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<1>
Accession Number
373224384
Title
Kidney Function after off-pump or on-pump Coronary Artery Bypass Graft
Surgery: A randomized clinical trial.
Source
JAMA - Journal of the American Medical Association. 311 (21) (pp
2191-2198), 2014. Date of Publication: 04 Jun 2014.
Author
Garg A.X.; Devereaux P.J.; Yusuf S.; Cuerden M.S.; Parikh C.R.; Coca S.G.;
Walsh M.; Novick R.; Cook R.J.; Jain A.R.; Pan X.; Noiseux N.; Vik K.;
Stolf N.A.; Ritchie A.; Favaloro R.R.; Parvathaneni S.; Whitlock R.P.; Ou
Y.; Lawrence M.; Lamy A.
Institution
(Garg, Cuerden) Division of Nephrology, Department of Medicine, Western
University, London, ON, Canada
(Garg) Department of Epidemiology and Biostatistics, Western University,
London, ON, Canada
(Garg, Devereaux, Yusuf, Walsh) Department of Clinical Epidemiology and
Biostatistics, McMaster University, Hamilton, ON, Canada
(Devereaux, Yusuf, Walsh, Whitlock, Ou, Lawrence, Lamy) Population Health
Research Institute, Hamilton, ON, Canada
(Cuerden, Cook) Department of Statistics and Actuarial Science, University
of Waterloo, Waterloo, ON, Canada
(Parikh, Coca) Section of Nephrology, Yale University School of Medicine,
New Haven, CT, United States
(Novick) Division of Cardiac Surgery, Western University, London, ON,
Canada
(Jain) SAL Hospital and Medical Institute, Ahmadabad, India
(Pan) Department of Cardiovascular Surgery, Fuiwai Hospital, Chinese
Academy of Medical Sciences, Peking Union Medical College, Beijing, China
(Noiseux) Department of Cardiac Surgery, Centre Hospitalier de
l'Universite de Montreal CHUM, Montreal, QC, Canada
(Vik) University Hospital Motol, Praha, Czechia
(Stolf) Instituto do Coracao do Hospital Das Clinicas da, Sao Paulo,
Brazil
(Ritchie) Essex Cardiothoracic Centre and Anglia Ruskin University, Essex,
United Kingdom
(Favaloro) Department of Cardiovascular Surgery, Hospital Universitario
Fundacion Favaloro, Buenos Aires, Argentina
(Parvathaneni) Mercy Hospital, Springfield, MO, United States
(Whitlock, Lamy) Division of Cardiac Surgery, McMaster University,
Hamilton, ON, Canada
Publisher
American Medical Association
Abstract
IMPORTANCE: Most acute kidney injury observed in the hospital is defined
by sudden mild or moderate increases in the serum creatinine
concentration, which may persist for several days. Such acute kidney
injury is associated with lower long-term kidney function. However, it has
not been demonstrated that an intervention that reduces the risk of such
acute kidney injury better preserves long-term kidney function.
<br/>OBJECTIVE(S): To characterize the risk of acute kidney injury with an
intervention in a randomized clinical trial and to determine if there is a
difference between the 2 treatment groups in kidney function 1 year later.
DESIGN, SETTING, AND PARTICIPANTS: The Coronary Artery Bypass Grafting
Surgery Off- or On-pump Revascularisation Study (CORONARY) enrolled 4752
patients undergoing first isolated coronary artery bypass graft (CABG)
surgery at 79 sites in 19 countries. Patients were randomized to receive
CABG surgery either with a beating-heart technique (off-pump) or with
cardiopulmonary bypass (on-pump). From January 2010 to November 2011, 2932
patients (from 63 sites in 16 countries) from CORONARY were enrolled into
a kidney function substudy to record serum creatinine concentrations
during the postoperative period and at 1 year. The last 1-year serum
creatinine concentration was recorded on January 18, 2013. MAIN OUTCOMES
AND MEASURES: Acute kidney injury within 30 days of surgery (>=50%
increase in serum creatinine concentration from prerandomization
concentration) and loss of kidney function at 1 year (>=20% loss in
estimated glomerular filtration rate from prerandomization level). RESULTS
Off-pump (n = 1472) vs on-pump (n = 1460) CABG surgery reduced the risk of
acute kidney injury (17.5%vs 20.8%, respectively; relative risk, 0.83
[95%CI, 0.72-0.97], P = .01); however, there was no significant difference
between the 2 groups in the loss of kidney function at 1 year (17.1%vs
15.3%, respectively; relative risk, 1.10 [95%CI, 0.95-1.29], P = .23).
Results were consistent with multiple alternate continuous and categorical
definitions of acute kidney injury or kidney function loss, and in the
subgroup with baseline chronic kidney disease. CONCLUSIONS AND RELEVANCE:
Use of off-pump compared with on-pump CABG surgery reduced the risk of
postoperative acute kidney injury, without evidence of better preserved
kidney function with off-pump CABG surgery at 1 year. In this setting, an
intervention that reduced the risk of mild to moderate acute kidney injury
did not alter longer-term kidney function. TRIAL REGISTRATION:
clinicaltrials.gov Identifier: NCT00463294 Copyright 2014 American Medical
Association. All rights reserved.

<2>
Accession Number
2010148569
Title
Restrictive vs liberal red blood cell transfusion strategies in patients
with acute myocardial infarction and anemia: Rationale and design of the
REALITY trial.
Source
Clinical Cardiology. 44 (2) (pp 143-150), 2021. Date of Publication:
February 2021.
Author
Ducrocq G.; Calvo G.; Gonzalez-Juanatey J.R.; Durand-Zaleski I.;
Avendano-Sola C.; Puymirat E.; Lemesle G.; Arnaiz J.A.; Martinez-Selles
M.; Rousseau A.; Cachanado M.; Vicaut E.; Silvain J.; Karam C.; Danchin
N.; Simon T.; Steg P.G.
Institution
(Ducrocq, Steg) Universite de Paris, AP-HP, French Alliance for
Cardiovascular Trials (FACT), INSERM U1148, Paris, France
(Calvo) Area del Medicament Hospital Clinic of Barcelona, University of
Barcelona, Barcelona, Spain
(Gonzalez-Juanatey) Cardiology Department, University Hospital, IDIS,
CIBERCV, University of Santiago de Compostela, Santiago de Compostela,
Spain
(Durand-Zaleski) AP-HP Health Economics Research Unit, Hotel Dieu
Hospital, INSERM UMR 1153 CRESS, Paris, France
(Avendano-Sola) Clinical Pharmacology Service, Hospital Universitario
Puerta de Hierro-Majadahonda, Madrid, Spain
(Puymirat, Danchin) Hopital Europeen Georges Pompidou, AP-HP, French
Alliance for Cardiovascular Trials (FACT), and Universite de Paris, Paris,
France
(Lemesle) Institut Coeur Poumon, Centre Hospitalier Universitaire de
Lille, Faculte de Medecine de Lille, Universite de Lille, Institut Pasteur
de Lille, Inserm U1011, F-59000 Lille, France; French Alliance for
Cardiovascular Trials (FACT), Paris, France
(Arnaiz) Clinical Trials Unit, Clinical Pharmacology Department, Hospital
Clinic, Barcelona, Spain
(Martinez-Selles) Servicio de Cardiologia, Hospital Universitario Gregorio
Maranon, CIBERCV; Universidad Europea, Universidad Complutense, Madrid,
Spain
(Rousseau, Cachanado) Clinical Research Platform (URCEST-CRB-CRCEST),
AP-HP, Hopital Saint Antoine, Paris, France
(Vicaut) AP-HP, Department of Biostatistics, Universite Paris-Diderot,
Sorbonne-Paris Cite, Fernand Widal Hospital, France
(Silvain) Sorbonne Universite, ACTION Study Group, Institut de
Cardiologie, Hopital Pitie-Salpetriere, AP-HP, INSERM UMRS 1166, Paris,
France
(Karam) Cardiology Department, Ambroise Pare Hospital, AP-HP, Boulogne,
University of Versailles-Saint Quentin en Yvelines, Boulogne-Billancourt,
France
(Simon) Department of Clinical Pharmacology-Clinical Research Platform
(URCEST-CRB-CRCEST), AP-HP, Hopital Saint Antoine, French Alliance for
Cardiovascular Trials (FACT), Sorbonne-Universite, Paris, France
(Steg) Royal Brompton Hospital, Imperial College, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Anemia is common in patients with acute myocardial infarction
(AMI), and is an independent predictor of mortality. The optimal
transfusion strategy in these patients is unclear. Hypothesis: We
hypothesized that a "restrictive" transfusion strategy (triggered by
hemoglobin <=8 g/dL) is clinically noninferior to a "liberal" transfusion
strategy (triggered by hemoglobin <=10 g/dL), but is less costly.
<br/>Method(s): REALITY is an international, randomized, multicenter,
open-label trial comparing a restrictive vs a liberal transfusion strategy
in patients with AMI and anemia. The primary outcome is the incremental
cost-effectiveness ratio (ICER) at 30 days, using the primary composite
clinical outcome of major adverse cardiovascular events (MACE; comprising
all-cause death, nonfatal stroke, nonfatal recurrent myocardial
infarction, or emergency revascularization prompted by ischemia) as the
effectiveness criterion. Secondary outcomes include the ICER at 1 year,
and MACE (and its components) at 30 days and at 1 year. <br/>Result(s):
The trial aimed to enroll 630 patients. Based on estimated event rates of
11% in the restrictive group and 15% in the liberal group, this number
will provide 80% power to demonstrate clinical noninferiority of the
restrictive group, with a noninferiority margin corresponding to a
relative risk equal to 1.25. The sample size will also provide 80% power
to show the cost-effectiveness of the restrictive strategy at a threshold
of 50 000 per quality-adjusted life year. <br/>Conclusion(s): REALITY will
provide important guidance on the management of patients with AMI and
anemia.<br/>Copyright &#xa9; 2020 The Authors. Clinical Cardiology
published by Wiley Periodicals LLC.

<3>
Accession Number
2011153828
Title
Rationale and design of the CLEAR-outcomes trial: Evaluating the effect of
bempedoic acid on cardiovascular events in patients with statin
intolerance.
Source
American Heart Journal. 235 (pp 104-112), 2021. Date of Publication: May
2021.
Author
Nicholls S.; Lincoff A.M.; Bays H.E.; Cho L.; Grobbee D.E.; Kastelein
J.J.; Libby P.; Moriarty P.M.; Plutzky J.; Ray K.K.; Thompson P.D.;
Sasiela W.; Mason D.; McCluskey J.; Davey D.; Wolski K.; Nissen S.E.
Institution
(Nicholls) Monash Cardiovascular Research Centre, Monash University,
Melbourne, Australia
(Lincoff, Cho, Mason, McCluskey, Davey, Wolski, Nissen) Department of
Cardiovascular Medicine, Cleveland
(Bays) Louisville Metabolic and Atherosclerosis Research Center,
Louisville, KY, United States
(Grobbee) University Medical Center Utrecht, Julius Center, Utrecht,
Netherlands
(Kastelein) Department of Vascular Medicine, University of Amsterdam
Academic Medical Center, Amsterdam, Netherlands
(Libby, Plutzky) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Boston, MA, United States
(Moriarty) Clinical Pharmacology, University of Kansas Medical Center,
Kansas City, KS, United States
(Ray) Department of Primary Care & Public Health, Imperial College London,
London, United Kingdom
(Thompson) Division of Cardiology, Hartford Hospital, Hartford, CT, United
States
(Sasiela) Esperion Therapeutics, Ann Arbor, MI, United States
Publisher
Mosby Inc.
Abstract
Although statins play a pivotal role in the prevention of atherosclerotic
cardiovascular disease, many patients fail to achieve recommended lipid
levels due to statin-associated muscle symptoms. Bempedoic acid is an oral
pro-drug that is activated in the liver and inhibits cholesterol synthesis
in hepatocytes, but is not activated in skeletal muscle which has the
potential to avoid muscle-related adverse events. Accordingly, this agent
effectively lowers atherogenic lipoproteins in patients who experience
statin-associated muscle symptoms. However, the effects of bempedoic acid
on cardiovascular morbidity and mortality have not been studied. Study
design: Cholesterol Lowering via Bempedoic acid, an ACL-Inhibiting Regimen
(CLEAR) Outcomes is a randomized, double-blind, placebo-controlled
clinical trial. Included patients must have all of the following: (i)
established atherosclerotic cardiovascular disease or have a high risk of
developing atherosclerotic cardiovascular disease, (ii) documented statin
intolerance, and (iii) an LDL-C >=100 mg/dL on maximally-tolerated
lipid-lowering therapy. The study randomized 14,014 patients to treatment
with bempedoic acid 180 mg daily or matching placebo on a background of
guideline-directed medical therapy. The primary outcome is a composite of
the time to first cardiovascular death, nonfatal myocardial infarction,
nonfatal stroke, or coronary revascularization. The trial will continue
until 1620 patients experience a primary endpoint, with a minimum of 810
hard ischemic events (cardiovascular death, nonfatal myocardial infarction
or nonfatal stroke) and minimum treatment duration of 36 months and a
projected median treatment exposure of 42 months. <br/>Conclusion(s):
CLEAR Outcomes will determine whether bempedoic acid 180 mg daily reduces
the incidence of adverse cardiovascular events in high vascular risk
patients with documented statin intolerance and elevated LDL-C
levels.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<4>
[Use Link to view the full text]
Accession Number
634267739
Title
Intraoperative oxygen concentration and neurocognition after cardiac
surgery a randomized clinical trial.
Source
Anesthesiology. 134 (2) (pp 189-201), 2021. Date of Publication: February
2021.
Author
Shaefi S.; Shankar P.; Mueller A.L.; O'Gara B.P.; Spear K.; Khabbaz K.R.;
Bagchi A.; Chu L.M.; Banner-Goodspeed V.; Leaf D.E.; Talmor D.S.;
Marcantonio E.R.; Subramaniam B.
Institution
(Shaefi, Shankar, Mueller, O'Gara, Banner-Goodspeed, Talmor, Subramaniam)
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, MA, United
States
(Spear, Khabbaz, Chu) Division of Cardiac Surgery, Department of Surgery,
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(Marcantonio) Division of General Medicine, Department of Medicine, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(Mueller, Bagchi) Department of Anesthesia, Critical Care and Pain
Medicine, Massachusetts General Hospital, Harvard Medical School, Boston,
MA, United States
(Leaf) Division of Renal Medicine, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Despite evidence suggesting detrimental effects of
perioperative hyperoxia, hyperoxygenation remains commonplace in cardiac
surgery. Hyperoxygenation may increase oxidative damage and neuronal
injury leading to potential differences in postoperative neurocognition.
Therefore, this study tested the primary hypothesis that intraoperative
normoxia, as compared to hyperoxia, reduces postoperative cognitive
dysfunction in older patients having cardiac surgery. <br/>Method(s): A
randomized double-blind trial was conducted in patients aged 65 yr or
older having coronary artery bypass graft surgery with cardiopulmonary
bypass. A total of 100 patients were randomized to one of two
intraoperative oxygen delivery strategies. Normoxic patients (n = 50)
received a minimum fraction of inspired oxygen of 0.35 to maintain a
Pao<inf>2</inf> above 70 mmHg before and after cardiopulmonary bypass and
between 100 and 150 mmHg during cardiopulmonary bypass. Hyperoxic patients
(n = 50) received a fraction of inspired oxygen of 1.0 throughout surgery,
irrespective of Pao<inf>2</inf> levels. The primary outcome was
neurocognitive function measured on postoperative day 2 using the
Telephonic Montreal Cognitive Assessment. Secondary outcomes included
neurocognitive function at 1, 3, and 6 months, as well as postoperative
delirium, mortality, and durations of mechanical ventilation, intensive
care unit stay, and hospital stay. <br/>Result(s): The median age was 71
yr (interquartile range, 68 to 75), and the median baseline neurocognitive
score was 17 (16 to 19). The median intraoperative Pao<inf>2</inf> was 309
(285 to 352) mmHg in the hyperoxia group and 153 (133 to 168) mmHg in the
normoxia group (P < 0.001). The median Telephonic Montreal Cognitive
Assessment score on postoperative day 2 was 18 (16 to 20) in the hyperoxia
group and 18 (14 to 20) in the normoxia group (P = 0.42). Neurocognitive
function at 1, 3, and 6 months, as well as secondary outcomes, were not
statistically different between groups. <br/>Conclusion(s): In this
randomized controlled trial, intraoperative normoxia did not reduce
postoperative cognitive dysfunction when compared to intraoperative
hyperoxia in older patients having cardiac surgery. Although the optimal
intraoperative oxygenation strategy remains uncertain, the results
indicate that intraoperative hyperoxia does not worsen postoperative
cognition after cardiac surgery.<br/>Copyright &#xa9; 2020, the American
Society of Anesthesiologists, Inc. All Rights Reserved.

<5>
Accession Number
626131352
Title
Conservative Fluid Management After Sepsis Resuscitation: A Pilot
Randomized Trial.
Source
Journal of Intensive Care Medicine. 35 (12) (pp 1374-1382), 2020. Date of
Publication: December 2020.
Author
Semler M.W.; Janz D.R.; Casey J.D.; Self W.H.; Rice T.W.
Institution
(Semler, Casey, Rice) Division of Allergy, Pulmonary, and Critical Care
Medicine, Vanderbilt University Medical Center, Nashville, TN, United
States
(Janz) Section of Pulmonary/Critical Care Allergy/Immunology, Louisiana
State University School of Medicine, New Orleans, LA, United States
(Self) Department of Emergency Medicine, Vanderbilt University Medical
Center, Nashville, TN, United States
Publisher
SAGE Publications Inc.
Abstract
Rationale: The feasibility and clinical outcomes of conservative fluid
management after sepsis resuscitation remain unknown. <br/>Objective(s):
To evaluate the effect of a conservative fluid management protocol on
fluid balance and intensive care unit (ICU)-free days among patients with
sepsis. <br/>Method(s): In a single-center phase II/III randomized trial,
we enrolled adults with suspected infection, >=2 systemic inflammatory
response syndrome criteria, and either shock (mean arterial pressure <60
mm Hg or vasopressors) or respiratory insufficiency (mechanical
ventilation or oxygen saturation <97% and fraction of inspired oxygen
>=0.3). Patients were randomized 1:1 to usual care or a conservative fluid
management protocol. The protocol restricted intravenous fluid
administration during shock to treatment of oliguria or increasing
vasopressor requirement. In the absence of shock, loop diuretic infusion
targeted equal fluid input and output each study day. The primary outcomes
were mean daily fluid balance (phase II) and ICU-free days (phase III).
<br/>Result(s): At the completion of phase II (n = 30), the difference in
mean daily fluid balance between groups (-398 mL) was less than the
prespecified threshold (-500 mL) and the trial was stopped. Patients in
the conservative fluid management (n = 15) and usual care (n = 15) groups
experienced similar cumulative fluid input (8450 mL vs 7049 mL; P =.90) of
which only 14% was intravenous crystalloid or colloid. Loop diuretic
infusion occurred more frequently in the conservative fluid management
group (40% vs 0%; P =.02), and cumulative fluid output was 10 645 mL in
the conservative fluid management group compared to 6286 mL in the usual
care group (P =.39). Hemodynamic, respiratory, and renal function did not
differ between the groups. <br/>Conclusion(s): In this phase II trial, a
conservative fluid management protocol did not decrease mean daily fluid
balance by more than 500 mL among patients with sepsis. Registration:
Clinicaltrials.gov; NCT02159079.<br/>Copyright &#xa9; The Author(s) 2019.

<6>
Accession Number
2010560475
Title
Incidence and recurrence of new-onset atrial fibrillation detected during
hospitalization for non-cardiac surgery: a systematic review and
meta-analysis.
Source
Canadian Journal of Anesthesia. 68 (7) (pp 1045-1056), 2021. Date of
Publication: July 2021.
Author
McIntyre W.F.; Vadakken M.E.; Rai A.S.; Thach T.; Syed W.; Um K.J.;
Ibrahim O.; Dalmia S.; Bhatnagar A.; Mendoza P.A.; Benz A.P.; Bangdiwala
S.I.; Spence J.; McClure G.R.; Huynh J.T.; Zhang T.; Inami T.; Conen D.;
Devereaux P.J.; Whitlock R.P.; Healey J.S.; Belley-Cote E.P.
Institution
(McIntyre, Vadakken, Rai, Bhatnagar, Benz, Bangdiwala, Spence, Zhang,
Conen, Devereaux, Whitlock, Healey, Belley-Cote) Population Health
Research Institute, McMaster University, Hamilton, ON, Canada
(McIntyre, Um, Ibrahim, Dalmia, Spence, Huynh, Conen, Devereaux, Whitlock,
Healey, Belley-Cote) Department of Medicine, McMaster University,
Hamilton, ON, Canada
(McIntyre, Mendoza, Benz, Bangdiwala, Spence, Conen, Devereaux, Healey)
Department of Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, ON, Canada
(Thach, Syed) Faculty of Health Sciences, McMaster University, Hamilton,
ON, Canada
(McClure, Whitlock) Department of Surgery, McMaster University, Hamilton,
ON, Canada
(Inami) Department of Cardiovascular Medicine, Nippon Medical School,
Tokyo, Japan
Publisher
Springer
Abstract
Purpose: This systematic review aimed to summarize reports of the
incidence and long-term recurrence of new-onset atrial fibrillation (AF)
associated with non-cardiac surgery. Sources: We searched CENTRAL, MEDLINE
and EMBASE from inception to November 2019. We included studies that
reported on the incidence of new-onset perioperative AF during
hospitalization for non-cardiac surgery and/or AF recurrence in such
patients following discharge. Reviewers screened articles and abstracted
data independently and in duplicate. We assessed study quality by
appraising methodology for collecting AF history, incident AF during
hospitalization, and AF recurrence after discharge. Principal findings:
From 39,233 citations screened, 346 studies that enrolled a total of
5,829,758 patients met eligibility criteria. Only 27 studies used
prospective, continuous inpatient electrocardiographic (ECG) monitoring to
detect incident AF. Overall, the incidence of postoperative AF during
hospitalization ranged from 0.004 to 50.3%, with a median [interquartile
range] of 8.7 [3.8-15.0]%. Atrial fibrillation incidence varied with type
of surgery. Prospective studies using continuous ECG monitoring reported
significantly higher incidences of AF than those that did not (13.9% vs
1.9%, respectively; P < 0.001). A total of 13 studies (25,726 patients)
with follow-up up to 5.4 years reported on AF recurrence following
hospital discharge; only one study used a prospective systematic
monitoring protocol. Recurrence rates ranged from 0 to 37.3%.
<br/>Conclusion(s): Rates of AF incidence first detected following
non-cardiac surgery and long-term AF recurrence vary markedly. Differences
in the intensity of ECG monitoring and type of surgery may account for
this variation. Trial registration: PROSPERO (CRD42017068055); registered
1 September 2017.<br/>Copyright &#xa9; 2021, Canadian Anesthesiologists'
Society.

<7>
Accession Number
2007059270
Title
Clinical risk predictors in atrial fibrillation patients following
successful coronary stenting: ENTRUST-AF PCI sub-analysis.
Source
Clinical Research in Cardiology. 110 (6) (pp 831-840), 2021. Date of
Publication: June 2021.
Author
Goette A.; Eckardt L.; Valgimigli M.; Lewalter T.; Laeis P.; Reimitz
P.-E.; Smolnik R.; Zierhut W.; Tijssen J.G.; Vranckx P.
Institution
(Goette) Medizinische Klinik II: Kardiologie Und Intensivmedizin, St.
Vincenz-Krankenhaus, Am Busdorf 2, Paderborn 33098, Germany
(Goette) Working Group of Molecular Electrophysiology, University Hospital
Magdeburg, Magdeburg, Germany
(Goette, Eckardt, Lewalter) Atrial Fibrillation Network, Munster, Germany
(Eckardt) Division of Electrophysiology, Department of Cardiology and
Angiology, University of Munster, Munster, Germany
(Valgimigli) Department of Cardiology, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
(Lewalter) Department of Cardiology, Hospital Munich South, Munich,
Germany
(Lewalter) University of Bonn, Bonn, Germany
(Laeis, Reimitz, Smolnik, Zierhut) Daiichi Sankyo Europe, Munich, Germany
(Tijssen) Department of Cardiology, Amsterdam University Medical Centers,
University of Amsterdam, Amsterdam, Netherlands
(Tijssen) Cardialysis, RotterdamNetherlands
(Vranckx) Department of Cardiology and Intensive Care, Jessa Ziekenhuis,
Faculty of Medicine and Life Sciences at the Hasselt University, Hasselt,
Belgium
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Aims: This subgroup analysis of the ENTRUST-AF PCI trial
(ClinicalTrials.gov Identifier: NCT02866175; Date of registration: August
2016) evaluated type of AF, and CHA<inf>2</inf>DS<inf>2</inf>-VASc score
parameters as predictors for clinical outcome. <br/>Method(s): Patients
were randomly assigned after percutaneous coronary intervention (PCI) to
either edoxaban (60 mg/30 mg once daily [OD]; n = 751) plus a
P2Y<inf>12</inf> inhibitor for 12 months or a vitamin K antagonist [VKA]
(n = 755) plus a P2Y<inf>12</inf> inhibitor and aspirin (100 mg OD, for
1-12 months). The primary outcome was a composite of major/clinically
relevant non-major bleeding (CRNM) within 12 months. The composite
efficacy endpoint consisted of cardiovascular death, stroke, systemic
embolic events, myocardial infarction (MI), and definite stent thrombosis.
<br/>Result(s): Major/CRNM bleeding event rates were 20.7%/year and
25.6%/year with edoxaban and warfarin, respectively (HR [95% CI]: 0.83
[0.654-1.047]). The event rates of composite outcome were 7.26%/year and
6.86%/year, respectively (HR [95% CI]): 1.06 [0.711-1.587]), and of
overall net clinical benefit were 12.48%/year and 12.80%/year,
respectively (HR [(95% CI]: 0.99 [(0.730; 1.343]). Increasing
CHA<inf>2</inf>DS<inf>2</inf>-VASc score was associated with increased
rates of all outcomes. CHA<inf>2</inf>DS<inf>2</inf>-VASc score >= 5 was a
marker for stent thrombosis. Paroxysmal AF was associated with a higher
occurrence of MI (4.87% versus 2.01%, p = 0.0024). <br/>Conclusion(s):
After PCI in AF patients, increasing CHA<inf>2</inf>DS<inf>2</inf>-VASc
score was associated with increased bleeding rates and
CHA<inf>2</inf>DS<inf>2</inf>-VASc score (>= 5) predicted the occurrence
of stent thrombosis. Paroxysmal AF was associated with MI. These findings
may have important clinical implications in AF patients.<br/>Copyright
&#xa9; 2020, The Author(s).

<8>
[Use Link to view the full text]
Accession Number
635084082
Title
Temporary mechanical circulatory support devices: updates from recent
studies.
Source
Current opinion in cardiology. 36 (4) (pp 375-383), 2021. Date of
Publication: 01 Jul 2021.
Author
Marbach J.A.; Chweich H.; Miyashita S.; Kapur N.K.
Institution
(Marbach, Chweich) Division of Pulmonary, Critical Care and Sleep Medicine
(Marbach, Miyashita, Kapur) Department of Medicine
(Miyashita, Kapur) Cardiovascular Center, Tufts Medical Center and Tufts
University School of Medicine, Boston, MA, United States
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: Over the past several years, the role of short-term
mechanical circulatory support (MCS) devices has become the dominant focus
in efforts to improve outcomes in patients with cardiogenic shock (CS).
Alongside these efforts, temporary MCS devices have been increasingly used
to support patients prior to cardiac surgery, during high-risk
percutaneous coronary intervention, awaiting cardiac transplantation, and
in the setting of refractory cardiac arrest. The present review aims to
provide an update on the recent literature evaluating the evolving role of
temporary MCS devices, and to provide insights into the current challenges
and future directions of MCS research. RECENT FINDINGS: Recent
observational data have demonstrated potential roles for intra-aortic
balloon pump preoperatively in high-risk patients awaiting coronary artery
bypass grafting, and advanced heart failure patients awaiting
transplantation. Impella continues to demonstrate promising results as
part of an early MCS strategy in CS, as a temporary bridge to
transplantation, and as a mechanism for left ventricular unloading in
patients on venoarterial extracorporeal membrane oxygenation (ECMO).
Finally, the first randomized trial of ECMO facilitated resuscitation in
the United States demonstrated improved survival in patients with
refractory out of hospital cardiac arrest. SUMMARY: Though randomized data
remains limited, observational data continue to support the role of
temporary MCS devices in a variety of clinical settings.<br/>Copyright
&#xa9; 2021 Wolters Kluwer Health, Inc. All rights reserved.

<9>
Accession Number
634676233
Title
Is there a renoprotective value to leukodepletion during heart valve
surgery? A randomized controlled trial (ROLO).
Source
Journal of cardiothoracic surgery. 16 (1) (pp 58), 2021. Date of
Publication: 26 Mar 2021.
Author
Khoshbin E.; Spencer S.; Solomon L.; Tang A.; Clark S.; Stokes E.;
Wordsworth S.; Dabner L.; Edwards J.; Reeves B.; Rogers C.
Institution
(Khoshbin, Clark) Department of Cardiothoracic Surgery, Freeman Hospital,
High Heaton, Newcastle upon Tyne NE7 7DN, United Kingdom
(Spencer) School of Health and Medicine, Lancaster University, Bailing,
Upper Market Street, Lancaster, Lancashire, LA1 4YW, UK
(Solomon) Renal Unit, Lancashire Teaching Hospitals NHS Foundation Trust,
Sharoe Green Lane, Fulwood, Preston, Lancashire, PR2 9HT, UK
(Tang) Department of Cardiothoracic Surgery, Blackpool Victoria Hospital,
Blackpool FY3 8NR, United Kingdom
(Stokes, Wordsworth) Department of Public Health, University of Oxford,
Rosemary Rue Building, Old Road Campus ,Headington, Oxford OX3 7LF, United
Kingdom
(Dabner, Edwards, Reeves, Rogers) Clinical Trials and Evaluation Unit,
Bristol Medical School, University of Bristol, Bristol BS2 8HW, United
Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Acute Kidney Injury (AKI) adversely affects outcomes after
cardiac surgery. A major mediator of AKI is the activation of leukocytes
through exposure to the cardiopulmonary bypass circuit. We evaluate the
use of leukodepletion filters throughout bypass to protect against
post-operative AKI by removing activated leukocytes during cardiac
surgery. <br/>METHOD(S): This is a single-centre, double-blind, randomized
controlled trial comparing the use of leukodepletion versus a standard
arterial filter throughout bypass. Elective adult patients undergoing
heart valve surgery with or without concomitant procedures were
investigated. The primary clinical outcome measured was the development of
AKI according to the KDIGO criteria. Secondary measures included
biomarkers of renal tubular damage (urinary Retinol Binding Protein and
Kidney Injury Molecule-1), glomerular kidney injury (urinary Micro Albumin
and serum Cystatin C) and urinary Neutrophil Gelatinase Associated
Lipocalin, as well as the length of hospital stay and quality of life
measures through EQ-5D-5L questionnaires. <br/>RESULT(S): The ROLO trial
randomized 64 participants with a rate of recruitment higher than
anticipated (57% achieved, 40% anticipated). The incidence of AKI was
greater in the leukodepletion filter group (44% versus 23%, risk
difference 21, 95% CI -2 to 44%). This clinical finding was supported by
biomarker levels especially by a tendency toward glomerular insult at 48h,
demonstrated by a raised serum Cystatin C (mean difference 0.11, 95% CI
0.00 to 0.23, p =0.068) in the leukodepleted group. There was however no
clear association between the incidence or severity of AKI and length of
hospital stay. On average, health related quality of life returned to
pre-operative levels in both groups within 3months of surgery.
<br/>CONCLUSION(S): Leukocyte depletion during cardiopulmonary bypass does
not significantly reduce the incidence of AKI after valvular heart
surgery. Other methods to ameliorate renal dysfunction after cardiac
surgery need to be investigated. TRIAL REGISTRATION: The trial was
registered by the International Standard Randomized Controlled Trial
Number Registry ISRCTN42121335 . Registered on the 18 February 2014. The
trial was run by the Bristol Clinical Trials and Evaluation Unit. This
trial was financially supported by the National Institute of Health
Research (Research for Patient Benefit), award ID: PB-PG-0711-25,090.

<10>
Accession Number
2007448640
Title
Comparative study of self-demonstration versus video based education on
level of anxiety and self-efficacy in patient undergoing cardiac surgery:
A double-blinded randomized controlled trial.
Source
Indian Journal of Public Health Research and Development. 12 (3) (pp
163-169), 2021. Date of Publication: 06 Jun 2021.
Author
Gaikwad R.R.; Diwate A.D.; Das A.K.; Ahya N.
Institution
(Gaikwad, Diwate, Das, Ahya) DVVPF's College of Physiotherapy, Ahmednagar,
India
Publisher
Institute of Medico-Legal Publications
Abstract
Aim: To compare the effect of self-demonstration versus video based
education in reducing anxiety and improving self-efficacy of a patient
undergoing cardiac surgery. Methodology: A Double Blinded, Randomized
Control Trial conducted at Dr. Vikhe Patil Memorial Hospital. Study
duration was 12 months. A total number of 58 patients were included in
this study. The patients divided into two groups. Group I which receives
self-demonstration and Group II which receives video based demonstration
by simple random sampling using chit method. Outcome Measures: Primary
outcome measure is Self-efficacy questionnaire. Secondary outcome measure
is Hospital Anxiety Depression Scale. <br/>Result(s): Within the group
analysis, Group I and Group II showed that there was significant
difference between pre and post intervention anxiety and depression.
Between the group analysis, there was no significant difference found for
anxiety (P=0.4925) and depression (P= 0.9441). In Group I and Group II
there was no statistical significant difference for Score of Self Efficacy
Questionnaire (P=0.6970). <br/>Conclusion(s): Our study concluded that
Self-Demonstration and Video Based Education both are equally effective in
reduction of anxiety. Similarly the study supports equal effectiveness of
above techniques in term of self efficacy post operatively.<br/>Copyright
&#xa9; 2021, Institute of Medico-Legal Publications. All rights reserved.

<11>
Accession Number
635219432
Title
Lidocaine for postoperative pain after cardiac surgery: a systematic
review.
Source
Journal of cardiothoracic surgery. 16 (1) (pp 157), 2021. Date of
Publication: 31 May 2021.
Author
Boswell M.R.; Moman R.N.; Burtoft M.; Gerdes H.; Martinez J.; Gerberi
D.J.; Wittwer E.; Murad M.H.; Hooten W.M.
Institution
(Boswell, Moman, Burtoft, Gerdes, Martinez, Wittwer, Hooten) Department of
Anesthesiology and Perioperative Medicine, Mayo Clinic, MN, 200 First St
SW, Rochester 55902, United States
(Gerberi) Mayo Clinic Library, Mayo Clinic, MN, Rochester, United States
(Murad) Division of Preventative Medicine, Department of Internal
Medicine, Mayo Clinic, MN, Rochester, United States
(Hooten) Division of Pain Medicine, Mayo Clinic, MN, Rochester, United
States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Lidocaine is one of the most widely used local anesthetics with
well-known pharmacological properties. The purpose of this systematic
review is to investigate the effects of lidocaine on postoperative pain
scores and recovery after cardiac surgery. <br/>METHOD(S): A comprehensive
database search was conducted by a reference librarian for randomized
clinical trials (RCT) from January 1, 1980 to September 1, 2019. Eligible
study designs included randomized controlled trials of lidocaine for
postoperative pain management in adults undergoing cardiac surgery. After
removal of duplicates, 947 records were screened for eligibility and 3
RCTs met inclusion criteria. <br/>RESULT(S): Sources of bias were
identified in 2 of 3 RCTs. Lidocaine was administered intravenously,
topically, and intrapleurally. Key findings included [1] 2% lidocaine
placed topically on chest tube prior to intraoperative insertion was
associated with significantly lower pain scores and lower cumulative doses
of fentanyl; and [2] 2% lidocaine administered intrapleurally was
associated with significantly lower pain scores and significant
improvements in pulmonary mechanics. Lidocaine infusions were not
associated with significant changes in pain scores or measures of
recovery. No significant associations were observed between lidocaine and
overall mortality, hospital length of stay or ICU length of stay. No data
were reported for postoperative nausea and vomiting or arrhythmias.
<br/>CONCLUSION(S): Due to the favorable risk profile of topical lidocaine
and the need for further advancements in the postoperative care of adults
after cardiac surgery, topically administered lidocaine could be
considered for incorporation into established postoperative recovery
protocols.

<12>
Accession Number
2012840618
Title
Association between perioperative chlorhexidine oral care and
postoperative pneumonia in non-cardiac surgical patients: A systematic
review and meta-analysis.
Source
Surgery (United States). (no pagination), 2021. Date of Publication: 2021.
Author
Liang S.; Zhang X.; Hu Y.; Yang J.; Li K.
Institution
(Liang, Zhang, Hu, Li) West China School of Nursing, West China Hospital,
Sichuan University, Chengdu, China
(Yang) Department of Gastrointestinal Surgery, West China School of
Nursing, West China Hospital, Sichuan University, Chengdu, China
Publisher
Mosby Inc.
Abstract
Background: Postoperative pneumonia is the third most common complication
after surgery, and its occurrence is associated with a poor prognosis in
patients. Perioperative chlorhexidine oral care has been reported to
reduce the incidence of postoperative pneumonia in patients undergoing
cardiac surgery. However, whether perioperative chlorhexidine oral care
can reduce the incidence of postoperative pneumonia in noncardiac surgical
patients is still unknown. The aim of this systematic review and
meta-analysis was to determine the association between perioperative
chlorhexidine oral care and postoperative pneumonia in noncardiac surgical
patients. <br/>Method(s): A comprehensive systematic search of PubMed,
Ovid Embase, Web of Science, the Cochrane Library, Wanfang Database, and
the China National Knowledge Infrastructure was conducted to include
studies from the inception of each database through March 2021. The
reference lists of all included studies were also searched by hand.
Eligible studies were published and unpublished randomized controlled
trials and observational studies evaluating the effect of perioperative
chlorhexidine oral care on the reported incidence of postoperative
pneumonia. Relative risks or odds ratio with their 95% confidence
intervals were calculated and risk of bias was assessed for eligible
studies. <br/>Result(s): Seven randomized controlled trials with a total
of 1,773 patients and 3 observational studies with a total of 12,528
noncardiac surgical patients were included. A total of 621 and 5,904
patients received perioperative chlorhexidine oral care in randomized
controlled trials and observational studies, respectively. Six (85%)
randomized controlled trials had a high risk of bias, and 2 (67%)
observational studies had a high quality. Perioperative chlorhexidine oral
care significantly reduced the incidence of postoperative pneumonia in
randomized controlled trials (relative risk, 0.60; 95% confidence
interval, 0.44-0.80; P <.001) and observational studies (odds ratio, 0.26;
95% confidence interval, 0.08-0.90; P =.03). <br/>Conclusion(s):
Perioperative chlorhexidine oral care led by a nurse significantly
decreases the incidence of postoperative pneumonia in noncardiac surgical
patients and may be more convenient and economical compared with dental
professional-led perioperative oral care.<br/>Copyright &#xa9; 2021
Elsevier Inc.

<13>
Accession Number
2012838929
Title
Sex, Racial, and Ethnic Disparities in U.S. Cardiovascular Trials in More
Than 230,000 Patients.
Source
Annals of Thoracic Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Preventza O.; Critsinelis A.; Simpson K.; Olive J.K.; LeMaire S.A.;
Cornwell L.D.; Jimenez E.; Byrne J.; Chatterjee S.; Rosengart T.K.;
Coselli J.S.
Institution
(Preventza, Simpson, Olive, LeMaire, Cornwell, Jimenez, Chatterjee,
Rosengart, Coselli) Division of Cardiothoracic Surgery, Michael E. DeBakey
Department of Surgery, Baylor College of Medicine, Houston, TX, United
States
(Preventza, LeMaire, Jimenez, Chatterjee, Rosengart, Coselli) Department
of Cardiovascular Surgery, Texas Heart Institute, Houston, TX, United
States
(Preventza, LeMaire, Byrne, Chatterjee, Rosengart, Coselli) Department of
Cardiovascular Surgery, CHI St Luke's Health-Baylor St Luke's Medical
Center, Houston, TX, United States
(Critsinelis) Division of Cardiothoracic Transplantation and Circulatory
Support, Michael E. DeBakey Department of Surgery, Baylor College of
Medicine, Houston, TX, United States
(LeMaire) Office of Surgical Research, Michael E. DeBakey Department of
Surgery, Baylor College of Medicine, Houston, TX, United States
(Cornwell, Jimenez) Division of Cardiothoracic Surgery, Michael E. DeBakey
VA Medical Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: The current representation of female patients and racial and
ethnic minorities in cardiovascular trials is unclear. We evaluated these
groups' inclusion in U.S. cardiovascular trials. <br/>Method(s): Using
publicly available data from ClinicalTrials.gov, we evaluated
cardiovascular trials pertaining to coronary artery bypass grafting
(CABG), heart valve disease, aortic aneurysm, ventricular assist devices,
and heart transplantation. This yielded 178 U.S. trials (159 completed, 19
active but not recruiting) started between September 1998 and May 2017,
with 237,132 participants. To examine female patients' and racial and
ethnic minorities' representation in these trials, we calculated
participation-to-prevalence ratios (PPRs). Values of 0.8 to 1.2 reflect
similar representation. <br/>Result(s): All 178 trials reported sex
distribution, whereas only 76 (42.7%) trials reported racial distribution
and 52 (29.2%) trials reported ethnic (Hispanic vs non-Hispanic)
distribution. Among all trials, participants were 28.3% female, 11.2% were
Hispanic/Latino, 4.0% were African American, 10.4% were Asian, and 2.3%
were other. The CABG PPR for female patients was 0.64, for Hispanic
patients was 0.72, for African American patients was 0.28, and for Asian
patients was 3.20. Between 2008-2012 and 2013-2017, the CABG PPR decreased
for female patients (0.67->0.50) and African American patients
(0.37->0.17) but increased for Hispanic patients (0.38->1.32) and Asian
patients (3.51->4.57). <br/>Conclusion(s): Participation in cardiovascular
trials by female patients and minorities (except Asian patients) remains
low. Given that inherent differences among the previously mentioned groups
could affect outcomes, balance is clearly needed. The engagement of our
surgical leadership, community, and industry to address these disparities
is vitally important.<br/>Copyright &#xa9; 2020

<14>
Accession Number
2012324775
Title
Computed tomography derived predictors of permanent pacemaker implantation
after transcatheter aortic valve replacement: A meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2021.
Date of Publication: 2021.
Author
Maier O.; Piayda K.; Afzal S.; Polzin A.; Westenfeld R.; Jung C.; Zeus T.;
Antoch G.; Kelm M.; Veulemans V.
Institution
(Maier, Piayda, Afzal, Polzin, Westenfeld, Jung, Zeus, Kelm, Veulemans)
Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich
Heine University, Medical Faculty, Dusseldorf, Germany
(Antoch) Department of Diagnostic and Interventional Radiology, Heinrich
Heine University, Medical Faculty, Dusseldorf, Germany
(Kelm) Heinrich Heine University, Medical Faculty, CARID (Cardiovascular
Research Institute Dusseldorf), Dusseldorf, Germany
Publisher
John Wiley and Sons Inc
Abstract
Objectives: This meta-analysis sought to assess predictors of permanent
pacemaker implantation (PPI) after transcatheter aortic valve replacement
(TAVR) with focus on preprocedural multi-slice computed tomography (MSCT)
derived data. <br/>Background(s): Transcatheter aortic valve replacement
(TAVR) has expanded to a well-established treatment for severe symptomatic
aortic stenosis at high and intermediate surgical risk. PPI after TAVR
remains one of the most frequent procedure-related complications and
appears to be influenced by several factors. <br/>Method(s): The authors
conducted a literature search in PubMed/MEDLINE and EMBASE databases to
identify studies that investigated preprocedural MSCT data and the rate of
PPI following TAVR with new-generation devices. <br/>Result(s): Ten
observational studies (n = 2707) met inclusion criteria for the final
analysis. PPI was performed in 387 patients (14.3%) after TAVR. Patients
requiring PPI had a larger annulus perimeter (MD: 1.66 mm; p <.001) and a
shorter membranous septum length (MD: -1.1 mm; p <.05). Concerning
calcification distribution, patients with requirement for new pacemaker
implantation showed increased calcification of the left coronary cusp (MD:
47.6 mm³; p <.001), and the total left ventricular outflow
tract (MD: 24.42 mm³; p <.01). Lower implantation depth (MD:
0.95 mm; p <.05) and oversizing (MD: 1.52%; p <.05) were procedural
predictors of PPI following TAVR. <br/>Conclusion(s): Besides the
well-known impact of electrocardiographic and procedure-related factors on
conduction disturbances, MSCT derived distribution of the aortic valve and
left ventricular outflow tract calcification, as well as membranous septum
length, are associated with an increased risk of PPI following
TAVR.<br/>Copyright &#xa9; 2021 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<15>
Accession Number
2012319103
Title
The effect of non-point-of-care haemostasis management protocol
implementation in cardiac surgery: A systematic review.
Source
Transfusion Medicine. (no pagination), 2021. Date of Publication: 2021.
Author
Boxma R.P.J.; Garnier R.P.; Bulte C.S.E.; Meesters M.I.
Institution
(Boxma, Garnier, Bulte) Department of Anesthesiology, Amsterdam University
Medical Center, Location VU Medical Center, Amsterdam, Netherlands
(Meesters) Department of Anesthesiology, Catharina Hospital Eindhoven,
Eindhoven, Netherlands
Publisher
Blackwell Publishing Ltd
Abstract
Objectives: This systematic review aims to outline the evidence on the
implementation of a non-point-of-care (non-point-of-care [POC])
haemostasis management protocol compared to experience-based practice in
adult cardiac surgery. <br/>Background(s): Management of coagulopathy in
cardiac surgery is complex and remains highly variable among centres and
physicians. Although various guidelines recommend the implementation of a
transfusion protocol, the literature on this topic has never been
systematically reviewed. <br/>Method(s): PubMed, Embase, Cochrane Library,
and Web of Science were searched from January 2000 till May 2020.
<br/>Result(s): A total of seven studies (one randomised controlled trial
[RCT], one prospective cohort study, and five retrospective studies) met
the inclusion criteria. Among the six non-randomised, controlled studies,
the risk of bias was determined to be serious to critical, and the one RCT
was determined to have a high risk of bias. Five studies showed a
significant reduction in red blood cells, fresh frozen plasma, and/or
platelet transfusion after the implementation of a structural non-POC
algorithm, ranging from 2% to 28%, 2% to 19.5%, and 7% to17%,
respectively. One study found that fewer patients required transfusion of
any blood component in the protocol group. Another study had reported a
significantly increased transfusion rate of platelet concentrate in the
haemostasis algorithm group. <br/>Conclusion(s): Owing to the high
heterogeneity and a substantial risk of bias of the included studies, no
conclusion can be drawn on the additive value of the implementation of a
cardiac-surgery-specific non-POC transfusion and haemostasis management
algorithm compared to experience-based practice. To define the exact
impact of a transfusion protocol on blood product transfusion, bleeding,
and adverse events, well-designed prospective clinical trials are
required.<br/>Copyright &#xa9; 2021 The Authors. Transfusion Medicine
published by John Wiley & Sons Ltd on behalf of British Blood Transfusion
Society.

<16>
Accession Number
635218488
Title
Alternatives for Vitamin K Antagonists as Thromboprophylaxis for
Mechanical Heart Valves and Mechanical Circulatory Support Devices: A
Systematic Review.
Source
Seminars in thrombosis and hemostasis. (no pagination), 2021. Date of
Publication: 31 May 2021.
Author
Liesdek O.C.D.; Urbanus R.T.; de Heer L.M.; Fischer K.; Suyker W.J.L.;
Schutgens R.E.G.
Institution
(Liesdek, de Heer, Suyker) Department of Cardiothoracic Surgery,
University Medical Center Utrecht, Utrecht University, Utrecht,
Netherlands
(Liesdek, Urbanus, Fischer, Schutgens) Van Creveldkliniek, University
Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
Publisher
NLM (Medline)
Abstract
The holy grail of anticoagulation in patients with intracardiac devices,
such as mechanical heart valves (MHVs) and left ventricular assist devices
(LVADs), comprises safe prevention of thrombosis without interrupting
normal hemostasis. Device-induced thrombosis and anticoagulant-related
bleeding problems are dreaded complications that may cause a significantly
reduced quality of life and increased morbidity and mortality. Vitamin K
antagonists are the current standard for oral anticoagulation therapy in
patients with MHVs and LVADs. Even within the therapeutic range,
hemorrhage is the primary complication of these drugs, which emphasizes
the need for safer anticoagulants for the prevention of device-induced
thrombosis. Device-induced thrombosis is a complex multifactorial
phenomenon that likely requires anticoagulant therapy targeting multiple
pathways. Here, we review the preclinical and clinical data describing the
efficacy of a variety of anticoagulants as thromboprophylaxis after
implantation of intracardiac devices.<br/>Copyright Thieme. All rights
reserved.

<17>
[Use Link to view the full text]
Accession Number
2007675191
Title
Modifying dietary patterns in cardiothoracic transplant patients to reduce
cardiovascular risk: The AMEND-IT Trial.
Source
Clinical Transplantation. 35 (2) (no pagination), 2021. Article Number:
e14186. Date of Publication: February 2021.
Author
Entwistle T.R.; Miura K.; Keevil B.G.; Morris J.; Yonan N.; Pohl M.; Green
A.C.; Fildes J.E.
Institution
(Entwistle, Yonan, Fildes) The Ex-Vivo Lab, Division of Cell Matrix
Biology and Regenerative Medicine, School of Biological Sciences, Faculty
of Biology, Medicine and Health, Manchester Academic Health Science
Centre, The University of Manchester, Manchester, United Kingdom
(Entwistle, Fildes) The Transplant Centre, Manchester Foundation Trust,
Manchester, United Kingdom
(Miura, Green) Cancer and Population Studies, QIMR Berghofer Medical
Research Institute, Brisbane, QLD, Australia
(Keevil) Department of Clinical Biochemistry, University Hospital South
Manchester NHS Foundation Trust, Manchester Academic Health Science
Centre, University of Manchester, Manchester, United Kingdom
(Morris) Department of Medical Statistics, Manchester Foundation Trust,
Manchester Academic Health Science Centre, The University of Manchester,
Manchester, United Kingdom
(Pohl) Igelosa Life Science AB, Lund, Sweden
(Green) CRUK Manchester Institute and University of Manchester, Manchester
Academic Health Science Centre, Manchester, United Kingdom
Publisher
Blackwell Publishing Ltd
Abstract
Background: Cardiovascular disease (CVD) is common after cardiothoracic
transplantation and causes substantial morbidity. <br/>Aim(s): To assess
feasibility and potential effectiveness of dietary interventions to reduce
CVD risk. <br/>Material(s) and Method(s): In a pilot intervention, we
recruited patients from a tertiary hospital and randomly allocated them to
a Mediterranean or low-fat diet for 12 months. Feasibility was measured by
patient participation, retention, and adherence. Changes in weight, body
mass index (BMI), heart rate, blood pressure, glucose markers, and blood
lipids were assessed using longitudinal generalized estimating equation
regression models with 95% confidence intervals. <br/>Result(s): Of 56
heart and 60 lung transplant recipients, 52 (45%) consented, 41 were
randomized, and 39 (95%) completed the study with good adherence to
randomized diets. After 12 months, changes in many risk factors were seen
in the Mediterranean and low-fat-diet groups, respectively, including mean
BMI (-0.5 vs. 0.0 kg/m²), systolic/diastolic blood pressure
+0.5/+0.1 vs -4.4/-3.5 mmHg; fasting glucose -0.26 vs -0.27 mmol/L; total
cholesterol -0.56 vs -0.40 mmol/L. Changes in BMI and systolic/diastolic
blood pressure in 49 eligible patients who did not take part were +0.7
kg/m² and +2.5/+1.8 mmHg. <br/>Discussion(s): Dietary
interventions in cardiothoracic transplant patients are feasible and
potentially beneficial. <br/>Conclusion(s): A definitive nutritional
intervention study in these high-risk patients is warranted.<br/>Copyright
&#xa9; 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

<18>
Accession Number
634277954
Title
Use of Pericardium for Cardiac Reconstruction Procedures in Acquired Heart
Diseases-A Comprehensive Review.
Source
Thoracic and Cardiovascular Surgeon. 69 (1) (pp 83-91), 2021. Date of
Publication: 01 Jan 2021.
Author
De Martino A.; Milano A.D.; Bortolotti U.
Institution
(De Martino, Bortolotti) Section of Cardiac Surgery, University Hospital,
Pisa, Italy
(Milano) Department of Cardiac Surgery, University of Bari Aldo Moro,
Bari, Italy
Publisher
Georg Thieme Verlag
Abstract
Background: Reconstruction of cardiac structures has been the goal of many
surgeons even before the advent of open-heart procedures with
cardiopulmonary bypass. Unsatisfactory results with synthetic materials
has switched the attention to biological tissues, among which pericardium,
either autologous or of animal origin, has been widely used as patch
material. <br/>Method(s): We have reviewed the literature to assess the
effective role of pericardial tissue in the correction of various acquired
cardiac lesions. Particularly, special attention was given not only to
established techniques but also to detect any peculiar and unusual
application of pericardium. <br/>Result(s): Autologous pericardium is
frequently used as patch material particularly when limited valvular
lesions must be corrected, while xenograft pericardium appears
particularly useful in patients with endocarditis and extensive
destruction of the intracardiac structures by infection and abscesses.
Pericardium is an extremely versatile material owing to its pliability and
strength; however, it tends to calcify in the long term when in contact
with blood, although stability of the repair is maintained in most cases.
<br/>Conclusion(s): Pericardium plays an important role in various cardiac
and aortic pathologies. Tissues resistant to fibrosis and calcification to
be used as patch material are the ideal solution for more successful
cardiac reconstruction procedures and will hopefully be provided by the
ongoing research.<br/>Copyright &#xa9; 2021 Georg Thieme Verlag. All
rights reserved.

<19>
Accession Number
2010851713
Title
Progression of Tricuspid Regurgitation After Surgery for Ischemic Mitral
Regurgitation.
Source
Journal of the American College of Cardiology. 77 (6) (pp 713-724), 2021.
Date of Publication: 16 Feb 2021.
Author
Bertrand P.B.; Overbey J.R.; Zeng X.; Levine R.A.; Ailawadi G.; Acker
M.A.; Smith P.K.; Thourani V.H.; Bagiella E.; Miller M.A.; Gupta L.; Mack
M.J.; Gillinov A.M.; Giustino G.; Moskowitz A.J.; Gelijns A.C.; Bowdish
M.E.; O'Gara P.T.; Gammie J.S.; Hung J.; Taddei-Peters W.C.; Buxton D.;
Caulder R.; Geller N.L.; Gordon D.; Jeffries N.O.; Lee A.; Moy C.S.;
Gombos I.K.; Ralph J.; Weisel R.D.; Gardner T.J.; Rose E.A.; Parides M.K.;
Ascheim D.D.; Moquete E.; Chang H.; Chase M.; Foo J.; Chen Y.; Goldfarb
S.; Kirkwood K.; Dobrev E.; Levitan R.; O'Sullivan K.; Overbey J.; Santos
M.; Williams D.; Weglinski M.; Williams P.; Wood C.; Ye X.; Nielsen S.L.;
Wiggers H.; Malgaard H.; Mack M.; Adame T.; Settele N.; Adams J.; Ryan W.;
Smith R.L.; Grayburn P.; Chen F.Y.; Nohria A.; Cohn L.; Shekar P.; Aranki
S.; Couper G.; Davidson M.; Bolman R.M.; Burgess A.; Conboy D.; Lawrence
R.; Noiseux N.; Stevens L.-M.; Prieto I.; Basile F.; Dionne J.; Fecteau
J.; Blackstone E.H.; Lackner P.; Berroteran L.; Dolney D.; Fleming S.;
Palumbo R.; Whitman C.; Sankovic K.; Sweeney D.K.; Geither C.; Doud K.;
Pattakos G.; Clarke P.A.; Argenziano M.; Williams M.; Goldsmith L.; Smith
C.R.; Naka Y.; Stewart A.; Schwartz A.; Bell D.; Van Patten D.; Sreekanth
S.; Alexander J.H.; Milano C.A.; Glower D.D.; Mathew J.P.; Harrison J.K.;
Welsh S.; Berry M.F.; Parsa C.J.; Tong B.C.; Williams J.B.; Ferguson T.B.;
Kypson A.P.; Rodriguez E.; Harris M.; Akers B.; O'Neal A.; Puskas J.D.;
Guyton R.; Baer J.; Baio K.; Neill A.A.; Voisine P.; Senechal M.; Dagenais
F.; O'Connor K.; Dussault G.; Ballivian T.; Keilani S.; Speir A.M.; Magee
P.; Ad N.; Keyte S.; Dang M.; Slaughter M.; Headlee M.; Moody H.; Solankhi
N.; Birks E.; Groh M.A.; Shell L.E.; Shepard S.A.; Trichon B.H.; Nanney
T.; Hampton L.C.; Mangusan R.; Michler R.E.; D'Alessandro D.A.; DeRose
J.J.; Goldstein D.J.; Bello R.; Jakobleff W.; Garcia M.; Taub C.; Spevak
D.; Swayze R.; Sookraj N.; Perrault L.P.; Basmadjian A.-J.; Bouchard D.;
Carrier M.; Cartier R.; Pellerin M.; Tanguay J.F.; El-Hamamsy I.; Denault
A.; Demers P.; Jonathan Lacharite S.R.; Horvath K.A.; Corcoran P.C.;
Siegenthaler M.P.; Murphy M.; Iraola M.; Greenberg A.; Sai-Sudhakar C.;
Hasan A.; McDavid A.; Kinn B.; Page P.; Sirois C.; Latter D.; Leong-Poi
H.; Bonneau D.; Errett L.; Peterson M.D.; Verma S.; Feder-Elituv R.; Cohen
G.; Joyner C.; Fremes S.E.; Moussa F.; Christakis G.; Karkhanis R.; Yau
T.; Farkouh M.; Woo A.; Cusimano R.J.; David T.; Feindel C.; Garrard L.;
Fredericks S.; Mociornita A.; Mullen J.C.; Choy J.; Meyer S.; Kuurstra E.;
Young C.A.; Beach D.; Villanueva R.; Atluri P.; Woo Y.J.; Mayer M.L.;
Bowdish M.; Starnes V.A.; Shavalle D.; Matthews R.; Javadifar S.; Romar
L.; Kron I.L.; Johnston K.; Dent J.M.; Kern J.; Keim J.; Burks S.; Gahring
K.; Bull D.A.; Desvigne-Nickens P.; Dixon D.O.; Haigney M.; Holubkov R.;
Jacobs A.; Miller F.; Murkin J.M.; Spertus J.; Wechsler A.S.; Sellke F.;
McDonald C.L.; Byington R.; Dickert N.; Ikonomidis J.S.; Williams D.O.;
Yancy C.W.; Fang J.C.; Giannetti N.; Richenbacher W.; Rao V.; Furie K.L.;
Miller R.; Pinney S.; Roberts W.C.; Walsh M.N.; Kilcullen N.; Hung D.;
Keteyian S.J.; Brawner C.A.; Aldred H.; Browndyke J.; Toulgoat-Dubois Y.
Institution
(Bertrand, Zeng, Levine, Hung) Division of Cardiology, Massachusetts
General Hospital, Boston, MA, United States
(Overbey, Bagiella, Gupta, Giustino, Moskowitz, Gelijns) Department of
Population Health Science and Policy, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Ailawadi) Section of Adult Cardiac Surgery, University of Virginia,
Charlottesville, VA, United States
(Acker) Division of Cardiovascular Surgery, Department of Surgery,
University of Pennsylvania School of Medicine, Philadelphia, PA, United
States
(Smith) Department of Surgery, Duke University Medical Center, Durham, NC,
United States
(Thourani) Cardiothoracic Surgery, Piedmont Heart Institute, Atlanta, GA,
United States
(Miller) Division of Cardiovascular Sciences, National Heart, Lung, and
Blood Institute, National Institutes of Health, Bethesda, MD, United
States
(Mack) Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott &
White Health, Plano, TX, United States
(Gillinov) Department of Thoracic & Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Bowdish) Department of Surgery, Keck School of Medicine, University of
Southern California, Los Angeles, CA, United States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
MA, United States
(Gammie) Division of Cardiac Surgery, University of Maryland School of
Medicine, Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
Background: Whether to repair nonsevere tricuspid regurgitation (TR)
during surgery for ischemic mitral valve regurgitation (IMR) remains
uncertain. <br/>Objective(s): The goal of this study was to investigate
the incidence, predictors, and clinical significance of TR progression and
presence of >=moderate TR after IMR surgery. <br/>Method(s): Patients (n =
492) with untreated nonsevere TR within 2 prospectively randomized IMR
trials were included. Key outcomes were TR progression (either progression
by >=2 grades, surgery for TR, or severe TR at 2 years) and presence of
>=moderate TR at 2 years. <br/>Result(s): Patients' mean age was 66 +/- 10
years (67% male), and TR distribution was 60% <=trace, 31% mild, and 9%
moderate. Among 2-year survivors, TR progression occurred in 20 (6%) of
325 patients. Baseline tricuspid annular diameter (TAD) was not predictive
of TR progression. At 2 years, 37 (11%) of 323 patients had >=moderate TR.
Baseline TR grade, indexed TAD, and surgical ablation for atrial
fibrillation were independent predictors of >=moderate TR. However, TAD
alone had poor discrimination (area under the curve, <=0.65). Presence of
>=moderate TR at 2 years was higher in patients with MR recurrence (20%
vs. 9%; p = 0.02) and a permanent pacemaker/defibrillator (19% vs. 9%; p =
0.01). Clinical event rates (composite of >=1 New York Heart Association
functional class increase, heart failure hospitalization, mitral valve
surgery, and stroke) were higher in patients with TR progression (55% vs.
23%; p = 0.003) and >=moderate TR at 2 years (38% vs. 22%; p = 0.04).
<br/>Conclusion(s): After IMR surgery, progression of unrepaired nonsevere
TR is uncommon. Baseline TAD is not predictive of TR progression and is
poorly discriminative of >=moderate TR at 2 years. TR progression and
presence of >=moderate TR are associated with clinical events. (Comparing
the Effectiveness of a Mitral Valve Repair Procedure in Combination With
Coronary Artery Bypass Grafting [CABG] Versus CABG Alone in People With
Moderate Ischemic Mitral Regurgitation, NCT00806988; Comparing the
Effectiveness of Repairing Versus Replacing the Heart's Mitral Valve in
People With Severe Chronic Ischemic Mitral Regurgitation,
NCT00807040)<br/>Copyright &#xa9; 2021 American College of Cardiology
Foundation

<20>
Accession Number
2010544203
Title
Long-term outcomes of postoperative atrial fibrillation following non
cardiac surgery: A systematic review and metanalysis.
Source
European Journal of Internal Medicine. 85 (pp 27-33), 2021. Date of
Publication: March 2021.
Author
Albini A.; Malavasi V.L.; Vitolo M.; Imberti J.F.; Marietta M.; Lip
G.Y.H.; Boriani G.
Institution
(Albini, Malavasi, Vitolo, Imberti, Boriani) Cardiology Division,
Department of Biomedical, Metabolic and Neural Sciences, University of
Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
(Vitolo, Lip) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
(Marietta) Department of Oncology and Haematology, University Hospital,
Modena, Italy
(Lip) Aalborg Thrombosis Research Unit, Department of Clinical Medicine,
Aalborg University, Aalborg, Denmark
Publisher
Elsevier B.V.
Abstract
Background: New-onset atrial fibrillation (AF) in non-cardiac
postoperative setting is common and is associated with a high risk of
in-hospital mortality and morbidity. The long-term risks of stroke,
mortality and AF recurrence rate in patients with postoperative AF (POAF)
are unclear. <br/>Method(s): We performed a systematic literature review
in electronic databases from inception to March 5th, 2020 of studies
reporting the incidence of stroke, mortality and AF recurrence in patients
with POAF. We confined our analysis to studies with a cohort of at least
150 patients with POAF and with a median follow-up of 12 months as a
minimum. Odds Ratios (OR) were pooled using a random-effects model.
<br/>Result(s): Qualitative analysis included 8 studies (7 observational
cohort studies and 1 randomized controlled trial) enrolling 3,718,587
patients. Six studies underwent metanalysis comprising 17,684
postoperative patients with POAF and 2,169,248 postoperative patients
without POAF. The development of POAF conferred a four-fold increased risk
of stroke in the long-term [OR 4.05; 95% confidence interval (CI)
2.91-5.62]. Mortality in the two studies reporting long-term data was
higher in patients with POAF compared to those without POAF (OR 3.59; CI
95% 2.84-4.53). Data about recurrence were too heterogeneous to undergo
metanalysis. <br/>Conclusion(s): POAF is associated with a greater risk of
stroke and mortality over the long-term period. Studies focusing on AF
recurrence are needed to address the perception of POAF as a benign
transient entity. The increased mortality risk following POAF should
encourage systematic detection and prevention of this
arrhythmia.<br/>Copyright &#xa9; 2020

<21>
Accession Number
2011105914
Title
Randomized Evaluation of TriGuard 3 Cerebral Embolic Protection After
Transcatheter Aortic Valve Replacement: REFLECT II.
Source
JACC: Cardiovascular Interventions. 14 (5) (pp 515-527), 2021. Date of
Publication: 08 Mar 2021.
Author
Nazif T.M.; Moses J.; Sharma R.; Dhoble A.; Rovin J.; Brown D.; Horwitz
P.; Makkar R.; Stoler R.; Forrest J.; Messe S.; Dickerman S.; Brennan J.;
Zivadinov R.; Dwyer M.G.; Lansky A.J.
Institution
(Nazif, Moses) Columbia University Medical Center, New York, NY, United
States
(Dhoble) University of Texas Health Science Center, Houston, TX, United
States
(Sharma) Division of Cardiology, Stanford University, Stanford,
California, United States
(Rovin) Morton Plant Hospital, Clearwater, FL, United States
(Brown) Heart Hospital Baylor, Plano, TX, United States
(Horwitz) University of Iowa, Iowa City, IA, United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Stoler) Baylor Heart and Vascular Hospital, Dallas, TX, United States
(Forrest, Dickerman, Brennan, Lansky) Division of Cardiology, Yale School
of Medicine, New Haven, CT, United States
(Messe) Department of Neurology, Hospital of the University of
Pennsylvania, Philadelphia, PA, United States
(Zivadinov, Dwyer) Buffalo Neuroimaging Analysis Center, Department of
Neurology, State University of New York at Buffalo, Buffalo, NY, United
States
(Lansky) Barts Heart Centre, London and Queen Mary University of London,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Objectives: The REFLECT II (Randomized Evaluation of TriGuard 3 Cerebral
Embolic Protection After Transcatheter Aortic Valve Implantation) trial
was designed to investigate the safety and efficacy of the TriGUARD 3
(TG3) cerebral embolic protection in patients undergoing transcatheter
aortic valve replacement. <br/>Background(s): Cerebral embolization occurs
frequently following transcatheter aortic valve replacement and
procedure-related ischemic stroke occurs in 2% to 6% of patients at 30
days. Whether cerebral protection with TriGuard 3 is safe and effective in
reducing procedure-related cerebral injury is not known. <br/>Method(s):
This prospective, multicenter, single-blind, 2:1 randomized (TG3 vs. no
TG3) study was designed to enroll up to 345 patients. The primary 30-day
safety endpoint (Valve Academic Research Consortium-2 defined) was
compared with a performance goal (PG). The primary hierarchical composite
efficacy endpoint (including death or stroke at 30 days, National
Institutes of Health Stroke Scale score worsening in hospital, and
cerebral ischemic lesions on diffusion-weighted magnetic resonance imaging
at 2 to 5 days) was compared using the Finkelstein-Schoenfeld method.
<br/>Result(s): REFLECT II enrolled 220 of the planned 345 patients
(63.8%), including 41 roll-in and 179 randomized patients (121 TG3 and 58
control subjects) at 18 US sites. The sponsor closed the study early after
the U.S. Food and Drug Administration recommended enrollment suspension
for unblinded safety data review. The trial met its primary safety
endpoint compared with the PG (15.9% vs. 34.4% (p < 0.0001). The primary
hierarchal efficacy endpoint at 30 days was not met (mean scores [higher
is better]: -8.58 TG3 vs. 8.08 control; p = 0.857). A post hoc
diffusion-weighted magnetic resonance imaging analysis of per-patient
total lesion volume above incremental thresholds showed numeric reductions
in total lesion volume >500 mm³ (-9.7%) and >1,000
mm³ (-44.5%) in the TG3 group, which were more pronounced among
patients with full TG3 coverage: -51.1% (>500 mm³) and -82.9%
(>1,000 mm³). <br/>Conclusion(s): The REFLECT II trial
demonstrated that the TG3 was safe compared with a historical PG but did
not meet its pre-specified primary superiority efficacy
endpoint.<br/>Copyright &#xa9; 2021 American College of Cardiology
Foundation

<22>
[Use Link to view the full text]
Accession Number
633220892
Title
Effect of evolocumab on atherogenic lipoproteins during the peri- And
early postinfarction period: A placebo-controlled, randomized trial.
Source
Circulation. 142 (4) (pp 419-421), 2020. Date of Publication: 28 Jul 2020.
Author
Leucker T.M.; Blaha M.J.; Jones S.R.; Vavuranakis M.A.; Williams M.S.; Lai
H.; Schindler T.H.; Latina J.; Schulman S.P.; Gerstenblith G.
Institution
(Leucker, Blaha, Jones, Vavuranakis, Williams, Latina, Schulman,
Gerstenblith) Division of Cardiology, Department of Medicine, Baltimore,
MD, United States
(Lai) Department of Radiology, Johns Hopkins University School of
Medicine, Baltimore, MD, United States
(Schindler) Mallinckrodt Institute of Radiology, Division of Nuclear
Medicine, Washington University School of Medicine, Washington University
in St. Louis, MO, United States
Publisher
Lippincott Williams and Wilkins

<23>
Accession Number
2007018116
Title
Complete revascularization by percutaneous coronary intervention for
patients with st-segment-elevation myocardial infarction and multivessel
coronary artery disease: An updated meta-analysis of randomized trials.
Source
Journal of the American Heart Association. 9 (12) (no pagination), 2020.
Article Number: e015263. Date of Publication: 16 Jun 2020.
Author
Ahmad Y.; Howard J.P.; Arnold A.; Prasad M.; Seligman H.; Cook C.M.;
Warisawa T.; Shun-Shun M.; Ali Z.; Parikh M.A.; Al-Lamee R.; Sen S.;
Francis D.; Moses J.W.; Leon M.B.; Stone G.W.; Karmpaliotis D.
Institution
(Ahmad, Prasad, Ali, Parikh, Moses, Leon, Karmpaliotis) Columbia
University Medical Center, New York-Presbyterian Hospital, New York, NY,
United States
(Howard, Arnold, Seligman, Cook, Warisawa, Shun-Shun, Al-Lamee, Sen,
Francis) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Stone) Cardiovascular Research Foundation, New York, NY, 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 Heart Association Inc.
Abstract
BACKGROUND: For patients with ST-segment-elevation myocardial infarction
(STEMI) and multivessel coronary artery disease, the optimal treatment of
the non-infarct-related artery has been controversial. This up-to-date
meta-analysis focusing on individual clinical end points was performed to
further evaluate the benefit of complete revascularization with
percutaneous coronary intervention for patients with STEMI and multivessel
coronary artery disease. METHODS AND RESULTS: We systematically identified
all randomized trials comparing complete revascularization with
percutaneous coronary intervention to culprit-only revascularization for
multivessel disease in STEMI and performed a random-effects meta-analysis.
The primary efficacy end point was cardiovascular death analyzed on an
intention-to-treat basis. Secondary end points included all-cause
mortality, myocardial infarction, and unplanned revascularization. Ten
studies (7542 patients) were included: 3664 patients were randomized to
complete revascularization and 3878 to culprit-only revascularization.
Across all patients, complete revascularization was superior to
culprit-only revascularization for reduction in the risk of cardiovascular
death (relative risk [RR], 0.68; 95% CI, 0.47-0.98; P=0.037;
I²=21.8%) and reduction in the risk of myocardial infarction
(RR, 0.65; 95% CI, 0.54-0.79; P<0.0001; I²=0.0%). Complete
revascularization also significantly reduced the risk of unplanned
revascularization (RR, 0.37; 95% CI, 0.28-0.51; P<0.0001;
I²=64.7%). The difference in all-cause mortality with
percutaneous coronary intervention was not statistically significant (RR,
0.85; 95% CI, 0.69-1.04; P=0.108; I²=0.0%). <br/>CONCLUSION(S):
For patients with STEMI and multivessel disease, complete
revascularization with percutaneous coronary intervention significantly
improves hard clinical outcomes including cardiovascular death and
myocardial infarction. These data have implications for clinical practice
guidelines regarding recommendations for complete revascularization
following STEMI.<br/>Copyright &#xa9; 2020 The Authors.

<24>
Accession Number
2005455596
Title
Update on the role of surgery in the management of advanced epithelial
ovarian cancer.
Source
Clinical Advances in Hematology and Oncology. 18 (11) (pp 723-731), 2020.
Date of Publication: November 2020.
Author
Straubhar A.; Chi D.S.; Roche K.L.
Institution
(Straubhar, Chi, Roche) Gynecology Service, Department of Surgery,
Memorial Sloan Kettering Cancer Center, New York, NY, United States
Publisher
Millennium Medical Publishing, Inc.
Abstract
Surgical cytoreduction and platinum/taxane-based chemotherapy are the
cornerstones of the management of advanced ovarian cancer; however, the
optimal timing and order of these interventions remain a topic of debate.
Interpreting the available data, specifically regarding the role of
neoadjuvant chemotherapy in the primary setting and surgical cytoreduction
in the recurrent setting, requires careful evaluation of surgical quality
and patient selection. One tenet that has persisted throughout the
historical and modern literature is the prognostic effect of the volume of
residual disease after cytoreductive surgery. The goal of debulking
surgery has appropriately evolved to that of the complete gross resection
of all visible disease, and the repertoire of the gynecologic cancer
surgeon has grown to include radical pelvic, upper abdominal, and thoracic
procedures. Novel surgical techniques are under investigation, such as
minimally invasive cytoreductive procedures and the intraoperative
utilization of heated intraperi-toneal chemotherapy. Of equal importance
is a recent refocusing of attention on patient preferences and the
patient's experience during treatment and recovery. In this review
article, we examine the literature supporting the role of surgery in the
management of advanced ovarian cancer.<br/>Copyright &#xa9; 2020,
Millennium Medical Publishing, Inc.. All rights reserved.

<25>
Accession Number
2012305466
Title
Intra-abdominal hypertension and increased acute kidney injury risk: a
systematic review and meta-analysis.
Source
Journal of International Medical Research. 49 (5) (no pagination), 2021.
Date of Publication: 2021.
Author
Sun J.; Sun H.; Sun Z.; Yang X.; Zhou S.; Wei J.
Institution
(Sun, Zhou, Wei) Department of Nephrology, Dezhou People's Hospital,
Dezhou, China
(Sun) Department of Blood Transfusion, Dezhou People's Hospital, Dezhou,
China
(Sun) Department of Vascular Surgery, Dezhou People's Hospital, Dezhou,
China
(Yang) Department of Oncology, Dezhou People's Hospital, Dezhou, China
Publisher
SAGE Publications Ltd
Abstract
Objective: The present meta-analysis aimed to determine the relationship
between intra-abdominal hypertension (IAH) and an increased prevalence of
acute kidney injury (AKI) and identify the associated risk factors in
various patient populations, regardless of whether they were admitted to
an intensive care unit. <br/>Method(s): We used three databases for the
following search terms: "IAH," "abdominal compartment syndrome," "AKI,"
"acute kidney failure," and others. The articles retrieved were compared
to identify appropriate studies published until 7 May 2020. The main
outcome was AKI. <br/>Result(s): Six studies with 344 individuals were
included. The patients were divided into two main groups: the IAH and
non-IAH groups. Compared with patients without IAH, patients with IAH had
a higher risk of AKI (odds ratio = 2.57, 95% confidence interval:
1.55-4.26). In the subgroup and meta-regression analyses, body mass index,
age, the presence or absence of burns, and cardiac surgery did not affect
the risk of AKI. <br/>Conclusion(s): IAH was associated with AKI risk, and
this association was not influenced by age, body mass index, the presence
or absence of burns, or cardiac surgery.<br/>Copyright &#xa9; The
Author(s) 2021.

<26>
Accession Number
2012285227
Title
Clinical anatomy of the lumbar sinuvertebral nerve with regard to
discogenic low back pain and review of literature.
Source
European Spine Journal. (no pagination), 2021. Date of Publication: 2021.
Author
Quinones S.; Konschake M.; Aguilar L.L.; Simon C.; Aragones P.; Hernandez
L.M.; Abramovic A.; Tubbs S.R.; Bouzad J.; Valderrama-Canales F.J.;
Vazquez T.; Sanudo J.
Institution
(Quinones, Aragones, Bouzad, Valderrama-Canales, Vazquez, Sanudo)
Department of Anatomy and Embryology, Faculty of Medicine, Universidad
Complutense de Madrid, Madrid, Spain
(Konschake, Abramovic) Department of Anatomy, Histology and Embryology,
Institute of Clinical and Functional Anatomy, Medical University of
Innsbruck (MUI), Mullerstr. 59, Innsbruck 6020, Austria
(Aguilar) Unidad de Columna. Servicio de COT., Hospital Plato., Barcelona,
Spain
(Simon) Computer Science and Statistics, URJC., Madrid, Spain
(Simon) Instituto Universitario de Evaluacion Sanitaria, UCM, Madrid,
Spain
(Aragones) Department of Orthopedics. Hospital, Universitario Santa
Cristina, Madrid, Spain
(Hernandez) Human Anatomy and Embryology Unit, Department of Surgery,
Medical and Social Sciences, Scholl of Medicine and Health Sciences,
University of Alcala, UAH, Alcala de Henares, Madrid, Spain
(Abramovic) Department of Neurosurgery, Medical University of Innsbruck
(MUI), Innsbruck, Austria
(Tubbs) Department of Neurosurgery, Tulane University School of Medicine,
New Orleans, LA, United States
(Tubbs) Department of Neurology, Tulane University School of Medicine, New
Orleans, LA, United States
(Tubbs) Department of Surgery, Tulane University School of Medicine, New
Orleans, LA, United States
(Tubbs) Department of Structural and Cellular Biology, Tulane University
School of Medicine, New Orleans, LA, United States
(Tubbs) Department of Neurosurgery and Ochsner Neuroscience Institute,
Ochsner Health System, New Orleans, LA, United States
(Tubbs) Department of Anatomical Sciences, School of Medicine, St.
George's University, West Indies, Grenada
(Tubbs) University of Queensland, Brisbane, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Lumbar discogenic diffuse pain is still not understood. Authors
describe the sinuvertebral nerve (SVN) as one possible cause. Body-donor
studies are rare and controversial. Therefore, the aim was to revisit the
origin, course and distribution in a body-donor study. <br/>Method(s): Six
lumbar blocks (3 female, 3 male) aged between 59 and 94 years were
dissected. After removal of the back muscles, lamina, dura mater and cauda
equina, the anterior vertebral venous plexus, spinal artery and SVN were
exposed and evaluated. <br/>Result(s): 43 nerves out of 48 levels could be
evaluated. The origin of the SVN was constituted by two roots: a somatic
and a sympathetic branch arising from the rami communicantes. In 4/48
intervertebral canals studied (8.3%), we found two SVN at the same level.
In 35/48 cases, one SVN was found. In 9/48 cases, no SVN was found. The
SVN had a recurrent course below the inferior vertebral notch; in the
vertebral canal it showed different patterns: ascending branch (31/43,
72.1%), common branch diverging into two branches (10/43, 23.3%), double
ascending branch (1/43, 2.3%) finalizing two levels above and a descending
branch (1/43, 2.3%). In 12/43 cases (27.9%) the SVN had ipsilateral
connections with another SVN. The distribution ended in the middle of the
vertebral body supplying adjacent structures. <br/>Conclusion(s): A
thorough understanding of the anatomy of the SVN might lead to significant
benefits in therapy of discogenic low back pain. We suggest blocking the
SVN at the level of the inferior vertebral notch of two adjacent segments.
Level of evidence I: Diagnostic: individual cross-sectional studies with
consistently applied reference standard and blinding<br/>Copyright &#xa9;
2021, The Author(s).

<27>
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. 31 (7) (pp 3151-3158), 2021. Date of Publication: July
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.

<28>
Accession Number
2010962591
Title
Prospective model for predicting renal recovery in cardiac surgery
patients with acute kidney injury requiring renal replacement therapy.
Source
Nephrology. 26 (7) (pp 586-593), 2021. Date of Publication: July 2021.
Author
Hu P.; Song L.; Liang H.; Chen Y.; Wu Y.; Zhang L.; Li Z.; Fu L.; Tao Y.;
Liu S.; Ye Z.; Fu X.; Liang X.
Institution
(Hu, Liang) The Second School of Clinical Medicine, Southern Medical
University, Guangzhou, China
(Hu, Song, Liang, Chen, Wu, Zhang, Li, Fu, Tao, Liu, Ye, Fu, Liang)
Division of Nephrology, Guangdong Provincial People's Hospital, Guangdong
Academy of Medical Sciences, Guangzhou, China
(Hu) Division of Nephrology, Yixing People's Hospital, Yixing, Jiangsu,
China
Publisher
Blackwell Publishing
Abstract
Aim: To develop a model for predicting renal recovery in cardiac surgery
patients with acute kidney injury (AKI) requiring renal replacement
therapy (RRT). <br/>Method(s): Data from a prospective randomized
controlled trial, conducted in a tertiary hospital to compare the survival
effect of two dosages of hemofiltration for continuous RRT in cardiac
surgery patients between 20 March 2012 and 9 August 2015, were used to
develop the model. The outcome was renal recovery defined as alive and
dialysis-free 90 days after RRT initiation. Multivariate logistic
regression with a stepwise backward selection of variables based on Akaike
Information Criterion was applied to develop the model, which was
internally validated using bootstrapping. Model discrimination,
calibration and clinical value were assessed using the concordance index
(C-Index), calibration plots and decision curve analysis, respectively.
<br/>Result(s): Totally, 211 patients with AKI requiring RRT (66.8% male)
with median age of 57 years were included. The incidence of renal recovery
was 33.2% (n = 70). The model included six variables: body mass index
stratification, baseline estimated glomerular filtration rate,
hypertension, sepsis, mean arterial pressure and mechanical ventilation.
The C-Index for this model was 0.807 (95% CI, 0.744-0.870). After
correction by the bootstrap, the C-Index was 0.780 (95% CI, 0.720-0.845).
The calibration plots indicated good consistency between actual
observations and model prediction of renal recovery. Decision curve
analysis demonstrated the model was clinical usefulness.
<br/>Conclusion(s): We developed and validated a model to predict the
chance of renal recovery in cardiac surgery patients with AKI requiring
RRT.<br/>Copyright &#xa9; 2021 The Authors. Nephrology published by John
Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of
Nephrology.

<29>
Accession Number
2010797074
Title
Intranasal administration of 40 and 80 units of insulin does not cause
hypoglycemia during cardiac surgery: a randomized controlled trial.
Source
Canadian Journal of Anesthesia. 68 (7) (pp 991-999), 2021. Date of
Publication: July 2021.
Author
Roque P.; Nakadate Y.; Sato H.; Sato T.; Wykes L.; Kawakami A.; Yokomichi
H.; Matsukawa T.; Schricker T.
Institution
(Roque, Wykes) School of Human Nutrition, McGill University,
Ste-Anne-de-Bellevue, Montreal, QC, Canada
(Nakadate) Department of Anesthesiology, University of Yamanashi, 1110
Shimokato, Chuo, Yamanashi 409-3898, Japan
(Sato, Sato, Kawakami, Schricker) Department of Anesthesia, McGill
University Health Centre Glen Site, Royal Victoria Hospital, Montreal, QC,
Canada
(Yokomichi, Matsukawa) Department of Health science, University of
Yamanashi, Shimokato, Chuo, Yamanashi, Japan
Publisher
Springer
Abstract
Purpose: Intranasal insulin administration may improve cognitive function
in patients with dementia and may prevent cognitive problems after
surgery. Although the metabolic effects of intranasal insulin in
non-surgical patients have been studied, its influence on glucose
concentration during surgery is unknown. <br/>Method(s): We conducted a
randomized, double-blind, placebo-contolled trial in patients scheduled
for elective cardiac surgery. Patients with type 2 diabetes mellitus
(T2DM) and non-T2DM patients were randomly allocated to one of three
groups (normal saline, 40 international units [IU] of intranasal insulin,
and 80 IU intranasal insulin). Insulin was given after the induction of
general anesthesia. Glucose and plasma insulin concentrations were
measured in ten-minute intervals during the first hour and every 30 min
thereafter. The primary outcome was the change in glucose concentration 30
min after intranasal insulin administration. <br/>Result(s): A total of
115 patients were studied, 43 of whom had T2DM. In non-T2DM patients, 40
IU intranasal insulin did not affect glucose concentration, while 80 IU
intranasal insulin led to a statistically significant but not clinically
important decrease in blood glucose levels (mean difference, 0.4
mMol.L^-1; 95% confidence interval, 0.1 to 0.7). In T2DM
patients, neither 40 IU nor 80 IU of insulin affected glucose
concentration. No hypoglycemia (< 4.0 mMol.L^-1) was observed
after intranasal insulin administration in any patients. In non-T2DM
patients, changes in plasma insulin were similar in the three groups. In
T2DM patients, there was an increase in plasma insulin concentrations ten
minutes after administration of 80 IU of intranasal insulin compared with
saline. <br/>Conclusion(s): In patients with and without T2DM undergoing
elective cardiac surgery, intranasal insulin administration at doses as
high as 80 IU did not cause clinically important hypoglycemia. Trial
registration: www.ClinicalTrials.gov (NCT02729064); registered 5 April
2016.<br/>Copyright &#xa9; 2021, Canadian Anesthesiologists' Society.

<30>
[Use Link to view the full text]
Accession Number
2007540289
Title
Prothrombin complex concentrate vs. fresh frozen plasma in adult patients
undergoing heart surgery - a pilot randomised controlled trial (PROPHESY
trial).
Source
Anaesthesia. 76 (7) (pp 892-901), 2021. Date of Publication: July 2021.
Author
Green L.; Roberts N.; Cooper J.; Agarwal S.; Brunskill S.J.; Chang I.;
Gill R.; Johnston A.; Klein A.A.; Platton S.; Rossi A.; Sepehripour A.;
Stanworth S.; Monk V.; O'Brien B.
Institution
(Green) Blizard Institute, Barts and the London School of Medicine, Queen
Mary University of London, London, United Kingdom
(Green) Department of Haematology, Barts Health NHS Trust, London, United
Kingdom
(Green, Platton) Department of Cardiac Surgery, Barts Health NHS Trust,
London, United Kingdom
(Roberts, Rossi, Sepehripour) William Harvey Research Institute, Barts and
the London School of Medicine, Queen Mary University of London, London,
United Kingdom
(Cooper, Chang, Monk) Department of Anaesthesia, Manchester Royal
Infirmary, Manchester, United Kingdom
(Agarwal) Systematic Review Initiative, NHS Blood and Transplant, Oxford,
United Kingdom
(Brunskill) Department of Anaesthesia, University Hospital Southampton,
Southampton, United Kingdom
(Gill) William Harvey Research Institute, Barts and The London School of
Medicine and Dentistry, Queen Mary University of London, London, United
Kingdom
(Johnston) Department of Anaesthesia, Royal Papworth Hospital, Cambridge,
United Kingdom
(Klein) Department of Haematology, Oxford University Hospitals NHS
Foundation Trust, Oxford, United Kingdom
(Stanworth, O'Brien) Department of Anaesthesia, Barts Health NHS Trust,
London, United Kingdom
(Stanworth) NHS Blood and Transplant, Oxford, United Kingdom
(O'Brien) Outcomes Research Consortium, Cleveland Clinic, OH, United
States
Publisher
Blackwell Publishing Ltd
Abstract
There is equipoise regarding the use of prothrombin complex concentrate
vs. fresh frozen plasma in bleeding patients undergoing cardiac surgery.
We performed a pilot randomised controlled trial to determine the
recruitment rate for a large trial, comparing the impact of prothrombin
complex concentrate vs. fresh frozen plasma on haemostasis (1 h and 24 h
post-intervention), and assessing safety. Adult patients who developed
bleeding within 24 h of cardiac surgery that required coagulation factor
replacement were randomly allocated to receive prothrombin complex
concentrate (15 IU.kg^-1 based on factor IX) or fresh frozen
plasma (15 ml.kg^-1). If bleeding continued after the first
administration of prothrombin complex concentrate or fresh frozen plasma
administration, standard care was administered. From February 2019 to
October 2019, 180 patients were screened, of which 134 (74.4% (95%CI
67-81%)) consented, 59 bled excessively and 50 were randomly allocated; 25
in each arm, recruitment rate 35% (95%CI 27-44%). There were 23 trial
protocol deviations, 137 adverse events (75 prothrombin complex
concentrate vs. 62 fresh frozen plasma) and 18 serious adverse events (5
prothrombin complex concentrate vs. 13 fresh frozen plasma). There was no
increase in thromboembolic events with prothrombin complex concentrate. No
patient withdrew from the study, four were lost to follow-up and two died.
At 1 h after administration of the intervention there was a significant
increase in fibrinogen, Factor V, Factor XII, Factor XIII,
alpha<inf>2</inf>-antiplasmin and antithrombin levels in the fresh frozen
plasma arm, while Factor II and Factor X were significantly higher in the
prothrombin complex concentrate group. At 24 h, there were no significant
differences in clotting factor levels. We conclude that recruitment to a
larger study is feasible. Haemostatic tests have provided useful insight
into the haemostatic changes following prothrombin complex concentrate or
fresh frozen plasma administration. A definitive trial is needed to
ascertain the benefits and safety for each.<br/>Copyright &#xa9; 2020 The
Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of
Association of Anaesthetists

<31>
Accession Number
2005851133
Title
Conventional versus minimally invasive extracorporeal circulation in
patients undergoing cardiac surgery: protocol for a randomised controlled
trial (COMICS).
Source
Perfusion (United Kingdom). 36 (4) (pp 388-394), 2021. Date of
Publication: May 2021.
Author
Angelini G.D.; Reeves B.C.; Evans J.; Culliford L.A.; Collett L.; Rogers
C.A.; Stokes E.; Anastasiadis K.; Antonitsis P.; Carrel T.; Keller D.;
Liebold A.; Ashkanani F.; El-Essawi A.; Breitenbach I.; Lloyd C.; Bennett
M.; Cale A.; Mclean L.; Gunaydin S.; Gunertem E.; Oueida F.; Yassin I.;
Serrick C.; Rao V.; Moscarelli M.; Condello I.; Punjabi P.; Rajakaruna C.;
Bone D.; Lansdown W.; Moorjani N.; Dennis S.
Publisher
SAGE Publications Ltd
Abstract
Introduction: Despite low mortality, cardiac surgery patients may
experience serious life-threatening post-operative complications, often
due to extracorporeal circulation and reperfusion. Miniaturised
cardiopulmonary bypass (minimally invasive extracorporeal circulation) has
been developed aiming to reduce the risk of post-operative complications
arising with conventional extracorporeal circulation. <br/>Method(s): The
COMICS trial is a multi-centre, international, two-group parallel
randomised controlled trial testing whether type II, III or IV minimally
invasive extracorporeal circulation is effective and cost-effective
compared to conventional extracorporeal circulation in patients undergoing
elective or urgent coronary artery bypass grafting, aortic valve
replacement or coronary artery bypass grafting + aortic valve replacement.
Randomisation (1:1 ratio) is concealed and stratified by centre and
surgical procedure. The primary outcome is a composite of 12 serious
complications, objectively defined or adjudicated, 30 days after surgery.
Secondary outcomes (at 30 days) include other serious adverse events
(primary safety outcome), use of blood products, length of intensive care
and hospital stay and generic health status (also at 90 days). Status of
the trial: Two centres started recruiting on 08 May 2018; 10 are currently
recruiting and 603 patients have been randomised (11 May 2020). The
recruitment rate from 01 April 2019 to 31 March 2020 was 40-50
patients/month. About 80% have had coronary artery bypass grafting only.
Adherence to allocation is good. <br/>Conclusion(s): The trial is feasible
but criteria for progressing to a full trial were not met on time. The
Trial Steering and Data Monitoring Committees have recommended that the
trial should currently continue.<br/>Copyright &#xa9; The Author(s) 2020.

<32>
Accession Number
2005851101
Title
Preoperative C-reactive protein as a predictor of postoperative acute
kidney injury in patients undergoing coronary artery bypass grafting.
Source
Perfusion (United Kingdom). 36 (4) (pp 330-337), 2021. Date of
Publication: May 2021.
Author
Mohamed W.; Asimakopoulos G.
Institution
(Mohamed) Department of Cardiac Surgery, Glenfield Hospital, Leicester,
United Kingdom
(Asimakopoulos) Department of Cardiac Surgery, Royal Brompton Hospital,
London, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
C-reactive protein is a well-known marker of inflammation and may be
preoperatively elevated in the absence of infection in adult cardiac
surgery patients, indicating a baseline inflammatory process. We conducted
a literature search to assess the available evidence on whether there is
an association between preoperative C-reactive protein and acute kidney
injury after coronary artery bypass grafting. Included only were
observational studies which investigated this association. We excluded
abstracts, case reports, animal studies and articles in languages other
than English. Altogether, 199 papers were retrieved from the search
strategy reported, of which 6 studies were included in the final review.
The study types, publication details, patient groups and key results are
tabulated. A qualitative assessment of these papers was conducted. We
conclude that there is some evidence to support the association between
high preoperative C-reactive protein level and postoperative acute kidney
injury and complications after coronary artery bypass grafting. Owing to
variability in acute kidney injury definitions and C-reactive protein
levels for different cohorts in the observational studies reviewed, it is
unclear from current evidence what serum C-reactive protein cut-off level
is significantly associated with postoperative acute kidney injury.
Further evidence is needed to investigate whether raised preoperative
C-reactive protein in the absence of an infective cause could have a role
in risk prediction models for cardiac surgery-associated acute kidney
injury.<br/>Copyright &#xa9; The Author(s) 2020.

<33>
Accession Number
2005737801
Title
Myocardial protection in cardiac surgery: how limited are the options? A
comprehensive literature review.
Source
Perfusion (United Kingdom). 36 (4) (pp 338-351), 2021. Date of
Publication: May 2021.
Author
Whittaker A.; Aboughdir M.; Mahbub S.; Ahmed A.; Harky A.
Institution
(Whittaker, Aboughdir, Mahbub) Department of Medicine, St George's,
University of London, London, United Kingdom
(Aboughdir, Ahmed) Department of Medicine, Imperial College London,
London, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky) School of Medicine, University of Liverpool, Liverpool, United
Kingdom
Publisher
SAGE Publications Ltd
Abstract
For patients undergoing cardiopulmonary bypass, myocardial protection is a
key for successful recovery and improved outcomes following cardiac
surgery that requires cardiac arrest. Different solutions, components and
modes of delivery have evolved over the last few decades to optimise
myocardial protection. These include cold and warm and blood and
crystalloid solution through antegrade, retrograde or combined
cardioplegia delivery approach. However, each method has its own
advantages and disadvantages, posing a challenge to establish a
gold-standard cardioplegic solution with an optimised mode of delivery for
enhanced myocardial protection during cardiac surgery. The aim of this
review is to provide a brief history of the development of cardioplegia,
explain the electrophysiological concepts behind myocardial protection in
cardioplegia, analyse the current literature and summarise existing
evidence that warrants the use of varying cardioplegic techniques. We
provide a comprehensive and comparative overview of the effectiveness of
each technique in achieving optimal cardioprotection and propose novel
techniques for optimising myocardial protection in the
future.<br/>Copyright &#xa9; The Author(s) 2020.

<34>
Accession Number
633395132
Title
COVID-19 and congenital heart disease: An insight of pathophysiology and
associated risks.
Source
Cardiology in the Young. 31 (2) (pp 233-240), 2021. Date of Publication:
February 2021.
Author
Shammus R.; Mahmood S.; Kutty R.; Lotto A.; Guerrero R.; Harky A.;
Dhannapuneni R.
Institution
(Shammus, Mahmood) Medical School, St George's, University of London,
Cranmer Terrace, United Kingdom
(Kutty) Medical School, Imperial College London, South Kensington, United
Kingdom
(Lotto, Guerrero, Harky, Dhannapuneni) Department of Cardiac Surgery,
Alder Hey Children's Hospital, Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Life Science,
University of Liverpool, Liverpool, United Kingdom
(Lotto, Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool, United Kingdom
(Lotto) Faculty of Health, Liverpool John Moores University, Liverpool,
United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
Publisher
Cambridge University Press
Abstract
Abstract Objective: We aimed to examine the literature to determine if
both paediatric and adult patients diagnosed with congenital heart disease
(CHD) are at a higher risk of poor outcomes if they have the coronavirus
disease 2019 (COVID-19), compared to those without CHD. <br/>Method(s): A
systematic review was executed using the Preferred Reporting Items for
Systematic Reviews and Meta-analysis (PRISMA) guidelines. To identify
articles related to COVID-19 and CHD, an extensive literature search was
performed on EMBASE, Medline, Scopus, and Global Health databases using
keywords and MeSH terms. <br/>Result(s): A total of 12 articles met the
inclusion criteria and were included for analysis in this systematic
review. Two themes were identified for data extraction: evidence
supporting higher risks in CHD patients and evidence against higher risks
in CHD patients. After combining the data, there were 99 patients with
CHDs out of which 12 required admissions to ICU. <br/>Conclusion(s): This
systematic review suggests that CHD may increase the risk of poor outcomes
for those with COVID-19, but also highlights the necessity for more
research with larger sample sizes in order to make a more justified
conclusion, as the majority of papers that were analysed were case series
and case reports. Future research should aim to quantify the risks if
possible whilst accounting for various confounding factors such as age and
treatment history.<br/>Copyright &#xa9; 2021 Cambridge University Press.
All rights reserved.

<35>
Accession Number
635200170
Title
Veno-arterial extracorporeal membrane oxygenation for adult fulminant
myocarditis: A systematic review and meta-analysis.
Source
Perfusion. Conference: EuroELSO 2021. Virtual. 36 (1 SUPPL) (pp 7), 2021.
Date of Publication: May 2021.
Author
Quah K.; Ling R.R.; Poon W.H.; Tan C.S.; Dey S.; Sim Z.K.; MacLaren G.;
Ramanathan K.
Institution
(Quah, Ling, Poon, Dey, Sim, MacLaren, Ramanathan) Yong Loo Lin School of
Medicine, Singapore, Singapore
(Tan) Saw Swee Hock School of Public Health, National University of
Singapore, Singapore, Singapore
(MacLaren, Ramanathan) Cardiothoracic Intensive Care Unit, National
University Heart Centre, National University of Singapore, Singapore,
Singapore
Publisher
SAGE Publications Inc.
Abstract
Objective: Fulminant myocarditis (FM) is a rare, severe form of
myocarditis associated with significant mortality where veno-arterial
extracorporeal membrane oxygenation (VA-ECMO) is indicated. We performed a
systematic review to elucidate the efficacy and long term outcomes of
VA-ECMO for FM in adults. <br/>Method(s): A systematic search for studies
on ECMO for FM was conducted on Pubmed, Embase, Cochrane and Scopus
databases from origin until December 2020. Studies with >=10 adult
patients were included. Random effects meta-analysis (DerSimoniand and
Laird) were conducted. Study quality and certainty of evidence were
evaluated using the appropriate Joanna Briggs Institute (JBI) checklist
and the Grading of Recommendations, Assessment, Development, and
Evaluations (GRADE) approach respectively. <br/>Result(s): Eleven studies
(549 patients) were included in the meta-analysis. JBI appraisal found
that studies were of good quality, with all studies scoring at least 7/10.
The pooled survival of adult FM patients requiring ECMO was 63.5%
(95%-CI:58.4%-68.5%, high certainty); age was inversely associated with
survival (OR=0.988, 95%- CI:0.980-0.995, p=0.001). Patients had a pooled
mean duration of ECMO of 164.7 hours (95%-CI: 105.2-224.2, low certainty),
ICU length of stay (LOS) of 21 days (95%-CI: 14-28, moderate certainty)
and hospital LOS of 50 days (95%-CI: 14-84, low certainty). 364
complications were reported: most commonly renal (77), cardiovascular (76)
and haemorrhagic (59) in nature. 60.6% of patients were successfully
weaned from ECMO. Over 3-month to 2-year follow-up periods, survival
ranged from 77.3% to 91.6%. Among survivors, 6 out of 67 (9%) patients (2
studies) bridged to long-term ventricular assist devices (VAD) while 14
out of 169 (8%) patients (5 studies) required heart transplants.
<br/>Conclusion(s): Adult FM patients supported on VA-ECMO have favourable
outcomes in terms of both in-hospital mortality and long-term survival.

<36>
Accession Number
2011842517
Title
Risk of postoperative neurological exacerbation in patients with infective
endocarditis and intracranial haemorrhage.
Source
European Journal of Cardio-thoracic Surgery. 59 (2) (pp 426-433), 2021.
Date of Publication: 01 Feb 2021.
Author
Diab M.; Musleh R.; Lehmann T.; Sponholz C.; Pletz M.W.; Franz M.; Schulze
P.C.; Witte O.W.; Kirchhof K.; Doenst T.; Gunther A.
Institution
(Diab, Musleh, Doenst) Department of Cardiothoracic Surgery, Jena
University Hospital, Jena, Germany
(Musleh, Witte, Gunther) Department of Neurology, Jena University
Hospital, Jena, Germany
(Lehmann) Institute of Medical Statistics, Computer and Data Sciences,
Jena University Hospital, Jena, Germany
(Sponholz) Department of Anesthesiology and Intensive Care Medicine, Jena
University Hospital, Jena, Germany
(Pletz) Institute for Infectious Diseases and Infection Control, Jena
University Hospital, Jena, Germany
(Franz, Schulze) Division of Cardiology, Department of Internal Medicine
I, Jena University Hospital, Jena, Germany
(Kirchhof) Division of Neuroradiology, Department of Radiology, Jena
University Hospital, Jena, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: Cardiac surgery in patients with infective endocarditis (IE)
and preoperative intracranial haemorrhage (pre-ICH) is a highly debatable
issue, and guidelines are still not well defined. The goal of this study
was to investigate the effect of cardiac surgery and its timing on the
clinical outcomes of patients with IE and pre-ICH. <br/>Method(s): We did
a single-centre retrospective analysis of data from patients with
preoperative brain imaging who had surgery for left-sided IE between
January 2007 and May 2018. <br/>Result(s): Among the 363 patients included
in the study, 34 had pre-ICH. Hospital mortality was similar between the
patients with and without pre-ICH (29% vs 27%, respectively; P = 0.84).
Unadjusted, postoperative neurological deterioration appeared higher in
patients with pre-ICH (24% vs 17%; P = 0.35). In multivariable analysis,
pre-ICH did not qualify as an independent predictor for either
postoperative neurological deterioration [odds ratio 1.10, 95% confidence
interval (CI) 0.44-2.73; P = 0.84] or hospital mortality (odds ratio 1.02,
95% CI 0.43-2.40; P = 0.96). Postoperative partial thromboplastin time was
significantly elevated in 4 patients with relevant post-ICH compared with
those patients without relevant post-ICH (65.5 vs 37.6, respectively; P =
0.004). <br/>Conclusion(s): Pre-ICH was not an independent predictor for
postoperative neurological deterioration or hospital mortality in patients
with IE. Postoperative coagulation management seems to be crucial in
patients with IE with ICH. Although this is to date the largest
monocentric study addressing surgical decision and timing, the number of
patients with pre-ICH was low. Therefore, these conclusions should be
regarded with caution; randomized clinical trials are needed.
<br/>Copyright &#xa9; 2020 The Author(s).

<37>
Accession Number
2011842506
Title
A randomized controlled trial comparing controlled reoxygenation and
standard cardiopulmonary bypass in paediatric cardiac surgery.
Source
European Journal of Cardio-thoracic Surgery. 59 (2) (pp 349-358), 2021.
Date of Publication: 01 Feb 2021.
Author
Caputo M.; Scott L.J.; Deave T.; Dabner L.; Parry A.; Angelini G.D.;
Sheehan K.; Stoica S.; Ellis L.; Harris R.; Rogers C.A.
Institution
(Caputo, Parry, Sheehan, Stoica) Department of Cardiac Surgery, Bristol
Royal Hospital for Children, University Hospitals Bristol NHS Foundation
Trust, Bristol, United Kingdom
(Caputo, Angelini) Department of Cardiac Surgery, Bristol Heart Institute,
University of Bristol, Bristol, United Kingdom
(Scott, Dabner, Ellis, Harris, Rogers) Department of Cardiac Surgery,
Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of
Bristol, Bristol, United Kingdom
(Deave) Department of Cardiac Surgery, Centre for Health and Clinical
Research, University of the West of England, Bristol, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: Controlled reoxygenation on starting cardiopulmonary bypass
(CPB) rather than hyperoxic CPB may confer clinical advantages during
surgery for congenital cyanotic heart disease. <br/>Method(s): A
single-centre, randomized controlled trial was carried out to compare the
effectiveness of controlled reoxygenation (normoxia) versus hyperoxic CPB
in children with congenital cyanotic heart disease undergoing open-heart
surgery (Oxic-2). The co-primary clinical outcomes were duration of
inotropic support, intubation time and postoperative intensive care unit
(ICU) and hospital stay. Analysis of the primary outcomes included data
from a previous trial (Oxic-1) conducted to the same protocol.
<br/>Result(s): Ninety participants were recruited to Oxic-2 and 79 were
recruited to the previous Oxic-1 trial. There were no significant
differences between the groups for any of the co-primary outcomes:
inotrope duration geometric mean ratio (normoxia/hyperoxic) 0.97, 95%
confidence interval (CI) (0.69-1.37), P-value = 0.87; intubation time
hazard ratio (HR) 1.03, 95% CI (0.74-1.42), P-value = 0.87; postoperative
ICU stay HR 1.14 95% CI (0.77-1.67), P-value = 0.52, hospital stay HR
0.90, 95% CI (0.65-1.25), P-value = 0.53. Lower oxygen levels were
successfully achieved during the operative period in the normoxic group.
Serum creatinine levels were lower in the normoxic group at day 2, but not
on days 1, 3-5. Childhood developmental outcomes were similar. In the year
following surgery, 85 serious adverse events were reported (51 normoxic
group and 34 hyperoxic group). <br/>Conclusion(s): Controlled
reoxygenation (normoxic) CPB is safe but with no evidence of a clinical
advantage over hyperoxic CPB. <br/>Copyright &#xa9; 2020 The Author(s).

<38>
Accession Number
2012090479
Title
Influenza Vaccination Blunts the Inflammatory Response in Patients
Undergoing Cardiopulmonary Bypass.
Source
Annals of Thoracic Surgery. 111 (6) (pp 1923-1930), 2021. Date of
Publication: June 2021.
Author
Atoui R.; Ebrahim F.; Saroka K.; Mireau J.; McElhaney J.E.; Hare G.M.T.
Institution
(Atoui) Division of Cardiac Surgery, Health Sciences North, Northern
Ontario School of Medicine, Sudbury, ON, Canada
(Ebrahim) Department of Anesthesia, Hamilton Health Sciences, McMaster
University, Hamilton, ON, Canada
(Ebrahim, Hare) Department of Anesthesia, St Michael's Hospital,
University of Toronto, Toronto, ON, Canada
(Saroka) Laurentian University, Sudbury, ON, Canada
(Mireau) Department of Anesthesia, Health Sciences North, Northern Ontario
School of Medicine, Sudbury, ON, Canada
(McElhaney) Health Sciences North Research Institute, Sudbury, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery bypass grafting with cardiopulmonary bypass
(CPB) induces an inflammatory reaction that is associated with
postoperative complications. Influenza vaccination has been shown to
decrease cardiovascular morbidity in patients with cardiovascular disease,
possibly via its anti-inflammatory properties. We hypothesize that
influenza vaccination would attenuate the inflammatory reaction after CPB.
<br/>Method(s): Thirty patients undergoing coronary artery bypass grafting
were blindly randomized to receive the influenza vaccine (group I, n = 15)
or a placebo (group II, n = 15) preoperatively. Serum samples of
proinflammatory mediators (interleukin-6, interleukin-8, tumor necrosis
factor, C-reactive protein) as well as the anti-inflammatory
interleukin-10 were collected at different time points perioperatively.
Assessment of myocardial dysfunction was investigated by measuring
hemodynamic data, echocardiographic data, and troponin levels. Other
clinical outcomes were collected prospectively. <br/>Result(s):
Proinflammatory cytokine levels were significantly reduced in the
treatment group vs the placebo group (interleukin-6 [157.4 pg/dL vs 256
pg/dL, P =.043], interleukin-8 [65.03 pg/dL vs 118.56 pg/dL, P =.025], and
tumor necrosis factor [12.05 pg/dL vs 20.8 pg/dL, P =.003]). These
differences were observed at the end of CPB and persisted for 2 days
postoperatively. Interestingly, the level of the anti-inflammatory marker
interleukin-10 was significantly higher in group I (83.3 pg/dL vs 15.15
pg/dL, P =.008). Evidence of improved myocardial protection was observed
in group I, as reflected by troponin measurements postoperatively (6020.2
pg/dL vs 12,098.01 pg/dL, P =.052). <br/>Conclusion(s): Influenza
vaccination attenuates the inflammatory response to CPB as reflected by a
reduction in the level of troponin and proinflammatory mediators and an
increase in the anti-inflammatory cytokine interleukin-10.<br/>Copyright
&#xa9; 2021 The Society of Thoracic Surgeons

<39>
Accession Number
2011876646
Title
Association between admission body mass index and outcomes in critically
ill children: A systematic review and meta-analysis.
Source
Clinical Nutrition. 40 (5) (pp 2772-2783), 2021. Date of Publication: May
2021.
Author
Toh S.; Ong C.; Sultana R.; Kirk A.H.P.; Koh J.C.; Lee J.H.
Institution
(Toh, Sultana, Lee) Duke-NUS Medical School, 8 College Rd 169857,
Singapore
(Ong) Department of Nutrition and Dietetics, KK Women's and Children's
Hospital, 100 Bukit Timah Rd 229899, Singapore
(Kirk) Children's Intensive Care Unit, Division of Nursing, KK Women's and
Children's Hospital, 100 Bukit Timah Rd 229899, Singapore
(Koh) Department of Paediatric Medicine, KK Women's and Children's
Hospital, 100 Bukit Timah Rd 229899, Singapore
(Lee) Children's Intensive Care Unit, Department of Pediatric
Subspecialties, KK Women's and Children's Hospital, 100 Bukit Timah Rd
229899, Singapore
Publisher
Churchill Livingstone
Abstract
Background & aims: The association between nutritional status at pediatric
intensive care unit (PICU) admission with clinical outcomes remains
unclear. We conducted this systematic review to summarize the overall
impact of PICU admission body mass index (BMI) on clinical outcomes.
<br/>Method(s): We searched the following medical databases from inception
through May 2020: PubMed, Excerpta Medica database (Embase), Cumulative
Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library,
and Web of Science. We included studies on patients <=18 years old
admitted to a PICU that investigated the effect of BMI on mortality, PICU
or hospital length of stay (LOS), or duration of mechanical ventilation
(MV). Classification of underweight, overweight, and obese were based on
each study's criteria. <br/>Result(s): There was a total of 21,558
patients from 20 included studies. 12,936 (60.0%), 2965 (13.8%), 2182
(10.1%), 3348 (15.5%) were normal weight, underweight, overweight, and
obese patients, respectively. Relative to normal weight patients,
underweight (OR 1.32, 95% CI 0.89-1.98; p = 0.171) and overweight/obese
patients (OR 1.10, 95% CI 0.86-1.42; p = 0.446) did not have an increase
risk in mortality. There was also no difference in duration of MV, PICU
and hospital LOS between all three weight categories. Included studies
were heterogeneous and lacked standardized nutritional categorization.
Sensitivity analysis including only studies that used BMI z-scores as
nutritional classification (n = 5) revealed that underweight patients had
higher odds of mortality compared to patients with normal weight (OR 1.61,
95% CI 1.35-1.92; p < 0.001); studies that used percentiles as
classification did not reveal any differences in mortality. Sensitivity
analysis including only studies containing mixed PICU cohorts (i.e.,
excluding specialized cohorts e.g., congenital heart surgeries, burns)
revealed higher mortality odds in underweight patients (OR 1.53, 95% CI
1.25-1.87; p < 0.001) and overweight/obese patients (OR 1.51, 95% CI
1.14-2.01; p = 0.004) relative to normal weight patients.
<br/>Conclusion(s): Our systematic review did not reveal any association
between PICU admission BMI status and outcomes in critically ill children.
Further investigation with standardized nutrition status classification on
admission, stratified by patient subgroups, is needed to clarify the
association between nutritional status and clinical outcomes of PICU
patients.<br/>Copyright &#xa9; 2021 Elsevier Ltd and European Society for
Clinical Nutrition and Metabolism

<40>
Accession Number
2012213301
Title
Addition of low-dose sufentanil to ropivacaine for reducing shivering and
visceral traction pain during cesarean section.
Source
Journal of International Medical Research. 49 (5) (no pagination), 2021.
Date of Publication: 2021.
Author
Chen X.-R.; Gao T.; Zhang Y.; Peng M.-Q.
Institution
(Chen, Peng) Department of Anesthesia, Yongchuan Hospital of Chongqing
Medical University, Chongqing, China
(Gao, Zhang) Department of Anesthesia, University-Town Hospital of
Chongqing Medical University, Chongqing, China
Publisher
SAGE Publications Ltd
Abstract
Objective: To investigate the efficacy of low-dose sufentanil for
preventing shivering and visceral traction pain during cesarean section
under spinal anesthesia. <br/>Method(s): This was a prospective,
randomized, controlled study. A total of 112 full-term parturients who
underwent elective caesarean delivery were randomly divided into two
groups. Group R received 0.75% isobaric ropivacaine intrathecally and
group RS received 0.75% isobaric ropivacaine plus 5 microg sufentanil
intrathecally. <br/>Result(s): There were no significant differences in
the maximum sensory block time, motor block time, duration of the surgery,
and heart rate, mean arterial pressure, and blood oxygen saturation before
and 1, 5, and 10 minutes after spinal anesthesia, and at the end of the
surgery between the two groups. Shivering was significantly more common in
group R (n = 30) than in group RS (n = 8). The incidence of visceral
traction pain in group R (46.43%) was significantly higher than that in
group RS (14.29%). There was no significant difference in the newborns'
Apgar scores between the groups. <br/>Conclusion(s): Adding low-dose
sufentanil to ropivacaine can significantly reduce the incidence of
shivering and visceral traction pain after spinal
anesthesia.<br/>Copyright &#xa9; The Author(s) 2021.

<41>
Accession Number
2011298106
Title
A randomized controlled trial of ultrasound-assisted technique versus
conventional puncture method for saphenous venous cannulations in children
with congenital heart disease.
Source
BMC Anesthesiology. 21 (1) (no pagination), 2021. Article Number: 131.
Date of Publication: December 2021.
Author
Bian Y.; Bai J.; Zheng J.; Huang Y.
Institution
(Bian, Huang, Bai, Huang) Department of Anesthesiology, Shanghai
Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao
Tong University, 1678 Dongfang Road, Pudong, Shanghai 200127, China
(Zheng) Department of Anesthesiology and Pediatric Clinical Pharmacology
Laboratory, Shanghai Children's Medical Center Affiliated to School of
Medicine, Shanghai Jiao Tong University, Shanghai, China
Publisher
BioMed Central Ltd
Abstract
Background: The study investigated the success rate of the great saphenous
venous catheter placement performed by ultrasound-assisted technique
compared with the conventional puncture method in infants and toddlers
with congenital heart disease and aimed to assess the efficiency and
feasibility of this method within the context of pediatric peripheral
venous access. <br/>Method(s): We selected infants and toddlers who
underwent congenital cardiac surgery in our medical center from June 1,
2020, to September 7, 2020, by convenience sampling. Children were
stratified by the presence of the manifesting cardiac types (cyanotic or
acyanotic heart disease). They were assigned to the conventional puncture
method group or the ultrasound-assisted group through randomly blocked
randomization. The primary outcome was the success rate of the first
attempt. The second outcomes included the time to cannulation at the first
attempt, the redirections of the first attempt, overall puncture time, and
overall redirections of efforts. Besides, a binary logistic regression
model was implemented to identify the possible variables related to the
success rate of the first attempt. <br/>Result(s): A total of 144 children
in our medical center were recruited in the study. The success rate of the
first attempt in the ultrasound-assisted group was higher than that of the
conventional puncture method group in the stratification of cyanotic
children (66.7% vs. 33.3%, P = 0.035). Among children of acyanotic kind,
the difference in the success rate of the first attempt between the two
groups was not significant (57.6% vs. 42.4%, P = 0.194). Overall puncture
time (45.5 s vs. 94 s, P = 0.00) and the time to cannulation at the first
attempt (41.0 s vs. 60 s, P = 0.00) in the ultrasound-assisted group was
less than the conventional puncture method group. The ultrasound-assisted
group also required fewer redirections of the first attempt (three
attempts vs. seven attempts, P = 0.002) and fewer total redirections of
efforts (two attempts vs. three attempts, P = 0.027) than the conventional
puncture method group. The result of binary Logistic regression showed
that the success rate of the first attempt was related to age (OR:1.141;
95% CI = 1.010-1.290, P = 0.034), the redirections of the first attempt
(OR:0.698; 95% CI = 0.528-0.923, P = 0.012) and the saphenous venous width
(OR:1.181; 95% CI = 1.023-1.364, P = 0.023). <br/>Conclusion(s): The
ultrasound-assisted technique improves the saphenous venous cannulation
sufficiently in children with difficult peripheral veins. The younger age
is associated with a higher likelihood of peripheral venous difficulty.
The ultrasound-assisted methods can effectively screen peripheral veins,
e.g., selecting thicker diameter peripheral veins, making puncture less
uncomfortable, and improving success rates. This method can be used as one
of the effective and practical ways of peripheral venipuncture in
children, especially in difficult situations. It should be widely applied
as one of the alternative ultrasound techniques in the operating room.
Trial registration: ChiCTR.org.cn (ChiCTR-2,000,033,368). Prospectively
registered May 29, 2020.<br/>Copyright &#xa9; 2021, The Author(s).

<42>
Accession Number
2012851178
Title
Long-term mortality after percutaneous coronary intervention with
drug-eluting stents compared with coronary artery bypass grafting for
multivessel and left main disease: A meta-analysis.
Source
Kardiologia Polska. 78 (78) (pp 759-761), 2020. Date of Publication: 12
May 2020.
Author
Kowalewski M.; Gozdek M.; Zielinski K.; Raffa G.M.; Suwalski P.; Lorusso
R.
Institution
(Kowalewski, Suwalski) Department of Cardiac Surgery, Central Clinical
Hospital of the Ministry of the Interior and Administration, Centre of
Postgraduate Medical Education, Warsaw, Poland
(Kowalewski) Thoracic Research Centre, Collegium Medicum, Nicolaus
Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
(Kowalewski, Lorusso) Cardiothoracic Surgery Department, Heart and
Vascular Centre, Maastricht University Medical Centre, Maastricht,
Netherlands
(Gozdek) Department of Cardiology and Internal Medicine, Collegium
Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Zielinski) Medical University of Warsaw, Warsaw, Poland
(Raffa) Department for the Treatment and Study of Cardiothoracic Diseases
and Cardiothoracic Transplantation, IRCCS-ISMETT (Istituto Mediterraneo
per I Trapianti e Terapie ad alta specializzazione), Palermo, Italy
Publisher
Medycyna Praktyczna Cholerzyn

<43>
Accession Number
2012318527
Title
Near-infrared spectroscopy device selection affects intervention
management for cerebral desaturation during cardiopulmonary bypass
surgery.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2021. Date
of Publication: 2021.
Author
Kobayashi K.; Kitamura T.; Kohira S.; Inoue N.; Fukunishi T.; Miyaji K.
Institution
(Kobayashi, Kitamura, Inoue, Fukunishi, Miyaji) Department of
Cardiovascular Surgery, Kitasato University School of Medicine, 1-15-1
Kitasato, Minami, Sagamihara, Kanagawa 252-0375, Japan
(Kohira) Department of Medical Engineering, Kitasato University Hospital,
Sagamihara, Japan
Publisher
Springer Japan
Abstract
Objective: Currently, several near-infrared spectroscopy oximetry devices
are used for detecting cerebral ischemia during cardiopulmonary bypass
(CPB) surgery. We investigated whether two different models of
near-infrared spectroscopy oximetry devices affect the assessment of
cerebral ischemia and its management during CPB. <br/>Method(s): From
January 2017 to August 2017, 70 adult cardiovascular surgery cases were
randomly assigned to 1 of 2 different near-infrared spectroscopy oximetry
devices. The devices were INVOS 5100C (Medtronic, Minneapolis, MN, USA)
(group I; n = 35) and FORE-SIGHT ELITE (CAS Medical Systems, Branford, CT,
USA) (group F; n = 35). <br/>Result(s): There were no significant
differences in patient characteristics. The rSO<inf>2</inf> values were
significantly higher for patients in group F than for patients in group I.
Scalp-Cortex distance showed negative correlations with the mean
rSO<inf>2</inf> values in group I (P = 0.01). Interventions for low
rSO<inf>2</inf> during CPB for groups I and F were increase perfusion flow
(13:5; P = 0.03), blood transfusion (7:1; P = 0.02), and both (6:1; P =
0.04), respectively. The Scalp-Cortex distance in group I was
significantly longer in patients who required intervention than in
patients who did not (17.1 +/- 2.5 vs 15.1 +/- 1.6 mm; P = 0.007).
<br/>Conclusion(s): It is inappropriate to use the same intervention
criteria for different near-infrared spectroscopy oximetry devices.
Moreover, brain atrophy influence rSO<inf>2</inf> values depending on
device selection. It is important to note that inappropriate device
selection may misguide perfusionists into performing unnecessary or
excessive intervention during CPB.<br/>Copyright &#xa9; 2021, The Japanese
Association for Thoracic Surgery.

<44>
Accession Number
2012315448
Title
Comparison of ultrasound-guided femoral artery cannulation versus
palpation technique in neonates undergoing cardiac surgery.
Source
Journal of Vascular Access. (no pagination), 2021. Date of Publication:
2021.
Author
Salik F.; Bicak M.
Institution
(Salik, Bicak) Department of Anesthesiology and Reanimation, Diyarbakir
Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Publisher
SAGE Publications Ltd
Abstract
Objectives: Palpation technique for femoral artery cannulation can be very
difficult, especially in neonates. In this study, we evaluated whether
ultrasound-guided cannulation of the femoral artery is superior to
palpation technique in neonates undergoing cardiac surgery.
<br/>Method(s): Forty neonates undergoing cardiac surgery were
prospectively randomized into two groups (Ultrasound group and Palpation
group). Access time, number of attempts, number of successful cannulations
on first attempt, success rate, number of cannulas used, inadvertent
access, and complications were compared between the two groups. Cost
analyses of the cannulation were performed in two groups. <br/>Result(s):
In the ultrasound group, access time for femoral artery cannulation was
shorter (6.4 +/- 3.0 and 10.2 +/- 4.4, p = 0.003) and the number of
attempts (1.4 +/- 0.6 and 2.3 +/- 0.8, p < 0.001) was lower compared to
the palpation group. The number of successful cannulations on
first-attempt (15 (75%) and 5 (25%), p = 0.002) and the success rate (95%
(19) and 60% (12), p = 0.008) were higher in the ultrasound group. The
number of cannulas used in the ultrasound group was less than the
palpation group (p = 0.001). The cost of intervention was higher in the
palpation group compared to the ultrasound group (p = 0.048).
<br/>Conclusion(s): The ultrasound-guided cannulation of the femoral
artery in neonates is superior to the palpation technique based on the
increased of the number of successful first-attempt cannulation and
success rate, and the reducing of the access time, number of attempts,
number of cannulas used, and cost of cannulation.<br/>Copyright &#xa9; The
Author(s) 2021.

<45>
Accession Number
2012315363
Title
In search of optimal cardioplegia for minimally invasive valve surgery.
Source
Perfusion (United Kingdom). (no pagination), 2021. Date of Publication:
2021.
Author
Russell S.; Butt S.; Vohra H.A.
Institution
(Russell, Vohra) Department of Cardiac Surgery/Cardiovascular Sciences,
Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
(Butt) Department of Perfusion Sciences, St George's Hospital, London,
United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Cardioplegic solutions are used in cardiac surgery to achieve controlled
cardiac arrest during operations, making surgery safer. Cardioplegia can
either be blood or crystalloid based, with perceived pros and cons of each
type. Whilst it is known that cardioplegia causes cardiac arrest, there is
debate over which cardioplegic solution provides the highest degree of
myocardial protection during arrest. Myocardial damage is measured
post-operatively by biomarkers such as serum TnT, TnI or CK-MB. It is
known that the outcomes of minimally invasive valve surgery are comparable
to full sternotomy valve operations. Despite there being a wide diversity
in use of different cardioplegic solutions across the world, this
comprehensive literature review found no superiority of one cardioplegic
solution over the other for myocardial protection during minimally
invasive valve procedures.<br/>Copyright &#xa9; The Author(s) 2021.

<46>
Accession Number
2012315216
Title
Impact of chronic kidney disease on hemoglobin among patients with
peripheral artery disease treated with P2Y<inf>12</inf> inhibitors:
Insights from the EUCLID trial.
Source
Vascular Medicine (United Kingdom). (no pagination), 2021. Date of
Publication: 2021.
Author
Hsia J.; Kavanagh S.T.; Hopley C.W.; Baumgartner I.; Berger J.S.; Fowkes
G.R.; Jones W.S.; Mahaffey K.W.; Norgren L.; Patel M.R.; Rockhold F.;
Blomster J.; Katona B.G.; Hiatt W.R.; Bonaca M.P.
Institution
(Hsia, Kavanagh, Hiatt, Bonaca) CPC Clinical Research, Aurora, CO, United
States
(Hsia, Hiatt, Bonaca) Department of Medicine, University of Colorado
School of Medicine, Aurora, CO, United States
(Hopley) Department of Medicine, Geisel School of Medicine at Dartmouth,
Dartmouth Hitchcock Medical Center, Hanover, NH, United States
(Baumgartner) Department of Angiology, Inselspital, Bern, Switzerland
(Berger) Departments of Medicine and Surgery, New York University School
of Medicine, New York, NY, United States
(Fowkes) Centre for Population Health Sciences, University of Edinburgh,
Edinburgh, United Kingdom
(Jones, Patel, Rockhold) Duke Clinical Research Institute, Duke
University, Durham, NC, United States
(Mahaffey) Stanford University School of Medicine, Palo Alto, CA, United
States
(Norgren) Faculty of Medicine and Health, Orebro University Hospital,
Orebro, Sweden
(Blomster, Katona) AstraZeneca LP, Gothenburg, Sweden
(Blomster, Katona) GaithersburgMDUnited States
Publisher
SAGE Publications Ltd
Abstract
Patients with chronic kidney disease may develop new or more severe anemia
when treated with antiplatelet agents due to blood loss in conjunction
with impaired erythropoiesis. Because anemia independently predicts limb
amputation and mortality among patients with peripheral artery disease
(PAD), we evaluated the relationship between estimated glomerular
filtration rate (eGFR) and hemoglobin (Hb) levels in the EUCLID trial in
which patients with symptomatic PAD were randomized to ticagrelor or
clopidogrel. At baseline, 9025, 1870, and 1000 patients had eGFR 60,
45-59, and < 45 mL/min/1.73 m², respectively. The mean fall in
Hb during the trial was 0.46 +/- 1.68 g/dL and did not differ by baseline
eGFR category, although Hb fall 10% was more frequent among patients with
lower eGFR (p for trend < 0.0001). On-study treatment with iron,
erythropoiesis-stimulating agents, and/or red blood cell transfusion was
reported for 479 (5.3%), 165 (8.8%), and 129 (12.9%) patients in the three
eGFR categories, respectively (p for trend < 0.0001). After adjustment for
baseline and post-randomization effects, those not receiving anemia
treatment had a smaller reduction in Hb from baseline than those receiving
anemia treatment (p < 0.0001). Other determinants of Hb reduction included
absence of on-study myocardial infarction, coronary or peripheral
revascularization, residence outside North America, male sex, and baseline
eGFR. We conclude that among patients with PAD treated with
P2Y<inf>12</inf> inhibitors, lower baseline eGFR was associated with a
greater reduction in Hb. ClinicalTrials.gov Identifier:
NCT01732822.<br/>Copyright &#xa9; The Author(s) 2021.

<47>
Accession Number
2012314866
Title
Percutaneous coronary intervention versus coronary artery bypass grafting
in patients with coronary heart disease and type 2 diabetes mellitus:
Cumulative meta-analysis.
Source
Clinical Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Xie Q.; Huang J.; Zhu K.; Chen Q.
Institution
(Xie, Zhu, Chen) Department of Cardiology, Zhuzhou Central Hospital,
Zhuzhou, China
(Huang) Department of Cardiology, Liling Traditional Chinese Medicine
Hospital, Zhuzhou, China
Publisher
John Wiley and Sons Inc
Abstract
Previous meta-analyses showed that coronary artery bypass grafting (CABG)
has lower all-cause mortality than percutaneous coronary intervention
(PCI) for the management of coronary heart disease (CHD), but the
long-term outcomes were not analyzed thoroughly in patients with type 2
diabetes mellitus (T2DM). To perform a meta-analysis of randomized
controlled trials (RCTs) to explore the long-term effectiveness between
CABG and PCI in patients with T2DM and study the temporal trends using a
cumulative meta-analysis. PubMed, Embase, Cochrane library, and Clinical
Trials Registry for eligible RCTs published up to September 2020. The
outcomes were all-cause death, cardiac death, myocardial infarction,
repeat revascularization, and stroke. Nine RCTs and 4566 patients were
included. CABG resulted in better outcomes than PCI in terms of all-cause
death (RR = 1.41, 95%CI: 1.22-1.63, p < 0.001), cardiac death (RR = 1.56,
95%CI: 1.25-1.95, p < 0.001), and repeat revascularization (RR = 2.68,
95%CI: 1.86-3.85, p < 0.001), but with difference regarding the occurrence
of myocardial infarction (RR = 1.20, 95%CI: 0.78-1.85, p = 0.414), while
PCI was associated with better outcomes in terms of stroke occurrence (RR
= 0.51, 95%CI: 0.34-0.77, p = 0.001). The cumulative meta-analysis for
all-cause death showed that the differences between CABG and PCI started
to be significant at 3 years of follow-up, while the difference became
significant at 5 years for cardiac death. In patients with CHD and T2DM,
CABG results in better outcomes than PCI in terms of all-cause death,
cardiac mortality, and repeat revascularization, while PCI had better
outcomes in terms of stroke. The differences are mainly observed over the
long-term follow-up.<br/>Copyright &#xa9; 2021 The Authors. Clinical
Cardiology published by Wiley Periodicals LLC.

<48>
Accession Number
2011864941
Title
Distal versus proximal radial artery access for cardiac catheterization
and intervention: Design and rationale of the DIPRA trial.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Al-Azizi K.M.; Idris A.; Christensen J.; Hamandi M.; Hale S.;
Martits-Chalangari K.; Van Zyl J.S.; Ravindranathan P.; Banwait J.K.;
Mckracken J.; Smith A.; Apakama G.; Swim J.; Dolton P.; Chionh K.; Dimaio
M.; Thomas S.; Szerlip M.; Sayfo S.; Dib C.; Mack M.; Potluri S.
Institution
(Al-Azizi) Interventional Cardiology and Structural Heart Disease, Texas
A&M University College of Medicine, The Heart Hospital - Plano, Baylor
Scott & White Health, 1100 Allied Dr, Plano, TX 75093, United States
(Idris, Christensen) The Heart Hospital Plano - Baylor Scott & White,
United States
(Hamandi, Hale, Martits-Chalangari, Van Zyl, Ravindranathan, Banwait,
Mckracken, Smith, Apakama, Swim, Dolton, Chionh, Dimaio, Mack) Baylor
Research Institute, The Heart Hospital Plano - Baylor Scott & White,
United States
(Thomas, Szerlip, Sayfo, Potluri) Interventional Cardiology and Structural
Heart Disease, The Heart Hospital - Plano, Baylor Scott & White Health,
United States
(Dib) Interventional Cardiology, The Heart Hospital - Plano, Baylor Scott
& White Health, United States
Publisher
Elsevier Inc.
Abstract
Background: Radial artery (RA) catheterization is the access of choice
over femoral artery access for most interventional vascular procedures
given its safety and faster patient recovery. There has been growing
interest in distal radial artery (dRA) access as an alternative to the
conventional proximal radial artery (pRA) access. Preserving the RA is
important which serves as a potential conduit for future coronary artery
bypass surgery, dialysis conduit or preserve the artery for future
cardiovascular procedures. The dRA runs in close proximity to the radial
nerve, which raises the concern of potential detrimental effects on hand
function. Study design: The Distal versus Proximal Radial Artery Access
for cardiac catheterization and intervention (DIPRA) trial is a
prospective, randomized, parallel-controlled, open-label, single center
study evaluating the outcomes of hand function and effectiveness of dRA
compared to pRA access in patients undergoing cardiac catheterization. The
eligible subjects will be randomized to dRA and pRA access in a (1:1)
fashion. The primary end point is an evaluation of hand function at one
and twelve months follow-up. Secondary end points include rates of access
site hematoma, access site bleeding, other vascular access complications,
arterial access success rate, and RA occlusion at one and twelve months
follow up. <br/>Conclusion(s): Effects of dRA on hand function remains
unknown and it's use questionable in the presence of a widely accepted
pRA. DIPRA trial is designed to determine the safety and effectiveness of
dRA for diagnostic and interventional cardiovascular procedures compared
to the standard of care pRA.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<49>
Accession Number
2011294536
Title
Ascorbic acid in the acute care setting.
Source
Journal of Parenteral and Enteral Nutrition. (no pagination), 2021. Date
of Publication: 2021.
Author
Kressin C.; Pandya K.; Woodward B.M.; Donaldson C.; Flannery A.H.
Institution
(Kressin, Pandya, Woodward, Donaldson, Flannery) Acute Care Pharmacy
Services, University of Kentucky HealthCare, Lexington, KY, United States
(Flannery) Department of Pharmacy Practice and Science, University of
Kentucky College of Pharmacy, Lexington, KY, United States
Publisher
John Wiley and Sons Inc
Abstract
Ascorbic acid (AA) is an essential nutrient with many physiologic roles
not limited to the prevention of scurvy. Beyond its role as a supplement,
it has gained popularity in the acute care setting as an inexpensive
medication for a variety of conditions. Because of limitations with
absorption of oral formulations and reduced serum concentrations observed
in acute illness, intravenous (IV) administration, and higher doses, may
be needed to produce the desired serum concentrations for a particular
indication. Following a PubMed search, we reviewed published studies
relevant to AA in the acute care setting and summarized the results in a
narrative review. In the acute care setting, AA may be used for improved
wound healing, improved organ function in sepsis and acute respiratory
distress syndrome, faster resolution of vasoplegic shock after cardiac
surgery, reduction of resuscitative fluids in severe burn injury, and as
an adjunctive analgesic, among other uses. Each indication differs in its
level of evidence supporting exogenous administration of AA, but overall,
AA was not commonly associated with adverse effects in the identified
studies. Use of AA remains an active area of clinical investigation for
various indications in the acute care patient population.<br/>Copyright
&#xa9; 2021 American Society for Parenteral and Enteral Nutrition

<50>
Accession Number
634857154
Title
Major cardiovascular events at 5 years in surgical versus percutaneous
revascularization for left main stem disease: an updated meta-analysis.
Source
Interactive cardiovascular and thoracic surgery. 32 (4) (pp 530-536),
2021. Date of Publication: 19 Apr 2021.
Author
Urso S.; Sadaba R.; Nogales E.; Gonzalez J.M.; Tena M.A.; Paredes F.;
Gonzalez-Barbeito M.; Portela F.
Institution
(Urso, Tena, Paredes, Gonzalez-Barbeito, Portela) Cardiac Surgery
Department, Hospital Universitario Dr. Negrin, Las Palmas de Gran Canaria,
Spain
(Sadaba) Cardiac Surgery Department, Complejo Hospitalario de Navarra,
Pamplona, Spain
(Nogales) Cardiology Department, Hospital Universitario Insular, Las
Palmas de Gran Canaria, Spain
(Gonzalez) Research Unit, Hospital Universitario Dr. Negrin, Las Palmas de
Gran Canaria, Spain
Publisher
NLM (Medline)
Abstract
The aim of the present study was to analyse the incidence of major adverse
cardiovascular events in patients undergoing either coronary artery bypass
grafting (CABG) or percutaneous coronary intervention with drug-eluting
stents for left main stem disease. Five manuscripts publishing 5-year
results of 4 trials (SYNTAX, PRECOMBAT, NOBLE and EXCEL) were included.
Overall meta-analysis with inclusion of the 5-year results from the EXCEL
trial using the protocol definition for myocardial infarction showed that
CABG is associated with a significant reduction in the risk of major
adverse cardiovascular events (MACE) (risk ratio = 0.74; 95% confidence
interval=0.68-0.80). When the universal definition was used to define
myocardial infarction in the EXCEL trial, the analysis demonstrated a
larger benefit of coronary surgery in terms of reduction in the risk of
MACE (risk ratio=0.70; 95% confidence interval=0.63-0.76). Non-significant
differences were detected in terms of risk of overall mortality, cardiac
mortality or stroke. In conclusion, this meta-analysis shows that CABG
significantly reduces the risk of MACE in patients with left main stem
disease. The inclusion of the 5-year results of the EXCEL trial using
third universal definition amplifies the benefit of CABG over percutaneous
coronary intervention.<br/>Copyright &#xa9; The Author(s) 2021. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<51>
Accession Number
635203837
Title
Normal saline and lung recruitment with paediatric endotracheal suction
(NARES): A pilot, factorial, randomised controlled trial.
Source
Australian critical care : official journal of the Confederation of
Australian Critical Care Nurses. (no pagination), 2021. Date of
Publication: 26 May 2021.
Author
Schults J.A.; Cooke M.; Long D.; Schibler A.; Ware R.S.; Charles K.; Irwin
A.; Mitchell M.L.
Institution
(Schults, Long) Paediatric Intensive Care Unit, Queensland Children's
Hospital, South Brisbane, Queensland, Australia; Menzies Health Institute
Queensland, School of Nursing and Midwifery, Griffith University,
Queensland, Australia; Paediatric Critical Care Research Group, Centre for
Children's Health Research, The University of Queensland, South Brisbane,
Queensland, Australia
(Cooke, Charles) Menzies Health Institute Queensland, School of Nursing
and Midwifery, Griffith University, QLD, Australia
(Schibler) Paediatric Intensive Care Unit, Queensland Children's Hospital,
South Brisbane, Queensland, Australia; Paediatric Critical Care Research
Group, Centre for Children's Health Research, The University of
Queensland, South Brisbane, Queensland, Australia
(Ware) Menzies Health Institute Queensland, Griffith University, Nathan,
QLD, Australia
(Irwin) UQ Centre for Clinical Research, The University of Queensland,
Australia; Infection Management and Prevention Service, Queensland
Children's Hospital, South Brisbane, Queensland, Australia
(Mitchell) Menzies Health Institute Queensland, School of Nursing and
Midwifery, Griffith University, Queensland, Australia; Intensive Care
Unit, Princess Alexandra Hospital, Queensland, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND/OBJECTIVE: Endotracheal suction is one of the most common and
harmful procuedres performed on mechanically ventilated children. The aim
of the study was to establish the feasibility of a randomised controlled
trial (RCT) examining the effectiveness of normal saline instillation
(NSI) and a positive end-expiratory pressure recruitment manoeuvre (RM)
with endotracheal suction in the paediatric intensive care unit.
<br/>METHOD(S): Pilot 2 x 2 factorial RCT. The study was conducted at a
36-bed tertiary paediatric intensive care unit in Australia. Fifty-eight
children aged less than 16 years undergoing tracheal intubation and
invasive mechanical ventilation. (i) NSI or no NSI and (ii) RM or no RM
with endotracheal suction . The primary outcome was feasibility; secondary
outcomes were ventilator-associated pneumonia (VAP), change in
end-expiratory lung volume assessed by electrical impedance tomography,
dynamic compliance, and oxygen saturation-to-fraction of inspired oxygen
(SpO2/FiO2) ratio. RESULTS/FINDINGS: Recruitment, retention, and missing
data feasibility criteria were achieved. Eligibility and protocol
adherence criteria were not achieved, with 818 patients eligible and 58
enrolled; cardiac surgery was the primary reason for exclusion.
Approximately 30% of patients had at least one episode of nonadherence.
Children who received NSI had a reduced incidence of VAP; however, this
did not reach statistical significance (incidence rate ratio = 0.12, 95%
confidence interval = 0.01-1.10; p = 0.06). NSI was associated with a
significantly reduced SpO2/FiO2 ratio up to 10 min after suction. RMs were
not associated with a reduced VAP incidence (incidence rate ratio = 0.31,
95% confidence interval = 0.05-1.88), but did significantly improve
end-expiratory lung volume at 2 and 5 min after suction, dynamic
compliance, and SpO2/FiO2 ratio. <br/>CONCLUSION(S): RMs provided
short-term improvements in end-expiratory lung volume and oxygenation. NSI
with suction led to a reduced incidence of VAP; however, a definitive RCT
is needed to test statistical differences. A RCT of study interventions is
worthwhile and may be feasible with protocol modifications including the
widening of participant eligibility.<br/>Copyright &#xa9; 2021 Australian
College of Critical Care Nurses Ltd. All rights reserved.

<52>
Accession Number
635197372
Title
Bridging preference-based instrumental variable studies and
cluster-randomized encouragement experiments: study design, noncompliance,
and average cluster effect ratio.
Source
Biometrics. (no pagination), 2021. Date of Publication: 29 May 2021.
Author
Zhang B.; Heng S.; MacKay E.J.; Ye T.
Institution
(Zhang, Ye) Department of Statistics, Wharton School, University of
Pennsylvania, Philadelphia, PA, United States
(Heng) Graduate Group in Applied Mathematics and Computational Science,
School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA,
United States
(MacKay) Department of Anesthesiology and Critical Care, Perelman School
of Medicine, University of Pennsylvania, Philadelphia, PA, United States
Publisher
NLM (Medline)
Abstract
Instrumental variable methods are widely used in medical research to draw
causal conclusions when the treatment and outcome are confounded by
unmeasured confounding variables. One important feature of such studies is
that the instrumental variable is often applied at the cluster level,
e.g., hospitals' or physicians' preference for a certain treatment where
each hospital or physician naturally defines a cluster. This paper
proposes to embed such observational instrumental variable data into a
cluster-randomized encouragement experiment using nonbipartite matching.
Potential outcomes and causal assumptions underpinning the design are
formalized and examined. Testing procedures for two commonly-used
estimands, Fisher's sharp null hypothesis and the pooled effect ratio, are
extended to the current setting. We then introduce a novel
cluster-heterogeneous proportional treatment effect model and the relevant
estimand: the average cluster effect ratio. This new estimand is
advantageous over the structural parameter in a constant proportional
treatment effect model in that it allows treatment heterogeneity, and is
advantageous over the pooled effect ratio estimand in that it does not
suffer from Simpson's paradox. We develop an asymptotically valid
randomization-based testing procedure for this new estimand based on
solving a mixed integer quadratically-constrained optimization problem.
The proposed design and inferential methods are applied to a study of the
effect of using transesophageal echocardiography during CABG surgery on
patients' 30-day mortality rate. R package ivdesign implements the
proposed method. This article is protected by copyright. All rights
reserved.

<53>
Accession Number
635195304
Title
Institutional case-volume-incorporated mortality risk prediction model
after cardiac surgery.
Source
Asian journal of surgery. (no pagination), 2021. Date of Publication: 25
May 2021.
Author
Lee S.; Jang E.J.; Jo J.; Park D.; Ryu H.G.
Institution
(Lee, Park) Department of Anesthesiology and Pain Medicine, Seoul National
University College of Medicine, Seoul National University Hospital, 101
Daehak-Ro Jongno-Gu, Seoul 03080, South Korea
(Jang) Department of Information Statistics, ong National University,
Gyeongsangbuk-do 36729, South Korea
(Jo) Department of Statistics, Kyungpook National University, 80
Daehak-Ro, Daegu 41566, South Korea
(Ryu) Department of Anesthesiology and Pain Medicine, Seoul National
University College of Medicine, Seoul National University Hospital, 101
Daehak-Ro Jongno-Gu, Seoul 03080, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: Most risk prediction models predicting short-term mortality
after cardiac surgery incorporate patient characteristics, laboratory
data, and type of surgery, but do not account for surgical experience.
Considering the impact of case volume on patient outcome after high-risk
procedures, we attempted to develop a risk prediction model for mortality
after cardiac surgery that incorporates institutional case volume.
<br/>METHOD(S): Adult patients who underwent cardiac surgery from 2009 to
2016 were identified. Patients who underwent cardiac surgery (n = 57,804)
were randomly divided into the derivation cohort (n = 28,902) or the
validation cohorts (n = 28,902). A risk prediction model for in-hospital
mortality and 1-year mortality was developed from the derivation cohort
and the performance of the model was evaluated in the validation cohort.
<br/>RESULT(S): The model demonstrated fair discrimination (c-statistics,
0.76 for in-hospital mortality in both cohorts; 0.74 for 1-year mortality
in both cohorts) and acceptable calibration. Hospitals were classified
based on case volume into 50 or less, 50-100, 100-200, or more than 200
average cardiac surgery cases per year and case volume was a significant
variable in the prediction model. <br/>CONCLUSION(S): A new risk
prediction model that incorporates institutional case volume and
accurately predicts in-hospital and 1-year mortality after cardiac surgery
was developed and validated.<br/>Copyright &#xa9; 2021. Published by
Elsevier Taiwan LLC.

<54>
Accession Number
634856353
Title
Mitral and tricuspid annuloplasty ring dehiscence: a systematic review
with pooled analysis.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2021.
Date of Publication: 21 Apr 2021.
Author
Arjomandi Rad A.; Naruka V.; Vardanyan R.; Viviano A.; Salmasi M.Y.;
Magouliotis D.; Kendall S.; Casula R.; Athanasiou T.
Institution
(Arjomandi Rad, Vardanyan) Department of Medicine, Faculty of Medicine,
Imperial College London, London, United Kingdom
(Naruka, Viviano, Casula) Department of Cardiothoracic Surgery, Imperial
College NHS Trust, Hammersmith Hospital, London, United Kingdom
(Salmasi, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
(Magouliotis) Department of Surgery, Faculty of Medicine, School of Health
Sciences, University of Thessaly, Greece
(Kendall) Department of Cardiothoracic Surgery, James Cook University
Hospital, Middlesborough, United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Mitral and tricuspid ring annuloplasty dehiscence with
consequent recurrent valve regurgitation is a rare but challenging
procedural failure. The incidence and predisposing risk factors for
annuloplasty ring dehiscence include technical and pathological ones.
<br/>METHOD(S): A systematic database search with pooled analysis was
conducted of original articles that only included dehiscence rate of
mitral and tricuspid ring in EMBASE, MEDLINE, Cochrane database and Google
Scholar, from inception to November 2020. The outcomes included were
dehiscence rate in mitral and tricuspid, type of ring implanted,
dehiscence rate by pathology and by ring size and shape. <br/>RESULT(S):
Our search yielded 821 relevant studies. Thirty-three studies met the
inclusion criteria with a total of 10 340 patients (6543 mitral, 1414
tricuspid) of which 87 (mitral) and 30 (tricuspid) had dehiscence.
Overall, dehiscence rate was 1.43%, diagnosed at a median of
4.5+/-1.0months postoperatively. A significant difference in mitral
dehiscence rate was found by ring type (semi-rigid 1.86%, rigid 2.32%;
flexible 0.43%; P<0.001). There was no significant difference in rate of
dehiscence by ring size (P=0.067) and shape in mitral (P=0.281) but there
was higher dehiscence rate in ischaemic compared to non-ischaemic mitral
regurgitation (3.91% vs 1.63%; P=0.022). Among tricuspid studies, 9 of 10
studies did not report any dehiscence. <br/>CONCLUSION(S): Although rigid,
semi-rigid and flexible annuloplasty rings provide acceptable valve repair
outcomes, mitral annuloplasty ring dehiscence is clinically more common
among rigid rings. Understanding the multifactorial nature of ring
dehiscence will help in identifying the patients at high risk and improve
their clinical outcomes.<br/>Copyright &#xa9; The Author(s) 2021.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<55>
Accession Number
635205998
Title
Return to work after coronary artery bypass grafting and aortic valve
replacement surgery: A scoping review.
Source
Scandinavian journal of caring sciences. (no pagination), 2021. Date of
Publication: 31 May 2021.
Author
Mortensen M.; Sandvik R.K.N.M.; Svendsen OS.; Haaverstad R.; Moi A.L.
Institution
(Mortensen, Sandvik, Moi) Department of Health and Caring Sciences,
Western Norway University of Applied Sciences, Bergen, Norway
(Svendsen) Department of Anaesthesia and Intensive Care, Haukeland
University Hospital, Bergen, Norway
(Haaverstad) Section of Cardiothoracic Surgery, Department of Heart
Disease, Haukeland University Hospital, Bergen, Norway
(Haaverstad) Department of Clinical Science, Faculty of Medicine,
University of Bergen, Bergen, Norway
(Moi) Department of Plastic, Hand and Reconstructive Surgery, National
Burn Centre, Haukeland University Hospital, Bergen, Norway
Publisher
NLM (Medline)
Abstract
BACKGROUND: Coronary artery bypass grafting surgery and aortic valve
replacement surgery are essential treatment options for people suffering
from angina pectoris or aortic valve disease. Surgery aims to prolong life
expectancy, improve quality of life, and facilitate participation in
society for the individuals afflicted. The aim of this review was to
explore the literature on work participation in patients following
coronary artery bypass grafting or aortic valve replacement surgery, and
to identify demographic and clinical characteristics associated with
returning to work. <br/>METHOD(S): A scoping review framework of Arksey
and O'Malley was chosen. Four electronic databases: Medline, CINAHL,
Embase, and Google Scholar were searched for studies in English, Swedish,
Danish or Norwegian between January 1988 and January 2020. A blinded
selection of articles was performed. The data were then charted and
summarized by descriptive numerical analyses and categorized into themes.
<br/>RESULT(S): Forty-five out of 432 articles were included in the final
full-text analysis. Absence from work following coronary artery bypass
graft grafting or aortic valve replacement surgery lasted on average 30
weeks, whereas 34% of the patients never returned to work. Being female,
suffering from pre-existing depression, having limited secondary
education, or low income were associated with decreased return to work
rates. Previous employment was a decisive factor for returning to work
after surgery. Data on return to work after aortic valve replacement were
scarce. <br/>CONCLUSION(S): A significant number of patients never return
to work following coronary artery bypass grafting or aortic valve surgery,
and the time interval until work return is longer than expected. Failure
to resume work represents a threat to the patients' finances and quality
of life. Nurses are in a unique position to assess work-related issues and
have an active part in the multi-disciplinary facilitation of tailored
occupational counselling after cardiac surgery.<br/>Copyright &#xa9; The
Authors. Scandinavian Journal of Caring Sciences published by John Wiley &
Sons Ltd on behalf of Nordic College of Caring Science.

<56>
Accession Number
629252250
Title
Surgical aortic valve replacement and patient-prosthesis mismatch: A
meta-analysis of 108 182 patients.
Source
European Journal of Cardio-thoracic Surgery. 56 (1) (pp 44-54), 2019. Date
of Publication: 01 Jul 2019.
Author
Sa M.P.B.D.O.; De Carvalho M.M.B.; Sobral Filho D.C.; Cavalcanti L.R.P.;
Rayol S.D.C.; Diniz R.G.S.; Menezes A.M.; Clavel M.-A.; Pibarot P.; Lima
R.C.
Institution
(Sa, Cavalcanti, Rayol, Diniz, Menezes, Lima) Division of Cardiovascular
Surgery of Pronto Socorro Cardiologico de Pernambuco - PROCAPE, Av. Eng.
Domingos Ferreira no 4172, Recife, Pernambuco 51021-040, Brazil
(Sa, De Carvalho, Sobral Filho, Cavalcanti, Rayol, Diniz, Menezes, Lima)
University of Pernambuco - UPE, Recife, Brazil
(Sa, De Carvalho, Sobral Filho, Lima) Nucleus of Postgraduate and Research
in Health Sciences, Faculty of Medical Sciences and Biological Sciences
Institute - FCM/ICB, Recife, Brazil
(Clavel, Pibarot) Institut Universitaire de Cardiologie et de Pneumologie
de Quebec, Universite Laval, Canada
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: This study sought to evaluate the impact of patient-prosthesis
mismatch (PPM) on the risk of perioperative, early-, mid- and long-term
mortality rates after surgical aortic valve replacement. <br/>Method(s):
Databases were searched for studies published until March 2018. The main
outcomes of interest were perioperative mortality, 1-year mortality,
5-year mortality and 10-year mortality. <br/>Result(s): The search yielded
3761 studies for inclusion. Of these, 70 articles were analysed, and their
data were extracted. The total number of patients included was 108 182 who
underwent surgical aortic valve replacement. The incidence of PPM after
surgical aortic valve replacement was 53.7% (58 116 with PPM and 50 066
without PPM). Perioperative mortality [odds ratio (OR) 1.491, 95%
confidence interval (CI) 1.302-1.707; P < 0.001], 1-year mortality (OR
1.465, 95% CI 1.277-1.681; P < 0.001), 5-year mortality (OR 1.358, 95% CI
1.218-1.515; P < 0.001) and 10-year mortality (OR 1.534, 95% CI
1.290-1.825; P < 0.001) were increased in patients with PPM. Both severe
PPM and moderate PPM were associated with increased risk of perioperative
mortality, 1-year mortality, 5-year mortality and 10-year mortality when
analysed together and separately, although we observed a higher risk in
the group with severe PPM. <br/>Conclusion(s): Moderate/severe PPM
increases perioperative, early-, mid- and long-term mortality rates
proportionally to its severity. The findings of this study support the
implementation of surgical strategies to prevent PPM in order to decrease
mortality rates.<br/>Copyright &#xa9; 2019 The Author(s). Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<57>
[Use Link to view the full text]
Accession Number
2010671703
Title
Esmolol in Cardiac Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (4) (pp 1106-1114),
2021. Date of Publication: April 2021.
Author
Zangrillo A.; Bignami E.; Noe B.; Nardelli P.; Licheri M.; Gerli C.;
Crivellari M.; Oriani A.; Di Prima A.L.; Fominskiy E.; Di Tomasso N.;
Lembo R.; Landoni G.; Crescenzi G.; Monaco F.
Institution
(Zangrillo, Noe, Nardelli, Licheri, Gerli, Crivellari, Oriani, Di Prima,
Fominskiy, Di Tomasso, Lembo, Landoni, Monaco) Department of Anesthesia
and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Zangrillo, Landoni) Vita-Salute San Raffaele University, Milan, Italy
(Bignami) Anesthesiology, Critical Care and Pain Medicine Division,
Department of Medicine and Surgery, University of Parma, Parma, Italy
(Crescenzi) Department of Anaesthesia and Intensive Care Medicine,
Humanitas Clinical and Research Center - IRCCS, Milan, Rozzano, Italy
Publisher
W.B. Saunders
Abstract
Objective: To assess whether the administration of the ultra-short-acting
beta-blocker esmolol in cardiac surgery could have a cardioprotective
effect that translates into improved postoperative outcomes.
<br/>Design(s): Single-center, double-blinded, parallel-group randomized
controlled trial. <br/>Setting(s): A tertiary care referral center.
<br/>Participant(s): Patients undergoing elective cardiac surgery with
preoperative evidence of left ventricular end-diastolic diameter >60 mm
and/or left ventricular ejection fraction <50%. <br/>Intervention(s):
Patients were assigned randomly to receive either esmolol (1 mg/kg as a
bolus before aortic cross-clamping and 2 mg/kg mixed in the cardioplegia
solution) or placebo in a 1:1 allocation ratio. <br/>Measurements and Main
Results: The primary composite endpoint of prolonged intensive care unit
stay and/or in-hospital mortality occurred in 36/98 patients (36%) in the
placebo group versus 27/102 patients (27%) in the esmolol group (p =
0.13). In the esmolol group, a reduction in the maximum inotropic score
during the first 24 postoperative hours was observed (10 [interquartile
range 5-15] v 7 [interquartile range 5-10.5]; p = 0.04), as well as a
trend toward a reduction in postoperative low-cardiac-output syndrome
(13/98 v 6/102; p = 0.08) and the rate of hospital admission at one year
(26/95 v 16/96; p = 0.08). A trend toward an increase in the number of
patients with ejection fraction >=60% at hospital discharge also was
observed (4/95 v 11/92; p = 0.06). <br/>Conclusion(s): In the present
trial, esmolol as a cardioplegia adjuvant enhanced postoperative cardiac
performance but did not reduce a composite endpoint of prolonged intensive
care unit stay and/or mortality.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<58>
Accession Number
2010725783
Title
Prognostic performance of the Society of Thoracic Surgeons risk score in
patients with left main coronary artery disease undergoing
revascularisation: A post hoc analysis of the EXCEL trial.
Source
EuroIntervention. 16 (1) (pp 36-43), 2021. Date of Publication: 2021.
Author
Thuijs D.J.F.M.; Habib R.H.; Head S.J.; Puskas J.D.; Taggart D.P.; Stone
G.W.; Zhang Z.; Serruys P.W.; Sabik J.F.; Pieter Kappetein A.
Institution
(Thuijs, Head, Pieter Kappetein) Department of Cardiothoracic Surgery,
Erasmus University Medical Center, Rotterdam, Netherlands
(Habib) Society of Thoracic Surgeons Research Center, Chicago, IL, United
States
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Heart at Mount
Sinai Saint Luke's, New York, NY, United States
(Taggart) Department of Cardiac Surgery, John Radcliffe Hospital, Oxford,
United Kingdom
(Stone, Zhang) Clinical Trials Centre, Cardiovascular Research Foundation,
New York, NY, United States
(Stone) Center for Interventional Vascular Therapy, Division of
Cardiology, New York-Presbyterian Hospital, Columbia University Medical
Center, New York, NY, United States
(Serruys) Imperial College of Science, Technology and Medicine, London,
United Kingdom
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
Publisher
Europa Group
Abstract
Aims: Accurate risk prediction in patients undergoing revascularisation is
essential. We aimed to assess the predictive performance of Society of
Thoracic Surgeons (STS) risk models in patients with left main coronary
artery disease (LMCAD) undergoing coronary artery bypass grafting (CABG)
or percutaneous coronary intervention with everolimus-eluting stents
(PCI-EES). <br/>Methods and Results: The predictive performance of STS
risk models for perioperative mortality, stroke and renal failure was
evaluated for their discriminative ability (C statistic) and calibration
(Hosmer-Lemeshow goodness-of-fit-test; chi² and p-values) among
patients with LMCAD undergoing PCI-EES (n=935) and CABG (n=923) from the
randomised EXCEL trial. STS risk scores, in CABG patients, showed good
discrimination for 30-day mortality and average discrimination for stroke
(C statistic 0.730 and 0.629, respectively) with average calibration. For
PCI, STS risk scores had no discrimination for mortality (C statistic
0.507), yet good discrimination (C statistic 0.751) and calibration for
stroke. The predictive performance for renal failure was good for CABG (C
statistic 0.82), yet poor for PCI (C statistic 0.59). <br/>Conclusion(s):
In selected patients with LMCAD from the EXCEL trial, STS risk models
showed good predictive performance for CABG yet lacked predictive
performance for PCI for perioperative mortality and renal failure. The STS
stroke risk model was surprisingly more discriminating in PCI compared to
CABG. Improved and procedure-specific risk prediction instruments are
needed to accurately estimate adverse events after LMCAD revascularisation
by CABG and PCI.<br/>Copyright &#xa9; Europa Digital & Publishing 2020.
All rights reserved.

<59>
Accession Number
2007152240
Title
Methadone in Pain Management: A Systematic Review.
Source
Journal of Pain. 22 (3) (pp 233-245), 2021. Date of Publication: March
2021.
Author
Hanna V.; Senderovich H.
Institution
(Hanna, Senderovich) Faculty of Medicine, University of Toronto, Toronto,
ON, Canada
(Senderovich) Department of Family and Community Medicine, Division of
Palliative Care, Toronto, ON, Canada
(Senderovich) Department of Geriatrics, Palliative Care, and Pain
Medicine, Baycrest Health Sciences, Toronto, ON, Canada
Publisher
Elsevier B.V.
Abstract
Adequate analgesia can be challenging, as pharmacological options are not
necessarily effective for all types of pain and are associated with
adverse effects. Methadone is increasingly being considered in the
management of both cancer-related and noncancer-related pain. The purpose
of this article is to provide a narrative review of all available
randomized controlled trials (RCTs) investigating the effectiveness of
methadone in the management of pain, in relation to a comparison drug. The
primary outcome was analgesic effectiveness, and the secondary outcomes
were side effects and cost. A search of PubMed, Medline, Embase, and
Google Scholar databases was conducted to identify eligible RCTs and
methodologic quality was assessed. A total of 40 RCTs were included in
this review. The majority compared methadone to morphine or fentanyl.
Analgesic effectiveness of methadone was demonstrated in different types
of pain, including postprocedural, cancer-related, nociceptive, and
neuropathic pain. The evidence demonstrates that the use of methadone in
postprocedural pain and in cancer-related pain may be dependent on the
procedure and cancer type, respectively. Side effects experienced were
generally similar to the comparison drug, and lower cost was a benefit to
using methadone. Methadone may also be useful as an adjunctive analgesic
for adequate pain control, as well as in patients with renal impairment.
Additional high-quality, large-scale RCT evidence is needed to establish
its role as monotherapy or as an adjunctive medication. Future research
should also aim to standardize reported outcomes for measuring analgesic
effectiveness to permit for pooled analysis across studies.
<br/>Perspective(s): This article presents a systematic review, which
includes a summary of published RCTs investigating the effectiveness of
methadone in the management of pain. This is important for determining its
analgesic utility and for identifying gaps in existing
knowledge.<br/>Copyright &#xa9; 2020

<60>
Accession Number
2011085404
Title
Comparison of the outcomes of the prolonged antianginal therapy use in
stable coronary artery disease patients according to the data of
randomized and observational studies.
Source
Contemporary Clinical Trials Communications. 21 (no pagination), 2021.
Article Number: 100743. Date of Publication: March 2021.
Author
Martsevich S.Y.; Lukina Y.V.; Kutishenko N.P.; Semenova Y.V.
Institution
(Martsevich, Lukina, Kutishenko) Federal State Institution "National
Medical Research Center for Therapy and Preventive Medicine" of the
Ministry of Healthcare of the Russian Federation, Bld. 10, Petroverigskiy
Lane, Moscow 101990, Russian Federation
(Semenova) MEDSI Clinic, Solyanka St., 12 Bld. 1, Moscow 109028, Russian
Federation
Publisher
Elsevier Inc.
Abstract
Objective: To compare the results of treatment with antianginal drug
nicorandil in patients with stable coronary artery disease according to
the results of the observational study (OS) <<NIKEA>> and randomized
controlled trial (RCT) <<IONA>>. <br/>Method(s): <<NIKEA >> observational
program included 590 patients with stable angina pectoris. Subgroups in
the OS were formed based on the adherence to nicorandil use. Adherence was
assessed during follow-up direct questioning. <<IONA >> RCT included 5126
patients with stable angina pectoris. <br/>Result(s): Follow-up period and
mean age of patients were equal in OS and RCT. In OS the group of adherent
to nicorandil use patients had fewer males, life-saving drugs were
administered significantly more often than in RCT, comorbidities (arterial
hypertension, peripheral atherosclerosis and diabetes mellitus) were more
pronounced. Angina pectoris class III was diagnosed in 32% of the OS
patients vs 11% of the RCT patients, and class I - in 4.4% and 26%,
respectively (p<0.001). Both in RCT and OS, there were significantly fewer
cases of all cardiovascular events in the groups of nicorandil and
adherent to nicorandil use patients in comparison with the groups of
placebo and nonadherent patients. Both in RCT and OS the use of nicorandil
led to significant decrease in the risk of all cardiovascular events.
<br/>Conclusion(s): Results of the efficacy and effectiveness studies
complement each other and give the opportunity to assess the realisation
of the RCT results in real clinical practice.<br/>Copyright &#xa9; 2021

<61>
Accession Number
2005445040
Title
Perioperative coagulation profile with thromboelastography in
aspirin-treated patients undergoing posterior lumbar fusion.
Source
Pain Physician. 23 (6) (pp E619-E628), 2020. Date of Publication: 2020.
Author
Li X.; Wu J.; Zhang S.; Liu S.; Yuan J.; Wang C.; Miao X.; Lin X.; Li J.;
Shi Z.
Institution
(Li, Liu, Yuan, Wang, Miao, Lin, Li, Shi) Department of Orthopedics,
Shanghai Changhai Hospital, Shanghai, China
(Li) Department of Orthopaedics, No. 98 Hospital of PLA, Huzhou, China
(Wu) Department of Orthopedics, Shanghai Changzheng Hospital, Shanghai,
China
(Zhang) Department of Anesthesia, Shanghai Changzheng Hospital, Shanghai,
China
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: It has been generally recommended that platelet function may
recover after the recommended 5-day discontinuation period prior to
operation. The technique of thromboelastography has been demonstrated to
monitor intraoperative platelet function in liver transplantation and
coronary bypass surgery. However, there is a dearth of literature that
addresses the utility of thromboelastography in aspirin-treated patients
undergoing fusion. <br/>Objective(s): To introduce a functional method of
monitoring coagulation and validate the effectiveness of
thromboelastography perioperatively in assessing aspirin-treated patients
undergoing posterior lumbar fusion. <br/>Study Design: This research used
a retrospective study design. <br/>Setting(s): Orthopedic Department of
Changhai Hospital,Shanghai, China and Orthopedic and Anesthesia Department
of Changzheng Hospital. <br/>Method(s): Eighty patients were divided into
aspirin-naive and aspirin-treated groups in this study. They had equally
undergone lumbar fusion surgery for at least one or more segments between
January and June 2018. They matched for age, gender, number of fused
segments, and surgical procedures. The coagulation profile, including the
reaction time (R), kinetics (K), maximal amplitude (MA), alpha-angle, and
coagulation index (CI), platelet inhibition ratio (PIR) was analyzed by
thromboelastogram (TEG) prior to operation and on preoperative days 1, 3,
and 5. Correlation analysis included parameters such as waiting time,
intraoperative blood loss, and postoperative drainage. <br/>Result(s):
Perioperatively, the TEG values including R, K, MA, alpha-angle, and CI,
PIR, and correlation analysis showed no significant difference between the
2 groups, respectively (P > 0.05). <br/>Limitation(s): First, the
relatively small number of patients recruited limits control over other
factors; larger studies may need to confirm our findings. Second, the
patients were objectively less healthy with more medication treatment,
which may result in a variance in the amount of blood loss. Randomized
controlled studies are needed to further confirm these results.
<br/>Conclusion(s): TEG may be a helpful method to monitor perioperative
platelet function in aspirin-treated patients undergoing fusion. It may be
comparatively safe to relax the restriction of the aspirin-discontinued
therapeutic window to approximately 2 to 3 days prior to
surgery.<br/>Copyright &#xa9; 2020, American Society of Interventional
Pain Physicians. All rights reserved.

<62>
Accession Number
633483135
Title
The intraoperative use of recombinant activated factor VII in arterial
switch operations.
Source
Cardiology in the Young. 31 (3) (pp 386-390), 2021. Date of Publication:
March 2021.
Author
Zink J.; Spigel Z.A.; Ibarra C.; Gottlieb E.A.; Adachi I.; Mery C.M.;
Imamura M.; Heinle J.S.; McKenzie E.D.; Fraser C.D.; Binsalamah Z.M.
Institution
(Zink, Spigel, Ibarra, Adachi, Imamura, Heinle, McKenzie, Binsalamah)
Texas Children's Hospital, Houston, TX, United States
(Gottlieb, Mery, Fraser) Dell Children's Medical Center of Central Texas,
Austin, TX, United States
Publisher
Cambridge University Press
Abstract
Background: The rate of bleeding complications following arterial switch
operation is too low to independently justify a prospective randomised
study for benefit from recombinant factor VIIa. We aimed to evaluate
factor VIIa in a pilot study. <br/>Method(s): We performed a retrospective
cohort study of patients undergoing arterial switch operation from 2012 to
2017. Nearest-neighbour propensity score matching on age, gender, weight,
and associated cardiac defects was used to match 27 controls not receiving
recombinant factor VIIa to 30 patients receiving recombinant factor VIIa.
Fisher's exact test was performed to compare categorical variables.
Wilcoxon's rank-sum test was used to compare continuous variables between
cohorts. <br/>Result(s): Post-operative thrombotic complications were not
associated with factor VIIa administration (Odds Ratio (OR) 0.28, 95% CI
0.005-3.77, p = 0.336), nor was factor VIIa administration associated with
any re-explorations for bleeding. No intraoperative transfusion volumes
were different between the recombinant factor VIIa cohort and controls.
Post-operative prothrombin time (10.8 [10.3-12.3] versus 15.9 [15.1-17.2],
p < 0.001) and international normalised ratio (0.8 [0.73-0.90] versus 1.3
[1.2-1.4], p < 0.001]) were lower in recombinant factor VIIa cohort
relative to controls. <br/>Conclusion(s): In spite of a higher post-bypass
packed red blood cell transfusion requirement, patients receiving
recombinant factor VIIa had a similar incidence of bleeding
post-operatively. With no difference in thrombotic complications, and with
improved post-operative laboratory haemostasis, a prospective randomised
study is warranted to evaluate recombinant factor VIIa.<br/>Copyright
&#xa9; The Author(s), 2020. Published by Cambridge University Press.

<63>
Accession Number
2012240295
Title
Cervical intramedullary recurrent Ewing sarcoma after 10-year disease-free
survival in an adult: a case report and review of literature.
Source
Spinal Cord Series and Cases. 7 (1) (no pagination), 2021. Article Number:
45. Date of Publication: December 2021.
Author
Fukushima K.; Tsuji O.; Suzuki S.; Nori S.; Nagoshi N.; Okada E.; Yagi M.;
Emoto K.; Nakayama R.; Watanabe K.; Nakamura M.; Matsumoto M.
Institution
(Fukushima, Tsuji, Suzuki, Nori, Nagoshi, Okada, Yagi, Nakayama, Watanabe,
Nakamura, Matsumoto) Department of Orthopaedic Surgery, Keio University
School of Medicine, Tokyo, Japan
(Emoto) Division of Diagnostic Pathology, Keio University School of
Medicine, Tokyo, Japan
Publisher
Springer Nature
Abstract
Introduction: Intramedullary metastasis of Ewing sarcoma is extremely
rare. Here, we report an adult case of cervical intramedullary recurrent
Ewing sarcoma after a 10-year disease-free survival after the initial
surgery for a thoracic lesion. Case presentation: A 39-year-old man with a
history of surgery and chemoradiotherapy for thoracic Ewing sarcoma ten
years ago presented with neck pain and incomplete motor paralysis in the
right upper extremity, which had suddenly appeared three months before.
Cervical magnetic resonance imaging revealed a tear-drop-shaped
intramedullary lesion at the C3 level accompanied by diffuse edematous
change. Because of the rapid progression of his myelopathy, he underwent
surgery for this intramedullary lesion. Intraoperatively, the tumor
exhibited an orangish exophytic appearance. The unclearness of the tumor
boundary compelled us to perform a partial resection. The histopathology
showed the tumor comprised small round atypical cells with
immunoreactivity for Nkx2.2 and CD99, diagnosing a metastatic Ewing
sarcoma. Postoperatively, although his myelopathy improved transiently and
adjuvant chemotherapy radiation was undergone, he died of cranial
dissemination of the tumor two months and a half later.
<br/>Discussion(s): To our knowledge, 31 cases of primary and only 4 cases
of recurrent intramedullary spinal Ewing sarcoma have been reported to
date; however, this is the first case of recurrent intramedullary Ewing
sarcoma with a 10-year disease-free survival. Sadly, the prognosis of the
current case was extremely poor. There is no clear treatment guideline for
recurrent intramedullary Ewing sarcoma because of its rarity, and further
collection of similar cases would be required.<br/>Copyright &#xa9; 2021,
The Author(s), under exclusive licence to International Spinal Cord
Society.

<64>
Accession Number
2012216147
Title
Meta-Analysis of Duration of Dual Antiplatelet Therapy in Acute Coronary
Syndrome Treated With Coronary Stenting.
Source
American Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Knijnik L.; Fernandes M.; Rivera M.; Cardoso R.; Goyal A.; Liberman H.;
Sperling L.S.; McDaniel M.C.
Institution
(Knijnik) Division of Medicine, University of Miami, Miami, FL, United
States
(Fernandes, Goyal, Liberman, Sperling, McDaniel) Division of Cardiology,
Emory University, Atlanta, Georgia, United States
(Rivera) Division of Cardiology, Washington University-Saint Louis, St.
Louis, MO, United States
(Cardoso) Division of Cardiology, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
We aimed to evaluate if a shorter course of DAPT followed by P2Y12
inhibitor monotherapy is as effective as a 12-month course with fewer
bleeding events. PubMed, Scopus, and Cochrane Central were searched for
randomized controlled trials of ACS patients comparing dual antiplatelet
therapy (DAPT) for 1 to 3 months followed by a P2Y12 inhibitor to 12-month
DAPT. Quality assessment was performed with the Cochrane Collaboration
risk of bias assessment tool. Five randomized clinical trials were
included, with a total of 18,046 participants. Antiplatelet strategies
were aspirin and P2Y12 inhibitor for 12 months compared with aspirin and
P2Y12 inhibitor for 1 to 3 months followed by P212 inhibitor alone.
Patients randomized to 1 to 3 months of DAPT followed by P2Y12 inhibitor
monotherapy had lower rates of major bleeding (1.42% vs 2.53%; OR 0.53;
95% CI 0.42-0.67; p < 0.001; I² = 0%) and all-cause mortality
(1.00% vs 1.42%; OR 0.71; 95% CI 0.53-0.95; p = 0.02; I²=0%)
with similar major adverse cardiac events (MACE) (2.66% vs 3.11%; OR 0.86;
95% CI 0.71 - 1.03; p = 0.10; I² = 0 %) compared to 12 months
of DAPT. In conclusion, shorter course of DAPT for 1 to 3 months followed
by P2Y12 inhibitor monotherapy reduces major bleeding and all course
mortality without increasing major adverse cardiac events compared with
traditional DAPT for 12 months.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<65>
Accession Number
2012180036
Title
Survival of patients with acute pulmonary embolism treated with
venoarterial extracorporeal membrane oxygenation: A systematic review and
meta-analysis.
Source
Journal of Critical Care. 64 (pp 245-254), 2021. Date of Publication:
August 2021.
Author
Karami M.; Mandigers L.; Miranda D.D.R.; Rietdijk W.J.R.; Binnekade J.M.;
Knijn D.C.M.; Lagrand W.K.; den Uil C.A.; Henriques J.P.S.; Vlaar A.P.J.
Institution
(Karami, Henriques) Heart Center, Department of Cardiology, Amsterdam
Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
(Mandigers, Miranda, Rietdijk, den Uil) Department of Intensive Care
Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
(Binnekade, Knijn, Lagrand, Vlaar) Department of Intensive Care Medicine,
Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(den Uil) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
Publisher
W.B. Saunders
Abstract
Background: To examine whether venoarterial extracorporeal membrane
oxygenation (VA-ECMO) improves survival of patients with acute pulmonary
embolism (PE). <br/>Method(s): Following the PRISMA guidelines, a
systematic search was conducted up to August 2019 of the databases:
PubMed/MEDLINE, EMBASE and Cochrane. All studies reporting the survival of
adult patients with acute PE treated with VA-ECMO and including four
patients or more were included. Exclusion criteria were: correspondences,
reviews and studies in absence of a full text, written in other languages
than English or Dutch, or dating before 1980. Short-term (hospital or
30-day) survival data were pooled and presented with relative risks (RR)
and 95% confidence intervals (95% CI). Also, the following pre-defined
factors were evaluated for their association with survival in VA-ECMO
treated patients: age > 60 years, male sex, pre-ECMO cardiac arrest,
surgical embolectomy, catheter directed therapy, systemic thrombolysis,
and VA-ECMO as single therapy. <br/>Result(s): A total of 29 observational
studies were included (N = 1947 patients: VA-ECMO N = 1138 and control N =
809). There was no difference in short-term survival between VA-ECMO
treated patients and control patients (RR 0.91, 95% CI 0.71-1.16). In
acute PE patients undergoing VA-ECMO, age > 60 years was associated with
lower survival (RR 0.72, 95% CI 0.52-0.99), surgical embolectomy was
associated with higher survival (RR 1.96, 95% CI 1.39-2.76) and pre-ECMO
cardiac arrest showed a trend toward lower survival (RR 0.88, 95% CI
0.77-1.01). The other evaluated factors were not associated with a
difference in survival. <br/>Conclusion(s): At present, there is
insufficient evidence that VA-ECMO treatment improves short-term survival
of acute PE patients. Low quality evidence suggest that VA-ECMO patients
aged <=60 years or who received SE have higher survival rates. Considering
the limited evidence derived from the present data, this study emphasizes
the need for prospective studies. <br/>Protocol Registration: PROSPERO
CRD42019120370.<br/>Copyright &#xa9; 2021 The Authors

<66>
Accession Number
2011670422
Title
Transfusion Strategies for Pediatric Cardiac Surgery: A Meta-Analysis and
Trial Sequential Analysis.
Source
Pediatric Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Duan Z.X.; Chen D.X.; Yang B.Z.; Zhang X.Q.
Institution
(Duan, Zhang) Department of Anesthesiology, Yuncheng Central Hospital,
Yuncheng, Shanxi 044000, China
(Chen) Department of Anesthesiology, West China Hospital, Sichuan
University, No. 37 Wainan Guoxue Rd, Chengdu, Sichuan 610041, China
(Yang) Department of Anesthesiology, First Hospital of Shanxi Medical
University, Taiyuan, Shanxi 030001, China
Publisher
Springer
Abstract
This study aimed to compare the effects of restrictive and liberal red
blood cell (RBC) transfusion strategies on pediatric patients undergoing
cardiac surgery, including cyanotic and non-cyanotic children. A
literature search of the MEDLINE, EMBASE, PubMed, and the Cochrane Library
database was conducted. Meta-analyses were carried out comparing
restrictive and liberal transfusion strategies. Subgroup analyses were
performed based on the basis of cyanotic status. Five randomized
controlled trials with a total of 497 children were included. There was no
significant difference in the risk of in-hospital mortality between the
two transfusion strategies (risk ratio 1.21; 95% confidence interval 0.49
to 2.99; P = 0.68). The trial sequential analysis suggested that the
current meta-analysis had an absence of evidence for in-hospital
mortality, and the data were insufficient. Moreover, no significant
differences existed between groups in terms of risk of infection, blood
loss, duration of mechanical ventilation, pediatric intensive care unit
(PICU) stay duration, or hospital stay duration. Cyanotic children treated
with a liberal transfusion strategy had a shorter ventilator duration, but
the transfusion strategy did not affect in-hospital mortality, infection,
hospital stay, or PICU stay duration. On the basis of the available data,
our analysis indicates that a liberal transfusion strategy did not lead to
a better outcomes, but the data are extremely sparse, which highlights the
need for clearer transfusion guidelines specific to this specific
population. Trial registration number CRD42018102283.<br/>Copyright &#xa9;
2021, The Author(s), under exclusive licence to Springer Science+Business
Media, LLC, part of Springer Nature.

<67>
Accession Number
2011638305
Title
Bilateral transversus thoracis muscle plane block provides effective
analgesia and enhances recovery after open cardiac surgery.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Zhang Y.; Li X.; Chen S.
Institution
(Zhang, Chen) Department of Anesthesiology, First Affiliated Hospital of
Nanchang University, Nanchang, Jiangxi, China
(Li) Department of Nursing, The first Affiliated Hospital of Nanchang
University, Nanchang, Jiangxi, China
Publisher
Blackwell Publishing Inc.
Abstract
Background: The mid-sternum is the main source of pain after open cardiac
surgery. The aim of this study was to investigate the effect of bilateral
transversus thoracis muscle plane (TTMP) blocks on open cardiac surgery.
<br/>Method(s): Sixty patients were randomly divided into two groups:
bilateral TTMP blocks (TP group) or no nerve block (CO group). The primary
endpoint was perioperative sufentanil consumption. The secondary outcome
measures included postoperative pain, flurbiprofen axetil administration,
quality of sleep after extubation, time to extubation, time to the return
of gastrointestinal function, time to drain removal, the Intensive Care
Unit (ICU) stay time, and hospital stay. <br/>Result(s): The TP group
reported significantly less sufentanil and flurbiprofen axetil consumption
than the CO group. The CO group had higher Numerical Rating Scale (NRS)
pain scores at 1, 2, 6, 12, and 24 h after extubation both at rest and
during movement than the TP groups. Compared with the CO group,time to
extubation, time to the first bowel movement, ICU stay time, and hospital
stay were significantly decreased in the TP group. The TP group was rated
as better in the quality of the two nights of sleep after extubation.
<br/>Conclusion(s): Bilateral TTMP blocks can provide good perioperative
analgesia for patients undergoing open cardiac surgery and promote
postoperative recovery.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<68>
Accession Number
2005755017
Title
Effect of Desmopressin on Platelet Dysfunction During Antiplatelet
Therapy: A Systematic Review.
Source
Neurocritical Care. 34 (3) (pp 1026-1046), 2021. Date of Publication: June
2021.
Author
Andersen L.K.; Hvas A.-M.; Hvas C.L.
Institution
(Andersen, Hvas) Thrombosis and Hemostasis Research Unit, Department of
Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
(Hvas) Department of Anaesthesiology and Intensive Care, Aarhus University
Hospital, Aarhus, Denmark
Publisher
Springer
Abstract
Background and Objective: An increasing number of patients receive
antiplatelet therapy. Patients exposed to surgery while receiving platelet
inhibitors hold an increased bleeding risk. Especially in neurosurgery and
neurocritical care patients, bleeding and hematoma expansion are feared
complications as even minor bleedings may be hazardous. The objective of
this systematic review was to investigate the effect of desmopressin
(1-deamino-8-d-arginine vasopressin, DDAVP) on platelet function during
antiplatelet therapy in patients undergoing non-cardiac surgery, patients
who experience spontaneous or traumatic hemorrhage, healthy individuals
and in animals. <br/>Method(s): Studies were identified through a
systematic literature search in PubMed and EMBASE on August 19, 2019, with
an update on May 2, 2020, and from reference lists of the included
studies. Data on clinical and biochemical effect of DDAVP were extracted
from included studies for a qualitative data synthesis. <br/>Result(s): In
total, 22 studies were included: 18 human studies and four animal studies.
Overall, DDAVP improved bleeding time and increased platelet aggregation
in patients undergoing non-cardiac surgery, patients suffering
intracerebral or subarachnoid hemorrhage while receiving antiplatelet
therapy as well as in healthy individuals and animals exposed to
antiplatelet therapy. Observational data indicate that DDAVP may mitigate
hematoma expansion in patients with intracerebral hemorrhage or traumatic
brain injury. <br/>Conclusion(s): The present data hold biochemical
evidence that DDAVP improves platelet function during antiplatelet therapy
in humans and animals. The need for randomized trials is evident in order
to evaluate the potential clinical effect of DDAVP in management of
patients with spontaneous or traumatic hemorrhage, or undergoing
neurosurgery, while receiving antiplatelet therapy.<br/>Copyright &#xa9;
2020, Springer Science+Business Media, LLC, part of Springer Nature and
Neurocritical Care Society.

<69>
Accession Number
628237729
Title
Can postoperative massage therapy reduce pain and anxiety in cardiac
surgery patients?.
Source
Interactive Cardiovascular and Thoracic Surgery. 28 (5) (pp 716-721),
2019. Date of Publication: 01 May 2019.
Author
Grafton-Clarke C.; Grace L.; Roberts N.; Harky A.
Institution
(Grafton-Clarke) School of Medicine, Department of Life Sciences,
University of Liverpool, Liverpool, United Kingdom
(Grace, Roberts) Department of Cardiac Surgery, Barts Heart Centre, St
Bartholomew's Hospital, London, United Kingdom
(Harky) Department of Vascular Surgery, Countess of Chester, Chester,
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
cardiac surgery, is postoperative massage therapy effective in reducing
pain, anxiety and physiological parameters?' Altogether, 287 papers were
found using the reported search, of which 7 papers represented the best
evidence to answer the clinical question. The authors, journal, date and
country of publication, patient group studied, study type, relevant
outcomes and the results of these papers are tabulated. The specific
therapy protocols widely varied between studies, with differences in
frequency, specific timing in the postoperative period, techniques used
and experience of therapy provider. These variations limit the
generalization and transferability of the conclusions. The effect of
massage therapy on anxiety levels was reported in 5 studies. All but one
demonstrated a significant improvement in anxiety. Pain was also reported
in 5 studies, with significant improvement demonstrated in 4 studies.
Importantly, a number of these studies failed to report on analgesic
requirements nor demonstrate a reduction in opioid requirements, thus
limiting the validity of the drawn conclusions. There is significant
heterogeneity in randomized trials reporting on the effects of massage
therapy. Although there is evidence to suggest that massage therapy
reduces pain and anxiety following cardiac surgery, there are often
caveats to the conclusions drawn with other studies reporting no
significant difference. Therefore, in light of this, it would not be
logical to recommend massage therapy as an effective therapy. There is no
current evidence to suggest that massage therapy improves physiological
parameters, including the onset of atrial fibrillation
postoperatively.<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.

<70>
Accession Number
2011683155
Title
Minimal invasive aortic valve replacement through right mini-thoracotomy
versus conventional approach in the egypt.
Source
Systematic Reviews in Pharmacy. 12 (3) (pp 88-95), 2021. Date of
Publication: March 2021.
Author
Salama A.M.; Eid A.M.; Adel W.; Mortada K.; Elsharkawy A.
Institution
(Salama, Eid, Adel, Mortada, Elsharkawy) Cardiothoracic surgery
Department, Kasr alainy Faculty of medicine, Cairo University, Egypt
Publisher
EManuscript Technologies
Abstract
Background: Full median sternotomy was established a long time ago as the
standard approach for all varieties of heart surgery. Although that, it
may cause significant surgical trauma and morbidity, so minimally invasive
cardiac surgery for aortic valve replacement via partial sternotomy,
para-sternal approach and anterior mini-thoracotomy is used trying to
improve the outcome . <br/>Objective(s): To check the outcome of minimally
invasive aortic valve surgery through a right mini-thoracotomy, and its
rule in minimizing the surgical access, achieving better wound appearance,
decreasing post-operative discomfort and better postoperative recovery
with the same safety and results like conventional surgery .
<br/>Method(s): Our study was performed in the Armed Forces Hospitals El
Maddi& El Galaa and kobry elkobba, Egypt. Between January 2015 to March
2017, sixty patients were diagnosed with AVD requiring aortic valve
surgery were randomly selected, of them Thirty patients had aortic valve
surgery through full median sternotomy with aorto-right atrial cannulation
and the other thirty patients had right mini-thoracotomy with femoral
cannulation . Results# Minimally invasive aortic valve replacement (MIAVR)
was associated with reduced morbidity and mortality, where there was a
safer approach in case of reoperation, better cosmetic outcome, less
bleeding post-operative, lower number of blood products usage, less
intensive care unit and hospital stays, decreased time until return to
full activity and avoiding the incidence of sternal wound infection. That
good results were also achievable in high-risk patients .
<br/>Conclusion(s): Minimal Invasive Aortic Valve Replacement Through
Right Minithoracotomy is an acceptable alternative to Full median
sternotomy, has reduced morbidity and potential mortality and good
clinical outcome, with two concerns which are the operative cost and the
relatively long bypass and cross clamp time which are related to the
learning curve of the surgeons .<br/>Copyright &#xa9; 2021 EManuscript
Technologies. All rights reserved.

<71>
Accession Number
2007347394
Title
Intracorporeal versus extracorporeal urinary diversion following
robot-assisted radical cystectomy: a meta-analysis, cumulative analysis,
and systematic review.
Source
Journal of Robotic Surgery. 15 (3) (pp 321-333), 2021. Date of
Publication: June 2021.
Author
Tanneru K.; Jazayeri S.B.; Kumar J.; Alam M.U.; Norez D.; Nguyen S.;
Bazargani S.; Ganapathi H.P.; Bandyk M.; Marino R.; Koochekpour S.; Gautam
S.; Balaji K.C.; Costa J.
Institution
(Tanneru, Jazayeri, Kumar, Alam, Nguyen, Bazargani, Ganapathi, Bandyk,
Marino, Koochekpour, Gautam, Balaji, Costa) Department of Urology,
University of Florida, 655 8th St W, Jacksonville, FL 32209, United States
(Norez) Center for Data Solutions, University of Florida, Jacksonville,
FL, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Over the last decade, the increased utilization of robot-assisted radical
cystectomy (RARC) in the surgical treatment of muscle-invasive bladder
cancer has led to an uptrend in intracorporeal urinary diversions (ICUD).
However, the operative results comparing ICUD to extracorporeal urinary
diversion (ECUD) have varied widely. We performed a meta-analysis to
analyze perioperative outcomes and complications of ICUD compared to ECUD
following RARC. This study is registered at International Prospective
Register of Systematic Reviews (PROSPERO) CRD42020164074. A systematic
literature review was conducted using PubMed, EMBASE, and Cochrane
databases in August 2019. A total of six studies comparing ICUD vs ECUD
were identified and meta-analysis was conducted on these studies. In
addition, a cumulative analysis was also performed on 83 studies that
reported perioperative outcomes after RARC and ICUD or ECUD. The Weighed
Mean Difference of operative time and blood loss between ICUD and ECUD
group was (16; 95% confidence interval - 34 to 66) and (- 86; 95%
confidence interval - 124 to - 48), respectively. ICUD and ECUD had
comparable early (30-day) and mid-term (30-90-day) complication rate (RR
1.19; 95% confidence interval 0.71-2.0; p = 0.5) and (RR 0.91; 95%
confidence interval 0.71-1.15 p = 0.4) respectively. In the 83 studies
that were included in the cumulative analysis, the mean operative time for
ileal conduit and neobladders by ICUD were 307 and 428 min, respectively,
compared to ECUD 428 and 426 min, respectively. ICUD and ECUD have
comparable short- and mid-term complication rate. The ICUD group has lower
blood loss and lower rate of blood transfusion compared to
ECUD.<br/>Copyright &#xa9; 2020, Springer-Verlag London Ltd., part of
Springer Nature.

<72>
Accession Number
2005533885
Title
Incidence and Risk Factors for Silent Brain Infarction After On-Pump
Cardiac Surgery: A Meta-analysis and Meta-regression of 29 Prospective
Cohort Studies.
Source
Neurocritical Care. 34 (2) (pp 657-668), 2021. Date of Publication: April
2021.
Author
Guo J.; Zhou C.; Yue L.; Yan F.; Shi J.
Institution
(Guo, Zhou, Yue, Yan, Shi) Department of Anesthesiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, No. 167 Beilishi Street,
Xicheng District, Beijing 100037, China
Publisher
Springer
Abstract
Background: Silent brain infarction (SBI) happens at a considerable rate
after on-pump cardiac surgery. Though termed silent, SBI is related to
unfavorable clinical outcomes including higher incidence of future stroke
and neurocognitive impairment in the general population. The risk factors
of SBI have not been fully identified in both individual studies and
several meta-analyses addressing the topic. In this meta-analysis, we
aimed to conduct meta-regression analysis for the first time to explore
risk factors for SBI after on-pump cardiac surgery. <br/>Method(s): This
meta-analysis was conducted following the Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) guidelines. Medline, Embase,
Central, Web of Science, and Wiley databases were searched for relevant
studies. Preoperative patient baseline characteristics and intraoperative
surgical parameters were extracted from included studies. For
meta-regression, a P value of less than 0.1 was considered statistically
significant in both univariable and multivariable analyses.
<br/>Result(s): Twenty-nine studies with 1478 patients were included in
this meta-analysis. The summarized SBI rate after on-pump cardiac surgery
was 37% (95% CI 0.27-0.47, P < 0.0001). Heterogeneity between studies was
significant (I² = 94.9%, P < 0.0001). In multivariable
meta-regression, we found that age (coefficient 0.014, 95% CI 0.001-0.029,
P = 0.043), diabetes (coefficient 0.006, 95% CI - 0.001 to 0.013, P =
0.075), and proportion of CABG (coefficient - 0.001, 95% CI - 0.003 to
0.0003, P = 0.096) were significantly associated with SBI incidence.
<br/>Conclusion(s): From the meta-regression, we concluded that advanced
age and diabetes were related to increased SBI incidence after on-pump
cardiac surgery, while CABG procedure alone was associated with less SBI
onset. Studies with more accurate diagnoses of SBI are required to add
more conclusive evidence to the field.<br/>Copyright &#xa9; 2020, Springer
Science+Business Media, LLC, part of Springer Nature and Neurocritical
Care Society.

<73>
Accession Number
2011541098
Title
COVID-19 and Heart Transplant: A Case Series and Review of the Literature.
Source
Transplantation Proceedings. 53 (4) (pp 1219-1223), 2021. Date of
Publication: May 2021.
Author
Ballout J.A.; Ahmed T.; Kolodziej A.R.
Institution
(Ballout, Kolodziej) Gill Heart Institute, University of Kentucky,
Lexington, KY, United States
(Ahmed) Department of Internal Medicine, University of Kentucky,
Lexington, KY, United States
Publisher
Elsevier Inc.
Abstract
Coronavirus disease 2019 (COVID-19) has resulted in many challenges in
patient care, especially among high-risk populations such as heart
transplant recipients. Patients with heart transplant experience a
significantly higher mortality rate with COVID-19 infection, and
management is based on extrapolation from clinical trials done on
nontransplant patients and from clinical experience. Here we report 4
cases of patients with heart transplant who presented with COVID-19
infection in late 2020. Patients presented with symptoms similar to those
seen in the general population. All 4 patients were admitted to the
hospital, and they were all treated with dexamethasone. In addition, 2
patients received remdesivir. Immunosuppressive medications were adjusted
to maintain adequate levels of immunosuppression but at the same time
allow for an adequate immune response against the infection. All patients
were discharged alive from the hospital. We then performed a literature
review on studies that included heart transplant patients who developed
the infection and developed suggestions for a standardized management
approach, which we share in this article.<br/>Copyright &#xa9; 2021
Elsevier Inc.

<74>
Accession Number
2007495540
Title
Effectivity of dexamethasone in patients undergoing off-pump coronary
artery bypass surgery.
Source
Asian Cardiovascular and Thoracic Annals. 29 (5) (pp 388-393), 2021. Date
of Publication: June 2021.
Author
Hanafy D.A.; Harta I.K.A.P.; Prasetya I.M.I.; Busroh P.W.; Soetisna T.W.;
Sugisman; Wartono D.A.; Tjubandi A.; Herlambang B.
Institution
(Hanafy, Harta, Busroh, Soetisna, Sugisman, Wartono, Tjubandi, Herlambang)
National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Prasetya) RSUP Sanglah Hospital, Denpasar, Bali, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Background: Based on our previous pilot study, systemic inflammatory
response syndrome is more common in off-pump compared to on-pump coronary
artery bypass. Therefore, we conducted a clinical trial of dexamethasone
in patients undergoing off-pump coronary artery bypass. <br/>Method(s):
Sixty consecutive patients undergoing off-pump coronary artery bypass were
enrolled from August 2018 to January 2019 and randomized to a
dexamethasone or placebo group of 30 each. Clinical outcomes were
analyzed. <br/>Result(s): There was a lower incidence of major adverse
cardiac events in the dexamethasone group compared to the placebo group
(17% versus 43%, p = 0.024). Clinical outcomes in the dexamethasone group
were better than those in the placebo group, in terms of duration of
mechanical ventilation (p = 0.029), intensive care unit stay (p = 0.028),
hospital stay (p = 0.04), and vasoactive-inotropic score (p = 0.045).
There were significant differences in inflammatory markers between the two
groups: interleukin-6 (p = 0.0001), procalcitonin (p = 0.0001), and
C-reactive protein (p = 0.0001) were lower in the dexamethasone group.
There was a significant association between the incidence of major adverse
cardiac events and both interleukin-6 (p = 0.005) and procalcitonin (p =
0.007). <br/>Conclusion(s): Preoperative dexamethasone in patients
undergoing off-pump coronary artery bypass is effective in improving
clinical outcomes and controlling the postoperative inflammatory
reaction.<br/>Copyright &#xa9; The Author(s) 2020.

<75>
Accession Number
634915382
Title
Does preoperative pulmonary rehabilitation/physiotherapy improve patient
outcomes following lung resection?.
Source
Interactive cardiovascular and thoracic surgery. 32 (6) (pp 933-937),
2021. Date of Publication: 27 May 2021.
Author
Bibo L.; Goldblatt J.; Merry C.
Institution
(Bibo, Merry) Department of Cardiothoracic Surgery, Fiona Stanley
Hospital, Perth, Australia
(Goldblatt) Department of Cardiothoracic Surgery, Alfred Hospital,
Melbourne, Australia
Publisher
NLM (Medline)
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was whether preoperative
physiotherapy (pulmonary prehabilitation) is beneficial for patients
undergoing lung resection. Altogether 177 papers were found using the
reported search, of which 10 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. A meta-analysis by Li et al. showed that patients
who received a preoperative rehabilitation programme (PRP) had reduced
incidence of postoperative pulmonary complications (PPCs) (odds ratio
0.44, 95% CI 0.27-0.71), reduced length of stay (LOS) (-4.23days, 95% CI
-6.14 to -2.32days) and improved 6-min walking distance (71.25 m, 95% CI
39.68-102.82) and peak oxygen uptake consumption (VO2 peak) (3.26, 95% CI
2.17-4.35). A meta-analysis by Steffens et al. showed that PPCs were
reduced in patients with PRP (relative risk 0.49, 95% CI 0.33-0.73) and
reduced LOS (-2.86days, 95% CI -5.40 to -0.33). The results of 3
additional meta-analyses, 4 randomized controlled trials and 1
observational study all provide further support to PRP in enhanced
recovery after surgery and the improvement in exercise capacity. We
conclude that PRP improves exercise capacity in patients undergoing
surgical resection for lung cancer. Moderate quality evidence supports
preoperative exercise providing significant reduction in PPCs and hospital
LOS. Referral to exercise programmes should be considered in patients
awaiting lung resection, particularly those deemed borderline for
suitability for surgical resection.<br/>Copyright &#xa9; The Author(s)
2021. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<76>
Accession Number
634553466
Title
Does erector spinae plane block result in improved postoperative analgesia
and enhanced recovery in adult patients after cardiac surgery?.
Source
Interactive cardiovascular and thoracic surgery. 32 (6) (pp 873-877),
2021. Date of Publication: 27 May 2021.
Author
Misra S.; Awal S.
Institution
(Misra) Department of Anesthesiology and Critical Care, All India
Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
(Awal) Department of Anaesthesia and Critical Care Medicine, Institute of
Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
Publisher
NLM (Medline)
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was whether erector spinae
plane block (ESPB) resulted in improved postoperative analgesia and
enhanced recovery in adult cardiac surgical patients. A total of 333
papers were found using the reported search of which, 7 papers represented
the best evidence to answer the clinical question. The authors, journal,
date and country of publication, patient groups studied, study type,
relevant outcomes and results of these papers are tabulated. The cardiac
surgical procedures included off-pump coronary artery bypass surgery (1
study), mitral/tricuspid valve repair (1 study), robotic minimally
invasive coronary artery bypass surgery (1 study) and other cardiac
surgeries (4 studies). ESPB was compared to intravenous analgesia (5
studies), thoracic epidural analgesia (1 study) and serratus anterior
plane block and paravertebral block (1 study). With ESPB, there was
significant improvement in postoperative pain scores (4 studies),
decreased opioid requirement/rescue analgesia (3 studies), increased
duration of analgesia (1 study), decreased time to extubation (3 studies),
less increase in postoperative Troponin T (1 study), earlier ambulation (2
studies), earlier oral intake (1 study), earlier chest drain removal (1
study), better patient satisfaction (1 study), reduced adverse events (1
study) and decreased intensive care unit stay (3 studies). We conclude
that ESPB may be associated with improved postoperative analgesia and
enhanced recovery after adult cardiac surgery based on the available
evidence. However, there is a need for better quality randomized
controlled trials to consolidate these findings.<br/>Copyright &#xa9; The
Author(s) 2021. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<77>
[Use Link to view the full text]
Accession Number
633088898
Title
The Use of Central Venous to Arterial Carbon Dioxide Tension Gap for
Outcome Prediction in Critically Ill Patients: A Systematic Review and
Meta-Analysis.
Source
Critical care medicine. 48 (12) (pp 1855-1861), 2020. Date of Publication:
01 Dec 2020.
Author
Al Duhailib Z.; Hegazy A.F.; Lalli R.; Fiorini K.; Priestap F.;
Iansavichene A.; Slessarev M.
Institution
(Al Duhailib, Hegazy, Fiorini, Priestap, Slessarev) Division of Critical
Care, Department of Medicine, Western University, London Health Sciences
Centre, ON, London, Canada
(Al Duhailib) Department of Health Research Methods, Evidence, McMaster
University, ON, and Impact, Hamilton, Canada
(Al Duhailib) Department of Critical Care Medicine, King Faisal Specialist
Hospital and Research Centre, Riyadh, Saudi Arabia
(Hegazy) Department of Anesthesia and Perioperative Medicine, Western
University, London Health Sciences Centre, ON, London, Canada
(Lalli) Department of Pediatrics, Western University, London Health
Sciences Centre, ON, London, Canada
(Iansavichene) Health Science Library, London Health Sciences Centre,
Victoria Campus, ON, London, Canada
(Slessarev) Department of Medical Biophysics, Western University, ON,
London, Canada
(Slessarev) Brain and Mind Institute, Western University, ON, London,
Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVES: In this systematic review and meta-analysis, we assessed
whether a high CO2 gap predicts mortality in adult critically ill patients
with circulatory shock. DATA SOURCES: A systematic search of MEDLINE and
EMBASE electronic databases from inception to October 2019. STUDY
SELECTION: Studies from adult (age >= 18 yr) ICU patients with shock
reporting CO2 gap and outcomes of interest. Case reports and conference
abstracts were excluded. DATA EXTRACTION: Data extraction and study
quality assessment were performed independently in duplicate. DATA
SYNTHESIS: We used the Newcastle-Ottawa Scale to assess methodological
study quality. Effect sizes were pooled using a random-effects model. The
primary outcome was mortality (28 d and hospital). Secondary outcomes were
ICU length of stay, hospital length of stay, duration of mechanical
ventilation, use of renal replacement therapy, use of vasopressors and
inotropes, and association with cardiac index, lactate, and central venous
oxygen saturation. <br/>CONCLUSION(S): We included 21 studies (n = 2,155
patients) from medical (n = 925), cardiovascular (n = 685), surgical (n =
483), and mixed (n = 62) ICUs. A high CO2 gap was associated with
increased mortality (odds ratio, 2.22; 95% CI, 1.30-3.82; p = 0.004) in
patients with shock, but only those from medical and surgical ICUs. A high
CO2 gap was associated with higher lactate levels (mean difference 0.44
mmol/L; 95% CI, 0.20-0.68 mmol/L; p = 0.0004), lower cardiac index (mean
difference, -0.76L/min/m; 95% CI, -1.04 to -0.49L/min/m; p = 0.00001), and
central venous oxygen saturation (mean difference, -5.07; 95% CI, -7.78 to
-2.37; p = 0.0002). A high CO2 gap was not associated with longer ICU or
hospital length of stays, requirement for renal replacement therapy,
longer duration of mechanical ventilation, or higher vasopressors and
inotropes use. Future studies should evaluate whether resuscitation aimed
at closing the CO2 gap improves mortality in shock.

<78>
Accession Number
2012368643
Title
Influence of humanized care on self-efficacy, sleep and quality of life of
patients in cardiovascular surgery intensive care unit.
Source
American Journal of Translational Research. 13 (5) (pp 4884-4891), 2021.
Date of Publication: 30 May 2021.
Author
Zeng Z.; Guan Y.
Institution
(Zeng, Guan) Department of Cardiac Macrovascular Surgery Care Unit,
Jiangsu Province Hospital, Jiangsu Province, Nanjing 210029, China
Publisher
E-Century Publishing Corporation
Abstract
Objective: The present study aims to investigate the influence of
humanized care on self-efficacy, sleep quality (SQ) and quality of life
(QOL) of patients in a cardiovascular surgery intensive care unit (CSICU).
<br/>Method(s): A total of 134 patients hospitalized in CSICU from July,
2017 to September, 2019 were randomly allocated into control group and
observation group, of which 64 in control group were given routine nursing
care, and 70 in observation group were given humanized care additionally.
The cardiopulmonary function, self-efficacy, SQ, incidence of adverse
reactions, anxiety and depression, QOL, and patient satisfaction were
evaluated. <br/>Result(s): After nursing, patients in the observation
group showed enhanced cardiopulmonary function and self-efficacy, better
SQ and QOL, as well as lower incidence of adverse reactions and anxiety
and depression, and higher satisfaction. <br/>Conclusion(s): Humanized
care contributes to the recovery of cardiopulmonary function, and is
effective in alleviating anxiety and depression and enhancing
self-efficacy, SQ and QOL of patients in CSICU.<br/>Copyright &#xa9; 2021
E-Century Publishing Corporation. All rights reserved.

<79>
Accession Number
2012310475
Title
Relief of Ischemia in Ischemic Cardiomyopathy.
Source
Current Cardiology Reports. 23 (7) (no pagination), 2021. Article Number:
80. Date of Publication: July 2021.
Author
Moroni F.; Gertz Z.; Azzalini L.
Institution
(Moroni) Universita Vita-Salute San Raffaele, Milan, Italy
(Moroni) Division of Cardiology, VCU Health Pauley Heart Center, Virginia
Commonwealth University, West Hospital, 5th floor, West wing, 1200 East
Broad St, Richmond, VA, United States
(Gertz, Azzalini) Division of Cardiology, VCU Health Pauley Heart Center,
Virginia Commonwealth University, West Hospital, 5th floor, West wing,
Room 526 1200 East Broad St, Richmond, VA, United States
Publisher
Springer
Abstract
Purpose of the Review: Ischemic heart disease is among the most common
causes of morbidity and mortality worldwide. In its stable manifestation,
obstructing coronary artery stenoses prevent myocardial blood flow from
matching metabolic needs of the heart under exercise conditions, which
manifests clinically as dyspnea or chest pain. Prolonged bouts of ischemia
may result in permanent myocardial dysfunction, heart failure, and
eventually reduced survival. The aim of the present work is to review
currently available approaches to provide relief of ischemia in stable
coronary artery disease (CAD). Recent Findings: Several pharmacological
and interventional approaches have proven effectiveness in reducing the
burden of ischemia in stable CAD and allow for symptom control and quality
of life improvement. However, substantial evidence in favor of improved
survival with ischemia relief is lacking, and recently published
randomized controlled trial suggests that only selected groups of patients
may substantially benefit from this approach. <br/>Summary:
Pharmacological treatments aimed at reducing ischemia were shown to
significantly reduce ischemic symptoms but failed to provide prognostic
benefit. Myocardial revascularization is able to re-establish adequate
coronary artery flow and was shown to improve survival in selected groups
of patients, i.e., those with significant left main CAD or severe left
ventricular dysfunction in multivessel CAD. Outside the previously
mentioned categories, revascularization appears to improve symptoms
control over medical therapy, but does not confer prognostic advantage.
More studies are needed to elucidate the role of systematic invasive
functional testing to identify individuals more likely to benefit from
revascularization and to evaluate the prognostic role of chronic total
occlusion recanalization.<br/>Copyright &#xa9; 2021, The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<80>
Accession Number
2012394341
Title
Indirect impact of the COVID-19 pandemic on hospitalisations for
cardiometabolic conditions and their management: A systematic review.
Source
Primary Care Diabetes. (no pagination), 2021. Date of Publication: 2021.
Author
Seidu S.; Kunutsor S.K.; Cos X.; Khunti K.
Institution
(Seidu, Khunti) Leicester Real World Evidence Unit, Diabetes Research
Centre, University of Leicester, United Kingdom
(Kunutsor) National Institute for Health Research Bristol Biomedical
Research Centre, University Hospitals Bristol and Weston NHS Foundation
Trust and the University of Bristol, Bristol, United Kingdom
(Kunutsor) Musculoskeletal Research Unit, Translational Health Sciences,
Bristol Medical School, University of Bristol, Learning & Research
Building (Level 1), Southmead Hospital, Bristol BS10 5NB, United Kingdom
(Cos) DAP_Cat Research Group, Gerencia Territorial Barcelona Ciutat,
Institut Catala de la Salut, Foundation University Institute for Primary
Health Care Research Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
Publisher
Elsevier Ltd
Abstract
Background: The Coronavirus disease 2019 (COVID-19) pandemic has led to a
dramatic crisis in health care systems worldwide. These may have
significant implications for the management of cardiometabolic diseases.
We conducted a systematic review of published evidence to assess the
indirect impact of the COVID-19 pandemic on hospitalisations for
cardiovascular diseases and their management. <br/>Method(s): Studies that
evaluated volume of hospitalisations for cardiometabolic conditions and
their management with comparisons between the COVID-19 and pre-COVID
periods were identified from MEDLINE, Embase and the reference list of
relevant studies from January 2020 to 25 February 2021. <br/>Result(s): We
identified 103 observational studies, with most studies assessing
hospitalisations for acute cardiovascular conditions such as acute
coronary syndrome, ischemic strokes and heart failure. About 89% of
studies reported a decline in hospitalisations during the pandemic
compared to pre-pandemic times, with reductions ranging from 20.2 to 73%.
Severe presentation, less utilization of cardiovascular procedures, and
longer patient- and healthcare-related delays were common during the
pandemic. Most studies reported shorter length of hospital stay during the
pandemic than before the pandemic (1-8 vs 2-12 days) or no difference in
length of stay. Most studies reported no change in in-hospital mortality
among hospitalised patients. <br/>Conclusion(s): Clinical care of patients
for acute cardiovascular conditions, their management and outcomes have
been adversely impacted by the COVID-19 pandemic. Patients should be
educated via population-wide approaches on the need for timely medical
contact and health systems should put strategies in place to provide
timely care to patients at high risk. Systematic review registration:
PROSPERO 2021: CRD42021236102<br/>Copyright &#xa9; 2021 Primary Care
Diabetes Europe

<81>
Accession Number
2012391158
Title
Preventative effects of bisoprolol transdermal patches on postoperative
atrial fibrillation in high-risk patients undergoing non-cardiac surgery:
A subanalysis of the MAMACARI study.
Source
Journal of Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Iwano T.; Toda H.; Nakamura K.; Shimizu K.; Ejiri K.; Naito Y.; Mori H.;
Masuda T.; Miyoshi T.; Yoshida M.; Hikasa Y.; Morimatsu H.; Ito H.
Institution
(Iwano, Toda, Nakamura, Ejiri, Masuda, Miyoshi, Yoshida, Ito) Department
of Cardiovascular Medicine, Okayama University Graduate School of
Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho,
Kita-ku, Okayama 700-8558, Japan
(Shimizu, Hikasa, Morimatsu) Department of Anesthesiology, Okayama
University Graduate School of Medicine, Dentistry and Pharmaceutical
Sciences, Okayama, Japan
(Naito) Department of Cardiology, Fukuyama City Hospital, Fukuyama, Japan
(Mori) Department of Cardiology, Tsuyama Chuo Hospital, Tsuyama, Japan
(Masuda) Department of Cardiology, Himeji Red Cross Hospital, Himeji,
Japan
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Perioperative atrial fibrillation (POAF) after non-cardiac
surgery is a risk factor for cardiovascular events including stroke and
death. The aim of this subanalysis of the MAMACARI study, a multicenter
randomized control study on the effectiveness of a bisoprolol transdermal
patch for prevention of perioperative myocardial injury in high-risk
patients undergoing non-cardiac surgery, was to identify the predictors of
POAF after non-cardiac surgery in high-risk patients and to determine
changes in blood pressure and heart rate during bisoprolol patch
administration in the perioperative period. <br/>Methods and Results:
Patients aged over 60 years with hypertension and a high revised cardiac
risk index (>=2) who were scheduled to undergo non-cardiac surgery were
randomly assigned to a bisoprolol patch group (n = 120) or a control group
(n = 120). We divided the patients into two groups: patients with POAF
(POAF group; n = 16) and patients without POAF (non-POAF group; n = 206).
Multivariate analysis showed that bisoprolol patch therapy (OR: 0.30, 95%
CI: 0.092-0.978) and surgery time of 250 min or more (OR: 4.99, 95% CI:
1.37-18.2) were independently associated with POAF. Although systolic
blood pressure did not differ significantly between the two groups
throughout the perioperative period, treatment with a bisoprolol patch
significantly reduced heart rate throughout the perioperative period
compared with that in the control group. <br/>Conclusion(s): Low dose of a
bisoprolol patch in the perioperative period was effective for prevention
of POAF after non-cardiac surgery in high-risk patients, while long
surgery time was an independent risk factor for POAF. It is expected that
low dose of a bisoprolol patch can prevent POAF without causing
hypotension.<br/>Copyright &#xa9; 2021

<82>
Accession Number
2012311807
Title
Coronary artery bypass grafting versus percutaneous coronary intervention
in end-stage kidney disease: A systematic review and meta-analysis of
clinical studies.
Source
Hemodialysis International. (no pagination), 2021. Date of Publication:
2021.
Author
Kanbay M.; Tapoi L.; Ureche C.; Bulbul M.C.; Kapucu I.; Afsar B.; Basile
C.; Covic A.
Institution
(Kanbay) Department of Medicine, Division of Nephrology, Koc University
School of Medicine, Istanbul, Turkey
(Tapoi, Ureche) Cardiovascular Diseases Institute, "Grigore T. Popa"
University of Medicine and Pharmacy, Iasi, Romania
(Bulbul, Kapucu) Department of Medicine, Koc University School of
Medicine, Istanbul, Turkey
(Afsar) Department of Medicine, Division of Nephrology, Suleyman Demirel
University School of Medicine, Isparta, Turkey
(Basile) Division of Nephrology, Miulli General Hospital, Acquaviva delle
Fonti, Italy
(Covic) Department of Nephrology, "Grigore T. Popa" University of Medicine
and Pharmacy, Iasi, Romania
Publisher
Blackwell Publishing Inc.
Abstract
The most significant complication of end-stage kidney disease (ESKD) is
cardiovascular disease, mainly coronary artery disease (CAD). Although the
effective treatment of CAD is an important prognostic factor, whether
percutaneous coronary intervention (PCI) or coronary artery bypass
grafting (CABG) is better for treating CAD in this group of patients is
still controversial. We searched Pubmed/Medline, Web of Science, Embase,
the Cochrane Central Register of Controlled Trials articles that compared
the outcomes of CABG versus PCI in patients with ESKD requiring dialysis.
A total of 10 observational studies with 39,666 patients were included.
Our analysis showed that when compared to PCI, CABG had lower risk of need
for repeat revascularization (relative risk [RR] = 2.25, 95% confidence
interval [CI] 2.1-2.42, p < 0.00001) and cardiovascular death (RR = 1.19,
95% CI 1.14-1.23, p < 0.00001) and higher risk for short-term mortality
(RR = 0.43, 95% CI 0.38-0.48, p < 0.00001). There was no statistically
significant difference between the PCI and CABG groups in the risk for
late mortality (RR = 1.05, 95% CI 0.97-1.14, p = 0.25), myocardial
infarction (RR = 1.05, 95% CI 0.46-2.36, p = 0.91) or stroke (RR = 1.02,
95% CI 0.64-1.61, p = 0.95). This meta-analysis showed that in ESKD
patients requiring dialysis, CABG was superior to PCI in regard to
cardiovascular death and need for repeat revascularization and inferior to
PCI in regard to short term mortality. However, this meta-analysis has
limitations and needs confirmation with large randomized controlled
trials.<br/>Copyright &#xa9; 2021 International Society for Hemodialysis.

<83>
Accession Number
2012310704
Title
Evaluation of respiratory and peripheral muscle training in individuals
undergoing myocardial revascularization.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
de Aquino T.N.; de Faria Rosseto S.; Lucio Vaz J.; de Faria Cordeiro Alves
C.; Vidigal F.D.C.; Galdino G.
Institution
(de Aquino, de Faria Rosseto, Lucio Vaz, Galdino) Department of Motricity
Sciences, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
(de Aquino, de Faria Rosseto, Lucio Vaz, de Faria Cordeiro Alves)
Department of Rehabilitation and Cardiology of Hospital Santa Lucia, Pocos
de Caldas, Minas Gerais, Brazil
(Vidigal) Department of Nutrition, Federal University of Alfenas, Alfenas,
Minas Gerais, Brazil
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: To investigate the effect of peripheral muscle strength
training (PMT) and respiratory muscle strength training (RMT) muscle
strength training associated with conventional physical therapy on the
respiratory muscle strength, functional capacity, and quality of life in
the immediate postoperative period of patients undergoing coronary artery
bypass graft (CABG). <br/>Method(s): This was a randomized controlled
trial. Eighty-three patients undergoing CABG were divided into two groups:
Intervention group, patients that received PMT and RMT associated with
conventional physical therapy, one session a day for 5 days; control
group, patients that received conventional physical therapy, one session a
day for 5 days. All patients had respiratory muscle strength, peripheral
muscle strength, functional capacity, and quality of life evaluated by
manovacuometry, dynamometry, 6-min walking test, and 36-item Short-Form
Health Survey Questionnaire, respectively, before and 5 days after CABG.
<br/>Result(s): Both groups showed a significantly reduced respiratory
muscle strength after CABG; however, in the intervention group, the
inspiratory muscle strength reduction was lower (confidence interval [CI]
95%: 2.29 [1.9; 27.54]). The quality of live domains for pain (CI 95%:
3.08 [5.21; 24.97]) and vitality perception (CI 95%: 2.51 [2.12; 19.53])
worsened in the control and improved in the intervention group (pain: CI
95%: 1.19 [-3.38; 13.09]; vitality CI 95%: 0.07 [-6.55; 7.04]). Both
groups showed reduced functional capacity and expiratory muscle strength
after CABG. <br/>Conclusion(s): Conventional physical therapy combined
with PMT and RMT may reduce inspiratory muscle strength loss and improve
pain and vitality perception in the immediate postoperative period after
CABG.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<84>
Accession Number
2011874895
Title
Study protocol for DICE trial: Video-assisted thoracoscopic surgery
decortication versus interventional radiology guided chest tube insertion
for the management of empyema.
Source
Contemporary Clinical Trials Communications. 22 (no pagination), 2021.
Article Number: 100777. Date of Publication: June 2021.
Author
Williams E.; Hanna N.; Menard A.; Mussari B.; Nasirzadeh R.; Tarulli E.;
Dhillon G.R.; Reid K.; Petsikas D.; Pereira J.; Heffernan P.; Chung W.
Institution
(Williams, Hanna, Reid, Petsikas, Pereira, Chung) Division of Thoracic
Surgery, Department of Surgery, Queen's University, 76 Stuart Street,
Kingston, ON K7L 2V7, Canada
(Menard, Mussari, Nasirzadeh, Tarulli, Dhillon) Division of Interventional
Radiology, Department of Radiology, Queen's University, 76 Stuart Street,
Kingston, ON K7L 2V7, Canada
(Heffernan) Division of Respirology, Department of Medicine, Queen's
University, 76 Stuart Street, Kingston, ON K7L 2V7, Canada
Publisher
Elsevier Inc.
Abstract
Background: Empyema is a common thoracic surgery presentation, defined as
pus in the pleural space. Despite the commonality of empyema, consensus on
initial management remains ambiguous. Two standard of care treatment
options include inserting a chest tube (thoracostomy) and the
administration of intrapleural fibrinolytics, or an initial surgical
approach, surgical decortication. Due to the complexity of this pleural
space infection, often repeat interventions are required after initial
management in order to achieve source control and resolution of clinical
symptoms. This study aims to identify the most effective initial
management option for empyema. Study design: We present a study protocol
for a randomized control trial (RCT) comparing adult individuals with
empyema to one of two standard of care initial management options.
Participants will be randomized into either interventional radiology
guided chest tube insertion with intrapleural fibrinolytics (Dornase 5 mg
and Alteplase 10 mg intrapleural twice daily for three days) or
video-assisted thoracoscopic surgery (VATS) decortication. <br/>Method(s):
All adults with empyema meeting inclusion criteria will be invited to
participate. They will be randomized into one of two intervention groups;
interventional radiology guided chest tube insertion with fibrinolytics or
initial VATS decortication. Each intervention will take place within 48
hours of randomization. The primary outcome will be the rate of
re-intervention within 30 days. Re-intervention is defined as repeat chest
tube insertion, VATS decortication, or decortication via thoracotomy.
Secondary outcomes include a change in the size of empyema, length of
stay, morbidity, as well as 30-day and 90-day mortality, as well as
quality of life measurements. Anticipated impact: This study is aimed at
identifying the most effective initial management option for individuals
with empyema.<br/>Copyright &#xa9; 2021

<85>
Accession Number
2011545503
Title
Recognizing Cutibacterium acnes as a cause of infectious pericarditis: A
case report and review of literature.
Source
Anaerobe. 69 (no pagination), 2021. Article Number: 102359. Date of
Publication: June 2021.
Author
Li-Geng T.; Geraci T.C.; Narula N.; Zervou F.N.; Prasad P.J.; Decano A.G.;
Sterling S.; Zacharioudakis I.M.
Institution
(Li-Geng, Prasad, Decano, Sterling, Zacharioudakis) Department of
Medicine, NYU Langone Health, New York, NY, United States
(Geraci) Department of Cardiothoracic Surgery, NYU Langone Health, New
York, NY, United States
(Narula) Department of Pathology, NYU Langone Health, New York, NY, United
States
(Zervou, Prasad, Decano, Sterling, Zacharioudakis) Division of Infectious
Disease and Immunology, NYU Langone Health, New York, NY, United States
Publisher
Academic Press
Abstract
Cutibacterium acnes is an anaerobic bacterium commonly thought of as a
culture contaminant rather than a pathogen. We present a case of
Cutibacterium acnes pericarditis in a 22-year-old immunocompetent woman
managed with surgical pericardial window and a 4-week course of penicillin
G and review related literature on Cutibacterium acnes
pericarditis.<br/>Copyright &#xa9; 2021 Elsevier Ltd

<86>
Accession Number
2011261994
Title
Effects of comprehensive geriatric care models on postoperative outcomes
in geriatric surgical patients: a systematic review and meta-analysis.
Source
BMC Anesthesiology. 21 (1) (no pagination), 2021. Article Number: 127.
Date of Publication: December 2021.
Author
Saripella A.; Wasef S.; Nagappa M.; Riazi S.; Englesakis M.; Wong J.;
Chung F.
Institution
(Saripella, Wasef, Riazi, Wong, Chung) Department of Anesthesia and Pain
Medicine, Toronto Western Hospital, University Health Network, University
of Toronto, MCL 2-405, 399 Bathurst St, Toronto, ON M5T2S8, Canada
(Nagappa) Department of Anesthesia and Perioperative Medicine, London
Health Sciences Centre and St. Joseph Health Care, Schulich School of
Medicine & Dentistry, Western University, London, ON, Canada
(Englesakis) Library and Information Services, University Health Network,
Toronto, ON, Canada
(Wong) Department of Anesthesia and Pain Management, Women's College
Hospital, University of Toronto, Toronto, ON, Canada
Publisher
BioMed Central Ltd
Abstract
Background: The elderly population is highly susceptible to develop
post-operative complications after major surgeries. It is not clear
whether the comprehensive geriatric care models are effective in reducing
adverse events. The objective of this systematic review and meta-analysis
is to determine whether the comprehensive geriatric care models improved
clinical outcomes, particularly in decreasing the prevalence of delirium
and length of hospital stay (LOS) in elderly surgical patients.
<br/>Method(s): We searched Medline, PubMed, Embase, Cochrane Central
Register of Controlled Trials, Cochrane Database of Systematic Reviews,
Emcare Nursing, Web of Science, Scopus, CINAHL, ClinicalTrials. Gov, and
ICTRP between 2009 to January 23, 2020. We included studies on geriatric
care models in elderly patients (>=60 years) undergoing elective,
non-cardiac high-risk surgery. The outcomes were the prevalence of
delirium, LOS, rates of 30-days readmission, and 30-days mortality. We
used the Cochrane Review Manager Version 5.3. to estimate the pooled Odds
Ratio (OR) and Mean Difference (MD) using random effect model analysis.
<br/>Result(s): Eleven studies were included with 2672 patients
[Randomized Controlled Trials (RCTs): 4; Non-Randomized Controlled Trials
(Non-RCTs): 7]. Data pooled from six studies showed that there was no
significant difference in the prevalence of delirium between the
intervention and control groups: 13.8% vs 15.9% (OR: 0.76; 95% CI:
0.30-1.96; p = 0.57). Similarly, there were no significant differences in
the LOS (MD: -0.55; 95% CI: - 2.28, 1.18; p = 0.53), 30-day readmission
(12.1% vs. 14.3%; OR: 1.09; 95% CI: 0.67-1.77; p = 0.73), and 30-day
mortality (3.2% vs. 2.1%; OR: 1.34; 95% CI: 0.66-2.69; p = 0.42). The
quality of evidence was very low. <br/>Conclusion(s): The geriatric care
models involved pre-operative comprehensive geriatric assessment, and
intervention tools to address cognition, frailty, and functional status.
In non-cardiac high-risk surgeries, these care models did not show any
significant difference in the prevalence of delirium, LOS, 30-days
readmission rates, and 30-day mortality in geriatric patients. Further
RCTs are warranted to evaluate these models on the postoperative outcomes.
Trial registration: PROSPERO registration number -
CRD42020181779.<br/>Copyright &#xa9; 2021, The Author(s).

<87>
Accession Number
2011842516
Title
Clinical outcomes of complete versus incomplete revascularization in
patients treated with coronary artery bypass grafting: Insights from the
TiCAB trial.
Source
European Journal of Cardio-thoracic Surgery. 59 (2) (pp 417-425), 2021.
Date of Publication: 01 Feb 2021.
Author
Schaefer A.; Conradi L.; Schneeberger Y.; Reichenspurner H.; Sandner S.;
Tebbe U.; Nowak B.; Stritzke J.; Kastrati A.; Schunkert H.; Scheidt M.V.
Institution
(Schaefer, Conradi, Schneeberger, Reichenspurner) Department of
Cardiovascular Surgery, University Heart and Vascular Center Hamburg,
Hamburg, Germany
(Sandner) Division of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Tebbe) Department of Cardiology, Angiology, and Intensive Care Medicine,
District Hospital Lippe-Detmold, Detmold, Germany
(Nowak) CCB, Cardiovascular Center Bethanien, Frankfurt am Main, Germany
(Stritzke) Lanserhof Sylt, Marienstein Privatklinik, List, Germany
(Kastrati, Schunkert, Scheidt) Department of Cardiology, Deutsches
Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany
(Kastrati, Schunkert, Scheidt) DZHK (German Center for Cardiovascular
Research), Partner Site Munich Heart Alliance, Munich, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: In this post hoc analysis of the Ticagrelor in coronary artery
bypass grafting (CABG) trial, we aimed to analyse patients treated with
CABG receiving either complete revascularization (CR) or incomplete
revascularization (ICR) independent from random allocation to either
ticagrelor or aspirin. <br/>Method(s): Of 1859 patients enrolled in the
Ticagrelor in CABG trial, 1550 patients (83.4%) received CR and 309
patients (16.6%) ICR. Outcomes were evaluated regarding all-cause
mortality, cardiovascular death, myocardial infarction (MI), repeat
revascularization, stroke and bleeding within 12 months after CABG.
<br/>Result(s): Baseline parameters revealed significant differences
regarding clinical presentation (stable angina pectoris: CR 68.9% vs ICR
71.2%, instable angina pectoris: 14.1% vs 7.8%, non-ST elevation MI: 17.0%
vs 21.0%, P <= 0.01), lesion characteristics (chronic total occlusion: CR
91.3% vs ICR 96.8%, P <= 0.01), operative technique [off-pump coronary
artery bypass surgery (OPCAB): CR 3.0% vs ICR 6.1%, P <= 0.01] and number
of utilized grafts (total number of grafts: 2.69/patient vs 2.49/patient,
P <= 0.001). ICR patients displayed a significantly increased risk of
repeat revascularization [hazard ratio (HR) 1.91, 95% confidence interval
(CI) 1.16-3.16; P < 0.01] and percutaneous coronary intervention (HR 1.95,
95% CI 1.13-3.35; P < 0.05) within 12 months after CABG. Higher risk for
repeat revascularization in ICR patients was independent from random
allocation to either ticagrelor or aspirin and persisted after adjustment
for baseline imbalances. <br/>Conclusion(s): Patients with ICR presented
more stable at the time of admission, but received less grafts, highly
likely due to a higher rate of chronic total occlusion lesions and
performed OPCAB. Although mortality presented no difference between
groups, our results suggest that patients benefit from CR with regard to
prevention of repeat revascularization. <br/>Copyright &#xa9; 2020 The
Author(s).

<88>
Accession Number
2011842499
Title
Treatment strategies in ischaemic left ventricular dysfunction: A network
meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 59 (2) (pp 293-301), 2021.
Date of Publication: 01 Feb 2021.
Author
Gaudino M.; Hameed I.; Khan F.M.; Tam D.Y.; Rahouma M.; Yongle R.; Naik
A.; Di Franco A.; Demetres M.; Petrie M.C.; Jolicoeur E.M.; Girardi L.N.;
Fremes S.E.
Institution
(Gaudino, Hameed, Khan, Rahouma, Yongle, Naik, Di Franco, Girardi)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York,
NY, United States
(Tam, Fremes) Schulich Heart Centre, Sunnybrook Health Science University
of Toronto, Toronto, ON, Canada
(Demetres) Samuel J. Wood Library, C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
(Petrie) Institute of Cardiovascular and Medical Sciences, British Heart
Foundation Glasgow Cardiovascular Research Centre, University of Glasgow,
Glasgow, United Kingdom
(Jolicoeur) Montreal Heart Institute, Montreal, QC, Canada
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: The optimal revascularization strategy for patients with
ischaemic left ventricular systolic dysfunction (iLVSD) remains
controversial. We aimed to compare percutaneous coronary intervention
(PCI), coronary artery bypass grafting (CABG) and medical therapy (MT) in
a network meta-analysis. <br/>Method(s): All randomized controlled trials
and observational studies comparing any combination of PCI, CABG and MT in
patients with iLVSD were analysed in a frequentist network meta-analysis
(generic inverse variance method). Primary outcome was mortality at
longest available follow-up. Secondary outcomes were cardiac death,
stroke, myocardial infarction (MI) and repeat revascularization (RR).
<br/>Result(s): Twenty-three studies were included (n = 23 633; 4
randomized controlled trials). Compared to CABG, PCI was associated with
higher mortality [incidence rate ratio (IRR) 1.32, 95% confidence interval
(CI) 1.13-1.53], cardiac death (IRR 1.65, 95% CI 1.18-2.33), MI (IRR 2.18,
95% CI 1.70-2.80) and RR (IRR 3.75, 95% CI 2.89-4.85). Compared to CABG,
MT was associated with higher mortality (IRR 1.52, 95% CI 1.26-1.84),
cardiac death (IRR 3.83, 95% CI 2.12-6.91), MI (IRR 3.22, 95% CI
1.52-6.79) and RR (IRR 3.37, 95% CI 1.67-6.79). Compared to MT, PCI was
associated with lower cardiac death (IRR 0.43, 95% CI 0.24-0.78). CABG
ranked as the best revascularization strategy for mortality, cardiac
death, MI and RR; MT ranked as the strategy associated with the lowest
incidence of stroke. Left ventricular ejection fraction, year of study,
use of drug-eluting stents did not affect relative treatment effects.
<br/>Conclusion(s): CABG appears to be the best therapy for iLVSD,
although mainly based on observational data. Definitive randomized
controlled trials comparing CABG and PCI in iLVSD are required.
<br/>Copyright &#xa9; 2020 The Author(s).

<89>
Accession Number
2011247284
Title
Immune checkpoint inhibitors-associated pericardial disease: a systematic
review of case reports.
Source
Cancer Immunology, Immunotherapy. (no pagination), 2021. Date of
Publication: 2021.
Author
Inno A.; Maurea N.; Metro G.; Carbone A.; Russo A.; Gori S.
Institution
(Inno, Gori) Oncologia Medica, IRCCS Ospedale Sacro Cuore Don Calabria,
Via don A. Sempreboni 5, Negrar di Valpolicella, Verona 37024, Italy
(Maurea, Carbone) Divisione di Cardiologia, IRCCS Fondazione G. Pascale,
Napoli, Italy
(Metro) Oncologia Medica, Ospedale Santa Maria della Misericordia, Azienda
Ospedaliera Di Perugia, Perugia, Italy
(Russo) Oncologia Medica, Dipartimento di Discipline Chirurgiche,
Oncologiche E Stomatologiche, Policlinico Universitario "A. Giaccone",
Palermo, Italy
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Treatment with immune checkpoint inhibitors (ICIs) can be complicated by
cardiovascular toxicity, including pericardial disease. To date, no
prospective studies specifically investigated the optimal treatment of
ICI-associated pericardial disease, and the available evidence is based on
case reports and series only. We performed a systematic review of case
reports and series including 20 publications for a total of 28 cases of
ICI-associated pericardial disease. In this review, pericardial disease
was reversible in the majority of cases (75%), although 2 deaths were
reported. The majority of cases were life-threatening (G4, 53.6%) or
severe (G3, 21.4%), requiring pericardiocentesis. Higher rates of
improvement were associated with administration of corticosteroids (86.7%
vs 61.5%), presence of other immune-related adverse events (90.9% vs.
64.7%), and non-malignant effusions (86.7% vs 42.8%). ICIs were
discontinued in the majority of cases and then restarted in 7 patients
with no recurrence of pericardial disease. Based on these results,
ICI-associated G3-G4 pericardial disease as well as G2 pericardial disease
with moderate-severe effusion should be treated with ICIs discontinuation
and high-dose steroids, also performing pericardiocentesis, pericardial
drainage or pericardial window in case of cardiac tamponade. For G2 with
small effusion or G1 pericardial disease, ICIs might be continued and
colchicine or NSAIDs could be considered. For patients requiring ICIs
discontinuation, a rechallenge with ICIs seems to be feasible after
resolution or meaningful improvement of pericardial disease.<br/>Copyright
&#xa9; 2021, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<90>
Accession Number
608827565
Title
Staphylococcus aureus infections after elective cardiothoracic surgery:
Observations from an international randomized placebo-controlled trial of
an investigational S aureus vaccine.
Source
Open Forum Infectious Diseases. 1 (2) (no pagination), 2014. Date of
Publication: 01 Sep 2014.
Author
Allen K.B.; Fowler V.G.; Gammie J.S.; Hartzel J.S.; Onorato M.T.; DiNubile
M.J.; Sobanjo-ter Meulen A.
Institution
(Allen) St. Luke's Mid-America Heart and Vascular Institute, Kansas City,
MO, United States
(Fowler) Duke University Medical Center, Durham, NC, United States
(Gammie) University of Maryland School of Medicine, Baltimore, United
States
(Hartzel, Onorato, DiNubile, Sobanjo-ter Meulen) Merck Sharp and Dohme,
Whitehouse Station, NJ, United States
(Sobanjo-ter Meulen) The Bill and Melinda Gates Foundation, New York, NY,
United States
Publisher
Oxford University Press
Abstract
Background. An unmet need to prevent Staphylococcus aureus (SA) infections
after cardiothoracic surgery persists despite current practices.
Cost-effective implementation of preventive strategies requires
contemporary knowledge about modifiable risk factors. Methods. From 2007
to 2011, an international, double-blind, randomized placebo-controlled
trial of a novel SA vaccine (V710) was conducted in 7664 adults scheduled
for median sternotomy at 164 sites. We analyzed SA infections developing
up to 360 days postoperatively in 3832 placebo recipients. Results.
Coronary artery bypass grafting was performed in 80.8% (3096 of 3832) of
placebo recipients. The overall incidence of any postoperative SA
infection was 3.1% (120 of 3832). Invasive SA infections (including
bacteremia and deep sternal-wound infections) developed in 1.0%.
Methicillin-resistant SA (MRSA) accounted for 19% (23 of 120) of SA
infections, with 57% (13 of 23) of the MRSA infections occurring in
diabetic patients. All-cause mortality was 4.1% (153 of 3712) in patients
without SA infection, 7.2% (7 of 97) in methicillin-susceptible SA (MSSA)
infections, and 17.3% (4 of 23) in MRSA infections (P < .01).
Staphylococcus aureus nasal carriage was detected preoperatively in 18.3%
(701 of 3096) patients, including 1.6% colonized with MRSA. Postoperative
SA infections occurred in 7.0% (49 of 701) of colonized patients versus
2.3% (71 of 3131) of patients without colonization (relative risk = 3.1
[95% confidence interval, 2.2-4.4]). Conclusions. In this large
international cohort of patients undergoing cardiac surgery and observed
prospectively, invasive postoperative SA infections occurred in 1% of
adult patients despite modern perioperative management. The attributable
mortality rates were 3% for MSSA and 13% for MRSA infections. Preoperative
nasal colonization with SA increased the risk of postoperative infection
threefold. The utility of strategies to reduce this incidence warrants
continued investigation.<br/>Copyright &#xa9; The Author 2014.

<91>
Accession Number
2008467210
Title
Prognostic markers in patients undergoing transcatheter implantation of
Venus P-valve: Experience in Taiwan.
Source
Journal of the Formosan Medical Association. 120 (5) (pp 1202-1211), 2021.
Date of Publication: May 2021.
Author
Lin M.-T.; Chen C.-A.; Chen S.-J.; Chiu S.-N.; Lu C.-W.; Wu M.-H.; Wang
J.-K.
Institution
(Lin, Chen, Chiu, Lu, Wu, Wang) Department of Pediatrics, National Taiwan
University Hospital and Medical College, National Taiwan University,
Taipei, Taiwan (Republic of China)
(Chen) Department of Radiology, National Taiwan University Hospital and
Medical College, National Taiwan University, Taipei, Taiwan (Republic of
China)
Publisher
Elsevier B.V.
Abstract
Background/purpose: Prognostic factors remain unclear in patients
undergoing transcatheter implantation of Venus P-valve for their severe
pulmonary regurgitation associated with native right ventricular (RV)
outflow tract. <br/>Method(s): Between January 2017 and October 2018, we
prospectively collected data of patient characteristics, cardiac magnetic
resonance imaging, cardiopulmonary exercise testing, and levels of
N-terminal pro-B-type natriuretic peptide (NT-proBNP) before and 6-12
months after valve graft implantation. <br/>Result(s): Fifteen patients
(male: 8, median age: 24.8 years) were enrolled. The procedure success
rate was 100%. The median follow-up was 16.3 months without any
dysfunction of the valve graft. The cohort demonstrated a significant
improvement in cardiac index (from 3.3 to 3.9 L/min/m²) and
increase of percentage of New York Heart Association functional class I (P
< 10^-3), reduction in RV end-diastolic volume index (P =
0.008), and reductions in NT-proBNP levels (from 78.9 to 45.8 pg/mL, P =
0.040). However, the peak oxygen consumption (VO<inf>2</inf>) dropped from
50.2% to 48.5% of the predicted value. Interestingly, we determined that
patients with NT-proBNP levels below 70 pg/mL and left ventricular
end-diastolic pressure (LVEDP) below 11 mmHg had a significantly higher
chance of exhibiting improvement in peak VO<inf>2</inf> compared with
those without (3/4 vs 1/10, P = 0.041). <br/>Conclusion(s): In the small
cohort with severe pulmonary regurgitation, implantation of a Venus
P-valve led to promising reductions in RV volume. However, no definite
improvement in cardiopulmonary exercise capacity or RV ejection fraction
was achieved. Levels of NT-proBNP and LVEDP may be helpful for refining
the indications of the Venus P-valve implantation.<br/>Copyright &#xa9;
2020 Formosan Medical Association

<92>
Accession Number
635130631
Title
Laminopathies' Treatments Systematic Review: A Contribution towards a
'Treatabolome'.
Source
Journal of Neuromuscular Diseases. 8 (3) (pp 419-439), 2021. Date of
Publication: 2021.
Author
Atalaia A.; Ben Yaou R.; Wahbi K.; De Sandre-Giovannoli A.; Vigouroux C.;
Bonne G.
Institution
(Atalaia, Ben Yaou, Bonne) Sorbonne Universite, Inserm, Center of Research
in Myology, G.H. Pitie-Salpetriere, Paris, France
(Ben Yaou) AP-HP Sorbonne Universite, Neuromyology Department, Centre de
Reference Maladies Neuromusculaires Nord/Est/Ile-de-France (FILNEMUS
Network), Institut de Myologie, G.H. Pitie-Salpetriere, Paris, France
(Wahbi) Aphp, Cochin Hospital, Cardiol. Dept., FILNEMUS, Ctr. de Ref. de
Pathol. Neuromusculaire Nord/Est/Ile de France, Univ. de Paris, Paris,
France
(De Sandre-Giovannoli) AP-HM, Department of Medical Genetics, CRB-TAC (CRB
AP-HM), Children's Hospital la Timone, Marseille, France
(De Sandre-Giovannoli) Aix Marseille University, Inserm, Marseille Medical
Genetics, Marseille, France
(Vigouroux) AP-HP Saint-Antoine Hospital, Reference Centre of Rare
Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS),
Departments of Molecular Biology and Genetics and of Endocrinology, Paris
75012, France
(Vigouroux) Sorbonne Universite, Inserm, Saint-Antoine Research Center,
Paris, France
Publisher
IOS Press BV
Abstract
Background: Variants in the LMNA gene, encoding lamins A/C, are
responsible for a growing number of diseases, all of which complying with
the definition of rare diseases. LMNA-related disorders have a varied
phenotypic expression with more than 15 syndromes described, belonging to
five phenotypic groups: Muscular Dystrophies, Neuropathies,
Cardiomyopathies, Lipodystrophies and Progeroid Syndromes. Overlapping
phenotypes are also reported. Linking gene and variants with phenotypic
expression, disease mechanisms, and corresponding treatments is
particularly challenging in laminopathies. Treatment recommendations are
limited, and very few are variant-based. <br/>Objective(s): The
Treatabolome initiative aims to provide a shareable dataset of existing
variant-specific treatment for rare diseases within the Solve-RD EU
project. As part of this project, we gathered evidence of specific
treatments for laminopathies via a systematic literature review adopting
the FAIR (Findable, Accessible, Interoperable, and Reusable) guidelines
for scientific data production. <br/>Method(s): Treatments for
LMNA-related conditions were systematically collected from MEDLINE and
Embase bibliographic databases and clinical trial registries (Cochrane
Central Registry of Controlled Trials, clinicaltrial.gov and EudraCT). Two
investigators extracted and analyzed the literature data independently.
The included papers were assessed using the Oxford Centre for
Evidence-Based Medicine 2011 Levels of Evidence. <br/>Result(s): From the
4783 selected articles by a systematic approach, we identified 78 papers
for our final analysis that corresponded to the profile of data defined in
the inclusion and exclusion criteria. These papers include 2
guidelines/consensus papers, 4 meta-analyses, 14 single-arm trials, 15
case series, 13 cohort studies, 21 case reports, 8 expert reviews and 1
expert opinion. The treatments were summarized electronically according to
significant phenome-genome associations. The specificity of treatments
according to the different laminopathic phenotypical presentations is
variable. <br/>Conclusion(s): We have extracted Treatabolome-worthy
treatment recommendations for patients with different forms of
laminopathies based on significant phenome-genome parings. This dataset
will be available on the Treatabolome website and, through
interoperability, on genetic diagnosis and treatment support tools like
the RD-Connect's Genome Phenome Analysis Platform.<br/>Copyright &#xa9;
2021-The authors. Published by IOS Press.

<93>
Accession Number
634990065
Title
A systematic review of the evidence supporting post-operative diuretic use
following cardiopulmonary bypass in children with Congenital Heart
Disease.
Source
Cardiology in the Young. 31 (5) (pp 699-706), 2021. Date of Publication:
May 2021.
Author
Foote H.P.; Hornik C.P.; Hill K.D.; Rotta A.T.; Chamberlain R.; Thompson
E.J.
Institution
(Foote, Hornik, Hill, Rotta, Chamberlain, Thompson) Department of
Pediatrics, Duke University School of Medicine, Durham, NC, United States
(Hornik, Hill) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, NC, United States
Publisher
Cambridge University Press
Abstract
Background: Paediatric cardiac surgery on cardiopulmonary bypass induces
substantial physiologic changes that contribute to post-operative
morbidity and mortality. Fluid overload and oedema are prevalent
complications, routinely treated with diuretics. The optimal diuretic
choice, timing of initiation, dose, and interval remain largely unknown.
<br/>Method(s): To guide clinical practice and future studies, we used
PubMed and EMBASE to systematically review the existing literature of
clinical trials involving diuretics following cardiac surgery from 2000 to
2020 in children aged 0-18 years. Studies were assessed by two reviewers
to ensure that they met eligibility criteria. <br/>Result(s): We
identified nine studies of 430 children across four medication classes.
Five studies were retrospective, and four were prospective, two of which
included randomisation. All were single centre. There were five primary
endpoints - urine output, acute kidney injury, fluid balance, change in
serum bicarbonate level, and required dose of diuretic. Included studies
showed early post-operative diuretic resistance, suggesting higher initial
doses. Two studies of ethacrynic acid showed increased urine output and
lower diuretic requirement compared to furosemide. Children receiving
peritoneal dialysis were less likely to develop fluid overload than those
receiving furosemide. Chlorothiazide, acetazolamide, and tolvaptan
demonstrated potential benefit as adjuncts to traditional diuretic
regimens. <br/>Conclusion(s): Early diuretic resistance is seen in
children following cardiopulmonary bypass. Ethacrynic acid appears
superior to furosemide. Adjunct diuretic therapies may provide additional
benefit. Study populations were heterogeneous and endpoints varied.
Standardised, validated endpoints and pragmatic trial designs may allow
investigators to determine the optimal diuretic, timing of initiation,
dose, and interval to improve post-operative outcomes.<br/>Copyright
&#xa9; 2021 Cambridge University Press. All rights reserved.

<94>
Accession Number
634826093
Title
A systematic review of the evidence supporting post-operative medication
use in congenital heart disease.
Source
Cardiology in the Young. 31 (5) (pp 707-733), 2021. Date of Publication:
May 2021.
Author
Thompson E.J.; Foote H.P.; King C.E.; 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
(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- and 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; 2021 Cambridge University Press. All rights
reserved.

<95>
Accession Number
634304153
Title
Advances in the Management of Acute Venous Thromboembolism and New
Therapeutic Agents.
Source
Seminars in Respiratory and Critical Care Medicine. 42 (2) (pp 218-232),
2021. Date of Publication: 01 Apr 2021.
Author
Stevens H.; McFadyen J.; Chan N.
Institution
(Stevens, McFadyen) Atherothrombosis and Vascular Biology Program, Baker
Heart and Diabetes Institute, Melbourne, VIC, Australia
(Stevens, McFadyen) Australian Centre for Blood Diseases, Monash
University, Melbourne, VIC, Australia
(Stevens, McFadyen) Department of Clinical Haematology, Alfred Hospital,
Melbourne, VIC, Australia
(Chan) Thrombosis and Atherosclerosis Research Institute, 20 Copeland
Avenue, Hamilton, ON L8L 2X2, Canada
Publisher
Thieme Medical Publishers, Inc.
Abstract
Important advances in the understanding and management of venous
thromboembolism (VTE) have enhanced our ability to diagnose, prevent, and
treat VTE. In this narrative review, we discuss how recent advances in the
understanding and management of VTE are changing practice, highlight
ongoing unmet needs in VTE management, and outline how novel therapeutic
targets with little or no influence on hemostasis may help address these
unmet needs.<br/>Copyright &#xa9; 2021 Georg Thieme Verlag. All rights
reserved.

<96>
Accession Number
633756788
Title
Ventricular septal defect: Diagnosis and treatments in the neonates: A
systematic review.
Source
Cardiology in the Young. 31 (5) (pp 756-761), 2021. Date of Publication:
May 2021.
Author
Eleyan L.; Zaidi M.; Ashry A.; Dhannapuneni R.; Harky A.
Institution
(Eleyan, Harky) School of Medicine, Faculty of Health and Life Sciences,
University of Liverpool, Liverpool L69 3GE, United Kingdom
(Zaidi) Charing Cross Hospital, Imperial Healthcare NHS Trust, London,
United Kingdom
(Ashry, Dhannapuneni, Harky) Department of Congenital Cardiac Surgery,
Alder Hey Children Hospital, Liverpool, United Kingdom
(Ashry) Department of Cardiothoracic Surgery, Assiut University Hospital,
Assiut, Egypt
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool L14 3PE, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
Publisher
Cambridge University Press
Abstract
Background: Medical advancements have encouraged minimally invasive
surgical repair of congenital heart defects such as ventricular septal
defects (VSDs), and the diagnostic process can now be carried out using
non-traditional techniques such as pulse oximetry. This, in turn, has
improved clinical outcomes with reduced complication rates post-surgery.
However, the variations in type of VSDs, age of patient, comorbidities,
and access to closure devices may limit the efficacy of surgical
advancements. <br/>Method(s): Articles were identified amongst Scopus,
MEDLINE, and PubMed using various relevant search strings using PRISMA
guidelines. Of the 115 articles initially extracted, 10 were eventually
reviewed after duplicates and irrelevant studies were removed.
<br/>Result(s): Of the 24 eligible articles, 10 papers were selected for
analysis. Minimally invasive approaches to VSD repair was associated with
satisfactory short-term outcomes when compared to open repair. For
diagnosis of congenital VSD, whilst recent advances such as pulse oximetry
method and genome analysis are more sensitive, the limited availability
and access to such investigatory methods must be recognised.
<br/>Conclusion(s): Pulse oximetry and fetal echocardiography are
established non-invasive diagnostic tools for VSD. The recent advances in
minimally invasive treatment options including periventricular approach
and transcatheter techniques have improved patient outcomes, yet at the
expense of higher residual rates. Careful patient selection for each
technique and follow-up should be planned through multidisciplinary team
meetings.<br/>Copyright &#xa9; 2021 Cambridge University Press. All rights
reserved.

<97>
Accession Number
2006871952
Title
Association between intra-hospital uncontrolled glycemia and health
outcomes in patients with diabetes: A systematic review of observational
studies.
Source
Current Diabetes Reviews. 17 (3) (pp 304-316), 2021. Date of Publication:
2021.
Author
Carvalho R.C.; Nishi F.A.; Ribeiro T.B.; Franca G.G.; Aguiar P.M.
Institution
(Carvalho, Franca) Division of Pharmacy of University Hospital, University
of Sao Paulo, Sao Paulo, Brazil
(Carvalho, Nishi) Department of Nursing of University Hospital, University
of Sao Paulo, Sao Paulo, Brazil
(Ribeiro) Department of Preventive Medicine, Faculty of Medicine,
University of Sao Paulo, Sao Paulo, Brazil
(Aguiar) Department of Pharmacy, Faculty of Pharmaceutical Sciences,
University of Sao Paulo, Sao Paulo, Brazil
Publisher
Bentham Science Publishers
Abstract
Background: Many people are still getting affected by uncontrolled
glycemic events during hospital admission, which encompasses hypoglycemia,
hyperglycemia, and high glycemic variability. Introduction: Primary
studies have shown an association of glycemic dysregulation with increased
length of hospital stay and mortality among overall patients, however,
there is no systematic review of current evidence on the association
between uncontrolled in-hospital glycemia in patients with diabetes and
health outcomes. This study aimed to systematically review the current
evidence on the association between uncontrolled in-hospital glycemia in
patients with diabetes and health outcomes. <br/>Method(s): The
association between glycemic dysregulation and health outcomes for
inpatients with diabetes was systematically reviewed. PubMed, Embase, and
LILACS databases were searched. Two independent reviewers were involved in
each of the following steps: screening titles, abstracts, and fulltexts;
assessing the methodological quality; and extracting data from included
reviews. Descriptive analysis method was used. <br/>Result(s): Seven
cohort studies were included, and only two had a prospective design,
consisting of 7,174 hospitalized patients with diabetes. In-hospital
occurrence of hypoglycemia, hyperglycemia, and glycemic variability were
assessed, and outcomes were mortality, infections, renal complications,
and adverse events. Among the exposure and outcomes, an association was
observed between severe hypoglycemia and mortality, hyperglycemia and
infection, and hyperglycemia and adverse events. <br/>Conclusion(s):
In-hospital uncontrolled glycemia in patients with diabetes is associated
with poor health outcomes. More studies should be conducted for proper
investigation because diabetes is a complex condition. Effects of glycemic
dysregulation should be investigated on the basis of overall health of a
patient instead from only organ-target perspective, which makes the
investigation difficult.<br/>Copyright &#xa9; 2021 Bentham Science
Publishers.

<98>
Accession Number
2010980700
Title
Bilateral continuous erector spinae block versus multimodal intravenous
analgesia in coronary bypass surgery. A Randomized Trial.
Source
Egyptian Journal of Anaesthesia. 37 (1) (pp 152-158), 2021. Date of
Publication: 2021.
Author
Wasfy S.F.; Kamhawy G.A.; Omar A.H.; Abd El Aziz H.F.
Institution
(Wasfy, Abd El Aziz) Lecturer of Anesthesia, Faculty of Medicine, Ain
Shams University, Cairo, Egypt
(Kamhawy) Faculty of Medicine, Suez Canal University, Ismailia, Egypt
(Omar) Faculty of Medicine, Ain Shams University, Cairo, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Multiple studies have confirmed that erector spinae block is effective in
thoracic and breast surgeries. However, studies which investigate the
efficacy of this block in cardiac surgery are scarce. This study aimed to
compare continuous erector spinae block with multimodal intravenous
analgesia in coronary bypass surgery. <br/>Method(s): Forty patients
undergoing coronary bypass surgery were divided into either group A (IV)
(n = 20) who received multimodal intravenous analgesia or group B (ES) (n
= 20) who had continuous erector spinae block. We compared the two groups
regarding Visual Analog Scale (VAS) till 48 h after extubation, total
perioperative opioid consumption, post-extubation peak inspiratory flow,
duration of mechanical ventilation and ICU stay. <br/>Result(s): Group B
showed a significantly lower VAS score than group A. intraoperative
fentanyl was significantly less in group B (403.75 +/- 44.63) versus (685
+/- 99.47) in group A, p = 0.00. Postoperative morphine doses were 50%
less in group B; (15.9 +/- 2.63) versus (32.3 +/- 5.04) in group A, p =
0.00. Peak inspiratory flow was significantly higher in group B after
extubation. Duration of ventilation was shorter in group B (4.96 +/- 0.71
h) versus (6.08 +/- 0.69) in group A, p = 0.00. In addition, ICU stay was
also shorter in group B (35.52 +/- 3.87 h) versus (47.06 +/- 5.08 h) in
group A, p = 0.00. No clinically significant adverse effects were
recorded. <br/>Conclusion(s): Ultrasound-guided bilateral continuous
erector spinae block produced safe and effective analgesia for 48 h after
extubation following coronary bypass surgery. It also reduced
perioperative opioid consumption and allowed early tracheal extubation
without major adverse effects.<br/>Copyright &#xa9; 2021 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<99>
Accession Number
2008499346
Title
Effect of dexmedetomidine on hemodynamic changes and inflammatory
responses in patients undergoing off-pump coronary-artery bypass grafting.
Source
Experimental and Therapeutic Medicine. 20 (6) (no pagination), 2020.
Article Number: e9380. Date of Publication: December 2020.
Author
ZHAI W.; YANG L.; SUN P.; LI Y.; HAN J.; WANG G.
Institution
(ZHAI, LI) Tianjin Medical University, Tianjin 300070, China
(ZHAI, SUN, HAN) Department of Anesthesiology, Tianjin Chest Hospital,
Tianjin 300222, China
(YANG) Departments of Cardiovascular Surgery, General Hospital of Tianjin
Medical University, Tianjin 300052, China
(WANG) Departments of Anesthesiology, General Hospital of Tianjin Medical
University, Tianjin 300052, China
Publisher
Spandidos Publications
Abstract
The aim of the present study was to determine the effect of
dexmedetomidine on hemodynamic changes and inflammatory responses in
patients undergoing off-pump coronary artery bypass grafting (OPCABG). A
total of 300 patients about to receive OPCABG were randomized evenly into
the control group (n=116) and study group (n=123). Intravenous
dexmedetomidine pump infusion was administered to patients in the study
group at a rate of 0.4 mug.kg-1.h-1. The control group received
physiological saline at the same infusion speed. Changes in hemodynamic
parameters and inflammatory indices were compared between the two groups.
Hemodynamic parameters, such as the heart rate and mean arterial pressure,
were lower in patients from the study group, compared with that in the
control group (both P<0.05). The levels of pro-inflammatory factors, such
as interleukin (IL)-6, tumor necrosis factor-alpha and C-reactive protein,
were also reduced in the study group (P<0.05). The observed levels of
IL-10 were lower in the control group compared with that in the study
group, although a statistically significant difference was not achieved.
Thus, the administration of dexmedetomidine in patients undergoing OPCABG
stabilized hemodynamics and reduced inflammation.<br/>Copyright &#xa9;
2020 Spandidos Publications. All rights reserved.

<100>
Accession Number
2007701128
Title
Transcatheter versus surgical aortic valve replacement in patients with
chronic obstructive pulmonary disease.
Source
Scandinavian Cardiovascular Journal. 55 (3) (pp 168-172), 2021. Date of
Publication: 2021.
Author
Takagi H.; Kuno T.; Hari Y.; Nakashima K.; Yokoyama Y.; Ueyama H.; Ando T.
Institution
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Shizuoka
Medical Center, Shizuoka, Japan
(Takagi, Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Kuno, Ueyama) Department of Medicine, Mount Sinai Beth Israel Medical
Center, New York, NY, United States
(Yokoyama) Department of Surgery, Easton Hospital, Easton, PA, United
States
(Ando) Division of Interventional Cardiology, Department of Cardiology,
New York Presbyterian Hospital/Columbia University Medical Center, New
York, NY, United States
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: Although a number of studies compared mortality after
transcatheter aortic valve implantation (TAVI) with that after surgical
aortic replacement (SAVR) in patients with chronic obstructive pulmonary
disease (COPD), no meta-analysis of them has been conducted to date. To
determine whether TAVI or SAVR is associated with better postprocedural
survival in patients with COPD, a meta-analysis of all studies currently
available was performed. Design. To identify all comparative studies of
TAVI with SAVR in patients with COPD, PubMed and Web of Science were
searched through January 2020. Studies meeting the following criteria were
included in the present meta-analysis: the design was an observational
comparative study or a randomized controlled trial; the study population
was patients with COPD; patients were assigned to TAVI versus SAVR; and
outcomes included all-cause mortality. Adjusted (if unavailable,
unadjusted) odds or hazard ratios with their confidence intervals (CIs) of
mortality for TAVI versus SAVR were extracted from each study.
Study-specific estimates were combined in the random-effects model.
Results. Six eligible studies with a total of 4771 patients with COPD were
identified and included in the present meta-analysis. The meta-analysis
indicated significantly lower early (in-hospital or 30-day) mortality
after TAVI than after SAVR (odds ratio, 0.69; 95% CI, 0.53-0.90; p =.006)
but no significant difference in midterm (1-year to 5-year) mortality
between TAVI and SAVR (hazard ratio, 1.07; 95% CI, 0.79-1.44; p =.68).
Conclusions. In patients with COPD, TAVI was associated with reduced early
mortality, while midterm mortality appeared similar, as compared with
SAVR.<br/>Copyright &#xa9; 2020 Informa UK Limited, trading as Taylor &
Francis Group.

<101>
Accession Number
2007163048
Title
Pre-bypass levosimendan in ventricular dysfunction-effect on right
ventricle.
Source
Asian Cardiovascular and Thoracic Annals. 29 (4) (pp 260-267), 2021. Date
of Publication: May 2021.
Author
Kumar D.; Yadava O.P.; Ahlawat V.; Kundu A.; Yadav A.; Prakash A.
Institution
(Kumar, Yadava, Ahlawat, Kundu, Yadav, Prakash) Department of Cardiac
Surgery, National Heart Institute, New Delhi, India
Publisher
SAGE Publications Inc.
Abstract
Background: Levosimendan is an effective calcium sensitizer with
complementary mechanisms of action: calcium sensitization and opening of
adenosine triphosphate-dependent potassium channels, both on the
sarcolemma of the smooth muscle cells in the vasculature and on the
mitochondria of cardiomyocytes. Levosimendan has a long-acting metabolite
with a half-life of approximately 80 h. There have been a few small
studies on this drug regarding right ventricular function. In view of
this, we investigated the effect of levosimendan on right ventricular
function in patients with coronary artery disease. <br/>Method(s): This
was a prospective, randomized, double-blind study on 50 patients with
coronary artery disease and severe left ventricular dysfunction (left
ventricular ejection fraction <=35%) undergoing elective off-pump coronary
artery bypass. <br/>Result(s): Levosimendan had an inotropic effect on
right ventricular myocardium and a vasodilatory effect on blood vessels.
It caused a decline in pulmonary vascular resistance (p < 0.018), right
ventricular systolic pressure (p < 0.001), and pulmonary artery systolic
pressure (p < 0.001), and improved right ventricular diastolic function as
shown by the decrease in right ventricular Tei index (p < 0.001), right
ventricular end-diastolic pressure, and the ratio of early diastolic
tricuspid inflow to tricuspid lateral annular velocity (p < 0.006).
However, we found no beneficial effects on intensive care unit or hospital
stay (p = 0.164, p = 0.349, respectively) nor a mortality benefit.
<br/>Conclusion(s): Levosimendan has salutary effects on right ventricular
function in patients with severe left ventricular dysfunction undergoing
coronary artery bypass, in terms of improved hemodynamic
parameters.<br/>Copyright &#xa9; The Author(s) 2020.

<102>
Accession Number
635124114
Title
Protocol for a randomised controlled trial for Treatment in Thoracic
Aortic Aneurysm: Surgery versus Surveillance (TITAN: SvS).
Source
BMJ Open. 11 (5) (no pagination), 2021. Article Number: e052070. Date of
Publication: 26 May 2021.
Author
Guo M.H.; Appoo J.J.; Wells G.A.; Chu M.; Ouzounian M.; Fortier J.;
Boodhwani M.
Institution
(Guo, Fortier, Boodhwani) Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Appoo) Cardiac Surgery, University of Calgary, Calgary, AB, Canada
(Wells) School of Epidemiology and Public Health, University of Ottawa,
Ottawa, ON, Canada
(Wells) Cardiovascular Research Methods Centre, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Chu) Cardiac Surgery, Western University Schulich School of Medicine and
Dentistry, London, ON, Canada
(Ouzounian) Cardiac Surgery, University Health Network, Toronto, ON,
Canada
Publisher
BMJ Publishing Group
Abstract
Introduction Ascending thoracic aortic aneurysm (ATAA) is an asymptomatic
condition that can lead to catastrophic events of rupture or dissection.
Current guidelines are based on limited retrospective data and recommend
surgical intervention for ATAA with a diameter of greater or equal to 5.5
cm. Treatment in Thoracic Aortic Aneurysm: Surgery versus Surveillance is
the first prospective, multicentre, randomised controlled trial that
compares outcomes of patients undergoing early elective ascending aortic
surgery to patients undergoing medical surveillance. Methods and analysis
Patients between the ages of 18 and 80 with an asymptomatic ATAA between
5.0 cm and 5.4 cm in diameter are eligible for randomisation to early
surgery or surveillance. Patients in the surgery group will be followed at
1 month after discharge, then annually for a minimum of 2 years and up to
5 years. Patients in the surveillance group will be followed annually from
their index clinic visit for a minimum of 2 years and up to 5 years. The
primary outcome is all-cause mortality at follow-up. A sample size of 618
subjects (309 in each group) will achieve an 80% power at a 0.047
significance level. Ethics and dissemination This study has received
Ottawa Health Science Network Research Ethics Board approval (Protocol
20180007-01H), which was most recently updated on 25 November 2020. The
Research Ethics Board have granted approval to the study at 14
participating institutions, including the Ottawa Health Science Network
Research Ethics Board. On completion of data analysis, the result of the
trial will be presented at national and international conferences, and
published in relevant journals, regardless of the finding of the trial.
Trial registration number NCT03536312. <br/>Copyright &#xa9; 2021 BMJ
Publishing Group. All rights reserved.

<103>
Accession Number
631766863
Title
Long-term outcome of perioperative low cardiac output syndrome in cardiac
surgery: 1-year results of a multicenter randomized trial.
Source
Journal of critical care. 58 (pp 89-95), 2020. Date of Publication: 01 Aug
2020.
Author
Zangrillo A.; Lomivorotov V.V.; Pisano A.; Calabro M.G.; Belletti A.;
Brazzi L.; Grigoryev E.V.; Guarracino F.; Monaco F.; Garofalo E.;
Crivellari M.; Likhvantsev V.V.; Fominskiy E.V.; Paternoster G.;
Yavorovskiy A.; Pasyuga V.V.; Oriani A.; Lembo R.; Bianchi A.; Scandroglio
A.M.; Abubakirov M.N.; Di Tomasso N.; Landoni G.
Institution
(Zangrillo, Landoni) Department of Anesthesia and Intensive Care, IRCCS
San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele
University, Milan, Italy
(Lomivorotov) Department of Anesthesiology and Intensive Care, E.
Meshalkin National Medical Research Center, Novosibirsk, Russia;
Novosibirsk State University, Novosibirsk, Russia
(Pisano) Division of Cardiac Anesthesia and Intensive Care Unit, AORN dei
Colli - Monaldi Hospital, Naples, Italy
(Calabro, Belletti, Monaco, Crivellari, Fominskiy, Oriani, Lembo,
Scandroglio, Di Tomasso) Department of Anesthesia and Intensive Care,
IRCCS San Raffaele Scientific Institute, Milan, Italy
(Brazzi) Department of Anesthesia, Intensive Care and Emergency, Citta
della Salute e della Scienza Hospital, Turin, Italy; Department of
Surgical Sciences, University of Turin, Turin, Italy
(Grigoryev) Intensive Care Unit, Scientific Research Institute for Complex
Issues of Cardiovascular Diseases, Kemerovo, Russian Federation
(Guarracino) Division of Cardiothoracic Anesthesia and Intensive Care,
Department of Anesthesia and Critical Care Medicine, AOU Pisana, Pisa,
Italy
(Garofalo) Department of Anesthesia and Intensive Care, AOU Mater Domini
Germaneto, Catanzaro, Italy
(Likhvantsev) Department of Anesthesiology and Intensive Care, First
Moscow State Medical University, Moscow, Russia; V. Negovsky Reanimatology
Research Institute, Moscow, Russia
(Paternoster) Department of Anesthesia and Intensive Care, San Carlo
Hospital, Potenza, Italy
(Yavorovskiy) Department of Anesthesiology and Intensive Care, First
Moscow State Medical University, Moscow, Russian Federation
(Pasyuga) Department of Anesthesiology and Intensive Care, Federal Center
for Cardiovascular Surgery Astrakhan, Astrakhan, Russian Federation
(Bianchi) Department of Cardiovascular Anesthesia and Intensive Care, AO
Ordine Mauriziano, Turin, Italy
(Abubakirov) Department of Anesthesiology and Intensive Care, E. Meshalkin
National Medical Research Center, Novosibirsk, Russian Federation
Publisher
NLM (Medline)
Abstract
PURPOSE: Perioperative myocardial dysfunction occurs frequently in cardiac
surgery, and is a risk factor for morbidity and mortality. Levosimendan
has been suggested to reduce mortality of patients with perioperative
myocardial dysfunction. However, long-term outcome data on its efficacy in
cardiac surgery are lacking. MATERIALS AND METHODS: Cardiac surgery
patients with perioperative myocardial dysfunction were randomized to
levosimendan or placebo, in addition to standard inotropic care. One-year
mortality data were collected. <br/>RESULT(S): We randomized 506 patients
(248 to levosimendan 258 to placebo). At 1-year follow-up, 41 patients
(16.5%) died in the levosimendan group, while 47 (18.3%) died in the
placebo group (absolute risk difference -1.8; 95% CI -8.4 to 4.9; P=.60).
Female sex, history of chronic obstructive pulmonary disease, previous
myocardial infarction, serum creatinine, hematocrit, mean arterial
pressure, and duration of cardiopulmonary bypass were independently
associated with 1-year mortality. <br/>CONCLUSION(S): Levosimendan
administration does not improve 1-year survival in cardiac surgery
patients with perioperative myocardial dysfunction. One-year mortality in
these patients is 17%. Six predictive factors for long-term mortality were
identified. STUDY REGISTRATION NUMBER: NCT00994825
(ClinicalTrials.gov).<br/>Copyright &#xa9; 2020 Elsevier Inc. All rights
reserved.

<104>
Accession Number
635166874
Title
Pulmonary effects of dexmedetomidine infusion in thoracic aortic surgery
under hypothermic circulatory arrest: a randomized placebo-controlled
trial.
Source
Scientific reports. 11 (1) (pp 10975), 2021. Date of Publication: 26 May
2021.
Author
Kim S.; Park S.J.; Nam S.B.; Song S.-W.; Han Y.; Ko S.; Song Y.
Institution
(Kim, Park, Nam, Han, Ko) Department of Anesthesiology and Pain Medicine,
Yonsei University College of Medicine, Seoul, South Korea
(Nam) Anesthesia and Pain Research Institute, Yonsei University College of
Medicine, Seoul, South Korea
(Song) Department of Cardiovascular Surgery, Yonsei University College of
Medicine, Seoul, South Korea
(Song) Department of Anesthesiology and Pain Medicine, Yonsei University
College of Medicine, Seoul, South Korea
(Song) Anesthesia and Pain Research Institute, Yonsei University College
of Medicine, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
Dexmedetomidine has emerged as a promising organ protective agent. We
performed prospective randomized placebo-controlled trial investigating
effects of perioperative dexmedetomidine infusion on pulmonary function
following thoracic aortic surgery with cardiopulmonary bypass and moderate
hypothermic circulatory arrest. Fifty-two patients were randomized to two
groups: the dexmedetomidine group received 1 microg/kg of dexmedetomidine
over 20 min after induction of anesthesia, followed by 0.5 microg/kg/h
infusion until 12 h after aortic cross clamp (ACC)-off, while the control
group received the same volume of normal saline. The primary endpoints
were oxygenation indices including arterial O2 partial pressure (PaO2) to
alveolar O2 partial pressure ratio (a/A ratio), (A-a) O2 gradient,
PaO2/FiO2 and lung mechanics including peak inspiratory and plateau
pressures and compliances, which were assessed after anesthesia induction,
1 h, 6 h, 12 h, and 24 h after ACC-off. The secondary endpoints were serum
biomarkers including interleukin-6, tumor necrosis factor-alpha,
superoxide dismutase, and malondialdehyde (MDA). As a result,
dexmedetomidine did not confer protective effects on the lungs, but
inhibited elevation of serum MDA level, indicative of anti-oxidative
stress property, and improved urine output and lower requirements of
vasopressors.

<105>
Accession Number
635167186
Title
Relationship Between Residual Mitral Regurgitation and Clinical and
Quality-of-Life Outcomes After Transcatheter and Medical Treatments in
Heart Failure: The COAPT Trial.
Source
Circulation. (no pagination), 2021. Date of Publication: 27 May 2021.
Author
Kar S.; Mack M.J.; Lindenfeld J.; Abraham W.T.; Asch F.M.; Weissman N.J.;
Enriquez-Sarano M.; Lim D.S.; Mishell J.M.; Whisenant B.K.; Rogers J.H.;
Arnold S.V.; Cohen D.J.; Grayburn P.A.; Stone G.W.
Institution
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA; Bakersfield
Heart Hospital, Bakersfield, CA
(Mack) Baylor Scott & White Heart Hospital Plano, TX, Plano, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, TN, Nashville, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University,
Columbus, OH
(Asch, Weissman) MedStar Health Research Institute, Washington, DC;
Georgetown University, Washington, DC
(Enriquez-Sarano) Mayo Clinic, MN, Rochester
(Lim) Division of Cardiology, University of Virginia, VA, Charlottesville,
United States
(Mishell) Kaiser Permanente - San Francisco Hospital, San Francisco, CA
(Whisenant) Intermountain Heart Center, UT, Salt Lake City, United States
(Rogers) University of California Davis Medical Center, Sacramento, CA
(Arnold) Saint Luke's Mid America Heart Institute, Kansas City, MO;
University of Missouri-Kansas City School of Medicine, Kansas City, MO
(Cohen) St Francis Hospital, Roslyn, NY; Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY
(Grayburn) Baylor University Medical Center, Baylor Heart and Vascular
Institute, TX, Dallas, United States
(Stone) Clinical Trials Center, Cardiovascular Research Foundation, New
York, NY; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY
Publisher
NLM (Medline)
Abstract
Background: In the randomized COAPT trial, among 614 heart failure (HF)
patients with 3+ or 4+ secondary mitral regurgitation (MR), transcatheter
mitral valve repair (TMVr) with the MitraClip reduced MR, HF
hospitalizations (HFH), and mortality and improved quality of life
compared with guideline-directed medical therapy (GDMT) alone. We sought
to examine the prognostic relationship between MR reduction and outcomes
after TMVr and GDMT alone. <br/>Method(s): Outcomes in COAPT between 30
days and 2 years were examined based on the severity of residual MR at 30
days. <br/>Result(s): TMVr-treated patients had less severe residual MR at
30 days than GDMT-treated patients (0/1+, 2+, and 3+/4+: 72.9%, 19.9%, and
7.2% versus 8.2%, 26.1%, and 65.8%, respectively, P<0.0001). The rate of
composite death or HFH between 30 days and 2 years was lower in patients
with 30-day residual MR of 0/1+ and 2+ compared with 3+/4+ (37.7% versus
49.5% versus 72.2%, respectively, P<0.0001). This relationship was
consistent in the TMVr and GDMT arms (Pinteraction=0.92). The improvement
in KCCQ score from baseline to 30 days was maintained between 30 days and
2 years in patients with 30-day MR <=2+ but deteriorated in those with
30-day MR 3+/4+ (-0.3+/-1.7 versus -9.4+/-4.6, P=0.0008) consistently in
both groups (Pinteraction=0.95). <br/>Conclusion(s): In the COAPT trial,
reduced MR at 30 days was associated with greater freedom from death or
HFH and improved quality of life through 2-year follow-up whether the MR
reduction was achieved by TMVr or GDMT. Clinical Trial Registration:
https://www.clinicaltrials.gov Unique Identifier: NCT01626079.

<106>
Accession Number
635166280
Title
Systematic review and meta-analysis of mortality risk prediction models in
adult cardiac surgery.
Source
Interactive cardiovascular and thoracic surgery. (no pagination), 2021.
Date of Publication: 26 May 2021.
Author
Sinha S.; Dimagli A.; Dixon L.; Gaudino M.; Caputo M.; Vohra H.A.;
Angelini G.; Benedetto U.
Institution
(Sinha, Dimagli, Dixon, Caputo, Vohra, Angelini, Benedetto) Bristol Heart
Institute, Translational Health Sciences, University of Bristol, Bristol,
United Kingdom
(Gaudino) Weill Cornell Medical College, Cornell University, NY, United
States
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The most used mortality risk prediction models in cardiac
surgery are the European System for Cardiac Operative Risk Evaluation (ES)
and Society of Thoracic Surgeons (STS) score. There is no agreement on
which score should be considered more accurate nor which score should be
utilized in each population subgroup. We sought to provide a thorough
quantitative assessment of these 2 models. <br/>METHOD(S): We performed a
systematic literature review and captured information on discrimination,
as quantified by the area under the receiver operator curve (AUC), and
calibration, as quantified by the ratio of observed-to-expected mortality
(O:E). We performed random effects meta-analysis of the performance of the
individual models as well as pairwise comparisons and subgroup analysis by
procedure type, time and continent. <br/>RESULT(S): The ES2 {AUC 0.783
[95% confidence interval (CI) 0.765-0.800]; O:E 1.102 (95% CI
0.943-1.289)} and STS [AUC 0.757 (95% CI 0.727-0.785); O:E 1.111 (95% CI
0.853-1.447)] showed good overall discrimination and calibration. There
was no significant difference in the discrimination of the 2 models
(difference in AUC -0.016; 95% CI -0.034 to -0.002; P = 0.09). However,
the calibration of ES2 showed significant geographical variations
(P<0.001) and a trend towards miscalibration with time (P=0.057). This was
not seen with STS. <br/>CONCLUSION(S): ES2 and STS are reliable predictors
of short-term mortality following adult cardiac surgery in the populations
from which they were derived. STS may have broader applications when
comparing outcomes across continents as compared to ES2. REGISTRATION:
Prospero (https://www.crd.york.ac.uk/PROSPERO/)
CRD42020220983.<br/>Copyright &#xa9; The Author(s) 2021. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.