, nonfatal MI, or
nonfatal stroke after multivariate adjustments (HR, 1.594; 95% CI,
0.651-3.904, p = 0.3073). <br/>Conclusion(s): In conclusion, circulating
FABP4 is an independent prognostic predictor for the composite
cardiovascular events in the patients with stable CHD after coronary
interventions.<br/>Copyright &#xa9; 2020 Formosan Medical Association

<36>
Accession Number
2007794871
Title
The Shaggy Aorta Syndrome: An Updated Review.
Source
Annals of Vascular Surgery. 70 (pp 528-541), 2021. Date of Publication:
January 2021.
Author
Serra R.; Bracale U.M.; Jiritano F.; Ielapi N.; Licastro N.; Provenzano
M.; Andreucci M.; Pingitore A.; de Franciscis S.; Mastroroberto P.;
Serraino G.F.
Institution
(Serra, Ielapi, de Franciscis) Interuniversity Center of Phlebolymphology
(CIFL). International Research and Educational Program in Clinical and
Experimental Biotechnology" at the Department of Medical and Surgical
Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
(Serra, Licastro, de Franciscis) Department of Medical and Surgical
Sciences, University of Catanzaro, Catanzaro, Italy
(Bracale, Licastro) Department of Public Health, University of Naples
"Federico II", Naples, Italy
(Jiritano, Mastroroberto, Serraino) Department of Experimental and
Clinical Medicine, University of Catanzaro, Catanzaro, Italy
(Ielapi) Sapienza" University of Rome, Department of Public Health and
Infectious Disease, Roma, Italy
(Provenzano, Andreucci) Department of Health Sciences, University of
Catanzaro, Catanzaro, Italy
(Pingitore) Department of Radiology, Pugliese-Ciaccio Hospital of
Catanzaro, Catanzaro, Italy
Publisher
Elsevier Inc.
Abstract
Background: Shaggy aorta (SA) depicts the severe aortic surface
degeneration, extremely friable, and likely to cause spontaneous
peripheral and visceral embolization or during catheterization, aortic
manipulation, surgery, or minimally invasive procedures. This study aims
to provide the most accurate and up-to-date information on this disease.
<br/>Method(s): Potentially eligible studies to be included were
identified by searching the following databases: CENTRAL Library,
ClinicalTrials.gov, MEDLINE, and CINAHL, using a combination of subject
headings and text words to identify relevant studies: (Shaggy aorta) OR
(aortic embolization) OR (aortic embolism) OR (aortic thrombus) OR (aortic
plaque). From a total of 29,111 abstracts, and after applying inclusion
and exclusion criteria, we considered 60 studies for inclusion in this
review. <br/>Result(s): Appropriate measurement and assessment of the
aortic wall are pivotal in the modern era, in particular when percutaneous
procedures are performed, as SA has been identified as an independent risk
factor for spinal cord injury, mesenteric embolization, and cerebral
infarction after endovascular aortic repair. Furthermore, SA increases the
rate of cerebral complications during transcatheter aortic valve
implantation. <br/>Conclusion(s): In conclusion, prompt diagnosis of SA
syndrome and appropriate guidelines on the management of these conditions
may help physicians to better assess the patient risk and to minimize the
dreadful-related complications.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<37>
Accession Number
633172484
Title
Association of Culprit Lesion Location with Outcomes of
Culprit-Lesion-Only vs Immediate Multivessel Percutaneous Coronary
Intervention in Cardiogenic Shock: A Post Hoc Analysis of a Randomized
Clinical Trial.
Source
JAMA Cardiology. 5 (12) (pp 1329-1337), 2020. Date of Publication:
December 2020.
Author
Farhan S.; Vogel B.; Montalescot G.; Barthelemy O.; Zeymer U.; Desch S.;
De Waha-Thiele S.; Maier L.S.; Sandri M.; Akin I.; Fuernau G.; Ouarrak T.;
Hauguel-Moreau M.; Schneider S.; Thiele H.; Huber K.
Institution
(Farhan, Vogel) Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Farhan, Vogel, Huber) Wilhelminenspital, Department of Cardiology,
Vienna, Austria
(Montalescot, Barthelemy, Hauguel-Moreau) ACTION Study Group, Centre
Hospitalier Universitaire Pitie-Salpetriere, Sorbonne Universite Paris 6,
Paris, France
(Zeymer, Ouarrak, Schneider) Institut fur Herzinfarktforschung,
Ludwigshafen, Germany
(Desch, Sandri, Thiele) Heart Center Leipzig, University of Leipzig,
Leipzig Heart Institute, Leipzig, Germany
(De Waha-Thiele, Fuernau) Department of Internal
Medicine/Cardiology/Angiology/Intensive Care Medicine, University Heart
Center Luebeck, Luebeck, Germany
(Maier) Department of Cardiology, Pneumology, and Intensive Care,
University Hospital Regensburg, Regensburg, Germany
(Akin) University Medical Centre Mannheim, First Department of Medicine,
Faculty of Medicine, University of Heidelberg, Mannheim, Germany
(Huber) Medical School, Sigmund Freud University, Vienna, Austria
Publisher
American Medical Association
Abstract
Importance: Myocardial infarction with a culprit lesion located in the
left main or proximal left anterior descending artery compared with other
coronary segments is associated with more myocardium at risk and worse
clinical outcomes. <br/>Objective(s): To evaluate the association of
culprit lesion location with outcomes of culprit-lesion-only percutaneous
coronary intervention with optional staged revascularization vs immediate
multivessel percutaneous coronary intervention in patients with
multivessel disease, myocardial infarction, and cardiogenic shock.
<br/>Design, Setting, and Participant(s): Post hoc analysis of the Culprit
Lesion Only Coronary Intervention vs Multivessel Coronary Intervention in
Cardiogenic Shock (CULPRIT-SHOCK), an investigator-initiated randomized,
open-label clinical trial. Patients with multivessel disease, acute
myocardial infarction, and cardiogenic shock were enrolled at 83 European
centers from April 2013 through April 2017. <br/>Intervention(s): Patients
were randomized to culprit-lesion-only percutaneous coronary intervention
with optional staged revascularization or immediate multivessel
percutaneous coronary intervention (1:1). For this analysis, patients were
stratified by culprit lesion location in the left main or proximal left
anterior descending artery group and other-culprit-lesion location group.
<br/>Main Outcomes and Measures: End points included a composite of death
or kidney replacement therapy at 30 days and death at 1 year.
<br/>Result(s): The median age of the study population was 70
(interquartile range, 60-78 years) and 524 of the study participants were
men (76.4%). Of the 685 patients, 33.4% constituted the left main or
proximal left anterior descending artery group and 66.6% the
other-culprit-lesion location group. The left main or proximal left
anterior descending artery group had worse outcomes compared with the
other-culprit-lesion location group (56.8% vs 47.5%; P =.02 for the
composite end point at 30 days and 59.8% vs 50.1%; P =.02 for death at 1
year). In both groups, culprit-lesion-only vs immediate multivessel
percutaneous coronary intervention was associated with a reduced risk of
the composite end point at 30 days (49.1% vs 64.3% and 44.1% vs 50.9%; P
for interaction =.27). At 1 year, culprit-lesion-only vs immediate
multivessel percutaneous coronary intervention was associated with a
significantly reduced risk of death in the left main or proximal left
anterior descending artery but not the other-culprit-lesion location group
(50.0% vs 69.6%; P =.003 and 49.8% vs 50.4%; P =.89; P for interaction =
0.02). <br/>Conclusions and Relevance: In patients with multivessel
disease with myocardial infarction and cardiogenic shock, a culprit lesion
located in the left main or proximal left anterior descending artery vs
other coronary segments was associated with worse outcomes. These patients
may especially benefit from culprit-lesion-only percutaneous coronary
intervention with optional staged revascularization, although further
investigation is needed to confirm this finding.<br/>Copyright &#xa9; 2020
American Medical Association. All rights reserved.

<38>
Accession Number
2007424830
Title
Implantable cardioverter-defibrillators in cardiac transplant recipients:
A systematic review from the Electrophysiology Collaborative Consortium
for Meta-analysis-ELECTRAM investigators.
Source
PACE - Pacing and Clinical Electrophysiology. 43 (12) (pp 1529-1537),
2020. Date of Publication: December 2020.
Author
Garg J.; Shah K.; Turagam M.K.; Tzou W.; Gopinathannair R.; Natale A.;
Lakkireddy D.
Institution
(Garg) Division of Cardiology, Cardiac Arrhythmia Service, Medical College
of Wisconsin, Milwaukee, WI, United States
(Shah) Department of Cardiovascular Medicine, Beaumont Hospital, Oakland
University William Beaumont School of Medicine, Royal Oak, MI, United
States
(Turagam) Cardiac Arrhythmia Service, Helmsley Electrophysiology Center,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Tzou) Division of Cardiology, Section of Cardiac Electrophysiology,
University of Colorado School of Medicine, Aurora, CO, United States
(Gopinathannair, Lakkireddy) Division of Electrophysiology, Kansas City
Heart Rhythm Institute and Research Foundation, Kansas City, KS, United
States
(Natale) Division of Electrophysiology, Texas Cardiac Arrhythmia Institute
at St. David's Medical Center, Austin, TX, United States
Publisher
Blackwell Publishing Inc.
Abstract
Introduction: Implantable cardioverter-defibrillator (ICD) in patients
with heart failure with reduced ejection fraction reduces mortality
secondary to malignant arrhythmias. Whether cardiac transplant patients
considered high risk for sudden death (SD) derive similar benefits remains
controversial. <br/>Method(s): Systematic search, without language
restriction, using PubMed, EMBASE, SCOPUS, Google Scholar, and
ClinicalTrials.gov was performed from inception to June 4, 2020, for
studies that had reported outcomes in patients who had ICD implanted after
cardiac transplant. The outcomes studied were as follows: (a) SD and (b)
appropriate and inappropriate ICD therapies. <br/>Result(s): Seven studies
(from 1983 through 2018) with a total of 338 cardiac transplant patients
who received ICD met study inclusion criteria. The mean age was 48.37 +/-
14.85 years, and 70.4% were men. The pooled incidence of SD was 16.3% (95%
CI 6.2-29.0%; I²= 66%). Appropriate and inappropriate ICD
therapies were observed in 12.1% (95% CI 5.3-20.4; I²= 0%) and
3.5% (95% CI 0.11-9.58%; I²= 0%), respectively during the
follow-up period (27.48 +/- 24.27 months). The most common cause for SD
was heart failure (15.6%), followed by electromechanical disassociation,
malignant ventricular arrhythmias (4.7% each, respectively), and cardiac
allograft vasculopathy (CAV) (3.1%). Furthermore, approximately 60%
(10/17) of patients with appropriate ICD shocks had CAV.
<br/>Conclusion(s): Despite, low incidence of arrhythmic mortality, there
remains an increased burden of ventricular arrhythmias, as evident by a
12% appropriate ICD shock rates, suggesting ICD might be a practical
decision in selected cardiac transplant patients deemed high risk of SD
(i.e., patients with advanced CAV and left ventricular systolic
dysfunction).<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<39>
[Use Link to view the full text]
Accession Number
2007624116
Title
Outcomes of cardiac surgery in Jehovah's Witness patients: A review.
Source
Perfusion (United Kingdom). (no pagination), 2020. Date of Publication:
2020.
Author
Chambault A.-L.; Brown L.J.; Mellor S.; Harky A.
Institution
(Chambault, Brown, Mellor) Medical School, College of Medical and Dental
Sciences, University of Birmingham, Birmingham, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Life Sciences,
University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
(Harky) Department of Cardiac Surgery, Alder Hey Children Hospital,
Liverpool, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: To review current literature evidence on outcomes of cardiac
surgery in Jehovah's Witness patients. <br/>Method(s): A comprehensive
electronic literature search was done from 2010 to 20th August 2020
identifying articles that discussed optimisation/outcomes of cardiac
surgery in Jehovah's Witness either as a solo cohort or as comparative to
non-Jehovah's Witnesses. No limit was placed on place of publication and
the evidence has been summarised in a narrative manner within the
manuscript. <br/>Result(s): The outcomes of cardiac surgery in Jehovah's
Witness patients has been described, and also compared, to non-Witness
patients within a number of case reports, case series and comparative
cohort studies. Many of these studies note no significant differences
between outcomes of the two groups for a number of variables, including
mortality. Pre-, intra and post-operative optimisation of the patients by
a multidisciplinary team is important to achieve good outcomes.
<br/>Conclusion(s): The use of a bloodless protocol for Jehovah's
Witnesses does not appear to significantly impact upon clinical outcomes
when compared to non-Witness patients, and it has even been suggested that
a bloodless approach could provide advantages to all patients undergoing
cardiac surgery. Larger cohorts and research across multiple centres into
the long term outcomes of these patients is required.<br/>Copyright &#xa9;
The Author(s) 2020.

<40>
Accession Number
2010441185
Title
Remote ischaemic preconditioning attenuates cardiac biomarkers during
vascular surgery: A randomised clinical trial.
Source
Atherosclerosis. Conference: EAS 2020 Congress. 315 (pp e240-e241), 2020.
Date of Publication: December 2020.
Author
Kasepalu T.; Kuusik K.; Lepner U.; Starkopf J.; Zilmer M.; Eha J.; Vahi
M.; Kals J.
Institution
(Kasepalu, Lepner, Kals) University of Tartu, Department Of Surgery,
Tartu, Estonia
(Kuusik, Eha) University of Tartu, Department Of Cardiology, Tartu,
Estonia
(Starkopf) University of Tartu, Department Of Anaesthesiology And
Intensive Care, Tartu, Estonia
(Zilmer) University of Tartu, Department Of Biochemistry, Tartu, Estonia
(Vahi) University of Tartu, Institute Of Mathemathics And Statistics,
Tartu, Estonia
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: The risk for 30-day cardiovascular mortality or
myocardial infarction is estimated to be moderate or high in vascular
surgeries. The main aim of this study was to evaluate the effect of remote
ischaemic preconditioning (RIPC) on preventing the leakage of cardiac
damage biomarkers in patients undergoing vascular surgery. <br/>Method(s):
Randomised, sham-controlled, double-blinded, single-centre study has been
carried out. In recruitment patients undergoing open abdominal aortic
aneurysm repair, surgical lower limb revascularisation surgery or carotid
endarterectomy were enrolled non-consecutively. The RIPC protocol
consisting of 4 cycles of 5 minutes of ischaemia, followed by 5 minutes of
reperfusion, was applied. A RIPC or a sham procedure was performed
noninvasively at the same time as the patient was prepared for
anaesthesia. High sensitivity troponin T level was measured preoperatively
as well as 2, 8 and 24 hours after surgery and pro b-type natriuretic
peptide was measured preoperatively and 24 hours after surgery.
<br/>Result(s): There was significantly higher leakage of high sensitivity
troponin T (peak change median 2 ng/L, IQR 0.9-6.2 ng/L vs 0.6 ng/L, IQR
0.7-2.1 ng/L, p=0.0002) and pro b-type natriuretic peptide (change median
144 pg/mL, IQR 17-318 pg/mL vs 51 pg/mL, IQR 12-196 pg/mL, p=.02) in the
sham group compared to the RIPC group. <br/>Conclusion(s): RIPC reduces
the leakage of high sensitivity troponin T and pro b-type natriuretic
peptide. Therefore, it may reduce cardiac damage in patients undergoing
non-cardiac vascular surgery. The clinical significance of RIPC has to be
evaluated in larger studies excluding the factors known to influence its
effect.<br/>Copyright &#xa9; 2020

<41>
[Use Link to view the full text]
Accession Number
2010440618
Title
Comparison of 12-month regular or remote monitoring in patients after
coronary stenting.
Source
Atherosclerosis. Conference: EAS 2020 Congress. 315 (pp e247), 2020. Date
of Publication: December 2020.
Author
Osokina A.K.; Filatova A.Y.; Potekhina A.V.; Noeva E.A.; Shchinova A.M.;
Masenko V.P.; Arefieva T.I.; Provatorov S.I.
Institution
(Osokina, Potekhina, Noeva, Shchinova, Masenko, Provatorov) National
Medical Research Center of Cardiology, Institute Of Clinical Cardiology,
Moscow, Russian Federation
(Filatova) National Medical Research Center of Cardiology, Institute Of
Experimental Cardiology, Institute Of Clinical Cardiology, Moscow, Russian
Federation
(Arefieva) National Medical Research Center of Cardiology, Institute Of
Experimental Cardiology, Moscow, Russian Federation
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims: The low adherence to cardiovascular treatment is a
well known problem. We aimed to investigate the LDL and hsCRP blood level
dynamics in patients after coronary stenting (CS) receiving remote
monitoring or care with outpatient visits. <br/>Method(s): We enrolled 132
patients (93 men, 62 (55; 68) years), with stable angina, who underwent
CS. The patients were randomized into groups of care with regular
outpatient visits (Group 1, n=62) or to remote monitoring (Group 2, n=61).
The patients were receiving conventional treatment with LDL-based statin
regimen. The visits (cardio exam and blood testing for LDL, hsCRP,
transaminases and creatinkinase) and remote monitoring (56%
videoconference, 44% telephone care and blood tests interpretation) were
performed at 1, 3, 6 and 12 months after CS. <br/>Result(s): The groups of
care with outpatient visits and remote monitoring after CS showed the same
trend of LDL blood level decline with no differences between groups. Group
1 baseline/1mo/3mo/6mo/12mo LDL blood levels (mmol/l): 2.2(1.8;2.8)
/1.9(1.6;2.3)* /2.0(1.6;2.3)* /1.9(1.6;2.2)* /2.2(1.7;2.6). Group 2:
2.3(1.7;2.7) /1.9(1.7;2.7)* /1.8(1.6;2.5)* /1.9(1.7;2.9) /2.0(1.8;2.2),
respectively, (*p<0.05 vs. baseline). hsCRP level decrease was observed in
group 1 but not in group 2. Group 1 baseline/1mo/3mo/6mo hsCRP blood
levels (mg/l): 1.4(1.0;3.0) /1.3(0.6;2.1) /1.2*(0.8;2.0) /1.1(0.5;2.6)*
/1.4(0.8;2.6). Group 2: 1.5(0.6;3.0) /1.7(0.7;3.5) /1.5(0.6;2.7)
/2.6(1.5;4.5) /1.7(0.6;2.4), respectively, (*p<0.05 vs. baseline).
<br/>Conclusion(s): The remote monitoring is a safe strategy for improving
and maintaining the adherence to treatment in patients after CS. The
regular outpatient monitoring is associated with more favorable
inflammatory status.<br/>Copyright &#xa9; 2020

<42>
Accession Number
633811668
Title
Awareness and Attitude about Heart Transplantation among Undergraduate
Nursing Students: An Institution-Based Survey in India.
Source
Acta Medica International. 7 (2) (pp 76-80), 2020. Date of Publication:
July-December 2020.
Author
Sharma S.K.; Sadhanu H.; Naithani M.; Darbari A.; Bharadwaj J.; Sharma M.
Institution
(Sharma, Sadhanu, Sharma) Department of College of Nursing, AIIMS,
Rishikesh, India
(Naithani) Department of Biochemistry, AIIMS, Rishikesh, India
(Darbari) CTVS, AIIMS, Rishikesh, India
(Bharadwaj) Faculty (Nutrition), State Nursing College, Dehradun,
Uttarakhand, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: Heart transplantation is the currently available and
established lifesaving therapy for the end stage heart failure.
Considering the paucity of data about nurses' awareness and attitude about
heart transplantation, this survey was undertaken. The aim of this study
was to assess the awareness and attitude regarding heart transplantation
among undergraduate nursing students. A questionnaire based cross
sectional survey was conducted among undergraduate nursing students
studying in an institute of national importance in India. <br/>Material(s)
and Method(s): A prevalidated questionnaire was administered among 147
randomly selected participants who were willing to participate in the
study. <br/>Result(s): All the students (100%) were aware about organ
donation, but majority (77.5%) informed that their source of information
on this topic is by Internet/media. Around 18.4% of participants had
already pledged permission for organ donation after death and 70.8% were
willing to donate the organ after death. <br/>Conclusion(s): Results
showed the gap existence and need of addressing this among undergraduate
nursing students regarding organ donation and heart
transplantation.<br/>Copyright &#xa9; 2020 Wolters Kluwer Medknow
Publications. All rights reserved.

<43>
Accession Number
2007701128
Title
Transcatheter versus surgical aortic valve replacement in patients with
chronic obstructive pulmonary disease.
Source
Scandinavian Cardiovascular Journal. (no pagination), 2020. Date of
Publication: 2020.
Author
Takagi H.; Kuno T.; Hari Y.; Nakashima K.; Yokoyama Y.; Ueyama H.; Ando T.
Institution
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Kuno, Ueyama) Department of Medicine, Mount Sinai Beth Israel Medical
Center, New York, NY, United States
(Yokoyama) Department of Surgery, Easton Hospital, Easton, PA, United
States
(Ando) Division of Interventional Cardiology, Department of Cardiology,
New York Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: Although a number of studies compared mortality after
transcatheter aortic valve implantation (TAVI) with that after surgical
aortic replacement (SAVR) in patients with chronic obstructive pulmonary
disease (COPD), no meta-analysis of them has been conducted to date. To
determine whether TAVI or SAVR is associated with better postprocedural
survival in patients with COPD, a meta-analysis of all studies currently
available was performed. Design. To identify all comparative studies of
TAVI with SAVR in patients with COPD, PubMed and Web of Science were
searched through January 2020. Studies meeting the following criteria were
included in the present meta-analysis: the design was an observational
comparative study or a randomized controlled trial; the study population
was patients with COPD; patients were assigned to TAVI versus SAVR; and
outcomes included all-cause mortality. Adjusted (if unavailable,
unadjusted) odds or hazard ratios with their confidence intervals (CIs) of
mortality for TAVI versus SAVR were extracted from each study.
Study-specific estimates were combined in the random-effects model.
Results. Six eligible studies with a total of 4771 patients with COPD were
identified and included in the present meta-analysis. The meta-analysis
indicated significantly lower early (in-hospital or 30-day) mortality
after TAVI than after SAVR (odds ratio, 0.69; 95% CI, 0.53-0.90; p =.006)
but no significant difference in midterm (1-year to 5-year) mortality
between TAVI and SAVR (hazard ratio, 1.07; 95% CI, 0.79-1.44; p =.68).
Conclusions. In patients with COPD, TAVI was associated with reduced early
mortality, while midterm mortality appeared similar, as compared with
SAVR.<br/>Copyright &#xa9; 2020 Informa UK Limited, trading as Taylor &
Francis Group.

<44>
Accession Number
633817562
Title
Neuromuscular and Clinical Recovery in Thoracic Surgical Patients Reversed
With Neostigmine or Sugammadex.
Source
Anesthesia and analgesia. (no pagination), 2020. Date of Publication: 10
Dec 2020.
Author
Murphy G.S.; Avram M.J.; Greenberg S.B.; Bilimoria S.; Benson J.; Maher
C.E.; Teister K.J.; Szokol J.W.
Institution
(Murphy, Greenberg, Bilimoria, Benson, Maher, Teister, Szokol) From the
Department of Anesthesiology, NorthShore University HealthSystem,
University of Chicago Pritzker School of Medicine, Evanston, IL, United
States
(Avram) Department of Anesthesiology, Northwestern University Feinberg
School of Medicine, Chicago, IL, Mexico
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients undergoing thoracoscopic procedures may be at
high-risk for incomplete neuromuscular recovery and associated
complications. The aim of this clinical investigation was to assess the
incidence of postoperative residual neuromuscular blockade in adult
thoracic surgical patients administered neostigmine or sugammadex when
optimal dosing and reversal strategies for these agents were used. The
effect of choice of reversal agent on hypoxemic events and signs and
symptoms of muscle weakness were also determined. Additionally, operative
conditions in each group were graded by surgeons performing the
procedures. <br/>METHOD(S): Two hundred patients undergoing thoracoscopic
surgical procedures were enrolled in this nonrandomized controlled trial.
One hundred consecutive patients maintained at moderate levels of
neuromuscular blockade were reversed with neostigmine (neostigmine group)
followed by 100 consecutive patients given sugammadex to antagonize deeper
levels of neuromuscular blockade (sugammadex group). Anesthetic and
neuromuscular management were standardized. Surgeons rated operative
conditions at the conclusion of the procedure on a 4-point scale (grade 1
= excellent to grade 4 = poor). Train-of-four ratios were measured
immediately before extubation and at PACU admission (primary outcomes).
Postoperatively, patients were assessed for adverse respiratory events and
11 signs and 16 symptoms of muscle weakness. <br/>RESULT(S): The 2 groups
were similar in intraoperative management characteristics. The percentage
of patients with residual neuromuscular blockade, defined as a normalized
train-of-four ratio <0.9, was significantly greater in the neostigmine
group than the sugammadex group at both tracheal extubation (80% vs 6%,
respectively, P < .0001) and PACU admission (61% vs 1%, respectively, P <
.0001). Patients in the neostigmine group had less optimal operative
conditions (median score 2 [good] versus 1 [excellent] in the sugammadex
group; P < .0001), and more symptoms of muscle weakness were present in
these subjects (median number [interquartile range] 4 [1-8] vs 1 [0-2] in
the sugammadex group, P < .0001). No differences between groups in adverse
airway events were observed. <br/>CONCLUSION(S): Despite the application
of strategies documented to reduce the risk of residual neuromuscular
blockade, a high percentage of thoracoscopic patients whose neuromuscular
blockade was reversed with neostigmine were admitted to the PACU with
clinical evidence of residual paralysis. In contrast, muscle weakness was
rarely observed in patients whose neuromuscular blockade was antagonized
with sugammadex.

<45>
Accession Number
2010427472
Title
MAGGIC, STS, and EuroSCORE II Risk Score Comparison After Aortic and
Mitral Valve Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2020.
Date of Publication: 2020.
Author
Zhuo D.X.; Bilchick K.C.; Shah K.P.; Mehta N.K.; Mwansa H.; Nkanza-Kabaso
K.; Kwon Y.; Breathett K.K.; Hilton-Buchholz E.J.; Mazimba S.
Institution
(Zhuo, Bilchick, Shah, Mehta, Mazimba) University of Virginia Health
System, Department of Medicine, Division of Cardiovascular Medicine,
Charlottesville, VA, United States
(Mwansa) OSF Saint Francis Medical Center, Peoria, IL, United States
(Nkanza-Kabaso) University of Cape Town, Groote Schuur Hospital, Cape
Town, South Africa
(Kwon) University of Washington Medical Center, University of Washington
Division of Cardiology, Harborview Medical Center, Seattle, WA, United
States
(Breathett) University of Arizona College of Medicine, Division of
Cardiology/Sarver Heart Center, Tucson, AZ, United States
(Hilton-Buchholz) University of Virginia Health System, Department of
Anesthesiology, Charlottesville, VA, United States
Publisher
W.B. Saunders
Abstract
Objectives: To compare the Meta-Analysis Global Group in Chronic Heart
Failure (MAGGIC) risk score with the established Society of Thoracic
Surgeons (STS) and EuroSCORE II risk prediction models regarding mortality
discrimination after aortic and mitral valve surgery. <br/>Design(s):
Retrospective cohort study. <br/>Setting(s): Single tertiary academic
medical center. <br/>Participant(s): A total of 259 patients who underwent
open aortic valve replacement or open mitral valve repair/replacement from
2009-2014. <br/>Intervention(s): Retrospective chart review.
<br/>Measurements and Main Results: MAGGIC, STS, and EuroSCORE II risk
scores for each patient were studied using binary logistic regression and
receiver operating characteristic analysis for the primary endpoint of
one-year mortality and secondary endpoint of 30-day mortality. One-year
mortality C-statistics were similar across risk scores (STS 0.709, 95%
confidence interval [CI] 0.578-0.841; MAGGIC 0.673, 95% CI 0.547-0.799;
EuroSCORE II 0.642, 95% CI 0.521-0.762; p = 0.56 between STS and MAGGIC; p
= 0.20 between STS and EuroSCORE II; and p = 0.69 between MAGGIC and
EuroSCORE II). Thirty-day mortality C-statistics also were similar between
STS (0.797, 95% CI 0.655-0.939; p < 0.0001 v null hypothesis), MAGGIC
(0.721, 95% CI 0.581-0.860; p = 0.33 v STS), and EuroSCORE II (0.688, 95%
CI 0.557-0.818; p = 0.06 v STS; p = 0.68 v MAGGIC). <br/>Conclusion(s):
The MAGGIC risk score performs similarly to STS and EuroSCORE II risk
models in mortality discrimination after aortic and mitral valve surgery,
albeit in a small sample size. This finding has important implications in
establishing MAGGIC as a viable prognostic model in this population
subset, with fewer variables and ease of use representing key advantages
over STS and EuroSCORE II.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<46>
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

<47>
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

<48>
Accession Number
621249873
Title
Comparison between intravenous boluses versus infusion of tranexamic acid
(TXA) to reduce bleeding in paediatric cyanotic congenital heart disease
(CHD) surgeries.
Source
Journal of the College of Physicians and Surgeons Pakistan. 28 (3) (pp
180-183), 2018. Date of Publication: 01 Mar 2018.
Author
Junejo F.; Akhtar M.I.; Hamid M.; Ahmed S.S.; Minai F.; Amanullah M.
Institution
(Junejo, Akhtar, Hamid, Ahmed, Minai, Amanullah) Department of
Anaesthesia, The Aga Khan University Hospital, Karachi, Pakistan
Publisher
College of Physicians and Surgeons Pakistan
Abstract
Objective: To compare the intravenous boluses and intravenous continuous
infusion of tranexamic acid (TXA) to reduce postoperative bleeding in
cyanotic congenital heart disease surgeries. <br/>Study Design:
Single-blinded randomised clinical trial. Place and Duration of Study:
Anaesthesia Department, The Aga Khan University Hospital, Karachi, from
July 2016 to April 2017. Methodology: Sixty patients of cyanotic
congenital heart disease, undergoing either palliative or corrective
surgery involving cardiopulmonary bypass (CPB), were recruited. These 60
patients were divided randomly into two groups. The infusion group
received intravenous infusion of TXA at 5 mg/kg/hour while the bolus group
received three intravenous boluses of 10 mg/kg after induction, after
going to bypass and after protamine reversal. Data was collected through
predesigned proforma. There were two primary outcomes: postoperative
bleeding in the first 24 hours, and chest closure time. <br/>Result(s):
Postoperative bleeding was 13.94 (10.27-20.18) ml/kg in the first 24 hours
in infusion group and 15.05 (9.04- 23.50) ml/kg in the bolus group. Chest
closure time was 38.5 (25-45) in infusion group and 30 (20-46.25) minutes
in the bolus group. There was no statistically significant and clinical
difference between both groups regarding postoperative bleeding in the
first 24 hours and chest closure time. <br/>Conclusion(s): These infusion
and bolus groups had comparable postoperative bleeding and chest closure
time.<br/>Copyright &#xa9; Journal of the College of Physicians and
Surgeons Pakistan 2018.

<49>
Accession Number
2008381014
Title
High-Flow Nasal Cannula in the Immediate Postoperative Period: A
Systematic Review and Meta-analysis.
Source
Chest. 158 (5) (pp 1934-1946), 2020. Date of Publication: November 2020.
Author
Chaudhuri D.; Granton D.; Wang D.X.; Burns K.E.A.; Helviz Y.; Einav S.;
Trivedi V.; Mauri T.; Ricard J.-D.; Mancebo J.; Frat J.-P.; Jog S.;
Hernandez G.; Maggiore S.M.; Mbuagbaw L.; Hodgson C.L.; Jaber S.; Goligher
E.C.; Brochard L.; Rochwerg B.
Institution
(Chaudhuri, Granton, Rochwerg) Department of Medicine, McMaster
University, Hamilton
(Mbuagbaw, Rochwerg) Department of Health Research Methods, Evidence and
Impact, McMaster University, Hamilton
(Wang) Schulich School of Medicine, Western University, London
(Goligher, Brochard) Interdepartmental Division of Critical Care Medicine,
University of Toronto, Toronto, ON, Canada
(Brochard) Keenan Research Centre for Biomedical Science, Li Ka Shing
Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
(Burns, Trivedi, Jaber) Department of Anaesthesiology and Critical Care
Medicine B (DAR B), Saint-Eloi Teaching Hospital, PhyMed Exp, INSERM
U1046, University of Montpellier, Montpellier
(Ricard) Assistance Publique-Hopital de Paris, Service de Reanimation
Medico-chirurgicale, Hopital Louis Mourier, Colombes, France
(Ricard) Universite de Paris, INSERM, IAME, UMR 1137, Paris
(Frat) CHU de Poitiers, Medecine Intensive Reanimation, Poitiers, France
(Frat) INSERM, CIC-1402, equipe ALIVE, Poitiers, France
(Frat) Universite de Poitiers, Faculte de Medecine et de Pharmacie de
Poitiers, Poitiers, France
(Helviz, Einav) General Intensive Care Unit, Shaare Zedek Medical Center,
Jerusalem, Israel
(Einav) Faculty of Medicine, Hebrew University, Jerusalem, Israel
(Mauri) Dipartimento di fisopatologia medico-chirurgica e dei trapianti,
Universita degli Studi di Milano, Milan
(Mauri) Department of Anesthesia, Critical Care and Emergency, Fondazione
IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan
(Maggiore) Department of Medical, Oral and Biotechnological Sciences,
Gabriele d'Annunzio University of Chieti-Pescara, Chieti, Italy
(Maggiore) Department of Anesthesiology and Critical Care, SS. Annunziata
Hospital, Chieti, Italy
(Mancebo) Servei de Medicina Intensiva, Hospital Universitari Sant Pau,
Barcelona, Spain
(Jog) Department of Intensive Care Medicine, Deenanath Mangeshkar Hospital
and Research Centre, Pune, India
(Hernandez) University Hospital Virgen de la Salud, Toledo, Spain
(Hodgson) Department of Epidemiology and Preventive Medicine, Australian
and New Zealand Intensive Care Research Centre, Monash University,
Melbourne, VIC, Australia
Publisher
Elsevier Inc.
Abstract
Background: Studies have demonstrated that high-flow nasal cannula (HFNC)
prevents intubation in acute hypoxic respiratory failure when compared
with conventional oxygen therapy (COT). However, the data examining
routine HFNC use in the immediate postoperative period are less clear.
Research Question: Is routine HFNC use superior to COT or noninvasive
ventilation (NIV) use in preventing intubation in patients
postoperatively? Study Design and Methods: We comprehensively searched
databases (PubMed, Embase, Web of Science) to identify randomized
controlled trials (RCTs) that compared the effect of HFNC use with that of
COT or NIV in the immediate postoperative period on reintubation,
escalation of respiratory support, hospital mortality, ICU and hospital
length of stay (LOS), postoperative hypoxemia, and treatment
complications. We assessed individual study risk of bias (RoB) by using
the revised Cochrane RoB 2 tool and rated certainty in outcomes by using
the Grading of Recommendations Assessment, Development and Evaluation
framework. <br/>Result(s): We included 11 RCTs enrolling 2,201 patients.
Ten compared HFNC with COT and one with NIV. Compared with COT use, HFNC
use in the postoperative period was associated with a lower reintubation
rate (relative risk [RR], 0.32; 95% CI, 0.12-0.88; absolute risk reduction
[ARR], 2.9%; moderate certainty) and decreased escalation of respiratory
support (RR, 0.54; 95% CI, 0.31-0.94; ARR, 5.8%; very low certainty). Post
hoc subgroup analysis suggested that this effect was driven by patients
who were obese and/or at high risk (subgroup differences, P = .06). We did
not find differences in any of the other stated outcomes between HFNC and
COT. HFNC was also no different from NIV in reintubation rate, respiratory
therapy failure, or ICU LOS. <br/>Interpretation(s): With evidence of
moderate certainty, prophylactic HFNC reduces reintubation and escalation
of respiratory support compared with COT in the immediate postoperative
period after cardiothoracic surgery. This effect is likely driven by
patients who are at high risk and/or obese. These findings support
postoperative prophylactic HFNC use in the patients who are at high risk
and/or obese undergoing cardiothoracic surgery.<br/>Copyright &#xa9; 2020
American College of Chest Physicians

<50>
Accession Number
2010331191
Title
Motor impairment in children with congenital heart defects: A systematic
review.
Source
Pediatrics. 156 (6) (no pagination), 2020. Article Number: e20200083. Date
of Publication: 01 Dec 2020.
Author
Bolduc M.-E.; Dionne E.; Gagnon I.; Rennick J.E.; Majnemer A.;
Brossard-Racine M.
Institution
(Bolduc, Dionne, Gagnon, Majnemer, Brossard-Racine) School of Physical and
Occupational Therapy, McGill University, Montreal, Canada
(Rennick) Ingram School of Nursing, McGill University, Montreal, Canada
(Rennick, Majnemer, Brossard-Racine) Departments of Pediatrics, McGill
University, Montreal, Canada
(Majnemer, Brossard-Racine) Neurology and Neurosurgery, McGill University,
Montreal, Canada
(Bolduc, Dionne, Brossard-Racine) Advances in Brain and Child Development
Research Laboratory, The Research Institute of the McGill University
Health Centre, Montreal, Canada
(Rennick) Department of Nursing, Montreal Children's Hospital, McGill
University Health Centre, Montreal, Canada
Publisher
American Academy of Pediatrics
Abstract
CONTEXT: With improvements in survival rates in newborns with congenital
heart defects (CHDs) focus has now shifted toward enhancing
neurodevelopmental outcomes across their life span. <br/>OBJECTIVE(S): To
systematically review the prevalence and extent of motor difficulties in
infants, children, and adolescents with CHD requiring open-heart surgery.
DATA SOURCES: Data sources included Embase, Medline and the Cumulative
Index to Nursing and Allied Health Literature. STUDY SELECTION: Original
studies published between 1997 and 2019 examining gross and/or fine motor
skills in children born with a CHD requiring open-heart surgery were
selected. DATA EXTRACTION: The prevalence of motor impairments and mean
scores on standardized motor assessments were extracted. Findings were
grouped in 5 categories on the basis of the age of the children.
<br/>RESULT(S): Forty-six original studies were included in this
systematic review. The prevalence of mild to severe motor impairments
(scores <-1 SD below normative data or controls) across childhood ranged
from 12.3% to 68.6%, and prevalence ranged from 0% to 60.0% for severe
motor impairments (<-2 SDs). Although our results suggest that the overall
prevalence of motor impairments , <-1 SD remains rather constant across
childhood and adolescence, severe motor impairments (<-2 SDs) appear to be
more prevalent in younger children. LIMITATIONS: Variability in sampling
and methodology between the reviewed studies is the most important
limitation of this review. <br/>CONCLUSION(S): The results of this review
highlight that infants with CHD have an increased risk of motor
impairments across infancy, childhood, and adolescence. These findings
stress the importance of systematic screening or evaluation of motor
skills across childhood and adolescence in children with
CHD.<br/>Copyright &#xa9; 2020 by the American Academy of Pediatrics.

<51>
Accession Number
632765825
Title
Effect of random deferral of percutaneous coronary intervention in
patients with diabetes and stable ischaemic heart disease.
Source
Heart. 106 (21) (pp 1651-1657), 2020. Date of Publication: 01 Nov 2020.
Author
Williams C.; Brown D.L.
Institution
(Williams) Department of Medicine, Washington University in St Louis, St
Louis, MO, United States
(Brown) Cardiovascular Division, Washington University in St Louis, St
Louis, MO 63110-1010, United States
Publisher
BMJ Publishing Group
Abstract
Background In stable ischaemic heart disease (SIHD), measurement of
fractional flow reserve (FFR) to guide selection of lesions for
percutaneous coronary intervention (PCI) reduces death and myocardial
infarction (MI) compared with angiographic guidance. However, it is
unknown if the improved outcomes are due to avoidance of stenting of
physiologically insignificant lesions or are a by-product of placing fewer
stents. Methods We developed a Monte Carlo simulation using the PCI strata
of the Bypass Angioplasty Revascularization Investigation 2 Diabetes study
to investigate how random deferral of PCI impacts outcomes. To simulate
deferral, a randomly selected group of patients randomised to PCI were
removed and replaced by an equal number of randomly selected patients
randomised to intensive medical therapy (IMT) using a random number
generator in Python's NumPy module. The primary endpoint was the rate of
death or non-fatal MI at 1 year. Results Death/MI at 1 year occurred in
8.3% of 798 patients in the PCI group and 5.1% of 807 patients in the IMT
control group (p=0.02). Following 10 000 iterations of random replacement
of 10%, 20%, 30% or 40% of PCI patients with randomly selected IMT
patients, the rate of death/MI at 1 year progressively declined from 8.3%
to 8.0%, 7.6%, 7.3% and 7.0%, respectively. Conclusions In this simulation
model, random deferral of PCI procedures in SIHD progressively reduced
death/MI as the percentage of procedures deferred increases. FFR-guided
deferral of PCI may improve outcomes as a result of placing fewer stents
and be unrelated to the haemodynamic severity of lesions.<br/>Copyright
&#xa9; Author(s) (or their employer(s)) 2020. No commercial re-use. See
rights and permissions. Published by BMJ.

<52>
Accession Number
632631561
Title
Utility of 3D printed cardiac models in congenital heart disease: a
scoping review.
Source
Heart. 106 (21) (pp 1631-1637), 2020. Date of Publication: 01 Nov 2020.
Author
Illmann C.F.; Ghadiry-Tavi R.; Hosking M.; Harris K.C.
Institution
(Illmann, Hosking, Harris) Division of Cardiology, Children's Heart
Centre, BC Children's Hospital, Vancouver, BC V6H 3N1, Canada
(Illmann, Hosking, Harris) Department of Pediatrics, University of British
Columbia, Vancouver, BC, Canada
(Ghadiry-Tavi) Department of Pediatrics, University of Calgary, Calgary,
AB, Canada
Publisher
BMJ Publishing Group
Abstract
Objective Three-dimensional printing (3DP) is a novel technology with
applications in healthcare, particularly for congenital heart disease
(CHD). We sought to explore the spectrum of use of 3D printed CHD models
(3D-CM) and identify knowledge gaps within the published body of
literature to guide future research. Methods We conducted a scoping review
targeting published literature on the use of 3D-CMs. The databases of
MEDLINE, EMBASE and Web of Science were searched from their inception
until 19 July 2019. Inclusion criteria were primary research; studies
reporting use of 3D-CMs; and human subjects. Exclusion criteria were
studies where 3D-CMs were generated for proof of concept but not used; and
studies focused on bioprinting or computational 3D-CMs. Studies were
assessed for inclusion and data were extracted from eligible articles in
duplicate. Results The search returned 648 results. Following assessment,
79 articles were included in the final qualitative synthesis. The majority
(66%) of studies are case reports or series. 15% reported use of a control
group. Three main areas of utilisation are for (1) surgical and
interventional cardiology procedural planning (n=62), (2) simulation
(n=25), and (3) education for medical personnel or patients and their
families (n=17). Multiple studies used 3D-CMs for more than one of these
areas. Conclusions 3DP for CHD is a new technology with an evolving
literature base. Most of the published literature are experiential reports
as opposed to manuscripts on scientifically robust studies. Our study has
identified gaps in the literature and addressed priority areas for future
research.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2020. No
commercial re-use. See rights and permissions. Published by BMJ.

<53>
Accession Number
2005726644
Title
Outcomes After Left Main Coronary Artery Revascularization by Percutaneous
Coronary Intervention or Coronary Artery Bypass Grafting According to
Smoking Status.
Source
American Journal of Cardiology. 127 (pp 16-24), 2020. Date of Publication:
15 July 2020.
Author
Shahim B.; Redfors B.; Chen S.; Morice M.-C.; Gersh B.J.; Puskas J.D.;
Kandzari D.E.; Merkely B.; Horkay F.; Crowley A.; Serruys P.W.; Kappetein
A.P.; Sabik J.F.; Ben-Yehuda O.; Stone G.W.
Institution
(Shahim, Redfors, Chen, Crowley, Ben-Yehuda, Stone) Clinical Trials
Center, Cardiovascular Research Foundation, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors, Chen, Ben-Yehuda) NewYork-Presbyterian Hospital/Columbia
University Medical Center, New York, NY, United States
(Morice) Hopital prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Gersh) Department of Cardiovascular Medicine, Mayo Clinic College of
Medicine, Rochester, MN, United States
(Puskas) Mount Sinai Heart at Mount Sinai Saint Luke's, New York, NY,
United States
(Kandzari) Piedmont Heart Institute, Atlanta, Georgia
(Merkely, Horkay) Heart and Vascular Center, Semmelweis University,
Budapest, Hungary
(Serruys) Department of Cardiology, NUIG, National University of Ireland,
Galway, Ireland
(Serruys) Imperial College of Science, Technology and Medicine, London,
United Kingdom
(Kappetein) Thorax Center, Erasmus MC, Rotterdam, Netherlands
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Cigarette smoking is a well-known risk factor for coronary artery disease
(CAD). However, the impact of smoking on outcomes after coronary
revascularization, especially in patients with left main CAD (LMCAD) is
less well understood. The EXCEL trial randomized 1,905 patients with LMCAD
and visually assessed low or intermediate anatomical complexity (SYNTAX
score <=32) to PCI with everolimus-eluting stents or CABG. Patients were
categorized according to smoking status (current, former, or never), and
their outcomes at 5 years were compared by logistic regression with
follow-up time included as a log-transformed offset variable. The primary
endpoint was a composite of death, myocardial infarction, or stroke. Among
1893 patients with known smoking status at baseline, 416 (22%) were
current smokers and 774 (41%) were former smokers. The crude rates of the
primary endpoint were 19.5% for never smokers, 20.5% for former smokers (p
= 0.61 vs never smokers), and 23.1% for smokers (p = 0.15 vs never
smokers). Compared with never smokers, the adjusted risk of the primary
endpoint was higher for current smokers (adjOR 1.82, 95% confidence
interval [CI] 1.126 to 2.63; p = 0.001), but not for former smokers (adjOR
1.00, 95% CI 0.75 to 1.33, p = 0.10). The relative efficacy of PCI versus
CABG for the 5-year primary endpoint was similar irrespective of smoking
status (P<inf>interaction</inf> = 0.22). In conclusion, current smokers in
the EXCEL trial had a higher adjusted 5-year risk of the primary composite
endpoint of death, myocardial infarction, or stroke than never smokers,
whereas former smokers were not at increased risk. Active smoking was a
risk factor after LMCAD revascularization irrespective of
revascularization method.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<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
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

<56>
Accession Number
2007612399
Title
American Society of ExtraCorporeal Technology: Development of Standards
and Guidelines for Pediatric and Congenital Perfusion Practice (2019).
Source
World Journal for Pediatric and Congenital Heart Surgery. (no pagination),
2020. Date of Publication: 2020.
Author
Oldeen M.E.; Angona R.E.; Hodge A.; Klein T.
Institution
(Oldeen) Division of Cardiovascular-Thoracic Surgery, Ann Robert H. Lurie
Children's Hospital of Chicago, IL, United States
(Angona) University of Rochester Medical Center, Strong Memorial Hospital,
Rochester, NY, United States
(Hodge) Cardiothoracic Surgery, The Heart Center, Nationwide Children's
Hospital, Columbus, OH, United States
(Klein) Cincinnati Children's Hospital Medical Center, OH, United States
Publisher
SAGE Publications Inc.
Abstract
The development of standards and guidelines by professional societies
offers clinicians guidance toward providing evidence-based care. The
ultimate goals of standards and guidelines are to standardize care and
improve patient safety and outcomes while also minimizing risk. The
American Society of ExtraCorporeal Technology (AmSECT) currently offers
perfusionists several clinical resources, primarily the Standards and
Guidelines for Perfusion Practice; however, no document exists specific to
pediatric perfusion. Historically, the development of a pediatric-specific
document has been limited by available scientific evidence due to smaller
patient populations, sample sizes, and variable techniques among
congenital perfusionists. In the current setting of evolving clinical
practices and increasingly complex cardiac operations, a subcommittee of
pediatric perfusionists developed the Standards and Guidelines for
Pediatric and Congenital Perfusion Practice. The development process
included a comprehensive literature review for supporting evidence to
justify new recommendations or updates to the existing AmSECT Adult
Standards and Guidelines document. Multiple revisions incorporating
feedback from the community led to a finalized document accepted by the
AmSECT membership and made available electronically in May 2019. The
Standards and Guidelines for Pediatric and Congenital Perfusion Practice
is an essential tool for pediatric perfusionists and serves as the
backbone for institutionally based protocols, promotes improved
decision-making, and identifies opportunities for future research and
collaboration with other disciplines. The purpose of this manuscript is to
summarize the process of development, the content, and recommended
utilization of AmSECT's Standards and Guidelines for Pediatric and
Congenital Perfusion Practice.<br/>Copyright &#xa9; The Author(s) 2020.

<57>
[Use Link to view the full text]
Accession Number
2007589081
Title
The anti-adhesive effect of anti-VEGF agents in experimental models: A
systematic review.
Source
Wound Repair and Regeneration. (no pagination), 2020. Date of Publication:
2020.
Author
Giannis D.; Geropoulos G.; Ziogas I.A.; Gitlin J.; Oropallo A.
Institution
(Giannis) Institute of Health Innovations and Outcomes Research, The
Feinstein Institutes for Medical Research, Manhasset, NY, United States
(Giannis, Geropoulos, Ziogas) Surgery Working Group, Society of Junior
Doctors, Athens, Greece
(Geropoulos) Thoracic Surgery Department, University College London
Hospitals, NHS Foundation Trust, London, United Kingdom
(Ziogas) Aristotle University of Thessaloniki School of Medicine,
Thessaloniki, Greece
(Gitlin) The Donald and Barbara Zucker School of Medicine at
Hofstra/Northwell, Northwell Health, Hempstead, NY, United States
(Oropallo) Department of Vascular Surgery, The Donald and Barbara Zucker
School of Medicine at Hofstra/Northwell, Northwell Health, New Hyde Park,
NY, United States
Publisher
Blackwell Publishing Inc.
Abstract
Adhesions constitute a major problem in abdominal-pelvic and thoracic
surgery with significant impact in the postoperative quality of life and
healthcare services utilization. Adhesiogenesis is the result of increased
fibrin formation, impaired fibrinolysis, angiogenesis, and fibrosis.
Despite the recent advancements, the ideal anti-adhesive agent remains to
be determined. To this end, we performed a comprehensive literature search
in PubMed, EMBASE, and Scopus databases to identify studies investigating
the antiadhesive role of anti-VEGF agents in peritoneal, pleural, and
pericardial experimental adhesion models. Fifteen studies were eligible
for inclusion with a total population of 602 animals (334 rats, 180
rabbits, and 88 mice). The majority of included studies (11/15) used
bevacizumab, while three studies used other anti-VEGF antibodies and one
study used an anti-VEGFR-antibody. A rat model was used in nine studies,
while rabbit (n = 3) or mouse (n = 3) models were used less frequently.
Eleven studies used peritoneal models, three studies used pleural models,
and one study used a pericardial model. The scales (n = 12) and interval
(Range: 1-42 days) used for the evaluation of adhesions varied between the
studies. All studies demonstrated a significant decrease in adhesion
scores between the anti-VEGF and control groups up to 42 days
postprocedure. VEGF blockade resulted in decreased fibrosis in four out of
five studies that used peritoneal models, while the effect on pleural
models depended on the pleurodesis agent and was significant between 7 and
28 days. The effect of anti-VEGF agents on anastomosis integrity depends
on the dose and the model that is used (inconclusive results).Current data
support the anti-adhesive role of Anti-VEGF agents in all three serosal
surfaces up to 6 weeks postprocedure. Further studies are needed to
confirm the anti-adhesive role of anti-VEGF agents in pleural and
pericardial adhesion experimental models and investigate any effect on
anastomosis integrity in peritoneal models.<br/>Copyright &#xa9; 2020 by
the Wound Healing Society

<58>
Accession Number
631634625
Title
Genotype-guided warfarin dosing may benefit patients with mechanical
aortic valve replacements: randomized controlled study.
Source
Scientific reports. 10 (1) (pp 6988), 2020. Date of Publication: 24 Apr
2020.
Author
Lee K.E.; Yee J.; Lee G.Y.; Chung J.E.; Seong J.M.; Chang B.C.; Gwak H.S.
Institution
(Lee) College of Pharmacy, Chungbuk National University, 660-1, Yeonje-ri,
Osong-eup, Heungdeok-gu, Cheongju-si, 28160, Korea
(Yee, Lee, Seong, Gwak) College of Pharmacy and Graduate School of
Pharmaceutical Sciences, Ewha Womans University, 52 Ewhayeodae-gil
,Seodaemun-gu, Seoul 03760, South Korea
(Chung) College of Pharmacy, Hanyang University, Sangnok-gu, Ansan 15588,
South Korea
(Chang) Department of Thoracic and Cardiovascular Surgery, Bundang CHA
Medical Center, CHA University, Seongnam, 59 ,Bundang-gu 13496, South
Korea
(Chang) Department of Thoracic & Cardiovascular Surgery, Yonsei University
Medical Center, 50-1 Yonsei-ro ,Seodaemun-gu, Seoul 03722, South Korea
Publisher
NLM (Medline)
Abstract
This prospective, single-blind, randomized study was designed to evaluate
the effect of genotype-based warfarin dosing compared with standard
warfarin dosing in Korean patients with mechanical cardiac valves.
Patients were assigned to either the genotype-based dosing group or the
standard dosing group using stratified block randomization. The
genotype-based dosing equation was adopted from a previous study which
included VKORC1 rs9934438, CYP2C9 rs1057910, CYP4F2 rs2108622, and age.
Primary outcomes included the percentage of time in the therapeutic range
(pTTR): (i) during the first week following initiation of warfarin
therapy, (ii) during hospitalization and (iii) until the first outpatient
visit. A total of 91 patients were included in the analysis, 42 treated
with genotype-based warfarin dosing and 49 treated with standard warfarin
dosing. The genotype frequency differences of the three SNPs included in
this study (ie, VKORC1, CYP2C9, CYP4F2), between the genotype-based dosing
and standard dosing groups were not different. The genotype-based dosing
group trended toward higher pTTR when compared with the standard dosing
group, although this difference was not statistically significant. In
patients with aortic valve replacement, TTRTraditional and TTRRosendaal
were significantly higher in the genotype-based dosing group when compared
with the standard dosing group during the first week following treatment
initiation [ie, 58.5% vs. 38.1% (p=0.009) and 64.0% vs. 44.6% (p=0.012),
respectively]. Based on the results, the genotype-guided dosing did not
offer a significant clinical advantage, but a possible benefit in patients
with aortic valve replacement has been suggested.

<59>
Accession Number
631002191
Title
Effects of Exercise Training in Postoperative Patients With Congenital
Heart Disease: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of the American Heart Association. 9 (5) (pp e013516), 2020. Date
of Publication: 03 Mar 2020.
Author
Xu C.; Su X.; Ma S.; Shu Y.; Zhang Y.; Hu Y.; Mo X.
Institution
(Xu, Su, Ma, Shu, Zhang, Hu, Mo) Department of Cardiothoracic Surgery
Children's Hospital of Nanjing Medical University Nanjing China
Publisher
NLM (Medline)
Abstract
Background The purpose of this meta-analysis is to assess the effects of
exercise training on quality of life, specific biomarkers, exercise
capacity, and vascular function in congenital heart disease (CHD) subjects
after surgery. Methods and Results We searched the Cochrane Central
Register of Controlled Trials, MEDLINE, and EMBASE from the date of the
inception of the database through April 2019. Altogether, 1161 records
were identified in the literature search. Studies evaluating outcomes
before and after exercise training among postoperative patients with
congenital heart disease were included. The assessed outcomes were
exercise capacity, vascular function, serum NT-proBNP (N-terminal
pro-B-type natriuretic peptide) levels and quality of life. We analyzed
heterogeneity by using the I2 statistic and evaluated the evidence quality
according to the Grading of Recommendations Assessment, Development, and
Evaluation (GRADE) guidelines. Nine randomized controlled trials were
included. The evidence indicated that exercise interventions increased the
one of the quality of life questionnaire score (mean difference=3.19 [95%
CI, 0.23, 6.16]; P=0.03; I2=39%) from the score before the interventions.
However, no alterations in exercise capacity, vascular function, NT-proBNP
or quality of life were observed after exercise training. The results of
the subgroup analysis showed that NT-proBNP levels were lower in the group
with exercise training than in the group without exercise training over
the same duration of follow-up. The evidence quality was generally
assessed to be low. Conclusions In conclusion, there is insufficient
evidence to suggest that physical exercise improves long-term follow-up
outcomes of congenital heart disease, although it has some minor effects
on quality of life.

<60>
Accession Number
2006945507
Title
Cancer risk in heart or lung transplant recipients: A comprehensive
analysis of 21 prospective cohorts.
Source
Cancer Medicine. 9 (24) (pp 9595-9610), 2020. Date of Publication:
December 2020.
Author
Ge F.; Li C.; Xu X.; Huo Z.; Wang R.; Wen Y.; Peng H.; Wu X.; Liang H.;
Peng G.; Li R.; Huang D.; Chen Y.; Xiong S.; Zhong R.; Cheng B.; Li J.; He
J.; Liang W.
Institution
(Ge, Li, Huo, Wang, Wen, Peng, Wu, Liang, Peng, Li, Huang, Chen, Xiong,
Zhong, Cheng, Li, He, Liang) Department of Thoracic Surgery and Oncology,
China State Key Laboratory of Respiratory Disease & National Clinical
Research Center for Respiratory Disease, the First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, China
(Ge) First Clinical School, Guangzhou Medical University, Guangzhou, China
(Xu, Peng, Li, Huang, Chen) Department of Transplantation, the First
Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
(Huo, Wang, Wen, Peng, Wu) Nanshan School, Guangzhou Medical University,
Guangzhou, China
Publisher
Blackwell Publishing Ltd
Abstract
We performed a meta-analysis to determine cancer risks at multiple sites
and their associations with tumor mutation burden (TMB), an index for
immunogenicity, in heart or lung transplant recipients. A comprehensive
search of PubMed, Web of Science, EMBASE, and Medline was conducted.
Random effects models were used to calculate standardized incidence ratios
(SIRs) versus the general population and to determine the risks of
different cancers. Weighted linear regression (WLR) was used to analyze
the associations between the SIRs and TMBs. (PROSPERO CRD42020159599).
Data from 21 studies including 116,438 transplant recipients (51,173 heart
transplant recipients and 65,265 lung transplant recipients) with a total
follow-up of 601,330.7 person-years were analyzed. Compared with the
general population, heart transplant recipients displayed a 3.13-fold
higher cancer risk [SIR: 3.13; 95% confidence interval (CI): 2.38-4.13; p
< 0.001]; lung transplant recipients displayed a 4.28-fold higher cancer
risk [SIR: 4.28; 95% CI: 3.18-5.77; p < 0.001]. The correlation
coefficients were 0.54 (p = 0.049) and 0.79 (p < 0.001) in heart and lung
transplant recipients, respectively, indicating that 29% and 63% of the
differences in the SIRs for cancer types might be explained by the TMBs.
Our study demonstrated that both heart and lung transplant recipients
displayed a higher risk of certain site-specific cancers. These findings
can provide individualized guidance for clinicians for detection of cancer
among heart or lung transplantation recipients. In addition, we provided
evidence that increased risks of post-transplant cancers can be attributed
to immunosuppression.<br/>Copyright &#xa9; 2020 The Authors. Cancer
Medicine published by John Wiley & Sons Ltd.

<61>
Accession Number
633725343
Title
Myocardial Injury After Balloon Predilatation Versus Direct Transcatheter
Aortic Valve Replacement: Insights From the DIRECTAVI Trial.
Source
Journal of the American Heart Association. 9 (24) (pp e018405), 2020. Date
of Publication: 15 Dec 2020.
Author
Akodad M.; Roubille F.; Marin G.; Lattuca B.; Macia J.-C.; Delseny D.;
Gandet T.; Robert P.; Schmutz L.; Piot C.; Maupas E.; Robert G.; Targosz
F.; Albat B.; Cayla G.; Leclercq F.
Institution
(Akodad, Roubille, Macia, Delseny, Robert, Leclercq) Department of
Cardiology Montpellier University Hospital Montpellier France
(Akodad, Roubille) PhyMedExp INSERM U1046CNRS UMR 9214 Montpellier France
(Marin) Department of Medical Information Montpellier University Hospital
Montpellier France
(Lattuca, Schmutz, Cayla) Department of Cardiology CHU NimesMontpellier
University Nimes France
(Gandet, Albat) Department of Cardiovascular Surgery University Hospital
of Montpellier France
(Piot) Millenaire Clinic Montpellier France
(Maupas) Franciscaines Clinic Nimes France
(Robert) St Pierre Clinic Perpignan France
(Targosz) Perpignan Hospital Perpignan France
Publisher
NLM (Medline)
Abstract
Background Myocardial injury is associated with higher mortality after
transcatheter aortic valve replacement (TAVR) and might be increased by
prior balloon aortic valvuloplasty (BAV). We aimed to evaluate the impact
of prior BAV versus direct prosthesis implantation on myocardial injury
occurring after (TAVR) with balloon-expandable prostheses. Methods and
Results The DIRECTAVI (Direct Transcatheter Aortic Valve Implantation)
trial, an open-label randomized study, demonstrated noninferiority of TAVR
without BAV (direct TAVR group) compared with systematic BAV (BAV group)
with the Edwards SAPIEN 3 valve. High-sensitivity troponin was assessed
before and the day after the procedure. Incidence of myocardial injury
after the procedure (high-sensitivity troponin elevation >15x the upper
reference limit [14 ng/L]) was the main end point. Impact of myocardial
injury on 1-month adverse events (all-cause mortality, stroke, major
bleeding, major vascular complications, transfusion, acute kidney injury,
heart failure, pacemaker implantation, and aortic regurgitation) was
evaluated. Preprocedure and postprocedure high-sensitivity troponin levels
were available in 211 patients. The mean age of patients was 83 years
(78-87 years), with 129 men (61.1%). Mean postprocedure high-sensitivity
troponin was 124.9+/-81.4 ng/L in the direct TAVR group versus
170.4+/-127.7 ng/L in the BAV group (P=0.007). Myocardial injury occurred
in 42 patients (19.9%), including 13 patients (12.2%) in the direct TAVR
group and 29 (27.9%) in the BAV group (P=0.004). BAV increased by 2.8-fold
(95% CI, 1.4-5.8) myocardial injury probability. Myocardial injury was
associated with 1-month adverse events (P=0.03). Conclusions BAV increased
the incidence and magnitude of myocardial injury after TAVR with
new-generation balloon-expandable valves. Myocardial injury was associated
with 1-month adverse events. These results argue in favor of direct SAPIEN
3 valve implantation. Registration URL: https://www.Clinicaltrials.gov;
Unique identifier: NCT02729519.

<62>
Accession Number
633616562
Title
Coronary Computed Tomography Angiography Compared With Single Photon
Emission Computed Tomography Myocardial Perfusion Imaging as a Guide to
Optimal Medical Therapy in Patients Presenting With Stable Angina: The
RESCUE Trial.
Source
Journal of the American Heart Association. 9 (24) (pp e017993), 2020. Date
of Publication: 15 Dec 2020.
Author
Stillman A.E.; Gatsonis C.; Lima J.A.C.; Liu T.; Snyder B.S.; Cormack J.;
Malholtra V.; Schnall M.D.; Udelson J.E.; Hoffmann U.; Woodard P.K.
Institution
(Stillman) Department of Radiology and Imaging Sciences Emory University
Atlanta GA
(Gatsonis, Liu) Department of Biostatistics Brown University School of
Public Health Providence RI
(Gatsonis, Liu, Snyder, Cormack) Center for Statistical Sciences Brown
University School of Public Health Providence RI
(Lima) Departments of Medicine and Radiology Johns Hopkins University
Baltimore MD
(Malholtra) Pulse Heart Institute Tacoma WA
(Schnall) Department of Radiology University of Pennsylvania Boston MA
(Udelson) Division of Cardiology Tufts-New England Medical Center Boston
MA
(Hoffmann) Department of Radiology Massachusetts General Hospital Boston
MA
(Woodard) Mallinckrodt Institute of Radiology Washington University School
of Medicine St. Louis MO
Publisher
NLM (Medline)
Abstract
Background The RESCUE (Randomized Evaluation of Patients with Stable
Angina Comparing Utilization of Noninvasive Examinations) trial was a
randomized, controlled, multicenter, comparative efficacy outcomes trial
designed to assess whether initial testing with coronary computed
tomographic angiography (CCTA) is noninferior to single photon emission
computed tomography (SPECT) myocardial perfusion imaging in directing
patients with stable angina to optimal medical therapy alone or optimal
medical therapy with revascularization. Methods and Results The end point
was first major adverse cardiovascular event (MACE) (cardiac death or
myocardial infarction), or revascularization. Noninferiority margin for
CCTA was set a priori as a hazard ratio (HR) of 1.3 (95% CI=0, 1.605). One
thousand fifty participants from 44 sites were randomized to CCTA (n=518)
or SPECT (n=532). Mean follow-up time was 16.2 (SD 7.9) months. There were
no cardiac-related deaths. In patients with a negative CCTA there was 1
acute myocardial infarction; in patients with a negative SPECT examination
there were 2 acute myocardial infarctions; and for positive CCTA and
SPECT, 1 acute myocardial infarction each. Participants in the CCTA arm
had a similar rate of MACE or revascularization compared with those in the
SPECT myocardial perfusion imaging arm, (HR, 1.03; 95% CI=0.61-1.75)
(P=0.19). CCTA segment involvement by a stenosis of >=50% diameter was a
better predictor of MACE and revascularization at 1 year (P=0.02) than the
percent reversible defect size by SPECT myocardial perfusion imaging. Four
(1.2%) patients with negative CCTA compared with 14 (3.2%) with negative
SPECT had MACE or revascularization (P=0.03). Conclusions There was no
difference in outcomes of patients who had stable angina and who underwent
CCTA in comparison to SPECT as the first imaging test directing them to
optimal medical therapy alone or with revascularization. CCTA was a better
predictor of MACE and revascularization. Registration Information URL:
https://www.clinicaltrials.gov/. Identifier: NCT01262625.

<63>
Accession Number
633805546
Title
Late Breaking Abstract - Complication rates for bronchoscopy procedures
performed at a large UK tertiary teaching hospital.
Source
European Respiratory Journal. Conference: European Respiratory Society
International Congress, ERS 2020. 56 (Supplement 64) (no pagination),
2020. Date of Publication: September 2020.
Author
Crisp E.; Wong Y.K.; Nair A.
Institution
(Crisp, Wong, Nair) Respiratory Department, Nottingham University
Hospitals NHS Trust, Nottingham, United Kingdom
Publisher
European Respiratory Society
Abstract
Aims: Bronchoscopy involves visualisation of the airways with or without
additional procedures. Patients are often offered conscious sedation for
the procedure. The British Thoracic Society (BTS) guidelines suggest
common adverse events based on systematic review, though the ranges given
for incidence are wide. The guidelines discuss sedation drugs although not
dosing. We aimed to review local complication rates and sedation doses to
enable local data to be used to consent patients. <br/>Method(s): A
retrospective study of 2111 consecutive procedures performed at a large
tertiary teaching hospital in the UK between September 2016 and November
2018. Procedures included straight bronchoscopy, endobronchial ultrasound,
transbronchial biopsy and therapeutic bronchoscopy. Data was collected on
indication, sedation dose, FEV1 in the preceding 12months, additional
procedures, complications and mortality. <br/>Result(s): Complications
were documented in 496 cases (23.5%). The most common complications were
bleeding, occurring in 6.9% cases (3.2% minor, 3.7% moderate), and
procedure poorly tolerated, occurring in 6.9% procedures. Desaturation
occurred in 6.1% procedures, cough in 4.5%. Midazolam was used in 91.2%
procedures, mean dose 2mg (range 0.5-5mg). Alfentanil was used in 65.1%
procedures, mean dose 255mcg (range 100-900mcg). FEV1 was recorded in 42%
cases, mean 1.97l/min (range 0.15-4.98l/min). Over-sedation occurred in
0.3% procedures. There were no deaths attributed to a procedure.
<br/>Conclusion(s): Bronchoscopic procedures are generally well tolerated
and without major complications. Sedation doses and FEV1 vary
considerably, however in very few cases was over-sedation a concern.

<64>
Accession Number
633805102
Title
Perioperative management of patients with Pulmonary Hypertension
undergoing Non-Cardiac Surgery: A Systemic Review and UK Consensus
Statement.
Source
European Respiratory Journal. Conference: European Respiratory Society
International Congress, ERS 2020. 56 (Supplement 64) (no pagination),
2020. Date of Publication: September 2020.
Author
Price L.; Brame A.; Martinez G.; Mukerjee B.; Harries C.; Kempny A.;
Marino P.; Church C.; Johnson M.; Condliffe R.; Kiely D.; Davies R.;
Howard L.; Coghlan G.; Lordan J.; Taboada D.; Pickworth T.; Alexander D.;
Wong D.; Curry A.; Gaine S.; Garfield B.; Reed N.; Price S.; Ledot S.;
Dimopoulos K.; Wort S.J.
Institution
(Price) LondonUnited Kingdom
(Brame, Mukerjee, Harries, Kempny, Marino) Guys and St Thomas's Hospital,
London, United Kingdom
(Martinez) Addenbrookes Hospital, Cambridge, United Kingdom
(Church, Johnson) Scottish Pulmonary Vascular Unit, Glasgow, United
Kingdom
(Condliffe, Kiely) Royal Hallamshire, Sheffield, United Kingdom
(Davies, Howard) Hammersmith Hospital, London, United Kingdom
(Coghlan) Royal Free Hospital, London, United Kingdom
(Lordan) Newcastle, Newcatle, United Kingdom
(Taboada) Addenbrookes Hospital, Cambride, United Kingdom
(Pickworth, Alexander, Garfield) Royal Brompton Hospital, London, United
Kingdom
(Wong) Guys and St Thomas's Hospital, London, United Kingdom
(Curry) University Hospital Southampton, Southamton, United Kingdom
(Gaine) DublinIreland
(Reed, Price, Ledot, Dimopoulos, Wort) Royal Brompton and Harefield
Hospital, London, United Kingdom
Publisher
European Respiratory Society
Abstract
Background: The risk of complications, including death, is markedly
increased in patients with pulmonary hypertension (PH) undergoing
anaesthesia for surgical procedures. We performed a systematic literature
review of available studies in patients with PAH or chronic thromboembolic
PH (CTEPH) undergoing non-cardiac, non-obstetric surgery, finding a
mortality ranging between 2-18% in elective and 15-50% in emergency
surgery. Methods/Results: We devised relevant clinical questions based on
expert consensus opinion in order to provide recommendations of best
practice, using a Delphi scoring method. Based on findings from our
literature review and expert opinion, we provide 10 recommendations for
best clinical practice involving (1) preoperative planning and the use of
a perioperative MDT, (2) management of procedural sedation, (3) decision
making where surgery is performed, (4) patient-related risk assessment,
(5) procedure-related risk assessment, (6) perioperative optimization of
PH therapies, (7) perioperative parenteral PAH therapy, (8) perioperative
monitoring and anaesthetic management, (9) postoperative management, and
(1) management of perioperative pulmonary hypertensive crises, including
consideration of ECMO and lung transplantation. Areas for future research
are also suggested. <br/>Conclusion(s): This was a collaborative project
by UK PH services. We provide 10 recommendations for good clinical
practice in this common clinical scenario, where risk assessment is
crucial, as mortality remains high.

<65>
Accession Number
633804491
Title
Randomized Phase III Trial Assessing Regional Lung Function for Thoracic
Resection by Hyperpolarized 129Xenon Gas MRI.
Source
European Respiratory Journal. Conference: European Respiratory Society
International Congress, ERS 2020. 56 (Supplement 64) (no pagination),
2020. Date of Publication: September 2020.
Author
Shim Y.; Mata J.; Hartwig M.; Aragaki-Nakahodo A.; West K.; Emami K.;
Wadehra N.; Cleveland Z.; Walkup L.; Woods J.; Dusek A.; Mugler J.;
Driehuys B.
Institution
(Shim, Mata, Mugler) University of Virginia, Charlottesville, United
States
(Hartwig, Driehuys) Duke University, Durham, United States
(Aragaki-Nakahodo) University of Cincinnati, Cincinnati, United States
(West, Emami, Wadehra, Dusek) Polarean, Inc., Durham, United States
(Cleveland, Walkup, Woods) Cincinnati Children's Hospital Medical Center,
Cincinnati, United States
Publisher
European Respiratory Society
Abstract
3D imaging of pulmonary function without radiation can be achieved by
Hyperpolarized ¹²⁹Xe (HPX) inhaled in a single breath-hold
10-second MRI exam. We conducted a FDA phase III multicenter trial in
patients undergoing surgical thoracic resection to establish the
equivalence of HPX to evaluate regional pulmonary function with the
currently approved standard, 133Xe scintigraphy (XS). Subjects being
evaluated for thoracic resection were randomized to undergo either HPX
followed by XS or XS followed by HPX. ¹²⁹Xe was hyperpolarized
by the Polarean HPX system. Ventilation of the six (6) lung zones was
quantified to determine the contribution of each zone to total lung
function, and then these values were used to predict the % of remaining
lung function if the zones were resected. The primary endpoint would be
met if the 95% confidence interval (CI) of the mean intra-patient
differences fell within the prospectively defined equivalence margin of
+/-14.7%. 32 subjects received HPX and XS, (10 females, age 62.0+/-9.8,
O<inf>2</inf> use 2.7+/- 1.30 liter/min). HPX was well tolerated. Thirteen
subjects (41%) underwent lung resection. The intra-patient mean difference
of the remaining ventilation measured quantified by HPX vs XS was
1.4+/-5.93% (95% CI, -0.75-3.60%). The 95% CI for HPX fell within the
pre-defined equivalence margin, demonstrating equivalence between the two
imaging modalities to a significance level of p<0.001. In patients
undergoing thoracic resection planning, HPX demonstrated a diagnostic
ability to predict post-op in vivo lung function comparable to XS.
Radiation-free, high-resolution, quantitative HPX represents a notable
advance from the current XS technology.

<66>
Accession Number
633803446
Title
Impact of sleep-disordered breathing on sternal wound complications after
elective coronary artery bypass grafting surgery.
Source
European Respiratory Journal. Conference: European Respiratory Society
International Congress, ERS 2020. 56 (Supplement 64) (no pagination),
2020. Date of Publication: September 2020.
Author
Zilch J.; Tafelmeier M.; Lebek S.; Hirt S.; Floerchinger B.; Camboni D.;
Creutzenberg M.; Zeman F.; Schmid C.; Maier L.S.; Wagner S.; Arzt M.
Institution
(Zilch, Tafelmeier, Lebek, Maier, Wagner, Arzt) Department of Internal
Medicine II (Cardiology, Pneumology and Intensive Care), University
Medical Center Regensburg, Regensburg, Germany
(Hirt, Floerchinger, Camboni, Schmid) Department of Cardiothoracic
Surgery, University Medical Center Regensburg, Regensburg, Germany
(Creutzenberg) Department of Anesthesiology, University Medical Center
Regensburg, Regensburg, Germany
(Zeman) Center for Clinical Studies, University Medical Center Regensburg,
Regensburg, Germany
Publisher
European Respiratory Society
Abstract
Introduction: Sternal wound complications (SWC) are an occasional
complication after cardiac surgery. We hypothesized that in contrast to
central sleep apnea (CSA) obstructive sleep apnea (OSA) is associated with
SWC, due to negative intrathoracic pressure swings and hypoxia-induced
inflammation. Therefore, the objectives of the present analyses were to
determine association of CSA and OSA with postoperative SWC accounting for
established risk factors for SWC. <br/>Method(s): This subanalysis of the
ongoing prospective observational study CONSIDER-AF (ClinicalTrials.gov
identifier NCT02877745) examined risk factors for SWC in 308 patients. The
presence and type of sleep-disordered breathing (SDB: OSA or CSA;
Apnoea-Hypopnoea Index (AHI) >=15/h) were assessed with a portable SDB
monitoring device the night before surgery. Physician diagnosed SWC were
retrospectively identified according to medical file information.
<br/>Result(s): The incidence of SWC was similar in patients without SDB
and with CSA (6.3% vs. 6.0%, p=0.926). In patients with OSA SWC occurred
more often compared to those with either no SDB or CSA (13.6% vs. 6.2%,
p=0.047). The severity of SDB was significantly associated with SWC (AHI:
Odds Ratio 1.03, 95% CI 1.00-1.05, p=0.025). In a multivariable logistic
regression model including AHI, body mass index (BMI) and diabetes
mellitus only BMI was significantly associated with the incidence of SWC
(Odds Ratio 1.13, 95% CI 1.03-1.24, p=0.013). <br/>Conclusion(s): Compared
to patients without SDB and CSA, OSA patients had an increased incidence
of SWC. However, after accounting for established risk factors (diabetes
and BMI) AHI was not significantly associated with SWC.

<67>
Accession Number
2007709299
Title
Treating Moderate Aortic Stenosis: Too Early or Too Late?.
Source
Current Treatment Options in Cardiovascular Medicine. 23 (1) (no
pagination), 2021. Article Number: 6. Date of Publication: January 2021.
Author
Bernard S.; Elmariah S.
Institution
(Bernard, Elmariah) Department of Medicine, Division of Cardiology,
Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street,
Boston, MA 02114, United States
Publisher
Springer
Abstract
Purpose of review: It is well established that symptomatic severe aortic
stenosis (AS) carries a poor prognosis and requires valvular replacement
for definitive treatment. While moderate AS has traditionally been thought
of as a benign prelude to the aforementioned, recent data suggests that it
is associated with increased morbidity and mortality. This article will
consider treatment strategies for moderate AS, including early surgical
and transcatheter aortic valve replacement and medical therapy. Recent
findings: There are few randomized controlled trials dedicated to medical
and surgical therapies for moderate AS. Statins, antihypertensive agents
and bisphosphonates have not consistently demonstrated an effect on AS
progression, timing of aortic valve replacement, or improvement in patient
outcomes. Early surgical intervention for patients with concomitant left
ventricular dysfunction has been studied in a retrospective manner and
appears promising. <br/>Summary: Aside from the routine management of
comorbidities (i.e., coronary artery disease, hypertension,
hyperlipidemia), no specific treatment is recommended that is exclusively
directed towards moderate AS. Clinicians should maintain a high vigilance
for AS progression and the development of symptoms. Given the safety and
efficacy of transcatheter aortic valve replacement, a randomized
controlled trial is underway to evaluate its benefits in patients with
moderate AS and left ventricular systolic dysfunction.<br/>Copyright
&#xa9; 2021, Springer Science+Business Media, LLC, part of Springer
Nature.

<68>
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 c 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.

<69>
Accession Number
633808107
Title
Comparison of dynamic needle tip positioning versus conventional long-axis
in-plane techniques for ultrasound-guided internal jugular venous
catheterisation: a randomised controlled trial.
Source
Minerva anestesiologica. (no pagination), 2020. Date of Publication: 15
Dec 2020.
Author
Lee S.; Chang J.-E.; Oh Y.; Yang H.J.; Bae J.; Cho Y.J.; Jeon Y.; Nam K.;
Kim T.K.
Institution
(Lee, Oh, Yang, Bae, Cho, Jeon, Nam) Department of Anaesthesiology and
Pain Medicine, Seoul National University Hospital, Seoul National
University College of Medicine, Seoul, South Korea
(Chang, Oh, Yang) Department of Anaesthesiology and Pain Medicine, Seoul
Metropolitan Government-Seoul, National University Boramae Medical Centre,
Seoul National University College of Medicine, Seoul, South Korea
(Kim) Department of Anaesthesiology and Pain Medicine, Seoul Metropolitan
Government-Seoul, National University Boramae Medical Centre, Seoul
National University College of Medicine, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Continuous visualisation of the needle tip is essential for
successful ultrasound-guided central venous catheterisation, and the
dynamic needle tip positioning (DNTP) technique enables it. The aim of
this randomised, dual-centre trial was to compare the first-attempt
success rate of ultrasound-guided internal jugular catheterisation between
the DNTP and conventional long-axis in-plane (LAX-IP) techniques.
<br/>METHOD(S): Patients undergoing cardiac surgery at two tertiary
teaching hospitals were randomly allocated to either the DNTP or LAX-IP
group. Internal jugular venous catheterisation was performed by four
anaesthesiologists. The primary outcome was the firstattempt success rate
of central venous catheterisation. Procedural time and complications
related to catheterisation were compared as secondary outcomes.
<br/>RESULT(S): In total, 142 patients were analysed. The first-attempt
success rate was significantly higher in the DNTP group (59/72, 81.9%)
than in the LAX-IP group (46/70, 65.7%; odds ratio, 2.37; 95% confidence
interval 1.09-5.15; P = 0.028). In addition, the needle was redirected
less frequently in the DNTP group than the LAX-IP group (P = 0.026).
Procedural time was comparable between the groups. No significant
differences were observed in complications related to catheterisation,
including posterior wall puncture, carotid artery puncture, or haematoma.
<br/>CONCLUSION(S): The DNTP technique resulted in a significantly higher
success rate on the first attempt at internal jugular venous
catheterisation, and required less frequent redirection of the needle
during the procedure than the conventional LAX-IP technique.

<70>
Accession Number
633805972
Title
Exposure-Response Relationship of Tranexamic Acid in Cardiac Surgery.
Source
Anesthesiology. (no pagination), 2020. Date of Publication: 14 Dec 2020.
Author
Zufferey P.J.; Lanoiselee J.; Graouch B.; Vielle B.; Delavenne X.; Ollier
E.
Publisher
NLM (Medline)
Abstract
BACKGROUND: It is unclear whether high-dose regimens of tranexamic acid in
cardiac surgery (total dose, 80 to 100 mg/kg) confer a clinical advantage
over low-dose regimens (total dose, approximately 20 mg/kg), particularly
as tranexamic acid-associated seizure may be dose-related. The authors'
was to characterize the exposure-response relationship of this drug.
<br/>METHOD(S): Databases were searched for randomized controlled trials
of intravenous tranexamic acid in adult patients undergoing
cardiopulmonary bypass surgery. Observational studies were added for
seizure assessment. Tranexamic acid concentrations were predicted in each
arm of each study using a population pharmacokinetic model. The
exposure-response relationship was evaluated by performing a model-based
meta-analysis using nonlinear mixed-effect models. <br/>RESULT(S):
Sixty-four randomized controlled trials and 18 observational studies
(49,817 patients) were included. Seventy-three different regimens of
tranexamic acid were identified, with the total dose administered ranging
from 5.5 mg/kg to 20 g. The maximum effect of tranexamic acid for
postoperative blood loss reduction was 40% (95% credible interval, 34 to
47%), and the EC50 was 5.6 mg/l (95% credible interval, 0.7 to 11 mg/l).
Exposure values with low-dose regimens approached the 80% effective
concentration, whereas with high-dose regimens, they exceeded the 90%
effective concentration. The predicted cumulative blood loss up to 48 h
postsurgery differed by 58 ml between the two regimens, and the absolute
difference in erythrocyte transfusion rate was 2%. Compared to no
tranexamic acid, low-dose and high-dose regimens increased the risk of
seizure by 1.2-fold and 2-fold, respectively. However, the absolute risk
increase was only clinically meaningful in the context of prolonged
open-chamber surgery. <br/>CONCLUSION(S): In cardiopulmonary bypass
surgery, low-dose tranexamic acid seems to be an appropriate regimen for
reducing bleeding outcomes. This meta-analysis has to be interpreted with
caution because the results are observational and dependent on the lack of
bias of the predicted tranexamic acid exposures and the quality of the
included studies.<br/>Copyright &#xa9; 2020, the American Society of
Anesthesiologists, Inc. All Rights Reserved.

<71>
Accession Number
362373722
Title
Current and emerging therapeutic options for the treatment of chronic
chagasic cardiomyopathy.
Source
Vascular Health and Risk Management. 6 (1) (pp 593-601), 2010. Date of
Publication: 2010.
Author
Muratore C.A.; Baranchuk A.
Institution
(Muratore) Department of Cardiology, Arrhythmia Service, Hospital
Fernandez, Buenos Aires, Argentina
(Baranchuk) Department of Cardiology, Arrhythmia Service, Kingston General
Hospital, Kingston, ON, Canada
Publisher
Dove Medical Press Ltd
Abstract
Chagas' disease is an endemic disease in Latin America caused by a
unicellular parasite (Trypanosoma cruzi) that affects almost 18 million
people. This condition involves the heart, causing heart failure,
arrhythmias, heart block, thromboembolism, stroke, and sudden death. In
this article, we review the current and emerging treatment of Chagas'
cardiomyopathy focusing mostly on management of heart failure and
arrhythmias. Heart failure therapeutical options including drugs, stem
cells and heart transplantation are revised. Antiarrhythmic drugs,
catheter ablation, and intracardiac devices are discussed as well.
Finally, the evidence for a potential role of specific antiparasitic
treatment for the prevention of cardiovascular disease is reviewed. &#xa9;
2010 Muratore and Baranchuk, publisher and licensee Dove Medical Press
Ltd.

<72>
Accession Number
633793234
Title
Effects of lung recruitment in the prone position on dorsal lung aeration
and lung oxygenation-a randomized controlled study on post cardiac surgery
patients.
Source
Critical Care. Conference: 40th International Symposium on Intensive Care
and Emergency Medicine, e-ISICEM 2020. 24 (SUPPL 2) (no pagination), 2020.
Date of Publication: 2020.
Author
Martinsson A.M.
Institution
(Martinsson) CardioThoracic Anaesthesia and Intensive Care, Sahlgrenska
University Hospital, Goteborg, Sweden
Publisher
BioMed Central Ltd
Abstract
Introduction: Atelectasis in post cardiac surgery patients is more common
compared to non-cardiac surgery, and may lead to ventilation/perfusion
mismatch, infection, and an increase in ICU stay. A postoperative
recruitment maneuver (RM) to increase aeration and lung oxygenation is
clinical routine. In intensive care patients with severe respiratory
failure, RM in the prone position may increase survival and/or
oxygenation. The object was to compare prone to supine RM, regarding
dorsal aeration and lung oxygenation in the extubated patient.
<br/>Method(s): A prospective randomized controlled trial in postoperative
uncomplicated cardiac surgery patients. Subjects were randomized to RM in
the prone or supine position, 15 patients in each group. The primary
endpoints were ventilation distribution and end-expiratory lung volume
measured by electrical impedance tomography and lung oxygenation, early
after extubation. <br/>Result(s): The dorsal tidal volume in arbitrary
units (AU) after extubation was 363 (CI 0.95: 283-443) and 212 (CI 0.95:
170-254) in the prone and supine group respectively, p<0.001, d=1.30
(Figure 1). The dorsal EELV (AU) was 724 (CI 0.95: 456-992) and-163 (CI
0.95:-252-73) in the prone and supine group respectively, p<0.001, d=2.46.
The PaO2/FiO2 ratio after extubation was 46.6 (CI 0.95: 40.7-53.0) and
39.3 (CI 0.95: 34.8-43.8) in the prone and supine group respectively,
p=0.041, d=0.74. <br/>Conclusion(s): Prone positioning plus RM in the
prone position early after cardiac surgery is superior to supine RM,
regarding dorsal aeration and lung oxygenation after extubation. This new
beneficial recruitment strategy reduces dorsal atelectasis.

<73>
Accession Number
2010514105
Title
Safety and efficacy of lung recruitment manoeuvre as an adjunct to chest
physical therapy in post-operative paediatric congenital heart disease
patients on mechanical ventilation: An interventional study.
Source
European Journal of Molecular and Clinical Medicine. 7 (7) (pp 1931-1937),
2020. Date of Publication: September 2020.
Author
Lalwani L.; Kazi A.; Quazi N.; ZahiruddinQuazi; Gaidhane A.; Sonkusale M.;
Taksande A.
Institution
(Lalwani, Kazi) Dept. of Cardiovascular and Respiratory Sciences, Ravi
Nair Physiotherapy College, Datta Meghe Institute of Medical Science,
Sawangi, Wardha, India
(Quazi) Dept. of physiology, Jawaharlal Nehru Medical College, Datta Meghe
Institute Of Medical Science, Sawangi, Wardha, India
(ZahiruddinQuazi, Gaidhane) Dept. Of Community Medicine, Jawaharlal Nehru
Medical College, Datta Meghe Institute Of Medical Science, Sawangi,
Wardha, India
(Sonkusale) Dept. Of Cardiac Anaesthesia, Jawaharlal Nehru Medical
College, Datta Meghe Institute Of Medical Science, Sawangi, Wardha, India
(Taksande) Department Of Pediatrics, Jawaharlal Nehru Medical College,
Datta Meghe Institute Of Medical Science, Sawangi, Wardha, India
Publisher
Ubiquity Press
Abstract
Introduction: Paediatric Congenital heart diseases [CHD] after corrective
surgeries are under regular chest physical therapy [CPT] care for
preventing post-operative complication. Comprehensive literature search
was done and have not come across any studies showing the efficacy of
combined Lung Recruitment Manoeuvres [LRM] and [CPT]. so study was
conducted with aim to assess safety and efficacy of LRM as an adjunct to
CPT on oxygenation, ventilation and on adverse events in operative
paediatric CHD patients on mechanical ventilation. Method & Methodology:
48 patients operated case of CHD in the age group of Two to Fourteen years
intubated more than 6 hours were included in the study. Study populations
were divided into two groups. Control Group (Group A) that received CPT
and Interventional Group (Group B) that received CPT with LRM. Patients
were assessed pre-treatment and 15 minutes post treatment on Oxygenation,
Ventilation and adverse events during treatment. <br/>Result(s):There were
statistically significant improvement in oxygenation and ventilation
within the group with p<0.05. The study showed that there were no adverse
events in both the groups. <br/>Conclusion(s): The oxygenation and
ventilation improved in both the groups. No adverse events were observed
in both groups. Both the interventions are safe and
effective.<br/>Copyright &#xa9; 2020 Ubiquity Press. All rights reserved.

<74>
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;

<75>
Accession Number
628159950
Title
Updates on cardiac transplant and LVAD implants across the UK and Europe.
Source
Heart Asia. Conference: 2nd Asia Pacific Advanced Heart Failure Forum,
APAHFF 2018. Hong Kong. 11 (Supplement 1) (pp A2), 2019. Date of
Publication: April 2019.
Author
Tsui S.S.L.
Institution
(Tsui) Department of Cardiothoracic Surgery, Royal Papworth Hospital,
Cambridge, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Whilst there has recently been unprecedented growth in heart transplants
(HTx) in North America, the number has been static or falling in most
European countries. These have resulted in significant increases in the
waiting times. In the UK, an Urgent Heart Allocation Scheme has been in
existence since 2001. With a growing number of heart failure patients on
temporary mechanical circulatory support (MCS) devices, a Super Urgent
category was introduced in 2016. So far, ~15% of HTx in the UK are
performed under this new category and the median waiting time has been >>7
days. Post-transplant 30 day survival has been reassuring. However,
ongoing monitoring will be required to ensure effectiveness. The other
major development has been donation after circulatory death (DCD) HTx. To
date, ~100 DCD HTx have been performed worldwide, with 70 of these being
in the UK. Growing waiting lists have led to increased implantation of
bridge-to-transplant left ventricular assist devices (LVAD). However, the
extended waiting times for donor hearts in stable patients mean that
patients being bridged are effectively having destination therapy by
default. Whilst destination therapy is approved in some countries, the
available evidence has not been accepted by other countries. The Swedish
Evaluation of LVAD as Permanent Treatment in End-stage Heart Failure
(SweVAD) is a prospective randomised study comparing LVAD therapy with
optimal medical therapy. Recruitment commenced in 2016 with the aim of
randomising 74 patients. Outcomes and adverse events associated with
implantable MCS will further improve as new devices using novel pumping
mechanisms with lower shear stress are in development to address inherent
limitations of current devices.