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<1>
Accession Number
2010578981
Title
Efficacy of heart transplantation in patients with a failing Fontan: a
systematic review and meta-analysis.
Source
Cardiothoracic Surgeon. 29 (1) (no pagination), 2021. Article Number: 7.
Date of Publication: December 2021.
Author
Hassan W.; Kotak S.; Khatri M.; Ahmed A.; Ahmed J.; Ali S.S.; Khan T.M.
Institution
(Hassan, Kotak, Khatri, Ahmed, Ahmed, Ali) Department of Internal
Medicine, Dow University of Health Sciences, Baba e Urdu Road, Karachi,
Pakistan
(Khan) Pediatrics, Baylor College of Medicine, Houston, United States
(Khan) Pediatrics, Texas Children's Hospital, Houston, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: As the population of patients with Fontan palliation grows, so
does the number of patients with Fontan failure, necessitating heart
transplantation. However, due to mainly small-sized studies, outcomes
after heart transplantation in these patients remain unclear. The
objective of this study was to review the available literature and conduct
a meta-analysis to provide well-powered and generalizable estimates of
outcomes after heart transplantation in patients with a failing Fontan.
Main text: PubMed, Embase, and MEDLINE databases were searched for
original studies of patients with a failing Fontan who underwent heart
transplantation. The outcomes included were 1-year and 5-year survival,
acute rejection, renal dysfunction, sepsis, and multi-organ failure.
Proportions were pooled using random effects models to derive pooled
proportions (PPs) and corresponding 95% confidence intervals (CIs).
Meta-regression analysis was done to study the effects of age and gender
on key outcomes. Sixteen retrospective single-center cohort studies with
426 Fontan patients undergoing heart transplantation were included in this
meta-analysis. Pooled analysis of this study further revealed that 1-year
survival after heart transplantation was 79.9% ([75.8%, 83.7%];
I2 = 1.92%), and 5-year survival rate was 72.5% ([62.1%,
81.9%]; I2 = 72.12%). Secondary outcomes after heart
transplantation of failed Fontan procedure were acute rejection (PP 20%
[7.4%, 36.8%]; I2 = 72.48%), renal dysfunction (PP 31.3%
[10.5%, 57.2%]; I2 = 75.42%), multi-organ failure (PP 18.6%
[2.8 to 43.9%]; I2= 69.60%), and sepsis (PP 21.1% [9%, 36.8%];
I2 = 61.19%). Conclusion(s): Cardiac transplantation in
patients with a failing Fontan is associated with acceptable
interventional success and improved survival rates. Copyright ©
2021, The Author(s).

<2>
Accession Number
2011132929
Title
A systematic review and meta-analysis of bioresorbable vascular scaffolds
for below-the-knee arterial disease.
Source
International Angiology. 40 (1) (pp 42-51), 2021. Date of Publication:
February 2021.
Author
Ipema J.; Kum S.; Huizing E.; Schreve M.A.; Varcoe R.L.; Hazenberg C.E.;
de Vries J.-P.; Unlu C.
Institution
(Ipema, Huizing, Schreve, Unlu) Department of Vascular Surgery, Northwest
Clinics, Alkmaar, Netherlands
(Kum) Department of Surgery, Changi General Hospital, Singapore, Singapore
(Varcoe) Department of Surgery, Prince of Wales Hospital, Sydney,
Australia
(Varcoe) Faculty of Medicine, University of New South Wales, Sydney,
Australia
(Varcoe) The Vascular Institute, Prince of Wales Hospital, Sydney,
Australia
(Hazenberg) Department of Vascular Surgery, University Medical Center
(UMC) Utrecht, Utrecht, Netherlands
(de Vries) Department of Surgery, Division of Vascular Surgery, University
Medical Center Groningen (UMCG), Groningen, Netherlands
Publisher
Edizioni Minerva Medica
Abstract
Introduction: Different types of bioresorbable vascular scaffolds (BVSs)
have been developed and used in below-the-knee (BTK) arterial diseases.
This is the first study reviewing and analyzing the literature on BVS
treatment for BTK arterial disease. Evidence Acquisition: MEDLINE,
Embase, and Cochrane were searched for studies published until October 21,
2019. The search, study selection, quality assessment, and data extraction
were performed by 2 authors independently. Articles that studied the
treatment of BTK arterial disease by using BVSs were eligible. Exclusion
criteria were studies with a variant design (e.g. case reports <5
patients), non-BTK indications for BVS use, and nonhuman studies. Primary
endpoint was 12-month primary patency. Secondary endpoints were 12-month
freedom from clinically driven target lesion revascularization (CD-TLR),
limb salvage, survival, and amputation-free survival (AFS). Study quality
was assessed by the Methodological Index for Non-randomized Studies score.
 Evidence Synthesis: Five studies representing 155 patients with 160
treated limbs met the inclusion criteria. Pooled 12-month primary patency
per limb was 90% (143/160; 95% confidence interval [CI]: 0.84-0.95),
freedom from CD-TLR 96% (124/130; 95% CI: 0.91-0.99), limb salvage rate
97% (156/160; 95% CI: 0.94-1.00), survival rate 90% (112/125; 95% CI:
0.82-0.96), and AFS rate 89% (110/125; 95% CI: 0.81-0.94). Subgroup
analyses of included Absorb BVS studies showed similar results. All
studies were assessed as moderate quality. Conclusion(s): This
meta-analysis of case series showed good 12-month patency and clinical
results with BVSs for BTK arterial disease, even in patients with
multimorbidity and short but complex lesions. These results encourage a
revival of this scaffold. Copyright © 2021 Edizioni Minerva
Medica. All rights reserved.

<3>
Accession Number
2004814345
Title
Coagulation ability when separating from cardiopulmonary bypass with and
without fresh frozen plasma: a pilot study.
Source
General Thoracic and Cardiovascular Surgery. 68 (12) (pp 1361-1368), 2020.
Date of Publication: December 2020.
Author
Tamura T.; Yokota S.; Ito T.; Ando M.; Kubo Y.; Waters J.H.; Nishiwaki K.
Institution
(Tamura, Nishiwaki) Department of Anesthesiology, Nagoya University
Graduate School of Medicine, 65 Tsurumai-cho, Showa-Ku, Nagoya 466-8550,
Japan
(Tamura, Waters) Department of Anesthesiology, University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
(Yokota) Division of Anesthesiology, Japanese Red Cross Nagoya Daiichi
Hospital, Nagoya, Japan
(Ito) Division of Cardiovascular Surgery, Japanese Red Cross Nagoya
Daiichi Hospital, Nagoya, Japan
(Ando) Center for Advanced Medicine and Clinical Research, Nagoya
University Hospital, Nagoya, Japan
(Kubo) Department of Preventive Medicine, Nagoya University Hospital,
Nagoya, Japan
Publisher
Springer Japan
Abstract
Objective: Several strategies are employed for administering fresh frozen
plasma (FFP) during weaning from cardiopulmonary bypass (CPB). This study
evaluated by coagulation function aimed to compare two strategies of
administering FFP in cardiovascular surgery: administering 4 units of FFP
before separating from CPB or administering it after weaning from CPB.
 Method(s): Thirty patients who underwent CPB and were expected to
receive 8 units of FFP and 20 units of platelet concentrate were randomly
allocated into group A (8 units of FFP and 20 units of platelet
concentrate administered after separating from CPB) and group B (4 units
of FFP administered before separation, and 4 units of FFP and 20 units of
platelet concentrate administered after separating from CPB).
Thromboelastography (TEG6s, HAEMONETICS Japan GK, Tokyo, Japan)
was conducted at four time points before and after separation. Blood test
results, blood loss, and required amounts of blood transfusion were
compared. The primary outcome was the difference in coagulation function
evaluated by TEG6s 90 min after protamine administration. Result(s):
Twenty-eight patients were enrolled in the study. Coagulation function
after separating from CPB was not significantly different between the
groups. Additionally, no significant differences were found in intensive
care unit outcomes, such as 24-h transfusion requirements.
 Conclusion(s): Coagulation function 90 min after separating from CPB
was not significantly different between the groups. Prior FFP
administration before separation did not provide significant improvement
in coagulation function. Copyright © 2020, The Japanese
Association for Thoracic Surgery.

<4>
Accession Number
633388185
Title
Does intraoperative diuretic therapy affect the thoracic fluid content and
clinical outcome in patients undergoing mitral valve surgery?.
Source
Journal of Cardiac Critical Care. 4 (2) (pp 86-90), 2020. Article Number:
JCCC2080004. Date of Publication: 01 Dec 2020.
Author
Choudhury M.; Narula J.; Saini K.; Kapoor P.M.; Kiran U.
Institution
(Choudhury, Narula, Saini, Kapoor, Kiran) Cardiothoracic Sciences Centre,
All India Institute of Medical Sciences, New Delhi, India
Publisher
Thieme India
Abstract
Pulmonary congestion is inevitable in valvular heart disease. The
condition worsens when a patient undergoes cardiopulmonary bypass (CPB).
Thoracic fluid content (TFC) is an indicator of total volume status of
lung in health and disease. We hypothesize that intraoperative diuretic
therapy can improve the hemodynamic and clinical outcome in patients
undergoing mitral valve surgery by decreasing TFC as measured by impedance
cardiography (ICG). Sixty adult patients with critical mitral stenosis
scheduled for mitral valve surgery divided into diuretic (Gr D, n = 30)
and control (Gr C, n = 30) group. One mg/kg of furosemide was administered
before CPB to Gr D and similar volume of normal saline to Gr C.
Hemodynamic and TFC measurements were done by index of contractility
(ICON), NICOM monitor at baseline, before anesthesia induction (T1), post
skin closure (T2), postoperatively at 6th hour (T3), 24th hour (T4), and
48th hour (T5). The duration of mechanical ventilation (hour), intensive
care unit stay (day) and inotropic score was significantly higher in Gr C
(5.29 +/- 1.4 vs. 2.15 +/- 1.1; p = 0.001; 2.11 +/- 0.64 vs. 1.67 +/-
0.57, p = 0.002; 9 +/- 5.4 vs. 5.8 +/- 3.2, p = 0.05), respectively. Three
patients in Gr C developed respiratory complication during their course of
hospital stay. The baseline TFC value was comparable (p = 0.08). In Gr C.
it gradually increased over time and never reached the baseline value,
whereas in Gr D, there was slight increase in TFC till 6th postoperative
hour and it came below the baseline value at 48th hour. A significantly
higher TFC value in Gr C in comparison with Gr D from 6th to 48th
postoperative hour (p = 0.005, 0.000, and 0.005, respectively) was
observed. The ICON had a gradual improvement from 12th over 48th
postoperative hour in Gr D in comparison to Gr C. The systemic vascular
resistance index was decreased over time in Gr C, whereas in Gr D there
was a mild fall at the end of surgery and it came back to near the
baseline value at 48th postoperative hour. A continuous decrease in DO
<inf>2</inf>I except at 6th postoperative hour was seen in Gr C, whereas
it remained near the baseline value in Gr D. Linear regression analysis
showed significant direct correlation of TFC with intraoperative fluid
balance (r = 0.524, p = 0.001), cumulative fluid balance (r = 0.680, p =
0.000) and both peak and mean airway pressure (r = 0.436, p = 0.001 and r
= 0.548, p = 0.001, respectively). We concluded that TFC is clearly
influenced by intraoperative diuretic therapy. A decrease in TFC has an
association with better hemodynamic parameters that could find interesting
clinical applications in the decision, whether or not to include a
diuretic as a routine therapy during intraoperative management in valve
surgery patients. Copyright © 2020 Thieme India. All rights
reserved.

<5>
Accession Number
2010069814
Title
Preoperative vitamin D level predicts operative mortality after cardiac
surgery.
Source
E Journal of Cardiovascular Medicine. 8 (3) (pp 146-151), 2020. Date of
Publication: September 2020.
Author
Kunt A.T.; Tumer N.B.; Ozisik K.; Gunaydin S.
Institution
(Kunt) Kirikkale University, Faculty of Medicine, Department of
Cardiovascular Surgery, Kirikkale, Turkey
(Tumer, Ozisik, Gunaydin) University of Health Sciences Turkey, Ankara
City Hospital, Clinic of Cardiovascular Surgery, Ankara, Turkey
Publisher
Galenos Publishing House
Abstract
Objectives: The present study aimed to analyze the prognostic value of
preoperative serum vitamin D level in patients who underwent coronary
artery bypass graft (CABG) surgery. Material(s) and Method(s): The
data of 360 adult patients who underwent isolated CABG surgery were
retrospectively reviewed. We reached the data of preoperative serum
vitamin D [25-hydroxyvitamin D (25-OHD)] values of 305 patients. The
patient population was divided into two groups based on preoperative serum
25-OHD levels with a normal range of 25-75 nmol/L (group I: patients with
preoperative serum 25-OHD level <25 nmol/L and group II: patients with
preoperative serum 25-OHD level >=25 nmol/L). The effect of preoperative
25-OHD level on operative mortality (mortality which occurred during the
first 30 days after the operation) was determined using regression
analysis and the results were expressed as Odds ratio (OR) with a 95%
confidence interval (CI). A p value <0.05 was considered statistically
significant. Result(s): In the present study, operative mortality was
3.93% (n=12). One hundred and fifty seven patients (51.5%) had serum
25-OHD levels <25 nmol/L. The mean serum 25-OHD levels were significantly
lower in females than in males (p<0.001). On logistic regression analysis,
preoperative serum 25-OHD level was found to be independently associated
with operative mortality (OR: 0.201, 95% CI: 0.043- 0.935; p=0.041).
 Conclusion(s): The presence of vitamin D deficiency seems to be an
independent predictor of operative mortality after cardiac surgery in this
retrospective study; however, prospective randomized trials are warranted
to clarify the effect of preoperative vitamin D supplementation on
postoperative outcomes in cardiac surgical patients. © Copyright
2020 by Heart and Health Foundation of Turkey (TUSAV) / E Journal of
Cardiovascular Medicine published by Galenos Publishing House.

<6>
Accession Number
2010069797
Title
Our experience in anesthesia management in operations for congenital
pediatric cardiac diseases.
Source
E Journal of Cardiovascular Medicine. 8 (1) (pp 35-44), 2020. Date of
Publication: March 2020.
Author
Ozyaprak B.; Ata F.; Dayioglu M.; Anarat K.; Kaydul M.; Apaydin Y.; Gamli
M.; Karaca U.; Secici S.; Eris C.; Ata Y.; Kahraman N.; Erkan G.; Eroglu
A.
Institution
(Ozyaprak, Ata, Anarat, Kaydul, Apaydin, Gamli, Karaca) University of
Health Sciences Turkey, Bursa Yuksek Ihtisas Training and Research
Hospital, Clinic of Anesthesiology and Reanimation, Bursa, Turkey
(Dayioglu) Gazi University, Faculty of Medicine, Department of
Anesthesiology and Reanimation, Division of Intensive Care, Ankara, Turkey
(Secici) University of Health Sciences Turkey, Bursa Yuksek Ihtisas
Training and Research Hospital, Clinic of Pediatric Cardiovasculary
Surgery, Bursa, Turkey
(Eris, Ata, Kahraman) University of Health Sciences Turkey, Bursa Yuksek
Ihtisas Training and Research Hospital, Clinic of Cardiovasculary Surgery,
Bursa, Turkey
(Erkan) University of Health Sciences Turkey, Ahi Evren Training and
Research Hospital, Clinic of Anesthesiology and Reanimation Trabzon,
Turkey
(Eroglu) Karadeniz Technical University, Department of Anesthesiology and
Reanimation, Trabzon, Turkey
Publisher
Galenos Publishing House
Abstract
Objectives: Surgical treatment of congenital heart diseases (CHDs) is
performed in many centers today. We aimed to review the pediatric cardiac
surgery cases performed in our center and contribute to the literature
with our data. Material(s) and Method(s): In this study, 92 patients
who underwent palliative and complete correction for CHDs between March
2016 and March 2019 were evaluated retrospectively. Result(s): A
total of 92 patients, 37 (40.2%) females and 55 (59.8%) males, were
retrospectively examined for this study. The number of patients under and
over 1 year of age were 74 (80.44%) and 18 (19.56%), respectively. The
most common congenital cardiac anomaly was ventricular septal defect
(28.26%). All surgical procedures were classified according to complexity
based on the Aristotle Basic Scoring system to find that 45 patients
underwent Level 2, 23 patients underwent Level 4, 13 patients underwent
Level 1 and 11 patients underwent Level 3 surgeries. Among our patients,
78.2% and 21.8% were operated with and without cardiopulmonary bypass
(CPB), respectively. There were no significant differences between patient
age groups in terms of operation time, CPB time and cross-clamp time, but
the difference between the same parameters according to complexity level
was statistically significant (p<0.05). As the complexity level increased,
the durations were prolonged. Postoperative complications were found to be
increased under 1 year of age and at high complexity levels (Levels 3 and
4). Similarly, it was found that mortality significantly increased under 1
year of age and with high complexity levels (p<0.05). Conclusion(s):
In surgical procedures for CHDs, complexity levels according to Aristotle
Basic Scoring System and the patient's age are effective factors on
outcome. We believe that it is necessary to share the experiences of the
centers working in this field and to conduct randomized studies with
larger sample sizes. © Copyright 2020 by Heart and Health
Foundation of Turkey (TUSAV) / E Journal of Cardiovascular Medicine
published by Galenos Publishing House.

<7>
Accession Number
2008590931
Title
Simultaneous Surgical Ablation of Atrial Fibrillation with Cardiac
Surgery: A Review.
Source
E Journal of Cardiovascular Medicine. 7 (4) (pp 161-165), 2019. Date of
Publication: December 2019.
Author
Demirsoy E.; Ugur M.; Demir I.
Institution
(Demirsoy) Sisli Kolan International Hospital, Clinic of Cardiovascular
Surgery, Istanbul, Turkey
(Ugur) Ilhan Varank Training and Research Hospital, Clinic of
Cardiovascular Surgery, Istanbul, Turkey
(Demir) Istanbul University Istanbul Faculty of Medicine, Department of
Cardiovascular Surgery, Istanbul, Turkey
Publisher
Galenos Publishing House
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia with the
rate of 1-2% in general population. It is characterized by the absence of
coordinated pulses in the atrium and micro-re-entry. Increasing age,
coronary artery disease and valve pathologies are the risk factors for the
development of AF. It can be seen both non-cardiac surgery (10-20%) and
cardiac surgery (20-40%). This disease is expected to double in the next
25 years. Despite current drug and electrophysiological treatments, death
and functional limitations related to AF are still common. In this paper
we present the current status of simultaneous surgical ablation for AF in
the light of current literature. © Copyright 2019 by Heart and
Health Foundation of Turkey (TUSAV)

<8>
Accession Number
2006074466
Title
Effect of Dexmedetomidine on Delirium in Elderly Surgical Patients: A
Meta-analysis of Randomized Controlled Trials.
Source
Annals of Pharmacotherapy. 55 (5) (pp 624-636), 2021. Date of Publication:
May 2021.
Author
Lin C.; Tu H.; Jie Z.; Zhou X.; Li C.
Institution
(Lin, Tu, Zhou, Li) Huazhong University of Science and Technology Union
Shenzhen Hospital, Shenzhen, Guangdong, China
(Jie) Guangdong Medical University, Zhanjiang, Guangdong, China
Publisher
SAGE Publications Inc.
Abstract
Objective: The purpose of this meta-analysis is to assess the effect of
dexmedetomidine on delirium in elderly surgical patients. Data
Sources: The Cochrane Library, Web of Science, PubMed, EMBASE, and Google
Scholar were searched (January 1, 2000, to February 4, 2020) for
randomized controlled trials (RCTs). Study Selection and Data Extraction:
RCTs without language restrictions were included if delirium incidence was
assessed in elderly surgical patients receiving dexmedetomidine.
Intervention and basic information were extracted. Data Synthesis: 21
studies were included. Dexmedetomidine reduced delirium occurrence (risk
ratio [RR] = 0.55; 95% CI = 0.45 to 0.67) in elderly surgical patients
with sufficient evidence from trial sequential analysis. Dexmedetomidine
did not prevent delirium incidence for cardiac surgery (RR = 0.71; 95% CI
= 0.44 to 1.15) with insufficient evidence. Dexmedetomidine decreased
mortality incidence (RR = 0.47; 95% CI = 0.25 to 0.89), shortened the
length of intensive care unit (ICU; standard mean difference [SMD] =
-0.46) and hospital stays (SMD = -0.41), and increased bradycardia
incidence (RR = 1.60). Relevance to Patient Care and Clinical Practice:
This review revealed that dexmedetomidine could reduce delirium incidence
for elderly noncardiac surgical patients, and the effect of
dexmedetomidine on delirium for elderly cardiac surgical patients needs
further studies to guide clinicians. Conclusion(s): Dexmedetomidine
reduced delirium incidence in elderly surgical patients. The efficacy of
dexmedetomidine on delirium for elderly cardiac surgical patients warrants
further studies. Furthermore, dexmedetomidine was associated with an
increased bradycardia incidence, shorter length of ICU/hospital stays, and
a lower incidence of mortality. Copyright © The Author(s) 2020.

<9>
Accession Number
2010777994
Title
Effects of Bariatric Surgery on Heart Rhythm Disorders: a Systematic
Review and Meta-Analysis.
Source
Obesity Surgery. (no pagination), 2021. Date of Publication: 2021.
Author
Sanches E.E.; Topal B.; de Jongh F.W.; Cagiltay E.; Celik A.; Sundbom M.;
Ribeiro R.; Parmar C.; Ugale S.; Mahawar K.; Buise M.P.; Dekker L.R.;
Ramnarain D.; Pouwels S.
Institution
(Sanches) Department of Surgery, Haaglanden Medical Center, The Hague,
Netherlands
(Topal) Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis,
Amsterdam, Netherlands
(de Jongh) Department of Plastic Surgery, Haaglanden Medical Center, The
Hague, Netherlands
(Cagiltay) Department of Endocrinology and Metabolic Diseases, University
of Health Sciences Turkey, Sultan Abdulhamid Han Education and Research
Hospital, Istanbul, Turkey
(Celik) Metabolic Surgery Clinic, Sisli, Istanbul, Turkey
(Sundbom) Department of Surgical Sciences, Uppsala University, Uppsala,
Sweden
(Ribeiro) Centro Multidisciplinar da Doenca Metabolica, Clinica de Santo
Antonio, Reboleira, Lisbon, Portugal
(Parmar) Department of Surgery, Whittington Hospital, London, United
Kingdom
(Ugale) Bariatric & Metabolic Surgery Clinic, Virinchi Hospitals,
Hyderabad, India
(Mahawar) Bariatric Unit, Sunderland Royal Hospital, Sunderland, United
Kingdom
(Buise) Department of Anesthesiology, Intensive Care and Pain Medicine,
Catharina Hospital, Eindhoven, Netherlands
(Dekker) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Ramnarain, Pouwels) Department of Intensive Care Medicine,
Elisabeth-Tweesteden Hospital, P.O. Box 9051, Tilburg 5000 LC, Netherlands
Publisher
Springer
Abstract
The aim of this systematic review is to provide an overview of the
literature on the effects of bariatric surgery on obesity-associated
electrocardiogram (ECG) abnormalities and cardiac arrhythmias. Fourteen
studies were included with a methodological quality ranging from poor to
good. Majority of the studies showed a significant decrease of QT interval
and related measures after bariatric surgery. Seven studies were included
in the meta-analysis on effects of bariatric surgery on QTc interval and a
significant decrease in QTc interval of - 33.6 ms, 95%CI [- 49.8 to -
17.4] was seen. Bariatric surgery results in significant decrease in QTc
interval and P-wave dispersion, i.e., a normalization of initial
pathology. The effects on atrial fibrillation are conflicting and not yet
fully understood. Graphical abstract: [Figure not available: see
fulltext.] Copyright © 2021, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<10>
Accession Number
2010776905
Title
Determination of the optimal dose of ephedrine in the treatment of
arterial hypotension due to general anesthesia in neonates and infants
below 6 months old: the ephedrine study protocol for a randomized,
open-label, controlled, dose escalation trial.
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 208. Date of
Publication: December 2021.
Author
Szostek A.S.; Boucher P.; Subtil F.; Zerzaihi O.; Saunier C.; de Queiroz
Siqueira M.; Merquiol F.; Martin P.; Granier M.; Gerst A.; Lambert A.;
Storme T.; Chassard D.; Nony P.; Kassai B.; Gaillard S.
Institution
(Szostek, Boucher, de Queiroz Siqueira, Lambert, Storme, Chassard)
Hospices Civils de Lyon, Service d'anesthesie pediatrique-HFME, Bron
69677, France
(Subtil) Hospices Civils de Lyon, Service de Biostatistiques, Lyon, France
(Zerzaihi, Saunier, Kassai, Gaillard) Hospices Civils de Lyon, EPICIME-CIC
1407 de Lyon, Inserm, Departement d'epidemiologie clinique, Bron, CHU-Lyon
F-69677, France
(Merquiol, Martin) Department of Anesthesiology and Intensive Care,
University Hospital of Saint-Etienne, Saint-Etienne Cedex, France
(Granier, Gerst) Departement de Medecine Perioperatoire, Anesthesie et
Reanimation, Centre Hospitalier Universitaire Clermont-Ferrand,
Clermont-Ferrand 63000, France
(Nony, Kassai, Gaillard) Universite de Lyon; CNRS, UMR 5558, Laboratoire
de Biometrie et Biologie Evolutive, Villeurbanne F-69622, France
Publisher
BioMed Central Ltd
Abstract
Background: Arterial hypotension induced by general anesthesia is commonly
identified as a risk factor of morbidity, especially neurological, after
cardiac or noncardiac surgery in adults and children. Intraoperative
hypotension is observed with sevoflurane anesthesia in children, in
particular in neonates, infants younger than 6 months, and preterm babies.
Ephedrine is commonly used to treat intraoperative hypotension. It is an
attractive therapeutic, due to its dual action on receptors alpha and beta
and its possible peripheral intravenous infusion. There are few data in
the literature on the use of ephedrine in the context of pediatric
anesthesia. The actual recommended dose of ephedrine (0.1 to 0.2 mg/Kg)
frequently leads to a therapeutic failure in neonates and infants up to 6
months of age. The use of higher doses would probably lead to a better
correction of hypotension in this population. The objective of our project
is to determine the optimal dose of ephedrine for the treatment of
hypotension after induction of general anesthesia with sevoflurane, in
neonates and infants up to 6 months of age. Method(s): The ephedrine
study is a prospective, randomized, open-label, controlled,
dose-escalation trial. The dose escalation consists of 6 successive
cohorts of 20 subjects. The doses studied are 0.6, 0.8, 1, 1.2, and 1.4
mg/kg. The dose chosen as the reference is 0.1 mg/kg, the actual
recommended dose. Neonates and infants younger than 6 months, males and
females, including preterm babies who undergo a surgery with general
anesthesia inducted with sevoflurane were eligible. Parents of the subject
were informed. Then, the subjects were randomized if presenting a decrease
in mean blood pressure superior to 20% of their initial mean blood
pressure (before induction of anesthesia), despite a vascular filling with
sodium chloride 0.9%. The primary outcome is the success of the therapy
defined as an mBP superior to 80% of the baseline mBP (prior to
anesthesia) within 10 min post ephedrine administration. The subjects were
followed-up for 3 days postanesthesia. Discussion(s): This study is
the first randomized, controlled trial intending to determine the optimal
dose of ephedrine to treat hypotension in neonates and infants below 6
months old. Trial registration: ClinicalTrials.gov NCT02384876. Registered
on March 2015. Copyright © 2021, The Author(s).

<11>
Accession Number
2011433523
Title
Low-Density Lipoprotein Cholesterol Trends and the Development of Cardiac
Allograft Vasculopathy after Heart Transplantation.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2021. 40 (4
Supplement) (pp S206-S207), 2021. Date of Publication: April 2021.
Author
Aleksova N.; Umar F.; Bernick J.; Mielniczuk L.M.; Ross H.J.; Chih S.
Institution
(Aleksova, Ross) Peter Munk Cardiac Centre, Toronto General Hospital,
University Health Network, Toronto, ON, Canada
(Umar, Bernick, Mielniczuk, Chih) University of Ottawa Heart Institute,
Ottawa, ON, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: The relationship between low-density lipoprotein cholesterol
(LDL-C) and cardiac allograft vasculopathy (CAV) is unclear. The
objectives of this study were to characterize lipid profiles early after
heart transplant (HT), and to evaluate the relationship between early
serum LDL-C and the development of CAV. Method(s): We retrospectively
reviewed consecutive adults who underwent HT at the University of Ottawa
Heart Institute (Ottawa, Canada) and Toronto General Hospital (Toronto,
Canada) from 2010-2018. The primary outcome was the incidence of CAV
(ISHLT grade 1-3). The relationship between LDL-C and CAV was assessed
using Cox proportional hazards and logistic regression models adjusted a
priori for clinically important covariates including recipient and donor
age, recipient sex, ischemic time and pre-HT diabetes. Result(s): 386
patients followed for 4.4 (2.8-6.8) years were included. LDL-C at baseline
(2.11+/-0.86 mmol/L) and at 1-year after HT (2.20+/-0.88 mmol/L) was
similar (p=0.21) but was significantly lower at the end of study follow-up
(1.89+/-0.74 mmol/L) (p<0.01). Of 309 patients who underwent angiography,
54% developed CAV. The risk of CAV did not vary according to baseline,
1-year or change from baseline to 1-year pre-specified LDL-C thresholds
(Figure). The odds of CAV at 1-year was equally likely across LDL-C values
(adjusted OR 1.00, 95% CI: 0.61-1.63 for baseline and adjusted OR 1.25,
95% CI: 0.74-2.10 for 1-year LDL-C). Conclusion(s): There was no
relationship between early LDL-C and the development of CAV after HT. Our
findings do not support targeting a specific LDL-C for patients who do not
otherwise meet criteria for non-HT guideline recommended LDL-C targets.
Randomized studies are warranted to determine if lipid-lowering to a
specific LDL-C target decreases the development and progression of
CAV. Copyright © 2021

<12>
Accession Number
2011438402
Title
Identifying the association between tacrolimus exposure and toxicity in
heart and lung transplant recipients: A systematic review.
Source
Transplantation Reviews. 35 (2) (no pagination), 2021. Article Number:
100610. Date of Publication: April 2021.
Author
Braithwaite H.E.; Darley D.R.; Brett J.; Day R.O.; Carland J.E.
Institution
(Braithwaite, Darley, Brett, Day) St Vincent's Clinical School, UNSW
Medicine, University of New South Wales, Sydney, Australia
(Darley) Lung Transplant Unit, St Vincent's Hospital Darlinghurst, Sydney,
Australia
(Brett, Day, Carland) Department of Clinical Pharmacology and Toxicology,
St Vincent's Hospital, Sydney, Australia
(Carland) Department of Pharmacology, School of Medical Sciences,
University of New South Wales, Sydney, Australia
Publisher
W.B. Saunders
Abstract
Aims: Tacrolimus is the cornerstone of immunosuppression management in
heart and lung transplant recipients, improving overall survival. However,
tacrolimus-associated toxicities, including nephrotoxicity, neurotoxicity,
new-onset diabetes mellitus after transplant (NODAT), and gastrointestinal
toxicity, are known contributors to increased post-transplant morbidity
outcomes and reduced graft and recipient survival rates. The aim of this
systematic review was to identify correlations between pharmacokinetic
measures of tacrolimus exposure in heart and lung recipients and
tacrolimus toxicities. Method(s): MEDLINE, Embase, the Cochrane
Library, CENTRAL and WHO Clinical Trial Registries were searched for
published studies evaluating tacrolimus toxicities and their correlation
to pharmacokinetic monitoring parameters in thoracic transplant
recipients. Studies were reviewed by two authors, with data extracted for
evaluation. Risk of bias was assessed using the PEDro scale for randomised
control trials and the Newcastle Ottawa Scale for non-randomised cohort
studies. Result(s): Eighteen studies were eligible; a randomised
control trial, 11 observational cohort studies, and 6 case series or
studies. Of these, 9 studies were in heart transplant recipients alone and
5 in lung transplant recipients alone, 2 studies were in heart and lung
transplant recipients and 2 were heart, lung, liver or renal transplant
recipients. Studies used variable criteria to define toxicities.
Tacrolimus trough concentration (C<inf>0</inf>) was the marker of
tacrolimus exposure most commonly used. Ten studies reported on
nephrotoxicity. Elevated tacrolimus C<inf>0</inf> was associated with
acute kidney injury occurrence and severity in three observational
studies. Increasing C<inf>0</inf> was a predictor of renal impairment in 6
studies. One study found that for each 5 ng/mL per year of tacrolimus
exposure, defined by consecutive AUC, eGFR declined by 1.3
mL/min/1.73m2 (p < 0.001). Comparatively, 2 studies failed to
find a significant association between nephrotoxicity and tacrolimus
exposure. Seven studies reported on neurotoxicity, including
neuro-encephalopathies, polyneuropathies and symptomatic change in
neurological status. Neurotoxicity occurred both with tacrolimus
C<inf>0</inf> within therapeutic range and with supratherapeutic
C<inf>0</inf>. No significant association was found between NODAT and
tacrolimus C<inf>0</inf> in two studies. One study reported on
gastrointestinal toxicity, with supratherapeutic C<inf>0</inf> and
elevated peak concentration in one lung transplant recipient three days
prior to symptom development. Conclusion(s): No clearly defined
relationship between tacrolimus exposure and toxicities is described in
the literature. Studies with clear toxicity criteria and pharmacokinetic
markers of tacrolimus exposure are required to provide valuable
information that may optimise tacrolimus therapy, helping to reduce
toxicities in heart and lung transplant recipients. Copyright ©
2021 Elsevier Inc.

<13>
Accession Number
2011411474
Title
Oral Pregabalin in Cardiac Surgery: A Systematic Review and Meta-Analysis
of Randomized Controlled Trials.
Source
BioMed Research International. 2021 (no pagination), 2021. Article Number:
8835891. Date of Publication: 2021.
Author
Wang X.-X.; Dai J.; Hu X.-G.; Zhou A.-G.; Pan D.-B.
Institution
(Wang, Dai, Zhou, Pan) Department of Anesthesiology, First People's
Hospital of Changde City, Changde, Hunan, China
(Hu) Department of Anesthesiology, Taoyuan County People's Hospital,
Changde, Hunan, China
Publisher
Hindawi Limited
Abstract
Background. Pregabalin has received wide clinical attention as a new type
of analgesic. We undertake a systematic review and meta-analysis to
evaluate the effect of pregabalin on postoperative pain in patients
undergoing cardiac surgery. Methods. We searched PubMed, Embase, and
Cochrane Library (from inception to July 2020) for eligible studies. The
primary outcomes were the total morphine consumption at 24 h. A secondary
outcome was intraoperative fentanyl consumption, extubation time
postoperative, and length of stay in hospital. We calculated pooled
weighted mean difference (WMD) or odds ratio (OR) and 95% CIs using
random- or fixed-effects models. Results. Seven trials involving 463
patients were listed. Meta-analysis showed that the total morphine
consumption at 24 h in the pregabalin group was significantly less than
the control group (WMD: -5.44, 95% CI: -10.42-0.46, P=0.03). We found that
there is no significant difference between the two groups in
intraoperative fentanyl consumption. Compared with the control group, the
length of stay in hospital in the pregabalin group was significantly
shorter (WMD = -0.87, 95% CI: -1.42-0.32, P=0.002). And we found that
there were no significant differences between the two groups in extubation
time (WMD: 17.24, 95% CI: -24.36-58.84, P=0.42). Conclusions. Oral
pregabalin for cardiac surgery patients can effectively reduce the
patient's 24-hour morphine consumption after surgery, shorten the
patient's hospital stay, and is more conducive to early postoperative
recovery. Copyright © 2021 Xian-xue Wang et al.

<14>
Accession Number
2011343198
Title
The impact of CYP2C9 and VKORC1 genetic polymorphisms in anticoagulant
therapy management after cardiac surgery with extracorporeal circulation.
Source
Pharmacia. 68 (1) (pp 269-273), 2021. Date of Publication: 2021.
Author
Velizarova M.; Hristova J.; Svinarov D.; Ivanova S.; Jovinska S.; Abedinov
P.
Institution
(Velizarova, Hristova, Svinarov) Department of Clinical Laboratory,
Faculty of Medicine, Medical University Sofia, Alexander University
Hospital, Sofia, Bulgaria
(Ivanova) Department of Pharmaceutical Chemistry and Pharmacognozy,
Faculty of Pharmacy, Medical University Pleven, Sofia, Bulgaria
(Jovinska, Abedinov) St. Ekaterina University Hospital, Sofia, Bulgaria
Publisher
Pensoft Publishers
Abstract
Extracorporeal circulation during cardiac surgery is characterized with
increased risk for hypercoagulation because blood is exposed to foreign,
nonendothelial cell surfaces. Thus, the usage of extracorporeal
circulation is essentially not possible without anticoagulation.
Open-heart surgery as well as many perioperative factors, such as
acidosis, hypocalcemia, hypothermia, and hemodilution, might affect
hemostasis and lead to coagulopathy and bleeding. A new insight into the
effectiveness of anticoagulant therapy is applied to modify the dosing
regimen with respect to the genetic CYP2C9 and VKORCl allelic variants. A
systematic literature search was performed for VKORC1 and CYP2C9 and their
association with coumarin anticoagulant therapy and bleeding risk in
postoperative period of cardiac surgery with extracorporeal
circulation. Copyright © 2021. Velizarova M et al. This is an
open access article distributed under the terms of the Creative Commons
Attribution License (CC-BY 4.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author
and source are credited.

<15>
Accession Number
634554655
Title
A systematic review on the application of the hybrid operating room in
surgery: experiences and challenges.
Source
Updates in surgery. (no pagination), 2021. Date of Publication: 11 Mar
2021.
Author
Jin H.; Lu L.; Liu J.; Cui M.
Institution
(Jin) Second Department of General Surgery, Zhuhai People's Hospital
(Zhuhai Hospital Affiliated with Jinan University), China
(Lu) Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan
University), Guangdong Province, No. 79 of Kangning Road 519000, China
(Liu) Zhuhai Health Bureau, Guangdong Province, No. 351 of east Meihua
Road 519000, China
(Cui) China's Communist Party Committee, Zhuhai People's Hospital (Zhuhai
Hospital Affiliated with Jinan University), Guangdong Province, No. 79 of
Kangning Road 519000, China
Publisher
NLM (Medline)
Abstract
The hybrid operating room has been widely applied in different surgery
sub-specialties. We aim to identify the advantages of hybrid operating
rooms by focusing on intraoperative imaging and explore what to do for
further improving its application. We searched related literature in
websites including Pubmed, MEDLINE, Web of science, using the keywords
("hybrid operating room" or "integrated operating room" or
"multifunctional operating room") and ("surgery" or "technique" or
"intervention" or "radiology"). All the searched papers were screened and
underwent quality evaluation. A total of 30 literature was eventually
identified after full-text screening. These articles covered 10 countries
and presented data for 15,558 individuals. The median sample size was 536
(range 8-12,804). Application of the hybrid operating room in general
surgery, neurosurgery, thoracic surgery, urology, gynaecologic and
obstetrics surgery, cardiovascular surgery, was summarized. Four different
operative indicators were applied (operative duration, mortality rate,
operation success rate and complication rate). A hybrid OR could
significantly increase the operation success rate and reduce operative
duration, mortality rates, and complication rates. Further efforts could
be made to reduce radiation exposure in the hybrid operating room and
increase its cost-effectiveness ratio.

<16>
Accession Number
634553466
Title
Does erector spinae plane block result in improved postoperative analgesia
and enhanced recovery in adult patients after cardiac surgery?.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2021.
Date of Publication: 08 Mar 2021.
Author
Misra S.; Awal S.
Institution
(Misra) Department of Anesthesiology and Critical Care, All India
Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
(Awal) Department of Anaesthesia and Critical Care Medicine, Institute of
Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
Publisher
NLM (Medline)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was whether erector spinae
plane block (ESPB) resulted in improved postoperative analgesia and
enhanced recovery in adult cardiac surgical patients. A total of 333
papers were found using the reported search of which, 7 papers represented
the best evidence to answer the clinical question. The authors, journal,
date and country of publication, patient groups studied, study type,
relevant outcomes and results of these papers are tabulated. The cardiac
surgical procedures included off-pump coronary artery bypass surgery (1
study), mitral/tricuspid valve repair (1 study), robotic minimally
invasive coronary artery bypass surgery (1 study) and other cardiac
surgeries (4 studies). ESPB was compared to intravenous analgesia (5
studies), thoracic epidural analgesia (1 study) and serratus anterior
plane block and paravertebral block (1 study). With ESPB, there was
significant improvement in postoperative pain scores (4 studies),
decreased opioid requirement/rescue analgesia (3 studies), increased
duration of analgesia (1 study), decreased time to extubation (3 studies),
less increase in postoperative Troponin T (1 study), earlier ambulation (2
studies), earlier oral intake (1 study), earlier chest drain removal (1
study), better patient satisfaction (1 study), reduced adverse events (1
study) and decreased intensive care unit stay (3 studies). We conclude
that ESPB may be associated with improved postoperative analgesia and
enhanced recovery after adult cardiac surgery based on the available
evidence. However, there is a need for better quality randomized
controlled trials to consolidate these findings. Copyright © The
Author(s) 2021. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<17>
Accession Number
2010860383
Title
Racial and socioeconomic disparities in congenital heart surgery: A
research article.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Richardson C.J.; Itua P.; Duong T.; Lewars J.; Tiesenga F.
Institution
(Richardson) Department of Internal Medicine, Saint James School of
Medicine, The Quarter, Anguilla
(Itua) Department of Internal Medicine, All Saints University School of
Medicine, Roseau, Dominica
(Duong) Department of Internal Medicine, Windsor University School of
Medicine, Cayon, Saint Kitts and Nevis
(Lewars) Department of Internal Medicine, Saint James School of Medicine,
Arnos Vale, Saint Vincent and the Grenadines
(Tiesenga) Department of General Surgery, West Suburban Hospital Medical
Center, Oak Park, IL, United States
Publisher
Blackwell Publishing Inc.
Abstract
Background: Though the modern era has proven to be reassuring with the
advancement of perioperative care leading to improved survival, congenital
heart disease (CHD) continues to underscore its significance in the lives
of newborns and families worldwide. Particularly, CHD has
disproportionately afflicted vulnerable minorities such as Black and
Hispanic populations from the standpoint of ethnic disparities in
mortality following heart surgery, increased resource utilization, and
longer durations of stay. This study aims to identify and provide insight
regarding the relationships between the aforementioned factors to develop
targeted strategies of intervention to mitigate the outcomes for patients
of these specific populations. Method(s): Free, current peer-reviewed
literature from databases such as the American Heart Association, The
European Heart Journal, Science Direct, and PubMed regarding CHD, racial
disparities, and socioeconomic variances were accessed. The study was
narrowed to a patient population including only infants without
chromosomal anomalies or those that passed away before hospital discharge.
 Result(s): Having private insurance and maternal education showed
positive correlations with positive outcomes of patients post congenital
heart surgery. Teaching hospitals were linked with increased mortality and
complications. Male infants showed higher rates of complications.
Hispanics had increased odds of complications. Black patients had
increased risk for failures in being rescued. Conclusion(s): Race
plays a major role in the disparities in CHD, it is imperative to evaluate
the socioeconomic contributors, surgical efforts, and provisions in place
regarding minority patients. The apparency of these disparities, and
willingness to invoke changes in practice has the potential for
improvements in outcomes for these patients. Copyright © 2021
Wiley Periodicals LLC

<18>
Accession Number
2010797074
Title
Intranasal administration of 40 and 80 units of insulin does not cause
hypoglycemia during cardiac surgery: a randomized controlled trial.
Source
Canadian Journal of Anesthesia. (no pagination), 2021. Date of
Publication: 2021.
Author
Roque P.; Nakadate Y.; Sato H.; Sato T.; Wykes L.; Kawakami A.; Yokomichi
H.; Matsukawa T.; Schricker T.
Institution
(Roque, Wykes) School of Human Nutrition, McGill University,
Ste-Anne-de-Bellevue, Montreal, QC, Canada
(Nakadate) Department of Anesthesiology, University of Yamanashi, 1110
Shimokato, Chuo, Yamanashi 409-3898, Japan
(Sato, Sato, Kawakami, Schricker) Department of Anesthesia, McGill
University Health Centre Glen Site, Royal Victoria Hospital, Montreal, QC,
Canada
(Yokomichi, Matsukawa) Department of Health science, University of
Yamanashi, Shimokato, Chuo, Yamanashi, Japan
Publisher
Springer
Abstract
Purpose: Intranasal insulin administration may improve cognitive function
in patients with dementia and may prevent cognitive problems after
surgery. Although the metabolic effects of intranasal insulin in
non-surgical patients have been studied, its influence on glucose
concentration during surgery is unknown. Method(s): We conducted a
randomized, double-blind, placebo-contolled trial in patients scheduled
for elective cardiac surgery. Patients with type 2 diabetes mellitus
(T2DM) and non-T2DM patients were randomly allocated to one of three
groups (normal saline, 40 international units [IU] of intranasal insulin,
and 80 IU intranasal insulin). Insulin was given after the induction of
general anesthesia. Glucose and plasma insulin concentrations were
measured in ten-minute intervals during the first hour and every 30 min
thereafter. The primary outcome was the change in glucose concentration 30
min after intranasal insulin administration. Result(s): A total of
115 patients were studied, 43 of whom had T2DM. In non-T2DM patients, 40
IU intranasal insulin did not affect glucose concentration, while 80 IU
intranasal insulin led to a statistically significant but not clinically
important decrease in blood glucose levels (mean difference, 0.4
mMol.L-1; 95% confidence interval, 0.1 to 0.7). In T2DM
patients, neither 40 IU nor 80 IU of insulin affected glucose
concentration. No hypoglycemia (< 4.0 mMol.L-1) was observed
after intranasal insulin administration in any patients. In non-T2DM
patients, changes in plasma insulin were similar in the three groups. In
T2DM patients, there was an increase in plasma insulin concentrations ten
minutes after administration of 80 IU of intranasal insulin compared with
saline. Conclusion(s): In patients with and without T2DM undergoing
elective cardiac surgery, intranasal insulin administration at doses as
high as 80 IU did not cause clinically important hypoglycemia. Trial
registration: www.ClinicalTrials.gov (NCT02729064); registered 5 April
2016. Copyright © 2021, Canadian Anesthesiologists' Society.

<19>
Accession Number
2010795825
Title
A narrative review of platelet-rich plasma (PRP) in reproductive medicine.
Source
Journal of Assisted Reproduction and Genetics. (no pagination), 2021. Date
of Publication: 2021.
Author
Sharara F.I.; Lelea L.-L.; Rahman S.; Klebanoff J.S.; Moawad G.N.
Institution
(Sharara, Rahman) Virginia Center for Reproductive Medicine, 11150 Sunset
Hills Rd, Suite 100, Reston, VA 20190, United States
(Sharara, Moawad) Department of Obstetrics and Gynecology, George
Washington University, Washington, DC, United States
(Lelea) Department of Obstetrics and Gynecology, University of Central
Florida-HCA Consortium, Orlando, FL, United States
(Klebanoff) Department of Obstetrics and Gynecology, Main Line Health
Wynnewood, Wynnewood, PA, United States
(Moawad) The Center for Endometriosis and Advanced Pelvic Surgery,
Washington, DC, United States
Publisher
Springer
Abstract
Purpose: Platelet-rich plasma (PRP) has become a novel treatment in
various aspects of medicine including orthopedics, cardiothoracic surgery,
plastic surgery, dermatology, dentistry, and diabetic wound healing. PRP
is now starting to become an area of interest in reproductive medicine
more specifically focusing on infertility. Poor ovarian reserve,
menopause, premature ovarian failure, and thin endometrium have been the
main areas of research. The aim of this article is to review the existing
literature on the effects of autologous PRP in reproductive medicine
providing a summation of the current studies and assessing the need for
additional research. Method(s): A literature search is performed
using PubMed, MEDLINE, and CINAHL Plus to identify studies focusing on the
use of PRP therapy in reproductive medicine. Articles were divided into 3
categories: PRP in thin lining, PRP in poor ovarian reserve, and PRP in
recurrent implantation failure. Result(s): In women with thin
endometrium, the literature shows an increase in endometrial thickness and
increase in chemical and clinical pregnancy rates following autologous PRP
therapy. In women with poor ovarian reserve, autologous intraovarian PRP
therapy increased anti-Mullerian hormone (AMH) levels and decreased
follicle-stimulating hormone (FSH), with a trend toward increasing
clinical and live birth rates. This trend was also noted in women with
recurrent implantation failure. Conclusion(s): Limited literature
shows promise in increasing endometrial thickness, increasing AMH, and
decreasing FSH levels, as well as increasing chemical and clinical
pregnancy rates. The lack of standardization of PRP preparation along with
the lack of large randomized controlled trials needs to be addressed in
future studies. Until definitive large RCTs are available, PRP use should
be considered experimental. Copyright © 2021, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<20>
Accession Number
634443833
Title
Scheduled Prophylactic 6-Hourly IV AcetaminopheN to Prevent Postoperative
Delirium in Older CaRdiac SurgicAl Patients (PANDORA): protocol for a
multicentre randomised controlled trial.
Source
BMJ Open. 11 (3) (no pagination), 2021. Article Number: 044346. Date of
Publication: 10 Mar 2021.
Author
Khera T.; Mathur P.A.; Banner-Goodspeed V.M.; Narayanan S.; Mcgourty M.;
Kelly L.; Palihnich K.; Novack L.; Davis R.; Talmor D.; Marcantonio E.R.;
Subramaniam B.
Institution
(Khera, Mathur, Banner-Goodspeed, Narayanan, Mcgourty, Kelly, Talmor,
Subramaniam) Anesthesia, Critical Care and Pain Medicine, Beth Israel
Deaconess Medical Center, Boston, MA, United States
(Palihnich, Davis, Marcantonio) Medicine, Beth Israel Deaconess Medical
Center, Boston, MA, United States
(Novack) Soroka University Medical Center, Beer Sheva, Israel
(Novack) Ben-Gurion University of the Negev, Beer-Sheva, Israel
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium is common among older cardiac surgery
patients. Often difficult to predict and address prophylactically,
delirium complicates the postoperative course by increasing morbidity and
mortality as well as prolonging both hospital and intensive care unit
(ICU) lengths of stay. Based on our pilot trial, we intend to study the
effect of scheduled 6-hourly acetaminophen administration for 48 hours
post-cardiac surgery with cardiopulmonary bypass (CPB) on the incidence of
in-hospital delirium and long-term neurocognitive outcomes. Additionally,
effect on duration and severity of delirium, rescue analgesic consumption,
acute and chronic pain scores and lengths of hospital and ICU stay will
also be explored. Methods and analysis This multicentre, randomised,
placebo-controlled, quadruple-blinded trial will include 900 older (>60
years) cardiac surgical patients requiring CPB. Patients meeting the
inclusion criteria and not meeting any exclusion criteria will be enrolled
at seven centres across the USA with Beth Israel Deaconess Medical Center
(BIDMC), Boston, as the central coordinating centre. Additional sites may
be included to broaden or speed accrual. The primary outcome measure is
the incidence of in-hospital delirium till day 30. Secondary outcomes
include the duration and severity of in-hospital delirium, hospital and
ICU lengths of stay, postoperative pain scores, postoperative rescue
analgesic consumption, postoperative cognitive function and chronic
sternal pain. Creation of a biorepository and the use of
intraoperative-blinded electroencephalogram (EEG) and cerebral oximetry
data will support exploratory endpoints to determine mechanistic
predictors of postoperative delirium. Ethics and dissemination This trial
is approved and centrally facilitated by the Institutional Review Board at
BIDMC. An independent Data Safety and Monitoring Board is responsible for
maintaining safety oversight. Protocol # 2019 P00075, V.1.4 (dated 20
October 2020). Trial registration number NCT04093219. Copyright ©
Author(s) (or their employer(s)) 2021.

<21>
Accession Number
2011323073
Title
Surgical myocardial revascularization outcomes in Kawasaki disease:
Systematic review and meta-analysis.
Source
Open Medicine (Poland). 16 (1) (pp 375-386), 2021. Date of Publication: 01
Jan 2021.
Author
Salsano A.; Liao J.; Miette A.; Capoccia M.; Mariscalco G.; Santini F.;
Corno A.F.
Institution
(Salsano, Miette) Division of Cardiac Surgery, Ospedale Policlinico San
Martino, University of Genoa, L.go Rosanna Benzi, 10, Genoa 16143, Italy
(Salsano, Miette, Santini) Department of Integrated Surgical and
Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy
(Liao, Mariscalco) Cardiovascular Research Center, University of
Leicester, Leicester, United Kingdom
(Liao, Mariscalco) Department of Intensive Care Medicine and Cardiac
Surgery, Glenfield Hospital, University Hospitals of Leicester, Leicester,
United Kingdom
(Capoccia) Royal Brompton and Harefield NHS Foundation Trust, London,
United Kingdom
(Capoccia) Department of Aortic and Cardiac Surgery, Royal Brompton
Hospital, London, United Kingdom
(Corno) Houston Children Heart Institute, Hermann Children's Hospital,
Houston, TX, United States
(Corno) University Texas Health, McGovern Medical School, Houston, TX,
United States
Publisher
De Gruyter Open Ltd
Abstract
Background - Kawasaki disease (KD) is a systemic inflammatory condition
occurring predominantly in children. Coronary artery bypass grafting
(CABG) is performed in the presence of inflammation and aneurysms of the
coronary arteries. The objectives of our study were to assess which CABG
strategy provides better graft patency and early and long-term outcomes.
Methods - A systematic review using Medline, Cochrane, and Scopus
databases was performed in February 2020, incorporating a network
meta-analysis, performed by random-effect model within a Bayesian
framework, and pooled prevalence of adverse outcomes. Hazard ratios (HR)
and corresponding 95% credible intervals (CI) were calculated by Markov
chain Monte Carlo methods. Results - Among 581 published reports, 32
studies were selected, including 1,191 patients undergoing CABG for KD.
Graft patency of internal thoracic arteries (ITAs), saphenous veins (SV),
and other arteries (gastroepiploic artery and radial artery) was compared.
ITAs demonstrated the best patency rates at long-term follow-up (HR 0.33,
95% CI: 0.17-0.66). Pooled prevalence of early mortality after CABG was
0.28% (95% CI: 0.00-0.73%, I2 = 0%, tau2 = 0), with
63/1,108 and 56/1,108 patients, undergoing interventional procedures and
surgical re-interventions during follow-up, respectively. Pooled
prevalence was 3.97% (95% CI: 1.91-6.02%, I2 = 60%,
tau2 = 0.0008) for interventional procedures and 3.47% (95% CI:
2.26-4.68%, I2 = 5%, tau2 <0.0001) for surgical
re-interventions. Patients treated with arterial, venous, and mixed
(arterial plus second venous graft) CABG were compared to assess long-term
mortality. Mixed CABG (HR 0.03, 95% CI: 0.00-0.30) and arterial CABG (HR
0.13, 95% CI: 0.00-1.78) showed reduced long-term mortality compared with
venous CABG. Conclusions - CABG in KD is a safe procedure. The use of
arterial conduits provides better patency rates and lower mortality at
long-term follow-up. Copyright © 2021 Antonio Salsano et al.,
published by De Gruyter.

<22>
Accession Number
2011299373
Title
Indications and contraindications for extracorporeal life support for
severe heart or lung failure: A systematic review.
Source
Minerva Anestesiologica. 87 (2) (pp 199-209), 2021. Date of Publication:
February 2021.
Author
Brandi G.; Drewniak D.; Buehler P.K.; Budilivschi A.; Steiger P.; Krones
T.
Institution
(Brandi, Buehler, Steiger) Institute of Intensive Medicine, Zurich
University Hospital, University of Zurich, Zurich, Switzerland
(Drewniak, Budilivschi) Institute of Biomedical Ethics and History of
Medicine, Zurich University Hospital, University of Zurich, Zurich,
Switzerland
(Krones) Clinical Ethics Unit, Institute of Biomedical Ethics and History
of Medicine, Zurich University Hospital, University of Zurich, Zurich,
Switzerland
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: The effectiveness of extracorporeal life support (ECLS) in
critically ill patients remains unclear despite a substantial increase in
its use. This study critically assesses existing ECLS guidelines,
consensus statements, and position papers to systematically review them
for agreements and differences regarding indications and contraindications
for ECLS. EVIDENCE ACQUISITION: The aims of this review were to identify
available indications and contraindications for ECLS and to evaluate the
quality of the evidence on which they are based. Documents containing
recommendations regarding indications and/or contraindications for ECLS in
adults (aged 18+) were identified through Medline, EMBASE, and CENTRAL
searches. Additional documents were identified from guideline-specific
databases and the internet websites of professional societies. Based on
the Appraisal of Guidelines for Research and Evaluation (AGREE II), four
independent reviewers assessed the rigor of development and quality of the
documents. EVIDENCE SYNTHESIS: Eleven documents met the inclusion
criteria. Three documents received an average score of.50% in all domains.
However, the Editorial independence domain only scored <50% in most of the
documents. Overall, 13 cardiac and 13 pulmonary ECLS indications, and 23
cardiac and 14 pulmonary contraindications were identified. Indications
and contraindications for ECLS use are variable across the documents
included and leave considerable room for interpretation.
 CONCLUSION(S): The documents included for review show considerable
variability, with little consensus on indications and contraindications.
This lack of consensus may reflect a lack of clarity regarding ECLS
utility. Additionally, it may reveal the necessity for individualized,
patient-dependent criteria supported by the best evidence
available. Copyright © 2021 Edizioni Minerva Medica. All rights
reserved.

<23>
Accession Number
2011159578
Title
Role of targeted and universal mupirocin-based decolonization for
preventing surgical-site infections in patients undergoing cardiothoracic
surgery: A systematic review and meta-analysis.
Source
Experimental and Therapeutic Medicine. 21 (5) (pp 1-12), 2021. Date of
Publication: May 2021.
Author
WANG L.; JI Q.; HU X.
Institution
(WANG, JI) Departments of Operating Room, The First People's Hospital of
Lianyungang City, Lianyungang, Jiangsu 222002, China
(HU) Departments of Tongguan Operating Room, The First People's Hospital
of Lianyungang City, Lianyungang, Jiangsu 222002, China
Publisher
Spandidos Publications
Abstract
The purpose of the present study was to provide a systematic literature
review and pool evidence on the efficacy of mupirocin-based decolonization
protocol in reducing surgical-site infections (SSIs) in patients
undergoing cardiothoracic (CT) surgery based on their Staphylococcus (S.)
aureus carrier state. The PubMed, Embase, Ovid, BioMed Central, Cochrane
Central Register of Controlled Trials and Google Scholar databases were
searched for studies comparing mupirocin-based decolonization with
controls for reducing SSIs in patients following CT surgery. Studies were
grouped based on the targeted population of intervention, i.e. carriers or
all patients. A total of 17 studies were included. Of these, 8 studies
used targeted mupirocin-based decolonization, while universal
decolonization was performed in 9 studies. The results were conflicting
for studies performing targeted decolonization and it was not possible to
perform a meta-analysis due to non-homogenous studies. Pooled analysis of
34,859 patients indicated that universal mupirocin-based decolonization
significantly reduced the risk of all SSIs [risk ratio (RR): 0.54; 95% CI:
0.40,0.75; I2=73.35%]. The intervention significantly reduced the risk of
superficial SSIs (RR: 0.37; 95% CI: 0.25,0.55; I2=0%) but not of deep SSIs
(RR: 0.45; 95% CI: 0.19,1.09; I2=80.67%). The results indicated a
significantly reduced risk of S. aureus SSIs (SA-SSIs) with
mupirocin-based decolonization (RR: 0.44; 95% CI: 0.32,0.61; I2=0%) but
not for methicillin-resistant S. aureus (MRSA-SSIs; RR: 0.25; 95% CI:
0.05,1.28; I2=79.07%). Evidence on the role of targeted mupirocin-based
decolonization to reduce SSIs after CT surgery was non-coherent and
inconclusive. Analysis of low-quality retrospective studies suggested that
universal mupirocin-based decolonization may reduce all SSIs, superficial
SSIs and SA-SSIs, but not deep SSIs or MRSA-SSIs in patients after CT
surgery. Copyright © 2021 Spandidos Publications. All rights
reserved.

<24>
Accession Number
2011084399
Title
Perioperative management of patients with pulmonary hypertension
undergoing non-cardiothoracic, non-obstetric surgery: a systematic review
and expert consensus statement.
Source
British Journal of Anaesthesia. 126 (4) (pp 774-790), 2021. Date of
Publication: April 2021.
Author
Price L.C.; Martinez G.; Brame A.; Pickworth T.; Samaranayake C.;
Alexander D.; Garfield B.; Aw T.-C.; McCabe C.; Mukherjee B.; Harries C.;
Kempny A.; Gatzoulis M.; Marino P.; Kiely D.G.; Condliffe R.; Howard L.;
Davies R.; Coghlan G.; Schreiber B.E.; Lordan J.; Taboada D.; Gaine S.;
Johnson M.; Church C.; Kemp S.V.; Wong D.; Curry A.; Levett D.; Price S.;
Ledot S.; Reed A.; Dimopoulos K.; Wort S.J.
Institution
(Price, Brame, Samaranayake, Garfield, McCabe, Mukherjee, Harries, Kempny,
Gatzoulis, Dimopoulos, Wort) National Pulmonary Hypertension Service,
Royal Brompton Hospital, London, United Kingdom
(Price, McCabe, Kempny, Gatzoulis, Reed, Dimopoulos, Wort) National Heart
and Lung Institute, Imperial College London, London, United Kingdom
(Martinez) Department of Anaesthesia and Intensive Care, Royal Papworth
Hospital, Cambridge, United Kingdom
(Brame, Mukherjee, Marino, Wong) Intensive Care unit and Pulmonary
Hypertension Service, London, United Kingdom
(Pickworth, Alexander, Aw) Department of Anaesthesia, Royal Brompton
Hospital, London, United Kingdom
(Garfield, Price, Ledot) Adult Intensive Care Unit, Royal Brompton
Hospital, London, United Kingdom
(Kiely, Condliffe) Pulmonary Vascular Disease Unit, Royal Hallamshire
Hospital, Sheffield, United Kingdom
(Howard, Davies) National Pulmonary Hypertension Service, Hammersmith
Hospital, London, United Kingdom
(Coghlan, Schreiber) National Pulmonary Hypertension Service, Royal Free
Hospital, London, United Kingdom
(Lordan) National Pulmonary Hypertension Service, Freeman Hospital,
Newcastle upon Tyne, United Kingdom
(Taboada) Pulmonary Vascular Disease Unit, Royal Papworth Hospital,
Cambridge, United Kingdom
(Gaine) National Pulmonary Hypertension Unit, Mater Misericordiae
University Hospital, Dublin, Ireland
(Johnson, Church) Scottish Pulmonary Vascular Unit, NHS Golden Jubilee,
Clydebank, United Kingdom
(Kemp) Department of Respiratory Medicine, Royal Brompton Hospital,
London, United Kingdom
(Curry) Cardiothoracic Anaesthesia, University Hospital Southampton,
Southampton, Hampshire, United Kingdom
(Levett) Anaesthesia and Critical Care Research Area, Southampton NIHR
Biomedical Research Centre, University Hospital Southampton NHS Foundation
Trust, Southampton, United Kingdom
(Levett) Integrative Physiology and Critical Illness Group, Clinical and
Experimental Sciences, Faculty of Medicine, University of Southampton,
Southampton, United Kingdom
(Reed) Respiratory and Lung Transplantation, Harefield Hospital, Uxbridge,
United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: The risk of complications, including death, is substantially
increased in patients with pulmonary hypertension (PH) undergoing
anaesthesia for surgical procedures, especially in those with pulmonary
arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH).
Sedation also poses a risk to patients with PH. Physiological changes
including tachycardia, hypotension, fluid shifts, and an increase in
pulmonary vascular resistance (PH crisis) can precipitate acute right
ventricular decompensation and death. Method(s): A systematic
literature review was performed of studies in patients with PH undergoing
non-cardiac and non-obstetric surgery. The management of patients with PH
requiring sedation for endoscopy was also reviewed. Using a framework of
relevant clinical questions, we review the available evidence guiding
operative risk, risk assessment, preoperative optimisation, and
perioperative management, and identifying areas for future research.
 Result(s): Reported 30 day mortality after non-cardiac and
non-obstetric surgery ranges between 2% and 18% in patients with PH
undergoing elective procedures, and increases to 15-50% for emergency
surgery, with complications and death usually relating to acute right
ventricular failure. Risk factors for mortality include procedure-specific
and patient-related factors, especially markers of PH severity (e.g.
pulmonary haemodynamics, poor exercise performance, and right ventricular
dysfunction). Most studies highlight the importance of individualised
preoperative risk assessment and optimisation and advanced perioperative
planning. Conclusion(s): With an increasing number of patients
requiring surgery in specialist and non-specialist PH centres, a
systematic, evidence-based, multidisciplinary approach is required to
minimise complications. Adequate risk stratification and a
tailored-individualised perioperative plan is paramount. Copyright
© 2021 British Journal of Anaesthesia

<25>
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.
 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. 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.
 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. Copyright © 2020 Elsevier B.V.

<26>
Accession Number
2007577717
Title
PASCAL versus MitraClip-XTR edge-to-edge device for the treatment of
tricuspid regurgitation: a propensity-matched analysis.
Source
Clinical Research in Cardiology. 110 (3) (pp 451-459), 2021. Date of
Publication: March 2021.
Author
Sugiura A.; Vogelhuber J.; Ozturk C.; Schwaibold Z.; Reckers D.; Goto T.;
Kavsur R.; Becher M.U.; Zimmer S.; Nickenig G.; Weber M.
Institution
(Sugiura, Vogelhuber, Ozturk, Schwaibold, Reckers, Kavsur, Becher, Zimmer,
Nickenig, Weber) Herzzentrum Bonn, Medizinische Klinik und Poliklinik II,
Universitatsklinikum Bonn, Venusberg-Campus 1, Bonn 53127, Germany
(Goto) Department of Clinical Epidemiology and Health Economics, School of
Public Health, University of Tokyo, TXP Medical Co. Ltd., Tokyo, Japan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Transcatheter tricuspid valve repair (TTVR) is a promising
technique for the treatment of tricuspid regurgitation (TR). Data
comparing the performance of novel edge-to-edge devices (PASCAL and
MitraClip-XTR) are scarce. Method(s): We identified 80 consecutive
patients who underwent TTVR using either the PASCAL or MitraClip-XTR
system to treat symptomatic TR from July 2018 to June 2020. To adjust for
baseline imbalances, we performed a propensity score (PS) 1:1 matching.
The primary endpoint was a reduction in TR severity by at least one grade
at 30 days. Result(s): The PS-matched cohort (n = 44) was at
high-surgical risk (EuroSCORE II: 7.5% [interquartile range (IQR)
4.8-12.1%]) with a mean TR grade of 4.3 +/- 0.8 and median coaptation gap
of 6.2 mm [IQR 3.2-9.1 mm]. The primary endpoint was similarly observed in
both groups (PASCAL: 91% vs. MitraClip-XTR: 96%). Multiple device
implantation was the most common form (59% vs. 82%, p = 0.19), and the
occurrence of SLDA was comparable between the PASCAL and MitraClip-XTR
system (5.7% [2 of 35 implanted devices] vs. 4.4% [2 of 45 implanted
devices], p = 0.99). No periprocedural death or conversions to surgery
occurred, and 30-day mortality (5.0% vs. 5.0%, log-rank p = 0.99) and
3-month mortality (10.0% vs. 5.0%, log-rank p = 0.56) were similar between
both groups. During follow-up, functional NYHA class, 6-min walking
distance, and health status improved in both groups. Conclusion(s):
Both TTVR devices, PASCAL and MitraClip-XTR, appeared feasible and
comparable for an effective TR reduction. Randomized head-to-head
comparisons will help to further define the appropriate scope of
application of each system. Copyright © 2020, The Author(s).

<27>
Accession Number
2010047771
Title
Global longitudinal strain in chronic asymptomatic aortic regurgitation:
Systematic review.
Source
Echo Research and Practice. 7 (3) (pp 39-48), 2020. Date of Publication:
2020.
Author
deCampos D.; Teixeira R.; Saleiro C.; Botelho A.; Goncalves L.
Institution
(deCampos, Teixeira, Saleiro, Botelho, Goncalves) Servico de Cardiologia,
Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
(Teixeira, Goncalves) Faculdade de Medicina, Universidade de Coimbra,
Coimbra, Portugal
Publisher
BioScientifica Ltd.
Abstract
Chronic aortic regurgitation (AR) patients typically remain asymptomatic
for a long time. Left ventricular mechanics, namely global longitudinal
strain (GLS), has been associated with outcomes in AR patients. The
authors conducted a systematic review to summarize and appraise GLS impact
on mortality, the need for aortic valve replacement (AVR) and disease
progression in AR patients. A literature search was performed using these
key terms 'aortic regurgitation' and 'longitudinal strain' looking at all
randomized and nonrandomized studies conducted on chronic aortic
regurgitation. The search yielded six observational studies published from
2011 and 2018 with a total of 1571 patients with moderate to severe
chronic AR. Only two studies included all-cause mortality as their
endpoint. The other studies looked at the association between GLS with AVR
and disease progression. The mean follow-up period was 4.2 years. We noted
a great variability of clinical, methodological and/or statistical origin.
Thus, meta-analytic portion of our study was limited. Despite a relevant
heterogeneity, an impaired GLS was associated with adverse cardiac
outcomes. Left ventricular GLS may offer incremental value in risk
stratification and decision-making. Copyright © 2020 The authors
Published by Bioscientifica Ltd.

<28>
[Use Link to view the full text]
Accession Number
631990957
Title
Long-term and Temporal Outcomes of Transcatheter Versus Surgical
Aortic-valve Replacement in Severe Aortic Stenosis: A Meta-analysis.
Source
Annals of surgery. 273 (3) (pp 459-466), 2021. Date of Publication: 01 Mar
2021.
Author
Zhang X.-L.; Zhang X.-W.; Lan R.-F.; Chen Z.; Wang L.; Xu W.; Xu B.
Institution
(Zhang, Lan, Chen, Wang, Xu, Xu) Department of Cardiology, Affiliated Drum
Tower Hospital, Nanjing University School of Medicine, Nanjing, China
(Zhang) Department of Endocrinology, Affiliated Drum Tower Hospital,
Nanjing University School of Medicine, Nanjing, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To determine the 5-year and temporal performance of TAVR versus
SAVR. BACKGROUND: TAVR has become a valuable treatment for severe aortic
stenosis but the long-term safety and efficacy remain unclear.
 METHOD(S): Databases were searched until October 6, 2019 for
randomized trials with >=5 years' follow-up. Primary outcome was all-cause
mortality. Odds ratios (ORs) with 95% confidence intervals (CIs) were
pooled with random-effects models. RESULT(S): We included 4 trials
with 3,758 patients. TAVR was associated with a significantly higher
5-year all-cause mortality than SAVR (OR, 1.19; 95% CI, 1.03-1.37; P =
0.02). Landmark analysis showed no significant difference within 2 years
(OR, 0.92; 95% CI, 0.79-1.08; P = 0.33) but a statistically higher
mortality in TAVR between 2 and 5 years (OR, 1.32; 95% CI, 1.14-1.52; P =
0.0002), with significant difference between these 2 temporal phases (P
for interaction = 0.001). Similar interaction was found for cardiovascular
mortality and several other outcomes. Rates of all-cause mortality or
disabling stroke, permanent pacemaker implantation, aortic-valve
rehospitalization, and reintervention were higher, but rates of major
bleeding and new-onset fibrillation were lower in TAVR at 5 years. The
incidences of myocardial infarction, stroke, and transient ischemic attack
were not statistically different between TAVR and SAVR.
 CONCLUSION(S): TAVR was associated with a significantly higher
all-cause mortality at 5 years compared with SAVR. Of note, all-cause
mortality presented a characteristic temporal pattern showing increased
risk between 2 and 5 years but not within 2 years. Longer-term follow-up
data are warranted. Copyright © 2020 Wolters Kluwer Health, Inc.
All rights reserved.

<29>
Accession Number
634154934
Title
Silent brain infarcts and early cognitive outcomes after transcatheter
aortic valve implantation: a systematic review and meta-analysis.
Source
European heart journal. 42 (10) (pp 1004-1015), 2021. Date of Publication:
07 Mar 2021.
Author
Woldendorp K.; Indja B.; Bannon P.G.; Fanning J.P.; Plunkett B.T.; Grieve
S.M.
Institution
(Woldendorp, Indja, Bannon, Grieve) Faculty of Medicine and Health,
University of Sydney, Sydney NSW 2006, Australia
(Woldendorp, Bannon, Plunkett) Cardiothoracic Surgical Department, Royal
Prince Alfred Hospital, Sydney, Australia
(Woldendorp, Bannon, Plunkett) Baird Institute of Applied Heart and Lung
Research, 100 Carillon Avenue, Sydney, Australia
(Fanning) Prince Charles Hospital, Critical Care Research Group, Brisbane,
Australia
(Fanning) Faculty of Medicine, University of Queensland, Brisbane QLD
4072, Australia
(Grieve) Sydney Translational Imaging Laboratory, Charles Perkins Centre,
University of Sydney NSW 2006, Australia
(Grieve) Department of Radiology, Royal Prince Alfred Hospital,
Camperdown, Sydney, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Silent brain infarcts (SBIs) are frequently identified after
transcatheter aortic valve implantation (TAVI), when patients are screened
with diffusion-weighted magnetic resonance imaging (DW-MRI). Outside the
cardiac literature, SBIs have been correlated with progressive cognitive
dysfunction; however, their prognostic utility after TAVI remains
uncertain. This study's main goals were to explore (i) the incidence of
and potential risk factors for SBI after TAVI; and (ii) the effect of SBI
on early post-procedural cognitive dysfunction (PCD). METHODS AND RESULTS:
A systematic literature review was performed to identify all publications
reporting SBI incidence, as detected by DW-MRI after TAVI. Silent brain
infarct incidence, baseline characteristics, and the incidence of early
PCD were evaluated via meta-analysis and meta-regression models. We
identified 39 relevant studies encapsulating 2408 patients. Out of 2171
patients who underwent post-procedural DW-MRI, 1601 were found to have at
least one new SBI (pooled effect size 0.76, 95% CI: 0.72-0.81). The
incidence of reported stroke with focal neurological deficits was 3%.
Meta-regression noted that diabetes, chronic renal disease, 3-Tesla MRI,
and pre-dilation were associated with increased SBI risk. The prevalence
of early PCD increased during follow-up, from 16% at 10.0+/-6.3days to 26%
at 6.1+/-1.7months and meta-regression suggested an association between
the mean number of new SBI and incidence of PCD. The use of cerebral
embolic protection devices (CEPDs) appeared to decrease the volume of SBI,
but not their overall incidence. CONCLUSION(S): Silent brain infarcts
are common after TAVI; and diabetes, kidney disease, and pre-dilation
increase overall SBI risk. While higher numbers of new SBIs appear to
adversely affect early neurocognitive outcomes, long-term follow-up
studies remain necessary as TAVI expands to low-risk patient populations.
The use of CEPD did not result in a significant decrease in the occurrence
of SBI. Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. © The Author(s) 2021. For
permissions, please email: journals.permissions@oup.com.

<30>
Accession Number
633808107
Title
Comparison of dynamic needle tip positioning versus conventional long-axis
in-plane techniques for ultrasound-guided internal jugular venous
catheterization: a randomized controlled trial.
Source
Minerva anestesiologica. 87 (3) (pp 294-301), 2021. Date of Publication:
01 Mar 2021.
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 Anesthesiology and Pain
Medicine, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
(Chang, Oh, Yang) Department of Anesthesiology and Pain Medicine, Seoul
Metropolitan Government, Seoul National University Boramae Medical Center,
Seoul National University College of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Seoul Metropolitan
Government, Seoul National University Boramae Medical Center, Seoul
National University College of Medicine, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Continuous visualization of the needle tip is essential for
successful ultrasound-guided central venous catheterization, and the
dynamic needle tip positioning (DNTP) technique enables it. The aim of
this randomized, dual-center trial was to compare the first-attempt
success rate of ultrasound-guided internal jugular catheterization between
the DNTP and conventional long-axis in-plane (LAX-IP) techniques.
 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 catheterization was performed by four
anesthesiologists. The primary outcome was the first-attempt success rate
of central venous catheterization. Procedural time and complications
related to catheterization were compared as secondary outcomes.
 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 catheterization, including posterior
wall puncture, carotid artery puncture, or hematoma. CONCLUSION(S):
The DNTP technique resulted in a significantly higher success rate on the
first attempt at internal jugular venous catheterization and required less
frequent redirection of the needle during the procedure than the
conventional LAX-IP technique.

<31>
Accession Number
2011288449
Title
Effectiveness of preoperative breathing exercise interventions in patients
undergoing cardiac surgery: A systematic review.
Source
Revista Portuguesa de Cardiologia. 40 (3) (pp 229-244), 2021. Date of
Publication: March 2021.
Author
Rodrigues S.N.; Henriques H.R.; Henriques M.A.
Institution
(Rodrigues) Lisbon University, Lisbon, Portugal
(Rodrigues, Henriques, Henriques) Lisbon Nursing School, Lisbon, Portugal
(Rodrigues) Centro Hospitalar de Vila Nova de Gaia/Espinho, Oporto,
Portugal
(Henriques) ISAMB_Lisbon Medical School, Lisbon, Portugal
Publisher
Sociedade Portuguesa de Cardiologia
Abstract
Postoperative pulmonary complications are a common cause of morbidity and
mortality in patients undergoing cardiac surgery, leading to an increase
in length of hospital stay and healthcare costs. This systematic
literature review aims to determine whether patients undergoing cardiac
surgery who undergo preoperative breathing exercise training have better
postoperative outcomes such as respiratory parameters, postoperative
pulmonary complications, and length of hospital stay. Systematic searches
were performed in the CINAHL, Cochrane Central Register of Controlled
Trials, Cochrane Clinical Answers, Cochrane Database of Systematic
Reviews, MEDLINE and MedicLatina databases. Studies were included if they
examined adult patients scheduled for elective cardiac surgery, who
underwent a preoperative breathing exercise training aimed at improving
breathing parameters, preventing postoperative pulmonary complications,
and reducing hospital length of stay. This systematic review was based on
Cochrane and Prisma statement recommendations in the design, literature
search, analysis, and reporting of the review. The search yielded 608
records. Eleven studies met the inclusion criteria. Ten studies were
randomized controlled trials and one was an observational cohort study.
Data from 1240 participants was retrieved from these studies and
meta-analysis was performed whenever possible. A preoperative breathing
intervention on patients undergoing cardiac surgery may help improve
respiratory performance after surgery, reduce postoperative pulmonary
complications and hospital length of stay. However, more trials are needed
to support and strengthen the evidence. Copyright © 2021
Sociedade Portuguesa de Cardiologia

<32>
Accession Number
2011267296
Title
Optimal interval and duration of CAM-ICU assessments for delirium
detection after cardiac surgery.
Source
Journal of Clinical Anesthesia. 71 (no pagination), 2021. Article Number:
110233. Date of Publication: August 2021.
Author
Hamadnalla H.; Sessler D.I.; Troianos C.A.; Fang J.; Rivas E.; Ma C.;
Mascha E.J.; Turan A.
Institution
(Hamadnalla, Sessler, Fang, Rivas, Ma, Mascha, Turan) Department of
Outcomes Research, Cleveland Clinic, OH, United States
(Troianos) Anesthesiology Institute, Cleveland Clinic, OH, United States
(Ma, Mascha) Department of Quantitative Health Sciences, Cleveland Clinic,
OH, United States
(Turan) Department of General Anesthesiology, Cleveland Clinic, OH, United
States
(Hamadnalla) Department of Anesthesiology, Pain Management & Perioperative
Medicine, Henry Ford Health System, MI, United States
(Rivas) Department of Anesthesiology, Hospital Clinic de Barcelona,
Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS),
University of Barcelona, Barcelona, Spain
Publisher
Elsevier Inc.
Abstract
Study objective: Our goal was to determine when postoperative delirium
first occurs, and to assess evaluation strategies that reliably detect
delirium with lowest frequency of testing'. Design(s): This was a
retrospective study that used a database from a five-center randomized
trial. Setting(s): Postoperative cardiothoracic ICU and surgical
wards. Participant(s): Adults scheduled for elective coronary artery
bypass and/or valve surgery. Intervention and measurements: Postoperative
delirium was assessed using CAM-ICU questionnaires twice daily for 5 days
or until hospital discharge. Data were analyzed using frequency tables and
Kaplan-Meier time-to-event estimators, the latter being used to summarize
time to first positive CAM-ICU over POD1-5 for all patients for various
evaluation strategies, including all assessments, only morning assessment,
and only afternoon assessments. Sensitivity for various strategies were
compared using McNemar's test for paired proportions. Main Result(s):
A total of 95 of 788 patients (12% [95% CI, 10% to 15%]) had at least 1
episode of delirium within the first 5 postoperative days. Among all
patients with delirium, 65% were identified by the end of the first
postoperative day. Delirium was detected more often in the mornings (10%
of patients) than evenings (7% of patients). Compared to delirium
assessments twice daily for five days, we found that twice daily
assessments for 4 days detected an estimated 97% (95% CI 91%, 99%) of
delirium. Measurements twice daily for three days detected 90% (82%, 95%)
of delirium. Conclusion(s): Postoperative delirium is common, and
CAM-ICU assessments twice daily for 4 days, versus 5 days, detects nearly
all delirium with 20% fewer assessments. Four days of assessment may
usually be sufficient for clinical and research purposes. Copyright
© 2021

<33>
Accession Number
2011180639
Title
Platelet Reactivity in Patients With Acute Coronary Syndromes Awaiting
Surgical Revascularization.
Source
Journal of the American College of Cardiology. 77 (10) (pp 1277-1286),
2021. Date of Publication: 16 Mar 2021.
Author
Nakashima C.A.K.; Dallan L.A.O.; Lisboa L.A.F.; Jatene F.B.; Hajjar L.A.;
Soeiro A.M.; Furtado R.H.M.; Dalcoquio T.F.; Baracioli L.M.; Lima F.G.;
Giraldez R.R.C.V.; Silva B.A.; Costa M.S.S.; Strunz C.M.C.; Dallan L.R.P.;
Barbosa C.J.D.G.; Britto F.A.B.; Farkouh M.E.; Gurbel P.A.; Nicolau J.C.
Institution
(Nakashima, Dallan, Lisboa, Jatene, Hajjar, Soeiro, Furtado, Dalcoquio,
Baracioli, Lima, Giraldez, Silva, Costa, Strunz, Dallan, Nicolau)
Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de
Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
(Furtado) Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Barbosa) Hospital do Coracao do Brasil, Brasilia, Brazil
(Britto, Farkouh) Hospital das Clinicas, Faculdade de Medicina,
Universidade Federal de Uberlandia, Minas Gerais, Brazil
(Britto, Farkouh) Peter Munk Cardiac Centre and Heart and Stroke Richard
Lewar Centre, University of Toronto, Toronto, ON, Canada
(Gurbel) Sinai Center for Thrombosis Research and Drug Development, Sinai
Hospital of Baltimore, Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
Background: Dual antiplatelet therapy is recommended for patients with
acute coronary syndromes (ACS). Approximately 10% to 15% of these patients
will undergo coronary artery bypass graft (CABG) surgery for index events,
and current guidelines recommend stopping clopidogrel at least 5 days
before CABG. This waiting time has clinical and economic implications.
 Objective(s): This study aimed to evaluate if a platelet
reactivity-based strategy is noninferior to standard of care for 24-h
post-CABG bleeding. Method(s): In this randomized, open label
noninferiority trial, 190 patients admitted with ACS with indications for
CABG and on aspirin and P2Y<inf>12</inf> receptor inhibitors, were
assigned to either control group, P2Y<inf>12</inf> receptor inhibitor
withdrawn 5 to 7 days before CABG, or intervention group, daily
measurements of platelet reactivity by Multiplate analyzer (Roche
Diagnostics GmbH, Vienna, Austria) with CABG planned the next working day
after platelet reactivity normalization (pre-defined as >=46 aggregation
units). Result(s): Within the first 24 h of CABG, the median chest
tube drainage was 350 ml (interquartile range [IQR]: 250 to 475 ml) and
350 ml (IQR: 255 to 500 ml) in the intervention and control groups,
respectively (p for noninferiority <0.001). The median waiting period
between the decision to undergo CABG and the procedure was 112 h (IQR: 66
to 142 h) and 136 h (IQR: 112 to 161 h) (p < 0.001), respectively. In the
intention-to-treat analysis, a 6.4% decrease in the median in-hospital
expenses was observed in the intervention group (p = 0.014), with 11.2%
decrease in the analysis per protocol (p = 0.003). Conclusion(s): A
strategy based on platelet reactivity-guided is noninferior to the
standard of care in patients with ACS awaiting CABG regarding
peri-operative bleeding, significantly shortens the waiting time to CABG,
and decreases hospital expenses. (Evaluation of Platelet Aggregability in
the Release of CABG in Patients With ACS With DAPT;
NCT02516267) Copyright © 2021 American College of Cardiology
Foundation

<34>
Accession Number
2010778812
Title
Comparison of alternate preparative techniques on wall thickness in
coronary artery bypass grafts: The HArVeST randomized controlled trial.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Angelini G.D.; Johnson T.; Culliford L.; Murphy G.; Ashton K.; Harris T.;
Edwards J.; Clayton G.; Kim Y.; Newby A.C.; Reeves B.C.; Rogers C.A.
Institution
(Angelini, Johnson, Newby) Bristol Heart Institute, University of Bristol,
Bristol, United Kingdom
(Culliford, Ashton, Harris, Reeves, Rogers) Clinical Trials and Evaluation
Unit, Bristol Trials Centre, University of Bristol, Bristol, United
Kingdom
(Murphy) MRC Integrative Epidemiology Unit, University of Bristol,
Bristol, United Kingdom
(Edwards) Department of Cardiovascular Sciences, University of Leicester,
Leicester, United Kingdom
(Clayton) School of Health and Related Research, University of Sheffield,
Sheffield, United Kingdom
(Kim) Yongin Severance Hospital, Yonsei University College of Medicine,
Seoul, South Korea
Publisher
Blackwell Publishing Inc.
Abstract
Background: The success of coronary artery bypass grafting surgery (CABG)
is dependent on long-term graft patency, which is negatively related to
early wall thickening. Avoiding high-pressure distension testing for leaks
and preserving the surrounding pedicle of fat and adventitia during vein
harvesting may reduce wall thickening. Method(s): A single-centre,
factorial randomized controlled trial was carried out to compare the
impact of testing for leaks under high versus low pressure and harvesting
the vein with versus without the pedicle in patients undergoing CABG. The
primary outcomes were graft wall thickness, as indicator of medial-intimal
hyperplasia, and lumen diameter assessed using intravascular ultrasound
after 12 months. Result(s): Ninety-six eligible participants were
recruited. With conventional harvest, low-pressure testing tended to yield
a thinner vessel wall compared with high-pressure (mean difference [MD;
low minus high] -0.059 mm, 95% confidence interval (CI) -0.12, +0.0039, p
=.066). With high pressure testing, veins harvested with the pedicle fat
tended to have a thinner vessel wall than those harvested conventionally
(MD [pedicle minus conventional] -0.057 mm, 95% CI: -0.12, +0.0037, p
=.066, test for interaction p =.07). Lumen diameter was similar across
groups (harvest comparison p =.81; pressure comparison p =.24).
Low-pressure testing was associated with fewer hospital admissions in the
12 months following surgery (p =.0008). Harvesting the vein with the
pedicle fat was associated with more complications during the index
admission (p =.0041). Conclusion(s): Conventional saphenous vein
graft preparation with low-pressure distension and harvesting the vein
with a surrounding pedicle yielded similar graft wall thickness after 12
months, but low pressure was associated with fewer adverse
events. Copyright © 2021 The Authors. Journal of Cardiac Surgery
Published by Wiley Periodicals LLC

<35>
Accession Number
2010778684
Title
Impact of chronic obstructive pulmonary disease on 10-year mortality after
percutaneous coronary intervention and bypass surgery for complex coronary
artery disease: insights from the SYNTAX Extended Survival study.
Source
Clinical Research in Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Wang R.; Tomaniak M.; Takahashi K.; Gao C.; Kawashima H.; Hara H.; Ono M.;
van Klaveren D.; van Geuns R.-J.; Morice M.-C.; Davierwala P.M.; Mack
M.J.; Witkowski A.; Curzen N.; Berti S.; Burzotta F.; James S.; Kappetein
A.P.; Head S.J.; Thuijs D.J.F.M.; Mohr F.W.; Holmes D.R.; Tao L.; Onuma
Y.; Serruys P.W.
Institution
(Wang, Gao, Tao) Department of Cardiology, Xijing Hospital, Xi'an, China
(Wang, Gao, Kawashima, Hara, Ono, Onuma, Serruys) Department of
Cardiology, National University of Ireland, Galway (NUIG), P.O. University
Road, Galway H91 TK33, Ireland
(Wang, Gao, van Geuns) Department of Cardiology, Radboud University
Medical Center, Nijmegen, Netherlands
(Tomaniak) First Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
(Tomaniak) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Takahashi, Kawashima, Hara, Ono) Department of Cardiology, Amsterdam
Universities Medical Centers, Location Academic Medical Center, University
of Amsterdam, Amsterdam, Netherlands
(van Klaveren) Department of Public Health, Erasmus University Medical
Center, Rotterdam, Netherlands
(van Klaveren) Predictive Analytics and Comparative Effectiveness Center,
Institute for Clinical Research and Health Policy Studies, Tufts Medical
Center, Boston, United States
(Morice) ICPS Ramsay-Generale de Sante, Massy, France
(Davierwala, Mohr) Department of Cardiac Surgery, Heart Centre Leipzig,
Leipzig, Germany
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Witkowski) Department of Interventional Cardiology and Angiology,
National Institute of Cardiology, Warsaw, Poland
(Curzen) Cardiology Department, University Hospital Southampton,
Southampton, United Kingdom
(Berti) Cardiology Department, Heart Hospital-Fondazione C.N.R. Reg.
Toscana G. Monasterio, Massa, Italy
(Burzotta) Institute of Cardiology, Fondazione Policlinico Universitario
Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy
(James) Department of Medical Sciences and Uppsala Clinical Research
Center, Uppsala University, Uppsala, Sweden
(Kappetein, Head, Thuijs) Department of Cardiothoracic Surgery, Erasmus
University Medical Centre, Rotterdam, Netherlands
(Holmes) Mayo Clinic, Rochester, MN, United States
(Serruys) NHLI, Imperial College London, London, United Kingdom
(Serruys) Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aims: To evaluate the impact of chronic obstructive pulmonary disease
(COPD) on 10-year all-cause death and the treatment effect of CABG versus
PCI on 10-year all-cause death in patients with three-vessel disease (3VD)
and/or left main coronary artery disease (LMCAD) and COPD. Method(s):
Patients were stratified according to COPD status and compared with regard
to clinical outcomes. Ten-year all-cause death was examined according to
the presence of COPD and the revascularization strategy. Result(s):
COPD status was available for all randomized 1800 patients, of whom, 154
had COPD (8.6%) at the time of randomization. Regardless of the
revascularization strategy, patients with COPD had a higher risk of
10-year all-cause death, compared with those without COPD (43.1% vs.
24.9%; hazard ratio [HR]: 2.03; 95% confidence interval [CI]: 1.56-2.64; p
< 0.001). Among patients with COPD, CABG appeared to have a slightly lower
risk of 10-year all-cause death compared with PCI (42.3% vs. 43.9%; HR:
0.96; 95% CI: 0.59-1.56, p = 0.858), whereas among those without COPD,
CABG had a significantly lower risk of 10-year all-cause death (22.7% vs.
27.1%; HR: 0.81; 95% CI: 0.67-0.99, p = 0.041). There was no significant
differential treatment effect of CABG versus PCI on 10-year all-cause
death between patients with and without COPD (p<inf>interaction</inf> =
0.544). Conclusion(s): COPD was associated with a higher risk of
10-year all-cause death after revascularization for complex coronary
artery disease. The presence of COPD did not significantly modify the
beneficial effect of CABG versus PCI on 10-year all-cause death. Trial
registration: SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX
Extended Survival: ClinicalTrials.gov reference: NCT03417050 Graphic
abstract: [Figure not available: see fulltext.] Copyright © 2021,
The Author(s).

<36>
Accession Number
2010744076
Title
Pathway for enhanced recovery after spinal surgery-a systematic review of
evidence for use of individual components.
Source
BMC Anesthesiology. 21 (1) (no pagination), 2021. Article Number: 74. Date
of Publication: December 2021.
Author
Licina A.; Silvers A.; Laughlin H.; Russell J.; Wan C.
Institution
(Licina) Austin Health, 145 Studley Road, Heidelberg, VIC 3084, Australia
(Silvers) Monash Health, Clayton, Australia, Faculty of Medicine, Nursing
and Health Science, Monash University, Melbourne, VIC, Australia
(Laughlin, Wan) Royal Hobart Hospital, Hobart, TAS, Australia
(Russell) Department of Neurosurgery, Austin Health, Melbourne, VIC,
Australia
(Wan) St Vincent's Hospital, Melbourne, Australia
Publisher
BioMed Central Ltd
Abstract
Background: Enhanced recovery in spinal surgery (ERSS) has shown promising
improvements in clinical and economical outcomes. We have proposed an ERSS
pathway based on available evidence. We aimed to delineate the clinical
efficacy of individual pathway components in ERSS through a systematic
narrative review. Method(s): We included systematic reviews and
meta-analysis, randomized controlled trials, non-randomized controlled
studies, and observational studies in adults and pediatric patients
evaluating any one of the 22 pre-defined components. Our primary outcomes
included all-cause mortality, morbidity outcomes (e.g., pulmonary,
cardiac, renal, surgical complications), patient-reported outcomes and
experiences (e.g., pain, quality of care experience), and health services
outcomes (e.g., length of stay and costs). Following databases (1990
onwards) were searched: MEDLINE, EMBASE, and Cochrane Library (Cochrane
Database of Systematic Reviews and CENTRAL). Two authors screened the
citations, full-text articles, and extracted data. A narrative synthesis
was provided. We constructed Evidence Profile (EP) tables for each
component of the pathway, where appropriate information was available. Due
to clinical and methodological heterogeneity, we did not conduct a
meta-analyses. GRADE system was used to classify confidence in cumulative
evidence for each component of the pathway. Result(s): We identified
5423 relevant studies excluding duplicates as relating to the 22
pre-defined components of enhanced recovery in spinal surgery. We included
664 studies in the systematic review. We identified specific evidence
within the context of spinal surgery for 14/22 proposed components.
Evidence was summarized in EP tables where suitable. We performed thematic
synthesis without EP for 6/22 elements. We identified appropriate societal
guidelines for the remainder of the components. Conclusion(s): We
identified the following components with high quality of evidence as per
GRADE system: pre-emptive analgesia, peri-operative blood conservation
(antifibrinolytic use), surgical site preparation and antibiotic
prophylaxis. There was moderate level of evidence for implementation of
prehabilitation, minimally invasive surgery, multimodal perioperative
analgesia, intravenous lignocaine and ketamine use as well as early
mobilization. This review allows for the first formalized evidence-based
unified protocol in the field of ERSS. Further studies validating the
multimodal ERSS framework are essential to guide the future evolution of
care in patients undergoing spinal surgery. Copyright © 2021, The
Author(s).

<37>
Accession Number
2010304876
Title
Guidelines for enhanced recovery after cardiac surgery. Consensus document
of Spanish Societies of Anesthesia (SEDAR), Cardiovascular Surgery (SECCE)
and Perfusionists (AEP).
Source
Cirugia Cardiovascular. 28 (Supplement 1) (pp 1-40), 2021. Date of
Publication: March 2021.
Author
Margarit J.A.; Pajares M.A.; Garcia-Camacho C.; Castano-Ruiz M.; Gomez M.;
Garcia-Suarez J.; Soto-Viudez M.J.; Lopez-Menendez J.; Martin-Gutierrez
E.; Blanco-Morillo J.; Mateo E.; Hernandez-Acuna C.; Vives M.; Llorens R.;
Fernandez-Cruz J.; Acosta J.; Pradas-Irun C.; Garcia M.; Aguilar-Blanco
E.M.; Castano B.; Lopez S.; Bel A.; Gabaldon T.; Fernandez-Lopez A.R.;
Gutierrez-Carretero E.; Lopez-Forte C.; Moreno J.; Galan J.; Osseyran F.;
Bustamante-Munguira J.; Veiras S.; Vicente R.
Institution
(Margarit, Soto-Viudez, Hernandez-Acuna) Servicio de Cirugia Cardiaca,
Hospital Universitari de la Ribera, Valencia, Spain
(Pajares, Lopez-Forte, Osseyran, Vicente) Servicio de Anestesiologia,
Reanimacion y Terapeutica del Dolor, Hospital Universitari i Politecnic La
Fe, Valencia, Spain
(Garcia-Camacho) Unidad de Perfusion del Servicio de Cirugia Cardiaca,
Hospital Universitario Puerta del Mar, Cadiz, Spain
(Castano-Ruiz, Martin-Gutierrez) Servicio de Cirugia Cardiaca, Complejo
Asistencial Universitario de Leon, Leon, Spain
(Gomez, Fernandez-Cruz) Servicio de Anestesiologia, Reanimacion y
Terapeutica del Dolor, Hospital Universitari de la Ribera, Valencia, Spain
(Garcia-Suarez) Servicio de Anestesiologia, Reanimacion y Terapeutica del
Dolor, Hospital Universitario Puerta de Hierro, Madrid, Spain
(Lopez-Menendez) Servicio de Cirugia Cardiaca, Hospital Ramon y Cajal,
Madrid, Spain
(Blanco-Morillo) Unidad de Perfusion del Servicio de Cirugia
Cardiovascular, Hospital Clinico Universitario Virgen de la Arrixaca,
Murcia, Spain
(Mateo, Lopez, Gabaldon, Moreno) Servicio Anestesiologia, Reanimacion y
Terapeutica del Dolor, Hospital General Universitario de Valencia,
Valencia, Spain
(Vives) Servicio Anestesiologia, Reanimacion y Terapeutica del Dolor,
Hospital Universitari Dr. Josep Trueta, Girona, Spain
(Llorens) Servicio de Cirugia Cardiovascular, Hospiten Rambla, Santa Cruz
de Tenerife, Spain
(Acosta) Servicio Anestesiologia, Reanimacion y Terapeutica del Dolor,
Hospital Universitario Virgen del Rocio, Sevilla, Spain
(Pradas-Irun) Servicio de Cirugia Cardiaca, Hospital Universitari Dr.
Josep Trueta, Girona, Spain
(Garcia, Galan) Servicio de Anestesiologia, Reanimacion y Terapeutica del
Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(Aguilar-Blanco) Servicio de Cirugia Cardiaca, Hospital Universitario 12
de Octubre, Madrid, Spain
(Castano) Servicio de Anestesiologia, Reanimacion y Terapeutica del Dolor,
Complejo Hospitalario de Toledo, Toledo, Spain
(Bel) Servicio de Cirugia Cardiaca, Hospital Universitari i Politecnic La
Fe, Valencia, Spain
(Fernandez-Lopez) Servicio Anestesiologia, Reanimacion y Terapeutica del
Dolor, Hospital Universitario Virgen Macarena, Sevilla, Spain
(Gutierrez-Carretero) Servicio de Cirugia Cardiaca, Hospital Universitario
Virgen del Rocio, Sevilla, Spain
(Bustamante-Munguira) Servicio de Cirugia Cardiaca, Hospital Clinico
Universitario de Valladolid, Valladolid, Spain
(Veiras) Servicio Anestesiologia, Reanimacion y Terapeutica del Dolor,
Hospital Clinico Universitario de Santiago, Santiago de Compostela, Spain
Publisher
Elsevier Doyma
Abstract
The ERAS guidelines are intended to identify, disseminate and promote the
implementation of the best, scientific evidence-based actions to decrease
variability in clinical practice. The implementation of these practices in
the global clinical process will promote better outcomes and the
shortening of hospital and critical care unit stays, thereby resulting in
a reduction in costs and in greater efficiency. After completing a
systematic review at each of the points of the perioperative process in
cardiac surgery, recommendations have been developed based on the best
scientific evidence currently available with the consensus of the
scientific societies involved. Copyright © 2020 Sociedad Espanola
de Cirugia Cardiovascular y Endovascular

<38>
Accession Number
2010767217
Title
Optimal Frequency for Changing Single-Use Enteral Delivery Sets in Infants
after Congenital Heart Surgery: A Randomized Controlled Trial.
Source
Journal of the American College of Nutrition. (no pagination), 2020. Date
of Publication: 2020.
Author
Zhang L.; Shi H.; Li J.; Du N.; Chen X.; Wang J.; Gao X.; Si W.; Cui Y.
Institution
(Zhang, Du, Chen, Cui) Cardiac Intensive Care Unit, the Heart Center,
Guangzhou Women and Children Medical Center, Guangzhou Medical University,
Guangzhou, China
(Shi, Li, Si) Institute of Pediatrics, Guangzhou Women and Children
Medical Center, Guangzhou Medical University, Guangzhou, China
(Wang, Gao) Microbiology Laboratory, Guangzhou Women and Children Medical
Center, Guangzhou Medical University, Guangzhou, China
Publisher
Routledge
Abstract
Objective We aimed to assess the optimal frequency for changing single-use
enteral delivery sets during postoperative enteral feeding in infants with
congenital heart disease (CHD). Methods We enrolled 120 CHD infants who
were fed using an enteral nutrition pump directly connected to a milk
bottle with a single-use enteral delivery set in a four-arm randomized
controlled trial (ChiCTR2000039544). Patients were randomized into four
groups based on the replacement frequency of the enteral delivery set (6
h, 12 h, 18 h, and 24 h groups). The primary outcome was the percentage of
contaminated enteral delivery sets (overgrowth of microbiota and
colonization of pathogenic bacteria). Secondary outcomes included evidence
of infection, gastrointestinal tolerance, intestinal microflora dysbiosis,
and healthcare costs. Results The percentages of microbial overgrowth
detected in the 6 h, 12 h, 18 h, and 24 h groups were 6.7%, 30.0%, 46.7%,
and 80%, respectively (P < 0.001). Significant differences were observed
between the 6 h and 18 h groups (P < 0.001), the 6 h and 24 h groups (P <
0.001), and the 18 h and 24 h groups (P = 0.007). Meanwhile, pathogenic
bacterial colonization was detected in 0, 4, 6, and 11 delivery sets in
the 6 h, 12 h, 18 h, and 24 h groups, respectively (P = 0.002). No
difference in clinical symptoms was found among the four groups. The total
cost per patient in the 12 h group and the 18 h group was 340.2 RMB and
226.8 RMB, respectively. Conclusion Taking into consideration both
microbial overgrowth and cost-effectiveness, the results of this study
indicate that for children receiving continuous enteral feeding following
CHD surgery, the optimal frequency for changing the single-use enteral
delivery set when formula reconstituted from powder is used is 18
hours. Copyright © 2020 American College of Nutrition.

<39>
Accession Number
634365801
Title
Incentive spirometry for preventing pulmonary complications after coronary
artery bypass graft.
Source
Cochrane Database of Systematic Reviews. 2012 (9) (no pagination), 2012.
Article Number: CD004466. Date of Publication: 12 Sep 2012.
Author
Freitas E.R.F.S.; Soares B.G.O.; Cardoso J.R.; Atallah A.N.
Institution
(Freitas) UNOPAR / Centro Cochrane do Brasil, Physical Therapy Department,
Rua Belo Horizonte, 540 - apto 11, Londrina, Parana 86 020 060, Brazil
(Soares, Atallah) Universidade Federal de Sao Paulo, Brazilian Cochrane
Centre, Rua Pedro de Toledo 598, Sao Paulo, Sao Paulo 04039-001, Brazil
(Cardoso) Universidade Estadual de Londrina, Research Group, Laboratory of
Biomechanics and Clinical Epidemiology, Av. Robert Koch 60, Londrina, PR
86038-350, Brazil
Publisher
John Wiley and Sons Ltd
Abstract
Background: Incentive spirometry (IS) is a treatment technique that uses a
mechanical device to reduce pulmonary complications during postoperative
care. This is an update of a Cochrane review first published in 2007.
 Objective(s): Update the previously published systematic review to
compare the effects of IS for preventing postoperative pulmonary
complications in adults undergoing coronary artery bypass graft (CABG).
 Search Method(s): We searched CENTRAL and DARE on The Cochrane
Library (Issue 2 of 4 2011), MEDLINE OVID (1948 to May 2011), EMBASE (1980
to Week 20 2011), LILACS (1982 to July 2011), the Physiotherapy Evidence
Database (PEDro) (1980 to July 2011), Allied & Complementary Medicine
(AMED) (1985 to May 2011), CINAHL (1982 to May 2011). Selection
Criteria: Randomised controlled trials comparing IS with any type of
prophylactic physiotherapy for prevention of postoperative pulmonary
complications in adults undergoing CABG. Data Collection and
Analysis: Two reviewers independently evaluated trial quality using the
guidelines of the Cochrane Handbook for Systematic Reviews and extracted
data from included trials. For continuous outcomes, we used the generic
inverse variance method for meta-analysis and for dichotomous data we used
the Peto Odds Ratio. Main Result(s): This update included 592
participants from seven studies (two new and one that had been excluded in
the previous review in 2007. There was no evidence of a difference between
groups in the incidence of any pulmonary complications and functional
capacity between treatment with IS and treatment with physical therapy,
positive pressure breathing techniques (including continuous positive
airway pressure (CPAP), bilevel positive airway pressure (BiPAP) and
intermittent positive pressure breathing (IPPB), active cycle of breathing
techniques (ACBT) or preoperative patient education. Patients treated with
IS had worse pulmonary function and arterial oxygenation compared with
positive pressure breathing. Based on these studies there was no
improvement in the muscle strength between groups who received IS
demonstrated by maximal inspiratory pressure and maximal expiratory
pressure. Authors' conclusions: Our update review suggests there is no
evidence of benefit from IS in reducing pulmonary complications and in
decreasing the negative effects on pulmonary function in patients
undergoing CABG. In view of the modest number of patients studied,
methodological shortcomings and poor reporting of the included trials,
these results should still be interpreted cautiously. An appropriately
powered trial of high methodological rigour is needed to determine if
there are patients who may derive benefit from IS following
CABG. Copyright © 2012 The Cochrane Collaboration. Published by
John Wiley & Sons, Ltd.

<40>
Accession Number
634550726
Title
Colchicine efficacy and safety for the treatment of cardiovascular
diseases.
Source
Internal and emergency medicine. (no pagination), 2021. Date of
Publication: 11 Mar 2021.
Author
Andreis A.; Imazio M.; Casula M.; Avondo S.; De Ferrari G.M.
Institution
(Andreis, Imazio, Casula, Avondo, De Ferrari) Departement of Medical
Sciences, University Cardiology, A.O.U. Citta della Salute e della Scienza
di TorinoCorso Bramante 88, Turin 10126, Italy
Publisher
NLM (Medline)
Abstract
The emerging role of colchicine in the treatment of cardiovascular
diseases is a strong demand for a comprehensive understanding of its
efficacy and safety. This meta-analysis and systematic review aimed to
study the efficacy in the reduction of adverse cardiovascular outcomes
(CO), and the risk of colchicine-related adverse events (CRAEs). Fourteen
thousand and nine eighty three patients from 22 randomized controlled
trials (RCTs) were included, 9 in patients with coronary artery
disease-CAD, 9 in patients with pericarditis, 4 in patients with atrial
fibrillation-AF or heart failure. Colchicine was efficacious in the
reduction of adverse CO across different settings: pericardial diseases
(reduced risk of recurrent pericarditis, 17.6% vs. 35%, RR 0.50, 95% CI
0.41-0.61), CAD (reduced risk of cardiac death, myocardial infarction,
stroke,coronary revascularization or hospitalization, 6.1% vs. 8.5%, RR
0.73, 95% CI 0.64-0.83), AF (reduced risk of arrhythmia recurrence, 14.2%
vs. 22.7%, RR 0.62, 95% CI 0.44-0.88). Colchicine was associated with
increased risk of gastrointestinal CRAEs (11.2% vs. 8.8%, RR 1.87, 95% CI
1.41-2.47) and drug discontinuation (5.4% vs. 3.7%, RR 1.58, 95% CI
1.25-1.99). In both cases, the risk was proportional to the daily dose or
duration of treatment, possibly due to early drug discontinuation or
tolerance. Other CRAEs (muscle-related, liver,hematologic,cutaneous,
infections) were not increased by colchicine, as long as all-cause death
(2.2% vs. 1.9%, RR 1.11, 95% CI 0.79-1.54) or non-cardiovascular death
(1.5% vs. 1%, RR 1.43, 95% CI 0.93-2.19). Colchicine is efficacious and
safe for the treatment of cardiovascular diseases. The risk of
gastrointestinal CRAEs and drug discontinuation is not significant if
colchicine is used at lower doses (0.5 mg daily) or for longer periods of
time (>6 months).

<41>
Accession Number
634548322
Title
Atrial Fibrillation and Outcomes After Transcatheter or Surgical Aortic
Valve Replacement (From the PARTNER 3 Trial).
Source
The American journal of cardiology. (no pagination), 2021. Date of
Publication: 07 Mar 2021.
Author
Shahim B.; Malaisrie S.C.; George I.; Thourani V.H.; Biviano A.B.; Russo
M.J.; Brown D.L.; Babaliaros V.; Guyton R.A.; Kodali S.K.; Nazif T.M.;
McCabe J.M.; Williams M.R.; Genereux P.; Lu M.; Yu X.; Alu M.C.; Webb
J.G.; Mack M.J.; Leon M.B.; Kosmidou I.
Institution
(Shahim) Cardiovascular Research Foundation, NY, NY
(Malaisrie) Division of Cardiac Surgery, Northwestern University, Chicago,
Mexico
(George, Biviano, Kodali, Nazif) NewYork-Presbyterian Hospital/Columbia
University Irving Medical Center, NY, NY
(Thourani) Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta,
United States
(Russo) Division of Cardiac Surgery, Rutgers-Robert Wood Johnson Medical
School, NB
(Brown, Mack) Baylor Scott & White Health, TX, Plano, United States
(Babaliaros, Guyton) Emory University Medical Center, Atlanta, United
States
(McCabe) University of Washington, Seattle, WA
(Williams) NYU Langone, NY, NY
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, United States
(Lu, Yu) Edwards Lifesciences, Irvine, CA
(Alu, Leon, Kosmidou) Cardiovascular Research Foundation, New York, NY;
NewYork-Presbyterian Hospital/Columbia University Irving Medical Center,
New York, NY
(Webb) St. Paul's Hospital, Vancouver, Canada
Publisher
NLM (Medline)
Abstract
The prognostic impact of preexisting atrial fibrillation or flutter (AF)
in low-risk patients with severe aortic stenosis (AS) treated with
transcatheter (TAVR) or surgical aortic valve replacement (SAVR) remains
unknown. In this sub-analysis of the PARTNER 3 trial of patients with
severe aortic stenosis at low surgical risk randomized 1:1 to TAVR versus
SAVR, clinical outcomes were analyzed at 2 years according to AF status.
Among 948 patients included in the analysis [452 (47.7%) in the SAVR vs
496 (52.3%) in the TAVR arm], 168 (17.6%) patients had AF [88/452 (19.5%)
and 80/496 (16.1%) treated with SAVR and TAVR, respectively]. At 2 years,
patients with AF had higher unadjusted rates of the composite outcome of
death, stroke or rehospitalization (21.2% vs 12.9%, p=0.007) and
rehospitalization alone (15.3% vs 9.4%, p=0.03) but not all-cause death
(3.8 vs 2.6%, p=0.45) or stroke (4.8% vs 2.6%, p=0.12). In adjusted
analyses, patients with AF had a higher risk for the composite outcome of
death, stroke or rehospitalization (hazard ratio [HR] 1.80, 95% confidence
interval [CI] 1.20-2.71, p=0.0046) and rehospitalization alone (HR 1.8,
95% CI 0.12-2.9, p=0.015), but not death or stroke. There was no
interaction between treatment modality and AF on the composite outcome
(Pinter=0.83). In conclusion, preexisting AF in patients with severe AS at
low surgical risk was associated with increased risk of the composite
outcome of death, stroke or rehospitalization at 2 years, irrespective of
treatment modality. Copyright © 2021. Published by Elsevier Inc.

<42>
Accession Number
634547618
Title
Effect of a Smartphone-Based Intervention on Secondary Prevention
Medication Prescriptions After Coronary Artery Bypass Graft Surgery: The
MISSION-1 Randomized Controlled Trial.
Source
American heart journal. (no pagination), 2021. Date of Publication: 06 Mar
2021.
Author
Qu J.; Du J.; Rao C.; Chen S.; Gu D.; Li J.; Zhang H.; Zhao Y.; Hu S.;
Zheng Z.
Institution
(Qu, Rao, Gu, Zhang, Hu, Zheng) National Clinical Research Center for
Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease,
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China; Department of Cardiovascular Surgery, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Du) National Clinical Research Center for Cardiovascular Diseases, State
Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing, China; Department of Cardiovascular
Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China; Department of Cardiothoracic Surgery, Shenzhen Children's
Hospital, Shenzhen, China
(Chen) National Clinical Research Center for Cardiovascular Diseases,
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China; Information Center,
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
(Li, Zhao) National Clinical Research Center for Cardiovascular Diseases,
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Studies found that patients who underwent coronary artery
bypass grafting (CABG) often fail to receive optimal evidence-based
secondary prevention medications. We evaluated the effectiveness of a
smartphone-based quality improvement effort on improving prescription of
medical therapies. METHOD(S): In this cluster-randomized controlled
trial, 60 hospitals were randomized to a control arm (n=30) or to an
intervention arm using smartphone-based multifaceted quality improvement
interventions (n=30). The primary outcome was prescription of statin. The
secondary outcomes were prescription of beta-blocker,
angiotensin-converting enzyme inhibitor or angiotensin receptor blocker
(ACE inhibitor or ARB), and optimal medical therapy for eligible patients.
 RESULT(S): Between June 1, 2015 and September 15, 2016, a total of
10006 CABG patients were enrolled (5653 in 26 intervention and 4353 in 29
control hospitals, five hospitals withdrew). Statin prescribing rate was
87.8% in the intervention arm and 84.4% in the control arm. We saw no
evidence of an effect of intervention on statin prescribing in the
intention-to-treat analysis (odds ratio, 1.31; 95% confidence interval,
0.68 to 2.54; P=0.43) or in key patient subsets. The prescription rates of
ACE inhibitor or ARB and optimal medical therapy were comparable between
study groups, while beta-blocker was more often prescribed in the
intervention arm. Post hoc analysis demonstrated a greater increase in
statin prescribing rate over time in the intervention arm.
 CONCLUSION(S): A smartphone-based quality improvement intervention
compared with usual care did not increase statin prescribing for patients
who received CABG. New studies focusing on the best practice of this
technique may be warranted. CLINICAL TRIAL REGISTRATION:
https://www.clinicaltrials.gov (NCT02430012). Copyright © 2021.
Published by Elsevier Inc.

<43>
Accession Number
600294691
Title
Everolimus-eluting stent for the treatment of bare metal in-stent
restenosis: Clinical and angiographic outcomes at nine-month follow-up of
XERES (Xience Evaluation in bare metal stent REStenosis) trial.
Source
EuroIntervention. 10 (6) (no pagination), 2014. Date of Publication: 01
Oct 2014.
Author
Carrie D.; Delarche N.; Piot C.; Berland J.; Menneveau N.; Bonello L.; Py
A.; Teiger E.; Leborgne L.; Bayet G.; Wittenberg O.; Schiele F.
Institution
(Carrie) Cardiology B, Cardiovascular and Metabolic Pole, Rangueil
Hospital, Toulouse, France
(Delarche) Cardiology Department, Hospital Centre, Pau, France
(Piot) Cardiology Department, Arnaud de Villeneuve Hospital, Montpellier,
France
(Berland) Cardiology Department, St. Hilaire Clinic, Rouen, France
(Menneveau, Schiele) Cardiology Department, Jean Minjoz Hospital,
Besancon, France
(Bonello) Cardiology Department, North Hospital, Marseille, France
(Py) Cardiology Department, Alexandre Dumas Medical Centre, Amiens, France
(Teiger) Cardiology Department, Henri Mondor Hospital, Creteil, France
(Leborgne) Cardiology Department, North Hospital, Amiens, France
(Bayet) Cardiology Department, Rhone Durance Clinic, Avignon, France
(Wittenberg) Cardiology Department, Beauregard Polyclinic, Marseille,
France
Publisher
Europa Group
Abstract
Aims: Restenosis is a frequent complication of coronary stent
implantation, especially bare metal stent (BMS) implantation. The
everolimus-eluting stent (EES) has previously been shown to be efficacious
in the treatment of de novo lesions. We performed this study to evaluate
clinical, angiographic and IVUS results after EES implantation for the
treatment of BMS ISR.
Methods and results: XERES was a prospective, multicentre, nationwide
study, enrolling 97 consecutive patients with in-stent restenosis (ISR)
after BMS implantation across 20 centres in France. Suitable lesions had a
reference vessel diameter between 2.5 mm and 4 mm, a length <=22 mm and a
diameter stenosis between 50 and 100-. The primary endpoint was
angiographic in-stent late loss (LL) as determined by quantitative
coronary angiography (QCA) at nine-month follow-up. QCA was required to be
performed in each included patient and IVUS was performed in a subgroup of
27 patients. At nine-month follow-up, the in-stent late loss was
0.35+/-0.63 mm. The rate of in-stent binary restenosis was 12.22-,
including two complete occlusions. The average volume of neointimal
hyperplasia was 15.6+/-9.9 mm3. The in-stent percent volume obstruction
was 8.5+/-5.2-. The in-segment percent area and diameter obstruction were
32+/-17- and 27+/-11-, respectively. Two initial malappositions were
persistent and two other patients had late acquired stent malapposition.
The cumulative incidence of major adverse cardiac events (MACE) was 10.1-.
Conclusions: EES for the treatment of bare metal in-stent restenosis
seemed safe and efficacious.

<44>
Accession Number
365787657
Title
Prasugrel versus clopidogrel for acute coronary syndromes without
revascularization.
Source
New England Journal of Medicine. 367 (14) (pp 1297-1309), 2012. Date of
Publication: 04 Oct 2012.
Author
Roe M.T.; Armstrong P.W.; Fox K.A.A.; White H.D.; Prabhakaran D.; Goodman
S.G.; Cornel J.H.; Bhatt D.L.; Clemmensen P.; Martinez F.; Ardissino D.;
Nicolau J.C.; Boden W.E.; Gurbel P.A.; Ruzyllo W.; Dalby A.J.; McGuire
D.K.; Leiva-Pons J.L.; Parkhomenko A.; Gottlieb S.; Topacio G.O.; Hamm C.;
Pavlides G.; Goudev A.R.; Oto A.; Tseng C.D.; Merkely B.; Gasparovic V.;
Corbalan R.; McLendon R.C.; Winters K.J.; Brown E.B.; Lokhnygina Y.;
Aylward P.E.; Huber K.; Hochman J.S.; Ohman E.; Bassand J.P.; Castillo
V.R.; Chua T.; Cinteza M.; Erlinge D.; Foley D.P.; Fridrich V.; Ge J.;
Goodman S.; Goudev A.; Gratsiansky N.; Hamm C.W.; Jeong M.H.; Jun-Ren Z.;
Lopez-Sendon J.; Luscher T.; Mogrovejo W.E.; Nicolau J.; Petrauskiene B.;
Roe M.; Sritara P.; Syvanne M.; Topacio G.; Verheugt F.; Widimsky P.;
Wiviott S.D.; Zambahari R.; Van de Werf F.; Budaj A.; Gersh B.J.;
Montalescot G.; Pocock S.J.; Wilcox R.G.; Williams D.O.; Wilson M.; Mehta
R.H.; Alexander J.H.; Kong D.F.; Lopes R.; Mahaffey K.W.; Melloni C.;
Newby L.; Shah B.R.; Tricoci P.; George D.J.; Beaven A.W.; Blackwell K.L.;
Morse M.A.; Onken J.E.; Ready N.E.; Strickler J.H.; Zafar S.; Hafley G.;
Pieper K.; Stevens S.; Schibler T.; Chan M.; Chin C.T.; Gharacholou S.;
Subherwal S.; McLendon R.; Marshall D.; Macias W.; Lenarz L.; Petijean H.;
Plat F.; van Kranen R.; Zamoryakhin D.; Albisu J.; Alvarez C.;
Amuchastegui M.; Astesiano A.L.; Beloscar J.; Bergallo J.; Bono J.;
Bordonava A.; Botta C.E.; Budassi N.; Caccavo A.; Cartasegna L.; Colombo
H.; Costello R.; Covelli G.; De Valais F.; Dran R.; Duronto E.; Forte
E.H.; Garcia D.F.; Garcia Escudero A.; Hominal M.; Hrabar A.D.; Ibanez
J.O.; Jure H.; Leon de la Fuente R.; Lobo Marquez L.; Luciardi H.; Luquez
H.; Marino J.; Martingano R.; Moises Azize G.; Nul D.; Patocchi C.; Piombo
A.; Prado A.; Rodriguez M.; Romero Acuna A.; Scaro G.B.; Sosa Liprandi A.;
Varini S.D.; Vigo S.J.; Aroney G.; Arstall M.; Blenkhorn A.; Carroll P.;
Chew D.; Collins N.; Hammett C.; Lee A.; Marrinan M.; Roberts-Thomson P.;
Waites J.; Benzer W.; Lang I.; Podczeck-Schweighofer A.; Baetsle P.;
Beauloye C.; De Tollenaere M.; Lancellotti P.; Marechal P.; Van Dorpe A.;
Albuquerque D.; Andrade Lotufo P.; Ardnt M.; Arminio G.; Alves da Cost
F.A.; Baracioli L.M.; Bertolim Precoma D.; Carvalho Neuenschwander F.;
Damiao Gomes Seabra M.; De Souza J.; Duda N.T.; Dutra O.P.; Feitosa A.;
Filho H.; Finimundi H.C.; Gomes M.; Gubolino L.; Guimaraes A.E.; Hernandes
M.; Jardim C.A.; Kunz Sebba Barroso de Souza W.; Leaes P.E.; Maia L.N.;
Manenti E.; Marin Neto J.A.; Marino R.; Michalaros Y.; Mora Junior R.;
Moraes Junior J.B.; Nogueira Liberato de Sousa L.; Pimentel Filho P.;
Polanczyk C.; Rabelo Alves A.; Ramos R.; Reis G.; Rocha Faria Neto J.;
Rossi Dos Santos F.; Saporito W.; Saraiva J.F.; Sartori P.C.; Scholz Issa
J.; Silva Junior D.; Sousa A.; Teixeira M.; Zimmermann S.L.; Lazov P.;
Tokmakova M.; Penchev K.; Petrov I.; Baldjiev E.; Georgiev P.;
Hergeldjieva V.; Manolova A.; Dimov B.; Mihov A.; Pencheva G.; Raev D.;
Ramshev K.; Tumbev H.; Tzekova M.; Boichev B.; Kadiiski A.; Devedzhiev T.;
Bakbak A.; Berlingieri J.; Burstein J.; Dery J.P.; Heath J.; Huynh T.;
Kassam S.; Kostuk W.; Labonte R.; Maccallum C.; Nawaz S.; Quraishi A.U.;
Senaratne M.; Syan G.; Syan R.; Vizel S.; Castro P.; Florenzano F.; Lamich
R.; Manriquez L.; Potthoff S.; Stockins B.; Bugueno C.; Cobos J.;
Sepulveda P.; Opazo M.; Montecinos H.; Ke Y.; Chen Y.D.; Chen J.; Wang J.;
Li W.; Xu B.; Ma G.; Li Z.; Sun Y.; Tang J.; Yuan Z.; Tang L.; Zhou Y.; He
Q.; Xu J.; Zhang H.; Yang K.; Zhou S.; Zhao S.; Zheng Z.; Li X.; Wang D.;
Hong X.; Guan R.; Wang L.; Huang H.; Xia Y.; Hao Y.; Zhang S.; Zhao X.;
Liu X.; Yan J.; Huang Y.; Wang B.; Vallejo G.S.; Bohorquez R.; Gomez N.I.;
Fernandez R.; Mayorga L.E.; Gomez J.; Quintero A.; Figueredo A.; Senior
J.; Accini J.L.; Roncallo E.; Frischwasser S.; Sanchez M.S.; Bouzid Y.;
Ciglenecki N.; Certic J.F.; Grman J.; Sutalo K.; Bergovec M.; Knezevic A.;
Mirat J.; Padovan M.; Car S.; Samardzic P.; Bagatin J.; Kraus L.; Coufal
Z.; Janota T.; Kettner J.; Linhart A.; Hondl M.; Osmancik P.; Padour M.;
Telekes P.; Vojacek J.; Vojtisek P.; Francek L.; Sedlon P.; Bronnum-Schou
J.; Hansen P.; Nielsen H.; El-Etreby A.; El Hawary A.; El Rakshy Y.;
Mowafy A.; Ragy H.; Reda A.; Sabri S.; Nyman K.; Laine M.; Bressollette
E.; Rifai A.; Danchin N.; Ovize M.; Cottin Y.; Farah B.; Furber A.; Coste
P.; Elbaz M.; Morel O.; Schiele F.; Elhadad S.; Belhassane A.; El Mansour
N.; Leroy F.; Coisne D.; Ferrari E.; Nguyen-Khac O.; Range G.; Moulin F.;
Poulard J.E.; Sechtem U.; Kaelsch T.; Ebelt H.; Gawaz M.; Genth-Zotz S.;
Moellmann H.; Heuer H.; Kadel C.; Klein H.; Werner G.; Boudriot E.;
Kruells-Muench J.; Baer F.; Alexopoulos D.; Manolis A.; Platogiannis D.;
Anastasiou-Nana M.; Nanas I.; Cokkinos D.; Fotiadis I.; Koliopoulos N.;
Moschos N.; Olympios C.; Ples Z.; Illyes L.; Csikasz J.; Zolyomi S.; Kis
E.; Kovacs Z.; Lupkovics G.; Nagy A.; Regos L.; Tomcsanyi J.; Janosi A.;
Medvegy M.; Szakal I.; Vertes A.; Szalai G.; Banker D.; Dani S.; Kumar S.;
Sarna M.K.; Seerangachar R.K.; Deshpande A.; Khan I.A.; Gupta S.K.;
Dharmadhikari A.; Babu P.; Fulwani M.; Kerkar P.G.; Varma S.; Singh P.;
Babu R.; Menon J.; Sengupta S.; Sathe S.; Premchand R.K.; Kalra R.;
Kalashetti S.; Pai V.; Bose V.; Jain V.; Kale V.; Benjarge P.; Ghaisas N.;
Thanvi S.; Durgaprasad R.; Kulkarni R.L.; Joshi H.; Abyankar A.; Bisne V.;
Chopra V.; Reddy P.; Sarma R.; Garg N.; Agarwal D.K.; Arneja J.;
Bandyopadhyay S.; Bharani A.; Yadav R.; Dutta S.; Chidambaram N.; Dande
A.; Gadkari M.; Grant P.; Khan A.; Gupta R.; Gupta J.B.; Shetty G.; Lavhe
P.V.; Jain R.; Joseph J.; Calambur N.; Joseph S.; Mardikar H.; Mathur A.;
Mohanan P.; Kumbla M.; Nair T.; Nambiar A.; Jathappa N.; Parale G.; Patel
T.; Puri A.; Rao B.; Saligrama R.; Sawhney J.; Sethi S.; Singh B.;
Srinivas A.; Jagadesa B.S.; Foley D.; Mahon N.; Mulvihill N.; Nash P.;
Arad T.; Balkin J.; Francis A.; Hammerman H.; Hasin Y.; Katz A.; Kracoff
O.; Marmor A.; Mosseri M.; Atar S.; Roth A.; Zahger D.; Turgeman Y.; Weiss
A.; De Luca M.; Antonelli G.; Piovaccari G.; Barbiero M.; Cuccia C.; De
Servi S.; Fedele F.; Golino P.; Manari A.; Menozzi A.; Berti S.; Moretti
L.; Musumeci G.; Pajes G.; Paloscia L.; Mos L.; Salvioni A.; Volpe M.; De
Luca G.; Astarita C.; Merlini P.; Di Lorenzo L.; Fattore L.; Ambrosio G.;
Mircoli L.; Galvani M.; Cavallini C.; Nassiacos D.; Scioli R.; Yoon J.;
Kim D.K.; Hur S.H.; Bae J.H.; Rha S.W.; Lee S.R.; Kim K.S.; Ko Y.G.; Jeong
J.O.; Lee S.K.; Hong T.J.; Kim M.; Hwang J.Y.; Shin E.K.; Kim S.W.;
Anusauskiene J.; Dambrauskaite A.; Jarasuniene D.; Raugaliene R.;
Babarskiene M.R.; Ahmad W.A.; Yusof Z.; Maskon O.; Ong T.K.; Abdullah
H.N.; Chandran A.; Chong Y.S.; Lee C.Y.; Ramanathan L.; Sciberras R.;
Xuereb R.G.; Fajardo P.; Ramos-Lopez G.; Alcocer M.A.; Ramirez M.C.;
Ibarra M.O.; Esperon G.L.; Diaz C.S.; Hamer A.; Elliott J.; Harding S.;
Hart H.; Castillo B.G.; Ortega R.N.; Frago G.; Henriquez F.; Acosta D.C.;
Zambrano E.C.; Mogrovejo W.; Chois A.; Gamio C.F.; Barrera M.A.; Cabrera
J.; Dextre L.Z.; Reyes M.; Tellez D.; Castillo R.; Chavez C.; Godoy A.;
Llerena N.; Morales C.A.; Habaluyas R.; Rogelio G.; Ramos E.J.; Chua P.;
Mendoza V.; Tirador L.; Abanilla J.; Edmilao M.I.; Coching R.M.; Morales
D.; Dalkowski M.; Sciborski R.; Lewczuk J.; Hoffmann A.; Lesnik J.;
Andruszkiewicz B.; Wojciechowski D.; Kus W.; Jozwa R.; Kasprzak J.;
Lubinski A.; Karczmarczyk A.; Wojcik J.; Gruchala M.; Bartus S.; Bronisz
M.; Mirek-Bryniarska E.; Dudek D.; Gorny J.; Grzywna R.; Kawka-Urbanek T.;
Niezgoda K.; Olszewski R.; Ogorek M.; Gniot J.; Nessler J.; Ponikowski P.;
Wita K.; Zinka E.; Zmudka K.; Szelemej R.; Moreira J.; Bastos J.M.;
Ferreira J.; Martins D.; Providencia L.; Ribeiro V.G.; Silva G.; Seixo F.;
Morais J.; Rinaldi R.; Rodriguez-Ospina L.; Colon-Hernandez P.; Matei C.;
Tatu-Chitoiu G.P.; Iordachescu-Petica D.; Teodorescu I.; Ochean V.;
Constantinescu M.C.; Stanciulescu G.E.; Bobescu E.; Bolohan F.R.; Coman
I.M.; Creteanu M.; Dan G.A.; Dobre I.; Ionescu P.; Minescu B.; Olinic
D.M.; Pop C.; Stamate S.C.; Gurevich V.; Bichan N.; Baranov E.;
Zateyshchikov D.; Barbarich V.; Gordeev I.; Tereshchenko S.; Dovgalevskiy
Y.; Boyarkin M.; Shogenov Z.; Suprun E.; Shalaev S.; Arutyunov G.;
Supryadkina T.; Perepech N.; Nikolskaya I.; Rossovskaya M.; Khaisheva L.;
Simanenkov V.; Boldueva S.; Zrazhevskiy K.; Barbarash O.; Egorova L.;
Markov V.; Novikova N.; Alexeeva N.; Ermoshkina L.; Ishmurzin G.;
Miloradovic V.; Pavlovic M.; Ilic S.; Krotin M.; Neskovic A.; Otasevic P.;
Vasiljevic-Pokrajcic Z.; Ostojic M.; Chan M.Y.; Goh P.P.; Kokles M.; Bugan
V.; Urban M.; Sirotiakova J.; Belicova M.; Duris T.; Poliacik P.; Slanina
M.; Letcher G.; Abelson M.; Dalby A.; Gould T.; Manga P.; Pillay T.;
Theron H.; Venter T.; van Zyl L.; Essop M.; van der Merwe N.; Alegret
J.M.; Gomez D.L.; Vera T.R.; Bruguera I Cortada J.; Garcia J.H.; Dalli E.;
Paz M.A.; Ridocci F.; Coronado J.L.; Romero C.; Urbano R.H.; Carlsson R.;
Falck G.; Gallino A.; Linka A.; Lai W.T.; Shyu K.G.; Li A.H.; Chiang C.E.;
Hou J.Y.; Kuanprasert S.; Srimahachota S.; Wongvipaporn C.; Laothavorn P.;
Krittayaphong R.; Tangsuntornwiwat S.; Moleerergpoom W.; Kaewsuwanna P.;
Sakulsaengprapha T.; Viboolkitvarakul N.; Buakhamsri A.; Braam R.; Basart
D.C.; Troquay R.P.; Herrman J.P.; van der Heijden D.J.; Broeders M.; Romer
T.; Post J.C.; Viergever E.; Zwart P.; Groutars R.; Breedveld R.; Ronner
E.; Hoedemaker G.; van Kalmthout P.; Kuijper A.; Geertman J.H.; Hamer B.;
Werter C.; Westendorp I.; Kruik H.J.; Zouari S.B.; Boughzala E.; Boujnah
R.; Gamra H.; Haouala H.; Kammoun S.; Ben Khalfallah A.; Maatouk F.; Ural
D.; Kutlu M.; Sahin M.; Ebinc H.; Kucukoglu S.; Demirtas M.; Kirma C.;
Altun A.; Aydinlar A.; Aydogdu S.; Cayli M.; Bozkurt E.; Buyukoner E.E.;
Erdogan D.; Acikel M.; Ozdemir M.; Ozdemir K.; Yazici M.; Goloborodko B.;
Nykonov V.; Vakaliuk I.; Yagensky A.; Vatutin M.; Shcherbak V.; Kovalskyy
I.; Bagriy A.; Ushakov O.; Zhurba S.; Sierkova V.; Bashkirtsev O.;
Vasylenko A.; Karpenko Y.; Kaidashev I.; Amosova K.; Batushkin V.; Faynyk
A.; Horbach L.; Karpenko O.; Koval' O.; Kraiz I.; Potapenko P.; Rudenko
L.; Malynovsky Y.; Tseluyko V.; Volkov V.; Prokhorov O.; Sarkar D.;
Moriarty A.; El-Harari M.; Brigden G.; Qureshi N.; Alamgir F.; de Belder
A.; Keeling P.; Cooke J.; Brown N.; Junejo S.; Vuyyuru R.; Connolly D.;
Kadr H.; Griffiths H.; Tang K.; Cotton J.; Barr C.; Lindsay S.;
Venkataraman A.; Rittoo D.; Jacob A.; Watkin R.; Lang C.; Pye M.; Chambers
J.; Mavromatis K.; Rossi P.; Ahmad A.; Anderson H.; Roberts J.; Klugherz
B.; Haidar A.; Downes T.; Russo D.; Wallace W.; Bhagwat R.; Mathew T.;
Jetty P.; Henderson D.; Dy J.; Isserman S.; Kondle V.; Quintana O.; Brener
S.; Masud Z.; Vijay N.; Jain M.; Longo J.; Safley D.; Pancholy S.;
Shaoulian E.; Allan J.; Bazzi A.; Chahin J.; Shurmur S.; Santos R.;
Goldberg J.; Gigliotti O.; Irimpen A.; Khan M.; Kusnick B.; Treasure C.;
Rogers J.; Zebrack J.; Turner M.; Adjei N.; Ingram C.; Mathis C.; Buchanan
W.; Heins G.; Ahsan C.; Anderson J.; Atassi K.; Bachinsky W.; Baig M.;
Rodriguez A.; Tang A.; Foreman R.; Berlin H.; Bouchard A.; Thew S.;
Borromeo S.; Bowden W.; Boyek T.; Arter J.; Blair J.; Chandna H.; Katz J.;
Conn E.; Connelly T.; Del Core M.; Shanes J.; Dotani I.; Drenning D.;
Bustros N.; Fastabend C.; Flores E.; Goudreau E.; Gredler F.; Greenfield
R.; Guidera S.; Gogia H.; Hearne S.; Hermany P.; Taheri H.; Izzo M.;
Jaffrani N.; Johnson G.; Keedy D.; Waxman F.; Kesselbrenner M.; Floro J.;
Korban E.; Labroo A.; Lui H.; Georgeson S.; Breall J.; Baman R.; Mandak
J.; Marais H.; Lee D.; Meisner J.; Micale P.; Meymandi S.; Vicari R.;
Mouhaffel A.; Moscoso R.; Papademetriou V.; Piegari G.; Promisloff S.;
Rivera E.; Rogers W.; Roth D.; Sadler D.; Canto J.; Schmedtje J.; Shaikh
S.; Shalev Y.; Sharma M.; Rahman A.; Schwartz S.; Sporn D.; Staniloae C.;
Tami L.; Barnum O.; Tu T.; Tuma J.; Wali A.; Welka S.; Wilson V.; Younis
L.; Zakhary B.; Ziperman D.; Singh N.; Kukuy E.; Leimbach W.; Chang M.;
Carter M.; Simpson P.; Miklin J.; Niess G.; Schaefer S.; Lambert C.; Soh
E.; Heintz K.; Miller J.; Chandrashekhar Y.; Pappas J.; Rashid H.U.;
Wright W.; Rees A.; Bach R.; Wu W.; Singhi S.; Quyyumi A.; Lau T.; Nobel
J.; Kamdar A.; Kabour A.; Stys T.; Keller N.; Kumar A.; Danisa K.; Smith
S.; Espinoza A.; Deac D.; Roberts D.; Gumm D.; Saucedo J.; Gimple L.;
Weinstein D.; Blonder R.; Moran M.; Iwaoka R.; Bayron C.; Tejada L.; White
L.; Ingersoll H.; Casterella P.; Chiaramida S.; Harris J.; Rodriguez R.;
Vo A.; Dave K.; Giacomini J.; Kotha P.; Park C.; Arif I.; McGrew F.; Atieh
M.; Huang X.; Zarrella G.; McGarvey J.; Koganti D.; Albirini A.; Kozman
H.; Slepian M.; Quion J.A.; Ramanathan K.; Bessen M.; Rafael A.; Aycock G.
Institution
(Roe, McLendon, Lokhnygina, Ohman) Duke Clinical Research Institute, Duke
University Medical Center, 2400 Pratt St, Durham, NC 27705, United States
(Roe, Ohman) Division of Cardiology, Department of Medicine, Duke
University Medical Center, Durham, NC, United States
(Armstrong) Division of Cardiology, University of Alberta, Edmonton, AB,
Canada
(Goodman) Division of Cardiology, St. Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Fox) Centre for Cardiovascular Science, University of Edinburgh,
Edinburgh, United Kingdom
(White) Auckland City Hospital, Green Lane Cardiovascular Service,
Auckland, New Zealand
(Prabhakaran) Center for Chronic Disease Control, New Delhi, India
(Cornel) Department of Cardiology, Medical Center Alkmaar, Alkmaar,
Netherlands
(Bhatt) VA Boston Healthcare System, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Clemmensen) Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Martinez) Department of Cardiology, Cordoba National University, Cordoba,
Argentina
(Ardissino) Division of Cardiology, Azienda Ospedaliero-Universitaria di
Parma, Parma, Italy
(Nicolau) Heart Institute (InCor), University of Sao Paulo Medical School,
Sao Paulo, Brazil
(Boden) Department of Medicine, Stratton VA Medical Center, Albany Medical
College, Albany, NY, United States
(Hochman) Leon H. Charney Division of Cardiology, New York University
School of Medicine, NYU Langone Medical Center, NY, United States
(Gurbel) Sinai Center for Thrombosis Research, Sinai Hospital of
Baltimore, Baltimore, United States
(Ruzyllo) Department of Coronary Artery Disease, Institute of Cardiology,
Warsaw, Poland
(Dalby) Milpark Hospital, Johannesburg, South Africa
(McGuire) University of Texas-Southwestern Medical Center, Dallas, TX,
United States
(Leiva-Pons) Cardiology Department, Hospital Central Dr. Morones Prieto,
San Luis Potosi, Mexico
(Parkhomenko) Emergency Cardiology, Institute of Cardiology, Kiev, Ukraine
(Gottlieb) Department of Cardiology, Bikur Cholim Hospital, Jerusalem,
Israel
(Topacio) Department of Medicine, Medical Center Manila, Manila,
Philippines
(Hamm) Kerckhoff Heart Center, Bad Nauheim, Germany
(Pavlides) Cardiology Division, Onassis Cardiac Surgery Center, Kallithea,
Greece
(Goudev) Cardiology Department, Queen Giovanna University Hospital, Sofia,
Bulgaria
(Oto) Department of Cardiology, Hacettepe University Faculty of Medicine,
Ankara, Turkey
(Tseng) Division of Cardiology, National Taiwan University College of
Medicine, Taipei, Taiwan (Republic of China)
(Merkely) Heart Center, Semmelweis University, Budapest, Hungary
(Gasparovic) Department of Intensive Care Medicine, Clinical Hospital
Center Zagreb, Zagreb, Croatia
(Corbalan) Cardiovascular Division, Faculty of Medicine, Pontificia
Universidad Catolica de Chile, Santiago, Chile
(Cinteza) Division of Cardiology, Emergency University Hospital of
Bucharest, Bucharest, Romania
(Winters, Brown) Eli Lilly, Indianapolis, IN, United States
(Aylward) South Australian Health and Medical Research Institute, Flinders
University Medical Centre, Adelaide, SA, Australia
(Huber) Third Department of Medicine, Cardiology and Emergency Medicine,
Wilhelminenhospital, Vienna, Austria
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND: The effect of intensified platelet inhibition for patients
with unstable angina or myocardial infarction without ST-segment elevation
who do not undergo revascularization has not been delineated.
 METHOD(S): In this double-blind, randomized trial, in a primary
analysis involving 7243 patients under the age of 75 years receiving
aspirin, we evaluated up to 30 months of treatment with prasugrel (10 mg
daily) versus clopidogrel (75 mg daily). In a secondary analysis involving
2083 patients 75 years of age or older, we evaluated 5 mg of prasugrel
versus 75 mg of clopidogrel. RESULT(S): At a median follow-up of 17
months, the primary end point of death from cardiovascular causes,
myocardial infarction, or stroke among patients under the age of 75 years
occurred in 13.9% of the prasugrel group and 16.0% of the clopidogrel
group (hazard ratio in the prasugrel group, 0.91; 95% confidence interval
[CI], 0.79 to 1.05; P = 0.21). Similar results were observed in the
overall population. The prespecified analysis of multiple recurrent
ischemic events (all components of the primary end point) suggested a
lower risk for prasugrel among patients under the age of 75 years (hazard
ratio, 0.85; 95% CI, 0.72 to 1.00; P = 0.04). Rates of severe and
intracranial bleeding were similar in the two groups in all age groups.
There was no significant between-group difference in the frequency of
nonhemorrhagic serious adverse events, except for a higher frequency of
heart failure in the clopidogrel group. CONCLUSION(S): Among patients
with unstable angina or myocardial infarction without ST-segment
elevation, prasugrel did not significantly reduce the frequency of the
primary end point, as compared with clopidogrel, and similar risks of
bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY
ACS ClinicalTrials.gov number, NCT00699998.) Copyright © 2012
Massachusetts Medical Society.

<45>
Accession Number
2010726516
Title
Comparison of the effect of single vs dual antiplatelet agents on
post-operative haemorrhage after renal transplantation: A systematic
review and meta-analysis.
Source
Transplantation Reviews. 35 (1) (no pagination), 2021. Article Number:
100594. Date of Publication: January 2021.
Author
Lee T.; D'Souza K.; Hameed A.; Yao J.; Lam S.; Chadban S.; Ying T.;
Celermajer D.; Sandroussi C.; Pleass H.C.C.; Laurence J.M.
Institution
(Sandroussi, Laurence) RPA Institute of Academic Surgery, University of
Sydney, RPA Institute of Academic Surgery, Level 9 E, Tranplantation
Services, Missenden Road, Camperdwon, NSW 2050, Australia
(Lee, Hameed, Pleass, Laurence) Department of Surgery, Westmead Hospital,
Corner of Hawkesbury Rd and Darcy, Westmead, NSW 2145, Australia
(Lee, Yao, Lam, Sandroussi, Pleass, Laurence) Royal Prince Alfred
Hospital, Missenden Road, Camperdwon, NSW 2050, Australia
(Chadban, Ying) Department of Renal Medicine, Royal Prince Alfred
Hospital, Camperdwon, NSW 2050, Australia
(D'Souza, Chadban, Ying, Celermajer) University of Sydney Medical School,
Australia
(Celermajer) Department of Cardiology, Royal Prince Alfred Hospital,
Camperdwon, NSW 2050, Australia
Publisher
W.B. Saunders
Abstract
Objectives: A significant proportion of renal transplant patients have
cardiovascular comorbidities for which they receive treatment with
antiplatelet agents. The aim of this study was to systematically review
the current literature reporting perioperative outcomes for patients
receiving dual antiplatelet therapy compared to single antiplatelet
therapy at the time of kidney transplantation with particular reference to
the risks of postoperative haemorrhage. Material(s) and Method(s):
Embase, Medline and Cochrane databases were utilized to identify articles
reporting outcomes of renal transplant recipients on single antiplatelet
therapy and dual antiplatelet therapy. These outcomes were compared using
a random effects model meta-analysis where appropriate. Result(s):
Six articles were incorporated in the analysis, including 130 receiving
dual antiplatelet therapy, and 781 in the single antiplatelet therapy
group. There was a significantly higher risk of post-operative
haemorrhagic events in the dual antiplatelet therapy group compared to the
single antiplatelet therapy group (RR 1.58, 95% CI 1.19-2.09, p = 0.001).
Post-operative cardiovascular event rates were similar between both groups
in individual studies, although this could not be quantitatively analysed.
 Conclusion(s): The use of dual antiplatelet therapy was associated
with a higher risk of post-operative haemorrhage compared to the use of
single antiplatelet therapy without increased rates of surgical
intervention. However, the use of dual antiplatelet therapy may provide
protection from cardiovascular events in an inherently higher risk patient
group. Copyright © 2020

<46>
Accession Number
2010707990
Title
Effectiveness of securing central venous catheters with topical tissue
adhesive in patients undergoing cardiac surgery: a randomized controlled
pilot study.
Source
BMC Anesthesiology. 21 (1) (no pagination), 2021. Article Number: 70. Date
of Publication: December 2021.
Author
Prachanpanich N.; Morakul S.; Kiatmongkolkul N.
Institution
(Prachanpanich, Morakul, Kiatmongkolkul) Department of Anesthesiology,
Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok
10400, Thailand
Publisher
BioMed Central Ltd
Abstract
Background: Central venous catheters (CVCs) play an important role during
cardiac surgery. Topical tissue adhesives form a thin film of coating that
becomes bound to keratin in the epidermis. The advantage of this "super
glue" lies in its antimicrobial activity. This study aimed to evaluate
fixation of CVCs with topical tissue adhesive in patients (prone to bleed)
undergoing cardiac surgery regarding its ability to reduce the incidence
of pericatheter leakage. Method(s): This randomized controlled trial
included 150 patients > 15 years of age who were (1) scheduled to undergo
elective cardiac surgery, (2) required CVC insertion at the internal
jugular vein, and (3) scheduled for transfer postoperatively to the
cardiac intensive care unit. We randomly assigned patients to a topical
tissue adhesive group (TA) or a standard control group (SC). The primary
outcome was a change in dressing immediately postoperatively due to
pericatheter blood oozing. Secondary outcomes were the number of
dressings, total dressings per catheter day, and composite outcome of
catheter failure within 3 days. Both intention-to-treat and per-protocol
analyses were performed. Seven patients violated the protocol (three TA
patients and four SC patients). Result(s): Regarding the primary
outcome, the SC group exhibited a significantly increased incidence of
dressing change immediately postoperatively due to pericatheter leakage
compared with the TA group in both the intention-to-treat analysis (5.33%
vs 18.67%, RR 0.25 [95% CI 0.08 to 0.79], P = 0.012) and the per-protocol
analysis (5.56% vs 16.90%, RR 0.289 [95% CI 0.09 to 0.95], P = 0.031). No
significant differences were noted in the number of dressings, total
dressings per catheter day, or composite outcome of catheter failure
within 3 days between the two groups. Multiple logistic regression
analysis was performed to adjust baseline characteristics that were
different in the per-protocol analysis. The results showed that the risk
ratio of immediate postoperative dressing change in TA patients was 0.25
compared to the SC group ([95% CI 0.07 to 0.87], P = 0.029) in the
per-protocol analysis. Conclusion(s): The use of a topical tissue
adhesive can reduce the incidence of immediate postoperative pericatheter
blood oozing. Trial registration: TCTR20180608004, retrospectively
registered on June 06, 2018. Copyright © 2021, The Author(s).

<47>
Accession Number
2010541033
Title
A double-edged sword of immuno-microenvironment in cardiac homeostasis and
injury repair.
Source
Signal Transduction and Targeted Therapy. 6 (1) (no pagination), 2021.
Article Number: 79. Date of Publication: December 2021.
Author
Sun K.; Li Y.-Y.; Jin J.
Institution
(Sun, Jin) MOE Laboratory of Biosystem Homeostasis and Protection, and
Life Sciences Institute, Zhejiang University, Hangzhou 310058, China
(Li) Key Laboratory for Developmental Genes and Human Disease, Ministry of
Education, Institute of Life Sciences, Jiangsu Province High-Tech Key
Laboratory for Bio-Medical Research, Southeast University, Nanjing 210096,
China
(Jin) Sir Run Run Shaw Hospital, College of Medicine Zhejiang University,
Hangzhou 310016, China
Publisher
Springer Nature
Abstract
The response of immune cells in cardiac injury is divided into three
continuous phases: inflammation, proliferation and maturation. The
kinetics of the inflammatory and proliferation phases directly influence
the tissue repair. In cardiac homeostasis, cardiac tissue resident
macrophages (cTMs) phagocytose bacteria and apoptotic cells. Meanwhile, NK
cells prevent the maturation and transport of inflammatory cells. After
cardiac injury, cTMs phagocytose the dead cardiomyocytes (CMs), regulate
the proliferation and angiogenesis of cardiac progenitor cells. NK cells
prevent the cardiac fibrosis, and promote vascularization and
angiogenesis. Type 1 macrophages trigger the cardioprotective responses
and promote tissue fibrosis in the early stage. Reversely, type 2
macrophages promote cardiac remodeling and angiogenesis in the late stage.
Circulating macrophages and neutrophils firstly lead to chronic
inflammation by secreting proinflammatory cytokines, and then release
anti-inflammatory cytokines and growth factors, which regulate cardiac
remodeling. In this process, dendritic cells (DCs) mediate the regulation
of monocyte and macrophage recruitment. Recruited eosinophils and Mast
cells (MCs) release some mediators which contribute to coronary
vasoconstriction, leukocyte recruitment, formation of new blood vessels,
scar formation. In adaptive immunity, effector T cells, especially Th17
cells, lead to the pathogenesis of cardiac fibrosis, including the distal
fibrosis and scar formation. CMs protectors, Treg cells, inhibit reduce
the inflammatory response, then directly trigger the regeneration of local
progenitor cell via IL-10. B cells reduce myocardial injury by preserving
cardiac function during the resolution of inflammation. Copyright
© 2021, The Author(s).

<48>
Accession Number
2011330004
Title
Modified design of stimulation of the left ventricular endocardium for
cardiac resynchronization therapy in nonresponders, previously untreatable
and high-risk upgrade patients (SOLVE-CRT) trial.
Source
American Heart Journal. 235 (pp 158-162), 2021. Date of Publication: May
2021.
Author
Singh J.P.; Walsh M.N.; Kubo S.H.; Auricchio A.; Delnoy P.P.; Gold M.R.;
Sanders P.; Lindenfeld J.; Rinaldi C.A.; Ullery S.
Institution
(Singh) Cardiac Arrhythmia Service, Massachusetts General Hospital,
Harvard Medical School, Boston, MA, United States
(Walsh) St Vincent's Heart Center, Indiannapolis, IN, United States
(Kubo) EBR Systems, Inc, Sunnyvale, CA, United States
(Auricchio) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Delnoy) Department of Cardiology, Isala Hospital, Zwolle, Netherlands
(Gold) Cardiology Division, Medical University of South Carolina,
Charleston, SC, United States
(Sanders) Centre for Heart Rhythm Disorders, University of Adelaide and
Royal Adelaide Hospital, Australia
(Lindenfeld) Section of Heart Failure and Cardiac Transplantation,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Rinaldi) King's College Cardiology Department Guys and St Thomas' NHS
Foundation Trust, London, United Kingdom
(Ullery) Namsa, Contract Research Organization, Minneapolis, United States
Publisher
Mosby Inc.
Abstract
The WiSE system is a novel, leadless endocardial system that can provide
cardiac resynchronization therapy in patients who cannot be treated with a
conventional epicardial left ventricular lead. Safety and efficacy were
being evaluated in the pivotal, randomized, double-blind SOLVE-CRT Trial
(Stimulation of the Left Ventricular Endocardium for Cardiac
Resynchronization Therapy.) The trial was initiated in 2018; however,
patient enrollment was significantly impacted by the COVID-19 pandemic
necessitating a change in design. This article describes the revised trial
and the scientific rationale for the specific changes in the
protocol. Copyright © 2021 Elsevier Inc.

<49>
Accession Number
634093241
Title
A Randomized, Double-Blind, Placebo-Controlled, Clinical Trial of
High-Dose, Short-Term Vitamin D Administration in the Prevention of Acute
Kidney Injury after Cardiac Surgery.
Source
CardioRenal Medicine. 11 (1) (pp 52-58), 2021. Date of Publication:
February 2021.
Author
Eslami P.; Hekmat M.; Beheshti M.; Baghaei R.; Mirhosseini S.M.;
Pourmotahari F.; Ziai S.A.; Foroughi M.
Institution
(Eslami, Foroughi) Cardiovascular Research Center, Shahid Beheshti
University of Medical Sciences, Saadat Abad, Tehran 19987-34383, Iran,
Islamic Republic of
(Hekmat, Beheshti, Baghaei, Mirhosseini, Pourmotahari) Clinical Research
and Development Center, Shahid Modarres Hospital, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ziai) Department of Pharmacology, School of Medicine, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
S. Karger AG
Abstract
Background: Acute kidney injury (AKI) after cardiac surgery is a
relatively common complication affecting short- A nd long-term survival.
The renoprotective effect of vitamin D (VitD) has been confirmed in
several experimental models. This study was conducted to evaluate the
effect of high-dose VitD administration in patients with VitD
insufficiency on the incidence of postoperative AKI, the urinary level of
tubular biomarkers, and serum anti-inflammatory biomarker after coronary
artery bypass graft. Design and Method: In this randomized double-blind
controlled clinical trial, the patients were randomly allocated to either
the VitD group (n = 50), receiving 150,000 IU VitD tablets daily for 3
consecutive days before surgery or the control group (n = 61), receiving
placebo tablets. Result(s): There was no difference in the incidence
of postoperative AKI between the groups. Both of the urinary levels of
interleukin-18 and kidney injury molecule-1 were significantly increased
after the operation (p < 0.001, for both). Also, the serum level of
interleukin-10 was increased after 3 days of VitD supplementation (p =
0.001). In comparison with the control group, it remained on a higher
level after the operation (p < 0.001) and the next day (p = 0.03). The
patients with AKI had more postoperative bleeding and received more blood
transfusion. Conclusion(s): VitD pretreatment was unable to impose
any changes in the incidence of AKI and the urinary level of renal
biomarkers. However, high-dose administration of VitD may improve the
anti-inflammatory state before and after the operation. Further studies
are needed to assess the renoprotective effect of VitD on coronary surgery
patients. Copyright © 2021 S. Karger AG, Basel. All rights
reserved.

<50>
Accession Number
2007982278
Title
IL-8 and CRP moderate the effects of preoperative psychological
interventions on postoperative long-term outcomes 6 months after CABG
surgery - The randomized controlled PSY-HEART trial.
Source
Brain, Behavior, and Immunity. 91 (pp 202-211), 2021. Date of Publication:
January 2021.
Author
Salzmann S.; Euteneuer F.; Laferton J.A.C.; Shedden-Mora M.C.; Schedlowski
M.; Moosdorf R.; Rief W.
Institution
(Salzmann, Euteneuer, Laferton, Rief) Department of Clinical Psychology
and Psychotherapy, Philipps University of Marburg, Marburg, Germany
(Euteneuer) Clinical Psychology and Psychotherapy, Medical School Berlin,
Berlin, Germany
(Laferton) Department of Clinical Psychology and Psychotherapy,
Psychologische Hochschule Berlin, Berlin, Germany
(Shedden-Mora) Department of Psychosomatic Medicine and Psychotherapy,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Schedlowski) Institute of Medical Psychology and Behavioral
Immunobiology, University Clinic Essen, Essen, Germany
(Schedlowski) Department of Clinical Neuroscience, Osher Center for
Integrative Medicine, Karolinska Institute, Stockholm 17177, Sweden
(Moosdorf) Department for Cardiovascular Surgery, Heart Center, Philipps
University of Marburg, Marburg, Germany
Publisher
Academic Press Inc.
Abstract
Introduction: Inflammation has been related to several somatic and
psychological disorders and may moderate effects of psychological
interventions. In the PSY-HEART trial patients benefitted from
preoperative psychological interventions before undergoing coronary artery
bypass graft surgery (CABG) and, if necessary, concomitant valvular
surgery, compared to standard medical care. In this study we examined
whether patients' baseline inflammatory status moderated the intervention
effects. Material(s) and Method(s): In a prospective three-arm
randomized clinical trial with 6-months follow-up, 124 patients scheduled
for CABG surgery alone or concomitant with valvular surgery were
randomized to (i) standard medical care only (SMC) or two preoperative
psychological interventions: (ii) CBT-based optimizing expectations
(EXPECT) and an (iii) an active control group focusing on emotional
support (SUPPORT). Available baseline CRP- (n = 79), IL-6- (n = 78), IL-8-
(n = 78) and TNF-alpha-(n = 80) parameters were considered as potential
moderators (CRP as a categorical and continuous moderator). Linear mixed
model analyses were calculated to test whether baseline inflammatory
levels moderated intervention effects on disability, mental and physical
quality of life at 6 months after surgery. Result(s): IL-8 moderated
intervention effects on patients' disability and categorical CRP moderated
intervention effects on mental quality of life. Follow-up tests indicated
that EXPECT (and in part SUPPORT) led to lower postoperative disability
and higher mental quality of life compared to SMC in patients with low
baseline inflammatory markers. EXPECT indicated higher mental quality of
life compared to SUPPORT in the high CRP subgroup. Patients in the SMC
group had higher mental quality of life in the high CRP subgroup compared
to the low CRP subgroup. Conclusion(s): Especially for patients with
a lower inflammatory baseline status preoperative psychological
interventions might be helpful to optimize long-term CABG surgery
outcomes. Copyright © 2020 Elsevier Inc.

<51>
Accession Number
2011433495
Title
Infective Endocarditis Following Heart Transplantation: A Systematic
Review.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2021. 40 (4
Supplement) (pp S138), 2021. Date of Publication: April 2021.
Author
Jordan A.M.; Patel S.V.; Maynes E.J.; Weber M.P.; Moss S.; Royer T.L.;
Tchantchaleishvili V.; Massey H.T.; Rame J.E.; Zurlo J.J.; Aburjania N.
Institution
(Jordan, Patel, Maynes, Weber, Tchantchaleishvili, Massey) Division of
Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, United
States
(Moss, Royer, Zurlo, Aburjania) Division of Infectious Disease and
Environmental Medicine, Thomas Jefferson University, Philadelphia, PA,
United States
(Rame) Division of Cardiology, Thomas Jefferson University, Philadelphia,
PA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Infective endocarditis (IE) is a rare but potentially fatal
complication following heart transplantation (HTx). There is a lack of
literature regarding the patterns and clinical course of IE development
following HTx. We sought to pool the existing data in regards to defining
characteristics, management options, and outcomes of IE following HTx.
 Method(s): An electronic search of Cochrane Central Register of
Controlled Trials, Cumulative Index to Nursing and Allied Health
Literature, Ovid Medline, and the Scopus databases were performed to
identify all articles in the English literature that report IE following
HTx in patients greater than 17 years of age. Systematic search yielded 37
patients from 29 articles. Patient-level data were extracted and analyzed.
 Result(s): Median patient age was 53 [IQR 43, 62] years and 78.4%
(29/37) were male. Median time to IE presentation post-HTx was 6.5 [2.6,
16.2] months. IE of the mitral valve was observed in 45.9% (17/37) of
patients, followed by mural IE in 24.3% (9/37), and tricuspid valve IE in
24.3% (9/37). The most common organisms were Staphylococcus aureus in
27.0% (10/37), Aspergillus fumigatus in 18.9% (7/37), Enterococcus
faecalis in 10.8% (4/37), and an undetermined or unspecified organism in
16.2% (6/37) patients. Aspergillus fumigatus associated mortality occurred
in 85.7% (6/7). Surgical management of post-HTx IE was observed in 43.2%
(16/37). This included valve surgery for 35.1% (13/37), particularly of
the mitral valve in 46.2% (6/13), aortic valve 38.5% (5/13), tricuspid
valve 15.4% (2/13), and pulmonic artery graft in 15.4% (2/13).
Kaplan-Meier analysis of the survival is shown in the figure.
 Conclusion(s): In addition to bacterial organisms, Aspergillus
fumigatus also represents a frequent cause of IE in post-HTx patients.
Overall HTx patient survival after IE occurs is poor, and may be worse
with Aspergillus fumigatus IE. Copyright © 2021

<52>
Accession Number
2011432346
Title
Retrospective Evaluation of Rabbit Anti-Thymocyte Globulin (rATG)
Induction in Heart Transplant Patients.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2021. 40 (4
Supplement) (pp S133), 2021. Date of Publication: April 2021.
Author
Lee G.; Cheng R.; Wu C.; Vasbinder A.; Wong B.; Farris S.; Fishbein D.;
Wong J.
Institution
(Lee, Wong) Pharmacy, University of Washington Medical Center, Seattle,
WA, United States
(Cheng, Farris, Fishbein) Cardiology, University of Washington Medical
Center, Seattle, WA, United States
(Wu, Vasbinder) Statistics, University of Washington Medical Center,
Seattle, WA, United States
(Wong) Pharmacy, Kaiser Permanente, Seattle, WA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: The use and dosing intensity of rATG as induction therapy in
heart transplantation remains controversial. We sought to evaluate the
efficacy and safety of rATG at a total dose of 4.5mg/kg compared to less
than 4.5mg/kg. Method(s): This study was a cross-sectional
retrospective chart review of adults who underwent heart transplantation
from January 1, 2016 - December 31, 2018 at a single quaternary care
center. Exposure was defined as a full rATG (4.5mg/kg total) induction per
institutional protocol compared to partial (less than 4.5mg/kg) induction.
The primary outcome was the incidence of ISHLT 1990 defined acute cellular
rejection (ACR) at two years. Secondary outcomes were all-cause mortality,
proportion of infections, and time to therapeutic tacrolimus levels.
 Result(s): A total of 201 patients met inclusion criteria. 61
received partial rATG induction and 140 received full rATG induction. When
comparing partial vs full induction, there was no difference in any-grade
of ACR (78.7% vs 88.6%, p=0.11). There was a trend toward a higher
cumulative incidence of ACR grade 2 or above over two years in the partial
as compared to the full induction group (18% vs 11.4%, p=0.21). On
multivariate Cox PH analysis, partial vs full induction, the estimated
hazard ratio was 1.45 (CI 0.62-3.37, p=0.39). Adjusted landmark survival
analysis conditional on survival to 1 month showed no difference between
the two groups. The number of patients with at least one infection within
3 months of transplant was similar between the groups (partial 29.5% vs
full 20.0% p=0.20). Both groups achieved therapeutic tacrolimus levels by
day 7 after initiation. Conclusion(s): The dose of rATG does not
appear to affect the overall incidence of biopsy-proven rejection, though
there appears to be a trend towards severe rejection with rATG induction
doses less than 4.5mg/kg. The total cumulative dose of rATG induction did
not impact medium-term survival. Prospective, randomized, controlled
trials are needed to validate these observations. Copyright ©
2021

<53>
Accession Number
2011430297
Title
Heart in the Box with Long Term Outcome Post-Heart Transplantation.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 2021. 40 (4
Supplement) (pp S125), 2021. Date of Publication: April 2021.
Author
Salabat R.; Emerson D.; Megna D.; Ramzy D.; Kobashigawa J.A.; Thottam M.;
Singer-Englar T.; Patel J.; Kittleson M.; Czer L.; Trento A.; Chikwe J.;
Esmailian F.
Institution
(Salabat, Emerson, Megna, Ramzy, Kobashigawa, Thottam, Singer-Englar,
Patel, Kittleson, Czer, Trento, Chikwe, Esmailian) Smidt Heart Institute
at Cedars-Sinai, Los Angeles, CA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: The organ care system (OCS) has been found to have comparable
30-day mortality compared to standard of care (SOC) therapy for the donor
heart. At our institution, we had previously shown comparable results on
1-year outcome in terms of rejection, antibody development and survival.
In this current study, this cohort of patients were followed, and we
evaluated long term results. Method(s): Between 2011 and 2013, we
randomized 38 heart transplant (HTx) patients to either OCS or SOC. We
assessed total ischemic time (TIT), cold ischemic time (CIT), development
of de novo antibodies (abs) and donor specific antibodies (DSA) within 8
year post-HTx, 8-year survival, 8-year freedom from cardiac allograft
vasculopathy (CAV), 8-year freedom from non-fatal major cardiac events
(NF-MACE: Myocardial Infarction, Heart Failure, angioplasty,
pacemaker/ICD, stroke), 8-year freedom from any-treated rejection (ATR),
biopsy (bx) proven cellular rejection (ACR >2R), bx proven
antibody-mediated rejection (AMR1, 2, or 3). Result(s): OSC group had
significant longer TIT but significantly shorter CIT compared to SOC.
There was no statistically significant difference in 8-year freedom from
CAV, NF-MACE, ATR, ACR and AMR. Moreover, 8-year survival was not
statistically significant different between the two groups. There were
total of 8 deaths in the OCS group and the cause of death included 3
immediate postoperative cases of hemorrhage and thrombotic event, two died
of complications of malignancy, one due to multi-organ failure, one
patient died due to complications of CMV infection and last patient died
of unknown etiology. In the SOC group, there were 5 deaths. Causes of
death included once case of rejection, one case of stroke, one patient
died of CMV infection, one due to patient non-compliance, and one patient
died of unknown cause at an outside hospital. Conclusion(s): OCS
appears to be a valid tool to extend total donor ischemic time without
compromising long term outcomes. Copyright © 2021

<54>
Accession Number
2011442914
Title
Does contingent biofeedback improve cardiac interoception? A preregistered
replication of Meyerholz, Irzinger, Withoft, Gerlach, and Pohl (2019)
using the heartbeat discrimination task in a randomised control trial.
Source
PLoS ONE. 16 (3 March) (no pagination), 2021. Article Number: e0248246.
Date of Publication: March 2021.
Author
Rominger C.; Grassmann T.M.; Weber B.; Schwerdtfeger A.R.
Institution
(Rominger, Grasmann, Weber, Schwerdtfeger) Institute of Psychology,
University of Graz, Graz, Austria
(Rominger) Otto Loewi Research Center, Section of Physiology, Medical
University of Graz, Graz, Austria
Publisher
Public Library of Science
Abstract
Meyerholz, Irzinger, Withoft, Gerlach, and Pohl (2019) reported on a
comparably large effect (d = 1.21) of a contingent biofeedback procedure
on cardiac accuracy as assessed by the heartbeat tracking task. However,
this task has recently been criticized as a measure of interoceptive
accuracy. We aimed to replicate this finding by using the well-validated
heartbeat discrimination task and to compare the biofeedback with a deep
breathing and a control condition (viewing a film clip). The trial was
preregistered at open science framework (https://osf.io/9fxn6). Overall,
93 participants were randomized to one of the three conditions and the
heartbeat discrimination task was presented prior and after the 20-minutes
training sessions. The study had a power of .86 to detect a medium-sized
effect in the biofeedback group and a power of .96 to detect a
medium-sized interaction of intervention group and time. A general
tendency for improvement in heartbeat detection accuracy was found across
intervention groups (d = 0.19, p = .08); however, groups did not differ
significantly. In particular, there was no significant interaction of
intervention group and time (f = .00, p = .98) and no reliable effect for
the biofeedback group (d = 0.15, p = .42). One limitation is that a
different, but well-validated task was used to quantify interoceptive
accuracy. This study suggests that biofeedback might not improve
interoceptive accuracy in the cardiac domain, but effects seem to depend
on the specific task applied. Copyright © 2021 Rominger et al.

<55>
Accession Number
2011412244
Title
Tricuspid valve replacement: Mechanical or biological prostheses? A
systematic review and meta-analysis.
Source
Heart Surgery Forum. 24 (2) (pp E209-E214), 2021. Date of Publication: 03
Mar 2021.
Author
Cheng Z.; Fang T.; Wang D.; Guo Y.
Institution
(Cheng, Guo) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan 610041, China
(Fang) Department of Cardiology, West China Hospital, Sichuan University,
Chengdu, Sichuan 610041, China
(Wang) First School of Clinical Medicine, Lanzhou University, Lanzhou
730000, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Tricuspid valve replacement (TVR) is seldom performed in
cardiac valve surgery, and there currently are no clinical guidelines as
to which type of prostheses is better in tricuspid valve position. This
meta-analysis was performed to compare the results of mechanical and
biological prostheses for TVR. Method(s): We searched the Pubmed,
Cochrane, and Embase clinical trial databases to collect all related
studies published from January 1, 2000 to July 31, 2020. A random-effects
model was used to evaluate the odds ratios (OR) and its 95% confidence
intervals (CI) of time-to-event related effects of the surgical
procedures; every study's quality was evaluated by the Newcastle-Ottawa
Scale (NOS). Result(s): A total of 13 retrospective studies,
including 1453 patients were analyzed. There were no statistically
differences between mechanical and biological prostheses with respect to
prosthetic valve failure [OR = 0.84, 95% CI(0.54, 1.28), P = .41],
bleeding [OR = 0.84, 95% CI(0.54,1.28), P = .41], reoperation [OR = 1.02,
95% CI(0.58,1.78), P = .95], early mortality [OR = 1.35, 95%
CI(0.82,2.25), P = .24] and longtime survival [OR = 1.09, 95% CI(0.70,
1.69), P = .70], but a significant difference can be seen in mechanical
prostheses with a higher risk of thrombosis [OR = 0.17, 95% CI(0.05,
0.60), P = .006, I2 = 0%]. Conclusion(s): In tricuspid
valve position, mechanical valve prostheses have a higher risk of
thrombosis than biological prostheses, but no statistical differences
between mechanical and biological prostheses with respect to prosthetic
valve failure, bleeding, reoperation, early mortality, and long-term
survival. The valve disease and patient's age and risk factors are the
most important considerations in the decision-making process. The more
specific conclusion needs to be further proved by large-sample,
multi-center, randomized, double-blind and control trials. Copyright
© 2021 Forum Multimedia Publishing LLC. All rights reserved.

<56>
Accession Number
2011412224
Title
Acupoint catgut embedding reduces insulin resistance in diabetic patients
undergoing open cardiac surgery.
Source
Heart Surgery Forum. 24 (1) (pp E60-E64), 2021. Date of Publication: 13
Jan 2021.
Author
Zhang Y.; Gong H.; Zhan B.; Chen S.
Institution
(Zhang, Gong, Chen) Department of Anesthesiology, First Affiliated
Hospital of Nanchang University, China
(Zhan) Department of Cardiology, Second Affiliated Hospital of Nanchang
University, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Objective: Acupoint catgut embedding (ACE) has been used safely for
thousands of years in traditional Chinese medicine. The aim of this study
was to assess whether ACE can improve insulin resistance and promote rapid
recovery after open cardiac surgery. Method(s): A group of 200
patients undergoing cardiac surgery were randomly allocated to receive
either ACE (ACE group) or sham ACE (SHAM group). The primary outcome of
our trial was insulin resistance assessed 1, 3, 5, and 7 days after
surgery. The homeostasis model assessment (HOMA-IR) was used to measure
perioperative insulin resistance. Secondary outcomes included insulin,
glucose, and inflammatory cytokine (interleukin (IL) 6 and IL-8) levels;
time to extubation; incidence of infection; time to first feces; acute
kidney injury; incidence of postoperative nausea and vomiting (PONV);
length of stay in the ICU; length of hospital stay; and other clinical
parameters. Result(s): The ACE group had lower insulin, glucose,
IL-6, IL-8, and HOMA-IR levels than the SHAM group one week after the
operation. The incidence of infection, incidence of PONV, time to drain
removal, and length of hospital stay significantly were lower in the ACE
group than in the SHAM group. Conclusion(s): ACE can improve insulin
resistance and promote rapid recovery after open cardiac
surgery. Copyright © 2021 Forum Multimedia Publishing LLC. All
rights reserved.

<57>
Accession Number
2011412219
Title
Predictors of prosthetic valve endocarditis following transcatheter aortic
valve replacement: A meta-analysis.
Source
Heart Surgery Forum. 24 (1) (pp E101-E107), 2021. Date of Publication: 13
Jan 2021.
Author
Jiang W.; Wu W.; Guo R.; Xie M.; Yim W.Y.; Wang Y.; Hu X.
Institution
(Jiang) Department of Gastroenterology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
(Wu) Department of Gastroenterology, Zhongnan Hospital, Wuhan University,
Wuhan, China
(Guo, Xie, Yim, Wang, Hu) Department of Cardiovascular Surgery, Union
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has gained
increasing acceptance for patients with aortic disease. A rare but fatal
complication prosthetic valve endocarditis (PVE) could greatly influence
the clinical outcomes of TAVR. This meta-analysis aims to pin down the
predictors of PVE in TAVR patients. Method(s): We performed a
systematic search for studies that reported the incidence and risk factors
of PVE after TAVR. Data on studies, patients, baseline characteristics,
and procedural characteristics were abstracted. Crude risk ratios (RRs)
and 95% confidence intervals for each predictor were calculated by the use
of random-effects models. Heterogeneity assumption was assessed by an
I2 test. Result(s): We obtained data from 8 studies that
included 68,805 TAVR patients, of whom 1,256 (1.83%) were diagnosed with
PVE after TAVR. 280 patients died within the 30-days of PVE diagnosis and
the pooled in-hospital mortality was 22.3%. The summary estimates
indicated an increased risk of PVE after TAVR for males (RR 1.53, P =
.0001); for patients with orotracheal intubation (RR 1.65, P = .01), new
pacemaker implantation (RR 1.46, P = .003), and residual aortic
regurgitation (>=2 grade) (RR 1.62, P = .05); while older age (RR 0.97, P
= .0007) and implantation of a self-expandable valve (RR 0.74, P = .02)
were associated with a lower risk of PVE after TAVR. Conclusion(s):
Clinical characteristics and periprocedure factors including age, male
sex, valve type, orotracheal intubation, pacemaker implantation, and
residual regurgitation were proven to be associated with the occurrence of
PVE-TAVR. Clinicians should pay particular attention to PVE when treating
TAVR patients with these predictors. Copyright © 2021 Forum
Multimedia Publishing LLC. All rights reserved.

<58>
Accession Number
2011412218
Title
Comparison of transcatheter mitral-valve repair and surgical mitral-valve
repair in elderly patients with mitral regurgitation.
Source
Heart Surgery Forum. 24 (1) (pp E108-E115), 2021. Date of Publication: 13
Jan 2021.
Author
Yuan H.; Wei T.; Wu Z.; Lu T.; Chen J.; Zeng Y.; Tan L.; Huang C.
Institution
(Yuan, Wu, Lu, Chen, Zeng, Tan, Huang) Department of Cardiovascular
Surgery, The Second Xiangya Hospital, Central South University, Changsha,
Hunan, China
(Yuan, Wu, Lu, Tan, Huang) Engineering Laboratory of Hunan Province for
Cardiovascular Biomaterials, Hunan, China
(Wei) Department of Pediatrics, Hunan Provincial Maternal and Child Health
Care Hospital, Hunan, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Purpose: To summarize comparative studies of MitraClip versus surgical
repair in typical, real-world elderly patients with severe mitral
regurgitation (MR) and analyze the safety and effectiveness of these
therapeutic options. Method(s): PubMed, Medline, Embase, and Cochrane
Controlled Register of Trials (CENTRAL) were searched for comparative
studies of transcatheter mitral-valve repair (TMVR) versus surgical
mitral-valve repair (SMVR) in elderly patients with severe MR from January
2000 to June 2020. Statistical pooling for incidence estimates was
performed according to a random-effects model with generic
inverse-variance weighting, computing risk estimates with 95% confidence
intervals (CIs), using RevMan 5.3. Result(s): A total of 14 reports
comparing MitraClip with SMVR, enrolling 3355 patients with severe MR,
were included in this study. Mean age, Logistic EuroSCORE, and incidence
of diabetes mellitus (DM) were significantly higher in the MitraClip
group, except the rate of patients with New York Heart Association (NYHA)
class of >II and mean value of ejection fraction (EF). The arithmetic mean
of freedom from acute mobility was similar. The 2 groups had equal
all-cause mortality at 30 days, but different at 1 year (14% versus 9%)
and 3 years in 7 studies (37% versus 25%). The freedom from recurrent MR
>=3+ was 88% and 97.3% at 30 days, 76.0% and 90.0% at 1 year, and 79% and
95% at 3 years in the MitraClip and surgical repair group, respectively.
 Conclusion(s): Although MitraClip is safe and effective in selected
high-risk patients, the surgery may be the only gold standard for "gray"
patients. Further studies are needed to determine whether MitraClip should
be recommended. Copyright © 2021 Forum Multimedia Publishing LLC.
All rights reserved.

<59>
Accession Number
2011412208
Title
Efficacy of histidine-tryptophan-ketoglutarate solution versus blood
cardioplegia in cardiac surgical procedures: A randomized controlled ,
parallel group study.
Source
Heart Surgery Forum. 24 (1) (pp E170-E176), 2021. Date of Publication: 13
Jan 2021.
Author
Ali I.; Hassan A.; Shokri H.; Khorshid R.
Institution
(Ali, Hassan, Khorshid) Cardiothoracic Surgery Department, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
(Shokri) Department of Anesthesiology and Intensive Care, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: In cardiac surgery, myocardial protection is required during
cross-clamping followed by reperfusion. The use of cardioplegic solutions
helps preserve myocardial energy stores, hindering electrolyte
disturbances and acidosis during periods of myocardial ischaemia. This
study aimed to compare the efficacy and safety between the
histidine-tryptophan-ketoglutarate (HTK) solution and blood cardioplegia
in various cardiac surgeries. Method(s): Three-hundred-twenty
patients aged 30-70 years old undergoing various cardiac surgeries were
randomized into the HTK group and the blood cardioplegia group. The
ventilation time, total bypass time, cross-clamp time, length of intensive
care unit (ICU) or hospital stay, and postoperative complications were
analyzed. Result(s): The total bypass time and cross-clamp time were
significantly shorter in the HTK group than in the blood cardioplegia
group (P < 0.001). Segmental wall motion abnormalities (SWMA) at
postoperative echocardiography were significantly higher in in the blood
cardioplegia group (P = 0.008). The number of patients requiring DC Shock
was significantly higher in the HTK group (P < 0.001). The number of
patients requiring inotropic support was significantly higher in the blood
cardioplegia group (P < 0.001). The length of ICU, hospital stay, and
ventilation time were significantly longer in the blood cardioplegia group
than in the HTK group (P = 0.004, P < 0.001, P < 0.001, respectively). The
number of patients requiring prolonged ventilation was significantly
higher in the blood cardioplegia group compared with the HTK group (P =
0.022). There was no significant difference between the study groups
regarding electrocardiographic changes, 30-day mortality, and 30-day
readmission. Conclusion(s): The use of HTK cardioplegia was
associated with significantly shorter cross-clamp time, bypass time,
duration of mechanical ventilation, length of ICU stay, and length of
hospital stay. It is associated with less incidence of postoperative
segmental wall abnormalities and less need for inotropic support than
blood cardioplegia. Custodiol cardioplegia is a safe and feasible option
that can be used as an effective substitute for blood cardioplegia to
enhance myocardial protection. Copyright © 2021 Forum Multimedia
Publishing LLC. All rights reserved.

<60>
Accession Number
2010857046
Title
Invasive therapy versus conservative therapy for patients with stable
coronary artery disease: An updated meta-analysis.
Source
Clinical Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Vij A.; Kassab K.; Chawla H.; Kaur A.; Kodumuri V.; Jolly N.; Doukky R.
Institution
(Vij, Kassab, Doukky) Division of Cardiology, Cook County Health, Chicago,
IL, United States
(Vij, Doukky) Department of Medicine, Rush Medical college, Chicago, IL,
United States
(Chawla) Division of Cardiology, MedStar Union Memorial Hospital,
Baltimore, MD, United States
(Kaur) Department of Pathology, University of Chicago-Northshore,
Evanston, IL, United States
(Kodumuri) Division of Cardiology, Ascension All Saints Hospital, Racine,
WI, United States
(Jolly) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Heart disease remains the leading cause of death in the United
States. Although there are clear indications for revascularization in
patients with acute coronary syndromes, there is debate regarding the
benefits of revascularization in stable ischemic heart disease. We sought
to perform a comprehensive meta-analysis to assess the role of
revascularization compared to conservative medical therapy alone in
patients with stable ischemic heart disease. Hypothesis: There is no
significant difference in all-cause mortality or cardiovascular mortality
between invasive and medical arms. Method(s): We performed a
systematic literature search from January 2000 to June 2020. Our
literature search yielded seven randomized controlled trials. We analyzed
a total of 12 013 patients (6109 in revascularization arm and 5904 in
conservative medical therapy arm). Primary outcome was all-cause
mortality. Secondary outcomes included major adverse cardiac events (MACE)
(death, myocardial infarction [MI], or stroke), cardiovascular mortality,
MI, and stroke. Additional subgroup analysis for all-cause mortality was
performed comparing percutaneous coronary intervention (PCI) with bare
metal stent versus conservative therapy; and PCI with drug eluting stent
versus conservative therapy. Result(s): There was no statistically
significant difference in primary outcome of all-cause mortality between
either arm (odds ratio [OR] = 0.95; 95% CI [confidence interval], 0.83 to
1.08; p =.84). There were statistically significant lower rates of MACE
(death, MI or stroke) in the revascularization arm when compared to
conservative arm. Conclusion(s): Our analysis did not show any
survival advantage of an initial invasive strategy over conservative
medical therapy in patients with stable coronary artery disease
(CAD). Copyright © 2021 The Authors. Clinical Cardiology
published by Wiley Periodicals LLC.

<61>
Accession Number
634537095
Title
Angiographic Patency of Coronary Artery Bypass Conduits: A Network
Meta-Analysis of Randomized Trials.
Source
Journal of the American Heart Association. (pp e019206), 2021. Date of
Publication: 09 Mar 2021.
Author
Gaudino M.; Hameed I.; Robinson N.B.; Ruan Y.; Rahouma M.; Naik A.;
Weidenmann V.; Demetres M.; Y Tam D.; Hare D.L.; Girardi L.N.;
Biondi-Zoccai G.; E Fremes S.
Institution
(Gaudino, Hameed, Robinson, Ruan, Rahouma, Naik, Weidenmann, Girardi)
Department of Cardiothoracic Surgery Weill Cornell Medicine New York NY
(Demetres) Weill Cornell Medicine New York NY, Samuel J. Wood Library and
C.V. Starr Biomedical Information Centre
(Y Tam, E Fremes) Schulich Heart Centre Sunnybrook Health Science
University of Toronto Toronto Ontario Canada
(Hare) Department of Cardiology Austin Health Melbourne Australia
(Biondi-Zoccai) Department of Medico-Surgical Sciences and Biotechnologies
Sapienza University Rome Italy
(Biondi-Zoccai) Mediterranea Cardiocentro Naples Italy
Publisher
NLM (Medline)
Abstract
Background Several randomized trials have compared the patency of coronary
artery bypass conduits. All of the published studies, however, have
performed pairwise comparisons and a comprehensive evaluation of the
patency rates of all conduits has yet to be published. We set out to
investigate the angiographic patency rates of all conduits used in
coronary bypass surgery by performing a network meta-analysis of the
current available randomized evidence. Methods and Results A systematic
literature search was conducted for randomized controlled trials comparing
the angiographic patency rate of the conventionally harvested saphenous
vein, the no-touch saphenous vein, the radial artery (RA), the right
internal thoracic artery, or the gastroepiploic artery. The primary
outcome was graft occlusion. A total of 4160 studies were retrieved of
which 14 were included with 3651 grafts analyzed. The weighted mean
angiographic follow-up was 5.1 years. Compared with the conventionally
harvested saphenous vein, both the RA (incidence rate ratio [IRR] 0.54;
95% CI, 0.35-0.82) and the no-touch saphenous vein (IRR 0.55; 95% CI,
0.39-0.78) were associated with lower graft occlusion. The RA ranked as
the best conduit (rank score for RA 0.87 versus 0.85 for no-touch
saphenous vein, 0.23 for right internal thoracic artery, 0.29 for
gastroepiploic artery, and 0.25 for the conventionally harvested saphenous
vein). Conclusions Compared with the conventionally harvested saphenous
vein, only the RA and no-touch saphenous vein grafts are associated with
significantly lower graft occlusion rates. The RA ranks as the best
conduit. Registration URL: https://www.crd.york.ac.uk/prospero; Unique
identifier: CRD42020164492.

<62>
Accession Number
634536684
Title
Reoperative Mitral Surgery Versus Transcatheter Mitral Valve Replacement:
A Systematic Review.
Source
Journal of the American Heart Association. (pp e019854), 2021. Date of
Publication: 09 Mar 2021.
Author
Sengupta A.; Yazdchi F.; Alexis S.L.; Percy E.; Premkumar A.; Hirji S.;
Bapat V.N.; Bhatt D.L.; Kaneko T.; Tang G.H.L.
Institution
(Sengupta, Alexis, Tang) Department of Cardiovascular Surgery Mount Sinai
Hospital New York NY
(Yazdchi, Percy, Premkumar, Hirji, Kaneko) Division of Cardiac Surgery
Brigham and Women's Hospital Boston MA
(Bapat) Minneapolis Heart Institute Foundation Minneapolis MN
(Bhatt) Brigham and Women's Heart & Vascular CenterHarvard Medical School
Boston MA
Publisher
NLM (Medline)
Abstract
Bioprosthetic mitral structural valve degeneration and failed mitral valve
repair (MVr) have traditionally been treated with reoperative mitral valve
surgery. Transcatheter mitral valve-in-valve (MVIV) and valve-in-ring
(MVIR) replacement are now feasible, but data comparing these approaches
are lacking. We sought to compare the outcomes of (1) reoperative mitral
valve replacement (redo-MVR) and MVIV for structural valve degeneration,
and (2) reoperative mitral valve repair (redo-MVr) or MVR and MVIR for
failed MVr. A literature search of PubMed, Embase, and the Cochrane
Library was conducted up to July 31, 2020. Thirty-two studies involving 25
832 patients were included. Redo-MVR was required in =35% of patients
after index surgery at 10 years, with 5% to 15% 30-day mortality. MVIV
resulted in >95% procedural success with 30-day and 1-year mortality of 0%
to 8% and 11% to 16%, respectively. Recognized complications included left
ventricular outflow tract obstruction (0%-6%), valve migration (0%-9%),
and residual regurgitation (0%-6%). Comparisons of redo-MVR and MVIV
showed no statistically significant differences in mortality (11.3% versus
11.9% at 1 year, P=0.92), albeit higher rates of major bleeding and
arrhythmias with redo-MVR. MVIR resulted in 0% to 34% mortality at 1 year,
whereas both redo-MVr and MVR for failed repairs were performed with
minimal mortality and durable long-term results. MVIV is therefore a
viable alternative to redo-MVR for structural valve degeneration, whereas
redo-MVr or redo-MVR is preferred for failed MVr given the suboptimal
results with MVIR. However, not all patients will be candidates for
MVIV/MVIR because anatomical restrictions may preclude transcatheter
options from adequately addressing the underlying pathology.

<63>
Accession Number
634533768
Title
Prevention of Cardiac Surgery-Associated Acute Kidney Injury by
Implementing the KDIGO Guidelines in High-Risk Patients Identified by
Biomarkers: The PrevAKI-Multicenter Randomized Controlled Trial.
Source
Anesthesia and analgesia. (no pagination), 2021. Date of Publication: 08
Mar 2021.
Author
Zarbock A.; Kullmar M.; Ostermann M.; Lucchese G.; Baig K.; Cennamo A.;
Rajani R.; McCorkell S.; Arndt C.; Wulf H.; Irqsusi M.; Monaco F.; Di
Prima A.L.; Garcia Alvarez M.; Italiano S.; Miralles Bagan J.; Kunst G.;
Nair S.; L'Acqua C.; Hoste E.; Vandenberghe W.; Honore P.M.; Kellum J.A.;
Forni L.G.; Grieshaber P.; Massoth C.; Weiss R.; Gerss J.; Wempe C.;
Meersch M.
Institution
(Zarbock, Kullmar, Massoth, Weiss, Wempe, Meersch) From the Department of
Anesthesiology, Intensive Care Medicine and Pain Medicine, University
Hospital Munster, Munster, Germany
(Ostermann, Lucchese, Baig, Cennamo, Rajani, McCorkell) Department of
Critical Care, Guy's & St Thomas' National Health Service Foundation
Hospital, London, United Kingdom
(Arndt, Wulf) Department of Anesthesiology and Intensive Care Medicine
(Irqsusi) Department of Cardiac Surgery, University Hospital Marburg,
Marburg, Germany
(Monaco, Di Prima) Department of Anesthesia and Intensive Care, Istituto
di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific
Institute, Milan, Italy
(Garcia Alvarez, Italiano, Miralles Bagan) Department of Anesthesiology,
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(Kunst, Nair) Department of Anesthetics, King's College Hospital, Denmark
Hill, London, United Kingdom
(L'Acqua) Department of Anesthesia and Critical Care, Centro Cardiologico
Monzino Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
(Hoste, Vandenberghe) Department of Intensive Care Medicine, University
Hospital Gent, Gent, Belgium
(Honore) Department of Intensive Care, CHU Brugmann University Hospital,
Brussels, Belgium
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, PA, United States
(Forni) Department of Intensive Care Medicine, Royal Surrey County
Hospital & Faculty of Health Sciences, University of Surrey, Guildford,
United Kingdom
(Grieshaber) Department of Cardiac Surgery, University Hospital Giessen,
Giessen, Germany
(Gerss) Institute of Biostatistics and Clinical Research, University of
Munster, Munster, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Prospective, single-center trials have shown that the
implementation of the Kidney Disease: Improving Global Outcomes (KDIGO)
recommendations in high-risk patients significantly reduced the
development of acute kidney injury (AKI) after surgery. We sought to
evaluate the feasibility of implementing a bundle of supportive measures
based on the KDIGO guideline in high-risk patients undergoing cardiac
surgery in a multicenter setting in preparation for a large definitive
trial. METHOD(S): In this multicenter, multinational, randomized
controlled trial, we examined the adherence to the KDIGO bundle consisting
of optimization of volume status and hemodynamics, functional hemodynamic
monitoring, avoidance of nephrotoxic drugs, and prevention of
hyperglycemia in high-risk patients identified by the urinary biomarkers
tissue inhibitor of metalloproteinases-2 [TIMP-2] and insulin growth
factor-binding protein 7 [IGFBP7] after cardiac surgery. The primary end
point was the adherence to the bundle protocol and was evaluated by the
percentage of compliant patients with a 95% confidence interval (CI)
according to Clopper-Pearson. Secondary end points included the
development and severity of AKI. RESULT(S): In total, 278 patients
were included in the final analysis. In the intervention group, 65.4% of
patients received the complete bundle as compared to 4.2% in the control
group (absolute risk reduction [ARR] 61.2 [95% CI, 52.6-69.9]; P < .001).
AKI rates were statistically not different in both groups (46.3%
intervention versus 41.5% control group; ARR -4.8% [95% CI, -16.4 to 6.9];
P = .423). However, the occurrence of moderate and severe AKI was
significantly lower in the intervention group as compared to the control
group (14.0% vs 23.9%; ARR 10.0% [95% CI, 0.9-19.1]; P = .034). There were
no significant effects on other specified secondary outcomes.
 CONCLUSION(S): Implementation of a KDIGO-derived treatment bundle is
feasible in a multinational setting. Furthermore, moderate to severe AKI
was significantly reduced in the intervention group. Copyright ©
2021 International Anesthesia Research Society.

<64>
Accession Number
2008587761
Title
Perioperative nutritional prehabilitation in malnourished children with
congenital heart disease: A randomized controlled trial.
Source
Nutrition. 84 (no pagination), 2021. Article Number: 111027. Date of
Publication: April 2021.
Author
El-Ganzoury M.M.; El-Farrash R.A.; Ahmed G.F.; Hassan S.I.; Barakat N.M.
Institution
(El-Ganzoury, El-Farrash, Barakat) Pediatrics Departments Faculty of
Medicine, Ain Shams University, Cairo, Egypt
(Ahmed) National Nutrition Institute, Cairo, Egypt
(Hassan) Ministry of Health, Cairo, Egypt
Publisher
Elsevier Inc.
Abstract
Objective: The poor preoperative nutritional state of children with
congenital heart disease (CHD) is often exacerbated postoperatively. The
aim of this study was to evaluate the effect of perioperative 1- versus
2-wk nutritional prehabilitation programs on growth and surgical outcomes
in malnourished children with CHD. Method(s): Forty malnourished
infants scheduled for elective CHD surgery were randomized to receive
either 1 or 2 wk of a nutritional prehabilitation program. Pre- and
postoperative anthropometric parameters and feeding characteristics,
feeding tolerance, duration of mechanical ventilation, intensive care unit
(ICU) length of stay (LOS) and total hospital LOS were documented.
 Result(s): The 2-wk prehabilitation group showed higher
weight-for-age z-score and body mass index than the 1-wk group both
preoperatively postnutritional, and postoperatively with significantly
higher weight gain postoperatively. The 2-wk prehabilitation group had a
shorter duration of postoperative mechanical ventilation, ICU LOS, and
total hospital LOS. Conclusion(s): The 2-wk prehabilitation program
was associated with better anthropometric measurements, shorter ICU LOS
postoperatively, and shorter duration of hospitalization and mechanical
ventilation. The preoperative nutritional status of children with CHD had
a negative effect on ICU LOS and duration of mechanical
ventilation. Copyright © 2020 Elsevier Inc.

<65>
Accession Number
2010034241
Title
Carotid Intraplaque Neovascularization on Contrast-Enhanced Ultrasound
Correlates with Cardiovascular Events and Poor Prognosis: A Systematic
Review and Meta-analysis.
Source
Ultrasound in Medicine and Biology. 47 (2) (pp 167-176), 2021. Date of
Publication: February 2021.
Author
Yan H.; Wu X.; He Y.; Staub D.; Wen X.; Luo Y.
Institution
(Yan, Wu, He, Wen, Luo) Department of Medical Ultrasound, West China
Hospital, Sichuan University, Chengdu, China
(Staub) Department of Angiology, University Hospital Basel, University of
Basel, Basel, Switzerland
Publisher
Elsevier Inc.
Abstract
The goal of this meta-analysis is to investigate whether carotid
intraplaque neovascularization (IPN) on contrast-enhanced ultrasound
(CEUS) correlates with past cardiovascular events (CVEs) and prognosis.
The present meta-analysis included 22 studies involving 3232 patients. The
pooled analysis revealed that the presence of IPN was significantly
associated with a higher incidence of future CVEs (pooled relative risk =
3.28, 95% confidence interval [CI]: 2.28-4.73) and a lower event-free
probability (pooled hazard ratio = 2.51, 95% CI: 1.48-4.27). The presence
of IPN was significantly associated with higher rates of past cardiac
events (odds ratio = 4.25, 95% CI: 2.48-7.29) and past cerebrovascular
accidents (odds ratio = 4.83, 95% CI: 2.66-8.78). Our results suggest that
carotid IPN on CEUS significantly correlates with past cardiac events and
cerebrovascular accidents and can predict future CVEs. Carotid CEUS is
useful in CVE risk stratification. Copyright © 2020 World
Federation for Ultrasound in Medicine & Biology

<66>
Accession Number
2011317711
Title
Visual loss in patients undergoing cardiac surgery.
Source
Journal of Clinical Anesthesia. 71 (no pagination), 2021. Article Number:
110229. Date of Publication: August 2021.
Author
Zhang B.; He L.-X.; Yao Y.-T.
Institution
(Zhang) Department of Anesthesiology, Tianjin Union Medical Center,
Tianjin, China
(He, Yao) Department of Anesthesiology, Fuwai Hospital, National Center
for Cardiovascular Diseases, Peking Union Medical College and Chinese
Academy of Medical Sciences, Beijing, China
Publisher
Elsevier Inc.

<67>
Accession Number
2010240118
Title
Effects of a dual-filter-based cerebral embolic protection device in
transcatheter aortic valve replacement on cerebral oxygen saturation: A
prospective pilot study.
Source
Journal of Cardiac Surgery. 36 (4) (pp 1241-1248), 2021. Date of
Publication: April 2021.
Author
Voss S.; Ernst A.; Erlebach M.; Ruge H.; Sideris K.; Bleiziffer S.; Voss
B.; Tassani-Prell P.; Mayr N.P.
Institution
(Voss, Ernst, Erlebach, Ruge, Sideris, Voss) Department of Cardiovascular
Surgery, German Heart Center Munich, Technische Universitat Munchen,
Munich, Germany
(Voss, Ernst, Erlebach, Ruge, Sideris, Voss) Department of Cardiovascular
Surgery, Insure (Institute of Translational Cardiac Surgery), German Heart
Center Munich, Technische Universitat Munchen, Munich, Germany
(Bleiziffer) Clinic for Thoracic and Cardiovascular Surgery, Heart and
Diabetes Centre North Rhine Westphalia, Bad Oeynhausen, Germany
(Tassani-Prell, Mayr) Department of Anaesthesiology, German Heart Center
Munich, Technische Universitat Munchen, Munich, Germany
Publisher
Blackwell Publishing Inc.
Abstract
Purpose: The Sentinel Cerebral Protection System (Sentinel-CPS) is
increasingly used in transcatheter aortic valve replacement (TAVR).
However, the impact of inserting the Sentinel-CPS inside the
brain-supplying arteries on cerebral perfusion and oxygenation is unknown.
 Method(s): Twenty patients undergoing transfemoral TAVR with (n = 10)
and without (n = 10) cerebral embolic protection using the Sentinel-CPS
were prospectively observed. All patients received conscious sedation and
cerebral oxygen saturation (rSO<inf>2</inf>) was continuously measured
with near-infrared spectroscopy (NIRS). The cumulative perioperative
cerebral desaturation was calculated for each patient by multiplying
rSO<inf>2</inf> below an individualized desaturation threshold by time. In
addition, rSO<inf>2</inf> values at the time of Sentinel-CPS insertion,
filter positioning, and device retraction were analyzed. Result(s):
There was no significant difference in cumulative cerebral desaturation in
patients with Sentinel-CPS (median [IQR]) (0 [0/81] s%) and without
(median [IQR]) (0 [0/23] s%), p =.762. A total of 6 patients (33.3%)
experienced a perioperative decrease in rSO<inf>2</inf> below the
individualized desaturation threshold (n = 3 with Sentinel-CPS, n = 3
without Sentinel-CPS; p = 1.000). Cerebral desaturation was detected
during valve deployment (n = 5) and after postdilatation (n = 1). No
desaturation events occurred during Sentinel-CPS insertion, filter
positioning, or retraction. Conclusion(s): Our pilot study revealed
no difference in cumulative perioperative cerebral desaturation between
TAVR with and without Sentinel-CPS. Catheter- and filter-based
manipulations in the brain-supplying arteries for Sentinel-CPS application
were not associated with a decrease of cerebral perfusion and
oxygenation. Copyright © 2021 The Authors. Journal of Cardiac
Surgery published by Wiley Periodicals LLC

<68>
Accession Number
634288798
Title
Prophylactic corticosteroids for paediatric heart surgery with
cardiopulmonary bypass.
Source
Cochrane Database of Systematic Reviews. 2020 (10) (no pagination), 2020.
Article Number: CD013101. Date of Publication: 12 Oct 2020.
Author
Gibbison B.; Villalobos Lizardi J.C.; Aviles Martinez K.I.; Fudulu D.P.;
Medina Andrade M.A.; Perez-Gaxiola G.; Schadenberg A.W.L.; Stoica S.C.;
Lightman S.L.; Angelini G.D.; Reeves B.C.
Institution
(Gibbison) Department of Cardiac Anaesthesia and Intensive Care, Bristol
Heart Institute/University Hospitals Bristol NHS FT, Bristol, United
Kingdom
(Villalobos Lizardi, Aviles Martinez) Emergency Pediatric Department,
Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, Mexico
(Fudulu, Angelini) Department of Cardiac Surgery, University Hospital
Bristol NHS Trust, Bristol, United Kingdom
(Medina Andrade) Thoracic and Cardiovascular Department, Hospital Civil
Fray Antonio Alcalde de Guadalajara, Guadalajara, Mexico
(Perez-Gaxiola) Evidence-Based Medicine Department, Hospital Pediatrico de
Sinaloa, Culiacan, Mexico
(Schadenberg) Department of Paediatric Intensive Care, University Hospital
Bristol NHS Trust, Bristol, United Kingdom
(Stoica) Department of Paediatric Cardiac Surgery, University Hospital
Bristol NHS Trust, Bristol, United Kingdom
(Lightman) Henry Wellcome Laboratories for Integrative Metabolism and
Neuroscience, University of Bristol, Bristol, United Kingdom
(Reeves) School of Clinical Sciences, University of Bristol, Bristol,
United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Corticosteroids are routinely given to children undergoing
cardiac surgery with cardiopulmonary bypass (CPB) in an attempt to
ameliorate the inflammatory response. Their use is still controversial and
the decision to administer the intervention can vary by centre and/or by
individual doctors within that centre. Objective(s): This review is
designed to assess the benefits and harms of prophylactic corticosteroids
in children between birth and 18 years of age undergoing cardiac surgery
with CPB. Search Method(s): We searched CENTRAL, MEDLINE, Embase and
Conference Proceedings Citation Index-Science in June 2020. We also
searched four clinical trials registers and conducted backward and forward
citation searching of relevant articles. Selection Criteria: We
included studies of prophylactic administration of corticosteroids,
including single and multiple doses, and all types of corticosteroids
administered via any route and at any time-point in the perioperative
period. We excluded studies if steroids were administered therapeutically.
We included individually randomised controlled trials (RCTs), with two or
more groups (e.g. multi-drug or dose comparisons with a control group) but
not 'head-to-head' trials without a placebo or a group that did not
receive corticosteroids. We included studies in children, from birth up to
18 years of age, including preterm infants, undergoing cardiac surgery
with the use of CPB. We also excluded studies in patients undergoing heart
or lung transplantation, or both; studies in patients already receiving
corticosteroids; in patients with abnormalities of the
hypothalamic-pituitary-adrenal axis; and in patients given steroids at the
time of cardiac surgery for indications other than cardiac surgery.
 Data Collection and Analysis: We used the Covidence systematic review
manager to extract and manage data for the review. Two review authors
independently assessed studies for inclusion, extracted data, and assessed
risks of bias. We resolved disagreements by consensus or by consultation
with a third review author. We assessed the certainty of evidence with
GRADE. Main Result(s): We found 3748 studies, of which 888 were
duplicate records. Two studies had the same clinical trial registration
number, but reported different populations and interventions. We therefore
included them as separate studies. We screened titles and abstracts of
2868 records and reviewed full text reports for 84 studies to determine
eligibility. We extracted data for 13 studies. Pooled analyses are based
on eight studies. We reported the remaining five studies narratively due
to zero events for both intervention and placebo in the outcomes of
interest. Therefore, the final meta-analysis included eight studies with a
combined population of 478 participants. There was a low or unclear risk
of bias across the domains. There was moderate certainty of evidence that
corticosteroids do not change the risk of in-hospital mortality (five
RCTs; 313 participants; risk ratio (RR) 0.83, 95% confidence interval (CI)
0.33 to 2.07) for children undergoing cardiac surgery with CPB. There was
high certainty of evidence that corticosteroids reduce the duration of
mechanical ventilation (six RCTs; 421 participants; mean difference (MD)
11.37 hours lower, 95% CI -20.29 to -2.45) after the surgery. There was
high-certainty evidence that the intervention probably made little to no
difference to the length of postoperative intensive care unit (ICU) stay
(six RCTs; 421 participants; MD 0.28 days lower, 95% CI -0.79 to 0.24) and
moderate-certainty evidence that the intervention probably made little to
no difference to the length of the postoperative hospital stay (one RCT;
176 participants; mean length of stay 22 days; MD -0.70 days, 95% CI -2.62
to 1.22). There was moderate certainty of evidence for no effect of the
intervention on all-cause mortality at the longest follow-up (five RCTs;
313 participants; RR 0.83, 95% CI 0.33 to 2.07) or cardiovascular
mortality at the longest follow-up (three RCTs; 109 participants; RR 0.40,
95% CI 0.07 to 2.46). There was low certainty of evidence that
corticosteroids probably make little to no difference to children
separating from CPB (one RCT; 40 participants; RR 0.20, 95% CI 0.01 to
3.92). We were unable to report information regarding adverse events of
the intervention due to the heterogeneity of reporting of outcomes. We
downgraded the certainty of evidence for several reasons, including
imprecision due to small sample sizes, a single study providing data for
an individual outcome, the inclusion of both appreciable benefit and harm
in the confidence interval, and publication bias. Authors' conclusions:
Corticosteroids probably do not change the risk of mortality for children
having heart surgery using CPB at any time point. They probably reduce the
duration of postoperative ventilation in this context, but have little or
no effect on the total length of postoperative ICU stay or total
postoperative hospital stay. There was inconsistency in the adverse event
outcomes reported which, consequently, could not be pooled. It is
therefore impossible to provide any implications and policy-makers will be
unable to make any recommendations for practice without evidence about
adverse effects. The review highlighted the need for well-conducted RCTs
powered for clinical outcomes to confirm or refute the effect of
corticosteroids versus placebo in children having cardiac surgery with
CPB. A core outcome set for adverse event reporting in the paediatric
major surgery and intensive care setting is required. Copyright ©
2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<69>
[Use Link to view the full text]
Accession Number
634434288
Title
Neuromuscular electrical stimulation in early rehabilitation of patients
with postoperative complications after cardiovascular surgery: A
randomized controlled trial.
Source
Medicine (United States). 99 (42) (no pagination), 2020. Article Number:
e22769. Date of Publication: 2020.
Author
Sumin A.N.; Oleinik P.A.; Bezdenezhnykh A.V.; Ivanova A.V.
Institution
(Sumin, Oleinik, Bezdenezhnykh, Ivanova) Research Institute for Complex
Issues of Cardiovascular Diseases, 6 Sosnovy Boulevard, Kemerovo, Russian
Federation
Publisher
Lippincott Williams and Wilkins
Abstract
Background: To evaluate the effectiveness of neuromuscular electrical
stimulation (NMES) in early rehabilitation of patients with postoperative
complications after cardiovascular surgery. Method(s): 37 patients
(25 men and 12 women) aged 45 to 70 years with postoperative complications
after cardiovascular surgery were included in the study. Eighteen patients
underwent NMES daily since postoperative day 3 until discharge in addition
to standard rehabilitation program (NMES group), and 19 patients underwent
standard rehabilitation program only (non-NMES group). The primary outcome
was the knee extensors strength at discharge in NMES group and in control.
Secondary outcomes were the handgrip strength, knee flexor strength, and
cross-sectional area (CSA) of the quadriceps femoris in groups at
discharge. Result(s): Baseline characteristics were not different
between the groups. Knee extensors strength at discharge was significantly
higher in the NMES group (28.1 [23.8; 36.2] kg on the right and 27.45
[22.3; 33.1] kg on the left) than in the non-NMES group (22.3 [20.1; 27.1]
and 22.5 [20.1; 25.9] kg, respectively; P<.001). Handgrip strength, knee
flexor strength, quadriceps CSA, and 6 minute walk distance at discharge
in the groups had no significant difference. Conclusion(s): This
pilot study shows a beneficial effect of NMES on muscle strength in
patients with complications after cardiovascular surgery. The use of NMES
showed no effect on strength of non-stimulated muscle, quadriceps CSA, and
distance of 6-minute walk test at discharge. Further blind randomized
controlled trials should be performed with emphasis on the effectiveness
of NEMS in increasing muscle strength and structure in these
patients. Copyright © 2020 the Author(s).

<70>
Accession Number
2010311580
Title
Multicentre, randomized comparison of two-stent and provisional stenting
techniques in patients with complex coronary bifurcation lesions: The
DEFINITION II trial.
Source
European Heart Journal. 41 (27) (pp 2523-2536), 2020. Date of Publication:
14 Jul 2020.
Author
Zhang J.-J.; Ye F.; Xu K.; Kan J.; Tao L.; Santoso T.; Munawar M.;
Tresukosol D.; Li L.; Sheiban I.; Li F.; Tian N.-L.; Rodriguez A.E.;
Paiboon C.; Lavarra F.; Lu S.; Vichairuangthum K.; Zeng H.; Chen L.; Zhang
R.; Ding S.; Gao F.; Jin Z.; Hong L.; Ma L.; Wen S.; Wu X.; Yang S.; Yin
W.-H.; Zhang J.; Wang Y.; Zheng Y.; Zhou L.; Zhu Y.; Xu T.; Wang X.; Qu
H.; Tian Y.; Lin S.; Liu L.; Lu Q.; Li Q.; Li B.; Jiang Q.; Han L.; Gan
G.; Yu M.; Pan D.; Shang Z.; Zhao Y.; Liu Z.; Yuan Y.; Chen C.; Stone
G.W.; Han Y.; Chen S.-L.
Institution
(Zhang, Ye, Kan, Chen) Division of Cardiology, Nanjing First Hospital,
Nanjing Medical University, 68 Changle Road, Nanjing 210006, China
(Xu, Han) Division of Cardiology, General Hospital of Northern Theater
Command, Shenyang, China
(Tao) Division of Cardiology, Xijing Hospital, 4th Military Medical
University, Xi'an, China
(Santoso) Division of Cardiology, Medistra Hospital, University of
Indonesia Medical School, Jakarta, Indonesia
(Munawar) Division of Cardiology, Binawaluya Cardiac Center, Jakarta,
Indonesia
(Tresukosol) Division of Cardiology, Medicine Siriraj Hospital, Bangkok,
Thailand
(Li) Division of Cardiology, Guangzhou Red Cross Hospital, Guangzhou,
China
(Sheiban) Division of Cardiology, Pederzoli Hospital-Peschiera Del Garda,
Verona, Italy
(Li) Division of Cardiology, Oriental General Hospital, Huainan, China
(Tian) Division of Cardiology, Nanjing Heart Center, Nanjing, China
(Rodriguez) Division of Cardiology, Otamendi Hospital, Buenos Aires,
Argentina
(Paiboon) Division of Cardiology, Bangkok General Hospital, Bangkok,
Thailand
(Lavarra) Division of Cardiology, Jilin Cardiovascular Hospital,
Changchun, China
(Lu) Division of Cardiology, Taicang 1st People's Hospital, Taicang, China
(Vichairuangthum) Division of Cardiology, Bangplee Hospital, Bangkok,
Thailand
(Zeng) Division of Cardiology, Wuhan Tongji Hospital, United Medical
University, Wuhan, China
(Chen) Division of Cardiology, Fujian Medical University Union Hospital,
Fujian Institute of Coronary Artery Disease, Fujian Heart Medical Center,
Fuzhou, China
(Zhang) Division of Cardiology, Shanghai Ruijin Hospital, Shanghai
Communication University, Shanghai, China
(Ding) Division of Cardiology, Xinhua Hospital, Huainan, China
(Gao) Division of Cardiology, Gansu Provincial People's Hospital, Lanzhou,
China
(Jin) Division of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Hong) Division of Cardiology, Jiangxi Provincial People's Hospital,
Nanchang, China
(Ma) Division of Cardiology, Anhui Provincial Hospital, Hefei, China
(Wen) Division of Cardiology, Tianjin 4th Central Hospital, Tianjin, China
(Wu) Division of Cardiology, Wuxi 3rd People's Hospital, Wuxi, China
(Yang) Division of Cardiology, Yixing People's Hospital, Yixing, China
(Yin) Division of Cardiology, Cheng-Hsin General Hospital, Taipei, Taiwan
(Republic of China)
(Zhang) Division of Cardiology, Cangzhou Central Hospital, Cangzhou, China
(Wang) Division of Cardiology, Xiamen Cardiovascular Hospital, Xiamen
University, Xiamen, China
(Zheng) Division of Cardiology, Jintan Traditional Chinese Medicine
Hospital, Jintan, China
(Zhou) Division of Cardiology, Liyang Hospital of Traditional Chinese
Medicine, Liyang, China
(Zhou) Division of Cardiology, Chuzhou People's Hospital, Chuzhou, China
(Zhu) Division of Cardiology, Huaian 2nd People's Hospital, Huaian, China
(Xu) Division of Cardiology, Xinyang Central Hospital, Xinyang, China
(Wang) Division of Cardiology, Lianyungang Traditional Chinese Medicine
Hospital, Lianyungang, China
(Qu) Division of Cardiology, XuanCheng Central Hospital, Xuancheng, China
(Tian) Division of Cardiology, Xuyi People's Hospital, Xuyi, China
(Lin) Division of Cardiology, Jintan People's Hospital, Jintan, China
(Liu) Division of Cardiology, Huainan People's Hospital, Huainan, China
(Lu) Division of Cardiology, 2nd People's Hospital, Shandong University,
Jinan, China
(Li) Division of Cardiology, Changzhou Traditional Chinese Medicine
Hospital, China
(Li) Division of Cardiology, Affiliated Hospital of Guangdong Medical
University, Zhanjiang, China
(Jiang) Division of Cardiology, Anqing 1st People's Hospital, Anqing,
China
(Han) Division of Cardiology, Changshu People's Hospital, Changshu, China
(Gan) Division of Cardiology, 17th Metallurgical Hospital, Maanshan, China
(Yu) Division of Cardiology, Qingdao Campus of Fuwai Hospital, Qingdao,
China
(Pan) Division of Cardiology, Xuzhou 2nd People's Hospital, Xuzhou, China
(Shang) Division of Cardiology, Wuxi Huishan District People's Hospital,
Wuxi, China
(Zhao) Division of Cardiology, Nanjing 81 Hospital, Nanjing, China
(Liu) Division of Cardiology, Hongze People's Hospital, Huai'an, China
(Yuan) Trinity College, University of Toronto, Toronto, Canada
(Chen) Mailman School of Public Health, Columbia University, New York, NY,
United States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Ican School
of Medicine at Mount Sinai, New York, NY, United States
(Chen) College of Pharmacy, Nanjing Medical University, Nanjing, China
Publisher
Oxford University Press
Abstract
Aim: The present study aimed to assess the benefits of two-stent
techniques for patients with DEFINITION criteria-defined complex coronary
bifurcation lesions. Methods and Results: In total, 653 patients with
complex bifurcation lesions at 49 international centres were randomly
assigned to undergo the systematic two-stent technique (two-stent group)
or provisional stenting (provisional group). The primary endpoint was the
composite of target lesion failure (TLF) at the 1-year follow-up,
including cardiac death, target vessel myocardial infarction (TVMI), and
clinically driven target lesion revascularization (TLR). The safety
endpoint was definite or probable stent thrombosis. At the 1-year
follow-up, TLF occurred in 37 (11.4%) and 20 (6.1%) patients in the
provisional and two-stent groups, respectively [77.8%: double-kissing
crush; hazard ratio (HR) 0.52, 95% confidence interval (CI) 0.30-0.90; P =
0.019], largely driven by increased TVMI (7.1%, HR 0.43, 95% CI 0.20-0.90;
P = 0.025) and clinically driven TLR (5.5%, HR 0.43, 95% CI 0.19-1.00; P =
0.049) in the provisional group. At the 1 year after indexed procedures,
the incidence of cardiac death was 2.5% in the provisional group,
non-significant to 2.1% in the two-stent group (HR 0.86, 95% CI 0.31-2.37;
P = 0.772). Conclusion(s): For DEFINITION criteria-defined complex
coronary bifurcation lesions, the systematic two-stent approach was
associated with a significant improvement in clinical outcomes compared
with the provisional stenting approach. Further study is urgently
warranted to identify the mechanisms contributing to the increased rate of
TVMI after provisional stenting. Study registration:
http://www.clinicaltrials.com; Identifier: NCT02284750. Copyright
© 2020 Published on behalf of the European Society of Cardiology. All
rights reserved.

<71>
Accession Number
2010311439
Title
Clinical impact of conduction disturbances in transcatheter aortic valve
replacement recipients: A systematic review and meta-analysis.
Source
European Heart Journal. 41 (29) (pp 2771-2781), 2020. Date of Publication:
01 Aug 2020.
Author
Faroux L.; Chen S.; Muntane-Carol G.; Regueiro A.; Philippon F.;
Sondergaard L.; Jrgensen T.H.; Lopez-Aguilera J.; Kodali S.; Leon M.;
Nazif T.; Rodes-Cabau J.
Institution
(Faroux, Muntane-Carol, Philippon, Rodes-Cabau) Quebec Heart and Lung
Institute, Laval University, 2725 chemin Ste-Foy, Quebec City, QC G1V4G5,
Canada
(Chen, Kodali, Leon, Nazif) Columbia University Medical Center, New
York-Presbyterian Hospital, 177 Fort Washington Avenue, New York, NY
10032, United States
(Regueiro) Institut Clinic Cardiovascular, Hospital Clinic, Institut
d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Carrer de
Villaroel, 170, Barcelona 08036, Spain
(Sondergaard, Jrgensen) Rigshospitalet, University of Copenhagen,
Blegdamsvej 9, Copenhagen 2100, Denmark
(Lopez-Aguilera) Hospital Reina Sofia of Cordoba, Avenida Menendez Pidal,
Cordoba 14004, Spain
Publisher
Oxford University Press
Abstract
Aims: The clinical impact of new-onset persistent left bundle branch block
(NOP-LBBB) and permanent pacemaker implantation (PPI) on transcatheter
aortic valve replacement (TAVR) recipients remains controversial. We aimed
to evaluate the impact of (i) periprocedural NOP-LBBB and PPI post-TAVR on
1-year all-cause death, cardiac death, and heart failure hospitalization
and (ii) NOP-LBBB on the need for PPI at 1-year follow-up. Methods
and Results: We performed a systematic search from PubMed and EMBASE
databases for studies reporting raw data on 1-year clinical impact of
NOP-LBBB or periprocedural PPI post-TAVR. Data from 30 studies, including
7792 patients (12 studies) and 42 927 patients (21 studies) for the
evaluation of the impact of NOP-LBBB and PPI after TAVR were sourced,
respectively. NOP-LBBB was associated with an increased risk of all-cause
death [risk ratio (RR) 1.32, 95% confidence interval (CI) 1.17-1.49; P <
0.001], cardiac death (RR 1.46, 95% CI 1.20-1.78; P < 0.001), heart
failure hospitalization (RR 1.35, 95% CI 1.05-1.72; P = 0.02), and PPI (RR
1.89, 95% CI 1.58-2.27; P < 0.001) at 1-year follow-up. Periprocedural PPI
after TAVR was associated with a higher risk of all-cause death (RR 1.17,
95% CI 1.11-1.25; P < 0.001) and heart failure hospitalization (RR 1.18,
95% CI 1.03-1.36; P = 0.02). Permanent pacemaker implantation was not
associated with an increased risk of cardiac death (RR 0.84, 95% CI
0.67-1.05; P = 0.13). Conclusion(s): NOP-LBBB and PPI after TAVR are
associated with an increased risk of all-cause death and heart failure
hospitalization at 1-year follow-up. Periprocedural NOP-LBBB also
increased the risk of cardiac death and PPI within the year following the
procedure. Further studies are urgently warranted to enhance preventive
measures and optimize the management of conduction disturbances
post-TAVR. Copyright © 2020 Published on behalf of the European
Society of Cardiology. All rights reserved.

<72>
Accession Number
2011095559
Title
Hemoadsorption: Effective in reducing circulating fragments of the
endothelial glycocalyx during cardiopulmonary bypass in patients
undergoing on-pump cardiac surgery?.
Source
Minerva Anestesiologica. 87 (1) (pp 35-42), 2020. Date of Publication:
January 2021.
Author
Hohn A.; Baumann A.; Pietroschinsky E.; Franklin J.; Illerhaus A.;
Buchwald D.; Hinkelbein J.; Zahn P.K.; Annecke T.
Institution
(Hohn, Pietroschinsky, Illerhaus, Hinkelbein, Annecke) Faculty of
Medicine, University of Cologne, Cologne, Germany
(Hohn, Pietroschinsky, Hinkelbein, Annecke) Department of Anesthesiology
and Intensive Care Medicine, Cologne University Hospital, Cologne, Germany
(Hohn) Department of Anesthesiology and Intensive Care Medicine, Kliniken
Maria Hilf GmbH, Moenchengladbach, Germany
(Baumann, Zahn) Department of Anesthesiology, Intensive Care, Palliative
Care and Pain Medicine, BG University Hospital Bergmannsheil,
Ruhr-University Bochum, Bochum, Germany
(Franklin) Institute of Medical Statistics, Informatics and Epidemiology,
University of Cologne, Cologne, Germany
(Illerhaus) Department of Dermatology, Cologne University Hospital,
Cologne, Germany
(Buchwald) Department of Cardiac and Thoracic Surgery, BG University
Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
(Annecke) Department of Anesthesiology and Intensive Care Medicine,
Kliniken der Stadt Koln GmbH, University of Witten Herdecke, Cologne,
Germany
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: The vascular endothelial glycocalyx is susceptible to ischemia
and hypoxia. Released soluble components of the endothelial glycocalyx
(EG) have been identified as potential damage associated molecular
patterns (DAMPs) able to enhance an ongoing inflammatory response.
Shedding of the EG has been associated with released atrial-natriuretic
peptide (ANP) during cardiac surgery procedures. A novel hemoadsorption
technique (CytoSorb) has been shown to effectively remove molecules up to
55 kDa unspecifically from circulation. It is not known whether ANP or
glycocalyx components can be removed successfully by this technique.
 METHOD(S): In 15 patients undergoing on-pump cardiac surgery, the
hemoadsorption device was integrated in the cardiopulmonary bypass (CPB)
circuit. Pre- and post-adsorber concentrations of ANP, heparan sulphate
(HEP), syndecan-1 (SYN) and hyaluronan (HYA) were measured at 10 (T1), 30
(T2), and 60 (T3) minutes after aortic cross-clamping and complete CPB.
 RESULT(S): Hemoadsorption significantly reduced mean HEP
concentrations (-157.5 [333.4] ng/mL; P<0.001) post adsorber. For ANP and
SYN no statistically significant changes were detected whereas mean [SD]
HYA concentrations even increased significantly (+21.6 [43.0] ng/mL;
P<0.001) post adsorber. CONCLUSION(S): In this study representing a
real-life scenario, we could demonstrate that the novel hemoadsorption
device (CytoSorb) was able to effectively adsorb HEP from the circulation
if integrated in a CPB circuit. However, blood concentrations of HYA, SYN,
and ANP could not be reduced during CPB in our
investigation. Copyright © 2020 Edizioni Minerva Medica. All
rights reserved.

<73>
Accession Number
633405364
Title
Randomised sham-controlled double-blind trial evaluating remote ischaemic
preconditioning in solid organ transplantation: A study protocol for the
RIPTRANS trial.
Source
BMJ Open. 10 (11) (no pagination), 2020. Article Number: 038340. Date of
Publication: 16 Nov 2020.
Author
Uutela A.; Helantera I.; Lemstrom K.; Passov A.; Syrjala S.; Aberg F.;
Makisalo H.; Nordin A.; Lempinen M.; Sallinen V.
Institution
(Uutela, Helantera, Aberg, Makisalo, Nordin, Lempinen, Sallinen)
Department of Transplantation and Liver Surgery, Helsinki University
Hospital, University of Helsinki, Helsinki, Finland
(Lemstrom, Syrjala) Department of Cardiothoracic Surgery, Helsinki
University Hospital, University of Helsinki, Helsinki, Finland
(Passov) Department of Perioperative, Intensive Care and Pain Medicine,
Helsinki University Hospital, University of Helsinki, Helsinki, Finland
Publisher
BMJ Publishing Group
Abstract
Introduction Remote ischaemic preconditioning (RIPC) using a non-invasive
pneumatic tourniquet is a potential method for reducing
ischaemia-reperfusion injury. RIPC has been extensively studied in animal
models and cardiac surgery, but scarcely in solid organ transplantation.
RIPC could be an inexpensive and simple method to improve function of
transplanted organs. Accordingly, we aim to study whether RIPC performed
in brain-dead organ donors improves function and longevity of transplanted
organs. Methods and analyses RIPTRANS is a multicentre, sham-controlled,
parallel group, randomised superiority trial comparing RIPC intervention
versus sham-intervention in brain-dead organ donors scheduled to donate at
least one kidney. Recipients of the organs (kidney, liver, pancreas,
heart, lungs) from a randomised donor will be included provided that they
give written informed consent. The RIPC intervention is performed by
inflating a thigh tourniquet to 300 mm Hg 4 times for 5 min. The
intervention is done two times: first right after the declaration of brain
death and second immediately before transferring the donor to the
operating theatre. The sham group receives the tourniquet, but it is not
inflated. The primary endpoint is delayed graft function (DGF) in kidney
allografts. Secondary endpoints include short-term functional outcomes of
transplanted organs, rejections and graft survival in various time points
up to 20 years. We aim to show that RIPC reduces the incidence of DGF from
25% to 15%. According to this, the sample size is set to 500 kidney
transplant recipients. Ethics and dissemination This study has been
approved by Helsinki University Hospital Ethics Committee and Helsinki
University Hospital's Institutional Review Board. The study protocol was
be presented at the European Society of Organ Transplantation congress in
Copenhagen 14-15 September 2019. The study results will be submitted to an
international peer-reviewed scientific journal for publication. Trial
registration number NCT03855722. Copyright ©

<74>
Accession Number
2008595723
Title
Antitussive effect of a magnesium infusion during anesthetic emergence in
patients with double-lumen endotracheal tube: A randomized controlled
trial.
Source
Journal of Thoracic Disease. 12 (10) (pp 5691-5699), 2020. Date of
Publication: October 2020.
Author
Hur M.; Kim J.Y.; Kim D.H.; Yoo J.Y.; Shin H.-B.; Park B.; Kim M.; Park
E.; Park S.Y.
Institution
(Hur, Kim, Kim, Yoo, Kim, Park, Park) Department of Anesthesiology and
Pain Medicine, Ajou University, School of Medicine, Suwon, South Korea
(Shin, Park) Office of Biostatistics, Medical Research Collaboration
Center, Ajou Research Institute for Innovative Medicine, Ajou University
School of Medicine, Suwon, South Korea
Publisher
AME Publishing Company
Abstract
Background: A double-lumen endotracheal tube (DLT) inserted into the
bronchus can stimulate the respiratory tracts, causing coughing. Opioids
have been introduced to prevent emergence cough. However, the
administration of a significant opioid dose at the end of surgery may
result in undesirable events. Magnesium, common intracellular ion,
suppress bronchial smooth muscle contraction and have antitussive effect.
We investigated the antitussive effects of a magnesium infusion during
anesthetic emergence in patients who underwent thoracic surgery requiring
one-lung ventilation (OLV) anesthesia with a DLT. Method(s):
One-hundred forty patients undergoing OLV anesthesia with a DLT were
enrolled in this prospective, randomized double-blinded trial. In
combination with a low dose of remifentanil, patients were randomly
allocated to receive either magnesium sulphate (infusion of 15 mg/kg/hour
after a single bolus of 30 mg/kg) or normal saline during the operation
and emergence. Primary outcomes were the severity and incidence of cough
during emergence. Result(s): The severity of cough was assessed by
the cough severity grading score: 0, no cough; 1, single cough; 2, cough
persistence <5 seconds; 3, cough persistence >=5 seconds. There was a
significant difference in the severity score of cough between the groups
[median (IQR): 2 (0 to 3) in control group vs. 0 (0 to 1) in magnesium
group, P=0.003]. However, there was no significant difference in the
overall incidence of cough between both groups [42 (64.6%) in control
group vs. 31 (47.7%) in magnesium group, P=0.077]. Conclusion(s):
Magnesium attenuated the severity of cough during emergence after OLV
anesthesia using a DLT without adverse events. Copyright © 2020
AME Publishing Company. All rights reserved.

<75>
Accession Number
2008595715
Title
Obstructive sleep apnea-induced multi-organ dysfunction after elective
coronary artery bypass surgery in coronary heart disease patients.
Source
Journal of Thoracic Disease. 12 (10) (pp 5603-5616), 2020. Date of
Publication: October 2020.
Author
Wang J.; Wang X.; Yu W.; Zhang K.; Wei Y.
Institution
(Wang, Yu, Zhang) Department of Cardiac Surgery, Beijing An Zhen Hospital,
Capital Medical University, Beijing, China
(Wang) Center for Cardiac Intensive Care, Beijing An Zhen Hospital,
Capital Medical University, Beijing, China
(Wang) Department of General Surgery, Chinese PLA general hospital,
Beijing, China
(Wei) Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(Wei) Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen
Hospital, Capital Medical University, 2 Anzhen Road, Chaoyang District,
Beijing 100029, China
Publisher
AME Publishing Company
Abstract
Background: The aim of this study was to explore the underlying impact of
obstructive sleep apnea (OSA) on postoperative parameters of multi-organ
function among coronary heart disease (CHD) patients following elective
coronary artery bypass grafting (CABG). Method(s): Electronic
literature databases were searched manually and automatically for relevant
English articles. All of the included articles focused on a comparison of
the incidence of postoperative parameters of multi-organ function in CHD
patients undergoing elective CABG with and without OSA. Studies were
excluded if they met any one of the following criteria: (I) duplicate
publication; (II) ongoing or unpublished studies; (III) only published as
abstracts or conference proceedings; and (IV) less than 30 patients in the
patient cohort. Result(s): A total of 13 articles met our inclusion
criteria. The current study demonstrated OSA significantly increased the
incidence of major adverse cardiac and cerebrovascular events (MACCEs) in
CHD patients undergoing elective CABG compared with the controls [odds
risk (OR), 1.97; 95% CI, 1.50 to 2.59, P<0.0001]. In addition, OSA was
associated with an increased risk of new revascularization in CHD patients
undergoing elective CABG (OR, 9.47; 95% CI, 2.69 to 33.33, P<0.0001).
Moreover, reintubation and tracheostomy in the OSA group was increased
243% (OR, 3.43; 95% CI, 1.35 to 8.71; P=0.009) and 372% (OR, 4.72; 95% CI,
1.23 to 18.13; P=0.024), respectively, compared with the control group.
Besides, we also confirmed OSA significantly increased the acute kidney
injury (AKI) incidence by 124% (OR, 2.24; 95% CI, 1.07 to 4.72; P<0.0001).
 Conclusion(s): OSA may contribute to postoperative multi-organ
dysfunction among CHD patients undergoing elective CABG by increasing the
incidence of MACCEs, especially new revascularization, as well as
respiratory, and renal complications. Copyright © 2020 AME
Publishing Company. All rights reserved.

<76>
Accession Number
2010719472
Title
Intranasal Fentanyl for Intervention-Associated Breakthrough Pain After
Cardiac Surgery.
Source
Clinical Pharmacokinetics. (no pagination), 2021. Date of Publication:
2021.
Author
Valtola A.; Laakso M.; Hakomaki H.; Anderson B.J.; Kokki H.; Ranta V.-P.;
Rinne V.; Kokki M.
Institution
(Valtola, Laakso) Heart Centre, Kuopio University Hospital, Kuopio,
Finland
(Laakso, Kokki) School of Medicine, University of Eastern Finland, Kuopio,
Finland
(Hakomaki, Ranta) School of Pharmacy, University of Eastern Finland,
Kuopio, Finland
(Rinne) Admescope Ltd, Oulu, Finland
(Anderson) Department of Anaesthesiology, University of Auckland,
Auckland, New Zealand
(Kokki) Department of Anaesthesia and Intensive Care, Kuopio University
Hospital, KYS, PO Box 100, Kuopio 70029, Finland
Publisher
Adis
Abstract
Background: Cardiac bypass surgery patients have early postoperative
interventions that elicit breakthrough pain. We evaluated the use of
intranasal fentanyl for breakthrough pain management in these patients.
 Method(s): Multimodal analgesia (paracetamol 1 g three times a day,
oxycodone 2-3 mg boluses with a patient-controlled intravenous pump) was
used in 16 patients (age 49-70 years, weight 59-129 kg) after cardiac
bypass surgery. Intranasal fentanyl 100 microg or 200 microg was used to
manage breakthrough pain on the first and third postoperative mornings in
a randomised order. Blood samples were collected for up to 3 h after
fentanyl administration, pain was assessed with a numeric rating scale of
0-10. Plasma fentanyl concentration was assayed using liquid
chromatography-mass spectrometry. Body composition was measured with a
bioelectrical impedance device. Result(s): Bioavailability of
intranasal fentanyl was high (77%), absorption half-time short (< 2 min)
and an analgesic plasma concentration >= 0.5 ng/mL was achieved in 31 of
32 administrations. Fentanyl exposure correlated inversely with skeletal
muscle mass and total body water. Fentanyl analgesia was effective both on
the first postoperative morning with chest pleural tube removal and during
physiotherapy on the third postoperative morning. The median time of
subsequent oxycodone administration was 1.1 h after intranasal fentanyl
100 microg and 2.1 h after intranasal fentanyl 200 microg, despite similar
oxycodone concentrations (median 13.8, range 5.2-35 ng/mL) in both
fentanyl dose groups. Conclusion(s): Intranasal fentanyl 100 microg
provided rapid-onset analgesia within 10 min and is an appropriate
starting dose for incidental breakthrough pain in the first 3
postoperative days after cardiac bypass surgery. Clinical Trial
Registration: EudraCT Number: 2018-001280-22. Copyright © 2021,
The Author(s).

<77>
[Use Link to view the full text]
Accession Number
633089585
Title
A Comparison of the Required Bronchial Cuff Volume Obtained by 2 Cuff
Inflation Methods, Capnogram Waveform-Guided Versus Pressure-Guided: A
Prospective Randomized Controlled Study.
Source
Anesthesia and analgesia. 132 (3) (pp 827-835), 2021. Date of Publication:
01 Mar 2021.
Author
Yamada Y.; Tanabe K.; Nagase K.; Ishihara T.; Iida H.
Institution
(Yamada, Tanabe, Nagase, Iida) From the Department of Anesthesiology and
Pain Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
(Ishihara) Gifu University Hospital Innovative and Clinical Research
Promotion Center, Gifu University, Gifu, Japan
Publisher
NLM (Medline)
Abstract
BACKGROUND: Double-lumen endobronchial tubes (DLTs) are used for one-lung
ventilation (OLV) during thoracic surgery. Overinflation into the
bronchial cuff causes damage to the tracheobronchial mucosa, whereas
underinflation leads to an incomplete collapse of the nonventilated lung
or incomplete ventilation of the ventilated lung. However, how to
determine the appropriate bronchial cuff volume and pressure during OLV is
unclear. The objective of this study is to compare the required bronchial
cuff volume for lung separation obtained by 2 different cuff inflation
methods under closed- and open-chest conditions. METHOD(S): A total
of 64 patients scheduled to undergo elective thoracic surgery requiring
OLV were recruited. Left DLTs were used for both right- and left-sided
surgery. The patients were randomly assigned to 1 of 2 inflation-type
groups to estimate the bronchial cuff volume. In the capnogram
waveform-guided bronchial cuff inflation group (capno group, n = 27), the
bronchial cuff was inflated until a capnometer sampling gas containing CO2
from the nonventilated lung displayed a flat line. The corresponding
bronchial cuff volume and pressure were then recorded. In the
pressure-guided bronchial cuff inflation group (pressure group, n = 29),
the bronchial cuff was inflated by a cuff inflator to a pressure of 20 cm
H2O. Lung separation was confirmed when a flat line of a capnometer was
observed after gas sampling from the nonventilated lung. RESULT(S):
Under closed-chest conditions, the bronchial cuff sealing volume for the
capno group was significantly lower than that for the pressure group (mean
[standard deviation {SD}], 1.00 [0.65] mL vs 1.44 [0.59] mL, mean
difference, -0.44; 97.5% confidence interval [CI], -0.78 to -0.11; P =
.010). Under open-chest conditions, the bronchial cuff sealing volume for
the capno group was also significantly lower than that for the pressure
group (mean [SD], 0.65 [0.66] mL vs 1.22 [0.45] mL, mean difference,
-0.58; 97.5% CI, -0.88 to -0.27; P < .001). CONCLUSION(S): The lowest
cuff volume providing an air-tight bronchial seal was obtained by the
capnogram waveform-guided bronchial cuff inflation method. Since the cuff
volume required to achieve an air-tight seal decreases after opening the
chest, readjustment of the bronchial cuff volume to prevent bronchial cuff
damage to the tracheobronchial mucosa after opening the chest may be
advisable. Copyright © 2020 International Anesthesia Research
Society.

<78>
Accession Number
632045316
Title
Prognostic Assessment of Right Ventricular Systolic Dysfunction on
Post-Transcatheter Aortic Valve Replacement Short-Term Outcomes:
Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. 9 (12) (pp e014463), 2020. Date
of Publication: 16 Jun 2020.
Author
Grevious S.N.; Fernandes M.F.; Annor A.K.; Ibrahim M.; Saint Croix G.R.;
de Marchena E.; G Cohen M.; Alfonso C.E.
Institution
(Grevious, Ibrahim, Alfonso) Cardiovascular Division Department of
Medicine Boston University School of Medicine Boston MA
(Fernandes, Alfonso) Cardiovascular Division Department of Medicine Emory
University School of Medicine Atlanta GA
(Annor) Department of Medicine Baylor College of Medicine Houston TX
(Saint Croix, de Marchena, G Cohen) Department of Medicine University of
Miami Miller School of Medicine Miami FL
(de Marchena, G Cohen) Cardiovascular Division Department of Medicine
University of Miami Miller School of Medicine Miami FL
Publisher
NLM (Medline)
Abstract
Background Right ventricular systolic dysfunction (RVSD) is a known risk
factor for adverse outcome in surgical aortic valve replacement.
Transcatheter aortic valve replacement (TAVR), on the other hand, has been
shown to be either beneficial or have no effect on right ventricular
systolic function. However, the prognostic significance of RVSD on TAVR
has not been clearly determined. We conducted a systematic review and
meta-analysis to define the impact of RVSD on outcomes in terms of 1-year
mortality in patients with severe aortic stenosis undergoing TAVR. Methods
and Results An extensive literature review was performed, with an aim to
identify clinical studies that focused on the prognosis and short-term
mortality of patients with severe symptomatic aortic stenosis who
underwent TAVR. A total of 3166 patients from 8 selected studies were
included. RVSD, as assessed with tricuspid annular plane systolic
excursion, fractional area change or ejection fraction, was found to be a
predictor of adverse procedural outcome after TAVR (hazard ratio, 1.31;
95% CI, 1.1-1.55; P=0.002). Overall, we found that RVSD did affect
post-TAVR prognosis in 1-year mortality rate. Conclusions Patients with
severe, symptomatic aortic stenosis and concomitant severe RVSD have a
poor 1-year post-TAVR prognosis when compared with patients without RVSD.
Right ventricular dilation and severe tricuspid regurgitation were
associated with increased 1-year morality post-TAVR and should be
considered as independent risk factors. Further evaluations of long-term
morbidity, mortality, as well as sustained improvement in functional class
and symptoms need to be conducted to determine the long-term effects.

<79>
Accession Number
2011412415
Title
Estimating the risk of conversion from video-assisted thoracoscopic lung
surgery to thoracotomy-a systematic review and meta-analysis.
Source
Journal of Thoracic Disease. 13 (2) (pp 812-823), 2021. Date of
Publication: February 2021.
Author
Power A.D.; Merritt R.E.; Abdel-Rasoul M.; Moffatt-Bruce S.D.; D'Souza
D.M.; Kneuertz P.J.
Institution
(Power, Merritt, Moffatt-Bruce, D'Souza, Kneuertz) Division of Thoracic
Surgery, Department of Surgery, The Ohio State University Wexner Medical
Center, Columbus, OH, United States
(Abdel-Rasoul) Center for Biostatistics, The Ohio State University College
of Medicine, Columbus, OH, United States
Publisher
AME Publishing Company
Abstract
Background: Understanding the risk of conversion from video-assisted
thoracic surgery (VATS) to thoracotomy is important when considering
patient selection and preoperative surgical risk assessment. This review
aims to estimate the rate of intraoperative conversions to thoracotomy,
predictive factors, and associated outcomes for VATS anatomic lung
resections. Method(s): PubMed/MEDLINE and EMBASE were searched
systematically in May of 2020. Observational studies examining conversions
of VATS anatomic resections to thoracotomy were included. Conversion
rates, causes, risk factors, and post-operative outcomes were reviewed and
analyzed in aggregate. Result(s): Twenty retrospective studies were
reviewed, with a total of 72,932 patients undergoing VATS anatomic lung
resection. The median conversion rate was 9.6% (95% CI: 6.6-13.9%). Nine
studies reported a total of 114 emergency conversions, with a median
incidence rate of 1.3% (95% CI: 0.6-2.8%). The most common reasons for
thoracotomy were vascular injury/bleeding, difficulty lymph node
dissection, and adhesions, accounting for 27.9%, 26.2% and 19% of
conversions, respectively. Risk factors for conversion varied, but
frequently included nodal disease, large tumors, and induction therapy.
The risk of complications (OR 2.06; 95% CI: 1.77-2.40) and mortality (OR
4.11; 95% CI: 1.59-10.61) were significantly increased following
conversions. There was also a significant increase in chest tube duration
and length of stay following conversion. Conclusion(s): The risk of
conversion to thoracotomy may be as high as one in ten patients undergoing
VATS anatomic lung resections, but may vary significantly based on patient
selection. Although emergent conversions are rare, the need for
thoracotomy may significantly increase postoperative morbidity and
mortality. Copyright © 2021 Journal of Thoracic Disease. All
rights reserved.

<80>
Accession Number
2011409173
Title
A systematic review of the quality of cardiovascular surgery studies that
extracted data from the MAUDE database.
Source
Journal of Vascular Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Ziapour B.; Zaepfel C.; Iafrati M.D.; Suarez L.B.; Salehi P.
Institution
(Ziapour) Department of General Surgery, Allegheny General Hospital,
Pittsburgh, Pa, United States
(Zaepfel) Tufts Medical Center, Boston, MA, United States
(Iafrati, Salehi) Division of Vascular Surgery, Cardiovascular Center at
Tufts Medical Center, Boston, MA, United States
(Suarez) Cardiovascular Center at Tufts Medical Center, Boston, MA, United
States
Publisher
Mosby Inc.
Abstract
Objective: To investigate opportunities and limitations of using the
Manufacturer and User Facility Device Experience (MAUDE) database for
cardiovascular surgery research, we analyzed the quality of studies having
ever used MAUDE, in the field of cardiovascular surgery. Method(s):
We systematically searched the Cochrane Library, PubMed, EMBASE, and
Google Scholar for randomized and nonrandomized studies, from inception to
July 2019. Two authors evaluated the quality of the retrieved
observational studies, according to the National Institutes of Health
quality assessment tool for either case series or cross-sectional studies.
These tools quantify the quality of case series and
cohorts/cross-sectional studies, respectively, with nine and 14 queries.
 Result(s): Fifty-eight studies were included in the final qualitative
review. Of 58 identified studies, 32 were case series, 8 were abstracts of
case series, and 13 were reviews or case discussion with an included
series from MAUDE. Also, five articles were cross-sectional studies. Of
the 32 formal case series, 26 (81%) were found to have poor quality. The
most common reasons for a poor quality designation included a lack of
consecutive participants, undetermined comparability of participants, and
undetermined follow-up adequacy. Only one out of five cross-sectional
studies had fair quality; four others were evaluated as poor quality
studies. Conclusion(s): Cardiovascular surgery studies using the
MAUDE database, whether case series or cross-sectional design, are mostly
of poor quality. Their low quality is partly caused by poor study design,
but mainly by intrinsic limitations to the MAUDE database: cases recruited
are not consecutive; patient characteristics are not detailed enough to
allow a meaningful comparison of patient characteristics between different
patient entries; outcome measures are unclear; there is a limited
follow-up; and time-to-event data are lacking. We conclude that the
quality of cardiovascular surgery publications that rely on data from
MAUDE could be improved if investigators were to extract all relevant data
points from MAUDE entries, then apply standard quality assessment tools in
compiling and reporting the data. MAUDE might be improved if it used
medical case report standards during the process of reporting and indexing
adverse events. To calculate the incidence rate of any adverse event, all
event-free cases, as well as all adverse events in patients using a
device, are required. Neither of these two variables is available in the
MAUDE at the time of writing. Copyright © 2021 Society for
Vascular Surgery

<81>
Accession Number
2006727190
Title
Platelet quiescence in patients with acute coronary syndrome undergoing
coronary artery bypass graft surgery.
Source
Journal of the American Heart Association. 10 (5) (pp 1-4), 2021. Article
Number: e016602. Date of Publication: 2021.
Author
Sarathy K.; Wells G.A.; Singh K.; Couture E.; Chong A.Y.; Rubens F.;
Lordkipanidze M.; Tanguay J.-F.; So D.
Institution
(Sarathy, Wells, Chong, Rubens, So) University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Singh) Gold Coast University Hospital, QLD, Australia
(Couture) Universite de Sherbrooke, Sherbrooke, QC, Canada
(Lordkipanidze, Tanguay) Montreal Heart Institute, Montreal, QC, Canada
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The optimal antiplatelet strategy for patients with acute
coronary syndromes who require coronary artery bypass surgery remains
unclear. While a more potent antiplatelet regimen will predispose to
perioperative bleeding, it is hypothesized that through "platelet
quiescence," ischemic protection conferred by such therapy may provide a
net clinical benefit. METHODS AND RESULTS: We compared patients undergoing
coronary artery bypass surgery who were treated with a more potent
antiplatelet inhibition strategy with those with a less potent inhibition
through a meta-analysis. The primary outcome was all-cause mortality after
bypass surgery. The analysis identified 4 studies in which the
antiplatelet regimen was randomized and 6 studies that were nonrandomized.
Combining all studies, there was an overall higher mortality with weaker
strategies compared with more potent strategies (odds ratio, 1.38; 95% CI,
1.03-1.85; P=0.03). CONCLUSION(S): Our findings support the concept
of platelet quiescence, in reducing mortality for patients with acute
coronary syndrome requiring coronary artery bypass surgery. This suggests
the routine up-front use of potent antiplatelet regimens in acute coronary
syndrome, irrespective of likelihood of coronary artery bypass
graft. Copyright © 2021 The Authors. Published on behalf of the
American Heart Association, Inc., by Wiley.

<82>
Accession Number
2006726895
Title
Effect of melatonin on delirium after on-pump coronary artery bypass graft
surgery: A randomized clinical trial.
Source
Iranian Journal of Medical Sciences. 46 (2) (pp 120-127), 2021. Date of
Publication: 2021.
Author
Zadeh F.J.; Janatmakan F.; Shafaeebejestan E.; Jorairahmadi S.
Institution
(Zadeh, Janatmakan, Shafaeebejestan, Jorairahmadi) Department of
Anesthesia, Ahvaz Anesthesiology and Pain Research Center, Ahvaz
Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic Republic
of
Publisher
Shriaz University of Medical Sciences
Abstract
Background: Patients undergoing cardiac surgery are particularly prone to
delirium. This study aimed to evaluate the effect of melatonin
administration on the inhibition of postoperative delirium in patients
undergoing open-heart surgery. Method(s): This study was conducted as
a double-blind randomized clinical trial in Golestan Hospital. Ahvaz,
Iran, (September 2018 to March 2019). Sixty patients undergoing elective
on-pump coronary artery bypass graft surgery were enrolled in the study,
and they were randomly divided into a group receiving 3 mg of melatonin
and a group receiving a placebo. The main outcomes were delirium
occurrence and delirium intensity up to 48 hours after extubation. The
data were analyzed using SPSS, version 22, (SPSS, Chicago, IL). Group
comparisons were performed using the t test and the Chi-square test.
Statistical significance was defined as a P value of less than 0.05.
 Result(s): On the first postoperative day, delirium developed in four
(13.3%) patients in the melatonin group and 11 (36.6%) patients in the
control group; the difference between the groups was statistically
significant (P=0.037). On the second postoperative day, delirium developed
in three (10%) patients in the melatonin group and 14 (46.6%) patients in
the control group, with the difference in the incidence of delirium
between the groups constituting statistical significance (P=0.029). The
severity of delirium between group was significant on the first and second
postoperative days (P=0.003). Conclusion(s): Melatonin may be
effective in reducing the severity of delirium after cardiac surgery. The
effect of melatonin as a delirium prevention agent should be considered in
patients admitted in the cardiovascular intensive care. Trial Registration
Number: IRCT20180909040979N3. Copyright © 2021, Shriaz University
of Medical Sciences. All rights reserved.

<83>
Accession Number
634475740
Title
Preoperative Statin Therapy for Atrial Fibrillation and Renal Failure
after Cardiac Surgery.
Source
Thoracic and Cardiovascular Surgeon. 69 (2) (pp 141-147), 2021. Date of
Publication: 01 Mar 2021.
Author
Kuhn E.W.; Liakopoulos O.J.; Choi Y.-H.; Rahmanian P.; Eghbalzadeh K.;
Slottosch I.; Deppe A.C.; Wahlers T.C.W.
Institution
(Kuhn, Liakopoulos, Choi, Rahmanian, Eghbalzadeh, Slottosch, Deppe,
Wahlers) Department of Cardiothoracic Surgery, Heart Center of the
University Hospital of Cologne, Cologne, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Performing cardiac surgery in patients with cardiovascular
risk factors incorporates a steady risk for the development of
postoperative complications. Perioperative statin intake was associated
with an improvement of perioperative outcomes in these patients. However,
the European Association for Cardio-Thoracic Surgery guidelines regarding
the perioperative statin treatment were changed recently due to large
studies reporting about relevant adverse effects related to statin
therapy. Method(s): All relevant databases were searched including
the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and
the metaRegister of Controlled Trials. Various registries were screened
(National Research Register, the ClinicalTrials.gov, and gray literature)
with search on online conference indices of relevant scientific meetings.
No language restrictions were applied. Result(s): We identified 10
randomized controlled studies summarizing 3,468 participants undergoing
various kinds of cardiac surgical procedures. All included studies
presented with marked differences regarding study design. Pooled analysis
indicated that statin pretreatment was associated with a formally reduced
incidence of postoperative atrial fibrillation (AF) (odds ratio [OR] 0.63,
95% confidence interval [CI] 0.39-1.00; p = 0.05) but with an increased
incidence of renal failure (OR 1.20, 95% CI 1.01-1.44; p = 0.04) compared
with control. Substantial heterogeneity was observed among studies
reporting about AF. Conclusion(s): Current but sparse evidence
reveals that statin pretreatment is associated with a higher rate of
postoperative renal failure compared with control therapy but is
ineffective to substantially reduce postoperative AF. Given the relevant
heterogeneity among included studies, statin pretreatment cannot be
generally recommended. Copyright © 2021 Georg Thieme Verlag. All
rights reserved.

<84>
Accession Number
634475739
Title
Perioperative Beta-Blocker for Atrial Fibrillation after Cardiac Surgery:
A Meta-Analysis.
Source
Thoracic and Cardiovascular Surgeon. 69 (2) (pp 133-140), 2021. Date of
Publication: 01 Mar 2021.
Author
Kim S.H.; Jang M.-J.; Hwang H.Y.
Institution
(Kim, Hwang) Department of Thoracic and Cardiovascular Surgery, Seoul
National University Hospital, Seoul, South Korea
(Jang) Medical Research Collaborating Center, Seoul National University
Hospital, Seoul, South Korea
Publisher
Georg Thieme Verlag
Abstract
Background: This meta-analysis was conducted to evaluate the impact of
perioperative use of beta-blocker (BB) on postoperative atrial
fibrillation (POAF) after cardiac surgery other than isolated coronary
artery bypass grafting (CABG). Method(s): Five online databases were
searched. Studies were included if they (1) enrolled patients who
underwent cardiac surgery other than isolated CABG and (2) demonstrated
the impact of perioperative use of BB on POAF based on the randomized
controlled trial or adjusted analysis. The primary outcome was the
occurrence rates of POAF after cardiac surgery. A meta-regression and
subgroup analysis were performed according to the proportion of patients
with cardiac surgery other than isolated CABG and the timing of BB use,
respectively. Result(s): Thirteen articles (5 randomized and 8
nonrandomized studies: n = 25,496) were selected. Proportion of enrolled
patients undergoing cardiac surgery other than isolated CABG ranged from 7
to 100%. The BBs were used in preoperative, postoperative, and both
periods in 5, 5, and 3 studies, respectively. The pooled analyses showed
that the risk of POAF was significantly lower in patients with
perioperative BB than those without (odds ratio, 95% confidence interval =
0.56, 0.35-0.91 and 0.70, 0.55-0.91 in randomized and nonrandomized
studies, respectively). The risk of POAF was lower in the BB group
irrespective of the proportion of nonisolated CABG. Benefit regarding
in-hospital mortality was inconclusive. Perioperative stroke and length of
stay were not significantly different between BB and non-BB groups.
 Conclusion(s): Perioperative use of BB is effective in preventing
POAF even in patients undergoing cardiac surgery other than isolated CABG,
although it did not translate into improved clinical
outcomes. Copyright © 2021 Georg Thieme Verlag. All rights
reserved.

<85>
Accession Number
634514103
Title
RenalGuard system and conventional hydration for preventing
contrast-associated acute kidney injury in patients undergoing cardiac
interventional procedures: A systematic review and meta-analysis.
Source
International journal of cardiology. (no pagination), 2021. Date of
Publication: 01 Mar 2021.
Author
Wang Y.; Guo Y.
Institution
(Wang, Guo) Department of Cardiovascular Surgery, West China Hospital,
Sichuan University, Chengdu, Sichuan, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Contrast-associated acute kidney injury (CA-AKI) can increase
the mortality of patients undergoing transcatheter aortic valve
replacement (TAVR) or percutaneous coronary intervention (PCI). The
purpose of this paper was to compare the efficacy of the RenalGuard System
and conventional hydration regimen in preventing CA-AKI in patients with
TAVR or PCI. METHOD(S): We searched PubMed, Embase, Web of Science,
and the Cochrane Central Register of Clinical Trials (last updated July
11, 2020) for suitable reports. The primary outcome was the occurrence of
CA-AKI. The secondary outcomes were renal replacement therapy (RRT), major
cardiovascular events (MACEs), and other adverse complications.
 RESULT(S): The search strategy yielded 270 studies (with data for
2067 participants). In the subgroup of PCI, low incidence of CA-AKI (6.7%
vs 15.7%; 95%CI: 0.27 to 0.54; I2=8%; P<0.00001) associate with RenalGuard
group (RG) rather than control group (CG). Similarly, in the subgroup of
TAVR, a low incidence of CA-AKI (15.6% vs 26.9%; 95%CI: 0.35 to 0.82;
I2=88%; P=0.004) relates to RG. However, this result is highly
heterogeneous. Compare with conventional hydration, RenalGuard
significantly reduce the incidence of pulmonary edema (1.5%vs4.1%; 95%CI:
0.18 to 0.72; I2=0%; P=0.004). CONCLUSION(S): RenalGuard System can
lessen the risk of CA-AKI and RRT in patients undergoing PCI. But for
patients experiencing TAVR, due to unique hemodynamic effects, the role of
RenalGuard remains questionable. RenalGuard is more secure than
conventional hydration. Future work should elucidate the feasibility and
safety of this prophylactic intervention in cardiac interventional
therapy. Copyright © 2021. Published by Elsevier B.V.

<86>
Accession Number
634511076
Title
Meta-Analysis of Stroke and Mortality Rates in Patients Undergoing
Valve-in-Valve Transcatheter Aortic Valve Replacement.
Source
Journal of the American Heart Association. (pp e019512), 2021. Date of
Publication: 08 Mar 2021.
Author
Macherey S.; Meertens M.; Mauri V.; Frerker C.; Adam M.; Baldus S.;
Schmidt T.
Institution
(Macherey, Meertens, Mauri, Frerker, Adam, Baldus, Schmidt) Department III
of Internal Medicine University Hospital of Cologne Cologne Germany
Publisher
NLM (Medline)
Abstract
Background During the past decade, the use of transcatheter aortic valve
replacement (TAVR) was extended beyond treatment-naive patients and
implemented for treatment of degenerated surgical bioprosthetic valves.
Selection criteria for either valve-in-valve (viv) TAVR or redo surgical
aortic valve replacement are not well established, and decision making on
the operative approach still remains challenging for the interdisciplinary
heart team. Methods and Results This review was intended to analyze all
studies on viv-TAVR focusing on short- and mid-term stroke and mortality
rates compared with redo surgical aortic valve replacement or native TAVR
procedures. A structured literature search and review process led to 1667
potentially relevant studies on July 1, 2020. Finally, 23 studies
fulfilled the inclusion criteria for qualitative analysis. All references
were case series either with or without propensity score matching and
registry analyses. Quantitative synthesis of data from 8509 patients
revealed that viv-TAVR is associated with mean 30-day stroke and mortality
rates of 2.2% and 4.2%, respectively. Pooled data analysis showed no
significant differences in 30-day stroke rate, 30-day mortality, and
1-year mortality between viv-TAVR and comparator treatment (native TAVR
[n=11 804 patients] or redo surgical aortic valve replacement [n=498
patients]). Conclusions This review is the first one comparing the risk
for stroke and mortality rates in viv-TAVR procedures with native TAVR
approach and contributes substantial data for the clinical routine.
Moreover, this systematic review is the most comprehensive analysis on
ischemic cerebrovascular events and early mortality in patients undergoing
viv-TAVR. In this era with increasing numbers of bioprosthetic valves used
in younger patients, viv-TAVR is a suitable option for the treatment of
degenerated bioprostheses.

<87>
Accession Number
634510960
Title
Prognosis of Claims- Versus Trial-Based Ischemic and Bleeding Events
Beyond 1 Year After Coronary Stenting.
Source
Journal of the American Heart Association. (pp e018744), 2021. Date of
Publication: 06 Mar 2021.
Author
Butala N.M.; Faridi K.F.; Secemsky E.A.; Song Y.; Curtis J.; Gibson C.M.;
Kazi D.; Shen C.; Yeh R.W.
Institution
(Butala, Secemsky, Kazi, Shen, Yeh) Richard A. and Susan F. Smith Center
for Outcomes Research in Cardiology Division of Cardiovascular Medicine
Beth Israel Deaconess Medical Center Boston MA
(Butala) Cardiology Division Department of Medicine Massachusetts General
HospitalHarvard Medical School Boston MA
(Faridi, Curtis) Section of Cardiovascular Medicine Department of Medicine
Yale School of Medicine New Haven CT
(Song, Gibson, Yeh) Baim Institute for Clinical Research Boston MA
Publisher
NLM (Medline)
Abstract
Background It is unknown whether clinical events identified with
administrative claims have similar prognosis compared with
trial-adjudicated events in cardiovascular clinical trials. We compared
the prognostic significance of claims-based end points in context of
trial-adjudicated end points in the DAPT (Dual Antiplatelet Therapy)
study. Methods and Results We matched 1336 patients aged >=65 years who
received percutaneous coronary intervention in the DAPT study with the
CathPCI registry linked to Medicare claims. We compared death at 21 months
post-randomization using Cox proportional hazards models among patients
with ischemic events (myocardial infarction or stroke) and bleeding events
identified by: (1) both trial adjudication and claims; (2) trial
adjudication only; and (3) claims only. A total of 47 patients (3.5%) had
ischemic events identified by both trial adjudication and claims, 24
(1.8%) in trial adjudication only, 15 (1.1%) in claims only, and 1250
(93.6%) had no ischemic events, with annualized unadjusted mortality rates
of 12.8, 5.5, 14.9, and 1.26 per 100 person-years, respectively. A total
of 44 patients (3.3%) had bleeding events identified with both trial
adjudication and claims, 13 (1.0%) in trial adjudication only, 65 (4.9%)
in claims only, and 1214 (90.9%) had no bleeding events, with annualized
unadjusted mortality rates of 11.0, 16.8, 10.7, and 0.95 per 100
person-years, respectively. Among patients with no trial-adjudicated
events, patients with events in claims only had a high subsequent adjusted
mortality risk (hazard ratio (HR) ischemic events: 31.5; 95% CI,
8.9-111.9; HR bleeding events 23.9; 95% CI, 10.7-53.2). Conclusions In
addition to trial-adjudicated events, claims identified additional
clinically meaningful ischemic and bleeding events that were
prognostically significant for death.

<88>
Accession Number
634510332
Title
The history of light therapy in hospital physiotherapy and medicine with
emphasis on Australia: Evolution into novel areas of practice.
Source
Physiotherapy theory and practice. (pp 1-12), 2021. Date of Publication:
07 Mar 2021.
Author
Liebert A.; Kiat H.
Institution
(Liebert) Fox Valley Medical Centre, NSW, Australia
(Kiat) Cardiac Health Institute Wahroonga, Sydney Adventist Hospital, NSW,
Australia
Publisher
NLM (Medline)
Abstract
Objective: The objective of this narrative review was to investigate the
history of light therapy in hospital settings, with reference to
physiotherapy and particularly in an Australian context.Types of articles
and search method:a review of available literature was conducted on
PubMed, Medline and Google Scholar using keywords light therapy,
photobiomodulation, physiotherapy, low-level laser, heliotherapy.
Physiotherapy textbooks from Sydney University Library were searched.
Historical records were accessed from the San Hospital library. Interviews
were conducted with the San Hospital Chief Librarian and a retired former
Head Physiotherapist from Royal Prince Alfred Hospital. Summary:
Historically, light treatment has been used in both medical and
physiotherapy practice. From its roots in ancient Egypt, India, and
Greece, through to medieval times, the modern renaissance in 'light as
therapy ' was begun by Florence Nightingale who, in the 1850s, advocated
the use of clean air and an abundance of sunlight to restore health.
Modern light therapy (phototherapy) had a marked uptake in use in medicine
in Scandinavia, America, and Australia from 1903, following the pioneering
work of Niels Finsen in the late 19th century, which culminated in Dr
Finsen receiving the Nobel Prize for Medicine for the treatment of
tuberculosis scarring with ultraviolet (UV) light, and treatment of
smallpox scarring with red light. Treatment with light, especially UVB
light, has been widely applied by physiotherapists in hospitals for
dermatological conditions since the 1950s, particularly in Australia,
Scandinavia, USA, England and Canada. In parallel, light treatment in
hospitals for hyperbilirubinemia was used for neonatal jaundice. Since the
1980s light was also used in the medical specialties of ophthalmology,
dermatology, and cardiology. In more recent years in physiotherapy, light
was mostly used as an adjunct to the management of
orthopedic/rheumatological conditions. Since the 1990s, there has been
global use of light, in the form of photobiomodulation for the management
of lymphedema, including in supportive cancer care. Photobiomodulation in
the form of low-level laser has been used by physiotherapists and pain
doctors since the 1990s in the management of chronic pain. The use of
light as therapy is exemplified by its use in the San Hospital in Sydney,
where light therapy was introduced in 1903 (after Dr. John Harvey Kellogg
visited Niels Finsen in Denmark) and is practiced by nurses,
physiotherapists and doctors until the present day. The use of light has
expanded into new and exciting practices including supportive cancer care,
and treatment of depression, oral mucositis, retinopathy of prematurity,
and cardiac surgery complications. Light is also being used in the
treatment of neurological diseases, such as Parkinson's disease, traumatic
brain injury, and multiple sclerosis. The innovative uses of light in
physiotherapy treatment would not be possible without the previous
experience of successful application of light treatment.
 Conclusion(s): Light therapy has had a long tradition in medicine and
physiotherapy. Although it has fallen somewhat out of favour over the past
decades, there has been a renewed interest using modern techniques in
recent times. There has been continuous use of light as a therapy in
hospitals in Australia, most particularly the San Hospital in Sydney where
it has been in use for almost 120 years.

<89>
Accession Number
2010842047
Title
Serum potassium levels provide prognostic information in symptomatic heart
failure beyond traditional clinical variables.
Source
ESC Heart Failure. (no pagination), 2021. Date of Publication: 2021.
Author
Toledo C.C.; Vellosa Schwartzmann P.; Miguel Silva L.; da Silva Ferreira
G.; Bianchini Cardoso F.; Citelli Ribeiro V.; Paim L.R.; Antunes-Correa
L.M.; Carvalho Sposito A.; Matos Souza J.R.; Modolo R.; Nadruz W.;
Fernandes de Carvalho L.S.; Coelho-Filho O.R.
Institution
(Toledo, Miguel Silva, da Silva Ferreira, Bianchini Cardoso, Citelli
Ribeiro, Paim, Antunes-Correa, Carvalho Sposito, Matos Souza, Modolo,
Nadruz, Fernandes de Carvalho, Coelho-Filho) Faculty of Medical Science,
University of Campinas, Sao Paulo, Brazil
(Antunes-Correa) School of Physical Education, University of Campinas, Sao
Paulo, Brazil
(Vellosa Schwartzmann) Cardiology Unit, Unimed Hospital, Ribeirao Preto,
Sao Paulo, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Aims: Despite of recent advances in the pharmacological treatment, heart
failure (HF) maintains significant morbidity and mortality rates. While
serum potassium disorders are common and associated with adverse outcomes,
the exact recommended potassium level for patients with HF are not
entirely established. We aimed to investigate the prognostic role of
potassium levels on a cohort of patients with symptomatic chronic HF.
 Methods and Results: Patients with symptomatic chronic HF were
identified at the referral to 6 min walking test (6MWT) and were
prospectively followed up for cardiovascular events. Clinical and
laboratorial data were retrospectively obtained. The primary endpoint was
the composite of cardiovascular death, hospitalization due to HF, and
heart transplantation. The cohort included 178 patients with HF with the
mean age of 51 +/- 12.76 years, 39% were female, 85% of non-ischaemic
cardiomyopathy, and 38% had New York Heart Association Class III with a
relatively high Meta-Analysis Global Group in Chronic Heart Failure
(MAGGIC) score (12.91 +/- 6.6). The mean left ventricular ejection
fraction was 39.98 +/- 15.79%, and the mean 6MWT distance was 353 +/- 136
m. After a median follow-up of 516 days, there were 22 major
cardiovascular events (4 cardiovascular deaths, 13 HF admissions, and 5
heart transplants). Patients were stratified according to cut-point level
of serum potassium of 4.7 mmol/L to predict combined cardiac events based
on receiver operating characteristic analysis. Individuals with higher
potassium levels had worse renal function (glomerular filtration rate, K
<= 4.7: 102.8 +/- 32.2 mL/min/1.73 m2 vs. K > 4.7: 85.42 +/-
36.2 mL/min/1.73 m2, P = 0.004), higher proportion of New York
Heart Association Class III patients (K <= 4.7: 28% vs. K > 4.7: 48%, P =
0.0029), and also higher MAGGIC score (K <= 4.7: 12.08 +/- 5.7 vs. K >
4.7: 14.9 +/- 7.9, P = 0.0089), without significant differences on the
baseline pharmacological HF treatment. Both potassium levels [hazard ratio
(HR) 4.26, 95% confidence interval (CI) 1.59-11.421, P = 0.003] and 6MWT
distance (HR 0.99, 95% CI 0.993-0.999, P = 0.01) were independently
associated with the primary outcome. After adjustments for MAGGIC score
and 6MWT distance, potassium levels > 4.7 mmol/L maintained a significant
association with outcomes (HR 3.57, 95% CI 1.305-9.807, P = 0.013).
Patients with K > 4.7 mmol/L were more likely to present clinical events
during the follow-up (log rank = 0.005). Adding potassium levels to the
model including 6MWT and MAGGIC significantly improved the prediction of
events over 2 years (integrated discrimination index 0.105, 95% CI
0.018-0.281, P = 0.012 and net reclassification index 0.447, 95% CI
0.077-0.703, P = 0.028). Conclusion(s): Potassium levels were
independently associated with worse outcomes in patients with chronic
symptomatic HF, also improving the accuracy model for prognostic
prediction when added to MAGGIC score and 6MWT distance. The potassium
levels above 4.7 mmol/L might identify those patients at an increased risk
of cardiovascular events. Copyright © 2021 The Authors. ESC Heart
Failure published by John Wiley & Sons Ltd on behalf of European Society
of Cardiology.

<90>
Accession Number
2010832436
Title
Is vacuum-assisted closure therapy feasible for children with deep sternal
wound infection after cardiac surgery? The pooling results from current
literature.
Source
Artificial Organs. (no pagination), 2021. Date of Publication: 2021.
Author
Wu Y.; Wang J.; Dai J.; Wang G.; Li H.; Li Y.; Wu C.; Wei G.
Institution
(Wu, Dai, Wang, Li, Li, Wu) Department of Cardiothoracic Surgery,
Children's Hospital of Chongqing Medical University, Chongqing, China
(Wu, Wang, Dai, Wang, Li, Li, Wu, Wei) Ministry of Education Key
Laboratory of Child Development and Disorders, China International Science
and Technology Cooperation Base of Child Development and Critical
Disorders, National Clinical Research Center for Child Health and
Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
Publisher
Blackwell Publishing Inc.
Abstract
Vacuum-assisted closure (VAC) has been used for children with deep sternal
wound infections (DSWI); however, the safety and efficiency have not been
determined. A meta-analysis was performed for outcomes of VAC therapy in
children with DSWI after cardiac surgery. Electronic databases, including
PubMed, Scopus, and Cochrane Library CENTRAL were searched systematically
from January 1990 to October 2020 for the literature which reported the
outcomes of VAC therapy for children with DSWI after cardiac surgery.
Meta-regression and subgroup analyses were performed to find risk factors
for prolonged length of VAC therapy and hospital stay. Eleven studies were
included in this study, involving 217 subjects. VAC therapy was performed
due to mediastinitis after congenital heart diseases (CHD) repair. In
children with DSWI after cardiac surgery, length of VAC therapy, and
hospital stay were 11.1 days (95% CI, 9.6-12.5 days) and 29.8 days (95%
CI, 22.8-36.9 days), respectively. Incidence of infectious and
wound-related complications was 8.5% (95% CI, 4.1%-13.0%). Overall
mortality in this setting was 5.8% (95% CI, 2.5%-9.1%). In conclusion, in
children with DSWI after cardiac surgery, length of VAC therapy and
hospital stay were 11.1 and 29.8 days, respectively. Overall mortality was
5.8%. Although not significant, delayed chest closure, complex CHD, and
Gram-negative bacilli/fungal infections may potentially contribute to
prolonged duration of VAC treatment. Copyright © 2021
International Center for Artificial Organs and Transplantation and Wiley
Periodicals LLC.

<91>
Accession Number
2010803854
Title
Predictors of permanent pacemaker insertion after TAVR: A systematic
review and updated meta-analysis.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2021. Date
of Publication: 2021.
Author
Mahajan S.; Gupta R.; Malik A.H.; Mahajan P.; Aedma S.K.; Aronow W.S.;
Mehta S.S.; Lakkireddy D.R.
Institution
(Mahajan, Mahajan, Aedma) Department of Internal Medicine, Carle
Foundation Hospital, Urbana, IL, United States
(Gupta) Department of Cardiology, Lehigh Valley Heart Institute, Lehigh
Valley Health Network, Allentown, PA, United States
(Malik, Aronow) Department of Cardiology, Westchester Medical Center and
New York Medical College, Valhalla, NY, United States
(Mehta) Department of Cardiology, Heart and Vascular Institute, Carle
Foundation Hospital, Urbana, IL, United States
(Lakkireddy) Department of Cardiology, Kansas City Heart Rhythm Institute
and Research Foundation, Overland Park, KS, United States
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: The aim of this analysis was to evaluate the predictors
associated with increased risk of permanent pacemaker implantation (PPMI)
following transcatheter aortic valve replacement (TAVR).
 Background(s): While TAVR has evolved as the standard of care for
patients with severe aortic stenosis, conduction abnormalities leading to
the need for PPMI is one of the most common postprocedural complications.
 Method(s): A systematic literature search was performed to identify
relevant trials from inception to May 2020. Summary effects were
calculated using a DerSimonian and Laird random-effects model as odds
ratio with 95% confidence intervals for all the clinical endpoints.
 Result(s): Thirty-seven observational studies with 71 455 patients
were identified. The incidence of PPMI following TAVR was 22%. Risk was
greater in men and increased with age. Patients with diabetes mellitus,
presence of right bundle branch block, baseline atrioventricular
conduction block, and left anterior fascicular block were noted to be at
higher risk. Other significant predictors include the presence of high
calcium volume in the area below the left coronary cusp and noncoronary
cusp, use of self-expandable valve over balloon-expandable valve, depth of
implant, valve size/annulus size, predilatation balloon valvuloplasty, and
postimplant balloon dilation. Conclusion(s): Fourteen factors were
found to be associated with increased risk of PPMI after TAVR, suggesting
early identification of high-risk populations and targeting modifiable
risk factors may aid in reducing the need for this post TAVR
PPMI. Copyright © 2021 Wiley Periodicals LLC

<92>
Accession Number
2011176863
Title
The role of radiotherapy in patients with solid tumours after solid organ
transplantation: a systematic review.
Source
The Lancet Oncology. 22 (3) (pp e93-e104), 2021. Date of Publication:
March 2021.
Author
Mazzola R.; Cuccia F.; Bertani A.; Tubin S.; Conaldi P.G.; Corradini S.;
Tolia M.; Guba M.; Alongi F.
Institution
(Mazzola, Cuccia, Alongi) Advanced Radiation Oncology Department, IRCCS
Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
(Bertani) Department for the Treatment and Study of Cardiothoracic
Diseases and Cardiothoracic Transplantation, Division of Thoracic Surgery
and Lung Transplantation, IRCCS-ISMETT, Palermo, Italy
(Conaldi) Department of Research, IRCCS-ISMETT, Palermo, Italy
(Tubin) MedAustron Center for Ion Therapy and Research, Wiener Neustadt,
Austria
(Corradini) Department of Radiation Oncology, University Hospital,
Ludwig-Maximilian University of Munich, Munich, Germany
(Guba) Department of General, Visceral and Transplantation Surgery,
Ludwig-Maximilian University of Munich, Munich, Germany
(Tolia) Radiotherapy Department, School of Medicine, University of Crete,
Herakleion, Greece
(Alongi) Radiation Oncology, University of Brescia, Brescia, Italy
Publisher
Lancet Publishing Group
Abstract
For patients diagnosed with cancer who have previously received an organ
transplant, radiotherapy represents a challenging clinical scenario
without well established care algorithms. Immunosuppressive therapy can be
a cause for concern among clinicians treating this category of patients.
Potential immune modulation following irradiation could affect recipient
organ tolerance and the outcomes of the transplantation itself. The main
aim of this systematic review was to define the safety and effectiveness
of radiotherapy in patients diagnosed with cancer who have previously
received an organ transplant. We searched PubMed and Embase for articles
published between Jan 1, 1995, and April 30, 2020 for studies in patients
who had undergone radiotherapy for post-transplantation malignancies. The
Review is framed by the PICO (population, intervention, control, and
outcomes) criteria, and primarily focuses on modern treatment
techniques. Copyright © 2021 Elsevier Ltd

<93>
Accession Number
2010260480
Title
Inhaled nitric oxide and acute kidney injury risk: a meta-analysis of
randomized controlled trials.
Source
Renal Failure. 43 (1) (pp 281-290), 2021. Date of Publication: 2021.
Author
Wang J.; Cong X.; Miao M.; Yang Y.; Zhang J.
Institution
(Wang) Journal Editorial Department, Henan Provincial People's Hospital,
People's Hospital of Zhengzhou University, Zhengzhou, China
(Cong, Miao, Yang, Zhang) Department of Anesthesiology and Perioperative
Medicine, Henan Provincial People's Hospital, People's Hospital of
Zhengzhou University, Zhengzhou, China
Publisher
Taylor and Francis Ltd.
Abstract
Purpose: There are conflicting results as to the effect of inhaled nitric
oxide (iNO) therapy on the risk of acute kidney injury (AKI). The aim of
this study was to perform a meta-analysis to assess the updated data.
 Method(s): We systematically searched Web of Science, the Cochrane
Library, Wanfang, and PubMed for relevant randomized control trials
between database inception and 9/07/2020. Relative risks (RRs) with 95%
confidence intervals (CIs) predicting the risk of AKI were extracted to
obtain summary estimates using fixed-effects models. The Trim and Fill
method was used to evaluate the sensitivity of the results and adjust for
publication bias in meta-analysis. Result(s): 15 randomized
controlled studies from 14 articles involving 1853 patients were included
in the study. Analyzing the eligible studies we found: (1) iNO therapy
significantly increased the risk of AKI in acute respiratory distress
syndrome patients (RR 1.55, 95% CI 1.15-2.10, p = 0.004; I 2
for heterogeneity 0%; P <inf>het</inf> = 0.649). (2) The use of iNO was
associated with reduced AKI risk in patients undergoing cardiac surgery
(RR 0.80, 95% CI 0.64-0.99, p = 0.037; I 2 for heterogeneity
0%; P <inf>het</inf> = 0.528). (3) For organ transplantation recipients,
there was no effect of iNO administration on the risk of AKI (RR 0.50, 95%
CI 0.16-1.56, p = 0.233; I 2 for heterogeneity 0%; P
<inf>het</inf> = 0.842). The Trim and Fill analysis showed that the
overall effect of this meta-analysis was stable. Conclusion(s): The
effect of iNO on AKI risk might be disease-specific. Future RCTs with
larger patient populations should aim to validate our
findings. Copyright © 2021 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<94>
Accession Number
2010217295
Title
Transapical off-pump mitral valve repair with NeoChord implantation: A
systematic review.
Source
Journal of Cardiac Surgery. 36 (4) (pp 1492-1498), 2021. Date of
Publication: April 2021.
Author
Ahmed A.; Abdel-Aziz T.A.; AlAsaad M.M.R.; Majthoob M.
Institution
(Ahmed) Department of Cardiothoracic Surgery, Faculty of Medicine, Ain
Shams University, Cairo, Egypt
(Abdel-Aziz, AlAsaad, Majthoob) Department of Cardiothoracic Surgery,
Dubai Hospital, Dubai, United Arab Emirates
Publisher
Blackwell Publishing Inc.
Abstract
Introduction: Mitral valve repair (MVr) is the gold standard for the
treatment of degenerative mitral valve regurgitation (MR). The recently
introduced NeoChord DS1000 has gained increasing recognition as a
feasible, potentially safe, and effective procedure with minor
complications and promising outcomes. This study aims to conduct a
systematic review of the published literature that discusses the technical
feasibility and outcome of transapical off-pump MVr with NeoChord DS1000
device implantation in the treatment of degenerative MR. Method(s):
This review was performed according to the PRISMA statement. Databases
searched in this review included Pubmed, Web of Science, Scopus, and
Cochrane databases for systematic reviews. All English articles on humans
reporting isolated MVr using NeoChord DS1000 device were included provided
that basic preoperative data, operative specifications, and postoperative
mortality and morbidity were reported. Result(s): This review
included six studies comprised 249 patients who had NeoChord mitral
procedure. Almost all patients included had severe MR (243/249, 97.6%).
Operative success was achieved in 241 out of the 249 patients (96.8%). No
intraoperative mortality was reported. Intraoperative arrhythmia was
reported in six patients (2.4%) and significant bleeding was reported in
eight patients (3.2%). Conclusion(s): Awaiting more evidence,
NeoChord mitral procedure appears to be a promising procedure that can be
considered in selected cases. Copyright © 2021 Wiley Periodicals
LLC

<95>
Accession Number
2006087059
Title
Endothelial dysfunction and coronary vasoreactivity-a review of the
history, physiology, diagnostic techniques, and clinical relevance.
Source
Current Cardiology Reviews. 17 (1) (pp 85-100), 2021. Date of Publication:
2021.
Author
Gunawardena T.; Merinopoulos I.; Wickramarachchi U.; Vassiliou V.;
Eccleshall S.
Institution
(Gunawardena, Merinopoulos, Wickramarachchi, Eccleshall) Department of
Cardiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich
NR4 7UY, United Kingdom
(Vassiliou) Norwich Medical School, University of East Anglia and Royal
Brompton Hospital and Imperial College London, London, United Kingdom
Publisher
Bentham Science Publishers
Abstract
The fervency for advancement and evolution in percutaneous coronary
intervention has revolutionised the treatment of coronary artery disease.
Historically, the focus of the interventional cardiologist was directed at
the restoration of luminal patency of the major epicardial coronary
arteries, yet whilst this approach is evolving with much greater
utilisation of physiological assessment, it often neglects consideration
of the role of the coronary microcirculation, which has been shown to
clearly influence prognosis. In this review, we explore the narrative of
the coronary circulation as more than just a simple conduit for blood but
an organ with functional significance. We review organisation and
physiology of the coronary circulation, as well as the current methods and
techniques used to examine it. We discuss the studies exploring coronary
artery endothelial function, appreciating that coronary artery disease
occurs on a spectrum of disorder and that percutaneous coronary
intervention has a latent effect on the coronary circulation with
long-term consequences. It is concluded that greater recognition of the
coronary artery endothelium and mechanisms of the coronary circulation
should further guide revascularisation strategies. Copyright ©
2020 Bentham Science Publishers.

<96>
Accession Number
2006074334
Title
Carotid access for transcatheter aortic valve replacement: A
meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 97 (4) (pp 723-733),
2021. Date of Publication: March 2021.
Author
Sharma S.P.; Chaudhary R.; Ghuneim A.; Harder W.; David S.; Choksi N.;
Kondur S.; Kambhatla S.; Kondur A.
Institution
(Sharma, Ghuneim, Harder, Choksi, Kondur, Kambhatla, Kondur) Department of
Cardiology, Garden City Hospital, Garden City, MI, United States
(Chaudhary) Division of Hospital Internal Medicine, Mayo Clinic,
Rochester, MN, United States
(David) Division of Cardiology, Ascension Providence Hospital, Southfield,
MI, United States
(Kambhatla) Division of Internal Medicine, Garden City Hospital, Garden
City, MI, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: We sought to evaluate the feasibility and safety of carotid
access transcatheter aortic valve replacement (TAVR) by performing a
meta-analysis of published cases. Background(s): Several case series
and regional data have provided initial basis for carotid access TAVR in
patients with prohibitive femoral approach. We performed this
meta-analysis to provide further evidence of feasibility and safety of
carotid TAVR. Method(s): We searched PubMed, EMBASE, CINAHL, and
Cochrane CENTRAL for any study on carotid access TAVR involving 5 patients
since inception till March 1, 2020. Random-effects model was used to
compute overall effects. The outcomes analyzed were all-cause mortality,
Transient ischemic attack (TIA)/stroke, need for permanent pacemaker (PPM)
implantation, pericardial tamponade, access site complications, major
bleeding, and length of stay. Result(s): There was a total of 17
retrospective studies (n = 2082) with a median follow-up of 1 month. Mean
age of the patient was 80 years. Mean Euroscore and STS scores were 15 +/-
6.2 and 7.9 +/- 3.3, respectively. The procedural success rate was 99%.
The rate of all-cause mortality was 6.7% (range 4.6-9.7%, p <.001,
I2 = 67%). Incidence of TIA/stroke was 3.9% (range 3.1-4.8%, p
<.001, I2 = 0%) and PPM implantation was 16.7% (range
12.5-21.9%, p <.001, I2 = 56%). Rate of pericardial tamponade,
vascular complication, and major bleeding were 1.7, 2.5, and 7%,
respectively. Average length of hospital stay was 7.7 days.
 Conclusion(s): Our results show that transcarotid approach is a
feasible option in patients with prohibitive femoral access for
TAVR. Copyright © 2020 Wiley Periodicals LLC

<97>
Accession Number
2008403481
Title
Perioperative management of patients with suspected or confirmed COVID-19:
review and recommendations for perioperative management from a
retrospective cohort study.
Source
British Journal of Anaesthesia. 125 (6) (pp 895-911), 2020. Date of
Publication: December 2020.
Author
Zheng H.; Hebert H.L.; Chatziperi A.; Meng W.; Smith B.H.; Yan J.; Zhou
Z.; Zhang X.; Luo A.; Wang L.; Zhu W.; Hu J.; Colvin L.A.
Institution
(Zheng, Yan, Zhou, Zhang, Luo) Department of Anesthesiology and Pain
Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan, China
(Hebert, Meng, Smith, Colvin) Division of Population Health and Genomics,
School of Medicine, University of Dundee, Ninewells Hospital and Medical
School, Dundee, Scotland, United Kingdom
(Chatziperi) Department of Anaesthesia and Pain Medicine, Western General
Hospital, NHS Lothian, Edinburgh, United Kingdom
(Wang) Medical Affairs Office, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China
(Zhu) Department of Orthopedics, Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China
(Hu) Department of Gastrointestinal Surgery Center, Tongji Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
Publisher
Elsevier Ltd
Abstract
Background: Current guidelines for perioperative management of coronavirus
disease 19 (COVID-19) are mainly based on extrapolated evidence or expert
opinion. We aimed to systematically investigate how COVID-19 affects
perioperative management and clinical outcomes, to develop evidence-based
guidelines. Method(s): First, we conducted a rapid literature review
in EMBASE, MEDLINE, PubMed, Scopus, and Web of Science (January 1 to July
1, 2020), using a predefined protocol. Second, we performed a
retrospective cohort analysis of 166 women undergoing Caesarean section at
Tongji Hospital, Wuhan during the COVID-19 pandemic. Demographic, imaging,
laboratory, and clinical data were obtained from electronic medical
records. Result(s): The review identified 26 studies, mainly case
reports/series. One large cohort reported greater mortality in elective
surgery patients diagnosed after, rather than before surgery. Higher 30
day mortality was associated with emergency surgery, major surgery, poorer
preoperative condition and surgery for malignancy. Regional anaesthesia
was favoured in most studies and personal protective equipment (PPE) was
generally used by healthcare workers (HCWs), but its use was poorly
described for patients. In the retrospective cohort study, duration of
surgery, oxygen therapy and hospital stay were longer in suspected or
confirmed patients than negative patients, but there were no differences
in neonatal outcomes. None of the 262 participating HCWs was infected with
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) when using
level 3 PPE perioperatively. Conclusion(s): When COVID-19 is
suspected, testing should be considered before non-urgent surgery. Until
further evidence is available, HCWs should use level 3 PPE perioperatively
for suspected or confirmed patients, but research is needed on its timing
and specifications. Further research must examine longer-term outcomes.
Clinical trial registration: CRD42020182891 (PROSPERO). Copyright
© 2020

<98>
Accession Number
2006000680
Title
Rheumatic heart disease anno 2020: Impacts of gender and migration on
epidemiology and management.
Source
European Journal of Clinical Investigation. 50 (12) (no pagination), 2020.
Article Number: e13374. Date of Publication: December 2020.
Author
Mutagaywa R.K.; Wind A.-M.; Kamuhabwa A.; Cramer M.J.; Chillo P.;
Chamuleau S.
Institution
(Mutagaywa, Chillo) School of Medicine, Muhimbili University of Health and
Allied Sciences, Dar Es Salaam, Tanzania
(Mutagaywa, Wind, Cramer, Chamuleau) Division of Heart and Lung,
Department of Cardiology, Faculty of Medicine, University Medical Centre
Utrecht, Utrecht, Netherlands
(Kamuhabwa) School of Pharmacy, Muhimbili University of Health and Allied
Sciences, Dar Es Salaam, Tanzania
(Chamuleau) Division of Heart and Lung, Department of Cardiology, Faculty
of Medicine, Amsterdam University Medical Centre, Amsterdam, Netherlands
Publisher
Blackwell Publishing Ltd
Abstract
Background: The epidemiology and management of diseases can be influenced
by social demographic factors. Gender and migration are among these
factors. Method(s): We aimed at reviewing the impacts of gender and
migration on rheumatic heart disease (RHD) epidemiology and management by
a nonsystematic literature review of published studies on RHD worldwide.
Our PubMed search terms included RHD pathophysiology, diagnosis,
complications, management or prevention, combined with words 'rheumatic
mitral stenosis (MS)', 'outcomes after percutaneous balloon mitral
valvuloplasty (PBMV)', 'gender or sex difference' and 'migration'. The
reporting of this study conforms to SANRA (the Scale for Assessment of
Narrative Review Articles) guidelines. Result(s): We retrieved eight
studies about the impact of sex on outcomes after PBMV. All of these
studies showed a female predominance for RHD. Two studies showed that
there is no impact, three studies showed female sex as a predictor of poor
outcomes, and the other three showed male sex a predictor of poor
outcomes. Although RHD is reported to be eradicated in the developed
countries, 2.1% of refugees recently screened for RHD in Italy were found
to have subclinical RHD. This prevalence is similar to those found in
India (2.0%), Cambodia (2.2%) and Mozambique (3%). Conclusion(s):
There are contradicting results for outcomes after PBMV between males and
females. It is not clear whether sex difference plays a role in
pathophysiology, diagnosis, management and prognosis of MS. Migration has
impacts on epidemiology and management of RHD. Further studies are
required in these two fields to explore their relationship to
RHD. Copyright © 2020 Stichting European Society for Clinical
Investigation Journal Foundation. Published by John Wiley & Sons Ltd

<99>
Accession Number
2004107413
Title
Effect of red blood cell storage duration on major postoperative
complications in cardiac surgery: A randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 160 (6) (pp 1505-1514.e3),
2020. Date of Publication: December 2020.
Author
Koch C.G.; Sessler D.I.; Duncan A.E.; Mascha E.J.; Li L.; Yang D.;
Figueroa P.; Sabik J.F.; Mihaljevic T.; Svensson L.G.; Blackstone E.H.
Institution
(Koch) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins Medicine, Baltimore, Md, United States
(Sessler, Mascha, Yang) Department of Outcomes Researc, Cleveland Clinic,
Cleveland, OH, United States
(Duncan) Department of Cardiothoracic Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Mascha, Yang, Blackstone) Department of Quantitative Health Sciences,
Cleveland Clinic, Cleveland, OH, United States
(Li) Division of Science, Department of Biostatistics, MD Anderson Cancer
Center, Houston, Tex, United States
(Figueroa) Department of Clinical Pathology, Cleveland Clinic, Cleveland,
OH, United States
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
(Mihaljevic, Svensson, Blackstone) Department of Thoracic and
Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, United States
Publisher
Mosby Inc.
Abstract
Background: Although observational studies suggest an association between
transfusion of older red blood cell (RBC) units and increased
postoperative risk, randomized trials have not supported this. The
objective of this randomized trial was to test the effect of RBC storage
age on outcomes after cardiac surgery. Method(s): From July 2007 to
May 2016, 3835 adults undergoing coronary artery bypass grafting, cardiac
valve procedures, or ascending aorta repair, either alone or in
combination, were randomized to transfusion of RBCs stored for <=14 days
(younger units) or for >=20 days (older units) intraoperatively and
throughout the postoperative hospitalization. According to protocol, 2448
patients were excluded because they did not receive RBC transfusions.
Among the remaining 1387 modified intent-to-treat patients, 701 were
randomized to receive younger RBC units (median age, 11 days) and the
remaining 686 to receive older units (median age, 25 days). The primary
endpoint was composite morbidity and mortality, analyzed using a
generalized estimating equation (GEE) model. The trial was discontinued
midway owing to enrollment constraints. Result(s): A total of 5470
RBC units were transfused, including 2783 in the younger RBC storage group
and 2687 in the older RBC storage group. The GEE average relative-effect
odds ratio was 0.77 (95% confidence interval [CI], 0.50-1.19; P = .083)
for the composite morbidity and mortality endpoint. In-hospital mortality
was lower for the younger RBC storage group (2.1% [n = 15] vs 3.4% [n =
23]), as was occurrence of other adverse events except for atrial
fibrillation, although all CIs crossed 1.0. Conclusion(s): This
clinical trial, which was stopped at its midpoint owing to enrollment
constraints, supports neither the efficacy nor the futility of transfusing
either younger or older RBC units. The effects of transfusing RBCs after
even more prolonged storage (35-42 days) remains untested. Copyright
© 2019 The American Association for Thoracic Surgery

<100>
Accession Number
2011271057
Title
Pupillometric monitoring of nociception in cardiac anesthesia.
Source
Deutsches Arzteblatt International. 117 (pp 833-840), 2020. Date of
Publication: 2020.
Author
Bartholmes F.; Malewicz N.M.; Ebel M.; Zahn P.K.; Meyer-Friessem C.H.
Institution
(Bartholmes, Malewicz, Ebel, Zahn, Meyer-Friesem) BG-Universitatsklinikum
Bergmannsheil gGmbH, Klinik fur Anasthesie, Intensiv- und Schmerzmedizin,
Bochum, Germany
Publisher
Deutscher Arzte-Verlag GmbH
Abstract
Background: High-dose opioids are conventionally used for cardiac
anesthesia, but without monitoring of nociception. In non-cardiac surgical
procedures the intraoperative dose of opioids can be individualized and
reduced with pupillometric monitoring of the pupillary pain index (PPI;
scale 1-9). A randomized controlled trial was carried out to explore
whether pupillometry can be used for nociception monitoring in cardiac
anesthesia and whether it leads to opioid reduction. Method(s): A
sample of 57 cardiac surgery patients receiving continuously administered
sufentanil (initial dosage 0.7 microg*kg-1*h-1) was divided
into a PPI group (sufentanil reduction if PPI<3 up to a minimum of 0.15
microg*kg-1*h-1, n=32) and a control group (standard
anesthesia; n = 25). The primary outcome was the time from the end of
anesthesia to extubation. The secondary outcomes were total intraoperative
dose of sufentanil/noradrenaline, postoperative pain intensity (numeric
rating scale [NRS] 0-10) and intraoperative awareness. German Clinical
Trials Registry no. DRKS 00012329. Result(s): The primary outcome,
extubation time, did not differ between the two groups (1.14 h, 95%
confidence interval [-0.99; 3.27], p = 0.592). Compared with the control
patients (68% male, age 70 +/- 10.4 years, PPI 1.1 +/- 0.2), the mean
sufentanil infusion rate in the PPI patients (81% male, age 68 +/- 10.3
years, PPI 1.1 +/- 0.2) decreased by 81.8% (-0.68
microg*kg-1*h-1 [-0,7; -0.67], p<0.001) to the
predetermined minimum level, without intraoperative awareness. Moreover,
the noradrenaline dose was reduced by 56% (1235.51 microg [321.91;
2149.12], p = 0.005) and the postoperative pain intensity by 45% (2.11 NRS
[0.93; 3.3] after 24 h, p = 0.003). Conclusion(s): Pupillometry is
appropriate for nociception monitoring in cardiac anesthesia. Thereby a
considerable reduction of intraoperative opioids as well as increased
intraoperative hemodynamic stability was achieved and postoperative
opioid-induced hyperalgesia was prevented. The consistently low PPI
scores, indicating adequate analgesia, suggest that further reduction of
opioid doses is feasible. Copyright © 2020 Deutscher Arzte-Verlag
GmbH. All rights reserved.

<101>
Accession Number
634378365
Title
Systematic review of endovascular stent grafting versus open surgical
repair for the elective treatment of arch/descending thoracic aortic
aneurysms.
Source
BMJ Open. 11 (3) (no pagination), 2021. Article Number: e043323. Date of
Publication: 04 Mar 2021.
Author
McCarthy A.; Gray J.; Sastry P.; Sharples L.; Vale L.; Cook A.; McMeekin
P.; Freeman C.; Catarino P.; Large S.
Institution
(McCarthy, Gray, McMeekin) Health and Life Sciences, Northumbria
University, Newcastle upon Tyne, United Kingdom
(Sastry) Cardiothoracic Surgery, John Radcliffe Hospital, Oxford,
Oxfordshire, United Kingdom
(Sharples) Medical Statistics, London School of Hygiene and Tropical
Medicine, London, United Kingdom
(Vale) Health Economics Group, Population Health Sciences Institute,
Newcastle University, Tyne and Wear, Newcastle upon Tyne, United Kingdom
(Cook) Wessex Institute, University of Southampton, Southampton,
Hampshire, United Kingdom
(Cook) Southampton Clinical Trials Unit, University of Southampton,
Southampton, Hampshire, United Kingdom
(Cook) University Hospital Southampton NHS Foundation Trust, Southampton,
United Kingdom
(Freeman) Papworth Trials Unit Collaboration, Papworth Hospital NHS
Foundation Trust, Cambridge, United Kingdom
(Catarino, Large) Cardiac Surgery, Papworth Hospital NHS Foundation Trust,
Cambridge, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objective To review comparisons of the effectiveness of endovascular stent
grafting (ESG) against open surgical repair (OSR) for treatment of chronic
arch or descending thoracic aortic aneurysms (TAA). Design Systematic
review and meta-analysis Data sources MEDLINE, EMBASE, CENTRAL, WHO
International Clinical Trials Routine data collection, current controlled
trials, clinical trials and the NIHR portfolio were searched from January
1994 to March 2020. Eligibility criteria for selective studies All
identified studies that compared ESG and OSR, including randomised
controlled trials (RCTs), quasi-randomised and non-RCTs, comparative
cohort studies and case-control studies matched on main outcomes were
sought. Participants had to receive elective treatments for
arch/descending (TAA). Studies were excluded where other thoracic aortic
conditions (eg, rupture or dissection) were reported, unless results for
patients receiving elective treatment for arch/descending TAA reported
separately. Data extraction and synthesis Data were extracted by one
reviewer and checked by another. Risk of Bias was assessed using the
ROBINS-I tool. Meta-analysis was conducted using random effects. Where
meta-analysis not appropriate, results were reported narratively. Results
Five comparative cohort studies met inclusion criteria, reporting 3955 ESG
and 21 197 OSR patients. Meta-analysis of unadjusted short-term (30 day)
all-cause mortality favoured ESG (OR 0.75; 95% CI 0.55 to 1.03)).
Heterogeneity identified between larger and smaller studies. Sensitivity
analysis of four studies including only descending TAA showed no
statistical significance (OR 0.73, 95% CI 0.45 to 1.18)), moderate
heterogeneity. Meta-analysis of adjusted short-term all-cause mortality
favoured ESG (OR 0.71, 95% CI 0.51 to 0.98)), no heterogeneity.
Longer-term (beyond 30 days) survival from all-cause mortality favoured
OSR in larger studies and ESG in smaller studies. Freedom from
reintervention in the longer-term favoured OSR. Studies reporting
short-term non-fatal complications suggest fewer events following ESG.
Conclusions There is limited and increasingly dated evidence on the
comparison of ESG and OSR for treatment of arch/descending TAA. PROSPERO
registration number CRD42017054565. Copyright © Author(s) (or
their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

<102>
Accession Number
634378356
Title
Measurement and prognosis of frail patients undergoing transcatheter
aortic valve implantation: A systematic review and meta-analysis.
Source
BMJ Open. 11 (3) (no pagination), 2021. Article Number: e040459. Date of
Publication: 04 Mar 2021.
Author
Li Z.; Dawson E.; Moodie J.; Martin J.; Bagur R.; Cheng D.; Kiaii B.;
Hashi A.; Bi R.; Yeschin M.; John-Baptiste A.
Institution
(Li, Dawson, Martin, Bagur, Cheng, Yeschin, John-Baptiste) Department of
Epidemiology and Biostatistics, Western University, London, ON, Canada
(Li, Dawson, Moodie, Martin, Cheng, John-Baptiste) Department of
Anesthesia and Perioperative Medicine, Western University, London, ON,
Canada
(Li, Dawson, Moodie, Martin, Cheng, John-Baptiste) Centre for Medical
Evidence, Decision Integrity and Clinical Impact (MEDICI), Western
University, London, ON, Canada
(Cheng) Department of Medicine, Division of Critical Care Medicine, London
Health Sciences Centre, London, ON, Canada
(Kiaii) Department of Surgery, Division of Cardiac Surgery, London Health
Sciences Centre, London, ON, Canada
(Hashi) Faculty of Sciences, Western University, London, ON, Canada
(Bi, John-Baptiste) Schulich Interfaculty Program in Public Health,
Western University, London, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Objectives Our objectives were to review the literature to identify
frailty instruments in use for transcatheter aortic valve implantation
(TAVI) recipients and synthesise prognostic data from these studies, in
order to inform clinical management of frail patients undergoing TAVI.
Methods We systematically reviewed the literature published in 2006 or
later. We included studies of patients with aortic stenosis, diagnosed as
frail, who underwent a TAVI procedure that reported mortality or clinical
outcomes. We categorised the frailty instruments and reported on the
prevalence of frailty in each study. We summarised the frequency of
clinical outcomes and pooled outcomes from multiple studies. We explored
heterogeneity and performed subgroup analysis, where possible. We also
used Grading of Recommendations, Assessment, Development and Evaluation
(GRADE) to assess the overall certainty of the estimates. Results Of 49
included studies, 21 used single-dimension measures to assess frailty, 3
used administrative data-based measures, and 25 used multidimensional
measures. Prevalence of frailty ranged from 5.67% to 90.07%. Albumin was
the most commonly used single-dimension frailty measure and the Fried or
modified Fried phenotype were the most commonly used multidimensional
measures. Meta-analyses of studies that used either the Fried or modified
Fried phenotype showed a 30-day mortality of 7.86% (95% CI 5.20% to
11.70%) and a 1-year mortality of 26.91% (95% CI 21.50% to 33.11%). The
GRADE system suggests very low certainty of the respective estimates.
Conclusions Frailty instruments varied across studies, leading to a wide
range of frailty prevalence estimates for TAVI recipients and substantial
heterogeneity. The results provide clinicians, patients and healthcare
administrators, with potentially useful information on the prognosis of
frail patients undergoing TAVI. This review highlights the need for
standardisation of frailty measurement to promote consistency. PROSPERO
registration number CRD42018090597. Copyright © Author(s) (or
their employer(s)) 2021.

<103>
Accession Number
2011208222
Title
Efficacy of systemic lidocaine on postoperative quality of recovery and
analgesia after video-assisted thoracic surgery: A randomized controlled
trial.
Source
Journal of Clinical Anesthesia. 71 (no pagination), 2021. Article Number:
110223. Date of Publication: August 2021.
Author
Yao Y.; Jiang J.; Lin W.; Yu Y.; Guo Y.; Zheng X.
Institution
(Yao, Jiang, Lin, Yu, Guo, Zheng) Department of Anesthesiology, Shengli
Clinical Medical College of Fujian Medical University, Fuzhou, Fujian,
China
Publisher
Elsevier Inc.
Abstract
Study objective: Intraoperative systemic lidocaine has become widely
accepted as an adjunct to general anesthesia, associated with
opioid-sparing and enhanced recovery. We hypothesized that perioperative
systemic lidocaine improves postoperative pain and enhances the quality of
recovery (QoR) in patients following video-assisted thoracic surgery
(VATS). Design(s): Prospective, single-center, double-blind,
randomized placebo-controlled clinical trial. Setting(s): Single
institution, tertiary university hospital. Patient(s): Adult patients
aged 18 to 65 undergoing VATS were eligible for participation.
 Intervention(s): Patients enrolled in this study were randomized to
receive either system lidocaine (a bolus of 1.5 mg kg-1,
followed by an infusion of 2 mg kg-1 h-1 until the
end of the surgical procedure) or identical volumes and rates of 0.9%
saline. Measurements: The primary outcome was a global QoR-15 score 24 h
after surgery. Secondary outcomes included postoperative pain score,
cumulative opioid consumption, emergence time, length of PACU stay,
adverse events, and patient satisfaction. Main Result(s): There was
no difference in the global QoR-15 scores at 24 h postoperatively between
the lidocaine and saline groups (median 117, IQR 113.5-124, vs. median
116, IQR 111-120, P = 0.067), with a median difference of 3 (95% CI 0 to
6, P = 0.507). Similarly, postoperative pain scores, postoperative
cumulative opioid consumption, PACU length of stay, the occurrence of
PONV, and patient satisfaction were comparable between the two groups (all
P > 0.05). Conclusion(s): Our current findings do not support using
perioperative systemic lidocaine as a potential strategy to improve
postoperative pain and enhance QoR in patients undergoing VATS. Trial
registration: Chinese Clinical Trial Registry (identifier:
ChiCTR1900027515). Copyright © 2021 Elsevier Inc.

<104>
Accession Number
2011105914
Title
Randomized Evaluation of TriGuard 3 Cerebral Embolic Protection After
Transcatheter Aortic Valve Replacement: REFLECT II.
Source
JACC: Cardiovascular Interventions. 14 (5) (pp 515-527), 2021. Date of
Publication: 08 Mar 2021.
Author
Nazif T.M.; Moses J.; Sharma R.; Dhoble A.; Rovin J.; Brown D.; Horwitz
P.; Makkar R.; Stoler R.; Forrest J.; Messe S.; Dickerman S.; Brennan J.;
Zivadinov R.; Dwyer M.G.; Lansky A.J.
Institution
(Nazif, Moses) Columbia University Medical Center, New York, NY, United
States
(Dhoble) University of Texas Health Science Center, Houston, TX, United
States
(Sharma) Division of Cardiology, Stanford University, Stanford,
California, United States
(Rovin) Morton Plant Hospital, Clearwater, FL, United States
(Brown) Heart Hospital Baylor, Plano, TX, United States
(Horwitz) University of Iowa, Iowa City, IA, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Stoler) Baylor Heart and Vascular Hospital, Dallas, TX, United States
(Forrest, Dickerman, Brennan, Lansky) Division of Cardiology, Yale School
of Medicine, New Haven, CT, United States
(Messe) Department of Neurology, Hospital of the University of
Pennsylvania, Philadelphia, PA, United States
(Zivadinov, Dwyer) Buffalo Neuroimaging Analysis Center, Department of
Neurology, State University of New York at Buffalo, Buffalo, NY, United
States
(Lansky) Barts Heart Centre, London and Queen Mary University of London,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Objectives: The REFLECT II (Randomized Evaluation of TriGuard 3 Cerebral
Embolic Protection After Transcatheter Aortic Valve Implantation) trial
was designed to investigate the safety and efficacy of the TriGUARD 3
(TG3) cerebral embolic protection in patients undergoing transcatheter
aortic valve replacement. Background(s): Cerebral embolization occurs
frequently following transcatheter aortic valve replacement and
procedure-related ischemic stroke occurs in 2% to 6% of patients at 30
days. Whether cerebral protection with TriGuard 3 is safe and effective in
reducing procedure-related cerebral injury is not known. Method(s):
This prospective, multicenter, single-blind, 2:1 randomized (TG3 vs. no
TG3) study was designed to enroll up to 345 patients. The primary 30-day
safety endpoint (Valve Academic Research Consortium-2 defined) was
compared with a performance goal (PG). The primary hierarchical composite
efficacy endpoint (including death or stroke at 30 days, National
Institutes of Health Stroke Scale score worsening in hospital, and
cerebral ischemic lesions on diffusion-weighted magnetic resonance imaging
at 2 to 5 days) was compared using the Finkelstein-Schoenfeld method.
 Result(s): REFLECT II enrolled 220 of the planned 345 patients
(63.8%), including 41 roll-in and 179 randomized patients (121 TG3 and 58
control subjects) at 18 US sites. The sponsor closed the study early after
the U.S. Food and Drug Administration recommended enrollment suspension
for unblinded safety data review. The trial met its primary safety
endpoint compared with the PG (15.9% vs. 34.4% (p < 0.0001). The primary
hierarchal efficacy endpoint at 30 days was not met (mean scores [higher
is better]: -8.58 TG3 vs. 8.08 control; p = 0.857). A post hoc
diffusion-weighted magnetic resonance imaging analysis of per-patient
total lesion volume above incremental thresholds showed numeric reductions
in total lesion volume >500 mm3 (-9.7%) and >1,000
mm3 (-44.5%) in the TG3 group, which were more pronounced among
patients with full TG3 coverage: -51.1% (>500 mm3) and -82.9%
(>1,000 mm3). Conclusion(s): The REFLECT II trial
demonstrated that the TG3 was safe compared with a historical PG but did
not meet its pre-specified primary superiority efficacy
endpoint. Copyright © 2021 American College of Cardiology
Foundation

<105>
Accession Number
2010719386
Title
Randomized controlled trial of energy healing effects on pain and anxiety
in AIS posterior surgery: a pilot study.
Source
Spine Deformity. (no pagination), 2021. Date of Publication: 2021.
Author
McNeil N.; Bastrom T.P.; Bartley C.E.; Yaszay B.; Upasani V.V.; Newton
P.O.
Institution
(McNeil, Bastrom, Bartley, Yaszay, Upasani, Newton) Rady Children's
Hospital, 3020 Children's Way, MC 5063, San Diego, CA 92123, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objectives: Energy healing (EH) is a part of the diverse group of
Complementary and Alternative Medicines (CAM). The purpose of this study
was to evaluate the effects of EH therapy prior to and following posterior
surgical correction for adolescent idiopathic scoliosis (AIS) compared to
controls. Method(s): Patients were prospectively randomized to one of
two groups: standard operative care for surgery (controls) vs. standard
care with the addition of three EH sessions. The outcomes included visual
analog scales (VAS) for pain and anxiety (0-10), days until conversion to
oral pain medication, and length of hospital stay. For the experimental
group, VAS was assessed pre- and post-EH session. Result(s): Fifty
patients were enrolled-28 controls and 22 EH patients. The controls had a
median of 12 levels fused vs. 11 in the EH group (p = 0.04). Pre-operative
thoracic and lumbar curve magnitudes were similar (p > 0.05). Overall VAS
pain scores increased from pre- to post-operative (p < 0.001), whereas the
VAS anxiety scores decreased immediately post-operative (p < 0.001). The
control and pre-EH assessments were statistically similar. Significant
decreases in VAS pain and anxiety scores from pre to post-EH assessment
were noted for the EH group. Both groups transitioned to oral pain
medication a median of 2 days post-operative (p = 0.11). The median days
to discharge was four in the controls and three in the EH group (p =
0.07). Conclusion(s): In this pilot study, EH therapy resulted in a
decrease in patient's pre-operative anxiety. Offering this CAM modality
may enhance the wellbeing of the patient and their overall recovery when
undergoing posterior surgical correction for AIS. Level of Evidence:
Therapeutic Level II. Copyright © 2021, Scoliosis Research
Society.

<106>
Accession Number
2010403664
Title
Assessment of prognostic value of intraoperative oliguria for
postoperative acute kidney injury: a retrospective cohort study.
Source
British Journal of Anaesthesia. 126 (4) (pp 799-807), 2021. Date of
Publication: April 2021.
Author
Zhao B.-C.; Lei S.-H.; Yang X.; Zhang Y.; Qiu S.-D.; Liu W.-F.; Li C.; Liu
K.-X.
Institution
(Zhao, Lei, Yang, Zhang, Qiu, Liu, Li, Liu) Department of Anaesthesiology,
Nanfang Hospital, Southern Medical University, Guangzhou, China
Publisher
Elsevier Ltd
Abstract
Background: Oliguria is often viewed as a sign of renal hypoperfusion and
an indicator for volume expansion during surgery. However, the prognostic
association and the predictive utility of intraoperative oliguria for
postoperative acute kidney injury (AKI) are unclear. Method(s): We
conducted a retrospective cohort study on patients undergoing major
thoracic surgery in an academic hospital to assess the association of
intraoperative oliguria with postoperative AKI and its predictive value.
To contextualise our findings, we included our results in a meta-analysis
of observational studies on the importance of oliguria during noncardiac
surgery. Result(s): In our cohort study, 3862 patients were included;
205 (5.3%) developed AKI after surgery. Intraoperative urine output of 0.3
ml kg-1 h-1 was the optimal threshold for oliguria
in multivariable analysis. Patients with oliguria had an increased risk of
AKI (adjusted odds ratio: 2.60; 95% confidence interval: 1.24-5.05).
However, intraoperative oliguria had a sensitivity of 5.9%, specificity of
98%, positive likelihood ratio of 2.74, and negative likelihood ratio of
0.96, suggesting poor predictive ability. Moreover, it did not improve
upon the predictive performance of a multivariable model, based on
discrimination and reclassification indices. Our findings were generally
consistent with the results of a systematic review and meta-analysis,
including six additional studies. Conclusion(s): Intraoperative
oliguria has moderate association with, but poor predictive ability for,
postoperative AKI. It remains of clinical interest as a risk factor
potentially modifiable to interventions. Copyright © 2020 British
Journal of Anaesthesia

<107>
Accession Number
2010148029
Title
A mortality risk score for septuagenarians undergoing orthotopic heart
transplantation.
Source
Clinical Transplantation. 35 (3) (no pagination), 2021. Article Number:
e14202. Date of Publication: March 2021.
Author
Diaz-Castrillon C.E.; Seese L.; Hong Y.; Dufendach K.; Hickey G.; Sultan
I.; Kilic A.
Institution
(Diaz-Castrillon, Seese, Hong, Dufendach, Sultan, Kilic) Division of
Cardiac Surgery, Department of Cardiothoracic Surgery, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Hickey) Division of Cardiology, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Hickey, Sultan, Kilic) Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
Publisher
Blackwell Publishing Ltd
Abstract
Background: With septuagenarians undergoing orthotopic heart
transplantation (OHT) more frequently, we aimed to develop a risk score
for 1-year mortality in this population. Method(s): Septuagenarian
OHT recipients were identified from the UNOS registry between 1987 and
2018. The primary outcome was 1-year post-OHT mortality. Patients were
randomly divided into derivation and validation cohorts. Associated
covariates were entered into a multivariable logistic regression model. A
risk score was created using the magnitudes of the odds ratios from the
derivation cohort, and its 1-year post-OHT mortality prediction capacity
was tested in the validation cohort. Result(s): A total of 1156
septuagenarians were included, and they were randomly divided into
derivation (66.7%, n = 771) and validation (33.3%, n = 385) cohorts. An
11-point risk score incorporating 4 variables was created, which included
mechanical ventilation, serum bilirubin, serum creatinine, and donor age.
The predicted 1-year mortality ranged from 4.2% (0 points) to 48.1%
(11-points) (p <.001). After cross-validation, the c-index was 0.67 with a
Brier score of 0.10. Risk scores above 3 points portended a survival
disadvantage at 1-year follow-up (p <.001). Conclusion(s): This
11-point risk score for septuagenarians is predictive of mortality within
1-year of OHT and has potential utilization in improving recipient
evaluation and selection of elderly patients. Copyright © 2021
John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

<108>
Accession Number
634503923
Title
Antiplatelet therapy driven by platelet function: A real-world bridging
protocol experience with cangrelor in patients undergoing surgery after
acute coronary syndrome.
Source
Blood Transfusion. Conference: 26. Congresso Nazionale della Societa
Italiana per lo Studio dell'Emostasi e della Trombosi - SISET. Italy. 18
(SUPPL 4) (pp S406-S407), 2020. Date of Publication: November 2020.
Author
Ciatti F.; Muraca I.; Migliorini A.; Gori A.M.; Giusti B.; Carrabba N.;
Valenti R.; Marcucci R.
Institution
(Ciatti, Muraca, Migliorini, Carrabba, Valenti) Universita di Firenze,
Cardiotoracovascolare, Firenze, Italy
(Gori, Giusti, Marcucci) Universita di Firenze, Medicina Sperimentale e
Clinica, Firenze, Italy
Publisher
Edizioni SIMTI
Abstract
Background. Perioperative management of dual antiplatelet therapy (DAPT)
after percutaneous coronary intervention (PCI) in patients at high
thrombotic risk undergoing non-deferrable surgery remains poorly defined.
Cangrelor is an intravenous P2Y12 receptor antagonist approved for use
during PCI. It has been tested in a randomized trial as a "bridge" to
cardiac surgery from discontinuation of oral P2Y12 receptor antagonists.
We sought to describe a real-world experience of a bridging protocol using
cangrelor for patients referred to relevant bleeding risk surgery or
invasive procedures requiring withdrawal of DAPT. Methods. We collected
data from our Institution (Careggi Hospital) about 4 patients with
previous PCI, still on DAPT, undergoing non-deferrable surgery or invasive
procedures which required discontinuation of one or both antiplatelet
agents. A standardized cangrelor infusion dose, according BRIDGE protocol.
was applied. Results. Between March 2019 and December 2019, a total of 4
patients (69,5 +/- 7,8 years; male 100%) were enrolled. Patients had
undergone PCI within the previous month (median 18,5, IQR 15.5-20 days)
due to acute coronary syndrome (NSTEMI in 90% of cases) and stents of main
vessels were implanted. All patients, referred to nondeferrable
intermediate-high bleeding risk surgery or invasive procedure (as
intestinal biopsy, hemicolectomy, percutaneous endoscopic gastrostomy,
anterior excision of the rectum), required discontinuation of ticagrelor
(n 1/4) or clopidogrel (n 3/4). 3 patients were on clopidogrel therapy for
comitant atrial fibrillation and therefore need for triple antithrombotic
therapy. All patients discontinued both aspirin and P2Y12 antiplatelet
agent through the perioperative phase. Cangrelor infusion was started at a
bridging dose 3,75+/-0,4 days before surgery and was discontinued 2 hours
before. During cangrelor infusion platelet reactivity was monitored using
VeryfyNow system. In 2 high thrombotic risk patients cangrelor was resumed
at 12 hours after surgery, before switching oral therapy, in order to take
advantage of rapid drug offset in case of bleeding events. In one patient,
who undergone hemicolectomy, drainages were left and removed after
discontinuation of cangrelor. A P2Y12 antiplatelet agent loading dose was
administered within 2 hours from cangrelor discontinuation. Only 1 patient
received blood transfusions due to an increased perioperative bleeding.
The hospital course was uneventful and patients were discharged with the
previous antithrombotic therapy. Conclusion. According to our experience
perioperative bridge therapy with cangrelor is a feasible and safety
strategy for stented patients at high ischemic/hemorrhagic risk referred
to non-deferrable cardiac and also non-cardiac surgery requiring DAPT
discontinuation. The management of the "bridging therapy" with the
monitoring of platelet function allows to tailor the timing and the dosage
of drugs in order to minimze bleeding and thrombotic events.

<109>
Accession Number
2011311274
Title
Recent achievements in transcatheter closure of ventricular septal
defects: A systematic review of literature and a meta-analysis.
Source
Kardiologia Polska. 79 (2) (pp 161-169), 2021. Date of Publication: 25 Feb
2021.
Author
Werynski P.; Skorek P.; Wojcik A.; Rudek-Budzynska A.; Dziewulska A.;
Rudzinski A.
Institution
(Werynski, Skorek, Wojcik, Rudek-Budzynska, Dziewulska, Rudzinski)
Department of Pediatric Cardiology, Polish-American Institute of
Pediatrics, Jagiellonian University, Medical College, Krakow, Poland
Publisher
Medycyna Praktyczna Cholerzyn
Abstract
Background Ventricular septal defect (VSD) is one of the most common
congenital heart defects. Currently, surgery remains the treatment of
choice. However, transcatheter techniques for closing of various types of
VSDs have become an alternative. aims The objective of our study was to
present the outcomes of transcatheter closure of various types of VSD
based on a systematic review of recent publications. methods A systematic
review of studies published in English between January 2014 and March 2020
was performed using the PubMed database (MEDLINE) independently by 2
reviewers. Data on success and complication rates were extracted. Studies
including fewer than 5 patients and those with acquired VSD were excluded
from the analysis. results Finally, 44 studies were included for analysis,
with a total number of 4050 patients. The pooled estimate of the overall
success rate based on the random effects model was 97.96% (95% CI,
97.37-98.56; Q test P <0.001; I2 = 50%). Early residual shunt
was the most common complication with a pooled estimate rate of 22.25%
(95% CI, 16.46-28.05; P <0.001; I2 = 95%). However, only 92
patients had permanent VSD. Complete atrioventricular block constituted
the most dangerous complication, and the pooled estimate rates were
assessed as 0.64% (95% CI, 0.39-0.88; I2 = 0%) for transient
VSD and 0.32% (95% CI, 0.15-0.49; P >0.99; I2 = 0%) for
permanent VSD. conclusions Transcatheter closure of selected VSDs appears
to be an effective and safe method of treatment. Recent studies have shown
high rates of successful interventions with a low incidence of
complications. Copyright by the Author(s), 2021

<110>
Accession Number
2011311450
Title
Incidence of early atrial fibrillation after transcatheter versus surgical
aortic valve replacement: A meta-analysis of randomized controlled trials.
Source
Journal of Atrial Fibrillation. 13 (4) (pp 23-27), 2020. Date of
Publication: January 2021.
Author
Altaii H.; Morcos R.; Riad F.S.; Abdulameer H.; Khalili H.; Maini B.;
Lieberman E.; Vivas Y.; Wiegn P.; Joglar J.A.; Mackall J.; Al-Kindi S.G.;
Thal S.
Institution
(Altaii, Morcos, Khalili, Maini, Lieberman, Vivas) Division of Cardiology,
Florida Atlantic University, Boca Raton, FL, United States
(Khalili, Maini, Lieberman) Tenet Healthcare, Delray Medical Center,
Delray Beach, FL, United States
(Riad, Mackall, Al-Kindi, Thal) Harrington Heart and Vascular Institute,
University Hospitals and Case Western Reserve University, Cleveland, OH,
United States
(Abdulameer) Department of Surgery, Florida Atlantic University, Boca
Raton, FL, United States
(Wiegn, Joglar) Clinical Cardiac Electrophysiology, University of Texas
Southwestern Medical Center, Dallas, TX, United States
Publisher
CardioFront LLC
Abstract
Background: Post-operative atrial fibrillation (POAF) is common after
aortic valve replacement (AVR) and is associated with worse outcomes. We
performed a meta-analysis of randomized controlled trials comparing
Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve
Replacement (TAVR) for incidence of POAF at 30 days. Method(s): We
searched databases from 1/1/1990 to 1/1/2020 for randomized studies
comparing TAVR and SAVR. POAF was defined as either worsening or new-onset
atrial fibrillation. Random effects model was used to estimate the risk of
POAF with TAVR vs SAVR in all trials, and in subgroups (low, intermediate,
high risk, and in self-expandable vs balloon expandable valves).
Sensitivity analysis was performed including only studies reporting
new-onset atrial fibrillation Results: Seven RCTs were identified that
enrolled 7,934 patients (3,999 to TAVR and 3,935 to SAVR). The overall
incidence of POAF was 9.7% after TAVR and 33.3% after SAVR. TAVR was
associated with a lower risk of POAF compared with SAVR (OR 0.21
[0.18-0.24]; P < 0.0001). Compared with SAVR, TAVR was associated with a
significantly lower risk of POAF in the high-risk cohort (OR 0.37
[0.27-0.49]; P < 0.0001), in the intermediate-risk cohort (OR 0.23
[0.19-0.28]; P < 0.0001), low-risk cohort (OR 0.13 [0.10-0.16]; P <
0.0001). Sensitivity analysis of 4 trials including only new-onset POAF
showed similar summary estimates (OR 0.21, 95% CI [0.18-0.25]; P< 0.0001).
 Conclusion(s): TAVR is associated with a significantly lower risk of
post-operative atrial fibrillation compared with SAVR in all strata.
Further studies are needed to identify the contribution of post-operative
atrial fibrillation to the differences in clinical outcomes after TAVR and
SAVR. Copyright © 2020 CardioFront LLC. All rights reserved.

<111>
Accession Number
2011311447
Title
Contemporary anticoagulation practices for postoperative atrial
fibrillation: A single center experience.
Source
Journal of Atrial Fibrillation. 13 (4) (pp 6-10), 2020. Date of
Publication: January 2021.
Author
Riad F.S.; German K.; Deitz S.; Sahadevan J.; Sundaram V.; Waldo A.L.
Institution
(Riad, German, Deitz, Sahadevan, Sundaram, Waldo) Harrington Heart and
Vascular Institute, University Hospitals and Case Western Reserve
University, Cleveland, OH, United States
(Sahadevan) Department of Medicine, Louis Stokes Veteran Affairs Medical
Center, Cleveland, OH, United States
Publisher
CardioFront LLC
Abstract
Aims: Postoperative atrial fibrillation (POAF) is a frequent in-hospital
complication after cardiac surgery. Surprisingly, despite its prevalence,
management of this condition has not been well studied. One promising
approach that has been evaluated in a limited number of studies is use of
anticoagulation. However, the trends and patterns of real-world use of
anticoagulation in POAF patients has not been systemically investigated.
In this study, we aimed to determine real-world patterns of
anticoagulation use for patients with POAF. Method(s): We identified
200 patients undergoing coronary artery bypass (CABG) or cardiac valve
surgery at University Hospitals Cleveland Medical Center over a 2 year
period beginning January 2016 with new onset POAF. We reviewed charts to
verify candidacy for inclusion in the study and to extract data on
anticoagulation use, adverse outcomes, and
CHA<inf>2</inf>DS<inf>2</inf>-VASc scores. Result(s): Anticoagulation
use was low after CABG, but high after bioprosthetic valve surgery. The
most common anticoagulant used was warfarin. Anticoagulation use was not
correlated with CHA<inf>2</inf>DS<inf>2</inf>-VASc score or cardioversion.
Stroke and mortality were higher among patients not receiving
anticoagulation, however, confirmation of this finding in larger
randomized studies is warranted. Conclusion(s): Anticoagulation use
is low after CABG and this practice does not appear to be affected by
CHA<inf>2</inf>DS<inf>2</inf>VASc score or cardioversion. This differs
with previously reported provider attitudes towards management of this
condition. Stroke and mortality appear to be elevated for patients not
receiving anticoagulation but further investigation is required to confirm
this observation. Copyright © 2020 CardioFront LLC. All rights
reserved.

<112>
Accession Number
634493053
Title
Effectiveness of Standard Local Anesthetic Bupivacaine and Liposomal
Bupivacaine for Postoperative Pain Control in Patients Undergoing Truncal
Incisions: A Randomized Clinical Trial.
Source
JAMA Network Open. (no pagination), 2021. Article Number: e210753. Date of
Publication: 2021.
Author
Sandhu H.K.; Miller C.C.; Tanaka A.; Estrera A.L.; Charlton-Ouw K.M.
Institution
(Sandhu, Miller, Tanaka, Estrera, Charlton-Ouw) McGovern Medical School,
University of Texas Health Science Center, Houston, United States
(Tanaka, Estrera) Memorial Hermann Hospital, Texas Medical Center,
Houston, United States
(Charlton-Ouw) HCA Houston Healthcare, Gulf Coast Division, Houston, TX,
United States
(Charlton-Ouw) Department of Clinical Sciences, University of Houston,
College of Medicine, 1200 Binz St, Houston, TX 77004, United States
Publisher
American Medical Association
Abstract
Importance: Liposomal bupivacaine for pain relief is purported to last 3
days compared with 8 hours with standard bupivacaine. However, its
effectiveness is unknown in truncal incisions for cardiothoracic or
vascular operations. Objective(s): To compare the effectiveness of
single-administration standard bupivacaine vs liposomal bupivacaine in
patients undergoing truncal incisions. Design, Setting, and
Participant(s): This randomized clinical trial enrolled patients
undergoing sternotomy, thoracotomy, minithoracotomy, and laparotomy from a
single cardiovascular surgery department in an academic medical center
between November 2012 and June 2018. The study was powered to detect a
Cohen effect size of 0.35 with a power of greater than 80%. Data analysis
was performed from July to December 2018. Intervention(s): Patients
were randomized to standard bupivacaine or liposomal bupivacaine.
 Main Outcomes and Measures: Pain was assessed over 3 postoperative
days by the Numeric Rating Scale (NRS). Adjunctive opioids were converted
to morphine equivalents units (MEU). NRS scores were compared using
Wilcoxon rank-sum (3-day area under the curve) and 2-way nonparametric
mixed models (daily scale score) to assess time-by-group interaction.
Secondary outcomes included cumulative opioid consumption. Result(s):
A total of 280 patients were analyzed, with 140 in each group
(single-administration standard bupivacaine vs liposomal bupivacaine).
Mean (SD) age was 60.2 (14.4) years, and 101 of 280 patients (36%) were
women. Irrespective of treatment assignment, pain decreased by a mean of
approximately 1 point per day over 3 days (beta = -0.87; SE = 0.11; mixed
model regression P <.001). Incision type was associated with pain with
patients undergoing thoracotomy (including minithoracotomy) reporting
highest median (interquartile range [IQR]) pain scores on postoperative
days 1 (liposomal vs standard bupivacaine, 6 [4-8] vs 5 [3-7]; P =.049,
Wilcoxon rank-sum) and 2 (liposomal vs standard bupivacaine, 5 [4-7] vs 4
[2-6]; P =.003, Wilcoxon rank-sum) but not day 3 (liposomal vs standard
bupivacaine, 3 [2-6] vs 3 [1-5]; P =.10, Wilcoxon rank-sum), irrespective
of treatment group. Median (IQR) 3-day cumulative NRS was 12.0 (8.0-16.5)
for bupivacaine and 13.5 (9.0-17.0) for liposomal bupivacaine (P =.15,
Wilcoxon rank-sum) Furthermore, use of opioids was greater following
liposomal bupivacaine compared with standard bupivacaine (median [IQR],
41.5 [21.3-73.8] MEU vs 33.0 [17.8-62.5] MEU; P =.03, Wilcoxon rank-sum).
On multivariable analysis, no interaction by incision type was observed
for mean pain scores or opioid use. Conclusions and Relevance: In
this randomized clinical trial involving truncal incisions for
cardiovascular procedures, liposomal bupivacaine did not provide improved
pain control and did not reduce adjunctive opioid use compared with
conventional bupivacaine formulation over 3 postoperative days. Trial
Registration: ClinicalTrials.gov Identifier: NCT02111746. Copyright
© 2021 American Medical Association. All rights reserved.

<113>
Accession Number
634492746
Title
Newer Volatile Anesthetic Agents in Cardiac Anesthesia: Review of
Literature.
Source
Journal of Cardiac Critical Care. (no pagination), 2021. Date of
Publication: 2021.
Author
Mandke A.; Sarkar M.; Deshpande C.; Maheshwari A.; Kumar B.; Bhavani M.;
Varma S.; Shah H.; Bhanu L.; Khanderkar S.; Ganpathy K.; Soni K.; Nebu R.;
Saxena G.
Institution
(Mandke) Department of Cardiac Anaesthesia, Kokilaben Dhirubhai Ambani
Hospital, Mumbai, Maharashtra, India
(Sarkar) Department of Anaesthesia, Dnyandeo Yashwantrao Patil Hospital,
Mumbai, Maharashtra, India
(Deshpande) Department of Anaesthesia BYL, Nair Ch. Hospital, Mumbai,
Maharashtra, India
(Maheshwari) Department of Cardiac Anaesthesia, Sir Ganga Ram Hospital,
New Delhi, India
(Kumar) Department of Cardiac Anaesthesia, PGIMER, Chandigarh, India
(Bhavani) Department of Anaesthesia, Madras Medical College, Chennai,
Tamil Nadu, India
(Varma) Department of Cardiac Anaesthesia, MGM, Healthcare, Chennai, Tamil
Nadu, India
(Shah) Department of Cardiac Anaesthesia, Narayana Hrudyalaya, Ahmedabad,
Gujrat, India
(Bhanu) Department of Anaesthesia, Gandhi Medical College, Hyderabad,
Telangana, India
(Khanderkar) Department of Cardiac Anaesthesia, KDA, Mumbai, Maharashtra,
India
(Ganpathy) Department of Anaesthesia, Apollo Hospitals, Chennai, Tamil
Nadu, India
(Soni) Department of Anaesthesia, Apollo Hospital, Bhat, Ahmedabad,
Gujarat, India
(Nebu) Department of Cardiac Anaesthesia, KEM Hospital, Mumbai,
Maharashtra, India
(Saxena) Medical Division Affairs, Baxter India, Tower A, DLF Cyber City
Phase 2, Gurgaon, Haryana 122002, India
Publisher
Thieme India
Abstract
Myocardial protection with volatile anesthetic agents have been suggested
by multiple studies. These studies, however, are scattered and are often
limited to a particular aspect of cardiac anesthesia. Older inhalational
agents like halothane is known to cause significant hepatic damage in
patients undergoing long duration surgeries while isoflurane is known to
have marked vasodilating properties that also affects the coronary
arteries leading to coronary steal phenomenon. Additionally, newer agents,
like sevoflurane and desflurane, have shown more prominent
cardioprotective effects than older agents. We searched ScholarOne,
Medline, Embase, and the Cochrane Central Register of Controlled Trials
(CENTRAL) in the Cochrane Library. The medical subject headings (MeSH)
terms anaesthesia, inhalational, anaesthesia, intravenous, or TIVA, and
Cardiac anaesthesia or Cardiac Surgery were used. Additional studies were
identified by review of the reference sections of all eligible studies.
The aim of this review article is to bring together the evidences with
newer inhalational agents and provide a holistic view of their benefits
and shortcomings in cardiac anesthesia. Copyright © 2021
Cambridge University Press. All rights reserved.

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