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<1>
Accession Number
362336704
Title
CABG added no benefit to medical therapy for preventing death in coronary
artery disease with heart failure.
Source
Annals of Internal Medicine. 155 (4) (pp JC2-JC9), 2011. Date of
Publication: August 16, 2011.
Author
Velazquez E.J.
Institution
(Velazquez) Duke Clinical Research Institute, Durham, NC, United States
Publisher
American College of Physicians

<2>
Accession Number
2010606383
Title
Delirium in older adults is associated with development of new dementia: a
systematic review and meta-analysis.
Source
International Journal of Geriatric Psychiatry. 36 (7) (pp 993-1003), 2021.
Date of Publication: July 2021.
Author
Pereira J.V.-B.; Aung Thein M.Z.; Nitchingham A.; Caplan G.A.
Institution
(Pereira, Aung Thein) Faculty of Medicine, University of New South Wales,
Sydney, Australia
(Nitchingham, Caplan) Department of Geriatric Medicine, Prince of Wales
Hospital, Prince of Wales Clinical School University of New South Wales,
Sydney, Australia
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: Observational studies have examined the association between
delirium and development of new dementia. However, no recent review has
collectively assessed the available evidence quantitatively and
qualitatively. We systematically reviewed and critically evaluated the
literature regarding the association between delirium and dementia, and
calculated the odds of developing new dementia after having delirium.
 Method(s): This systematic review and meta-analysis was conducted
according to Preferred reporting items for systematic reviews and
meta-analyses guidelines. MEDLINE, EMBASE and PsycINFO, were searched for
English-language articles that compared the incidence of new dementia in
older adult (>=65) inpatients with delirium, to inpatients without
delirium. A random effects model was used for meta-analysis, and overall
effect size was calculated using reported raw data of event counts. The
Newcastle-Ottawa Quality Assessment scale assessed risk of bias.
 Result(s): Six observational studies met eligibility criteria, with
follow-up times ranging from six months to five years. Four looked at hip
fracture surgical patients; one was on cardiac surgery patients and one
examined geriatric medical patients. All studies excluded patients with
pre-existing dementia. Pooled meta-analysis revealed that older adult
inpatients who developed delirium had almost twelve times the odds of
subsequently developing new dementia compared to non-delirious patients
(OR = 11.9 [95% CI: 7.29-19.6]; p < 0.001). Conclusion(s): Older
adult inpatients who develop delirium are at significant risk of
subsequently developing dementia. This emphasises the importance of
delirium prevention and cognitive monitoring post-delirium. The included
studies mainly examined post-surgical patients-further research on medical
and intensive care unit cohorts is warranted. Future studies should assess
whether delirium duration, severity and subtype influence the risk of
developing dementia. Copyright © 2021 John Wiley & Sons Ltd.

<3>
Accession Number
2011445282
Title
The expansion of no-touch harvesting sequential vein graft after off-pump
coronary artery bypass grafting.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2381-2388), 2021. Date of
Publication: July 2021.
Author
Hou X.; Zhang K.; Liu T.; Li Y.; Zhao Y.; Song B.; Huang Z.; Xu S.; Zheng
J.; Dong R.
Institution
(Hou, Zhang, Liu, Li, Zhao, Song, Huang, Xu, Zheng, Dong) Department of
Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University,
Beijing, China
Publisher
Blackwell Publishing Inc.
Abstract
Background and Aim of the Study: Many studies support that the no-touch
(NT) procedure can improve the patency rate of vein grafts. However, it is
not clear that the sequential vein graft early expansion in the NT
technique during off-pump coronary artery bypass grafting (CABG). This
study will explore this issue. Method(s): This was a prospective
single-center randomized controlled clinical trial. A total of 100
patients undergoing off-pump CABG with the sequential saphenous graft were
randomly assigned to two groups: the NT and conventional (CON) groups.
Perioperative and postoperative data were collected during the hospital
stay. The mean diameter of sequential grafts was measured using cardiac
computed tomography angiography 3 months after the operation.
 Result(s): There was a significant difference in the average diameter
of sequential grafts between the two groups (NT: [2.98 +/- 0.42], CON:
[3.26 +/- 0.51], p =.005). There was no difference in occlusion of
sequential venous grafts between the two groups (NT: 4/48 [8.3%], CON:
5/49 [10.2%], p = 1.000). There were differences in surgery time between
the two groups (NT: 220 [188,240], CON: 190 [175,230], p =.009).
 Conclusion(s): The sequential graft early expansion in the NT
technique is not as pronounced as that in the conventional technique,
which may have a long-term protective effect on the grafts. Copyright
© 2021 The Authors. Journal of Cardiac Surgery Published by Wiley
Periodicals LLC

<4>
Accession Number
2011934044
Title
Impact of Different Annuloplasty Methods for Tricuspid Regurgitation: A
Network Meta-Analysis.
Source
Annals of Thoracic Surgery. 111 (6) (pp 2004-2010), 2021. Date of
Publication: June 2021.
Author
Yokoyama Y.; Takagi H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Although moderate to severe tricuspid valve regurgitation (TR)
is an independent risk factor for progressive heart failure and increased
mortality, the best method for tricuspid valve repair remains
controversial. Therefore, this study conducted a network meta-analysis to
compare early and late outcomes for suture, flexible band, and rigid ring
as tricuspid annuloplasty (TAP) in patients with TR. Method(s):
Medline and EMBASE were searched through February 15, 2020 to identify
randomized controlled trials and observational trials that investigated
early and late outcomes after TAP for TR. The outcomes of interest were
perioperative mortality, all-cause mortality, and TR recurrence with more
than 1-year follow-up. TR recurrence was defined as at least moderate (TR
grade 2) on serial echocardiograms. Result(s): Two randomized
controlled trials and 15 observational trials were identified, including
6138 patients who underwent TAP. The median follow-up period was 1 to 7.4
years. There were no significant differences of perioperative and
all-cause mortality among 3 TAP methods. Rigid ring TAP was associated
with a significant reduction in TR recurrence compared with suture TAP
(hazard ratio, 0.42; 95% confidence interval, 0.23 to 0.78; P =.005).
There were no significant differences in TR recurrence were observed
between flexible band and suture TAP or flexible band and rigid ring TAP.
 Conclusion(s): This network meta-analysis demonstrated significant
reduction in TR recurrence for rigid ring TAP compared with suture TAP,
although no significant differences were observed between suture and
flexible band TAP or between flexible band and rigid ring TAP. There were
no significant mortality differences among suture, flexible band, and
rigid ring TAP procedures. Copyright © 2021 The Society of
Thoracic Surgeons

<5>
Accession Number
2011326702
Title
Redefining the Risk of Surgery for Clinical Stage IIIA (N2) Non-Small Cell
Lung Cancer: A Pooled Analysis of the STS GTSD and ESTS Registry.
Source
Lung. 199 (3) (pp 311-318), 2021. Date of Publication: June 2021.
Author
Arndt A.T.; Brunelli A.; Cicconi S.; Falcoz P.-E.; Salati M.; Kozower B.;
Liptay M.J.; Rocco G.; Karush J.M.; Geissen N.; Basu S.; Seder C.W.
Institution
(Liptay, Karush, Geissen, Basu, Seder) Department of Cardiovascular and
Thoracic Surgery, Rush University Medical Center, Chicago, IL 60612,
United States
(Brunelli) Department of Thoracic Surgery, St. James's University
Hospital, Leeds, United Kingdom
(Cicconi) Molecular and Clinical Cancer Medicine, University of Liverpool,
Liverpool, United Kingdom
(Falcoz) Department of Thoracic Surgery, Nouvel Hopital Civil, Strasbourg,
France
(Salati) Unit of Thoracic Surgery, AOU Ospedali Riuniti, Ancona, Italy
(Kozower) Division of Cardiothoracic Surgery, Washington University School
of Medicine, St. Louis, MO, United States
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, NY, United States
(Arndt) Department of Cardiovascular and Thoracic Surgery, Rush University
Medical Center, Professional Building, Suite 774, Chicago, IL 60612,
United States
Publisher
Springer
Abstract
Background: Management of clinical stage IIIA-N2 (cIIIA-N2) non-small cell
lung cancer (NSCLC) remains controversial. We evaluated treatment
strategies and outcomes in cIIIA-N2 NSCLC patients who underwent pulmonary
resection in The Society of Thoracic Surgeons General Thoracic Surgery
Database (STS GTSD) and the European Society of Thoracic Surgeons (ESTS)
Registry. Method(s): The STS GTSD and ESTS Registry were queried for
patients who underwent pulmonary resection for cIIIA-N2 NSCLC between 2012
and 2016. Demographic variables, treatment strategies, and outcome
measures were collected and analyzed. Significance of differences was
determined using the chi2 test for categorical variables and
the Wilcoxon rank sum test for continuous variables. Result(s):
Pulmonary resection was performed in 4279 cIIIA-N2 NSCLC patients (2928
STS GTSD; 1351 ESTS). Induction therapy was administered to 49%. Lobectomy
was performed in 67.1% and pneumonectomy in 13%. Lobectomy was associated
with 19.2% major morbidity and 1.6% operative mortality, while
pneumonectomy was associated with 34.1% and 5%, respectively. Induction
therapy was associated with a higher rate of major morbidity or mortality
than upfront surgery (23.2% vs 19.5%, p = 0.004), driven by pneumonectomy
(40.7% vs 30.3%, p = 0.012) rather than lobectomy (20.3% vs 18.8%, p =
0.31). Conclusion(s): Pulmonary resection for cIIIA-N2 NSCLC is
associated with low rates of operative morbidity and mortality, with
lobectomy having lower morbidity and mortality than pneumonectomy.
Induction therapy, particularly chemoradiotherapy, is associated with a
higher rate of composite morbidity or mortality than upfront surgery in
pneumonectomy patients but not lobectomy patients. Copyright ©
2021, The Author(s), under exclusive licence to Springer Science+Business
Media, LLC, part of Springer Nature.

<6>
Accession Number
2012858898
Title
Novel autologous, high concentrated fibrin as advanced hemostatic agent
for coronary surgery.
Source
Transfusion and Apheresis Science. (no pagination), 2021. Article Number:
103171. Date of Publication: 2021.
Author
Micovic S.; Everts P.; Calija B.; Strugarevic E.; Grubor N.; Boricic M.;
Lesanovic J.; Box H.; Abazovic D.
Institution
(Micovic, Calija, Strugarevic, Boricic, Lesanovic) Cardiovascular
Institute Dedinje, Milana Tepica 1, Belgrade 11000, Serbia
(Everts) Gulf Coasts Biologics Inc., 4331 Veronica S Shoemaker Blvd, Fort
Myers, FL 33916, United States
(Grubor) Clinical Centre of Serbia, Pasterova2, Belgrade 11000, Serbia
(Box) St Catherine's Hospital, Michelangelolaan 2, Eindhoven 5623 EJ,
Netherlands
(Abazovic) Emergency Medical Centre of Montenegro, Vaka Durovica bb,
Podgorica 81110, Montenegro
Publisher
Elsevier Ltd
Abstract
Background: Variability in transfusion outcomes and excessive
postoperative bleeding represents a significant problem in cardiac
surgery. The effort to reduce bleeding complications and transfusion
outcomes is desirable. Our study investigated the feasibility of reducing
bleeding complications and transfusion requirements by applying
perioperatively prepared autologous bio-regenerative fibrin sealant.
 Method(s): A prospective, case-control study enrolled 74 patients
undergoing coronary artery bypass grafting by a single surgeon. Patients
in the control group (N = 43), received traditional methods of hemostasis,
while patients in the experimental group (N = 31) were treated
additionally with autologous bio-regenerative fibrin. Result(s):
Patients were well-matched with regard to basic demographic, laboratory
and procedural data. Allogeneic blood transfusion requirement in control
group was 39.5 % (17 of 43 patients), compared to 6.5 % (2 of 31 patients)
in treated group (p < 0,001). The lower infection rate in the experimental
group was also noted. No safety issues were identified during the
preparation and application process. Conclusion(s): Autologous
bio-regenerative fibrin can be safely prepared, with no time consuming,
and was demonstrated to be a useful tool to decrease allogeneic blood
transfusion requirements following elective coronary artery bypass
grafting surgery. A prospective randomized trial is needed to confirm
these findings. Copyright © 2021 Elsevier Ltd

<7>
Accession Number
634650910
Title
Active clearance vs conventional management of chest tubes after cardiac
surgery: a randomized controlled study.
Source
Journal of cardiothoracic surgery. 16 (1) (pp 44), 2021. Date of
Publication: 23 Mar 2021.
Author
St-Onge S.; Chauvette V.; Hamad R.; Bouchard D.; Jeanmart H.; Lamarche Y.;
Perrault L.P.; Demers P.
Institution
(St-Onge, Chauvette, Hamad, Bouchard, Lamarche, Perrault, Demers)
Department of Surgery, Faculty of Medicine, Montreal Heart Institute,
Universite de Montreal ,5000 Belanger Street, Montreal, QC H1T1C8, Canada
(Jeanmart) Department of Surgery, Faculty of Medicine, Hopital du
Sacre-Coeur de Montreal, Universite de Montreal, Montreal, QC, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Chest tubes are routinely used after cardiac surgery to
evacuate shed mediastinal blood. Incomplete chest drainage due to chest
tube clogging can lead to retained blood after cardiac surgery. This can
include cardiac tamponade, hemothorax, bloody effusions and postoperative
atrial fibrillation (POAF). Prior published non randomized studies have
demonstrated that active tube clearance (ATC) of chest tubes can reduce
retained blood complications prompting the ERAS Cardiac Society guidelines
to recommend this modality. OBJECTIVE(S): A randomized prospective
trial to evaluate whether an ATC protocol aimed at improving chest tube
patency without breaking the sterile field could efficiently reduce
complications related to retained blood after cardiac surgery.
 METHOD(S): This was a pragmatic, single-blinded, parallel randomized
control trial held from November 2015 to June 2017 including a 30-day post
index surgery follow-up. The setting was two academic centers affiliated
with the Universite de Montreal School of Medicine; the Montreal Heart
Institute and the Hopital du Sacre-Coeur de Montreal. Adult patients
admitted for non-emergent coronary bypass grafting and/or valvular heart
surgery through median sternotomy, in sinus rhythm for a minimum of 30days
prior to the surgical intervention were eligible for inclusion. In the
active tube clearance group (ATC), a 28F PleuraFlow device was positioned
within the mediastinum. In the standard drainage group, a conventional
chest tube (Teleflex Inc.) was used. Other chest tubes were left at the
discretion of the operating surgeon. RESULT(S): A total of 520 adult
patients undergoing cardiac surgery were randomized to receive either ATC
(n=257) or standard drainage (n=263). ATC was associated with a 72%
reduction in re-exploration for bleeding (5.7% vs 1.6%, p=.01) and an 89%
reduction in complete chest tube occlusion (2% vs 19%, p=.01). There was
an 18% reduction in POAF between the ATC and control group that was not
statistically significant (31% vs 38%, p=.08). CONCLUSIONS AND RELEVANCE:
In this RCT, the implementation of active clearance of chest tubes reduced
re-exploration and chest tube clogging in patients after cardiac surgery
further supporting recommendations to consider this modality
postoperatively. TRIAL REGISTRATION: Clinical Trials NCT02808897 .
Retrospectively registered 22 June 2016.

<8>
Accession Number
634322374
Title
Providing Epidemiological Data in Lumbar Spine Imaging Reports Did Not
Affect Subsequent Utilization of Spine Procedures: Secondary Outcomes from
a Stepped-Wedge Randomized Controlled Trial.
Source
Pain medicine (Malden, Mass.). 22 (6) (pp 1272-1280), 2021. Date of
Publication: 04 Jun 2021.
Author
Suri P.; Meier E.N.; Gold L.S.; Marcum Z.A.; Johnston S.K.; James K.T.;
Bresnahan B.W.; O'Reilly M.; Turner J.A.; Kallmes D.F.; Sherman K.J.; Deyo
R.A.; Luetmer P.H.; Avins A.L.; Griffith B.; Heagerty P.J.; Rundell S.D.;
Jarvik J.G.; Friedly J.L.
Institution
(Suri, Meier, Gold, Johnston, James, O'Reilly, Turner, Heagerty, Rundell,
Jarvik, Friedly) Clinical Learning, Evidence, Research Center, University
of Washington, Seattle, WA, United States
(Suri, Turner, Rundell, Friedly) Department of Rehabilitation Medicine,
University of Washington, Seattle, WA, United States
(Suri) Seattle Epidemiologic Research and Information Center, VA Puget
Sound Health Care System, Seattle, WA, United States
(Suri) Rehabilitation Care Services, VA Puget Sound Health Care System,
Seattle, WA, United States
(Meier, Heagerty) Department of Biostatistics, University of Washington,
Seattle, WA, United States
(Gold, Johnston, James, Bresnahan, O'Reilly, Jarvik) Department of
Radiology, School of Medicine, University of Washington, Seattle, WA,
United States
(Marcum) Department of Pharmacy, School of Pharmacy, University of
Washington, Seattle, WA, United States
(Turner) Department of Psychiatry and Behavioral Sciences, University of
Washington, Seattle, WA, United States
(Kallmes, Luetmer) Department of Radiology, Mayo Clinic, Rochester, MN,
United States
(Sherman) SeattleWAUnited States
(Deyo) Departments of Family Medicine and Internal Medicine, Oregon Health
& Science University, Portland, Oregon, USA
(Avins) Division of Research (ALA), Kaiser Permanente Northern California,
Oakland, CA, United States
(Griffith) Department of Radiology, Henry Ford Hospital, Detroit, MI,
United States
(Jarvik) Department of Neurological Surgery, University of Washington,
Seattle, WA, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To evaluate the effect of inserting epidemiological information
into lumbar spine imaging reports on subsequent nonsurgical and surgical
procedures involving the thoracolumbosacral spine and sacroiliac joints.
DESIGN: Analysis of secondary outcomes from the Lumbar Imaging with
Reporting of Epidemiology (LIRE) pragmatic stepped-wedge randomized trial.
SETTING: Primary care clinics within four integrated health care systems
in the United States. SUBJECTS: 238,886 patients >=18years of age who
received lumbar diagnostic imaging between 2013 and 2016. METHOD(S):
Clinics were randomized to receive text containing age- and
modality-specific epidemiological benchmarks indicating the prevalence of
common spine imaging findings in people without low back pain, inserted
into lumbar spine imaging reports (the "LIRE intervention"). The study
outcomes were receiving 1) any nonsurgical lumbosacral or sacroiliac spine
procedure (lumbosacral epidural steroid injection, facet joint injection,
or facet joint radiofrequency ablation; or sacroiliac joint injection) or
2) any surgical procedure involving the lumbar, sacral, or thoracic spine
(decompression surgery or spinal fusion or other spine surgery).
 RESULT(S): The LIRE intervention was not significantly associated
with subsequent utilization of nonsurgical lumbosacral or sacroiliac spine
procedures (odds ratio [OR]=1.01, 95% confidence interval [CI] 0.93-1.09;
P=0.79) or any surgical procedure (OR=0.99, 95 CI 0.91-1.07; P=0.74)
involving the lumbar, sacral, or thoracic spine. The intervention was also
not significantly associated with any individual spine procedure.
 CONCLUSION(S): Inserting epidemiological text into spine imaging
reports had no effect on nonsurgical or surgical procedure utilization
among patients receiving lumbar diagnostic imaging. Copyright ©
The Author(s) 2021. Published by Oxford University Press on behalf of the
American Academy of Pain Medicine. All rights reserved. For permissions,
please e-mail: journals.permissions@oup.com.

<9>
Accession Number
634030079
Title
Lipoprotein(a), LDL-cholesterol, and hypertension: predictors of the need
for aortic valve replacement in familial hypercholesterolaemia.
Source
European heart journal. 42 (22) (pp 2201-2211), 2021. Date of Publication:
07 Jun 2021.
Author
Perez de Isla L.; Watts G.F.; Alonso R.; Diaz-Diaz J.L.; Muniz-Grijalvo
O.; Zambon D.; Fuentes F.; de Andres R.; Padro T.; Lopez-Miranda J.; Mata
P.
Institution
(Perez de Isla) Cardiology Department, Hospital Clinico San Carlos,
IDISSC, Facultad de Medicina, Universidad Complutense ,C/Profesor Martin
Lagos s/n, Madrid 28040, Spain
(Perez de Isla, Alonso, Mata) Fundacion Hipercolesterolemia Familiar,
Madrid, Spain
(Watts) School of Medicine, Faculty of Health and Medical Sciences,
University of Western Australia, Perth, WA, Australia
(Watts) Lipid Disorders Clinic, Cardiometabolic Services, Department of
Cardiology, Royal Perth Hospital, Perth, WA, Australia
(Alonso) Center for Advanced Metabolic Medicine and Nutrition, Santiago de
Chile, Chile
(Diaz-Diaz) Department of Internal Medicine, Hospital Abente y Lago, A
Coruna, Spain
(Muniz-Grijalvo) Department of Internal Medicine, Hospital Virgen del
Rocio, Sevilla, Spain
(Zambon) Department of Endocrinology, Hospital Clinic, Barcelona, Spain
(Fuentes, Lopez-Miranda) Lipids and Atherosclerosis Unit, CIBERObn,
IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba,
Spain
(de Andres) Department of Internal Medicine, Fundacion Jimenez Diaz,
Madrid, Spain
(Padro) Programa-ICCC Cardiovascular, Institut de Recerca del Hospital
Santa Creu i Sant Pau, IIB Santa Pau, Barcelona, Spain
Publisher
NLM (Medline)
Abstract
AIMS: Familial hypercholesterolaemia (FH) and elevated lipoprotein(a)
[Lp(a)] are inherited disorders associated with premature atherosclerotic
cardiovascular disease (ASCVD). Aortic valve stenosis (AVS) is the most
prevalent valvular heart disease and low-density lipoprotein cholesterol
(LDL-C) and Lp(a) may be involved in its pathobiology. We investigated the
frequency and predictors of severe AVS requiring aortic valve replacement
(AVR) in molecularly defined patients with FH. METHODS AND RESULTS:
SAFEHEART is a long-term prospective cohort study of a population with FH
and non-affected relatives (NAR). We analysed the frequency and predictors
of the need for AVR due to AVS in this cohort. Five thousand and
twenty-two subjects were enrolled (3712 with FH; 1310 NAR). Fifty patients
with FH (1.48%) and 3 NAR (0.27%) required AVR [odds ratio 5.71; 95%
confidence interval (CI): 1.78-18.4; P=0.003] after a mean follow-up of
7.48 (3.75) years. The incidence of AVR was significantly higher in
patients with FH (log-rank 5.93; P=0.015). Cox regression analysis
demonstrated an association between FH and AVR (hazard ratio: 3.89; 95%
CI: 1.20-12.63; P=0.024), with older age, previous ASCVD, hypertension,
increased LDL-CLp(a)-years, and elevated Lp(a) being independently
predictive of an event. CONCLUSION(S): The need for AVR due to AVS is
significantly increased in FH patients, particularly in those who are
older and have previous ASCVD, hypertension, increased LDL-CLp(a)-years
and elevated Lp(a). Reduction in LDL-C and Lp(a) together with control of
hypertension could retard the progression of AVS in FH, but this needs
testing in clinical trials.ClinicalTrials.gov number
NCT02693548. Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. © The Author(s) 2021. For
permissions, please email: journals.permissions@oup.com.

<10>
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Accession Number
632870258
Title
Early intervention or watchful waiting for asymptomatic severe aortic
valve stenosis: a systematic review and meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). 21 (11) (pp
897-904), 2020. Date of Publication: 01 Nov 2020.
Author
Ullah W.; Gowda S.N.; Khan M.S.; Sattar Y.; Al-Khadra Y.; Rashid M.;
Mohamed M.O.; Alkhouli M.; Kapadia S.; Bagur R.; Mamas M.A.; Fischman
D.L.; Alraies M.C.
Institution
(Ullah) Abington Jefferson Health, Abington, United States
(Gowda) University of South Dakota, Sioux Falls
(Khan) Mercy Saint Vincent Medical Center, MI
(Sattar) Icahn school of medicine at Mount Sinai Elmhurst Hospital, NY
(Al-Khadra, Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United
States
(Rashid, Mohamed, Mamas) Keele Cardiovascular Research Group, Centre for
Prognosis Research, Institute of Primary Care and Health Sciences, Keele
University, Academic Department of Cardiology, Royal Stoke Hospital,
United Kingdom
(Alkhouli) Department of Cardiovascular Diseases, Mayo Clinic School of
Medicine, Rochester, MN, United States
(Bagur) London Health Sciences Centre, London, ON, Canada
(Mamas, Fischman) Department of Cardiology, Thomas Jefferson Hospital,
Philadelphia, PA, United States
(Alraies) Detroit Medical Center, DMC Heart Hospital, Detroit, MI, United
States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The management of patients with severe but asymptomatic aortic
stenosis is challenging. Evidence on early aortic valve replacement (AVR)
versus symptom-driven intervention in these patients is unknown.
 METHOD(S): Electronic databases were searched, articles comparing
early-AVR with conservative management for severe aortic stenosis were
identified. Pooled adjusted odds ratio (OR) was computed using a
random-effect model to determine all-cause and cardiovascular mortality.
 RESULT(S): A total of eight studies consisting of 2201 patients were
identified. Early-AVR was associated with lower all-cause mortality [OR
0.24, 95% confidence interval (CI) 0.13-0.45, P <= 0.00001] and
cardiovascular mortality (OR 0.21, 95% CI 0.06-0.70, P = 0.01) compared
with conservative management. The number needed to treat to prevent 1
all-cause and cardiovascular mortality was 4 and 9, respectively. The odds
of all-cause mortality in a selected patient population undergoing
surgical AVR (SAVR) (OR 0.16, 95% CI 0.09-0.29, P <= 0.00001) and SAVR or
transcatheter AVR (TAVR) (OR 0.53, 95% CI 0.35-0.81, P = 0.003) were
significantly lower compared with patients who are managed conservatively.
A subgroup sensitivity analysis based on severe aortic stenosis (OR 0.24,
95% CI 0.11-0.52, P = 0.0004) versus very severe aortic stenosis (OR 0.20,
95% CI 0.08-0.51, P = 0.0008) also mirrored the findings of overall
results. CONCLUSION(S): Patients with asymptomatic aortic valve
stenosis have lower odds of all-cause and cardiovascular mortality when
managed with early-AVR compared with conservative management. However,
because of significant heterogeneity in the classification of asymptomatic
patients, large scale studies are required.

<11>
[Use Link to view the full text]
Accession Number
632112573
Title
Ten-Year Outcomes after Drug-Eluting Stents Versus Coronary Artery Bypass
Grafting for Left Main Coronary Disease: Extended Follow-Up of the
PRECOMBAT Trial.
Source
Circulation. (pp 1437-1446), 2020. Date of Publication: 2020.
Author
Park D.-W.; Ahn J.-M.; Park H.; Yun S.-C.; Kang D.-Y.; Lee P.H.; Kim
Y.-H.; Lim D.-S.; Rha S.-W.; Park G.-M.; Gwon H.-C.; Kim H.-S.; Chae
I.-H.; Jang Y.; Jeong M.-H.; Tahk S.-J.; Seung K.B.; Park S.-J.
Institution
(Park, Ahn, Park, Kang, Lee, Kim, Park) Department of Cardiology, Asan
Medical Center, Seoul, South Korea
(Yun) Division of Biostatistics, Asan Medical Center, Seoul, South Korea
(Lim) Korea University, Anam Hospital, Seoul, South Korea
(Rha) Korea University, Kuro Hospital, Seoul, South Korea
(Park) Ulsan University, Hospital, South Korea
(Gwon, Kim) Samsung Medical Center, Seoul, South Korea
(Kim) Seoul National University, Hospital, South Korea
(Chae) Seoul National University, Bundan Hospital, Seongnam, South Korea
(Jang) Yonsei University, Severance Hospital, Seoul, South Korea
(Jeong) Chonnam National University Hospital, Gwangju, South Korea
(Tahk) Ajou University, Medical Center, Suwon, South Korea
(Seung) Catholic University of Korea, St. Mary's Hospital, Seoul, South
Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Long-term comparative outcomes after percutaneous coronary
intervention (PCI) with drug-eluting stents and coronary-artery bypass
grafting (CABG) for left main coronary artery disease are highly debated.
 Method(s): In the PRECOMBAT trial (Premier of Randomized Comparison
of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in
Patients with Left Main Coronary Artery Disease), patients with
unprotected left main coronary artery disease were randomly assigned to
undergo PCI with sirolimus-eluting stents (n=300) or CABG (n=300) in 13
hospitals in Korea from April 2004 to August 2009. The follow-up was
extended to at least 10 years for all patients (median, 11.3 years). The
primary outcome was the incidence of major adverse cardiac or
cerebrovascular events (composite of death from any cause, myocardial
infarction, stroke, or ischemia-driven target-vessel revascularization).
 Result(s): At 10 years, a primary outcome event occurred in 29.8% of
the PCI group and in 24.7% of the CABG group (hazard ratio [HR] with PCI
vs CABG, 1.25 [95% CI, 0.93-1.69]). The 10-year incidence of the composite
of death, myocardial infarction, or stroke (18.2% vs 17.5%; HR 1.00 [95%
CI, 0.70-1.44]) and all-cause mortality (14.5% vs 13.8%; HR 1.13 [95% CI,
0.75-1.70]) were not significantly different between the PCI and CABG
groups. Ischemia-driven target-vessel revascularization was more frequent
after PCI than after CABG (16.1% vs 8.0%; HR 1.98 [95% CI, 1.21-3.21).
 Conclusion(s): Ten-year follow-up of the PRECOMBAT trial of patients
with left main coronary artery disease randomized to PCI or CABG did not
demonstrate significant difference in the incidence of major adverse
cardiac or cerebrovascular events. Because the study was underpowered, the
results should be considered hypothesis-generating, highlighting the need
for further research. Registration: URL: https://www.clinicaltrials.gov;
Unique identifiers: NCT03871127 and NCT00422968. Copyright © 2020
Lippincott Williams and Wilkins. All rights reserved.

<12>
[Use Link to view the full text]
Accession Number
632047029
Title
Epidemiology of infective endocarditis in transcatheter aortic valve
replacement: systemic review and meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). 21 (10) (pp
790-801), 2020. Date of Publication: 01 Oct 2020.
Author
Prasitlumkum N.; Vutthikraivit W.; Thangjui S.; Leesutipornchai T.;
Kewcharoen J.; Riangwiwat T.; Dworkin J.
Institution
(Prasitlumkum, Kewcharoen, Dworkin) Department of Internal Medicine,
University of Hawaii Internal Medicine Residency Program, Honolulu, HI,
United States
(Vutthikraivit) Department of Internal Medicine, Texas Tech University
Health Sciences Center, Lubbock, TX, United States
(Thangjui, Leesutipornchai) Department of Internal Medicine, Faculty of
Medicine, Chulalongkorn University, Bangkok, Thailand
(Riangwiwat) Cardiology Department, Geisinger Medical Center, Danville,
PA, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Infective endocarditis following transcatheter aortic valve
replacement (TAVR) is an emerging problem, with a high rate of morbidity
and mortality. However, little is known about the burden of disease, and
data on infective endocarditis incidence are scarce. This study aimed to
evaluate the incidence of infective endocarditis in TAVR by performing a
systematic review and meta-analysis of the literature. METHOD(S): We
comprehensively searched the databases of MEDLINE and EMBASE from
inception to October 2019. Included studies were prospective or
retrospective cohort studies that reported the event rate of infective
endocarditis in patients who underwent TAVR. Data from each study were
combined using the random-effects method to calculate pooled incidence
with 95% confidence intervals (CIs). RESULT(S): A total of 30 studies
consisting of 73 780 patients undergoing TAVR were included in this
meta-analysis. Overall, the pooled estimated incidence of infective
endocarditis following TAVR was 7 in 1000 patients (95% CI: 0.5-1%). For
early infective endocarditis, the pooled estimated incidence was 8 per
1000 patients (95% CI: 0.5-1.1%). For late infective endocarditis, the
pooled estimated incidence was 2 in 1000 patients (95% CI: 0.1-0.4%).
Significantly, the overall pooled infective endocarditis mortality rate
was 39% (95% CI: 28.7-49.4%). CONCLUSION(S): The current study
demonstrates the incidence of overall, early, and late infective
endocarditis following TAVR, ranging from 2 to 8 per 1000 patients.
Although it remains a rare event, infective endocarditis following TAVR is
associated with high mortality.

<13>
Accession Number
635279260
Title
Aortic valve function post-replacement of severe aortic stenosis by
transcatheter procedure versus surgery: a systematic review and
metanalysis.
Source
Scientific reports. 11 (1) (pp 11975), 2021. Date of Publication: 07 Jun
2021.
Author
Abi Khalil C.; Ignatiuk B.; Erdem G.; Chemaitelly H.; Barilli F.;
El-Shazly M.; Al Suwaidi J.; Aboulsoud S.; Kofler M.; Stastny L.; Jneid
H.; Bonaros N.
Institution
(Abi Khalil) Research Department, Weill Cornell Medicine-Qatar, Doha,
Qatar
(Abi Khalil) Joan and Sanford I. Weill Department of Medicine, Weill
Cornell Medicine, NY, United States
(Abi Khalil) Department of Health Policy, London School of Economics,
London, United Kingdom
(Ignatiuk, Erdem, Bonaros) Department of Health Policy, London School of
Economics, London, United Kingdom
(Ignatiuk) Ospedali Riuniti Padova Sud IT, Monselice, Italy
(Erdem) Istanbul Kent University, Istanbul, Turkey
(Chemaitelly, El-Shazly, Al Suwaidi) Research Department, Weill Cornell
Medicine-Qatar, Doha, Qatar
(Barilli) Department of CardioVascular Surgery, S. Croce e Carle Hospital,
Cuneo, Italy
(El-Shazly) Department of Cardiovascular Medicine, Heart and Vascular
Institute, Cleveland Clinic, OH, United States
(Aboulsoud, Kofler) Department of Internal Medicine, Faculty of Medicine,
Cairo University, Cairo, Egypt
(Stastny, Bonaros) Department of Cardiac Surgery, Medical University of
Innsbruck, Innsbruck, Austria
(Jneid) Michael E. DeBakey VA Medical Center, Baylor College of Medicine,
Houston, United States
Publisher
NLM (Medline)
Abstract
Transcatheter aortic valve replacement (TAVR) has shown to reduce
mortality compared to surgical aortic valve replacement (sAVR). However,
it is unknown which procedure is associated with better post-procedural
valvular function. We conducted a meta-analysis of randomized clinical
trials that compared TAVR to sAVR for at least 2 years. The primary
outcome was post-procedural patient-prosthesis-mismatch (PPM). Secondary
outcomes were post-procedural and 2-year: effective orifice area (EOA),
paravalvular gradient (PVG) and moderate/severe paravalvular leak (PVL).
We identified 6 trials with a total of 7022 participants with severe
aortic stenosis. TAVR was associated with 37% (95% CI [0.51-0.78) mean RR
reduction of post-procedural PPM, a decrease that was not affected by the
surgical risk at inclusion, neither by the transcatheter heart valve
system. Postprocedural changes in gradient and EOA were also in favor of
TAVR as there was a pooled mean difference decrease of 0.56 (95% CI
[0.73-0.38]) in gradient and an increase of 0.47 (95% CI [0.38-0.56]) in
EOA. Additionally, self-expandable valves were associated with a higher
decrease in gradient than balloon ones (beta=0.38; 95% CI [0.12-0.64]).
However, TAVR was associated with a higher risk of moderate/severe PVL
(pooled RR: 9.54, 95% CI [5.53-16.46]). All results were sustainable at 2
years.

<14>
Accession Number
2013030343
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: 01 Jun 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, The Alfred Hospital,
Melbourne, Australia
Publisher
Oxford University Press
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) (-4.23 days, 95% CI
-6.14 to -2.32 days) and improved 6-min walking distance (71.25 m, 95% CI
39.68-102.82) and peak oxygen uptake consumption (VO2peak)
(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 (-2.86 days, 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. Copyright © 2021 Oxford
University Press. All rights reserved.

<15>
Accession Number
2013030334
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: 01 Jun 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
Oxford University Press
Abstract
A best evidence topic in cardiac surgery was written according to a
structured protocol. The question addressed was whether erector spinae
plane block (ESPB) resulted in improved postoperative analgesia and
enhanced recovery in adult cardiac surgical patients. A total of 333
papers were found using the reported search of which, 7 papers represented
the best evidence to answer the clinical question. The authors, journal,
date and country of publication, patient groups studied, study type,
relevant outcomes and results of these papers are tabulated. The cardiac
surgical procedures included off-pump coronary artery bypass surgery (1
study), mitral/tricuspid valve repair (1 study), robotic minimally
invasive coronary artery bypass surgery (1 study) and other cardiac
surgeries (4 studies). ESPB was compared to intravenous analgesia (5
studies), thoracic epidural analgesia (1 study) and serratus anterior
plane block and paravertebral block (1 study). With ESPB, there was
significant improvement in postoperative pain scores (4 studies),
decreased opioid requirement/rescue analgesia (3 studies), increased
duration of analgesia (1 study), decreased time to extubation (3 studies),
less increase in postoperative Troponin T (1 study), earlier ambulation (2
studies), earlier oral intake (1 study), earlier chest drain removal (1
study), better patient satisfaction (1 study), reduced adverse events (1
study) and decreased intensive care unit stay (3 studies). We conclude
that ESPB may be associated with improved postoperative analgesia and
enhanced recovery after adult cardiac surgery based on the available
evidence. However, there is a need for better quality randomized
controlled trials to consolidate these findings. Copyright © 2021
Oxford University Press. All rights reserved.

<16>
Accession Number
2012392088
Title
Effects of levosimendan on renal blood flow and glomerular filtration in
patients with acute kidney injury after cardiac surgery: a double blind,
randomized placebo-controlled study.
Source
Critical Care. 25 (1) (no pagination), 2021. Article Number: 207. Date of
Publication: December 2021.
Author
Tholen M.; Ricksten S.-E.; Lannemyr L.
Institution
(Tholen, Ricksten, Lannemyr) Department of Anesthesiology and Intensive
Care Medicine At the Sahlgrenska Academy, University of Gothenburg and
Section for Cardiothoracic Anesthesia and Intensive Care, Sahlgrenska
University Hospital, Bla Straket 7, 5th Floor, Gothenburg 413 45, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is a common and serious complication
after cardiac surgery, and current strategies aimed at treating AKI have
proven ineffective. Levosimendan, an inodilatating agent, has been shown
to increase renal blood flow and glomerular filtration rate in
uncomplicated postoperative patients and in patients with the cardiorenal
syndrome. We hypothesized that levosimendan through its specific effects
on renal vasculature, a preferential vasodilating effect on preglomerular
resistance vessels, could improve renal function in AKI-patients with who
did not have clinical indication for inotropic support. Method(s): In
this single-center, double-blind, randomized controlled study, adult
patients with postoperative AKI within 2 days after cardiac surgery, who
were hemodynamically stable with a central venous oxygen saturation
(ScvO<inf>2</inf>) >= 60% without inotropic support were eligible for
inclusion. After randomization, study drug infusions, levosimendan (n =
16) or placebo (n = 13) were given for 5 h. A bolus infusion of
levosimendan (12 microg/kg), were given for 30 min followed by 0.1
microg/kg/min for 5 h. Renal blood flow and glomerular filtration rate
were measured using infusion clearance of para-aminohippuric acid and a
filtration marker, respectively. As a safety issue, norepinephrine was
administered to maintain mean arterial pressure between 70-80 mmHg.
Intra-group differences were tested by Mann-Whitney U-tests, and a linear
mixed model was used to test time and group interaction. Result(s):
Twenty-nine patients completed the study. At inclusion, the mean serum
creatinine was higher in the patients randomized to levosimendan (148 +/-
29 vs 127 +/- 22 micromol/L, p = 0.030), and the estimated GFR was lower
(46 +/- 12 vs 57 +/- 11 ml/min/1.73 m2, p = 0.025).
Levosimendan induced a significantly (p = 0.011) more pronounced increase
in renal blood flow (15%) compared placebo (3%) and a more pronounced
decrease in renal vascular resistance (- 18% vs. - 4%, respectively, p =
0.043). There was a trend for a minor increase in glomerular filtration
rate with levosimendan (4.5%, p = 0.079), which did differ significantly
from the placebo group (p = 0.440). The mean norepinephrine dose was
increased by 82% in the levosimedan group and decreased by 29% in the
placebo group (p = 0.012). Conclusion(s): In hemodynamically stable
patients with AKI after cardiac surgery, levosimendan increases renal
blood flow through renal vasodilatation. Trial registration NCT02531724,
prospectly registered on 08/20/2015.
https://clinicaltrials.gov/ct2/show/NCT02531724?cond=AKI&cntry=SE&age=1&dr
aw=2&rank=1 Copyright © 2021, The Author(s).

<17>
Accession Number
635273957
Title
The utility of mayo clinic's early screen for discharge planning (ESDP)
tool: A critical narrative review.
Source
Journal of Acute Care Physical Therapy. (no pagination), 2021. Date of
Publication: 2021.
Author
Socwell C.P.; Kanagasaba K.; Pope R.
Institution
(Socwell) Faculty of Health Sciences and Medicine, Bond University, 2
Promethean Way, Robina, QLD 4226, Australia
(Kanagasaba) Faculty of Health Sciences and Medicine, Bond University,
Robina, Australia
(Pope) School of Community Health, Charles Sturt University, Albury,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: The aim of this critical narrative review was to identify and
synthesize available research evidence on the utility of Mayo Clinic's
Early Screen for Discharge Planning (ESDP) tool to (1) identify adult
patients early during their hospital stay who require referral to
specialized hospital discharge planning services (SHDCPS) and (2) review
its utility in predicting patient outcomes including hospital length of
stay (LOS), readmission risk, and discharge destination. This review also
begins by highlighting the important role of physical therapists in
discharge planning. Method(s): A critical narrative review was
conducted of relevant studies identified through a systematic search of
PubMed, CINAHL, Embase, and ProQuest databases and subsequent systematic
screening and selection process. Studies were included and critically
appraised if they met eligibility criteria: studies investigating the
development, predictive validity and utility of the ESDP in hospital
patient populations, and studies comparing the ESDP with other discharge
planning tools. Key data were then extracted and tabulated before a
critical narrative synthesis of key findings was completed.
 Result(s): Seven studies met the eligibility criteria, with 5 studies
receiving a rating of "good" quality. The included studies investigated
the ESDP tool in adults within acute inpatient hospital settings,
including heart failure, colorectal surgery, general medical and surgical,
and oncology wards. Conclusion(s): Five of the 7 included studies
were of good quality and, together, studies provided evidence that the
ESDP tool correctly identifies adults requiring referral to SHDCPS.
However, further research of the ESDP tool is recommended to account for
variations observed in special populations and expand knowledge of its
utility to predict outcomes such as hospital LOS, readmission risk, and
discharge destination. Copyright © 2021 Academy of Acute Care
Physical Therapy, APTA.

<18>
Accession Number
635273898
Title
Improvement in physical function after coronary artery bypass graft
surgery using a novel rehabilitation intervention a randomized controlled
trial.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. (no pagination),
2021. Date of Publication: 2021.
Author
Rengo J.L.; Savage P.D.; Hirashima F.; Leavitt B.J.; Ades P.A.; Toth M.J.
Institution
(Rengo, Savage, Ades, Toth) Division of Cardiology, Department of
Medicine, College of Medicine, The University of Vermont, Burlington,
United States
(Hirashima, Leavitt) Division of Cardiothoracic Surgery, Department of
Surgery, College of Medicine, The University of Vermont, Burlington,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose: Cardiorespiratory and skeletal muscle deconditioning occurs
following coronary artery bypass graft surgery and hospitalization.
Outpatient, phase 2 cardiac rehabilitation (CR) is designed to remediate
this deconditioning but typically does not begin until several weeks
following hospital discharge. Although an exercise program between
discharge and the start of CR could improve functional recovery,
implementation of exercise at this time is complicated by postoperative
physical limitations and restrictions. Our objective was to assess the
utility of neuromuscular electrical stimulation (NMES) as an adjunct to
current rehabilitative care following postsurgical discharge and prior to
entry into CR on indices of physical function in patients undergoing
coronary artery bypass graft surgery. Method(s): Patients were
randomized to 4 wk of bilateral, NMES (5 d/wk) to their quadriceps muscles
or no intervention (control). Physical function testing was performed at
hospital discharge and 4 wk post-discharge using the Short Physical
Performance Battery and the 6-min walk tests. Data from 37 patients (19
control/18 NMES) who completed the trial were analyzed. The trial was
registered at ClinicalTrials.gov (NCT03892460). Result(s): Physical
function measures improved from discharge to 4 wk post-surgery across our
entire cohort (P <.001). Patients randomized to NMES, however, showed
greater improvements in 6-min walk test distance and power output compared
with controls (P <.01). Conclusion(s): Our results provide evidence
supporting the utility of NMES to accelerate recovery of physical function
after coronary artery bypass graft surgery. Copyright © 2021
Wolters Kluwer Health, Inc. All rights reserved.

<19>
Accession Number
625728509
Title
B-type natriuretic peptide is associated with remodeling and exercise
capacity after transcatheter aortic valve replacement for aortic stenosis.
Source
Clinical Cardiology. 42 (2) (pp 270-276), 2019. Date of Publication:
February 2019.
Author
Sato K.; Kumar A.; Krishnaswamy A.; Mick S.; Desai M.Y.; Griffin B.P.;
Kapadia S.R.; Popovic Z.B.
Institution
(Sato, Kumar, Krishnaswamy, Mick, Desai, Griffin, Kapadia, Popovic)
Department of Cardiovascular Medicine, Heart and Vascular Institute,
Cleveland Clinic, Cleveland, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: We aimed to assess longitudinal changes of B-type natriuretic
peptide (BNP) in aortic stenosis (AS) patients treated by transcatheter
aortic valve replacement (TAVR). Method(s): From our TAVR database,
we identified 193 consecutive patients with severe symptomatic AS who
underwent TAVR and were prospectively followed using serial BNP levels and
echocardiography. Patients were divided into subgroups according to type
of left ventricular (LV) remodeling as having normal LV mass and relative
wall thickness, or showing concentric remodeling (CR), concentric
hypertrophy (CH), and eccentric hypertrophy (EH). Result(s): At
baseline, 30 patients (16%) had EH, 115 (60%) had CH, 37 (19%) had CR, and
11 (6%) had normal LV geometry. After TAVR, BNP decreased in the first 30
days, with further improvement during follow-up. Patients with EH had
higher BNP at baseline (P < 0.01) and a greater subsequent decrease (P <
0.001). During the median follow-up of 1331 days (interquartile range:
632-1678), 119 (62%) patients died. BNP showed a time-dependent
association with all-cause mortality both in a univariable (hazards ratio
[HR] 1.24, 95% confidence interval [CI]: 1.04-1.47, P = 0.017), and in a
multivariable model with Society of Thoracic Surgeons score and baseline
BNP forced into the analysis (HR 1.32, 95% CI: 1.001-1.73, P = 0.049).
Elevated BNP was associated with a larger LV end-diastolic volume index (P
< 0.001) and shorter 6-minute walk test distance (P = 0.013) throughout
follow-up. Conclusion(s): In patients with AS, BNP was associated
with LV remodeling phenotypes and functional status before and after TAVR.
Elevated BNP levels were associated with poor prognosis. Copyright
© 2018 The Authors. Clinical Cardiology published by Wiley
Periodicals, Inc.

<20>
Accession Number
358101992
Title
Effects of allopurinol and vitamin E on renal function in patients with
cardiac coronary artery bypass grafts.
Source
Vascular Health and Risk Management. 5 (pp 489-494), 2009. Date of
Publication: 2009.
Author
Nouri-Majalan N.; Ardakani E.F.; Forouzannia K.; Moshtaghian H.
Institution
(Nouri-Majalan) Department of Nephrology, Afshar Hospital, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Ardakani) Ali Bin Abu Taleb Medical College, Yazd Azad University, Yazd,
Iran, Islamic Republic of
(Forouzannia) Department of Cardiovascular Surgery, Afshar Hospital,
Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Islamic
Republic of
(Moshtaghian) Department of Anesthesiology, Afshar Hospital, Shahid
Sadoughi University of Medical Sciences, Yazd, Iran, Islamic Republic of
Publisher
Dove Medical Press Ltd
Abstract
Background: Acute renal failure is a common complication of cardiac
surgery, with oxidants found to play an important role in renal injury. We
therefore assessed whether the supplemental antioxidant vitamin E and the
inhibitor of xanthine oxidase allopurinol could prevent renal dysfunction
after coronary artery bypass graft (CABG) surgery. Method(s): Of 60
patients with glomerular filtration rate (GFR) < 60 mL/min scheduled to
undergo CABG surgery, 30 were randomized to treatment with vitamin E and
allopurinol for 3-5 days before surgery and 30 to no treatment. Serum
creatinine levels and potassium and creatinine clearances were measured
preoperatively and daily until day 5 after surgery. Result(s): The
patients consisted of 31 males and 29 females, with a mean age of 63 +/- 9
years. After surgery, there were no significant differences in mean serum
creatinine (1.2 +/- 0.33 vs 1.2 +/- 0.4 mg/dL; p = 0.43) concentrations,
or creatinine clearance (52 +/- 12.8 vs 52 +/- 12.8 mL/min; p = 0.9). The
frequency of acute renal failure did not differ in treatment group
compared with control (16% vs 13%; p = 0.5). Length of stay in the
intensive care unit (ICU) was significantly longer in the control than in
the treated group (3.9 +/- 1.5 vs 2.6 +/- 0.7 days; p < 0.001).
 Conclusion(s): Prophylactic treatment with vitamin E and allopurinol
had no renoprotective effects in patients with pre-existing renal failure
undergoing CABG surgery. Treatment with these agents, however, reduces the
duration of ICU stay. © 2009 Nouri-Majalan et al, publisher and
licensee Dove Medical Press Ltd.

<21>
Accession Number
2010712343
Title
The Effects of Bispectral Index-Guided Anesthesia on Postoperative
Delirium in Elderly Patients: A Systematic Review and Meta-Analysis.
Source
World Neurosurgery. 147 (pp e57-e62), 2021. Date of Publication: March
2021.
Author
Shan W.; Chen B.; Huang L.; Zhou Y.
Institution
(Shan, Chen, Huang, Zhou) Department of Anesthesiology, The 1st Affiliated
Hospital, School of Medicine, Zhejiang University, Hangzhou, China
Publisher
Elsevier Inc.
Abstract
Objective: Postoperative delirium (POD) is a form of delirium that affects
patients who have undergone surgical procedures and anesthesia, usually
peaking between 1 and 3 days after their operation. The aim of this
meta-analysis was to determine whether monitoring of depth of anesthesia
may influence the incidence of POD. Method(s): A systematic
literature search was conducted on studies that reported POD in elderly
patients (>60 years old) who underwent surgery. This meta-analysis was
carried out using random-effects model. Result(s): Compared with
control group, intraoperative bispectral index (BIS) monitoring reduced
POD (odds ratio 1.32, 95% confidence interval 1.11-1.57, P = 0.001,
I2 = 51%). In the mixed-surgery group, compared with the
control group, BIS monitoring decreased the incidence of POD (odds ratio
1.24, 95% confidence interval 1.07-1.44, P = 0.004, I2 = 61%).
There was also no significant difference in the incidence of POD among
patients who underwent cardiac, colon, and orthopedic surgeries.
 Conclusion(s): BIS monitoring during surgery can reduce the incidence
of POD in elderly patients. Whether BIS monitoring may reduce the
incidence of POD in a single type of surgery needs further
study. Copyright © 2020 Elsevier Inc.

<22>
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. 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. 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. 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. Copyright © The
Author(s) 2021.

<23>
Accession Number
2008003932
Title
Do economic evaluations of TAVI deal with learning effects, innovation,
and context dependency? A review.
Source
Health Policy and Technology. 10 (1) (pp 111-119), 2021. Date of
Publication: March 2021.
Author
Enzing J.J.; Vijgen S.; Knies S.; Boer B.; Brouwer W.B.F.
Institution
(Enzing, Knies, Boer, Brouwer) Erasmus School of Health Policy &
Management, Erasmus University Rotterdam, Rotterdam, Netherlands
(Enzing, Vijgen, Knies) Zorginstituut Nederland, Diemen, Netherlands
Publisher
Elsevier B.V.
Abstract
Introduction: Most collectively funded healthcare systems set limits to
their benefit package. Doing so requires judgements which may involve
economic evaluations. Performing such evaluations brings methodological
challenges, which may be more pronounced in non-pharmaceutical
interventions. For example, for medical devices, the validity of
assessment results may be limited by learning effects, incremental
innovation of the devices and the context-dependency of their outcomes.
 Objective(s): To review the extent to which "learning effects",
"incremental innovation" (related to outcomes) and "context-dependency"
are included and/or discussed in peer reviewed economic evaluations on
medical devices using Transcatheter Aortic Valve Implementation (TAVI) as
an example. Method(s): A systematic review was performed including
full economic evaluations of TAVI for operable patients with aortic
stenosis identified using the Pubmed database. Study characteristics,
study results and text fragments concerning the aforementioned aspects
were extracted. The quality of the studies was assessed using a quality
checklist (CHEC-extended). Result(s): Within 207 screened records, 15
studies were identified. Two studies referred to all three aspects, four
studies referred to none. "Learning effects" were discussed in five
studies, one of which described a method to cope with this challenge.
"Incremental innovation" was described in seven studies. Limitations in
generalizability of results related to context of care provision were
discussed in seven studies. Conclusion(s): The challenges related to
economic evaluations of TAVI and their influence on the validity of
reported results, are typically only partly discussed and rarely dealt
within peer reviewed studies. It is important for better informed policy
decisions that this improves. Copyright © 2020 Fellowship of
Postgraduate Medicine

<24>
Accession Number
2007541500
Title
Anticoagulation With or Without Antiplatelet Therapy Following
Transcatheter Aortic Valve Replacement for Patients With Atrial
Fibrillation: A Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 24 (pp 42-47), 2021. Date of
Publication: March 2021.
Author
Yokoyama Y.; Briasoulis A.; Takagi H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Briasoulis) Division of Cardiology, Heart failure and Transplantation,
University of Iowa, IA, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Although current guidelines recommend oral anticoagulants
(OAC) with or without antiplatelet therapy (APT) following transcatheter
aortic valve replacement (TVAR) in patients with an indication for
long-term anticoagulation therapy, the optimal antithrombotic strategy
remains unknown in these population. Herein, we conducted a meta-analysis
comparing the outcome of OAC alone versus OAC with APT following TAVR in
patients with atrial fibrillation (AF). Method(s): MEDLINE and EMBASE
were searched through May 2020 to identify clinical trials that
investigated OAC alone versus OAC with APT following TAVR in patients with
AF. From each study, we extracted the hazard ratios (HRs) or risk ratios
of major or life threatening bleeding, stroke, all-cause mortality and
cardiovascular mortality. Result(s): 1 randomized controlled trial
and 3 observational studies were identified, which enrolled a total of
2032 patients with AF who underwent TAVR assigned to the OAC group (n =
722) or OAC with APT group (n = 1310). Pooled analyses demonstrated the
rate of major or life threatening bleeding was significantly lower in the
OAC group compared to the OAC with APT group (HR [95% Confidence Interval
[CI] = 0.54 [0.38-0.77], P =.0006]). However, the rate of stroke was
similar in both groups (HR [95% CI] = 1.22 [0.80-1.87], P =.36). All-cause
and cardiovascular mortalities were also similar in both groups.
 Conclusion(s): We observed that OAC with APT following TAVR in
patients with AF increased the risk of bleeding compared to OAC alone
without decreasing the risk of stroke. Copyright © 2020 Elsevier
Inc.

<25>
Accession Number
2006096658
Title
Nitric oxide added to the sweep gas of the oxygenator during
cardiopulmonary bypass in infants: A pilot randomized controlled trial.
Source
Artificial Organs. 45 (1) (pp 22-28), 2021. Date of Publication: January
2021.
Author
Niebler R.A.; Chiang-Ching H.; Daley K.; Janecke R.; Jobe S.M.; Mitchell
M.E.; Varner C.; Woods K.; Scott J.P.
Institution
(Niebler, Jobe, Woods) Departments of Pediatrics, Medical College of
Wisconsin, Milwaukee, WI, United States
(Niebler, Daley, Mitchell, Varner, Scott) Herma Heart Institute,
Children's Wisconsin, Milwaukee, WI, United States
(Chiang-Ching) School of Public Health, University of Wisconsin,
Milwaukee, WI, United States
(Janecke, Jobe) Versiti Blood Research Institute, Milwaukee, WI, United
States
(Mitchell) Departments of Cardiothoracic Surgery, Medical College of
Wisconsin, Milwaukee, WI, United States
(Scott) Departments of Anesthesia, Medical College of Wisconsin,
Milwaukee, WI, United States
Publisher
Blackwell Publishing Inc.
Abstract
Our objective was to assess the effect of nitric oxide added to the sweep
gas of the oxygenator during cardiopulmonary bypass (CPB) in infants on
platelet count, platelet function, clinical outcomes, and safety. A
randomized, double-blinded, placebo-controlled clinical trial in infants
less than a year of age undergoing cardiac surgery requiring CPB was
undertaken. Nitric oxide at a dose of 20 ppm was added to the sweep gas in
the treatment group. Blood was collected at baseline and prior to
separation from CPB to measure platelet count and function as determined
by responsiveness to specific agonists. Clinical outcomes were observed
through hospital discharge. Methemoglobin levels were measured
preoperatively, at the conclusion of CPB, and upon admission to the ICU.
Forty patients consented and were randomized in the trial. Eighteen
patients were randomized to the treatment group and 22 were included in
the placebo group. The groups were similar in terms of age, weight,
gender, and surgical complexity. No significant differences were found in
measures of platelet count, platelet response to agonist, or clinical
outcomes. Patients in the treatment group had higher methemoglobin levels
after receiving nitric oxide, but no levels approached toxicity (maximum
2.4%). Nitric oxide added to the sweep gas of the oxygenator during CPB in
infants did not have an appreciable effect on the preservation of platelet
count, platelet responsiveness to agonist, or clinical outcomes.
Methemoglobin levels were increased after receiving nitric oxide but were
far below a toxic level of 15%. Copyright © 2020 International
Center for Artificial Organ and Transplantation (ICAOT) and Wiley
Periodicals LLC.

<26>
Accession Number
2005826298
Title
Postoperative neurocognitive disorders in cardiac surgery: Investigating
the role of intraoperative hypotension. a systematic review.
Source
International Journal of Environmental Research and Public Health. 18 (2)
(pp 1-15), 2021. Article Number: 786. Date of Publication: 02 Jan 2021.
Author
Czok M.; Pluta M.P.; Putowski Z.; Krzych L.J.
Institution
(Czok, Pluta, Putowski, Krzych) Department of Anaesthesiology and
Intensive Care, Faculty of Medical Sciences in Katowice, Medical
University of Silesia, Katowice 40752, Poland
Publisher
MDPI AG
Abstract
Perioperative neurocognitive disorders remain a challenging obstacle in
patients after cardiac surgery, as they significantly contribute to
postoperative morbidity and mortality. Identifying the modifiable risk
factors and mechanisms for postoperative cognitive decline (POCD) and
delirium (POD) would be an important step forward in preventing such
adverse events and thus improving patients' outcome. Intraoperative
hypotension is frequently discussed as a potential risk factor for
neurocognitive decline, due to its significant impact on blood flow and
tissue perfusion, however the studies exploring its association with POCD
and POD are very heterogeneous and present divergent results. This review
demonstrates 13 studies found after structured systematic search strategy
and discusses the possible relationship between intraoperative hypotension
and postoperative neuropsychiatric dysfunction. Copyright © 2021
by the authors. Licensee MDPI, Basel, Switzerland.

<27>
Accession Number
634979249
Title
Coronary artery bypass grafting in a patient with situs inversus totalis
and Hodgkin lymphoma: Three-year follow-up report and systematic
literature review.
Source
Asian journal of surgery. 44 (6) (pp 885-886), 2021. Date of Publication:
01 Jun 2021.
Author
Cheng Z.; Zhang J.; Shi J.; Guo Y.
Institution
(Cheng, Zhang, Shi, Guo) Department of Cardiovascular Surgery, West China
Hospital, Sichuan University, Chengdu, Sichuan 610041, China
Publisher
NLM (Medline)

<28>
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. 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. 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). 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. Copyright © 2021
Elsevier Inc.

<29>
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. 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. Method(s): PubMed, Embase, Cochrane Library,
and Web of Science were searched from January 2000 till May 2020.
 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. 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. Copyright © 2021 The Authors. Transfusion Medicine
published by John Wiley & Sons Ltd on behalf of British Blood Transfusion
Society.

<30>
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. 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). 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).
 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. Copyright © 2021, The Japanese
Association for Thoracic Surgery.

<31>
Accession Number
2013035474
Title
Pharmacodynamic Effects of Pre-Hospital Administered Crushed Prasugrel in
Patients With ST-Segment Elevation Myocardial Infarction.
Source
JACC: Cardiovascular Interventions. 14 (12) (pp 1323-1333), 2021. Date of
Publication: 28 Jun 2021.
Author
Vogel R.F.; Delewi R.; Angiolillo D.J.; Wilschut J.M.; Lemmert M.E.;
Diletti R.; van Vliet R.; van der Waarden N.W.P.L.; Nuis R.-J.; Paradies
V.; Alexopoulos D.; Zijlstra F.; Montalescot G.; Krucoff M.W.; van Mieghem
N.M.; Smits P.C.; Vlachojannis G.J.
Institution
(Vogel, Vlachojannis) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(Delewi) Department of Cardiology, Amsterdam University Medical Center,
Amsterdam, Netherlands
(Angiolillo) Department of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Wilschut, Lemmert, Diletti, Nuis, Zijlstra, van Mieghem) Department of
Cardiology, Erasmus Medical Center, Rotterdam, Netherlands
(Lemmert) Department of Cardiology, Isala Hospital, Zwolle, Netherlands
(van Vliet, Paradies, Smits, Vlachojannis) Department of Cardiology,
Maasstad Hospital, Rotterdam, Netherlands
(van der Waarden) Emergency Medical Service, AmbulanceZorg
Rotterdam-Rijnmond, Barendrecht, Netherlands
(Alexopoulos) Department of Cardiology, National and Kapodistrian
University of Athens Medical School, Attikon University Hospital, Athens,
Greece
(Montalescot) Department of Cardiology, ACTION Group, Groupe Hospitalier
Pitie-Salpetriere Hospital (Assistance Publique-Hopitaux de Paris),
Sorbonne University, Paris, France
(Krucoff) Department of Cardiology, Duke University Medical Center,
Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to compare the pharmacodynamic effects of
pre-hospitally administered P2Y<inf>12</inf> inhibitor prasugrel in
crushed versus integral tablet formulation in patients with ST-segment
elevation myocardial infarction (STEMI) undergoing primary percutaneous
coronary intervention (pPCI). Background(s): Early dual antiplatelet
therapy is recommended in STEMI patients. Yet, onset of oral
P2Y<inf>12</inf> inhibitor effect is delayed and varies according to
formulation administered. Method(s): The COMPARE CRUSH (Comparison of
Pre-hospital Crushed Versus Uncrushed Prasugrel Tablets in Patients With
STEMI Undergoing Primary Percutaneous Coronary Interventions) trial
randomized patients with suspected STEMI to crushed or integral prasugrel
60-mg loading dose in the ambulance. Pharmacodynamic measurements were
performed at 4 time points: before antiplatelet treatment, at the
beginning and end of pPCI, and 4 h after study treatment onset. The
primary endpoint was high platelet reactivity at the end of pPCI. The
secondary endpoint was impact of platelet reactivity status on markers of
coronary reperfusion. Result(s): A total of 441 patients were
included. In patients with crushed prasugrel, the occurrence of high
platelet reactivity at the end of pPCI was reduced by almost one-half
(crushed 34.7% vs. uncrushed 61.6%; odds ratio [OR] = 0.33; 95% confidence
interval [CI] = 0.22 to 0.50; p < 0.01). Platelet reactivity <150
P2Y<inf>12</inf> reactivity units at the beginning of coronary angiography
correlated with improved Thrombolysis In Myocardial Infarction flow grade
3 in the infarct artery pre-pPCI (OR: 1.78; 95% CI: 1.08 to 2.94; p =
0.02) but not ST-segment resolution (OR: 0.80; 95% CI: 0.48 to 1.34; p =
0.40). Conclusion(s): Oral administration of crushed compared with
integral prasugrel significantly improves platelet inhibition during the
acute phase in STEMI patients undergoing pPCI. However, a considerable
number of patients still exhibit inadequate platelet inhibition at the end
of pPCI, suggesting the need for alternative agents to bridge the gap in
platelet inhibition. Copyright © 2021 American College of
Cardiology Foundation

<32>
Accession Number
2013015386
Title
Rationale and design of the intravenous iron for treatment of anemia
before cardiac surgery trial.
Source
American Heart Journal. 239 (pp 64-72), 2021. Date of Publication:
September 2021.
Author
Myles P.S.; Richards T.; Klein A.; Smith J.; Wood E.M.; Heritier S.;
McGiffin D.; Zavarsek S.; Symons J.; McQuilten Z.K.; Baker R.A.; Karkouti
K.; Wallace S.
Institution
(Myles, Symons, Wallace) Department of Anaesthesiology and Perioperative
Medicine, Alfred Hospital, Melbourne, Victoria, Australia
(Myles, Richards, Klein, Symons, Wallace) Department of Anaesthesiology
and Perioperative Medicine, Monash University, Melbourne, Victoria,
Australia
(Richards) Department of Surgery, University of Western Australia, Perth,
Western Australia, Australia
(Klein) Department of Anaesthesia and Intensive Care, Royal Papworth
Hospital, Cambridge, United Kingdom
(Smith) Department of Cardiothoracic Surgery, Monash Health, Clayton,
Victoria, Australia
(Smith) Department of Surgery, Monash University, Clayton, Victoria,
Australia
(Wood, McQuilten) Department of Clinical Haematology, Monash Health and
University, Clayton, Victoria, Australia
(Wood, Heritier, McQuilten) School of Public Health and Preventive
Medicine, Monash University, Melbourne, Victoria, Australia
(McGiffin) Department of Cardiothoracic Surgery, Alfred Hospital,
Melbourne, Victoria, Australia
(Zavarsek) Deakin Health Economics, Institute for Health Transformation,
Faculty of Health, Deakin University, Burwood, Victoria, Australia
(Baker) Cardiothoracic Quality and Outcomes, SALHN Perfusion Service,
Flinders Medical Centre and Flinders University, Adelaide, South
Australia, Australia
(Karkouti) Department of Anesthesia and Pain Medicine, University of
Toronto, Toronto, ON, Canada
Publisher
Mosby Inc.
Abstract
Background Approximately 20% to 30% of patients awaiting cardiac surgery
are anemic. Anemia increases the likelihood of requiring a red cell
transfusion and is associated with increased complications, intensive
care, and hospital stay following surgery. Iron deficiency is the
commonest cause of anemia and preoperative intravenous (IV) iron therapy
thus may improve anemia and therefore patient outcome following cardiac
surgery. We have initiated the intravenous iron for treatment of anemia
before cardiac surgery (ITACS) Trial to test the hypothesis that in
patients with anemia awaiting elective cardiac surgery, IV iron will
reduce complications, and facilitate recovery after surgery. Methods ITACS
is a 1,000 patient, international randomized trial in patients with anemia
undergoing elective cardiac surgery. The patients, health care providers,
data collectors, and statistician are blinded to whether patients receive
IV iron 1,000 mg, or placebo, at 1-26 weeks before their planned date of
surgery. The primary endpoint is the number of days alive and at home up
to 90 days after surgery. Results To date, ITACS has enrolled 615 patients
in 30 hospitals in 9 countries. Patient mean (SD) age is 66 (12) years,
63% are male, with a mean (SD) hemoglobin at baseline of 118 (12) g/L; 40%
have evidence (ferritin <100 ng/mL and/or transferrin saturation <25%)
suggestive of iron deficiency. Most (59%) patients have undergone coronary
artery surgery with or without valve surgery. Conclusions The ITACS Trial
will be the largest study yet conducted to ascertain the benefits and
risks of IV iron administration in anemic patients awaiting cardiac
surgery. Copyright © 2021

<33>
Accession Number
2012992412
Title
Indirect comparison of the efficacy and safety of alirocumab and
evolocumab: A systematic review and network meta-analysis.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 7 (3) (pp
225-235), 2021. Date of Publication: 01 May 2021.
Author
Guedeney P.; Sorrentino S.; Giustino G.; Chapelle C.; Laporte S.; Claessen
B.E.; Ollier E.; Camaj A.; Kalkman D.N.; Vogel B.; De Rosa S.; Indolfi C.;
Lattuca B.; Zeitouni M.; Kerneis M.; Silvain J.; Collet J.-P.; Mehran R.;
Montalescot G.
Institution
(Guedeney, Vogel, Lattuca, Zeitouni, Kerneis, Silvain, Collet,
Montalescot) Department of Cardiology, Sorbonne Universite, ACTION Study
Group, UMR_S 1166, Institut de Cardiologie, Pitie Salpetriere Hospital
(AP-HP), Paris, France
(Guedeney, Sorrentino, Giustino, Claessen, Camaj, Kalkman, Mehran)
Department of Interventional Cardiovascular Research and Clinical Trials,
The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Sorrentino, De Rosa, Indolfi) Division of Cardiology, Department of
Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy
(Chapelle, Laporte, Ollier) Unite de Recherche Clinique Innovation et
Pharmacologie CHU de Saint-Etienne, Saint-Etienne, France
(Kalkman) Department of Clinical and Experimental Cardiology, Amsterdam
UMC, University of Amsterdam, Heart Center, Amsterdam Cardiovascular
Sciences, Meibergdreef 9, Amsterdam, Netherlands
Publisher
Oxford University Press
Abstract
Aims: Although alirocumab and evolocumab have both been associated with
improved outcomes in patients with dyslipidaemia or established
atherosclerotic cardiovascular disease, data on their respective
performances are scarce. This study aimed at providing an indirect
comparison of the efficacy and safety of alirocumab vs. evolocumab.
 Methods and Results: We conducted a systematic review and network
meta-analysis of randomized trials comparing alirocumab or evolocumab to
placebo with consistent background lipid-lowering therapy up to November
2018. We estimated the relative risk (RR) and the 95% confidence intervals
(CIs) using fixed-effect model in a frequentist pairwise and network
meta-analytic approach. A total of 30 trials, enrolling 59 026 patients
were included. Eligibility criteria varied significantly across trials
evaluating alirocumab and evolocumab. Compared with evolocumab, alirocumab
was associated with a significant reduction in all-cause death (RR 0.80,
95% CI 0.66-0.97) but not in cardiovascular death (RR 0.83, 95% CI
0.65-1.05). This study did not find any significant differences in
myocardial infarction (RR 1.15, 95% CI 0.99-1.34), stroke (RR 0.96, 95% CI
0.71-1.28), or coronary revascularization (RR 1.13, 95% CI 0.99-1.29)
between the two agents. Alirocumab was associated with a 27% increased
risk of injection site reaction compared to evolocumab; however, no
significant differences were found in terms of treatment discontinuations,
systemic allergic reaction, neurocognitive events, ophthalmologic events,
or new-onset of or worsening of pre-existing diabetes. Conclusion(s):
Alirocumab and evolocumab share a similar safety profile except for
injection site reaction. No significant differences were observed across
the efficacy endpoints, except for all-cause death, which may be related
to the heterogeneity of the studied populations treated with the two
drugs. Copyright © The Author(s) 2020.

<34>
Accession Number
2012992277
Title
Severe tricuspid bioprosthetic valve stenosis as an unusual cause of
pulmonary embolism: A case report.
Source
European Heart Journal - Case Reports. 5 (5) (pp 1-7), 2021. Date of
Publication: 01 May 2021.
Author
Naser J.A.; Arghami A.; Eleid M.F.; Pislaru S.V.
Institution
(Naser) Department of Internal Medicine, Mayo Clinic College of Medicine,
200 First Street SW, Rochester, MN 55905, United States
(Arghami) Department of Cardiovascular Surgery, Mayo Clinic College of
Medicine, 200 First Street SW, Rochester, MN 55905, United States
(Eleid, Pislaru) Department of Cardiovascular Medicine, Mayo Clinic
College of Medicine, 200 First Street SW, Rochester, MN 55905, United
States
Publisher
Oxford University Press
Abstract
Background Bioprosthetic tricuspid valve stenosis (TS) is an uncommon and
frequently under-diagnosed condition. Although the resulting right heart
failure symptoms are well-known, the associated thrombogenic potential is
under-recognized. Case summary A 44-year-old woman with bioprosthetic
tricuspid valve (TV) replacement in 2001 was referred for urgent
consultation due to acute worsening of dyspnoea and severe swelling and
pain in her left arm and neck. She was diagnosed with atrial fibrillation
6 months before the presentation and was found to have right atrial (RA)
thrombus with pulmonary embolism and extensive retrograde venous extension
1 month prior. Review of studies done at her local institution revealed
10mmHg mean gradient (MG) across the bioprosthetic TV that was only
reported as mild-moderate TS. Echocardiography done at our instruction
confirmed suspicion of severe TS with calcified immobile leaflets.
Computed tomography showed persistent RA thrombus and therefore surgical
replacement of the TV was undertaken. Subsequently, patient's dyspnoea
rapidly improved. Discussion Progressive dyspnoea and symptoms of right
heart failure in a patient with a history of bioprosthetic TV replacement
should be investigated for prosthetic valve dysfunction. Due to its
rarity, TS diagnosis can be overlooked on routine echocardiography. In our
patient, despite a measured MG of 10 mmHg, the presence of critical TS was
not initially recognized. As TS is associated with increased thrombogenic
potential and given the rare occurrence of in situ RA thrombosis,
physicians must have a high index of suspicion for TS in the appropriate
clinical context. Copyright © 2021 Oxford University Press. All
rights reserved.

<35>
Accession Number
2012992260
Title
A case report of open-aorta, direct transcatheter valve-in-valve
implantation: An innovative approach to manage the hazard of coronary flow
compromise in transcatheter aortic valve re-interventions.
Source
European Heart Journal - Case Reports. 5 (5) (pp 1-6), 2021. Date of
Publication: 01 May 2021.
Author
Calcaterra D.; Kaur N.; Dasari G.; Daniel G.
Institution
(Calcaterra) Division of Cardiothoracic Surgery, Department of Surgery,
Bethesda Heart Hospital, Florida Atlantic University, 777 Glades Rd, Boca
Raton, FL 33431, United States
(Kaur, Dasari, Daniel) Division of Cardiology, Bethesda Heart Hospital,
Florida Atlantic University, Boca Raton, FL, United States
Publisher
Oxford University Press
Abstract
Background Coronary flow compromise is a significant risk of transcatheter
aortic valve therapy. Warranting preservation of coronary flow is even
more challenging with transcatheter aortic valve re-intervention since the
implantation of a transcatheter valve within a degenerated bioprosthetic
or transcatheter valve increases significantly this hazard. Case summary
We present a case of heart failure secondary to transcatheter aortic valve
degeneration requiring a transcatheter aortic valve re-intervention.
Pre-operative imaging studies demonstrated a high risk for iatrogenic
coronary flow impairment. The patient underwent a successful surgical
removal of the prosthetic valve leaflets followed by direct transcatheter
aortic valve implantation. Conclusion We reviewed the literature on the
approach to difficult coronaries in transcatheter aortic valve therapy,
and we describe an innovative hybrid approach that may represent a viable
alternative in cases where catheter techniques of coronary flow
preservation are not applicable. Copyright © 2021 Oxford
University Press. All rights reserved.

<36>
Accession Number
2012934959
Title
The Impact of Transfusions on Mortality After Transcatheter or Surgical
Aortic Valve Replacement.
Source
Annals of Thoracic Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Mumtaz M.; Wyler von Ballmoos M.C.; Deeb G.M.; Popma J.J.; Van Mieghem
N.M.; Kleiman N.S.; Gleason T.G.; Chawla A.; Hockmuth D.; Zorn G.L.;
Tadros P.; Li S.; Reardon M.J.
Institution
(Mumtaz) Department of Cardiovascular and Thoracic Surgery, University of
Pittsburgh Medical Center, Pinnacle Heath, Harrisburg, PA, United States
(Wyler von Ballmoos, Kleiman, Reardon) Department of Cardiothoracic
Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX,
United States
(Deeb) Department of Cardiac Surgery, University of Michigan Hospitals,
Ann Arbor, MI, United States
(Popma) Department of Interventional Cardiology, Beth Israel Deaconess
Medical Center, Boston, MA, United States
(Van Mieghem) Department of Interventional Cardiology, Erasmus University
Medical Center, Rotterdam, Netherlands
(Gleason) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Chawla, Hockmuth) Iowa Heart Center, Des Moines, IA, United States
(Zorn, Tadros) University of Kansas Medical Center, Kansas City, KS,
United States
(Li) Department of Statistics, Medtronic, Mounds View, MN, United States
Publisher
Elsevier Inc.
Abstract
Background: An increasing body of evidence suggests that packed red blood
cell (PRBC) transfusion may be associated with increased morbidity and
mortality after transcatheter and surgical aortic valve replacement. It
remains unclear whether PRBC transfusion is a surrogate marker or truly an
independent risk factor for mortality after aortic valve replacement in
different populations. Method(s): The Surgical Replacement and
Transcatheter Aortic Valve Implantation (SURTAVI) trial randomized 1660
patients with symptomatic, severe aortic stenosis at intermediate risk for
operative death to transcatheter aortic valve replacement or surgical
aortic valve replacement. Baseline characteristics and outcomes including
all-cause and cardiovascular mortality at 30 days and thereafter were
compared between participants with and participants without PRBC
transfusion. Cox proportional hazards models with time-varying covariates
were fitted to estimate the effect of PRBC transfusion on mortality after
adjustment for comorbidities and procedural complications. Result(s):
Patients receiving PRBC were older, more commonly female and frail, with
more comorbidities. The Society of Thoracic Surgeons Predicted Risk of
Mortality baseline score was higher in the transfused group. After
adjustment for these differences, PRBC transfusion was associated with
mortality at 30 days, but not thereafter. The effect of PRBC on mortality
(hazard ratio 1.04; 95% confidence interval, 0.96 to 1.11; P =.304) at 30
days was not independent of procedural complications (hazard ratio 21.04;
95% CI, 7.26 to 60.95; P <.001). Conclusion(s): Poor health status,
procedural complications, PRBC transfusion, and mortality are correlated
with each other. Transfusion of PRBC did not independently increase risk
for mortality. In this intermediate-risk population, transfusion appears
to be a risk marker of chronic conditions and periprocedural complications
as opposed to a risk factor for postprocedural mortality. (Clinical trial
registration: www.clinicaltrials.gov NCT01586910.) Copyright ©
2020

<37>
Accession Number
635268893
Title
The effect of N-acetyl cysteine injection on renal function after coronary
artery bypass graft surgery: a randomized double blind clinical trial.
Source
Journal of cardiothoracic surgery. 16 (1) (pp 161), 2021. Date of
Publication: 05 Jun 2021.
Author
Javaherforooshzadeh F.; Shaker Z.; Rashidi M.; Akhondzadeh R.; Hayati F.
Institution
(Javaherforooshzadeh) Department of anesthesia, Ahvaz Anesthesiology and
Pain Research Centre, Ahvaz Jundishapur University of Medical Sciences,
Ahvaz, Iran, Islamic Republic of
(Shaker, Rashidi, Akhondzadeh) Department of anesthesia, Ahvaz
Anesthesiology and Pain Research Centre, Ahvaz Jundishapur University of
Medical Sciences, Ahvaz, Iran, Islamic Republic of
(Hayati) Department of Internal Medicine, School of Medicine. Chronic
Renal Failure Research Center, Ahvaz Jundishapur University of Medical
Sciences, Ahvaz, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
BACKGROUND: This study aimed to compare the effects of N-acetyl cysteine
on renal function after coronary artery bypass graft surgery.
 METHOD(S): In this randomized clinical trial conducted in Golestan
Hospital, Ahvaz, Iran, 60 candidates for coronary artery bypass graft
surgery were selected and divided into two N-acetyl cysteine and control
groups (30 people each). Patients received 3 (2 intraoperative and 1
postoperative) doses of IV N-acetyl cysteine (100mg/kg) (n=30) or placebo
(n=30) over 24h. Prescription times were as follows: after induction of
anesthesia, in the Next 4h, and in the 16h after on. Primary outcomes were
serum levels of BUN and Cr, at baseline,4 and 48h after surgery. And also
need renal replacement therapy (RRT). Secondary outcomes included the
hemodynamic variables, Blood products transfusion. RESULT(S): There
were significant differences in BUN between groups at 4h (P=0.02) and 48h
after surgery (P=0.001) There were significant differences in Cr level
between groups at 4h (P<0.001) and 48h after surgery (P=0.001). MAP at
different times (at 4h p=0.002 and 48h after surgery P<0.001) were
significantly different between the two groups. There was a significant
difference between the two groups in terms of the unit of Packed cell
transfusion (P=0.002) and FFP transfusion (P<0.001). CONCLUSION(S):
In the present study, we found that administration of N-acetyl cysteine
can reduce the incidence of acute kidney injury in patients undergoing
coronary artery bypass graft surgery and improved kidney functions. TRIAL
REGISTRY: IRCT20190506043492N3 Registered at 2020.06.07.

<38>
Accession Number
2012752707
Title
Left Internal Mammary Artery Skeletonization Reduces Bleeding-A Randomized
Controlled Trial.
Source
Annals of Thoracic Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Mazur P.; Litwinowicz R.; Tchantchaleishvili V.; Natorska J.; Zabczyk M.;
Bochenek M.; Przybylski R.; Iwaniec T.; Kedziora A.; Filip G.; Kapelak B.
Institution
(Mazur, Litwinowicz, Kedziora, Filip, Kapelak) Department of
Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow,
Poland
(Mazur, Natorska, Zabczyk, Kapelak) Institute of Cardiology, Jagiellonian
University Medical College, Krakow, Poland
(Tchantchaleishvili) Division of Cardiac Surgery, Department of Surgery,
Thomas Jefferson University, Philadelphia, PA, United States
(Bochenek, Przybylski) Department of Heart Transplantation and Mechanical
Circulatory Support, Wroclaw Medical University, Wroclaw, Poland
(Iwaniec) Department of Hematology, Jagiellonian University Medical
College, Poland
Publisher
Elsevier Inc.
Abstract
Background: The objective of this study was to compare the impact of
skeletonized versus pedicled left internal mammary artery (LIMA)
harvesting on bleeding after coronary artery bypass grafting (CABG).
 Method(s): In a randomized, single-blinded trial with a parallel
group design and equal allocation, we randomly assigned 62 patients
undergoing primary elective CABG in a tertiary cardiac center to
skeletonized or pedicled LIMA dissection. Before surgery, all aspects of
coagulation were assessed. Patients were blinded to LIMA dissection
technique and monitored for cumulative drainage at 12 hours (primary
outcome) as well as myocardial necrosis markers. Result(s): With
recruitment complete, there were 31 patients in each group; all patients
were analyzed. Median postoperative drainage was 395 mL at 12 hours in all
patients; it was lower by 28% at 12 hours (P =.02) in patients with
skeletonized LIMA (Cohen's d, 0.6; 95% confidence interval (CI),
0.09-1.11). Patients with a LIMA pedicle received more fresh-frozen plasma
transfusions than did the skeletonized LIMA group (Median 3; interquartile
range 3-5 versus median 3; interquartile range 3-3; P =.03). Study arms
did not differ in blood coagulation. Left internal mammary artery
skeletonization (odds ratio = 0.04; 95% CI, 0.003-0.44; P =.009) and
higher body mass index (odds ratio = 0.63; 95% CI, 0.45-0.89; P =.008)
decreased the odds of being in the top drainage quartile at 12 hours
(>=550 mL). Creatine kinase was lower in skeletonized LIMA directly after
surgery (median 218 U/L; interquartile range 175-310 U/L versus median 424
U/L; interquartile range 256-510 U/L; P <.001), at 6 hours (median 324
U/L; interquartile range 239-424 U/L versus median 529 U/L; interquartile
range 374-707 U/L; P <.001), and 12 hours after surgery (median 351 U/L;
interquartile range 277-552 U/L versus median 695 U/L; interquartile range
509-1067 U/L; P <.001). Conclusion(s): Left internal mammary artery
skeletonization results in lower mediastinal drainage after CABG than
pedicled LIMA harvesting. Copyright © 2021

<39>
Accession Number
2012392225
Title
Delirium and depression in cardiac surgery: A comprehensive review of risk
factors, pathophysiology, and management.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
FatehiHassanabad A.; Bahrami N.; Novick R.J.; Ali I.S.
Institution
(Fatehi Hassanabad, Novick, Ali) Section of Cardiac Surgery, Department of
Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular
Institute, Calgary, AB, Canada
(Bahrami) Department of Medicine, Department of Medicine, Cumming School
of Medicine, Calgary, AB, Canada
Publisher
Blackwell Publishing Inc.
Abstract
Background: Mental health and wellbeing continue to gain more attention as
they are inextricably associated with clinical outcomes, particularly
quality of life. Many medical ailments and major surgeries affect
patients' mental health, including depression and delirium. Aim(s):
The objective of this manuscript was to comprehensively review and
critically examine the literature pertaining to cardiac surgery,
depression, and delirium. Method(s): This is a narrative review
article. We performed our search analysis by using the following key
words: "Cardiac Surgery", "Depression", "Delirium", "Clinical outcomes",
and "Mental Health". Search analysis was done on MedLine PubMed, accessing
indexed peer-reviewed publications. Result(s): Cardiac Surgery is a
life-altering intervention indicated to improve morbidity and mortality in
patients with cardiovascular diseases. Psychiatric conditions before and
after cardiac surgery worsen patient prognosis and increase mortality
rate. Specifically, preoperative depression increases postoperative
depression and is associated with impaired functional status, slow
physical recovery, and an increased readmission rate. Discussion(s):
Although the exact pathophysiology between depression and cardiovascular
disease (CVD) is unknown, several pathways have been implicated. Unmanaged
depression can also lead to other psychological conditions such as
delirium. Like depression, the exact association between delirium and CVD
is not well understood, but believed to be multifactorial.
 Conclusion(s): Herein, we provide a comprehensive review of the links
between depression, delirium, and cardiovascular surgery. We critically
examine the current data that pertains to the pathophysiology of these
debilitating mental health issues in the context of cardiac surgery.
Finally, we summarize the various treatment options available for managing
depression and delirium in the cardiac surgery patient
population. Copyright © 2021 Wiley Periodicals LLC

<40>
Accession Number
635270347
Title
Pedicled or skeletonized bilateral internal mammary artery harvesting - a
meta- analysis and trial sequential analysis.
Source
Expert review of cardiovascular therapy. (no pagination), 2021. Date of
Publication: 07 Jun 2021.
Author
Iddawela S.; Mellor S.L.; Zahra S.A.; Khare Y.; Harky A.
Institution
(Iddawela) Department of Cardiology, University Hospitals Birmingham,
Birmingham, United Kingdom
(Mellor) College of Medical and Dental Sciences, University of Birmingham,
Birmingham, United Kingdom
(Zahra, Khare) Department of Medicine, University of London, St
George'sLondon UK
(Harky) Department of Cardio-thoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky) Faculty of Life Sciences, University of Liverpool, Liverpool,
United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVE: There is varying evidence on the role of skeletonization of
internal mammary artery in reducing the risk of sternal wound infections
and ischemia following bilateral internal mammary artery grafting.
Post-operative clinical outcomes of skeletonized bilateral internal
mammary artery versus pedicled bilateral internal mammary artery
harvesting in patients undergoing coronary artery bypass surgery were
compared. METHOD(S): A comprehensive electronic search was conducted
using MEDLINE, Scopus, EMBASE, Cochrane database and Google Scholar from
inception until 15th June 2020. All studies directly comparing
skeletonized and pedicled bilateral internal mammary artery harvesting
were included. Meta-analysis and trial sequential analysis was conducted.
 RESULT(S): Nine studies (one randomized controlled trial and eight
observational studies) consisting of 3649 patients (2050 patients with
skeletonized bilateral internal mammary artery grafting and 1599 patients
with pedicled bilateral internal mammary artery grafting) were included.
Pooled effects analysis and trial sequential analysis reported
significantly lower risk of sternal wound infection with skeletonized
bilateral internal mammary artery harvesting (OR 0.27, 95% CI 0.20 - 0.51,
p < 0.00001). CONCLUSION(S): Skeletonization reduces the risk of
sternal wound infections by preserving vasculature as much as possible.
This facilitates its use in patients at high risk of sternal wound
infection.

<41>
Accession Number
635266114
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: 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
Thieme Medical Publishers, Inc.
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. Copyright © 2021 Lippincott
Williams and Wilkins. All rights reserved.

<42>
Accession Number
635260127
Title
Factors influencing physical activity engagement following coronary artery
bypass graft surgery: A mixed methods systematic review.
Source
Heart & lung : the journal of critical care. 50 (5) (pp 589-598), 2021.
Date of Publication: 01 Jun 2021.
Author
Gray E.; Dasanayake S.; Sangelaji B.; Hale L.; Skinner M.
Institution
(Gray, Dasanayake, Sangelaji, Hale, Skinner) Centre for Health, Activity
and Rehabilitation Research, School of Physiotherapy, Division of Health
Sciences, University of Otago, Dunedin, New Zealand
Publisher
NLM (Medline)
Abstract
BACKGROUND: Engagement in physical activity during the initial months
following coronary artery bypass graft (CABG) surgery is important in
order to improve health, quality of life and functional outcomes. There
are, however, many potential barriers to physical activity engagement
during the recovery period. No review studies have focused on barriers and
facilitators to engagement in physical activity during the early stages of
recovery following CABG surgery. OBJECTIVE(S): To explore the factors
that influence engagement in physical activity during the first three
months following CABG surgery. METHOD(S): Four electronic databases
were searched. Extracted data from selected studies were synthesised using
the Joanna Briggs Institute convergent integrated approach.
 RESULT(S): Nineteen studies met the inclusion criteria. Four main
themes that influenced engagement were identified: sociodemographic
variables; physical symptoms; psychosocial factors; and environmental
factors. More barriers were identified than facilitating factors.
Psychosocial factors were the most commonly reported barriers in the
literature. CONCLUSION(S): The findings of this review provide
insights into factors that inhibit and facilitate engagement in physical
activity following CABG surgery. Further research specifically exploring
factors that influence engagement, especially facilitators, is
required. Copyright © 2021 Elsevier Inc. All rights reserved.

<43>
Accession Number
2010331191
Title
Motor Impairment in Children With Congenital Heart Defects: A Systematic
Review.
Source
Pediatrics. 146 (6) (no pagination), 2020. Article Number: e20200083. Date
of Publication: 01 Dec 2020.
Author
Bolduc M.-E.; Dionne E.; Gagnon I.; Rennick J.E.; Majnemer A.;
Brossard-Racine M.
Institution
(Bolduc, Dionne, Gagnon, Majnemer, Brossard-Racine) School of Physical and
Occupational Therapy, McGill University, Montreal, Canada
(Rennick) Ingram School of Nursing, McGill University, Montreal, Canada
(Rennick, Majnemer, Brossard-Racine) Departments of Pediatrics, McGill
University, Montreal, Canada
(Majnemer, Brossard-Racine) Neurology and Neurosurgery, McGill University,
Montreal, Canada
(Bolduc, Dionne, Brossard-Racine) Advances in Brain and Child Development
Research Laboratory, The Research Institute of the McGill University
Health Centre, Montreal, Canada
(Rennick) Department of Nursing, Montreal Children's Hospital, McGill
University Health Centre, Montreal, Canada
Publisher
American Academy of Pediatrics
Abstract
CONTEXT: With improvements in survival rates in newborns with congenital
heart defects (CHDs) focus has now shifted toward enhancing
neurodevelopmental outcomes across their life span. OBJECTIVE(S): To
systematically review the prevalence and extent of motor difficulties in
infants, children, and adolescents with CHD requiring open-heart surgery.
DATA SOURCES: Data sources included Embase, Medline and the Cumulative
Index to Nursing and Allied Health Literature. STUDY SELECTION: Original
studies published between 1997 and 2019 examining gross and/or fine motor
skills in children born with a CHD requiring open-heart surgery were
selected. DATA EXTRACTION: The prevalence of motor impairments and mean
scores on standardized motor assessments were extracted. Findings were
grouped in 5 categories on the basis of the age of the children.
 RESULT(S): Forty-six original studies were included in this
systematic review. The prevalence of mild to severe motor impairments
(scores <-1 SD below normative data or controls) across childhood ranged
from 12.3% to 68.6%, and prevalence ranged from 0% to 60.0% for severe
motor impairments (<-2 SDs). Although our results suggest that the overall
prevalence of motor impairments , <-1 SD remains rather constant across
childhood and adolescence, severe motor impairments (<-2 SDs) appear to be
more prevalent in younger children. LIMITATIONS: Variability in sampling
and methodology between the reviewed studies is the most important
limitation of this review. CONCLUSION(S): The results of this review
highlight that infants with CHD have an increased risk of motor
impairments across infancy, childhood, and adolescence. These findings
stress the importance of systematic screening or evaluation of motor
skills across childhood and adolescence in children with
CHD. Copyright © 2020 by the American Academy of Pediatrics.

<44>
Accession Number
619323234
Title
The effect of 6% hydroxyethyl starch (130/0.4) on acute kidney injury in
paediatric cardiac surgery: a prospective, randomised trial.
Source
Anaesthesia. 73 (2) (pp 205-215), 2018. Date of Publication: February
2018.
Author
Oh H.-W.; Lee J.-H.; Kim H.-C.; Kim E.-H.; Song I.-K.; Kim H.-S.; Kim
J.-T.
Institution
(Oh) Department of Anaesthesiology and Pain Medicine, Seoul National
University Hospital, Seoul National University College of Medicine, Seoul,
South Korea
(Lee, Kim, Kim, Kim) Department of Anaesthesiology and Pain Medicine,
Seoul National University Hospital, Seoul, South Korea
(Kim) Department of Anaesthesiology and Pain Medicine, Dongsan Medical
Centre, Keimyung University College of Medicine, Daegu, South Korea
(Song) Department of Anaesthesiology and Pain Medicine, Asan Medical
Centre, University of Ulsan College of Medicine, Seoul, South Korea
Publisher
Blackwell Publishing Ltd
Abstract
We have evaluated the effect of a colloid solution on acute kidney injury
in paediatric cardiac surgery. A total of 195 patients were ramdomly
divided into an hydroxyethyl starch group and a control group. In the
starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte) was
used as the primary fluid for volume resuscitation but was limited to 30
ml.kg-1. In the control group, only crystalloid fluid was used
during the peri-operative period. The incidence of acute kidney injury,
peri-operative transfusion, clinical outcomes and laboratory data were
compared. The incidence of acute kidney injury determined by Paediatric
Risk, Injury, Failure, Loss, End-stage renal disease (pRIFLE) and Acute
Kidney Injury Network (AKIN) criteria were no different between the two
groups (starch group 40.8% vs. control group 30.0%; p = 0.150 using
pRIFLE; 19.6% vs. 21.1% respectively, p = 0.602 using AKIN). There were no
differences in clinical outcomes such as mortality, major adverse events,
intensive care unit stay or duration of mechanical ventilation. Clotting
time as measured using rotational thromboelastometry (ROTEM) was
prolonged, and clot firmness after 10 min and maximal clot firmness were
shorter in the starch group compared with the control group after sternal
closure. There was no difference in transfusion between the two groups.
Patients with acute kidney injury had worse clinical courses than those
without acute kidney injury. We conclude that intra-operative use of 6%
hydroxyethyl starch 130/0.4 up to 30 ml.kg-1 was not associated
with postoperative acute kidney injury in paediatric cardiac
patients. Copyright © 2017 The Association of Anaesthetists of
Great Britain and Ireland

<45>
Accession Number
361488812
Title
A modification of the trans-oesophageal echocardiography protocol can
reduce post-operative dysphagia following cardiac surgery.
Source
Journal of International Medical Research. 39 (1) (pp 96-104), 2011. Date
of Publication: February 2011.
Author
Chin J-H.; Lee E-H.; Choi D-K.; Choi I.-C.
Institution
(Chin, Lee, Choi, Choi) Department of Anaesthesiology and Pain Medicine,
Asan Medical Centre, University of Ulsan College of Medicine, 388-1
Pungnap 2-dong, Songpa-gu, Seoul 138-736, South Korea
Publisher
SAGE Publications Ltd
Abstract
Use of intra-operative trans-oesophageal echocardiography (TEE) is an
independent risk factor for post-operative dysphagia. This study
investigated whether modifying the TEE probe-placement protocol could
reduce the incidence of post-operative dysphagia. In group I (n = 100),
the TEE probe was inserted after anaesthetic induction and remained in
place until the completion of surgery. In group II (n = 100), the TEE
probe was inserted after anaesthetic induction, the heart was examined,
then the probe was removed. The probe was inserted again before weaning
from cardiopulmonary bypass and then immediately removed after
examination. The incidence of dysphagia was significantly higher in group
I than in group II patients (51.1% versus 28.6%). Multivariate regression
analysis showed that the length of time that the TEE probe was in the
oesophagus was an independent predictor of dysphagia. Modification of the
TEE protocol in this way can reduce the incidence of post-operative
dysphagia in cardiac surgery patients. © 2011 Field House Publishing
LLP.

<46>
Accession Number
2006943570
Title
Do women require less permanent pacemaker after transcatheter aortic valve
implantation? A meta-analysis and meta-regression.
Source
Journal of the American Heart Association. 10 (7) (no pagination), 2021.
Article Number: e019429. Date of Publication: 2021.
Author
Ravaux J.M.; Di Mauro M.; Vernooy K.; Van'T Hof A.W.; Veenstra L.; Kats
S.; Maessen J.G.; Lorusso R.
Institution
(Ravaux, Di Mauro, Kats, Maessen, Lorusso) Department of Cardio-Thoracic
Surgery, Heart and Vascular Centre, Maastricht University Medical Centre
(MUMC), P. Debyelaan, 25, Maastricht 6202 AZ, Netherlands
(Di Mauro, Vernooy, Van'T Hof, Veenstra, Lorusso) Cardiovascular Research
Institute Maastricht (CARIM), Maastricht University Medical Center,
Maastricht, Netherlands
(Vernooy, Van'T Hof, Maessen) Department of Cardiology, Maastricht
University Medical Centre (MUMC), Maastricht, Netherlands
(Vernooy) Department of cardiology, Radboud University Medical Center
(Radboudumc), Nijmegen, Netherlands
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Limited clinical evidence and literature are available about
the potential impact of sex on permanent pacemaker implantation (PPI)
after transcatheter aortic valve implantation (TAVI). The aim of this work
was to evaluate the relationship between sexes and atrioventricular
conduction disturbances requiring PPI after TAVI. METHODS AND RESULTS:
Data were obtained from 46 studies from PubMed reporting information about
the impact of patient sex on PPI after TAVI. Total proportions with 95%
Cls were reported. Funnel plot and Egger test were used for estimation of
publication bias. The primary end point was 30-day or in-hospital PPI
after TAVI, with odds ratios and 95% CIs extracted. A total of 70 313
patients were included, with a cumulative proportion of 51.5% of women (35
691 patients; 95% CI, 50.2-52.7). The proportion of women undergoing TAVI
dropped significantly over time (P<0.0001). The cumulative PPI rate was
15.6% (95% CI, 13.3-18.3). The cumulative rate of PPI in women was 14.9%
(95% CI, 12.6-17.6), lower than in men (16.6%; 95% CI, 14.2-19.4). The
risk for post-TAVI PPI was lower in women (odds ratio, 0.90; 95% CI,
0.84-0.96 [P=0.0022]). By meta-regression analysis, age (P=0.874) and
ventricular function (P=0.302) were not significantly associated with PPI
among the sexes. Balloon-expandable TAVI significantly decrease the
advantage of women for PPI, approaching the same rate as in men
(P=0.0061). CONCLUSION(S): Female sex is associated with a reduced
rate of PPI after TAVI, without influence of age or ventricular function.
Balloon-expandable devices attenuate this advantage in favor of women.
Additional investigations are warranted to elucidate sex-based differences
in developing conduction disturbances after TAVI. Copyright ©
2021 The Authors. Published on behalf of the American Heart Association,
Inc., by Wiley.

<47>
Accession Number
2011981519
Title
Noninvasive cardiovascular imaging for myocardial necrosis, viability,
stunning and hibernation: Evidence from an umbrella review encompassing 12
systematic reviews, 286 studies, and 201,680 patients.
Source
Minerva Cardiology and Angiology. 69 (2) (pp 191-200), 2021. Date of
Publication: April 2021.
Author
Nudi F.; Iskandrian A.E.; Schillaci O.; Nudi A.; Di Belardino N.; Frati
G.; Biondi Zoccai G.
Institution
(Nudi, Nudi) Service of Hybrid Cardio Imaging, Madonna della Fiducia
Clinic, Rome, Italy
(Nudi) Replycare, Rome, Italy
(Iskandrian) Division of Cardiovascular Diseases, Department of Medicine,
University of Alabama at Birmingham, Birmingham, AL, United States
(Schillaci) Department of Biomedicine and Prevention, Tor Vergata
University, Rome, Italy
(Di Belardino) Unit of Cardiology, Ospedali Riuniti di Anzio-Nettuno,
Anzio, Rome, Italy
(Frati, Biondi Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University, Latina, Rome, Italy
(Frati) IRCCS Neuromed, Pozzilli, Isernia, Italy
(Biondi Zoccai) Mediterranea Cardiocentro, Naples, Italy
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: The concomitant presence of myocardial necrosis with
myocardial ischemia, stunning or hibernation may complicates appraisal of
left ventricular (LV) function and patient management. Several imaging
modalities have been proposed for the accurate assessment of myocardial
necrosis, viability, stunning and hibernation, with mixed results. We
aimed to review the evidence base on myocardial necrosis, stunning and
hibernation by conducting an umbrella review (i.e. overview of systematic
reviews). EVIDENCE ACQUISITION: We searched PubMed and The Cochrane
Library for meta-analyses focusing on the diagnostic, prognostic, or
management appraisal of myocardial necrosis, viability, stunning and
hibernation. Diagnostic test accuracy, prognostic yield, and clinical
outcomes were systematically abstracted from shortlisted reviews. EVIDENCE
SYNTHESIS: From an initial set of 6069 citations, 12 systematic reviews
were finally included, encompassing 286 studies and 201,680 patients.
Cardiac magnetic resonance imaging (CMR) had favorable results in 4
reviews that focused on the diagnosis of myocardial stunning or
hibernation in patients followed for 6+/-4 months after coronary
revascularization (sensitivity 96% and specificity 91%). Positron emission
tomography (PET), single photon emission tomography (SPECT) and CMR in 6
meta-analyses had each a significant and independent prognostic role for
the prediction of fatal and non-fatal cardiovascular events in patients
with follow-up of 2.8+/-1.7 years. Finally, 2 reviews with 2.3+/-1.1 years
of follow-up showed moderate quality evidence in favor of coronary
revascularization in patients with objective signs of myocardial
viability. CONCLUSION(S): The appraisal of myocardial necrosis and
residual viability remains a cornerstone of the modern management of
patients with CAD. Current imaging modalities (echocardiography, PET,
SPECT and CMR) are widely used. Further trials using contemporary methods
are warranted to further clarify the impact of viability assessment on
patient management, and the cumulative risk of morbidity and
mortality. Copyright © 2020 EDIZIONI MINERVA MEDICA.

<48>
Accession Number
2011267629
Title
Association of non-invasive measures of subclinical atherosclerosis and
arterial stiffness with mortality and major cardiovascular events in
chronic kidney disease: systematic review and meta-analysis of cohort
studies.
Source
Clinical Kidney Journal. 13 (5) (pp 842-854), 2020. Date of Publication:
2020.
Author
Kouis P.; Kousios A.; Kanari A.; Kleopa D.; Papatheodorou S.I.; Panayiotou
A.G.
Institution
(Kouis, Kousios, Kanari, Kleopa, Panayiotou) Cardiovascular Epidemiology
and Genetics Research Lab, Cyprus International Institute for
Environmental and Public Health, Cyprus University of Technology,
Limassol, Cyprus
(Kouis) Respiratory Physiology Laboratory, Medical School, University of
Cyprus, Nicosia, Cyprus
(Kousios) Renal and Transplant Centre, Hammersmith Hospital, Imperial
College NHS Trust, London, United Kingdom
(Papatheodorou) Cyprus International Institute for Environmental and
Public Health, Cyprus University of Technology, Limassol, Cyprus
(Papatheodorou) Department of Epidemiology, Harvard TH Chan School of
Public Health, Boston, MA, United States
Publisher
Oxford University Press
Abstract
Background. Non-invasive cardiovascular disease (CVD) risk prediction, in
subclinical stages, aiming to stratify patients and tailor interventions
remains an unmet need in chronic kidney disease (CKD). In this
meta-analysis, we summarize the association of carotid intima-media
thickness (cIMT), coronary artery calcium score (CACS) and pulse wave
velocity (PWV) with all-cause mortality, cardiovascular (CV) mortality and
CV events in non-dialysis CKD and patients on haemodialysis. Methods.
Systematic review and meta-analysis of prospective cohort studies.
Results. Out of 27 984 records, a total of 45 studies were eligible for
quantitative synthesis; 11 for cIMT, 18 for CACS and 16 for PWV involving
2235, 4904 and 5717 patients, respectively. Meta-analysis was possible
from pooled data of five cIMT studies (708 subjects), eight CACS studies
(862 subjects) and nine PWV studies (1508 subjects). In dialysis patients,
cIMT was associated with all-cause mortality [relative risk (RR) per unit
increase: 1.08, 95% confidence interval (CI) 1.00-1.17, I2:
68%] and CV mortality (RR: 1.29, 95% CI 1.14-1.47, I2: 0%).
High versus low CACS was associated with all-cause mortality (RR: 2.51,
95% CI 1.66-3.79, I2: 5.7%) and CV events (RR: 3.77 95% CI
2.16-6.58, I2: 20.2%). High versus low PWV was associated with
all-cause (RR: 5.34, 95% CI 3.01-9.47, I2: 0%) and CV mortality
(RR: 8.55, 95% CI 4.37-16.73, I2: 0%). The combined estimated
for all-cause mortality per 1 m/s increment unit in PWV was 1.25 (95% CI
1.17-1.34, I2: 0%) and for CV mortality was 1.24 (95% CI
1.16-1.34, I2: 15.5%). In non-dialysis patients, CACS was
associated with CV events (RR: 4.02, 95% CI 1.57-10.29, I2:
63.4%). High versus low PWV was associated with all-cause mortality (RR:
2.52, 95% CI 1.40-4.55, I2: 62.6%). Conclusions. Non-invasive
measures of atherosclerosis and arterial stiffening are associated with
all-cause and CV mortality as well as CV events among patients with all
stages of CKD. These markers could be considered for the evaluation of CV
morbidity and mortality risks. Moreover, the results of this meta-analysis
support the study of interventions, with effect on these markers of
vascular disease, on long-term CVD outcomes. Copyright VC The
Author(s) 2019

<49>
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. Copyright © 2021 The Authors. Clinical
Cardiology published by Wiley Periodicals LLC.

<50>
Accession Number
2012861568
Title
Post-operative pain following cardiac implantable electronic device
implantation: Insights from the BRUISE CONTROL trials.
Source
Europace. 23 (5) (pp 748-756), 2021. Date of Publication: 01 May 2021.
Author
Nair G.M.; Birnie D.H.; Sumner G.L.; Krahn A.D.; Healey J.S.; Nery P.B.;
Kalfon E.; Verma A.; Ayala-Paredes F.; Coutu B.; Becker G.; Philippon F.;
Eikelboom J.; Sandhu R.K.; Sapp J.; Leather R.; Yung D.; Thibault B.;
Simpson C.S.; Ahmad K.; Sturmer M.; Kavanagh K.; Crystal E.; Wells G.A.;
Essebag V.
Institution
(Nair, Birnie, Nery, Wells) Arrhythmia Service, Division of Cardiology,
University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
(Sumner, Sandhu, Kavanagh) Department of Medicine, University of Calgary,
Libin Cardiovascular Institute, Calgary, AB, Canada
(Krahn) Department of Medicine, University of British Columbia, Vancouver,
BC, Canada
(Healey, Eikelboom) Division of Cardiology, Department of Medicine,
McMaster University, Hamilton Health Sciences, Population Health Research
Institute, Hamilton, ON, Canada
(Kalfon) Department of Medicine, Galilee Medical Center, Nahariya, Israel
(Verma) Department of Medicine, Southlake Regional Health Center,
University of Toronto, Toronto, ON, Canada
(Ayala-Paredes) Department of Medicine, Universite de Sherbrooke,
Sherbrooke, QC, Canada
(Coutu) Department of Medicine, Centre Hospitalier de l'Universite de
Montreal, Hopital Hotel-Dieu, Montreal, QC, Canada
(Becker) Department of Medicine, McGill University Health Center,
Montreal, QC, Canada
(Philippon) Department of Medicine, Quebec Heart Institute, Sainte-Foy,
QC, Canada
(Sapp) Department of Medicine, QEII Health Sciences Centre, Halifax, NS,
Canada
(Leather, Yung) Scarborough Health Network, University of Toronto,
Toronto, ON, Canada
(Thibault) Division of Cardiology, Department of Medicine, Montreal Heart
Institute, Montreal, QC, Canada
(Simpson) Department of Medicine, Queen's University, Kingston, ON, Canada
(Ahmad) Department of Medicine, University of Toronto, Toronto, ON, Canada
(Sturmer, Essebag) Division of Cardiology, Department of Medicine,
University of Calgary, Libin Cardiovascular Institute, Calgary, AB, Canada
(Crystal) Department of Medicine, Sunnybrook Health Sciences Center,
University of Toronto, Toronto, ON, Canada
Publisher
Oxford University Press
Abstract
Aims: Post-operative pain following cardiac implantable electronic device
(CIED) insertion is associated with patient dissatisfaction, emotional
distress, and emergency department visits. We sought to identify factors
associated with post-operative pain and develop a prediction score for
post-operative pain. Methods and Results: All patients from the
BRUISE CONTROL-1 and 2 trials were included in this analysis. A validated
Visual Analogue Scale (VAS) was used to assess the severity of pain
related to CIED implant procedures. Patients were asked to grade the most
severe post-operative pain, average post-operative pain, and pain on the
day of the first post-operative clinic. Multivariable regression analyses
were performed to identify predictors of significant post-operative pain
and to develop a pain-prediction score. A total of 1308 patients were
included. Multivariable regression analysis found that the presence of
post-operative clinically significant haematoma {CSH; P value < 0.001;
odds ratio (OR) 3.82 [95% confidence interval (CI): 2.37-6.16]}, de novo
CIED implantation [P value < 0.001; OR 1.90 (95% CI: 1.47-2.46)], female
sex [P value < 0.001; OR 1.61 (95% CI: 1.22-2.12)], younger age [<65
years; P value < 0.001; OR 1.54 (95% CI: 1.14-2.10)], and lower body mass
index [<20 kg/m2; P value < 0.05; OR 2.05 (95% CI: 0.98-4.28)]
demonstrated strong and independent associations with increased
post-operative pain. An 11-point post-operative pain prediction score was
developed using the data. Conclusion(s): Our study has identified
multiple predictors of post-operative pain after CIED insertion. We have
developed a prediction score for post-operative pain that can be used to
identify individuals at risk of experiencing significant post-operative
pain. Copyright © 2020 Published on behalf of the European
Society of Cardiology. All rights reserved.

<51>
Accession Number
2012996323
Title
Percutaneous versus Surgical Intervention for Severe Aortic Valve
Stenosis: A Systematic Review.
Source
BioMed Research International. 2021 (no pagination), 2021. Article Number:
3973924. Date of Publication: 2021.
Author
Iervolino A.; Singh S.S.A.; Nappi P.; Bellomo F.; Nappi F.
Institution
(Iervolino) Department of Cardiovascular Sciences, Fondazione Policlinico
Universitario A. Gemelli IRCSS, Italy
(Singh) Department of Cardiothoracic Surgery, Golden Jubilee National
Hospital, Glasgow, United Kingdom
(Nappi, Bellomo) Department of Clinical and Experimental Medicine,
University of Messina, Italy
(Nappi) Department of Cardiac Surgery, Centre Cardiologique du Nord de
Saint-Denis, Paris, France
Publisher
Hindawi Limited
Abstract
Aortic stenosis is a disease that is increasing in prevalence and
manifests as decreased cardiac output, which if left untreated can result
in heart failure and ultimately death. It is primarily a disease of the
elderly who often have multiple comorbidities. The advent of transcatheter
aortic valve therapies has changed the way we treat these conditions.
However, long-term results of these therapies remain uncertain. Recently,
there has been an increasing number of studies examining the role of both
surgical aortic valve replacement and transcatheter aortic valve
replacement. We therefore performed a systematic review using Ovid
MEDLINE, Ovid Embase, and the Cochrane Library. Two investigators searched
papers published between January 1, 2007, and to date using the following
terms: "aortic valve stenosis,""aortic valve operation,"and "transcatheter
aortic valve therapy."Both strategies in aortic stenosis treatment
highlighted specific indications alongside the pitfalls such as structural
valve degeneration and valve thrombosis which have a bearing on clinical
outcomes. We propose some recommendations to help clinicians in the
decision-making process as technological improvements make both surgical
and transcatheter therapies viable options for patients with aortic
stenosis. Finally, we assess the role of finite element analysis in
patient selection for aortic valve replacement. THVT and AVR-S are both
useful tools in the armamentarium against aortic stenosis. The decision
between the two treatment strategies should be best guided by a strong
robust evidence base, ideally with a long-term follow-up. This is best
performed by the heart team with the patient as the center of the
discussion. Copyright © 2021 Adelaide Iervolino et al.

<52>
Accession Number
635256264
Title
A Comparative Effectiveness Systematic Review and Meta-Analysis of Drugs
for the Prophylaxis of Junctional Ectopic Tachycardia.
Source
Current cardiology reviews. (no pagination), 2021. Date of Publication: 03
Jun 2021.
Author
Mendel B.; Christianto; Setiawan M.; Prakoso R.; Siagian S.N.
Institution
(Mendel, Christianto, Setiawan) Faculty of Medicine, Universitas
Indonesia, Jakarta, Malaysia
(Prakoso, Siagian) Pediatric Cardiology and Congenital Heart Defect
Division, Department of Cardiology and Vascular Medicine, National
Cardiovascular Center Harapan Kita, Jakarta, Malaysia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Junctional ectopic tachycardia (JET) is an arrhythmia
originating from the AV junction, which may occur following congenital
heart surgery, especially when the intervention is near the
atrioventricular junction. OBJECTIVE(S): The aim of this systematic
review and meta-analysis is to compare the effectiveness of amiodarone,
dexmedetomidine and magnesium in preventing JET following congenital heart
surgery. METHOD(S): This meta-analysis was conducted according to the
Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA)
statement, where 11 electronic databases were searched from date of
inception to August 2020. The incidence of JET was calculated with the
relative risk of 95% confidence interval (CI). Quality assessment of the
included studies was assessed using the Consolidated Standards of
Reporting Trials (CONSORT) 2010 statement. RESULT(S): Eleven studies
met the predetermined inclusion criteria and were included in this
meta-analysis. Amiodarone, dexmedetomidine and magnesium significantly
reduced the incidence of postoperative JET [Amiodarone: risk ratio 0.34;
I2= 0%; Z=3.66 (P=0.0002); 95% CI 0.19-0.60. Dexmedetomidine: risk ratio
0.34; I2= 0%; Z=4.77 (P<0.00001); 95% CI 0.21-0.52. Magnesium: risk ratio
0.50; I2= 24%; Z=5.08 (P<0.00001); 95% CI 0.39-0.66]. CONCLUSION(S):
All three drugs show promise in reducing the incidence of JET. Our
systematic review found that dexmedetomidine is better in reducing the
length of ICU stays as well as mortality. In addition, dexmedetomidine
also has the least pronounced side effects among the three. However, it
should be noted that this conclusion was derived from studies with small
sample sizes. Therefore, dexmedetomidine may be considered as the drug of
choice for preventing JET. Copyright© Bentham Science Publishers;
For any queries, please email at epub@benthamscience.net.

<53>
Accession Number
626112800
Title
Systematic review to assess the possibility of return of cerebral and
cardiac activity after normothermic regional perfusion for donors after
circulatory death.
Source
British Journal of Surgery. 106 (3) (pp 174-180), 2019. Date of
Publication: February 2019.
Author
Shapey I.M.; Summers A.; Augustine T.; van Dellen D.
Institution
(Shapey, Summers, Augustine, van Dellen) Faculty of Biology, Medicine and
Health, University of Manchester, Manchester, United Kingdom
(Shapey, Summers, Augustine, van Dellen) Department of Renal and
Pancreatic Transplantation, Manchester Royal Infirmary, Manchester
University NHS Foundation Trust, Manchester, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: Normothermic regional perfusion (NRP) is a novel technique
that aids organ recovery from donors after circulatory death (DCDs).
However, ethical concerns exist regarding the potential return of
spontaneous cerebral and cardiac activity (ROSCCA). This study aimed to
determine the likelihood of ROSCCA in NRP-DCDs of abdominal organs.
 Method(s): Extracorporeal cardiopulmonary resuscitation (ECPR) for
refractory out-of-hospital cardiac arrest (OOHCA) was identified as a
comparator for NRP-DCDs and as a validation cohort. A systematic search
identified all articles relating to NRP-DCDs and ECPR-OOHCA. Rates of
ROSCCA and survival outcomes (ECPR-OOHCA only) were recorded and analysed
according to the duration of no perfusion. Result(s): In NRP-DCDs, 12
of 410 articles identified by database searching were eligible for
inclusion. There were no instances of ROSCCA recorded among 493 donors. In
ECPR-OOHCA, eight of 947 screened articles were eligible for inclusion
(254 patients). Where the absence of perfusion exceeded 5 min in
ECPR-OOHCA, there were no survivors with a favourable neurological
outcome. Conclusion(s): ROSCCA is unlikely following commencement of
NRP and has not occurred to date. Strict observance of the 5-min interval
following asystole provides satisfactory assurance that ROSCCA will not
occur following NRP. Copyright © 2019 The Authors. BJS published
by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

<54>
Accession Number
626066430
Title
Pharmacokinetics of tacrolimus granules in pediatric de novo liver,
kidney, and heart transplantation: The OPTION study.
Source
Pediatric Transplantation. 23 (1) (no pagination), 2019. Article Number:
e13328. Date of Publication: February 2019.
Author
Webb N.J.A.; Baumann U.; Camino M.; Frauca E.; Undre N.; Garcia-Guereta
L.; Tonshoff B.; Reding R.; Rubik J.; Di-Filippo S.; Deschenes G.
Institution
(Webb) Department of Paediatric Nephrology and NIHR/Wellcome Trust
Manchester Clinical Research Facility, University of Manchester,
Manchester Academic Health Science Centre, Royal Manchester Children's
Hospital, Manchester, United Kingdom
(Baumann) Division of Paediatric Gastroenterology and Hepatology,
Children's Hospital, Hannover Medical School, Hannover, Germany
(Camino) Hospital Universitario Gregorio Maranon, Madrid, Spain
(Frauca) Hospital Universitario La Paz, Madrid, Spain
(Undre) Astellas Pharma EMEA, Chertsey, Surrey, United Kingdom
Publisher
Blackwell Publishing Inc.
Abstract
Tacrolimus granules were developed for patients who are unable to swallow
capsules. Therapeutic drug monitoring (TDM) is required to optimize
efficacy and safety, which is based on C<inf>trough</inf> for tacrolimus
capsules. Pharmacokinetic (PK) data for tacrolimus granules are required
to establish the basis for TDM in those who are unable to swallow
capsules. In this phase IV study (NCT01371331) of children undergoing
liver, kidney, or heart transplantation, patients received tacrolimus
granules 0.15 mg/kg twice daily; first dose was administered within 24
hours of reperfusion. PK analysis samples were collected after
reperfusion, after first dose of tacrolimus (Day 1), and at steady state
(Day 7; >4 days stable dose). Of the 52 transplant recipients enrolled, 38
had two evaluable PK profiles. Mean AUC<inf>tau</inf> after first dose of
tacrolimus was 211, 97, and 224 hour*ng/mL in liver, kidney, and heart
transplant recipients, respectively; corresponding mean AUC<inf>tau</inf>
at steady state was 195, 208, and 165 hour*ng/mL. C<inf>trough</inf> and
AUC<inf>tau</inf> were positively correlated after first dose of
tacrolimus and at steady state (Pearson's coefficients: r = 0.81 and r =
0.87, respectively). This study demonstrated that C<inf>trough</inf> is a
reliable marker for TDM in pediatric transplant recipients treated with
tacrolimus granules, consistent with TDM for other tacrolimus
formulations. Copyright © 2019 John Wiley & Sons A/S. Published
by John Wiley & Sons Ltd

<55>
Accession Number
624755353
Title
Repetitive levosimendan infusions for patients with advanced chronic heart
failure in the vulnerable post-discharge period.
Source
ESC Heart Failure. 6 (1) (pp 174-181), 2019. Date of Publication: February
2019.
Author
Polzl G.; Allipour Birgani S.; Comin-Colet J.; Delgado J.F.; Fedele F.;
Garcia-Gonzales M.J.; Gustafsson F.; Masip J.; Papp Z.; Stork S.; Ulmer
H.; Vrtovec B.; Wikstrom G.; Altenberger J.
Institution
(Polzl, Allipour Birgani) Department of Internal Medicine III, Medical
University Innsbruck, Innsbruck, Austria
(Comin-Colet) Department of Cardiology, Bellvitge University Hospital and
IDIBELL, University of Barcelona Hospitalet de Llobregat, Barcelona, Spain
(Delgado) Department of Cardiology, University Hospital 12 de Octubre,
CIBERCV, Madrid, Spain
(Fedele) Department of Cardiovascular, Respiratory, Nephrology,
Anesthesiology and Geriatric Sciences, Sapienza University of Rome, Rome,
Italy
(Garcia-Gonzales) Department of Cardiology, University Hospital Canarias,
San Cristobal de La Laguna, Tenerife, Spain
(Gustafsson) Department of Cardiology, Copenhagen University Hospital,
Rigshospitalet, Copenhagen, Denmark
(Masip) Intensive Care Department, Consorci Sanitari Integral, University
of Barcelona, Barcelona, Spain
(Masip) Cardiology Department, Hospital Sanitas CIMA, Barcelona, Spain
(Papp) Department of Cardiology, Division of Clinical Physiology, Faculty
of Medicine, University of Debrecen, Debrecen, Hungary
(Stork) Department of Internal Medicine and Comprehensive Heart Failure
Center, University Hospital Wurzburg, Wurzburg, Germany
(Ulmer) Department for Medical Statistics, Informatics and Health
Economics, Medical University Innsbruck, Innsbruck, Austria
(Vrtovec) Department of Cardiology, University Medical Center Ljubljana,
Ljubljana, Slovenia
(Wikstrom) Department of Cardiology, Institute of Medical Sciences,
Uppsala University Hospital, Uppsala, Sweden
(Altenberger) Cardiac Rehabilitation Center Grossgmain,
Pensionsversicherungsanstalt, Teaching Hospital of Paracelsus Medical
Private University, Salzburg, Austria
Publisher
Wiley-Blackwell
Abstract
Hospitalization for acute heart failure (HF) is associated with a
substantial morbidity burden and with associated healthcare costs and an
increased mortality risk. However, few if any major medical innovations
have been witnessed in this area in recent times. Levosimendan is a
first-in-class calcium sensitizer and potassium channel opener indicated
for the management of acute HF. Experience in several clinical studies has
indicated that administration of intravenous levosimendan in intermittent
cycles may reduce hospitalization and mortality rates in patients with
advanced HF; however, none of those trials were designed or powered to
give conclusive insights into that possibility. This paper describes the
rationale and protocol of LeoDOR (levosimendan infusions for patients with
advanced chronic heart failure), a randomized, double-blind,
placebo-controlled, international, multicentre trial that will explore the
efficacy and safety of intermittent levosimendan therapy, in addition to
optimized standard therapy, in patients following hospitalization for
acute HF. Salient features of LeoDOR include the use of two treatment
regimens, in order to evaluate the effects of different schedules and
doses of levosimendan during a 12 week treatment phase, and the use of a
global rank primary endpoint, in which all patients are ranked across
three hierarchical groups ranging from time to death or urgent heart
transplantation or implantation of a ventricular assist device to time to
rehospitalization and, lastly, time-averaged proportional change in
N-terminal pro-brain natriuretic peptide. Secondary endpoints include
changes in HF symptoms and functional status at 14 weeks. Copyright
© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons
Ltd on behalf of the European Society of Cardiology.

<56>
Accession Number
624632544
Title
Heart transplantation for infective endocarditis: Viable option for a
limited few?.
Source
Transplant Infectious Disease. 21 (1) (no pagination), 2019. Article
Number: e13006. Date of Publication: February 2019.
Author
Murphy K.M.; Vikram H.R.
Institution
(Murphy) Department of Cardiovascular Diseases, Mayo Clinic, Phoenix, AZ,
United States
(Vikram) Division of Infectious Diseases, Mayo Clinic, Phoenix, AZ, United
States
Publisher
Blackwell Publishing Inc.
Abstract
Active infection in the recipient is considered a relative
contraindication for solid organ transplantation. However, heart
transplantation (HT) can be curative in patients with ventricular assist
device infections. For patients with infective endocarditis (IE), valve
replacement is part of the management strategy based on emergent, acute,
or elective indications. HT has been utilized as an uncommon and sporadic
treatment option for carefully selected patients with refractory or
recurrent IE after all other surgical treatment options have been
exhausted or are not feasible. Herein, we review 19 published cases of IE
in whom HT was undertaken in the setting of ongoing active infection with
reported good outcomes. We attempt to propose general criteria for HT in
the setting of IE and discuss challenges and hurdles that clinicians might
encounter when considering HT for active IE in the absence of robust data
or clearly defined criteria. Copyright © 2018 John Wiley & Sons
A/S. Published by John Wiley & Sons Ltd

<57>
Accession Number
624224548
Title
Zero-Balance Ultrafiltration of Priming Blood Attenuates Procalcitonin and
Improves the Respiratory Function in Infants After Cardiopulmonary Bypass:
A Randomized Controlled Trial.
Source
Artificial Organs. 43 (2) (pp 167-172), 2019. Date of Publication:
February 2019.
Author
Gholampour Dehaki M.; Niknam S.; Azarfarin R.; Bakhshandeh H.; Mahdavi M.
Institution
(Gholampour Dehaki, Niknam, Azarfarin, Bakhshandeh, Mahdavi) Rajaie
Cardiovascular, Medical & Research Center-Perfusion, Tehran Province,
Tehran, Iran, Islamic Republic of
Publisher
Blackwell Publishing Inc.
Abstract
Blood priming is needed for cardiopulmonary bypass (CPB) in neonates and
infants to avoid exceeding hemodilution; however, transfusion-related
inflammation affects post-CPB outcomes in infant open-heart surgery.
Procalcitonin, a newly detected inflammatory moderator and a sensitive
parameter for predicting pulmonary dysfunction secondary to CPB, rises
after CPB. We hypothesized that the hemofiltration of priming blood before
CPB might decrease inflammatory mediators in the blood and post-CPB
inflammatory replications, thereby improving the respiratory function
after CPB in infants. Sixty infants with a weight below 10 kg were divided
randomly into two equal groups of CPB with the zero-balance
ultrafiltration (Z-BUF) of priming blood and CPB without it. The
procalcitonin level was measured before anesthesia, after admission to the
intensive care unit (ICU), and 24 h afterward. The respiratory index and
pulmonary compliance were measured after anesthesia, at the end of CPB,
and 2 h after admission to the ICU. Additionally, time to extubation was
recorded. The Z-BUF of priming blood maintained electrolytes within a
physiologic level, and procalcitonin had a slighter rise in the Z-BUF
Group at 24 h after admission to the ICU (P = 0.05). The respiratory index
was decreased in the Z-BUF Group, but the difference with the control
group did not reach statistical significance (P > 0.05). The change in
pulmonary compliance was significantly increased in the cyanotic patients
in the intervention group, but there was no significant difference between
the two groups. The time to extubation and the ICU stay were shorter in
the Z-BUF Group (P < 0.05). A positive correlation was found between the
peak procalcitonin concentration and the time to extubation directly and
pulmonary compliance reversely. These results suggest that the Z-BUF of
priming blood may have some beneficial clinical effects such as improved
respiratory function and attenuated procalcitonin. Copyright ©
2018 International Center for Artificial Organs and Transplantation and
Wiley Periodicals, Inc.

<58>
Accession Number
618763459
Title
Randomized comparison of balloon aortic valvuloplasty performed with or
without rapid cardiac pacing: The pacing versus no pacing (PNP) study.
Source
Journal of Interventional Cardiology. 31 (1) (pp 51-59), 2018. Date of
Publication: February 2018.
Author
Dall'Ara G.; Marzocchi A.; Taglieri N.; Moretti C.; Rodino G.; Chiarabelli
M.; Bottoni P.; Marrozzini C.; Sabattini M.R.; Bacchi-Reggiani M.-L.;
Rapezzi C.; Saia F.
Institution
(Dall'Ara, Marzocchi, Taglieri, Moretti, Rodino, Chiarabelli, Bottoni,
Marrozzini, Sabattini, Bacchi-Reggiani, Rapezzi, Saia) Cardiology Unit,
Cardio-Thoraco-Vascular Department, University Hospital of Bologna,
Policlinico S. Orsola-Malpighi, Bologna, Italy
(Dall'Ara) Dottorato di ricerca XXXdegreeciclo, Scienze
Cardio-Nefro-Toraciche, University of Bologna, Bologna, Italy
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: To compare the effectiveness and safety of balloon aortic
valvuloplasty (BAV) performed with or without rapid ventricular pacing
(RP). Background(s): BAV technique is poorly standardized.
 Method(s): One hundred consecutive patients were randomly assigned
1:1 between BAV performed with or without RP. Exclusion criteria were an
immediate indication for surgical or transcatheter aortic valve
replacement, presentation in cardiogenic shock or pulmonary edema
refractory to medical stabilization. Result(s): There were 51
patients in the BAV group performed with RP, 49 in the BAV group without
RP (noRP). Procedural success (50% hemodynamic gradient reduction) was
achieved in 37.3% and 55.1%, respectively (P = 0.16). Fewer people in the
noRP group complained of poor tolerance to the procedure (16% vs 41%). The
primary efficacy endpoint, a 50% reduction in the mean echocardiographic
trans-aortic gradient, was met in 21/49 patients in the noRP group
compared to 20/51 in the RP (42.9% vs 39.2%; P = 0.84). No significant
difference between the groups was observed in the primary safety endpoint,
a 30-day composite of death, myocardial infarction, stroke, acute aortic
regurgitation, and BARC bleeding >=3 (8.2% noRP vs 13.7%; P = 0.53). The
noRP group required fewer bailout temporary pacemakers (P = 0.048) and had
a lower incidence of moderate/severe renal function worsening (4.1% vs
17.6%; P = 0.052). Conclusion(s): Rapid ventricular pacing did not
influence BAV efficacy or safety and tolerance was slightly
worse. Copyright © 2017, Wiley Periodicals, Inc.

<59>
Accession Number
600699540
Title
Cerebral oximetry to reduce perioperative morbidity.
Source
Anaesthesia and Intensive Care. 42 (3) (pp 310-314), 2014. Date of
Publication: 01 May 2014.
Author
Cowie D.A.; Nazarethi J.; Story D.A.
Institution
(Cowie, Nazarethi, Story) Department of Anaesthesia, Austin Health,
Heidelberg, VIC, Australia
(Cowie, Nazarethi, Story) Faculty of Medicine, Dentistry and Health
Sciences, University of Melbourne, Parkville, VIC, Australia
Publisher
Australian Society of Anaesthetists
Abstract
The use of cerebral oximetry to guide intraoperative management has been
shown to improve patient outcomes in cardiac surgery. This pilot trial
assessed the feasibility of performing a similar study of outcome in
patients over the age of 70 years undergoing non-cardiac surgery. Patients
over the age of 70 years undergoing total knee or hip arthroplasty or
bowel resection surgery were randomly assigned to have cerebral oximetry
values monitored (intervention group) or not monitored (control) while
under general anaesthesia. Indicators of proof of concept were: rate of
complications, rate of cerebral desaturation, relationship between
cerebral desaturation and complications, and anaesthetist response to
cerebral desaturation. Forty patients were recruited and randomised to a
control group (n=20) or an intervention group (n=20). The proportion of
the study population who had a complication was 40% (95% confidence
interval [CI] 26% to 55%). Cerebral desaturation (<75% of baseline)
occurred in only two patients (5.0% (CI 1.4% to 16%)), one in each group,
and neither of those patients recorded a complication. Changes to
anaesthetic management on the basis of cerebral oximetry values occurred
in only two patients in the intervention group (10% (CI 2.8% to 30%)).
Maintenance of cerebral oximetry values appeared to be closer to baseline
in the intervention group than in the control group but this difference
was not significant (P=0.15). Our results indicated that complications
occurred frequently in the study population but did not appear to be
associated with cerebral desaturation events. These findings do not
support a larger intervention study using the current study population.

<60>
Accession Number
600454715
Title
Surgical Versus Percutaneous Revascularization in Patients with
Multivessel Coronary Artery Disease.
Source
Current Atherosclerosis Reports. 16 (12) (pp 1-13), 2014. Article Number:
461. Date of Publication: December 2014.
Author
Davierwala P.M.; Mohr F.W.
Institution
(Davierwala, Mohr) Department of Cardiac Surgery, Heart Center, University
of Leipzig, Struempellstrase 39, Leipzig 04289, Germany
Publisher
Current Medicine Group LLC 1
Abstract
New-generation stents have been continually developed in order to improve
the safety and efficacy of percutaneous coronary intervention (PCI).
Several randomized clinical trials have been conducted over the last two
decades to compare the outcomes of PCI with coronary artery bypass
grafting (CABG), which has been the time-tested treatment of multivessel
coronary artery disease. The Synergy between PCI with Taxus and Cardiac
Surgery (SYNTAX) trial is one of the most recent and largest randomized
controlled trials comparing PCI using the paclitaxel-eluting
first-generation stent with CABG and was uniquely formulated to represent
"real world" daily practice. The final 5-year main results of this trial
and its various prespecified subgroups have been published in the past
year. These results will form the basis of the new guidelines that will be
published in the near future. This review is a compilation of the results
of the SYNTAX trial and comparisons with other contemporary trials,
meta-analyses, and retrospective studies of large registries and how these
results help cardiac surgeons and cardiologists in judicious
decision-making for their patients with multivessel coronary artery
disease requiring revascularization. Copyright © 2014, Springer
Science+Business Media New York.

<61>
Accession Number
52170694
Title
Meta-analysis of percutaneous coronary intervention versus coronary artery
bypass graft surgery in patients with diabetes and left main and/or
multivessel coronary artery disease.
Source
Acta Diabetologica. 50 (5) (pp 765-773), 2013. Date of Publication:
October 2013.
Author
Gao F.; Zhou Y.J.; Shen H.; Wang Z.J.; Yang S.W.; Liu X.L.
Institution
(Gao, Zhou, Shen, Wang, Yang, Liu) Department of Cardiology, An Zhen
Hospital, Capital Medical University, Anzhenli Avenue, Chao Yang District,
Beijing 100029, China
Publisher
Springer-Verlag Italia s.r.l.
Abstract
The optimal coronary revascularization strategy for patients with diabetes
and left main and/or multivessel disease is undetermined. The aim of our
study was to evaluate percutaneous coronary intervention (PCI) versus
coronary artery bypass graft (CABG) in those patients. We identified 13
articles, published before October 2011, enrolling 6992 patients, whose
follow-up period ranged from 1 to 5 years. Patients with PCI had a
significant reduction in cerebral vascular attack (CVA) (OR, 0.29; 95 %
CI, 0.16-0.51; p < 0.0001, I 2 = 0 %) as compared with CABG,
whereas there was a fourfold increased risk of repeat revascularization
associated with PCI even using drug-eluting stent (OR, 4.44; 95 % CI,
3.42-5.78; X2 = 4.92, p < 0.00001, I 2 = 0 %). The
overall mortality (OR, 0.97; 95 % CI, 0.81-1.15; p = 0.70, I 2
= 0 %) was comparable between the PCI and CABG. However, in subgroup
analysis, the composite outcome (death/myocardial infarction/CVA) was
significantly reduced in favor of DES implantation (OR, 0.79; 95 % CI,
0.63-0.99; X2 = 1.07, p = 0.04, I 2 = 0 %). Our
study confirmed the cerebral vascular benefits of PCI by significantly
reducing CVA risks, and the composite outcome was better in patients
undergoing PCI with drug-eluting stent, despite a higher repeat
revascularization rate. It poses imperative demands for future prospective
randomized studies to define the optimal strategy in patients with
diabetes and left main and/or multivessel disease. © 2012
Springer-Verlag.

<62>
Accession Number
611311079
Title
In patients with post-sternotomy mediastinitis is vacuum-assisted closure
superior to conventional therapy?.
Source
Interactive Cardiovascular and Thoracic Surgery. 17 (5) (pp 861-865),
2013. Date of Publication: November 2013.
Author
Yu A.W.; Rippel R.A.; Smock E.; Jarral O.A.
Institution
(Yu, Rippel) Royal Free and University College Medical School, London,
United Kingdom
(Smock) Department of Plastic Surgery, St. George's Hospital, London,
United Kingdom
(Jarral) Department of Cardiothoracic Surgery, London Chest Hospital,
London, 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 whether vacuumassisted
closure therapy (VAC) is superior to conventional therapy for treating
post-sternotomy mediastinitis. Altogether >261 papers were found using the
reported search, of which 9 represented the best evidence to answer the
clinical question. The authors, journal, date and country of publication,
patient group studied, study type, relevant outcomes and results of these
papers are tabulated. Several studies indicate that VAC therapy is
associated with shorter lengths of intensive care and in-hospital stay as
well as faster rates of wound healing and fewer dressing changes. It has
also been shown that VAC therapy is correlated with a statistically
significant reduction in reinfection rates, particularly those that occur
in the early postoperative period (at the 1-week follow-up). Patients can
be discharged with the dressing in situ and managed in the community with
a view to delayed closure or reconstruction. However, the studies
comparing VAC with conventional therapy are all retrospective in nature
and reinforce the need for randomized controlled trials in order to more
accurately establish differences in outcomes between VAC and conventional
therapy. Additionally, owing tlo the variability of treatment protocols
within the non-VAC arm, it is more challenging to draw definitive
conclusions regarding the superiority of VAC therapy to every modality
that is considered conventional treatment. We conclude that VAC therapy is
a portable and an increasingly economical option for the treatment of post
sternotomy mediastinitis. Although reductions in mortality rates were not
reproduced in all studies, evidence suggests that VAC should still be
considered as a first-line therapy for post-sternotomy mediastinitis and
as a bridge therapy to musculocutaneous reconstruction or primary closure.

<63>
Accession Number
2010725794
Title
Influence of final kissing balloon inflation on long-term outcomes after
PCI of distal left main bifurcation lesions in the EXCEL trial.
Source
EuroIntervention. 16 (3) (pp 218-224), 2021. Date of Publication: 2021.
Author
Kini A.S.; Dangas G.D.; Baber U.; Vengrenyuk Y.; Kandzari D.E.; Leon M.B.;
Morice M.-C.; Serruys P.W.; Kappetein A.P.; Sabik J.F.; Dressler O.;
Mehran R.; Sharma S.K.; Stone G.W.
Institution
(Kini, Dangas, Baber, Vengrenyuk, Mehran, Sharma, Stone) Mount Sinai
Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Dangas, Leon, Dressler, Mehran, Stone) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Kandzari) Piedmont Heart Institute, Atlanta, GA, United States
(Leon) New York Presbyterian Hospital, Columbia University Medical Center,
New York, NY, United States
(Morice) Hopital Prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Serruys) Department of Cardiology, NUIG, National University of Ireland,
Galway, Ireland
(Serruys) Imperial College of Science, Technology and Medicine, London,
United Kingdom
(Kappetein) Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
Publisher
Europa Group
Abstract
Aims: The impact of final kissing balloon inflation (FKBI) after
percutaneous coronary intervention (PCI) of bifurcation lesions on
long-term clinical outcomes remains controversial. We sought to determine
the impact of FKBI on four-year outcomes after PCI of distal left main
(LM) bifurcation lesions. Methods and Results: The EXCEL trial
compared PCI with everolimus-eluting stents and coronary artery bypass
graft surgery (CABG) in patients with left main (LM) disease. We examined
four-year clinical outcomes after PCI of distal LM bifurcation lesions
according to use of FKBI. The primary endpoint was the composite rate of
death, myocardial infarction (MI), or stroke. The major secondary endpoint
was the composite rate of death, MI, stroke, or ischaemia-driven
revascularisation (IDR). Among 948 patients randomised to PCI, 759 had
distal LM lesions treated, 430 of which were treated with one stent and
329 of which were treated with two or more stents. The four-year rates of
the primary and major secondary endpoints were similar with versus without
FKBI in both the one-stent and >=2-stent groups in both unadjusted and
adjusted analyses. Conclusion(s): In the EXCEL trial, the performance
of FKBI after PCI of distal LM bifurcation lesions was not associated with
improved four-year clinical outcomes regardless of whether one stent or
>=2 stents were implanted. Copyright © Europa Digital &
Publishing 2020. All rights reserved.

<64>
Accession Number
2010618891
Title
Long-term Outcome of Axillo-axillary Bypass in Patients with Subclavian or
Innominate Artery Stenosis.
Source
Annals of Vascular Surgery. 73 (pp 321-328), 2021. Date of Publication:
May 2021.
Author
Huijben M.; Meershoek A.J.A.; de Borst G.J.; Toorop R.J.
Institution
(Huijben, Meershoek, de Borst, Toorop) Department of Vascular Surgery,
University Medical Centre Utrecht, Utrecht, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Subclavian or innominate artery stenosis (SAS) may cause upper
extremity and cerebral ischemia. In patients with symptomatic subclavian
or innominate artery stenosis, percutaneous transluminal angioplasty is
the treatment of first choice. When percutaneous transluminal angioplasty
is technically restricted or unsuccessful, an extrathoracic bypass
grafting, such as an axillo-axillary bypass can be considered. The patency
rate of axillo-axillary bypass is often questioned. The aim of this study
was to assess long-term outcomes of patients undergoing axillo-axillary
bypass for subclavian or innominate artery stenosis (SAS) and to provide a
literature overview. Method(s): In this single-center study, data
from patients who underwent axillo-axillary bypass for symptomatic SAS
between 2002 and 2018 were retrospectively analyzed. Bypass material was
Dacron (54%) or polytetrafluoroethylene (PTFE) (46%). Primary outcome was
graft patency and secondary outcome was the occurrence of mortality and
stroke. In addition, a systematic literature search was performed in
MEDLINE and EMBASE databases including all studies describing patency of
axillo-axillary bypass. Result(s): In total, 28 axillo-axillary
bypasses had been performed. Cumulative primary, primary-assisted, and
secondary patency rates at one year were 89%, 93%, and 96%, respectively.
Cumulative primary, primary-assisted, and secondary patency rates at five
years were 76%, 84%, and 87%, respectively. The primary-assisted patency
rates at five years for Dacron and PTFE were 93% and 73%, respectively. A
total of four primary axillo-axillary bypass occlusions occurred (14%),
with a mean of 12 months (range, 0.4-25) after operation. The 30-day
mortality was 7%; one patient died after a stroke and one died of a
myocardial infarction. At the first postoperative follow-up control, 22 of
the 26 remaining patients (85%) had relief of symptoms. The literature
search included 7 studies and described a one-year primary patency range
of 93-100% (n = 137) and early postoperative adverse events included death
(range, 0-13%) and stroke (range, 0-5%). Conclusion(s): Patency rates
of axillo-axillary bypasses for patients with a symptomatic SAS are good.
However, the procedural complication rate in this series is high and
attention should be paid to intervention indication. Copyright ©
2020

<65>
Accession Number
2010511356
Title
Anesthetic Induction With Etomidate in Cardiac Surgical Patients: A
PRISMA-Compliant Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (4) (pp 1073-1085),
2021. Date of Publication: April 2021.
Author
Yao Y.-T.; He L.-X.; Fang N.-X.; Ma J.
Institution
(Yao, He, Fang) Department of Anesthesiology, Fuwai Hospital, National
Center for Cardiovascular Diseases, Peking Union Medical College and
Chinese Academy of Medical Sciences, Beijing, China
(Ma) Department of Pharmacy, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Publisher
W.B. Saunders
Abstract
Objective: This meta-analysis aimed to systematically review the effects
of etomidate (ETM) during anesthetic induction on patients undergoing
cardiac surgery. Design(s): Systematic review and meta-analysis.
 Setting(s): Operating room. Participant(s): Patients undergoing
cardiac surgery. Intervention(s): ETM or control drugs.
 Measurements and Main Results: PubMed, Cochrane Library, OVID, and
EMBASE were searched through August 31, 2020. Primary outcomes included
hemodynamic profiles and stress responses. Secondary outcomes included
morbidity, mortality, and postoperative recovery. For
continuous/dichotomous variables, treatment effects were calculated as
weighted mean difference (WMD)/odds ratio (OR) and 95% confidence interval
(CI). A database search yielded 18 randomized controlled trials including
1,241 patients. The present meta-analysis demonstrated that
ETM-anesthetized patients had lower heart rates (WMD, -3.31; 95% CI -5.43
to -1.19; p = 0.002), higher blood pressures (systolic blood pressure:
WMD, 12.02; 95% CI 6.24 to 17.80; p < 0.0001; diastolic blood pressure:
WMD, 5.23; 95% CI 2.39 to 8.08; p = 0.0003; mean arterial pressure (MAP):
WMD, 8.64; 95% CI 5.85 to 11.43; p < 0.00001), less requirement for
vasopressor (OR, 0.26; 95% CI 0.15 to 0.44; p < 0.00001), and more
nitroglycerin usage (OR, 14.89; 95% CI 4.92 to 45.08; p < 0.00001) during
anesthetic induction. Current meta-analysis also demonstrated that
single-dose ETM lowered cortisol levels transiently and did not have a
significant effect on endogenous norepinephrine and epinephrine levels and
was not associated with increased postoperative inotrope and/or
vasopressor requirement. Additionally, the meta-analysis suggested that
ETM anesthesia was associated with neither increased mortality nor
morbidity, except a higher incidence of transient adrenal insufficiency in
ETM recipients. Conclusion(s): The present meta-analysis suggested
that single-dose ETM during anesthetic induction could be associated with
more stable hemodynamics, transient and reversible lower cortisol levels,
and a higher adrenal insufficiency incidence, but not worse outcomes in
cardiac surgical patients. Copyright © 2020 Elsevier Inc.

<66>
Accession Number
633940752
Title
Minimally invasive surgery versus transcatheter aortic valve replacement:
A systematic review and meta-analysis.
Source
Open Heart. 8 (1) (no pagination), 2021. Article Number: e001535. Date of
Publication: 17 Jan 2021.
Author
Sayed A.; Almotawally S.; Wilson K.; Munir M.; Bendary A.; Ramzy A.; Hirji
S.; Ibrahim Abushouk A.
Institution
(Sayed, Almotawally, Wilson, Munir) Faculty of Medicine, Ain Shams
University, Cairo, Egypt
(Bendary, Ramzy) Faculty of Medicine, Cardiology, Benha University, Benha,
Egypt
(Hirji) Division of Cardiac Surgery, Brigham and Women's Hospital, Boston,
MA, United States
(Ibrahim Abushouk) Division of Cardiology, Beth Israel Deaconess Medical
Center, Boston, MA, United States
Publisher
BMJ Publishing Group
Abstract
Transcatheter aortic valve replacement (TAVR) has recently been approved
for use in patients who are at intermediate and low surgical risk.
Moreover, recent years have witnessed a renewed interest in minimally
invasive aortic valve replacement (miAVR). The present meta-analysis
compared the outcomes of TAVR and miAVR in the management of aortic
stenosis (AS). We conducted an electronic search across six databases from
2002 (TAVR inception) to December 2019. Data from relevant studies
regarding the clinical and length of hospitalisation outcomes were
extracted and analysed using R software. We identified a total of 11
cohort studies, of which seven were matched/propensity matched. Our
analysis demonstrated higher rates of midterm mortality (>=1 year) with
TAVR (risk ratio (RR): 1.93, 95% CI: 1.16 to 3.22), but no significant
differences with respect to 1 month mortality (RR: 1.00, 95% CI: 0.55 to
1.81), stroke (RR: 1.08, 95% CI: 0.40 to 2.87) and bleeding (RR: 1.45, 95%
CI: 0.56 to 3.75) rates. Patients undergoing TAVR were more likely to
experience paravalvular leakage (RR: 14.89, 95% CI: 6.89 to 32.16), yet
less likely to suffer acute kidney injury (RR: 0.38, 95% CI: 0.21 to 0.69)
compared with miAVR. The duration of hospitalisation was significantly
longer in the miAVR group (mean difference: 1.92 (0.61 to 3.24)). Grading
of Recommendations Assessment, Development and Evaluation assessment
revealed <=moderate quality of evidence in all outcomes. TAVR was
associated with lower acute kidney injury rate and shorter length of
hospitalisation, yet higher risks of midterm mortality and paravalvular
leakage. Given the increasing adoption of both techniques, there is an
urgent need for head-to-head randomised trials with adequate follow-up
periods. Copyright © Author(s) (or their employer(s)) 2021.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<67>
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. 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. 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. 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. Copyright © 2021 Cambridge University Press.
All rights reserved.

<68>
[Use Link to view the full text]
Accession Number
2008004489
Title
Evaluation of Automated Delivery of Propofol Using a Closed-Loop
Anesthesia Delivery System in Patients Undergoing Thoracic Surgery: A
Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (4) (pp 1089-1095),
2021. Date of Publication: April 2021.
Author
Sethi N.; Dutta A.; Puri G.D.; Panday B.C.; Sood J.; Gupta M.; Choudhary
P.K.; Sharma S.
Institution
(Sethi, Dutta, Panday, Sood, Gupta, Choudhary, Sharma) Department of
Anaesthesiology, Pain, and Perioperative Medicine, Sir Ganga Ram Hospital,
New Delhi, India
(Puri) Department of Anaesthesia and Intensive Care, Post Graduate
Institute of Medical Education and Research, Chandigarh, India
Publisher
W.B. Saunders
Abstract
Objective: Automated propofol total intravenous anesthesia (TIVA)
administered by a closed-loop anesthesia delivery system (CLADS) exhibits
greater efficiency than conventional manual methods, but its use in major
thoracic surgery is limited. Design(s): Prospective, single-blind,
randomized controlled study. Setting(s): Single-center tertiary care
hospital. Participant(s): Patients undergoing thoracic surgery.
 Intervention(s): Patients were randomly allocated to receive
CLADS-driven (CLADS group) or manually controlled (manual group) propofol
TIVA. Measurements and Main Results: Anesthesia depth consistency
(primary objective) and anesthesia delivery performance, propofol usage,
work ergonomics, intraoperative hemodynamics, and recovery profile
(secondary objectives) were analyzed. No differences were found for
anesthesia depth consistency (percentage of time the bispectral index was
within +/- 10 of target) (CLADS group: 82.5% [78.5%-87.2%] v manual group:
86.5% [74.2%-92.5%]; p = 0.581) and delivery performance, including median
performance error (CLADS group: 3 [-4 to 6] v manual group: 1 [-2.5 to
6]); median absolute performance error (CLADS group: 10 [10-12] v manual
group:10 [8-12]); wobble (CLADS group: 10 [8-12] v manual group: 9
[6-10.5]); and global score (CLADS group: 24.2 [21.2-29.3] v manual group:
22.1 [17.3-32.3]) (p > 0.05). However, propofol requirements were
significantly lower in the CLADS group for induction (CLADS group: 1.27
+/- 0.21] mg/kg v manual group: 1.78 +/- 0.51 mg/kg; p = 0.014) and
maintenance (CLADS group: 4.02 +/- 0.99 mg/kg/h v manual group: 5.11 +/-
1.40 mg/kg/h; p = 0.025) of TIVA. Ergonomically, CLADS-driven TIVA was
found to be significantly superior to manual control (infusion adjustment
frequency/h) (manual infusion: 9.6 [7.8-14.9] v CLADS delivery [none]).
 Conclusion(s): In thoracic surgery patients, CLADS-automated propofol
TIVA confers significant ergonomic advantage along with lower propofol
usage. Copyright © 2020 Elsevier Inc.

<69>
Accession Number
2006134466
Title
Comprehensive comparisons among inotropic agents on mortality and risk of
renal dysfunction in patients who underwent cardiac surgery: A network
meta-analysis of randomized controlled trials.
Source
Journal of Clinical Medicine. 10 (5) (pp 1-12), 2021. Article Number:
1032. Date of Publication: 01 Mar 2021.
Author
Chen W.-C.; Lin M.-H.; Chen C.-L.; Chen Y.-C.; Chen C.-Y.; Lin Y.-C.; Hung
C.-C.
Institution
(Chen) Graduate Institute of Biomedical Sciences, China Medical
University, No. 91, Hsueh-Shih Road, Taichung 40402, Taiwan (Republic of
China)
(Chen, Chen, Chen, Lin) Division of Pulmonary and Critical Care Medicine,
Department of Internal Medicine, China Medical University Hospital, No. 2,
Yude Rd., North Dist., Taichung 404332, Taiwan (Republic of China)
(Chen) Department of Education, China Medical University Hospital, No. 2,
Yude Rd., North Dist., Taichung 404332, Taiwan (Republic of China)
(Lin, Hung) Department of Pharmacy, China Medical University, No. 100,
Sec. 1, Jingmao Rd., Beitun Dist., Taichung 406040, Taiwan (Republic of
China)
(Chen) Department of Pharmacy, China Medical University Hsinchu Hospital,
China Medical University, No. 199, Sec. 1, Xinglong Rd., Hsinchu County,
Zhubei 30272, Taiwan (Republic of China)
(Lin) School of Medicine, China Medical University, No. 91, Hsueh-Shih
Road, Taichung 40402, Taiwan (Republic of China)
(Hung) Department of Pharmacy, China Medical University Hospital, No. 2
Yude Road, Taichung 40447, Taiwan (Republic of China)
(Hung) Department of Healthcare Administration, Asia University, 500,
Lioufeng Rd., Wufeng, Taichung 41354, Taiwan (Republic of China)
Publisher
MDPI AG
Abstract
Several kinds of inotropes have been used in critically ill patients to
improve hemodynamics and renal dysfunction after cardiac surgery; however,
the treatment strategies for reducing mortality and increasing renal
protection in patients who underwent cardiac surgery remain controversial.
Therefore, we performed a comprehensive network meta-analysis to overcome
the lack of head-to-head comparisons. A systematic database was searched
up to 31 December 2020, for randomized controlled trials that compared
different inotropes on mortality outcomes and renal protective effects
after cardiac surgery. A total of 29 trials were included and a
frequentist network meta-analysis was performed. Inconsistency analyses,
publication bias, and subgroup analyses were also conducted. Compared with
placebo, use of levosimendan significantly decreased the risks of
mortality (odds ratio (OR): 0.74; 95% confidence interval (CI): 0.56-0.97)
and risk of acute renal injury (OR: 0.61; 95% CI: 0.45-0.82), especially
in low systolic function patients. Use of levosimendan also ranked the
best treatment based on the P-score (90.1%), followed by placebo (64.5%),
milrinone (49.6%), dopamine (49.5%), dobutamine (29.1%), and fenoldopam
(17.0%). Taking all the available data into consideration, levosimendan
was a safe renal-protective choice for the treatment of patients
undergoing cardiac surgery, especially for those with low systolic
function. Copyright © 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<70>
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. 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. 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. Copyright © The Author(s) 2020.

<71>
Accession Number
635182071
Title
Natriuretic Peptide Clearance Receptor (NPR-C) Pathway as a Novel
Therapeutic Target in Obesity-Related Heart Failure With Preserved
Ejection Fraction (HFpEF).
Source
Frontiers in Physiology. 12 (no pagination), 2021. Article Number: 674254.
Date of Publication: 21 May 2021.
Author
Egom E.E.A.
Institution
(Egom) Institut du Savoir Montfort, Hopital Montfort, University of
Ottawa, Ottawa, ON, Canada
(Egom) Laboratory of Endocrinology and Radioisotopes, Institute of Medical
Research and Medicinal Plants Studies, Yaounde, Cameroon
Publisher
Frontiers Media S.A.
Abstract
Heart failure (HF) with preserved ejection fraction (HFpEF) is a major
public health problem with cases projected to double over the next two
decades. There are currently no US Food and Drug Administration-approved
therapies for the health-related outcomes of HFpEF. However, considering
the high prevalence of this heterogeneous syndrome, a directed therapy for
HFpEF is one the greatest unmet needs in cardiovascular medicine.
Additionally, there is currently a lack of mechanistic understanding about
the pathobiology of HFpEF. The phenotyping of HFpEF patients into
pathobiological homogenous groups may not only be the first step in
understanding the molecular mechanism but may also enable the development
of novel targeted therapies. As obesity is one of the most common
comorbidities found in HFpEF patients and is associated with many
cardiovascular effects, it is a viable candidate for phenotyping. Large
outcome trials and registries reveal that being obese is one of the
strongest independent risk factors for developing HFpEF and that this
excess risk may not be explained by traditional cardiovascular risk
factors. Recently, there has been increased interest in the intertissue
communication between adipose tissue and the heart. Evidence suggests that
the natriuretic peptide clearance receptor (NPR-C) pathway may play a role
in the development and pathobiology of obesity-related HFpEF. Therefore,
therapeutic manipulations of the NPR-C pathway may represent a new
pharmacological strategy in the context of underlying molecular
mechanisms. © Copyright © 2021 Egom.

<72>
Accession Number
2011208222
Title
Efficacy of systemic lidocaine on postoperative quality of recovery and
analgesia after video-assisted thoracic surgery: A randomized controlled
trial.
Source
Journal of Clinical Anesthesia. 71 (no pagination), 2021. Article Number:
110223. Date of Publication: August 2021.
Author
Yao Y.; Jiang J.; Lin W.; Yu Y.; Guo Y.; Zheng X.
Institution
(Yao, Jiang, Lin, Yu, Guo, Zheng) Department of Anesthesiology, Shengli
Clinical Medical College of Fujian Medical University, Fuzhou, Fujian,
China
Publisher
Elsevier Inc.
Abstract
Study objective: Intraoperative systemic lidocaine has become widely
accepted as an adjunct to general anesthesia, associated with
opioid-sparing and enhanced recovery. We hypothesized that perioperative
systemic lidocaine improves postoperative pain and enhances the quality of
recovery (QoR) in patients following video-assisted thoracic surgery
(VATS). Design(s): Prospective, single-center, double-blind,
randomized placebo-controlled clinical trial. Setting(s): Single
institution, tertiary university hospital. Patient(s): Adult patients
aged 18 to 65 undergoing VATS were eligible for participation.
 Intervention(s): Patients enrolled in this study were randomized to
receive either system lidocaine (a bolus of 1.5 mg kg-1,
followed by an infusion of 2 mg kg-1 h-1 until the
end of the surgical procedure) or identical volumes and rates of 0.9%
saline. Measurements: The primary outcome was a global QoR-15 score 24 h
after surgery. Secondary outcomes included postoperative pain score,
cumulative opioid consumption, emergence time, length of PACU stay,
adverse events, and patient satisfaction. Main Result(s): There was
no difference in the global QoR-15 scores at 24 h postoperatively between
the lidocaine and saline groups (median 117, IQR 113.5-124, vs. median
116, IQR 111-120, P = 0.067), with a median difference of 3 (95% CI 0 to
6, P = 0.507). Similarly, postoperative pain scores, postoperative
cumulative opioid consumption, PACU length of stay, the occurrence of
PONV, and patient satisfaction were comparable between the two groups (all
P > 0.05). Conclusion(s): Our current findings do not support using
perioperative systemic lidocaine as a potential strategy to improve
postoperative pain and enhance QoR in patients undergoing VATS. Trial
registration: Chinese Clinical Trial Registry (identifier:
ChiCTR1900027515). Copyright © 2021 Elsevier Inc.

<73>
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. 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. 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. 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 Copyright © 2021 Primary Care
Diabetes Europe

<74>
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. 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. 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. Copyright © 2021

<75>
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.
 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. 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).
 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. Copyright © The
Author(s) 2021.

<76>
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. Copyright © The Author(s) 2021.

<77>
Accession Number
2012313271
Title
Iatrogenic atrial septal defect persistence after percutaneous mitral
valve repair: a meta-analysis.
Source
Acta Cardiologica. (no pagination), 2021. Date of Publication: 2021.
Author
Maier O.; Hellhammer K.; Horn P.; Afzal S.; Jung C.; Westenfeld R.; Zeus
T.; Kelm M.; Veulemans V.
Institution
(Maier, Horn, Afzal, Jung, Westenfeld, Zeus, Kelm, Veulemans) Department
of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty,
Heinrich Heine University, Dusseldorf, Germany
(Hellhammer) Department of Cardiology and Angiology, Elisabeth-Krankenhaus
Essen, Essen, Germany
(Kelm) CARID (Cardiovascular Research Institute Dusseldorf), Dusseldorf,
Germany
Publisher
Taylor and Francis Ltd.
Abstract
Background: Percutaneous mitral valve repair (PMVR) requires a puncture of
the atrial septum, resulting in iatrogenic atrial septal defect (iASD),
which usually causes a transient left-to-right shunt. However, the
influencing risk factors for iASD persistence and functional consequences
are not fully understood. This meta-analysis aimed to summarise available
data on the persistence of iASD following PMVR. Method(s): The
authors conducted a literature search in PubMed/MEDLINE and EMBASE
databases to identify studies investigating iASD persistence in PMVR
patients. Result(s): Six observational studies (n = 361) met
inclusion criteria for the final analysis. Prevalence of persistent iASD
was documented with 28% after 12 months follow-up. iASD size increased
over time with a diameter of 5.3 +/- 0.76 mm after one month and 6.5 +/-
0.21 mm after 12 months. Possible predictors of iASD persistence after
PMVR appeared to be pre-existing AF (RR 1.24; p =.03), residual mitral
regurgitation > IIdegree (RR 2.06; p =.03) and prolonged fluoroscopic time
(RR 8.27; p =.01). Patients with iASD persistence had a higher risk for
development of right heart overload regarding the increased area of the
right atrium (MD 5.24; p =.004) and enlarged diameter of the right
ventricle (MD 3.33; p <.0001). Rehospitalization was more frequently
reported in iASD patients (RR 9.52; p =.004). Conclusion(s): This
meta-analysis proved iASD persistence in 28% of PMVR after 12 months
follow-up with a higher risk for right heart volume overload and more
frequent rehospitalization compared to patients without iASD persistence.
Since percutaneous catheter-based treatments with transseptal approaches
are rising, further evidence about the hemodynamic impact of persistent
iASD is warranted. Copyright © 2021 Belgian Society of
Cardiology.

<78>
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. Copyright © 2021 International Society for Hemodialysis.

<79>
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). 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.
 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. 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. Copyright © 2021 Wiley Periodicals LLC

<80>
Accession Number
2012105718
Title
10-Year Follow-Up After Revascularization in Elderly Patients With Complex
Coronary Artery Disease.
Source
Journal of the American College of Cardiology. 77 (22) (pp 2761-2773),
2021. Date of Publication: 08 Jun 2021.
Author
Ono M.; Serruys P.W.; Hara H.; Kawashima H.; Gao C.; Wang R.; Takahashi
K.; O'Leary N.; Wykrzykowska J.J.; Sharif F.; Piek J.J.; Garg S.; Mack
M.J.; Holmes D.R.; Morice M.-C.; Head S.J.; Kappetein A.P.; Thuijs
D.J.F.M.; Noack T.; Davierwala P.M.; Mohr F.W.; Cohen D.J.; Onuma Y.
Institution
(Ono, Hara, Kawashima, Takahashi, Wykrzykowska, Piek) Department of
Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Ono, Serruys, Hara, Kawashima, Gao, Wang, O'Leary, Sharif, Onuma)
Department of Cardiology, National University of Ireland, Galway (NUIG),
Galway, Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
(Gao, Wang) Department of Cardiology, Radboud University, Nijmegen,
Netherlands
(Wykrzykowska) University Medical Center Groningen, Groningen, Netherlands
(Sharif) CURAM-SFI Centre for Research in Medical Devices, Galway, Ireland
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center, Dallas, TX, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Morice) Departement of Cardiologie, Hopital prive Jacques Cartier,
Generale de Sante Massy, France
(Head, Kappetein, Thuijs) Department of Cardiothoracic Surgery, Erasmus
University Medical Centre, Rotterdam, Netherlands
(Noack, Davierwala, Mohr) University Department of Cardiac Surgery, Heart
Centre Leipzig, Leipzig, Germany
(Cohen) Cardiovascular Research Foundation, New York, NY, United States
(Cohen) St. Francis Hospital, Roslyn, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: The optimal revascularization strategy for the elderly with
complex coronary artery disease remains unclear. Objective(s): The
goal of this study was to investigate 10-year all-cause mortality, life
expectancy, 5-year major adverse cardiac or cerebrovascular events
(MACCE), and 5-year quality of life (QOL) after percutaneous coronary
intervention (PCI) or coronary artery bypass graft (CABG) in elderly
individuals (>70 years old) with 3-vessel disease (3VD) and/or left main
disease (LMD). Method(s): In the present pre-specified analysis on
age of the SYNTAX Extended Survival study, 10-year all-cause death and
5-year MACCE were compared with Kaplan-Meier estimates and Cox
proportional hazards models among elderly or nonelderly patients. Life
expectancy was estimated by restricted mean survival time within 10 years,
and QOL status according to the Seattle Angina Questionnaire up to 5 years
was assessed by linear mixed-effects models. Result(s): Among 1,800
randomized patients, 575 patients (31.9%) were elderly. Ten-year mortality
did not differ significantly between PCI and CABG in elderly (44.1% vs.
41.1%; hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 0.84 to
1.40) and nonelderly patients (21.1% vs. 16.6%; HR: 1.30; 95% CI: 1.00 to
1.69; p<inf>interaction</inf> = 0.332). Among elderly patients, 5-year
MACCE was comparable between PCI and CABG (39.4% vs. 35.1%; HR: 1.18; 95%
CI: 0.90 to 1.56), whereas it was significantly higher in PCI over CABG
among nonelderly patients (36.3% vs. 23.0%; HR: 1.69; 95% CI: 1.36 to
2.10; p<inf>interaction</inf> = 0.043). There were no significant
difference in life expectancy (mean difference: 0.2 years in favor of
CABG; 95% CI: -0.4 to 0.7) and 5-year QOL status between PCI and CABG
among elderly patients. Conclusion(s): Elderly patients with 3VD
and/or LMD had comparable 10-year all-cause death, life expectancy, 5-year
MACCE, and 5-year QOL status irrespective of revascularization mode.
(Synergy Between PCI With TAXUS and Cardiac Surgery: SYNTAX Extended
Survival [SYNTAXES]; NCT03417050) (SYNTAX Study: TAXUS Drug-Eluting Stent
Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed
Arteries [SYNTAX]; NCT00114972) Copyright © 2021 American College
of Cardiology Foundation

<81>
Accession Number
2011566749
Title
Does the Nuss procedure for treating pectus excavatum compromise the long
term internal mammary artery flow? A systematic review.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2518-2523), 2021. Date of
Publication: July 2021.
Author
Elsayed H.H.; Ahmed T.A.; Hassaballa A.S.; Sharkawy H.Y.
Institution
(Elsayed) Thoracic Surgery Department, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
(Ahmed, Hassaballa, Sharkawy) Cardiothoracic Surgery Department, Ain Shams
University, Cairo, Egypt
Publisher
Blackwell Publishing Inc.
Abstract
Introduction: The Nuss procedure is the most common procedure used to
treat patients with pectus excavatum. The effect of the Nuss bars on the
long-term internal mammary artery flow (IMA) is not well studied. This
could have an impact on patients requiring a coronary artery bypass
grafting surgery after the Nuss procedure. We performed a systematic
review to study the impact of the Nuss bars on the IMA long term flow.
 Method(s): A Medline search from January 1990 to August 2020 was
performed using [Nuss OR thoracoscopic pectus OR minimally invasive
pectus] AND [Internal mammary OR Internal thoracic OR IMA OR ITA]. English
language papers only were included. This trial was registered with
PROSPERO under registration number CRD42021234010. Result(s): A total
of 48 papers were identified using the reported search, of which three
represented the best evidence to answer the clinical question. One study
looked at the IMA flow via computed tomography (CT)-angiography on the
10th postoperative day after the Nuss procedure and found 15 out of 34
patients (44%) to have abnormal IMA blood flow but with no clinical
consequences. Two studies looked at the IMA flow after removal of the
Nuss-bar. The first study utilized CT-angiography on the 5th postoperative
day after Nuss-bar removal and found four out of the six patients studied
(67%) to have abnormal flow. The last study was composed of 19 patients
and looked at IMA flow during the presence of the Nuss-bars and after its
removal utilizing Doppler-angiography. It found 11 out of 19 patients
(58%) to have abnormal blood flow with the bars in place. After removal of
the bars, only two patients (10%) were found to have unilateral IMA
obstructed flow. Conclusion(s): In patients undergoing the Nuss
procedure for management of pectus excavatum, the internal mammary artery
flow is compromised in 44%-58% of patients with the bar in situ. When
these patients are assessed 10 days following removal of the bar, some
reversal of compromised IMA flow is evident. However, in up to 67% of
patients, abnormal IMA flow remains. Further studies are required to
determine whether this abnormal flow is permanent, which will require
examining patients at longer follow-up intervals. Patients undergoing
coronary artery bypass grafting who have a history of a Nuss procedure
should receive preoperative IMA imaging. Copyright © 2021 Wiley
Periodicals LLC

<82>
Accession Number
2011071048
Title
Surgical aortic valve replacement in small aortic annulus.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2502-2509), 2021. Date of
Publication: July 2021.
Author
Vaidya Y.P.; Cavanaugh S.M.; Sandhu A.A.
Institution
(Vaidya, Cavanaugh) Department of Surgery, SUNY Upstate Medical
University, Syracuse, NY, United States
(Sandhu) Department of Cardiothoracic Surgery, SUNY Upstate Medical
University, Syracuse, NY, United States
Publisher
Blackwell Publishing Inc.
Abstract
Background: Although aortic valve replacement (AVR) has been the standard
of treatment for severe aortic stenosis, a small aortic annulus (SAA)
poses significant challenges. Improvements in valve designs and evolution
in surgical techniques have led to improved outcomes, however, the ideal
prosthetic valve remains elusive. Method(s): We performed a
comprehensive literature review to discuss the surgical management of
aortic stenosis, with a special focus on patients with SAA.
 Result(s): Stentless valves and root replacement techniques have been
shown to overcome the hemodynamic challenges associated with conventional
stented bioprostheses, but are technically challenging and require longer
cross-clamp times. Sutureless and rapid deployment valves mitigate the
long operative time while maintaining the hemodynamic advantages. The use
of transcatheter AVR has emerged as another reasonable alternative and has
shown promise among patients with SAA, however, long-term outcomes are
awaited. Conclusion(s): There is no consensus regarding the type of
valve prosthesis or replacement technique among patients with SAA.
Consideration of patient comorbidities and valvular anatomy is paramount
in planning the optimal strategy for AVR. Further long-term clinical
trials are necessary to assess outcomes and achieve progress toward the
development of the ideal prosthesis. Copyright © 2021 Wiley
Periodicals LLC

<83>
Accession Number
2011055764
Title
The music video therapy in postoperative analgesia in preschool children
after cardiothoracic surgery.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2308-2313), 2021. Date of
Publication: July 2021.
Author
Huang Y.-L.; Lei Y.-Q.; Liu J.-F.; Cao H.; Yu X.-R.; Chen Q.
Institution
(Huang, Lei, Liu, Cao, Yu, Chen) Department of Cardiac Surgery, Fujian
Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical
University, Fuzhou, China
(Huang, Lei, Liu, Cao, Yu, Chen) Fujian Key Laboratory of Women and
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
(Huang, Lei, Liu, Cao, Yu, Chen) Department of Cardiac surgery, Fujian
Branch of Shanghai Children's Medical Center, Affiliated to Shanghai
Jiaotong University School of Medicine, Fuzhou, China
(Huang, Lei, Liu, Cao, Yu, Chen) Department of Cardiac surgery, Fujian
Children's Hospital, Fuzhou, China
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: To observe the effect of music video (MV) therapy on early
postoperative pain in preschool children after cardiothoracic surgery.
 Method(s): 116 preschool children undergoing cardiothoracic surgery
were randomly divided into the MV and control groups from June 2019 to
March 2020. The related vital signs parameters, the Wong-Baker FACES pain
rating scale, the FLACC scale, the number of postoperative PCA press and
the cumulants of sufentanil use were recorded and analyzed.
 Result(s): There were no statistically significant differences in
general characteristics and preintervention data between the two groups.
However, there were significantly lower in the heart rate, mean arterial
pressure, respiratory rate, the number of postoperative PCA press, and the
dosage of sufentanil in the MV group than those in the control group after
the intervention. The Wong-Baker FACES and FLACC scales in the MV group
were significantly lower than those in the control group at the time point
of immediately after the first intervention, 1 day, and 2 days after the
intervention. The two pain scores showed a downward trend over time, and
the corresponding scores in the MV group were better than those in the
control group. Conclusion(s): MV therapy can be an effective
nonpharmaceutical intervention in the clinical to relieve children's
postoperative pain after cardiothoracic surgery. Copyright © 2021
Wiley Periodicals LLC

<84>
Accession Number
2011044231
Title
Valve-in-valve transcatheter aortic valve replacement versus redo surgical
aortic valve replacement: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2486-2495), 2021. Date of
Publication: July 2021.
Author
Ahmed A.; Levy K.H.
Institution
(Ahmed, Levy) CUNY School of Medicine, New York, NY, United States
Publisher
Blackwell Publishing Inc.
Abstract
Background/Aim: With the growing contemporary use of bioprosthetic valves,
whose limited long-term durability has been well-documented, an increase
in the need for reintervention is expected. We perform a meta-analysis to
compare the current standard of care, redo surgical aortic valve
replacement (Redo SAVR) with the less invasive alternative, valve-in-valve
transcatheter aortic valve replacement (ViV TAVR) for treating structural
valve deterioration. Method(s): After a comprehensive literature
search, studies comparing ViV TAVR to Redo SAVR were pooled to perform a
pairwise meta-analysis using the random-effects model. Primary outcomes
were 30-day and follow-up mortality. Result(s): A total of nine
studies including 9127 patients were included. ViV TAVR patients were
significantly older (mean difference [MD], 5.82; p =.0002) and more
frequently had hypercholesterolemia (59.7 vs. 60.0%; p =.0006), coronary
artery disease (16.1 vs. 16.1%; p =.04), periphery artery disease (15.4
vs. 5.7%; p =.004), chronic obstructive pulmonary disease (29.3 vs. 26.2%;
p =.04), renal failure (30.2 vs. 24.0%; p =.009), and >1 previous cardiac
surgery (23.6 vs. 15.9%; p =.004). Despite this, ViV TAVR was associated
with decreased 30-day mortality (OR, 0.56; p <.0001). Conversely, Redo
SAVR had lower 30-day paravalvular leak (OR, 6.82; p =.04), severe
patient-prosthesis mismatch (OR, 3.77; p <.0001), and postoperative aortic
valve gradients (MD, 5.37; p <.0001). There was no difference in follow-up
mortality (HR, 1.02; p =.86). Conclusion(s): Despite having patients
with an increased baseline risk, ViV TAVR was associated with lower 30-day
mortality, while Redo SAVR had lower paravalvular leak, severe
patient-prosthesis mismatch, and postoperative gradients. Although ViV
TAVR remains a feasible treatment option in high-risk patients, randomized
trials are necessary to elucidate its efficacy over Redo
SAVR. Copyright © 2021 Wiley Periodicals LLC

<85>
Accession Number
2010983563
Title
Benefits of mitral valve repair over replacement in the elderly: a
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2524-2530), 2021. Date of
Publication: July 2021.
Author
Di Tommaso E.; Rapetto F.; Guida G.A.; Zakkar M.; Bruno V.D.
Institution
(Di Tommaso, Bruno) Bristol Medical School, Translational Health Science,
University of Bristol, Bristol, United Kingdom
(Rapetto, Guida) Bristol Heart Institute, University Hospital Bristol and
Weston NHS Foundation Trust, Bristol, United Kingdom
(Zakkar) Department of Cardiovascular Sciences, Clinical Sciences Wing,
Glenfield General Hospital, University of Leicester, Leicester, United
Kingdom
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: Mitral valve (MV) repair has demonstrated excellent short- and
long-term outcomes, however, its merit in the elderly population is still
debated. We conducted a meta-analysis of studies that have compared the MV
repair to replacement in the elderly population. Method(s): A
systematic literature search was conducted for any study published on MV
surgery on elderly patients (>=75 years old). A pooled risk-ratio
meta-analysis was done to evaluate short-term mortality, postoperative
complications, surgical timings, and long-term survival rates.
 Result(s): A total of nine retrospective observational studies were
included in the quantitative meta-analysis. Pooled meta-analysis showed a
reduced risk of short-term mortality for the MV repair group (risk ratio
[RR] = 0.41 [0.24-0.71], p-value =.005). Postoperative neurological
complications were in favor of repair, although not significantly (RR =
0.49 [0.21-1.11], p-value =.07). Operative timings (cardiopulmonary bypass
and crossclamp time) were not different between the groups although no
data were available on the complexity of the repairs. Long-term survival
rates were in favor of the repairs (pooled treatment effect of -0.47
[-0.64; -0.29], p =.005). Conclusion(s): MV surgery is a safe and
effective procedure for the elderly. MV repair demonstrated better
short-term outcomes compared to replacement. Long-term survival rates are
significantly better after repair. Copyright © 2021 The Authors.
Journal of Cardiac Surgery published by Wiley Periodicals LLC

<86>
Accession Number
2010983405
Title
Global longitudinal strain to determine optimal timing for surgery in
primary mitral regurgitation: A systematic review.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2458-2466), 2021. Date of
Publication: July 2021.
Author
Modaragamage Dona A.C.; Afoke J.; Punjabi P.P.; Kanaganayagam G.S.
Institution
(Modaragamage Dona) Faculty of Medicine, Imperial College London, London,
United Kingdom
(Afoke, Punjabi) Department of Cardiothoracic Surgery, National Heart and
Lung Institute, Imperial College London, Imperial College Healthcare NHS
Trust, Hammersmith Hospital, London, United Kingdom
(Kanaganayagam) Department of Cardiology, National Heart and Lung
Institute, Imperial College London, Imperial College Healthcare NHS Trust,
Hammersmith Hospital, London, United Kingdom
Publisher
Blackwell Publishing Inc.
Abstract
Background: Primary mitral regurgitation (PMR) results in adverse
remodeling changes and left ventricular (LV) dysfunction. Assessing LV
function has prognostic value in predicting morbidity and mortality.
Indications for surgery include parameters such as LV ejection fraction
(LVEF) and systolic dimensions. Current guidelines are limited in
identifying patients at optimal time for surgery. Impaired postoperative
LVEF indicates poor prognostic outcomes and subsequent heart failure.
Global longitudinal strain (GLS) via speckle tracking echocardiography
(STE) presents as a promising parameter to detect subclinical dysfunction
in asymptomatic patients. Method(s): Following PRISMA guidelines, a
literature search was conducted with Cochrane Library, PudMed, SCOPUS, and
Web of Science. Key MeSH terms included "mitral regurgitation," "mitral
valve insufficiency," "global longitudinal strain," "deformation,"
"LV-GLS," and "GLS." Inclusion criteria included (1) patients with severe
PMR, (2) mixed population of symptomatic and asymptomatic patients, (3)
standardized methods in assessing LV systolic function using 2D-STE, (4)
valve repair or replacement surgery, and (5) patient outcomes measured
after surgery. Search returned 234 papers, 12 of which met the inclusion
criteria and were subsequently reviewed. Result(s): Baseline GLS is
an independent predictor of postoperative outcomes, ranging from -17.9 to
-21.7% GLS. A significant negative correlation was observed between
preoperative GLS and postoperative LVEF. Impaired baseline GLS was
associated with higher mortality rates. Better long-term survival rates
were seen in patients who underwent early surgery. Conclusion(s): GLS
shows sensitivity in predicting long-term postoperative outcomes. Further
analysis is required to determine preoperative GLS threshold to identify
asymptomatic patients at the optimal time for mitral valve
surgery. Copyright © 2021 The Authors. Journal of Cardiac Surgery
Published by Wiley Periodicals LLC

<87>
Accession Number
2010983387
Title
Mitral valve repair for mitral regugitation in the elderly: Yes, we have
to, but look at the etiologies!.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2531-2532), 2021. Date of
Publication: July 2021.
Author
Calafiore A.M.; Di Marco M.; Guarracini S.; Katsavrias K.; Di Mauro M.
Institution
(Calafiore) Department of Cardiovascular Sciences, Gemelli Molise,
Campobasso, Italy
(Di Marco) Department of Cardiology, "Santo Spirito" Hospital, Pescara,
Italy
(Guarracini) Department of Cardiology, "Pierangeli" Hospital, Pescara,
Italy
(Katsavrias) Department of Cardiac Surgery, Henry Durant Hospital, Athens,
Greece
(Di Mauro) Cardio-Thoracic Surgery Unit, Heart and Vascular Centre,
Maastricht University Medical Centre (MUMC), Cardiovascular Research
Institute Maastricht (CARIM), Maastricht, Netherlands
Publisher
Blackwell Publishing Inc.
Abstract
The meta-analysis by Di Tommaso et al. demonstrated as elderly patients
with mitral regurgitation (MR) undergoing mitral valve repair had lower
short-term mortality and higher long-term survival with respect to
patients undergoing mitral valve replacement. The benefit of repair is
such, that initial surgical strategy is advisable in the elderly even in
case of mild symptoms if compared with conservative management. However,
even if repair can be performed in presence of some specific etiologies,
as degenerative MR or secondary MR, there are always cases where a
replacement can be an acceptable solution compared to a repair with
uncertain future, regardless of our believes and our technical
ability. Copyright © 2021 Wiley Periodicals LLC

<88>
Accession Number
2010933939
Title
Absence of electrocardiographic left ventricular hypertrophy and poor
outcome in patients undergoing transcatheter aortic valve replacement-A
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2233-2239), 2021. Date of
Publication: July 2021.
Author
Martha J.W.; Pranata R.; Yonas E.; Wibowo A.; Akbar M.R.
Institution
(Martha, Pranata, Wibowo, Akbar) Department of Cardiology and Vascular
Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum
Pusat Hasan Sadikin, Bandung, Indonesia
(Pranata) Faculty of Medicine, Universitas Pelita Harapan, Tangerang,
Indonesia
(Yonas) Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia
Publisher
Blackwell Publishing Inc.
Abstract
Objective: This systematic review and meta-analysis aimed to evaluate
whether the absence of electrocardiographic (ECG) left ventricular
hypertrophy (LVH) was associated with poor outcome in patients undergoing
transcatheter aortic valve replacement (TAVR). Method(s): We
performed systematic review search on PubMed, Embase, and Scopus up until
January 22, 2021. The key exposure was the absence of ECG LVH, defined as
the absence of LVH by electrocardiographic criteria. The outcome of
interest was composite poor outcome, which is a composite of mortality
and/or rehospitalization after TAVR. The effect estimate was reported as
hazard ratio (HR). In addition, we generate sensitivity and specificity,
positive and negative likelihood ratio (PLR and NLR), diagnostic odds
ratio (DOR), and area under curve (AUC). Result(s): There are four
studies comprising of 827 patients included in this systematic review and
meta-analysis. The prevalence of poor outcome in this pooled analysis was
30%. The absence of ECG LVH was associated with increased poor outcome in
patients undergoing TAVR (HR: 1.86, [1.34, 2.57], p <.001; I2:
0%). Absence of ECG LVH was associated with a sensitivity of 0.75 [0.64,
0.83], specificity of 0.42 [0.30, 0.55], PLR of 1.3 [1.1, 1.5], NLR of
0.60 [0.45, 0.80], DOR 2 [1, 5], and AUC of 0.66 [0.62, 0.70]. Fagan's
nomogram indicates in a 22% prevalence of poor outcome in the included
studies, the absence of ECG LVH and ECG LVH was associated with 27% and
15% posttest probability for poor outcome, respectively.
 Conclusion(s): Absence of ECG LVH was associated with poor outcome in
patients undergoing TAVR. Copyright © 2021 The Authors. Journal
of Cardiac Surgery published by Wiley Periodicals LLC

<89>
Accession Number
2010888347
Title
The effects of neuro-linguistic programming and guided imagery on the pain
and comfort after open-heart surgery.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2389-2397), 2021. Date of
Publication: July 2021.
Author
Dogan A.; Saritas S.
Institution
(Dogan) Department of Nursing, Faculty of Health Sciences, Toros
University, Mersin, Turkey
(Saritas) Department of Surgical Nursing, Faculty of Nursing, Inonu
University, Malatya, Turkey
Publisher
Blackwell Publishing Inc.
Abstract
Objective: The present study aims to evaluate the effects of
neuro-linguistic programming (NLP) and guided imagery on postoperative
pain and comfort after open-heart surgery. Method(s): In the current,
prospective, randomized, single-blind clinical study, the participants
received NLP with a new behavior formation technique or the guided imagery
relaxation technique using an audio compact disc for a duration of 30 min.
 Result(s): The patients in the NLP group had significantly lower
posttest pain levels, compared to the patients in the guided imagery and
control groups. Moreover, the patients in the guided imagery group had
significantly higher posttest comfort levels, compared to the patients in
the NLP and control groups. Conclusion(s): The application of both
NLP and guided imagery interventions resulted in reduced postoperative
pain and increased postoperative comfort levels after open-heart
surgery. Copyright © 2021 Wiley Periodicals LLC

<90>
Accession Number
2010860383
Title
Racial and socioeconomic disparities in congenital heart surgery: A
research article.
Source
Journal of Cardiac Surgery. 36 (7) (pp 2454-2457), 2021. Date of
Publication: July 2021.
Author
Richardson C.J.; Itua P.; Duong T.; Lewars J.; Tiesenga F.
Institution
(Richardson) Department of Internal Medicine, Saint James School of
Medicine, The Quarter, Anguilla
(Itua) Department of Internal Medicine, All Saints University School of
Medicine, Roseau, Dominica
(Duong) Department of Internal Medicine, Windsor University School of
Medicine, Cayon, Saint Kitts and Nevis
(Lewars) Department of Internal Medicine, Saint James School of Medicine,
Arnos Vale, Saint Vincent and the Grenadines
(Tiesenga) Department of General Surgery, West Suburban Hospital Medical
Center, Oak Park, IL, United States
Publisher
Blackwell Publishing Inc.
Abstract
Background: Though the modern era has proven to be reassuring with the
advancement of perioperative care leading to improved survival, congenital
heart disease (CHD) continues to underscore its significance in the lives
of newborns and families worldwide. Particularly, CHD has
disproportionately afflicted vulnerable minorities such as Black and
Hispanic populations from the standpoint of ethnic disparities in
mortality following heart surgery, increased resource utilization, and
longer durations of stay. This study aims to identify and provide insight
regarding the relationships between the aforementioned factors to develop
targeted strategies of intervention to mitigate the outcomes for patients
of these specific populations. Method(s): Free, current peer-reviewed
literature from databases such as the American Heart Association, The
European Heart Journal, Science Direct, and PubMed regarding CHD, racial
disparities, and socioeconomic variances were accessed. The study was
narrowed to a patient population including only infants without
chromosomal anomalies or those that passed away before hospital discharge.
 Result(s): Having private insurance and maternal education showed
positive correlations with positive outcomes of patients post congenital
heart surgery. Teaching hospitals were linked with increased mortality and
complications. Male infants showed higher rates of complications.
Hispanics had increased odds of complications. Black patients had
increased risk for failures in being rescued. Conclusion(s): Race
plays a major role in the disparities in CHD, it is imperative to evaluate
the socioeconomic contributors, surgical efforts, and provisions in place
regarding minority patients. The apparency of these disparities, and
willingness to invoke changes in practice has the potential for
improvements in outcomes for these patients. Copyright © 2021
Wiley Periodicals LLC

<91>
Accession Number
2010795825
Title
A narrative review of platelet-rich plasma (PRP) in reproductive medicine.
Source
Journal of Assisted Reproduction and Genetics. 38 (5) (pp 1003-1012),
2021. Date of Publication: May 2021.
Author
Sharara F.I.; Lelea L.-L.; Rahman S.; Klebanoff J.S.; Moawad G.N.
Institution
(Sharara, Rahman) Virginia Center for Reproductive Medicine, 11150 Sunset
Hills Rd, Suite 100, Reston, VA 20190, United States
(Sharara, Moawad) Department of Obstetrics and Gynecology, George
Washington University, Washington, DC, United States
(Lelea) Department of Obstetrics and Gynecology, University of Central
Florida-HCA Consortium, Orlando, FL, United States
(Klebanoff) Department of Obstetrics and Gynecology, Main Line Health
Wynnewood, Wynnewood, PA, United States
(Moawad) The Center for Endometriosis and Advanced Pelvic Surgery,
Washington, DC, United States
Publisher
Springer
Abstract
Purpose: Platelet-rich plasma (PRP) has become a novel treatment in
various aspects of medicine including orthopedics, cardiothoracic surgery,
plastic surgery, dermatology, dentistry, and diabetic wound healing. PRP
is now starting to become an area of interest in reproductive medicine
more specifically focusing on infertility. Poor ovarian reserve,
menopause, premature ovarian failure, and thin endometrium have been the
main areas of research. The aim of this article is to review the existing
literature on the effects of autologous PRP in reproductive medicine
providing a summation of the current studies and assessing the need for
additional research. Method(s): A literature search is performed
using PubMed, MEDLINE, and CINAHL Plus to identify studies focusing on the
use of PRP therapy in reproductive medicine. Articles were divided into 3
categories: PRP in thin lining, PRP in poor ovarian reserve, and PRP in
recurrent implantation failure. Result(s): In women with thin
endometrium, the literature shows an increase in endometrial thickness and
increase in chemical and clinical pregnancy rates following autologous PRP
therapy. In women with poor ovarian reserve, autologous intraovarian PRP
therapy increased anti-Mullerian hormone (AMH) levels and decreased
follicle-stimulating hormone (FSH), with a trend toward increasing
clinical and live birth rates. This trend was also noted in women with
recurrent implantation failure. Conclusion(s): Limited literature
shows promise in increasing endometrial thickness, increasing AMH, and
decreasing FSH levels, as well as increasing chemical and clinical
pregnancy rates. The lack of standardization of PRP preparation along with
the lack of large randomized controlled trials needs to be addressed in
future studies. Until definitive large RCTs are available, PRP use should
be considered experimental. Copyright © 2021, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<92>
Accession Number
2010483740
Title
Valve-in-valve transcatheter aortic valve replacement versus redo surgical
valve replacement for degenerated bioprosthetic aortic valve: An updated
meta-analysis comparing midterm outcomes.
Source
Catheterization and Cardiovascular Interventions. 97 (7) (pp 1481-1488),
2021. Date of Publication: 01 Jun 2021.
Author
Thandra A.; Abusnina W.; Jhand A.; Shaikh K.; Bansal R.; Pajjuru V.S.;
Al-Abdouh A.; Kanmanthareddy A.; Alla V.M.
Institution
(Thandra, Abusnina, Shaikh, Kanmanthareddy, Alla) Division of
Cardiovascular Diseases, Creighton University School of Medicine, Omaha,
NE, United States
(Jhand) Division of Cardiovascular Diseases, University of Nebraska
Medical Center, Omaha, NE, United States
(Bansal, Pajjuru) Division of Internal Medicine, Creighton University
School of Medicine, Omaha, NE, United States
(Al-Abdouh) Division of Internal Medicine, Saint Agnes Hospital,
Baltimore, MD, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Redo surgical aortic valve replacement (redo SAVR) and
valve-in-valve transcatheter aortic valve replacement (ViV TAVR) are the
two treatment strategies available for patients with severe symptomatic
bioprosthetic aortic valve dysfunction. Herein, we performed a systematic
review and meta-analysis comparing both early and mid-term outcomes of ViV
TAVR versus redo SAVR in patients with bioprosthetic aortic valve disease.
 Method(s): PubMed, Cochrane reviews, and Google scholar electronic
databases were searched and studies comparing ViV TAVR versus redo SAVR
were included. The primary outcome of interest was mid-term (1-5 years)
and 1-year all-cause mortality. Secondary outcomes included were 30-day
all-cause mortality, myocardial infarction, pacemaker implantation,
stroke, acute kidney injury, major or life-threatening bleeding, and
postprocedural aortic valve gradients. Pooled risk ratios (RR) with their
corresponding 95% confidence intervals (CIs) were calculated for all
outcomes using the DerSimonian-Laird random-effects model. Result(s):
Nine observational studies with a total of 2,891 individuals and mean
follow-up of 26 months met the inclusion criteria. There is no significant
difference in mid-term and 1-year mortality between ViV-TAVR and redo SAVR
groups with RR of 1.15 (95% CI 0.99-1.32; p =.06) and 1.06 (95% CI
0.69-1.61; p =.8). 30-day mortality rate was significantly lower in
ViV-TAVR group with RR of 0.65 (95% CI 0.45-0.93; p =.02). ViV-TAVR group
had lower 30-day bleeding, length of stay, and higher postoperative
gradients. Conclusion(s): Our study demonstrates a lower 30-day
mortality and similar 1-year and mid-term mortality for ViV TAVR compared
to redo SAVR despite a higher baseline risk. Given these findings and the
ongoing advances in the transcatheter therapeutics, VIV TAVR should be
preferred over redo SAVR particularly in those at intermediate-high
surgical risk. Copyright © 2021 Wiley Periodicals LLC.

<93>
Accession Number
620697056
Title
Cognitive Outcomes After Transcatheter Aortic Valve Implantation: A
Metaanalysis.
Source
Journal of the American Geriatrics Society. 66 (2) (pp 254-262), 2018.
Date of Publication: February 2018.
Author
Khan M.M.; Herrmann N.; Gallagher D.; Gandell D.; Fremes S.E.;
Wijeysundera H.C.; Radhakrishnan S.; Sun Y.R.; Lanctot K.L.
Institution
(Khan, Herrmann, Sun, Lanctot) Neuropsychopharmacology Research Group,
Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto,
ON, Canada
(Khan, Sun, Lanctot) Department of Pharmacology and Toxicology, University
of Toronto, Toronto, ON, Canada
(Herrmann, Gallagher, Lanctot) Department of Psychiatry, Sunnybrook Health
Sciences Centre and University of Toronto, Toronto, ON, Canada
(Gandell) Department of Geriatric Medicine, Sunnybrook Health Sciences
Centre, Toronto, ON, Canada
(Fremes, Wijeysundera, Radhakrishnan) Schulich Heart Centre, Sunnybrook
Health Sciences Centre, Toronto, ON, Canada
Publisher
Blackwell Publishing Inc.
Abstract
Objectives: To quantitatively summarize changes in cognitive performance
in individuals with severe aortic stenosis undergoing transcatheter aortic
valve implantation (TAVI). Design(s): Metaanalysis.
 Participant(s): Individuals undergoing TAVI (N = 1,065 (48.5% male)
from 18 studies, average age >=80). Measurements: The MEDLINE, EMBASE, and
Cochrane Central databases were searched for original peer-reviewed
reports assessing cognitive performance using standardized cognitive tests
before and after TAVI. Data were extracted for cognitive scores before
TAVI; perioperatively (within 7 days after TAVI); 1, 3, and 6 months after
TAVI, and 12 to 34 months after TAVI (over the long term). Standardized
mean differences (SMDs) were generated using random-effects models for
changes in cognition at each time point. Metaregression analyses were
conducted to assess the association between population and procedural
characteristics and cognitive outcomes. Risk of bias was assessed.
 Result(s): There were no significant changes from baseline in
perioperative cognitive performance (SMD = 0.05, 95% confidence interval
(CI) = -0.08-0.18; z = 0.75, P =.46), although overall cognitive
performance had improved significantly 1 month after TAVI (SMD = -0.33,
95% CI = -0.50 to -0.16; z = 3.83, P <.001). There were no differences in
cognitive performance 3 and 6 months after TAVI or over the long term.
Cognitive outcomes were not associated with any covariates in regression
analyses. Conclusion(s): Cognitive performance is preserved after
TAVI, suggesting TAVI is not detrimental to cognition. © 2017,
Copyright the Authors Journal compilation © 2017, The American
Geriatrics Society

<94>
Accession Number
635243246
Title
Effect of operating room nursing combined with anaesthesia in cardiac
surgery on quality of life and nursing satisfaction of patients.
Source
Basic and Clinical Pharmacology and Toxicology. Conference: 2021
International Workshop on Pharmaceutical and Clinical Research, WPCR 2021.
Virtual. 128 (SUPPL 3) (pp 21-22), 2021. Date of Publication: May 2021.
Author
Xu J.; Shi X.; Hu Y.; Huo D.
Institution
(Xu) Operating Theatre, First Affiliated Hospital, Shandong First Medical
University, China
(Shi, Hu, Huo) Department of Anesthesiology and Perioperative Medicine,
First Affiliated Hospital, Shandong First Medical University Shandong,
China
Publisher
Blackwell Publishing Ltd
Abstract
Objective: To investigate the effect of operating room nursing combined
with anaesthesia in cardiac surgery on quality of life and nursing
satisfaction of patients. Method(s): A total of 90 patients
undergoing cardiac surgery admitted to our hospital in the past one year
were selected and randomly divided into control group (n = 45) and
experimental group (n = 45). The control group patients were given routine
nursing care, while based on this, the experimental group patients
received operating room nursing combined with anaesthesia. After that, the
quality of life in both groups after treatment was evaluated by the MOS
item short from health survey (SF-36), and the nursing satisfaction was
compared between the two groups. Result(s): The SF-36 score and
nursing satisfaction in the experimental group were both significantly
higher than those in the control group (P < 0.05). Conclusion(s):
Compared with routine nursing care, operating room nursing combined with
anaesthesia in cardiac surgery can achieve higher nursing satisfaction and
further improve quality of life in patients, which is worthy of
application and promotion.

<95>
Accession Number
2012346800
Title
Perioperative liberal versus restrictive fluid strategies and
postoperative outcomes: a systematic review and metanalysis on
randomised-controlled trials in major abdominal elective surgery.
Source
Critical Care. 25 (1) (no pagination), 2021. Article Number: 205. Date of
Publication: December 2021.
Author
Messina A.; Robba C.; Calabro L.; Zambelli D.; Iannuzzi F.; Molinari E.;
Scarano S.; Battaglini D.; Baggiani M.; De Mattei G.; Saderi L.; Sotgiu
G.; Pelosi P.; Cecconi M.
Institution
(Messina, Calabro, Zambelli, Cecconi) Department of Anaesthesia and
Intensive Care Medicine, Humanitas Clinical and Research Center - IRCCS,
Via Alessandro Manzoni, 56, Rozzano, MI 20089, Italy
(Messina, Cecconi) Department of Biomedical Sciences, Humanitas
University, Pieve Emanuele, MI, Italy
(Robba, Iannuzzi, Molinari, Scarano, Battaglini, Pelosi) Anaesthesia and
Intensive Care, IRCCS for Oncology and Neuroscience, San Martino
Policlinico Hospital, Genoa, Italy
(Iannuzzi, Molinari, Scarano, Pelosi) Department of Surgical Sciences and
Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy
(Baggiani) Anesthesia and Intensive Care Medicine, Maggiore Della Carita
University Hospital, Novara, Italy
(De Mattei) Anesthesia and Intensive Care Medicine, Azienda Sanitaria
Universitaria Integrata Udine, Udine, Italy
(Saderi, Sotgiu) Clinical Epidemiology and Medical Statistics Unit,
Department of Medical, Surgical and Experimental, University of Sassari,
Sassari, Italy
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative complications impact on early and long-term
patients' outcome. Appropriate perioperative fluid management is pivotal
in this context; however, the most effective perioperative fluid
management is still unclear. The enhanced recovery after surgery pathways
recommend a perioperative zero-balance, whereas recent findings suggest a
more liberal approach could be beneficial. We conducted this trial to
address the impact of restrictive vs. liberal fluid approaches on overall
postoperative complications and mortality. Method(s): Systematic
review and meta-analysis, including randomised controlled trials (RCTs).
We performed a systematic literature search using MEDLINE (via Ovid),
EMBASE (via Ovid) and the Cochrane Controlled Clinical trials register
databases, published from 1 January 2000 to 31 December 2019. We included
RCTs enrolling adult patients undergoing elective abdominal surgery and
comparing the use of restrictive/liberal approaches enrolling at least 15
patients in each subgroup. Studies involving cardiac, non-elective
surgery, paediatric or obstetric surgeries were excluded. Result(s):
After full-text examination, the metanalysis finally included 18 studies
and 5567 patients randomised to restrictive (2786 patients; 50.0%) or
liberal approaches (2780 patients; 50.0%). We found no difference in the
occurrence of severe postoperative complications between restrictive and
liberal subgroups [risk difference (95% CI) = 0.009 (- 0.02; 0.04); p
value = 0.62; I<inf>2</inf> (95% CI) = 38.6% (0-66.9%)]. This result was
confirmed also in the subgroup of five studies having a low overall risk
of bias. The liberal approach was associated with lower overall renal
major events, as compared to the restrictive [risk difference (95% CI) =
0.06 (0.02-0.09); p value = 0.001]. We found no difference in either early
(p value = 0.33) or late (p value = 0.22) postoperative mortality between
restrictive and liberal subgroups Conclusion(s): In major abdominal
elective surgery perioperative, the choice between liberal or restrictive
approach did not affect overall major postoperative complications or
mortality. In a subgroup analysis, a liberal as compared to a restrictive
perioperative fluid policy was associated with lower overall complication
renal major events, as compared to the restrictive. Trial Registration:
CRD42020218059; Registration: February 2020,
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=218059. Copyright © 2021, The Author(s).

<96>
Accession Number
2012344298
Title
The GEnetic Syntax Score: a genetic risk assessment implementation tool
grading the complexity of coronary artery disease-rationale and design of
the GESS study.
Source
BMC Cardiovascular Disorders. 21 (1) (no pagination), 2021. Article
Number: 284. Date of Publication: December 2021.
Author
Vizirianakis I.S.; Chatzopoulou F.; Papazoglou A.S.; Karagiannidis E.;
Sofidis G.; Stalikas N.; Stefopoulos C.; Kyritsis K.A.; Mittas N.;
Theodoroula N.F.; Lampri A.; Mezarli E.; Kartas A.; Chatzidimitriou D.;
Pappa-Konidari A.; Angelis E.; Karvounis Eta.; Sianos G.
Institution
(Vizirianakis, Kyritsis, Theodoroula) Laboratory of Pharmacology, School
of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, Greece
(Vizirianakis) Department of Life and Health Sciences, University of
Nicosia, Nicosia 1700, Cyprus
(Chatzopoulou, Chatzidimitriou, Pappa-Konidari) Laboratory of
Microbiology, School of Medicine, Aristotle University of Thessaloniki,
Thessaloniki, Greece
(Chatzopoulou, Lampri, Mezarli) Labnet Laboratories, Thessaloniki, Greece
(Papazoglou, Karagiannidis, Sofidis, Stalikas, Stefopoulos, Kartas,
Karvounis, Sianos) Department of Cardiology, AHEPA University Hospital,
Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636,
Greece
(Mittas) Department of Chemistry, International Hellenic University,
Kavala, Greece
(Angelis) Department of Informatics, Aristotle University of Thessaloniki,
Thessaloniki, Greece
Publisher
BioMed Central Ltd
Abstract
Background: Coronary artery disease (CAD) remains one of the leading
causes of mortality worldwide and is associated with multiple inherited
and environmental risk factors. This study is designed to identify,
design, and develop a panel of genetic markers that combined with clinical
and angiographic information, will facilitate the creation of a
personalized risk prediction algorithm (GEnetic Syntax Score-GESS). GESS
score could be a reliable tool for predicting cardiovascular risk for
future adverse events and for guiding therapeutic strategies.
 Method(s): GESS (ClinicalTrials.gov Identifier: NCT03150680) is a
prospective, non-interventional clinical study designed to enroll 1080
consecutive patients with no prior history of coronary revascularization
procedure, who undergo scheduled or emergency coronary angiography in
AHEPA, University General Hospital of Thessaloniki. Next generation
sequencing (NGS) technology will be used to genotype specific
single-nucleotide polymorphisms (SNPs) across the genome of study
participants, which were identified as clinically relevant to CAD after
extensive bioinformatic analysis of literature-based SNPs. Enrichment
analyses of Gene Ontology-Molecular Function, Reactome Pathways and
Disease Ontology terms were also performed to identify the top 15
statistically significant terms and pathways. Furthermore, the SYNTAX
score will be calculated for the assessment of CAD severity of all
patients based on their angiographic findings. All patients will be
followed-up for one-year, in order to record any major adverse
cardiovascular events. Discussion(s): A group of 228 SNPs was
identified through bioinformatic and pharmacogenomic analysis to be
involved in CAD through a wide range of pathways and was correlated with
various laboratory and clinical parameters, along with the patients'
response to clopidogrel and statin therapy. The annotation of these SNPs
revealed 127 genes being affected by the presence of one or more SNPs. The
first patient was enrolled in the study in February 2019 and enrollment is
expected to be completed until June 2021. Hence, GESS is the first trial
to date aspiring to develop a novel risk prediction algorithm, the GEnetic
Syntax Score, able to identify patients at high risk for complex CAD based
on their molecular signature profile and ultimately promote
pharmacogenomics and precision medicine in routine clinical settings.
Trial registration GESS trial registration: ClinicalTrials.gov Number:
NCT03150680. Registered 12 May 2017- Prospectively registered,
https://clinicaltrials.gov/ct2/show/NCT03150680. Copyright ©
2021, The Author(s).

<97>
[Use Link to view the full text]
Accession Number
635248280
Title
Cerebral Embolic Protection and Outcomes of Transcatheter Aortic Valve
Replacement: Results from the Transcatheter Valve Therapy Registry.
Source
Circulation. (pp 2229-2240), 2021. Date of Publication: 2021.
Author
Butala N.M.; Makkar R.; Secemsky E.A.; Gallup D.; Marquis-Gravel G.;
Kosinski A.S.; Vemulapalli S.; Valle J.A.; Bradley S.M.; Chakravarty T.;
Yeh R.W.; Cohen D.J.
Institution
(Butala, Secemsky, Yeh) Richard A. and Susan F. Smith Center for Outcomes
Research in Cardiology, Division of Cardiovascular Medicine, Beth Israel
Deaconess Medical Center, Boston, MA, United States
(Butala) Massachusetts General Hospital, Harvard Medical School, Boston,
United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Gallup, Marquis-Gravel, Kosinski, Vemulapalli) Duke Clinical Research
Institute, Durham, NC, United States
(Valle) University of Colorado School of Medicine, Aurora, United States
(Valle) Michigan Heart and Vascular Institute, Ann Arbor, United States
(Bradley) Minneapolis Heart Institute, MN, United States
(Cohen) Cardiovascular Research Foundation, New York, United States
(Cohen) St. Francis Hospital, Roslyn, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Stroke remains a devastating complication of transcatheter
aortic valve replacement (TAVR), which has persisted despite refinements
in technique and increased operator experience. While cerebral embolic
protection devices (EPDs) have been developed to mitigate this risk, data
regarding their impact on stroke and other outcomes after TAVR are
limited. Method(s): We performed an observational study using data
from the Society for Thoracic Surgeons/American College of Cardiology
Transcatheter Valve Therapy Registry. Patients were included if they
underwent elective or urgent transfemoral TAVR between January 2018 and
December 2019. The primary outcome was in-hospital stroke. To adjust for
confounding, the association between EPD use and clinical outcomes was
evaluated using instrumental variable analysis, a technique designed to
support causal inference from observational data, with site-level
preference for EPD use within the same quarter of the procedure as the
instrument. We also performed a propensity score-based secondary analysis
using overlap weights. Result(s): Our analytic sample included 123
186 patients from 599 sites. The use of EPD during TAVR increased over
time, reaching 28% of sites and 13% of TAVR procedures by December 2019.
There was wide variation in EPD use across hospitals, with 8% of sites
performing >50% of TAVR procedures with an EPD and 72% performing no
procedures with an EPD in the last quarter of 2019. In our primary
analysis using the instrumental variable model, there was no association
between EPD use and in-hospital stroke (adjusted relative risk, 0.90 [95%
CI, 0.68-1.13]; absolute risk difference, -0.15% [95% CI, -0.49 to 0.20]).
However, in our secondary analysis using the propensity score-based model,
EPD use was associated with 18% lower odds of in-hospital stroke (adjusted
odds ratio, 0.82 [95% CI, 0.69-0.97]; absolute risk difference, -0.28%
[95% CI, -0.52 to -0.03]). Results were generally consistent across the
secondary end points, as well as subgroup analyses. Conclusion(s): In
this nationally representative observational study, we did not find an
association between EPD use for TAVR and in-hospital stroke in our primary
instrumental variable analysis, and found only a modestly lower risk of
in-hospital stroke in our secondary propensity-weighted analysis. These
findings provide a strong basis for large-scale randomized, controlled
trials to test whether EPDs provide meaningful clinical benefit for
patients undergoing TAVR. Copyright © 2021 Lippincott Williams
and Wilkins. All rights reserved.

<98>
Accession Number
2007111339
Title
Angiogenic CD34 stem cell therapy in coronary microvascular repair-A
systematic review.
Source
Cells. 10 (5) (no pagination), 2021. Article Number: 1137. Date of
Publication: May 2021.
Author
Rai B.; Shukla J.; Henry T.D.; Quesada O.
Institution
(Rai, Henry, Quesada) Lindner Center for Research, The Christ Hospital,
Cincinnati, OH 45219, United States
(Shukla) University of Cincinnati Medical School, Cincinnati, OH 45219,
United States
(Quesada) Women's Heart Center, Vascular and Lung Institute, The Christ
Hospital, Cincinnati, OH 45219, United States
Publisher
MDPI AG
Abstract
Ischemia with non-obstructive coronary arteries (INOCA) is an increasingly
recognized disease, with a prevalence of 3 to 4 million individuals, and
is associated with a higher risk of morbidity, mortality, and a worse
quality of life. Persistent angina in many patients with INOCA is due to
coronary microvascular dysfunction (CMD), which can be difficult to
diagnose and treat. A coronary flow reserve <2.5 is used to diagnose
endothelial-independent CMD. Antianginal treatments are often ineffective
in endothelial-independent CMD and thus novel treatment modalities are
currently being studied for safety and efficacy. CD34+ cell
therapy is a promising treatment option for these patients, as it has been
shown to promote vascular repair and enhance angiogenesis in the
microvasculature. The resulting restoration of the microcirculation
improves myocardial tissue perfusion, resulting in the recovery of
coronary microvascular function, as evidenced by an improvement in
coronary flow reserve. A pilot study in INOCA patients with
endothelialindependent CMD and persistent angina, treated with autologous
intracoronary CD34+ stem cells, demonstrated a significant
improvement in coronary flow reserve, angina frequency, Canadian
Cardiovascular Society class, and quality of life (ESCaPE-CMD,
NCT03508609). This work is being further evaluated in the ongoing FREEDOM
(NCT04614467) placebo-controlled trial. Copyright © 2021 by the
authors. Licensee MDPI, Basel, Switzerland.

<99>
Accession Number
2007255406
Title
Long-Term Outcomes of Left Main Coronary Artery Disease Treated With
Drug-Eluting Stents vs Coronary Artery Bypass Grafting: A Meta-Analysis
and Systematic Review.
Source
Cardiovascular Revascularization Medicine. 23 (pp 14-19), 2021. Date of
Publication: February 2021.
Author
Al-abcha A.; Saleh Y.; Mujer M.; Herzallah K.; Abela G.S.
Institution
(Al-abcha, Mujer) Department of Internal Medicine, Michigan State
University, East Lansing, MI, United States
(Saleh) Department of Cardiology, Houston Methodist Hospital, Houston, TX,
United States
(Herzallah) Department of Cardiology, Tufts Medical Center, Boston, MA,
United States
(Abela) Department of Internal Medicine, Division of Cardiology, Michigan
State University, East Lansing, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: Currently, DES is a reasonable treatment option for LMCA
disease but CABG continues to be first-line treatment. Multiple randomized
clinical trials (RCTs) have compared outcomes between these two treatment
modalities. Recently, these trials published their long-term results with
conflicting findings. Method(s): We conducted a systematic review and
meta-analysis of RCTs that compared DES vs CABG in patients with LMCA
disease. We only included trials with follow up duration of at least 5
years. The primary outcome was all-cause mortality. Secondary outcomes
included risk of cardiac death, myocardial infarction (MI), stroke and
repeat revascularization. Result(s): We included a total of 4 RCTs.
The median-weighted follow up period was 6.5 years. There was no
significant difference between DES and CABG in all-cause mortality (Risk
ratio (RR) 1.10; 95% confidence interval (CI) 0.92 to 1.31; p = 0.28),
risk of cardiac death (RR of 1.08, 95% CI 0.84 to 1.38; p = 0.56), total
MI (RR of 1.22, 95% CI 0.96 to 1.56; p = 0.11), and stroke (RR of 0.85,
95% CI 0.46 to 1.57; p = 0.60). The risk of repeat revascularization (RR
of 1.75, 95% CI 1.50 to 2.03; p < 0.00001), and non-periprocedural MI (RR
of 2.13, 95% CI 1.53 to 2.97; p < 0.00001) were significantly higher in
the DES arm. Conclusion(s): DES has similar long-term outcomes
compared to CABG in terms of all-cause mortality, cardiac death, total MI
and stroke; but was associated with a higher risk of repeat
revascularization, and non-periprocedural MI. Copyright © 2020
Elsevier Inc.

<100>
Accession Number
2007179403
Title
Drug-Eluting Stents Versus Bare-Metal Stents in Large Coronary Artery
Revascularization: Systematic Review and Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 23 (pp 42-49), 2021. Date of
Publication: February 2021.
Author
Changal K.H.; Mir T.; Khan S.; Nazir S.; Elzanatey A.; Meenakshisundaram
C.; Mubbasher S.; Sheikh M.A.
Institution
(Changal, Nazir, Mubbasher) Cardiovascular Medicine, University of Toledo
Health Sciences, United States
(Mir) Internal Medicine, Detroit Medical Center, Wayne State University,
United States
(Khan) Internal Medicine, Mercy St. Vincent medical Center, Toledo, OH,
United States
(Elzanatey, Meenakshisundaram) Internal Medicine, University of Toledo
Health Sciences, United States
(Sheikh) Cardiovascular Medicine and Interventional Cardiology, Promedica
Toledo Hospital, United States
Publisher
Elsevier Inc.
Abstract
Objectives: We aim to determine if drug eluting stents (DES) are better
than bare-metal stents (BMS) in large coronary artery (diameter >= 3 mm)
percutaneous coronary intervention (PCI). Background(s): DES have
become the standard of care for PCI in coronary artery disease (CAD).
However, the superiority of DES over BMS in large vessel CAD is not clear
and previous studies have shown conflicting results. Method(s):
Randomized controlled trials (RCTs) comparing outcomes of PCI with BMS and
DES for large vessel CAD were identified from the year 2000 to August
2019. The outcomes were studied individually and included all-cause
mortality, myocardial infarction (MI), target lesion revascularization
(TLR), and stent thrombosis. Aggregated odds ratio and 95% CI were
calculated using a random-effects model. Result(s): Eight RCTs were
included (4 with data for first-generation DES, 3 with data for
second-generation DES, and 1 with data for both first- and
second-generation DES). Compared to BMS, second generation DES had a
significantly lower rate of all-cause mortality (2.4% vs. 3.9%, OR 0.74,
95% CI 0.56-0.98, P 0.04), TLR (3.5% vs. 8.6% OR 0.38 95% CI 0.28-0.53, P
< 0.001), and MI (2.1% vs. 2.9% OR 0.73 95% CI 0.53-1.0, P 0.05). The
difference in all-cause mortality was not seen with first-generation DES.
 Conclusion(s): Newer DES are associated with a lower mortality, TLR,
and MI and thus should be preferred over BMS for large coronary artery
PCI. Copyright © 2020 Elsevier Inc.

<101>
Accession Number
2011437979
Title
Efficacy of tramadol for postoperative pain management in dogs: systematic
review and meta-analysis.
Source
Veterinary Anaesthesia and Analgesia. 48 (3) (pp 283-296), 2021. Date of
Publication: May 2021.
Author
Donati P.A.; Tarragona L.; Franco J.V.A.; Kreil V.; Fravega R.; Diaz A.;
Verdier N.; Otero P.E.
Institution
(Donati, Tarragona, Kreil, Diaz, Verdier, Otero) Department of
Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias,
Universidad de Buenos Aires, Buenos Aires, Argentina
(Franco) Argentine Cochrane Centre, Instituto Universitario Hospital
Italiano, Buenos Aires, Argentina
(Fravega) Hospital Veterinario de Santiago, Santiago, Chile
(Verdier) Department of Anesthesiology and Perioperative Intensive Care,
University of Veterinary Medicine, Vienna, Austria
Publisher
Association of Veterinary Anaesthetists and American College of Veterinary
Anesthesia and Analgesia
Abstract
Objective: To evaluate the evidence of analgesic efficacy of tramadol for
the management of postoperative pain and the presence of associated
adverse events in dogs. Databases used: A comprehensive search using
PubMed/MEDLINE, LILACS, Google Scholar and CAB databases with no
restrictions on language and following a prespecified protocol was
performed from June 2019 to July 2020. Included were randomized controlled
trials (RCTs) performed in dogs that had undergone general anesthesia for
any type of surgery. Two authors independently classified the studies,
extracted data and assessed their risk of bias using Cochrane's tool.
RevMan and GRADE methods were used to rate the certainty of evidence
(CoE). Conclusion(s): Overall 26 RCTs involving 848 dogs were
included. Tramadol administration probably results in a lower need for
rescue analgesia versus no treatment or placebo [moderate CoE; relative
risk (RR): 0.47; 95% confidence interval (CI): 0.26-0.85; I2 =
0%], and may result in a lower need for rescue analgesia versus
buprenorphine (low CoE; RR: 0.50; 95% CI: 0.20-1.24), codeine (low CoE;
RR: 0.75; 95% CI: 0.16-3.41) and nalbuphine (low CoE; RR: 0.05; 95% CI:
0.00-0.72). However, tramadol administration may result in an increased
requirement for rescue analgesia versus methadone (low CoE; RR: 3.45; 95%
CI: 0.66-18.08; I2 = 43%) and COX inhibitors (low CoE; RR:
2.27; 95% CI: 0.68-7.60; I2 = 45%). Compared with multimodal
therapy, tramadol administration may make minimal to no difference in the
requirement for rescue analgesia (low CoE; RR: 1.12; 95% CI: 0.48-2.60;
I2 = 0%). Adverse events were inconsistently reported and the
CoE was very low. The overall CoE of the analgesic efficacy of tramadol
for postoperative pain management in dogs was low or very low, and the
main reasons for downgrading the evidence were risk of bias and
imprecision. Copyright © 2021 Association of Veterinary
Anaesthetists and American College of Veterinary Anesthesia and Analgesia

<102>
Accession Number
2011123568
Title
Impact of age on the comparison between short-term vs 12-month dual
antiplatelet therapy in patients with acute coronary syndrome treated with
the COMBO dual therapy stent: 2-Year follow-up results of the REDUCE
trial.
Source
Atherosclerosis. 321 (pp 39-44), 2021. Date of Publication: March 2021.
Author
Kedhi E.; Verdoia M.; Suryapranata H.; Damen S.; Camaro C.; Benit E.;
Barbieri L.; Rasoul S.; Liew H.B.; Polad J.; Ahmad W.A.; Zambahari R.;
Lalmand J.; van der Schaaf R.J.; Koh T.H.; Timmermans P.; Dilling-Boer D.;
Veenstra L.F.; van' t Hof A.W.; Lee S.W.; Roolvink V.; Ligtenberg E.;
Postma S.; Kolkman E.J.; Brouwer M.A.; Dudek D.; De Luca G.
Institution
(Kedhi) St-Jan Hospital, Brugge, Belgium
(Verdoia, Barbieri, De Luca) AOU Maggiore della Carita, Eastern Piedmont
University, Novara, Italy
(Suryapranata, Damen, Camaro, Brouwer) Radboud University Medical Center,
Nijmegen, Netherlands
(Benit, Timmermans, Dilling-Boer) Jessa Ziekenhuis, Hasselt, Belgium
(Rasoul, Veenstra) Atrium Medical Center, Heerlen, Netherlands
(Liew) Queen Elizabeth II, Sabah, Malaysia
(Polad) Jeroen Bosch Ziekenhuis, 's Hertogenbosch, Netherlands
(Ahmad) University Malaya, Kuala Lumpur, Malaysia
(Zambahari) National Heart Institute, Kuala Lumpur, Malaysia
(Lalmand) Centre Hospitalier Universitaire,Charleroi, Belgium
(van der Schaaf) Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
(Koh) National Heart Center, Singapore, Singapore
(van' t Hof, Roolvink) Isala Hospital, Zwolle, Netherlands
(Lee) Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
(Ligtenberg) OrbusNeich Medical BV, Hoevelaken, Netherlands
(Postma, Kolkman) Diagram BV, Zwolle, Netherlands
(Dudek) Jagiellonian University Medical College, Krakow, Poland
Publisher
Elsevier Ireland Ltd
Abstract
Background and aims: The impact of advanced age on the optimal duration of
dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome
(ACS) undergoing percutaneous coronary revascularization (PCI) is still
greatly debated. Therefore, the aim of the present sub-analysis of the
REDUCE trial was to assess the impact of age on the comparison between a
short 3 months vs standard 12 months DAPT in ACS patients treated with the
COMBO Dual Stent Therapy. Method(s): The REDUCE trial is a
prospective, multicenter, investigator-initiated study that randomized ACS
patients undergoing PCI with the COMBO drug eluting stent to either 3 or
12 months of DAPT. The study population was divided according to age (<or
>= 75 years). Primary study endpoint was a composite of all-cause
mortality, myocardial infarction, definite/probable stent thrombosis (ST),
stroke, target-vessel revascularization (TVR) and bleeding (BARC II, III,
V) at 12 months. Secondary endpoints were cardiovascular mortality and the
individual components of the primary endpoint within 24 months.
 Result(s): From June 2014 to May 2016, 1496 patients were included in
the study, of whom 205 (13.7%) >=75 years of age. Among them, 50.7% of the
elderly and 50.2% of younger patients were assigned to the 3-month DAPT
treatment. Baseline characteristics were well matched between the two
arms, except for a higher rate of males (p=0.02) and a reduced number of
lesions on the right coronary artery (p=0.02) in elderly patients treated
for the short DAPT duration. Median follow-up was 682.5 days
[IQR:667-731]. At 12 months, no difference in the primary endpoint was
observed according to DAPT duration in both patients aged >=75 years
(22.1% vs 18.8%, HR [95%CI] = 1.6 [0.73-3.5], p=0.24) and younger ones
(9.7% vs 10.9%, HR [95%CI] = 0.85 [0.59-1.27], p=0.44; p INT = 0.15).
Results were confirmed after correction for baseline differences among the
elderly (adjusted HR [95%CI] = 1.7 [0.75-3.9], p=0.21). Comparable rates
of survival, thrombotic (MI, stent thrombosis, TVR, stroke) and bleeding
events were observed with the two DAPT strategies, with no impact of age.
 Conclusion(s): The present study shows that among ACS patients
randomized in the REDUCE trial, a 3-month DAPT strategy was comparable to
a standard 12-month DAPT at a 2-year follow-up for both ischemic and
bleeding endpoints, in elderly and younger patients. Thus, despite
presenting the limitations of a subgroup analysis, our study strengthens
the feasibility of a shorter DAPT duration even among high-risk subsets of
ACS patients. Copyright © 2021 Elsevier B.V.

<103>
Accession Number
2007807064
Title
Intermediate and Late Outcomes With PCI vs CABG for Left Main Disease -
Landmark Meta-Analysis of Randomized Trials.
Source
Cardiovascular Revascularization Medicine. 23 (pp 114-118), 2021. Date of
Publication: February 2021.
Author
Akintoye E.; Salih M.; Olagoke O.; Oseni A.; Sistla P.; Alqasrawi M.;
Panos A.; Panaich S.; Sellke F.
Institution
(Akintoye, Salih, Oseni, Sistla, Alqasrawi, Panaich) Division of
Cardiovascular Medicine, University of Iowa Hospital and Clinics, Iowa,
IA, United States
(Olagoke) Department of Medicine, John H Stroger Jr. Hospital of Cook
County, Chicago, IL, United States
(Panos) Division of Cardiothoracic Surgery, University of Iowa Hospital
and Clinics, Iowa, IA, United States
(Sellke) Department of Cardiothoracic Surgery, Alpert Medical School,
Brown University, RI, United States
Publisher
Elsevier Inc.
Abstract
PCI to improve survival is currently recommended as a reasonable
alternative to CABG in patients with unprotected left main disease.
However, RCTs to support this recommendation has generated mixed results
and recently published EXCEL trial has sparked debate about differences in
late mortality. To address this point, we performed landmark meta-analysis
of 4 RCTs with 5 year follow up data - EXCEL, NOBLE, PRECOMBAT and SYNTAX
LEFT MAIN. Overall, there was no significant difference in all-cause
mortality between PCI and CABG at 5 years (RR = 1.03 [95% CI =
0.79-1.33]). However, there was apparent change in the direction of
association before and after the 1 year landmark that underscores the need
for long term follow up in these trials. In addition, we found that PCI
was associated with significantly lower rate of intermediate stroke at 1
year (RR = 0.44 [0.24-0.82]) but higher rate of late MI after 1 year (3.31
[2.11-5.18]) compared to CABG. Copyright © 2020 Elsevier Inc.

<104>
Accession Number
2007357205
Title
Cost-effectiveness analysis of mitral valve repair with the MitraClip
delivery system for patients with mitral regurgitation: a systematic
review.
Source
Heart Failure Reviews. 26 (3) (pp 587-601), 2021. Date of Publication: May
2021.
Author
Rezapour A.; Azari S.; Arabloo J.; Pourasghari H.; Behzadifar M.; Alipour
V.; Omidi N.; Sadeghian S.; Aghajani H.; Bragazzi N.L.
Institution
(Rezapour, Azari, Arabloo, Alipour) Health Management and Economics
Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Azari, Pourasghari) Hospital Management Research Center, Iran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Behzadifar) Social Determinants of Health Research Center, Lorestan
University of Medical Sciences, Khorramabad, Iran, Islamic Republic of
(Omidi) Department of Cardiology, Tehran Heart Center, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sadeghian, Aghajani) Department of Interventional Cardiology, Tehran
Heart Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Bragazzi) Laboratory for Industrial and Applied Mathematics (LIAM),
Department of Mathematics and Statistics, York University, Toronto, Canada
Publisher
Springer
Abstract
To assess the cost-effectiveness of mitral valve repair with the MitraClip
delivery system for patients with mitral regurgitation and heart failure,
a systematic literature search was conducted in various electronic
databases to January 3, 2020. Eligibility criteria are the population
(patients with mitral regurgitation (MR)), intervention (transcatheter
mitral valve repair using the MitraClip), comparator (conventional medical
treatment), outcomes, and designs (Model-based or trial-based full
economic evaluations).The quality of included studies was assessed using
the CHEERS checklist. Mortality and survival rate, quality-adjusted life
year (QALY), life years gained (LYG), total cost, and the incremental
cost-effectiveness ratio (ICER) regarding the use of MitraClip System were
considered as the key outcomes. Eight articles were eligible for full-text
assessment. Ultimately, a total of seven studies were considered in the
current systematic review. Results demonstrated that MitraClip reduces
mortality rate and increases survival rate. The mortality rate at 1 year
and 10 years was 16.7% versus 29.77% and 70.9% versus 98.8%, respectively.
Total cost data based on 2019 USD show that the MitraClip has the highest
cost in the USA ($121,390) and the lowest cost in Italy ($33,062). The
results showed that in all selected countries, willingness-to-pay (WTP)
thresholds are upper than the cost per QALY; also, the highest ICER for
the MitraClip is in the USA ($55,600/QALY) and the lowest in Italy
($10,616/QALY). To conclude, evidence from this systematic review suggests
that MitraClip Delivery System improved both life expectancy and QALY
compared with medical treatment in patients at high surgical risk and it
was also a cost-effective treatment option for patients with mitral
regurgitation. Copyright © 2020, Springer Science+Business Media,
LLC, part of Springer Nature.

<105>
Accession Number
2010857046
Title
Invasive therapy versus conservative therapy for patients with stable
coronary artery disease: An updated meta-analysis.
Source
Clinical Cardiology. 44 (5) (pp 675-682), 2021. Date of Publication: May
2021.
Author
Vij A.; Kassab K.; Chawla H.; Kaur A.; Kodumuri V.; Jolly N.; Doukky R.
Institution
(Vij, Kassab, Doukky) Division of Cardiology, Cook County Health, Chicago,
IL, United States
(Vij, Doukky) Department of Medicine, Rush Medical college, Chicago, IL,
United States
(Chawla) Division of Cardiology, MedStar Union Memorial Hospital,
Baltimore, MD, United States
(Kaur) Department of Pathology, University of Chicago-Northshore,
Evanston, IL, United States
(Kodumuri) Division of Cardiology, Ascension All Saints Hospital, Racine,
WI, United States
(Jolly) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Heart disease remains the leading cause of death in the United
States. Although there are clear indications for revascularization in
patients with acute coronary syndromes, there is debate regarding the
benefits of revascularization in stable ischemic heart disease. We sought
to perform a comprehensive meta-analysis to assess the role of
revascularization compared to conservative medical therapy alone in
patients with stable ischemic heart disease. Hypothesis: There is no
significant difference in all-cause mortality or cardiovascular mortality
between invasive and medical arms. Method(s): We performed a
systematic literature search from January 2000 to June 2020. Our
literature search yielded seven randomized controlled trials. We analyzed
a total of 12 013 patients (6109 in revascularization arm and 5904 in
conservative medical therapy arm). Primary outcome was all-cause
mortality. Secondary outcomes included major adverse cardiac events (MACE)
(death, myocardial infarction [MI], or stroke), cardiovascular mortality,
MI, and stroke. Additional subgroup analysis for all-cause mortality was
performed comparing percutaneous coronary intervention (PCI) with bare
metal stent versus conservative therapy; and PCI with drug eluting stent
versus conservative therapy. Result(s): There was no statistically
significant difference in primary outcome of all-cause mortality between
either arm (odds ratio [OR] = 0.95; 95% CI [confidence interval], 0.83 to
1.08; p =.84). There were statistically significant lower rates of MACE
(death, MI or stroke) in the revascularization arm when compared to
conservative arm. Conclusion(s): Our analysis did not show any
survival advantage of an initial invasive strategy over conservative
medical therapy in patients with stable coronary artery disease
(CAD). Copyright © 2021 The Authors. Clinical Cardiology
published by Wiley Periodicals LLC.

<106>
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. 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. 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. 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. 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. Copyright © 2021 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<107>
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. Copyright © The Author(s) 2021.

<108>
Accession Number
2011580852
Title
Impact of early (<7 days) pacemaker implantation after cardiac surgery on
long-term pacemaker dependency.
Source
PACE - Pacing and Clinical Electrophysiology. 44 (6) (pp 1018-1026), 2021.
Date of Publication: June 2021.
Author
Badoz M.; Favoulet B.; Serzian G.; Ecarnot F.; Guillon B.; Chopard R.;
Meneveau N.
Institution
(Badoz, Favoulet, Serzian, Ecarnot, Guillon, Chopard, Meneveau) Department
of Cardiology, University Hospital Besancon, Boulevard Fleming, Besancon,
France
(Badoz, Ecarnot, Chopard, Meneveau) EA3920, University of Burgundy
Franche-Comte, Besancon, France
Publisher
Blackwell Publishing Inc.
Abstract
Objective: We aimed to investigate pacemaker dependency after at least 1
year in patients with early (<7 days) implantation, compared to those who
received a pacemaker >=7 days after cardiac surgery. Secondary endpoints
were length of hospital stay and in-hospital complications.
 Method(s): Retrospective analysis of 108 consecutive patients who
received a pacemaker after cardiac surgery between 06/2012 and 06/2018.
Characteristics and outcomes were compared between patients with early (<7
days) and late (>=7 days) implantation. Patients were followed up with
evaluation of pacemaker dependency between April and June 2019. We
identified predictors of dependency by logistic regression.
 Result(s): In total, 63.9% were men, average age 71.9 +/- 11.8 years;
32 (29.6%) had early implantation, and 76 (70.4%) late implantation. After
a median 3.2 years [IQR 1.9, 4.5] of follow-up, 30 patients (27.8%) had
died, and there was no difference in pacemaker dependency among survivors
(66.7% vs. 46.5%, early vs. late respectively, p =.15). Patients in the
early group had a shorter length of stay (11.5 [9.0, 14.0] vs. 15.0 [11.5,
20] days, p =.002) and less often had new-onset atrial fibrillation (AF)
post-surgery (22.7% vs. 47.8%, p =.05). The only significant predictor of
dependency was aortic valve replacement surgery (OR = 4.70, 95% CI [1.36
to 16.24]). Conclusion(s): Early implantation of a permanent
pacemaker (<7 days after cardiac surgery) does not impact on the
proportion of patients with long-term (>12 months) pacemaker dependency,
but is associated with shorter length of stay and less frequent new-onset
AF. These findings warrant prospective confirmation in randomized
trials. Copyright © 2021 Wiley Periodicals LLC

<109>
Accession Number
2011265215
Title
Coronary CT angiography: a guide to examination, interpretation, and
clinical indications.
Source
Expert Review of Cardiovascular Therapy. 19 (5) (pp 413-425), 2021. Date
of Publication: 2021.
Author
Cademartiri F.; Casolo G.; Clemente A.; Seitun S.; Mantini C.; Bossone E.;
Saba L.; Sverzellati N.; Nistri S.; Punzo B.; Cavaliere C.; La Grutta L.;
Gentile G.; Maffei E.
Institution
(Cademartiri, Punzo, Cavaliere) Department of Radiology, SDN IRCCS,
Naples, Italy
(Casolo) Department of Cardiology, Ospedale Della Versilia, Viareggio,
Italy
(Clemente) Department of Radiology, Fondazione Toscana Gabriele
Monasterio, Massa, Italy
(Seitun) Department of Radiology, Ospedale San Martino, Genova, Italy
(Mantini) Department of Neuroscience, Imaging and Clinical Sciences, "G.
d'Annunzio" University, Chieti, Italy
(Bossone) Department of Cardiology, Ospedale Cardarelli, Naples, Italy
(Saba) Department of Radiology, University of Cagliari, Cagliari, Italy
(Sverzellati) Department of Radiology, University of Parma, Parma, Italy
(Nistri) Department of Cardiology, CMSR, Vicenza, Italy
(La Grutta) Department of Radiology, University of Palermo, Palermo, Italy
(Gentile) Department of Radiology, Ismett Irccs, Palermo, Italy
(Maffei) Department of Radiology, ASUR Marche, Area Vasta 1, Urbino, Italy
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: The introduction of Cardiac Computed Tomography (CCT) has
changed the paradigm in the field of diagnostic cardiovascular medicine.
CCT is the primary tool in the assessment of suspected Coronary Artery
Disease (CAD) and should be followed by functional assessment when needed
to stratify disease and to plan potential interventional or surgical
therapy. Areas Covered: We provided the current state of the knowledge on
the main aspects of technique of examination, image interpretation and
clinical indications. We have focused our attention on the basic routine
applications and activities. Expert Opinion: The primary role of CCT in
suspected CAD will progressively become the standard approach. In general,
any situation in which anatomy of the heart and thoracic
vessels/structures is mandatory must be approached using CT first,
whenever possible. The quantity and quality of information that can be
provided by CCT is big and the operators should learn how to deal with
this information. On the other hand, CCT is only apparently a
straightforward and simple examination. It is actually the most complex
diagnostic procedure that can be performed on CT and requires highly
skilled operators and state-of-art-technology. Copyright © 2021
Informa UK Limited, trading as Taylor & Francis Group.

<110>
Accession Number
2007339890
Title
Donor heart preservation with hydrogen sulfide: A systematic review and
meta-analysis.
Source
International Journal of Molecular Sciences. 22 (11) (no pagination),
2021. Article Number: 5737. Date of Publication: 01 Jun 2021.
Author
Ertugrul I.A.; van Suylen V.; Damman K.; de Koning M.-S.L.Y.; van Goor H.;
Erasmus M.E.
Institution
(Ertugrul, van Suylen, Erasmus) University Medical Centre Groningen,
Department of Cardiothoracic Surgery, University of Groningen, Groningen
9700 RB, Netherlands
(Damman, de Koning) University Medical Centre Groningen, Department of
Cardiology, University of Groningen, Groningen 9700 RB, Netherlands
(van Goor) University Medical Centre Groningen, Department of Pathology
and Medical Biology, University of Groningen, Groningen 9700 RB,
Netherlands
Publisher
MDPI AG
Abstract
Preclinical studies have shown that postconditioning with hydrogen sulfide
(H<inf>2</inf>S) exerts cardioprotective effects against myocardial
ischemia-reperfusion injury (IRI). The aim of this study was to appraise
the current evidence of the cardioprotective effects of H<inf>2</inf>S
against IRI in order to explore the future implementation of
H<inf>2</inf>S in clinical cardiac transplantation. The current literature
on H<inf>2</inf>S postconditioning in the setting of global myocardial
ischemia was systematically reviewed and analyzed, performing
meta-analyses. A literature search of the electronic databases Medline,
Embase and Cinahl identified 1835 studies that were subjected to our
pre-defined inclusion criteria. Sixteen studies were considered eligible
for inclusion. Postconditioning with H<inf>2</inf>S showed significant
robust effects with regard to limiting infarct size (standardized mean
difference (SMD) = -4.12, 95% CI [-5.53--2.71], p < 0.00001). Furthermore,
H<inf>2</inf>S postconditioning consistently resulted in a significantly
lower release of cardiac injury markers, lower levels of oxidative stress
and improved cardiac function. Postconditioning with slow-releasing
H<inf>2</inf>S donors offers a valuable opportunity for novel therapies
within cardiac preservation for transplantation. Before clinical
implication, studies evaluating the long-term effects of H<inf>2</inf>S
treatment and effects of H<inf>2</inf>S treatment in large animal studies
are warranted. Copyright © 2021 by the authors. Licensee MDPI,
Basel, Switzerland.

<111>
Accession Number
635179573
Title
Effect of dexamethasone on complications or all cause mortality after
major non-cardiac surgery: Multicentre, double blind, randomised
controlled trial.
Source
The BMJ. 373 (no pagination), 2021. Article Number: n1162. Date of
Publication: 02 Jun 2021.
Author
Asehnoune K.; Le Moal C.; Lebuffe G.; Le Penndu M.; Josse N.C.; Boisson
M.; Lescot T.; Faucher M.; Jaber S.; Godet T.; Leone M.; Motamed C.; David
J.S.; Cinotti R.; El Amine Y.; Liutkus D.; Garot M.; Marc A.; Le Corre A.;
Thomasseau A.; Jobert A.; Flet L.; Feuillet F.; Pere M.; Futier E.;
Roquilly A.
Institution
(Asehnoune, Le Penndu, Marc, Roquilly) CHU Nantes, Universite de Nantes,
Pole Anesthesie-Reanimation, Service d'Anesthesie Reanimation
Chirurgicale, Hotel Dieu, Nantes, France
(Le Moal, Liutkus) Service d'Anesthesie, Centre Hospitalier le Mans, Le
Mans, France
(Lebuffe, Garot) Centre Hospitalier Universitaire (CHU) Lille, Pole
Anesthesie Reanimation, Lille, France
(Josse, Le Corre) Service d'Anesthesie, Hopital Prive du Confluent,
Nantes, France
(Boisson, Thomasseau) CHU de Poitiers, Universite de Poitiers, Service
d'Anesthesie-Reanimation, Poitiers, France
(Lescot) Hopital Saint Antoine, Service d'Anesthesie Reanimation
Chirurgicale, Assistance Publique des Hopitaux de Paris, Paris, France
(Faucher) Institut Paoli Calmette, Service d'Anesthesie, Marseille, France
(Jaber) Anesthesia and Critical Care Department B, Saint Eloi Teaching
Hospital, PhyMedExp, Centre Hospitalier Universitaire Montpellier,
University of Montpellier, INSERM U1046, Montpellier, France
(Godet, Futier) Service d'Anesthesie et Reanimation, Hopital Estaing, CHU
Clermont Ferrand, Clermont-Ferrand, France
(Leone) Department of Anesthesiology and Critical Care Medicine, Hopital
Nord, Aix Marseille University, Assistance Publique Hopitaux de Marseille,
Marseille, France
(Motamed) Departement d'Anesthesie and VVC, Gustave Roussy Cancer Center,
Villejuif, France
(David) Service d'Anesthesie Reanimation, Groupe Hospitalier Sud, Civils
de Lyon, Pierre Benite, France
(Cinotti) CHU Nantes, Universite de Nantes, Pole Anesthesie-Reanimation,
Service d'Anesthesie Reanimation Chirurgicale, Hopital Guillaume et Rene
Laennec, Saint-Herblain, France
(El Amine) CH Valenciennes, Service d'Anesthesie, Valenciennes, France
(Jobert, Pere) CHU de Nantes, Direction de la Recherche, Plateforme de
Methodologie et Biostatistique, Nantes, France
(Flet) CHU Nantes, Service Pharmacie, Hotel Dieu, Nantes, France
(Feuillet) Universite de Nantes, Universite de Tours, INSERM, SPHERE
U1246, Nantes, France
Publisher
BMJ Publishing Group
Abstract
Objective To assess the effect of dexamethasone on complications or all
cause mortality after major non-cardiac surgery. Design Phase III,
randomised, double blind, placebo controlled trial. Setting 34 centres in
France, December 2017 to March 2019. Participants 1222 adults (>50 years)
requiring major non-cardiac surgery with an expected duration of more than
90 minutes. The anticipated time frame for recruitment was 24 months.
Interventions Participants were randomised to receive either dexamethasone
(0.2 mg/kg immediately after the surgical procedure, and on day 1) or
placebo. Randomisation was stratified on the two prespecified criteria of
cancer and thoracic procedure. Main outcomes measures The primary outcome
was a composite of postoperative complications or all cause mortality
within 14 days after surgery, assessed in the modified intention-to-treat
population (at least one treatment administered). Results Of the 1222
participants who underwent randomisation, 1184 (96.9%) were included in
the modified intention-to-treat population. 14 days after surgery, 101 of
595 participants (17.0%) in the dexamethasone group and 117 of 589 (19.9%)
in the placebo group had complications or died (adjusted odds ratio 0.81,
95% confidence interval 0.60 to 1.08; P=0.15). In the stratum of
participants who underwent non-thoracic surgery (n=1038), the primary
outcome occurred in 69 of 520 participants (13.3%) in the dexamethasone
group and 93 of 518 (18%) in the placebo group (adjusted odds ratio 0.70,
0.50 to 0.99). Adverse events were reported in 288 of 613 participants
(47.0%) in the dexamethasone group and 296 of 609 (48.6%) in the placebo
group (P=0.46). Conclusions Dexamethasone was not found to significantly
reduce the incidence of complications and death in patients 14 days after
major non-cardiac surgery. The 95% confidence interval for the main result
was, however, wide and suggests the possibility of important clinical
effectiveness. Trial registration ClinicalTrials.gov
NCT03218553. Copyright © 2021 BMJ Publishing Group. All rights
reserved.

<112>
Accession Number
634350869
Title
Postoperative Cognitive Dysfunction and the Protective Effects of Enriched
Environment: A Systematic Review.
Source
Neurodegenerative Diseases. 20 (4) (pp 113-122), 2021. Date of
Publication: May 2021.
Author
Hua M.; Min J.
Institution
(Hua) First Clinical Medical College, Nanchang University, Nanchang, China
(Min) Department of Anesthesiology, First Affiliated Hospital, Nanchang
University, Nanchang, China
Publisher
S. Karger AG
Abstract
Background: Currently, the number of individuals who undergo surgery is
greatly increased. As a consequence, postoperative cognitive dysfunction
(POCD) has gradually gained more attention. Summary: POCD is a
perioperative complication requiring sensitive preoperative and
postoperative neuropsychiatric tests, and its incidence in both cardiac
and noncardiac surgery is high, especially in elderly individuals.
Surgical, patient, and anesthetic factors may all lead to the occurrence
and development of POCD. The key mechanism of POCD may be the inflammatory
response of the central nervous system during surgery, which is similar to
that of Alzheimer's disease (AD). Enriched environment (EE), a factor that
can significantly improve and prevent neurodegenerative diseases, may have
a beneficial effect on POCD. Key Messages: This review aims to elucidate
the mechanism of the occurrence and development of POCD, analyze the
possible influence of EE on POCD at the molecular level, and provide a
direction for its treatment. Copyright © 2021

<113>
Accession Number
2007462446
Title
The effectiveness of nursing delivered interventions on readmission rate
among patients post coronary artery bypass graft surgery; A systematic
review.
Source
Medico-Legal Update. 21 (3) (pp 292-298), 2021. Date of Publication: 05
Jun 2021.
Author
Abu Shaikha H.S.; Alosta M.R.; Abu Sabra M.A.; Alshraideh J.A.
Institution
(Abu Shaikha) School of Nursing, Philadelphia University, Amman, Jordan
(Alosta, Alshraideh) School of Nursing, the University of Jordan, Amman,
Jordan
(Abu Sabra) School of Nursing, Al-Zaytoonah University of Jordan (ZUJ),
Amman, Jordan
Publisher
World Informations Syndicate
Abstract
Introduction: Despite that hospital readmission after CABG surgery became
an international concern, few studies have focused on nurse's role in the
reduction of the readmission rate.The purpose: This review aims to assess
the effectiveness of nursing interventions that are reported to reduce
patient's readmission post CABG surgery. Method(s): a systematic
review following the PRISM Aprotocol was operated. Relevant studies were
retrieved from two main electronic databases. Result(s): Eight
studies met the inclusion criteria. The retrieved studies were conducted
to identify the effectiveness of nursing interventions on readmission rate
among patients post CABG surgery. Different types of nursing interventions
were identified and generally, it decreased the readmission rate among
patients in most of the studies. Conclusion(s): Different nursing
interventions have been reported to reduce readmission rate after coronary
artery bypass graft surgery. However, a better reporting of these nursing
interventions and linking it with nursing staff training and qualification
is recommended. This review is registered at PROSPERO; the registration
number is: CRD42020143206. Copyright © 2021, World Informations
Syndicate. All rights reserved.

<114>
Accession Number
635235274
Title
Association between vitamin D levels and lower-extremity deep vein
thrombosis: a case-control study.
Source
Sao Paulo medical journal = Revista paulista de medicina. 139 (3) (pp
279-284), 2021. Date of Publication: 2021.
Author
Korkmaz U.T.K.; Ersoy S.; Yuksel A.; Celik H.; Ucaroglu E.R.; Velioglu Y.;
Cetinkaya A.; Demir D.; Esen U.; Erdem K.
Institution
(Korkmaz) BSc, Department of Cardiovascular Surgery, School of Medicine,
Bolu Abant Izzet Baysal University, Bolu, Turkey
(Ersoy) BSc, Department of Family Medicine, Health Sciences University,
Umraniye Training and Research Hospital, Istanbul, Turkey
(Yuksel, Velioglu) BSc, Department of Cardiovascular Surgery, School of
Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
(Celik) MD, MSc. Specialist Doctor, Department of Physiology, School of
Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
(Ucaroglu) MD, MSc. Specialist Doctor, Department of Cardiovascular
Surgery, School of Medicine, Bolu Abant Izzet Baysal University, Bolu,
Turkey
(Cetinkaya) Department of Physiology, School of Medicine, Bolu Abant Izzet
Baysal University, Bolu, Turkey
(Demir) BSc, Department of Cardiovascular Surgery, Health Sciences
University, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa,
Turkey
(Esen) BSc, Department of Family Medicine, Basaksehir Cam and Sakura City
Hospital, Istanbul, Turkey
(Erdem) BSc, Department of Cardiovascular Surgery, School of Medicine,
Bolu Abant Izzet Baysal University, Bolu, Turkey
Publisher
NLM (Medline)
Abstract
BACKGROUND: Vitamin D has relationships with pathogenesis and inflammation
pathways in many diseases. Its deficiency may make clinicians think not
only of supplementation but also of presence of other diseases.
 OBJECTIVE(S): To investigate the relationship between vitamin D
levels and deep vein thrombosis (DVT), given that reduced levels are
related to increased risk of cardiovascular diseases. DESIGN AND SETTING:
Case-control study conducted in the cardiovascular surgery and family
medicine departments of a hospital in Turkey. METHOD(S): A total of
280 participants were included: 140 each in the DVT and control groups.
Basic clinical characteristics, comorbidities and serum 25-hydroxyvitamin
D (25(OH)D) levels were recorded and then compared between the groups.
Serum 25(OH)D levels were also evaluated separately in three subgroups
(sufficient, insufficient and deficient). RESULT(S): Serum 25(OH)D
levels were significantly lower in the DVT group than in the controls (P <
0.001). Females in the DVT group had lower 25(OH)D levels than those in
the control group (P = 0.002). Nonetheless, the median 25(OH)D level
(16.41 ng/ml) of the control group was still below the reference value.
Logistic regression analysis showed that 25(OH)D was a significant
predictor of DVT. Weight, height and body mass index, which all presented
interaction, were significant in the logistic regression analysis but not
in individual analyses. CONCLUSION(S): The serum vitamin D levels of
DVT patients were lower than those of controls. If the results obtained
from our study are supported by further large-scale randomized controlled
trials, vitamin D replacement may be brought into the agenda for
protection against DVT.

<115>
Accession Number
2007462424
Title
Aortic valve stenosis: A review of the literature.
Source
Medico-Legal Update. 21 (3) (pp 144-146), 2021. Date of Publication: 05
Jun 2021.
Author
Al-Kazaleh A.; Albashtawy M.; Albashtawy S.; Albashtawy B.; Suliman M.;
Abdalrahim A.; Alkhawaldeh A.
Institution
(Al-Kazaleh, Albashtawy) Princess Salma Faculty of Nursing, AL al-Bayt
University, Mafraq, Jordan
(Albashtawy) Faculty of Medicine, Hashemite University, Zarqa, Jordan
(Albashtawy) Medical Intern, King Abdullah University Hospital, Jordan
(Suliman, Abdalrahim, Alkhawaldeh) Princess Salma Faculty of Nursing, AL
al-Bayt University, Mafraq, Jordan
Publisher
World Informations Syndicate
Abstract
Aortic valve stenosis is considered one of the common and serious valve
disease. This short review intends to explore the Aortic Stenosis (AS)
regarding chief symptoms, diagnostic tests, current treatment, and
patient's education. The searching was carried out in electronic data
bases: Google scholar and PubMed. The chief symptoms of AS may consist of
dyspnea and further symptoms of, angina, heart failure and syncope. The
past studies have revealed that medical treatment does not considerably
influence disease development in AS. Aortic valve replacement (AVR) is the
first current treatment for symptomatic, hemodynamically severe AS. Nurses
and physicians have a vital function in educating patients. Copyright
© 2021, World Informations Syndicate. All rights reserved.

<116>
Accession Number
635192821
Title
Left atrial appendage occlusion during cardiac surgery to prevent stroke.
Source
New England Journal of Medicine. 384 (22) (pp 2081-2091), 2021. Date of
Publication: 03 Jun 2021.
Author
Whitlock R.P.; Belley-Cote E.P.; Paparella D.; Healey J.S.; Brady K.;
Sharma M.; Reents W.; Budera P.; Baddour A.J.; Fila P.; Devereaux P.J.;
Bogachev-Prokophiev A.; Boening A.; Teoh K.H.T.; Tagarakis G.I.; Slaughter
M.S.; Royse A.G.; McGuinness S.; Alings M.; Punjabi P.P.; Mazer C.D.;
Folkeringa R.J.; Colli A.; Avezum A.; Nakamya J.; Balasubramanian K.;
Vincent J.; Voisine P.; Lamy A.; Yusuf S.; Connolly S.J.
Institution
(Whitlock, Belley-Cote, Healey, Sharma, Devereaux, Nakamya,
Balasubramanian, Lamy) McMaster University, Hamilton, ON, Canada
(Whitlock, Belley-Cote, Healey, Brady, Sharma, Devereaux, Vincent, Lamy,
Yusuf, Connolly) Hamilton Health Sciences, Hamilton, ON, Canada
(Whitlock, Belley-Cote, Healey, Brady, Sharma, Devereaux, Nakamya,
Balasubramanian, Vincent, Lamy, Yusuf, Connolly) The Population Health
Research Institute, Hamilton, ON, Canada
(Teoh) Southlake Regional Health Centre, Newmarket, ON, Canada
(Mazer) The University of Toronto, Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Toronto, Canada
(Voisine) Quebec Heart and Lung Institute, Quebec, QC, Canada
(Paparella) University of Foggia, Foggia, Italy
(Paparella) Santa Maria Hospital, Gruppo Villa Maria Care and Research,
Bari, Italy
(Colli) The University of Pisa, Pisa, Italy
(Reents) Rhon-Klinikum Campus Bad Neustadt, Bad Neustadt, Germany
(Boening) University Hospital Giessen, Giessen, Germany
(Budera) The Institute for Clinical and Experimental Medicine, Prague,
Czechia
(Fila) The Center of Cardiovascular Surgery and Transplantation, Brno,
Czechia
(Baddour) "G. Papanikolaou" Hospital, Thessaloniki, Greece
(Tagarakis) Aristotle University of Thessaloniki, Thessaloniki, Greece
(Bogachev-Prokophiev) E. Meshalkin National Medical Research Center,
Novosibirsk, Russian Federation
(Slaughter) The University of Louisville, Louisville, KY, United States
(Royse) The University of Melbourne, Royal Melbourne Hospital, Melbourne,
VIC, Australia
(McGuinness) Auckland City Hospital, Auckland, New Zealand
(Alings) Amphia Ziekenhuis, Breda, Netherlands
(Folkeringa) Medical Center Leeuwarden, Leeuwarden, Netherlands
(Punjabi) The National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Avezum) The International Research Center, Hospital Alemao Oswaldo Cruz,
Sao Paulo, Brazil
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Surgical occlusion of the left atrial appendage has been
hypothesized to prevent ischemic stroke in patients with atrial
fibrillation, but this has not been proved. The procedure can be performed
during cardiac surgery undertaken for other reasons. METHODS We conducted
a multicenter, randomized trial involving participants with atrial
fibrillation and a CHA<inf>2</inf>DS<inf>2</inf>-VASc score of at least 2
(on a scale from 0 to 9, with higher scores indicating greater risk of
stroke) who were scheduled to undergo cardiac surgery for another
indication. The participants were randomly assigned to undergo or not
undergo occlusion of the left atrial appendage during surgery; all the
participants were expected to receive usual care, including oral
anticoagulation, during follow-up. The primary outcome was the occurrence
of ischemic stroke (including transient ischemic attack with positive
neuroimaging) or systemic embolism. The participants, research personnel,
and primary care physicians (other than the surgeons) were unaware of the
trial-group assignments. RESULTS The primary analysis population included
2379 participants in the occlusion group and 2391 in the no-occlusion
group, with a mean age of 71 years and a mean
CHA<inf>2</inf>DS<inf>2</inf>-VASc score of 4.2. The participants were
followed for a mean of 3.8 years. A total of 92.1% of the participants
received the assigned procedure, and at 3 years, 76.8% of the participants
continued to receive oral anticoagulation. Stroke or systemic embolism
occurred in 114 participants (4.8%) in the occlusion group and in 168
(7.0%) in the no-occlusion group (hazard ratio, 0.67; 95% confidence
interval, 0.53 to 0.85; P=0.001). The incidence of perioperative bleeding,
heart failure, or death did not differ significantly between the trial
groups. CONCLUSIONS Among participants with atrial fibrillation who had
undergone cardiac surgery, most of whom continued to receive ongoing
antithrombotic therapy, the risk of ischemic stroke or systemic embolism
was lower with concomitant left atrial appendage occlusion performed
during the surgery than without it. Copyright A© 2021

<117>
Accession Number
2012895992
Title
Current clinical applications and potential perspective of micro-computed
tomography in cardiovascular imaging: A systematic scoping review.
Source
Hellenic Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Papazoglou A.S.; Karagiannidis E.; Moysidis D.V.; Sofidis G.; Bompoti A.;
Stalikas N.; Panteris E.; Arvanitidis C.; Herrmann M.D.; Michaelson J.S.;
Sianos G.
Institution
(Papazoglou, Karagiannidis, Moysidis, Sofidis, Stalikas, Sianos) First
Department of Cardiology, AHEPA University Hospital, Aristotle University
of Thessaloniki, St. Kiriakidi 1, Thessaloniki 54636, Greece
(Bompoti) Medway NHS Foundation Trust, United Kingdom
(Panteris) Biomic_AUTh, Center for Interdisciplinary Research and
Innovation (CIRI-AUTH), Balkan Center, B1.4, Thessaloniki, 10th km
Thessaloniki-Thermi Rd, P.O. Box 8318 GR 57001, Greece
(Arvanitidis) Institute of Marine Biology, Biotechnology and Aquaculture
(IMBBC), Hellenic Centre for Marine Research (HCMR), Heraklion, Crete
70013, Greece
(Arvanitidis) LifeWatch ERIC, Sector II-II, Plaza de Espana, Seville
41071, Spain
(Herrmann, Michaelson) Department of Pathology, Massachusetts General
Hospital and Harvard Medical School, Boston, United States
Publisher
Hellenic Cardiological Society
Abstract
Micro-computed tomography (micro-CT) constitutes an emerging imaging
technique, which can be utilized in cardiovascular medicine to study
in-detail the microstructure of heart and vessels. This paper aims to
systematically review the clinical utility of micro-CT in cardiovascular
imaging and propose future applications of micro-CT imaging in
cardiovascular research. A systematic scoping review was conducted by
searching for original studies written in English according to Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
extension for scoping reviews. Medline, Scopus, ClinicalTrials.gov, and
the Cochrane library were systematically searched through December 11,
2020 to identify publications concerning micro-CT applications in
cardiovascular imaging. Preclinical-animal studies and case reports were
excluded. The Newcastle-Ottawa assessment scale for observational studies
was used to evaluate study quality. In total, the search strategy
identified 30 studies that report on micro-CT-based cardiovascular imaging
and satisfy our eligibility criteria. Across all included studies, the
total number of micro-CT scanned specimens was 1,227. Six studies involved
postmortem 3D-reconstruction of congenital heart defects, while eleven
studies described atherosclerotic vessel (coronary or carotid)
characteristics. Thirteen other studies employed micro-CT for the
assessment of medical devices (mainly stents or prosthetic valves). In
conclusion, micro-CT is a novel imaging modality, effectively adapted for
the 3D visualization and analysis of cardiac soft tissues and devices at
high spatial resolution. Its increasing use could make significant
contributions to our improved understanding of the histopathophysiology of
cardiovascular diseases, and, thus, has the potential to optimize
interventional procedures and technologies, and ultimately improve patient
outcomes. Copyright © 2021 Hellenic Society of Cardiology

<118>
Accession Number
635236819
Title
Retrograde autologous priming during cardiopulmonary bypass reduces blood
transfusion rate in adult cardiac surgery: A prospective randomized
clinical trial.
Source
Asian journal of surgery. (no pagination), 2021. Date of Publication: 29
May 2021.
Author
Chen R.-Q.; Li J.-B.; Lin J.; Lin Z.-J.
Institution
(Chen, Li, Lin, Lin) Department of Anesthesiology, Zhangzhou Municipal
Hospital Affiliated to Fujian Medical University, Zhangzhou 363000, China
Publisher
NLM (Medline)

<119>
Accession Number
635232751
Title
The Effect of the Neuman Systems Model on Anxiety in Patients Undergoing
Coronary Artery Bypass Graft: A Randomized Controlled Trial.
Source
The journal of nursing research : JNR. (no pagination), 2021. Date of
Publication: 21 May 2021.
Author
Akhlaghi E.; Babaei S.; Mardani A.; Eskandari F.
Institution
(Akhlaghi) RN, Doctoral Candidate, School of Nursing and Midwifery, Iran
University of Medical Sciences, Tehran, Iran PhD, RN, Assistant Professor,
Nursing and Midwifery Care Research Center, Faculty of Nursing and
Midwifery, Isfahan University of Medical Science, Isfahan, Iran RN,
Doctoral Candidate, Nursing Care Research Center, School of Nursing and
Midwifery, Iran University of Medical Sciences, Tehran, Iran PhD, RN,
Support Worker, Psychiatric/Mental Health Nursing, Mental Health Community
Making Life Better, Sydney, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Coronary artery bypass graft (CABG) surgery is the most
commonly used surgical procedure for patients with coronary artery
disease. Anxiety is a significant psychological problem associated with
CABG surgery that may reduce related treatment outcomes. PURPOSE: This
study was designed to investigate the effect on anxiety of applying the
Neuman Systems Model in patients awaiting and undergoing CABG surgery.
 METHOD(S): A single-blind, parallel-group randomized controlled trial
was conducted on patients scheduled to receive coronary artery bypass
surgery in an urban area of Iran. Seventy participants were enrolled using
a convenience sampling method and randomly assigned to either the
intervention group (n = 35) or the control group (n = 35). Participants in
the intervention group received intervention in accordance with the Neuman
Systems Model format, including meetings held at three levels of
prevention. Patients' anxiety was measured using the State Anxiety
Inventory before the intervention, immediately after the intervention, and
at discharge time. The chi-square test, Fisher's exact test, independent
sample t test, one-way repeated measures analysis of variance test, and
Fisher's least significant difference were used to analyze the data.
 RESULT(S): No significant difference was found between the mean
anxiety scores of the two groups before the intervention (p = .48, t =
0.71). However, the mean anxiety score of the intervention group was
significantly lower than that of the control group immediately after the
intervention (p = .008, t = 2.73) and at discharge time (p = .007, t =
2.77). CONCLUSION(S): The Neuman-based program is an effective and
low-cost intervention that may be applied to reduce anxiety in patients
awaiting and undergoing CABG surgery. This program may be a good guide in
providing healthcare services. Copyright © 2021 by the Taiwan
Nurses Association.

<120>
Accession Number
635232750
Title
Relationship between septo-valvular angle and pacemaker implantation risk
after transcatheter aortic valve implantation: a preliminary study.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). (no pagination),
2021. Date of Publication: 01 Jun 2021.
Author
De Stasio V.; Cavallo A.U.; Spiritigliozzi L.; Pugliese L.; Presicce M.;
Di Donna C.; Di Tosto F.; Pasqualetto M.; D'Errico F.; Benelli L.;
Sbordone F.P.; Grimaldi F.; Cerimele C.; Vanni G.; Romeo F.; Floris R.;
Garaci F.; Chiocchi M.
Institution
(De Stasio) Department of Diagnostic Imaging and Interventional Radiology,
Molecular Imaging and Radiotherapy, Radiology Division Department of
Medical Sciences, Cardiology Division Breast Unit, Department of Surgical
Science, Policlinico Tor Vergata University, Rome, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Pre-transcatheter aortic valve implantation (TAVI) computed
tomography (CT) has proven to be crucial in identifying pre- and
post-procedural predicting factors predisposing the onset of major
arrhythmias that require permanent pacemaker (PPM) implantation caused by
the compressive effects of the prostheses on the conduction system at the
membranous septum (MS) and the muscular crest of the interventricular
septum.We hypothesized that the width of the angle between the MS and the
aortic annulus (septo-valvular angle, SVA) may be a determining factor for
the impingement of the conduction system. Therefore, our analysis aims to
verify if the pre-TAVI assessment of the angle between the MS and the
aortic annulus (SVA) might be a predictive factor for the onset of
arrhythmias that requires PPM. METHOD(S): Two cardiovascular
specialist radiologists retrospectively and double-blind evaluated a
randomized list of preprocedural CT of 57 patients who underwent TAVI with
a self-expandable valve from April 2019 to February 2020. Two anatomical
features were measured by readers: width of the SVA and MS length (MSL).
 RESULT(S): A PPM was implanted in 18 patients (31%) after the
procedure. There was no significant difference in the anatomical
measurements performed between the two observers, regarding both
anatomical measurements (intraclass correlation coefficient was 0.944 for
the SVA and 0.774 for the MSL]. Receiver-operating characteristic curves
(ROC) performed for both measurements have documented: for the SVA
sensitivity 94% and Negative predictive value (NPV) 96% (area under the
curve: 0.77; 95% confidence interval 0.66-0.90). The MSL ROC was not
significant. The mean SVA value stratified for patients who did not
undergo PPM implantation and patients who did resulted as significant (P <
0.005). CONCLUSION(S): Measurement of the SVA performed in
preprocedural CT scans has proven to be related to the onset of major
arrhythmias after TAVI requiring permanent pacemaker implantation with
high sensitivity (94%) and NPV (96%). Copyright © 2021 Italian
Federation of Cardiology. All rights reserved.

<121>
Accession Number
635232397
Title
Meta-analysis of the Safety and Efficacy of the Sentinel Cerebral
Protection System in Transcatheter Aortic Valve Implantation.
Source
The American journal of cardiology. (no pagination), 2021. Date of
Publication: 29 May 2021.
Author
Radwan Y.; Al-Abcha A.; Salam M.F.; Khor S.Y.; Prasad R.M.; Elshafie A.;
Abela G.
Institution
(Radwan, Salam, Khor, Prasad, Elshafie) Department of Internal Medicine,
Michigan State University, East Lansing, MI, United States
(Al-Abcha) Department of Internal Medicine, Michigan State University,
East Lansing, MI, United States
(Abela) Department of Cardiology, Michigan State University, East Lansing,
MI, United States
Publisher
NLM (Medline)

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