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<1>
Accession Number
629427427
Title
Comparison of the sustainability of mitral annular dynamics between two
semi-rigid annuloplasty devices.
Source
European Journal of Cardio-thoracic Surgery. 56 (2) (pp 360-368), 2019.
Date of Publication: 01 Aug 2019.
Author
Bouchez S.; Timmermans F.; Philipsen T.; Francois K.; Bove T.
Institution
(Bouchez) Department of Cardiac Anesthesiology, University Hospital of
Gent, Gent, Belgium
(Timmermans) Department of Cardiology, University Hospital of Gent, Gent,
Belgium
(Philipsen, Francois, Bove) Department of Cardiac Surgery, University
Hospital of Gent, Corneel Heymanslaan 10, Gent 9000, Belgium
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: The choice of annuloplasty device is fundamental at the time
of mitral valve repair, the goal being to optimally restore the
physiological 3-dimensional (3D) structure and dynamics of the mitral
annulus (MA). This study evaluated MA dynamics after annuloplasty with 2
different semi-rigid devices. <br/>Method(s): Thirty-three patients
eligible for mitral valve repair were selected for annuloplasty with the
Physio II ring (Edwards Lifesciences, Irving, CA, USA) (n = 17) or the
Memo 3D ring (LivaNova, Saluggia, Italy) (n = 16). MA dynamics were
assessed with transoesophageal 3D echocardiography intraoperatively and 1
year after repair. <br/>Result(s): The postoperative changes in the
anteroposterior diameter {3.7% [standard deviation (SD) 2.7] vs 1.9% [SD
1.3]; P = 0.013} and in the annular height [27.7% (SD 8.7) vs 18.0% (SD
13.9); P = 0.003] were significantly larger with the Memo 3D ring during
the cardiac cycle. The restoration of the saddle shape at baseline was
superior with the Physio II ring, defined by a larger systolic annular
height-to-commissural width ratio [15.1% (SD 2.3) vs 7.1% (SD 2.4); P <
0.001]. These observations of MA dynamics were sustained after 1 year,
shown by a greater anteroposterior extension [5.1% (SD 1.0) vs 1.7% (SD
1.6); P = 0.002] and change in annular height-to-commissural width ratio
[15.7% (SD 12.7) vs 3.1% (SD 3.0); P = 0.020] for the Memo 3D ring. There
were no significant differences in mitral valve function between the 2
devices. <br/>Conclusion(s): The MA dynamics after annuloplasty with the
Physio II and Memo 3D rings demonstrated a better systolic 3D restoration
of the saddle shape with the Physio II ring, whereas the saddle-shaped
geometry improved significantly with the Memo 3D ring, as a dynamic
phenomenon. The Memo 3D ring also showed increased anteroposterior annular
mobility and folding dynamics throughout the cardiac cycle. Moreover, the
observed differences in MA dynamics between both devices appeared to be
sustainable 1 year after ring implantation.<br/>Copyright &#xa9; 2019 The
Author(s). All rights reserved.

<2>
Accession Number
612936805
Title
Aortic valve replacement with mechanical vs. biological prostheses in
patients aged 50-69 years.
Source
European Heart Journal. 37 (34) (pp 2658-2667), 2016. Date of Publication:
07 Sep 2016.
Author
Glaser N.; Jackson V.; Holzmann M.J.; Franco-Cereceda A.; Sartipy U.
Institution
(Glaser, Jackson, Franco-Cereceda, Sartipy) Department of Cardiothoracic
Surgery and Anesthesiology, Karolinska University Hospital, Stockholm
SE-171 76, Sweden
(Glaser, Jackson, Franco-Cereceda, Sartipy) Department of Molecular
Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
(Holzmann) Department of Emergency Medicine, Karolinska University
Hospital, Stockholm, Sweden
(Holzmann) Department of Internal Medicine, Karolinska Institutet,
Stockholm, Sweden
Publisher
Oxford University Press
Abstract
Aims: The objective was to investigate the long-term all-cause mortality
in patients aged 50-69 years after aortic valve replacement (AVR) with
bioprosthetic or mechanical valves. <br/>Methods and Results: All patients
aged 50-69 years who had undergone AVR in Sweden 1997-2013 were identified
from the SwedishWebsystem for Enhancement and Development of
Evidence-based care in Heart disease Evaluated According to Recommended
Therapies register. Subsequent patient-level record linkage with national
health-data registers provided patient characteristics, vital status, and
clinical outcomes. Of the 4545 patients, 60% (2713/4545) had received
mechanical valves and 40% (1832/4545) bioprostheses. In 1099 propensity
score-matched patient pairs, 16% (180/1099) had died in the mechanical
valve group and 20% (217/1099) in the bioprosthetic group; mean follow-up
6.6 (maximum 17.2) years. Survival was higher in the mechanical than in
the bioprosthetic group: 5-, 10-, and 15-year survival 92, 79, and 59% vs.
89, 75, and 50%; hazard ratio 1.34; 95% confidence interval (CI)
1.09-1.66; P = 0.006. There was no difference in stroke [subdistribution
hazard ratio (sHR) 1.04; 95% CI 0.72-1.50, P = 0.848]; however, the risk
for aortic valve reoperation was higher (sHR 2.36; 95% CI 1.42-3.94, P =
0.001), and for major bleeding lower (sHR 0.49; 95% CI 0.34-0.70, P <
0.001), in patients who had received bioprostheses than in those with
mechanical valves. <br/>Conclusion(s): Patients aged 50-69 years who
received mechanical valves had better long-term survival after AVR than
those with bioprostheses. The risk of stroke was similar; however,
patients with bioprostheses had a higher risk of aortic valve reoperation
and a lower risk of major bleeding.<br/>Copyright &#xa9; The Author 2016.

<3>
Accession Number
2007166849
Title
Off-label Use for Direct Oral Anticoagulants: Valvular Atrial
Fibrillation, Heart Failure, Left Ventricular Thrombus, Superficial Vein
Thrombosis, Pulmonary Hypertension-a Systematic Review.
Source
Annals of Pharmacotherapy. 55 (8) (pp 995-1009), 2021. Date of
Publication: August 2021.
Author
Brokmeier H.; Kido K.
Institution
(Brokmeier) Mayo Clinic School of Health Sciences, Rochester, MN, United
States
(Kido) West Virginia University School of Pharmacy, Morgantown, WV, United
States
Publisher
SAGE Publications Inc.
Abstract
Objective: To evaluate clinical literature for direct oral anticoagulants
(DOACs) therapy for non-Food and Drug Administration approved indications.
<br/>Data Sources: Articles from MEDLINE, Cochrane Library, Google
Scholar, and OVID databases were reviewed from 1946 through September 4,
2020. Study Selection and Data Extraction: Fully published studies
assessing DOACs for atrial fibrillation (AF) with valvular heart disease
(VHD), heart failure (HF), left ventricular thrombus (LVT), superficial
vein thrombosis (SVT), or pulmonary hypertension (PH) were evaluated.
<br/>Data Synthesis: Our review showed that DOACs are safe to use in
patients with AF and VHD except for mitral stenosis or mechanical heart
valve. Rivaroxaban 2.5 mg twice daily should be used with caution in
patients with HF with reduced ejection fraction until further evaluation
is performed. Four retrospective studies for DOAC use in patients with LVT
showed conflicting results. One phase 3 randomized controlled trial showed
noninferiority of rivaroxaban to fondaparinux for SVT treatment. The use
of DOACs for pulmonary arterial hypertension was not evaluated in any
clinical study, but 2 retrospective studies for the use of DOACs in
patients with chronic thromboembolic PH (CTEPH) showed similar efficacy
between DOACs and warfarin. Relevance to Patient Care and Clinical
Practice: This review provides clinicians with a comprehensive literature
review surrounding DOAC use in common off-label indications.
<br/>Conclusion(s): DOACs can be considered for AF complicated by VHD
except for mitral stenosis or mechanical valve replacement. DOACs
(especially rivaroxaban) are considered as an alternative therapy for SVT
and CTEPH. Further prospective studies for DOAC uses are needed for HF or
LVT.<br/>Copyright &#xa9; The Author(s) 2020.

<4>
Accession Number
2013100852
Title
Hyperthermic intrathoracic chemotherapy (HITHOC): narrative review of the
current literature, recommendations and future studies.
Source
Annals of Translational Medicine. 9 (11) (no pagination), 2021. Article
Number: :955. Date of Publication: June 2021.
Author
Markowiak T.; Larisch C.; Hofmann H.-S.; Ried M.
Institution
(Markowiak, Larisch, Hofmann, Ried) Department of Thoracic Surgery,
University Medical Center Regensburg, Regensburg, Germany
(Hofmann) Department of Thoracic Surgery, Hospital Barmherzige Bruder
Regensburg, Regensburg, Germany
Publisher
AME Publishing Company
Abstract
Although the method of hyperthermic intrathoracic chemotherapy (HITHOC)
after cytoreductive surgery is known for more than 20 years now, the
interest of the scientific community has been growing especially in recent
years with annually increasing numbers of publications. The feasibility
and safety of HITHOC has already been demonstrated. The primary objective
now is to reach a consent about the optimal implementation and
standardization of the procedure. In the international clinical practice
of HITHOC the parameters of temperature, duration, type and number of
chemotherapeutic agents vary, making a comparison of the short- and
long-term results difficult. For about ten years, the combination of
surgical cytoreduction and HITHOC has been performed more routinely in
several departments of thoracic surgery in Germany, especially in
university hospitals. Recently, a group of experts for thoracic surgery of
five departments of thoracic surgery elaborated recommendations for the
HITHOC procedure in Germany. These recommendations represent a
standardized and consistent implementation of HITHOC. Through this,
postoperative complications associated to HITHOC should be reduced and a
better comparison of the results should be enabled. This article is
intended to give a brief overview of the literature, current
recommendations in the implementation of HITHOC and also aims to show
future perspectives of this procedure.<br/>Copyright &#xa9; Annals of
Translational Medicine. All rights reserved.

<5>
Accession Number
2005875486
Title
Persistent pulmonary hypertension in corrected valvular heart disease:
Hemodynamic insights and long-term survival.
Source
Journal of the American Heart Association. 10 (2) (pp 1-21), 2021. Article
Number: e019949. Date of Publication: 2021.
Author
Bermejo J.; Gonzalez-Mansilla A.; Mombiela T.; Fernandez A.I.;
Martinez-Legazpi P.; Yotti R.; Garcia-Orta R.; Sanchez-Fernandez P.L.;
Castano M.; Segovia-Cubero J.; Escribano-Subias P.; Roman J.A.S.; Borras
X.; Alonso-Gomez A.; Botas J.; Crespo-Leiro M.G.; Velasco S.; Bayes-Genis
A.; Lopez A.; Munoz-Aguilera R.; Jimenez-Navarro M.; Gonzalez-Juanatey
J.R.; Evangelista A.; Elizaga J.; Martin-Moreiras J.; Gonzalez-Santos
J.M.; Moreno-Escobar E.; Fernandez-Aviles F.; Garcia-Robles J.A.;
Perez-David E.; Del Villar C.P.; Sanz R.; Gutierrez-Ibanes E.; Vazquez
M.E.; Mur A.; Benito Y.; Barrio A.; Vazquez A.; Uribe I.; Gonzalez M.;
Sanchez P.L.; Arribas A.; Lorenzo M.M.C.; Nieto A.D.; De Prado A.P.;
Alonso D.; Gomez-Bueno M.; Silva I.S.; Cavero M.A.; Dominguez L.; De
Meneses R.T.; Cano M.J.R.; Lopez-Guarch C.J.; Mota P.; Galito C.A.; Mora
M.C.B.; Rubio D.M.; Campuzano R.; Marzoa R.; Cuenca J.; Munoz R.;
Suberviola V.; Herrera C.B.; Mora L.; Sarrion M.M.; Vaqueriza D.; Ferrer
E.; Cid B.; Monzonis A.M.; Arizon De Prado J.M.; Santisteban M.;
Garcia-Dorado D.; De Teresa E.; Chinchilla F.C.; Alonso J.
Institution
(Bermejo, Gonzalez-Mansilla, Mombiela, Fernandez, Martinez-Legazpi,
Elizaga, Fernandez-Aviles, Garcia-Robles, Perez-David, Del Villar, Sanz,
Gutierrez-Ibanes, Vazquez, Mur, Benito, Barrio, Vazquez) Hospital General
Universitario Gregorio Maranon, Instituto de Investigacion Sanitaria
Gregorio Maranon, Facultad de Medicina, Universidad Complutense de Madrid,
CIBERCV, Madrid, Spain
(Yotti) Instituto de Salud Carlos III, Madrid, Spain
(Garcia-Orta, Uribe, Gonzalez) Hospital Virgen de las Nieves, Granada,
Spain
(Sanchez-Fernandez, Martin-Moreiras, Gonzalez-Santos, Sanchez, Arribas,
Lorenzo, Nieto) Hospital Clinico Universitario de Salamanca, CIBERCV
Salamanca, Salamanca, Spain
(Castano, De Prado, Alonso) Hospital Universitario de Leon, Leon, Spain
(Segovia-Cubero, Gomez-Bueno, Silva, Cavero) Hospital Puerta de Hierro
Majadahonda, CIBERCV, Majadahonda, Spain
(Escribano-Subias, Dominguez, De Meneses, Cano, Lopez-Guarch) Hospital 12
de Octubre, CIBERCV, Madrid, Spain
(Roman, Mota) Hospital Clinico de Valladolid, CIBERCV, Valladolid, Spain
(Borras, Galito) Hospital Santa Creu i San Pau, CIBERCV, Barcelona, Spain
(Alonso-Gomez, Mora, Rubio) Hospital Universitario de Araba-Txagorritxu,
Vitoria, Spain
(Botas) Hospital Universitario Fundacion Alcorcon, Alcorcon, Spain
(Crespo-Leiro, Marzoa, Cuenca) Complejo Hospitalario Universitario de A
Coruna, CIBERCV, A Coruna, Spain
(Velasco) Hospital de Galdakao-Usansolo, Usansolo, Spain
(Bayes-Genis, Ferrer) Hospital Universitari Germans Trias i Pujol,
CIBERCV, Badalona, Spain
(Lopez, Arizon De Prado, Santisteban) Hospital Universitario Reina Sofia,
Cordoba, Spain
(Munoz-Aguilera, Munoz, Suberviola, Herrera, Mora, Sarrion, Vaqueriza)
Hospital Infanta Leonor, Madrid, Spain
(Jimenez-Navarro, De Teresa, Chinchilla) Hospital Virgen de la Victoria,
CIBERCV, Malaga, Spain
(Gonzalez-Juanatey, Cid, Monzonis) Hospital Clinico de Santiago de
Compostela, CIBERCV, Santiago de Compostela, Spain
(Evangelista, Garcia-Dorado) Hospital Universitario de la Vall d'Hebron,
CIBERCV, Barcelona, Spain
(Moreno-Escobar) Hospital Universitario San Cecilio, Granada, Spain
(Campuzano) Complejo Universitario Fundacion Alcorcon, Alcorcon, Spain
(Alonso) Hospital Universitario de Getafe, Madrid, Spain
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The determinants and consequences of pulmonary hypertension
after successfully corrected valvular heart disease remain poorly
understood. We aim to clarify the hemodynamic bases and risk factors for
mortality in patients with this condition. METHODS AND RESULTS: We
analyzed long-term follow-up data of 222 patients with pulmonary
hypertension and valvular heart disease successfully corrected at least 1
year before enrollment who had undergone comprehensive hemodynamic and
imaging characterization as per the SIOVAC (Sildenafil for Improving
Outcomes After Valvular Correction) clinical trial. Median (interquartile
range) mean pulmonary pressure was 37 mm Hg (32-44 mm Hg) and pulmonary
artery wedge pressure was 23 mm Hg (18-26 mm Hg). Most patients were
classified either as having combined precapillary and postcapillary or
isolated postcapillary pulmonary hypertension. After a median follow-up of
4.5 years, 91 deaths accounted for 4.21 higher-than-expected mortality in
the age-matched population. Risk factors for mortality were male sex,
older age, diabetes mellitus, World Health Organization functional class
III and higher pulmonary vascular resistance-either measured by
catheterization or approximated from ultrasound data. Higher pulmonary
vascular resistance was related to diabetes mellitus and smaller residual
aortic and mitral valve areas. In turn, the latter correlated with
prosthetic nominal size. Six-month changes in the composite clinical score
and in the 6-minute walk test distance were related to survival.
<br/>CONCLUSION(S): Persistent valvular heart disease-pulmonary
hypertension is an ominous disease that is almost universally associated
with elevated pulmonary artery wedge pressure. Pulmonary vascular
resistance is a major determinant of mortality in this condition and is
related to diabetes mellitus and the residual effective area of the
corrected valve. These findings have important implications for
individualizing valve correction procedures. REGISTRATION: URL:
https://www.clini caltr ials.gov; Unique identifier:
NCT00862043.<br/>Copyright &#xa9; 2021 The Authors.

<6>
Accession Number
2011311450
Title
Incidence of early atrial fibrillation after transcatheter versus surgical
aortic valve replacement: A meta-analysis of randomized controlled trials.
Source
Journal of Atrial Fibrillation. 13 (4) (pp 23-27), 2020. Date of
Publication: January 2021.
Author
Altaii H.; Morcos R.; Riad F.S.; Abdulameer H.; Khalili H.; Maini B.;
Lieberman E.; Vivas Y.; Wiegn P.; Joglar J.A.; Mackall J.; Al-Kindi S.G.;
Thal S.
Institution
(Altaii, Morcos, Khalili, Maini, Lieberman, Vivas) Division of Cardiology,
Florida Atlantic University, Boca Raton, FL, United States
(Khalili, Maini, Lieberman) Tenet Healthcare, Delray Medical Center,
Delray Beach, FL, United States
(Riad, Mackall, Al-Kindi, Thal) Harrington Heart and Vascular Institute,
University Hospitals and Case Western Reserve University, Cleveland, OH,
United States
(Abdulameer) Department of Surgery, Florida Atlantic University, Boca
Raton, FL, United States
(Wiegn, Joglar) Clinical Cardiac Electrophysiology, University of Texas
Southwestern Medical Center, Dallas, TX, United States
Publisher
CardioFront LLC
Abstract
Background: Post-operative atrial fibrillation (POAF) is common after
aortic valve replacement (AVR) and is associated with worse outcomes. We
performed a meta-analysis of randomized controlled trials comparing
Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve
Replacement (TAVR) for incidence of POAF at 30 days. <br/>Method(s): We
searched databases from 1/1/1990 to 1/1/2020 for randomized studies
comparing TAVR and SAVR. POAF was defined as either worsening or new-onset
atrial fibrillation. Random effects model was used to estimate the risk of
POAF with TAVR vs SAVR in all trials, and in subgroups (low, intermediate,
high risk, and in self-expandable vs balloon expandable valves).
Sensitivity analysis was performed including only studies reporting
new-onset atrial fibrillation Results: Seven RCTs were identified that
enrolled 7,934 patients (3,999 to TAVR and 3,935 to SAVR). The overall
incidence of POAF was 9.7% after TAVR and 33.3% after SAVR. TAVR was
associated with a lower risk of POAF compared with SAVR (OR 0.21
[0.18-0.24]; P < 0.0001). Compared with SAVR, TAVR was associated with a
significantly lower risk of POAF in the high-risk cohort (OR 0.37
[0.27-0.49]; P < 0.0001), in the intermediate-risk cohort (OR 0.23
[0.19-0.28]; P < 0.0001), low-risk cohort (OR 0.13 [0.10-0.16]; P <
0.0001). Sensitivity analysis of 4 trials including only new-onset POAF
showed similar summary estimates (OR 0.21, 95% CI [0.18-0.25]; P< 0.0001).
<br/>Conclusion(s): TAVR is associated with a significantly lower risk of
post-operative atrial fibrillation compared with SAVR in all strata.
Further studies are needed to identify the contribution of post-operative
atrial fibrillation to the differences in clinical outcomes after TAVR and
SAVR.<br/>Copyright &#xa9; 2020 CardioFront LLC. All rights reserved.

<7>
Accession Number
2007505643
Title
The effect of preoperative chemotherapy on liver regeneration after portal
vein embolization/ligation or liver resection in patients with colorectal
liver metastasis: a systematic review protocol.
Source
Systematic Reviews. 9 (1) (no pagination), 2020. Article Number: 279. Date
of Publication: December 2020.
Author
Pavel M.-C.; Casanova R.; Estalella L.; Memba R.; Llacer-Millan E.;
Achalandabaso M.; Julia E.; Geoghegan J.; Jorba R.
Institution
(Pavel, Casanova, Estalella, Memba, Llacer-Millan, Achalandabaso, Julia,
Jorba) HPB Unit, Department of General Surgery, Hospital Universitari de
Tarragona Joan XXIII, C/ Dr. Mallafre Guasch, 4, Tarragona 43005, Spain
(Pavel, Estalella, Memba, Llacer-Millan, Jorba) Departament de Medicina i
Cirugia, Universitat Rovira i Virgili, Reus, Spain
(Geoghegan) HPB and Liver Transplant Surgery Department, St. Vincent's
University Hospital, Dublin, Ireland
Publisher
BioMed Central Ltd
Abstract
Introduction: Liver resection (LR) in patients with liver metastasis from
colorectal cancer remains the only curative treatment. Perioperative
chemotherapy improves prognosis of these patients. However, there are
concerns regarding the effect of preoperative chemotherapy on liver
regeneration, which is a key event in avoiding liver failure after LR. The
primary objective of this systematic review is to assess the effect of
neoadjuvant chemotherapy on liver regeneration after (LR) or portal vein
embolization (PVE) in patients with liver metastasis from colorectal
cancer. The secondary objectives are to evaluate the impact of the type of
chemotherapy, number of cycles, and time between end of treatment and
procedure (LR or PVE) and to investigate whether there is an association
between degree of hypertrophy and postoperative liver failure.
<br/>Method(s): This meta-analysis will include studies reporting liver
regeneration rates in patients submitted to LR or PVE. Pubmed, Scopus, Web
of Science, Embase, and Cochrane databases will be searched. Only studies
comparing neoadjuvant vs no chemotherapy, or comparing chemotherapy
characteristics (bevacizumab administration, number of cycles, and time
from finishing chemotherapy until intervention), will be included. We will
select studies from 1990 to present. Two researchers will individually
screen the identified records, according to a list of inclusion and
exclusion criteria. Primary outcome will be future liver remnant
regeneration rate. Bias of the studies will be evaluated with the ROBINS-I
tool, and quality of evidence for all outcomes will be determined with the
GRADE system. The data will be registered in a predesigned database. If
selected studies are sufficiently homogeneous, we will perform a
meta-analysis of reported results. In the event of a substantial
heterogeneity, a qualitative systematic review will be performed.
<br/>Discussion(s): The results of this systematic review may help to
better identify the patients affected by liver metastasis that could
present low regeneration rates after neoadjuvant chemotherapy. These
patients are at risk to develop liver failure after extended hepatectomies
and therefore are not good candidates for such aggressive procedures.
Systematic review registration: PROSPERO registration number:
CRD42020178481 (July 5, 2020).<br/>Copyright &#xa9; 2020, The Author(s).

<8>
Accession Number
2013026302
Title
Biomarkers of Cerebral Injury for Prediction of Postoperative Cognitive
Dysfunction in Patients Undergoing Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Wiberg S.; Holmgaard F.; Zetterberg H.; Nilsson J.-C.; Kjaergaard J.;
Wanscher M.; Langkilde A.R.; Hassager C.; Rasmussen L.S.; Blennow K.;
Vedel A.G.
Institution
(Wiberg, Kjaergaard, Hassager) Department of Cardiology, Rigshospitalet,
University of Copenhagen, Copenhagen, Denmark
(Holmgaard, Nilsson, Wanscher, Vedel) Department of Cardiothoracic
Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Zetterberg, Blennow) Department of Psychiatry and Neurochemistry,
Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the
University of Gothenburg, Molndal, Sweden
(Zetterberg, Blennow) Clinical Neurochemistry Laboratory, Sahlgrenska
University Hospital, Molndal, Sweden
(Zetterberg) Department of Neurodegenerative Disease, UCL Institute of
Neurology, London, United Kingdom
(Zetterberg) UK Dementia Research Institute at UCL, London, United Kingdom
(Langkilde) Department of Radiology, Rigshospitalet, University of
Copenhagen, Copenhagen, Denmark
(Hassager, Rasmussen) Department of Clinical Medicine, University of
Copenhagen, Copenhagen, Denmark
(Rasmussen) Department of Anesthesia, Center of Head and Orthopedics,
Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Publisher
W.B. Saunders
Abstract
Objectives: To assess the ability of the biomarkers neuron-specific
enolase (NSE), tau, neurofilament light chain (NFL), and glial fibrillary
acidic protein (GFAP) to predict postoperative cognitive dysfunction
(POCD) at discharge in patients who underwent cardiac surgery.
<br/>Design(s): Post hoc analyses (with tests being prespecified before
data analyses) from a randomized clinical trial. <br/>Setting(s):
Single-center study from a primary heart center in Denmark.
<br/>Participant(s): Adult patients undergoing elective or subacute
on-pump coronary artery bypass grafting and/or aortic valve replacement.
<br/>Intervention(s): Blood was collected before induction of anesthesia,
after 24 hours, after 48 hours, and at discharge from the surgical ward.
The International Study of Postoperative Cognitive Dysfunction test
battery was applied to diagnose POCD at discharge and after three months.
Linear mixed models of covariance were used to assess whether repeated
measurements of biomarker levels were associated with POCD. Receiver
operating characteristic (ROC) curves were applied to assess the
predictive value of each biomarker measurement for POCD. <br/>Measurements
and Main Results: A total of 168 patients had biomarkers measured at
baseline, and 47 (28%) fulfilled the POCD criteria at discharge. Patients
with POCD at discharge had significantly higher levels of tau (p = 0.02)
and GFAP (p = 0.01) from baseline to discharge. The biomarker measurements
achieving the highest area under the ROC curve for prediction of POCD at
discharge were NFL measured at discharge (AUC, 0.64; 95% confidence
interval [CI], 0.54-0.73), GFAP measured 48 hours after induction (AUC,
0.64; 95% CI, 0.55-0.73), and GFAP measured at discharge (AUC, 0.64; 95%
CI, 0.54-0.74), corresponding to a moderate predictive ability.
<br/>Conclusion(s): Postoperative serum levels of tau and GFAP were
elevated significantly in patients with POCD who underwent cardiac surgery
at discharge; however, the biomarkers achieved only modest predictive
abilities for POCD at discharge. Postoperative levels of NSE were not
associated with POCD at discharge.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<9>
Accession Number
635317125
Title
Anti-Xa Monitoring of Low-Molecular-Weight Heparin during Pregnancy: A
Systematic Review.
Source
Seminars in Thrombosis and Hemostasis. (no pagination), 2021. Date of
Publication: 2021.
Author
Kjaergaard A.B.; Fuglsang J.; Hvas A.-M.
Institution
(Kjaergaard, Hvas) Department of Clinical Biochemistry, Aarhus University
Hospital, Aarhus, Denmark
(Fuglsang) Department of Obstetrics and Gynecology, Aarhus University
Hospital, Aarhus, Denmark
(Fuglsang, Hvas) Department of Clinical Medicine, Aarhus University,
Aarhus, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Low-molecular-weight heparin (LMWH) is commonly used for preventing or
treating venous thromboembolic disease (VTE) during pregnancy. The
physiological changes in maternal metabolism have led to discussions on
optimal LMWH dosing strategy and possible need for monitoring. The aim of
this systematic review is to summarize and discuss whether LMWH dose
adjustment according to anti-Xa provides superior effectiveness and safety
compared with weight adjusted or fixed dosed LMWH in pregnant women. A
systematic literature search was performed in PubMed, Embase, and Scopus
on September 26, 2020. The study is reported according to Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines. Effectiveness was defined as episodes of thrombosis and safety
as bleeding episodes. In total, 33 studies were included: 4 randomized
controlled studies and 29 cohort studies. Prophylactic dosing strategies
employing weight dosed, fixed dosed, or anti-Xa adjusted LMWH dosing
performed equal in effectiveness and safety. In pregnant women with VTE or
high thromboembolic risk, therapeutic weight-adjusted LMWH and weight plus
anti-Xa-adjusted LMWH provided equal results in terms of effectiveness and
safety. Pregnant women with mechanical heart valves (MHVs) received
therapeutic anti-Xa-adjusted LMWH with four out of seven studies
presenting mean peak anti-Xa within target ranges. Still, pregnant women
with MHV experienced both thrombosis and bleeding with anti-Xa in target.
Based on the results of this systematic review, current evidence does not
support the need for anti-Xa monitoring when using LMWH as
thromboprophylaxis or treatment during pregnancy. Nonetheless, the need
for anti-Xa monitoring in pregnant women with MHV may need further
scrutiny.<br/>Copyright &#xa9; 2021 Cambridge University Press. All rights
reserved.

<10>
Accession Number
635276103
Title
Prognostic factors for chronic post-surgical pain after lung or pleural
surgery: A protocol for a systematic review and meta-analysis.
Source
BMJ Open. 11 (6) (no pagination), 2021. Article Number: e051554. Date of
Publication: 15 Jun 2021.
Author
Clephas P.R.D.; Hoeks S.E.; Trivella M.; Guay C.S.; Singh P.M.; Klimek M.;
Heesen M.
Institution
(Clephas, Hoeks, Klimek) Anesthesiology, Erasmus MC, Rotterdam,
Zuid-Holland, Netherlands
(Trivella) Cardiovascular Medicine, Clinical Sciences Division, Oxford
University, Oxford, Oxfordshire, United Kingdom
(Guay, Singh) Anesthesiology, Washington University School of Medicine in
St Louis, St Louis, MO, United States
(Heesen) Anesthesiology, Kantonsspital Baden AG, Baden, Switzerland
Publisher
BMJ Publishing Group
Abstract
Introduction Chronic post-surgical pain (CPSP) after lung or pleural
surgery is a common complication and associated with a decrease in quality
of life, long-term use of pain medication and substantial economic costs.
An abundant number of primary prognostic factor studies are published each
year, but findings are often inconsistent, methods heterogeneous and the
methodological quality questionable. Systematic reviews and meta-analyses
are therefore needed to summarise the evidence. Methods and analysis The
reporting of this protocol adheres to the Preferred Reporting Items for
Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. We
will include retrospective and prospective studies with a follow-up of at
least 3 months reporting patient-related factors and surgery-related
factors for any adult population. Randomised controlled trials will be
included if they report on prognostic factors for CPSP after lung or
pleural surgery. We will exclude case series, case reports, literature
reviews, studies that do not report results for lung or pleural surgery
separately and studies that modified the treatment or prognostic factor
based on pain during the observation period. MEDLINE, Scopus, Web of
Science, Embase, Cochrane, CINAHL, Google Scholar and relevant literature
reviews will be searched. Independent pairs of two reviewers will assess
studies in two stages based on the PICOTS criteria. We will use the
Quality in Prognostic Studies tool for the quality assessment and the
CHARMS-PF checklist for the data extraction of the included studies. The
analyses will all be conducted separately for each identified prognostic
factor. We will analyse adjusted and unadjusted estimated measures
separately. When possible, evidence will be summarised with a
meta-analysis and otherwise narratively. We will quantify heterogeneity by
calculating the Q and I 2 statistics. The heterogeneity will be further
explored with meta-regression and subgroup analyses based on clinical
knowledge. The quality of the evidence obtained will be evaluated
according to the Grades of Recommendation Assessment, Development and
Evaluation guideline 28. Ethics and dissemination Ethical approval will
not be necessary, as all data are already in the public domain. Results
will be published in a peer-reviewed scientific journal. PROSPERO
registration number CRD42021227888. <br/>Copyright &#xa9; 2021 BMJ
Publishing Group. All rights reserved.

<11>
Accession Number
632245525
Title
Safety and Effectiveness of Early Oral Hydration in Patients After
Cardiothoracic Surgery.
Source
American journal of critical care : an official publication, American
Association of Critical-Care Nurses. 29 (4) (pp 292-300), 2020. Date of
Publication: 01 Jul 2020.
Author
Ford C.; McCormick D.; Parkosewich J.; Derycke-Chapman K.; Marshall J.;
Mancarella J.; Chepulis A.
Institution
(Ford, McCormick, Parkosewich, Derycke-Chapman, Marshall, Mancarella,
Chepulis) About the Authors: Catherine Ford and Donna McCormick are
clinical nurses; Katrien Derycke-Chapman, Judith Marshall, Jessica
Mancarella, and Anne Chepulis are former clinical nurses in the
cardiothoracic intensive care unit, Heart and Vascular Center, Yale New
Haven Hospital, New Haven, Connecticut
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients fast after cardiothoracic surgery because of concerns
for nausea, vomiting, dysphagia, and aspiration pneumonia; fasting,
however, causes thirst, a distressing symptom. To our knowledge, no
studies exist to guide hydration practices in this population.
<br/>OBJECTIVE(S): To determine the effect of early oral hydration on
adverse events and thirst in patients after cardiothoracic surgery.
<br/>METHOD(S): This study applied a prospective 2-group design in which
149 patients from an 18-bed cardiothoracic intensive care unit were
randomized to either usual care (a 6-hour fast) or early oral hydration
after extubation. The research protocol involved nurses evaluating
patients' readiness for oral hydration and then offering them ice chips.
If patients tolerated the ice chips, they were allowed to drink water 1
hour later. <br/>RESULT(S): Most patients (91.3%) had undergone coronary
artery or valve surgery, or both. Demographic and clinical variables were
similar in both groups. No significant between-group differences were
found for the incidence of nausea, vomiting, or dysphagia, and no
aspiration pneumonia occurred. Significantly more patients with a high
thirst level were in the usual care group (81.2%) than in the early oral
hydration group (56.5%; P = .002, r2 test). After adjustment for
demographic and clinical variables by using logistic regression, early
oral hydration was independently and negatively associated with a high
thirst level (odds ratio, 0.30 [95% CI, 0.13-0.69]; P = .004).
<br/>CONCLUSION(S): This research provides new evidence that oral
hydration (ice chips and water) soon after extubation is safe and
significantly reduces thirst in particular patients.<br/>Copyright &#xa9;
2020 American Association of Critical-Care Nurses.

<12>
Accession Number
2012834484
Title
PCV20 Cost-Effectiveness of a Tacrolimus-Mycophenolate Mofetil Regimen for
Organ Rejection Prophylaxis in Heart Transplant Recipients in Colombia.
Source
Value in Health. Conference: HEOR: Evolving for Tomorrow's Challenges.
Virtual, Online. 24 (Supplement 1) (pp S70), 2021. Date of Publication:
June 2021.
Author
Lasalvia P.; Hernandez F.; Montoya G.
Institution
(Lasalvia, Hernandez) NeuroEconomix, Bogota, Colombia
(Montoya) Astellas Farma Colombia, Bogota, Colombia
Publisher
Elsevier Ltd
Abstract
Objectives: Evidence of the cost-effectiveness of the calcineurin
inhibitor tacrolimus is required to guide its inclusion in the Colombian
National Benefit Plan as a treatment for organ rejection prophylaxis in
heart transplant recipients. A model was developed to estimate the
cost-effectiveness of tacrolimus-mycophenolate mofetil (TAC-MMF) versus
cyclosporine-mycophenolate mofetil (CYC-MMF) for organ rejection
prophylaxis in heart transplant recipients in Colombia. <br/>Method(s): A
Markov model with monthly cycle length was constructed to estimate costs
and quality-adjusted life years (QALY) for each treatment alternative over
a 15-year time horizon from the perspective of the Colombian third-party
payer. The following states were considered: alive with a functioning
graft, history of acute graft rejection, cardiac allograft vasculopathy,
and death. The costs were estimated using the Social Security (Instituto
del Seguro Social) Rates Manual and reports of the Medicine Price
Information System, and the resources and cost-generating events were
identified using a base case constructed with clinical experts. The
rejection rate for each treatment alternative was taken from a previously
undertaken meta-analysis. Information on vasculopathy and mortality was
taken from observational studies with follow-up times beyond 1 month, and
was later adjusted to probabilistic distributions to obtain a monthly
probability of developing the outcome. <br/>Result(s): The TAC-MMF regimen
represented a 0.236 difference in QALY and a cost difference of US
-$18,337 versus CYC-MMF over the 15-year time horizon (US $1 = Colombian
peso ~3763, November 2020), which makes the former a dominant
intervention. The main differentiators of the treatment alternatives in
the model were acute rejection rate, cardiac allograft vasculopathy, and
treatment cost. In this regard, the cost of CYC treatment was higher than
the cost of TAC treatment. <br/>Conclusion(s): Under the model
assumptions, the TAC-MMF regimen could be a dominant option over the
CYC-MMF regimen for organ rejection prophylaxis in heart transplant
recipients in Colombia.<br/>Copyright &#xa9; 2021

<13>
Accession Number
2012834187
Title
PCV2 Real-World Outcomes of Antithrombotic Therapies in Patients with
Coronary Artery Disease That Require Long-Term Oral Anticoagulation.
Source
Value in Health. Conference: HEOR: Evolving for Tomorrow's Challenges.
Virtual, Online. 24 (Supplement 1) (pp S67), 2021. Date of Publication:
June 2021.
Author
Osterland A.; Widmer R.J.; Godley P.J.
Institution
(Osterland, Widmer, Godley) Baylor Scott & White Health, Austin, TX,
United States
Publisher
Elsevier Ltd
Abstract
Objectives: In patients with coronary artery disease (CAD), guidelines
recommend daily low-dose aspirin (ASA) and/or P2Y12 inhibitors for
long-term maintenance. However, patients may also be indicated to receive
oral anticoagulants (OAC) long-term, raising important questions about
safety and effectiveness of combination OAC/antiplatelet regimens. This
research aims to assess real-world effectiveness and safety in patients
with CAD receiving OAC with or without ASA. <br/>Method(s): This
retrospective cohort study used medical and pharmacy claims data linked to
electronic health record (EHR) data at an integrated delivery network
(IDN) in Texas between January 2014 and December 2019. Patients were
followed up to 12 months after their index date, defined as the date of
their first OAC claim. Inclusion criteria were: (1) age >=18 years, (2)
stable CAD (diagnosed or >=6 months post-coronary revascularization
procedure), (3) IDN health plan continuous enrollment >=6 months pre-index
and >=12 months post-index, (4) proportion of days covered by OAC >=80%
for the first 6 months post-index, and (5) no P2Y12 inhibitors post-index.
Patients were grouped by ASA use from outpatient EHR data. Major adverse
cardiovascular events (MACE: cardiovascular-related death, non-fatal
stroke, and non-fatal MI) were measured for effectiveness, and major
bleeding events were measured for safety. <br/>Result(s): 418 patients
(n=297, OAC-only; n=121, OAC/ASA) met study criteria with mean (SD) age
75.8 (9.7) years. Overall, patients were primarily white (68.4%), male
(59.3%), and insured through Medicare (71.1%). Direct OACs were more
common than warfarin (67.7% vs. 32.3%). In the OAC-only and OAC/ASA
groups, MACE occurred in four (1.3%) and one (0.8%, P=NS) patient(s),
respectively, whereas thirteen (4.4%) and six (5.0%, P=NS) patients,
respectively, experienced major bleeding events. <br/>Conclusion(s): Rates
of MACE and major bleeding events in this real-world study were low
compared to similar randomized controlled trials. Additional larger,
randomized studies are needed to compare safety and
effectiveness.<br/>Copyright &#xa9; 2021

<14>
Accession Number
2012831840
Title
PCV8 Balloon-expandable versus self-expandable transcatheter aortic valve
replacement.
Source
Value in Health. Conference: HEOR: Evolving for Tomorrow's Challenges.
Virtual, Online. 24 (Supplement 1) (pp S68), 2021. Date of Publication:
June 2021.
Author
Okumura L.; Sanchez L.; Alves M.; Candolfi P.
Institution
(Okumura) Edwards LLC, SAO PAULO, Brazil
(Sanchez) Edwards Lifesciences Mexico, Mexico City, DF, Mexico
(Alves) Edwards LLC, Sao Paulo, Brazil
(Candolfi) Edwards Lifesciences, Inc., Irvine, CA, United States
Publisher
Elsevier Ltd
Abstract
Objectives: to assess the financial consequences of choosing different
transcatheter aortic valve replacement (TAVR) valves, namely
balloon-expandable valves (BEV) or self-expandable valves (SEV) for the
treatment of high risk severe aortic stenosis (SAS). <br/>Method(s): A
cost-consequence analysis (CCA) was performed based on a comprehensive
review in Pubmed/Medline and Cochrane to identify eligible comparative
studies of BEV vs SEVs that included patients with SAS in randomized
controlled trials or cohort studies as source of clinical
outcomes/consequences. Outcomes were chosen based on VARC-2 consensus
(valve academic research consortium-2) and included: early and late
mortality and postoperative complications - such as acute myocardial
infarction, acute kidney injury, stroke, and paravalvular leak. Hospital
resources was also considered with length-of-stay as a proxy. Published
micro-costing studies that informed 30-day and 5-year direct medical costs
were included in the model if they considered the Brazilian private health
care system payer's perspective. Outputs of CCA were given in Brazilian
Reais (BRL/R$) and expressed as total costs (valve and complication
costs). Univariate sensitivity analyses were performed to explore the
uncertainty of complication cost. <br/>Result(s): In the base case
scenario, the average cost of BEV and SEV valves were R$90k and R$78k,
while cost of consequences (or complications related to the procedure)
were R$23k and R$35k respectively. The total costs were estimated at
R$113.7k and R$113k for BEV and SEV respectively. Sensitivity analyses
based on cost of consequences uncertainty (lowest and highest cost of SEV
R$[23.7;40.5k]), led to total cost difference between both BEV and SEV of
R$[-4.8k;5.5k]. <br/>Conclusion(s): In this CCA model, total cost seems
very close between TAVR valves. However, one technology (BEV) seems to
have lower complication cost than the other one, leading to better
effectiveness that could translate into better quality of life for the
patients with SAS. This potential additional benefit should be explored in
further cost-utility analysis.<br/>Copyright &#xa9; 2021

<15>
Accession Number
2012831817
Title
PCV28 Cost-effectiveness Analysis Of Viscoelastic Point-Of-Care Testing
Versus Standard Laboratory Tests For Guiding Transfusion Therapy In
Brazilian Patients Who Underwent Complex Cardiac Surgery.
Source
Value in Health. Conference: HEOR: Evolving for Tomorrow's Challenges.
Virtual, Online. 24 (Supplement 1) (pp S72), 2021. Date of Publication:
June 2021.
Author
Osuna A.; Figueroa-Lara A.
Institution
(Osuna) French School of Public Health, Paris 75, France
(Figueroa-Lara) Werfen, Mexico City, MEX, Mexico
Publisher
Elsevier Ltd
Abstract
Objectives: In patients undergoing complex cardiac surgery, periprocedural
significant bleeding is amongst the most alarming complications.
Transfusion of allogeneic red blood cells may be necessary in at least
half of the procedures with cardiopulmonary bypass (CPB), this, in turn,
is associated with increased morbidity, mortality, and costs. This study
assessed the cost-effectiveness of viscoelastic point-of-care testing (VE
POC) vs standard laboratory tests (SLTs) for guiding transfusion therapy
in Brazilian patients who underwent complex cardiac surgery in terms of
quality adjusted life years (QALY). <br/>Method(s): We designed a decision
tree from the perspective of the Brazilian public health system (Unified
Health System -SUS-). We calculated the incremental cost-effectiveness
ratio (ICER) under a 12-month time horizon; short (1 month) and long (11
months) term complications for each guiding transfusion therapy were
considered. An alternative was considered cost-effective if the ICER was
equivalent or below the value of three gross domestic product per capita
for Brazil (United States dollar -USD $26,151) per QALY gained. Direct
medical costs were obtained from the SUS and standardized to 2020 US
dollars. Evidence of adverse events was collected from randomized clinical
trials and published cohort studies. Probabilistic sensitivity analysis
was conducted using Monte Carlo simulations. The model was developed using
TreeAge Pro software^TM. <br/>Result(s): VE POC is more
effective in terms of QALYs (0.052), albeit it is more expensive (USD $84)
than SLTs. The ICER of VE POC in comparison with SLTs is USD $1,628.
Therefore, VE POC is projected to be cost-effective compared to SLTs.
<br/>Conclusion(s): To date, this is the first study carried out in Brazil
that compares the cost-effectiveness of VE POC against SLT in patients who
underwent complex cardiac surgery. Our findings suggest that the Brazilian
public health system may include VE POC as part of the management of
complex cardiac surgeries.<br/>Copyright &#xa9; 2021

<16>
Accession Number
635340070
Title
Outcome of mitral valve repair or replacement for non-ischemic mitral
regurgitation: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 16 (1) (pp 175), 2021. Date of
Publication: 15 Jun 2021.
Author
Fan Q.; Li X.; Cao G.; Yu P.; Zhang F.
Institution
(Fan, Li, Cao) Department of Cardiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Hubei Province
430022, China
(Fan) Department of Nephrology, Wuhan HanKou Hospital, Hubei Province
430012, China
(Li) Department of Cardiology, People's Hospital of Jianghan University,
Wuhan 43003, China
(Yu) Key Laboratory of Metallurgical Equipment and Control Technology,
Wuhan University of Science and Technology, Hubei Province 430081, China
(Zhang) Department of Cardiology, Union Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Hubei Province 430022,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Mitral regurgitation (MR) is a rather common valvular heart
disease. The aim of this systematic review and meta-analysis was to
compare the outcomes, and complications of mitral valve (MV) replacement
with surgical MV repair of non-ischemic MR (NIMR) METHODS: MEDLINE,
EMBASE, and the Cochrane Central Register of Controlled Trials were
searched until October, 2020. Studies were eligible for inclusion if they
included patients with MR and reported early (30-day or in-hospital) or
late all-cause mortality. For each study, data on all-cause mortality and
incidence of reoperation and operative complications in both groups were
used to generate odds ratios (ORs) or hazard ratios (HRs). This study is
registered with PROSPERO, CRD42018089608. <br/>RESULT(S): The literature
search yielded 4834 studies, of which 20 studies, including a total of
21,898 patients with NIMR, were included. The pooled analysis showed that
lower age, less female inclusion and incident of hypertension,
significantly higher rates of diabetes and atrial fibrillation in the MV
replacement group than MV repair group. No significant differences in the
rates of pre-operative left ventricle ejection fraction (LVEF) and heart
failure were observed between groups. The number of patients in the MV
repair group was lower than in the MV replacement group. We found that
there were significantly increased risks of mortality associated with
replacement of MR. Moreover, the rate of re-operation and post-operative
MR in the MV repair group was lower than in the MV replacement group.
<br/>CONCLUSION(S): In patients with NIMR, MV repair achieves higher
survival and leads to fewer complications than surgical MV replacement. In
light of these results, we suggest that MV repair surgery should be a
priority for NIMR patients.

<17>
Accession Number
2012846140
Title
Preoperative proteinuria may be a risk factor for postoperative acute
kidney injury:a meta-analysis.
Source
Renal Failure. 43 (1) (pp 958-967), 2021. Date of Publication: 2021.
Author
Huang D.-D.; Li Y.-Y.; Fan Z.; Wu Y.-G.
Institution
(Huang, Li, Fan, Wu) Department of Nephropathy, The First Affiliated
Hospital, Anhui Medical University, Hefei, Anhui, China
Publisher
Taylor and Francis Ltd.
Abstract
Objective: To investigate the relationship between preoperative
proteinuria and postoperative acute kidney injury (AKI). <br/>Method(s):
We performed a search on databases included PubMed, Embase, the Cochrane
Library, and Web of Science, from December 2009 to September 2020. Data
extracted from eligible studies were synthesized to calculate the odds
ratio (OR) and 95% confidence interval (CI). A fixed or random effects
model was applied to calculate the pooled OR based on heterogeneity
through the included studies. <br/>Result(s): This meta-analysis of 11
observational studies included 203,987 participants, of whom 21,621
patients suffered from postoperative AKI and 182,366 patients did not
suffer from postoperative AKI. The combined results demonstrated that
preoperative proteinuria is an independent risk factor for postoperative
AKI (adjusted OR = 1.65, 95%CI:1.44-1.89, p < 0.001). Subgroup analysis
showed that both preoperative mild proteinuria (adjusted OR = 1.30,
95%CI:1.24-1.36, p < 0.001) and preoperative heavy proteinuria (adjusted
OR = 1.93, 95%CI:1.65-2.27, p < 0.001) were independent risk factors for
postoperative AKI. The heterogeneity was combined because its values were
lower. Further subgroup analysis found that preoperative proteinuria
measured using dipstick was an independent risk factor for postoperative
AKI (adjusted OR = 1.48, 95%CI:1.37-1.60, p < 0.001). Finally,
preoperative proteinuria was an independent risk factor for postoperative
AKI in the non-cardiac surgery group (adjusted OR = 2.06, 95%CI:1.31-3.24,
p = 0.002) and cardiac surgery group (adjusted OR = 1.69, 95%CI:1.39-2.06,
p < 0.001) <br/>Conclusion(s): Preoperative proteinuria is an independent
risk factor for postoperative AKI and in instances when proteinuria is
detected using dipsticks.<br/>Copyright &#xa9; 2021 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<18>
Accession Number
2013072110
Title
Asian pacific society of cardiology consensus recommendations on the use
of mitraclip for mitral regurgitation.
Source
European Cardiology Review. 16 (no pagination), 2021. Article Number: e25.
Date of Publication: 2021.
Author
Yeo K.K.; Tan J.W.C.; Muller D.W.M.; Walters D.L.; Lindenfeld J.; Lee
M.K.Y.; Chui A.S.F.; Satish S.; Santoso T.; Kubo S.; Meng J.C.K.; Sin
K.Y.K.; Ewe S.H.; Sim D.; Tay E.; Meemook K.; Sung S.-H.; Nguyen Q.N.; Pan
X.; Amaki M.; Izumo M.; Hayashida K.; Kim J.S.; Kang D.-Y.; Stone G.;
Matsumoto T.
Institution
(Yeo, Tan, Sin, Ewe, Sim) National Heart Centre, Singapore, Singapore
(Muller) St. Vincent's Hospital, Sydney, Australia
(Walters) St. Vincent's Private Hospital Northside, Chermside, Australia
(Lindenfeld) Vanderbilt University Medical Center, Nashville, TN, United
States
(Lee, Chui) Queen Elizabeth Hospital, Hong Kong, Hong Kong
(Satish) Apollo Hospitals, Chennai, India
(Santoso) Medistra Hospital, Jakarta, Indonesia
(Kubo) Kurashiki Central Hospital, Kurashiki, Japan
(Meng) CVSKL Hospital, Kuala Lumpur, Malaysia
(Tay) National University Heart Centre, Singapore, Singapore
(Meemook) Ramathibodi Hospital Mahidol University, Bangkok, Thailand
(Sung) Taipei Veterans General Hospital, Taipei, Taiwan (Republic of
China)
(Nguyen) Department of Cardiology, Hanoi Medical University, Vietnam
National Heart Institute, Hanoi, Vietnam
(Pan) Fuwai Hospital CAMS, PUMC, National Center for Cardiovascular
Diseases, Beijing, China
(Amaki) National Cerebral and Cardiovascular Center, Suita, Japan
(Izumo) St Marianna University School of Medicine, Kawasaki, Japan
(Hayashida) Keio University School of Medicine, Tokyo, Japan
(Kim) Yonsei University, Seoul, South Korea
(Kang) Asan Medical Center, Seoul, South Korea
(Stone) Icahn School of Medicine at Mount Sinai, New York, United States
(Matsumoto) Sendai Kousei Hospital, Sendai, Japan
Publisher
Radcliffe Cardiology
Abstract
Transcatheter mitral valve repair with the MitraClip, a catheter-based
percutaneous edge-to-edge repair technique to correct mitral regurgitation
(MR), has been demonstrated in Western studies to be an effective and safe
MR treatment strategy. However, randomised clinical trial data on its use
in Asian-Pacific patients is limited. Hence, the Asian Pacific Society of
Cardiology convened an expert panel to review the available literature on
MitraClip and to develop consensus recommendations to guide clinicians in
the region. The panel developed statements on the use of MitraClip for the
management of degenerative MR, functional MR, and other less common
indications, such as acute MR, dynamic MR, hypertrophic obstructive
cardiomyopathy, and MR after failed surgical repair. Each statement was
voted on by each panel member and consensus was reached when 80% of
experts voted 'agree' or 'neutral'. This consensus-building process
resulted in 10 consensus recommendations to guide general cardiologists in
the evaluation and management of patients in whom MitraClip treatment is
being contemplated.<br/>Copyright &#xa9; 2021 Radcliffe Group Ltd. All
rights reserved.

<19>
Accession Number
2013168814
Title
Impact of Optimal Medical Therapy on 10-Year Mortality After Coronary
Revascularization.
Source
Journal of the American College of Cardiology. 78 (1) (pp 27-38), 2021.
Date of Publication: 06 Jul 2021.
Author
Kawashima H.; Serruys P.W.; Ono M.; Hara H.; O'Leary N.; Mack M.J.; Holmes
D.R.; Morice M.-C.; Head S.J.; Kappetein A.P.; Thuijs D.J.F.M.; Milojevic
M.; Noack T.; Mohr F.-W.; Davierwala P.M.; Sharif F.; McEvoy J.W.; Onuma
Y.
Institution
(Kawashima, Serruys, Ono, Hara, O'Leary, Sharif, McEvoy, Onuma) Department
of Cardiology, National University of Ireland, Galway, Galway, Ireland
(Kawashima, Ono, Hara) Department of Cardiology, Academic Medical Center,
University of Amsterdam, Amsterdam, Netherlands
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Mack) Department of Cardiothoracic Surgery, Baylor Scott and White
Health, Dallas, TX, United States
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Morice) Hopital Prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Head, Kappetein, Thuijs, Milojevic) Department of Cardiothoracic Surgery,
Erasmus University Medical Centre, Rotterdam, Netherlands
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Noack, Mohr, Davierwala) University Department of Cardiac Surgery, Heart
Centre Leipzig, Leipzig, Germany
Publisher
Elsevier Inc.
Abstract
Background: The benefit of optimal medical therapy (OMT) on 5-year
outcomes in patients with 3-vessel disease and/or left main disease after
percutaneous coronary intervention or coronary artery bypass grafting
(CABG) was demonstrated in the randomized SYNTAX (Synergy Between PCI With
Taxus and Cardiac Surgery) trial. <br/>Objective(s): The objective of this
analysis is to assess the impact of the status of OMT at 5 years on
10-year mortality after percutaneous coronary intervention or CABG.
<br/>Method(s): This is a subanalysis of the SYNTAXES (Synergy Between PCI
With Taxus and Cardiac Surgery Extended Survival) study, which evaluated
for up to 10 years the vital status of patients who were originally
enrolled in the SYNTAX trial. OMT was defined as the combination of 4
types of medications: at least 1 antiplatelet drug, statin,
angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, and
beta-blocker. After stratifying participants by the number of individual
OMT agents at 5 years and randomized treatment, a landmark analysis was
conducted to assess the association between treatment response and 10-year
mortality. <br/>Result(s): In 1,472 patients, patients on OMT at 5 years
had a significantly lower mortality at 10 years compared with those on <=2
types of medications (13.1% vs 19.9%; adjusted HR: 0.470; 95% CI:
0.292-0.757; P = 0.002) but had a mortality similar to those on 3 types of
medications. Furthermore, patients undergoing CABG with the individual OMT
agents, antiplatelet drug and statin, at 5 years had lower 10-year
mortality than those without. <br/>Conclusion(s): In patients with
3-vessel and/or left main disease undergoing percutaneous coronary
intervention or CABG, medication status at 5 years had a significant
impact on 10-year mortality. Patients on OMT with guideline-recommended
pharmacologic therapy at 5 years had a survival benefit. (Synergy Between
PCI With Taxus and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES];
NCT03417050; Taxus Drug-Eluting Stent Versus Coronary Artery Bypass
Surgery for the Treatment of Narrowed Arteries [SYNTAX];
NCT00114972)<br/>Copyright &#xa9; 2021 American College of Cardiology
Foundation

<20>
Accession Number
2013160678
Title
Distal transradial access for post-CABG coronary and surgical grafts
angiography and interventions.
Source
Indian Heart Journal. (no pagination), 2021. Date of Publication: 2021.
Author
Oliveira M.D.P.; Navarro E.C.; Caixeta A.
Institution
(Oliveira, Caixeta) Department of Interventional Cardiology, Hospital Sao
Paulo, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao
Paulo, SP, Brazil
(Oliveira, Navarro) Department of Interventional Cardiology, Hospital
Regional Do Vale Do Paraiba, Taubate, Sao Paulo, Brazil
Publisher
Elsevier B.V.
Abstract
Background: Post-CABG coronary and grafts angiography (CGAG) and
interventions (PCI) have historically been performed via classic
transfemoral approach. Particularly for those with left internal mammary
artery (LIMA) grafts, left standard transradial access (lsTRA) represents
a feasible alternative, with significant fewer vascular complications, but
it has ergonomic disadvantage for the operator because of the need to bend
over the patients, especially in obese ones. Distal transradial access
(dTRA) may provide important advantages, including shorter hemostasis and
greater patient and operator comfort, mainly for left dTRA (ldTRA). We aim
to describe the feasibility and safety of right and left dTRA for
post-CABG CGAG and PCI. <br/>Material(s) and Method(s): From February 2019
to April 2021, 111 consecutive post-CABG patients submitted to CGAG and/or
PCI via dTRA have been enrolled. <br/>Result(s): Mean patient age was 67.6
years old. Most were male (88.3%) and had chronic coronary syndromes
(61.3%). Overall, 35.1% had acute coronary syndromes. Distal RA was
successfully punctured in all 111 patients, always without ultrasound
guidance. All procedures involving LIMA grafts were done via ipsilateral
ldTRA. We had only 5 (4.5%) access site crossovers. Successful dTRA sheath
insertion was then achieved in 95.5% of all patients, mostly (74.8%) via
ldTRA and with standard 6Fr sheath (99.1%). Distal and proximal RA pulses
were palpable in all patients at hospital discharge. No major adverse
cardiac and cerebrovascular events and no major complications related to
dTRA were recorded. <br/>Conclusion(s): dTRA for routine post-CABG CGAG
and PCI by experienced transradial operators appears to be feasible.
Further randomized and larger trials are needed to assure clinical
benefits and safety of this new technique.<br/>Copyright &#xa9; 2021

<21>
Accession Number
635341889
Title
Interleukin-6 Is an Early Plasma Marker of Severe Postoperative
Complications in Thoracic Surgery: Exploratory Results From a Substudy of
a Randomized Controlled Multicenter Trial.
Source
Anesthesia and analgesia. (no pagination), 2021. Date of Publication: 16
Jun 2021.
Author
Neff T.A.; Braun J.; Rana D.; Puhan M.; Filipovic M.; Seeberger M.; Stuber
F.; Neff S.B.; Beck-Schimmer B.; Schlapfer M.
Institution
(Neff, Neff) From the Department of Anesthesiology, Cantonal Hospital
Muensterlingen, Muensterlingen, Switzerland
(Braun, Puhan) Epidemiology, Biostatistics and Prevention Institute,
University Zurich, Zurich, Switzerland
(Rana, Beck-Schimmer, Schlapfer) Institute of Anesthesiology, University
Hospital Zurich, Zurich, Switzerland
(Filipovic) Department of Anesthesiology, Cantonal Hospital St. Gallen,
St. Gallen, Switzerland
(Seeberger) Department of Anesthesiology, University Hospital Basel,
Basel, Switzerland
(Stuber) Department of Anesthesiology, University Hospital Bern, Bern,
Switzerland
(Beck-Schimmer, Schlapfer) Institute of Physiology, University Zurich,
Zurich, Switzerland
(Beck-Schimmer) Department of Anesthesiology, University of Illinois at
Chicago, Chicago, IL, Mexico
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative complications in surgery are a significant
burden, not only for the patients but also economically. While several
predicting factors have already been identified, it is still not well
known if increased levels of inflammatory markers in the immediate
perioperative phase correlate with a higher incidence of postoperative
complications. This study aimed to evaluate which patient characteristics
and intraoperative parameters correlate with increased plasma values of
monocyte chemoattractant protein 1 (MCP-1) and interleukin 6 (IL-6) of
thoracic surgery patients. A second goal was to explore whether MCP-1 and
IL-6 are associated with the incidence of postoperative complications. We
hypothesized that there is a positive association between inflammatory
markers and the occurrence of complications within 6 months after surgery.
<br/>METHOD(S): This is a substudy of a recent randomized controlled
trial, which defined the effect of desflurane versus propofol anesthesia
on morbidity and mortality in patients undergoing thoracic surgery. MCP-1
and IL-6 were determined in plasma obtained before and 30 minutes after
1-lung ventilation, 6 hours after surgery, and on postoperative days 1 and
2. Complications were recorded for 6 months. Mixed linear models were used
to examine factors associated with MCP-1 and IL-6 levels. Logistic
regression models and receiver operating characteristic curves were used
to determine the association between MCP-1 and IL-6 and postoperative
complications. <br/>RESULT(S): In the original study, 460 patients were
included, MCP-1 and IL-6 levels were determined in 428 patients. MCP-1 was
positively associated with the duration of surgery (P = .016), whereas
IL-6 levels increased with both the length (P < .001) and invasiveness of
lung surgery (thoracoscopic wedge resection or lobectomy versus open
lobectomy, P = .005; thoracoscopic wedge resection or lobectomy versus
pneumonectomy, P = .021). In an exploratory approach, elevated IL-6 plasma
peaks were associated with the occurrence of severe complications defined
as Clavien-Dindo score grade >=IVa during the postoperative phase up to 6
months after thoracic surgery (P = .006). <br/>CONCLUSION(S): In summary,
this substudy reveals factors, which correlate with high MCP-1 and IL-6
values. Moreover, higher IL-6 seems to be associated with postoperative
severe complications. Perioperative IL-6 monitoring might be helpful for
risk estimation in the perioperative setting of patients after lung
surgery.<br/>Copyright &#xa9; 2021 International Anesthesia Research
Society.

<22>
Accession Number
635340678
Title
Skeletonized vs Pedicled Internal Mammary Artery Graft Harvesting in
Coronary Artery Bypass Surgery: A Post Hoc Analysis From the COMPASS
Trial.
Source
JAMA cardiology. (no pagination), 2021. Date of Publication: 16 Jun 2021.
Author
Lamy A.; Browne A.; Sheth T.; Zheng Z.; Dagenais F.; Noiseux N.; Chen X.;
Bakeen F.G.; Brtko M.; Stevens L.-M.; Alboom M.; Lee S.F.; Copland I.;
Salim Y.; Eikelboom J.
Institution
(Lamy, Browne, Sheth, Lee, Copland, Salim, Eikelboom) Population Health
Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
(Lamy, Alboom) Department of Surgery, McMaster University, Hamilton,
Ontario, Canada
(Lamy, Lee, Salim) Department of Health Research Methods, Evidence, and
Impact, McMaster University, Hamilton, Ontario, Canada
(Sheth, Salim, Eikelboom) Department of Medicine, McMaster University,
Hamilton, Ontario, Canada
(Zheng) Department of Cardiovascular Surgery, Fuwai Hospital, Beijing,
China
(Dagenais) Department of Cardiac Surgery, Quebec Heart and Lung Institute
affiliated with Laval University, Quebec City, QC, Canada
(Noiseux, Stevens) Department of Cardiac Surgery, Centre Hospitalier de
l'Universite de Montreal, Montreal, QC, Canada
(Chen) Department of Thoracic and Cardiovascular Surgery, Nanjing First
Hospital affiliated with Nanjing Medical University, Nanjing, China
(Bakeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Brtko) Department of Cardiac Surgery, Fakultni Nemocnice Hradec Kralove,
Hradec Kralove, Kralovehradecky, Czechia
Publisher
NLM (Medline)
Abstract
Importance: The relative safety and patency of skeletonized vs pedicled
internal mammary artery grafts in patients undergoing coronary artery
bypass graft (CABG) surgery are unknown. <br/>Objective(s): To investigate
the association of skeletonized vs pedicled harvesting with internal
mammary artery graft patency and clinical outcomes 1 year after CABG
surgery. <br/>Design, Setting, and Participant(s): This study was a post
hoc analysis of the multicenter, randomized, double-blind,
placebo-controlled Cardiovascular Outcomes for People Using
Anticoagulation Strategies (COMPASS) clinical trial, which enrolled 27 395
patients from 602 centers in 33 countries from March 2013 through May
2016. Eligibility criteria for the trial included CABG surgery for
coronary artery disease with at least 2 grafts implanted and an estimated
glomerular filtration rate of at least 30 mL/min. A total of 1002 of 1448
patients were randomized to the CABG arm of the COMPASS trial and
underwent skeletonized (282 [28.1%]) or pedicled (720 [71.9%]) internal
mammary artery harvesting. The patients had evaluable angiography results
1 year after surgery. Data were analyzed from October 11, 2019, to May 14,
2020. <br/>Intervention(s): Patients underwent graft harvesting with
either the pedicled technique or skeletonized technique. <br/>Main
Outcomes and Measures: The primary outcome was graft occlusion 1 year
after CABG surgery, as assessed by computed tomography angiography.
<br/>Result(s): A total of 1002 patients underwent skeletonized (282
[28.1%]; mean [SD] age, 65.9 [8.1] years; 229 men [81.2%]; 194 White
patients [68.8%]) or pedicled (720 [71.9%]; mean [SD] age, 64.8 [7.6]
years; 603 men [83.8%]; 455 White patients [63.2%]) internal mammary
artery harvesting. Rates of internal mammary artery graft occlusion 1 year
after CABG surgery were higher in the skeletonized group than in the
pedicled group (33 of 344 [9.6%] vs 30 of 764 [3.9%]; graft-level adjusted
odds ratio, 2.41; 95% CI, 1.39-4.20; P=.002), including the left internal
mammary artery to left anterior descending artery (21 of 289 [7.3%] vs 25
of 725 [3.4%]; graft-level adjusted odds ratio, 2.10; 95% CI, 1.14-3.88,
P=.02). After a mean follow-up of 23 months, skeletonized graft harvesting
was also associated with a higher rate of major adverse cardiovascular
events (20 [7.1%] vs 15 [2.1%]; adjusted hazard ratio, 3.19; 95% CI,
1.53-6.67; P=.002) and repeated revascularization (14 [5.0%] vs 10 [1.4%];
adjusted hazard ratio, 2.75; 95% CI, 1.10-6.88; P=.03). <br/>Conclusions
and Relevance: This post hoc analysis of the COMPASS randomized clinical
trial found that harvesting of the internal mammary artery during CABG
surgery using a skeletonized technique was associated with a higher rate
of graft occlusion and worse clinical outcomes than the traditional
pedicled technique. Future randomized clinical trials are needed to
establish the safety and patency of the skeletonized technique. Trial
Registration: ClinicalTrials.gov Identifier: NCT01776424.

<23>
Accession Number
635339237
Title
"Mitral valve replacement: time for a patient-level meta-analysis?".
Source
The Annals of thoracic surgery. (no pagination), 2021. Date of
Publication: 12 Jun 2021.
Author
Deutsch C.; Bramlage K.; Bramlage P.
Institution
(Deutsch, Bramlage, Bramlage) Institute for Pharmacology and Preventive
Medicine Menzelstrasse 21 Mahlow, Cloppenburg 15831, Germany
Publisher
NLM (Medline)

<24>
Accession Number
635339071
Title
Utilization, Costs, and Outcomes of Conscious Sedation Versus General
Anesthesia for Transcatheter Aortic Valve Replacement.
Source
Circulation. Cardiovascular interventions. (pp
CIRCINTERVENTIONS120010310), 2021. Date of Publication: 16 Jun 2021.
Author
Herrmann H.C.; Cohen D.J.; Hahn R.T.; Babaliaros V.C.; Yu X.; Makkar R.;
McCabe J.; Szerlip M.; Kapadia S.; Russo M.; Malaisrie S.C.; Webb J.G.;
Szeto W.Y.; Kodali S.; Thourani V.H.; Mack M.J.; Leon M.B.
Institution
(Herrmann, Szeto) Perelman School of Medicine of the University of
Pennsylvania, Philadelphia, United States
(Cohen) Cardiovascular Research Foundation, NY
(Hahn, Kodali, Leon) Columbia University Medical Center, S. Kodali, NY
(Babaliaros) Emory University, Atlanta, United States
(Yu) Edwards Lifesciences, Inc, Irvine
(Makkar) Cedars-Sinai Medical Center, Los Angeles, Mexico
(McCabe) University of Washington, Seattle, United States
(Szerlip, Mack) Baylor Scott and White Health, Plano, United States
(Kapadia) Cleveland Clinic, Cleveland, United States
(Russo) Rutgers-Robert Wood Johnson Medical School, NB
(Malaisrie) Northwestern University Hospital, Chicago, Mexico
(Webb) St. Paul's Hospital, Vancouver BC
(Thourani) Piedmont Heart Institute, Atlanta, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The potential advantages for conscious sedation (CS) as
compared to general anesthesia (GA) have not been evaluated in studies
with core laboratory echocardiographic assessments and monitored end
points. We compared CS versus GA for SAPIEN 3 transcatheter aortic valve
replacement in patients at intermediate- and low-surgical risk.
<br/>METHOD(S): This analysis included patients in the PARTNER 2
(Placement of Aortic Transcatheter Valve Trial) intermediate-risk registry
and the PARTNER 3 randomized low-risk study. CS was compared to GA with
respect to death, stroke, bleeding, paravalvular regurgitation, length of
stay, and costs. Outcomes were assessed by a core echocardiographic
laboratory, and clinical events were independently adjudicated.
<br/>RESULT(S): Baseline characteristics were similar between the CS and
GA groups. Postprocedure hospital length of stay was significantly shorter
for CS versus GA both in intermediate-risk patients (4.4+/-0.2 and
5.2+/-0.2 days, respectively, P<0.01) and low-risk patients (2.7+/-0.1 and
3.4+/-0.2 days, respectively, P<0.001). There were no significant
differences between CA and GA patients in either the 30-day or 1-year
rates of death, stroke, rehospitalization, or paravalvular aortic
regurgitation >=moderate. In the intermediate-risk cohort, adjusted 30-day
health care costs were $3833 lower per patient in the CS group.
<br/>CONCLUSION(S): The selective use of CS is associated with shorter
procedure times, shorter intensive care unit and hospital length of stay,
lower costs, and no difference in clinical outcomes to 1 year, including
>=moderate paravalvular regurgitation. Our data demonstrate similar safety
profiles with both approaches and support the continued use of CS for most
patients undergoing the procedure. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifiers: NCT03222128 and
NCT02675114.

<25>
[Use Link to view the full text]
Accession Number
2007165306
Title
Can colchicine prevent acute myocardial infarction? Systematic review and
meta-analysis.
Source
Revista Argentina de Cardiologia. 89 (1) (pp 42-49), 2021. Date of
Publication: 2021.
Author
Masson W.; Lobo M.; Lavalle-Cobo A.; Molinero G.
Institution
(Masson) Tte Gral Peron 4190, Ciudad Autonoma de Buenos Aires C1199AB,
Argentina
(Masson, Lobo, Lavalle-Cobo, Molinero) Council on Epidemiology and
Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980,
Buenos Aires C1115AAD, Argentina
(Masson, Lobo, Lavalle-Cobo) Department of Cardiology, Hospital Italiano
de Buenos Aires, Tte. Gral. Juan Domingo Peron 4190, Buenos Aires
(C1199ABB), Argentina
(Lobo, Lavalle-Cobo) Department of Cardiology, Hospital Militar Campo de
Mayo, Tte. Gral. Ricchieri S/N, Buenos Aires (B1659AMA), Argentina
(Lavalle-Cobo) Department of Cardiology, Sanatorio Finochietto, Av.
Cordoba 2678, Buenos Aires (C1187AAN), Argentina
Publisher
Sociedad Argentina de Cardiologia
Abstract
Objective: The association between the use of colchicine and the incidence
of acute myocardial infarction (AMI) is inconsistent. The main objective
of this study was to evaluate the effect of colchicine on the incidence of
AMI. Assessment of the incidence of stroke and cardiovascular mortality
were secondary endpoints. <br/>Method(s): A meta-analysis of randomized
studies that evaluated the use of colchicine in patients with
atherosclerotic disease and reported cardiovascular events was performed,
after searching the PubMed/MEDLINE, Embase, Scielo and Cochrane Controlled
Trials databases. A fixed or random effects model were used depending on
the heterogeneity observed. <br/>Result(s): Seven studies were selected
for the analysis of the primary end point (5966 subjects in the colchicine
arm and 5948 patients in the control arm). This meta-analysis demonstrated
that colchicine therapy was associated with a lower risk of AMI (OR: 0.76,
95% CI: 0.62-0.92; I² = 15%). Likewise, a significant reduction
in the incidence of stroke was observed without a significant effect on
cardiovascular mortality with pharmacological intervention.
<br/>Conclusion(s): The use of colchicine in patients with atherosclerotic
cardiovascular disease was associated with a significant reduction in the
incidence of AMI. The incorporation of colchicine into the therapeutic
arsenal of cardiovascular disease should be considered by future clinical
practice guidelines.<br/>Copyright &#xa9; 2021, Sociedad Argentina de
Cardiologia. All rights reserved.

<26>
Accession Number
2003777031
Title
Aortic involvement in relapsing polychondritis: case-based review.
Source
Rheumatology International. 41 (4) (pp 827-837), 2021. Date of
Publication: April 2021.
Author
Erdogan M.; Esatoglu S.N.; Hatemi G.; Hamuryudan V.
Institution
(Erdogan, Esatoglu, Hatemi, Hamuryudan) Division of Rheumatology,
Department of Internal Medicine, Cerrahpasa Medical School, Istanbul
University - Cerrahpasa, Cerrahpasa, Istanbul 34998, Turkey
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Relapsing polychondritis is a systemic inflammatory disease that mainly
affects ears, nose, eyes, joints, and large airway. Relapsing
polychondritis may also affect cardiac valves and large vessels with the
aorta being most frequently involved. We conducted a systematic literature
review to delineate the clinical characteristics, treatment, and outcome
of relapsing polychondritis patients with aortic involvement including
thoracic and abdominal aorta, aortic valve, and coronary arteries. 113
patients reported in 85 manuscripts were retrieved through the systematic
literature search and references of the selected manuscripts. With the
addition of a patient from our center, a total of 114 patients were
included in the analyses. Aortic vessel involvement was the predominant
type of involvement that was identified in 93 (82%) patients, while aortic
valve involvement was identified in 41 patients (36%). The median age at
aortic involvement was 37 years [IQR: 30-53] with a delay of 5 years [IQR:
1-8] between first relapsing polychondritis symptom and aortic
involvement. Nineteen percent of the patients were asymptomatic at the
time of aortic involvement diagnosis. The initial treatment was
immunosuppressives in 41 patients (56%) and surgery in 28 patients (38%).
The mortality ratio was 27% in a 24 month follow-up [IQR: 7.5-54 months].
Aortic dissection or rupture was the most frequent causes of mortality.
Concomitant coronary artery involvement suggested a worse outcome. Aortic
involvement in relapsing polychondritis is a mortal complication despite
medical and surgical treatments. It may be asymptomatic in 19% of the
patients which warrants the importance of screening.<br/>Copyright &#xa9;
2019, Springer-Verlag GmbH Germany, part of Springer Nature.

<27>
Accession Number
634801297
Title
The Unique Immunomodulatory Properties of MSC-Derived Exosomes in Organ
Transplantation.
Source
Frontiers in Immunology. 12 (no pagination), 2021. Article Number: 659621.
Date of Publication: 06 Apr 2021.
Author
Zheng Q.; Zhang S.; Guo W.-Z.; Li X.-K.
Institution
(Zheng, Zhang, Guo, Li) Department of Hepatobiliary and Pancreatic
Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou,
China
(Li) Division of Transplantation Immunology, National Research Institute
for Child Health and Development, Tokyo, Japan
Publisher
Frontiers Media S.A.
Abstract
Methods for suppressing the host immune system over the long term and
improving transplantation tolerance remain a primary issue in organ
transplantation. Cell therapy is an emerging therapeutic strategy for
immunomodulation after transplantation. Mesenchymal stem cells (MSCs) are
adult multipotent stem cells with wide differentiation potential and
immunosuppressive properties, which are mostly used in regenerative
medicine and immunomodulation. In addition, emerging research suggests
that MSC-derived exosomes have the same therapeutic effects as MSCs in
many diseases, while avoiding many of the risks associated with cell
transplantation. Their unique immunomodulatory properties are particularly
important in the immune system-overactive graft environment. In this
paper, we review the effects of MSC-derived exosomes in the immune
regulation mechanism after organ transplantation and graft-versus-host
disease (GvHD) from various perspectives, including immunosuppression,
influencing factors, anti-inflammatory properties, mediation of tissue
repair and regeneration, and the induction of immune tolerance. At
present, the great potential of MSC-derived exosomes in immunotherapy has
attracted a great deal of attention. Furthermore, we discuss the latest
insights on MSC-derived exosomes in organ transplantation and GvHD,
especially its commercial production concepts, which aim to provide new
strategies for improving the prognosis of organ transplantation
patients.<br/>&#xa9; Copyright &#xa9; 2021 Zheng, Zhang, Guo and Li.

<28>
Accession Number
2010881399
Title
Catheter-based treatment of the dissected ascending aorta: A systematic
review.
Source
European Journal of Cardio-thoracic Surgery. 59 (1) (pp 80-91), 2021. Date
of Publication: 01 Jan 2021.
Author
Wang C.; Von Segesser L.K.; Maisano F.; Ferrari E.
Institution
(Wang) Department of Cardiovascular Surgery, Jinling Hospital, Nanjing
University, School Medicine, Nanjing, China
(Von Segesser) Department of Surgery and Anesthesiology, Cardiovascular
Research Unit, University Hospital of Lausanne, Lausanne, Switzerland
(Maisano, Ferrari) Department of Cardiovascular Surgery, University
Hospital of Zurich, Zurich, Switzerland
(Ferrari) Department of Cardiac Surgery, Cardiocentro Ticino Foundation,
Lugano, Switzerland
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: Type A aortic dissection requires immediate surgical repair.
Despite improvements in surgery and anaesthesia, there is still a
considerable risk when high-risk patients are concerned. Less invasive
endovascular treatments are under evaluation. We investigated the current
status of catheter-based treatment for type A aortic dissection with the
entry tear located in the ascending aorta. <br/>Method(s): A PubMed search
was supplemented by searching through bibliographies and key articles.
Demographics, risk score, stent graft detail, access route, mortality,
cause of death, complications, reinterventions and follow-up data were
extracted and analysed. <br/>Result(s): Thirty-one articles (7
retrospective reports; 24 case reports/series) were included in the study.
In total, 104 patients (mean age 71 +/- 14 years) received endovascular
treatment for acute (63) or chronic (41) type A dissection. A history of a
major cardiac or aortic operation was present in 29 patients. The mean
EuroSCORE II was 30 +/- 20 in 4 reports. A total of 114 stent grafts were
Implanted: 'off-the-shelf', 65/114; custom made, 12/114; and modified,
7/114. Hospital complications included intraprocedural conversion to open
surgery (2/104), stroke (2/104), coronary stenting (2/104), early endoleak
(9/104) and repeat aortic endovascular treatment for endoleak (5/104).
Hospital mortality was 10% (intraoperative death 2/104). Mean duration of
follow-up time was 21 +/- 21 months (range 1-81 months); follow-up data
were available for 86 patients: 10 patients died of non-aortic-related
causes; reintervention for aortic disease (endovascular repair or open
surgery) was performed in 8 patients. <br/>Conclusion(s): Catheter-based
ascending aorta repair for type A aortic dissection with the entry tear in
the ascending aorta can be considered in carefully selected high-risk
patients. Further analysis and specifically designed devices are
required.<br/>Copyright &#xa9; 2020 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<29>
Accession Number
2013009990
Title
Effect of once-weekly exenatide on hospitalization for acute coronary
syndrome or coronary revascularization in patients with type 2 diabetes
mellitus.
Source
American Heart Journal. 239 (pp 59-63), 2021. Date of Publication:
September 2021.
Author
Barbery C.E.; Giczewska A.; White J.; Lokhnygina Y.; Mentz R.J.; Holman
R.R.; Pagidipati N.; Hernandez A.F.; Jones W.S.
Institution
(Barbery, Mentz, Pagidipati, Hernandez, Jones) Division of Cardiology,
Department of Medicine, Duke University School of Medicine, Durham, NC,
United States
(Giczewska, White, Lokhnygina, Mentz, Pagidipati, Hernandez, Jones) Duke
Clinical Research Institute, Duke University School of Medicine, Durham,
NC, United States
(Holman) Diabetes Trials Unit, Radcliffe Department of Medicine,
University of Oxford, Oxford, United Kingdom
Publisher
Mosby Inc.
Abstract
Cardiovascular (CV) outcome studies of glucagon-like peptide-1 receptor
agonists (GLP-1 RAs) have shifted the paradigm of type 2 diabetes
management given their benefits regarding a reduction in major adverse CV
events. However, the relationship between GLP-1 RAs and coronary
revascularization remains poorly understood. In this EXSCEL post-hoc
analysis, we used univariate Cox proportional models and Kaplan Meier
survival analysis to evaluate the effect of once-weekly exenatide (EQW) on
a composite outcome of hospitalization for acute coronary syndrome (ACS)
or coronary revascularization. Similar models were utilized to evaluate
the relationship between significant participant characteristics within
the entire study population and the composite outcome. Of the 14,736
participants in EXSCEL with complete follow-up data, 1642 (11.1%)
experienced an ACS or coronary revascularization event during a median
follow-up of 3.3 years (interquartile range, 2.3-4.4). EQW had no effect
on hospitalization for ACS or coronary revascularization (HR 1.00, 95% CI
0.91-1.10). Among EXSCEL participants, enrollment in Latin America (HR
0.51, 95% CI 0.43-0.60) and a history of peripheral artery disease (HR
0.79, 95% CI 0.70-0.90) were associated with a reduced risk for coronary
revascularization, whereas enrollment in North America (HR 1.92, 95% CI
1.74-2.12), a history of CV disease (HR 3.24, 95% CI 2.78-3.78), and a
previous myocardial infarction (HR 1.54, 95% CI 1.39-1.71) were associated
with increased risk for study end points. EQW had no association with
hospitalization for ACS or coronary revascularization. Participant
enrollment location and CV disease burden may play a role in the variable
CV efficacy of GLP-1 RAs that has been observed in trials thus
far.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<30>
Accession Number
2012992886
Title
Oncological outcomes of unsuspected pN2 in patients with non-small-cell
lung cancer: A systematic review and meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 32 (5) (pp 727-736),
2021. Date of Publication: 01 May 2021.
Author
Ijsseldijk M.A.; ten Broek R.P.G.; Wiering B.; Hekma E.; de Roos M.A.J.
Institution
(Ijsseldijk, ten Broek) Division of Surgery, Radboud University Medical
Center, Nijmegen, Netherlands
(Ijsseldijk, ten Broek, Wiering) Division of Surgery, Slingeland
Ziekenhuis, Doetinchem, Netherlands
(Hekma, de Roos) Division of Surgery, Rijnstate Hospital, Arnhem,
Netherlands
Publisher
Oxford University Press
Abstract
OBJECTIVES: Optimal treatment of stage IIIA (N2) non-small-cell lung
cancer (NSCLC) is controversial. Guidelines advise induction therapy
before surgical resection. A proportion of patients with cN0 NSCLC are
postoperatively upstaged due to unsuspected N2 disease. Survival of
unsuspected N2 NSCLC treated with surgery varies and technical feasibility
of video-assisted thoracic surgery (VATS) is unknown. The purpose of this
study was to assess prevalence and survival of unsuspected N2 NSCLC
treated with thoracotomy or VATS. <br/>METHOD(S): A systematic review and
meta-analysis was performed of all available literatures through Pubmed,
Cochrane, EMBASE, Web of Science, Trials registries and System for
Information on Grey Literature (SIGLE) from 2000 to 2019. Outcomes of
interest were prevalence, overall survival (OS) and disease-free survival
of unsuspected N2 NSCLC. Secondary outcomes were number of harvested lymph
nodes, postoperative complications and survival of unsuspected N2 NSCLC
treated with VATS. <br/>RESULT(S): Seventeen studies with patients with
clinical stage N0-1 and unsuspected pN2 NSCLC were included. Prevalence of
unsuspected pN2 was 8.6%. Three- and 5-year OS was 58% [95% confidence
interval (CI) 37-78%) (N = 4337] and 35% (95% CI 28-43%) (N = 4337).
Three- and 5-y ear disease-free survival was 48% (95% CI 30-66%) (N = 109)
and 35% (95% CI 24-46%) (N = 517). VATS resulted in a low complication
rate with similar 5-year OS as thoracotomy. <br/>CONCLUSION(S): In
patients with cN0-1 NSCLC, a minority has unsuspected pN2 NSCLC. Even for
these patients, 5-year OS and disease-free survival are reasonable. VATS
with adequate lymph node dissection is the treatment of choice when in
experienced hands. Adjuvant therapy should be provided in absence of
relevant comorbidity.<br/>Copyright &#xa9; The Author(s) 2021. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<31>
Accession Number
2012992879
Title
Modified ultrafiltration reduces postoperative blood loss and transfusions
in adult cardiac surgery: A meta-analysis of randomized controlled trials.
Source
Interactive Cardiovascular and Thoracic Surgery. 32 (5) (pp 671-682),
2021. Date of Publication: 01 May 2021.
Author
Low Z.K.; Gao F.; Sin K.Y.K.; Yap K.H.
Institution
(Low, Yap) Department of Cardiothoracic Surgery, KK Women's and Children's
Hospital, Singapore, Singapore
(Gao) Department of Biostatistics, National Heart Centre Singapore,
Singapore, Singapore
(Gao) Duke-NUS Medical School, Singapore, Singapore
(Sin, Yap) Department of Cardiothoracic Surgery, National Heart Centre
Singapore, Singapore, Singapore
Publisher
Oxford University Press
Abstract
OBJECTIVES: Cardiopulmonary bypass in cardiac surgery has been associated
with several deleterious effects including haemodilution and systemic
inflammation. Modified ultrafiltration (MUF) has been well established in
paediatric cardiac surgery in counteracting postperfusion syndrome.
However, MUF is less commonly used in adult cardiac surgery. In this
meta-analysis, we compared clinical outcomes in adult patients who
underwent cardiopulmonary bypass with and without MUF. <br/>METHOD(S):
Electronic searches were performed using Pubmed, Ovid Medline, EMBASE and
the Cochrane Library until April 2020. Selection criteria were randomized
studies of adult cardiac surgery patients comparing MUF versus no MUF.
Primary outcomes were postoperative mortality, haematocrit, blood
transfusion, chest tube drainage, duration of intensive care unit (ICU)
stay and duration of mechanical ventilation. <br/>RESULT(S): Thirteen
randomized controlled trials were included, comprising 626 patients in the
MUF group, and 610 patients in the control (no-MUF) group. There was a
significantly improved postoperative haematocrit [mean difference 2.70,
95% confidence interval (CI) 0.68-4.73, P = 0.009], lower chest tube
drainage (mean difference -105 ml, 95% CI -202 to -7 ml, P = 0.032), lower
postoperative blood transfusion rate (mean difference -0.73 units, 95% CI
-0.98 to -0.47 units, P < 0.0001) and shorter duration of ICU stay (mean
difference -0.13 days, 95% CI -0.27 to -0.00 days, P = 0.048) in the MUF
group. There was no difference in ventilation time (mean difference -0.47
h, 95% CI -2.05 to 1.12 h, P = 0.56) or mortality rates (odds ratio 0.62,
95% CI 0.28-1.33, P = 0.22). There were no reported complications
associated with MUF. <br/>CONCLUSION(S): MUF is a safe and feasible option
in adult cardiac patients, with significant benefits including improved
postoperative haematocrit, as well as reduced postoperative chest tube
bleeding, transfusion requirements and duration of ICU stay.<br/>Copyright
&#xa9; The Author(s) 2021. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<32>
Accession Number
2011046958
Title
Lung recruitment in the prone position after cardiac surgery: a randomised
controlled study.
Source
British Journal of Anaesthesia. 126 (5) (pp 1067-1074), 2021. Date of
Publication: May 2021.
Author
Martinsson A.; Houltz E.; Wallinder A.; Lindgren S.; Thoren A.
Institution
(Martinsson, Houltz, Lindgren, Thoren) Department of Anaesthesiology and
Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Wallinder) Department of Cardiothoracic Surgery, Sahlgrenska Academy,
University of Gothenburg, Sahlgrenska University Hospital, Gothenburg,
Sweden
Publisher
Elsevier Ltd
Abstract
Background: Atelectasis after cardiac surgery is common and promotes
ventilation/perfusion mismatch, infection, and delayed discharge from
critical care. Recruitment manoeuvres are often performed to reduce
atelectasis. In severe respiratory failure, recruitment manoeuvres in the
prone position may increase oxygenation, survival, or both. We compared
the effects of recruitment manoeuvres in the prone vs supine position on
lung aeration and oxygenation in cardiac surgical patients.
<br/>Method(s): Subjects were randomised to recruitment manoeuvres (40 cm
H<inf>2</inf>O peak inspiratory pressure and 20 cm H<inf>2</inf>O PEEP for
30 s) in either the prone or supine position after uncomplicated cardiac
surgery. The co-primary endpoints were lung aeration (end-expiratory lung
volume measured by electrical impedance tomography (arbitrary units
[a.u.]) and lung oxygenation (ratio of arterial oxygen partial pressure to
fractional inspired oxygen [PaO<inf>2</inf>/FiO<inf>2</inf> ratio]).
Secondary outcomes included postoperative oxygen requirement and adverse
events. <br/>Result(s): Thirty subjects (27% female; age, 48-81 yr) were
recruited. Dorsal lung tidal volume was higher after prone recruitment
manoeuvres (363 a.u.; 95% confidence intervals [CI], 283-443; n=15) after
extubation, compared with supine recruitment manoeuvres (212 a.u.; 95% CI,
170-254; n=15; P<0.001). Prone recruitment manoeuvres increased dorsal
end-expiratory lung volume by 724 a.u. (95% CI, 456-992) after extubation,
compared with 163 a.u. decrease (95% CI, 73-252) after supine recruitment
manoeuvres (P<0.001). The PaO<inf>2</inf>/FiO<inf>2</inf> ratio after
extubation was higher after prone recruitment manoeuvres (46.6; 95% CI,
40.7-53.0) compared with supine recruitment manoeuvres (39.3; 95% CI,
34.8-43.8; P=0.04). Oxygen therapy after extubation was shorter after
prone (33 h [13]) vs supine recruitment manoeuvres (52 h [22]; P=0.01). No
adverse events occurred. <br/>Conclusion(s): Recruitment manoeuvres in the
prone position after cardiac surgery improve lung aeration and
oxygenation. Clinical trial registration: NCT03009331.<br/>Copyright
&#xa9; 2021 British Journal of Anaesthesia

<33>
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. <br/>Aim(s):
The objective of this manuscript was to comprehensively review and
critically examine the literature pertaining to cardiac surgery,
depression, and delirium. <br/>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. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<34>
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. <br/>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. <br/>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). <br/>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<br/>Copyright &#xa9; 2021, The Author(s).

<35>
Accession Number
2011521006
Title
The use of minimal fluoroscopy for cardiac electrophysiology procedures: A
meta-analysis and review of the literature.
Source
Clinical Cardiology. 44 (6) (pp 814-823), 2021. Date of Publication: June
2021.
Author
Chiang L.L.W.; Li C.; Hong K.L.; Hui W.S.; Beh S.Y.; Gong M.; Liu T.; Li
G.; Xia Y.; Ho J.; Roever L.; Duong S.; Huang G.; Tse G.; Baranchuk A.;
Glover B.M.
Institution
(Chiang) Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong
Kong
(Li, Tse) Department of Medicine and Therapeutics, Faculty of Medicine,
Chinese University of Hong Kong, Hong Kong
(Li, Tse) Li Ka Shing Institute of Health Sciences, Faculty of Medicine,
Chinese University of Hong Kong, Hong Kong
(Li, Hui, Beh) Faculty of Medicine, Newcastle University, Newcastle,
United Kingdom
(Hong, Duong, Huang, Glover) Division of Cardiology, University of
Toronto, Toronto, ON, Canada
(Gong, Liu, Li) Tianjin Key Laboratory of Ionic-Molecular Function of
Cardiovascular disease, Department of Cardiology, Tianjin Institute of
Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
(Xia) Department of Cardiology, First Affiliated Hospital of Dalian
Medical University, Dalian, China
(Ho) Department of Anaesthesia and Intensive care, Faculty of Medicine,
Chinese University of Hong Kong, Hong Kong
(Roever) Federal University of Uberlandia, Department of Clinical
Research, Uberlandia, Minas Gerais, Brazil
(Baranchuk) Division of Cardiology, Kingston General Hospital, Queen's
University, Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Conventional catheter ablation involves prolonged exposure to
ionizing radiation, potentially leading to detrimental health effects.
Minimal fluoroscopy (MF) represents a safer alternative, which should be
explored. Data on the safety and efficacy of this technique are limited.
Hypothesis: Our hypothesis is that MF is of equal efficacy and safety to
conventional catheter ablation with the use of fluoroscopy by performing a
meta-analysis of both randomized controlled trials (RCTs) and real-world
registry studies. <br/>Method(s): Pubmed and Embase were searched from
their inception to July 2020 for RCTs, cohort and observational studies
that assessed the outcomes of catheter ablation using a MF technique
versus the conventional approach. <br/>Result(s): Fifteen studies
involving 3795 patients were included in this meta-analysis. There was a
significant reduction in fluoroscopy and procedural time with no
difference in acute success (odds ratio [OR]:0.74, 95% CI: 0.50-1.10, p
=.14), long-term success (OR:0.92, 95% CI: 0.65-1.31, p =.38), arrhythmia
recurrence (OR:1.24, 95% CI: 0.75-2.06, p =.97) or rate of complications.
(OR:0.83, 95% CI: 0.46-1.48, p =.65). Additionally sub-group analysis for
those undergoing catheter ablation for atrial fibrillation (AF) did not
demonstrate a difference in success or complication rates (OR:0.86, 95%
CI: 0.30-2.42, p =.77). Multivariate meta-regression did not identify the
presence of moderator variables. <br/>Conclusion(s): This updated
meta-analysis demonstrated an overall reduction in procedural and
fluoroscopy time for those undergoing a minimal fluoroscopic approach.
There was no significant difference in either acute or chronic success
rates or complications between a MF approach and conventional approach for
the management of all arrhythmias including those undergoing catheter
ablation for AF.<br/>Copyright &#xa9; 2021 The Authors. Clinical
Cardiology published by Wiley Periodicals LLC.

<36>
Accession Number
2011184075
Title
A Rare Case of Diffuse Idiopathic Pulmonary Neuroendocrine Cell
Hyperplasia (DIPNECH) in a Filipino Woman: A Case Report and Review of
Literature.
Source
SN Comprehensive Clinical Medicine. 3 (7) (pp 1632-1636), 2021. Date of
Publication: July 2021.
Author
Montevirgen R.C.; Paz-Pacheco E.
Institution
(Montevirgen, Paz-Pacheco) Section of Endocrinology, Diabetes and
Metabolism, The Medical City Hospital, Pasig City, Philippines
Publisher
Springer Nature
Abstract
Diffuse idiopathic neuroendocrine cell hyperplasia (DIPNECH) is a rare
condition in which few case reports have been published describing the
disorder and its prognosis to date. DIPNECH is described as a diffuse
abnormal proliferation of neuroendocrine cells found in the lining of the
lower respiratory system. It typically occurs in non-smoking, middle-aged
women and is believed to occur spontaneously with no known precursor.
DIPNECH is considered to be a premalignant lesion that potentially
develops into a carcinoid tumor of the lungs. We present a case of a
66-year-old Filipino woman diagnosed with breast carcinoma with an
incidental finding of a round lung density in the right paravertebral
region (T10-11) seen on chest X-ray. Further imaging study using a chest
CT scan showed multiple non-calcified nodules in the right middle and both
lower lobes with no involvement of the airways were noted. She underwent
CT-guided biopsy of the dominant lung nodule and was noted to be positive
for synaptophysin, chromogranin, CD-56, and a Ki-67 of 1-3%, which is
consistent with a typical carcinoid tumor. Video-assisted thoracic surgery
(VATS) with wedge resection of the right and middle lobes was performed.
The background lung tissue on biopsy revealed neuroendocrine tumorlets
measuring 0.1 to 0.4 cm. After the multidisciplinary consultation, it was
agreed to preserve the remaining lung parenchyma with monitoring using a
chest CT scan, and pulmonary function test with diffusing lung capacity
for carbon monoxide (DLCO) every 6 months was advised. At present, the
patient remains asymptomatic. To our knowledge, there is no published case
of DIPNECH in the Filipino population and no available data on morbidity
and mortality, especially in the local setting. A multidisciplinary
approach to diagnosis and management is highly recommended. It has been
observed to have a slow progression; thus close monitoring and strict
follow-up should be advised. Currently, lung preservation is the goal of
management.<br/>Copyright &#xa9; 2021, The Author(s), under exclusive
licence to Springer Nature Switzerland AG.

<37>
[Use Link to view the full text]
Accession Number
635313996
Title
Association of smoking with postoperative atrial fibrillation in patients
with cardiac surgery: A PRISMA-compliant article.
Source
Medicine. 100 (23) (pp e26179), 2021. Date of Publication: 11 Jun 2021.
Author
Wan Q.; Li S.; Hu J.
Institution
(Wan, Hu) Jiangxi Provincial People's Hospital Affiliated to Nanchang
University, Nanchang of Jiangxi
(Li) Second Clinical Medical College of Nanchang University, Nanchang,
China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cigarette smoking is an important modifiable risk factor for
incident atrial fibrillation. However, the impact of smoking on
postoperative atrial fibrillation in patients undergoing cardiac surgery
remains controversial. We performed this meta-analysis to explore the
association of smoking with postoperative atrial fibrillation in patients
with cardiac surgery. <br/>METHOD(S): We systematically searched 2
computer-based databases (PubMed and EMBASE) up to July 2019 for all
relevant studies. A random-effects model was selected to pool the odds
ratios (ORs) and 95% confidence intervals (CIs). In this meta-analysis,
the protocol and reporting of the results were based on the Preferred
Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)
statement. <br/>RESULT(S): A total of 36 studies were included in this
meta-analysis. Overall, smoking was not associated with an increased risk
of postoperative atrial fibrillation in patients undergoing cardiac
surgery (odds ratio [OR] = 0.89; 95% confidence interval [CI] 0.79-1.02).
The corresponding results were stable in the subgroup analyses.
Specifically, smoking was not associated with an increased risk of
postoperative atrial fibrillation regardless of the type of cardiac
surgery: coronary artery bypass grafting (OR = 0.91; 95% CI 0.77-1.07),
valve surgery (OR = 0.15; 95% CI 0.01-1.56), and coronary artery bypass
grafting+valve surgery (OR = 0.91; 95% CI 0.70-1.18). <br/>CONCLUSION(S):
Based on currently published studies, smoking was not associated with an
increased risk of postoperative atrial fibrillation in patients undergoing
cardiac surgery.<br/>Copyright &#xa9; 2021 the Author(s). Published by
Wolters Kluwer Health, Inc.

<38>
Accession Number
634929808
Title
Antifibrinolytics reduces blood loss in thoracic surgery: a systematic
review and meta-analysis.
Source
ANZ journal of surgery. 91 (6) (pp 1251-1259), 2021. Date of Publication:
01 Jun 2021.
Author
Leow L.; Ng J.; Luo H.D.; Choong A.M.T.L.; Mithiran H.; Kofidis T.; Tam
J.K.C.
Institution
(Leow, Luo, Choong, Mithiran, Kofidis, Tam) Department of Cardiac,
Thoracic and Vascular Surgery, National University Heart Centre Singapore,
National University Hospital Singapore, Singapore
(Ng) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
(Choong, Tam) Department of Surgery, Yong Loo Lin School of Medicine,
National University of Singapore, Singapore
(Choong) Cardiovascular Research Institute, National University of
Singapore, Singapore
Publisher
NLM (Medline)
Abstract
BACKGROUND: The purpose of this systematic review is to evaluate the
efficacy of antifibrinolytics in non-cardiac thoracic surgery.
<br/>METHOD(S): We searched for all randomized controlled trials on this
topic. A set of strict inclusion and exclusion criteria was developed. Six
studies were meta-analysed together then in subgroups of topical
tranexamic acid and intravenous aprotinin. We compared postoperative chest
drain output, transfusions requirements and duration of hospital stay
where available to determine the efficacy of topical tranexamic acid or
intravenous aprotinin in reducing blood loss. <br/>RESULT(S): The use of
antifibrinolytics reduces 24-h chest drain output (-290.21mL [-524.75,
-55.66], P =0.02, I2 =98%), red blood cell transfusion requirements
(-1.27units [-2.24, -0.30], P =0.01, I2 =100%) and shortened duration of
hospital stay (-1.81days [-3.25, -0.36], P =0.01, I2 =96%). The subgroup
analysis also supported this trend. <br/>CONCLUSION(S): We conclude that
the use of antifibrinolytics appears to reduce postoperative blood loss by
reducing chest drain output, transfusion requirements and length of stay
after thoracic surgery.<br/>Copyright &#xa9; 2021 Royal Australasian
College of Surgeons.

<39>
Accession Number
634578782
Title
Ischaemic breast necrosis following coronary artery bypass grafting using
left internal mammary artery: understanding the risks.
Source
ANZ journal of surgery. 91 (6) (pp 1266-1270), 2021. Date of Publication:
01 Jun 2021.
Author
B S.; Khanna A.; Song C.
Institution
(B, Khanna, Song) Department of Plastic Surgery, Fiona Stanley Hospital,
Perth, WA, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Coronary artery bypass grafting (CABG) is a common procedure
performed commonly using left internal mammary artery (LIMA). We report a
case of sternal wound dehiscence and breast necrosis following LIMA
harvest in a 55-year-old obese lady with macromastia, diabetes mellitus,
hypertension and end stage renal disease requiring dialysis. We also
review the existing literature. <br/>METHOD(S): Publications were
identified from Medline All, Web of Science Core Collection, Google
Scholar and Cochrane Central Register of Controlled Trial between 1974 and
2 January 2020. We assessed patient co-morbidities, presentation time
frame, quadrant of breast necrosis and reconstruction option utilized.
<br/>RESULT(S): There were 18 cases of breast necrosis reported post-CABG.
The patients were aged 50 or over, morbidly obese and had large tubular
breasts. Other risk factors included chronic renal insufficiency, diabetes
and hypertension. The presentation was delayed with necrosis only evident
7days or more after CABG. All the reported cases had necrosis at lower
inner quadrant of the left breast with nipple-areola complex.
<br/>CONCLUSION(S): Blood supply to the breast is segmental with
considerable overlap, however, this overlap is reduced in large breasts.
Patients with macromastia and multiple co-morbidities need preoperative
imaging (computed tomography angiogram) to evaluate breast vascularity
prior to CABG. Risk of breast necrosis needs to be explained during the
informed consent. Surgical management of the hypermastia (breast reduction
or amputation) may be a factor in facilitating the CABG procedure if
indeed the LIMA is absolutely indicated considering the risks and
benefits.<br/>Copyright &#xa9; 2021 Royal Australasian College of
Surgeons.

<40>
[Use Link to view the full text]
Accession Number
634575472
Title
Association Between Cerebral Desaturation and Postoperative Delirium in
Thoracotomy With One-Lung Ventilation: A Prospective Cohort Study.
Source
Anesthesia and analgesia. 133 (1) (pp 176-186), 2021. Date of Publication:
01 Jul 2021.
Author
Cui F.; Zhao W.; Mu D.-L.; Zhao X.; Li X.-Y.; Wang D.-X.; Jia H.-Q.; Dai
F.; Meng L.
Institution
(Cui, Mu, Wang) From the Department of Anesthesiology and Critical Care,
Peking University First Hospital, Beijing, China
(Zhao, Jia) Department of Anesthesiology, Fourth Hospital of Hebei Medical
University, Shijiazhuang, China
(Zhao) Department of Anesthesiology, Second Xiangya Hospital, Central
South University, Changsha, China
(Zhao, Meng) Department of Anesthesiology, Yale University School of
Medicine, New Haven, CT, United States
(Li) Department of Biostatistics, Peking University First Hospital,
Beijing, China
(Dai) Department of Biostatistics, Yale University School of Public
Health, New Haven, CT, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The association between cerebral desaturation and
postoperative delirium in thoracotomy with one-lung ventilation (OLV) has
not been specifically studied. <br/>METHOD(S): A prospective observational
study performed in thoracic surgical patients. Cerebral tissue oxygen
saturation (Scto2) was monitored on the left and right foreheads using a
near-infrared spectroscopy oximeter. Baseline Scto2 was measured with
patients awake and breathing room air. The minimum Scto2 was the lowest
measurement at any time during surgery. Cerebral desaturation and
hypersaturation were an episode of Scto2 below and above a given threshold
for >=15 seconds during surgery, respectively. The thresholds based on
relative changes by referring to the baseline measurement were <80%, <85%,
<90%, <95%, and <100% baseline for desaturation and >105%, >110%, >115%,
and >120% baseline for hypersaturation. The thresholds based on absolute
values were <50%, <55%, <60%, <65%, and <70% for desaturation and >75%,
>80%, >85%, and >90% for hypersaturation. The given area under the
threshold (AUT)/area above the threshold (AAT) was analyzed. Delirium was
assessed until postoperative day 5. The primary analysis was the
association between the minimum Scto2 and delirium using multivariable
logistic regression controlled for confounders (age, OLV time, use of
midazolam, occurrence of hypotension, and severity of pain). The secondary
analysis was the association between cerebral desaturation/hypersaturation
and delirium, and between the AUT/AAT and delirium using multivariable
logistic regression controlled for the same confounders. Multiple testing
was corrected using the Holm-Bonferroni method. We additionally monitored
somatic tissue oxygen saturation on the forearm and upper thigh.
<br/>RESULT(S): Delirium occurred in 35 (20%) of 175 patients (65 +/- 6
years old). The minimum left or right Scto2 was not associated with
delirium. Cerebral desaturation defined by <90% baseline for left Scto2
(odds ratio [OR], 5.82; 95% confidence interval [CI], 2.12-19.2; corrected
P =.008) and <85% baseline for right Scto2 (OR, 4.27; 95% CI, 1.77-11.0;
corrected P =.01) was associated with an increased risk of delirium.
Cerebral desaturation defined by other thresholds, cerebral
hypersaturation, the AUT/AAT, and somatic desaturation and hypersaturation
were all not associated with delirium. <br/>CONCLUSION(S): Cerebral
desaturation defined by <90% baseline for left Scto2 and <85% baseline for
right Scto2, but not the minimum Scto2, may be associated with an
increased risk of postthoracotomy delirium. The validity of these
thresholds needs to be tested by randomized controlled
trials.<br/>Copyright &#xa9; 2021 International Anesthesia Research
Society.

<41>
Accession Number
634222338
Title
Novel risk score for predicting recurrence of atrial fibrillation after
the Cryo-Maze procedure.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 59 (6) (pp 1218-1225),
2021. Date of Publication: 14 Jun 2021.
Author
Kakuta T.; Fukushima S.; Minami K.; Saito T.; Kawamoto N.; Tadokoro N.;
Ikuta A.; Kobayashi J.; Fujita T.
Institution
(Kakuta, Fukushima, Saito, Kawamoto, Tadokoro, Ikuta, Kobayashi, Fujita)
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular
Research Center, Suita, Osaka, Japan
(Minami) Department of Surgical Intensive Care, National Cerebral and
Cardiovascular Research Center, Suita, Osaka, Japan
Publisher
NLM (Medline)
Abstract
OBJECTIVES: This study aimed to develop a novel risk score model for
quantitative prediction of the rate of atrial fibrillation (AF) recurrence
after the Cryo-Maze procedure in patients with persistent AF.
<br/>METHOD(S): We enrolled 450 consecutive patients who underwent the
Cryo-Maze procedure for persistent AF concomitant with other cardiac
procedures in our institute between 2001 and 2019. We randomly divided the
cohort into two groups. We derived a model in a 'development cohort' (270
patients; 60%) and validated it in a 'test cohort' (180 patients; 40%) by
receiver operating characteristic curve analysis. <br/>RESULT(S): The
median follow-up was 5.2 (interquartile range: 2.0-9.9) years. The 1-, 5-,
10- and 15-year rates of freedom from AF recurrence in the entire cohort
were 91.4%, 83.5%, 76.2% and 57.1%, respectively. Risk factors for AF
recurrence examined by logistic regression analysis included F-wave
voltage in V1<0.2mV, preoperative AF duration >5years and left atrial
volume index >100ml/m2. Points were assigned to each risk factor according
to its odds ratio. A novel risk score model was developed using these
three variables and age, with a range up to 10 points. High score (>7)
predicted high rates of AF recurrence after the Cryo-Maze procedure. The
area under the receiver operating characteristic curve of the novel risk
model score was 0.78 (95% confidence interval: 0.65-0.91) in the test
cohort. <br/>CONCLUSION(S): Use of the Cryo-Maze procedure should be
carefully considered in patients with a higher model score because of a
higher risk of AF recurrence.<br/>Copyright &#xa9; The Author(s) 2021.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<42>
Accession Number
634155039
Title
Cerebral oximetry and preventing neurological complication post-cardiac
surgery: a systematic review.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 59 (6) (pp 1144-1154),
2021. Date of Publication: 14 Jun 2021.
Author
Semrau J.S.; Motamed M.; Ross-White A.; Boyd J.G.
Institution
(Semrau, Boyd) Centre for Neuroscience Studies, Queen's University, ON,
Kingston, Canada
(Motamed) School of Medicine, Faculty of Health Sciences, Queen's
University, ON, Kingston, Canada
(Ross-White) Library Services, Queen's University, ON, Kingston, Canada
(Boyd) Kingston Health Sciences Centre, ON, Kingston, Canada
(Boyd) Department of Critical Care, Faculty of Health Sciences, Queen's
University, ON, Kingston, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVES: This systematic review aims to provide an up-to-date summary
of the current literature examining the relationship between
intraoperative regional cerebral oxygen saturation and neurological
complications after cardiac surgery. <br/>METHOD(S): Observational and
interventional studies investigating the link between regional cerebral
oxygen saturation and postoperative delirium, cognitive dysfunction and
stroke were included. After database searching and study screening, study
characteristics and major findings were extracted. <br/>RESULT(S):
Twenty-seven studies were identified. Of the observational studies (n=17),
8 reported that regional cerebral oxygen desaturations were significantly
associated with neurological complications after cardiac surgery. Of the
interventional studies (n=10), 3 provided evidence for monitoring cerebral
oximetry during cardiac surgery as a means of reducing incidence of
postoperative cognitive dysfunction or stroke. There was significant
heterogeneity in the tools and rigor used to diagnose neurological
complications. <br/>CONCLUSION(S): Studies to date show an inconsistent
relationship between regional cerebral oxygen saturation and neurological
outcomes after cardiac surgery, and lack of clear benefit of targeting
cerebral oximetry to minimize neurological complications. Standardized
assessments, definitions of impairment and desaturation thresholds will
help determine the benefits of cerebral oximetry monitoring during cardiac
surgery.<br/>Copyright &#xa9; The Author(s) 2021. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<43>
Accession Number
634017057
Title
Chest keloids: effect of surgical excision and adjuvant radiotherapy on
recurrence, a systematic review and meta-analysis.
Source
ANZ journal of surgery. 91 (6) (pp 1104-1109), 2021. Date of Publication:
01 Jun 2021.
Author
Miles O.J.; Zhou J.; Paleri S.; Fua T.; Ramakrishnan A.
Institution
(Miles) Department of Plastic and Reconstructive Surgery, St Vincent's
Hospital Melbourne, VIC, Australia
(Zhou) Department of Plastic and Reconstructive Surgery, Alfred Hospital
Melbourne, Melbourne, VIC, Australia
(Paleri) Department of Cardiology, St Vincent's Hospital Melbourne, VIC,
Australia
(Fua) Department of Radiation Oncology, Peter MacCallum Cancer Centre,
Melbourne, VIC, Australia
(Ramakrishnan) Department of Plastic and Reconstructive Surgery, Royal
Melbourne Hospital, Melbourne, VIC, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Chest keloids are a difficult sub-group of scars to treat,
likely secondary to the high wound tension in the area that promotes
excessive fibroblast proliferation and collagen deposition. Excision and
adjuvant radiotherapy has been demonstrated as an efficacious treatment
for keloids in general, but no meta-analysis exists to support the claims
for chest keloids. This study aims to identify the rate of recurrence
after surgical resection and radiotherapy on patients with chest keloids.
<br/>METHOD(S): A search was performed using Embase, MEDLINE, Pubmed and
Cochrane database on 22 December 2018 for terms 'radiotherapy', 'keloid'
and 'chest'. Papers included met a prospectively designed inclusion
criteria assessed by multiple investigators. <br/>RESULT(S): Twelve
studies, including 1 randomized controlled trial, were included for a
total of 400 patients with a chest keloid scar managed with surgical
excision and adjuvant radiotherapy. Overall pooled-estimate of recurrence
rate was 22% (95% CI 12-32%). Meta-regression did not demonstrate a
significant effect for method of wound closure, type of radiotherapy,
radiotherapy dose (BED10 ) and study type. <br/>CONCLUSION(S): Excision
and adjuvant radiotherapy represents an effective method of treatment for
chest keloids, however sufficient prospective data, including randomized
controlled trials, did not yet exist to support these findings. Further
studies with sufficient sub-group analysis for keloid location are
required to add to the pool of literature that can be added to this
meta-analysis.<br/>Copyright &#xa9; 2021 Royal Australasian College of
Surgeons.

<44>
Accession Number
631887534
Title
Effects of auricular acupressure on the quality of sleep and anxiety in
patients undergoing cardiac surgery: A single-blind, randomized controlled
trial.
Source
Applied nursing research : ANR. 53 (pp 151269), 2020. Date of Publication:
01 Jun 2020.
Author
Bang Y.Y.; Park H.
Institution
(Bang) Department of Nursing, KyungBok University, Gyeonggi-do, South
Korea
(Park) College of Nursing, Ewha Womans University, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
AIM: This study aimed to evaluate the effects of auricular acupressure
(AA), a non-invasive type of reflexotherapy, on sleep quality and anxiety
in patients after cardiac surgery. BACKGROUND: Sleep disturbances and
anxiety hinder the recovery of patients after cardiac surgery; thus,
appropriate and adequate nursing interventions must be pursued. AA is a
complementary therapy suitable for patients with limited pharmacological
therapy options. <br/>METHOD(S): A single-blind, randomized controlled
trial with a pretest-posttest control group design was applied. The study
consisted of 42 patients, comprising an experimental group (n = 21) and a
control group (n = 21). AA was applied for six days per trial for a total
of 2 trials, while sleep (sleep score, sleep satisfaction) and anxiety
(state, trait) were measured at three time points (pre-op, 7 days post-op,
and 14 days post-op). <br/>RESULT(S): The sleep and sleep satisfaction
scores of the experimental group were significantly higher than those of
the control group. No significant difference was found in anxiety
state/trait between the two groups. <br/>CONCLUSION(S): We conclude that
AA is a safe, effective, noninvasive, and low-risk nursing intervention
that can improve sleep quality in patients after cardiac
surgery.<br/>Copyright &#xa9; 2020 Elsevier Inc. All rights reserved.

<45>
Accession Number
2007532993
Title
Association between vitamin d levels and lower-extremity deep vein
thrombosis: A case-control study.
Source
Sao Paulo Medical Journal. 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, Ersoy, Yuksel, Celik, Ucaroglu, Velioglu, Cetinkaya, Demir,
Esen, Erdem) Bolu Abant Izzet Baysal University, Bolu, Turkey
(Korkmaz) Department of Cardiovascular Surgery, School of Medicine, Bolu
Abant Izzet Baysal University, Bolu, Turkey
(Ersoy) Department of Family Medicine, Health Sciences University,
Umraniye Training and Research Hospital, Istanbul, Turkey
(Yuksel) Department of Cardiovascular Surgery, School of Medicine, Bolu
Abant Izzet Baysal University, Bolu, Turkey
(Celik) Department of Physiology, School of Medicine, Bolu Abant Izzet
Baysal University, Bolu, Turkey
(Ucaroglu) Department of Cardiovascular Surgery, School of Medicine, Bolu
Abant Izzet Baysal University, Bolu, Turkey
(Velioglu) 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) Department of Cardiovascular Surgery, Health Sciences University,
Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
(Esen) Department of Family Medicine, Basaksehir Cam and Sakura City
Hospital, Istanbul, Turkey
(Erdem) Department of Cardiovascular Surgery, School of Medicine, Bolu
Abant Izzet Baysal University, Bolu, Turkey
Publisher
Associacao Paulista de Medicina
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.
<br/>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. <br/>METHOD(S): A total of
280 participants were included: 140 each in the DVT and control groups.
Basic clin-ical 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 sub-groups
(sufficient, insufficient and deficient). <br/>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). None-theless, 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. <br/>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 re-placement may be brought into the agenda for
protection against DVT.<br/>Copyright &#xa9; 2021 by Associacao Paulista
de Medicina.

<46>
Accession Number
635315199
Title
Airway Pressure Release Ventilation Mode Improves Circulatory and
Respiratory Function in Patients After Cardiopulmonary Bypass, a
Randomized Trial.
Source
Frontiers in Physiology. 12 (no pagination), 2021. Article Number: 684927.
Date of Publication: 03 Jun 2021.
Author
Ge H.; Lin L.; Xu Y.; Xu P.; Duan K.; Pan Q.; Ying K.
Institution
(Ge, Xu, Xu, Duan) Department of Respiratory Care, Regional Medical
Center, National Institute of Respiratory Diseases, Sir Run Run Shaw
Hospital, School of Medicine, Zhejiang University, Hangzhou, China
(Lin) Department of Critical Care Medicine, Sir Run Run Shaw Hospital,
School of Medicine, Zhejiang University, Hangzhou, China
(Pan) College of Information Engineering, Zhejiang University of
Technology, Hangzhou, China
(Ying) Department of Respiratory and Critical Care, Regional Medical
Center, National Institute of Respiratory Diseases, Sir Run Run Shaw
Hospital, School of Medicine, Zhejiang University, Hangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Importance: Postoperative pulmonary complications and cardiovascular
complications are major causes of morbidity, mortality, and resource
utilization in cardiac surgery patients. <br/>Objective(s): To investigate
the effects of airway pressure release ventilation (APRV) on respiration
and hemodynamics in post cardiac surgery patients. <br/>Main Outcomes and
Measures: A single-center randomized control trial was performed. In
total, 138 patients undergoing cardiopulmonary bypass were prospectively
screened. Ultimately 39 patients met the inclusion criteria and were
randomized into two groups: 19 patients were managed with pressure control
ventilation (PCV) and 20 patients were managed with APRV. Respiratory
mechanics after 4 h, hemodynamics within the first day, and Chest
radiograph score (CRS) and blood gasses within the first three days were
recorded and compared. <br/>Result(s): A higher cardiac index (3.1 +/- 0.7
vs. 2.8 +/- 0.8 Lmin^-1m²; p < 0.05), and shock
volume index (35.4 +/- 9.2 vs. 33.1 +/- 9.7 ml m^-2; p < 0.05)
were also observed in the APRV group after 4 h as well as within the first
day (p < 0.05). Compared to the PCV group, the PaO2/FiO<inf>2</inf> was
significantly higher after 4 h in patients of APRV group (340 +/- 97 vs.
301 +/- 82, p < 0.05) and within the first three days (p < 0.05) in the
APRV group. CRS revealed less overall lung injury in the APRV group (p <
0.001). The duration of mechanical ventilation and ICU length of stay were
not significantly (p = 0.248 and 0.424, respectively). <br/>Conclusions
and Relevance: Compared to PCV, APRV may be associated with increased
cardiac output improved oxygenation, and decreased lung injury in
postoperative cardiac surgery patients.<br/>&#xa9; Copyright &#xa9; 2021
Ge, Lin, Xu, Xu, Duan, Pan and Ying.

<47>
Accession Number
2012844249
Title
Modular minimally invasive extracorporeal circulation ensures perfusion
safety and technical feasibility in cardiac surgery; a systematic review
of the literature.
Source
Perfusion (United Kingdom). (no pagination), 2021. Date of Publication:
2021.
Author
Anastasiadis K.; Antonitsis P.; Asteriou C.; Deliopoulos A.; Argiriadou H.
Institution
(Anastasiadis, Antonitsis, Asteriou, Deliopoulos, Argiriadou)
Cardiothoracic Department, School of Medicine, Aristotle University of
Thessaloniki, Thessaloniki, Greece
Publisher
SAGE Publications Ltd
Abstract
Introduction: Despite extensive evidence that shows clinical of
superiority of MiECC, worldwide penetration remains low due to concerns
regarding air handling and volume management in the context of a closed
system. The purpose of this study is to thoroughly investigate perfusion
safety and technical feasibility of performing all cardiac surgical
procedures with modular (hybrid) MiECC, as experienced from the
perfusionist's perspective. <br/>Method(s): We retrospectively reviewed
perfusion charts of consecutive adult patients undergoing all types of
elective, urgent, and emergency cardiac surgery under modular MiECC. The
primary outcome measure was perfusion safety and technical feasibility, as
evidenced in the need for conversion from a closed to an open circuit. A
systematic review of the literature was conducted aiming to ultimately
clarify whether there are any safety issues regarding MiECC technology.
<br/>Result(s): We challenged modular MiECC use in a series of 403
consecutive patients of whom a significant proportion (111/403; 28%)
underwent complex surgery including reoperations (4%), emergency repair of
acute type A aortic dissection and composite aortic surgery (1.7%).
Technical success rate was 100%. Conversion to an open circuit was
required in 18/396 patients (4.5%), excluding procedures performed under
circulatory arrest. Open configuration accounted for 40% +/- 21% of total
procedural perfusion time and was related to significant hemodilution and
increase in peak lactate levels. Systematic review revealed that safety of
the procedure challenged originated from a single report, while no
clinical adverse event related to MiECC was identified.
<br/>Conclusion(s): Use of modular MiECC secures safety and ensures
technical feasibility in all cardiac surgical procedures. It represents a
type III active closed system, while its stand-by component is reserved
for a small (<5%) proportion of procedures and for a partial procedural
time. Thus, it eliminates any safety concern regarding air handling and
volume management, while it overcomes any unexpected intraoperative
scenario.<br/>Copyright &#xa9; The Author(s) 2021.

<48>
Accession Number
2012507977
Title
Heparin-induced thrombocytopenia: Construction of a pretest diagnostic
score derived from the analysis of a prospective multinational database,
with internal validation.
Source
Journal of Thrombosis and Haemostasis. (no pagination), 2021. Date of
Publication: 2021.
Author
Tardy-Poncet B.; de Maistre E.; Pouplard C.; Presles E.; Alhenc-Gelas M.;
Lasne D.; Horellou M.-H.; Mouton C.; Serre-Sapin A.; Bauters A.; Nguyen
P.; Mullier F.; Perrin J.; Le Gal G.; Morange P.-E.; Grunebaum L.;
Lillo-Le Louet A.; Elalamy I.; Gruel Y.; Greinacher A.; Lecompte T.; Tardy
B.
Institution
(Tardy-Poncet, Presles, Tardy) CIC 1408, Inserm U1059 SAINBIOSE, F-Crin
INNOVTE, Universite de Lyon, Saint-Etienne, France
(de Maistre) Hemostasis Unit, CHU Dijon, Dijon, France
(Pouplard, Gruel) Division of Hematology - Hemostasis, University Hospital
of Tours, Tours, France
(Alhenc-Gelas) Hemostasis Unit, Hopital Europeen Georges Pompidou, AP-HP,
Paris, France
(Lasne) Hemostasis Unit, Hopital Necker, AP-HP, Paris, France
(Lasne) Universite Paris Sud Paris Saclay, Inserm U1176, Le
Kremlin-Bicetre, France
(Horellou) Hematology Laboratory Unit, Hopital Universitaire Paris-centre,
Paris, France
(Mouton) Hemostasis Unit, CHU Bordeaux, Bordeaux, France
(Serre-Sapin) Hemostasis Unit, CHU Clermont-Ferrand, Clermont-Ferrand,
France
(Bauters) Hemostasis Unit, CHU Lille, Lille, France
(Nguyen) Hemostasis Unit, CHU Reims, Reims, France
(Mullier) Namur Thrombosis and Hemostasis Center, Hematology Laboratory,
Universite catholique de Louvain, CHU UCL Namur, Yvoir, Belgium
(Perrin) Hemostasis Unit, CHU Nancy, Nancy, France
(Le Gal) Department of Medicine, University of Ottawa, Ottawa Hospital
Research Institute, Thrombosis Research Group, Ottawa, ON, Canada
(Morange) C2VN, Aix Marseille University, INSERM, INRA; Laboratory of
Hematology, La Timone Hospital, Assistance Publique des Hopitaux de
Marseille, Marseille, France
(Grunebaum) Laboratory of Hematology, CHU Strasbourg, Strasbourg, France
(Lillo-Le Louet) Pharmacovigilance Center, Georges Pompidou European
Hospital, AP-HP, Paris, France
(Elalamy) Hematology and Thrombosis Center, Tenon University Hospital,
INSERM UMRS 938, Sorbonne University, Paris, France
(Greinacher) Institut fuer Immunologie und Transfusionsmedizin,
Universitaetsmedizin Greifswald, Greifswald, Germany
(Lecompte) Department of Medicine, Geneva University Hospitals, and Geneva
Platelet Group (GpG), Faculty of Medicine, University of Geneva, Geneva,
Switzerland
Publisher
Blackwell Publishing Ltd
Abstract
Background: Diagnosis of heparin-induced thrombocytopenia (HIT) requires
pretest probability assessment and dedicated laboratory assays.
<br/>Objective(s): To develop a pretest score for HIT. <br/>Design(s):
Observational; analysis of prospectively collected data of hospitalized
patients suspected with HIT (ClinicalTrials.gov NCT00748839).
<br/>Setting(s): Thirty-one tertiary hospitals in France, Switzerland, and
Belgium. <br/>Patient(s): Patients tested for HIT antibodies (2280
evaluable), randomly allocated to derivation and validation cohorts.
Measurements: Independent adjudicators diagnosed HIT based on the
prospectively collected data and serotonin release assay results.
<br/>Result(s): Heparin-induced thrombocytopenia was diagnosed in 234
(14.7%) and 99 (14.5%) patients in the two cohorts. Eight features were
associated with HIT (in brackets, points assigned for score calculation of
the score): unfractionated heparin (1); therapeutic-dose heparin (1);
cardiopulmonary bypass (cardiac surgery) (2); major trauma (3); 5- to
21-day interval from anticoagulation initiation to suspicion of HIT (4);
>=40% decrease in platelet count over <=6 days (3); thrombotic event,
arterial (3) or venous (3). The C-statistic was 0.79 (95% CI, 0.76-0.82).
In the validation cohort, the area under the receiver operating
characteristic curve was 0.77 (95% CI, 0.74-0.80). Three groups of scores
were defined; HIT prevalence reached almost 30% in the high-probability
group. <br/>Limitation(s): The performance of the score may depend on
settings and practices. <br/>Conclusion(s): The objective,
easy-to-collect, clinical features of HIT we evidenced were incorporated
into a pretest score, which may guide clinical decisions regarding
diagnostic testing and anticoagulation.<br/>Copyright &#xa9; 2021
International Society on Thrombosis and Haemostasis

<49>
Accession Number
626390306
Title
Acute and long-term efficacy and safety with a single cryoballoon
application as compared with the standard dual application strategy: A
prospective randomized study using the second-generation cryoballoon for
pulmonary vein isolation in patients with symptomatic atrial fibrillation.
Source
Europace. 20 (10) (pp 1598-1605), 2018. Date of Publication: 01 Oct 2018.
Author
Mortsell D.; Malmborg H.; Lonnerholm S.; Jansson V.; Blomstrom-Lundqvist
C.
Institution
(Malmborg, Lonnerholm, Jansson, Blomstrom-Lundqvist) Department of Medical
Sciences, Department of Cardiology, Uppsala University, Sjukhusvagen 85,
Uppsala SE 751 85, Sweden
Publisher
Oxford University Press
Abstract
Aims A single cryoballoon (CB) application per vein for pulmonary vein
isolation (PVI) in patients with atrial fibrillation (AF) could save time
and was therefore compared to the standard approach of two consecutive CB
applications for acute and long-term efficacy and safety. Methods Patients
with symptomatic AF were randomized to a single CB application per vein
guided by an Achieve catheter and results (Single cryo-arm) or to two CB
applications using a standard guidewire (Routine cryo-arm). The primary
endpoint was the rate of acute complete PVI. Secondary endpoints were
freedom from AF evaluated by electrocardiogram and 7 days Holter at 6 and
12 months, symptoms by Symptom Severity Questionnaires and EHRA score and
quality of life (QoL) by EQ5D-5L at 12 months. Among 140 patients
included, PVI was achieved in 271 (100%) veins in the Single cryo-arm and
in 269/271 (99.3%) veins in the Routine cryo-arm, P=0.25. The procedure
time was shorter in the Single cryo-arm, mean +/- standard deviation
99.4+/-33.3min vs. 118.4+/-34.3min, P=0.0015. Freedom from AF after one
procedure at 12 months did not differ; 73.9.0% (Single cryo) vs. 71.4%
(Routine), P=0.74. Symptoms and QoL did also not differ between the two
groups. There was a lower complication rate in the Single cryo-group, 2.9%
vs. 12.9%, P=0.03. Conclusion A single CB application shortens the
procedure time without affecting acute or long-term efficacy, as compared
to the routine two-application strategy, which with the lower complication
rates has important implications when defining standards for
PVI.<br/>Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. &#xa9; The Author(s) 2018.

<50>
Accession Number
608566031
Title
How does coronary stent implantation impact on the status of the
microcirculation during primary percutaneous coronary intervention in
patients with ST-elevation myocardial infarction?.
Source
European Heart Journal. 36 (45) (pp 3165-3177), 2015. Date of Publication:
01 Dec 2015.
Author
De Maria G.L.; Cuculi F.; Patel N.; Dawkins S.; Fahrni G.; Kassimis G.;
Choudhury R.P.; Forfar J.C.; Prendergast B.D.; Channon K.M.; Kharbanda
R.K.; Banning A.P.
Institution
(De Maria, Cuculi, Patel, Dawkins, Fahrni, Kassimis, Forfar, Prendergast,
Channon, Kharbanda, Banning) Oxford Heart Centre, NIHR Biomedical Research
Centre, Oxford University Hospitals, Headley Way, Oxford OX39DU, United
Kingdom
(Cuculi) Department of Cardiology, LuzernerKantonsspital, Luzern,
Switzerland
(Choudhury) Acute Vascular Imaging Centre, Radcliffe Department of
Medicine, University of Oxford, Oxford, United Kingdom
(Choudhury) Division of Cardiovascular Medicine, BHF Centre of Research
Excellence, University of Oxford, Oxford, United Kingdom
Publisher
Oxford University Press
Abstract
Aims Primary percutaneous coronary intervention (PPCI) is the optimal
treatment for patients presenting with ST-elevation myocardial infarction
(STEMI). An elevated index of microcirculatory resistance (IMR) reflects
microvascular function and when measured after PPCI, it can predict an
adverse clinical outcome. We measured coronary microvascular function in
STEMI patients and compared sequential changes before and after stent
implantation. Methods and results In 85 STEMI patients, fractional flow
reserve, coronary flow reserve, and IMR were measured using a pressure
wire (Certus, St Jude Medical, St Paul, MN, USA) immediately before and
after stent implantation. Stenting significantly improved all of the
measured parameters of coronary physiology including IMR from 67.7
[interquartile range (IQR): 56.2 95.8] to 36.7 (IQR: 22.7 59.5), P, 0.001.
However, after stenting, IMR remained elevated (. 40) in 28 (32.9%)
patients. In 15 of these patients (17.6% of the cohort), only a partial
reduction in IMR occurred and these patients were more likely to be late
presenters (pain to wire time. 6 h). The extent of jeopardized myocardium
[standardized beta: 2 0.26 (IMR unit/Bypass Angioplasty Revascularization
Investigation score unit), P: 0.009] and pre-stenting IMR [standardized
beta: 2 0.34 (IMR unit), P: 0.001] predicted a reduction in IMR after
stenting (DIMR 14 post-stenting IMR 2 pre-stenting IMR), whereas
thrombotic burden [standardized beta: 0.24 (IMR unit/thrombus score unit),
P: 0.01] and deployed stent volume [standardized beta: 0.26 (IMR unit/mm3
of stent), P: 0.01] were associated with a potentially deleterious
increase in IMR. Conclusion Improved perfusion of the myocardium by stent
deployment during PPCI is not universal. The causes of impaired
microvascular function at the completion of PPCI treatment are
heterogeneous, but can reflect a later clinical presentation and/or the
location and extent of the thrombotic burden.<br/>Copyright &#xa9; 2015
The Author.

<51>
Accession Number
2007162085
Title
Intra-coronary administration of tacrolimus improves myocardial perfusion
and left ventricular function in patients with ST-segment elevation
myocardial infarction (COAT-STEMI) undergoing primary percutaneous
coronary intervention.
Source
Acta Cardiologica Sinica. 37 (3) (pp 239-253), 2021. Date of Publication:
2021.
Author
Sung P.-H.; Huang W.-C.; Chao T.-H.; Lee C.-H.; Yang T.-Y.; Lin Y.-S.;
Chang R.-Y.; Chong J.-T.; Yang C.-H.; Chen C.-J.; Chung S.-Y.; Hsueh
S.-K.; Wu C.-J.; Yip H.-K.
Institution
(Sung, Yang, Chen, Chung, Hsueh, Wu, Yip) Division of Cardiology,
Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital
and Chang Gung University, College of Medicine, Taiwan (Republic of China)
(Huang) Department of Cardiology, Kaohsiung Veterans General Hospital,
Kaohsiung, Taiwan (Republic of China)
(Chao, Lee) Division of Cardiology, Department of Internal Medicine,
National Cheng Kung University College of Medicine and Hospital, Tainan,
Taiwan (Republic of China)
(Yang, Lin) Division of Cardiology, Department of Internal Medicine, Chang
Gung Memorial Hospital, Chiayi, Taiwan (Republic of China)
(Chang) Division of Cardiology, Department of Internal Medicine, Ditmanson
Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan
(Republic of China)
(Chong) Division of Cardiology, Department of Internal Medicine, Pingtung
Christian Hospital, Pingtung, Taiwan (Republic of China)
(Sung, Yip) Institute for Translational Research in Biomedicine, Kaohsiung
Chang Gung Memorial Hospital and Chang Gung University, College of
Medicine, Kaohsiung, Taiwan (Republic of China)
(Sung, Yip) Center for Shockwave Medicine and Tissue Engineering,
Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (Republic of
China)
(Yip) Department of Medical Research, China Medical University Hospital,
China Medical University, Taichung, Taiwan (Republic of China)
(Yip) Department of Nursing, Asia University, Taichung, Taiwan (Republic
of China)
Publisher
Republic of China Society of Cardiology
Abstract
ound: Ischemia-reperfusion injury following acute ST-segment elevation
myocardial infarction (STEMI) is strongly related to inflammation.
However, whether intracoronary (IC) tacrolimus, an immunosuppressant, can
improve myocardial perfusion is uncertain. <br/>Method(s): A multicenter
double-blind randomized controlled trial was conducted in Taiwan from 2014
to 2017. Among 316 STEMI patients with Killip class 3 undergoing primary
percutaneous coronary intervention (PCI), 151 were assigned to the study
group treated with IC tacrolimus 2.5 mg to the culprit vessel before first
balloon inflation, and the remaining 165 were assigned to the placebo
group receiving IC saline only. The primary endpoint was percentage of
post-PCI TIMI-3 flow. The primary composite endpoints included achievement
of TIMI-3 flow, TIMImyocardial perfusion (TMP) grade, or 90-min ST-segment
resolution (STR). The secondary endpoints were left ventricular ejection
fraction (LVEF) and 1-month/1-year major adverse cardio-cerebral vascular
events (MACCEs) (defined as death,myocardial infarction, stroke,
target-vessel revascularization or re-hospitalization for heart failure).
<br/>Result(s): Although post-PCI TIMI-3 epicardial flowandMACCE rate at
1month and 1 year did not differ between the two groups, TMP grade (2.54
vs. 2.23, p < 0.001) and 90-min STR (67% vs. 61%, p < 0.001) were
significantly higher in the tacrolimus-treated group than in the placebo
group. The STEMI patients treated with tacrolimus also had significantly
higher 3D LVEF and less grade 2 or 3 LV diastolic dysfunction at 9 months
compared to those without. <br/>Conclusion(s): IC tacrolimus for STEMI
improved coronary microcirculation and 9-month LV systolic and diastolic
functions. However, the benefit of tacrolimus on clinical outcomes remains
inconclusive due to insufficient patient enrollment.<br/>Copyright &#xa9;
2021, Republic of China Society of Cardiology. All rights reserved.

<52>
Accession Number
2003618443
Title
Reducing delirium and cognitive dysfunction after off-pump coronary
bypass: A randomized trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 161 (4) (pp 1275-1282.e4),
2021. Date of Publication: April 2021.
Author
Szwed K.; Pawliszak W.; Szwed M.; Tomaszewska M.; Anisimowicz L.;
Borkowska A.
Institution
(Szwed, Szwed, Tomaszewska, Borkowska) Department of Clinical
Neuropsychology, Collegium Medium, Nicolaus Copernicus University,
Bydgoszcz, Poland
(Pawliszak, Anisimowicz) Department of Cardiac Surgery, Collegium Medium,
Nicolaus Copernicus University, Bydgoszcz, Poland
Publisher
Mosby Inc.
Abstract
Background: Neuropsychiatric complications of surgical coronary
revascularization are inconspicuous but frequent and clinically relevant.
So far, attempts to reduce their occurrence, such as the introduction of
off-pump coronary artery bypass (OPCAB) grafting method, have not brought
the desired results. The aim of this trial was to determine whether using
any of the 2 selected modifications of OPCAB could decrease the incidence
of these undesired sequelae. <br/>Method(s): In this single-center,
assessor- and patient-blinded, superiority, randomized controlled trial,
192 patients scheduled for elective isolated OPCAB were randomized to 3
parallel arms. The control arm underwent "conventional" OPCAB with vein
grafts. The first study arm underwent anaortic OPCAB (ANA) with total
arterial revascularization. The second study arm underwent OPCAB with vein
grafts using carbon dioxide surgical field flooding (CO<inf>2</inf>FF).
Outcomes included the incidence of postoperative delirium (PD) and early
postoperative cognitive dysfunction (ePOCD). <br/>Result(s): The incidence
of PD was 35.9% in the control (OPCAB) arm, 32.8% in the CO<inf>2</inf>FF
arm, and 12.5% in the ANA arm (chi² [2, N = 191] = 10.17; P
=.006). Post hoc tests revealed that the incidence of PD in the ANA arm
differed from that in the OPCAB arm (odds ratio [OR], 0.26; 95% confidence
interval [CI], 0.09-0.68; P =.002). The incidence of ePOCD was 34.4% in
the OPCAB arm, 28.1% in the CO<inf>2</inf>FF arm, and 9.5% in the ANA arm
(chi² [2, N = 191] = 11.58; P =.003). Post hoc tests revealed
that the incidence of ePOCD differed between the ANA and OPCAB arms (OR,
0.20; 95% CI, 0.06-0.58; P <.001). <br/>Conclusion(s): Performing ANA
significantly decreases the incidence of PD and ePOCD compared with
"conventional" OPCAB with vein grafts, whereas CO<inf>2</inf>FF is
inconsequential in this regard. These results, which probably reflect
decreased delivery of embolic load to the brain in ANA, may have practical
applicability in daily practice to improve clinical
outcomes.<br/>Copyright &#xa9; 2019 The American Association for Thoracic
Surgery

<53>
[Use Link to view the full text]
Accession Number
2007540330
Title
Effect of low-dose colchicine in acute and chronic coronary syndromes: A
systematic review and meta-analysis.
Source
European Journal of Clinical Investigation. 51 (4) (no pagination), 2021.
Article Number: e13464. Date of Publication: April 2021.
Author
Aimo A.; Pascual Figal D.A.; Bayes-Genis A.; Emdin M.; Georgiopoulos G.
Institution
(Aimo, Emdin) Institute of Life Sciences, Scuola Superiore Sant'Anna,
Pisa, Italy
(Aimo, Emdin) Cardiology Division, Fondazione Toscana Gabriele Monasterio,
Pisa, Italy
(Pascual Figal) Cardiology Department, Virgen de la Arrixaca Hospital and
School of Medicine, University of Murcia, Murcia, Spain
(Pascual Figal) Centro Nacional de Investigaciones Cardiovasculares
(CNIC), Madrid, Spain
(Pascual Figal, Bayes-Genis) CIBER Cardiovascular, Instituto de Salud
Carlos III, Madrid, Spain
(Bayes-Genis) Hospital Universitari Germans Trias i Pujol, Badalona
(Barcelona), Spain
(Georgiopoulos) School of Biomedical Engineering & Imaging Sciences,
King's College London, St Thomas' Hospital Campus, London, United Kingdom
(Georgiopoulos) Department of Clinical Therapeutics, National and
Kapodistrian University of Athens School of Medicine, Athens, Greece
Publisher
Blackwell Publishing Ltd
Abstract
Background: Sparse evidence of the prognostic benefit of the
anti-inflammatory drug colchicine in chronic and acute coronary syndromes
(CCS/ACS) exists. <br/>Method(s): We performed a systematic search of
studies on CCS or ACS comparing colchicine vs. placebo and reporting data
on cardiovascular outcomes (primary end points of each study) and/or
changes in hs-CRP. <br/>Result(s): Ten studies were selected: three on CCS
(LoDoCo, LoDoCo2 and the CCS subgroup of COLCHICINE-PCI; total patient
number = 6256), three on ACS (COLCOT, COPS, ACS subgroup of
COLCHICINE-PCI; n = 5,654) and five (n = 532) on hs-CRP changes from 1
week to 12 months, in CCS and/or ACS. In patients with CCS, colchicine
reduced by 49% risk of a composite end point (hazard ratio [HR] 0.51, 95%
confidence interval [CI] 0.32 to 0.81, P =.005). The favourable effect of
colchicine on the risk of cardiovascular events did not change when
excluding COLCHICINE-PCI from analysis (HR 0.51, 95% CI 0.25 to 1.03, P
=.061). In patients with ACS, the use of colchicine tended to decrease the
occurrence of the combined end point compared with placebo (HR = 0.77, 95%
CI 0.56 to 1.05, P =.100), and colchicine became significantly protective
when removing COLCHICINE-PCI from analysis (HR = 0.72, 95% CI 0.56 to
0.92, P =.009). Furthermore, colchicine tended to reduce the hs-CRP
increase (standardized mean difference=-0.31, 95% CI -0.72 to 0.1, P
=.133) compared with placebo. <br/>Conclusion(s): Colchicine therapy near
halves the risk of cardiovascular events in CCS compared with placebo and
is associated with a nonsignificant 23% risk reduction in ACS, together
with a trend towards a greater reduction of hs-CRP.<br/>Copyright &#xa9;
2020 Stichting European Society for Clinical Investigation Journal
Foundation. Published by John Wiley & Sons Ltd

<54>
Accession Number
2010856784
Title
Joint preoperative transthoracic and intraoperative transoesophageal
echocardiographic assessment of functional mitral regurgitation severity
provides better association with long-term mortality.
Source
Interactive Cardiovascular and Thoracic Surgery. 32 (1) (pp 9-19), 2021.
Date of Publication: 01 Jan 2021.
Author
Asher S.R.; Malzberg G.W.; Ong C.S.; Malapero R.J.; Wang H.; Shekar P.;
Kaneko T.; Pelletier M.P.; Mallidi H.; Heydarpour M.; Shook D.C.; Shernan
S.K.; Fox J.A.; Muehlschlegel J.D.; Xu X.; Nguyen T.B.; Sundt T.M.; Body
S.C.
Institution
(Asher) Department of Anesthesiology, Rhode Island Hospital, Providence,
RI, United States
(Malzberg, Malapero, Wang, Shook, Shernan, Fox, Muehlschlegel) Department
of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's
Hospital, Boston, MA, United States
(Ong, Sundt) Division of Cardiac Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Shekar, Kaneko, Pelletier, Mallidi) Division of Cardiac Surgery, Brigham
and Women's Hospital, Boston, MA, United States
(Heydarpour) Division of Endocrinology, Department of Medicine, Brigham
and Women's Hospital, Boston, MA, United States
(Xu, Nguyen) Department of Anesthesiology, Critical Care and Pain
Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
(Body) Department of Anesthesiology, Boston University, School of
Medicine, Boston, MA, United States
Publisher
Oxford University Press
Abstract
OBJECTIVES: Functional mitral regurgitation (MR) is observed with
ischaemic heart disease or aortic valve disease. Assessing the value of
mitral valve repair or replacement (MVR/P) is complicated by frequent
discordance between preoperative transthoracic echocardiographic (pTTE)
and intraoperative transoesophageal echocardiographic (iTOE) assessment of
MR severity. We examined the association of pTTE and iTOE with
postoperative mortality in patients with or without MR, at the time of
coronary artery bypass grafting (CABG) and/or aortic valve replacement
without MVR/P. <br/>METHOD(S): Medical records of 6629 patients undergoing
CABG and/or aortic valve replacement surgery with or without functional MR
and who did not undergo MVR/P were reviewed. MR severity assessed by pTTE
and iTOE were examined for association with postoperative mortality using
proportional hazards regression while accounting for patient and operative
characteristics. <br/>RESULT(S): In 72% of 709 patients with clinically
significant (moderate or greater) functional MR detected by pTTE, iTOE
performed after induction of anaesthesia demonstrated a reduction in MR
severity, while 2% of patients had increased severity of MR by iTOE. iTOE
assessment of MR was better associated with long-term postoperative
mortality than pTTE in patients with moderate MR [hazard ratio (HR) 1.31
(1.11-1.55) vs 1.02 (0.89-1.17), P-value for comparison of HR 0.025] but
was not different for more than moderate MR [1.43 (0.96-2.14) vs 1.27
(0.80-2.02)]. <br/>CONCLUSION(S): In patients undergoing CABG and/or
aortic valve replacement without MVR/P, these findings support
intraoperative reassessment of MR severity by iTOE as an adjunct to pTTE
in the prediction of mortality. Alone, these findings do not yet provide
evidence for an operative strategy.<br/>Copyright &#xa9; 2020 The
Author(s) 2020. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<55>
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. <br/>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. <br/>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 <br/>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.<br
/>Copyright &#xa9; 2021, The Author(s).

<56>
Accession Number
620129627
Title
Staging classification of aortic stenosis based on the extent of cardiac
damage.
Source
European Heart Journal. 38 (45) (pp 3351-3358), 2017. Date of Publication:
01 Dec 2017.
Author
Genereux P.; Pibarot P.; Redfors B.; Mack M.J.; Makkar R.R.; Jaber W.A.;
Svensson L.G.; Kapadia S.; Tuzcu E.M.; Thourani V.H.; Babaliaros V.;
Herrmann H.C.; Szeto W.Y.; Cohen D.J.; Lindman B.R.; McAndrew T.; Alu
M.C.; Douglas P.S.; Hahn R.T.; Kodali S.K.; Smith C.R.; Miller D.C.; Webb
J.G.; Leon M.B.
Institution
(Genereux, Redfors, McAndrew, Hahn, Kodali, Leon) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Genereux) Hopital du Sacre-Coeur de Montreal, Universite de Montreal,
Montreal, QC, Canada
(Pibarot) Pulmonary Hypertension and Vascular Biology Research Group,
Laval University, Quebec, Canada
(Redfors) Sahlgrenska University Hospital, Gothenburg, Sweden
(Mack) Baylor Scott and White Health, Plano, TX, United States
(Makkar) Interventional Technologies in the Heart Institute, Cedars-Sinai
Medical Center, Los Angeles, CA, United States
(Jaber, Svensson, Kapadia, Tuzcu) Heart and Vascular Institute, Cleveland
Clinic, Cleveland, OH, United States
(Thourani, Babaliaros) Emory University School of Medicine, Atlanta, GA,
United States
(Herrmann, Szeto) Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, PA, United States
(Cohen) Saint Luke's Mid America Heart Institute, Kansas City, MO, United
States
(Lindman) Vanderbilt University Medical Center, Nashville, TN, United
States
(Alu, Hahn, Kodali, Smith, Leon) Columbia University Medical Center, 161
Ft. Washington Avenue, New York, NY 10032, United States
(Douglas) Duke Clinical Research Institute, Duke University Medical
Center, Durham, NC, United States
(Miller) Stanford University, Stanford, CA, United States
(Webb) University of British Columbia, St. Paul's Hospital, Vancouver, BC,
Canada
Publisher
Oxford University Press
Abstract
Aims In patients with aortic stenosis (AS), risk stratification for aortic
valve replacement (AVR) relies mainly on valverelated factors, symptoms
and co-morbidities. We sought to evaluate the prognostic impact of a
newly-defined staging classification characterizing the extent of
extravalvular (extra-aortic valve) cardiac damage among patients with
severe AS undergoing AVR. Methods and results Patients with severe AS from
the PARTNER 2 trials were pooled and classified according to the presence
or absence of cardiac damage as detected by echocardiography prior to AVR:
no extravalvular cardiac damage (Stage 0), left ventricular damage (Stage
1), left atrial or mitral valve damage (Stage 2), pulmonary vasculature or
tricuspid valve damage (Stage 3), or right ventricular damage (Stage 4).
One-year outcomes were compared using Kaplan- Meier techniques and
multivariable Cox proportional hazards models were used to identify 1-year
predictors of mortality. In 1661 patients with sufficient
echocardiographic data to allow staging, 47 (2.8%) patients were
classified as Stage 0, 212 (12.8%) as Stage 1, 844 (50.8%) as Stage 2, 413
(24.9%) as Stage 3, and 145 (8.7%) as Stage 4. Oneyear mortality was 4.4%
in Stage 0, 9.2% in Stage 1, 14.4% in Stage 2, 21.3% in Stage 3, and 24.5%
in Stage 4 (Ptrend < 0.0001). The extent of cardiac damage was
independently associated with increased mortality after AVR (HR 1.46 per
each increment in stage, 95% confidence interval 1.27-1.67, P < 0.0001).
Conclusion This newly described staging classification objectively
characterizes the extent of cardiac damage associated with AS and has
important prognostic implications for clinical outcomes after
AVR.<br/>Copyright &#xa9; 2017 The Author.

<57>
Accession Number
635292235
Title
P2Y12 inhibitor monotherapy or dual antiplatelet therapy after coronary
revascularisation: Individual patient level meta-analysis of randomised
controlled trials.
Source
The BMJ. 373 (no pagination), 2021. Article Number: n1332. Date of
Publication: 16 Jun 2021.
Author
Valgimigli M.; Gragnano F.; Branca M.; Franzone A.; Baber U.; Jang Y.;
Kimura T.; Hahn J.-Y.; Zhao Q.; Windecker S.; Gibson C.M.; Kim B.-K.;
Watanabe H.; Song Y.B.; Zhu Y.; Vranckx P.; Mehta S.; Hong S.-J.; Ando K.;
Gwon H.-C.; Serruys P.W.; Dangas G.D.; McFadden E.P.; Angiolillo D.J.; Heg
D.; Juni P.; Mehran R.
Institution
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Valgimigli, Windecker) Department of Cardiology, Bern University
Hospital, University of Bern, Bern, Switzerland
(Gragnano) Department of Translational Medical Sciences, University of
Campania Luigi Vanvitelli, Caserta, Italy
(Branca, Heg) Clinical Trials Unit, Bern, Switzerland
(Franzone) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(Baber, Dangas, Mehran) Icahn School of Medicine at Mount Sinai, New York,
NY, United States
(Jang, Kim, Hong) Severance Cardiovascular Hospital, Yonsei University
College of Medicine, Seoul, South Korea
(Kimura, Watanabe) Department of Cardiovascular Medicine, Kyoto
University, Graduate School of Medicine, Kyoto, Japan
(Hahn, Song, Gwon) Heart Vascular Stroke Institute, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Zhao, Zhu) Department of Cardiovascular Surgery, Ruijin Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Gibson) Division of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Belgium
(Mehta) Department of Medicine, McMaster University, Hamilton, ON, Canada
(Mehta) Hamilton Health Sciences, Hamilton, ON, Canada
(Ando) Kokura Memorial Hospital, Department of Cardiology, Kitakyushu,
Japan
(Serruys) Department of Cardiology, National University of Ireland Galway,
Galway, Ireland
(Serruys) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(McFadden) Cardialysis Core Laboratories and Clinical Trial Management,
Rotterdam, Netherlands
(McFadden) Department of Cardiology, Cork University Hospital, Cork,
Ireland
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Juni) Applied Health Research Centre, Li Ka Shing Knowledge Institute,
Department of Medicine, St Michael's Hospital, University of Toronto,
Toronto, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Objective To assess the risks and benefits of P2Y 12 inhibitor monotherapy
compared with dual antiplatelet therapy (DAPT) and whether these
associations are modified by patients' characteristics. Design Individual
patient level meta-analysis of randomised controlled trials. Data sources
Searches were conducted in Ovid Medline, Embase, and three websites
(www.tctmd.com, www.escardio.org, www.acc.org/cardiosourceplus) from
inception to 16 July 2020. The primary authors provided individual
participant data. Eligibility criteria Randomised controlled trials
comparing effects of oral P2Y 12 monotherapy and DAPT on centrally
adjudicated endpoints after coronary revascularisation in patients without
an indication for oral anticoagulation. Main outcome measures The primary
outcome was a composite of all cause death, myocardial infarction, and
stroke, tested for non-inferiority against a margin of 1.15 for the hazard
ratio. The key safety endpoint was Bleeding Academic Research Consortium
(BARC) type 3 or type 5 bleeding. Results The meta-analysis included data
from six trials, including 24 096 patients. The primary outcome occurred
in 283 (2.95%) patients with P2Y 12 inhibitor monotherapy and 315 (3.27%)
with DAPT in the per protocol population (hazard ratio 0.93, 95%
confidence interval 0.79 to 1.09; P=0.005 for non-inferiority; P=0.38 for
superiority; tau 2 =0.00) and in 303 (2.94%) with P2Y 12 inhibitor
monotherapy and 338 (3.36%) with DAPT in the intention to treat population
(0.90, 0.77 to 1.05; P=0.18 for superiority; tau 2 =0.00). The treatment
effect was consistent across all subgroups, except for sex (P for
interaction=0.02), suggesting that P2Y 12 inhibitor monotherapy lowers the
risk of the primary ischaemic endpoint in women (hazard ratio 0.64, 0.46
to 0.89) but not in men (1.00, 0.83 to 1.19). The risk of bleeding was
lower with P2Y 12 inhibitor monotherapy than with DAPT (97 (0.89%) v 197
(1.83%); hazard ratio 0.49, 0.39 to 0.63; P<0.001; tau 2 =0.03), which was
consistent across subgroups, except for type of P2Y 12 inhibitor (P for
interaction=0.02), suggesting greater benefit when a newer P2Y 12
inhibitor rather than clopidogrel was part of the DAPT regimen.
Conclusions P2Y 12 inhibitor monotherapy was associated with a similar
risk of death, myocardial infarction, or stroke, with evidence that this
association may be modified by sex, and a lower bleeding risk compared
with DAPT.<br/>Copyright &#xa9; 2019 Author(s). Published by BMJ.

<58>
Accession Number
2013107324
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,
Universidad Complutense, 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, 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
Oxford University Press
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. <br/>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. <br/>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.
<br/>Copyright &#xa9; 2021 Published on behalf of the European Society of
Cardiology. All rights reserved.

<59>
Accession Number
2013046140
Title
A comparative study of IV fentanyl versus IV paracetamol for pain relief
in postoperatively after cardiac surgery.
Source
Medical Forum Monthly. 32 (4) (pp 149-152), 2021. Date of Publication:
April 2021.
Author
Khan N.A.; Sattar M.K.; Adnan M.; Khan Z.; Mohsin M.U.; Ammar A.
Institution
(Khan, Sattar, Mohsin, Ammar) Department of Anaesthesia, Nishtar Medical
University, Multan, Pakistan
(Adnan) Department of Anaesthesia, The Children Hospital, Institute of
Child Health, Multan, Pakistan
(Khan) Department of Anaesthesia, Sheikh Zaid Medical College, Hospital
Rahim Yar Khan, Pakistan
Publisher
Medical Forum Monthly
Abstract
Objective: To compare the efficacy of IV acetaminophen and IV fentanyl for
pain reduction after cardiac surgery. <br/>Study Design: Randomized
Controlled Trial study. Place and Duration of Study: This study was
conducted at the Department of Anesthesia, Nishtar Hospital Multan, and
Shaikh Zaid Hospital Rahim Yar Khan, from March, 2019 to February, 2021.
<br/>Material(s) and Method(s): Total 76 patients underwent cardiac
surgery requiring general anesthesia. A Visual Analog Scale (VAS) on 0-10
scales was used for assessment of pain. The scores for pain assessment
were given as 0 for no pain, 1-4 for mild, 5-7 for moderate and 8-10 for
severe pain. Patient's pain score was recorded by the same author that
recorded the intraoperative observations, after 5, 15, and 30 minutes
after surgical procedure. If the score on the numerical rating score was
greater than 3, rescue analgesia fentanyl 25 mug was administered in
increments. Total dose of fentanyl used was also recorded. SPSS version 23
was used for data analysis. Numerical variables like age and VAS score
were analyzed and presented as mean and SD. Categorical variables like age
were presented as frequency and percentages. Tests of significance
student's t-test and chi square test were applied to see association among
variables. P value <= 0.05 was considered as significant. <br/>Result(s):
Mean pain score was 1.66 +/- 0.74 and 2.16 +/- 0.88 in fentanyl and
paracetamol groups, respectively, and the difference was statistically
significant (p =0.010). QoR score was 14.63 +/- 1.34 and 15.34 +/- 1.38 in
fentanyl and paracetamol groups, respectively, and the difference was of
statistical significance (p =0.026). Nausea was reported by 36.8 %
patients of the fentanyl group and 26.3 % of the paracetamol group,
however, the difference was not statistically significant (p = 0.324).
Vomiting was reported by 34.2 % patients of the fentanyl group and 13.2 %
of the paracetamol group, and the difference was statistically significant
(p = 0.031). Complaint of dry mouth was present in 52.6 % patients of the
fentanyl group and 28.9 % of the paracetamol group, and the observed
difference was of statistical significance (p = 0.036).
<br/>Conclusion(s): It can be concluded from the results of our study
that, IV paracetamol was not associated with significant pain reduction as
compared to IV fentanyl however it was safer in terms of dry mouth and
vomiting.<br/>Copyright &#xa9; 2021 Medical Forum Monthly. All rights
reserved.

<60>
Accession Number
2007504155
Title
AviteneTM microfibrillar collagen hemostat for adjunctive hemostasis in
surgical procedures: A systematic literature review.
Source
Medical Devices: Evidence and Research. 14 (pp 155-163), 2021. Date of
Publication: 2021.
Author
Cziperle D.J.
Institution
(Cziperle) Ann B. Barshinger Cancer Institute, Lancaster, PA, United
States
Publisher
Dove Medical Press Ltd
Abstract
Adequate hemostasis during surgical procedures is essential for successful
patient outcomes and reduced healthcare resource utilization. Topical
hemostatic agents can act as catalysts for the clotting cascade or as a
scaffold to promote platelet activation or aggregation. Although an
ever-increasing number of topical absorbable hemostatic agents are now
available for perioperative use, health care providers are disadvantaged
by the lack of comparative data on feasibility, clinical effectiveness,
advantages, and limitations of each in specific surgical settings. This
knowledge is important for appropriate product choice when patient
characteristics, type of surgical procedure, type of bleeding, and product
availability may differ widely. This manuscript provides the first
comprehensive overview of AviteneTM Microfibrillar Collagen Hemostat
(MCH), a bovine collagen-based absorbable hemostat that has been widely
used for over four decades in the United States and abroad. MCH is
indicated as an adjunct to hemostasis across a broad spectrum of surgical
specialties and has been shown to achieve hemostasis with positive patient
outcomes and a favorable safety profile in many applications, including
hepatic, orthopedic, splenic, oral, and otolaryngologic surgery. Although
published clinical data regarding the use of MCH in cardiovascular surgery
is limited, evidence suggests moderate use in this specialty. The
information contained in this systematic review will help health care
providers understand the clinical use and effectiveness of the product to
determine appropriate use in differing bleeding scenarios across multiple
surgical specialties. Future studies may include comparative functional
and cost analyses to explore the economic advantages of using absorbable
hemostatic agents compared with each other or with conventional techniques
of hemostasis, when appropriate.<br/>Copyright &#xa9; 2021 Cziperle.

<61>
Accession Number
635323294
Title
Perioperative platelet reduction after sutureless or stented valve
implantation: results from the PERSIST-AVR controlled randomized trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2021.
Date of Publication: 12 Jun 2021.
Author
Lorusso R.; Jiritano F.; Roselli E.; Shrestha M.; Folliguet T.; Meuris B.;
Pollari F.; Fischlein T.
Institution
(Lorusso, Jiritano) Cardio-Thoracic Surgery Department, Heart and Vascular
Center, Maastricht University Medical Center (MUMC+), Maastricht,
Netherlands
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
(Jiritano) Cardiac Surgery Unit, Department of Experimental and Clinical
Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
(Roselli) Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH,
USA
(Shrestha) Hannover Medical School, Hannover, Germany
(Folliguet) Department of Cardiac Surgery, Hopital Henri Mondor,
Universite Paris 12, Creteil, Paris, France
(Meuris) Cardiac Surgery Department, Universitaire Ziekenhuizen Leuven,
Leuven, Belgium
(Pollari, Fischlein) Klinikum Nurnberg, Cardiovascular Center, Paracelsus
Medical University, Nuremberg, Germany
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Platelet count reduction is a common but not fully understood
phenomenon after aortic valve replacement (AVR) with bioprosthesis
implantation. The aim of the present study was to investigate the
occurrence and the clinical impact of platelet count reduction in patients
receiving the Perceval bioprosthesis compared to those receiving standard
sutured stented bioprosthetic aortic valve in a randomized, controlled AVR
study. <br/>METHOD(S): PERceval Sutureless Implant versus STandard Aortic
Valve Replacement is a prospective, randomized, adaptive, open-label
trial. Patients were randomized (March 2016-September 2018) to AVR with a
sutureless or stented valve. Ad hoc analyses have been performed to
evaluate the occurrence of platelet count reduction and the clinical
impact of the platelet variations in the 2 groups. <br/>RESULT(S): The
Perceval group showed a higher platelet reduction than the control group
(46% vs 32%). The phenomenon was transient in both groups, with a slow
recovery of the platelet count by hospital discharge. No differences were
observed between groups regarding need of transfusions, blood loss, major
bleeding and stroke events. <br/>CONCLUSION(S): The Perceval sutureless
aortic bioprosthesis implantation is associated with higher rate of
transient platelet reduction as compared to stented bioprostheses for AVR.
However, the platelet count reduction is transient and the decline does
not affect the patient's clinical outcomes. Current explanations for this
phenomenon are speculative, and further investigations are required to
elucidate it. CLINICAL TRIAL REGISTRATION NUMBER:
NCT02673697-ClinicalTrials.gov-4 February 2016.<br/>Copyright &#xa9; The
Author(s) 2021. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<62>
Accession Number
635322405
Title
Impact of comorbidities and antiplatelet regimen on platelet reactivity
levels in patients undergoing transcatheter aortic valve implantation.
Source
Journal of cardiovascular pharmacology. (no pagination), 2021. Date of
Publication: 31 May 2021.
Author
Trejo-Velasco B.; Tello-Montoliu A.; Cruz-Gonzalez I.; Moreno R.;
Baz-Alonso J.A.; Juan Salvadores P.; Romaguera R.; Molina-Navarro E.;
Paredes-Galan E.; Fernandez-Barbeira S.; Ortiz-Saez A.; Bastos-Fernandez
G.; De Miguel-Castro A.; Figueiras-Guzman A.; Iniguez-Romo A.; Alfonso
Jimenez-Diaz V.
Institution
(Trejo-Velasco) Cardiology Department, Hospital Universitario de
Salamanca. Instituto de Investigacion Biomedica de Salamanca (IBSAL),
Salamanca, Spain. Cardiology Department, Hospital Universitario Virgen de
la Arrixaca, IMIB-Arrixaca, Murcia, Spain. Centro de Investigacion en Red
de Enfermedades Cardiovasculares (Network Research Center for
Cardiovascular Diseases), CIBER-CV, Madrid, Spain. Interventional
Cardiology. Instituto de Investigacion del Hospital La Paz (IDIPAZ).
University Hospital La Paz, Madrid, Spain. Cardiology Department, Hospital
Alvaro Cunqueiro, University Hospital of Vigo,Vigo, Spain. Cardiovascular
Research Unit, Cardiology Department, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Vigo, Spain; Cardiovascular Research Group,
Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO,
Vigo, Spain. Cardiology Department, Hospital Universitario de Bellvitge,
Barcelona,Spain. Cardiology Department, Hospital Universitario Virgen de
las Nieves, Granada,Spain. Departamento de Medicina Preventiva y Salud
Publica, Facultad de Medicina, Universidad de Santiago de Compostela
Publisher
NLM (Medline)
Abstract
ABSTRACT: The aim of our study is to assess the impact of anemia, chronic
kidney disease (CKD) and diabetes mellitus on platelet reactivity (PR) in
patients with severe aortic stenosis, both at baseline and after
transcatheter aortic valve implantation (TAVI). This study is a
pre-specified subanalysis of the REAC-TAVI prospective, multicentre trial
that included patients pre-treated with aspirin+clopidogrel before TAVI.
PR was measured at baseline and at 5 different time points after TAVI with
the VerifyNow assay (Accriva Diagnostics, San Diego, CA), over a 3-month
follow-up period. Patients with high PR (HPR) at baseline, before TAVI,
(n=48) were randomized to aspirin+clopidogrel or aspirin+ticagrelor for 3
months, while those with normal PR (NPR) (n=20) were continued on
aspirin+clopidogrel. A "Raiser-response" in PR was defined as an increase
in PR units >20% of baseline after TAVI. Patients with HPR before TAVI
presented concomitant anemia and CKD more frequently than their
counterparts with NPR. Anemia and higher body mass index were
independently associated to HPR to clopidogrel at baseline. Moreover,
anemic patients with baseline HPR that were continued on clopidogrel
presented higher PR after TAVI than HPR patients switched to ticagrelor.
All patients with baseline NPR presented a "Raiser-response" after TAVI,
which was non-existent among HPR patients managed with ticagrelor. In
summary, anemia appears as a relevant factor associated to baseline HPR
and higher PR after TAVI in patients with baseline HPR randomized to
clopidogrel, while ticagrelor proved more effective than clopidogrel at
attaining sustained reductions in PR during follow-up, regardless of
baseline comorbidities.<br/>Copyright &#xa9; 2021 Wolters Kluwer Health,
Inc. All rights reserved.

<63>
Accession Number
635322180
Title
Coronary revascularization in patients with chronic kidney disease and
end-stage renal disease: a meta-analysis.
Source
International journal of clinical practice. (pp e14506), 2021. Date of
Publication: 12 Jun 2021.
Author
Li X.; Xiao F.; Zhang S.
Institution
(Li, Xiao, Zhang) Department of Cardiac Surgery, Peking University First
Hospital, Beijing, China
Publisher
NLM (Medline)
Abstract
To compare coronary artery bypass grafting (CABG) and percutaneous
coronary intervention (PCI) for revascularizing coronary arteries in
patients with chronic kidney disease (CKD) and end-stage renal disease
(ESRD). CKD is described as a continuous decrease in the glomerular
filtration rate or abnormalities in kidney structure or function. PubMed,
Cochrane Library, and Embase databases were searched for studies on the
revascularization of coronary arteries in patients with CKD and ESRD.
Since no randomized controlled trials (RCTs) have addressed this issue so
far, 31 observational studies involving 74,805 patients were included in
this meta-analysis. Compared with PCI, patients undergoing CABG had
significantly higher early mortality (CKD: RR = 1.62, 95% CI: 1.17-2.25,
Pheterogeneity = 0.476, I2 = 0; ESRD: RR = 1.99, 95% CI: 1.46-2.71,
Pheterogeneity = 0.001, I2 = 66.9%). Patients with ESRD undergoing CABG
had significantly lower all-cause mortality (RR = 0.95, 95% CI: 0.93-0.96,
Pheterogeneity < 0.001, I2 = 82.9%) and cardiac mortality (RR = 0.73, 95%
CI: 0.58-0.92, Pheterogeneity = 0.908, I2 = 0). The long-term risk of
repeat revascularization (CKD: RR = 0.24, 95% CI: 0.19-0.30,
Pheterogeneity = 0.489, I2 = 0; ESRD: RR = 0.23, 95% CI: 0.15-0.34,
Pheterogeneity = 0.012, I2 = 54.4%) and myocardial infarction (CKD: RR =
0.57, 95% CI: 0.38-0.85, Pheterogeneity = 0.025, I2 = 49.9%; ESRD: RR =
0.42, 95% CI: 0.40-0.44, Pheterogeneity = 0.49, I2 = 0) remained
significantly higher in the PCI group. Patients with ESRD, but not CKD,
who underwent CABG had significantly lower all-cause mortality and cardiac
mortality. However, CABG was associated with an increased risk of early
mortality in patients with CKD or ESRD. Adequately powered, contemporary,
prospective RCTs are needed to define the optimal revascularization
strategy for patients with CKD and ESRD.<br/>Copyright This article is
protected by copyright. All rights reserved.

<64>
Accession Number
635320590
Title
Prophylactic dialysis improves short-term clinical outcome in patients
with non-dialysis-dependent chronic kidney disease undergoing cardiac
surgery: a meta-analysis of randomized controlled trials.
Source
Coronary artery disease. (no pagination), 2021. Date of Publication: 10
Jun 2021.
Author
An X.; Ye N.; Bian W.; Cheng H.
Institution
(An) Division of Nephrology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Several studies have reported that prophylactic dialysis can
reduce the mortality of non-dialysis-dependent chronic kidney disease
(CKD) patients after cardiac surgery. However, the results of
complications in these randomized controlled trials (RCTs) were not
consistent. We aimed to perform a meta-analysis to systematically evaluate
the effect of prophylactic dialysis in these non-dialysis-dependent CKD
patients. <br/>METHOD(S): We systematically searched Medline, Embase,
Cochrane's Library and other online sources for related RCTs. Effects of
prophylactic dialysis on the incidence of 30 days' mortality and
postoperative complications were analyzed. <br/>RESULT(S): Four RCTs
comprising 395 patients were included, all of them treated by coronary
artery bypass grafting. Treatment of preoperative and intraoperative
prophylactic dialysis significantly reduced the rate of 30-day all-cause
mortality (risk ratio [RR]: 0.27, 95% confidence interval [CI], 0.13-0.58,
P < 0.001, I2 = 0%) and the incidence of pulmonary complications (RR:
0.39, 95% CI, 0.20-0.77, P = 0.007, I2 = 0%), low cardiac output (RR:
0.29, 95% CI, 0.09-0.99, P = 0.05, I2 = 0%), and acute kidney injury (RR:
0.19, 95% CI: 0.07-0.52, P = 0.001, I2 = 0%). However, there were no
statistically significant differences between the dialysis group and the
control group in gastrointestinal bleeding, sepsis or multiple organ
failure, wound infection, arrhythmia, transient neurologic deficit, stroke
and re-exploration for bleeding. <br/>CONCLUSION(S): Prophylactic dialysis
can improve the 30-day clinical outcomes of non-dialysis-dependent CKD
patients undergoing cardiac surgery, it was associated with the 30-day
mortality benefit and led to a decrease in the incidence of pulmonary
complications, as well as low cardiac output, and acute kidney
injury.<br/>Copyright &#xa9; 2021 Wolters Kluwer Health, Inc. All rights
reserved.

<65>
Accession Number
635320557
Title
Efficacy of an autologous blood patch for prolonged air leak, a systematic
review.
Source
The Annals of thoracic surgery. (no pagination), 2021. Date of
Publication: 08 Jun 2021.
Author
Hugen N.; Hekma E.J.; Claessens N.J.M.; Smit H.J.M.; Reijnen M.M.P.J.
Institution
(Hugen) Department of Thoracic Surgery, Rijnstate Hospital, Arnhem, the
Netherlands; Department of Surgery, Radboud university medical center, the
Netherlands
(Hekma) Department of Thoracic Surgery, Rijnstate Hospital, Arnhem,
Netherlands
(Claessens, Smit) Department of Respiratory Medicine, Rijnstate Hospital,
Arnhem, Netherlands
(Reijnen) Department of Thoracic Surgery, Rijnstate Hospital, Arnhem, the
Netherlands; Multi-Modality Medical Imaging Group, TechMed Centre,
University of Twente, Enschede, The Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: Prolonged air leak (PAL) following pulmonary surgery remains a
clinical challenge and sometimes needs surgical reintervention. An
autologous blood patch (ABP) may provide a noninvasive method to cease air
leak. Its value, however, is debatable. The aim of this systematic review
is to synthesize evidence regarding the efficacy of ABP in patients with
PAL. <br/>METHOD(S): A comprehensive search for published studies was
performed in the Medline database, Embase and the Cochrane library.
Randomized controlled trials, case-control studies and case series in
which a postoperative ABP was performed were included. Findings from these
studies were tabulated and data was synthesized graphically. PROSPERO
registration number CRD42020157591. <br/>RESULT(S): A total of 8 studies
was included in the analysis, comprising 151 patients. Studies
demonstrated heterogeneity in ABP timing and practice and an intermediate
to high risk of bias was scored. The majority of studies demonstrated a
beneficial effect of the ABP, with a high rate of success of over 89%. One
randomized trial did not find a difference in time to cease of air leak
following ABP compared with conservative tube thoracostomy. The overall
complication rate was 10%. <br/>CONCLUSION(S): Quality of included studies
is limited due to lack of comparison groups. Synthesized data in this
review demonstrates a high rate of successful procedures and acceptable
complication rates, which seems to be encouraging to justify a large
randomized clinical trial on the use of ABP for patients who suffer from
PAL following thoracic surgery.<br/>Copyright &#xa9; 2021. Published by
Elsevier Inc.

<66>
Accession Number
635319371
Title
Safety and Efficacy of Different Antithrombotic Strategies after
Transcatheter Aortic Valve Implantation: A Network Meta-Analysis.
Source
Thrombosis and Haemostasis. (no pagination), 2021. Date of Publication:
2021.
Author
Navarese E.P.; Grisafi L.; Spinoni E.G.; Mennuni M.G.; Rognoni A.;
Ratajczak J.; Podhajski P.; Koni E.; Kubica J.; Patti G.
Institution
(Navarese, Kubica) Department of Cardiology and Internal Medicine,
Collegium Medicum, Nicolaus Copernicus University, Via Solaroli 17,
Novara, Italy
(Grisafi, Spinoni, Patti) Department of Translational Medicine, University
of Eastern Piedmont, Novara, Italy
(Grisafi, Spinoni, Mennuni, Rognoni, Patti) Department of Thoracic, Heart
and Vascular Diseases, Maggiore della Carita Hospital, Novara, Italy
(Ratajczak) Department of Health Promotion, Nicolaus Copernicus
University, Bydgoszcz, Poland
(Ratajczak, Podhajski) Department of Cardiology and Internal Medicine,
Nicolaus Copernicus University, Bydgoszcz, Poland
(Koni) Department of Interventional Cardiology, Santa Corona Hospital,
Ligure, Pietra, Italy
Publisher
Georg Thieme Verlag
Abstract
Background The optimal pharmacological therapy after transcatheter aortic
valve implantation (TAVI) remains uncertain. We compared efficacy and
safety of various antiplatelet and anticoagulant approaches after TAVI by
a network meta-analysis. Methods A total of 14 studies (both observational
and randomized) were considered, with 24,119 patients included. Primary
safety endpoint was the incidence of any bleeding complications during
follow-up. Secondary safety endpoint was major bleeding. Efficacy
endpoints were stroke, myocardial infarction, and cardiovascular
mortality. A frequentist network meta-analysis was conducted with a
random-effects model. The following strategies were compared: dual
antiplatelet therapy (DAPT), single antiplatelet therapy (SAPT), oral
anticoagulation (OAC), and OAC + SAPT. The mean follow-up was 15 months.
Results In comparison to DAPT, SAPT was associated with a 44% risk
reduction of any bleeding (odds ratio [OR]: 0.56 [95% confidence interval,
CI: 0.39-0.80]). SAPT was ranked as the safest strategy for the prevention
of any bleeding (p -score: 0.704), followed by OAC alone (p -score: 0.476)
and DAPT (p -score: 0.437). Consistent results were observed for major
bleeding. The incidence of cardiovascular death and secondary ischemic
endpoints did not differ among the tested antithrombotic approaches. In
patients with indication for long-term anticoagulation, OAC alone showed
similar rates of stroke (OR: 0.92 [95% CI: 0.41-2.05], p = 0.83) and
reduced occurrence of any bleeding (OR: 0.49 [95% CI: 0.37-0.66], p <
0.01) versus OAC + SAPT. Conclusion The present network meta-analysis
supports after TAVI the use of SAPT in patients without indication for OAC
and OAC alone in those needing long-term anticoagulation.<br/>Copyright
&#xa9; 2021 Georg Thieme Verlag. All rights reserved.

<67>
Accession Number
619304993
Title
Stopping versus continuing acetylsalicylic acid before coronary artery
bypass surgery: A systematic review and meta-analysis of 14 randomized
controlled trials with 4499 patients.
Source
European Journal of Cardio-thoracic Surgery. 52 (5) (pp 838-847), 2017.
Date of Publication: 01 Nov 2017.
Author
Sa M.P.B.O.; Soares A.F.; Miranda R.G.A.; Araujo M.L.; Menezes A.M.;
Vasconcelos Silva F.P.; Lima R.C.
Institution
(Sa, Soares, Miranda, Araujo, Menezes, Vasconcelos Silva, Lima) Division
of Cardiovascular Surgery, Pronto Socorro Cardiologico de Pernambuco
(PROCAPE), Recife, Brazil
(Sa, Soares, Miranda, Araujo, Menezes, Vasconcelos Silva, Lima) University
of Pernambuco (UPE), Recife, Brazil
(Sa, Lima) Nucleus of Postgraduate and Research in Health Sciences of
Faculty of Medical Sciences, Biological Sciences Instituite (FCM/ICB),
Recife, Brazil
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
This study aimed to evaluate the efficacy and safety of continuing versus
stopping aspirin [acetylsalicylic acid (ASA)] preoperatively in patients
undergoing coronary artery bypass graft surgery. MEDLINE, EMBASE,
CENTRAL/Cochrane Controlled Trials Register (CCTR), ClinicalTrials.gov,
Scientific Electronic Library Online (SciELO), Literatura Latino Americana
em Ciencias da Saude (LILACS), Google Scholar and reference lists of
relevant articles were searched for randomized controlled trials that
reported efficacy outcomes ofmyocardial infarction and mortality, and
safety outcomes of blood loss, packed red blood cell transfusion and
surgical re-exploration were compared between groups. Fourteen studies
fulfilled our eligibility criteria and included a total of 4499 patients
(2329 for 'continuing ASA' and 2170 for 'stopping ASA'). In the pooled
analysis, continuing aspirin therapy did not reduce the risk of myocardial
infarction [risk ratio 0.834, 95% confidence interval (CI) 0.688-1.010; P
= 0.063] or operative mortality (risk ratio 1.384, 95% CI 0.727-2.636; P =
0.323). Preoperative ASA increased postoperative chest tube drainage (mean
difference 143 ml, 95% CI 39-248 ml; P = 0.007) and packed red blood cell
transfusion (mean difference 142ml, 95% CI 55-228; P = 0.001) but did not
increase the risk of surgical re-exploration (risk ratio 1.316, 95% CI
0.910-1.905; P = 0.145). This meta-analysis found no statistically
significant difference regarding the risk of operative mortality and
myocardial infarction between the 'continuing ASA' and 'stopping ASA'
strategies. On the other hand, the mean volume of blood loss and packed
red blood cell transfusion was higher in the 'continuing ASA' group, but
this finding did not translate into higher risk of reoperation for
bleeding.<br/>Copyright &#xa9; The Author 2017. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<68>
Accession Number
370015116
Title
Quality of life after PCI vs CABG among patients with diabetes and
multivessel coronary artery disease: A randomized clinical trial.
Source
JAMA - Journal of the American Medical Association. 310 (15) (pp
1581-1590), 2013. Date of Publication: 16 Oct 2013.
Author
Abdallah M.S.; Wang K.; Magnuson E.A.; Spertus J.A.; Farkouh M.E.; Fuster
V.; Cohen D.J.
Institution
(Abdallah, Wang, Magnuson, Spertus, Cohen) Saint Luke's Mid America Heart
Institute, University of Missouri-Kansas City School of Medicine,
4401Wornall Rd, Kansas City, MO 64111, United States
(Abdallah, Magnuson, Spertus, Cohen) University of Missouri-Kansas City
School of Medicine, Kansas City, MO, United States
(Farkouh, Fuster) Mount Sinai School of Medicine, New York, NY, United
States
(Farkouh) Peter Munk Cardiac Centre, Li Ka Shing Knowledge Institute,
University of Toronto, Toronto, ON, Canada
Publisher
American Medical Association
Abstract
IMPORTANCE: The FREEDOM trial demonstrated that among patients with
diabetes mellitus and multivessel coronary artery disease, coronary artery
bypass graft (CABG) surgery resulted in lower rates of death and
myocardial infarction but a higher risk of stroke when compared with
percutaneous coronary intervention (PCI) using drug-eluting stents.
Whether there are treatment differences in health status, as assessed from
the patient's perspective, is unknown. <br/>OBJECTIVE(S): To compare the
relative effects of CABG vs PCI using drug-eluting stents on health status
among patients with diabetes mellitus and multivessel coronary artery
disease. DESIGN, SETTING, AND PARTICIPANTS: Between 2005 and 2010, 1900
patients from 18 countries with diabetes mellitus and multivessel coronary
artery disease were randomized to undergo either CABG surgery (n = 947) or
PCI (n = 953) as an initial treatment strategy. Of these, a total of 1880
patients had baseline health status assessed (935 CABG, 945 PCI) and
comprised the primary analytic sample. INTERVENTIONS: Initial
revascularization with CABG surgery or PCI. MAIN OUTCOMES AND MEASURES:
Health statuswas assessed using the angina frequency, physical
limitations, and quality-of-life domains of the Seattle Angina
Questionnaire at baseline, at 1, 6, and 12 months, and annually
thereafter. For each scale, scores range from 0 to 100 with higher scores
representing better health. The effect of CABG surgery vs PCI was
evaluated using longitudinal mixed-effect models. <br/>RESULT(S): At
baseline, mean (SD) scores for the angina frequency, physical limitations,
and quality-of-life subscales of the Seattle Angina Questionnaire were
70.9 (25.1), 67.3 (24.4), and 47.8 (25.0) for the CABG group and 71.4
(24.7), 69.9 (23.2), and 49.2 (25.7) for the PCI group, respectively. At
2-year follow-up, mean (SD) scores were 96.0 (11.9), 87.8 (18.7), and 82.2
(18.9) after CABG and 94.7 (14.3), 86.0 (19.3), and 80.4 (19.6) after PCI,
with significantly greater benefit of CABG on each domain (mean treatment
benefit, 1.3 [95%CI, 0.3-2.2], 4.4 [95%CI, 2.7-6.1], and 2.2 [95%CI,
0.7-3.8] points, respectively; P < .01 for each comparison). Beyond 2
years, the 2 revascularization strategies provided generally similar
patient-reported outcomes. CONCLUSIONS AND RELEVANCE: For patients with
diabetes and multivessel CAD, CABG surgery provided slightly better
intermediate-term health status and quality of life than PCI using
drug-eluting stents. Themagnitude of benefit was small, without consistent
differences beyond 2 years, in part due to the higher rate of repeat
revascularization with PCI.

<69>
Accession Number
2006747342
Title
Left ventricular noncompaction-a systematic review of risk factors in the
pediatric population.
Source
Journal of Clinical Medicine. 10 (6) (pp 1-18), 2021. Article Number:
1232. Date of Publication: 02 Mar 2021.
Author
Luczak-Wozniak K.; Werner B.
Institution
(Luczak-Wozniak) Department of Pediatric Cardiology and General
Pediatrics, Doctoral School, Medical University of Warsaw, Warsaw 02-091,
Poland
(Werner) Department of Pediatric Cardiology and General Pediatrics,
Medical University of Warsaw, Warsaw 02-091, Poland
Publisher
MDPI AG
Abstract
Left ventricular noncompaction (LVNC) is a heterogeneous, often hereditary
group of diseases, which may have diverse clinical manifestations. This
article reviews the risk factors for unfavorable outcomes of LVNC in
children, as well as discuss the diagnostic methods and the differences
between pediatric and adult LVNC. Through a systematic review of the
literature, a total of 1983 articles were outlined; 23 of them met the
inclusion criteria. In echocardiography the following have been associated
with adverse outcomes in children: Left ventricular ejection fraction,
end-diastolic dimension, left ventricular posterior wall compaction, and
decreased strains. T-wave abnormalities and increased spatial peak QRS-T
angle in ECG, as well as arrhythmia, were observed in children at greater
risk. Cardiac magnetic resonance is a valuable tool to identify those with
systolic dysfunction and late gadolinium enhancement. Genetic testing
appears to help identify children at risk, because mutations in particular
genes have been associated with worse outcomes. ECG and imaging tests,
such as echocardiography and magnetic resonance, help outline risk factors
for unfavorable outcomes of LVNC in children and in identifying
outpatients who require more attention. Refining the current diagnostic
criteria is crucial to avoid inadequate restrain from physical
activity.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<70>
Accession Number
2010910314
Title
Peguero-Lo Presti criteria for the diagnosis of left ventricular
hypertrophy: A systematic review and meta-analysis.
Source
PLoS ONE. 16 (1 January) (no pagination), 2021. Article Number: e0246305.
Date of Publication: January 2021.
Author
Yu Z.; Song J.; Cheng L.; Li S.; Lu Q.; Zhang Y.; Lin X.; Liu D.
Institution
(Yu, Song, Cheng, Lu) Department of Electrocardiography, No. 4 Affiliated
Hospital of Jiangsu University, Zhenjiang, China
(Li) Department of Cardiology, No. 4 Affiliated Hospital of Jiangsu
University, Zhenjiang, China
(Zhang) Department of Infection Management, Affiliated Hospital of Jiangsu
University, Zhenjiang, China
(Lin) Department of Internal Medicine, First People's Hospital of Daishan,
Zhejiang, China
(Liu) Department of Critical Care Medicine, Affiliated Hospital of Jiangsu
University, Zhenjiang, China
Publisher
Public Library of Science
Abstract
Background The Peguero-Lo Presti criteria are novel electrocardiographic
(ECG) diagnostic criteria for the detection of left ventricular
hypertrophy (LVH) and represent the sum of the amplitude of the deepest S
wave in any lead with the S wave in lead V<inf>4</inf>
(S<inf>D</inf>+SV<inf>4</inf>). The diagnostic efficacy of the Peguero-Lo
Presti criteria in LVH is still debatable. We aimed to test the
sensitivity and specificity of the Peguero-Lo Presti criteria and compared
them with those of the Cornell voltage index to assess their overall
performance in LVH diagnosis. Methods Electronic databases (e.g., Medline,
Web of Knowledge, Embase, and the Cochrane Library) were searched from
their inception until May 18, 2020. Trials written in English that
investigated the Peguero-Lo Presti criteria for detecting LVH were
included. Data were independently extracted and analyzed by two
investigators. Results A total of 51 records were screened, and 6 trials
comprising 13,564 patients were finally included. A bivariate analysis
showed that the sensitivity of the Peguero-Lo Presti criteria (0.52, 95%
confidence interval (CI) 0.46-0.58) was higher than that of the Cornell
voltage index (0.29, 95% CI 0.23-0.36) and Sokolow-Lyon criteria (0.24,
95% CI 0.21-0.27); the diagnostic accuracy of the Peguero-Lo Presti
criteria (0.69, 95% CI 0.65-0.73) was also higher than that of the Cornell
voltage index (0.67, 95% CI 0.62-0.71) and Sokolow-Lyon criteria (0.28,
95% CI 0.25-0.32); and the specificity of the Peguero-Lo Presti criteria
(0.85, 95% CI 0.79-0.90) was similar to that of the Cornell voltage index
(0.92, 95% CI 0.89-0.95) and Sokolow-Lyon criteria (0.94, 95%CI
0.88-0.97). Two trials (including 12,748 patients) were discharged because
they included partly healthy subjects and accounted for substantial
heterogeneity. Pooled analysis of the remaining 4 trials (including 816
patients) showed that the sensitivity of the Peguero-Lo Presti criteria
(0.56, 95% CI 0.51-0.61) was also higher than that of the Cornell voltage
index (0.36, 95% CI 0.31-0.42) and Sokolow-Lyon criteria (0.24, 95% CI
0.18-0.31); the diagnostic accuracy of the Peguero-Lo Presti criteria
(0.84, 95% CI 0.80-0.87) was also higher than that of the Cornell voltage
index (0.54, 95% CI 0.50-0.58) and Sokolow-Lyon criteria (0.38, 95% CI
0.34-0.42); and the specificity of the Peguero-Lo Presti criteria (0.90,
95% CI 0.87-0.92) was similar to that of the Cornell voltage index (0.93,
95% CI 0.88-0.96) and Sokolow-Lyon criteria (0.97, 95% CI 0.90-0.99). Both
the likelihood ratio and posttest probability of the Peguero-Lo Presti
criteria and Cornell voltage index were moderate. Conclusion Based on this
systematic review and meta-analysis, the Peguero-Lo Presti criteria-based
ECG diagnostic method for LVH has high sensitivity, specificity and
diagnostic accuracy and should be applied in clinical practice
settings.<br/>Copyright: &#xa9; 2021 Yu et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<71>
Accession Number
2010569485
Title
Nalbuphine Versus Ketorolac as an Adjuvant to Local Wound Infiltration
Anesthesia in Open Colorectal Surgery: A Prospective Randomized Controlled
Study.
Source
Pain and Therapy. 10 (1) (pp 551-565), 2021. Date of Publication: June
2021.
Author
Ren Y.-F.; Fu X.; Wang Y.-T.; Liu H.; Zheng X.-Z.; Liu J.; Li L.-J.; You
F.-M.
Institution
(Ren, Fu, Wang, Liu, Li, You) Hospital of Chengdu University of
Traditional Chinese Medicine, Chengdu, Sichuan, China
(Zheng, Liu) Department of Anesthesiology, Medical College of Henan
University, Kaifeng, Henan, China
Publisher
Adis
Abstract
Introduction: Adding adjuvants to local wound infiltration (LWI) provides
long analgesic duration with fewer adverse effects. We aimed to compare
the clinical effects of nalbuphine and ketorolac as an adjuvant to LWI in
patients undergoing open colorectal cancer surgery. <br/>Method(s): A
total of 126 ASA I-III patients aged >= 18 years who were scheduled for
open colorectal cancer surgery were included. Patients were randomly
assigned to receive LWI using 10 mL 0.75% ropivacaine, with 20 mL normal
saline (group R), 10 mg nalbuphine in 1 mL (group RN), or 25 mg ketorolac
in 0.8 mL (group RK). Analgesia duration was the primary outcome. The
total 48-h postoperative morphine-equivalent consumption and additional
rescue analgesia rates were recorded as key secondary outcomes.
<br/>Result(s): Among 126 patients randomized, 124 completed the trial.
The duration until the first press of the analgesia pump was significantly
shorter in group R (median: 320.0 min) compared with group RN (median:
829.5 min) and group RK (median: 820.0 min) (P < 0.001). The median
difference in morphine consumption was 113.0 mg for group R vs. group RN
(P < 0.001), and 115.5 mg for group R vs. group RK (P < 0.001). The
proportion of patients using additional morphine within the first day
after surgery in group R showed a higher relative risk (RR) compared with
group RN (RR, 3.89; P = 0.001) and group RK (RR, 3.17; P = 0.001). There
were no apparent differences between the RN and RK groups in any outcomes,
whether in adjusted or unadjusted analysis. <br/>Conclusion(s): Among
patients undergoing open colorectal cancer surgery, both nalbuphine and
ketorolac infiltration achieved equally prolonged duration of analgesia
and reduced morphine consumption compared with ropivacaine alone after
surgery, suggesting that the equivalent analgesic dose of nalbuphine and
ketorolac as local anesthetic adjuvants in LWI could have a similar
analgesic effect. Trial Registration: ChiCTR1800019209.<br/>Copyright
&#xa9; 2021, The Author(s).

<72>
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.
<br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC.

<73>
Accession Number
2011981514
Title
Effects of treprostinil on pulmonary arterial hypertension during surgery
for congenital heart disease complicated with severe pulmonary arterial
hypertension.
Source
Minerva Cardiology and Angiology. 69 (2) (pp 154-160), 2021. Date of
Publication: April 2021.
Author
Jiang H.; Yu X.; Zhang L.; Wang M.
Institution
(Jiang, Wang) Department of Ultrasonography, Weihai Central Hospital,
Weihai, China
(Yu) Blood Purification Center, Weihai Central Hospital, Weihai, China
(Zhang) Penglai People's Hospital, Yantai, China
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: The aim of this study is to evaluate the effects of
treprostinil injection on the control of pulmonary blood pressure in
children with congenital heart disease (CHD) complicated by severe
pulmonary arterial hypertension (PAH). <br/>METHOD(S): Eighty children
with CHD complicated by severe pulmonary arterial hypertension admitted to
our hospital from January 2015 to June 2018 were selected and randomly
divided into a control group (N.=40) and a treatment group (N.=40). Based
on standard treatment, the treatment group was intravenously infused with
8-12 ng/kg.min treprostinil, while the control group received the same
dose of normal saline. Hemodynamic parameters such as BP, AP, P and SpO2%
were monitored before anesthesia induction (T0), before cardiopulmonary
bypass (T1), 1 h after cardiopulmonary bypass (T2) and at the end of
cardiopulmonary bypass (T3). Pulmonary arterial pressure parameters (PASP,
PADP and PAMP) were measured at T1, T2 and T3 by transesophageal
echocardiography. <br/>RESULT(S): For the treatment group, the HR values
at T2 and T3 were lower than that at T0 (P<0.05). For the control group,
HR at T3 was lower than that at T0 (P<0.05). HR at T3 of the treatment
group was lower than that of the control group (P<0.05). SpO2 of the
treatment group was higher than that of the control group at T3 (P<0.05).
At T2 and T3, PASP, PADP and PAMP of both groups were lower than those
before surgery (P<0.05), and the values of the treatment group were lower
than those of the control group (P<0.05). <br/>CONCLUSION(S): Treprostinil
can improve cardiac function and reduce pulmonary circulation resistance
in PAH children.<br/>Copyright &#xa9; 2020 EDIZIONI MINERVA MEDICA.

<74>
Accession Number
2010854932
Title
Beneficial effect of left atrial appendage closure during cardiac surgery:
A meta-analysis of 280 585 patients.
Source
European Journal of Cardio-thoracic Surgery. 57 (2) (pp 252-262), 2020.
Date of Publication: 01 Feb 2020.
Author
Gutierrez E.M.; Castano M.; Gualis J.; Martinez-Comendador J.M.; Maiorano
P.; Castillo L.; Laguna G.
Institution
(Castano, Gualis, Maiorano, Castillo, Laguna) Servicio de Cirugia
Cardiaca, Hospital Universitario de Leon - CAULE, Leon, Spain
(Martinez-Comendador) Servicio de Cirugia Cardiaca, Complexo Hospitalario
Universitario A Coruna (CHUAC), A Coruna, Spain
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
In non-rheumatic atrial fibrillation (AF), left atrial appendage (LAA) is
thought to be the source of embolism in 90% of the strokes. Thus, as
recent clinical trials have shown the non-inferiority of percutaneous LAA
closure (LAAc) in comparison to medical treatment, and despite a IIb
recommendation in the latest guidelines for concomitant surgical LAAc, we
sought to investigate the beneficial effect of LAAc in the surgical
population. A meta-analysis model was performed comparing studies
including any cardiac surgery with or without concomitant surgical LAAc
reporting stoke/embolic events and/or mortality, from inception to January
2019. Twenty-two studies (280 585 patients) were included in the model.
Stroke/embolic events both in the perioperative period [relative risk (RR)
0.66, 95% confidence interval (CI) 0.53-0.82; P = 0.0001] and during
follow-up of >2 years (RR 0.67, 95% CI 0.51-0.89; P < 0.005) were
significantly reduced in patients who underwent surgical LAAc (RR 0.71,
95% CI 0.58-0.87; P = 0.001). Regarding the rate of preoperative AF, LAAc
showed protective effect against stroke/embolic events in studies with
>70% preoperative AF (RR 0.64, 95% CI 0.53-0.77; P < 0.00001) but no
benefit in the studies with <30% of preoperative AF (RR 0.77, 95% CI
0.46-1.28; P = 0.31). Postoperative mortality was also significantly lower
in surgical patients with LAAc at the mid- and long-term follow-up. (RR
0.72, 95% CI 0.67-0.78; P < 0.00001; I² = 0%). Based on these
findings, concomitant surgical LAAc is associated with lower rates of
embolic events and stroke in the postoperative period in patients with
preoperative AF and also improves postoperative mortality in the mid- and
long-term follow-up.<br/>Copyright &#xa9; The Author(s) 2019. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<75>
Accession Number
2005527908
Title
Effects of epidural block anesthesia combined with general anesthesia on
cognitive function and analgesic effect after thoracoscopic surgery.
Source
International Journal of Clinical and Experimental Medicine. 13 (11) (pp
8966-8973), 2020. Article Number: ijcem0117128. Date of Publication: 2020.
Author
Zhou W.; Wang B.; Cai X.; Xu Z.
Institution
(Zhou, Wang, Cai, Xu) Department of Anesthesiology, Affiliated Hospital of
Nantong University, Nantong, Jiangsu Province, China
Publisher
E-Century Publishing Corporation
Abstract
Objective: To investigate the effects of epidural block anesthesia
combined with general anesthesia on cognitive function and analgesic
effect after thoracoscopic surgery. <br/>Method(s): A randomized
controlled study was conducted on 82 patients who underwent thoracoscopic
surgery in the Affiliated Hospital of Nantong University from January 2018
to January 2019. Patients were divided into an observation group (n=41)
and a control group (n=41) by random number method. The control group
received general anesthesia, while the observation group also had epidural
block anesthesia in addition to general anesthesia. Changes of heart rate
(HR), mean arterial pressure (MAP) and blood oxygen saturation
(SpO<inf>2</inf> ) were compared between the two groups at different
anesthesia time points. Intraoperative and postoperative indicators of
both groups were recorded. Changes of serum interleukin-6 (IL-6), tumor
necrosis factor-alpha (TNF-alpha) and high-sensitivity C-reactive protein
(hs-CRP) before and after surgery were analyzed. At 1 h, 6 h, 24 h and 48
h after surgery, the changes of visual analogue scale (VAS) and
mini-mental state examination (MMSE) were detected in both groups. At 6 h,
24 h, and 48 h after surgery, the incidence of postoperative cognitive
dysfunction (POCD) and the need for analgesia of both groups were recorded
and compared. <br/>Result(s): The dosages of propofol and remifentanil in
the observation group were significantly lower than those in the control
group (P<0.05). VAS and MMSE scores of the observation group were
significantly better than those of the control group at 1 h, 6 h, 24 h and
48 h after surgery (P<0.05). Compared with the control group, the
incidences of POCD in the observation group were significantly lower at 6
h, 24 h and 48 h after surgery, and the analgesia rates in the observation
group were also significantly lower at 6 h-24 h and 24 h-48 h after
surgery (P<0.05). There were no significant differences in IL-6, TNF-alpha
and hs-CRP between the two groups before surgery (P>0.05); IL-6, TNF-alpha
and hs-CRP levels in both groups were increased after surgery, and the
levels in control group were significantly higher compared with
observation group (P<0.05). <br/>Conclusion(s): The application of
epidural block anesthesia combined with general anesthesia results in
stable hemodynamics, improved analgesic effect, better incidence of POCD,
and less inflammatory response, which is of high clinical value in
thoracoscopic surgery.<br/>Copyright &#xa9; 2020, E-Century Publishing
Corporation. All rights reserved.

<76>
Accession Number
2011822815
Title
Long-Term Outcomes Comparing Medical Therapy versus Revascularization for
Spontaneous Coronary Artery Dissection.
Source
American Journal of Medicine. 134 (7) (pp e403-e408), 2021. Date of
Publication: July 2021.
Author
Krittanawong C.; Nazir S.; Hassan Virk H.; Hahn J.; Wang Z.; Fogg S.E.;
Sharma S.K.; Alam M.; Jneid H.
Institution
(Krittanawong, Hahn, Jneid) Michael E. DeBakey VA Medical Center, Houston,
Tex, United States
(Krittanawong, Hahn, Alam, Jneid) Section of Cardiology, Baylor School of
Medicine, Houston, Tex, United States
(Nazir) Department of Cardiology, University of Toledo, ToledoOhio
(Hassan Virk) Harrington Heart & Vascular Institute, Case Western Reserve
University, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
(Wang) Robert D. and Patricia E. Kern Center for the Science of Health
Care Delivery, Mayo Clinic, Rochester, Minn, United States
(Wang) Division of Health Care Policy and Research, Department of Health
Sciences Research, Mayo Clinic, Rochester, Minn, United States
(Fogg, Alam) Texas Heart Institute, Houston, Tex, United States
(Sharma) Cardiac Catheterization Laboratory of the Cardiovascular
Institute, Mount Sinai Hospital, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
The ideal management of spontaneous coronary artery dissection (SCAD) has
yet to be clearly defined. We conducted a comprehensive search of Ovid
MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews,
Scopus, and Web of Science from database inception from 1966 through
September 2020 for all original studies (randomized controlled trials and
observational studies) that evaluated patients with SCAD. Study groups
were defined by allocation to medical therapy (medical therapy) versus
invasive therapy (invasive therapy) (ie, percutaneous coronary
intervention or coronary artery bypass grafting). The risk of death (risk
ratio [RR] = 0.753; 95% confidence interval [CI]: 0.21-2.73; I²
= 21.1%; P = 0.61), recurrence of SCAD (RR = 1.09; 95% CI: 0.61-1.93;
I² = 0.0%; P = 0.74), and repeat revascularization (RR = 0.64;
95% CI: 0.21-1.94; I² = 57.6%; P = 0.38) were not statistically
different between medical therapy and invasive therapy for a follow-up
ranging from 4 months to 3 years. In conclusion, in this meta-analysis of
observational studies, the long-term risk of death, recurrent SCAD, and
repeat revascularization did not significantly differ among patients with
SCAD treated with medical therapy compared with those treated with
invasive therapy. These findings support the current expert consensus that
patients should be treated with medical therapy when clinically stable and
no high-risk features are present. Further large-scale studies including
randomized controlled trials are needed to confirm these
findings.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<77>
Accession Number
2011668736
Title
Low-temperature electrocautery reduces adverse effects from secondary
cardiac implantable electronic device procedures: Insights from the
WRAP-IT trial.
Source
Heart Rhythm. 18 (7) (pp 1142-1150), 2021. Date of Publication: July 2021.
Author
Mittal S.; Wilkoff B.L.; Poole J.E.; Kennergren C.; Wright D.J.; Berman
B.J.; Riggio D.; Sholevar D.P.; Martinez-Arraras J.; Moubarak J.B.;
Schaller R.D.; Love J.C.; Pickett R.A.; Philippon F.; Eldadah Z.; Lande
J.D.; Lexcen D.R.; Holbrook R.; Tarakji K.G.
Institution
(Mittal) Valley Health System, Ridgewood, NJ, United States
(Wilkoff, Tarakji) Cleveland Clinic, Cleveland, OH, United States
(Poole) University of Washington School of Medicine, Seattle, WA, United
States
(Kennergren) Sahlgrenska University Hospital, Goteborg, Sweden, Sweden
(Wright) Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
(Berman) Chula Vista Cardiac Center, Chula Vista, CA, United States
(Riggio) Arizona Arrhythmia Consultants, Scottsdale, AZ, United States
(Sholevar) Virtua Health System, Camden, NJ, United States
(Martinez-Arraras) Amarrillo Heart Group, Amarillo, TX, United States
(Moubarak) Hamot Medical Center, Erie, PA, United States
(Schaller) University of Pennsylvania, Philadelphia, PA, United States
(Love) Maine Medical Center, Portland, ME, United States
(Pickett) Saint Thomas Research Institute, LLC Thomas, Nashville, TN,
United States
(Philippon) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec (IUCPQ), Quebec, Canada
(Eldadah) MedStar Heart and Vascular Institute, Washington, DC, United
States
(Lande, Lexcen, Holbrook) Medtronic, Mounds View, MN, United States
Publisher
Elsevier B.V.
Abstract
Background: Cardiac device procedures require tissue dissection to free
existing device lead(s). Common techniques include blunt dissection,
standard electrocautery, and low-temperature electrocautery (PlasmaBlade,
Medtronic); however, data on the type of electrosurgical tool used and the
development of procedure- or lead-related adverse events are limited.
<br/>Objective(s): The purpose of this study was to determine whether
standard or low-temperature electrocautery impacts the development of an
adverse event. <br/>Method(s): We evaluated patients enrolled in WRAP-IT
(Worldwide Randomized Antibiotic EnveloPe Infection PrevenTion Trial)
undergoing cardiac implantable electronic device (CIED) revision, upgrade,
or replacement. All adverse events were adjudicated by an independent
physician committee. Data were analyzed using Cox proportional hazard
regression modeling. <br/>Result(s): In total, 5641 patients underwent
device revision/upgrade/replacement. Electrocautery was used in 5205
patients (92.3%) (mean age 70.6 +/- 12.7 years; 28.8% female), and
low-temperature electrocautery was used in 1866 patients (35.9%). Compared
to standard electrocautery, low-temperature electrocautery was associated
with a 23% reduction in the incidence of a procedure- or lead-related
adverse event through 3 years of follow up (hazard ratio [HR] 0.77; 95%
confidence interval [CI] 0.65-0.91; P = .002). After controlling for the
number of active leads, degree of capsulectomy, degree of lead dissection,
and renal dysfunction, low-temperature electrocautery was associated with
a 32% lower risk of lead-related adverse events (HR 0.68; 95% CI
0.52-0.89; P = .004). These effects were consistent across a spectrum of
lead-related adverse event types. <br/>Conclusion(s): This study
represents one of the largest assessments of electrocautery use in
patients undergoing CIED revision, upgrade, or replacement procedures.
Compared to standard electrocautery, low-temperature electrocautery
significantly reduces adverse effects from these procedures.<br/>Copyright
&#xa9; 2021 Heart Rhythm Society

<78>
Accession Number
2011465986
Title
Diagnostic accuracy of stroke volume variation for predicting fluid
responsiveness in children undergoing cardiac surgery: A systematic review
and meta-analysis.
Source
Paediatric Anaesthesia. 31 (7) (pp 755-762), 2021. Date of Publication:
July 2021.
Author
Luo D.; Liu F.; Dai W.; Zhang J.; Shao Q.; Tao W.; Xiao R.; Feng X.; Qian
K.
Institution
(Luo, Liu, Zhang, Shao, Tao, Xiao, Qian) Department of Intensive Care
Unit, The First Affiliated Hospital of Nanchang University, Nanchang,
China
(Luo, Dai) Department of Intensive Care Unit, The Fifth Dongxin's Hospital
of Shangrao City, Shangrao, China
(Feng) Department of Anesthesiology, The Second Affiliated Hospital of
Nanchang University, Nanchang, China
Publisher
Blackwell Publishing Ltd
Abstract
Background: Stroke volume variation appears to be reliable for predicting
fluid responsiveness in adults, and its predictive value in pediatric
patients has been recently reported. However, its predictive value in
children undergoing cardiac surgery is unclear. <br/>Method(s): A review
and meta-analysis were performed on the diagnostic utility of stroke
volume variation for predicting fluid responsiveness in children
undergoing cardiac surgery. All relevant articles for prospective research
assessing the value of stroke volume variation were searched in the
Embase, MEDLINE (PubMed), and Cochrane databases through March 2020. The
primary outcome was the accuracy of stroke volume variation for predicting
fluid responsiveness in children. The combined data were analyzed by a
meta-analysis. Publication quality was assessed using the QUADAS (quality
assessment for studies of diagnostic accuracy, maximum score) standard
guidelines. <br/>Result(s): Six articles were included in the
meta-analysis, following the search strategy. A total of 251 children were
included from 6 prospective studies. Fluid therapy for all patients used
crystalloids or colloids. The results of the analysis revealed a pooled
diagnostic odds ratio of 8.23 (95% CI: 3.07-22.11), pooled sensitivity of
0.73 (95% CI: 0.64-0.80), and pooled specificity of 0.66 (95% CI:
0.58-0.74). Additionally, the overall area of the summary receiver
operating characteristic curve was 0.78. There was significant moderate
heterogeneity in these studies (p <.05, I² = 42.1%) due to
thresholds. <br/>Conclusion(s): There was some heterogeneity due to
thresholds in the included studies. An evaluation of stroke volume
variation may represent a reliable predictor of fluid responsiveness in
children undergoing cardiac surgery. After operative cardiac output
optimization, the possible impact of goal-directed fluid treatment
depending on stroke volume variation on the perioperative outcome in the
children population should subsequently be assessed.<br/>Copyright &#xa9;
2021 John Wiley & Sons Ltd

<79>
Accession Number
2010670022
Title
Fever Associated With Dexmedetomidine in Adult Acute Care Patients: A
Systematic Review of the Literature.
Source
Journal of Clinical Pharmacology. 61 (7) (pp 848-856), 2021. Date of
Publication: July 2021.
Author
Schurr J.W.; Ambrosi L.; Lastra J.L.; McLaughlin K.C.; Hacobian G.;
Szumita P.M.
Institution
(Schurr, Ambrosi, Lastra) Renaissance School of Medicine at Stony Brook
University, Stony Brook, NY, United States
(McLaughlin, Hacobian, Szumita) Department of Pharmacy Services, Brigham
and Women's Hospital, Boston, MA, United States
Publisher
Blackwell Publishing Inc.
Abstract
Dexmedetomidine-associated fever has been reported in the literature and
can lead to lengthy workups and unnecessary antibiotic exposure. We
conducted a systematic review to evaluate and describe the evidence of
fever or hyperthermia caused by dexmedetomidine in adult patients. Data
sources included PubMed/MEDLINE, EMBASE, CINAHL, and Web of Sciences.
English-language studies of any design published from inception through
April 2020 including conference abstracts were included. The target
population was hospitalized adult patients. Quality of evidence was
determined based on GRADE recommendations and risk of bias assessed using
the Evidence Project Risk of Bias tool. Naranjo scores were assessed to
determine the likeliness of adverse event being caused by dexmedetomidine.
All data were extracted independently and with the guidance of a medical
librarian. Four hundred and eighty-eight total citations were found on
formal search, with 329 left after removal of duplicates. Independent
record screening was performed, leaving 17 citations including 4
retrospective cohort studies, 1 case series, and 12 case reports. Quality
of evidence ranged from very low to low for identified analyses. Evidence
with patient-level data (case reports and series) were combined to
establish a cohort for descriptive results. The median Naranjo score was 4
(range, 3 to 8), and dexmedetomidine doses ranged from 0.1 to 2 mug.h/kg.
Obesity and cardiac surgery appear to be significant risk factors.
Dexmedetomidine-associated fever appears uncommon, but the true incidence
is unknown. Clinicians should keep dexmedetomidine-associated fever in
their differential, and stewardship programs should consider assessing for
this adverse effect in their patient monitoring.<br/>Copyright &#xa9;
2021, The American College of Clinical Pharmacology

<80>
Accession Number
2010384814
Title
Del Nido Cardioplegia in Coronary Artery Bypass Grafting Surgery: A safe,
efficacious and economic alternative to St. Thomas solution; an experience
from a developing nation.
Source
Perfusion (United Kingdom). 36 (5) (pp 470-475), 2021. Date of
Publication: July 2021.
Author
Moktan Lama P.B.; Khakural P.; Sigdel S.; Raj Bhatta M.; Sah Teli R.;
Baral R.K.; Bhattarai A.; Pradhan B.; Koirala B.
Institution
(Moktan Lama, Khakural, Raj Bhatta, Sah Teli, Baral, Bhattarai, Koirala)
Department of Cardiothoracic Vascular Surgery, Manmohan Cardiothoracic
Vascular and Transplant Center, Institute of Medicine, Tribhuvan
University, Maharajgunj, Kathmandu, Nepal
(Sigdel, Pradhan) Department of Cardiothoracic and Vascular
Anesthesiology, Manmohan Cardiothoracic Vascular and Transplant Center,
Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu, Nepal
Publisher
SAGE Publications Ltd
Abstract
Introduction: del Nido cardioplegia is a newer solution getting popular
worldwide, whereas in Nepal, St. Thomas cardioplegia solution is
conventionally used. There is no national recommendation on cardioplegia
solutions supported by evidences from Nepalese studies. This study aimed
to evaluate and compare the efficacy of these solutions in Nepalese
patients undergoing coronary artery bypass grafting. <br/>Method(s):
Patients undergoing coronary revascularization, from May 2018 to December
2019, were randomized into St. Thomas and del Nido groups based on the
cardioplegia administered, with 45 patients in each group. Preoperative,
intraoperative, and postoperative parameters and cost of cardioplegia
preparation in the two groups were compared. <br/>Result(s): The
cardiopulmonary bypass time (106.13 +/- 24.65 minutes vs 107.62 +/- 18.69
minutes, p = 0.02), aortic cross clamp time (66.22 +/- 15.40 minutes vs
72.07 +/- 12.23 minutes, p = 0.04), volume (1059.22 +/- 100.30 ml vs
1526.67 +/- 271.81 ml, p < 0.001) and number of cardioplegia doses (1.00
+/- 0.00 vs 2.51 +/- 0.66, p < 0.001) were significantly lower with del
Nido cardioplegia. A lower CPK-MB at second post-operative (59.91 +/-
31.62 vs 73.82 +/- 37.25, p = 0.03) and a higher left ventricle ejection
fraction at discharge (56.33 +/- 8.94% vs 50.45 +/- 8.55%, p < 0.001) was
observed in del Nido group. There was one death in St. Thomas group. ICU
and hospital stay were similar in both groups. St. Thomas solution was
found to be costlier than del Nido solution (USD 5.40 +/- 0.96 vs USD 3.50
+/- 0.34, p < 0.001). <br/>Conclusion(s): The del Nido cardioplegia was
found to be efficacious, safe and more economical alternative to St.
Thomas solution.<br/>Copyright &#xa9; The Author(s) 2021.

<81>
Accession Number
2006048893
Title
Infective endocarditis by Acinetobacter species: a systematic review.
Source
Journal of Chemotherapy. 33 (4) (pp 203-215), 2021. Date of Publication:
2021.
Author
Ioannou P.; Mavrikaki V.; Kofteridis D.P.
Institution
(Ioannou, Mavrikaki, Kofteridis) Department of Internal Medicine &
Infectious Diseases, University Hospital of Heraklion, Heraklion, Crete,
Greece
Publisher
Taylor and Francis Ltd.
Abstract
A. baumannii-A. calcoaceticus complex infections are increasingly
frequent, especially in intensive care units. Such infections are
associated with a mortality that can be as high as 62%. On the other hand,
infective endocarditis (IE) is an uncommon disease with notable morbidity
and mortality. Even though IE is rarely caused by Acinetobacter species,
these infections can be particularly problematic due to increasing
antimicrobial resistance. The purpose of this study was to systemically
review all published cases of IE by Acinetobacter species in the
literature. A systematic review of PubMed, Scopus and Cochrane library
(through 25 April 2020) for studies providing epidemiological, clinical,
microbiological as well as treatment data and outcomes of IE by
Acinetobacter species was performed. A total of 35 studies, containing
data of 37 patients, were included. A prosthetic valve was present in
40.5%, while the most common causative pathogen was A. baumannii-A.
calcoaceticus complex, followed by A. lwoffii. Aortic valve was the
commonest infected site, followed by mitral valve. Diagnosis was set with
transthoracic echocardiography in 48.6%, while the diagnosis was set at
autopsy in 20%. Fever and sepsis were the commonest clinical
presentations, followed by heart failure and embolic phenomena.
Aminoglycosides, cephalosporins and carbapenems were the commonest
antimicrobials used. Clinical cure was noted in 70.3%, while overall
mortality was 32.4%. Development of heart failure was independently
associated with mortality by IE. This systematic review thoroughly
describes IE by Acinetobacter and provides information on epidemiology,
clinical presentation, treatment and outcomes.<br/>Copyright &#xa9; 2020
Edizioni Scientifi che per l'Informazione su Farmaci e Terapia.

<82>
Accession Number
634603085
Title
P2Y12 inhibitor monotherapy after coronary stenting according to type of
P2Y12 inhibitor.
Source
Heart. 107 (13) (pp 1077-1083), 2021. Date of Publication: 01 Jul 2021.
Author
Kim J.; Jang W.J.; Lee W.S.; Choi K.H.; Lee J.M.; Park T.K.; Yang J.H.;
Choi J.-H.; Song Y.B.; Choi S.-H.; Gwon H.-C.; Lee S.H.; Oh J.-H.; Chun
W.J.; Park Y.H.; Im E.-S.; Jeong J.-O.; Cho B.R.; Oh S.K.; Yun K.H.; Cho
D.-K.; Lee J.-Y.; Koh Y.-Y.; Bae J.-W.; Choi J.W.; Yoon H.J.; Lee S.U.;
Cho J.H.; Choi W.G.; Rha S.-W.; Hahn J.-Y.
Institution
(Kim, Choi, Lee, Park, Yang, Choi, Song, Choi, Gwon, Lee, Hahn) Division
of Cardiology, Department of Medicine, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Jang) Division of Cardiology, Department of Internal Medicine, Ewha
Womans University College of Medicine Seoul Hospital, Seoul, South Korea
(Lee) Department of Cardiology, Chung-Ang University Hospital, Seoul,
South Korea
(Oh, Chun, Park) Department of Cardiology, Samsung Changwon Hospital,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Im) Division of Cardiology, Dongsuwon General Hospital, Suwon, South
Korea
(Jeong) Department of Cardiology, Chungnam National University Hospital,
Daejeon, South Korea
(Cho) Department of Cardiology, Kangwon National University Hospital,
Chuncheon, South Korea
(Oh, Yun) Department of Cardiology, Wonkwang University Hospital, Iksan,
South Korea
(Cho) Department of Cardiology, Myongji Hospital, Goyang, South Korea
(Lee) Department of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan
University School of Medicine, Seoul, South Korea
(Koh) Department of Cardiology, Chosun University Hospital, Gwangju, South
Korea
(Bae) Division of Cardiology, Department of Internal Medicine, Chungbuk
National University Hospital, Cheongju, South Korea
(Choi) Division of Cardiology, Seoul Eulji Hospital, Eulji University
College of Medicine, Seoul, South Korea
(Yoon) Department of Cardiology, Keimyung University Dongsan Medical
Center, Daegu, South Korea
(Lee) Department of Cardiology, Kwangju Christian Hospital, Gwangju, South
Korea
(Cho) Division of Cardiology, Saint Carollo Hospital, Suncheon, South
Korea
(Choi) Department of Cardiology, Konkuk University Chungju Hospital,
Chungju, South Korea
(Rha) Department of Cardiology, Korea University Guro Hospital, Seoul,
South Korea
Publisher
BMJ Publishing Group
Abstract
Objective To compare P2Y12 inhibitor monotherapy after 3-month dual
antiplatelet therapy (DAPT) with 12-month DAPT according to the type of
P2Y12 inhibitor in patients undergoing percutaneous coronary intervention
(PCI). Methods The Smart Angioplasty Research Team: Comparison Between
P2Y12 Antagonist Monotherapy vs Dual Antiplatelet Therapy in Patients
Undergoing Implantation of Coronary Drug-Eluting Stents (SMART-CHOICE)
randomised trial compared 3-month DAPT followed by P2Y12 inhibitor
monotherapy with 12-month DAPT. In this trial, 2993 patients undergoing
successful PCI with drug-eluting stent were enrolled in Korea. As a
prespecified analysis, P2Y12 inhibitor monotherapy after 3-month DAPT
versus 12-month DAPT were compared among patients receiving clopidogrel
and those receiving potent P2Y12 inhibitor (ticagrelor or prasugrel),
respectively. The primary endpoint was a composite of all-cause death,
myocardial infarction or stroke at 12 months after the index procedure.
Results Among 2993 patients (mean age 64 years), 58.2% presented with
acute coronary syndrome. Clopidogrel was prescribed in 2312 patients
(77.2%) and a potent P2Y12 inhibitor in 681 (22.8%). There were no
significant differences in the primary endpoint between the P2Y12
inhibitor monotherapy group and the DAPT group among patients receiving
clopidogrel (3.0% vs 3.0%; HR: 1.02; 95% CI 0.64 to 1.65; p=0.93) as well
as among patients receiving potent P2Y12 inhibitors (2.4% vs 0.7%; HR:
3.37; 95% CI 0.77 to 14.78; p=0.11; interaction p=0.1). Among patients
receiving clopidogrel, P2Y12 inhibitor monotherapy compared with DAPT
showed consistent treatment effects across various subgroups for the
primary endpoint. Among patients receiving potent P2Y12 inhibitors, the
rate of bleeding (Bleeding Academic Research Consortium types 2- 5) was
significantly lower in the P2Y12 inhibitor monotherapy group than in the
DAPT group (1.5% vs 5.0%; HR: 0.33; 95% CI 0.12 to 0.87; p=0.03).
Conclusions Compared with 12-month DAPT, clopidogrel monotherapy after
3-month DAPT showed comparable cardiovascular outcomes in patients
undergoing PCI. Trial registration number NCT02079194. <br/>Copyright
&#xa9;

<83>
Accession Number
635309194
Title
Anxiety and depression symptoms are higher among surrogate decision makers
of patients with severe acute brain injury versus no brain injury.
Source
American Journal of Respiratory and Critical Care Medicine. Conference:
American Thoracic Society International Conference, ATS 2021. Virtual. 203
(9) (no pagination), 2021. Date of Publication: May 2021.
Author
Wendlandt B.; Ceppe A.; Carson S.S.; Cox C.E.; Olm-Shipman C.
Institution
(Wendlandt, Ceppe, Carson, Olm-Shipman) University of North Carolina,
Chapel Hill, NC, United States
(Cox) Duke Univ Medical Ctr, Durham, NC, United States
Publisher
American Thoracic Society
Abstract
Introduction: Severe Acute Brain Injury (SABI) is caused by conditions
such as stroke, traumatic brain injury, and hypoxemic ischemic
encephalopathy after cardiac arrest. Because of the neurological
devastation associated with SABI, these critically ill patients typically
depend on surrogate decision makers. Surrogates struggle with particularly
complex decisions because of the substantial prognostic uncertainty for
functional and cognitive recovery in SABI. We hypothesized that surrogates
of patients with SABI experience more anxiety and depression symptoms than
surrogates of non-neurological critically ill patients. <br/>Method(s): We
conducted a secondary analysis of the data from a multicenter randomized
trial of a decision aid intervention for surrogates of adult patients
experiencing prolonged mechanical ventilation. Eligible patients were
enrolled from medical, surgical, trauma, cardiac, andneurologic intensive
care units (ICUs). Primary ICU service and admitting diagnoses were used
to identify patients experiencing SABI. Our primary outcome was surrogate
anxiety and depression symptoms 6 months after trial enrollment as
measured by the Hospital Anxiety and Depression Scale (HADS). Multiple
linear regression was used to compare total HADS as well as depression and
anxiety subscales between SABI and non-SABI surrogates, adjusting for
randomization arm, baseline HADS score at enrollment, surrogate age,
surrogate sex, surrogate race, and patient death by 6 months, which were
selected a priori. <br/>Result(s): 6-month follow up data were complete
for 206 (95%) patients, 60 (29%) with SABI and 146 (71%) without, and
their 206 primary surrogate decision makers. Mean patient age was 54.5
years (SD 16.3), 34% were women, and 76% were white. Mean surrogate age
was 52.4 years (SD 12.4) and 77% were women. Unadjusted mean HADS score 6
months after trial enrollment was higher for SABI surrogates than for
non-SABI surrogates (13.8 [SD 9.3] vs. 11.2 [SD 7.6], p=0.03). In the
multivariable model, SABI surrogates experienced both higher anxiety
symptoms (anxiety subscale OR 1.50, 95% CI 0.37 to 2.62, p=0.009) and
depression symptoms (depression subscale OR 1.75, 95% CI 0.64 to 2.86,
p=0.002) than non-SABI surrogates at 6 months. Model results are shown in
Table 1. <br/>Conclusion(s): Compared to surrogates of critically ill
patients not experiencing SABI, surrogates of patients with SABI
experienced higher anxiety and depression symptoms at 6 months. Further
work is needed to understand contributors to heightened levels of distress
in this population.

<84>
Accession Number
635297149
Title
Intravenous albumin in adult cardiac surgery: a meta-analysis.
Source
Vox Sanguinis. Conference: 31st Regional ISBT Congress, ISBT In Focus.
Virtual. 116 (SUPPL 1) (pp 183), 2021. Date of Publication: May 2021.
Author
Keshavarz H.; Skubas N.; Callum J.; Fergusson D.; Wu B.; Shehata N.
Institution
(Keshavarz) Centre for Innovation, CBS, Ottawa, Canada
(Keshavarz) International Collaboration for Transfusion Medicine
Guidelines (ICTMG), Ottawa, Canada
(Skubas) Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, OH,
United States
(Callum) Transfusion Medicine, Kingston Health Sciences Centre, Kingston,
Canada
(Fergusson) Clinical Epidemiology Program/Medicine and Surgery, School of
Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
(Wu) College of Osteopathic Medicine, Touro University Nevada, Henderson,
NV, United States
(Shehata) Departments of Medicine, Institute of Health Policy Management
and Evaluation, University of Toronto, Toronto, Canada
Publisher
Blackwell Publishing Ltd
Abstract
Background: Intravenous albumin is often used to prime the cardiopulmonary
circuit and for volume resuscitation in adult patients undergoing
cardiothoracic surgery. The effectiveness and the safety of intravenous
albumin has not been synthesized. <br/>Aim(s): This systematic review
examines the effectiveness of intravenous albumin in reducing mortality
and other clinically important outcomes compared to no albumin or
alternative solutions for adult patients undergoing cardiothoracic
surgery. <br/>Method(s): MEDLINE, Embase, CCRT, Transfusion Evidence
Library from inception (1946) to December, 19th 2019 as well as, reference
lists of eligible systematic reviews were searched. Randomized controlled
trials (RCTs) or observational comparative studies published in English
were included. The primary outcome was mortality. Secondary outcomes
included kidney failure, hospital and intensive care unit (ICU) length of
stay, and blood loss. Risk of bias for the RCTs was assessed using the
Cochrane Risk of Bias tool and overall quality of outcomes was assessed
using the GRADE criteria (GRADEproGDT). Random effects models were used to
calculate the pooled risk difference and 95% confidence intervals (CI) for
binary outcomes, and the standardized mean difference (SMD) with 95% CIs
to estimate the effect on the continuous outcomes using Review Manager
5.4.1. <br/>Result(s): A total of 1435 references were retrieved, and 48
RCTs met inclusion criteria (Table 1). Intravenous albumin compared to no
albumin did not significantly reduce mortality, kidney failure, length of
hospital stay, length of ICU stay, or blood loss (Table 1).
Summary/Conclusions: The use of intravenous albumin did not reduce
mortality or other clinically important outcomes when used for priming of
the cardiopulmonary circuit or volume resuscitation in adult patients
undergoing cardiothoracic surgery.

<85>
Accession Number
635295479
Title
A trial of opioid-free anesthesia for major or intermediate non-cardiac
surgery.
Source
Fundamental and Clinical Pharmacology. Conference: Annual Meeting of
French Society of Pharmacology and Therapeutics. Online. 35 (SUPPL 1) (pp
22-23), 2021. Date of Publication: June 2021.
Author
Laviolle B.; Esvan M.; Tual C.; Mouchel C.; Beloeil H.
Institution
(Laviolle, Beloeil) CHU Rennes, Inserm, Univ Rennes, Rennes, France
(Esvan, Tual, Mouchel) CHU Rennes, Inserm, Rennes, France
Publisher
Blackwell Publishing Ltd
Abstract
Introduction: Opioids are widely used to supplement general anesthesia but
may contribute to short-term post-operative adverse events. Opioid-free
multimodal anesthesia (OFA) may reduce opioid exposure, and thereby
decrease opioid-related adverse events. Dexmedetomidine is an
alpha-2-receptor agonist that may be effective at providing adequate pain
control while reducing the risk of opioid-related adverse effects.
<br/>Material(s) and Method(s): In this multicenter, single-blind,
parallel-group trial, we randomly assigned 316 adults undergoing elective
intermediate or major non-cardiac surgery to receive either a standard
opioid-based anesthesia (OBA) using intravenous remifentanil or OFA using
intravenous dexmedetomidine. The primary outcome was a composite of severe
post-operative opioid-related adverse events (defined as post-operative
hypoxemia, ileus or cognitive dysfunction) within the first 48 hours after
extubation. Morphine consumption, occurrence of opioid-related adverse
events, and severe bradycardia were also recorded. <br/>Result(s): The
primary outcome occurred in 122 (78%) patients in the OFA group and 105
(67%) patients in the OBA group (relative risk, 1.16; 95% confidence
interval [CI], 1.01-1.33; P = 0.031). The rate of hypoxemia was 72% in the
OFA group and 61 % in the OBA group (relative risk, 1.19; 95% confidence
interval [CI], 1.02-1.40; P = 0.030) and the between-group difference was
not significant for ileus or cognitive dysfunction. Morphine consumption
48 hours after surgery (median difference:-3.3 mg 95%CI,-0.8-5.5) and
post-operative nausea and vomiting (relative risk, 0.64; 95% CI,
0.45-0.90) were both significantly reduced in the OFA group, while
analgesia was similar in both groups. Bradycardia requiring atropine
administration was more frequent in the OFA group than in the OBA group
(relative risk, 2.14; 95%CI 1.18-3.88). Discussion/Conclusion: Among
patients undergoing intermediate or major non-cardiac surgery, OFA with
dexmedetomidine increased the rate of opioid-related adverse events as
compared with usual care. Despite lower post-operative opioid consumption
and nausea and vomiting incidence, OFA also increased occurrence of per
operative severe bradycardia.

<86>
Accession Number
2013105258
Title
Comparative study of three techniques of repair for severe functional
tricuspid valve regurgitation.
Source
Systematic Reviews in Pharmacy. 11 (8) (pp 779-784), 2020. Date of
Publication: 2020.
Author
Shafeek A.M.A.; Bary K.H.A.; Essa M.; Sobhy E.
Institution
(Shafeek, Bary, Essa, Sobhy) Zagazig University Hospitals, Egypt
Publisher
EManuscript Technologies
Abstract
Background: The optimal technique for repair of functional tricuspid valve
regurgitation (FTR) remains uncertain. Various modalities of
annuloplastyhave been used to repair such pathology, including rigid or
flexible rings (complete or incomplete), sutures, and bands. Aim of work:
The goal of this study was to compare the outcome of tricuspid valve (TV)
repair by pericardial band, Dacron band and Carpentier ring in patients
with left sided valve surgery. Patients & Methods: This study was
conducted from October 2016 to December 2019 and included 123 patients
with functionally severe tricuspid regurgitation secondary to left-sided
valve diseases (isolated mitral valve disease or combined mitral and
aortic valve disease).Those patients were operated at Zagazig University
Hospitals and Nasser Institute. We randomized patients into three groups
according to the method used for management of tricuspid regurgitation.
There were 41 patients in each group. Repair of TV was performed using
Carpentier-Edwards Physio Tricuspid annuloplasty ring in group (A), Dacron
band in group (B), and pericardial band in group (C). As, there was one
mortality in each group, only 40 patients were enrolled in statistical
analysis for each group. <br/>Result(s): There was no significant
difference between the three groups regarding the preoperative findings
including age, sex, BMI, NYHA functional class and preoperative
echocardiography findings. Duration of ward stay was longer in the
pericardial group. Postoperatively, there was significant reduction in the
mean pulmonary artery systolic pressure (PASP) and right ventricular
dimension in the three groups, and notably evident in group (A).
<br/>Conclusion(s): Using semi-rigid (Carpentier-Edwards Physio Tricuspid
annuloplasty ring) or flexible ring (Dacron band) or pericardial strip are
good options in the repair of functional tricuspid valve regurgitation.
However, Carpentier ring placement is s consistent with improved RV
remodeling and is likely to improve the right ventricular efficiency and a
favorable result. Tricuspid valve (TV), Tricuspid regurgitation (TR),
Dacron band, pericardial band.<br/>Copyright &#xa9; 2020 EManuscript
Technologies. All rights reserved.

<87>
Accession Number
2012384818
Title
Factors influencing physical activity engagement following coronary artery
bypass graft surgery: A mixed methods systematic review.
Source
Heart and Lung. 50 (5) (pp 589-598), 2021. Date of Publication: 01 Sep
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
Mosby Inc.
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. <br/>Objective(s): To explore the factors
that influence engagement in physical activity during the first three
months following CABG surgery. <br/>Method(s): Four electronic databases
were searched. Extracted data from selected studies were synthesised using
the Joanna Briggs Institute convergent integrated approach.
<br/>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. <br/>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.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<88>
Accession Number
635312189
Title
Patient and hospital factors associated with 30-day readmissions after
coronary artery bypass graft (CABG) surgery: a systematic review and
meta-analysis.
Source
Journal of cardiothoracic surgery. 16 (1) (pp 172), 2021. Date of
Publication: 10 Jun 2021.
Author
Shawon M.S.R.; Odutola M.; Falster M.O.; Jorm L.R.
Institution
(Shawon, Odutola, Falster, Jorm) Centre for Big Data Research in Health,
University of New South Wales (UNSW) Sydney, Kensington, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Readmission after coronary artery bypass graft (CABG) surgery
is associated with adverse outcomes and significant healthcare costs, and
30-day readmission rate is considered as a key indicator of the quality of
care. This study aims to: quantify rates of readmission within 30days of
CABG surgery; explore the causes of readmissions; and investigate how
patient- and hospital-level factors influence readmission. <br/>METHOD(S):
We conducted systematic searches (until June 2020) of PubMed and Embase
databases to retrieve observational studies that investigated readmission
after CABG. Random effect meta-analysis was used to estimate rates and
predictors of 30-day post-CABG readmission. <br/>RESULT(S): In total, 53
studies meeting inclusion criteria were identified, including 8,937,457
CABG patients. The pooled 30-day readmission rate was 12.9% (95% CI:
11.3-14.4%). The most frequently reported underlying causes of 30-day
readmissions were infection and sepsis (range: 6.9-28.6%), cardiac
arrythmia (4.5-26.7%), congestive heart failure (5.8-15.7%), respiratory
complications (1-20%) and pleural effusion (0.4-22.5%). Individual factors
including age (OR per 10-year increase 1.12 [95% CI: 1.04-1.20]), female
sex (OR 1.29 [1.25-1.34]), non-White race (OR 1.15 [1.10-1.21]), not
having private insurance (OR 1.39 [1.27-1.51]) and various comorbidities
were strongly associated with 30-day readmission rates, whereas
associations with hospital factors including hospital CABG volume, surgeon
CABG volume, hospital size, hospital quality and teaching status were
inconsistent. <br/>CONCLUSION(S): Nearly 1 in 8 CABG patients are
readmitted within 30days and the majority of these are readmitted for
noncardiac causes. Readmission rates are strongly influenced by patients'
demographic and clinical characteristics, but not by broadly defined
hospital characteristics.

<89>
Accession Number
635310813
Title
Randomized comparison between bare-metal stent plus colchicine versus
drug-eluting stent alone in prevention of clinical adverse events after
percutaneous coronary intervention.
Source
Future Cardiology. 17 (4) (pp 539-547), 2021. Date of Publication: July
2021.
Author
Correa-Sadouet C.; Matias Rodriguez-Granillo A.; Gallardo C.; Mieres J.;
Fontana L.; Curotto M.V.; Wainer P.; Allende N.G.; Fernandez-Pereira C.; M
Vetulli H.; De La Hoz R.P.; Kastrati A.; Rodriguez A.E.
Institution
(Correa-Sadouet, Matias Rodriguez-Granillo, Gallardo, Fontana, Curotto, M
Vetulli) Cardiology Department, Sanatorio Otamendi, Ciudad de Buenos
Aires, Argentina
(Matias Rodriguez-Granillo, Mieres, Fernandez-Pereira, Rodriguez)
Interventional Cardiology Department, Sanatorio Otamendi, Ciudad de Buenos
Aires, Argentina
(Matias Rodriguez-Granillo, Mieres, Fernandez-Pereira, Rodriguez) Centro
de Estudios en Cardiologia Intervencionista, Ciudad de Buenos Aires,
Argentina
(Wainer) Internal Medicine Department, Sanatorio Otamendi, Ciudad de
Buenos Aires, Argentina
(Allende) Cardiology Department, Clinica IMA, Adrogue, Provincia de Buenos
Aires, Argentina
(De La Hoz) Cardiology Department, Hospital de Clinicas Jose de San
Martin, Ciudad de Buenos Aires, Argentina
(Kastrati) Deutsches Herzzentrum Munich, Germany
Publisher
Future Medicine Ltd.
Abstract
The use of colchicine is associated with a significant reduction of
cardiac adverse events in patients with coronary artery disease. Past
small randomized trials with oral immunosuppressive or anti-inflammatory
therapies have demonstrated a reduction of adverse clinical events after
bare metal stent implantation. The potential role of adjunctive colchicine
after bare-metal stent implantation, compared with drug-eluting stent
alone, is unknown. The primary end point of the study will be to compare
cost-effectiveness at 1 year of follow-up of coronary intervention with
bare-metal stent implantation plus 1 mg of colchicine during 3 months
versus percutaneous coronary intervention with drug-eluting stent
implantation alone. ClinicalTrials.gov identifier: NCT04382443</ext-link.
Colchicine is an anti-inflammatory drug used to reduce the chance of heart
attacks in patients with heart disease. The use of stents - small tubes
inserted into blood vessels to keep them open - in this group of people is
well known, and several small clinical trials have been carried out to
investigate this. Our trial aims to assess if there is a role for using
colchicine after inserting a stent, compared with using stents that
release drugs themselves (drug-eluting stents), to reduce side effects and
complications of cardiac procedures. Our primary objective will be to
demonstrate that this drug, combined with the old metallic stent designs,
will prevent future complications in comparison with the latest generation
of drug-eluting stents. <br/>Copyright &#xa9; 2020 Future Medicine Ltd.

<90>
Accession Number
635252249
Title
The Optimising Cardiac Surgery ouTcOmes in People with diabeteS (OCTOPuS)
randomised controlled trial to evaluate an outpatient pre-cardiac surgery
diabetes management intervention: A study protocol.
Source
BMJ Open. 11 (6) (no pagination), 2021. Article Number: 050919. Date of
Publication: 09 Jun 2021.
Author
Holt R.I.G.; Dritsakis G.; Barnard-Kelly K.; Thorne K.; Whitehead A.;
Cohen L.; Dixon E.; Patel M.; Newland-Jones P.; Green M.; Partridge H.;
Luthra S.; Ohri S.; Salhiyyah K.; Lord J.; Niven J.; Cook A.
Institution
(Holt) Human Development and Health, Faculty of Medicine, University of
Southampton, Southampton, United Kingdom
(Holt) Southampton National Institute for Health Research, Biomedical
Research Centre, University Hospital, Southampton Nhs Foundation Trust,
Southampton, United Kingdom
(Dritsakis, Thorne, Whitehead, Dixon) Clinical Trial Units, University of
Southampton, Southampton, United Kingdom
(Barnard-Kelly, Cohen) Barnard Health - Health Psychology Research,
Fareham, United Kingdom
(Patel, Newland-Jones, Green) Department of Diabetes and Endocrinology,
University Hospital Southampton, Southampton, Hampshire, United Kingdom
(Partridge) Diabetes and Endocrinology, Royal Bournemouth and Christchurch
Hospitals Nhs Foundation Trust, Bournemouth, Bournemouth, United Kingdom
(Luthra, Ohri) Division of Cardiac Surgery, Wessex Cardiothoracic Centre,
University Hospital Southampton, Southampton, Hampshire, United Kingdom
(Salhiyyah) Middle East University, Amman, Jordan
(Lord) Southampton Health Technology Assessments Centre, University of
Southampton, Southampton, Hampshire, United Kingdom
(Niven) Patient Representative, Southampton, United Kingdom
(Cook) Wessex Institute, University of Southampton, Southampton,
Hampshire, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiothoracic surgical outcomes are poorer in people with
diabetes compared with those without diabetes. There are two important
uncertainties in the management of people with diabetes undergoing major
surgery: (1) how to improve diabetes management in the weeks leading up to
an elective procedure and (2) whether that improved management leads to
better postoperative outcomes. We previously demonstrated the feasibility
of delivering the Optimising Cardiac Surgery ouTcOmes in People with
diabeteS (OCTOPuS) intervention, an outpatient intervention delivered by
diabetes healthcare professionals for people with suboptimally managed
diabetes over 8-12 weeks before elective cardiac surgery. The present
study will assess the clinical and cost-effectiveness of the intervention
in cardiothoracic centres across the UK. Methods and analysis A
multicentre, parallel group, single-blinded 1:1 individually randomised
trial comparing time from surgery until clinically fit for discharge in
adults with suboptimally managed type 1 diabetes or type 2 diabetes
undergoing elective surgery between the OCTOPuS intervention and usual
care (primary endpoint). Secondary endpoints will include actual time from
surgery to discharge from hospital; days alive and either out of hospital
or judged as clinically fit for discharge; mortality; time on intensive
therapy unit (ITU)/ventilator; infections; acute myocardial infarction;
change in weight; effect on postoperative renal function and incidence of
acute kidney injury; change in HbA 1c; frequency and severity of
self-reported hypoglycaemia; operations permanently cancelled for
suboptimal glycaemic levels; cost-effectiveness; psychosocial
questionnaires. The target sample size will be 426 recruited across
approximately 15 sites. The primary analysis will be conducted on an
intention-to-treat population. A two-sided p value of 0.05 or less will be
used to declare statistical significance for all analyses and results will
be presented with 95% CIs. Ethics and dissemination The trial was approved
by the South Central-Hampshire A Research Ethics Committee (20/SC/0271).
Results will be disseminated through conferences, scientific journals,
newsletters, magazines and social media. Trial registration number
ISRCTN10170306.<br/>Copyright &#xa9;

<91>
Accession Number
2007532304
Title
Impact of bundle branch block on permanent pacemaker implantation after
transcatheter aortic valve implantation: A meta-analysis.
Source
Journal of Clinical Medicine. 10 (12) (no pagination), 2021. Article
Number: 2719. Date of Publication: 02 Jun 2021.
Author
Ravaux J.M.; Di Mauro M.; Vernooy K.; Mariani S.; Ronco D.; Simons J.;
Van'T Hof A.W.; Veenstra L.; Kats S.; Maessen J.G.; Lorusso R.
Institution
(Ravaux, Di Mauro, Mariani, Ronco, Simons, Kats, Maessen, Lorusso)
Department of Cardio-Thoracic Surgery, Heart and Vascular Centre,
Maastricht University Medical Centre (MUMC), Maastricht 6202 AZ,
Netherlands
(Vernooy, Van'T Hof, Veenstra) Department of Cardiology, Maastricht
University Medical Centre (MUMC), Maastricht 6202 AZ, Netherlands
(Vernooy, Van'T Hof, Maessen, Lorusso) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University Medical Center, Maastricht 6202
AZ, Netherlands
(Vernooy) Department of Cardiology, Radboud University Medical Center
(Radboudumc), Nijmegen 6525 GA, Netherlands
(Ronco) Department of Medicine and Surgery, Circolo Hospital, University
of Insubria, Varese 21100 VA, Italy
Publisher
MDPI AG
Abstract
Data regarding the impact of infra-Hisian conduction disturbances leading
to permanent pacemaker implantation (PPI) after transcatheter aortic valve
implantation (TAVI) remain limited. The aim of this study was to determine
the impact of right and/or left bundle branch block (RBBB/LBBB) on
post-TAVI PPI. We performed a systematic literature review to identify
studies reporting on RBBB and/or LBBB status and post-TAVI PPI. Study
design, patient characteristics, and the presence of branch block were
analyzed. Odds ratios (ORs) with 95% CI were extracted. The final analysis
included 36 studies, reporting about 55,851 patients. Data on LBBB were
extracted from 33 studies. Among 51,026 patients included, 5503 showed
pre-implant LBBB (11.9% (10.4%- 13.8%)). The influence of LBBB on
post-TAVI PPI was not significant OR 1.1474 (0.9025; 1.4588), p = 0.2618.
Data on RBBB were extracted from 28 studies. Among 46,663 patients
included, 31,603 showed pre-implant RBBB (9.2% (7.3%-11.6%)). The
influence of RBBB on post-TAVI PPI was significant OR 4.8581 (4.1571;
5.6775), p < 0.0001. From this meta-analysis, the presence of RBBB
increased the risk for post-TAVI PPI, independent of age or LVEF, while
this finding was not con-firmed for patients experimenting with LBBB. This
result emphasizes the need for pre-operative evaluation strategies in
patient selection for TAVI.<br/>Copyright &#xa9; 2021 by the authors.
Licensee MDPI, Basel, Switzerland.

<92>
Accession Number
2007514220
Title
Pain relief and post-operative outcome in patients receiving tramadol via
thoracic epidural versus intravenous method in coronary artery bypass
graft surgery.
Source
Indian Journal of Forensic Medicine and Toxicology. 15 (2) (pp 2620-2628),
2021. Date of Publication: April-June 2021.
Author
Mehta J.; Bhavsar M.; Thomas S.M.; Shah P.; Chauhan D.
Institution
(Mehta, Thomas, Shah, Chauhan) Department of Anaesthesiology, Smt.
B.K.Shah Medical Institute & Research Centre SumandeepVidyapeeth Deemed To
Be University, Piparia, Vadodara, Gujarat, India
(Bhavsar) Critical Care, Zydus Cancer Center, Ahmedabad, Gujarat, India
Publisher
Institute of Medico-Legal Publications
Abstract
Background & Objectives:Acute pain is common after cardiac surgery and can
keep patients from participating in activities that prevent postoperative
complications especially respiratory complications. Accurate assessment
and understanding of pain are vital for providing satisfactory pain
control and optimizing recovery. Our aim of the study was to compare pain
relief and post-operative outcome in patients receiving Tramadol via
Thoracic epidural versus intravenous method in coronary artery bypass
graft surgery. Methodology: Sixty patients aging 40-65 years posted for
off pump coronary artery bypass graft surgery were selected. They were
randomly assigned into two groups.Group IVA (n = 30) received Inj.
Tramadol (1 mg/kgiv)and Group TEA (n = 30) received Tramadol 0.5
mg/kgepidurallyhalf an hour before shifting in cardiac recovery room.
Hemodynamic parameters like Heart rate, systolic and diastolic blood
pressure, pulmonary artery pressure were recorder for 72 hours
postoperatively. We have compared extubation time in both the groups. Pain
was assessed by visual analogue scale (VAS). Any patients with the VAS
more than 4 were treated with rescue analgesic. Duration of analgesia and
total no. of rescue analgesia were recorded. Duration of stay in cardiac
recovery room and in hospital was also recorded. Observation & Results: We
have observed statistically significant difference in hemodynamic
parameters between two groups with better stability in TEA group from
shifting till next 72 hours. Extubation time was also earlier in TEA
group. Mean duration of analgesia and VAS score was also better TEA group.
All these led to shorter length of cardiac recovery stay and earlier
discharge from the hospital with less complication. <br/>Conclusion(s):
Thoracic epidural analgesia is better than intravenous technique in terms
of early extubation,maintaining hemodynamic stability and better
postoperative analgesia with reduced length of cardiac recovery and
hospital stay.<br/>Copyright &#xa9; 2021, Institute of Medico-Legal
Publications. All rights reserved.

<93>
Accession Number
635312796
Title
Safety of Direct Oral Anticoagulants Compared to Warfarin for Atrial
Fibrillation after Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Seminars in thoracic and cardiovascular surgery. (no pagination), 2021.
Date of Publication: 07 Jun 2021.
Author
Hage A.; Dolan D.P.; Nasr V.G.; Castelo-Branco L.; Motta-Calderon D.;
Ghandour H.; Hage F.; Papatheodorou S.; Chu M.W.A.
Institution
(Hage, Hage) Epidemiology, Harvard T.H. Chan School of Public Health,
Boston, MA, USA; Division of Cardiac Surgery, Western University, London,
Ontario, Canada
(Dolan) Epidemiology, Harvard T.H. Chan School of Public Health, Boston,
MA, USA; Division of Thoracic Surgery, Brigham and Women's Hospital,
Boston, MA, USA
(Nasr) Epidemiology, Harvard T.H. Chan School of Public Health, Boston,
MA, USA; Division of Cardiac Anesthesia, Department of Anesthesiology,
Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA,
USA
(Castelo-Branco) Epidemiology, Harvard T.H. Chan School of Public Health,
Boston, MA, USA; Neuroscience, Neuromodulation Center, Spaulding
Rehabilitation Hospital, Boston, MA, USA
(Motta-Calderon) Epidemiology, Harvard T.H. Chan School of Public Health,
Boston, MA, USA; Division of General Internal Medicine, Brigham and
Women's Hospital, Boston, MA, USA
(Ghandour) Global Surgery, Harvard Medical School, MA, Boston, United
States
(Papatheodorou) Epidemiology, Harvard T.H. Chan School of Public Health,
MA, Boston, United States
(Chu) Division of Cardiac Surgery, Western University, London, ON, Canada
Publisher
NLM (Medline)
Abstract
The evidence for use of direct oral anticoagulants (DOACs) in the
management of post-operative cardiac surgery atrial fibrillation (POAF) is
limited and mostly founded on clinical trials that excluded this patient
population. We performed a systematic review and meta-analysis of clinical
trials and observational studies to evaluate the hypothesis that DOACs are
safe compared to warfarin for the anticoagulation of patients with POAF.
We searched PubMed, EMBASE, Web of Science, clinicaltrials.gov, and the
Cochrane Library for clinical trials and observational studies comparing
DOAC with warfarin in patients >=18 years old who had post-cardiac surgery
atrial fibrillation. Primary outcomes included stroke, systemic
embolization, bleeding, and mortality. We performed a random-effects
meta-analysis of all outcomes. The meta-analysis for the primary outcomes
showed significantly lower risk of stroke with DOAC use (6 studies, 7143
patients, RR 0.64; 95% CI 0.50 to 0.81, I2: 0.0%) compared to warfarin, a
trend towards lower risk of systemic embolization (4 studies, 7289
patients, RR 0.64, 95% CI 0.41 to 1.01, I2: 31.99%) and similar risks of
bleeding (14 studies, 10182 patients, RR 0.91; 95% CI 0.74 to 1.10, I2:
26.6%) and mortality (12 studies, 9843 patients, relative risk [RR] 1.01;
95% CI 0.74 to 1.37, I2: 26.5%). Current evidence suggests that DOACs,
compared to warfarin, in the management of atrial fibrillation after
cardiac surgery is associated with lower risk of stroke and a strong trend
for lower risk of systemic embolization, and no evidence of increased risk
for hospital readmission, bleeding and mortality.<br/>Copyright &#xa9;
2021 Elsevier Ltd. All rights reserved.

<94>
Accession Number
635311309
Title
Health-Related Quality of Life and Angina in Fractional Flow Reserve-
Versus Angiography-Guided Coronary Artery Bypass Grafting: FARGO Trial
(Fractional Flow Reserve Versus Angiography Randomization for Graft
Optimization).
Source
Circulation: Cardiovascular Quality and Outcomes. (pp 723-733), 2021.
Article Number: e007302. Date of Publication: 2021.
Author
Thuesen A.L.; Riber L.P.; Veien K.T.; Christiansen E.Ho.; Jensen S.E.;
Modrau I.; Andreasen J.J.; Borregaard B.; Junker A.; Mortensen P.E.;
Jensen L.O.
Institution
(Thuesen, Veien, Borregaard, Junker, Jensen) Department of Cardiology,
Odense University Hospital, Denmark
(Thuesen, Riber, Mortensen) Department of Cardiothoracic Surgery, Odense
University Hospital, Denmark
(Christiansen) Department of Cardiology, Aarhus University Hospital,
Skejby, Denmark
(Modrau) Department of Cardiothoracic Surgery, Aarhus University Hospital,
Skejby, Denmark
(Jensen) Department of Cardiology, Aalborg University Hospital, Denmark
(Andreasen) Department of Cardiothoracic Surgery, Aalborg University
Hospital, Denmark
(Andreasen) Department of Clinical Research, Aalborg University, Denmark
(Borregaard, Jensen) Department of Clinical Research, University of
Southern Denmark, Odense, Denmark
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In coronary artery bypass grafting (CABG), the use of
fractional flow reserve (FFR) is insufficiently investigated. Stenosis
assessment usually relies on visual estimates of lesion severity. This
study evaluated health-related quality of life (HRQoL) and angina after
FFR- versus angiography-guided CABG. <br/>Method(s): One hundred patients
referred for CABG were randomized to FFR- or angiography-guided CABG. In
the FFR group, lesions with FFR>0.80 were deferred, while the surgeon was
blinded to the FFR values in the angiography group. Before and 6 months
after CABG, HRQoL was assessed by the health state classifier EQ-5D of the
EuroQoL 5-level instrument and angina status based on the Canadian
Cardiovascular Society classification system were registered.
<br/>Result(s): Six-month angiography included FFR evaluations of deferred
lesions. In total, completed EQ-5D of the EuroQoL 5-level instrument
questionnaires were available in 86 patients (43 in the FFR versus 43 in
the angiography-guided group). HRQoL was significantly improved and angina
significantly decreased from baseline to 6 months after CABG with no
difference between the randomization groups. Graft failure rates and
clinical outcomes were similar in both groups. Patients with graft failure
or FFR<0.80 of the previous deferred lesions had significantly lower
visual analogue scale scores (78.7+/-14.2 versus 86.8+/-14.7, P=0.004) and
more angina compared with patients without graft failure or FFR>=0.80 at
6-month follow-up. <br/>Conclusion(s): FFR- versus angiography-guided CABG
demonstrated similar improvements in HRQoL and angina 6 months after CABG.
Graft failure or low FFR in deferred lesions were associated with low
HRQoL and angina. Registration: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT02477371.<br/>Copyright &#xa9; 2021 Lippincott
Williams and Wilkins. All rights reserved.

<95>
Accession Number
635306083
Title
Association of Novel Locus with Rheumatic Heart Disease in Black African
Individuals: Findings from the RHDGen Study.
Source
JAMA Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Machipisa T.; Chong M.; Muhamed B.; Chishala C.; Shaboodien G.; Pandie S.;
De Vries J.; Laing N.; Joachim A.; Daniels R.; Ntsekhe M.; Hugo-Hamman
C.T.; Gitura B.; Ogendo S.; Lwabi P.; Okello E.; Damasceno A.; Novela C.;
Mocumbi A.O.; Madeira G.; Musuku J.; Mtaja A.; Elsayed A.; Elhassan
H.H.M.; Bode-Thomas F.; Okeahialam B.N.; Zuhlke L.J.; Mulder N.; Ramesar
R.; Lesosky M.; Parks T.; Cordell H.J.; Keavney B.; Engel M.E.; Pare G.
Institution
(Machipisa, Muhamed, Chishala, Shaboodien, Pandie, De Vries, Laing,
Joachim, Daniels, Ntsekhe, Zuhlke, Lesosky, Engel) Department of Medicine,
University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
(Machipisa, Muhamed, Chishala, Shaboodien) Hatter Institute for
Cardiovascular Diseases Research in Africa, Cape Heart Institute,
Department of Medicine, University of Cape Town, Cape Town, South Africa
(Machipisa, Chong, Muhamed, Pare) Population Health Research Institute,
David Braley Cardiac, Vascular, Stroke Research Institute, 237 Barton St
E, Hamilton, ON L8L 2X2, Canada
(Machipisa, Chong, Muhamed, Pare) Thrombosis and Atherosclerosis Research
Institute, David Braley Cardiac, Vascular, Stroke Research Institute,
Hamilton, ON, Canada
(Machipisa, Chong, Muhamed, Pare) Department of Pathology and Molecular
Medicine, McMaster University, Michael G. DeGroote School of Medicine,
Hamilton, ON, Canada
(Hugo-Hamman) Rheumatic Heart Disease Clinic, Windhoek Central Hospital,
Ministry of Health and Social Services, Windhoek, Namibia
(Gitura, Ogendo) Cardiology Department of Medicine, Kenyatta National
Hospital, University of Nairobi, Nairobi, Kenya
(Lwabi, Okello) Uganda Heart Institute, Kampala, Uganda
(Damasceno, Novela) Faculty of Medicine, Eduardo Mondlane University,
Nucleo de Investigacao, Departamento de Medicina, Hospital Central de
Maputo, Maputo, Mozambique
(Mocumbi) Instituto Nacional de Saude Ministerio da Saude, Maputo,
Mozambique
(Madeira) Emergency Department, World Health Organization Mozambique,
Maputo, Mozambique
(Musuku, Mtaja) Department of Paediatrics and Child Health, University
Teaching Hospital-Children's Hospital, University of Zambia, Lusaka,
Zambia
(Elsayed, Elhassan) Department of Cardiothoracic Surgery, Alshaab Teaching
Hospital, Alazhari Health Research Center, Alzaiem Alazhari University,
Khartoum, Sudan
(Bode-Thomas, Okeahialam) Department of Paediatrics, Jos University
Teaching Hospital, University of Jos, Jos, Plateau State, Nigeria
(Zuhlke) Division of Paediatric Cardiology, Department of Paediatrics and
Child Health, Red Cross War Memorial Children's Hospital, University of
Cape Town, South Africa
(Mulder) Computational Biology Division, Department of Integrative
Biomedical Sciences, Institute of Infectious Disease and Molecular
Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town,
South Africa
(Ramesar) Department of Pathology, University of Cape Town, Cape Town,
South Africa
(Parks) Wellcome Centre for Human Genetics, University of Oxford, Oxford,
United Kingdom
(Cordell) Population Health Sciences Institute, Faculty of Medical
Sciences, Newcastle University, International Centre for Life, Newcastle
upon Tyne, United Kingdom
(Keavney) Division of Cardiovascular Sciences, School of Medical Sciences,
Faculty of Biology, Medicine, and Health, University of Manchester,
Manchester, United Kingdom
(Keavney) Manchester University, National Health Service Foundation Trust,
Manchester Academic Health Science Centre, Manchester, United Kingdom
(Pare) Department of Clinical Epidemiology and Biostatistics, McMaster
University, Hamilton, ON, Canada
Publisher
American Medical Association
Abstract
Importance: Rheumatic heart disease (RHD), a sequela of rheumatic fever
characterized by permanent heart valve damage, is the leading cause of
cardiac surgery in Africa. However, its pathophysiologic characteristics
and genetics are poorly understood. Understanding genetic susceptibility
may aid in prevention, control, and interventions to eliminate RHD.
<br/>Objective(s): To identify common genetic loci associated with RHD
susceptibility in Black African individuals. <br/>Design, Setting, and
Participant(s): This multicenter case-control genome-wide association
study (GWAS), the Genetics of Rheumatic Heart Disease, examined more than
7 million genotyped and imputed single-nucleotide variations. The 4809
GWAS participants and 116 independent trio families were enrolled from 8
African countries between December 31, 2012, and March 31, 2018. All GWAS
participants and trio probands were screened by use of echocardiography.
Data analyses took place from May 15, 2017, until March 14, 2021.
<br/>Main Outcomes and Measures: Genetic associations with RHD.
<br/>Result(s): This study included 4809 African participants (2548 RHD
cases and 2261 controls; 3301 women [69%]; mean [SD] age, 36.5 [16.3]
years). The GWAS identified a single RHD risk locus, 11q24.1 (rs1219406
[odds ratio, 1.65; 95% CI, 1.48-1.82; P = 4.36 x 10^-8]), which
reached genome-wide significance in Black African individuals. Our
meta-analysis of Black (n = 3179) and admixed (n = 1055) African
individuals revealed several suggestive loci. The study also replicated a
previously reported association in Pacific Islander individuals
(rs11846409) at the immunoglobulin heavy chain locus, in the meta-analysis
of Black and admixed African individuals (odds ratio, 1.16; 95% CI,
1.06-1.27; P = 1.19 x 10^-3). The HLA (rs9272622) associations
reported in Aboriginal Australian individuals could not be replicated. In
support of the known polygenic architecture for RHD, overtransmission of a
polygenic risk score from unaffected parents to affected probands was
observed (polygenic transmission disequilibrium testing mean [SE], 0.27
[0.16] SDs; P =.04996), and the chip-based heritability was estimated to
be high at 0.49 (SE = 0.12; P = 3.28 x 10^-5) in Black African
individuals. <br/>Conclusions and Relevance: This study revealed a novel
candidate susceptibility locus exclusive to Black African individuals and
an important heritable component to RHD susceptibility in African
individuals.<br/>Copyright &#xa9; 2021 American Medical Association. All
rights reserved.

<96>
Accession Number
2010403664
Title
Assessment of prognostic value of intraoperative oliguria for
postoperative acute kidney injury: a retrospective cohort study.
Source
British Journal of Anaesthesia. 126 (4) (pp 799-807), 2021. Date of
Publication: April 2021.
Author
Zhao B.-C.; Lei S.-H.; Yang X.; Zhang Y.; Qiu S.-D.; Liu W.-F.; Li C.; Liu
K.-X.
Institution
(Zhao, Lei, Yang, Zhang, Qiu, Liu, Li, Liu) Department of Anaesthesiology,
Nanfang Hospital, Southern Medical University, Guangzhou, China
Publisher
Elsevier Ltd
Abstract
Background: Oliguria is often viewed as a sign of renal hypoperfusion and
an indicator for volume expansion during surgery. However, the prognostic
association and the predictive utility of intraoperative oliguria for
postoperative acute kidney injury (AKI) are unclear. <br/>Method(s): We
conducted a retrospective cohort study on patients undergoing major
thoracic surgery in an academic hospital to assess the association of
intraoperative oliguria with postoperative AKI and its predictive value.
To contextualise our findings, we included our results in a meta-analysis
of observational studies on the importance of oliguria during noncardiac
surgery. <br/>Result(s): In our cohort study, 3862 patients were included;
205 (5.3%) developed AKI after surgery. Intraoperative urine output of 0.3
ml kg^-1 h^-1 was the optimal threshold for oliguria
in multivariable analysis. Patients with oliguria had an increased risk of
AKI (adjusted odds ratio: 2.60; 95% confidence interval: 1.24-5.05).
However, intraoperative oliguria had a sensitivity of 5.9%, specificity of
98%, positive likelihood ratio of 2.74, and negative likelihood ratio of
0.96, suggesting poor predictive ability. Moreover, it did not improve
upon the predictive performance of a multivariable model, based on
discrimination and reclassification indices. Our findings were generally
consistent with the results of a systematic review and meta-analysis,
including six additional studies. <br/>Conclusion(s): Intraoperative
oliguria has moderate association with, but poor predictive ability for,
postoperative AKI. It remains of clinical interest as a risk factor
potentially modifiable to interventions.<br/>Copyright &#xa9; 2020 British
Journal of Anaesthesia

<97>
Accession Number
2010201846
Title
Evaluation of a novel Cardiac Peri-Operative Transfusion Trigger Scoring
system in patients with coronary artery disease.
Source
BMC Cardiovascular Disorders. 21 (1) (no pagination), 2021. Article
Number: 40. Date of Publication: December 2021.
Author
Ma H.-P.; Zhang L.; Chen C.-L.; Li J.; Ma Z.T.; Jiang Q.Q.; Liang Y.Y.; Li
S.S.; Long F.; Zheng H.
Institution
(Ma, Zhang, Chen, Li, Ma, Jiang, Liang, Li, Long, Zheng) Department of
Anesthesiology, The First Affiliated Hospital of Xinjiang Medical
University, 37 Liyushan South Road, Xinshi District, Urumqi, Xinjiang
830054, China
Publisher
BioMed Central Ltd
Abstract
Background: A simple and accurate scoring system to guide perioperative
blood transfusion in patients with coronary artery disease (CAD)
undergoing cardiac surgery is lacking. The trigger point for blood
transfusions for these patients may be different from existing transfusion
guidelines. This study aimed to evaluate the safety and efficacy of a new
scoring strategy for use in guiding transfusion decisions in patients with
CAD. <br/>Method(s): A multicenter randomized controlled trial was
conducted at three third-level grade-A hospitals from January 2015 to May
2018. Data of 254 patients in a Cardiac Peri-Operative Transfusion Trigger
Score (cPOTTS) group and 246 patients in a group receiving conventional
evaluation of the need for transfusion (conventional group) were analysed.
The requirements for transfusion and the per capita consumption of red
blood cells (RBCs) were compared between groups. <br/>Result(s): Baseline
characteristics of the two groups were comparable. Logistic regression
analyses revealed no significant differences between the two groups in
primary outcomes (1-year mortality and perioperative ischemic cardiac
events), secondary outcomes (shock, infections, and renal impairment), ICU
admission, and ICU stay duration. However, patients in the cPOTTS group
had significantly shorter hospital stays, lower hospital costs, lower
utilization rate and lower per capita consumption of transfused RBCs than
controls. Stratified analyses revealed no significant differences between
groups in associations between baseline characteristics and perioperative
ischemic cardiac events, except for hemofiltration or dialysis and NYHA
class in I. <br/>Conclusion(s): This novel scoring system offered a
practical and straightforward guideline of perioperative blood transfusion
in patients with CAD. Trial registration
chiCTR1800016561(2017/7/19).<br/>Copyright &#xa9; 2021, The Author(s).

<98>
Accession Number
2004098379
Title
Evaluating the role of transesophageal echocardiography (TEE) or
intracardiac echocardiography (ICE) in left atrial appendage occlusion: a
meta-analysis.
Source
Journal of Interventional Cardiac Electrophysiology. 60 (1) (pp 41-48),
2021. Date of Publication: January 2021.
Author
Akella K.; Murtaza G.; Turagam M.; Sharma S.; Madoukh B.; Amin A.;
Gopinathannair R.; Lakkireddy D.
Institution
(Akella, Murtaza, Gopinathannair, Lakkireddy) The Kansas City Heart Rhythm
Institute (KCHRI) HCA MidWest, Overland Park Regional Medical Center,
12200 W 106th Street, Overland Park, KS 66215, United States
(Turagam) Division of Cardiology, Icahn School of Medicine at Mount Sinai,
New York, NY, United States
(Sharma) Department of Cardiology, Garden City Hospital, Garden City, MI,
United States
(Madoukh) Department of Internal Medicine, Overland Park Regional Medical
Center, Overland Park, KS, United States
(Amin) Section of Cardiac Electrophysiology, Department of Cardiology,
OhioHealth Heart and Vascular Physicians, Riverside Methodist Hospital,
3535 Olentangy River Road, Columbus, OH 43214, United States
Publisher
Springer
Abstract
Purpose: Intracardiac echocardiography (ICE) is increasingly common among
periprocedural imaging modalities used during complex cardiac procedures.
We sought to perform a meta-analysis comparing transesophageal
echocardiography (TEE) and ICE in endocardial left atrial appendage
occlusion (LAAO). <br/>Method(s): We searched PubMed and Google Scholar
regarding abstracts and manuscripts using keywords: atrial fibrillation,
left atrial appendage occlusion, Watchman, Amplatzer Cardiac Plug, Amulet,
intracardiac echocardiography, and transesophageal echocardiography from
their inception to July 12, 2019. Data extraction was performed using
standard form for the following: title, year of publication, sample size,
comorbid conditions, LAAO device, type of pre-procedural imaging,
intraprocedural imaging, and clinical outcomes including the following:
acute procedural success, fluoroscopy, and total procedure time and
complications. <br/>Result(s): A total of 42 relevant studies were
screened resulting in inclusion of 8 observational studies comparing TEE
and ICE in endocardial LAAO. Outcomes assessed including procedural
success (RR 1.00, 95% CI (0.97-1.03, p = 0.98)), complications (RR 0.77,
95% CI (0.52 to 1.15, p = 0.20)), fluoroscopy time (mean difference -
0.40, 95% CI (-3.12-2.32, p = 0.77)), and procedural time (mean difference
- 8.02, 95% CI (-22.81 to 6.76, p = 0.29)) were found to be similar
between both groups. <br/>Conclusion(s): While TEE is the gold standard
for perioperative imaging with LAAO, ICE is a feasible and safe
alternative that reduces exposure to general anesthesia and associated
potential risks.<br/>Copyright &#xa9; 2020, Springer Science+Business
Media, LLC, part of Springer Nature.

<99>
Accession Number
2007385474
Title
Cardiac complications attributed to hydroxychloroquine: A systematic
review of the literature pre-covid-19.
Source
Current Cardiology Reviews. 17 (3) (pp 389-397), 2021. Date of
Publication: 2021.
Author
Fram G.; Wang D.D.; Malette K.; Villablanca P.; Kang G.; So K.; Basir
M.B.; Khan A.; McKinnon J.E.; Zervos M.; O'neill W.W.
Institution
(Fram, Wang, Malette, Villablanca, Kang, So, Basir, O'neill) Center for
Structural Heart Disease, Henry Ford Health System, Detroit, MI 48202,
United States
(Khan) Section of Cardiac Electrophysiology, Henry Ford Health System,
Detroit, MI, United States
(McKinnon, Zervos) Divison of Infectious Disease, Henry Ford Health
System, Detroit, MI, United States
Publisher
Bentham Science Publishers
Abstract
Introduction: Hydroxychloroquine has been used for rheumatological
diseases for many decades and is considered a safe medication. With the
COVID-19 outbreak, there has been an in-crease in reports associating
cardiotoxicity with hydroxychloroquine. It is unclear if the cardiotoxic
profile of hydroxychloroquine is previously underreported in the
literature or is it a manifestation of COVID-19 and therapeutic
interventions. This manuscript evaluates the incidence of cardiotoxic-ity
associated with hydroxychloroquine prior to the onset of COVID-19.
<br/>Method(s): PubMED, EMBASE, and Cochrane databases were searched for
keywords derived from MeSH terms prior to April 9, 2020. Inclusion
eligibility was based on appropriate reporting of cardiac conditions and
study design. <br/>Result(s): A total of 69 articles were identified (58
case reports, 11 case series). The majority (84%) of patients were female,
with a median age of 49.2 (range 16-92) years. 15 of 185 patients with
car-diotoxic events were in the setting of acute intentional overdose. In
acute overdose, the median ingestion was 17,857 +/- 14,873 mg. 2 of 15
patients died after acute intoxication. In patients with long-term
hydroxychloroquine use (10.5 +/- 8.9 years), new onset systolic heart
failure occurred in 54 of 155 patients (35%) with median cumulative
ingestion of 1,493,800 +/- 995,517 mg. The majority of patients improved
with the withdrawal of hydroxychloroquine and standard therapy.
<br/>Conclusion(s): Millions of hydroxychloroquine doses are prescribed
annually. Prior to the COVID-19 pandemic, cardiac complications attributed
to hydroxychloroquine were uncommon. Further studies are needed to
understand the impact of COVID-19 on the cardiovascular system to
understand the presence or absence of potential medication interactions
with hydroxychloroquine in this new pathophysiological
state.<br/>Copyright &#xa9; 2021 Bentham Science Publishers.

<100>
[Use Link to view the full text]
Accession Number
634289140
Title
Safety and effectiveness of strategies to reduce radiation exposure to
proceduralists performing cardiac catheterization procedures: A systematic
review.
Source
JBI Evidence Synthesis. 19 (1) (pp 4-33), 2021. Date of Publication:
January 2021.
Author
Fernandez R.; Ellwood L.; Barrett D.; Weaver J.
Institution
(Fernandez, Ellwood) Centre for Evidence Based Initiatives in Health Care:
A JBI Centre of Excellence, Wollongong, NSW, Australia
(Fernandez, Ellwood) Centre for Research in Nursing and Health, St George
Hospital, Sydney, NSW, Australia
(Fernandez) School of Nursing, University of Wollongong, Sydney, NSW,
Australia
(Barrett) Interventional Cardiology, St Andrews Private Hospital, Ipswich,
QLD, Australia
(Weaver) Cardiology Department, Royal Prince Alfred Hospital, Sydney, NSW,
Australia
(Weaver) School of Medicine, University of New South Wales, Sydney, NSW,
Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: The objective of this systematic review was to synthesize the
best available evidence on the effect of various radiation protection
strategies on radiation dose received by proceduralists performing cardiac
catheterization procedures involving fluoroscopy. Introduction: Cardiac
catheterization procedures under fluoroscopy are the gold standard
diagnostic and treatment method for patients with coronary artery disease.
The growing demand of procedures means that proceduralists are being
exposed to increasing amounts of radiation, resulting in an increased risk
of deterministic and stochastic effects. Standard protective strategies
and equipment such as lead garments reduce radiation exposure; however,
the evidence surrounding additional equipment is contradictory. Inclusion
criteria: Randomized controlled trials that compared the use of an
additional radiation protection strategy with conventional radiation
protection methods were considered for inclusion. The primary outcome of
interest was the radiation dose received by the proceduralist during
cardiac catheterization procedures. <br/>Method(s): A three-step search
was conducted in MEDLINE, CINAHL, Embase, and the Cochrane Library
(CENTRAL). Trials published in the English language with adult
participants were included. Trials published from database inception until
July 2019 were eligible for inclusion. The methodological quality of the
included studies was assessed using the JBI critical appraisal checklist
for randomized controlled trials. Quantitative data were extracted from
the included papers using the JBI data extraction tool. Results that could
not be pooled in meta-analysis were reported in a narrative form.
<br/>Result(s): Fifteen randomized controlled trials were included in the
review. Six radiation protection strategies were assessed: Leaded and
unleaded pelvic or arm drapes, transradial protection board, remotely
controlled mechanical contrast injector, extension tubing for contrast
injection, real-time radiation monitor, and a reduction in frame rate to
7.5 frames per second. Pooled data from two trials demonstrated a
statistically significant decrease in the mean radiation dose (P<0.00001)
received by proceduralists performing transfemoral cardiac catheterization
on patients who received a leaded pelvic drape compared to standard
protection. One trial that compared the use of unleaded pelvic drapes
placed on patients compared to standard protection reported a
statistically significant decrease (P=0.004) in the mean radiation dose
received by proceduralists. Compared to standard protection, two trials
that used unleaded arm drapes for patients, one trial that used a remotely
controlled mechanical contrast injector, and one trial that used a
transradial protection board demonstrated a statistically significant
reduction in the radiation dose received by proceduralists. Similarly,
using a frame rate of 7.5 versus 15 frames per second and monitoring
radiation dose in real-time radiation significantly lowered the radiation
dose received by the proceduralist. One trial demonstrated no
statistically significant difference in proceduralist radiation dose among
those who used the extension tubing compared to standard protection (P=1).
<br/>Conclusion(s): This reviewprovides evidence to support the use of
leaded pelvic drapes for patients as an additional radiation protection
strategy for proceduralists performing transradial or transfemoral cardiac
catheterization. Further studies on the effectiveness of using a lower
fluoroscopy framerate, real-timeradiationmonitor, and transradial
protection board are needed.<br/>Copyright &#xa9; 2021 JBI.

<101>
Accession Number
2005512447
Title
Efficacy of fractional flow reserve-guided percutaneous cornary
intervention for patients with angina pectoris a network meta-analysis.
Source
International Heart Journal. 61 (6) (pp 1097-1106), 2020. Date of
Publication: 2020.
Author
Shinohara H.; Kodera S.; Kiyosue A.; Ando J.; Morita H.; Komuro I.
Institution
(Shinohara, Kodera, Kiyosue, Ando, Morita, Komuro) Department of
Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
Publisher
International Heart Journal Association
Abstract
Evaluation of hemodynamic parameters, such as fractional flow reserve
(FFR), is recommended before percutaneous coronary intervention (PCI) for
patients with angina pectoris (AP). However, the advantage of FFR-guided
PCI has not been fully established. This study was performed to confirm
whether FFR-guided PCI im-proves the prognosis compared with other
treatments. Multiple databases were searched for studies published from
2000 to 2018, and a network meta-analysis (NMA) was performed to compare
outcomes of FFR-guided PCI, non-FFR-guided PCI, coronary artery bypass
grafting (CABG), and medical treatment (MT) for AP based on estimated odds
ratios (ORs). The study included 18,093 patients from 15 randomized
controlled trials (RCTs). No evidence of inconsistency was observed among
the studies. The NMA showed that the all-cause mortality of FFR-guided PCI
was not significantly different from that of the other treatment groups
(CABG: OR, 1.1; 95% confidence interval [CI], 0.67-1.7; non-FFR-guided
PCI: OR, 0.85; 95% CI, 0.53-1.4; and MT: OR, 0.83; 95% CI, 0.52-1.3). The
NMA for the composite of all-cause mortality and myocardial infarction,
which included 15,454 patients from 12 RCTs, showed that FFR-guided PCI
significantly reduced the composite outcome compared with non-FFR-guided
PCI and MT (non-FFR-guided PCI: OR, 0.66; 95% CI, 0.46-0.95 and MT: OR,
0.66; 95% CI, 0.46-0.95). Although FFR-guided PCI for AP did not show
significant prognostic improvement compared with non-FFR-guided PCI, CABG,
and MT, FFR-guided PCI may significantly reduce the composite of all-cause
mortality and myocardial infarction compared with non-FFR-guided PCI and
MT.<br/>Copyright &#xa9; 2020, International Heart Journal Association.
All rights reserved.

<102>
Accession Number
633784819
Title
A six-week inspiratory muscle training and aerobic exercise improves
respiratory muscle strength and exercise capacity in lung cancer patients
after video-assisted thoracoscopic surgery: A randomized controlled trial.
Source
Clinical rehabilitation. 35 (6) (pp 840-850), 2021. Date of Publication:
01 Jun 2021.
Author
Liu J.-F.; Kuo N.-Y.; Fang T.-P.; Chen J.-O.; Lu H.-I.; Lin H.-L.
Institution
(Liu, Fang, Lin) Department of Respiratory Care, Chang Gung University of
Science and Technology, Chiayi, Taiwan (Republic of China)
(Liu, Kuo) Department of Respiratory Therapy, Chang Gung Memorial
Hospital-Kaohsiung Medical Center and Chang Gung University College of
Medicine, Kaohsiung, Taiwan (Republic of China)
(Fang, Lin) Department of Respiratory Therapy, Chiai Chang Gung Memorial
Hospital, Chiayi, Taiwan (Republic of China)
(Chen) Department of Nursing, Tajen University, Pingtung, Taiwan (Republic
of China)
(Lu) Division of Thoracic and Cardiovascular Surgery, Department of
Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University
College of Medicine Kaohsiung, Kaohsiung, Taiwan (Republic of China)
(Lin) Department of Respiratory Therapy, Chang Gung University, Taoyuan,
Taiwan (Republic of China)
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To compare the postoperative outcomes of inspiratory muscle
training and aerobic exercise, along with standard care, on lung cancer
patients undergoing video-assisted thoracoscopic surgery (VATS). DESIGN: A
parallel-group, single-blind randomized clinical trial. SETTING: Thoracic
surgery ward and outpatient clinic in a teaching hospital. SUBJECTS:
Overall 63 patients underwent VATS were randomly assigned to a triaging
(TG, n=32) or control group (CG, n=31). A total of 54 patients (TG, n=26;
CG, n=28) completed the study. INTERVENTION: TG: six-week threshold
inspiratory muscle training and aerobic exercise. CG: standard care. MAIN
MEASURES: Maximum inspiratory pressure (PImax), maximum expiratory
pressure (PEmax) lung expansion volume, and 6-min walking test (6MWT) were
performed on the day of chest tube removal (baseline), and 2, 6, and
12weeks postoperatively. <br/>RESULT(S): The TG showed significant
improvement in PImax at week 6 (71.6+/-34.9 vs. 94.3+/-32.8cmH2O,
P=0.018), PEmax at week 2 (70.9+/-24.3 vs. 90.9+/-28.2cmH2O, P=0.015) and
week 12 (76.1+/-20.2 vs. 98.6+/-35.3cmH2O, P=0.012), the lung expansion
volume at week 2 (1080+/-433 vs 1457+/-624mL, P=0.02) and week 12
(1200+/-387 vs 1885+/-678mL, P<0.001), in addition to the 6MWT at week 2
(332+/-78 vs 412+/-74m, P=0.002), week 6 (360+/-70 vs 419+/-60m, P=0.007)
and week 12 (360+/-58 vs 402+/-65m, P=0.036). <br/>CONCLUSION(S): A six
weeks of inspiratory muscle training and aerobic exercise had improved
respiratory muscle strength and aerobic exercise postoperatively in lung
cancer patients after VATS as early as 2weeks.

<103>
Accession Number
635252158
Title
Postoperative low molecular weight heparin bridging treatment for patients
at high risk of arterial thromboembolism (PERIOP2): Double blind
randomised controlled trial.
Source
The BMJ. 373 (no pagination), 2021. Article Number: n1205. Date of
Publication: 09 Jun 2021.
Author
Kovacs M.J.; Wells P.S.; Anderson D.R.; Lazo-Langner A.; Kearon C.; Bates
S.M.; Blostein M.; Kahn S.R.; Schulman S.; Sabri E.; Solymoss S.; Ramsay
T.; Yeo E.; Rodger M.A.
Institution
(Kovacs, Lazo-Langner) Department of Medicine, Western University, London,
ON, Canada
(Wells) Department of Medicine, University of Ottawa, Ottawa Hospital
Research Institute, Ottawa, ON, Canada
(Anderson) Department of Medicine, Dalhousie University, Halifax, NS,
Canada
(Kearon, Bates, Schulman) Department of Medicine, McMaster University and
Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada
(Blostein, Kahn, Solymoss, Rodger) Department of Medicine, McGill
University, Montreal, QC, Canada
(Sabri, Ramsay) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Yeo) Department of Medicine, University of Toronto, Toronto, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Objective To determine the efficacy and safety of dalteparin postoperative
bridging treatment versus placebo for patients with atrial fibrillation or
mechanical heart valves when warfarin is temporarily interrupted for a
planned procedure. Design Prospective, double blind, randomised controlled
trial. Setting 10 thrombosis research sites in Canada and India between
February 2007 and March 2016. Participants 1471 patients aged 18 years or
older with atrial fibrillation or mechanical heart valves who required
temporary interruption of warfarin for a procedure. Intervention Random
assignment to dalteparin (n=821; one patient withdrew consent immediately
after randomisation) or placebo (n=650) after the procedure. Main outcome
measures Major thromboembolism (stroke, transient ischaemic attack,
proximal deep vein thrombosis, pulmonary embolism, myocardial infarction,
peripheral embolism, or vascular death) and major bleeding according to
the International Society on Thrombosis and Haemostasis criteria within 90
days of the procedure. Results The rate of major thromboembolism within 90
days was 1.2% (eight events in 650 patients) for placebo and 1.0% (eight
events in 820 patients) for dalteparin (P=0.64, risk difference -0.3%, 95%
confidence interval -1.3 to 0.8). The rate of major bleeding was 2.0% (13
events in 650 patients) for placebo and 1.3% (11 events in 820 patients)
for dalteparin (P=0.32, risk difference -0.7, 95% confidence interval -2.0
to 0.7). The results were consistent for the atrial fibrillation and
mechanical heart valves groups. Conclusions In patients with atrial
fibrillation or mechanical heart valves who had warfarin interrupted for a
procedure, no significant benefit was found for postoperative dalteparin
bridging to prevent major thromboembolism. Trial registration
Clinicaltrials.gov NCT00432796. <br/>Copyright &#xa9; The Author(s), 2021.

<104>
[Use Link to view the full text]
Accession Number
632727030
Title
Effects of Massage on Postoperative Pain in Infants With Complex
Congenital Heart Disease.
Source
Nursing research. 69 (5S Suppl 1) (pp S36-S46), 2020. Date of Publication:
01 Sep 2020.
Author
Harrison T.M.; Brown R.; Duffey T.; Frey C.; Bailey J.; Nist M.D.; Renner
L.; Fitch J.
Institution
(Harrison) Tondi M. Harrison, PhD, RN, FAAN, is Associate Professor, The
Ohio State University College of Nursing, Columbus. Roger Brown, PhD, is
Professor, University of Wisconsin-Madison School of Nursing. Travis
Duffey, LMT, is Licensed Massage Therapist, Nationwide Children's
Hospital, Columbus, Ohio. Corrie Frey, LMT, CIMI, CPMT, is Licensed
Massage Therapist, Nationwide Children's Hospital, Columbus, Ohio. Jacob
Bailey, BSN, RN, is Staff Nurse, COPC Ohio Center for Pediatrics, Dublin.
Marliese Dion Nist, PhD, RNC, is Postdoctoral Fellow, The Ohio State
University College of Nursing, Columbus, Ohio. Lauren Renner, MSN, RN,
CPNP, is APRN Clinical Leader, Nationwide Children's Hospital, Columbus,
Ohio. Jill Fitch, MD, is Pediatric Intensivist, Nationwide Children's
Hospital, Columbus, OH
Publisher
NLM (Medline)
Abstract
BACKGROUND: Pain management is an essential component of care for
pediatric patients following surgery. Massage reduces self-reported
postoperative pain in adults with heart disease but has received little
attention in postoperative pediatric patients with complex congenital
heart disease (CCHD). <br/>OBJECTIVE(S): The aim of the study was to
evaluate the effectiveness of massage compared to a rest period on
postoperative pain scores and physiological responses in infants with
CCHD. <br/>METHOD(S): We used a two-group randomized clinical trial design
with a sample of 60 infants with CCHD between 1 day and 12 months of age
following their first cardiothoracic surgery. Both groups received
standard postoperative care. Group 1 received a daily 30-minute
restriction of nonessential caregiving (quiet time), and Group 2 received
a daily 30-minute massage. Interventions continued for seven consecutive
days. Pain was measured six times daily using the Face, Legs, Activity,
Cry, Consolability Pain Assessment Tool (FLACC). Average daily doses of
analgesics were recorded. Heart rates (HRs), respiratory rates (RRs), and
oxygen saturations (SpO2) were recorded continuously. Daily averages, pre-
and postintervention FLACC scores, and physiological responses were
analyzed using descriptive statistics, generalized linear mixed models
repeated measures, latent growth models, and/or regression discontinuity
analysis. Fentanyl-equivalent narcotic values were used as a time-varying
covariate. <br/>RESULT(S): Adjusted pain scores were lower for the massage
group on all days except Day 7. Overall, there were no group effects on
level of pain or differential rate of change in pain. However, the massage
group had lower daily pain scores with small to medium effect size
differences, largest at Days 4, 5, and 6, and lower average daily HR and
RR. There was little difference between groups in SpO2. Infants
demonstrated immediate effects of massage, with HR and RR decreasing and
oxygen saturations increasing. DISCUSSION: This study provides beginning
evidence that postoperative massage may reduce pain and improve
physiological parameters in infants with congenital heart disease. This
nonpharmacological adjunct to pain management may provide a particular
benefit for this population by reducing demand on the cardiorespiratory
system.

<105>
Accession Number
635286610
Title
Is there a Predictive Value of Hemoglobin A1C for Complications of Cardiac
Surgery?.
Source
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 30
(6) (pp 686-693), 2021. Date of Publication: 01 Jun 2021.
Author
Ozturk S.; Kayacoglu I.; Sensoz Y.; Ozcelik S.; Arslan Y.; Ozturk I.
Institution
(Ozturk, Kayacoglu, Sensoz, Ozcelik, Arslan) Department of Anesthesiology,
Goztepe Education and Research Hospital, Istanbul, Turkey
(Ozturk) Department of Cardiovascular Surgery, Goztepe Education and
Research Hospital, Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To investigate the effect of preoperative hemoglobin A1c levels
for the complications of cardiac surgery. STUDY DESIGN: Meta-analysis.
Place of Study: Siyami Ersek Chest and Cardiovascular Surgery Education
and Research Hospital, Istanbul, Turkey. METHODOLOGY: PubMed, Scopus, Web
of Science and Ovid electronic databases were used. The studies were
included the recorded preoperative levels of hemoglobin A1C and
postoperative complications developed after cardiac surgery. Results of
the studies were evaluated, based on either random or fixed effect model,
according to presence of heterogeneity (I2>25%). <br/>RESULT(S): In total,
2,312 articles were obtained. After reviewing the articles, 33 articles
covering 3500 patients meeting the inclusion criteria were included. The
results pointed out that there was a relationship between preoperative
hemoglobin A1c levels and mediastinitis, stroke, pneumonia, sepsis, renal
failure and mortality. Heterogeneity was observed for myocardial
infarction, atrial fibrillation and multiorgan failure (I2 >25%).
<br/>CONCLUSION(S): Preoperative hemoglobin A1C levels were associated
with development of mediastinitis, stroke, pneumonia, sepsis, renal
failure and mortality after cardiac surgery. Key Words: Hemoglobin A1C,
Cardiac surgery, Complication, Meta-analysis.

<106>
Accession Number
635286107
Title
Surgical Cardiac Sympathetic Denervation for Ventricular Arrhythmias: A
Systematic Review.
Source
Methodist DeBakey cardiovascular journal. 17 (1) (pp 24-35), 2021. Date of
Publication: 05 Apr 2021.
Author
Chihara R.K.; Chan E.Y.; Meisenbach L.M.; Kim M.P.
Institution
(Chihara, Chan, Meisenbach, Kim) Houston Methodist Hospital, Houston, TX
(Chihara, Chan, Kim) Weill Cornell Medical College, NY
Publisher
NLM (Medline)
Abstract
Ventricular arrhythmias are potentially life-threatening disorders that
are commonly treated with medications, catheter ablation and implantable
cardioverter defibrillator (ICD). Adult patients who continue to be
symptomatic, with frequent ventricular arrhythmia cardiac events or
defibrillation from ICD despite medical treatment, are a challenging
subgroup to manage. Surgical cardiac sympathetic denervation has emerged
as a possible treatment option for people refractory to less invasive
medical options. Recent treatment guidelines have recommendedcardiac
sympathectomy for ventricular tachycardia (VT) or VT/fibrillation storm
refractory to antiarrhythmic medications, long QT syndrome, and
catecholaminergic polymorphic VT, with much of the data pertaining to
pediatric literature. However, for the adult population, the disease
indications, complications, and risks of cardiac sympathectomy are less
understood, as are the most effective surgical cardiac denervation
techniques for this patient demographic. This systematic review navigates
available literature evaluating surgical denervation disease state
indications, techniques, and sympathectomy risks for medically refractory
ventricular arrhythmia in the adult patient population.

<107>
Accession Number
2013028543
Title
BRG1 inhibits apoptosis of human aortic dissection smooth muscle cells and
promotes proliferation by regulating the expression of incrna HIF1A-AS 1.
Source
Acta Medica Mediterranea. 37 (3) (pp 1491-1495), 2021. Date of
Publication: 2021.
Author
Wang L.
Institution
(Wang) Chengdu First People's Hospital, Chengdu, China
Publisher
A. CARBONE Editore
Abstract
Objective: To analyze the role of Brahma related gene-1 (BRG1) in
inhibiting apoptosis and promoting proliferation of aortic dissection
smooth muscle cells by regulating the expression of long non-coding RNA
hypoxia-inducing factor-1A-antisense chain 2 (IncRNA HIF1A-AS 1).
<br/>Method(s): The study group was randomly selected from 20 cases of
aortic dissection in thoracic surgery. Twenty normal healthy donors were
selected as a control group. The expression level of BRG1 in the two
groups was measured by real-time fluorescence quantitative PCR and protein
imprinting. The human primary aortic smooth muscle cells were HAoSMC
cultured, and the BRG1 low expression group and the control group were
obtained by lentivirus infection. Real-time quantitative PCR method was
used to determine the expression level of IncRNA HIF1A-AS 1 for each
group. HAoSMC cells were transfected with an empty plasmid or an HIF1A-AS
1 interference plasmid to obtain an HIF1A-AS 1 interference control group
and an HIF1A-AS 1 interference group. Real-time quantitative PCR was used
to determine the expression level of IncRNA HIF1A-AS 1 in each group. The
expression levels of apoptosis-related proteins were determined by western
blotting and real-time fluorescence quantitative PCR caspase3. Bcl-2 two
groups. Changes in cell proliferation were determined with the CCK-8
method. <br/>Result(s): Compared with the control group, the expression
level of BRG1 in the middle aortic tissues of the experimental group was
significantly increased (P<0.01). Compared with the BRG1 control group,
the expression level of IncRNA HIF1A-AS 1 in the BRG1 low-expression group
was significantly reduced (P<0.01). Compared with the HIF1A-AS 1
interference control group, the expression levels of IncRNA HIF1A-AS 1 and
caspase-3 in the HIF1A-AS 1 interference group were significantly reduced,
and the expression levels of Bcl-2 were significantly increased (P<0.01).
Compared with the HIF1A-AS 1 interference control group, the expression
level of caspase-3 in the HIF1A-AS 1 interference group was significantly
reduced, and the expression level of Bcl-2 was significantly increased
(P<0.01). <br/>Conclusion(s): Low expression of BRG1 can significantly
inhibit the expression of IncRNA HIF1A-AS 1, thereby inhibiting the
apoptosis of human aortic dissection smooth muscle cells and promoting
cell proliferation.<br/>Copyright &#xa9; 2021 A. CARBONE Editore. All
rights reserved.

<108>
Accession Number
2012861841
Title
Can mitomycin facilitate endoscopic dilatation treatment of benign
oesophageal stricture?.
Source
Interactive Cardiovascular and Thoracic Surgery. 24 (1) (pp 112-114),
2017. Date of Publication: 2017.
Author
Deng H.-Y.; Wang W.-P.; Lin Y.-D.; Chen L.-Q.
Institution
(Deng, Wang, Lin, Chen) Department of Thoracic Surgery, West China
Hospital, Sichuan University, Chengdu, China
Publisher
Oxford University Press
Abstract
A best evidence topic in cardiothoracic surgery was written according to a
structured protocol. The question addressed was 'Can mitomycin facilitate
endoscopic dilatation treatment of benign esophageal stricture (mainly
including caustic and anastomotic esophageal stricture)?' Altogether, 115
papers were found using the reported search, of which 6 represented the
best evidence to answer the clinical question, which included 1 randomized
controlled trial, 1 systematic review and 4 cohort studies. The authors,
journal, date and country of publication, patient group studied, study
type, relevant outcomes and results of these papers are tabulated.
Mytomicin was topically applied as an adjunct to endoscopic dilatation
with a concentration of 0.1-1 mg/ml in those included studies. Most of the
studies reported that topical application of mitomycin could augment the
effect of endoscopic dilatation treatment to achieve less dilatation
number and significant improvement of dysphagia in patients suffering
benign oesophageal stricture, and would not increase the risk of
complications. These satisfying adjunct effects were observed in both
child patients and adult patients. Therefore, we conclude that mitomycin
can serve as a useful adjunct to endoscopic dilatation for benign
oesophageal stricture. On the basis of our evidence, we strongly believe
that topical application of mitomycin would augment the efficacy of
endoscopic dilatation of benign oesophageal stricture.<br/>Copyright
&#xa9; 2017 Oxford University Press. All rights reserved.

<109>
Accession Number
635289386
Title
The Efficacy of Resin Hemoperfusion Cartridge on Inflammatory Responses
during Adult Cardiopulmonary Bypass.
Source
Blood purification. (pp 1-7), 2021. Date of Publication: 09 Jun 2021.
Author
He Z.; Lu H.; Jian X.; Li G.; Xiao D.; Meng Q.; Chen J.; Zhou C.
Institution
(He, Lu, Jian, Xiao, Meng, Chen, Zhou) Department of Cardiovascular
Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong
Provincial People's Hospital, Guangdong Academy of Medical Sciences,
Guangzhou, China
(Li) Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital
of Sun Yat-sen University, Guangzhou, China
Publisher
NLM (Medline)
Abstract
AIM: This study aimed to evaluate the efficacy of the resin hemoperfusion
device (HA380 hemoperfusion cartridge) on inflammatory responses during
adult cardiopulmonary bypass (CPB). <br/>METHOD(S): Sixty patients
undergoing surgical valve replacement were randomized into the HP group (n
= 30) with an HA380 hemoperfusion cartridge in the CPB circuit or the
control group (n = 30) with the conventional CPB circuit. The results of
routine blood tests, blood biochemical indexes, and inflammatory factors
were analyzed at V0 (pre-CPB), V1 (CPB 30 min), V2 (ICU 0 h), V3 (ICU 6
h), and V4 (ICU 24 h). <br/>RESULT(S): The HP group had significantly
lower levels of IL-6, IL-8, and IL-10. Significant estimation of group
differences in the generalized estimating equation (GEE) models was also
observed in IL-6 and IL-10. The HP group had significantly lower levels of
creatinine (Cr), aminotransferase (AST), and total bilirubin (TBil)
compared to the control group. The estimation of differences of Cr, AST,
and TBil all reached statistical significance in GEE results. The HP group
had significantly less vasopressor requirement and shorter mechanical
ventilation time and ICU stay time as compared to the control group.
<br/>CONCLUSION(S): The HA380 hemoperfusion cartridge could effectively
reduce the systemic inflammatory responses and improve postoperative
recovery of patients during adult CPB.<br/>Copyright &#xa9; 2021 S. Karger
AG, Basel.

<110>
Accession Number
635286198
Title
The Better Option of Revascularization in Complex Coronary Artery Disease
Patients Complicate With Chronic Kidney Disease: A Review and
Meta-Analysis.
Source
Current problems in cardiology. (pp 100886), 2021. Date of Publication: 08
May 2021.
Author
Chen X.; Zhang X.; Yan Y.; Wang G.
Institution
(Chen) Department of Emergency, Beijing Friendship Hospital, Capital
Medical University, Beijing, China
(Zhang, Yan) Department of Cardiology, Beijing Anzhen Hospital, Capital
Medical University, Beijing, China
(Wang) Department of Emergency, Beijing Friendship Hospital, Capital
Medical University, Beijing, China
Publisher
NLM (Medline)
Abstract
The treatment of complex coronary artery disease (CAD) combined with
chronic kidney disease (CKD) faces great challenges. We thus did a
systematic review and meta-analysis to assess the effect of percutaneous
coronary intervention (PCI) and coronary artery bypass graft (CABG). We
systematically searched PubMed, Embase, Cochrane Library and other
relevant articles refer to reference. Our main endpoints were main adverse
cardiovascular and cerebrovascular events (MACCE), all cause death,
myocardial infarction (MI), repeat revascularization and stoke. 24 studies
were included in our analysis. Compared with PCI, CABG improved outcomes
such as MACCE (Odds Ratio [OR] 1.75; 95%CI 1.26-2.42), all cause death (OR
1.13; 95%CI 1.00-1.28), repeat revascularization (OR 4.24; 95%CI
3.29-5.47) and MI (OR 2.16; 95%CI 1.59-2.91), but stoke (OR 0.84, 95%CI
0.61-1.17). CABG shows absolute advantage in complex CAD complicated with
CKD and ESRD patients than stent implantation in the long-term
following-up.<br/>Copyright &#xa9; 2021 Elsevier Inc. All rights reserved.