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<1>
Accession Number
636044158
Title
Perioperative Outcome of Robotic Approach Versus Manual Videothoracoscopic
Major Resection in Patients Affected by Early Lung Cancer: Results of a
Randomized Multicentric Study (ROMAN Study).
Source
Frontiers in Oncology. 11 (no pagination), 2021. Article Number: 726408.
Date of Publication: 09 Sep 2021.
Author
Veronesi G.; Abbas A.E.-S.; Muriana P.; Lembo R.; Bottoni E.; Perroni G.;
Testori A.; Dieci E.; Bakhos C.T.; Car S.; Luzzi L.; Alloisio M.; Novellis
P.
Institution
(Veronesi, Muriana, Perroni, Dieci, Novellis) Department of Thoracic
Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Veronesi) Faculty of Medicine and Surgery, Vita-Salute San Raffaele
University, Milan, Italy
(Abbas, Bakhos) Department of Thoracic Medicine and Surgery, Lewis Katz
School of Medicine, Temple University Hospital, Philadelphia, PA, United
States
(Abbas, Bakhos) Department of Surgery, Lewis Katz School of Medicine,
Temple University Hospital, Philadelphia, PA, United States
(Lembo) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Bottoni, Testori, Alloisio) Division of Thoracic and General Surgery,
Humanitas Clinical and Research Center, Rozzano, Italy
(Car) Division of Thoracic Surgery, Department of Surgery, University of
Maryland School of Medicine, Baltimore, MD, United States
(Luzzi) Thoracic Surgery Unit, Department of Medicine, Surgery and Neuro
Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera
Universitaria Senese, Siena, Italy
(Alloisio) Department of Biomedical Science, Humanitas University,
Rozzano, Italy
Publisher
Frontiers Media S.A.
Abstract
Introduction: We report the results of the first prospective international
randomized control trial to compare the perioperative outcome and surgical
radicality of the robotic approach with those of traditional
video-assisted surgery in the treatment of early-stage lung cancer.
<br/>Method(s): Patients with clinical stage T1-T2, N0-N1 non-small cell
lung cancer (NSCLC) were randomly assigned to robotic-assisted
thoracoscopic surgery (RATS) or video-assisted thoracic surgery (VATS)
resection arms. The primary objective was the incidence of adverse events
including complications and conversion to thoracotomy. The secondary
objectives included extent of lymph node (LN) dissection and other
indicators. <br/>Result(s): This trial was closed at 83 cases as the
probability of concluding in favor of the robot arm for the primary
outcome was null according to the observed trend. In this study, we report
the results of the analysis conducted on the patients enrolled until trial
suspension. Thirty-nine cases were randomized in the VATS arm and 38 in
the robotic arm. Six patients were excluded from analysis. Despite finding
no difference between the two arms in perioperative complications,
conversions, duration of surgery, or duration of postoperative stay, a
significantly greater degree of LN assessment by the robotic technique was
observed in regards to the median number of sampled LN stations [6,
interquartile range (IQR) 4-6 vs. 4, IQR 3-5; p = 0.0002], hilar LNs (7,
IQR 5-10 vs. 4, IQR 2-7; p = 0.0003), and mediastinal LNs (7, IQR 5-10 vs.
5, IQR 3-7; p = 0.0001). <br/>Conclusion(s): The results of this trial
demonstrated that RATS was not superior to VATS considering the
perioperative outcome for early-stage NSCLC, but the robotic approach
allowed an improvement of LN dissection. Further studies are suggested to
validate the results of this trial. Clinical Trial Registration:
clinicaltrials.gov, identifier NCT02804893.<br/>&#xa9; Copyright &#xa9;
2021 Veronesi, Abbas, Muriana, Lembo, Bottoni, Perroni, Testori, Dieci,
Bakhos, Car, Luzzi, Alloisio and Novellis.

<2>
Accession Number
2014624272
Title
The BYPASS-CTCA Study: The value of Computed Tomography Cardiac
Angiography (CTCA) in improving patient-related outcomes in patients with
previous bypass operation undergoing invasive coronary angiography: Study
Protocol of a Randomised Controlled Trial.
Source
Annals of Translational Medicine. 9(17) (no pagination), 2021. Article
Number: 76593. Date of Publication: September 2021.
Author
Beirne A.-M.; Rathod K.S.; Castle E.; Andiapen M.; Richards A.; Bellin A.;
Hammond V.; Godec T.; Moon J.C.; Davies C.; Bourantas C.V.; Wragg A.;
Ahluwalia A.; Pugliese F.; Mathur A.; Jones D.A.
Institution
(Beirne, Rathod, Andiapen, Ahluwalia, Mathur, Jones) Centre for
Cardiovascular Medicine and Devices, William Harvey Research Institute,
Queen Mary University of London, London, United Kingdom
(Beirne, Rathod, Andiapen, Richards, Bourantas, Wragg, Mathur, Jones)
Barts Interventional Group, Barts Heart Centre, Barts Health NHS Trust,
London, United Kingdom
(Beirne, Rathod, Andiapen, Richards, Moon, Davies, Bourantas, Wragg,
Ahluwalia, Pugliese, Mathur, Jones) NIHR Barts Biomedical Research Centre,
Barts Heart Centre and William Harvey Research Institute, Queen Mary
University of London, London, United Kingdom
(Castle, Moon, Davies, Pugliese) Department of Cardiac Imaging, Barts
Heart Centre, Barts Health NHS Trust, London, United Kingdom
(Bellin, Hammond, Godec, Ahluwalia, Jones) Barts Cardiovascular Clinical
Trials Unit, Queen Mary University of London, London, United Kingdom
Publisher
AME Publishing Company
Abstract
Background: Patients with ischaemic heart disease and previous coronary
artery bypass grafting (CABG) often need coronary evaluation by means of
invasive coronary angiography (ICA). ICA in such patients is technically
more challenging and carries a higher risk of complications including
kidney damage, myocardial infarction, stroke and death. Improvements in
Computed Tomography Cardiac Angiography (CTCA) technology have ensured its
emergence as a useful clinical tool in CABG assessment, allowing for its
potential use in planning interventional procedures in this patient group.
<br/>Method(s): The BYPASS-CTCA study is a prospective, single centre,
randomised controlled trial assessing the value of upfront CTCA in
patients with previous surgical revascularisation undergoing ICA
procedures. A total of 688 patients with previous CABG, requiring ICA for
standard indications, will be recruited and randomised to receive ICA
alone, or CTCA prior to angiography. Subjects will be followed up over a
12-month period post procedure. The primary endpoints are ICA procedural
duration, incidence of contrast-induced nephropathy (CIN) and patient
satisfaction scores post ICA. Secondary endpoints include contrast dose
(mL) and radiation dose (mSv) during ICA, number of catheters used,
angiography-related complications and cost-effectiveness of CTCA (QALY)
over 12 months. <br/>Discussion(s): The study will investigate the
hypothesis that CTCA prior to ICA in patients with previous CABG can
reduce procedural duration, post-procedural kidney damage and improve
patient satisfaction, therefore strengthening its role in this group of
patients.<br/>Copyright &#xa9; 2021 AME Publishing Company. All rights
reserved.

<3>
Accession Number
2014434688
Title
Meta-analysis of randomised controlled trials of perioperative
dexmedetomidine to reduce delirium and mortality after cardiac surgery.
Source
British Journal of Anaesthesia. 127(5) (pp e168-e170), 2021. Date of
Publication: November 2021.
Author
Sanders R.D.; Wehrman J.; Irons J.; Dieleman J.; Scott D.; Shehabi Y.
Institution
(Sanders, Wehrman, Irons) University of Sydney, Camperdown, NSW, Australia
(Sanders, Irons) Department of Anaesthetics, Royal Prince Alfred Hospital,
Camperdown, NSW, Australia
(Sanders) Institute of Academic Surgery, Camperdown, NSW, Australia
(Dieleman) Department of Anaesthesia & Perioperative Medicine, Westmead
Hospital, Westmead, NSW, Australia
(Scott) Department of Anaesthesia & Acute Pain Medicine, St Vincent's
Hospital, Melbourne, VIC, Australia
(Scott) University of Melbourne, Melbourne, VIC, Australia
(Shehabi) Monash Health School of Clinical Sciences, Monash University,
Melbourne, VIC, Australia
(Shehabi) Prince of Wales Clinical School of Medicine, University of New
South Wales, Randwick, NSW, Australia
Publisher
Elsevier Ltd

<4>
Accession Number
2013143794
Title
Pre-operative atrial fibrillation and early right ventricular failure
after left ventricular assist device implantation: a systematic review and
meta-analysis.
Source
American Heart Journal. 239 (pp 120-128), 2021. Date of Publication:
September 2021.
Author
Kittipibul V.; Blumer V.; Hernandez G.A.; Fudim M.; Flowers R.; Chaparro
S.; Agarwal R.
Institution
(Kittipibul, Flowers) Department of Medicine, University of Miami/Jackson
Memorial Hospital, Miami, FL, United States
(Blumer, Fudim, Agarwal) Division of Cardiology, Duke University Medical
Center, Durham, NC, United States
(Hernandez) Division of Cardiology, University of Mississippi Medical
Center, Jackson, MS, United States
(Chaparro) Advanced Heart Failure Program, Baptist Health South Florida,
Miami, FL, United States
Publisher
Mosby Inc.
Abstract
Background: Right ventricular failure (RVF) remains a major cause of
morbidity and mortality after left ventricular assist device (LVAD).
Atrial fibrillation (AF) is known for its deleterious effects on cardiac
function and hemodynamics. The association of pre-operative AF with the
risk of early post-LVAD RVF has not been well described. <br/>Method(s): A
comprehensive literature search was performed through April, 9 2021.
Cohort studies comparing the risk of post-operative RVF and/or need for
right ventricular assist device (RVAD) after LVAD in patients with or
without AF were included. Pooled odds ratio (OR) with 95% confidence
intervals (CI) and I² statistic were calculated using the
random-effects model. <br/>Result(s): Six studies were included in the
analysis. Post-operative RVF was reported in 5 studies (1,841 patients)
and RVAD use was reported in 4 studies (1,355 patients). There is a
non-significant trend toward a higher risk of post-operative RVF in the AF
group (pooled OR=1.25, 95%CI=0.99-1.58). No significant association
between AF and RVAD use is noted (pooled OR=1.17, 95%CI=0.82-1.66).
<br/>Conclusion(s): Pre-operative AF is not significantly associated with
higher risks of post-operative RVF and RVAD use after LVAD implantation,
although the trend toward higher post-operative RVF is observed in
patients with pre-operative AF. Additional research using a larger study
population is warranted to better understand the association of
pre-operative AF and the development of post-LVAD RVF.<br/>Copyright
&#xa9; 2021

<5>
Accession Number
2013054432
Title
The effect of perioperative hemadsorption in patients operated for acute
infective endocarditis-A randomized controlled study.
Source
Artificial Organs. 45(11) (pp 1328-1337), 2021. Date of Publication:
November 2021.
Author
Asch S.; Kaufmann T.P.; Walter M.; Leistner M.; Danner B.C.; Perl T.;
Kutschka I.; Niehaus H.
Institution
(Asch, Kaufmann, Walter, Leistner, Danner, Kutschka, Niehaus) Department
of Thoracic- and Cardiovascular Surgery, University Hospital,
Georg-August-University, Gottingen, Germany
(Asch) Department of Cardiac and Thoracic Surgery, Hospital Fulda, Fulda,
Germany
(Leistner) Department of Anesthesiology, University Hospital Wurzburg,
Wurzburg, Germany
(Perl) Department of Anaesthesiology, University Hospital,
Georg-August-University, Gottingen, Germany
(Niehaus) Department of Cardiothoracic, Transplant and Vascular Surgery,
Hanover Medical School, Hannover, Germany
Publisher
John Wiley and Sons Inc
Abstract
Patients operated for infective endocarditis (IE) are at high risk of
developing an excessive systemic hyperinflammatory state, resulting in
systemic inflammatory response syndrome and septic shock. Hemoadsorption
(HA) by cytokine adsorbers has been successfully applied to remove
inflammatory mediators. This randomized controlled trial investigates the
effect of perioperative HA therapy on inflammatory parameters and
hemodynamic status in patients operated for IE. A total of 20 patients
were randomly assigned to either HA therapy or the control group. HA
therapy was initiated intraoperatively and continued for 24 hours
postoperatively. Cytokine levels (IL-6, IL-1b, TNF-alpha), leukocytes,
C-reactive protein (CRP), and Procalcitonin (PCT) as well as catecholamine
support, and volume requirement were compared between both groups.
Operative procedures included aortic (n = 7), mitral (n = 6), and multiple
valve surgery (n = 7). All patients survived to discharge. No significant
differences concerning median cytokine levels (IL-6 and TNF-alpha) were
observed between both groups. CRP and PCT baseline levels were
significantly higher in the HA group (59.5 vs. 26.3 mg/dL, P =.029 and
0.17 vs. 0.05 microg/L, P =.015) equalizing after surgery. Patients in the
HA group required significantly higher doses of vasopressors (0.093 vs.
0.025 microg/kg/min norepinephrine, P =.029) at 12 hours postoperatively
as well as significantly more overall volume replacement (7217 vs. 4185 mL
at 12 hours, P =.015; 12 021 vs. 4850 mL at 48 hours, P =.015). HA therapy
did neither result in a reduction of inflammatory parameters nor result in
an improvement of hemodynamic parameters in patients operated for IE. For
a more targeted use of HA therapy, appropriate selection criteria are
required.<br/>Copyright &#xa9; 2021 The Authors. Artificial Organs
published by International Center for Artificial Organ and Transplantation
(ICAOT) and Wiley Periodicals LLC.

<6>
Accession Number
2015169499
Title
ES12.01 Defining Operability.
Source
Journal of Thoracic Oncology. Conference: 2021 World Conference on Lung
Cancer Worldwide Virtual Event. Virtual, Online. 16(10 Supplement) (pp
S832-S833), 2021. Date of Publication: October 2021.
Author
Opitz I.
Institution
(Opitz) Department of Thoracic Surgery, University Hospital Zurich,
Zurich, Switzerland
Publisher
Elsevier Inc.
Abstract
Stage III, so called loco-regionally or locally advanced>> NSCLC comprises
about one third of NSCLC patients and is very heterogeneous with varying
outcome. Because of the heterogeneity (IIIA 36 %, IIIB 26% and IIIC 13%
5-years survival rate) a schematic management approach is very difficult,
which is reflected in complex algorithms of existing guidelines. The
current optimal staging and treatment decision for this patient group -
usually a combination of local therapy (surgery or radiotherapy) and
systemic therapy - requires multidisciplinary expert team effort.The
definition of functional, technical, and oncological operability is
depending on many factors and is not standardized to date. For adequate
decision-making, several points need to be taken into consideration:
Thorough preop-staging needs to be performed with caveat to differences
between clinical and pathological staging. Recent analysis of Navani et
al¹. used individual participant data from randomized
controlled trials (RCTs) and assessed agreement between clinical TNM
(cTNM) stage at randomization and pathologic TNM (pTNM) stage. The results
are based on 698 patients and demonstrated suboptimal agreement between
clinical and pathologic staging. Discrepancies between clinical and
pathologic T and N staging could have led to different treatment decisions
in 10% and 38% of cases, respectively. Agreement between clinical N stage
and pathologic N stage showed accordance between cN2 and pN2 is 67%
(104/155) and if clinical staging overestimates the extent of nodal
disease (114 patients [15%] in this meta-analysis), then this may mean
patients are potentially denied from surgery. Eventually, further
molecular and immunological staging of the tumors may help to move
forwards to more personalized precision medicine.Functional assessment is
equally important for the indication for tumor resection. Current
guidelines include algorithms²; however, patients with limited
lung function and emphysema should be assessed for a potential lung volume
reduction effect where resection can even lead to improvement of lung
function^3-5. Extremely important is also the patient's
individual expectation for postoperative quality of life and fitness, and
should be taken into account during decision-making (figure 1). Figure 1:
Algorithm illustrating the approach to patients with reduced lung function
and stage I lung cancer⁶ [Formula presented] The most critical
point of operability assessment is how to define resectability. Across
guidelines, only limited agreement exists (table 1) and in here, solely
the fact that bulky N2 (only NCCN guidelines give a clear recommendation
what "bulky" means > 3cm) should be excluded from surgery is in alignment
between the different existing recommendations, besides clear resection
margins. With regard to the number or zones of lymph node involvement, the
variety ranges from "single", to "discrete", to "low volume" which are not
further refined. Table 1: Summary of UK, European and American guidelines
on the management of potentially resectable N2 NSCLC [Formula presented]
(created by Evison¹² using guidance from indicated Guidelines)
ACCP American College of Chest Physicians, BTS British Thoracic Society,
CRT chemoradiotherapy, cCRT concurrent chemoradiotherapy, ESMO European
Society of Medical Oncology, IASLC International Association for the Study
of Lung Cancer, NICE National Institute for Health and Care Excellence,
NCCN National Comprehensive Cancer Network, NSCLC non-small cell lung
cancer, PFS progression-free survival, SCTS The Society for Cardiothoracic
Surgery in Great Britain and Ireland. A special condition of patients with
stage III tumors represents bulky, centrally necrotic tumors difficult to
control by radiotherapy and multiple nodules in one lobe deserves extra
attention in favor of surgery. In any case, multidisciplinary tumor boards
and clinics for treatment allocation are relevant, including here a
thoracic surgeon who has a major part of his/her practice dedicated to
thoracic oncology in NSCLC surgery for the assessment of functional,
technical, and oncological operability. 1. Navani N, Fisher DJ, Tierney
JF, Stephens RJ, Burdett S, Group NM-aC. The Accuracy of Clinical Staging
of Stage I-IIIa Non-Small Cell Lung Cancer: An Analysis Based on
Individual Participant Data. Chest. 2019;155(3):502-9. 2. Brunelli A,
Charloux A, Bolliger CT, Rocco G, Sculier JP, Varela G, et al. ERS/ESTS
clinical guidelines on fitness for radical therapy in lung cancer patients
(surgery and chemo-radiotherapy). The European respiratory journal.
2009;34(1):17-41. 3. Korst RJ, Ginsberg RJ, Ailawadi M, Bains MS, Downey
RJ, Jr., Rusch VW, et al. Lobectomy improves ventilatory function in
selected patients with severe COPD. Ann Thorac Surg. 1998;66(3):898-902.
4. Edwards JG, Duthie DJ, Waller DA. Lobar volume reduction surgery: a
method of increasing the lung cancer resection rate in patients with
emphysema. Thorax. 2001;56(10):791-5. 5. Carretta A, Zannini P, Puglisi A,
Chiesa G, Vanzulli A, Bianchi A, et al. Improvement of pulmonary function
after lobectomy for non-small cell lung cancer in emphysematous patients.
Eur J Cardiothorac Surg. 1999;15(5):602-7. 6. Yacoub WN, Meyers BF.
Surgical resection in combination with lung volume reduction surgery for
stage I non-small cell lung cancer. Semin Thorac Cardiovasc Surg.
2010;22(1):38-43. 7. Lim E, Baldwin D, Beckles M, Duffy J, Entwisle J,
Faivre-Finn C, et al. Guidelines on the radical management of patients
with lung cancer. Thorax. 2010;65 Suppl 3:iii1-27. 8. Ramnath N, Dilling
TJ, Harris LJ, Kim AW, Michaud GC, Balekian AA, et al. Treatment of stage
III non-small cell lung cancer: Diagnosis and management of lung cancer,
3rd ed: American College of Chest Physicians evidence-based clinical
practice guidelines. Chest. 2013;143(5 Suppl):e314S-e40S. 9. Eberhardt WE,
De Ruysscher D, Weder W, Le Pechoux C, De Leyn P, Hoffmann H, et al. 2nd
ESMO Consensus Conference in Lung Cancer: locally advanced stage III
non-small-cell lung cancer. Ann Oncol. 2015;26(8):1573-88. 10. National
Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in
Oncology (NCCN Guidelines) Non-Small Cell Lung Cancer Version 5.2018. 2018
[ 11. National Institute for Health and Care Excellence. Lung cancer:
diagnosis and management. 2019 [ 12. Evison M, AstraZeneca UKL. The
current treatment landscape in the UK for stage III NSCLC. British journal
of cancer. 2020;123(Suppl 1):3-9.<br/>Copyright &#xa9; 2021

<7>
Accession Number
2015133650
Title
Utilization and procedural adverse outcomes associated with Watchman
device implantation.
Source
Europace. 23(2) (pp 247-253), 2021. Date of Publication: 01 Feb 2021.
Author
Khalil F.; Arora S.; Killu A.M.; Tripathi B.; Desimone C.V.; Egbe A.;
Noseworthy P.A.; Kapa S.; Mulpuru S.; Gersh B.; Mohamad A.; Friedman P.;
Holmes D.; Deshmukh A.J.
Institution
(Khalil, Killu, Desimone, Egbe, Noseworthy, Kapa, Mulpuru, Gersh, Mohamad,
Friedman, Holmes, Deshmukh) Department of Cardiovascular Medicine, Mayo
Clinic, 200 First Street SW, Rochester, MN 55901, United States
(Arora) Division of Cardiology, Case Western Reserve University,
Cleveland, OH, United States
(Tripathi) Department of Cardiology, University of Arizona, Phoenix, AZ,
United States
Publisher
Oxford University Press
Abstract
Aims: The Food and Drug Administration (FDA) approval of the Watchman
device [percutaneous left atrial appendage occlusion (LAAO)] has resulted
in the widespread use of this procedure in many centres across the USA. We
sought to estimate the nationwide utilization and frequency of adverse
outcomes associated with Watchman device implantation. The objective of
this study was to evaluate the Watchman device implantation
peri-procedural complications and comparison of the results with the
previous studies. <br/>Methods and Results: The National Inpatient Sample
(NIS) was queried for all hospitalizations with a primary diagnosis of
atrial fibrillation or atrial flutter during the year 2016 with
percutaneous LAAO during the same admission (ICD-10 code - 02L73DK). The
frequency of peri-procedural complications, including mortality,
procedure-related stroke, major bleeding requiring blood transfusion, and
pericardial effusion, was assessed. We compared the complication rates
with the published randomized controlled trials and the European Watchman
registry. An estimated 5175 LAAO procedures were performed in 2016. The
majority of procedures was performed in males (59.1%), age >=75 years
(58.7%), and White (83.1%). The overall complication rate was 1.9%. The
in-hospital mortality was 0.29%. Pericardial effusion requiring
pericardiocentesis was the most frequent complication (0.68%). Bleeding
requiring transfusion was noted in 0.1% of device implants. The rates of
post-procedure stroke and systemic embolism were 0% and 0.29%,
respectively. <br/>Conclusion(s): Percutaneous LAAO with the Watchman
device in the USA is associated with low in-hospital complications and a
similar safety profile to a recently published EWOLUTION cohort. The
complication rates were lower than those reported in the major randomized
clinical trials (RCTs). We report the frequency of peri-procedural
complications of the LAAO using the Watchman device from the NIS database.
We also compare the frequency of peri-procedural complications with the
previously published RCTs and EWOLUTION cohort. Our findings are in
concordance with findings from EWOLUTION cohort and compare favourably
with RCTs. <br/>Copyright &#xa9; 2020 Published on behalf of the European
Society of Cardiology. All rights reserved.

<8>
Accession Number
2015125080
Title
Protamine sulfate during transcatheter aortic valve implantation (PS TAVI)
- A single-center, single-blind, randomized placebo-controlled trial.
Source
Kardiologia Polska. 79(9) (pp 995-1002), 2021. Date of Publication: 30 Sep
2021.
Author
Zbronski K.; Grodecki K.; Gozdowska R.; Ostrowska E.; Wysinska J.; Rymuza
B.; Scislo P.; Wilimski R.; Kochman J.; Filipiak K.J.; Opolski G.; Huczek
Z.
Institution
(Zbronski, Grodecki, Gozdowska, Ostrowska, Wysinska, Rymuza, Scislo,
Kochman, Filipiak, Opolski, Huczek) 1st Department of Cardiology, Medical
University of Warsaw, Warszawa, Poland
(Wilimski) Department of Cardiac Surgery, Medical University of Warsaw,
Warszawa, Poland
Publisher
Via Medica
Abstract
Background: Bleeding complications after transcatheter aortic valve
implantation (TAVI) negatively affect the post-procedural prognosis.
Routine use of protamine sulfate (PS) to reverse unfractionated heparin
after TAVI was never assessed in a randomized controlled trial.
<br/>Aim(s): The aim of this study was to assess the impact of PS on
bleeding complications after TAVI. <br/>Method(s): Between December 2016
and July 2020 311 patients qualified to TAVI in one academic center were
screened. Patients that met the inclusion criteria were randomized to
either PS or normal saline administration at the moment of optimal valve
deployment. Baseline, procedural, and follow-up data for up to 30 days
were collected and analyzed. The primary endpoint (PE) was a composite of
life-threatening and major bleeding according to Valve Academic Research
Consortium within 48 hours after the procedure. <br/>Result(s): Overall,
100 patients (48 males, median age 82 years) met the inclusion criteria
and were included in the study. Forty-seven subjects (47%) were randomized
to PS. The primary endpoint occurred in 29% of the study population.
Despite numerically lower rates of PE in patients randomized to PS, a
statistical significance was not reached (21% in the PS group and 36% in
the placebo group; odds ratio [OR], 0.48; 95% confidence intervals [CI]
0.2-1.2; P = 0.11). There were no significant differences in secondary
endpoints. <br/>Conclusion(s): Routine protamine sulfate administration
did not significantly decrease the rate of major and life-threatening
bleeding complications after TAVI. Larger studies are required to assess
the impact of routine PS use.<br/>Copyright &#xa9; by the Author(s), 2021

<9>
Accession Number
2015123206
Title
Is Epicardial Adipose Tissue Associated with Atrial Fibrillation following
Cardiac Surgery? A Systematic Review and Meta-Analysis.
Source
Heart Surgery Forum. 24(5) (pp E801-E807), 2021. Date of Publication: 08
Sep 2021.
Author
Sha R.; Han W.; Lin M.; Zhong J.
Institution
(Sha, Han, Lin, Zhong) Key Laboratory of Cardiovascular Remodeling and
Function Research, Chinese Ministry of Education, Chinese National Health
Commission and Chinese Academy of Medical Sciences, State and Shandong
Province Joint Key Laboratory of Translational Cardiovascular Medicine,
Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine,
Shandong University, Jinan, China
(Lin) Peking University First Hospital, Beijing, China
(Zhong) Department of Cardiology, Qilu Hospital (Qingdao), Cheeloo College
of Medicine, Shandong University, Qingdao, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Although epicardial adipose tissue (EAT) has been proven to be
related to atrial fibrillation (AF) and post-ablation AF recurrence, the
association between EAT and AF after cardiac surgery (AFACS) remains
unclear. <br/>Objective(s): This study was a systematic review and
meta-analysis that assessed the relationship between EAT and AFACS.
<br/>Method(s): Electronic databases were systematically searched for
"atrial fibrillation" and "epicardial adipose tissue." The analysis was
stratified according to the EAT measurement into three meta-analyses as
(1) total EAT volume, (2) left atrial (LA)-EAT volume, and (3) EAT
thickness. Standardized mean difference (SMD) was estimated using a random
effects model. <br/>Result(s): Eight articles with 10 studies (546
patients) were included. The meta-analysis revealed that EAT was higher in
those with AFACS irrespective of the EAT measurement (total EAT volume:
SMD = 0.56 mL, 95% confidence interval, CI = 0.56-1.10 mL, I² =
0.90, P = .04; EAT thickness: SMD = 0.85 mm, 95% CI = 0.04-1.65 mm,
I² = 0.90, P = .04; LA-EAT volume: SMD = 0.57 mL, 95% CI =
0.23-0.92 mL, I² = 0.00, P = .001). <br/>Conclusion(s): EAT was
higher in patients with AFACS, measured either as volume or
thickness.<br/>Copyright &#xa9; 2021 Forum Multimedia Publishing, LLC

<10>
Accession Number
2015124694
Title
Intraoperative Methylprednisolone and Neurodevelopmental Outcomes in
Infants After Cardiac Surgery.
Source
Annals of Thoracic Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Zyblewski S.C.; Martin R.H.; Shipes V.B.; Hamlin-Smith K.; Atz A.M.;
Bradley S.M.; Kavarana M.N.; Mahle W.T.; Everett A.D.; Graham E.M.
Institution
(Zyblewski, Hamlin-Smith, Atz, Graham) Department of Pediatrics, Medical
University of South Carolina, Charleston, SC, United States
(Martin, Shipes) Department of Public Health Sciences, Medical University
of South Carolina, Charleston, SC, United States
(Bradley, Kavarana) Section of Pediatric Cardiac Surgery, Medical
University of South Carolina, Charleston, SC, United States
(Mahle) Department of Pediatrics, Children's Healthcare of Atlanta and
Emory University, Atlanta, Georgia, Georgia
(Everett) Department of Pediatrics, The Johns Hopkins University,
Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
Background: Neurodevelopmental impairment is an important consequence for
survivors of surgery for critical congenital heart disease. This study
sought to determine whether intraoperative methylprednisolone during
neonatal cardiac surgery is associated with neurodevelopmental outcomes at
12 months of age and to identify early prognostic variables associated
with neurodevelopmental outcomes. <br/>Method(s): We performed a planned
secondary analysis of a 2-center, double-blind, randomized,
placebo-controlled trial of intraoperative methylprednisolone in neonates
undergoing cardiac surgery. A brain injury biomarker was measured during
surgery. Bayley Scales of Infant and Toddler Development-III (BSID-III)
were performed at 12 months of age. Two-sample t tests and generalized
linear models were used. <br/>Result(s): There were 129 participants (n =
61 methylprednisolone; n = 68 placebo). There were no significant
differences in BSID-III scores and brain injury biomarker levels between
treatment groups. Participants who underwent a palliative (versus
corrective) procedure had lower mean BSID-III cognitive (101 +/- 15 versus
106 +/- 14; P = .03) and motor scores (85 +/- 18 versus 94 +/- 16; P <
.01). Longer ventilation time was associated with lower motor scores.
Longer cardiac intensive care unit stay was associated with lower
cognitive, language, and motor scores. Cardiopulmonary bypass time, aortic
cross-clamp time, and deep hypothermic circulatory arrest were not
associated with BSID-III scores. <br/>Conclusion(s): Neurodevelopmental
outcomes were not associated with intraoperative methylprednisolone or
intraoperative variables. Participants who underwent a neonatal palliative
(versus corrective) procedure had longer cardiac intensive care unit stays
and worse neurodevelopmental outcomes at 1 year. This work suggests that
interventions focused solely on the operative period may not be associated
with a long-term neurodevelopmental benefit.<br/>Copyright &#xa9; 2021 The
Society of Thoracic Surgeons

<11>
Accession Number
635358125
Title
Skeletonized vs Pedicled Internal Mammary Artery Graft Harvesting in
Coronary Artery Bypass Surgery: A Post Hoc Analysis from the COMPASS
Trial.
Source
JAMA Cardiology. 6(9) (pp 1042-1049), 2021. Date of Publication: September
2021.
Author
Lamy A.; Browne A.; Sheth T.; Zheng Z.; Dagenais F.; Noiseux N.; Chen X.;
Bakaeen F.G.; Brtko M.; Stevens L.-M.; Alboom M.; Lee S.F.; Copland I.;
Salim Y.; Eikelboom J.
Institution
(Lamy, Browne, Sheth, Lee, Copland, Salim, Eikelboom) Population Health
Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada
(Lamy, Alboom) Department of Surgery, McMaster University, Hamilton, ON,
Canada
(Lamy, Lee, Salim) Department of Health Research Methods, Evidence, and
Impact, McMaster University, Hamilton, ON, Canada
(Sheth, Salim, Eikelboom) Department of Medicine, McMaster University,
Hamilton, ON, Canada
(Zheng) Department of Cardiovascular Surgery, Fuwai Hospital, Beijing,
China
(Dagenais) Department of Cardiac Surgery, Quebec Heart and Lung Institute
Affiliated with Laval University, Quebec City, QC, Canada
(Noiseux, Stevens) Department of Cardiac Surgery, Centre Hospitalier de
l'Universite de Montreal, Montreal, QC, Canada
(Chen) Department of Thoracic and Cardiovascular Surgery, Nanjing First
Hospital Affiliated with Nanjing Medical University, Nanjing, China
(Bakaeen) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, United States
(Brtko) Department of Cardiac Surgery, Fakultni Nemocnice Hradec Kralove,
Hradec Kralove, Kralovehradecky, Czechia
Publisher
American Medical Association
Abstract
Importance: The relative safety and patency of skeletonized vs pedicled
internal mammary artery grafts in patients undergoing coronary artery
bypass graft (CABG) surgery are unknown. <br/>Objective(s): To investigate
the association of skeletonized vs pedicled harvesting with internal
mammary artery graft patency and clinical outcomes 1 year after CABG
surgery. <br/>Design, Setting, and Participant(s): This study was a post
hoc analysis of the multicenter, randomized, double-blind,
placebo-controlled Cardiovascular Outcomes for People Using
Anticoagulation Strategies (COMPASS) clinical trial, which enrolled 27 395
patients from 602 centers in 33 countries from March 2013 through May
2016. Eligibility criteria for the trial included CABG surgery for
coronary artery disease with at least 2 grafts implanted and an estimated
glomerular filtration rate of at least 30 mL/min. A total of 1002 of 1448
patients were randomized to the CABG arm of the COMPASS trial and
underwent skeletonized (282 [28.1%]) or pedicled (720 [71.9%]) internal
mammary artery harvesting. The patients had evaluable angiography results
1 year after surgery. Data were analyzed from October 11, 2019, to May 14,
2020. <br/>Intervention(s): Patients underwent graft harvesting with
either the pedicled technique or skeletonized technique. <br/>Main
Outcomes and Measures: The primary outcome was graft occlusion 1 year
after CABG surgery, as assessed by computed tomography angiography.
<br/>Result(s): A total of 1002 patients underwent skeletonized (282
[28.1%]; mean [SD] age, 65.9 [8.1] years; 229 men [81.2%]; 194 White
patients [68.8%]) or pedicled (720 [71.9%]; mean [SD] age, 64.8 [7.6]
years; 603 men [83.8%]; 455 White patients [63.2%]) internal mammary
artery harvesting. Rates of internal mammary artery graft occlusion 1 year
after CABG surgery were higher in the skeletonized group than in the
pedicled group (33 of 344 [9.6%] vs 30 of 764 [3.9%]; graft-level adjusted
odds ratio, 2.41; 95% CI, 1.39-4.20; P =.002), including the left internal
mammary artery to left anterior descending artery (21 of 289 [7.3%] vs 25
of 725 [3.4%]; graft-level adjusted odds ratio, 2.10; 95% CI, 1.14-3.88, P
=.02). After a mean follow-up of 23 months, skeletonized graft harvesting
was also associated with a higher rate of major adverse cardiovascular
events (20 [7.1%] vs 15 [2.1%]; adjusted hazard ratio, 3.19; 95% CI,
1.53-6.67; P =.002) and repeated revascularization (14 [5.0%] vs 10
[1.4%]; adjusted hazard ratio, 2.75; 95% CI, 1.10-6.88; P =.03).
<br/>Conclusions and Relevance: This post hoc analysis of the COMPASS
randomized clinical trial found that harvesting of the internal mammary
artery during CABG surgery using a skeletonized technique was associated
with a higher rate of graft occlusion and worse clinical outcomes than the
traditional pedicled technique. Future randomized clinical trials are
needed to establish the safety and patency of the skeletonized technique.
Trial Registration: ClinicalTrials.gov Identifier:
NCT01776424.<br/>Copyright &#xa9; 2021 American Medical Association. All
rights reserved.

<12>
Accession Number
2011840389
Title
Reporting in clinical studies on platelet-rich plasma therapy among all
medical specialties: A systematic review of Level i and II studies.
Source
PLoS ONE. 16(4 April) (no pagination), 2021. Article Number: e0250007.
Date of Publication: April 2021.
Author
Nazaroff J.; Oyadomari S.; Brown N.; Wang D.
Institution
(Nazaroff, Wang) University of California Irvine School of Medicine,
Irvine, CA, United States
(Oyadomari, Brown) Department of Orthopaedic Surgery, University of
California Irvine Health, Orange, CA, United States
Publisher
Public Library of Science
Abstract
The clinical practice of platelet-rich plasma (PRP) therapy has grown
significantly in recent years in multiple medical specialties. However,
comparisons of PRP studies across medical fields remain challenging
because of inconsistent reporting of protocols and characterization of the
PRP being administered. The purpose of this systematic review was to
determine the quantity of level I/II studies within each medical specialty
and compare the level of study reporting across medical fields. Methods
The Cochrane Database, PubMed, and EMBASE databases were queried for level
I/II clinical studies on PRP injections across all medical specialties.
From these studies, data including condition treated, PRP processing and
characterization, delivery, control group, and assessed outcomes were
collected. Results A total of 132 studies met the inclusion and exclusion
criteria and involved 28 different conditions across 8 specialties
(cardiothoracic surgery, cosmetic, dermatology, musculoskeletal (MSK),
neurology, oral maxillofacial surgery, ophthalmology, and plastic
surgery). Studies on PRP for MSK injuries made up the majority of the
studies (74%), with knee osteoarthritis and tendinopathy being most
commonly studied. Of the 132 studies, only 44 (33%) characterized the
composition of PRP used, and only 23 (17%) reported the leukocyte
component. MSK studies were more likely to use patient-reported outcome
measures to assess outcomes, while studies from other specialties were
more likely to use clinician-or imagingbased objective outcomes. Overall,
61% of the studies found PRP to be favorable over control treatment, with
no difference in favorable reporting between MSK and other medical
specialties. Conclusions The majority of level I/II clinical studies
investigating PRP therapy across all medical specialties have been
conducted for MSK injuries with knee osteoarthritis and tendinopathy being
the most commonly studied conditions. Inconsistent reporting of PRP
composition exists among all studies in medicine. Rigorous reporting in
human clinical studies across all medical specialties is crucial for
evaluating the effects of PRP and moving towards disease-specific and
individualized treatment.<br/>Copyright &#xa9; 2021 Public Library of
Science. All rights reserved.

<13>
Accession Number
2005033251
Title
Comparison of infective endocarditis risk between balloon and
self-expandable valves following transcatheter aortic valve replacement:
systematic review and meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. 36(3) (pp 363-374), 2021.
Date of Publication: July 2021.
Author
Prasitlumkum N.; Thangjui S.; Leesutipornchai T.; Kewcharoen J.;
Limpruttidham N.; Pai R.G.
Institution
(Prasitlumkum, Kewcharoen, Limpruttidham) University of Hawaii Internal
Medicine Residency Program, 1356 Lusitana St, Honolulu, HI 96813, United
States
(Thangjui, Leesutipornchai) Faculty of Medicine, Chulalongkorn University,
Bangkok, Thailand
(Pai) Department of Cardiology, University of California Riverside,
Riverside, CA, United States
Publisher
Springer Japan
Abstract
This study aimed to compare incidence of IE between BE and SE valves by
performing a systematic review and meta-analysis of the literature. We
comprehensively searched the databases of MEDLINE and EMBASE from
inception to November 2019. Included studies were published observational
studies that compared the risk of IE among patients undergoing TAVR
employing BE versus SE valves, using the random-effects to calculate risk
ratios and 95% confidence intervals (CIs).Ten cohort studies from April
2013 to November 2019 were included in this meta-analysis involving 13,478
subjects (6289 SE and 7189 BE types). Our study showed no statistical
difference in IE rates between each type of valves (pooled OR 0.96, 95%
CI: 0.68-1.35, p = 0.801 with I2 = 14.7%). There was no difference in IE
rate between BE and SE valves following TAVR. Further studies are
warranted to confirm our findings.<br/>Copyright &#xa9; 2020, Japanese
Association of Cardiovascular Intervention and Therapeutics.

<14>
Accession Number
636089760
Title
Using telemedicine to improve the quality of life of parents of infants
with CHD surgery after discharge.
Source
International journal for quality in health care : journal of the
International Society for Quality in Health Care. 33(3) (no pagination),
2021. Date of Publication: 25 Sep 2021.
Author
Zhang Q.-L.; Lei Y.-Q.; Liu J.-F.; Cao H.; Chen Q.
Institution
(Zhang, Lei, Liu, Cao, Chen) Department of Cardiac Surgery, Fujian Branch
of Shanghai Children's Medical Center, No.966 of Hengyu Road, Fuzhou,
Fujian 350014, China
(Zhang, Lei, Liu, Cao, Chen) Fujian Children's Hospital, No.966 of Hengyu
Road, Fuzhou, Fujian 350014, China
(Zhang, Lei, Liu, Cao, Chen) Fujian Maternity and Child Health Hospital,
Affiliated Hospital of Fujian Medical University, No.18 of Danshan Road,
Fuzhou, Fujian 350001, China
(Zhang, Lei, Liu, Cao, Chen) Fujian Key Laboratory of Women and Children's
Critical Diseases Research, Fujian Maternity and Child Health Hospital,
No.18 of Danshan Road, Fuzhou, Fujian 350001, China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The purpose of this study was to investigate the effect of
using telemedicine to improve the quality of life of parents of infants
with congenital heart disease (CHD) surgery after discharge.
<br/>METHOD(S): A prospective randomized controlled study was conducted in
a provincial hospital in China from November 2020 to April 2021 to compare
the quality of life of parents of infants with CHD surgery after discharge
between the WeChat follow-up group and the outpatient follow-up group. A
total of 84 patients (42 in each group) and 168 parents (84 in each group)
participated in this study. <br/>RESULT(S): One month after discharge, the
Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS)
scores of parents in the intervention group were significantly lower than
those in the control group (P<0.05). Compared with the SAS and SDS scores
at discharge, the scores of parents in the intervention group were
significantly lower at 1 month after discharge (P<0.05), while the scores
of parents in the control group were similar at 1 month after discharge
(P>0.05). At discharge, in both the intervention group and the control
group, the SAS and SDS scores of the mothers were higher than those of the
fathers (P<0.05). One month after discharge, in the control group, the SAS
and SDS scores of the mothers were higher than those of the fathers
(P<0.05). One month after discharge, in the intervention group, the SAS
and SDS scores of the mothers were similar to those of the fathers
(P>0.05). The comparison of the SAS and SDS scores of parents with
different education levels showed that in both the intervention group and
control group, the lower the parents' educational levels, the higher their
SAS and SDS scores (P<0.05). One month after discharge, in the control
group, the lower the parents' education levels, the higher their SAS and
SDS scores (P<0.05). One month after discharge, in the intervention group,
the SAS and SDS scores were similar among parents with different
educational levels. The results of the World Health Organization Quality
of Life Brief scale showed that the scores of the physiological,
psychological, social and environmental fields at 1 month after discharge
in the intervention group were significantly higher than those in the
control group (P<0.05). <br/>CONCLUSION(S): Providing health education and
medical support to the parents of infants with CHD surgery after discharge
via telemedicine can effectively relieve parents' anxiety and depression
and improve their quality of life.<br/>Copyright &#xa9; The Author(s)
2021. Published by Oxford University Press on behalf of International
Society for Quality in Health Care. All rights reserved. For permissions,
please e-mail: journals.permissions@oup.com.

<15>
Accession Number
2014931813
Title
Evaluation of a "tummy time" intervention to improve motor skills in
infants after cardiac surgery.
Source
Cardiology in the Young. (no pagination), 2021. Date of Publication:
2021.
Author
Uzark K.; Smith C.; Yu S.; Lowery R.; Tapley C.; Romano J.C.; Butcher J.
Institution
(Uzark, Romano) Department of Cardiac Surgery, University of Michigan,
Mott Children's Hospital, Ann Arbor, MI, United States
(Uzark, Smith, Yu, Lowery, Tapley, Romano, Butcher) Department of
Pediatrics, University of Michigan, Mott Children's Hospital, Ann Arbor,
MI, United States
Publisher
Cambridge University Press
Abstract
Background: Infants who require open heart surgery are at increased risk
for developmental delays including gross motor impairments which may have
implications for later adaptive skills and cognitive performance. We
sought to evaluate the feasibility and efficacy of a tummy time
intervention to improve motor skill development in infants after cardiac
surgery. <br/>Method(s): Infants <4 months of age who underwent cardiac
surgery were randomly assigned to tummy time with or without outpatient
reinforcement or standard of care prior to hospital discharge. The Alberta
Infant Motor Scale (AIMS) was administered to each infant prior to and 3
months after discharge. Groups were compared, and the association between
parent-reported tummy time at home and change in motor scores at follow-up
was examined. <br/>Result(s): Parents of infants (n = 64) who had cardiac
surgery at a median age of 5 days were randomly assigned to tummy time
instruction (n = 20), tummy time + outpatient reinforcement (n = 21) or
standard of care (n = 23). Forty-nine (77%) returned for follow-up. At
follow-up, reported daily tummy time was not significantly different
between groups (p = 0.17). Fifteen infants had <15 minutes of tummy time
daily. Infants who received >15 minutes of tummy time daily had a
significantly greater improvement in motor scores than infants with <15
minutes of tummy time daily (p = 0.01). <br/>Conclusion(s): In infants
following cardiac surgery, <15 minutes of tummy time daily is associated
with increased motor skill impairment. Further research is needed to
elucidate the best strategies to optimise parental compliance with tummy
time recommendations. <br/>Copyright &#xa9; The Author(s), 2021. Published
by Cambridge University Press.

<16>
Accession Number
2015121358
Title
Targeting Higher Intraoperative Blood Pressures Does Not Reduce Adverse
Cardiovascular Events Following Noncardiac Surgery.
Source
Journal of the American College of Cardiology. 78(18) (pp 1753-1764),
2021. Date of Publication: 02 Nov 2021.
Author
Wanner P.M.; Wulff D.U.; Djurdjevic M.; Korte W.; Schnider T.W.; Filipovic
M.
Institution
(Wanner, Djurdjevic, Schnider, Filipovic) Division of Anaesthesiology,
Intensive Care, Rescue and Pain Medicine, Cantonal Hospital St. Gallen,
St. Gallen, Switzerland
(Wulff) University of Basel, Basel, Switzerland and Max Planck Institute
for Human Development, Berlin, Germany
(Korte) Center for Laboratory Medicine, St. Gallen, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: Intraoperative arterial hypotension is strongly associated
with postoperative major adverse cardiovascular events (MACE); however,
whether targeting higher intraoperative mean arterial blood pressures
(MAPs) may prevent adverse events remains unclear. <br/>Objective(s): This
study sought to determine whether targeting higher intraoperative MAP
lowers the incidence of postoperative MACE. <br/>Method(s): This
single-center randomized controlled trial assigned adult patients at
cardiovascular risk undergoing major noncardiac surgery to an
intraoperative MAP target of >=60 mm Hg (control) or >=75 mm Hg (MAP
>=<inf>75</inf>). The primary outcome was acute myocardial injury on
postoperative days 0-3 and/or 30-day MACE/acute kidney injury (AKI) (acute
coronary syndrome, congestive heart failure, coronary revascularization,
stroke, AKI, and all-cause mortality). The secondary outcome was 1-year
MACE. <br/>Result(s): In total, 458 patients were randomized
(intention-to-treat population: 451). The cumulative intraoperative
duration with MAP <65 mm Hg was significantly shorter in the MAP
>=<inf>75</inf> group (median 9 minutes [interquartile range: 3 to 24
minutes] vs 23 minutes [interquartile range: 8-49 minutes]; P < 0.001).
The primary outcome incidence was 48% for MAP >=<inf>75</inf> and 52% for
control (risk difference -4.2%; 95% CI: -13% to +5%), the primary
contributor being AKI (incidence 44%). Acute myocardial injury occurred in
15% (MAP >=<inf>75</inf>) and 19% (control) of patients. The secondary
outcome incidence was 17% for MAP >=<inf>75</inf> and 15% for control
(risk difference +2.7; 95% CI: -4% to +9.5%). <br/>Conclusion(s): These
findings do not support universally targeting higher intraoperative blood
pressures to reduce postoperative complications. Despite a 60% reduction
in hypotensive time with MAP <65 mm Hg, no significant reductions in acute
myocardial injury or 30-day MACE/AKI could be found. (Biomarkers, Blood
Pressure, BIS: Risk Stratification/Management of Patients at Cardiac Risk
in Major Noncardiac Surgery [BBB]; NCT02533128)<br/>Copyright &#xa9; 2021
The Authors

<17>
Accession Number
2014151076
Title
Update on pulmonary ossifications in the differential diagnosis of
solitary pulmonary nodules.
Source
Journal of Clinical Medicine. 10(20) (no pagination), 2021. Article
Number: 4795. Date of Publication: October-2 2021.
Author
Gielis J.F.; Berzenji L.; Siozopoulou V.; Luijks M.; Van Schil P.E.Y.
Institution
(Gielis, Berzenji, Van Schil) Department of Thoracic and Vascular Surgery,
Antwerp University Hospital, University of Antwerp, Antwerp 2650, Belgium
(Siozopoulou) Department of Pathology, Antwerp University Hospital,
Antwerp 2650, Belgium
(Luijks) Department of Pathology, ZNA Stuivenberg, Antwerp 2060, Belgium
Publisher
MDPI
Abstract
Pulmonary ossifications have often been regarded as rare, post-mortem
findings without any clinical significance. We have investigated the
occurrence of pulmonary ossifications in patients undergoing thoracic
procedures, and how this may affect the differential diagnosis of solitary
pulmonary nodules. In addition, we have performed a literature search on
the occurrence and possible pathogenesis of these ossifications. From
January 2008 until August 2019, we identified pulmonary ossifications in
34 patients who underwent elective pulmonary surgery. Pre-operative
imaging was unable to differentiate these ossifications from solid tumors.
A definitive diagnosis was made by an experienced pathologist (VS, ML).
The PubMed database was researched in December 2019 with the search terms
"pulmonary ossifications"; "heterotopic ossifications"; and "solitary
pulmonary nodule". In total, 27 patients were male, with a mean age of 63
+/- 12 years (age 41 to 82 on diagnosis). All lesions were identified on
thoracic CT and marked for resection by a multidisciplinary team. A total
of 17 patients were diagnosed with malignancy concurrent with
ossifications. There was a clear predilection for the right lower lobe (12
cases, 35.3%) and most ossifications had a nodular form (70.6%). We could
not identify a clear association with any other pathology, either
cancerous or non-cancerous in origin. Oncologic or pulmonary comorbidities
did not influence patient survival. Pulmonary ossifications are not as
seldom as thought and are not just a curiosity finding by pathologists.
These formations may be mistaken for a malignant space-occupying lesion,
both pre-and perioperatively, as they are indistinguishable in imaging. We
propose these ossifications as an underestimated addition to the
differential diagnosis of a solitary pulmonary nodule.<br/>Copyright
&#xa9; 2021 by the authors. Licensee MDPI, Basel, Switzerland.

<18>
Accession Number
2014117499
Title
New thoracotomy closure, a simple way to decrease chronic post-operative
pain in selected patients-blinded prospective study.
Source
Journal of Personalized Medicine. 11(10) (no pagination), 2021. Article
Number: 1007. Date of Publication: October 2021.
Author
Petrache I.A.; Oancea C.; Hasan E.M.; Neagoe O.C.; Tudorache E.; Ionica
M.; Burlacu O.N.
Institution
(Petrache, Burlacu) First Discipline of Surgical Semiology, First
Department of Surgery, "Victor Babes" University of Medicine and Pharmacy
Timisoara, Eftimie Murgu Square No. 2, Timisoara 300041, Romania
(Petrache, Hasan, Burlacu) Clinic of Thoracic Surgery, Emergency Clinical
Municipal Hospital Timisoara, Gheorghe Dima Street No. 5, Timisoara
300079, Romania
(Oancea, Tudorache) Discipline of Pneumology, Department of Infectious
Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara,
Eftimie Murgu Square No. 2, Timisoara 300041, Romania
(Neagoe, Ionica) Second Clinic of General Surgery and Surgical Oncology,
Emergency Clinical Municipal Hospital Timisoara, Gheorghe Dima Street No.
5, Timisoara 300079, Romania
(Neagoe) Second Discipline of Surgical Semiology, First Department of
Surgery, "Victor Babes" University of Medicine and Pharmacy Timisoara,
Eftimie Murgu Square No. 2, Timisoara 300041, Romania
Publisher
MDPI
Abstract
Background and Objectives: Chronic post-thoracotomy pain syndrome (PTPS)
is a very common and uncomfortable complication, occurring frequently
after thoracic operations, leading to the necessity of further medication
and hospitalizations. One important risk factor in developing chronic pain
is the chest closure technique, which can lead to chronic intercostal
nerve damage. This study proposes an alternative nerve-sparring closure
technique to standard peri-costal sutures, aimed toward minimizing the
risk of chronic pain in selected patients. <br/>Material(s) and Method(s):
We performed a prospective randomized study on 311 patients operated for
various thoracic pathology over a period of 12 months, evaluating incision
types, chest closure technique, and number of drains with drainage
duration. The patients were divided into three groups: peri-costal (PC),
proposed extra-costal (EC), and simple (SC) suture, respectively. Pain was
measured on day 1, 2, 5, 7, and at 6 months post-operatively using the
Visual Analogic Scale. <br/>Result(s): No significant differences in pain
level were recorded in the first two post-operative days between the PC
and EC groups. How-ever, a significant decrease in pain level was observed
on day 5 and at 6 months post-operatively, with a mean level of 3.5 +/-
1.8, 1.2 +/- 1 for the EC group compared to a mean value of 5.3 +/- 1.6,
3.2 +/- 1.5, respectively. No significant differences were observed
regarding other evaluated variables. <br/>Conclusion(s): The lower
recorded pain scores in patients with extra-costal chest closure are a
strong argument to use this technique. Its ease of use is similar to the
classic peri-costal closure, and the time needed to perform it is not
significantly increased. The association of this technique with less
invasive procedures and short drainage duration limits chronic
post-operative pain. This procedure may represent an option for decreasing
healthcare costs associated with the management of PTPS.<br/>Copyright
&#xa9; 2021 by the authors. Licensee MDPI, Basel, Switzerland.

<19>
Accession Number
2014115047
Title
Strategies to prevent acute kidney injury after pediatric cardiac surgery
a network meta-analysis.
Source
Clinical Journal of the American Society of Nephrology. 16(10) (pp
1480-1490), 2021. Date of Publication: October 2021.
Author
Van den Eynde J.; Cloet N.; Van Lerberghe R.; Saa M.P.B.O.; Vlasselaers
D.; Toelen J.; Verbakel J.Y.; Budts W.; Gewillig M.; Kutty S.; Pottel H.;
Mekahli D.
Institution
(Van den Eynde, Kutty) Helen B. Taussig Heart Center, The Johns Hopkins
Hospital and School of Medicine, Baltimore, MD, United States
(Van den Eynde, Cloet, Van Lerberghe, Budts, Gewillig) Department of
Cardiovascular Sciences, KU Leuven, Leuven, Belgium
(Saa) Division of Cardiovascular Surgery of Pronto Socorro Cardioloogico
de Pernambuco-PROCAPE, University of Pernambuco-UPE, Recife, Brazil
(Vlasselaers) Department of Intensive Care Medicine, University Hospitals
Leuven, Leuven, Belgium
(Toelen) Division of Woman and Child, Department of Pediatrics, University
Hospitals Leuven, Leuven, Belgium
(Toelen) Department of Development and Regeneration, KU Leuven, Leuven,
Belgium
(Verbakel) Department of Public Health and Primary Care, KU Leuven,
Leuven, Belgium
(Verbakel) Nuffield Department of Primary Care Health Sciences, University
of Oxford, Oxford, United Kingdom
(Budts) Congenital and Structural Cardiology, University Hospitals Leuven,
Leuven, Belgium
(Gewillig) Pediatric Cardiology, University Hospitals Leuven, Leuven,
Belgium
(Pottel) Department of Public Health and Primary Care, KU Leuven Campus
Kulak Kortrijk, Kortrijk, Belgium
(Mekahli) Department of Pediatric Nephrology, University Hospitals of
Leuven, Leuven, Belgium
(Mekahli) PKD Research Group, GPURE, Department of Development and
Regeneration, KU Leuven, Leuven, Belgium
Publisher
American Society of Nephrology
Abstract
Background and objectives AKI is a common complication after pediatric
cardiac surgery and has been associated with higher morbidity and
mortality. We aimed to compare the efficacy of available pharmacologic and
nonpharmacologic strategies to prevent AKI after pediatric cardiac
surgery. Design, setting, participants, & measurements PubMed/MEDLINE,
Embase, Cochrane Controlled Trials Register, and reference lists of
relevant articles were searched for randomized controlled trials from
inception until August 2020. Random effects traditional pairwise, Bayesian
network meta-analyses, and trial sequential analyses were performed.
Results Twenty randomized controlled trials including 2339 patients and 11
preventive strategies met the eligibility criteria. No overall significant
differences were observed compared with control for corticosteroids,
fenoldopam, hydroxyethyl starch, or remote ischemic preconditioning in
traditional pairwise meta-analysis. In contrast, trial sequential analysis
suggested a 80% relative risk reduction with dexmedetomidine and evidence
of <57% relative risk reduction with remote ischemic preconditioning.
Nonetheless, the network meta-analysis was unable to demonstrate any
significant differences among the examined treatments, including also
acetaminophen, aminophylline, levosimendan, milrinone, and normothermic
cardiopulmonary bypass. Surface under the cumulative ranking curve
probabilities showed that milrinone (76%) was most likely to result in the
lowest risk of AKI, followed by dexmedetomidine (70%), levosimendan (70%),
aminophylline (59%), normothermic cardiopulmonary bypass (57%), and remote
ischemic preconditioning (55%), although all showing important overlap.
Conclusions Current evidence from randomized controlled trials does not
support the efficacy of most strategies to prevent AKI in the pediatric
population, apart from limited evidence for dexmedetomidine and remote
ischemic preconditioning.<br/>Copyright &#xa9; 2021 by the American
Society of Nephrology.

<20>
Accession Number
2014114922
Title
Acute kidney injury after coronary artery bypass graft surgery: A
narrative review of causes, diagnosis, and prevention.
Source
Family Medicine and Primary Care Review. 23(3) (pp 372-379), 2021. Date of
Publication: 2021.
Author
Jannati M.; Kojuri J.
Institution
(Jannati) Cardiac Surgery Ward, Namazi Hospital, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Kojuri) Cardiology Department, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
Publisher
Polish Society of Family Medicine
Abstract
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is
a common cardiac event associated with short and long-term consequences
and occurs in 30-51% of CABG patients. AKI may be associated with many
other factors and is also responsible for many other pathologies. An
increased level of serum creatinine (SCr) after surgery is one of the
signs of AKI that may occur more often during cardiopulmonary bypass (CPB)
in susceptible individuals. Preparing preoperative checklists is a good
practice for the prevention of AKI. Defining new opportunities and
strategies of perioperative care is a useful procedure for decreasing the
risk of AKI after cardiac surgery. Collecting more data on preoperative
risk factors and improving the intraoperative practices may decrease the
incidence of AKI in the aggregate population. In this review study, we are
going to review the literature on the pathophysiology of AKI and introduce
the discussion about the features of patients who are more at the risk of
AKI than others.<br/>Copyright &#xa9; by Wydawnictwo Continuo.

<21>
Accession Number
2014097512
Title
Effect of different loading doses of dexmedetomidine on controlled
hypotension and the incidence of bradycardia during rhinoplasty: A
clinical trial.
Source
Anesthesiology and Pain Medicine. 11(4) (no pagination), 2021. Article
Number: e118857. Date of Publication: August 2021.
Author
Motlagh S.D.; Rokhtabnak F.; Ghodraty M.R.; Delarestaghi M.M.; Saadat S.;
Araghi Z.
Institution
(Motlagh, Rokhtabnak, Ghodraty, Saadat, Araghi) Department of
Anesthesiology, Pain, and Intensive Care Medicine, Firoozgar University
Hospital, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Delarestaghi) Department of Otolaryngology Head and Neck Surgery,
Firoozgar University Hospital, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Delarestaghi) Department of ENT and Head and Neck Research and the Five
Senses Institute, Firoozgar University Hospital, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Kowsar Medical Institute
Abstract
Controlled hypotension, with a mean arterial pressure (MAP) of 60 mmHg-70
mmHg, provides a bloodless and visible surgical field during rhinoplasty.
It has been shown that dexmedetomidine, an alpha2-adrenoreceptor agonist,
is a suitable choice in this regard. One of the disadvantages of this drug
is the possibility of severe bradycardia during infusion. Therefore, we
compared lower intravenous (IV) loading doses to determine whether the
hypotensive effect of the drug was preserved and the bradycardia incidence
decreased. In this randomized, double-blinded clinical trial, 81 patients
aged 18 to 50 years with the American Society of Anesthesiologists
physi-cal status (ASA-PS) class I and II, scheduled for rhinoplasty
randomly received 1.0, 0.9, and 0.8 microg/kg (named as groups 1.0, 0.9,
and 0.8, respectively) of IV dexmedetomidine before the induction of
anesthesia followed by infusion (0.3-0.7 microg/kg/h) during operation.
The patients' heart rate (HR), MAP, the requirements for nitroglycerin
(NTG) and extra fentanyl, as well as the incidence of bradycar-dia, were
recorded. Bleeding and visibility of the surgical field were scored by the
surgeon using a 6-point visual scale. MAPs, HRs, and consumption of NTG
and extra fentanyl were similar in the studied groups. The surgical field
was more visible and bloodless in group 1.0 compared to group 0.8 (P <
0.001); the differences were not significant between groups 1.0 and 0.9 (P
= 0.605). The incidence (P = 0.027) and the severity of bradycardia (P =
0.017) were higher in the groups with higher loading doses. We concluded
that dexmedetomidine is an acceptable agent to provide controlled
hypotension. A loading dose of 0.9 microg/kg, but not 0.8 microg/kg,
provides similar surgical field conditions as the dose of 1 microg/kg.
Furthermore, despite the decrease in the incidence of bradycardia, the
hypotensive effect of the drug is preserved.<br/>Copyright &#xa9; 2021,
Author(s).

<22>
Accession Number
2013963717
Title
Slow gait speed is associated with worse postoperative outcomes in cardiac
surgery: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Chang J.; Nathalie J.; Nguyenhuy M.; Xu R.; Virk S.A.; Saxena A.
Institution
(Chang) The Royal Melbourne Hospital, Parkville, VIC, Australia
(Nathalie) St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
(Nguyenhuy) Western Hospital, Footscray, VIC, Australia
(Xu) The University of Melbourne, Parkville, VIC, Australia
(Virk) Department of Cardiology, Concord Repatriation General Hospital,
Concord West, NSW, Australia
(Saxena) Department of Cardiothoracic Surgery and Transplantation, Fiona
Stanley Hospital, Murdoch, WA, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: Frailty is associated with poorer outcomes in cardiac surgery,
but the heterogeneity in frailty assessment tools makes it difficult to
ascertain its true impact in cardiac surgery. Slow gait speed is a simple,
validated, and reliable marker of frailty. We performed a systematic
review and meta-analysis to examine the effect of slow gait speed on
postoperative cardiac surgical patients. <br/>Method(s): PubMED, MEDLINE,
and EMBASE databases were searched from January 2000 to August 2021 for
studies comparing slow gait speed and "normal" gait speed. Primary outcome
was in-hospital mortality. Secondary outcomes were composite mortality and
major morbidity, AKI, stroke, deep sternal wound infection, prolonged
ventilation, discharge to a healthcare facility, and ICU length of stay.
<br/>Result(s): There were seven eligible studies with 36,697 patients.
Slow gait speed was associated with increased likelihood of in-hospital
mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]:
1.87-2.87). Additionally, they were more likely to suffer from composite
mortality and major morbidity (RR: 1.52; 95% CI: 1.38-1.66), AKI (RR:
2.81; 95% CI: 1.44-5.49), deep sternal wound infection (RR: 1.77; 95% CI:
1.59-1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48-2.63),
reoperation (RR: 1.38; 95% CI: 1.05-1.82), institutional discharge (RR:
2.08; 95% CI: 1.61-2.69), and longer ICU length of stay (MD: 21.69; 95%
CI: 17.32-26.05). <br/>Conclusion(s): Slow gait speed is associated with
poorer outcomes in cardiac surgery. Frail patients are twofold more likely
to die during hospital admission than nonfrail counterparts and are at an
increased risk of developing various perioperative
complications.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<23>
Accession Number
2013963525
Title
Effects of single versus dual antiplatelet therapy on the adverse events
after transcatheter aortic valve implantation: A meta-analysis.
Source
Clinical Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Yu S.; Zhang S.; Yao C.; Liu J.
Institution
(Yu, Zhang, Yao, Liu) Heart Center, Affiliated Zhongshan Hospital of
Dalian University, Dalian, China
Publisher
John Wiley and Sons Inc
Abstract
Dual antiplatelet therapy (DAPT) was currently recommended for
transcatheter aortic valve implantation (TAVI) postoperative management in
clinical application. However, POPular-TAVI trial showed DAPT increased
the incidence of adverse events compared to single antiplatelet therapy
(SAPT). Herein, we performed a meta-analysis to investigate the effect of
SAPT versus DAPT on the adverse events after TAVI. Eleven studies were
available from PubMed, Embase, Cochrane Library, and Web of Science from
inception to April 1, 2021. The pooled effect size was presented as
relative risk (RR) with 95% confidence intervals (CIs). The sensitivity
analysis was used to assess the stability of analysis results, and Begg's
test was applied to evaluate the publication bias. The Cochran Q test and
the I² statistic were used to evaluate the heterogeneity, and
the source of heterogeneity was explored by meta-regression. A total of
4804 patients were obtained, with 2257 in SAPT group and 2547 in DAPT
group. Compared to the DAPT, SAPT was associated with the decreased risk
of all-cause bleeding (RR: 0.51, 95% CI: 0.44-0.61), major bleeding (RR:
0.53, 95% CI: 0.32-0.86), and minor bleeding (RR: 0.58, 95% CI:
0.34-0.98). There were no significant differences in mortality and
myocardial infarction events, stroke events, and acute kidney injury
between the two groups. SAPT was superior to DAPT in decreasing all-cause
bleeding, major bleeding, and minor bleeding, suggesting that SAPT could
be preferentially recommended for TAVI postoperative management in most
patients without another indication for DAPT and oral
anticoagulation.<br/>Copyright &#xa9; 2021 The Authors. Clinical
Cardiology published by Wiley Periodicals LLC.

<24>
Accession Number
636229552
Title
Factors Associated with Return to Work After Heart Transplantation: A
Systematic Review of the Literature.
Source
The American journal of the medical sciences. (no pagination), 2021. Date
of Publication: 22 Sep 2021.
Author
Rivera E.L.; Aponte J.; Montes M.C.; Adams C.D.; Gomez-Mesa J.E.
Institution
(Rivera) Master of Occupational Health Program, Health Sciences
Department, Universidad Libre, Cali, Columbia; Cardiology Service,
Department of Internal Medicine, Fundacion Valle del Lili, Cali, Columbia
(Aponte) Master of Occupational Health Program, Health Sciences
Department, Universidad Libre, Cali, Columbia
(Montes, Adams, Gomez-Mesa) Cardiology Service, Department of Internal
Medicine, Fundacion Valle del Lili, Cali, Columbia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Heart transplantation represents one of the last treatment
options for advanced heart failure. Little is known about the factors
associated with return to work in patients after heart transplantation.
The aim of this study is to identify those factors. <br/>METHOD(S): A
systematic literature review was conducted in the PubMed, LILACS, SCIELO
and ScienceDirect databases using the keywords "trasplante cardiaco",
"calidad de vida", "reingreso laboral", "return to work", "heart
transplantation" and "occupation related". Quantitative studies with
patients over 18 years of age that were published between January 2007 and
June 2017 were included. <br/>RESULT(S): A total of 6 articles were
included, none from Latin America. Heart transplantation patients had a
mean age of 51 years; approximately 17% over 65 years of age; 73%-84%
males; 7%-16.4% professionals; 70%-86.6% previously employed; and 30%-60%
returned to work. The following factors were related to return to work:
higher education (p=0.0017), young age (p=0.003), better scores on the
physical and mental domains of the SF-36 questionnaire (p=0.035), higher
six-minute walk test results (median of 560 m), and previous employment
with less than 24 months interrupted by the inability to work (p=0.017).
Return to work occurred, on average, 6 to 7.5 months after heart
transplantation. <br/>CONCLUSION(S): Return to work after heart
transplantation is variable, with a tendency to be low, and is lower in
patients near to retirement age. Protective factors were related to the
social, physical and mental environment.<br/>Copyright &#xa9; 2021.
Published by Elsevier Inc.

<25>
Accession Number
636227076
Title
Comparison of plasma concentrations of levobupivacaine with and without
epinephrine for thoracic paravertebral block: A randomized trial.
Source
Anaesthesia, critical care & pain medicine. (pp 100952), 2021. Date of
Publication: 21 Sep 2021.
Author
Yamazaki A.; Fujii K.; Aratani Y.; Kuriyama T.; Kawamata T.
Institution
(Yamazaki, Fujii, Aratani, Kuriyama, Kawamata) Department of
Anaesthesiology, Wakayama Medical University School of Medicine, 811-1
Kimiidera, Wakayama 641-8509, Japan
Publisher
NLM (Medline)
Abstract
BACKGROUND: Thoracic paravertebral block (TPVB) is effective for analgesia
for unilateral thoracic surgery. However, since the paravertebral space is
highly vascular, injection of local anaesthetics into the paravertebral
space may induce systemic local anaesthetic toxicity. We examined the
effect of addition of epinephrine to paravertebral levobupivacaine on its
plasma concentration. <br/>METHOD(S): In a randomised single blind trial,
twenty-four male patients who were scheduled to undergo elective
unilateral pulmonary lobectomy or segmentectomy under general anaesthesia
combined with TPVB were enrolled in this study. They were randomly divided
into two groups: one group received a single bolus thoracic paravertebral
injection of 1mg/kg of 0.25% levobupivacaine with 5mug/mL epinephrine and
the other group received a single bolus thoracic paravertebral injection
of 1mg/kg of 0.25% levobupivacaine alone. Arterial blood samples were
obtained for plasma levobupivacaine assay after injection. The peak plasma
concentration (Cmax) and the time to peak plasma concentration (Tmax), for
levobupivacaine were calculated. <br/>RESULT(S): There were no significant
differences in patient's characteristics between the two groups. The mean
arterial Cmax values of levobupivacaine were 0.48+/-0.11mug/mL with
epinephrine and 0.71+/-0.31mug/mL without epinephrine (P=0.041). The mean
arterial Tmax values of levobupivacaine were 46.0+/-35.6min with
epinephrine and 12.0+/-7.2min without epinephrine (P=0.005).
<br/>CONCLUSION(S): The addition of 5-mug/mL epinephrine to a single bolus
thoracic paravertebral injection of 1-mg/kg levobupivacaine significantly
decreased Cmax and delayed Tmax of levobupivacaine. The addition of
epinephrine to levobupivacaine may be a useful strategy to reduce systemic
levobupivacaine toxicity. CLINICAL TRIAL REGISTRATION NUMBER: UMIN
000021942.<br/>Copyright &#xa9; 2021. Published by Elsevier Masson SAS.

<26>
Accession Number
2013787537
Title
Intrinsic left ventricular impairment in Marfan syndrome: A systematic
review and meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Xu H.; Ma N.; Guo R.; Luo H.; Zhang L.; Liu D.; Zang S.; Zhao L.; Zhang
X.; Qiao C.
Institution
(Xu, Ma, Guo, Luo, Zhang, Liu, Zang, Zhao, Zhang, Qiao) Department of
Cardiac Surgery, The First Affiliated Hospital of Zhengzhou University,
Zhengzhou University, Zhengzhou, Henan, China
(Xu, Ma, Guo, Luo, Zhang, Liu, Zang, Zhao, Zhang, Qiao) Heart
Transplantation Center, The First Affiliated Hospital of Zhengzhou
University, Zhengzhou University, Zhengzhou, Henan, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Intrinsic cardiac impairment in Marfan syndrome (MFS) has been
explored in many clinical studies; however, their results have been
inconsistent. This meta-analysis aimed to assess the difference in cardiac
structure and function between Marfan patients and healthy individuals,
and to verify the hypothesis of intrinsic cardiac impairment in MFS.
<br/>Method(s): Electronic searches for studies were performed in the
PubMed, Embase, and Cochrane Library databases. Nine studies with 490
patients with MFS and 478 controls were included in the analysis. Age and
sex were strictly matched between Marfan patients and healthy controls in
every study. <br/>Result(s): There was no difference in the left
ventricular end systolic diameter index (mean difference [MD]: 0.33; 95%
confidence interval [CI]: (-0.24, 0.89); p = 0.26) and left ventricular
end diastolic diameter index (MD: 0.18; 95% CI: [-0.47, 0.83]; p = 0.58)
between Marfan patients and controls. Marfan patients showed larger left
ventricular end systolic volume index (MD: 2.62; 95% CI: [0.27, 4.97]; p =
0.03) and left ventricular end diastolic volume index (MD: 4.16; 95% CI:
[2.70, 5.63]; p < 0.01) than the control group. Furthermore, Marfan
patients showed a lower left ventricular ejection fraction than healthy
people (MD: -2.59%; 95% CI: [-4.64%, -0.54%]; p = 0.01).
<br/>Conclusion(s): Intrinsic cardiac impairment was observed in MFS. MFS
patients showed the larger left ventricular volume and poorer left
ventricular function than matched controls. Considering the potentially
adverse impact on cardiac function, intrinsic cardiac impairment in MFS
should be considered during the cardiac surgery.<br/>Copyright &#xa9; 2021
Wiley Periodicals LLC

<27>
Accession Number
2013567593
Title
All roads lead to Rome, but some are safer.
Source
Journal of Cardiac Surgery. 36(11) (pp 4320-4321), 2021. Date of
Publication: November 2021.
Author
Di Mauro M.; Calafiore A.M.; Lorusso R.
Institution
(Di Mauro, Lorusso) Department of Cardio-Thoracic Surgery, Heart &
Vascular Centre, Maastricht University Medical Centre (MUMC+), Maastricht,
Netherlands
(Calafiore) Department of Cardiac Surgery, Anthea Hospital, GVM Research
and Care, Bari, Italy
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Since the first in-human implantation, trans-catheter aortic valve
replacement (TAVR) has shown an exciting development in both technical and
technological terms, becoming the standard of care for many patients, even
not only inoperable ones. Although trans-femoral (TF) access has the
scepter of first-line route for TAVR, in some cases, this access is not
feasible, so several alternative routes were introduced over time. The
network meta-analysis by Hameed et al. has the great merit to provide a
comprehensive picture. Hence, through either direct and indirect
comparison, the authors confirmed as TF is the gold standard as access,
followed by trans-carotid and trans-subclavian. Conversely, trans-thoracic
(trans apical and trans-aortic) routes are the least safe and should be
reserved only to sporadic cases.<br/>Copyright &#xa9; 2021 Wiley
Periodicals LLC

<28>
Accession Number
2010284454
Title
Left or bilateral internal mammary artery employment in coronary artery
bypass grafting: midterm results.
Source
Asian Cardiovascular and Thoracic Annals. 29(8) (pp 758-762), 2021. Date
of Publication: October 2021.
Author
Fomenko M.S.; Schneider Y.A.; Tsoi V.G.; Pavlov A.A.; Shilenko P.A.
Institution
(Fomenko, Schneider, Tsoi, Pavlov, Shilenko) Federal State Budgetary
Institution, Federal Centers of High Medical Technologies, Health
Ministry, Kaliningrad, Russian Federation
Publisher
SAGE Publications Inc.
Abstract
Background: The gold standard for coronary artery bypass grafting to the
left anterior descending artery is use of the left internal mammary
artery. Better long-term survival has been reported using bilateral
internal mammary arteries compared to left internal mammary artery only,
but many surgeons are reluctant to employ bilateral internal mammary
arteries in coronary artery bypass grafting. This study aimed to evaluate
the effectiveness and safety of bilateral internal mammary artery use.
<br/>Method(s): From 2014 to 2017, 1703 patients underwent coronary artery
bypass grafting in our institute. Of these, 772 met the inclusion criteria
and were randomly assigned to receive bilateral (n = 387) or left (n =
385) internal mammary artery grafts. The mean age was 67.1 +/- 6.0 years
(range 48-85 years) and 474 (61.4%) were male. The mean number of diseased
vessels was 3.1 +/- 0.9, and mean EuroSCORE II was 3.4% +/- 1.1%.
<br/>Result(s): Hospital mortality was 1.2% in the left internal mammary
artery group vs. 1.8% in the bilateral internal mammary artery group (p =
0.55). There was no difference in procedure-related complications between
groups. Mean follow-up was 65.9 months. Survival in the bilateral internal
mammary artery group at 1, 3, and 5 years was 98.7%, 98.7%, and 94.8% vs.
98.1%, 98.1%, and 90.9%, respectively, in the left internal mammary artery
group (p = 0.63). <br/>Conclusion(s): Application of bilateral internal
mammary arteries in coronary artery bypass grafting is safe and effective,
with comparable midterm results to those with the left internal mammary
artery only.<br/>Copyright &#xa9; The Author(s) 2021.

<29>
Accession Number
635029742
Title
The opioid sparing effect of erector spinae plane block for various
surgeries: a meta-analysis of randomized-controlled trials.
Source
Minerva anestesiologica. 87(8) (pp 903-914), 2021. Date of Publication: 01
Aug 2021.
Author
Fanelli A.; Torrano V.; Cozowicz C.; Mariano E.R.; Balzani E.
Institution
(Fanelli) Anesthesia and Pain Medicine Unit, Department of Emergency and
Urgency, S. Orsola-Malpighi Polyclinic Hospital, Bologna, Italy
(Torrano) Anesthesia and Intensive Care Unit 1, Department of Emergency
and Urgency, ASST Grande Ospedale Metropolitano Niguarda Hospital, Milan,
Italy
(Cozowicz) Department of Anesthesiology, Perioperative Medicine and
Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria
(Mariano) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University School of Medicine, Stanford, CA, USA
(Mariano) Anesthesiology and Perioperative Care Service, Veterans Affairs
Palo Alto Health Care System, Palo Alto, CA, USA
(Balzani) Department of Medicine and Surgery, University of Turin, Turin,
Italy
Publisher
NLM (Medline)
Abstract
INTRODUCTION: The erector spinae plane block (ESPB) is a newer fascial
plane block which has been broadly applied for postoperative analgesia
after various surgeries, but the effectiveness in these populations is not
well established. EVIDENCE ACQUISITION: A systematic database search was
conducted in PubMed, PMC, Embase, and Scopus for randomized controlled
trials (RCTs) comparing ESPB with control, placebo, or other blocks. The
primary outcome was intravenous opioid consumption in milligram morphine
equivalents 24 h after surgery. Standardized mean differences (SMDs) with
95% confidence intervals (CI) were calculated using a random-effects
model. EVIDENCE SYNTHESIS: A total of 29 RCTs were included. An analysis
was conducted by subgroups differentiated by surgery type, 'no block' vs.
ESPB, and other blocks vs. ESPB. ESPB was effective in reducing opioid
consumption against no block for breast surgery (SMD -1.13; 95% CI),
thoracic surgery (SMD -3.00; 95% CI), and vertebral surgery (SMD -1.78;
95% CI). ESPB was effective against alternative blocks for breast surgery
(vs. paravertebral, SMD -1.07; 95% CI) and abdominal surgery (SMD -1.77;
95% CI). ESPB showed moderate effect in thoracic surgery against
paravertebral (SMD 0.58; 95% CI) and against no block in abdominal surgery
(SMD 0.80; 95% CI). In only one case did ESPB perform worse than another
block: vs. PECS block for breast surgery (SMD 1.66; 95% CI).
<br/>CONCLUSION(S): ESPB may be a useful addition to the multimodal
analgesic regimen for a variety of surgeries especially when the
alternative is no block. Unanswered questions include determining of the
mechanism of action, refining of the EPSB technique, and establishing
recommended local anesthetic dose and volume.

<30>
Accession Number
634952520
Title
Volatile anesthetics versus intravenous anesthetics for noncardiac
thoracic surgery: a systematic review and meta-analysis.
Source
Minerva anestesiologica. 87(8) (pp 927-939), 2021. Date of Publication: 01
Aug 2021.
Author
Fan Y.; Yu D.; Liang X.
Institution
(Fan) School of Medicine, Department of Anesthesiology, Sichuan Cancer
Center, Sichuan Cancer Hospital &amp; Institute, University of Electronic
Science and Technology of China, Chengdu, China
(Yu) Department of Anesthesiology, Second People's Hospital of Yibin,
China
(Liang) Department of Anesthesiology, West China Hospital, Sichuan
University, Chengdu, China
Publisher
NLM (Medline)
Abstract
INTRODUCTION: We performed this meta-analysis of randomized controlled
trials (RCTs) to investigate two types of anesthetics for noncardiac
thoracic surgery regarding their effects on clinical outcomes and the
inflammatory response. EVIDENCE ACQUISITION: We searched Cochrane Library,
PubMed and Embase for RCTs comparing volatile anesthetics to intravenous
anesthetics for noncardiac thoracic surgery. EVIDENCE SYNTHESIS: This
study reviewed 16 RCTs with 1467 patients. Volatile anesthetics reduced
postoperative complications and the length of intensive care unit stay for
lung surgery. They also lowered the concentrations of interleukin
(IL)-1beta, IL-6, IL-8 and tumour necrosis factor-alpha (TNF-alpha) in the
airways of patients undergoing noncardiac thoracic surgery. However, there
was no difference in short-term mortality, postoperative complications
after esophagectomy, IL-1beta, IL-6, IL-8 or TNF-alpha concentrations in
the blood, IL-10 level in either the airway or the blood, overall monocyte
chemoattractant protein-1. <br/>CONCLUSION(S): In lung surgery, but not
esophagectomy, volatile anesthetics may be a better choice than
intravenous anesthetics, possibly because volatile anesthetics reduce
airway inflammation.

<31>
Accession Number
2014114937
Title
The impact of vascular access sidedness on the incidence of local vascular
complications in elective congenital cardiac catheterization procedures
requiring simultaneous arterial and venous sheaths.
Source
Iranian Heart Journal. 22(4) (pp 112-126), 2021. Date of Publication:
Autumn 2021.
Author
Ezzeldin D.A.; Amin Y.; Mansour A.
Institution
(Ezzeldin, Amin, Mansour) Cardiology Department, Ain Shams University
Hospital, Abbassya, Cairo, Egypt
Publisher
Iranian Heart Association
Abstract
Background: Local vascular complications in pediatrics undergoing
congenital cardiac catheterization are consistently reported to be the
commonest regardless of the access type and side. <br/>Method(s): This is
a retrospective study with data collection of multidetector computed
tomography studies performed between 2016 and 2019 from 3 large cardiac
centers in our country. <br/>Result(s): Totally, 190 patients who required
both arterial and venous access sites were randomization into Group I or
the planned ipsilateral group (the planned insertion of both arterial and
venous sheaths in the same limb), Group II or the planned contralateral
group (the planned insertion of arterial and venous sheaths in different
limbs), and Group III or the unplanned group (unplanned vascular access
sidedness after the failure of initial randomization). The incidence and
types of local vascular complications during the hospital stay were
recorded. Patients with the unplanned vascular access site had a higher
incidence of local vascular complications, longer hospital stays, with
higher needs for heparin and thrombolytic therapy than patients with the
planned vascular access site. Patients with a systematically planned
contralateral access site showed a lower incidence of arterial thrombosis,
delayed capillary refilling time, and arteriovenous fistula, as well as
lower needs for heparin and thrombolytic administration than patients with
the planned ipsilateral vascular access site. <br/>Conclusion(s):
Systematic planned contralateral vascular access in patients who undergo
congenital heart disease catheterization requiring both arterial and
venous sheaths is associated with a lower incidence of vascular
complications, especially in patients weighing less than 10
kg.<br/>Copyright &#xa9; 2021, Iranian Heart Association. All rights
reserved.

<32>
Accession Number
2014114936
Title
The effect of patient-controlled analgesia on patient satisfaction after
coronary artery bypass grafting: A clinical trial.
Source
Iranian Heart Journal. 22(4) (pp 101-111), 2021. Date of Publication:
2021.
Author
Hosseinzadeh A.; Lakdizaji S.; Zamanzadeh V.; Totonchi M.Z.
Institution
(Hosseinzadeh, Totonchi) Rajaie Cardiovascular Medical and Research
Center, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Lakdizaji, Zamanzadeh) Department of Nursing, Faculty of Nursing and
Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic
Republic of
Publisher
Iranian Heart Association
Abstract
Background: Acute pain management has been a challenge for health
professionals. We designed the present study to evaluate the effectiveness
of pain control between intravenous patient-controlled analgesia (IV PCA)
and conventional nurse-controlled analgesia (NCA) after coronary artery
bypass graft (CABG) surgery concerning patient satisfaction during the
postoperative period in the intensive care unit (ICU). <br/>Method(s): In
this randomized clinical trial, 80 patients who underwent first-time
elective CABG were enrolled by the convenience sampling method and were
randomly allocated to 2 groups: PCA and NCA. PCA plus a continuous
infusion of morphine was started immediately after the transfer of the
patients to the ICU. NCA was based on the IV injections of morphine on
demand. The level of pain was assessed using a numeric rating scale, and
patient satisfaction was assessed using the pain treatment satisfaction
scale. Further, sedation levels, morphine consumption, and side effects
were evaluated from extubation until 48 hours after surgery. Additionally,
nurses' opinions regarding the PCA method were obtained. <br/>Result(s):
Numeric rating scale scores were higher in the NCA group than in the PCA
group. Morphine consumption in the PCA group was significantly higher than
that in the NCA group. Patient satisfaction was higher in the PCA group
than in the NCA group (P<0.001). PCA was safe, and there were no
differences in the incidence of serious adverse effects such as nausea and
vomiting or respiratory depression. <br/>Conclusion(s): In our patients,
PCA with a background infusion of morphine increased morphine consumption
and improved pain relief, without increasing side effects. It appears that
NCA can be recommended for patients after CABG.<br/>Copyright &#xa9; 2021,
Iranian Heart Association. All rights reserved.

<33>
Accession Number
2014114926
Title
The influence of the mechanical ventilation weaning protocol in patients
with acute kidney injury undergoing adult cardiac surgery.
Source
Iranian Heart Journal. 22(4) (pp 6-14), 2021. Date of Publication: Autumn
2021.
Author
Ziyaeifard M.; Assadzade H.; Makhmalbaf G.; Totonchi Z.; Faritus S.Z.
Institution
(Ziyaeifard, Assadzade, Totonchi, Faritus) Rajaie Cardiovascular Medical
and Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Makhmalbaf) Faculty of medicine, Birjand University of Medical Sciences,
Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: Mechanical ventilation is an important risk factor for acute
kidney injury (AKI) in cardiac surgery patients. The Weaning protocol can
speed weaning after open-heart surgery and might reduce the AKI risk in
these patients. We explore the influence of the weaning protocol on the
intubation time in cardiac surgery patients who developed AKI.
<br/>Method(s): In a randomized clinical trial, 100 patients with AKI
after open-heart surgery were enrolled. After surgery, the patients were
randomized to the weaning protocol group (the intervention group) and the
conventional weaning group (the control group). Arterial blood gas,
hemodynamic variables, the serum blood urea nitrogen level, the creatinine
level, and the intubation time were recorded and compared between the 2
groups. <br/>Result(s): The weaning protocol group displayed a
statistically significant shorter intubation time than the conventional
weaning group (8.89+/-1.74 h vs 9.93+/-1.56 h; P=0.002). The postoperative
serum urea level (r=0.240, P<0.016) and creatinine level (r=0.245,
P<0.014) were positively correlated with the intubation time and the
weaning protocol compared with conventional weaning. The weaning protocol
decreased the urea and creatinine levels in cardiac surgery patients
(P<0.04). <br/>Conclusion(s): The use of the weaning protocol in cardiac
surgery patients with AKI conferred shorter intubation times and lower
blood urea nitrogen and creatinine levels than the use of conventional
weaning.<br/>Copyright &#xa9; 2021, Iranian Heart Association. All rights
reserved.

<34>
Accession Number
2015109159
Title
Comparison of ECMO vs ECpella in patients with non post-pericardiotomy
cardiogenic shock: An updated meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Iannaccone M.; Venuti G.; di Simone E.; De Filippo O.; Bertaina M.;
Colangelo S.; Boccuzzi G.; de Piero M.E.; Attisani M.; Barbero U.; Zanini
P.; Livigni S.; Noussan P.; D'Ascenzo F.; de Ferrari G.M.; Porto I.;
Truesdell A.G.
Institution
(Iannaccone, di Simone, Bertaina, Colangelo, Boccuzzi, Zanini, Noussan)
Division of Cardiology, San Giovanni Bosco Hospital, ASL Citta di Torino,
Turin, Italy
(Venuti) Division of Cardiology, A.O. Papardo, Messina, Italy
(De Filippo, Attisani, D'Ascenzo, de Ferrari) Division of Cardiology,
Citta della Scienza e della Salute, University of Turin, Turin, Italy
(de Piero, Livigni) Department of Anesthesiology and Intensive Care, San
Giovanni Bosco Hospital, ASL Citta di Torino, Turin, Italy
(Barbero) Division of Cardiology, Sevigliano ASL CN1, Italy
(Porto) Cardiovascular Disease Unit, IRCCS Policlinic Hospital San
Martino, Genova, Italy
(Truesdell) Virginia Heart/Inova Heart and Vascular Institute, Falls
Church, VA, United States
Publisher
Elsevier Inc.
Abstract
Introduction: The impact of Impella and ECMO (ECPELLA) in cardiogenic
shock (CS) remains to be defined. The aim of this meta-analysis is to
evaluate the benefit of ECPELLA compared to VA-ECMO in patients with non
post-pericardiotomy CS. <br/>Method(s): All studies reporting short term
outcomes of ECpella or VA ECMO in non post-pericardiotomy CS were
included. The primary endpoint was 30-day mortality. Vascular and bleeding
complications and LVAD implantation/heart transplant within 30-days were
assessed as secondary outcomes. <br/>Result(s): Of 407 studies identified,
13 observational studies (13,682 patients, 13,270 with ECMO and 412 with
ECpella) were included in this analysis. 30-day mortality was 55.8%
(51.6-59.9) in the VA-ECMO group and 58.3% (53.5-63.0) in the ECpella
group. At meta-regression analysis the implantation of IABP did not affect
mortality in the ECMO group. The rate of major bleeding in patients on
VA-ECMO and ECpella support were 21.3% (16.9-26.5) and 33.1% (25.9-41.2)
respectively, while the rates of the composite outcome of LVAD
implantation and heart transplantation within 30-days in patients on
VA-ECMO and ECpella support were 14.4% (9.0-22.2) and 10.8%. When directly
compared in 3 studies, ECpella showed a positive effect on 30-day
mortality compared to ECMO (OR: 1.81: 1.039-3.159). <br/>Conclusion(s):
Our data suggest that ECpella may reduce 30-day mortality and increase
left ventricle recovery, despite increased of bleeding
rates.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<35>
Accession Number
2013959776
Title
Adhesion barriers in cardiac surgery: A systematic review of efficacy.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Head W.T.; Paladugu N.; Kwon J.H.; Gerry B.; Hill M.A.; Brennan E.A.;
Kavarana M.N.; Rajab T.K.
Institution
(Head, Paladugu, Kwon, Gerry, Hill, Kavarana, Rajab) Department of
Surgery, Medical University of South Carolina, Charleston, SC, United
States
(Brennan) Department of Research & Education Services (Libraries), Medical
University of South Carolina, Charleston, SC, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Postoperative pericardial adhesions have been associated with
increased morbidity, mortality, and surgical difficulty. Barriers exist to
limit adhesion formation, yet little is known about their use in cardiac
surgery. The study presented here provides the first major systematic
review of adhesion barriers in cardiac surgery. <br/>Method(s): Scopus and
PubMed were assessed on November 20, 2020. Inclusion criteria were
clinical studies on human subjects, and exclusion criteria were studies
not published in English and case reports. Risk of bias was evaluated with
the Cochrane Risk of Bias Tool. Barrier efficacy data was assessed with
Excel and GraphPad Prism 5. <br/>Result(s): Twenty-five studies were
identified with a total of 13 barriers and 2928 patients.
Polytetrafluoroethylene (PTFE) was the most frequently evaluated barrier
(13 studies, 67% of patients) with adhesion formation rate of 37.31% and
standardized tenacity score of 26.50. Several barriers had improved
efficacy. In particular, Cova CARD had a standardized tenacity score of
15.00. <br/>Conclusion(s): Overall, the data varied considerably in terms
of study design and reporting bias. The amount of data was also limited
for the non-PTFE studies. PTFE has historically been effective in
preventing adhesions. More recent barriers may be superior, yet the
current data is nonconfirmatory. No ideal adhesion barrier currently
exists, and future barriers must focus on the requirements unique to
operating in and around the heart.<br/>Copyright &#xa9; 2021 Wiley
Periodicals LLC

<36>
Accession Number
2013959738
Title
Comparative efficacy of five surgical methods in the treatment of mitral
regurgitation: A systematic review and network meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Huang W.; Hou B.; Li Q.; Zhang Y.; Wang L.
Institution
(Huang, Hou, Li, Zhang) Baotou Clinical Medical College of Inner Mongolia
Medical University, Baotou, China
(Wang) Department of Cardiology, Baotou Central Hospital, Baotou, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: This study has been compared the effectiveness of different
surgical methods in the treatment of mitral regurgitation (MR) in adults
by using the network meta-analysis method, so as to provide reference for
clinical selection of the best surgical scheme. <br/>Method(s): The
PubMed, EMBASE, the Cochrane Library, CNKI, and Chongqing VIP Information
databases were comprehensively searched until December 2020. We collected
retrospective comparative studies on surgical procedures including 3D
endoscopic mitral valve surgery (3D-MVS), robot-assisted mitral valve
surgery (R-MVS); totally thoracoscopic mitral valve surgery (T-MVS), small
incision mitral valve surgery (M-MVS), and traditional thoracotomy mitral
valve surgery (C-MVS). Stata16.0 and Addis1.16.8 software was used for
network meta-analysis using the Bayesian approach. <br/>Result(s): A total
of 31 studies were included, 12,998 patients, involving five surgical
methods. Network meta-analysis showed that: in terms of complications
(odds ratio [OR]: 0.65, 95% CI: 0.13-3.00, probability rank = 0.37) and MR
(OR: 0.03, 95% CI: 0.0-8315, probability rank = 0.64), the 3D-MVS group
had the lowest event rate. In terms of blood transfusion rate (OR: 0.55,
95% CI: 0.16-1.84, probability rank = 0.45), T-MVS had the lowest event
rate. In addition, with the exception of operation time and chest
drainage, the R-MVS group has the best curative effect.
<br/>Conclusion(s): This minimally invasive surgery has their own
advantages and disadvantages. Overall, 3D-MVS is most satisfactory, but
more samples are needed.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<37>
Accession Number
636227328
Title
Weight Gain After Heart Transplantation in Adults: Systematic Review and
Meta-Analysis.
Source
ASAIO journal (American Society for Artificial Internal Organs : 1992).
(no pagination), 2021. Date of Publication: 20 Sep 2021.
Author
Miura K.; Yu R.; Sivapalan K.; Liyanage U.E.; Entwistle T.; McKenzie S.C.;
Green A.C.
Institution
(Miura) From the Population Health Department, QIMR Berghofer Medical
Research Institute, Herston, Queensland, Australia Faculty of Medicine,
The University of Queensland, Herston, Queensland, Australia Transplant
Centre, University Hospital of South Manchester NHS Foundation Trust,
Manchester, United Kingdom Advanced Heart Failure and Cardiac Transplant
Unit, The Prince Charles Hospital, Chermside, Queensland, Australia CRUK
Manchester Institute and University of Manchester, Manchester Academic
Health Science Centre, Manchester, United Kingdom
Publisher
NLM (Medline)
Abstract
Gain in weight is common after heart transplantation but the magnitude of
usual weight gain and whether this varies by country is unknown. We
systematically reviewed all relevant studies to quantify weight change
among heart transplant recipients (HTRs) in the years after
transplantation and assess variation with geographic location. We searched
PubMed, Cumulative Index to Nursing and Allied Health Literature, and
Excerpta Medica Database databases to September 2020. Eligible studies
reported adult HTRs' mean/median weight and/or body mass index (BMI) up to
time of transplantation (baseline) and posttransplantation in any
language. Weighted mean differences (WMDs) (95% confidence intervals
[CIs]) of weight/BMI from baseline to posttransplantation were estimated
using a random-effects model. Ten studies met the inclusion criteria.
Pooled analysis showed weight gain of 7.1 kg (95% CI, 4.4-9.8kg) in HTRs
12 months posttransplant, with corresponding BMI increase of 1.69 kg/m2
(95% CI, 0.83-2.55 kg/m2). Greatest weight gain at 12 months
posttransplant occurred in US HTRs (WMD weight 10.42 kg, BMI 3.25 kg/m2)
and least, in European HTRs (WMD weight 3.10 kg, BMI 0.78 kg/m2). In
conclusion, HTRs gain substantial weight in the years after
transplantation, but varying widely by geographic location.<br/>Copyright
&#xa9; 2021 by the American Society for Artificial Internal Organs.

<38>
Accession Number
636226120
Title
Cardiovascular Mortality after Venous Thromboembolism: A Meta-Analysis of
Prospective Cohort Studies.
Source
Seminars in Thrombosis and Hemostasis. (no pagination), 2021. Date of
Publication: 2021.
Author
Noumegni S.R.; Grangereau T.; Demir A.; Bressollette L.; Couturaud F.;
Hoffmann C.
Institution
(Noumegni, Grangereau, Bressollette, Hoffmann) Department of Vascular
Medicine, Brest Teaching Hospital, Brest University, GETBO, Brest EA 3878,
France
(Noumegni, Bressollette, Couturaud, Hoffmann) EA3878 (GETBO), Western
Brittany Thrombosis Study Group, Brest University, Brest, France
(Grangereau) Department of Cardiovascular Medicine, Guingamp Hospital,
Guingamp, France
(Demir) Department of Vascular Medicine, Bordeaux Teaching Hospital,
Bordeaux, France
(Couturaud) Department of Internal Medicine and Pneumology, Brest Teaching
Hospital, Brest, France
Publisher
Thieme Medical Publishers, Inc.
Abstract
Many studies from current literature show that cardiovascular diseases in
patients with venous thromboembolism (VTE) are more frequent than in the
general population without VTE. However, data summarizing the impact of
cardiovascular diseases on mortality of patients with VTE are lacking. In
this systematic review and meta-analysis, we aimed to determine the
frequency and incidence rate of cardiovascular death in patients with VTE.
MEDLINE and EMBASE were searched from January 1, 2000 to February 28,
2021. Eligible studies were observational prospective cohort studies
including patients with VTE and reporting all causes of death.
Cardiovascular death was defined as deaths that result from new or
recurrent pulmonary embolism, death due to acute myocardial infarction,
sudden cardiac death or heart failure, death due to stroke, death due to
cardiovascular procedures or hemorrhage, death due to ruptured aortic
aneurysm or aortic dissection and death due to other cardiovascular
causes. Random-effect models meta-analysis served to determine all pooled
effect size of interest with their 95% confidence interval (CI). Thirteen
observational studies enrolling 22,251 patients were identified and
included. The mean/median age varied between 49 and 75 years. The
proportion of men ranged from 38.3 to 53.2%. The overall pooled frequency
of cardiovascular death in patients with VTE was 3.9% (95% CI: 2.5-5.6%),
while the overall pooled frequency of all-cause mortality was 12.0% (95%
CI: 9.1-15.4%). The pooled proportion of cardiovascular death among all
causes of deaths in patients with VTE was 35.2% (95% CI: 22.2-49.3%). The
pooled incidence rate of cardiovascular death was 1.92 per 100
patient-years (95% CI: 0-4.1). The frequency of cardiovascular death in
patients with VTE was significantly higher than in patients without VTE
(risk ratio: 3.85, 95% CI: 2.75-5.39). Based on this updated meta-analysis
from 13 prospective cohort studies, cardiovascular death in patients with
VTE is more frequent than in the general population without
VTE.<br/>Copyright &#xa9; 2021 Georg Thieme Verlag. All rights reserved.

<39>
Accession Number
623769495
Title
Rejuvenation of allogenic red cells: benefits and risks.
Source
Vox Sanguinis. 113(6) (pp 509-529), 2018. Date of Publication: August
2018.
Author
Aujla H.; Wozniak M.; Kumar T.; Murphy G.J.; Cardigan R.; Deary A.; Hodge
R.; Smethurst P.; Braund R.; Mellor P.; Edmondson D.; Collett D.;
Griffiths A.; New H.; Landrigan M.; Gray A.
Publisher
John Wiley and Sons Inc
Abstract
Background and objectives: To review preclinical and clinical studies that
have evaluated the effects of red cell rejuvenation in vivo and in vitro
and to assess the potential risks and benefits from their clinical use.
<br/>Material(s) and Method(s): A systematic review and narrative
synthesis of the intervention of red cell rejuvenation using a red cell
processing solution containing inosine, pyruvate, phosphate and adenine.
Outcomes of interest in vitro were changes in red cell characteristics
including adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG),
deformability and the accumulation of oxidized lipids and other reactive
species in the red cell supernatant. Outcomes in vivo were 24-h
post-transfusion survival and the effects on oxygen delivery, organ
function and inflammation in transfused recipients. <br/>Result(s): The
literature search identified 49 studies evaluating rejuvenated red cells.
In vitro rejuvenation restored cellular properties including 2,3-DPG and
ATP to levels similar to freshly donated red cells. In experimental
models, in vivo transfusion of rejuvenated red cells improved oxygen
delivery and myocardial, renal and pulmonary function when compared to
stored red cells. In humans, in vivo 24-h survival of rejuvenated red
cells exceeded 75%. In clinical studies, rejuvenated red cells were found
to be safe, with no reported adverse effects. In one adult cardiac surgery
trial, transfusion of rejuvenated red cells resulted in improved
myocardial performance. <br/>Conclusion(s): Transfusion of rejuvenated red
cells reduces organ injury attributable to the red cell storage lesion
without adverse effects in experimental studies in vivo. The clinical
benefits of this intervention remain uncertain.<br/>Copyright &#xa9; 2018
International Society of Blood Transfusion

<40>
Accession Number
2014119996
Title
EVALUATION of DEXMEDETOMIDINE VERSUS PROPOFOL for FAST TRACK ANESTHESIA in
CORONARY OPEN-HEART SURGERY: A COMPARATIVE RANDOMIZED STUDY.
Source
Turkish Journal of Physiotherapy and Rehabilitation. 32(3) (pp
12705-12711), 2021. Date of Publication: 2021.
Author
Abdelkader H.M.; Eldin H.S.; Mohamed A.K.; Haggag A.M.; Rashed M.M.
Institution
(Abdelkader) Assistantlecturer, misr University for science and
technology, Egypt
(Eldin) Professor of anesthesia, Cairo University, Egypt
(Mohamed) anesthesiaCairo University, Egypt
(Haggag) Ain shams University, Egypt
(Rashed) Ain shamsuniversity, Egypt
Publisher
Turkish Physiotherapy Association
Abstract
Objectives: Our comparative randomized study aims to compare the
intraoperative effectiveness of dexmedetomidine and propofol in fast-track
anesthesia in coronary open-heart surgery. <br/>Method(s): We conducted
this study as a randomized controlled prospective investigation at Misr
University Teaching Hospital. The effect on heart rate, postoperative
delirium, mean arterial blood pressure, and BIS spectral index were
assessed among the two groups. <br/>Result(s): A total of 40 patients were
included in the present study and randomized into two groups; group I
(dexmedetomidine) (n= 20) and group II (propofol) (n= 20), with a mean age
of 61.21 (10.50), and 61.91 (9.74). Postoperative delirium was
significantly higher in group II than group I (p= 0.042). The mean
arterial blood pressure seemed to be significantly lower in group I than
group II after 10 minutes of drug infusion, on the bypass, after bypass by
15 minutes, and before transferring the patient to the ICU (p< 0.001).
Significantly higher heart rate values were noticed in group II than group
I after induction, after 10 minutes of drug infusion, after bypass by 15
minutes, and before transferring the patient to the ICU (p< 0.001). The
length of ICU stay (p= 0.020) and time of extubation (p< 0.001) were also
significantly longer in group II than group I. Group II showed total
higher mean BIS values after induction, after 10 minutes of drug infusion,
and after bypass by 15 minutes than group I (p< 0.001).
<br/>Conclusion(s): Dexmedetomidine can lower the risk of cardiovascular
complications.<br/>Copyright &#xa9; 2021 Turkish Physiotherapy
Association. All rights reserved.

<41>
Accession Number
2013906511
Title
Do continuous forms of intra-operative ultrafiltration enhance recovery
after adult cardiac surgery with cardiopulmonary bypass? A protocol for
systematic review and meta-analysis of randomized controlled trials.
Source
Systematic Reviews. 10(1) (no pagination), 2021. Article Number: 265. Date
of Publication: December 2021.
Author
Bierer J.; Horne D.; Stanzel R.; Henderson M.; Boulos L.; Hayden J.
Institution
(Bierer, Horne) Division of Cardiac Surgery, Department of Surgery,
Dalhousie University, Halifax, Canada
(Stanzel, Henderson) Department of Clinical Perfusion, Nova Scotia Health
Authority, Halifax, Canada
(Boulos) Maritime SPOR SUPPORT Unit, Halifax, Canada
(Hayden) Department of Community Health & Epidemiology, Dalhousie
University, Halifax, Canada
Publisher
BioMed Central Ltd
Abstract
Background: Cardiac surgery with cardiopulmonary bypass (CPB) is
associated with a systemic inflammatory syndrome that adversely impacts
cardiopulmonary function and can contribute to prolonged postoperative
recovery. Intra-operative ultrafiltration during CPB is a strategy
developed by pediatric cardiac specialists, aiming to dampen the
inflammatory syndrome by removing circulating cytokines and improving
coagulation profiles during the cardiac operation. Although
ultrafiltration is commonly used in the pediatric population, it is not
routinely used in the adult population. This study aims to evaluate if
randomized evidence supports the use of continuous intra-operative
ultrafiltration to enhance recovery for adults undergoing cardiac surgery
with CPB. <br/>Method(s): This systematic review and meta-analysis will
include randomized controlled trials (RCT) that feature continuous forms
of ultrafiltration during adult cardiac surgery with CPB, specifically
assessing for benefit in mortality rates, invasive ventilation time and
intensive care unit length of stay (ICU LOS). Relevant RCTs will be
retrieved from databases, including MEDLINE, Embase, CENTRAL and Scopus,
by a pre-defined search strategy. Search results will be screened for
inclusion and exclusion criteria by two independent persons with
consensus. Selected RCTs will have study demographics and outcome data
extracted by two independent persons and transferred into RevMan. Risk of
bias will be independently assessed by the Revised Cochrane Risk-of-Bias
(RoB2) tool and studies rated as low-, some-, or high- risk of bias.
Meta-analyses will compare the intervention of continuous ultrafiltration
against comparators in terms of mortality, ventilation time, ICU LOS, and
renal failure. Heterogeneity will be measured by the chi² test
and described by the I² statistic. A sensitivity analysis will
be completed by excluding included studies judged to have a high risk of
bias. Summary of findings and certainty of the evidence, determined by the
GRADE approach, will display the analysis findings. <br/>Discussion(s):
The findings of this systematic review and meta-analysis will summarize
the evidence to date of continuous forms of ultrafiltration in adult
cardiac surgery with CPB, to both inform adult cardiac specialists about
this technique and identify critical questions for future research in this
subject area. Systematic review registration: This systematic review and
meta-analysis is registered in PROSPERO CRD42020219309
(https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020219309)
.<br/>Copyright &#xa9; 2021, The Author(s).

<42>
Accession Number
2013386520
Title
Brucella prosthetic valve endocarditis: A systematic review.
Source
Journal of the Saudi Heart Association. 33(3) (pp 198-212), 2021. Date of
Publication: 2021.
Author
Taamallah K.; Hammami F.; Gharsallah H.; Koubaa M.; Ben Jemaa M.; Fehri W.
Institution
(Taamallah, Fehri) Cardiology Department, Military Hospital of Tunis,
Tunis, Tunisia
(Hammami, Koubaa, Ben Jemaa) Infectious Diseases Department, Hedi Chaker
University Hospital, University of Sfax, Sfax, Tunisia
(Gharsallah) Intensive Care Unit Department, Military Hospital of Tunis,
Tunis, Tunisia
Publisher
Saudi Heart Association
Abstract
Objective: Brucella prosthetic valve endocarditis is a rare but a
life-threatening complication of brucellosis. It remains a diagnostic
challenge. Optimal treatment of Brucella prosthetic valve endocarditis is
debated. Available data is limited to case reports or small case series.
The purpose of this study was to systematically review all published cases
of Brucella prosthetic valve endocarditis in the literature.
<br/>Method(s): A systematic review of PubMed database, Google, Google
Scholar, and Scopus (From January 1974 to the present) for studies
providing epidemiological, clinical and microbiological data as well as
data on treatment and outcomes of Brucella prosthetic valve endocarditis
was performed. <br/>Result(s): A total of 51 reported cases were reviewed.
Brucella melitensis (45%) and Brucella abortus (11.7%) were the most
frequently isolated species. Most common type of prosthesis valve was
mechanical prothesis (84.3%) and ten patients had double valve prosthesis
(19.6%). Fever and dyspnea were present in 100% and 37.2% of the cases,
respectively. The diagnosis was set with echocardiographic finding in 30
cases (93.7%), which revealed vegetation in 27 cases (84.3%). Most used
antibiotics were rifampicin, doxycycline and aminoglycoside or
cotrimoxazole. No deaths were noted in patients treated by combined
medical and surgical treatment, but mortality was noted in 27.7% of the
cases treated by antibiotics alone (p 1/4 0.006). <br/>Conclusion(s): This
systematic review highlights diagnostic challenges and demonstrates that
surgery improved outcome by reducing mortality in patients treated with
the combined surgical and medical treatment option. Brucellosis should be
considered in the differential diagnosis of prosthetic valve endocarditis
in patients residing in or traveling to areas of endemicity.<br/>Copyright
&#xa9; 2021 Saudi Heart Association.

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

<44>
Accession Number
2011842766
Title
Silent brain infarcts and early cognitive outcomes after transcatheter
aortic valve implantation: A systematic review and meta-analysis.
Source
European Heart Journal. 42(10) (pp 1004-1015), 2021. Date of Publication:
07 Mar 2021.
Author
Woldendorp K.; Indja B.; Bannon P.G.; Fanning J.P.; Plunkett B.T.; Grieve
S.M.
Institution
(Woldendorp, Indja, Bannon, Grieve) Faculty of Medicine and Health,
University of Sydney, Sydney, NSW 2006, Australia
(Woldendorp, Bannon, Plunkett) Cardiothoracic Surgical Department, Royal
Prince Alfred Hospital, Sydney, NSW 2050, Australia
(Woldendorp, Bannon, Plunkett) Baird Institute of Applied Heart and Lung
Research, 100 Carillon Avenue, Sydney, NSW 2042, Australia
(Fanning) The Prince Charles Hospital, Critical Care Research Group,
Brisbane, QLC 4032, Australia
(Fanning) Faculty of Medicine, University of Queensland, Brisbane, QLD
4072, Australia
(Grieve) Sydney Translational Imaging Laboratory, Charles Perkins Centre,
University of Sydney, NSW 2006, Australia
(Grieve) Department of Radiology, Royal Prince Alfred Hospital,
Camperdown, Sydney, NSW 2050, Australia
Publisher
Oxford University Press
Abstract
Background: Silent brain infarcts (SBIs) are frequently identified after
transcatheter aortic valve implantation (TAVI), when patients are screened
with diffusion-weighted magnetic resonance imaging (DW-MRI). Outside the
cardiac literature, SBIs have been correlated with progressive cognitive
dysfunction; however, their prognostic utility after TAVI remains
uncertain. This study's main goals were to explore (i) the incidence of
and potential risk factors for SBI after TAVI; and (ii) the effect of SBI
on early post-procedural cognitive dysfunction (PCD). <br/>Methods and
Results: A systematic literature review was performed to identify all
publications reporting SBI incidence, as detected by DW-MRI after TAVI.
Silent brain infarct incidence, baseline characteristics, and the
incidence of early PCD were evaluated via meta-analysis and
meta-regression models. We identified 39 relevant studies encapsulating
2408 patients. Out of 2171 patients who underwent post-procedural DW-MRI,
1601 were found to have at least one new SBI (pooled effect size 0.76, 95%
CI: 0.72-0.81). The incidence of reported stroke with focal neurological
deficits was 3%. Meta-regression noted that diabetes, chronic renal
disease, 3-Tesla MRI, and pre-dilation were associated with increased SBI
risk. The prevalence of early PCD increased during follow-up, from 16% at
10.0 +/- 6.3 days to 26% at 6.1 +/- 1.7 months and meta-regression
suggested an association between the mean number of new SBI and incidence
of PCD. The use of cerebral embolic protection devices (CEPDs) appeared to
decrease the volume of SBI, but not their overall incidence.
<br/>Conclusion(s): Silent brain infarcts are common after TAVI; and
diabetes, kidney disease, and pre-dilation increase overall SBI risk.
While higher numbers of new SBIs appear to adversely affect early
neurocognitive outcomes, long-term follow-up studies remain necessary as
TAVI expands to low-risk patient populations. The use of CEPD did not
result in a significant decrease in the occurrence of SBI.<br/>Copyright
&#xa9; 2021 Published on behalf of the European Society of Cardiology. All
rights reserved.

<45>
Accession Number
2011487984
Title
A meta-analysis of transcarotid versus transfemoral transcatheter aortic
valve replacement.
Source
Catheterization and Cardiovascular Interventions. 98(4) (pp 767-773),
2021. Date of Publication: October 2021.
Author
McGrath D.P.; Kawabori M.; Wessler B.; Chen F.Y.; Zhan Y.
Institution
(McGrath) Tufts University School of Medicine, Boston, MA, United States
(Kawabori, Chen, Zhan) Division of Cardiac Surgery, CardioVascular Center,
Tufts Medical Center, Boston, MA, United States
(Wessler) Division of Cardiology, CardioVascular Center, Tufts Medical
Center, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Carotid access has shown promise as an excellent delivery
route for transcatheter aortic valve replacement (TAVR). We aimed to
compare outcomes of transcarotid (TC) and transfemoral (TF) TAVR by
conducting a search and analysis of the best evidence in the literature to
shed light on its safety and effectiveness. <br/>Method(s): The
PubMed/MEDLINE, Embase, and Cochrane library from inception to July 2020
were searched to identify articles reporting comparative data on TC versus
TF approaches for TAVR. Patients' baseline characteristics and clinical
outcomes were extracted from the articles and pooled for analysis.
<br/>Result(s): Five studies, including a total of 2470 patients, were
included in the study with 1859 patients in the TF group and 611 patients
in the TC group. The TC group had higher prevalence of peripheral vascular
disease, while the patients in the TF group was older. Meta-analysis
revealed that there was no significant differences between the two groups
with regard to 30-day mortality (p = 0.09), stroke (p = 0.28), new
dialysis (p = 0.58), major bleeding (p = 0.69), or pacemaker implantation
(p = 0.44). The TF group had a higher incidence of vascular complications
(3.9% vs. 2.3%; OR 2.22; 95% CI [1.13, 4.38]; p = 0.02).
<br/>Conclusion(s): Compared with the TF approach, TC-TAVR is associated
with comparable procedural and clinical outcomes. Our analysis found a
lower rate of vascular complication in TC access compared with TF access.
This supports consideration of such an alternative access when there are
concerns over the feasibility of TF access.<br/>Copyright &#xa9; 2021
Wiley Periodicals LLC.

<46>
Accession Number
2010554056
Title
Effectiveness of postural lung recruitment on postoperative atelectasis
assessed by lung ultrasound in children undergoing lateral thoracotomy
cardiac surgery with cardiopulmonary bypass.
Source
Pediatric Pulmonology. 56(6) (pp 1724-1732), 2021. Date of Publication:
June 2021.
Author
He P.; Wu C.; Yang Y.; Zheng J.; Dong W.; Wu J.; Sun Y.; Zhang M.
Institution
(He, Wu, Yang, Zheng, Sun, Zhang) Department of Anesthesiology, School of
Medicine, Shanghai Children's Medical Centre, Shanghai Jiao Tong
University, Shanghai, China
(Dong) Department of Cardio-Thoracic Surgery, School of Medicine, Shanghai
Children's Medical Centre, Shanghai Jiao Tong University, Shanghai, China
(Wu) Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, United
States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To assess the effects of postural lung recruitment maneuvers
on the postoperative atelectasis assessed by lung ultrasound (LUS)
compared with supine position recruitment maneuvers in children undergoing
right lateral thoracotomy cardiac surgery with cardiopulmonary bypass.
<br/>Method(s): In this randomized and controlled trial, 84 patients aged
3 years or younger, scheduled for right lateral thoracotomy cardiac
surgery with cardiopulmonary bypass (CPB) were randomly allocated to
postural lung recruitment group or control group. The first LUS exam was
performed immediately upon completion of the cardiac surgery (T1), and a
repeat ultrasound exam started 1 min after lung recruitment maneuvers
(T2). The primary outcome was the incidence of significant atelectasis at
T2. <br/>Result(s): The incidence of significant atelectasis at T2 in the
postural lung recruitment maneuver group was lower compared with that in
the control group (30.2% vs. 58.1%; odds ratio: 0.31; 95% confidence
interval: 0.13-0.76; p =.009). The LUS scores for consolidations and
B-lines of the left lung were higher than those of the right lung in both
groups at T1. More significant reduction of the left LUS scores and sizes
of atelectatic areas were found in the postural lung recruitment group
than those in the control group. <br/>Conclusion(s): Postoperative
postural recruitment maneuver was more effective to improve reaeration of
lung than supine position recruitment maneuver in children undergoing
right lateral thoracotomy cardiac surgery with CPB.<br/>Copyright &#xa9;
2021 Wiley Periodicals LLC

<47>
Accession Number
2014905952
Title
Percutaneous vs. surgical revascularization for patients with unprotected
left main stenosis: a meta-analysis of 5-year follow-up randomized
controlled trials.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 7(5) (pp
476-485), 2021. Date of Publication: 01 Nov 2021.
Author
D'ascenzo F.; De Filippo O.; Elia E.; Doronzo M.P.; Omede P.; Montefusco
A.; Pennone M.; Salizzoni S.; Conrotto F.; Gallone G.; Angelini F.;
Franchin L.; Bruno F.; Boffini M.; Gaudino M.; Rinaldi M.; De Ferrari G.M.
Institution
(D'ascenzo, De Filippo, Elia, Doronzo, Omede, Montefusco, Pennone,
Conrotto, Gallone, Angelini, Franchin, Bruno, De Ferrari) Division of
Cardiology, Department of Medical Sciences, Citta della Salute e della
Scienza, Corso Bramante 88, Turin 10126, Italy
(Salizzoni, Boffini, Rinaldi) Division of Cardiology, Department of
Medical Sciences, Citta della Salute e della Scienza, Corso Bramante 88,
Turin 10126, Italy
(Gaudino) Department of Cardiothoracic Surgery, Cornell Medicine, 1300
York Ave, New York, NY 10065, United States
Publisher
Oxford University Press
Abstract
Aims: A 5-year survival of patients with unprotected left main (ULM)
stenosis according to the choice of revascularization (percutaneous vs.
surgical) remains to be defined. <br/>Methods and Results: Randomized
controlled trials (RCTs) comparing percutaneous coronary intervention
(PCI) vs. coronary artery bypass graft (CABG) with a follow-up of at least
5 years were included. All-cause death was the primary endpoint. MACCE [a
composite endpoint of all-cause mortality, myocardial infarction (MI),
stroke, and repeat revascularization] along with its single components and
cardiovascular (CV) death were the secondary ones. Analyses were
stratified according to the use of first- vs. last-generation coronary
stents. Subgroup comparisons were performed according to SYNTAX score
(below or above 33) and to age (using cut-offs of each trial's subgroup
analysis). Four RCTs with 4394 patients were identified: 2197 were treated
with CABG, 657 with first generation, and 1540 with last-generation
stents. At 5-year rates of all-cause death did not differ [odds ratio (OR)
0.93, 95% confidence interval (CI) 0.71-1.21], as those of CV death and
stroke. Coronary artery bypass graft reduced rates of MACCE (OR 0.69, 95%
CI 0.60-0.79), mainly driven by MI (OR 0.48, 95% CI 0.36-0.65) and
revascularization (OR 0.53, 95% CI 0.45-0.64). Benefit of CABG for MACCE
was consistent, although with different extent, across values of SYNTAX
score (OR 0.76, 95% CI 0.59-0.97 for values < 32 and OR 0.63, 95% CI
0.47-0.84 for values >= 33) while was not evident for 'younger' patients
(OR 0.83, 95% CI 0.65-1.07 vs. OR 0.65, 95% CI 0.51-0.84 for 'older'
patients). <br/>Conclusion(s): For patients with ULM disease followed-up
for 5 years, no significant difference was observed in all-cause and
cardiovascular death between PCI and CABG. Coronary artery bypass graft
reduced risk of MI, revascularization, and MACCE especially in older
patients and in those with complex coronary disease and a high SYNTAX
score.<br/>Copyright &#xa9; 2020 Published on behalf of the European
Society of Cardiology.

<48>
Accession Number
2014503161
Title
ACTIVATION (PercutAneous Coronary inTervention prIor to transcatheter
aortic VAlve implantaTION): A Randomized Clinical Trial.
Source
JACC: Cardiovascular Interventions. 14(18) (pp 1965-1974), 2021. Date of
Publication: 27 Sep 2021.
Author
Patterson T.; Clayton T.; Dodd M.; Khawaja Z.; Morice M.C.; Wilson K.; Kim
W.-K.; Meneveau N.; Hambrecht R.; Byrne J.; Carrie D.; Fraser D.; Roberts
D.H.; Doshi S.N.; Zaman A.; Banning A.P.; Eltchaninoff H.; Le Breton H.;
Smith D.; Cox I.; Frank D.; Gershlick A.; de Belder M.; Thomas M.;
Hildick-Smith D.; Prendergast B.; Redwood S.; Pocock S.; Wang D.; Irague
F.
Institution
(Patterson, Wilson, Prendergast, Redwood) Cardiovascular Department, St
Thomas' Hospital, Kings College London, London, United Kingdom
(Clayton, Dodd) Department of Medical Statistics, London School of Hygiene
and Tropical Medicine, London, United Kingdom
(Khawaja) Cardiology Department, Lewisham and Greenwich NHS Foundation
Trust, United Kingdom
(Morice) Institut Cardiovasculaire Paris Sud, Massy, France
(Morice) Cardiovascular European Research Center, Massy, France
(Kim) Cardiology Department, Kerckhoff-Klinik Bad Nauheim Abteilung
Kardiologie, Bad Nauheim, Germany
(Meneveau) Department of Cardiology, University Hospital Jean Minjoz,
Besancon, France
(Meneveau) EA3920, University of Burgundy Franche-Comte, Besancon, France
(Hambrecht) Cardiology Department, Klinikum Links der Weser GmbH, Bremen,
Germany
(Byrne) Cardiothoracic Department, King's College Hospital, London, United
Kingdom
(Carrie) Cardiology Department, Hopital Rangueil, Centre Hospitalier
Universitaire de Toulouse, Toulouse, France
(Fraser) Cardiology Department, Manchester Royal Infirmary, Manchester,
United Kingdom
(Roberts) Lancashire Cardiac Centre, Blackpool Victoria Hospital NHS
Trust, Blackpool, United Kingdom
(Doshi) Cardiology Department, Queen Elizabeth Hospital, Birmingham,
United Kingdom
(Zaman) Cardiology Department, Newcastle upon Tyne Hospitals NHS
Foundation Trust of the Freeman Hospital, Newcastle, United Kingdom
(Banning) Department of Cardiology, John Radcliffe Hospital, Oxford,
United Kingdom
(Eltchaninoff) Cardiology Department, Hopital Charles-Nicolle, Centre
Hospitalier Universitaire de Rouen, Rouen, France
(Le Breton) Service de Cardiologie, Hopital Pontchaillou, Centre
Hospitalier Universitaire de Rennes, Rennes, France
(Smith) Cardiology Department, Morriston Hospital, Swansea, United Kingdom
(Cox) Cardiology Department, Derriford Hospital, Plymouth, United Kingdom
(Frank) Cardiology Department, Oberarzt Facharzt fur Innere Medizin und
Kardiologie, Kiel, Germany
(Gershlick) Department of Cardiovascular Sciences, Glenfield Hospital,
University of Leicester, Leicester, United Kingdom
(de Belder) Cardiology Department, Barts Heart Centre, London, United
Kingdom
(Thomas) Edwards Lifesciences, Irvine, CA, United States
(Hildick-Smith) Sussex Cardiac Centre, Brighton and Sussex University
Hospitals, Brighton, United Kingdom
Publisher
Elsevier Inc.
Abstract
Objectives: This study sought to determine if percutaneous coronary
intervention (PCI) prior to transcatheter aortic valve replacement (TAVR)
in patients with significant coronary artery disease would produce
noninferior clinical results when compared with no PCI (control arm).
<br/>Background(s): PCI in patients undergoing TAVR is not without risk,
and there are no randomized data to inform clinical practice.
<br/>Method(s): Patients with severe symptomatic aortic stenosis and
significant coronary artery disease with Canadian Cardiovascular Society
class <=2 angina were randomly assigned to receive PCI or no PCI prior to
TAVR. The primary endpoint was a composite of all-cause death or
rehospitalization at 1 year. Noninferiority testing (prespecified margin
of 7.5%) was performed in the intention-to-treat population.
<br/>Result(s): At 17 centers, 235 patients underwent randomization. At 1
year, the primary composite endpoint occurred in 48 (41.5%) of the PCI arm
and 47 (44.0%) of the no-PCI arm. The requirement for noninferiority was
not met (difference: -2.5%; 1-sided upper 95% confidence limit: 8.5%;
1-sided noninferiority test P = 0.067). On analysis of the as-treated
population, the difference was -3.7% (1-sided upper 95% confidence limit:
7.5%; P = 0.050). Mortality was 16 (13.4%) in the PCI arm and 14 (12.1%)
in the no-PCI arm. At 1 year, there was no evidence of a difference in the
rates of stroke, myocardial infarction, or acute kidney injury, with
higher rates of any bleed in the PCI arm (P = 0.021). <br/>Conclusion(s):
Observed rates of death and rehospitalization at 1 year were similar
between PCI and no PCI prior to TAVR; however, the noninferiority margin
was not met, and PCI resulted in a higher incidence of bleeding.
(Assessing the Effects of Stenting in Significant Coronary Artery Disease
Prior to Transcatheter Aortic Valve Implantation;
ISRCTN75836930)<br/>Copyright &#xa9; 2021 American College of Cardiology
Foundation

<49>
Accession Number
2014501808
Title
5-Year Outcomes Comparing Surgical Versus Transcatheter Aortic Valve
Replacement in Patients With Chronic Kidney Disease.
Source
JACC: Cardiovascular Interventions. 14(18) (pp 1995-2005), 2021. Date of
Publication: 27 Sep 2021.
Author
Garcia S.; Cubeddu R.J.; Hahn R.T.; Ternacle J.; Kapadia S.R.; Kodali
S.K.; Thourani V.H.; Jaber W.A.; Asher C.R.; Elmariah S.; Makkar R.; Webb
J.G.; Herrmann H.C.; Lu M.; Devireddy C.M.; Malaisrie S.C.; Smith C.R.;
Mack M.J.; Sorajja P.; Cavalcante J.L.; Goessl M.; Shroff G.R.; Leon M.B.;
Pibarot P.
Institution
(Garcia, Sorajja, Cavalcante, Goessl) Minneapolis Heart Institute, Abbott
Northwestern Hospital, Minneapolis, MN, United States
(Garcia, Sorajja, Cavalcante, Goessl) Valve Science Center, Minneapolis
Heart Institute Foundation, Minneapolis, MN, United States
(Cubeddu) NCH Healthcare System, Naples, FL, United States
(Hahn, Smith, Leon) Cardiovascular Research Foundation, New York, NY,
United States
(Hahn, Kodali, Smith, Leon) Division of Cardiology, Columbia University
Medical Center/NewYork-Presbyterian Hospital, New York, NY, United States
(Ternacle, Pibarot) Institut Universitaire de Cardiologie et de
Pneumologie de Quebec/Quebec Heart & Lung Institute, Laval University,
Quebec, Quebec, Canada
(Kapadia) Department of Cardiovascular Medicine, Heart, Vascular, and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Thourani) Department of Cardiovascular Surgery, Marcus Heart and Vascular
Center, Piedmont Heart and Vascular Institute, Atlanta, GA, United States
(Jaber) Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH,
United States
(Asher) Department of Cardiovascular Medicine, Heart and Vascular
Institute, Cleveland Clinic Weston, Weston, FL, United States
(Elmariah) Massachusetts General Hospital, Boston, MA, United States
(Makkar) Cedars-Sinai Heart Institute, Los Angeles, CA, United States
(Webb) St. Paul's Hospital, Vancouver, BC, Canada
(Herrmann) Department of Cardiology, Hospital of the University of
Pennsylvania, Philadelphia, PA, United States
(Lu) Edwards Lifesciences, Irvine, CA, United States
(Devireddy) Department of Cardiology, Emory University School of Medicine,
Atlanta, GA, United States
(Malaisrie) Department of Cardiac Surgery, Northwestern University
Feinberg School of Medicine and Northwestern Memorial Hospital, Chicago,
IL, United States
(Mack) Department of Cardiothoracic Surgery, Baylor Scott & White Health,
Plano, TX, United States
(Shroff) Hennepin Healthcare and University of Minnesota Medical School,
Minneapolis, MN, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to compare 5-year cardiovascular,
renal, and bioprosthetic valve durability outcomes in patients with severe
aortic stenosis (AS) and chronic kidney disease (CKD) undergoing
transcatheter aortic valve replacement (TAVR) or surgical aortic valve
replacement (SAVR). <br/>Background(s): Patients with severe AS and CKD
undergoing TAVR or SAVR are a challenging, understudied clinical subset.
<br/>Method(s): Intermediate-risk patients with moderate to severe CKD
(estimated glomerular filtration rate <60 mL/min/m²) from the
PARTNER (Placement of Aortic Transcatheter Valve) 2A trial (patients
randomly assigned to SAPIEN XT TAVR or SAVR) and SAPIEN 3 Intermediate
Risk Registry were pooled. The composite primary outcome of death, stroke,
rehospitalization, and new hemodialysis was evaluated using Cox regression
analysis. Patients with and without perioperative acute kidney injury
(AKI) were followed through 5 years. A core laboratory-adjudicated
analysis of structural valve deterioration and bioprosthetic valve failure
was also performed. <br/>Result(s): The study population included 1,045
TAVR patients (512 SAPIEN XT, 533 SAPIEN 3) and 479 SAVR patients. At 5
years, SAVR was better than SAPIEN XT TAVR (52.8% vs 68.0%; P = 0.04) but
similar to SAPIEN 3 TAVR (52.8% vs 58.7%; P = 0.89). Perioperative AKI was
more common after SAVR than TAVR (26.3% vs 10.3%; P < 0.001) and was
independently associated with long-term outcomes. Compared with SAVR,
bioprosthetic valve failure and stage 2 or 3 structural valve
deterioration were significantly greater for SAPIEN XT TAVR (P < 0.05) but
not for SAPIEN 3 TAVR. <br/>Conclusion(s): In intermediate-risk patients
with AS and CKD, SAPIEN 3 TAVR and SAVR were associated with a similar
risk for the primary endpoint at 5 years. AKI was more common after SAVR
than TAVR, and SAPIEN 3 valve durability was comparable with that of
surgical bioprostheses.<br/>Copyright &#xa9; 2021 American College of
Cardiology Foundation

<50>
Accession Number
2013785921
Title
Iron supplementation for patients undergoing cardiac surgery: a systematic
review and meta-analysis of randomized controlled trials.
Source
Canadian Journal of Anesthesia. (no pagination), 2021. Date of
Publication: 2021.
Author
Yang S.S.; Al Kharusi L.; Gosselin A.; Chirico A.; Baradari P.G.; Cameron
M.J.
Institution
(Yang, Al Kharusi, Gosselin, Chirico, Baradari, Cameron) Faculty of
Medicine, McGill University, Montreal, QC, Canada
(Yang, Cameron) Division of Critical Care, Department of Anesthesia,
Jewish General Hospital, K1400-3755, Cote Sainte Catherine, Montreal, QC
H3T 1E2, Canada
Publisher
Springer
Abstract
Purpose: Iron supplementation has been evaluated in several randomized
controlled trials (RCTs) for its potential to increase baseline hemoglobin
and decrease red blood cell transfusion during cardiac surgery. This
study's main objective was to evaluate the current evidence for iron
administration in cardiac surgery patients. <br/>Method(s): We searched
MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar
from inception to 19 November 2020 for RCTs evaluating perioperative iron
administration in adult patients undergoing cardiac surgery. The RCTs were
assessed using a risk of bias assessment and the quality of evidence was
assessed using the grading of recommendations, assessments, development,
and evaluations. <br/>Result(s): We reviewed 1,767 citations, and five
studies (n = 554) met the inclusion criteria. The use of iron showed no
statistical difference in incidence of transfusion (risk ratio, 0.86; 95%
confidence interval, 0.65 to 1.13). Trial sequential analysis suggested an
optimal information size of 1,132 participants, which the accrued
information size did not reach. <br/>Conclusion(s): The current literature
does not support or refute the routine use of iron therapy in cardiac
surgery patients. Trial registration: PROSPERO (CRD42020161927);
registered 19 December 2019.<br/>Copyright &#xa9; 2021, Canadian
Anesthesiologists' Society.

<51>
Accession Number
2013462912
Title
Pseudomeningocele-a rare complication following thoracic spinal
decompression surgery: clinical features, treatment guidelines, technical
notes, and evaluation of results.
Source
International Orthopaedics. 45(10) (pp 2609-2618), 2021. Date of
Publication: October 2021.
Author
Wang L.; Yang X.; Wang H.; Chen Z.; Sun C.; Li W.
Institution
(Wang, Yang, Wang, Chen, Sun, Li) Department of Orthopaedics, Peking
University Third Hospital, Haidian District, 49 North Garden Road, Beijing
100191, China
(Wang, Yang, Wang, Chen, Sun, Li) Engineering Research Center of Bone and
Joint Precision Medicine, Beijing, China
(Wang, Yang, Wang, Chen, Sun, Li) Beijing Key Laboratory of Spinal Disease
Research, Beijing, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Pseudomeningocele (PMC) is a rare complication following thoracic
spinal decompression surgery. The aim of this study is to assess the
clinical features and treatment of PMC and provide the technical notes
with revision surgery. <br/>Method(s): Between January 2010 and December
2019, patients who developed PMC after posterior thoracic surgery were
enrolled. An additional 25 patients who suffered cerebrospinal fluid
leakage (CSFL) but did not develop PMC in the same period were randomly
selected. General data, intra-operative factors, CSFL position, cost,
modified Japanese Orthopaedic Association (mJOA) scores, patient
satisfaction, and clinical features were recorded and compared between the
two groups. <br/>Result(s): Eighteen patients were diagnosed with PMC
after thoracic spinal surgery. The average length, width, and depth were
16.25 +/- 5.73 cm, 6.96 +/- 3.61 cm and 4.39 +/- 2.2 cm, respectively. The
most common symptom was neurological deficits following incision problems
and headache. Compared with the control group, the PMC group showed a
longer duration of initial surgery, greater estimated blood loss, an
increased rate of CSFL on the ventral side, reduced mJOA scores, and lower
patient satisfaction at the final follow-up. <br/>Conclusion(s): PMC is a
rare complication of thoracic surgery with an incidence of 1.12%. PMC
typically occurs at the upper and lower thoracic spine, resulting in
increased health care costs, poorer neurological recovery, and a lower
rate of patient satisfaction. The management of PMC should be
individualized depending on diagnosis time and symptoms.<br/>Copyright
&#xa9; 2021, SICOT aisbl.

<52>
Accession Number
2011616143
Title
Transcatheter aortic valve implantation in low-risk patients: A case of
rational over exuberance. The time is not now.
Source
Asian Cardiovascular and Thoracic Annals. 29(8) (pp 836-847), 2021. Date
of Publication: October 2021.
Author
Navaratnarajah M.; Luthra S.; Ohri S.
Institution
(Navaratnarajah, Luthra, Ohri) Department of Cardiac Surgery, Southampton
University Hospital, Southampton, United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Background: Review of evidence and concerns, relating to extension of
transcatheter aortic valve implantation usage to low-risk patients.
<br/>Method(s): Comprehensive literature review was conducted identifying
articles relating to transcatheter aortic valve implantation.
<br/>Result(s): Transcatheter aortic valve implantation is effective in
patients with aortic stenosis. Currently, long-term durability and
cost-effectiveness are unproven, anticoagulation requirement undefined,
permanent pacemaker implantation and paravalvular leak rates higher than
following surgical aortic valve replacement. <br/>Conclusion(s): Current
evidence supporting transcatheter aortic valve implantation usage in
low-risk patients is insufficient. Extending use now, to this large young
patient population is premature, and should be delayed.<br/>Copyright
&#xa9; The Author(s) 2021.

<53>
Accession Number
2011409173
Title
A systematic review of the quality of cardiovascular surgery studies that
extracted data from the MAUDE database.
Source
Journal of Vascular Surgery. 74(5) (pp 1708-1720.e5), 2021. Date of
Publication: November 2021.
Author
Ziapour B.; Zaepfel C.; Iafrati M.D.; Suarez L.B.; Salehi P.
Institution
(Ziapour) Department of General Surgery, Allegheny General Hospital,
Pittsburgh, Pa, United States
(Zaepfel) Tufts Medical Center, Boston, MA, United States
(Iafrati, Salehi) Division of Vascular Surgery, Cardiovascular Center at
Tufts Medical Center, Boston, MA, United States
(Suarez) Cardiovascular Center at Tufts Medical Center, Boston, MA, United
States
Publisher
Elsevier Inc.
Abstract
Objective: To investigate opportunities and limitations of using the
Manufacturer and User Facility Device Experience (MAUDE) database for
cardiovascular surgery research, we analyzed the quality of studies having
ever used MAUDE, in the field of cardiovascular surgery. <br/>Method(s):
We systematically searched the Cochrane Library, PubMed, EMBASE, and
Google Scholar for randomized and nonrandomized studies, from inception to
July 2019. Two authors evaluated the quality of the retrieved
observational studies, according to the National Institutes of Health
quality assessment tool for either case series or cross-sectional studies.
These tools quantify the quality of case series and
cohorts/cross-sectional studies, respectively, with nine and 14 queries.
<br/>Result(s): Fifty-eight studies were included in the final qualitative
review. Of 58 identified studies, 32 were case series, 8 were abstracts of
case series, and 13 were reviews or case discussion with an included
series from MAUDE. Also, five articles were cross-sectional studies. Of
the 32 formal case series, 26 (81%) were found to have poor quality. The
most common reasons for a poor quality designation included a lack of
consecutive participants, undetermined comparability of participants, and
undetermined follow-up adequacy. Only one out of five cross-sectional
studies had fair quality; four others were evaluated as poor quality
studies. <br/>Conclusion(s): Cardiovascular surgery studies using the
MAUDE database, whether case series or cross-sectional design, are mostly
of poor quality. Their low quality is partly caused by poor study design,
but mainly by intrinsic limitations to the MAUDE database: cases recruited
are not consecutive; patient characteristics are not detailed enough to
allow a meaningful comparison of patient characteristics between different
patient entries; outcome measures are unclear; there is a limited
follow-up; and time-to-event data are lacking. We conclude that the
quality of cardiovascular surgery publications that rely on data from
MAUDE could be improved if investigators were to extract all relevant data
points from MAUDE entries, then apply standard quality assessment tools in
compiling and reporting the data. MAUDE might be improved if it used
medical case report standards during the process of reporting and indexing
adverse events. To calculate the incidence rate of any adverse event, all
event-free cases, as well as all adverse events in patients using a
device, are required. Neither of these two variables is available in the
MAUDE at the time of writing.<br/>Copyright &#xa9; 2021 Society for
Vascular Surgery

<54>
Accession Number
2010676561
Title
Methylene blue for vasoplegic syndrome in cardiopulmonary bypass surgery:
A systematic review and meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. 29(8) (pp 717-728), 2021. Date
of Publication: October 2021.
Author
Perdhana F.; Kloping N.A.; Witarto A.P.; Nugraha D.; Yogiswara N.; Luke
K.; Kloping Y.P.; Rehatta N.M.
Institution
(Perdhana, Rehatta) Department of Anaesthesiology and Reanimation, Faculty
of Medicine, Universitas Airlangga - Dr Soetomo General Hospital,
Surabaya, Indonesia
(Kloping, Witarto, Nugraha, Yogiswara, Luke, Kloping) Faculty of Medicine,
Universitas Airlangga, Surabaya, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Background: To evaluate the benefit of methylene blue as an adjunct
treatment by assessing hemodynamic, morbidity rate, intensive care unit
length of stay, and mortality rate outcomes in adult patients with
vasoplegic syndrome. <br/>Method(s): A systematic search through
electronic databases including Pubmed, Embase, Scopus, and Medline for
studies assessing the use of methylene blue in patients with vasoplegic
syndrome compared to control treatments. The Newcastle-Ottawa Scale tool
was used for observational studies, and Jadad Scale was used for
controlled trials to assess the risk of bias. <br/>Result(s): This
systematic review included six studies for qualitative synthesis and five
studies for quantitative synthesis. Pooled analysis revealed that mean
arterial pressure, systemic vascular resistance, heart rate, and hospital
stay were not statistically significant in methylene blue administration
compared to control. However, administration of methylene blue in
vasoplegic syndrome patients significantly reduces renal failure (OR =
0.25; 95% CI = 0.08-0.75), development of multiple organ failure (OR =
0.09; 95% CI = 0.02-0.51), and mortality rate (OR = 0.12; 95% CI =
0.03-0.46). <br/>Conclusion(s): Adjunct administration of methylene blue
for vasoplegic syndrome patients significantly reduces renal failure,
multiple organ failure, and mortality.<br/>Copyright &#xa9; The Author(s)
2021.

<55>
Accession Number
2005714493
Title
Transcatheter mitral valve repair for functional mitral regurgitation:
Evaluating the evidence.
Source
Journal of Thoracic and Cardiovascular Surgery. 162(5) (pp 1504-1511),
2021. Date of Publication: November 2021.
Author
Gelijns A.C.; Moskowitz A.J.; O'Gara P.T.; Giustino G.; Mack M.J.; Mancini
D.M.; Bagiella E.; Hung J.; Ailawadi G.; Leon M.B.; Acker M.A.; Alexander
J.H.; Dickert N.W.; Taddei-Peters W.C.; Miller M.A.
Institution
(Gelijns, Moskowitz, Giustino, Mancini, Bagiella) Population Health
Science and Policy, Icahn School of Medicine at Mount Sinai, NY, United
States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
MA, United States
(Mack) Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott &
White Health, Plano, Tex, United States
(Hung) Division of Cardiology, Massachusetts General Hospital, Boston, MA,
United States
(Ailawadi) Section of Adult Cardiac Surgery, University of Virginia,
Charlottesville, Va, United States
(Leon) Center for Interventional Vascular Therapy, Columbia University
Medical Center/New York-Presbyterian Hospital and Cardiovascular Research
Foundation, New York, NY, United States
(Acker) Cardiovascular Surgery, Surgery, University of Pennsylvania School
of Medicine, Philadelphia, Pa, United States
(Alexander) Division of Cardiology, Duke Clinical Research Institute, Duke
University School of Medicine, Durham, NC, United States
(Dickert) Division of Cardiology, Emory University School of Medicine,
Atlanta, Ga, United States
(Taddei-Peters, Miller) Division of Cardiovascular Sciences, National
Heart, Lung, and Blood Institute, Bethesda, Md, United States
Publisher
Elsevier Inc.
Abstract
Objectives: Two trials (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients with Functional
Mitral Regurgitation Trial and Percutaneous Repair with the MitraClip
Device for Severe Functional/Secondary Mitral Regurgitation Trial) were
published in 2018 evaluating the effectiveness and safety of transcatheter
repair for patients with heart failure with significant functional mitral
regurgitation, which yielded different results. This article reviews the
strength of the evidence, differences in trial designs, ethical and
implementation implications, and delineates future research needs to help
guide the appropriate dissemination of transcatheter repair for functional
patients with mitral regurgitation. <br/>Method(s): The National Heart,
Lung, and Blood Institute convened a workshop of interdisciplinary experts
to address these objectives. <br/>Result(s): Transcatheter repair of
functional mitral regurgitation can provide significant benefits in terms
of heart failure hospitalizations, survival, and quality of life when
appropriate heart failure candidates with moderate to severe or severe
mitral regurgitation while on optimal guideline-directed medical therapy
can be identified. Key ingredients for success are preoperative evaluation
and management and postoperative care by an interdisciplinary heart team.
<br/>Conclusion(s): Given the discordance observed between trials, ongoing
innovation in patient management, and potential expansion of indications
for use, the evidence base must be expanded to optimize appropriate
implementation of this complex therapy. This will require more complete
capture of outcome data in real-world settings for all eligible candidates
whether or not they receive this therapy. Inevitably, the indications for
use of this therapy will expand, as will the devices and therapeutic
approaches for this population, necessitating the study of comparative
effectiveness through randomized trials or observational studies.
Moreover, given the substantial variations in care delivery, conducting
implementation research to delineate characteristics of the optimal care
model would be of benefit.<br/>Copyright &#xa9; 2020

<56>
Accession Number
636219009
Title
Efficacy of Single-shot Thoracic Paravertebral Block Combined with
Intravenous Analgesia Versus Continuous Thoracic Epidural Analgesia for
Chronic Pain After Thoracotomy.
Source
Pain physician. 24(6) (pp E753-E759), 2021. Date of Publication: 01 Sep
2021.
Author
Li X.-L.; Zhang J.; Wan L.; Wang J.
Institution
(Li, Zhang, Wan) Department of Anesthesiology, Beijing Friendship
Hospital, Capital Medical University, Beijing, China
(Wang) Pain Department, Zao Zhuang Municipal Hospital, Shandong Province,
Zaozhuang, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients undergoing thoracic surgery frequently suffer from
chronic pain after thoracotomy. Chronic pain can lead to a significant
decline in a patient's quality of life. However, the effect of single-shot
thoracic paravertebral block (TPVB) combined with intravenous analgesia on
chronic pain incidence is unclear. <br/>OBJECTIVE(S): The objective was to
evaluate the impact of single-shot TPVB combined with intravenous
analgesia versus continuous thoracic epidural analgesia (TEA) on chronic
pain incidence after thoracotomy. STUDY DESIGN: A randomized controlled
study. SETTING: Hospital department in China. <br/>METHOD(S): Ninety-six
patients undergoing thoracotomy were randomly assigned to 2 groups:
single-shot TPVB combined with intravenous analgesia (Group P) and
continuous TEA (Group E). The pain intensity was assessed using the Verbal
Rating Scale (VRS). The outcome measures were chronic pain incidence and
the acute and chronic pain intensity. <br/>RESULT(S): The chronic pain
incidence at rest in Group P was significantly higher than that in Group E
at 3 months and 12 months postoperation (55.2% versus 28.6%, P = 0.019;
34.5% versus 14.3%, P = 0.027). The patients in Group E showed less pain
intensity at rest compared with those in Group P at 3 months postoperation
(0.0 versus 1.0, P = 0.034). At 6 hours and 24 hours postoperation, the
acute pain intensity at coughing and at rest in Group E was lower than
that in group P (VRS at coughing: 6 hours: 0.0 versus 2.0, P = 0.001; 24
hours: 3.0 versus 5.0, P = 0.010. VRS at rest: 6 hours: 0.0 versus 2.0, P
= 0.000; 24 hours: 1.0versus. 2.0, P = 0.001). LIMITATIONS: An important
limitation of this study is that it is not a double-blind study.
<br/>CONCLUSION(S): In patients undergoing thoracotomy, continuous TEA
significantly reduced the chronic pain incidence at rest at 3 months and
12 months after operation and provided better acute pain relief up to 24
hours after operation compared with single-shot TPVB combined with
intravenous analgesia.

<57>
Accession Number
2015068816
Title
The use of novel oral anticoagulants compared to vitamin K antagonists
(warfarin) in patients with left ventricular thrombus after acute
myocardial infarction.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 7(5) (pp
398-404), 2021. Date of Publication: 01 Sep 2021.
Author
Jones D.A.; Wright P.; Alizadeh M.A.; Fhadil S.; Rathod K.S.; Guttmann O.;
Knight C.; Timmis A.; Baumbach A.; Wragg A.; Mathur A.; Antoniou S.
Institution
(Jones, Alizadeh, Rathod, Guttmann, Knight, Timmis, Baumbach, Wragg,
Mathur) Barts Interventional Group, Interventional Cardiology, Barts Heart
Centre, St Bartholomew's Hospital, King George v Building, West
Smithfield, London EC1A 7BE, United Kingdom
(Jones, Alizadeh, Rathod, Guttmann, Knight, Timmis, Baumbach, Wragg,
Mathur) Charterhouse Square Barts and the London School of Medicine and
Dentistry, Queen Mary University of London, London EC1M 6BQ, United
Kingdom
(Wright, Fhadil, Antoniou) Department of Pharmacy, Barts Heart Centre, St
Bartholomew's Hospital, King George v Building, West Smithfield, London
EC1A 7BE, United Kingdom
Publisher
Oxford University Press
Abstract
Aim: Current guidelines recommend the use of vitamin K antagonist (VKA)
for up to 3-6 months for treatment of left ventricular (LV) thrombus
post-acute myocardial infarction (AMI). However, based on evidence
supporting non-inferiority of novel oral anticoagulants (NOAC) compared to
VKA for other indications such as deep vein thrombosis, pulmonary embolism
(PE), and thromboembolic prevention in atrial fibrillation, NOACs are
being increasingly used off licence for the treatment of LV thrombus
post-AMI. In this study, we investigated the safety and effect of NOACs
compared to VKA on LV thrombus resolution in patients presenting with AMI.
<br/>Methods and Results: This was an observational study of 2328
consecutive patients undergoing coronary angiography +/- percutaneous
coronary intervention (PCI) for AMI between May 2015 and December 2018, at
a UK cardiac centre. Patients' details were collected from the hospital
electronic database. The primary endpoint was rate of LV thrombus
resolution with bleeding rates a secondary outcome. Left ventricular
thrombus was diagnosed in 101 (4.3%) patients. Sixty patients (59.4%) were
started on VKA and 41 patients (40.6%) on NOAC therapy (rivaroxaban:
58.5%, apixaban: 36.5%, and edoxaban: 5.0%). Both groups were well matched
in terms of baseline characteristics including age, previous cardiac
history (previous myocardial infarction, PCI, coronary artery bypass
grafting), and cardiovascular risk factors (hypertension, diabetes,
hypercholesterolaemia). Over the follow-up period (median 2.2 years),
overall rates of LV thrombus resolution were 86.1%. There was greater and
earlier LV thrombus resolution in the NOAC group compared to patients
treated with warfarin (82% vs. 64.4%, P = 0.0018, at 1 year), which
persisted after adjusting for baseline variables (odds ratio 1.8, 95%
confidence interval 1.2-2.9). Major bleeding events during the follow-up
period were lower in the NOAC group, compared with VKA group (0% vs. 6.7%,
P = 0.030) with no difference in rates of systemic thromboembolism (5% vs.
2.4%, P = 0.388). <br/>Conclusion(s): These data suggest improved thrombus
resolution in post-acute coronary syndrome (ACS) LV thrombosis in patients
treated with NOACs compared to VKAs. This improvement in thrombus
resolution was accompanied with a better safety profile for NOAC patients
vs. VKA-treated patients. Thus, provides data to support a randomized
trial to answer this question.<br/>Copyright &#xa9; 2020 Published on
behalf of the European Society of Cardiology.

<58>
Accession Number
2014092647
Title
Video-assisted thoracoscopy for penetrating cardiac box injury in stable
patients.
Source
Brazilian Journal of Cardiovascular Surgery. 36(4) (pp 550-556), 2021.
Date of Publication: 2021.
Author
Vinck E.E.; Angel E.P.; Barrios R.V.; Martinez S.I.; Arias C.A.; Garzon
J.C.; Ebels T.; Alzate S.A.; Fernandez A.
Institution
(Vinck) Department of Cardiovascular Surgery, Cardio VID Clinic -
Pontifical Bolivarian University, Medellin, Colombia
(Angel) Department of Surgery, Pontificia Universidad Javeriana, Bogota,
Colombia
(Barrios, Martinez, Fernandez) Department of Thoracic Surgery, El Bosque
University, Bogota, Colombia
(Arias) Department of Cardiovascular Surgery, Central Military Hospital,
Bogota, Colombia
(Garzon) Department of Thoracic Surgery, Fundacion Cardioinfantil, Bogota,
Colombia
(Ebels) Department of Cardio-thoracic Surgery, University Medical Center
Groningen, Groningen, Netherlands
(Alzate) Department of Cardiovascular Surgery, Fundacion Clinica Shaio,
Bogota, Colombia
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: In high-volume trauma centers, especially in developing
countries, penetrating cardiac box injuries are frequent. Although many
aspects of penetrating chest injuries have been well established,
video-assisted thoracoscopy is still finding its place in cardiac box
trauma and algorithmic approaches are still lacking. The purpose of this
manuscript is to provide a streamlined recommendation for penetrating
cardiac box injury in stable patients. <br/>Method(s): Literature review
was carried out using PubMed/ MEDLINE and Google Scholar databases to
identify articles describing the characteristics and concepts of
penetrating cardiac box trauma, including the characteristics of
tamponade, cardiac ultrasound, indications and techniques of pericardial
windows and, especially, the role of video-assisted thoracoscopy in stable
patients. <br/>Result(s): Penetrating cardiac box injuries, whether by
stab or gunshot wounds, require rapid surgical consultation. Unstable
patients require immediate open surgery, however, determining which stable
patients should be taken to thoracoscopic surgery is still controversial.
Here, the classification of penetrating cardiac box injury used in
Colombia is detailed, as well as the algorithmic approach to these types
of trauma. <br/>Conclusion(s): Although open surgery is mandatory in
unstable patients with penetrating cardiac box injuries, a more
conservative and minimally invasive approach may be undertaken in stable
patients. As rapid decision-making is critical in the trauma bay, surgeons
working in high-volume trauma centers should expose themselves to
thoracoscopy and always consider this possibility in the setting of
penetrating cardiac box injuries in stable patients, always in the context
of an experienced trauma team.<br/>Copyright &#xa9; 2021, Sociedade
Brasileira de Cirurgia Cardiovascular. All rights reserved.

<59>
Accession Number
636193093
Title
Is Perioperative Dexmedetomidine Associated With a Reduced Risk of
Perioperative Neurocognitive Disorders Following Cardiac Surgery? A
Systematic Review and Meta-Analysis With Trial Sequential Analysis of
Randomized Controlled Trials.
Source
Frontiers in Medicine. 8 (no pagination), 2021. Article Number: 645975.
Date of Publication: 29 Sep 2021.
Author
Xiong X.; Chen D.; Shi J.
Institution
(Xiong, Shi) Department of Anesthesiology, The Affiliated Hospital of
Guizhou Medical University, Guiyang, China
(Chen) Department of Anesthesiology, West China Hospital, Sichuan
University, Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Background: To assess the effect of dexmedetomidine on the reducing risk
of perioperative neurocognitive disorders (PNDs) following cardiac
surgery. <br/>Method(s): A systematic review and meta-analysis with trial
sequential analysis (TSA) of randomized controlled trials were performed.
PubMed, Embase, Cochrane Library, and CNKI databases (to August 16, 2020)
were searched for relevant articles to analyze the incidence of PND for
intraoperative or postoperative dexmedetomidine administration after
cardiac surgery. PND included postoperative cognitive dysfunction (POCD)
and postoperative delirium (POD). <br/>Result(s): A total of 24 studies
with 3,610 patients were included. Compared with the control group, the
incidence of POD in the dexmedetomidine group was significantly lower
(odds ratio [OR]: 0.59, 95% CI: 0.43-0.82, P = 0.001), with firm evidence
from TSA. Subgroup analyses confirmed that dexmedetomidine reduced the
incidence of POD with firm evidence following coronary artery bypass
grafting surgery (OR: 0.45, 95% CI: 0.26-0.79, P = 0.005), and
intervention during the postoperative period (OR: 0.48, 95% CI: 0.34-0.67,
P < 0.001). Furthermore, the incidence of POD in the dexmedetomidine group
was also decreased in mixed cardiac surgery (OR: 0.68, 95% CI: 0.47-0.98,
P = 0.039). Irrespective of whether "Confusion Assessment Method/Confusion
Assessment Method for intensive care unit" or "other tools" were used as
diagnostic tools, the results showed a decreased risk of POD in the
dexmedetomidine group. There was no significant difference in the
incidence of POCD (OR: 0.47, 95% CI: 0.22-1.03, P = 0.060) between the two
groups, but this result lacked firm evidence from TSA. <br/>Conclusion(s):
The administration of dexmedetomidine during the perioperative period
reduced the incidence of POD in patients after cardiac surgery, but there
was no significant benefit in the incidence of POCD. The effect of
dexmedetomidine on the incidence of POD or POCD following different types
of surgery and the optimal dose and timing of dexmedetomidine warrant
further investigation. Trial registration: PROSPERO registration number:
CRD42020203980. Registered on September 13, 2020.<br/>&#xa9; Copyright
&#xa9; 2021 Xiong, Chen and Shi.

<60>
Accession Number
2011808435
Title
Predictors of pacemaker implantation after transcatheter aortic valve
implantation according to kind of prosthesis and risk profile: A
systematic review and contemporary meta-Analysis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 7(2) (pp
143-153), 2021. Date of Publication: 01 Apr 2021.
Author
Bruno F.; D'Ascenzo F.; Vaira M.P.; Elia E.; Omede P.; Kodali S.; Barbanti
M.; Rodes-Cabau J.; Husser O.; Sossalla S.; Van Mieghem N.M.; Bax J.;
Hildick-Smith D.; Munoz-Garcia A.; Pollari F.; Fischlein T.; Budano C.;
Montefusco A.; Gallone G.; De Filippo O.; Rinaldi M.; La Torre M.;
Salizzoni S.; Atzeni F.; Pocar M.; Conrotto F.; De Ferrari G.M.
Institution
(Bruno, D'Ascenzo, Vaira, Elia, Omede, Budano, Montefusco, Gallone, De
Filippo, Conrotto, De Ferrari) Division of Cardiology, Cardiovascular and
Thoracic Department, Citta della Salute e della Scienza Hospital and
University of Turin, Italy
(Kodali) Department of Cardiology, Division of Cardiology, Columbia
University Medical Center, New York, NY, United States
(Barbanti) Department of Cardiology, C.A.S.T. Policlinic G. Rodolico
Hospital, University of Catania, Catania, Italy
(Rodes-Cabau) Department of Cardiology, Quebec Heart and Lung Institute,
Laval University, Quebec City, QC, Canada
(Husser) Klinik fur Innere Medizin i St.-Johannes-Hospital, Dortmund,
Germany
(Sossalla) Department for Internal Medicine II, Cardiology, Pneumology,
University Hospital Regensburg, Regensburg, Germany
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Bax) Department of Cardiology, Heart Lung Center, Leiden University
Medical Center, Leiden, Netherlands
(Hildick-Smith) Department of Cardiology, Sussex Cardiac Centre, Brighton
and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
(Munoz-Garcia) Department of Cardiology, Hospital Virgen de la Victoria,
Malaga, Spain
(Pollari, Fischlein) Department of Cardiac Surgery, Cardiovascular Center,
Klinikum Nurnberg-Paracelsus Medical University, Breslauer Str. 201,
Nuremberg, Germany
(Rinaldi, La Torre, Salizzoni, Atzeni, Pocar) Division of Cardiosurgery,
Cardiovascular and Thoracic Department, Citta della Salute e della Scienza
Hospital and University of Turin, Italy
Publisher
Oxford University Press
Abstract
Aims: Permanent pacemaker implantation (PPI) may be required after
transcatheter aortic valve implantation (TAVI). Evidence on PPI prediction
has largely been gathered from high-risk patients receiving
first-generation valve implants. We undertook a meta-Analysis of the
existing literature to examine the incidence and predictors of PPI after
TAVI according to generation of valve, valve type, and surgical risk.
<br/>Methods and Results: We made a systematic literature search for
studies with >=100 patients reporting the incidence and adjusted
predictors of PPI after TAVI. Subgroup analyses examined these features
according to generation of valve, specific valve type, and surgical risk.
We obtained data from 43 studies, encompassing 29 113 patients. Permanent
pacemaker implantation rates ranged from 6.7% to 39.2% in individual
studies with a pooled incidence of 19% (95% CI 16-21). Independent
predictors for PPI were age [odds ratio (OR) 1.05, 95% confidence interval
(CI) 1.01-1.09], left bundle branch block (LBBB) (OR 1.45, 95% CI
1.12-1.77), right bundle branch block (RBBB) (OR 4.15, 95% CI 3.23-4.88),
implantation depth (OR 1.18, 95% CI 1.11-1.26), and self-expanding valve
prosthesis (OR 2.99, 95% CI 1.39-4.59). Among subgroups analysed according
to valve type, valve generation and surgical risk, independent predictors
were RBBB, self-expanding valve type, first-degree atrioventricular block,
and implantation depth. <br/>Conclusion(s): The principle independent
predictors for PPI following TAVI are age, RBBB, LBBB, self-expanding
valve type, and valve implantation depth. These characteristics should be
taken into account in pre-procedural assessment to reduce PPI rates.
PROSPERO ID CRD42020164043.<br/>Copyright &#xa9; 2020 Published on behalf
of the European Society of Cardiology. All rights reserved.

<61>
Accession Number
2011803715
Title
Subclinical leaflet thrombosis after transcatheter aortic valve
replacement: A meaningless finding? A systematic review and meta-analysis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 7(1) (pp
107-108), 2021. Date of Publication: 01 Jan 2021.
Author
Casula M.; Fortuni F.; Ferlini M.; Mauri S.; Rebuffi C.; Rossini R.;
Ferrario M.; Oltrona Visconti L.
Institution
(Casula, Fortuni, Oltrona Visconti) Coronary Care Unit, Fondazione IRCCS
Policlinico San Matteo, Viale Camillo Golgi 19, Pavia 27100, Italy
(Casula, Fortuni) Department of Molecular Medicine, University of Pavia,
Via Forlanini 6, Pavia 27100, Italy
(Ferlini, Mauri, Ferrario, Oltrona Visconti) Division of Cardiology,
Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, Pavia
27100, Italy
(Rebuffi) Scientific Documentation Center, Fondazione IRCCS Policlinico
San Matteo, Viale Camillo Golgi, Pavia 27100, Italy
(Rossini) Cardiologia, Ospedale Santa Croce e Carle, Via Michele Coppino
26, Cuneo 12100, Italy
Publisher
Oxford University Press

<62>
Accession Number
2011541150
Title
Preoperative lymphopaenia, mortality, and morbidity after elective
surgery: systematic review and meta-analysis.
Source
British Journal of Anaesthesia. 127(1) (pp 32-40), 2021. Date of
Publication: July 2021.
Author
Schroth J.; Weber V.; Jones T.F.; Del Arroyo A.G.; Henson S.M.; Ackland
G.L.
Institution
(Schroth, Weber, Jones, Del Arroyo, Henson, Ackland) Translational
Medicine and Therapeutics, William Harvey Research Institute, Barts and
the London School of Medicine and Dentistry, Queen Mary University of
London, London, United Kingdom
Publisher
Elsevier Ltd
Abstract
Background: In the general adult population, lymphopaenia is associated
with an increased risk for hospitalisation with infection and
infection-related death. The quality of evidence and strength of
association between perioperative lymphopaenia across different surgical
procedures and mortality/morbidity has not been examined by systematic
review or meta-analysis. <br/>Method(s): We searched MEDLINE, Embase, Web
of Science, Google Scholar, and Cochrane databases from their inception to
June 29, 2020 for observational studies reporting lymphocyte count and
in-hospital mortality rate in adults. We defined preoperative lymphopaenia
as a lymphocyte count 1.0-1.5x10⁹ L^-1. Meta-analysis
was performed using either fixed or random effects models. Quality was
assessed using the Newcastle-Ottawa Scale. The I² index was
used to quantify heterogeneity. The primary outcome was in-hospital
mortality rate and mortality rate at 30 days. <br/>Result(s): Eight
studies met the inclusion criteria for meta-analysis, comprising 4811
patients (age range, 46-91 yr; female, 20-79%). These studies examined
preoperative lymphocyte count exclusively. Studies were of moderate to
high quality overall, ranking >7 using the Newcastle-Ottawa Scale.
Preoperative lymphopaenia was associated with a threefold increase in
mortality rate (risk ratio [RR]=3.22; 95% confidence interval [CI],
2.19-4.72; P<0.01, I²=0%) and more frequent major postoperative
complications (RR=1.33; 95% CI, 1.21-1.45; P<0.01, I²=6%),
including cardiovascular morbidity (RR=1.77; 95% CI, 1.45-2.15; P<0.01,
I²=0%), infections (RR=1.45; 95% CI, 1.19-1.76; P<0.01,
I²=0%), and acute renal dysfunction (RR=2.66; 95% CI,
1.49-4.77; P<0.01, I²=1%). <br/>Conclusion(s): Preoperative
lymphopaenia is associated with death and complications more frequently,
independent of the type of surgery. Prospero registry number:
CRD42020190702.<br/>Copyright &#xa9; 2021 British Journal of Anaesthesia

<63>
Accession Number
2011401524
Title
Coronary revascularization in patients with stable coronary disease and
diabetes mellitus.
Source
Diabetes and Vascular Disease Research. 18(2) (no pagination), 2021. Date
of Publication: 2021.
Author
Bhat S.; Yatsynovich Y.; Sharma U.C.
Institution
(Bhat, Yatsynovich, Sharma) Department of Medicine, University at Buffalo,
NY, United States
(Yatsynovich, Sharma) Division of Cardiovascular Diseases, University at
Buffalo, NY, United States
(Sharma) The Clinical and Translational Science Institute, University at
Buffalo, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Purpose of Study: Diabetes mellitus accelerates the development of
atherosclerosis. Patients with diabetes mellitus have higher incidence and
mortality rates from cardiovascular disease and undergo a
disproportionately higher number of coronary interventions compared to the
general population. Proper selection of treatment modalities is thus
paramount. Treatment strategies include medical management and
interventional approaches including coronary artery bypass graft (CABG)
surgery and percutaneous coronary interventions (PCI). The purpose of this
review is to assimilate emerging evidence comparing CABG to PCI in
patients with diabetes and present an outlook on the latest advances in
percutaneous interventions, in addition to the optimal medical therapies
in patients with diabetes. Key Methods: A systematic search of PubMed, Web
of Science and EMBASE was performed to identify prospective, randomized
trials comparing outcomes of CABG and PCI, and also PCI with different
generations of stents used in patients with diabetes. Additional review of
bibliography of selected studies was also performed. Main
<br/>Conclusion(s): Most of the trials discussed above demonstrate a
survival advantage of CABG over PCI in patients with diabetes. However,
recent advances in PCI technology are starting to challenge this
narrative. Superior stent designs, use of specific drug-eluting stents,
image-guided stent deployment, and the use of contemporary antiplatelet
and lipid-lowering therapies are continuing to improve the PCI outcomes.
Prospective data for such emerging interventional technologies in diabetes
is however lacking currently and is the need of the hour.<br/>Copyright
&#xa9; The Author(s) 2021.

<64>
Accession Number
2007099778
Title
Three-year clinical outcomes of the absorb bioresorbable vascular scaffold
compared to Xience everolimus-eluting stent in routine PCI in patients
with diabetes mellitus-AIDA sub-study.
Source
Catheterization and Cardiovascular Interventions. 98(4) (pp 713-720),
2021. Date of Publication: October 2021.
Author
Kerkmeijer L.S.M.; Tijssen R.Y.G.; Hofma S.H.; van der Schaaf R.J.;
Arkenbout E.K.; Weevers A.P.J.D.; Kraak R.P.; Onuma Y.; Serruys P.W.; Piek
J.J.; Tijssen J.G.P.; Henriques J.P.S.; de Winter R.J.; Wykrzykowska J.J.
Institution
(Kerkmeijer, Tijssen, Kraak, Piek, Tijssen, Henriques, de Winter,
Wykrzykowska) Heart Center; department of Clinical and Experimental
Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University
of Amsterdam, Amsterdam, Netherlands
(Hofma, Kraak) The Department of Cardiology, Medical Center Leeuwarden,
Leeuwarden, Netherlands
(van der Schaaf) The Department of Cardiology, Onze Lieve Vrouwe Gasthuis,
Amsterdam, Netherlands
(Arkenbout) The Department of Cardiology, Tergooi Hospital, Blaricum,
Netherlands
(Weevers) The Department of Cardiology, Albert Schweitzer Hospital,
Dordrecht, Netherlands
(Onuma) Thorax Center, Erasmus Medical Center, Rotterdam, Netherlands
(Serruys) NHLI, Imperial College London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: In this prespecified AIDA-trial sub-study we investigate the
clinical performance of absorb bioresorbable vascular scaffold (BVS)
compared to Xience everolimus-eluting stent (EES) in routine percutaneous
coronary intervention (PCI) in patients with diabetes mellitus (DM) at
complete 3-year follow-up. <br/>Methods and Results: All 1,845 randomized
patients were subdivided by medical history with DM or without DM. Of the
924 Absorb BVS patients, 171 (18.5%) patients had DM, of which 65 (38.0%)
were treated with insulin (iTDM). Of the 921 Xience EES patients, 153
(16.6%) patients had DM, of which 45 (29.4%) were insulin-treated diabetes
mellitus (iTDM). Target vessel failure (TVF), composite of cardiac death,
target vessel myocardial infarction, and target vessel revascularization,
occurred in 18.7% of diabetic patients treated with Absorb patients versus
in 18.0% patients treated with Xience EES (p =.840). In nondiabetics the
rates of TVF were 12.3% in Absorb BVS versus 11.0% in Xience EES (p
=.391). Definite/probable device thrombosis occurred more frequently in
Absorb BVS compared to Xience EES in both diabetic and nondiabetic
patients (4.8% versus 0.7%; p =.028 and 3.2% vs. 0.5%; p <.001,
respectively). <br/>Conclusion(s): In routine PCI practice, both Absorb
BVS and Xience EES have worse clinical outcomes in diabetic patients as
compared to nondiabetic patients. Throughout all clinical presentations,
Absorb BVS was associated with higher rates of device thrombosis at 3-year
follow-up.<br/>Copyright &#xa9; 2020 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<65>
Accession Number
2013891164
Title
Effectiveness of chlorhexidine in preventing infections among patients
undergoing cardiac surgeries: a meta-analysis and systematic review.
Source
Antimicrobial Resistance and Infection Control. 10(1) (no pagination),
2021. Article Number: 140. Date of Publication: December 2021.
Author
Wei J.; He L.; Weng F.; Huang F.; Teng P.
Institution
(Wei, He, Weng, Huang, Teng) Surgical Intensive Care Unit, The First
Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou
310003, China
Publisher
BioMed Central Ltd
Abstract
Background: Although several meta-analyses reported the impact of
chlorhexidine (CHX) use in patients undergoing various types of surgery,
no meta-analysis summarized the overall effectiveness of CHX specifically
for cardiac surgery. This meta-analysis aimed to examine the impact of CHX
on infections after cardiac surgery compared with other cleansers or
antiseptics. <br/>Method(s): PubMed, Embase, and the Cochrane Library were
searched from inception up to October 2020 for potentially eligible
studies: (1) population: patients who underwent cardiac surgery; (2)
intervention or exposure: any type of CHX use in the treatment or exposed
group; (3) outcome: number of patients with infections; (4) comparison:
placebo or other antiseptic agents; (5) English. The primary outcome was
surgical site infection (SSI). <br/>Result(s): Fourteen studies were
included, with 8235 and 6901 patients in the CHX and control groups. CHX
was not protective against SSI (OR = 0.77, 95% CI: 0.57-1.04, P = 0.090).
CHX was protective for superficial wound infection (OR = 0.42, 95% CI:
0.26-0.70, P = 0.001), but not with deep wound infection (P = 0.509). CHX
was not protective against urinary tract of infection (P = 0.415) but was
protective for bloodstream infection (OR = 0.36, 95% CI: 0.16-0.80, P =
0.012), nosocomial infections (OR = 0.55, 95% CI: 0.44-0.69, P < 0.001),
and pneumonia (OR = 0.26, 95% CI: 0.11-0.61, P = 0.002).
<br/>Conclusion(s): In patients undergoing cardiac surgery, CHX does not
protect against SSI, deep wound infection, and urinary tract infections
but might protect against superficial SSI, bloodstream infection,
nosocomial infections, and pneumonia.<br/>Copyright &#xa9; 2021, The
Author(s).

<66>
Accession Number
2013648627
Title
Trifecta versus perimount bioprosthesis for surgical aortic valve
replacement; systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 36(11) (pp 4335-4342), 2021. Date of
Publication: November 2021.
Author
Yokoyama Y.; Kuno T.; Takagi H.; Fukuhara S.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Fountain Hill, PA, United States
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York City, NY, United States
(Kuno) Department of Cardiology, Montefiore Medical Center/Albert Einstein
Medical College, New York City, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, Michigan, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Recent studies suggested higher rates of early structural valve
degeneration or reintervention for the Trifecta valve compared to other
valves. Thus, we conducted a systematic review and meta-analysis comparing
the outcomes of the Trifecta valve and the Perimount valves in patients
who underwent a surgical aortic valve replacement (SAVR). <br/>Method(s):
All randomized control trials and observational studies which investigated
the outcomes of the Trifecta valve and Perimount valves were identified
with PubMed and EMBASE. The endpoints were the rates of reintervention and
all-cause mortality. Hazard ratios (HRs) for reintervention and all-cause
mortality were combined with the random-effects model. <br/>Result(s): Our
search identified 6 eligible observational studies which enrolled a total
of 11,135 patients who underwent SAVR with either the Trifecta valve (n =
4932) or Perimount (n = 6203). Pooled analyses demonstrated that the
reintervention rates were significantly higher with the Trifecta valve
compared with Perimount valves (HR [95% confidence interval {CI}] = 3.16
[1.83-5.46]; p <.0001; I²= 40%). In contrast, all-cause
mortality was not significantly different between the two groups (HR [95%
CI] = 1.09 [0.75-1.58]; p =.32, I²= 12%). <br/>Conclusion(s):
Our analysis showed that AVR with the Trifecta valve was associated with
higher rates of reintervention compared for that with the Perimount valve.
Although further long-term randomized trials are warranted, surgeons need
to be cautious when choosing a bioprosthetic valve for patients undergoing
SAVR.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<67>
Accession Number
2013600986
Title
In which patients should the Trifecta bioprosthesis be chosen?.
Source
Journal of Cardiac Surgery. 36(11) (pp 4343-4344), 2021. Date of
Publication: November 2021.
Author
Takaseya T.; Takagi K.; Tayama E.
Institution
(Takaseya, Takagi, Tayama) Department of Surgery, Kurume University of
Medicine, Fukuoka, Japan
Publisher
John Wiley and Sons Inc

<68>
Accession Number
2013600436
Title
Harvesting techniques of the saphenous vein graft for coronary artery
bypass: Insights from a network meta-analysis.
Source
Journal of Cardiac Surgery. 36(11) (pp 4369-4375), 2021. Date of
Publication: November 2021.
Author
Yokoyama Y.; Shimamura J.; Takagi H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
PA, United States
(Shimamura) Division of Cardiac Surgery, Department of Surgery, Western
University, London Health Sciences Centre, ON, Canada
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, NY, United States
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: The optimal harvesting technique of saphenous vein (SVG) in
coronary artery bypass grafting (CABG) is still to be elucidated. The
present study aimed to compare the methods of SVG harvesting technique,
which were open vein harvesting (OVH), endoscopic vein harvesting (EVH),
and no-touch vein harvesting (NT), using a network meta-analysis of
randomized controlled trials (RCTs), and propensity-score matched (PSM)
studies. <br/>Method(s): MEDLINE and EMBASE were searched through April
2021 to identify RCTs and PSM studies that investigated the outcomes in
patients who underwent CABG with the SVG using one of three methods; OVH,
EVH, and NT. The outcomes of interest were all-cause mortality, the rates
of revascularization, and graft failure. Risk ratios (RRs) were extracted
for the rates of graft failure, and hazard ratios (HRs) were extracted for
all-cause mortality and the rates of revascularization. <br/>Result(s):
Eligible seven RCT and five PSM studies were identified which enrolled a
total of 8111 patients. All-cause mortality was significantly lower in
patients with EVH compared with OVH (HR [95% confidence interval (CI)]
=0.77 [0.65-0.92], p =.0032). The rates of revascularization were similar
among the groups. The rate of graft failures was significantly lower in
patients with NT compared with OVH (HR [95% CI] =0.54 [0.32-0.90], p
=.019) and with EVH (HR [95% CI] =0.39 [0.17-0.86], p =.023).
<br/>Conclusion(s): NT vein harvesting is favorable for graft patency, and
OVH showed higher all-cause mortality than EVH. Further well-powered RCTs
are needed to confirm our findings.<br/>Copyright &#xa9; 2021 Wiley
Periodicals LLC

<69>
Accession Number
2012319103
Title
The effect of non-point-of-care haemostasis management protocol
implementation in cardiac surgery: A systematic review.
Source
Transfusion Medicine. 31(5) (pp 328-338), 2021. Date of Publication:
October 2021.
Author
Boxma R.P.J.; Garnier R.P.; Bulte C.S.E.; Meesters M.I.
Institution
(Boxma, Garnier, Bulte) Department of Anesthesiology, Amsterdam University
Medical Center, Location VU Medical Center, Amsterdam, Netherlands
(Meesters) Department of Anesthesiology, Catharina Hospital Eindhoven,
Eindhoven, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Objectives: This systematic review aims to outline the evidence on the
implementation of a non-point-of-care (non-point-of-care [POC])
haemostasis management protocol compared to experience-based practice in
adult cardiac surgery. <br/>Background(s): Management of coagulopathy in
cardiac surgery is complex and remains highly variable among centres and
physicians. Although various guidelines recommend the implementation of a
transfusion protocol, the literature on this topic has never been
systematically reviewed. <br/>Method(s): PubMed, Embase, Cochrane Library,
and Web of Science were searched from January 2000 till May 2020.
<br/>Result(s): A total of seven studies (one randomised controlled trial
[RCT], one prospective cohort study, and five retrospective studies) met
the inclusion criteria. Among the six non-randomised, controlled studies,
the risk of bias was determined to be serious to critical, and the one RCT
was determined to have a high risk of bias. Five studies showed a
significant reduction in red blood cells, fresh frozen plasma, and/or
platelet transfusion after the implementation of a structural non-POC
algorithm, ranging from 2% to 28%, 2% to 19.5%, and 7% to17%,
respectively. One study found that fewer patients required transfusion of
any blood component in the protocol group. Another study had reported a
significantly increased transfusion rate of platelet concentrate in the
haemostasis algorithm group. <br/>Conclusion(s): Owing to the high
heterogeneity and a substantial risk of bias of the included studies, no
conclusion can be drawn on the additive value of the implementation of a
cardiac-surgery-specific non-POC transfusion and haemostasis management
algorithm compared to experience-based practice. To define the exact
impact of a transfusion protocol on blood product transfusion, bleeding,
and adverse events, well-designed prospective clinical trials are
required.<br/>Copyright &#xa9; 2021 The Authors. Transfusion Medicine
published by John Wiley & Sons Ltd on behalf of British Blood Transfusion
Society.

<70>
Accession Number
2006858932
Title
The venous thromboembolism prophylaxis in patients receiving thoracic
surgery: A systematic review.
Source
Asia-Pacific Journal of Clinical Oncology. 17(5) (pp e142-e152), 2021.
Date of Publication: October 2021.
Author
Wang Q.; Ding J.; Yang R.
Institution
(Wang, Ding, Yang) Department of Thoracic Surgery, The Affiliated Brain
Hospital of Nanjing Medical University (South Branch, Nanjing Chest
Hospital), Nanjing, China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Venous thromboembolism (VTE) is a significant and preventable
cause of mortality and morbidity in thoracic surgery. It usually deep
venous thromboembolism (DVT) and pulmonary thromboembolism (PE). We
conducted this article to perform a systematic review on prophylaxis of
perioperative VTE in patients undergoing thoracic surgery especially lung
surgery and esophageal surgery and to identify potential areas for future
research. <br/>Method(s): The systematic review we conducted included
studies of patients undergoing thoracic surgery especially lung surgery
and esophageal surgery. <br/>Result(s): The study identified 2621
references. Finally, 22 trials with a total of 9072 patients were
included. Only six studies declared that they continued a follow-up after
the discharge of the patients. (range: 1-3 months); three studies reported
on major bleeding events as an outcome measure, and the incidence varied
from 0.8% to 1.6%. Total 346 VTEs occurred, and the overall mean risk of
VTE was estimated at 3.8% (range: 0.77-27%). <br/>Conclusion(s): The
evidence for using thromboprophylaxis in thoracic surgery is limited and
controversial, predominantly based on clinical consensus. Future research
is needed to focus on identifying risk of VTE and providing sufficient
evidence with high quality to support clinical strategies concerning the
prophylaxis for VTE.<br/>Copyright &#xa9; 2020 John Wiley & Sons
Australia, Ltd

<71>
Accession Number
2014999807
Title
Right Ventricular-Pulmonary Arterial Coupling in Patients With HF
Secondary MR: Analysis From the COAPT Trial.
Source
JACC: Cardiovascular Interventions. 14(20) (pp 2231-2242), 2021. Date of
Publication: 25 Oct 2021.
Author
Brener M.I.; Grayburn P.; Lindenfeld J.; Burkhoff D.; Liu M.; Zhou Z.; Alu
M.C.; Medvedofsky D.A.; Asch F.M.; Weissman N.J.; Bax J.; Abraham W.; Mack
M.J.; Stone G.W.; Hahn R.T.
Institution
(Brener, Burkhoff, Hahn) Division of Cardiology, Columbia University
Irving Medical Center, New York, NY, United States
(Grayburn) Baylor Heart and Vascular Institute, Baylor University Medical
Center, Dallas, TX, United States
(Lindenfeld) Vanderbilt Heart and Vascular Institute, Vanderbilt
University Medical Center, Nashville, TN, United States
(Burkhoff, Liu, Zhou, Alu, Stone) Cardiovascular Research Foundation, New
York, New York, United States
(Medvedofsky, Asch, Weissman) Cardiovascular Core Laboratory, MedStar
Health Research Institute, Washington, DC, United States
(Bax) Heart Lung Center, Leiden University Medical Center, Leiden,
Netherlands
(Abraham) Davis Heart and Lung Research Institute, The Ohio State
University Medical Center, Columbus, OH, United States
(Mack) Baylor Scott & White Heart and Vascular Hospital, 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: The aim of this study was to determine the prognostic impact
of right ventricular (RV)-pulmonary arterial (PA) coupling in patients
with heart failure (HF) with severe secondary mitral regurgitation (SMR)
enrolled in the COAPT (Cardiovascular Outcomes Assessment of the MitraClip
Percutaneous Therapy for Heart Failure Patients With Functional Mitral
Regurgitation) trial. <br/>Background(s): RV contractile function and PA
pressures influence outcomes in patients with SMR, but the impact of RV-PA
coupling in patients randomized to transcatheter edge-to-edge repair
(TEER) vs guideline-directed medical therapy (GDMT) is unknown.
<br/>Method(s): RV-PA coupling was assessed by the ratio of RV free wall
longitudinal strain derived from speckle-tracking echocardiography and
noninvasively measured RV systolic pressure. Advanced RV-PA uncoupling was
defined as RV free wall longitudinal strain/RV systolic pressure <=0.5%/mm
Hg. The primary endpoint was a composite of all-cause mortality or HF
hospitalization at 24-month follow-up. <br/>Result(s): A total of 372
patients underwent speckle-tracking echocardiography, and 70.2% had
advanced RV-PA uncoupling. By multivariable analysis, advanced RV-PA
uncoupling was strongly associated with an increased risk for the primary
24-month endpoint of death or HF hospitalization (HR: 1.87; 95% CI:
1.31-2.66; P = 0.0005). A similar association was present for all-cause
mortality alone (HR: 2.57; 95% CI: 1.54-4.29; P = 0.0003). The impact of
RV-PA uncoupling was consistent in patients randomized to TEER and GDMT
alone. Compared with GDMT alone, the addition of TEER improved 2-year
outcomes in patients with (48.0% vs 74.8%; HR: 0.51; 95% CI: 0.37-0.71)
and those without (28.8% vs 47.8%; HR: 0.51; 95% CI: 0.27-0.97) advanced
RV-PA uncoupling (P<inf>interaction</inf> = 0.98). <br/>Conclusion(s): In
the COAPT trial, advanced RV dysfunction assessed by RV-PA uncoupling was
a powerful predictor of 2-year adverse outcomes in patients with HF and
SMR. (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous
Therapy for Heart Failure Patients With Functional Mitral Regurgitation
[The COAPT Trial]; NCT01626079)<br/>Copyright &#xa9; 2021 American College
of Cardiology Foundation

<72>
Accession Number
2013939989
Title
Late health outcomes after dexrazoxane treatment: A report from the
Children's Oncology Group.
Source
Cancer. (no pagination), 2021. Date of Publication: 2021.
Author
Chow E.J.; Aplenc R.; Vrooman L.M.; Doody D.R.; Huang Y.-S.V.; Aggarwal
S.; Armenian S.H.; Baker K.S.; Bhatia S.; Constine L.S.; Freyer D.R.; Kopp
L.M.; Leisenring W.M.; Asselin B.L.; Schwartz C.L.; Lipshultz S.E.
Institution
(Chow, Doody, Baker, Leisenring) Fred Hutchinson Cancer Research Center,
Seattle Children's Hospital, Seattle, WA, United States
(Aplenc, Huang) Children's Hospital of Philadelphia, Philadelphia, PA,
United States
(Vrooman) Dana-Farber Cancer Institute, Boston Children's Hospital,
Boston, MA, United States
(Aggarwal) Wayne State University, Detroit, MI, United States
(Armenian) City of Hope, Duarte, CA, United States
(Bhatia) University of Alabama at Birmingham, Birmingham, AL, United
States
(Constine, Asselin) Golisano Children's Hospital, University of Rochester
Medical Center, Rochester, NY, United States
(Freyer) Children's Hospital Los Angeles, University of Southern
California, Los Angeles, CA, United States
(Kopp) University of Arizona, Tucson, AZ, United States
(Schwartz) Children's Wisconsin, Medical College of Wisconsin, Milwaukee,
WI, United States
(Lipshultz) Oishei Children's Hospital, Roswell Park Comprehensive Center,
University at Buffalo Jacobs School of Medicine and Biomedical Sciences,
Buffalo, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The objective of this study was to examine long-term outcomes
among children newly diagnosed with cancer who were treated in
dexrazoxane-containing clinical trials. <br/>Method(s): P9404 (acute
lymphoblastic leukemia/lymphoma [ALL]), P9425 and P9426 (Hodgkin
lymphoma), P9754 (osteosarcoma), and Dana-Farber Cancer Institute 95-01
(ALL) enrolled 1308 patients between 1996 and 2001: 1066 were randomized
(1:1) to doxorubicin with or without dexrazoxane, and 242 (from P9754)
were nonrandomly assigned to receive dexrazoxane. Trial data were linked
with the National Death Index, the Organ Procurement and Transplantation
Network, the Pediatric Health Information System (PHIS), and Medicaid.
Osteosarcoma survivors from the Childhood Cancer Survivor Study (CCSS; n =
495; no dexrazoxane) served as comparators in subanalyses. Follow-up
events were assessed with cumulative incidence, Cox regression, and
Fine-Gray methods. <br/>Result(s): In randomized trials (cumulative
prescribed doxorubicin dose, 100-360 mg/m²; median follow-up,
18.6 years), dexrazoxane was not associated with relapse (hazard ratio
[HR], 0.84; 95% confidence interval [CI], 0.63-1.13), second cancers (HR,
1.19; 95% CI, 0.62-2.30), all-cause mortality (HR, 1.07; 95% CI,
0.78-1.47), or cardiovascular mortality (HR, 1.45; 95% CI, 0.41-5.16).
Among P9754 patients (all exposed to dexrazoxane; cumulative doxorubicin,
450-600 mg/m²; median follow-up, 16.6-18.4 years), no
cardiovascular deaths or heart transplantation occurred. The 20-year heart
transplantation rate among CCSS osteosarcoma survivors (mean doxorubicin,
377 +/- 145 mg/m²) was 1.6% (vs 0% in P9754; P =.13). Among
randomized patients, serious cardiovascular outcomes (cardiomyopathy,
ischemic heart disease, and stroke) ascertained by PHIS/Medicaid occurred
less commonly with dexrazoxane (5.6%) than without it (17.6%; P =.02),
although cardiomyopathy rates alone did not differ (4.4% vs 8.1%; P =.35).
<br/>Conclusion(s): Dexrazoxane did not appear to adversely affect
long-term mortality, event-free survival, or second cancer
risk.<br/>Copyright &#xa9; 2021 American Cancer Society