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<1>
Accession Number
2010744907
Title
Methodologic Considerations on Four Cardiovascular Interventions Trials
With Contradictory Results.
Source
Annals of Thoracic Surgery. 111 (2) (pp 690-699), 2021. Date of
Publication: February 2021.
Author
Gaudino M.; Ruel M.; Obadia J.-F.; De Bonis M.; Puskas J.; Biondi-Zoccai
G.; Angiolillo D.J.; Charlson M.; Crea F.; Taggart D.P.
Institution
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute,
University of Ottawa, Ottawa, ON, Canada
(Obadia) Department of Cardiovascular Surgery, Hopital Cardiologique Louis
Pradel, Lyon, France
(De Bonis) Department of Cardiac Surgery, IRCCS San Raffaele University
Hospital, Milan, Italy
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Saint Luke's,
New York, NY, United States
(Biondi-Zoccai) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Biondi-Zoccai) Mediterranea Cardiocentro, Naples, Italy
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Charlson) Department of Healthcare Policy and Research, Weill Cornell
Medical College, New York, NY, United States
(Crea) Department of Cardiovascular and Thoracic Sciences, Fondazione
Policlinico Gemelli-IRCCS, Universita Cattolica del Sacro Cuore, Rome,
Italy
(Taggart) John Radcliffe Hospital, University of Oxford, Oxford, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Contradictory findings from randomized trials addressing
similar research questions are not uncommon in medicine. Although
differing results may reflect true differences in the treatment effects or
in the deliverability of the intervention, more commonly it is as a
consequence of small but important discrepancies in study design.
<br/>Method(s): The writing group selected 4 recent trials with apparently
contradictory results (2 on revascularization for left main coronary
stenosis and 2 on treatment of secondary mitral regurgitation). Detailed
methodologic analysis was performed to elucidate the difference in
findings. <br/>Result(s): Differences in the definition of the primary
outcome are the most likely explanation for the contradictory findings of
NOBLE versus EXCEL. Differences in study design (leading to substantially
different patient populations) and in outcome definition might explain the
discrepant findings of MITRA-FR versus COAPT. <br/>Conclusion(s): As shown
by the comparative analysis of NOBLE and EXCEL and MITRA-FR and COAPT,
changes in study design, outcome definitions, and patient population can
markedly affect the outcome of randomized clinical trials.<br/>Copyright
&#xa9; 2021 The Society of Thoracic Surgeons

<2>
Accession Number
2005866690
Title
Impact of chronic kidney disease on chronic total occlusion
revascularization outcomes: A meta-analysis.
Source
Journal of Clinical Medicine. 10 (3) (pp 1-9), 2021. Article Number: 440.
Date of Publication: 01 Feb 2021.
Author
Lee W.-C.; Wu P.-J.; Fang C.-Y.; Chen H.-C.; Wu C.-J.; Fang H.-Y.
Institution
(Lee, Wu, Fang, Chen, Wu, Fang) Division of Cardiology, Department of
Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung
University College of Medicine, Kaohsiung 83301, Taiwan (Republic of
China)
(Lee) Institute of Clinical Medicine, College of Medicine, National Cheng
Kung University, Tainan 83301, Taiwan (Republic of China)
Publisher
MDPI AG
Abstract
Objectives: To examine the impact of revascularization and associated
clinical outcomes of chronic kidney disease (CKD) chronic total occlusion
(CTO) and non-CKD CTO groups. <br/>Background(s): The influence of CKD on
clinical outcomes after percutaneous coronary intervention (PCI) for CTO
lesions is unknown, and there is no systemic review of this topic to date.
<br/>Method(s): We searched the PubMed, Embase, ProQuest, ScienceDirect,
Cochrane Library, ClinicalKey, Web of Science, and ClinicalTrials.gov
databases for articles published between 1 January 2010 and 31 March 2020.
CKD was defined as estimated glomerular filtration rate of <60 mL/min/1.73
m² according to the Modification of Diet in Renal Disease
formula. Data included demographics, lesion distributions, incidence of
contrast-induced nephropathy (CIN), acute kidney injury (AKI), procedural
success rate, mortality, and target lesion revascularization (TLR)/target
vessel revascularization (TVR). <br/>Result(s): Six studies were
ultimately included in this systematic review. A high prevalence (25.5%;
range, 19.6-37.9%) of CKD was noted in the CTO population. In the non-CKD
group, outcomes were better: less incidence of CIN or AKI (odds ratio
(OR), 2.860; 95% confidence interval (CI), 1.775-4.608), higher procedural
success rate (OR, 1.382; 95% CI, 1.036-1.843), and lower long-term
mortality (OR, 4.502; 95% CI, 3.561-5.693). The incidence of TLR/TVR (OR,
1.118; 95% CI, 0.888-1.407) did not differ between groups.
<br/>Conclusion(s): In the CKD CTO PCI population, a lower procedural
success rate, a higher incidence of CIN or AKI, and higher in-hospital and
long-term mortality rate were noted due to more complex lesions and more
comorbidities. However, the incidence of TLR/TVR did not differ between
groups.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<3>
Accession Number
2003929359
Title
Impact of established cardiovascular disease on outcomes in the randomized
global leaders trial.
Source
Catheterization and Cardiovascular Interventions. 96 (7) (pp 1369-1378),
2020. Date of Publication: December 2020.
Author
Garg S.; Chichareon P.; Kogame N.; Takahashi K.; Modolo R.; Chang C.-C.;
Tomaniak M.; Fath-Ordoubadi F.; Anderson R.; Oldroyd K.G.; Stables R.H.;
Kukreja N.; Chowdhary S.; Galasko G.; Hoole S.; Zaman A.; Hamm C.W.; Steg
P.G.; Juni P.; Valgimigli M.; Windecker S.; Onuma Y.; Serruys P.W.
Institution
(Garg) Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust,
Blackburn, United Kingdom
(Chichareon, Kogame, Takahashi, Modolo) Department of Clinical and
Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC,
University of Amsterdam, Heart Center, Amsterdam, Netherlands
(Chichareon) Cardiology Unit, Department of Internal Medicine, Faculty of
Medicine, Prince of Songkla University, Songkhla, Thailand
(Modolo) Department of Internal Medicine, Cardiology Division, University
of Campinas (UNICAMP). Campinas, Brazil
(Chang, Tomaniak) Erasmus Medical Center, Thoraxcenter, Rotterdam,
Netherlands
(Tomaniak) First Department of Cardiology, Medical University of Warsaw,
Warsaw, Poland
(Fath-Ordoubadi) Manchester Heart Centre, Manchester Royal Infirmary,
Manchester University Foundation Trust, Manchester, United Kingdom
(Anderson) Department of Cardiology, University Hospital of Wales,
Cardiff, United Kingdom
(Oldroyd) West of Scotland Heart and Lung Centre, Golden Jubilee National
Hospital, Glasgow, United Kingdom
(Stables) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Kukreja) Department of Cardiology, East and North Hertfordshire NHS
Trust, Hertfordshire, United Kingdom
(Chowdhary) Wythenshawe Hospital, Manchester University Foundation Trust,
Manchester, United Kingdom
(Galasko) Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS
Foundation Trust, Blackpool, United Kingdom
(Hoole) Department of Interventional Cardiology, Royal Papworth Hospital,
Cambridge, United Kingdom
(Zaman) Department of Cardiology, Freeman Hospital and Institute of
Cellular Medicine, Newcastle University, Newcastle-upon-Tyne, United
Kingdom
(Hamm) Kerckhoff Heart Center, Campus University of Giessen, Bad Nauheim,
Germany
(Steg) FACT, French Alliance for Cardiovascular Trials; Hopital Bichat,
AP-HP; Universite Paris-Diderot; and INSERM U-1148, Paris, France
(Steg) Royal Brompton Hospital, Imperial College, London, United Kingdom
(Juni) Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto,
Canada
(Valgimigli, Windecker) Department of Cardiology, Bern University
Hospital, Bern, Switzerland
(Onuma, Serruys) Department of Cardiology, National University of Ireland
Galway, Galway, Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Objective: To investigate the impact of different anti-platelet strategies
on outcomes after percutaneous coronary intervention (PCI) in patients
with established cardiovascular disease (CVD). <br/>Method(s): GLOBAL
LEADERS was a randomized, superiority, all-comers trial comparing
one-month dual anti-platelet therapy (DAPT) with ticagrelor and aspirin
followed by 23-month ticagrelor monotherapy (experimental treatment) with
standard 12-month DAPT followed by 12-month aspirin monotherapy (reference
treatment) in patients treated with a biolimus A9-eluting stent.
Established CVD was defined as >=1 prior myocardial infarction, PCI,
coronary artery bypass operation, stroke, or established peripheral
vascular disease. The primary endpoint was a composite of all-cause death
or new Q-wave MI at 2-years. The secondary safety endpoint was BARC 3 or 5
bleeding. Exploratory secondary endpoints were the patient-orientated
composite endpoint and net adverse clinical events. <br/>Result(s): Among
the 15,761 patients in this cohort were 6,693 patients (42.5%) with
established CVD. Compared to those without established CVD, these patients
had significantly higher rates of the primary (5.1 vs. 3.3%,
HR1.59[1.36-1.86], p <.001) and secondary composite endpoints with no
significant differences in bleeding. There was a nonsignificant reduction
in the primary endpoint in patients with established CVD receiving the
experimental treatment (4.6 vs. 5.6%, HR0.82[0.66-1.02], p =.07). When
comparing patients without CVD to those with one or three territories of
CVD, the hazard ratio for the primary endpoint increased in unadjusted and
adjusted models. <br/>Conclusion(s): The poorer outcomes in patients with
established CVD are not mitigated by prolonged monotherapy with a potent
P2Y12 inhibitor suggesting a greater need to focus on modifiable risk
factors.<br/>Copyright &#xa9; 2019 Wiley Periodicals, Inc.

<4>
Accession Number
2003783543
Title
Distal transradial access for cardiac catheterization: A systematic
scoping review.
Source
Catheterization and Cardiovascular Interventions. 96 (7) (pp 1381-1389),
2020. Date of Publication: December 2020.
Author
Coomes E.A.; Haghbayan H.; Cheema A.N.
Institution
(Coomes) Department of Medicine, University of Toronto, Toronto, ON,
Canada
(Haghbayan) Division of Cardiology, London Health Sciences Centre, Western
University, London, ON, Canada
(Haghbayan) Department of Social and Preventive Medicine, Universite
Laval, QC, Canada
(Cheema) Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto,
ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Objective: Systematically review the literature for cardiac
catheterization and coronary angiography via distal transradial access
(dTRA) and its outcomes. <br/>Background(s): dTRA, via anatomical
snuffbox, may have several advantages over conventional transradial access
(cTRA) for percutaneous cardiac procedures, including easier left-sided
access for aorto-coronary grafts, future proximal radial artery
preservation, and patient and operator comfort. However, its procedural
characteristics and safety profile remain unclear. <br/>Method(s): Ovid
MEDLINE and EMBASE were searched from inception to September 2018. Two
authors independently performed two-stage selection and data extraction.
Reports assessing the dTRA approach for cardiac intervention in adults
reporting any outcomes were eligible. Descriptive summary statistics were
calculated from pooled data. <br/>Result(s): A total of 19 publications
comprising 4,212 participants undergoing dTRA were included. Mean age was
63.8 years, and 23.0% were female. dTRA was primarily undertaken for
assessment of stable coronary artery disease (87.6%), with 41.7% for
diagnostic procedures and 46.9% undergoing percutaneous coronary
intervention. The overall success rate for undertaking the dTRA approach
was 95.4% (69-100%). Complications occurred in 2.4% of cases, of which the
leading complications were bleeding/hematoma (18.2%). Complication rates
did not significantly differ between dTRA and cTRA. The occurrence of
radial artery occlusion in patients undergoing dTRA was low (1.7%).
<br/>Conclusion(s): Observational data demonstrate that dTRA is a safe and
feasible method for percutaneous cardiac procedures, with high rates of
procedural success and low rates of complication. As data comparing dTRA
with cTRA remain limited, future high-quality randomized comparative
studies are required.<br/>Copyright &#xa9; 2019 Wiley Periodicals, Inc.

<5>
Accession Number
2006151338
Title
Percutaneous large-bore axillary access is a safe alternative to surgical
approach: A systematic review.
Source
Catheterization and Cardiovascular Interventions. 96 (7) (pp 1481-1488),
2020. Date of Publication: December 2020.
Author
Southmayd G.; Hoque A.; Kaki A.; Tayal R.; Rab S.T.
Institution
(Southmayd, Hoque, Rab) Division of Cardiology, Emory University School of
Medicine, Atlanta, GA, United States
(Kaki) Division of Cardiology, Ascension St. John Hospital, Detroit, MI,
United States
(Tayal) Division of Cardiology, RWJ Barnabas Health, Newark Beth Israel
Medical Center, Newark, NJ, United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To systematically review relevant literature regarding
cardiovascular outcomes of large-bore axillary arterial access via
percutaneous and surgical approaches. <br/>Background(s): In patients with
severe peripheral arterial disease (PAD) undergoing cardiac interventions,
large-bore femoral access may be prohibitive. The axillary artery provides
an alternative vascular access for transcatheter aortic valve replacement
(TAVR) or mechanical circulatory support. There have been limited
comparisons of percutaneous transaxillary (pTAX) approach with the more
traditional surgical transaxillary (sTAX) approach. <br/>Method(s): Pubmed
and Medline databases were queried through January 2019 for studies
describing pTAX or sTAX approaches with TAVR or Impella insertion. Primary
outcomes were access-related mortality, 30-day mortality, stroke, major
vascular complications, and major bleeding. <br/>Result(s): One hundred
and fifty five studies were reviewed, with additional unpublished data
from 1 institution. Twenty-two studies met the inclusion criteria. Patient
data was heterogeneous, with 69% TAVR and 31% Impella use in the pTAX
group, and 96% TAVR and 4% Impella use in the sTAX group. There was more
cardiogenic shock in the pTAX group. When compared to surgical approach,
the percutaneous approach had similar 30-day mortality for TAVR (5.6% vs
4.6%, OR non-significant) and Impella (43.4% vs 38.6%, OR
non-significant), similar stroke rates (4.3% vs 4.2%, OR non-significant),
similar major vascular complications (2.8% vs 2.3%, OR non-significant)
and less major bleeding (2.7% vs 17.9%, OR significant).
<br/>Conclusion(s): Data suggests large-bore pTAX access has similar
30-day mortality, stroke rates, and major vascular complications as sTAX
access, with less major bleeding. Additional studies are needed to
validate results.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC.

<6>
Accession Number
2007982244
Title
Randomized Controlled Trial of Working Memory Intervention in Congenital
Heart Disease.
Source
Journal of Pediatrics. 227 (pp 191-198.e3), 2020. Date of Publication:
December 2020.
Author
Calderon J.; Wypij D.; Rofeberg V.; Stopp C.; Roseman A.; Albers D.;
Newburger J.W.; Bellinger D.C.
Institution
(Calderon, Bellinger) Department of Psychiatry, Boston Children's
Hospital, Boston, MA, United States
(Calderon, Bellinger) Department of Psychiatry, Harvard Medical School,
Boston, MA, United States
(Wypij, Rofeberg, Stopp, Roseman, Albers, Newburger) Department of
Cardiology, Boston Children's Hospital, Boston, MA, United States
(Wypij) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
(Wypij, Newburger) Department of Pediatrics, Harvard Medical School,
Boston, MA, United States
(Bellinger) Department of Neurology, Boston Children's Hospital, Boston,
MA, United States
(Bellinger) Department of Neurology, Harvard Medical School, Boston, MA,
United States
Publisher
Mosby Inc.
Abstract
Objectives: To evaluate the efficacy of Cogmed Working Memory Training
compared with the standard of care to improve executive function and
social outcomes in adolescents with congenital heart disease (CHD) who
underwent open-heart surgery in infancy and to identify factors associated
with changes in outcomes following the intervention. Study design: In a
single-center, randomized controlled trial, adolescents (13-16 years) with
CHD were randomly assigned to either Cogmed (home-based 45-minutes
sessions for 5-8 weeks) or to a control group. The primary outcome was
working memory. Secondary outcomes included inhibitory control and
cognitive flexibility as well as parent-reported executive function,
symptoms of attention deficit hyperactivity disorder, and social outcomes.
All measures were assessed at baseline, post-treatment (1-3 weeks
post-training) and at 3-month follow-up. Data were analyzed using an
intention-to-treat approach. <br/>Result(s): Sixty adolescents with CHD
participated (28 assigned to Cogmed). No improvement at the post-treatment
or 3-month follow-up assessments was found for the primary outcome measure
of working memory. Compared with the control group, participants assigned
to the intervention demonstrated benefits in inhibitory control and
attention at the 3-month follow-up (P = .02) and in parent-reported
cognitive regulatory skills at post-treatment and 3-month follow-up (P =
.02 and P = .04, respectively). Preterm birth, biventricular CHD, and
history of attention deficit hyperactivity disorder diagnosis were
associated with improved response to the intervention. <br/>Conclusion(s):
Cogmed intervention produced improvements in the self-regulatory control
abilities of adolescents with CHD. The training did not enhance other
areas of executive function or behavioral outcomes. Further studies are
needed to evaluate the longer-term potential benefits to other domains.
Trial registration: Clinicaltrials.gov: NCT02759263.<br/>Copyright &#xa9;
2020 Elsevier Inc.

<7>
Accession Number
2007637037
Title
Dual Antiplatelet Therapy for Long-term Secondary Prevention of
Atherosclerotic Cardiovascular Events.
Source
Clinical Therapeutics. 42 (10) (pp 2084-2097), 2020. Date of Publication:
October 2020.
Author
Dobesh P.P.; Finks S.W.; Trujillo T.C.
Institution
(Dobesh) University of Nebraska Medical Center, College of Pharmacy,
Omaha, NE, United States
(Finks) University of Tennessee College of Pharmacy, Memphis, TN, United
States
(Trujillo) University of Colorado, Skaggs School of Pharmacy and
Pharmaceutical Sciences, Pharmacy & Pharmaceutical Sciences, Aurora, CO,
United States
Publisher
Excerpta Medica Inc.
Abstract
Purpose: Dual antiplatelet therapy (DAPT) with aspirin and a
P2Y<inf>12</inf> inhibitor is currently recommended to prevent further
ischemic events after percutaneous coronary intervention and acute
coronary syndrome (ACS). Guidelines currently recommend a minimum of 6
months after elective drug-eluting stent placement and at least 12 months
of DAPT after ACS; however, the benefits of prolonged treatment are
unclear. The purpose of this review was to conduct a detailed examination
of the data refuting or supporting the use of DAPT beyond 1 year in
patients with ACS and in patients receiving percutaneous coronary
intervention with stenting. <br/>Method(s): A search of PubMed was
performed to identify articles published in the last 20 years that
addressed the role of DAPT beyond 12 months' duration. <br/>Finding(s): A
number of studies have shown ischemic benefits associated with prolonging
DAPT beyond 12 months, but this finding is dependent on the patient
population studied and the quality of the study design. Many studies also
show that longer duration therapy has been associated with increased
bleeding risk. In patients with previous myocardial infarction completing
at least 1 year of DAPT, continuing DAPT with a reduced dose of ticagrelor
60 mg BID is a regimen to be considered for these patients; in general ACS
patients, a reduced dose of 60 mg BID of ticagrelor after the first year
of DAPT should be considered; and in the post-percutaneous coronary
intervention patients, DAPT beyond 1 year should be considered after
careful evaluation of the patient's thrombotic and bleeding risks.
Implications: The duration of DAPT, and the choice of P2Y<inf>12</inf>
inhibitor, should be tailored to the individual patient. To optimize
patient outcomes, the benefits and risks associated with prolonging DAPT
need to be evaluated, considering comorbidities and the presence of
bleeding and ischemic risk factors. Despite some limitations, risk scores,
such as the DAPT score, are available to help guide decisions for the best
approach for each patient.<br/>Copyright &#xa9; 2020

<8>
Accession Number
2007575433
Title
Vitamin D for prevention of sternotomy healing complications: REINFORCE-D
trial.
Source
Trials. 21 (1) (no pagination), 2020. Article Number: 1018. Date of
Publication: December 2020.
Author
Cecrle M.; Cerny D.; Sedlackova E.; Mikova B.; Dudkova V.; Drncova E.;
Pokusova M.; Skalsky I.; Tamasova J.; Halacova M.
Institution
(Cecrle, Cerny, Halacova) Department of Clinical Pharmacy, Na Homolce
Hospital, Prague, Czechia
(Cecrle, Cerny) Institute of Pharmacology, 1st Faculty of Medicine,
Charles University, Prague, Czechia
(Sedlackova, Skalsky) Department of Cardiac Surgery, Na Homolce Hospital,
Prague, Czechia
(Mikova) Department of Radiology, Na Homolce Hospital, Prague, Czechia
(Dudkova, Drncova) Department of Clinical Biochemistry, Hematology and
Immunology, Na Homolce Hospital, Prague, Czechia
(Pokusova) Hospital Pharmacy, Na Homolce Hospital, Prague, Czechia
(Tamasova) Department of Medical Physics, Na Homolce Hospital, Prague,
Czechia
(Halacova) Department of Pharmacology, 2nd Faculty of Medicine, Charles
University, Prague, Czechia
Publisher
BioMed Central Ltd
Abstract
Background: Most cardiac surgery patients undergo median sternotomy during
open heart surgery. Sternotomy healing is an arduous, very complex, and
multifactorial process dependent on many independent factors affecting the
sternum and the surrounding soft tissues. Complication rates for median
sternotomy range from 0.5 to 5%; however, mortality rates from
complications are very variable at 7-80%. Low calcidiol concentration
below 80 nmol/L results in calcium absorptive impairment and carries a
risk of bone loss, which is considered as a risk factor in the sternotomy
healing process. The primary objective of this clinical trial is to
compare the incidence of all postoperative sternotomy healing
complications in two parallel patient groups administered cholecalciferol
or placebo. The secondary objectives are focused on general patient
recovery process: sternal bone healing grade at the end of the trial,
length of hospitalization, number of days spent in the ICU, number of days
spent on mechanical lung ventilation, and number of hospital readmissions
for sternotomy complications. <br/>Method(s): This clinical trial is
conducted as monocentric, randomized, double-blind, placebo-controlled,
with planned enrollment of 600 patients over 4 years, approximately 300 in
the placebo arm and 300 in the treatment arm. Males and females from 18 to
95 years of age who fulfill the indication criteria for undergoing cardiac
surgery with median sternotomy can be included in this clinical trial, if
they meet the eligibility criteria. <br/>Discussion(s): REINFORCE-D is the
first monocentric trial dividing patients into groups based on serum
calcidiol levels, and with dosing based on serum calcidiol levels. This
trial may help to open up a wider range of postoperative healing issues.
Trial registration: EU Clinical Trials Register, EUDRA CT No:
2016-002606-39. Registered on September 8, 2016.<br/>Copyright &#xa9;
2020, The Author(s).

<9>
Accession Number
2011216217
Title
Potential Renoprotective Strategies in Adult Cardiac Surgery: A Survey of
Society of Cardiovascular Anesthesiologists Members to Explore the
Rationale and Beliefs Driving Current Clinical Decision-Making.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
McIlroy D.R.; Roman B.; Billings F.T.; Bollen B.A.; Fox A.; Geube M.; Liu
H.; Shore-Lesserson L.; Zarbock A.; Shaw A.D.
Institution
(McIlroy, Billings) Vanderbilt University Medical Center, Nashville, TN,
United States
(McIlroy) Monash University, Commercial Road, Melbourne, Victoria,
Australia
(Roman) Ochsner Medical Center, New Orleans, LA, United States
(Bollen) Missoula Anesthesiology and The International Heart Institute of
Montana, Missoula, MT, United States
(Fox) UT Southwestern Medical Center, Dallas, TX, United States
(Geube) Cleveland Clinic, Cleveland, OH, United States
(Liu) University of California Davis Health, Sacramento, CA, United States
(Shore-Lesserson) Zucker School of Medicine at Hofstra Northwell,
Manhasset, NY, United States
(Zarbock) University Hospital Munster, Munster, Germany
(Shaw) University of Alberta, Edmonton, AB, Canada
Publisher
W.B. Saunders
Abstract
Objectives: The authors sought to (1) characterize the rationale
underpinning anesthesiologists' use of various perioperative strategies
hypothesized to affect renal function in adult patients undergoing cardiac
surgery, (2) characterize existing belief about the quality of evidence
addressing the renal impact of these strategies, and (3) identify
potentially renoprotective strategies for which anesthesiologists would
most value a detailed, evidence-based review. <br/>Design(s): Survey of
perioperative practice in adult patients undergoing cardiac surgery.
<br/>Setting(s): Online survey. <br/>Participant(s): Members of the
Society of Cardiovascular Anesthesiologists (SCA). <br/>Intervention(s):
None. Measurements & Main Results: The survey was distributed to more than
2,000 SCA members and completed in whole or in part by 202 respondents.
Selection of target intraoperative blood pressure (and relative
hypotension avoidance) was the strategy most frequently reported to
reflect belief about its potential renal effect (79%; 95% CI: 72-85). Most
respondents believed the evidence supporting an effect on renal injury of
intraoperative target blood pressure during cardiac surgery was of high or
moderate quality. Other factors, including a specific nonrenal rationale,
surgeon preference, department- or institution-level decisions, tradition,
or habit, also frequently were reported to affect decision making across
queried strategies. Potential renoprotective strategies most frequently
requested for inclusion in a subsequent detailed, evidence-based review
were intraoperative target blood pressure and choice of vasopressor agent
to achieve target pressure. <br/>Conclusion(s): A large number of
perioperative strategies are believed to variably affect renal injury in
adult patients undergoing cardiac surgery, with wide variation in
perceived quality of evidence for a renal effect of these
strategies.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<10>
Accession Number
2011111957
Title
Outcomes 2 Years After Transcatheter Aortic Valve Replacement in Patients
at Low Surgical Risk.
Source
Journal of the American College of Cardiology. 77 (9) (pp 1149-1161),
2021. Date of Publication: 09 Mar 2021.
Author
Leon M.B.; Mack M.J.; Hahn R.T.; Thourani V.H.; Makkar R.; Kodali S.K.;
Alu M.C.; Madhavan M.V.; Chau K.H.; Russo M.; Kapadia S.R.; Malaisrie
S.C.; Cohen D.J.; Blanke P.; Leipsic J.A.; Williams M.R.; McCabe J.M.;
Brown D.L.; Babaliaros V.; Goldman S.; Herrmann H.C.; Szeto W.Y.; Genereux
P.; Pershad A.; Lu M.; Webb J.G.; Smith C.R.; Pibarot P.
Institution
(Leon, Hahn, Kodali, Alu, Madhavan, Chau, Smith) Columbia University
Irving Medical Center/NewYork Presbyterian Hospital, New York, NY, United
States
(Leon, Hahn, Alu, Madhavan) Cardiovascular Research Foundation, New York,
NY, United States
(Mack, Brown) Baylor Scott & White Health, Plano, TX, United States
(Thourani) Piedmont Heart Institute, Atlanta, GA, United States
(Makkar) Cedars Sinai Medical Center, Los Angeles, CA, United States
(Russo) Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ,
United States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Malaisrie) Northwestern University Feinberg School of Medicine, Chicago,
IL, United States
(Cohen) University of Missouri-Kansas City, Kansas City, MO, United States
(Blanke, Leipsic, Webb) St. Paul's Hospital, University of British
Columbia, Vancouver, BC, Canada
(Williams) NYU-Langone Medical Center, New York, NY, United States
(McCabe) University of Washington, Seattle, WA, United States
(Babaliaros) Emory University School of Medicine, Atlanta, GA, United
States
(Goldman) Lankenau Institute for Medical Research, Main Line Health,
Wynnewood, PA, United States
(Herrmann, Szeto) University of Pennsylvania, Philadelphia, PA, United
States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Pershad) University of Arizona College of Medicine, Phoenix, AZ, United
States
(Lu) Edwards Lifesciences, Irvine, CA, United States
(Pibarot) Department of Medicine, Laval University, Quebec, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: In low surgical risk patients with symptomatic severe aortic
stenosis, the PARTNER 3 (Safety and Effectiveness of the SAPIEN 3
Transcatheter Heart Valve in Low Risk Patients With Aortic Stenosis) trial
demonstrated superiority of transcatheter aortic valve replacement (TAVR)
versus surgery for the primary endpoint of death, stroke, or
re-hospitalization at 1 year. <br/>Objective(s): This study determined
both clinical and echocardiographic outcomes between 1 and 2 years in the
PARTNER 3 trial. <br/>Method(s): This study randomly assigned 1,000
patients (1:1) to transfemoral TAVR with the SAPIEN 3 valve versus surgery
(mean Society of Thoracic Surgeons score: 1.9%; mean age: 73 years) with
clinical and echocardiography follow-up at 30 days and at 1 and 2 years.
This study assessed 2-year rates of the primary endpoint and several
secondary endpoints (clinical, echocardiography, and quality-of-life
measures) in this as-treated analysis. <br/>Result(s): Primary endpoint
follow-up at 2 years was available in 96.5% of patients. The 2-year
primary endpoint was significantly reduced after TAVR versus surgery
(11.5% vs. 17.4%; hazard ratio: 0.63; 95% confidence interval: 0.45 to
0.88; p = 0.007). Differences in death and stroke favoring TAVR at 1 year
were not statistically significant at 2 years (death: TAVR 2.4% vs.
surgery 3.2%; p = 0.47; stroke: TAVR 2.4% vs. surgery 3.6%; p = 0.28).
Valve thrombosis at 2 years was increased after TAVR (2.6%; 13 events)
compared with surgery (0.7%; 3 events; p = 0.02). Disease-specific health
status continued to be better after TAVR versus surgery through 2 years.
Echocardiographic findings, including hemodynamic valve deterioration and
bioprosthetic valve failure, were similar for TAVR and surgery at 2 years.
<br/>Conclusion(s): At 2 years, the primary endpoint remained
significantly lower with TAVR versus surgery, but initial differences in
death and stroke favoring TAVR were diminished and patients who underwent
TAVR had increased valve thrombosis. (Safety and Effectiveness of the
SAPIEN 3 Transcatheter Heart Valve in Low Risk Patients With Aortic
Stenosis [PARTNER 3]; NCT02675114)<br/>Copyright &#xa9; 2021 American
College of Cardiology Foundation

<11>
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. <br/>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.
<br/>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. <br/>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.<br/>Copyright
&#xa9; 2021 British Journal of Anaesthesia

<12>
Accession Number
2011343153
Title
The direct comparison of inhaled versus intravenous levosimendan in
children with pulmonary hypertension undergoing on-cardiopulmonary bypass
cardiac surgery: A randomized, controlled, non-inferiority study.
Source
Journal of Clinical Anesthesia. 71 (no pagination), 2021. Article Number:
110231. Date of Publication: August 2021.
Author
Abdelbaser I.; Mageed N.A.; Elfayoumy S.I.; Elgamal M.-A.F.; Elmorsy M.M.;
Taman H.I.
Institution
(Abdelbaser, Mageed, Elmorsy, Taman) Department of Anesthesia and Surgical
Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Elfayoumy) Department of Anesthesia and Surgical Intensive Care, Faculty
of Medicine, Portsaid University, Portsaid, Egypt
(Elgamal) Department of Cardiac Surgery, Faculty of Medicine, Mansoura
University, Mansoura, Egypt
Publisher
Elsevier Inc.
Abstract
Study objective: Pulmonary arterial hypertension is commonly seen in
children with left to right intracardiac shunts and affects the outcomes
of cardiac surgery. Our study aimed to compare the efficacy of inhaled
levosimendan (LS) versus intravenous LS in reducing elevated pulmonary
artery pressure (PAP) in children scheduled for cardiac surgery.
<br/>Design(s): Non-inferiority, prospective, randomized, blinded,
controlled study. <br/>Setting(s): Operative room and intensive care unit
(ICU), institutional children's hospital of Mansoura Faculty of Medicine,
Egypt. <br/>Patient(s): 50 patients of either sex, aged 1 to 5 years
undergoing surgical repair of intracardiac left to right shunt complicated
by pulmonary hypertension were recruited for the study.
<br/>Intervention(s): In the intravenous LS group, patients received
intravenous infusion of LS a rate of 0.1 mug/kg/min and in the inhaled LS
group, LS (36 mug/kg/6 h) was delivered by nebulization. Measurements: The
primary endpoint was systolic PAP, while the secondary endpoints were the
heart rate, mean arterial blood pressure, dose of norepinephrine, time to
extubation and ICU length of stay. <br/>Main Result(s): Both intravenous
and inhaled routes of LS similarly reduced the high systolic PAP over all
time points of measurement and intravenous LS was associated with higher
heart rate, lower arterial pressure and the need for a higher dose of
norepinephrine than the inhaled LS. <br/>Conclusion(s): Inhalation of LS
is non-inferior to intravenous LS in reducing high PAP in children who
underwent on-pump cardiac surgery and it is associated with less
tachycardia and hypotension with reduced need for vasoactive
drugs.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<13>
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.<br/>Copyright &#xa9; 2021 Antonio Salsano et al.,
published by De Gruyter.

<14>
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.<br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2021.

<15>
Accession Number
634288827
Title
Inotropic agents and vasodilator strategies for the treatment of
cardiogenic shock or low cardiac output syndrome.
Source
Cochrane Database of Systematic Reviews. 2020 (11) (no pagination), 2020.
Article Number: CD009669. Date of Publication: 05 Nov 2020.
Author
Uhlig K.; Efremov L.; Tongers J.; Frantz S.; Mikolajczyk R.; Sedding D.;
Schumann J.
Institution
(Uhlig, Schumann) Department of Anaesthesiology and Surgical Intensive
Care, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
(Efremov, Mikolajczyk) Institute for Medical Epidemiology, Biometrics and
Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical
School of the Martin-Luther-University Halle-Wittenberg, Halle (Saale),
Germany
(Tongers, Sedding) Cardiology, Angiology and Intensive Care Medicine,
University Hospital Halle (Saale), Halle (Saale), Germany
(Frantz) Department of Internal Medicine I, University Hospital Wurzburg,
Wurzburg, Germany
Publisher
John Wiley and Sons Ltd
Abstract
Background: Cardiogenic shock (CS) and low cardiac output syndrome (LCOS)
are potentially life-threatening complications of acute myocardial
infarction (AMI), heart failure (HF) or cardiac surgery. While there is
solid evidence for the treatment of other cardiovascular diseases of acute
onset, treatment strategies in haemodynamic instability due to CS and LCOS
remains less robustly supported by the given scientific literature.
Therefore, we have analysed the current body of evidence for the treatment
of CS or LCOS with inotropic and/or vasodilating agents. This is the
second update of a Cochrane review originally published in 2014.
<br/>Objective(s): Assessment of efficacy and safety of cardiac care with
positive inotropic agents and vasodilator agents in CS or LCOS due to AMI,
HF or after cardiac surgery. <br/>Search Method(s): We conducted a search
in CENTRAL, MEDLINE, Embase and CPCI-S Web of Science in October 2019. We
also searched four registers of ongoing trials and scanned reference lists
and contacted experts in the field to obtain further information. No
language restrictions were applied. <br/>Selection Criteria: Randomised
controlled trials (RCTs) enrolling patients with AMI, HF or cardiac
surgery complicated by CS or LCOS. <br/>Data Collection and Analysis: We
used standard methodological procedures according to Cochrane standards.
<br/>Main Result(s): We identified 19 eligible studies including 2385
individuals (mean or median age range 56 to 73 years) and three ongoing
studies. We categorised studies into 11 comparisons, all against standard
cardiac care and additional other drugs or placebo. These comparisons
investigated the efficacy of levosimendan versus dobutamine, enoximone or
placebo; enoximone versus dobutamine, piroximone or
epinephrine-nitroglycerine; epinephrine versus norepinephrine or
norepinephrine-dobutamine; dopexamine versus dopamine; milrinone versus
dobutamine and dopamine-milrinone versus dopamine-dobutamine. All trials
were published in peer-reviewed journals, and analyses were done by the
intention-to-treat (ITT) principle. Eighteen of 19 trials were small with
only a few included participants. An acknowledgement of funding by the
pharmaceutical industry or missing conflict of interest statements
occurred in nine of 19 trials. In general, confidence in the results of
analysed studies was reduced due to relevant study limitations (risk of
bias), imprecision or indirectness. Domains of concern, which showed a
high risk in more than 50% of included studies, encompassed performance
bias (blinding of participants and personnel) and bias affecting the
quality of evidence on adverse events. All comparisons revealed
uncertainty on the effect of inotropic/vasodilating drugs on all-cause
mortality with a low to very low quality of evidence. In detail, the
findings were: levosimendan versus dobutamine (short-term mortality: RR
0.60, 95% CI 0.36 to 1.03; participants = 1701; low-quality evidence;
long-term mortality: RR 0.84, 95% CI 0.63 to 1.13; participants = 1591;
low-quality evidence); levosimendan versus placebo (short-term mortality:
no data available; long-term mortality: RR 0.55, 95% CI 0.16 to 1.90;
participants = 55; very low-quality evidence); levosimendan versus
enoximone (short-term mortality: RR 0.50, 0.22 to 1.14; participants = 32;
very low-quality evidence; long-term mortality: no data available);
epinephrine versus norepinephrine-dobutamine (short-term mortality: RR
1.25; 95% CI 0.41 to 3.77; participants = 30; very low-quality evidence;
long-term mortality: no data available); dopexamine versus dopamine
(short-term mortality: no deaths in either intervention arm; participants
= 70; very low-quality evidence; long-term mortality: no data available);
enoximone versus dobutamine (short-term mortality RR 0.21; 95% CI 0.01 to
4.11; participants = 27; very low-quality evidence; long-term mortality:
no data available); epinephrine versus norepinephrine (short-term
mortality: RR 1.81, 0.89 to 3.68; participants = 57; very low-quality
evidence; long-term mortality: no data available); and dopamine-milrinone
versus dopamine-dobutamine (short-term mortality: RR 1.0, 95% CI 0.34 to
2.93; participants = 20; very low-quality evidence; long-term mortality:
no data available). No information regarding all-cause mortality were
available for the comparisons milrinone versus dobutamine, enoximone
versus piroximone and enoximone versus epinephrine-nitroglycerine.
Authors' conclusions: At present, there are no convincing data supporting
any specific inotropic or vasodilating therapy to reduce mortality in
haemodynamically unstable patients with CS or LCOS. Considering the
limited evidence derived from the present data due to a high risk of bias
and imprecision, it should be emphasised that there is an unmet need for
large-scale, well-designed randomised trials on this topic to close the
gap between daily practice in critical care of cardiovascular patients and
the available evidence. In light of the uncertainties in the field,
partially due to the underlying methodological flaws in existing studies,
future RCTs should be carefully designed to potentially overcome given
limitations and ultimately define the role of inotropic agents and
vasodilator strategies in CS and LCOS.<br/>Copyright &#xa9; 2020 The
Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<16>
Accession Number
2006738263
Title
A study on the impact of the novel biochemical parameter- calcium score in
preventing the progression of the cardiovascular diseases to invasive
interventions.
Source
Journal of Nutritional Science and Vitaminology. 66 (Supplement) (pp
S11-S17), 2020. Date of Publication: 2020.
Author
Thomas A.K.; Radhakrishnan D.
Institution
(Thomas) Home Science Department, C.M.S College, Kottayam, Kerala, India
(Radhakrishnan) St. Theresa's College, Ernakulam, Kerala, India
Publisher
Center for Academic Publications Japan
Abstract
Cardiovascular diseases is increasing its pace day by day. Though the
traditional biomarkers are made available the novel biomarkers are being
incorporated to predict the risk of cardiovascular diseases for earlier
detection. The present study aimed to investigate the impact of calcium
score level the novel biochemical parameter in preventing the progression
of the cardiovascular patients to PTCA (percutaneous transluminal coronary
angioplasty) and CABG (coronary artery bypass grafting). Four hundred
cardiovascular patients irrespective of sex were randomly selected from
Visakhapatnam district Andhrapradesh. Information of subjects was
collected using an interview schedule. Data collected were consolidated
and tabulated. From this group a sub sample of 50 patients was selected
and grouped as primordial, secondary and post PTCA. The subjects were then
analyzed for their biochemical parameters before and after intervention.
Statistical analysis was done and interpreted. An extensive evidence of
calcium score was shown among 61.2% of the cardiovascular patients, a
minimum evidence of 22.2% and moderate evidence of about 16.5%. The paired
sample t-test is employed to observe any statistical significant
difference between the before and after treatment effects. The analysis
for the calcium score level was found to be significantly lower (mean
difference=424.0134; t=13.297; df=49; p=0.01) in post intervention
(mean=88.3766+/-88.40) than pre-intervention (512.39+/-260.79812). The
present study identified calcium score the novel biochemical parameter as
a key preventive measure among the usual biochemical management conducted
by the clinicians to diagnosis and confirm the progression of the
disease.<br/>Copyright &#xa9; 2020, Center for Academic Publications
Japan. All rights reserved.

<17>
Accession Number
634499786
Title
Ascorbic acid in the acute care setting.
Source
JPEN. Journal of parenteral and enteral nutrition. (no pagination), 2021.
Date of Publication: 05 Mar 2021.
Author
Kressin C.; Pandya K.; Woodward B.M.; Donaldson C.; Flannery A.H.
Institution
(Kressin, Pandya, Woodward, Donaldson, Flannery) Acute Care Pharmacy
Services, University of Kentucky HealthCare, Lexington, KY 40536, United
States
(Flannery) Department of Pharmacy Practice and Science, University of
Kentucky College of Pharmacy, Lexington, KY 40536, United States
Publisher
NLM (Medline)
Abstract
Ascorbic acid is an essential nutrient with many physiologic roles not
limited to the prevention of scurvy. Beyond its role as a supplement, it
has gained popularity in the acute care setting as an inexpensive
medication for a variety of conditions. Due to limitations with absorption
of oral formulations and reduced serum concentrations observed in acute
illness, intravenous administration, and higher doses, may be needed to
produce the desired serum concentrations for a particular indication.
Following a PubMed search, we reviewed published studies relevant to
ascorbic acid in the acute care setting and summarized the results in a
narrative review. In the acute care setting, ascorbic acid may be used for
improved wound healing, improved organ function in sepsis and acute
respiratory distress syndrome, faster resolution of vasoplegic shock after
cardiac surgery, reduction of resuscitative fluids in severe burn injury,
and as an adjunctive analgesic, among other uses. Each indication differs
in its level of evidence supporting exogenous administration of ascorbic
acid, but overall, ascorbic acid was not commonly associated with adverse
effects in the identified studies. Use of ascorbic acid remains an active
area of clinical investigation for various indications in the acute care
patient population. This article is protected by copyright. All rights
reserved.

<18>
Accession Number
634492872
Title
Intermediate-Term Outcomes of Endoscopic or Open Vein Harvesting for
Coronary Artery Bypass Grafting: The REGROUP Randomized Clinical Trial.
Source
JAMA Network Open. (no pagination), 2021. Date of Publication: 2021.
Author
Zenati M.A.; Bhatt D.L.; Stock E.M.; Hattler B.; Wagner T.H.; Bakaeen
F.G.; Biswas K.
Institution
(Zenati) Division of Cardiac Surgery, Department of Surgery, Veterans
Affairs Boston Healthcare System, Brigham and Women's Hospital, Harvard
Medical School, 1400 VFWPkwy, Boston, MA 02132, United States
(Bhatt) Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
(Stock) Cooperative Studies Program, Perry Point/Baltimore Coordinating
Center, Office of Research and Development, US Department of Veterans
Affairs, Perry Point, MD, United States
(Hattler) VA Eastern Colorado Healthcare System, Denver, United States
(Wagner) VA Health Economics Resource Center, Department of Surgery,
Stanford University, Palo Alto, CA, United States
(Bakaeen) Cleveland Clinic, Cleveland, OH, United States
(Biswas) Perry Point Cooperative Studies Program Coordinating Center,
Office of Research and Development, US Department of Veterans Affairs,
Perry Point, MD, United States
(Biswas) Department of Epidemiology and Public Health, University of
Maryland, School of Medicine, Baltimore, United States
Publisher
American Medical Association

<19>
Accession Number
634485972
Title
Late Survival Benefit of Percutaneous Coronary Intervention Compared With
Medical Therapy in Patients With Coronary Chronic Total Occlusion: A
10-Year Follow-Up Study.
Source
Journal of the American Heart Association. (pp e019022), 2021. Date of
Publication: 04 Mar 2021.
Author
Park T.K.; Choi K.H.; Lee J.M.; Yang J.H.; Song Y.B.; Hahn J.-Y.; Choi
J.-H.; Gwon H.-C.; Lee S.H.; Choi S.-H.
Institution
(Park, Lee, Choi, Lee, Yang, Song, Hahn, Choi, Gwon, Lee, Choi) Division
of Cardiology Department of Medicine Heart Vascular and Stroke Institute
Samsung Medical CenterSungkyunkwan University School of Medicine Seoul
Republic of Korea
Publisher
NLM (Medline)
Abstract
Background As an initial treatment strategy, percutaneous coronary
intervention (PCI) for coronary chronic total occlusion (CTO) did not show
midterm survival benefits compared with optimal medical therapy (OMT). We
sought to evaluate the benefit of PCI compared with OMT in patients with
CTO over extended long-term follow-up. Methods and Results Between March
2003 and February 2012, 2024 patients with CTO were enrolled in a
single-center registry and followed for =10 years. We excluded patients
with CTO who underwent coronary artery bypass graft (n=477) and classified
patients into the CTO-PCI group (n=883) or OMT group (n=664) according to
initial treatment strategy. Patients with multivessel disease received PCI
for obstructive non-CTO lesions in both groups. In the CTO-PCI group, 699
patients (79.2%) underwent successful revascularization. The CTO-PCI group
had a lower 10-year rate of cardiac death (10.4% versus 22.3%; hazard
ratio [HR], 0.44 [95% CI, 0.32-0.59]; P<0.001) than the OMT group. After
propensity score matching analyses, the CTO-PCI group had a lower 10-year
rate of cardiac death (13.6% versus 20.8%; HR, 0.64 [95% CI, 0.45-0.91];
P=0.01) than the OMT group. The relative reduction in cardiac death at 10
years was mainly driven by a relative reduction between 3 and 10 years
(8.3% versus 16.6%; HR, 0.43 [95% CI, 0.27-0.71]; P<0.001) but not at 3
years (5.7% versus 5.0%; HR, 1.12 [95% CI, 0.63-2.00]; P=0.71). The
beneficial effects of CTO-PCI were consistent among subgroups. Conclusions
As an initial treatment strategy, CTO-PCI might reduce late cardiac death
compared with OMT in patients with CTO. Extended follow-up of randomized
trials may confirm the findings of the present study.

<20>
Accession Number
634469919
Title
Sex differences in clinical outcomes of patients with stable coronary
artery disease after percutaneous coronary intervention.
Source
Current pharmaceutical design. (no pagination), 2021. Date of Publication:
03 Mar 2021.
Author
Vardas E.P.; Oikonomou E.; Siasos G.; Theofilis P.; Dilaveris P.;
Papanikolaou A.; Tousoulis D.
Institution
(Vardas, Oikonomou, Siasos, Theofilis, Dilaveris, Papanikolaou, Tousoulis)
1st Cardiology Clinic, 'Hippokration' General Hospital, National and
Kapodistrian University of Athens, School of Medicine
Publisher
NLM (Medline)
Abstract
Potential sex-related differences in the periprocedural and long-term
postprocedural outcomes of coronary angioplasty in patients with stable
coronary artery disease have been studied thoroughly over the last few
decades, to determine whether female sex should be regarded as an
independent risk factor that affects clinical outcomes. Based on a
significant number of observational studies and meta-analyses, sex has not
yet emerged as an independent risk factor for either mortality or major
cardiac and cerebrovascular events, despite the fact that in the early
1980s, for several reasons, female sex was associated with unfavourable
outcomes. Therefore, it remains debatable whether female sex should be
considered as an independent risk factor for periprocedural and long-term
bleeding events. The pharmacological and technological advancements that
support current coronary angioplasty procedures, as well as the
non-delayed treatment of coronary artery disease in females have certainly
lessened the outcome differences between the two sexes. However, females
show fluctuations in blood coagulability through their lifetime and higher
prevalence of bleeding episodes associated with the antithrombotic
treatment, following transcatheter coronary reperfusion interventions. In
conclusion, the clinical results of percutaneous coronary intervention in
patients with stable coronary artery disease, during the periprocedural
and long-term postprocedural periods, appear to show no significant
differences between the two sexes, except for bleeding rates, which seem
to be higher in females, a difference that mandates further systematic
research.<br/>Copyright&#xa9; Bentham Science Publishers; For any queries,
please email at epub@benthamscience.net.

<21>
Accession Number
2011342120
Title
Efficacy and safety of edoxaban in patients early after surgical
bioprosthetic valve implantation or valve repair: A randomized clinical
trial.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2021.
Date of Publication: 2021.
Author
Shim C.Y.; Seo J.; Kim Y.J.; Lee S.H.; De Caterina R.; Lee S.; Hong G.-R.;
Lee C.J.; Shin D.-H.; Ha J.-W.; Suh Y.J.; Choi J.Y.; Cho I.-J.; Roh Y.H.
Institution
(Shim, Seo, Hong) Division of Cardiology, Severance Cardiovascular
Hospital, Yonsei University College of Medicine, Seoul, South Korea
(Kim) Department of Radiology, Research Institute of Radiological Science,
Severance Hospital, Yonsei University College of Medicine, Seoul, South
Korea
(Lee, Lee) Division of Cardiovascular Surgery, Department of Thoracic and
Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(De Caterina) Cardio-Thoracic and Vascular Department, Pisa University
Hospital and University of Pisa, Pisa, Italy
Publisher
Mosby Inc.
Abstract
Objective: Early warfarin anticoagulation is recommended in patients
undergoing surgical bioprosthetic valve implantation or valve repair. It
is unclear whether non-vitamin K antagonist oral anticoagulants can be a
full alternative to warfarin. This study aimed to compare efficacy and
safety of edoxaban with warfarin in patients early after surgical
bioprosthetic valve implantation or valve repair. <br/>Method(s): The
Explore the Efficacy and Safety of Edoxaban in Patients after Heart Valve
Repair or Bioprosthetic Valve Replacement study was a prospective,
randomized (1:1), open-label, clinical trial conducted from December 2017
to September 2019. Patients were randomly assigned to receive edoxaban (60
mg or 30 mg once daily) or warfarin for the first 3 months after surgical
bioprosthetic valve implantation or valve repair. The primary efficacy
outcome was a composite of death, clinical thromboembolic events, or
asymptomatic intracardiac thrombosis. The primary safety outcome was the
occurrence of major bleeding. <br/>Result(s): Of 220 participants, 218
(109 per group) were included in the modified intention-to-treat analysis.
The primary efficacy outcome occurred in 4 patients (3.7%) taking warfarin
and none taking edoxaban (risk difference, -0.0367; 95% confidence
interval, -0.0720 to -0.0014; P < .001 for noninferiority). The primary
safety outcome occurred in 1 patient (0.9%) taking warfarin and 3 patients
(2.8%) taking edoxaban (risk difference, 0.0183; 95% confidence interval,
-0.0172 to 0.0539; P = .013 for noninferiority). <br/>Conclusion(s):
Edoxaban is noninferior to warfarin for preventing thromboembolism and is
potentially comparable for risk of major bleeding during the first 3
months after surgical bioprosthetic valve implantation or valve
repair.<br/>Copyright &#xa9; 2021 The American Association for Thoracic
Surgery

<22>
Accession Number
2011320758
Title
Consensus for Thoracoscopic Left Upper Lobectomy-Essential Components and
Targets for Simulation.
Source
Annals of Thoracic Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Bryan D.S.; Ferguson M.K.; Antonoff M.B.; Backhus L.M.; Birdas T.J.;
Blackmon S.H.; Boffa D.J.; Chang A.C.; Chmielewski G.W.; Cooke D.T.;
Donington J.S.; Gaissert H.A.; Hagen J.A.; Hofstetter W.L.; Kent M.S.; Kim
K.W.; Krantz S.B.; Lin J.; Martin L.W.; Meyerson S.L.; Mitchell J.D.;
Molena D.; Odell D.D.; Onaitis M.W.; Puri V.; Putnam J.B.; Seder C.W.;
Shrager J.B.; Soukiasian H.J.; Stiles B.M.; Tong B.C.; Veeramachaneni N.K.
Institution
(Bryan) Department of Surgery, University of Chicago, Chicago, IL, United
States
(Ferguson, Donington) Section of Thoracic Surgery, Department of Surgery,
University of Chicago, Chicago, IL, United States
(Antonoff, Hofstetter) Department of Thoracic and Cardiovascular Surgery,
University of Texas MD Anderson Cancer Center, Houston, TX, United States
(Backhus, Shrager) Division of Thoracic Surgery, Department of
Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto,
CA, United States
(Birdas) Division of Cardiothoracic Surgery, Indiana University School of
Medicine, Indianapolis, IN, United States
(Blackmon) Division of General Thoracic Surgery, Mayo Clinic, Rochester,
MN, United States
(Boffa) Section of Thoracic Surgery, Yale School of Medicine, New Haven,
CT, United States
(Chang, Lin) Section of Thoracic Surgery, University of Michigan, Ann
Arbor, MI, United States
(Chmielewski) Section of Thoracic Surgery, Advocate Aurora Healthcare,
Aurora, IL, United States
(Cooke) Section of General Thoracic Surgery, University of California,
Davis Health, Davis, CA, United States
(Gaissert) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Hagen) Division of Thoracic Surgery, Sanger Heart and Vascular Institute,
Charlotte, NC, United States
(Kent) Division of Thoracic Surgery and Interventional Pulmonology, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(Kim) Wellstar Health System, Marietta, Georgia
(Krantz) Division of Thoracic Surgery, NorthShore University Health
System, Evanston, IL, United States
(Martin) Division of Thoracic Surgery, University of Virginia School of
Medicine, Charlottesville, VA, United States
(Meyerson) Section of Thoracic Surgery, University of Kentucky, Lexington,
KY, United States
(Mitchell) Division of Cardiothoracic Surgery, Section of General Thoracic
Surgery, University of Colorado Denver, Aurora, CO, United States
(Molena) Thoracic Service, Memorial Sloan Kettering Cancer Center, New
York, NY, United States
(Odell) Division of Thoracic Surgery, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
(Onaitis) Division of Cardiovascular and Thoracic Surgery, University of
California San Diego Medical Center, San Diego, CA, United States
(Puri) Division of Cardiothoracic Surgery, Washington University School of
Medicine, St. Louis, MO, United States
(Putnam) Department of Thoracic Surgery, Baptist MD Anderson Cancer
Center, Jacksonville, FL, United States
(Seder) Department of Cardiovascular and Thoracic Surgery, Rush University
Medical Center, Chicago, IL, United States
(Soukiasian) Division of Thoracic Surgery, Cedars-Sinai Medical Center,
Los Angeles, CA, United States
(Stiles) Division of Thoracic Surgery, New York-Presbyterian Hospital,
Weill Cornell Medical College, New York, NY, United States
(Tong) Division of Cardiovascular and Thoracic Surgery, Duke University
Medical Center, Durham, NC, United States
(Veeramachaneni) Department of Cardiovascular and Thoracic Surgery,
University of Kansas Health System, Kansas City, KS, United States
Publisher
Elsevier Inc.
Abstract
Background: Simulation-based training is a valuable component of
cardiothoracic surgical education. Effective curriculum development
requires consensus on procedural components and focused attention on
specific learning objectives. Through use of a Delphi process, we
established consensus on the steps of video-assisted thoracoscopic surgery
(VATS) left upper lobectomy and identified targets for simulation.
<br/>Method(s): Experienced thoracic surgeons were randomly selected for
participation. Surgeons voted and commented on the necessity of individual
steps comprising VATS left upper lobectomy. Steps with greater than 80% of
participants in agreement of their necessity were determined to have
established "consensus." Participants voted on the physical or cognitive
complexity of each, or both, and chose steps most amenable to focused
simulation. <br/>Result(s): Thirty thoracic surgeons responded and joined
in the voting process. Twenty operative steps were identified, with
surgeons reaching consensus on the necessity of 19. Components deemed most
difficult and amenable to simulation included those related to dissection
and division of the bronchus, artery, and vein. <br/>Conclusion(s):
Through a Delphi process, surgeons with a variety of practice patterns can
achieve consensus on the operative steps of left upper lobectomy and
agreement on those most appropriate for simulation. This information can
be implemented in the development of targeted simulation for VATS
lobectomy.<br/>Copyright &#xa9; 2021

<23>
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.]<br/>Copyright &#xa9; 2021, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<24>
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.<br/>Copyright &#xa9; 2020 American College of Nutrition.

<25>
Accession Number
364831727
Title
Low-Dose rivaroxaban reduced mortality in patients with a recent acute
coronary syndrome.
Source
Annals of Internal Medicine. 156 (10) (pp JC5-3), 2012. Date of
Publication: 2012.
Author
Mega J.L.
Institution
(Mega) Brigham and Women's Hospital, Boston, MA, United States
Publisher
American College of Physicians

<26>
Accession Number
2010726858
Title
Diagnostic test accuracy of the initial electrocardiogram after
resuscitation from cardiac arrest to indicate invasive coronary
angiographic findings and attempted revascularization: A systematic review
and meta-analysis.
Source
Resuscitation. 160 (pp 20-36), 2021. Date of Publication: March 2021.
Author
McFadden P.; Reynolds J.C.; Madder R.D.; Brown M.
Institution
(McFadden) Spectrum Health Department of Emergency Medicine, Grand Rapids,
MI, United States
(Reynolds, Brown) Michigan State University College of Human Medicine,
Department of Emergency Medicine, 15 Michigan Street NE, Suite 736D, Grand
Rapids, MI 49503, United States
(Madder) Frederik Meijer Heart and Vascular Institute, Spectrum Health,
Grand Rapids, MI, United States
Publisher
Elsevier Ireland Ltd
Abstract
Aim: Conduct a diagnostic test accuracy systematic review and
meta-analysis of the post-return of spontaneous circulation (ROSC)
electrocardiogram (ECG) to indicate an acute-appearing coronary lesion and
revascularization. <br/>Method(s): We searched PubMed, EMBASE, CINAHL,
Cochrane Library, and Web of Science through February 18, 2020. Two
investigators screened titles and abstracts, extracted data, and assessed
risks of bias using QUADAS-2. We estimated sensitivity (Sn), specificity
(Sp), and likelihood ratios (LR) for all reported ECG features to indicate
all reported reference standards. Random-effects meta-analysis pooled
comparable studies without critical risk of bias. GRADE methodology
evaluated the certainty of evidence. <br/>Result(s): Overall, 48 studies
reported 94 combinations of ECG features and reference standards with wide
variation in their definitions. Most studies had risks of bias from
selection for coronary angiography and blinding to the ECG and/or
reference standard. Meta-analysis combined 6 studies for STE and acute
coronary lesion (Sn 0.70 [95% CI 0.54-0.82]; Sp 0.85 [95% CI 0.78-0.90];
LR + 4.7 [95% CI 3.3-6.7]; LR- 0.4 [95% CI 0.2-0.6]) and 4 studies for STE
and revascularization (Sn 0.53 [95% CI 0.47-0.58]; Sp 0.86 [95% CI
0.80-0.91]; LR + 3.9 [95% CI 2.8-5.5]; LR- 0.5 [95% CI 0.5-0.6]). Overall
certainty of evidence was low with substantial heterogeneity.
<br/>Conclusion(s): Based on low certainty evidence, STE had good
classification for acute coronary lesion and fair classification for
revascularization. STE was more specific than sensitive for these outcomes
and no single ECG feature excluded them. Uniform definitions and
terminology would greatly facilitate the interpretation of subsequent
studies.<br/>Copyright &#xa9; 2021 Elsevier B.V.

<27>
Accession Number
633990523
Title
Music intervention to relieve anxiety and pain in adults undergoing
cardiac surgery: A systematic review and meta-Analysis.
Source
Open Heart. 8 (1) (no pagination), 2021. Article Number: e001474. Date of
Publication: 25 Jan 2021.
Author
Kakar E.; Billar R.J.; Van Rosmalen J.; Klimek M.; Takkenberg J.J.M.;
Jeekel J.
Institution
(Kakar, Jeekel) Department of Surgery, Erasmus MC, Rotterdam,
South-Holland, Netherlands
(Kakar, Jeekel) Department of Neuroscience, Erasmus MC, Rotterdam,
South-Holland, Netherlands
(Billar) Pediatric Surgery, Erasmus MC, Rotterdam, South-Holland,
Netherlands
(Van Rosmalen) Department of Biostatics, Erasmus MC, Rotterdam,
South-Holland, Netherlands
(Klimek) Department of Anesthesiology, Erasmus MC, Rotterdam,
South-Holland, Netherlands
(Takkenberg) CardioThoracic Surgery, Erasmus University Medical Center,
Rotterdam, South-Holland, Netherlands
Publisher
BMJ Publishing Group
Abstract
Objectives Previous studies have reported beneficial effects of
perioperative music on patients' anxiety and pain. We performed a
systematic review and meta-Analysis of randomised controlled trials
investigating music interventions in cardiac surgery. Methods Five
electronic databases were systematically searched. Primary outcomes were
patients' postoperative anxiety and pain. Secondary outcomes were hospital
length of stay, opioid use, vital parameters and time on mechanical
ventilation. PRISMA guidelines were followed and PROSPERO database
registration was completed (CRD42020149733). A meta-Analysis was performed
using random effects models and pooled standardised mean differences (SMD)
with 95% confidence intervals were calculated. Results Twenty studies were
included for qualitative analysis (1169 patients) and 16 (987 patients)
for meta-Analysis. The first postoperative music session was associated
with significantly reduced postoperative anxiety (SMD =-0.50 (95% CI-0.67
to-0.32), p<0.01) and pain (SMD =-0.51 (95% CI-0.84 to-0.19), p<0.01).
This is equal to a reduction of 4.00 points (95% CI 2.56 to 5.36) and 1.05
points (95% CI 0.67 to 1.41) on the State-Trait Anxiety Inventory and
Visual Analogue Scale (VAS)/Numeric Rating Scale (NRS), respectively, for
anxiety, and 1.26 points (95% CI 0.47 to 2.07) on the VAS/NRS for pain.
Multiple days of music intervention reduced anxiety until 8 days
postoperatively (SMD =-0.39 (95% CI-0.64 to-0.15), p<0.01). Conclusions
Offering recorded music is associated with a significant reduction in
postoperative anxiety and pain in cardiac surgery. Unlike pharmacological
interventions, music is without side effects so is promising in this
population.<br/>Copyright &#xa9;

<28>
Accession Number
633981962
Title
Evaluation of mesenteric artery disease in patients with severe aortic
valve stenosis.
Source
Journal of Investigative Medicine. 69 (3) (pp 719-723), 2021. Date of
Publication: 01 Mar 2021.
Author
Idil Soylu A.; Avcloglu U.; Uzunkaya F.; Soylu K.
Institution
(Idil Soylu, Uzunkaya) Department of Radiology, Ondokuz Mayis University,
Faculty of Medicine, Samsun, Turkey
(Avcloglu) Department of Gastroenterology, Ondokuz Mayis University,
Faculty of Medicine, Samsun, Turkey
(Soylu) Department of Cardiology, Faculty of Medicine, Ondokuz Mayis
University, Samsun, Turkey
Publisher
BMJ Publishing Group
Abstract
The aim of this study is to evaluate the mesenteric artery stenosis (MAS)
in routinely performed CT angiography (CTA) of patients with severe aortic
stenosis (AS) planned for transcatheter aortic valve implantation (TAVI)
before the procedure. Patients with AS (AS group) who routinely underwent
CTA before the TAVI procedure due to severe AS and patients who had CTA
for other indications (control group) were retrospectively and
sequentially scanned. The demographic characteristics of the patients in
both groups were similar. Calcification and stenosis in the mesenteric
arteries were recorded according to the localization of celiac truncus,
superior mesenteric artery (SMA) and inferior mesenteric artery (IMA).
Class 0-3 classification was used for calcification score. Stenoses with a
stenosis degree >=50% were considered as significant. A total of 184
patients, 73 patients with severe AS and 111 control groups, were included
in the study. SMA and IMA calcification scores of patients with AS were
significantly higher than the control group (p=0.035 for SMA and p=0.020
for IMA). In addition, the rate of patients with significant MAS in at
least 1 artery (45.2% vs 22.5%, p=0.001) and the rate of patients with
significant stenosis in multiple arteries were also significantly higher
in the AS group (8.2% vs 1.8%, p=0.037). According to the study results,
patients with AS are at a higher risk for MAS. Chronic mesenteric ischemia
should be kept in mind in patients with AS who have symptoms such as
non-specific abdominal pain and weight loss.<br/>Copyright &#xa9; American
Federation for Medical Research 2021.No commercial re-use.Seerights and
permissions.Published by BMJ.

<29>
Accession Number
2006077092
Title
Cardiac amyloidosis therapy: A systematic review.
Source
Cardiogenetics. 11 (1) (pp 10-17), 2021. Date of Publication: March 2021.
Author
Iodice F.; Di Mauro M.; Esposito A.; Migliaccio M.G.; Iannuzzi A.; Pacileo
R.; Caiazza M.
Institution
(Iodice, Di Mauro, Esposito, Migliaccio, Iannuzzi, Pacileo, Caiazza)
Department of Translational Medical Sciences, University of Campania
"Luigi Vanvitelli", Naples 81100, Italy
Publisher
Page Press Publications
Abstract
Heart involvement in Cardiac Amyloidosis (CA) results in a worsening of
the prognosis in almost all patients with both light-chain (AL) and
transthyretin amyloidosis (ATTR). The mainstream CA is a restrictive
cardiomyopathy with hypertrophic phenotype at cardiac imaging that
clinically leads to heart failure with preserved ejection fraction
(HFpEF). An early diagnosis is essential to reduce cardiac damage and to
improve the prognosis. Many therapies are available, but most of them have
late benefits to cardiac function; for this reason, novel therapies are
going to come soon.<br/>Copyright &#xa9; 2021 by the authors. Licensee
MDPI, Basel, Switzerland.

<30>
Accession Number
2010298191
Title
Clinical outcomes of TAVI or SAVR in men and women with aortic stenosis at
intermediate operative risk: A post hoc analysis of the randomised SURTAVI
trial.
Source
EuroIntervention. 16 (10) (pp 833-841), 2020. Date of Publication:
November 2020.
Author
Van Mieghem N.M.; Reardon M.J.; Yakubov S.J.; Heiser J.; Merhi W.;
Windecker S.; Makkar R.; Cheng W.; Robbins M.; Fail P.; Feinberg II E.;
Stoler R.C.; Hebeler R.; Serruys P.W.; Popma J.J.
Institution
(Van Mieghem) Department of Interventional Cardiology, Erasmus University
Medical Center, Rotterdam, Netherlands
(Reardon) Department of Cardiothoracic Surgery and Interventional
Cardiology, Houston- Methodist-Debakey Heart and Vascular Center, Houston,
TX, United States
(Yakubov) Department of Cardiology, Riverside Methodist - Ohio Health,
Columbus, OH, United States
(Heiser, Merhi) Departments of Cardiothoracic Surgery and Interventional
Cardiology, Spectrum Health Hospitals, Grand Rapids, MI, United States
(Windecker) Department of Interventional Cardiology, University Hospital
Bern, Bern, Switzerland
(Makkar) Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA,
United States
(Cheng) Cardiac Surgery, Cedars-Sinai Medical Center, Los Angeles, CA,
United States
(Robbins) Interventional Cardiology, Saint Thomas Heart, Ascension Medical
Group, Nashville, TN, United States
(Fail, Feinberg II) Interventional Cardiology, Cardiovascular Institute of
the South, Houma, LA, United States
(Stoler) Interventional Cardiology, Baylor Scott and White Heart and
Vascular Hospital, Dallas, TX, United States
(Hebeler) Cardiothoracic Surgery, Baylor Scott and White Heart and
Vascular Hospital, Dallas, TX, United States
(Serruys) Department of Cardiology, National University of Ireland,
Galway, Ireland
(Popma) Department of Interventional Cardiology, Beth Israel Deaconess
Medical Center, Boston, MA, United States
Publisher
Europa Group
Abstract
Aims: In patients with aortic stenosis randomised to transcatheter aortic
valve implantation (TAVI) or surgical aortic valve replacement (SAVR),
sex-specific differences in complication rates are unclear in
intermediate-risk patients. The purpose of this analysis was to identify
sex-specific differences in outcome for patients at intermediate surgical
risk randomised to TAVI or SAVR in the international Surgical Replacement
and Transcatheter Aortic Valve Implantation (SURTAVI) trial. <br/>Methods
and Results: A total of 1,660 intermediate-risk patients underwent TAVI
with a supra-annular, self-expanding bioprosthesis or SAVR. The population
was stratified by sex and treatment modality (female TAVI=366, male
TAVI=498, female SAVR=358, male SAVR=438). The primary endpoint was a
composite of all-cause mortality or disabling stroke at two years.
Compared to males, females had a smaller body surface area, a higher
Society of Thoracic Surgeons score (4.7+/-1.6% vs 4.3+/-1.6%, p<0.01) and
were more frail. Men required more concomitant revascularisation (23% vs
16%). All-cause mortality or disabling stroke at two years was similar
between TAVI and SAVR for females (10.2% vs 10.5%, p=0.90) and males
(14.5% vs 14.4%, p=0.99); the difference between females and males was
10.2% vs 14.5%, for TAVI (p=0.08) and 10.5% vs 14.4%, SAVR (p=0.13).
Functional status improvement was more pronounced after TAVI in females
than in males. <br/>Conclusion(s): Aortic valve replacement, either by
surgical or transcatheter approach, appears similarly effective and safe
for males and females at intermediate surgical risk. Functional status
appears to improve most in females after TAVI.<br/>Copyright &#xa9; Europa
Digital & Publishing 2020.

<31>
Accession Number
2003927538
Title
Outcomes of patients who undergo percutaneous coronary intervention with
covered stents for coronary perforation: A systematic review and pooled
analysis of data.
Source
Catheterization and Cardiovascular Interventions. 96 (7) (pp 1360-1366),
2020. Date of Publication: December 2020.
Author
Nagaraja V.; Schwarz K.; Moss S.; Kwok C.S.; Gunning M.
Institution
(Nagaraja) Department of Cardiovascular Medicine, Heart and Vascular
Institute, Cleveland Clinic, Cleveland, OH, United States
(Schwarz) Cardiology Department, Worcestershire Royal Hospital, Worcester,
United Kingdom
(Moss) Orange Base Hospital, Orange, NSW, Australia
(Kwok) School of Primary, Community and Social Care, Keele University,
Stoke-on-Trent, United Kingdom
(Kwok, Gunning) Royal Stoke University Hospital, Stoke-on-Trent, United
Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Objectives: This review aims to evaluate the adverse outcomes for patients
after treatment with covered stents. <br/>Background(s): Coronary
perforation is a potentially fatal complication of percutaneous coronary
revascularization which may be treated using covered stents. Studies have
evaluated long-term outcomes among patients who received these devices,
but hitherto no literature review has taken place. <br/>Method(s): We
conducted a systematic review of adverse outcomes for patients after
treatment with covered stents. Data from studies were pooled and outcomes
were compared according to stent type. <br/>Result(s): A total of 29
studies were analyzed with data from 725 patients who received covered
stents. The proportion of patients with chronic total occlusions, vein
graft percutaneous coronary intervention (PCI), intracoronary imaging and
rotational atherectomy were 16.9, 11.5, 9.2, and 6.6%, respectively. The
stents used were primarily polytetrafluoroethylene (PTFE) (70%) and
Papyrus (20.6%). Mortality, major adverse cardiovascular events,
pericardiocentesis/tamponade and emergency surgery were 17.2, 35.3, 27.1,
and 5.3%, respectively. Stratified analysis by use of PTFE, Papyrus and
pericardial stents, suggested no difference in mortality (p =.323), or
target lesion revascularization (p =.484). Stent thrombosis,
pericardiocentesis/tamponade and emergency coronary artery bypass surgery
(CABG) occurred more frequently in patients with PTFE stent use (p =.011,
p =.005, p =.012, respectively). In-stent restenosis was more common with
pericardial stent use (<.001, pooled analysis for first- and
second-generation pericardial stents). <br/>Conclusion(s): Cases of
coronary perforation which require implantation of a covered stent are
associated with a high rate of adverse outcomes. The use of PTFE covered
stents appears to be associated with more stent thrombosis,
pericardiocentesis/tamponade, and emergency CABG when compared to Papyrus
or pericardial stents.<br/>Copyright &#xa9; 2019 Wiley Periodicals, Inc.

<32>
Accession Number
2010693263
Title
Complications in children with ventricular assist devices: systematic
review and meta-analyses.
Source
Heart Failure Reviews. (no pagination), 2021. Date of Publication: 2021.
Author
George A.N.; Hsia T.-Y.; Schievano S.; Bozkurt S.
Institution
(George, Schievano, Bozkurt) Institute of Cardiovascular Science,
University College London, London, United Kingdom
(Hsia) Pediatric Cardiac Surgery, Arnold Palmer Hospital for Children,
Orlando, FL, United States
Publisher
Springer
Abstract
Heart failure is a significant cause of mortality in children with
cardiovascular diseases. Treatment of heart failure depends on patients'
symptoms, age, and severity of their condition, with heart transplantation
required when other treatments are unsuccessful. However, due to lack of
fitting donor organs, many patients are left untreated, or their
transplant is delayed. In these patients, ventricular assist devices
(VADs) are used to bridge to heart transplant. However, VAD support
presents various complications in patients. The aim of this study was to
compile, review, and analyse the studies reporting risk factors and
aetiologies of complications of VAD support in children. Random effect
risk ratios (RR) with 95% confidence intervals were calculated to analyse
relative risk of thrombosis (RR = 3.53 [1.04, 12.06] I² = 0% P
= 0.04), neurological problems (RR = 0.95 [0.29, 3.15] I² = 53%
P = 0.93), infection (RR = 0.31 [0.05, 2.03] I² = 86% P =
0.22), bleeding (RR = 2.57 [0.76, 8.66] I² = 0% P = 0.13), and
mortality (RR = 2.20 [1.36, 3.55] I² = 0% P = 0.001) under
pulsatile-flow and continuous-flow VAD support, relative risk of mortality
(RR = 0.45 [0.15, 1.37] I² = 36% P = 0.16) under left VAD and
biVAD support, relative risk of thrombosis (RR = 1.72 [0.46, 6.44]
I² = 0% P = 0.42), infection (RR = 1.77 [0.10, 32.24]
I² = 46% P = 0.70) and mortality (RR = 0.92 [0.14, 6.28]
I² = 45% P = 0.93) in children with body surface area < 1.2
m² and > 1.2 m² under VAD support, relative risk of
mortality in children supported with VAD and diagnosed with cardiomyopathy
and congenital heart diseases (RR = 1.31 [0.10, 16.61] I² = 73%
P = 0.84), and cardiomyopathy and myocarditis (RR = 0.91 [0.13, 6.24]
I² = 58% P = 0.92). Meta-analyses results show that further
research is necessary to reduce complications under VAD
support.<br/>Copyright &#xa9; 2021, The Author(s), under exclusive licence
to Springer Science+Business Media, LLC part of Springer Nature.

<33>
Accession Number
2010532882
Title
Is there an immunogenomic difference between thoracic and abdominal aortic
aneurysms?.
Source
Journal of Cardiac Surgery. 36 (4) (pp 1520-1530), 2021. Date of
Publication: April 2021.
Author
Yap Z.J.; Sharif M.; Bashir M.
Institution
(Yap) Department of Anaesthetic, Dorset County Hospital, Dorset, United
Kingdom
(Sharif) Department of Molecular & Clinical Medicine, Ninewells Hospital
and Medical School, Dundee, United Kingdom
(Bashir) Department of Emergency Medicine and Surgery, Royal Blackburn
Teaching Hospital, Blackburn, United Kingdom
Publisher
Blackwell Publishing Inc.
Abstract
Background and Aim: Aortic aneurysms most commonly occur in the
infra-renal and proximal thoracic regions. While generally asymptomatic,
progressive aneurysmal dilation can become rapidly lethal when dissection
or ruptures occurs, highlighting the need for more robust screening.
Abdominal aortic aneurysm (AAA) is more prevalent compared to thoracic
aortic aneurysm (TAA). The true incidence of TAA is underreported due to
the absence of population screening and the silent nature of TAA. To
achieve the optimum survival rate in aortic aneurysms, knowledge of
natural course, genetic association, and surgical results are needed to be
applied with adequate medical treatment and careful selection of patients
for operation. The purpose of this paper is to provide a comprehensive
review of the literature on natural history, immunology, and genetic
differences between thoracic and AAAs. <br/>Method(s): The literature was
collected from OVID, SCOPUS, and PubMed. <br/>Result(s): (1) AAA expands
faster than TAA. AAA expands at approximately 0.3-0.45 cm annually,
depending on various factors (advancing age, diameter of aorta, smoking
etc.). TAA expands up to 0.3 cm annually in a non-bicuspid aortic valve
patient. (2) An increase in Matrix metallopeptidase 1, 2, 9, 12, 14 led to
degrading extracellular matrix of the aortic vessel wall. This
significantly contributed to the pathogenesis in AAA, whereas overactive
Transforming growth factor-beta played a major role in the pathogenesis of
TAA. <br/>Conclusion(s): In the future, genetic testing may be the gold
standard for tackling the geneticheterogeneity of aneurysms, therefore,
identifying at-risk individuals developing TAA andAAA
earlier.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<34>
Accession Number
2010385929
Title
HTK versus multidose cardioplegias for myocardial protection in adult
cardiac surgery: A meta-analysis.
Source
Journal of Cardiac Surgery. 36 (4) (pp 1334-1343), 2021. Date of
Publication: April 2021.
Author
Reynolds A.C.; Asopa S.; Modi A.; King N.
Institution
(Reynolds) Swansea University Medical School, Swansea, United Kingdom
(Asopa) South West Cardiothoracic Centre, University Hospitals Plymouth,
Plymouth, United Kingdom
(Modi) Sussex Cardiac Centre, Brighton and Sussex University Hospital,
Brighton, United Kingdom
(King) School of Biomedical Sciences, Faculty of Health, University of
Plymouth, Plymouth, United Kingdom
Publisher
Blackwell Publishing Inc.
Abstract
Background: Histidine-tryptophan-ketoglutarate (HTK) cardioplegia for
myocardial protection obviates the need for maintenance cardioplegia
doses, and thus allows for greater focus on procedure accuracy. The aim of
this meta-analysis is to evaluate the safety and efficacy of HTK versus
multidose cardioplegias during cardiac surgery in an adult population.
<br/>Method(s): Electronic searches were performed using PubMed, Science
Direct, and Google Scholar databases. The key search terms included HTK
cardioplegia AND cardiac surgery AND adult. This was followed by a
meta-analysis investigating cardiopulmonary bypass (CPB) duration,
cross-clamp duration, spontaneous defibrillation, inotropic support,
mortality, atrial fibrillation, creatine kinase muscle brain band (CK-MB)
and troponin I (TnI). <br/>Result(s): Seven randomized controlled trials
(n = 804) were analyzed. Spontaneous defibrillation following aortic
cross-clamp removal significantly favored HTK (odds ratio [OR], 2.809; 95%
confidence interval [CI], 1.574 to 5.012; I² = 0%; p <.01).
There were no other notable significant differences between HTK and
multidose cardioplegia in any of the parameters measured. In particular,
the OR for mortality was 1.237 (95% CI, 0.385 to 3.978; I² =
0%; p =.721) and the mean difference for CPB duration overall was 2.072
min (95% CI, -2.405 to 6.548; I² = 74%; p =.364).
<br/>Conclusion(s): HTK is safe and effective during adult cardiac surgery
when compared with multidose cardioplegias for myocardial protection
during surgical correction of acquired pathology in the adult population.
HTK may, therefore, be suitable for complex cases or those of extensive
duration, without the prospect of increased postoperative morbidity or
mortality.<br/>Copyright &#xa9; 2021 The Authors. Journal of Cardiac
Surgery published by Wiley Periodicals LLC

<35>
Accession Number
2010325983
Title
Pernicious pregnancy: Type B aortic dissection in pregnant women.
Source
Journal of Cardiac Surgery. 36 (4) (pp 1232-1240), 2021. Date of
Publication: April 2021.
Author
Rimmer L.; Mellor S.; Harky A.; Gouda M.; Bashir M.
Institution
(Rimmer, Bashir) Vascular Surgery Department, Royal Blackburn Teaching
Hospital, Blackburn, United Kingdom
(Mellor) College of Medical and Dental Sciences, University of Birmingham,
Birmingham, United Kingdom
(Harky) Liverpool Heart and Chest Hospital NHS Foundation Trust,
Liverpool, United Kingdom
(Gouda) Vascular & Endovascular Surgery, Mataria Teaching Hospital, Cairo,
Egypt
Publisher
Blackwell Publishing Inc.
Abstract
Background: Type B aortic dissection (TBAD) occurs seldomly, particularly
in pregnancy, but has disastrous consequences for both mother and fetus.
The focus of immediate surgical repair of type A aortic dissection due to
higher mortality of patients is less clear in its counterpart, TBAD, in
which management is controversial and debated. This article collates
knowledge so far on this rare event during pregnancy. <br/>Method(s): A
comprehensive literature search was performed in PubMed, Scopus, Google
Scholar, Embase, and Medline. Key search terms included "type B aortic
dissection," "pregnancy," and corresponding synonyms. Non-English papers
were excluded. <br/>Result(s): Risk factors for TBAD include aortic wall
stress due to hypertension, previous cardiac surgery, structural
abnormalities (bicuspid aortic valve, aortic coarctation), and connective
tissue disorders. In pregnancy, pre-eclampsia is a cause of increased
aortic wall stress. Management of this condition is often conservative,
but this is dependent on a number of factors, including gestation,
cardiovascular stability of the patient, and symptomology. In most cases,
a cesarean section before intervention is carried out unless certain
indications are present. <br/>Conclusion(s): Due to a scarce number of
cases across the decades, it is difficult to determine which management is
optimal. The gold-standard management of TBAD has traditionally been the
medical treatment for uncomplicated cases and open surgery for those
needing urgent intervention, but with the advent of techniques, such as
thoracic endovascular aortic repair, the management of these group of
patients continues to develop.<br/>Copyright &#xa9; 2021 Wiley Periodicals
LLC

<36>
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. <br/>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. <br/>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%). <br/>Conclusion(s): Awaiting more evidence,
NeoChord mitral procedure appears to be a promising procedure that can be
considered in selected cases.<br/>Copyright &#xa9; 2021 Wiley Periodicals
LLC

<37>
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. <br/>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. <br/>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. <br/>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.
<br/>Conclusion(s): Our results show that transcarotid approach is a
feasible option in patients with prohibitive femoral access for
TAVR.<br/>Copyright &#xa9; 2020 Wiley Periodicals LLC

<38>
Accession Number
2005720677
Title
Clinical risk model for predicting 1-year mortality after transcatheter
aortic valve replacement.
Source
Catheterization and Cardiovascular Interventions. 97 (4) (pp E544-E551),
2021. Date of Publication: March 2021.
Author
Yamamoto M.; Otsuka T.; Shimura T.; Yamaguchi R.; Adachi Y.; Kagase A.;
Tokuda T.; Yashima F.; Watanabe Y.; Tada N.; Naganuma T.; Araki M.;
Yamanaka F.; Mizutani K.; Tabata M.; Watanabe S.; Sato Y.; Ueno H.; Takagi
K.; Higashimori A.; Shirai S.; Hayashida K.
Institution
(Yamamoto, Shimura, Yamaguchi, Adachi) Department of Cardiology, Toyohashi
Heart Center, Toyohashi, Japan
(Yamamoto, Kagase, Tokuda) Department of Cardiology, Nagoya Heart Center,
Nagoya, Japan
(Otsuka) Department of Hygiene and Public Health, Nippon Medical School,
Tokyo, Japan
(Otsuka) Center for Clinical Research, Nippon Medical School Hospital,
Tokyo, Japan
(Yashima) Department of Cardiology, Saiseikai Utsunomiya Hospital,
Tochigi, Japan
(Yashima, Hayashida) Department of Cardiology, Keio University School of
Medicine, Tokyo, Japan
(Watanabe) Department of Cardiology, Teikyo University School of Medicine,
Tokyo, Japan
(Tada) Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan
(Naganuma) Department of Cardiology, New Tokyo Hospital, Chiba, Japan
(Araki) Department of Cardiology, Saiseikai Yokohama City Eastern
Hospital, Yokohama, Japan
(Yamanaka) Department of Cardiology, Syonan Kamakura General Hospital,
Kamakura, Kanagawa, Japan
(Mizutani) Department of Cardiovascular Medicine, Osaka City University
Graduate School of Medicine, Osaka, Japan
(Tabata, Watanabe) Department of Cardiovascular Surgery, Tokyo Bay
Urayasu-Ichikawa Medical Center, Chiba, Japan
(Sato) Department of Preventive Medicine and Public Health, Keio
University, Minato, Japan
(Ueno) Department of Cardiology, Toyama University Hospital, Toyama, Japan
(Takagi) Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan
(Higashimori) Department of Cardiology, Kishiwada Tokushukai Hospital,
Osaka, Japan
(Shirai) Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Estimating 1-year life expectancy is an essential factor when
evaluating appropriate indicators for transcatheter aortic valve
replacement (TAVR). <br/>Background(s): It is clinically useful in
developing a reliable risk model for predicting 1-year mortality after
TAVR. <br/>Method(s): We evaluated 2,588 patients who underwent TAVR using
data from the Optimized CathEter vAlvular iNtervention (OCEAN) Japanese
multicenter registry from October 2013 to May 2017. The 1-year clinical
follow-up was achieved by 99.5% of the entire population (n = 2,575).
Patients were randomly divided into two cohorts: the derivation cohort (n
= 1,931, 75% of the study population) and the validation cohort (n = 644).
Considerable clinical variables including individual patient's
comorbidities and frailty markers were used for predicting 1-year
mortality following TAVR. <br/>Result(s): In the derivation cohort, a
multivariate logistic regression analysis demonstrated that sex, body mass
index, Clinical Frailty Scale, atrial fibrillation, peripheral artery
disease, prior cardiac surgery, serum albumin, renal function as estimated
glomerular filtration rate, and presence of pulmonary disease were
independent predictors of 1-year mortality after TAVR. Using these
variables, a risk prediction model was constructed to estimate the 1-year
risk of mortality after TAVR. In the validation cohort, the risk
prediction model revealed high discrimination ability and acceptable
calibration with area under the curve of 0.763 (95% confidence interval,
0.728-0.795, p <.001) in the receiver operating characteristics curve
analysis and a Hosmer-Lemeshow chi² statistic of 5.96 (p =.65).
<br/>Conclusion(s): This risk prediction model for 1-year mortality may be
a reliable tool for risk stratification and identification of adequate
candidates in patients undergoing TAVR.<br/>Copyright &#xa9; 2020 The
Authors. Catheterization and Cardiovascular Interventions published by
Wiley Periodicals LLC.

<39>
Accession Number
2005419632
Title
Association between surgical risk and 30-day stroke after transcatheter
versus surgical aortic valve replacement: a systematic review and
meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 97 (4) (pp E536-E543),
2021. Date of Publication: March 2021.
Author
Matsuda Y.; Nai Fovino L.; Giacoppo D.; Scotti A.; Massussi M.; Ueshima
D.; Sasano T.; Fabris T.; Tarantini G.
Institution
(Matsuda, Nai Fovino, Giacoppo, Scotti, Massussi, Ueshima, Fabris,
Tarantini) Department of Cardiac, Thoracic, Vascular Sciences and Public
Health, University of Padua Medical School, Padua, Italy
(Matsuda, Sasano) Department of Cardiovascular Medicine, Graduate School
of General Medical and Dental Science, Tokyo Medical and Dental
University, Tokyo, Japan
Publisher
John Wiley and Sons Inc
Abstract
Background: Stroke is a feared complication of transcatheter aortic valve
replacement (TAVR) and surgical aortic valve replacement (SAVR).
<br/>Objective(s): With this meta-analysis we aimed to evaluate the
incidence of 30-day stroke with TAVR and SAVR focusing on its possible
correlation with surgical risk. <br/>Method(s): Major electronic databases
were searched for studies published between January 2002 and October 2019
reporting the rates of 30-day stroke after TAVR and SAVR. Data were pooled
using fixed- and random-effects models. The primary outcome of the study
was stroke rate within 30-day from TAVR or SAVR. Results were stratified
according to surgical risk score (high, intermediate and low).
<br/>Result(s): A total of 23 studies were identified (TAVR: 14,589
patients; SAVR: 11,681 patients). Regardless of the model used, in the
overall population TAVR was associated with a significant reduction in the
risk of stroke compared with SAVR (fixed effect: OR 0.78, 95% CI
0.66-0.92, p =.003; random-effects: OR 0.80, 95% CI 0.64-1.00, p =.045).
Rates of 30-day stroke after TAVR and SAVR were not significantly
different in the high- (OR 1.01, 95% CI 0.44-1.98, p =.105) and
intermediate-risk groups (OR 0.92, 95% CI 0.63-1.36, p =.319), while
low-risk patients had a lower rate of 30-day stroke after TAVR than SAVR
(OR 0.65, 95% CI 0.50-0.83, p <.001). Meta-regression showed a significant
association between surgical risk score and 30-day stroke rate (p =.007).
<br/>Conclusion(s): TAVR is associated with a lower risk of 30-day stroke
compared with SAVR, mainly as a result of the significant advantage
observed in patients at low surgical risk.<br/>Copyright &#xa9; 2020 Wiley
Periodicals LLC.

<40>
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2021, The
Author(s).

<41>
Accession Number
2010440751
Title
Erdheim-Chester Disease With Extensive Pericardial Involvement: A Case
Report and Systematic Review.
Source
Cardiology Research. 11 (2) (pp 118-128), 2020. Date of Publication: 2020.
Author
Sanchez-Nadales A.; Anampa-Guzman A.; Navarro-Motta J.
Institution
(Sanchez-Nadales, Navarro-Motta) Department of Medicine, Advocate Illinois
Masonic Medical Center, Chicago, IL, United States
(Anampa-Guzman) Sociedad Cientifica de San Fernando, Faculty of Medicine,
Universidad Na- cional Mayor de San Marcos, Lima, Peru
(Sanchez-Nadales) Alejandro Sanchez-Nadales, Department of Medicine,
Advocate Illinois Masonic Medical Center, Chicago, IL, United States
Publisher
Elmer Press
Abstract
Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis
characterized by systemic xanthogranulomatous infiltration. We described
the case of a female adult presenting with pericardial effusion.
Pericardial infiltration is the most frequent cardiac manifestation of ECD
and is the one discussed in this article. We found that the majority of
patients with pericardial infiltration needed a cardiovascular procedure.

<42>
[Use Link to view the full text]
Accession Number
2010440234
Title
Efficacy of Allopurinol in Cardiovascular Diseases: A Systematic Review
and Meta-Analysis.
Source
Cardiology Research. 11 (14) (pp 226-232), 2020. Date of Publication:
August 2020.
Author
Khanal S.; Basyal B.; Munir S.; Minalyan A.; Khan R.; Alraies C.; Fischman
D.L.; Ullah W.
Institution
(Ullah, Khanal, Basyal, Munir, Minalyan) Abington Jefferson Health, United
States
(Khan) Medstar Union Memorial Hospital, Baltimore, United States
(Alraies) Detroit Medical Center, DMC Heart Hospital, United States
(Fischman) Thomas Jefferson University, Philadelphia, United States
(Ullah) Abington Jefferson Health, United States
Publisher
Elmer Press
Abstract
Background: Given current evidence, the use of allopurinol for the
prevention of major cardiovascular events (acute cardiovascular syndrome
(ACS) or cardiovascular mortality) in patients undergoing coronary artery
bypass graft (CABG), after index ACS or heart failure remains unknown.
<br/>Method(s): Multiple databases were queried to identify studies
comparing the efficacy of allopurinol in patients undergoing CABG, after
ACS or heart failure. The unadjusted odds ratio (OR) was calculated using
a random effect model. <br/>Result(s): A total of nine studies comprising
850 patients (allopurinol 480, control 370) were identified. The pooled OR
of periprocedural ACS (OR: 0.25, 95% confidence interval (CI): 0.06 -
0.96, P = 0.05) and cardiovascular mortality (OR: 0.22, 95% CI: 0.07 -
0.71, P = 0.01) was significantly lower in patients receiving allopurinol
during CABG compared to patients in the control group. The overall number
needed to treat (NNT) to prevent one ACS event was 11 (95% CI: 7 28),
while the NNT to prevent one death was 24 (95% CI: 13 - 247). By contrast,
the odds of cardiovascular mortality in the allopurinol group were not
significantly different from the control group in patients on long-term
allopurinol after ACS or heart failure (OR: 0.33, 95% CI: 0.01 - 8.21, P =
0.50) and (OR: 1.12, 95% CI: 0.39 - 3.20, P = 0.83), respectively.
Similarly, the use of allopurinol did not reduce the odds of recurrent ACS
events at 2 years (OR: 0.32, 95% CI: 0.03 - 3.18, P = 0.33).
<br/>Conclusion(s): Periprocedural use of allopurinol might be associated
with a significant reduction in the odds of ACS and cardiovascular
mortality in patients undergoing CABG. Allopurinol, however, offers no
long-term benefits in terms of secondary prevention of ACS or mortality.
Larger scale studies are needed to validate our findings.<br/>Copyright
&#xa9; The authors

<43>
Accession Number
632980316
Title
Pregnancy outcome in women with mechanical prosthetic heart valvesat their
first trimester of pregnancy treated with unfractionated heparin (UFH) or
enoxaparin: A randomized clinical trial.
Source
Journal of Cardiovascular and Thoracic Research. 12 (3) (pp 209-213),
2020. Date of Publication: 2020.
Author
Movahedi M.; Motamedi M.; Sajjadieh A.; Bahrami P.; Saeedi M.
Institution
(Movahedi, Motamedi) Department of Obstetrics and Gynecology, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Sajjadieh, Bahrami) Department of Internal Medicine, Isfahan University
of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Saeedi) Department of Cardiac Surgery, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Saeedi) Department of General Medicine, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: Pregnancy increases the risks of thromboembolism for the
mother and fetus in patients with mechanical heart valves. The results of
some studies have indicated that low molecular weight heparin (LMWH), in
comparison with unfractionated heparin (UFH), leads to a lower incidence
rate of thrombocytopenia and a decrease in bleeding. <br/>Method(s): The
present randomized clinical trial involved 31 pregnant women with
mechanical heart valves at their first trimester (0-14 weeks) of
pregnancy. To perform the study, the patients were divided into two
groups, i.e. group A (LMWH group-16 patients) and group B (UFH group-15
patients). The birth weight, mode of delivery, and gestational age at
birth as well as the maternal and fetal complications were compared
between the two groups. <br/>Result(s): The mean age of mothers in the UFH
and LMWH groups was 32.67+/-9.11 and 31.50+/-5.81 years, respectively (P
value > 0.05). Although the rate of maternal and fetal complications was
higher in the UFH group as compared with the LMWH group, the observed
difference was not significant (P value > 0.05). <br/>Conclusion(s): LMWH
can be regarded as a safer therapy for both the mother and fetus due to
its lower number of refill prescriptions and fewer changes in the blood
level.<br/>Copyright &#xa9; 2020 The Author (s).

<44>
Accession Number
632644453
Title
Transcatheter versus surgical aortic valve replacement in renal transplant
patients: A meta-analysis.
Source
Cardiology Research. 11 (5) (pp 280-285), 2020. Date of Publication: 2020.
Author
Mir T.; Darmoch F.; Ullah W.; Sattar Y.; Hakim Z.; Pacha H.M.; Fouad L.;
Gardi D.; Glazier J.J.; Zehr K.; Alraies M.C.
Institution
(Mir) Wayne State University/Detroit Medical Center, Detroit, MI, United
States
(Darmoch) Internal Medicine, Beth Israel Deaconess Medical Center/Harvard
School of Medicine, Boston, MA, United States
(Ullah) Internal Medicine, Abington Jefferson Health, 1200 Old York Road,
Abington, PA 19044, United States
(Sattar) Internal Medicine, Icahn School of Medicine, Mount Sinai Elmhurst
Hospital, New York, NY, United States
(Hakim, Gardi, Glazier, Zehr, Alraies) Cardiovascular Medicine, Detroit
Medical Center, Wayne State University, Detroit, MI, United States
(Pacha) University of Texas Health Science Center, McGovern Medical
School, Memorial Hermann Heart and Vascular Institute, Houston, TX, United
States
(Fouad) Detroit Medical Center, Heart Hospital, Detroit, MI, United States
Publisher
Elmer Press
Abstract
Background: The outcome of transcutaneous aortic valve replacement (TAVR)
in patients with kidney transplant is unknown, as majority of these
patients were excluded from the major TAVR clinical trials. We sought to
compare patients with severe aortic stenosis who underwent TAVR versus
surgical aortic valve replacement (SAVR) with a history of kidney
transplant. <br/>Method(s): PubMed, Google Scholar and Cochrane databases
were searched to identify relevant articles. The incidence of all-cause
mortality and acute kidney injury (AKI) was calculated using relative risk
on a random effect model. <br/>Result(s): A total of 1,538 patients (TAVR
328, SAVR 1,210) were included in the study. TAVR was associated with
lower mortality as compared with SAVR at 30 days from the index procedure
(odds ratio (OR) 0.48, 95% confidence interval (CI): 0.25-0.93; P = 0.03).
Oneyear mortality was studied in three studies and showed comparable
mortality in patients undergoing TAVR and SAVR (OR: 0.76, 95% CI:
0.10-5.51; P = 0.78). Compared to SAVR, TAVR carries an identical risk of
AKI (OR: 0.44, 95% CI: 0.10-1.90; P = 0.27). A sensitivity analysis
performed by exclusion of Voudris et al study showed a non-significant
difference in the mortality incidence of two groups at 30 days (OR: 0.72,
95% CI: 0.27-1.91; P = 0.51). <br/>Conclusion(s): In patients with a
history of kidney transplant, TAVR was associated with a comparable risk
of mortality and AKI compared to SAVR.<br/>Copyright &#xa9; 2020 Elmer
Press.

<45>
Accession Number
632466012
Title
Early prediction of acute kidney injury in neonates with cardiac surgery.
Source
World Journal of Pediatric Surgery. 3 (2) (no pagination), 2020. Article
Number: e000107. Date of Publication: 25 Jun 2020.
Author
Shi S.; Fan J.; Shu Q.
Institution
(Shi, Fan) Cardiac Intensive Care Unit, Children's Hospital, Zhejiang
University, School of Medicine, Hangzhou, China
(Shu) Department of Thoracic and Cardiovascular Surgery, Children's
Hospital, Zhejiang University, School of Medicine, Hangzhou, China
Publisher
BMJ Publishing Group
Abstract
Background Acute kidney injury (AKI) occurs in 42-64 of the neonatal
patients experiencing cardiac surgery, contributing to postoperative
morbidity and mortality. Current diagnostic criteria, which are mainly
based on serum creatinine and hourly urine output, are not sufficiently
sensitive and precise to diagnose neonatal AKI promptly. The purpose of
this review is to screen the recent literature, to summarize the novel and
cost-effective biomarkers and approaches for neonatal AKI after cardiac
surgery (CS-AKI), and to provide a possible research direction for future
work. Data sources We searched PubMed for articles published before
November 2019 with pertinent terms. Sixty-seven articles were found and
screened. After excluding 48 records, 19 articles were enrolled for final
analysis. Results Nineteen articles were enrolled, and 18 possible urinary
biomarkers were identified and evaluated for their ability to diagnose
CS-AKI. Urinary neutrophil gelatinase-associated lipocalin (uNGAL), serum
cystatin C (sCys), urinary human kidney injury molecule-1 (uKIM-1),
urinary liver fatty acid-binding protein (uL-FABP) and interleukin-18
(uIL-18) were the most frequently described as the early predictors of
neonatal CS-AKI. Conclusions Neonates are vulnerable to CS-AKI. UNGAL,
sCys, uL-FABP, uKIM-1 and uIL-18 are potential biomarkers for early
prediction of neonatal CS-AKI. Renal regional oxygen saturation by
near-infrared spectroscopy is a non-invasive approach for early
identification of neonatal AKI. Further work should focus on exploring a
sensitive and specific combined diagnostic model that includes novel
biomarkers and other complementary methods.<br/>Copyright &#xa9; Author(s)
(or their employer(s)) 2020. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<46>
Accession Number
631934264
Title
Comparing transcatheter aortic valve replacement (AVR) with surgical AVR
in lower risk patients: A comprehensive meta-analysis and systematic
review.
Source
Cardiology Research. 11 (3) (pp 168-178), 2020. Article Number: 1046. Date
of Publication: 01 Jun 2020.
Author
Khan M.S.; Mir T.; Ullah W.; Ali Z.; Idris O.; Khan G.; Ur Rashid M.;
Salman; Mehmood M.; Ali S.S.
Institution
(Khan, Salman) Department of Internal Medicine, Mercy St Vincent Medical
Center, Toledo, OH 43608, United States
(Mir) Department of Internal Medicine, Detroit Medical Center, Wayne State
University, Detroit, MI 48201, United States
(Ullah, Ali) Department of Internal Medicine, Abington Jefferson Health,
Abington, PA 19001, United States
(Idris, Mehmood, Ali) Department of Cardiology, Mercy Saint Vincent
Medical Center, Toledo, OH 43608, United States
(Khan) University of Missouri, Kansas City, MO 64110, United States
(Ur Rashid) Department of Internal Medicine, Advent Health, Orlando, FL
32803, United States
(Khan) Department of Internal Medicine, Mercy Saint Vincent Medical
Center, Toledo, OH 43608, United States
Publisher
Elmer Press
Abstract
Background: Transcutaneous aortic valve replacement (TAVR) is a novel
percutaneous procedure for severe aortic stenosis and has been recently
approved by Food and Drug Administration in lower risk patients. We
performed the first ever meta-analysis and literature review of clinical
trials comparing both 30-day and 1-year outcomes in lower risk patients
undergoing TAVR vs. surgical aortic valve replacement (SAVR, having
Society of Thoracic Surgeons score < 4% or equivalent). <br/>Method(s):
Using predefined selection criteria as above, 68 articles were identified.
Seven eligible articles were selected after extensive review. Primary
effect outcomes were 30-day and 1-year all-cause mortality using risk
ratio (RR) with significant P value of < 0.05. <br/>Result(s): A total of
4,859 subjects were included. Risk of 30-day all-cause mortality was 40.1%
less in TAVR group, RR 0.59 (95% confidence interval (CI): 0.38-0.92, P =
0.02) with no significant heterogeneity. Six studies except Schymik et al
also reported 1-year risk. This was, however, not statistically
significant with a 21% decrease in the TAVR group, RR 0.79 (95% CI:
0.57-1.09, P = 0.15). Six studies reported 30-day risk of secondary
outcomes. The risk of 30-day stroke was 36% less in TAVR group, although
this was not statistically significant, RR 0.64 (95% CI: 0.38-1.9, P =
0.10). The risk of acute kidney injury (AKI) stage 2 and above was 56%
less in post-TAVR patients, RR 0.43 (95% CI: 0.35-0.54, P < 0.001) with no
heterogeneity. For vascular complications, RR was high in TAVR group 4.62
(95% CI: 1.42-15.18, P = 0.01). Significant heterogeneity was demonstrated
though (I2 = 81). The risks for permanent pacemaker (PPM) were also higher
in the TAVR group, RR 3.30 (95% CI: 2.04-5.33, P < 0.001) and significant
heterogeneity was observed. After removing Thyregod et al and Partner 3
trial from the analysis, heterogeneity was removed, but the RR was still
high 3.21 (95% CI: 2.54-4.068, P < 0.001). Post-operative incidence of
endocarditis among TAVR patients was low but not statistically
significant. The 30-day risk for infective endocarditis was RR 0.67 (95%
CI: 0.13-3.48, P = 0.63). The 1-year risk was similarly low but not
significant, RR 0.73 (95% CI: 0.28-1.92, P = 0.53). <br/>Conclusion(s):
Among low risk patients, TAVR was found to be superior in short-term
all-cause mortality and 1-year stroke, a result that was statistically
significant for TAVR and close to significance for stroke. TAVR patients
were also less likely to have post-operative bleeding and AKI stage 2 and
beyond. Post-operative incidence of endocarditis among TAVR patients was
low but not statistically significant. However, the rates of PPM and
vascular complications are higher in TAVR patients. The results of TAVR in
low risk population are thus extremely encouraging. However, the issue of
long-term valve durability in this group needs further studies. Also,
caution needs to be exercised while extending the indications to extremely
young patients due to lack of enough studies.<br/>Copyright &#xa9; The
authors.

<47>
Accession Number
2003914641
Title
Vascular Complications after Transfemoral Transcatheter Aortic Valve
Implantation: A Systematic Review and Meta-Analysis.
Source
Structural Heart. 4 (1) (pp 62-71), 2020. Date of Publication: 02 Jan
2020.
Author
Rahhab Z.; Ramdat Misier K.; El Faquir N.; Kroon H.; Ziviello F.; Kardys
I.; Daemen J.; De Jaegere P.; Reardon M.J.; Popma J.; Van Mieghem N.M.
Institution
(Rahhab, Ramdat Misier, El Faquir, Kroon, Ziviello, Kardys, Daemen, De
Jaegere, Van Mieghem) Department of Cardiology, Thoraxcenter, Erasmus
Medical Center, Rotterdam, Netherlands
(Reardon) Department of Cardiovascular Surgery, Houston Methodist
Hospital, Houston, TX, United States
(Popma) Department of Cardiology, Beth Israel Deaconess Medical Center,
Harvard University, Boston, MA, United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Vascular complications (VCs) after transcatheter aortic valve
implantation (TAVI) are associated with impaired outcome. We performed a
meta-analysis to determine in-hospital/30-day major VCs rate after
transfemoral-TAVI adjudicated by an independent clinical-event-committee,
and to compare the major VCs rate with regard to consecutive generations
of balloon-expandable and self-expanding platforms, device profile,
experience and patient risk-profile. <br/>Method(s): A systematic,
computerized search with predefined criteria was performed in PubMed,
Embase and Cochrane on March 27, 2018. The overall pooled proportion of VC
was calculated using a random-effects model. Subgroups were examined based
on sheath size, STS-score and start-date of inclusion (early (< January
2012); late-phase (>= January 2012) studies). <br/>Result(s): A total of
24 studies with 14308 patients were included. The pooled major VCs rate
was 7.71% and was lower in low-profile vs. high-profile device studies
(5.51% vs. 8.46%, p = 0.0015). Major VCs rate decreased significantly with
transition to newer generation balloon-expandable valves ((Sapien vs.
Sapien XT (15.18% vs. 8.48%, p < 0.00001); Sapien XT vs. Sapien 3 (8.48%
vs. 4.48%, p = 0.005)) and there was a tendency towards fewer major VCs in
EvolutR vs. CoreValve (5.98% vs. 7.97%, p = 0.094). Major VC rate was
lower in late-phase vs. early-phase studies (5.82% vs. 7.84%, p = 0.048)
and a tendency towards a lower rate was seen in intermediate vs. high-risk
studies (7.09% vs. 9.62%, p = 0.059). <br/>Conclusion(s): The pooled rate
of independently adjudicated major VCs after transfemoral-TAVI was 7.71%.
Experience and device profile are associated with fewer major
VCs.<br/>Copyright &#xa9; 2019, &#xa9; 2019 The Author(s). Published with
license by Taylor & Francis Group, LLC.

<48>
Accession Number
2008022128
Title
Effectiveness of polypill for prevention of cardiovascular disease
(polypars): Protocol of a randomized controlled trial.
Source
Archives of Iranian Medicine. 23 (8) (pp 548-556), 2020. Date of
Publication: August 2020.
Author
Malekzadeh F.; Gandomkar A.; Malekzadeh Z.; Poustchi H.; Moghadami M.;
Fattahi M.R.; Moini M.; Anushiravani A.; Mortazavi R.; Boogar S.S.;
Mohammadkarimi V.; Abtahi F.; Merat S.; Sepanlou S.G.; Malekzadeh R.
Institution
(Malekzadeh, Malekzadeh, Poustchi, Anushiravani, Merat, Sepanlou,
Malekzadeh) Digestive Disease Research Center, Digestive Disease Research
Institute, Shariati Hospital, Tehran University of Medical Sciences, North
Kargar Ave, Tehran 14117-13135, Iran, Islamic Republic of
(Malekzadeh, Gandomkar, Moghadami, Anushiravani, Malekzadeh)
Non-Communicable Disease Research Center, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Malekzadeh) Non-Communicable Diseases Research Center, Endocrinology and
Metabolism Population Sciences Institute, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Poustchi, Malekzadeh) Digestive Oncology Research Center, Digestive
Disease Research Institute, Shariati Hospital, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Fattahi, Moini) Gastroenterohepatology Research Center, Shiraz University
of Medical Sciences, Shiraz, Iran, Islamic Republic of
(Mortazavi, Boogar, Mohammadkarimi) Department of Internal Medicine,
School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran,
Islamic Republic of
(Abtahi) Department of Cardiology, Cardiovascular Research Center School
of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic
Republic of
(Merat, Malekzadeh) Liver and Pancreatobiliary Diseases Research Center,
Digestive Disease Research Institute, Shariati Hospital, Tehran University
of Medical Sciences, Teheran, Iran, Islamic Republic of
Publisher
Academy of Medical Sciences of I.R. Iran
Abstract
Background: Cardiovascular diseases (CVDs) are the leading cause of death
in Iran. A fixed-dose combination therapy (polypill) was proposed as a
cost-effective strategy for CVD prevention, especially in lower-resource
settings. We conducted the PolyPars trial to assess the effectiveness and
safety of polypill for prevention of CVD. <br/>Method(s): The PolyPars
trial is a pragmatic cluster randomized controlled trial nested within the
Pars Cohort Study. Participants were randomized to an intervention arm and
a control arm. Participants in the control arm received minimal
non-pharmacological care, while those in the intervention arm received
polypill in addition to minimal care. The polypill comprises
hydrochlorothiazide 12.5 mg, aspirin 81 mg, atorvastatin 20 mg, and either
enalapril 5 mg or valsartan 40 mg. The primary outcome of the study is
defined as the first occurrence of acute coronary syndrome (non-fatal
myocardial infarction and unstable angina), fatal myocardial infarction,
sudden cardiac death, new-onset heart failure, coronary artery
revascularization procedures, transient ischemic attack, cerebrovascular
accidents (fatal or non-fatal), and hospitalization due to any of the
mentioned conditions. The secondary outcomes of the study include adverse
events, compliance, non-cardiovascular mortality, changes in blood
pressure, fasting blood sugar, and lipids after five years of follow-up.
<br/>Result(s): From December 2014 to December 2015, 4415 participants (91
clusters) were recruited. Of those, 2200 were in the polypill arm and 2215
in the minimal care arm. The study is ongoing. This trial was registered
with ClinicalTrials.gov number NCT03459560. <br/>Conclusion(s): Polypill
may be effective for primary prevention of CVDs in developing
countries.<br/>Copyright &#xa9; 2020 The Author(s).

<49>
Accession Number
631146426
Title
Comparing cardiac troponin levels using sevoflurane and isoflurane in
patients undergoing cardiac surgery: A systematic review and
meta-analysis.
Source
Journal of Cardiovascular and Thoracic Research. 12 (1) (pp 1-9), 2020.
Date of Publication: 2020.
Author
Hosseinifard H.; Ghadimi N.; Kaveh S.; Shabaninejad H.; Lijassi A.;
Azarfarin R.
Institution
(Hosseinifard) Biostatistics, School of Health Management and Information
Sciences, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Kaveh) Health Technology Assessment, School of Health Management and
Information Sciences, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Shabaninejad) Department of Health Services Management, School of Health
Management and Information Sciences, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Shabaninejad) Population Health Sciences Institute, Newcastle University,
Newcastle, United Kingdom
(Lijassi) Faculty of Medicine and Pharmacy of Rabat, Mohammed V University
of Rabat, Rabat, Morocco
(Azarfarin) Echocardiography Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
Tabriz University of Medical Sciences
Abstract
Introduction: Cardiac troponin is one of the heart biomarkers and its high
levels correlates with a high risk of cardiomyocytes damage. This study
aimed to compare sevoflurane and isoflurane effect on troponin levels in
patients undergoing cardiac surgery. <br/>Method(s): We systematically
searched for RCTs which had been published in Cochrane library, PubMed,
Web of science, CRD, Scopus, and Google Scholar by the end of February
30th, 2019. The quality of articles was evaluated with the Cochrane
checklist. GRADE was used for quality of evidence for this meta-analysis.
Meta-analysis was done based on random or fixed effect model.
<br/>Result(s): Five studies with total of 190 (sevoflurane) and 191
(isoflurane) patients were included. The results showed that pooled mean
difference of troponin levels between the two groups was significant at
ICU admission time and 24 hours after entering. The comparison of troponin
level changes between the two groups (baseline = at time ICU) in 24 and 48
hours after ICU admission was significant. <br/>Conclusion(s): This
meta-analysis showed that blood troponin levels were significantly lower
at the time of arrival in ICU with isoflurane and after 24 hours with
sevoflurane. Generally, given the small mean difference between isoflurane
and sevoflurane, it seems that none of the medications has a negative
effect on the cardiac troponin level.<br/>Copyright &#xa9; 2020 The
Author(s). This is an open access article distributed under the terms of
the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0), which permits unrestricted
use, distribution, and reproduction in any medium, provided the original
work is properly cited.

<50>
Accession Number
2006109685
Title
Outcomes with MANTA Device for Large-Bore Access Closure after
Transcatheter Aortic Valve Replacement: A Meta-Analysis.
Source
Structural Heart. 4 (5) (pp 420-426), 2020. Date of Publication: 02 Sep
2020.
Author
Megaly M.; Buda K.G.; Brilakis E.S.; Pershad A.; Louka B.; Saad M.;
Abdelaziz H.K.; Anantha Narayanan M.; Syed M.; Mentias A.; Omer M.;
Alexander J.; Titus J.; Garcia S.
Institution
(Megaly, Brilakis, Omer, Alexander, Titus, Garcia) Minneapolis Heart
Institute, Abbott Northwestern Hospital, Minneapolis, MN, United States
(Megaly, Buda) Division of Cardiology, Hennepin Healthcare, Minneapolis,
MN, United States
(Pershad) Division of Cardiology, Banner University Medical Center,
University of Arizona, Phoenix, AZ, United States
(Louka) Division of Cardiology, Willis Knighton Medical Center,
Shreveport, LA, United States
(Saad, Abdelaziz) Division of Cardiology, Ain Shams University, Cairo,
Egypt
(Saad) Division of Cardiology, The Warren Alpert School of Medicine at
Brown University, Providence, RI, United States
(Abdelaziz) Lancashire Cardiac Center, Blackpool Victoria Hospital,
Blackpool, United Kingdom
(Anantha Narayanan) Division of Vascular Medicine, Yale-New Haven
Hospital, New Haven, CT, United States
(Syed) Division of Cardiology, University of Toledo, Toledo, OH, United
States
(Mentias) Division of Cardiology, Cleveland Clinic Foundation, Cleveland,
OH, United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Data comparing MANTA to other vascular closure devices (VCDs)
after TAVR is limited. <br/>Method(s): We performed a meta-analysis of all
published studies reporting the outcomes of MANTA vs. other VCDs in TAVR
patients. Outcomes included major and minor vascular complications, major
and minor bleeding, VCD failure, blood transfusion, additional surgical or
endovascular treatment, flow-limiting dissection, hematomas,
pseudoaneurysm, change in hemoglobin, and length of stay (LOS).
Definitions used were according to the "Valve Academic Research
Consortium-2 consensus document" (VARC-2). <br/>Result(s): We included
five observational studies with a total of 1,410 patients (MANTA n = 601,
other VCDs = 809). Three studies compared MANTA to the Proglide device
(Abbot Vascular, CA, USA), and two studies compared MANTA to the Prostar
XL device (Abbott Vascular, IL, USA). The prevalence of moderate to severe
calcification was higher in the MANTA group (31% vs. 21%, p = 0.01)
compared with other VCDs group. During the index hospitalization, there
was no difference in all major or minor complications between MANTA and
other VCDs. In a sensitivity analysis, comparing MANTA to Proglide, the
risk of major and minor vascular complications, major and minor bleeding,
and VCD failure was similar for both devices. <br/>Conclusion(s): In the
TAVR population, although more used in calcified vessels, the safety
profile and efficacy of the new collagen-based VCD, MANTA, is similar to
currently available suture based VCD's Proglide and Prostar
XL.<br/>Copyright &#xa9; 2020 Cardiovascular Research Foundation.

<51>
Accession Number
2005602733
Title
Re-Thinking the Role of Statistics in Informing Heart Team Decisions: A
Consensus Distribution Approach.
Source
Structural Heart. (pp 1-2), 2020. Date of Publication: 2020.
Author
McAndrew T.; Redfors B.
Institution
(McAndrew) Department of Biostatistics and Epidemiology, School of Public
Health and Health Sciences, University of Massachusetts Amherst, Amherst,
MA, United States
(McAndrew, Redfors) The Cardiovascular Research Foundation, New York, NY,
United States
(Redfors) Department of Cardiology, NewYork-Presbyterian Hospital,
Columbia University Medical Center, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
Bellwether Publishing, Ltd.

<52>
Accession Number
2005221304
Title
Extrapolation of Survival Benefits in Patients with Transthyretin Amyloid
Cardiomyopathy Receiving Tafamidis: Analysis of the Tafamidis in
Transthyretin Cardiomyopathy Clinical Trial.
Source
Cardiology and Therapy. 9 (2) (pp 535-540), 2020. Date of Publication: 01
Dec 2020.
Author
Li B.; Alvir J.; Stewart M.
Institution
(Li, Alvir) Pfizer, New York, NY, United States
(Stewart) Pfizer, Groton, CT, United States
Publisher
Adis
Abstract
Introduction: In the Tafamidis in Transthyretin Cardiomyopathy Clinical
Trial (ATTR-ACT; ClinicalTrials.gov number NCT01994889), tafamidis reduced
the risk of all-cause mortality in patients with transthyretin amyloid
cardiomyopathy (ATTR-CM) by 30% versus placebo. Median overall survival
was not achieved in either treatment arm (57.1 and 70.5% of patients in
the placebo and tafamidis groups, respectively, survived at 30 months),
limiting assessment of the potential survival benefits of treatment.
<br/>Method(s): A survival extrapolation analysis was conducted following
technical support guidelines from the National Institute for Health and
Care Excellence. Multiple models (i.e., exponential, Weibull, gamma,
log-logistic, log-normal, Gompertz, generalized gamma, and generalized F)
were applied to systematically fit different candidate curves to existing
patient-level data from the 30-month treatment period in ATTR-ACT. The
relative goodness-of-fit for each candidate curve was then tested by
Akaike's and Bayesian information criteria to select a single model that
was fitted to the placebo and pooled tafamidis treatment arms.
<br/>Result(s): A gamma distribution was selected as best fitting model
and fitted to both treatment arms. The resulting estimated median overall
survival was 35.16 months for placebo and 52.64 months for tafamidis
(difference 17.48 months). <br/>Conclusion(s): This extrapolation of
survival data from ATTR-ACT further supports the efficacy of tafamidis in
patients with ATTR-CM. Owing to the limitations of this analysis, these
survival estimates should be interpreted with caution; however, they are
consistent with recently presented findings from a combined analysis of
data from ATTR-ACT and interim data from an ongoing long-term extension
study (median follow-up 36 months; ClinicalTrials.gov number NCT02791230).
Trial Registration: ClinicalTrials.gov: NCT01994889.<br/>Copyright &#xa9;
2020, The Author(s).

<53>
Accession Number
2004937022
Title
Mitraclip Plus Medical Therapy Versus Medical Therapy Alone for Functional
Mitral Regurgitation: A Meta-Analysis.
Source
Cardiology and Therapy. 9 (1) (pp 5-17), 2020. Date of Publication: 01 Jun
2020.
Author
Goel S.; Pasam R.T.; Wats K.; Chava S.; Gotesman J.; Sharma A.; Malik
B.A.; Ayzenberg S.; Frankel R.; Shani J.; Gidwani U.
Institution
(Goel, Gidwani) Department of Cardiology, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Pasam, Wats, Chava, Gotesman, Malik, Ayzenberg, Frankel, Shani)
Department of Cardiology, Maimonides Medical Center, Brooklyn, New York,
NY, United States
(Sharma) Division of Cardiology, Gundersen Health System, La Crosse, WI,
United States
(Sharma) Institute of Cardiovascular Science and Technology, New York, NY,
United States
Publisher
Adis
Abstract
Introduction: The purpose of this meta-analysis is to compare the efficacy
of MitraClip plus medical therapy versus medical therapy alone in patients
with functional mitral regurgitation (FMR). FMR caused by left ventricular
dysfunction is associated with poor prognosis. Whether MitraClip improves
clinical outcomes in this patient population remains controversial.
<br/>Method(s): We conducted an electronic database search of PubMed,
CINAHL, Cochrane Central, Scopus, Google Scholar, and Web of Science
databases for randomized control trials (RCTs) and observational studies
with propensity score matching (PSM) that compared MitraClip plus medical
therapy with medical therapy alone for patients with FMR and reported on
subsequent mortality, heart failure re-hospitalization, and other outcomes
of interest. Event rates were compared using a random-effects model with
odds ratio as the effect size. <br/>Result(s): Five studies (n = 1513;
MitraClip = 796, medical therapy = 717) were included in the final
analysis. MitraClip plus medical therapy compared to medical therapy alone
was associated with a significant reduction in overall mortality (OR =
0.66, 95% CI = 0.44-0.99, P = 0.04) and heart failure (HF)
re-hospitalization rates (OR = 0.57, 95% CI = 0.36-0.91, P = 0.02). There
was reduced need for heart transplantation or mechanical support
requirement (OR = 0.48, 95% CI = 0.25-0.91, P = 0.02) and unplanned mitral
valve surgery (OR = 0.21, 95% CI = 0.07-0.61, P = 0.004) in the MitraClip
group. No effect was observed on cardiac mortality (P = 0.42) between the
two groups. <br/>Conclusion(s): MitraClip plus medical therapy improves
overall mortality and reduces HF re-hospitalization rates compared to
medical therapy alone in patients with FMR.<br/>Copyright &#xa9; 2019, The
Author(s).

<54>
Accession Number
2002625742
Title
Early Aortic Valve Replacement versus Watchful Waiting in Asymptomatic
Severe Aortic Stenosis: A Study-Level Meta-Analysis.
Source
Structural Heart. 3 (6) (pp 483-490), 2019. Date of Publication: 02 Nov
2019.
Author
Sa M.P.B.O.; Cavalcanti L.R.P.; Escorel Neto A.C.A.; Perazzo A.M.;
Simonato M.; Clavel M.-A.; Pibarot P.; Lima R.C.
Institution
(Sa, Cavalcanti, Escorel Neto, Perazzo, Lima) Division of Cardiovascular
Surgery of Pronto Socorro Cardiologico de Pernambuco-PROCAPE, Recife,
Brazil
(Sa, Cavalcanti, Escorel Neto, Perazzo, Lima) University of
Pernambuco-UPE, Recife, Brazil
(Sa, Lima) Nucleus of Postgraduate and Research in Health Sciences of
Faculty of Medical Sciences and Biological Sciences Instituite-FCM/ICB,
Recife, Brazil
(Simonato) Escola Paulista de Medicina-UNIFESP, Sao Paulo, Brazil
(Clavel, Pibarot) Institut Universitaire de Cardiologie et de Pneumologie
du Quebec, QC, Canada
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: The management of patients with asymptomatic, severe aortic
stenosis (AS) is controversial. We performed a meta-analysis to examine
the impact on outcomes of early aortic valve replacement (AVR) in patients
with severe asymptomatic AS versus a watchful-waiting (WW) approach.
<br/>Method(s): Databases were searched for studies published until April
2019. Main outcome of interest was death during follow-up. <br/>Result(s):
The search yielded 1,889 studies for inclusion. Of these, seven articles
were analyzed and their data extracted. The total number of patients
included was 3,839. The overall HR (95% CI) for death showed a
statistically significant difference between the groups, with lower risk
in the "early AVR" group (random effect model: HR 0.280; 95% CI
0.159-0.494, P < 0.001). There was evidence of significant statistical
heterogeneity of treatment effect among the studies for death. Funnel plot
analysis disclosed no asymmetry around the axis for the outcome of
interest, which means that we have low risk of publication bias related to
this outcome. Sensitivity analysis showed that none of the studies had a
particular impact on the results. The meta-regression coefficients for the
modulating factors age, male sex, presence of hypertension and presence of
diabetes were significant for mortality, showing that the early
intervention becomes even more protective in comparison with the
conservative approach when we take these factors into consideration.
<br/>Conclusion(s): Early AVR seems to be a better approach than WW in the
treatment of asymptomatic patients with severe AS, but we would still
advocate a case-by-case decision-making process.<br/>Copyright &#xa9;
2019, &#xa9; 2019 Cardiovascular Research Foundation.

<55>
Accession Number
623954886
Title
Transcatheter versus Surgical Aortic Valve Replacement in Patients with
Moderate to Severe Chronic Kidney Disease: A Systematic Review and
Analysis.
Source
Structural Heart. 2 (2) (pp 129-136), 2018. Date of Publication: 04 Mar
2018.
Author
Panchal H.B.; Leon M.B.; Kirtane A.J.; Kodali S.K.; McCarthy P.; Davidson
C.J.; Thourani V.; Beohar N.
Institution
(Panchal) Division of Cardiology, East Tennessee State University, Johnson
City, TN, United States
(Leon, Kirtane, Kodali) Division of Cardiology, Columbia University
Medical Center, New York Presbyterian Hospital, Columbia University, New
York, NY, United States
(McCarthy, Davidson) Division of Cardiothoracic Surgery, Northwestern
University, Chicago, IL, United States
(Thourani) Department of Cardiac Surgery, Medstar Washington Hospital
Center, Washington, DC, United States
(Beohar) Columbia University Division of Cardiology at Mount Sinai Medical
Center, Miami Beach, FL, United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Patients with chronic kidney disease (CKD) and aortic stenosis
(AS) have poor prognosis after both transcatheter aortic valve replacement
(TAVR) and surgical aortic valve replacement (SAVR). The objective of our
study was to assess the outcomes of TAVR versus SAVR for severe AS among
patients with moderate to severe CKD (stage >=3). <br/>Method(s): PubMed,
Cochrane Center Register of Controlled Trials and clinical trial registry
were searched through April 2017. Seven studies comparing TAVR (n = 878)
and SAVR (n = 2531) in patients with CKD stage >=3 were included. End
points were clinical and qualitative outcomes. Odds ratio (OR) or mean
difference (MD) with 95% confidence interval (CI) was computed and p <
0.05 was considered significant. <br/>Result(s): There was no difference
in all-cause mortality (p = 0.7), cerebrovascular accidents (p = 0.28),
myocardial infarction (p = 0.55) or new permanent pacemaker placement (p =
0.06) with TAVR compared with SAVR. Post-procedural worsening renal
failure or acute kidney injury (AKI), new dialysis and length of intensive
care unit stay were lower with TAVR compared with SAVR (OR:0.47,
CI:0.33-0.68, p < 0.0001; OR:0.44, CI:0.25-0.74, p = 0.002 and MD: -68.32
hours, CI: -86.35 to -50.28 hours, p < 0.00001 respectively). Major
vascular complications were higher and red blood cell transfusion was
lower with TAVR compared with SAVR (OR:8.84, CI:1.6-49, p = 0.01 and
OR:0.39, CI:0.18-0.82, p = 0.01 respectively). <br/>Conclusion(s): The
results of our meta-analysis comparing TAVR with SAVR in patients with
severe AS and moderate to severe CKD suggest that TAVR is comparable to
SAVR with the advantage of a decreased incidence of worsening of renal
failure or AKI, new dialysis, and intensive care unit stay.<br/>Copyright
&#xa9; 2017, &#xa9; 2017 Cardiovascular Research Foundation.

<56>
Accession Number
623954776
Title
Outcomes for Percutaneous Mitral Valve-in-Valves and Mitral Valve-in-Rings
in the Transapical and Transseptal Access Routes: A Systematic Review and
Pooled Analysis.
Source
Structural Heart. 2 (3) (pp 214-220), 2018. Date of Publication: 04 May
2018.
Author
Sengodan P.; Sankaramangalam K.; Banerjee K.; Athappan G.; Jobanputra Y.;
Krishnaswamy A.; Tuzcu M.E.; Kapadia S.
Institution
(Sengodan) Department of Medicine, Cleveland Clinic at Fairview Hospital,
Cleveland, OH, United States
(Sankaramangalam, Banerjee, Jobanputra, Krishnaswamy, Kapadia) Department
of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
(Athappan) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Tuzcu) Department of Cardiovascular Medicine, Cleveland Clinic Abu Dhabi,
Al Maryah Island, United Arab Emirates
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: The transapical (TA) route for mitral valve-in-valve (MVIV)
and mitral valve-in-ring (MVIR) techniques has been predominantly used.
Currently, there is an increasing trend towards the transseptal (TS)
route. The purpose of the study was to assess the outcomes of TA and TS
access for percutaneous MVIV and MVIR techniques in terms of procedural
success, 30-day mortality, major bleeding events and valve embolization.
<br/>Method(s): A comprehensive literature search of EMBASE, PubMed, and
the Cochrane CENTRAL was completed. We identified and pooled all studies
reporting either the TS or TA approach for MVIV or MVIR with at least five
patients using weighted proportional analysis. For analysis we used
studies reporting the outcomes of percutaneous MVIV or MVIR based on the
TS/TA approach. <br/>Result(s): From the initial 1,993 abstracts, 15
studies reporting on 236 patients were analyzed to find the pooled
estimate of the endpoints. In the TA arm, 11 studies were included, and in
the TS arm, 8 studies were included. Of these, 5 studies reported data for
both the TA and TS arms. There was no difference between the groups in
terms of technical success, 30-day all-cause mortality, major bleeding
events, and valve embolization. <br/>Conclusion(s): Although the TA
approach has been used in most of the published studies, the TS approach
appears to be equally effective at 30 days. Long-term studies are needed
to establish the relative efficacy of one approach over the
other.<br/>Copyright &#xa9; 2018, &#xa9; 2018 Cardiovascular Research
Foundation.

<57>
Accession Number
623954762
Title
Subclinical Leaflet Thrombosis and Clinical Outcomes after TAVR: A
Systematic Review and Meta-Analysis.
Source
Structural Heart. 2 (3) (pp 223-228), 2018. Date of Publication: 04 May
2018.
Author
Kalra A.; Raza S.; Puri R.; Deo S.V.; Auffret V.; Khera S.; Attizzani
G.F.; Zia A.; Khan M.S.; Reardon M.J.; Kleiman N.S.; Latib A.; Rodes-Cabau
J.; Sabik J.F.; Bhatt D.L.
Institution
(Kalra, Attizzani) Harrington Heart & Vascular Institute, University
Hospitals Cleveland Medical Center, Division of Cardiovascular Medicine,
Department of Medicine, Case Western Reserve University School of
Medicine, Cleveland, OH, United States
(Raza, Deo, Sabik) Department of Surgery, University Hospitals Cleveland
Medical Center, Cleveland, OH, United States
(Puri) Quebec Heart & Lung Institute, Laval University, Cleveland Clinic
Coordinating Center for Clinical Research (C5R), Cleveland, OH, United
States
(Puri) Department of Medicine, University of Adelaide, North Terrace
Campus, Adelaide, Australia
(Auffret) Department of Cardiology and Vascular Disease, CIC-IT 804,
Rennes 1 University, Pontchaillou University Hospital, Signal and Image
Processing Laboratory (LTSI), INSERM U1099, Rennes, France
(Khera) Massachusetts General Hospital, Harvard Medical School, Boston,
MA, United States
(Zia) Dow University of Health Sciences, Karachi, Pakistan
(Khan) Department of Internal Medicine, John H. Stroger, Jr. Hospital of
Cook County, Chicago, IL, United States
(Reardon, Kleiman) Houston Methodist DeBakey Heart and Vascular Center,
Houston Methodist Hospital, Houston, TX, United States
(Latib) Interventional Cardiology Unit, Cardiology and Cardiothoracic
Surgery Department, San Raffaele University Hospital, Milan, Italy
(Rodes-Cabau) Quebec Heart & Lung Institute, Laval University, QC, Canada
(Bhatt) Brigham and Women's Hospital Heart & Vascular Center, Harvard
Medical School, Boston, MA, United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Little is known about the influence of subclinical leaflet
thrombosis (SCLT) on clinical outcomes after transcatheter aortic valve
replacement (TAVR). Therefore, we sought to perform a systematic review
and meta-analysis of studies that reported clinical outcomes in patients
with or without SCLT after TAVR. <br/>Method(s): We searched Medline,
PubMed, and Embase in September 2017 for studies reporting the clinical
outcomes in patients with or without SCLT after TAVR. SCLT was defined as
the presence of hypo-attenuated leaflet thickening (HALT) and/or
hypo-attenuation affecting leaflet motion (HAM) shown on computed
tomography. End-points studied included (1) mortality; (2) stroke; and (3)
stroke and/or TIA. Odds ratio (OR) meta-analysis was conducted by the Peto
method using a random effects model; results are presented at the 95%
confidence level. <br/>Result(s): A total of five studies (91 patients
with SCLT; 672 patients without SCLT) met the inclusion criteria. Pooled
incidence of SCLT was 15.2% (7.8-27.7%) in patients undergoing TAVR. There
was no significant difference in mortality (OR: 0.86 [0.29-2.51]), stroke
(OR: 1.3 [0.26-6.67]), or stroke and/or TIA (OR: 4.56 [0.35-58.8]) in
patients with or without SCLT. <br/>Conclusion(s): This study-level
meta-analysis suggests a 15% incidence of SCLT post-TAVR, with no
statistically significant associations with mortality and stroke/TIA,
though with broad confidence intervals and limited statistical power.
Given the lack of availability of patient-level data, as well as the
relatively limited numbers of patients included across a handful of
registries, ongoing surveillance as well as systematic attempts to
understand better the clinical significance of SCLT will be
required.<br/>Copyright &#xa9; 2018, &#xa9; 2018 Cardiovascular Research
Foundation.

<58>
Accession Number
625374244
Title
Outcomes of Patients with Significant Obesity Undergoing TAVR or SAVR in
the Randomized PARTNER 2A Trial.
Source
Structural Heart. 2 (6) (pp 500-511), 2018. Date of Publication: 02 Nov
2018.
Author
Chen S.; Redfors B.; Ben-Yehuda O.; Crowley A.; Dvir D.; Hahn R.T.;
Pibarot P.; Jaber W.A.; Webb J.G.; Yoon S.-H.; Makkar R.R.; Alu M.C.;
Thourani V.H.; Tuzcu E.M.; Mack M.J.; George I.; Nazif T.; Kodali S.K.;
Leon M.B.
Institution
(Chen, Redfors, Ben-Yehuda, Crowley, Leon) Cardiovascular Research
Foundation, New York, NY, United States
(Dvir) Division of Cardiology, University of Washington, Seattle, WA,
United States
(Hahn, Alu, George, Nazif, Kodali, Leon) Structural Heart & Valve Center,
Columbia University Irving Medical Center, New York, NY, United States
(Pibarot) Quebec Heart & Lung Institute, Laval University, QC, Canada
(Jaber, Tuzcu) Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH,
United States
(Webb) Centre for Heart Valve Innovation, St. Paul's Hospital, Vancouver,
BC, Canada
(Yoon, Makkar) Department of Medicine, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Thourani) Medstar Heart & Vascular Institute, Washington Hospital Center,
Washington, DC, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Patients with severe aortic stenosis (AS) at intermediate
surgical risk, treated with transcatheter aortic valve replacement (TAVR)
or surgical aortic valve replacement (SAVR) have similar 2-year survival.
Significant obesity (SigOb), defined as body mass index (BMI) >= 35
kg/m², has been associated with increased surgical risk and
post-operative complications. There are no data comparing clinical
outcomes after SAVR versus TAVR in patients with SigOb. <br/>Method(s): In
the PARTNER 2A trial, 2032 patients with severe AS and intermediate
surgical risk were randomized to TAVR with the SAPIEN XT valve or SAVR.
After excluding 32 patients who had very low BMI < 18.5 kg/m²,
the remaining 2000 patients were categorized based on BMI at baseline to
SigOb or not SigOb, and compared in regards to 2-year risk of adverse
cardiovascular events. <br/>Result(s): A total of 250 patients (12.5%)
were SigOb and were younger, more often female, and more frequently
diabetic. The 30-day and 2-year rates of the primary composite endpoint
death and disabling stroke as well as the risks of its components, were
similar for patients with versus without SigOb. However, the 2-year
relative risk of cardiovascular death was lower with TAVR versus SAVR for
SigOb patients (5.7% vs 15.4%, p = 0.02; HR 0.36, 95% CI 0.15-0.88) but
not for not SigOb patients (10.6% vs 10.7%, p = 0.91; HR 0.98, 95% CI
0.73-1.32; p<inf>interaction</inf> = 0.03). These results remained
consistent after multivariable adjustment. <br/>Conclusion(s): In the
PARTNER 2A Trial, intermediate-risk patients with severe AS and BMI >= 35
kg/m² undergoing TAVR experienced significantly lower
cardiovascular mortality than similar patients undergoing
SAVR.<br/>Copyright &#xa9; 2018, &#xa9; 2018 Cardiovascular Research
Foundation.

<59>
Accession Number
624532513
Title
A Meta-Analysis of Clinical Outcomes of Transcatheter Aortic Valve
Replacement in Patients with End-Stage Renal Disease.
Source
Structural Heart. 2 (6) (pp 548-556), 2018. Date of Publication: 02 Nov
2018.
Author
Amione-Guerra J.; Mattathil S.; Prasad A.
Institution
(Amione-Guerra, Mattathil, Prasad) Department of Medicine, Division of
Cardiology, University of Texas Health Science Center at San Antonio, San
Antonio, TX, United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: End-stage renal disease (ESRD) is associated with an increased
incidence of severe aortic stenosis (AS). For these patients the usual
care has been surgical aortic valve replacement (SAVR). ESRD patients are
at increased surgical risk. Trans-aortic valve replacement (TAVR) may be
an alternative to SAVR for these patients. However, TAVR trials have
excluded patients with ESRD. <br/>Method(s): MEDLINE, OMBASE and Cochrane
databases were queried for relevant studies. A meta-analysis was performed
on the selected studies. Primary outcome was early all-cause mortality;
secondary outcomes included 1-year mortality, bleeding, neurological
deficits, vascular complications, pacemaker requirement, and myocardial
infarction. <br/>Result(s): A total of 16 studies included 3,499 patients.
Most patients were high risk as demonstrated by Society of Thoracic
Surgeons (STS) scores > 10 in most studies. Post-TAVR early and 1-year
mortality were 10% (95%CI: 7.8-10.5%) and 33% (95%CI: 24.1-36.8%)
respectively. Most common post-procedure complications were bleeding 17%
(95%CI: 14.8-20.8%), pacemaker implant 14% (95%CI: 11.6-17.5%) and
vascular complications 7% (95%CI: 4.3-9.9%). Neurological deficits and
myocardial infarction were less common both at 1.2% (95%CI: 0.4-2.4%,
0.3-2.5% respectively). Three studies with 2,545 patients compared TAVR
versus SAVR, there was no difference in early mortality (~ 10%, RR:1.0,
95%CI 0.60-1.64, p = 0.9). TAVR was associated with decreased risk of
vascular complications (RR:0.58 95%CI: 0.3-0.8, p = 0.03).
<br/>Conclusion(s): These results suggest that TAVR outcomes in ESRD
patients are comparable to those patients considered extreme surgical
risk. Compared to SAVR, there was no difference in early mortality, but
fewer vascular complications. As the ESRD population continues to grow,
future prospective studies should focus on this particular patient
population.<br/>Copyright &#xa9; 2018, &#xa9; 2018 Cardiovascular Research
Foundation.

<60>
Accession Number
624531623
Title
Impact of Transcatheter Mitral Valve Repair on Left Ventricular Remodeling
in Secondary Mitral Regurgitation: A Meta-Analysis.
Source
Structural Heart. 2 (6) (pp 541-547), 2018. Date of Publication: 02 Nov
2018.
Author
Megaly M.; Khalil C.; Abraham B.; Saad M.; Tawadros M.; Stanberry L.;
Kalra A.; Goldsmith S.R.; Bart B.; Bae R.; Brilakis E.S.; Gossl M.;
Sorajja P.
Institution
(Megaly, Stanberry, Bae, Brilakis, Gossl, Sorajja) Valve Science Center,
Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Megaly, Goldsmith, Bart) Division of Cardiology, Department of Medicine,
Hennepin Healthcare, Minneapolis, MN, United States
(Khalil) Department of Medicine, University at Buffalo, Buffalo, NY,
United States
(Abraham) St. John Hospital and Medical Center, Detroit, MI, United States
(Saad) Department of Cardiovascular Medicine, University of Arkansas for
Medical Sciences, Little Rock, AR, United States
(Saad) Department of Cardiology, Ain Shams University, Cairo, Egypt
(Tawadros) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Kalra) Division of Cardiology, Case Western Reserve University School of
Medicine, Cleveland, OH, United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Secondary mitral regurgitation (MR) arises from left
ventricular (LV) dilatation and remodeling, and commonly is treated with
transcatheter mitral valve repair. We examined the impact of MitraClip on
reverse cardiac remodeling in patients with severe, symptomatic secondary
MR. <br/>Method(s):: An electronic search was performed through January
2018 for studies that reported cardiac chamber dimensions prior to and
after treatment with MitraClip in patients with secondary MR. The mean
difference (MD) with 95% CI was calculated using fixed or random inverse
variance models. Outcomes of interest were changes in LV end-systolic and
end-diastolic volumes (LVESV, LVEDV) and dimensions (LVESD, LVEDD).
Secondary outcomes included left atrial (LA) volume, systolic pulmonary
artery pressure (sPAP) and LV ejection fraction (LVEF). <br/>Result(s): A
total of 16 studies with 1,266 patients were included in the present
analysis. The weighted mean follow-up period (+/-SD) was 11.5 +/- 7.2
months. MitraClip was associated with significant reduction in LVEDV
(-14.24 ml, 95% CI [-22.53, -5.94], p = 0.0008), LVESV (-7.67 ml, CI
[-12.30, -3.03], p = 0.001), LVEDD (-2.92 mm [-3.65, -2.19 mm], p <
0.00001), and LVESD (-1.92 mm [-2.92, -0.92], p = 0.0002). MitraClip was
also associated with reduction in LA volume (-16.36 ml [23.23, -9.49 ml],
p < 0.00001) and sPAP (-6.93 mmHg [-8.76, -5.10], p < 0.00001), and a
significant increase in LVEF (+ 2.78% [0.91, 4.66], p = 0.004).
<br/>Conclusion(s): In patients with severe symptomatic secondary MR,
MitraClip is associated with modest, but favorable LV and LA reverse
remodeling. The impact of these changes on clinical outcomes deserves
further study.<br/>Copyright &#xa9; 2018, &#xa9; 2018 Cardiovascular
Research Foundation.

<61>
Accession Number
624252536
Title
Impact of Atrial Fibrillation on the Outcomes after MitraClip: A
Meta-Analysis.
Source
Structural Heart. 2 (6) (pp 531-537), 2018. Date of Publication: 02 Nov
2018.
Author
Megaly M.; Abraham B.; Saad M.; Omer M.; Elbadawi A.; Tawadros M.; Khalil
C.; Nairoz R.; Almomani A.; Sengupta J.; Kalra A.; Brilakis E.; Gafoor S.
Institution
(Megaly, Sengupta, Brilakis) Minneapolis Heart Institute, Abbott
Northwestern Hospital, Minneapolis, MN, United States
(Megaly) Division of Cardiology, Department of Medicine, Hennepin County
Medical Center, Minneapolis, MN, United States
(Abraham) Department of Medicine, St. John Providence Hospital, Detroit,
MI, United States
(Saad, Almomani) Department of Cardiovascular Medicine, University of
Arkansas, Little Rock, AR, United States
(Saad) Division of Cardiology, Ain Shams University, Cairo, Egypt
(Omer) Cardiology Division, Saint Luke's Hospital, Kansas City, MO, United
States
(Elbadawi) Division of Cardiology, Rochester General Hospital, Rochester,
NY, United States
(Tawadros) Department of Cardiology, Ain Shams University Medical School,
Cairo, Egypt
(Khalil) Department of Internal Medicine, University of Buffalo, Buffalo,
NY, United States
(Nairoz) Division of Cardiology, University of South California, Los
Angeles, CA, United States
(Kalra) Division of Cardiology, Case Western Reserve University School of
Medicine, Cleveland, OH, United States
(Gafoor) Division of Cardiology, Swedish Medical Center, Seattle, WA,
United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Atrial fibrillation (AF) has been associated with worse
outcomes in patients undergoing mitral valve surgery for mitral
regurgitation. The impact of preexisting AF on the outcomes after
transcatheter mitral valve repair with MitraClip (Abbott Vascular, Santa
Clara, CA, USA) has not been well studied. <br/>Method(s): An electronic
search was performed until December 2017 for studies reporting outcomes
after MitraClip in patients with AF versus those with no AF. Outcomes of
interest included all-cause mortality, stroke and major adverse
cardiovascular events (MACE) defined as the composite outcome of death,
stroke, and myocardial infarction at the longest follow-up reported.
<br/>Result(s): A total of four studies including 1473 patients (AF n =
697; no AF n = 776) were included. There was no difference in procedural
success or procedural time between patients with AF versus those without
AF. AF was associated with increased mortality after MitraClip compared
with patients with no AF (OR 1.54, 95% CI (1.16, 2.04), p = 0.003,
I² = 0%) over a mean follow-up period of 10.2 months. In a
sensitivity analysis excluding early postoperative (30-day) outcomes, AF
remained associated with higher mortality (OR 1.53, 95% CI (1.15, 2.03), p
= 0.003, I² = 19%). AF was associated with a higher incidence
of MACE after MitraClip (OR 1.46, 95% CI (1.03, 2.07), p = 0.03,
I² = 13%). No difference was observed in the risk of stroke
between patients with versus without AF after MitraClip (OR 1.13, 95%CI
(0.36, 3.56), p = 0.84, I² = 37%). <br/>Conclusion(s): Compared
with patients without AF, patients with preexisting AF are at higher risk
of death and MACE after MitraClip.<br/>Copyright &#xa9; 2018, &#xa9; 2018
Cardiovascular Research Foundation.

<62>
Accession Number
623954503
Title
Safety and Efficacy of Percutaneous Mitral Valve-in-Valve and Mitral
Valve-in-Ring Procedures: Systematic Review and Pooled Analysis of 30 Day
and One Year Outcomes.
Source
Structural Heart. 2 (5) (pp 421-430), 2018. Date of Publication: 03 Sep
2018.
Author
Sengodan P.; Sankaramangalam K.; Jobanputra Y.; Athappan G.; Jaber W.;
White J.; Mick S.; Navia J.; Krishnaswamy A.; Tuzcu E.M.; Kapadia S.
Institution
(Sengodan) Department of Medicine, Cleveland Clinic, Cleveland, OH, United
States
(Sankaramangalam, Jobanputra, Jaber, White, Krishnaswamy, Kapadia)
Department of Cardiovascular Medicine, Heart & Vascular Institute,
Cleveland Clinic, Cleveland, OH, United States
(Athappan) Minneapolis Heart Institute, Minneapolis, MN, United States
(Mick, Navia) Department of Thoracic and Cardiovascular Surgery, Heart and
Vascular Institute, Cleveland Clinic, Cleveland, OH, United States
(Tuzcu) Department of Cardiovascular Medicine, Cleveland Clinic, Abu
Dhabi, United Arab Emirates
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: The purpose of this study was to perform a systematic review
and pooled analysis to evaluate 30-day and 1-year outcomes of
transcatheter mitral valve-in-valve (VIV) and valve-in-ring (VIR)
procedures. Data from the Valve-in-Valve Data Registry revealed that there
were several safety and efficacy concerns, although procedural success was
achieved in most cases. <br/>Method(s): Studies reporting data on either
mitral VIV and/or VIR with at least five patients were pooled using
weighted proportional analysis. <br/>Result(s): The 30-day pooled estimate
of all-cause mortality in the mitral VIV group was 7%, valve embolization,
5%, stroke, 3%, and major bleeding, 9%. At 1 year the all-cause mortality
was 11%, valve thrombosis, 10%, stroke, 6%, and major bleeding, 16%. In
the mitral VIR group, the 30-day pooled estimate for all-cause mortality
was 8%, renal failure, 11%, valve embolization, 3%, and left ventricular
outflow tract obstruction, 10% and at 1 year the all-cause mortality was
about 22%. <br/>Conclusion(s): Mitral VIV and VIR procedures are safe and
feasible in high risk surgical candidates. The long-term safety and
efficacy data beyond 1 year for both mitral VIV and VIR need to be
established.<br/>Copyright &#xa9; 2018, &#xa9; 2018 Cardiovascular
Research Foundation.

<63>
Accession Number
623954493
Title
Mono versus Dual Antiplatelet Therapy after Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
Structural Heart. 2 (5) (pp 448-462), 2018. Date of Publication: 03 Sep
2018.
Author
Khalil C.; Mosleh W.; Megaly M.; Gandhi S.; Iskander F.H.; Iskander M.H.;
Ibrahim A.; Shah T.; Ekladios C.; Corbelli J.
Institution
(Khalil, Mosleh, Ibrahim, Shah, Ekladios, Corbelli) Division of
Cardiology, University at Buffalo, The State University of New York,
Buffalo, NY, United States
(Megaly) Division of Cardiology, Hennepin County Medical
Center-Minneapolis Heart Institute Foundation, Minneapolis, MN, United
States
(Gandhi) Division of Cardiology, University of Toronto, Toronto, ON,
Canada
(Iskander, Iskander) Division of Cardiology, Cook County Health and
Hospitals System, Chicago, IL, United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Dual antiplatelet therapy (DAPT) is routinely prescribed after
transcatheter aortic valve replacement (TAVR) despite the lack of
definitive data demonstrating its superiority over mono-antiplatelet
therapy (MAPT). We aim to investigate the benefits of DAPT versus MAPT and
at different follow-up time points post TAVR. <br/>Method(s): A systematic
search was conducted for studies investigating DAPT versus MAPT in
patients who underwent TAVR. The primary outcome was net adverse clinical
events (NACE) at longest reported follow-up, defined as a composite
end-point of all-cause mortality, major stroke, myocardial infarction
(MI), and combined life threatening and major bleeding. Secondary
endpoints included each outcome individually. We performed subgroup
analysis according to study type (randomized control trials vs.
observational studies) and follow-up duration post-TAVR (<= 30 days,
between 3 and 6 months, and >= 1 year). <br/>Result(s): Twelve studies
with 9,650 patients were included. Post-TAVR MAPT was associated with
significantly reduced NACE (0.60 [0.45, 0.81], p < 0.001), all-cause
mortality (OR 0.54 [0.33, 0.88], p = 0.01), and combined life threatening
and major bleeding (0.57 [0.39, 0.84], p = 0.005) in the first 30 days
after the procedure when compared to DAPT. The difference in outcomes
diminishes with longer-term follow up durations (3-6 month or >= 6-month).
No differences were seen with other secondary endpoints.
<br/>Conclusion(s): MAPT is associated with improved outcomes compared to
DAPT in the first 30 days post-TAVR with no difference in outcomes on
longer-term follow up. Future prospective, adequately powered,
multicenter, placebo-controlled, randomized double-blinded cohort studies
are warranted to confirm our findings.<br/>Copyright &#xa9; 2018, &#xa9;
2018 Cardiovascular Research Foundation.

<64>
Accession Number
623954484
Title
Single Anti-Platelet Therapy versus Dual Anti-Platelet Therapy after
Transcatheter Aortic Valve Replacement: A Meta-Analysis.
Source
Structural Heart. 2 (5) (pp 408-418), 2018. Date of Publication: 03 Sep
2018.
Author
Abuzaid A.; Ranjan P.; Fabrizio C.; Felpel K.; Chawla R.; Topic A.;
Elgendy I.Y.
Institution
(Abuzaid, Ranjan, Fabrizio, Felpel, Chawla, Topic) Department of
Cardiovascular Medicine, Sidney Kimmel Medical College at Thomas Jefferson
University/Christiana Care Health System, Newark, DE, United States
(Elgendy) Department of Medicine, Division of Cardiovascular Medicine,
University of Florida, Gainesville, FL, United States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: The optimal anti-platelet regimen after transcatheter aortic
valve replacement (TAVR) remains uncertain. The objective of this study
was to compare the efficacy and safety of single anti-platelet therapy
(SAPT) vs. dual anti-platelet therapy (DAPT) after transcatheter aortic
valve replacement (TAVR). <br/>Method(s): Electronic databases were
searched for randomized and observational studies, which compared SAPT
versus DAPT after TAVR. The primary outcomes were all-cause mortality, and
major bleeding. Summary adjusted risk ratios (RR) were calculated using a
Der-Simonian and Liard model. The risk of bias of the included studies was
assessed by the Cochrane scale and New-castle Ottawa assessment tool.
<br/>Result(s): A total of 10 studies with 2,412 patients were included.
There was no difference in 30-days all-cause mortality (RR 1.19, 95% CI
0.79-1.81, p = 0.41, I² = 0.0%) and at the longest available
follow up (i.e. mean 6.4 months) (RR 1.03, 95% CI 0.69-1.57, p = 0.86,
I² = 0.0%). The risk of major bleeding was higher in the DAPT
group (RR 2.14, 95% CI 1.37-3.31, p = 0.001). These findings were
consistent on analyzing randomized versus observational studies
(P<inf>interaction</inf> = 0.97, and 0.76 for all-cause mortality and
major bleeding, respectively). There was no difference in the risk of
life-threatening bleeding, major vascular complications, myocardial
infarction, and stroke between both groups (all p-values > 0.05).
<br/>Conclusion(s): DAPT post TAVR is associated with an increased risk of
major bleeding with no benefit on mortality, stroke, or myocardial
infarction. The evidence is driven mainly from observational studies, and
therefore future high quality randomized trials are needed.<br/>Copyright
&#xa9; 2018, &#xa9; 2018 Cardiovascular Research Foundation.

<65>
Accession Number
623935711
Title
Outcomes after Transcatheter and Surgical Aortic Valve Replacement in
Intermediate Risk Patients with Preoperative Mitral Regurgitation:
Analysis of PARTNER II Randomized Cohort.
Source
Structural Heart. 2 (4) (pp 336-343), 2018. Date of Publication: 04 Jul
2018.
Author
Malaisrie S.C.; Hodson R.W.; McAndrew T.C.; Davidson C.; Swanson J.; Hahn
R.T.; Pibarot P.; Jaber W.A.; Quader N.; Zajarias A.; Svensson L.; George
I.; Trento A.; Thourani V.H.; Szeto W.Y.; Dewey T.; Smith C.R.; Leon M.B.;
Webb J.G.
Institution
(Malaisrie, Davidson) Division of Cardiac Surgery, Northwestern
University, Bluhm Cardiovascular Institute, Chicago, IL, United States
(Hodson, Swanson) Providence Valve Center, Providence St. Vincent Medical
Center, Portland, OR, United States
(McAndrew, Leon) Cardiovascular Research Foundation, New York, NY, United
States
(Hahn, George, Smith, Leon) Columbia University Medical Center, New York,
NY, United States
(Pibarot) Department of Medicine, Laval University, Quebec, QC, Canada
(Jaber, Svensson) Cleveland Clinic, Cleveland, OH, United States
(Quader, Zajarias) Washington University School of Medicine, St. Louis,
MI, United States
(Trento) Cedars Sinai Medical Center, Los Angeles, CA, United States
(Thourani) Medstar Washington Hospital Center, Washington, DC, United
States
(Szeto) University of Pennsylvania, Philadelphia, PA, United States
(Dewey) Medical City Dallas Hospital, Dallas, TX, United States
(Webb) Centre for Heart Valve Innovation, St. Paul's Hospital, Vancouver,
BC, Canada
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Preoperative mitral regurgitation (MR) in patients undergoing
transcatheter (TAVR) and surgical aortic valve replacement (SAVR) has been
studied in high-risk cohorts. This study examines the outcomes of
preoperative MR (>= moderate) in a larger, intermediate-risk cohort.
<br/>Method(s): The Placement of Aortic Transcatheter Valves (PARTNER) 2A
Trial randomized 2032 intermediate-risk patients with severe, symptomatic
aortic stenosis to TAVR or SAVR. An ad-hoc analysis was performed on 1738
patients with baseline MR echocardiographic data. Patients were analyzed
according to the degree of preoperative MR (>= moderate versus <= mild).
<br/>Result(s): At baseline, >= moderate MR was reported in 300 patients
(17%). At 30 days, >= moderate MR had improved in 47% to <= mild.
Thirty-day mortality was higher in SAVR patients with >= moderate MR (8.0
versus 3.5%; p = 0.01), but this difference was not seen in TAVR (2.7 vs.
3.1%; p = 0.78). At 2-years, the combined outcome of death (20.5 vs.
16.3%; p = 0.07), stroke (12.9 vs. 9.0%; p = 0.06), and rehospitalization
(22.0 versus 17.4%; p = 0.06) was higher in the >= moderate MR (40.4 vs.
32.6%; p = 0.009), and similar between SAVR and TAVR (39.8 vs. 41.0%; p =
0.89). <br/>Conclusion(s): Significant MR is prevalent in patients with
severe AS and affects clinical outcomes after both TAVR and SAVR. SAVR
patients with MR have high early risk, but the increased risk of
death/stroke/rehospitalization becomes similar in both groups over time.
Improvement in MR is common, especially in patients with lower ejection
fraction and larger left-ventricular dimensions.<br/>Copyright &#xa9;
2018, &#xa9; 2018 Cardiovascular Research Foundation.

<66>
Accession Number
622467924
Title
Clinical Acceptability Of Trimetazidine Modified-Release 80 mg Once Daily
Versus Trimetazidine Modified-Release 35 mg Twice Daily In Stable Angina
Pectoris.
Source
Cardiology and Therapy. 7 (1) (pp 61-70), 2018. Date of Publication: 01
Jun 2018.
Author
Pozdnyakov Y.M.; Uskov V.L.; Gon-charenko I.I.; Prasolova T.P.; Guseva
V.G.; Shinkar A.S.; Samsonova S.M.; Vikhrova I.V.; Kuz'kina S.A.; Mitina
L.V.; Timofeeva I.V.; Archakova T.M.; Kovaleva N.Y.; Romanova E.A.; Tivon
Y.V.; Antonova Y.N.; Kurganova O.B.; Davydova N.N.; Klyuchantseva O.V.;
Popovskaya Y.V.; Kharitonova E.I.; Kuzmina T.N.; Buzmakova K.V.; Kaplenko
L.I.; Pospelova N.V.; Stepanova A.Y.; Kol-basheva N.A.; Krasnova G.M.;
Pal'vin-skaya A.Y.; Toloknova V.A.; Bikmullina R.F.; Gainullina A.A.;
Kedrina E.V.; Mikhailova S.A.; Nabiullina T.A.; Nizamova A.F.; Uskova
A.A.; Yushkova A.E.; Andreeva O.V.; Fedotova G.V.; Besser-geneva O.L.;
Gavrilyuk D.D.; Ehalo N.V.; Zlo-bina M.V.; Zhemartseva E.Y.; Markushina
I.A.; Pavlovets V.P.; Sobolenko A.A.; Apanovich I.E.; Kireeva N.V.;
Maksimova I.V.; Butz T.V.; Pavlova I.A.; Bachurina S.N.; Orlyachenko S.V.;
Zaitseva T.V.; Beznogova V.F.; Litsis N.N.; Novozhenina A.Y.; Abramyan
L.L.; Adamyan M.M.; Askerko S.N.; Bolmosov A.N.; Vasilieva I.N.; Volodova
S.I.; Grishko P.V.; Zherebetskaya E.S.; Zemlyanaya N.S.; Klysh-nikova
L.N.; Kononchik E.I.; Kuznetsova N.A.; Kuz'minova I.A.; Marmurova I.V.;
Mikhailova R.Y.; Mordovina I.P.; Nazarkina O.V.; Per-epechko A.P.;
Pivovarova N.G.; Potapova T.P.; Prokofiev D.A.; Proniushkina N.E.;
Savelieva E.V.; A Semovskikh N.; Timonenkova L.D.; Fomin V.V.; Furman
O.A.; Tsutsieva R.M.; Chibrikina M.V.; Shoshina I.N.; Yashchenko P.;
Bocharova T.I.; Demya-nenko O.L.; Zhukova L.B.; Melnikov A.Y.; Mer-kulieva
I.A.; Tyasina E.I.; Pakholkova N.S.; Rogozina S.V.; Chugunova I.V.;
Brazhnik M.L.; Guseva Y.V.; Anisimova A.N.; Kuzeyina S.S.; Kulakhmetova
R.G.; Petrova I.S.; Ignatyeva I.A.; Morozova T.A.; Ryb-nikova N.V.;
Gritsenko I.I.; Kondratskaya O.V.; Shishkin A.V.; Gogleva N.N.; Kulipanova
V.M.; Mitrofanova S.V.; Parada E.V.; Svistunova S.Y.; Sergeeva T.M.;
Kryukova V.V.; Suprun T.N.; Fedorova E.M.; Shnor O.F.; Mitroshina T.N.;
Shemetova T.S.; Val'kevich L.P.; Varnikova S.N.; Ivanova E.A.; Shlykova
O.N.; Guryanova I.R.; Zheltova V.L.; Bulygina E.D.; Gorskaya E.V.; Kosenko
L.V.; Musaeva F.K.; Fedorchenko M.Y.; Harish V.I.; Serbarinova O.M.;
Yatsenya Y.A.; Golubev M.N.; Kopaev D.E.; Miludina L.A.; Polischuk L.V.;
Shilintseva O.A.; Krylova L.M.; Vasilik M.V.; Zotov D.D.; Kalishevich
N.B.; Kachmazova L.I.; Kontorikova S.G.; Mamoshko T.A.; Osnovin S.A.;
Timosh-enko (Schmalz) I.O.; Kashina A.N.; Kiryanova O.G.; Kotova L.E.;
Kuvshinova L.E.; Ulyanova I.M.; Shevelo O.F.; Kir-eeva I.B.; Korohova
L.V.; Lisunova T.I.; Medvedeva E.V.; Matvienko T.E.; Shovgaryan S.L.;
Nebolsina T.F.; Mikusheva M.A.; Misharin N.N.; Kutaliya T.O.; Chernova
V.N.; Yanina Y.A.; Permyakova O.V.; Skurikhina N.N.; Goldinova L.M.;
Pri-khodko T.N.; Myshyakova A.G.; Akhmerova E.Z.; Zaitseva K.V.; Ozerchuk
A.A.; Polyakova I.M.; Rodionova; Safiullina I.D.; Arsentieva I.N.; Volkova
O.O.; Kondrina I.N.; Kharlova T.E.; Grigorieva T.L.; Kurtmulaeva K.V.;
Rogozina O.M.
Institution
(Pozdnyakov) Moscow Regional Cardiology Centre, Zhukovsky, Russian
Federation
Publisher
Springer Healthcare
Abstract
Introduction: Trimetazidine (TMZ) is an anti-ischemic metabolic agent that
has been shown to be efficacious in angina treatment, both in monotherapy
and in combination. A new formulation of TMZ modified-release (MR) 80 mg
was developed, which is to be taken once daily (od), instead of twice
daily (bid) for the currently available TMZ MR 35 mg, with the aim of
simplifying the medication regimen. <br/>Method(s): The present study was
an international, multicenter, randomized, double-blind, parallel-group
phase III study with a 12-week treatment period. The safety of TMZ MR 80
mg once daily was assessed compared to TMZ MR 35 mg twice daily, in
patients previously treated successfully by the latter. Emergent adverse
events (EAEs), biological parameters, vital signs, 12-lead resting ECG
(electrocardiogram) and Canadian Cardiovascular Society (CCS)
classification were recorded. <br/>Result(s): One-hundred and sixty-five
patients previously diagnosed with stable angina pectoris on treatment
were randomized to receive either TMZ MR 80 mg od or TMZ MR 35 mg bid. In
the TMZ MR 80 mg group, fewer patients had >= 1 EAE (17.1 vs. 22.9% in the
TMZ MR 35 mg group). Serious EAEs were reported by three patients in each
group. No EAE required dose modification, withdrawal, or temporary
interruption of study treatments. Vital signs, 12-lead ECG, and laboratory
parameters did not change. No worsening in CCS classes was observed with
either treatment. <br/>Conclusion(s): TMZ MR 80 mg od and TMZ MR 35 mg bid
have similar safety profiles. This new once-daily formulation could
improve patient compliance with therapy, thereby enhancing clinical
benefit. Trial Registration: ISRCTN registry, ISRCTN 84362208.
<br/>Funding(s): Institut de Recherches Internationales Servier and
Servier, Moscow, Russian Federation. Plain Language Summary: Plain
language summary available for this article.<br/>Copyright &#xa9; 2018,
The Author(s).

<67>
Accession Number
616464043
Title
Improvement of Subjective Well-Being by Ranolazine in Patients with
Chronic Angina and Known Myocardial Ischemia (IMWELL Study).
Source
Cardiology and Therapy. 6 (1) (pp 81-88), 2017. Date of Publication: 01
Jun 2017.
Author
Bavry A.A.; Park K.E.; Choi C.Y.; Mahmoud A.N.; Wen X.; Elgendy I.Y.
Institution
(Bavry, Park, Choi, Mahmoud, Wen, Elgendy) Department of Medicine,
University of Florida, Gainesville, FL, United States
(Bavry, Park, Choi) North Florida/South Georgia Veterans Health System,
Gainesville, FL, United States
(Wen) Health Outcomes, College of Pharmacy, University of Rhode Island,
Kingston, RI, United States
Publisher
Springer Healthcare
Abstract
Introduction: We aimed to assess if ranolazine would improve angina
symptoms among patients with documented myocardial ischemia.
<br/>Method(s): Eligible subjects had chronic stable angina and at least
one coronary stenosis with fractional flow reserve (FFR) <=0.80 or at
least one chronic total occlusion (CTO) without attempted
revascularization. Subjects were randomized to oral ranolazine 500 mg
twice daily for 1 week, then ranolazine 1000 mg twice daily for 15 weeks
versus matching placebo. The primary end point was change in angina at 16
weeks as assessed by the Seattle Angina Questionnaire (SAQ).
<br/>Result(s): Between September 2014 and January 2016, 25 subjects were
randomized to ranolazine versus 25 to placebo. The most common reason for
eligibility was CTO (72%), while the remainder had myocardial ischemia
documented by low FFR. The mean FFR was 0.57 +/- 0.12. Sixty-eight percent
of subjects were on two or more anti-angina medications at baseline. Study
medication was discontinued in 32% (eight of 25) of the ranolazine group
versus 36% (nine of 25) of the placebo group. By intention-to-treat, 46
subjects had baseline and follow-up SAQ data completed. Ranolazine was not
associated with an improvement in angina compared with placebo at 16
weeks. The results were similar among 33 subjects that completed study
medication. The incidence of ischemia-driven hospitalization or
catheterization was 12% (three of 25) of the ranolazine group versus 20%
(five of 25) in the placebo group (p > 0.05). <br/>Conclusion(s): In
subjects with chronic stable angina and documented myocardial ischemia,
ranolazine did not improve angina symptoms at 16 weeks. <br/>Funding(s):
Gilead. Clinical trial registration: The study was registered at
ClinicalTrials.gov (NCT02265796).<br/>Copyright &#xa9; 2016, The
Author(s).

<68>
Accession Number
616464036
Title
A Randomized Trial to Assess the Contribution of a Novel Thorax Support
Vest (Corset) in Preventing Mechanical Complications of Median Sternotomy.
Source
Cardiology and Therapy. 6 (1) (pp 41-51), 2017. Date of Publication: 01
Jun 2017.
Author
Caimmi P.P.; Sabbatini M.; Kapetanakis E.I.; Cantone S.; Ferraz M.V.;
Cannas M.; Tesler U.F.
Institution
(Caimmi) Department of Cardiac Surgery, University Hospital of Novara
"Maggiore della Carita", Novara, Italy
(Caimmi, Cannas) Department of Science Health, UPO University, Novara,
Italy
(Caimmi, Tesler) "Policlinico di Monza" Hospital Group, Department Cardiac
Surgery, San Gaudenzio Clinic, Novara, Italy
(Sabbatini) Department of Science and Innovation Technology, UPO
University, Alessandria, Italy
(Kapetanakis) Department of Thoracic Surgery, "Sotiria" Chest Diseases
Hospital of Athens, Athens, Greece
(Cantone) "Policlinico di Monza" Health Care Group, Department Cardiac
Anaestehsiology, San Gaudenzio Clinic, Novara, Italy
(Ferraz) Department of Cardiac Surgery, Beneficencia Portouguesa Hospital,
Piracicaba, Brazil
Publisher
Springer Healthcare
Abstract
Objectives: Mechanical complications of median sternotomy may cause
significant morbidity and mortality in cardiac surgical patients. This
study was aimed at assessing the role of Posthorax support vest (Epple,
Inc., Vienna, Austria) in the prevention of sternal complications and the
improvement of anatomical healing in patients at high risk for mechanical
sternal dehiscence after cardiac surgery by mean of median sternotomy.
<br/>Method(s): A prospective, randomized, study was performed and 310
patients with predisposing factors for sternal dehiscence after sternotomy
for cardiac surgery were included. The patients were divided into two
groups: patients who received the Posthorax support vest after surgery,
and patients who did not. Primary variables assessed included the
incidence of mechanical sternal complications, the quality of sternal
healing, the rate of re-operation, the duration of hospitalization, rate
and duration of hospital, re-admission for sternal complications.
Secondary variables assessed were the post-operative pain, the number of
requests for supplemental analgesia and the quality of life measured by
means of the EQ-5D format. <br/>Result(s): Patients using vest
demonstrated a lower incidence of mechanical sternal complications, a
better anatomical sternum healing, lower hospital stay, no re-operations
for sternal dehiscence before discharge and lower re-admissions for
mechanical sternal complication. In addition, patients using a vest
reported a better quality of life with better freedom from limitations in
mobility, self-care, and pain. <br/>Conclusion(s): Our findings
demonstrate that the use of the Posthorax vest reduces post-sternotomy
mechanical complications and improves the healing of the sternotomy, the
clinical course, and the post-operative quality of life.<br/>Copyright
&#xa9; 2016, The Author(s).

<69>
Accession Number
619397142
Title
Treatment of Stable Angina with a New Fixed-Dose Combination of Ivabradine
and Metoprolol: Effectiveness and Tolerability in Routine Clinical
Practice.
Source
Cardiology and Therapy. 6 (2) (pp 239-249), 2017. Date of Publication: 01
Dec 2017.
Author
Divchev D.; Stockl G.
Institution
(Divchev) Department of Cardiology and Angiology, University Hospital
Marburg, Baldingerstrasse, Marburg 35043, Germany
(Stockl) Department of Medical Affairs, Servier Deutschland GmbH, Munich,
Germany
Publisher
Springer Healthcare
Abstract
Introduction: In this prospective, multicenter, observational cohort
study, the effectiveness and tolerability of the first fixed-dose
combination (FDC) formulation of the selective heart rate reducing agent
ivabradine and the beta-blocker metoprolol was evaluated in stable angina
pectoris (AP) patients in a clinical practice setting. <br/>Method(s):
Stable AP outpatients received a FDC of ivabradine and metoprolol (b.i.d.)
for 4 months, in addition to cardiovascular standard therapy. Resting
heart rate (HR), number of angina attacks, short-acting nitrate
consumption, severity of symptoms (assessed by patient judgment and
documented by CCS score) and tolerability were documented. Medication
adherence was assessed by a modified four-item Morisky questionnaire.
Descriptive statistics were performed on all data. <br/>Result(s): A total
of 747 stable AP patients (mean age, 66.4 years, 62% male, 50% and 31%
with previous PCI and myocardial infarction, respectively) were included.
Apart from ivabradine and beta-blockers as free combination, most
frequently used concomitant standard medications at baseline were aspirin
(68%), statins (71%), ACEI/AT1-blockers (76%), diuretics (35%), and
calcium antagonists (15%). Highly prevalent comorbidities were
hypertension (86%), hyperlipidemia (65%), and diabetes (35%). After 4
months, switch to treatment with the FDC was associated with a significant
reduction in mean HR by 10 bpm. Proportion of patients with >= 1 angina
attacks/week decreased from 38 to 7%. Patients in CCS class 1 increased
(25 to 63%), while they decreased in CCS class 3 (19 to 5%). Medication
adherence was also significantly improved (p < 0.001 for all changes from
baseline). Mostly mild adverse events were documented in 5.4% of patients.
<br/>Conclusion(s): In these stable AP patients in a real-life setting,
treatment with a FDC of ivabradine and metoprolol was associated with
reduced HR and angina symptoms, while exercise capacity (CCS score) was
improved. These effects may be mainly mediated by the increased medication
adherence of patients observed with use of the FDC formulation.
<br/>Funding(s): Servier Trial registration number:
ISRCTN51906157.<br/>Copyright &#xa9; 2017, The Author(s).

<70>
Accession Number
601111717
Title
Ivabradine Versus Beta-Blockers in Patients with Conduction Abnormalities
or Left Ventricular Dysfunction Undergoing Cardiac Surgery.
Source
Cardiology and Therapy. 3 (1-2) (pp 13-26), 2013. Date of Publication:
2013.
Author
Iliuta L.; Rac-Albu M.
Institution
(Iliuta, Rac-Albu) "Carol Davila" University of Medicine and Pharmacy,
Bucharest, Romania
Publisher
Springer Healthcare
Abstract
Introduction: In patients with conduction abnormalities or left ventricle
(LV) dysfunction the use of beta-blockers for post cardiac surgery rhythm
control is difficult and controversial, with a paucity of information
about other drugs such ivabradine used postoperatively. The objective of
this study was to compare the efficacy and safety of ivabradine versus
metoprolol used perioperatively in cardiac surgery patients with
conduction abnormalities or LV systolic dysfunction.
Methods: This was an open-label, randomized clinical trial enrolling 527
patients with conduction abnormalities or LV systolic dysfunction
undergoing coronary artery bypass grafting or valvular replacement,
randomized to take ivabradine or metoprolol, or metoprolol plus
ivabradine. The primary endpoints were the composites of 30-day mortality,
in-hospital atrial fibrillation (AF), in-hospital three-degree
atrioventricular block and need for pacing, in-hospital worsening heart
failure (HF; safety endpoints), duration of hospital stay and
immobilization and the above endpoint plus in-hospital bradycardia,
gastrointestinal symptoms, sleep disturbances, cold extremities (efficacy
plus safety endpoint).
Results: Heart rate reduction and prevention of postoperative AF or
tachyarrhythmia with combined therapy was more effective than with
metoprolol or ivabradine alone during the immediate postoperative
management of cardiac surgery patients. In the Ivabradine group, the
frequency of early postoperative pacing and HF worsening was smaller than
in the Metoprolol group and in combined therapy group. The frequency of
primary combined endpoint was lower in the combined Ivabradine +
Metoprolol group compared with the monotherapy groups.
Conclusion: Considering efficacy and safety, the cardiac rhythm reduction
after open heart surgery in patients with conduction abnormalities or LV
dysfunction with ivabradine plus metoprolol emerged as the best treatment
in this trial.<br/>Copyright &#xa9; 2013, The Author(s).

<71>
Accession Number
2010744922
Title
Platelet Transfusion in Cardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
Annals of Thoracic Surgery. 111 (2) (pp 607-614), 2021. Date of
Publication: February 2021.
Author
Yanagawa B.; Ribeiro R.; Lee J.; Mazer C.D.; Cheng D.; Martin J.; Verma
S.; Friedrich J.O.
Institution
(Yanagawa, Ribeiro, Lee, Verma) Division of Cardiac Surgery, St Michael's
Hospital, University of Toronto, Toronto, ON, Canada
(Mazer) Department of Anesthesia, St Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Mazer, Friedrich) Department of Critical Care and Medicine, St Michael's
Hospital, University of Toronto, Toronto, ON, Canada
(Cheng, Martin) Department of Anesthesia and Perioperative Medicine,
MEDICI Center, University of Western Ontario, London, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Blood transfusion is a well-established independent risk
factor for mortality in patients undergoing cardiac surgery but the impact
of platelet transfusion is less clear. We performed a systematic review
and meta-analysis of observational studies comparing outcomes of patients
who received platelet transfusion after cardiac surgery. <br/>Method(s):
We searched MEDLINE and EMBASE databases to January 2019 for studies
comparing perioperative outcomes in patients undergoing cardiac surgery
with and without platelet transfusion. <br/>Result(s): There were nine
observational studies reporting 101,511 patients: 12% with and 88% without
platelet transfusion. In unmatched/unadjusted studies, patients who
received platelet transfusion were older, with greater incidence of renal,
peripheral, and cerebrovascular disease, myocardial infarction, left
ventricular dysfunction, and anemia. They were more likely to have
nonelective, combined surgery; preoperative hemodynamic instability and
endocarditis; and more likely to be receiving clopidogrel preoperatively.
Perioperative complications were significantly increased without adjusting
for these baseline differences. After pooling only matched/adjusted data,
differences were not found between patients who did receive platelets and
patients who did not in operative mortality (risk ratio [RR] 1.26; 95%
confidence interval [CI], 0.69 to 2.32, P =.46, five studies), stroke (RR
0.94; 95% CI, 0.62 to 1.45; P =.79; five studies), myocardial infarction
(RR 1.29; 95% CI, 0.95 to 1.77; P =.11; three studies), reoperation for
bleeding (RR 1.20; 95% CI, 0.46 to 3.18; P =.71; three studies), infection
(RR 1.02; 95% CI, 0.86 to 1.20; P =.85; six studies); and perioperative
dialysis (RR 0.91; 95% CI, 0.63 to 1.32; P =.62; three studies).
<br/>Conclusion(s): After accounting for baseline differences, platelet
transfusion was not linked with perioperative complications in cardiac
surgery patients. Given the small number of observational studies, these
findings should be considered hypothesis generating.<br/>Copyright &#xa9;
2021 The Society of Thoracic Surgeons

<72>
Accession Number
2010734659
Title
Sutureless versus conventional bioprostheses for aortic valve replacement
in severe symptomatic aortic valve stenosis.
Source
Journal of Thoracic and Cardiovascular Surgery. 161 (3) (pp 920-932),
2021. Date of Publication: March 2021.
Author
Fischlein T.; Folliguet T.; Meuris B.; Shrestha M.L.; Roselli E.E.;
McGlothlin A.; Kappert U.; Pfeiffer S.; Corbi P.; Lorusso R.; Fabre O.;
Pinaud F.; Troise G.; Kueri S.; Siepe M.; Bonaros N.; Tan E.; Andreas M.;
Garcia-Puente J.; Voisine P.; Rega F.; Girdauskas E.; Berastegui E.; Hanke
T.; Kats S.; Blasio A.; Muneretto C.; Repossini A.; Tribastone S.; De
Kerchove L.; Mikus E.; Solinas M.; Rambaldini M.; Chocron S.; De Bock D.;
Wang S.; Grabenwoeger M.; Raanani E.; Glauber M.; Maluenda G.; Ramlawi B.;
Bouchard D.; Johnston D.; Diegeler A.; Bitran D.; Teoh K.; Vincentelli A.;
Castillo J.C.; Albat B.; Oberwalder P.; Ramchandani M.; Heimansohn D.
Institution
(Fischlein, Pfeiffer) Klinikum Nurnberg, Cardiovascular Center, Paracelsus
Medical University, Nuremberg, Germany
(Folliguet) Department of Cardiac Surgery, Hopital Henri Mondor,
Universite Paris 12, Creteil, Paris, France
(Meuris) UZ Gasthuisberg Leuven, University Hospital, Leuven, Belgium
(Shrestha) Hannover Medical School, Hannover, Germany
(Roselli) Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(McGlothlin) Berry Consultants, LCC, Austin, Tex, United States
(Kappert) Herzzentrum Dresden GmbH Universitatsklinik, Dresden, Germany
(Pfeiffer) Schon Klinik Vogtareuth, Vogtareuth, Germany
(Corbi) Poitiers University Hospital, Poitiers, France
(Lorusso) Cardio-Thoracic Surgery Department, Heart and Vascular Center,
Maastricht University Medical Center (MUMC+), Cardiovascular Research
Institute Maastricht (CARIM), Maastricht, Netherlands
Publisher
Mosby Inc.
Abstract
Objective: Sutureless aortic valves are a novel option for aortic valve
replacement. We sought to demonstrate noninferiority of sutureless versus
standard bioprostheses in severe symptomatic aortic stenosis.
<br/>Method(s): The Perceval Sutureless Implant Versus Standard-Aortic
Valve Replacement is a prospective, randomized, adaptive, open-label
trial. Patients were randomized (March 2016 to September 2018) to aortic
valve replacement with a sutureless or stented valve using conventional or
minimally invasive approach. Primary outcome was freedom from major
adverse cerebral and cardiovascular events (composite of all-cause death,
myocardial infarction, stroke, or valve reintervention) at 1 year.
<br/>Result(s): At 47 centers (12 countries), 910 patients were randomized
to sutureless (n = 453) or conventional stented (n = 457) valves; mean
ages were 75.4 +/- 5.6 and 75.0 +/- 6.1 years, and 50.1% and 44.9% were
female, respectively. Mean +/- standard deviation Society of Thoracic
Surgeons scores were 2.4 +/- 1.7 and 2.1 +/- 1.3, and a ministernotomy
approach was used in 50.4% and 47.3%, respectively. Concomitant procedures
were performed with similar rates in both groups. Noninferiority was
demonstrated for major adverse cerebral and cardiovascular events at 1
year, whereas aortic valve hemodynamics improved equally in both groups.
Use of sutureless valves significantly reduced surgical times (mean
extracorporeal circulation times: 71.0 +/- 34.1 minutes vs 87.8 +/- 33.9
minutes; mean crossclamp times: 48.5 +/- 24.7 vs 65.2 +/- 23.6; both P
<.0001), but resulted in a higher rate of pacemaker implantation (11.1% vs
3.6% at 1 year). Incidences of perivalvular and central leak were similar.
<br/>Conclusion(s): Sutureless valves were noninferior to stented valves
with respect to major adverse cerebral and cardiovascular events at 1 year
in patients undergoing aortic valve replacement (alone or with coronary
artery bypass grafting). This suggests that sutureless valves should be
considered as part of a comprehensive valve program.<br/>Copyright &#xa9;
2020 The American Association for Thoracic Surgery

<73>
Accession Number
2007620868
Title
The effect of antiplatelet therapy on survival and cardiac allograft
vasculopathy following heart transplantation: A systematic review and
meta-analysis.
Source
Clinical Transplantation. 35 (1) (no pagination), 2021. Article Number:
e14125. Date of Publication: January 2021.
Author
Aleksova N.; Brahmbhatt D.H.; Kiamanesh O.; Petropoulos J.-A.; Chang Y.;
Guyatt G.; Chih S.; Ross H.J.
Institution
(Aleksova, Brahmbhatt, Kiamanesh, Ross) Ted Rogers Centre for Heart
Research at the Peter Munk Cardiac Centre, Toronto General Hospital,
Toronto, ON, Canada
(Brahmbhatt) National Heart & Lung Institute, Imperial College London,
London, United Kingdom
(Kiamanesh) Division of Cardiology, University of Calgary, Calgary, AB,
Canada
(Petropoulos) Health Sciences Library, McMaster University, Hamilton, ON,
Canada
(Chang, Guyatt) Department of Health Research Methods, Evidence, and
Impact, McMaster University, Hamilton, ON, Canada
(Chih) University of Ottawa Heart Institute, Ottawa, ON, Canada
Publisher
Blackwell Publishing Ltd
Abstract
Cardiac allograft vasculopathy (CAV) is mediated by endothelial
inflammation, platelet activation and thrombosis. Antiplatelet therapy may
prevent the development of CAV. This systematic review and meta-analysis
summarizes and appraises the evidence on the effect of antiplatelet
therapy after heart transplantation (HT). CENTRAL(Ovid), MEDLINE(Ovid),
Embase(Ovid) were searched from inception until April 30, 2020. Outcomes
included CAV, all-cause mortality, and CAV-related mortality. Data were
pooled using random-effects models. Seven observational studies including
2023 patients, mean age 52 years, 22% female, 47% with ischemic
cardiomyopathy followed over a mean 7.1 years proved eligible. All studies
compared acetylsalicylic acid (ASA) to no treatment and were at serious
risk of bias. Data from 1911 patients in 6 studies were pooled in the
meta-analyses. The evidence is very uncertain about the effect of ASA on
all-cause or CAV-related mortality. ASA may reduce the development of CAV
(RR 0.75, 95% CI: 0.44-1.29) based on very low certainty evidence. Two
studies that conducted propensity-weighted analyses showed further
reduction in CAV with ASA (HR 0.31, 95% CI: 0.13-0.74). In conclusion,
there is limited evidence that ASA may reduce the development of CAV.
Definitive resolution of the impact of antiplatelet therapy on CAV and
mortality will require randomized clinical trials.<br/>Copyright &#xa9;
2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

<74>
Accession Number
2006053570
Title
WeChat-based education and rehabilitation program in unprotected left main
coronary artery disease patients after coronary artery bypass grafting: An
effective approach in reducing anxiety, depression, loss to follow-up, and
improving quality of life.
Source
Brazilian Journal of Medical and Biological Research. 54 (4) (pp 1-10),
2021. Article Number: e10370. Date of Publication: 2021.
Author
Ma C.; Wang B.; Zhao X.; Fu F.; Zheng L.; Li G.; Guo Q.
Institution
(Ma, Wang, Zhao, Fu, Zheng, Li) Department of Cardiovascular Surgery,
Second Affiliated Hospital, Harbin Medical University, Harbin,
Heilongjiang, China
(Guo) Ministry of Nursing, 4th Affiliated Hospital, Harbin Medical
University, Harbin, Heilongjiang, China
Publisher
Associacao Brasileira de Divulgacao Cientifica
Abstract
This study aimed to investigate the effect of WeChat-based education and
rehabilitation program (WERP) on anxiety, depression, health-related
quality of life (HRQoL), major adverse cardiac/cerebrovascular events
(MACCE)-free survival, and loss to follow-up rate in unprotected left main
coronary artery disease (ULMCAD) patients after coronary artery bypass
grafting (CABG). In this randomized controlled study, 140 ULMCAD patients
who underwent CABG were randomly assigned to WERP group (n=70) or control
care (CC) group (n=70). During the 12-month intervention period, anxiety
and depression (using hospital anxiety and depression scale (HADS)) and
HRQoL (using 12-Item Short-Form Health Survey (SF-12)) were assessed
longitudinally. During the total 36-month follow-up period (12-month
intervention and 24-month non-intervention periods), MACCE and loss to
follow-up were recorded. During the intervention period, HADS-anxiety
score at month 9 (M9) (P=0.047) and month 12 (M12) (P=0.034), anxiety rate
at M12 (P=0.028), and HADS-D score at M12 (P=0.048) were all reduced in
WERP group compared with CC group. As for HRQoL, SF-12 physical component
summary score at M9 (P=0.020) and M12 (P=0.010) and SF-12 mental component
summary score at M9 (P=0.040) and M12 (P=0.028) were all increased in WERP
group compared with CC group. During the total follow-up period, WERP
group displayed a trend of longer MACCE-free survival than that in CC
group but without statistical significance (P=0.195). Additionally, loss
to follow-up rate was attenuated in WERP group compared with CC group
(P=0.033). WERP serves as an effective approach in optimizing mental
health care and promoting life quality in ULMCAD patients after
CABG.<br/>Copyright &#xa9; 2021, Associacao Brasileira de Divulgacao
Cientifica. All rights reserved.

<75>
Accession Number
2008499688
Title
Comparisons of Nonhyperemic Pressure Ratios: Predicting Functional Results
of Coronary Revascularization Using Longitudinal Vessel Interrogation.
Source
JACC: Cardiovascular Interventions. 13 (22) (pp 2688-2698), 2020. Date of
Publication: 23 Nov 2020.
Author
Omori H.; Kawase Y.; Mizukami T.; Tanigaki T.; Hirata T.; Kikuchi J.; Ota
H.; Sobue Y.; Miyake T.; Kawamura I.; Okubo M.; Kamiya H.; Hirakawa A.;
Kawasaki M.; Nakagawa M.; Tsuchiya K.; Suzuki Y.; Ito T.; Terashima M.;
Kondo T.; Suzuki T.; Escaned J.; Matsuo H.
Institution
(Omori, Kawase, Mizukami, Tanigaki, Hirata, Kikuchi, Ota, Sobue, Miyake,
Kawamura, Okubo, Kamiya, Kawasaki, Nakagawa, Tsuchiya, Kondo, Matsuo)
Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
(Mizukami) Clinical Research Institute for Clinical Pharmacology and
Therapeutics, Showa University, Tokyo, Japan
(Hirakawa) Department of Biostatistics and Bioinformatics, Graduate School
of Medicine, University of Tokyo, Tokyo, Japan
(Suzuki, Ito) Department of Cardiovascular Medicine, Nagoya Heart Center,
Nagoya, Japan
(Terashima, Suzuki) Department of Cardiovascular Medicine, Toyohashi Heart
Center, Toyohashi, Japan
(Escaned) Hospital Clinico San Carlos IDISSC and Universidad Complutense
de Madrid, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to investigate the accuracy of
pre-percutaneous coronary intervention (PCI) predicted nonhyperemic
pressure ratios (NHPRs) with actual post-PCI NHPRs and to assess the
efficacy of PCI strategy using pre-PCI NHPR pullback. <br/>Background(s):
Predicting the functional results of PCI is feasible using pre-PCI
longitudinal vessel interrogation with the instantaneous wave-free ratio
(iFR), a pressure-based, adenosine-free NHPR. However, the reliability of
novel NHPRs (resting full-cycle ratio [RFR] and diastolic pressure ratio
[dPR]) for this purpose remains uncertain. <br/>Method(s): In this
prospective, multicenter, randomized controlled trial, vessels were
randomly assigned to receive pre-PCI iFR, RFR, or dPR pullback (50 vessels
each). The pre-PCI predicted NHPRs were compared with actual NHPRs after
contemporary PCI using intravascular imaging. The number and the total
length of treated lesions were compared between NHPR pullback-guided and
angiography-guided strategies. <br/>Result(s): The predicted NHPRs were
strongly correlated with actual NHPRs: iFR, r = 0.83 (95% confidence
interval: 0.72 to 0.90; p < 0.001); RFR, r = 0.84 (95% confidence
interval: 0.73 to 0.91; p < 0.001), and dPR, r = 0.84 (95% confidence
interval: 0.73 to 0.91; p < 0.001). The number and the total length of
treated lesions were lower with the NHPR pullback strategy than with the
angiography-guided strategy, leading to physiological improvement.
<br/>Conclusion(s): Predicting functional PCI results on the basis of
pre-procedural RFR and dPR pullbacks yields similar results to iFR.
Compared with an angiography-guided strategy, a pullback-guided PCI
strategy with any of the 3 NHPRs reduced the number and the total length
of treated lesions. (Study to Examine Correlation Between Predictive Value
and Post PCI Value of iFR, RFR and dPR; UMIN000033534)<br/>Copyright
&#xa9; 2020

<76>
Accession Number
2004546806
Title
Right ventricular assessment in patients undergoing transcatheter or
surgical aortic valve replacement.
Source
Catheterization and Cardiovascular Interventions. 96 (7) (pp E711-E722),
2020. Date of Publication: December 2020.
Author
Schueler R.; Ozturk C.; Laser J.V.; Wirth F.; Werner N.; Welz A.; Nickenig
G.; Sinning J.-M.; Hammerstingl C.
Institution
(Ozturk, Laser, Wirth, Werner, Nickenig, Sinning) Heart Centre Bonn,
Department of Internal Medicine, Cardiology, Pulmonology and Angiology,
University of Bonn, Bonn, Germany
(Welz) Heart Centre Bonn, Department of Cardiovascular Surgery, University
Hospital Bonn, Bonn, Germany
(Schueler) Contilia Heart and Vessel Centrum, Department of Cardiology and
Angiology, Elisabeth Hospital, Essen, Germany
(Hammerstingl) Heart and Vessel Medicine Mediapark, Department of
Cardiology, Cologne, Germany
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is an
alternative treatment option to surgical aortic valve replacement (SAVR)
in selected high-risk patients. In this study, we aimed to evaluate the
prognostic value of right ventricular (RV) functional imaging to predict
clinical response to TAVR and SAVR. <br/>Method(s): One hundred and ten
patients with symptomatic severe aortic valve stenosis (AVS) undergoing
successful TAVR and 32 controls undergoing SAVR were prospectively
enrolled. Six months follow up (FU) included two-dimensional (2D)
transthoracic echocardiography (TTE) with RV deformation imaging.
<br/>Result(s): Baseline TTE showed no significant differences between
groups (TAVR and SAVR) in conventional left ventricular (LV) and RV
functional parameters (LV ejection fraction [LV-EF]: p =.21; tricuspidal
annular plane systolic excursion [TAPSE]: 1.8 +/- 0.5 cm, 1.9 +/- 0.4 cm,
p =.21), and RV strain (right ventricular-global longitudinal strain
[RV-GLS] -11.6 +/- 5.2%, -11.5 +/- 6.5%, p =.70). At FU LV function was
unchanged in both groups (p >.05); RV function was significantly improved
after TAVR (RV-GLS: -11.6 +/- 5.2%, -13.4 +/- 6.1%, p =.005; TAPSE: 1.8
+/- 0.5 cm, 1.9 +/- 0.3 cm, p =.05), and worsened after SAVR (RV-GLS:
-11.5 +/- 6.5%, -8.9 +/- 5.2%, p =.04; TAPSE: 1.9 +/- 0.4 cm, 1.5 +/- 0.3
cm, p <.001). Functional New York Heart Association (NYHA) class remained
unchanged in patients after SAVR (p =.21), and improved after TAVR (p
<.001). Baseline RV function was linked with clinical response to TAVR
(TAPSE, p <.0001; RV-GLS, p =.04), and the development of RV-GLS was
associated with functional worsening after SAVR (p =.05).
<br/>Conclusion(s): Baseline RV function and changes of right heart
mechanics are closely associated with functional improvements after AVR.
SAVR, but not TAVR, seems to have detrimental effects on
RV-function.<br/>Copyright &#xa9; 2020 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals, Inc.

<77>
Accession Number
2004097924
Title
The importance of the Heart Team evaluation before transcatheter aortic
valve replacement: Results from the BRAVO-3 trial.
Source
Catheterization and Cardiovascular Interventions. 96 (7) (pp E688-E694),
2020. Date of Publication: December 2020.
Author
Camaj A.; Claessen B.E.; Mehran R.; Yudi M.B.; Power D.; Baber U.;
Hengstenberg C.; Lefevre T.; Van Belle E.; Giustino G.; Guedeney P.;
Sorrentino S.; Kupatt C.; Webb J.G.; Hildick-Smith D.; Hink H.U.;
Deliargyris E.N.; Anthopoulos P.; Sharma S.K.; Kini A.; Sartori S.;
Chandrasekhar J.; Dangas G.D.
Institution
(Camaj, Claessen, Mehran, Power, Baber, Giustino, Sharma, Kini, Sartori,
Chandrasekhar, Dangas) The Zena and Michael A. Wiener Cardiovascular
Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Yudi) Austin Health, Heidelberg, VIC, Australia
(Hengstenberg) DZHK (German Centre for Cardiovascular Research), partner
site Munich Heart Alliance, Munich, Germany, and Deutsches Herzzentrum
Munchen, Technische Universitat Munchen, Munich, Germany
(Lefevre) Institut Cardio Vasculaire Paris Sud, Hopital Prive Jacques
Cartier, Massy, France
(Van Belle) Department of Cardiology and INSERM UMR 1011, University
Hospital, and CHRU Lille, Lille, France
(Guedeney) Sorbonne Universite, ACTION Study Group, INSERM UMRS_1166
Institut de cardiologie (AP-HP), Paris, France
(Sorrentino) Division of Cardiology, Department of Medical and Surgical
Sciences, Magna Graecia University, Catanzaro, Italy
(Kupatt) LMU Munich, Munich, Germany
(Webb) St. Paul's Hospital, Vancouver, BC, Canada
(Hildick-Smith) Sussex Cardiac Centre-Brighton & Sussex University
Hospitals NHS Trust, Brighton, East Sussex, United Kingdom
(Hink) Universitatsmedizin Mainz, Mainz, Germany
(Deliargyris) Science and Strategy Consulting Group, Basking Ridge, NJ,
United States
(Anthopoulos) Arena Pharmaceuticals, Inc., Zurich, Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Background/Objectives: Clinicians use validated scores to risk-stratify
patients undergoing transcatheter aortic valve replacement (TAVR).
However, evaluation by the Heart Team often deems patients to be at higher
risk than their formal scores suggest. We sought to assess clinical
outcomes of TAVR patients defined as high-risk by the Heart Team's
assessment versus the patient's logistic EuroSCORE (LES). <br/>Method(s):
The BRAVO-3 trial randomized patients at high risk (LES >= 18, or deemed
inoperable by the Heart Team) to TAVR with periprocedural anticoagulation
with unfractionated heparin versus bivalirudin. Endpoints included net
adverse cardiac events (NACE: the composite of all-cause mortality, MI,
stroke, or bleeding), major adverse cardiovascular events (MACE: death,
MI, or stroke), the individual components of MACE, major vascular
complications, BARC >= 3b bleeding and VARC life-threatening bleeding at
30 days. We compared patients deemed high-risk based on LES >= 18 versus
high-risk by the Heart Team despite lower LES. <br/>Result(s): A total of
467/800 (58.4%) patients were deemed high-risk by the Heart Team despite
LES < 18. After multivariable analysis, there were no differences in the
odds of endpoints between groups (NACE, OR<inf>LES>=18</inf>: 1.32, 95% CI
0.86-2.02, p =.21; MACE, OR<inf>LES>=18</inf>: 1.27, 95% CI 0.72-2.25, p
=.41; major vascular complications, OR<inf>LES>=18</inf>: 0.97, 95% CI
0.65-1.44, p =.88; BARC >=3b, OR<inf>LES>=18</inf>: 1.38, 95% CI
0.82-2.33, p =.23; and VARC life-threatening bleeding,
OR<inf>LES>=18</inf>: 0.99, 95% CI 0.69-1.41, p =.95). <br/>Conclusion(s):
Patients undergoing TAVR and labeled high-risk by LES >= 18 or Heart Team
assessment despite LES < 18 have comparable short-term outcomes.
Assignment of high-risk status to over 50% of patients is attributable to
Heart Team's clinical assessment.<br/>Copyright &#xa9; 2020 Wiley
Periodicals, Inc.

<78>
Accession Number
2011046903
Title
Structural valve degeneration: Redo or valve-in-valve? Enough
meta-analysis and retrospective studies, we need a randomised trial.
Source
Archives of Cardiovascular Diseases. 114 (2) (pp 85-87), 2021. Date of
Publication: February 2021.
Author
Lebreton G.
Institution
(Lebreton) Department of cardio-thoracic surgery, Pitie-Salpetriere
hospital, Institute of CArdioMetabolism (ICAN), UMR 1166, Sorbonne
University, Paris, France
Publisher
Elsevier Masson s.r.l.

<79>
Accession Number
2007164367
Title
Three-dimensional geometry of coronary arteries after arterial switch
operation for transposition of the great arteries and late coronary
events.
Source
Journal of Thoracic and Cardiovascular Surgery. 161 (4) (pp 1396-1404),
2021. Date of Publication: April 2021.
Author
Batteux C.; Abakka S.; Gaudin R.; Vouhe P.; Raisky O.; Bonnet D.
Institution
(Batteux, Abakka, Gaudin, Vouhe, Raisky, Bonnet) Department of Congenital
and Pediatric Cardiology, Centre de Reference Malformations Cardiaques
Congenitales Complexes, Hopital Necker-Enfants Malades, Assistance
Publique-Hopitaux de Paris, Paris, France
(Vouhe, Raisky, Bonnet) Universite de Paris, Paris, France
Publisher
Mosby Inc.
Abstract
Objective: Using 3-dimensional (3D) modeling to predict late coronary
events after the arterial switch operation (ASO) for transposition of the
great arteries (TGA). <br/>Method(s): We reviewed 100 coronary computed
tomography scans performed after ASO randomly selected from
free-from-coronary-event patients and 21 coronary computed tomography
scans from patients who had a coronary event later than 3 years after ASO.
Using 3D modeling software, we defined and measured 6 geometric criteria
for each coronary artery: Clockwise position of coronary ostium, First
centimeter angle defined as the angle between of the coronary artery
ostium and the first centimeter of the vessel, Minimal 3D angle between
the coronary first centimeter and the aortic wall, ostium height defined
as the distance between the ostium and the aortic valve, distance between
the coronary ostium and the pulmonary artery, and distance between the
coronary first centimeter and the pulmonary artery. <br/>Result(s): None
of the right ostium geometric parameters were associated with coronary
events. Four out of 6 criteria of left coronary artery geometry were
associated to coronary events: Clockwise position of the left ostium
>67degree (P <.001), First centimeter angle >62degree (P <.01), minimal 3D
angle <39degree (P =.003), distance between the coronary ostium and the
pulmonary artery <1 mm/mm (P =.03). The association of first centimeter
angle >62degree and minimal angle in 3D <39degree had a 88% sensitivity
and a 81% specificity to predict coronary events (receiver operator
characteristics curve, 0.847; 95% confidence interval, 0.745-0.949; P
<.001). <br/>Conclusion(s): The acquired geometric characteristics of the
transferred left coronary artery are associated with coronary events.
Imaging coronary arteries after ASO might be useful to select patients at
higher risk of coronary events and to tailor surveillance.<br/>Copyright
&#xa9; 2020 The American Association for Thoracic Surgery

<80>
Accession Number
2010920415
Title
Mortality in patients with cardiogenic shock supported with VA ECMO: A
systematic review and meta-analysis evaluating the impact of etiology on
29,289 patients.
Source
Journal of Heart and Lung Transplantation. 40 (4) (pp 260-268), 2021. Date
of Publication: April 2021.
Author
Alba A.C.; Foroutan F.; Buchan T.A.; Alvarez J.; Kinsella A.; Clark K.;
Zhu A.; Lau K.; McGuinty C.; Aleksova N.; Francis T.; Stanimirovic A.;
Vishram-Nielsen J.; Malik A.; Ross H.J.; Fan E.; Rac V.E.; Rao V.; Billia
F.
Institution
(Alba, Foroutan, Buchan, Alvarez, Kinsella, Clark, Zhu, Lau, McGuinty,
Aleksova, Vishram-Nielsen, Malik, Ross, Rac, Rao, Billia) Ted Rogers
Center of Excellence, Peter Munk Cardiac Centre, Toronto, ON, Canada
(Francis, Stanimirovic) Toronto Health Economics and Technology Assessment
(THETA) Collaborative, Institute of Health Policy, Management and
Evaluation, Dalla Lana School of Public Health
(Fan) Interdepartmental Division of Critical Care Medicine, University of
Toronto, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA ECMO) is
associated with variable outcomes. In this meta-analysis, we evaluated the
mortality after VA ECMO across multiple etiologies of cardiogenic shock
(CS). <br/>METHOD(S): In June 2019, we performed a systematic search
selecting observational studies with >=10 adult patients reporting on
short-term mortality (30-day or mortality at discharge) after initiation
of VA ECMO by CS etiology published after 2009. We performed meta-analyses
using random effect models and used metaregression to evaluate mortality
across CS etiology. <br/>RESULT(S): We included 306 studies (29,289
patients): 25 studies on after heart transplantation (HTx) (771 patients),
13 on myocarditis (906 patients), 33 on decompensated heart failure (HF)
(3,567 patients), 64 on after cardiotomy shock (8,231 patients), 10 on
pulmonary embolism (PE) (221 patients), 80 on acute myocardial infarction
(AMI) (7,774 patients), and 113 on after cardiac arrest [CA] (7,814
patients). With moderate certainty on effect estimates, we observed
significantly different mortality estimates for various etiologies (p <
0.001), which is not explained by differences in age and sex across
studies: 35% (95% CI: 29-42) for after HTx, 40% (95% CI: 33-46) for
myocarditis, 53% (95% CI: 46-59) for HF, 52% (95% CI: 38-66) for PE, 59%
(95% CI: 56-63) for cardiotomy, 60% (95% CI: 57-64) for AMI, 64% (95% CI:
59-69) for post-in-hospital CA, and 76% (95% CI: 69-82) for
post-out-of-hospital CA. Univariable metaregression showed that variation
in mortality estimates within etiology group was partially explained by
population age, proportion of females, left ventricle venting, and CA.
<br/>CONCLUSION(S): Using an overall estimate of mortality for patients
with CS requiring VA ECMO is inadequate given the differential outcomes by
etiology. To further refine patient selection and management to improve
outcomes, additional studies evaluating patient characteristics impacting
outcomes by specific CS etiology are needed.<br/>Copyright &#xa9; 2021
International Society for Heart and Lung Transplantation

<81>
Accession Number
2010676561
Title
Methylene blue for vasoplegic syndrome in cardiopulmonary bypass surgery:
A systematic review and meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2021. Date of
Publication: 2021.
Author
Perdhana F.; Kloping N.A.; Witarto A.P.; Nugraha D.; Yogiswara N.; Luke
K.; Kloping Y.P.; Rehatta N.M.
Institution
(Perdhana, Rehatta) Department of Anaesthesiology and Reanimation, Faculty
of Medicine, Universitas Airlangga - Dr Soetomo General Hospital,
Surabaya, Indonesia
(Kloping, Witarto, Nugraha, Yogiswara, Luke, Kloping) Faculty of Medicine,
Universitas Airlangga, Surabaya, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Background: To evaluate the benefit of methylene blue as an adjunct
treatment by assessing hemodynamic, morbidity rate, intensive care unit
length of stay, and mortality rate outcomes in adult patients with
vasoplegic syndrome. <br/>Method(s): A systematic search through
electronic databases including Pubmed, Embase, Scopus, and Medline for
studies assessing the use of methylene blue in patients with vasoplegic
syndrome compared to control treatments. The Newcastle-Ottawa Scale tool
was used for observational studies, and Jadad Scale was used for
controlled trials to assess the risk of bias. <br/>Result(s): This
systematic review included six studies for qualitative synthesis and five
studies for quantitative synthesis. Pooled analysis revealed that mean
arterial pressure, systemic vascular resistance, heart rate, and hospital
stay were not statistically significant in methylene blue administration
compared to control. However, administration of methylene blue in
vasoplegic syndrome patients significantly reduces renal failure (OR =
0.25; 95% CI = 0.08-0.75), development of multiple organ failure (OR =
0.09; 95% CI = 0.02-0.51), and mortality rate (OR = 0.12; 95% CI =
0.03-0.46). <br/>Conclusion(s): Adjunct administration of methylene blue
for vasoplegic syndrome patients significantly reduces renal failure,
multiple organ failure, and mortality.<br/>Copyright &#xa9; The Author(s)
2021.

<82>
Accession Number
2003725188
Title
Temporal Trends in Mortality after Transcatheter Aortic Valve Replacement:
A Systematic Review and Meta-Regression Analysis.
Source
Structural Heart. 4 (1) (pp 16-23), 2020. Date of Publication: 02 Jan
2020.
Author
Mattke S.; Schneider S.; Orr P.; Lakdawalla D.; Goldman D.
Institution
(Mattke, Orr) Center for Improving Chronic Illness Care, University of
Southern California, Los Angeles, CA, United States
(Schneider) Center for Self-Report Science, University of Southern
California, Los Angeles, CA, United States
(Lakdawalla, Goldman) Leonard D. Schaeffer Center for Health Policy &
Economics, University of Southern California, Los Angeles, CA, United
States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: We estimated trends for mortality after transcatheter aortic
valve replacement (TAVR) using meta-analytic techniques. Mortality rates
after TAVR have reportedly declined as the procedure became more
routinized and device technology improved. Confirming this finding with a
systematic assessment of the evidence could have substantial implications
for the choice between TAVR and surgical valve replacements.
<br/>Method(s): We conducted a systematic literature review up to June 20,
2018 and extracted data on 30-day and 1-year mortality rates, surgical
risk, device type, study design, and the proportion of procedures that
used a transapical approach. We used meta-regression to test whether
risk-adjusted 30-day and 1-year mortality rates declined over time.
<br/>Result(s): We identified 145 studies and 179 subsamples, once results
for separately reported subgroups were broken out. Of these, 160
subsamples (89%) representing 137 studies and 91,652 patients contained
information on 30-day mortality, and 93 subsamples (52%) representing 84
studies and 40,765 patients information on 1-year mortality. The adjusted
30-day mortality rate after TAVR fell from 10.48% (95% CI 7.97-11.65%) in
2007 to 2.27% (95% CI 1.14-4.49%) in 2016, corresponding to a relative
decrease of 78% over 10 years. The adjusted mortality rate within 1 year
after TAVR was 30.24% (95% CI 24.53-36.65%) in 2007 and fell to 11.35%
(95% CI 8.32-15.31%) in 2014, corresponding to a relative decrease of 63%
over 8 years. <br/>Conclusion(s): The results suggest that near-term
survival after TAVR has improved substantially within the short period
after the procedure was introduced and support the increasing utilization
of TAVR.<br/>Copyright &#xa9; 2019, &#xa9; 2019 Cardiovascular Research
Foundation.

<83>
Accession Number
633147519
Title
The effect of early oral stimulation with breast milk on the feeding
behavior of infants after congenital cardiac surgery.
Source
Journal of cardiothoracic surgery. 15 (1) (pp 309), 2020. Date of
Publication: 09 Oct 2020.
Author
Yu X.-R.; Huang S.-T.; Xu N.; Wang L.-W.; Wang Z.-C.; Cao H.; Chen Q.
Institution
(Yu, Huang, Xu, Wang, Wang, Cao, Chen) Department of Cardiac Surgery,
Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian
Medical University, Fuzhou, China
(Yu, Huang, Xu, Wang, Wang, Cao, Chen) Fujian Key Laboratory of Women and
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
(Wang, Chen) Department of Cardiovascular Surgery, Union Hospital, Fujian
Medical University, Fuzhou, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To investigate the effect of early oral stimulation with breast
milk on the feeding behavior of infants after congenital cardiac surgery.
<br/>METHOD(S): Infants with congenital heart disease were randomly
divided into the breast milk oral stimulation group (n =23), physiological
saline oral stimulation group (n =23) and control group (n =23). Debra
Beckman's oral exercise program was used with breast milk and
physiological saline in the breast milk oral stimulation group and the
physiological saline oral stimulation group, respectively. The time oral
feeding and total oral nutrition were started, the length of intensive
care unit (ICU) stay and hospital stay, weight and the complications at
discharge were recorded for each group and statistically analyzed.
<br/>RESULT(S): The time oral feeding and total oral nutrition were
started and the length of ICU stay and hospital stay were significantly
less in the breast milk oral stimulation group and physiological saline
oral stimulation group than in the control group (P <0.05). There were no
significant differences in other indicators between the breast milk oral
stimulation group and the physiological saline oral stimulation group,
except for the time total oral nutrition began (P <0.05). However, there
were no significant differences in weight or complications at discharge
among the three groups (P>0.05). <br/>CONCLUSION(S): Early oral
stimulation exercises with breast milk can help infant patients quickly
recover total oral nutrition and reduce the length of ICU and hospital
stay after cardiac surgery.

<84>
Accession Number
633136255
Title
Mitral valve re-repair vs replacement following failed initial repair: a
systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 15 (1) (pp 304), 2020. Date of
Publication: 07 Oct 2020.
Author
Veerappan M.; Cheekoty P.; Sazzad F.; Kofidis T.
Institution
(Veerappan, Cheekoty, Sazzad, Kofidis) Department of Cardiac, Thoracic and
Vascular Surgery, National University Heart Centre, National University
Health System-NUHS, 1E Kent Ridge Road ,9th Floor ,Tower Block 119228,
Singapore
(Veerappan) School of Medicine, University of Dundee, Dundee, United
Kingdom
(Cheekoty) School of Medicine, Newcastle University, Newcastle, United
Kingdom
(Sazzad, Kofidis) Department of Surgery, Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
(Sazzad, Kofidis) Cardiovascular Research Institute, National University
of Singapore, Singapore
Publisher
NLM (Medline)
Abstract
BACKGROUND: The optimal treatment strategy following a failed mitral valve
repair remains unclear. This study aims to compare and analyse available
studies which report the clinical outcomes post mitral valve re-repair
(MVr) or replacement (MVR) after a prior mitral valve repair.
<br/>METHOD(S): Based on PRISMA guidelines, a literature search was
performed utilising PubMed, Cochrane and Scopus databases to identify
retrospective cohort studies that reported outcomes of MVr and MVR after a
prior mitral valve repair. Data regarding operative mortality, clinical
outcomes and complications were extracted, synthesized and meta-analysed
where appropriate. <br/>RESULT(S): Eight studies with a total cohort of
1632 patients were used. After analysis, no significant differences in the
short term and long-term operative mortality, incidence of stroke,
congestive heart failure, Grade 1 and Grade 2 mitral regurgitation,
requirement of 3rd mitral valve operation and reoperation due bleeding
were found between the two groups. However, a slightly higher incidence of
postoperative atrial fibrillation (OR: 0.11, CI: 0.02 to 0.17, I2 =0%, p
=0.02) was observed in the MVR group, as compared to the MVr group.
<br/>CONCLUSION(S): MVr appears to be a viable alternative to MVR for
mitral valve reoperation, given that they are associated with similar
post-operative outcomes.

<85>
Accession Number
634463572
Title
Prognostic significance of cardiac amyloidosis in patients with aortic
stenosis: A systematic review and meta-analysis.
Source
Giornale Italiano di Cardiologia. Conference: 81 Congresso Nazionale della
Societa Italiana di Cardiologia. 21 (12 SUPPL 2) (pp e129), 2020. Date of
Publication: December 2020.
Author
Ceriello L.; Ricci F.; Khanji M.Y.; Dangas G.; Bucciarelli-Ducci C.; Di
Mauro M.; Fedorowski A.; Zimarino M.; Gallina S.
Institution
(Ceriello, Ricci, Gallina) Department of Neuroscience, Imaging and
Clinical Sciences, G. d'Annunzio University, Chieti, Italy
(Ricci, Fedorowski) Department of Clinical Sciences, Lund University,
Malmo, Sweden
(Khanji) Newham University Hospital, Barts Health Nhs Trust, London,
United Kingdom
(Khanji) Centre for Advanced Cardiovascular Imaging and Research, William
Harvey Research Institute, Queen Mary University of London, United Kingdom
(Dangas) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Bucciarelli-Ducci) Bristol Heart Institute, Nihr Bristol Biomedical
Research Centre, University Hospitals Bristol and Weston Nhs Trust,
Bristol, United Kingdom
(Bucciarelli-Ducci) University of Bristol, Bristol, United Kingdom
(Di Mauro) Cardio-Thoracic Surgery Unit, Maastricht University Medical
Centre (Mumc), Cardiovascular Research Institute Maastricht (Carim),
Maastricht, Netherlands
(Fedorowski) Department of Cardiology, Skane University Hospital, Malmo,
Sweden
(Zimarino) Interventional Cath Lab, Asl 2 Abruzzo, Chieti, Italy
(Ricci) Casa di Cura Villa Serena, Citta S. Angelo, Pescara, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Objectives. We performed a systematic review and meta-analysis to clarify
whether concurrent cardiac amyloidosis (CA) portends excess mortality in
elderly patients with aortic stenosis (AS). Background. CA has been
increasingly recognized in elderly patients with AS, but with uncertain
prognostic significance. Methods. Our systematic review of the literature
published between January 2000 and April 2020, sought observational
studies reporting summary-level outcome data of all-cause mortality in AS
patients with or without concurrent CA. Pooled estimate of Mantel-Haenszel
odds ratio (OR) and 95% confidence intervals (CIs) for all-cause death was
assessed as the primary endpoint. We performed subgroup analysis
stratified by severity of left ventricular hypertrophy (LVH) and
study-level meta-regression analysis to explore the effect of covariates
on summary effect size and to address statistical heterogeneity. Results.
We identified 4 studies including 609 AS patients (9% AS-CA; 69% men; age,
84+/-5 years). The average follow-up was 20+/-5 months. Compared with lone
AS, AS-CA was associated with 2-fold increase in allcause mortality
(pooled OR: 2.30; 95% CI: 1.02-5.18; I2 = 62%). When analysed according to
LVH severity, pooled ORs (95% CI) for all-cause mortality were 1.20
(0.65-2.22) for mild LVH (<16 mm), and 4.81 (2.19-10.56) for
moderate/severe LVH (>=16 mm). Meta-regression analysis confirmed a
stronger relationship proportional to the degree of LVH, regardless of age
and aortic valve replacement, explaining between-study heterogeneity
variance. Conclusions. Cardiac amyloidosis heralds significantly higher
risk of allcause death in elderly patients with AS. Severity of LVH
appears to be a major prognostic determinant in patients with dual AS-CA
pathology.

<86>
Accession Number
634463302
Title
Impact of coronary stenting on top of medical therapy on hard composite
endpoints in patients with chronic coronary syndromes: A meta-analysis of
randomized controlled trials.
Source
Giornale Italiano di Cardiologia. Conference: 81 Congresso Nazionale della
Societa Italiana di Cardiologia. 21 (12 SUPPL 2) (pp e57-e58), 2020. Date
of Publication: December 2020.
Author
Galli M.; Vescovo G.M.; Andreotti F.; Porto I.; D'Amario D.; Crea F.
Institution
(Galli, Andreotti, D'Amario, Crea) Universita Cattolica Del Sacro Cuore,
Roma, Italy
(Vescovo) University of Padova, Padova, Italy
(Porto) University of Genova, Genova, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction. Whether percutaneous coronary intervention (PCI) with stent
implantation on top of optimal medical therapy (OMT) modifies hard
composite clinical outcomes in chronic coronary syndromes (CCS) patients
remains controversial. Methods. This study was registered in PROSPERO
(CRD42020166754) and follows the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses and Cochrane Collaboration reporting. Randomized
controlled trials (RCTs) that compared PCI with stent implantation on top
of OMT versus OMT alone in CCS patients were included. Main exclusion
criteria were left main disease, severe left ventricular dysfunction and
severe kidney failure. To overcome the potential limitations deriving from
different follow-up durations among studies or multiple events by the same
person, Incidence Risk Ratio (IRR) with 95% confidence intervals (CIs)
were calculated. Results. Six RCTs enrolling a total of 10,751 patients
were included. At an average follow-up of 3.6 years, PCI+OMT compared with
OMT alone was associated with no difference in the two co-primary
composite endpoints of all-cause death/myocardial infarction (MI)/stroke
(IRR, 1.00; 95% CI, 0.91-1.10) and cardiovascular (CV) death/MI (IRR,
0.97; 95% CI, 0.86-1.11). There was no significant difference in the
individual secondary endpoints constituting primary outcomes between
groups. Consistent results were found when limiting analysis to RCTs
enrolling patients with moderate-to-severe ischemia or using DES in the
PCI arm or enrolling patients since the year 2000 or using a definite and
more specific definition of periprocedural MI. Conclusion. In CCS patients
with inducible myocardial ischemia and without severely reduced ejection
fraction or left main disease, adding PCI to OMT does not reduce the
incidence of hard composite or individual outcomes.

<87>
Accession Number
634463270
Title
Aortic valve replacement vs balloon-expandable and self-expandable
transcatheter implantation: A network meta-analysis.
Source
Giornale Italiano di Cardiologia. Conference: 81 Congresso Nazionale della
Societa Italiana di Cardiologia. 21 (12 SUPPL 2) (pp e39), 2020. Date of
Publication: December 2020.
Author
Bruno F.; D'Ascenzo F.; Baldetti L.; Franchin L.; Marengo G.; Beviario S.;
Melillo F.; Gallone G.; De Filippo O.; La Torre M.; Rinaldi M.; Omede P.;
Conrotto F.; Salizzoni S.; Giustetto C.; De Ferrari G.M.
Institution
(Bruno, D'Ascenzo, Franchin, Marengo, Beviario, Gallone, De Filippo,
Omede, Conrotto, Giustetto, De Ferrari) A.O.U. Citta della Salute e della
Scienza Torino, Divisione di Cardiologia
(La Torre, Rinaldi, Salizzoni) A.O.U. Citta della Salute e della Scienza
Torino, Divisione di Cardiochirurgia
(Baldetti, Melillo) Irccs San Raffaele Scientif Institute Milan, Divisione
di Cardiologia
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction. While clinical equipoise has been demonstrated for surgery
and transcatheter aortic valve interventions (TAVI) in appropriate
candidates with severe aortic stenosis, observational data have raised
concerns about safety of self-expandable (SE) compared to
balloonexpandable (BE) valves in TAVI, although potentially limited by
patient selection bias. Methods. All randomized controlled trials (RCTs)
comparing BE vs. SE TAVI or/and vs. aortic valve replacement (AVR) were
included and compared through Network Meta Analysis (NMA). All-cause and
cardiovascular (CV) mortality during follow-up were the primary endpoints,
while stroke, rates of permanent pacemaker implantation (PPI),
moderate/severe paravalvular leak (PVL) and re-intervention were the
secondary endpoints. Results. We obtained data from 11 RCTs, encompassing
9752 patients (3 with patients at low, 3 with patients at intermediate and
5 with patients at high surgical risk). After one and two years, no
significant differences were noted for all-cause and CV mortality between
BE, SE and surgical bioprosthetic valves. Compared to surgical
bioprostheses, both BE and SE TAVI reduced the risk of acute kidney injury
(OR 0.42; CI 95% 0.30-0.60 and OR 0.44; CI 95% 0.32-0.60), new-onset
atrial fibrillation (OR 0.24; CI 95% 0.14-0.42 and OR 0.21; CI 95%
0.13-0.34) and major bleedings (OR 0.32; CI 95% 0.16-0.65 and OR 0.47; CI
95% 0.25-0.89) but were associated with increased risk of vascular
complications (OR 2.29; CI 95% 1.37-3.85 for BE and OR 2.76; CI 95%
1.66-4.61 for SE). The BE prostheses reduced the risk of moderate/severe
PVL at 30-day (OR 0.31; CI 95% 0.17-0.55) and of PPI both at 30-day (OR
0.51; CI 95% 0.33-0.79) and 1 year (OR 0.40; CI 95% 0.30-0.55) as compared
to SE TAVI. Aortic valve reintervention was increased in SE prostheses
compared to surgery (OR 3.13; CI 95% 1.47-6.64), while in BE prostheses
were not (OR 2.26; CI 95% 0.93-5.47). Conclusions. A TAVI strategy,
independently from BE or SE prostheses, offers a survival benefits
comparable to AVR. The BE prostheses are associated with a reduction of
PPI and PVL compared to SE prostheses without any differences in all-cause
and CV mortality during two years of follow-up.

<88>
Accession Number
634463262
Title
Predictors of pacemaker implantation after tavi according to kind of
prostheses and risk profile: A contemporary meta-analysis.
Source
Giornale Italiano di Cardiologia. Conference: 81 Congresso Nazionale della
Societa Italiana di Cardiologia. 21 (12 SUPPL 2) (pp e39), 2020. Date of
Publication: December 2020.
Author
Bruno F.; D'Ascenzo F.; Vaira M.P.; Elia E.; Omede P.; Budano C.;
Montefusco A.; Gallone G.; De Filippo O.; Rinaldi M.; La Torre M.; Atzeni
F.; Salizzoni S.; Conrotto F.; Giustetto C.; De Ferrari G.M.
Institution
(Bruno, D'Ascenzo, Vaira, Elia, Omede, Budano, Montefusco, Gallone, De
Filippo, Conrotto, Giustetto, De Ferrari) A.O.U. Citta della Salute e
della Scienza Torino, Divisione di Cardiologia
(Rinaldi, La Torre, Atzeni, Salizzoni) A.O.U. Citta della Salute e della
Scienza, Divisione di Cardiochirurgia, Torino, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction. Permanent pacemaker implantation (PPI) may be required after
transcatheter aortic valve implantation (TAVI). Evidence on PPI prediction
has largely been gathered from high risk patients receiving first
generation valve implants, but there is lack of data regarding
low/intermediate risk patients and last generation devices. Accordingly,
we undertook a meta-analysis of the existing literature to examine the
incidence and predictors of PPI after TAVI according to surgical risk,
generation of valve and valve type. Methods. We made a systematic
literature search for studies with >=100 patients reporting the incidence
and adjusted predictors of PPI after TAVI. Subgroup analyses examined
these features according to surgical risk, generation of valve and
specific valve type. Results. We obtained data from 43 studies,
encompassing 29, 113 patients. PPI rated ranged from 6.7%-39.2% in
individual studies with a pool incidence of 19% (95% CI 16-21).
Independent predictors for PPI were age (OR: 1.05; 95% CI: 1.01-1.09),
left bundle branch block (LBBB) (OR: 1.45; 95% CI: 1.12-1.77), right
bundle branch block (RBBB) (OR: 4.15; 95% CI: 3.23-4.88), implantation
depth (OR: 1.18; 95% CI: 1.11-1.26) and self-expanding valve prosthesis
(OR: 2.99; 95% CI: 1.39-4.59). Among subgroups analyzed according to valve
type, valve generation and surgical risk, independent predictors were
RBBB, self-expanding valve type, first degree atrioventricular block and
implantation depth. Conclusions. Patient's characteristics (age), baseline
ECG (RBBB, LBBB), procedural factors (valve implantation depth) and type
of valve implanted (self-expanding valve type) are the main independent
predictors of PPI following TAVI and they should be taken into account to
evaluate pre-operative risk of conduction disorders, in order to reduce
PPI and improve clinical outcomes after TAVI.

<89>
Accession Number
634461901
Title
Safety of transdermal hormone therapy in menopausal women at increased
risk for venous thromboembolism.
Source
Menopause. Conference: Annual Meeting of the North American Menopause
Society, NAMS 2020. 27 (12) (pp 1473-1474), 2020. Date of Publication:
2020.
Author
Sobel T.; Shen W.
Institution
(Sobel, Shen) Johns Hopkins University School of Medicine, Baltimore, MD,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: It is estimated that over 45% of women in the United States are
menopausal. Many of these women suffer from vasomotor symptoms such as hot
flashes and night sweats, as well as sleep disturbance, fatigue, and mood
changes. Menopause hormone therapy (MHT) is the gold standard treatment,
but its use is controversial since the Women's Health Initiative (WHI)
study found an increased risk of breast cancer, coronary heart disease,
stroke, and venous thromboembolic events (VTE) with use of oral conjugated
equine estrogen and medroxyprogesterone acetate. However, several studies
have shown no increased risk of VTE with transdermal MHT use in healthy
postmenopausal women. The proposed mechanism is avoidance of hepatic
first-pass metabolism by transdermal estrogens, and therefore, no
activation of coagulation factors. Several societies have endorsed use of
transdermal MHT over oral MHT in healthy postmenopausal women. The
Endocrine Society provides a level C of evidence that "transdermal
estrogen does not increase venothrombotic episode risk" and ACOG's
committee opinion from 2013 recommends prescribers consider "the possible
thrombosis-sparing properties of transdermal forms of estrogen therapy,"
while the International Menopause Society (IMS) reports "The risk of
venous thromboembolism is less with transdermal than with oral estradiol."
However, there is a paucity of data surrounding use of transdermal MHT in
women at increased risk for VTE. These include women with personal or
family history of VTE, overweight/obesity, hereditary or acquired
thrombophilia, tobacco use, autoimmune disease, chronic inflammatory
disorders, recent surgery, trauma, immobilization, etc. Given the limited
data, clinicians are hesitant to prescribe MHT in these at-risk women who
are left to suffer with vasomotor symptoms without relief. It is our
objective in this literature review to provide clinicians with evidence on
the risk profile of transdermal MHT use in postmenopausal women at
increased risk of VTE. <br/>Design(s): We performed a search of PubMed,
Embase and Scopus using these MeSH terms: "transdermal menopause hormone
therapy", "hormone replacement therapy", "estrogen replacement therapy",
"hypercoagulability", "venous thromboembolism", "thrombophilia",
"transdermal patch", "immobilization", "surgery", "autoimmune", and "high
risk menopause hormone therapy". We searched all relevant papers from 2000
to 2020, resulting in 136 papers, the majority of which were after the WHI
study from 2001. We included 13 primary articles on transdermal MHT use in
postmenopausal women at increased risk of VTE. These include four
randomized controlled trials, eight observational trials, and one
non-randomized clinical trial. <br/>Result(s): Two studies included women
with prior history of VTE and found transdermal MHT use was associated
with decreased fibrinogen levels, and not associated with increased VTE
risk or increased coagulation factor levels. 11 studies included women
with risk factors for VTE. Of these, three found no increased VTE risk in
overweight or obese women using transdermal MHT. Three found a lower risk
of VTE in transdermal MHT users compared to oral MHT users with hereditary
thrombophilias or prothrombotic genetic polymorphisms. One found decreased
levels of prothrombotic factors in women with insulin resistance who used
transdermal MHT, while one found no activation of coagulation in women
with angiographically proven coronary artery disease who used transdermal
MHT. One found no increase in VTE risk amongst transdermal MHT users with
a variety of VTE risk factors including: obesity, varicose veins, active
smokers, recent immobilization, recent surgery, malignancy, cardiovascular
or cerebrovascular disorders, myeloproliferative disorders, and inherited
thrombophilia. Two found no significant difference in coagulation factor
levels in oral or transdermal MHT users who were postoperative or had
well-controlled non-insulin dependent diabetes mellitus or impaired
glucose tolerance. <br/>Conclusion(s): This literature review provides
evidence supporting the safety of transdermal MHT use in postmenopausal
women with risk factors for VTE. These studies found no increased risk of
VTE with transdermal MHT use in obese/overweight women, women with
hereditary thrombophilias, women who recently underwent surgery, or women
with prothrombotic genetic polymorphisms.

<90>
Accession Number
634467060
Title
Cardiac surgery outcomes in patients with antecedent kidney, liver, and
pancreas transplantation: a meta-analysis.
Source
Reviews in cardiovascular medicine. 21 (4) (pp 589-599), 2020. Date of
Publication: 30 Dec 2020.
Author
Bacusca A.E.; Enache M.; Tarus A.; Litcanu C.I.; Burlacu A.; Tinica G.
Institution
(Bacusca, Enache, Tarus, Litcanu, Tinica) Department of Cardiovascular
Surgery - Cardiovascular Diseases Institute, "Grigore T. Popa" University
of Medicine, Iasi 700115, Romania
(Burlacu) Department of Interventional Cardiology - Cardiovascular
Diseases Institute, "Grigore T. Popa" University of Medicine, Iasi 700115,
Romania
Publisher
NLM (Medline)
Abstract
Cardiovascular events are among the most common causes of late death in
the transplant recipient (Tx) population. Moreover, major cardiac surgical
procedures are more challenging and risky due to immunosuppression and the
potential impact on the transplanted organ's functional capacity. We aimed
to assess open cardiac surgery safety in abdominal solid organ transplant
recipients, comparing the postoperative outcomes with those of
nontransplant (N-Tx) patients. Electronic databases of PubMed, EMBASE, and
SCOPUS were searched. The endpoints were: overall rate of infectious
complications (wound infection, septicemia, pneumonia), cardiovascular and
renal events (stroke, cardiac tamponade, acute kidney failure), 30-days,
5-years, and 10-years mortality post-cardiac surgery interventions in
patients with and without prior solid organ transplantation. This
meta-analysis included five studies. Higher rates of wound infection (Tx
vs. N-Tx: OR: 2.03, 95% CI: 1.54 to 2.67, I2 = 0%), septicemia (OR: 3.91,
95% CI: 1.40 to 10.92, I2 = 0%), cardiac tamponade (OR: 1.83, 95% CI: 1.28
to 2.62, I2 = 0%) and kidney failure (OR: 1.70, 95 %CI: 1.44 to 2.02, I2 =
89%) in transplant recipients were reported. No significant differences in
pneumonia occurrence (OR: 0.95, 95% CI: 0.71 to 1.27, I2 = 0%) stroke (OR:
0.89, 95% CI: 0.54 to 1.48, I2 = 78%) and 30-day mortality (OR: 1.92, 95%
CI: 0.97 to 3.80, I2 = 0%) were observed. Surprisingly, 5-years (OR: 3.74,
95% CI: 2.54 to 5.49, I2 = 0%) and 10-years mortality rates were
significantly lower in the N-Tx group (OR: 3.32, 95% CI: 2.35 to 4.69, I2
= 0%). Our study reveals that open cardiac surgery in transplant
recipients is associated with worse postoperative outcomes and higher
long-term mortality rates.<br/>Copyright &#xa9; 2020 Bacusca et al.
Published by IMR Press.

<91>
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. <br/>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. <br/>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. <br/>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.
<br/>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. <br/>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.<br/>Copyright &#xa9;
2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<92>
[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. <br/>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. <br/>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. <br/>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.
<br/>Copyright &#xa9; 2020 the Author(s).

<93>
Accession Number
2011271673
Title
Radionuclide assessment of cardioprotective efficiency of hypoxic
preconditioning.
Source
Russian Electronic Journal of Radiology. 9 (3) (pp 65-72), 2019. Date of
Publication: 2019.
Author
Vesnina Zh.V.; Krivonogov N.G.; Arsenjeva Yu.A.; Nesterov E.A.; Lishmanov
Yu.B.
Institution
(Vesnina, Krivonogov, Arsenjeva, Lishmanov) Cardiology Research Institute,
Tomsk Nationale Research Medical Centre, Russian Academy of Sciences,
Tomsk, Russian Federation
(Nesterov) Tomsk National Research Polytechnic University, Tomsk, Russian
Federation
Publisher
I.M. Sechenov First Moscow State Medical University
Abstract
Purpose. Using radiocardiopulmonography to evaluate the cardioprotective
effectiveness of hypoxic preconditioning (HP) during myocardial
revascularization under extracorporeal circulation (EC). Material and
methods. A total of 63 patients (mean age of 52.8 +/- 1.4 years) who
underwent coronary bypass surgery (CABG) under EC condition were examined.
All patients had chronic heart failure of NYHA class I-III. Patients were
randomized into 2 groups: study group comprised 33 patients who received
HP during CABG; comparison group comprised 30 patients. Patients of both
groups were comparable in regard to clinical and intraoperative data. The
preconditioning was performed as a single-cycle 10-minute hypoxemia
session followed by 5-min period of reoxygenation before global ischemia.
Radiocardiopulmonography with 99mTc-pertechnetate was performed before and
6-8 days after surgery with the calculation of the parameters of
cardiopulmonary hemodynamics. Results. In the examined patients before
CABG we observed a decrease in the mean values of the cardiac output (MO),
cardiac index (HI), stroke index (SI) and circulation efficiency ratio
(CER) as a consequence of a decrease in the pumping function of the heart,
as well as an increase in the pulmonary circulation time (TPUL) due to
both arterial and venous components, which indicated the development of
pulmonary hypertension and venous congestion of the left heart. In the
postoperative period, positive statistically significant change in most
parameters of cardiopulmonary hemodynamics occurred as a result of
successful myocardial revascularization in patients of both groups: the
values of MO, SI, CER increased, and half-emptying period of the left and
right ventricles and the value of TPUL decreased. It should be noted that
the positive dynamics of these parameters was statistically more
pronounced in the patients of the study group. Also, in contrast to the
comparison group, the arterial component of circulation in the lungs and
the half-emptying period of the right ventricle significantly decreased in
patients with HP, which indicated a reduction in pulmonary hypertension
and a regression of right ventricular failure. On day 2 after surgery
blood levels of creatine-kinase (CK) and CK-MB were increased in patients
of both groups. The mean level of CK-MB was significantly higher (by 33%)
in the comparison group relative to the study group (p = 0.046825), and
the relative index (RI = CK-MB/CK x 100) in the study group did not exceed
6%. This data suggested that HP increased the tolerance of the heart to
the effects of "ischemia-reperfusion". Conclusion. Hypoxic preconditioning
exerted cardioprotective activity in patients undergoing open-heart
surgery under EC.<br/>Copyright &#xa9; 2019 Russian Electronic Journal of
Radiology. All rights reserved.

<94>
Accession Number
2011288449
Title
Effectiveness of preoperative breathing exercise interventions in patients
undergoing cardiac surgery: A systematic review.
Source
Revista Portuguesa de Cardiologia. (no pagination), 2021. Date of
Publication: 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.<br/>Copyright &#xa9; 2021
Sociedade Portuguesa de Cardiologia

<95>
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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2021 The Authors. Journal of Cardiac Surgery
Published by Wiley Periodicals LLC

<96>
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. <br/>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. <br/>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). <br/>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.]<br/>Copyright &#xa9; 2021,
The Author(s).

<97>
Accession Number
634454173
Title
In coronary artery disease, PCI increases all-cause and cause-specific
mortality compared with CABG.
Source
Annals of internal medicine. (no pagination), 2021. Date of Publication:
02 Mar 2021.
Author
Nanna M.G.; Newby L.K.
Institution
(Nanna, Newby) Duke Clinical Research Institute, Durham, NC
Publisher
NLM (Medline)
Abstract
SOURCE CITATION: Gaudino M, Hameed I, Farkouh ME, et al. Overall and
cause-specific mortality in randomized clinical trials comparing
percutaneous interventions with coronary bypass surgery: a meta-analysis.
JAMA Intern Med. 2020;180:1638-46. 33044497.

<98>
Accession Number
634365789
Title
ANalgesic Efficacy and safety of MOrphiNe versus methoxyflurane in
patients with acute myocardial infarction: The rationale and design of the
ANEMON-SIRIO 3 study: A multicentre, open-label, phase II, randomised
clinical trial.
Source
BMJ Open. 11 (3) (no pagination), 2021. Article Number: e043330. Date of
Publication: 01 Mar 2021.
Author
Kubica A.; Kosobucka A.; Niezgoda P.; Adamski P.; Buszko K.; Lesiak M.;
Wojakowski W.; Gasior M.; Gorcy J.; Kleinrok A.; Nadolny K.; Navarese E.;
Kubica J.
Institution
(Kubica, Kosobucka) Departament of Health Promotion, Nicolaus Copernicus
University in Torun Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
(Niezgoda, Adamski, Navarese, Kubica) Department of Cardiology and
Internal Medicine, Nicolaus Copernicus University in Torun Ludwik Rydygier
Collegium Medicum, Bydgoszcz, Poland
(Buszko) Department of Theoretical Foundations of Biomedical Science and
Medical Informatics, Nicolaus Copernicus University in Torun Ludwik
Rydygier Collegium Medicum, Bydgoszcz, Poland
(Lesiak) 1st Department of Cardiology, Poznan University of Medical
Sciences, Poznan, Poland
(Wojakowski) Department of Cardiology and Structural Heart Diseases,
Medical University of Silesia, Katowice, Poland
(Gasior) 3rd Department of Cardiology, School of Medicine with the
Division of Dentistry, Medical University of Silesia, Zabrze, Poland
(Gorcy) Department of Cardiology, Pomeranian Medical University in
Szczecin, Szczecin, Poland
(Kleinrok) Department of Cardiology, Pope John Paul II Reginal Hospital,
Zamosc, Poland
(Kleinrok) Medical Department, University of Information Technology and
Management, Rzeszow, Poland
(Nadolny) Department of Emergency Medicine and Disasters, Medical
University of Bialystok, Bialystok, Poland
(Nadolny) Department of Emergency Medical Service, Higher School of
Strategic Planning, Dabrowa Gornicza, Poland
Publisher
BMJ Publishing Group
Abstract
Introduction The unfavourable influence of morphine on the
pharmacokinetics of ticagrelor resulting in weaker and retarded
antiplatelet effect in patients with acute coronary syndrome (ACS) has
been previously shown. Replacing morphine with methoxyflurane, a potent,
non-opioid analgesic agent, that does not weaken or delay the effect of
antiplatelet agents may improve the clinical efficacy of treatment of
patients with ACS. Methods The ANEMON-SIRIO 3 study was designed as a
multicentre, open-label, phase II, randomised clinical trial aimed to test
the analgesic efficacy and safety of methoxyflurane in patients with ACS.
The study population will comprise patients with ST-elevation myocardial
infarction or non-ST-elevation ACS admitted to the study centres with
typical chest pain requiring analgesic treatment. Before percutaneous
coronary intervention (PCI) for the patients with index ACS will be
randomly assigned in 1:1 ratio to receive methoxyflurane administered by
inhalation, or to obtain morphine administered intravenously. Analgesic
treatment will be followed by 300 mg loading dose of aspirin and 180 mg
loading dose of ticagrelor. Patients will be assessed with regard to pain
intensity according to the Numeric Pain Rating Scale at baseline, 3 min
after study drug administration and immediately after PCI. Moreover,
patients will be actively monitored with regard to the occurrence of side
effects of evaluated therapies, as well as adverse events that may be
related to insufficient platelet inhibition (no-reflow phenomenon assessed
immediately after PCI, administration of GPIIb/IIIa inhibitors during PCI,
acute stent thrombosis). Ethics and dissemination The study will be
conducted in six Polish clinical centres from the beginning of in
accordance with the ethical standards of the institutional research
committee and with the 1964 Helsinki declaration and its later amendments
or comparable ethical standards. Trial registration details
ClinicalTrials.gov, NCT04476173.<br/>Copyright &#xa9; 2021 American
Society of Civil Engineers

<99>
Accession Number
2010666010
Title
Monitoring the Impact of Aggressive Glycemic Intervention during Critical
Care after Cardiac Surgery with a Glycemic Expert System for
Nurse-Implemented Euglycemia: The MAGIC GENIE Project.
Source
Journal of Diabetes Science and Technology. 15 (2) (pp 251-264), 2021.
Date of Publication: 2021.
Author
Rao R.H.; Perreiah P.L.; Cunningham C.A.
Institution
(Rao, Perreiah, Cunningham) Division of Endocrinology, Medicine Service
Line, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
Publisher
SAGE Publications Inc.
Abstract
A novel, multi-dimensional protocol named GENIE has been in use for
intensive insulin therapy (IIT, target glucose <140 mg/dL) in the surgical
intensive care unit (SICU) after open heart surgery (OHS) at VA Pittsburgh
since 2005. Despite concerns over increased mortality from IIT after the
publication of the NICE-SUGAR Trial, it remains in use, with ongoing
monitoring under the MAGIC GENIE Project showing that GENIE performance
over 12 years (2005-2016) aligns with the current consensus that IIT with
target blood glucose (BG) <140 mg/dL is advisable only if it does not
provoke severe hypoglycemia (SH). Two studies have been conducted to
monitor glucometrics and outcomes during GENIE use in the SICU. One
compares GENIE (n = 382) with a traditional IIT protocol (FORMULA, n =
289) during four years of contemporaneous use (2005-2008). The other
compares GENIE's impact overall (n = 1404) with a cohort of patients who
maintained euglycemia after OHS (euglycemic no-insulin [ENo-I], n = 111)
extending across 12 years (2005-2016). GENIE performed significantly
better than FORMULA during contemporaneous use, maintaining lower
time-averaged glucose, provoking less frequent, severe, prolonged, or
repetitive hypoglycemia, and achieving 50% lower one-year mortality, with
no deaths from mediastinitis (0 of 8 cases vs 4 of 9 on FORMULA). Those
benefits were sustained over the subsequent eight years of exclusive use
in OHS patients, with an overall one-year mortality rate (4.2%) equivalent
to the ENo-I cohort (4.5%). The results of the MAGIC GENIE Project show
that GENIE can maintain tight glycemic control without provoking SH in
patients undergoing OHS, and may be associated with a durable survival
benefit. The results, however, await confirmation in a randomized control
trial.<br/>Copyright &#xa9; 2021 Diabetes Technology Society.

<100>
Accession Number
2006144373
Title
Cardiac rupture-the most serious complication of takotsubo syndrome: A
series of five cases and a systematic review.
Source
Journal of Clinical Medicine. 10 (5) (pp 1-11), 2021. Article Number:
1066. Date of Publication: 01 Mar 2021.
Author
Zalewska-Adamiec M.; Bachorzewska-Gajewska H.; Dobrzycki S.
Institution
(Zalewska-Adamiec, Bachorzewska-Gajewska, Dobrzycki) Department of
Invasive Cardiology, Medical University of Bialystok, Bialystok 15-276,
Poland
(Bachorzewska-Gajewska) Department of Clinical Medicine, Medical
University of Bialystok, Bialystok 15-295, Poland
Publisher
MDPI AG
Abstract
Background: The most serious complication of the acute Takotsubo phase is
a myocardial perforation, which is rare, but it usually results in the
death of the patient. <br/>Method(s): In the years 2008-2020, 265 patients
were added to the Podlasie Takotsubo Registry. Cardiac rupture was
ob-served in five patients (1.89%), referred to as the Takotsubo syndrome
with complications of cardiac rupture (TS+CR) group. The control group
consisted of 50 consecutive patients with uncomplicated TS. The diagnosis
of TS was based on the Mayo Clinic Criteria. <br/>Result(s): Cardiac
rupture was observed in women with TS aged 74-88 years. Patients with TS
and CR were older (82.20 vs. 64.84; p = 0.011), than the control group,
and had higher troponin, creatine kinase, aspartate aminotransferase, and
blood glucose levels (168.40 vs. 120.67; p = 0.010). The TS+CR group
demonstrated a higher heart rate (95.75 vs. 68.38; p <0.0001) and the
Global Registry of Acute Coronary Events (GRACE) scores (186.20 vs.
121.24; p <0.0001) than the control group. In patients with CR, ST segment
elevation was recorded significantly more often in the III, V4, V5 and V6
leads. Left ventricular free wall rupture was noted in four patients, and
in one case, rupture of the ventricular septum. In a multi-variate
logistic regression, the factors that increase the risk of CR in TS were
high GRACE scores, and the presence of ST segment elevation in lead III.
<br/>Conclusion(s): Cardiac rupture in TS is rare but is the most severe
mechanical complication and is associated with a very high risk of death.
The main risk factors for left ventricular perforation are female gender,
older age, a higher concentration of cardiac enzymes, higher GRACE scores,
and ST elevations shown using electrocardiogram (ECG).<br/>Copyright
&#xa9; 2021 by the authors. Licensee MDPI, Basel, Switzerland.

<101>
Accession Number
2007244173
Title
Transcatheter Versus Surgical Aortic Valve Replacement: An Updated
Systematic Review and Meta-Analysis With a Focus on Outcomes by Sex.
Source
Heart Lung and Circulation. 30 (1) (pp 86-99), 2021. Date of Publication:
January 2021.
Author
Dagan M.; Yeung T.; Stehli J.; Stub D.; Walton A.S.; Duffy S.J.
Institution
(Dagan, Yeung, Stehli, Stub, Walton, Duffy) Department of Cardiology, The
Alfred Hospital, Melbourne, Vic, Australia
(Stub, Walton, Duffy) Baker IDI Heart and Diabetes Institute, Melbourne,
Vic, Australia
(Stub, Duffy) Centre of Cardiovascular Research and Education in
Therapeutics, Department of Epidemiology and Preventive Medicine, Monash
University, Melbourne, Vic, Australia
Publisher
Elsevier Ltd
Abstract
Background and Aims: Women at increased surgical risk have been shown to
have better outcomes with transcatheter aortic valve implantation (TAVI)
as compared to surgical valve replacement (SAVR). With the scope of TAVI
moving into low-surgical risk patients, we aimed to update the current
literature to include the new low-risk randomised controlled trial (RCT)
data in investigating outcomes by sex. <br/>Method(s): We systematically
searched MEDLINE (Ovid), PubMed, Cochrane Central Register of Controlled
Trials (CENTRAL), ClinicalTrials.gov and reference lists for relevant RCTs
comparing TAVI to SAVR published prior to 4 May 2020. Data extraction was
performed by two independent authors and included trial design details,
baseline characteristics and outcome data stratified by sex. Risk of bias
was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Quantitative
synthesis of pooled data was performed using Mantel-Haenszel fixed or
random effects model. Q-statistic and the I² test were used for
assessment of heterogeneity. <br/>Result(s): Our search yielded eight RCTs
included in the final quantitative synthesis. The overall pooled cohort
was 8,040, of whom 41.4% were female. Women had significantly lower rates
of one-year all-cause mortality (12.2% vs 17.7%, pooled OR 0.59, 95% CI
0.40-0.86) and one-year composite endpoint (9.7% vs 12.4%, pooled OR 0.73,
95% CI 0.58-0.92) with TAVI as compared to SAVR. The selective mortality
benefit with TAVI over SAVR in women did not persist to 5 years (pooled HR
1.01, 95% CI 0.87-1.17). At 30 days, women demonstrated lower rates of
major bleeding and acute kidney injury following TAVI compared to SAVR.
For men, these outcomes were similar regardless of type of intervention.
Both sexes were at increased risk of major vascular complications with
TAVI as compared to SAVR, however women demonstrated nearly double the
odds of major vascular complication with TAVI compared to men.
<br/>Conclusion(s): Our updated meta-analysis demonstrates that at
one-year women undergoing TAVI have significantly lower mortality and
better safety outcomes compared to those undergoing SAVR. These benefits
are not seen in men. In the new low-risk era, these results are ever more
important for guiding appropriate patient selection.<br/>Copyright &#xa9;
2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<102>
Accession Number
2008003932
Title
Do economic evaluations of TAVI deal with learning effects, innovation,
and context dependency? A review.
Source
Health Policy and Technology. 10 (1) (pp 111-119), 2021. Date of
Publication: March 2021.
Author
Enzing J.J.; Vijgen S.; Knies S.; Boer B.; Brouwer W.B.F.
Institution
(Enzing, Knies, Boer, Brouwer) Erasmus School of Health Policy &
Management, Erasmus University Rotterdam, Rotterdam, Netherlands
(Enzing, Vijgen, Knies) Zorginstituut Nederland, Diemen, Netherlands
Publisher
Elsevier B.V.
Abstract
Introduction: Most collectively funded healthcare systems set limits to
their benefit package. Doing so requires judgements which may involve
economic evaluations. Performing such evaluations brings methodological
challenges, which may be more pronounced in non-pharmaceutical
interventions. For example, for medical devices, the validity of
assessment results may be limited by learning effects, incremental
innovation of the devices and the context-dependency of their outcomes.
<br/>Objective(s): To review the extent to which "learning effects",
"incremental innovation" (related to outcomes) and "context-dependency"
are included and/or discussed in peer reviewed economic evaluations on
medical devices using Transcatheter Aortic Valve Implementation (TAVI) as
an example. <br/>Method(s): A systematic review was performed including
full economic evaluations of TAVI for operable patients with aortic
stenosis identified using the Pubmed database. Study characteristics,
study results and text fragments concerning the aforementioned aspects
were extracted. The quality of the studies was assessed using a quality
checklist (CHEC-extended). <br/>Result(s): Within 207 screened records, 15
studies were identified. Two studies referred to all three aspects, four
studies referred to none. "Learning effects" were discussed in five
studies, one of which described a method to cope with this challenge.
"Incremental innovation" was described in seven studies. Limitations in
generalizability of results related to context of care provision were
discussed in seven studies. <br/>Conclusion(s): The challenges related to
economic evaluations of TAVI and their influence on the validity of
reported results, are typically only partly discussed and rarely dealt
within peer reviewed studies. It is important for better informed policy
decisions that this improves.<br/>Copyright &#xa9; 2020 Fellowship of
Postgraduate Medicine

<103>
Accession Number
2010636470
Title
The best approach for functional tricuspid regurgitation: A network
meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Di Mauro M.; Lorusso R.; Parolari A.; Ravaux J.M.; Bonalumi G.; Guarracini
S.; Ricci F.; Benedetto U.; Calafiore A.M.
Institution
(Di Mauro, Lorusso, Ravaux) Cardio-Thoracic Surgery Unit, Heart and
Vascular Centre, Maastricht University Medical Centre (MUMC),
Cardiovascular Research Institute Maastricht (CARIM), Maastricht,
Netherlands
(Parolari) IRCCS Policlinic S. Donato and Department of Biomedical
Sciences for Health, UOC of University Cardiac Surgery and Translational
Research, University of Milan, Milan, Italy
(Bonalumi) Department of Cardiac Surgery, Centro Cardiologico
Monzino-IRCCS, Milan, Italy
(Guarracini) Department of Cardiovascular Disease, "Pierangeli" Hospital,
Pescara, Italy
(Ricci) Department of Neuroscience, Imaging and Clinical Sciences, "G.
d'Annunzio" University, Chieti, Italy
(Ricci) Department of Clinical Sciences, Lund University, Malmo, Sweden
(Benedetto) Department of Cardiothoracic Surgery, Bristol Heart Institute,
Bristol University, Bristol, United Kingdom
(Calafiore) Department of Cardiac Surgery, Gemelli Molise, Campobasso,
Italy
Publisher
Blackwell Publishing Inc.
Abstract
Objective: For many years, functional tricuspid regurgitation (FTR) was
considered negligible after treatment of left-sided heart valve surgery.
The aim of the present network meta-analysis is to summarize the results
of four approaches to establish the possible gold standard.
<br/>Method(s): A systematic search was performed to identify all
publications reporting the outcomes of four approaches for FTR, not
tricuspid annuloplasty (no TA), suture annuloplasty (SA), flexible (FRA),
rigid rings (RRA). All studies reporting at least one the four endpoints
(early and late mortality, early and late moderate or more TFR) were
included in a Bayesian network meta-analysis. <br/>Result(s): There were
31 included studies with 9663 patients. Aggregate early mortality was 5.3%
no TA, 7.2% SA, 6.6% FRA, and 6.4% RRA; early TR moderate-or-more was
9.6%, 4.8%, 4.6%, and 3.8%; late mortality was 22.5%, 18.2%, 11.9%, and
11.9%; late TR moderate-or-more was 27.9%, 18.3%, 14.3%, and 6.4%. Rigid
or semirigid ring annuloplasty was the most effective approach for
decreasing the risk of late moderate or more FTR (-85% vs. no TA; -64% vs.
SA; -32% vs. FRA). Concerning late mortality, no significant differences
were found among different surgical approaches; however, flexible or rigid
rings reduced significantly the risk of late mortality (78% and 47%,
respectively) compared with not performing TA mortality. No differences
were found for early outcomes. <br/>Conclusion(s): Ring annuloplasty seems
to offer better late outcomes compare to either suture annuloplasty or not
performing TA. In particular rigid or semirigid rings provide more stable
FTR across time.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<104>
Accession Number
2007001317
Title
Durable circulatory support with a paracorporeal device as an option for
pediatric and adult heart failure patients.
Source
Journal of Thoracic and Cardiovascular Surgery. 161 (4) (pp 1453-1464.e4),
2021. Date of Publication: April 2021.
Author
Bartfay S.-E.; Dellgren G.; Hallhagen S.; Wahlander H.; Dahlberg P.;
Redfors B.; Ekelund J.; Karason K.
Institution
(Bartfay, Dahlberg, Karason) Department of Cardiology, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Bartfay, Dellgren, Dahlberg, Karason) Institute of Medicine, Sahlgrenska
Academy, University of Gothenburg, Gothenburg, Sweden
(Dellgren) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Dellgren, Karason) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Hallhagen, Wahlander) Department of Pediatric Cardiology, Queen Silvia
Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
(Hallhagen, Wahlander, Redfors) Institute of Clinical Sciences,
Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
(Redfors) Department of Cardiothoracic Anesthesia and Intensive Care,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Ekelund) Centre of Registers Vastra Gotaland, Sahlgrenska University
Hospital, Gothenburg, Sweden
Publisher
Mosby Inc.
Abstract
Objectives: Not all patients in need of durable mechanical circulatory
support are suitable for a continuous-flow left ventricular assist device.
We describe patient populations who were treated with the paracorporeal
EXCOR, including children with small body sizes, adolescents with complex
congenital heart diseases, and adults with biventricular failure.
<br/>Method(s): Information on clinical data, echocardiography, invasive
hemodynamic measurements, and surgical procedures were collected
retrospectively. Differences between various groups were compared.
<br/>Result(s): Between 2008 and 2018, a total of 50 patients (21 children
and 29 adults) received an EXCOR as bridge to heart transplantation or
myocardial recovery. The majority of patients had heart failure compatible
with Interagency Registry for Mechanically Assisted Circulatory Support
profile 1. At year 5, the overall survival probability for children was
90%, and for adults 75% (P =.3). After we pooled data from children and
adults, the survival probability between patients supported by a
biventricular assist device was similar to those treated with a left
ventricular assist device/ right ventricular assist device (94% vs 75%,
respectively, P =.2). Patients with dilated cardiomyopathy had a trend
toward better survival than those with other heart failure etiologies (92%
vs 70%, P =.05) and a greater survival free from stroke (92% vs 64%, P
=.01). Pump house exchange was performed in nine patients due to chamber
thrombosis (n = 7) and partial membrane rupture (n = 2). There were 14
cases of stroke in eleven patients. <br/>Conclusion(s): Despite severe
illness, patient survival on EXCOR was high, and the long-term overall
survival probability following heart transplantation and recovery was
advantageous. Treatment safety was satisfactory, although still hampered
by thromboembolism, mechanical problems, and infections.<br/>Copyright
&#xa9; 2020 The American Association for Thoracic Surgery

<105>
Accession Number
2006981181
Title
Improving health-related quality of life and adherence to health-promoting
behaviors among coronary artery bypass graft patients: a non-randomized
controlled trial study.
Source
Quality of Life Research. 30 (3) (pp 769-780), 2021. Date of Publication:
March 2021.
Author
Zafari Nobari S.; Vasli P.; Hosseini M.; Nasiri M.
Institution
(Zafari Nobari, Vasli, Hosseini) Department of Nursing, School of Nursing
and Midwifery, Shahid Beheshti University of Medical Sciences, Vali Asr
Ave., Niayesh Cross Road, Tehran, Iran, Islamic Republic of
(Nasiri) Department of Basic Sciences, School of Nursing and Midwifery,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: This study aimed to determine the impact of a healthy lifestyle
empowerment program on health-related quality of life and adherence to
health-promoting behaviors in coronary artery bypass graft patients.
<br/>Method(s): This non-randomized controlled trial was conducted in 2019
on 97 coronary artery bypass graft patients in Iran. Participants were
selected by culturally pragmatic and non-randomized method and assigned to
healthy lifestyle empowerment program group (HLEPG) (n = 49) and
conventional education group (CEG) (n = 48). Data were collected by the
12-item short-form health survey (SF-12) and health-promoting lifestyle
profile II (HPLP2), which were administered at baseline and three-month
follow-up. The healthy lifestyle empowerment program and conventional
education as two interventions were performed for HLEPG and CEG,
respectively. Data analysis was performed using the paired t-test,
independent t-test, analysis of covariance and linear mixed method at the
0.05 significance level. <br/>Result(s): In the follow-up, both groups
showed a significant increase in the mean score of health-related quality
of life (p <= 0.001) but this increase was visibly greater in the HLEPG
(from 23.47 +/- 7.48 to 35.60 +/- 5.95) than in the CEG (from 22.93 +/-
5.93 to 27.6 +/- 4.90). The healthy lifestyle empowerment program also
significantly increased the mean score of adherence to health-promoting
behaviors in the HLEPG (p <= 0.001), whereas no such change was observed
in the CEG. The results of the linear mixed model showed that the
follow-up scores health-related quality of life and adherence to
health-promoting behaviors of the HLEPG were 27.26 and 7.56 units
significantly greater than the CEG after HLEP, respectively (p < 0.001).
<br/>Conclusion(s): Considering the results of this study, health care
providers are recommended to devise and implement healthy lifestyle
empowerment programs to improve the health-related quality of life of
coronary artery bypass surgery patients. Clinical trial registration:
Registered at Iranian Registry of Clinical Trials
(IRCT20171213037860N1).<br/>Copyright &#xa9; 2020, Springer Nature
Switzerland AG.

<106>
Accession Number
2010985258
Title
Current Use, Capacity, and Perceived Barriers to the Use of Extracorporeal
Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest in
Canada.
Source
CJC Open. 3 (3) (pp 327-336), 2021. Date of Publication: March 2021.
Author
Grunau B.; Shemie S.D.; Wilson L.C.; Dainty K.N.; Nagpal D.; Hornby L.;
Lamarche Y.; van Diepen S.; Kanji H.D.; Gould J.; Saczkowski R.; Brooks
S.C.
Institution
(Grunau) Department of Emergency Medicine and Centre for Health Evaluation
and Outcome Sciences, University of British Columbia and St Paul's
Hospital, Vancouver, BC, Canada
(Shemie) Division of Critical Care Medicine, McGill University, Montreal,
QC, Canada
(Shemie, Wilson, Hornby) Deceased Donation, Canadian Blood Services,
Ottawa, ON, Canada
(Dainty) Patient-Centred Outcomes, North York General Hospital, Toronto,
ON, Canada
(Dainty) Institute of Health Policy Management and Evaluation, University
of Toronto, Toronto, ON, Canada
(Nagpal) Divisions of Cardiac Surgery and Critical Care Medicine, Western
University, London, ON, Canada
(Hornby) Children's Hospital of Eastern Ontario Research Institute,
Ottawa, ON, Canada
(Lamarche) Divisions of Cardiac Surgery and Critical Care Medicine,
University of Montreal, Montreal, QC, Canada
(van Diepen) Department of Critical Care and Division of Cardiology,
Department of Medicine, University of Alberta, Edmonton, AB, Canada
(Kanji) Division of Critical Care Medicine, University of British
Columbia, Vancouver, BC, Canada
(Gould) Department of Emergency Medicine, Dalhousie University, Saint
John, NB, Canada
(Saczkowski) Division of Cardiac Surgery, Kelowna General Hospital,
Kelowna, BC, Canada
(Brooks) Department of Emergency Medicine, Queen's University, Kingston,
ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is a
therapeutic option for refractory cardiac arrest. We sought to perform an
environmental scan to describe ECPR utilization in Canada and perceived
barriers for application to out-of-hospital cardiac arrest (OHCA).
<br/>Method(s): This was a national cross-sectional study. We identified
all cardiovascular surgery- and extracorporeal membrane oxygenation
(ECMO)-capable hospitals in Canada and emergency medical services (EMS)
agencies delivering patients to those centres. We requested the medical
lead from each hospital's ECMO service and each EMS agency to submit data
regarding ECMO and ECPR utilization, as well as perceived barriers to ECPR
provision for OHCA. <br/>Result(s): We identified and received survey data
from 39 of 39 Canadian hospital institutions and 21 of 22 EMS agencies. Of
hospitals, 38 (97%) perform ECMO and 27 (69%) perform ECPR (74% of which
perform <=5 cases per year). Of the 18 (46%) sites offering ECPR for OHCA,
8 apply a formal protocol for eligibility and initiation procedures. EMS
agencies demonstrate heterogeneity with intra-arrest transport practices.
The primary rationale for nontransport of refractory OHCA is that
hospital-based care offers no additional therapies. Perceived barriers to
the use of ECPR for OHCA were primarily related to limited evidence
supporting its use, rather than resources required. <br/>Conclusion(s):
Many Canadian cardiovascular surgery- or ECMO-equipped hospitals use ECPR;
roughly half employ ECPR for OHCAs. Low case volumes and few formal
protocols indicate that this is not a standardized therapy option in most
centres. Increased application may be dependent on a stronger evidence
base including data from randomized clinical trials currently
underway.<br/>Copyright &#xa9; 2020 Canadian Cardiovascular Society

<107>
Accession Number
2010836924
Title
Effect of Acute Immunosuppression on Left Ventricular Recovery and
Mortality in Fulminant Viral Myocarditis: A Case Series and Review of
Literature.
Source
CJC Open. 3 (3) (pp 292-302), 2021. Date of Publication: March 2021.
Author
Turgeon P.Y.; Massot M.; Beaupre F.; Belzile D.; Beaudoin J.; Bernier M.;
Bourgault C.; Germain V.; Laliberte C.; Morin J.; Gervais P.; Trahan S.;
Charbonneau E.; Dagenais F.; Senechal M.
Institution
(Turgeon, Massot, Beaupre, Belzile, Beaudoin, Bernier, Bourgault, Germain,
Laliberte, Morin, Senechal) Department of Cardiology, Institut
Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Quebec,
Canada
(Gervais) Department of Infectious Disease, Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec, Quebec, Canada
(Trahan) Department of Pathology, Institut Universitaire de Cardiologie et
de Pneumologie de Quebec, Quebec, Canada
(Charbonneau, Dagenais) Department of Cardiac Surgery, Institut
Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Quebec,
Canada
Publisher
Elsevier Inc.
Abstract
Background: Fulminant viral myocarditis (FVM) is a rare cause of
cardiogenic shock associated with high morbidity and mortality rates. An
inappropriately activated immune system results in severe myocardial
inflammation. Acute immunosuppressive therapy for FVM therefore gained in
popularity and was described in numerous retrospective studies.
<br/>Method(s): We conducted an extensive review of the literature and
compared it with our single-centre retrospective review of all cases of
FVM from 2009-2019 to evaluate the possible effect of acute
immunosuppression with intravenous immunoglobulins and/or high dose
corticosteroids in patients with FVM. <br/>Result(s): We report on 17
patients with a mean age of 46 +/- 15 years with a mean left ventricular
ejection fraction (LVEF) of 15 +/- 9% at admission. Fourteen (82%) of our
patients had acute LVEF recovery to >= 45% after a mean time from
immunosuppression of 74 +/- 49 hours (3.1 days). Extracorporeal membrane
oxygenation (ECMO) was required in 35% (6/17) of our patients for an
average support of 126 +/- 37 hours. Overall mortality was 12% (2/17). No
patient needed a long-term left ventricular assist device or heart
transplant. All surviving patients achieved complete long-term LVEF
recovery. <br/>Conclusion(s): Our cohort of 17 severely ill patients
received acute immunosuppressive therapy and showed a rapid LVEF recovery,
short duration of ECMO support, and low mortality rate. Our suggested
scheme of investigation and treatment is presented. These results bring
more cases of successfully treated FVM with immunosuppression and ECMO to
the literature, which might stimulate further prospective trials or a
registry.<br/>Copyright &#xa9; 2020 Canadian Cardiovascular Society

<108>
Accession Number
2003618443
Title
Reducing delirium and cognitive dysfunction after off-pump coronary
bypass: A randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 161 (4) (pp 1275-1282.e4),
2021. Date of Publication: April 2021.
Author
Szwed K.; Pawliszak W.; Szwed M.; Tomaszewska M.; Anisimowicz L.;
Borkowska A.
Institution
(Szwed, Szwed, Tomaszewska, Borkowska) Department of Clinical
Neuropsychology, Collegium Medium, Nicolaus Copernicus University,
Bydgoszcz, Poland
(Pawliszak, Anisimowicz) Department of Cardiac Surgery, Collegium Medium,
Nicolaus Copernicus University, Bydgoszcz, Poland
Publisher
Mosby Inc.
Abstract
Background: Neuropsychiatric complications of surgical coronary
revascularization are inconspicuous but frequent and clinically relevant.
So far, attempts to reduce their occurrence, such as the introduction of
off-pump coronary artery bypass (OPCAB) grafting method, have not brought
the desired results. The aim of this trial was to determine whether using
any of the 2 selected modifications of OPCAB could decrease the incidence
of these undesired sequelae. <br/>Method(s): In this single-center,
assessor- and patient-blinded, superiority, randomized controlled trial,
192 patients scheduled for elective isolated OPCAB were randomized to 3
parallel arms. The control arm underwent "conventional" OPCAB with vein
grafts. The first study arm underwent anaortic OPCAB (ANA) with total
arterial revascularization. The second study arm underwent OPCAB with vein
grafts using carbon dioxide surgical field flooding (CO<inf>2</inf>FF).
Outcomes included the incidence of postoperative delirium (PD) and early
postoperative cognitive dysfunction (ePOCD). <br/>Result(s): The incidence
of PD was 35.9% in the control (OPCAB) arm, 32.8% in the CO<inf>2</inf>FF
arm, and 12.5% in the ANA arm (chi² [2, N = 191] = 10.17; P
=.006). Post hoc tests revealed that the incidence of PD in the ANA arm
differed from that in the OPCAB arm (odds ratio [OR], 0.26; 95% confidence
interval [CI], 0.09-0.68; P =.002). The incidence of ePOCD was 34.4% in
the OPCAB arm, 28.1% in the CO<inf>2</inf>FF arm, and 9.5% in the ANA arm
(chi² [2, N = 191] = 11.58; P =.003). Post hoc tests revealed
that the incidence of ePOCD differed between the ANA and OPCAB arms (OR,
0.20; 95% CI, 0.06-0.58; P <.001). <br/>Conclusion(s): Performing ANA
significantly decreases the incidence of PD and ePOCD compared with
"conventional" OPCAB with vein grafts, whereas CO<inf>2</inf>FF is
inconsequential in this regard. These results, which probably reflect
decreased delivery of embolic load to the brain in ANA, may have practical
applicability in daily practice to improve clinical
outcomes.<br/>Copyright &#xa9; 2019 The American Association for Thoracic
Surgery

<109>
Accession Number
634334888
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 e016602), 2021. Date
of Publication: 01 Feb 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 Ontario Canada
(Singh) Gold Coast University Hospital Queensland Australia
(Couture) Universite de Sherbrooke Sherbrooke Quebec Canada
(Lordkipanidze, Tanguay) Montreal Heart Institute Montreal Quebec Canada
Publisher
NLM (Medline)
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). Conclusions 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.

<110>
Accession Number
634430494
Title
Long-term safety of tildrakizumab in patients with moderate-to-severe
psoriasis: Incidence of major adverse cardiovascular events through 148
weeks from resurface 1 and resurface 2 phase 3 trials.
Source
Journal of the Dermatology Nurses' Association. Conference: 24th World
Congress of Dermatology. Italy. 12 (2) (no pagination), 2020. Date of
Publication: March-April 2020.
Author
Iversen L.; Griffiths C.; Lambert J.; Peserico A.; Kimball A.B.;
Pau-charles I.; Blauvelt A.; Thaci D.; Reich K.
Institution
(Iversen) Department of Dermatology, Aarhus University Hospital, Aarhus,
Denmark
(Griffiths) Centre for Dermatology Research, University of Manchester,
Manchester, United Kingdom
(Lambert) Department of Dermatology, Ghent University Hospital, Ghent,
Belgium
(Peserico) Clinica Dermatologica, Department of Medicine, Dimed University
of Padua, Padua, Italy
(Kimball) Beth Israel Deaconess Hospital, Harvard Medical School, Boston,
MA, United States
(Pau-charles) Almirall R and D, Barcelona, Spain
(Blauvelt) Oregon Medical Research Center, Portland, OR, United States
(Thaci) Comprehensive Centre for Inflammation Medicine, University of
Lubeck, Lubeck, Germany
(Reich) Dermatologikum Berlin and Sciderm Research Institute, Hamburg,
Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Tildrakizumab (TIL) is a high-affinity anti-IL-23p19
monoclonal antibody FDAapproved for treating of moderate-to-severe plaque
psoriasis in the US. <br/>Objective(s): To evaluate major adverse
cardiovascular events (MACE) in two phase 3 trials: reSURFACE1/2
(NCT01722331/NCT01729754). <br/>Material(s) and Method(s): Pooled analysis
of adult patients with moderate-to-severe plaque psoriasis from two
3-part, parallel group, double-blinded, randomized controlled trials:
reSURFACE1 (64 week) and reSURFACE2 (52 week). Detailed methodology has
previously been published (Reich et al., Lancet, 2017). Safety data over
148 weeks pooled across trials and treatment groups were included. Groups
were defined as placebo, etanercept (until week 28), TIL 100mg (100mg-only
in at least one part of the study), TIL 200mg (200mg-only in at least one
part of the study), continuous TIL 100mg (100mg throughout the 3
double-blind parts plus open-label extension), continuous 200mg (200mg
throughout all parts), TIL100/200mg (any TIL dose in at least one part)
and continuous TIL 100/200mg (consistently exposed to TIL but dose could
change throughout all parts). Exposure-adjusted incidence rates (EAIR) for
confirmed MACE (including non-fatal myocardial infarction, non-fatal
stroke, unstable angina, coronary revascularization, resuscitated cardiac
arrest, and cardiovascular deaths that were confirmed as "cardiovascular"
or "sudden") were reported. <br/>Result(s): Overall, 928 patients on TIL
200mg, 872 on TIL 100mg, 316 on continuous TIL 200mg, 352 on continuous
TIL 100mg, 543 on placebo, 1646 on TIL 100/200mg, 808 on continuous TIL
100/200mg, and 313 on etanercept were included. The EAIR of MACE was
0.54/100 subject-years of exposure among TIL 200mg, 0.40 (TIL 100mg), 0.29
(continuous TIL 200mg), 0.36 (continuous TIL 100mg), 0.49 (placebo), 0.47
(TIL 100/200mg), 0.35 (continuous TIL 100/200mg), and 0.65 (etanercept).
<br/>Conclusion(s): Tildrakizumab had a favourable long-term safety
profile as demonstrated by a low rate of MACE (comparable to etanercept
and placebo) in patients with moderate-tosevere plaque psoriasis.

<111>
Accession Number
2011283088
Title
Effects of different oral care strategies on postoperative pneumonia in
infants with mechanical ventilation after cardiac surgery: A prospective
randomized controlled study.
Source
Translational Pediatrics. 10 (2) (pp 359-365), 2021. Date of Publication:
February 2021.
Author
Yu X.-R.; Xu N.; Huang S.-T.; Zhang Q.-L.; Wang Z.-C.; Cao H.; Chen Q.
Institution
(Yu, Xu, Huang, Zhang, Wang, Cao, Chen) Department of Cardiac Surgery,
Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian
Medical University, Fuzhou, China
(Yu, Xu, Huang, Zhang, Wang, Cao, Chen) Fujian Key Laboratory of Women and
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
(Wang, Chen) Department of Cardiovascular Surgery, Union Hospital, Fujian
Medical University, Fuzhou, China
Publisher
AME Publishing Company
Abstract
Background: To explore the effects of different oral care strategies on
postoperative pneumonia in infants with mechanical ventilation after
cardiac surgery. <br/>Method(s): A prospective randomized controlled study
was conducted at a hospital in Fujian Province, China. Participants were
randomly divided into the breast milk oral care group, physiological
saline oral care group, and sodium bicarbonate oral care group to explore
the effects of different oral care strategies on postoperative pneumonia
in infants on mechanical ventilation cardiac surgery. <br/>Result(s): The
mechanical ventilation duration, the hospitalization costs, and the length
of intensive care unit (ICU) stay and postoperative hospital stay in the
breast milk oral care group were significantly shorter than those in the
physiological saline oral care group and the sodium bicarbonate oral care
group. The incidence of postoperative pneumonia in the breast milk oral
care group was 3.2%, which was significantly lower than that in the
physiological saline oral care group (22.6%) and the sodium bicarbonate
oral care group (19.4%). <br/>Conclusion(s): Using breast milk for oral
care in infants after cardiac surgery has a lower incidence of
postoperative pneumonia than traditional oral care strategies of
physiological saline and sodium bicarbonate, and it is worthy of clinical
application.<br/>Copyright &#xa9; Translational Pediatrics. All rights
reserved.

<112>
Accession Number
2011314065
Title
A commentary on "Beta-blocker exposure for short-term outcomes following
non-cardiac surgery: A meta-analysis of observational studies" [Int. J.
Surg. 76 (2020) 153-162].
Source
International Journal of Surgery. 88 (no pagination), 2021. Article
Number: 105909. Date of Publication: April 2021.
Author
Zong G.; Hu Y.; Han A.; Liu S.
Institution
(Zong, Hu, Han) Jiaozhou Central Hospital of Qingdao, 29 Xuzhou Road,
Jiaozhou, Qingdao, Shandong 266300, China
(Liu) Community Health Service Center, Landong Road, LINGSHANWEI Street,
Huangdao District, Qingdao, Shandong 266400, China
Publisher
Elsevier Ltd

<113>
Accession Number
2011271075
Title
Levosimendan in the treatment of patients with acute cardiac conditions.
Source
Kardiologia Polska. 78 (7-8) (pp 825-834), 2020. Date of Publication:
2020.
Author
Tycinska A.; Gierlotka M.; Bugajski J.; Deja M.; Depukat R.; Gruchala M.;
Grzesk G.; Kasprzak J.D.; Kubica J.; Kucewicz-Czech E.; Leszek P.; Plonka
J.; Sobkowicz B.; Straburzynska-Migaj E.; Wilk K.; Zawislak B.; Zymlinski
R.; Stepinska J.
Institution
(Tycinska, Sobkowicz, Wilk) Department of Cardiology, Medical University
of Bialystok, Bialystok, Poland
(Gierlotka, Bugajski, Plonka) Department of Cardiology, University
Hospital in Opole, Institute of Medical Sciences, University of Opole,
Opole, Poland
(Deja) Department of Cardiac Surgery, Faculty of Medical Sciences in
Katowice, Medical University of Silesia, Katowice, Poland
(Depukat) Department of Cardiology and Cardiovascular Interventions,
University Hospital, Krakow, Poland
(Gruchala) 1st Department of Cardiology, Medical University of Gdansk,
Gdansk, Poland
(Grzesk) Department of Cardiology and Clinical Pharmacology, Faculty of
Health Sciences Collegium Medicum, Nicolaus Copernicus University,
Bydgoszcz, Poland
(Kasprzak) I Department and Chair of Cardiology, Bieganski Hospital,
Medical University of Lodz, Lodz, Poland
(Kubica) Department of Cardiology and Internal Medicine, Collegium
Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Kucewicz-Czech) Department of Cardiac Anaesthesiology and Intensive
Therapy, Medical University of Silesia, Katowice, Poland
(Leszek) Department of Heart Failure and Transplantology, National
Institute of Cardiology, Warsaw, Poland
(Straburzynska-Migaj) 1st Department of Cardiology, University of Medical
Sciences in Poznan, University Hospital of Lord's Transfiguration, Poznan,
Poland
(Zawislak) Intensive Cardiac Care Unit, University Hospital, Krakow,
Poland
(Zymlinski) Department of Heart Diseases, Wroclaw Medical University,
Wroclaw, Poland
(Zymlinski) Centre for Heart Diseases, University Hospital, Wroclaw,
Poland
(Stepinska) Department of Intensive Cardiac Therapy, National Institute of
Cardiology, Warsaw, Poland
Publisher
Medycyna Praktyczna Cholerzyn
Abstract
Levosimendan is a new inodilator which involves 3 main mechanisms:
increases the calcium sensitivity of cardiomyocytes, acts as a vasodilator
due to the opening of potassium channels, and has a cardioprotective
effect. Levosimendan is mainly used in the treatment of acute
decompensated heart failure (class IIb recommendation according to the
European Society of Cardiology guidelines). However, numerous clinical
trials indicate the validity of repeated infusions of levosimendan in
patients with stable heart failure as a bridge therapy to heart
transplantation, and in patients with accompanying right ventricular heart
failure and pulmonary hypertension. Due to the complex mechanism of
action, including the cardioprotective and antiaggregating effect, the use
of levosimendan may be particularly beneficial in acute coronary
syndromes, preventing the occurrence of acute heart failure. There are
data indicating that levosimendan administered prior to cardiac surgery
may improve outcomes in patients with severely impaired left ventricular
function. The multidirectional mechanism of action also affects other
organs and systems. The positive effect of levosimendan in the treatment
of cardiorenal and cardiohepatic syndromes has been shown. It has a safe
and predictable profile of action, does not induce tolerance, and shows no
adverse effects affecting patients survival or prognosis. However, with
inconclusive results of previous studies, there is a need for a
welldesigned multicenter randomized placebocontrolled study, including an
adequately large group of outpatients with chronic advanced systolic heart
failure.<br/>Copyright by the Polish Cardiac Society, Warsaw 2020.

<114>
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. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2020 Deutscher Arzte-Verlag
GmbH. All rights reserved.

<115>
Accession Number
2011254119
Title
Prediction of fluoroscopic angulations for transcatheter aortic valve
implantation by CT angiography: Influence on procedural parameters.
Source
European Heart Journal Cardiovascular Imaging. 18 (8) (pp 906-914), 2017.
Date of Publication: 01 Aug 2017.
Author
Hell M.M.; Biburger L.; Marwan M.; Schuhbaeck A.; Achenbach S.; Lell M.;
Uder M.; Arnold M.
Institution
(Hell, Biburger, Marwan, Schuhbaeck, Achenbach, Arnold) Department of
Cardiology, Faculty of Medicine, Friedrich-Alexander-University
Erlangen-Nurnberg (FAU), Ulmenweg 18, Erlangen 91054, Germany
(Lell, Uder) Department of Radiology, Faculty of Medicine,
Friedrich-Alexander-University Erlangen-Nurnberg (FAU), Maximilliansplatz
1, Erlangen 91054, Germany
Publisher
Oxford University Press
Abstract
Aims: Repeated angiograms to achieve an exactly orthogonal visualization
of the aortic valve plane can substantially contribute to the total
contrast amount required for transcatheter aortic valve implantation
(TAVI). We investigated whether pre-procedural identification of an
optimal fluoroscopic projection by cardiac computed tomography (CT) can
significantly reduce the amount of a procedure-related contrast agent
compared with angiographic determination of suitable angulations.
<br/>Methods and Results: Eighty consecutive patients (81 +/- 5 years, 55%
male) with symptomatic severe aortic valve stenosis and normal renal
function who underwent cardiac CT prior to TAVI were prospectively
randomized. In 40 patients, a CT-predicted suitable angulation was used
for the first aortic angiogram (CT cohort); in the other 40 patients, the
first aortogram was acquired at LAO 10degree/cranial 10 (angiography
cohort). Additional aortograms were performed if no satisfactory view of
the aortic valve plane was obtained. The number of aortograms needed to
achieve a satisfactory fluoroscopic projection (1.2 +/- 0.6 vs. 3.2 +/-
1.7; P < 0.001) and the total amount of contrast agent per TAVI procedure
were significantly lower in the CT cohort (95 +/- 21 vs. 125 +/- 36 mL; P
< 0.001). Incidence of acute kidney injury was not significantly
different. There was no significant difference regarding radiation dose,
time of procedure, degree of post-procedural aortic regurgitation,
complications and 30-day mortality between the cohorts.
<br/>Conclusion(s): Pre-procedural identification of a suitable
fluoroscopic projection by cardiac CT significantly reduces a procedural
contrast agent volume required for TAVI.<br/>Copyright &#xa9; 2016
Published on behalf of the European Society of Cardiology. All rights
reserved.

<116>
Accession Number
2010667182
Title
Music reduces patient-reported pain and anxiety and should be routinely
offered during flexible cystoscopy: Outcomes of a systematic review.
Source
Arab Journal of Urology. (no pagination), 2021. Date of Publication: 2021.
Author
Gauba A.; Ramachandra M.N.; Saraogi M.; Geraghty R.; Hameed B.M.Z.;
Abumarzouk O.; Somani B.K.
Institution
(Gauba, Ramachandra, Saraogi, Geraghty, Somani) Department of Urology,
University Hospital Southampton NHS Trust, Southampton, United Kingdom
(Hameed) Department of Urology, Kasturba Medical College Manipal, Manipal
Academy of Higher Education, Manipal, India
(Abumarzouk) Department of Surgery, Hamad General Hospital, Hamad Medical
Corporation, Doha, Qatar
Publisher
Taylor and Francis Ltd.
Abstract
Objective: To conduct a systematic review of the literature to assess
whether music reduces the use of analgesics and anxiolytics during
flexible cystoscopy. <br/>Method(s): The systematic review was performed
in line with the Cochrane guidelines and Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) checklist. The databases
searched included the Medical Literature Analysis and Retrieval System
Online (MEDLINE), Scopus, Cumulative Index to Nursing and Allied Health
Literature (CINAHL), Clinicaltrials.gov, the Excerpta Medica dataBASE
(EMBASE), Cochrane library, Google Scholar, and Web of Science from
inception of the databases to February 2020. The primary outcome measure
was the effect of music on pain and anxiety, and secondary outcome
measures were patient heart rate and blood pressure. <br/>Result(s): The
initial search yielded 234 articles and after going through titles and
abstracts, four studies (399 patients, 199 in the music group and 200 in
no music group) were included for the final review. There were three
randomised controlled trials and one prospective study published between
2014 and 2017. These studies were done in China, the USA and Italy, with
the study duration between 9 and 24 months. All patients had 2% topical
lignocaine jelly given per-urethra before the procedure. The choice of
music was classical in three studies and a mixture of different music
types in one study. Three of the four studies showed significantly reduced
pain and anxiety with the use of music for flexible cystoscopy procedures.
Heart rate was noted to be higher for the no music group, reflecting a
higher pain perceived by these patients. <br/>Conclusion(s): The present
review showed that listening to music was associated with reduced anxiety
and pain during flexible cystoscopy. Listening to music is therefore
likely to increase procedural satisfaction and willingness to undergo the
procedure again, considering repeated flexible cystoscopy is often needed
for surveillance. As music is simple, inexpensive and easily accessible,
it should be routinely offered to patients for outpatient and office-based
urological procedures. Abbreviations: IQR: interquartile range; NRS:
numerical rating scale; PTSD: post-traumatic stress disorder; RCT:
randomised control trial; STAI: State-trait Anxiety Inventory; VAS: visual
analogue scale.<br/>Copyright &#xa9; 2021 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<117>
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.
<br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2021,
The Author(s).

<118>
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. <br/>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. <br/>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). <br/>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. <br/>Level of Evidence:
Therapeutic Level II.<br/>Copyright &#xa9; 2021, Scoliosis Research
Society.

<119>
Accession Number
2010710351
Title
Human glycocalyx shedding: Systematic review and critical appraisal.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2021. Date of
Publication: 2021.
Author
Hahn R.G.; Patel V.; Dull R.O.
Institution
(Hahn) Research Unit, Sodertalje Hospital, Sodertalje, Sweden
(Hahn) Karolinska Institute at Danderyds Hospital (KIDS), Stockholm,
Sweden
(Patel) Department of Internal Medicine, Northwestern Medicine McHenry
Hospital, McHenry, IL, United States
(Dull) Department of Anesthesiology, Pathology, Physiology, Surgery,
University of Arizona, College of Medicine, Tucson, AZ, United States
Publisher
Blackwell Munksgaard
Abstract
Background: The number of studies measuring breakdown products of the
glycocalyx in plasma has increased rapidly during the past decade. The
purpose of the present systematic review was to assess the current
knowledge concerning the association between plasma concentrations of
glycocalyx components and structural assessment of the endothelium.
<br/>Method(s): We performed a literature review of Pubmed to determine
which glycocalyx components change in a wide variety of human diseases and
conditions. We also searched for evidence of a relationship between plasma
concentrations and the thickness of the endothelial glycocalyx layer as
obtained by imaging methods. <br/>Result(s): Out of 3,454 publications, we
identified 228 that met our inclusion criteria. The vast majority
demonstrate an increase in plasma glycocalyx products. Sepsis and trauma
are most frequently studied, and comprise approximately 40 publications.
They usually report 3-4-foldt increased levels of glycocalyx degradation
products, most commonly of syndecan-1. Surgery shows a variable picture.
Cardiac surgery and transplantations are most likely to involve elevations
of glycocalyx degradation products. Structural assessment using imaging
methods show thinning of the endothelial glycocalyx layer in
cardiovascular conditions and during major surgery, but thinning does not
always correlate with the plasma concentrations of glycocalyx products.
The few structural assessments performed do not currently support that
capillary permeability is increased when the plasma levels of glycocalyx
fragments in plasma are increased. <br/>Conclusion(s): Shedding of
glycocalyx components is a ubiquitous process that occurs during both
acute and chronic inflammation with no sensitivity or specificity for a
specific disease or condition.<br/>Copyright &#xa9; 2021 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<120>
Accession Number
2010703944
Title
Hyper-oncotic vs. Hypo-oncotic Albumin Solutions: a Systematic Review of
Clinical Efficacy and Safety.
Source
SN Comprehensive Clinical Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Haynes G.R.; Bassiri K.
Institution
(Haynes) Department of Anesthesiology, Tulane University School of
Medicine, 1430 Tulane Ave, New Orleans, LA 70112, United States
(Bassiri) Meridian HealthComms, Plumley Moor Road, Plumley, United Kingdom
Publisher
Springer Nature
Abstract
Several albumin solutions are available for volume expansion.
Hyper-oncotic solutions (>= 20%) are more effective than hypo-oncotic (<=
5%) as they recruit endogenous extracellular fluid into blood vessels
rather than adding volume. The latter may cause volume overload, with
several associated complications. This systematic review aimed to evaluate
evidence on the efficacy and safety of hyper-oncotic vs. hypo-oncotic
albumin solutions across different clinical settings. The review was
conducted according to PRISMA guidelines. Ninety articles were retained
(58 randomized controlled trials). Four studies directly compared albumin
solutions. SWIPE showed that cumulative fluid balance at 48 h was
significantly lower with 20% vs. 5% albumin (mean - 576 mL; P = 0.01).
Twenty percent albumin was also associated with decreased chloride load
vs. 4% albumin in critically ill patients. All 10 pre-/intraoperative
studies evaluated 4-5% solutions; 14 studies evaluated 4-5% albumin in
postoperative patients. Renal injury was reported in some studies;
however, hydroxyethyl starch was associated with higher incidence vs.
albumin. Importantly, 20% albumin preserved cumulative organ function in
liver transplantation, and 25% albumin was more beneficial than saline in
cardiac surgery patients. Thirty-two studies were performed in critically
ill patients. Several studies reported increased risk of positive fluid
balance and chloride load with hypo-oncotic albumin, whereas multiple
benefits were associated with 20% albumin, including improved endothelial
function and perfusion. Of 18 pediatric studies that evaluated <= 10%
albumin, benefits such as correction of hypotension and improved cardiac
output were noted. In conclusion, hyper-oncotic albumin solutions should
be more routinely used to avoid potential risks associated with
hypo-oncotic solutions.<br/>Copyright &#xa9; 2021, The Author(s).

<121>
Accession Number
601246117
Title
Quality of life in cardiac resynchronization recipients: Association with
response and impact on outcome.
Source
PACE - Pacing and Clinical Electrophysiology. 38 (1) (pp 8-17), 2015. Date
of Publication: 01 Jan 2015.
Author
Lenarczyk R.; Jedrzejczyk-Patej E.; Mazurek M.; Szulik M.; Kowalski O.;
Pruszkowska P.; Sokal A.; SREDNIAWA M.D.; Boidol J.; Kowalczyk J.;
Podolecki T.; Mencel G.; Kalarus Z.
Institution
(Lenarczyk, Jedrzejczyk-Patej, Mazurek, Szulik, Kowalski, Pruszkowska,
Sokal, SREDNIAWA, Boidol, Kowalczyk, Podolecki, Mencel, Kalarus)
Department of Cardiology Congenital Heart Disease and Electrotherapy,
Silesian Medical University, Silesian Centre for Heart Diseases,
Sklodowskiej-Curie 9, Zabrze 41-800, Poland
Publisher
Blackwell Publishing Inc.
Abstract
Background The prognostic impact of improvement in health-related quality
of life (QoL) and its relation to response in cardiac resynchronization
therapy (CRT) recipients remains unknown. Aim To assess the correspondence
between response to CRT and improvements in QoL and to verify if a change
in QoL after pacing influences outcome in CRT patients. Methods
Ninety-seven participants of the Triple-Site Versus Standard Cardiac
Resynchronization Therapy Trial (TRUST CRT) randomized trial, in New York
Heart Association class III-IV, QRS width >= 120 ms, left ventricular
ejection fraction <=35%, and significant mechanical dyssynchrony were
included. Subjects filled out the Minnesota-QoL questionnaire prior to and
6 months after CRT with defibrillator (CRT-D) implantation. Data on major
adverse cardiac events (MACEs: death, heart failure hospitalization, heart
transplant) collected within the next 2.5 years and adjudicated blindly
constituted the censoring variables. Results Within the first 6 months of
resynchronization QoL improved in 81%, while worsening in 19% of patients.
Clinical response, but not the echocardiographic one, was associated with
improved QoL. During subsequent 2.5 years MACEs occurred in 37% of
patients (23% died). Subjects without QoL improvement were significantly
(both P < 0.05) more prone to experience MACE (61% vs 32%) and die (44% vs
18%) within the follow-up. Unimproved QoL increased the probability of
future MACE by 2.7 times (95% confidence intervals [CI]: 1.26-5.83; P =
0.01) and death by 3.2 times (95% CI: 1.23-8.32; P = 0.02) independently
from clinical and echocardiographic response. Conclusions Clinical
response, but not the echocardiographic one, was associated with improved
QoL in CRT recipients. These preliminary data suggest that lack of
improvement in QoL after CRT was associated with a strongly unfavorable
prognosis, regardless of functional or echocardiographic response. Our
results merit further studies with a larger number of
patients.<br/>Copyright &#xa9; 2014 Wiley Periodicals, Inc.

<122>
Accession Number
2008417187
Title
Meta-Analysis of Bioprosthetic Valve Thrombosis After Transcatheter Aortic
Valve Implantation.
Source
American Journal of Cardiology. 138 (pp 92-99), 2021. Date of Publication:
01 Jan 2021.
Author
Rheude T.; Pellegrini C.; Stortecky S.; Marwan M.; Xhepa E.; Ammon F.;
Pilgrim T.; Mayr N.P.; Husser O.; Achenbach S.; Windecker S.; Cassese S.;
Joner M.
Institution
(Rheude, Pellegrini, Xhepa, Cassese, Joner) Klinik fur Herz- und
Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technische
Universitat Munchen, Munich, Germany
(Stortecky, Pilgrim, Windecker) Department of Cardiology, Bern University
Hospital, University of Bern, Bern, Switzerland
(Marwan, Ammon, Achenbach) Department of Cardiology,
Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
(Husser) Klinik fur Innere Medizin I, Kardiologie, St. Johannes-Hospital
Dortmund, Dortmund, Germany
(Mayr) Institut fur Anasthesiologie, Deutsches Herzzentrum Munchen,
Technische Universitat Munchen, Munich, Germany
(Joner) DZHK (German Centre for Cardiovascular Research), Munich Heart
Alliance, Munich, Germany
Publisher
Elsevier Inc.
Abstract
Bioprosthetic valve thrombosis may complicate transcatheter aortic valve
implantation (TAVI). This meta-analysis sought to evaluate the prevalence
and clinical impact of subclinical leaflet thrombosis (SLT) and clinical
valve thrombosis (CVT) after TAVI. We summarized diagnostic strategies,
prevalence of SLT and/or CVT and estimated their impact on the risk of
all-cause death and stroke. Twenty studies with 12,128 patients were
included. The prevalence of SLT and CVT was 15.1% and 1.2%, respectively.
The risk of all-cause death was not significantly different between
patients with SLT (relative risk [RR] 0.77; p = 0.22) and CVT (RR 1.29; p
= 0.68) compared with patients without. The risk of stroke was higher in
patients with CVT (RR 7.51; p <0.001) as compared with patients without,
while patients with SLT showed no significant increase in the risk of
stroke (RR 1.81; p = 0.17). Reduced left ventricular function was
associated with increased prevalence, while oral anticoagulation was
associated with reduced prevalence of bioprosthetic valve thrombosis.
Bioprosthetic valve thrombosis is frequent after TAVI, but does not
increase the risk of death. Clinical valve thrombosis is associated with a
significantly increased risk of stroke. Future studies should focus on
prevention and treatment of bioprosthetic valve thrombosis.<br/>Copyright
&#xa9; 2020 Elsevier Inc.

<123>
Accession Number
2011153652
Title
COVID-19 Mortality in Transplant Recipients.
Source
International Journal of Organ Transplantation Medicine. 11 (4) (pp
145-162), 2020. Date of Publication: 2020.
Author
Alfishawy M.; Elbendary A.; Mohamed M.; Nassar M.
Institution
(Alfishawy) Infectious Diseases Consultants and Academic Researchers of
Egypt (IDCARE), Cairo, Egypt
(Alfishawy) Aswan Heart Centre, Aswan, Egypt
(Elbendary) Dermatology Department, Kasr Alainy Faculty of Medicine,
Cairo, Egypt
(Mohamed) Nephrology Division, University of Tennessee Health Science
Center, Memphis, TN, United States
(Nassar) Internal Medicine Department, Beni Suef University, Beni Suef,
Egypt
Publisher
Iranian Society for Organ Transplantation
Abstract
Background: Organ transplant recipients are vulnerable to multiple
infectious agents and in a world with a circulating SARS-CoV-2 virus, it
would be expected that patients who are immunosuppressed would have higher
mortality. <br/>Objective(s): To determine the COVID-19 mortality in
transplant recipients. <br/>Method(s): We conducted a search in PubMed and
Google scholar databases using the keywords for COVID-19 and
transplantation. All related studies between January 1, 2020 and May 7,
2020 were reviewed. All relevant published articles related to COVID-19 in
transplant recipients were included. <br/>Result(s): 46 articles were
included; they studied a total of 320 transplant patients-220 kidney
transplant recipients, 42 liver, 19 heart, 22 lung, 8 HSCT, and 9 dual
organ transplant recipients. The overall mortality rate was 20% and was
variable among different organs and different countries. 65 transplant
recipients died of complications attributable to COVID-19; 33 were males
(15% of males in this cohort), 8 females (8% of females in this cohort),
and 24 whose sex was not determined. They had a median age of 66 (range:
32-87) years. The median transplantation duration was 8 years (range: 30
days to 20 years). The most frequent comorbidity reported was
hypertensions followed by diabetes mellitus, obesity, malignancy, ischemic
heart disease, and chronic obstructive pulmonary disease. The most
frequent cause of death reported was acute respiratory distress syndrome.
<br/>Conclusion(s): Transplant recipients in our cohort had a high
mortality rate. However, outcomes were not the same in different countries
based on outbreak settings. Mortality was noted in elder patients with
comorbidities.<br/>Copyright &#xa9; 2020, International Journal of Organ
Transplantation Medicine. All Rights Reserved.

<124>
Accession Number
2007044667
Title
Prevention of post-cardiac surgery vitamin D deficiency in children with
congenital heart disease: a pilot feasibility dose evaluation randomized
controlled trial.
Source
Pilot and Feasibility Studies. 6 (1) (no pagination), 2020. Article
Number: 159. Date of Publication: 01 Dec 2020.
Author
McNally J.D.; O'Hearn K.; Fergusson D.A.; Lougheed J.; Doherty D.R.;
Maharajh G.; Weiler H.; Jones G.; Khamessan A.; Redpath S.; Geier P.;
McIntyre L.; Lawson M.L.; Girolamo T.; Menon K.
Institution
(McNally, Menon) Department of Pediatrics, Division of Critical Care,
University of Ottawa, Ottawa, Canada
(McNally) CHEO, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
(O'Hearn) Children's Hospital of Eastern Ontario Research Institute,
Ottawa, Canada
(Fergusson) Department of Medicine, University of Ottawa, Ottawa, Canada
(Fergusson) Clinical Epidemiology Program, Ottawa Hospital Research
Institute, Ottawa, Canada
(Lougheed) Department of Pediatrics, Division of Cardiology, University of
Ottawa, Ottawa, Canada
(Doherty) Children's Health Ireland at Temple Street, Dublin, Ireland
(Maharajh, Girolamo) Department of Pediatric Surgery, Division of
Cardiovascular Surgery, University of Ottawa, Ottawa, Canada
(Weiler) School of Human Nutrition, Faculty of Agricultural and
Environmental Sciences, McGill University, Montreal, Canada
(Jones) School of Medicine, Department of Biomedical and Molecular
Sciences, Queen's University, Kingston, Canada
(Khamessan) Euro-Pharm International Canada Inc., Montreal, Canada
(Redpath) Department of Pediatrics, Division of Neonatology, University of
Ottawa, Ottawa, Canada
(Geier) Department of Pediatrics, Division of Nephrology, University of
Ottawa, Ottawa, Canada
(McIntyre) Department of Medicine (Division of Critical Care), Ottawa
Hospital Research Institute (OHRI), University of Ottawa, Ottawa, Canada
(Lawson) Department of Pediatrics, Division of Endocrinology, University
of Ottawa, Ottawa, Canada
Publisher
BioMed Central Ltd
Abstract
Background: The vast majority of children undergoing cardiac surgery have
low vitamin D levels post-operative, which may contribute to greater
illness severity and worse clinical outcomes. Prior to the initiation of a
large phase III clinical trial focused on clinical outcomes, studies are
required to evaluate the feasibility of the study protocol, including
whether the proposed dosing regimen can safely prevent post-operative
vitamin D deficiency in this high-risk population. <br/>Method(s): We
conducted a two-arm, double-blind dose evaluation randomized controlled
trial in children requiring cardiopulmonary bypass for congenital heart
disease. Pre-operatively, participants were randomized to receive
cholecalciferol representing usual care (< 1 year = 400 IU/day, > 1 year =
600 IU/day) or a higher dose approximating the Institute of Medicine
tolerable upper intake level (< 1 year = 1600 IU/day, > 1 year = 2400
IU/day). The feasibility outcomes were post-operative vitamin D status
(primary), vitamin D-related adverse events, accrual rate, study
withdrawal rate, blinding, and protocol non-adherence. <br/>Result(s):
Forty-six children were randomized, and five withdrew prior to surgery,
leaving 41 children (21 high dose, 20 usual care) in the final analysis.
The high dose group had higher 25-hydroxyvitamin D concentrations both
intraoperatively (mean difference + 25.9 nmol/L; 95% CI 8.3-43.5) and
post-operatively (mean difference + 17.2 nmol/L; 95% CI 5.5-29.0). Fewer
participants receiving high-dose supplementation had post-operative serum
25-hydroxyvitamin D concentrations under 50 nmol/L, compared with usual
care (RR 0.31, 95% CI 0.11-0.87). Post-operative vitamin D status was
associated with the treatment arm and the number of doses received. There
were no cases of hypercalcemia, and no significant adverse events related
to vitamin D. While only 75% of the target sample size was recruited
(limited funding), the consent rate (83%), accrual rate (1.5 per site
month), number of withdrawals (11%), and ability to maintain blinding
support feasibility of a larger trial. <br/>Conclusion(s): Pre-operative
daily high-dose supplementation improved vitamin D status pre-operatively
and at time of pediatric ICU admission. The protocol for a more definitive
trial should limit enrollment of children with at least 30 days between
randomization and surgery to allow adequate duration of supplementation or
consider a loading dose. Trial registration: ClinicalTrials.gov,
NCT01838447. Registered on April 24, 2013.<br/>Copyright &#xa9; 2020, The
Author(s).

<125>
Accession Number
2010331795
Title
Mitral regurgitation following PASCAL mitral valve repair system: A single
arm meta-analysis.
Source
Indian Heart Journal. 73 (1) (pp 129-131), 2021. Date of Publication: 01
Jan 2021.
Author
Kansara T.; Kumar A.; Majmundar M.; Basman C.
Institution
(Kansara, Majmundar) Department of Internal Medicine, New York Medical
College - Metropolitan Hospital Center, New York, NY, United States
(Kumar) Department of Cardiovascular Research, Cleveland Clinic, Akron,
OH, United States
(Basman) Department of Cardiology, Lenox Hill Hospital, New York, NY,
United States
Publisher
Elsevier B.V.
Abstract
Major consequences of untreated severe mitral regurgitation (MR) includes
heart failure, ventricular remodeling and pulmonary hypertension leading
to significant morbidity and mortality. MitraClip is the most widely used
device for treatment of severe MR. To overcome some of the shortcomings of
MitraClip, novel devices like PASCAL mitral valve repair system are
developed. We performed a single arm meta-analysis for patients with
severe mitral regurgitation (MR) undergoing PASCAL mitral valve repair
system. The results showed that 93.8% patients had reduction in MR grade,
with an average operative time of 88 min and an average increase of 86.33
m in 6-min walk test.<br/>Copyright &#xa9; 2020 Cardiological Society of
India

<126>
Accession Number
2008574687
Title
Systematic Review and Meta-Analysis of Diagnostic Test Accuracy Studies
Evaluating Point-of-Care Tests of Coagulopathy in Cardiac Surgery.
Source
Transfusion Medicine Reviews. 35 (1) (pp 7-15), 2021. Date of Publication:
January 2021.
Author
Wozniak M.J.; Abbasciano R.; Monaghan A.; Lai F.Y.; Corazzari C.; Tutino
C.; Kumar T.; Whiting P.; Murphy G.J.
Institution
(Wozniak, Abbasciano, Monaghan, Lai, Corazzari, Kumar, Murphy) Department
of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre
in Cardiovascular Medicine, University of Leicester, Clinical Sciences
Wing, Glenfield General Hospital, Leicester, United Kingdom
(Corazzari, Tutino) Cardiac Surgery Unit, Insubria University, Varese,
Italy
(Whiting) Centre for Research Synthesis and Decision Analysis (CReSyDA),
Bristol Medical School, University of Bristol, Bristol, United Kingdom
Publisher
W.B. Saunders
Abstract
Treatment guidelines recommend the routine use of point-of-care diagnostic
tests for coagulopathy in the management of cardiac surgery patients at
risk of severe bleeding despite uncertainty as to their diagnostic
accuracy. We performed a systematic review and meta-analysis of studies
that evaluated the diagnostic accuracy of viscoelastometry, platelet
function tests, and modified thromboelastography (TEG) tests, for
coagulopathy in cardiac surgery patients. The reference standard included
resternotomy for bleeding, transfusion of non-red cell components, or
massive transfusion. We searched MEDLINE, EMBASE, CINAHL, and Clinical
Trials.gov, from inception to June 2019. Study quality was assessed using
QUADAS-2. Bivariate models were used to estimate summary sensitivity and
specificity with (95% confidence intervals). All 29 studies (7440
participants) included in the data synthesis evaluated the tests as
predictors of bleeding. No study evaluated their role in the management of
bleeding. None was at low risk of bias. Four were judged as low concern
regarding applicability. Pooled estimates of diagnostic accuracy were;
Viscoelastic tests, 12 studies, sensitivity 0.61 (0.44, 0.76), specificity
0.83 (0.70, 0.91) with significant heterogeneity. Platelet function tests,
12 studies, sensitivity 0.63 (0.53, 0.72), specificity 0.75 (0.64, 0.84)
with significant heterogeneity. TEG modification tests, 3 studies,
sensitivity 0.80 (0.67, 0.89), specificity 0.76 (0.69, 0.82) with no
evidence of heterogeneity. Studies reporting the highest values for
sensitivity and specificity had important methodological limitations. In
conclusion, we did not demonstrate predictive accuracy for commonly used
point-of-care devices for coagulopathic bleeding in cardiac surgery.
However, the certainty of the evidence was low.<br/>Copyright &#xa9; 2020

<127>
Accession Number
2007726724
Title
Near Infrared Spectroscopy in Anemia Detection and Management: A
Systematic Review.
Source
Transfusion Medicine Reviews. 35 (1) (pp 22-28), 2021. Date of
Publication: January 2021.
Author
Crispin P.; Forwood K.
Institution
(Crispin) John Curtin School of Medical Research, Australian National
University, Acton, ACT, Australia
(Crispin) Haematology Department, Canberra Hospital, Garran, ACT,
Australia
(Forwood) Haematology Department, Dunedin Hospital, Dunedin, New Zealand
Publisher
W.B. Saunders
Abstract
Red cell transfusions are intended to improve oxygen delivery to tissues.
Although studies comparing hemoglobin concentration triggers for
transfusion have been done, the hemoglobin threshold for clinical benefit
remains uncertain. Direct measurement of tissue oxygenation with
non-invasive near infrared spectroscopy has been proposed as a more
physiological transfusion trigger, but its clinical role remains unclear.
This systematic review examined the role of near infrared spectroscopy for
detection of anemia and guiding transfusion decisions. Abstracts were
identified up until May 2019 through searches of PubMed, EMBASE and The
Web of Science. There were 69 studies meeting the inclusion criteria, most
(n = 65) of which were observational studies. Tissue oxygen saturation had
been measured in a wide range of clinical settings, with neonatal
intensive care (n = 26) and trauma (n = 7) being most common. Correlations
with hemoglobin concentration and tissue oxygenation were noted and there
were correlations between changes in red cell mass and changes in tissue
oxygenation through blood loss or transfusion. The value of tissue
oxygenation for predicting transfusion was determined in only four
studies, all using muscle oxygen saturation in the adult trauma setting.
The overall sensitivity was low at 34% (27%-42%) and while it had better
specificity at 78% (74%-82%), differing and retrospective approaches
create a high level of uncertainty with respect to these conclusions.
There were four prospective randomized studies involving 540 patients, in
cardiac and neurological surgery and in neonates that compared near
infrared spectroscopy to guide transfusion decisions with standard
practice. These showed a reduction in the number of red cells transfused
per patient (OR: 0.44 [0.09-0.79]), but not the number of patients who
received transfusion (OR: 0.71 [0.46-1.10]), and no change in clinical
outcomes. Measuring tissue oxygen saturation has potential to help guide
transfusion; however, there is a lack of data upon which to recommend
widespread implementation into clinical practice. Standardization of
measurements is required and greater research into levels at which tissue
oxygenation may lead to adverse clinical outcomes would help in the design
of future clinical trials.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<128>
Accession Number
2007668844
Title
Effect of Preoperative Infusion of Levosimendan on Biomarkers of
Myocardial Injury and Haemodynamics After Paediatric Cardiac Surgery: A
Randomised Controlled Trial.
Source
Drugs in R and D. 21 (1) (pp 79-89), 2021. Date of Publication: March
2021.
Author
Abril-Molina A.; Gomez-Luque J.M.; Perin F.; Esteban-Molina M.;
Ferreiro-Marzal A.; Fernandez-Guerrero C.; Ocete-Hita E.
Institution
(Abril-Molina, Gomez-Luque, Ocete-Hita) Pediatric Intensive Care Unit,
Hospital Universitario Virgen de las Nieves, University of Granada,
Granada, Spain
(Perin) Paediatric Cardiology Unit, Hospital Universitario Virgen de las
Nieves, Granada, Spain
(Esteban-Molina, Ferreiro-Marzal) Paediatric Cardiac Surgery Unit,
Hospital Universitario Virgen de las Nieves, Granada, Spain
(Fernandez-Guerrero) Pediatric Anesthesia Unit, Hospital Universitario
Virgen de las Nieves, Granada, Spain
Publisher
Adis
Abstract
Objective: The aim was to test the hypothesis that preoperative infusion
of levosimendan would decrease patients' cardiac biomarker profiles during
the immediate postoperative stage (troponin I and B-type natriuretic
peptide levels) more efficiently than placebo after cardiopulmonary
bypass. <br/>Method(s): In a randomised, placebo-controlled,
double-blinded study, 30 paediatric patients were scheduled for congenital
heart disease surgery. 15 patients (50%) received prophylactic
levosimendan and 15 patients (50%) received placebo from 12 h before
cardiopulmonary bypass to 24 h after surgery. <br/>Result(s): Troponin I
levels were higher in the placebo group at 0, 12, and 24 h after
cardiopulmonary bypass, although the mean differences between the study
groups and the 95% confidence intervals (CIs) for troponin I levels did
not present statistically significant differences at any of the three time
points considered (mean differences [95% CIs] - 3.32 pg/ml [- 19.34 to
12.70], - 2.42 pg/ml [- 19.78 to 13.95], and - 79.94 pg/ml [- 266.99 to
16.39] at 0, 12, and 24 h, respectively). A similar lack of statistically
significant difference was observed for B-type natriuretic peptide (mean
differences [95% CIs] 36.86 pg/dl [- 134.16 to 225.64], - 350.79 pg/dl [-
1459.67 to 557.45], and - 310.35 pg/dl [- 1505.76 to 509.82]). Lactic acid
levels were significantly lower with levosimendan; the mean differences
between the study groups and the 95% CIs for lactate levels present
statistically significant differences at 0 h (- 1.52 mmol/l [- 3.19 to -
0.25]) and 12 h (- 1.20 mmol/l [- 2.53 to - 0.10]) after cardiopulmonary
bypass. Oxygen delivery (DO<inf>2</inf>) was significantly higher at 12 h
and 24 h after surgery (mean difference [95% CI] 627.70
ml/min/m² [122.34-1162.67] and 832.35 ml/min/m²
[58.15 to 1651.38], respectively). <br/>Conclusion(s): Levosimendan does
not significantly improve patients' postoperative troponin I and B-type
natriuretic peptide profiles during the immediate postoperative stage in
comparison with placebo, although both were numerically higher with
placebo. Levosimendan, however, significantly reduced lactic acid levels
and improved patients' DO<inf>2</inf> profiles. These results highlight
the importance of this new drug and its possible benefit with regard to
myocardial injury; however, evaluation in larger, adequately powered
trials is needed to determine the efficacy of levosimendan. Trial registry
number: EudraCT 2012-005310-19.<br/>Copyright &#xa9; 2020, The Author(s).

<129>
Accession Number
634237668
Title
Pharmacogenomics of the Efficacy and Safety of Colchicine in COLCOT.
Source
Circulation. Genomic and precision medicine. (no pagination), 2021. Date
of Publication: 09 Feb 2021.
Author
Dube M.-P.; Legault M.-A.; Lemacon A.; Lemieux Perreault L.-P.; Fouodjio
R.; Waters D.D.; Kouz S.; Pinto F.J.; Maggioni A.P.; Diaz R.; Berry C.;
Koenig W.; Lopez-Sendon J.; Gamra H.; Kiwan G.S.; Asselin G.; Provost S.;
Barhdadi A.; Sun M.; Cossette M.; Blondeau L.; Mongrain I.; Dubois A.;
Rhainds D.; Bouabdallaoui N.; Samuel M.; de Denus S.; L'Allier P.L.;
Guertin M.-C.; Roubille F.; Tardif J.-C.
Institution
(Dube, Lemacon, Sun) Montreal Heart Institute & Universite de Montreal
Beaulieu-Saucier Pharmacogenomics Centre & Universite de Montreal, Faculty
of Medicine, Department of Medicine, Universite de Montreal, Montreal,
Canada
(Legault) Montreal Heart Institute & Universite de Montreal
Beaulieu-Saucier Pharmacogenomics Centre & Universite de Montreal, Faculty
of Medicine, Department of Biochemistry and Molecular Medicine, Montreal,
Canada
(Lemieux Perreault, Fouodjio, Asselin, Provost, Barhdadi, Mongrain,
Dubois, de Denus) Montreal Heart Institute & Universite de Montreal
Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
(Waters) San Francisco General Hospital, San Francisco, CA
(Kouz) Centre Hospitalier Regional de Lanaudiere, Joliette, Canada
(Pinto) Santa Maria University Hospital (CHULN), CAML, CCUL, Faculdade de
Medicina da Universidade de Lisboa, Lisboa, Portugal
(Maggioni) Maria Cecilia Hospital, GVM Care & Research, Cotignola,
Ravenna, Italy
(Diaz) Estudios Clinicos Latinoamerica, Rosario, Argentina
(Berry) University of Glasgow & NHS Glasgow Clinical Research Facility,
Glasgow, United Kingdom
(Koenig) Deutsches Herzzentrum Munchen, Technische Universitat Munchen &
DZHK (German Centre for Cardiovascular Research), Munich & Institute of
Epidemiology and Medical Biometry, University of Ulm, partner site Munich
Heart Alliance, Ulm, Germany
(Lopez-Sendon) IdiPaz, UAM, Spain
(Gamra) Fattouma Bourguiba University Hospital, Monastir, Tunisia
(Kiwan) Cardiology, Bellevue Medical Center, Beirut, Lebanon
(Cossette, Blondeau, Guertin) Montreal Heart Institute & Montreal Health
Innovation Coordinating Centre, Montreal, Canada
(Rhainds, L'Allier) Montreal Heart Institute, Montreal, Canada
(Bouabdallaoui, Samuel, Tardif) Montreal Heart Institute & Universite de
Montreal, Faculty of Medicine, Department of Medicine, Montreal, Canada
(Roubille) PhyMedExp (Physiologie et Medecine Experimentale du Coeur et
des Muscles), Universite de Montpellier, INSERM, Centre National de la
Recherche Scientifique, Cardiology Department, CHU de Montpellier,
Montpellier, France
Publisher
NLM (Medline)
Abstract
Background - The randomized, placebo-controlled COLchicine Cardiovascular
Outcomes Trial (COLCOT) has shown the benefits of colchicine 0.5 mg daily
to lower the rate of ischemic cardiovascular events in patients with a
recent myocardial infarction. Here, we conducted a post-hoc
pharmacogenomic study of COLCOT with the aim to identify genetic
predictors of the efficacy and safety of treatment with colchicine.
Methods - There were 1522 participants of European descent from the COLCOT
trial available for the pharmacogenomic study of COLCOT trial. The
pharmacogenomic study's primary cardiovascular (CV) endpoint was defined
as for the main trial, as time to first occurrence of CV death,
resuscitated cardiac arrest, myocardial infarction, stroke or urgent
hospitalization for angina requiring coronary revascularization. The
safety endpoint was time to the first report of gastrointestinal events.
Patients' DNA was genotyped using the Illumina Global Screening array
followed by imputation. We performed a genome-wide association study
(GWAS) in colchicine-treated patients. Results - None of the genetic
variants passed the GWAS significance threshold for the primary CV
endpoint conducted in 702 patients in the colchicine arm who were
compliant to medication. The GWAS for gastrointestinal events was
conducted in all 767 patients in the colchicine arm and found two
significant association signals, one with lead variant rs6916345 (hazard
ratio (HR)=1.89, 95% confidence interval (CI) 1.52-2.35, P=7.41x10-9) in a
locus which colocalizes with Crohn's disease, and one with lead variant
rs74795203 (HR= 2.51, 95% CI 1.82-3.47; P=2.70x10-8), an intronic variant
in gene SEPHS1. The interaction terms between the genetic variants and
treatment with colchicine versus placebo were significant. Conclusions -
We found two genomic regions associated with gastrointestinal events in
patients treated with colchicine. Those findings will benefit from
replication to confirm that some patients may have genetic predispositions
to lower tolerability of treatment with colchicine.

<130>
Accession Number
634418410
Title
Acupoint Catgut Embedding Reduces Insulin Resistance in Diabetic Patients
Undergoing Open Cardiac Surgery.
Source
The heart surgery forum. 24 (1) (pp E060-E064), 2021. Date of Publication:
20 Jan 2021.
Author
Zhang Y.; Gong H.; Zhan B.; Chen S.
Institution
(Zhang, Chen) Department of Anesthesiology, First Affiliated Hospital of
Nanchang University
(Gong) Department of Anesthesiology, First Affiliated Hospital of Nanchang
University.
(Zhan) Department of Cardiology, Second Affiliated Hospital of Nanchang
University
Publisher
NLM (Medline)
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. <br/>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. <br/>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. <br/>CONCLUSION(S): ACE can improve insulin
resistance and promote rapid recovery after open cardiac surgery.

<131>
Accession Number
634417182
Title
Comparison of Transcatheter Mitral-Valve Repair and Surgical Mitral-Valve
Repair in Elderly Patients with Mitral Regurgitation.
Source
The heart surgery forum. 24 (1) (pp E108-E115), 2021. Date of Publication:
15 Feb 2021.
Author
Yuan H.; Wei T.; Wu Z.; Lu T.; Chen J.; Zeng Y.; Tan L.; Huang C.
Institution
(Yuan, Lu, Chen, Zeng, Tan, Huang) Department of Cardiovascular Surgery,
Second Xiangya Hospital, Central South University, Changsha, Hunan, China
(Wei) Department of Pediatrics, Hunan Provincial Maternal and Child Health
Care Hospital, Hunan, China
(Wu) Engineering Laboratory of Hunan Province for Cardiovascular
Biomaterials, Hunan, China
Publisher
NLM (Medline)
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. <br/>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. <br/>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.
<br/>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.

<132>
Accession Number
634417123
Title
Predictors of Prosthetic Valve Endocarditis following Transcatheter Aortic
Valve Replacement: A Meta-Analysis.
Source
The heart surgery forum. 24 (1) (pp E101-E107), 2021. Date of Publication:
10 Feb 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, Yim, Wang, Hu) Department of Cardiovascular Surgery, Union Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
(Xie) Department of Cardiovascular Surgery, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
Publisher
NLM (Medline)
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. <br/>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. <br/>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. <br/>CONCLUSION(S): Clinical
characteristics and peri- procedure 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.

<133>
Accession Number
634416552
Title
Efficacy of Histidine-Tryptophan-Ketoglutarate Solution Versus Blood
Cardioplegia in Cardiac Surgical Procedures: A Randomized Controlled ,
Parallel Group Study.
Source
The heart surgery forum. 24 (1) (pp E170-E176), 2021. Date of Publication:
17 Feb 2021.
Author
Ali I.; Hassan A.; Shokri H.; Khorshed R.
Institution
(Ali, Hassan, Khorshed) 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
NLM (Medline)
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. <br/>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. <br/>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. <br/>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.

<134>
Accession Number
634430105
Title
Low level laser therapy to prevented wound complication after cardiac
surgery.
Source
Journal of the Dermatology Nurses' Association. Conference: 24th World
Congress of Dermatology. Italy. 12 (2) (no pagination), 2020. Date of
Publication: March-April 2020.
Author
Baptista I.
Institution
(Baptista) University of The Paraiba Valley, Nursing, Sao Jose Dos Campos,
Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
Wound dehiscence and infection prevails in individuals who have
cardiovascular risk factors, allied with surgery risk factors such as:
time of surgery, extracorporeal circulation (CEC) and hemostats
mechanisms, thus can increase morbidity after cardiac surgery. Therefore,
we are looking forward to prevent it applying Low Level Laser Therapy
(LLLT). We analyze forty patients after cardiac surgery by sternotomy
divided into two groups: Control Group - submitted to conventional
therapeutic Hospital scheme and Laser Group - submitted to Diode Laser
irradiation with lambda= 655nm, Dose= 8J/cm2, under preventive form
surround the surgery wound and starting Immediately Post-Operative (IPO)
and 2 more time, according hospital protocol guidelines. The risk factors
related to wound dehiscence in our sample were: caucasian ethnic group
with p-value = 0.048; increased triglycerides with p-value = 0.08;
overweight (IMC average = 29.6 k/m2) with p-value = 0.004. Control Group
14 (35,0%) patients CEC, and 10 (25,0%) patients blood transfusion. In
Laser Group 14 (35,0%) patients were on CEC, and 7 (17,5%) blood
transfusion. Our clinical trial showed that 1 (5,0%) patient presented
wound dehiscence, five times less incidence than Control Group, in which 5
patients (25,0%) presented wound dehiscence and infection (p-value =
0.077). The Laser Group presented huge pain relief, since the first days
after the procedure, especially, when compared with the other group. The
Control Group stayed in hospital twice longer than Laser Group
(p-value=0.015). We can affirm that Low Level Laser Therapy provides an
efficient, secure and a less invasive procedure, which can prevent
dehiscence in sternotomy wound treatment, especially regarding the
disease's natural history of such patients, with cost-effectiveness for
patients as well as for medical institutions involved.

<135>
Accession Number
634418356
Title
Comparison of coronary artery bypass graft versus drug-eluting stents in
dialysis patients: an updated systemic review and meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). 22 (4) (pp 285-296),
2021. Date of Publication: 01 Apr 2021.
Author
Prasitlumkum N.; Cheungpasitporn W.; Sato R.; Thangjui S.; Thongprayoon
C.; Kewcharoen J.; Bathini T.; Vallabhajosyula S.; Ratanapo S.;
Chokesuwattanaskul R.
Institution
(Prasitlumkum) Department of Cardiology, University of California
Riverside, Riverside, CA, United States
(Cheungpasitporn) Department of Internal Medicine, University of
Mississippi Medical Center, Jackson, MS, United States
(Sato) Department of Critical Care Medicine, Respiratory Institute,
Cleveland Clinic, OH, United States
(Thangjui) Department of Internal Medicine, Basset Healthcare Network,
Cooperstown, NY, United States
(Thongprayoon) Department of Medicine, Mayo Clinic, Rochester, MN
(Kewcharoen) Department of Medicine, University of Hawaii, Honolulu, HI,
United States
(Bathini) Department of Internal Medicine, University of Arizona, Tucson,
AZ, United States
(Vallabhajosyula) Section of Interventional Cardiology, Division of
Cardiovascular Medicine, Department of Medicine, Emory University School
of Medicine, Atlanta, United States
(Ratanapo) Department of Cardiovascular Medicine, Phramongkutklao Hospital
(Chokesuwattanaskul) Faculty of Medicine, King Chulalongkorn Memorial
Hospital, Chulalongkorn University, Bangkok, Thailand
Publisher
NLM (Medline)
Abstract
INTRODUCTION: As percutaneous coronary intervention (PCI) technologies
have been far improved, we hence conducted an updated systemic review and
meta-analysis to determine the comparability between coronary artery
bypass graft (CABG) and PCI with drug-eluting stent (DES) in ESRD
patients. <br/>METHOD(S): We comprehensively searched the databases of
MEDLINE, EMBASE, PUBMED and the Cochrane from inception to January 2020.
Included studies were published observational studies that compared the
risk of cardiovascular outcomes among dialysis patients with CABG and DES.
Data from each study were combined using the random-effects, generic
inverse variance method of DerSimonian and Laird to calculate risk ratios
and 95% confidence intervals. Subgroup analyses and meta-regression were
performed to explore heterogeneity. <br/>RESULT(S): Thirteen studies were
included in this analysis, involving total 56 422 (CABG 21 740 and PCI 34
682). Compared with DES, our study demonstrated CABG had higher 30-day
mortality [odds ratio (OR) 3.85, P = 0.009] but lower cardiac mortality
(OR 0.78, P < 0.001), myocardial infarction (OR 0.5, P < 0.001) and repeat
revascularization (OR 0.35, P < 0.001). No statistical differences were
found between CABG and DES for long-term mortality (OR 0.92, P = 0.055),
composite outcomes (OR 0.88, P = 0.112) and stroke (OR 1.49, P = 0.457).
Meta-regression suggested diabetes and the presence of left main coronary
artery disease as an effect modifier of long-term mortality.
<br/>CONCLUSION(S): PCI with DES shared similar long-term mortality,
composite outcomes and stroke outcomes to CABG among dialysis patients but
still was associated with an improved 30-day survival. However, CABG had
better rates of myocardial infarction, repeat revascularization and
cardiac mortality.<br/>Copyright &#xa9; 2021 Italian Federation of
Cardiology - I.F.C. All rights reserved.

<136>
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. <br/>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). <br/>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. <br/>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.<br/>Copyright &#xa9; 2021, The Author(s).

<137>
Accession Number
634419039
Title
Inhibition of Platelet Aggregation After Coronary Stenting in Patients
Receiving Oral Anticoagulation.
Source
Deutsches Arzteblatt international. 118 (Forthcoming) (no pagination),
2021. Date of Publication: 04 Jun 2021.
Author
Genz C.; Braun-Dullaeus R.C.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Approximately 18% of patients with atrial fibrillation undergo
a percutaneous coronary intervention (PCI) to treat coronary heart
disease. Pharmacological anticoagulation in patients with atrial
fibrillation and PCI involves a trade-off of potential ischemic and
hemorrhagic complications. <br/>METHOD(S): This review is based on
pertinent publications that were retrieved by a selective literature
search, including current guidelines and recommendations. <br/>RESULT(S):
Dual antiplatelet therapy (DAPT) with acetylsalicylic acid (ASA) and a
P2Y12 inhibitor protects against stent thrombosis, but not against
thromboembolic stroke. In contrast, oral anticoagulation does provide
effective prevention against stroke during atrial fibrillation. Combining
DAPT with oral anticoagulation (triple therapy) over the long term, as has
been recommended to date, carries an elevated risk of hemorrhage. In a
randomized controlled trial, 44% of patients with atrial fibrillation
receiving triple therapy sustained a hemorrhagic event, compared to 19.4%
of patients receiving dual therapy. A meta-analysis has shown that
clinically relevant hemorrhage is less common under combined treatment
with one of the new oral anticoagulants (NOAC) and a single antiplatelet
drug than under triple therapy including a vitamin K antagonist (hazard
ratio, 0.56; 95% confidence interval 0.39; 0.80]), but no significant
difference was found with respect to stent thrombosis, myocardial
infarction, or overall mortality. <br/>CONCLUSION(S): After coronary stent
implantation, dual therapy with a NOAC and a P2Y12 inhibitor is
recommended, subsequent to triple therapy given only during the
peri-interventional period.