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<1>
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Accession Number
2010486310
Title
Postoperative delirium after coronary artery bypass graft surgery:
Dexmedetomidine infusion alone or with the addition of oral melatonin.
Source
Egyptian Journal of Anaesthesia. 37 (1) (pp 62-68), 2021. Date of
Publication: 2021.
Author
Mahrose R.; ElSerwi H.; Maurice A.; Elsersi M.
Institution
(Mahrose, ElSerwi, Maurice, Elsersi) Department of Anesthesiology,
Intensive Care and Pain Management, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Postoperative delirium is a common complication of cardiac
surgery. This study aimed to assess the effect of supplementing
dexmedetomidine infusion with oral melatonin in prevention of
postoperative delirium after coronary artery bypass graft surgery.
 Method(s): 110 patients of both sexes above 60 years of age were
included. Anesthetic management was standardized. Patients were randomly
allocated into one of the two study groups, dexmedetomidine/melatonin (DM)
group or dexmedetomidine (D) group. Patients in the DM group received oral
Melatonin tablet 5 mg the night before surgery and same dose was repeated
every 24 hours for 3 postoperative days. After completion of surgery and
upon ICU arrival, patients in both groups received a bolus of 0.4
microg/kg dexmedetomidine followed by 0.2-0.7 microg/kg/h infusion, for 24
maximum hours. Delirium was assessed for 5 days postoperatively at 12 hr
intervals using confusion assessment method (CAM) for ICU and after
discharge from ICU to surgical ward using CAM. Delirious patients were
treated with IV haloperidol. Result(s): No significant differences
between studied groups regarding baseline, preoperative, intraoperative
and postoperative characteristics. Incidence of delirium was significantly
lower, onset significantly more delayed, and duration was significantly
shorter in group-DM as compared to group-D. No significant differences
between all cases, cases who had delirium, and cases who did not have
delirium in the two groups as regards extubation time, ICU stay, and
hospital stay. Conclusion(s): supplementing dexmedetomidine with
melatonin decreases incidence, delays onset, and shortens duration of
postoperative delirium in patients above 60 years of age undergoing CABG
surgery. Copyright © 2021 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<2>
Accession Number
2011131007
Title
Incidence, predictors, and outcomes associated with acute kidney injury in
patients undergoing transcatheter aortic valve replacement: from the
BRAVO-3 randomized trial.
Source
Clinical Research in Cardiology. 110 (5) (pp 649-657), 2021. Date of
Publication: May 2021.
Author
Chandrasekhar J.; Sartori S.; Mehran R.; Aquino M.; Vogel B.; Asgar A.W.;
Webb J.G.; Tchetche D.; Dumonteil N.; Colombo A.; Windecker S.; Claessen
B.E.; ten Berg J.M.; Hildick-Smith D.; Wijngaard P.; Lefevre T.;
Deliargyris E.N.; Hengstenberg C.; Anthopoulos P.; Dangas G.D.
Institution
(Chandrasekhar, Sartori, Mehran, Aquino, Vogel, Claessen, Dangas) The Zena
and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine
at Mount Sinai, New York, United States
(Chandrasekhar) Department of Cardiology, Box Hill Hospital, Eastern
Health Clinical School, Monash University, Melbourne, Australia
(Mehran, Dangas) Mount Sinai Medical Center, One Gustave L. Levy Place,
Box 1030, New York, NY 10029, United States
(Asgar) Institut de Cardiologie de Montreal, Montreal, Canada
(Webb) St. Paul's Hospital, Vancouver, Canada
(Tchetche, Dumonteil) Clinic Pasteur of Toulouse, Toulouse, France
(Colombo) San Raffaele Hospital of Milan (IRCCS), Milan, Italy
(Windecker) Bern University Hospital, Bern, Switzerland
(ten Berg) St. Antonius Ziekenhuis, Nieuwegein, Netherlands
(Hildick-Smith) Sussex Cardiac Centre, Brighton, United Kingdom
(Wijngaard, Anthopoulos) The Medicines Company, Zurich, Switzerland
(Lefevre) Hopital Prive Jacques Cartier, Massy, France
(Deliargyris) The Medicines Company, Parsippany, NJ, United States
(Hengstenberg) Munich Heart Alliance, Munich, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Acute kidney injury (AKI) is not uncommon in patients
undergoing transcatheter aortic valve replacement (TAVR).
 Objective(s): We examined the incidence, predictors, and outcomes of
AKI from the BRAVO 3 randomized trial. Method(s): The BRAVO-3 trial
included 802 patients undergoing transfemoral TAVR randomized to
bivalirudin vs. unfractionated heparin (UFH). The primary endpoint of the
trial was Bleeding Academic Research Consortium (BARC) type >= 3b bleeding
at 48 h. Total follow-up was to 30 days. AKI was adjudicated using the
modified RIFLE (Valve Academic Research Consortium, VARC 1) criteria
through 30-day follow-up, and in a sensitivity analysis AKI was assessed
at 7 days (modified VARC-2 criteria). We examined the incidence,
predictors, and 30-day outcomes associated with diagnosis of AKI. We also
examined the effect of procedural anticoagulant (bivalirudin or
unfractionated heparin, UFH) on AKI within 48 h after TAVR.
 Result(s): The trial population had a mean age of 82.3 +/- 6.5 years
including 48.8% women with mean EuroScore I 17.05 +/- 10.3%. AKI occurred
in 17.0% during 30-day follow-up and was associated with greater adjusted
risk of 30-day death (13.0% vs. 3.5%, OR 5.84, 95% CI 2.62-12.99) and a
trend for more BARC >= 3b bleeding (15.1% vs. 8.6%, OR 1.80, 95% CI
0.99-3.25). Predictors of 30-day AKI were baseline hemoglobin, body
weight, and pre-existing coronary disease. AKI occurred in 10.7% at 7 days
and was associated with significantly greater risk of 30-day death (OR
6.99, 95% CI 2.85-17.15). Independent predictors of AKI within 7 days
included pre-existing coronary or cerebrovascular disease, chronic kidney
disease (CKD), and transfusion which increased risk, whereas post-dilation
was protective. The incidence of 48-h AKI was higher with bivalirudin
compared to UFH in the intention to treat cohort (10.9% vs. 6.5%, p =
0.03), but not in the per-protocol assessment (10.7% vs. 7.1%, p = 0.08).
 Conclusion(s): In the BRAVO 3 trial, AKI occurred in 17% at 30 days
and in 10.7% at 7 days. AKI was associated with a significantly greater
adjusted risk for 30-day death. Multivariate predictors of AKI at 30 days
included baseline hemoglobin, body weight, and prior coronary artery
disease, and predictors at 7 days included pre-existing vascular disease,
CKD, transfusion, and valve post-dilation. Bivalirudin was associated with
greater AKI within 48 h in the intention to treat but not in the
per-protocol analysis. Graphic abstract: [Figure not available: see
fulltext.] Copyright © 2021, Springer-Verlag GmbH Germany, part
of Springer Nature.

<3>
Accession Number
2007495769
Title
Short-term and long-term outcomes of revascularization interventions for
patients with severely reduced left ventricular ejection fraction: a
meta-analysis.
Source
ESC Heart Failure. 8 (1) (pp 634-643), 2021. Date of Publication: February
2021.
Author
Pei J.; Wang X.; Xing Z.; Zheng K.; Hu X.
Institution
(Pei, Wang, Xing, Hu) Department of Cardiovascular Medicine, The Second
Xiangya Hospital, Central South University, 139 Middle Renmin Road,
Changsha, Hunan 410011, China
(Xing) Department of Emergency Medicine, Second Xiangya Hospital, Central
South University, Changsha, China
(Zheng) Department of Cardiovascular Medicine, Beijing Anzhen Hospital,
Capital Medical University, Beijing, China
Publisher
Wiley-Blackwell
Abstract
Aims: This meta-analysis aimed to determine whether coronary artery bypass
grafting (CABG) or percutaneous coronary intervention (PCI) should be
preferred in patients with severely reduced left ventricular (LV) ejection
fraction. Methods and Results: We searched the PubMed, EMBASE, and
Cochrane Library databases from the conception of the databases till 1 May
2020 for studies on patients with severely reduced LV ejection fraction
undergoing CABG and PCI. The primary clinical endpoints were 30 day and
long-term mortalities. The secondary endpoints were 30 day and long-term
incidences of myocardial infarction (MI) and stroke, long-term
cardiovascular mortality, and repeat revascularization. Eighteen studies
involving 11 686 patients were analysed. Compared with PCI, CABG had lower
long-term mortality [hazard ratio (HR): 0.70, 95% confidence interval
(CI): 0.61-0.80, P < 0.01], cardiovascular mortality (HR: 0.60, 95% CI:
0.43-0.85, P < 0.01), MI (HR: 0.51, 95% CI: 0.36-0.72, P < 0.01), and
repeat revascularization (HR: 0.32, 95% CI: 0.23-0.47, P < 0.01) risk.
Significant differences were not observed for long-term stroke (HR: 1.18,
95% CI: 0.74-1.87, P = 0.49), 30 day mortality (HR: 1.18, 95% CI:
0.89-1.56, P = 0.25), and MI (HR: 0.42, 95% CI: 0.16-1.11, P = 0.08) risk.
CABG was associated with a higher risk of stroke within 30 days (HR: 2.88,
95% CI: 1.07-7.77, P = 0.04). In a subgroup analysis of propensity
score-matched studies, CABG was associated with a higher long-term risk of
stroke (HR: 1.61, 95% CI: 1.20-2.16, P < 0.01). Conclusion(s): Among
patients with severely reduced LV ejection fraction, CABG resulted in a
lower mortality rate and an increased risk of stroke. Copyright ©
2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on
behalf of European Society of Cardiology

<4>
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Accession Number
635024401
Title
Longitudinal course of depressive, anxiety, and posttraumatic stress
disorder symptoms after heart surgery: A meta-analysis of 94 studies.
Source
Psychosomatic Medicine. 83 (1) (pp 85-93), 2021. Date of Publication:
2021.
Author
Rosson S.; Monaco F.; Miola A.; Cascino G.; Stubbs B.; Correll C.U.; Firth
J.; Ermis C.; Perrotti A.; Marciello F.; Carvalho A.F.; Brunoni A.R.;
Fusar-Poli P.; Fornaro M.; Gentile G.; Granziol U.; Pigato G.; Favaro A.;
Solmi M.
Institution
(Rosson, Miola, Gentile, Favaro, Solmi) Neurosciences Department,
University of Padua, Padua, Italy
(Monaco) Department OfMental Health, Residential Eating Disorder Unit
"mariconda", Asl Salerno, Italy
(Cascino, Marciello) Department OfMedicine, Surgery and Dentistry "scuola
Medica Salernitana", Section of Neurosciences, University of Salerno,
Salerno, Italy
(Stubbs) Physiotherapy Department, South London and Maudsley National
Health Services Foundation Trust, King's College London, London, United
Kingdom
(Stubbs) Department of Psychological Medicine, Institute of Psychiatry
Psychology and Neuroscience, King's College London, London, United Kingdom
(Correll) Department of Psychiatry, The ZuckerHillside Hospital, Northwell
Health, Glen Oaks, NY, United States
(Correll) Department of Psychiatry and Molecular Medicine, Zucker School
OfMedicine at Hofstra/Northwell, Hempstead, NY, United States
(Correll) The Feinstein Institute ForMedical Research, Center for
Psychiatric Neuroscience, Manhasset, NY, United States
(Correll) Department of Child and Adolescent Psychiatry, Charite
Universitatsmedizin Berlin, Berlin, Germany
(Firth) Division of Psychology AndMentalHealth, Faculty of Biology
Medicine and Health, University OfManchester, Manchester, United Kingdom
(Firth) Nicm Health Research Institute, School of Science and Health,
University of Western Sydney, Sydney, Australia
(Firth) Centre for Youth Mental Health, University of Melbourne,
Melbourne, Australia
(Ermis) Department of Child and Adolescent Psychiatry, Dokuz Eylul
University, Izmir, Turkey
(Perrotti) Cardio-Thoracic Surgery Department, University Hospital Jean
Minjoz, Besancon, France
(Perrotti) Ea 3920, University of Franche-Comte, Besancon, France
(Carvalho) Centre for Addiction AndMentalHealth (CAMH), University of
Toronto, Toronto, ON, Canada
(Carvalho) Department of Psychiatry, University of Toronto, Toronto, ON,
Canada
(Brunoni) Department of Psychiatry and Psychotherapy, University Hospital,
Lmu Munich, Munich, Germany
(Brunoni) Service of Interdisciplinary Neuromodulation, Department of
Psychiatry, Laboratory of Neurosciences (LIM-27), National Institute of
Biomarkers in Neuropsychiatry (INBioN), Institute of Psychiatry,
University of Sao Paulo, Sao Paulo, Brazil
(Brunoni) Hospital Universitario, Departamento de Clinica Medica,
Faculdade de Medicina da Usp, Sao Paulo, Brazil
(Fusar-Poli, Solmi) Early Psychosis: Interventions and Clinical-detection
(EPIC) Laboratory, Department of Psychosis Studies, Institute of
Psychiatry, Psychology and Neuroscience, King's College London, London,
United Kingdom
(Fusar-Poli) Oasis Service, South London and Maudsley Nhs Foundation
Trust, London, United Kingdom
(Fusar-Poli) Department of Brain and Behavioral Sciences, University of
Pavia, Pavia, Italy
(Fusar-Poli) National Institute ForHealth Research, Maudsley Biomedical
Research Centre, South London and Maudsley Nhs Foundation Trust, London,
United Kingdom
(Fornaro) Neuroscience, Reproductive Science and Odontostolmatology,
Section of Psychiatry, University School of Medicine Federico Ii, Naples,
Italy
(Favaro, Solmi) Neuroscience Centre, University of Padua, Padua, Italy
(Granziol) Department of General Psychology, University of Padua, Padua,
Italy
(Pigato) Psychiatry Unit, Padua University Hospital, Padua, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: This study aimed to analyze the longitudinal course of
depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms in
patients with cardiac disease after heart surgery (HS). Method(s): We
conducted a systematic review and random-effects meta-analysis of cohort
studies in patients undergoing HS, measuring anxiety, depressive, and PTSD
symptoms before and at least 30 days thereafter. Subgroup and
meta-regression analyses, investigation of publication bias, and quality
assessment were undertaken. Result(s):We included 94 studies relating
to 15,561 patients. HS included coronary artery bypass graft surgery,
valve replacement, implantable cardioverter-defibrillator placement, left
ventricular assist device placement, heart transplantation, and other
types of HS. Across studies, symptoms of depression (g = 0.32; 95%
confidence interval [CI] = 0.25 to 0.39; p < .001) and anxiety improved
after HS (g = 0.52; 95% CI = 0.43 to 0.62; p < .001), whereas PTSD
symptoms worsened (g = -0.42; 95% CI = -0.80 to -0.04; p = .032). The
reduction of depression and anxiety levels was more pronounced for
patients with underlying coronary artery disease and heart failure and
persisted for 1 year after HS, whereas the increase in PTSD symptoms
returned to baseline after 6 months. Depression improvement was inversely
associated with older age, diabetes, hypertension, and dyslipidemia and
positively with baseline heart failure. No additional clinical or
demographic variables were associated with the course of anxiety symptoms.
Quality of included studies was low overall. Publication bias was
nonsignificant. Conclusion(s): Depressive and anxiety symptoms
improve for 1 year after HS, whereas PTSD symptoms might worsen. Older
patients and those withmetabolic comorbidities, valve disease, or
ventricular arrhythmias are at higher risk for continued depressive and
anxiety symptoms and should be monitored closely. Copyright ©
2021 Lippincott Williams and Wilkins. All rights reserved.

<5>
Accession Number
635009948
Title
Hypertension and Atrial Fibrillation: A Study on Epidemiology and
Mendelian Randomization Causality.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 644405. Date of Publication: 23 Mar 2021.
Author
Liao L.-Z.; Wen X.-Y.; Zhang S.-Z.; Li W.-D.; Zhuang X.-D.
Institution
(Liao, Wen, Li) Guangzhou Higher Education Mega Center, Guangdong
Pharmaceutical University, Guangzhou, China
(Liao, Wen, Li) Guangdong Engineering Research Center for Light and
Health, Guangzhou Higher Education Mega Center, Guangzhou, China
(Liao, Wen, Li) Guangdong Key Laboratory of Pharmaceutical Bioactive
Substances, Guangdong Pharmaceutical University, Guangzhou, China
(Zhang, Zhuang) The First Affiliated Hospital of Sun Yat-sen University,
Guangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Introduction: Hypertension (HT) and atrial fibrillation (AF) often
coexist. However, the causality between these two conditions remains to be
determined. Method(s): We used individual participant data from the
Atherosclerosis Risk in Communities (ARIC) prospective cohort with 9,474
participants. HT was ascertained at visit 1 (1987-1989), and incident AF
was identified by ECGs conducted during study examinations at each visit,
hospital discharge codes, and death certificates. We used the Kaplan-Meier
estimate to compute the cumulative incidence of AF by the HT subgroup.
Then we used Cox hazard regression model to assess the association between
HT and incident AF. The causality between genetically determined HT and AF
was analyzed by the two-sample Mendelian randomization (MR) based on
publicly summarized genome-wide association studies (GWASs) data.
 Result(s): A total of 1,414 cases (14.9%) of AF were identified
during the follow-up period (median 24.1 years). After adjusting for all
covariates, the hazard ratio between the participants with HT and incident
AF was 1.50 [95% confidence interval (CI) 1.29-1.73]. In the HT -> AF MR
analysis, we detected a causal correlation between HT and AF (OR: 1.90,
95% CI 1.18-3.04, P = 0.01) with no evidence of heterogeneity from
single-nucleotide polymorphisms. Besides, the genetically determined SBP
and DBP (10 mmHg) were consistently associated with a higher risk of AF.
 Conclusion(s): In the ARIC study, the incident AF increased by 50% in
patients with HT. In the MR analysis, our results supported causal
inference between HT and AF. © Copyright © 2021 Liao, Wen,
Zhang, Li and Zhuang.

<6>
Accession Number
2008453611
Title
Effect of volatile anesthetics on mortality and clinical outcomes in
patients undergoing coronary artery bypass grafting: A meta-analysis of
randomized clinical trials.
Source
Minerva Anestesiologica. 86 (10) (pp 1065-1078), 2020. Date of
Publication: October 2020.
Author
Zhang Y.-N.; Yang L.; Zhang W.-S.; Liu J.
Institution
(Zhang, Yang, Zhang, Liu) Department of Anesthesiology, West China
Hospital, Sichuan University, Chengdu, China
(Zhang, Zhang, Liu) Laboratory of Anesthesia and Critical Care Medicine,
Translational Neuroscience Center, West China Hospital, Sichuan
University, Chengdu, China
(Zhang) Department of Anesthesiology, Affiliated Hospital of Zunyi Medical
University, Zunyi, China
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: It remains unclear whether intraoperative use of volatile
anesthetics has a positive effect on postoperative clinical outcomes in
patients undergoing coronary artery bypass grafting (CABG). Therefore, we
aimed to systematically analyze the long- and short-term mortality rates
and the clinical outcomes of volatile anesthesia compared to those of
total intravenous anesthesia (TIVA) in patients undergoing CABG. EVIDENCE
ACQUISITION: We queried the MEDLINE, Embase, and CENTRAL databases from
inception to October 2019 for relevant randomized clinical trials (RCTs)
on the intraoperative use of volatile anesthetics in patients undergoing
CABG. EVIDENCE SYNTHESIS: We pooled and analyzed 36 eligible RCTs with
10,308 patients and found that there was no significant difference in the
long- and short-term mortality rate between the use of volatile anesthesia
and TIVA during CABG. 30-day mortality, volatile group (39/2,824, 1.4%)
vs. TIVA group (35/2,786, 1.3%), RR=1.11, 95% CI [0.70, 1.74], P value for
effect =0.66, I2=0%, moderate-certainty evidence; One-year
mortality, volatile group (77/2,749, 2.8%) vs. TIVA group (78/2,731,
2.9%), RR=0.98, 95% CI [0.72, 1.34], P value for effect =0.90,
I2=0%, moderate-certainty evidence. Mechanical ventilation time
was reduced in volatile group (MD -0.65, 95% CI [-1.07, -0.24], P value
for effect =0.002, I2=26%). CONCLUSION(S): There is no
difference in the long- and short-term mortality and clinical outcomes
between intraoperative use of volatile anesthetics and TIVA during CABG.
However, volatile anesthetics may shorten the mechanical ventilation time.
There is a need for high-quality multicenter RCTs that specifically assess
factors that influence mortality and clinical outcomes. Copyright
© 2020 EDIZIONI MINERVA MEDICA.

<7>
Accession Number
623207069
Title
Effect of aspirin in vascular surgery in patients from a randomized
clinical trial (POISE-2).
Source
British Journal of Surgery. 105 (12) (pp 1591-1597), 2018. Date of
Publication: November 2018.
Author
Biccard B.M.; Sigamani A.; Chan M.T.V.; Sessler D.I.; Kurz A.; Tittley
J.G.; Rapanos T.; Harlock J.; Szalay D.; Tiboni M.E.; Popova E.; Vasquez
S.M.; Kabon B.; Amir M.; Mrkobrada M.; Mehra B.R.; El Beheiry H.; Mata E.;
Tena B.; Sabate S.; Zainal Abidin M.K.; Shah V.R.; Balasubramanian K.;
Devereaux P.J.
Institution
(Biccard) Department of Anaesthesia and Perioperative Medicine, Groote
Schuur Hospital and University of Cape Town, Cape Town, South Africa
(Sigamani) Narayana Hrudayalaya Limited, Bangalore, India
(Mehra) Mahatma Gandhi Institute of Medical Sciences, Sevagram, India
(Shah) Viroc Hospital, Vadodara, India
(Chan) Department of Anaesthetics, Chinese University of Hong Kong, Hong
Kong
(Sessler) Department of Outcomes Research, Cleveland Clinic, Cleveland,
OH, United States
(Kurz) Department of General Anesthesiology, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
(Tittley, Rapanos, Harlock, Szalay) Division of Vascular Surgery, McMaster
University, Hamilton, ON, Canada
(Tiboni) Department of Medicine, McMaster University, Hamilton, ON, Canada
(Balasubramanian, Devereaux) Population Health Research Institute,
Hamilton, ON, Canada
(Mrkobrada) Department of Medicine, Schulich School of Medicine and
Dentistry, Western University, London, ON, Canada
(El Beheiry) University of Toronto, Trillium Health Partners, Toronto, ON,
Canada
(Popova) Biomedical Research Institute (IIB - Sant Pau), Barcelona, Spain
(Tena) Department of Anaesthesiology, Hospital Clinic, Barcelona, Spain
(Sabate) Department of Anaesthesiology, Fundacio Puigvert (IUNA),
Barcelona, Spain
(Mata) Hospital Universitario La Princesa, Madrid, Spain
(Vasquez) Grupo de Cardiologia Preventiva Universidad Autonoma de
Bucaramanga, Bucaramanga, Colombia
(Kabon) Department of Anaesthesiology, Medical University of Vienna,
Vienna, Austria
(Amir) Department of Surgery, Shifa International Hospital/Shifa
Tameer-e-Millat University, Islamabad, Pakistan
(Zainal Abidin) Department of Anaesthesiology and Intensive Care, Sarawak
General Hospital, Kuching, Sarawak, Malaysia
Publisher
John Wiley and Sons Ltd
Abstract
Background: In the POISE-2 (PeriOperative ISchemic Evaluation 2) trial,
perioperative aspirin did not reduce cardiovascular events, but increased
major bleeding. There remains uncertainty regarding the effect of
perioperative aspirin in patients undergoing vascular surgery. The aim of
this substudy was to determine whether there is a subgroup effect of
initiating or continuing aspirin in patients undergoing vascular surgery.
 Method(s): POISE-2 was a blinded, randomized trial of patients having
non-cardiac surgery. Patients were assigned to perioperative aspirin or
placebo. The primary outcome was a composite of death or myocardial
infarction at 30 days. Secondary outcomes included: vascular occlusive
complications (a composite of amputation and peripheral arterial
thrombosis) and major or life-threatening bleeding. Result(s): Of 10
010 patients in POISE-2, 603 underwent vascular surgery, 319 in the
continuation and 284 in the initiation stratum. Some 272 patients had
vascular surgery for occlusive disease and 265 had aneurysm surgery. The
primary outcome occurred in 13.7 per cent of patients having aneurysm
repair allocated to aspirin and 9.0 per cent who had placebo (hazard ratio
(HR) 1.48, 95 per cent c.i. 0.71 to 3.09). Among patients who had surgery
for occlusive vascular disease, 15.8 per cent allocated to aspirin and
13.6 per cent on placebo had the primary outcome (HR 1.16, 0.62 to 2.17).
There was no interaction with the primary outcome for type of surgery (P =
0.294) or aspirin stratum (P = 0.623). There was no interaction for
vascular occlusive complications (P = 0.413) or bleeding (P = 0.900) for
vascular compared with non-vascular surgery. Conclusion(s): This
study suggests that the overall POISE-2 results apply to vascular surgery.
Perioperative withdrawal of chronic aspirin therapy did not increase
cardiovascular or vascular occlusive complications. Registration number:
NCT01082874 (http://www.clinicaltrials.gov). Copyright © 2018 BJS
Society Ltd Published by John Wiley & Sons Ltd

<8>
Accession Number
2010857046
Title
Invasive therapy versus conservative therapy for patients with stable
coronary artery disease: An updated meta-analysis.
Source
Clinical Cardiology. 44 (5) (pp 675-682), 2021. Date of Publication: May
2021.
Author
Vij A.; Kassab K.; Chawla H.; Kaur A.; Kodumuri V.; Jolly N.; Doukky R.
Institution
(Vij, Kassab, Doukky) Division of Cardiology, Cook County Health, Chicago,
IL, United States
(Vij, Doukky) Department of Medicine, Rush Medical college, Chicago, IL,
United States
(Chawla) Division of Cardiology, MedStar Union Memorial Hospital,
Baltimore, MD, United States
(Kaur) Department of Pathology, University of Chicago-Northshore,
Evanston, IL, United States
(Kodumuri) Division of Cardiology, Ascension All Saints Hospital, Racine,
WI, United States
(Jolly) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Heart disease remains the leading cause of death in the United
States. Although there are clear indications for revascularization in
patients with acute coronary syndromes, there is debate regarding the
benefits of revascularization in stable ischemic heart disease. We sought
to perform a comprehensive meta-analysis to assess the role of
revascularization compared to conservative medical therapy alone in
patients with stable ischemic heart disease. Hypothesis: There is no
significant difference in all-cause mortality or cardiovascular mortality
between invasive and medical arms. Method(s): We performed a
systematic literature search from January 2000 to June 2020. Our
literature search yielded seven randomized controlled trials. We analyzed
a total of 12 013 patients (6109 in revascularization arm and 5904 in
conservative medical therapy arm). Primary outcome was all-cause
mortality. Secondary outcomes included major adverse cardiac events (MACE)
(death, myocardial infarction [MI], or stroke), cardiovascular mortality,
MI, and stroke. Additional subgroup analysis for all-cause mortality was
performed comparing percutaneous coronary intervention (PCI) with bare
metal stent versus conservative therapy; and PCI with drug eluting stent
versus conservative therapy. Result(s): There was no statistically
significant difference in primary outcome of all-cause mortality between
either arm (odds ratio [OR] = 0.95; 95% CI [confidence interval], 0.83 to
1.08; p =.84). There were statistically significant lower rates of MACE
(death, MI or stroke) in the revascularization arm when compared to
conservative arm. Conclusion(s): Our analysis did not show any
survival advantage of an initial invasive strategy over conservative
medical therapy in patients with stable coronary artery disease
(CAD). Copyright © 2021 The Authors. Clinical Cardiology
published by Wiley Periodicals LLC.

<9>
Accession Number
2011573309
Title
Dexmedetomidine reduces the incidence of postoperative delirium after
cardiac surgery: a meta-analysis of randomized controlled trials.
Source
BMC Anesthesiology. 21 (1) (no pagination), 2021. Article Number: 153.
Date of Publication: December 2021.
Author
Li P.; Li L.-X.; Zhao Z.-Z.; Xie J.; Zhu C.-L.; Deng X.-M.; Wang J.-F.
Institution
(Li, Li, Zhao, Xie, Zhu, Deng, Wang) Faculty of Anesthesiology, Changhai
Hospital, Naval Medical University, 168 Changhai Road, Shanghai, China
Publisher
BioMed Central Ltd
Abstract
Background: The role of dexmedetomidine in preventing postoperative
delirium (POD) after cardiac surgery remains controversial because of
several recent trials with negative results. We aimed to perform an
updated meta-analysis of randomized controlled trials (RCTs) to clarify
this controversy. Method(s): RCTs investigating the perioperative
administration of dexmedetomidine in cardiac surgery were retrieved from
PubMed, Web of Science, and the Cochrane library until August,27,2020. Two
researchers independently screened the literature, collected the data and
evaluated the bias risk of the included studies. The meta-analysis was
performed with the RevMan 5.3. Result(s): A total of 15 studies
including 2813 patients were included in the study. A pooled result showed
that dexmedetomidine could reduce the risk of POD in adult population
underwent cardiac surgery (OR 0.56, 95%CI 0.36-0.89, P = 0.0004,
I2 = 64%). The subgroup analysis demonstrated that the
protective effect of dexmedetomidine was only present in the patients
injected with dexmedetomidine after surgery but not from the start of
surgery, in the adult patients without specific age limitation but not in
the elderly, and in the studies in comparison with other sedatives but not
with placebo. There were no statistical differences when analyzing the
secondary outcomes including hypotension (OR 1.13; 95% CI 0.54-2.37, P <
0.00001, I2 = 85%), bradycardia (OR 1.72; 95% CI 0.84-3.53, P =
0.04, I2 = 58%) and atrial fibrillation (OR 0.87; 95% CI
0.70-1.08, P = 0.43, I2 = 0). Conclusion(s):
Dexmedetomidine can reduce the incidence of POD compared to other
sedatives and opioids after cardiac surgery in adult patients. The proper
population and timing for perioperative use of dexmedetomidine after
cardiac surgery remain to be further investigated. Copyright ©
2021, The Author(s).

<10>
Accession Number
2011532557
Title
Early outcomes from the CLASP IID trial roll-in cohort for prohibitive
risk patients with degenerative mitral regurgitation.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2021.
Date of Publication: 2021.
Author
Lim D.S.; Smith R.L.; Zahr F.; Dhoble A.; Laham R.; Lazkani M.; Kodali S.;
Kliger C.; Hermiller J.; Vora A.; Sarembock I.J.; Gray W.; Kapadia S.;
Greenbaum A.; Rassi A.; Lee D.; Chhatriwalla A.; Shah P.; Rodes-Cabau J.;
Ibrahim H.; Satler L.; Herrmann H.C.; Mahoney P.; Davidson C.; Petrossian
G.; Guerrero M.; Koulogiannis K.; Marcoff L.; Gillam L.
Institution
(Lim) Department of Medicine, Division of Cardiovascular Medicine,
University of Virginia Health System, Charlottesville, VA, United States
(Smith) Department of Surgery, Division of Cardiovascular Surgery, Baylor
Scott and White The Heart Hospital Plano, Plano, TX, United States
(Zahr) Department of Medicine, Division of Cardiovascular Medicine, Oregon
Health & Science University, Portland, OR, United States
(Dhoble) Department of Medicine, Division of Cardiovascular Medicine, The
University of Texas Health Science Center at Houston, Houston, TX, United
States
(Laham) Department of Medicine, Division of Cardiovascular Medicine, Beth
Israel Deaconess Medical Center, Boston, MA, United States
(Lazkani) Department of Medicine, Division of Cardiovascular Medicine,
UCHealth Medical Center of the Rockies, Loveland, CO, United States
(Kodali) Department of Medicine, Division of Cardiovascular Medicine,
Columbia University Medical Center, New York, NY, United States
(Kliger) Department of Medicine, Division of Cardiovascular Medicine,
Northwell-Lenox Hill, New York, NY, United States
(Hermiller) Department of Medicine, Division of Cardiovascular Medicine,
St. Vincent Heart Center of Indiana, Indianapolis, IN, United States
(Vora) Department of Medicine, Division of Cardiovascular Medicine, UPMC
Pinnacle Health Harrisburg, Harrisburg, PA, United States
(Sarembock) Department of Medicine, Division of Cardiovascular Medicine,
The Christ Hospital and Lindner Clinical Research Center, Cincinnati, OH,
United States
(Gray) Department of Medicine, Division of Cardiovascular Medicine,
Lankenau Heart Institute, Wynnewood, PA, United States
(Kapadia) Department of Medicine, Division of Cardiovascular Medicine,
Cleveland Clinic Foundation, Cleveland, OH, United States
(Greenbaum) Department of Medicine, Division of Cardiovascular Medicine,
Emory University, Atlanta, GA, United States
(Rassi) Department of Medicine, Division of Cardiovascular Medicine,
Kaiser Permanente San Francisco Medical Center, San Francisco, CA, United
States
(Lee) Department of Medicine, Division of Cardiovascular Medicine,
Stanford University Medical Center, Palo Alto, CA, United States
(Chhatriwalla) Department of Medicine, Division of Cardiovascular
Medicine, Saint Luke's Hospital of Kansas City, Kansas City, MO, United
States
(Shah) Department of Medicine, Division of Cardiovascular Medicine,
Brigham and Women's Hospital, Boston, MA, United States
(Rodes-Cabau) Department of Medicine, Division of Cardiovascular Medicine,
Laval Hospital, Quebec City, QC, Canada
(Ibrahim) Department of Medicine, Division of Cardiovascular Medicine, New
York University Langone Medical Center, New York, NY, United States
(Satler) Department of Medicine, Division of Cardiovascular Medicine,
MedStar Washington Hospital Center, Washington, DC, United States
(Herrmann) Department of Medicine, Division of Cardiovascular Medicine,
University of Pennsylvania, Philadelphia, PA, United States
(Mahoney) Department of Medicine, Division of Cardiovascular Medicine,
Sentara Norfolk General Hospital, Norfolk, VA, United States
(Davidson) Department of Medicine, Division of Cardiovascular Medicine,
Northwestern University, Chicago, IL, United States
(Petrossian) Department of Medicine, Division of Cardiovascular Medicine,
St. Francis Hospital, The Heart Center, Roslyn, NY, United States
(Guerrero) Department of Medicine, Division of Cardiovascular Medicine,
Mayo Clinic Rochester, Rochester, MN, United States
(Koulogiannis, Marcoff, Gillam) Department of Medicine, Division of
Cardiovascular Medicine, Atlantic Health System Morristown Medical Center,
Morristown, NJ, United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: We report the 30-day outcomes from the roll-in cohort of the
CLASP IID trial, representing the first procedures performed by each site.
 Background(s): The currently enrolling CLASP IID/IIF pivotal trial is
a multicenter, prospective, randomized trial assessing the safety and
effectiveness of the PASCAL transcatheter valve repair system in patients
with clinically significant MR. The trial allows for up to three roll-in
patients per site. Method(s): Eligibility criteria were: DMR >=3+,
prohibitive surgical risk, and deemed suitable for transcatheter repair by
the local heart team. Trial oversight included a central screening
committee and echocardiographic core laboratory. The primary safety
endpoint was a 30-day composite MAE: cardiovascular mortality, stroke,
myocardial infarction (MI), new need for renal replacement therapy, severe
bleeding, and non-elective mitral valve re-intervention, adjudicated by an
independent clinical events committee. Thirty-day echocardiographic,
functional, and quality of life outcomes were assessed. Result(s): A
total of 45 roll-in patients with mean age of 83 years and 69% in NYHA
class III/IV were treated. Successful implantation was achieved in 100%.
The 30-day composite MAE rate was 8.9% including one cardiovascular death
(2.2%) due to severe bleeding from a hemorrhagic stroke, one MI, and no
need for re-intervention. MR<=1+ was achieved in 73% and <=2+ in 98% of
patients. 89% of patients were in NYHA class I/II (p <.001) with
improvements in 6MWD (30 m; p =.054) and KCCQ (17 points; p <.001).
 Conclusion(s): Early results representing sites with first experience
with the PASCAL repair system showed favorable 30-day outcomes in patients
with DMR>=3+ at prohibitive surgical risk. Copyright © 2021 Wiley
Periodicals LLC.

<11>
Accession Number
2010436865
Title
Unusual presentation of empyema necessitans: case report and review of the
literature.
Source
General Thoracic and Cardiovascular Surgery. 69 (6) (pp 1026-1030), 2021.
Date of Publication: June 2021.
Author
White-Dzuro C.G.; Assi P.E.; Thomas H.C.; Thayer W.P.
Institution
(White-Dzuro, Thomas) Vanderbilt University School of Medicine, Nashville,
TN, United States
(White-Dzuro, Assi, Thayer) Department of Plastic Surgery, Vanderbilt
University Medical Center, D-4207 Medical Center North, 1161 21st Avenue
South, Nashville, TN 37212, United States
Publisher
Springer Japan
Abstract
Empyema necessitans is characterized by the extension of a pleural empyema
into adjacent structures beyond the pleural space. Although rare, it adds
significant complications to patients already suffering from pleural
empyema. Standard of surgical care has yet to be characterized or
described in the literature. Here, we describe the unusual presentation of
a 55-year-old man with methicillin-sensitive Staphylococcus aureus empyema
necessitans and outline both our surgical intervention and thoracic
reconstruction. We present our case's presentation, management, and
outcome. We then review the literature and describe a multidisciplinary
approach for management. Empyema necessitans is a very rare and morbid
condition requiring urgent intervention to promote optimal
outcomes. Copyright © 2021, The Japanese Association for Thoracic
Surgery.

<12>
Accession Number
634597421
Title
The effect of in-hospital physiotherapy on handgrip strength and physical
activity levels after cardiac valve surgery: a randomized controlled
trial.
Source
Annals of palliative medicine. 10 (2) (pp 2217-2223), 2021. Date of
Publication: 01 Feb 2021.
Author
Chen J.; Zhang T.; Bao W.; Zhao G.; Chen Z.
Institution
(Chen, Zhang, Bao, Zhao) Department of Rehabilitation Medicine, First
Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou,
China
(Chen) Department of Rehabilitation Medicine, First Affiliated Hospital,
Zhejiang University School of Medicine, Hangzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients who undergo cardiac valve surgery undertake routine
physical therapy program. Despite its routine use, its influence on
physical activity level post- surgery has not been illustrated. This study
was to investigate whether 5 days of in-hospital physiotherapy could
improve physical activity levels after cardiac valve surgery.
 METHOD(S): The study is a single-blind randomized controlled trial
which performed in Cardiothoracic Surgery Department. Patients who
underwent cardiac valve surgery (n=34) for confirmed cardiac valve
disorders were assessed during hospitalization. The intervention group
received a daily post-operative physiotherapy intervention, consisting of
individualized mobilization, breathing exercises, ambulation with or
without a walking aid. There was no physiotherapy treatment in the control
group. Measurements: physical activity was assessed with the handgrip
strength test and the timed up and go test. RESULT(S): The treatment
group showed significantly greater handgrip strength [20.58 (7.17) vs.
12.96 (4.65) kg] and less time on the timed up and go test [5.92 (2.91)
vs. 6.53 (1.60) s] compared to the control group on the 5th post-operative
day. Whilst there was no significant difference on the timed up and go
test between the 2 groups, handgrip strength on the 5th post-operative day
was significantly different between the 2 groups. CONCLUSION(S):
Patients who received physiotherapy during hospitalization showed
increased levels of handgrip strength and physical activity on the 5th day
after cardiac valve surgery compared to the control group. The clinical
value of increased levels of physical activity after in-hospital
physiotherapy following cardiac valve surgery requires further
investigation.

<13>
Accession Number
635068872
Title
Assessing protein biomarkers' role in CVD risk prediction in persons with
HIV (PWH).
Source
Topics in Antiviral Medicine. Conference: Conference on Retroviruses and
Opportunistic Infections, CROI 2021. Virtual. 29 (1) (pp 182), 2021. Date
of Publication: March 2021.
Author
Safo S.E.; Haine L.M.; Baker J.; Reilly C.; Duprez D.; Neaton J.; Jain
M.K.; Arenas-Pinto A.; Wang J.; Polizzotto M.N.; Staub T.
Institution
(Safo, Haine, Reilly, Duprez, Neaton, Wang) University of Minnesota,
Minneapolis, MN, United States
(Baker) Hennepin County Medical Center, Minneapolis, MN, United States
(Jain) University of Texas Southwestern, Dallas, TX, United States
(Arenas-Pinto) UCL Institute of Clinical Trials and Methodology, London,
United Kingdom
(Polizzotto) University of New South Wales, Sydney, Australia
(Staub) Luxembourg Hospital Center, Luxembourg City, Luxembourg
Publisher
International Antiviral Society
Abstract
Background: PWH have higher rates of CVD than the general population yet
CVD risk prediction models rely on traditional risk factors and fail to
capture the heterogeneity of CVD risk in PWH. The purpose of this study
was to identify protein biomarkers that are able to discriminate between
CVD cases and controls in PWH, and to assess if a protein score can
predict CVD risk beyond traditional risk factors in PWH Methods: We
analyzed 459 baseline protein expression levels from five OLINK panels in
a matched CVD (MI, coronary revascularization, stroke, CVD death)
case-control study with 390 PWH from INSIGHT trials (131 cases, 259
controls). We filtered out proteins that did not differentiate cases from
controls (p-value >0.05); 107 proteins remained. We formed 200 training
datasets via bootstrap. For each bootstrap training set, a two-component
partial least squares discriminant model (PLSDA) was fit. The importance
of each variable in the discrimination of cases and controls in the PLSDA
projection was assessed by the variable importance in projection (VIP)
score. Proteins with average VIP scores > 1 were used in penalized
logistic regression models with elastic net penalty, and proteins were
ranked based on the number of times the protein had a nonzero coefficient.
Proteins in the top 25th percentile were considered to have high
discrimination. A protein score (PS) of the top-ranked proteins was
developed using the bootstrap training (for weights) and the entire data.
 Result(s): Participants had mean age 47 years, bmi 24.6 kg/m^2, 13%
were females, 4.9% had CVD at baseline and 69% were on ART at baseline.
Eight proteins including the hepatocyte growth factor and interleukin-6
were identified as able to distinguish between CVD cases and controls
within PWH. The PS was found to be predictive of CVD independent of
established CVD and HIV factors (Odds ratio: 2.17, CI: 1.58-2.99). A model
with the PS and traditional risk factors had a 5.9% improvement in AUC
over the baseline model (AUC=0.731 vs 0.69), which is an increase in model
predictive power of 18%. Individuals with a PS above the median score were
3.1 (CI: 1.83-5.41) times more likely to develop CVD than those with a
protein score below the median score. Conclusion(s): A PS improved
discrimination of PWH with CVD and those without, and helped identify PWH
with high risk for developing CVD. If validated, this score could be used
in addition with established factors to identify CVD at-risk individuals
who might benefit from aggressive risk-reduction. (Table Presented).

<14>
Accession Number
635076987
Title
A cost-effective, reusable pericardiocentesis simulation model with an
interchangeable model heart and chest wall.
Source
Academic Emergency Medicine. Conference: Society for Academic Emergency
Medicine Annual Meeting, SAEM 2021. Virtual. 28 (SUPPL 1) (pp S231), 2021.
Date of Publication: May 2021.
Author
Soltanianzadeh Y.; Malik R.; Hsu E.; Weinick D.; Satnick D.; Baer H.;
McHugh J.; Bolger S.J.
Institution
(Soltanianzadeh, Malik, Hsu, Weinick) Mount Sinai Morningside and West
(Satnick) Mount Sinai Morningside / Mount Sinai West
(Baer) Mount Sinai Morningside/ Mount Sinai West Hospital
(McHugh) Mount Sinai
(Bolger) Mount Sinai Morningside and Mount Sinai West
Publisher
Blackwell Publishing Inc.
Abstract
Background and Objectives: Given the exorbitant cost of pericardiocentesis
task trainers, there has been a push to develop "Do It Yourself" models.
Currently a cost effective, gelatin model exists but is limited in its
reusability. We propose a novel "removable lid" ultrasound guided
pericardiocentesis model that remains cost effective, sustainable, and
educational. Method(s): 43 emergency medicine residents from Mount
Sinai Morningside and West in New York City participated in the study.
Residents were randomly divided into either the control group (Group A)
that used the EMDAILY model or the interventional group (Group B) that
used our novel removable lid model. Each group consisted of 4-5 residents
that rotated through the station for 30 minutes at a time. The study began
with a 10 minute didactic session led by a faculty member. They were then
given 20 minutes to practice their pericardiocentesis skills on either the
original model or the interventional model. The residents were given a pre
and post-session survey to assess their knowledge on pericardiocentesis.
The day after the practice session, a second survey was sent to assess if
the residents had enough time with the model. This was to ensure the
changing of the lids and balloons did not take away a significant time
from the training. In addition, the faculty team leaders of each group
recorded the number of models, balloons, and lids used for their
respective groups to evaluate the sustainability of the different models.
Descriptive statistics were used to report the data. Result(s): Group
A, had 3 control models that became unusable after a single needle
insertion. They switched to the novel model in order to still have the
opportunity to learn and practice the pericardiocentesis techniques. They
used a total of 4 removal balloons and 2 removable lids. Group B used a
total of 3 balloons and 2 lids. 13 residents responded to the post-survey
question asking if they felt they had enough time with the models. 92%
responded yes they had enough time. The cost for the EMDAILY model and the
novel model were $20. Each model took two hours to make. From the
educational assessment pre and post survey, we found there was a similar
number of correctly answered questions about pericardiocentesis.
 Conclusion(s): The study demonstrates that our novel low-cost, time
efficient, durable pericardiocentesis model may serve as an effective
training tool for ultrasound-guided pericardiocentesis.

<15>
Accession Number
635076724
Title
Determining the prevalence of direct oral anticoagulant use in ST-segment
elevation myocardial infarction patients.
Source
Academic Emergency Medicine. Conference: Society for Academic Emergency
Medicine Annual Meeting, SAEM 2021. Virtual. 28 (SUPPL 1) (pp S382), 2021.
Date of Publication: May 2021.
Author
Porter E.; Li I.; Servati N.; Mokszycki R.K.
Institution
(Porter, Li, Servati, Mokszycki) University of Massachusetts, Memorial
Medical Center
Publisher
Blackwell Publishing Inc.
Abstract
Background and Objectives: Approximately 80% of atrial fibrillation (AF)
patients require lifelong anticoagulation, with direct oral anticoagulants
(DOACs) recommended as first line therapy. Patients with AF are at a 55%
increased risk of myocardial infarction (MI). Percutaneous coronary
intervention (PCI) is the preferred treatment for patients with
ST-elevation myocardial infarction (STEMI). However, trials evaluating the
effectiveness of PCI have excluded those on DOACs. The purpose of this
study is to determine the prevalence of DOAC use in STEMI patients
undergoing PCI. Method(s): A single-centered, retrospective,
cross-sectional analysis was conducted in adult patients who presented to
the ED with a STEMI requiring emergent PCI with a DOAC listed as a home
medication between October 2017 and September 2020. The primary objective
was to determine the prevalence of DOAC use prior to emergent PCI for
STEMI. Secondary outcomes included peri-procedural antiplatelet and
anticoagulant management. Safety was assessed using Thrombolysis in
Myocardial Infarction (TIMI) methodology to stratify patients into TIMI
major, minor, or minimal bleeding. Mean values with standard deviations
and percentages were used to describe continuous and categorical
variables, respectively. Result(s): A total of 6,304 MI activations
occurred during the defined study period, from which 1,695 STEMI patients
were identified. Ultimately, 6 patients (0.35%) met inclusion criteria.
Patients were excluded if a DOAC was held prior to presentation or
coronary artery bypass graft was required as a rescue procedure. The
average age was 77 (9.6) years. AF was the primary indication for DOAC use
(83%), with an average CHA2DS2VaSc score of 4.3 (1.6). All patients
received aspirin, ticagrelor, and heparin prior to PCI. Four patients
required peri-procedural doses of heparin, while 1 patient received
tirofiban. No patients met TIMI major bleeding criteria.
 Conclusion(s): The prevalence of DOAC use in STEMI patients was low.
Despite this limited population size, it is reassuring that there were no
major safety events identified in the cohort. Future larger randomized
control trials are needed to confirm these results.

<16>
Accession Number
635069885
Title
The clinical evidence base for the effectiveness of protease-modulating
matrix wound dressings in adult patients.
Source
Journal of Wound Care. Conference: World Union of Wound Healing Societies,
WUWHS 2020. Abu Dhabi . 29 (SUPPL 7B) (pp 285), 2020. Date of Publication:
2020.
Author
Zeynep U.; Yazan A.-A.; Ahmed E.K.; Sammy A.-B.
Publisher
MA Healthcare Ltd
Abstract
Background and Aims: Protease-modulating matrix (Promogran) is a novel
treatment of wounds. High levels of corrosive matrix metalloproteinases
within the wound environment cause denaturation of connective tissue
proteins crucial to healing progression. Protease modulation may be
achieved by direct absorption of proteases, by depleting co-factors within
the wound, or by release of protease inhibitors. There is limited evidence
for their effectiveness. This aim of this study is to investigate the
evidence base of proteasemodulating matrix (Promogran) dressings in the
treatment of contaminated and infected acute or chronic wounds.
 Method(s): A PUBMED search from 1980 to 2019; search terms used were
wound OR wounds AND protease-modulating matrix. The inclusion criteria
were: systematic reviews, randomised controlled trials, cohort studies,
case- control studies and case series. The exclusion criteria were:
letters, comments, notes, case reports, and review articles. There was no
restriction over language. Result(s): The PUBMED search engine found
10 articles that satisfied the above criteria. Protease-modulating matrix
wound dressings significantly reduced the risk SSI in colorectal surgery,
neurological surgery, spinal surgery, and certain cardiovascular and
orthopaedic procedures. There are significant experimental data to
demonstrate the promotion of granulation and ensure and healing in
difficult to treat wounds successfully. However, there is a lack of high
quality comparative evidence to support the use of Protease-modulating
matrix wound - most studies being limited by lack of blinding, poor
reporting quality, poor validity or size. Conclusion(s):
Protease-modulating matrix wound dressings result in a significant
reduction in the activities of neutrophil-derived elastase, plasmin, and
matrix metalloproteinase. There is limited but increasing mechanistic
evidence to support the hypothesis that this novel treatment modality for
chronic wounds physically modifies the wound microenvironment, and thereby
promotes granulation tissue formation and stimulates wound repair.
Overall, this review provides very limited evidence to support the use of
protease modulating matricesdressings in the management of wounds.
Randomized controlled trials using standardised outcome measures and
longer follow-up periods are needed to determine the most appropriate
dressing for contaminated and infected acute and chronic wounds.

<17>
Accession Number
2012124425
Title
An assessment of the effectiveness of regional analgesia after VATS
measured by an objective method for assessing testosterone, cortisol,
a-Amylase, sIgA, and b-endorphin levels a randomised controlled trial.
Source
Endokrynologia Polska. 72 (2) (pp 133-142), 2021. Date of Publication: 11
Jan 2021.
Author
Bialka S.; Sliwczynska M.; Marciniak A.; Czyzewski D.; Misiolek H.
Institution
(Bialka, Czyzewski, Misiolek) Department of Anaesthesiology, Intensive
Care, and Emergency Medicine, Medical University of Silesia, Zabrze 41
800, Poland
(Sliwczynska, Marciniak) Department of Thoracic Surgery, Faculty of
Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland
Publisher
Via Medica
Abstract
Introduction: Thoracic surgeries are associated with intense postoperative
pain. General opioid analgesia is still the main anaesthetic method. Due
to the large number of opioid-induced side effects, alternative methods of
pain relief are sought. One of them is the use of balanced analgesia,
which consists of regional analgesia, non-opioid painkillers, and small
doses of opioids. Material(s) and Method(s): The objective of this
study was to assess the effectiveness of preoperative thoracic
paravertebral block (ThPVB) in the treatment of postoperative pain after
video-Assisted thoracic surgery (VATS) by measuring hormone levels in
blood serum or saliva. It was a randomised, open-label study conducted in
a single university hospital setting between May 2018 and September 2019.
In total, 119 patients were scheduled for elective video-Assisted thoracic
surgery. Performed interventions included: preoperative thoracic
paravertebral block with 0.5% bupivacaine, followed by postoperative
oxycodone combined with nonopioid analgesics. Follow-up period comprised
first 24 hours and one, two, and six months after surgery. Main outcomes
were measured by pain intensity assessed using the Numerical Rating Scale
(NRS) and the levels of the following hormones: Testosterone, cortisol,
a-Amylase activity, sIgA, and b-endorphin. Result(s): A total of 119
patients were randomised into two groups and, of these, 49 were
subsequently excluded from the analysis. The final analysis included 37
patients from the study group and 33 from the control group. There were no
statistically significant differences in the analysed parameters the
relative change T1 T0. There was a tendency towards statistical
significance in the relative change T2 T0 in testosterone levels. At rest,
no statistically significant differences were found between groups and
time in the percentage of patients with NRS 1. During cough, the
percentage of patients with NRS 1 was higher at T1 and T2 time points in
the ThPVB group. Of the factors considered, only a-Amylase levels
statistically significantly increased the chance for higher NRS score
after a month [OR = 1.013; 95% PU: 1.001 1.025; p 0.01].
 Conclusion(s): ThPVB is effective and safe for patients undergoing
VATS. It can be an effective alternative for general anaesthesia using
high doses of opioids. Copyright © 2021 Via Medica. All rights
reserved.

<18>
Accession Number
2012109122
Title
High-flow nasal cannula vs. Incentive spirometer after cardiac surgery: A
randomized controlled trial.
Source
Journal of the Medical Association of Thailand. 104 (5) (pp 794-801),
2021. Date of Publication: May 2021.
Author
Pibul W.; Kocharunjitt W.; Foofuengmonkolkit K.
Institution
(Pibul, Kocharunjitt, Foofuengmonkolkit) Cardiovascular Thoracic Surgery
Unit, Rajavithi Hospital, Rangsit University, Bangkok, Thailand
Publisher
Medical Association of Thailand
Abstract
Background: Respiratory care after cardiac surgery is a challenging area
of medical treatment. High-flow nasal oxygen cannula (HFNC) may be used
for reducing the reintubation rate. Objective(s): The present study
aimed to compare the use of HFNC with that of an incentive spirometer (IS)
with respect to the reintubation rates in patients after cardiac surgery.
 Material(s) and Method(s): The authors conducted a prospective
randomized controlled trial of 67 cardiac surgery patients. The HFNC group
received the HFNC immediately after extubation performed within 24 hours,
and the IS group received the IS with breathing exercises. Reintubation,
length of intensive care unit, length of hospital stay, ratio of arterial
partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2),
partial pressure of carbon dioxide (PaCO2), and peak expiratory flow rate
(PEFR) were analyzed and compared. Result(s): The reintubation rate
was higher in the HFNC group, but the difference was not statistically
significant (p=0.054). Hypoxia was the most common cause of intervention
failure at 29.4% and 24.2% in the HFNC and IS groups, respectively. Four
(11.8%) reintubated patients in the HFNC group later progressed to
hospital-Acquired pneumonia, which resulted in longer hospital stays
(p=0.010). The PaO2/FiO2 ratio and PEFR decreased by 33.5% and 62.5%,
respectively, on postoperative day 1 and improved the following day. The
PaCO2 was within the normal limits in both groups. Conclusion(s):
Compared to IS, prophylactic HFNC 24 hours after cardiac surgery increased
the reintubation rate, but not significantly. The decision to administer
prophylactic HFNC support after extubation in cardiac surgery patients
should be contemplated on an individual basis. Trial registration: This
trial is registered at clinicaltrials.in.th, Thai Clinical Trials
Registry, TCTR20180201001. Copyright © 2021 Medical Association
of Thailand. All rights reserved.

<19>
Accession Number
2012106162
Title
REVeAL-HF: Design and Rationale of a Pragmatic Randomized Controlled Trial
Embedded Within Routine Clinical Practice.
Source
JACC: Heart Failure. 9 (6) (pp 409-419), 2021. Date of Publication: June
2021.
Author
Ahmad T.; Yamamoto Y.; Biswas A.; Ghazi L.; Martin M.; Simonov M.; Hsiao
A.; Kashyap N.; Velazquez E.J.; Desai N.R.; Wilson F.P.
Institution
(Ahmad, Velazquez, Desai) Section of Cardiovascular Medicine, Yale
University School of Medicine, New Haven, CT, United States
(Ahmad, Yamamoto, Biswas, Ghazi, Martin, Desai, Wilson) Clinical and
Translational Research Accelerator, Yale University School of Medicine,
New Haven, CT, United States
(Simonov, Hsiao, Kashyap) Joint Data Analytics Team, Yale University
School of Medicine, New Haven, CT, United States
(Wilson) Section of Nephrology, Yale University School of Medicine, New
Haven, CT, United States
Publisher
Elsevier Inc.
Abstract
Heart failure (HF) is one of the most common causes of hospitalization in
the United States and carries a significant risk of morbidity and
mortality. Use of evidence-based interventions may improve outcomes, but
their use is encumbered in part by limitations in accurate
prognostication. The REVeAL-HF (Risk EValuation And its Impact on ClinicAL
Decision Making and Outcomes in Heart Failure) trial is the first to
definitively evaluate the impact of knowledge about prognosis on clinical
decision making and patient outcomes. The REVeAL-HF trial is a pragmatic,
completely electronic, randomized controlled trial that has completed
enrollment of 3,124 adults hospitalized for HF, defined as having an
N-terminal pro-B-type natriuretic peptide level of >500 pg/ml and
receiving intravenous diuretic agents within 24 h of admission. Patients
randomized to the intervention had their risk of 1-year mortality
generated with information in the electronic health record and presented
to their providers, who had the option to give feedback on their
impression of this risk assessment. The authors are examining the impact
of this information on clinical decision-making (use of HF
pharmacotherapies, referral to electrophysiology, palliative care
referral, and referral for advanced therapies like heart transplantation
or mechanical circulatory support) and patient outcomes (length of stay,
post-discharge 30-day rehospitalizations, and 1-year mortality). The
REVeAL-HF trial will definitively examine whether knowledge about
prognosis in HF has an impact on clinical decision making and patient
outcomes. It will also examine the relationship between calculated,
perceived, and real risk of mortality in this patient population. (Risk
EValuation And Its Impact on ClinicAL Decision Making and Outcomes in
Heart Failure [REVeAL-HF]; NCT03845660). Copyright © 2021

<20>
Accession Number
2012105719
Title
Moderate Aortic Stenosis in Patients With Heart Failure and Reduced
Ejection Fraction.
Source
Journal of the American College of Cardiology. 77 (22) (pp 2796-2803),
2021. Date of Publication: 08 Jun 2021.
Author
Jean G.; Van Mieghem N.M.; Gegenava T.; van Gils L.; Bernard J.; Geleijnse
M.L.; Vollema E.M.; El Azzouzi I.; Spitzer E.; Delgado V.; Bax J.J.;
Pibarot P.; Clavel M.-A.
Institution
(Jean, Bernard, Pibarot, Clavel) Institut universitaire de cardiologie et
de pneumologie, Universite Laval, Quebec, Quebec, Canada
(Van Mieghem, van Gils, Geleijnse, El Azzouzi, Spitzer) Department of
Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
(Gegenava, Vollema, Delgado, Bax) Department of Cardiology, Leiden
University Medical Center, Leiden, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: The study investigators previously reported that moderate
aortic stenosis (AS) is associated with a poor prognosis in patients with
heart failure (HF) with reduced left ventricular ejection fraction (LVEF)
(HFrEF). However, the respective contribution of moderate AS versus HFrEF
to the outcomes of these patients is unknown. Objective(s): This
study sought to determine the impact of moderate AS on outcomes in
patients with HFrEF. Method(s): The study included 262 patients with
moderate AS (aortic valve area >1.0 and <1.5 cm2; and peak
aortic jet velocity >2 and <4 m/s, at rest or after dobutamine stress
echocardiography) and HFrEF (LVEF <50%). These patients were matched 1:1
for sex, age, estimated glomerular filtration rate, New York Heart
Association functional class III to IV, presence of diabetes, LVEF, and
body mass index with patients with HFrEF but no AS (i.e., peak aortic jet
velocity <2 m/s). The endpoints were all-cause mortality and the composite
of death and HF hospitalization. Result(s): A total of 262 patients
with HFrEF and moderate AS were matched with 262 patients with HFrEF and
no AS. Mean follow-up was 2.9 +/- 2.2 years. In the moderate AS group,
mean aortic valve area was 1.2 +/- 0.2 cm2, and mean gradient
was 14.5 +/- 4.7 mm Hg. Moderate AS was associated with an increased risk
of mortality (hazard ratio [HR]: 2.98; 95% confidence interval [CI]: 2.08
to 4.31; p < 0.0001) and of the composite of HF hospitalization and
mortality (HR: 2.34; 95% CI: 1. 72 to 3.21; p < 0.0001). In the moderate
AS group, aortic valve replacement (AVR) performed in 44 patients at a
median follow-up time of 10.9 +/- 16 months during follow-up was
associated with improved survival (HR: 0.59; 95% CI: 0.35 to 0.98; p =
0.04). Notably, surgical AVR was not significantly associated with
improved survival (p = 0.92), whereas transcatheter AVR was (HR: 0.43; 95%
CI: 0.18 to 1.00; p = 0.05). Conclusion(s): In this series of
patients with HFrEF, moderate AS was associated with a marked incremental
risk of mortality. AVR, and especially transcatheter AVR during follow-up,
was associated with improved survival in patients with HFrEF and moderate
AS. These findings provide support to the realization of a randomized
trial to assess the effect of early transcatheter AVR in patients with
HFrEF and moderate AS. Copyright © 2021 American College of
Cardiology Foundation

<21>
Accession Number
2012105718
Title
10-Year Follow-Up After Revascularization in Elderly Patients With Complex
Coronary Artery Disease.
Source
Journal of the American College of Cardiology. 77 (22) (pp 2761-2773),
2021. Date of Publication: 08 Jun 2021.
Author
Ono M.; Serruys P.W.; Hara H.; Kawashima H.; Gao C.; Wang R.; Takahashi
K.; O'Leary N.; Wykrzykowska J.J.; Sharif F.; Piek J.J.; Garg S.; Mack
M.J.; Holmes D.R.; Morice M.-C.; Head S.J.; Kappetein A.P.; Thuijs
D.J.F.M.; Noack T.; Davierwala P.M.; Mohr F.W.; Cohen D.J.; Onuma Y.
Institution
(Ono, Hara, Kawashima, Takahashi, Wykrzykowska, Piek) Department of
Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Ono, Serruys, Hara, Kawashima, Gao, Wang, O'Leary, Sharif, Onuma)
Department of Cardiology, National University of Ireland, Galway (NUIG),
Galway, Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
(Gao, Wang) Department of Cardiology, Radboud University, Nijmegen,
Netherlands
(Wykrzykowska) University Medical Center Groningen, Groningen, Netherlands
(Sharif) CURAM-SFI Centre for Research in Medical Devices, Galway, Ireland
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center, Dallas, TX, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Morice) Departement of Cardiologie, Hopital prive Jacques Cartier,
Generale de Sante Massy, France
(Head, Kappetein, Thuijs) Department of Cardiothoracic Surgery, Erasmus
University Medical Centre, Rotterdam, Netherlands
(Noack, Davierwala, Mohr) University Department of Cardiac Surgery, Heart
Centre Leipzig, Leipzig, Germany
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Cohen) St. Francis Hospital, Roslyn, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: The optimal revascularization strategy for the elderly with
complex coronary artery disease remains unclear. Objective(s): The
goal of this study was to investigate 10-year all-cause mortality, life
expectancy, 5-year major adverse cardiac or cerebrovascular events
(MACCE), and 5-year quality of life (QOL) after percutaneous coronary
intervention (PCI) or coronary artery bypass graft (CABG) in elderly
individuals (>70 years old) with 3-vessel disease (3VD) and/or left main
disease (LMD). Method(s): In the present pre-specified analysis on
age of the SYNTAX Extended Survival study, 10-year all-cause death and
5-year MACCE were compared with Kaplan-Meier estimates and Cox
proportional hazards models among elderly or nonelderly patients. Life
expectancy was estimated by restricted mean survival time within 10 years,
and QOL status according to the Seattle Angina Questionnaire up to 5 years
was assessed by linear mixed-effects models. Result(s): Among 1,800
randomized patients, 575 patients (31.9%) were elderly. Ten-year mortality
did not differ significantly between PCI and CABG in elderly (44.1% vs.
41.1%; hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 0.84 to
1.40) and nonelderly patients (21.1% vs. 16.6%; HR: 1.30; 95% CI: 1.00 to
1.69; p<inf>interaction</inf> = 0.332). Among elderly patients, 5-year
MACCE was comparable between PCI and CABG (39.4% vs. 35.1%; HR: 1.18; 95%
CI: 0.90 to 1.56), whereas it was significantly higher in PCI over CABG
among nonelderly patients (36.3% vs. 23.0%; HR: 1.69; 95% CI: 1.36 to
2.10; p<inf>interaction</inf> = 0.043). There were no significant
difference in life expectancy (mean difference: 0.2 years in favor of
CABG; 95% CI: -0.4 to 0.7) and 5-year QOL status between PCI and CABG
among elderly patients. Conclusion(s): Elderly patients with 3VD
and/or LMD had comparable 10-year all-cause death, life expectancy, 5-year
MACCE, and 5-year QOL status irrespective of revascularization mode.
(Synergy Between PCI With TAXUS and Cardiac Surgery: SYNTAX Extended
Survival [SYNTAXES]; NCT03417050) (SYNTAX Study: TAXUS Drug-Eluting Stent
Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed
Arteries [SYNTAX]; NCT00114972) Copyright © 2021 American College
of Cardiology Foundation

<22>
Accession Number
2012120935
Title
Risk factors associated with longer stays in cardiovascular surgical
intensive care unit after CABG.
Source
Journal of the Formosan Medical Association. (no pagination), 2021. Date
of Publication: 2021.
Author
Kao K.-D.; Lee S.-Y.K.C.; Liu C.-Y.; Chou N.-K.
Institution
(Kao) Department of Nursing, National Taiwan University Hospital, Taiwan
(Republic of China)
(Kao, Lee) School of Nursing, National Taipei University of Nursing and
Health Sciences, Taiwan (Republic of China)
(Liu) Department of Speech Language Pathology and Audiology, National
Taipei University of Nursing and Health Sciences, Taiwan (Republic of
China)
(Chou) Department of Cardiovascular Surgery, National Taiwan University
Hospital, Taiwan (Republic of China)
Publisher
Elsevier B.V.
Abstract
Background/Purpose: Monitoring ICU length of stay (LOS) after CABG and
examining its risk factors can guide initiatives on the improvement of
care. But few have evaluated this issue to include personal and clinical
factors, and demands of ICU care. This study applied Donabedian model to
identify risk factors for longer ICU stays after CABG. Lifestyle, clinical
factors during and after CABG, TISS were viewed as structure factors, and
infection and organ failures during ICU did as process factors.
 Method(s): This retrospective cohort study used data via medical
records at a medical center. A stratified randomized sample of 230 adults
from a cohort of 690 isolated CABGs was to reflect the rate of 34.7%
longer than 3-day-ICU LOS. The sample comprised of longer-stay group (n =
150) and shorter-stay group (n = 80). Result(s): Hierarchical
logistic regression analysis revealed that potential signs of infection
(3-day average WBC higher than 10,000/muL, OR: 3.41 and the body
temperature higher than 38 degreeC, OR:5.67) and acute renal failure (OR:
8.97) remained as the most significant predicted factors of stay longer
than 3 ICU days. Along with higher TISS score within 24 hours (OR:1.06),
structure factors of female gender (OR:4.16) smoking(OR: 4.87), higher CCI
before surgery(OR:1.49), bypass during CABG (OR:3.51) had higher odds of
risk to stay longer. Conclusion(s): Further quality improvement
initiatives to shorten ICU stay after CABG may include the promotion of a
smoking cessation program in clinical practice, and better management of
the manpower allocation, infection control and renal
failure. Copyright © 2021

<23>
Accession Number
2012114963
Title
External stenting and disease progression in saphenous vein grafts two
years after coronary artery bypass grafting: A multicenter randomized
trial.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2021.
Date of Publication: 2021.
Author
Taggart D.P.; Gavrilov Y.; Krasopoulos G.; Rajakaruna C.; Zacharias J.; De
Silva R.; Channon K.M.; Gehrig T.; Donovan T.J.; Friedrich I.; Benedetto
U.; Vohra H.; Bittar M.N.; Bose A.; Berman M.; Kharbanda R.; Paraforos A.;
Ladyshenskij L.; Bonaros N.; Schachner T.; Sandner S.; Angleitner P.;
Bolotin G.; Jacobs S.; Thielmann M.; Wendt D.; Choi Y.-H.; Liakopoulos O.;
Ohri S.; Lipey A.
Institution
(Taggart) Nuffield Department of Surgical Sciences, University of Oxford,
John Radcliffe Hospital, Oxford, United Kingdom
(Gavrilov) TechnoSTAT Ltd, Raanana, Israel
(Krasopoulos) Oxford University Hospitals NHS Foundation Trust, Oxford,
United Kingdom
(Rajakaruna, Benedetto, Vohra) Department of Cardiothoracic Surgery,
University Hospitals Bristol, Bristol, United Kingdom
(Zacharias, Bittar, Bose) Department of Cardiothoracic Surgery, Blackpool
Victoria Hospital, Blackpool, United Kingdom
(De Silva, Berman) Department of Cardiothoracic Surgery, Papworth
Hospital, Cambridge, United Kingdom
(Channon, Kharbanda) Department of Cardiovascular Medicine, University of
Oxford, John Radcliffe Hospital, Oxford, United Kingdom
(Gehrig, Donovan, Friedrich, Paraforos) Herzzentrum Trier, Krankenhaus der
Barmherzigen Bruder, Trier, Germany
(Ladyshenskij) Department of Cardiothoracic Surgery, Immanuel Klinikum
Bernau Herzzentrum Brandenburg, Bernau bei Berlin, Brandenburg, Germany
(Bonaros, Schachner) Department of Cardiothoracic Surgery, Medical
University of Innsbruck, Innsbruck, Austria
(Sandner, Angleitner) Department of Cardiothoracic Surgery, Medizinische
Universitat Wien, Wien, Vienna, Austria
(Bolotin) Department of Cardiothoracic Surgery, Rambam Medical Center,
Haifa, Israel
(Jacobs) Department of Cardiothoracic Surgery, German Heart Centre Berlin,
Berlin, Germany
(Thielmann, Wendt) Department of Cardiothoracic Surgery, West-German Heart
and Vascular Center Essen, University Hospital Essen, Essen, Germany
(Choi, Liakopoulos) Department of Cardiac Surgery, Kerckhoff Heart Center,
Bad Nauheim, Germany
(Choi, Liakopoulos) Justus-Liebig-University Giesen, Campus Kerckhoff, Bad
Nauheim, Germany
(Choi, Liakopoulos) German Center for Cardiovascular Research (DZHK),
Partner Site Rhine Main, Frankfurt/Main, Germany
(Choi, Liakopoulos) Department of Cardiothoracic Surgery, Uniklinik Koln,
Koln, Germany
(Ohri) Department of Cardiothoracic Surgery, University Hospital
Southampton, Southampton, United Kingdom
(Lipey) Department of Cardiothoracic Surgery, Sheba Medical Center, Ramat
Gan, Israel
Publisher
Mosby Inc.
Abstract
Objectives: Little data exist regarding the potential of external stents
to mitigate long-term disease progression in saphenous vein grafts. We
investigated the effect of external stents on the progression of saphenous
vein graft disease. Method(s): A total of 184 patients undergoing
isolated coronary artery bypass grafting, using an internal thoracic
artery graft and at least 2 additional saphenous vein grafts, were
enrolled in 14 European centers. One saphenous vein graft was randomized
to an external stent, and 1 nonstented saphenous vein graft served as the
control. The primary end point was the saphenous vein graft Fitzgibbon
patency scale assessed by angiography, and the secondary end point was
saphenous vein graft intimal hyperplasia assessed by intravascular
ultrasound in a prespecified subgroup at 2 years. Result(s):
Angiography was completed in 128 patients and intravascular ultrasound in
the entire prespecified cohort (n = 51) at 2 years. Overall patency rates
were similar between stented and nonstented saphenous vein grafts (78.3%
vs 82.2%, P =.43). However, the Fitzgibbon patency scale was significantly
improved in stented versus nonstented saphenous vein grafts, with
Fitzgibbon patency scale I, II, and III rates of 66.7% versus 54.9%, 27.8%
versus 34.3%, and 5.5% versus 10.8%, respectively (odds ratio, 2.02; P
=.03). Fitzgibbon patency scale was inversely related to saphenous vein
graft minimal lumen diameter, with Fitzgibbon patency scale I, II, and III
saphenous vein grafts having an average minimal lumen diameter of 2.62 mm,
1.98 mm, and 1.32 mm, respectively (P <.05). Externally stented saphenous
vein grafts also showed significant reductions in mean intimal hyperplasia
area (22.5%; P <.001) and thickness (23.5%; P <.001). Conclusion(s):
Two years after coronary artery bypass grafting, external stenting
improves Fitzgibbon patency scales of saphenous vein grafts and
significantly reduces intimal hyperplasia area and thickness. Whether this
will eventually lead to improved long-term patency is still
unknown. Copyright © 2021 The Authors

<24>
Accession Number
2012114667
Title
Long-Term Renal Outcomes in Children With Acute Kidney Injury Post Cardiac
Surgery.
Source
Kidney International Reports. (no pagination), 2021. Date of Publication:
2021.
Author
Sethi S.K.; Sharma R.; Gupta A.; Tibrewal A.; Akole R.; Dhir R.; Soni K.;
Bansal S.B.; Jha P.K.; Bhan A.; Kher V.; Raina R.
Institution
(Sethi, Dhir, Soni) Department of Pediatric Nephrology, Kidney Institute,
Medanta - The Medicity, Gurgaon, Haryana, India
(Sharma, Akole) Pediatric Cardiac Intensive Care, Medanta - The Medicity,
Gurgaon, Haryana, India
(Gupta) Department of Biochemistry, Aster Clinical Lab, Bangalore, India
(Tibrewal, Raina) Department of Nephrology, Akron's Children Hospital,
Akron, OH, United States
(Bansal, Jha, Kher) Kidney Institute, Medanta, The Medicity Hospital,
Gurgaon, Haryana, India
(Bhan) CTVS, Medanta - The Medicity, Gurgaon, Haryana, India
Publisher
Elsevier Inc.
Abstract
Introduction: The long-term renal outcomes of survivors of pediatric acute
kidney injury (AKI) are varied within the current literature, and we aim
to establish long-term renal outcomes for pediatric patients after cardiac
surgery. We studied long-term renal outcomes and markers of kidney injury
in pediatric patients after congenital cardiac surgery. Method(s): In
a prospective case-control observational study (the Renal Outcomes in
Children with acute Kidney injury post cardiac Surgery [ROCKS] trial) we
reviewed all children who underwent cardiac surgery on cardiopulmonary
bypass (December 2010-2017). Result(s): During the study period, 2035
patients underwent cardiac surgery, of whom 9.8% developed AKI
postoperatively. Forty-four patients who had postoperative AKI had a
long-term follow-up, met our inclusion criteria, and were compared with 49
control subjects. We conducted a univariate analysis of reported
parameters. At a median follow-up of 41 months, the cases had
significantly higher urine levels of neutrophil gelatinase-associated
lipocalin (NGAL), interleukin-18 (IL-18), and kidney injury molecule-1
(KIM-1). The biomarkers remained higher after adjusting for the urine
creatinine, and the ratio of urine KIM-1/urine creatinine was
significantly higher among cases. None of the patients had proteinuria or
hypertension on follow-up. The presence of AKI, AKI stage, and younger age
were not associated with the occurrence of low glomerular filtration rate
(GFR) at follow-up. Conclusion(s): Urinary biomarker abnormalities
persist years after a congenital cardiac surgery in children, who may have
a low GFR on follow-up. The presence of AKI, AKI stage, and younger age at
surgery are not associated with the occurrence of low GFR at follow-up.
Children with a higher surgical complexity score have lower GFR on
follow-up. Copyright © 2021

<25>
Accession Number
2012109410
Title
Erector spinae plane block in acute interventional pain management: A
systematic review.
Source
Scandinavian Journal of Pain. (no pagination), 2021. Date of Publication:
2021.
Author
Viderman D.; Dautova A.; Sarria-Santamera A.
Institution
(Viderman, Sarria-Santamera) Department of Biomedical Sciences, Nazarbayev
University School of Medicine (NUSOM), Kerei-Zhanibek Str. 5/1, Nur-Sultan
010000, Kazakhstan
(Dautova) Nazarbayev University Library, Nazarbayev University,
Nur-Sultan, Kazakhstan
Publisher
De Gruyter Open Ltd
Abstract
Erector Spinae Plane Block (ESPB) was described by Forero in 2016. ESPB is
currently widely used in acute postoperative pain management. The benefits
of ESPB include simplicity and efficacy in various surgeries. The aim of
this review was to conduct a comprehensive overview of available evidence
on erector spinae plane block in clinical practice. We included randomized
controlled trials and systematic reviews reporting the ESPB in human
subjects. The review was conducted in accordance with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines. Twenty-one articles including five systematic reviews and 16
randomized controlled trials were included and analyzed. ESPB appears to
be an effective, safe, and simple method for acute pain management in
cardiac, thoracic, and abdominal surgery. The incidence of side effects
has been reported to be rare. A critical issue is to make sure that new
evidence is not just of the highest quality, in form of well powered and
designed randomized controlled trials but also including a standardized
and homogeneous set of indicators that permit to assess the comparative
effectiveness of the application of ESPB in acute interventional pain
management. Copyright © 2021 Walter de Gruyter GmbH,
Berlin/Boston 2021.

<26>
Accession Number
2012088895
Title
Aortic valve replacement vs. balloon-expandable and self-expandable
transcatheter implantation: A network meta-analysis.
Source
International Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
D'Ascenzo F.; Bruno F.; Baldetti L.; De Filippo O.; Marengo G.; Breviario
S.; Melillo F.; Thyregod H.G.H.; Thiele H.; Sondergaard L.; Popma J.J.;
Kodali S.; Franchin L.; Annaratone M.; Marruncheddu L.; Gallone G.; Crimi
G.; La Torre M.; Rinaldi M.; Omede P.; Conrotto F.; Salizzoni S.; De
Ferrari G.M.
Institution
(D'Ascenzo, Bruno, De Filippo, Marengo, Breviario, Franchin, Gallone,
Omede, Conrotto, De Ferrari) Division of Cardiology, Cardiovascular and
Thoracic Department, Citta della Salute e della Scienza Hospital and
University of Turin, Italy
(Baldetti) Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific
Institute, Italy
(Melillo) Unit of echocardiography, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Thyregod) Departments of cardiothoracic and cardiology, Rigshospitalet,
Copenhagen University Hospital, Denmark
(Thiele) Heart Center Leipzig, University of Leipzig, Germany
(Sondergaard, Popma) Beth Israel Deaconess Boston, United States
(Kodali) Columbia University Medical Center (SKK), United States
(Annaratone) Politecnico di Torino, Turin, Italy
(Marruncheddu) Department of Clinical Internal, Anesthesiological and
Cardiovascular Science, Sapienza University of Rome, Rome, Italy
(Crimi) Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
(La Torre, Rinaldi, Salizzoni) Division of Cardiosurgery, Cardiovascular
and Thoracic Department, Citta della Salute e della Scienza Hospital and
University of Turin, Italy
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Recently, observational data have raised concerns about
safety of selfexpandable (SE) compared to balloon-expandable (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
were the primary endpoints, stroke, rates of permanent pacemaker
implantation (PPI), moderate/severe paravalvular leak (PVL) and
reintervention were the secondary endpoints. Results We obtained data from
11 RCTs, encompassing 9752 patients. After one and two years, no
significant differences for allcause and CV mortality were observed.
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). 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. Conclusions A TAVI strategy,
independently from BE or SE prostheses, offers a midterm survival
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. PROSPERO ID
CRD42020182407. Copyright © 2021 Elsevier B.V.

<27>
Accession Number
2011573713
Title
Mitochondrial transplantation therapy for ischemia reperfusion injury: a
systematic review of animal and human studies.
Source
Journal of Translational Medicine. 19 (1) (no pagination), 2021. Article
Number: 214. Date of Publication: December 2021.
Author
Hayashida K.; Takegawa R.; Shoaib M.; Aoki T.; Choudhary R.C.; Kuschner
C.E.; Nishikimi M.; Miyara S.J.; Rolston D.M.; Guevara S.; Kim J.;
Shinozaki K.; Molmenti E.P.; Becker L.B.
Institution
(Hayashida, Takegawa, Shoaib, Aoki, Choudhary, Kuschner, Nishikimi,
Miyara, Kim, Shinozaki, Becker) The Feinstein Institutes for Medical
Research, Northwell Health System, 350 Community Drive, Manhasset, NY,
United States
(Hayashida, Takegawa, Shoaib, Aoki, Choudhary, Kuschner, Nishikimi,
Miyara, Rolston, Kim, Shinozaki, Becker) Department of Emergency Medicine,
North Shore University Hospital, Northwell Health System, 350 Community
Dr, Manhasset, NY 11030, United States
(Shoaib, Kuschner, Rolston, Kim, Shinozaki, Molmenti, Becker) Zucker
School of Medicine At Hofstra/Northwell, New York, NY, United States
(Guevara, Molmenti) Department of Surgery, Northwell Health, Manhasset,
NY, United States
Publisher
BioMed Central Ltd
Abstract
Background: Mitochondria are essential organelles that provide energy for
cellular functions, participate in cellular signaling and growth, and
facilitate cell death. Based on their multifactorial roles, mitochondria
are also critical in the progression of critical illnesses.
Transplantation of mitochondria has been reported as a potential promising
approach to treat critical illnesses, particularly ischemia reperfusion
injury (IRI). However, a systematic review of the relevant literature has
not been conducted to date. Here, we systematically reviewed the animal
and human studies relevant to IRI to summarize the evidence for
mitochondrial transplantation. Method(s): We searched MEDLINE, the
Cochrane library, and Embase and performed a systematic review of
mitochondrial transplantation for IRI in both preclinical and clinical
studies. We developed a search strategy using a combination of keywords
and Medical Subject Heading/Emtree terms. Studies including cell-mediated
transfer of mitochondria as a transfer method were excluded. Data were
extracted to a tailored template, and data synthesis was descriptive
because the data were not suitable for meta-analysis. Result(s):
Overall, we identified 20 animal studies and two human studies. Among
animal studies, 14 (70%) studies focused on either brain or heart IRI.
Both autograft and allograft mitochondrial transplantation were used in 17
(85%) animal studies. The designs of the animal studies were heterogeneous
in terms of the route of administration, timing of transplantation, and
dosage used. Twelve (60%) studies were performed in a blinded manner. All
animal studies reported that mitochondrial transplantation markedly
mitigated IRI in the target tissues, but there was variation in biological
biomarkers and pathological changes. The human studies were conducted with
a single-arm, unblinded design, in which autologous mitochondrial
transplantation was applied to pediatric patients who required
extracorporeal membrane oxygenation (ECMO) for IRI-associated myocardial
dysfunction after cardiac surgery. Conclusion(s): The evidence
gathered from our systematic review supports the potential beneficial
effects of mitochondrial transplantation after IRI, but its clinical
translation remains limited. Further investigations are thus required to
explore the mechanisms of action and patient outcomes in critical settings
after mitochondrial transplantation. Systematic review registration The
study was registered at UMIN under the registration number
UMIN000043347. Copyright © 2021, The Author(s).

<28>
Accession Number
2011533710
Title
COMPARATIVE STUDY BETWEEN THE EFFECT OF VOLUME-CONTROLLED VENTILATION AND
PRESSURE CONTROLLED VENTILATION VOLUME GUARANTEED ON GAS EXCHANGE AND
RESPIRATORY DYNAMICS DURING ONE-LUNG VENTILATION.
Source
Egyptian Journal of Anaesthesia. 37 (1) (pp 248-255), 2021. Date of
Publication: 2021.
Author
Ammar A.A.; Abdelkader A.Z.; Elhady S.M.; Yacout A.G.
Institution
(Ammar, Abdelkader, Elhady, Yacout) Anesthesia and Surgical Intensive
Care, Alexandria Faculty of Medicine, Alexandria, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Impairment of gas exchange is a common problem during one lung
ventilation (OLV) with a hazardous effect on morbidity and mortality. The
current study compares the effect of volume-controlled ventilation (VCV)
versus pressure-controlled ventilation volume guaranteed (PCV-VG) on gas
exchange during OLV. Settings and Design: This study was a prospective
randomized study. Method(s): The study was carried out on 30 adult
patients who were randomly assigned to two groups. Group VCV: VCV was
performed throughout the operation. Group PCV-VG: PCV-VG was performed
throughout the operation. Haemodynamic parameters ((HR), MAP), and (CVP)),
blood gas analysis, and PaO<inf>2</inf>/FiO<inf>2</inf> were recorded:
before induction of anaesthesia (T0); during TLV (T1); 1/2 an hour after
OLV (T2); 1 h after OLV (T3); 20 minutes after resuming TLV (T4); 6, 12,
and 24 hours after surgery (T5, 6, and T7). (Ppeak), (Pmean) and (Cdyn)
were recorded during (T1, 2, 3, and T4) time intervals. TNFalpha level was
measured in venous Samples in the following times: (1) before induction of
anaesthesia (T0); (2) Directly after surgery (T1); (3) 5th
postoperative day (T2). The patients were followed for 5 days for
recording of PPCs. Result(s): PCV-VG ventilation leads to a
significant decrease in Ppeak and Pmean and significant increase in Cdyn
(P <= 0.05). However, it had no effect on intra- and postoperative
oxygenation values. Conclusion(s): PCV-VG is superior to VCV as
regard respiratory dynamics during one lung ventilation (OLV), while it
does not differ as regard items of gas exchange, inflammatory response and
PPCs. Abbreviations: OLV: one lung ventilation; TLV: two lung ventilation;
VCV: volume-controlled ventilation; PCV-VG: pressure-controlled
ventilation volume guaranteed; PaO<inf>2</inf>: arterial oxygen tension;
FiO<inf>2</inf>: fraction of inspired oxygen; P<inf>peak</inf>: Peak
inspiratory pressure; P<inf>mean</inf>: mean inspiratory pressure;
C<inf>dyn</inf>: dynamic compliance TNFalpha: Tumour necrosis factor
alpha; PPCs: postoperative pulmonary complications. Copyright ©
2021 The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<29>
Accession Number
2012070201
Title
Dexmedetomidine for heart arrhythmia prevention in coronary artery bypass
surgery patients.
Source
Medical Forum Monthly. 32 (2) (pp 147-151), 2021. Date of Publication:
February 2021.
Author
Siddiq S.; Imran-Ul-Hassan S.; Hasnain Z.; Awan K.; Ikram M.; Saleem J.
Institution
(Siddiq) Department of Anesthesia, Services Hospital, Lahore, Pakistan
(Imran-Ul-Hassan, Hasnain, Awan, Ikram, Saleem) Department of Anesthesia,
Punjab Institute of Cardiology, Lahore, Pakistan
Publisher
Medical Forum Monthly
Abstract
Objective: The aim of this study was to compare the incidence of various
types of cardiac arrhythmias between the two groups of CABG cardiac
surgery treated peri operatively with dexmedetomidine with those treated
with placebo in the department of cardiac surgery, Punjab Institute of
Cardiology, Lahore, Pakistan. Study Design: Randomized controlled
trial study. Place and Duration of Study: This study was conducted at the
Department of Cardiac Surgery and Anesthesia, Punjab Institute of
Cardiology, Lahore from January 2020 to June 2020. Material(s) and
Method(s): Patients of elective cardiac surgery were enrolled and divided
into two groups. As per the inclusion criteria step in the research
proposal all the patients undergoing off-pump CABG surgery of ASA class II
and III, with age of 35 to 75 years having ejection fraction (EF) of >35%
were enrolled. Patients in the trial group or DEX group was given 0.5
mcg/kg/h of dexmedetomidine during the induction process and later on an
infusion was started at a dose of 0.5 mcg/kg/h till the completion of the
surgery even till the shifting of the patient in the High risk units.The
frequency of atrial fibrillation and other types of arrhythmias was
documented and compared with the two groups using chi square test. Data
was stratified for age and gender, post-stratified chi square test was
applied to see the effect of these variables on the outcome variable.
P<0.05 was taken significant. Result(s): A total of 60 cases (30 in
each group) fulfilling the selection criteria were enrolled to compare the
incidence of various types of cardiac arrhythmias between the two groups
of CABG cardiac surgery treated peri-operatively with dexmedetomidine with
those treated with placebo. Patients treated with DEX had an overall lower
incidence of various types of arrhythmias. Most common arrhythmia was
ventricular tachycardia and premature ventricular contractions.
 Conclusion(s): With the use of dexmedetomidine as a sedative and
adjuvant of general anesthesia drugs, the incidence of various
tachyarrhythmia is decreased during cardiac surgery and in the
post-operative period; but the decrease in the incidence was not
statistically significant for all types of arrhythmias. Copyright
© 2021 Medical Forum Monthly. All rights reserved.

<30>
Accession Number
2012070200
Title
Effect of peri-operative dexmedetomidine on incidence of delirium in
elderly patients after cardiac surgery.
Source
Medical Forum Monthly. 32 (2) (pp 142-146), 2021. Date of Publication:
February 2021.
Author
Imran-Ul-Hassan S.; Hasnain Z.; Awan K.; Liaquat M.; Ikram M.; Saleem J.
Institution
(Imran-Ul-Hassan, Hasnain, Awan, Liaquat, Ikram, Saleem) Department of
Anesthesia, Punjab Institute of Cardiology, Lahore, Pakistan
Publisher
Medical Forum Monthly
Abstract
Objective: The aim of this study was to compare the frequency of delirium
in patients of elective cardiac surgery treated peri operatively with
dexmedetomidine with those treated with midazolam. Study Design:
Randomized controlled trial study. Place and Duration of Study: This study
was conducted at the Department of cardiac surgery, Punjab Institute of
Cardiology, Lahore, Pakistan from July, 2020 till December, 2020.
 Material(s) and Method(s): Dexmedetomidine was given to half of the
patients included in the study and other drug was taken as a controlled
drug, Midazolam.The objective of this study was to compare the frequency
of delirium in patients of elective cardiac surgery treated with peri
operatively with dexmedetomidine with those treated with midazolam
prei-operatively. Delirium was assessed using the scale - MMSE Scoring
scale. Mini-Mental State Examination (MMSE) Score is of total 30 score.
Patients were asked some questions in the form of an interview and 1 mark
was given for each correct answer. Any patient with a score of less than
24 was labeled as having a cognitive impairment or delirium.
 Result(s): The comparison of frequency of deliriumin patients of
cardiac surgery treated with perioperative dexmedetomidine vs midazolam
was done, 8.57% (n=2) in Dexmedetomidine group and 22.86%(n=8) in
midazolam group were found with delirium, p value was 0.04.
 Conclusion(s): Delirium is a stressful complication observed in the
post-operative period. With the use of dexmedetomidine along with the
induction of general anesthesia, the chances of post-operative delirium
can be reduced. This trial should be done on a larger scale documenting
the effects of DEX on all the parameters monitored during the general
anesthesia. Copyright © 2021 Medical Forum Monthly. All rights
reserved.

<31>
Accession Number
2012058387
Title
Surgical Risk Scoring in TAVR: Still Needed? A Metaregression Analysis.
Source
Current Problems in Cardiology. (no pagination), 2021. Article Number:
100875. Date of Publication: 2021.
Author
Baro R.; Cura F.; Belardi J.; Brugaletta S.; Lamelas P.
Institution
(Baro, Cura, Belardi, Lamelas) Instituto Cardiovascular de Buenos Aires,
Buenos Aires, Argentina
(Brugaletta) Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS,
Barcelona, Spain
(Lamelas) Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, ON, Canada
Publisher
Mosby Inc.
Abstract
Several randomized controlled trials evaluating the effectiveness of
transcatheter aortic valve replacement (TAVR) against surgical aortic
valve replacement have been published to date. The fact that higher risk
populations were implemented first does not necessarily mean that they
benefit more from a TAVR procedure. We performed meta-analysis of the 8
randomized clinical trials performing TAVR for both mortality and stroke
outcomes. Meta-regression was used to evaluate the association between
mean surgical risk using the Society of Thoracic Surgeons (STS) score and
hazard ratio observed in each of the trials. Overall, TAVR was associated
with a significant reduction of both mortality and stroke across the whole
spectrum of patients enrolled, with no evidence of significant
heterogeneity. Metaregression analysis does not suggest a statistically
significant association between STS score and hazard ratio for both
mortality and stroke. This observation suggests reconsidering the use of
risk scores to prioritize TAVR utilization in higher risk patients, while
more focus should be done on patient's life expectancy related to TAVR
durability. Copyright © 2021 Elsevier Inc.

<32>
Accession Number
2011822367
Title
Applications of Head-Mounted Displays and Smart Glasses in Vascular
Surgery.
Source
Annals of Vascular Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Lareyre F.; Chaudhuri A.; Adam C.; Carrier M.; Mialhe C.; Raffort J.
Institution
(Lareyre) Department of Vascular Surgery, Hospital of
Antibes-Juan-les-Pins, France
(Lareyre, Raffort) Universite Cote d'Azur, CHU, Inserm U1065, Nice C3M,
France
(Chaudhuri) Bedfordshire-Milton Keynes Vascular Centre, Bedfordshire
Hospitals NHS Foundation Trust, Bedford, United Kingdom
(Adam, Carrier) Laboratory of Applied Mathematics and Computer Science
(MICS), CentraleSupelec, Universite Paris-Saclay, France
(Mialhe) Cardiovascular Surgery Unit, Cardio Thoracic Centre of Monaco,
Monaco
(Raffort) Clinical Chemistry, Laboratory, University Hospital of Nice,
France
Publisher
Elsevier Inc.
Abstract
Objectives: Advances in virtual, augmented and mixed reality have led to
the development of wearable technologies including head mounted displays
(HMD) and smart glasses. While there is a growing interest on their
potential applications in health, only a few studies have addressed so far
their use in vascular surgery. The aim of this review was to summarize the
fundamental notions associated with these technologies and to discuss
potential applications and current limits for their use in vascular
surgery. Method(s): A comprehensive literature review was performed
to introduce the fundamental concepts and provide an overview of
applications of HMD and smart glasses in surgery. Result(s): HMD and
smart glasses demonstrated a potential interest for the education of
surgeons including anatomical teaching, surgical training, teaching and
telementoring. Applications for pre-surgical planning have been developed
in general and cardiac surgery and could be transposed for a use in
vascular surgery. The use of wearable technologies in the operating room
has also been investigated in both general and cardiovascular surgery and
demonstrated its potential interest for image-guided surgery and data
collection. Conclusion(s): Studies performed so far represent a proof
of concept of the interest of HMD and smart glasses in vascular surgery
for education of surgeons and for surgical practice. Although these
technologies exhibited encouraging results for applications in vascular
surgery, technical improvements and further clinical research in large
series are required before hoping using them in daily clinical
practice. Copyright © 2021

<33>
Accession Number
2011580852
Title
Impact of early (<7 days) pacemaker implantation after cardiac surgery on
long-term pacemaker dependency.
Source
PACE - Pacing and Clinical Electrophysiology. (no pagination), 2021. Date
of Publication: 2021.
Author
Badoz M.; Favoulet B.; Serzian G.; Ecarnot F.; Guillon B.; Chopard R.;
Meneveau N.
Institution
(Badoz, Favoulet, Serzian, Ecarnot, Guillon, Chopard, Meneveau) Department
of Cardiology, University Hospital Besancon, Boulevard Fleming, Besancon,
France
(Badoz, Ecarnot, Chopard, Meneveau) EA3920, University of Burgundy
Franche-Comte, Besancon, France
Publisher
Blackwell Publishing Inc.
Abstract
Objective: We aimed to investigate pacemaker dependency after at least 1
year in patients with early (<7 days) implantation, compared to those who
received a pacemaker >=7 days after cardiac surgery. Secondary endpoints
were length of hospital stay and in-hospital complications.
 Method(s): Retrospective analysis of 108 consecutive patients who
received a pacemaker after cardiac surgery between 06/2012 and 06/2018.
Characteristics and outcomes were compared between patients with early (<7
days) and late (>=7 days) implantation. Patients were followed up with
evaluation of pacemaker dependency between April and June 2019. We
identified predictors of dependency by logistic regression.
 Result(s): In total, 63.9% were men, average age 71.9 +/- 11.8 years;
32 (29.6%) had early implantation, and 76 (70.4%) late implantation. After
a median 3.2 years [IQR 1.9, 4.5] of follow-up, 30 patients (27.8%) had
died, and there was no difference in pacemaker dependency among survivors
(66.7% vs. 46.5%, early vs. late respectively, p =.15). Patients in the
early group had a shorter length of stay (11.5 [9.0, 14.0] vs. 15.0 [11.5,
20] days, p =.002) and less often had new-onset atrial fibrillation (AF)
post-surgery (22.7% vs. 47.8%, p =.05). The only significant predictor of
dependency was aortic valve replacement surgery (OR = 4.70, 95% CI [1.36
to 16.24]). Conclusion(s): Early implantation of a permanent
pacemaker (<7 days after cardiac surgery) does not impact on the
proportion of patients with long-term (>12 months) pacemaker dependency,
but is associated with shorter length of stay and less frequent new-onset
AF. These findings warrant prospective confirmation in randomized
trials. Copyright © 2021 Wiley Periodicals LLC

<34>
Accession Number
2011566749
Title
Does the Nuss procedure for treating pectus excavatum compromise the long
term internal mammary artery flow? A systematic review.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Elsayed H.H.; Ahmed T.A.; Hassaballa A.S.; Sharkawy H.Y.
Institution
(Elsayed) Thoracic Surgery Department, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
(Ahmed, Hassaballa, Sharkawy) Cardiothoracic Surgery Department, Ain Shams
University, Cairo, Egypt
Publisher
Blackwell Publishing Inc.
Abstract
Introduction: The Nuss procedure is the most common procedure used to
treat patients with pectus excavatum. The effect of the Nuss bars on the
long-term internal mammary artery flow (IMA) is not well studied. This
could have an impact on patients requiring a coronary artery bypass
grafting surgery after the Nuss procedure. We performed a systematic
review to study the impact of the Nuss bars on the IMA long term flow.
 Method(s): A Medline search from January 1990 to August 2020 was
performed using [Nuss OR thoracoscopic pectus OR minimally invasive
pectus] AND [Internal mammary OR Internal thoracic OR IMA OR ITA]. English
language papers only were included. This trial was registered with
PROSPERO under registration number CRD42021234010. Result(s): A total
of 48 papers were identified using the reported search, of which three
represented the best evidence to answer the clinical question. One study
looked at the IMA flow via computed tomography (CT)-angiography on the
10th postoperative day after the Nuss procedure and found 15 out of 34
patients (44%) to have abnormal IMA blood flow but with no clinical
consequences. Two studies looked at the IMA flow after removal of the
Nuss-bar. The first study utilized CT-angiography on the 5th postoperative
day after Nuss-bar removal and found four out of the six patients studied
(67%) to have abnormal flow. The last study was composed of 19 patients
and looked at IMA flow during the presence of the Nuss-bars and after its
removal utilizing Doppler-angiography. It found 11 out of 19 patients
(58%) to have abnormal blood flow with the bars in place. After removal of
the bars, only two patients (10%) were found to have unilateral IMA
obstructed flow. Conclusion(s): In patients undergoing the Nuss
procedure for management of pectus excavatum, the internal mammary artery
flow is compromised in 44%-58% of patients with the bar in situ. When
these patients are assessed 10 days following removal of the bar, some
reversal of compromised IMA flow is evident. However, in up to 67% of
patients, abnormal IMA flow remains. Further studies are required to
determine whether this abnormal flow is permanent, which will require
examining patients at longer follow-up intervals. Patients undergoing
coronary artery bypass grafting who have a history of a Nuss procedure
should receive preoperative IMA imaging. Copyright © 2021 Wiley
Periodicals LLC

<35>
Accession Number
2011560159
Title
Cardiovascular safety of febuxostat compared to allopurinol for the
treatment of gout: A systematic and meta-analysis.
Source
Clinical Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Gao L.; Wang B.; Pan Y.; Lu Y.; Cheng R.
Institution
(Gao, Wang, Pan, Lu, Cheng) Department of Comprehensive Surgery, General
Hospital of Chinese People's Liberation Army & National Clinical Research
Center for Geriatric Disease, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
The cardiovascular safety of febuxostat compared to allopurinol for the
treatment of gout remains equivocal. Febuxostat had a better safety
outcome compared with allopurinol. In this systematic review and
meta-analysis, we searched MEDLINE and Embase for articles published
between March 1, 2000 and April 4, 2021, without any language
restrictions. We did a systematic review and meta-analysis of included
clinical trials to evaluate the cardiovascular safety of febuxostat
compared to allopurinol for treatment of chronic gout. Two reviewers
independently selected studies, assessed study quality, and extracted
data. Risk ratios were calculated with random effects and were reported
with corresponding 95% confidence intervals (CI). From 240 potentially
relevant citations, 224 papers were excluded; 16 studies were ultimately
included in the analysis. Febuxostat had a better safety outcome compared
with allopurinol,which was the composite of urgent coronary
revascularization (OR: 0.84, 95% CI: 0.77-0.90, p <.0001) and stroke (OR:
0.87, 95% CI: 0.79-0.97, p =.009). However, that difference was not found
in nonfatal myocardial infarction (OR: 0.99, 95% CI: 0.80-1.22, p =.91),
cardiovascular related mortality (OR: 0.98, 95% CI: 0.69-1.38, p =.89) and
all-cause mortality (OR: 0.93, 95% CI: 0.75-1.15, p =.52). No significant
differences in cardiovascular related mortality and all-cause mortality
were observed across any subgroup. This meta-analysis adds new evidence
regarding the cardiovascular safety of febuxostat in patients. Initiation
of febuxostat in patients was not associated with an increased risk of
death or serious cardiovascular related adverse events compared with
allopurinol. Copyright © 2021 The Authors. Clinical Cardiology
published by Wiley Periodicals LLC.

<36>
Accession Number
2011547428
Title
Effects of Colchicine on Cardiovascular Outcomes in Patients with Coronary
Artery Disease: A Systematic Review and One-Stage and Two-Stage
Meta-Analysis of Randomized-Controlled Trials.
Source
High Blood Pressure and Cardiovascular Prevention. (no pagination), 2021.
Date of Publication: 2021.
Author
Teo Y.N.; Teo Y.H.; Syn N.L.; Goh M.W.; Yoong C.S.Y.; Lee C.-H.; Chan
M.Y.-Y.; Chai P.; Yeo T.-C.; Sia C.-H.
Institution
(Teo, Teo, Syn, Goh, Yoong, Lee, Chan, Chai, Yeo, Sia) Department of
Medicine, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore
(Lee, Chan, Chai, Yeo, Sia) Department of Cardiology, National University
Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9,
Singapore 119228, Singapore
Publisher
Adis
Abstract
Aim: Colchicine has received emerging interest due to its cardiovascular
benefits in patients with coronary artery disease (CAD). We conducted a
one-stage meta-analysis of reconstructed individual patient data (IPD)
from randomized-controlled trials to summarize the effects of colchicine
on cardiovascular outcomes in patients with CAD. Method(s): Four
databases (PubMed, Embase, Cochrane, SCOPUS) were searched for articles
published from inception to 30th September 2020, examining the effect of
colchicine on cardiovascular outcomes in patients with CAD, yielding 10
randomized-controlled trials with a combined cohort of 12,781 patients.
IPD was reconstructed from Kaplan-Meier curves published in 3 studies and
analysed using the shared-frailty Cox model. Aggregate data meta-analysis
of all 10 studies was performed for outcomes unsuitable for IPD
reconstruction. Result(s): In patients receiving colchicine compared
to placebo, one-stage meta-analysis demonstrated a hazard ratio of 0.70
(95% CI 0.61-0.80) for the composite outcome of cardiovascular death,
non-fatal myocardial infarction, non-fatal stroke, and urgent
hospitalization for angina requiring coronary revascularization. Aggregate
data meta-analysis demonstrated a significant reduction in hazard rate for
stroke (HR 0.45; 95% CI 0.27-0.75) and urgent revascularization (HR 0.59;
95% CI 0.38-0.91); and a relative risk reduction for myocardial infarction
(RR 0.72; 95% CI of 0.52-1.00) and post-operative atrial fibrillation (RR
0.64; 95% CI 0.48-0.86). Conclusion(s): Given the significant
benefits of colchicine demonstrated on IPD, and its consistent benefits
when analyzed using aggregate data meta-analysis, we propose that
colchicine may be considered as an additional pharmacological adjunct to
the first line therapy for patients with coronary artery
disease. Copyright © 2021, Italian Society of Hypertension.

<37>
Accession Number
2011540551
Title
Meta-analysis of minimalist versus standard care approach for
transcatheter aortic valve replacement.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2021. Date of
Publication: 2021.
Author
Qureshi W.T.; Kundu A.; Mir T.; Khan A.; Anwaruddin S.; Sattar Y.; Ogunsua
A.; Dutta A.; Majeed C.N.; Walker J.; Kakouros N.
Institution
(Qureshi, Kundu, Khan, Ogunsua, Kakouros) Division of Cardiovascular
Medicine, University of Massachusetts Medical School, Worcester, MA,
United States
(Mir) Department of Internal Medicine, Detroit Medical Centre, Wayne State
University, Detroit, United States
(Anwaruddin) Division of Cardiovascular Medicine, Hospital of the
University of Pennsylvania, Philadelphia, PA, United States
(Sattar) Department of Internal Medicine, Icahn School of Medicine at
Mount, Sinai Elmhurst Hospital, Queens, , NY, United States
(Dutta) Department of Critical Care Medicine, Memorial Sloan Kettering,
NY, United States
(Majeed) Department of Internal Medicine, Section on Hospital Medicine,
Wake Forest School of Medicine, Winston-Salem, NC, United States
(Walker) Division of Cardiothoracic Surgery, University of Massachusetts
Medical School, Worcester, MA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: The change in practice of transcatheter aortic valve
replacement (TAVR) to a minimalist approach is a debate. Method(s):
Online database search for studies that compared the minimalist approach
with the standard approach for TAVR were searched from inception through
September 2020. We calculated pooled odds ratios (ORs) and 95% confidence
intervals (CIs) using the fixed or random-effects model. Result(s): A
total of 9 studies with 2,880 TAVR patients (minimalist TAVR;1066 and
standard TAVR; 1,814) were included. Compared to standard approach, there
were no significant differences in in-hospital mortality, 30-day
mortality, or hospital readmissions. However, there was a reduced risk of
acute kidney injury (OR0.49;95%CI0.27-0.89), major bleeding
(OR0.21;95%CI0.12-0.38) and major vascular complications
(OR0.60,95%CI0.39-0.91) associated with the minimalist TAVR group. There
was comparatively shorter hospital length of stay (mean difference
-2.41;95%CI-2.99,-1.83) days, procedural time (mean difference
-43.99;95%CI-67.25,-20.75) minutes, fluoroscopy time (mean difference
-2.69;95%CI-3.44,-1.94) minutes and contrast volume (mean difference
-26.98;95%CI-42.18,-11.79) ml in the minimalist TAVR group.
 Conclusion(s): This meta-analysis demonstrated potential benefits of
the minimalist TAVR approach over the standard approach regarding some
adverse clinical outcomes as well as procedural outcomes without
significant differences in mortality or readmission rates. Copyright
© 2021 Informa UK Limited, trading as Taylor & Francis Group.

<38>
Accession Number
2011540294
Title
Real world coronary artery ostia full accessibility after last generation
transcatheter aortic valve implantation.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2021. Date of
Publication: 2021.
Author
Rigatelli G.; Zuin M.; Roncon L.; Nanjiundappa A.; Daggubati R.
Institution
(Rigatelli, Roncon) Division of Cardiology, Rovigo General Hospital,
Rovigo, Italy
(Zuin) Department of Translational Medicine, Section of Internal and
CardioRespiratory Medicine, University of Ferrara, Ferrara, Italy
(Nanjiundappa) Center of Vascular Excellence, West Virginia University
Medical School, Charlstone, United States
(Daggubati) West Virginia University School of Medicine, Heart and
Vascular Institute, Morgantown, United States
Publisher
SAGE Publications Inc.
Abstract
Aim: We evaluate, performing a pooled meta-analysis, the current coronary
artery accessibility rate in transcatheter aortic valve implantation
(TAVI) patients during the follow-up. Full coronary artery accessibility
after TAVI has not been adequately addressed by the current literature.
 Method(s): According to the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses guidelines, data on coronary artery access were
obtained from the ratio between in the full coronary engagement (n) and
the number of coronary angiography and/or percutaneous coronary
intervention (N). Data were synthesized using random-effects
meta-analyses. Result(s): Out of 7048 TAVI patients, 276 (3.9%) (mean
age 76.8 years, 111 (40.2%) females) were analysed. Full coronary artery
accessibility for coronary angiographies and percutaneous coronary
interventions were obtained in 83.0% (95% confidence interval (CI):
0.66-0.92, p = 0.001, I2: 88.2%) and 96.0% (95% CI: 0.90-0.98,
p < 0.0001, I2: 0) of cases (p for difference <.0.001). Left
coronary artery (n = 219) was easily fully engaged compared to the right
one (90.9% (95% CI: 0.80-0.96, p < 0.0001, I2: 58.4% and 82.0%
(95% CI: 0.60-0.93, p = 0.006, I2: 83.2%), respectively, (p for
difference < 0.001). Using age as moderator variable, meta-regression
revealed a positive and negative correlation with coronary artery
accessibility in patients treated with Sapien-Edwards (p = 0.008) and
CoreValve (p = 0.010) platforms, respectively. Conversely, a negative
correlation (p = 0.01) was found between coronary artery accessibility and
mean time after Sapien-Edwards platform implantation (p = 0.01).
 Conclusion(s): Full coronary artery accessibility during coronary
angiographies and/or percutaneous coronary interventions results
suboptimal for both coronary artery ostia and worse for right compared to
left coronary artery after TAVI. Copyright © The Author(s) 2021.

<39>
Accession Number
635050033
Title
Single-dose intravenous ketorolac for acute postoperative pain in adults.
Source
Cochrane Database of Systematic Reviews. 2021 (5) (no pagination), 2021.
Article Number: CD013263. Date of Publication: 17 May 2021.
Author
McNicol E.D.; Ferguson M.C.; Schumann R.
Institution
(McNicol) Department of Anesthesiology and Perioperative Medicine, Tufts
Medical Center, Boston, MA, United States
(Ferguson) Pharmacy Practice, Southern Illinois University Edwardsville,
Edwardsville, IL, United States
(Schumann) Department of Anesthesia, Critical Care and Pain Medicine, VA
Boston Healthcare System, West Roxbury, MA, United States
Publisher
John Wiley and Sons Ltd
Abstract
Background: Postoperative pain is common and may be severe. Postoperative
administration of non-steroidal anti-inflammatory drugs (NSAIDs) reduces
patient opioid requirements and, in turn, may reduce the incidence and
severity of opioid-induced adverse events (AEs). Objective(s): To
assess the analgesic efficacy and adverse effects of single-dose
intravenous ketorolac, compared with placebo or an active comparator, for
moderate to severe postoperative pain in adults. Search Method(s): We
searched the following databases without language restrictions: CENTRAL,
MEDLINE, Embase and LILACS on 20 April 2020. We checked clinical trials
registers and reference lists of retrieved articles for additional
studies. Selection Criteria: Randomized double-blind trials that
compared a single postoperative dose of intravenous ketorolac with placebo
or another active treatment, for treating acute postoperative pain in
adults following any surgery. Data Collection and Analysis: We used
standard methodological procedures expected by Cochrane. Our primary
outcome was the number of participants in each arm achieving at least 50%
pain relief over a four- and six-hour period.Our secondary outcomes were
time to and number of participants using rescue medication; withdrawals
due to lack of efficacy, adverse events (AEs), and for any other cause;
and number of participants experiencing any AE, serious AEs (SAEs), and
NSAID-related or opioid-related AEs.For subgroup analysis, we planned to
analyze different doses of parenteral ketorolac separately and to analyze
results based on the type of surgery performed.We assessed the certainty
of evidence using GRADE. Main Result(s): We included 12 studies,
involving 1905 participants undergoing various surgeries
(pelvic/abdominal, dental, and orthopedic), with 17 to 83 participants
receiving intravenous ketorolac in each study. Mean study population ages
ranged from 22.5 years to 67.4 years. Most studies administered a dose of
ketorolac of 30 mg; one study assessed 15 mg, and another administered 60
mg. Most studies had an unclear risk of bias for some domains,
particularly allocation concealment and blinding, and a high risk of bias
due to small sample size. The overall certainty of evidence for each
outcome ranged from very low to moderate. Reasons for downgrading
certainty included serious study limitations, inconsistency and
imprecision. Ketorolac versus placebo. Very low-certainty evidence from
eight studies (658 participants) suggests that ketorolac results in a
large increase in the number of participants achieving at least 50% pain
relief over four hours compared to placebo, but the evidence is very
uncertain (risk ratio (RR) 2.81, 95% confidence interval (CI) 1.80 to
4.37). The number needed to treat for one additional participant to
benefit (NNTB) was 2.4 (95% CI 1.8 to 3.7). Low-certainty evidence from 10
studies (914 participants) demonstrates that ketorolac may result in a
large increase in the number of participants achieving at least 50% pain
relief over six hours compared to placebo (RR 3.26, 95% CI 1.93 to 5.51).
The NNTB was 2.5 (95% CI 1.9 to 3.7). Among secondary outcomes, for time
to rescue medication, moderate-certainty evidence comparing intravenous
ketorolac versus placebo demonstrated a mean median of 271 minutes for
ketorolac versus 104 minutes for placebo (6 studies, 633 participants).
For the number of participants using rescue medication, very low-certainty
evidence from five studies (417 participants) compared ketorolac with
placebo. The RR was 0.60 (95% CI 0.36 to 1.00), that is, it did not
demonstrate a difference between groups. Ketorolac probably results in a
slight increase in total adverse event rates compared with placebo (74%
versus 65%; 8 studies, 810 participants; RR 1.09, 95% CI 1.00 to 1.19;
number needed to treat for an additional harmful event (NNTH) 16.7, 95% CI
8.3 to infinite, moderate-certainty evidence). Serious AEs were rare.
Low-certainty evidence from eight studies (703 participants) did not
demonstrate a difference in rates between ketorolac and placebo (RR 0.62,
95% CI 0.13 to 3.03). Ketorolac versus NSAIDs Ketorolac was compared to
parecoxib in four studies and diclofenac in two studies. For our primary
outcome, over both four and six hours there was no evidence of a
difference between intravenous ketorolac and another NSAID (low-certainty
and moderate-certainty evidence, respectively). Over four hours, four
studies (337 participants) produced an RR of 1.04 (95% CI 0.89 to 1.21)
and over six hours, six studies (603 participants) produced an RR of 1.06
(95% CI 0.95 to 1.19). For time to rescue medication, low-certainty
evidence from four studies (427 participants) suggested that participants
receiving ketorolac waited an extra 35 minutes (mean median 331 minutes
versus 296 minutes). For the number of participants using rescue
medication, very low-certainty evidence from three studies (260
participants) compared ketorolac with another NSAID. The RR was 0.90 (95%
CI 0.58 to 1.40), that is, there may be little or no difference between
groups. Ketorolac probably results in a slight increase in total adverse
event rates compared with another NSAID (76% versus 68%, 5 studies, 516
participants; RR 1.11, 95% CI 1.00 to 1.23; NNTH 12.5, 95% CI 6.7 to
infinite, moderate-certainty evidence). Serious AEs were rare.
Low-certainty evidence from five studies (530 participants) did not
demonstrate a difference in rates between ketorolac and another NSAID (RR
3.18, 95% CI 0.13 to 76.99). Only one of the five studies reported a
single serious AE. Authors' conclusions: The amount and certainty of
evidence for the use of intravenous ketorolac as a treatment for
postoperative pain varies across efficacy and safety outcomes and amongst
comparators, from very low to moderate. The available evidence indicates
that postoperative intravenous ketorolac administration may offer
substantial pain relief for most patients, but further research may impact
this estimate. Adverse events appear to occur at a slightly higher rate in
comparison to placebo and to other NSAIDs. Insufficient information is
available to assess whether intravenous ketorolac has a different rate of
gastrointestinal or surgical-site bleeding, renal dysfunction, or
cardiovascular events versus other NSAIDs. There was a lack of studies in
cardiovascular surgeries and in elderly populations who may be at
increased risk for adverse events. Copyright © 2021 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<40>
Accession Number
2007230937
Title
Cardiac rehabilitation in german speaking countries of
europe-evidence-based guidelines from germany, austria and switzerland
llkardreha-dach-part 1.
Source
Journal of Clinical Medicine. 10 (10) (no pagination), 2021. Article
Number: 2192. Date of Publication: 02 May 2021.
Author
Rauch B.; Salzwedel A.; Bjarnason-Wehrens B.; Albus C.; Meng K.; Schmid
J.-P.; Benzer W.; Hackbusch M.; Jensen K.; Schwaab B.; Altenberger J.;
Benjamin N.; Bestehorn K.; Bongarth C.; Dorr G.; Eichler S.; Einwang
H.-P.; Falk J.; Glatz J.; Gielen S.; Grilli M.; Grunig E.; Guha M.;
Hermann M.; Hoberg E.; Hofer S.; Kaemmerer H.; Ladwig K.-H.; Mayer-Berger
W.; Metzendorf M.-I.; Nebel R.; Neidenbach R.C.; Niebauer J.; Nixdorff U.;
Oberhoffer R.; Reibis R.; Reiss N.; Saure D.; Schlitt A.; Voller H.; von
Kanel R.; Weinbrenner S.; Westphal R.
Institution
(Rauch) Institut fur Herzinfarktforschung Ludwigshafen, Ludwigshafen
D-67063, Germany
(Rauch) Zentrum fur Ambulante Rehabilitation, ZAR Trier GmbH, Trier
D-54292, Germany
(Salzwedel, Eichler, Voller) Department of Rehabilitation Medicine,
Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam
D-14469, Germany
(Bjarnason-Wehrens) Institut fur Kreislaufforschung und Sportmedizin, Abt.
Praventive und rehabilitative Sport-und Leistungsmedizin, Deutsche
Sporthochschule Koln, Koln D-50937, Germany
(Albus) Department of Psychosomatics and Psychotherapy, Faculty of
Medicine, University Hospital, Koln D-50937, Germany
(Meng) Institut fur Klinische Epidemiologie und Biometrie (IKE-B),
Universitat Wurzburg, Wurzburg D-97078, Germany
(Schmid) Klinik Barmelweid AG, Barmelweid CH-5017, Switzerland
(Benzer) Reha-Klinik Montafon, Schruns A-6780, Austria
(Hackbusch, Jensen, Saure) Institute of Medical Biometry and Informatics
(IMBI), University of Heidelberg, Heidelberg D-69120, Germany
(Schwaab) Curschmann Klinik Dr. Guth GmbH & Co KG, Timmendorfer Strand
D-23669, Germany
(Altenberger) Rehabilitationszentrum Grosgmain, Grosgmain A-5084, Austria
(Benjamin, Grunig) Zentrum fur Pulmonale Hypertonie, Thorax-Klinik am
Universitatsklinikum Heidelberg, Heidelberg D-69126, Germany
(Bestehorn) Institut fur Klinische Pharmakologie, Technische Universitat
Dresden, Fiedlerstrase 42, Dresden D-01307, Germany
(Bongarth, Einwang) Klinik Hohenried gGmbH, Rehabilitationszentrum am
Starnberger See, Bernried D-82347, Germany
(Dorr) Alexianer St. Josefs-Krankenhaus Potsdam-Sanssouci, Potsdam
D-14471, Germany
(Falk, Weinbrenner) Deutsche Rentenversicherung Bund (DRV-Bund), Berlin
D-10709, Germany
(Glatz) Reha-Zentrum Seehof der Deutschen Rentenversicherung Bund, Teltow
D-14513, Germany
(Gielen) Klinikum Lippe, Standort Detmold, Detmold D-32756, Germany
(Grilli) Universitatsbibliothek, Universitatsmedizin Mannheim, Mannheim
D-68167, Germany
(Guha) Reha-Zentrum am Sendesaal, Bremen D-28329, Germany
(Hermann) Klinik fur Kardiologie, Universitatsspital Zurich, Ramistrasse
100, Zurich CH-8091, Switzerland
(Hoberg) Wismarstrase 13, Heikendorf D-24226, Germany
(Hofer) Universitatsklinik fur Medizinische Psychologie und
Psychotherapie, Medizinische Universitat Innsbruck, Innsbruck A-6020,
Austria
(Kaemmerer) Klinik fur Angeborene Herzfehler und Kinderkardiologie,
Deutsches Herzzentrum Munchen, Klinik der Technischen Universitat Munchen,
Munchen D-80636, Germany
(Ladwig) Department of Psychosomatic Medicine and Psychotherapy, Klinikum
rechts der Isar, Technische Universitat Munchen (TUM), Langerstrase 3,
Munich D-81675, Germany
(Mayer-Berger) Klinik Roderbirken der Deutschen Rentenversicherung
Rheinland, Leichlingen D-42799, Germany
(Metzendorf) Cochrane Metabolic and Endocrine Disorders Group, Institute
of General Practice (ifam), Medical Faculty of the Heinrich-Heine
University, Werdener Strase. 4, Dusseldorf D-40227, Germany
(Nebel) Hermann-Albrecht-Klinik METTNAU, Medizinische Reha-Einrichtungen
der Stadt Radolfzell, Radolfzell D-73851, Germany
(Neidenbach) Institut fur Sportwissenschaft, Universitat Wien, Auf der
Schmelz 6 (USZ I), Wien AU-1150, Austria
(Niebauer) Universitatsinstitut fur Praventive und Rehabilitative
Sportmedizin, Uniklinikum Salzburg Paracelsus Medizinische
Privatuniversitat, Salzburg A-5020, Austria
(Nixdorff) EPC GmbH, European Prevention Center, Medical Center
Dusseldorf, Dusseldorf D-40235, Germany
(Oberhoffer) Lehrstuhl fur Praventive Padiatrie, Fakultat fur Sport-und
Gesundheitswissenschaften, Technische Universitat Munchen, Munchen
D-80992, Germany
(Reibis) Kardiologische Gemeinschaftspraxis Am Park Sanssouci, Potsdam
D-14471, Germany
(Reiss) Schuchtermann-Schiller'sche Kliniken, Ulmenallee 5-12, Bad
Rothenfelde D-49214, Germany
(Schlitt) Paracelsus Harz-Klinik Bad Suderode GmbH, Quedlinburg D-06485,
Germany
(Voller) Klinik am See, Rudersdorf D-15562, Germany
(von Kanel) Klinik fur Konsiliarpsychiatrie und Psychosomatik,
Universitatsspital Zurich, Zurich CH-8091, Switzerland
(Westphal) Herzzentrum Segeberger Kliniken, Bad Segeberg D-23795, Germany
Publisher
MDPI AG
Abstract
Background: Although cardiovascular rehabilitation (CR) is well accepted
in general, CR-attendance and delivery still considerably vary between the
European countries. Moreover, clinical and prognostic effects of CR are
not well established for a variety of cardiovascular diseases.
 Method(s): The guidelines address all aspects of CR including
indications, contents and delivery. By processing the guidelines, every
step was externally supervised and moderated by independent members of the
"Association of the Scientific Medical Societies in Germany" (AWMF). Four
meta-analyses were performed to evaluate the prognostic effect of CR after
acute coronary syndrome (ACS), after coronary bypass grafting (CABG), in
patients with severe chronic systolic heart failure (HFrEF), and to define
the effect of psychological interventions during CR. All other indications
for CR-delivery were based on a predefined semi-structured literature
search and recommendations were established by a formal consenting process
including all medical societies involved in guideline generation.
 Result(s): Multidisciplinary CR is associated with a significant
reduction in all-cause mortality in patients after ACS and after CABG,
whereas HFrEF-patients (left ventricular ejection fraction <40%)
especially benefit in terms of exercise capacity and health-related
quality of life. Patients with other cardiovascular diseases also benefit
from CR-participation, but the scientific evidence is less clear. There is
increasing evidence that the beneficial effect of CR strongly depends on
"treatment intensity" including medical supervision, treatment of
cardiovascular risk factors, information and education, and a minimum of
individually adapted exercise volume. Additional psychologic interventions
should be performed on the basis of individual needs. Conclusion(s):
These guidelines reinforce the substantial benefit of CR in specific
clinical indications, but also describe remaining deficits in CR-delivery
in clinical practice as well as in CR-science with respect to methodology
and presentation. Copyright © 2021 by the authors. Licensee MDPI,
Basel, Switzerland.

<41>
Accession Number
2007230870
Title
Duration of antiplatelet therapy following transcatheter aortic valve
replacement: Systematic review and network meta-analysis.
Source
Journal of the American Heart Association. 10 (9) (no pagination), 2021.
Article Number: e019490. Date of Publication: 2021.
Author
Kuno T.; Yokoyama Y.; Briasoulis A.; Mori M.; Iwagami M.; Ando T.; Takagi
H.; Bangalore S.
Institution
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Briasoulis) Division of Cardiology, Heart Failure and Transplantation,
University of Iowa, Iowa City, IA, United States
(Mori) Division of Cardiac Surgery, Yale School of Medicine, New Haven,
CT, United States
(Iwagami) Department of Health Services Research, University of Tsukuba,
Japan
(Ando) Department of Cardiology, Kawasaki Saiwai Hospital, Kawasaki, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Bangalore) Division of Cardiovascular Medicine, New York University
School of Medicine, New York, NY, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Although current guidelines recommend dual antiplatelet
therapy (DAPT) for 3 to 6 months following transcath-eter aortic valve
replacement (TAVR), there are no studies directly comparing outcomes of
different durations of DAPT following TAVR. METHODS AND RESULTS: PubMed,
EMBASE, and Cochrane Database were searched through November 2020 to
identify clinical studies that investigated single antiplatelet therapy
versus DAPT use following TAVR. Studies using oral anticoagulants and
antiplatelet therapy concomitantly were excluded. The DAPT group was
subdivided by the duration of DAPT. We extracted the risk ratios (RRs) of
major or life-threatening bleeding, stroke, and all-cause mortality. Four
randomized controlled trials, 2 propensity-score matched studies, and 1
observational study were identified, yielding a total of 2498 patients who
underwent TAVR assigned to the single antiplatelet therapy group (n=1249),
3-month DAPT group (n=485), or 6-month DAPT group (n=764). Pooled analyses
demonstrated that when compared with the single antiplatelet therapy
group, the rates of major or life-threatening bleeding were significantly
higher in the 3-and 6-month DAPT groups (RR [95% CI]=2.13 [1.33- 3.40],
P=0.016; RR [95% CI]=2.54 [1.49- 4.33], P=0.007, respectively) with no
difference between the 3-month DAPT versus 6-month DAPT groups. The rates
of stroke and all-cause mortality were similar among the 3 groups.
 CONCLUSION(S): In this network meta-analysis of antiplatelet therapy
following TAVR, single antiplatelet therapy with aspirin had lower
bleeding without increasing stroke or death when compared with either 3-or
6-month DAPT. Copyright © 2021 The Authors. Published on behalf
of the American Heart Association, Inc., by Wiley.

<42>
Accession Number
2007173473
Title
Efficacy of dexmedetomidine versus morphine as an adjunct to bupivacaine
in caudal anesthesia for pediatric thoracic surgeries: A randomized
controlled trial.
Source
Anesthesiology and Pain Medicine. 11 (2) (no pagination), 2021. Article
Number: e112296. Date of Publication: April 2021.
Author
Ismail A.A.; Hamza H.M.; Gado A.A.
Institution
(Ismail, Hamza, Gado) Lecturer of Anesthesia and Pain Management,
Anesthesia Department, Faculty of Medicine, Cairo University, Egypt
Publisher
Kowsar Medical Institute
Abstract
Background: Caudal anesthesia is an effective method of pain management,
which can be successfully employed to minimize post-thoracotomy pain in
pediatric patients. However, its main disadvantage is the short
postoperative analgesic period, which can be prolonged by the concurrent
administration of one of many adjuvants. Objective(s): This
prospective randomized, blinded study aimed to compare the efficacy of
dexmedetomidine versus morphine as adjuvants to bupivacaine in caudal
anesthesia for thoracic surgeries in pediatric patients. Method(s):
Fifty patients were randomly allocated into two equal groups. To achieve
caudal epidural block anesthesia, the patients in group M (n = 25) were
administered morphine and bupivacaine, while group D (n = 25) received a
mixture of dexmedetomidine and bupivacaine. The primary outcome of this
study was the postoperative analgesic duration achieved. The secondary
outcomes included morphine administration in the first 24 hours following
caudal block anesthesia, the face, legs, activity, cry, consolability
(FLACC) scale scores, and adverse effects, including vomiting, itching,
bradycardia, hypotension, and respiratory depression. Result(s): The
results showed that patients who had received dexmedetomidine achieved a
longer postoperative analgesia as compared to those who had received
morphine (P < 0.001). Postoperatively, the heart rate, blood pressure,
pain score, and mean consumption of morphine were lower in group D as
compared to the group M. There was no significant difference in the
adverse effects between the two groups. Conclusion(s): The use of
dexmedetomidine as an adjuvant to bupivacaine for caudal anesthesia during
pediatric thoracic surgeries induced better and prolonged postoperative
analgesia as compared to morphine. Copyright © 2021, Author(s).

<43>
[Use Link to view the full text]
Accession Number
635086375
Title
Free Hemoglobin Ratio as a Novel Biomarker of Acute Kidney Injury after
On-Pump Cardiac Surgery: Secondary Analysis of a Randomized Controlled
Trial.
Source
Anesthesia and Analgesia. (pp 1548-1558), 2021. Date of Publication: 2021.
Author
Hu J.; Rezoagli E.; Zadek F.; Bittner E.A.; Lei C.; Berra L.
Institution
(Hu) Department of Critical Care Medicine, Chinese PLA General Hospital,
Beijing, China
(Bittner, Berra) Department of Anesthesia, Critical Care and Pain
Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114,
United States
(Rezoagli) School of Medicine and Surgery, University of Milan-Bicocca,
Monza, Italy
(Zadek) Department of Pathophysiology and Transplantation, University of
Milan, Milan, Italy
(Lei) Department of Anesthesiology and Perioperative Medicine, Xijing
Hospital, Fourth Military Medical University, Xi'an, China
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Cardiac surgery with cardiopulmonary bypass (CPB) is
associated with a high risk of postoperative acute kidney injury (AKI).
Due to limitations of current diagnostic strategies, we sought to
determine whether free hemoglobin (fHb) ratio (ie, levels of fHb at the
end of CPB divided by baseline fHb) could predict AKI after on-pump
cardiac surgery. METHOD(S): This is a secondary analysis of a
randomized controlled trial comparing the effect of nitric oxide
(intervention) versus nitrogen (control) on AKI after cardiac surgery
(NCT01802619). A total of 110 adult patients in the control arm were
included. First, we determined whether fHb ratio was associated with AKI
via multivariable analysis. Second, we verified whether fHb ratio could
predict AKI and incorporation of fHb ratio could improve predictive
performance at an early stage, compared with prediction using urinary
biomarkers alone. We conducted restricted cubic spline in logistic
regression for model development. We determined the predictive
performance, including area under the receiver-operating-characteristics
curve (AUC) and calibration (calibration plot and accuracy, ie, number of
correct predictions divided by total number of predictions). We also used
AUC test, likelihood ratio test, and net reclassification index (NRI) to
compare the predictive performance between competing models (ie, fHb ratio
versus neutrophil gelatinase-associated lipocalin [NGAL],
N-acetyl-beta-d-glucosaminidase [NAG], and kidney injury molecule-1
[KIM-1], respectively, and incorporation of fHb ratio with NGAL, NAG, and
KIM-1 versus urinary biomarkers alone), if applicable. RESULT(S):
Data stratified by median fHb ratio showed that subjects with an fHb ratio
>2.23 presented higher incidence of AKI (80.0% vs 49.1%; P =.001), more
need of renal replacement therapy (10.9% vs 0%; P =.036), and higher
in-hospital mortality (10.9% vs 0%; P =.036) than subjects with an fHb
ratio <=2.23. fHb ratio was associated with AKI after adjustment for
preestablished factors. fHb ratio outperformed urinary biomarkers with the
highest AUC of 0.704 (95% confidence interval [CI], 0.592-0.804) and
accuracy of 0.714 (95% CI, 0.579-0.804). Incorporation of fHb ratio
achieved better discrimination (AUC test, P =.012), calibration
(likelihood ratio test, P <.001; accuracy, 0.740 [95% CI, 0.617-0.832] vs
0.632 [95% CI, 0.477-0.748]), and significant prediction increment (NRI,
0.638; 95% CI, 0.269-1.008; P <.001) at an early stage, compared with
prediction using urinary biomarkers alone. CONCLUSION(S): Results
from this exploratory, hypothesis-generating retrospective, observational
study shows that fHb ratio at the end of CPB might be used as a novel,
widely applicable biomarker for AKI. The use of fHb ratio might help for
an early detection of AKI, compared with prediction based only on urinary
biomarkers. Copyright © 2021 Lippincott Williams and Wilkins. All
rights reserved.

<44>
Accession Number
635084189
Title
Kidney Transplant List Status and Outcomes in the ISCHEMIA-CKD Trial.
Source
Journal of the American College of Cardiology. (no pagination), 2021. Date
of Publication: 04 May 2021.
Author
Herzog C.A.; Simegn M.A.; Xu Y.; Costa S.R.; Mathew R.O.; El-Hajjar M.C.;
Gulati S.; Maldonado R.A.; Daugas E.; Madero M.; Fleg J.L.; Anthopolos R.;
Stone G.W.; Sidhu M.S.; Maron D.J.; Hochman J.S.; Bangalore S.
Institution
(Herzog, Simegn) Department of Medicine, Hennepin Healthcare, Minneapolis,
MN, USA; University of Minnesota, Minneapolis, MN, USA
(Xu, Anthopolos, Hochman, Bangalore) NYU Grossman School of Medicine, NY,
NY, United States
(Costa) Dartmouth-Hitchcock Medical Center, NH, United States
(Mathew) Columbia V.A. Health Care System, SC, Columbia, United States
(El-Hajjar, Sidhu) Albany Medical College and Albany Medical Center,
Albany, NY, USA
(Gulati) Fortis Flt Lt Rajan Dhall Hospital, New Delhi, Delhi, India
(Maldonado) CordobaArgentina
(Daugas) Department of Nephrology, Bichat, Assistance Publique-Hopitaux,
Paris, France
(Madero) Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City,
Mexico
(Fleg) National Heart, Lung, Blood Institute, MD, Bethesda, United States
(Stone) Icahn School of Medicine at Mount Sinai, Cardiovascular Research
Foundation, NY, NY, United States
(Maron) Department of Medicine, Stanford University, Stanford, CA, USA
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients with chronic kidney disease (CKD) and coronary artery
disease frequently undergo preemptive revascularization before kidney
transplant listing. OBJECTIVE(S): In this post-hoc analysis from
ISCHEMIA-CKD, we compared outcomes of patients not listed versus those
listed according to management strategy. METHOD(S): In ISCHEMIA-CKD
(n=777), 194 patients (25%) with chronic coronary syndromes and at least
moderate ischemia were listed for transplant. The primary (all-cause
mortality or nonfatal myocardial infarction [MI]) and secondary (death,
nonfatal MI, hospitalization for unstable angina, heart failure,
resuscitated cardiac arrest, or stroke) outcomes were analyzed using Cox
multivariable modeling. Heterogeneity of randomized treatment effect
between listed versus not listed groups was assessed. RESULT(S):
Compared with those not listed, listed patients were younger (60 versus 65
years), less likely of Asian race (15% versus 29%), more likely on
dialysis (83% versus 44%), had fewer anginal symptoms, and more likely to
have coronary angiography and coronary revascularization irrespective of
treatment assignment. Among patients assigned to an invasive strategy
versus conservative strategy, the adjusted hazard ratios (aHR) (95%
confidence interval [CI]) for the primary outcome were 0.91 (0.54-1.54)
and 1.03 (0.78-1.37) for those listed and not listed, respectively
(pinteraction=0.68). Adjusted HR for secondary outcomes were 0.89
(0.55-1.46) in listed and 1.17 (0.89-1.53) in those not listed
(pinteraction=0.35). CONCLUSION(S): In ISCHEMIA-CKD, an invasive
strategy in kidney transplant candidates did not improve outcomes compared
with conservative management. These data do not support routine coronary
angiography or revascularization in patients with advanced CKD and chronic
coronary syndromes listed for transplant. Copyright © 2021.
Published by Elsevier Inc.

<45>
Accession Number
635084082
Title
Temporary mechanical circulatory support devices: updates from recent
studies.
Source
Current opinion in cardiology. (no pagination), 2021. Date of Publication:
14 May 2021.
Author
Marbach J.A.; Chweich H.; Miyashita S.; Kapur N.K.
Institution
(Marbach) Division of Pulmonary, Critical Care and Sleep Medicine
Department of Medicine The Cardiovascular Center, Tufts Medical Center and
Tufts University School of Medicine, Haval Chweich contributed equally to
this study, Boston, MA
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: Over the past several years, the role of short-term
mechanical circulatory support (MCS) devices has become the dominant focus
in efforts to improve outcomes in patients with cardiogenic shock (CS).
Alongside these efforts, temporary MCS devices have been increasingly used
to support patients prior to cardiac surgery, during high-risk
percutaneous coronary intervention, awaiting cardiac transplantation, and
in the setting of refractory cardiac arrest. The present review aims to
provide an update on the recent literature evaluating the evolving role of
temporary MCS devices, and to provide insights into the current challenges
and future directions of MCS research. RECENT FINDINGS: Recent
observational data have demonstrated potential roles for intra-aortic
balloon pump preoperatively in high-risk patients awaiting coronary artery
bypass grafting, and advanced heart failure patients awaiting
transplantation. Impella continues to demonstrate promising results as
part of an early MCS strategy in CS, as a temporary bridge to
transplantation, and as a mechanism for left ventricular unloading in
patients on venoarterial extracorporeal membrane oxygenation (ECMO).
Finally, the first randomized trial of ECMO facilitated resuscitation in
the United States demonstrated improved survival in patients with
refractory out of hospital cardiac arrest. SUMMARY: Though randomized data
remains limited, observational data continue to support the role of
temporary MCS devices in a variety of clinical settings. Copyright
© 2021 Wolters Kluwer Health, Inc. All rights reserved.

<46>
Accession Number
635082553
Title
Plasma volume and atrial natriuretic peptide during induction of
anaesthesia.
Source
Acta anaesthesiologica Scandinavica. (no pagination), 2021. Date of
Publication: 15 May 2021.
Author
Damen T.; Nygren A.
Institution
(Damen, Nygren) Department of Anaesthesiology and Intensive Care Medicine,
Institute of Clinical Sciences at the Sahlgrenska Academy, University of
Gothenburg, Sahlgrenska University Hospital, Section of Cardiothoracic
Anaesthesia and Intensive Care, Gothenburg, Sweden
Publisher
NLM (Medline)
Abstract
We thank Dr Saito for the interest in our paper "Effects of different mean
arterial pressure targets on plasma volume, ANP and glycocalyx-A
randomized trial" where cardiac surgery patients were randomised to a mean
arterial pressure (MAP) of 60 or 90 mm Hg using norepinephrine (NE)
infusion.1,2 The plasma volume (PV) and the Mid Regional-pro Atrial
Natriuretic Peptide (MR-proANP) increased in the group randomised to lower
MAP. All patients had a normal left ventricular ejection fraction of 45%
or more. Copyright This article is protected by copyright. All rights
reserved.

<47>
Accession Number
635080683
Title
Current clinical applications and potential perspective of micro-computed
tomography in cardiovascular imaging: A systematic scoping review.
Source
Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese.
(no pagination), 2021. Date of Publication: 12 May 2021.
Author
Papazoglou A.S.; Karagiannidis E.; Moysidis D.V.; Sofidis G.; Bompoti A.;
Stalikas N.; Panteris E.; Arvanitidis C.; Herrman M.D.; Michaelson J.S.;
Sianos G.
Institution
(Papazoglou, Karagiannidis, Moysidis, Sofidis, Stalikas, Sianos) First
Department of Cardiology, AHEPA University Hospital, Aristotle University
of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
(Bompoti) Medway NHS Foundation Trust, United Kingdom
(Panteris) Center for Interdisciplinary Research and Innovation
(CIRI-AUTH), Balkan Center, B1.4, 10th Km Thessaloniki-Thermi Rd ,P.O. Box
8318, Thessaloniki GR 57001, Greece
(Arvanitidis) Institute of Marine Biology, Biotechnology and Aquaculture
(IMBBC), Hellenic Centre for Marine Research (HCMR), Heraklion, Crete,
70013, Greece; LifeWatch ERIC, Sector II-II, Plaza de Espana, 41071,
Seville Spain
(Herrman, Michaelson) Department of Pathology, Massachusetts General
Hospital and Harvard Medical School, Boston
Publisher
NLM (Medline)
Abstract
BACKGROUND: Micro-computed tomography (micro-CT) constitutes an emerging
imaging technique, which can be utilized in cardiovascular medicine to
study in-detail the microstructure of heart and vessels. This paper aims
to systematically review the clinical utility of micro-CT in
cardiovascular imaging and propose future applications of micro-CT imaging
in cardiovascular research. METHOD(S): A systematic scoping review
was conducted by searching for original studies written in English
according to Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) extension for scoping reviews. Medline, Scopus,
ClinicalTrials.gov, and the Cochrane library were systematically searched
through December 11, 2020 to identify publications concerning micro-CT
applications in cardiovascular imaging. Preclinical-animal studies and
case reports were excluded. The Newcastle-Ottawa assessment scale for
observational studies was used to evaluate study quality. RESULT(S):
In total, the search strategy identified 30 studies that report on
micro-CT-based cardiovascular imaging and satisfy our eligibility
criteria. Across all included studies, the total number of micro-CT
scanned specimens was 1,227. Six studies involved postmortem
3D-reconstruction of congenital heart defects, while eleven studies
described atherosclerotic vessel (coronary or carotid) characteristics.
Thirteen other studies employed micro-CT for the assessment of medical
devices (mainly stents or prosthetic valves). CONCLUSION(S): Micro-CT
is a novel imaging modality, effectively adapted for the 3D visualization
and analysis of cardiac soft tissues and devices at high spatial
resolution. Its increasing use could make significant contributions to our
improved understanding of the histopathophysiology of cardiovascular
diseases, and thus has the potential to optimize interventional procedures
and technologies and improving patient outcomes. Copyright © 2021
Hellenic Society of Cardiology. Published by Elsevier B.V. All rights
reserved.

<48>
Accession Number
634842793
Title
Heparin-induced thrombocytopenia: construction of a pre-test diagnostic
score derived from the analysis of a prospective multinational database,
with internal validation.
Source
Journal of thrombosis and haemostasis : JTH. (no pagination), 2021. Date
of Publication: 19 Apr 2021.
Author
Tardy-Poncet B.; de Maistre E.; Pouplard C.; Presles E.; Alhenc-Gelas M.;
Lasne D.; Horellou M.-H.; Mouton C.; Serre-Sapin A.; Bauters A.; Nguyen
P.; Mullier F.; Perrin J.; Le Gal G.; Morange P.-E.; Grunebaum L.;
Lillo-Le Louet A.; Elalamy I.; Gruel Y.; Greinacher A.; Lecompte T.; Tardy
B.
Institution
(Tardy-Poncet, Presles, Tardy) Universite de Lyon, CIC 1408,
Saint-Etienne, France
(de Maistre) Hemostasis unit, CHU Dijon, Dijon, France
(Pouplard, Gruel) Division of Hematology - Hemostasis, University Hospital
of Tours, Tours, France
(Alhenc-Gelas) Hemostasis unit, Hopital Europeen Georges Pompidou, AP-HP,
Paris, France
(Lasne) Hemostasis unit, Hopital Necker, AP-HP, Inserm U1176, France
(Horellou) Hematology Laboratory Unit, Hopital Universitaire Paris-centre,
Paris, France
(Mouton) Hemostasis unit, CHU Bordeaux, Bordeaux, France
(Serre-Sapin) Hemostasis unit, CHU Clermont-Ferrand, Clermont-Ferrand,
France
(Bauters) Hemostasis unit, CHU Lille, Lille, France
(Nguyen) Hemostasis unit, CHU Reims, Reims, France
(Mullier) Namur Thrombosis and Hemostasis Center, Hematology Laboratory,
CHU UCL Namur, Universite catholique de Louvain, Yvoir, Belgium
(Perrin) Hemostasis unit, CHU Nancy, Nancy, France
(Le Gal) Department of Medicine, University of Ottawa, Ottawa Hospital
Research Institute, Thrombosis Research Group, Ottawa, Canada
(Morange) Aix Marseille University, INSERM, INRA, Laboratory of
Hematology, La Timone Hospital, Assistance Publique des Hopitaux de
Marseille, Marseille, France
(Grunebaum) Laboratory of Hematology, CHU Strasbourg, Strasbourg, France
(Lillo-Le Louet) Pharmacovigilance center, Georges Pompidou European
Hospital, AP-HP, Paris, France
(Elalamy) Hematology and Thrombosis Center, Tenon University Hospital,
INSERM, Sorbonne University, Paris UMRS 938, France
(Greinacher) Institut fuer Immunologie und Transfusionsmedizin,
Universitaetsmedizin Greifswald, Greifswald, Germany
(Lecompte) Department of Medicine, Geneva University Hospitals, Geneva
Platelet Group (GpG), Faculty of Medicine, University of Geneva, Geneva,
Switzerland
Publisher
NLM (Medline)
Abstract
BACKGROUND: Diagnosis of heparin-induced thrombocytopenia (HIT) requires
pre-test probability assessment and dedicated laboratory assays.
 OBJECTIVE(S): To develop a pre-test score for HIT. DESIGN:
Observational; analysis of prospectively collected data of hospitalized
patients suspected with HIT (ClinicalTrials.gov NCT00748839). SETTING:
Thirty-one tertiary hospitals in France, Switzerland, and Belgium.
PATIENTS: Patients tested for HIT antibodies (2,280 evaluable), randomly
allocated to derivation and validation cohorts. MEASUREMENTS: Independent
adjudicators diagnosed HIT based on the prospectively collected data and
Serotonin Release Assay results. RESULT(S): HIT was diagnosed in 234
(14.7%) and 99 (14.5%) patients in the two cohorts. Eight features were
associated with HIT (in brackets, points assigned for score calculation of
the score): unfractionated heparin (1); therapeutic-dose heparin (1);
cardiopulmonary bypass (cardiac surgery) (2); major trauma (3); 5- to
21-day interval from anticoagulation initiation to suspicion of HIT (4);
>= 40% decrease in platelet count over <= six days (3); thrombotic event,
arterial (3) or venous (3). The C-statistic was 0.79 [95% CI, 0.76-0.82].
In the validation cohort, the area under the receiver operating
characteristic curve was 0.77 [95% CI, 0.74-0.80]. Three groups of scores
were defined; HIT prevalence reached almost 30% in the high-probability
group. LIMITATION: The performance of the score may depend on settings and
practices. CONCLUSION(S): The objective, easy-to-collect, clinical
features of HIT we evidenced were incorporated into a pre-test score,
which may guide clinical decisions regarding diagnostic testing and
anticoagulation. Copyright This article is protected by copyright. All
rights reserved.

<49>
Accession Number
2007396266
Title
Effects of platelet-rich plasma on the healing of sternal wounds: A
meta-analysis.
Source
Wound Repair and Regeneration. 29 (1) (pp 153-167), 2021. Date of
Publication: January/February 2021.
Author
Yao D.; Feng G.; Zhao F.; Hao D.
Institution
(Yao, Feng, Zhao, Hao) No. 3 Department of Burns and Plastic Surgery and
Wound Healing Center, The Fourth Medical Center of Chinese PLA General
Hospital, Beijing, China
Publisher
Blackwell Publishing Inc.
Abstract
Sternal wound infection (SWI) is a devastating complication after cardiac
surgery. Platelet-rich plasma (PRP) may have a positive impact on sternal
wound healing. A systematic review with meta-analyses was performed to
evaluate the clinical effectiveness of topical application of autologous
PRP for preventing SWI and promoting sternal wound healing compared to
placebo or standard treatment without PRP. Relevant studies published in
English or Chinese were retrieved from the Cochrane Central Register of
Controlled Trials (The Cochrane Library), PubMed, Ovid EMBASE, Web of
Science, Springer Link, and the WHO International Clinical Trials Registry
Platform (ICTRP) using the search terms "platelet-rich plasma" and
"sternal wound" or "thoracic incision." References identified through the
electronic search were screened, the data were extracted, and the
methodological quality of the included studies was assessed. The
meta-analysis was performed for the following outcomes: incidence of SWI,
incidence of deep sternal wound infection (DSWI), postoperative blood loss
(PBL), and other risk factors. In the systematic review, totally 10
comparable studies were identified, involving 7879 patients. The
meta-analysis for the subgroup of retrospective cohort studies (RSCs)
showed that the incidence of SWI and DSWI in patients treated with PRP was
significantly lower than that in patients without PRP treatment. However,
for the subgroup of randomized controlled trials (RCTs), there was no
significant difference in the incidence of SWI or DSWI after intervention
between the PRP and control groups. There was no significant difference in
PBL in both RCTs and RSCs subgroups. Neither adverse reactions nor in-situ
recurrences were reported. According to the results, PRP could be
considered as a candidate treatment to prevent SWI and DSWI. However, the
quality of the evidence is too weak, and high-quality RCTs are needed to
assess its efficacy on preventing SWI and DSWI. Copyright © 2020
The Wound Healing Society

<50>
Accession Number
2011406291
Title
Continuous erector spinae plane block versus thoracic epidural analgesia
in video-assisted thoracic surgery: a study protocol for a prospective
randomized open label non-inferiority trial.
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 321. Date of
Publication: December 2021.
Author
van den Broek R.J.C.; Koopman J.S.H.A.; Postema J.M.C.; Verberkmoes N.J.;
Chin K.J.; Bouwman R.A.; Versyck B.J.B.
Institution
(van den Broek, Bouwman, Versyck) Department of Anesthesiology and Pain
Medicine, Catharina Hospital, Michelangelolaan 2, Eindhoven 5623 EJ,
Netherlands
(Koopman, Postema) Department of Anesthesiology and Pain Medicine,
Maasstad Hospital, Maasstadweg 21, Rotterdam 3079 DZ, Netherlands
(Verberkmoes) Heart Center Catharina Hospital, Michelangelolaan 2,
Eindhoven 5623 EJ, Netherlands
(Chin) Department of Anesthesiology and Pain Medicine, Toronto Western
Hospital, University of Toronto, 339 Bathurst St, Toronto, ON M5T 2S8,
Canada
(Versyck) Department of Anesthesiology and Pain Medicine, AZ Turnhout,
Steenweg op Merksplas 44, Turnhout 2300, Belgium
Publisher
BioMed Central Ltd
Abstract
Background: Thoracic epidural analgesia is considered the gold standard
for pain relief in video-assisted thoracoscopic surgery. This neuraxial
technique blocks pain sensation by injecting a local anesthetic agent in
the epidural space near the spinal cord to block spinal nerve roots.
Recently, the erector spinae plane block has been introduced as a
practical alternative to the thoracic epidural. This interfascial regional
anesthesia technique interrupts pain sensation by injecting a local
anesthetic agent in between the muscular layers of the thoracic wall.
Several case series and three RCTs described it as an effective pain
management technique in video-assisted thoracoscopic surgery (Scimia et
al., Reg Anesth Pain Med 42:537, 2017; Adhikary et al., Indian J Anaesth
62:75-8, 2018; Kim, A randomized controlled trial comparing continuous
erector spinae plane block with thoracic epidural analgesia for
postoperative pain management in video-assisted thoracic surgery, n.d.;
Yao et al., J Clin Anesth 63:109783, 2020; Ciftci et al., J Cardiothorac
Vasc Anesth 34:444-9, 2020). The objective of this study is to test the
hypothesis that a continuous erector spinae plane block incorporated into
an opioid-based systemic multimodal analgesia regimen is non-inferior in
terms of the quality of postoperative recovery compared to continuous
thoracic epidural local anesthetic-opioid analgesia in patients undergoing
elective unilateral video-assisted thoracoscopic surgery. Method(s):
This is a prospective randomized open label non-inferiority trial. A total
of 90 adult patients undergoing video-assisted thoracoscopic surgery will
be randomized 1:1 to receive pain treatment with either (1) continuous
erector spinae plane block plus intravenous patient-controlled analgesia
with piritramide (study group) or (2) continuous thoracic epidural
analgesia with a local anesthetic-opioid infusate (control group). All
patients will receive additional systemic multimodal analgesia with
paracetamol and non-steroidal anti-inflammatory drugs. The primary
endpoint is the quality of recovery as measured by the Quality of
Recovery-15 score. Secondary endpoints are postoperative pain as Numerical
Rating Score scores, length of hospital stay, failure of analgesic
technique, postoperative morphine-equivalent consumption, itching, nausea
and vomiting, total operative time, complications related to surgery,
perioperative hypotension, complications related to pain treatment,
duration of bladder catheterization, and time of first assisted
mobilization > 20 m and of mobilization to sitting in a chair.
 Discussion(s): This randomized controlled trial aims to confirm
whether continuous erector spinae plane block plus patient-controlled
opioid analgesia can equal the analgesic effect of a thoracic epidural
local anesthetic-opioid infusion in patients undergoing video-assisted
thoracoscopic surgery. Trial registration: Netherlands Trial Register
NL6433. Registered on 1 March 2018. This trial was prospectively
registered. Copyright © 2021, The Author(s).

<51>
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. 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. 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%). 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. Copyright © Translational Pediatrics. All rights
reserved.

<52>
Accession Number
2010766215
Title
The effectiveness of Sufi music for mental health outcomes. A systematic
review and meta-analysis of 21 randomised trials.
Source
Complementary Therapies in Medicine. 57 (no pagination), 2021. Article
Number: 102664. Date of Publication: March 2021.
Author
Gurbuz-Dogan R.N.; Ali A.; Candy B.; King M.
Institution
(Gurbuz-Dogan, Ali, Candy, King) Division of Psychiatry, University
College London, London, United Kingdom
Publisher
Churchill Livingstone
Abstract
Background: There is some evidence that Sufi music therapy might improve
physical and mental well-being; however, no systematic review or
meta-analysis has pooled and critiqued the evidence. The aim of this
systematic review was to evaluate the effects of Sufi music therapy on
mental health outcomes. Method(s): We searched Medline, PsycINFO, the
Web of Science, Science Direct, PsycARTICLES, Cochrane Library, SCOPUS,
CINAHL Plus, AMED, and ULAKBIM databases, and the reference lists of the
studies found. Papers published in academic peer-reviewed journals were
included, as well as from other sources such as chapters in edited books,
the grey literature, or conference presentations. Articles published up to
March 2020 in Turkish and English were included. Our primary outcome of
interest was anxiety and secondary outcomes of interest were other mental
health outcomes such as depression. To assess the methodological quality
of the articles, the Cochrane Risk of Bias Tool was used. The quality of
evidence was assessed using the GRADEpro GDT system. Result(s): This
search yielded 21 clinical trials that were eligible for inclusion. A
meta-analysis, using a random effects model, of 18 randomised controlled
trials involving 1454 participants showed that Sufi music therapy with
makams, compared with treatment as usual (TAU) or a no-music control
group, reduced symptoms of anxiety in the short term in patients
undergoing an operation or treatments such as chemotherapy or
haemodialysis (standardised mean difference SMD= -1.15, 95 % CI, -1.64 to
-0.65; very low-quality evidence). The evidence of Sufi music with makam's
effect on anxiety is rated as very low. Qualitative synthesis of secondary
outcomes revealed significant effects for depression, positive symptoms in
schizophrenia, stress, which however were based on fewer studies. Trials
were of moderate methodological quality, and there was significant
heterogeneity across the studies. Conclusion(s): Sufi music may
reduce anxiety of patients undergoing medical procedures like
haemodialysis, coronary artery surgery, angiography, colonoscopy, bone
marrow aspiration and biopsy procedures. Evidence from single studies
suggests effects on depression and stress as well. However, due to
methodological limitations of the studies, further, higher quality studies
are required in other cultures. Copyright © 2021

<53>
Accession Number
634475739
Title
Perioperative Beta-Blocker for Atrial Fibrillation after Cardiac Surgery:
A Meta-Analysis.
Source
Thoracic and Cardiovascular Surgeon. 69 (2) (pp 133-140), 2021. Date of
Publication: 01 Mar 2021.
Author
Kim S.H.; Jang M.-J.; Hwang H.Y.
Institution
(Kim, Hwang) Department of Thoracic and Cardiovascular Surgery, Seoul
National University Hospital, Seoul, South Korea
(Jang) Medical Research Collaborating Center, Seoul National University
Hospital, Seoul, South Korea
Publisher
Georg Thieme Verlag
Abstract
Background: This meta-analysis was conducted to evaluate the impact of
perioperative use of beta-blocker (BB) on postoperative atrial
fibrillation (POAF) after cardiac surgery other than isolated coronary
artery bypass grafting (CABG). Method(s): Five online databases were
searched. Studies were included if they (1) enrolled patients who
underwent cardiac surgery other than isolated CABG and (2) demonstrated
the impact of perioperative use of BB on POAF based on the randomized
controlled trial or adjusted analysis. The primary outcome was the
occurrence rates of POAF after cardiac surgery. A meta-regression and
subgroup analysis were performed according to the proportion of patients
with cardiac surgery other than isolated CABG and the timing of BB use,
respectively. Result(s): Thirteen articles (5 randomized and 8
nonrandomized studies: n = 25,496) were selected. Proportion of enrolled
patients undergoing cardiac surgery other than isolated CABG ranged from 7
to 100%. The BBs were used in preoperative, postoperative, and both
periods in 5, 5, and 3 studies, respectively. The pooled analyses showed
that the risk of POAF was significantly lower in patients with
perioperative BB than those without (odds ratio, 95% confidence interval =
0.56, 0.35-0.91 and 0.70, 0.55-0.91 in randomized and nonrandomized
studies, respectively). The risk of POAF was lower in the BB group
irrespective of the proportion of nonisolated CABG. Benefit regarding
in-hospital mortality was inconclusive. Perioperative stroke and length of
stay were not significantly different between BB and non-BB groups.
 Conclusion(s): Perioperative use of BB is effective in preventing
POAF even in patients undergoing cardiac surgery other than isolated CABG,
although it did not translate into improved clinical
outcomes. Copyright © 2021 Georg Thieme Verlag. All rights
reserved.

<54>
Accession Number
2012053601
Title
Informativity of radionuclide renal scintigraphy and biochemical markers
in detection of renal dysfunction in patients undergoing myocardial
revascularization.
Source
Russian Electronic Journal of Radiology. 11 (1) (pp 144-150), 2021. Date
of Publication: 2021.
Author
Vesnina Z.V.; Kozlov B.N.; Lishmanov Y.B.
Institution
(Vesnina, Kozlov, Lishmanov) Cardiology Research Institute, Tomsk National
Research Medical Centre, Russian Academy of Sciences, Tomsk, Russian
Federation
Publisher
I.M. Sechenov First Moscow State Medical University
Abstract
Acute renal injury (AKI) is a common complication of cardiac surgery.
Diagnostic criteria of acute renal dysfunction based on serum creatinine
concentrations do are not suitable for early detection of AKI. Purpose. To
evaluate the diagnostic significance of radionuclide scintigraphy and
biochemical markers in the detection of renal dysfunction in patients with
coronary artery disease (CAD) in the early postoperative period after
coronary artery bypass grafting (CABG). Material and methods. A randomized
controlled trial comprised a total of 108 CAD patients (all men aged 54.94
+/- 0.72 years) who underwent direct myocardial revasculariza-tion by
CABG. All patients received dynamic renal scintigraphy with 99mTc-DTPA and
blood tests measuring serum concentrations of creatinine, lipocalin
(NGAL), and Cystatin C before and after CABG. Results. After CABG, the
mean values of total glomerular filtration rate (GFR) and GFR for each
kidney significantly decreased whereas the serum concentrations of
neutro-phil gelatinase-associated lipocalin (NGAL) and Cystatin C in blood
serum significantly in-creased. In the postoperative period, the
creatinine clearance also significantly decreased. Statistical analysis
revealed direct correlations of cardiopulmonary bypass duration with the
changes in GFR (R = 0.42; P = 0.017) and s-NGAL (R = 0.39, P = 0.02) in
cardiac sur-gery patients. Conclusion. Radionuclide method is not inferior
to testing biochemical markers in the evaluation of early postoperative
renal dysfunction in regard to diagnostic value and
informativeness. Copyright © 2021 Russian Electronic Journal of
Radiology. All rights reserved.

<55>
Accession Number
2011875444
Title
Economic outcomes of depression screening after acute coronary syndromes:
The CODIACS-QoL randomized clinical trial.
Source
General Hospital Psychiatry. 71 (pp 47-54), 2021. Date of Publication: 01
Jul 2021.
Author
Ladapo J.A.; Davidson K.W.; Moise N.; Chen A.; Clarke G.N.; Dolor R.J.;
Margolis K.L.; Thanataveerat A.; Kronish I.M.
Institution
(Ladapo, Chen) David Geffen School of Medicine at UCLA, Los Angeles, CA,
United States
(Davidson) Center for Personalized Health, Feinstein Institutes for
Medical Research, Northwell Health, Manhasset, NY, United States
(Moise, Thanataveerat, Kronish) Columbia University Irving Medical Center,
New York, NY, United States
(Clarke) Kaiser Permanente, Portland, OR, United States
(Dolor) Duke University School of Medicine, Durham, NC, United States
(Margolis) HealthPartners Institute, Minneapolis, MN, United States
Publisher
Elsevier Inc.
Abstract
Objective: To evaluate the cost-effectiveness of screening for depression
in patients with acute coronary syndrome (ACS) and no history of
depression. Method(s): Cost-effectiveness analysis of a randomized
trial enrolling 1500 patients with ACS between 2013 and 2017. Patients
were randomized to no screening, screening and notifying the primary care
provider (PCP), and screening, notifying the PCP, and providing enhanced
depression treatment. Outcomes measured were Healthcare utilization,
costs, and incremental cost-effectiveness ratios. Result(s): 7.1% of
patients screened positive for depressive symptoms. There was no
significant difference in usage of mental health services, cardiovascular
tests and procedures, and medications. Mean total costs in No Screen group
($7440), in Screen, Notify, and Treat group ($6745), and in Screen and
Notify group ($6204). The difference was only significant in the Screen
and Notify group versus the No Screen group (-$1236, 95% confidence
interval -$2388 to -$96). Because mean QALYs were higher (+0.003 QALY in
Screen and Notify; +0.004 QALYs in Screen, Notify, and Treat) and mean
total costs were lower in both intervention groups, these interventions
were cost-effective. There was substantial uncertainty because confidence
intervals around cost differences were wide and QALY effects were small.
 Conclusion(s): Depression screening strategies for patients with ACS
may be modestly cost-effective. Copyright © 2021

<56>
Accession Number
2011806867
Title
Plexus anesthesia versus general anesthesia for carotid endarterectomy: A
systematic review with meta-analyses.
Source
Annals of Medicine and Surgery. 65 (no pagination), 2021. Article Number:
102327. Date of Publication: May 2021.
Author
Marsman M.S.; Wetterslev J.; Keus F.; van Aalst D.; van Rooij F.G.;
Heyligers J.M.M.; Moll F.L.; Jahrome A.K.; Vriens P.W.H.E.; Koning G.G.
Institution
(Marsman) Department of Vascular Surgery, Rijnstate Hospital, Arnhem,
Netherlands
(Wetterslev) Copenhagen Trial Unit, Center for Clinical Intervention
Research, Rigshospitalet Copenhagen University Hospital, Copenhagen,
Denmark
(Keus) Department of Critical Care, University of Groningen, University
Medical Center Groningen, Netherlands
(van Aalst) Department of Anesthesiology, Radboud University Medical
Center Nijmegen, Nijmegen, Netherlands
(van Rooij) Department of Neurology, Medical Center Leeuwarden,
Leeuwarden, Netherlands
(Heyligers, Vriens) Department of Vascular Surgery, Elisabeth-TweeSteden
Hospital, Tilburg, Netherlands
(Moll) Department of Vascular Surgery, University Medical Center Utrecht,
Utrecht, Netherlands
(Jahrome) Department of Vascular Surgery, Medical Center Leeuwarden,
Leeuwarden, Netherlands
(Koning) Department of Vascular Surgery, ZGT, Hospital Group Twente,
Almelo/Hengelo, Netherlands
Publisher
Elsevier Ltd
Abstract
Introduction: Traditional carotid endarterectomy is considered to be the
standard technique for prevention of a new stroke in patients with a
symptomatic carotid stenosis. Use of plexus anesthesia or general
anesthesia in traditional carotid endarterectomy is, to date, not
unequivocally proven to be superior to one other. A systematic review was
needed for evaluation of benefits and harms to determine which technique,
plexus anesthesia or general anesthesia is more effective for traditional
carotid endarterectomy in patients with symptomatic carotid stenosis.
 Method(s): The review was conducted according to our protocol
following the recommendations of Cochrane and reported according to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Searches were updated on the October 1, 2020. We did not find any
randomized clinical trial comparing plexus anesthesia and general
anesthesia in carotid endarterectomy with patch angioplasty matching our
protocol criteria in patients with a symptomatic and significant (>=50%)
carotid stenosis. Conclusion(s): Based on the current, high risk of
bias evidence, we concluded there is a need for new randomized clinical
trials with overall low risk of bias comparing plexus anesthesia with
general anesthesia in carotid endarterectomy with patch closure of the
arterial wall in patients with a symptomatic and significant (>=50%)
stenosis of the internal carotid artery. Protocol unique identification
number (UIN): CRD42019139913,
(https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=139913); Copyright © 2021

<57>
Accession Number
2010703944
Title
Hyper-oncotic vs. Hypo-oncotic Albumin Solutions: a Systematic Review of
Clinical Efficacy and Safety.
Source
SN Comprehensive Clinical Medicine. 3 (5) (pp 1137-1147), 2021. Date of
Publication: May 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. Copyright © 2021, The Author(s).

<58>
Accession Number
2010606836
Title
Ten-Year Outcomes of Percutaneous Coronary Intervention Versus Coronary
Artery Bypass Grafting for Patients with Type 2 Diabetes Mellitus
Suffering from Left Main Coronary Disease: A Meta-Analysis.
Source
Diabetes Therapy. 12 (4) (pp 1041-1054), 2021. Date of Publication: April
2021.
Author
Wang H.; Wei Y.; Li X.; Jhummun V.; Ahmed M.A.
Institution
(Wang, Wang, Wei, Li) Department of Cardiology, The People's Hospital of
Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021, China
(Jhummun) Nanjing Medical University, Nanjing, Jiangsu, China
(Ahmed) Department of Cardiology, Peking University People's Hospital,
Beijing, China
Publisher
Adis
Abstract
Introduction: In this meta-analysis, we aimed to systematically compare
the 10-year outcomes of percutaneous coronary intervention (PCI) versus
coronary artery bypass grafting (CABG) in patients with type 2 diabetes
mellitus (T2DM) suffering from left main coronary artery disease (LMCD).
 Method(s): Medical Literature Analysis and Retrieval System Online
(MEDLINE), http://www.ClinicalTrials.gov, Excerpta Medica dataBASE
(EMBASE), Cochrane Central, Web of Science, and Google scholar were
searched for publications comparing 10-year outcomes of PCI versus CABG in
patients with T2DM suffering from LMCD. Cardiovascular outcomes were
considered as the clinical endpoints. Statistical analysis was carried out
using RevMan software (version 5.4). Risk ratios (RR) with 95% confidence
intervals (CI) were used to represent the data after analysis.
 Result(s): Eight studies (three randomized trials and five
observational studies) with a total number of 3835 participants with T2DM
were included in this analysis; 2340 participants were assigned to the PCI
group and 1495 participants were assigned to the CABG group. Results of
this analysis showed that mortality (RR 0.85, 95% CI 0.73-1.00; P = 0.05),
myocardial infarction (RR 0.53, 95% CI 0.35-0.80; P = 0.002), repeated
revascularization (RR 0.34, 95% CI 0.26-0.46; P = 0.00001), and target
vessel revascularization (RR 0.26, 95% CI 0.18-0.38; P = 0.00001) were
significantly higher with PCI when compared to CABG in these patients with
diabetes and LMCD. Major adverse cardiac and cerebrovascular events were
also significantly higher with PCI at 10 years (RR 0.67, 95% CI 0.49-0.92;
P = 0.01). However, CABG was associated with a significantly higher risk
of stroke (RR 2.16, 95% CI 1.39-3.37; P = 0.0007). Conclusion(s):
During a long-term follow-up time period of 10 years, PCI was associated
with worse clinical outcomes compared to CABG in these patients with T2DM
suffering from LMCD. However, a significantly higher risk of stroke was
observed with CABG. This piece of information might be vital in order to
carefully choose and prevent complications following revascularization in
such patients. Copyright © 2021, The Author(s).

<59>
Accession Number
2010126569
Title
Interleukin-6, C-reactive protein, fibrinogen, and risk of recurrence
after ischaemic stroke: Systematic review and meta-analysis.
Source
European Stroke Journal. 6 (1) (pp 62-71), 2021. Date of Publication:
March 2021.
Author
McCabe J.J.; O'Reilly E.; Coveney S.; Collins R.; Healy L.; McManus J.;
Mulcahy R.; Moynihan B.; Cassidy T.; Hsu F.; Worrall B.; Murphy S.;
O'Donnell M.; Kelly P.J.
Institution
(McCabe, O'Reilly, Coveney, Collins, Healy, McManus, Mulcahy, Moynihan,
Murphy, O'Donnell, Kelly) Health Research Board (HRB) Stroke Clinical
Trials Network Ireland (SCTNI), Dublin, Ireland
(McCabe, Coveney, Murphy, Kelly) Neurovascular Unit for Applied
Translational and Therapeutics Research, Catherine McAuley Centre, Dublin,
Ireland
(McCabe, Cassidy, Murphy) School of Medicine, University College Dublin,
Dublin, Ireland
(McCabe, Murphy) Medicine for the Elderly Department/Stroke Medicine,
Mater Misericordiae University Hospital, Dublin, Ireland
(Coveney, Collins) Department of Geriatric Medicine, Tallaght University
Hospital, Dublin, Ireland
(Healy) Department of Geriatric Medicine, Cork University Hospital, Cork,
Ireland
(McManus) Department of Geriatric Medicine, University Hospital Limerick,
Ireland
(Mulcahy) Department of Geriatric Medicine, Waterford University Hospital,
Waterford, Ireland
(Moynihan) Department of Medicine, Royal College of Surgeons in Ireland,
Dublin, Ireland
(Cassidy) Department of Geriatric and Stroke Medicine, St Vincent's
University Hospital, Dublin, Ireland
(Hsu) The Department of Biostatistical Sciences, Division of Public Health
Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States
(Worrall) Departments of Neurology and Public Health Sciences, University
of Virginia, Charlottesville, VA, United States
(O'Donnell) Department of Geriatric Medicine, University Hospital Galway,
Galway, Ireland
(O'Donnell) Department of Translational Medicine, National University of
Ireland Galway, Ireland
(Kelly) Department of Neurology/Stroke Medicine, Mater Misericordiae
University Hospital, Dublin, Ireland
Publisher
SAGE Publications Ltd
Abstract
Background: Recent randomised trials showed benefit for anti-inflammatory
therapies in coronary disease but excluded stroke. The prognostic value of
blood inflammatory markers after stroke is uncertain and guidelines do not
recommend their routine measurement for risk stratification.
 Method(s): We performed a systematic review and meta-analysis of
studies investigating the association of C-reactive protein (CRP),
interleukin-6 (IL-6) and fibrinogen and risk of recurrent stroke or major
vascular events (MVEs). We searched EMBASE and Ovid Medline until 10/1/19.
Random-effects meta-analysis was performed for studies reporting
comparable effect measures. Result(s): Of 2,515 reports identified,
39 met eligibility criteria (IL-6, n = 10; CRP, n = 33; fibrinogen, n =
16). An association with recurrent stroke was reported in 12/26 studies
(CRP), 2/11 (fibrinogen) and 3/6 (IL-6). On random-effects meta-analysis
of comparable studies, CRP was associated with an increased risk of
recurrent stroke [pooled hazard ratio (HR) per 1 standard-deviation (SD)
increase in log<inf>e</inf>-CRP (1.14, 95% CI 1.06-1.22, p < 0.01)] and
MVEs (pooled HR 1.21, CI 1.10-1.34, p < 0.01). Fibrinogen was also
associated with recurrent stroke (HR 1.26, CI 1.07-1.47, p < 0.01) and
MVEs (HR 1.31, 95% CI 1.15-1.49, p < 0.01). Trends were identified for
IL-6 for recurrent stroke (HR per 1-SD increase 1.17, CI 0.97-1.41, p =
0.10) and MVEs (HR 1.22, CI 0.96-1.55, p = 0.10). Conclusion(s):
Despite evidence suggesting an association between inflammatory markers
and post-stroke vascular recurrence, substantial methodological
heterogeneity was apparent between studies. Individual-patient pooled
analysis and standardisation of methods are needed to determine the
prognostic role of blood inflammatory markers and to improve patient
selection for randomised trials of inflammatory therapies. Copyright
© European Stroke Organisation 2021.

<60>
Accession Number
2005533885
Title
Incidence and Risk Factors for Silent Brain Infarction After On-Pump
Cardiac Surgery: A Meta-analysis and Meta-regression of 29 Prospective
Cohort Studies.
Source
Neurocritical Care. 34 (2) (pp 657-668), 2021. Date of Publication: April
2021.
Author
Guo J.; Zhou C.; Yue L.; Yan F.; Shi J.
Institution
(Guo, Zhou, Yue, Yan, Shi) Department of Anesthesiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, No. 167 Beilishi Street,
Xicheng District, Beijing 100037, China
Publisher
Springer
Abstract
Background: Silent brain infarction (SBI) happens at a considerable rate
after on-pump cardiac surgery. Though termed silent, SBI is related to
unfavorable clinical outcomes including higher incidence of future stroke
and neurocognitive impairment in the general population. The risk factors
of SBI have not been fully identified in both individual studies and
several meta-analyses addressing the topic. In this meta-analysis, we
aimed to conduct meta-regression analysis for the first time to explore
risk factors for SBI after on-pump cardiac surgery. Method(s): This
meta-analysis was conducted following the Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) guidelines. Medline, Embase,
Central, Web of Science, and Wiley databases were searched for relevant
studies. Preoperative patient baseline characteristics and intraoperative
surgical parameters were extracted from included studies. For
meta-regression, a P value of less than 0.1 was considered statistically
significant in both univariable and multivariable analyses.
 Result(s): Twenty-nine studies with 1478 patients were included in
this meta-analysis. The summarized SBI rate after on-pump cardiac surgery
was 37% (95% CI 0.27-0.47, P < 0.0001). Heterogeneity between studies was
significant (I2 = 94.9%, P < 0.0001). In multivariable
meta-regression, we found that age (coefficient 0.014, 95% CI 0.001-0.029,
P = 0.043), diabetes (coefficient 0.006, 95% CI - 0.001 to 0.013, P =
0.075), and proportion of CABG (coefficient - 0.001, 95% CI - 0.003 to
0.0003, P = 0.096) were significantly associated with SBI incidence.
 Conclusion(s): From the meta-regression, we concluded that advanced
age and diabetes were related to increased SBI incidence after on-pump
cardiac surgery, while CABG procedure alone was associated with less SBI
onset. Studies with more accurate diagnoses of SBI are required to add
more conclusive evidence to the field. Copyright © 2020, Springer
Science+Business Media, LLC, part of Springer Nature and Neurocritical
Care Society.

<61>
Accession Number
2010082676
Title
Personalized Blood Pressure Management During Cardiac Surgery With
Cerebral Autoregulation Monitoring: A Randomized Trial.
Source
Seminars in Thoracic and Cardiovascular Surgery. 33 (2) (pp 429-438),
2021. Date of Publication: Summer 2021.
Author
Hogue C.W.; Brown C.H.; Hori D.; Ono M.; Nomura Y.; Balmert L.C.;
Srdanovic N.; Grafman J.; Brady K.
Institution
(Hogue) Department of Anesthesiology, Bluhm Cardiovascular Institute,
Northwestern University Feinberg School of Medicine, Chicago, IL, United
States
(Brown) Department of Anesthesiology & Critical Care Medicine, Division of
Cardiac Anesthesia, The Johns Hopkins University School of Medicine,
Baltimore, MD, United States
(Hori, Nomura) Department of Cardiovascular Surgery, Saitama Medical
Center, Jichi Medical University, Saitama, Japan
(Ono) Department of Cardiac Surgery, Methodist Hospital, San Antonio, TX,
United States
(Balmert, Srdanovic) Department of Preventative Medicine, Biostatistics,
Northwestern University Feinberg School of Medicine, Chicago, IL, United
States
(Grafman) Department of Physical Medicine & Rehabilitation, Neurology,
Cognitive Neurology and Alzheimer's Center, Department of Psychiatry,
Feinberg School of Medicine & Department of Psychology, Weinberg College
of Arts and Sciences, Northwestern University, Chicago, IL, United States
(Brady) Department of Anesthesiology, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
Publisher
W.B. Saunders
Abstract
The purpose of this study was to determine if setting mean arterial
pressure (MAP) targets during cardiopulmonary bypass (CPB) based on
individualized cerebral autoregulation data reduces the frequency of
neurological complications compared with usual care. Patients (n = 460) >=
55 years old at risk for neurological complications were randomized to
have MAP targets during CPB to be above the lower limit of transcranial
Doppler determined cerebral autoregulation versus usual institutional
practices. The primary outcome was the frequency of the composite endpoint
of clinical stroke, or new brain magnetic resonance imaging-detected
ischemic injury, or cognitive decline 4-6 weeks after surgery from
baseline. Secondary outcomes were components of the primary composite
outcome and clinically detected delirium. Complete outcome data were
available from 194 patients (stroke assessments, n = 460; magnetic
resonance imaging data, n = 164; cognitive data n = 336). There was no
difference between groups in the frequency of the composite neurological
end-point or its components (P = 0.752). Compared with the usual care
there was a 45% reduction in the frequency of clinically detected delirium
in the autoregulation group (8.2% vs 14.9%, risk ratio = 0.55, 95%
confidence interval = 0.32, 0.93, P = 0.035) and improved performance on
test of memory 4-6 weeks after surgery from baseline (P = 0.019). Basing
MAP during CPB on cerebral autoregulation monitoring did not reduce the
frequency of the primary neurological outcome in high-risk patients
compared with usual care but it was associated with a reduction in the
frequency of delirium and better performance on tests of memory 4-6 weeks
after surgery. Copyright © 2020

<62>
Accession Number
2008378029
Title
Global Longitudinal Strain Predicts Survival and Left Ventricular Function
After Mitral Valve Surgery: A Meta-analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 33 (2) (pp 337-342),
2021. Date of Publication: Summer 2021.
Author
Canessa M.; Thamman R.; Americo C.; Soca G.; Dayan V.
Institution
(Canessa, Americo, Soca, Dayan) National Institute of Cardiac Surgery,
Montevideo, Uruguay
(Thamman) School of Medicine, University of Pittsburgh, Pittsburgh, PA,
United States
(Dayan) Centro Cardiovascular Universitario, Montevideo, Uruguay
Publisher
W.B. Saunders
Abstract
The timing for surgical treatment in patients with primary organic severe
mitral valve regurgitation and preserved left ventricular ejection
fraction (LVEF) systolic is a challenge since it depends upon LV end
systolic dimension and LVEF which may be late markers of LV dysfunction.
Echocardiography is the most important tool in the diagnosis of
mechanisms, etiology, severity, and hemodynamic consequences of mitral
regurgitation. The global longitudinal strain (GLS), a new and sensitive
method for the detection of LV dysfunction, might be a useful method for
the evaluation of preclinical systolic dysfunction. Nevertheless, its role
for predicting postoperative outcomes is not well established. A
meta-analysis was performed to address the role of GLS in patients with
severe mitral regurgitation and preserved LVEF who underwent mitral
surgery. We included studies that compared outcomes according to
preoperative GLS in regard to survival and postoperative LV function. We
included 2358 patients enrolled in 8 studies. Patients with reduced GLS%
had worse long term survival after mitral valve surgery (hazard ratio =
1.13, 95% confidence interval [CI]: 1.02-1.26). Patients with
preoperatively reduced GLS% had lower LVEF after surgery (mean difference
[MD] = -5.06%, 95% CI: -8.97-1.16%) and additionally, patients who
presented postoperative LVEF dysfunction had worse preoperative GLS (MD =
4.33, 95% CI: 3.89-4.76). In patients with primary mitral regurgitation,
preoperative GLS is a predictor for long term survival and postoperative
LVEF. It is a useful parameter to be included when considering early
surgery in patients with severe mitral regurgitation and normal
LVEF. Copyright © 2020 Elsevier Inc.

<63>
Accession Number
2007902358
Title
Quality of Life After Ministernotomy Versus Full Sternotomy Aortic Valve
Replacement.
Source
Seminars in Thoracic and Cardiovascular Surgery. 33 (2) (pp 328-334),
2021. Date of Publication: Summer 2021.
Author
Rodriguez-Caulo E.A.; Guijarro-Contreras A.; Guzon A.; Otero-Forero J.;
Mataro M.J.; Sanchez-Espin G.; Porras C.; Villaescusa J.M.; Melero-Tejedor
J.M.; Jimenez-Navarro M.
Institution
(Rodriguez-Caulo, Guzon, Otero-Forero, Mataro, Sanchez-Espin, Porras,
Villaescusa, Melero-Tejedor) UGC Heart Area, Cardiovascular Surgery
Department, Hospital Universitario Virgen de la Victoria de Malaga,
Fundacion Publica Andaluza para la Investigacion de Malaga en Biomedicina
y Salud (FIMABIS), University of Malaga, CIBERCV Enfermedades
Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
(Guijarro-Contreras, Jimenez-Navarro) UGC Heart Area, Cardiology
Department, Hospital Universitario Virgen de la Victoria de Malaga,
Fundacion Publica Andaluza para la Investigacion de Malaga en Biomedicina
y Salud (FIMABIS), University of Malaga, CIBERCV Enfermedades
Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
Publisher
W.B. Saunders
Abstract
Quality of life and patient satisfaction after ministernotomy have never
been compared to conventional full sternotomy in randomized trials. The
QUALITY-AVR trial is a single-blind, single-center, independent,
randomized clinical trial comparing ministernotomy to full sternotomy in
patients with isolated severe aortic stenosis scheduled for elective
aortic valve replacement. One hundred patients were randomized in a 1:1
computational fashion. The primary endpoint was a difference between
intervention groups of >=0.10 points in change from baseline quality of
life Questionnaire EuroQOL-index, measured at 1, 6, or 12 months.
Secondary endpoints were differences in change from other baseline
EuroQOL-index utilities, cardiac surgery-specific satisfaction
questionnaire (SATISCORE), a combined safety endpoint of 4 major adverse
complications at 1 month (all-cause mortality, acute myocardial
infarction, neurologic events, and acute renal failure), bleeding through
drains within the first 24 hours, intubation time, and other minor
endpoints. Clinical follow-up was scheduled at baseline, 1, 6, and 12
months after randomization. Change from baseline mean difference
EQ-5D-index was +0.20 points (95% confidence interval 0.10-0.30, P <
0.001) and median difference +0.14 (95% confidence interval 0.06-0.22, P <
0.001), favoring the ministernotomy group at 1 month. Patient satisfaction
was also better at 1 month (Satiscore 83 +/- 9 vs 77 +/- 13 points; P =
0.010). The ministernotomy group had significantly less bleeding in the
first 24 hours (299 +/- 140 vs 509 +/- 251 mL, P = 0.001). Ministernotomy
provides a faster recovery with improved quality of life and satisfaction
at 1 month compared to full sternotomy. Copyright © 2020 Elsevier
Inc.

<64>
Accession Number
634033227
Title
A randomized trial to assess the effect of cricoid displacing maneuver on
the success rate of blind placement of double-lumen tube and Univent
bronchial blocker.
Source
Annals of palliative medicine. 10 (2) (pp 1976-1984), 2021. Date of
Publication: 01 Feb 2021.
Author
Xu Z.; Yu H.; Luo Y.; Ye Y.; Zhou C.; Liang P.
Institution
(Xu, Yu, Ye, Liang) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu, China
(Luo) West China School of Medicine, Sichuan University, Chengdu, China
(Zhou) Department of Anesthesiology, West China Hospital, Sichuan
University, Chengdu, China; Lab of Anesthesia & Critical Care Medicine,
Translational Neuroscience Center, West China Hospital of Sichuan
University, Chengdu, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Double lumen tube (DLT) and Univent are two commonly used lung
isolation devices that often require bronchoscopy assistance. In order to
facilitate blind placement for situations where bronchoscopy was
unavailable, the cricoid displacing maneuver (CDM) was adopted. This study
was designed to explore whether the CDM could improve the successful blind
placement rate in left lung isolation esophageal surgeries.
 METHOD(S): 120 ASA 1-3 patients who received left lung isolation
esophageal surgeries from October 2014 to February 2016 and October 2018
to January 2020 were enrolled in this single-centered prospective
assessorblinded randomized controlled trial. After anesthesia induction,
patients were intubated either with DLT or Univent by applying the CDM,
and the position of devices was checked by bronchoscopy. After turning
into the right decubitus position, the devices were pulled back to the
trachea, and placement was conducted once again. Successful placement rate
for the first attempt, time needed for initial placement, malposition and
reposition times by bronchoscopy during surgery, bronchus injury score,
rank of lung isolation and postoperative anesthesia-related complications
were recorded. RESULT(S): At supine position, the successful
placement rates for the first attempt of DLT-CDM, DLTcontrol, Univent-CDM
and Univent-Control were 100%, 76.7%, 96.7% and 66.7% respectively (DLT:
P=0.016; Univent: P=0.003) while at right decubitus position were 86.7%,
66.7%, 93.3% and 66.7% (DLT: P=0.067; Univent: P=0.010). There was no
significant difference in the time needed for successful intubation and no
severe complications. CONCLUSION(S): The current study provided
evidence that the CDM is an effective and safe blind endobronchial
placement technique for left DLT and Univent. We suggest that CDM could be
applied to the endobronchial placement of left DLT and Univent.

<65>
[Use Link to view the full text]
Accession Number
634862914
Title
Effects of colloid preload on the incidence of hypotension in spinal
anesthesia for cesarean section: a systematic review and meta-analysis.
Source
Chinese medical journal. 134 (9) (pp 1043-1051), 2021. Date of
Publication: 20 Apr 2021.
Author
Gong R.-S.; Liu X.-W.; Li W.-X.; Zhao J.
Institution
(Gong) Department of Anesthesia, China-Japan Friendship Hospital, Chinese
Academy of Medical Sciences & Peking Union Medical College, Beijing, China
(Liu, Li, Zhao) Department of Anesthesia, China-Japan Friendship Hospital,
Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Hypotension is a common complication caused by spinal
anesthesia (SA), which may have adverse impacts on the condition of the
parturient and fetus. Liquid infusion was found to be relatively effective
for reducing the incidence of hypotension. However, the question of
whether colloid preload can optimize hemodynamic variables in the cesarean
section remains controversial. This study aims to determine the effects of
colloid preload on the incidence of hypotension induced by SA in elective
cesarean section. METHOD(S): Related keywords were searched on
PubMed, EMBASE, and Cochrane Library from inception dates to May 2020.
Studies included were evaluated for eligibility and quality. The primary
outcome was the intra-operative incidence of hypotension and severe
hypotension. The secondary outcomes included the lowest intra-operative
systolic blood pressure, the maximal intra-operative heart rate, the
intra-operative needs of ephedrine and phenylephrine, the incidence of
maternal nausea and/or vomiting, and neonatal outcomes (umbilical artery
pH and Apgar scores). Apart from the above, RevMan 5.3 was used for the
data analysis. RESULT(S): Altogether nine randomized controlled
trials were included in the meta-analysis. There were no significant
differences in the incidence of intra-operative hypotension, severe
hypotension, or neonatal outcomes between the colloid preload group and
control group, except for the umbilical artery pH. CONCLUSION(S):
This meta-analysis suggests that colloid preload does not significantly
reduce the incidence of hypotension associated with SA in elective
cesarean section. Copyright © 2021 The Chinese Medical
Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND
license.

<66>
Accession Number
2011141904
Title
Advances in Clinical Cardiology 2020: A Summary of Key Clinical Trials.
Source
Advances in Therapy. 38 (5) (pp 2170-2200), 2021. Date of Publication: May
2021.
Author
Kearney A.; Linden K.; Savage P.; Menown I.B.A.
Institution
(Kearney, Linden, Savage, Menown) Craigavon Cardiac Centre, Southern
Health and Social Care Trust, Craigavon, United Kingdom
Publisher
Adis
Abstract
Introduction: Despite the challenge of a global pandemic, 2020 has been an
invaluable year in cardiology research with numerous important clinical
trials published or presented virtually at major international meetings.
This article aims to summarise these trials and place them in clinical
context. Method(s): The authors reviewed clinical trials presented at
major cardiology conferences during 2020 including the American College of
Cardiology, European Association for Percutaneous Cardiovascular
Interventions, European Society of Cardiology, Transcatheter
Cardiovascular Therapeutics and the American Heart Association. Trials
with a broad relevance to the cardiology community and those with
potential to change current practice were included. Result(s): A
total of 87 key cardiology clinical trials were identified for inclusion.
New interventional and structural cardiology data included trials
evaluating bifurcation percutaneous coronary intervention (PCI)
techniques, intravascular ultrasound (IVUS)-guided PCI, instantaneous
wave-free (iFR) physiological assessment, new generation stents (DynamX
bioadaptor), transcatheter aortic valve implantation (TAVI) in low-risk
patients, and percutaneous mitral or tricuspid valve interventions.
Preventative cardiology data included new data with proprotein convertase
subtilisin-kexin type 9 (PCSK9) inhibitors (evolocumab and alirocumab),
omega-3 supplements, evinacumab and colchicine in the setting of chronic
coronary artery disease. Antiplatelet data included trials evaluating both
the optimal length of course following PCI and combination of antiplatelet
agents and regimes including combination antithrombotic therapies for
patients with atrial fibrillation (AF). Heart failure data included the
use of sodium-glucose cotransporter 2 (SGLT2) inhibitors (sotagliflozin,
empagliflozin and dapagliflozin) and mavacamten in hypertrophic
cardiomyopathy. Electrophysiology trials included early rhythm control in
AF and screening for AF. Conclusion(s): This article presents a
summary of key clinical cardiology trials during the past year and should
be of relevance to both clinicians and cardiology
researchers. Copyright © 2021, Crown.

<67>
[Use Link to view the full text]
Accession Number
2011109567
Title
Mitral valve surgery: current status and future prospects of the minimally
invasive approach.
Source
Expert Review of Medical Devices. 18 (3) (pp 245-260), 2021. Date of
Publication: 2021.
Author
Van Praet K.M.; Kempfert J.; Jacobs S.; Stamm C.; Akansel S.; Kofler M.;
Sundermann S.H.; Nazari Shafti T.Z.; Jakobs K.; Holzendorf S.; Unbehaun
A.; Falk V.
Institution
(Van Praet, Kempfert, Jacobs, Stamm, Akansel, Kofler, Sundermann, Nazari
Shafti, Unbehaun, Falk) Department of Cardiothoracic and Vascular Surgery,
German Heart Center Berlin, Berlin, Germany
(Van Praet, Kempfert, Sundermann, Nazari Shafti, Unbehaun, Falk) German
Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin,
Germany
(Sundermann, Falk) Department of Cardiothoracic Surgery, Charite -
Universitatsmedizin Berlin, Berlin, Germany
(Nazari Shafti, Falk) Berlin Institute of Health (BIH), Berlin, Germany
(Jakobs) Institute for Anesthesiology, German Heart Center Berlin, Berlin,
Germany
(Holzendorf) Department of Perfusion, German Heart Center Berlin, Berlin,
Germany
(Falk) Department of Health Sciences, ETH Zurich, Translational
Cardiovascular Technologies, Switzerland
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: During the past five years the approach to procedural
planning, operative techniques and perfusion strategies for minimally
invasive mitral valve surgery (MIMVS) has evolved. With the goal to
provide a maximum of patient safety the procedure has been modified
according to individual patient characteristics and is largely based on
preoperative imaging. Areas covered: In this review article we describe
the important factors in image based therapy planning and simulation,
different access strategies, the operative key-steps, a rationale use of
devices, and highlight a few future developments in the field of MIMVS.
Published studies were identified through pearl growing, citation chasing,
a search of PubMed using the systematic review methods filter, and the
authors' topic knowledge. Expert opinion: With the help of expert teams
including surgeons specialized in mitral repair, anesthesiologists and
perfusionists a broad spectrum of mitral valve pathologies and related
pathologies can be treated with excellent functional outcomes. Avoiding
procedure related complications is the key for success for any MIMVS
program. Copyright © 2021 Informa UK Limited, trading as Taylor &
Francis Group.

<68>
Accession Number
633151479
Title
Impact of renin-angiotensin system blocker after aortic valve
replacement-a systematic review and meta-analysis.
Source
Annals of palliative medicine. 10 (2) (pp 1244-1252), 2021. Date of
Publication: 01 Feb 2021.
Author
Zeng L.; Li J.; Yang J.; Liao Y.; Chen M.
Institution
(Zeng, Yang) West China Hospital, Sichuan University, Chengdu, China
(Li, Chen) Department of Cardiology, West China Hospital, Chengdu, China
(Liao) Department of Cardiology, West China Hospital, Chengdu, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Data reporting the impact of renin-angiotensin system
inhibitor (RASi) after aortic valve replacement (AVR) is controversy.
 METHOD(S): The PubMed database was systematically searched for
studies reporting the mortality and hazard ratios (HRs) of RASi following
surgical and transcatheter AVR (SAVR, TAVR). Random-effects model was used
when the I2 statistic was more than 50% and its P value was less than
0.05, otherwise, the fixed-effects model was conducted. RESULT(S):
Nine articles incorporating 33,063 patients were eligible. Patients having
the description of RASi were associated with lower all-cause mortality at
30 days (OR, 0.80, 95% CI, 0.69 to 0.94), 1 year (OR, 0.75, 95% CI, 0.69
to 0.81) and beyond 1 year (OR, 0.52, 95% CI, 0.38 to 0.73) after AVR.
Consistently, patients with RASi had lower risk for all-cause mortality
(HR, 0.87, 95% CI, 0.84 to 0.91) beyond 1 year following AVR albeit
adjusting confounders. Interestingly, beneficial effect of RASi was still
observed in patients with preserved ejection fraction following TAVR (HR,
0.90, 95% CI, 0.87 to 0.94). In addition, patients taking RASi had lower
cardiovascular mortality than those patients without RASi after TAVR (30
days, OR, 0.63, 95% CI, 0.44 to 0.90; 1 year, OR, 0.60, 95% CI, 0.50 to
0.73; beyond 1 year, OR, 0.63, 95% CI, 0.54 to 0.74). CONCLUSION(S):
Patients with RASi exhibited better short- and long-term survival
following AVR compared to those patients without RASi, which warranted
further studies to support such findings.

<69>
Accession Number
632921243
Title
Effects of different positive end-expiratory pressure titrating strategies
on oxygenation and respiratory mechanics during one- lung ventilation: a
randomized controlled trial.
Source
Annals of palliative medicine. 10 (2) (pp 1133-1144), 2021. Date of
Publication: 01 Feb 2021.
Author
Xu D.; Wei W.; Chen L.; Li S.; Lian M.
Institution
(Xu) Department of Anesthesiology, Shanghai General Hospital of Nanjing
Medical University, Shanghai, China
(Wei, Chen, Lian) Department of Anesthesiology, Shanghai General Hospital,
Shanghai Jiao Tong University, Shanghai, China
(Li) Department of Anesthesiology, Shanghai General Hospital of Nanjing
Medical University, Shanghai, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Positive end-expiratory pressure (PEEP) is widely used to
reduce the risk of hypoxemia and atelectasis during one-lung ventilation
(OLV); however, the optimal strategy for PEEP titrating remains
unclear.The purpose of the study was to investigate the effects of
different PEEP titrating strategies on oxygenation and respiratory
mechanics during OLV. METHOD(S): Patients undergoing thoracic surgery
with general anesthesia were randomly allocated into five groups. In P0
group, PEEP was set to zero; in PLIP2 group, PEEP was set to 2 cmH2O plus
the pressure of lower inflection point (LIP) of pressure-volume (P-V)
curve; in PLIPS group, PEEP was titrated to achieve maximum static
compliance from the averaged LIP pressure value; in groups PSTAT and PDYN,
the incremental PEEP values were titrated to achieve maximum static
compliance or maximum dynamic compliance from 4 cmH2O. Hemodynamic
measurements, respiratory mechanics, and blood gas analyses were recorded
at the beginning of OLV, OLV 15 min, OLV 30 min, OLV 45 min, and OLV 60
min. Also, the intrapulmonary shunt (Qs/Qt), physiological dead space to
tidal volume ratio (VD/VT), and oxygenation index (OI) were calculated and
compared. RESULT(S): Seventy-five patients consented to participate
in this study. Dynamic compliance, peak inspiratory pressure (PIP), and
plateau inspiratory pressure (Pplat) increased after PEEP titration during
OLV. PIP, Qs/ Qt, and OI showed no differences among groups. Group PDYN
showed lower Pplat, lower driving pressure, and higher dynamic compliance
when compared with zero PEEP group. CONCLUSION(S): The PEEP titrating
strategy according to dynamic compliance can improve respiratory
mechanics, whereas it has no significant effects on oxygenation, dead
space ratio, and intrapulmonary shunt, suggesting that it is better during
OLV for thoracic surgery.

<70>
[Use Link to view the full text]
Accession Number
632824063
Title
Effect of intrathecal morphine plus patient-controlled analgesia with
morphine versus patient-controlled analgesia with morphine alone on total
morphine dose 24 hours post-surgery: a systematic review.
Source
JBI evidence synthesis. 18 (8) (pp 1611-1640), 2020. Date of Publication:
01 Aug 2020.
Author
Pitre L.; Garbee D.; Tipton J.; Schiavo J.; Pitt A.
Institution
(Pitre) School of Nursing, United States 2The Louisiana Centre for
Promotion of Optimal Health Outcomes: A JBI Centre of Excellence 3School
of Dentistry, Louisiana State University Health Sciences Center, New
Orleans, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The objective of this review was to evaluate the effects of
preoperative intrathecal morphine (ITM) in addition to patient-controlled
analgesia with morphine (PCAM) versus PCAM without preoperative ITM on
total morphine dose in the first 24 hours postoperatively in adult
patients undergoing abdominal or thoracic surgery. INTRODUCTION:
Postoperative pain is a significant problem for patients undergoing major
abdominal and thoracic surgery. Intrathecal morphine can reduce
postoperative pain and reduce intravenous (IV) morphine requirements
during the first 24 hours after surgery; however, the amount of IV
morphine dose reduction achieved has not been well established. This
knowledge could help anesthesia providers determine if ITM is an
appropriate analgesic option for patients. INCLUSION CRITERIA: This review
included studies with participants 18 years of age or older receiving
general anesthesia for abdominal or thoracic surgery. Studies were
included that used the intervention of preoperative ITM in addition to
PCAM versus PCAM without preoperative ITM. Total morphine dose in
milligrams during the first 24 hours after surgery was the outcome of
interest. METHOD(S): A search of PubMed and CINAHL was conducted for
studies published between January 1984 and October 2018 using the key
terms intrathecal, morphine, postoperative, pain, patient-controlled
analgesia and general anesthesia. Index terms and keywords from identified
articles were used to search CINAHL, Cochrane Central Register of
Controlled Trials (CENTRAL), Embase, ClinicalTrials.gov, Ovid MEDLINE,
ProQuest Dissertations and Theses/Nursing and Allied Health Databases, and
Scopus. The reference lists of articles that underwent critical appraisal
were searched for additional studies. Methodological quality was assessed
using the JBI Critical Appraisal Checklist for Randomized Controlled
Trials. Two independent reviewers assessed each selected article. Study
results were pooled in statistical meta-analysis using the JBI System for
the Unified Management, Assessment and Review of Information, and two
studies were described in narrative form. Differences in IV morphine dose
between the ITM plus PCAM and PCAM alone groups were calculated to produce
the weighted mean difference (WMD) utilizing a 95% confidence interval
(CI). Heterogeneity was assessed using chi and I values. Subgroup analysis
was conducted on two studies that included IV non-opioid analgesia in
addition to ITM and PCAM for postoperative analgesia. RESULT(S):
Seven RCTs with a total sample size of 352 patients were included in this
review. Five studies that evaluated postoperative total morphine dose in
milligrams with and without preoperative ITM were included for statistical
meta-analysis, with 277 participants from four countries. Total morphine
dose was significantly reduced in patients who received ITM (WMD = -24.44
mg, 95% CI -28.70 to -20.18 mg) compared to PCAM without ITM. Subgroup
analysis of two studies involving 112 participants using IV acetaminophen
in addition to ITM and PCAM indicated no additional benefit after ITM was
already administered (WMD = -25.93, 95% CI -32.05 to -19.80 mg). Two
studies with 75 participants were described narratively because total
morphine dose was reported as median rather than mean values.
 CONCLUSION(S): In this review, ITM provided a significant decrease in
overall total morphine dose during the first 24 hours after surgery in
abdominal surgery patients. The addition of IV non-opioids to the
postoperative analgesia protocol showed no additional reduction in
postoperative IV morphine dose between groups. SYSTEMATIC REVIEW
REGISTRATION NUMBER: PROSPERO CRD42018100613.

<71>
Accession Number
634899918
Title
Is trans-vaginal mesh procedure using polytetrafluoroethylene(PTFE) mesh
ORIHIME feasible for the anterior vaginal prolapse repair?-comparative
study between PTFE mesh and polypropylene mesh up to 1 year.
Source
International Urogynecology Journal. Conference: 45th Annual Meeting of
the International Urogynecological Association, IUGA 2020. Virtual. 31
(SUPPL 1) (pp S171), 2020. Date of Publication: 2020.
Author
Takeyama M.; Kuwata T.; Kashihara H.; Kato C.
Institution
(Takeyama, Kuwata, Kashihara, Kato) First Towakai Hospital
Publisher
Springer
Abstract
Introduction: Trans vaginal mesh (TVM) procedures for pelvic organ
prolapse using polypropylene(PP) mesh have been prohibited in many
countries and negative opinions are dominant on the safety and efficacy of
TVM. Here in Japan, as no device kit have been available, sophisticated
TVM procedures with self-cut mesh and special needles have uniquely
developed and the outcomes have been better than those with device kits,
and then TVM is one of the major procedure for the POP repair even now.
However, on April 2019, polyform, the only one PP mesh available for TVM
in Japan became unavailable. Then the polytetrafluoroethylene (PTFE) mesh
ORIHIME became the only one mesh available for TVM in Japan. PTFE is a
degradation-free material and stable to hydrolysis, and has been used in
many medical fields such as cardiac surgery. ORIHIME is a macroporous type
1 mesh made from PTFE designed for POP repair (Fig.1). ORIHIME has been
available since January 2018 in Japan. Now in Japan, one of the most
popular anterior TVM is the TVM-A2, which has been developed from anterior
ProliftTM by shrinking the size and omitting anterior arms. Weakness of
ORIHIME when using in TVM is lower friction coefficient which makes it
difficult to hold the mesh arms stable at the anchoring points. To
overcome this weakness, we tried to widen the mesh arms to 35mm and give
many cuts in the both sides of the arms to increase the friction
coefficient. Objective(s): The objectives of this study are to
investigate the feasibility of anterior TVM using PTFE mesh ORIHIME.
 Method(s): One hundred of POP patients scheduled to undergo TVM were
randomly divided into two groups, one is ORIHIME group and the other is
Polyform group, both composed of 50 patients. Operative procedure was
TVM-A2. The shape of the mesh used is shown in Fig.2 and anchoring points
and the needle insertion points are shown in Fig.3. Examinations including
POP-Q quantification, complications, lower urinary tract symptoms were
made preoperatively, 3M, 6M,12M after operation. Recurrence is defined
when POP-Q stage is 2 or more. Statistical processing used Mann- Whitney U
test. Result(s): There are no significant differences in POP-Q
values, age, body weight, BMI, parity and urination function between two
groups preoperatively. Operation time of ORIHINME group and Polyform group
are 28.6+/-4.5 and 28.3+/-4.4 respectively. Amount of bleeding are
18.4.0+/-14.0 gr and 22.7+/-14.2gr, respectively. There were no
perioperative complications in either groups. Nonrecurrence rate of
ORIHIME group and Polyform group were 94% and 98% at 3 month after
operation, 94% and 96% at 6 month after operation and 91.7% and 95.7% at
12 month after operation. There were no cases of mesh extrusion in either
groups up to 12 months. The number of cases with stress incontinence
requiring surgery were 11 and 10 cases, respectively up to 12 month after
operation. There was no case of difficulty urinating for more than one
month. Conclusion(s): TVM-A2 using minimal ORIHIME mesh is effective
and safe for the reconstruction of anterior vaginal prolapse.

<72>
Accession Number
2011867433
Title
Effects of dexmedetomidine on clinical outcomes and renal function after
CABG.
Source
Journal of Cellular and Molecular Anesthesia. 6 (1) (pp 31-38), 2021. Date
of Publication: December 2021.
Author
Rahab M.; Heydarpour E.; Totonchi Z.; Kachoueian N.; Davani S.Z.; Kiaei
M.M.; Mehrabanian M.J.; Panahi M.; Ahmadvand P.; Kharazani S.; Mortazian
M.
Institution
(Rahab, Ahmadvand) Hazrat-E-Rasoul Akram Hospital, Iran University of
Medical Science, Tehran, Iran, Islamic Republic of
(Heydarpour, Totonchi) Rajaie Cardiovascular, Medical and Research Center,
Tehran, Iran, Islamic Republic of
(Kachoueian) Department of Cardiovascular Surgery, School of Medicine,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Davani) Department of General Surgery, School of Medicine, Hazrat-e
Rasool General Hospital, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Kiaei) Department of Anesthesiology, School of Medicine, Hasheminejad
Kidney Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Mehrabanian) Department of Anesthesiology, School of Medicine, Tehran
Heart Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Panahi, Kharazani) Rajaie Cardiovascular, Medical and Research Center,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Mortazian) AJA University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Shahid Beheshti University of Medical Sciences, Anesthesiology Research
Center
Abstract
Background: This study was carried out to determine the effects of
dexmedetomidine on clinical outcomes and renal function after coronary
artery bypass grafting (CABG) to address the increased rate of CABG? and
the importance of modification in stress responses and control of adverse
effects on renal function and with the aim of cost reduction.
 Material(s) and Method(s): This double-blind randomized clinical
trial was carried out with the participation of 129 subjects under
elective CABG in Rajaei Heart Center, Tehran, Iran in 2017. Patients were
randomly assigned to four groups with simple randomization including one
placebo (normal saline infusion) group and three dexmedetomidine groups;
0.5 microg/kg/h on CPB, 0.5 microg/kg/h in 24 hours, and 0.75 microg/kg/h
in 24 hours. The blood pressure, blood urea nitrogen (BUN), serum
creatinine, transfused blood volume, urine volume, and hemofiltration on
pump and lactate were assessed at different time intervals.
 Result(s): Results showed more stability especially in central venous
pressure (CVP) (p=0.001) and systolic blood pressure (p=0.006) in the
groups receiving dexmedetomidine 0.75 microg/kg/h per 24 hours. But
diastolic blood pressure and heart rate were the same across the groups
(p>0.05). All other variables including hepatic and renal function tests
were the same across the groups (P>0.05). Conclusion(s): Overall,
according to the obtained results in the current study, it may be
concluded that dexmedetomidine would have some promising effects on
hemodynamic stability but there are no obvious renoprotective effects for
this medication. Copyright © 2021 Journal of Cellular and
Molecular Anesthesia. All rights reserved.

<73>
Accession Number
2011859241
Title
Perioperative dexmedetomidine administration to prevent delirium in adults
after non-cardiac surgery: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 73 (no pagination), 2021. Article Number:
110308. Date of Publication: October 2021.
Author
Qin C.; Jiang Y.; Lin C.; Li A.; Liu J.
Institution
(Qin, Jiang, Lin, Li) Department of Anesthesiology, Affiliated Hospital of
Guilin Medical University, Guilin, Guangxi 541001, China
(Qin, Liu) Department of Anesthesiology, The First Affiliated Hospital of
Guangxi Medical University, Nanning, Guangxi 530021, China
Publisher
Elsevier Inc.
Abstract
Study objective: To evaluate the efficacy of perioperative dexmedetomidine
(DEX) administration for preventing delirium in adults after non-cardiac
surgery. Design(s): Systematic review and meta-analysis of randomized
controlled trials (RCTs). Intervention(s): Perioperative
administration of DEX to prevent delirium in adults following non-cardiac
surgery. Measurements: The incidence of postoperative delirium (POD).
 Method(s): The databases of PubMed, Embase and Cochrane Central
Register were searched from inception to Mar 4, 2021 for all available
RCTs that assessed DEX for POD in adults after non-cardiac surgery. Risk
ratio (RR) with a 95% confidence interval (CI) was calculated for
dichotomous data. Standardized mean difference (SMD) was calculated for
continuous data. Risk of bias was assessed using the second version of the
Cochrane risk-of-bias tool for RCTs (RoB 2.0), and the level of certainty
for main outcomes were assessed by the Grading of Recommendations
Assessment, Development, and Evaluation (GRADE) methodology. Main
Result(s): Thirteen studies, including the meta-analysis with a total of
4015 patients (DEX group: 2050 patients; placebo group: 1965 patients),
showed that DEX significantly reduced the incidence of POD in adults after
non-cardiac surgery compared with control group (RR: 0.60; 95%CI: 0.46 to
0.77, P = 0.0001, I2 = 55%, GRADE = moderate). Meanwhile, there
was a statistical difference by the subgroup analysis between the mean age
>= 65 years group and the mean age<65 years group. There were no
statistical differences in length of hospital stay following surgery (SMD:
-0.36; 95%CI: -0.80 to 0.07, P = 0.1, I2 = 97%, GRADE = low)
and all-cause mortality rate (RR:0.57; 95%CI: 0.25 to 1.28, P < 0.17,
I2 = 0%, GRADE = moderate) compared with placebo group.
However, Meta-analysis showed that DEX administration significantly
resulted in intraoperative bradycardia when compared with placebo group
(RR: 1.39; 95%CI: 1.14 to 1.69, P = 0.0009, I2 = 0%, GRADE =
high), and as well as intraoperative hypotension (RR: 1.25; 95%CI: 1.11 to
1.42, P = 0.0004, I2 = 0%, GRADE = high). Conclusion(s):
This systematic review and meta-analysis suggests that perioperative
administration of DEX could significantly reduce the incidence of POD in
patients elder than 65 years following non-cardiac surgery. However, there
was no definite evidence that perioperative DEX could reduce the incidence
of POD in patients younger than 65 years of age after non-cardiac surgery.
In addition, perioperative DEX administration was associated with an
elevated risk of bradycardia and hypotension. Copyright © 2021
Elsevier Inc.

<74>
Accession Number
2011890104
Title
Selected 2020 Highlights in Congenital Cardiac Anesthesia.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Welch T.P.; Trivedi P.M.; Fang Z.A.; Ing R.J.; Mittnacht A.J.C.; Mossad
E.B.
Institution
(Welch, Trivedi, Mossad) Division of Pediatric Cardiovascular Anesthesia,
Baylor College of Medicine, Texas Children's Hospital, Houston, TX, United
States
(Fang) Department of Anesthesia and Pain Medicine, Hospital for Sick
Children Toronto, ON, Canada
(Ing) Department of Anesthesiology, Children's Hospital Colorado,
University of Colorado School of Medicine, Aurora, CO, United States
(Mittnacht) Department of Anesthesiology, Westchester Medical Center, New
York Medical College, Valhalla, NY, United States
Publisher
W.B. Saunders
Abstract
This article is a review of the highlights of pertinent literature
published during the 12 months of 2020 that are of interest to the
congenital cardiac anesthesiologist. After a search of the US National
Library of Medicine's PubMed database, several topics emerged for which
significant contributions were made in 2020. The authors of the present
article considered the following topics noteworthy to be included in this
review: pediatric cardiac care in the coronavirus disease 2019 era, the
use of mechanical circulatory support in coronavirus disease 2019-related
multisystem inflammatory syndrome in children, transfusion and coagulation
management in children undergoing congenital heart surgery, and pulmonary
vein stenosis. Copyright © 2021 Elsevier Inc.

<75>
Accession Number
635011044
Title
Hemodynamic Profiles Before and After Surgery in Bicuspid Aortic Valve
Disease-A Systematic Review of the Literature.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 629227. Date of Publication: 24 Mar 2021.
Author
Cave D.G.W.; Panayiotou H.; Bissell M.M.
Institution
(Cave, Panayiotou, Bissell) Department of Biomedical Imaging Science,
Leeds Institute of Cardiovascular and Metabolic Medicine, University of
Leeds, Leeds, United Kingdom
Publisher
Frontiers Media S.A.
Abstract
Bicuspid aortic valve (BAV) disease presents a unique management challenge
both pre- and post-operatively. 4D flow MRI offers multiple tools for the
assessment of the thoracic aorta in aortic valve disease. In particular,
its assessment of flow patterns and wall shear stress have led to new
understandings around the mechanisms of aneurysm development in BAV
disease. Novel parameters have now been developed that have the potential
to predict pathological aortic dilatation and may help to risk stratify
BAV patients in future. This systematic review analyses the current 4D
flow MRI literature after aortic valve and/or ascending aortic replacement
in bicuspid aortic valve disease. 4D flow MRI has also identified distinct
challenges posed by this cohort at the time of valve replacement compared
to standard management of tri-leaflet disorders, and may help tailor the
type and timing of replacement. Eccentric pathological flow patterns seen
after bioprosthetic valve implantation, but not with mechanical
prostheses, might be an important future consideration in intervention
planning. 4D flow MRI also has promising potential in supporting the
development of artificial valve prostheses and aortic conduits with more
physiological flow patterns. © Copyright © 2021 Cave,
Panayiotou and Bissell.

<76>
Accession Number
635010040
Title
Remote Ischemic Preconditioning to Prevent Acute Kidney Injury After
Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials.
Source
Frontiers in Cardiovascular Medicine. 8 (no pagination), 2021. Article
Number: 601470. Date of Publication: 18 Mar 2021.
Author
Liu Z.; Zhao Y.; Lei M.; Zhao G.; Li D.; Sun R.; Liu X.
Institution
(Liu, Zhao, Zhao, Li, Sun, Liu) Department of Thoracic and Cardiovascular
Surgery, Shenzhen Baoan Women's and Children's Hospital, Jinan University,
Guangzhou, China
(Lei) Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Beijing,
China
Publisher
Frontiers Media S.A.
Abstract
Objective: Randomized controlled trials (RCTs) evaluating the influence of
remote ischemic preconditioning (RIPC) on acute kidney injury (AKI) after
cardiac surgery showed inconsistent results. We performed a meta-analysis
to evaluate the efficacy of RIPC on AKI after cardiac surgery.
 Method(s): Relevant studies were obtained by search of PubMed,
Embase, and Cochrane's Library databases. A random-effect model was used
to pool the results. Meta-regression and subgroup analyses were used to
determine the source of heterogeneity. Result(s): Twenty-two RCTs
with 5,389 patients who received cardiac surgery -2,702 patients in the
RIPC group and 2,687 patients in the control group-were included. Moderate
heterogeneity was detected (p for Cochrane's Q test = 0.03, I2
= 40%). Pooled results showed that RIPC significantly reduced the
incidence of AKI compared with control [odds ratio (OR): 0.76, 95%
confidence intervals (CI): 0.61-0.94, p = 0.01]. Results limited to
on-pump surgery (OR: 0.78, 95% CI: 0.64-0.95, p = 0.01) or studies with
acute RIPC (OR: 0.78, 95% CI: 0.63-0.97, p = 0.03) showed consistent
results. Meta-regression and subgroup analyses indicated that study
characteristics, including study design, country, age, gender, diabetic
status, surgery type, use of propofol or volatile anesthetics, cross-clamp
time, RIPC protocol, definition of AKI, and sample size did not
significantly affect the outcome of AKI. Results of stratified analysis
showed that RIPC significantly reduced the risk of mild-to-moderate AKI
that did not require renal replacement therapy (RRT, OR: 0.76, 95% CI:
0.60-0.96, p = 0.02) but did not significantly reduce the risk of severe
AKI that required RRT in patients after cardiac surgery (OR: 0.73, 95% CI:
0.50-1.07, p = 0.11). Conclusion(s): Current evidence supports RIPC
as an effective strategy to prevent AKI after cardiac surgery, which seems
to be mainly driven by the reduced mild-to-moderate AKI events that did
not require RRT. Efforts are needed to determine the influences of patient
characteristics, procedure, perioperative drugs, and RIPC protocol on the
outcome. © Copyright © 2021 Liu, Zhao, Lei, Zhao, Li, Sun
and Liu.

<77>
Accession Number
2011510249
Title
Virtual reality vs. Kalinox for management of pain in intensive care unit
after cardiac surgery: a randomized study.
Source
Annals of Intensive Care. 11 (1) (no pagination), 2021. Article Number:
74. Date of Publication: December 2021.
Author
Laghlam D.; Naudin C.; Coroyer L.; Aidan V.; Malvy J.; Rahoual G.;
Estagnasie P.; Squara P.
Institution
(Laghlam, Coroyer, Aidan, Malvy, Rahoual, Estagnasie, Squara) Department
of Cardiology and Critical Care, CERIC, Clinique Ambroise Pare, 27
boulevard Victor Hugo, Neuilly-sur-Seine 92200, France
(Naudin) Department of Clinical Research, Clinique Ambroise Pare, 27
boulevard Victor Hugo, Neuilly-sur-Seine 92200, France
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: The management of pain and anxiety remains a challenge in
the intensive care unit. By distracting patients, virtual reality (VR) may
have a role in painful procedures. We compared VR vs. an inhaled equimolar
mixture of N<inf>2</inf>O and O<inf>2</inf> (Kalinox) for pain and anxiety
management during the removal of chest drains after cardiac surgery.
 Method(s): Prospective, non-inferiority, open-label study. Patients
were randomized, for Kalinox or VR session during drain removal. The
analgesia/nociception index (ANI) was monitored during the procedure for
objective assessment of pain and anxiety. The primary endpoint was the
DELTAANI (ANI<inf>min</inf> - ANI<inf>0</inf>) during the procedure, based
on ANIm (average on 4 min). We prespecified VR as non-inferior to Kalinox
with a margin of 3 points. Self-reported pain and anxiety were also
analysed using numeric rate scale (NRS). Result(s): 200 patients were
included, 99 in the VR group and 101 in the Kalinox group; 90 patients
were analysed in both groups in per-protocol analysis. The median age was
68.0 years [60.0-74.8]. The DELTAANI was - 15.1 +/- 12.9 in the Kalinox
group and - 15.7 +/- 11.6 in the VR group (NS). The mean difference was,
therefore, - 0.6 [- 3.6 to 2.4], including the non-inferiority margin of
3. Patients in the VR group had a significantly higher pain NRS scale
immediately after the drain removal, 5.0 [3.0-7.0] vs. 3.0 [2.0-6.0], p =
0.009, but no difference 10 min after. NRS of anxiety did not differ
between the two groups. Conclusion(s): Based on the ANI, the current
study showed that VR did not reach the statistical requirements for a
proven non-inferiority vs. Kalinox in managing pain and anxiety during
chest drain removal. Moreover, VR was less effective based on NRS. More
studies are needed to determine if VR might have a place in the overall
approach to pain and anxiety in intensive care units. Trial registration
NCT, NCT03956264. Registered 20 May 2019,
https://clinicaltrials.gov/ct2/show/NCT03956264. Copyright ©
2021, The Author(s).

<78>
Accession Number
2011816149
Title
Update on coronary artery bioresorbable vascular scaffolds in percutaneous
coronary revascularization.
Source
Reviews in Cardiovascular Medicine. 22 (1) (pp 137-145), 2021. Date of
Publication: March 2021.
Author
Azzi N.; Shatila W.
Institution
(Azzi) Department of Cardiology, Lebanese American University, Rizk
Hospital, Beirut 1100, Lebanon
(Shatila) Department of Cardiology, Texas Heart Institute, Houston, TX
77030, United States
(Shatila) Baylor College of Medicine, Houston, TX 77030, United States
Publisher
IMR Press Limited
Abstract
Coronary angioplasty was first introduced in 1977. From plain old balloon
angioplasty to the introduction of bare metal stents in 1986 and dual
antiplatelet therapy in 1992 to much more later on. Due to the
unacceptable rate of stent restenosis, drug eluting stents (DES) were
introduced in 2000. The first generation showed an increase in late stent
thrombosis which led to the introduction of the second generation DES with
biocompatible or biodegradable polymers and thinner platforms. However
very late stent thrombosis and late restenosis might still pose problems
in the latter. Furthermore, there has been major debate regarding the
impact of long-term vessel caging on normal vasomotricity and long-term
positive remodeling. To resolve these issues, the bioresorbable vascular
scaffolds (BVS) were launched into the real world in 2011, showing
promising initial results. Multiple randomized trials, meta-analyses, and
registries were performed, mainly with the Absorb Bioresorbable Vascular
Scaffold System (Abbott Vascular, Chicago, IL, USA). This new technology
is hindered by certain features, such as the BVS radial strength, its
strut thickness, and the inflammatory process related to scaffold
degradation. Moreover, there is known data indicating higher thrombosis
rate with the Absorb BVS compared with the new generation of DES, despite
similar cardiovascular death. In this review, we discuss the clinical
procedural and technical evidence on BVS, with emphasis on their clinical
impact. We finally tackle the future directions on device and procedural
improvement while asking: is the bioresorbable technology still the way to
the future?. Copyright © 2021 The Authors. Published by IMR
Press.

<79>
[Use Link to view the full text]
Accession Number
634905191
Title
The effect of immediate postoperative Boussignac CPAP on adverse pulmonary
events after thoracic surgery: A multicentre, randomised controlled trial.
Source
European Journal of Anaesthesiology. 38 (2) (pp 164-170), 2021. Date of
Publication: February 2021.
Author
Puente-Maestu L.; Lopez E.; Sayas J.; Alday E.; Planas A.; Parise D.J.;
Martinez-Borja M.; Garutti I.
Institution
(Puente-Maestu) Servicio de Neumologia Hospital General Universitario
Gregorio Maranon, Spain
(Puente-Maestu, Garutti) Instituto de Investigacion Sanitaria Gregorio
Maranon (IiSGM), Spain
(Puente-Maestu, Lopez, Sayas, Garutti) Facultad de Medicina, Universidad
Complutense de Madrid (UCM), Spain
(Garutti) Servicio de Anestesia Hospital General Universitario Gregorio
Maranon, Spain
(Lopez) Servicio de Anestesia Hospital General Universitario 12 de
Octubre, Spain
(Lopez, Sayas) Instituto de Investigacion Sanitaria 12 de Octubre (I12),
Spain
(Sayas) Servicio de Neumologia Hospital General Universitario 12 de
Octubre, Spain
(Sayas, Planas) Servicio de Anestesia Hospital General Universitario La
Princesa, Spain
(Alday, Planas) Instituto de Investigacion Sanitaria del Hospital de la
Princesa (IIS La Princea), Spain
(Alday, Planas) Facultad de Medicina, Universidad Autonoma de Madrid
(UAM), Spain
(Parise, Martinez-Borja) Servicio de Anestesia Hospital General
Universitario Ramon y Cajal, Spain
(Parise, Martinez-Borja) Instituto de Investigacion Sanitaria Hospital
Ramon y Cajal (IRICYS), Spain
(Parise, Martinez-Borja) Facultad de Medicina Universidad de Alcala de
Henares (UAH), Madrid, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND The effectiveness of prophylactic continuous positive pressure
ventilation (CPAP) after thoracic surgery is not clearly established.
OBJECTIVE The aim of this study was to assess the effectiveness of CPAP
immediately after lung resection either by thoracotomy or thoracoscopy in
preventing atelectasis and pneumonia. DESIGN A multicentre, randomised,
controlled, open-label trial. SETTINGS Four large University hospitals at
Madrid (Spain) from March 2014 to December 2016. PATIENTS Immunocompetent
patients scheduled for lung resection, without previous diagnosis of
sleep-apnoea syndrome or severe bullous emphysema. Four hundred and
sixty-four patients were assessed, 426 were randomised and 422 were
finally analysed. INTERVENTION Six hours of continuous CPAP through a
Boussignac system versus standard care. MAIN OUTCOME MEASURES Primary
outcome: incidence of the composite endpoint 'atelectasis R pneumonia'.
Secondary outcome: incidence of the composite endpoint 'persistent air
leak R pneumothorax'. RESULTS The primary outcome occurred in 35 patients
(17%) of the CPAP group and in 58 (27%) of the control group [adjusted
relative risk (ARR) 0.53, 95% CI 0.30 to 0.93]. The secondary outcome
occurred in 33 patients (16%) of the CPAP group and in 29 (14%) of the
control group [ARR 0.92, 95% CI 0.51 to 1.65]. CONCLUSION Prophylactic
CPAP decreased the incidence of the composite endpoint 'postoperative
atelectasis R pneumonia' without increasing the incidence of the endpoint
'postoperative persistent air leaks R pneumothorax'. Copyright ©
2020 European Society of Anaesthesiology and Intensive Care. Unauthorized
reproduction of this article is prohibited.

<80>
Accession Number
2011631697
Title
Meta-Analysis Comparing Valve in Valve Transcatheter Mitral Valve
Replacement Versus Redo Surgical Mitral Valve Replacement for Degenerating
Bioprosthetic Valves.
Source
American Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Zahid S.; Ullah W.; Khan M.U.; Sarvepalli D.; Inayat A.; Salman F.; Khan
M.Z.
Institution
(Zahid) Rochester General Hospital, NY, United States
(Ullah) Abington Jefferson, PA, United States
(Khan, Khan) West Virginia University, WV, United States
(Sarvepalli) Gunter Medical College, India
(Inayat) Sisters of Charity Hospital, NY, United States
(Salman) St. Vincent Medical Center, Toledo, OH, United States
Publisher
Elsevier Inc.

<81>
Accession Number
2011521006
Title
The use of minimal fluoroscopy for cardiac electrophysiology procedures: A
meta-analysis and review of the literature.
Source
Clinical Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Chiang L.L.W.; Li C.; Hong K.L.; Hui W.S.; Beh S.Y.; Gong M.; Liu T.; Li
G.; Xia Y.; Ho J.; Roever L.; Duong S.; Huang G.; Tse G.; Baranchuk A.;
Glover B.M.
Institution
(Chiang) Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong
Kong
(Li, Tse) Department of Medicine and Therapeutics, Faculty of Medicine,
Chinese University of Hong Kong, Hong Kong
(Li, Tse) Li Ka Shing Institute of Health Sciences, Faculty of Medicine,
Chinese University of Hong Kong, Hong Kong
(Li, Hui, Beh) Faculty of Medicine, Newcastle University, Newcastle,
United Kingdom
(Hong, Duong, Huang, Glover) Division of Cardiology, University of
Toronto, Toronto, ON, Canada
(Gong, Liu, Li) Tianjin Key Laboratory of Ionic-Molecular Function of
Cardiovascular disease, Department of Cardiology, Tianjin Institute of
Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
(Xia) Department of Cardiology, First Affiliated Hospital of Dalian
Medical University, Dalian, China
(Ho) Department of Anaesthesia and Intensive care, Faculty of Medicine,
Chinese University of Hong Kong, Hong Kong
(Roever) Federal University of Uberlandia, Department of Clinical
Research, Uberlandia, Minas Gerais, Brazil
(Baranchuk) Division of Cardiology, Kingston General Hospital, Queen's
University, Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Conventional catheter ablation involves prolonged exposure to
ionizing radiation, potentially leading to detrimental health effects.
Minimal fluoroscopy (MF) represents a safer alternative, which should be
explored. Data on the safety and efficacy of this technique are limited.
Hypothesis: Our hypothesis is that MF is of equal efficacy and safety to
conventional catheter ablation with the use of fluoroscopy by performing a
meta-analysis of both randomized controlled trials (RCTs) and real-world
registry studies. Method(s): Pubmed and Embase were searched from
their inception to July 2020 for RCTs, cohort and observational studies
that assessed the outcomes of catheter ablation using a MF technique
versus the conventional approach. Result(s): Fifteen studies
involving 3795 patients were included in this meta-analysis. There was a
significant reduction in fluoroscopy and procedural time with no
difference in acute success (odds ratio [OR]:0.74, 95% CI: 0.50-1.10, p
=.14), long-term success (OR:0.92, 95% CI: 0.65-1.31, p =.38), arrhythmia
recurrence (OR:1.24, 95% CI: 0.75-2.06, p =.97) or rate of complications.
(OR:0.83, 95% CI: 0.46-1.48, p =.65). Additionally sub-group analysis for
those undergoing catheter ablation for atrial fibrillation (AF) did not
demonstrate a difference in success or complication rates (OR:0.86, 95%
CI: 0.30-2.42, p =.77). Multivariate meta-regression did not identify the
presence of moderator variables. Conclusion(s): This updated
meta-analysis demonstrated an overall reduction in procedural and
fluoroscopy time for those undergoing a minimal fluoroscopic approach.
There was no significant difference in either acute or chronic success
rates or complications between a MF approach and conventional approach for
the management of all arrhythmias including those undergoing catheter
ablation for AF. Copyright © 2021 The Authors. Clinical
Cardiology published by Wiley Periodicals LLC.

<82>
Accession Number
2011265215
Title
Coronary CT angiography: a guide to examination, interpretation, and
clinical indications.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2021. Date of
Publication: 2021.
Author
Cademartiri F.; Casolo G.; Clemente A.; Seitun S.; Mantini C.; Bossone E.;
Saba L.; Sverzellati N.; Nistri S.; Punzo B.; Cavaliere C.; La Grutta L.;
Gentile G.; Maffei E.
Institution
(Cademartiri, Punzo, Cavaliere) Department of Radiology, SDN IRCCS,
Naples, Italy
(Casolo) Department of Cardiology, Ospedale Della Versilia, Viareggio,
Italy
(Clemente) Department of Radiology, Fondazione Toscana Gabriele
Monasterio, Massa, Italy
(Seitun) Department of Radiology, Ospedale San Martino, Genova, Italy
(Mantini) Department of Neuroscience, Imaging and Clinical Sciences, "G.
d'Annunzio" University, Chieti, Italy
(Bossone) Department of Cardiology, Ospedale Cardarelli, Naples, Italy
(Saba) Department of Radiology, University of Cagliari, Cagliari, Italy
(Sverzellati) Department of Radiology, University of Parma, Parma, Italy
(Nistri) Department of Cardiology, CMSR, Vicenza, Italy
(La Grutta) Department of Radiology, University of Palermo, Palermo, Italy
(Gentile) Department of Radiology, Ismett Irccs, Palermo, Italy
(Maffei) Department of Radiology, ASUR Marche, Area Vasta 1, Urbino, Italy
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: The introduction of Cardiac Computed Tomography (CCT) has
changed the paradigm in the field of diagnostic cardiovascular medicine.
CCT is the primary tool in the assessment of suspected Coronary Artery
Disease (CAD) and should be followed by functional assessment when needed
to stratify disease and to plan potential interventional or surgical
therapy. Areas Covered: We provided the current state of the knowledge on
the main aspects of technique of examination, image interpretation and
clinical indications. We have focused our attention on the basic routine
applications and activities. Expert Opinion: The primary role of CCT in
suspected CAD will progressively become the standard approach. In general,
any situation in which anatomy of the heart and thoracic
vessels/structures is mandatory must be approached using CT first,
whenever possible. The quantity and quality of information that can be
provided by CCT is big and the operators should learn how to deal with
this information. On the other hand, CCT is only apparently a
straightforward and simple examination. It is actually the most complex
diagnostic procedure that can be performed on CT and requires highly
skilled operators and state-of-art-technology. Abbreviations: CABG =
Coronary Artery Bypass GraftCAD = Coronary Artery DiseaseCAG =
Conventional Coronary AngiographyCCT = Cardiac Computed TomographyCT =
Computed TomographySSCT = Single-Source Computed TomographyDSCT =
Dual-Source Computed TomographyOMT = Optimal Medical TherapyPCI =
Percutaneous Coronary InterventionNSTEMI = Non-ST Elevation Myocardial
InfarctionSTEMI = ST Elevation Myocardial InfarctionSPECT = Single-Photon
Emission Computed TomographyPET = Positron Emission TomographyRCT =
Randomized Clinical Trialmm = millimeterkV = kiloVoltmAs =
milliAmpere/secondFOV = Field of View. Copyright © 2021 Informa
UK Limited, trading as Taylor & Francis Group.

<83>
Accession Number
2004358741
Title
Distribution of polymorphisms in the CYP2C19 and ABCB1 genes among
patients with acute coronary syndrome in Lower Silesian population.
Source
Advances in Clinical and Experimental Medicine. 28 (12) (pp 1633-1638),
2019. Date of Publication: 2019.
Author
Wojcik T.; Szymkiewicz P.; Wisniewski J.; Lebioda A.; Jonkisz A.; Gamian
A.; Kuliczkowski W.; Sciborski K.; Mysiak A.; Protasiewicz M.
Institution
(Wojcik, Szymkiewicz, Kuliczkowski, Sciborski, Mysiak, Protasiewicz)
Department and Clinic of Cardiology, Wroclaw Medical University, Poland
(Wisniewski, Gamian) Department and Section of Biochemistry, Wroclaw
Medical University, Poland
(Lebioda, Jonkisz) Section of Molecular Techniques, Wroclaw Medical
University, Poland
Publisher
Wroclaw University of Medicine
Abstract
Background. Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel
administered totreat patients with acute coronary syndrome (ACS) is still
being used. However, despite theproven efficacy of this treatment regimen,
thromboembolic complications have been observed insome individuals.
Thereason for this phenomenon is linked totheso-called increased
responsiveness ofplatelets despite high platelet resistance (HPR). A
significant role in HPR is attributed to genetically determined
differences in the absorption and activation of clopidogrel. Objectives.
Theaim of thestudy was toassess theincidence ofpolymorphisms of the ABCB1
and CYPC19 genes that encode proteins involved intheabsorption and
metabolism of clopidogrel. Material and methods. The analysis was
performed in 199 consecutive patients from Lower Silesian voivodeship
(Poland) who underwent coronary angioplasty with stenting for ACS. The
single nucleotide polymorphism of the CYP2C19 and ABCB1 genes was
performed using a mini sequencing or restriction fragment length
polymorphism method. Results. Theresults of this study revealed thehigh
incidence ofpatients who may be unresponsive toantiplatelet treatment due
togenetic causes. TheCYPC19*2 allele intheform ofhomozygote ormutation
heterozygote appeared in26.1% of thestudy population. ABCB1 (C3435C>T)
polymorphism was associated with 84% ofpatients. Thetotal incidence
ofallelic disorders of low drug absorption and metabolism reached 14.6%.
Conclusions. Thedata obtained should prompt clinicians touse more recent
antiplatelet agents (ticagrelor orprasugrel) first, instead of
clopidogrel. Copyright © 2019 by Wroclaw Medical University.

<84>
Accession Number
613791534
Title
The impact of an educational pain management booklet intervention on
postoperative pain control after cardiac surgery.
Source
European Journal of Cardiovascular Nursing. 16 (1) (pp 18-27), 2017. Date
of Publication: 01 Jan 2017.
Author
Bjornnes A.K.; Parry M.; Lie I.; Fagerland M.W.; Watt-Watson J.; Rustoen
T.; Stubhaug A.; Leegaard M.
Institution
(Bjornnes, Rustoen) Department of Research and Development, Division of
Emergencies and Critical Care, Oslo University Hospital, Norway and
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo,
Norway
(Parry, Watt-Watson) Lawrence S. Bloomberg Faculty of Nursing, University
of Toronto, Canada
(Lie) Department of Cardiothoracic Surgery, Oslo University Hospital,
Ulleval/Center for Patient Centered Heart and Lung Research, Division of
Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Norway
(Fagerland) Oslo Centre for Biostatistics and Epidemiology, Research
Support Services, Oslo University Hospital, Norway
(Stubhaug) Department of Pain Management and Research, Oslo University
Hospital, Institute of Clinical Medicine, Faculty of Medicine, University
of Oslo, Norway
(Leegaard) Oslo and Akershus University, College of Applied Sciences,
Faculty of Health Sciences, Institute of Nursing, Norway
Publisher
SAGE Publications Inc.
Abstract
Background: Relevant discharge information about the use of analgesic
medication and other strategies may help patients to manage their pain
more effectively and prevent postoperative persistent pain. Aim(s):
To examine patients' pain characteristics, analgesic intake and the impact
of an educational pain management booklet intervention on postoperative
pain control after cardiac surgery. Concerns about pain and pain
medication prior to surgery will also be described. Method(s): From
March 2012 to September 2013, 416 participants (23% women) were
consecutively enrolled in a randomized controlled trial. The intervention
group received usual care plus an educational booklet at discharge with
supportive telephone follow-up on postoperative day 10, and the control
group received only usual care. The primary outcome was worst pain
intensity (The Brief Pain Inventory - Short Form). Data about pain
characteristics and analgesic use were collected at 2 weeks and at 1, 3, 6
and 12 months post-surgery. General linear mixed models were used to
determine between-group differences over time. Result(s): Twenty-nine
percent of participants reported surgically related pain at rest and 9%
reported moderate to severe pain at 12 months post-surgery. Many
participants had concerns about pain and pain medication, and analgesic
intake was insufficient post-discharge. No statistically significant
differences between the groups were observed in terms of the outcome
measures following surgery. Conclusion(s): Postoperative pain and
inadequate analgesic use were problems for many participants regardless of
group allocation, and the current intervention did not reduce worst pain
intensity compared with control. Further examination of supportive
follow-up monitoring and/or self-management strategies post-discharge is
required. Copyright © European Society of Cardiology.

<85>
Accession Number
361240004
Title
Age difference explains gender difference in cardiac intervention rates
after acute myocardial infarction.
Source
Healthcare Policy. 6 (1) (pp 88-103), 2010. Date of Publication: August
2010.
Author
Fransoo R.R.; Martens P.J.; Prior H.J.; Burland E.; Chateau D.; Katz A.
Institution
(Fransoo, Martens, Prior, Burland, Chateau, Katz) Manitoba Centre for
Health Policy, 408 - 727 McDermot Avenue, Winnipeg, MB R3E 3P5, Canada
(Fransoo, Martens) Community Health Sciences, Faculty of Medicine,
University of Manitoba, Winnipeg, MB, Canada
(Chateau) Biostatistical Consulting Unit, Community Health Sciences,
Winnipeg, MB, Canada
(Katz) Family Medicine and Community Health Sciences, Faculty of Medicine,
University of Manitoba, Winnipeg, MB, Canada
Publisher
Longwoods Publishing Corp.
Abstract
Many investigators have reported higher rates of cardiac procedures for
males than females after acute myocardial infarction (AMI), suggesting
that men are treated more aggressively than women. However, others have
reported no significant differences after controlling for age, resulting
in uncertainty about the existence of a true gender bias in cardiac care.
In this study, a population-based cohort approach was used to calculate
age-specific procedure rates by sex from administrative data. Chi-square
tests and generalized linear modelling were used to assess gender
differences and interactions. for all four procedures studied, rates were
significantly higher for males than females (p<0.01). However,
age-specific rates revealed few significant differences by gender and a
sharp decrease in intervention rates with age for both males and females.
generalized linear modelling confirmed that patient age was a significant
predictor of intervention rates, whereas sex was not. The significant
gender difference in overall rates was completely confounded by the older
age profile of female AmI patients compared to their male counterparts.

<86>
Accession Number
2006994999
Title
Social determinants of health and outcomes for children and adults with
congenital heart disease: a systematic review.
Source
Pediatric Research. 89 (2) (pp 275-294), 2021. Date of Publication:
January 2021.
Author
Davey B.; Sinha R.; Lee J.H.; Gauthier M.; Flores G.
Institution
(Davey) Division of Cardiology, Connecticut Children's Medical Center,
Hartford, CT, United States
(Davey, Sinha, Lee, Flores) Department of Pediatrics, University of
Connecticut School of Medicine, Farmington, CT, United States
(Sinha) Division of Cardiac Surgery, Connecticut Children's Medical
Center, Hartford, CT, United States
(Lee) Research Department, Connecticut Children's Medical Center,
Hartford, CT, United States
(Gauthier) Health Sciences Library, University of Connecticut School of
Medicine, Farmington, CT, United States
(Flores) Health Services Research Institute, Connecticut Children's
Medical Center, Hartford, CT, United States
Publisher
Springer Nature
Abstract
Background: Social determinants of health (SDH) can substantially impact
health outcomes. A systematic review, however, has never been conducted on
associations of SDH with congenital heart disease (CHD) outcomes. The aim,
therefore, was to conduct such a systematic review. Method(s): Seven
databases were searched through May 2020 to identify articles on SDH
associations with CHD. SDH examined included poverty, uninsurance, housing
instability, parental educational attainment, immigration status, food
insecurity, and transportation barriers. Studies were independently
selected and coded by two researchers based on the PICO statement.
 Result(s): The search generated 3992 citations; 88 were included in
the final database. SDH were significantly associated with a lower
likelihood of fetal CHD diagnosis, higher CHD incidence and prevalence,
increased infant mortality, adverse post-surgical outcomes (including
hospital readmission and death), decreased healthcare access (including
missed appointments, no shows, and loss to follow-up), impaired
neurodevelopmental outcomes (including IQ and school performance) and
quality of life, and adverse outcomes for adults with CHD (including
endocarditis, hospitalization, and death). Conclusion(s): SDH are
associated with a wide range of adverse outcomes for fetuses, children,
and adults with CHD. SDH screening and referral to appropriate services
has the potential to improve outcomes for CHD patients across the
lifespan. Impact: Social determinants of health (SDH) are associated with
a wide range of adverse outcomes for fetuses, children, and adults with
congenital heart disease (CHD).This is the first systematic review (to our
knowledge) on associations of SDH with congenital heart disease CHD
outcomes.SDH screening and referral to appropriate services has the
potential to improve outcomes for CHD patients across the
lifespan. Copyright © 2020, International Pediatric Research
Foundation, Inc.

<87>
Accession Number
633377302
Title
Association of Circulating Monocyte Chemoattractant Protein-1 Levels with
Cardiovascular Mortality: A Meta-analysis of Population-Based Studies.
Source
JAMA Cardiology. 6 (5) (pp 587-592), 2021. Date of Publication: May 2021.
Author
Georgakis M.K.; De Lemos J.A.; Ayers C.; Wang B.; Bjorkbacka H.; Pana
T.A.; Thorand B.; Sun C.; Fani L.; Malik R.; Dupuis J.; Engstrom G.;
Orho-Melander M.; Melander O.; Boekholdt S.M.; Zierer A.; Elhadad M.A.;
Koenig W.; Herder C.; Hoogeveen R.C.; Kavousi M.; Ballantyne C.M.; Peters
A.; Myint P.K.; Nilsson J.; Benjamin E.J.; Dichgans M.
Institution
(Georgakis, Malik, Dichgans) Institute for Stroke and Dementia Research,
University Hospital, Ludwig-Maximilians-University, Feodor-Lynen-Str. 17,
Munich 81377, Germany
(Georgakis) Graduate School for Systemic Neurosciences,
Ludwig-Maximilians-University, Munich, Germany
(De Lemos, Ayers) Division of Cardiology, University of Texas,
Southwestern Medical Center, Dallas, United States
(Wang, Dupuis) Department of Biostatistics, Boston University, School of
Public Health, Boston, MA, United States
(Bjorkbacka, Engstrom, Orho-Melander, Melander, Nilsson) Department of
Clinical Sciences Malmo, Lund University, Malmo, Sweden
(Pana, Myint) Institute of Applied Health Sciences, School of Medicine,
Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United
Kingdom
(Thorand, Elhadad) Research Unit of Molecular Epidemiology, Helmholtz
Zentrum Munchen, German Research Center for Environmental Health,
Neuherberg, Germany
(Thorand, Herder, Peters) German Center for Diabetes Research,
Munchen-Neuherberg, Germany
(Sun, Hoogeveen, Ballantyne) Department of Medicine, Baylor College of
Medicine, Houston, TX, United States
(Fani, Kavousi) Department of Epidemiology, Erasmus MC University Medical
Center, Rotterdam, Netherlands
(Boekholdt) Amsterdam UMC, University of Amsterdam, Department of
Cardiology, Amsterdam, Netherlands
(Zierer, Elhadad, Peters) Institute of Epidemiology, Helmholtz Zentrum
Munchen, German Research Center for Environmental Health, Neuherberg,
Germany
(Elhadad, Koenig, Peters) German Research Center for Cardiovascular
Disease, Partner Site of Munich Heart Alliance, Munich, Germany
(Koenig) Deutsches Herzzentrum Munchen, Technische Universitat Munchen,
Munich, Germany
(Koenig) Institute of Epidemiology and Medical Biometry, University of
Ulm, Ulm, Germany
(Herder) Institute for Clinical Diabetology, German Diabetes Center,
Leibniz Center for Diabetes Research at Heinrich Heine University
Dusseldorf, Dusseldorf, Germany
(Herder) Department of Endocrinology and Diabetology, Medical Faculty,
Heinrich Heine University Dusseldorf, Dusseldorf, Germany
(Peters) Institute of Medical Information Sciences, Biometry and
Epidemiology, Ludwig-Maximilians-University, Munich, Germany
(Benjamin) Section of Cardiovascular Medicine and Preventive Medicine,
Department of Medicine, Boston University, School of Medicine, Boston, MA,
United States
(Benjamin) Department of Epidemiology, Boston University, School of Public
Health, Boston, MA, United States
(Benjamin) Framingham Heart Study, National Heart, Lung, and Blood
Institute, Boston University, Framingham, MA, United States
(Dichgans) Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
(Dichgans) German Centre for Neurodegenerative Diseases, Munich, Germany
Publisher
American Medical Association
Abstract
Importance: Human genetics and studies in experimental models support a
key role of monocyte-chemoattractant protein-1 (MCP-1) in atherosclerosis.
Yet, the associations of circulating MCP-1 levels with risk of coronary
heart disease and cardiovascular death in the general population remain
largely unexplored. Objective(s): To explore whether circulating
levels of MCP-1 are associated with risk of incident coronary heart
disease, myocardial infarction, and cardiovascular mortality in the
general population. Data Sources and Selection: Population-based cohort
studies, identified through a systematic review, that have examined
associations of circulating MCP-1 levels with cardiovascular end points.
Data Extraction and Synthesis: Using a prespecified harmonized analysis
plan, study-specific summary data were obtained from Cox regression models
after excluding individuals with overt cardiovascular disease at baseline.
Derived hazard ratios (HRs) were synthesized using random-effects
meta-analyses. Main Outcomes and Measures: Incident coronary heart
disease (myocardial infarction, coronary revascularization, and unstable
angina), nonfatal myocardial infarction, and cardiovascular death (from
cardiac or cerebrovascular causes). Result(s): The meta-analysis
included 7 cohort studies involving 21401 individuals (mean [SD] age, 53.7
[10.2] years; 10012 men [46.8%]). Mean (SD) follow-up was 15.3 (4.5) years
(326392 person-years at risk). In models adjusting for age, sex, and
race/ethnicity, higher MCP-1 levels at baseline were associated with
increased risk of coronary heart disease (HR per 1-SD increment in MCP-1
levels: 1.06 [95% CI, 1.01-1.11]; P =.01), nonfatal myocardial infarction
(HR, 1.07 [95% CI, 1.01-1.13]; P =.02), and cardiovascular death (HR, 1.12
[95% CI, 1.05-1.20]; P <.001). In analyses comparing MCP-1 quartiles,
these associations followed dose-response patterns. After additionally
adjusting for vascular risk factors, the risk estimates were attenuated,
but the associations of MCP-1 levels with cardiovascular death remained
statistically significant, as did the association of MCP-1 levels in the
upper quartile with coronary heart disease. There was no significant
heterogeneity; the results did not change in sensitivity analyses
excluding events occurring in the first 5 years after MCP-1 measurement,
and the risk estimates were stable after additional adjustments for
circulating levels of interleukin-6 and high-sensitivity C-reactive
protein. Conclusions and Relevance: Higher circulating MCP-1 levels
are associated with higher long-term cardiovascular mortality in
community-dwelling individuals free of overt cardiovascular disease. These
findings provide further support for a key role of MCP-1-signaling in
cardiovascular disease.. Copyright © 2021 American Medical
Association. All rights reserved.

<88>
Accession Number
2012011219
Title
Case study-based systematic review of literature on lymphoma-associated
cardiac tamponade.
Source
Wspolczesna Onkologia. 25 (1) (pp 57-63), 2021. Date of Publication: 2021.
Author
Shareef M.A.; Eshaq A.M.; Alshawaf R.; Alharthi E.; Al Muslat A.A.;
AbuDawas R.; AlAmodi A.A.
Institution
(Shareef) Department of Internal Medicine, Sebasticook Valley Hospital,
Pittsfield, ME, United States
(Eshaq, Al Muslat, AbuDawas) College of Medicine, Alfiasal University,
Riyadh, Saudi Arabia
(Alshawaf) Internal Medicine Department, Security Forces Hospital Program,
Riyadh, Saudi Arabia
(Alharthi) Internal Medicine Department, Prince Sultan Military Medical
City, Riyadh, Saudi Arabia
(AlAmodi) Department of Epidemiology and Biostatistics, School of Public
Health, College of Health Sciences, Jackson State University, Jackson, MS,
United States
Publisher
Termedia Publishing House Ltd.
Abstract
This study aimed to compile all the relevant studies of patients
presenting with pericardial tamponade before or after diagnosis of
lymphoma, describe the clinical presentations of patients with lymphoma
and cardiac tamponade, and assess the difference in overall survival based
on the timing of cardiac tamponade diagnosis. A comprehensive search
strategy was conducted in the following databases: PubMed and Cochrane
Library, using the following keywords: Lymphoma AND Cardiac Tamponade. The
criteria for eligibility included cases with a confirmed diagnosis of
lymphoma and cardiac tamponade, human studies, and publications in English
language. The statistical analysis was performed using IBM Statistical
Package for Social Sciences (SPSS) version 20. We included 48 research
articles (n = 52 cases) with adequate reporting of measured outcomes. The
median age of the patients was 52 (9-94) years. Only 6 patients were noted
to have primary cardiac lymphoma, while the majority of cases were
considered to have secondary cardiac lymphoma (88.5%). According to the
data on the type of lymphoma reported through cytology and
immunohistochemistry, 49 patients were diagnosed with non-Hodgkin
lymphoma, and of these cases the most common subtype was large B-cell
lymphoma (42.9%). Overall, the average duration of illness was 14 +/- 23
days. A total of 13 patients had distant heart sounds, 12 cases were noted
to be hypotensive, and 13 subjects were found to have increased jugular
venous pressure. Our retrospective study demonstrated that most patients
presented with pericardial tamponade after lymphoma diagnosis, and those
were mostly secondary cardiac lymphoma of the non-Hodgkin type with large
B-cell as the most common subtype. Dyspnoea, oedema, and constitutional
symptoms were the most common presenting signs. The median overall
survival of patients with lymphoma and cardiac tamponade is 4 months, with
no significant difference in mortality in the presentation timing before
and after the diagnosis of lymphoma. Copyright © 2021 Termedia
Publishing House Ltd.. All rights reserved.

<89>
Accession Number
627895110
Title
Randomized evaluation of fibrinogen versus placebo in complex
cardiovascular surgery: Post hoc analysis and interpretation of phase III
results.
Source
Interactive Cardiovascular and Thoracic Surgery. 28 (4) (pp 566-574),
2019. Date of Publication: 01 Apr 2019.
Author
Rahe-Meyer N.; Levy J.H.; Mazer C.D.; Schramko A.; Klein A.A.; Brat R.;
Okita Y.; Ueda Y.; Schmidt D.S.; Gill R.
Institution
(Rahe-Meyer) Department of Anaesthesiology and Critical Care, Franziskus
Hospital, Bielefeld, Germany
(Levy) Department of Anesthesiology and Critical Care, Duke University
School of Medicine, Durham, NC, United States
(Mazer) Department of Anesthesia, St. Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Schramko) Department of Anesthesiology, Intensive Care and Pain Medicine,
Helsinki University Hospital, Helsinki, Finland
(Klein) Department of Anaesthesia and Intensive Care, Papworth Hospital,
Cambridge, United Kingdom
(Brat) Department of Cardiac Surgery, Faculty of Medicine, University of
Ostrava, Ostrava, Czechia
(Okita) Department of Cardiovascular Surgery, Kobe University Hospital,
Kobe, Japan
(Ueda) Department of Cardiac Surgery, Nagoya University Graduate School of
Medicine, Nagoya, Japan
(Schmidt) CSL Behring, Marburg, Germany
(Gill) Department of Anaesthesia, University Hospital of Southampton,
Southampton, United Kingdom
Publisher
Oxford University Press
Abstract
Objectives: In a multicentre, randomized-controlled, phase III trial in
complex cardiovascular surgery (Randomized Evaluation of Fibrinogen vs
Placebo in Complex Cardiovascular Surgery: REPLACE), single-dose human
fibrinogen concentrate (FCH) was associated with the transfusion of
increased allogeneic blood products (ABPs) versus placebo. Post hoc
analyses were performed to identify possible reasons for this result.
 Method(s): We stratified REPLACE results by adherence to the
transfusion algorithm, pretreatment fibrinogen level (<=2 g/l vs >2 g/l)
and whether patients were among the first 3 treated at their centre.
 Result(s): Patients whose treatment was adherent with the transfusion
algorithm [FCH, n = 47 (60.3%); placebo, n = 57 (77.0%); P = 0.036]
received smaller quantities of ABPs than those with non-adherent treatment
(P < 0.001). Among treatment-adherent patients with pretreatment plasma
fibrinogen <=2 g/l, greater reduction in 5-min bleeding mass was seen with
FCH versus placebo (median -22.5 g vs -15.5 g; P = 0.071). Considering
patients with the above conditions and not among the first 3 treated at
their centre (FCH, n = 15; placebo, n = 22), FCH was associated with
trends towards reduced transfusion of ABPs (median 2.0 vs 4.0 units; P =
0.573) and greater reduction in 5-min bleeding mass (median -21.0 g vs
-9.5 g; P = 0.173). Differences from a preceding single-centre phase II
study with positive outcomes included more patients with pretreatment
fibrinogen >2 g/l and fewer patients undergoing thoracoabdominal aortic
aneurysm repair. Conclusion(s): None of the patient stratifications
provided a clear explanation for the lack of efficacy seen for FCH in the
REPLACE trial versus the positive phase II outcomes. However, together,
the 3 factors demonstrated trends favouring FCH. Less familiarity with the
protocol and procedures and unavoidable differences in the study
populations may explain the differences seen between the phase II study
and REPLACE. Copyright © The Author(s) 2018.

<90>
[Use Link to view the full text]
Accession Number
2007540285
Title
A mortality risk score for heart transplants after contemporary
ventricular assist device bridging.
Source
Journal of Cardiac Surgery. 36 (2) (pp 449-456), 2021. Date of
Publication: February 2021.
Author
Huckaby L.V.; Seese L.M.; Hickey G.; Sultan I.; Kilic A.
Institution
(Huckaby, Seese, Sultan, Kilic) Division of Cardiac Surgery, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Hickey) Division of Cardiology, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
Publisher
Blackwell Publishing Inc.
Abstract
Background: We sought to derive a risk score for 1-year mortality
following orthotopic heart transplantation (OHT) in patients bridged with
a contemporary centrifugal left ventricular assist device (LVAD).
 Method(s): Adult patients (>=18 years) in the United Network for
Organ Sharing database undergoing OHT between 2010 and 2019 who were
bridged with a HeartWare or HeartMate III device were included. Derivation
and validation cohorts were randomly assigned with a 2:1 ratio. Threshold
analysis and multivariable logistic regression were utilized to obtain
adjusted odds ratios for 1-year post-OHT mortality. A risk score was
generated using these adjusted odds ratios in the derivation cohort and
the predictive performance of the composite index was evaluated in the
validation set. Result(s): A total of 3434 patients were identified.
In the derivation cohort, the mean age was 53.5 +/- 12.1 years and 1758
(76.8%) were male; 1789 (78.1%) were bridged with a HeartWare device.
Multivariable logistic regression revealed that recipient age >=50 years,
bilirubin level >=2.4 mg/dl, ischemic time >=4 h, and preoperative
hemodialysis predicted 1-year post-transplant mortality. Stratification
into risk groups in the validation cohort revealed significant differences
in postoperative renal failure, stroke, and short-term mortality. One-year
post-transplant mortality was 5%, 6.7%, and 14.8% in the low-, moderate-,
and high-risk categories, respectively (p <.001). Conclusion(s):
Among patients bridged to OHT with newer generation centrifugal LVADs,
older age, increasing bilirubin, longer ischemic time, and pre-OHT
dialysis independently predicted post-transplant mortality. The composite
risk score based on these factors may assist in patient selection and
prognostication in those supported with contemporary LVADs. Copyright
© 2020 Wiley Periodicals LLC

<91>
Accession Number
2007229599
Title
Prognostic association of routinely measured biomarkers in patients
admitted to critical care: a systematic review.
Source
Biomarkers. 26 (1) (pp 1-12), 2021. Date of Publication: 2021.
Author
Wan Y.I.; Brayne A.B.; Haines R.W.; Puthucheary Z.A.; Prowle J.R.
Institution
(Wan, Brayne, Haines, Puthucheary, Prowle) Adult Critical Care Unit, The
Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
(Wan, Brayne, Haines, Puthucheary, Prowle) William Harvey Research
Institute, Queen Mary University of London, London, United Kingdom
(Brayne) Northern Devon Healthcare NHS Trust, Barnstaple, United Kingdom
Publisher
Taylor and Francis Ltd.
Abstract
Purpose: To examine reported prognostic associations of routine blood
measurements in the intensive care unit. Material(s) and Method(s):
We searched PubMed, EMBASE through 28th May 2020 to identify
all studies in adult critical care investigating associations between
parameters measured routinely in whole blood, plasma or serum, and length
of stay or mortality. Registration: PROSPERO; CRD42019122058.
 Result(s): A total of 128 studies, reporting 28 different putative
prognostic biomarkers, met eligibility criteria. Those most frequently
examined were red cell distribution width, neutrophil-to-lymphocyte ratio,
C-reactive protein, and platelet count. A higher red cell distribution
width, a lower platelet count, and a higher neutrophil-to-lymphocyte ratio
were consistently associated with both increased mortality and length of
stay. A lower level of albumin was consistently associated with greater
mortality. C-reactive protein was inconsistent. Most studies (n = 110)
used regression modelling with wide variation in variable selection and
covariate-adjustment; none externally validated the proposed predictive
models. Conclusion(s): Simple regression models have so far proved
inadequate for the complexity of data available from routine blood
sampling in critical care. Adoption of a direct causal framework may help
better assess mechanistic processes, aid design of future studies, and
guide clinical decision making using routine data. Copyright ©
2020 Informa UK Limited, trading as Taylor & Francis Group.

<92>
[Use Link to view the full text]
Accession Number
634886889
Title
The safety of antihypertensive agents on perioperation of cardiac surgery:
A systematic review based on meta-analysis.
Source
Journal of Hypertension. Conference: European Meeting on Hypertension and
Cardiovascular Protection and International Society of Hypertension,
ESH-ISH 2021. Virtual. 39 (SUPPL 1) (pp e137), 2021. Date of Publication:
April 2021.
Author
Li C.; Ma L.; Wang Q.; Zhao X.; Ma R.; Li N.; Yu J.
Institution
(Li, Ma, Wang, Zhao, Ma, Li, Yu) Lanzhou University, Second Hospital,
Center of Hypertension, Lanzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: To assess the safety of anti-hypertensive agents including
calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors
or angiotensin receptor antagonists (ACEIs/ARBs), and beta blockers during
perioperation of cardiac surgery. Design and method: We included
randomized controlled trials investigating perioperative application of
CCBs, ACEIs/ARBs or beta blockers in cardiac surgery. We extracted data
for in-hospital mortality and serious side effects, among which atrial
fibrillation (AF), stroke and acute renal failure (ARF) were assessed
independently. Result(s): Twenty-three trials with 5378 patients were
included. There were no significant differences between CCBs and placebo,
nitroglycerin, or nitroprusside in terms of side effects, AF and ARF.
Incidences of side effects (RR [95% CI] 0.55 [0.38, 0.80], I2=0, p<0.01)
and ARF (RR [95% CI] 0.16 [0.05, 0.53], I2=0, p<0.01) were significantly
reduced in ACEIs/ARBs group, compared with placebo, while differences in
the incidences of AF and stoke were not found. No differences were found
in the incidences of in-hospital death, side effects, ARF and stroke
between beta blockers and placebo. However, use of beta blockers
significantly reduced the incidence of AF (RR [95% CI] 0.51 [0.39, 0.67],
I2=48%, p<0.01). Conclusion(s): Perioperative use of CCBs, ACEIs/ARBs
or beta blockers does not increase incidences of side effects in patients
undergoing cardiac surgery and beta blockers are more appropriate in
patients with high risk of postoperative atrial tachycardia. Large
randomized trials are needed to confirm these findings.

<93>
Accession Number
2011264781
Title
Longitudinal assessment of preoperative dexamethasone administration on
cognitive function after cardiac surgery: a 4-year follow-up of a
randomized controlled trial.
Source
BMC Anesthesiology. 21 (1) (no pagination), 2021. Article Number: 129.
Date of Publication: December 2021.
Author
Glumac S.; Kardum G.; Sodic L.; Bulat C.; Covic I.; Carev M.; Karanovic N.
Institution
(Glumac, Carev, Karanovic) Department of Anesthesiology and Intensive
Care, University Hospital of Split, Spinciceva 1, Split 21000, Croatia
(Kardum) Department of Psychology, Faculty of Humanities and Social
Sciences, University of Split, Split, Croatia
(Sodic) Department of Neurology, University Hospital of Split, Split,
Croatia
(Bulat) Department of Cardiac Surgery, University Hospital of Split,
Split, Croatia
(Covic) School of Medicine, University of Split, Split, Croatia
(Carev, Karanovic) Department of Anesthesiology and Intensive Medicine,
School of Medicine, University of Split, Split, Croatia
Publisher
BioMed Central Ltd
Abstract
Background: The pathogenesis of postoperative cognitive decline (POCD) is
still poorly understood; however, the inflammatory response to surgical
procedures seems likely to be involved. In addition, our recent randomized
controlled trial showed that perioperative corticosteroid treatment may
ameliorate early POCD after cardiac surgery. To assess the long-term
effect of dexamethasone administration on cognitive function, we conducted
a 4-year follow-up. Method(s): The patients were randomized to
receive a single intravenous bolus of 0.1 mg kg- 1
dexamethasone or placebo 10 h before elective cardiac surgery. The
endpoint in both groups was POCD incidence on the 6th day and four years
postoperatively. Result(s): Of the 161 patients analyzed previously,
the current follow-up included 116 patients. Compared to the 62 patients
in the placebo group, the 54 patients in the dexamethasone group showed a
lower incidence of POCD on the 6th day (relative risk (RR), 0.510; 95 %
confidence interval (CI), 0.241 to 1.079; p = 0.067, time interval also
analyzed previously) and four years (RR, 0.459; 95 % CI, 0.192 to 1.100; p
= 0.068) after cardiac surgery. The change in cognitive status between the
two postoperative measurements was not significant (p = 0.010) among the
patients in the dexamethasone group, in contrast to patients in the
placebo group (p = 0.673). Conclusion(s): Although statistical
significance was not reached in the current study, the prophylactic
administration of dexamethasone seems to be useful to prevent POCD
development following cardiac surgery. However, further large multicenter
research is needed to confirm these directions. Trial registration:
ClinicalTrials.gov identifier: NCT02767713 (10/05/2016). Copyright
© 2021, The Author(s).

<94>
Accession Number
2011864963
Title
When to Consider Deferral of Surgery in Acute Type A Aortic Dissection: A
Review.
Source
Annals of Thoracic Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Sabe A.A.; Percy E.D.; Kaneko T.; Plichta R.P.; Hughes G.C.
Institution
(Sabe, Percy, Kaneko) Division of Cardiac Surgery, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Plichta, Hughes) Division of Cardiovascular and Thoracic Surgery, Duke
University Medical Center, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: Acute type A aortic dissection (ATAAD) is a surgical emergency
with an operative mortality of up to 30%, a rate that has not changed
meaningfully in more than 2 decades. A growing body of research has
highlighted several comorbidities and presenting factors in which delay or
permanent deferral of surgery may be considered; however, modern
comprehensive summative reviews are lacking. The urgency and timing of
this review are underscored by significant challenges in resource use
posed by the coronavirus disease 2019 (COVID-19) pandemic. This review
provides an update on the current understanding of risk assessment,
surgical candidacy, and operative timing in patients with ATAAD.
 Method(s): A literature search was conducted through PubMed and
Embase databases to identify relevant studies relating to risk assessment
in ATAAD. Articles were selected by group consensus on the basis of
quality and relevance. Result(s): Several patient factors have been
identified that increase risk in ATAAD repair. In particular, frailty,
advanced age, previous cardiac surgery, and use of novel anticoagulant
medications have been studied. The understanding of malperfusion syndromes
has also expanded significantly, including recommendations for surgical
delay. Finally, approaches to triage have been significantly influenced by
resource limitations related to the ongoing COVID-19 pandemic. Although
medical management remains a reasonable option in carefully selected
patients at prohibitive risk for open surgery, endovascular therapies for
treatment of ATAAD are rapidly evolving. Conclusion(s): Early
surgical repair remains the preferred treatment for most patients with
ATAAD. However, improvements in risk stratification should guide
appropriate delay or permanent deferral of surgery in select
individuals. Copyright © 2021

<95>
Accession Number
2011822815
Title
Long-Term Outcomes Comparing Medical Therapy versus Revascularization for
Spontaneous Coronary Artery Dissection.
Source
American Journal of Medicine. (no pagination), 2021. Date of Publication:
2021.
Author
Krittanawong C.; Nazir S.; Hassan Virk H.; Hahn J.; Wang Z.; Fogg S.E.;
Sharma S.K.; Alam M.; Jneid H.
Institution
(Krittanawong, Hahn, Jneid) Michael E. DeBakey VA Medical Center, Houston,
Tex, United States
(Krittanawong, Hahn, Alam, Jneid) Section of Cardiology, Baylor School of
Medicine, Houston, Tex, United States
(Nazir) Department of Cardiology, University of Toledo, Toledo, Ohio,
United States
(Hassan Virk) Harrington Heart & Vascular Institute, Case Western Reserve
University, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
(Wang) Robert D. and Patricia E. Kern Center for the Science of Health
Care Delivery, Mayo Clinic, Rochester, Minn, United States
(Wang) Division of Health Care Policy and Research, Department of Health
Sciences Research, Mayo Clinic, Rochester, Minn, United States
(Fogg, Alam) Texas Heart Institute, Houston, Tex, United States
(Sharma) Cardiac Catheterization Laboratory of the Cardiovascular
Institute, Mount Sinai Hospital, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
The ideal management of spontaneous coronary artery dissection (SCAD) has
yet to be clearly defined. We conducted a comprehensive search of Ovid
MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews,
Scopus, and Web of Science from database inception from 1966 through
September 2020 for all original studies (randomized controlled trials and
observational studies) that evaluated patients with SCAD. Study groups
were defined by allocation to medical therapy (medical therapy) versus
invasive therapy (invasive therapy) (ie, percutaneous coronary
intervention or coronary artery bypass grafting). The risk of death (risk
ratio [RR] = 0.753; 95% confidence interval [CI]: 0.21-2.73; I2
= 21.1%; P = 0.61), recurrence of SCAD (RR = 1.09; 95% CI: 0.61-1.93;
I2 = 0.0%; P = 0.74), and repeat revascularization (RR = 0.64;
95% CI: 0.21-1.94; I2 = 57.6%; P = 0.38) were not statistically
different between medical therapy and invasive therapy for a follow-up
ranging from 4 months to 3 years. In conclusion, in this meta-analysis of
observational studies, the long-term risk of death, recurrent SCAD, and
repeat revascularization did not significantly differ among patients with
SCAD treated with medical therapy compared with those treated with
invasive therapy. These findings support the current expert consensus that
patients should be treated with medical therapy when clinically stable and
no high-risk features are present. Further large-scale studies including
randomized controlled trials are needed to confirm these
findings. Copyright © 2021 Elsevier Inc.

<96>
Accession Number
2011797455
Title
Effect of Availability of Transcatheter Aortic-Valve Implantation on
Survival for all Patients With Severe Aortic Stenosis.
Source
American Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Chao A.; Picard M.H.; Passeri J.J.; Cui J.; Nethery R.C.; Wasfy J.H.
Institution
(Chao) Department of Biostatistics, Yale School of Public Health, New
Haven, CT, United States
(Picard, Passeri, Cui, Wasfy) Cardiology Division, Department of Medicine,
Massachusetts General Hospital, Boston, MA, United States
(Nethery) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Clinical outcomes for the overall severe aortic stenosis (AS) patient
population are not well described because those medically managed are not
included in procedural registries, and AS severity is not identifiable
from administrative data. We aim to assess whether transcatheter aortic
valve implantation (TAVI) availability has been associated with overall
changes in survival for the whole AS patient population. This is important
because patients with AS in real-world practice may differ from those
included in randomized controlled trials, potentially attenuating the
purported treatment efficacy estimated in trials. Classic severe AS
patients (mean gradient >=40 mmHg) were identified from an
echocardiography database. Survival was defined as time since severe AS
diagnosis until death. We first compared survival among all patients
before and after TAVI availability in 2008. To further understand
mechanism, we then assessed whether any survival changes were attributable
to TAVI with extended Cox regression models comparing survival among TAVI,
surgical aortic valve replacement, and medically managed patients. 3663
classic severe AS patients were included in the study. Median survival
years for all patients were greater during the TAVI-era than Pre-TAVI-era
(>11.5 vs 6.8, 5-year-HR = 0.8, time-varying effect p <0.0001), and
increased median survival was greatest for patients age 65 to74 (>11.5 vs
9.5, 5-year-HR = 0.7, time-varying effect p = 0.045). TAVI patients age 65
to 74 had the lowest risk of death compared to medically managed patients
(HR = 0.2, 95% CI = [0.1, 0.3], p <0.0001). In conclusion, in the
TAVI-era, overall survival for patients with severe AS has doubled. This
improvement is most marked for patients 65 to 74 years of
age. Copyright © 2021 Elsevier Inc.

<97>
Accession Number
2011514624
Title
The impact of exogenous nitric oxide during cardiopulmonary bypass for
cardiac surgery.
Source
Perfusion (United Kingdom). (no pagination), 2021. Date of Publication:
2021.
Author
Loughlin J.M.; Browne L.; Hinchion J.
Institution
(Loughlin, Hinchion) Department of Cardiothoracic Surgery, Cork University
Hospital, Cork, Ireland
(Browne) Department of Clinical Perfusion, Cork University Hospital, Cork,
Ireland
Publisher
SAGE Publications Ltd
Abstract
Objectives: Cardiac surgery using cardiopulmonary bypass frequently
provokes a systemic inflammatory response syndrome. This can lead to the
development of low cardiac output syndrome (LCOS). Both of these can
affect morbidity and mortality. This study is a systematic review of the
impact of gaseous nitric oxide (gNO), delivered via the cardiopulmonary
bypass (CPB) circuit during cardiac surgery, on post-operative outcomes.
It aims to summarise the evidence available, to assess the effectiveness
of gNO via the CPB circuit on outcomes, and highlight areas of further
research needed to develop this hypothesis. Method(s): A
comprehensive search of Pubmed, Embase, Web of Science and the Cochrane
Library was performed in May 2020. Only randomised control trials (RCTs)
were considered. Result(s): Three studies were identified with a
total of 274 patients. There was variation in the outcomes measures used
across the studies. These studies demonstrate there is evidence that this
intervention may contribute towards cardioprotection. Significant
reductions in cardiac troponin I (cTnI) levels and lower vasoactive
inotrope scores were seen in intervention groups. A high degree of
heterogeneity between the studies exists. Meta-analysis of the duration of
mechanical ventilation, length of ICU stay and length of hospital stay
showed no significant differences. Conclusion(s): This systematic
review explored the findings of three pilot RCTs. Overall the hypothesis
that NO delivered via the CPB circuit can provide cardioprotection has
been supported by this study. There remains a significant gap in the
evidence, further high-quality research is required in both the adult and
paediatric populations. Copyright © The Author(s) 2021.

<98>
Accession Number
2011346118
Title
Comparison of Del Nido and Blood Cardioplegia in Pediatric Patients
Undergoing Surgical Repair for Congenital Heart Disease.
Source
Pediatric Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Isildak F.U.; Yavuz Y.
Institution
(Isildak, Yavuz) Department of Anesthesiology and Reanimation, Kartal
Kosuyolu High Speciality Educational and Research Hospital, Istanbul,
Turkey
(Isildak) T. C. Saglik Bakanligi Kartal Kosuyolu Yuksek Ihtisas Egitim ve
Arastirma Hastanesi, Cevizli, 2, Denizer Caddesi, Cevizli Kavsagi, Kartal,
Istanbul 34865, Turkey
Publisher
Springer
Abstract
The aim of the study is to investigate the impact of two different
cardioplegia solutions, the del Nido (dN) and blood cardioplegia (BC), on
postoperative troponin concentrations, vasoactive-inotrope score, and
length of hospital stay in pediatric patients undergoing cardiovascular
surgery for CHD. 80 subjects aged between 1 and 120 months who were
scheduled for surgical repair for a CHD were prospectively enrolled in
this study. Study subjects were allocated to one of the study groups using
simple randomization technique as follows: The del Nido cardioplegia group
(n = 40, median age 8.5 [5.5-14] months) and conventional blood
cardioplegia group (n = 40, median age 11 [5-36] months). Aortic
cross-clamp time and cardiopulmonary bypass time were recorded in all
subjects. Troponin I and vasoactive-inotropic score, which indicates the
amount of cardiovascular support by various inotropes or vasopressors,
were recorded following the repair. The difference in troponin I,
vasoactive-inotropic score (VIS), length of ICU stay, and length of
hospital stay between the two groups was the primary outcome measure of
this study. The volume of cardioplegia was significantly lower in dN group
than that of the BC group (p < 0.001). Cardiopulmonary bypass time and
aortic cross-clamp time were significantly shorter in subjects receiving
dN cardioplegia than those receiving BC (p = 0.006, and p = 0.001,
respectively). Subjects assigned to BC had higher Troponin I
concentrations at postoperative 24th hour compared to subjects receiving
dN cardioplegia [1.60 (0.92-2.49) ng/mL vs. 1.03 (0.55-1.83) ng/mL, p =
0.045]. VIS was also significantly higher in BC group at 24th [10 (10-13)
vs. 10 (5-10), p = 0.032] and 48th hours [10 (1.5-10) vs. 0 (0-10), p =
0.005] compared to that of the dN cardioplegia group. The median
extubation time was 7.5 (3.5-20.5) hours in dN cardioplegia group and 5
(4-10) hours in the BC group (p = 0.384). There were no significant
differences between the groups with respect to the length of ICU stay and
length of hospital stay. No mortality and no significant arrhythmias
requiring medical or electrical cardioversion were noted in any of the
groups. In conclusion, dN cardioplegia provides shorter aortic cross-clamp
time and cardiopulmonary bypass time, and lower postoperative troponin I
concentration and vasoactive-inotrope scores compared to BC in pediatric
subjects undergoing surgical repair for CHD. However, lengths of ICU and
hospital stay are similar in dN cardioplegia and BC groups. Copyright
© 2021, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<99>
Accession Number
2011184075
Title
A Rare Case of Diffuse Idiopathic Pulmonary Neuroendocrine Cell
Hyperplasia (DIPNECH) in a Filipino Woman: A Case Report and Review of
Literature.
Source
SN Comprehensive Clinical Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Montevirgen R.C.; Paz-Pacheco E.
Institution
(Montevirgen, Paz-Pacheco) Section of Endocrinology, Diabetes and
Metabolism, The Medical City Hospital, Pasig City, Philippines
Publisher
Springer Nature
Abstract
Diffuse idiopathic neuroendocrine cell hyperplasia (DIPNECH) is a rare
condition in which few case reports have been published describing the
disorder and its prognosis to date. DIPNECH is described as a diffuse
abnormal proliferation of neuroendocrine cells found in the lining of the
lower respiratory system. It typically occurs in non-smoking, middle-aged
women and is believed to occur spontaneously with no known precursor.
DIPNECH is considered to be a premalignant lesion that potentially
develops into a carcinoid tumor of the lungs. We present a case of a
66-year-old Filipino woman diagnosed with breast carcinoma with an
incidental finding of a round lung density in the right paravertebral
region (T10-11) seen on chest X-ray. Further imaging study using a chest
CT scan showed multiple non-calcified nodules in the right middle and both
lower lobes with no involvement of the airways were noted. She underwent
CT-guided biopsy of the dominant lung nodule and was noted to be positive
for synaptophysin, chromogranin, CD-56, and a Ki-67 of 1-3%, which is
consistent with a typical carcinoid tumor. Video-assisted thoracic surgery
(VATS) with wedge resection of the right and middle lobes was performed.
The background lung tissue on biopsy revealed neuroendocrine tumorlets
measuring 0.1 to 0.4 cm. After the multidisciplinary consultation, it was
agreed to preserve the remaining lung parenchyma with monitoring using a
chest CT scan, and pulmonary function test with diffusing lung capacity
for carbon monoxide (DLCO) every 6 months was advised. At present, the
patient remains asymptomatic. To our knowledge, there is no published case
of DIPNECH in the Filipino population and no available data on morbidity
and mortality, especially in the local setting. A multidisciplinary
approach to diagnosis and management is highly recommended. It has been
observed to have a slow progression; thus close monitoring and strict
follow-up should be advised. Currently, lung preservation is the goal of
management. Copyright © 2021, The Author(s), under exclusive
licence to Springer Nature Switzerland AG.

<100>
Accession Number
2007151638
Title
Commentary: How to overcome an inferiority complex.
Source
Journal of Thoracic and Cardiovascular Surgery. 161 (6) (pp 2125-2129),
2021. Date of Publication: June 2021.
Author
Kurlansky P.
Institution
(Kurlansky) Division of Cardiac Surgery, Department of Surgery, Columbia
University, New York, NY, United States
Publisher
Mosby Inc.

<101>
Accession Number
634020437
Title
Management of colon-invading renal cell carcinoma: Operative technique and
systematic review.
Source
Urology Annals. 13 (1) (pp 1-8), 2021. Date of Publication: January-March
2021.
Author
Byrnes K.G.; Khan J.S.A.; Haroon U.M.; McCawley N.; Cheema I.A.
Institution
(Byrnes, Khan, Haroon, McCawley, Cheema) Department of Urology, Beaumont
Hospital, Dublin, Ireland
(McCawley) Department of Colorectal Surgery, Beaumont Hospital, Dublin,
Ireland
Publisher
Wolters Kluwer Medknow Publications
Abstract
Invasion into adjacent organs by non-metastatic renal cell carcinoma (RCC)
occurs in 1% of patients suitable for resection. Colonic invasion is rare
and presents technical challenges. No prospective data exists to guide
management of these patients. We present the first reported case of a
colon-invading RCC managed with simultaneous open right radical
nephrectomy and extended right hemicolectomy. PubMed, Scopus and EMBASE
databases were searched for relevant case reports reporting management of
colon-invading renal cell carcinoma. Case reports, case series and cohort
studies were eligible. A chart review was performed on a patient who
presented with right-sided colon-invading RCC. Four previously reported
cases were identified. The current case was managed with simultaneous open
radical nephrectomy and extended right hemicolectomy. The patient remains
well six months postoperatively with no evidence of disease recurrence.
Histopathological evaluation of the resected specimen confirmed a T4 clear
cell RCC with sarcomatoid differentiation. Colon-invading RCC is rare.
This is the first reported case of right-sided, colon-invading RCC treated
with radical resection. The current case confirms radical resection is a
feasible management strategy for similar presentations. En bloc resection
of involved organs remains the only potentially curative option for
locally advanced disease. Copyright © 2021 Wolters Kluwer Medknow
Publications. All rights reserved.

<102>
Accession Number
2011834610
Title
Microcirculatory effects of landiolol: a double-blind, randomised,
controlled study after cardiac surgery.
Source
British Journal of Anaesthesia. 126 (6) (pp e212-e214), 2021. Date of
Publication: June 2021.
Author
Ferraris A.; Jacquet-Lagreze M.; Cazenave L.; Fornier W.; Jalalzai W.;
Rousseau-Saine N.; Allaouchiche B.; Junot S.; Pozzi M.; Fellahi J.-L.
Institution
(Ferraris, Jacquet-Lagreze, Cazenave, Fornier, Jalalzai, Rousseau-Saine,
Fellahi) Service d'Anesthesie-Reanimation, Hopital Louis Pradel, Hospices
Civils de Lyon, Lyon, France
(Ferraris, Jacquet-Lagreze, Cazenave, Fellahi) Laboratoire CarMeN, Inserm
UMR 1060, Universite Claude Bernard Lyon 1, Lyon, France
(Allaouchiche, Junot) VetAgro Sup, Universite de Lyon, Unite APCSe, Campus
Veterinaire de Lyon, Marcy l'Etoile, France
(Pozzi) Service de Chirurgie Cardiaque, Hopital Louis Pradel, Hospices
Civils de Lyon, Lyon, France
Publisher
Elsevier Ltd

<103>
Accession Number
2005723874
Title
Study of the effects of simple exercise with or without physiotherapy on
prevention of deep vein thrombosis among postmenopausal women requiring
coronary artery bypass graft surgery.
Source
International Journal of Women's Health and Reproduction Sciences. 9 (1)
(pp 69-74), 2021. Date of Publication: 2021.
Author
Hashemzadeh K.; Dehdilani M.; Gol M.K.
Institution
(Hashemzadeh) Department of Heart Surgery, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Dehdilani) Department of Anesthesiology, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Gol) Nursing and Midwifery Faculty, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
Publisher
Aras Part Medical International Press
Abstract
Objectives: Menopause is one of the risk factors for deep vein thrombosis
(DVT) that may increase its likelihood after coronary artery bypass graft
surgery (CABG). Hence, it is essentially advised to prevent DVT. In this
regard, the purpose of this study was to investigate the effects of simple
exercise with and without physiotherapy on DVT prevention in
postmenopausal women requiring CABG. Material(s) and Method(s): This
quasi-experimental study was carried out on 34 patients in Tabriz Shahid
Madani hospital from 1 March to the end of July 2019. It is noteworthy
that participants were selected based on a random sampling method. The
experimental group, namely, the exercise group (n=17) did cardiovascular
exercises for 40 minutes the day before the surgery. However, the other
group received physiotherapy for each leg for 15 minutes in addition to
cardiovascular exercise. Then, DVT diagnosis blood tests, clinical
examinations, and Doppler sonography were performed and recorded in all
participants' portfolios. The obtained data were analyzed using SPSS
software, and the SPSS tests included Kolmogorov-Smirnov, paired t test,
and independent t-test at the significance level of 0.05. Result(s):
The results of intra-group DVT and blood tests before and after the
intervention revealed a statistically significant difference in terms of
complete blood count, hemoglobin, hematocrit (P <= 0.05). However, no
statistically significant differences were reported considering the other
variables (P >= 0.11). Finally, in the case of inter-group variations, a
comparison of the results of the two groups represented no statistically
significant difference in any of the studied variables (P >= 0.15).
 Conclusion(s): In general, a light exercise session either with or
without physiotherapy did not have any positive effects on DVT prevention
in postmenopausal women in need of CABG. Copyright © 2021 The
Author(s).

<104>
Accession Number
2010554056
Title
Effectiveness of postural lung recruitment on postoperative atelectasis
assessed by lung ultrasound in children undergoing lateral thoracotomy
cardiac surgery with cardiopulmonary bypass.
Source
Pediatric Pulmonology. 56 (6) (pp 1724-1732), 2021. Date of Publication:
June 2021.
Author
He P.; Wu C.; Yang Y.; Zheng J.; Dong W.; Wu J.; Sun Y.; Zhang M.
Institution
(He, Wu, Yang, Zheng, Sun, Zhang) Department of Anesthesiology, School of
Medicine, Shanghai Children's Medical Centre, Shanghai Jiao Tong
University, Shanghai, China
(Dong) Department of Cardio-Thoracic Surgery, School of Medicine, Shanghai
Children's Medical Centre, Shanghai Jiao Tong University, Shanghai, China
(Wu) Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, United
States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To assess the effects of postural lung recruitment maneuvers
on the postoperative atelectasis assessed by lung ultrasound (LUS)
compared with supine position recruitment maneuvers in children undergoing
right lateral thoracotomy cardiac surgery with cardiopulmonary bypass.
 Method(s): In this randomized and controlled trial, 84 patients aged
3 years or younger, scheduled for right lateral thoracotomy cardiac
surgery with cardiopulmonary bypass (CPB) were randomly allocated to
postural lung recruitment group or control group. The first LUS exam was
performed immediately upon completion of the cardiac surgery (T1), and a
repeat ultrasound exam started 1 min after lung recruitment maneuvers
(T2). The primary outcome was the incidence of significant atelectasis at
T2. Result(s): The incidence of significant atelectasis at T2 in the
postural lung recruitment maneuver group was lower compared with that in
the control group (30.2% vs. 58.1%; odds ratio: 0.31; 95% confidence
interval: 0.13-0.76; p =.009). The LUS scores for consolidations and
B-lines of the left lung were higher than those of the right lung in both
groups at T1. More significant reduction of the left LUS scores and sizes
of atelectatic areas were found in the postural lung recruitment group
than those in the control group. Conclusion(s): Postoperative
postural recruitment maneuver was more effective to improve reaeration of
lung than supine position recruitment maneuver in children undergoing
right lateral thoracotomy cardiac surgery with CPB. Copyright ©
2021 Wiley Periodicals LLC

<105>
Accession Number
2010277195
Title
Multivariable risk scores for predicting short-term outcomes for emergency
department patients with unexplained syncope: A systematic review.
Source
Academic Emergency Medicine. 28 (5) (pp 502-510), 2021. Date of
Publication: May 2021.
Author
Sweanor R.A.L.; Redelmeier R.J.; Simel D.L.; Albassam O.T.; Shadowitz S.;
Etchells E.E.
Institution
(Sweanor, Redelmeier, Albassam, Shadowitz, Etchells) Department of
Medicine, University of Toronto, Toronto, ON, Canada
(Redelmeier, Albassam, Shadowitz, Etchells) Department of Medicine
Sunnybrook Health Science Centre, University of Toronto, Toronto, ON,
Canada
(Albassam) Division of Cardiology, King Abdulaziz University Hospital,
King Abdulaziz University, Jeddah, Saudi Arabia
(Simel) Division of General Internal Medicine, Duke Veterans Affairs
Medical Center, Durham, NC, United States
(Simel) Duke University, Durham, NC, United States
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: Emergency department (ED) patients with unexplained syncope
are at risk of experiencing an adverse event within 30 days. Our objective
was to systematically review the accuracy of multivariate risk
stratification scores for identifying adult syncope patients at high and
low risk of an adverse event over the next 30 days. Method(s): We
conducted a systematic review of electronic databases (MEDLINE, Cochrane,
Embase, and CINAHL) from database creation until May 2020. We sought
studies evaluating prediction scores of adults presenting to an ED with
syncope. We included studies that followed patients for up to 30 days to
identify adverse events such as death, myocardial infarction, stroke, or
cardiac surgery. We only included studies with a blinded comparison
between baseline clinical features and adverse events. We calculated
likelihood ratios and confidence intervals (CIs). Result(s): We
screened 13,788 abstracts. We included 17 studies evaluating nine risk
stratification scores on 24,234 patient visits, where 7.5% (95% CI = 5.3%
to 10%) experienced an adverse event. A Canadian Syncope Risk Score (CSRS)
of 4 or more was associated with a high likelihood of an adverse event
(LR<inf>score>=4</inf> = 11, 95% CI = 8.9 to 14). A CSRS of 0 or less
(LR<inf>score<=0</inf> = 0.10, 95% CI = 0.07 to 0.20) was associated with
a low likelihood of an adverse event. Other risk scores were not validated
on an independent sample, had low positive likelihood ratios for
identifying patients at high risk, or had high negative likelihood ratios
for identifying patients at low risk. Conclusion(s): Many risk
stratification scores are not validated or not sufficiently accurate for
clinical use. The CSRS is an accurate validated prediction score for ED
patients with unexplained syncope. Its impact on clinical decision making,
admission rates, cost, or outcomes of care is not known. Copyright
© 2021 by the Society for Academic Emergency Medicine

<106>
Accession Number
634851185
Title
A prospective randomized comparison of manta and proglide in terms of
vascular complications in tavi.
Source
Thoracic and Cardiovascular Surgeon. Conference: 50th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG 2021.
Online. 69 (SUPPL 1) (no pagination), 2021. Date of Publication: January
2021.
Author
Kofler M.; Unbehaun A.; Klein C.; Ivleva A.; Meyer A.; Buz S.; Sundermann
S.H.; Falk V.; Kempfert J.
Institution
(Kofler, Unbehaun, Klein, Ivleva, Meyer, Buz, Sundermann, Falk, Kempfert)
BerlinGermany
Publisher
Georg Thieme Verlag
Abstract
Vascular and bleeding complications following transcatheter aortic valve
implantation (TAVI) are known toincrease morbidity and mortality. We aimed
to compare the rate of vascular and bleeding complications between a
novelplug-based vascular closure device (PB-VCD) and a wide available
suture-based vascular closure device (SB-VCD) inpatients undergoing TAVI
in a prospective randomized study. Method(s): From September 2019 to
April 2020, a total of 145 patients with severe aortic stenosis scheduled
for isolatedtransfemoral TAVI were prospectively included.
Block-randomization using varying block sizes was performed to
randomizepatients either to PB-VCD ( n = 73, 50.3%) or to SB-VCD ( n = 72,
49.7%) in a 1:1 ratio. The primary endpoint of the studywas any vascular
complication (major and minor combined) defined in accordance to the Valve
Academic ResearchConsortium - II (VARC-II) criteria. Secondary endpoints
were rates of VARC-II bleeding complications. Result(s): The rate of
any vascular complication according to VARC-II occurred in 21.9% ( n = 16)
and 26.4% ( n = 19) ofpatients treated with PB-VCD and SB-VCD respectively
( p = 0.664). Details regarding individual vascular and bleedingVARC-II
endpoints are listed in the attached table. Conclusion(s): PB-VCD and
SB-VCD show comparable results in all assessed rates of vascular and
bleeding complicationsdefined in accordance to VARC-II criteria. Presented
results should be interpreted under the light of the relatively lowsample
size of the study.

<107>
Accession Number
634851161
Title
The impact of standardized eras (Enhanced Recovery After Surgery) protocol
in patients undergoing minimally invasive heart valve surgery.
Source
Thoracic and Cardiovascular Surgeon. Conference: 50th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG 2021.
Online. 69 (SUPPL 1) (no pagination), 2021. Date of Publication: January
2021.
Author
Gebauer A.; Reichenspurner H.; Girdauskas E.
Institution
(Gebauer, Reichenspurner, Girdauskas) HamburgGermany
Publisher
Georg Thieme Verlag
Abstract
ERAS (enhanced recovery after surgery) protocol is a pre-, intra-, and
postoperative, multimodal strategyaiming to reduce postoperative
complications and hospital length of stay (LOS) in a cost-effective way.
Core elements areimmediate extubation after surgery in the OR, early
physical therapy under adjusted pain therapy and early hospitaldischarge
with direct transfer to rehab. At our center, ERAS-protocol started in
February 2018 in selected patientsundergoing minimally invasive heart
valve surgery. The data collected in this retrospective cohort analysis
providesinformation about potential medical and economic benefits of ERAS
protocol in minimally invasive heart valve surgery. Method(s):
Non-randomized, retrospective cohort analysis. Pre-, intra-, and
postoperative data of a total of 210 patientsundergoing minimally invasive
heart valve surgery. A total of 101 patients received treatment following
ERAS protocol and109 patients received routine care. The data contains
information about pre-existing health condition, individual patientrisk,
measures of physical activity, type, and duration of surgery,
convalescence, measures of pre-and postoperative echoand rehabilitation.
Primary end-points were postoperative complications and hospital LOS,
broken down into total LOS, ICULOS, and postoperative LOS. Result(s):
Patients were predominantly men (77% in ERAS vs. 75% in control group)
with low EuroSCORE II (0.836 vs.0.808) and without differences in disease
characteristics. In the ERAS group 47% of the patients had right
lateralminithoracotomy (vs. 56% in the control group) and 54% had partial
upper sternotomy (44% in control group). No intra-orperioperative
complications were associated with ERAS-protocol. In-hospital mortality
was 0% in both groups. There wereno significant difference in the
appearance of nosocomial infections (13% in ERAS versus 16% in control
group, p = 0.48)and rehospitalization (17% readmissions from rehab in
ERAS-group versus 9% in control group, p = 0.38). A significantdecrease in
hospital LOS (6.1 +/- 2.6 vs. 7.7 +/- 3.7 days, p = 0.005) as well as
intensive care LOS (1.5 +/- 1.1 vs. 2.1 +/- 1.9days, p = 0.019) in the
ERAS cohort was shown. Conclusion(s): Our ERAS protocol is safe and
leads to quicker hospital discharge without compromising patient safety
inpatients undergoing minimally invasive heart valve surgery. Findings of
this analysis shall prepare the setup of theINCREASE study, a randomized
clinical trial, which is expected to provide high-quality data about the
execution of ERASprotocol in the treatment of heart valve pathologies and
their potential transfer into standard-of-care treatment.

<108>
Accession Number
634850985
Title
Singe-center experience: Minimally invasive aortic valve replacement.
Source
Thoracic and Cardiovascular Surgeon. Conference: 50th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG 2021.
Online. 69 (SUPPL 1) (no pagination), 2021. Date of Publication: January
2021.
Author
Mehdiani A.; Smiris K.; Sipahi F.; Boeken U.; Akhyari P.; Lichtenberg A.
Institution
(Mehdiani, Smiris, Sipahi, Boeken, Akhyari, Lichtenberg) DusseldorfGermany
Publisher
Georg Thieme Verlag
Abstract
Further development of minimally invasive techniques for isolated aortic
valve replacement (MIS-AVR) ismandatory in cardiac surgery, especially
under the aspect of the current successful development of interventional
methods.To maintain MIS-AVR case numbers and to establish it more widely,
the feasibility and safety of alternative access strategiesmust be
continuously demonstrated. Method(s): Between 2015 and 2019, isolated
AVR was performed in 215 patients in our department using a
rapiddeployment prosthesis, involving right anterolateral thoracotomy
(RALT) or J -shaped partial upper sternotomy (JS). In RALTgroup
cardiopulmonary bypass (CPB) was established via femoral approach, mainly
using percutaneous closure systems,while in the JS group central
cannulation was used. Thus calcification of femoral vessels was a
contraindication for RALT,those patients where threated via JS. All
patients received preoperative CT-scans for surgical planning.
Perioperative dataand 30-day mortality were retroperspectively analyzed.
 Result(s): There were 99 (46%) patients in RALT and 116 (54%)
patients in JS group. Patients in RALT compared with JSwere mostly women
(63 vs. 48%, p < 0.05), but did not show any difference regarding
EuroSCORE II or age. Analysis ofintraoperative data revealed a by trend
prolonged duration pf operation, CPB and cross clamp time in group RALT
versus JS( p = n.s.) while postoperative data such as ICU and hospital
stay were comparable between the 2 groups. We observed anincidence of
pacemaker implantation with 10 and 12%, however without significance. No
patient suffered from woundinfection, and patients in group JS were
expectably free of any vessel complication whereas one patient in group
RALTsuffered from bleeding due to a technical failure of the femoral
closing system. Conversion to full sternotomy was observedin 2 patients
(2%) in RALT and no patient in JS group. Paravalvular leakage could be
detected in 4% (RALT) and 6% (JS)patients ( p = n.s.). Two patients died
during hospital stay in group RALT (2 vs. 0%, p = n.s.)
 Conclusion(s): Aortic valve replacement via right anterolateral
thoracotomy or partial upper sternotomy seems to be a validand
reproducible technique for AVR patients. The definitive evidence should be
obtained in controlled clinical trials. Theoptimal selection for
successful access strategy is extremely important and should be performed
individually for eachpatient. A CT scan is essential for careful
preoperative planning.

<109>
Accession Number
634850854
Title
Packing of the chest as last resort to control bleeding in thoracic
surgery.
Source
Thoracic and Cardiovascular Surgeon. Conference: 50th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG 2021.
Online. 69 (SUPPL 1) (no pagination), 2021. Date of Publication: January
2021.
Author
Sandhaus T.; Seiz E.; Steinert M.; Doenst T.
Institution
(Sandhaus, Seiz, Doenst) JenaGermany
(Steinert) LeipzigGermany
Publisher
Georg Thieme Verlag
Abstract
Severe pleural empyema, thoracic trauma, anticoagulation therapy and liver
cirrhosis are associated with ahigh risk of uncontrolled bleeding in
thoracic operations. Packing is an established treatment in patients with
the sameproblems at the liver. Removal of the abdominal bandages requires
a second operation. In thoracic surgery, this procedureis not established
in routine practice. In general, these conditions are associated with
extremely high mortality. There areno established evidence-based treatment
algorithms or randomized clinical trials. Thus far, only a few small
reports exist inthe literature. We analyzed the outcome of our packing
strategy in thoracic surgical patients. Method(s): We retrospectively
analyzed all 64 patients treated with a packing strategy over a period of
4 years. Patientdemographics, operations, clinical course and mortality
were evaluated. Result(s): The majority of the patients were male
81.3%, (female 18.7%) and mean age was 59.5 +/- 15.5. Indications for
theprocedure were stage III empyema (59%), hemothorax (36%), and
pneumothorax 6%. 28 patients (43.8%) had anoncological underlying disease,
34 (53.1) had significant anticoagulation therapy and 7 (10.9%) clotting
disorders. Duringthe operations, an average of 3.3 +/- 1.5 abdominal
bandages was left in the hemithorax (right 62.5%, left 37.5%). De-Packing
was performed in average 56 hours later. Median length of postoperative
hospitalization was 14.8 +/- 14.3 days andhospital mortality was 39.1%.
Anticoagulation therapy and the need of a second packing (12%) were
identified assignificant risk factors. Conclusion(s): Patients with
severe thoracic bleeding who cannot be conventionally controlled carry a
high risk. A packingstrategy seems to be an option in these last resort
situations. Although it was associated with a high mortality, 61% of
thepatients survived in our collective.

<110>
[Use Link to view the full text]
Accession Number
634888011
Title
Comparison of two haemodynamic monitoring systems in the cardiac
catheterization laboratory: The manifold (Manual) vs. automated acist CVI.
Source
Journal of Hypertension. Conference: European Meeting on Hypertension and
Cardiovascular Protection and International Society of Hypertension,
ESH-ISH 2021. Virtual. 39 (SUPPL 1) (pp e279), 2021. Date of Publication:
April 2021.
Author
Mahmud A.; Balghith M.; Ayoub K.; Alanezi A.F.; Alhadadi B.; Alshammary
H.; Alshehri J.; Alshammary M.; Alghamdi A.; Khan F.M.
Institution
(Mahmud, Balghith, Ayoub, Alanezi, Alhadadi, Alshammary, Alshehri,
Alshammary, Alghamdi, Khan) King Abdul Aziz Cardiac Center, King Abdul
Aziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Hemodynamic monitoring is an integral part of any cardiac
catheterization procedure and can be potentially prone to many
distortions, including damping and resonance. The optimum damping ratio
recommended for accurate haemodynamic monitoring ranges between 0.4 to
0.8. The most common systems used include Manifold, the manual system and
the automated, ACICT CVia device, which is claimed to be as accurate as
the manual system and easier to use. The aim of this prospective study was
to compare damping ratio, ascending aortic pressure waveform and invasive
blood pressures(BP) between manifold and ACIST CVia, in patients
undergoing cardiac catheterization. Design and method: This study was
conducted at the cardiac catheterization Laboratory at King Abdul-Aziz
Cardiac Center, National Guard Health Affairs, Riyadh in adult patients
undergoing elective cardiac catheterization procedures. The fast-flush
test was performed at the beginning of the procedure using manifold and
ACIST in a cross-over fashion. The square wave was analysed to calculate
the damping coefficient for each device. Data was analyzed by JMP Pro (SAS
for Windows, Version 13) p<0.05 considered significant. The patients gave
informed consent and the study was approved by the Institutional Ethics
Committee. Result(s): We compared the two systems in a randomised
cross-over fashion in 54 subjects (mean age 58.1+/-12, 24% females). The
mean damping ratio was 0.61+/-0.11(range 0.34-0.95) with manifold vs.
0.95+/-0.27(range 0.53-2.1) with ACIST, mean difference 0.33, p<0.0001.
The over-damped ACIST yielded lower BP measurements compared with
manifold; mean difference 6 mm Hg systolic and 5 mm Hg diastolic with
almost 30% of the subjects showing a discrepancy of > 10 mm Hg between the
two systems. Conclusion(s): To the best of our knowledge, this is the
first study comparing a manual haemdynamic monitoring system to an
automated one used widely in cardiac catheterization laboratories. In our
study, while the mannifold met the international recommendations for
accurate haemodynamic monitoring, ACIST device was overdamped, resulting
in significant underestimation of invasive pressures. We recommend using
the manifold system for studies involving haemodynamically compromised
patients and in patients depending upon accurate haemodynamics for
diagnostic purposes.

<111>
[Use Link to view the full text]
Accession Number
634887799
Title
Epidemiological profile of hypertense patients in primary care setting in
Rio De Janeiro City.
Source
Journal of Hypertension. Conference: European Meeting on Hypertension and
Cardiovascular Protection and International Society of Hypertension,
ESH-ISH 2021. Virtual. 39 (SUPPL 1) (pp e271-e272), 2021. Date of
Publication: April 2021.
Author
De Oliveira M.A.; Rey H.C.V.; Ribeiro A.L.P.
Institution
(De Oliveira, Rey) National Institute of Cardiology, Rio de Janeiro,
Brazil
(Ribeiro) Federal University of Minas Gerais, Belo Horizonte, Brazil
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Observational study, to describe in the context of family
medicine care, epidemiological data of a cohort of hypertensive patients.
Design and method: Prospective cohort observational study of hypertensive
patients selected from a randomized sample, conducted in primary care
units in the city of Rio de Janeiro, where 1,000 patients aged over 18
years were allocated in 2016 and 2017 who were referred for
electrocardiogram. Clinical evaluations were documented in a care form and
recorded in a database. Follow-up by telephone following one year.
Continuous variables will be described as mean and standard deviation or
median and interquartile difference. Categorical variables will be
described as frequency and proportion, with their respective 95%
confidence intervals. Statistical analyzes, to assess the significance of
the differences found between the strategies, will be performed as
recommended. The statistical program R was used. Result(s): In the
selected sample of patients in basic health units, the prevalence of
hypertension was 72.38%. Of the total sample 35.6% were male, the average
age was 57.75 years and the median age 59. Among the hypertensive 35.52%
were male, the average The mean age was 60.97 years and the median age
61.5. Most patients had primary education, 58.22%, and received less than
2 minimum wages, 78.69%. In hypertensive patients the prevalence of risk
factors was 64.35% of sedentary lifestyle, 25.63% of dyslipidemia, 24.51%
of diabetes mellitus and 14.76% of smoking. And the prevalence of
associated clinical conditions was 4.32% stroke, 1.53% chronic kidney
disease, 2.3% heart failure and 1.25% atrial fibrillation. 5.71% of the
patients had previous acute myocardial infarction (AMI), 2.65% had already
undergone coronary angioplasty and 0.56% had myocardial revascularization
surgery. Among non-hypertensive, 36.03% were male, the average age was
younger than hypertensive people, 49.12 years, even as the median age, 49.
There were less people with some cardiovascular risk factors as
dyslipidemia (11,4%) and diabetes (10.66%). Conclusion(s): Studies
such as this are necessary to understand the population served and to
implement strategies to improve the quality of the HA primary care program
with measures to prevent or delay the onset of related complications.
(Figure Presented).

<112>
[Use Link to view the full text]
Accession Number
634886096
Title
Analyzing esc guidelines (GL) of arterial hypertension, myocardial
revascularization, syncope and pregnancy for decision making efficacy: The
winner is arterial hypertension gl.
Source
Journal of Hypertension. Conference: European Meeting on Hypertension and
Cardiovascular Protection and International Society of Hypertension,
ESH-ISH 2021. Virtual. 39 (SUPPL 1) (pp e383), 2021. Date of Publication:
April 2021.
Author
Koller A.; Takacs J.
Institution
(Koller, Takacs) Semmelweis University, Budapest, Hungary
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: Guidelines (GLs) for medical practice are essential collection
of knowledge, helping the daily clinical decision making in specific
health conditions. Accordingly, the European Society of Cardiology (ESC)
also develops and publishes GLs. We hypothesized that not every GL of ESC
is equally efficient in decision making due to the lack of sufficient
evidence. Design and method: Design: Exploratory data analysis.
 Method(s): A total of 636 levels of evidence (LEVEL) of and classes
of recommendations (CLASS) data were processed on four ESC GLs-Arterial
Hypertension (AH), Myocardial Revascularization (MR), Syncope (S) and
Pregnancy (P). Result(s): Results: The frequency distributions of
LEVEL by CLASS showed that AH had the highest rate of Evidence A in each
class of recommendations. However, the percent of Evidence A was under 50%
on 'to do' and 'not to do' classes. MR showed a similar frequency
distribution than AH, but the frequency of Evidence A was only 36.4% on
'to do' and 25.0% on 'not to do' classes. In S and P, the percent of
Evidence B and/or C was the highest in each class of recommendations.
Percent of uncertainty was between 24.3% (AH) and 75.5% (P). The deviation
of LEVEL from an optimal decision making revealed that the observed
percentages were significantly lower in Evidence A than the expected
percentages in the studied GLs. Thus Arterial Hypertension GL provided the
highest level of Certainty, whereas Pregnancy GL the highest level of
Uncertainty. Conclusion(s): Conclusion(s): There is a great
disparity of certainty among the four ESC GLs. To ensure the relevant
level of Certainty, our findings recommend to reveal the ratio of
certainty and uncertainty in the GLs, and to increase the level of strong
evidence by conducting new basic science experimental studies and clinical
investigations, such as multiple randomized clinical trials or
meta-analyses.

<113>
Accession Number
634852813
Title
Influence of air pollution on perioperative outcomes & potential for big
data driven discoveries.
Source
Anesthesia and Analgesia. Conference: Annual Meeting of the Society for
Technology in Anesthesia, STA 2021. Virtual. 132 (3 SUPPL) (pp 49-51),
2021. Date of Publication: March 2021.
Author
Kovtun R.; Ha L.; Mendoza D.; Pearson J.
Institution
(Kovtun, Ha) University of Utah, School of Medicine, United States
(Mendoza) Department of Atmospheric Sciences, Department of City and
Metropolitan Planning, University of Utah, United States
(Pearson) Department of Anesthesiology, University of Utah School of
Medicine, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Mounting evidence demonstrates that short-term and long-term
exposure to air pollution increases the risk of cardiovascular mortality
and reduces life expectancy.1 These effects are especially pronounced in
populations with chronic medical conditions, the elderly, and patients
with low socioeconomic status.1 While surgical populations, especially
those with cardiovascular comorbidities, could constitute another
population vulnerable to air pollution, to date this relationship has not
been widely studied. Therefore, we performed a literature review aimed to
understand the extent of current research that examines the influence of
air pollution on perioperative outcomes. Method(s): Air pollution was
used as a broad term or defined as any of the six principal air pollutants
regulated by the EPA as part of the National Ambient Air Quality Standards
(NAAQS). These included carbon monoxide, lead, ozone, nitrogen dioxide,
sulfur dioxide, and particulate matter. Studies were identified by
electronic database searches in PubMed and Scopus from 1960 to the
present. Principal PubMed medical subject heading (MeSH) terms used were
air pollution, carbon monoxide, ozone, particulate matter, lead, nitrogen
dioxide, sulfur dioxide, perioperative period, postoperative
complications, intraoperative complications, surgical procedures. This
search yield over 2,000 results, so the MeSH terms were modified to
include more relevant subheadings like adverse effects, toxicity,
complications, and epidemiology. This search yielded n=80 results in the
English language. Out of these articles, we manually identified the
relevant ones, and performed citation chaining for each via Scopus. A
total of n=12 studies were included in this review. Conclusion(s):
Based on the current literature review there seems to be a relationship
between air pollution and increased adverse perioperative outcomes,
however, a large gap in research still exists. The majority of studies
examined the impact of residential air pollution levels on outcomes of
organ transplants. Spencer-Hwang et al2 found that in kidney transplant
patients for each 10-ppb increase in ozone, the risk of fatal coronary
heart disease increased by 35%. Moreover, studies of lung transplant
recipients correlated residential proximity to major roads with increased
risk of chronic lung allograft dysfunction and mortality.3 , 4 , 5 , 6
However other data suggests that macrolide use likely ameliorated some of
these effects.6 , 7 , 8 In addition, recent data from Al-Kindi et al9
identified that every 10-ppb increase in particulate matter was associated
with a 26% increased risk of mortality among heart transplant patients.
Beyond organ transplantation, Li et al1 0 found that increased levels of
air pollution were associated with decreased clinical pregnancy rates
among IVF patients, while increased ozone levels had a beneficial role.11
Studies also shows that increased short-term air pollution may also be
deleterious. Che et al1 2 identified that the incidence of delirium in the
surgical population increased with rising levels of air pollution in the
hospital area. Moreover, Mannisto et al found that increased ambient
levels of nitric oxides prior to delivery were associated with a higher
incidence of cardiovascular events especially in those delivering via
caesarian section. This data suggests that there is a link between ambient
air pollution and perioperative outcomes. However, the degree to which
this relationship impacts the surgical population is well studied with
only n=12 studies to date. Recent technological advances, including the
decreasing cost of air quality equipment, public atmospheric pollution
models, ubiquitous GPS in patient smartphones, and the advent of large
scale electronic health records in the past decade, make it possible to
better study the influence of air pollution on perioperative and other
health outcomes both in acute and chronic timescales. Using these Big Data
sources could elucidate the impact of air pollution on the surgical
population and help us assess the health and financial burden placed on
the system by poor air quality.

<114>
Accession Number
2011803720
Title
Implementation of appropriate use criteria for cardiology tests and
procedures: A systematic review and meta-analysis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 7 (1) (pp
34-41), 2021. Date of Publication: 01 Jan 2021.
Author
Winchester D.E.; Merritt J.; Waheed N.; Norton H.; Manja V.; Shah N.R.;
Helfrich C.D.
Institution
(Winchester) Cardiology Section, Malcom Randall VAMC, 1601 SW Archer Rd
111-D, Gainesville, FL, United States
(Winchester, Merritt) Division of Cardiovascular Medicine, University of
Florida College of Medicine, 1600 SW Archer Rd, Gainesville, FL 32610,
United States
(Waheed) Department of Internal Medicine, University of Florida College of
Medicine, 1600 SW Archer Rd, Gainesville, FL 32610, United States
(Norton) University of Florida College of Medicine, Health Science Center
Library, 1600 SW Archer Rd, Gainesville, FL 32610, United States
(Manja) Department of Surgery, University of California Davis, 2315
Stockton Blvd, Sacramento, CA 95817, United States
(Manja) VA Northern California Health Care System, 10535 Hospital Way,
Mather, CA 95655, United States
(Shah) Department of Medicine, Providence VA Medical Center, Brown
University Warren Alpert Medical School, 830 Chalkstone Ave, Providence,
RI 02908, United States
(Shah) Department of Health Services, Policy and Practice, Brown
University School of Public Health, 121 S Main St, Providence, RI 02903,
United States
(Helfrich) Seattle-Denver Center for Innovation in Veteran-Centered and
Value-Driven Care, 1660 S. Columbian Way Mailstop S-152, Seattle, WA
98108, United States
Publisher
Oxford University Press
Abstract
Aims: The American College of Cardiology appropriate use criteria (AUC)
provide clinicians with evidence-informed recommendations for cardiac
care. Adopting AUC into clinical workflows may present challenges, and
there may be specific implementation strategies that are effective in
promoting effective use of AUC. We sought to assess the effect of
implementing AUC in clinical practice. Methods and Results: We
conducted a meta-analysis of studies found through a systematic search of
the MEDLINE, Web of Science, Cochrane, or CINAHL databases. Peer-reviewed
manuscripts published after 2005 that reported on the implementation of
AUC for a cardiovascular test or procedure were included. The main outcome
was to determine if AUC implementation was associated with a reduction in
inappropriate/rarely appropriate care. Of the 18 included studies, the
majority used pre/post-cohort designs; few (n = 3) were randomized trials.
Most studies used multiple strategies (n = 12, 66.7%). Education was the
most common individual intervention strategy (n = 13, 72.2%), followed by
audit and feedback (n = 8, 44.4%) and computerized physician order entry
(n = 6, 33.3%). No studies reported on formal use of stakeholder
engagement or 'nudges'. In meta-analysis, AUC implementation was
associated with a reduction in inappropriate/rarely appropriate care (odds
ratio 0.62, 95% confidence interval 0.49-0.78). Funnel plot suggests the
possibility of publication bias. Conclusion(s): We found most
published efforts to implement AUC observed reductions in
inappropriate/rarely appropriate care. Studies rarely explored how or why
the implementation strategy was effective. Because interventions were
infrequently tested in isolation, it is difficult to make observations
about their effectiveness as stand-alone strategies. Copyright ©
2020 Published by Oxford University Press on behalf of the European
Society of Cardiology.

<115>
Accession Number
2011518103
Title
Effects of dexmedetomidine on neurocognitive disturbance after elective
non-cardiac surgery in senile patients: a systematic review and
meta-analysis.
Source
Journal of International Medical Research. 49 (5) (no pagination), 2021.
Date of Publication: 2021.
Author
Bi X.; Wei J.; Zhang X.
Institution
(Bi) Department of Anesthesiology, the Affiliated Hospital of Southwest
Medical University, Luzhou, Sichuan Province, China
(Wei) Department of Pharmacology, the Sixth People's Hospital of Chengdu,
Chengdu, Sichuan, China
(Zhang) Department of Neonatology, the Affiliated Hospital of Southwest
Medical University, Luzhou, Sichuan Province, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Senile patients often experience neurocognitive disturbance
after non-cardiac surgery. Several clinical trials have investigated if
the perioperative intravenous use of dexmedetomidine has a positive effect
on the prevention of neurocognitive dysfunction, but the results have been
inconsistent. We performed a meta-analysis to investigate the effects of
dexmedetomidine on neurocognitive disturbance after elective non-cardiac
surgery in senile patients. Method(s): The PubMed, Cochrane Library,
EMBASE and China National Knowledge Infrastructure databases were
comprehensively searched for all randomized controlled trials published
before 1 February 2020 that investigated the efficacy of dexmedetomidine
in the prevention of postoperative delirium (POD) or postoperative
cognitive dysfunction (POCD). Result(s): Sixteen studies involving
4376 patients were included in this meta-analysis. Compared with the
control (i.e., saline), the perioperative intravenous use of
dexmedetomidine significantly reduced the incidence of POD and POCD.
However, patients in the dexmedetomidine group were more likely to develop
bradycardia and hypotension during the administration of dexmedetomidine
than patients in the control group. There were no differences between the
two groups in the incidence of nausea and vomiting or mortality rate.
 Conclusion(s): Dexmedetomidine has a positive effect on the
prevention of neurocognitive disturbance in senile patients after elective
non-cardiac surgery. Copyright © The Author(s) 2021.

<116>
Accession Number
2011401524
Title
Coronary revascularization in patients with stable coronary disease and
diabetes mellitus.
Source
Diabetes and Vascular Disease Research. 18 (2) (no pagination), 2021. Date
of Publication: 2021.
Author
Bhat S.; Yatsynovich Y.; Sharma U.C.
Institution
(Bhat, Yatsynovich, Sharma) Department of Medicine, University at Buffalo,
NY, United States
(Yatsynovich, Sharma) Division of Cardiovascular Diseases, University at
Buffalo, NY, United States
(Sharma) The Clinical and Translational Science Institute, University at
Buffalo, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Purpose of Study: Diabetes mellitus accelerates the development of
atherosclerosis. Patients with diabetes mellitus have higher incidence and
mortality rates from cardiovascular disease and undergo a
disproportionately higher number of coronary interventions compared to the
general population. Proper selection of treatment modalities is thus
paramount. Treatment strategies include medical management and
interventional approaches including coronary artery bypass graft (CABG)
surgery and percutaneous coronary interventions (PCI). The purpose of this
review is to assimilate emerging evidence comparing CABG to PCI in
patients with diabetes and present an outlook on the latest advances in
percutaneous interventions, in addition to the optimal medical therapies
in patients with diabetes. Key Methods: A systematic search of PubMed, Web
of Science and EMBASE was performed to identify prospective, randomized
trials comparing outcomes of CABG and PCI, and also PCI with different
generations of stents used in patients with diabetes. Additional review of
bibliography of selected studies was also performed. Main
 Conclusion(s): Most of the trials discussed above demonstrate a
survival advantage of CABG over PCI in patients with diabetes. However,
recent advances in PCI technology are starting to challenge this
narrative. Superior stent designs, use of specific drug-eluting stents,
image-guided stent deployment, and the use of contemporary antiplatelet
and lipid-lowering therapies are continuing to improve the PCI outcomes.
Prospective data for such emerging interventional technologies in diabetes
is however lacking currently and is the need of the hour. Copyright
© The Author(s) 2021.

<117>
Accession Number
2011346384
Title
Cardiac implantable electronic device surgery with interruption of
warfarin forgoing post-operative bridging therapy in patients with
moderate or high thromboembolic risks.
Source
Thrombosis Journal. 19 (1) (no pagination), 2021. Article Number: 28. Date
of Publication: December 2021.
Author
Ng A.K.-Y.; Ng P.Y.; Tam E.W.-Y.; Siu C.-W.; Fan K.
Institution
(Ng, Tam, Fan) Cardiac Medical Unit, Grantham Hospital, 125 Wong Chuk Hang
Road, Hong Kong
(Ng) Department of Adult Intensive Care, Queen Mary Hospital, 102 Pokfulam
Road, Hong Kong
(Ng) Division of Respiratory and Critical Care Medicine, Department of
Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong,
Hong Kong
(Siu) Department of Medicine, Queen Mary Hospital, The University of Hong
Kong, Hong Kong
Publisher
BioMed Central Ltd
Abstract
Background: For patients taking warfarin and undergoing pacemaker or
implantable cardioverter-defibrillator surgery, clinical evidence and
guidelines support continuation of warfarin therapy, as opposed to
interruption of warfarin therapy with heparin bridging. Interruption of
warfarin without post-operative bridging therapy may be a feasible
alternative but data is sparse. Method(s): This is a single-arm
observational study including adults who had interruption of warfarin
therapy without post-operative bridging therapy for cardiac implantable
electronic device (CIED) surgery performed between 2010 and 2019 in a
tertiary referral hospital. The primary outcome was a composite of
all-cause mortality, arterial or venous thromboembolic events. The
secondary outcomes were clinically significant device-pocket hematoma and
other procedural complications. Result(s): Of the 411 patients
analysed including 257 patients (62.5%) who had mechanical heart valves,
the primary outcome developed in 5 (1.2%) patients within 30 days after
surgery, including death in 3 (0.7%) patients, transient ischemic attack
in 1 (0.2%) patient and non-CNS embolism in 1 (0.2%) patient. Clinically
significant hematomas occurred in 24 (5.8%) patients, including 15 (3.7%)
requiring additional interruption of anti-coagulation and 6 (1.5%)
requiring clot evacuation. Other procedural complications and bleeding
events were rare (< 1%). Conclusion(s): Warfarin interruption without
post-operative bridging therapy for CIED surgery was associated with low
thromboembolic risks and acceptable bleeding risk. Randomized controlled
trials are required to formulate an optimal approach to anti-coagulation
management. Copyright © 2021, The Author(s).

<118>
Accession Number
2011834961
Title
Comparison of the analgesic effect of quadratus lumborum block and
epidural block in open uterine surgery: A randomized controlled trial.
Source
Minerva Anestesiologica. 87 (4) (pp 414-422), 2021. Date of Publication:
April 2021.
Author
She H.; Jiang P.; Zhu J.; Zhou Y.; Wang Y.; Kan M.; Wu J.
Institution
(She, Jiang, Zhu, Wang, Kan, Wu) Department of Anesthesiology, Affiliated
Hospital of Jiangsu University, Zhenjiang, China
(Zhou) Department of Surgery, Affiliated Hospital of Jiangsu University,
Zhenjiang, China
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: Effective regional analgesia during open surgery could reduce
opioid consumption and enhance early recovery. We compared the effects of
the newly developed quadratus lumborum block (QLB) and the traditional
epidural block (EB) in open uterine surgery. METHOD(S): In this
randomized controlled trial, we included patients scheduled for elective
open uterine surgery during May - September 30, 2019. Patients received
QLB or EB for perioperative pain relief before general anesthesia.
Perioperative opioid consumption, and numeric rating scale (NRS: 0-10)
pain scores after surgery, heart rate (HR), mean arterial pressure (MAP),
ephedrine and urapidil use during surgery, lower limb muscle strength,
timing of first flatus and defecation, nausea, vomiting, and other
complications within 24 h post-surgery, were the primary and secondary
outcomes, respectively. RESULT(S): Data of 72 (86%; 36/group) of 83
eligible patients were analyzed. Remifentanil consumption during surgery
was higher in the QLB than in the EB group, while cumulative sufentanil
consumption within 24 h post-surgery was similar between both groups. NRS
pain scores at rest and during activity were higher at 1 h post-surgery,
and MAP was higher at 5-, 15-, and 30-min postincision in the QLB than in
the EB group; HR was similar between groups. Lower ephedrine requirements,
higher lower limb muscle strength at 1 h post-surgery, and lower nausea
incidence were observed in the QLB group. CONCLUSION(S): QLB produces
a less intense but longer block and fewer side effects in the first 24 h
after open uterine surgery than those produced by EB. Copyright ©
2021 Edizioni Minerva Medica. All rights reserved.

<119>
Accession Number
2011808435
Title
Predictors of pacemaker implantation after transcatheter aortic valve
implantation according to kind of prosthesis and risk profile: A
systematic review and contemporary meta-Analysis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 7 (2) (pp
143-153), 2021. Date of Publication: 01 Apr 2021.
Author
Bruno F.; D'Ascenzo F.; Vaira M.P.; Elia E.; Omede P.; Kodali S.; Barbanti
M.; Rodes-Cabau J.; Husser O.; Sossalla S.; Van Mieghem N.M.; Bax J.;
Hildick-Smith D.; Munoz-Garcia A.; Pollari F.; Fischlein T.; Budano C.;
Montefusco A.; Gallone G.; De Filippo O.; Rinaldi M.; La Torre M.;
Salizzoni S.; Atzeni F.; Pocar M.; Conrotto F.; De Ferrari G.M.
Institution
(Bruno, D'Ascenzo, Vaira, Elia, Omede, Budano, Montefusco, Gallone, De
Filippo, Conrotto, De Ferrari) Division of Cardiology, Cardiovascular and
Thoracic Department, Citta della Salute e della Scienza Hospital and
University of Turin, Italy
(Kodali) Department of Cardiology, Division of Cardiology, Columbia
University Medical Center, New York, NY, United States
(Barbanti) Department of Cardiology, C.A.S.T. Policlinic G. Rodolico
Hospital, University of Catania, Catania, Italy
(Rodes-Cabau) Department of Cardiology, Quebec Heart and Lung Institute,
Laval University, Quebec City, QC, Canada
(Husser) Klinik fur Innere Medizin i St.-Johannes-Hospital, Dortmund,
Germany
(Sossalla) Department for Internal Medicine II, Cardiology, Pneumology,
University Hospital Regensburg, Regensburg, Germany
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Bax) Department of Cardiology, Heart Lung Center, Leiden University
Medical Center, Leiden, Netherlands
(Hildick-Smith) Department of Cardiology, Sussex Cardiac Centre, Brighton
and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
(Munoz-Garcia) Department of Cardiology, Hospital Virgen de la Victoria,
Malaga, Spain
(Pollari, Fischlein) Department of Cardiac Surgery, Cardiovascular Center,
Klinikum Nurnberg-Paracelsus Medical University, Breslauer Str. 201,
Nuremberg, Germany
(Rinaldi, La Torre, Salizzoni, Atzeni, Pocar) Division of Cardiosurgery,
Cardiovascular and Thoracic Department, Citta della Salute e della Scienza
Hospital and University of Turin, Italy
Publisher
Oxford University Press
Abstract
Aims: 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. We undertook a meta-Analysis of the
existing literature to examine the incidence and predictors of PPI after
TAVI according to generation of valve, valve type, and surgical risk.
 Methods and Results: 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 generation of valve, specific valve type, and surgical risk.
We obtained data from 43 studies, encompassing 29 113 patients. Permanent
pacemaker implantation rates ranged from 6.7% to 39.2% in individual
studies with a pooled incidence of 19% (95% CI 16-21). Independent
predictors for PPI were age [odds ratio (OR) 1.05, 95% confidence interval
(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 analysed according
to valve type, valve generation and surgical risk, independent predictors
were RBBB, self-expanding valve type, first-degree atrioventricular block,
and implantation depth. Conclusion(s): The principle independent
predictors for PPI following TAVI are age, RBBB, LBBB, self-expanding
valve type, and valve implantation depth. These characteristics should be
taken into account in pre-procedural assessment to reduce PPI rates.
PROSPERO ID CRD42020164043. Copyright © 2020 Published on behalf
of the European Society of Cardiology. All rights reserved.

<120>
Accession Number
2011803715
Title
Subclinical leaflet thrombosis after transcatheter aortic valve
replacement: A meaningless finding? A systematic review and meta-analysis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 7 (1) (pp
107-108), 2021. Date of Publication: 01 Jan 2021.
Author
Casula M.; Fortuni F.; Ferlini M.; Mauri S.; Rebuffi C.; Rossini R.;
Ferrario M.; Oltrona Visconti L.
Institution
(Casula, Fortuni, Oltrona Visconti) Coronary Care Unit, Fondazione IRCCS
Policlinico San Matteo, Viale Camillo Golgi 19, Pavia 27100, Italy
(Casula, Fortuni) Department of Molecular Medicine, University of Pavia,
Via Forlanini 6, Pavia 27100, Italy
(Ferlini, Mauri, Ferrario, Oltrona Visconti) Division of Cardiology,
Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, Pavia
27100, Italy
(Rebuffi) Scientific Documentation Center, Fondazione IRCCS Policlinico
San Matteo, Viale Camillo Golgi, Pavia 27100, Italy
(Rossini) Cardiologia, Ospedale Santa Croce e Carle, Via Michele Coppino
26, Cuneo 12100, Italy
Publisher
Oxford University Press

<121>
Accession Number
2011784767
Title
Biodegradable polymer-coated versus durable polymer-coated
sirolimus-eluting stents: The final 5-year outcomes of the I-LOVE-IT 2
trial.
Source
EuroIntervention. 16 (18) (pp E1518-E1526), 2021. Date of Publication:
2021.
Author
Xu K.; Xu B.; Guan C.; Jing Q.; Zheng Q.; Wang H.; Zhao X.; Li Y.; Li J.;
Yang Y.; Han Y.; Li X.; Yu P.; Zang H.; Wang Z.; Cao X.; Zhang J.; Pang W.
Institution
(Xu, Jing, Li, Li, Han) General Hospital of Northern Theater Command,
Shenyang, China
(Xu, Guan, Yang) Fu Wai Hospital, National Center for Cardiovascular
Diseases, Beijing, China
(Zheng) Affiliated Tangdu Hospital, The Air Force Medical University,
Xi'an, China
(Li) Fourth Affiliated Hospital, Harbin Medical University, Harbin, China
(Zhao) Affiliated Changhai Hospital, The Navy Medical University,
Shanghai, China
(Wang) Affiliated Xijing Hospital, The Air Force Medical University,
Xi'an, China
(Zhao) Jilin University First Hospital, Changchun, China
(Li) No. 960 Hospital of PLA, Jinan, China
(Yu) Pingdu People's Hospital, Pingdu, China
(Zang) No. 463 Hospital of PLA, Shenyang, China
(Wang) Xinxiang Central Hospital, Xinxiang, China
(Cao) No. 252 Hospital of PLA, Baoding, China
(Zhang) Cangzhou Central Hospital, Cangzhou, China
(Pang) Shengjing Hospital, Shenyang, China
Publisher
Europa Group
Abstract
Aims: This analysis presents the final five-year results of the I-LOVE-IT
2 trial, a non-inferiority study comparing a biodegradable polymer (BP)
sirolimus-eluting stent (SES) with a durable polymer (DP) SES in patients
with coronary artery disease. Methods and Results: Overall, 2,737
Chinese patients eligible for coronary stenting were treated with BP-SES
or DP-SES in a 2:1 ratio. Patients who were randomised to the BP-SES group
were additionally re-randomised to receive either six-month or 12-month
dual antiplatelet therapy (DAPT) in a 1:1 ratio. The primary endpoint was
12-month target lesion failure (TLF: cardiac death, target vessel
myocardial infarction (MI), or clinically indicated target lesion
revascularisation). At five years, the overall follow-up rate was 90.8%,
and the cumulative incidence of TLF as the primary endpoint was similar
between BP-SES and DP-SES (hazard ratio [HR] 1.01, 95% confidence interval
[CI]: 0.79 to 1.28), as was that for the patient-oriented composite
endpoint (PoCE: all-cause death, all MI and any revascularisation) (HR
1.03, 95% CI: 0.86 to 1.23), or definite/probable stent thrombosis (ST)
(HR 0.91, 95% CI: 0.70 to 1.77). Cumulative events were also similar
between the six-month DAPT and 12-month DAPT groups after BP-SES
implantation. Conclusion(s): I-LOVE-IT 2 showed that the five-year
safety and efficacy of BP-SES and DP-SES were similar, as were those
between six months and 12 months of DAPT after BP-SES implantation.
ClinicalTrials.gov Identifier: NCT01681381. Copyright © Europa
Digital & Publishing 2021. All rights reserved.

<122>
Accession Number
2011853565
Title
Toward Eliminating Perinatal Comfort Care for Prenatally Diagnosed Severe
Congenital Heart Defects: A Vision.
Source
Mayo Clinic Proceedings. 96 (5) (pp 1276-1287), 2021. Date of Publication:
May 2021.
Author
Stephens E.H.; Dearani J.A.; Qureshi M.Y.; Segura L.G.; Arendt K.W.;
Bendel-Stenzel E.M.; Ruano R.
Institution
(Stephens, Dearani) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, MN, United States
(Qureshi) Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN,
United States
(Segura, Arendt) Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic, Rochester, MN, United States
(Bendel-Stenzel, Ruano) Division of Maternal-Fetal Medicine, Mayo Clinic,
Rochester, MN, United States
(Bendel-Stenzel) Division of Neonatal Medicine, Mayo Clinic, Rochester,
MN, United States
Publisher
Elsevier Ltd
Abstract
Over the past 40 years, the medical and surgical management of congenital
heart disease has advanced considerably. However, substantial room for
improvement remains for certain lesions that have high rates of morbidity
and mortality. Although most congenital cardiac conditions are well
tolerated during fetal development, certain abnormalities progress in
severity over the course of gestation and impair the development of other
organs, such as the lungs or airways. It follows that intervention during
gestation could potentially slow or reverse elements of disease
progression and improve prognosis for certain congenital heart defects. In
this review, we detail specific congenital cardiac lesions that may
benefit from fetal intervention, some of which already have documented
improved outcomes with fetal interventions, and the state-of-the-science
in each of these areas. This review includes the most relevant studies
from a PubMed database search from 1970 to the present using key words
such as fetal cardiac, fetal intervention, fetal surgery, and EXIT
procedure. Fetal intervention in congenital cardiac surgery is an exciting
frontier that promises further improvement in congenital heart disease
outcomes. When fetuses who can benefit from fetal intervention are
identified and appropriately referred to centers of excellence in this
area, patient care will improve. Copyright © 2020 Mayo Foundation
for Medical Education and Research

<123>
Accession Number
2011842766
Title
Silent brain infarcts and early cognitive outcomes after transcatheter
aortic valve implantation: A systematic review and meta-analysis.
Source
European Heart Journal. 42 (10) (pp 1004-1015), 2021. Date of Publication:
07 Mar 2021.
Author
Woldendorp K.; Indja B.; Bannon P.G.; Fanning J.P.; Plunkett B.T.; Grieve
S.M.
Institution
(Woldendorp, Indja, Bannon, Grieve) Faculty of Medicine and Health,
University of Sydney, Sydney, NSW 2006, Australia
(Woldendorp, Bannon, Plunkett) Cardiothoracic Surgical Department, Royal
Prince Alfred Hospital, Sydney, NSW 2050, Australia
(Woldendorp, Bannon, Plunkett) Baird Institute of Applied Heart and Lung
Research, 100 Carillon Avenue, Sydney, NSW 2042, Australia
(Fanning) The Prince Charles Hospital, Critical Care Research Group,
Brisbane, QLC 4032, Australia
(Fanning) Faculty of Medicine, University of Queensland, Brisbane, QLD
4072, Australia
(Grieve) Sydney Translational Imaging Laboratory, Charles Perkins Centre,
University of Sydney, NSW 2006, Australia
(Grieve) Department of Radiology, Royal Prince Alfred Hospital,
Camperdown, Sydney, NSW 2050, Australia
Publisher
Oxford University Press
Abstract
Background: Silent brain infarcts (SBIs) are frequently identified after
transcatheter aortic valve implantation (TAVI), when patients are screened
with diffusion-weighted magnetic resonance imaging (DW-MRI). Outside the
cardiac literature, SBIs have been correlated with progressive cognitive
dysfunction; however, their prognostic utility after TAVI remains
uncertain. This study's main goals were to explore (i) the incidence of
and potential risk factors for SBI after TAVI; and (ii) the effect of SBI
on early post-procedural cognitive dysfunction (PCD). Methods and
Results: A systematic literature review was performed to identify all
publications reporting SBI incidence, as detected by DW-MRI after TAVI.
Silent brain infarct incidence, baseline characteristics, and the
incidence of early PCD were evaluated via meta-analysis and
meta-regression models. We identified 39 relevant studies encapsulating
2408 patients. Out of 2171 patients who underwent post-procedural DW-MRI,
1601 were found to have at least one new SBI (pooled effect size 0.76, 95%
CI: 0.72-0.81). The incidence of reported stroke with focal neurological
deficits was 3%. Meta-regression noted that diabetes, chronic renal
disease, 3-Tesla MRI, and pre-dilation were associated with increased SBI
risk. The prevalence of early PCD increased during follow-up, from 16% at
10.0 +/- 6.3 days to 26% at 6.1 +/- 1.7 months and meta-regression
suggested an association between the mean number of new SBI and incidence
of PCD. The use of cerebral embolic protection devices (CEPDs) appeared to
decrease the volume of SBI, but not their overall incidence.
 Conclusion(s): Silent brain infarcts are common after TAVI; and
diabetes, kidney disease, and pre-dilation increase overall SBI risk.
While higher numbers of new SBIs appear to adversely affect early
neurocognitive outcomes, long-term follow-up studies remain necessary as
TAVI expands to low-risk patient populations. The use of CEPD did not
result in a significant decrease in the occurrence of SBI. Copyright
© 2021 Published on behalf of the European Society of Cardiology. All
rights reserved.

<124>
Accession Number
2011840389
Title
Reporting in clinical studies on platelet-rich plasma therapy among all
medical specialties: A systematic review of Level i and II studies.
Source
PLoS ONE. 16 (4 April) (no pagination), 2021. Article Number: e0250007.
Date of Publication: April 2021.
Author
Nazaroff J.; Oyadomari S.; Brown N.; Wang D.
Institution
(Nazaroff, Wang) University of California Irvine School of Medicine,
Irvine, CA, United States
(Oyadomari, Brown) Department of Orthopaedic Surgery, University of
California Irvine Health, Orange, CA, United States
Publisher
Public Library of Science
Abstract
The clinical practice of platelet-rich plasma (PRP) therapy has grown
significantly in recent years in multiple medical specialties. However,
comparisons of PRP studies across medical fields remain challenging
because of inconsistent reporting of protocols and characterization of the
PRP being administered. The purpose of this systematic review was to
determine the quantity of level I/II studies within each medical specialty
and compare the level of study reporting across medical fields. Methods
The Cochrane Database, PubMed, and EMBASE databases were queried for level
I/II clinical studies on PRP injections across all medical specialties.
From these studies, data including condition treated, PRP processing and
characterization, delivery, control group, and assessed outcomes were
collected. Results A total of 132 studies met the inclusion and exclusion
criteria and involved 28 different conditions across 8 specialties
(cardiothoracic surgery, cosmetic, dermatology, musculoskeletal (MSK),
neurology, oral maxillofacial surgery, ophthalmology, and plastic
surgery). Studies on PRP for MSK injuries made up the majority of the
studies (74%), with knee osteoarthritis and tendinopathy being most
commonly studied. Of the 132 studies, only 44 (33%) characterized the
composition of PRP used, and only 23 (17%) reported the leukocyte
component. MSK studies were more likely to use patient-reported outcome
measures to assess outcomes, while studies from other specialties were
more likely to use clinician-or imagingbased objective outcomes. Overall,
61% of the studies found PRP to be favorable over control treatment, with
no difference in favorable reporting between MSK and other medical
specialties. Conclusions The majority of level I/II clinical studies
investigating PRP therapy across all medical specialties have been
conducted for MSK injuries with knee osteoarthritis and tendinopathy being
the most commonly studied conditions. Inconsistent reporting of PRP
composition exists among all studies in medicine. Rigorous reporting in
human clinical studies across all medical specialties is crucial for
evaluating the effects of PRP and moving towards disease-specific and
individualized treatment. Copyright © 2021 Public Library of
Science. All rights reserved.

<125>
Accession Number
2011832117
Title
Ablation strategies for arrhythmogenic right ventricular cardiomyopathy: A
systematic review and meta-analysis.
Source
Journal of Geriatric Cardiology. 17 (11) (pp 694-703), 2020. Date of
Publication: 2020.
Author
Shen L.-S.; Liu L.-M.; Zheng L.-H.; Hu F.; Hu Z.-C.; Liu S.-Y.; Guo J.-R.;
Bhagat K.K.; Yao Y.
Institution
(Shen, Liu, Zheng, Hu, Hu, Liu, Yao) Arrhythmia Center, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Guo) Arrhythmia Center, Yunnan Fuwai Cardiovascular Hospital, Kunming,
China
(Bhagat) Eternal hospital, Jaipur, Rajasthan, India
Publisher
Science Press
Abstract
Background Catheter ablation for ventricular tachycardia (VT) in patients
with arrhythmogenic right ventricular cardiomyopathy (ARVC) has
significantly evolved over the past decade. However, different ablation
strategies showed inconsistency in acute and long-term outcomes. Methods
We searched the databases of Medline, Embase and Cochrane Library through
October 17, 2019 for studies describing the clinical outcomes of VT
ablation in ARVC. Data including VT recurrence, all-cause mortality, acute
procedural efficacy and major procedural complications were extracted. A
meta-analysis with trial sequential analysis was further performed in
comparative studies of endo-epicardial versus endocardial-only ablation.
Results A total of 24 studies with 717 participants were enrolled. The
literatures of epicardial ablation were mainly published after 2010 with
total ICD implantation of 73.7%, acute efficacy of 89.8%, major
complication of 5.2%, follow-up of 28.9 months, VT freedom of 75.3%,
all-cause mortality of 1.1% and heart transplantation of 0.6%.
Meta-analysis of 10 comparative studies revealed that compared with
endocardial-only approach, epicardial ablation significantly decreased VT
recurrence (OR: 0.50; 95% CI: 0.30-0.85; P = 0.010), but somehow increased
major procedural complications (OR: 4.64; 95% CI: 1.28-16.92; P = 0.02),
with not evident improvement of acute efficacy (OR: 2.74; 95% CI:
0.98-7.65; P = 0.051) or all-cause mortality (OR: 0.87; 95% CI: 0.09-8.31;
P = 0.90). Conclusion Catheter ablation for VT in ARVC is feasible and
effective. Epicardial ablation is associated with better long-term VT
freedom, but with more major complications and unremarkable survival or
acute efficacy benefit. Copyright © 2020 JGC All rights reserved;
www.jgc301.com

<126>
Accession Number
2011832105
Title
Risk scoring model for prediction of non-home discharge after
transcatheter aortic valve replacement.
Source
Journal of Geriatric Cardiology. 17 (10) (pp 621-627), 2020. Date of
Publication: 2020.
Author
Okoh A.K.; Ozturk E.; Gold J.; Siddiqui E.; Dhaduk N.; Haik B.; Chen
C.-G.; Cohen M.; Russo M.J.
Institution
(Okoh, Gold, Haik, Chen, Cohen) Cardiovascular Outcomes Research
Institute, RWJ Barnabas Health-NBIMC, Newark, NJ, United States
(Ozturk) Department of Medicine, Division of Biostatistics, Hacettepe
University, Ankara, Turkey
(Siddiqui, Dhaduk) Rutgers New Jersey Medical School, Newark, NJ, United
States
(Russo) Department of Surgery, Division of Cardiothoracic Surgery, Rutgers
Robert Wood Johnson Medical School, New Brunswick, NJ, United States
Publisher
Science Press
Abstract
Background Patients undergoing transcatheter aortic valve replacement
(TAVR) are likely to be discharged to a location other than home. We aimed
to determine the association between preoperative risk factors and
non-home discharge after TAVR. Methods Patients discharged alive after
TAVR at three centers were identified from a prospectively maintained
database randomly divided into 80% derivation and 20% validation cohorts.
Logistic regression models were fit to identify preoperative factors
associated with non-home discharge in the derivation cohort. Multivariable
models were developed and a nomogram based risk-scoring system was
developed for use in preoperative counseling. Results Between June 2012
and December 2018, a total of 1,163 patients had TAVR at three centers.
Thirty-seven patients who died before discharge were excluded. Of the
remaining 1,126 patients (97%) who were discharged alive, the incidence of
non-home discharge was 25.6% (n = 289). The patient population was
randomly divided into the 80% (n = 900) derivation cohort and 20% (n =
226) validation cohort. Mean +/- SD age of the study population was 83 +/-
8 years. In multivariable analysis, factors that were significantly
associated with non-home discharge were extreme age, female sex, higher
STS scores, use of general anesthesia, elective procedures, chronic liver
disease, non-transfemoral approach and postoperative complications. The
unbiased estimate of the C-index was 0.81 and the model had excellent
calibration. Conclusions One out of every four patients undergoing TAVR is
discharged to a location other than home. Identification of preoperative
factors associated with non-home discharge can assist patient counseling
and postoperative disposition planning. Copyright © 2020 JGC All
rights reserved; www.jgc301.com

<127>
Accession Number
2011882500
Title
Ivabradine Versus Amiodarone in the Management of Postoperative Junctional
Ectopic Tachycardia: A Randomized, Open-Label, Noninferiority Study.
Source
JACC: Clinical Electrophysiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Arvind B.; Kothari S.S.; Juneja R.; Saxena A.; Ramakrishnan S.; Gupta
S.K.; Chowdhury U.K.; Devagourou V.; Talwar S.; Hote M.P.; Rajashekar P.;
Sahu M.K.; Singh S.P.
Institution
(Arvind, Kothari, Juneja, Saxena, Ramakrishnan, Gupta) Department of
Cardiology, All India Institute of Medical Sciences, New Delhi, India
(Chowdhury, Devagourou, Talwar, Hote, Rajashekar, Sahu, Singh) Department
of Cardiothoracic and Vascular Surgery, All India Institute of Medical
Sciences, New Delhi, India
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to compare the efficacy of ivabradine and
amiodarone in the management of postoperative junctional ectopic
tachycardia (JET) after cardiac surgery in children. Background(s):
JET is a serious arrhythmia occurring in children after cardiac surgery
and requires aggressive management. Amiodarone has been conventionally
used in its treatment. Recent studies have reported the utility of
ivabradine in this regard. Method(s): In this open-label randomized
controlled trial, 94 children (age <=18 years) who developed postoperative
JET were allocated to receive either amiodarone or ivabradine. The primary
end point was restoration of normal sinus rhythm. Result(s): Sinus
rhythm was achieved in 43 out of the 46 patients (93.5%) in the amiodarone
group and 46 out of the 48 patients (95.8%) in the ivabradine group (mean
difference of treatment effect: 2.3%; 95% confidence interval: -6.7% to
11.5%). The median (interquartile range) time taken to achieve sinus
rhythm conversion was similar in both the groups: 21.5 (17-30.2) versus 22
(13.4-38.5) hours (p = 0.36)]. The time taken to rate control of JET was
significantly less in the amiodarone group: median 7.0 (5.5-9.5) versus
8.0 (5.8-10.8) hours (p = 0.02)]. No drug-related adverse events were
observed in the ivabradine group. Conclusion(s): Oral ivabradine is
not inferior to intravenous amiodarone in converting postoperative JET to
sinus rhythm. There was no difference in time taken to sinus rhythm
conversion between the groups, although the rate control was earlier in
patients who received amiodarone. Monotherapy with ivabradine may be
considered as an alternative to amiodarone in the management of
postoperative JET. (Comparison of Two Drugs, Ivabradine and Amiodarone, in
the Management of Junctional Ectopic Tachycardia, an Abnormality in
Cardiac Rhythm in Patients Under 18 years Who Undergo Cardiac Surgery:
CTRI/2018/08/015182) Copyright © 2021 American College of
Cardiology Foundation

<128>
Accession Number
2011475457
Title
Leaflet fusion length is associated with aortic dilation and flow
alterations in non-dysfunctional bicuspid aortic valve.
Source
European Radiology. (no pagination), 2021. Date of Publication: 2021.
Author
Guala A.; Evangelista A.; Teixido-Tura G.; La Mura L.; Dux-Santoy L.;
Ruiz-Munoz A.; Valente F.; Galian-Gay L.; Gutierrez L.; Gonzalez-Alujas
T.; Dentamaro I.; Johnson K.M.; Wieben O.; Sao Aviles A.;
Ferreira-Gonzalez I.; Rodriguez-Palomares J.F.
Institution
(Guala, Evangelista, Teixido-Tura, La Mura, Sao Aviles, Ferreira-Gonzalez,
Rodriguez-Palomares) Vall d'Hebron Institut de Recerca (VHIR), Barcelona,
Spain
(Guala, Evangelista, Teixido-Tura, Ruiz-Munoz, Rodriguez-Palomares)
CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
(Evangelista, Teixido-Tura, La Mura, Dux-Santoy, Valente, Galian-Gay,
Gutierrez, Gonzalez-Alujas, Dentamaro, Ferreira-Gonzalez,
Rodriguez-Palomares) Department of Cardiology, Hospital Universitari Vall
d'Hebron, Barcelona, Spain
(Evangelista) Instituto del Corazon, Quironsalud-Teknon, Barcelona, Spain
(Evangelista, Ferreira-Gonzalez) Universitat Autonoma de Barcelona,
Bellaterra, Spain
(La Mura) Department of Advanced Biomedical Sciences, University Federico
II, Naples, Italy
(Dentamaro) Department of Cardiology, Hospital "F. Miulli", Acquaviva
delle Fonti, Italy
(Johnson, Wieben) Departments of Medical Physics & Radiology, University
of Wisconsin, Madison, WI, United States
(Ferreira-Gonzalez) CIBER-ESP, Instituto de Salud Carlos III, Madrid,
Spain
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: Bicuspid aortic valve (BAV), the most common congenital valve
defect, is associated with increased risk of aortic dilation and related
complications; however, current risk assessment is not effective. Most of
BAV have three leaflets with a fusion between two of them of variable
length. This study aimed to ascertain whether the extent of leaflet fusion
(often called raphe) is related to aortic dilation and flow abnormalities
in BAV with no significant valvular dysfunction. Method(s): One
hundred and twenty BAV patients with no significant valvular dysfunction
or history of surgical repair or aortic valve replacement were
consecutively and prospectively enrolled (September 2014-October 2018).
Cardiac magnetic resonance protocol included a 4D flow sequence for
haemodynamic assessment. Moreover, a stack of double-oblique cine images
of the aortic valve were used to quantify fusion length (in systole) and
leaflet length (diastole). Inter- and intra-observer reproducibility was
tested in 30 randomly selected patients. Result(s): Aortic valve
leaflet fusion was measurable in 112 of 120 (93%) cases with good
reproducibility (ICC = 0.826). Fusion length varied greatly (range:
2.3-15.4 mm; mean: 7.8 +/- 3.2 mm). After correction for demographic and
clinical conditions, fusion length was independently associated with
diameter and z-score at the sinus of Valsalva (p = 0.002 and p = 0.002,
respectively) and ascending aorta (p = 0.028 and p = 0.046). Fusion length
was positively related to flow asymmetry, vortices and circumferential
wall shear stress, thereby possibly providing a pathophysiological link
with aortic dilation. Conclusion(s): Aortic valve fusion length is
related to aortic dilation and flow abnormalities in BAV patients. Key
Points: * The length of the fusion between leaflets in non-dysfunctional
bicuspid aortic valves varies substantially and can be reliably measured
by cine CMR. * Aortic valve leaflet fusion length is independently related
to aortic sinus and ascending aorta diameter. * Increased flow asymmetry,
circumferential wall shear stress and presence of vortices are positively
related to aortic valve leaflet fusion length. Copyright © 2021,
European Society of Radiology.

<129>
Accession Number
2011279407
Title
An umbrella review of systematic reviews and meta-analyses of
observational investigations of obstructive sleep apnea and health
outcomes.
Source
Sleep and Breathing. (no pagination), 2021. Date of Publication: 2021.
Author
Chen W.; Li Y.; Guo L.; Zhang C.; Tang S.
Institution
(Chen, Li, Guo, Zhang, Tang) Department of Gastroenterology, The First
Affiliated Hospital, Jinan University, Guangzhou, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: The previous analysis of systematic reviews and meta-analyses
have illustrated that obstructive sleep apnea (OSA) is correlated with
multiple health outcomes. In the present research, our main aim was to
execute an umbrella review to assess the available evidence for the
associations between OSA and health outcomes. Method(s): Herein, a
meta-analysis of previous observational investigations that have reported
associations between OSA and health outcomes in all human populations and
settings was performed. We used these studies to execute an umbrella
review of available meta-analyses and systematic reviews. Result(s):
Sixty-six articles comprising 136 unique outcomes were enrolled in this
analysis. Of the 136 unique outcomes, 111 unique outcomes had significant
associations (p < 0.05). Only 7 outcomes (coronary revascularization after
PCI, postoperative respiratory failure, steatosis, alaninetrans aminase
(ALT) elevation, metabolic syndrome (MS), psoriasis, and Parkinson's
disease) had a high quality of evidence. Twenty-four outcomes had a
moderate quality of evidence, and the remaining 80 outcomes had a weak
quality of evidence. Sixty-nine outcomes exhibited significant
heterogeneity. Twenty-five outcomes exhibited publication bias.
Sixty-three (95%) studies showed critically low methodological quality.
 Conclusion(s): Among the 66 meta-analyses exploring 136 unique
outcomes, only 7 statistically significant outcomes were rated as high
quality of evidence. OSA may correlate with an increased risk of coronary
revascularization after PCI, postoperative respiratory failure, steatosis,
ALT elevation, MS, psoriasis, and Parkinson's disease. Copyright
© 2021, The Author(s).

<130>
Accession Number
2011256184
Title
Albumin in adult cardiac surgery: a narrative review.
Source
Canadian Journal of Anesthesia. (no pagination), 2021. Date of
Publication: 2021.
Author
Hanley C.; Callum J.; Karkouti K.; Bartoszko J.
Institution
(Hanley) Department of Anesthesia, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Queen's
University, Kingston, ON, Canada
(Karkouti) Department of Anesthesia and Pain Management, Sinai Health
System, Women's College Hospital, University Health Network, Toronto, ON,
Canada
(Karkouti, Bartoszko) Department of Anesthesia and Pain Management,
Toronto General Hospital, University Health Network, University of
Toronto, 200 Elizabeth Street 3EN-464, Toronto, ON M5G 2C4, Canada
(Karkouti) Institute of Health Policy Management and Evaluation,
University of Toronto, Toronto, ON, Canada
Publisher
Springer
Abstract
Purpose: Intravascular fluids are a necessary and universal component of
cardiac surgical patient care. Both crystalloids and colloids are used to
maintain or restore circulating plasma volume and ensure adequate organ
perfusion. In Canada, human albumin solution (5% or 25% concentration) is
a colloid commonly used for this purpose. In this narrative review, we
discuss albumin supply in Canada, explore the perceived advantages of
albumin, and describe the clinical literature supporting and refuting
albumin use over other fluids in the adult cardiac surgical population.
Source: We conducted a targeted search of PubMed, Embase, Medline, Web of
Science, ProQuest Dissertations and Theses Global, the Cochrane Central
Register of Controlled trials, and the Cochrane Database of Systematic
Reviews. Search terms included albumin, colloid, cardiac surgery,
bleeding, hemorrhage, transfusion, and cardiopulmonary bypass. Principal
findings: Albumin is produced from fractionated human plasma and imported
into Canada from international suppliers at a cost of approximately $21
million CAD per annum. While it is widely used in cardiac surgical
patients across the country, it is approximately 30-times more expensive
than equivalent doses of balanced crystalloid solutions, with wide
inter-institutional variability in use and no clear association with
improved outcomes. There is a general lack of high-quality evidence for
the superiority of albumin over crystalloids in this patient population,
and conflicting evidence regarding safety. Conclusion(s): In cardiac
surgical patients, albumin is widely utilized despite a lack of high-
quality evidence supporting its efficacy or safety. A well-designed
randomized controlled trial is needed to clarify the role of albumin in
cardiac surgical patients. Copyright © 2021, Canadian
Anesthesiologists' Society.

<131>
Accession Number
634894429
Title
Risk factors of postoperative delirium after cardiac surgery: a
meta-analysis.
Source
Journal of cardiothoracic surgery. 16 (1) (pp 113), 2021. Date of
Publication: 26 Apr 2021.
Author
Chen H.; Mo L.; Hu H.; Ou Y.; Luo J.
Institution
(Chen) Education and Training Department, First Affiliated Hospital of
University of South China, Hengyang, China
(Mo, Luo) Department of Cardiothoracic Surgery, First Affiliated Hospital
of University of South China, Hengyang, China
(Hu) Nursing Department, First Affiliated Hospital of University of South
China, Hengyang, China
(Ou) Nursing Department, First Affiliated Hospital of University of South
China, Hengyang, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative delirium is a frequent event after cardiac
surgery. This meta-analysis aimed to identify relevant risk factors.
 METHOD(S): In this meta-analysis, all original researches regarding
patients undergoing mixed types of cardiac surgery (excluding
transcatheter procedures) and postoperative delirium were evaluated for
inclusion. On July 28th 2020, we searched PubMed, Embase, Web of Science
and Scopus. Data about name of first author, year of publication,
inclusion and exclusion criteria, research design, setting, method of
delirium assessment, incidence of delirium, odds ratio (OR) and
corresponding 95% confidence interval (CI) of risk factors, and other
information relevant was collected. OR and 95% CI were used as metrics for
summarized results. Random effects model was applied. RESULT(S):
Fourteen reports were included with a total sample size of 13,286. The
incidence of delirium ranged from 4.1 to 54.9%. Eight risk factors were
identified including aging, diabetes, preoperative depression, mild
cognitive impairment, carotid artery stenosis, NYHA functional class III
or IV, time of mechanical ventilation and length of intensive care unit
stay. CONCLUSION(S): In this study several risk factors associated
with postoperative delirium after cardiac surgery were identified.
Utilizing the information may allow us to identifying patients at high
risk of developing postoperative delirium prior to delirium onset.

<132>
[Use Link to view the full text]
Accession Number
634905156
Title
Protective effect of sevoflurane on vascular endothelial glycocalyx in
patients undergoing heart valve surgery: A randomised controlled trial.
Source
European Journal of Anaesthesiology. 38 (5) (pp 477-486), 2021. Date of
Publication: May 2021.
Author
Fang F.-Q.; Sun J.-H.; Wu Q.-L.; Feng L.-Y.; Fan Y.-X.; Ye J.-X.; Gao W.;
He G.-L.; Wang W.-J.
Institution
(Fang) Zhejiang University School of Medicine, Hangzhou, China
(Sun, Wu, Feng, Fan, Ye, Gao, He, Wang) Hospital of Wenzhou Medical
University, Wenzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDThe glycocalyx plays an important physiological role and may be
damaged during cardiopulmonary bypass. Sevoflurane can protect the
glycocalyx; however, its relevance in a clinical setting is
unknown.OBJECTIVEGlycocalyx degradation during cardiopulmonary bypass in
patients was investigated. On the basis of the available experimental
data, we hypothesised that sevoflurane-based anaesthesia would confer
additional protection against cardiopulmonary bypass-induced glycocalyx
damage.DESIGNRandomised controlled study.SETTINGClinical study at The
First Affiliated Hospital of Wenzhou Medical University between June 2018
and March 2019.PATIENTSFifty-one patients.INTERVENTIONSAfter intubation
and mechanical ventilation, patients undergoing elective heart valve
surgery were maintained under general anaesthesia with either propofol or
sevoflurane during surgery.MAIN OUTCOME MEASURESGlycocalyx markers (such
as syndecan-1, heparan sulphate and hyaluronan), sheddases responsible for
the degradation of the endothelial glycocalyx (such as matrix
metalloproteinase-9 and cathepsin-B), urine albumin-To-creatinine ratio
and levels of lactic acid and myocardial enzymes were all measured.
Postoperative mechanical ventilation time and length of stay in the
cardiac care unit and hospital were also measured. Morbidity and mortality
after 30 days and 1 year were evaluated.RESULTSThe vascular endothelial
glycocalyx was damaged during cardiopulmonary bypass. The glycocalyx
damage in the sevoflurane group was less extensive than that in the
propofol group. The urine albumin-To-creatinine ratio increased in both
groups but was lower in the sevoflurane group. Enzymes including matrix
metalloproteinase-9 and cathepsin-B were positively correlated with
glycocalyx marker concentrations. After operation, the sevoflurane group
showed lower levels of lactic acid and myocardial enzyme, as well as
shorter duration of postoperative mechanical ventilation than the propofol
group.CONCLUSIONSevoflurane can decrease glycocalyx degradation in
patients undergoing heart valve surgery under cardiopulmonary bypass.TRIAL
REGISTRATIONChinese Clinical Trial Registry, chictr.org.cn, identifier:
ChiCTR1800016367. Copyright © 2021 Lippincott Williams and
Wilkins. All rights reserved.

<133>
Accession Number
634884020
Title
The Effect of Coronary Angiography Timing on Cardiac Surgery Associated
Acute Kidney Injury Incidence and Prognosis.
Source
Frontiers in Medicine. 8 (no pagination), 2021. Article Number: 619210.
Date of Publication: 15 Apr 2021.
Author
Liu K.; Li M.; Li L.; Wu B.; Xu X.; Ge Y.; Mao H.; Xing C.
Institution
(Liu, Li, Li, Wu, Xu, Ge, Mao, Xing) Department of Nephrology, The First
Affiliated Hospital of Nanjing Medical University (Jiangsu Province
Hospital), Nanjing, China
Publisher
Frontiers Media S.A.
Abstract
Introduction: Acute kidney injury has been identified as a common
complication of cardiac surgery. To date, the effect of the time interval
from coronary angiography to cardiac surgery on postoperative acute kidney
injury is still controversial. The aim of this study was to investigate
the relationship between the timing of coronary angiography and cardiac
surgery associated acute kidney injury. Method(s): Eight hundred
thirteen patients who underwent coronary angiography and cardiac surgery
successively from January 2017 to December 2018 were included in this
retrospective cohort study. We applied multivariate logistic regression,
propensity score analysis, and subgroup analysis to evaluate the
association between the time interval and postoperative acute kidney
injury incidence and prognosis. Meta-analysis was conducted to verify the
results. Result(s): The overall incidence of the cardiac surgery
associated acute kidney injury was 28.8%. Age (OR = 1.046, 95%CI:
1.017-1.075), cardiopulmonary bypass (OR = 3.439, 95%CI: 1.316-8.986) and
diabetes (OR = 2.522, 95%CI: 1.439-4.417) were found to be independent
risk factors of postoperative acute kidney injury in multivariate logistic
regression and propensity score analysis. Undergoing cardiac surgery
within 7 days after coronary angiography was not associated with increased
incidence of postoperative acute kidney injury or worse prognosis.
Meta-analysis obtained consistent results. Conclusion(s): The time
interval shorter than 7 days had no influence on cardiac surgery
associated acute kidney injury incidence and prognosis. The decision of
delaying the surgery should be made after comprehensive evaluation of the
patient. © Copyright © 2021 Liu, Li, Li, Wu, Xu, Ge, Mao and
Xing.

<134>
[Use Link to view the full text]
Accession Number
634905247
Title
Postoperative pain therapy with hydromorphone; comparison of
patient-controlled analgesia with target-controlled infusion and standard
patient-controlled analgesia: A randomised controlled trial.
Source
European Journal of Anaesthesiology. 37 (12) (pp 1168-1175), 2020. Date of
Publication: December 2020.
Author
Wehrfritz A.; Ihmsen H.; Fuchte T.; Kim M.; Kremer S.; Weiss A.; Schuttler
J.; Jeleazcov C.
Institution
(Wehrfritz, Ihmsen, Fuchte, Kim, Kremer, Weis, Schuttler, Jeleazcov)
Department of Anaesthesiology, University Hospital Erlangen,
Friedrich-Alexander-University Erlangen-Nurnberg (FAU), Erlangen, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND The challenge of managing acute postoperative pain is the well
tolerated and effective administration of analgesics with a minimum of
side effects. The standard therapeutic approach is patient-controlled
analgesia (PCA) with systemic opioids. To overcome problems of oscillating
opioid concentrations, we studied patient-controlled analgesia by
target-controlled infusion (TCI-PCA) as an alternative. OBJECTIVE To
compare efficacy, safety and side effects of standard PCA with TCI-PCA for
postoperative pain therapy with hydromorphone. DESIGN Single-blinded,
randomised trial. SETTING University Hospital, Germany from December 2013
to April 2015. PARTICIPANTS Fifty adults undergoing cardiac surgery.
INTERVENTIONS Postoperative pain therapy on the ICU was managed with
intravenous (i.v.) hydromorphone and patients randomised to TCI-PCA with
target plasma concentrations between 0.8 and 10 ng ml-1, or PCA
with bolus doses of 0.2 mg. Pain was regularly assessed using the 11-point
numerical rating scale (NRS). Blood pressure, heart rate, oxygen
saturation and cardiac output were continuously monitored, and adverse
events were registered throughout the study. MAIN OUTCOME MEASURES NRS
pain ratings, hydromorphone doses, haemodynamic effects and side effects.
RESULTS NRS pain ratings, total doses of hydromorphone and haemodynamic
data did not differ significantly between TCI-PCA and PCA. The number of
bolus doses during PCA was significantly higher than the number of target
increases during TCI-PCA (P = 0.006). The number of negative requests was
also significantly higher during PCA than during TCI-PCA (P = 0.02). The
respiratory rate on the first postoperative morning was 25 +/- 6
min-1 during TCI-PCA, compared with 19 +/- 4 min-1
during PCA (P = 0.022). Nausea occurred in 30% after TCI-PCA and 24% after
PCA (P = 0.46). CONCLUSION TCI-PCA was effective and well tolerated in
acute postoperative pain management after cardiac surgery. Further studies
are needed to evaluate this approach in clinical practice. Copyright
© 2020 European Society of Anaesthesiology and Intensive Care.
Unauthorized reproduction of this article is prohibited.

<135>
Accession Number
634854501
Title
A meta-analysis of optimal medical therapy with or without percutaneous
coronary intervention in patients with stable coronary artery disease.
Source
Coronary artery disease. (no pagination), 2021. Date of Publication: 19
Apr 2021.
Author
Shah R.; Nayyar M.; Le F.K.; Labroo A.; Nasr A.; Rashid A.; Davis D.A.;
Weintraub W.S.; Boden W.E.
Institution
(Shah) Department of Medicine, University of Tennessee, Memphis, Tennessee
Department of Cardiology, Gulf Coast Medical center, Alabama University of
Osteopathic Medicine, Panama City, Florida Department of Biology,
University of Memphis, Memphis, Tennessee Department of Cardiology,
University of Tennessee, Jackson, Tennessee Department of Medicine,
MedStar Washington Hospital Center, Washington, DC Department of Medicine,
Veterans Affairs (VA) New England Healthcare System, Boston University
Department of Medicine, Boston University School of Medicine, Boston,
Massachusetts, USA
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether percutaneous coronary intervention (PCI) improves
clinical outcomes in patients with chronic angina and stable coronary
artery disease (CAD) has been a continuing area of investigation for more
than two decades. The recently reported results of the International Study
of Comparative Health Effectiveness with Medical and Invasive Approaches,
the largest prospective trial of optimal medical therapy (OMT) with or
without myocardial revascularization, provides a unique opportunity to
determine whether there is an incremental benefit of revascularization in
stable CAD patients. METHOD(S): Scientific databases and websites
were searched to find randomized clinical trials (RCTs). Pooled risk
ratios were calculated using the random-effects model. RESULT(S):
Data from 10 RCTs comprising 12125 patients showed that PCI, when added to
OMT, were not associated with lower all-cause mortality (risk ratios,
0.96; 95% CI, 0.87-1.08), cardiovascular mortality (risk ratios, 0.91; 95%
CI, 0.79-1.05) or myocardial infarction (MI) (risk ratios, 0.90; 95% CI,
0.78-1.04) as compared with OMT alone. However, OMT+PCI was associated
with improved anginal symptoms and a lower risk for revascularization
(risk ratios, 0.52; 95% CI, 0.37-0.75). CONCLUSION(S): In patient
with chronic stable CAD (without left main disease or reduced ejection
fraction), PCI in addition to OMT did not improve mortality or MI compared
to OMT alone. However, this strategy is associated with a lower rate of
revascularization and improved anginal symptoms. Copyright © 2021
Wolters Kluwer Health, Inc. All rights reserved.

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