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<1>
Accession Number
2011659721
Title
Effect of Mitral Valve Gradient After MitraClip on Outcomes in Secondary
Mitral Regurgitation: Results From the COAPT Trial.
Source
JACC: Cardiovascular Interventions. 14 (8) (pp 879-889), 2021. Date of
Publication: 26 Apr 2021.
Author
Halaby R.; Herrmann H.C.; Gertz Z.M.; Lim S.; Kar S.; Lindenfeld J.;
Abraham W.T.; Grayburn P.A.; Naidu S.; Asch F.M.; Weissman N.J.; Zhang Y.;
Mack M.J.; Stone G.W.
Institution
(Halaby, Herrmann, Naidu) Cardiovascular Division, Department of Medicine,
University of Pennsylvania, Philadelphia, PA, United States
(Gertz) Division of Cardiology, Department of Internal Medicine, Virginia
Commonwealth University Medical Center, Richmond, VA, United States
(Lim) Division of Cardiovascular Medicine, University of Virginia Health
System Hospital, University of Virginia, Charlottesville, VA, United
States
(Kar) Interventional Cardiology, Los Robles Regional Medical Center,
Thousand Oaks, CA, United States
(Lindenfeld) Division of Cardiovascular Medicine, Department of Medicine,
Vanderbilt University Medical Center, Nashville, TN, United States
(Abraham) Division of Cardiovascular Medicine, Department of Internal
Medicine, Ohio State University, Columbus, OH, United States
(Grayburn, Mack) Division of Cardiology, Baylor Scott & White Heart and
Vascular Hospital, Dallas, TX, United States
(Asch, Weissman) MedStar Health Research Institute, Washington, DC, United
States
(Zhang, Stone) Cardiovascular Research Foundation, New York, NY, United
States
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The authors sought to evaluate the association between mean
mitral valve gradient (MVG) and clinical outcomes among patients who
underwent MitraClip treatment for secondary mitral regurgitation (SMR) in
the COAPT (Cardiovascular Outcomes Assessment of the MitraClip
Percutaneous Therapy for Heart Failure Patients with Functional Mitral
Regurgitation) trial. <br/>Background(s): In the COAPT trial, patients
with heart failure (HF) and severe SMR who remained symptomatic despite
guideline-directed medical therapy had marked 2-year reductions in
mortality and HF hospitalizations after treatment with MitraClip.
<br/>Method(s): MitraClip-treated patients were divided into quartiles (Q)
based on discharge echocardiographic MVG (n = 250). Endpoints including
all-cause mortality, HF hospitalization, and health status measures at 2
years were compared between quartiles. <br/>Result(s): Mean MVG after
MitraClip was 2.1 +/- 0.4 mm Hg, 3.0 +/- 0.2 mm Hg, 4.2 +/- 0.5 mm Hg, and
7.2 +/- 2.0 mm Hg in Q1 (n = 63), Q2 (n = 61), Q3 (n = 62), and Q4 (n =
64), respectively. There was no difference across quartiles in the 2-year
composite endpoint of all-cause mortality or HF hospitalization (43.2%,
49.2%, 40.6%, and 40.9%, respectively; p = 0.80), nor in improvements in
New York Heart Association functional class, Kansas City Cardiomyopathy
Questionnaire score, or 6-min walk time. Results were similar after
adjustment for baseline clinical and echocardiographic characteristics,
post-procedure MR grade, and number of clips (all-cause mortality or HF
hospitalization Q4 [44.6%] vs. Q1 to Q3 [40.3%]; adjusted hazard ratio:
1.23, 95% confidence interval: 0.60 to 2.51; p = 0.57).
<br/>Conclusion(s): Among HF patients with severe SMR, higher MVGs on
discharge did not adversely affect clinical outcomes following MitraClip.
These findings suggest that in select patients with HF and SMR otherwise
meeting the COAPT inclusion criteria, the benefits of MR reduction may
outweigh the effects of mild-to-moderate mitral stenosis after
MitraClip.<br/>Copyright &#xa9; 2021 American College of Cardiology
Foundation

<2>
Accession Number
2008594026
Title
A Comparison of Volatile Anesthesia and Total Intravenous Anesthesia
(TIVA) Effects on Outcome From Cardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (4) (pp 1096-1105),
2021. Date of Publication: April 2021.
Author
Beverstock J.; Park T.; Alston R.P.; Song C.C.A.; Claxton A.; Sharkey T.;
Hutton S.; Fathers J.; Cawley W.
Institution
(Beverstock, Park, Alston, Song, Claxton, Sharkey, Hutton, Fathers,
Cawley) College of Medicine and Veterinary Medicine, University of
Edinburgh, Edinburgh, United Kingdom
(Alston) Department of Anaesthesia, Critical Care and Pain Medicine, Royal
Infirmary of Edinburgh, Edinburgh, United Kingdom
Publisher
W.B. Saunders
Abstract
Objective: The primary objective of this study was to compare one-year
mortality in patients undergoing cardiac surgery with volatile anesthesia
or total intravenous anesthesia (TIVA). Secondary objectives were to
compare in-hospital and 30-day mortality, postoperative levels of creatine
kinase (CK-MB) and cardiac troponin, and durations of tracheal intubation,
intensive care unit (ICU) and hospital stays. <br/>Design(s): Systematic
review and meta-analysis of randomized controlled trials (RCTs).
<br/>Setting(s): International, multi-institution centers.
<br/>Participant(s): Adults patients undergoing heart surgery.
<br/>Intervention(s): Volatile anesthesia and TIVA. <br/>Measurements and
Main Results: Meta-analysis found no statistically significant difference
between patients receiving TIVA and volatile anesthesia in one-year
mortality (n = 6440, OR = 1.22, 95% CI 0.97 to 1.54, p = 0.09, Z = 1.67,
I² = 0%), troponin (n = 3127, SMD = 0.26, 95% CI -0.01 to 0.52,
p = 0.05, Z = 1.92, I² = 90%) and CK-MB concentration 24h
postoperatively (n = 1214, SMD = 0.10, 95% CI -0.17 to 0.36, unadjusted p
= 0.48, Z = 0.71, I² = 79%), or time to tracheal extubation (n
= 1059, SMD = 0.10, 95% CI -0.28 to 0.49, p = 0.60, Z = 0.53, I2 = 88%).
The durations of ICU stay (n = 2003, SMD = 0.29, 95% CI 0.01 to 0.57, p =
0.04, Z = 2.05, I² = 88%) and hospital stay (n = 1214, SMD =
0.42, 95% CI 0.10 to 0.75, p = 0.01, Z = 2.53, I² = 91%) were
shorter in the volatile anesthetic compared to TIVA group.
<br/>Conclusion(s): No significant differences in mortality (in-hospital,
30-day, 1-year), troponin and CK-MB concentrations 24 h postoperatively,
or time to tracheal extubation were found between patients who had
volatile anesthesia or TIVA. Compared to TIVA, volatile anesthesia was
associated with shorter durations of hospital and ICU stays.<br/>Copyright
&#xa9; 2020 Elsevier Inc.

<3>
Accession Number
2010445353
Title
Continuous postoperative pericardial flushing reduces postoperative
bleeding after coronary artery bypass grafting: A randomized trial.
Source
EClinicalMedicine. 31 (no pagination), 2021. Article Number: 100661. Date
of Publication: January 2021.
Author
Diephuis E.C.; de Borgie C.A.; Zwinderman A.; Winkelman J.A.; van Boven
W.-J.P.; Henriques J.P.S.; Eberl S.; Juffermans N.P.; Schultz M.J.; Klautz
R.J.M.; Koolbergen D.R.
Institution
(Diephuis, Winkelman, van Boven, Klautz, Koolbergen) Department of
Cardiothoracic Surgery, Amsterdam University Medical Center, location AMC,
Meibergdreef 9, Amsterdam, AZ 1105, Netherlands
(Klautz, Koolbergen) Department of Cardiothoracic Surgery, Leiden
University Medical Center (LUMC), Leiden, Netherlands
(Henriques) Department of Cardiology, Amsterdam University Medical Center,
location AMC, Amsterdam, Netherlands
(de Borgie, Zwinderman) Clinical Research Unit, University of Amsterdam,
Amsterdam, Netherlands
(Eberl) Department of anesthesiology, Amsterdam University Medical Center,
location AMC, Amsterdam, Netherlands
(Juffermans, Schultz) Department of Intensive Care, Amsterdam University
Medical Center, location AMC, Amsterdam, Netherlands
(Schultz) Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol
University, Bangkok, Thailand
(Schultz) Nuffield Department of Medicine, University of Oxford, Oxford,
United Kingdom
Publisher
Lancet Publishing Group
Abstract
Background: Prolonged or excessive bleeding after cardiac surgery can lead
to a broad spectrum of secondary complications. One of the underlying
causes is incomplete wound drainage, with subsequent accumulation of blood
and clots in the pericardium. We developed the continuous postoperative
pericardial flushing (CPPF) therapy to improve wound drainage and reduce
postoperative blood loss and bleeding-related complications after cardiac
surgery. This study compared CPPF to standard care in patients after
coronary artery bypass grafting (CABG). <br/>Method(s): This is a single
center, open label, randomized trial that enrolled patients at the
Amsterdam UMC, location AMC, Amsterdam, the Netherlands. The study was
registered at the 'Netherlands Trial Register', study identifier NTR5200
[1]. Adults undergoing CABG were randomly assigned to receive CPPF therapy
or standard care, participants and investigators were not masked to group
assignment. The primary end point was postoperative blood loss in the
first 12-hours after surgery. <br/>Finding(s): Between the January 15,
2014 and the March 13, 2017, 169 patients were enrolled and assigned to
CPPF therapy (study group; n = 83) or standard care (control group; n =
86). CPPF reduced postoperative blood loss when compared to standard care
(median differences -385 ml, reduction 76% p=<=0.001), with the remark
that these results are overestimated due to a measurement error in part of
the study group. None of patients in the study group required reoperation
for non-surgical bleeding versus 3 (4%, 95% CI -0.4% to 7.0%) in the
control group. None of the patients in the study group suffered from
cardiac tamponade, versus 3 (4%, 95% CI -0,4% to 7.0%) in the control
group. The incremental cost-effectiveness ratio was 116.513 (95% bootstrap
CI -882.068 to +897.278). <br/>Interpretation(s): The use of CPPF therapy
after CABG seems to reduce bleeding and bleeding related complications.
With comparable costs and no improvement in Qualty of Life (QoL), cost
consideration for the implementation of CPPF is not relevant. None of the
patients in the study group required re-interventions for non-surgical
bleeding or acute cardiac tamponade, which underlines the proof of concept
of this novel therapy. <br/>Funding(s): This study was funded by ZonMw,
the Netherlands organization for health research and development (project
837001405).<br/>Copyright &#xa9; 2020 The Authors

<4>
Accession Number
2011343153
Title
The direct comparison of inhaled versus intravenous levosimendan in
children with pulmonary hypertension undergoing on-cardiopulmonary bypass
cardiac surgery: A randomized, controlled, non-inferiority study.
Source
Journal of Clinical Anesthesia. 71 (no pagination), 2021. Article Number:
110231. Date of Publication: August 2021.
Author
Abdelbaser I.; Mageed N.A.; Elfayoumy S.I.; Elgamal M.-A.F.; Elmorsy M.M.;
Taman H.I.
Institution
(Abdelbaser, Mageed, Elmorsy, Taman) Department of Anesthesia and Surgical
Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Elfayoumy) Department of Anesthesia and Surgical Intensive Care, Faculty
of Medicine, Portsaid University, Portsaid, Egypt
(Elgamal) Department of Cardiac Surgery, Faculty of Medicine, Mansoura
University, Mansoura, Egypt
Publisher
Elsevier Inc.
Abstract
Study objective: Pulmonary arterial hypertension is commonly seen in
children with left to right intracardiac shunts and affects the outcomes
of cardiac surgery. Our study aimed to compare the efficacy of inhaled
levosimendan (LS) versus intravenous LS in reducing elevated pulmonary
artery pressure (PAP) in children scheduled for cardiac surgery.
<br/>Design(s): Non-inferiority, prospective, randomized, blinded,
controlled study. <br/>Setting(s): Operative room and intensive care unit
(ICU), institutional children's hospital of Mansoura Faculty of Medicine,
Egypt. <br/>Patient(s): 50 patients of either sex, aged 1 to 5 years
undergoing surgical repair of intracardiac left to right shunt complicated
by pulmonary hypertension were recruited for the study.
<br/>Intervention(s): In the intravenous LS group, patients received
intravenous infusion of LS a rate of 0.1 mug/kg/min and in the inhaled LS
group, LS (36 mug/kg/6 h) was delivered by nebulization. Measurements: The
primary endpoint was systolic PAP, while the secondary endpoints were the
heart rate, mean arterial blood pressure, dose of norepinephrine, time to
extubation and ICU length of stay. <br/>Main Result(s): Both intravenous
and inhaled routes of LS similarly reduced the high systolic PAP over all
time points of measurement and intravenous LS was associated with higher
heart rate, lower arterial pressure and the need for a higher dose of
norepinephrine than the inhaled LS. <br/>Conclusion(s): Inhalation of LS
is non-inferior to intravenous LS in reducing high PAP in children who
underwent on-pump cardiac surgery and it is associated with less
tachycardia and hypotension with reduced need for vasoactive
drugs.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<5>
Accession Number
2006726711
Title
Ultrasound-guided serratus plane block as an effective adjunct to systemic
analgesia in four dogs undergoing thoracotomy.
Source
Open Veterinary Journal. 10 (4) (pp 407-411), 2020. Date of Publication:
2020.
Author
Asorey I.; Sambugaro B.; Bhalla R.J.; Drozdzynska M.
Institution
(Asorey, Sambugaro, Bhalla, Drozdzynska) Dick White Referrals, Station
Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, United Kingdom
Publisher
Faculty of Veterinary Medicine, University of Tripoli
Abstract
Background: Ultrasound-guided serratus plane block (UGSPB) is a
loco-regional anesthesia technique designed to desensitize the thoracic
wall. It is a compartmental block, where local anesthetic is delivered to
the fascial, inter-muscular plane. Since its original description in
humans, two cadaveric veterinary studies, redefining the technique, have
been performed. Taking into account the successful use of the UGSPB in
human medicine, we employed the veterinary description to perform this
block in four dogs undergoing thoracotomy. The case series described below
aims to share our experience of the clinical application of this new
loco-regional anesthesia technique in dogs. Case Description: Four dogs,
with different underlying medical conditions underwent cranial lateral
thoracotomy. The analgesia protocol consisted of intravenous methadone and
UGSPB performed half an hour before the beginning of the procedure. The
cardiovascular system was closely monitored for any signs of nociception.
Fentanyl, although available as rescue analgesia, was not required in any
of these cases as no signs of nociception were present.
<br/>Conclusion(s): To the authors' knowledge, this is the first
veterinary clinical report using the UGSPB as a part of a multimodal
analgesia protocol in dogs undergoing thoracotomy. Based on this
observation, UGSPB has the potential to prevent nociception and reduce the
intraoperative opioid requirements in dogs undergoing thoracotomy. A
prospective randomized clinical trial is required to confirm these
promising results.<br/>Copyright &#xa9; 2020, Faculty of Veterinary
Medicine, University of Tripoli. All rights reserved.

<6>
Accession Number
2005164124
Title
Effects of l-carnitine on serum lactate and cardiac complications in
patients with heart failure undergoing coronary artery bypass grafting: A
randomized clinical trial.
Source
Iranian Heart Journal. 21 (4) (pp 14-24), 2020. Date of Publication:
Autumn 2020.
Author
Jahangirifard A.; Farzanegan B.; Fani K.; Kermanshahi T.Z.; Faritus Z.;
Shojaeifard M.; Rad N.S.
Institution
(Jahangirifard) Department of Anesthesiology, Masih Daneshvari Hospital,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Farzanegan, Fani) Department of Anesthesiology, Modarres Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Kermanshahi) Department of Anesthesiology, Shohadaye Tajrish Hospital,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Faritus) Rajaie Cardiovascular Medical and Research Center, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Shojaeifard, Rad) Echocardiography Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: The effects of L-carnitine on serum lactate and its metabolism
remain uncertain, particularly in candidates for revascularization with a
high likelihood of a postoperative rise in lactate levels. The present
study aimed to assess the effects of L-carnitine on lactate levels after
coronary artery bypass graft surgery (CABG) in patients with grade I heart
failure. <br/>Method(s): in this randomized clinical trial, 64 consecutive
patients suffering from mild heart failure (grade I) who were candidated
for coronary revascularization were randomly divided into 2 groups (32
patients in each group) receiving L-carnitine (3 g orally 2 hours before
surgery) or a placebo for the same duration before surgery. Postoperative
adverse events, as well as the trend of the change in the levels of serum
lactate, creatinine, and hemoglobin, within 24 hours after surgery were
assessed. <br/>Result(s): No difference was revealed between the 2 groups
in terms of serum lactate levels before surgery (1.51 +/- 0.79 in the
intervention group vs 1.35 +/- 0.43 in the control group; P = 0.33),
during intra-aortic balloon pumping (2.27 +/- 1.28 in the intervention
group vs 2.70 +/- 1.42 in the control group; P = 0.20), and also after
separating the pump (2.96 +/- 1.61 in the intervention group vs 2.56 +/-
0.87 in the control group; P = 0.22). No difference was also observed
concerning postoperative complications, including atrial fibrillation (P =
0.42), delirium (P = 0.99), agitation (P = 0.88), intra-aortic balloon
pump insertion (P = 0.99), atelectasis (P = 0.98), and respiratory
distress (P = 0.99). <br/>Conclusion(s): Administrating L-carnitine had no
protective effects on the rise in postoperative serum lactate levels
following CABG in our patients with low-grade heart failure.<br/>Copyright
&#xa9; 2020, Iranian Heart Association. All rights reserved.

<7>
Accession Number
2011712226
Title
Application of situational adaptation training combined with childlike
nursing for children undergoing tonsillectomy or adenoidectomy.
Source
International Journal of Pediatric Otorhinolaryngology. 145 (no
pagination), 2021. Article Number: 110707. Date of Publication: June 2021.
Author
Li X.; Qiao X.-F.; Sun L.; Wang G.-P.; Bai Y.-H.
Institution
(Li) Department of Surgery, Children's Hospital of Shanxi Province,
Taiyuan 030001, China
(Qiao, Sun, Wang, Bai) Department of Otorhinolaryngology, Shanxi
Provincial People's Hospital Affiliated to Shanxi Medical University,
Taiyuan 030001, China
Publisher
Elsevier Ireland Ltd
Abstract
Objective: This study aimed to investigate the clinical effect of
situational adaptation training combined with child-friendly nursing in
relieving the preoperative anxiety of children undergoing tonsillectomy or
adenoidectomy. <br/>Method(s): A total of 160 children undergoing
tonsillectomy or adenoidectomy were randomly divided into two groups: a
control group and a test group. In addition to the routine operating room
nursing in the control group, children in the test group underwent
situational adaptation training one day before surgery and child-friendly
nursing on the day of surgery. The heart rates and differences in average
dynamic pressure were compared between groups, both preoperatively and
during anesthesia induction. The cooperativeness with anesthesia was also
assessed. The anxiety states of children and their family members after
the interventions were scored using the anxiety visual analog scale (VAS).
The postoperative satisfaction with nursing was assessed and compared
between groups. <br/>Result(s): The heart rates, differences in average
dynamic pressure, cooperativeness with anesthesia, and VAS scores were
significantly lower in the test group than in the control group. The VAS
scores of family members were significantly lower in the test group than
in the control group. The satisfaction degrees with nursing were
significantly higher in the test group than in the control group.
<br/>Conclusion(s): Situational adaptation training combined with
child-friendly nursing can significantly relieve the preoperative anxiety
of children undergoing tonsillectomy or adenoidectomy and their family
members. This treatment improves child cooperativeness during therapy,
significantly reduces the amplitude of physiological stress response
during surgery, and increases the satisfaction with nursing. Thus,
situational adaptation training combined with child-friendly nursing is
worthy of application in clinics.<br/>Copyright &#xa9; 2021

<8>
Accession Number
633533102
Title
Positive expiratory pressure in postoperative cardiac patients in
intensive care: A randomized controlled trial.
Source
Clinical rehabilitation. 35 (5) (pp 681-691), 2021. Date of Publication:
01 May 2021.
Author
Pieczkoski S.M.; de Oliveira A.L.; Haeffner M.P.; Azambuja A.C.M.; Sbruzzi
G.
Institution
(Pieczkoski, Azambuja, Sbruzzi) Postgraduate Program in Human Movement
Sciences, Universidade Federal do Rio Grande do Sul, RS, Porto Alegre,
Brazil
(de Oliveira, Sbruzzi) Physiotherapy Course, Universidade Federal do Rio
Grande do Sul, RS, Porto Alegre, Brazil
(Haeffner, Sbruzzi) Hospital de Clinicas de Porto Alegre, RS, Porto
Alegre, Brazil
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate effectiveness of positive expiratory pressure
blow-bottle device compared to expiratory positive airway pressure and
conventional physiotherapy on pulmonary function in postoperative cardiac
surgery patients in intensive care unit. DESIGN: A randomized controlled
trial. SETTINGS: Tertiary care. SUBJECTS: 48 patients (16 in each group;
aged 64.5+/-9.1years, 38 male) submitted to cardiac surgery.
INTERVENTIONS: Patients were randomized into conventional physiotherapy
(G1), positive expiratory pressure blow-bottle device (G2) or expiratory
positive airway pressure, both associated with conventional physiotherapy
(G3). G2 and G3performed three sets of 10 repetitions in each session for
each technique. MAIN MEASURES: Pulmonary function (primary); respiratory
muscle strength, radiological changes, pulmonary complications, length of
intensive care unit and hospital stay (secondary) assessed preoperatively
and on the 3rd postoperative day. <br/>RESULT(S): Pulmonary function
(except for forced expiratory volume in one second/ forced vital capacity
% predicted) and respiratory muscle strength showed significant reduction
from the preoperative to the 3rd postoperative in all groups (P<0.001),
with no difference between groups (P>0.05). Regarding radiological
changes, length of intensive care unit stay and length of hospital stay,
there was no significant difference between groups (P>0.05).
<br/>CONCLUSION(S): Both positive expiratory pressure techniques
associated with conventional physiotherapy were similar, but there was no
difference regarding the use of positive expiratory pressure compared to
conventional physiotherapy. CLINICAL TRIAL REGISTRATION NUMBER:
NCT03639974.https://clinicaltrials.gov/ct2/show/NCT03639974.

<9>
Accession Number
2010427472
Title
MAGGIC, STS, and EuroSCORE II Risk Score Comparison After Aortic and
Mitral Valve Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (6) (pp 1806-1812),
2021. Date of Publication: June 2021.
Author
Zhuo D.X.; Bilchick K.C.; Shah K.P.; Mehta N.K.; Mwansa H.; Nkanza-Kabaso
K.; Kwon Y.; Breathett K.K.; Hilton-Buchholz E.J.; Mazimba S.
Institution
(Zhuo, Bilchick, Shah, Mehta, Mazimba) University of Virginia Health
System, Department of Medicine, Division of Cardiovascular Medicine,
Charlottesville, VA, United States
(Mwansa) OSF Saint Francis Medical Center, Peoria, IL, United States
(Nkanza-Kabaso) University of Cape Town, Groote Schuur Hospital, Cape
Town, South Africa
(Kwon) University of Washington Medical Center, University of Washington
Division of Cardiology, Harborview Medical Center, Seattle, WA, United
States
(Breathett) University of Arizona College of Medicine, Division of
Cardiology/Sarver Heart Center, Tucson, AZ, United States
(Hilton-Buchholz) University of Virginia Health System, Department of
Anesthesiology, Charlottesville, VA, United States
Publisher
W.B. Saunders
Abstract
Objectives: To compare the Meta-Analysis Global Group in Chronic Heart
Failure (MAGGIC) risk score with the established Society of Thoracic
Surgeons (STS) and EuroSCORE II risk prediction models regarding mortality
discrimination after aortic and mitral valve surgery. <br/>Design(s):
Retrospective cohort study. <br/>Setting(s): Single tertiary academic
medical center. <br/>Participant(s): A total of 259 patients who underwent
open aortic valve replacement or open mitral valve repair/replacement from
2009-2014. <br/>Intervention(s): Retrospective chart review.
<br/>Measurements and Main Results: MAGGIC, STS, and EuroSCORE II risk
scores for each patient were studied using binary logistic regression and
receiver operating characteristic analysis for the primary endpoint of
one-year mortality and secondary endpoint of 30-day mortality. One-year
mortality C-statistics were similar across risk scores (STS 0.709, 95%
confidence interval [CI] 0.578-0.841; MAGGIC 0.673, 95% CI 0.547-0.799;
EuroSCORE II 0.642, 95% CI 0.521-0.762; p = 0.56 between STS and MAGGIC; p
= 0.20 between STS and EuroSCORE II; and p = 0.69 between MAGGIC and
EuroSCORE II). Thirty-day mortality C-statistics also were similar between
STS (0.797, 95% CI 0.655-0.939; p < 0.0001 v null hypothesis), MAGGIC
(0.721, 95% CI 0.581-0.860; p = 0.33 v STS), and EuroSCORE II (0.688, 95%
CI 0.557-0.818; p = 0.06 v STS; p = 0.68 v MAGGIC). <br/>Conclusion(s):
The MAGGIC risk score performs similarly to STS and EuroSCORE II risk
models in mortality discrimination after aortic and mitral valve surgery,
albeit in a small sample size. This finding has important implications in
establishing MAGGIC as a viable prognostic model in this population
subset, with fewer variables and ease of use representing key advantages
over STS and EuroSCORE II.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<10>
Accession Number
365093246
Title
Review: Perioperative statins reduce perioperative MI and AF in
statin-naive patients.
Source
Annals of Internal Medicine. 156 (12) (pp JC6-JC2), 2012. Date of
Publication: 19 Jun 2012.
Author
Chopra V.
Institution
(Chopra) University of Michigan Health System, Ann Arbor, MI, United
States
Publisher
American College of Physicians
Abstract
Question: Does perioperative statin treatment improve clinical outcomes in
adults having surgery and not using long-term statins? Review scope
Included studies evaluated perioperative statin treatment in patients >=
18 years of age who were having surgery and were not maintained on
long-term statin treatment before surgery (statinnaive). Exclusion
criteria included percutaneous coronary interventions and cardioversions.
Studies had to report >= 1 of the following outcomes: perioperative death,
myocardial infarction (MI), atrial fibrillation (AF), length of hospital
stay, or length of intensive care unit (ICU) stay. Review methods MEDLINE,
EMBASE/Excerpta Medica, Biosis, Cochrane Central Register of Controlled
Trials, Conference Proceedings Index, Web sites (ClinicalTrials.gov,
International Federation of Pharmaceutical Manufacturers, and
Pharmaceutical Research and Manufacturers of America), and reference lists
were searched to April 2011 for published and unpublished randomized
controlled trials (RCTs). Experts and study authors were contacted. 15
RCTs (n = 2292, 59% to 90% men) met inclusion criteria. Studies enrolled
patients having cardiac surgery (11 RCTs, n = 1056), noncardiac surgery (2
RCTs, n = 1030), and vascular surgery (2 RCTs, n = 206). 14 studies used a
placebo control, and 1 study compared high-dose with low-dose
atorvastatin. Statins assessed were atorvastatin (8 RCTs, n = 852),
fluvastatin (3 RCTS, n = 1076), simvastatin (2 RCTs, n = 121),
rosuvastatin (1 RCT, n = 200), and pravastatin (1 RCT, n = 43). 7 studies
were at low risk for bias (Cochrane Statistical Methods Group criteria).
Main results Compared with controls, perioperative statins reduced risk
for MI in patients having any surgery and AF in patients having cardiac
surgery; groups did not differ for mortality in patients having any
surgery (Table). Perioperative statins reduced length of hospital stay,
but not length of ICU stay, more than controls (Table). Conclusion
Perioperative statins reduce risk for myocardial infarction and atrial
fibrillation in statin-naIve patients. &#xa9; 2012 American College of
Physicians.

<11>
Accession Number
2011035457
Title
Bovine pericardial versus porcine stented replacement mitral valves: Early
hemodynamic performance and clinical results of a randomized comparison of
the Perimount and the Mosaic valves.
Source
Journal of Thoracic Disease. 13 (1) (pp 262-269), 2021. Date of
Publication: January 2021.
Author
Fu B.; Liu X.; Wei R.; Chen Q.; Guo Z.; Jiang N.
Institution
(Fu, Liu, Wei, Chen, Guo, Jiang) Department of Cardiovascular Surgery,
Tianjin Chest Hospital, Tianjin, China
(Fu, Liu, Wei) Tianjin Medical University, Tianjin, China
Publisher
AME Publishing Company
Abstract
Background: To compare the hemodynamic and clinical outcomes following
mitral valve replacement with the Perimount valve with those of the Mosaic
valve. <br/>Method(s): A total of 145 consecutive patients with rheumatic
heart valve disease who underwent single bioprosthetic mitral valve
replacement were randomized to receive either the Perimount (n=72) valve
or the Mosaic bioprosthesis (n=73). The mean age of patients was 72.1
years (range, 58-89 years) with a sex distribution of 55.2% female and
44.8% male. Patients underwent follow up transthoracic echocardiography at
3 months and 1 year postoperatively. We compared demographics,
preoperative clinical data, operative data, hemodynamic profiles, and
clinical outcomes. <br/>Result(s): The cross-clamp time was similar, with
50.7+/-15.3 minutes for the Perimount and 50.7+/-21.8 minutes for the
Mosaic bioprosthesis. The total bypass time was also similar, with
91.3+/-25.7 minutes for the Perimount and 87.8+/-25.6 minutes for the
Mosaic valve. The peak and mean pressure gradients were lower in the
Perimount group for all valve sizes and the difference was statistically
significant at 1 year. The effective orifice area (EOA) was slightly
larger in the Perimount valve (1.98+/-0.21 vs. 1.89+/-0.71 cm2, P=0.538)
postoperatively, but there was no significant difference at 1 year. There
were no differences in preoperative or postoperative left atrium diameter
(LAD), left ventricular diastolic diameter (LVDD), left ventricular
systolic diameter (LVSD), left ventricular ejection fraction (LVEF),
pulmonary artery pressure (PAP). The mortality and major complications
rate were similar between the two groups. <br/>Conclusion(s): The
Perimount prostheses is superior to the Mosaic prostheses after mitral
valve replacement, achieving statistically significant lower gradients and
larger EOA when compared on the basis of manufacturer-labeled valve sizes.
Both valves appear to provide satisfactory clinical results.<br/>Copyright
&#xa9; 2021 Journal of Thoracic Disease.

<12>
Accession Number
2010974301
Title
Bariatric Surgery in Patients with Obesity and Ventricular Assist Devices
Considered for Heart Transplantation: Systematic Review and Individual
Participant Data Meta-analysis.
Source
Journal of Cardiac Failure. 27 (3) (pp 338-348), 2021. Date of
Publication: March 2021.
Author
daSilva-deAbreu A.; ALHAFEZ B.A.; CURBELO-PENA Y.; LAVIE C.J.; VENTURA
H.O.; LORO-FERRER J.F.; MANDRAS S.A.
Institution
(daSilva-deAbreu, LAVIE, VENTURA, MANDRAS) John Ochsner Heart and Vascular
Institute, Ochsner Clinic Foundation, New Orleans, LA, United States
(daSilva-deAbreu, LAVIE, VENTURA, MANDRAS) The University of Queensland
Ochsner Clinical School, New Orleans, LA, United States
(daSilva-deAbreu, LORO-FERRER) Doctoral School, Universidad de Las Palmas
de Gran Canaria, Las Palmas, Spain
(ALHAFEZ) Department of Internal Medicine, The Ohio State University,
Columbus, OH, United States
(CURBELO-PENA) Service of General Surgery, Consorci Sanitari de l'Alt
Penedes i Garraf, Barcelona, Spain
Publisher
Elsevier B.V.
Abstract
Background: Class II obesity (body mass index BMI >=35 kg/m²)
is a contraindication to heart transplantation (HT). Although few
single-center studies (case reports/series and small cohorts) have
reported promising outcomes of bariatric surgery (BS) in patients with
obesity and ventricular assist devices, low sample sizes have made their
analysis and interpretation challenging. <br/>Methods and Results: We
conducted a systematic search in ClinicalTrials.gov, Cochrane, Embase,
PubMed, Google Scholar, and most relevant bariatric and heart failure
journals. We extracted baseline and outcome individual participant data
for every ventricular assist device patient undergoing BS with reported
postoperative BMI and their respective timepoints when BMI data were
measured. Fourteen references with 29 patients were included. The mean age
was 41.9 +/- 12.2 years, 82.8% underwent laparoscopic sleeve gastrectomy,
and 39.3% had reported perioperative adverse events. The mean pre-BS BMI
was 45.5 +/- 6.6 kg/m² and decreased significantly during
follow-up (rho -0.671; P< .00001). Among 23 patients with documented
listing status, 78.3% were listed for HT. Thirteen of 28 patients (46.4%)
underwent HT at 14.4 +/- 7.0 months. There were no reported deaths for the
HT-free 1-year period. Median follow-up was 24 months (interquartile
range, 12-30 months). Twenty-two of 28 patients (78.6%) achieved the
composite outcome (BMI of<35 kg/m²/HT/listing for HT/myocardial
recovery) at 11 months (interquartile range, 3-17 months). Patients with a
BMI<45 kg/m² had a higher chance of achieving the composite
outcome (P< .003). <br/>Conclusion(s): BS may help patients with obesity
and ventricular assist devices to lose a significant amount of weight and
improve their candidacy for HT or even achieve myocardial
recovery.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<13>
Accession Number
2006096824
Title
Comparison of simple versus complex stenting in patients with true distal
left main bifurcation lesions.
Source
Catheterization and Cardiovascular Interventions. 97 (5) (pp 776-785),
2021. Date of Publication: 01 Apr 2021.
Author
Lee C.H.; Ahn J.-M.; Kang D.-Y.; Han M.; Park H.; Lee P.H.; Lee S.-W.;
Park S.-W.; Park D.-W.; Park S.-J.
Institution
(Lee) Division of Cardiology, Department of Internal Medicine, Keimyung
University Dongsan Hospital, Daegu, South Korea
(Ahn, Kang, Park, Lee, Lee, Park, Park, Park) Department of Cardiology,
Asan Medical Center, University of Ulsan College of Medicine, Seoul, South
Korea
(Han) Division of Biostatistics, Center for Medical Research and
Information, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Distal left main (LM) bifurcation disease is one of the most
challenging lesion subsets for percutaneous coronary intervention (PCI)
and optimal stenting strategy for such complex lesions is still debated.
This study aimed to compare clinical outcomes following single versus dual
stenting for true distal LM bifurcation lesions. <br/>Method(s): Patients
with true distal LM bifurcation lesions (type 1,1,1 or 0,1,1: both left
anterior descending and circumflex artery >2.5 mm diameter) receiving PCI
with drug-eluting stents (DES) from two large clinical registries were
evaluated. The primary outcome was target-lesion failure (TLF), defined as
a composite of cardiac death, target-vessel myocardial infarction (MI), or
target-lesion revascularization (TLR). Outcomes were compared with the use
of propensity scores and inverse probability-weighting adjustment to
reduce treatment selection bias. <br/>Result(s): Among 1,002 patients
undergoing true distal LM PCI, 440 (43.9%) and 562 (56.1%) were treated
with single and dual stents, respectively. The TLF rates at 3 year was
20.3% in the single-stent group and 24.1% in the dual-stenting group
(log-rank p = 0.18). The adjusted risk for TLF did not differ
significantly between two groups (hazard ratio [HR] with dual-stent vs.
single-stent: 1.27, 95% confidence interval [CI]: 0.95-1.71). The adjusted
risks for death, MI, repeat revascularization, or stent thrombosis were
also similar between the single- and dual-stenting groups.
<br/>Conclusion(s): In patients undergoing PCI for true distal LM disease,
single- and dual-stent strategies showed a similar adjusted risk of TLF at
3 years. Our findings should be confirmed or refuted through large,
randomized clinical trials.<br/>Copyright &#xa9; 2021 Wiley Periodicals
LLC

<14>
Accession Number
2010123141
Title
Effect of sevoflurane on the inflammatory response during cardiopulmonary
bypass in cardiac surgery: the study protocol for a randomized controlled
trial.
Source
Trials. 22 (1) (no pagination), 2021. Article Number: 25. Date of
Publication: December 2021.
Author
Cardoso T.A.A.M.; Kunst G.; Neto C.N.; de Ribamar Costa Junior J.; Silva
C.G.S.; Bastos G.M.; Borges J.B.; Hirata M.H.
Institution
(Cardoso, Neto, Silva) Department of Surgery and Anesthesia, Dante
Pazzanese Institute of Cardiology, Captain Pinto Ferreira Street, 62, ap
92, Jardim Paulista, Sao Paulo 01423-020, Brazil
(Kunst) Department of Anaesthetics, Intensive Care Medicine and Pain
Therapy, King's College Hospital NHS Foundation Trust, Denmark Hill,
London, United Kingdom
(de Ribamar Costa Junior) Department of Interventional Cardiology, Dante
Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Bastos, Borges) Molecular Cardiology Research Laboratory, Dante Pazzanese
Institute of Cardiology, Sao Paulo, Brazil
(Hirata) Department of Clinical and Toxicological Analysis, School of
Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
Publisher
BioMed Central Ltd
Abstract
Background: Recent experimental evidence shows that sevoflurane can reduce
the inflammatory response during cardiac surgery with cardiopulmonary
bypass. However, this observation so far has not been assessed in an
adequately powered randomized controlled trial. <br/>Method(s): We plan to
include one hundred patients undergoing elective coronary artery bypass
graft with cardiopulmonary bypass who will be randomized to receive either
volatile anesthetics during cardiopulmonary bypass or total intravenous
anesthesia. The primary endpoint of the study is to assess the
inflammatory response during cardiopulmonary bypass by measuring
PMN-elastase serum levels. Secondary endpoints include serum levels of
other pro-inflammatory markers (IL-1beta, IL-6, IL-8, TNFalpha),
anti-inflammatory cytokines (TGFbeta and IL-10), and microRNA expression
in peripheral blood to achieve possible epigenetic mechanisms in this
process. In addition clinical endpoints such as presence of major
complications in the postoperative period and length of hospital and
intensive care unit stay will be assessed. <br/>Discussion(s): The trial
may determine whether adding volatile anesthetic during cardiopulmonary
bypass will attenuate the inflammatory response. Trial registration:
ClinicalTrials.gov NCT02672345. Registered on February 2016 and updated on
June 2020.<br/>Copyright &#xa9; 2021, The Author(s).

<15>
Accession Number
2007948573
Title
Comparison of acute kidney injury with radial vs. femoral access for
patients undergoing coronary catheterization: An updated meta-analysis of
46,816 patients.
Source
Experimental and Therapeutic Medicine. 20 (5) (no pagination), 2020.
Article Number: 42. Date of Publication: November 2020.
Author
Wang C.; Chen W.; Yu M.; Yang P.
Institution
(Wang, Chen, Yu, Yang) Department of Cardiology, China-Japan Union
Hospital of Jilin University, Jilin Provincial Precision Medicine
KeyLaboratory for Cardiovascular Genetic Diagnosis, Jilin Provincial
Engineering Laboratory for Endothelial Function, Genetic Diagnosis of
Cardiovascular Disease, Jilin Provincial Molecular Biology Research Center
for Precision Medicine ofMajor Cardiovascular Disease, Jilin Provincial
Cardiovascular Research Institute, Changchun, Jilin 130028, China
Publisher
Spandidos Publications
Abstract
Trans-radial access for percutaneous coronary intervention or angiography
has gained popularity amongst interventional cardiologists. Radial access
is also thought to reduce the incidence of acute kidney injury (AKI) in
the immediate post-operative period. The purpose of the present study was
to perform a comprehensive updated systematic review and meta-analysis
comparing the incidence of AKI following the radial vs. femoral route of
coronary catheteriza- tion. An electronic literature search of the PubMed,
BioMed Central, Scopus, Cochrane Central Register of Controlled Trials and
Google Scholar databases up to 1st January 2020 was performed. A total of
14 studies were included, 2 of which were randomized controlled trials
(RCTs), and 6 studies utilized propensity score matching. Comparison of
the data of 21,479 patients in the radial group and 25,337 patients in the
femoral group indicated a reduced incidence of AKI with the radial route
[odds ratio (OR):0.66, 95% CI: 0.54-0.81, P<0.0001, I²=74%].
Similar results were obtained with sub-group analyses for RCTs (OR: 0.87,
95% CI: 0.77-0.98, P=0.02, I²=0%), retrospective studies (OR:
0.57, 95% CI: 0.36-0.90, P=0.02, I²=86%) and propensity
score-matched studies (OR: 0.63, 95% CI: 0.48-0.83, P=0.0009,
I²=45%). Multivariable-adjusted ORs of AKI for the radial vs.
femoral route were extracted from non-RCTs and pooled for a meta-analysis,
which also demonstrated similar results (OR: 0.70, 95% CI: 0.57-0.88,
P=0.002, I²=70%). Within the limitations of the study, the
present results indicate that, as compared to femoral access, the use of
trans-radial access for coronary catheterization is associated with a
significantly reduced incidence of AKI. A reduction of AKI by ~34% may be
expected with the use of radial access.<br/>Copyright &#xa9; 2020
Spandidos Publications. All rights reserved.

<16>
Accession Number
2005155426
Title
Comparing the myocardial protection of custodiol alone and in combination
with modified del nido in patients undergoing cardiac surgery; a
double-blind randomized clinical trial.
Source
International Cardiovascular Research Journal. 14 (3) (pp 95-101), 2020.
Article Number: e104728. Date of Publication: September 2020.
Author
Reihanifard N.; Nemati M.H.; Akhlagh S.H.; Abadi A.M.K.H.
Institution
(Reihanifard) Shiraz University of Medical Sciences, Shiraz, IR, Iran,
Islamic Republic of
(Nemati) Department of Surgery, Section of Cardiac Surgery, Shiraz
University of Medical Sciences, Shiraz, IR, Iran, Islamic Republic of
(Akhlagh) Anesthesiology and Critical Care Research Center, Shiraz
University of Medical Sciences, Shiraz, IR, Iran, Islamic Republic of
(Abadi) Clinical Research Development Center of Nemazee Hospital, Shiraz
University of Medical Sciences, Shiraz, IR, Iran, Islamic Republic of
Publisher
Iranian Cardiovascular Research Journal
Abstract
Background: Coronary Artery Bypass Grafting (CABG) has been considered as
the complete treatment of Ischemic Heart Disease (IHD). Cardioplegic
(extracellular and intracellular) solutions have been suggested to reduce
the cross-clamping duration. It was hypothesized that the combination of
the two intra-and extra-cellular solutions, namely Del Nido (DN) and
custodiol, could result in beneficiary clinical and economic outcomes.
<br/>Objective(s): The present study aimed to compare the myocardial
protection of custodiol alone and in combination with modified DN in
patients undergoing cardiac surgery. <br/>Method(s): This prospective,
double-blind, clinical trial was conducted on 50 patients undergoing redo
CABG surgery. Aortic clamping was performed using custodiol (20 cc/kg) in
group A. In group B, custodiol 1000 cc was combined with 15 cc/kg cold DN
and was injected using the antigrade method. The two groups were compared
regarding the levels of Creatinine Kinase-MB (CK-MB) and troponin at the
time of anesthesia induction and two hours and 48 hours after the surgery,
intraoperative and postoperative variables, and 48-hour mortality rate.
<br/>Result(s): The results showed similar CK-MB levels in the two groups
at the induction time (P = 0.12). However, a significant difference was
observed between the two groups in this regard two hours (P = 0.018) and
48 hours after the surgery (P = 0.021). Within-group comparisons revealed
significant changes in CK-MB and troponin levels in both groups, with a
steep increase from induction until two hours after the surgery and a
decrease from two hours until 48 hours after the surgery (P < 0.001). The
results indicated no significant difference between the two groups
regarding CK-MB and troponin levels, frequency of intraoperative and
postoperative dysrhythmia, need for intraoperative defibrillation,
ischemic time, and 48-hour mortality rate (P > 0.05). However, the costs
were two-folds higher in group A than in group B (P < 0.001).
<br/>Conclusion(s): The present study findings showed that the selected
solution was appropriate in terms of clinical aspects for the patients
undergoing CABG surgery with long surgical duration or low Ejection
Fraction (EF) and reduced the costs to half. Considering the significant
difference in the CK-MB level and the lower troponin level in the combined
group (not statistically significant), further studies are required to
confirm the clinical priority of the combined solution.<br/>Copyright
&#xa9; 2020, Iranian Cardiovascular Research Journal. All rights reserved.

<17>
Accession Number
633663525
Title
Congenital diaphragmatic hernia repair in patients requiring
extracorporeal membrane oxygenation: are outcomes better with repair on
ECMO or after decannulation?.
Source
Interactive cardiovascular and thoracic surgery. 32 (4) (pp 632-637),
2021. Date of Publication: 19 Apr 2021.
Author
Low Z.K.; Tan A.S.M.; Nakao M.; Yap K.H.
Institution
(Low, Tan, Nakao, Yap) Department of Cardio-thoracic Surgery, KK Women's
and Children's Hospital, Singapore
Publisher
NLM (Medline)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was whether congenital
diaphragmatic hernia repair outcomes are better before or after
decannulation in infants requiring extracorporeal membrane oxygenation
(ECMO). A total of 884 papers were found using the reported search, of
which 9 represented the best evidence to answer the clinical question. The
authors, journal, date and country of publication, patient group studied,
study type, relevant outcomes and results of these papers are tabulated.
We conclude that infants with congenital diaphragmatic hernia requiring
ECMO should undergo a trial of weaning and aim for post-decannulation
repair, as this has been associated with improved survival, shorter ECMO
duration and fewer bleeding complications. However, if weaning of ECMO is
unsuccessful, the patient should ideally undergo early on-ECMO repair
(within 72h of cannulation), which has been associated with improved
survival, less bleeding, shorter ECMO duration and fewer circuit changes
compared to late on-ECMO repair. Anticoagulation protocols including
perioperative administration of aminocaproic acid or tranexamic acid, as
well as close perioperative monitoring of coagulation parameters have been
associated with reduced bleeding risk with on-ECMO repairs.<br/>Copyright
&#xa9; The Author(s) 2020. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<18>
Accession Number
630361971
Title
Discharge Education Intervention to Reduce Anxiety and Depression in
Cardiac Surgery Patients: A Randomized Controlled Study.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. 35 (2) (pp 185-192), 2020. Date of
Publication: 01 Apr 2020.
Author
Yaman Aktas Y.; Gok Ugur H.; Orak O.S.
Institution
(Yaman Aktas) Department of Surgical Nursing, Faculty of Health Sciences,
Giresun University, Giresun, Turkey
(Gok Ugur) Department of Public Health Nursing, Faculty of Health
Sciences, Ordu University, Ordu, Turkey
(Orak) Department of Psychiatric Nursing, Faculty of Health Sciences,
Ondokuz Mayis University, Samsun, Turkey
Publisher
NLM (Medline)
Abstract
PURPOSE: This study aimed to determine possible effects of a discharge
education intervention on anxiety and depression among cardiac surgery
patients in a private hospital in the city of Ordu, Turkey. DESIGN: A
randomized controlled trial. <br/>METHOD(S): Thirty-three patients were
placed in standard care group and 33 into standard care plus discharge
education group. Patients in the discharge education group were provided
an individual training from the first day of the hospital admission until
the day of the discharge. The standard care group received usual discharge
instructions. FINDINGS: The Hospital Anxiety and Depression Scale-anxiety
subscale scores were not significantly different between patients in the
discharge and standard care groups (group: F = 1.58; P > .05). There was a
significant difference for depression, indicating that the discharge
education group had significantly lower depression than the standard care
group (group: F = 19.23; P < .01). <br/>CONCLUSION(S): Our findings
supported that the discharge education intervention reduced depression in
cardiac surgery patients.<br/>Copyright &#xa9; 2019 American Society of
PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

<19>
Accession Number
2010571273
Title
Effect of Evolocumab on Complex Coronary Disease Requiring
Revascularization.
Source
Journal of the American College of Cardiology. 77 (3) (pp 259-267), 2021.
Date of Publication: 26 Jan 2021.
Author
Oyama K.; Furtado R.H.M.; Fagundes A.; Zelniker T.A.; Tang M.; Kuder J.;
Murphy S.A.; Hamer A.; Wang H.; Keech A.C.; Giugliano R.P.; Sabatine M.S.;
Bergmark B.A.
Institution
(Oyama, Furtado, Fagundes, Zelniker, Tang, Kuder, Murphy, Giugliano,
Sabatine, Bergmark) TIMI Study Group, Division of Cardiovascular Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Oyama) Department of Cardiovascular Medicine, Tohoku University Graduate
School of Medicine, Sendai, Japan
(Furtado) Hospital Israelita Albert Einsteinand Instituto do Coracao da
Faculdade de Medicina da USP, Sao Paulo, Brazil
(Zelniker) Division of Cardiology, Vienna General Hospital and Medical
University of Vienna, Vienna, Austria
(Hamer, Wang) Amgen, Thousand Oaks, CA, United States
(Keech) National Health and Medical Research Council Clinical Trials
Centre, Sydney Medical School, University of Sydney, Sydney, New South
Wales, Australia
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to evaluate the ability of the proprotein
convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab to reduce
the risk of complex coronary atherosclerosis requiring revascularization.
<br/>Background(s): PCSK9 inhibitors induce plaque regression and reduce
the risk of coronary revascularization overall. <br/>Method(s): FOURIER
(Further Cardiovascular Outcomes Research with PCSK9 Inhibition in
Subjects with Elevated Risk) was a randomized trial of the PCSK9 inhibitor
evolocumab versus placebo in 27,564 patients with stable atherosclerotic
cardiovascular disease on statin therapy followed for a median of 2.2
years. Clinical documentation of revascularization events was blindly
reviewed to assess coronary anatomy and procedural characteristics.
Complex revascularization was the composite of complex percutaneous
coronary intervention (PCI) (as per previous analyses, >=1 of: multivessel
PCI, >=3 stents, >=3 lesions treated, bifurcation PCI, or total stent
length >60 mm) or coronary artery bypass grafting surgery (CABG).
<br/>Result(s): In this study, 1,724 patients underwent coronary
revascularization, including 1,482 who underwent PCI, 296 who underwent
CABG, and 54 who underwent both. Complex revascularization was performed
in 632 (37%) patients. Evolocumab reduced the risk of any coronary
revascularization by 22% (hazard ratio [HR]: 0.78; 95% CI: 0.71 to 0.86; p
< 0.001), simple PCI by 22% (HR: 0.78; 95% CI: 0.70 to 0.88; p < 0.001),
complex PCI by 33% (HR: 0.67; 95% CI: 0.54 to 0.84; p < 0.001), CABG by
24% (HR: 0.76; 95% CI: 0.60 to 0.96; p = 0.019), and complex
revascularization by 29% (HR: 0.71; 95% CI: 0.61 to 0.84; p < 0.001). The
magnitude of the risk reduction with evolocumab in complex
revascularization tended to increase over time (20%, 36%, and 41% risk
reductions in the first, second, and beyond second years).
<br/>Conclusion(s): Adding evolocumab to statin therapy significantly
reduced the risk of developing complex coronary disease requiring
revascularization, including complex PCI and CABG individually. (Further
Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with
Elevated Risk (FOURIER); NCT01764633.)<br/>Copyright &#xa9; 2021 American
College of Cardiology Foundation

<20>
Accession Number
2006979593
Title
Optimal threshold of left ventricular ejection fraction for aortic valve
replacement in asymptomatic severe aortic stenosis: A systematic review
and meta-analysis.
Source
Journal of the American Heart Association. 10 (7) (no pagination), 2021.
Article Number: e020252. Date of Publication: 2021.
Author
Perry A.S.; Li S.
Institution
(Perry, Li) Division of Cardiology, University of Washington School of
Medicine, Seattle, WA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The optimal threshold of left ventricular ejection fraction
(LVEF) that should prompt aortic valve replacement (AVR) in asymptomatic
patients with high-gradient severe aortic stenosis (AS) is controversial.
The aim of this study was to assess the relationship between LVEF and
mortality benefit in comparing early AVR versus watchful waiting in
asymptomatic patients with severe AS. METHODS AND RESULTS: MEDLINE,
Embase, Web of Science, and Google Scholar were searched for observational
studies and randomized controlled trials on adults with asymptomatic
severe AS. Severe AS was defined by a peak aortic velocity >=4 m/s and/or
mean aortic valve gradient >=40 mm Hg and/or calculated aortic valve area
<1.0 cm² or an indexed valve area <0.6 cm². Studies
comparing AVR with conservative management were included and meta-analysis
on all-cause mortality was performed. Ten eligible studies were identified
with a total of 3332 patients. In 5 observational studies comparing early
AVR versus watchful waiting, our meta-analysis showed early AVR was
associated with lower mortality with a hazard ratio (HR) of 0.41 (CI,
0.23-0.71; P<0.01). In 4 observational studies comparing AVR versus no
AVR, our meta-analysis showed AVR was associated with lower mortality with
a HR of 0.31 (CI, 0.17-0.58; P<0.001). In a meta-regression analysis
pooling all 10 studies, there was no statistically significant correlation
between study mean LVEF and the size of mortality benefit of AVR (P=0.83).
<br/>CONCLUSION(S): Among asymptomatic patients with high-gradient severe
AS, AVR was associated with a mortality benefit across the spectrum of
LVEF. Our study calls into question the need of an LVEF threshold for
recommending AVR in this patient population.<br/>Copyright &#xa9; 2021 The
Authors. Published on behalf of the American Heart Association, Inc., by
Wiley.

<21>
Accession Number
2011084455
Title
Intravenous iron supplement for iron deficiency in cardiac transplant
recipients (IronIC): A randomized clinical trial.
Source
Journal of Heart and Lung Transplantation. 40 (5) (pp 359-367), 2021. Date
of Publication: May 2021.
Author
Brautaset Englund K.V.; Ostby C.M.; Rolid K.; Gude E.; Andreassen A.K.;
Gullestad L.; Broch K.
Institution
(Brautaset Englund, Ostby, Rolid, Gude, Andreassen, Gullestad, Broch)
Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway
(Brautaset Englund, Rolid, Gullestad) University of Oslo, Oslo, Norway
(Brautaset Englund, Rolid, Gude, Andreassen, Gullestad, Broch) K.G. Jebsen
Cardiac Research Center and Center for Heart Failure Research, Faculty of
Medicine, University of Oslo, Oslo, Norway
Publisher
Elsevier Inc.
Abstract
Aims: Heart transplant recipients have reduced exercise capacity despite
preserved graft function. The IronIC trial was designed to test the
hypothesis that intravenous iron therapy would improve peak oxygen
consumption in these patients. <br/>Methods and Results: This randomized,
placebo-controlled, double-blind trial was performed at our national
center for heart transplantation. One hundred and 2 heart transplant
recipients with a serum ferritin <100 microg/liter or 100 to 300
microg/liter, in combination with transferrin saturation of <20%, and
hemoglobin level >100 g/liter were enrolled >=1 year after
transplantation. A cardiopulmonary exercise test was performed before
administration of the study drug and at 6 months follow-up. The primary
endpoint was peak oxygen consumption. Key secondary outcomes included iron
status, handgrip strength, quality of life, and safety. Fifty-two patients
were randomized to receive ferric derisomaltose 20 mg/kg, and 50 to
placebo. The between-group difference in baseline-adjusted peak oxygen
consumption was 0.3 ml/kg/min (95% confidence interval -0.9 to 1.4, p =
0.66). In patients with a baseline ferritin <30 microg/liter, peak oxygen
consumption was significantly higher in the ferric derisomaltose arm. At 6
months, iron stores were restored in 86% of the patients receiving ferric
derisomaltose vs 20% in patients receiving placebo (p < 0.001). Quality of
life was significantly better in patients receiving ferric derisomaltose.
Twenty-seven adverse events occurred in the intravenous iron group vs 30
in the placebo group (p = 0.39). <br/>Conclusion(s): Intravenous iron
treatment did not improve peak oxygen consumption in heart transplant
recipients with ferritin <100 microg/liter or 100 to 300 microg/liter in
combination with transferrin saturation <20%. Trial registration number:
http//www.clinicaltrials.gov identifier NCT03662789.<br/>Copyright &#xa9;
2021 The Authors

<22>
Accession Number
2010777994
Title
Effects of Bariatric Surgery on Heart Rhythm Disorders: a Systematic
Review and Meta-Analysis.
Source
Obesity Surgery. 31 (5) (pp 2278-2290), 2021. Date of Publication: May
2021.
Author
Sanches E.E.; Topal B.; de Jongh F.W.; Cagiltay E.; Celik A.; Sundbom M.;
Ribeiro R.; Parmar C.; Ugale S.; Mahawar K.; Buise M.P.; Dekker L.R.;
Ramnarain D.; Pouwels S.
Institution
(Sanches) Department of Surgery, Haaglanden Medical Center, The Hague,
Netherlands
(Topal) Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis,
Amsterdam, Netherlands
(de Jongh) Department of Plastic Surgery, Haaglanden Medical Center, The
Hague, Netherlands
(Cagiltay) Department of Endocrinology and Metabolic Diseases, University
of Health Sciences Turkey, Sultan Abdulhamid Han Education and Research
Hospital, Istanbul, Turkey
(Celik) Metabolic Surgery Clinic, Sisli, Istanbul, Turkey
(Sundbom) Department of Surgical Sciences, Uppsala University, Uppsala,
Sweden
(Ribeiro) Centro Multidisciplinar da Doenca Metabolica, Clinica de Santo
Antonio, Reboleira, Lisbon, Portugal
(Parmar) Department of Surgery, Whittington Hospital, London, United
Kingdom
(Ugale) Bariatric & Metabolic Surgery Clinic, Virinchi Hospitals,
Hyderabad, India
(Mahawar) Bariatric Unit, Sunderland Royal Hospital, Sunderland, United
Kingdom
(Buise) Department of Anesthesiology, Intensive Care and Pain Medicine,
Catharina Hospital, Eindhoven, Netherlands
(Dekker) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Ramnarain, Pouwels) Department of Intensive Care Medicine,
Elisabeth-Tweesteden Hospital, P.O. Box 9051, Tilburg 5000 LC, Netherlands
Publisher
Springer
Abstract
The aim of this systematic review is to provide an overview of the
literature on the effects of bariatric surgery on obesity-associated
electrocardiogram (ECG) abnormalities and cardiac arrhythmias. Fourteen
studies were included with a methodological quality ranging from poor to
good. Majority of the studies showed a significant decrease of QT interval
and related measures after bariatric surgery. Seven studies were included
in the meta-analysis on effects of bariatric surgery on QTc interval and a
significant decrease in QTc interval of - 33.6 ms, 95%CI [- 49.8 to -
17.4] was seen. Bariatric surgery results in significant decrease in QTc
interval and P-wave dispersion, i.e., a normalization of initial
pathology. The effects on atrial fibrillation are conflicting and not yet
fully understood. Graphical abstract: [Figure not available: see
fulltext.]<br/>Copyright &#xa9; 2021, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<23>
Accession Number
633674109
Title
Protocol for the Prognosticating Delirium Recovery Outcomes Using
Wakefulness and Sleep Electroencephalography (P-DROWS-E) study: A
prospective observational study of delirium in elderly cardiac surgical
patients.
Source
BMJ Open. 10 (12) (no pagination), 2020. Article Number: e044295. Date of
Publication: 13 Dec 2020.
Author
Kendall Smith S.; Nguyen T.; Labonte A.K.; Kafashan M.; Hyche O.; Guay
C.S.; Wilson E.; Chan C.W.; Luong A.; Brian Hickman L.; Fritz B.A.; Emmert
D.; Graetz T.J.; Melby S.J.; Lucey B.P.; Ju Y.-E.S.; Wildes T.S.; Avidan
M.S.; Palanca B.J.A.
Institution
(Kendall Smith, Nguyen, Labonte, Kafashan, Hyche, Guay, Wilson, Chan,
Luong, Brian Hickman, Fritz, Emmert, Graetz, Wildes, Avidan, Palanca)
Department of Anesthesiology, Washington University in Saint Louis School
of Medicine, Saint Louis, MO, United States
(Melby) Department of Surgery, Washington University in Saint Louis School
of Medicine, Saint Louis, MO, United States
(Lucey, Ju) Department of Neurology, Washington University in Saint Louis
School of Medicine, Saint Louis, MO, United States
(Palanca) Department of Biomedical Engineering, Washington University in
St Louis, Saint Louis, MO, United States
(Palanca) Division of Biology and Biomedical Sciences, Washington
University in St Louis, Saint Louis, MO, United States
Publisher
BMJ Publishing Group
Abstract
Introduction Delirium is a potentially preventable disorder characterised
by acute disturbances in attention and cognition with fluctuating
severity. Postoperative delirium is associated with prolonged intensive
care unit and hospital stay, cognitive decline and mortality. The
development of biomarkers for tracking delirium could potentially aid in
the early detection, mitigation and assessment of response to
interventions. Because sleep disruption has been posited as a contributor
to the development of this syndrome, expression of abnormal
electroencephalography (EEG) patterns during sleep and wakefulness may be
informative. Here we hypothesise that abnormal EEG patterns of sleep and
wakefulness may serve as predictive and diagnostic markers for
postoperative delirium. Such abnormal EEG patterns would mechanistically
link disrupted thalamocortical connectivity to this important clinical
syndrome. Methods and analysis P-DROWS-E (Prognosticating Delirium
Recovery Outcomes Using Wakefulness and Sleep Electroencephalography) is a
220-patient prospective observational study. Patient eligibility criteria
include those who are English-speaking, age 60 years or older and
undergoing elective cardiac surgery requiring cardiopulmonary bypass. EEG
acquisition will occur 1-2 nights preoperatively, intraoperatively, and up
to 7 days postoperatively. Concurrent with EEG recordings, two times per
day postoperative Confusion Assessment Method (CAM) evaluations will
quantify the presence and severity of delirium. EEG slow wave activity,
sleep spindle density and peak frequency of the posterior dominant rhythm
will be quantified. Linear mixed-effects models will be used to evaluate
the relationships between delirium severity/duration and EEG measures as a
function of time. Ethics and dissemination P-DROWS-E is approved by the
ethics board at Washington University in St. Louis. Recruitment began in
October 2018. Dissemination plans include presentations at scientific
conferences, scientific publications and mass media. Trial registration
number NCT03291626.<br/>Copyright &#xa9;

<24>
Accession Number
2005150192
Title
Does quicker mean better? Comparison of rapid deployment versus
conventional aortic valve replacement a meta-analysis.
Source
International Heart Journal. 61 (5) (pp 951-960), 2020. Date of
Publication: 2020.
Author
Lu Y.; Wang J.; Chen Z.; Wei J.; Li F.; Cai Z.
Institution
(Lu, Wang, Cai) Department of Cardiology, The Second Affiliated Hospital,
Zhejiang University School of Medicine, Hangzhou, China
(Chen) Department of Clinical Epidemiology and Biostatistics, Second
Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou,
China
(Wei) Children's Hospital, Zhejiang University School of Medicine,
Hangzhou, China
(Li) Department of Cardiovascular Surgery, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
Publisher
International Heart Journal Association
Abstract
The aim of this meta-analysis was to compare the clinical outcomes in
patients who underwent rapid deployment aortic valve replacement (RDAVR)
and conventional bio prosthetic aortic valve replacement (CAVR). We
performed a literature search by August 2018. The primary outcomes were
hospital and 1-year mortal-ity, and the secondary endpoints included the
aortic cross-clamp (ACC), cardiopulmonary bypass (CPB) time, and
postoperative and valve-related complications. Two randomized controlled
trials and 13 propensity score-matched studies were included. There was no
difference between RDAVR and CAVR in hospital mortality (2.5% versus 2.1%;
risk ratio (RR) 1.16 [95% confidence interval (CI) 0.80-1.68]) or 1-year
mortality (2.9% versus 4.1%; RR 0.69 [95% CI 0.34-1.34]). RDAVR
significantly reduced the ACC time ((mean difference (MD) -24.33 [95% CI
-28.35 to -20.32]) and CPB time (MD -21.51 [95% CI -22.83 to -20.20]). The
pooled analysis showed that RDAVR doubled the occurrence of permanent
pacemaker implantation (8.6% versus 4.3%; RR 2.05 [95% CI 1.62-2.60]).
Meanwhile, the blood transfusion amount (MD -1.54 [95% CI -2.22 to -0.86])
and postoperative atrial fibrillation (POAF) occurrence (RR 0.83 [95% CI
0.69-0.99]) was reduced. The difference of paravalvular leakage frequency
between RDAVR and CAVR was marginal (RR 1.77 [95% CI 1.00-3.17]; P =
0.05). Furthermore, RDAVR was related to larger valves (MD 0.70 cm [95% CI
0.33-1.07]) and lower mean pressure gradients (MD -1.93 mmHg [95% CI -3.58
to -0.28]). The hospital and 1-year survival rates between RDAVR and CAVR
are comparable. RDAVR reduces POAF occurrence and blood transfusion but is
associated with a higher occurrence of pacemaker
implantation.<br/>Copyright &#xa9; International Heart Journal
Association.

<25>
Accession Number
634817417
Title
Aspirin Alone Versus Dual Antiplatelet Therapy After Transcatheter Aortic
Valve Implantation: A Systematic Review and Patient-Level Meta-Analysis.
Source
Journal of the American Heart Association. 10 (8) (pp e019604), 2021. Date
of Publication: 20 Apr 2021.
Author
Brouwer J.; Nijenhuis V.J.; Rodes-Cabau J.; Stabile E.; Barbanti M.; Costa
G.; Mahmoodi B.K.; Ten Berg J.M.
Institution
(Brouwer, Nijenhuis, Mahmoodi, Ten Berg) Department of Cardiology St.
Antonius Hospital Nieuwegein The Netherlands
(Rodes-Cabau) Department of Cardiology Quebec Heart & Lung Institute Laval
University Quebec City Quebec Canada
(Stabile) Department of Advanced Biomedical Sciences University "Federico
II" Naples Italy
(Barbanti, Costa) Department of Cardiology A.O.U. Policlinico "G. Rodolico
- San Marco" Catania Italy
(Ten Berg) Cardiovascular Research Institute Maastricht (CARIM) Maastricht
The Netherlands
Publisher
NLM (Medline)
Abstract
Background In patients undergoing transcatheter aortic valve implantation
without an indication for oral anticoagulation, it is unclear whether
single or dual antiplatelet therapy (DAPT) is necessary to minimize both
the bleeding and thromboembolic risk. In this patient-level meta-analysis,
we further investigate the effect of aspirin alone compared with DAPT for
preventing both thromboembolic and bleeding events after transcatheter
aortic valve implantation. Methods and Results We conducted a systematic
review of all available randomized controlled trials comparing aspirin
with DAPT. In total, 1086 patients were included across 4 eligible trials.
The primary outcomes were the composite of all-cause mortality, major or
life-threatening bleeding, stroke or myocardial infarction (first
composite outcome), and the same composite excluding bleeding (second
composite outcome), both tested at 30 days and 3 months. The first
composite outcome occurred significantly less in the aspirin-alone group
at 30 days (10.3% versus 14.7%, odds ratio [OR], 0.67; 95% CI, 0.46-0.97,
P=0.034) and 3 months (11.0% versus 16.5%, hazard ratio [HR], 0.66; 95%
CI, 0.47-0.94, P=0.02), compared with the DAPT group. The second composite
outcome occurred in 5.5% and 6.6% at 30 days (OR, 0.83; 95% CI, 0.50-1.38,
P=0.47) and in 6.9% and 8.5% at 3 months in the aspirin-alone group
compared with the DAPT group (HR, 0.82; 95% CI, 0.52-1.29, P=0.39),
respectively. Conclusions In patients without an indication for oral
anticoagulation undergoing transcatheter aortic valve implantation,
aspirin alone significantly reduced the composite of thromboembolic and
bleeding events, and does not increase the composite of thromboembolic
events after transcatheter aortic valve implantation, compared with DAPT.

<26>
Accession Number
2011708714
Title
Efficacy, Safety, and Strategies for Recombinant-Activated Factor VII in
Cardiac Surgical Bleeding: A Narrative Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Kidd B.; Sutherland L.; Jabaley C.S.; Flynn B.
Institution
(Kidd, Flynn) Division of Critical Care Medicine, Department of
Anesthesiology, University of Kansas Medical Center, Kansas City, KS,
United States
(Sutherland) Division of Critical Care Medicine, Department of
Anesthesiology, Columbia University, New York, NY, United States
(Jabaley) Division of Critical Care Medicine, Department of
Anesthesiology, Emory University, Atlanta, GA, United States
(Jabaley) Emory Critical Care Center, Atlanta, GA, United States
Publisher
W.B. Saunders
Abstract
As perioperative bleeding continues to be a major source of morbidity and
mortality in cardiac surgery, the search continues for an ideal hemostatic
agent for use in this patient population. Transfusion of blood products
has been associated both with increased costs and risks, such as
infection, prolonged mechanical ventilation, increased length of stay, and
decreased survival. Recombinant-activated factor VII (rFVIIa) first was
approved for the US market in 1999 and since that time has been used in a
variety of clinical settings. This review summarizes the existing
literature pertaining to perioperative rFVIIa, in addition to society
recommendations and current guidelines regarding its use in cardiac
surgery.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<27>
Accession Number
2006842568
Title
Impact of renin-angiotensin system inhibitors on outcomes after surgical
or transcatheter aortic valve replacement. A meta-analysis.
Source
Revista Espanola de Cardiologia. 74 (5) (pp 421-426), 2021. Date of
Publication: May 2021.
Author
Amat-Santos I.J.; Santos-Martinez S.; Julca F.; Catala P.;
Rodriguez-Gabella T.; Redondo-Dieguez A.; Hinojosa W.; Veras C.; Campo A.;
Serrador Frutos A.; Carrasco-Moraleja M.; San Roman J.A.
Institution
(Amat-Santos, Santos-Martinez, Julca, Catala, Rodriguez-Gabella,
Redondo-Dieguez, Hinojosa, Veras, Campo, Serrador Frutos, San Roman)
Departamento de Cardiologia, Hospital Clinico Universitario de Valladolid,
CIBERCV, Valladolid, Spain
(Amat-Santos, Carrasco-Moraleja, San Roman) Departamento de Cardiologia,
Hospital Clinico Universitario de Valladolid, Valladolid, Spain
Publisher
Ediciones Doyma, S.L.
Abstract
Introduction and objectives: To determine whether renin-angiotensin system
inhibitor (RASi) prescription is associated with better outcomes after
transcatheter aortic valve implantation (TAVI) and surgical aortic valve
replacement (SAVR). <br/>Method(s): All comparative studies of RASi vs no
RASi prescription in patients undergoing TAVI/SAVR were gathered from
PubMed, Web of Science, and Google Scholar through August, 2019. We
extracted hazard ratios (HRs) with their confidence intervals (CIs) for
mortality from each study and combined study-specific estimates using
inverse variance-weighted averages of logarithmic HRs in the random
effects model. <br/>Result(s): We identified 6 eligible studies with a
total of 21 390 patients (TAVI: 17 846; SAVR: 3544) and included them in
the present meta-analysis. The 6 studies were observational comparative
studies (including 3 propensity score matched and 3 cohort studies) of
RASi vs no RASi prescription. The analysis demonstrated that RASi
prescription was associated with significantly lower mortality in the
whole group of patients undergoing aortic valve intervention (HR, 0.64;
95%CI, 0.47-0.88; P < .001). However, subgroup analysis suggested
differences according to the selected therapy, with TAVI showing better
mortality rates in the RASi group (HR, 0.67; 95%CI, 0.49-0.93) but not in
the SAVR group (HR, 0.61; 95%CI, 0.29-1.30). No funnel plot asymmetry was
identified, suggesting minimum publication bias. Sensitivity analyses
sequentially eliminating dissimilar studies did not substantially alter
the primary result favoring RASI prescription. <br/>Conclusion(s): These
findings suggest a mortality benefit of RASi in patients with AS treated
with aortic valve replacement that might be particularly relevant
following TAVI. Future randomized studies are warranted to confirm this
relevant finding.
Introduccion y objetivos: Determinar si la prescripcion de inhibidores del
sistema renina-angiotensina (iSRA) se asocia a mejores resultados tras
implante percutaneo de valvula aortica (TAVI) o recambio valvular aortico
quirurgico (RVAQ). Metodos: Se seleccionaron de PubMed, Web of Science, y
Google Scholar hasta agosto de 2019 estudios comparativos de iSRA vs
no-iSRA en pacientes sometidos a TAVI/RVAQ. Se extrajeron las hazard
ratios (HR) con sus intervalos de confianza para mortalidad de cada
estudio y estimadores especificos en el modelo de efectos aleatorios.
Resultados: Se incluyeron 6 estudios con un total de 21.390 pacientes
(TAVI: 17.846, RVAQ: 3.544). Los 6 fueron estudios comparativos (3
analisis de propension y 3 de cohortes) comparando iSRA vs no-iSRA. Se
demostro que la prescripcion de iSRA se asocia con una mortalidad
significativamente menor en pacientes sometidos a intervencion valvular
aortica (HR = 0,64; IC95%, 0,47-0,88; p < 0,001). Sin embargo, el analisis
por subgrupos sugirio diferencias en funcion de la terapia seleccionada,
con menor mortalidad en los sometidos a TAVI tratados con iSRA (HR = 0,67;
IC95%, 0,49-0,93) pero no en los tratados con RVAQ (HR = 0,61; IC95%,
0,29-1,30). No se identifico asimetria en el analisis funnel plot,
sugiriendo bajo riesgo de sesgo de publicacion. El analisis de
sensibilidad eliminando sucesivamente diferentes estudios no altero de
forma substancial el resultado. Conclusiones: Estos resultados sugieren
reduccion de la mortalidad con la prescripcion de iSRA en pacientes con
estenosis aortica sometidos a recambio valvular aortico, en particular
tras TAVI. Futuros estudios aleatorizados deberan confirmar o refutar este
relevante hallazgo.<br/>Copyright &#xa9; 2020 Sociedad Espanola de
Cardiologia

<28>
Accession Number
627895169
Title
Does the use of a hot-shot lead to improved outcomes following adult
cardiac surgery?.
Source
Interactive Cardiovascular and Thoracic Surgery. 28 (3) (pp 473-477),
2019. Date of Publication: 01 Mar 2019.
Author
Volpi S.; Ali J.M.; De Silva R.
Institution
(Volpi, Ali, De Silva) Department of Cardiothoracic Surgery, Royal
Papworth Hospital, Cambridge CB23 3RE, United Kingdom
Publisher
Oxford University Press
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was: Does the use of a
'hot-shot' (terminal warm blood cardioplegia) lead to improved outcomes
following adult cardiac surgery? Altogether, 567 papers were found using
the reported search, of which 9 represented the best evidence to answer
the clinical question. The authors, journal, date and country of
publication, patient group studied, study type, relevant outcomes and
results of these papers are tabulated. We conclude that evidence
supporting the use of a hot-shot prior to weaning from cardiopulmonary
bypass is rather limited. All 8 of the randomized trials to date are small
studies which examine heterogeneous groups of patients, and unfortunately,
the conclusions are inconsistent, perhaps in part related to the inability
to demonstrate statistical significance with small group size. From the
evidence, it appears likely that the use of a hot-shot results in more
rapid biochemical, electrical and possibly functional myocardial recovery
from cardiopulmonary bypass. However, no study has been able to
demonstrate that this leads to improved clinical outcomes other than lower
incidence of atrial fibrillation.<br/>Copyright &#xa9; 2018 The Author.

<29>
Accession Number
355011345
Title
Oral magnesium prophylaxis provides spontaneous resumption of cardiac
rhythm in patients undergoing cardiac surgery.
Source
Journal of International Medical Research. 37 (2) (pp 318-324), 2009. Date
of Publication: 2009.
Author
Besogul Y.; Aslan R.
Institution
(Besogul, Aslan) Department of Cardiovascular Surgery, Osmangazi
University Medical School and Research Hospital, Eskisehir, Turkey
(Besogul) Baukent mah. Costu sok, No. 67/22 Alpata evleri, Eskisehir,
Turkey
Publisher
Field House Publishing LLP
Abstract
Evidence is growing that magnesium supplementation in patients undergoing
cardiac surgery is beneficial, however the best administration route has
not been established. Previously, we showed that intra-operative direct
flush infusion of magnesium into the aortic root before reperfusion was
effective. The present study compared pre-operative oral administration of
magnesium for 10 days with intra-operative flush infusion of magnesium for
spontaneous resumption of cardiac rhythm and ventricular fibrillation in
patients undergoing cardiac surgery with cardiopulmonary bypass (CBP). The
rate of spontaneous resumption of cardiac rhythm, the number of shocks
required for defibrillation, the energy required for defibrillation and
the occurrence of post-CPB ventricular tachyarrhythmias were not
significantly different between the groups. Serum magnesium levels were
minimally increased following administration of magnesium but were within
the normal range at all times in both groups. Oral administration of
magnesium might provide myoprotective effects during cardiac surgery, but
larger trials with a greater statistical power need to be carried out in
order to show this. Copyright &#xa9; 2009 Field House Publishing LLP.

<30>
Accession Number
2010775383
Title
Extracorporeal life support in patients with acute myocardial infarction
complicated by cardiogenic shock - Design and rationale of the ECLS-SHOCK
trial.
Source
American Heart Journal. 234 (pp 1-11), 2021. Date of Publication: April
2021.
Author
Thiele H.; Freund A.; Gimenez M.R.; de Waha-Thiele S.; Akin I.; Poss J.;
Feistritzer H.-J.; Fuernau G.; Graf T.; Nef H.; Hamm C.; Bohm M.; Lauten
A.; Schulze P.C.; Voigt I.; Nordbeck P.; Felix S.B.; Abel P.; Baldus S.;
Laufs U.; Lenk K.; Landmesser U.; Skurk C.; Pieske B.; Tschope C.;
Hennersdorf M.; Wengenmayer T.; Preusch M.; Maier L.S.; Jung C.; Kelm M.;
Clemmensen P.; Westermann D.; Seidler T.; Schieffer B.; Rassaf T.;
Mahabadi A.-A.; Vasa-Nicotera M.; Meincke F.; Seyfarth M.; Kersten A.;
Rottbauer W.; Boekstegers P.; Mullenbach R.; Dengler T.; Kadel C.; Schempf
B.; Karagiannidis C.; Hopf H.-B.; Lehmann R.; Bufe A.; Baumanns S.; Oner
A.; Linke A.; Sedding D.; Ferrari M.; Bruch L.; Goldmann B.; John S.;
Mollmann H.; Franz J.; Lapp H.; Lauten P.; Noc M.; Goslar T.; Oerlecke I.;
Ouarrak T.; Schneider S.; Desch S.; Zeymer U.
Institution
(Thiele, Freund, Gimenez, Poss, Feistritzer, Desch) Heart Center Leipzig
at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
(de Waha-Thiele, Fuernau, Graf) University Heart Center Luebeck, Luebeck,
Germany
(Akin) University Clinic Mannheim, Mannheim, Germany
(Nef, Hamm) University Clinic Giessen, Giessen, Germany
(Hamm) Kerckhoff Clinic Bad Nauheim, Bad Nauheim, Germany
(Bohm) University Clinic Homburg, Homburg, Germany
(Lauten) Helios Clinic Erfurt, Erfurt, Germany
(Schulze) University Hospital Jena, Jena, Germany
(Voigt) Contilia Elisabeth-Krankenhaus, Essen, Germany, Essen, Germany
(Nordbeck) University Clinic Wurzburg, Wurzburg, Germany
(Felix, Abel) Dept. of Internal Medicine B, University Medicine
Greifswald, Greifswald, Germany
(Baldus) Heart Center Cologne, University Clinic Cologne, Cologne, Germany
(Laufs, Lenk) University Clinic Leipzig, Leipzig, Germany
(Landmesser, Skurk) Charite, Campus Benjamin Franklin, Berlin, Germany
(Pieske, Tschope) Charite University Medicine, Campus Virchow Klinikum and
German Heart Center and Berlin Brandenburger Center for Regenerative
Therapies (BCRT) of the Berlin Institute of Health (BIH), Berlin, Germany
(Hennersdorf) SLK-Clinic Heilbronn, Heilbronn, Germany
(Wengenmayer) University Heart Center Freiburg - Bad Krozingen, Freiburg,
Germany
(Preusch) University Clinic Heidelberg, Heidelberg, Germany
(Maier) University Clinic Regensburg, Regensburg, Germany
(Jung, Kelm) University Clinic Dusseldorf, Dusseldorf, Germany
(Clemmensen, Westermann) University Heart Center Hamburg, Hamburg, Germany
(Seidler) Heart Center Gottingen, University Medicine Gottingen,
Gottingen, Germany
(Schieffer) University Clinic Marburg, Marburg, Germany
(Rassaf, Mahabadi) Dept. of Cardiology and Vascular Medicine, West German
Heart- and Vascular Center, University Hospital Essen, Germany
(Vasa-Nicotera) University Clinic Frankfurt, Frankfurt, Germany
(Meincke) Asklepios Clinic St. Georg, Hamburg, Germany
(Seyfarth) Heart Center Wuppertal, Witten-Herdecke University, Wuppertal,
Germany
(Kersten) University Clinic Aachen, Aachen, Germany
(Rottbauer) University Clinic Ulm, Ulm, Germany
(Boekstegers) Helios Clinic Siegburg, Siegburg, Germany
(Mullenbach) Klinikum Kassel, Kassel, Germany
(Dengler) SLK Clinic Bad Friedrichshall, Bad Friedrichshall, Germany
(Kadel) Clinic Frankfurt Hochst, Frankfurt, Germany
(Schempf) Clinic Reutlingen, Reutlingen, Germany
(Karagiannidis) ARDS and ECMO Center Cologne-Merheim, Cologne, Germany
(Hopf, Lehmann) Asklepios Clinic Langen, Langen, Germany
(Bufe) Helios Clinic Krefeld, Krefeld, University Witten/Herdecke, Germany
(Baumanns) Kliniken Maria Hilf, Monchengladbach, Germany
(Oner) University Clinic Halle, Halle, Germany
(Linke) Heart Center Dresden - Technical University Dresden, Dresden,
Germany
(Sedding) University Clinic Halle, Halle, Germany
(Ferrari) Helios Klinik HSK Wiesbaden, Wiesbaden, Germany
(Bruch) Unfallkrankenhaus Berlin, Berlin, Germany
(Goldmann) Asklepios Clinic Hamburg-Harburg, Hamburg, Germany
(John) Paracelsius Private University, Clinic Nuremberg, Campus South,
Nuremberg, Germany
(Mollmann) St. Johannes Hospital Dortmund, Dortmund, Germany
(Franz) Clinic Winnenden, Winnenden, Germany
(Lapp, Lauten) Zentralklinik Bad Berka, Bad Berka, Germany
(Noc, Goslar) University Medical Center Ljubljana, Ljubljana, Slovenia
(Oerlecke) Leipzig Heart Institute, Leipzig, Germany
(Ouarrak, Schneider, Zeymer) Institut fur Herzinfarktforschung,
Ludwigshafen, Germany
Publisher
Mosby Inc.
Abstract
Background: In acute myocardial infarction complicated by cardiogenic
shock the use of mechanical circulatory support devices remains
controversial and data from randomized clinical trials are very limited.
Extracorporeal life support (ECLS) - venoarterial extracorporeal membrane
oxygenation - provides the strongest hemodynamic support in addition to
oxygenation. However, despite increasing use it has not yet been properly
investigated in randomized trials. Therefore, a prospective randomized
adequately powered clinical trial is warranted. <br/>Study Design: The
ECLS-SHOCK trial is a 420-patient controlled, international, multicenter,
randomized, open-label trial. It is designed to compare whether treatment
with ECLS in addition to early revascularization with percutaneous
coronary intervention or alternatively coronary artery bypass grafting and
optimal medical treatment is beneficial in comparison to no-ECLS in
patients with severe infarct-related cardiogenic shock. Patients will be
randomized in a 1:1 fashion to one of the two treatment arms. The primary
efficacy endpoint of ECLS-SHOCK is 30-day mortality. Secondary outcome
measures such as hemodynamic, laboratory, and clinical parameters will
serve as surrogate endpoints for prognosis. Furthermore, a longer
follow-up at 6 and 12 months will be performed including quality of life
assessment. Safety endpoints include peripheral ischemic vascular
complications, bleeding and stroke. <br/>Conclusion(s): The ECLS-SHOCK
trial will address essential questions of efficacy and safety of ECLS in
addition to early revascularization in acute myocardial infarction
complicated by cardiogenic shock.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<31>
Accession Number
2011687821
Title
Global prevalence and predictors of postoperative delirium among
non-cardiac surgical patients: A systematic review and meta-analysis.
Source
International Journal of Surgery Open. 32 (no pagination), 2021. Article
Number: 100334. Date of Publication: May 2021.
Author
Abate S.M.; Checkole Y.A.; Mantedafro B.; Basu B.; Aynalem A.E.
Institution
(Abate, Basu) Department of Anesthesiology, College of Health Sciences and
Medicine, Dilla University, Dilla, Ethiopia
(Checkole, Aynalem) Department of Mental Health and Psychiatry, College of
Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
(Mantedafro) Department of Internal Medicine, College of Health Sciences
and Medicine, Dilla University, Dilla, Ethiopia
Publisher
Elsevier Ltd
Abstract
Background: Postoperative delirium is a recent health problem among the
elderly which is associated with delayed functional recovery, longer
hospital stays, increased morbidity and mortality, and incurs a
significant financial cost. Body of evidence is lacking on the global
prevalence of postoperative delirium and its determinants. Therefore, this
study aimed to provide evidence on the prevalence of postoperative
delirium. <br/>Method(s): A comprehensive search was conducted in
PubMed/Medline; Science direct and LILACS from December 2010 to August
2020 without language restriction. The Heterogeneity among the included
studies was checked with forest plot, chi2 test, I2 test, and the
p-values. All observational studies reporting the prevalence of
postoperative delirium were included. <br/>Result(s): A total of 930
articles were identified from different databases and 70 articles were
selected for evaluation after the successive screening. Forty-three
articles with 13,179 participants were included. The Meta-Analysis
revealed that the global prevalence of postoperative delirium was 20% (95%
confidence interval (CI):17 to 24). The systematic review showed that
postoperative delirium was approximately 3 times more likely in patients
undergoing surgery under general anesthesia, OR = 2.68 (95% confidence
interval (CI): 1.10 to 6.54). <br/>Conclusion(s): The Meta-Analysis
revealed that postoperative delirium among surgical patients is strongly
associated with different modifiable risk factors. Therefore, the
perioperative mitigating strategic protocol should be employed to prevent
postoperative delirium and its undesirable outcomes. Registration: This
systematic review and meta-analysis was registered research registry with
the registration number (UIN: reviewregistry979).<br/>Copyright &#xa9;
2021 The Author(s)

<32>
Accession Number
2011594788
Title
Outcome of cardiac rehabilitation in improving quality of life among women
having IHD: A randomized controlled trail.
Source
Pakistan Journal of Medical and Health Sciences. 15 (1) (pp 488-490),
2021. Date of Publication: January 2021.
Author
Mustansar A.; Noor R.; Mahmood S.; Yaqoob T.; Latif W.; Laique T.
Institution
(Mustansar, Mahmood) Department of Physiotherapy, UHS, Lahore, Pakistan
(Noor) Department of Physiotherapy, Riphah University, Islamabad, Pakistan
(Yaqoob) Department of Public Health, UHS, Lahore, Pakistan
(Latif) Department of Statistics, University of Health Sciences, Lahore,
Pakistan
(Laique) Department of Pharmacology, Allama Iqbal Medical College, Lahore,
Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Background: Cardiac rehabilitation deals with optimizing function in
patients with heart disease or current cardiac surgery. <br/>Aim(s): To
determine the outcome of cardiac rehabilitation in improving quality of
life in women of ischemic heart disease. Study design: Randomized
controlled trial. Methodology: Patients (n=74) were enrolled in present
study held at University Teaching Hospital, University of Lahore & Punjab
Institute of Cardiology, as a reference placement for 6 months. Informed
consent was taken from all of them. Data analyzed by SPSS 22.0v.
<br/>Result(s): The mean age of the patients was 49.11+/-3.96 years. The
mean post back depression inventory score in cardiac rehabilitation group
was 10.24+/-6.19 while in conventional group was 19.57+/-7.08
(p-value=<0.001). Among cardiac rehabilitation group the mean post SF 36
was 66.43+/-9.69 while in conventional group was 56.22+/-10.88
(p-value=<0.001). <br/>Conclusion(s): This study concluded that cardiac
rehabilitation greatly improves the quality of life of patients with
ischemic heart disease following traditional rehabilitation compared to
the conventional group.<br/>Copyright &#xa9; 2021 Lahore Medical And
Dental College. All rights reserved.

<33>
Accession Number
2007397634
Title
Percutaneous balloon mitral valvotomy during pregnancy: A systematic
review and meta-analysis.
Source
Acta Obstetricia et Gynecologica Scandinavica. 100 (4) (pp 666-675), 2021.
Date of Publication: April 2021.
Author
Sreerama D.; Surana M.; Moolchandani K.; Chaturvedula L.; Keepanasseril
A.; Pillai A.A.; Nair N.S.
Institution
(Sreerama, Surana, Moolchandani, Chaturvedula, Keepanasseril) Department
of Obstetrics & Gynaecology, Jawaharlal Institute of Postgraduate Medical
Education & Research (JIPMER), Puducherry, India
(Keepanasseril) School of Dentistry, Amrita Institute of Medical Sciences,
Kochi, India
(Keepanasseril) Department of Medicine, McMaster University, Hamilton,
Canada
(Pillai) Department of Cardiology, Jawaharlal Institute of Postgraduate
Medical Education & Research (JIPMER), Puducherry, India
(Nair) Biostatistics, Jawaharlal Institute of Postgraduate Medical
Education & Research (JIPMER), Puducherry, India
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The objective of this study was to systematically review the
maternal and fetal outcomes in pregnant women who underwent percutaneous
balloon mitral valvuloplasty (PBMV) during pregnancy. <br/>Material(s) and
Method(s): A search was conducted on MEDLINE and Embase databases to
identify studies published between 2000 and 2018 that reported on maternal
and fetal outcomes following PBMV performed in pregnancy. Randomized
controlled trials, cohort studies, case-control studies, cross-sectional
studies and case series with four or more pregnancies in which PBMV was
performed during pregnancy were included. Reference lists from relevant
articles were also hand-searched for relevant citations. A successful
procedure was defined as one where there was a reported improvement in the
valve area or reduction in the mitral valve gradient. A random effects
model was used to derive pooled estimates of various outcomes and the
final estimates were reported as percentages with a 95% confidence
interval (95% CI). <br/>Result(s): Twenty-one observational studies
reporting 745 pregnancies were included in the review, all of them having
reported outcomes without a comparison group. Most of the studies fell
into the low-risk category as determined using the Joanna Briggs Institute
(JBI) critical appraisal checklist for case series. Most of the studies
(86%) were reported from low- to middle-income countries and PBMV was
mostly performed during the second trimester of pregnancy. Forty-three
procedures (5.7%) were unsuccessful, nearly half (n = 19) of them reported
among women with the severe subvalve disease (Wilkins subvalve score 3 or
more). There were 11 maternal deaths among those with suboptimal valve
anatomy (severe subvalve disease or Wilkin score >8). Mitral regurgitation
was the most common cardiac complication (12.7%; 95% CI 7.3%-19.1%),
followed by restenosis (2.4%; 95% CI 0.02%-7.2%). Pooled incidence of
cesarean section was 12.1% (95% CI 3.6%-23.8%), preterm delivery 3.9% (95%
CI 0.6%-9.0%), stillbirth 0.9% (95%CI 0.2%-2.2%) and low birthweight 5.4%
(95% CI 0.2%-14.7%). <br/>Conclusion(s): PBMV may be an effective and safe
procedure for optimizing outcomes in pregnant women with mitral stenosis
in the absence of severe subvalve disease.<br/>Copyright &#xa9; 2020
Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).
Published by John Wiley & Sons Ltd

<34>
[Use Link to view the full text]
Accession Number
2007057648
Title
Effects of the ABCB1 C3435T single nucleotide polymorphism on major
adverse cardiovascular events in acute coronary syndrome or coronary
artery disease patients undergoing percutaneous coronary intervention and
treated with clopidogrel: A systematic review and meta-analysis.
Source
Expert Opinion on Drug Safety. 19 (12) (pp 1605-1616), 2020. Date of
Publication: December 2020.
Author
Biswas M.; Rahaman S.; Biswas T.K.; Ibrahim B.
Institution
(Biswas, Rahaman) Department of Pharmacy, University of Rajshahi,
Rajshahi, Bangladesh
(Biswas) Department of Medicine, Faridpur Medical College Hospital,
Faridpur, Bangladesh
(Ibrahim) School of Pharmaceutical Sciences, Universiti Sains Malaysia,
Penang, Malaysia
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: The effects of the ABCB1 C3435T genetic polymorphism on
clopidogrel responses are conflicting and inconclusive especially in
patients undergoing percutaneous coronary intervention (PCI). This study
examined the pooled risk of major adverse cardiovascular events (MACE) and
bleeding events associated with the ABCB1 C3435T polymorphism in acute
coronary syndrome or coronary artery disease patients undergoing PCI and
treated with clopidogrel. Areas covered: Literature was searched in
different resources for eligible studies. The pooled risk ratio was
measured using RevMan software, with p<0.05 (two-sided) set as
statistically significant. Expert opinion: The ABCB1 C3435T homozygous
mutant (TT) was associated with significantly increased risk of MACE
compared to either wild type genotype (CC) or the combination of wild type
and heterozygous genotypes (TT vs. CC: RR 1.33; 95% CI 1.06-1.68; p=0.02;
TT vs. CC+CT: RR 1.32; 95% CI 1.10-1.60; p=0.004). Safety outcomes, i.e.
bleeding events were not significantly different between the genetic
models investigated (TT vs. CC: RR 1.93; 95% CI 0.86-4.35; p=0.11; TT vs.
CC+CT: RR 1.36; 95% CI 0.89-2.09; p=0.16; CT+TT vs. CC: RR 1.20; 95% CI
0.59-2.44; p=0.61). It is suggested that ABCB1 C3435T genotype should be
tested for ACS/CAD patients undergoing PCI to ensure optimum therapy of
clopidogrel.<br/>Copyright &#xa9; 2020 Informa UK Limited, trading as
Taylor & Francis Group.

<35>
Accession Number
2007444099
Title
Anesthesia for Patients Undergoing Anesthesia for Elective Thoracic
Surgery During the COVID-19 Pandemic: A Consensus Statement From the
Israeli Society of Anesthesiologists.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 34 (12) (pp 3211-3217),
2020. Date of Publication: December 2020.
Author
Shaylor R.; Verenkin V.; Matot I.
Institution
(Shaylor, Verenkin, Matot) Division of Anesthesia, Pain and Intensive
Care, Tel Aviv Sourasky Medical Center, Tel Aviv University, the Sackler
Faculty of Medicine, Tel Aviv, Israel
Publisher
W.B. Saunders
Abstract
Anesthesia for thoracic surgery requires specialist intervention to
provide adequate operating conditions and one-lung ventilation. The
pandemic caused by severe acute respiratory syndrome-associated
coronavirus 2 (SARS-CoV-2) is transmitted by aerosol and droplet spread.
Because of its virulence, there is a risk of transmission to healthcare
workers if appropriate preventive measures are not taken. Coronavirus
disease 2019 (COVID-19) patients may show no clinical signs at the early
stages of the disease or even remain asymptomatic for the whole course of
the disease. Despite the lack of symptoms, they may be able to transfer
the virus. Unfortunately, during current COVID-19 testing procedures,
about 30% of tests are associated with a false-negative result. For these
reasons, standard practice is to assume all patients are COVID-19 positive
regardless of swab results. Here, the authors present the recommendations
produced by the Israeli Society of Anesthesiologists for use in thoracic
anesthesia for elective surgery during the COVID-19 pandemic for both the
general population and COVID-19-confirmed patients. The objective of these
recommendations is to make changes to some routine techniques in thoracic
anesthesia to augment patients' and the medical staff's
safety.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<36>
Accession Number
634169074
Title
Association of Effective Regurgitation Orifice Area to Left Ventricular
End-Diastolic Volume Ratio with Transcatheter Mitral Valve Repair
Outcomes: A Secondary Analysis of the COAPT Trial.
Source
JAMA Cardiology. 6 (4) (pp 427-436), 2021. Date of Publication: April
2021.
Author
Lindenfeld J.; Abraham W.T.; Grayburn P.A.; Kar S.; Asch F.M.; Lim D.S.;
Nie H.; Singhal P.; Sundareswaran K.S.; Weissman N.J.; Mack M.J.; Stone
G.W.
Institution
(Lindenfeld) Advanced Heart Failure, Vanderbilt Heart and Vascular
Institute, Nashville, TN, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, United States
(Grayburn) Baylor University Medical Center, Baylor Heart and Vascular
Institute, Dallas, Texas, United States
(Kar) Center of Advanced Cardiac and Vascular Interventions, Los Angeles,
CA, United States
(Asch) MedStar Health Research Institute, Hyattsville, MD, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville,
United States
(Nie, Singhal, Sundareswaran) Abbott, Santa Clara, CA, United States
(Weissman) MedStar Health Research Institute, Hyattsville, MD, United
States
(Mack) Baylor Scott and White Heart Hospital Plano, Plano, Texas, United
States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
American Medical Association
Abstract
Importance: Transcatheter mitral valve repair (TMVr) plus maximally
tolerated guideline-directed medical therapy (GDMT) reduced heart failure
(HF) hospitalizations (HFHs) and all-cause mortality (ACM) in symptomatic
patients with HF and secondary mitral regurgitation (SMR) compared with
GDMT alone in the Cardiovascular Outcomes Assessment of the MitraClip
Percutaneous Therapy for Heart Failure Patients With Functional Mitral
Regurgitation (COAPT) trial but not in a similar trial, Multicenter Study
of Percutaneous Mitral Valve Repair MitraClip Device in Patients With
Severe Secondary Mitral Regurgitation (MITRA-FR), possibly because the
degree of SMR relative to the left ventricular end-diastolic volume index
(LVEDVi) was substantially lower. <br/>Objective(s): To explore
contributions of the degree of SMR using the effective regurgitation
orifice area (EROA), regurgitant volume (RV), and LVEDVi to the benefit of
TMVr in the COAPT trial. <br/>Design, Setting, and Participant(s): This
post hoc secondary analysis of the COAPT randomized clinical trial
performed December 27, 2012, to June 23, 2017, evaluated a subgroup of
COAPT patients (group 1) with characteristics consistent with patients
enrolled in MITRA-FR (n = 56) (HF with grade 3+ to 4+ SMR, left
ventricular ejection fraction of 20%-50%, and New York Heart Association
function class II-IV) compared with remaining (group 2) COAPT patients (n
= 492) using the end point of ACM or HFH at 24 months, components of the
primary end point, and quality of life (QOL) (per the Kansas City
Cardiomyopathy Questionnaire overall summary score) and 6-minute walk
distance (6MWD). The same end points were evaluated in 6 subgroups of
COAPT by combinations of EROA and LVEDVi and of RV relative to LVEDVi.
<br/>Intervention(s): Interventions were TMVr plus GDMT vs GDMT alone.
<br/>Result(s): A total of 548 participants (mean [SD] age, 71.9 [11.2]
years; 351 [64%] male) were included. In group 1, no significant
difference was found in the composite rate of ACM or HFH between TMVr plus
GDMT vs GDMT alone at 24 months (27.8% vs 33.1%, P =.83) compared with a
significant difference at 24 months (31.5% vs 50.2%, P <.001) in group 2.
However, patients randomized to receive TMVr vs those treated with GDMT
alone had significantly greater improvement in QOL at 12 months (mean [SD]
Kansas City Cardiomyopathy Questionnaire summary scores: group 1: 18.36
[5.38] vs 0.43 [4.00] points; P =.01; group 2: 16.54 [1.57] vs 5.78 [1.82]
points; P <.001). Group 1 TMVr-randomized patients vs those treated with
GDMT alone also had significantly greater improvement in 6MWD at 12 months
(mean [SD] paired improvement: 39.0 [28.6] vs -48.0 [18.6] m; P =.02).
Group 2 TMVr-randomized patients vs those treated with GDMT alone tended
to have greater improvement in 6MWD at 12 months, but the difference did
not reach statistical significance (mean [SD] paired improvement: 35.0
[7.7] vs 16.0 [9.1] m; P =.11). <br/>Conclusions and Relevance: A small
subgroup of COAPT-resembling patients enrolled in MITRA-FR did not achieve
improvement in ACM or HFH at 24 months but had a significant benefit on
patient-centered outcomes (eg, QOL and 6MWD). Further subgroup analyses
with 24-month follow-up suggest that the benefit of TMVr is not fully
supported by the proportionate-disproportionate hypothesis. Trial
Registration: ClinicalTrials.gov Identifier: NCT01626079.<br/>Copyright
&#xa9; 2021 American Medical Association. All rights reserved.

<37>
Accession Number
633371190
Title
Effectiveness of Home-Based Mobile Guided Cardiac Rehabilitation as
Alternative Strategy for Nonparticipation in Clinic-Based Cardiac
Rehabilitation among Elderly Patients in Europe: A Randomized Clinical
Trial.
Source
JAMA Cardiology. 6 (4) (pp 463-468), 2021. Date of Publication: April
2021.
Author
Snoek J.A.; Prescott E.I.; Van Der Velde A.E.; Eijsvogels T.M.H.;
Mikkelsen N.; Prins L.F.; Bruins W.; Meindersma E.; Gonzalez-Juanatey
J.R.; Pena-Gil C.; Gonzalez-Salvado V.; Moatemri F.; Iliou M.-C.; Marcin
T.; Eser P.; Wilhelm M.; Van'T Hof A.W.J.; De Kluiver E.P.
Institution
(Snoek, Van Der Velde, De Kluiver) Isala Heart Center, Zwolle, Netherlands
(Snoek) Sports Medicine Department Isala, Zwolle, Netherlands
(Prescott, Mikkelsen) Department of Cardiology, Bispebjerg Frederiksberg
University Hospital, Copenhagen, Denmark
(Eijsvogels) Radboud Institute for Health Sciences, Department of
Physiology, Radboud University Medical Center, Nijmegen, Netherlands
(Prins) Diagram, Zwolle, Netherlands
(Meindersma) Department of Cardiology, Radboud University Medical Center,
Nijmegen, Netherlands
(Gonzalez-Juanatey, Pena-Gil, Gonzalez-Salvado) Department of Cardiology,
Hospital Clinico Universitario de Santiago, Instituto de Investigacion
Sanitaria, CIBER CV, Madrid, Spain
(Moatemri, Iliou) Department of Cardiac Rehabilitation, Assistance
Publique Hopitaux de Paris, Paris, France
(Marcin, Eser, Wilhelm) Department of Cardiology, Inselspital Bern
University Hospital, University of Bern, Bern, Switzerland
(Van'T Hof) Department of Cardiology, Maastricht University Medical Center
and Cardiovascular Research Institute Maastricht (CARIM), Maastricht,
Netherlands
(Van'T Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
American Medical Association
Abstract
Importance: Although nonparticipation in cardiac rehabilitation is known
to increase cardiovascular mortality and hospital readmissions, more than
half of patients with coronary artery disease in Europe are not
participating in cardiac rehabilitation. <br/>Objective(s): To assess
whether a 6-month guided mobile cardiac rehabilitation (MCR) program is an
effective therapy for elderly patients who decline participation in
cardiac rehabilitation. <br/>Design, Setting, and Participant(s): Patients
were enrolled in this parallel multicenter randomized clinical trial from
November 11, 2015, to January 3, 2018, and follow-up was completed on
January 17, 2019, in a secondary care system with 6 cardiac institutions
across 5 European countries. Researchers assessing primary outcome were
masked for group assignment. A total of 4236 patients were identified with
a recent diagnosis of acute coronary syndrome, coronary revascularization,
or surgical or percutaneous treatment for valvular disease, or documented
coronary artery disease, of whom 996 declined to start cardiac
rehabilitation. Subsequently, 179 patients who met the inclusion and
exclusion criteria consented to participate in the European Study on
Effectiveness and Sustainability of Current Cardiac Rehabilitation
Programmes in the Elderly trial. Data were analyzed from January 21 to
October 11, 2019. <br/>Intervention(s): Six months of home-based cardiac
rehabilitation with telemonitoring and coaching based on motivational
interviewing was used to stimulate patients to reach exercise goals.
Control patients did not receive any form of cardiac rehabilitation
throughout the study period. <br/>Main Outcomes and Measures: The primary
outcome parameter was peak oxygen uptake (Vo<inf>2</inf>peak) after 6
months. <br/>Result(s): Among 179 patients randomized (145 male [81%];
median age, 72 [range, 65-87] years), 159 (89%) were eligible for primary
end point analysis. Follow-up at 1 year was completed for 151 patients
(84%). Peak oxygen uptake improved in the MCR group (n = 89) at 6 and 12
months (1.6 [95% CI, 0.9-2.4] mL/kg^-1/min^-1and 1.2
[95% CI, 0.4-2.0] mL/kg^-1/min^-1, respectively),
whereas there was no improvement in the control group (n = 90) (+0.2 [95%
CI, -0.4 to 0.8] mL/kg^-1/min^-1and +0.1 [95% CI, -0.5
to 0.7] mL/kg^-1/min^-1, respectively). Changes in
Vo<inf>2</inf>peak were greater in the MCR vs control groups at 6 months
(+1.2 [95% CI, 0.2 to 2.1] mL/kg^-1/min^-1) and 12
months (+0.9 [95% CI, 0.05 to 1.8] mL/kg^-1/min^-1).
The incidence of adverse events was low and did not differ between the MCR
and control groups. <br/>Conclusions and Relevance: These results suggest
that a 6-month home-based MCR program for patients 65 years or older with
coronary artery disease or a valvular intervention was safe and beneficial
in improving Vo<inf>2</inf>peak when compared with no cardiac
rehabilitation. Trial Registration: trialregister.nl Identifier:
NL5168.<br/>Copyright &#xa9; 2021 American Medical Association. All rights
reserved.

<38>
Accession Number
2010710351
Title
Human glycocalyx shedding: Systematic review and critical appraisal.
Source
Acta Anaesthesiologica Scandinavica. 65 (5) (pp 590-606), 2021. Date of
Publication: May 2021.
Author
Hahn R.G.; Patel V.; Dull R.O.
Institution
(Hahn) Research Unit, Sodertalje Hospital, Sodertalje, Sweden
(Hahn) Karolinska Institute at Danderyds Hospital (KIDS), Stockholm,
Sweden
(Patel) Department of Internal Medicine, Northwestern Medicine McHenry
Hospital, McHenry, IL, United States
(Dull) Department of Anesthesiology, Pathology, Physiology, Surgery,
University of Arizona, College of Medicine, Tucson, AZ, United States
Publisher
Blackwell Munksgaard
Abstract
Background: The number of studies measuring breakdown products of the
glycocalyx in plasma has increased rapidly during the past decade. The
purpose of the present systematic review was to assess the current
knowledge concerning the association between plasma concentrations of
glycocalyx components and structural assessment of the endothelium.
<br/>Method(s): We performed a literature review of Pubmed to determine
which glycocalyx components change in a wide variety of human diseases and
conditions. We also searched for evidence of a relationship between plasma
concentrations and the thickness of the endothelial glycocalyx layer as
obtained by imaging methods. <br/>Result(s): Out of 3,454 publications, we
identified 228 that met our inclusion criteria. The vast majority
demonstrate an increase in plasma glycocalyx products. Sepsis and trauma
are most frequently studied, and comprise approximately 40 publications.
They usually report 3-4-foldt increased levels of glycocalyx degradation
products, most commonly of syndecan-1. Surgery shows a variable picture.
Cardiac surgery and transplantations are most likely to involve elevations
of glycocalyx degradation products. Structural assessment using imaging
methods show thinning of the endothelial glycocalyx layer in
cardiovascular conditions and during major surgery, but thinning does not
always correlate with the plasma concentrations of glycocalyx products.
The few structural assessments performed do not currently support that
capillary permeability is increased when the plasma levels of glycocalyx
fragments in plasma are increased. <br/>Conclusion(s): Shedding of
glycocalyx components is a ubiquitous process that occurs during both
acute and chronic inflammation with no sensitivity or specificity for a
specific disease or condition.<br/>Copyright &#xa9; 2021 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

<39>
Accession Number
2010324642
Title
Ivabradine plus conventional treatment vs conventional treatment alone in
reducing the mean heart rate in heart transplant recipients: A randomized
clinical trial.
Source
Clinical Transplantation. 35 (4) (no pagination), 2021. Article Number:
e14227. Date of Publication: April 2021.
Author
dos Santos C.C.; Rossi Neto J.M.; Finger M.A.; Timerman A.; Contreras C.;
Chaccur P.
Institution
(dos Santos, Rossi Neto, Finger, Timerman, Contreras, Chaccur) Instituto
Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
Publisher
Blackwell Publishing Ltd
Abstract
The absence of afferent nerves for heart rate (HR) regulation leaves the
transplanted heart under the influence of its internal and hormonal
control. The HR of heart transplantation (HTx) recipients varies from to
90-110 bpm, indicating a lack of vagal parasympathetic tone. We
hypothesized that the reduction in mean HR using an If-channel antagonist
(ivabradine) could be effective and safe in HTx recipients. The primary
objective of this open-label randomized clinical trial was to compare the
mean HR at 3, 6, 12, 18, 24, 30, and 36 months after randomization between
an ivabradine plus conventional treatment group (IG) and conventional
treatment alone group (CG). The secondary objectives were reduction in
mortality, graft dysfunction, and ventricular mass. All patients were
randomized between 1 and 12 months after HTx. Ivabradine started at
randomization. Of the 35 patients, 54.28% were in the CG and 45.72% in the
IG. There were no significant between-group differences in demographics.
Over time, the HR differences between the groups became significant (P
<.01). There were no significant between-group differences in mortality,
graft dysfunction, and ventricular mass. We conclude that ivabradine could
effectively and consistently reduce the HR in HTx
recipients.<br/>Copyright &#xa9; 2021 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd

<40>
Accession Number
2006799525
Title
Management of the aortic root in type A aortic dissection: A valve sparing
approach.
Source
Journal of Cardiac Surgery. 36 (5) (pp 1753-1756), 2021. Date of
Publication: May 2021.
Author
Mohamed Ahmed E.; Chen E.P.
Institution
(Mohamed Ahmed, Chen) Division of Cardiothoracic Surgery, Department of
Surgery, Emory School of Medicine, Atlanta, GA, United States
Publisher
Blackwell Publishing Inc.
Abstract
Background: Type A acute aortic dissection (TAAAD) is rapidly fatal
without emergency repair. Surgical outcomes have improved over the years
with improvements in technique and postoperative care. Classically,
supracomissural aortic replacement has been the standard of care. However,
reintervention rates, particularly on the aortic root in certain groups of
patients, shifted the focus towards improving long-term results of
surgical repair. With regard to the aortic root, root replacement has been
the gold standard. However, the surgical community realized that valve
replacement in itself is a disease, and valve sparing aortic root
replacement (VSRR) took center stage in the care of these patients.
<br/>Method(s): We searched the Pubmed and EMBASE databases for articles
related to VSRR and composite valve conduit (CVC) root replacement, and
the long-term results of these techniques in TAAAD. <br/>Result(s):
Supracomissural repair is limited by reintervention, and CVC results are
affected by complications related to the prosthetic valve. Conversely,
VSRR is associated with good short-term outcomes, improvement in quality
of life, and it is durable. <br/>Conclusion(s): VSRR is a sound technique
in TAAAD in experienced hands.<br/>Copyright &#xa9; 2020 Wiley Periodicals
LLC

<41>
Accession Number
634826093
Title
A systematic review of the evidence supporting post-operative medication
use in congenital heart disease.
Source
Cardiology in the Young. (no pagination), 2021. Date of Publication: 2021.
Author
Thompson E.J.; Foote H.P.; King C.E.; Srinivasan S.; Ciociola E.C.; Leung
D.; Rotta A.T.; Hill K.D.; Cohen-Wolkowiez M.; Hornik C.P.
Institution
(Thompson, Foote, King, Rotta, Hill, Cohen-Wolkowiez, Hornik) Department
of Pediatrics, Duke University School of Medicine, Durham, NC, United
States
(Srinivasan, Ciociola, Hill, Cohen-Wolkowiez, Hornik) Duke Clinical
Research Institute, Duke University School of Medicine, Durham, NC, United
States
(Leung) Department of Pediatrics, University of North Carolina at Chapel
Hill, Chapel Hill, NC, United States
Publisher
Cambridge University Press
Abstract
Background: Targeted drug development efforts in patients with CHD are
needed to standardise care, improve outcomes, and limit adverse events in
the post-operative period. To identify major gaps in knowledge that can be
addressed by drug development efforts and provide a rationale for current
clinical practice, this review evaluates the evidence behind the most
common medication classes used in the post-operative care of children with
CHD undergoing cardiac surgery with cardiopulmonary bypass.
<br/>Method(s): We systematically searched PubMed and EMBASE from 2000 to
2019 using a controlled vocabulary and keywords related to diuretics,
vasoactives, sedatives, analgesics, pulmonary vasodilators, coagulation
system medications, antiarrhythmics, steroids, and other endocrine drugs.
We included studies of drugs given post-operatively to children with CHD
undergoing repair or palliation with cardiopulmonary bypass.
<br/>Result(s): We identified a total of 127 studies with 51,573 total
children across medication classes. Most studies were retrospective
cohorts at single centres. There is significant age- A nd disease-related
variability in drug disposition, efficacy, and safety. <br/>Conclusion(s):
In this study, we discovered major gaps in knowledge for each medication
class and identified areas for future research. Advances in data
collection through electronic health records, novel trial methods, and
collaboration can aid drug development efforts in standardising care,
improving outcomes, and limiting adverse events in the post-operative
period.<br/>Copyright &#xa9; The Author(s), 2021. Published by Cambridge
University Press.

<42>
Accession Number
634814396
Title
Cardiac outcomes of depression treatment in patients with acute coronary
syndrome.
Source
Asia-Pacific Psychiatry. Conference: 19th International Congress of the
Pacific Rim College of Psychiatrists. Seoul South Korea. 13 (SUPPL 1) (no
pagination), 2021. Date of Publication: April 2021.
Author
Kim J.-M.
Institution
(Kim) Department of Psychiatry, Chonnam National University Hospital,
South Korea
Publisher
Wiley-Blackwell
Abstract
Depression is common after acute coronary syndrome (ACS) with adverse
effects on course and prognosis. Despite the clinical importance, there
has been a heated debate on the utility of depression screening and
treatment in clinical practice for ACS, since it has been unclear whether
this procedure actually improves cardiac outcome. To address this, we
recruited and categorised participants by depression screening and
diagnosis status at baseline and 24 week treatment allocation into five
groups: 651 screen-negative, 55 screen-positive but not fulfilling
depressive disorder diagnostic criteria, 149 randomised to escitalopram,
151 randomised to placebo, and 146 not randomised and receiving medical
treatment only (MTO). We then followed these cohorts for 5-12 years to
investigate the impacts of depression screening, diagnosis, and treatment
on major adverse cardiac event (MACE). Principal findings were that
screening positive for depression was associated with a higher hazard of
MACE, even in the cases without diagnostic criteria for depressive
disorder; that escitalopram treatment was associated with significantly
better outcomes than placebo and MTO in patients with depressive disorder
following ACS; and that MTO was associated with worse cardiac outcomes
even compared to placebo, despite milder depressive symptoms at baseline.
Our findings, we believe, provide support for routine depression screening
and diagnostic assessment following ACS and the recommendation of
appropriate treatment in those found to have depressive disorder, which
could improve long-term cardiac outcomes. To our knowledge, this study is
the longest and most extensive evaluations of its kind. We believe our
findings are novel and a significant and original contribution not only
for specialists in Cardiology or Psychiatry but also for general
physicians.

<43>
Accession Number
634826230
Title
Empagliflozin reduces the total burden of cardiovascular events including
recurrent events in the empa-reg outcome trial.
Source
Journal of the American Geriatrics Society. Conference: American
Geriatrics Society Annual Meeting, AGS 2021. Virtual. 69 (SUPPL 1) (pp
S88), 2021. Date of Publication: April 2021.
Author
Fitchett D.H.; Inzucchi S.E.; Wanner C.; Anker S.D.; Pocock S.; Kaspers
S.; Johansen O.; George J.T.; Jamal W.; Hantel S.; Lund S.S.
Institution
(Inzucchi) Section of Endocrinology, Yale University, School of Medicine,
New Haven, CT, United States
(Wanner) Wurzburg University Clinic, Wurzburg, Germany
(Johansen) Boehringer Ingelheim Norway KS, Asker, Norway
(Anker) Dept of Cardiology (CVK) and BIH Center for Regenerative Therapies
(BCRT) DZHK partner site Berlin Charite, University Medicine, Berlin,
Germany
(Kaspers, George, Jamal, Lund) Boehringer Ingelheim International GmbH,
Ingelheim, Germany
(Pocock) Dept of Medical Statistics, London School of Hygeine and Tropical
Medicine, London, United Kingdom
(Hantel) Boehringer Ingelheim Pharma GmbH and Co. KG, Biberach, Germany
(Fitchett) St Michael's Hosp, Div of Cardiology, Univ of Toronto, Toronto,
ON, Canada
Publisher
Blackwell Publishing Inc.
Abstract
Introduction In EMPA-REG OUTCOME, empagliflozin (EMPA) reduced the risk of
major adverse cardiovascular (CV) events (MACE), CV mortality and
hospitalization for heart failure (HHF) in analyses of first events in
patients with type 2 diabetes (T2D) and atherosclerotic CV disease
(ASCVD). We assessed the effect of EMPA on the total burden of CV events.
Methods Patients were randomized to EMPA 10 mg, EMPA 25 mg, or placebo. We
assessed the effects of EMPA pooled vs placebo on any (first plus
recurrent) adjudicated CV event (composite of myocardial infarction (MI),
stroke, coronary revascularization (CR), hospitalization for unstable
angina, transient ischemic attack, HHF, and CV death) using a negative
binomial model. Results Among 7,020 treated patients (mean [SD] age 63 [9]
years), there were 2,142 total adjudicated CV events, most frequently CR
(585), MI (421), and HHF (321). EMPA reduced the risk of total adjudicated
CV events by 24% vs placebo (event rate ratio [95% CI]: 0.76 [0.67, 0.87],
p<0.0001). The data suggest a directionally similar treatment effect in
age groups <65 or >=65 yrs and a reduction in risk in older patients (>=65
yrs (<65 yrs, N=3893: 0.87 [0.72, 1.05]; >=65 yrs, N=3127: 0.66 [0.55,
0.80]; p=0.0508 for interaction)). Risk reductions were driven
predominantly by reductions in HHF (0.58 [0.42, 0.81], p=0.0012), MI (0.79
[0.620, 0.998], p=0.0486), and CV death (0.62 [0.49, 0.77], p<0.0001). The
estimated number of total CV events prevented with EMPA was 414.4, and the
number of patients needed to treat over 3 years to prevent one event was
10.2 [6.6, 22.7]. Conclusions EMPA produced a sizeable risk reduction in
the total burden of any adjudicated CV outcome, including HHF, MI and CV
death, in patients with T2D and ASCVD.

<44>
Accession Number
2011740748
Title
The Use of Radial Artery for CABG: An Update.
Source
BioMed Research International. 2021 (no pagination), 2021. Article Number:
5528006. Date of Publication: 2021.
Author
Nappi F.; Bellomo F.; Nappi P.; Chello C.; Iervolino A.; Chello M.; Acar
C.
Institution
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord de
Saint-Denis, Paris, France
(Bellomo, Nappi) Department of Clinical and Experimental Medicine,
University of Messina, Italy
(Chello) Regenerative Medicine, Universita Campus Bio-Medico di Roma, Rome
00128, Italy
(Iervolino) Department of Cardiovascular Sciences, Fondazione Policlinico
Universitario A. Gemelli IRCSS, Italy
(Chello) Cardiovascular Surgery, Universita Campus Bio-Medico di Roma,
Rome 00128, Italy
(Acar) Department of Cardiac Surgery, La Pitie Salpetriere Hospital,
Paris, France
Publisher
Hindawi Limited
Abstract
We used the radial artery as a second target conduit for coronary artery
bypass grafting since 1971. However, randomized clinical studies have
demonstrated differences in clinical outcomes between the radial artery
and other grafts because these trials are underpowered. As we proceed
toward 50 years of experience with radial artery grafting, we examined the
literature to define the best second-best target vessel for coronary
artery bypass grafting. The literature was reviewed with emphasis, and a
large number of randomized controlled trials, propensity-matched
observational series, and meta-analyses were identified with a large
patient population who received arterial conduit and saphenous vein
grafts. The radial artery has been shown to be effective and safe when
used as a second target conduit for coronary artery bypass grafting.
Results and patency rates were superior to those for saphenous vein
grafting. It has also been shown that the radial artery is a safe and
effective graft as a third conduit into the territory of the artery right
coronary artery. However, there is little evidence based on a few
comparable series limiting the use of the gastroepiploic artery. In its
fifth decade of use, we can finally deduced that the aorto-to-coronary
radial bypass graft is the conduit of choice for coronary operations after
the left internal thoracic artery to the left anterior descending artery.
<br/>Copyright &#xa9; 2021 Francesco Nappi et al.

<45>
Accession Number
2011733667
Title
Effect of a smartphone-based intervention on secondary prevention
medication prescriptions after coronary artery bypass graft surgery: The
MISSION-1 randomized controlled trial.
Source
American Heart Journal. 237 (pp 79-89), 2021. Date of Publication: July
2021.
Author
Qu J.; Du J.; Rao C.; Chen S.; Gu D.; Li J.; Zhang H.; Zhao Y.; Hu S.;
Zheng Z.
Institution
(Qu, Du, Rao, Chen, Gu, Li, Zhang, Zhao, Hu, Zheng) National Clinical
Research Center for Cardiovascular, Diseases, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, Peking Union Medical
College, Beijing, China
(Qu, Du, Rao, Gu, Zhang, Hu, Zheng) Department of Cardiovascular Surgery,
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese
Academy of Medical Sciences, Peking Union Medical College, Beijing, China
(Chen) Information Center, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
(Du) Department of Cardiothoracic Surgery, Shenzhen Children's Hospital,
Shenzhen, China
Publisher
Mosby Inc.
Abstract
Background: Studies found that patients who underwent coronary artery
bypass grafting (CABG) often fail to receive optimal evidence-based
secondary prevention medications. We evaluated the effectiveness of a
smartphone-based quality improvement effort on improving the prescription
of medical therapies. <br/>Method(s): In this cluster-randomized
controlled trial, 60 hospitals were randomized to a control arm (n = 30)
or to an intervention arm using smartphone-based multifaceted quality
improvement interventions (n = 30). The primary outcome was the
prescription of statin. The secondary outcomes were prescription of
beta-blocker, angiotensin-converting enzyme inhibitor, or angiotensin
receptor blocker (ACE inhibitor or ARB), and optimal medical therapy for
eligible patients. <br/>Result(s): Between June 1, 2015 and September 15,
2016, a total of 10,006 CABG patients were enrolled (5,653 in 26
intervention and 4,353 in 29 control hospitals, 5 hospitals withdrew).
Statin prescribing rate was 87.8% in the intervention arm and 84.4% in the
control arm. We saw no evidence of an effect of intervention on statin
prescribing in the intention-to-treat analysis (odds ratio [OR], 1.31; 95%
confidence interval (CI), 0.68-2.54; P = .43) or in key patient subsets.
The prescription rates of ACE inhibitor or ARB and optimal medical therapy
were comparable between study groups, while beta-blocker was more often
prescribed in the intervention arm. Post hoc analysis demonstrated a
greater increase in statin prescribing rate over time in the intervention
arm. <br/>Conclusion(s): A smartphone-based quality improvement
intervention compared with usual care did not increase statin prescribing
for patients who received CABG. New studies focusing on the best practice
of this technique may be warranted.<br/>Copyright &#xa9; 2021 Elsevier
Inc.

<46>
Accession Number
2011731500
Title
Impact of Anesthesia Strategy and Valve Type on Clinical Outcomes After
Transcatheter Aortic Valve Replacement.
Source
Journal of the American College of Cardiology. 77 (17) (pp 2204-2215),
2021. Date of Publication: 04 May 2021.
Author
Feistritzer H.-J.; Kurz T.; Stachel G.; Hartung P.; Lurz P.; Eitel I.;
Marquetand C.; Nef H.; Doerr O.; Vigelius-Rauch U.; Lauten A.; Landmesser
U.; Treskatsch S.; Abdel-Wahab M.; Sandri M.; Holzhey D.; Borger M.; Ender
J.; Ince H.; Oner A.; Meyer-Saraei R.; Hambrecht R.; Wienbergen H.; Fach
A.; Augenstein T.; Frey N.; Konig I.R.; Vonthein R.; Funkat A.-K.;
Berggreen A.E.; Heringlake M.; Desch S.; de Waha-Thiele S.; Thiele H.
Institution
(Feistritzer, Stachel, Hartung, Lurz, Abdel-Wahab, Sandri, Holzhey,
Borger, Ender, Desch, Thiele) Heart Center Leipzig at University of
Leipzig, Leipzig, Germany
(Feistritzer, Stachel, Hartung, Lurz, Abdel-Wahab, Sandri, Holzhey,
Borger, Ender, Funkat, Desch, Thiele) Leipzig Heart Institute, Leipzig,
Germany
(Kurz, Eitel, Marquetand, Meyer-Saraei, Berggreen, Heringlake, de
Waha-Thiele) University Clinic Schleswig-Holstein and University Heart
Center Lubeck, Lubeck, Germany
(Kurz, Eitel, Marquetand, Lauten, Landmesser, Meyer-Saraei, Konig, Desch,
de Waha-Thiele) German Center for Cardiovascular Research (DZHK), Lubeck,
Germany
(Nef, Doerr, Vigelius-Rauch) Medizinische Klinik I, Abteilung fur
Kardiologie, Universitatsklinikum Marburg/Giesen, Giesen, Germany
(Lauten, Landmesser, Treskatsch) Universitatsklinikum Charite, Campus
Benjamin Franklin, Berlin, Germany
(Ince, Oner) Medizinische Klinik I im Zentrum fur Innere Medizin,
Universitatsklinikum Rostock, Rostock, Germany
(Hambrecht, Wienbergen, Fach, Augenstein) Klinikum Links der Weser,
Herzzentrum Bremen, Bremen, Germany
(Frey) Department of Cardiology, Angiology and Pulmology, University
Hospital Heidelberg, Heidelberg, Germany
(Konig, Vonthein) Institut fur Medizinische Biometrie und Statistik,
University of Lubeck, Lubeck, Germany
(Vonthein) Institut fur Statistik, Ludwig-Maximilians-Universitat Munchen,
Munich, Germany
Publisher
Elsevier Inc.
Abstract
Background: The randomized SOLVE-TAVI (compariSon of secOnd-generation
seLf-expandable vs. balloon-expandable Valves and gEneral vs. local
anesthesia in Transcatheter Aortic Valve Implantation) trial compared
newer-generation self-expanding valves (SEV) and balloon-expandable valves
(BEV) as well as local anesthesia with conscious sedation (CS) and general
anesthesia (GA) in patients undergoing transfemoral transcatheter aortic
valve replacement (TAVR). Both strategies showed similar outcomes at 30
days. <br/>Objective(s): The purpose of this study was to compare clinical
outcomes during 1-year follow-up in the randomized SOLVE-TAVI trial.
<br/>Method(s): Using a 2 x 2 factorial design 447 intermediate- to
high-risk patients with severe, symptomatic aortic stenosis were randomly
assigned to transfemoral TAVR using either the SEV (Evolut R, Medtronic
Inc., Minneapolis, Minnesota) or the BEV (Sapien 3, Edwards Lifesciences,
Irvine, California) as well as CS or GA at 7 sites. <br/>Result(s): In the
valve-comparison strategy, rates of the combined endpoint of all-cause
mortality, stroke, moderate or severe paravalvular leakage, and permanent
pacemaker implantation were similar between the BEV and SEV group (n = 84,
38.3% vs. n = 87, 40.4%; hazard ratio: 0.94; 95% confidence interval: 0.70
to 1.26; p = 0.66) at 1 year. Regarding the anesthesia comparison, the
combined endpoint of all-cause mortality, stroke, myocardial infarction,
and acute kidney injury occurred with similar rates in the GA and CS
groups (n = 61, 25.7% vs. n = 54, 23.8%; hazard ratio: 1.09; 95%
confidence interval: 0.76 to 1.57; p = 0.63). <br/>Conclusion(s): In
intermediate- to high-risk patients undergoing transfemoral TAVR,
newer-generation SEV and BEV as well as CS and GA showed similar clinical
outcomes at 1 year using a combined clinical endpoint. (SecOnd-generation
seLf-expandable Versus Balloon-expandable Valves and gEneral Versus Local
Anesthesia in TAVI [SOLVE-TAVI]; NCT02737150)<br/>Copyright &#xa9; 2021
American College of Cardiology Foundation

<47>
Accession Number
2006979598
Title
Surgical and transcatheter mitral valve replacement in mitral annular
calcification: A systematic review.
Source
Journal of the American Heart Association. 10 (7) (no pagination), 2021.
Article Number: e018514. Date of Publication: 2021.
Author
Alexis S.L.; Malik A.H.; El-Eshmawi A.; George I.; Sengupta A.; Kodali
S.K.; Hahn R.T.; Khalique O.K.; Zaid S.; Guerrero M.; Bapat V.N.; Leon
M.B.; Adams D.H.; Tang G.H.L.
Institution
(Alexis, El-Eshmawi, Sengupta, Adams, Tang) From the Department of
Cardiovascular Surgery, Mount Sinai Health System, New York, NY, United
States
(Malik) Department of Medicine, Westchester Medical Center, Valhalla, NY,
United States
(George, Bapat) Division of Cardiac Surgery, New York Presbyterian
Hospital, Columbia University Medical Center, New York, NY, United States
(Kodali, Hahn, Khalique, Leon) Division of Cardiology, New York
Presbyterian Hospital, Columbia University Medical Center, New York, NY,
United States
(Zaid) Department of Cardiology, Westchester Medical Center, Valhalla, NY,
United States
(Guerrero) Division of Cardiology, Mayo Clinic, Rochester, MN, United
States
(Bapat) Now with Department of Cardiothoracic Surgery, Minneapolis Heart
Institute, Abbott Northwestern Hospital, Minneapolis, MN, United States
Publisher
American Heart Association Inc.
Abstract
Mitral annular calcification with mitral valve disease is a challenging
problem that could necessitate surgical mitral valve replacement (SMVR).
Transcatheter mitral valve replacement (TMVR) is emerging as a feasible
alternative in high-risk patients with appropriate anatomy. PubMed,
Embase, and Cochrane Central Register of Controlled Trials were searched
from inception to December 25, 2019 for studies discussing SMVR or TMVR in
patients with mitral annular calcification; 27 of 1539 articles were
selected for final review. TMVR was used in 15 studies. Relevant data were
available on 82 patients who underwent hybrid transatrial TMVR, and 354
patients who underwent transapical or transseptal TMVR. Outcomes on SMVR
were generally reported as small case series (447 patients from 11
studies); however, 1 large study recently reported outcomes in 9551
patients. Patients who underwent TMVR had a shorter median follow-up of 9
to 12 months (range, in-hospital-19 months) compared with patients with
SMVR (54 months; range, in-hospital-120 months). Overall, those undergoing
TMVR were older and had higher Society of Thoracic Surgeons risk scores.
SMVR showed a wide range of early (0%-27%; median 6.3%) and long-term
mortality (0%-65%; median at 1 year, 15.8%; 5 years, 38.8%, 10 years,
62.4%). The median in-hospital, 30-day, and 1-year mortality rates were
16.7%, 22.7%, and 43%, respectively, for transseptal/transapical TMVR, and
9.5%, 20.0%, and 40%, respectively, for transatrial TMVR. Mitral annular
calcification is a complex disease and TMVR, with a versatile option of
transatrial approach in patients with challenging anatomy, offers a
promising alternative to SMVR in high-risk patients. However, further
studies are needed to improve technology, patient selection, operative
expertise, and long-term outcomes.<br/>Copyright &#xa9; 2021 The Authors.

<48>
Accession Number
2007007498
Title
Hybrid repair versus conventional open repair approaches for aortic arch
disease: A comprehensive review.
Source
Brazilian Journal of Cardiovascular Surgery. 36 (2) (pp 244-252), 2021.
Date of Publication: 2021.
Author
Ribeiro T.S.; de Paiva Gadelha Junior H.; dos Santos M.A.
Institution
(Ribeiro, de Paiva Gadelha Junior) Department of Integrated Medicine,
Onofre Lopes University Hospital, Federal University of Rio Grande do
Norte, Natal, Brazil
(dos Santos) Dante Pazzanese Institute of Cardiology, Sao Paulo, SP,
Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: To investigate whether hybrid repair has supremacy over
conventional open repair in aortic arch diseases. <br/>Method(s): A
comprehensive search was undertaken in two major databases (PubMed and
MEDLINE) to identify all studies comparing the two surgical techniques in
five years, up to December 2018, that met the established criteria in this
study. The search returned 310 papers, and 305 were selected after
removing duplicates. The abstracts of the remaining articles were
assessed, resulting in 15 studies that went to full-text analysis. After
application of the inclusion and exclusion criteria, 8 papers remained for
the final revision. <br/>Result(s): Eight studies met the criteria, with
the inclusion of 1,837 patients. From a short-term perspective, hybrid
repair and conventional open repair had similar outcomes in terms of
postoperative mortality and acute neurological events. Hybrid repair was
associated with less respiratory complications and risk of new
intervention, as well as reduced hospital length of stay. Conventional
open repair showed better mid- and long-term outcomes. <br/>Conclusion(s):
Hybrid repair should be used in selected patients, with a high risk or
very high-risk profile for conventional surgery. Finally, since most of
the current data were obtained from limited to large samples, with narrow
follow-up and had great heterogeneity, the best approach to the aortic
arch is still variable. Therefore, the decision of the approach should be
individualized and evaluated by the whole Heart Team, considering the
expertise of the surgical team.<br/>Copyright &#xa9; 2021, Sociedade
Brasileira de Cirurgia Cardiovascular. All rights reserved.

<49>
Accession Number
2011718367
Title
Deep sedation versus general anaesthesia for transcatheter mitral valve
repair: An individual patient data meta-analysis of observational studies.
Source
EuroIntervention. 16 (16) (pp 1359-1365), 2021. Date of Publication: 2021.
Author
Jobs A.; Grund S.; De Waha-Thiele S.; Ledwoch J.; Sievert H.; Rassaf T.;
Luedike P.; Kelm M.; Hellhammer K.; Horn P.; Westenfeld R.; Patzelt J.;
Langer H.F.; Lurz P.; Desch S.; Eitel I.; Thiele H.
Institution
(Jobs, Lurz, Desch, Thiele) Heart Center Leipzig at University of Leipzig,
Department of Internal Medicine/Cardiology, Leipzig Heart Institute,
Leipzig, Germany
(Jobs, De Waha-Thiele, Patzelt, Langer, Eitel) Department of Cardiology,
Angiology and Intensive Care Medicine, University Heart Center Lubeck,
Medical Clinic II, University of Lubeck, Lubeck, Germany
(Jobs, De Waha-Thiele, Ledwoch, Patzelt, Langer, Eitel) German Center for
Cardiovascular Research (DZHK), Berlin, Germany
(Grund) Leibniz Institute for Science and Mathematics Education Kiel,
Kiel, Germany
(Ledwoch) Medizinische Klinik und Poliklinik, Klinikum rechts der Isar,
Technische Universitat Munchen, Munich, Germany
(Ledwoch, Sievert) CardioVascular Center Frankfurt, Frankfurt, Germany
(Rassaf, Luedike) Department of Cardiology and Vascular Medicine, West
German Heart and Vascular Center Essen, University Hospital Essen, Essen,
Germany
(Kelm, Hellhammer, Horn, Westenfeld) Department of Cardiology,
Pulmonology, and Vascular Medicine, Medical Faculty of the Heinrich Heine
University Dusseldorf, Dusseldorf, Germany
(Patzelt, Langer) Department of Cardiology and Cardiovascular Medicine,
University Hospital, Eberhard Karls University Tubingen, Tubingen, Germany
Publisher
Europa Group
Abstract
Aims: The aim of this meta-analysis was to compare general anaesthesia
(GA) and deep sedation (DS) with regard to safety and length of intensive
care unit (ICU) stay in patients undergoing percutaneous edge-toedge
mitral valve repair (PMVR). <br/>Methods and Results: Four studies
comparing GA and DS in patients undergoing PMVR were included in an
individual patient data meta-analysis. Data were pooled after multiple
imputation. The composite safety endpoint of all-cause death, stroke,
pneumonia, or major to life-threatening bleeding occurred in 87 of 626
(13.9%) patients with no difference between patients treated with DS as
compared to GA (56 and 31 events in 420 and 206 patients, respectively).
In this regard, the odds ratio (OR) was 1.27 (95% confidence interval
[CI]: 0.78 to 2.09; p=0.338) and 1.26 (95% CI: 0.49 to 3.22; p=0.496)
following the onestage and two-stage approach, respectively. Length of ICU
stay was longer after GA as compared to DS (ratio of days 3.08, 95% CI:
2.18 to 4.36, p<0.001, and 2.88, 95% CI: 1.45 to 5.73, p=0.016, following
the one-stage and two-stage approach, respectively). <br/>Conclusion(s):
Both DS and GA might offer a similar safety profile. However, ICU stay
seems to be shorter after DS.<br/>Copyright &#xa9; Europa Digital &
Publishing 2021. All rights reserved.

<50>
Accession Number
2007017894
Title
Long-term results after drug-eluting versus bare-metal stent implantation
in saphenous vein grafts: Randomized controlled trial.
Source
Journal of the American Heart Association. 9 (20) (no pagination), 2020.
Article Number: e017434. Date of Publication: 20 Oct 2020.
Author
Fahrni G.; Farah A.; Engstrom T.; Galatius S.; Eberli F.; Rickenbacher P.;
Conen D.; Mueller C.; Pfister O.; Twerenbold R.; Coslovsky M.; Cattaneo
M.; Kaiser C.; Mangner N.; Schuler G.; Pfisterer M.; Mobius-Winkler S.;
Jeger R.V.
Institution
(Fahrni, Rickenbacher, Conen, Mueller, Pfister, Twerenbold, Coslovsky,
Cattaneo, Kaiser, Pfisterer, Jeger) University Hospital, Basel,
Switzerland
(Farah) Klinikum Westfalen, Dortmund, Germany
(Farah) Central Clinic, Bad Berka, Germany
(Engstrom) Rigshospitalet, Copenhagen, Denmark
(Galatius) Bispebjerg University Hospital, Copenhagen, Denmark
(Galatius) Gentofte Hospital, Hellerup, Denmark
(Eberli) Triemli Hospital, Zurich, Switzerland
(Conen) Population Health Research Institute, McMaster University,
Hamilton, Canada
(Mangner) Herzzentrum Dresden, Technische Universitat Dresden, Dresden,
Germany
(Mangner, Schuler, Mobius-Winkler) Heart Center, University of Leipzig,
Germany
(Mobius-Winkler) University of Jena, Germany
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Efficacy data on drug-eluting stents (DES) versus bare-metal
stents (BMS) in saphenous vein grafts are con-troversial. We aimed to
compare DES with BMS among patients undergoing saphenous vein grafts
intervention regarding long-term outcome. METHODS AND RESULTS: In this
multinational trial, patients were randomized to paclitaxel-eluting or
BMS. The primary end point was major adverse cardiac events (cardiac
death, nonfatal myocardial infarction, and target-vessel revascularization
at 1 year. Secondary end points included major adverse cardiac events and
its individual components at 5-year follow-up. One hundred seventy-three
patients were included in the trial (89 DES versus 84 BMS). One-year major
adverse cardiac event rates were lower in DES compared with BMS (2.2%
versus 16.0%, hazard ratio, 0.14; 95% CI, 0.03-0.64, P=0.01), which was
mainly driven by a reduction of subsequent myocardial infarctions and need
for target-vessel revascularization. Five-year major adverse cardiac event
rates remained lower in the DES compared with the BMS arm (35.5% versus
56.1%, hazard ratio, 0.40; 95% CI, 0.23-0.68, P<0.001). A
landmark-analysis from 1 to 5 years revealed a persistent benefit of DES
over BMS (hazard ratio, 0.33; 95% CI, 0.13-0.74, P=0.007) in terms of
target-vessel revascularization. More patients in the BMS group underwent
multiple target-vessel revascularization procedures throughout the study
period compared with the DES group (DES 1.1% [n=1] versus BMS 9.5% [n=8],
P=0.013). Enrollment was stopped before the target sample size of 240
patients was reached. <br/>CONCLUSION(S): In this randomized controlled
trial with prospective long-term follow-up of up to 5 years, DES showed a
better efficacy than BMS with sustained benefits over time. DES may be the
preferred strategy in this patient population. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT00595647.<br/>Copyright &#xa9; 2020 The Authors.

<51>
Accession Number
2007011941
Title
Myocardial injury after balloon predilatation versus direct transcatheter
aortic valve replacement: Insights from the directavi trial.
Source
Journal of the American Heart Association. 9 (24) (no pagination), 2020.
Article Number: e018405. Date of Publication: 15 Dec 2020.
Author
Akodad M.; Roubille F.; Marin G.; Lattuca B.; Macia J.-C.; Delseny D.;
Gandet T.; Robert P.; Schmutz L.; Piot C.; Maupas E.; Robert G.; Targosz
F.; Albat B.; Cayla G.; Leclercq F.
Institution
(Akodad, Roubille, Macia, Delseny, Robert, Leclercq) Department of
Cardiology, Montpellier University Hospital, Montpellier, France
(Akodad, Roubille) PhyMedExp, INSERM U1046, CNRS UMR 9214, Montpellier,
France
(Marin) Department of Medical Information, Montpellier University
Hospital, Montpellier, France
(Lattuca, Schmutz, Cayla) Department of Cardiology, CHU Nimes, Montpellier
University, Nimes, France
(Gandet, Albat) Department of Cardiovascular Surgery, University Hospital
of Montpellier, France
(Piot) Millenaire Clinic, Montpellier, France
(Maupas) Franciscaines Clinic, Nimes, France
(Robert) St Pierre Clinic, Perpignan, France
(Targosz) Perpignan Hospital, Perpignan, France
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Myocardial injury is associated with higher mortality after
transcatheter aortic valve replacement (TAVR) and might be increased by
prior balloon aortic valvuloplasty (BAV). We aimed to evaluate the impact
of prior BAV versus direct prosthesis implantation on myocardial injury
occurring after (TAVR) with balloon-expandable prostheses. METHODS AND
RESULTS: The DIRECTAVI (Direct Transcatheter Aortic Valve Implantation)
trial, an open-label randomized study, demonstrated noninferiority of TAVR
without BAV (direct TAVR group) compared with systematic BAV (BAV group)
with the Edwards SAPIEN 3 valve. High-sensitivity troponin was assessed
before and the day after the procedure. Incidence of myo-cardial injury
after the procedure (high-sensitivity troponin elevation >15x the upper
reference limit [14 ng/L]) was the main end point. Impact of myocardial
injury on 1-month adverse events (all-cause mortality, stroke, major
bleeding, major vascular complications, transfusion, acute kidney injury,
heart failure, pacemaker implantation, and aortic regurgitation) was
evaluated. Preprocedure and postprocedure high-sensitivity troponin levels
were available in 211 patients. The mean age of patients was 83 years
(78-87 years), with 129 men (61.1%). Mean postprocedure high-sensitivity
troponin was 124.9+/-81.4 ng/L in the direct TAVR group versus
170.4+/-127.7 ng/L in the BAV group (P=0.007). Myocardial injury occurred
in 42 patients (19.9%), including 13 patients (12.2%) in the direct TAVR
group and 29 (27.9%) in the BAV group (P=0.004). BAV increased by 2.8-fold
(95% CI, 1.4-5.8) myocardial injury probability. Myocardial injury was
associated with 1-month adverse events (P=0.03). <br/>CONCLUSION(S): BAV
increased the incidence and magnitude of myocardial injury after TAVR with
new-generation balloon-expandable valves. Myocardial injury was associated
with 1-month adverse events. These results argue in favor of direct SAPIEN
3 valve implantation.<br/>Copyright &#xa9; 2020 The Authors. Published on
behalf of the American Heart Association, Inc., by Wiley.

<52>
Accession Number
2007011932
Title
Coronary computed tomography angiography compared with single photon
emission computed tomography myocardial perfusion imaging as a guide to
optimal medical therapy in patients presenting with stable angina: The
rescue trial.
Source
Journal of the American Heart Association. 9 (24) (no pagination), 2020.
Article Number: e017993. Date of Publication: 15 Dec 2020.
Author
Stillman A.E.; Gatsonis C.; Lima J.A.C.; Liu T.; Snyder B.S.; Cormack J.;
Malholtra V.; Schnall M.D.; Udelson J.E.; Hoffmann U.; Woodard P.K.
Institution
(Stillman) Department of Radiology and Imaging Sciences, Emory University,
Atlanta, GA, United States
(Gatsonis, Liu) Department of Biostatistics, Providence, RI, United States
(Gatsonis, Liu, Snyder, Cormack) Center for Statistical Sciences, Brown
University School of Public Health, Providence, RI, United States
(Lima) Departments of Medicine and Radiology, Johns Hopkins University,
Baltimore, MD, United States
(Malholtra) Pulse Heart Institute, Tacoma, WA, United States
(Schnall) Department of Radiology, University of Pennsylvania, Boston, MA,
United States
(Udelson) Division of Cardiology, Tufts-New England Medical Center,
Boston, MA, United States
(Hoffmann) Department of Radiology, Massachusetts General Hospital,
Boston, MA, United States
(Woodard) Mallinckrodt Institute of Radiology, Washington University
School of Medicine, St. Louis, MO, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The RESCUE (Randomized Evaluation of Patients with Stable
Angina Comparing Utilization of Noninvasive Examinations) trial was a
randomized, controlled, multicenter, comparative efficacy outcomes trial
designed to assess whether initial testing with coronary computed
tomographic angiography (CCTA) is noninferior to single photon emission
computed tomography (SPECT) myocardial perfusion imaging in directing
patients with stable angina to optimal medical therapy alone or optimal
medical therapy with revascularization. METHODS AND RESULTS: The end point
was first major adverse cardiovascular event (MACE) (cardiac death or
myocardial in-farction), or revascularization. Noninferiority margin for
CCTA was set a priori as a hazard ratio (HR) of 1.3 (95% CI=0, 1.605). One
thousand fifty participants from 44 sites were randomized to CCTA (n=518)
or SPECT (n=532). Mean follow-up time was 16.2 (SD 7.9) months. There were
no cardiac-related deaths. In patients with a negative CCTA there was 1
acute myocardial infarction; in patients with a negative SPECT examination
there were 2 acute myocardial infarctions; and for positive CCTA and
SPECT, 1 acute myocardial infarction each. Participants in the CCTA arm
had a similar rate of MACE or revascularization compared with those in the
SPECT myocardial perfusion imaging arm, (HR, 1.03; 95% CI=0.61-1.75)
(P=0.19). CCTA segment involvement by a stenosis of >=50% diameter was a
better predictor of MACE and revascularization at 1 year (P=0.02) than the
percent reversible defect size by SPECT myocardial perfusion imaging. Four
(1.2%) patients with negative CCTA compared with 14 (3.2%) with negative
SPECT had MACE or revascularization (P=0.03). <br/>CONCLUSION(S): There
was no difference in outcomes of patients who had stable angina and who
underwent CCTA in comparison to SPECT as the first imaging test directing
them to optimal medical therapy alone or with revascularization. CCTA was
a better predictor of MACE and revascularization.<br/>Copyright &#xa9;
2020 The Authors. Published on behalf of the American Heart Association,
Inc., by Wiley.

<53>
Accession Number
2011173246
Title
Percutaneous mitral valve repair with MitraClip device in hemodynamically
unstable patients: A systematic review.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2021.
Date of Publication: 2021.
Author
Martinez-Gomez E.; McInerney A.; Tirado-Conte G.; de Agustin J.A.;
Jimenez-Quevedo P.; Escudero A.; Pozo Osinalde E.; Viana-Tejedor A.;
Goirigolzarri J.; Marroquin L.; Vivas D.; Ferrera C.; Noriega F.;
Restrepo-Cordoba M.A.; Gonzalo N.; Escaned J.; Fernandez-Ortiz A.;
Amat-Santos I.; Estevez-Loureiro R.; Macaya C.; Nombela-Franco L.
Institution
(Martinez-Gomez, McInerney, Tirado-Conte, de Agustin, Jimenez-Quevedo,
Escudero, Pozo Osinalde, Viana-Tejedor, Goirigolzarri, Marroquin, Vivas,
Ferrera, Noriega, Restrepo-Cordoba, Gonzalo, Escaned, Fernandez-Ortiz,
Macaya, Nombela-Franco) Cardiology Department, Cardiovascular Institute,
Hospital Clinico San Carlos, IdISSC, Madrid, Spain
(Amat-Santos) Cardiology Department, CIBERCV, Hospital Clinico
Universitario, Valladolid, Spain
(Estevez-Loureiro) Interventional Cardiology Unit, University Hospital
Alvaro Cunqueiro, Vigo, Spain
Publisher
John Wiley and Sons Inc
Abstract
Background: Very few data exist on percutaneous mitral valve repair (PMVr)
in unstable patients with concomitant moderate-severe mitral regurgitation
(MR). The purpose of this systematic review was to evaluate baseline
characteristics, management and clinical outcomes of critically ill
patients undergoing PMVr with MitraClip. <br/>Method(s): We conducted a
systematic review of the published data on MitraClip from its first use in
2003 to December 2020. Studies referring to critically ill patients in
cardiogenic shock or acute refractory pulmonary edema were included. A
total of 40 publications including 254 patients with significant MR (Grade
4 in 91%) were included. <br/>Result(s): Mean age was 70 +/- 12 years with
mean Euroscore II and STS of 21 +/- 13 and 20.5 +/- 16, respectively.
Clinical presentation was with cardiogenic shock and acute myocardial
infarction in 72.8 and 60.0% of patients, respectively. Device success was
achieved in 238 (93.7%) patients with a significant reduction in MR (Grade
<= 2 in 91.8%, p <.001). The median weaning time from the procedure, to
discontinuation of mechanical circulatory or respiratory support, was 2
days (IQR 1-4), with an in-hospital mortality and non-fatal complication
rate of 12.6 and 9.1%, respectively. Kaplan-Meier curves estimated an
overall mortality rate of 39.1% at 12-month follow-up, with persistent
reduction in MR severity for survivors (Grade <= 2 in 81.3%) and one case
of mitral valve reintervention. <br/>Conclusion(s): Percutaneous mitral
valve repair with MitraClip device is a technically feasible and
potentially viable management option in high-risk patients with
cardiogenic shock or refractory pulmonary edema and concomitant
moderate-severe MR. Prospective trials are required to confirm these
findings, and definitively determine the value of MitraClip in
hemodynamically unstable patients.<br/>Copyright &#xa9; 2021 Wiley
Periodicals LLC.

<54>
Accession Number
2011155961
Title
Systematic Review and Meta-Analysis of the Impact of Bariatric Surgery on
Lower Urinary Tract Symptoms in Males.
Source
Obesity Surgery. (no pagination), 2021. Date of Publication: 2021.
Author
Stefanova I.; Currie A.C.; Newton R.C.; Albon L.; Slater G.; Birnie A.;
Hawkins W.; Pring C.
Institution
(Stefanova) Department of General Surgery, East Surrey Hospital, Redhill,
United Kingdom
(Currie) Department of Bariatric Surgery, Ashford and St Peters Hospital
Trust, Guildford Street, Chertsey KT16 0PZ, United Kingdom
(Newton, Slater, Hawkins, Pring) Department of Bariatric Surgery, St
Richard's Hospital, Chichester, United Kingdom
(Albon) Department of Bariatric Surgery and Diabetes, St Richard's
Hospital, Chichester, United Kingdom
(Birnie) Department of Urology, St Richard's Hospital, Chichester, United
Kingdom
Publisher
Springer
Abstract
Background: Obesity is a chronic disease with multisystem morbidity. There
are multiple studies reporting the effect of bariatric surgery on
cardiovascular and metabolic disease, but few examine its impact on lower
urinary tract symptoms. This article aims to perform a systematic review
with meta-analysis, to determine the effects of bariatric surgery on lower
urinary tract symptoms in male patients. <br/>Method(s): Medline, Embase,
conference proceedings, and reference lists were searched for studies
reporting the quantitative measurement of lower urinary tract symptoms
score pre- and postweight loss surgery. The primary outcome was
International Prostate Symptom Score (IPSS) before and after bariatric
surgery. Secondary outcomes were changed in body mass index (BMI) and
total body weight (TBW). Weighted mean differences (MD) were calculated
for continuous outcomes. <br/>Result(s): Seven studies were included in
the analysis of 334 patients undergoing bariatric surgery. Mean study
follow-up was between 3 and 36 months. IPSS score ranged from 3-12.7
preoperatively and 1.9-6.9 postoperatively. There was a statistically
significant improvement in the IPSS score following bariatric surgery (MD
2.82, 95% CI 0.96 to 4.69, p=0.003). Bariatric surgery also resulted in
statistically significant reduction of BMI and TBW. <br/>Conclusion(s):
Bariatric surgery produces a significant improvement on lower urinary
tract symptoms in men with obesity. This may be due to improvement of
insulin sensitivity, testosterone levels or lipid profile associated with
weight loss. Graphical abstract: [Figure not available: see
fulltext.]<br/>Copyright &#xa9; 2021, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<55>
Accession Number
634822612
Title
Intraoperative methylprednisolone and neurodevelopmental outcomes in
infants after cardiac surgery.
Source
The Annals of thoracic surgery. (no pagination), 2021. Date of
Publication: 14 Apr 2021.
Author
Zyblewski S.C.; Martin R.H.; Shipes V.B.; Hamlin-Smith K.; Atz A.M.;
Bradley S.M.; Kavarana M.N.; Mahle W.T.; Everett A.D.; Graham E.M.
Institution
(Zyblewski) Department of Pediatrics, Medical University of South
Carolina, SC., Charleston, United States
(Martin, Shipes) Department of Public Health Sciences, Medical University
of South Carolina, SC, Charleston, United States
(Hamlin-Smith, Atz, Graham) Department of Pediatrics, Medical University
of South Carolina, SC, Charleston, United States
(Bradley, Kavarana) Section of Pediatric Cardiac Surgery, Medical
University of South Carolina, SC, Charleston, United States
(Mahle) Department of Pediatrics, Children's Healthcare of Atlanta and
Emory University, Atlanta, United States
(Everett) Department of Pediatrics, Johns Hopkins University, MD,
Baltimore, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Neurodevelopmental impairment is a significant consequence for
survivors of surgery for critical congenital heart disease. This study
sought to determine if intraoperative methylprednisolone during neonatal
cardiac surgery is associated with neurodevelopmental outcomes at 12
months of age and to identify early prognostic variables associated with
neurodevelopmental outcomes. <br/>METHOD(S): A planned secondary analysis
of a two-center, double-blind, randomized, placebo-controlled trial of
intraoperative methylprednisolone in neonates undergoing cardiac surgery
was performed. A brain injury biomarker was measured perioperatively.
Bayley Scales of Infant and Toddler Development-III (BSID-III) were
performed at 12 months of age. Two sample t-tests and generalized linear
models were used. <br/>RESULT(S): There were 129 participants (n=61
methylprednisolone, n=68 placebo). There were no significant differences
in BSID-III scores and brain injury biomarker levels between the two
treatment groups. Participants who underwent a palliative (vs. corrective)
procedure had lower mean BSID-III cognitive (101+15 vs. 106+14, p=0.03)
and motor scores (85+18 vs. 94+16, p<0.01). Longer ventilation time was
associated with lower motor scores. Longer cardiac intensive care unit
(CICU) stay was associated with lower cognitive, language, and motor
scores. Cardiopulmonary bypass time, aortic cross clamp time, and deep
hypothermic circulatory arrest were not associated with BSID-III scores.
<br/>CONCLUSION(S): Neurodevelopmental outcomes were not associated with
intraoperative methylprednisolone or intraoperative variables.
Participants who underwent a neonatal palliative (vs. corrective)
procedure had longer CICU stays and worse neurodevelopmental outcomes at 1
year. This work suggests that interventions focused solely on the
operative period may not be associated with a long-term neurodevelopmental
benefit.<br/>Copyright &#xa9; 2021. Published by Elsevier Inc.

<56>
Accession Number
634821883
Title
Predictors of unplanned 30-day readmissions after coronary artery bypass
graft: a systematic review and meta-analysis of cohort studies.
Source
European journal of cardiovascular nursing : journal of the Working Group
on Cardiovascular Nursing of the European Society of Cardiology. (no
pagination), 2021. Date of Publication: 17 Apr 2021.
Author
Son Y.-J.; Lee H.-J.; Lim S.-H.; Hong J.; Seo E.J.
Institution
(Son) Red Cross College of Nursing, Chung-Ang University, Seoul 06974,
South Korea
(Lee) Department of Nursing, Tongmyoung University, Busan 48520, South
Korea
(Lim) Department of Thoracic and Cardiovascular Surgery, Ajou University,
Suwon 16499, South Korea
(Hong) Department of Thoracic and Cardiovascular Surgery, Chung-Ang
University, Seoul 06974, South Korea
(Seo) Ajou University College of Nursing and Research Institute of Nursing
Science, 164, Worldcup-Ro, Yeongtong-Gu, Suwon 16499, Republic of Korea
Publisher
NLM (Medline)
Abstract
AIMS: Coronary artery bypass graft (CABG) is one of the most performed
cardiac surgery globally. CABG is known to have a high rate of short-term
readmissions. The 30-day unplanned readmission rate as a quality measure
is associated with adverse health outcomes. This study aimed to identify
and synthesize the perioperative risk factors for 30-day unplanned
readmission after CABG. METHODS AND RESULTS: We systematically searched
seven databases and reviewed studies to identify all eligible English
articles published from 1 October 1999 to 30 September 2019. Random-effect
models were employed to perform pooled analyses. Odds ratio and 95%
confidence interval were used to estimate the risk factors for 30-day
unplanned readmission. The 30-day hospital readmission rates after CABG
ranged from 9.2% to 18.9% in 14 cohort studies. Among preoperative
characteristics, older adults, female, weight loss, high serum creatinine,
anticoagulant use or dialysis, and comorbidities were found to be
statistically significant. Postoperative complications, prolonged length
of hospital stay, and mechanical ventilation were revealed as the
postoperative risk factors for 30-day unplanned readmission. However,
intraoperative risk factors were not found to be significant in this
review. <br/>CONCLUSION(S): Our findings emphasize the importance of a
comprehensive assessment during the perioperative period of CABG.
Healthcare professionals can perform a readmission risk stratification and
develop strategies to reduce readmission rates after CABG using the risk
factors identified in this review. Future studies with prospective cohort
samples are needed to identify the personal or psychosocial factors
influencing readmission after CABG, including perioperative risk
factors.<br/>Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. &#xa9; The Author(s) 2021. For
permissions, please email: journals.permissions@oup.com.

<57>
Accession Number
634816216
Title
A Tale of Two Centrifugal Flow Ventricular Assist Devices as Bridge to
Heart Transplant.
Source
The Annals of thoracic surgery. (no pagination), 2021. Date of
Publication: 12 Apr 2021.
Author
Alwair H.; Whitehouse K.; Slaughter M.S.; Trivedi J.R.
Institution
(Alwair, Whitehouse, Slaughter, Trivedi) Department of Cardiovascular and
Thoracic Surgery, University of Louisville School of Medicine, KY,
Louisville, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Use of continuous flow left ventricular assist devices (CFVAD)
has previously increased over the years as bridge to transplant (BTT). The
Heartware HVAD and HeartMate III (HM3) are currently approved centrifugal
flow devices used for BTT. We sought to evaluate outcomes of the patients
listed and transplanted after receiving these two devices. <br/>METHOD(S):
The United Network of Organ Sharing (UNOS) thoracic transplant database
was queried after August 23, 2017 till December 2018 to identify patients
aged > 18 years listed for HTx and supported by either HVAD or HM3.
Patient characteristics were evaluated at time of listing and transplant.
Primary study end point was 1-year mortality after LVAD implantation.
Non-parametric tests were used to evaluate the device groups.
<br/>RESULT(S): There were 569 patients listed for HTx during the study
period of which 226 had HM3 and 343 HVAD. The HM3 group had more men (82%
v. 74%, p=0.02), diabetics (38% v. 29%, p=0.02) and had a higher BMI (28
vs. 27, p=0.04) at listing. Between HM3 and HVAD groups, the 1-year
mortality was 20% v. 17% respectively (log-rank p=0.28, Figure 1). The
post-transplant survival at 1-year was 97% and 94% respectively for the
HM3 and HVAD groups (p=0.1). <br/>CONCLUSION(S): In relatively
well-matched group of patients listed for heart transplant with a
centrifugal flow LVAD the 6 month and 1-year mortality on the waitlist as
well as post transplant were not statistically different. Additional
real-world experience or a randomized trial would be needed to determine
if one is superior.<br/>Copyright &#xa9; 2021. Published by Elsevier Inc.

<58>
[Use Link to view the full text]
Accession Number
634815058
Title
Bariatric Surgery and Cardiovascular Outcomes in Patients with Obesity and
Cardiovascular Disease:: A Population-Based Retrospective Cohort Study.
Source
Circulation. (pp 1468-1480), 2021. Date of Publication: 2021.
Author
Doumouras A.G.; Wong J.A.; Paterson J.M.; Lee Y.; Sivapathasundaram B.;
Tarride J.-E.; Thabane L.; Hong D.; Yusuf S.; Anvari M.
Institution
(Doumouras, Lee, Hong, Anvari) Division of General Surgery, McMaster
University, Hamilton, ON, Canada
(Wong, Yusuf) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Paterson) Department of Family Medicine, McMaster University, Hamilton,
ON, Canada
(Tarride, Thabane) Department of Health Research Methods, Evidence, and
Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Lee) Center for Health Economics and Policy Analysis, McMaster
University, Hamilton, ON, Canada
(Sivapathasundaram) Ices, Toronto, ON, Canada
(Sivapathasundaram) Population Health Research Institute, Hamilton Health
Sciences and McMaster University, Canada
(Tarride) Institute of Health Policy, Management, and Evaluation,
University of Toronto, Canada
(Thabane) Programs for Assessment of Technology in Health, The Research
Institute of St Joe's Hamilton, St Joseph's Healthcare Hamilton, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Bariatric surgery has been shown to significantly reduce
cardiovascular risk factors. However, whether surgery can reduce major
adverse cardiovascular events (MACE), especially in patients with
established cardiovascular disease, remains poorly understood. The present
study aims to determine the association between bariatric surgery and MACE
among patients with cardiovascular disease and severe obesity.
<br/>Method(s): This was a propensity score-matched cohort study using
province-wide multiple-linked administrative databases in Ontario, Canada.
Patients with previous ischemic heart disease or heart failure who
received bariatric surgery were matched on age, sex, heart failure
history, and a propensity score to similar controls from a primary care
medical record database in a 1:1 ratio. The primary outcome was the
incidence of extended MACE (first occurrence of all-cause mortality,
myocardial infarction, coronary revascularization, cerebrovascular events,
and heart failure hospitalization). Secondary outcome included 3-component
MACE (myocardial infarction, ischemic stroke, and all-cause mortality).
Outcomes were evaluated through a combination of matching via propensity
score and subsequent multivariable adjustment. <br/>Result(s): A total of
2638 patients (n=1319 in each group) were included, with a median
follow-up time of 4.6 years. The primary outcome occurred in 11.5%
(151/1319) of the surgery group and 19.6% (259/1319) of the controls
(adjusted hazard ratio [HR], 0.58 [95% CI, 0.48-0.71]; P<0.001). The
association was notable for those with heart failure (HR, 0.44 [95% CI,
0.31-0.62]; P<0.001; absolute risk difference, 19.3% [95% CI,
12.0%-26.7%]) and in those with ischemic heart disease (HR, 0.60 [95% CI,
0.48-0.74]; P<0.001; absolute risk difference, 7.5% [95% CI, 4.7%-10.5%]).
Surgery was also associated with a lower incidence of the secondary
outcome (HR, 0.66 [95% CI, 0.52-0.84]; P=0.001) and cardiovascular
mortality (HR, 0.35 [95% CI, 0.15-0.80]; P=0.001). <br/>Conclusion(s):
Bariatric surgery was associated with a lower incidence of MACE in
patients with cardiovascular disease and obesity. These findings require
confirmation by a large-scale randomized trial.<br/>Copyright &#xa9; 2021
Lippincott Williams and Wilkins. All rights reserved.

<59>
[Use Link to view the full text]
Accession Number
634814107
Title
Safety and Efficacy of Human Chorionic Gonadotropin Hormone-Derivative
EA-230 in Cardiac Surgery Patients: A Randomized Double-Blind
Placebo-Controlled Study.
Source
Critical Care Medicine. (pp 790-803), 2021. Date of Publication: 2021.
Author
Van Groenendael R.; Beunders R.; Hemelaar P.; Hofland J.; Morshuis W.J.;
Van Der Hoeven J.G.; Gerretsen J.; Wensvoort G.; Kooistra E.J.; Claassen
W.J.; Waanders D.; Lamberts M.G.A.; Buijsse L.S.E.; Kox M.; Van Eijk L.T.;
Pickkers P.
Institution
(Van Groenendael, Beunders, Hemelaar, Van Der Hoeven, Gerretsen, Kooistra,
Claassen, Waanders, Lamberts, Buijsse, Kox, Pickkers) Department of
Intensive Care Medicine, Radboud University Medical Center, Nijmegen,
Netherlands
(Van Groenendael, Van Der Hoeven, Kooistra, Kox, Van Eijk, Pickkers)
Radboud Center for Infectious Diseases (RCI), Radboud University Medical
Center, Nijmegen, Netherlands
(Van Groenendael, Beunders, Van Der Hoeven, Kooistra, Kox, Van Eijk,
Pickkers) Radboud Institute for Molecular Life Sciences (RIMLS), Radboud
University Medical Center, Nijmegen, Netherlands
(Van Groenendael, Hofland, Van Eijk) Department of Anesthesiology, Pain
and Palliative Medicine, Radboud University Medical Center, Nijmegen,
Netherlands
(Morshuis) Department of Cardiothoracic Surgery, Radboud University
Medical Center, Nijmegen, Netherlands
(Wensvoort) Exponential Biotherapies, Inc. (EBI), The Hague, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: To determine the safety and efficacy of human chorionic
gonadotropin hormone-derivative EA-230 in cardiac surgery patients.
Cardiac surgery induces systemic inflammation and may impair renal
function, affecting patient outcome. EA-230 exerted immunomodulatory and
renoprotective effects in preclinical models and was safe and showed
efficacy in phase I and II human studies. DESIGN: Double-blinded,
placebo-controlled, randomized study. SETTING: Collaboration of the
Cardiothoracic Surgery, Anesthesiology, and the Intensive Care departments
of a tertiary hospital in the Netherlands. PATIENTS: One hundred eighty
patients undergoing an on-pump coronary artery bypass procedure with or
without concomitant valve surgery. INTERVENTIONS: Ninety mg/kg/hr EA-230
or placebo administered during surgery. MEASUREMENTS AND MAIN RESULTS:
During the study, no safety concerns emerged. EA-230 did not modulate
interleukin-6 plasma concentrations (area under the curve 2,730 pg/mL x hr
[1,968-3,760] vs 2,680 pg/mL x hr [2,090-3,570] for EA-230 and placebo
group, respectively; p = 0.80). Glomerular filtration rate increased
following surgery (mean +/- sem increase in the EA-230 vs placebo groups:
glomerular filtration rate<inf>iohexol</inf>measured using iohexol plasma
clearance: 19 +/- 2 vs 16 +/- 2 mL/min/1.73 m²; p = 0.13 and
estimated glomerular filtration rate with the Modification of Diet in
Renal Disease equation using creatinine: 6 +/- 1 vs 2 +/- 1 mL/min/1.73
m²; p = 0.01). The "injury" stage of the Risk, Injury, Failure,
Loss of kidney function, and End-stage kidney disease criteria for acute
kidney injury was 7% in the EA-230 group versus 18% in the placebo group
(p = 0.07). In addition, EA-230-treated patients had a less positive fluid
balance compared with placebo-treated patients (217 +/- 108 vs 605 +/- 103
mL; p = 0.01), while the use of vasoactive agents was similar in both
groups (p = 0.39). Finally, hospital length of stay was shorter in EA-230
treated patients (8 d [7-11] vs 10 d [8-12]; p = 0.001). Efficacy results
were more pronounced in patients that had longer duration of surgery and
thus longer duration of study drug infusion. <br/>CONCLUSION(S): EA-230
was safe in patients undergoing on-pump cardiac surgery. It did not
modulate interleukin-6 plasma concentrations but appeared to exert
beneficial renal and cardiovascular effects and shortened in-hospital
length of stay.<br/>Copyright &#xa9; 2021 BMJ Publishing Group. All rights
reserved.

<60>
Accession Number
627898638
Title
Epidural analgesia versus paravertebral block in video-assisted
thoracoscopic surgery.
Source
Interactive Cardiovascular and Thoracic Surgery. 28 (3) (pp 404-406),
2019. Date of Publication: 01 Mar 2019.
Author
Harky A.; Clarke C.G.; Kar A.; Bashir M.
Institution
(Harky) Department of Vascular Surgery, Countess of Chester Hospital,
Liverpool Road, Chester CH2 1UL, United Kingdom
(Clarke) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
(Kar) Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's
Hospital, London, United Kingdom
(Bashir) Department of Aortovascular Surgery, Manchester Royal Infirmary,
Manchester, United Kingdom
Publisher
Oxford University Press
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was: In patients undergoing
video-assisted thoracoscopic surgery, is paravertebral block (PVB)
superior to epidural analgesia (EP) in terms of pain control and its
postoperative complication rates? Altogether, 153 papers were found using
the reporting search, of which 4 represented the best evidence to answer
the clinical question. The authors, journal, date and country of
publication, patient group studied, study type, relevant outcomes and
results of these papers are tabulated. At present, there are a limited
number of studies directly comparing pain control and postoperative
outcomes between PVB and EP, and no large-scale randomized trials have
been reported. Three of the 4 papers are small prospective randomized
trials, with a small cohort study featuring as the final piece of
literature. There is no conclusive body of evidence to recommend either
route as more efficacious from a pain control perspective; one study
demonstrated significantly lower levels of pain with EP (P = 0.01), with a
second study demonstrating significantly better pain control with PVB (P <
0.01) and a third failing to demonstrate any significant difference (P =
0.899). The frequency of requiring supplemental analgesia was similar
between the PVB and EP cohorts (56% vs 48%, P = 0.26). PVB is associated
with lower rates of postoperative complications compared to EP,
specifically urinary retention (64% vs 34.6%, P = 0.0036) and hypotension
(32% vs 7%, P = 0.0031; 21% vs 3%, P = 0.02). In summary, PVBs appear to
offer an equivalent level of analgesic effect following video-assisted
thoracoscopic surgery, with a more favourable side-effect profile,
compared to EP. This does need to be contextualized in light of the
scarcity of published material, with the available studies each containing
a small number of participants.<br/>Copyright &#xa9; 2018 The Author(s).

<61>
Accession Number
624377360
Title
A systemic review and meta-analysis: Long-term results of the Bentall
versus the David procedure in patients with Marfan syndrome.
Source
European Journal of Cardio-thoracic Surgery. 54 (3) (pp 411-419), 2018.
Date of Publication: 01 Sep 2018.
Author
Burgstaller J.M.; Held U.; Mosbahi S.; Stak D.; Steurer J.; Eckstein F.;
Berdajs D.A.
Institution
(Burgstaller, Held, Steurer) Horten Center for Patient-Oriented Research
and Knowledge Transfer, University of Zurich, Zurich, Switzerland
(Mosbahi) Department of General Surgery, County Hospital Freiburg,
Freiburg im Breisgau, Switzerland
(Stak) Department of Cardiac Surgery, Triemli City Hospital, Zurich,
Switzerland
(Eckstein, Berdajs) Department of Cardiac Surgery, University Hospital
Basel, Spitalstrasse 21, Basel 4031, Switzerland
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
This systemic review of the literature and meta-analysis aimed to evaluate
the current state of the evidence for and against reimplantation of the
aortic valve (RAV) versus the composite valve graft (CVG) intervention in
patients with Marfan syndrome. Random effects metaregression was performed
across the study arms with logit-transformed proportions of in-hospital
deaths as an outcome measure when possible. Results are presented as odds
ratios with 95% confidence intervals (CIs) and P-values. Other outcomes
are summarized with medians, interquartile ranges (IQR) and ranges and the
numbers of patients at risk. Twenty retrospective studies that included a
combined 2156 patients with long-term follow-up were identified for
analysis after a literature search. The in-hospital mortality rate
favoured the RAV procedure with an odds ratio of 0.23 [95% CI 0.09-0.55, P
= 0.001]. The survival rate at mid-term for the RAV cohort was 96.7% (CI
94.2-98.5) vs. 86.4% (CI 82.8-89.6) for the CVG group and 93.1% (CI
66.4-100) for the RAV group vs. 82.6% (CI 74.9-89.2) for the CVG group for
the long term. Freedom from valve-related reintervention (median
percentages) for the long term was 97.6% (CI 90.3-100%) for the RAV
procedure and 88.6% (CI 79.1-95.5) for a CVG. This systematic review of
the literature stresses the advantages of the RAV procedure in patients
with Marfan syndrome in regard to long- and short-term results as the
treatment of choice in aortic root surgery. The RAV procedure reduces
in-hospital as well as long-term deaths and protects against aortic valve
reintervention.<br/>Copyright &#xa9; 2018 The Author(s). Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<62>
Accession Number
613242361
Title
Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial
fibrillation: Reintervention, rehospitalization, and quality-of-life
outcomes in the FIRE and ICE trial.
Source
European Heart Journal. 37 (38) (pp 2858-2865), 2016. Date of Publication:
07 Oct 2016.
Author
Kuck K.-H.; Furnkranz A.; Chun K.R.J.; Metzner A.; Ouyang F.; Schluter M.;
Elvan A.; Lim H.W.; Kueffer F.J.; Arentz T.; Albenque J.-P.; Tondo C.;
Kuhne M.; Sticherling C.; Brugada J.
Institution
(Kuck, Metzner, Ouyang, Schluter) Department of Cardiology, Asklepios
Klinik St. Georg, Lohmuhlenstr. 5, Hamburg 20099, Germany
(Furnkranz, Chun) Cardioangiologisches Centrum Bethanien, Frankfurt,
Germany
(Elvan) Isala Klinieken, Zwolle, Netherlands
(Lim, Kueffer) Medtronic Inc., Minneapolis, MN, United States
(Arentz) Herz-Zentrum, Bad Krozingen, Germany
(Albenque) Clinique Pasteur, Toulouse, France
(Tondo) Centro Cardiologico Monzino, University of Milan, Milan, Italy
(Kuhne, Sticherling) Universitatsspital Basel, Basel, Switzerland
(Brugada) Hospital Clinic, University of Barcelona, Barcelona, Spain
Publisher
Oxford University Press
Abstract
Aims The primary safety and efficacy endpoints of the randomized FIRE AND
ICE trial have recently demonstrated non-inferiority of cryoballoon vs.
radiofrequency current (RFC) catheter ablation in patients with
drug-refractory symptomatic paroxysmal atrial fibrillation (AF). The aim
of the current study was to assess outcome parameters that are important
for the daily clinical management of patients using key secondary
analyses. Specifically, reinterventions, rehospitalizations, and
quality-of-life were examined in this randomized trial of cryoballoon vs.
RFC catheter ablation. Methods and results Patients (374 subjects in the
cryoballoon group and 376 subjects in the RFC group) were evaluated in the
modified intention-to-treat cohort. After the index ablation, log-rank
testing over 1000 days of follow-up demonstrated that there were
statistically significant differences in favour of cryoballoon ablation
with respect to repeat ablations (11.8% cryoballoon vs. 17.6% RFC; P =
0.03), direct-current cardioversions (3.2% cryoballoon vs. 6.4% RFC; P =
0.04), all-cause rehospitalizations (32.6% cryoballoon vs. 41.5% RFC; P =
0.01), and cardiovascular rehospitalizations (23.8% cryoballoon vs. 35.9%
RFC; P < 0.01). There were no statistical differences between groups in
the quality-of-life surveys (both mental and physical) as measured by the
Short Form-12 health survey and the EuroQol five-dimension questionnaire.
There was an improvement in both mental and physical quality-of-life in
all patients that began at 6 months after the index ablation and was
maintained throughout the 30 months of follow-up. Conclusion Patients
treated with cryoballoon as opposed to RFC ablation had significantly
fewer repeat ablations, direct-current cardioversions, all-cause
rehospitalizations, and cardiovascular rehospitalizations during
follow-up. Both patient groups improved in quality-of-life scores after AF
ablation.<br/>Copyright &#xa9; 2016 The Author 2016.

<63>
Accession Number
613120360
Title
Percutaneous Intervention for Concurrent Chronic Total Occlusions in
Patients With STEMI: The EXPLORE Trial.
Source
Journal of the American College of Cardiology. 68 (15) (pp 1622-1632),
2016. Date of Publication: 11 Oct 2016.
Author
Henriques J.P.S.; Hoebers L.P.; Barbato E.; Nijveldt R.; van Rossum A.C.;
Elias J.; van Dongen I.M.; Claessen B.E.P.M.; Tijssen J.G.; van der Schaaf
R.; Tijssen J.G.P.; Zijlstra F.; de Boer M.-J.; Michels R.; Agostoni P.;
van Houwelingen K.G.; Verberne H.J.; Hirsch A.; Piek J.J.; de Winter R.J.;
Koch K.T.; Vis M.M.; Baan J.; Wykrzykowska J.; Ramunddal T.; Ioanes D.;
Laanmets P.; van der Schaaf R.J.; Slagboom T.; Amoroso G.; Eriksen E.;
Tuseth V.; Bax M.; Schotborgh C.E.; Suttorp M.J.; Strauss B.H.; Marques
K.M.; Bertrand O.; Meuwissen M.; van der Ent M.; Koolen J.
Institution
(Henriques, Hoebers, Elias, van Dongen, Claessen, Tijssen) Academic
Medical Center, University of Amsterdam, Amsterdam, Netherlands
(Ramunddal, Ioanes) Sahlgrenska University Hospital, Gothenburg, Sweden
(Laanmets) North Estonia Medical Center, Tallinn, Estonia
(Eriksen) Haukeland University Hospital, Bergen, Norway
(Bax) Haga Teaching Hospital, The Hague, Netherlands
(Suttorp) Sint Antonius Ziekenhuis, Nieuwegein, Netherlands
(Strauss) Sunnybrook Health Sciences Centre, Toronto, Canada
(Barbato) Onze Lieve Vrouwe Ziekenhuis, Aalst, Belgium
(Nijveldt, van Rossum, Marques) VU University Medical Center, Amsterdam,
Netherlands
(van der Schaaf) Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background In 10% to 15% of patients with ST-segment elevation myocardial
infarction (STEMI), concurrent coronary chronic total occlusion (CTO) in a
non-infarct-related artery is present and is associated with increased
morbidity and mortality. Objectives The EXPLORE (Evaluating Xience and
Left Ventricular Function in Percutaneous Coronary Intervention on
Occlusions After ST-Elevation Myocardial Infarction) trial evaluated
whether patients with STEMI and concurrent CTO in a non-infarct-related
artery benefit from additional percutaneous coronary intervention (PCI) of
CTO shortly after primary PCI. Methods From November 2007 through April
2015, we enrolled 304 patients with acute STEMI who underwent primary PCI
and had concurrent CTO in 14 centers in Europe and Canada. A total of 150
patients were randomly assigned to early PCI of the CTO (CTO PCI), and 154
patients were assigned to conservative treatment without PCI of the CTO
(no CTO PCI). Primary outcomes were left ventricular ejection fraction
(LVEF) and left ventricular end diastolic volume (LVEDV) on cardiac
magnetic resonance imaging after 4 months. Results The
investigator-reported procedural success rate in the CTO PCI arm of the
trial was 77%, and the adjudicated success rate was 73%. At 4 months, mean
LVEF did not differ between the 2 groups (44.1 +/- 12.2% vs. 44.8 +/-
11.9%, respectively; p = 0.60). Mean LVEDV at 4 months was 215.6 +/- 62.5
ml in the CTO PCI arm versus 212.8 +/- 60.3 ml in the no-CTO PCI arm (p =
0.70). Subgroup analysis revealed that patients with CTO located in the
left anterior descending coronary artery who were randomized to the CTO
PCI strategy had significantly higher LVEF compared with patients
randomized to the no-CTO PCI strategy (47.2 +/- 12.3% vs. 40.4 +/- 11.9%;
p = 0.02). There were no differences in terms of 4-month major adverse
coronary events (5.4% vs. 2.6%; p = 0.25). Conclusions Additional CTO PCI
within 1 week after primary PCI for STEMI was feasible and safe. In
patients with STEMI and concurrent CTO, we did not find an overall benefit
for CTO PCI in terms of LVEF or LVEDV. The finding that early CTO PCI in
the left anterior descending coronary artery subgroup was beneficial
warrants further investigation. (Evaluating Xience and Left Ventricular
Function in Percutaneous Coronary Intervention on Occlusions After
ST-Segment Elevation Myocardial Infarction; NTR1108)<br/>Copyright &#xa9;
2016 American College of Cardiology Foundation

<64>
Accession Number
2011615436
Title
Hepatitis E in solid organ transplant recipients: A systematic review and
meta-analysis.
Source
World Journal of Gastroenterology. 27 (12) (pp 1240-1254), 2021. Date of
Publication: 28 Mar 2021.
Author
Hansrivijit P.; Trongtorsak A.; Puthenpura M.M.; Boonpheng B.;
Thongprayoon C.; Wijarnpreecha K.; Choudhury A.; Kaewput W.; Mao S.A.; Mao
M.A.; Jadlowiec C.C.; Cheungpasitporn W.
Institution
(Hansrivijit) Department of Internal Medicine, UPMC Pinnacle, Harrisburg,
PA 17104, United States
(Trongtorsak) Department of Internal Medicine, Amita Health Saint Francis
Hospital, Evanston, IL 60202, United States
(Puthenpura) Department of Medicine, Drexel University, College of
Medicine, Philadelphia, PA 19129, United States
(Boonpheng) David Geffen School of Medicine, University of California, Los
Angeles, Division of Nephrology, Los Angeles, CA 90095, United States
(Thongprayoon) Department of Internal Medicine, Mayo Clinic, Rochester, MN
55905, United States
(Wijarnpreecha) Department of Gastroenterology and Hepatology, Mayo
Clinic, College of Medicine, Jacksonville, FL 32224, United States
(Choudhury) School of Systems and Enterprises, Stevens Institute of
Technology, Hoboken, NJ 07030, United States
(Kaewput) Department of Military and Community Medicine, Phramongkutklao
College of Medicine, Bangkok 10400, Thailand
(Mao) Department of Transplant Surgery, Mayo Clinic, Jacksonville, FL
32224, United States
(Mao) Department of Nephrology and Hypertension, Mayo Clinic,
Jacksonville, FL 32224, United States
(Jadlowiec) Department of Transplant Center, Mayo Clinic, Scottsdale, AZ
85259, United States
(Cheungpasitporn) Department of Medicine, Mayo Clinic, Rochester, MN
55905, United States
Publisher
Baishideng Publishing Group Co
Abstract
BACKGROUND Hepatitis E virus (HEV) infection is underdiagnosed due to the
use of serological assays with low sensitivity. Although most patients
with HEV recover completely, HEV infection among patients with
pre-existing chronic liver disease and organ-transplant recipients on
immunosuppressive therapy can result in decompensated liver disease and
death. AIM To demonstrate the prevalence of HEV infection in solid organ
transplant (SOT) recipients. METHODS We searched Ovid MEDLINE, EMBASE, and
the Cochrane Library for eligible articles through October 2020. The
inclusion criteria consisted of adult patients with history of SOT. HEV
infection is confirmed by either HEV-immunoglobulin G, HEV-immunoglobulin
M, or HEV RNA assay. RESULTS Of 563 citations, a total of 22 studies (n =
4557) were included in this meta-analysis. The pooled estimated prevalence
of HEV infection in SOT patients was 20.2% [95% confidence interval (CI):
14.9-26.8]. The pooled estimated prevalence of HEV infection for each
organ transplant was as follows: liver (27.2%; 95%CI: 20.0-35.8), kidney
(12.8%; 95%CI: 9.3-17.3), heart (12.8%; 95%CI: 9.3-17.3), and lung (5.6%;
95%CI: 1.6-17.9). Comparison across organ transplants demonstrated
statistical significance (Q = 16.721, P = 0.002). The subgroup analyses
showed that the prevalence of HEV infection among SOT recipients was
significantly higher in middle-income countries compared to high-income
countries. The pooled estimated prevalence of de novo HEV infection was
5.1% (95%CI: 2.6-9.6) and the pooled estimated prevalence of acute HEV
infection was 4.3% (95%CI: 1.9-9.4). CONCLUSION HEV infection is common in
SOT recipients, particularly in middle-income countries. The prevalence of
HEV infection in lung transplant recipients is considerably less common
than other organ transplants. More studies examining the clinical impacts
of HEV infection in SOT recipients, such as graft failure, rejection, and
mortality are warranted.<br/>Copyright &#xa9; The Author(s) 2021.
Published by Baishideng Publishing Group Inc. All rights reserved.

<65>
Accession Number
2010074806
Title
Technology-based interventions in oral anticoagulation management:
Meta-analysis of randomized controlled trials.
Source
Journal of Medical Internet Research. 22 (7) (no pagination), 2020.
Article Number: e18386. Date of Publication: July 2020.
Author
Zheng C.; Dai H.; Lin C.; Zhang Y.; Zhang H.; Chen F.; Liu Y.; Xiao J.;
Chen C.
Institution
(Zheng) Fuqing City Hospital, Fuzhou, China
(Dai, Zhang, Zhang, Chen, Liu, Xiao) Affiliated Fuzhou First Hospital,
Fujian Medical University, Fuzhou, China
(Lin) School of Basic Medical Sciences, Fujian Medical University, Fuzhou,
China
(Chen) School of Pharmacy, Fujian Medical University, Fuzhou, China
Publisher
JMIR Publications Inc.
Abstract
Background: An increasing number of patients have received prophylactic or
therapeutic oral anticoagulants (OACs) for thromboembolic complications of
diseases. The use of OACs is associated with both clinical benefits and
risks. Considering the challenges imposed by this class of drugs, as well
as the enormous progress made in portable device technology, it is
possible that technology-based interventions may improve clinical benefits
for patients and optimize anticoagulation management. <br/>Objective(s):
This study was designed to comprehensively evaluate the role of
technology-based interventions in the management of OACs. <br/>Method(s):
We searched 6 databases-PubMed, EMBASE, Cochrane, Cumulative Index to
Nursing and Allied Health Literature, Scopus, and PsycINFO-to retrieve
relevant studies published as of November 1, 2019, to evaluate the effect
of technology-based interventions on oral anticoagulation management.
RevMan (version 5.3; Cochrane) software was used to evaluate and analyze
clinical outcomes. The methodological quality of studies was assessed by
the Cochrane risk of bias tool. <br/>Result(s): A total of 15 randomized
controlled trials (RCTs) were selected for analysis. They reported data
for 2218 patients (1110 patients in the intervention groups and 1108
patients in the control groups). A meta-analysis was performed on the
effectiveness and safety data reported in the RCTs. Technology-based
interventions significantly improved the effectiveness of oral
anticoagulation management (mean difference [MD]=6.07; 95% CI 0.84-11.30;
I²=72%; P=.02). The safety of oral anticoagulation management
was also improved, but the results were not statistically significant.
Bleeding events were reduced (major bleeding events MD=1.02; 95% CI
0.78-1.32; I²=0%; P=.90; minor bleeding events MD=1.06, 95% CI
0.77-1.44; I²=41%; P=.73) and thromboembolism events were
reduced (MD=0.71; 95% CI 0.49-1.01; I²=0%; P=.06). In general,
patients were more satisfied with technology-based interventions, which
could also improve their knowledge of anticoagulation management, improve
their quality of life, and reduce mortality and hospitalization events.
<br/>Conclusion(s): Using technology to manage OACs can improve the
effectiveness and safety of oral anticoagulation management, result in
higher patient satisfaction, and allow greater understanding of
anticoagulation.<br/>Copyright &#xa9; Caiyun Zheng, Hengfen Dai, Chun Lin,
Yan Zhang, Hong Zhang, Fan Chen, Yunchun Liu, Jingwen Xiao, Chaoxin Chen.
Originally published in the Journal of Medical Internet Research
(http://www.jmir.org), 15.07.2020. This is an open-access article
distributed under the terms of the Creative Commons Attribution License
(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted
use, distribution, and reproduction in any medium, provided the original
work, first published in the Journal of Medical Internet Research, is
properly cited. The complete bibliographic information, a link to the
original publication on http://www.jmir.org/, as well as this copyright
and license information must be included.

<66>
Accession Number
2007712970
Title
Effects of stem cells on non-ischemic cardiomyopathy: a systematic review
and meta-analysis of randomized controlled trials.
Source
Cytotherapy. 22 (12) (pp 699-711), 2020. Date of Publication: December
2020.
Author
Xia L.; Zeng L.; Pan J.; Ding Y.
Institution
(Xia, Pan, Ding) Department of Clinical Medicine, School of Medicine,
Zhejiang University City College, Hangzhou, China
(Zeng) Department of Pharmacology, School of Medicine, Zhejiang University
City College, Hangzhou, China
Publisher
Elsevier B.V.
Abstract
Background aims: To assess the impacts of stem cell therapy on clinical
outcomes in patients with non-ischemic cardiomyopathy (NICM). The effect
of stem cell therapy on prognosis is unclear and controversial.
<br/>Method(s): The authors performed a systematic review and
meta-analysis of the effects of autologous stem cell transplantation in
patients with NICM on a composite outcome of all-cause mortality and heart
transplantation, left ventricular ejection fraction (LVEF), left
ventricular end-diastolic diameter (LVEDD), New York Heart Association
(NYHA) classification, 6-minute walk test (6-MWT) distance and serum brain
natriuretic peptide (BNP) level, considering studies published before
March 19, 2020. <br/>Result(s): Twelve trials with 623 subjects met
inclusion criteria. Compared with the control group, stem cell therapy
improved LVEF (weighted mean difference [WMD], 4.08%, 95% confidence
interval [CI], 1.93-6.23, P = 0.0002) and 6-MWT distance (WMD, 101.49 m,
95% CI, 45.62-157.35, P = 0.0004) and reduced BNP level (-294.94 pg/mL,
95% CI, -383.97 to -205.90, P < 0.00001) and NYHA classification (-0.70,
95% CI, -0.98 to -0.43, P < 0.00001). However, LVEDD showed no significant
difference between the two groups (WMD, -0.09 cm, 95% CI, -0.23 to 0.06, P
= 0.25). In 10 studies (535 subjects) employing the intracoronary route
for cell delivery, mortality and heart transplantation were decreased
(risk ratio [RR], 0.73, 95% CI, 0.52-1.00, P = 0.05). Furthermore, in four
studies (248 subjects) with peripheral CD34+ cells, either all-cause
mortality (RR, 0.44, 95% CI, 0.23-0.86, P = 0.02) or mortality and heart
transplantation (RR, 0.45, 95% CI, 0.27-0.77, P = 0.003) improved in the
treatment group compared with the control. The trial sequential analysis
suggested the information size of LVEF, 6-WMT and BNP has been adequate
for evidencing the benefits of stem cells on NICM. However, to determine
the potential survival benefit, more clinical data are required to make
the statistical significance in meta-analysis more conclusive.
<br/>Conclusion(s): This meta-analysis demonstrates that stem cell therapy
may improve survival, exercise capacity and cardiac ejection fraction in
NICM, which suggests that stem cells are a promising option for NICM
treatment.<br/>Copyright &#xa9; 2020 International Society for Cell & Gene
Therapy

<67>
Accession Number
2007651468
Title
In-hospital clinical outcomes of transcatheter aortic valve replacement in
patients with concomitant carotid artery stenosis: Insights from the
national inpatient sample.
Source
IJC Heart and Vasculature. 31 (no pagination), 2020. Article Number:
100621. Date of Publication: December 2020.
Author
Chakraborty S.; Faisaluddin M.; Ashish K.; Amgai B.; Bandyopadhyay D.;
Patel N.; Hajra A.; Aggarwal G.; Ghosh R.K.; Kalra A.
Institution
(Chakraborty) Miami Valley Hospital, Dayton, OH, United States
(Faisaluddin) Deccan College of Medical Sciences, Hyderabad, India
(Ashish) Crozer-Chester Medical Center, Philadelphia, United States
(Amgai, Patel) Interfaith Medical Center, Brooklyn, NY, United States
(Bandyopadhyay) Icahn School of Medicine at Mount Sinai/Mount Sinai St
Luke's and West, Manhattan, NY, United States
(Hajra) Jacobi Medical Center/Albert Einstein College of Medicine, Bronx,
NY, United States
(Aggarwal) Jersey City Medical Center, Jersey City, NJ, United States
(Ghosh) Medstar Union Memorial, Baltimore, MD, United States
(Kalra) Cleveland Clinic Foundation, Akron General, Akron, OH, United
States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Carotid artery stenosis (CAS) is a common occurrence in
elderly patients undergoing transcatheter aortic valve replacement (TAVR).
We conducted a retrospective study to identify the impact of CAS on
in-hospital outcomes following TAVR. <br/>Method(s): We queried the
National Inpatient Sample (NIS) for 2016-2017 and identified patients who
underwent TAVR with concomitant CAS using the ICD-10 codes. The primary
endpoint of our study was in-hospital mortality and acute ischemic stroke.
<br/>Result(s): We identified 80,740 TAVR-related hospitalizations. Of
these, 6.9% (N = 5555) patients had concomitant CAS. The mean age for CAS
patients was 80 +/- 7.4 years. Females were represented equally in both
groups. Traditional comorbidities like dyslipidemia [78.3% (N = 4350) vs.
68.2% (N = 51261); P < 0.001] and peripheral arterial disease [27.4% (N =
1525) vs. 12.7% (N = 9526); P < 0.001] were more frequently observed among
CAS patients. Patients with CAS had higher rates of previous stroke [17.5%
(N = 970) vs. 11.8% (N = 8902); P < 0.001] and CABG 23.8% (N = 1320) vs.
18.6% (N = 14022); P < 0.001]. Other cardiovascular risk factors were
similar between the two groups. Moreover, no differences in in-hospital
outcomes including mortality [odds ratio (OR): 1.35, CI: 0.48-3.83; P =
0.57] were observed in the propensity matched cohort. <br/>Conclusion(s):
Our study did not find any major differences in outcomes in the CAS group
following TAVR; however, a more detailed randomized controlled study with
long-term follow-up of these patients is needed.<br/>Copyright &#xa9; 2020
The Authors

<68>
Accession Number
2011659251
Title
Mucormycosis after Coronavirus disease 2019 infection in a heart
transplant recipient - Case report and review of literature.
Source
Journal of Medical Mycology. 31 (2) (no pagination), 2021. Article Number:
101125. Date of Publication: June 2021.
Author
Khatri A.; Chang K.-M.; Berlinrut I.; Wallach F.
Institution
(Khatri, Chang, Berlinrut, Wallach) Division of Infectious Diseases,
Department of Medicine, Donald and Barbara Zucker School of Medicine at
Hofstra/Northwell Health, 400 Community Drive, Infectious Diseases Suite,
Manhasset, NY 11030, United States
Publisher
Elsevier Masson s.r.l.
Abstract
Mucormycosis is an invasive fungal infection (IFI) due to several species
of saprophytic fungi, occurring in patients with underlying co-morbidities
(including organ transplantation). During the ongoing Coronavirus disease
2019 (COVID-19) pandemic, there have been increasing reports of bacterial
and fungal co-infections occurring in COVID-19 patients, including
COVID-19 associated pulmonary aspergillosis (CAPA). We describe a case of
mucormycosis occurring after COVID-19, in an individual who received a
recent heart transplant for severe heart failure. Two months after heart
transplant, our patient developed upper respiratory and systemic symptoms
and was diagnosed with COVID-19. He was managed with convalescent plasma
therapy and supportive care. Approximately three months after COVID-19
diagnosis, he developed cutaneous mucormycosis at an old intravascular
device site. He underwent extensive surgical interventions, combined with
broad-spectrum antifungal therapy. Despite the aggressive therapeutic
measures, he died after a prolonged hospital stay. In this case report, we
also review the prior well-reported cases of mucormycosis occurring in
COVID-19 patients and discuss potential mechanisms by which COVID-19 may
predispose to IFIs. Similar to CAPA, mucormycosis with COVID-19 may need
to be evaluated as an emerging disease association. Clinicians should be
vigilant to evaluate for invasive fungal infections such as mucormycosis
in patients with COVID-19 infection.<br/>Copyright &#xa9; 2021 Elsevier
Masson SAS

<69>
[Use Link to view the full text]
Accession Number
634795606
Title
Assessing Left Ventricular Early Diastolic Velocities with Tissue Doppler
and Speckle Tracking by Transesophageal and Transthoracic
Echocardiography.
Source
Anesthesia and Analgesia. (pp 1400-1409), 2021. Date of Publication: 2021.
Author
Mauermann E.; Bouchez S.; Bove T.; Vandenheuvel M.; Wouters P.
Institution
(Mauermann, Bouchez, Vandenheuvel, Wouters) Department of Anesthesiology
and Perioperative Medicine, Ghent University Hospital, Ghent, Belgium
(Mauermann) Department for Anesthesia, Surgical Intensive Care,
Prehospital Emergency Medicine and Pain Therapy, Basel University
Hospital, Basel, Switzerland
(Bove) Department of Cardiac Surgery, Ghent University Hospital, Ghent,
Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Assessing diastolic dysfunction is essential and should be
part of every routine echocardiography examination. However, clinicians
routinely observe lower mitral annular velocities by transesophageal
echocardiography (TEE) under anesthesia than described by awake
transthoracic echocardiography (TTE). It would be important to know
whether this difference persists under constant loading conditions. We
hypothesized that mean early diastolic mitral annular velocity, measured
by tissue Doppler imaging (TDI,) would be different in the midesophageal
4-chamber (ME 4Ch) than in the apical 4-chamber (AP 4Ch) view under
unchanged or constant loading conditions. Secondarily we examined (1) in
an alternative transesophageal view with presumed superior Doppler beam
alignment, the deep transgastric view (DTG), compared to those in the AP
4Ch, and (2) early diastolic speckle tracking-based strain rate (), in the
ME 4Ch and in the AP 4Ch. <br/>METHOD(S): Twenty-five consecutive adult
patients undergoing on-pump cardiac surgery from February 2017 to July
2017 were included. Both TTE and TEE measurements were obtained under
anesthesia in a randomized order in the AP 4Ch, ME 4Ch, and DTG views.
Within-patient average values were compared by paired t tests with a
Bonferroni adjustment. Box plots, correlation, and agreement by
Bland-Altman were examined for all 3 comparisons. A second
echocardiographer independently acquired and analyzed images; images were
reanalyzed after 4 weeks. Image quality and reproducibility were also
reported. <br/>RESULT(S): Averaged measurements were lower in the ME 4Ch
than in the AP 4Ch (6.6 +/- 1.7 cm/s vs 7.0 +/- 1.5 cm, P =.028;
within-patient difference mean +/- standard deviation: 0.6 +/- 1.2 cm/s).
An alternative TEE view for, the DTG, also exhibited lower mean values
(6.0 +/- 1.6 cm/s, P =.006; within-patient difference mean +/- standard
deviation: 1.1 +/- 1.8 cm/s). strain rate showed a low degree of bias, but
greater variability (ME 4Ch: 0.87 +/- 0.32%/s vs AP 4Ch: 0.73 +/- 0.18%/s,
P =.078; within-patient difference mean +/- standard deviation: -0.1 +/-
0.2%/s). <br/>CONCLUSION(S): This study confirms that TEE modestly
underestimates but not to a clinically relevant extent. While in the DTG
is not a promising alternative, the future role for speckle tracking-based
early diastolic strain rate is unknown.<br/>Copyright &#xa9; 2022 American
Society of Mechanical Engineers (ASME). All rights reserved.

<70>
Accession Number
2011181830
Title
Navigating inferior vena cava filters in invasive cardiology procedures: A
systematic review.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2021. Date
of Publication: 2021.
Author
Shah K.; Patel S.; Hanson I.; Williamson B.; Kutinsky I.; Dixon S.; Haines
D.E.; Mehta N.K.
Institution
(Shah, Hanson, Williamson, Kutinsky, Dixon, Haines, Mehta) Department of
Cardiovascular Medicine, Beaumont Hospital, Oakland University William
Beaumont School of Medicine, Royal Oak, MI, United States
(Patel) Department of Cardiovascular Medicine, Henry Ford Hospital,
Detroit, MI, United States
(Mehta) Department of Cardiovascular Medicine, University of Virginia,
Charlottesville, VA, United States
Publisher
Blackwell Publishing Inc.
Abstract
Background: Transfemoral venous access (TFV) is the cornerstone of
minimally invasive cardiac procedures. Although the presence of inferior
vena cava filters (IVCFs) was considered a relative contraindication to
TFV procedures, small experiences have suggested safety. We conducted a
systematic review of the available literature on cardiac procedural
success of TFV with IVCF in-situ. <br/>Method(s): Two independent
reviewers searched PubMed, EMBASE, SCOPUS, and Google Scholar from
inception to October 2020 for studies that reported outcomes in patients
with IVCFs undergoing TFV for invasive cardiac procedures. We investigated
a primary outcome of acute procedural success and reviewed the pooled data
for patient demographics, procedural complications, types of IVCF, IVCF
dwell time, and procedural specifics. <br/>Result(s): Out of the 120
studies initially screened, 8 studies were used in the final analysis with
a total of 100 patients who underwent 110 procedures. The most common IVCF
was the Greenfield Filter (36%), 60% of patients were males and the mean
age was 67.8 years. The overall pooled incidence of acute procedural
success was 95.45% (95% confidence interval = 89.54-98.1) with no
heterogeneity (I² = 0%, p = 1) and there were no reported
filter-related complications. <br/>Conclusion(s): This systematic review
is the largest study of its kind to demonstrate the safety and feasibility
of TFV access in a variety of cardiac procedures in the presence of
IVCF.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC