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<1>
Accession Number
2013097946
Title
Non-steroidal anti-inflammatory drugs and bone healing in animal models-a
systematic review and meta-analysis.
Source
Systematic Reviews. 10 (1) (no pagination), 2021. Article Number: 201.
Date of Publication: December 2021.
Author
Al-Waeli H.; Reboucas A.P.; Mansour A.; Morris M.; Tamimi F.; Nicolau B.
Institution
(Al-Waeli) Faculty of Dentistry, Dalhousie University, 5981 University
Ave, Halifax, NS B3H 4R2, Canada
(Reboucas) Faculty of Dentistry, Federal University of Minas Gerais, Minas
Gerais, Brazil
(Mansour) School of Dental Medicine, University at Buffalo, Buffalo, NY
14214, United States
(Morris) Schulich Library, McGill University, 2001 Avenue McGill College
Suite 500, Montreal, QC H3A 1G1, Canada
(Reboucas, Tamimi) College of Dental Medicine, Qatar University,
University Street, Doha, Qatar
(Nicolau) Faculty of Dentistry, McGill University, 2001 Avenue McGill
College Suite 500, Montreal, QC H3A 1G1, Canada
Publisher
BioMed Central Ltd
Abstract
Background: Non-steroidal anti-inflammatory drugs (NSAID) have excellent
anti-inflammatory and analgesic properties and are extensively used to
treat post-traumatic or surgical musculoskeletal pain. Although an
extensive literature exists on the administration of NSAID on animal bone
healing, no systematic review and meta-analysis of animal studies that
investigate the effect of NSAID administration on bone fracture healing.
Objective of this study is to conduct a systematic review and
meta-analysis to estimate the effect of NSAIDs administration on bone
healing biomechanical and histomorphometric measurements in different
animal models after bone fracture surgery. <br/>Method(s): We performed a
systematic review and meta-analysis of animal studies to estimate the
effect of NSAID administration after bone fracture on healing outcomes. We
searched eight databases without limiting the search to starting date up
to 1 February 2021 for articles on fractured bone healing in animal models
in which NSAID were administered. <br/>Result(s): Out of 6732 articles
screened, 47 were included and 3 common bone healing outcomes were
analysed: biomechanical properties (maximum force to break, stiffness, and
work-to-failure), micro-computed tomography (mu-CT), and histomorphometric
measurements. The studies were generally of low-quality scores because
crucial information, especially concerning randomization, blinding, and
allocation concealment, was poorly reported. Our results show that the
negative effects of NSAID after bone fracture on certain biomechanical
properties of the healing bones was not statistically significant in mice
compared with other animals, in females compared with males, and in
younger compared with older animals. <br/>Conclusion(s): The findings
demonstrated that NSAIDs administration decreased the biomechanical
properties of healing bones after fracture surgery in comparison to the
control group. Moreover, different effect on certain outcomes was detected
among different sites, sex of the animals, and the time of assessment.
Trial registration: Protocol published and registered in SYstematic Review
Center for Laboratory animal Experimentation (SYRCLE) in 2017,
https://www.radboudumc.nl/getmedia/757ec408-7a9e-4635-8233-ae951effea54/No
n-Steroidal-Anti-inflammatory-Drugs-and-bone-healing-in-animal-Models-Syst
ematic-Review-and-Meta-Analysis.aspx<br/>Copyright &#xa9; 2021, The
Author(s).

<2>
Accession Number
2005670271
Title
Safety and effectiveness of riociguat for chronic thromboembolic pulmonary
hypertension in real-world clinical practice: interim data from
post-marketing surveillance in Japan.
Source
Pulmonary Circulation. 10 (3) (no pagination), 2020. Date of Publication:
July 2020.
Author
Tanabe N.; Ogo T.; Hatano M.; Kigawa A.; Sunaya T.; Sato S.
Institution
(Tanabe) Department of Respirology, Chiba University, Chiba, Japan
(Ogo) Department of Cardiovascular Medicine, National Cerebral and
Cardiovascular Center, Osaka, Japan
(Hatano) Department of Cardiovascular Medicine, The University of Tokyo,
Tokyo, Japan
(Kigawa) Medical Affairs Pulmonology and Cardiology, Bayer Yakuhin, Ltd,
Osaka, Japan
(Sunaya) Data Sciences and Analytics, Research and Development Japan,
Bayer Yakuhin, Ltd, Osaka, Japan
(Sato) Pharmacovigilance and Medical Governance, Medical Affairs, Bayer
Yakuhin, Ltd, Osaka, Japan
Publisher
SAGE Publications Ltd
Abstract
This multicenter, prospective, non-interventional study
(ClinicalTrials.gov: NCT02117791) evaluated the safety and effectiveness
of riociguat for chronic thromboembolic pulmonary hypertension in Japanese
clinical practice, registering all patients with chronic thromboembolic
pulmonary hypertension treated with riociguat following its launch in
Japan in April 2014. Safety was assessed by analyzing the adverse drug
reactions. Effectiveness measurements included the assessment of change in
World Health Organization functional class, six-minute walk test, and
hemodynamics. Overall, 1031 patients were included in the safety analysis
with 811 (78.7%) patients in World Health Organization functional class
II/III. The mean treatment duration was 591.4 days (median 441.0 days).
Adverse drug reactions were reported in 19.5% of patients, the most common
being hypotension (5.9%), headache (3.0%), dizziness (1.9%), and
gastroesophageal reflux disease (1.5%). Serious adverse drug reactions
were reported in 2.1% of patients. Estimated survival was 97.0% at one
year, 95.8% at two years, and 94.4% at three years. The effectiveness
analysis (n = 1027) showed significant increases from baseline in
six-minute walking distance, and significant reductions from baseline in
mean pulmonary arterial pressure and pulmonary vascular resistance. These
interim results of riociguat in Japanese patients with chronic
thromboembolic pulmonary hypertension demonstrated a safety profile that
was generally consistent with those of pivotal clinical studies. The study
is ongoing, and will continue to provide insights into the safety and
effectiveness of riociguat in real-world practice.<br/>Copyright &#xa9;
The Author(s) 2020.

<3>
Accession Number
368470188
Title
A multi-center randomized double-blind placebo-controlled trial of
Xiongshao Capsule in preventing restenosis after percutaneous coronary
intervention: A subgroup analysis of senile patients.
Source
Chinese Journal of Integrative Medicine. 17 (9) (pp 669-674), 2011. Date
of Publication: September 2011.
Author
Shang Q.-H.; Xu H.; Lu X.-Y.; Wen C.; Shi D.-Z.; Chen K.-J.
Institution
(Shang) Beijing University of Chinese Medicine, Beijing (100029), China
(Xu, Lu, Wen) National Integrative Medicine Center for Cardiovascular
Diseases, China-Japan Friendship Hospital, Beijing (100029), China
(Shi, Chen) Xiyuan Hospital, China Academy of Chinese Medical Sciences,
Beijing (100091), China
Publisher
Chinese Journal of Integrated Traditional and Western Medicine Press
Abstract
Objective: To evaluate the safety and efficacy of Xiongshao Capsule (XS),
consisting of Chuangxiongol and paeoniflorin, in preventing restenosis
after percutaneous coronary intervention (PCI) in senile coronary heart
disease (CHD) patients. <br/>Method(s): A multi-center, randomized,
double-blind, placebo-controlled trial was conducted. A total of 335 CHD
patients were randomly assigned to treatment with oral administration of
XS, or a placebo for 6 months after successful PCI. A clinical follow-up
was performed at 1, 3 and 6 months after PCI and an angiographic follow-up
was scheduled at 6 months. The primary endpoint was angiographic
restenosis defined as a luminal stenosis 50% in follow-up. The secondary
endpoints were combined incidence of death, target lesion nonfatal
myocardial infarction, repeat target-vessel angioplasty, and coronary
artery bypass graft surgery (CABG). The follow-up for the above clinical
endpoint events was continued to 1 year after PCI. <br/>Result(s): The
subgroup analysis of 152 senile patients (68 cases angiographic follow-up)
showed that the restenosis rates tended to reduce in the XS group as
compared with that in the placebo group (24.32% vs. 38.71%, P > 0.05), and
the minimum lumen diameter (MLD) significantly increased in the follow-up
(2.15 +/- 0.84 for XS vs. 1.73 +/- 0.91 for placebo, P < 0.05). The
incidence of recurrent angina at 3 and 6 months after PCI was also
significantly reduced in the XS group (4.11% and 12.33%) as compared with
those in the placebo group (17.72% and 43.04%), but there was no
significant difference in the combined incidence of clinical outcomes
(6.85% in the XS group vs. 11.39% in the placebo group, P > 0.05). No
significant adverse reactions occurred within the 6-month follow-up period
in the XS group. <br/>Conclusion(s): Administration of XS in addition to
standardized Western medication for 6 months is demonstrated to be safe
and effective in reducing post-PCI recurrent angina and inhibiting luminal
restenosis after PCI in senile CHD patients. &#xa9; 2011 The Chinese
Journal of Integrated Traditional and Western Medicine Press and
Springer-Verlag Berlin Heidelberg.

<4>
Accession Number
362453997
Title
Haemodynamic changes during left anterior descending artery exposure in
off-pump coronary artery bypass: Comparison between use of moist
laparotomy pads and deep pericardial traction sutures for heart
displacement.
Source
Journal of International Medical Research. 39 (4) (pp 1211-1218), 2011.
Date of Publication: August 2011.
Author
Kim D.H.; Park S.Y.; Cho H.B.; Park S.K.; Kang M.; Hong Y.S.; Hong Y.W.
Institution
(Kim, Park, Cho, Park, Kang, Hong) Department of Anaesthesiology and Pain
Medicine, Ajou University School of Medicine, Suwon, South Korea
(Hong) Department of Thoracic and Cardiovascular Surgery, Ajou University
School of Medicine, Suwon, South Korea
Publisher
SAGE Publications Ltd
Abstract
Haemodynamic changes occurring during heart displacement, using moist
laparotomy pads placed behind the heart (PAD group, n = 26) or deep
pericardial traction sutures (DPS group, n = 25) to facilitate exposure of
the left anterior descending artery during off-pump coronary artery bypass
surgery, were compared. Haemodynamic variables were assessed before and 10
min after displacement of the heart. The central venous pressure, mean
pulmonary artery pressure and pulmonary capillary wedge pressure increased
in both groups. After heart displacement in the PAD group, the cardiac
index, stroke volume index, mixed venous oxygen saturation, right
ventricular ejection fraction and left ventricular stroke work index
decreased significantly, and the systemic vascular resistance and
pulmonary vascular resistance increased significantly; these parameters
remained unchanged in the DPS group. It was concluded that displacement of
the heart using moist laparotomy pads caused significant haemodynamic
derangement compared with that caused by deep pericardial traction
sutures. &#xa9; 2011 Field House Publishing LLP.

<5>
[Use Link to view the full text]
Accession Number
635379746
Title
Clinical investigation of nosocomial infections in adult patients after
cardiac surgery.
Source
Medicine (United States). 100 (4) (no pagination), 2021. Article Number:
e24162. Date of Publication: 29 Jan 2021.
Author
Liu Z.; Zhang X.; Zhai Q.
Institution
(Liu, Zhang, Zhai) Qilu Hospital Affiliated to Shandong University,
Shandong, Jinan, China
Publisher
Lippincott Williams and Wilkins
Abstract
Nosocomial infections (NI) are common complications after cardiac surgery.
To date, there have been few manuscripts investigating NI in the intensive
care unit after cardiac surgery. Our study was designed to investigate the
characteristics of the distribution of pathogenic bacteria, antibiotic
resistance and risk factors for NI. A total of 1360 patients received
standard postoperative care, including antibiotic prophylaxis.
Microbiological examinations of sputum, blood, catheter tips and excrement
were performed as clinically indicated to isolate pathogens. Thirty
potential associated variables were collected and compared between the 2
different groups according to the development of NI using univariate and
multivariate analyses. Eighty-nine patients (6.54%) acquired a
microbiologically documented NI. There was a significant difference in
mortality between the 2 groups with or without postoperative NI (23.60% vs
2.28%, P < .00). A total of 98 pathogens (73.13%) were isolated from
sputum, 32 pathogens (23.88%) from blood and only 1 (0.75%) from urine.
Three (2.24%) surgical site infections were detected, including 2
superficial surgical site infections and 1 mediastinitis. The most common
pathogens were Gram-negative bacteria (78.36%), followed by Gram-positive
bacteria (14.93%) and fungi (6.71%). The major pathogenic species had
different levels of drug resistance, and most of them exhibited multidrug
resistance. Six out of thirty variables were identified as independent
risk factors for the development of NI, namely, duration of surgery, low
cardiac output syndrome, continuous veno-venous hemofiltration, mechanical
ventilation time, reintubation and tracheostomy. We analyzed the
characteristics of the distribution of pathogens, antibiotic resistance
and risk factors for NI in our center and provided some suggestions for
clinical practice. In addition to antibiotic treatment, avoidance of risk
factors and aggressive infection control measures may be crucial to stop
or prevent outbreaks.<br/>Copyright &#xa9; 2021 the Author(s).

<6>
[Use Link to view the full text]
Accession Number
635379706
Title
Simultaneous cardio-cerebral infarction in the coronavirus disease
pandemic era A case series.
Source
Medicine (United States). 100 (4) (no pagination), 2021. Article Number:
e24496. Date of Publication: 29 Jan 2021.
Author
Eskandarani R.; Sahli S.; Sawan S.; Alsaeed A.
Institution
(Eskandarani, Sahli, Sawan, Alsaeed) Emergency Medicine Administration,
King Fahad Medical City, Riyadh, Saudi Arabia
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Simultaneous occurrence of acute ischemic stroke and
myocardial infarction is reported to have variable precipitating causes.
This occurrence has been rarely reported in the literature and described
only in very few case reports. During the surge of coronavirus disease
(COVID-19) in our region, we noted an increase in the simultaneous
occurrence of cardio-cerebral infarction. This led us to explore the
possible mechanisms and pathophysiology that could contribute to this
increase. The retrospective nature of the study limited us from drawing
any conclusion about causation. Rather, we aimed to formulate a hypothesis
for future, more rigorous studies. Patient concerns: We present an
overview of 5 cases of simultaneous cardio-cerebral infarction that we
encountered in our emergency department within 1 month. Diagnosis: In all
cases, diagnosis was confirmed using an electrocardiogram, assessment of
laboratory cardiac markers, and imaging. <br/>Intervention(s): In all
cases, dual antiplatelet therapy was started and thrombolysis was held, as
the condition was considered high risk in most of the patients. Cardiac
catheterization lab was not activated either because the patient was
unstable or the risk of COVID-19 in staff outweighed the benefit added in
patient treatment. <br/>Outcome(s): Two out of 5 patients died because of
early complications that lasted for few days. The remaining 3 were
discharged from the hospital in moderate functionality for extensive
therapy and rehabilitation. <br/>Conclusion(s): Early recognition and
immediate treatment is important in different scenarios leading to
thrombosis as the outcome. Additionally, addressing the unknown risks that
could contribute to our traditional understanding of these causative
mechanisms is important. The hypothesis of exacerbated damage caused by
inflammatory and immunological endothelial systemic damage should further
be explored to be able to delineate new possibilities in managing these
conditions.<br/>Copyright &#xa9; 2021 the Author(s).

<7>
[Use Link to view the full text]
Accession Number
635379675
Title
Bispectral index monitoring of the clinical effects of propofol
closed-loop target-controlled infusion systematic review and meta-analysis
of randomized controlled trials.
Source
Medicine (United States). 100 (4) (no pagination), 2021. Article Number:
e23930. Date of Publication: 29 Jan 2021.
Author
Wang D.; Song Z.; Zhang C.; Chen P.
Institution
(Wang, Song, Zhang, Chen) Department of Anesthesiology, China-Japan Union
Hospital of Jilin University, Changchun, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: To investigate whether closed-loop systems under bispectral
index anesthesia depth monitoring can reduce the intraoperative propofol
dosage. <br/>Method(s): All randomized controlled trials (RCTs) on
reducing propofol dosage under closed-loop systems were collected, and the
literature was screened out, the abstracts and full texts were carefully
read, and the references were tracked, data extraction and quality
evaluation were conducted on the included research, and the RevMan5.3
software was used for meta-analysis. The main results were propofol and
the incidence of adverse reactions such as hypertensive hypotension and
postoperative cognitive dysfunction. A total of 879 cases were included in
8 articles, including 450 occurrences in the closed-loop system group and
429 cases in the open-loop system group. <br/>Result(s): Compared with
manual control, closed-loop systems under bispectral index anesthesia
depth monitoring reduced the dose of propofol (MD: -0.62, 95% CI:
-1.08--0.16, P = .008), with heterogeneity(I² = 80%).
Closed-loop systems significantly reduced the incidence of abnormal blood
pressure(MD: -0.02, 95%CI: -0.05-0.01, P = .15, I² = 74%) and
postoperative cognitive dysfunction (MD: -0.08, 95% CI: -0.14 -0.01, P =
.02, I² = 94%). <br/>Conclusion(s): Bispectral index monitoring
of propofol closed-loop target-controlled infusion system can reduce the
amount of propofol, reduce the incidence of adverse reactions such as
hypertensive or hypotension and postoperative cognitive
dysfunction.<br/>Copyright &#xa9; 2021 the Author(s).

<8>
Accession Number
2011670422
Title
Transfusion Strategies for Pediatric Cardiac Surgery: A Meta-Analysis and
Trial Sequential Analysis.
Source
Pediatric Cardiology. 42 (6) (pp 1241-1251), 2021. Date of Publication:
August 2021.
Author
Duan Z.X.; Chen D.X.; Yang B.Z.; Zhang X.Q.
Institution
(Duan, Zhang) Department of Anesthesiology, Yuncheng Central Hospital,
Yuncheng, Shanxi 044000, China
(Chen) Department of Anesthesiology, West China Hospital, Sichuan
University, No. 37 Wainan Guoxue Rd, Chengdu, Sichuan 610041, China
(Yang) Department of Anesthesiology, First Hospital of Shanxi Medical
University, Taiyuan, Shanxi 030001, China
Publisher
Springer
Abstract
This study aimed to compare the effects of restrictive and liberal red
blood cell (RBC) transfusion strategies on pediatric patients undergoing
cardiac surgery, including cyanotic and non-cyanotic children. A
literature search of the MEDLINE, EMBASE, PubMed, and the Cochrane Library
database was conducted. Meta-analyses were carried out comparing
restrictive and liberal transfusion strategies. Subgroup analyses were
performed based on the basis of cyanotic status. Five randomized
controlled trials with a total of 497 children were included. There was no
significant difference in the risk of in-hospital mortality between the
two transfusion strategies (risk ratio 1.21; 95% confidence interval 0.49
to 2.99; P = 0.68). The trial sequential analysis suggested that the
current meta-analysis had an absence of evidence for in-hospital
mortality, and the data were insufficient. Moreover, no significant
differences existed between groups in terms of risk of infection, blood
loss, duration of mechanical ventilation, pediatric intensive care unit
(PICU) stay duration, or hospital stay duration. Cyanotic children treated
with a liberal transfusion strategy had a shorter ventilator duration, but
the transfusion strategy did not affect in-hospital mortality, infection,
hospital stay, or PICU stay duration. On the basis of the available data,
our analysis indicates that a liberal transfusion strategy did not lead to
a better outcomes, but the data are extremely sparse, which highlights the
need for clearer transfusion guidelines specific to this specific
population. Trial registration number CRD42018102283.<br/>Copyright &#xa9;
2021, The Author(s), under exclusive licence to Springer Science+Business
Media, LLC, part of Springer Nature.

<9>
Accession Number
2011048373
Title
Is surgical resection of primary tumour superior to exploratory
thoracotomy without resection in treating lung cancer patients with
unexpected pleural metastasis detected during operation?.
Source
Interactive Cardiovascular and Thoracic Surgery. 30 (4) (pp 582-587),
2021. Date of Publication: 2021.
Author
Deng H.-Y.; Zheng X.; Zhu D.-X.; Zhou Q.
Institution
(Deng, Zheng, Zhu) Lung Cancer Center, West China Hospital, Sichuan
University, Chengdu, China
Publisher
Oxford University Press
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was 'In lung cancer patients
with unexpected pleural metastasis detected during operation, is surgical
resection of primary tumour superior to exploratory thoracotomy without
resection in improving long-term survival?'. Altogether, 1443 papers were
found using the reported search, of which 1 meta-analysis and 10
retrospective observational cohort studies represented the best evidence
to answer the clinical question. The authors, journal, date and country of
publication, patient group studied, study type, relevant outcomes and
results of these papers were tabulated. One meta-analysis and 9 cohort
studies found that surgical resection of the primary tumour, on the
discovery of pleural metastases, yielded a better overall survival than
exploratory thoracotomy alone, while 1 cohort study showed no difference.
Six studies found that main tumour resection was an independent favourable
prognostic factor for overall survival in lung cancer patients with
unexpected pleural metastasis detected during operation, while 3 cohort
studies also showed improved progression-free survival over exploratory
thoracotomy. Therefore, we conclude that surgical resection of the primary
tumour is superior to exploratory thoracotomy in treating lung cancer
patients with unexpected pleural metastasis detected during
operation.<br/>Copyright &#xa9; The Author(s) 2020. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<10>
Accession Number
2010832436
Title
Is vacuum-assisted closure therapy feasible for children with deep sternal
wound infection after cardiac surgery? The pooling results from current
literature.
Source
Artificial Organs. 45 (8) (pp 827-837), 2021. Date of Publication: August
2021.
Author
Wu Y.; Wang J.; Dai J.; Wang G.; Li H.; Li Y.; Wu C.; Wei G.
Institution
(Wu, Dai, Wang, Li, Li, Wu) Department of Cardiothoracic Surgery,
Children's Hospital of Chongqing Medical University, Chongqing, China
(Wu, Wang, Dai, Wang, Li, Li, Wu, Wei) Ministry of Education Key
Laboratory of Child Development and Disorders, China International Science
and Technology Cooperation Base of Child Development and Critical
Disorders, National Clinical Research Center for Child Health and
Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
Publisher
John Wiley and Sons Inc
Abstract
Vacuum-assisted closure (VAC) has been used for children with deep sternal
wound infections (DSWI); however, the safety and efficiency have not been
determined. A meta-analysis was performed for outcomes of VAC therapy in
children with DSWI after cardiac surgery. Electronic databases, including
PubMed, Scopus, and Cochrane Library CENTRAL were searched systematically
from January 1990 to October 2020 for the literature which reported the
outcomes of VAC therapy for children with DSWI after cardiac surgery.
Meta-regression and subgroup analyses were performed to find risk factors
for prolonged length of VAC therapy and hospital stay. Eleven studies were
included in this study, involving 217 subjects. VAC therapy was performed
due to mediastinitis after congenital heart diseases (CHD) repair. In
children with DSWI after cardiac surgery, length of VAC therapy, and
hospital stay were 11.1 days (95% CI, 9.6-12.5 days) and 29.8 days (95%
CI, 22.8-36.9 days), respectively. Incidence of infectious and
wound-related complications was 8.5% (95% CI, 4.1%-13.0%). Overall
mortality in this setting was 5.8% (95% CI, 2.5%-9.1%). In conclusion, in
children with DSWI after cardiac surgery, length of VAC therapy and
hospital stay were 11.1 and 29.8 days, respectively. Overall mortality was
5.8%. Although not significant, delayed chest closure, complex CHD, and
Gram-negative bacilli/fungal infections may potentially contribute to
prolonged duration of VAC treatment.<br/>Copyright &#xa9; 2021
International Center for Artificial Organs and Transplantation and Wiley
Periodicals, Inc.

<11>
Accession Number
2010573233
Title
Outpatient Versus Inpatient Percutaneous Coronary Intervention in Patients
With Left Main Disease (from the EXCEL Trial).
Source
American Journal of Cardiology. 143 (pp 21-28), 2021. Date of Publication:
15 Mar 2021.
Author
Gaba P.; Serruys P.W.; Karmpaliotis D.; Lembo N.J.; Banning A.P.; Zhang
Z.; Morice M.-C.; Kandzari D.E.; Gershlick A.H.; Ben-Yehuda O.; Sabik
J.F.; Kappetein A.P.; Stone G.W.
Institution
(Gaba, Karmpaliotis, Lembo, Ben-Yehuda) NewYork-Presbyterian
Hospital/Columbia University Irving Medical Center, New York, NY, United
States
(Serruys) Department of Cardiology, National University of Ireland Galway
(NUIG), Galway, Ireland
(Serruys) Department of Cardiology, Imperial College of London, London,
United Kingdom
(Karmpaliotis, Lembo, Zhang, Ben-Yehuda, Stone) Clinical Trials Center,
Cardiovascular Research Foundation, New York, NY, United States
(Banning) John Radcliffe Hospital, Oxford, United Kingdom
(Morice) Hopital Prive Jacques Cartier, Ramsay Generale de Sante, Massy,
France
(Kandzari) Piedmont Heart Institute, Atlanta, Georgia, Georgia
(Gershlick) University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
(Kappetein) Thoraxcenter, Erasmus MC, Rotterdam, Netherlands
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, New York
Publisher
Elsevier Inc.
Abstract
Prior studies in patients with noncomplex coronary artery disease have
demonstrated the safety of percutaneous coronary intervention (PCI) in the
outpatient setting. We sought to examine the outcomes of outpatient PCI in
patients with unprotected left main coronary artery disease (LMCAD). In
the EXCEL trial, 1905 patients with LMCAD and site-assessed low or
intermediate SYNTAX scores were randomized to PCI with everolimus-eluting
stents versus coronary artery bypass grafting. The primary end point was
major adverse cardiovascular events (MACE; the composite of death, stroke,
or myocardial infarction). In this sub-analysis, outcomes at 30 days and 5
years were analyzed according to whether PCI was performed in the
outpatient versus inpatient setting. Among 948 patients with LMCAD
assigned to PCI, 935 patients underwent PCI as their first procedure,
including 100 (10.7%) performed in the outpatient setting. Patients who
underwent outpatient compared with inpatient PCI were less likely to have
experienced recent myocardial infarction. Distal left main bifurcation
disease involvement and SYNTAX scores were similar between the groups.
Comparing outpatient to inpatient PCI, there were no significant
differences in MACE at 30 days (4.0% vs 5.0% respectively, adjusted OR
0.52 95% CI 0.12 to 2.22; p = 0.38) or 5 years (20.6% vs 22.1%
respectively, adjusted OR 0.72, 95% CI 0.40 to 1.29; p = 0.27). Similar
results were observed in patients with distal left main bifurcation
lesions. In conclusion, in the EXCEL trial, outpatient PCI of patients
with LMCAD was not associated with an excess early or late hazard of MACE.
These data suggest that outpatient PCI may be safely performed in select
patients with LMCAD.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<12>
Accession Number
2010541373
Title
Driveline damage and repair in continuous-flow left ventricular assist
devices: A systematic review.
Source
Artificial Organs. 45 (8) (pp 819-826), 2021. Date of Publication: August
2021.
Author
D'Antonio N.D.; Maynes E.J.; Tatum R.T.; Prochno K.W.; Saxena A.; Maltais
S.; Samuels L.E.; Morris R.J.; Massey H.T.; Tchantchaleishvili V.
Institution
(D'Antonio, Maynes, Tatum, Prochno, Saxena, Samuels, Morris, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Maltais) Division of Cardiac Surgery, Centre Hospitalie de l'Universite
de Montreal, Montreal, QC, Canada
Publisher
John Wiley and Sons Inc
Abstract
With mounting time on continuous-flow left ventricular assist device
(CF-LVAD) support, patients occasionally sustain damage to the device
driveline. Outcomes associated with external and internal driveline damage
and repair are currently not well documented. We sought to evaluate the
outcomes of driveline damage and its repair. Electronic search was
performed to identify all relevant studies published over the past 20
years. Fifteen studies were selected for analysis comprising of 55
patients with CF-LVAD dysfunction due to driveline damage. Demographic and
perioperative variables along with outcomes including survival rates were
extracted and pooled for the systematic review. Most patients (53/55) were
supported on HeartMate II LVAD (Abbott Laboratories, Abbott Park, IL).
Internal damage was more commonly reported than external damage [69.1%
(38/55) vs. 30.9% (17/55), P =.01]. Median time to driveline damage was
1.9 years [IQR 1.0, 2.5]. Most patients presented with a CF-LVAD alarm
[94.5% (52/55)] and patients with internal driveline damage had a
significantly higher rate of alarm activation compared to that observed
for those with external damage [38/38 (100%) vs. 14/17 (82.4%), P =.04].
Patients with internal driveline dysfunction were more likely to
experience component wear compared to those with external driveline
dysfunction [10/38 (26.3%) vs. 0/17 (0%), P =.05]; 14.5% of patients
(8/55) underwent external repair of the driveline, 5.5% (3/55) were
treated with rescue tape, and 5.5% (3/55) were placed on an ungrounded
cable, indicating a short-to-shield event had occurred. A total of 49.1%
of patients (27/55) underwent CF-LVAD exchange, 5.5% (3/55) were weaned
off the CF-LVAD to explant, and 5.5% (3/55) underwent emergent heart
transplantation. The median length of hospital stay was 12 days [IQR 7,
12] and 30-day mortality rate was 14.5% (8/55). Driveline damage was more
commonly reported at an internal location and despite being a
well-recognized complication, mortality still appears high.<br/>Copyright
&#xa9; 2021 International Center for Artificial Organs and Transplantation
and Wiley Periodicals LLC.

<13>
Accession Number
2007462424
Title
Aortic valve stenosis: A review of the literature.
Source
Medico-Legal Update. 21 (3) (pp 144-146), 2021. Date of Publication: 05
Jun 2021.
Author
Al-Kazaleh A.; Albashtawy M.; Albashtawy S.; Albashtawy B.; Suliman M.;
Abdalrahim A.; Alkhawaldeh A.
Institution
(Al-Kazaleh, Albashtawy) Princess Salma Faculty of Nursing, AL al-Bayt
University, Mafraq, Jordan
(Albashtawy) Faculty of Medicine, Hashemite University, Zarqa, Jordan
(Albashtawy) Medical Intern, King Abdullah University Hospital, Jordan
(Suliman, Abdalrahim, Alkhawaldeh) Princess Salma Faculty of Nursing, AL
al-Bayt University, Mafraq, Jordan
Publisher
World Informations Syndicate
Abstract
Aortic valve stenosis is considered one of the common and serious valve
disease. This short review intends to explore the Aortic Stenosis (AS)
regarding chief symptoms, diagnostic tests, current treatment, and
patient's education. The searching was carried out in electronic data
bases: Google scholar and PubMed. The chief symptoms of AS may consist of
dyspnea and further symptoms of, angina, heart failure and syncope. The
past studies have revealed that medical treatment does not considerably
influence disease development in AS. Aortic valve replacement (AVR) is the
first current treatment for symptomatic, hemodynamically severe AS. Nurses
and physicians have a vital function in educating patients.<br/>Copyright
&#xa9; 2021, World Informations Syndicate. All rights reserved.

<14>
[Use Link to view the full text]
Accession Number
635379763
Title
Long-term outcomes of single stenting compared with double stenting
strategy for unprotected left main coronary artery disease: A protocol for
systematic review and meta-analysis.
Source
Medicine (United States). 99 (52) (no pagination), 2020. Article Number:
e23639. Date of Publication: 24 Dec 2020.
Author
Wang J.-J.; Li X.; Yan D.-D.; Zhang Z.
Institution
(Wang, Li, Yan, Zhang) The First Clinical Medical College, Lanzhou
University, Lanzhou, China
(Wang, Zhang) Department of Cardiology, The First Hospital of Lanzhou
University, Lanzhou, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The optimal interventions for unprotected left main coronary
artery (ULMCA) disease have long been debated, and long-term clinical
studies comparing single stenting to double stenting strategies for ULMCA
are currently lacking. <br/>Method(s): We plan to perform a systematic
review and meta-analysis of clinical trials comparing single stenting with
double stents strategy for ULMCA disease. We will search PubMed, EMBASE,
Web of science and Cochrane Library using a comprehensive strategy. The
related conference proceedings and reference lists of the included studies
will also be checked to identify additional studies. Two reviewers will
screen retrieved records, extract information and assess the risk of bias
independently. STATA software will be used to conduct data synthesis.
There is no requirement of ethical approval and informed consent.
<br/>Result(s): This study will be submitted to a peer-reviewed journal
for publication. <br/>Conclusion(s): We hope it will provide a relatively
comprehensive reference for clinical practice and future relevant clinical
trials. Ethics and dissemination: Ethics approval and patient consent are
not required, as this study is a systematic review and metaanalysis.
INPLASY registration number: INPLASY2020110030 Abbreviations: DES =
drug-eluting stents, DS = double stents, ST = stent thrombosis, SS =
single stent, ULMCA = unprotected left main coronary artery.<br/>Copyright
&#xa9; 2020 Lippincott Williams and Wilkins. All rights reserved.

<15>
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.

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

<17>
[Use Link to view the full text]
Accession Number
635232751
Title
The Effect of the Neuman Systems Model on Anxiety in Patients Undergoing
Coronary Artery Bypass Graft: A Randomized Controlled Trial.
Source
The journal of nursing research : JNR. 29 (4) (pp e162), 2021. Date of
Publication: 02 Jun 2021.
Author
Akhlaghi E.; Babaei S.; Mardani A.; Eskandari F.
Institution
(Akhlaghi) Doctoral Candidate, School of Nursing and Midwifery, Iran
University of Medical Sciences, RN, Tehran, Iran, Islamic Republic of
(Babaei) Nursing and Midwifery Care Research Center, Faculty of Nursing
and Midwifery, Isfahan University of Medical Science, RN, Isfahan, Iran,
Islamic Republic of
(Mardani) Doctoral Candidate, Nursing Care Research Center, School of
Nursing and Midwifery, Iran University of Medical Sciences, RN, Tehran,
Iran, Islamic Republic of
(Eskandari) PhD, RN, Support Worker, Psychiatric/Mental Health Nursing,
Mental Health Community Making Life Better, Sydney, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Coronary artery bypass graft (CABG) surgery is the most
commonly used surgical procedure for patients with coronary artery
disease. Anxiety is a significant psychological problem associated with
CABG surgery that may reduce related treatment outcomes. PURPOSE: This
study was designed to investigate the effect on anxiety of applying the
Neuman Systems Model in patients awaiting and undergoing CABG surgery.
<br/>METHOD(S): A single-blind, parallel-group randomized controlled trial
was conducted on patients scheduled to receive coronary artery bypass
surgery in an urban area of Iran. Seventy participants were enrolled using
a convenience sampling method and randomly assigned to either the
intervention group (n = 35) or the control group (n = 35). Participants in
the intervention group received intervention in accordance with the Neuman
Systems Model format, including meetings held at three levels of
prevention. Patients' anxiety was measured using the State Anxiety
Inventory before the intervention, immediately after the intervention, and
at discharge time. The chi-square test, Fisher's exact test, independent
sample t test, one-way repeated measures analysis of variance test, and
Fisher's least significant difference were used to analyze the data.
<br/>RESULT(S): No significant difference was found between the mean
anxiety scores of the two groups before the intervention (p = .48, t =
0.71). However, the mean anxiety score of the intervention group was
significantly lower than that of the control group immediately after the
intervention (p = .008, t = 2.73) and at discharge time (p = .007, t =
2.77). <br/>CONCLUSION(S): The Neuman-based program is an effective and
low-cost intervention that may be applied to reduce anxiety in patients
awaiting and undergoing CABG surgery. This program may be a good guide in
providing healthcare services.<br/>Copyright &#xa9; 2021 The Authors.
Published by Wolters Kluwer Health, Inc.

<18>
Accession Number
635086361
Title
Efficacy of parasternal block to decrease intraoperative opioid use in
coronary artery bypass surgery via sternotomy: A randomized controlled
trial.
Source
Regional Anesthesia and Pain Medicine. 46 (8) (pp 671-678), 2021. Date of
Publication: 01 Aug 2021.
Author
Bloc S.; Perot B.P.; Gibert H.; Law Koune J.-D.; Burg Y.; Leclerc D.;
Vuitton A.-S.; De La Jonquiere C.; Luka M.; Waldmann T.; Vistarini N.;
Aubert S.; Menager M.M.; Merzoug M.; Naudin C.; Squara P.
Institution
(Bloc, Gibert, Law Koune, Burg, Leclerc, Vuitton, De La Jonquiere)
Anesthesiology Department, Cmc Ambroise Pare, Neuilly-sur-Seine, France
(Bloc, Merzoug, Naudin, Squara) Clinical Research Department, Cmc Ambroise
Pare, Neuilly-sur-Seine, France
(Perot, Luka, Menager) Laboratory of Inflammatory Responses and
Transcriptomic Networks in Diseases, Imagine Institute Inserm Umr 1163,
ATIP-Avenir Team, Universite de Paris, Paris, France
(Waldmann, Vistarini, Aubert) Cardiac Surgery Department, Cmc Ambroise
Pare, Neuilly-sur-Seine, France
(Squara) Critical Care Medicine Department, Cmc Ambroise Pare,
Neuilly-sur-Seine, France
Publisher
BMJ Publishing Group
Abstract
Objective This study aims to assess the effect of a preoperative
parasternal plane block (PSB) on opioid consumption required to maintain
hemodynamic stability during sternotomy for coronary artery bypass graft
surgery. Methods This double-blind, randomized, placebo-controlled trial
prospectively enrolled 35 patients scheduled for coronary artery bypass
graft surgery under general anesthesia with propofol and remifentanil.
Patients were randomized to receive preoperative PSB using either
ropivacaine (PSB group) or saline solution (placebo group) (1:1 ratio).
The primary endpoint was the maximal effect-site concentration of
remifentanil required to maintain heart rate and blood pressure within the
recommended ranges during sternotomy. Results Median maximum concentration
of remifentanil necessary to maintain adequate hemodynamic status during
sternotomy was significantly reduced in PSB group (4.2 (2.5-6.0) ng/mL)
compared with placebo group (7.0 (5.2-8.0) ng/mL) (p=0.02). Mean maximum
concentration of propofol used to control depth of anesthesia was also
reduced (3.9+/-1.1 mug/mL vs 5.0+/-1.5 mug/mL, PSB vs placebo,
respectively; p=0.02). This reduction in propofol consumption during
sternotomy enabled a more adequate level of sedation to be maintained in
patients (minimum patient state index was 11.7+/-8.7 in placebo group and
18.3+/-6.8 in PSB group; p=0.02). PSB reduced postoperative inflammatory
response by limiting concentrations of proinflammatory cytokines IL-8,
IL-18, IL-23, IL-33 and MCP-1 measured in the first 7-day after surgery
(p<0.05). Conclusions Preoperative PSB reduced the maximum concentrations
of remifentanil and propofol required to maintain hemodynamic stability
and depth of anesthesia during sternotomy. Trial registration number
NCT03734159. Sebastien Bloc, M.D. 1,2; Brieuc P. Perot, Ph.D. 3; Hadrien
Gibert, M.D. 1; Jean-Dominique Law Koune, M.D. 1; Yannick Burg, M.D. 1;
Didier Leclerc, M.D. 1; Anne-Sophie Vuitton, M.D. 1; Christophe De La
Jonquiere, M.D. 1; Marine Luka, L.S. 3; Thierry Waldmann, M.D. 4; Nicolas
Vistarini, M.D. 4; Stephane Aubert, M.D. 4; Mickael M. Menager, Ph.D. 3;
Messaouda Merzoug, Ph.D. 2; Cecile Naudin, Ph.D. 2; Pierre Squara, M.D.
2,5<br/>Copyright &#xa9;

<19>
Accession Number
2007879955
Title
Admission hyperglycemia is associated with reperfusion failure in patients
with st-elevation myocardial infarction undergoing primary percutaneous
coronary intervention: A systematic review and meta-analysis.
Source
American Journal of Cardiovascular Disease. 11 (3) (pp 348-359), 2021.
Date of Publication: 2021.
Author
Kewcharoen J.; Ali M.; Trongtorsak A.; Mekraksakit P.; Vutthikraivit W.;
Kanjanauthai S.
Institution
(Kewcharoen, Ali) University of Hawaii Internal Medicine Residency
Program, Honolulu, HI, United States
(Trongtorsak) Department of Internal Medicine, King Chulalongkorn Memorial
Hospital, Chulalongkorn University, Bangkok, Thailand
(Mekraksakit, Vutthikraivit) Department of Internal Medicine, Texas Tech
University Health Sciences Center, Lubbock, TX, United States
(Kanjanauthai) Division of Cardiovascular Medicine, Keck School of
Medicine of University of Southern California, Los Angeles, CA, United
States
Publisher
E-Century Publishing Corporation
Abstract
Background: Admission hyperglycemia (AH) is a common finding in patients
with acute coronary syndrome and has been reported to be associated with
increased morbidity and mortality. Prior studies suggest that AH could be
associated with reperfusion failure. We conducted a systematic review and
meta-analysis to explore an association between AH and risk of reperfusion
failure in patients with ST-elevation myocardial infarction (STEMI)
undergoing primary percutaneous coronary intervention (pPCI).
<br/>Method(s): Two investigators searched the databases of MEDLINE and
EMBASE from inception to February 2021. Study eligibility was
independently determined by two investigators and needed to demonstrate
association of AH and rate of reperfusion failure, or sufficient raw data
to calculate the effect size. Participants were classified into two groups
corresponding to their level of admission hyper-glycemia. Group 1 was
defined as an AH of >=120-150 mg/dl, and group 2 as >=150-200 mg/dl. Data
from each study were combined using the random-effects model, the generic
inverse-variance method of Der Simonian and Laird. The heterogeneity of
effect size was quantified using the I² statistic. A
sensitivity analysis was performed by omitting one study at a time.
Publication bias was assessed using a funnel plot and the Egger's test.
All data analyses were performed using STATA SE version 14.2.
<br/>Result(s): A total of ten studies from 2008 to 2019 met eligibility
criteria and were included in the final analysis. We found that AH is
associated with increased risk of reperfusion failure in both group 1
(pooled OR=1.78, 95% CI: 1.35-2.33, I²=63.2%, P<0.001) and
group 2 (pooled OR=1.44, 95% CI: 1.14-1.82, I²=57.1%, P<0.001).
Sensitivity analysis showed that none of the results were significantly
altered after removing one study at a time. In subgroup analysis of
non-diabetic patients, we found that AH is also associated with increased
risk of reperfusion failure in both group 1 (pooled OR=1.81, 95% CI:
1.29-2.54, P<0.001) and group 2 (pooled OR=1.61, 95% CI: 1.17-2.21,
P<0.001). We did not perform a funnel plot or Egger's test as the number
of available outcomes was insufficient to reject the assumption of funnel
plot asymmetry. <br/>Conclusion(s): Our systematic review and
meta-analysis demonstrated that AH is associated with increased risk of
reperfusion failure in STEMI patients undergoing pPCI, in the non-diabetic
population.<br/>Copyright &#xa9; 2021, E-Century Publishing Corporation.
All rights reserved.

<20>
Accession Number
2012931076
Title
Coronary revascularisation in patients with chronic kidney disease and
end-stage renal disease: A meta-analysis.
Source
International Journal of Clinical Practice. (no pagination), 2021. Date of
Publication: 2021.
Author
Li X.; Xiao F.; Zhang S.
Institution
(Li, Xiao, Zhang) Department of Cardiac Surgery, Peking University First
Hospital, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To compare coronary artery bypass grafting (CABG) and
percutaneous coronary intervention (PCI) for revascularising 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. <br/>Method(s): PubMed, Cochrane Library and Embase databases
were searched for studies on the revascularisation of coronary arteries in
patients with CKD and ESRD. <br/>Result(s): Since no randomised 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 have 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 have
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 revascularisation (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 =.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. <br/>Conclusion(s): 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 revascularisation
strategy for patients with CKD and ESRD.<br/>Copyright &#xa9; 2021 The
Authors. International Journal of Clinical Practice published by John
Wiley & Sons Ltd.

<21>
Accession Number
635568786
Title
Predictive Factors of Prolonged Ventilation Following Cardiac Surgery with
Cardiopulmonary Bypass.
Source
Brazilian journal of cardiovascular surgery. (no pagination), 2021. Date
of Publication: 07 Jul 2021.
Author
Aksoy R.; Karakoc A.Z.; Cevirme D.; Elibol A.; Yigit F.; Yilmaz U.; Rabus
M.B.
Institution
(Aksoy, Karakoc, Cevirme, Elibol, Yigit, Yilmaz, Rabus) Department of
Cardiovascular Surgery, University of Health Sciences, Kosuyolu Heart
Education and Research Hospital, Istanbul, Turkey
Publisher
NLM (Medline)
Abstract
INTRODUCTION: In this trial, we initially aimed to investigate the major
predictive factors for prolonged mechanical ventilation (PMV) following
cardiac surgery with cardiopulmonary bypass (CPB) in our center and,
secondarily, we tried to find out the effects of the independent factors
on mortality. <br/>METHOD(S): Between July 2017 and August 2018, 207
patients who underwent cardiac surgery with CPB were retrospectively
investigated. The patients were randomly divided into two subgroups
according to the duration of ventilator dependence (group 1 <24 hours,
n=164, 79%; group 2 >24 hours, n=43, 21%). <br/>RESULT(S): 207 patients
(mean age 59.47+/-10.56) who underwent cardiac surgery with CPB were
enrolled in this study (n=145, 70% of male patients; n=62, 30% of female
patients). Amid these patients, 43 (n=43, 20.77%) had prolonged intubation
time. After multivariate logistic regression analysis among preoperative
factors, female gender (OR=2.321, P=0.028), leukocytosis (OR=1.233,
P=0.006), perioperative lactate level (OR=1.224, P=0.027), CPB time
(OR=1.012, P=0.012) and postoperative revision for bleeding (OR=23.125,
P=0.040) were significantly detected. The effect of predictive factors on
mortality after cardiac surgery was determined and found that PMV did not
affect hospital mortality (OR=1.979, P=0.420). <br/>CONCLUSION(S): In our
report, we revealed, differently from previous studies, that
intraoperative lactate levels which manifest organ perfusion and
oxygenation were included and were significantly different in the early
extubation group compared to the PMV group. Female gender, preoperative
leukocytosis, intraoperative CPB time, lactate levels and postoperative
revision for bleeding were the independent predictive factors for PMV.
Moreover, PMV did not affect the early-term mortality during hospital
stay.

<22>
Accession Number
635563754
Title
Multiple versus single arterial grafting in the elderly: a meta-analysis
of randomized controlled trials and propensity score studies.
Source
The Journal of cardiovascular surgery. (no pagination), 2021. Date of
Publication: 08 Jul 2021.
Author
Saraiva F.A.; Moreira R.; Cerqueira R.J.; Mancio J.; Barros A.S.; Lourenco
A.P.; Leite-Moreira A.F.
Institution
(Saraiva, Moreira, Cerqueira, Mancio, Barros, Lourenco) Cardiovascular
Research and Development Center, Department of Surgery and Physiology,
Faculty of Medicine of the University of Porto, Porto, Portugal
(Cerqueira, Leite-Moreira) Department of Cardiothoracic Surgery, Centro
Hospitalar Universitario Sao Joao, Porto, Portugal
(Mancio) Bart's Health NHS Trust, St. Bartholomew's Hospital, London,
United Kingdom
(Lourenco) Department of Anesthesiology, Centro Hospitalar Universitario
Sao Joao, Porto, Portugal
(Leite-Moreira) Cardiovascular Research and Development Center, Department
of Surgery and Physiology, Faculty of Medicine of the University of Porto,
Porto, Portugal
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The benefit of adding a second arterial conduit is still
controversial, mainly in specific subgroups. We conducted a meta-analysis
of randomized controlled trials (RCTs) and propensity score (PS) studies
comparing survival and early results in elderly patients who underwent
coronary artery bypass grafting (CABG) with multiple (MAG) versus single
arterial grafting (SAG). EVIDENCE ACQUISITION: MEDLINE, Web of Science and
Cochrane Library were used to find relevant literature (1960-April 2020).
Survival at a >= 1-year follow-up and early outcomes were evaluated.
Outcomes were collected from matched samples or PS adjusted analysis:
hazard ratio (HR) along with their variance, frequencies or odds ratios.
Random effect models were used to compute combined statistical measures
and 95% confidence intervals (CI) through generic inverse variance method
(time-to-event) or Mantel-Haenszel method (binary events). EVIDENCE
SYNTHESIS: Eleven PS cohorts and 1 RCT comprising > 18,800 patients older
than 70 (>6200 MAG and >12,500 SAG) were included in this meta-analysis.
MAG was associated with lower long-term mortality (pooled HR: 0.81, 95%CI:
0.72-0.91, p<0.01, I2=64%) in the absence of higher risk of early
mortality (pooled OR: 0.74, 95%CI: 0.44 to 1.25, p=0.27, I2=0%). In a
meta-regression, MAG survival advantage was more pronounced in studies
with a higher MAG usage rate (beta = -0.0052, p=0.021).
<br/>CONCLUSION(S): Current evidence suggests that advanced age should not
limit MAG's use considering its benefits in long-term survival. Of note,
an individualized patient selection for this approach is warranted.

<23>
Accession Number
632731502
Title
Systematic review and meta-analysis of outcomes of anatomic repair in
congenitally corrected transposition of great arteries.
Source
World Journal of Cardiology. 12 (8) (pp 427-436), 2020. Date of
Publication: August 2020.
Author
Chatterjee A.; Miller N.J.; Cribbs M.G.; Mukherjee A.; Law M.A.
Institution
(Chatterjee, Miller, Cribbs) Division of Cardiovascular Diseases,
University of Alabama at Birmingham, Birmingham, AL 35294, United States
(Cribbs, Law) Department of Pediatric Cardiology, University of Alabama at
Birmingham, Birmingham, AL 35294, United States
(Mukherjee) Department of Epidemiology, University of Alabama at
Birmingham School of Public health, Birmingham, AL 35233, United States
(Chatterjee) Division of Cardiovascular Disease, University of Alabama at
Birmingham, 510 20th St S FOT 920, Birmingham, AL 35294, United States
Publisher
Baishideng Publishing Group Co
Abstract
BACKGROUND Treatment of congenitally corrected transposition of great
arteries (cc-TGA) with anatomic repair strategy has been considered
superior due to restoration of the morphologic left ventricle in the
systemic circulation. However, data on long term outcomes are limited to
single center reports and include small sample sizes. AIM To perform a
systematic review and meta-analysis for observational studies reporting
outcomes on anatomic repair for cc-TGA. METHODS MEDLINE and Scopus
databases were queried using predefined criteria for reports published
till December 31, 2017. Studies reporting anatomic repair of minimum 5
cc-TGA patients with at least a 2 year follow up were included.
Meta-analysis was performed using Comprehensive meta-analysis v3.0
software. RESULTS Eight hundred and ninety-five patients underwent
anatomic repair with a pooled follow-up of 5457.2 patient-years (PY).
Pooled estimate for operative mortality was 8.3% [95% confidence interval
(CI): 6.0%-11.4%]. 0.2% (CI: 0.1%-0.4%) patients required mechanical
circulatory support postoperatively and 1.7% (CI: 1.1%-2.4%) developed
post-operative atrioventricular block requiring a pacemaker. Patients
surviving initial surgery had a transplant free survival of 92.5% (CI:
89.5%-95.4%) per 100 PY and a low rate of need for pacemaker (0.3/100 PY;
CI: 0.1-0.4). 84.7% patients (CI: 79.6%-89.9%) were found to be in New
York Heart Association (NYHA) functional class I or II after 100 PY follow
up. Total re-intervention rate was 5.3 per 100 PY (CI: 3.8-6.8).
CONCLUSION Operative mortality with anatomic repair strategy for cc-TGA is
high. Despite that, transplant free survival after anatomic repair for
cc-TGA patients is highly favorable. Majority of patients maintain NYHA
I/II functional class. However, monitoring for burden of re-interventions
specific for operation type is very essential.<br/>Copyright &#xa9; 2020
Baishideng Publishing Group Co. All rights reserved.

<24>
Accession Number
632325727
Title
Intra-procedural arrhythmia during cardiac catheterization: A systematic
review of literature.
Source
World Journal of Cardiology. 12 (6) (pp 269-284), 2020. Date of
Publication: 26 Jun 2020.
Author
Shaik F.A.; Slotwiner D.J.; Gustafson G.M.; Dai X.
Institution
(Shaik, Slotwiner, Gustafson, Dai) Division of Cardiology, New York
Presbyterian Queens Hospital, Flushing, NY 11355, United States
Publisher
Baishideng Publishing Group Co
Abstract
BACKGROUND Cardiac catheterization is among the most performed medical
procedures in the modern era. There were sporadic reports indicating that
cardiac arrhythmias are common during cardiac catheterization, and there
are risks of developing serious and potentially life-threatening
arrhythmias, such as sustained ventricular tachycardia (VT), ventricular
fibrillation (VF) and high-grade conduction disturbances such as complete
heart block (CHB), requiring immediate interventions. However, there is
lack of systematic overview of these conditions. AIM To systematically
review existing literature and gain better understanding of the incidence
of cardiac arrhythmias during cardiac catheterization, and their impact on
outcomes, as well as potential approaches to minimize this risk. METHODS
We applied a combination of terms potentially used in reports describing
various cardiac arrhythmias during common cardiac catheterization
procedures to systematically search PubMed, EMBASE and Cochrane databases,
as well as references of full-length articles. RESULTS During right heart
catheterization (RHC), the incidence of atrial arrhythmias (premature
atrial complexes, atrial fibrillation and flutter) was low (< 1%); these
arrhythmias were usually transient and self-limited. RHC associated with
the development of a new RBBB at a rate of 0.1%-0.3% in individuals with
normal conduction system but up to 6.3% in individuals with pre-existing
left bundle branch block. These patients may require temporary pacing due
to transient CHB. Isolated premature ventricular complexes or
non-sustained VT are common during RHC (up to 20% of cases). Sustained
ventricular arrhythmias (VT and/or VF) requiring either withdrawal of
catheter or cardioversion occurred infrequently (1%-1.3%). During left
heart catheterizations (LHC), the incidence of ventricular arrhythmias has
declined significantly over the last few decades, from 1.1% historically
to 0.1% currently. The overall reported rate of VT/VF in diagnostic LHC
and coronary angiography is 0.8%. The risk of VT/VF was higher during
percutaneous coronary interventions for stable coronary artery disease
(1.1%) and even higher for patients with acute myocardial infarctions
(4.1%-4.3%). Intravenous adenosine and papaverine bolus for fractional
flow reserve measurement, as well as intracoronary imaging using optical
coherence tomography have been reported to induce VF. Although uncommon,
LHC and coronary angiography were also reported to induce conduction
disturbances including CHB. CONCLUSION Cardiac arrhythmias are common and
potentially serious complications of cardiac catheterization procedures,
and it demands constant vigilance and readiness to intervene during
procedures.<br/>Copyright &#xa9; The Author(s) 2020. Published by
Baishideng Publishing Group Inc. All rights reserved.

<25>
Accession Number
630834148
Title
Diagnosis and treatment of heart failure with preserved left ventricular
ejection fraction.
Source
World Journal of Cardiology. 12 (1) (pp 7-25), 2020. Date of Publication:
26 Jan 2020.
Author
Henning R.J.
Institution
(Henning) College of Public Health, University of South Florida, Tampa, FL
33612, United States
Publisher
Baishideng Publishing Group Co
Abstract
Nearly six million people in United States have heart failure. Fifty
percent of these people have normal left ventricular (LV) systolic heart
function but abnormal diastolic function due to increased LV myocardial
stiffness. Most commonly, these patients are elderly women with
hypertension, ischemic heart disease, atrial fibrillation, obesity,
diabetes mellitus, renal disease, or obstructive lung disease. The annual
mortality rate of these patients is 8%-12% per year. The diagnosis is
based on the history, physical examination, laboratory data,
echocardiography, and, when necessary, by cardiac catheterization.
Patients with obesity, hypertension, atrial fibrillation, and volume
overload require weight reduction, an exercise program, aggressive control
of blood pressure and heart rate, and diuretics. Miniature devices
inserted into patients for pulmonary artery pressure monitoring provide
early warning of increased pulmonary pressure and congestion. If
significant coronary heart disease is present, coronary revascularization
should be considered.<br/>Copyright &#xa9; The Author(s) 2020. Published
by Baishideng Publishing Group Inc. All rights reserved.

<26>
Accession Number
2010397828
Title
Transradial vs transfemoral secondary access outcomes in transcatheter
aortic valve implantation: A systematic review and meta-analysis.
Source
World Journal of Cardiology. 12 (11) (pp 571-583), 2020. Date of
Publication: 26 Nov 2020.
Author
Radhakrishnan S.L.; Ho K.K.L.
Institution
(Radhakrishnan) Division of General Medicine, Department of Medicine, Beth
Israel Deaconess Medical Center, Boston, MA 02215, United States
(Ho) Division of Cardiovascular Medicine, Department of Medicine, Beth
Israel Deaconess Medical Center, Boston, MA 02215, United States
Publisher
Baishideng Publishing Group Co
Abstract
BACKGROUND Complications of transcatheter aortic valve implantation (TAVI)
procedures include bleeding, vascular complications, and strokes. These
complications are often associated with the type of access used. The two
types of access in TAVI procedures are primary and secondary. The main use
of the primary access is for valve delivery, while secondary access is
used for angiography and hemodynamic monitoring. While there are many
options for primary access, those for secondary access are transfemoral
and transradial. AIM To compare outcomes between transradial vs
transfemoral secondary access (TFSA). METHODS A systematic search was
conducted using major databases (EMBASE, PubMed, Cochrane Central, Google
Scholar), which resulted in 5 studies that met the criteria for study
selection. Outcomes of interest were 30-d rates each of
major/life-threatening bleeding, vascular complications, strokes, and
mortality. All 5 studies were observational. Only adjusted or matched data
were used when available in this meta-analysis. RESULTS A total of 5065
patients underwent TAVI, with 1453 patients (28.7%) having undergone
transradial secondary access (TRSA) and 3612 patients (71.3%) TFSA.
Irrespective of the site of primary access, the odds of having major or
life-threatening bleeding were 60% lower in the TRSA group than the TFSA
group (P < 0.00001). The odds of having major vascular complications were
52% lower in the TRSA group (P < 0.0001) with no difference in minor
vascular complications between the 2 groups. Similarly, the odds of
mortality in 30-d after the procedure were 41% lower (P = 0.006) and the
odds of stroke were 54% lower (P = 0.001) in the TRSA group than the TFSA
group. CONCLUSION The transradial secondary approach appears to be a safer
alternative to the transfemoral secondary approach in TAVI
procedures.<br/>Copyright &#xa9; The Author(s) 2020. Published by
Baishideng Publishing Group Inc. All rights reserved.

<27>
Accession Number
2010397827
Title
Rapid right ventricular pacing for balloon valvuloplasty in congenital
aortic stenosis: A systematic review.
Source
World Journal of Cardiology. 12 (11) (pp 540-549), 2020. Date of
Publication: 26 Nov 2020.
Author
Mylonas K.S.; Ziogas I.A.; Mylona C.S.; Avgerinos D.V.; Bakoyiannis C.;
Mitropoulos F.; Tzifa A.
Institution
(Mylonas) Department of Cardiothoracic Surgery, Yale New Haven Hospital,
New Haven, CT 06510, United States
(Ziogas) Medical School, Aristotle University of Thessaloniki,
Thessaloniki 54124, Greece
(Mylona) Department of Pediatrics, Trikala General Hospital, Trikala
42100, Greece
(Avgerinos) Department of Cardiothoracic Surgery, New York Presbyterian
Hospital, New York, NY 10065, United States
(Bakoyiannis) Division of Vascular Surgery, First Department of Surgery,
Laiko General Hospital, National and Kapodistrian University of Athens,
Athens 11527, Greece
(Mitropoulos) Department of Pediatric Cardiac Surgery, Mitera Children's
Hospital, Athens 15123, Greece
(Tzifa) Department of Pediatric Cardiology and Adult Congenital Heart
Disease, Mitera Children's Hospital, Athens 15123, Greece
Publisher
Baishideng Publishing Group Co
Abstract
BACKGROUND Balloon aortic valvuloplasty (BAV) is a well-established
treatment modality for congenital aortic valve stenosis. AIM To evaluate
the role of rapid right ventricular pacing (RRVP) in balloon stabilization
during BAV on aortic regurgitation (AR) in pediatric patients. METHODS A
systematic review of the MEDLINE, Cochrane Library, and Scopus databases
was conducted according to the PRISMA guidelines (end-of-search date: July
8, 2020). The National Heart, Lung, and Blood Institute and
Newcastle-Ottawa scales was utilized for quality assessment. RESULTS Five
studies reporting on 72 patients were included. The studies investigated
the use of RRVP-assisted BAV in infants (> 1 mo) and older children, but
not in neonates. Ten (13.9%) patients had a history of some type of aortic
valve surgical or catheterization procedure. Before BAV, 58 (84.0%), 7
(10.1%), 4 (5.9%) patients had AR grade 0 (none), 1 (trivial), 2 (mild),
respectively. After BAV, 34 (49.3%), 6 (8.7%), 26 (37.7%), 3 (4.3%),
patients had AR grade 0, 1, 2, and 3 (moderate), respectively. No patient
developed severe AR after RRVP. One (1.4%) developed ventricular
fibrillation and was defibrillated successfully. No additional arrhythmias
or complications occurred during RRVP. CONCLUSION RRVP can be safely used
to achieve balloon stability during pediatric BAV, which could potentially
decrease AR rates.<br/>Copyright &#xa9; The Author(s) 2020. Published by
Baishideng Publishing Group Inc. All rights reserved.

<28>
Accession Number
627472223
Title
Who benefits from percutaneous closure of patent foramen ovale vs medical
therapy for stroke prevention? In-depth and updated meta-analysis of
randomized trials.
Source
World Journal of Cardiology. 11 (4) (pp 126-136), 2019. Date of
Publication: 26 Apr 2019.
Author
Dahal K.; Yousuf A.; Watti H.; Liang B.; Sharma S.; Rijal J.; Katikaneni
P.; Modi K.; Tandon N.; Azrin M.; Lee J.
Institution
(Dahal, Yousuf, Watti, Katikaneni, Modi) Division of Cardiology,
Department of Medicine, Louisiana State University Health Sciences Center,
Shreveport, LA 71103, United States
(Liang) Department of Medicine, University of Connecticut Health Center,
Farmington, CT 06030, United States
(Sharma) Kansas City Heart Rhythm Institute, Overland Park, KS 66215,
United States
(Rijal) Division of Cardiology, Hartford Medical Center, Hartford, CT
06102, United States
(Tandon) Cardiology Section, Overton Brooks VA Medical Center, Shreveport,
LA 71101, United States
(Azrin, Lee) Division of Cardiology, University of Connecticut Health
Center, Farmington, CT 06030, United States
Publisher
Baishideng Publishing Group Co
Abstract
BACKGROUND A few randomized clinical trials (RCT) and their meta-analyses
have found patent foramen ovale closure (PFOC) to be beneficial in
prevention of stroke compared to medical therapy. Whether the benefit is
extended across all groups of patients remains unclear. AIM To evaluate
the efficacy and safety of PFOC vs medical therapy in different groups of
patients presenting with stroke, we performed this meta-analysis of RCTs.
METHODS Electronic search of PubMed, EMBASE, Cochrane Central, CINAHL and
ProQuest Central and manual search were performed from inception through
September 2018 for RCTs. Ischemic stroke (IS), transient ischemic attack
(TIA), a composite of IS, TIA and systemic embolism (SE), mortality, major
bleeding, atrial fibrillation (AF) and procedural complications were the
major outcomes. Random-effects model was used to perform analyses. RESULTS
Meta-analysis of 6 RCTs including 3560 patients showed that the PFOC,
compared to medical therapy reduced the risk of IS [odds ratio: 0.34; 95%
confidence interval: 0.15-0.78; P = 0.01] and the composite of IS, TIA and
SE [0.55 (0.32-0.93); P = 0.02] and increased the AF risk [4.79
(2.35-9.77); P < 0.0001]. No statistical difference was observed in the
risk of TIA [0.86 (0.54-1.38); P = 0.54], mortality [0.74 (0.28-1.93); P =
0.53] and major bleeding [0.81 (0.42-1.56); P = 0.53] between two
strategies. Subgroup analyses showed that compared to medical therapy,
PFOC reduced the risk of stroke in persons who were males, <= 45 years of
age and had large shunt or atrial septal aneurysm. CONCLUSION In certain
groups of patients presenting with stroke, PFOC is beneficial in
preventing future stroke compared to medical therapy.<br/>Copyright
&#xa9;The Author(s) 2019. Published by Baishideng Publishing Group Inc.
All rights reserved.

<29>
Accession Number
626825393
Title
Percutaneous devices for left atrial appendage occlusion: A contemporary
review.
Source
World Journal of Cardiology. 11 (2) (pp 57-70), 2019. Date of Publication:
01 Feb 2019.
Author
Pacha H.M.; Al-khadra Y.; Soud M.; Darmoch F.; Pacha A.M.; Chadi Alraies
M.
Institution
(Pacha, Soud) MedStar Washington Hospital Center, Washington, DC 20010,
United States
(Al-khadra) Cleveland Clinic, Medicine Institute, Cleveland, OH 44195,
United States
(Darmoch) Beth Israel Deaconess Medical center, Harvard Medical School,
Boston, MA 02215, United States
(Pacha) University Hospital of Mainz, Mainz 55122, Germany
(Chadi Alraies) Wayne State University, Detroit Medical Center, Detroit
Heart Hospital, 311 Mack Ave, Detroit, MI 48201, United States
Publisher
Baishideng Publishing Group Co
Abstract
Patient with atrial fibrillation (AF) are at risk of developing stroke
with the left atrial appendage (LAA) being the most common site for
thrombus formation. If left untreated, AF is associated with 4 to 5 folds
increase in the risk of ischemic stroke in all age groups. About 5% to 15%
of AF patients have atrial thrombi on transesophageal echocardiography,
and 91% of those thrombi are located in the LAA in patient with
nonrheumatic AF. Although oral anticoagulants are the gold-standard
treatment for stroke prevention in patients with non-valvular AF, some
patients are at high risk of bleeding and deemed not candidates for
anticoagulation. Therefore, LAA occlusion (LAAO) has emerged as
alternative approach for stroke prevention in those patients. Surgical
LAAO is associated with high rate of unsuccessful closure and recommended
only in patients with AF and undergoing cardiac surgery. Percutaneous LAAO
uses transvenous access with trans-septal puncture and was first tested
using the PLAATO device. Watchman is the most common and only Food and
Drug Administration (FDA) approved device for LAAO. LAAO using Watchman
device is non-inferior to warfarin therapy in preventing ischemic
stroke/systemic thromboembolism. However, it is associated with lower
rates of hemorrhagic stroke, bleeding and death. Amplatzer is another
successful LAAO device that has CE mark and is waiting for FDA approval.
Optimal antithrombotic therapy post LAAO is still under debate and highly
patient-specific. The aim of this paper is to systematically review the
current literature to evaluate the efficacy and safety of different LAAO
devices.<br/>Copyright &#xa9;The Author(s) 2019. Published by Baishideng
Publishing Group Inc. All rights reserved.

<30>
Accession Number
625259015
Title
Surgical left atrial appendage occlusion during cardiac surgery: A
systematic review and meta-analysis.
Source
World Journal of Cardiology. 10 (11) (pp 242-249), 2018. Date of
Publication: 01 Nov 2018.
Author
Atti V.; Anantha-Narayanan M.; Turagam M.K.; Koerber S.; Rao S.;
Viles-Gonzalez J.F.; Suri R.M.; Velagapudi P.; Lakkireddy D.; Benditt D.G.
Institution
(Atti) Department of Medicine, Michigan State University-Sparrow Hospital,
East Lansing, MI 48912, United States
(Anantha-Narayanan, Benditt) Division of Cardiovascular Diseases,
Department of Medicine, University of Minnesota, Minneapolis, MN 55455,
United States
(Turagam) Helmsley Electrophysiology Center, Icahn School of medicine at
Mount Sinai, New York City, NY 10029, United States
(Koerber) Department of Cardiac Electrophysiology, Medical University of
South Carolina, Charleston, SC 29425, United States
(Rao) Department of Cardiovascular Diseases, Genesys Heart Institute,
Ascension Genesys Hospital, Grand Blanc, MI, United States
(Viles-Gonzalez) Baptist Health South Florida, Department of Medicine,
Wertheim College of Medicine, Miami, FL 33176, United States
(Suri) Cleveland Clinic Foundation, Cleveland Clinic Abu Dhabi, Department
of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH
44195, United States
(Velagapudi) Structural Heart and Valve Center, Center for Interventional
Vascular Therapy, Division of Cardiology, Columbia University Medical
Center, New York City, NY 10027, United States
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Kansas City, MO 64132, United States
Publisher
Baishideng Publishing Group Co
Abstract
AIM To evaluate the safety and efficacy of surgical left atrial appendage
occlusion (s-LAAO) during concomitant cardiac surgery. METHODS We
performed a comprehensive literature search through May 31st 2018 for all
eligible studies comparing s-LAAO vs no occlusion in patients undergoing
cardiac surgery. Clinical outcomes during follow-up included: embolic
events, stroke, all-cause mortality, atrial fibrillation (AF), reoperation
for bleeding and postoperative complications. We further stratified the
analysis based on propensity matched studies and AF predominance. RESULTS
Twelve studies (n = 40107) met the inclusion criteria. s-LAAO was
associated with lower risk of embolic events (OR: 0.63, 95%CI: 0.53-0.76;
P < 0.001) and stroke (OR: 0.68, 95%CI: 0.57-0.82; P < 0.0001). Stratified
analysis demonstrated this association was more prominent in the AF
predominant strata. There was no significant difference in the incidence
risk of all-cause mortality, AF, and reoperation for bleeding and
postoperative complications. CONCLUSION Concomitant s-LAAO during cardiac
surgery was associated with lower risk of follow-up thromboembolic events
and stroke, especially in those with AF without significant increase in
adverse events. Further randomized trials to evaluate long-term benefits
of s-LAAO are warranted.<br/>Copyright &#xa9; The Author(s) 2018.
Published by Baishideng Publishing Group Inc. All rights reserved.

<31>
Accession Number
618464567
Title
Randomized trial of near-infrared spectroscopy for personalized
optimization of cerebral tissue oxygenation during cardiac surgery.
Source
British Journal of Anaesthesia. 119 (3) (pp 384-393), 2017. Date of
Publication: September 2017.
Author
Rogers C.A.; Stoica S.; Ellis L.; Stokes E.A.; Wordsworth S.; Dabner L.;
Clayton G.; Downes R.; Nicholson E.; Bennett S.; Angelini G.D.; Reeves
B.C.; Murphy G.J.
Institution
(Rogers, Ellis, Dabner, Clayton, Reeves) Clinical Trials and Evaluation
Unit, School of Clinical Sciences, University of Bristol, Bristol Royal
Infirmary, Bristol BS2 8HW, United Kingdom
(Stoica, Downes, Nicholson, Angelini) Bristol Heart Institute, National
Institute for Health Research Bristol Biomedical Research Unit in
Cardiovascular Medicine, University Hospitals Bristol NHS Foundation
Trust, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom
(Stokes, Wordsworth) Health Economics Research Centre, Nuffield Department
of Population Health, University of Oxford, Old Road Campus, Old Road,
Headington, Oxford OX3 7LF, United Kingdom
(Bennett) Cardiac Anaesthesia and Intensive Care, King Faisal Cardiac
Center, NGHA, Jeddah, Saudi Arabia
(Murphy) Department of Cardiovascular Sciences, National Institute for
Health Research Leicester Biomedical Research Unit in Cardiovascular
Medicine, University of Leicester, Clinical Sciences Wing, Glenfield
General Hospital, Leicester LE3 9QP, United Kingdom
Publisher
Oxford University Press
Abstract
Background. We assessed whether a near-infrared spectroscopy (NIRS)-based
algorithm for the personalized optimization of cerebral oxygenation during
cardiopulmonary bypass combined with a restrictive red cell transfusion
threshold would reduce perioperative injury to the brain, heart, and
kidneys. Methods. In a randomized controlled trial, participants in three
UK centres were randomized with concealed allocation to a NIRS (INVOS
5100; Medtronic Inc., Minneapolis, MN, USA)-based patient-specific'
algorithm that included a restrictive red cell transfusion threshold
(haematocrit 18%) or to a generic' non-NIRS-based algorithm (standard
care). The NIRS algorithm aimed to maintain cerebral oxygenation at an
absolute value of > 50% or at > 70% of baseline values. The primary
outcome for the trial was cognitive function measured up to 3 months
postsurgery. Results. The analysis population comprised eligible
randomized patients who underwent valve or combined valve surgery and
coronary artery bypass grafts using cardiopulmonary bypass between
December 2009 and January 2014 (n=98 patient-specific algorithm; n=106
generic algorithm). There was no difference between the groups for the
three core cognitive domains (attention, verbal memory, and motor
coordination) or for the non-core domains psychomotor speed and
visuo-spatial skills. The NIRS group had higher scores for verbal fluency;
mean difference 3.73 (95% confidence interval 1.50, 5.96). Red cell
transfusions, biomarkers of brain, kidney, and myocardial injury, adverse
events, and health-care costs were similar between the groups.
Conclusions. These results do not support the use of NIRS-based algorithms
for the personalized optimization of cerebral oxygenation in adult cardiac
surgery. Clinical trial registration.http://www.controlled-trials.com,
ISRCTN 23557269.<br/>Copyright &#xa9; 2017 The Author.

<32>
Accession Number
613196284
Title
Randomized controlled trial of remote ischemic preconditioning and atrial
fibrillation in patients undergoing cardiac surgery.
Source
World Journal of Cardiology. 8 (10) (pp 615-622), 2016. Date of
Publication: 2016.
Author
Lotfi A.S.; Eftekhari H.; Atreya A.R.; Kashikar A.; Sivalingam S.K.;
Giannoni M.; Visintainer P.; Engelman D.
Institution
(Lotfi, Eftekhari, Atreya, Sivalingam, Giannoni) Department of Cardiology,
Baystate Medical Center, Tufts University School of Medicine, Springfield,
MA 01199, United States
(Kashikar) Department of Anesthesiology, Baystate Medical Center, Tufts
University School of Medicine, Springfield, MA 01199, United States
(Visintainer) Department of Epidemiology and Biostatistics, Baystate
Medical Center, Tufts University School of Medicine, Springfield, MA
01199, United States
(Engelman) Department of Cardiac Surgery, Baystate Medical Center, Tufts
University School of Medicine, Springfield, MA 01199, United States
Publisher
Baishideng Publishing Group Co
Abstract
AIM To study whether remote ischemic preconditioning (RIPC) has an impact
on clinical outcomes, such as post-operative atrial fibrillation (POAF).
METHODS This was a prospective, single-center, single-blinded,randomized
controlled study. One hundred and two patients were randomized to receive
RIPC (3 cycles of 5 min ischemia and 5 min reperfusion in the upper arm
after induction of anesthesia) or no RIPC (control). Primary outcome was
POAF lasting for five minutes or longer during the first seven days after
surgery. Secondary outcomes included length of hospital stay, incidence of
inpatient mortality, myocardial infarction, and stroke. RESULTS POAF
occurred at a rate of 54% in the RIPC group and 41.2% in the control group
(P = 0.23). No statistically significant differences were noted in
secondary outcomes between the two groups. CONCLUSION This is the first
study in the United States to suggest that RIPC does not reduce POAF in
patients with elective or urgent cardiac surgery. There were no
differences in adverse effects in either group. Further studies are
required to assess the relationship between RIPC and POAF.<br/>Copyright
&#xa9; 2016 Baishideng Publishing Group Inc. All rights reserved.

<33>
Accession Number
608999136
Title
Percutaneous assist devices in acute myocardial infarction with
cardiogenic shock: Review, meta-analysis.
Source
World Journal of Cardiology. 8 (1) (pp 98-111), 2016. Date of Publication:
2016.
Author
Romeo F.; Acconcia M.C.; Sergi D.; Romeo A.; Francioni S.; Chiarotti F.;
Caretta Q.
Institution
(Romeo, Sergi, Romeo) Department of Cardiovascular Disease, University of
Rome - Tor Vergata, Rome 00133, Italy
(Acconcia) Department of Cardiovascular Disease, University of Rome - La
Sapienza, Rome 00161, Italy
(Francioni) Center for Biomedical Technology, Integrated Department
Services to Education, University of Florence, Florence 50134, Italy
(Chiarotti) Department of Cell Biology and Neuroscience, Italian National
Institute of Health, Rome 00161, Italy
(Caretta) Department of Experimental and Clinical Medicine, University of
Florence, Florence 50134, Italy
Publisher
Baishideng Publishing Group Co
Abstract
AIM: To assess the impact of percutaneous cardiac support in cardiogenic
shock (CS) complicating acute myocardial infarction (AMI), treated with
percutaneous coronary intervention. <br/>METHOD(S): We selected all of the
studies published from January 1^st, 1997 to May
15^st, 2015 that compared the following percutaneous mechanical
support in patients with CS due to AMI undergoing myocardial
revascularization: (1) intra-aortic balloon pump (IABP) vs Medical
therapy; (2) percutaneous left ventricular assist devices (PLVADs) vs
IABP; (3) complete extracorporeal life support with extracorporeal
membrane oxygenation (ECMO) plus IABP vs IABP alone; and (4) ECMO plus
IABP vs ECMO alone, in patients with AMI and CS undergoing myocardial
revascularization. We evaluated the impact of the support devices on
primary and secondary endpoints. Primary endpoint was the inhospital
mortality due to any cause during the same hospital stay and secondary
endpoint late mortality at 6-12 mo RESULTS: One thousand two hundred and
seventytwo studies met the initial screening criteria. After detailed
review, only 30 were selected. There were 6 eligible randomized controlled
trials and 24 eligible observational studies totaling 15799 patients. We
found that the inhospital mortality was: (1) significantly higher with
IABP support vs medical therapy (RR = +15%, P = 0.0002); (2) was higher,
although not significantly, with PLVADs compared to IABP (RR = +14%, P =
0.21); and (3) significantly lower in patients treated with ECMO plus IABP
vs IABP (RR = -44%, P = 0.0008) or ECMO (RR = -20%, P = 0.006) alone. In
addition, Trial Sequential Analysis showed that in the comparison of IABP
vs medical therapy, the sample size was adequate to demonstrate a
significant increase in risk due to IABP. <br/>CONCLUSION(S): Inhospital
mortality was significantly higher with IABP vs medical therapy. PLVADs
did not reduce early mortality. ECMO plus IABP significantly reduced
inhospital mortality compared to IABP.<br/>Copyright &#xa9; The Author(s)
2016.

<34>
Accession Number
608999125
Title
Biodegradable polymer stents vs second generation drug eluting stents: A
meta-analysis and systematic review randomized controlled trials.
Source
World Journal of Cardiology. 8 (2) (pp 240-246), 2016. Date of
Publication: 2016.
Author
Pandya B.; Gaddam S.; Raza M.; Asti D.; Nalluri N.; Vazzana T.; Kandov R.;
Lafferty J.
Institution
(Pandya) Department of Internal Medicine, Staten Island University
Hospital, Staten Island, NY 10305, United States
(Gaddam, Raza, Asti, Nalluri, Vazzana, Kandov, Lafferty) Department of
Cardiology, Staten Island University Hospital, Staten Island, NY 10305,
United States
Publisher
Baishideng Publishing Group Co
Abstract
AIM: To evaluate the premise, that biodegradable polymer drug eluting
stents (BD-DES) could improve clinical outcomes compared to second
generation permanent polymer drug eluting stents (PP-DES), we pooled the
data from all the available randomized control trials (RCT) comparing the
clinical performance of both these stents. <br/>METHOD(S): A systematic
literature search of PubMed, Cochrane, Google scholar databases, EMBASE,
MEDLINE and SCOPUS was performed during time period of January 2001 to
April 2015 for RCT and comparing safety and efficacy of BD-DES vs second
generation PP-DES. The primary outcomes of interest were definite stent
thrombosis, target lesion revascularization, myocardial infarction,
cardiac deaths and total deaths during the study period. <br/>RESULT(S): A
total of 11 RCT's with a total of 12644 patients were included in the
meta-analysis, with 6598 patients in BD-DES vs 6046 patients in second
generation PP-DES. The mean follow up period was 16 mo. Pooled analysis
showed non-inferiority of BD-DES, comparing events of stent thrombosis (OR
= 1.42, 95%CI: 0.79-2.52, P = 0.24), target lesion revascularization (OR =
0.99, 95%CI: 0.84-1.17, P = 0.92), myocardial infarction (OR = 1.06,
95%CI: 0.86-1.29, P = 0.92), cardiac deaths (OR = 1.07, 95%CI 0.82-1.41, P
= 0.94) and total deaths (OR = 0.96, 95%CI: 0.80-1.17, P = 0.71).
<br/>CONCLUSION(S): BD-DES, when compared to second generation PP-DES,
showed no significant advantageand the outcomes were comparable between
both the groups.<br/>Copyright &#xa9; The Author(s) 2016.

<35>
Accession Number
370351627
Title
Low dose tranexamic acid effect on post-coronary artery bypass grafting
bleeding.
Source
Asian Cardiovascular and Thoracic Annals. 21 (6) (pp 669-674), 2013. Date
of Publication: December 2013.
Author
Esfandiari B.R.; Bistgani M.M.; Kabiri M.
Institution
(Esfandiari, Bistgani) Department of Cardiothoracic Surgery, Faculty of
Medicine, Shahr-e-kord University of Medical Sciences, Shahrekord, Iran,
Islamic Republic of
(Kabiri) Department of Anesthesiology, Faculty of Medicine, Shahr-e-kord
University of Medical Sciences, Shahr-e-kord, Iran, Islamic Republic of
Publisher
SAGE Publications Inc.
Abstract
Objective: This study investigated the effects of low-dose tranexamic acid
on post-coronary artery bypass surgery bleeding. <br/>Background(s):
Diffuse microvascular bleeding is still a common problem after cardiac
procedures. This study was designed to evaluate the hemostatic effects of
low-dose tranexamic acid in on-pump coronary artery bypass graft surgery.
<br/>Method(s): In this prospective randomized placebo-controlled study,
150 patients who were candidates for coronary artery bypass were enrolled
and randomly assigned to 1 of 2 groups (tranexamic acid or placebo). Total
drainage volume and the need for transfusion as well as surgical
complications were recorded and compared in the 2 groups. <br/>Result(s):
There was significantly less mediastinal chest tube drainage up to 48 h in
the tranexamic acid group (432+/-210 mL) compared to the placebo group
(649+/-235 mL, p=0.006). In the placebo group, 43 (58%) patients were
given allogeneic blood during hospital stay compared to 22 (25%) in the
tranexamic acid group (p<0.001). No significant difference in
postoperative complications was seen. <br/>Conclusion(s): The use of
low-dose tranexamic acid can significantly reduce blood loss and need for
transfusion, with no increase in complications. &#xa9; The Author(s) 2012
Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

<36>
Accession Number
365132744
Title
Cognitive dysfunction after off-pump versus on-pump coronary artery bypass
surgery: A meta-analysis.
Source
Journal of International Medical Research. 40 (3) (pp 852-858), 2012. Date
of Publication: June 2012.
Author
Sun J.H.; Wu X.Y.; Wang W.J.; Jin L.L.
Institution
(Sun, Wang, Jin) Department of Anaesthesia, The First Affiliated Hospital,
Wenzhou Medical College, 2 Fu-Xue Street, Lucheng District, Wenzhou, China
(Wu) Department of Anaesthesia, Shengjing Hospital, China Medical
University, Shenyang, China
Publisher
SAGE Publications Ltd
Abstract
Objective: A meta-analysis to compare the incidence of postoperative
cognitive dysfunction (POCD) following off-pump coronary artery bypass
grafting (OPCAB) versus after conventional coronary artery bypass grafting
(CABG). <br/>METHOD(S): A systematic search of the Medline, EMBASE and
Cochrane Library databases was performed to identify randomized controlled
trials published until the end of November 2011. Data were analysed using
RevMan version 5.0 software. <br/>RESULT(S): The literature search
identified 13 randomized controlled trials which included a total of 2326
cases. Meta-analysis found that the incidence of POCD was significantly
higher following CABG than after OPCAB during the perioperative period (1
- 2 weeks) and at 3 months postsurgery. There were no significant
between-group differences at 6 or 12 months postsurgery.
<br/>CONCLUSION(S): Compared with CABG, OPCAB was found to be associated
with a reduced incidence of early-stage POCD. Caution must be taken when
interpreting these findings because of limitations in the available data.
&#xa9; 2012 Field House Publishing LLP.

<37>
Accession Number
2007134768
Title
High flow oxygen therapy at two initial flow settings versus conventional
oxygen therapy in cardiac surgery patients with postextubation hypoxemia:
A single-center, unblinded, randomized, controlled trial.
Source
Journal of Clinical Medicine. 10 (10) (no pagination), 2021. Article
Number: 2079. Date of Publication: 02 May 2021.
Author
Theologou S.; Ischaki E.; Zakynthinos S.G.; Charitos C.; Michopanou N.;
Patsatzis S.; Mentzelopoulos S.D.
Institution
(Theologou, Charitos, Michopanou, Patsatzis) Department of Cardiac
Surgery, Evaggelismos General Hospital, Athens 10675, Greece
(Ischaki, Zakynthinos, Mentzelopoulos) First Department of Intensive Care
Medicine, National and Kapodistrian University of Athens Medical School,
Evaggelismos General Hospital, Athens 10675, Greece
Publisher
MDPI AG
Abstract
In cardiac surgery patients with pre-extubation PaO<inf>2</inf> /inspired
oxygen fraction (FiO<inf>2</inf> ) < 200 mmHg, the possible benefits and
optimal level of high-flow nasal cannula (HFNC) support are still unclear;
therefore, we compared HFNC support with an initial gas flow of 60 or 40
L/min and conventional oxygen therapy. Ninety nine patients were randomly
allocated (respective ratio: 1:1:1) to I = intervention group 1 (HFNC
initial flow = 60 L/min, FiO<inf>2</inf> = 0.6), intervention group 2
(HFNC initial flow = 40 L/min, FiO<inf>2</inf> = 0.6), or control group
(Venturi mask, FiO<inf>2</inf> = 0.6). The primary outcome was occurrence
of treatment failure. The baseline characteristics were similar. The
hazard for treatment failure was lower in intervention group 1 vs. control
(hazard ratio (HR): 0.11, 95% CI: 0.03-0.34) and intervention group 2 vs.
control (HR: 0.30, 95% CI: 0.12-0.77). During follow-up, the probability
of peripheral oxygen saturation (SpO<inf>2</inf> ) > 92% and respiratory
rate within 12-20 breaths/min was 2.4-3.9 times higher in intervention
group 1 vs. the other 2 groups. There was no difference in PaO<inf>2</inf>
/FiO<inf>2</inf>, patient comfort, intensive care unit or hospital stay,
or clinical course complications or adverse events. In hypoxemic cardiac
surgery patients, postextubation HFNC with an initial gas flow of 60 or 40
L/min resulted in less frequent treatment failure vs. conventional
therapy. The results in terms of SpO<inf>2</inf> /respiratory rate targets
favored an initial HFNC flow of 60 L/min.<br/>Copyright &#xa9; 2021 by the
authors. Licensee MDPI, Basel, Switzerland.

<38>
Accession Number
2012212460
Title
Impact of low triiodothyronine syndrome on long-term outcomes in patients
with myocardial infarction with nonobstructive coronary arteries.
Source
Annals of Medicine. 53 (1) (pp 741-749), 2021. Date of Publication: 2021.
Author
Gao S.; Ma W.; Huang S.; Lin X.; Yu M.
Institution
(Gao, Ma, Huang, Lin, Yu) Department of Cardiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: Low triiodothyronine syndrome (LT3S), frequently seen in
patients with acute myocardial infarction (AMI), has been regarded as a
predictor of poor outcomes after AMI. However, little is known about the
prognostic value of LT3S in euthyroid patients with myocardial infarction
with nonobstructive coronary arteries (MINOCA). <br/>Method(s): A total of
1162 MINOCA patients were enrolled and divided into LT3S and no-LT3S
groups. LT3S was defined as decreased free T3 (fT3 < 2.36 pg/mL) with
normal values of thyroid-stimulating hormone. The primary endpoint was a
composite of major adverse cardiovascular events (MACE), including
all-cause death, nonfatal MI, stroke, revascularization, and
hospitalization for unstable angina or heart failure. Kaplan-Meier, Cox
regression, propensity score matching (PSM), and receiver-operating
characteristic analyses were performed. <br/>Result(s): Patients with LT3S
(prevalence of 17.5%) had a significantly higher incidence of MACE (19.6%
vs. 12.9%; p =.013) than patients without during the median follow-up of
41.7 months. LT3S was closely associated with an increased risk of MACE
even after multivariable adjustment (HR 1.50, 95% CI: 1.03-2.18, p =.037).
After PSM, 197 pairs of patients with or without LT3S were identified, and
LT3S remained a robust risk factor of worse outcomes (HR 1.53, 95% CI:
1.02-2.65, p =.042). Moreover, LT3S had an area under the curve (AUC) of
0.60 for predicting MACE. When adding LT3S to the thrombolysis in
myocardial infarction (TIMI) risk score, the combined model yielded a
significant improvement in discrimination for MACE. <br/>Conclusion(s):
LT3S was independently associated with poor outcomes after MINOCA. Routine
assessment of LT3S may provide valuable prognostic information in this
specific population.<br/>Copyright &#xa9; 2021 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<39>
Accession Number
2011638305
Title
Bilateral transversus thoracis muscle plane block provides effective
analgesia and enhances recovery after open cardiac surgery.
Source
Journal of Cardiac Surgery. 36 (8) (pp 2818-2823), 2021. Date of
Publication: August 2021.
Author
Zhang Y.; Li X.; Chen S.
Institution
(Zhang, Chen) Department of Anesthesiology, First Affiliated Hospital of
Nanchang University, Nanchang, Jiangxi, China
(Li) Department of Nursing, The first Affiliated Hospital of Nanchang
University, Nanchang, Jiangxi, China
Publisher
John Wiley and Sons Inc
Abstract
Background: The mid-sternum is the main source of pain after open cardiac
surgery. The aim of this study was to investigate the effect of bilateral
transversus thoracis muscle plane (TTMP) blocks on open cardiac surgery.
<br/>Method(s): Sixty patients were randomly divided into two groups:
bilateral TTMP blocks (TP group) or no nerve block (CO group). The primary
endpoint was perioperative sufentanil consumption. The secondary outcome
measures included postoperative pain, flurbiprofen axetil administration,
quality of sleep after extubation, time to extubation, time to the return
of gastrointestinal function, time to drain removal, the Intensive Care
Unit (ICU) stay time, and hospital stay. <br/>Result(s): The TP group
reported significantly less sufentanil and flurbiprofen axetil consumption
than the CO group. The CO group had higher Numerical Rating Scale (NRS)
pain scores at 1, 2, 6, 12, and 24 h after extubation both at rest and
during movement than the TP groups. Compared with the CO group,time to
extubation, time to the first bowel movement, ICU stay time, and hospital
stay were significantly decreased in the TP group. The TP group was rated
as better in the quality of the two nights of sleep after extubation.
<br/>Conclusion(s): Bilateral TTMP blocks can provide good perioperative
analgesia for patients undergoing open cardiac surgery and promote
postoperative recovery.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<40>
Accession Number
2011464218
Title
Tranexamic acid for primary elective off-pump coronary artery bypass
grafting surgery.
Source
Canadian Journal of Anesthesia. 68 (8) (pp 1287-1289), 2021. Date of
Publication: August 2021.
Author
Weingarten B.R.; Tran D.T.T.; Mahaffey R.; Sohmer B.
Institution
(Weingarten, Tran, Mahaffey, Sohmer) Department of Anesthesiology and Pain
Medicine, University of Ottawa Heart Institute, University of Ottawa,
Ottawa, ON, Canada
Publisher
Springer

<41>
Accession Number
2013080682
Title
Influence of fractional flow reserve on grafts patency: Systematic review
and patient-level meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2021.
Date of Publication: 2021.
Author
G. Toth G.; Collet C.; Langhoff Thuesen A.; Mizukami T.; Casselman F.;
Riber L.P.; Van Praet F.; Junker A.; Nagumo S.; De Bruyne B.; Okkels
Jensen L.; Barbato E.
Institution
(G. Toth) Division of Cardiology, University Heart Center Graz, Medical
University of Graz, Graz, Austria
(Collet, Mizukami, Nagumo, De Bruyne, Barbato) Cardiovascular Center
Aalst, OLV Clinic, Aalst, Belgium
(Langhoff Thuesen, Riber) Department of Cardiothoracic Surgery, Odense
University Hospital, Odense, Denmark
(Langhoff Thuesen, Junker, Okkels Jensen) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Mizukami) Clinical Research Institute for Clinical Pharmacology and
Therapeutics, Showa University, Tokyo, Japan
(Casselman, Van Praet) Departement of Cardiovascular and Thoracic Surgery,
OLV Hospital Aalst, Aalst, Belgium
(Nagumo) Division of Cardiology, Department of Internal medicine, Showa
University Fujigaoka Hospital, Kanagawa, Japan
(De Bruyne) Department of Cardiology, Universtiy Hospital Center Lausanne,
Lausanne, Switzerland
(Barbato) Department of Advanced Biomedical Sciences, University Federico
II, Naples, Italy
Publisher
John Wiley and Sons Inc
Abstract
Objective: To investigate the impact of invasive functional guidance for
coronary artery bypass graft surgery (CABG) on graft failure.
<br/>Background(s): Data on the impact of fractional flow reserve (FFR) in
guiding CABG are still limited. <br/>Method(s): Systematic review and
individual patient data meta-analysis were performed. Primary objective
was the risk of graft failure, stratified by FFR. Risk estimates are
reported as odds ratios (ORs) derived from the aggregated data using
random-effects models. Individual patient data were analyzed using mixed
effect model to assess relationship between FFR and graft failure. This
meta-analysis is registered in PROSPERO (CRD42020180444). <br/>Result(s):
Four prospective studies comprising 503 patients referred for CABG, with
1471 coronaries, assessed by FFR were included. Graft status was available
for 1039 conduits at median of 12.0 [IQR 6.6; 12.0] months. Risk of graft
failure was higher in vessels with preserved FFR (OR 5.74, 95% CI
1.71-19.29). Every 0.10 FFR units decrease in the coronaries was
associated with 56% risk reduction of graft failure (OR 0.44, 95% CI 0.34
to 0.59). FFR cut-off to predict graft failure was 0.79.
<br/>Conclusion(s): Surgical grafting of coronaries with functionally
nonsignificant stenoses was associated with higher risk of graft
failure.<br/>Copyright &#xa9; 2021 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<42>
Accession Number
2007175054
Title
Role of Using a Thromboelastometry-Based Protocol for Transfusion
Management in Combined Coronary Artery Bypass Grafting and Valve Surgery:
A Randomized Clinical Trail.
Source
Indian Journal of Hematology and Blood Transfusion. 37 (3) (pp 422-429),
2021. Date of Publication: July 2021.
Author
Khalaf-Adeli E.; Pourfathollah A.A.; Noohi F.; Alizadeh-Ghavidel A.;
Bakhshandeh-Abkenar H.; Shamriz R.; Alavi S.M.
Institution
(Khalaf-Adeli, Pourfathollah) Blood Transfusion Research Center, High
Institute for Research and Education in Transfusion Medicine, Tehran,
Iran, Islamic Republic of
(Pourfathollah) Departments of Immunology, Faculty of Medicine, Tarbiat
Modares University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Noohi) Cardiac Intervention Research Center, Rajaie Cardiovascular
Medical and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Alizadeh-Ghavidel) Heart Valve Disease Research Center, Rajaie
Cardiovascular Medical and Research Center, University of Medical
Sciences, IranTehran, Iran, Islamic Republic of
(Bakhshandeh-Abkenar, Alavi) Rajaie Cardiovascular Medical and Research
Center, Iran University of Medical Sciences, Mellat park, Valiasr Avenue,
Tehran, Iran, Islamic Republic of
(Shamriz) Coagulation Laboratory, Iranian Blood Transfusion Organization,
Tehran, Iran, Islamic Republic of
Publisher
Springer
Abstract
The aim of this study was to evaluate the impact of using a
thromboelastometry-based protocol on transfusion requirements in patients
undergoing combined coronary artery bypass grafting (CABG) and valve
surgery. 80 adult patients scheduled for elective combined CABG and valve
surgery were included in this clinical trial study. Patients were randomly
allocated to the thromboelastometry (ROTEM) (n = 40) or control groups (n
= 40). In the ROTEM group, transfusion was directed according to a
thromboelastometry-based protocol. In the control group, transfusion was
conducted according to the routine practices including conventional
coagulation testing and clinical judgments. Finally, transfusion
requirements were compared between groups. Use of thromboelastometry-
based protocol resulted in 67% reduction in blood products units'
consumption as well as 23% in the percentage of patients transfused. This
reduction was especially evident in relation to fresh frozen plasma (FFP)
and platelet consumption. No significant differences were found both in
the percentage of patients receiving RBC and number of transfused RBC
units. Using thromboelastometry tests incorporated a protocol results in
reduction of transfusion requirements in patients undergoing elective
combined CABG and valve surgery.<br/>Copyright &#xa9; 2020, Indian Society
of Hematology and Blood Transfusion.

<43>
Accession Number
2013690078
Title
B-PO03-147 OMEGA-3 POLYUNSATURATED FATTY ACIDS REDUCES POST-OPERATIVE
ATRIAL FIBRILLATION IN PATIENTS UNDERGOING CARDIAC SURGERY.
Source
Heart Rhythm. Conference: Heart Rhythm 2021. Boston United States. 18 (8
Supplement) (pp S248-S249), 2021. Date of Publication: August 2021.
Author
Shah S.; Shah K.B.; Turagam M.K.; Bhardwaj R.; Contractor T.; Mandapati
R.; Natale A.; Lakkireddy D.R.; Garg J.
Publisher
Elsevier B.V.
Abstract
Background: Preoperative and post-operative omega-3 polyunsaturated fatty
acids (PUFA) supplementation (both oral/enteral or parenteral) is an
attractive therapeutic option for patients undergoing cardiac surgery
surgery due to their anti-inflammatory and anti-arrhythmic properties.
<br/>Objective(s): We aimed to demonstrate if PUFA supplementation
prevents post-operative atrial fibrillation (POAF) in patients undergoing
cardiac surgery. <br/>Method(s): A systemic literature search was
performed (until November 9, 2020) using PubMed, EMBASE, Web of Science,
and Cochrane Central Register of Controlled Trials to identify trials
(both randomized and prospective) evaluating PUFA supplementation
post-cardiac surgery for POAF prevention. Mantel-Haenszel risk ratio (RR)
with the Hartung-Knapp-Sidik-Jonkman random-effects model was used to
summarize data between the two groups. Heterogeneity was assessed using I2
statistics. <br/>Result(s): We included a total of 4,930 participants
(2,270 in the PUFA group and 2,660 in the placebo group) enrolled in 22
clinical trials. Patients in the placebo group were older compared to the
PFA group (64.9+/-2.80 vs 64.6+/-1.75 years). There was a significant
reduction in the incidence of POAF in PUFA group as compared to the
placebo (27.04% vs 36.20%, RR 0.69; 95% CI, 0.57-0.84; p<0.001,
respectively). The test of heterogeneity (I2) was 56%. Number needed to
treat was 11. <br/>Conclusion(s): Perioperative supplementation of n-3
polyunsaturated fatty acids significantly prevents the occurrence of
postoperative atrial fibrillation in patients undergoing cardiac surgery.
[Formula presented]<br/>Copyright &#xa9; 2021

<44>
Accession Number
2013687786
Title
B-PO02-134 LONG TERM FOLLOW-UP OF STEREOTACTIC BODY RADIATION THERAPY FOR
REFRACTORY VENTRICULAR TACHYCARDIA.
Source
Heart Rhythm. Conference: Heart Rhythm 2021. Boston United States. 18 (8
Supplement) (pp S152), 2021. Date of Publication: August 2021.
Author
Wight J.A.; Schwartz A.; Bigham T.; Higgins K.; Lloyd M.S.
Publisher
Elsevier B.V.
Abstract
Background: Initial studies of stereotactic body radiation therapy (SBRT)
for refractory ventricular tachycardia (VT) demonstrated impressive
efficacy. Follow-up analyses have found mixed results and the role of SBRT
for refractory VT remains unclear. We performed palliative, cardiac radio
ablation in patients with ventricular tachycardia refractory to ablation
and medical management. <br/>Objective(s): To analyze the efficacy of SBRT
for refractory ventricular tachycardia over long term followup.
<br/>Method(s): Arythmogenic regions were targeted by combining computed
tomography imaging with electrophysiologic mapping with collaboration from
a radiation oncologist, electrophysiologist and cardiac imaging
specialist. Patients were treated with a single fraction 25 Gy. Total
durations of VT, the quantity of antitachycardia pacing (ATP) and shocks
before and after treatment as recorded by implantable
cardioverter-defibrillators (ICDs) were analyzed. Follow-up extended until
most recent device interrogation unless transplant, death or repeat
ablation occurred sooner. <br/>Result(s): Fourteen patients (age 50-78, 4
females) were treated and had an average of two prior ablations. Eight had
ACC/AHA Stage D heart failure and four had left ventricular assist
devices. Two patients died shortly after SBRT, one received a prompt heart
transplant and another had significant VT durations in the following
months that were inaccurately recorded by their device. Ten of the
fourteen patients remained with adequate data post SBRT for analysis with
an average follow-up duration of 216 days. Seven of the ten patients had a
decrease in VT post SBRT. Comparing the 90 days before treatment to
cumulative follow-up, patients had a 59% reduction in VT, 39% reduction in
ATP and a 60% reduction in shocks. Three patients received repeat ablation
following SBRT. Pneumonitis was the only complication, occurring in four
of the fourteen patients. <br/>Conclusion(s): SBRT may have value in
patients with refractory VT storm acutely but the utility over long-term
follow-up appears modest. Prospective randomized data is needed to better
clarify the role of SBRT in managing refractory VT.<br/>Copyright &#xa9;
2021

<45>
[Use Link to view the full text]
Accession Number
635558072
Title
Pharmacological Agents That Prevent Postoperative Cognitive Dysfunction in
Patients With General Anesthesia: A Network Meta-analysis.
Source
American journal of therapeutics. 28 (4) (pp e420-e433), 2020. Date of
Publication: 01 Oct 2020.
Author
Li M.; Yang Y.; Ma Y.; Wang Q.
Institution
(Li) Institute of Urology, Chinese Medicine Hospital of Linyi, Linyi City,
China
(Yang) Department of Anesthesiology, Women and Children's Health Care
Hospital of Linyi, Linyi City, China
(Ma) The Evidence Based Medicine Center, Lanzhou University, Lanzhou City,
China; and
(Wang) Department of Health Research Methods, Evidence, McMaster
University, and Impact, Hamilton, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative cognitive dysfunction (POCD) is associated with
prolonged hospital stays, increased mortality, and negative socioeconomic
consequences. Dexmedetomidine, ketamine, dexamethasone, and lidocaine have
previously been reported to be effective for preventing POCD. STUDY
QUESTION: In this network meta-analysis, we apply direct and indirect
comparisons to rank these pharmacological agents in terms of their effect
on POCD, through which we seek to provide evidence for future clinical
medication. DATA SOURCES: A comprehensive literature search of PubMed,
EMBASE, the Cochrane Library, and Web of Science was conducted to identify
randomized controlled trials that examined the effects of dexmedetomidine,
ketamine, dexamethasone, or lidocaine on POCD induced by general
anesthesia. STUDY DESIGN: For eligible studies, 2 reviewers independently
extracted data and assessed the respective risk of bias. Bayesian network
meta-analysis was conducted using R-3.4.1 software. A total of 30 articles
were included in this meta-analysis. <br/>RESULT(S): Direct comparison
showed that dexmedetomidine [odds ratio (OR) = 0.42, 95% confidence
interval (CI): 0.32-0.55] may decrease the incidence of POCD for
noncardiac surgery; dexmedetomidine (OR = 0.08, 95% CI: 0.01-0.63) and
ketamine (OR = 0.09, 95% CI: 0.02-0.32) were found to decrease POCD for
cardiac surgery. The R-software ranking result for prevention of POCD was
dexmedetomidine, lidocaine, ketamine, placebo, and dexamethasone,
respectively, in noncardiac surgery, and dexmedetomidine, ketamine,
lidocaine, placebo, and dexamethasone in cardiac surgery.
<br/>CONCLUSION(S): Dexmedetomidine exhibited obvious superiority to other
agents for noncardiac surgery; dexmedetomidine and ketamine exhibited a
significantly better performance than other agents for cardiac surgery.
Dexamethasone did not show better efficacy than the placebo. However, more
rigorously designed studies comprising larger sample sizes are needed to
confirm our findings.<br/>Copyright &#xa9; 2020 Wolters Kluwer Health,
Inc. All rights reserved.

<46>
Accession Number
2007881105
Title
Post-coronary artery bypass graft surgery insomnia: Quetiapine vs
alprazolam.
Source
Iranian Heart Journal. 22 (3) (pp 74-80), 2021. Date of Publication: 2021.
Author
Mirmohammadsadeghi A.; Narimani I.; Chitsaz A.
Institution
(Mirmohammadsadeghi) Cardiovascular Surgery, Isfahan University of Medical
Sciences (IUMS), Isfahan, Iran, Islamic Republic of
(Narimani, Chitsaz) Isfahan University of Medical Sciences (IUMS),
Isfahan, Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: Given that insomnia is common and not always easily handled
after coronary artery bypass graft surgery (CABG), this study was
conducted to compare the efficacy of quetiapine and alprazolam in
post-CABG insomnia. <br/>Method(s): In this clinical trial, 90 patients
undergoing CABG were selected and randomly divided into 2 groups of 45
patients. The first group received 12.5 mg of oral quetiapine and the
second group received 0.5 mg of alprazolam before bedtime (at 10 PM). The
patients' insomnia was evaluated and compared using the Insomnia Severity
Index (ISI) questionnaire on 3 occasions: 1 month before surgery and then
3 days and 14 days after surgery. <br/>Result(s): The mean score of
insomnia 1 month before surgery and 3 days after surgery had no
statistically significant difference in both groups (P =0.89 and P =0.55,
respectively). The mean score of insomnia on the 14th postoperative day,
which was at the end of the 10-day treatment period, was 15.33 +/- 3.87 in
the alprazolam group and 13.33 +/- 4.71 in the quetiapine group (P >0.05
and P =0.043, respectively). In the quetiapine group, 2 patients
experienced drowsiness on the following day and 1 patient developed
pruritus; none of them experienced restless leg syndrome or dystonia. Nine
patients in the quetiapine group and 3 patients in the alprazolam group
had drug noncompliance. <br/>Conclusion(s): Despite more drug
noncompliance, very low-dose quetiapine was more effective than alprazolam
in improving the sleep quality of our early postoperative CABG
patients.<br/>Copyright &#xa9; 2021, Iranian Heart Association. All rights
reserved.

<47>
Accession Number
2007879922
Title
Prognostic effect of the syntax score on 10-year outcomes after left main
coronary artery revascularization in a randomized population: Insights
from the extended precombat trial.
Source
Journal of the American Heart Association. 10 (14) (no pagination), 2021.
Article Number: e020359. Date of Publication: 20 Jul 2021.
Author
Lee J.; Ahn J.-M.; Kim J.H.; Jeong Y.J.; Hyun J.; Yang Y.; Lee J.S.; Park
H.; Kang D.-Y.; Lee P.H.; Park D.-W.; Park S.-J.
Institution
(Lee, Ahn, Jeong, Hyun, Yang, Park, Kang, Lee, Park, Park) Department of
Cardiology, Center for Medical Research and Information, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
(Lee) Division of Clinical Epidemiology and Biostatistics, Center for
Medical Research and Information, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, South Korea
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The long-term prognostic effect of the SYNTAX (Synergy Between
Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score
(SS) after percutaneous coronary intervention (PCI) or coronary artery
bypass graft (CABG) for left main coronary artery disease is
controversial. METHODS AND RESULTS: In the PRECOMBAT (Premier of
Randomized Comparison of Bypass Surgery Versus Angioplasty Using
Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery
Disease) trial, 600 patients with left main coronary artery disease were
randomized to undergo PCI with drug-eluting stents (n=300) or CABG
(n=300). We compared 10-year outcomes after PCI and CABG according to SS
categories and evaluated the predictive value of SS in each
revascularization arm. The primary outcome was a major adverse cardiac or
cerebrovascular event (composite of death, myocardial infarction, stroke,
or ischemia-driven target-vessel revascularization) at 10 years. Among 566
patients with valid SS measurement at baseline, 240 (42.4%) had low SS,
200 (35.3%) had intermediate SS, and 126 (22.3%) had high SS. The 10-year
rates of major adverse cardiac or cerebrovascular events were not
significantly different between PCI and CABG in low (21.6% versus 22.2%,
P=0.97), intermediate (31.8% versus 22.2%; P=0.13), and high SS (46.2%
versus 35.7%; P=0.31) (P-for-interaction=0.46). There were no significant
interactions between SS categories and revascularization modalities for
death (P=0.92); composite of death, myocardial infarction, or stroke
(P=0.87); and target-vessel revascularization (P=0.06). Higher SS
categories were associated with higher risks for major adverse cardiac or
cerebrovascular events in the PCI arm but not in the CABG arm.
<br/>CONCLUSION(S): Ten-year clinical outcomes between PCI and CABG were
not significantly different according to the SS. The SS was predictive of
major adverse cardiac or cerebrovascular events after PCI but not after
CABG. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT03871127.<br/>Copyright &#xa9; 2021 The Authors.

<48>
Accession Number
2013718101
Title
10-Year Results of Mitral Repair and Coronary Bypass for Ischemic
Regurgitation: A Randomized Trial.
Source
Annals of Thoracic Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Fattouch K.; Dioguardi P.; Guccione F.; Nogara A.; Salardino M.;
Sampognaro R.; Bacarella D.; Moscarelli M.
Institution
(Fattouch, Dioguardi, Guccione, Nogara, Salardino, Sampognaro, Bacarella,
Moscarelli) GVM Care & Research, Department of Cardiovascular Surgery,
Maria Eleonora Hospital, Palermo, Italy
(Fattouch, Moscarelli) GVM Care & Research, Department of Cardiovascular
Surgery, Maria Cecilia Hospital, Cotignola, Italy
Publisher
Elsevier Inc.
Abstract
Background: The decision to treat moderate ischemic mitral regurgitation
(IMR) at the time of coronary artery bypass surgery (CABG) remains
controversial. We previously conducted a prospective randomized trial that
showed a benefit of adding restricted annuloplasty to bypass surgery
(CABG-Ring group) in terms of IMR grade, New York Heart Association
classification, and left ventricle reverse remodeling. Here, we present
the long-term (>10 years) follow-up data from this randomized trial.
<br/>Method(s): The original trial arms accounted for 54 patients in the
CABG-alone and 48 in the CABG-Ring group; patients were re-contacted for
follow-up to obtain relevant clinical and echocardiographic information.
<br/>Result(s): The mean follow-up was 160.4 +/- 45.5 months. Survival
probabilities in the CABG-alone and CABG-Ring groups were 96% vs 93% at 3
years, 85% vs 89% at 6 years, 79% vs 85% at 9 years, 77% vs 83% at 12
years, and 72% vs 80% at 15 years, respectively (P = .18) Freedom from at
least moderate IMR or reintervention at last follow-up was also higher in
the CABG-Ring group (P < .001). Compared with the CABG-alone group, the
CABG-Ring group had a higher degree of left ventricular reverse remodeling
(54.7 +/- 6.9 mm vs 51.6 +/- 6 mm, respectively; P = .03), lower New York
Heart Association class (P < .001), and a lower rate of rehospitalization
(P = .002). <br/>Conclusion(s): Long-term follow-up data from our
randomized trial further support the utility of performing restricted
annuloplasty at the time of CABG to prevent further progression of IMR,
mitral reintervention, and left ventricle remodeling. Untreated IMR was
associated with significantly higher New York Heart Association class and
rehospitalization.<br/>Copyright &#xa9; 2021

<49>
Accession Number
2013682337
Title
Prognostic relevance of exercise testing in hypertrophic cardiomyopathy. A
systematic review.
Source
International Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Rodrigues T.; Raposo S.C.; Brito D.; Lopes L.R.
Institution
(Rodrigues, Brito) Cardiology Department, Centro Hospitalar Universitario
Lisboa Norte, Av. Prof. Egas Moniz, Lisboa 1649-028, Portugal
(Rodrigues, Brito, Lopes) CAML, CCUL, Lisbon School of Medicine,
Universidade de Lisboa, Av. Prof. Egas Moniz, Lisboa 1649-028, Portugal
(Raposo) Unidade de Saude Familiar Reynaldo dos Santos, Agrupamento de
Centros de Saude Estuario do Tejo, Administracao Regional de Saude Lisboa
e Vale do Tejo, Portugal
(Raposo) Lisbon School of Medicine, Universidade de Lisboa, Lisboa,
Portugal
(Lopes) Barts Heart Centre, St. Bartholomew's Hospital, London, United
Kingdom
(Lopes) Centre for Heart Muscle Disease, Institute of Cardiovascular
Science, University College London, London, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: Cardiopulmonary exercise test (CPET) is indicated as part of
the assessment in hypertrophic cardiomyopathy (HCM) patients and stress
echocardiography is often used to assess symptoms. However, the role of
exercise testing for prognostic stratification in HCM is still not
established. <br/>Aim(s): To systematically review the evidence on the
role of exercise testing for prognostic stratification in hypertrophic
cardiomyopathy. <br/>Method(s): A systematic review was conducted for
eligible publications, between 2010 and 2020, that included evaluation of
outcomes and prognosis. In these studies, patients underwent exercise
echocardiography and/or cardiopulmonary exercise testing, performed
according to predefined protocols. Diverse parameters were assessed in
order to determine which were relevant for the prognosis. Analyzed
outcomes included death from any cause, sudden cardiac death (SCD) and
equivalents, cardiovascular death, heart failure requiring hospitalization
or progression to New York Heart Association classes III or IV, cardiac
transplantation, non-sustained ventricular tachycardia, stroke, myocardial
infarction and invasive septal reduction therapy. <br/>Result(s): Eighteen
publications were included, corresponding to a total of 7525 patients. The
mean follow-up period varied between 1 and 8 years. The main findings of
these studies revealed that the major predictors of outcomes were abnormal
heart rate recovery, abnormal blood pressure response exercise induced
wall motion abnormalities, lower peak VO2, higher VE/VCO2, and pulmonary
hypertension/exercise-induced pulmonary hypertension. <br/>Conclusion(s):
Although most studies concluded that exercise test results are useful to
determine prognosis in HCM, further investigation is needed regarding
whether it adds independent value to the current risk stratification
strategies.<br/>Copyright &#xa9; 2021 The Author(s)

<50>
Accession Number
2013279605
Title
Comparative clinical efficacy of novel bidirectional cannula in cardiac
surgery via peripheral cannulation for cardiopulmonary bypass.
Source
Perfusion (United Kingdom). (no pagination), 2021. Date of Publication:
2021.
Author
Gunaydin S.; Babaroglu S.; Budak A.B.; Sayin B.; Cayhan V.; Ozisik K.
Institution
(Gunaydin, Babaroglu, Budak, Ozisik) Department of Cardiovascular Surgery,
Ankara City Hospital, University of Health Sciences, Ankara, Turkey
(Sayin, Cayhan) Department of Radiology, Ankara City Hospital, University
of Health Sciences, Ankara, Turkey
Publisher
SAGE Publications Ltd
Abstract
Objectives: The aim of this study is to evaluate the safety and efficacy
of the novel bidirectional cannula that ensures stable distal perfusion
compared to conventional cannula in patients undergoing femoral arterial
cannulation for cardiopulmonary bypass (CPB). <br/>Method(s): During a
1-year period, 64 patients undergoing surgery via peripheral cannulation
were prospectively randomized to receive 19 F bidirectional (BiflowTM,
LivaNova, Italy) or 19 F conventional (HLS Peripheral cannula, Getinge
GroupTM, Germany) cannula with 6 F downstream line (BicakcilarTM, Turkey)
for femoral artery cannulation. The primary outcome included the efficacy
(adequacy of antegrade/retrograde comparative flow via cannula measured by
doppler ultrasonography) and the secondary outcome was the safety
(early/late complications and adverse events). <br/>Result(s): Percent
flow (distal/proximal) after cannulation measured by doppler
ultrasonography was significantly better in study group (33.1 +/- 5
ml/min) versus downstream cannula (16.1 +/- 4, p = 0.012). SpO<inf>2</inf>
measured by near infrared spectroscopy (NIRS) also demonstrated
significantly better saturation in distal calf of the cannulated leg in
bidirectional cannula group (67.5% +/- 10% vs 52.5 +/- 8, p = 0.04). The
incidence of serious adverse events was seroma on femoral region (one
patient), superficial wound infection (one patient), pseudo-hematoma (two
patients) in bidirectional cannula group and in-hospital femoral
embolectomy/artery repair (two patients), superficial wound infection
(three patients), cannulation site hematoma (three patients) in
conventional cannula group. <br/>Conclusion(s): This study demonstrates
that in patients undergoing femoral arterial cannulation for CPB during
cardiac surgery, the use of a novel bidirectional cannula is safe and easy
to insert and provides stable distal perfusion of the cannulated
limb.<br/>Copyright &#xa9; The Author(s) 2021.

<51>
Accession Number
635563068
Title
Effectiveness of endovascular versus open surgical repair for thoracic
aortic aneurysm: a systematic review and meta-analysis.
Source
The Journal of cardiovascular surgery. (no pagination), 2021. Date of
Publication: 08 Jul 2021.
Author
Mahboub-Ahari A.; Sadeghi-Ghyassi F.; Heidari F.
Institution
(Mahboub-Ahari) Tabriz Health Services Management Research Center, School
of Management and Medical Informatics, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Mahboub-Ahari) National Institute of Health Research, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sadeghi-Ghyassi) Research Center for Evidence-Based Medicine: A JBI
Centre of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran,
Islamic Republic of
(Heidari) Research Center for Evidence-Based Medicine: A JBI Centre of
Excellence, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Since the approval, the TEVAR is widely used for the repair
of thoracic aortic aneurysm. However, the long-term mortality and
re-intervention rates compared to OSR are unclear. We aimed to compare the
effectiveness of the thoracic endovascular aortic repair (TEVAR) with open
surgical repair (OSR) specifically for thoracic aortic aneurysms. EVIDENCE
ACQUISITION: We conducted a comprehensive search in MEDLINE, PubMed,
EMBASE, CINAHL, PROSPERO, Centre for Reviews and Dissemination, and the
Cochrane Library up to November 2020. The main outcomes were early
mortality, mid-to-long-term survival, and re-intervention. The quality of
the evidence was assessed using the GRADE methodology. All analyses were
performed using RevMan with the random effect model and Comprehensive
Meta-Analysis software. EVIDENCE SYNTHESIS: One systematic review and 15
individual studies were included. Pooled analysis showed that 30-day
mortality, stroke, renal failure, and pulmonary complications were
significantly lower in TEVAR vs. open surgery. The pooled rate of
re-intervention significantly favored the OSR. The long-term survival and
mortality favored TEVAR and OSR in one and two studies, respectively, but
was non-significant in 7 analyzes. <br/>CONCLUSION(S): Early clinical
outcomes including the 30-day mortality, stroke, renal failure, and
pulmonary complications significantly favored the TEVAR. However, the
mid-to-long-term re-intervention rate favored the OSR and long-term
survival was inconsistent among the studies. The quality of evidence was
very low. More studies with longer follow-ups are needed. The use of TEVAR
should be decided by taking into account other factors including patient
characteristics and preferences, cost, and surgeon expertise.

<52>
Accession Number
610630784
Title
Pulmonary collapse alone provides effective de-airing in cardiac surgery:
A prospective randomized study.
Source
Perfusion (United Kingdom). 31 (4) (pp 320-326), 2016. Date of
Publication: May 2016.
Author
Landenhed M.; Cunha-Goncalves D.; Al-Rashidi F.; Pierre L.; Hoglund P.;
Koul B.
Institution
(Landenhed, Cunha-Goncalves, Al-Rashidi, Pierre, Koul) Department of
Cardiothoracic Surgery, Anesthesia and Intensive Care, Skane University
Hospital, Lund University, Lund SE-221 85, Sweden
(Hoglund) Clinical Research and Competence Center, Skane University
Hospital, Lund University, Lund, Sweden
Publisher
SAGE Publications Ltd
Abstract
Objectives: We previously described and showed that the method for cardiac
de-airing involving: (1) bilateral, induced pulmonary collapse by opening
both pleurae and disconnecting the ventilator before cardioplegic arrest
and (2) gradual pulmonary perfusion and ventilation after cardioplegic
arrest is superior to conventional de-airing methods, including carbon
dioxide insufflation of the open mediastinum. This study investigated
whether one or both components of this method are responsible for the
effective de-airing of the heart. <br/>Method(s): Twenty patients
scheduled for open, left heart surgery were randomized to two de-airing
techniques: (1) open pleurae, collapsed lungs and conventional pulmonary
perfusion and ventilation; and (2) intact pleurae, expanded lungs and
gradual pulmonary perfusion and ventilation. <br/>Result(s): The number of
cerebral microemboli measured by transcranial Doppler sonography was lower
in patients with open pleurae 9 (6-36) vs 65 (36-210), p=0.004. Residual
intra-cardiac air grade I or higher as monitored by transesophageal
echocardiography 4-6 minutes after weaning from cardiopulmonary bypass was
seen in few patients with open pleurae 0 (0%) vs 7 (70%), p=0.002.
<br/>Conclusion(s): Bilateral, induced pulmonary collapse alone is the key
factor for quick and effective de-airing of the heart. Gradual pulmonary
perfusion and ventilation, on the other hand, appears to be less
important.<br/>Copyright &#xa9; 2015 SAGE Publications.

<53>
Accession Number
601626426
Title
Bypass Grafting Versus Percutaneous Intervention in Multivessel Coronary
Disease: the Current State.
Source
Current Cardiology Reports. 17 (2) (pp 1-8), 2015. Date of Publication:
February 2015.
Author
Sipahi I.
Institution
(Sipahi) Department of Cardiology, Acibadem University Medical School,
Acibadem Maslak Hospital, Buyukdere Cad 40, Istanbul 34457, Turkey
(Sipahi) Harrington Heart and Vascular Institute, University Hospitals
Case Medical Center, Case Western Reserve University School of Medicine,
Cleveland, OH, United States
Publisher
Current Medicine Group LLC 1
Abstract
Whether stenting or coronary artery bypass grafting (CABG) is the best
revascularization strategy in patients with multivessel disease has been a
heavily debated controversy. The trials comparing the two methods were
unfortunately underpowered for mortality. Moreover, results of clinical
trials appeared to contradict with each other. Because CABG is
unequivocally a more cumbersome method, stenting became commonly preferred
in the absence of evidence for mortality difference. Meta-analysis is a
powerful tool, especially when several high-quality randomized trials are
available on the same issue. In these instances, meta-analyses can
overcome the power limitation of the individual trials. Our recent
meta-analysis reveals that, as compared to stenting, CABG leads to
unequivocal reductions in mortality and myocardial infarctions in patients
with multivessel disease. These benefits are seen regardless of whether
patients are diabetic or not and also do not depend on whether bare-metal
or drug-eluting stents are used.<br/>Copyright &#xa9; 2015, Springer
Science+Business Media New York.

<54>
Accession Number
52050740
Title
Percutaneous mitral valvuloplasty using echocardiographic intercommissural
diameter as reference for balloon sizing: A randomized controlled trial.
Source
Clinical Cardiology. 35 (12) (pp 749-754), 2012. Date of Publication:
December 2012.
Author
Sanati H.R.; Zahedmehr A.; Shakerian F.; Bakhshandeh H.; Firoozi A.; Kiani
R.; Sadeghpour A.; Asgharnedjad E.; Mikaelpour A.; Nabati M.
Institution
(Sanati, Zahedmehr, Shakerian, Bakhshandeh, Firoozi, Kiani, Asgharnedjad)
Department of Interventional Cardiology, Cardiovascular Intervention
Research Center, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Sadeghpour, Mikaelpour, Nabati) Rajaei Cardiovascular, Medical and
Research Center, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background: Percutaneous balloon mitral valvuloplasty is the preferred
therapeutic strategy in patients with mitral stenosis, but it has
shortcomings in a subset of patients. Hypothesis: A new method of balloon
sizing through echocardiographic measurement of the intercommissural
diameter would be safe and effective and lead to better outcomes.
<br/>Method(s): Eighty-six mitral-stenosis patients were randomly assigned
to undergo balloon mitral valvuloplasty either with height-based balloon
reference sizing (HBRS group, n = 43) or with balloons sized by the
echocardiographic measurement of intercommissural diameter (EBRS group, n
= 43). Postprocedural mitral valve area (MVA) and severity of mitral
regurgitation (MR) were assessed via echocardiography and
ventriculography. Intention-to-treat approach was applied for the
statistical analysis. <br/>Result(s): Baseline characteristics were not
different between the groups. The mean of the estimated balloon reference
sizes was significantly higher in the HBRS patients than in the EBRS group
(26.4 +/- 0.92 mm, 95% confidence interval [CI]: 26.2-26.6 vs 24.5 +/-
1.03 mm, 95% CI: 24.2-24.7, respectively; P = 0.006). Final MVAs were
significantly larger in the EBRS group (1.5 +/- 0.2 cm², 95%
CI: 1.46-1.59 vs 1.4 +/- 0.2 cm², 95% CI: 1.35-1.47,
respectively; P = 0.01). The occurrence of new or aggravated MR was
significantly lower in the EBRS group as assessed both by echocardiography
(P = 0.04) and ventriculography (P = 0.05). Mitral regurgitation was
aggravated in 13 (29.3%) patients in the HBRS group and in 5 (11.5%)
patients in the EBRS group. <br/>Conclusion(s): Percutaneous balloon
mitral valvuloplasty via the Inoue technique using balloons sized by the
echocardiographic measurement of the maximal commissural diameter is an
effective and safe method that might lead to an acceptable increase in the
MVA and significant decrease in the rate and severity of iatrogenic MR.
&#xa9; 2012 Wiley Periodicals, Inc.

<55>
Accession Number
2010889929
Title
Endovascular Aneurysm Repair with Bifurcated Stent Grafts in Patients with
Narrow Versus Regular Aortic Bifurcation: Systematic Review and
Meta-analysis of Comparative Studies.
Source
Annals of Vascular Surgery. 73 (pp 385-396), 2021. Date of Publication:
May 2021.
Author
Galanakis N.; Kontopodis N.; Charalambous S.; Palioudakis S.; Kakisis I.;
Geroulakos G.; Tsetis D.; Ioannou C.V.
Institution
(Galanakis, Charalambous, Tsetis) Interventional Radiology Unit,
Department of Medical Imaging, University of Crete, Medical School,
Heraklion, Crete, Greece, Greece
(Kontopodis, Ioannou) Vascular Surgery Unit, Department of Cardiothoracic
and Vascular Surgery, University of Crete, Medical School, Heraklion,
Crete, Greece, Greece
(Palioudakis) Thoracic Surgery Unit, Department of Cardiothoracic and
Vascular Surgery, University of Crete, Medical School, Heraklion, Crete,
Greece, Greece
(Kakisis, Geroulakos) Department of Vascular Surgery, "Attikon" University
Hospital, National and Kapodistrian University of Athens, Athens, Greece
Publisher
Elsevier Inc.
Abstract
Background: Narrow aortic bifurcation (NAB) is considered as a risk factor
for endograft limb thrombosis. The purpose of the study was to investigate
the effect of narrow aortic bifurcation on outcomes of elective
endovascular aneurysm repair (EVAR). <br/>Method(s): A systematic review
that conformed to the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines was performed. We searched electronic
bibliographic databases using a combination of controlled vocabulary
(thesaurus) and free-text terms to identify relevant studies comparing
outcomes of EVAR in patients with NAB versus those with regular aortic
bifurcation. Pooled estimates of dichotomous outcomes were calculated
using odds ratio (OR) and those of continuous outcomes using mean
difference and 95% confidence interval (CI). To account for expected
heterogeneity, the random-effects model was applied for statistical
analysis. <br/>Result(s): Six observational studies were included,
reporting a total of 2,673 patients (412 with NAR and 2,261 with friendly
anatomy). Perioperative mortality was similar between the groups (OR 1.14,
95% CI 0.30-4.34, P = 0.85, I² = 0%). Limb stenosis and kinking
requiring additional intraoperative procedures was significantly more
common among patients with NAB (OR 3.02, 95% CI 2.16-4.22, P < 0.00001,
I² = 0%). Nevertheless, 30-day reintervention rate was similar
between the groups, as was the rate of limb occlusion during follow-up.
<br/>Conclusion(s): Available evidence suggests that at the expense of
significantly more intraoperative additional procedures, EVAR with
bifurcated devices can be safely performed in patients with
NAB.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<56>
Accession Number
2008476891
Title
Clinical Outcomes of the Self-Expandable Evolut R Valve Versus the
Balloon-Expandable SAPIEN 3 Valve in Transcatheter Aortic Valve
Implantation: A Meta-Analysis and Systematic Review.
Source
Cardiovascular Revascularization Medicine. 25 (pp 57-62), 2021. Date of
Publication: April 2021.
Author
Al-abcha A.; Saleh Y.; Charles L.; Prasad R.; Baloch Z.Q.; Hasan M.A.;
Abela G.S.
Institution
(Al-abcha, Charles, Prasad) Department of Internal Medicine, Michigan
State University, East Lansing, MI, United States
(Saleh) Department of Cardiology, Houston Methodist Hospital, Houston, TX,
United States
(Baloch, Abela) Department of Internal Medicine, Division of Cardiology,
Michigan State University, East Lansing, MI, United States
(Hasan) Department of Cardiology, Ochsner Clinic, New Orleans, LA, United
States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is now indicated
in patients with symptomatic aortic stenosis and low, moderate, and high
surgical risk. There are multiple types of valves available in TAVR.
SAPIEN 3, and Evolut R are two of the most commonly used valves.
<br/>Method(s): We conducted a systematic review and meta-analysis of all
studies that compared SAPIEN 3 vs Evolut R in patients undergoing TAVR.
The primary endpoint of this meta-analysis was 30-day mortality. Secondary
outcomes included major of life-threatening bleeding, risk of stroke, need
of permanent pacemaker implantation, and risk of moderate to severe
paravalvular regurgitation (PVR). <br/>Result(s): We included a total of 9
studies. One study was a randomized clinical trial, five were prospective
observational studies and three were retrospective. 30-day mortality rate
was similar between SAPIEN 3 and Evolut R (odds ratio (OR) 1.19; 95%
confidence interval (CI) 0.72 to 1.93; p = 0.47). The risk of major or
life-threatening bleeding (OR of 0.83, 95% CI 0.50 to 1.39; p = 0.48), and
the risk of stroke (OR of 0.82, 95% CI 0.38 to 1.78; p = 0.62) were also
similar between the two types of valves. Compared to SAPIEN 3, Evolut R
was associated with statistically significant risk of permanent pacemaker
implantation (OR of 1.40, 95% CI 1.15 to 1.70; p = 0.0007), and moderate
to severe PVR (OR of 2.56, 95% CI 1.14 to 5.74; p = 0.02).
<br/>Conclusion(s): At 30 day follow up, both Evolut R and SAPIEN 3 shared
similar risks of 30-day mortality, major or life-threatening bleeding, and
stroke; however greater odds of pacemaker placement implantation and
moderate to severe PVR were associated with Evolut R.<br/>Copyright &#xa9;
2020 Elsevier Inc.

<57>
Accession Number
2013151631
Title
Simultaneous Left Ventricular Aneurysm and Ventricular Septal Rupture
Complicating Delayed STEMI Presentation: A Case-Based Review of Post-MI
Mechanical Complications Amid the COVID-19 Pandemic.
Source
Journal of Investigative Medicine High Impact Case Reports. 9 (no
pagination), 2021. Date of Publication: 2021.
Author
Goraya M.H.N.; Kalsoom S.; Almas T.; Amin M.K.; Hussain N.; Awan J.R.;
Ehtesham M.; Niaz M.A.; Virk H.U.H.; Filby S.J.
Institution
(Goraya) Services Institute of Medical Sciences, Lahore, Pakistan
(Kalsoom) Conemaugh Memorial Medical Center, Johnstown, PA, United States
(Almas, Ehtesham, Niaz) Royal College of Surgeons in Ireland, Dublin,
Ireland
(Amin) Texas Tech University Health Sciences Center, Amarillo, TX, United
States
(Hussain) Banner-University Medical Center, Tucson, AZ, United States
(Awan) University Hospital Limerick, Limerick, Ireland
(Virk, Filby) University Hospitals Cleveland Medical Center, Cleveland,
OH, United States
Publisher
SAGE Publications Ltd
Abstract
Amid the coronavirus disease 2019 (COVID-19) pandemic, there is an
unprecedented increase in public avoidance of hospitals predominantly
driven by fear of contracting the virus. Recent publications highlight a
re-emergence of rare post-myocardial infarction complications. While
mechanical complications are infrequent in the era of primary percutaneous
coronary intervention, they are associated with high mortality rates. The
concurrent occurrence of mechanical complications such as left ventricular
aneurysm and ventricular septal rupture is an extremely rare entity. We
hereby delineate a unique case of a 53-year-old Caucasian male who
underwent successful concomitant closure of a ventricular septal rupture,
left ventricular aneurysmectomy, and 3-vessel coronary artery bypass
grafting. Due to a delayed initial presentation owing to the patient's
fear of contracting COVID-19, the surgery was carried out 3 months after
the myocardial infarction. His postoperative evaluation confirmed normal
contractility of the left ventricle and complete closure of the
ventricular septal rupture. Six months postoperatively, the patient
continues to do well. We also present a literature review of the
mechanical complications following delayed presentation of myocardial
infarction amid the COVID-19 pandemic. This article illustrates that
clinicians should remain cognizant of these extremely rare but potentially
lethal collateral effects during the ongoing global public-health
challenge. Furthermore, it highlights a significant concern regarding the
delay in first medical contact due to the reluctance of patients to visit
the hospital during the COVID-19 pandemic.<br/>Copyright &#xa9; 2021
American Federation for Medical Research.

<58>
Accession Number
2011657114
Title
Colchicine for Secondary Prevention of Cardiovascular Disease: A
Systematic Review and Meta-analysis of Randomized Controlled Trials.
Source
Canadian Journal of Cardiology. 37 (5) (pp 776-785), 2021. Date of
Publication: May 2021.
Author
Samuel M.; Tardif J.-C.; Bouabdallaoui N.; Khairy P.; Dube M.-P.; Blondeau
L.; Guertin M.-C.
Institution
(Samuel, Tardif, Bouabdallaoui, Khairy, Dube) Montreal Heart Institute,
Universite de Montreal, Montreal, Quebec, Canada
(Blondeau, Guertin) Montreal Health Innovations Coordinating Center,
Montreal, Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Background: Reduction of inflammation with colchicine has emerged as a
therapeutic option for secondary prevention of cardiovascular disease
(CVD) in patients with coronary artery disease (CAD). Our objective was to
consolidate evidence from randomized controlled trials (RCTs) evaluating
the efficacy and safety of low-dose colchicine for secondary prevention of
CVD among patients with CAD on standard medical therapy. <br/>Method(s):
RCTs comparing the incidence of cardiovascular (CV) events between
patients with clinically manifest CAD randomized to colchicine vs placebo
(or no colchicine) were included. The primary composite efficacy endpoint
included CV mortality, myocardial infarction (MI), ischemic stroke, and
urgent coronary revascularization. The DerSimonian and Laird
random-effects model was used to calculate pooled hazard ratios (HRs) and
95% confidence intervals (CIs). <br/>Result(s): Four RCTs, with a pooled
sample size of 11,594 patients, were included (colchicine n = 5774;
placebo/no colchicine n = 5820). Included RCTs studied populations with
stable CAD (N = 2) and acute coronary syndrome (N = 2). Compared with
placebo or no colchicine, colchicine was associated with a statistically
significant reduction in the incidence of the primary composite endpoint
(pooled HR, 0.68; 95% CI, 0.54-0.81; I² = 37.7%). The reduction
in CV events among patients randomized to colchicine was driven by
statistically significant reductions in MIs, ischemic strokes, and urgent
coronary revascularizations (P < 0.05 for all) and was relatively
consistent among subgroups. The incidence of safety outcomes did not
differ between groups (P > 0.05). <br/>Conclusion(s): In secondary
prevention of CV events, the addition of low-dose colchicine to standard
medical therapy reduces the incidence of major CV events-except CV
mortality-when compared with standard medical therapy alone.<br/>Copyright
&#xa9; 2020 Canadian Cardiovascular Society

<59>
Accession Number
2011053267
Title
Virtual reality-assisted conscious sedation during transcatheter aortic
valve implantation: A randomised pilot study.
Source
EuroIntervention. 16 (12) (pp E1014-E1020), 2020. Date of Publication:
2020.
Author
Bruno R.R.; Lin Y.; Wolff G.; Polzin A.; Veulemans V.; Klein K.;
Westenfeld R.; Zeus T.; Kelm M.; Jung C.
Institution
(Bruno, Lin, Wolff, Polzin, Veulemans, Klein, Westenfeld, Zeus, Kelm,
Jung) Division of Cardiology Pulmonology and Vascular Medicine, Medical
Faculty, University Hospital Dusseldorf, Dusseldorf, Germany
(Kelm) Cardiovascular Research Institute Dusseldorf (CARID), Dusseldorf,
Germany
Publisher
Europa Group
Abstract
Aims: Virtual reality (VR) has been used successfully in different
clinical settings to treat anxiety. This prospective, randomised pilot
study aimed to investigate the feasibility and safety of VR in patients
undergoing conscious sedation during transfemoral transcatheter aortic
valve implantation (TAVI). <br/>Methods and Results: Thirty-two patients
were included and randomised to VR intervention (n=16) or control (n=16).
In the intervention group, patient-selected relaxing 3D videos were
projected during the TAVI procedure; pain and anxiety before and after
TAVI were measured using visual analogue scales (VAS; 0-10). The median
age was 83 years (IQR 78.25-87). Patients' baseline characteristics did
not differ significantly between the groups. During TAVI under conscious
sedation, the median duration of VR intervention was 30.5 minutes (IQR
23.5-46); 81.3% of the patients watched the videos until device
implantation, 37.5% during the whole procedure. The VR intervention group
reported significantly less anxiety after the procedure (VAS 2 [IQR
0-3.75] vs 5 [IQR 2-8], p=0.04) than patients randomised to control. In
the intervention group, 93.8% would use VR during TAVI again. Nausea and
vomiting did not occur more frequently compared to control.
<br/>Conclusion(s): VR interventions during TAVI to assist conscious
sedation are safe and feasible, even in very old and frail patients. In
this small cohort, there was a significant reduction in periprocedural
anxiety.<br/>Copyright &#xa9; Europa Digital & Publishing 2020.

<60>
Accession Number
2013403946
Title
Activation of the innate immune response and organ injury after cardiac
surgery: a systematic review and meta-analysis of randomised trials and
analysis of individual patient data from randomised and non-randomised
studies.
Source
British Journal of Anaesthesia. (no pagination), 2021. Date of
Publication: 2021.
Author
Abbasciano R.G.; Lai F.Y.; Roman M.A.; Rizzello A.; Pathak S.; Ramzi J.;
Lucarelli C.; Layton G.R.; Kumar T.; Wozniak M.J.; Eagle-Hemming B.;
Akowuah E.; Rogers C.A.; Angelini G.D.; Murphy G.J.
Institution
(Abbasciano, Lai, Roman, Rizzello, Pathak, Kumar, Wozniak, Eagle-Hemming,
Murphy) Department of Cardiovascular Sciences, University of Leicester,
Leicester, United Kingdom
(Ramzi) Leicester Medical School, University of Leicester, Leicester,
United Kingdom
(Lucarelli) Department of Cardiac Surgery, University of Verona, Verona,
Italy
(Layton) University Hospitals of Leicester NHS Trust, Leicester, United
Kingdom
(Akowuah) South Tees Hospitals NHS Foundation Trust, Middlesbrough, United
Kingdom
(Rogers) Clinical Trials and Evaluation Unit, Bristol Trials Centre,
University of Bristol, Bristol, UK, United Kingdom
(Angelini) Bristol Heart Institute, University of Bristol, Bristol, UK,
United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: It is unclear whether the innate immune response represents a
therapeutic target for organ protection strategies in cardiac surgery.
<br/>Method(s): A systematic review of trials of interventions targeting
the inflammatory response to cardiac surgery reporting treatment effects
on both innate immune system cytokines and organ injury was performed. The
protocol was registered at the International Prospective Register of
Systematic Reviews: CRD42020187239. Searches of the Cochrane Central
Register of Controlled Trials, MEDLINE, and Embase were performed.
Random-effects meta-analyses were used for the primary analysis. A
separate analysis of individual patient data from six studies (n=785)
explored sources of heterogeneity for treatment effects on cytokine
levels. <br/>Result(s): Searches to May 2020 identified 251 trials
evaluating 24 interventions with 20 582 participants for inclusion. Most
trials had important limitations. Methodological limitations of the
included trials and heterogeneity of the treatment effects on cytokine
levels between trials limited interpretation. The primary analysis
demonstrated inconsistency in the direction of the treatment effects on
innate immunity and organ failure or death between interventions. Analyses
restricted to important subgroups or trials with fewer limitations showed
similar results. Meta-regression, pooling available data from all trials,
demonstrated no association between the direction of the treatment effects
on inflammatory cytokines and organ injury or death. The analysis of
individual patient data demonstrated heterogeneity in the association
between the cytokine response and organ injury after cardiac surgery for
people >75 yr old and those with some chronic diseases.
<br/>Conclusion(s): The certainty of the evidence for a causal
relationship between innate immune system activation and organ injury
after cardiac surgery is low.<br/>Copyright &#xa9; 2021 British Journal of
Anaesthesia

<61>
Accession Number
2011452014
Title
Atrial Fibrillation and Outcomes After Transcatheter or Surgical Aortic
Valve Replacement (from the PARTNER 3 Trial).
Source
American Journal of Cardiology. 148 (pp 116-123), 2021. Date of
Publication: 01 Jun 2021.
Author
Shahim B.; Malaisrie S.C.; George I.; Thourani V.H.; Biviano A.B.; Russo
M.J.; Brown D.L.; Babaliaros V.; Guyton R.A.; Kodali S.K.; Nazif T.M.;
McCabe J.M.; Williams M.R.; Genereux P.; Lu M.; Yu X.; Alu M.C.; Webb
J.G.; Mack M.J.; Leon M.B.; Kosmidou I.
Institution
(Shahim, Alu, Leon, Kosmidou) Cardiovascular Research Foundation, New
York, NY, United States
(Malaisrie) Division of Cardiac Surgery, Northwestern University, Chicago,
IL, United States
(George, Biviano, Kodali, Nazif, Alu, Leon, Kosmidou) NewYork-Presbyterian
Hospital/Columbia University Irving Medical Center, New York, NY, United
States
(Thourani) Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta,
Georgia, United States
(Russo) Division of Cardiac Surgery, Rutgers-Robert Wood Johnson Medical
School, New Brunswick, NJ, United States
(Brown, Mack) Baylor Scott & White Health, Plano, TX, United States
(Babaliaros, Guyton) Emory University Medical Center, Atlanta, Georgia,
United States
(McCabe) University of Washington, Seattle, WA, United States
(Williams) NYU Langone, New York, NY, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Lu, Yu) Edwards Lifesciences, Irvine, CA, United States
(Webb) St. Paul's Hospital, Vancouver, BC, Canada
Publisher
Elsevier Inc.
Abstract
The prognostic impact of preexisting atrial fibrillation or flutter (AF)
in low-risk patients with severe aortic stenosis treated with
transcatheter (TAVR) or surgical aortic valve replacement (SAVR) remains
unknown. In this sub-analysis of the PARTNER 3 trial of patients with
severe aortic stenosis at low surgical risk randomized 1:1 to TAVR versus
SAVR, clinical outcomes were analyzed at 2 years according to AF status.
Among 948 patients included in the analysis (452 [47.7%] in the SAVR vs
496 [52.3%] in the TAVR arm), 168 (17.6%) patients had AF [88/452 (19.5%)
and 80/496 (16.1%) treated with SAVR and TAVR, respectively]. At 2 years,
patients with AF had higher unadjusted rates of the composite outcome of
death, stroke or rehospitalization (21.2% vs 12.9%, p = 0.007) and
rehospitalization alone (15.3% vs 9.4%, p = 0.03) but not all cause death
(3.8% vs 2.6%, p = 0.45) or stroke (4.8% vs 2.6%, p = 0.12). In adjusted
analyses, patients with AF had a higher risk for the composite outcome of
death, stroke or rehospitalization (hazard ratio [HR] 1.80, 95% confidence
interval [CI] 1.20-2.71, p = 0.0046) and rehospitalization alone (HR 1.8,
95% CI 0.12-2.9, p = 0.015), but not death or stroke. There was no
interaction between treatment modality and AF on the composite outcome
(Pinter = 0.83). In conclusion, preexisting AF in patients with severe AS
at low surgical risk was associated with increased risk of the composite
outcome of death, stroke or rehospitalization at 2 years, irrespective of
treatment modality.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<62>
[Use Link to view the full text]
Accession Number
632690573
Title
Percutaneous Coronary Intervention Compared with Coronary Artery Bypass
Graft Surgery for Patients With 3-vessel Disease: A Preferred Reporting
Items for Systematic Reviews and Meta-Analyses-compliant Systematic Review
and Meta-analysis.
Source
Journal of cardiovascular pharmacology. 76 (5) (pp 527-532), 2020. Date of
Publication: 01 Nov 2020.
Author
Zhao H.; Zhang D.
Institution
(Zhao) The Affiliated Hospital of Shandong University of Traditional
Chinese Medicine, Shandong, China; and
(Zhang) Department of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing, China
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Previous investigations showed inconsistent results for
comparison in clinical outcomes between patients with 3-vessel disease
(3VD) treated with percutaneous coronary intervention (PCI) and coronary
artery bypass graft (CABG) surgery. A systematic review and meta-analysis
is essential to compare the clinical outcomes of PCI with CABG surgery for
patients with 3VD. <br/>METHOD(S): We systematically searched on PubMed
and Web of Science for articles which compared PCI with CABG for patients
with 3VD and published from January 1989 to January 2020. We computed the
hazard ratios (HRs) and 95% confidence intervals (CIs) for individual
clinical outcomes. <br/>RESULT(S): This study indicated that the PCI group
was associated with a 1.51-fold higher risk of all-cause mortality
compared with the CABG group in patients with 3VD (HR 1.51, 95% CI
1.38-1.65). In addition, the PCI group showed a 3.08-fold and 2.94-fold
higher risk compared with the CABG group in risks of myocardial infarction
(MI) and target-vessel revascularization (TVR), respectively (MI: HR 3.08,
95% CI 2.61-3.63; TVR: HR 2.94, 95% CI 1.94-4.46). <br/>CONCLUSION(S): In
conclusion, in patients with 3VD, PCI was consistently associated with
higher rates of all-cause mortality, MI, and TVR, compared with CABG.

<63>
Accession Number
2013687921
Title
B-PO02-047 HIS-BUNDLE PACING FOLLOWING PROSTHETIC AORTIC VALVE
REPLACEMENT.
Source
Heart Rhythm. Conference: Heart Rhythm 2021. Boston United States. 18 (8
Supplement) (pp S114-S115), 2021. Date of Publication: August 2021.
Author
Garg J.; Bharat Shah K.; Turagam M.K.; Natale A.; Lakkireddy D.R.
Publisher
Elsevier B.V.
Abstract
Background: His-bundle pacing (HBP) has emerged as a potential alternative
to conventional RV apical pacing; with a potential to reduce
electromechanical dyssynchrony. <br/>Objective(s): We aimed to assess
feasibility and safety of permanent HBP in patients following prosthetic
aortic valve replacement (surgical or transcatheter). <br/>Method(s): A
systematic search, using PubMed, EMBASE, SCOPUS, Google Scholar, and
ClinicalTrials.gov from inception to January 4^th, 2021, was
performed. HBP was performed using the Select Secure (3830; Medtronic)
pacing lead, delivered through a fixed curve or deflectable sheath
(C315HIS/C304; Medtronic). Outcomes studied were - (1) implant success;
(2) Post-procedure paced QRS duration; (3) HBP threshold at follow-up; (4)
procedure related complications. <br/>Result(s): Seventy-two patients (age
80.8+/-7.5 years; female 53%, left ventricular ejection fraction
52.8+/-11.3%, left bundle branch block=73%) underwent HBP. HBP was
successful in 82.7% patients (95% CI 56.1-99.1). QRS duration narrowed
significantly from 141.8+/-25.1 to 120.0+/-12.1 msec (p<0.001). Mean
threshold post-implantation was 1.41+/-1.04 V at 1.0 ms, which remained
stable at 1.43+/-1.1 V at 1.0 ms during mean follow up of 8.6+/-8 months
(P=0.91). When compared with baseline, there was no significant change in
lead impedance and R-wave sensing on follow up. Lead revision was
performed in 1.8% (n=2) of patients due to high pacing thresholds at 3
months follow-up. There were no other major adverse events.
<br/>Conclusion(s): Permanent HBP is feasible in majority of patients
requiring pacemaker following prosthetic aortic valve implantation, with
stable pacing threshold and QRS normalization on mid-term follow up.
[Formula presented]<br/>Copyright &#xa9; 2021

<64>
Accession Number
2013687572
Title
B-PO03-157 PROPHYLACTIC LEFT ATRIAL APPENDAGE EXCLUSION IN PATIENTS
UNDERGOING CARDIAC SURGERY: RESULTS OF PROSPECTIVE, MULTICENTER,
RANDOMIZED ATLAS TRIAL.
Source
Heart Rhythm. Conference: Heart Rhythm 2021. Boston United States. 18 (8
Supplement) (pp S253), 2021. Date of Publication: August 2021.
Author
Gerdisch M.W.; Edward Garrett H.; Mumtaz M.; Grehan J.; Castillo-Sang M.;
Miller J.; Zorn G.; Gall S.; Johnkoski J.; Ramlawi B.
Publisher
Elsevier B.V.
Abstract
Background: Post-operative atrial fibrillation (POAF) occurs in 30-40% of
cardiac surgery (CS) patients (pts). Routine care for managing POAF is
variable. Oral anticoagulation (OAC) may be prescribed to prevent
thromboembolic events (TEs) but has a bleeding risk. Since the left atrial
appendage (LAA) is the primary site of thrombus formation with AF,
prophylactic LAA exclusion (LAAE) during CS may mitigate TE risk.
<br/>Objective(s): The ATLAS prospective, randomized, multi-center,
feasibility trial evaluated TE and major bleeding rates with and without
LAAE in CS pts who developed POAF. <br/>Method(s): Pts without
pre-existing AF, HAS-BLED>=2, CHA<inf>2</inf>DS<inf>2</inf>-VASc>=2,
undergoing valvular or CABG surgery were randomized 2:1 to concomitant
LAAE (epicardial clip) or No LAAE. OAC was per centers' routine care. POAF
pts were followed for 1 yr. <br/>Result(s): 23 sites enrolled 562 pts (376
LAAE, 186 No LAAE). Baseline parameters were similar in LAAE Vs No LAAE
arms: age 69.2 Vs 68.9 yrs, HAS-BLED: 2.8 Vs. 2.9,
CHA<inf>2</inf>DS<inf>2</inf>-VASc: 3.4 Vs 3.4. LAAE was successful in
99%, procedural SAE rate was 0.3%. No LAAE-related renal failures were
reported. Mortality was similar between arms at 30 days and 1 yr (p=0.35,
p=0.36). POAF developed in 47.3% (178) of LAAE and 38.2% (71) of No LAAE
pts (p=0.047). OAC was used in 31% of LAAE Vs. 35% of No LAAE. Through 1
yr, LAAE resulted in 51% reduction in TEs Vs. No LAAE (p=0.40). Bleeding
rate on OACs was 23% Vs. 5.4% without OACs (p=0.005) and was similar for
both in LAAE and No LAAE groups. <br/>Conclusion(s): Prophylactic LAAE in
high-risk CS pts trended towards reduced TE Vs. No LAAE. OAC use increased
bleeding risk. Adequately powered RCTs of prophylactic LAAE during CS
should be planned. [Formula presented]<br/>Copyright &#xa9; 2021

<65>
Accession Number
2013687506
Title
B-AB11-04 ASSOCIATION BETWEEN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR AND
SURVIVAL IN PATIENTS AWAITING HEART TRANSPLANTATION: A META-ANALYSIS AND
SYSTEMATIC REVIEW.
Source
Heart Rhythm. Conference: Heart Rhythm 2021. Boston United States. 18 (8
Supplement) (pp S21-S22), 2021. Date of Publication: August 2021.
Author
Lin A.; Duran J.; Urey M.; Hsu J.C.; Adler E.; Birgersdotter-Green U.M.
Publisher
Elsevier B.V.
Abstract
Background: Patients with end-stage heart failure (HF) are at high risk of
sudden cardiac death. However, implantable cardioverter-defibrillator
(ICD) is not routinely recommended given the high competing risk of pump
failure. A unique population worth separate consideration are patients
with end-stage HF awaiting heart transplantation (HT) as prolonged
survival improves the chances of receiving HT given the long wait times.
<br/>Objective(s): To evaluate the association between presence of ICD and
survival in patients with end stage heart failure awaiting HT.
<br/>Method(s): We performed an extensive literature search and systematic
review of studies that compared HF patients with and without an ICD
awaiting heart transplantation. We separately assessed the rates of total
mortality, sudden cardiac death (SCD), non-SCD, and HT. Risk ratio (RR)
95% confidence intervals were measured using the Mantel-Haenszel method.
The random effects model was used due to heterogeneity across study
cohorts. <br/>Result(s): Ten studies with a total of 36,205 patients were
included. 62% of patients had ICD implanted. Patients with an ICD had
decreased total mortality (9.7% vs 17.1%, RR 0.62, 95% CI 0.52 - 0.73, p <
0.0001), SCD (1.0% vs 10.1%, RR 0.27, 95% CI 0.12 - 0.59, p = 0.001), and
increased rates of heart transplantation (64.4% vs 58.9%, RR 1.10, 95% CI
1.05 - 1.15, p < 0.0001). There was no difference in prevalence of non-SCD
(16.5% vs 16.9%, RR 0.76, 95% CI 0.51 - 1.13, p = 0.17).
<br/>Conclusion(s): ICD implantation in HF patients awaiting HT is
associated with improved outcomes, characterized by lower total mortality
and SCD in addition to higher rates of HT. [Formula
presented]<br/>Copyright &#xa9; 2021

<66>
Accession Number
2010921774
Title
Dosimetric comparison of neoadjuvant proton beam therapy vs VMAT in distal
oesophageal cancer.
Source
Radiotherapy and Oncology. Conference: ESTRO 2020. Vienna Austria. 152
(Supplement 1) (pp S789-S790), 2020. Date of Publication: November 2020.
Author
Nicholas O.; Selby A.; Lambert J.; Hugtenburg R.; Gwynne S.H.
Institution
(Nicholas) Swansea University, Swansea University Medical School, Swansea,
United Kingdom
(Selby) Swansea Bay University Health Board, Department of Physics- South
West Wales Cancer Centre, Swansea, United Kingdom
(Lambert) Rutherford Cancer Centres, Department of Physics, Newport,
United Kingdom
(Hugtenburg) Swansea University, Department of Medical Physics, Swansea,
United Kingdom
(Gwynne) Swansea Bay University Health Board, South West Wales Cancer
Centre, Swansea, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Purpose or Objective Despite established survival benefit, use of
neoadjuvant chemoradiotherapy (NACRT) for oesophageal cancer remains low
in the UK due in part to concerns of postoperative pulmonary and cardiac
toxicities. Pencil beam scanning proton beam therapy (PBS) has the
potential to reduce dose to lung and heart, therefore reduce these
toxicities. NeoSCOPE is a UK phase II randomized control trial of two
NACRT regimens in oesophageal cancer that undertook a rigorous RTTQA
programme. We undertook a planning comparison study of robustly planned
PBS vs VMAT using cases and treatment planning parameters from the
NeoSCOPE trial to establish any potential reductions in lung and heart
dose that may reduce the incidence of postoperative pulmonary and cardiac
toxicities. Material and Methods We created PBS and VMAT plans for four
datasets from NeoSCOPE that had 4DCT-generated ITVs. PBS plans were
robustly optimised on ITV (95% coverage) using 5mm setup uncertainty and
3.5% range uncertainty. Gantry angles of 135degree, 180degree and
225degree were used. Second-to-worst ITV coverage were reported. VMAT was
optimised to PTV (ITV+5mm margin) with all plans using one full 360degree
arc. Both plans were optimised using treatment parameters from the
NeoSCOPE trial to a dose of 45Gy/25#. Additionally, we reported dose to V5
lung and V40 heart. Treatment planning and dose analysis were done on
Pinnacle (Phillips, v14 (PBS) and v16 (VMAT)). Results Table Presented
Figure Presented Image 1: Typical beam arrangement used (135degree,
180degree and 225degree) Conclusion We selected a three beam arrangement
rather than two to improve plan robustness to breathing motion and to
reduce the effect of anatomical changes along any one beam path at the
expense of greater lung dose. Despite this, PBS still showed significant
dosimetric advantage in most parameters with acceptable coverage of ITV.
Lung V5 is shown to be an independent dosimetric factor in multivariate
analysis in reducing the incidence of postoperative pulmonary
complications. This study shows lung V5 reduction of over 50% in all 4
cases. Similiarly, both DVH parameters (V40, V25) for heart dose showed a
significant reduction which may lower the incidence of post-operative
cardiac toxicity. Further considerations will be required during treatment
delivery to account for intra/interfraction tumour motion, breathing
motion and interplay effects. This study indicates that delivering NACRT
with PBS for oesophageal cancer may lead to a meaningful reduction in
post-op pulmonary and cardiac toxicity. However, there remains a paucity
of published clinical data for PBS in this setting. We recommend that
NACRT with PBS for distal oesophageal cancer is tested prospectively in a
randomised controlled trial.<br/>Copyright &#xa9; 2020 Elsevier Ireland
Ltd

<67>
Accession Number
635550224
Title
Is airway pressure release ventilation, a better primary mode of
post-operative ventilation for adult patients undergoing open heart
surgery? A prospective randomised study.
Source
Annals of Cardiac Anaesthesia. 24 (3) (pp 288-293), 2021. Date of
Publication: July-September 2021.
Author
Manjunath V.; Reddy B.; Prasad S.
Institution
(Manjunath, Reddy, Prasad) Department of Cardiac Anaesthesia, Sri Jayadeva
Institute of Cardiovascular Sciences and Research, Karnataka, Bangalore,
India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Context: Cardiopulmonary bypass (CPB) induced acute lung injury is
accounted for most of the post-operative pulmonary dysfunction which leads
to decreased compliance and hypoxemia. Airway Pressure Release Ventilation
(APRV) as compared to other modes of ventilation has shown to improve gas
exchange in Acute lung injury (ALI)/Acute respiratory distress syndrome
(ARDS) lungs. <br/>Aim(s): We hypothesized APRV as a better primary mode
of postoperative ventilation in adult post-cardiac surgery patients.
Methodology: The study included 90 postoperative surgical patients, which
were randomized into three groups: SIMV-PC(P), APRV(A), and SIMV-VC(V)
with 30 patients in each group. Subjects and Methods: Lung compliance and
serial arterial blood gas were assessed at regular intervals.
PaO<inf>2</inf>/FiO<inf>2</inf>ratio (a measure of oxygenation) and lung
compliance were used as an indirect indicator for improvement in lung
function. Hemodynamic parameters were closely observed for all the
patients. Statistical Analysis Used: Statistical analysis was done using
'R' software. <br/>Result(s): There was a statistically significant
improvement in PaO2/FiO2 ratio in the APRV group as compared to other
groups. There was also an improvement in lung compliance after 6 h of
ventilation and lesser duration of ventilation in the APRV group. However,
it was not statistically significant. <br/>Conclusion(s): Our study
suggests that APRV can be a useful alternative primary mode of ventilation
to improve lung compliance and oxygenation in adult post-cardiac surgical
patients.<br/>Copyright &#xa9; 2021 Wolters Kluwer Medknow Publications.
All rights reserved.

<68>
Accession Number
635550297
Title
A prospective study on use of thrive (transnasal humidified rapid
insufflation ventilatory exchange) versus conventional nasal oxygenation
following extubation of adult cardiac surgical patients.
Source
Annals of Cardiac Anaesthesia. 24 (3) (pp 353-357), 2021. Date of
Publication: July-September 2021.
Author
Burra V.; Putta G.; Prasad S.; Manjunath V.
Institution
(Burra) Department of Cardiac Anesthesia, SRM Institute of Medical
Sciences, Chennai, India
(Putta) Department of Anesthesia, Apollo Institute of Medical Sciences and
Research, Andhra Pradesh, Chittor, India
(Prasad, Manjunath) Department of Anesthesia, Sri Jayadeva Institute of
Cardiovascular Sciences and Research, Karnataka, Bangalore, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Postoperative pulmonary complications in cardiac surgery
increase mortality and morbidity. High flow nasal cannula oxygen therapy
(HFNC) is one of the preventive measures to reduce the incidence of lung
complications. HFNC can decrease dyspnea and improve physiologic
parameters after extubation, including respiratory rate and heart rate,
compared with conventional oxygen therapy. In this study, we evaluated the
role of THRIVE (Transnasal Humidified Rapid Insufflation Ventilatory
Exchange) after extubation. Methodology: We prospectively randomized 60
adults aged between 18 and 65 years undergoing elective cardiac surgery to
either High flow oxygen therapy using THRIVE (Group A) or conventional
nasal cannula (group B). Arterial paO2, paCO2, pH at three points of time
i.e., 1, 2, 4 hrs after extubation were evaluated using arterial blood gas
analysis. Ventilation duration, the incidence of reintubation, sedation
score, mortality, and other complications were also assessed.
<br/>Result(s): Thirty adults in each group had comparable patient
characteristics. There was a statistically significant decline in
paCO<inf>2</inf>in group A at 1, 2, 4 hrs post extubation (P = 0.022,
0.02, <0.001) with a significant increase in oxygenation (P < 0.001) when
compared to group B.ICU stay duration was similar between two groups. No
complications were noted in both groups. <br/>Conclusion(s): THRIVE is
safe to use following extubation in adult cardiac surgical
patients.<br/>Copyright &#xa9; 2021 Wolters Kluwer Medknow Publications.
All rights reserved.

<69>
Accession Number
635550240
Title
Volatile anesthetic preconditioning modulates oxidative stress and nitric
oxide in patients undergoing coronary artery bypass grafting.
Source
Annals of Cardiac Anaesthesia. 24 (3) (pp 319-326), 2021. Date of
Publication: July-September 2021.
Author
Dharmalingam S.; Amirtharaj G.; Ramachandran A.; Korula M.
Institution
(Dharmalingam, Korula) Department of Anaesthesiology, Division of
Gastrointestinal Sciences, Christian Medical College, Ida Scudder Road,
Tamil Nadu, Vellore, India
(Amirtharaj, Ramachandran) The Wellcome Trust Research Laboratory,
Division of Gastrointestinal Sciences, Christian Medical College, Ida
Scudder Road, Tamil Nadu, Vellore, India
(Ramachandran) Department of Pharmacology, Toxicology and Therapeutics,
University of Kansas Medical Center, Kansas City, KS 66160, United States
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Myocardial preconditioning using volatile anesthetics such as
isoflurane and sevoflurane have beneficial effects in decreasing morbidity
in cardiac surgical patients. Studies in animal models have indicated that
reactive oxygen and nitrogen species probably play a role in mediating
these effects. However, data from human studies are scarce and the
differential effect of sevoflurane vs. isoflurane on reactive oxygen
species (ROS) and reactive nitrogen species (RNS) has not been studied
extensively. <br/>Material(s) and Method(s): Randomized clinical control
trial comparing preconditioning effects of volatile agents isoflurane and
sevoflurane when administered during coronary artery bypass surgeries on
cardiopulmonary bypass (CPB). Serum samples were collected at 3 time
points before induction, after cross clamp release and one hour after
separation from CPB. Levels of oxidative stress markers and nitric oxide
were analyzed in these samples. <br/>Result(s): Hemodynamic indices,
cardio-pulmonary bypass duration, and ICU stay were similar between the
groups. CKMB values 12 hours post-op were decreased in majority of
patients in the sevoflurane group compared to isoflurane. Serum
malondialdehyde and nitrate levels were lower with sevoflurane (P < 0.05)
when compared to the isoflurane group, but no significant differences in
protein carbonyl content or protein thiol content were evident between the
2 groups. Sevoflurane also prevented the decrease in total thiols during
later stages of surgery. <br/>Conclusion(s): Volatile anesthetics,
isoflurane and sevoflurane modulate oxidative and nitrosative stress
during CABG. Between the two pre-conditioning agents, isoflurane seems to
provide better protection during the pre-bypass period, while sevoflurane
provides protection during both pre- as well as post-bypass
period.<br/>Copyright &#xa9; 2021 Wolters Kluwer Medknow Publications. All
rights reserved.

<70>
Accession Number
635550227
Title
Comparison of postoperative delirium within 24 hours between ketamine and
propofol infusion during cardiopulmonary bypass machine: A randomized
controlled trial.
Source
Annals of Cardiac Anaesthesia. 24 (3) (pp 294-301), 2021. Date of
Publication: July-September 2021.
Author
Siripoonyothai S.; Sindhvananda W.
Institution
(Siripoonyothai) Department of Anesthesiology, Phramongkutklao Hospital,
315 Ratchawithi Rd., Thung Phaya Thai, Rajadevi, Thailand
(Sindhvananda) Department of Anesthesiology, Faculty of Medicine,
Chulalongkorn University, Rama IV, Bangkok, Thailand
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Postoperative delirium (POD) is a common complication in
cardiac surgery especially in elderly population which can lead to a delay
of weaning from ventilator and extubation. Cardiopulmonary bypass
(CPB)-induced inflammation is related to POD. Anti-inflammatory effect of
anesthetic agent might attenuate POD. <br/>Aim(s): The present study was
primarily aimed to compare within-24-h POD between ketamine-based
anesthesia and propofol-based anesthesia during CPB. The secondary
objective was to identify risk factors associated with within-24-h POD.
Setting and Design: Our study was a randomized controlled trial in
patients undergoing cardiac surgery with CPB. Enrolling patients were aged
>65 years, and able to comprehensive communication. Exclusion criteria
were aortic surgery, cognitive disorders, cerebrovascular and carotid
disease, and positive result of preoperative CAM-ICU. <br/>Material(s) and
Method(s): Patients were randomly assigned to group Ketamine infusion of 1
mg/kg/h and group Propofol infusion of 1.5-6 mg/kg/h during CPB. POD was
evaluated by validated Thai version CAM-ICU at 8-24 hour after ICU
arrival. Statistics: Chi-square, Fisher exact and t-test tests, univariate
analysis and multivariate logistic regression were utilized.
<br/>Result(s): Total 82 patients entered this study and 64 patients
remained after exclusion (Group Ketamine = 32 and Group Propofol = 32).
Within-24-h POD were 31.25% and 56.25% (P = 0.04) and mean arterial
pressure (MAP) were 71.45 and 65.53 mmHg (P = 0.01) respectively in
Ketamine and Propofol group. Postoperative leukocytosis was a significant
risk to POD (adjusted OR 124.5). <br/>Conclusion(s): With limitations of
the study, prevention of 24-h POD in general by ketamine was inconclusive.
In comparison with propofol, ketamine leaded to less events of 24-h POD
and kept higher MAP. Severity of postoperative inflammation was a
significant prediction of 24-h POD.<br/>Copyright &#xa9; 2021 Wolters
Kluwer Medknow Publications. All rights reserved.

<71>
Accession Number
2013716635
Title
Prognostic implications of atrial fibrillation in patients with stable
coronary artery disease: A systematic review and meta-analysis of adjusted
observational studies.
Source
Reviews in Cardiovascular Medicine. 22 (2) (pp 439-444), 2021. Date of
Publication: 30 Jun 2021.
Author
Saglietto A.; Varbella V.; Ballatore A.; Xhakupi H.; de Ferrari G.M.;
Anselmino M.
Institution
(Saglietto, Varbella, Ballatore, Xhakupi, de Ferrari, Anselmino) Division
of Cardiology, "Citta della Salute e della Scienza di Torino" Hospital,
Department of Medical Sciences, University of Turin, Turin 10126, Italy
Publisher
IMR Press Limited
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered
in clinical practice. Despite the frequent coexistence with coronary
artery disease (CAD), the prognostic independent implication of AF in
patients with stable CAD remains controversial. Our aim was to perform a
pairwise meta-analysis of adjusted observational studies comparing
cardiovascular outcomes in patients with stable CAD with and without
concomitant AF, in search of AF-specific prognostic implications. We
performed random effect meta-analysis of binary outcome events in studies
comparing stable CAD patients with versus without AF providing risk
estimates adjusted for confounding variables. Literature search was
performed in PubMed/MEDLINE and Google Scholar. Death was the primary
endpoint of the analysis, while myocardial infarction, coronary
revascularization and stroke secondary endpoints. 5 studies were included
in the meta-analysis, encompassing a total of 30230 stable CAD patients
(2844 with AF, 27386 without AF). Stable CAD patients with AF presented an
independent increased risk of death (HR 1.39, 95% CI: 1.17-1.66) and
stroke (HR 1.88, 95% CI: 1.45-2.45) compared to those without AF. Instead,
risk of myocardial infarction (HR 0.90, 95% CI: 0.66-1.22) and coronary
revascularization (HR 0.96, 95% CI: 0.79-1.16) did not differ in stable
CAD patients with and without the arrhythmia. In patients with stable CAD,
AF exerts an independent negative prognostic effect, increasing the risk
of death and stroke. However, the small number of eligible studies
included in this analysis highlights the astonishing lack of data
regarding prognostic implications of concomitant AF in patients with
stable CAD.<br/>Copyright &#xa9; 2021 The Author(s). Published by IMR
Press.

<72>
Accession Number
2013716626
Title
Determinants of atrial fibrillation after cardiac surgery.
Source
Reviews in Cardiovascular Medicine. 22 (2) (pp 329-341), 2021. Date of
Publication: 30 Jun 2021.
Author
Qureshi M.; Ahmed A.; Massie V.; Marshall E.; Harky A.
Institution
(Qureshi, Ahmed, Massie, Marshall) School of Medicine, University of
Liverpool, Cedar House, Ashton Street, Liverpool L69 3GE, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool L14 3PE, United Kingdom
Publisher
IMR Press Limited
Abstract
Post-operative Atrial fibrillation (POAF) is a common complication post
cardiac surgery. It can result in detrimental short- and long-term
outcomes due to the increased risk of stroke, cardiac arrest and
congestive heart failure in addition to prolonged intensive care and total
hospital stay raising the overall healthcare cost. Accurately identifying
predictors and biomarkers for POAF ensures that patients at greatest risk
can be given the appropriate prophylactic measures; resources can be
distributed to the groups who are most in need and where they will gain
the optimum effect. Commonly recurring predictors can be investigated
further to unveil the pathophysiology behind POAF, which has yet to be
fully understood. This literature review aims to examine relevant studies
on the proposed predictors of POAF: increased age, gender, history of
atrial fibrillation, hypertension, cardiopulmonary bypass time and the use
of beta blockers amongst others. This paper will discuss the significance
of both the well-known and newfound risk factors to consolidate the areas
that require further exploration in order to highlight those at risk and
to unravel the mechanism behind POAF.<br/>Copyright &#xa9; 2021 The
Author(s). Published by IMR Press.

<73>
Accession Number
2013682146
Title
Efficacy of Erector Spinae Plane Block for Analgesia in Thoracic Surgery:
A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Koo C.-H.; Lee H.-T.; Na H.-S.; Ryu J.-H.; Shin H.-J.
Institution
(Koo, Lee, Na, Ryu, Shin) Department of Anesthesiology & Pain Medicine,
Seoul National University Bundang Hospital, Seongnam, South Korea
(Ryu) Department of Anesthesiology & Pain Medicine, Seoul National
University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objective: The objective of this study was to determine whether erector
spinae plane block (ESPB) can provide an effective analgesia for managing
pain after thoracic surgery and compare the efficacy of ESPB with that of
other regional analgesic techniques. <br/>Design(s): Systematic review and
meta-analysis of randomized controlled trials. <br/>Setting(s): PubMed,
EMBASE, CENTRAL, CINAHL, Scopus, and Web of Science were searched.
<br/>Participant(s): Patients undergoing thoracic surgeries.
<br/>Intervention(s): Erector spinae plane block with local anesthetics
for postoperative analgesia. Measurement and Main Results: Seventeen
studies, including 1,092 patients, were included in the final analysis.
Erector spinae plane block reduced 24-hour postoperative opioid
consumption (mean difference [MD] -17.49, 95% CI -26.87 to -8.12), pain
score at rest (MD -0.82, 95% CI -1.31 to -0.33), and pain score at
movement (MD -0.77, 95% CI -1.20 to -0.3) compared to no block. Compared
with other regional blocks, various results have been observed. Although
statistical results showed that ESPB is inferior to thoracic paravertebral
block and intercostal nerve block and superior to serratus anterior plan
block in postoperative analgesia, clinical differences remain unclear. The
incidence of hematoma was lower in the ESPB group than in the other groups
(odds ratio 0.19, 95% CI 0.05-0.73). <br/>Conclusion(s): Erector spinae
plane block may provide effective analgesia after thoracic surgery.
Compared with other techniques, it is a safer method, without clinically
important differences, for postoperative pain control. Therefore, ESPB may
be considered as a valuable option for postoperative pain management after
thoracic surgery.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<74>
Accession Number
635553587
Title
Aortic valve repair decreases risks of VRE in AI at 10 years: a propensity
score-matched analysis.
Source
The Annals of thoracic surgery. (no pagination), 2021. Date of
Publication: 03 Jul 2021.
Author
Jabagi H.; Chan V.; Ruel M.; Mesana T.G.; Boodhwani M.
Institution
(Jabagi, Chan, Ruel, Mesana, Boodhwani) Division of Cardiac Surgery,
University of Ottawa Heart Institute, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Aortic valve repair(AVr) has emerged as a feasible and
effective alternative to replacement(AVR) in patients with aortic
insufficiency(AI), however, little data exists comparing outcomes. Thus,
the objective of this study was to compare early and long-term valve
related complications between AVr and AVR in the treatment of AI.
<br/>METHOD(S): Single centre, retrospective study of all patients(n=417)
undergoing AVr (n=264) or AVR (n=153) for primary AI. Propensity-matching
using a 1:1 greedy matching algorithm identified 140 patients using six
covariates (age, gender, LV function, size, presence of aortopathy, and
urgency of operation) for comparison. The primary outcome was a composite
of all valve-related events(VRE), including: endocarditis, myocardial
infarction(MI), stroke, transient ischemic attack(TIA), thromboembolisms,
bleeding, and aortic valve(AV) reoperation. VRE were defined as per
published guidelines. Survival and freedom from VRE were reported using
the Kaplan-Meier method. <br/>RESULT(S): Propensity-matching identified 70
well matched pairs with no major differences in baseline demographics,
comorbidities, or AI severity(p=0.57). Perioperative outcomes showed no
significant differences in VRE (AVR 8 vs AVr 7,p=0.78) or mortality (AVR 3
vs AVr 1,p=0.62). Event-free survival from the primary outcome at 10-years
was significantly better after AVr than after AVR (82%vs68%,p=0.024), with
no significant differences in 10-year overall survival between
groups(82%vs72%,p=0.29). No significant differences in AI severity(p=0.07)
or reoperation rate(p=0.44) were detected between groups.
<br/>CONCLUSION(S): This study demonstrated a lower long-term risk of VRE
with repair compared to replacement, with low mortality and comparable
durability. Further prospective randomized control trials are necessary to
formally compare outcomes and determine superiority.<br/>Copyright &#xa9;
2021. Published by Elsevier Inc.

<75>
Accession Number
635542436
Title
Reliable and valid assessment of procedural skills in resuscitative
endovascular balloon occlusion of the aorta (REBOA).
Source
The journal of trauma and acute care surgery. (no pagination), 2021. Date
of Publication: 02 Jul 2021.
Author
Engberg M.; Lonn L.; Konge L.; Mikkelsen S.; Horer T.; Lindgren H.; Sovik
E.; Svendsen M.B.; Frendo M.; Taudorf M.; Russell L.
Institution
(Engberg) Copenhagen Academy for Medical Education and Simulation (CAMES),
Centre for Human Resources and Education, Capital Region of Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences,
University of Copenhagen, Denmark. Department of Radiology, Copenhagen
University Hospital Rigshospitalet, Denmark. The Mobile Emergency Care
Unit, Department of Anaesthesiology and Intensive Care, Odense University
Hospital, Odense, Denmark The Prehospital Research Unit, Region of
Southern Denmark, Odense University Hospital, Odense, Denmark. Department
of Regional Health Research, University of Southern Denmark, Odense,
Denmark. Department of Cardiothoracic and Vascular Surgery and Department
of Surgery, Faculty of Life Science, Orebro University Hospital, Orebro,
Sweden. Department of Clinical Sciences, Faculty of Medicine, Lund
University, Lund, Sweden. Department of Surgery, Section of Interventional
Radiology, Helsingborg Hospital, Helsingborg, Sweden. Department of
Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim,
Norway. Department of Otorhinolaryngology, Head & Neck Surgery and
Audiology, Copenhagen University Hospital Rigshospitalet, Denmark
Department of Intensive Care, Copenhagen University Hospital
Rigshospitalet, Denmark
Publisher
NLM (Medline)
Abstract
BACKGROUND: Valid and reliable assessment of skills is essential for
improved and evidence-based training concepts. In a recent study, we
presented a novel tool to assess procedural skills in resuscitative
endovascular balloon occlusion of the aorta (REBOA), REBOA-RATE, based on
international expert consensus. Although expert consensus is a strong
foundation, the performance of REBOA-RATE has not been explored. The study
aimed to examine the reliability and validity of REBOA-RATE.
<br/>METHOD(S): This was an experimental simulation-based study. We
enrolled doctors with three levels of expertise to perform two
REBOA-procedures in a simulated scenario of out-of-hospital cardiac
arrest. Procedures were video-recorded, and videos were blinded and
randomized. Three clinical experts independently rated all procedures
using REBOA-RATE. Data were analyzed using Messick's framework for
validity evidence, including generalizability analysis of reliability and
determination of a pass/fail standard. <br/>RESULT(S): Forty-two doctors
were enrolled: 16 novices, 13 anesthesiologists and 13 endovascular
experts. They all performed two procedures, yielding 84 procedures and 252
ratings. REBOA-RATE showed high internal consistency (Cronbach's alpha =
0.95) and excellent interrater reliability (intraclass correlation
coefficient = 0.97). Assessment using one rater and three procedures could
ensure overall reliability suitable for high-stakes testing (G-coefficient
> 0.80). Mean scores (SD) for the three groups in the second procedure
were: Novices 32% (24%), anesthesiologists 55% (29%), endovascular experts
93% (4%), p < 0.001. The pass/fail standard was set at 81%, which all
experts but no novices passed. <br/>CONCLUSION(S): Data strongly support
the reliability and validity of REBOA-RATE, which successfully
discriminated between all experience levels. REBOA-RATE requires minimal
instruction, and one rater is sufficient for reliable assessment.
Together, these are strong arguments for the use of REBOA-RATE to assess
REBOA skills, allowing for competency-based training and certification
concepts. LEVEL OF EVIDENCE: Level V ('Diagnostic' test, no or poor gold
standard).<br/>Copyright &#xa9; 2021 Lippincott Williams & Wilkins, Inc.

<76>
Accession Number
2007371725
Title
Techniques for blood loss estimation in major non-cardiac surgery: a
systematic review and meta-analysis.
Source
Canadian Journal of Anesthesia. 68 (2) (pp 245-255), 2021. Date of
Publication: February 2021.
Author
Tran A.; Heuser J.; Ramsay T.; McIsaac D.I.; Martel G.
Institution
(Tran, Heuser, Martel) Department of Surgery, University of Ottawa,
Ottawa, ON, Canada
(Ramsay, McIsaac, Martel) Ottawa Hospital Research Institute, The Ottawa
Hospital - General Campus, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
(McIsaac) Department of Anesthesiology, University of Ottawa, Ottawa, ON,
Canada
Publisher
Springer
Abstract
Purpose: Estimated blood loss (EBL) is an important tool in clinical
decision-making and surgical outcomes research. It guides perioperative
transfusion practice and serves as a key predictor of short-term
perioperative risks and long-term oncologic outcomes. Despite its
widespread clinical and research use, there is no gold standard for blood
loss estimation. We sought to systematically review and compare techniques
for intraoperative blood loss estimation in major non-cardiac surgery with
the objective of informing clinical estimation and research standards.
Source: A structured search strategy was applied to Ovid Medline, Embase,
and Cochrane Library databases from inception to March 2020, to identify
studies comparing methods of intraoperative blood loss in adult patients
undergoing major non-cardiac surgery. We summarized agreement between
groups of pairwise comparisons as visual estimation vs formula estimation,
visual estimation vs other, and formula estimation vs other. For each of
these comparisons, we described tendencies for higher or lower EBL values,
consistency of findings, pooled mean differences, standard deviations, and
confidence intervals. Principle findings: We included 26 studies involving
3,297 patients in this review. We found that visual estimation is the most
frequently studied technique. In addition, visual techniques tended to
provide lower EBL values than formula-based estimation or other
techniques, though this effect was not statistically significant in pooled
analyses likely due to sample size limitations. When accounting for the
contextual mean blood loss, similar case-to-case variation exists for all
estimation techniques. <br/>Conclusion(s): We found that significant
case-by-case variation exists for all methods of blood loss evaluation and
that there is significant disagreement between techniques. Given the
importance placed on EBL, particularly for perioperative prognostication
models, clinicians should consider the universal adoption of a practical
and reproducible method for blood loss evaluation. Trial registration:
PROSPERO (CRD42015029439); registered: 18 November 2015.PROSPERO
(CRD42015029439); registered: 18 November 2015.<br/>Copyright &#xa9; 2020,
Canadian Anesthesiologists' Society.

<77>
Accession Number
614998047
Title
Risk prediction models for delirium in the intensive care unit after
cardiac surgery: A systematic review and independent external validation.
Source
British Journal of Anaesthesia. 118 (3) (pp 391-399), 2017. Date of
Publication: March 2017.
Author
Lee A.; Mu J.L.; Joynt G.M.; Chiu C.H.; Lai V.K.W.; Gin T.; Underwood M.J.
Institution
(Lee, Mu, Joynt, Chiu, Lai, Gin) Department of Anaesthesia and Intensive
Care, Chinese University of Hong Kong, Hong Kong, Hong Kong
(Underwood) Division of Cardiothoracic Surgery, Department of Surgery,
Chinese University of Hong Kong, Hong Kong, Hong Kong
Publisher
Oxford University Press
Abstract
Numerous risk prediction models are available for predicting delirium
after cardiac surgery, but few have been directly compared with one
another or been validated in an independent data set.We conducted a
systematic review to identify validated risk prediction models of
delirium(using the Confusion Assessment Method-Intensive Care Unit tool)
after cardiac surgery and assessed the transportability of the risk
prediction models on a prospective cohort of 600 consecutive patients
undergoing cardiac surgery at a university hospital in Hong Kong from July
2013 to July 2015. The discrimination (c-statistic), calibration (GiViTI
calibration belt), and clinical usefulness (decision curve analysis) of
the risk predictionmodels were examined in a stepwisemanner. Three
published high-quality intensive care unit deliriumrisk prediction models
(n5939) were identified: Katznelson, the original PRE-DELIRIC, and the
international recalibrated PRE-DELIRIC model. Deliriumoccurred in 83
patients (13.8%, 95% CI: 11.2-16.9%). After updating the intercept and
regression coefficients in the Katznelsonmodel, there was fair
discrimination (0.62, 95% CI: 0.58-0.66) and good calibration. As the
original PRE-DELIRIC model was already validated externally and
recalibrated in six countries, we performed a logistic calibration on the
recalibrated model and found acceptable discrimination (0.75, 95% CI:
0.72-0.79) and good calibration. Decision curve analysis demonstrated that
the recalibrated PREDELIRIC riskmodel was marginally more clinically
useful than the Katznelsonmodel. Current models predict deliriumrisk in
the intensive care unit after cardiac surgery with only fair to moderate
accuracy and are insufficient for routine clinical use.<br/>Copyright
&#xa9; The Author 2017.

<78>
Accession Number
608459502
Title
Preoperative intra-aortic counterpulsation in high-risk patients
undergoing cardiac surgery: A meta-analysis of randomized controlled
trials.
Source
European Journal of Cardio-thoracic Surgery. 49 (1) (pp 5-17), 2016. Date
of Publication: January 2016.
Author
Pilarczyk K.; Boening A.; Jakob H.; Langebartels G.; Markewitz A.; Haake
N.; Heringlake M.; Trummer G.
Institution
(Pilarczyk, Jakob) Department of Thoracic and Cardiovascular Surgery, West
German Heart Centre Essen, University Hospital Essen, Essen, Germany
(Boening) Department of Cardiovascular Surgery, Justus-Liebig University
Giesen, Giessen, Germany
(Langebartels) Department of Cardiothoracic Surgery, Cologne University
Heart Centre, Cologne, Germany
(Markewitz) Department of Cardiovascular Surgery, Bundeswehr Central
Hospital, Koblenz, Germany
(Haake) Department of Cardiovascular Surgery, School of Medicine,
University of Schleswig-Holstein, Kiel, Germany
(Heringlake) Department of Anesthesiology, University of Lubeck, Lubeck,
Germany
(Trummer) Department of Cardiovascular Surgery, Heart Center Freiburg
University, Freiburg, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
In contrast to the results of previous studies, recent randomized
controlled trials (RCTs) failed to show a benefit of prophylactic aortic
counterpulsation in high-risk patients undergoing cardiac surgery. The
present analysis aims to redefine the effects of this treatment modality
in the light of this new evidence. MEDLINE, EMBASE, CENTRAL/CCTR, Google
Scholar and reference lists of relevant articles were searched for
full-text articles of RCTs in English or German. Assessments for
eligibility, relevance, study validity and data extraction were performed
by two reviewers independently using prespecified criteria. The primary
outcome was hospital mortality. A total of nine eligible RCTs with 1171
patients were identified: 577 patients were treated preoperatively with
intra-aortic balloon pump (IABP) and 594 patients served as controls. The
pooled odds ratio (OR) for hospital mortality (22 hospital deaths in the
intervention arm, 54 in the control group) was 0.381 (95% CI 0.230-0.629;
P < 0.001). The pooled analyses of five RCTs including only patients
undergoing isolated on-pump coronary artery bypass grafting (n[IABP] =
348, n[control] = 347) also showed a statistically significant improvement
in mortality for preoperative IABP implantation (fixed-effects model: OR
0.267, 95% CI 0.129-0.552, P < 0.001). The pooled OR for hospital
mortality from two randomized off-pump trials was 0.556 (fixed-effects
model, 95% CI 0.207-1.493, P = 0.226). Preoperative aortic
counterpulsation was associated with a significant reduction in low
cardiac output syndrome (LCOS) in the total population (fixed-effects
model: OR 0.330, 95% CI 0.214- 0.508, P < 0.001) as well as in the
subgroup of CAGB patients (fixed-effects model: OR 0.113, 95% CI
0.056-0.226, P < 0.001), whereas there was no benefit in the off-pump
population (fixed-effects model: OR 0.555, 95% CI 0.209-1.474, P = 0.238).
Preoperative IABP implantation was associated with a reduction of
intensive care unit (ICU) stay in all investigated populations with a
greater effect in the total population [fixed-effects model: standard mean
difference (SMD) -0.931 +/- 0.198, P < 0.001] as well as in the subgroup
of CAGB patients (fixedeffects model: SMD -1.240 +/- 0.156, P < 0.001),
compared with the off-pump group (fixed-effects model: SMD -0.723 +/-
0.128, P < 0.001). Despite contradictory results from recent trials, the
present study confirms the findings of previous meta-analyses that
prophylactic aortic counterpulsation reduces hospital mortality, incidence
of LCOS and ICU requirement in high-risk patients undergoing on-pump
cardiac surgery. However, owing to small sample sizes and the lack of a
clear-cut definition of high-risk patients, an adequately powered,
prospective RCT is necessary to find a definite answer to the question, if
certain groups of patients undergoing cardiac surgery benefit from a
prophylactic IABP insertion.<br/>Copyright &#xa9; The Author 2015.

<79>
Accession Number
612908922
Title
The risk of acute kidney injury following transapical versus transfemoral
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Clinical Kidney Journal. 9 (4) (pp 560-566), 2016. Date of Publication:
August 2016.
Author
Thongprayoon C.; Cheungpasitporn W.; Gillaspie E.A.; Greason K.L.; Kashani
K.B.
Institution
(Thongprayoon, Cheungpasitporn, Kashani) Division of Nephrology and
Hypertension, Mayo Clinic, 200 First Street SW, Rochester, MN 55905,
United States
(Gillaspie, Greason) Division of Cardiovascular Surgery, Department of
Surgery, Mayo Clinic, Rochester, MN, United States
(Kashani) Division of Pulmonary and Critical Care Medicine, Mayo Clinic,
Rochester, MN, United States
Publisher
Oxford University Press
Abstract
Background: The aim of this systematic review is to examine the literature
for the risk of acute kidney injury (AKI) in patients who underwent
transcatheter aortic valve replacement (TAVR) based on transapical (TA)
versus transfemoral (TF) approaches. <br/>Method(s): A literature search
was conducted utilizing Embase, Medline, Cochrane Database of Systematic
Reviews and ClinicalTrials.gov from inception through December 2015.
Studies that reported relative risk, odds ratio or hazard ratio comparing
the AKI risk in patients who underwent TA-TAVR versus TF-TAVR were
included. Pooled risk ratio (RR) and 95% confidence interval (CI) were
calculated using a random effect, generic inverse variance method.
<br/>Result(s): Seventeen cohort studies with 5085 patients were enrolled
in the analysis to assess the risk of AKI in patients undergoing TA-TAVR
versus TF-TAVR. The pooled RR of AKI in patients who underwent TA-TAVR was
2.26 (95% CI 1.79-2.86) when compared with TF-TAVR. When meta-analysis was
confined to the studies with adjusted analysis for confounders evaluating
the risk of AKI following TAVR, the pooled RR of TA-TAVR was 2.89 (95% CI
2.12-3.94). The risk for moderate to severe AKI [RR 1.02 (95% CI
0.57-1.80)] in patients who underwent TA-TAVR compared with TF-TAVR was
not significantly higher. <br/>Conclusion(s): Our meta-analysis
demonstrates an association between TA-TAVR and a higher risk of AKI.
Future studies are required to assess the risks of moderate to severe AKI
and mortality following TA-TAVR versus TF-TAVR.<br/>Copyright &#xa9; The
Author 2016.

<80>
Accession Number
621863445
Title
Effectiveness of pericardial lavage with or without tranexamic acid in
cardiac surgery patients receiving intravenous tranexamic acid: A
randomized controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 50 (6) (pp 1124-1131), 2016.
Date of Publication: December 2016.
Author
Kimenai D.M.; Gerritse B.M.; Lucas C.; Rosseel P.M.; Bentala M.; Hattum
P.; van der Meer N.J.M.; Scohy T.V.
Institution
(Kimenai) Department of Extracorporeal Circulation, Amphia Hospital,
Breda, Netherlands
(Gerritse, Hattum, van der Meer, Scohy) Department of Anesthesiology,
Amphia Hospital, Breda, Netherlands
(Lucas) Department of Clinical Epidemiology, Biostatistics and
Bioinformatics, Academic Medical University Centre of Amsterdam,
Amsterdam, Netherlands
(Rosseel) Department of Cardiothoracic Surgery, Amphia Hospital, Breda,
Netherlands
(Bentala) Department of Clinical Pharmacology, Amphia Hospital, Breda,
Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Pericardial lavage with saline, with or without tranexamic
acid (TA), is still not evidence-based within current clinical practice as
a part of a blood conservation strategy in cardiac surgery patients
receiving intravenous TA administration. The objective was to determine
whether intravenous TA combined with pericardial lavage with saline, with
or without TA, reduces blood loss by 25% after cardiac surgery measured in
the first 12 h postoperatively. <br/>METHOD(S): In this single-centre,
randomized controlled, multiple-armed, parallel study, individual patients
were randomly assigned to receive either topical administration of 2 g TA
diluted in 200 ml of saline (TA group), 200 ml of saline (placebo group)
or no topical administration at all (control group). Eligible participants
were all adults aged 18 or older and scheduled for elective cardiac
surgery on cardiopulmonary bypass. All patients received 2 g TA
intravenously before sternal incision and 2 g TA after cardiopulmonary
bypass. The main outcome measure was the 12-h postoperative blood loss.
<br/>RESULT(S): In total, 739 individuals were analysed according to
intention-to-treat analyses (TA group, n = 245 patients; placebo group, n
= 249 patients; control group, n = 245 patients). There was no difference
in the median 12-h postoperative blood loss between the three groups [TA
group, 290 (IQR 190-430) ml; placebo group, 290 (IQR 210-440) ml; control
group, 300 (IQR 190-450) ml, P = 0.759]. <br/>CONCLUSION(S): Pericardial
lavage, with or without TA, does not result in a statistically significant
difference in the 12-h postoperative blood loss in cardiac surgery
patients receiving intravenous TA administration. Pericardial lavage with
saline, with or without TA, should not be a part of a blood conservation
strategy.<br/>Copyright &#xa9; The Author 2016. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<81>
Accession Number
607093663
Title
Safety and efficacy of glucose-insulin-potassium treatment in coronary
artery bypass graft surgery and percutaneous coronary intervention.
Source
Interactive Cardiovascular and Thoracic Surgery. 21 (5) (pp 667-676),
2015. Date of Publication: November 2015.
Author
Ali-Hassan-Sayegh S.; Mirhosseini S.J.; Zeriouh M.; Dehghan A.M.;
Shahidzadeh A.; Akbar Karimi-Bondarabadi A.; Sabashnikov A.; Popov A.-F.
Institution
(Ali-Hassan-Sayegh, Mirhosseini, Dehghan, Shahidzadeh, Akbar
Karimi-Bondarabadi) Cardiovascular Research Center, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran, Islamic Republic of
(Zeriouh, Sabashnikov, Popov) Department of Cardiothoracic Transplantation
and Mechanical Circulatory Support, Harefield Hospital, Royal Brompton and
Harefield NHS Foundation Trust, Middlesex, London UB9 6JH, United Kingdom
Publisher
Oxford University Press
Abstract
The purpose of this meta-analysis was to evaluate protective effects of
glucose-insulin-potassium (GIK) on outcomes after coronary artery bypass
grafting (CABG) or percutaneous coronary intervention (PCI). We
systematically searched Medline/Pubmed, Elsevier, Embase, Web of Knowledge
and Google Scholar. A total of 1206 studies were retrieved during the
extensive literature search of all major databases; however, 38 trials
reporting the end-point of interest were selected. We performed a pooled
analysis of outcomes following PCI: incidence of cardiac arrest [odds
ratio (OR) of 0.91; 95% confidence interval (CI): 0.76-1.09; P = 0.3],
stroke (OR of 1.71; 95% CI: 0.37-1.37; P = 0.3), cardiogenic shock (OR of
1.02; 95% CI: 0.92-1.14; P = 0.6), reinfarction (OR of 0.95; 95% CI:
0.81-1.14; P = 0.5) and mortality (OR of 1.04; 95% CI: 0.96-1.13; P =
0.3); and following CABG: incidence of atrial fibrillation (OR of 0.86;
95% CI: 0.70-1.05; P = 0.1), incidence of ventricular fibrillation (OR of
0.83; 95% CI: 0.62-1.13; P = 0.2), reinfarction (OR of 0.97; 95% CI:
0.74-1.27; P = 0.8), infection (OR of 1.04; 95% CI: 0.67-1.62; P = 0.8),
length of intensive care unit stay (LIS) [standard mean differences (SMD)
of -0.27; 95% CI: -0.40 to -0.14; P = 0.000], length of hospital stay
(LHS) (SMD of -0.035; 95% CI: -0.12 to -0.05; P = 0.4) and mortality (OR
of 0.72; 95% CI: 0.41-1.26; P = 0.2). Our results showed that GIK did not
have considerable cardioprotective effects. However, patients undergoing
CABG seem to be better responders to GIK therapy compared with patients
undergoing PCI. Furthermore, in contrast to CABG, GIK therapy in patients
undergoing PCI might be associated with more complications rather than
protective effects.<br/>Copyright &#xa9; The Author 2015. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<82>
Accession Number
611310878
Title
Pulsatile flow decreases gaseous micro-bubble filtering properties of
oxygenators without integrated arterial filters during cardiopulmonary
bypass.
Source
Interactive Cardiovascular and Thoracic Surgery. 17 (5) (pp 811-817),
2013. Date of Publication: November 2013.
Author
Milano A.D.; Dodonov M.; Onorati F.; Menon T.; Gottin L.; Malerba G.;
Mazzucco A.; Faggian G.
Institution
(Milano, Dodonov, Onorati, Menon, Mazzucco, Faggian) Division of Cardiac
Surgery, University of Verona Medical School, Piazzale Stefani, 1, Verona
37126, Italy
(Gottin) Division of Anesthesiology, University of Verona Medical School,
Verona, Italy
(Malerba) Division of Genetics and Bioinformatics, University of Verona
Medical School, Verona, Italy
Publisher
Oxford University Press
Abstract
OBJECTIVES: Cardiopulmonary bypass (CPB) has a risk of embolic injury with
an important role of gaseous micro-bubbles (GMBs), coming from
CPB-circuit. Pulsatile perfusion (PP) can provide specific conditions for
supplementary GMB-activity with respect to non-pulsatile (NP). We aimed to
test GMB-filtering properties of three modern oxygenators under pulsatile
and non-pulsatile conditions. <br/>METHOD(S): Seventy-eight patients
undergoing on-pump myocardial revascularization were randomized
prospectively into three equal groups according to the oxygenator model
used during CPB. Terumo Capiox-FX25, Sorin Synthesis or Maquet
Quadrox-i-Adult membrane oxygenators were tested. Each group was divided
equally to undergo PP or NP. GMBs were counted by means of a GAMPT-BCC200
bubble-counter with two probes placed at preoxygenator and arterial
post-filter positions. Results were evaluated in terms of GMBvolume,
GMB-number, amount of large over-ranged GMBs, a series of filtering
indices and major neurological outcomes. <br/>RESULT(S): PP decreased
GMB-filtering properties of the tested oxygenators. Those with integrated
filters (CAPIOX-FX25 and SYNTHESIS) did not show significant differences
between perfusion groups, while QUADROX-i oxygenator with external
arterial filter showed significantly higher GMB-volume (P < 0.001),
GMB-number (P < 0.001) and amount of over-ranged bubbles (P < 0.001)
detected in arterial line during PP. Despite the differences in filtering
capacity of all circuits with both types of perfusion, no important
differences in clinical outcomes and major neurological events were
observed. <br/>CONCLUSION(S): Pulsatile flow decreases gaseous
micro-bubble filtering properties of oxygenators without integrated
arterial filters during CPB. PP requires specially designed circuit
components to avoid the risk of additional GMB delivery.

<83>
Accession Number
52547257
Title
When clinical trials fail to address treatment gaps: The failure of
niacin-laropiprant to reduce cardiovascular events.
Source
Current Atherosclerosis Reports. 15 (6) (no pagination), 2013. Article
Number: 332. Date of Publication: June 2013.
Author
Rosenson R.S.; Gotto Jr. A.M.
Institution
(Rosenson) Icahn School of Medicine, Mount Sinai, One Gustave L. Levy
Place, New York, NY 10029, United States
(Gotto Jr.) Weill Cornell Medical College, Cornell University, 1305 York
Avenue Y-805, New York, NY 10021, United States
Publisher
Current Medicine Group LLC 1

<84>
Accession Number
2007343922
Title
Infective endocarditis by yersinia species: A systematic review.
Source
Tropical Medicine and Infectious Disease. 6 (1) (no pagination), 2021.
Article Number: 19. Date of Publication: March 2021.
Author
Ioannou P.; Vougiouklakis G.; Baliou S.; Miliara E.; Kofteridis D.P.
Institution
(Ioannou, Vougiouklakis, Miliara, Kofteridis) Department of Internal
Medicine & Infectious Diseases, University Hospital of Heraklion,
Heraklion, Crete 71110, Greece
(Baliou) National Hellenic Research Foundation, Athens 11635, Greece
Publisher
MDPI AG
Abstract
Yersinia spp. are non-spore-forming Gram-negative bacilli. They comprise
only three species known to cause disease in humans, namely Y. pestis, Y.
enterocolitica and Y. pseudotuberculosis. Since infective endocarditis
(IE) is rarely caused by Yersinia, the management of these infections can
be problematic due to the lack of experience. The purpose of this study
was to systematically review all published cases of IE by Yersinia species
in the literature. A systematic review of PubMed, Scopus and Cochrane
Library (through 1 November 2020) for studies providing epidemiological,
clinical and microbiological information as well as data on treatment and
outcomes of IE caused by Yersinia species was performed. A total of 12
studies, containing data of 12 patients, were included. A prosthetic valve
was present in 17% of patients. The mitral valve was the most commonly
infected site, followed by the aortic valve. Fever, sepsis and embolic
phenomena were common clinical signs, followed by heart failure.
Aminoglycosides, cephalosporins and quinolones were the most commonly used
antimicrobials. Clinical cure was noted in 83%, while overall mortality
was 17%. This systematic review describes IE by Yersinia and provides
information on patients' epidemiology, clinical signs and the related
therapeutic strategies and outcomes.<br/>Copyright &#xa9; 2021 by the
authors. Licensee MDPI, Basel, Switzerland.

<85>
Accession Number
2013478360
Title
Selenium supplementation and oxidative stress: A review.
Source
PharmaNutrition. 17 (no pagination), 2021. Article Number: 100263. Date of
Publication: September 2021.
Author
Zakeri N.; kelishadi M.R.; Asbaghi O.; Naeini F.; Afsharfar M.; Mirzadeh
E.; Naserizadeh S.K.
Institution
(Zakeri) Nutrition Research Center, Department of Clinical Nutrition,
Faculty of Nutrition and Food Science, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(kelishadi) Department of Community Nutrition, School of Nutrition and
Food Science, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Asbaghi) Student Research Committee, Lorestan University of Medical
Sciences, Khorramabad, Iran, Islamic Republic of
(Naeini) Department of Clinical Nutrition, School of Nutritional Science,
Tehran University of Medical Science, Tehran, Iran, Islamic Republic of
(Afsharfar) Department of Nutrition, School of Medicine, Zahedan
University of Medical Sciences, Zahedan, Iran, Islamic Republic of
(Mirzadeh) Department of Phisycal Ejucation And Sports Science, Central
Tehran Branch, Islamic Azad University, Tehran, Iran, Islamic Republic of
(Naserizadeh) Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Publisher
Elsevier B.V.
Abstract
Background: Oxidative stress is defined as an imbalance between the
production of oxidants (free radicals or reactive oxygen species) and
their eradication by protective mechanisms, such as antioxidants (vitamin
C, vitamin E, b-carotene, selenium and methionine). Increased oxidative
stress is associated with metabolic risk factors and may contribute to the
development of several obesity-related comorbidities, including insulin
resistance, type 2 diabetes, nonalcoholic fatty liver disease, and
atherosclerosis. <br/>Method(s): The present review aimed to evaluate the
effects of selenium supplementation on oxidative stress biomarkers. We
have searched PubMed, Scopus, ISI web of science, Embase and the Cochrane
library databases were searched to evaluate the clinical efficacy.
<br/>Result(s): We detected 14 studies that evaluated the effect of
selenium supplementation on oxidative stress biomarkers n adults.
<br/>Conclusion(s): Several studies have shown that Supplementation with
selenium significantly reduce Malondialdehyde levels and increase
Glutathione and total antioxidant capacity levels.<br/>Copyright &#xa9;
2021

<86>
Accession Number
2011934044
Title
Impact of Different Annuloplasty Methods for Tricuspid Regurgitation: A
Network Meta-Analysis.
Source
Annals of Thoracic Surgery. 111 (6) (pp 2004-2010), 2021. Date of
Publication: June 2021.
Author
Yokoyama Y.; Takagi H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Although moderate to severe tricuspid valve regurgitation (TR)
is an independent risk factor for progressive heart failure and increased
mortality, the best method for tricuspid valve repair remains
controversial. Therefore, this study conducted a network meta-analysis to
compare early and late outcomes for suture, flexible band, and rigid ring
as tricuspid annuloplasty (TAP) in patients with TR. <br/>Method(s):
Medline and EMBASE were searched through February 15, 2020 to identify
randomized controlled trials and observational trials that investigated
early and late outcomes after TAP for TR. The outcomes of interest were
perioperative mortality, all-cause mortality, and TR recurrence with more
than 1-year follow-up. TR recurrence was defined as at least moderate (TR
grade 2) on serial echocardiograms. <br/>Result(s): Two randomized
controlled trials and 15 observational trials were identified, including
6138 patients who underwent TAP. The median follow-up period was 1 to 7.4
years. There were no significant differences of perioperative and
all-cause mortality among 3 TAP methods. Rigid ring TAP was associated
with a significant reduction in TR recurrence compared with suture TAP
(hazard ratio, 0.42; 95% confidence interval, 0.23 to 0.78; P =.005).
There were no significant differences in TR recurrence were observed
between flexible band and suture TAP or flexible band and rigid ring TAP.
<br/>Conclusion(s): This network meta-analysis demonstrated significant
reduction in TR recurrence for rigid ring TAP compared with suture TAP,
although no significant differences were observed between suture and
flexible band TAP or between flexible band and rigid ring TAP. There were
no significant mortality differences among suture, flexible band, and
rigid ring TAP procedures.<br/>Copyright &#xa9; 2021 The Society of
Thoracic Surgeons

<87>
[Use Link to view the full text]
Accession Number
635368551
Title
A single preoperative dose of tranexamic acid reduces perioperative blood
loss: A meta-analysis.
Source
Annals of Surgery. 273 (1) (pp 75-81), 2021. Date of Publication: January
2021.
Author
Heyns M.; Knight P.; Steve A.K.; Yeung J.K.
Institution
(Heyns, Knight, Steve, Yeung) Department of Surgery, Plastic and
Reconstructive Surgery, University of Calgary, Calgary, AB, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: To review the efficacy and safety of a single dose of
intravenous tranexamic acid (TXA) given preoperatively. Summary Background
Data: TXA is a synthetic antifibrinolytic that has been used in various
surgical disciplines to reduce blood loss, blood transfusions, ecchymosis,
and hematoma formation. However, there is no universal standard on the
most effective dose and route of TXA administration, limiting its routine
use in many centers. This study evaluates the current evidence for the
efficacy and safety of a single preoperative dose of TXA on surgical blood
loss in all surgical disciplines. <br/>Method(s): With the guidance of a
research librarian, in accordance with the Cochrane Handbook Medline,
Cochrane Central and Embase were searched in November 2018. Search terms
included ''Tranexamic Acid'' AND ''Intravenous,'' with studies limited to
randomized controlled trails in adult humans. Two independent reviewers
and an arbitrator assessed articles for inclusion. Criteria included a
single preoperative bolus dose of intravenous TXA, surgical patients, and
intraoperative blood loss measurement or perioperative blood loss up to 24
hours postsurgery. Quality assessment was done using the Cochrane
Collaboration risk-of-bias tool by 2 reviewers. Statistical analysis was
carried out using Cochrane Review Manager 5.3. The primary outcome was
surgical blood loss. Secondary outcomes included venous thromboembolic
complications, transfusion requirements, and dosing. <br/>Result(s): A
total of 1906 articles were screened, 57 met inclusion criteria. The
majority of included studies were orthopedic (27), followed by obstetric
and gynecological (16), oral maxillofacial and otolaryngology (10),
cardiac (3), and 1 plastic surgery study focusing on acute burn
reconstruction. Across all surgical specialties (n = 5698), the
perioperative estimated blood loss was lower in patients receiving TXA,
with a standard mean difference of -153.33 mL (95% CI = -187.79 to
-118.87). Overall, surgical patients with TXA had a 72% reduced odds of
transfusion (odds ratio = 0.28 [95% CI = 0.22 - 0.36]). The most
frequently used dose of TXA was 15 mg/kg. There was no difference in the
incidence of venous thromboembolic events between TXA and control groups.
<br/>Conclusion(s): While there is a growing body of evidence to support
benefits of perioperative TXA use, this is the first meta-analysis to
identify the efficacy and safety of a single preoperative dose of IV TXA.
The potential implications for expanding the use of preoperative TXA for
elective day surgery procedures is substantial. Preoperative intravenous
TXA reduced perioperative blood loss and transfusion requirements in a
variety of surgical disciplines without increasing the risk of
thromboembolic events. Therefore, it should be considered for prophylactic
use in surgery to reduce operative bleeding.<br/>Copyright &#xa9; 2020
Wolters Kluwer Health, Inc. All rights reserved.

<88>
Accession Number
2011048374
Title
A randomized trial comparing the effects of sternal band and plate
fixation of the sternum with that of figure-of-8 wires on sternal edge
motion and quality of recovery after cardiac surgery.
Source
Interactive Cardiovascular and Thoracic Surgery. 30 (6) (pp 863-870),
2021. Date of Publication: 2021.
Author
Royse A.G.; El-Ansary D.; Hoang W.; Lui E.; McCusker M.; Tivendale L.;
Yang Y.; Canty D.J.; Royse C.F.
Institution
(Royse, El-Ansary, Tivendale, Yang, Canty, Royse) Department of Surgery,
University of Melbourne, Parkville, VIC, Australia
(El-Ansary, Hoang, Tivendale, Royse) Department of Surgery, Royal
Melbourne Hospital, Melbourne, VIC, Australia
(Royse, El-Ansary, Royse) Department of Health Professions, Faculty of
Art, Design and Health, Swinburne University of Technology, Melbourne,
VIC, Australia
(Lui, McCusker) Department of Radiology, University of Melbourne,
Parkville, VIC, Australia
(Yang) Department of Intensive Care, Western Hospital, Melbourne, VIC,
Australia
(Canty) Department of Anaesthesia and Pain Management, Monash Medical
Centre, Melbourne, VIC, Australia
(Royse) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Royse) Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH,
United States
Publisher
Oxford University Press
Abstract
OBJECTIVES: We sought to compare the effects of conventional wire cerclage
with that of the band and plate fixation of the sternum. <br/>METHOD(S): A
parallel randomized open-label trial with 1:1 allocation ratio compared
healing after adult cardiac surgery using 'figure-of-8' stainless steel
wire cerclage or a band and plate system (plates). The primary end point
was maximal sternal edge displacement during active coughing of >_2 mm in
>_2 of 4 sites measured with ultrasound by 2 assessors blinded to the
other at 6 weeks postoperatively. Secondary end points at 12 weeks
included ultrasound assessment, computed tomography (CT) scan and
multidimensional assessment of quality of recovery using the Postoperative
Quality of Recovery Scale. <br/>RESULT(S): Of 50 patients, 26 received
plates and 24 wires. Two patients died and 1 withdrew consent leaving 25
plates and 22 wires for primary end point analysis. Operations included 37
coronary, 5 valve and 8 combined coronary and valve procedures. At 6
weeks, less sternal movement was observed in patients with plates than
those with wires, 4% (1/25) vs 32% (7/22), P = 0.018. Agreement between
observers was high, kappa = 0.850. At 12 weeks, less ultrasound motion was
seen in patients with plates, 0% (0/23) than those with wires, 25% (5/20),
P = 0.014. Recovery from pain was higher for patients with plates 92%
(22/24) than those with wires 67% (14/21), P = 0.004. CT bone edge
separation was less for plates 38% (9/24) than wires 71% (15/21), P =
0.036. CT mild bone synthesis or greater was similar between patients with
plates 21% (5/24) and wires 14% (3/21), P = 0.71. <br/>CONCLUSION(S):
Patients receiving the band and plate system had significantly less
sternal edge motion than those receiving wires, 6 and 12 weeks after
cardiac surgery and experienced less pain.<br/>Copyright &#xa9; The
Author(s) 2020. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<89>
Accession Number
632332614
Title
Clinical outcomes of leadless pacemaker: a systematic review.
Source
Minerva cardiology and angiology. 69 (3) (pp 346-357), 2021. Date of
Publication: 01 Jun 2021.
Author
Oliveira S.F.; Carvalho M.M.; Adao L.; Nunes J.P.
Institution
(Oliveira) Faculty of Medicine, University of Porto, Porto, Portugal
(Carvalho, Nunes) Faculty of Medicine, University of Porto, Porto,
Portugal
(Carvalho, Adao, Nunes) Sao Joao University Hospital, Porto, Portugal
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Transvenous pacemakers are associated with a significant
amount of complications. Leadless pacemakers (LP) are emerging as an
alternative to conventional devices. This article provides a systematic
review of patient eligibility, safety and clinical outcomes of the LP
devices. EVIDENCE ACQUISITION: A systematic search for articles describing
the use of LP was conducted. Out of two databases, 24 articles were
included in the qualitative analysis. These articles comprised a total of
4739 patients, with follow-up times of 1-38 months. Further information
was obtained from 10 more studies. EVIDENCE SYNTHESIS: From a population
of 4739 patients included in the qualitative analysis, 4670 LP were
implanted with success (98.5%). A total of 248 complications were
described (5.23%) during the follow-up. The most common were pacing issues
such as elevated thresholds, dislodgements or battery failure (68
patients), events at the femoral access site such as hemorrhage, hematoma
or pseudoaneurysms (64 patients) and procedure related cardiac injuries
such as cardiac perforation, tamponade or pericardial effusion (47
patients). There were 360 deaths during the follow-up and 11 were
described as procedure or device related. Four studies presented the
strategy of using a combined approach of atrioventricular node ablation
(AVNA) and LP implantation. <br/>CONCLUSION(S): Leadless pacemakers seem
to have a relatively low complication rate. These devices may be a good
option in patients with an indication for single-chamber pacing, in
patients with conditions precluding conventional transvenous pacemaker
implantations. Studies directly comparing LP and transvenous pacemakers
and data on longer follow-up periods are needed.

<90>
Accession Number
633343007
Title
Long-term outcomes of percutaneous or surgical treatment in left main
disease.
Source
Minerva cardiology and angiology. 69 (3) (pp 313-321), 2021. Date of
Publication: 01 Jun 2021.
Author
Chiabrando J.G.; Vescovo G.M.; Lombardi M.; Del Buono M.G.; Romeo F.J.;
Berrocal D.H.; Guzman L.; Biondi-Zoccai G.; Abbate A.
Institution
(Chiabrando) Interventional Cardiology Service, Hospital Italiano de
Buenos Aires, Buenos Aires, Argentina
(Chiabrando) Health Science Statistics Applied Laboratory (LEACS),
Department of Pharmacology and Toxicology, School of Medicine, University
of Buenos Aires, Buenos Aires, Argentina
(Vescovo) Department of Cardiac Thoracic, Vascular Sciences and Public
Health, University of Padua, Padua, Italy
(Lombardi, Del Buono, Abbate) VCU Pauley Heart Center, Virginia
Commonwealth University, VA, Richmond, United States
(Lombardi, Del Buono) Department of Cardiovascular and Thoracic Sciences,
Sacred Heart Catholic University, Rome, Italy
(Romeo, Berrocal) Interventional Cardiology Service, Hospital Italiano de
Buenos Aires, Buenos Aires, Argentina
(Guzman) Wake Forest University, Winston-Salem, United States
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University, Rome, Italy
(Biondi-Zoccai) NaplesItaly
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Long-term efficacy and safety of either surgical or
percutaneous treatment left main coronary artery disease treatment is
lacking. EVIDENCE ACQUISITION: We conducted a systematic review and
meta-analysis of the most updated randomized clinical trials that compared
the efficacy of coronary artery bypass surgery (CABG) or percutaneous
coronary intervention (PCI) for the Left Main Coronary Artery (LMCA)
disease. It was also conducted a systematic search of PubMed, Google
Scholar, reference lists of relevant articles, and Medline. The search
utilized the following terms: "left main PCI versus CABG," "drug-eluting
stents," "bypass surgery" and "left main stenting." The search of articles
compatible with our inclusion and exclusion criteria was performed from
inception through April 2020 and returned a combined total of 304
articles. EVIDENCE SYNTHESIS: We identified 6 studies, providing data on
5812 patients. The mean follow-up was 6.7 years. PCI was associated with
an increased risk of major vascular events (MACE) (IRR 1.24, 95% CI
[1.03-1.67], P<0.01), and coronary revascularization (IRR 1.69, 95% CI
[1.42-2.03], P<0.01) compared to CABG. Furthermore, all-cause death, MI
and stroke events were not statistically different between the two
therapeutic revascularization methodologies (IRR 1.06, 95% CI [0.90-1.24],
P=0.47, IRR 1.35, 95% CI [0.84-2.16], P=0.03 and IRR 0.66, 95% CI
[0.43-1.01], P=0.05, respectively). <br/>CONCLUSION(S): LMCA PCI has an
overall same survival compared to CABG in the long term follow-up.
Nevertheless, MACE and revascularization events were more frequent in PCI
compared to CABG.

<91>
Accession Number
2013221273
Title
Operator preference and determinants of size selection when additional
intermediate-size aortic transcatheter heart valves are made available.
Source
International Journal of Cardiology. 338 (pp 168-173), 2021. Date of
Publication: 01 Sep 2021.
Author
Kawashima H.; Serruys P.W.; Mylotte D.; Rosseel L.; Amat-Santos I.J.; Rao
R.S.; Onuma Y.; Wijns W.; Abdel-Wahab M.; Baumbach A.; Soliman O.
Institution
(Kawashima, Serruys, Mylotte, Rosseel, Onuma, Wijns, Soliman) Department
of Cardiology, National University of Ireland, Galway (NUIG) and CORRIB
Corelab and Center for Research and Imaging, Galway, Ireland
(Kawashima) Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Serruys, Soliman) CURAM, the SFI Research Centre for Medical Devices,
Galway, Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
(Amat-Santos) CIBERCV, Hospital Clinico Universitario, Valladolid, Spain
(Rao) RHL Heart center, Rajasthan Hospital, Jaipur, India
(Abdel-Wahab) Heart Center Leipzig at University of Leipzig and Leipzig
Heart Institute, Leipzig, Germany
(Baumbach) William Harvey Research Institute, Queen Mary University of
London, Barts Heart Centre, London, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: Appropriate size selection of transcatheter heart valves
(THVs) is fundamental to reduce transcatheter aortic valve implantation
(TAVI) related complications, particularly paravalvular aortic
regurgitation, new permanent pacemaker implantation, and annular rupture.
We sought to investigate the frequency of operator selection of
intermediate-size balloon-expandable Myval THVs (Meril Life Sciences Pvt.
Ltd., India) for TAVI in a real-world dataset. <br/>Method(s): In this
retrospective survey of patients treated with TAVI using the Myval THV,
20, 23, 26, and 29 mm are conventional-size THVs, 21.5, 24.5 and 27.5 mm
are intermediate-size THVs, and 30.5 and 32 mm are extra-large THVs.
Operator size selection for implantation was based on multislice computed
tomography (MSCT) derived aortic-root dimensions. <br/>Result(s): A total
of 1115 patients underwent Myval THV implantation in 27 countries
worldwide. The Myval intermediate-size THVs were used in 468 (42.0%)
patients. MSCT data were available in 562 patients. There was no
statistical difference between the Intermediate/Upsized and Appropriately
sized groups or Intermediate/Downsized and Appropriately sized groups in
terms of different variables measured with MSCT except for annular
dimensions and degree of calcification. <br/>Conclusion(s):
Intermediate-size Myval balloon-expandable THVs are used in nearly half of
all cases in contemporary real-world TAVI practice, addressing the unmet
need of TAVI operators for a more calibrated THV choice. Our hypothesis
should be tested in randomized prospective studies currently initiated in
Europe, including clinical outcomes of patients treated with both
conventional- and intermediate-size THVs.<br/>Copyright &#xa9; 2021 The
Author(s)

<92>
Accession Number
2011983011
Title
Long-term Healthcare Expenditures Over Time for Tissue and Mechanical
Aortic Valve Replacement.
Source
Annals of Thoracic Surgery. 112 (2) (pp 526-531), 2021. Date of
Publication: August 2021.
Author
Nguyen T.C.; Walker T.; Gunnarsson C.; Moore M.; Keuffel E.L.
Institution
(Nguyen) Memorial Hermann Medical Center, University of Texas, Houston,
TX, United States
(Walker, Moore) Edwards Lifesciences, Irvine, California, United States
(Gunnarsson) Gunnarsson Consulting, Jupiter, Florida, United States
(Keuffel) Health Finance & Access Initiative, Bryn Mawr, Pennsylvania,
United States
Publisher
Elsevier Inc.
Abstract
Background: Guidelines currently indicate the use of surgical aortic valve
replacement (SAVR) to treat severe cases of aortic stenosis, particularly
for low- to medium-risk patients. Although several studies have compared
health outcomes of tissue and mechanical SAVR, this economic simulation
model estimates the difference in long-term healthcare costs associated
with tissue relative to mechanical SAVR. <br/>Method(s): The deterministic
and Monte Carlo simulation models used literature-based epidemiologic and
cost inputs to calculate annual expenditures related to SAVR for up to 25
years after initial surgery. A series of 3 cohort studies across different
age groups provided the health outcome probabilities for tissue valve
patients. Outcome probabilities for mechanical valve patients were based
on relative risks reported in comparative meta-analyses or large cohort
studies. <br/>Result(s): Relative to mechanical SAVR the expected net
discounted savings for a patient receiving tissue SAVR at ages 45, 55, and
65 years were $12,266, $15,462, and $16,008, respectively (based on 2018
US dollars) over a 25-year horizon (95% confidence intervals exceed $0).
For a 45-year-old tissue SAVR patient, the estimated per-patient cost
difference (relative to mechanical SAVR) of reoperation over 25 years
($16,201) were offset by expected savings on anticoagulation monitoring
($26,257) over the same period. In a sensitivity analysis in which
mortality risk was assumed equal, significant long-term savings associated
with tissue SAVR still accrued in each of the 3 age cohorts.
<br/>Conclusion(s): Payers, providers, and the healthcare system may
financially benefit from the use of tissue valves because significant
savings were associated with the use of tissue valves relative to
mechanical valves for SAVR.<br/>Copyright &#xa9; 2021 The Society of
Thoracic Surgeons

<93>
Accession Number
2011346118
Title
Comparison of Del Nido and Blood Cardioplegia in Pediatric Patients
Undergoing Surgical Repair for Congenital Heart Disease.
Source
Pediatric Cardiology. 42 (6) (pp 1388-1393), 2021. Date of Publication:
August 2021.
Author
Isildak F.U.; Yavuz Y.
Institution
(Isildak, Yavuz) Department of Anesthesiology and Reanimation, Kartal
Kosuyolu High Speciality Educational and Research Hospital, Istanbul,
Turkey
(Isildak) T. C. Saglik Bakanligi Kartal Kosuyolu Yuksek Ihtisas Egitim ve
Arastirma Hastanesi, Cevizli, 2, Denizer Caddesi, Cevizli Kavsagi, Kartal,
Istanbul 34865, Turkey
Publisher
Springer
Abstract
The aim of the study is to investigate the impact of two different
cardioplegia solutions, the del Nido (dN) and blood cardioplegia (BC), on
postoperative troponin concentrations, vasoactive-inotrope score, and
length of hospital stay in pediatric patients undergoing cardiovascular
surgery for CHD. 80 subjects aged between 1 and 120 months who were
scheduled for surgical repair for a CHD were prospectively enrolled in
this study. Study subjects were allocated to one of the study groups using
simple randomization technique as follows: The del Nido cardioplegia group
(n = 40, median age 8.5 [5.5-14] months) and conventional blood
cardioplegia group (n = 40, median age 11 [5-36] months). Aortic
cross-clamp time and cardiopulmonary bypass time were recorded in all
subjects. Troponin I and vasoactive-inotropic score, which indicates the
amount of cardiovascular support by various inotropes or vasopressors,
were recorded following the repair. The difference in troponin I,
vasoactive-inotropic score (VIS), length of ICU stay, and length of
hospital stay between the two groups was the primary outcome measure of
this study. The volume of cardioplegia was significantly lower in dN group
than that of the BC group (p < 0.001). Cardiopulmonary bypass time and
aortic cross-clamp time were significantly shorter in subjects receiving
dN cardioplegia than those receiving BC (p = 0.006, and p = 0.001,
respectively). Subjects assigned to BC had higher Troponin I
concentrations at postoperative 24th hour compared to subjects receiving
dN cardioplegia [1.60 (0.92-2.49) ng/mL vs. 1.03 (0.55-1.83) ng/mL, p =
0.045]. VIS was also significantly higher in BC group at 24th [10 (10-13)
vs. 10 (5-10), p = 0.032] and 48th hours [10 (1.5-10) vs. 0 (0-10), p =
0.005] compared to that of the dN cardioplegia group. The median
extubation time was 7.5 (3.5-20.5) hours in dN cardioplegia group and 5
(4-10) hours in the BC group (p = 0.384). There were no significant
differences between the groups with respect to the length of ICU stay and
length of hospital stay. No mortality and no significant arrhythmias
requiring medical or electrical cardioversion were noted in any of the
groups. In conclusion, dN cardioplegia provides shorter aortic cross-clamp
time and cardiopulmonary bypass time, and lower postoperative troponin I
concentration and vasoactive-inotrope scores compared to BC in pediatric
subjects undergoing surgical repair for CHD. However, lengths of ICU and
hospital stay are similar in dN cardioplegia and BC groups.<br/>Copyright
&#xa9; 2021, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<94>
Accession Number
2011320758
Title
Consensus for Thoracoscopic Left Upper Lobectomy-Essential Components and
Targets for Simulation.
Source
Annals of Thoracic Surgery. 112 (2) (pp 436-442), 2021. Date of
Publication: August 2021.
Author
Bryan D.S.; Ferguson M.K.; Antonoff M.B.; Backhus L.M.; Birdas T.J.;
Blackmon S.H.; Boffa D.J.; Chang A.C.; Chmielewski G.W.; Cooke D.T.;
Donington J.S.; Gaissert H.A.; Hagen J.A.; Hofstetter W.L.; Kent M.S.; Kim
K.W.; Krantz S.B.; Lin J.; Martin L.W.; Meyerson S.L.; Mitchell J.D.;
Molena D.; Odell D.D.; Onaitis M.W.; Puri V.; Putnam J.B.; Seder C.W.;
Shrager J.B.; Soukiasian H.J.; Stiles B.M.; Tong B.C.; Veeramachaneni N.K.
Institution
(Bryan) Department of Surgery, University of Chicago, Chicago, IL, United
States
(Ferguson, Donington) Section of Thoracic Surgery, Department of Surgery,
University of Chicago, Chicago, IL, United States
(Antonoff, Hofstetter) Department of Thoracic and Cardiovascular Surgery,
University of Texas MD Anderson Cancer Center, Houston, TX, United States
(Backhus, Shrager) Division of Thoracic Surgery, Department of
Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto,
CA, United States
(Birdas) Division of Cardiothoracic Surgery, Indiana University School of
Medicine, Indianapolis, IN, United States
(Blackmon) Division of General Thoracic Surgery, Mayo Clinic, Rochester,
MN, United States
(Boffa) Section of Thoracic Surgery, Yale School of Medicine, New Haven,
CT, United States
(Chang, Lin) Section of Thoracic Surgery, University of Michigan, Ann
Arbor, MI, United States
(Chmielewski) Section of Thoracic Surgery, Advocate Aurora Healthcare,
Aurora, IL, United States
(Cooke) Section of General Thoracic Surgery, University of California,
Davis Health, Davis, CA, United States
(Gaissert) Division of Thoracic Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Hagen) Division of Thoracic Surgery, Sanger Heart and Vascular Institute,
Charlotte, NC, United States
(Kent) Division of Thoracic Surgery and Interventional Pulmonology, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(Kim) Wellstar Health System, Marietta, Georgia
(Krantz) Division of Thoracic Surgery, NorthShore University Health
System, Evanston, IL, United States
(Martin) Division of Thoracic Surgery, University of Virginia School of
Medicine, Charlottesville, VA, United States
(Meyerson) Section of Thoracic Surgery, University of Kentucky, Lexington,
KY, United States
(Mitchell) Division of Cardiothoracic Surgery, Section of General Thoracic
Surgery, University of Colorado Denver, Aurora, CO, United States
(Molena) Thoracic Service, Memorial Sloan Kettering Cancer Center, New
York, NY, United States
(Odell) Division of Thoracic Surgery, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
(Onaitis) Division of Cardiovascular and Thoracic Surgery, University of
California San Diego Medical Center, San Diego, CA, United States
(Puri) Division of Cardiothoracic Surgery, Washington University School of
Medicine, St. Louis, MO, United States
(Putnam) Department of Thoracic Surgery, Baptist MD Anderson Cancer
Center, Jacksonville, FL, United States
(Seder) Department of Cardiovascular and Thoracic Surgery, Rush University
Medical Center, Chicago, IL, United States
(Soukiasian) Division of Thoracic Surgery, Cedars-Sinai Medical Center,
Los Angeles, CA, United States
(Stiles) Division of Thoracic Surgery, New York-Presbyterian Hospital,
Weill Cornell Medical College, New York, NY, United States
(Tong) Division of Cardiovascular and Thoracic Surgery, Duke University
Medical Center, Durham, NC, United States
(Veeramachaneni) Department of Cardiovascular and Thoracic Surgery,
University of Kansas Health System, Kansas City, KS, United States
Publisher
Elsevier Inc.
Abstract
Background: Simulation-based training is a valuable component of
cardiothoracic surgical education. Effective curriculum development
requires consensus on procedural components and focused attention on
specific learning objectives. Through use of a Delphi process, we
established consensus on the steps of video-assisted thoracoscopic surgery
(VATS) left upper lobectomy and identified targets for simulation.
<br/>Method(s): Experienced thoracic surgeons were randomly selected for
participation. Surgeons voted and commented on the necessity of individual
steps comprising VATS left upper lobectomy. Steps with greater than 80% of
participants in agreement of their necessity were determined to have
established "consensus." Participants voted on the physical or cognitive
complexity of each, or both, and chose steps most amenable to focused
simulation. <br/>Result(s): Thirty thoracic surgeons responded and joined
in the voting process. Twenty operative steps were identified, with
surgeons reaching consensus on the necessity of 19. Components deemed most
difficult and amenable to simulation included those related to dissection
and division of the bronchus, artery, and vein. <br/>Conclusion(s):
Through a Delphi process, surgeons with a variety of practice patterns can
achieve consensus on the operative steps of left upper lobectomy and
agreement on those most appropriate for simulation. This information can
be implemented in the development of targeted simulation for VATS
lobectomy.<br/>Copyright &#xa9; 2021 The Society of Thoracic Surgeons

<95>
Accession Number
2011141904
Title
Advances in Clinical Cardiology 2020: A Summary of Key Clinical Trials.
Source
Advances in Therapy. 38 (5) (pp 2170-2200), 2021. Date of Publication: May
2021.
Author
Kearney A.; Linden K.; Savage P.; Menown I.B.A.
Institution
(Kearney, Linden, Savage, Menown) Craigavon Cardiac Centre, Southern
Health and Social Care Trust, Craigavon, United Kingdom
Publisher
Adis
Abstract
Introduction: Despite the challenge of a global pandemic, 2020 has been an
invaluable year in cardiology research with numerous important clinical
trials published or presented virtually at major international meetings.
This article aims to summarise these trials and place them in clinical
context. <br/>Method(s): The authors reviewed clinical trials presented at
major cardiology conferences during 2020 including the American College of
Cardiology, European Association for Percutaneous Cardiovascular
Interventions, European Society of Cardiology, Transcatheter
Cardiovascular Therapeutics and the American Heart Association. Trials
with a broad relevance to the cardiology community and those with
potential to change current practice were included. <br/>Result(s): A
total of 87 key cardiology clinical trials were identified for inclusion.
New interventional and structural cardiology data included trials
evaluating bifurcation percutaneous coronary intervention (PCI)
techniques, intravascular ultrasound (IVUS)-guided PCI, instantaneous
wave-free (iFR) physiological assessment, new generation stents (DynamX
bioadaptor), transcatheter aortic valve implantation (TAVI) in low-risk
patients, and percutaneous mitral or tricuspid valve interventions.
Preventative cardiology data included new data with proprotein convertase
subtilisin-kexin type 9 (PCSK9) inhibitors (evolocumab and alirocumab),
omega-3 supplements, evinacumab and colchicine in the setting of chronic
coronary artery disease. Antiplatelet data included trials evaluating both
the optimal length of course following PCI and combination of antiplatelet
agents and regimes including combination antithrombotic therapies for
patients with atrial fibrillation (AF). Heart failure data included the
use of sodium-glucose cotransporter 2 (SGLT2) inhibitors (sotagliflozin,
empagliflozin and dapagliflozin) and mavacamten in hypertrophic
cardiomyopathy. Electrophysiology trials included early rhythm control in
AF and screening for AF. <br/>Conclusion(s): This article presents a
summary of key clinical cardiology trials during the past year and should
be of relevance to both clinicians and cardiology
researchers.<br/>Copyright &#xa9; 2021, Crown.

<96>
Accession Number
53171883
Title
Post cardiac injury syndrome after initially uncomplicated CRT-D
implantation: a case report and a systematic review.
Source
Clinical Research in Cardiology. 103 (10) (pp 781-789), 2014. Date of
Publication: October 2014.
Author
Sedaghat-Hamedani F.; Zitron E.; Kayvanpour E.; Lorenz H.-M.; Katus H.A.;
Meder B.
Institution
(Sedaghat-Hamedani, Zitron, Kayvanpour, Katus, Meder) Department of
Medicine III, University of Heidelberg, INF 410, Heidelberg 69120, Germany
(Lorenz) Department of Medicine V, University of Heidelberg, Heidelberg,
Germany
Publisher
Dr. Dietrich Steinkopff Verlag GmbH and Co. KG
Abstract
Background: Post cardiac injury syndrome (PCIS) is an inflammatory process
that occurs in the setting of injury to the pericardium, epicardium or
myocardium. It may follow cardiac surgery, myocardial infarction, trauma,
intracardiac ablation, percutaneous coronary intervention or implantation
of a pacemaker or cardioverter-defibrillator.
Methods: In this paper, we report the first case of PCIS after
implantation of a "Cardiac Resynchronization Therapy Defibrillator"
(CRT-D) device and review systematically the available literature. To
obtain information on PCIS after implantation of heart rhythm devices
(HRD), we performed a systematic review of Medline, EMBASE and the
Cochrane Central Register of Controlled Trials (CENTRAL). The collected
data included age, gender, initial diagnosis, procedure type, time to
PCIS, symptoms, clinical manifestations, therapy and outcome. Included
were reports in English, French and Spanish.
Results: In our systematic review, we found PCIS after HRD implantation in
17 additional cases. The age ranged from 23 to 84 years. Symptoms
developed within 1 day-4 months after implantation. The use of
active-fixation atrial leads was reported in nine cases. Fever, dyspnoea,
chest pain, tachypnoea, tachycardia, palpitation, malaise, ankle edema,
dry cough, night sweats, nausea and vomiting were reported as associated
symptoms.
Conclusion: PCIS should be considered as a rare, but serious complication
of HRD implantation, may cause recurrent hospitalization and can be life
threatening. The incidence and possible causes of PCIS after HRD, such as
active fixation leads and specific lead positions as well as its treatment
deserve further investigation in prospective studies.<br/>Copyright &#xa9;
2014, Springer-Verlag Berlin Heidelberg.

<97>
Accession Number
2013683888
Title
Dose-response relationship among body mass index, abdominal adiposity and
atrial fibrillation in patients undergoing cardiac surgery: A
meta-analysis of 35 cohorts.
Source
PeerJ. 9 (no pagination), 2021. Article Number: e11855. Date of
Publication: 21 Jul 2021.
Author
Liu M.; Mei K.; Xie L.; Ma J.; Yu P.; Niu S.; Xu Y.; Zhao Y.; Liu X.
Institution
(Liu, Niu, Xu, Zhao) Department of Cardiology, Seventh People's Hospital
of Zhengzhou, Henan, Zhengzhou, China
(Mei) Anesthesiology Department, The People's Hospital of Shanggrao,
Jiangxi, Shangrao, China
(Xie) Department of Respiratory and Critical Care Medicine, The Second
Affiliated Hospital of Nanchang University, Jiangxi, Nanchang, China
(Ma) Department of Pharmacology and Systems Physiology, University of
Cincinnati, College of Medicine, Cincinnati, Oh, United States
(Yu) Department of Endocrine, The Second Affiliated Hospital of Nanchang
University, Jiangxi, Nanchang, China
(Liu) Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen
University, Guangdong, Guangzhou, China
(Liu) Guangdong Province Key Laboratory of Arrhythmia and
Electrophysiology, Guangdong, Guangzhou, China
(Liu) Guangzhou Key Laboratory of Molecular Mechanism and Translation in
Major Cardiovascular Disease, Guangzhou, China
Publisher
PeerJ Inc.
Abstract
Background. Whether overweight increases the risk of postoperative atrial
fibrillation (POAF) is unclear, and whether adiposity independently
contributes to POAF has not been comprehensively studied. Thus, we
conducted a meta-analysis to clarify the strength and shape of the
exposure-effect relationship between adiposity and POAF. Methods. The
PubMed, Cochrane Library, and EMBASE databases were searched for revelant
studies (randomized controlled trials (RCTs), cohort studies, and
nest-case control studies) reporting data regarding the relationship
between adiposity and the risk of POAF. Results. Thirty-five publications
involving 33,271 cases/141,442 patients were included. Analysis of
categorical variables showed that obesity (RR: 1.39, 95% CI [1.21-1.61]; P
< 0.001), but not being underweight (RR: 1.44, 95% CI [0.90-2.30]; P =
0.13) or being overweight (RR: 1.03, 95% CI [0.95-1.11]; P = 0.48) was
associated with an increased risk of POAF. In the exposure-effect analysis
(BMI) was 1.09 (95% CI [1.05-1.12]; P < 0.001) for the risk of POAF. There
was a significant linear relationship between BMI and POAF
(P<inf>nonlinearity</inf> = 0.44); the curve was flat and began to rise
steeply at a BMI of approximately 30. Notably, BMI levels below 30
(overweight) were not associated with a higher risk of POAF. Additionally,
waist obesity or visceral adiposity index was associated with the risk of
POAF. Conclusion. Based on the current evidence, our findings showed that
high body mass index or abdominal adiposity was independently associated
with an increased risk of POAF, while underweight or overweight might not
significantly increase the POAF risk.<br/>Copyright &#xa9; 2021 Liu et al.
Distributed under Creative Commons CC-BY 4.0

<98>
Accession Number
635541279
Title
Meta-analysis of impact of renin-angiotensin system inhibitors on survival
after transcatheter aortic valve implantation.
Source
Minerva cardiology and angiology. 69 (3) (pp 299-309), 2021. Date of
Publication: 01 Jun 2021.
Author
Takagi H.; Kuno T.; Hari Y.; Nakashima K.; Yokoyama Y.; Ueyama H.; Ando T.
Institution
(Takagi) Shizuoka Medical Center, Department of Cardiovascular Surgery,
Shizuoka, Japan
(Takagi) Department of Cardiovascular Surgery, Kitasato University School
of Medicine, Sagamihara, Japan
(Kuno, Ueyama) Department of Medicine, Mount Sinai Beth Israel Medical
Center, NY, NY, United States
(Hari, Nakashima) Shizuoka Medical Center, Department of Cardiovascular
Surgery, Shizuoka, Japan
(Hari, Nakashima) Department of Cardiovascular Surgery, Kitasato
University School of Medicine, Sagamihara, Japan
(Yokoyama) Department of Surgery, Easton Hospital, PA, Easton, United
States
(Ando) Division of Interventional Cardiology, Department of Cardiology,
New York Presbyterian Hospital/Columbia University Medical Center, NY, NY,
United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: To determine whether renin-angiotensin system inhibitor
(RASI) prescription is associated with better survival after transcatheter
aortic valve implantation (TAVI), we performed the first meta-analysis of
currently available studies. EVIDENCE ACQUISITION: To identify all studies
reporting impact of RASI prescription on survival after TAVI, we searched
PubMed, Web of Science, Google Scholar, etc. through October 2019. We
extracted adjusted (if unavailable, unadjusted) hazard ratios (HRs) with
their confidence intervals (CIs) of midterm (up to >=6-month) all-cause
mortality for RASI prescription from each study and combined
study-specific estimates using inverse variance-weighted averages of
logarithmic HRs in the random-effects model. EVIDENCE SYNTHESIS: We
identified 13 eligible studies with a total of 26,132 TAVI patients and
included them in the present meta-analysis. None was a randomized
controlled trial, 5 were observational studies comparing patients with
versus without RASI prescription (including 3 propensity score matched
studies), and 8 were observational studies investigating RASI prescription
as one of covariates. The primary meta-analysis of all studies
demonstrated that RASI prescription was associated with significantly
lower midterm mortality (HR=0.83; 95% CI: 0.76 to 0.92; P=0.0002).
Although we identified significant funnel plot asymmetry (P=0.036 by the
rank correlation test) suggesting publication bias, correcting for it
using the trim-and-fill method did not substantially alter the result
favoring RASI prescription (corrected HR=0.85; 95% CI: 0.76 to 0.95;
P=0.004). <br/>CONCLUSION(S): RASI prescription may be associated with
better midterm survival after TAVI.

<99>
Accession Number
635530881
Title
Health system costs of rheumatic heart disease care in South Africa.
Source
BMC public health. 21 (1) (pp 1303), 2021. Date of Publication: 03 Jul
2021.
Author
Hellebo A.G.; Zuhlke L.J.; Watkins D.A.; Alaba O.
Institution
(Hellebo) Health Economics Unit, Faculty of Health Sciences, School of
Public Health and Family Medicine, University of Cape Town, Cape Town,
South Africa
(Zuhlke) Division of Paediatric Cardiology, Department of Paediatrics,
Faculty of Health Sciences, Red Cross War Memorial Children's Hospital,
University of Cape Town, Cape Town, South Africa
(Zuhlke) Division of Cardiology, Department of Medicine, Faculty of Health
Sciences, Groote Schuur Hospital, University of Cape Town, Cape Town,
South Africa
(Watkins) Division of General Internal Medicine, Department of Medicine,
School of Medicine, University of Washington, Seattle, United States
(Watkins) Department of Global Health, University of Washington, Seattle,
United States
(Alaba) Health Economics Unit, Faculty of Health Sciences, School of
Public Health and Family Medicine, University of Cape Town, Cape Town,
South Africa
Publisher
NLM (Medline)
Abstract
BACKGROUND: Rheumatic Heart Disease (RHD) is a disease of poverty that is
neglected in developing countries, including South Africa. Lack of
adequate evidence regarding the cost of RHD care has hindered national and
international actions to prevent RHD related deaths. The objective of this
study was to estimate the cost of RHD-related health services in a
tertiary hospital in the Western Cape, South Africa. <br/>METHOD(S): The
primary data on service utilisation were collected from a randomly
selected sample of 100 patient medical records from the Global Rheumatic
Heart Disease Registry (the REMEDY study) - a registry of individuals
living with RHD. Patient-level clinical data, including, prices and
quantities of medications and laboratory tests, were collected from the
main tertiary hospital providing RHD care. All annual costs from a health
system perspective were estimated in 2017 (base year) in South African
Rand (ZAR) using a combination of ingredients and step-down costing
approaches and later converted to United States dollars (USD). Step-down
costing was used to estimate provider time costs and all other facility
costs such as overheads. A 3% discount rate was also employed in order to
allow depreciation and opportunity cost. We aggregated data to estimate
the total annual costs and the average annual per-patient cost of RHD and
conducted a one-way sensitivity analysis. <br/>RESULT(S): The estimated
total cost of RHD care at the tertiary hospital was USD 2 million (in 2017
USD) for the year 2017, with surgery costs accounting for 65%.
Per-patient, average annual costs were USD 3900. For the subset of costs
estimated using the ingredients approach, outpatient medications, and
consumables related to cardiac catheterisation and heart valve surgery
were the main cost drivers. <br/>CONCLUSION(S): RHD-related healthcare
consumes significant tertiary hospital resources in South Africa, with
annual per-patient costs higher than many other non-communicable and
infectious diseases. This analysis supports the scaling up of primary and
secondary prevention programmes at primary health centers in order to
reduce future tertiary care costs. The study could also inform resource
allocation efforts and provide cost estimates for future studies of
intervention cost-effectiveness.

<100>
Accession Number
635530479
Title
Effect of an Educational Support Programme on Caregiver Burden Among the
Family Members of Patients Undergoing Coronary Artery Bypass Graft
Surgery.
Source
Sultan Qaboos University medical journal. 21 (2) (pp e266-e274), 2021.
Date of Publication: 01 May 2021.
Author
Dalirirad H.; Najafi T.; Seyedfatemi N.
Institution
(Dalirirad, Najafi, Seyedfatemi) Department of Emergency & Critical Care
Nursing, School of Nursing & Midwifery, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
Objectives: The family caregivers of patients undergoing coronary artery
bypass graft (CABG) surgery experience considerable physical and emotional
distress. This study aimed to investigate the effect of an educational
support programme on caregiver burden among the family caregivers of
patients undergoing CABG surgery in Iran. <br/>Method(s): This
non-randomised controlled clinical trial was conducted from January to
April 2017 at a cardiovascular centre in Tehran, Iran. A total of 80
family caregivers of patients undergoing CABG surgery were sequentially
selected and non-randomly assigned to intervention and control groups. The
control group received routine care, whereas the intervention group
received additional education sessions at baseline, prior to surgery, the
day after surgery and before discharge. Caregiver burden was compared at
baseline and six weeks post-discharge using the Persian-language versions
of the Caregiver Burden Inventory (CBI) and Katz Index of Independence in
Activities of Daily Living (IADL). <br/>Result(s): A significant
difference was observed between family caregivers in the control and
intervention groups with regards to pre-post differences in mean CBI
scores (+1.67 +/- 19.23 versus +17.45 +/- 9.83; P <0.001), with an effect
size of -1.14. In addition, there was a significant increase in mean
post-discharge IADL scores among CABG patients in the intervention group
compared to the control group (4.42 +/- 1.05 versus 3.07 +/- 1.09; P
<0.001). <br/>Conclusion(s): An educational support programme
significantly reduced caregiver burden among the family members of
patients undergoing CABG surgery in Iran. As such, in addition to routine
care, healthcare providers should provide educational support to this
population to help mitigate caregiver burden.<br/>&#xa9; Copyright 2021,
Sultan Qaboos University Medical Journal, All Rights Reserved.

<101>
Accession Number
2013639910
Title
Impact of Diabetes on Outcomes After Transcatheter Mitral Valve Repair in
Heart Failure: COAPT Trial.
Source
JACC: Heart Failure. 9 (8) (pp 559-567), 2021. Date of Publication: August
2021.
Author
Shahim B.; Ben-Yehuda O.; Chen S.; Redfors B.; Madhavan M.V.; Kar S.; Lim
D.S.; Asch F.M.; Weissman N.J.; Cohen D.J.; Arnold S.V.; Liu M.;
Lindenfeld J.; Abraham W.T.; Mack M.J.; Stone G.W.
Institution
(Shahim, Ben-Yehuda, Chen, Redfors, Madhavan, Cohen, Liu, Stone) Clinical
Trials Center, Cardiovascular Research Foundation, New York, NY, United
States
(Ben-Yehuda, Chen, Redfors, Madhavan) NewYork-Presbyterian
Hospital/Columbia University Irving Medical Center, New York, NY, United
States
(Ben-Yehuda) Division of Cardiology, University of California San Diego,
San Diego, CA, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville, VA,
United States
(Asch, Weissman) MedStar Health Research Institute, Washington, DC, United
States
(Asch, Weissman) Georgetown University, Washington, DC, United States
(Cohen) St. Francis Hospital, Roslyn, NY, United States
(Arnold) University of Missouri-Kansas City School of Medicine, Kansas
City, MO, United States
(Arnold) Saint Luke's Mid America Heart Institute, Kansas City, MO, United
States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Abraham) Division of Cardiovascular Medicine, the Ohio State University,
Columbus, OH, United States
(Mack) Baylor Scott and White Health, Plano, TX, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Objectives: This paper sought to determine whether diabetes influences the
outcomes of transcatheter mitral valve repair (TMVr) in patients with
heart failure (HF) and secondary mitral regurgitation (SMR).
<br/>Background(s): Diabetes is associated with worse outcomes in patients
with HF. <br/>Method(s): The COAPT (Cardiovascular Outcomes Assessment of
the MitraClip Percutaneous Therapy for Heart Failure Patients With
functional Mitral Regurgitation) trial randomized HF patients with 3+ or
4+ SMR to MitraClip plus guideline-directed medical therapy (GDMT) versus
GDMT alone. Two-year outcomes were evaluated in patients with versus
without diabetes. <br/>Result(s): Of 614 patients, 229 (37.3%) had
diabetes. Diabetic patients had higher 2-year rates of death than those
without diabetes (40.8% vs 32.3%, respectively; adjusted P = 0.04) and
tended to have higher rates of HF hospitalization (HFH) (HFH: 50.1% vs
43.0%, respectively; adjusted P = 0.07). TMVr reduced the 2-year rate of
death consistently in patients with (30.3% vs 49.9%, respectively;
adjusted HR: 0.51; 95% CI: 0.32 to 0.81) and without (27.0% vs 38.3%,
respectively; adjusted HR: 0.57; 95% CI: 0.39-0.84) diabetes
(P<inf>interaction</inf> = 0.72). TMVr also consistently reduced the
2-year rates of HFH in patients with (32.2% vs 54.8%, respectively;
adjusted HR: 0.41; 95% CI: 0.28-0.58) and without (41.5% vs 59.0%,
respectively; adjusted HR: 0.54: 95% CI 0.35-0.82) diabetes
(P<inf>interaction</inf> = 0.33). Greater movements in quality-of-life
(QOL) and exercise capacity occurred with TMVr than with GDMT alone,
regardless of diabetic status. <br/>Conclusion(s): Among HF patients with
severe SMR in the COAPT trial, those with diabetes had a worse prognosis.
Nonetheless, diabetic and nondiabetic patients had consistent reductions
in the 2-year rates of death and HFH and improvements in QOL and
functional capacity following TMVr treatment using the MitraClip than with
maintenance on GDMT alone. (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation [COAPT]; NCT01626079)<br/>Copyright &#xa9; 2021
American College of Cardiology Foundation

<102>
Accession Number
2013625873
Title
Efficacy of compressive ischemic pressure release on pectoral's trigger
points on RT side cardiac output following open heart surgery: Randomized
clinical trial.
Source
Turkish Journal of Physiotherapy and Rehabilitation. 32 (3) (pp
8725-8729), 2021. Date of Publication: 2021.
Author
Elhafez H.M.; Badr S.A.A.; Abdelghany M.M.; Rezkallah S.S.; Tekla M.K.
Institution
(Elhafez) Faculty of Physical Therapy, Suez University
(Badr) Physical Therapy Department, KasrAlainy Hospital, Cairo University
Hospitals
(Abdelghany) Cardiovascular Department, Faculty of Medicine, Cairo
University
(Elhafez, Rezkallah, Tekla) Basic Science Department, Faculty of Physical
Therapy, Cairo University
Publisher
Turkish Physiotherapy Association
Abstract
Background: Every open heart surgery (OHS) presents a great risk for
complications according to the type of procedure being performed. This is
a widespread significant health problem with a huge burden on the
individual and economy. Finding a noninvasive effective treatment that's
non exhaustive for the therapist and non painful for the patient is highly
needed. Aim of Study: This study investigated the efficacy of compressive
ischemic pressure releases on pectorals Trigger Points (TrPs) on chest
pain, Pressure Pain Threshold (ppt) and Cardiac Output (CO) following OHS.
<br/>Method(s): Forty patients with OHS performed sternal- approach
maneuver participated in this study. They were recruited from Kasr
Al-ainy, between 20: 50 years oldwere assigned into two equal groups, the
experimental group (A) received compression ischemic pressure release of
pectorals muscles TrPs and diaphragmatic deep breathing exercise. The
control group (B) received diaphragmatic deep breathing exercise.Pain and
CO measurements were used to evaluate patients before and after treatment.
<br/>Result(s): there was a significant improvement in the Pain pressure
thresholds (p<0.0001) after ischemic pressure release of pectorals muscles
TrPs and significant improvement in the Rt side CO TAPSe thresholds
(p<0.0001), using mixed MANOVA test between the two groups.
<br/>Conclusion(s):compressive ischemic pressure release of trigger points
in pectoral muscles post open heart surgery was effective in reducing pain
and improving cardiac output in open heart patients.<br/>Copyright &#xa9;
2021 Turkish Physiotherapy Association. All rights reserved.

<103>
Accession Number
2013196155
Title
Effects of bilateral Pecto-intercostal Fascial Block for perioperative
pain management in patients undergoing open cardiac surgery: a prospective
randomized study.
Source
BMC Anesthesiology. 21 (1) (no pagination), 2021. Article Number: 175.
Date of Publication: December 2021.
Author
Zhang Y.; Gong H.; Zhan B.; Chen S.
Institution
(Zhang, Gong, Chen) Department of Anesthesiology, First Affiliated
Hospital of Nanchang University, 17 Yong wai zheng Street, Nanchang,
Jiangxi 330006, China
(Zhan) Department of cardiology, The second Affiliated Hospital of
Nanchang University, NO.1 minde Street, Nanchang, Jiangxi 330006, China
Publisher
BioMed Central Ltd
Abstract
Background: Open cardiac surgical patients may experience severe acute
poststernotomy pain. The ultrasound-guided Pecto-intercostal Fascial Block
(PIFB) can cover anterior branches of intercostal nerves from T2 to T6.
The aim of this study was to investigate the effect of bilateral PIFB in
patients undergoing open cardiac surgery. <br/>Method(s): A group of 108
patients were randomly allocated to either receive bilateral PIFB (PIFB
group) or no nerve block (SALI group). The primary endpoint was
postoperative pain. The secondary outcome measures included intraoperative
and postoperative sufentanil and parecoxib consumption, time to
extubation, time to first feces, length of stay in the ICU and the length
of hospital stay. Insulin, glucose, insulin resistance and interleukin
(IL)-6 at 1, 2, 3 days after surgery were mearsured. The homeostasis model
assessment (HOMA-IR) was used to measure perioperative insulin resistance.
<br/>Result(s): The PIFB group reported significantly less sufentanil and
parecoxib consumption than the SALI group. Compared to the PIFB group, the
SALI group had higher Numerical Rating Scale (NRS) pain scores at 24 h
after operation both at rest and during coughing. The time to extubation,
length of stay in the ICU and length of hospital stay were significantly
decreased in the PIFB group compared with the SALI group. The PIFB group
had a lower insulin, glucose, IL-6, HOMA-IR level than the SALI group 3
days after surgery. <br/>Conclusion(s): Bilateral PIFB provides effective
analgesia and accelerates recovery in patients undergoing open cardiac
surgery. Trial registration: This study was registered in the Chinese
Clinical Trial Registry (ChiCTR 2000030609) on 08/03/2020.<br/>Copyright
&#xa9; 2021, The Author(s).

<104>
Accession Number
2013195928
Title
Relation of insulin treatment for type 2 diabetes to the risk of major
adverse cardiovascular events after acute coronary syndrome: an analysis
of the BETonMACE randomized clinical trial.
Source
Cardiovascular Diabetology. 20 (1) (no pagination), 2021. Article Number:
125. Date of Publication: December 2021.
Author
Schwartz G.G.; Nicholls S.J.; Toth P.P.; Sweeney M.; Halliday C.;
Johansson J.O.; Wong N.C.W.; Kulikowski E.; Kalantar-Zadeh K.; Ginsberg
H.N.; Ray K.K.
Institution
(Schwartz) Division of Cardiology, University of Colorado School of
Medicine, 1700 N. Wheeling St. (Cardiology 111B), Aurora, CO 80045, United
States
(Nicholls) Victorian Heart Institute, Monash University, Melbourne,
Australia
(Toth) Cicarrone Center for the Prevention of Cardiovascular Disease,
Johns Hopkins University School of Medicine, Baltimore, MD, United States
(Toth) CGH Medical Center Sterling, Sterling, IL, United States
(Sweeney, Halliday, Johansson, Wong, Kulikowski) Resverlogix Corporation,
Calgary, AB, Canada
(Kalantar-Zadeh) Division of Nephrology and Hypertension, University of
California Irvine, Orange, CA, United States
(Ginsberg) Department of Medicine, Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, United States
(Ray) Imperial Centre for Cardiovascular Disease Prevention, Imperial
College, London, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: In stable patients with type 2 diabetes (T2D), insulin
treatment is associated with elevated risk for major adverse
cardiovascular events (MACE). Patients with acute coronary syndrome (ACS)
and T2D are at particularly high risk for recurrent MACE despite
evidence-based therapies. It is uncertain to what extent this risk is
further magnified in patients with recent ACS who are treated with
insulin. We examined the relationship of insulin use to risk of MACE and
modification of that risk by apabetalone, a bromodomain and extra-terminal
(BET) protein inhibitor. <br/>Method(s): The analysis utilized data from
the BETonMACE phase 3 trial that compared apabetalone to placebo in
patients with T2D, low HDL cholesterol, andACS. The primary MACE outcome
(cardiovascular death, myocardial infarction, or stroke) was examined
according to insulin treatment and assigned study treatment. Multivariable
Cox regression was used to determine whether insulin use was independently
associated with the risk of MACE. <br/>Result(s): Among 2418 patients
followed for median 26.5 months, 829 (34.2%) were treated with insulin.
Despite high utilization of evidence-based treatments including coronary
revascularization, intensive statin treatment, and dual antiplatelet
therapy, the 3-year incidence of MACE in the placebo group was elevated
among insulin-treated patients (20.4%) compared to those not-treated with
insulin (12.8%, P = 0.0001). Insulin treatment remained strongly
associated with the risk of MACE (HR 2.10, 95% CI 1.42-3.10, P = 0.0002)
after adjustment for demographic, clinical, and treatment variables.
Apabetalone had a consistent, favorable effect on MACE in insulin-treated
and not insulin-treated patients. <br/>Conclusion(s): Insulin-treated
patients with T2D, low HDL cholesterol, and ACS are at high risk for
recurrent MACE despite the use of evidence-based, contemporary therapies.
A strong association of insulin treatment with risk of MACE persists after
adjustment for other characteristics associated with MACE. There is unmet
need for additional treatments to mitigate this risk. Trial registration
ClinicalTrials.gov NCT02586155, registered October 26, 2015<br/>Copyright
&#xa9; 2021, The Author(s).

<105>
Accession Number
2007872671
Title
Effect of deep versus moderate neuromuscular blockade on quantitatively
assessed postoperative atelectasis using computed tomography in thoracic
surgery; a randomized double-blind controlled trial.
Source
Journal of Clinical Medicine. 10 (15) (no pagination), 2021. Article
Number: 3228. Date of Publication: 01 Aug 2021.
Author
Lee B.-J.; Lee H.N.; Chung J.-Y.; Kim D.; Kim J.I.; Seo H.
Institution
(Lee, Chung, Seo) Department of Anesthesiology and Pain Medicine, Kyung
Hee University Hospital at Gangdong, College of Medicine, Kyung Hee
University, Seoul 05278, South Korea
(Lee, Kim) Department of Radiology, Kyung Hee University Hospital at
Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, South
Korea
(Kim) Department of Thoracic Surgery, Kyung Hee University Hospital at
Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, South
Korea
Publisher
MDPI AG
Abstract
Background: postoperative atelectasis is a significant clinical problem
during thoracic surgery with one-lung ventilation. Intraoperative deep
neuromuscular blockade can improve surgical conditions, but an increased
risk of residual paralysis may aggravate postoperative atelectasis. Every
patient was verified to have full reversal before extubation. We compared
the effect of deep versus moderate neuromuscular blockade on postoperative
atelectasis quantitatively using chest computed tomography.
<br/>Method(s): patients undergoing thoracic surgery were randomly
allocated to two groups: moderate neuromuscular blockade during surgery
(group M) and deep neuromuscular blockade during surgery (group D). The
primary outcome was the proportion and the volume of postoperative
atelectasis measured by chest computed tomography on postoperative day 2.
The mean values of the repeatedly measured intraoperative dynamic lung
compliance during surgery were also compared. <br/>Result(s): the
proportion of postoperative atelectasis did not differ between the groups
(1.32 [0.47-3.20]% in group M and 1.41 [0.24-3.07]% in group D, p =
0.690). The actual atelectasis volume was 38.2 (12.8-61.4) mL in group M
and 31.9 (7.84-75.0) mL in group D (p = 0.954). Some factors described in
the lung protective ventilation were not taken into account and might
explain the atelectasis in both groups. The mean lung compliance during
one-lung ventilation was higher in group D (26.6% in group D vs. 24.1% in
group M, p = 0.026). <br/>Conclusion(s): intraoperative deep neuromuscular
blockade did not affect postoperative atelectasis when compared with
moderate neuromuscular blockade if full reversal was
verified.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<106>
Accession Number
2007872297
Title
Recent developments in rodent models of high-fructose diet-induced
metabolic syndrome: A systematic review.
Source
Nutrients. 13 (8) (no pagination), 2021. Article Number: 2497. Date of
Publication: August 2021.
Author
Chan A.M.L.; Ng A.M.H.; Mohd Yunus M.H.; Idrus R.B.H.; Law J.X.; Yazid
M.D.; Chin K.-Y.; Shamsuddin S.A.; Lokanathan Y.
Institution
(Chan, Ng, Idrus, Law, Yazid, Shamsuddin, Lokanathan) Centre for Tissue
Engineering and Regenerative Medicine, Faculty of Medicine, Universiti
Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala
Lumpur 56000, Malaysia
(Chan) Ming Medical Sdn. Bhd, D3-3 (2nd Floor), Block D3 Dana 1 Commercial
Centre, Jalan PJU 1A/22, Petaling Jaya 47101, Malaysia
(Mohd Yunus) Department of Physiology, Faculty of Medicine, Universiti
Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala
Lumpur 56000, Malaysia
(Chin) Department of Pharmacology, Faculty of Medicine, Universiti
Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala
Lumpur 56000, Malaysia
Publisher
MDPI AG
Abstract
Metabolic syndrome (MetS) is the physiological clustering of hypertension,
hyperglycemia, hyperinsulinemia, dyslipidemia, and insulin resistance. The
MetS-related chronic illnesses encompass obesity, the cardiovascular
system, renal operation, hepatic function, oncology, and mortality. To
perform pre-clinical research, it is imperative that these symptoms be
successfully induced and optimized in lower taxonomy. Therefore, novel and
future applications for a disease model, if proven valid, can be
extrapolated to humans. MetS model establishment is evaluated based on the
significance of selected test parameters, paradigm shifts from new
discoveries, and the accessibility of the latest technology or advanced
methodologies. Ultimately, the outcome of animal studies should be
advantageous for human clinical trials and solidify their position in
advanced medicine for clinicians to treat and adapt to serious or specific
medical situations. Rodents (Rattus norvegicus and Mus musculus) have been
ideal models for mammalian studies since the 18th century and have been
mapped extensively. This review compiles and compares studies published in
the past five years between the multitude of rodent comparative models.
The response factors, niche parameters, and replicability of diet
protocols are also compiled and analyzed to offer insight into
MetS-related disease-specific modelling.<br/>Copyright &#xa9; 2021 by the
authors. Licensee MDPI, Basel, Switzerland.

<107>
Accession Number
2013147120
Title
Incidence, Predictors, and Outcomes of Patients Discharged Home Versus
Other Medical Facility After Transcatheter or Surgical Aortic Valve
Replacement.
Source
Structural Heart. (no pagination), 2021. Date of Publication: 2021.
Author
Shreenivas S.; Lilly S.; Kodali S.; Thourani V.H.; Mack M.J.; Cohen D.J.;
Arnold S.V.; Zhang Y.; Leon M.B.; Kereiakes D.J.
Institution
(Shreenivas, Kereiakes) The Christ Hospital, Cincinnati, OH, United States
(Lilly) Ohio State University Medical Center, Columbus, OH, United States
(Kodali, Leon) Columbia University Medical Center/NewYork-Presbyterian
Hospital, New York, NY, United States
(Thourani) Piedmont Heart Institute, Atlanta, GA, United States
(Mack) Baylor Scott & White Health, Plano, TX, United States
(Cohen, Zhang, Leon) Cardiovascular Research Foundation, New York, NY,
United States
(Cohen) St. Francis Hospital, Roslyn, NY, United States
(Arnold) University of Missouri-Kansas City, Kansas City, MO, United
States
(Arnold) Saint Luke's MidAmerica Heart Institute, Kansas City, MO, United
States
Publisher
Bellwether Publishing, Ltd.
Abstract
Background: Discharge patterns for patients following treatment of aortic
stenosis with transcatheter (TAVR) or surgical aortic valve replacement
(SAVR) are poorly defined and could impact long-term clinical outcomes.
This study considers incidence, predictors, and outcomes of patients
discharged home versus to another medical facility after either treatment.
<br/>Method(s): This is a retrospective analysis of the multicenter
randomized PARTNER 2 trial of transcatheter versus surgical aortic valve
replacement and associated registries. All patients who received either
therapy and survived until discharge were included in two separate
analyses: one for patients receiving TAVR and one for patients receiving
SAVR. The primary outcome was 2-year mortality after discharge home versus
other medical facility. Also, a model was developed to predict discharge
patterns following TAVR or SAVR. <br/>Result(s): Of 4,312 patients who
underwent TAVR, 22% (n = 958) were discharged to other medical facilities;
916 patients underwent SAVR and 52.4% (n = 480) were discharged to other
medical facilities. Two-year mortality for patients undergoing aortic
valve replacement and discharged to other medical facility versus home was
36.6% vs 18.0% after TAVR (P < 0.0001) and 19.7% vs 11.1% (P < 0.001)
after SAVR. Patients discharged to another medical facility had worse
quality of life and were more likely to be readmitted after either
procedure. <br/>Conclusion(s): After adjusting for risk factors that may
relate to discharge location and death, discharge to other medical
facility is associated with increased mortality and worse quality of life
at 2 years following TAVR or SAVR treatment of aortic
stenosis.<br/>Copyright &#xa9; 2021 Cardiovascular Research Foundation.

<108>
Accession Number
2013135232
Title
Effectiveness of cervicothoracic and thoracic manual physical therapy in
managing upper quarter disorders-a systematic review.
Source
Journal of Manual and Manipulative Therapy. (no pagination), 2021. Date of
Publication: 2021.
Author
Schenk R.; Donaldson M.; Parent-Nichols J.; Wilhelm M.; Wright A.; Cleland
J.A.
Institution
(Schenk, Donaldson, Parent-Nichols, Wilhelm, Wright, Cleland) Department
of Public Health and Community Medicine, Program in Physical Therapy,
Tufts University School of Medicine, Boston, MA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Study Design: Systematic review. <br/>Background(s): Physical therapists
often use cervicothoracic and thoracic manual techniques to treat
musculoskeletal disorders of the upper quarter,however, the overall
effectiveness of this approach remains to be elucidated.
<br/>Objective(s): This systematic review explored studies that examined
the short- and long-term effectiveness of manual physical therapy directed
at the cervicothoracic and thoracic region in the management of upper
quarter musculoskeletal conditions. <br/>Method(s): The electronic
databases MEDLINE, AMED, CINAHL, and Embase were searched from their
inception through 30 October 2020. Eligible clinical trials included those
where human subjects treated with cervicothoracic and/or thoracic manual
procedures were compared with a control group or other interventions. The
methodological quality of individual studies was assessed using the PEDro
scale. <br/>Result(s): The initial search returned 950 individual
articles. After the screening of titles and abstracts, full texts were
reviewed by two authors, with 14 articles determined to be eligible for
inclusion. PEDro scores ranged from 66 to 10 (out of a maximum score of
10). In the immediate to 52-week follow-up period, studies provided
limited evidence that cervicothoracic and thoracic manual physical therapy
may reduce pain and improve function when compared to control/sham or
other treatments. <br/>Conclusion(s): Evidence provides some support for
the short-termeffectiveness of cervicothoracic and thoracic manual
physical therapy in reducing pain and improving function in people
experiencing upper quarter musculoskeletal disorders. Evidence is lacking
for long-term effectiveness as only two studies explored outcomes beyond
26 weeks and this was for patient-perceived improvement. Prospero ID:
CRD42020219456.<br/>Copyright &#xa9; 2021 Informa UK Limited, trading as
Taylor & Francis Group.

<109>
[Use Link to view the full text]
Accession Number
635533310
Title
Extracorporeal Cytokine Adsorption Therapy As a Preventive Measure in
Cardiac Surgery and As a Therapeutic Add-On Treatment in Sepsis: An
Updated Systematic Review of Comparative Efficacy and Safety.
Source
Critical Care Medicine. (pp 1347-1357), 2021. Date of Publication: 2021.
Author
Goetz G.; Hawlik K.; Wild C.
Institution
(Goetz, Wild) Hta Austria-Austrian Institute for Health Technology
Assessment GmbH, Former: Ludwig Boltzmann Institute for Hta, Vienna,
Austria
(Hawlik) Klinik Favoriten, Wiener Gesundheitsverbund, Vienna, Austria
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: Evaluating whether there is a clinical benefit of using
extracorporeal cytokine adsorption therapy in two indications. DESIGN:
Systematic review. SETTING: Search on four databases, Medline, Embase, The
Cochrane Library, and the European Network for Health Technology
Assessment planned and ongoing projects database. PATIENTS: Patients with
sepsis/septic shock; patients undergoing cardiac surgery INTERVENTIONS:
Cytokine adsorption. MEASUREMENTS AND MAIN RESULTS: Randomized controlled
trials and prospective studies with concurrent control were eligible for
the evidence synthesis. The quality of the individual studies and the
strength of the available evidence were assessed using the Cochrane risk
of bias tool and the Grading of Recommendations, Assessment, Development,
and Evaluation approach, respectively. For the preventive treatment of
extracorporeal cytokine adsorption therapy in patients undergoing cardiac
surgery, we found very lowquality inconclusive evidence for mortality
(five randomized controlled trials, n = 163), length of stay in the ICU
(five randomized controlled trials, n = 163), and length of
hospitalization (three randomized controlled trials, n = 101). Very
low-quality inconclusive evidence was found for (serious) adverse events
(four randomized controlled trials, n = 148). For the therapeutic
treatment of extracorporeal cytokine adsorption therapy in patients with
sepsis/septic shock, we found very low-quality inconclusive evidence for
mortality up to 60-day follow-up (two randomized controlled trials, n =
117), organ function (two randomized controlled trials, n = 117) and
length of stay in the ICU (one randomized controlled trial, n = 20). Very
low-quality inconclusive evidence was found for (serious) adverse events
(two randomized controlled trials, n = 117). <br/>CONCLUSION(S): Given the
available evidence, the efficacy and safety of extracorporeal cytokine
adsorption therapy in combination with standard care in the investigated
indications was not established. We strongly recommend considering
well-powered studies with patient-relevant endpoints instead of investing
further research funds on studies that may not shed light on the clinical
benefit of extracorporeal cytokine adsorption therapy. <br/>Copyright
&#xa9; 2021 by the Society of Critical Care Medicine and Wolters Kluwer
Health, Inc. All Rights Reserved.

<110>
Accession Number
635527190
Title
Parental Post Traumatic Stress and Healthcare Utilization in infants with
Complex Cardiac Defects.
Source
The Journal of pediatrics. (no pagination), 2021. Date of Publication: 30
Jun 2021.
Author
Golfenshtein N.; Hanlon A.L.; Lozano A.J.; Srulovici E.; Lisanti A.J.; Cui
N.; Medoff-Cooper B.
Institution
(Golfenshtein) University of Haifa, Department of Nursing, University of
Pennsylvania, School of Nursing. 418 Curie Blvd, Claire M. Fagin Hall.
Philadelphia PA 19104, Israel
(Hanlon, Lozano) Virginia Tech. Center for Biostatistics and Health Data
Science. 4 Riverside Circle, Roanoke, United States
(Srulovici) University of Haifa, Department of Nursing, Israel
(Lisanti) Center for Pediatric Nursing Research & Evidence-Based Practice,
Children's Hospital of Philadelphia. 3401 Civic Center Blvd, PA 19104.
USA, Philadelphia, United States
(Cui) School of Nursing & Rehabilitation, Shandong University, Shandong
Province 250012, 44 Wenhua Xi Road, Jinan, China
(Medoff-Cooper) University of Pennsylvania, School of Nursing 418 Curie
Blvd, Claire M. Fagin Hall. Philadelphia, PA 19104; Children's Hospital of
Philadelphia. 3401 Civic Center Blvd. Philadelphia, PA 19104
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To examine the associations between post-traumatic stress of
parents of infants with complex congenital heart defects, and their
healthcare utilization for their infants during the early months of life.
STUDY DESIGN: The current study is a secondary data analysis from a
randomized controlled trail, in which 216 parent-infant dyads were
recruited from 3 cardiac intensive care units of large pediatric centers
in Northeastern America. The current sample included 153 dyads with
post-traumatic stress data at hospital discharge and at 4-months followup.
Poisson regressions were used to estimate the effect of post-traumatic
stress change scores on number of emergency department (ED) visits,
unscheduled cardiologist visits, and unscheduled pediatrician visits
outcomes. <br/>RESULT(S): Infants whose parents gained PTSD over the study
period were at increased risk for ED visits, and unscheduled cardiologist
visits. Increased symptom severity predicted more unscheduled cardiologist
visits and more unscheduled pediatrician visits. Increased symprom
clusters (avoidance, arousal, re-experiencing) predicted more ED visits,
more unscheduled cardiologist visits, and more unscheduled pediatrician
visits. <br/>CONCLUSION(S): Parents of infants with cardiac conditions may
experience post-traumatic stress following cardiac surgery, which can be
linked to greater healthcare utilization. Findings highlight the
importance of screening and treating post-traumatic stress to preserve
parental mental health and prevent adverse outcomes.<br/>Copyright &#xa9;
2021. Published by Elsevier Inc.

<111>
Accession Number
619504651
Title
Is the use of renin-angiotensin systeminhibitors in patients with aortic
valve stenosis safe and of prognostic benefit? A systematic review and
meta-analysis.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 3 (1) (pp 21-27),
2017. Date of Publication: January 2017.
Author
Andersson C.; Abdulla J.
Institution
(Andersson, Abdulla) Department of Internal Medicine, Glostrup Hospital,
University of Copenhagen, Nordre Ringvej 57, Glostrup 2600, Denmark
Publisher
Oxford University Press
Abstract
Aortic valve stenosis (AVS) is associated with significant morbidity and
mortality, especially in the presence of symptoms and echocardiographic
signs of left ventricular remodelling (i.e. increase in left ventricular
mass, left ventricular dilation, and systolic dysfunction). Renin-
angiotensin system inhibitors (RASi) attenuate cardiac remodelling in
various conditions, but the safety and efficacy of RASi in AVS is unsure.
We performed a systematic review and meta-analysis to address these
issues. We identified three smaller randomized clinical trials and five
observational studies eligible for inclusion (PubMed, EMBASE, and Cochrane
library search criteria: Aortic stenosis, aortic valve,
angiotensin-converting enzyme inhibitor in different combinations,
published in English at any time up to 1 April 2016). Our analyses
suggested that use of RASi was safe, with no observed increase in
mortality risk [576/3389 patients receiving RASi vs. 1118/4384 controls
died; relative risk 0.93 (95% confidence interval 0.78-1.11), P=0.44]. Use
of RASi was also observed to lower the risk of aortic valve replacement
(AVR) surgery [67/2913 patients with RASi vs. 154/3666 controls underwent
AVR; relative risk 0.68 (95% confidence interval 0.51-0.91), P=0.01]. In
current clinical practice (based on published literature; mainly
observational studies), use of RASi appears to be safe in patients with
AVS and may reduce the need for AVR, but the evidence is overall weak.
Large-scale randomized clinical trials are warranted to address whether
prescription of RASi to treatment-naive patients may prevent disease
progression, delay AVR surgery need, and lower the risk of
mortality.<br/>Copyright &#xa9; The Author 2016.

<112>
Accession Number
619543971
Title
Impact of additive mitral valve surgery to coronary artery bypass grafting
on mortality in patients with coronary artery disease and ischaemic mitral
regurgitation: A systematic review and meta-analysis of randomized trials
and observational studies.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 2 (1) (pp
33-44), 2016. Date of Publication: January 2016.
Author
Masri A.; Al Halabi S.; Karimianpour A.; Gillinov A.M.; Naji P.; Sabik
J.F.; Mihaljevic T.; Svensson L.G.; Rodriguez L.L.; Griffin B.P.; Desai
M.Y.
Institution
(Masri, Al Halabi, Karimianpour, Gillinov, Naji, Sabik, Mihaljevic,
Svensson, Rodriguez, Griffin, Desai) Heart Valve Center, Heart and
Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J1-5,
Cleveland, OH 44195, United States
Publisher
Oxford University Press
Abstract
Aims Treatment of ischaemic mitral regurgitation (IMR) remains
controversial. While IMR is associated with worse outcomes, randomized
controlled trials (RCTs) and observational studies provided conflicting
evidence regarding the benefit of mitral valve replacement (MVR) or repair
(MVr) in addition to coronary artery bypass grafting (CABG). We conducted
a meta-analysis incorporating data from published RCTs and observational
studies comparing CABG vs. CABG + MVR/MVr. Methods and results
WesearchedPubMed,MEDLINE, Embase,Ovid, andCochrane for RCTs and
observational studies comparingCABG (Group 1) vs. CABG + MVR/MVr (Group
2). Outcome was 30-day and 1-year mortality after surgical
intervention.Mantel-Haenszel odds ratio (OR) was calculated using
random-effects meta-analysis for the outcome. Heterogeneity was assessed
by I2 statistics. Four RCTs and 11 observational studies met the inclusion
criteria (5781 patients, 507 in RCTs, 5274 in observational studies).
Group 1 vs. 2 weighted mean left ventricular ejection fraction in RCTs and
combined RCTs/observational studies was 41.5+12.3 vs. 40.3+10.4% (P-value
= 0.24) and 45.5+7.2 vs. 38+10% (P-value , 0.001), respectively. In RCTs,
there was no difference in 30-day [OR: 0.95, 95% confidence interval (95%
CI): 0.30-3.08, P = 0.94] or 1-year (OR: 0.90, 95% CI: 0.43-1.87, P =
0.78) mortality, respectively. For combined RCTs/observational studies,
therewas no difference in mortality at 30 days (OR: 0.67, 95% CI:
0.43-1.04, P = 0.08) or at 1 year (OR: 0.90, 95% CI: 0.7-1.15, P = 0.39).
Conclusion In a meta-analysis of RCTs and observational studies of IMR
patients, the addition of MVR/MVr to CABG did not improve
survival.<br/>Copyright &#xa9; The Author 2015.

<113>
Accession Number
601999145
Title
Remote ischemic conditioning and cardioprotection: a systematic review and
meta-analysis of randomized clinical trials.
Source
Basic Research in Cardiology. 110 (2) (no pagination), 2015. Date of
Publication: March 2015.
Author
Le Page S.; Bejan-Angoulvant T.; Angoulvant D.; Prunier F.
Institution
(Le Page, Prunier) Service de Cardiologie, CHU Angers, Remodelage et
Thrombose, EA 3860 Cardioprotection, L'UNAM Universite, Universite
d'Angers, Angers Cedex 9 49933, France
(Bejan-Angoulvant) Service de Pharmacologie, CHRU de Tours, CNRS GICC UMR
U7292, Universite Francois-Rabelais de Tours, Tours, France
(Angoulvant) Service de Cardiologie, CHRU de Tours, Federation
Hospitalo-Universitaires << SUPPORT >>, EA 4245 Cellules dendritiques
Immuno-modulation et Greffes, Universite Francois-Rabelais de Tours,
Tours, France
Publisher
Dr. Dietrich Steinkopff Verlag GmbH and Co. KG
Abstract
Remote ischemic conditioning (RIC) represents an innovative
cardioprotective method that has been investigated in numerous clinical
studies providing miscellaneous results. This systematic review and
meta-analysis sought to assess RIC-induced effects on myocardial injury
biomarkers and clinical outcomes in clinical situations at risk of
myocardial ischemia/reperfusion damage. PubMed and Cochrane databases were
searched for randomized clinical trials testing any RIC protocol versus a
control in a situation or procedure at risk of cardiac
ischemia/reperfusion damage, including coronary angioplasty and cardiac or
major vascular surgery. Data were collected from publications reporting
biological markers of myocardial injury or clinical events, including
major adverse cardiovascular and cerebral events (MACCE), all-cause
mortality, myocardial infarction incidence, and repeat revascularization.
Standardized mean difference (SMD) (continuous outcomes) and odds ratios
(OR) (dichotomous outcomes) were compared between groups. Heterogeneity
was investigated by means of meta-analysis regression. A total of 53
articles (44 studies) were identified by the search, with 5,317 patients
included in the systematic meta-analysis. RIC significantly reduced
troponin area under curve (AUC) (SMD -0.27, 95 % confidence interval (CI):
[-0.36, -0.18]; p < 0.01) and troponin peak (SMD: -0.22, 95 % CI: [-0.30,
-0.15]; p < 0.01). The same reduction was observed with creatine kinase MB
(CK-MB) AUC and peak. Long-term MACCE and all-cause mortality were
significantly lower in the RIC group (OR: 0.42, 95 % CI [0.28, 0.64]; p <
0.01 vs. OR: 0.27, 95 % CI [0.13, 0.58]; p < 0.01, respectively), as was
myocardial infarction incidence (OR: 0.54, 95 % CI [0.40, 0.73]; p <
0.01). We observed no difference regarding repeat revascularization. RIC
appears to be an effective method for reducing ischemia/reperfusion
myocardial injury, and our findings suggest that it may reduce long-term
clinical events.<br/>Copyright &#xa9; 2015, Springer-Verlag Berlin
Heidelberg.

<114>
Accession Number
611310768
Title
Aortic valve replacement in geriatric patients with small aortic roots:
Are sutureless valves the future?.
Source
Interactive Cardiovascular and Thoracic Surgery. 17 (5) (pp 778-782),
2013. Date of Publication: November 2013.
Author
Shrestha M.; Maeding I.; Hoffler K.; Koigeldiyev N.; Marsch G.; Siemeni
T.; Fleissner F.; Haverich A.
Institution
(Shrestha, Maeding, Hoffler, Koigeldiyev, Marsch, Siemeni, Fleissner,
Haverich) Division of Cardiac-Thoracic, Hannover Medical School,
Transplantation and Vascular Surgery, Carl-Neuberg-Str. 1, Hannover 30625,
Germany
Publisher
Oxford University Press
Abstract
OBJECTIVES: Aortic valve replacement (AVR) in geriatric patients (>75
years) with small aortic roots is a challenge. Patient-prosthesis mismatch
and the long cross-clamp time necessary for stentless valves or root
enlargement are matters of concern. We compared the results of AVR with
sutureless valves (Sorin Perceval), against those with conventional
biological valves. <br/>METHOD(S): Between April 2007 and December 2012,
120 isolated AVRs were performed in patients with a small annulus (<22 mm)
at our centre. In 70 patients (68 females, age 77.4 +/- 5.5 years),
conventional valves (C group) and in 50 patients (47 females, age 79.8 +/-
4.5 years), sutureless valves (P group) were implanted. The Logistic
EuroSCORE of the C group was 16.7 +/- 10.4 and that of the P group 20.4
+/- 10.7, (P = 0.054). Minimal-access surgery was performed in 4.3% (3/70)
patients in the C group and 72% (36/50) patients in the P group.
<br/>RESULT(S): The cardiopulmonary bypass (CPB) and cross-clamp times of
the C group were 75.3 +/- 23 and 50.3 +/- 14.2 min vs 58.7 +/- 20.9 and
30.1 +/- 9 min in the P group, (P < 0.001). In the C group, two annulus
enlargements were performed. Thirty-day mortality was 4.3% (n = 3) in the
C group and 0 in the P group, (n.s.). At follow-up (up to 5 years),
mortalities were 17.4% (n = 12) in the C group and 14% (n = 7) in the P
group, (n.s.). <br/>CONCLUSION(S): This study highlights the advantages of
sutureless valves for geriatric patients with small aortic roots reflected
by shorter cross-clamp and CPB times, even though most of these patients
were operated on via a minimally invasive access. Moreover, due to the
absence of a sewing ring, these valves are also almost stentless, with
greater effective orifice area (EOA) for any given size. This may
potentially result in better haemodynamics even without the root
enlargement. This is of advantage, as several studies have shown that
aortic root enlargement can significantly increase the risks of AVR.
Moreover, as seen in this series, these valves may also enable a broader
application of minimally invasive AVR.

<115>
Accession Number
52353066
Title
A Review of Emergency Cardiopulmonary Bypass for Severe Poisoning by
Cardiotoxic Drugs.
Source
Journal of Medical Toxicology. 9 (1) (pp 54-60), 2013. Date of
Publication: March 2013.
Author
Johnson N.J.; Gaieski D.F.; Allen S.R.; Perrone J.; DeRoos F.
Institution
(Johnson, Gaieski, Perrone, DeRoos) Department of Emergency Medicine,
Perelman School of Medicine, University of Pennsylvania, Ground
Silverstein, 3400 Spruce Street, Philadelphia, PA, United States
(Gaieski) Center for Resuscitation Science, University of Pennsylvania,
Philadelphia, PA, United States
(Allen) Division of Traumatology, Surgical Critical Care, and Emergency
Surgery, Department of Surgery, University of Pennsylvania, Philadelphia,
PA, United States
(Perrone, DeRoos) Division of Medical Toxicology, Department of Emergency
Medicine, Perelman School of Medicine, University of Pennsylvania,
Philadelphia, PA, United States
Publisher
Springer Science and Business Media, LLC
Abstract
Cardiovascular collapse remains a leading cause of death in severe acute
drug intoxication. Commonly prescribed medications such as
antidysrhythmics, calcium channel antagonists, and beta adrenergic
receptor antagonists can cause refractory cardiovascular collapse in
massive overdose. Emergency cardiopulmonary bypass (ECPB), a modality
originating in cardiac surgery, is a rescue technique that has been
successfully implemented in the treatment of refractory cardiogenic shock
and cardiac arrest unresponsive to traditional medical interventions. More
recently a growing number of animal studies, case reports, and case series
have documented its use in refractory hemodynamic collapse in poisoned
patients. This article will review current ECPB techniques and explore its
growing role in the treatment of severely hemodynamically compromised
poisoned patients. &#xa9; 2012 American College of Medical Toxicology.

<116>
Accession Number
635435636
Title
A randomized parallel design trial of the efficacy and safety of
tranexamic acid, dexmedetomidine and nitroglycerin in controlling
intraoperative bleeding and improving surgical field quality during
septorhinoplasty under general anesthesia.
Source
Medical Gas Research. 11 (4) (pp 131-137), 2021. Date of Publication: 01
Oct 2021.
Author
Modir H.; Moshiri E.; Naseri N.; Faraji F.; Almasi-Hashiani A.
Institution
(Modir, Moshiri) Departments of Anesthesiology and Critical Care, Arak
University of Medical Sciences, Arak, Iran, Islamic Republic of
(Naseri) Department of Otorhinolaryngology, Arak University of Medical
Sciences, Arak, Iran, Islamic Republic of
(Faraji) Students Research Committee, Arak University of Medical Sciences,
Arak, Iran, Islamic Republic of
(Almasi-Hashiani) Department of Epidemiology, School of Health, Arak
University of Medical Sciences, Arak, Iran, Islamic Republic of
Publisher
Wolters Kluwer Medknow Publications
Abstract
In this blinded clinical trial, we attempted to compare the efficacy and
safety of administering tranexamic acid, dexmedetomidine and nitroglycerin
in preventing intraoperative bleeding and improving the quality of the
surgical field during septorhinoplasty under general anesthesia. A total
of 105 patients scheduled for septorhinoplasty were enrolled and randomly
assigned into three groups based on the balanced-block randomization
method. First group received 1 mug/kg intravenous injection
dexmedetomidine, second group received 10 mg/kg intravenous injection
tranexamic acid and third group received 0.5 mug/kg nitroglycerin,
intravenously. The study sample was composed of 105 participants with the
total mean age of 25.85 +/- 6.52 years, and 59.05% of participants were
female and the mean of body mass index was 24.34 +/- 2.57
kg/m². The results showed that there was no statistically
significant difference in terms of arterial oxygen saturation, mean
arterial pressure, heart rate, bleeding rate, duration of surgery, and
surgeon satisfaction among the three groups; however, there was a
significant difference in the extubation time, recovery time and the dose
of administered propofol among the three groups. Dexmedetomidine reduced
the dose of administered propofol while increasing the extubation time and
recovery time. In the tranexamic acid group compared with the other two
groups, the recovery time was shorter. However, all the three drugs could
reduce intraoperative bleeding and lead to surgeon satisfaction. It can be
concluded that all these three drugs can be utilized to control bleeding
and improve the quality of the surgical field but the ultimate decision
lies with the anesthesiologist's judgment and the conditions of the
patient. The study protocol was registered in the Iranian Registry of
Clinical Trials (registration No. IRCT20141209020258N121) on September 24,
2019 and it was ethically approved by the Ethical Committee of Arak
University of Medical Sciences (approval No. IR.ARAKMU.REC.1397.355) on
February 24, 2019. Modir Hesameddin 1 Departments of Anesthesiology and
Critical Care, Arak University of Medical Sciences, Arak Moshiri Esmail 2
Departments of Anesthesiology and Critical Care, Arak University of
Medical Sciences, Arak Naseri Narges 3 Department of Otorhinolaryngology,
Arak University of Medical Sciences, Arak Faraji Fatemeh 4 Students
Research Committee, Arak University of Medical Sciences, Arak
Almasi-Hashiani Amir 5 Department of Epidemiology, School of Health, Arak
University of Medical Sciences, Arak H1. Ofo E, Singh A, Marais J.
Steroids in rhinoplasty: a survey of current UK otolaryngologists'
practice. J Laryngol Otol. 2006;120:108-112. Blackwell KE, Ross DA, Kapur
P, Calcaterra TC. Propofol for maintenance of general anesthesia: a
technique to limit blood loss during endoscopic sinus surgery. Am J
Otolaryngol. 1993;14:262-266. Brull R, Macfarlane AJR, Chan VWS. Spinal,
epidural and caudal anesthesia. In: Miller R, ed. Miller's Anesthesia.
Churchill Livingstone: Elsvier; 2015:1684-1720. Ducloy-Bouthors AS, Jude
B, Duhamel A, et al. High-dose tranexamic acid reduces blood loss in
postpartum haemorrhage. Crit Care. 2011;15:R117. Taksaudom N, Siwachat S,
Tantraworasin A. Additional effects of topical tranexamic acid in on-pump
cardiac surgery. Asian Cardiovasc Thorac Ann. 2017;25:24-30. Kumsar S,
Dirim A, Toksoz S, Saglam HS, Adsan O. Tranexamic acid decreases blood
loss during transurethral resection of the prostate (TUR -P). Cent
European J Urol. 2011;64:156-158. Dobrovolsky AB, Titaeva EV. The
fibrinolysis system: regulation of activity and physiologic functions of
its main components. Biochemistry (Mosc). 2002;67:99-108. McCormack PL.
Tranexamic acid: a review of its use in the treatment of
hyperfibrinolysis. Drugs. 2012;72:585-617. Nielsen JD, Gram J, Fabrin K,
Holm-Nielsen A, Jespersen J. Lack of correlation between blood
fibrinolysis and the immediate or post-operative blood loss in
transurethral resection of the prostate. Br J Urol. 1997;80:105-110.
Sethna NF, Zurakowski D, Brustowicz RM, Bacsik J, Sullivan LJ, Shapiro F.
Tranexamic acid reduces intraoperative blood loss in pediatric patients
undergoing scoliosis surgery. Anesthesiology. 2005;102:727-732. Wong J, El
Beheiry H, Rampersaud YR, et al. Tranexamic Acid reduces perioperative
blood loss in adult patients having spinal fusion surgery. Anesth Analg.
2008;107:1479-1486. Mayur G, Purvi P, Ashoo G, Pankaj D. Efficacy of
tranexamic acid in decreasing blood loss during and after cesarean
section: A randomized case controlled prospective study. J Obstet Gynecol
India. 2007;57:227-230. Alimian M, Mohseni M. The effect of intravenous
tranexamic acid on blood loss and surgical field quality during endoscopic
sinus surgery: a placebo-controlled clinical trial. J Clin Anesth.
2011;23:611-615. White PF. The changing role of non-opioid analgesic
techniques in the management of postoperative pain. Anesth Analg.
2005;101:S5-22. Rezaee M, Safavi M, Monabati M. Complete guide to
anesthesia drugs. Tehran: Jame-e-Negar Publishing House. 2013. Guven DG,
Demiraran Y, Sezen G, Kepek O, Iskender A. Evaluation of outcomes in
patients given dexmedetomidine in functional endoscopic sinus surgery. Ann
Otol Rhinol Laryngol. 2011;120:586-592. Praveen DV, Pushparani A, Anand K,
Balachandran S, Umadevi. Comparison of dexmedetomidine with
nitroglycerinefor hypotensive anaesthesia in functional endoscopic sinus
surgery. Indian J Clin Anaesth. 2016;3:376-388. Modares M, Rahnama P. Side
effects of glyceryl trinitrate ointment for primary dysmenorrhea: a
randomized clinical trial. Tehran Univ Med J. 2008;65:61-66. Hadavi MR,
Zarei Y, Tarogh S. Comparison of effects of labetalol and nitroglycerine
on intraoperative blood loss and surgical field quality in rhinoplasty
surgery. World J Plast Surg. 2015;4:60-65. Srivastava U, Dupargude AB,
Kumar D, Joshi K, Gupta A. Controlled hypotension for functional
endoscopic sinus surgery: comparison of esmolol and nitroglycerine. Indian
J Otolaryngol Head Neck Surg. 2013;65:440-444. Mayhew D, Mendonca V,
Murthy BVS. A review of ASA physical status - historical perspectives and
modern developments. Anaesthesia. 2019;74:373-379. Fromme GA, MacKenzie
RA, Gould AB, Jr., Lund BA, Offord KP. Controlled hypotension for
orthognathic surgery. Anesth Analg. 1986;65:683-686. Bayram A, Ulgey A,
Gunes I, et al. Comparison between magnesium sulfate and dexmedetomidine
in controlled hypotension during functional endoscopic sinus surgery. Rev
Bras Anestesiol. 2015;65:61-67. Berenjian S, Hassani V, Farhadi M, Zaman
B, Alimian M. Comparing the effect of tranexamic acid and dexmedetomidine
on bleeding during rhinoplasty. J Anesthesiol Pain. 2017;7:36-43. Eghbal
A, Modir H, Moshiri E, Khalili M, Barsari F, Mohammadbeigi A. Hypotensive
effect of labetalol and dexmedetomidine blood loss and surgical conditions
in functional endoscopic sinus surgery: A double-blind randomized clinical
trial. Formos J Surg. 2018;51:98-104. Modir H, Modir A, Rezaei O,
Mohammadbeigi A. Comparing remifentanil, magnesium sulfate, and
dexmedetomidine for intraoperative hypotension and bleeding and
postoperative recovery in endoscopic sinus surgery and
tympanomastoidectomy. Med Gas Res. 2018;8:42-47. Moshiri E, Modir H, Yazdi
B, Susanabadi A, Salehjafari N. Comparison of the effects of propofol and
dexmedetomidine on controlled hypotension and bleeding during endoscopic
sinus surgery. Ann Trop Med Public Health. 2017;10:721. Ghavimi MA, Taheri
Talesh K, Ghoreishizadeh A, Chavoshzadeh MA, Zarandi A. Efficacy of
tranexamic acid on side effects of rhinoplasty: A randomized double-blind
study. J Craniomaxillofac Surg. 2017;45:897-902. Sankar D, Krishnan R,
Veerabahu M, Vikraman B. Evaluation of the efficacy of tranexamic acid on
blood loss in orthognathic surgery. A prospective, randomized clinical
study. Int J Oral Maxillofac Surg. 2012;41:713-717. Ghodraty M, Khatibi A,
Rokhtabnak F, Maleki M, Parsa F. Comparing labetalol and nitroglycerine on
inducing controlled hypotension and intraoperative blood loss in
rhinoplasty: a single-blinded clinical trial. Anesth Pain Med.
2017;7:e13677. Jalali MM, Moosavi S, Fatemi S, Banan RA. Comparison
between dexamethasone and tranexamic acid on postoperative edema and
ecchymosis after rhinoplasty operation. J Guilan Univ Med Sci.
2012;21:72-77. Ayoglu H, Yapakci O, Ugur MB, et al. Effectiveness of
dexmedetomidine in reducing bleeding during septoplasty and tympanoplasty
operations. J Clin Anesth. 2008;20:437-441.<br/>Copyright &#xa9; 2021 BMJ
Publishing Group. All rights reserved.

<117>
Accession Number
2007884736
Title
Sugammadex for Fast-Track Surgery in Children Undergoing Cardiac Surgery:
A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35 (5) (pp 1388-1392),
2021. Date of Publication: May 2021.
Author
Li L.; Jiang Y.; Zhang W.
Institution
(Li) Department of Anesthesiology, Wenzhou Central Hospital, Wenzhou,
China
(Jiang) Department of Anesthesiology, Shanghai Children's Hospital,
Shanghai Jiao Tong University, Shanghai, China
(Zhang) Department of Anesthesiology, Women and Children's Hospital of
Jiaxing University, Jiaxing, China
Publisher
W.B. Saunders
Abstract
Objective: The purpose of this study was to evaluate the safety and
efficacy of sugammadex for fast-track surgery in children undergoing
cardiac surgery. <br/>Design(s): This was a prospective, randomized,
controlled clinical study. <br/>Setting(s): University hospital.
<br/>Participant(s): The study comprised 60 children undergoing cardiac
surgery. <br/>Intervention(s): The children in group S received
sugammadex, 4 mg/kg, for reversal of neuromuscular block, and the children
in group N received neostigmine, 30 microg/kg, and atropine, 15 microg/kg.
<br/>Measurements and Main Results: The recovery time to a train-of-four
of 0.9 and extubation time were significantly shorter in the group S than
in group N (3.4 +/- 1.2 min v 76.2 +/- 20.5 min and 31.0 +/- 6.4 min v
125.2 +/- 21.6 min, respectively; p < 0.01). The heart rate after drug
administration was higher in group S than in group N (102.7 +/- 9.4
beats/min v 96.9 +/- 8.5 beats/min; p = 0.03), whereas the mean arterial
pressure after drug administration was similar in both groups. The length
of hospital stay was shorter in group S (5.8 +/- 1.0 v 6.5 +/- 0.9 days; p
= 0.03), and the hospitalization expenses were decreased in group S
compared with that of group N ($1,036 +/- $114 v $1,286 +/- $187; p <
0.01). The incidence of postoperative atelectasis was less in group S than
in group N (0 v 20%; p = 0.024). <br/>Conclusion(s): Sugammadex can
shorten the extubation time and reduce the incidence of postoperative
atelectasis, with fewer adverse events, in children undergoing cardiac
surgery. It may be beneficial to use sugammadex for fast-track surgery in
children undergoing cardiac surgery.<br/>Copyright &#xa9; 2020 Elsevier
Inc.

<118>
Accession Number
2005711157
Title
Infective Endocarditis After Transcatheter Versus Surgical Aortic Valve
Replacement: A Meta-Analysis.
Source
Angiology. 71 (10) (pp 955-965), 2020. Date of Publication: 01 Nov 2020.
Author
Wang J.; Wang X.; Hou F.; Yuan W.; Dong R.; Wang L.; Shen H.; Zhou Y.
Institution
(Wang, Dong) Department of Cardiac Surgery, Beijing Anzhen Hospital
Capital Medical University, Beijing, China
(Wang, Yuan) Center for Cardiac Intensive Care, Beijing Anzhen Hospital
Capital Medical University, Beijing, China
(Wang, Shen, Zhou) Department of Cardiology, Beijing Anzhen Hospital,
Capital Medical University, Beijing, China
(Wang) Department of General Surgery, Chinese PLA general hospital,
Beijing, China
(Hou) Department of Cardiology, Qingdao Municipal Hospital, Qingdao, China
(Wang) Department of Epidemiology, Beijing Anzhen Hospital, Beijing
Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical
University, Beijing, China
Publisher
SAGE Publications Inc.
Abstract
We determined the incidence, clinical characteristics, and risk factors of
post-transcatheter aortic valve replacement (TAVR)-associated infective
endocarditis (IE). We compared the incidence of IE after TAVR versus after
surgical aortic valve replacement (SAVR). The incidence rate of IE 1-year
post-TAVR was 0.9% (95% confidence interval [CI]: 0.8-1.0). Transcatheter
aortic valve replacement was associated with significantly reduced IE
incidence (incidence rate ratio: 0.69, 95% CI: 0.52-0.92, P =.011)
compared with SAVR. In patients with TAVR IE, the pooled in-hospital
mortality was 37.8% (95% CI: 32.4-43.3, I² = 54.9%). Pooled
adjusted hazard ratio (HR) revealed that peri-procedural peripheral artery
disease (HR: 4.02, 95% CI: 2.28-7.10, P '.0001), moderate or severe
residual aortic regurgitation (HR: 2.34, 95% CI: 1.53-3.59, P '.0001),
orotracheal intubation (HR: 2.13, 95% CI: 1.19-3.82, P =.011), and male
gender (HR: 1.70, 95% CI: 1.47-1.97, P '.0001) were risk factors for
post-TAVR IE. Post-TAVR IE is a life-threatening complication often
resulting in in-hospital mortality. The current evidence-based
meta-analysis to identify risk factors may lead to the development of
effective preventive and therapeutic strategies for post-TAVR IE to
ultimately improve patient outcomes.<br/>Copyright &#xa9; The Author(s)
2020.

<119>
Accession Number
2013380040
Title
Preoperative inflammatory mediators and postoperative delirium: systematic
review and meta-analysis.
Source
British Journal of Anaesthesia. (no pagination), 2021. Date of
Publication: 2021.
Author
Noah A.M.; Almghairbi D.; Evley R.; Moppett I.K.
Institution
(Noah, Almghairbi, Evley, Moppett) Anaesthesia and Critical Care, Academic
Unit of Injury, Inflammation and Recovery Science, University of
Nottingham, Nottingham, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: Postoperative delirium has eluded attempts to define its
complex aetiology and describe specific risk factors. The role of
neuroinflammation as a risk factor, determined by measuring blood levels
of preoperative 'innate' inflammatory mediator levels, has been
investigated. However, results have been conflicting. We conducted a
systematic review and meta-analysis of the evidence on associations
between preoperative blood levels of inflammatory mediators and
postoperative delirium in the older person. Influence of type of surgery
was also assessed. <br/>Method(s): Original, low risk of bias studies,
published in peer-reviewed journals, which fulfilled the eligibility
criteria were included. Seventeen articles fulfilled study criteria. Data
extraction, synthesis, and risk of bias analysis were guided by Preferred
Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and
quality in prognostic studies guidelines. Meta-analyses used a
random-effects model. Inflammatory mediators included C-reactive protein,
interleukin-6, -8, and -10, tumour necrosis factor-alpha, insulin-like
growth factor-1, cortisol, and neopterin. Surgical groups were cardiac,
noncardiac, and hip fracture. <br/>Result(s): Higher preoperative
interleukin-6 was associated with postoperative delirium with a
standardised mean difference (95% confidence interval) of 0.33 (0.11-0.56)
and P=0.003. Higher neopterin was also associated with postoperative
delirium. <br/>Conclusion(s): The association of preoperative blood levels
of inflammatory mediators with postoperative delirium may be influenced by
the type of surgery and the specific mediator. The potential modulating
effect of type of surgery, intrinsic brain vulnerability, and the complex
interactions between inflammatory mediators and binding proteins will need
to be considered in future studies. Clinical trial registration:
CRD42019159471 (PROSPERO).<br/>Copyright &#xa9; 2021 British Journal of
Anaesthesia

<120>
Accession Number
620743815
Title
The prevalence and clinical relevance of asa nonresponse after cardiac
surgery: A prospective bicentric study.
Source
Clinical and Applied Thrombosis/Hemostasis. 24 (1) (pp 179-185), 2018.
Date of Publication: 2018.
Author
Wand S.; Adam E.H.; Wetz A.J.; Meybohm P.; Kunze-Szikszay N.; Zacharowski
K.; Popov A.F.; Moritz A.; Moldenhauer L.; Kaiser J.; Bauer M.; Weber C.F.
Institution
(Wand, Wetz, Kunze-Szikszay, Moldenhauer, Bauer, Weber) Department of
Anesthesiology, University Medical Center Gottingen, Gottingen, Germany
(Adam, Meybohm, Zacharowski, Kaiser) Department of Anesthesia, Intensive
Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt
am Main, Germany
(Popov) Department of Thoracic and Cardiovascular Surgery, University
Medical Center Gottingen, Gottingen, Germany
(Popov, Moritz) Department for Cardiothoracic and Vascular Surgery,
University Hospital Frankfurt, Frankfurt am Main, Germany
Publisher
SAGE Publications Inc.
Abstract
We aimed to identify the prevalence of acetylsalicylic acid (ASA)
nonresponse in patients after coronary artery bypass graft (CABG) surgery
and the possible consequences for the rate of major cardiovascular events.
This prospective, observational, bicentric cohort study was conducted in
two German University hospitals. A total of 400 patients (200 in each
study center) undergoing elective CABG surgery were enrolled after written
informed consent. Platelet function was analyzed on day 3 (d3) and day 5
(d5) postoperatively following stimulation with arachidonic acid
(ASPItest) and with thrombin receptor-activating peptide 6 (TRAPtest)
using multiple electrode aggregometry (Multiplate). Individuals with an
ASPItest 40 AUmin were categorized as ASA nonresponders. A 1-year
follow-up recorded the combined end point of cardiovascular events,
hospital admissions, or deaths related to cardiovascular disease. The
prevalence of ASA nonresponse was 51.5% on d3, and it significantly
increased to 71.3% on d5 (P 1/4 .0049). The area under the aggregation
curve in the TRAPtest (P < .0001), the platelet count on d5 (P 1/4 .009),
and the cardiopulmonary bypass time (P 1/4 .01) were identified as
independent predictors of an ASA nonresponse. A 1-year follow-up recorded
54 events fulfilling criteria for the combined end point with no
difference between ASA responders and nonresponders. This study indicates
a high incidence of perioperative ASA nonresponse in patients following
CABG. No effect on the incidence of cardiovascular events was recorded in
the 1-year follow-up. Therefore, a randomized dosage adjustment trial
should elucidate whether a tailored ASA treatment after CABG surgery
represents a useful concept.<br/>Copyright &#xa9; The Author(s) 2017.

<121>
Accession Number
2013670037
Title
Successful recovery in a paediatric patient with polytrauma following
multiple gunshot wounds: Case report and review of literature.
Source
Journal of the Pakistan Medical Association. 70 (2) (pp S122-S124), 2020.
Date of Publication: February 2020.
Author
Salim A.; Ahmed R.; Aziz A.; Dogar S.A.
Institution
(Salim, Ahmed, Aziz, Dogar) Aga Khan University, Karachi, Pakistan
Publisher
Pakistan Medical Association
Abstract
Our case report evaluates a 21/2 year old boy who presented to emergency
care, following multiple gunshot injuries and was managed emergently using
a multidisciplinary surgical approach at our center. The patient was
unresponsive, had poor perfusion, bilaterally decreased air entry, a
distended abdomen, and multiple entry and exit wounds. A multidisciplinary
team including Paediatric Surgery, Cardiothoracic Surgery, Paediatric
anaesthesiology team and Orthopaedic surgery were taken on board.
Following effective immediate management and stabilization, the patient
was admitted to the ward under careful observation. He was discharged on
post-operative day 28 after a successful recovery and on his 6 month
follow-up, the patient had shown significant improvement, with normal
bowel and pulmonary function. Rapid intervention along with a
multidisciplinary surgical approach helped ensure the success of the
treatment. Prior permission from the patient's guardians was acquired
before the preparation of this manuscript.<br/>Copyright &#xa9; 2020
Pakistan Medical Association. All rights reserved.

<122>
Accession Number
2007863240
Title
Staged percutaneous intervention for concurrent chronic total occlusions
in patients with st-segment-elevation myocardial infarction: A systematic
review and meta-analysis.
Source
Journal of the American Heart Association. 7 (8) (no pagination), 2018.
Article Number: e008415. Date of Publication: 17 Apr 2018.
Author
Villablanca P.A.; Olmedo W.; Weinreich M.; Gupta T.; Mohananey D.;
Albuquerque F.N.; Kassas I.; Briceno D.; Sanina C.; Brevik T.A.; Ong E.;
Ramakrishna H.; Attubato M.; Menegus M.; Wiley J.; Kalra A.
Institution
(Villablanca, Kassas, Attubato) Division of Cardiology, Department of
Medicine, New York University School of Medicine, New York, NY, United
States
(Olmedo, Weinreich, Gupta, Sanina, Brevik, Ong, Menegus, Wiley) Division
of Cardiology, Department of Medicine, Montefiore Medical Center, Albert
Einstein College of Medicine, New York, NY, United States
(Mohananey) Department of Medicine, Cleveland Clinic, Cleveland, OH,
United States
(Albuquerque) Division of Cardiology, Department of Medicine, University
of Miami Miller School of Medicine, Miami, FL, United States
(Briceno) Division of Cardiology, Department of Medicine, Perelman School
of Medicine at the University of Pennsylvania, Philadelphia, PA, United
States
(Ramakrishna) Division of Cardiovascular and Thoracic Anesthesiology, Mayo
Clinic, Phoenix, AZ, United States
(Kalra) Division of Cardiovascular Medicine, Department of Medicine, Case
Western Reserve University School of Medicine, Cleveland, OH, United
States
Publisher
American Heart Association Inc.
Abstract
Background--Studies have shown that chronic total occlusion (CTO) in a
noninfarct-related artery in patients with ST-segment- elevation
myocardial infarction is linked to increased mortality. It remains unclear
whether staged revascularization of a noninfarct-related artery CTO in
patients with ST-segment-elevation myocardial infarction translates to
improved outcomes. We performed a meta-analysis to compare outcomes
between patients presenting with ST-segment-elevation myocardial
infarction with concurrent CTO who underwent percutaneous coronary
intervention of noninfarct-related artery CTO versus those who did not.
Method and Results--We conducted an electronic database search of all
published data. The primary end point was major adverse cardiovascular
events. Secondary end points were all-cause mortality, cardiovascular
mortality, myocardial infarction, repeat revascularization with either
percutaneous coronary intervention or coronary artery bypass grafting,
stroke, and heart failure readmission. Odds ratios (ORs) and 95%
confidence intervals (CIs) were computed. Random effects model was used
and heterogeneity was considered if I² >25. Six studies (n=1253
patients) were included in the analysis. There was a significant
difference in major adverse cardiovascular events (OR, 0.54; 95% CI,
0.32-0.91), cardiovascular mortality (OR, 0.43; 95% CI, 0.20-0.95), and
heart failure readmissions (OR, 0.57; 95% CI, 0.36-0.89), favoring the
patients in the CTO percutaneous coronary intervention group. No
significant differences were observed between the 2 groups for all-cause
mortality (OR, 0.47; 95% CI, 0.22-1.00), myocardial infarction (OR, 0.78;
95% CI, 0.41-1.46), repeat revascularization (OR, 1.13; 95% CI,
0.56-2.27), and stroke (OR, 0.51; 95% CI, 0.20-1.33). Conclusions--In this
meta-analysis, CTO percutaneous coronary intervention of the
noninfarct-related artery in patients presenting with ST-segment-elevation
myocardial infarction was associated with a significant reduction in major
adverse cardiovascular events, cardiovascular mortality, and heart failure
readmissions.<br/>Copyright &#xa9; 2018 The Authors.