EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2015524156
Title
Cardiac troponin and infective endocarditis prognosis: A systematic review
and meta-analysis.
Source
European Heart Journal: Acute Cardiovascular Care. 10(3) (pp 356-366),
2021. Date of Publication: 01 Mar 2021.
Author
Postigo A.; Vernooij R.W.M.; Fernandez-Aviles F.; Martinez-Selles M.
Institution
(Postigo, Fernandez-Aviles, Martinez-Selles) Department of Cardiology,
Hospital General Universitario Gregorio Maranon, Madrid, Spain
(Postigo, Fernandez-Aviles, Martinez-Selles) Instituto de Investigacion
Sanitaria Gregorio Maranon, Madrid, Spain
(Postigo, Fernandez-Aviles, Martinez-Selles) Facultad de Medicina,
Universidad Complutense, Madrid, Spain
(Postigo, Fernandez-Aviles, Martinez-Selles) CIBERCV, Madrid, Spain
(Vernooij) Department of Nephrology and Hypertension, University Medical
Center Utrecht, Utrecht, Netherlands
(Vernooij) Julius Center for Health Sciences and Primary Care, University
Medical Center Utrecht, Utrecht, Netherlands
(Martinez-Selles) Facultad de Ciencias Biomedicas, Universidad Europea,
Madrid, Spain
Publisher
Oxford University Press
Abstract
Aims: Infective endocarditis (IE) is associated with high mortality and
morbidity. Cardiac troponin (Tn) elevation seems to be common in patients
with IE and could be associated with a poor prognosis. The aim of this
study was to synthesize the prognostic value of Tn in patients with IE.
<br/>Methods and Results: We searched in MEDLINE, EMBASE, and the Cochrane
library, including the Cochrane Central Register of Controlled Trials
(CENTRAL) until February 2020. Observational studies reporting on the
association between Tn and in-hospital and 1-year mortality, and IE
complications were considered eligible. As each centre uses different
conventional or ultra-sensitive Tn, with different normality threshold, we
considered them as normal or elevated according to the criteria specified
in each article. Articles were systematically selected, assessed for bias,
and, when possible, meta-analysed using a random effect model. After
retrieving 542 articles, 18 were included for qualitative synthesis and 9
for quantitative meta-analysis. Compared with patients with normal Tn
levels, patients with Tn elevation presented higher in-hospital mortality
[odds ratio (OR) 5.96, 95% confidence interval (CI) 3.46-10.26; P <
0.0001], 1-year mortality (OR 2.67, 95% CI 1.42-5.02; P = 0.002), and
surgery rates (OR 2.34, 95% CI 1.42-3.85; P = 0.0008). They also suffered
more frequent complications: Central nervous system events (OR 8.85, 95%
CI 3.23-24.26; P < 0.0001) and cardiac abscesses (OR 4.96, 95% CI
1.94-12.70; P = 0.0008). <br/>Conclusion(s): Tn elevation is associated
with a poor prognosis in patients with IE. Troponin determination seems to
provide additional help in the prognostic assessment of these
patients.<br/>Copyright &#xa9; 2021 Published on behalf of the European
Society of Cardiology. All rights reserved.

<2>
Accession Number
2015524126
Title
The value of urinary sodium assessment in acute heart failure.
Source
European Heart Journal: Acute Cardiovascular Care. 10(2) (pp 216-223),
2021. Date of Publication: 01 Feb 2021.
Author
Tersalvi G.; Dauw J.; Gasperetti A.; Winterton D.; Cioffi G.M.; Scopigni
F.; Pedrazzini G.; Mullens W.
Institution
(Tersalvi, Cioffi, Scopigni, Pedrazzini) Department of Cardiology,
Fondazione Cardiocentro Ticino, Via Tesserete 48, Lugano 6900, Switzerland
(Tersalvi, Dauw, Mullens) Department of Cardiology, Ziekenhuis
Oost-Limburg, Genk, Belgium
(Dauw) Doctoral School for Medicine and Life Sciences, Hasselt University,
Diepenbeek, Belgium
(Gasperetti) Centro Cardiologico Monzino, IRCCS, Milan, Italy
(Winterton) Department of Anesthesia and Intensive Care Medicine, ASST
Monza, Monza, Italy
(Cioffi) Department of Cardiology, Kantonsspital Luzern, Lucerne,
Switzerland
(Pedrazzini) Department of Biomedical Sciences, University of Italian
Switzerland, Lugano, Switzerland
(Mullens) Biomedical Research Institute, Faculty of Medicine and Life
Sciences, LCRC, Hasselt University, Diepenbeek, Belgium
Publisher
Oxford University Press
Abstract
Acute heart failure (AHF) is a frequent medical condition that needs
immediate evaluation and appropriate treatment. Patients with signs and
symptoms of volume overload mostly require intravenous loop diuretics in
the first hours of hospitalization. Some patients may develop diuretic
resistance, resulting in insufficient and delayed decongestion, with
increased mortality and morbidity. Urinary sodium measurement at baseline
and/or during treatment has been proposed as a useful parameter to tailor
diuretic therapy in these patients. This systematic review discusses the
current sum of evidence regarding urinary sodium assessment to evaluate
diuretic efficacy in AHF. We searched Medline, Embase, and Cochrane
Clinical Trials Register for published studies that tested urinary sodium
assessment in patients with AHF.<br/>Copyright &#xa9; 2020 Published on
behalf of the European Society of Cardiology. All rights reserved.

<3>
Accession Number
2015474460
Title
A clinical trial comparing complete revascularization at the time of
primary percutaneous coronary intervention versus during the index
hospital admission in patients with multi-vessel coronary artery disease
and ST-elevation myocardial infarction uncomplicated by cardiogenic shock.
Source
Anatolian Journal of Cardiology. 25(11) (pp 781-788), 2021. Date of
Publication: November 2021.
Author
Nichita-Brendea M.T.; Popescu M.I.; Popa V.; Carmen P.C.D.
Institution
(Nichita-Brendea, Popescu, Popa, Carmen) Department of Cardiology,
Emergency Clinical County Hospital, Oradea, Romania
(Popescu, Carmen) Department of Medical Disciplines, Faculty of Medicine
and Pharmacology, University of Oradea, Oradea, Romania
Publisher
Turkish Society of Cardiology
Abstract
Objective: In this study, we aimed to compare major adverse cardiac and
cerebrovascular events (MACCE), defined as a composite of death, stroke,
myocardial infarction and symptom-induced revascularization, and mortality
within one year of randomization between two strategies; complete
revascularization including non-culprit lesions percutaneous coronary
intervention (PCI) during primary PCI (PPCI) versus complete
revascularization during the same hospital admission in patients with
multi-vascular coronary artery disease (MVD) presenting with ST-elevation
myocardial infarction (STEMI) uncomplicated by cardiogenic shock.
<br/>Method(s): We randomized in a 1:1 manner 100 patients with MVD and
STEMI uncomplicated by cardiogenic shock who had undergone successful
culprit-lesion PCI to either a strategy of complete revascularization with
PCI of angiographically significant non-culprit lesions in the index PPCI
procedure or to a strategy of complete revascularization during a second
procedure that took place during the same hospital admission.
<br/>Result(s): The first primary outcome was death within a timeframe of
one year and the second a composite of MACCE within a year following
complete revascularization. Of the total number of patients monitored, 4%
in each of the two groups was associated with the first primary outcome
(p=0.984) and the second primary outcome in 6% (p=0.970). There was no
statistical difference between outcomes in the two groups.
<br/>Conclusion(s): Among patients with MVD and STEMI uncomplicated by
cardiogenic shock, there was no difference regarding outcomes when using a
strategy of complete revascularization of non-culprit lesions during PPCI
or the same hospital admission.<br/>&#xa9;Copyright 2021 by Turkish
Society of Cardiology

<4>
Accession Number
2015427957
Title
Progress of research in postoperative cognitive dysfunction in cardiac
surgery patients: A review article.
Source
International Journal of Surgery. 95 (no pagination), 2021. Article
Number: 106163. Date of Publication: November 2021.
Author
Bhushan S.; Li Y.; Huang X.; Cheng H.; Gao K.; Xiao Z.
Institution
(Bhushan, Li, Cheng, Gao, Xiao) Department of Cardiothoracic Surgery,
Chengdu Second People's Hospital, Chengdu, Sichuan 610017, China
(Huang) Department of Anesthesiology, West China Hospital of Medicine,
Sichuan University, Sichuan 610017, China
Publisher
Elsevier Ltd
Abstract
Background: Postoperative cognitive dysfunction (POCD) is a common
complication of central nervous system in middle-aged and elderly patients
after cardiac surgery. The purpose of this study was to review the
progress in diagnosis, pathogenesis and risk factors and control strategy
of POCD. <br/>Method(s): A systematic literature search was conducted
using Pubmed and EMBASE, using the Mesh terms and key words "POCD",
"diagnostic criteria", "pathogenesis", "influencing factors" and
"prevention strategies". Studies were retained for review after meeting
strict inclusion criteria that included only prospective studies
evaluating risk factors for POCD in patients who had elective cardiac
surgery. Diagnosis of POCD needed to be confirmed using the Diagnostic and
Statistical Manual of Montreal Cognitive Assessment (MoCA) Scale and other
criteria. <br/>Result(s): "Twenty two articles were selected for
inclusion. The incidence of POCD across the studies ranged from 9% to 54%.
Multiple factors have been associated with the pathogenesis and increased
risk of POCD, including neuroinflammation, dysfunction of cholinergic
system, abnormal protein function (beta-amyloid), old age, anesthetic,
surgical and other factors." <br/>Conclusion(s): POCD is a common
complication after cardiac surgery in elderly. The highest POCD incidence
was observed after open aortic, TAVI and CABG surgery. Age, cognitive
function, depression, CPB and anesthetic use are leading risk factors.
Further research is needed in determining interventions that will be
effective in preventing and treating POCD in cardiac surgical
setting.<br/>Copyright &#xa9; 2021 IJS Publishing Group Ltd

<5>
Accession Number
2014183298
Title
Effect of spironolactone use in pulmonary arterial hypertension - analysis
from pivotal trial databases.
Source
Pulmonary Circulation. 11(4) (no pagination), 2021. Date of Publication:
2021.
Author
Safdar Z.; Cho E.
Institution
(Safdar) Pulmonary Hypertension Center at Houston Methodist Lung Center,
Houston Methodist Hospital, Weill Cornell College of Medicine, Houston,
TX, United States
(Cho) United Therapeutics Corporation, Research Triangle Park, NC, United
States
(Cho) Department of Statistics, NC State University, Raleigh, NC, United
States
Publisher
John Wiley and Sons Inc
Abstract
Spironolactone, a common diuretic used in the treatment of pulmonary
arterial hypertension (PAH), improves cardiopulmonary hemodynamics by
attenuating the adverse effects of hyperaldosteronism on endothelin type-B
receptor function within pulmonary endothelial cells. Spironolactone has
demonstrated vascular remodeling properties and reduced all-cause
mortality in patients with severe heart failure. Despite widespread use,
however, its effect on morbidity and mortality in PAH has not been fully
explored. A large cohort of PAH patients from a harmonized dataset from
four pivotal trials were analyzed to characterize the patient population
and outcomes associated with spironolactone treatment. Of 1229 evaluable
patients, 74% were female, mean age of 47 +/- 15 years, baseline
six-minute walk distance (6MWD) 345 +/- 74 m and 75% were World health
Organization (WHO) functional class (FC) III/IV. Of the patients receiving
spironolactone, 43% were on subcutaneous treprostinil, compared to 29.9%
of those patients who were not receiving spironolactone. Long-term
spironolactone-treated PAH patients were older (p = 0.01), had lower
baseline 6MWD (p = 0.01) and cardiac index (p < 0.01), higher baseline
Borg dyspnea score (p = 0.01), WHO functional class, and right arterial
pressure (p < 0.01). Additionally, spironolactone-treated patients tended
to have higher hazard of clinical worsening (p < 0.01). A propensity
analysis was performed and when controlled for disease severity, revealed
that spironolactone-treated patients did not demonstrate improved outcomes
in terms of survival and clinical worsening. Across studies, the current
analysis has demonstrated that the actions of spironolactone within the
context of the PAH disease process may differ from its action in CHF
patients. Despite reported outcomes of spironolactone use in patients with
left heart disease, these findings may not translate to right heart
failure and pulmonary vascular pathology, as similar outcomes have not
necessarily been recognized in the PAH patient population. Future studies
are needed to explore these findings further.<br/>Copyright &#xa9; The
Author(s) 2021.

<6>
Accession Number
2013195490
Title
Management of Extensive Aorto-Iliac Disease: A Systematic Review and
Meta-Analysis of 9319 Patients.
Source
CardioVascular and Interventional Radiology. 44(10) (pp 1518-1535), 2021.
Date of Publication: October 2021.
Author
Salem M.; Hosny M.S.; Francia F.; Sallam M.; Saratzis A.; Saha P.; Patel
S.; Abisi S.; Zayed H.
Institution
(Salem) Department of Vascular Surgery, Queens Medical Centre, Nottingham
University Hospitals NHS Foundation Trust, Nottingham NG7 2UH, United
Kingdom
(Hosny, Francia, Sallam, Saha, Patel, Abisi, Zayed) Department of Vascular
Surgery, Level 1 North Wing, Guys & St Thomas' NHS Foundation Trust, St
Thomas' Hospital, Westminster Bridge Rd, London SE1 7EH, United Kingdom
(Saratzis) Leicester Biomedical Research Centre (BRC), Leicester Vascular
Institute and National Institute for Health Research (NIHR), Leicester,
United Kingdom
Publisher
Springer
Abstract
Purpose: Despite advances in endovascular management of aorto-iliac
occlusive disease (AIOD) including covered endovascular reconstruction of
aortic bifurcation (CERAB) techniques, guidelines for management of
symptomatic Trans-Atlantic Inter-Society Consensus (TASC II) type C/D
lesions favour open surgical revascularisation. This meta-analysis
investigates outcomes in patients with TASC II C/D lesions treated with
open bypass procedures (OS), standard endovascular treatments (SEV) or
CERAB. <br/>Method(s): Multiple databases (MEDLINE, EMBASE and the
Cochrane database) were searched to identify studies reporting
endovascular and open treatment of extensive AIOD. Studies were
independently assessed. Outcomes reported included 30-day
morbidity/mortality and patency rates. <br/>Result(s): A total of 9319
patients undergoing intervention for extensive AIOD were identified from
66 studies. Median patient age was 64 years (n = 3204) for SEV, 58 years
(n = 240) for CERAB and 59 years for OS (n = 5875). Pooled meta-analysis
for 30-day morbidity in patients undergoing SEV, CERAB and OS was 9, 10
and 15%, respectively. Thirty-day mortality rate was 0.79, 0 and 3% in the
SEV, CERAB and OS groups, respectively. In these groups, one-year primary
and secondary patency was 90, 88, 96 and 96, 97, and 97% whilst three-year
primary and secondary patency was 78, 82, 93 and 93, 97, 97% respectively.
Five-year primary and secondary patency was 71 and 89% for SEV and 88 and
95% for OS, respectively. CERAB data were only available to 3 years.
<br/>Conclusion(s): This meta-analysis shows that thirty-day morbidity and
mortality favours endovascular techniques. Primary patency remains better
with OS in both early and midterms;; however, secondary patency is
comparable in all groups. These findings suggest that SEV/CERAB may be
considered as an alternative to OS in higher-risk patients.<br/>Copyright
&#xa9; 2021, Springer Science+Business Media, LLC, part of Springer Nature
and the Cardiovascular and Interventional Radiological Society of Europe
(CIRSE).

<7>
Accession Number
2012847065
Title
A Pseudocoarctation of the Aorta With a Left Subclavian Artery Aneurysm, A
Case Report and A Review of the Literature.
Source
Vascular and Endovascular Surgery. 55(8) (pp 889-896), 2021. Date of
Publication: November 2021.
Author
Arikan A.A.; Omay O.; Cakir O.; Cesur S.; Cardakozu T.; Durmaz A.; Kucuk
B.; Kanko M.
Institution
(Arikan, Omay, Durmaz, Kucuk, Kanko) Department of Cardiovascular Surgery,
Kocaeli University Medical Faculty, Kocaeli, Turkey
(Cakir) Department of Radiology, Kocaeli University Medical Faculty,
Kocaeli, Turkey
(Cesur, Cardakozu) Department of Anesthesiology and Reanimation, Kocaeli
University Medical Faculty, Kocaeli, Turkey
Publisher
SAGE Publications Inc.
Abstract
Here we present a 47-year-old male diagnosed with a pseudocoarctation of
the aorta and a funnel-like subclavian artery aneurysm with a large
orifice and severe aortic valve insufficiency. The patient underwent a
two-stage repair for both pathologies. After an aortic valve replacement,
postcardiotomy pericardial effusion occurred and was medically managed.
Six months later, the patient underwent a distal arcus aorta and
subclavian artery replacement with a left posterolateral thoracotomy as
the second stage. Due to the strict adhesions, pulmonary veins were not
cannulated and an extracorporeal bypass between the pulmonary artery and
femoral artery was used for distal body perfusion. The coincidence of
subclavian aneurysms and a pseudocoarctation of the aorta is rare and a
literature review was performed to identify treatment options for this
pathology.<br/>Copyright &#xa9; The Author(s) 2021.

<8>
Accession Number
2011842516
Title
Clinical outcomes of complete versus incomplete revascularization in
patients treated with coronary artery bypass grafting: Insights from the
TiCAB trial.
Source
European Journal of Cardio-thoracic Surgery. 59(2) (pp 417-425), 2021.
Date of Publication: 01 Feb 2021.
Author
Schaefer A.; Conradi L.; Schneeberger Y.; Reichenspurner H.; Sandner S.;
Tebbe U.; Nowak B.; Stritzke J.; Kastrati A.; Schunkert H.; Scheidt M.V.
Institution
(Schaefer, Conradi, Schneeberger, Reichenspurner) Department of
Cardiovascular Surgery, University Heart and Vascular Center Hamburg,
Hamburg, Germany
(Sandner) Division of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Tebbe) Department of Cardiology, Angiology, and Intensive Care Medicine,
District Hospital Lippe-Detmold, Detmold, Germany
(Nowak) CCB, Cardiovascular Center Bethanien, Frankfurt am Main, Germany
(Stritzke) Lanserhof Sylt, Marienstein Privatklinik, List, Germany
(Kastrati, Schunkert, Scheidt) Department of Cardiology, Deutsches
Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany
(Kastrati, Schunkert, Scheidt) DZHK (German Center for Cardiovascular
Research), Partner Site Munich Heart Alliance, Munich, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: In this post hoc analysis of the Ticagrelor in coronary artery
bypass grafting (CABG) trial, we aimed to analyse patients treated with
CABG receiving either complete revascularization (CR) or incomplete
revascularization (ICR) independent from random allocation to either
ticagrelor or aspirin. <br/>Method(s): Of 1859 patients enrolled in the
Ticagrelor in CABG trial, 1550 patients (83.4%) received CR and 309
patients (16.6%) ICR. Outcomes were evaluated regarding all-cause
mortality, cardiovascular death, myocardial infarction (MI), repeat
revascularization, stroke and bleeding within 12 months after CABG.
<br/>Result(s): Baseline parameters revealed significant differences
regarding clinical presentation (stable angina pectoris: CR 68.9% vs ICR
71.2%, instable angina pectoris: 14.1% vs 7.8%, non-ST elevation MI: 17.0%
vs 21.0%, P <= 0.01), lesion characteristics (chronic total occlusion: CR
91.3% vs ICR 96.8%, P <= 0.01), operative technique [off-pump coronary
artery bypass surgery (OPCAB): CR 3.0% vs ICR 6.1%, P <= 0.01] and number
of utilized grafts (total number of grafts: 2.69/patient vs 2.49/patient,
P <= 0.001). ICR patients displayed a significantly increased risk of
repeat revascularization [hazard ratio (HR) 1.91, 95% confidence interval
(CI) 1.16-3.16; P < 0.01] and percutaneous coronary intervention (HR 1.95,
95% CI 1.13-3.35; P < 0.05) within 12 months after CABG. Higher risk for
repeat revascularization in ICR patients was independent from random
allocation to either ticagrelor or aspirin and persisted after adjustment
for baseline imbalances. <br/>Conclusion(s): Patients with ICR presented
more stable at the time of admission, but received less grafts, highly
likely due to a higher rate of chronic total occlusion lesions and
performed OPCAB. Although mortality presented no difference between
groups, our results suggest that patients benefit from CR with regard to
prevention of repeat revascularization.<br/>Copyright &#xa9; 2020 The
Author(s).

<9>
Accession Number
2011842499
Title
Treatment strategies in ischaemic left ventricular dysfunction: A network
meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 59(2) (pp 293-301), 2021.
Date of Publication: 01 Feb 2021.
Author
Gaudino M.; Hameed I.; Khan F.M.; Tam D.Y.; Rahouma M.; Yongle R.; Naik
A.; Di Franco A.; Demetres M.; Petrie M.C.; Jolicoeur E.M.; Girardi L.N.;
Fremes S.E.
Institution
(Gaudino, Hameed, Khan, Rahouma, Yongle, Naik, Di Franco, Girardi)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York,
NY, United States
(Tam, Fremes) Schulich Heart Centre, Sunnybrook Health Science University
of Toronto, Toronto, ON, Canada
(Demetres) Samuel J. Wood Library, C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
(Petrie) Institute of Cardiovascular and Medical Sciences, British Heart
Foundation Glasgow Cardiovascular Research Centre, University of Glasgow,
Glasgow, United Kingdom
(Jolicoeur) Montreal Heart Institute, Montreal, QC, Canada
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: The optimal revascularization strategy for patients with
ischaemic left ventricular systolic dysfunction (iLVSD) remains
controversial. We aimed to compare percutaneous coronary intervention
(PCI), coronary artery bypass grafting (CABG) and medical therapy (MT) in
a network meta-analysis. <br/>Method(s): All randomized controlled trials
and observational studies comparing any combination of PCI, CABG and MT in
patients with iLVSD were analysed in a frequentist network meta-analysis
(generic inverse variance method). Primary outcome was mortality at
longest available follow-up. Secondary outcomes were cardiac death,
stroke, myocardial infarction (MI) and repeat revascularization (RR).
<br/>Result(s): Twenty-three studies were included (n = 23 633; 4
randomized controlled trials). Compared to CABG, PCI was associated with
higher mortality [incidence rate ratio (IRR) 1.32, 95% confidence interval
(CI) 1.13-1.53], cardiac death (IRR 1.65, 95% CI 1.18-2.33), MI (IRR 2.18,
95% CI 1.70-2.80) and RR (IRR 3.75, 95% CI 2.89-4.85). Compared to CABG,
MT was associated with higher mortality (IRR 1.52, 95% CI 1.26-1.84),
cardiac death (IRR 3.83, 95% CI 2.12-6.91), MI (IRR 3.22, 95% CI
1.52-6.79) and RR (IRR 3.37, 95% CI 1.67-6.79). Compared to MT, PCI was
associated with lower cardiac death (IRR 0.43, 95% CI 0.24-0.78). CABG
ranked as the best revascularization strategy for mortality, cardiac
death, MI and RR; MT ranked as the strategy associated with the lowest
incidence of stroke. Left ventricular ejection fraction, year of study,
use of drug-eluting stents did not affect relative treatment effects.
<br/>Conclusion(s): CABG appears to be the best therapy for iLVSD,
although mainly based on observational data. Definitive randomized
controlled trials comparing CABG and PCI in iLVSD are
required.<br/>Copyright &#xa9; 2020 The Author(s).

<10>
Accession Number
2007038288
Title
Outcomes in non-ST-segment elevation myocardial infarction patients
according to heart failure at admission: Insights from a large trial with
systematic early invasive strategy.
Source
European Heart Journal: Acute Cardiovascular Care. 10(7) (pp 736-745),
2021. Date of Publication: 01 Sep 2021.
Author
Popovic B.; Sorbets E.; Abtan J.; Cohen M.; Pollack C.V.; Bode C.; Wiviott
S.D.; Sabatine M.S.; Mehta S.R.; Ruzyllo W.; Rao S.V.; French W.J.; Kerkar
P.; Kiss R.G.; Estrada J.L.N.; Elbez Y.; Ducrocq G.; Steg P.G.
Institution
(Popovic) Universite de Lorraine, CHRU de Nancy, Departement de
Cardiologie, Nancy, France
(Sorbets) Universite de Paris, Puis APHP, Hotel Dieu, Centre de Diagnostic
et de Therapeutique; French Alliance for Cardiovascular Trials (FACT),
INSERM LVTS-U1148, France
(Abtan, Elbez, Ducrocq, Steg) APHP, Department of Cardiology, Hopital
Bichat, France
(Cohen) Division of Cardiology, Newark Beth Israel Medical Center, Mount
Sinai School of Medicine, Newark, NJ, United States
(Pollack) Department of Emergency Medicine, Thomas Jefferson University
Hospital, Philadelphia, United States
(Pollack) Sidney Kimmel Medical College, United States
(Bode) Medizinische Universitatsklinik, Freiburg, Germany
(Wiviott, Sabatine) Brigham and Women's Hospital, Harvard Medical School,
Boston, MA, United States
(Mehta) McMaster University and the Population Health Research Institute,
Hamilton Health Sciences, Hamilton, ON, Canada
(Ruzyllo) Institute of Cardiology, Warsaw, Poland
(Rao) The Duke Clinical Research Institute, Durham, NC, United States
(French) David Geffen School of Medicine at UCLA, Torrance, CA, United
States
(Kerkar) Seth GS Medical College, India
(Kerkar) KEM Hospital Parel, India
(Kiss) Department of Cardiology, Military Hospital, Budapest, Hungary
(Estrada) Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
(Steg) NHLI Imperial College, ICMS Royal Brompton Hospital London, United
Kingdom
(Abtan, Ducrocq, Steg) French Alliance for Cardiovascular Trials (FACT),
INSERM LVTS-U1148, DHU FIRE, University of Paris, France
Publisher
Oxford University Press
Abstract
Background: Previous studies published before the era of systematic early
invasive strategy have reported a higher mortality in non-ST-segment
elevation myocardial infarction patients with heart failure. The aim of
our study was to compare the clinical characteristics, outcomes and causes
of death of patients according to their heart failure status at admission
in a large non-ST-segment elevation myocardial infarction population with
planned early invasive management. <br/>Method(s): We performed a post-hoc
analysis of the Treatment of Acute Coronary Syndrome with Otamixaban
randomised trial which included non-ST-segment elevation myocardial
infarction patients with systematic coronary angiography within 72 h.
Patients were categorised according to presence or absence of heart
failure (Killip grade >=2) at admission. <br/>Result(s): A total of 13,172
patients were enrolled, of whom 944 (7.2%) had heart failure. At day 30,
death occurred in 213 patients (1.6%) and cardiovascular death was the
dominant cause of death in both groups ((with vs without heart failure)
78.8% vs 78.4%, p = 0.94). At six months, death occurred in 90/944 (9.5%)
patients with heart failure and 258/12228 patients without heart failure
(2.1%) (p < 0.001). After adjustment on Global Registry of Acute Coronary
Events risk score, heart failure was an independent predictor of all-cause
mortality at day 30 (odds ratio: 1.58; 95% confidence interval, 1.06-2.36,
p = 0.02) and at day 180 (odds ratio: 1.77; 95% confidence interval,
1.3-2.42, p < 0.001) as well as of ischaemic complications (cardiovascular
death, myocardial infarction, stent thrombosis or stroke at day 30 (odds
ratio: 1.28; 95% confidence interval, 1.01-1.62, p = 0.04).
<br/>Conclusion(s): Non-ST-segment elevation myocardial infarction
patients with heart failure at admission still have worse outcomes than
those without heart failure, even with systematic early invasive strategy.
Further efforts are needed to improve the prognosis of these high risk
patients.<br/>Copyright &#xa9; 2020 Published on behalf of the European
Society of Cardiology. All rights reserved.

<11>
Accession Number
2003522934
Title
Efficacy and safety of vorapaxar for secondary prevention in low body
weight in patients with atherosclerosis: Analyses from the TRA
2degreeP-TIMI 50 Trial.
Source
European Heart Journal: Acute Cardiovascular Care. 10(2) (pp 190-199),
2021. Date of Publication: 01 Feb 2021.
Author
Xu H.; Bonaca M.P.; Goodrich E.; Scirica B.M.; Morrow D.A.
Institution
(Xu, Bonaca, Goodrich, Scirica, Morrow) TIMI Study Group, Brigham and
Women's Hospital, 350 Longwood Avenue, 1st office floor, Boston, MA 02115,
United States
Publisher
Oxford University Press
Abstract
Background: Vorapaxar inhibits the thrombin-mediated activation of
platelets, reduces thrombotic events in patients with myocardial
infarction or peripheral arterial disease while increasing bleeding. In
the TRA 2degreeP-TIMI 50 trial, we observed a nominally significant
interaction between low body weight and the reduced efficacy of vorapaxar.
<br/>Method(s): We investigated the relationship between body weight and
the efficacy and safety of vorapaxar within a multinational, randomized,
double-blind, placebo-controlled trial of vorapaxar in patients with
atherosclerosis. This analysis was performed among 20,138 patients with a
clinical indication for vorapaxar. <br/>Result(s): Compared with patients
weighing 60 kg or more, patients weighing less than 60 kg were older, more
frequently women, Asian and had renal insufficiency (each P<0.001). The
efficacy of vorapaxar with respect to cardiovascular death, myocardial
infarction and stroke showed a significant interaction with patients'
weight (Pinteraction<0.03). However among patients younger than 65 years,
vorapaxar reduced the primary endpoint regardless of weight (weight >=60
kg: 6.4% vs. 8.1%, hazard ratio (HR) 0.75, 95% confidence interval (CI)
0.65-0.86; weight <60 kg: 5.4% vs. 7.2%, HR 0.75, 95% CI 0.37-1.49,
Pinteraction=0.98). Among patients aged 65 years and older, the efficacy
of vorapaxar diminished in patients weighing less than 60 kg (high weight:
10.4% vs. 12.6%, HR 0.81, 95% CI 0.69-0.95; low weight: 16.1% vs. 9.0%, HR
1.62, 95% CI 0.95-2.76, Pinteraction=0.01). The relative increase in
bleeding with vorapaxar was not modified by weight (all
Pinteraction>0.05). <br/>Conclusion(s): Vorapaxar reduced vascular events
and improved net clinical outcome regardless of body weight in younger
patients. Elderly patients with low weight may not be good candidates for
aggressive secondary prevention with vorapaxar added to standard
therapy.<br/>Copyright &#xa9; 2021 Published on behalf of the European
Society of Cardiology. All rights reserved.

<12>
Accession Number
636447082
Title
Cardiogenic Shock after Acute Myocardial Infarction: A Review.
Source
JAMA - Journal of the American Medical Association. 326(18) (pp
1840-1850), 2021. Date of Publication: 09 Nov 2021.
Author
Samsky M.D.; Morrow D.A.; Proudfoot A.G.; Hochman J.S.; Thiele H.; Rao
S.V.
Institution
(Samsky, Rao) Duke Clinical Research Institute, Duke University, School of
Medicine, Durham, NC, United States
(Morrow) TIMI Study Group, Cardiovascular Division, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Proudfoot) Perioperative Medicine Department, Barts Heart Centre, St
Bartholomew's Hospital, London, United Kingdom
(Proudfoot) Clinic for Anesthesiology and Intensive Care,
Charite-Universitatsmedizin Berlin Corporate Member of Free, University
Berlin, Humboldt University, Berlin, Germany
(Proudfoot) Department of Anaesthesiology and Intensive Care, German Heart
Centre, Berlin, Germany
(Hochman) Cardiovascular Clinical Research Center, Division of Cardiology,
Department of Medicine, NYU Grossman School of Medicine, New York, NY,
United States
(Thiele) Department of Internal Medicine/Cardiology, Leipzig Heart
Institute, Heart Center Leipzig, University of Leipzig, Leipzig, Germany
Publisher
American Medical Association
Abstract
Importance: Cardiogenic shock affects between 40000 and 50000 people in
the US per year and is the leading cause of in-hospital mortality
following acute myocardial infarction. Observations: Thirty-day mortality
for patients with cardiogenic shock due to myocardial infarction is
approximately 40%, and 1-year mortality approaches 50%. Immediate
revascularization of the infarct-related coronary artery remains the only
treatment for cardiogenic shock associated with acute myocardial
infarction supported by randomized clinical trials. The Percutaneous
Coronary Intervention Strategies with Acute Myocardial Infarction and
Cardiogenic Shock (CULPRIT-SHOCK) clinical trial demonstrated a reduction
in the primary outcome of 30-day death or kidney replacement therapy; 158
of 344 patients (45.9%) in the culprit lesion revascularization-only group
compared with 189 of 341 patients (55.4%) in the multivessel percutaneous
coronary intervention group (relative risk, 0.83 [95% CI, 0.71-0.96]; P
=.01). Despite a lack of randomized trials demonstrating benefit,
percutaneous mechanical circulatory support devices are frequently used to
manage cardiogenic shock following acute myocardial infarction.
<br/>Conclusions and Relevance: Cardiogenic shock occurs in up to 10% of
patients immediately following acute myocardial infarction and is
associated with mortality rates of nearly 40% at 30 days and 50% at 1
year. Current evidence and clinical practice guidelines support immediate
revascularization of the infarct-related coronary artery as the primary
therapy for cardiogenic shock following acute myocardial
infarction..<br/>Copyright &#xa9; 2021 American Medical Association. All
rights reserved.

<13>
Accession Number
636395921
Title
Efficacy of a glucagon-like peptide-1 agonist and restrictive versus
liberal oxygen supply in patients undergoing coronary artery bypass
grafting or aortic valve replacement: Study protocol for a 2-by-2
factorial designed, randomised clinical trial.
Source
BMJ Open. 11(11) (no pagination), 2021. Article Number: e052340. Date of
Publication: 05 Nov 2021.
Author
Wiberg S.; Kjaergaard J.; Mogelvang R.; Moller C.H.; Kandler K.; Ravn H.;
Hassager C.; Kober L.; Nilsson J.C.
Institution
(Wiberg, Kjaergaard, Mogelvang, Hassager, Kober) Department of Cardiology,
Rigshospitalet, Copenhagen, Denmark
(Moller, Kandler) Department of Cardiothoracic Surgery, Rigshospitalet,
Copenhagen, Denmark
(Ravn, Nilsson) Department of Cardiothoracic Anesthesiology,
Rigshospitalet, Copenhagen, Denmark
Publisher
BMJ Publishing Group
Abstract
Introduction Coronary artery bypass grafting (CABG) and/or aortic valve
replacement (AVR) are associated with risk of death, as well as brain,
heart and kidney injury. Glucagon-like peptide-1 (GLP-1) analogues are
approved for treatment of type 2 diabetes, and GLP-1 analogues have been
suggested to have potential organ-protective and anti-inflammatory
effects. During cardiopulmonary bypass (CPB), consensus on the optimal
fraction of oxygen is lacking. The objective of this study is to determine
the efficacy of the GLP-1-analogue exenatide versus placebo and
restrictive oxygenation (50% fractional inspired oxygen, FiO2) versus
liberal oxygenation (100% FiO2) in patients undergoing open heart surgery.
Methods and analysis A randomised, placebo-controlled, double blind (for
the exenatide intervention)/single blind (for the oxygenation strategy),
2x2 factorial designed single-centre trial on adult patients undergoing
elective or subacute CABG and/or surgical AVR. Patients will be randomised
in a 1:1 and 1:1 ratio to a 6-hour and 15 min infusion of 17.4 mug of
exenatide or placebo during CPB and to a FiO2 of 50% or 100% during and
after weaning from CPB. Patients will be followed until 12 months after
inclusion of the last participant. The primary composite endpoint consists
of time to first event of death, renal failure requiring renal replacement
therapy, hospitalisation for stroke or heart failure. In addition, the
trial will include predefined sub-studies applying more advanced measures
of cardiac- A nd pulmonary dysfunction, renal dysfunction and cerebral
dysfunction. The trial is event driven and aims at 323 primary endpoints
with a projected inclusion of 1400 patients. Ethics and dissemination
Eligible patients will provide informed, written consent prior to
randomisation. The trial is approved by the local ethics committee and is
conducted in accordance with Danish legislation and the Declaration of
Helsinki. The results will be presented in peer-reviewed
journals.<br/>Copyright &#xa9; 2021 Author(s). Published by BMJ.

<14>
Accession Number
635574374
Title
A randomized control led study comparing CMAC video laryngoscope and
Macintosh laryngoscope for insertion of double lumen tube in patients
undergoing elective thoracotomy.
Source
Journal of Anaesthesiology Clinical Pharmacology. 37(2) (pp 266-271),
2021. Date of Publication: April-June 2021.
Author
Mathew A.; Chandy J.; Punnoose J.; Gnanamuthu B.R.; Jeyseelan L.;
Sahajanandan R.
Institution
(Mathew, Chandy, Punnoose, Sahajanandan) Department of Anaesthesia,
Christian Medical College, Tamil Nadu, Vellore, India
(Gnanamuthu) Department of CTVS, Christian Medical College, Tamil Nadu,
Vellore, India
(Jeyseelan) Department of Biostatistics, Christian Medical College, Tamil
Nadu, Vellore, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Double lumen tube (DLT) insertion for isolation of
lung during thoracic surgery is challenging and is associated with
considerable airway trauma. The advent of video laryngoscopy has
revolutionized the management of difficult airway. Use of video
laryngoscopy may reduce the time to intubate for DLTs even in patients
with normal airway. <br/>Material(s) and Method(s): A total of 87 ASA 1-3
adults, scheduled to undergo elective thoracotomy, requiring a DLT were
randomly allocated to videolaryngoscope (CMAC) arm or Macintosh
laryngoscope arm. It was on open label study, and only the patient was
blinded. The primary objective of this study was to compare the mean time
taken for DLT intubation with CMAC (Mac 3) and Macintosh laryngoscope
blade and the secondary objectives included the hemodynamic response to
intubation, the level of difficulty using the intubation difficulty scale
(IDS), and complications associated with intubation.Data was analysed
using the statistical software SPSS (version 18.0). <br/>Result(s): The
time taken for intubation was not significantly different (42.8 +/- 14.8 s
for CMAC and 42.5 +/- 11.5 s for Macintosh laryngoscope P -0.908). The
CMAC video laryngoscope was associated with an improved laryngoscopy grade
(Grade I in 81.8% with CMAC and in 46.5% with Macintosh), less pressure
applied on the tongue, and less external laryngeal pressure required.
Hemodynamic responses to intubation were similar in both groups.
<br/>Conclusion(s): Macintosh blade is as good as CMAC (mac 3) blade to
facilitate DLT intubation in adult patients with no anticipated airway
difficulty, however CMAC was superior as it offers better laryngoscopic
view, needed less force, and fewer external laryngeal
manipulations.<br/>Copyright &#xa9; 2021 Journal of Anaesthesiology
Clinical Pharmacology <br/> Published by Wolters Kluwer - Medknow.

<15>
Accession Number
2015265708
Title
Lung Ultrasound for Detecting Tracheal and Mainstem Intubation: A
Systematic Review and Meta-Analysis.
Source
Ultrasound in Medicine and Biology. 48(1) (pp 3-9), 2022. Date of
Publication: January 2022.
Author
Yang F.M.; Ma B.Z.; Liu Y.; Sun Q.; Li N.; Feng S.Y.; Wang W.J.
Institution
(Yang, Ma, Sun, Li, Feng, Wang) Emergency Department, Cangzhou Central
Hospital, Cangzhou City, China
(Liu) Anesthesiology Department, Cangzhou People's Hospital, Cangzhou
City, China
Publisher
Elsevier Inc.
Abstract
Precise positioning of the left or right main bronchus is a prerequisite
for effective lung isolation in thoracic surgeries. This study aimed to
clarify the ability of lung ultrasound to detect tracheal and mainstem
intubation. Studies that investigated the ability of lung ultrasound to
detect tracheal and mainstem intubation were searched from PubMed and
ScienceDirect databases from their inception to March 2021. The pooled
accuracy of this method and its sensitivity and specificity were computed
with a fixed-effects model using Stata 14.0. Nine eligible articles that
involved a total of 617 participants were included in this systematic
review and meta-analysis. Overall, the accuracy of lung ultrasound in
detecting tracheal and mainstem intubation was 86.7%, with a sensitivity
of 93.0% and a specificity of 75.0%. Subgroup analysis revealed that the
accuracy remained high regardless of patient age, ultrasonic method,
sample size, study design or ultrasonic skills training. Sensitivity
analysis indicated that the results were stable. Deeks' test showed no
publication bias. These findings imply that lung ultrasound is an
effective method for detecting tracheal and mainstem
intubation.<br/>Copyright &#xa9; 2021 World Federation for Ultrasound in
Medicine & Biology

<16>
Accession Number
636183577
Title
Ultrasound- Versus Fluoroscopy-Guided Strategy for Transfemoral
Transcatheter Aortic Valve Replacement Access: A Systematic Review and
Meta-Analysis.
Source
Circulation. Cardiovascular interventions. 14(10) (pp e010742), 2021. Date
of Publication: 01 Oct 2021.
Author
Kotronias R.A.; Bray J.J.H.; Rajasundaram S.; Vincent F.; Delhaye C.;
Scarsini R.; Marin F.; Terentes-Printzios D.; Halcox J.P.J.; Mamas M.A.;
Kharbanda R.; Van Belle E.; Banning A.P.
Institution
(Kotronias, Bray, Rajasundaram, Scarsini, Marin, Terentes-Printzios,
Kharbanda, Banning) Oxford Heart Centre, Oxford University Hospitals, NHS
Trust, United Kingdom (R.A.K., S.R., R.S., F.M., D.T.-P.
(Kotronias) Department of Cardiovascular Medicine, University of Oxford,
United Kingdom (R.A.K.)
(Bray, Halcox) Institute of Life Sciences 2, United Kingdom (J.J.H.B.,
Swansea Bay University Health Board and Swansea University Medical School
(Bray) University Hospital of Wales, Cardiff and Vale University Health
Board, United Kingdom (J.J.H.B.)
(Vincent, Delhaye, Van Belle) Centre Hospitalier Universitaire de
Lille-Cardiologie, C.D.
(Scarsini) Department of Medicine, Division of Cardiology, University of
Verona
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, UK and Heart Centre, Thomas Jefferson
University
Publisher
NLM (Medline)
Abstract
[Figure: see text].

<17>
Accession Number
2015112594
Title
Use of a modified tracheal tube in a child with traumatic bronchial
rupture: A case report and review of literature.
Source
World Journal of Clinical Cases. 9(29) (pp 8915-8922), 2021. Date of
Publication: 16 Oct 2021.
Author
Fan Q.-M.; Yang W.-G.
Institution
(Fan, Yang) Pediatric Intensive Care Unit, Shenzhen Children's Hospital,
Shenzhen, Guangdong Province 518000, China
(Fan) Medical College, Shantou University, Shantou, Guangdong Province
515063, China
Publisher
Baishideng Publishing Group Co
Abstract
BACKGROUND Trauma is one of the leading causes of death in the pediatric
population. Bronchial rupture is rare, but there are potentially severe
complications. Establishing and maintaining a patent airway is the key
issue in patients with bronchial rupture. Here we describe an innovative
method for maintaining a patent airway. CASE SUMMARY A 3-year-old boy fell
from the seventh floor. Oxygenation worsened rapidly with pulse oxygen
saturation decreasing below 60%, as his heart rate dropped. Persistent
pneumothorax was observed with insertion of the chest tube. Fiberoptic
bronchoscopy was performed, which confirmed the diagnosis of bronchial
rupture. A modified tracheal tube was inserted under the guidance of a
fiberoptic bronchoscope. Pulse oxygen saturation improved from 60% to 90%.
Twelve days after admission, right upper lobectomy was performed using
bronchial stump suture by video-assisted thoracic surgery without
complications. A follow-up chest radiograph showed good recovery. The
child was discharged from hospital three months after admission.
CONCLUSION A modified tracheal tube could be selected to ensure a patent
airway and adequate ventilation in patients with bronchial
rupture.<br/>Copyright &#xa9; 2021. The Author(s). Published by Baishideng
Publishing Group Inc. All rights reserved.

<18>
Accession Number
2015689015
Title
Percutaneous mitral valve repair in severe secondary mitral regurgitation:
Analysis of index hospitalization and economic evaluation based on the
MITRA-FR trial.
Source
Archives of Cardiovascular Diseases. (no pagination), 2021. Date of
Publication: 2021.
Author
Capelle A.; Obadia J.-F.; Iung B.; Messika-Zeitoun D.; Vahanian A.; Guerin
P.; Lefevre T.; Bonnet G.; Donal E.; Leurent G.; Trochu J.-N.; Armoiry X.
Institution
(Capelle) Pharmacy department, CHU de Saint-Etienne, Saint-Etienne, France
(Obadia) Service de cardiologie interventionnelle, hospices civils de
Lyon, hopital cardiovasculaire Louis-Pradel, Lyon, France
(Iung, Vahanian) Inserm 1148, universite de Paris, hopital Bichat, AP-HP,
Paris, France
(Messika-Zeitoun) Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, Canada
(Guerin, Trochu) Inserm, institut du Thorax, CNRS, CHU de Nantes,
universite Nantes, Nantes, France
(Lefevre) Institut Jacques-Cartier, Massy, France
(Bonnet) Inserm-UMR 626, service de cardiologie interventionnelle,
Assistance Publique-Hopitaux de Marseille, CHU de Timone, Aix-Marseille
universite, Marseille 13385, France
(Donal) Inserm, LTSI-UMR 1099, universite Rennes, CHU de Rennes, Rennes,
France
(Leurent) Inserm, LTSI-UMR 1099, Department of Cardiology, CHU de Rennes,
universite Rennes 1, Rennes, France
(Armoiry) UMR CNRS 5510 MATEIS, Pharmacy Department, School of Pharmacy
(ISPB), University of Lyon, Edouard-Herriot Hospital, Lyon, France
(Armoiry) Warwick Medical School, University of Warwick, Coventry, United
Kingdom
Publisher
Elsevier Masson s.r.l.
Abstract
Background: Percutaneous mitral valve repair (pMVR) is reimbursed in
France for severe secondary mitral regurgitation (SMR), but French data
regarding the hospitalization index stay are lacking. <br/>Aim(s): Our
objectives were to describe the index hospitalization stay and to evaluate
the cost of hospital stay for pMVR used in SMR. <br/>Method(s): A
secondary evaluation based on patients who were randomized to the
intervention group of the MITRA-FR study was undertaken. The economic
evaluation was conducted according to the French hospital perspective.
Medical resource use was estimated using specific data collected from
patients enrolled in the MITRA-FR study and non-specific data from
national statistics. <br/>Result(s): The population was represented by 144
patients who underwent pMVR at 33 French centres. There was a mean +/-
standard deviation of 7.9 +/- 1.5 hospital staff during procedures. The
mean procedure duration was 154 +/- 68 minutes and increased with the
number of implanted clips. Median total length of stay was 8 days. The
occurrence of a serious adverse event was not associated with an increased
risk of admission to the critical care unit, but was associated with an
increased length of stay. The mean total cost was 28,025 +/- 3424 , which
includes 21,547 for the cost of medical devices used during pMVR and 6478
+/- 3424 for other costs. <br/>Conclusion(s): The cost of pMVR is
substantial for patients with SMR, which advocates for further efforts to
identify the patients with SMR who are likely to derive a clear clinical
benefit from the procedure.<br/>Copyright &#xa9; 2021 Elsevier Masson SAS

<19>
Accession Number
2015687629
Title
Racial Disparities in Acute Coronary Syndrome Management Within a
Universal Healthcare Context: Insights From the AMI-OPTIMA Trial.
Source
CJC Open. (no pagination), 2021. Date of Publication: 2021.
Author
d'Entremont M.-A.; Wee C.C.; Nguyen M.; Couture E.L.; Lemaire-Paquette S.;
Kouz S.; Afilalo M.; Rinfret S.; Schampaert E.; Mansour S.; Montigny M.;
Eisenberg M.; Lauzon C.; Dery J.-P.; L'Allier P.; Tardif J.-C.; Huynh T.
Institution
(d'Entremont, Nguyen, Couture, Lemaire-Paquette) Sherbrooke University
Hospital Centre (CHUS), Department of Medicine, Division of Cardiology,
Sherbrooke, QC, Canada
(d'Entremont) Harvard T.H. Chan School of Public Health, Boston, MA,
United States
(Wee) Beth Israel Deaconess Medical Centre, Department of Medicine,
Division of General Medicine, Boston, MA, United States
(Wee) Harvard Medical School, Boston, MA, United States
(Kouz) Centre Hospitalier Regional de Lanaudiere, Department of Medicine,
Saint-Charles-Borromee, QC, Canada
(Afilalo) Jewish General Hospital, Department of Emergency Medicine,
Montreal, QC, Canada
(Rinfret, Eisenberg, Huynh) McGill Health University Centre, Department of
Medicine, Division of Cardiology, Montreal, QC, Canada
(Schampaert) Hopital du Sacre-Coeur de Montreal, Department of Medicine,
Division of Cardiology, Montreal, QC, Canada
(Mansour) Montreal University Hospital Centre (CHUM), Department of
Medicine, Division of Cardiology, Montreal, QC, Canada
(Montigny) Cite-de-la-Sante, Department of Medicine, Division of
Cardiology, Laval, QC, Canada
(Lauzon) Centre Hospitalier Regional de l'Amiante, Department of Medicine,
Thetford Mines, QC, Canada
(Dery) Quebec Heart and Lung Institute, Department of Medicine, Division
of Cardiology, Quebec City, QC, Canada
(L'Allier, Tardif) Montreal Heart Institute, Department of Medicine,
Division of Cardiology, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Although prior studies have demonstrated racial disparities
regarding acute coronary syndrome (ACS) care within private or mixed
healthcare systems, few researchers have explored such disparities within
universal healthcare systems. We aimed to evaluate the quality and
outcomes of in-hospital ACS management for White patients vs patients of
colour, within a universal healthcare context. <br/>Method(s): We
performed a post hoc analysis of the Acute Myocardial Infarction -
Knowledge Translation to Optimize Adherence to Evidence-Based Therapy
study, a cluster-randomized trial evaluating a knowledge-translation
intervention at 24 hospitals in Quebec, Canada (years: 2009 and 2012). The
primary endpoint was coronary catheterization. The secondary endpoints
included in-hospital mortality, percutaneous and surgical coronary
revascularization, major bleeding, total stroke, and discharge
prescription of evidence-based medical therapy. <br/>Result(s): Of 3444
included patients, 2738 were White, and 706 were people of colour. The
mean age was 68.2 years (33.3% women) among White patients and 69.5 years
(36.0% women) among patients of colour. Patients of colour were less
likely to undergo in-hospital coronary catheterization than were White
patients (74.5% vs 80.3%, P = 0.001). This difference was attenuated after
adjusting for patient-level characteristics (odds ratio 0.89; 95%
confidence interval 0.73-1.09), and it was eliminated after adjusting for
hospital-level characteristics (odds ratio 1.04; 95% confidence interval
0.73-1.49). <br/>Conclusion(s): Racial disparity in coronary
catheterization for ACS persists within a universal healthcare context.
Patients' comorbidities and hospital-level factors may be partially
responsible for this inequality. Future research on cardiovascular
healthcare in patients with diverse racial/ethnic backgrounds in universal
healthcare systems is needed to remediate racial inequality in ACS
management.<br/>Copyright &#xa9; 2021

<20>
Accession Number
2015687437
Title
Meta-Analysis of New-Onset Atrial Fibrillation Versus No History of Atrial
Fibrillation in Patients With Noncardiac Critical Care Illness.
Source
American Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Shah K.B.; Saado J.; Kerwin M.; Mazimba S.; Kwon Y.; Mangrum J.M.; Salerno
M.; Haines D.E.; Mehta N.K.
Institution
(Shah, Haines, Mehta) Department of Cardiovascular Medicine, Beaumont
Hospital, Oakland University William Beaumont School of Medicine, Royal
Oak, MI, United States
(Saado) Department of Internal Medicine, Virginia Commonwealth University,
Richmond, VA, United States
(Kerwin) Division of Internal Medicine
(Mazimba, Mangrum, Salerno, Mehta) Division of Cardiovascular Medicine,
University of Virginia, Charlottesville, VA, United States
(Kwon) Division of Cardiovascular Medicine and Critical care medicine,
Harborview Medical Center, University of Washington Medical Center,
Seattle, WA, United States
Publisher
Elsevier Inc.
Abstract
The incidence of new-onset secondary atrial fibrillation (NOSAF) is as
high as 44% in noncardiac critical illness. A systematic review and
meta-analysis were performed to evaluate the impact of NOSAF, compared
with history of prior atrial fibrillation (AF) and no history of AF in
noncardiac critically ill patients. Patients undergoing cardiothoracic
surgery were excluded. NOSAF incidence, intensive care unit (ICU)/hospital
length of stay (LOS), and mortality outcomes were analyzed. Of 2,360
studies reviewed, 19 studies met inclusion criteria (n = 306,805
patients). NOSAF compared with no history of AF was associated with
increased in-hospital mortality (risk ratio [RR] 2.06, 95% confidence
interval [CI] 1.76 to 2.41, p <0.001), longer ICU LOS (standardized
difference in means [SMD] 0.66, 95% CI 0.41 to 0.91, p <0.001), longer
hospital LOS (SMD 0.31, 95% CI 0.07 to 0.56, p = 0.001) and increased risk
of long-term (>1 year) mortality (RR 1.76, 95% CI 1.29 to 2.40, p <0.001).
NOSAF compared with previous AF was also associated with higher
in-hospital mortality (RR 1.29, 95% CI 1.12 to 1.49, p <0.001), longer ICU
LOS (SMD 0.37, 95% CI 0.03 to 0.70, p = 0.03) but no difference
in-hospital LOS (SMD -0.18, 95% CI -0.66 to 0.31, p = 0.47). In
conclusion, NOSAF, in the setting of noncardiac critical illness is
associated with increased in-hospital mortality compared with no history
of AF and previous AF. NOSAF (vs no history of AF) is also associated with
increased long-term mortality.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<21>
Accession Number
2015687216
Title
Meta-Analysis of Nonrandomized Studies to Assess the Optimal Timing of
Coronary Artery Bypass Grafting After Acute Myocardial Infarction.
Source
American Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Weigel F.; Nudy M.; Krakowski G.; Ahmed M.; Foy A.
Institution
(Weigel, Ahmed) Department of Internal Medicine
(Nudy, Krakowski, Foy) Division of Cardiology, Penn State Milton S.
Hershey Medical Center, Hershey, PA, United States
Publisher
Elsevier Inc.
Abstract
The optimal timing of coronary artery bypass grafting (CABG) in patients
after an acute myocardial infarction (MI) is unknown. We performed a
systematic review and meta-analysis of studies comparing mortality rates
in patients who underwent CABG at different time intervals after acute MI.
Bias assessments were completed for each study, and summary of proportions
of all-cause mortality were calculated based on CABG at various time
intervals after MI. A total of 22 retrospective studies, which included a
total of 137,373 patients were identified. The average proportion of
patients who died when CABG was performed within 6 hours of MI was 12.7%,
within 6 to 24 hours of MI was 10.9%, within 1 day of MI was 9.8%, any
time after 1 day of MI was 3.0%, within 7 days of MI was 5.9%, and any
time after 7 days of MI was 2.7%. Interstudy heterogeneity, assessed using
I² values, showed significant heterogeneity in death rates
within subgroups. Only 1 study accounted for immortal time bias, and there
was a serious risk of selection bias in all other studies. Confounding was
found to be a serious risk for bias in 55% of studies because of a lack of
accounting for type of MI, MI severity, or other verified cardiac risk
factors. The current publications comparing timing of CABG after MI is at
serious risk of bias because of patient selection and confounding, with
heterogeneity in both study populations and intervention time
intervals.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<22>
Accession Number
2014217288
Title
Restrictive versus liberal transfusion in patients with diabetes
undergoing cardiac surgery: An open-label, randomized, blinded outcome
evaluation trial.
Source
Diabetes, Obesity and Metabolism. (no pagination), 2021. Date of
Publication: 2021.
Author
Mistry N.; Shehata N.; Carmona P.; Bolliger D.; Hu R.; Carrier F.M.;
Alphonsus C.S.; Tseng E.E.; Royse A.G.; Royse C.; Filipescu D.; Mehta C.;
Saha T.; Villar J.C.; Gregory A.J.; Wijeysundera D.N.; Thorpe K.E.; Juni
P.; Hare G.M.T.; Ko D.T.; Verma S.; Mazer C.D.
Institution
(Mistry) Department of Anesthesia, St. Michael's Hospital, Institute of
Medical Sciences, University of Toronto, Toronto, ON, Canada
(Shehata) Division of Hematology, Departments of Medicine, Laboratory
Medicine and Pathobiology, Institute of Health Policy Management and
Evaluation, University of Toronto, Mount Sinai Hospital, Toronto, ON,
Canada
(Carmona) Department of Anesthesia and Critical Care, Hospital
Universitari and Politecnic La Fe, Valencia, Spain
(Bolliger) Clinic for Anaesthesia, Intermediate Care, Prehospital
Emergency Medicine and Pain Therapy, University Hospital Basel, Basel,
Switzerland
(Hu) Department of Anesthesia, Austin Hospital, Melbourne, VIC, Australia
(Carrier) Department of Anesthesiology & Department of Medicine, Critical
Care Division, Centre hospitalier de l'Universite de Montreal, Montreal,
QC, Canada
(Carrier) Carrefour de l'innovation et sante des populations, Centre de
recherche du CHUM, Montreal, QC, Canada
(Alphonsus) Department of Anaesthesia and Perioperative Medicine, Groote
Schuur Hospital and Faculty of Health Sciences, University of Cape Town,
Cape Town, South Africa
(Tseng) Division of Adult Cardiothoracic Surgery, Department of Surgery,
University of California San Francisco and San Francisco VA Medical
Center, San Francisco, CA, United States
(Royse, Royse) Department of Surgery, The Royal Melbourne Hospital,
Parkville, VIC, Australia
(Royse, Royse) Department of Surgery, The University of Melbourne,
Melbourne, VIC, Australia
(Royse) Outcomes Research Consortium, The Cleveland Clinic, Cleveland, OH,
United States
(Filipescu) Department of Cardiac Anaesthesia and Intensive Care Medicine,
Emergency Institute for Cardiovascular Diseases, Carol Davila University
of Medicine and Pharmacy, Bucharest, Romania
(Mehta) Department of Cardiac Anaesthesia, Epic Hospital, Ahmedabad, India
(Saha) Department of Anesthesiology and Perioperative Medicine, Kingston
General Hospital, Kingston, ON, Canada
(Villar) Fundacion Cardioinfantil-Instituto de Cardiologia, Bogota,
Colombia
(Villar) Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia
(Gregory) Department of Anesthesiology, Perioperative and Pain Medicine,
Libin Cardiovascular Institute, Cumming School of Medicine, University of
Calgary, Calgary, AB, Canada
(Wijeysundera) Department of Anesthesia, St. Michael's Hospital, Li Ka
Shing Knowledge Institute, Institute of Health Policy, Management and
Evaluation, University of Toronto, Toronto, ON, Canada
(Thorpe) Applied Health Research Centre, Li Ka Shing Knowledge Institute
of St. Michael's Hospital, Dalla Lana School of Public Health, University
of Toronto, Toronto, ON, Canada
(Juni) Applied Health Research Centre, Li Ka Shing Knowledge Institute of
St. Michael's Hospital, Department of Medicine, University of Toronto,
Toronto, ON, Canada
(Hare) Department of Anesthesia, St. Michael's Hospital, Li Ka Shing
Knowledge Institute, Department of Physiology, University of Toronto,
Toronto, ON, Canada
(Ko) Division of Cardiology, Schulich Heart Centre, Sunnybrook Health
Sciences Centre, Institute of Health Policy, Management and Evaluation
University of Toronto, ICES, Toronto, ON, Canada
(Verma) Division of Cardiac Surgery, St. Michael's Hospital, Li Ka Shing
Knowledge Institute, Department of Surgery, Department of Pharmacology and
Toxicology, University of Toronto, Toronto, ON, Canada
(Mazer) Department of Anesthesia, St. Michael's Hospital, Li Ka Shing
Knowledge Institute, Institute of Medical Sciences, Department of
Physiology, University of Toronto, Toronto, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Aim: To characterize the association between diabetes and transfusion and
clinical outcomes in cardiac surgery, and to evaluate whether restrictive
transfusion thresholds are harmful in these patients. <br/>Material(s) and
Method(s): The multinational, open-label, randomized controlled TRICS-III
trial assessed a restrictive transfusion strategy (haemoglobin [Hb]
transfusion threshold <75 g/L) compared with a liberal strategy (Hb <95
g/L for operating room or intensive care unit; or <85 g/L for ward) in
patients undergoing cardiac surgery on cardiopulmonary bypass with a
moderate-to-high risk of death (EuroSCORE >=6). Diabetes status was
collected preoperatively. The primary composite outcome was all-cause
death, stroke, myocardial infarction, and new-onset renal failure
requiring dialysis at 6 months. Secondary outcomes included components of
the composite outcome at 6 months, and transfusion and clinical outcomes
at 28 days. <br/>Result(s): Of the 5092 patients analysed, 1396 (27.4%)
had diabetes (restrictive, n = 679; liberal, n = 717). Patients with
diabetes had more cardiovascular disease than patients without diabetes.
Neither the presence of diabetes (OR [95% CI] 1.10 [0.93-1.31]) nor the
restrictive strategy increased the risk for the primary composite outcome
(diabetes OR [95% CI] 1.04 [0.68-1.59] vs. no diabetes OR 1.02
[0.85-1.22]; P<inf>interaction</inf> =.92). In patients with versus
without diabetes, a restrictive transfusion strategy was more effective at
reducing red blood cell transfusion (diabetes OR [95% CI] 0.28
[0.21-0.36]; no diabetes OR [95% CI] 0.40 [0.35-0.47];
P<inf>interaction</inf> =.04). <br/>Conclusion(s): The presence of
diabetes did not modify the effect of a restrictive transfusion strategy
on the primary composite outcome, but improved its efficacy on red cell
transfusion. Restrictive transfusion triggers are safe and effective in
patients with diabetes undergoing cardiac surgery.<br/>Copyright &#xa9;
2021 John Wiley & Sons Ltd.

<23>
Accession Number
636308951
Title
Efficacy of left ventricular unloading strategies during venoarterial
extracorporeal membrane oxygenation in patients with cardiogenic shock: A
protocol for a systematic review and Bayesian network meta-analysis.
Source
BMJ Open. 11(10) (no pagination), 2021. Article Number: e047046. Date of
Publication: 19 Oct 2021.
Author
Zhang P.; Wei S.; Zhai K.; Huang J.; Cheng X.; Tao Z.; Gao B.; Liu D.; Li
Y.
Institution
(Zhang, Wei, Zhai, Huang, Cheng, Tao, Gao, Liu, Li) Department of Cardiac
Surgery, Lanzhou University Second Hospital, Gansu, Lanzhou, China
(Zhang) State Key Laboratory of Cardiovascular Disease, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Wei, Zhai, Huang, Cheng, Tao, Li) Laboratory of Extracorporeal Life
Support, Lanzhou University Second Hospital, Gansu, Lanzhou, China
Publisher
BMJ Publishing Group
Abstract
Introduction Venoarterial extracorporeal membrane oxygenation (VA-ECMO)
has been widely used for patients with refractory cardiogenic shock. A
common side effect of this technic is the resultant increase in left
ventricular (LV) afterload which could potentially aggravate myocardial
ischaemia, delay ventricular recovery and increase the risk of pulmonary
congestion. Several LV unloading strategies have been proposed and
implemented to mitigate these complications. However, it is still
indistinct that which one is the best choice for clinical application.
This Bayesian network meta-analysis (NMA) aims to compare the efficacy of
different LV unloading strategies during VA-ECMO. Methods and analysis
PubMed, Embase, the Cochrane Library and the International Clinical Trials
Registry Platform will be explored from their inception to 31 December
2020. Random controlled trials and cohort studies that compared different
LV unloading strategies during VA-ECMO will be included in this study. The
primary outcome will be in-hospital mortality. The secondary outcomes will
include neurological complications, haemolysis, bleeding, limb ischaemia,
renal failure, gastrointestinal complications, sepsis, duration of
mechanical ventilation, length of intensive care unit and hospital stays.
Pairwise and NMA will respectively be conducted using Stata (V.16,
StataCorp) and Aggregate Data Drug Information System (V.1.16.5), and the
cumulative probability will be used to rank the included LV unloading
strategies. The risk of bias will be conducted using the Cochrane
Collaboration's tool or Newcastle-Ottawa Quality Assessment Scale
according to their study design. Subgroup analysis, sensitivity analysis
and publication bias assessment will be performed. The Grading of
Recommendations Assessment, Development and Evaluation will be conducted
to explore the quality of evidence. Ethics and dissemination Either ethics
approval or patient consent is not necessary, because this study will be
based on literature. The results will be disseminated through
peer-reviewed publications and conference presentations. PROSPERO
registration number CRD42020165093.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<24>
Accession Number
2013743186
Title
Intercostal Cryo Nerve Block in Minimally Invasive Cardiac Surgery: The
Prospective Randomized FROST Trial.
Source
Pain and Therapy. 10(2) (pp 1579-1592), 2021. Date of Publication:
December 2021.
Author
Lau W.C.; Shannon F.L.; Bolling S.F.; Romano M.A.; Sakwa M.P.; Trescot A.;
Shi L.; Johnson R.L.; Starnes V.A.; Grehan J.F.
Institution
(Lau, Shannon, Johnson) William Beaumont Hospital, 3601 West 13 Mile Road,
Royal Oak, MI 48703, United States
(Bolling, Romano) University of Michigan, Ann Arbor, MI, United States
(Sakwa) Memorial Care Heart and Vascular Institute, Long Beach, CA, United
States
(Trescot) The Pain and Headache Center, Eagle River, AK, United States
(Shi) NAMSA, Minneapolis, MN, United States
(Starnes) University of Southern California, Los Angeles, CA, United
States
(Grehan) United Heart and Vascular Institute-Allina, Saint Paul, MN,
United States
Publisher
Adis
Abstract
Introduction: Intercostal cryo nerve block has been shown to enhance
pulmonary function recovery and pain management in post-thoracotomy
procedures. However, its benefit have never been demonstrated in minimal
invasive thoracotomy heart valve surgery (Mini-HVS). The purpose of the
study was to determine whether intraoperative intercostal cryo nerve block
in conjunction with standard of care (collectively referred to hereafter
as CryoNB) provided superior analgesic efficacy in patients undergoing
Mini-HVS compared to standard-of-care (SOC). <br/>Method(s): FROST was a
prospective, 3:1 randomized (CryoNB vs. SOC), multicenter trial in
patients undergoing Mini-HVS. The primary endpoint was the 48-h
postoperative forced expiratory volume in 1 s (FEV1) result. Secondary
endpoints were visual analog scale (VAS) scores for pain at the surgical
site and general pain, intensive care unit and hospital length-of-stay,
total opioid consumption, and allodynia at 6 months postoperatively.
<br/>Result(s): A total of 84 patients were randomized to the two arms of
the trial CryoNB (n = 65) and SOC (n = 19). Baseline Society of Thoracic
Surgeons Predictive Risk of Mortality (STS PROM) score, ejection fraction,
and FEV1 were similar between cohorts. A higher 48-h postoperative FEV1
result was demonstrated in the CryoNB cohort versus the SOC cohort (1.20
+/- 0.46 vs. 0.93 +/- 0.43 L; P = 0.02, one-sided two-sample t test).
Surgical site VAS scores were similar between the CryoNB and SOC cohorts
at all postoperative timepoints evaluated, but VAS scores not related to
the surgical site were lower in the SOC group at 72, 94, and 120 h
postoperatively. The SOC cohort had a 13% higher opioid consumption than
the CryoNB cohort. One of 64 CryoNB patients reported allodynia that did
not require pain medication at 10 months. <br/>Conclusion(s): The results
of FROST demonstrated that intercostal CryoNB provided enhanced FEV1 score
at 48 h postoperatively with optimized analgesic effectiveness versus SOC.
Future larger prospective randomized trials are warranted to determine
whether intercostal CryoNB has an opioid-sparing effect in patients
undergoing Mini-HVS. Trial Registration: Clinicaltrials.gov identifier:
NCT02922153.<br/>Copyright &#xa9; 2021, The Author(s).

<25>
Accession Number
2013661326
Title
Dual antiplatelet therapy in patients with high cardiovascular risk.
Source
Heart International. 15(1) (pp 26-36), 2021. Date of Publication: 2021.
Author
Espinoza C.; Mukherjee D.
Institution
(Espinoza, Mukherjee) Division of Cardiovascular Diseases, Department of
Internal Medicine, Texas Tech University Health Science Center El Paso, El
Paso, TX, United States
Publisher
Touch Medical Media
Abstract
Coronary artery disease (CAD) is prevalent throughout the world, with a
significant impact on global health. There is a vast collection of data in
the medical literature relating to the topic of dual antiplatelet therapy
(DAPT) in patients considered to be at high cardiovascular (CV) risk. In
order to perform a narrative review of literature regarding the use of
DAPT in patients with high CV risk, PubMed, Google Scholar and Embase were
searched for English-language articles from 1985 to December 2020 by using
the medical subject heading terms and keywords 'antiplatelet therapy' and
'high-risk cardiovascular disease', alone or in combination. Both authors
critically reviewed the design, population characteristics and results of
the selected studies. The topic of DAPT in patients with high CV risk is
fluid and constantly evolving. The landmark trials of CURE, TRITON-TIMI 38
and PLATO provided evidence for the optimal use of DAPT in patients after
acute coronary syndrome, while the CHARISMA and MATCH trials provided
guidance for clinicians for their use in patients with stable coronary
artery disease. The American College of Cardiology/American Heart
Association focused update, published in 2016, and the European Society of
Cardiology guidelines, published in 2017, were developed to provide
guidance to clinicians based on the available data at the time to be able
to choose the appropriate DAPT strategy that would provide patients with
the maximum clinical benefit. The management of DAPT in patients with high
CV risk is a challenging task, with new data on the subject constantly
being reported. Balancing ischaemic benefit with potential bleeding
complications adds to the complexity of managing DAPT in these patients.
With all the available data and current clinical guidelines, patients
deemed at high CV risk should be considered for DAPT, taking into account
individual risk:benefit ratio. In most individuals with high CV risk, the
net clinical benefit favours the use of DAPT.<br/>Copyright &#xa9; 2021,
Touch Medical Media. All rights reserved.

<26>
Accession Number
2011876646
Title
Association between admission body mass index and outcomes in critically
ill children: A systematic review and meta-analysis.
Source
Clinical Nutrition. 40(5) (pp 2772-2783), 2021. Date of Publication: May
2021.
Author
Toh S.; Ong C.; Sultana R.; Kirk A.H.P.; Koh J.C.; Lee J.H.
Institution
(Toh, Sultana, Lee) Duke-NUS Medical School, 8 College Rd 169857,
Singapore
(Ong) Department of Nutrition and Dietetics, KK Women's and Children's
Hospital, 100 Bukit Timah Rd 229899, Singapore
(Kirk) Children's Intensive Care Unit, Division of Nursing, KK Women's and
Children's Hospital, 100 Bukit Timah Rd 229899, Singapore
(Koh) Department of Paediatric Medicine, KK Women's and Children's
Hospital, 100 Bukit Timah Rd 229899, Singapore
(Lee) Children's Intensive Care Unit, Department of Pediatric
Subspecialties, KK Women's and Children's Hospital, 100 Bukit Timah Rd
229899, Singapore
Publisher
Churchill Livingstone
Abstract
Background & aims: The association between nutritional status at pediatric
intensive care unit (PICU) admission with clinical outcomes remains
unclear. We conducted this systematic review to summarize the overall
impact of PICU admission body mass index (BMI) on clinical outcomes.
<br/>Method(s): We searched the following medical databases from inception
through May 2020: PubMed, Excerpta Medica database (Embase), Cumulative
Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library,
and Web of Science. We included studies on patients <=18 years old
admitted to a PICU that investigated the effect of BMI on mortality, PICU
or hospital length of stay (LOS), or duration of mechanical ventilation
(MV). Classification of underweight, overweight, and obese were based on
each study's criteria. <br/>Result(s): There was a total of 21,558
patients from 20 included studies. 12,936 (60.0%), 2965 (13.8%), 2182
(10.1%), 3348 (15.5%) were normal weight, underweight, overweight, and
obese patients, respectively. Relative to normal weight patients,
underweight (OR 1.32, 95% CI 0.89-1.98; p = 0.171) and overweight/obese
patients (OR 1.10, 95% CI 0.86-1.42; p = 0.446) did not have an increase
risk in mortality. There was also no difference in duration of MV, PICU
and hospital LOS between all three weight categories. Included studies
were heterogeneous and lacked standardized nutritional categorization.
Sensitivity analysis including only studies that used BMI z-scores as
nutritional classification (n = 5) revealed that underweight patients had
higher odds of mortality compared to patients with normal weight (OR 1.61,
95% CI 1.35-1.92; p < 0.001); studies that used percentiles as
classification did not reveal any differences in mortality. Sensitivity
analysis including only studies containing mixed PICU cohorts (i.e.,
excluding specialized cohorts e.g., congenital heart surgeries, burns)
revealed higher mortality odds in underweight patients (OR 1.53, 95% CI
1.25-1.87; p < 0.001) and overweight/obese patients (OR 1.51, 95% CI
1.14-2.01; p = 0.004) relative to normal weight patients.
<br/>Conclusion(s): Our systematic review did not reveal any association
between PICU admission BMI status and outcomes in critically ill children.
Further investigation with standardized nutrition status classification on
admission, stratified by patient subgroups, is needed to clarify the
association between nutritional status and clinical outcomes of PICU
patients.<br/>Copyright &#xa9; 2021 Elsevier Ltd and European Society for
Clinical Nutrition and Metabolism

<27>
Accession Number
2004685462
Title
Derivation and Validation of a Risk Stratification System for Predicting
Postoperative Cognitive Impairment.
Source
Journal of Investigative Surgery. 34(10) (pp 1121-1127), 2021. Date of
Publication: 2021.
Author
Liao Y.; Su X.; Ouyang W.; Li L.; Chen S.; Chou J.; Le Y.
Institution
(Liao, Su, Ouyang, Li, Chen, Chou, Le) Department of Anesthesiology, The
Third Xiangya Hospital, Central South University, Changsha, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: To establish and validate a risk stratification scoring system
(we name it as PreOp-BFS, which represents Pre-Operative Brain Fragility
Score) for postoperative cognitive impairment containing postoperative
cognitive dysfunction (POCD) and postoperative delirium (POD) in elderly
patients undergoing non-cardiac surgery. <br/>Method(s): We searched for
relevant literatures and reviews reported in PubMed and ScienceDirect
databases from January 1994 to December 2017. We performed a preoperative
risk factor for cognitive impairment in elderly patients (age >= 60 years)
who underwent non-cardiac surgery, and finally constructed a risk scoring
system to predict postoperative cognitive impairment. <br/>Result(s): The
test data included 49 patients with postoperative cognitive impairment and
31 patients without postoperative cognitive impairment. The postoperative
risk scale score ranged from 0 to 8 points. The incidence of postoperative
cognitive impairment was 16.2%, 62.9% and 96.2% in the low (0-2 scores),
medium (3-4 scores) and high (5-8 scores) risk groups, respectively. In
addition, the risk of postoperative cognitive impairment was significantly
higher in high and medium risk groups than in low risk group. Receiver
operating characteristic (ROC) analysis showed that the area under the
curve (AUC) of the risk scoring system was 0.862 [95% CI 0.784-0.941].
<br/>Conclusion(s): The preoperative risk stratification scoring system
(PreOp-BFS) established in this study had a good prediction effect, which
was helpful for rapid identification and screening of high-risk
susceptible patients with early postoperative cognitive impairment, and
for performing targeted perioperative prevention.<br/>Copyright &#xa9;
2020 Taylor & Francis Group, LLC.

<28>
Accession Number
2014620351
Title
Nonautologous Grafts in Coronary Artery Bypass Surgery: A Systematic
Review.
Source
Annals of Thoracic Surgery. 112(6) (pp 2094-2103), 2021. Date of
Publication: December 2021.
Author
Lampridis S.; George S.J.
Institution
(Lampridis, George) Bristol Medical School, University of Bristol,
Bristol, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Suitable autologous conduits may be lacking when performing
coronary artery bypass grafting. The aim of this review is to determine
the status of nonautologous grafts in coronary artery bypass grafting.
<br/>Method(s): We conducted a literature search on MEDLINE All, Embase
Classic, and Embase through Ovid from 1960 to April 2020. <br/>Result(s):
Of the 1579 records identified, 21 studies were included in the review.
The following grafts were assessed for patency: 109 homologous saphenous
veins (patency rates ranged from 66.7% at a median follow-up of 8.5 months
to 0% at 6-12 months and 7-18 months, respectively), 29 expanded
polytetrafluoroethylene grafts (from 80% at a median follow-up of 5 months
to 14.3% at 45 months), 12 human umbilical veins (50% at a median
follow-up of 6 months), 50 Bioflow bovine internal mammary arteries (from
15.8% to 0% at a mean follow-up of 9.5 months and 19 months,
respectively), 39 Perma-Flow grafts (80% and 76.9% at 1-3 months and 12
months, respectively), 20 No-React bovine internal mammary arteries (57.1%
at a median follow-up of 28 months and 23.1% at a mean follow-up of 7
months), 40 autologous venous endothelial cell-seeded expanded
polytetrafluoroethylene grafts (94.7% and 81% at a mean follow-up of 27
months and 60 months, respectively), and 12 autologous venous endothelial
cell-seeded cryopreserved homologous veins (83.3% at a mean follow-up of
8.5 months). <br/>Conclusion(s): The goal of an alternative conduit with
patency and attributes that match those of autografts remains elusive.
Autologous endothelial cell-seeded synthetic grafts have demonstrated
promising results but require further investigation.<br/>Copyright &#xa9;
2021 The Society of Thoracic Surgeons

<29>
Accession Number
2010082656
Title
Percutaneous Coronary Intervention With Drug Eluting Stents Versus
Coronary Artery Bypass Graft Surgery in Patients With Advanced Chronic
Kidney Disease: A Systematic Review and Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 33(4) (pp 958-969), 2021.
Date of Publication: Winter 2021.
Author
Doulamis I.P.; Tzani A.; Tzoumas A.; Iliopoulos D.C.; Kampaktsis P.N.;
Briasoulis A.
Institution
(Doulamis) Department of Cardiac Surgery, Boston Children's Hospital,
Harvard Medical School, Boston, MA, United States
(Tzani) Brigham and Women's Hospital Heart and Vascular Center, Harvard
Medical School, Boston, MA, United States
(Tzoumas) Medical School, Aristotle University of Thessaloniki,
Thessaloniki, Greece
(Iliopoulos) Department of Cardiothoracic Surgery, Hygeia Medical Center,
Athens, Greece
(Kampaktsis) Division of Cardiology, New York University Langone Medical
Center, New York, NY, United States
(Briasoulis) University of Iowa Hospitals and Clinics, Iowa City, IA,
United States
Publisher
W.B. Saunders
Abstract
Tomicron perform a systematic review and meta-analysis of the available
literature comparing safety and efficacy outcomes between percutaneous
coronary intervention (PCI) with drug-eluting stents (DES) and coronary
artery bypass grafting (CABG) in patients with chronic kidney disease
(CKD). Eligible studies included patients with eGFR < 60 mL/min/1.73
m² that underwent revascularization. Subgroup analyses
according to DES generation and dialysis status were performed. A total of
7157 and 8156 patients were included in the CABG and PCI arms respectively
across 16 studies eligible studies. Weighted mean age was 68.6 and 63.8
years for the CABG and PCI arms, respectively. Mean follow-up time was 3.2
and 2.9 years respectively. Compared to CABG, PCI was associated with
increased risk for all-cause mortality (hazard ratio [HR]: 1.28, 95%
confidence interval [CI]: 1.13, 1.46; P < 0.01), cardiac mortality (HR:
1.59, 95% CI: 1.13, 2.23; P = 0.01), myocardial infarction (MI) (HR: 1.89,
95% CI: 1.43, 2.49; P < 0.01), and repeat revascularization (HR: 2.97, 95%
CI: 2.20, 3.97; P < 0.01). Risk for stroke was lower (HR: 0.64, 95% CI:
0.50, 0,81; P < 0.01) in the PCI group. These results were unchanged when
1st or 2nd DES were used. A subgroup analysis showed no difference in
all-cause mortality for DES PCI vs CABG in dialysis patients (HR: 1.11,
95% CI: 0.71, 1.73; P = 0.65). In patients with CKD, PCI is associated
with higher risk of mortality, MI, and repeat revascularization compared
with CABG and regardless of DES generation. Risk of stroke is higher with
CABG. Type of revascularization had no impact on survival of dialysis
patients.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<30>
Accession Number
2015617709
Title
Systematic review and meta-analysis of mortality risk prediction models in
adult cardiac surgery.
Source
Interactive Cardiovascular and Thoracic Surgery. 33(5) (pp 673-686), 2021.
Date of Publication: 01 Nov 2021.
Author
Sinha S.; Dimagli A.; Dixon L.; Gaudino M.; Caputo M.; Vohra H.A.;
Angelini G.; Benedetto U.
Institution
(Sinha, Dimagli, Dixon, Caputo, Vohra, Angelini, Benedetto) Bristol Heart
Institute, Translational Health Sciences, University of Bristol, Bristol,
United Kingdom
(Gaudino) Weill Cornell Medical College, Cornell University, New York,
United States
Publisher
Oxford University Press
Abstract
OBJECTIVES: The most used mortality risk prediction models in cardiac
surgery are the European System for Cardiac Operative Risk Evaluation (ES)
and Society of Thoracic Surgeons (STS) score. There is no agreement on
which score should be considered more accurate nor which score should be
utilized in each population subgroup. We sought to provide a thorough
quantitative assessment of these 2 models. <br/>METHOD(S): We performed a
systematic literature review and captured information on discrimination,
as quantified by the area under the receiver operator curve (AUC), and
calibration, as quantified by the ratio of observed-to-expected mortality
(O:E). We performed random effects meta-analysis of the performance of the
individual models as well as pairwise comparisons and subgroup analysis by
procedure type, time and continent. <br/>RESULT(S): The ES2 {AUC 0.783
[95% confidence interval (CI) 0.765-0.800]; O:E 1.102 (95% CI
0.943-1.289)} and STS [AUC 0.757 (95% CI 0.727-0.785); O:E 1.111 (95% CI
0.853-1.447)] showed good overall discrimination and calibration. There
was no significant difference in the discrimination of the 2 models
(difference in AUC -0.016; 95% CI -0.034 to -0.002; P = 0.09). However,
the calibration of ES2 showed significant geographical variations (P <
0.001) and a trend towards miscalibration with time (P=0.057). This was
not seen with STS. <br/>CONCLUSION(S): ES2 and STS are reliable predictors
of short-term mortality following adult cardiac surgery in the populations
from which they were derived. STS may have broader applications when
comparing outcomes across continents as compared to ES2. REGISTRATION:
Prospero (https://www.crd.york.ac.uk/PROSPERO/) CRD42020220983.
<br/>Copyright &#xa9; 2021 The Author(s) 2021. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<31>
Accession Number
2015670935
Title
Anticoagulation therapy in patients with post-operative atrial
fibrillation: Systematic review with meta-analysis.
Source
Vascular Pharmacology. 142 (no pagination), 2022. Article Number: 106929.
Date of Publication: February 2022.
Author
Neves I.A.; Magalhaes A.; Lima da Silva G.; Almeida A.G.; Borges M.; Costa
J.; Ferreira J.J.; Pinto F.J.; Caldeira D.
Institution
(Neves) Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
(Magalhaes, Lima da Silva, Almeida, Pinto, Caldeira) Centro Cardiovascular
da Universidade de Lisboa, CAML, Faculdade de Medicina da Universidade de
Lisboa, Portugal
(Magalhaes, Lima da Silva, Almeida, Pinto, Caldeira) Cardiology
Department, Hospital Santa Maria - Centro Hospitalar Universitario Lisboa
Norte (CHULN), Lisbon, Portugal
(Borges, Costa, Ferreira, Caldeira) Laboratory of Clinical Pharmacology
and Therapeutics, Faculty of Medicine, Universidade de Lisboa, Lisbon,
Portugal
(Borges, Costa, Ferreira) Instituto de Medicina Molecular Joao Lobo
Antunes, Faculdade de Medicina, Universidade de Lisboa, Portugal
(Ferreira) CNS - Neurological Senior Campus, Torres Vedras, Portugal
Publisher
Elsevier Inc.
Abstract
Background: Post-operative atrial fibrillation (POAF) is a relevant
complication after surgery. Several studies have shown that POAF has
important consequences for long-term morbidity and mortality, by
increasing the risk of thromboembolic events. However, the use of oral
anticoagulation (OAC) is not well established in this context.
<br/>Method(s): We searched MEDLINE, CENTRAL, PsycInfo and Web of Science
for clinical trials and observational studies evaluating anticoagulation
vs. no anticoagulation in patients with POAF (after cardiac or non-cardiac
surgery). Data were screened and extracted by two independent reviewers.
We performed a random- effects model to estimate the pooled odds ratio
(OR) with 95% Confidence Intervals (CI), and heterogeneity was evaluated
by I² statistics. The outcomes of interest were all-cause
mortality, thromboembolic events, and bleeding events. <br/>Result(s):
Overall, 10 observational retrospective studies were included: 5 studies
with 203,946 cardiac surgery POAF patients, and 5 studies with 29,566
patients with POAF after non-cardiac surgery. In cardiac surgery POAF, the
OAC use was associated with lower risk of thromboembolic events (OR 0.68;
95%CI 0.47-0.96, I² = 31%; 4 studies) and the bleeding risk was
significantly increased (OR 4.30; 95%CI 3.69 to 5.02, 1 study). In
non-cardiac surgery POAF, OAC did not significantly reduce the risk of
thromboembolic events (OR 0.71, 95%CI 0.33-1.15; I² = 79%; 5
studies) but was associated with increased risk of bleeding (OR 1.20,
95%CI 1.10-1.32, I² = 0%; 3 studies). Mortality was not
significantly reduced in both cardiac and non-cardiac surgery POAF.
<br/>Conclusion(s): Oral anticoagulation was associated with a lower risk
of thromboembolic events in patients with POAF following cardiac surgery
but not in non-cardiac surgery. Bleeding risk was increased in both
settings. The confidence on pooled results is at most low, and further
data, namely randomized controlled trials are necessary to derive robust
conclusions.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<32>
Accession Number
2015627842
Title
Mechanical active compression-decompression versus standard mechanical
cardiopulmonary resuscitation: A randomised haemodynamic out-of-hospital
cardiac arrest study.
Source
Resuscitation. 170 (pp 1-10), 2022. Date of Publication: January 2022.
Author
Berve P.O.; Hardig B.M.; Skalhegg T.; Kongsgaard H.; Kramer-Johansen J.;
Wik L.
Institution
(Berve, Kramer-Johansen) Institute of Clinical Medicine, University of
Oslo, Oslo, Norway
(Berve, Kongsgaard, Kramer-Johansen, Wik) Norwegian National Advisory Unit
on Prehospital Emergency Medicine, Oslo University Hospital, Oslo, Norway
(Berve, Skalhegg, Kramer-Johansen, Wik) Air Ambulance Department, Division
of Prehospital Services, Oslo University Hospital, Oslo, Norway
(Berve, Wik) Department of Anaesthesiology, Oslo University Hospital,
Oslo, Norway
(Hardig) Clinical Sciences, Helsingborg, Section II, Faculty of Medicine,
Lund University, Sweden
(Hardig) Stryker/Jolife AB, Lund, Sweden
Publisher
Elsevier Ireland Ltd
Abstract
Background: Active compression-decompression cardiopulmonary resuscitation
(ACD-CPR) utilises a suction cup to lift the chest-wall actively during
the decompression phase (AD). We hypothesised that mechanical ACD-CPR
(Intervention), with AD up to 30 mm above the sternal resting position,
would generate better haemodynamic results than standard mechanical CPR
(Control). <br/>Method(s): This out-of-hospital adult non-traumatic
cardiac arrest trial was prospective, block-randomised and non-blinded. We
included intubated patients with capnography recorded during mechanical
CPR. Exclusion criteria were pregnancy, prisoners, and prior chest
surgery. The primary endpoint was maximum tidal carbon dioxide partial
pressure (p<inf>MT</inf>CO<inf>2</inf>) and secondary endpoints were
oxygen saturation of cerebral tissue (SctO<inf>2</inf>), invasive arterial
blood pressures and CPR-related injuries. Intervention device lifting
force performance was categorised as Complete AD (>=30 Newtons) or
Incomplete AD (<=10 Newtons). Haemodynamic data, analysed as one
measurement for each parameter per ventilation (Observation Unit, OU) with
non-linear regression statistics are reported as mean (standard
deviation). A two-sided p-value < 0.05 was considered as statistically
significant. <br/>Result(s): Of 221 enrolled patients, 210 were deemed
eligible (Control 109, Intervention 101). The Control vs. Intervention
results showed no significant differences for
p<inf>MT</inf>CO<inf>2</inf>: 29(17) vs 29(18) mmHg (p = 0.86), blood
pressures during compressions: 111(45) vs. 101(68) mmHg (p = 0.93) and
decompressions: 21(20) vs. 18(18) mmHg (p = 0.93) or for
SctO<inf>2</inf>%: 55(36) vs. 57(9) (p = 0.42). The 48 patients who
received Complete AD in > 50% of their OUs had higher SctO<inf>2</inf>
than Control patients: 58(11) vs. 55(36)% (p < 0.001). <br/>Conclusion(s):
Mechanical ACD-CPR provided similar haemodynamic results to standard
mechanical CPR. The Intervention device did not consistently provide
Complete AD. Clinical trial registration: ClinicalTrials.gov identifier
(NCT number): NCT02479152. The Haemodynamic Effects of Mechanical Standard
and Active Chest Compression-decompression During Out-of-hospital
CPR.<br/>Copyright &#xa9; 2021 Elsevier B.V.

<33>
Accession Number
2015620875
Title
Postoperative hypothermia following non-cardiac high-risk surgery: A
prospective study of temporal patterns and risk factors.
Source
PLoS ONE. 16(11 November) (no pagination), 2021. Article Number: e0259789.
Date of Publication: November 2021.
Author
Sabbag I.P.; Hohmann F.B.; Assuncao M.S.C.; de Freitas Chaves R.C.; Correa
T.D.; Menezes P.F.L.; Neto A.S.; Malbouisson L.M.S.; Lobo S.M.A.; Amendola
C.P.; de Aguilar-Nascimento J.E.; Silva J.M.
Institution
(Sabbag, Menezes, Malbouisson, Silva) Hospital das Clinicas, Medical
School, Universidade de Sao Paulo, Sao Paulo, Brazil
(Hohmann, Assuncao, de Freitas Chaves, Correa, Neto, Silva) Departamento
de Pacientes Graves, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
(Lobo) Unidade de Terapia Intensiva, Hospital de Base, Medical School of
Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
(Amendola) Unidade de Terapia Intensiva, Hospital de Cancer de Barretos,
Pio XII Foundation, SP, Barretos, Brazil
(de Aguilar-Nascimento) Unidade de Terapia Intensiva, Universidade Federal
de Mato Grosso, Cuiaba, Brazil
Publisher
Public Library of Science
Abstract
Background and objectives Hypothermia occurs commonly during surgery and
can cause postoperative complications. We aimed to describe the
characteristics and outcomes of hypothermia in patients undergoing major
surgeries. Methods This prospective, observational, multicenter study of a
nationally representative sample included all patients over 18 years of
age admitted to an intensive care unit (ICU). Thirty ICUs were selected
randomly at national level. The main outcome measure was the proportion of
patients who developed postoperative hypothermia in the first 24 hours of
ICU admission. Patients were divided into three groups based on
temperature: <35C, <36C, and >36C (no hypothermia). Patients'
characteristics, postoperative complications, and risk factors were
evaluated in all groups. To verify whether hypothermia was a strong risk
factor for postoperative complications, a Kaplan-Meier curve was generated
and adjusted using a Cox regression model. Results In total, 738 patients
had their temperatures measured. The percentage of patients with
temperature <35C (median [Q1-Q3], 34.7C [34.3-34.9C]) was 19.1% (95%
confidence interval [CI] = 16.1-22.5) and that of patients with
temperature <36C (median [Q1-Q3], 35.4C [35.0-35.8C]) was 64% (95% CI =
58.3-70.0). The percentage of surgical complications was 38.9%. Patients
with hypothermia were older, had undergone abdominal surgeries, had
undergone procedures of longer duration, and had more comorbidities. A
postoperative temperature <35C was an independent risk for composite
postoperative complications (hazard ratio = 1.523, 95% CI = 1.15-2.0),
especially coagulation and infection. Conclusions Inadvertent hypothermia
was frequent among patients admitted to the ICU and occurred more likely
after abdominal surgery, after a long procedure, in elderly patients, and
in patients with a higher number of comorbidities. Low postoperative
temperature was associated with postoperative complications.<br/>Copyright
&#xa9; 2021 Sabbag et al. This is an open access article distributed under
the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<34>
Accession Number
2015617718
Title
Does lung cancer screening with low-dose computerized tomography improve
survival?.
Source
Interactive Cardiovascular and Thoracic Surgery. 33(5) (pp 741-745), 2021.
Date of Publication: 01 Nov 2021.
Author
Manuel L.; Fong L.S.; Ly T.; Meredith G.
Institution
(Manuel, Ly, Meredith) Department of Cardiothoracic Surgery, Westmead
Hospital, Sydney, Australia
(Manuel, Fong) Department of Cardiothoracic Surgery, Prince of Wales
Hospital, Sydney, Australia
Publisher
Oxford University Press
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was Does lung cancer screening
with low-dose computerised tomography (LDCT) improve survival? More than
963 papers were found, of which 8 randomized control trials and 1
meta-analysis represented the best evidence to answer the clinical
question. The authors, journal, date and country of publication, patient
group studied, study type, relevant outcomes and results of these papers
were tabulated. The majority of studies trended towards greater incidence
of early lung cancer detection, and subsequent curative treatment, in the
LDCT screening populations with appropriately powered randomized control
trials (NELSON and NLST) demonstrating survival benefits of >20% in lung
cancer-specific mortality. However, this reduction must be evaluated
against the potential harms associated with screening, including
complications from diagnostic procedures, and costs of overdiagnosis, as
evidenced in several studies. We conclude that in high-risk populations,
lung cancer screening with LDCT results in earlier detection of low-stage
cancers and improved survival when compared to usual clinical care or
screening with a chest X-ray.<br/>Copyright &#xa9; 2021 Oxford University
Press. All rights reserved.

<35>
Accession Number
2015617697
Title
The cost-effectiveness of transcatheter aortic valve replacement in low
surgical risk patients with severe aortic stenosis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 7(6) (pp
556-563), 2021. Date of Publication: 01 Dec 2021.
Author
Tam D.Y.; Azizi P.M.; Fremes S.E.; Chikwe J.; Gaudino M.; Wijeysundera
H.C.
Institution
(Tam, Fremes) Division of Cardiac Surgery, Department of Surgery, Schulich
Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto,
Toronto, ON, Canada
(Tam, Azizi, Fremes, Wijeysundera) Institute of Health Policy, Management
and Evaluation, University of Toronto, Toronto, ON, Canada
(Chikwe) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York - Presbyterian Hospital, New York, NY, United States
(Wijeysundera) Division of Cardiology, Department of Medicine, Schulich
Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto,
2075 Bayview Avenue, Room A202, Toronto, ON M4N 3M5, Canada
Publisher
Oxford University Press
Abstract
Aims: The economic value of transcatheter aortic valve replacement (TAVR)
in low surgical risk patients with severe, symptomatic aortic stenosis is
not known. Our objective was to determine the cost-effectiveness of
balloon-expandable TAVR and self-expandable TAVR relative to surgical
aortic valve replacement (SAVR) in low-risk patients. <br/>Methods and
Results: A fully probabilistic Markov cohort model was constructed to
estimate differences in costs and effectiveness [quality-adjusted life
years (QALYs)] over the patient's life-time time from the third-party
payer's perspective. Clinical outcomes modelled were alive/well (no
complications), permanent stroke, >=moderate paravalvular leak, new
pacemaker, rehospitalization, and death. A network meta-analysis of the
PARTNER 3 and Evolut Low Risk trial was performed to compare
balloon-expandable TAVR, self-expandable TAVR, and SAVR for the efficacy
inputs. Incremental-cost effectiveness ratios (ICER) were calculated. The
total life-time costs in the balloon-expandable TAVR,
self-expandable-TAVR, and SAVR arms were $37 330 +/- 4724, $39 660 +/-
4862, and $34 583 +/- 6731, respectively, and total life-time QALYs gained
were 9.15 +/- 3.23, 9.13 +/- 3.23, and 9.05 +/- 3.20, respectively. The
ICERs for balloon-expandable TAVR and self-expandable TAVR against SAVR
were $27 196/QALY and $59 641/QALY, respectively. Balloon-expandable TAVR
was less costly and more effective than self-expandable TAVR. There was
substantial uncertainty, with 53% and 58% of model iterations showing
balloon-expandable TAVR to be the preferred option at willingness-to-pay
thresholds of $50 000/QALY and $100 000/QALY, respectively.
<br/>Conclusion(s): Compared with SAVR, TAVR, particularly with
balloon-expandable prostheses may be a cost-effective option for patients
with severe aortic stenosis at low surgical risk. <br/>Copyright &#xa9;
2020 Published on behalf of the European Society of Cardiology. All rights
reserved.

<36>
Accession Number
2015617622
Title
Is hybrid coronary revascularization really beneficial in the long term?.
Source
European Journal of Cardio-thoracic Surgery. 60(5) (pp 1158-1166), 2021.
Date of Publication: 01 Nov 2021.
Author
Wang C.; Li P.; Zhang F.; Li J.; Kong Q.
Institution
(Wang, Li, Zhang, Li, Kong) Department of Cardiac Surgery, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: This analysis aimed to compare both short-and long-term
outcomes of hybrid coronary revascularization (HCR) with different
techniques and coronary artery bypass grafting (CABG). <br/>METHOD(S):
Twenty-three studies were included, covering 10 468 different patients,
among whom 2403 patients underwent HCR with either simultaneous or staged
method and 8065 patients underwent CABG. <br/>RESULT(S): Compared with
CABG, HCR had a statistically significant lower risk of stroke [odds ratio
(OR) = 0.55, P = 0.049], major adverse cardiac and cerebrovascular events
(OR = 0.69, P = 0.024) and blood transfusion (BT) (OR = 0.39, P < 0.001),
whereas no significant differences were detected in mortality, myocardial
infarction and repeat revascularization. A network meta-analysis showed
that simultaneous HCR had significantly better outcomes in stroke (OR =
0.24, P = 0.01) and major adverse cardiac and cerebrovascular events (OR =
0.29, P < 0.001), and staged HCR had a significantly better outcome in BT
(OR = 0.31, P < 0.001). According to the frequentist statistic results,
simultaneous HCR had the highest probability of being the best treatment
in terms of mortality (84%), stroke (97%), myocardial infarction (88%) and
major adverse cardiac and cerebrovascular events (99%), whereas staged HCR
had the highest probability of being the best in postoperative repeat
revascularization (59%) and BT (83%). However, long-term results showed no
significant difference between the HCR and CABG techniques.
<br/>CONCLUSION(S): HCR appears to be a feasible option for multivessel
coronary artery disease patients. Compared to traditional CABG, HCR had
lower risk of adverse events in the short term, but in the long term,
survival rate and freedom from major adverse cardiac and cerebrovascular
events rate were similar between groups. <br/>Copyright &#xa9; 2021 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<37>
Accession Number
2015617597
Title
Antiplatelet therapy after transcatheter aortic valve implantation: A
systematic review and meta-analysis.
Source
European Journal of Cardio-thoracic Surgery. 60(5) (pp 1022-1029), 2021.
Date of Publication: 01 Nov 2021.
Author
Costa G.F.; Costa M.; Goncalves L.; Teixeira R.
Institution
(Costa, Costa, Goncalves, Teixeira) Servico de Cardiologia, Centro
Hospitalar e Universitario de Coimbra, Coimbra, Portugal
(Goncalves, Teixeira) Faculdade de Medicina da Universidade de Coimbra,
Coimbra, Portugal
(Goncalves, Teixeira) Coimbra Institute for Clinical and Biomedical
Research (ICBR), Coimbra, Portugal
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The aim of this study was to compare antithrombotic regimens
after transcatheter aortic valve implantation (TAVI) in patients without
an indication for long-term anticoagulation. TAVI is a safe and effective
approach for patients with symptomatic severe aortic stenosis and an
intermediate-to-high surgical risk. Nevertheless, the antithrombotic
regimen after procedure remains controversial. <br/>METHOD(S): We
systematically searched PubMed, Embase and Cochrane databases for
interventional studies comparing single antiplatelet therapy with double
antiplatelet therapy after TAVI. A meta-analysis was carried out to
compare thrombotic and bleeding events between both strategies.
<br/>RESULT(S): Four randomized clinical trials were included comprising a
total of 1085 patients. Our meta-analysis revealed a higher odds ratio
(OR) of major bleeding events (pooled OR 2.45, 95% confidence interval
(CI) 1.29-4.67; P < 0.01; I2 = 0%) and minor bleeding (pooled OR 1.73, 95%
CI 1.12-2.66; P = 0.01; I2 = 0%) for the double antiplatelet therapy group
compared with the single antiplatelet therapy group. There was no
difference between groups in the risk of stroke (pooled OR 1.04, 95% CI
0.58-1.86; P = 0.91; I2 = 0%), myocardial infarction (pooled OR 2.10, 95%
CI 0.75-5.84; P = 0.16, I2 = 0%) and all-cause mortality (pooled OR 1.07,
95% CI 0.63-1.86; P = 0.08; I2 = 0%) after TAVI. <br/>CONCLUSION(S): Our
pooled analysis suggests that for patients who underwent TAVI, double
antiplatelet therapy compared with single antiplatelet therapy alone
increased the risk of bleeding without reducing mortality and ischaemic
events. <br/>Copyright &#xa9; 2021 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<38>
Accession Number
2015617554
Title
Mitral and tricuspid annuloplasty ring dehiscence: A systematic review
with pooled analysis.
Source
European Journal of Cardio-thoracic Surgery. 60(4) (pp 801-810), 2021.
Date of Publication: 01 Oct 2021.
Author
Arjomandi Rad A.; Naruka V.; Vardanyan R.; Viviano A.; Salmasi M.Y.;
Magouliotis D.; Kendall S.; Casula R.; Athanasiou T.
Institution
(Arjomandi Rad, Vardanyan) Department of Medicine, Faculty of Medicine,
Imperial College London, London, United Kingdom
(Naruka, Viviano, Casula) Department of Cardiothoracic Surgery, Imperial
College Nhs Trust, Hammersmith Hospital, London, United Kingdom
(Salmasi, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
(Magouliotis) Department of Surgery, Faculty of Medicine, School of Health
Sciences, University of Thessaly, Larissa, Greece
(Kendall) Department of Cardiothoracic Surgery, James Cook University
Hospital, Middlesborough, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Mitral and tricuspid ring annuloplasty dehiscence with
consequent recurrent valve regurgitation is a rare but challenging
procedural failure. The incidence and predisposing risk factors for
annuloplasty ring dehiscence include technical and pathological ones.
<br/>METHOD(S): A systematic database search with pooled analysis was
conducted of original articles that only included dehiscence rate of
mitral and tricuspid ring in EMBASE, MEDLINE, Cochrane database and Google
Scholar, from inception to November 2020. The outcomes included were
dehiscence rate in mitral and tricuspid, type of ring implanted,
dehiscence rate by pathology and by ring size and shape. <br/>RESULT(S):
Our search yielded 821 relevant studies. Thirty-three studies met the
inclusion criteria with a total of 10 340 patients (6543 mitral, 1414
tricuspid) of which 87 (mitral) and 30 (tricuspid) had dehiscence.
Overall, dehiscence rate was 1.43%, diagnosed at a median of 4.5 +/- 1.0
months postoperatively. A significant difference in mitral dehiscence rate
was found by ring type (semi-rigid 1.86%, rigid 2.32%; flexible 0.43%; P <
0.001). There was no significant difference in rate of dehiscence by ring
size (P = 0.067) and shape in mitral (P = 0.281) but there was higher
dehiscence rate in ischaemic compared to non-ischaemic mitral
regurgitation (3.91% vs 1.63%; P = 0.022). Among tricuspid studies, 9 of
10 studies did not report any dehiscence. <br/>CONCLUSION(S): Although
rigid, semi-rigid and flexible annuloplasty rings provide acceptable valve
repair outcomes, mitral annuloplasty ring dehiscence is clinically more
common among rigid rings. Understanding the multifactorial nature of ring
dehiscence will help in identifying the patients at high risk and improve
their clinical outcomes. <br/>Copyright &#xa9; 2021 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<39>
Accession Number
2015627111
Title
Prevention and management of perioperative hypothermia in adult elective
surgical patients: A systematic review.
Source
Annals of Medicine and Surgery. 72 (no pagination), 2021. Article Number:
103059. Date of Publication: December 2021.
Author
Simegn G.D.; Bayable S.D.; Fetene M.B.
Institution
(Simegn, Bayable, Fetene) Department of Anaesthesia, College of Medicine
and Health Science, Debre Markos University, Ethiopia
Publisher
Elsevier Ltd
Abstract
Background: Body temperature is tightly regulated with hormonal and
cellular metabolism for normal functioning; however perioperative
hypothermia is common secondary to anesthesia and surgical exposure.
Prevention and maintaining body temperature should be started 1-2hrs
before induction of anesthesia, to do this both active and passive warming
system are effective to prevent complications associated with
perioperative hypothermia. <br/>Method(s): The aim of this systematic
review is to develop a clear clinical practice protocol in prevention and
management of perioperative hypothermia for elective adult surgical
patients. The study is conducted in accordance with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guideline 2020. After formulating clear criteria for the evidences to be
included an appropriate method of searching was conducted by using the Pub
Med, Google scholar and Cochrane library using the following MeSH terms:
(inadvertent hypothermia AND anesthesia, hypothermia AND perioperative
management and thermoregulation AND anesthesia) were used to draw
evidences. After a reasonable amount of evidences were collected,
appraisal and evaluation of study quality was based on WHO 2011 level of
evidence and degree of recommendation. Final conclusions and
recommendations are done by balancing the benefits and downsides of
alternative management strategies for perioperative management of
hypothermia. This systematic review registered with research registry
unique identifying number (UIN) of "reviewregistry1253" in addition the
overall AMSTAR 2 quality of this systematic review is moderate level.
<br/>Discussion(s): Preserving a patient's body temperature during
anesthesia and surgery is to minimize heat loss by reducing radiation and
convection from the skin, evaporation from exposed surgical areas, and
cooling caused by the introduction of cold intravenous fluids.
<br/>Conclusion(s): Hypothermia is least monitored complication during
anesthesia and surgery results cardiac abnormalities, impaired wound
healing, increased surgical site infections, shivering and delayed
postoperative recovery, and coagulopathies.<br/>Copyright &#xa9; 2021 The
Authors

<40>
Accession Number
2014561274
Title
Drug-eluting or bare-metal stents for left anterior descending or left
main coronary artery revascularization.
Source
Journal of the American Heart Association. 10(20) (no pagination), 2021.
Article Number: e018828. Date of Publication: 19 Oct 2021.
Author
Piccolo R.; Bonaa K.H.; Efthimiou O.; Varenne O.; Urban P.; Kaiser C.;
Raber L.; de Belder A.; Remkes W.; Van'T Hof A.W.J.; Stankovic G.; Lemos
P.A.; Wilsgaard T.; Reifart J.; Rodriguez A.E.; Ribeiro E.E.; Serruys
P.W.J.C.; Abizaid A.; Sabate M.; Byrne R.A.; de la Torre Hernandez J.M.;
Wijns W.; Esposito G.; Juni P.; Windecker S.; Valgimigli M.
Institution
(Piccolo, Esposito) Department of Advanced Biomedical Sciences, University
of Naples Federico II, Naples, Italy
(Bonaa, Wilsgaard) Department of Community Medicine, University of Tromso,
The Arctic University of Norway, Tromso, Norway
(Efthimiou) Institute of Social and Preventive Medicine
(Raber, Windecker, Valgimigli) Department of Cardiology, Bern University
Hospital, Switzerland
(Efthimiou) University of Bern, Switzerland
(Varenne) Department of Cardiology, Hopital Cochin, AP-HP, Paris, France
(Varenne) Faculte de Medecine, Universite de Paris, France
(Urban) Hopital de la Tour, Geneva, Switzerland
(Kaiser) Department of Cardiology, University Hospital Basel, University
of Basel, Switzerland
(de Belder) Department of Cardiology, Sussex Cardiac Centre, Brighton and
Sussex University Hospitals, Brighton, United Kingdom
(Remkes) Department of Cardiology, Isala Heart Centre, Zwolle, Netherlands
(Van'T Hof) Department of Cardiology, Maastricht University Medical
Center, Maastricht, Netherlands
(Van'T Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
(Stankovic) Department of Cardiology, Clinical Center of Serbia,
University of Belgrade, Serbia
(Lemos) Heart Institute (InCor), University of Sao Paulo Medical School,
Sao Paulo, Brazil
(Lemos) Hospital Israelita Albert Einstein, Sao Paulo-SP, Brazil
(Reifart) Department of Cardiology, Kerckhoff Klinik, Bad Nauheim, Germany
(Rodriguez) Cardiac Unit, Otamendi Hospital, Buenos Aires School of
Medicine, Buenos Aires, Argentina
(Ribeiro) Instituto do Coracao (INCOR), Sao Paulo, Brazil
(Serruys) International Centre for Circulatory Health, National Heart and
Lung Institute, Imperial College, London, United Kingdom
(Abizaid) Department of Invasive Cardiology, Institute Dante Pazzanese of
Cardiology, Sao Paulo, Brazil
(Sabate) Cardiology Department, Cardiovascular Institute (ICCV) and
Hospital Clinic, IDIBAPS, University of Barcelona, Spain
(Byrne) Dublin Cardiovascular Research Institute, Mater Private Hospital,
Dublin, Ireland
(Byrne) School of Pharmacy and Biomolecular Sciences, Royal College of
Surgeons in Ireland, Dublin, Ireland
(de la Torre Hernandez) Hospital Marques de Valdecilla, Santander, Spain
(Wijns) The Lambe Institute for Translational Medicine and Curam, Galway,
Ireland
(Wijns) Department of Cardiology, National University of Ireland Galway,
Galway, Ireland
(Juni) Department of Medicine, Applied Health Research Centre of the Li Ka
Shing Knowledge Institute, St Michael's Hospital, University of Toronto,
ON, Canada
(Valgimigli) CardioCentro Ticino, Lugano, Switzerland
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: New-generation drug-eluting stents (DES) reduce target-vessel
revascularization compared with bare-metal stents (BMS), and recent data
suggest that DES have the potential to decrease the risk of myocardial
infarction and cardiovascular mortality. We evaluated the treatment effect
of DES versus BMS according to the target artery (left anterior descending
[LAD] and/or left main [LM] versus other territories [no-LAD/LM]). METHODS
AND RESULTS: The Coronary Stent Trialist (CST) Collaboration gathered
individual patient data of randomized trials of DES versus BMS for the
treatment of coronary artery disease. The primary outcome was the
composite of cardiac death or myocardial infarction. Hazard ratios (HRs)
with 95% CIs were derived from a 1-stage individual patient data
meta-analysis. We included 26 024 patients across 19 trials: 13 650
(52.4%) in the LAD/LM and 12 373 (47.6%) in the no-LAD/LM group. At 6-year
follow-up, there was strong evidence that the treatment effect of DES
versus BMS depended on the target vessel (Pinteraction=0.024). Compared
with BMS, DES reduced the risk of cardiac death or myocardial infarction
to a greater extent in the LAD/LM (HR, 0.76; 95% CI, 0.68-0.85) than in
the no-LAD/LM territories (HR, 0.93; 95% CI, 0.83-1.05). This benefit was
driven by a lower risk of cardiac death (HR, 0.83; 95% CI, 0.70-0.98) and
myocardial infarction (HR, 0.74; 95% CI, 0.65-0.85) in patients with
LAD/LM disease randomized to DES. An interaction (P=0.004) was also found
for all-cause mortality with patients with LAD/LM disease deriving benefit
from DES (HR, 0.86; 95% CI, 0.76-0.97). <br/>CONCLUSION(S): As compared
with BMS, new-generation DES were associated with sustained reduction in
the composite of cardiac death or myocardial infarction if used for the
treatment of LAD or left main coronary stenoses.<br/>Copyright &#xa9; 2021
The Authors.

<41>
Accession Number
2014242391
Title
Superior Vena Cava Syndrome due to pericardial hematoma: A case report and
mini-review of literature.
Source
SAGE Open Medical Case Reports. 9 (no pagination), 2021. Date of
Publication: 2021.
Author
Saboe A.; Pramanda A.N.; Hasan M.; Kusumawardhani N.Y.; Maryani E.;
Ruhimat U.; Cool C.J.
Institution
(Saboe, Maryani) Department of Cardiology and Vascular Medicine, Faculty
of Medicine, Universitas Padjadjaran-Hasan Sadikin General Hospital,
Bandung, Indonesia
(Pramanda) Diagnostic Non-Invasive Division, Department of Cardiology and
Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran-Hasan
Sadikin General Hospital, Bandung, Indonesia
(Hasan, Kusumawardhani) Cardiovascular Imaging Division, Department of
Cardiology and Vascular Medicine, Faculty of Medicine, Universitas
Padjadjaran-Hasan Sadikin General Hospital, Bandung, Indonesia
(Ruhimat) Cardiothoracic Surgery Division, Department of Surgery, Faculty
of Medicine, Universitas Padjadjaran-Hasan Sadikin General Hospital,
Bandung, Indonesia
(Cool) Department of Radiology, Faculty of Medicine, Universitas
Padjadjaran-Hasan Sadikin General Hospital, Bandung, Indonesia
Publisher
SAGE Publications Ltd
Abstract
Superior vena cava syndrome is a life-threatening condition. Typically,
the clinical presentations are gradual; hence, the diagnosis is often
delayed until critical compression or obstruction has occurred.
Pericardial hematoma is a rare condition that could occur after cardiac
surgery. An asymptomatic, 25-year-old female, who underwent surgical
atrial septal defect closure 5 days ago, was sent for routine
echocardiography examination before discharge. An intrapericardiac
hematoma was detected at the right atrium's free wall without any
intracardiac hemodynamic consequences. The patient was discharged and
planned for monthly evaluation. During follow-up, the intrapericardiac
hematoma was expanding. In the third month's follow-up, the patient
complained of shortness of breath, headaches, and coughs. Echocardiography
evaluation revealed enlarged pericardial hematoma, which compressed the
right atrium and superior vena cava orifice, without echo' sign of cardiac
tamponade. Computed tomography scan revealed superior vena cava
compression by the pericardial hematoma and appearance of the collateral
vessel. The patient was diagnosed with superior vena cava syndrome and
sent for surgical evacuation. Pericardial hematoma after cardiac surgery
should be evaluated meticulously. Chronic expanding hematoma could cause
superior vena cava syndrome, which is fatal. Early diagnosis and
appropriate treatment are essential in managing this
condition.<br/>Copyright &#xa9; The Author(s) 2021.

<42>
Accession Number
2015656918
Title
Left atrial appendage closure during cardiac surgery for atrial
fibrillation: A meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Prasad R.M.; Saleh Y.; Al-Abcha A.; Abdelkarim O.; Abdelfattah O.M.;
Abdelnabi M.; Almaghraby A.; Elwany M.; DeBruyn E.; Abela G.S.
Institution
(Prasad, Al-Abcha) Department of Internal Medicine, Michigan State
University, East Lansing, MI, United States
(Saleh, Abdelkarim) Department of Cardiology, Houston Methodist DeBakey
Heart & Vascular Center, Houston, TX, United States
(Saleh, Abdelkarim, Almaghraby, Elwany) Department of Cardiology,
Alexandria University, Alexandria, Egypt
(Abdelfattah) Department of Internal Medicine, Morristown Medical Center,
Atlantic Health System, Morristown, NJ, United States
(DeBruyn) College of Medicine, University of Illinois, Chicago, IL, United
States
(Abela) Department of Cardiology, Michigan State University, East Lansing,
MI, United States
(Abdelnabi) Internal Medicine Department, Texas Tech University Health
Science Center, Lubbock, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Left atrial appendage closure (LAAC) during cardiac surgery in
atrial fibrillation (AF) patients has been investigated in multiple
studies with variable safety and efficacy results. <br/>Method(s): A
comprehensive review was performed of all studies comparing LAAC and
placebo arm during cardiac surgery in AF patients. A random-effect model
was used to calculate risk ratios, mean differences, and 95% confidence
intervals. <br/>Result(s): Five randomized controlled trials and 22
observational studies were included with a total of 540,111 patients. The
LAAC group had significantly decreased postoperative stroke/embolic events
as compared to the no LAAC group with all cardiac surgeries (3.74% vs
4.88%, p = 0.0002), isolated valvular surgery (1.95% vs 4.48%, p = 0.002).
However, CABG insignificantly favored the LAAC group for stroke/embolic
events (6.72% vs 8.30%, p = 0.07). There was no difference between both
groups in all-cause mortality in the perioperative period (p = 0.42), but
was significantly lower in the LAAC arm after two years (14.1% vs 18.3%, p
= 0.02). There was no difference in major bleeding, all-cause
rehospitalizations, or cross-clamp time between both groups (p = 0.53 and
p = 0.45). The bypass and the cross-clamp time were longer in the LAAC
group (4 and 9 min, respectively). <br/>Conclusion(s): In AF patients,
LAAC during cardiac surgery had a decreased risk of stroke and long-term
all-cause mortality. Additionally, there was no difference in major
bleeding, all-cause rehospitalizations, or cross-clamp time.<br/>Copyright
&#xa9; 2021

<43>
Accession Number
2014243457
Title
Radial versus femoral access in patients with coronary artery bypass
surgery: Frequentist and Bayesian meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2021.
Date of Publication: 2021.
Author
Nikolakopoulos I.; Vemmou E.; Xenogiannis I.; Karacsonyi J.; Rao S.V.;
Romagnoli E.; Tsigkas G.; Milkas A.; Velagapudi P.; Alaswad K.; Rangan
B.V.; Garcia S.; Burke M.N.; Brilakis E.S.
Institution
(Nikolakopoulos, Vemmou, Xenogiannis, Karacsonyi, Rangan, Garcia, Burke,
Brilakis) Minneapolis Heart Institute and Minneapolis Heart Institute
Foundation, Abbott Northwestern Hospital, Minneapolis, MN, United States
(Rao) Duke Clinical Research Institute, Durham, NC, United States
(Romagnoli) Department of Cardiovascular and Thoracic Sciences, Institute
of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS,
Universita Cattolica del Sacro Cuore, Rome, Italy
(Tsigkas) Department of Cardiology, University of Patras Medical School,
Patras, Greece
(Milkas) Acute Cardiac Care Unit, Athens Naval and Veterans Hospital,
Athens, Greece
(Velagapudi) University of Nebraska Medical Center, Omaha, NE, United
States
(Alaswad) Department of Cardiology, Henry Ford Hospital, Detroit, MI,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The optimal access site for cardiac catheterization in
patients with prior coronary artery bypass surgery (CABG) continues to be
debated. <br/>Method(s): We performed a random effects frequentist and
Bayesian meta-analysis of 4 randomized trials and 18 observational
studies, including 60,192 patients with prior CABG (27,236 in the radial
group; 32,956 in the femoral group) that underwent cardiac
catheterization. Outcomes included (1) access-site complications, (2)
crossover to a different vascular access, (3) procedure time, and (4)
contrast volume. Mean differences (MD) and 95% confidence interval (CI)
were calculated for continuous outcomes and odds ratios (OR) and 95% CI
for binary outcomes. <br/>Result(s): Among randomized trials, crossover
(OR: 7.63; 95% CI: 2.04, 28.51; p = 0.003) was higher in the radial group,
while access site complications (OR: 0.96; 95% CI: 0.34, 2.87; p = 0.94)
and contrast volume (MD: 15.08; 95% CI: -10.19, 40.35; p = 0.24) were
similar. Among observational studies, crossover rates were higher (OR:
5.09; 95% CI: 2.43, 10.65; p < 0.001), while access site complication
rates (OR: 0.52; 95% CI: 0.30, 0.89; p = 0.02) and contrast volume (MD:
-7.52; 95% CI: -13.14, -1.90 ml; p = 0.009) were lower in the radial
group. Bayesian analysis suggested that the odds of a difference existing
between radial and femoral are small for all endpoints except crossover to
another access site. <br/>Conclusion(s): In a frequentist and Bayesian
meta-analysis of patients with prior CABG undergoing coronary
catheterization, radial access was associated with lower incidence of
vascular access complications and lower contrast volume but also higher
crossover rate.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC.

<44>
Accession Number
2013979152
Title
SARS-CoV-2 infection in heart transplant recipients: a systematic
literature review of clinical outcomes and immunosuppression strategies.
Source
Heart Failure Reviews. (no pagination), 2021. Date of Publication: 2021.
Author
Ilonze O.J.; Ballut K.; Rao R.S.; Jones M.A.; Guglin M.
Institution
(Ilonze, Ballut, Rao, Jones, Guglin) Krannert Institute of Cardiology,
Section of Advanced Heart Failure and Transplant Cardiology, Division of
Cardiology, Indiana University School of Medicine, Indianapolis, United
States
(Ilonze) IndianapolisUnited States
Publisher
Springer
Abstract
The impact of SARS-CoV-2 infection on heart transplant recipients is
unknown. Literature is limited to case reports and series. The purpose of
this study is to identify the clinical features, outcomes, and
immunosuppression strategies of heart transplant recipients with COVID-19
infection. A systematic review was conducted using the search term
"Coronavirus" or COVID," "SARS-CoV-2," "cardiac transplantation," and
"heart transplant." Case reports and retrospective studies were gathered
by searching Medline/PubMed, Google Scholar, CINAHL, Cochrane CENTRAL, and
Web of Science. Thirty-three articles were selected for review. We
identified 74 cases of SARS-CoV-2 infection in heart transplant and
heart-kidney transplant recipients. The mean age was 60.5 +/- 15.8 years,
and 82.4% were males with median time from transplant of 6.5 years.
Commonest symptoms were fever, cough, and dyspnea, but new left
ventricular (LV) dysfunction was rare. Leukocytosis, lymphopenia, elevated
inflammatory markers, and bilateral ground-glass opacities were common.
Mortality was high, with particularly poor survival in patients who
required intensive care unit (ICU) admission and older patients.
Immunosuppression involved discontinuation of antimetabolites and
steroids. COVID-19 infection in heart transplant (HT) recipients presents
similarly to the general population, but new onset of LV dysfunction is
uncommon. Immunosuppression strategies include increase in corticosteroids
and discontinuation of antimetabolites.<br/>Copyright &#xa9; 2021, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<45>
Accession Number
636480103
Title
Conventional sternotomy versus right mini-thoracotomy versus robotic
approach for mitral valve replacement/repair; insights from a network
meta-analysis.
Source
The Journal of cardiovascular surgery. (no pagination), 2021. Date of
Publication: 19 Oct 2021.
Author
Yokoyama Y.; Kuno T.; Takagi H.; Briasoulis A.; Ota T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
PA, Bethlehem, United States
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, NY, NY, United States
(Kuno) Department of Cardiology, Montefiore Medical Center/Albert Einstein
Medical College, NY, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Briasoulis) Division of Cardiovascular medicine, Section of Heart failure
and Transplantation, University of Iowa, IA, Iowa City, United States
(Ota) Department of Surgery, University of Chicago Medicine, Chicago,
United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Minimally invasive cardiac surgery (MICS) through right
mini-thoracotomy as well as robotic surgery has emerged for the last
decade for mitral valve surgery. However, their risks and benefits are not
fully understood yet. Thus, we conducted a network meta-analysis comparing
the early- and long-term outcomes of mitral valve surgery via the
conventional sternotomy, MICS, and robotic approaches. EVIDENCE
ACQUISITION: MEDLINE and EMBASE were searched through November, 2020 to
identify randomized controlled trials (RCTs) and propensity-score matched
(PSM) trials that investigated early- and long-term outcomes after mitral
surgery via the conventional sternotomy, MICS, and robotic approaches. A
subalalysis focusing on only subjects who initially underwent mitral valve
repair was also conducted. EVIDENCE SYNTHESIS: Our systematic literature
search identified 2 RCTs and 19 PSM studies. MICS was related to
significant risk reductions of permanent pacemaker implantation, surgical
site infection, and transfusion compared to the sternotomy approach. The
robotic approach was associated with a significant increase in
re-exploration for bleeding compared to sternotomy. The subanalysis showed
that MICS was associated with a significant increase requiring mitral
valve reoperation compared to the sternotomy approach (hazard ratio [95%
confidence interval] =7.33 [1.54-34.97], p=0.012), while no significant
difference was observed between the sternotomy and the robotic approach.
<br/>CONCLUSION(S): Our network meta-analysis demonstrated that MICS was
associated with better short-term outcomes compared to the sternotomy
approach. Mitral valve reoperation was more frequent with MICS compared
with the sternotomy approach after mitral valve repair, while no
difference was observed between the sternotomy and robotic approaches.

<46>
Accession Number
636478056
Title
Transcatheter aortic valve replacement for structural degeneration of
previously implanted transcatheter valves (TAVR-in-TAVR): a systematic
review.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2021.
Date of Publication: 18 Oct 2021.
Author
Gallo M.; Fovino L.N.; Blitzer D.; Doulamis I.P.; Guariento A.; Salvador
L.; Tagliari A.P.; Ferrari E.
Institution
(Gallo, Ferrari) Department of Cardiac Surgery, Cardiocentro Ticino
Institute, Lugano, Switzerland
(Gallo, Salvador) Department of Cardiac Surgery, San Bortolo Hospital,
Vicenza, Italy
(Fovino) Department of Cardiology, University of Padova, Padova, Italy
(Blitzer) Department of Surgery, New York Presbyterian Hospital, Columbia
University, NY, NY, United States
(Doulamis) Department of Cardiac Surgery, Boston Children's Hospital,
Harvard Medical School, MA, Boston, United States
(Guariento) Department of Cardiovascular Surgery, Labatt Family Heart
Centre, Hospital for Sick Children, University of Toronto, ON, Toronto,
Canada
(Tagliari) Postgraduate Program in Health Sciences: Cardiology and
Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto
Alegre, Brazil
(Ferrari) University of Zurich, Zurich, Switzerland
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Transcatheter aortic valve replacement (TAVR) represents a
valid treatment for patients with aortic valve stenosis and high or
intermediate surgical risk. However, biological transcatheter valves can
also experience a structural degeneration after years, and a redo-TAVR
procedure (TAVR-in-TAVR) can be a valid option. We revised the current
available literature for indications, procedural and technical details and
outcome on TAVR-in-TAVR procedures for degenerated TAVR valves.
<br/>METHOD(S): A systematic search was conducted in the public medical
database for scientific articles on TAVR-in-TAVR procedures for
degenerated transcatheter valves. Data on demographics, indications, first
and second transcatheter valve type and size, mortality, complications and
follow-up were extracted and analysed. <br/>RESULT(S): A total of 13
studies (1 multicentre, 3 case series, 9 case reports) were included in
this review, with a total amount of 160 patients treated with TAVR-in-TAVR
procedures for transcatheter valve failure. The mean age was 74.8 +/- 7.8
with 84 males (52.8%). The mean elapsed time from the first TAVR procedure
was 58.1 +/- 23.4 months. Main indication for TAVR-in-TAVR was pure
stenosis (38.4%, with mean gradient of 44.5 +/- 18.5 mmHg), regurgitation
(31.4%), mixed stenosis and regurgitation (29.5%) and leaflet thrombosis
(8.8%). Procedural success rate was 86.8%, with second TAVR valve
malposition occurred in 4 cases (2.5%). The hospital mortality rate was
1.25% (2/160). Post-procedural echocardiographic control showed moderate
regurgitation in 5.6% of patients (9/160) and residual transvalvular mean
gradient >=20 mmHg in 5% of cases. Postoperative complications included
major vascular complications (8.7%), new pacemaker implantation (8.7%),
acute kidney failure (3.7%), stroke (0.6%) and coronary obstruction
(0.6%). The mean follow-up time was 6 +/- 5.6 months with 1
non-cardiovascular death reported. <br/>CONCLUSION(S): TAVR-in-TAVR
represents a valid alternative to standard surgery for the treatment of
degenerated transcatheter valves in high-risk patients. Despite these
promising results, further studies are required to assess durability and
haemodynamic performances of the second TAVR valve. SUBJ COLLECTION: 117,
122, 125.<br/>Copyright &#xa9; The Author(s) 2021. Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<47>
Accession Number
2010299065
Title
Infective endocarditis in patients with liver cirrhosis: a systematic
review.
Source
Journal of Chemotherapy. 33(7) (pp 443-451), 2021. Date of Publication:
2021.
Author
Ioannou P.; Savva E.; Kofteridis D.P.
Institution
(Ioannou, Savva, Kofteridis) Department of Internal Medicine & Infectious
Diseases, University Hospital of Heraklion, Heraklion, Greece
Publisher
Taylor and Francis Ltd.
Abstract
Liver cirrhosis is an increasing cause of mortality and morbidity in
developed countries. Infective Endocarditis (IE) is an uncommon disease
with notable morbidity and mortality. Even though cirrhosis is associated
with immune dysfunction and increased occurrence of bacterial infection,
IE is infrequently diagnosed in these patients. Thus, the purpose of this
study was to systematically review all published cases of IE in patients
with cirrhosis in the literature. A systematic review of PubMed, Scopus
and Cochrane (through 23^th April 2020) for studies providing
epidemiological, clinical, microbiological as well as treatment data and
outcomes of IE in patients with cirrhosis was performed. A total of 78
studies, containing data of 602 patients, were included. A prosthetic
valve was present in 17.8%, while the most common causative pathogen was
S. aureus in 26% followed by Streptococcus spp in 16.8%. Aortic valve was
the most commonly infected site, followed by mitral valve. Diagnosis was
set with a transthoracic ultrasound in 55.2%, while the diagnosis was set
at autopsy in 16.7%. Fever and heart failure were the most common clinical
presentations. Aminoglycosides, vancomycin, and cephalosporins were the
antimicrobials most frequently used for treatment. Clinical cure was noted
in 68.2%, while overall mortality was 41.4%. This systematic review
thoroughly describes IE in patients with liver cirrhosis and provides
information on epidemiology, clinical presentation, treatment and
outcomes.<br/>Copyright &#xa9; 2021 Edizioni Scientifi che per
l'Informazione su Farmaci e Terapia.

<48>
Accession Number
636301638
Title
Escalating incidence of infective endocarditis in Europe in the 21st
century.
Source
Open Heart. 8(2) (no pagination), 2021. Article Number: e001846. Date of
Publication: 20 Oct 2021.
Author
Talha K.M.; Baddour L.M.; Thornhill M.H.; Arshad V.; Tariq W.; Tleyjeh
I.M.; Scott C.G.; Hyun M.C.; Bailey K.R.; Anavekar N.S.; Palraj R.; Sohail
M.R.; Desimone D.C.; Dayer M.J.
Institution
(Talha, Baddour, Arshad, Tariq, Palraj, Sohail, Desimone) Division of
Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN,
United States
(Baddour, Anavekar, Desimone) Department of Cardiovascular Diseases, Mayo
Clinic, Rochester, MN, United States
(Thornhill) School of Clinical Dentistry, University of Sheffield, Faculty
of Medicine Dentistry and Health, Sheffield, United Kingdom
(Tleyjeh) Infectious Diseases Section, Department of Medical Specialties,
King Fahad Medical City, Riyadh, Saudi Arabia
(Tleyjeh) Division of Epidemiology, Mayo Clinic, Rochester, MN, United
States
(Scott, Hyun, Bailey) Department of Biomedical Statistics and Informatics,
Mayo Clinic, Rochester, MN, United States
(Sohail) Section of Infectious Diseases, Baylor College of Medicine,
Houston, TX, United States
(Dayer) Taunton and Somerset NHS Foundation Trust, Taunton, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Aim To provide a contemporary analysis of incidence trends of infective
endocarditis (IE) with its changing epidemiology over the past two decades
in Europe. Methods A systematic review was conducted at the Mayo Clinic,
Rochester. Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus and Web of
Science were searched for studies published between 1 January 2000 and 30
November 2020. All studies were independently reviewed by four referees
and those that included a population-based incidence of IE in patients,
irrespective of age, in Europe were included. Least squares regression was
used to estimate pooled temporal trends in IE incidence. Results Of 9138
articles screened, 18 studies were included in the review. Elderly men
predominated in all studies. IE incidence increased 4.1% per year (95% CI
1.8% to 6.4%) in the pooled regression analysis of eight studies that
included comprehensive and consistent trends data. When trends data were
weighted according to population size of individual countries, an increase
in yearly incidence of 0.27 cases per 100 000 people was observed.
Staphylococci and streptococci were the most common pathogens identified.
The rate of surgical intervention ranged from 10.2% to 60.0%, and the rate
of inpatient mortality ranged from 14.3% to 17.5%. In six studies that
examined the rate of injection drug use, five of them reported a rate of
less than 10%. Conclusion Based on findings from our systematic review, IE
incidence in Europe has doubled over the past two decades in Europe.
Multiple factors are likely responsible for this striking increase. Trial
registeration number CRD42020191196.<br/>Copyright &#xa9; Author(s) (or
their employer(s)) 2021.

<49>
Accession Number
634901699
Title
Comparison of the efficacy and safety of cuffed versus uncuffed
endotracheal tubes for infants in the intensive care setting: A pilot,
unblinded RCT.
Source
Archives of Disease in Childhood: Fetal and Neonatal Edition. 106(6) (pp
F614-F620), 2021. Date of Publication: 01 Nov 2021.
Author
Thomas R.E.; Erickson S.; Hullett B.; Minutillo C.; Lethbridge M.;
Vijayasekaran S.; Agrawal S.; Bulsara M.K.; Rao S.C.
Institution
(Thomas, Minutillo, Rao) Department of Neonatology, Perth Children's
Hospital, Nedlands, WA 6009, Australia
(Erickson) Department of Paediatric Critical Care, Perth Children's
Hospital, Nedlands, WA, Australia
(Hullett, Lethbridge) Department of Anaesthetics, Perth Children's
Hospital, Nedlands, WA, Australia
(Vijayasekaran) Department of Otolaryngology, Perth Children's Hospital,
Nedlands, WA, Australia
(Agrawal) Department of Neonatology, King Edward Memorial Hospital,
Subiaco, WA, Australia
(Bulsara) Institute for Health Research, University of Notre Dame,
Fremantle, WA, Australia
Publisher
BMJ Publishing Group
Abstract
Objective To study effectiveness and safety of cuffed versus uncuffed
endotracheal tubes (ETTs) in small infants in the intensive care unit
(ICU). Design Pilot RCT. Setting Neonatal and paediatric ICUs of
children's hospital in Western Australia. Participants Seventy-six infants
>=35 weeks gestation and infants <3 months of age, >=3 kg. Interventions
Patients randomly assigned to Microcuff cuffed or Portex uncuffed ETT.
Main outcomes measures Primary outcome was achievement of optimal ETT leak
in target range (10%-20%). Secondary outcomes included: reintubations,
ventilatory parameters, ventilatory complications, postextubation
complications and long-term follow-up. Results Success rate (achievement
of mean leak in the range 10%-20%) was 13/42 (30.9%) in the cuffed ETT
group and 6/34 (17.6%) in uncuffed ETT group (OR=2.09; 95% CI (0.71 to
6.08); p=0.28). Mean percentage time within target leak range in cuffed
ETT group 28% (IQR: 9-42) versus 15% (IQR: 0-28) in uncuffed ETT group
(p=0.01). There were less reintubations to optimise size in cuffed ETT
group 0/40 versus 10/36 (p<0.001). No differences were found in gaseous
exchange, ventilator parameters or postextubation complications. There
were fewer episodes of atelectasis in cuffed ETT group 0/42 versus 4/34
(p=0.03). No patient had been diagnosed with subglottic stenosis at
long-term follow-up. Conclusions There was no difference in the primary
outcome, though percentage time spent in optimal leak range was
significantly higher in cuffed ETT group. Cuffed ETTs reduced
reintubations to optimise ETT size and episodes of atelectasis. Cuffed
ETTs may be a feasible alternative to uncuffed ETTs in this group of
patients. Trial registration number ACTRN12615000081516.<br/>Copyright
&#xa9; Author(s) (or their employer(s)) 2021.

<50>
Accession Number
2013846371
Title
Parental Post-traumatic Stress and Healthcare Use in Infants with Complex
Cardiac Defects.
Source
Journal of Pediatrics. 238 (pp 241-248), 2021. Date of Publication:
November 2021.
Author
Golfenshtein N.; Hanlon A.L.; Lozano A.J.; Srulovici E.; Lisanti A.J.; Cui
N.; Medoff-Cooper B.
Institution
(Golfenshtein, Srulovici) Department of Nursing, University of Haifa,
Haifa, Israel
(Hanlon, Lozano) Center for Biostatistics and Health Data Science,
Virginia Tech, Roanoke, VA, United States
(Lisanti) Center for Pediatric Nursing Research & Evidence-Based Practice,
Children's Hospital of Philadelphia, Philadelphia, PA, United States
(Cui) School of Nursing & Rehabilitation, Shandong University, Jinan,
Shandong Province, China
(Medoff-Cooper) University of Pennsylvania, School of Nursing,
Philadelphia, PA, United States
(Medoff-Cooper) Children's Hospital of Philadelphia, Philadelphia, PA,
United States
Publisher
Elsevier Inc.
Abstract
Objective: To examine the associations between post-traumatic stress of
parents of infants with complex congenital heart defects and their
healthcare use for their infants during the early months of life. Study
design: The current study is a secondary data analysis from a randomized
controlled trial in which 216 parent-infant dyads were recruited from 3
cardiac intensive care units of large pediatric centers in Northeastern
America. The current sample included 153 dyads with post-traumatic stress
data at hospital discharge and at 4-months' follow-up. Poisson regressions
were used to estimate the effect of post-traumatic stress change scores on
number of emergency department (ED) visits, unscheduled cardiologist
visits, and unscheduled pediatrician visits outcomes. <br/>Result(s):
Infants whose parents gained post-traumatic stress disorder over the study
period were at increased risk for ED visits and unscheduled cardiologist
visits. Increased symptom severity predicted more unscheduled cardiologist
visits and more unscheduled pediatrician visits. Increased symptom
clusters (avoidance, arousal, re-experiencing) predicted more ED visits,
more unscheduled cardiologist visits, and more unscheduled pediatrician
visits. <br/>Conclusion(s): Parents of infants with cardiac conditions may
experience post-traumatic stress following cardiac surgery, which can be
linked to greater healthcare use. Findings highlight the importance of
screening and treating post-traumatic stress to preserve parental mental
health and prevent adverse outcomes.<br/>Copyright &#xa9; 2021 Elsevier
Inc.

<51>
Accession Number
2013724959
Title
Effect of hemodiafiltration on the progression of neuropathy with kidney
failure: A randomized controlled trial.
Source
Clinical Journal of the American Society of Nephrology. 16(9) (pp
1365-1375), 2021. Date of Publication: September 2021.
Author
Kang A.; Arnold R.; Gallagher M.; Snelling P.; Green J.; Fernando M.;
Kiernan M.C.; Hand S.; Grimley K.; Burman J.; Heath A.; Rogers K.;
Bhattacharya A.; Smyth B.; Bradbury T.; Hawley C.; Perkovic V.; Krishnan
A.V.; Jardine M.J.
Institution
(Kang, Gallagher, Smyth, Bradbury, Perkovic, Jardine) Renal and Metabolic
Division, The George Institute, University of New South Wales Sydney,
Sydney, NSW, Australia
(Kang, Fernando) Department of Renal Medicine, Prince of Wales Hospital,
Sydney, NSW, Australia
(Kang, Arnold, Fernando, Perkovic, Krishnan) Department of Medicine,
University of New South Wales Sydney, Sydney, NSW, Australia
(Gallagher, Hand, Burman, Jardine) Department of Renal Medicine, Concord
Hospital, Sydney, NSW, Australia
(Snelling, Grimley) Department of Renal Medicine, Royal Prince Alfred
Hospital, Sydney, NSW, Australia
(Green, Heath) Department of Renal Medicine, Sydney Adventist Hospital,
Sydney, NSW, Australia
(Kiernan) Department of Neurology, Royal Prince Alfred Hospital, Sydney,
NSW, Australia
(Kiernan) Brain and Mind Centre, University of Sydney, Sydney, NSW,
Australia
(Rogers, Bhattacharya) Statistics Division, The George Institute The
George Institute, University of New South Wales Sydney, Sydney, NSW,
Australia
(Rogers) Department of Statistics, University of Technology, Sydney, NSW,
Australia
(Smyth, Jardine) Kidney Health Division, National Health and Medical
Research Council of Australia Clinical Trials Centre, University of
Sydney, Sydney, NSW, Australia
(Smyth) Department of Renal Medicine, St. George Hospital, Sydney, NSW,
Australia
(Hawley) Australasian Kidney Trials Network, University of Queensland,
Brisbane, QLD, Australia
(Krishnan) Department of Neurology, Prince of Wales Hospital, Sydney, NSW,
Australia
Publisher
American Society of Nephrology
Abstract
Background and objectives Neuropathy is a common complication of kidney
disease that lacks proven diseasemodifying treatments. Hemodiafiltration
improves clearance of uremic toxins and is associated with better nerve
function than hemodialysis. We aimed to determine whether
hemodiafiltration reduces the progression of neuropathy in people
receiving hemodialysis. Design, setting, participants, & measurements The
Filtration in the Neuropathy of End-Stage Kidney Disease Symptom Evolution
(FINESSE) study was an open-label, blinded end point assessment,
controlled trial that randomized maintenance hemodialysis recipients to
hemodiafiltration or high-flux hemodialysis for 48 months or until death
or cessation of dialysis at four study centers. The primary outcome was
the mean change in the yearly modified total neuropathy score from
baseline, with time points weighted equally. Results A total of 124
participants were randomized and followed for a mean of 41 months. At
baseline, neuropathy was present in 91 (73%) participants (modified total
neuropathy score greater than or equal to two), and 38 (31%) had moderate
to severe neuropathy (modified total neuropathy score 9-28). Convection
volume in the hemodiafiltration arm was a median of 24.7 (interquartile
range, 22.4-26.5) L. The mean modified total neuropathy score (SEM)
worsened by 1.7 (0.4)/28 and 1.2 (0.4)/28 in the hemodiafiltration and
hemodialysis groups, respectively, with a mean difference of 0.5 (95%
confidence interval, 20.7 to 1.7; P50.37). There was no difference in
survival (hazard ratio, 1.24; 95% confidence interval, 0.61 to 2.51; log
rank P50.55) or any of the prespecified adverse events. There was no
difference between groups in the number of participants who suffered an
adverse event adjusted by follow-up time (relative risk, 1.05; 95%
confidence interval, 0.83 to 1.32; P50.68). Conclusions Neuropathy is
still a common complication of kidney disease without disease-altering
therapy. Hemodiafiltration did not affect neuropathy progression compared
with hemodialysis. Clinical Trial registry name and registration number:
Filtration in the Neuropathy of End-Stage Kidney Disease Symptom Evolution
(FINESSE), ACTRN12609000615280.<br/>Copyright &#xa9; 2021 by the American
Society of Nephrology.

<52>
Accession Number
2013674373
Title
Management of pediatric cardiac surgery wound: A literature review.
Source
Acta Biomedica. 92(4) (no pagination), 2021. Article Number: e2021203.
Date of Publication: 02 Sep 2021.
Author
Prendin A.; Tabacco B.; Fazio P.C.; de Barbieri I.
Institution
(Prendin) University-Hospital of Padua, Padua, Italy
(Tabacco) Independent researcher, Seattle, United States
(Fazio) Pediatric Intensive Care Unit, UniversityHospital of Padua, Padua,
Italy
(de Barbieri) Woman's & Child's Health Department, University-Hospital of
Padua, Padua, Italy
Publisher
Mattioli 1885
Abstract
Background: Sternal wound infection is a severe complication of cardiac
surgery in the pediatric population (0-18 years old) that can lead to
increased morbidity, mortality, and prolonged hospitalization. Health
professionals have the ability to perform some interventions during the
pre, intra and post-surgery to correctly manage sternal wounds, with the
goal of preventing infections. <br/>Objective(s): To identify and discuss
current best practice in the prevention, incidence, and treatment of
infections of the cardiac surgery site in the pediatric population.
<br/>Method(s): Between February 20^th 2021 and February
28^th 2021 we consulted the PubMed database adopting full text,
20 years, Humans, English, Child aged 0 to 18 years as criteria. Twenty
articles out of sixty-six were considered relevant to this study. These
were divided into four themes. <br/>Result(s): All studies highlight the
lack of standard guidelines for managing pediatric patients undergoing
cardiac surgery. Some centers developed protocols for managing antibiotic
prophylaxis supported by measurable interventions; others implemented
infection surveillance systems involving families taking care of patients
after hospital discharge. <br/>Discussion(s): the identification of
healthcare-associated infections in the pediatric population after cardiac
surgery is useful in all peri-operative phases. The limited and restricted
literature connected to single centers, with relatively small sample
sizes, the use of a single database. <br/>Conclusion(s): There is a lack
of standard guidelines. The prevention of site infection ought to the goal
of reducing surgical site infections. Building a network between the
multidisciplinary staff and the pediatric patient's family improves the
infection surveillance system, reducing the incidence of infections.
(www.actabiomedica.it).<br/>Copyright &#xa9; Mattioli 1885.

<53>
Accession Number
2013583849
Title
Insights Into the Emerging Role of Myocarditis in Dengue Fever.
Source
Current Tropical Medicine Reports. 8(4) (pp 239-245), 2021. Date of
Publication: December 2021.
Author
Gupta S.; Gupta M.; Gaba S.; Jesrani G.
Institution
(Gupta, Gupta, Gaba, Jesrani) Department of General Medicine, Government
Medical College and Hospital, Level 4 D Block, Sector 32, Chandigarh
160030, India
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose of Review: Dengue is an important public health problem in many
parts of the world. This article consolidates the current knowledge about
dengue myocarditis. Recent Findings: Cardiac involvement in dengue is a
common phenomenon. Myocarditis is the predominant manifestation. It can be
subclinical with no impact on the outcome, or it can cause potentially
fatal arrhythmias or cardiogenic shock and even lead to cardiomyopathy.
Myocardial inflammation is elicited by direct viral invasion and
production of inflammatory cytokines and free oxygen radicals. The
manifestations can overlap with dengue shock syndrome resulting from
capillary leakage. The diagnostic criterion is not well-defined and relies
on evaluation of cardiac biomarkers and electrocardiographic and
echocardiographic changes in the presence or absence of symptoms. There is
an emerging role of cardiac magnetic resonance imaging and strain
echocardiography. Treatment involves use of supportive therapies, and
there is no evidence for use of antiviral drugs, corticosteroids, and
immunosuppressants. <br/>Summary: Physicians need to be wary of
myocarditis in dengue. More research is needed for developing specific
treatment.<br/>Copyright &#xa9; 2021, The Author(s), under exclusive
licence to Springer Nature Switzerland AG.

<54>
Accession Number
2013557913
Title
Impact of Potentially Unwarranted Intravenous Antibiotics Targeting
Pulmonary Infections in Acute Decompensated Heart Failure.
Source
Journal of Pharmacy Technology. 37(6) (pp 298-303), 2021. Date of
Publication: December 2021.
Author
Wu S.; Alikhil M.; Forsyth R.; Allen B.
Institution
(Wu, Alikhil, Forsyth, Allen) Ascension St. Vincent's Riverside,
Jacksonville, FL, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Acute decompensated heart failure (ADHF) can present similarly
to pulmonary infections. The additional volume and sodium received from
intravenous antibiotics (IVAB) can be counterproductive, especially when
strong evidence of infection is lacking. <br/>Objective(s): The objective
was to evaluate the impact of potentially unwarranted IVAB on clinical
outcomes in patients with ADHF. <br/>Method(s): This multicenter,
retrospective, cohort study evaluated adults admitted with ADHF, a chest
radiograph within 24 hours, B-natriuretic peptide >100 pg/mL, and either
received no IVAB or IVAB for at least 48 hours. Subjects with recent
antibiotics, justification for antibiotics, or transferred to the
intensive care unit (ICU) within 24 hours of admission were excluded. The
primary outcome was hospital length of stay (LOS). Secondary outcomes
included utilization of loop diuretics, administration of fluid and
sodium, mortality, and 30-day readmissions. <br/>Result(s): Out of 240
subjects included, 120 received IVAB. LOS was significantly longer in the
IVAB group (5.12 days vs 3.73 days; P <.001). LOS remained significantly
longer in the IVAB group in a propensity score matched cohort (5.26 days
vs 3.70 days; P <.001). The IVAB group received more volume and sodium
from intravenous fluids (P <.001). ICU admission greater than 24 hours
after admission was higher with IVAB (20% vs 7.5%; P =.049). No
significant differences in total loop diuretics, intubation rate,
mortality, and 30-day readmissions were identified. <br/>Conclusion(s):
ADHF patients who received potentially unwarranted IVAB had longer
hospital LOS and were more likely to be admitted to the ICU after 24 hours
of hospitalization.<br/>Copyright &#xa9; The Author(s) 2021.

<55>
Accession Number
2013157893
Title
Review of the top 5 cardiology studies of 2019-20.
Source
Canadian Pharmacists Journal. 154(6) (pp 388-393), 2021. Date of
Publication: November 2021.
Author
Barry A.R.; Babadagli H.E.; Boswell R.; Chen J.W.; Dawson E.L.; Lopaschuk
D.G.; McMillan C.L.; Nguyen B.V.; Omar M.A.; Pollmann D.M.; Zhou J.S.;
Ackman M.L.
Institution
(Barry) Lower Mainland Pharmacy Services, Alberta Health Services,
Mazankowski Alberta Heart Institute, Edmonton, AB, United States
(Babadagli, Boswell, Chen, Lopaschuk, McMillan, Nguyen, Omar, Pollmann,
Zhou, Ackman) University of British Columbia, Vancouver, BC, United States
(Dawson) University of British Columbia, Vancouver, BC, United States
(Babadagli, Boswell, Chen, Lopaschuk, McMillan, Nguyen, Omar, Pollmann,
Zhou, Ackman) Pharmacy Services, Alberta Health Services, Mazankowski
Alberta Heart Institute, Edmonton, AB, United States
(Dawson) Pharmacy Services,Alberta Health Services, Mazankowski Alberta
Heart Institute, Edmonton, AB, United States
Publisher
SAGE Publications Ltd

<56>
Accession Number
2013153691
Title
Systematic review: hepatitis C viraemic allografts to hepatitis C-negative
recipients in solid organ transplantation.
Source
Alimentary Pharmacology and Therapeutics. 54(5) (pp 571-582), 2021. Date
of Publication: September 2021.
Author
Raasikh T.; Jamali T.; Flores A.; Cotton R.T.; Ramanathan V.; Tan H.P.;
Hernaez R.
Institution
(Raasikh, Jamali) Department of Medicine, Baylor College of Medicine,
Houston, TX, United States
(Flores, Hernaez) Section of Gastroenterology and Hepatology, Michael E.
DeBakey VA Medical Center, Houston, TX, United States
(Flores, Hernaez) Section of Gastroenterology, Department of Medicine,
Baylor College of Medicine, Houston, TX, United States
(Cotton) Division of Abdominal Transplantation, Department of Surgery,
Baylor College of Medicine, Houston, TX, United States
(Ramanathan) Division of Nephrology and Solid-Organ Transplantation,
Michael E. DeBakey VA Medical Center, Houston, TX, United States
(Tan) Surgery, Thomas E Starzl Transplantation Institute, University of
Pittsburgh Medical Center, VA Pittsburgh Medical Center, Pittsburgh, PA,
United States
(Hernaez) Center for Innovations in Quality, Effectiveness and Safety
(IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Given the success of direct-acting antivirals (DAAs) in
treating hepatitis C (HCV), interest is growing in utilizing solid organs
from allografts with active HCV to expand donor availability. <br/>Aim(s):
To review post-transplant outcomes and patient survival in HCV-negative
recipients receiving solid organ transplants (SOT) from viraemic, that is,
HCV+/NAT+ (nucleic acid testing) allografts. <br/>Method(s): A literature
search was conducted on PubMed and EMBASE from 01/01/2007 to 4/17/2021 for
articles matching eligibility criteria. Two authors independently screened
titles and abstracts. Disagreements were solved by a third independent
reviewer. Methodological quality assessment was done using a modified
Newcastle-Ottawa scale (NOS). Data synthesis was done qualitatively using
median, ranges and percentages. <br/>Result(s): Thirty-five studies were
included (or 852 SOTs): 343 kidney, 233 heart, 204 liver, and 72 lung
transplants from viraemic allografts. Of the recipients eligible for
sustained virological response at 12 weeks (SVR12) calculation, 100%
achieved cure from HCV. No deaths/graft failures were reported to be
related to HCV transmission. Seven SOT recipients had viral relapse, with
all seven patients treated successfully. Four patients developed fibrosing
cholestatic hepatitis with complete resolution post-treatment.
<br/>Conclusion(s): Transplanting viraemic organs into uninfected
individuals can become the standard of care for patients who do not have
contraindications to DAAs.<br/>Copyright &#xa9; 2021 John Wiley & Sons Ltd

<57>
Accession Number
2011657240
Title
Association Between Perioperative Atrial Fibrillation and Long-term Risks
of Stroke and Death in Noncardiac Surgery: Systematic Review and
Meta-analysis.
Source
CJC Open. 3(5) (pp 666-674), 2021. Date of Publication: May 2021.
Author
Huynh J.T.; Healey J.S.; Um K.J.; Vadakken M.E.; Rai A.S.; Conen D.; Meyre
P.; Butt J.H.; Kamel H.; Reza S.J.; Nguyen S.T.; Oqab Z.; Devereaux P.J.;
Balasubramanian K.; Benz A.P.; Belley-Cote E.P.; McIntyre W.F.
Institution
(Huynh, Healey, Um, Vadakken, Rai, Conen, Reza, Nguyen, Devereaux,
Belley-Cote, McIntyre) Department of Medicine, McMaster University,
Hamilton, ON, Canada
(Healey, Um, Vadakken, Rai, Conen, Nguyen, Oqab, Devereaux,
Balasubramanian, Benz, Belley-Cote, McIntyre) Population Health Research
Institute, McMaster University, Hamilton, ON, Canada
(Meyre) Department of Cardiology and Cardiovascular Research Institute
Basel, University Hospital of Basel, University of Basel, Basel,
Switzerland
(Butt) Department of Cardiology, Copenhagen University Hospital,
Copenhagen, Denmark
(Kamel) Feil Family Brain and Mind Research Institute, Department of
Neurology, Weill Cornell Medical College, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Atrial fibrillation (AF) is frequently reported as a
complication of noncardiac surgery. It is unknown whether new-onset
perioperative AF is associated with an increased risk of stroke and death
beyond the perioperative period. We performed a systematic review and
meta-analysis to assess the long-term risks of stroke and mortality
associated with new-onset perioperative AF after noncardiac surgery.
<br/>Method(s): MEDLINE and EMBASE were searched from inception to March
2020 for studies reporting on the association between perioperative AF and
the risk of stroke and death occurring beyond 30 days after noncardiac
surgery. Reference screening, study selection, data extraction, and
quality assessment were performed in duplicate. Data were pooled using
inverse variance-weighted random-effects models and presented as risk
ratios (RRs). <br/>Result(s): From 7344 citations, we included 31 studies
(3,529,493 patients). The weighted mean incidence of perioperative AF was
0.7%. During a mean follow-up of 28.1 +/- 9.4 months, perioperative AF was
associated with an increased risk of stroke (1.5 vs 0.9 strokes per 100
patient-years; RR: 2.9, 95% confidence interval [CI]: 2.1-3.9,
I² = 78%). Perioperative AF was also associated with a
significantly higher risk of all-cause mortality (21.0 vs 7.6 deaths per
100 patient-years; RR: 1.8, 95% CI: 1.5-2.2, I² = 94%). The
pooled adjusted hazard ratios for stroke and all-cause mortality were 1.9
(95% CI: 1.6-2.2, I² = 31%) and 1.5 (95% CI: 1.3-1.7,
I² = 20%), respectively. <br/>Conclusion(s): Patients who had
perioperative AF after noncardiac surgery had a higher long-term risk of
stroke and mortality compared with patients who did not. Whether this risk
is modifiable with oral anticoagulation therapy should be
investigated.<br/>Copyright &#xa9; 2021 The Authors

<58>
Accession Number
2011261994
Title
Effects of comprehensive geriatric care models on postoperative outcomes
in geriatric surgical patients: a systematic review and meta-analysis.
Source
BMC Anesthesiology. 21(1) (no pagination), 2021. Article Number: 127. Date
of Publication: December 2021.
Author
Saripella A.; Wasef S.; Nagappa M.; Riazi S.; Englesakis M.; Wong J.;
Chung F.
Institution
(Saripella, Wasef, Riazi, Wong, Chung) Department of Anesthesia and Pain
Medicine, Toronto Western Hospital, University Health Network, University
of Toronto, MCL 2-405, 399 Bathurst St, Toronto, ON M5T2S8, Canada
(Nagappa) Department of Anesthesia and Perioperative Medicine, London
Health Sciences Centre and St. Joseph Health Care, Schulich School of
Medicine & Dentistry, Western University, London, ON, Canada
(Englesakis) Library and Information Services, University Health Network,
Toronto, ON, Canada
(Wong) Department of Anesthesia and Pain Management, Women's College
Hospital, University of Toronto, Toronto, ON, Canada
Publisher
BioMed Central Ltd
Abstract
Background: The elderly population is highly susceptible to develop
post-operative complications after major surgeries. It is not clear
whether the comprehensive geriatric care models are effective in reducing
adverse events. The objective of this systematic review and meta-analysis
is to determine whether the comprehensive geriatric care models improved
clinical outcomes, particularly in decreasing the prevalence of delirium
and length of hospital stay (LOS) in elderly surgical patients.
<br/>Method(s): We searched Medline, PubMed, Embase, Cochrane Central
Register of Controlled Trials, Cochrane Database of Systematic Reviews,
Emcare Nursing, Web of Science, Scopus, CINAHL, ClinicalTrials. Gov, and
ICTRP between 2009 to January 23, 2020. We included studies on geriatric
care models in elderly patients (>=60 years) undergoing elective,
non-cardiac high-risk surgery. The outcomes were the prevalence of
delirium, LOS, rates of 30-days readmission, and 30-days mortality. We
used the Cochrane Review Manager Version 5.3. to estimate the pooled Odds
Ratio (OR) and Mean Difference (MD) using random effect model analysis.
<br/>Result(s): Eleven studies were included with 2672 patients
[Randomized Controlled Trials (RCTs): 4; Non-Randomized Controlled Trials
(Non-RCTs): 7]. Data pooled from six studies showed that there was no
significant difference in the prevalence of delirium between the
intervention and control groups: 13.8% vs 15.9% (OR: 0.76; 95% CI:
0.30-1.96; p = 0.57). Similarly, there were no significant differences in
the LOS (MD: -0.55; 95% CI: - 2.28, 1.18; p = 0.53), 30-day readmission
(12.1% vs. 14.3%; OR: 1.09; 95% CI: 0.67-1.77; p = 0.73), and 30-day
mortality (3.2% vs. 2.1%; OR: 1.34; 95% CI: 0.66-2.69; p = 0.42). The
quality of evidence was very low. <br/>Conclusion(s): The geriatric care
models involved pre-operative comprehensive geriatric assessment, and
intervention tools to address cognition, frailty, and functional status.
In non-cardiac high-risk surgeries, these care models did not show any
significant difference in the prevalence of delirium, LOS, 30-days
readmission rates, and 30-day mortality in geriatric patients. Further
RCTs are warranted to evaluate these models on the postoperative outcomes.
Trial registration: PROSPERO registration number -
CRD42020181779.<br/>Copyright &#xa9; 2021, The Author(s).

<59>
Accession Number
2010985007
Title
The optimal Fontan operation: Lateral tunnel or extracardiac conduit?.
Source
Journal of Thoracic and Cardiovascular Surgery. 162(6) (pp 1825-1834),
2021. Date of Publication: December 2021.
Author
Daley M.; d'Udekem Y.
Institution
(Daley) Department of Cardiac Surgery, The Royal Children's Hospital,
Melbourne, Australia
(Daley, d'Udekem) Department of Paediatrics, The University of Melbourne,
Melbourne, Australia
(Daley, d'Udekem) Murdoch Children's Research Institute, Melbourne,
Australia
(d'Udekem) Division of Cardiac Surgery, Children's National Hospital,
Washington, DC, United States
Publisher
Elsevier Inc.

<60>
Accession Number
2010968912
Title
Anemia: Another Stone in the Wall of Takotsubo Outcomes?.
Source
Angiology. 72(9) (pp 803-804), 2021. Date of Publication: October 2021.
Author
Manfredini R.; De Giorgi A.; Fabbian F.
Institution
(Manfredini, De Giorgi, Fabbian) Clinica Medica Unit, Department of
Medical Sciences, University of Ferrara, Italy
Publisher
SAGE Publications Inc.

<61>
Accession Number
2010801302
Title
Inflammatory Indicators and Hematological Indices in Contrast-Induced
Nephropathy Among Patients Receiving Coronary Intervention: A Systematic
Review and Meta-Analysis.
Source
Angiology. 72(9) (pp 867-877), 2021. Date of Publication: October 2021.
Author
Wu X.; Ma C.; Sun D.; Zhang G.; Wang J.; Zhang E.
Institution
(Wu, Sun, Zhang, Wang) Department of Pediatric Surgery, Tianjin Medical
University General Hospital, Tianjin, China
(Ma) Department of General Surgery, Tianjin Medical University General
Hospital, Tianjin, China
(Zhang) Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
Publisher
SAGE Publications Inc.
Abstract
Strong inflammatory indicators such as C-reactive protein (CRP),
high-sensitivity CRP (hsCRP), and hematological indices, including
platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR),
hematocrit (HCT), and red blood cell distribution width (RDW), may be
related with contrast-induced nephropathy (CIN). Our meta-analysis aimed
at exploring the relationship between these indicators and CIN incidence
among patients undergoing coronary intervention. Clinical studies were
retrieved from the electronic databases of PubMed, EMBASE, Google Scholar,
Clinical Trials, and Science Direct from their inception to June 3, 2020.
Meta-analysis was performed on pooled eligible studies. Finally, 26
studies involving 29 454 patients were included. Pooled analysis revealed
that patients with higher CRP (odds ratio [OR] = 1.06, 95% CI: 1.01-1.12,
P =.02), hsCRP (OR = 1.03, 95% CI: 1.01-1.06, P =.004), NLR (OR = 1.11,
95% CI: 1.01-1.20, P =.02), RDW (OR = 1.35, 95% CI: 1.19-1.53, P <.001),
and lower HCT (OR = 0.94, 95% CI: 0.92-0.97, P =.003) all exhibited
significantly higher CIN rates, but there was no significant association
between PLR and CIN risk (OR = 1.12, 95% CI: 0.99-1.26, P =.07).
Pre-angiography CRP/hsCRP and some hematological indices are associated
with CIN.<br/>Copyright &#xa9; The Author(s) 2021.

<62>
Accession Number
2011609085
Title
Double Blind Pilot Randomized Trial Comparing Extended Anticoagulation to
Placebo Following Major Lung Resection for Cancer.
Source
Seminars in Thoracic and Cardiovascular Surgery. 33(4) (pp 1123-1134),
2021. Date of Publication: Winter 2021.
Author
Shargall Y.; Schneider L.; Linkins L.-A.; Crowther M.; Farrokhyar F.;
Waddell T.K.; de Perrot M.; Douketis J.; Lopez-Hernandez Y.; Schnurr T.;
Haider E.; Agzarian J.; Hanna W.C.; Finley C.
Institution
(Shargall, Schneider, Farrokhyar, Lopez-Hernandez, Schnurr, Agzarian,
Hanna, Finley) Division of Thoracic Surgery, Department of Surgery,
McMaster University, Hamilton, ON, Canada
(Linkins, Crowther, Douketis) Division of Hematology and Thromboembolism,
Department of Medicine, McMaster University, Hamilton, ON, Canada
(Haider) Department of Radiology, McMaster University, Hamilton, ON,
Canada
(Shargall, Waddell, de Perrot) Division of Thoracic Surgery, Department of
Surgery, University of Toronto, Toronto, ON, Canada
(Shargall, Douketis, Agzarian, Hanna, Finley) Division of Thoracic
Surgery, St. Joseph's Healthcare Hamilton, Firestone Institute for
Respiratory Health, Hamilton, ON, Canada
Publisher
W.B. Saunders
Abstract
Venous thromboembolism (VTE), which comprises pulmonary embolus (PE) and
deep vein thrombosis (DVT), is a significant cause of postoperative
morbidity and mortality. This pilot randomized control trial (RCT)
evaluated the feasibility of a full-scale RCT investigating extended
thromboprophylaxis in patients undergoing oncological lung resections.
Patients undergoing oncological lung resections in 2 tertiary centers
received in-hospital, thromboprophylaxis and were randomized to receive
post-discharge low-molecular-weight heparin (LMWH) or placebo injections
once-daily for 30 days. At 30 days postoperatively, all patients underwent
chest computed tomography with PE protocol and bilateral leg venous
ultrasound. Primary outcomes included feasibility and safety; VTE
incidence and 90-day survival were secondary outcomes. Between December
2015 and June 2018, 619 patients were screened, of whom 62.7% (165/263) of
eligible patients consented to participate, and 133 (81%) were randomized.
One-hundred and 3 patients, (77.4%), completed the 90-day study follow-up.
Reasons for non-participation pre-randomization included patient
discomfort and LMWH/placebo administration challenges. Post-randomization
withdrawals were due to patient preference, surgeon preference and minor
adverse events. Six asymptomatic VTE events (5 PE and 1 DVT) were detected
within 30 days (3 in each group), for an overall incidence of 7%. There
were 3 minor and no major adverse events. This study is the first to
demonstrate the feasibility and safety of a full-scale extended
thromboprophylaxis RCT in thoracic surgical oncology. Our results
demonstrate that, while recruitment and retention rates were modest, the
study design is feasible and with minimal adverse events and no
intervention-related mortality.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<63>
Accession Number
2010470560
Title
Effect of Renin-Angiotensin System Inhibitors on Acute Kidney Injury Among
Patients Undergoing Cardiac Surgery: A Review and Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. 33(4) (pp 1014-1022),
2021. Date of Publication: Winter 2021.
Author
Zhou H.; Xie J.; Zheng Z.; Ooi O.C.; Luo H.
Institution
(Zhou) School of Management, University of Science and Technology of
China, Hefei, China
(Xie) School of Management, Technical University of Munich, Heilbronn,
Germany
(Zheng) Lee Kong Chian School of Business, Singapore Management
University, Singapore
(Ooi, Luo) Department of Cardiac, Thoracic & Vascular Surgery, National
University Hospital, Singapore
Publisher
W.B. Saunders
Abstract
Acute kidney injury (AKI) is a frequent complication of cardiac surgery,
which can lead to higher mortality and long-term renal function
impairment. The effect of perioperative renin-angiotensin system
inhibitors (RASi) therapy on AKI incidence in patients undergoing cardiac
surgery remains controversial. We reviewed related studies in PubMed,
Scopus, and Cochrane Library from inception to February 2020. Two
randomized controlled trials and 21 cohort studies were included in the
meta-analysis, involving 76,321 participants. The pooled odds ratio and
95% confidence interval were calculated using the DerSimonian and Laird
random-effects model. The results showed no significant association
between perioperative RASi therapy and postoperative AKI in patients
undergoing cardiac surgery. We highlighted the limitations of existing
studies and called for well-designed large-scale randomized controlled
trials to verify the conclusion.<br/>Copyright &#xa9; 2020 Elsevier Inc.

<64>
Accession Number
2014169761
Title
The global outbreak of Mycobacterium chimaera infections in cardiac
surgery-a systematic review of whole-genome sequencing studies and joint
analysis.
Source
Clinical Microbiology and Infection. 27(11) (pp 1613-1620), 2021. Date of
Publication: November 2021.
Author
Schreiber P.W.; Kohl T.A.; Kuster S.P.; Niemann S.; Sax H.
Institution
(Schreiber, Kuster, Sax) Division of Infectious Diseases and Hospital
Epidemiology, University Hospital Zurich, University of Zurich, Zurich,
Switzerland
(Kohl, Niemann) Molecular and Experimental Mycobacteriology,
Forschungszentrum Borstel, Leibniz-Zentrum fur Medizin und
Biowissenschaften, Borstel, Germany
(Kohl, Niemann) German Centre for Infection Research (DZIF), Partner Site
Hamburg-Lubeck-Borstel-Riems, Germany
Publisher
Elsevier B.V.
Abstract
Background: With the increasing dimensions of the international cardiac
surgery-associated Mycobacterium chimaera outbreak the hypothesis of a
point source arose. <br/>Objective(s): To review the published evidence of
clonality among cardiac surgery-associated M. chimaera isolates evaluated
by whole-genome sequencing (WGS) and to perform an integrative genomic
analysis of available genome data. Data sources: We searched PubMed and
EMBASE for studies applying WGS on cardiac surgery-associated M. chimaera
isolates. Study eligibility criteria: We included studies that applied WGS
on more than a single M. chimaera isolate. <br/>Method(s): Two authors
independently extracted data from included studies. Available genome data
from published studies were subjected to a joint analysis. <br/>Result(s):
Of 121 identified articles, nine studies were included. M. chimaera
isolates from LivaNova heater-cooler devices (HCDs) had a high level of
genetic similarity, but were genetically distant from isolates from HCDs
produced by other manufacturers. With the exception of a single (11.1%)
study, the remaining eight (89.9%) studies reported a high level of
genetic proximity between the majority of M. chimaera isolates derived
from cardiac surgery-associated patients and LivaNova HCDs. In-depth
analysis revealed involvement of three distinct M. chimaera subgroups in
the outbreak (1.1, 1.8, 2.1), with 1.1 suggested as causative of the
outbreak. Samples taken at the LivaNova production site supported
contamination with strains of subgroups 1.1 and 1.8. In the combined
analysis of 526 publicly available WGS data sets, nearly all isolates from
cardiac surgery-associated patients contained strain 1.1 (50/52, 96.2%),
and at least one of the outbreak strains was found in almost all LivaNova
HCDs (241/257, 93.8%), with strain 1.1 in particular present in 198/257
(77.0%). <br/>Conclusion(s): HCD contamination during production seems
plausible as the predominant point source for the global M. chimaera
outbreak. Although HCDs can be contaminated with mixed populations, M.
chimaera strains of the subgroup 1.1 caused most infections.<br/>Copyright
&#xa9; 2021 European Society of Clinical Microbiology and Infectious
Diseases

<65>
Accession Number
2014009365
Title
Comparison of high-flow and conventional nasal cannula oxygen in patients
undergoing endobronchial ultrasonography.
Source
Internal Medicine Journal. 51(11) (pp 1935-1939), 2021. Date of
Publication: November 2021.
Author
Yilmazel Ucar E.; Araz O.; Kerget B.; Akgun M.; Saglam L.
Institution
(Yilmazel Ucar, Araz, Kerget, Akgun, Saglam) Department of Pulmonary
Diseases, Ataturk University School of Medicine, Erzurum, Turkey
Publisher
John Wiley and Sons Inc
Abstract
Background: Oxygen therapy is required to prevent hypoxaemia during the
endobronchial ultrasonography (EBUS) procedure. <br/>Aim(s): To compare
the effectiveness of oxygen therapy delivered through high-flow nasal
cannula (HFNC) and conventional nasal cannula (CNC) in patients undergoing
EBUS. The primary outcome was the proportion of patients who desaturated.
Patient compliance and satisfaction were also evaluated. <br/>Method(s):
This single-centre prospective interventional study was conducted in a
tertiary hospital among patients who presented to the EBUS unit in 2018
and 2019. Patients were randomly assigned to the HFNC group or the CNC
group. <br/>Result(s): The study included 170 patients (111 men and 59
women) with a mean age of 58 +/- 14 years. The number of patients
experiencing desaturation while receiving oxygen was statistically
significantly lower (P < 0.001) in the HFNC group (n = 5) compared with
the CNC group (n = 26). Oxygen therapy was adjusted in two patients in the
CNC group due to desaturation. Saturation was significantly higher in the
HFNC group (P < 0.0001) at the end of the EBUS procedure. Heart rate at
the end of EBUS was lower in the HFNC group, but this difference was not
statistically significant (96 +/- 16 vs 101 +/- 19, P = 0.13). Five
patients in the HFNC group and 18 patients in the CNC group reported
discomfort during the procedure (P = 0.006). <br/>Conclusion(s): Oxygen
therapy delivered by HFNC seems to be safer and more effective than by CNC
in patients undergoing EBUS. Oxygen therapy with HFNC may be considered as
an alternative to CNC because it may increase patient comfort and thereby
improve compliance.<br/>Copyright &#xa9; 2020 Royal Australasian College
of Physicians.

<66>
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

<67>
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.

<68>
Accession Number
2013963298
Title
Effect of remimazolam besylate compared with propofol on the incidence of
delirium after cardiac surgery: study protocol for a randomized trial.
Source
Trials. 22(1) (no pagination), 2021. Article Number: 717. Date of
Publication: December 2021.
Author
Yang M.; Liu X.; Yang D.; Bai Y.; Qin B.; Tian S.; Dong R.; Song X.
Institution
(Yang, Liu, Yang, Bai, Qin, Tian, Dong) Liaocheng Cardiac Hospital,
Shandong 252200, China
(Yang, Liu, Yang, Bai, Qin, Tian, Dong, Song) Dong E Hospital Affiliated
to Shandong First Medical University, Shandong 252200, China
(Song) ICU, Shandong First Medical University, Shandong 250117, China
(Song) ICU, Shandong Provincial Hospital Affiliated to Shandong First
Medical University, Shandong 250021, China
Publisher
BioMed Central Ltd
Abstract
Background: Delirium is an acute cognitive disorder that presents with
fluctuation in cognition, apathy, and non-organized thinking, resulting in
increased morbidity, mortality, intensive care unit (ICU) stay, and total
healthcare costs. In patients undergoing cardiac surgery, delirium also
increases the risk of postoperative complications, such as respiratory
insufficiency, sternum instability, and need for re-operation of the
sternum. This study aims to understand the incidence of delirium in
patients after cardiac surgery in patients sedated with remimazolam
besylate versus propofol. <br/>Method(s): In this prospective,
double-blind, randomized controlled clinical trial, we aim to recruit 200
patients undergoing cardiac surgery between January 1, 2021, and December
31, 2021, who will be randomized to receive either remimazolam besylate or
propofol infusions postoperatively, until they are extubated. The primary
outcome is the incidence of delirium within 5 days after surgery.
Secondary outcomes include the time of delirium onset, duration of
delirium, ICU length of stay, hospital length of stay, and mechanical
ventilation time. <br/>Discussion(s): The key objective of this study is
to assess whether remimazolam besylate reduces the incidence of delirium
in patients after cardiac surgery compared to propofol sedation. In this
preliminary randomized controlled clinical trial, we will test the
hypothesis that the use of remimazolam besylate lowers the incidence of
delirium when compared to propofol in patients undergoing cardiac surgery.
Trial registration: chictr.org.cn ChiCTR2000038976. Registered on October
11, 2020<br/>Copyright &#xa9; 2021, The Author(s).

<69>
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

<70>
Accession Number
2015611026
Title
Unintentional pleurotomy during sternotomy: Prospective randomized study
at department of cardiothoracic surgery at Rajiv Gandhi Govt. General
Hospital.
Source
Journal International Medical Sciences Academy. 34(2) (pp 122-123), 2021.
Date of Publication: April 2021.
Author
Raj G.J.; Anand P.
Institution
(Raj) Institute of Cardiovascular & Thoracic Surgery, General Hospital.,
MMC, Tamilnadu, Chennai, India
(Anand) Dept. of Cardiovascular & Thoracic Surgery, Rajiv Gandhi Govt.,
General Hospital., MMC, Tamilnadu, Chennai, India
Publisher
International Medical Sciences Academy
Abstract
Sternotomy is the commonest access for cardiac surgeries and mediastinal
surgeries. Many a times pleura is inadvertently opened during sternotomy,
which may require insertion of chest tube insertion and added morbidity.
To avoid accidental pleurotomy, various methods has been postulated to
avoid the same. Commonest method being deflating Lungs before sternotomy.
Delaying the sternotomy for a few seconds after Deflation of Lungs and
whether it reduces accidental pleurotomy is to be studied. This is
considered as the Lungs take a while to deflate after disconnection of
circuit. Study was done among 100 patients who underwent sternotomy during
the period of November 2018-November 2019. They were divided into three
groups viz. A. Sternotomy with no Lung deflation. B. Sternotomy after five
second of Lung deflation. C. Sternotomy after 10 seconds of Lung
deflation. Data was collected, tabulated and analyzed.<br/>Copyright
&#xa9; 2021 International Medical Sciences Academy. All rights reserved.

<71>
Accession Number
2014364957
Title
Right Ventricular Outflow Tract Obstruction in Adults: A Systematic Review
and Meta-analysis.
Source
CJC Open. 3(9) (pp 1153-1168), 2021. Date of Publication: September 2021.
Author
Zeng Y.H.; Calderone A.; Rousseau-Saine N.; Elmi-Sarabi M.; Jarry S.;
Couture E.J.; Aldred M.P.; Dorval J.-F.; Lamarche Y.; Miles L.F.;
Beaubien-Souligny W.; Denault A.Y.
Institution
(Zeng, Calderone, Rousseau-Saine, Elmi-Sarabi, Jarry, Aldred, Denault)
Department of Anesthesiology, Montreal Heart Institute, University of
Montreal, Montreal, QC, Canada
(Couture) Department of Anesthesiology and Department of Medicine,
Division of Intensive Care Medicine, University Institute of Cardiology
and Respirology, Quebec, QC, Canada
(Dorval) Department of Cardiology, Montreal Heart Institute, University of
Montreal, Montreal, QC, Canada
(Lamarche) Department of Cardiac Surgery, Montreal Heart Institute,
University of Montreal, Montreal, QC, Canada
(Lamarche, Denault) Critical Care Division, Montreal Heart Institute,
University of Montreal, Montreal, QC, Canada
(Miles) Centre for Integrated Critical Care, The University of Melbourne,
Melbourne, Victoria, Australia and Department of Anaesthesia, Austin
Health, Melbourne, Australia
(Beaubien-Souligny) Department of Medicine, Nephrology Division, Centre
Hospitalier of the University of Montreal, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Right ventricular outflow tract obstruction (RVOTO) is a cause
of hemodynamic instability that can occur in several situations, including
cardiac surgery, lung transplantation, and thoracic surgery, and in
critically ill patients. The timely diagnosis of RVOTO is important
because it requires specific considerations, including the adverse effects
of positive inotropes, and depending on the etiology, the requirement for
urgent surgical intervention. <br/>Method(s): The objective of this
systematic review and meta-analysis was to determine the prevalence of
RVOTO in adult patients, and the distribution of all reported cases by
etiology. <br/>Result(s): Of 233 available reports, there were 229 case
reports or series, and 4 retrospective cohort studies, with one study also
reporting a prospective cohort. Of 291 reported cases of RVOTO, 61 (21%)
were congenital, 56 (19%) were iatrogenic, and 174 (60%) were neither
congenital nor iatrogenic (including intracardiac tumour). The mechanism
of RVOTO was an intrinsic obstruction in 169 cases (58%), and an extrinsic
obstruction in 122 cases (42%). A mechanical obstruction causing RVOTO was
present in 262 cases (90%), and 29 cases of dynamic RVOTO (10%) were
reported. In the 5 included cohorts, with a total of 1122 patients, the
overall prevalence was estimated to be 4.0% (1%-9%). <br/>Conclusion(s):
RVOTO, though rare, remains clinically important, and therefore,
multicentre studies are warranted to better understand the prevalence,
causes, and consequences of RVOTO.<br/>Copyright &#xa9; 2021 The Authors

<72>
Accession Number
2014200609
Title
Efficacy and safety of antithrombotic therapy with non-vitamin K
antagonist oral anticoagulants after transcatheter aortic valve
replacement: a systematic review and meta-analysis.
Source
Therapeutic Advances in Chronic Disease. 12 (no pagination), 2021. Date of
Publication: 2021.
Author
An Q.; Su S.; Tu Y.; Gao L.; Xian G.; Bai Y.; Zhan Q.; Xu X.; Xu D.; Zeng
Q.
Institution
(An, Tu) State Key Laboratory of Organ Failure Research, Department of
Cardiology, Nanfang Hospital, First Clinical Medical College, Southern
Medical University, Guangzhou, China
(Su, Gao, Xian, Bai, Zhan) State Key Laboratory of Organ Failure Research,
Department of Cardiology, Nanfang Hospital, First Clinical Medical
College, Southern Medical University, Guangzhou, China
(Xu) Department of Cardiology and Pneumology, University Medical Center of
Gottingen, Georg-August-University, Gottingen, Germany
(Xu, Zeng) State Key Laboratory of Organ Failure Research, Department of
Cardiology, Nanfang Hospital, First Clinical Medical College, Southern
Medical University, 1838 Northern Guangzhou Avenue, Guangzhou 510515,
China
(Su, Gao, Xian, Bai, Zhan) Guangdong Provincial Key Laboratory of Shock
and Microcirculation, Southern Medical University, Guangzhou, China
(Su, Gao, Xian, Bai, Zhan) Bioland Laboratory (Guangzhou Regenerative
Medicine and Health Guangdong Laboratory), Guangzhou, China
Publisher
SAGE Publications Ltd
Abstract
Objective: A meta-analysis was performed to compare the efficacy and
safety of antithrombotic therapy with non-vitamin K antagonist oral
anticoagulants (NOACs) versus standard care in patients after successful
transcatheter aortic valve replacement (TAVR). <br/>Method(s): A
systematic search of PubMed, Cochrane Central Register of Controlled
Trials, and EMBASE databases and ClinicalTrials.gov website (through 21
October 2020) was performed. Risk ratios (RRs) with 95% confidence
intervals (CIs) for all outcomes were calculated using random-effects
models. <br/>Result(s): Twelve studies (two studies were randomized
controlled trials) comprising 6943 patients were included (5299 had
indications for oral anticoagulation (OAC) and 1644 had none). No
significant differences were found between NOACs and the standard care in
the incidences of all stroke, a composite endpoint, and
major/life-threatening bleeding. NOACs were associated with lower
all-cause mortality than vitamin K antagonists (VKAs) in post-TAVR
patients with indications for OAC after more than 1 year of follow-up [RR
= 0.64; 95% CI, (0.42, 0.96); p = 0.03], whereas NOACs exhibited poor
outcomes than antiplatelet therapy (APT) in patients without indications
for OAC [RR = 1.66; 95% CI, (1.12, 2.45); p = 0.01]. In the prevention of
valve thrombosis, NOACs and VKAs were not significantly different in
patients with indications for OAC [RR = 0.66; 95% CI, (0.24, 1.84); p =
0.43], whereas NOACs were better than APT in patients without indications
for OAC [RR = 0.19; 95% CI, (0.04, 0.83); p = 0.03]. <br/>Conclusion(s):
In patients with indications for OAC, post-TAVR antithrombotic therapy
with NOACs was more favorable due to its lower all-cause mortality after
more than 1 year of follow-up. In those without indications for OAC, NOACs
presented poorer outcomes due to its higher all-cause
mortality.<br/>Copyright &#xa9; The Author(s), 2021.

<73>
Accession Number
2015626119
Title
Polycythaemia Vera and Coronary Artery Bypass Graft Surgery: A Systematic
Review of the Literature.
Source
Heart Lung and Circulation. (no pagination), 2021. Date of Publication:
2021.
Author
Janmohamed I.K.; Sondh R.S.; Ahmed H.; Afzal M.B.; Tyson N.; Harky A.
Institution
(Janmohamed) University of Leeds, Faculty of Health and Medicine, Leeds,
United Kingdom
(Sondh) St George's Hospital Medical School, University of London, London,
UK, United Kingdom
(Ahmed, Afzal) Imperial College London, Department of Medicine, London,
UK, United Kingdom
(Tyson) Nottingham University Hospitals, Department of Cardiac Surgery,
UK, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, UK, United Kingdom
Publisher
Elsevier Ltd
Abstract
Objectives: Polycythaemia vera (PV) is a condition that may potentially
put patients undergoing cardiac surgery at an increased risk of bleeding
and thrombosis; however, there is currently a paucity of literature
regarding the management of these patients. We aim to examine the
literature in this systematic review to indicate the interventions that
may be considered to minimise complications. <br/>Method(s): We conducted
a literature search using keywords and MeSH terms to identify articles
discussing PV and cardiac surgery. The studies were identified and
qualitatively analysed using the Preferred Reporting Items for Systematic
Reviews and Meta-analysis (PRISMA) protocol. <br/>Result(s): In total, 10
case reports representing 11 patients were identified for this systematic
review and were included in qualitative analysis. 63.6% of patients had
preoperative intermittent phlebotomy, and the majority of patients
received postoperative therapy that involved one antiplatelet and one
anticoagulant. Generous perioperative fluid management, phlebotomy,
preservation of core body temperature, early extubation, monitoring of
myocardial ischaemia, infarction and vascular events, intense chest
physiotherapy and patient mobilisation are important to consider to reduce
the risk of complications arising from surgery. <br/>Conclusion(s): These
considerations should be systematically discussed in a multidisciplinary
team, where the acute surgical need can be balanced appropriately against
the risk of haemorrhage and thrombosis.<br/>Copyright &#xa9; 2021
Australian and New Zealand Society of Cardiac and Thoracic Surgeons
(ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

<74>
Accession Number
2015371040
Title
Surgeon Strength: Ergonomics and Strength Training in Cardiothoracic
Surgery.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2021.
Date of Publication: 2021.
Author
Dairywala M.I.; Gupta S.; Salna M.; Nguyen T.C.
Institution
(Dairywala) Department of Cardiothoracic and Vascular Surgery, University
of Texas Health Science Center Houston, McGovern Medical School, Houston,
TX, United States
(Gupta) Division of Cardiac Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Salna) Division of Cardiac, Thoracic, and Vascular Surgery, Department of
Surgery, Columbia University Irving Medical Center, New York, NY, United
States
(Nguyen) Division of Adult Cardiothoracic Surgery, Department of Surgery,
UCSF Health, San Francisco, CA, United States
Publisher
W.B. Saunders
Abstract
With the high prevalence of musculoskeletal pain in surgeons and
interventionalists, it is critical to analyze the impact of ergonomics on
cardiothoracic surgeon health. Here, we review the existing literature and
propose recommendations to improve physical preparedness for surgery both
in and outside the operating room. For decades, cardiothoracic surgeons
have suffered from musculoskeletal pain, most commonly in the neck, and
back due to a lack of proper ergonomics during surgery. A lack of
dedicated ergonomics curriculum during training may leave surgeons at a
high predisposition for work-related musculoskeletal disorders. We
searched PubMed, Google Scholar, and other sources for studies relevant to
surgical ergonomics and prevalence of musculoskeletal disease among
surgeons and interventionalists. Whenever possible, data from quantitative
studies, and meta-analyses are presented. We also contacted experts and
propose an exercise routine to improve physical preparedness for demands
of surgery. To date, many studies have reported astonishingly high rates
of work-related pain in surgeons with rates as high as 87% in
minimally-invasive surgeons. Several optimizations regarding correct table
height, monitor positioning, and loupe angles have been discussed. Lastly,
implementation of ergonomics training at some programs have been effective
at reducing the rates of musculoskeletal pain among surgeons. Surgical
work-related stress injuries are more common than we think. Many factors
including smaller incisions and technological advancements have led to
this plight. Ultimately, work-related injuries are underreported and
understudied and the field of surgical ergonomics remains open for
investigative study.<br/>Copyright &#xa9; 2021

<75>
Accession Number
2014242360
Title
Shedding some light on tricuspid intervention.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Fattouch K.; Moscarelli M.
Institution
(Fattouch) Dicronis, Department of Cardiovascular Surgery, University of
Palermo, Palermo, Italy
(Moscarelli) Department of Cardiac Surgery, GVM Care and Research, Anthea
Hospital, Bari, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: More than 1.6 million Americans have at least moderate to
severe valvular tricuspid regurgitation, yet fewer than 8000 tricuspid
valve operations are performed annually in the USA. The undertreatment for
isolated tricuspid regurgitation might be related to the fact that in the
past years no clear guidelines on 'how' and 'when' to treat tricuspid
regurgitation were issued. <br/>Aim(s): Sarris-Michopoulos and colleagues
carried out a meta-analysis with the aim to investigate the role of
tricuspid valve repair versus tricuspid valve replacement in patients with
isolated tricuspid valve regurgitation. <br/>Material(s) and Method(s):
Outcomes of patients with first-time surgery for isolated tricuspid valve
regurgitation without previous left-sided valve surgery were reviewed. Ten
studies were included with a total of 1407 patients. <br/>Result(s):
Authors concluded that patients who underwent tricuspid valve repair
showed less 30-days mortality than replacement along with a reduced need
for post-operaitve permanent pacemaker implantation rate.
<br/>Discussion(s): Decision on whether to treat or not tricuspid valve is
demanding, particularly in the context of the newest percutaneous
technologies. Before intervention, careful evaluation of both tricuspid
valve and right ventricle must be performed. Nevertheless, intervention,
should not be deferred when clinically indicated. <br/>Conclusion(s): The
findings form this meta-analysis suggest that reparative surgery, perhaps
in an early stage, may be beneficial in selected cohort of
patients.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<76>
Accession Number
2014242358
Title
Predictors for the risk of permanent pacemaker implantation after
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Wang T.; Ou A.; Xia P.; Tian J.; Wang H.; Cheng Z.
Institution
(Wang, Xia, Tian) Department of Cardiovascular Medicine, The Fourth
Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
(Ou) Department of Radiology, Shengjing Hospital of China Medical
University, Shenyang, Liaoning, China
(Wang) Department of Emergency Medicine, The First Affiliated Hospital of
Lanzhou Medical University, Lanzhou, China
(Cheng) Department of Cardiac Surgery, West China Hospital, Sichuan
University, Chengdu, Sichuan, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a less
invasive treatment than surgery for severe aortic stenosis. However, its
use is restricted by the fact that many patients eventually require
permanent pacemaker implantation (PPMI). This meta-analysis was performed
to identify predictors of post-TAVR PPMI. <br/>Method(s): The PubMed,
Embase, Web of Science, and Cochrane Library databases were systematically
searched. Relevant studies that met the inclusion criteria were included
in the pooling analysis after quality assessment. <br/>Result(s): After
pooling 67 studies on post-TAVR PPMI risk in 97,294 patients,
balloon-expandable valve use was negatively correlated with PPMI risk
compared with self-expandable valve (SEV) use (odds ratio [OR]: 0.44, 95%
confidence interval [CI]: 0.37-0.53). Meta-regression analysis revealed
that history of coronary artery bypass grafting and higher Society of
Thoracic Surgeons (STS) risk score increased the risk of PPMI with SEV
utilization. Patients with pre-existing cardiac conduction abnormalities
in 28 pooled studies also had a higher risk of PPMI (OR: 2.33, 95% CI:
1.90-2.86). Right bundle branch block (OR: 5.2, 95% CI: 4.37-6.18) and
first-degree atrioventricular block (OR: 1.97, 95% CI: 1.38-2.79) also
increased PPMI risk. Although the trans-femoral approach was positively
correlated with PPMI risk, the trans-apical pathway showed no statistical
difference to the trans-femoral pathway. The approach did not increase
PPMI risk in patients with STS scores >8. Patient-prosthesis mismatch did
not influence post-TAVR PPMI risk (OR: 0.88, 95% CI: 0.67-1.16). We also
analyzed implantation depth and found no difference between patients with
PPMI after TAVR and those without. <br/>Conclusion(s): SEV selection,
pre-existing cardiac conduction abnormality, and trans-femoral pathway
selection are positively correlated with PPMI after TAVR. Pre-existing
left bundle branch block, patient-prosthesis mismatch, and implantation
depth did not affect the risk of PPMI after TAVR.<br/>Copyright &#xa9;
2021 Wiley Periodicals LLC

<77>
Accession Number
2014241792
Title
Safety and efficacy of cerebral embolic protection devices in patients
undergoing transcatheter aortic valve replacement: a meta-analysis of
in-hospital outcomes.
Source
Cardiovascular Intervention and Therapeutics. (no pagination), 2021. Date
of Publication: 2021.
Author
Shimamura J.; Kuno T.; Malik A.; Yokoyama Y.; Gupta R.; Ahmad H.;
Briasoulis A.
Institution
(Shimamura) Division of Cardiac Surgery, Sunnybrook Health Sciences
Centre, Toronto, ON, Canada
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein Medical College, Bronx, NY, United States
(Malik) Department of Cardiology, Westchester Medical Center and New York
Medical College, Valhalla, NY, United States
(Yokoyama) Department of Surgery, Easton Hospital, Easton, PA, United
States
(Gupta) Department of Cardiology, Lehigh Valley Heart Institute, Lehigh
Valley Health Network, Allentown, PA, United States
(Ahmad) Division of Cardiology, Westchester Medical Center, Valhalla, NY,
United States
(Briasoulis) Section of Heart Failure and Transplant, Division of
Cardiovascular Diseases, University of Iowa Hospitals and Clinics, 200
Hawkins Dr, Iowa City, IA 52242, United States
Publisher
Springer Japan
Abstract
The evidence regarding the impact of cerebral embolic protection devices
(EPDs) on outcomes following transcatheter aortic valve replacement (TAVR)
is limited. The objective of this study was to evaluate in-hospital
outcomes with the use of cerebral EPDs in TAVR. We performed a
comprehensive EMBASE and PUBMED search to investigate randomized control
studies or propensity score-matched retrospective studies which assessed
patients undergoing TAVR with or without EPD up to April 2021. Endpoints
of interest were in-hospital mortality, stroke, acute kidney injury,
pacemaker implantation, major bleeding, vascular complication, length of
stay. Ten studies involving 173,002 patients with EPD (n = 16,898, 9.8%)
and those without (n = 156,104, 90.2%) fulfilled the inclusion criteria.
The use of EPD was associated with significantly lower risk of in-hospital
stroke (odds ratio [95% confidential interval]: 0.64 [0.46; 0.89]), but
similar rate of in-hospital mortality (odds ratio [95% confidential
interval]: 0.75 [0.54; 1.05]). No differences were observed in acute
kidney injury, pacemaker implantation, major bleeding, vascular
complication, length of stay. EPD during TAVR was associated with lower
in-hospital stroke but did not affect procedural complications and length
of stay.<br/>Copyright &#xa9; 2021, Japanese Association of Cardiovascular
Intervention and Therapeutics.

<78>
Accession Number
636467151
Title
Assessment of Intercostal Nerve Block Analgesia for Thoracic Surgery: A
Systematic Review and Meta-analysis.
Source
JAMA Network Open. (no pagination), 2021. Article Number: e2133394. Date
of Publication: 2021.
Author
Guerra-Londono C.E.; Privorotskiy A.; Cozowicz C.; Hicklen R.S.;
Memtsoudis S.G.; Mariano E.R.; Cata J.P.
Institution
(Guerra-Londono, Cata) Department of Anesthesiology and Perioperative
Medicine, MD Anderson Cancer Center, University of Texas, 1515 Holcombe
Blvd, Houston, TX 77030, United States
(Privorotskiy) Eastern Virginia Medical School, Norfolk, United States
(Cozowicz) Department of Anesthesiology, Perioperative Medicine and
Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria
(Hicklen) Research Medical Library, MD Anderson Cancer Center, University
of Texas, Houston, United States
(Memtsoudis) Department of Anesthesia, Hospital for Special Surgery, New
York, NY, United States
(Mariano) Department of Anesthesia, School of Medicine, Stanford
University, Stanford, CA, United States
(Cata) Anesthesiology and Surgical Oncology Research Group, Houston, TX,
United States
Publisher
American Medical Association
Abstract
Importance: The use of intercostal nerve block (ICNB) analgesia with local
anesthesia is common in thoracic surgery. However, the benefits and safety
of ICNB among adult patients undergoing surgery is unknown.
<br/>Objective(s): To evaluate the analgesic benefits and safety of ICNB
among adults undergoing thoracic surgery. <br/>Data Sources: A systematic
search was performed in Ovid MEDLINE, Ovid Embase, Scopus, and the
Cochrane Library databases using terms for ICNB and thoracic surgery
(including thoracic surgery, thoracoscopy, thoracotomy, nerve block,
intercostal nerves). The search and results were not limited by date, with
the last search conducted on July 24, 2020. Study Selection: Selected
studies were experimental or observational and included adult patients
undergoing cardiothoracic surgery in which ICNB was administered with
local anesthesia via single injection, continuous infusion, or a
combination of both techniques in at least 1 group of patients. For
comparison with ICNB, studies that examined systemic analgesia and
different forms of regional analgesia (such as thoracic epidural analgesia
[TEA], paravertebral block [PVB], and other techniques) were included.
These criteria were applied independently by 2 authors, and discrepancies
were resolved by consensus. A total of 694 records were selected for
screening. Data Extraction and Synthesis: This study followed the
Preferred Reporting Items for Systematic Reviews and Meta-analyses
(PRISMA) reporting guideline. Data including patient characteristics, type
of surgery, intervention analgesia, comparison analgesia, and primary and
secondary outcomes were extracted independently by 3 authors. Synthesis
was performed using a fixed-effects model. <br/>Main Outcomes and
Measures: The coprimary outcomes were postoperative pain intensity
(measured as the worst static or dynamic pain using a validated 10-point
scale, with 0 indicating no pain and 10 indicating severe pain) and opioid
consumption (measured in morphine milligram equivalents [MMEs]) at
prespecified intervals (0-6 hours, 7-24 hours, 25-48 hours, 49-72 hours,
and >72 hours). Clinically relevant analgesia was defined as a 1-point or
greater difference in pain intensity score at any interval. Secondary
outcomes included 30-day postoperative complications and pulmonary
function. <br/>Result(s): Of 694 records screened, 608 were excluded based
on prespecified exclusion criteria. The remaining 86 full-text articles
were assessed for eligibility, and 20 of those articles were excluded. All
of the 66 remaining studies (5184 patients; mean [SD] age, 53.9 [10.2]
years; approximately 59% men and 41% women) were included in the
qualitative analysis, and 59 studies (3325 patients) that provided data
for at least 1 outcome were included in the quantitative meta-analysis.
Experimental studies had a high risk of bias in multiple domains,
including allocation concealment, blinding of participants and personnel,
and blinding of outcome assessors. Marked differences (eg, crossover
studies, timing of the intervention [intraoperative vs postoperative],
blinding, and type of control group) were observed in the design and
implementation of studies. The use of ICNB vs systemic analgesia was
associated with lower static pain (0-6 hours after surgery: mean score
difference, -1.40 points [95% CI, -1.46 to -1.33 points]; 7-24 hours after
surgery: mean score difference, -1.27 points [95% CI, -1.40 to -1.13
points]) and lower dynamic pain (0-6 hours after surgery: mean score
difference, -1.66 points [95% CI, -1.90 to -1.41 points]; 7-24 hours after
surgery: mean score difference, -1.43 points [95% CI, -1.70 to -1.17
points]). Intercostal nerve block analgesia was noninferior to TEA (mean
score difference in worst dynamic panic at 7-24 hours after surgery: 0.79
points; 95% CI, 0.28-1.29 points) and marginally inferior to PVB (mean
score difference in worst dynamic pain at 7-24 hours after surgery: 1.29
points; 95% CI, 1.16 to 1.41 points). The largest opioid-sparing effect of
ICNB vs systemic analgesia occurred at 48 hours after surgery (mean
difference, -10.97 MMEs; 95% CI, -12.92 to -9.02 MMEs). The use of ICNB
was associated with higher MME values compared with TEA (eg, 48 hours
after surgery: mean difference, 48.31 MMEs; 95% CI, 36.11-60.52 MMEs) and
PVB (eg, 48 hours after surgery: mean difference, 3.87 MMEs; 95% CI,
2.59-5.15 MMEs). <br/>Conclusions and Relevance: In this study,
single-injection ICNB was associated with a reduction in pain during the
first 24 hours after thoracic surgery and was clinically noninferior to
TEA or PVB. Intercostal nerve block analgesia had opioid-sparing effects;
however, TEA and PVB were associated with larger decreases in
postoperative MMEs, suggesting that ICNB may be most beneficial for cases
in which TEA and PVB are not indicated.<br/>Copyright &#xa9; 2021 American
Medical Association. All rights reserved.

<79>
Accession Number
2014448866
Title
With or without you: Co-chaperones mediate health and disease by modifying
chaperone function and protein triage.
Source
Cells. 10(11) (no pagination), 2021. Article Number: 3121. Date of
Publication: November 2021.
Author
Altinok S.; Sanchez-Hodge R.; Stewart M.; Smith K.; Schisler J.C.
Institution
(Altinok, Sanchez-Hodge, Stewart, Smith, Schisler) Computational Medicine
Program, Department of Pharmacology, Department of Pathology and Lab
Medicine, McAllister Heart Institute, The University of North Carolina at
Chapel Hill, Chapel Hill, NC 27599, United States
Publisher
MDPI
Abstract
Heat shock proteins (HSPs) are a family of molecular chaperones that
regulate essential protein refolding and triage decisions to maintain
protein homeostasis. Numerous co-chaperone proteins directly interact and
modify the function of HSPs, and these interactions impact the outcome of
protein triage, impacting everything from structural proteins to cell
signaling mediators. The chaperone/co-chaperone machinery protects against
various stressors to ensure cellular function in the face of stress.
However, coding mutations, expression changes, and post-translational
modifications of the chaperone/co-chaperone machinery can alter the
cellular stress response. Im-portantly, these dysfunctions appear to
contribute to numerous human diseases. Therapeutic targeting of chaperones
is an attractive but challenging approach due to the vast functions of
HSPs, likely contributing to the off-target effects of these therapies.
Current efforts focus on targeting co-chaperones to develop precise
treatments for numerous diseases caused by defects in protein quality
control. This review focuses on the recent developments regarding selected
HSP70/HSP90 co-chaperones, with a concentration on cardioprotection,
neuroprotection, cancer, and autoimmune diseases. We also discuss
therapeutic approaches that highlight both the utility and challenges of
targeting co-chaperones.<br/>Copyright &#xa9; 2021 by the authors.
Licensee MDPI, Basel, Switzerland.

<80>
Accession Number
2013887783
Title
Outcomes of sutureless aortic valve replacement versus conventional aortic
valve replacement and transcatheter aortic valve replacement, updated
systematic review, and meta-analysis.
Source
Journal of Cardiac Surgery. 36(12) (pp 4734-4742), 2021. Date of
Publication: December 2021.
Author
Kim K.S.; Makhdoum A.; Koziarz A.; Gupta S.; Alsagheir A.; Pandey A.; Reza
S.; Um K.; Teoh K.; Alhazzani W.; Lamy A.; Yanagawa B.; Belley-Cote E.P.;
Whitlock R.P.
Institution
(Kim, Pandey, Reza, Um, Lamy, Belley-Cote, Whitlock) Population Health
Research Institute, McMaster University, Hamilton, Canada
(Kim, Alhazzani) Department of Health Research Methodology, Evidence and
Impact, McMaster University, Hamilton, Canada
(Makhdoum, Yanagawa) Division of Cardiac Surgery, Department of Surgery,
University of Toronto, Toronto, Canada
(Koziarz) Temerty Faculty of Medicine, University of Toronto, Toronto,
Canada
(Gupta, Alsagheir, Lamy, Whitlock) Division of Cardiac Surgery, Department
of Surgery, McMaster University, Hamilton, ON, Canada
(Um, Alhazzani, Belley-Cote) Department of Medicine, McMaster University,
Hamilton, ON, Canada
(Teoh) Southlake Regional Health Sciences Centre, Newmarket, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Sutureless aortic valve replacement (SuAVR) is an alternative
to surgical aortic valve replacement (SAVR) and transcatheter aortic valve
replacement (TAVR). This study compares the effectiveness of SuAVR to SAVR
and TAVR. <br/>Method(s): We searched MEDLINE and EMBASE from inception to
July 2021 for studies evaluating SuAVR, SAVR, and TAVR in adults with
aortic stenosis. We performed screening, full-text assessment, data
collection, and risk of bias evaluation independently and in duplicate. We
evaluated risk of bias using by Cochrane and CLARITY's tools, and
certainty in evidence using the GRADE framework. Data were pooled using a
random-effects model. <br/>Result(s): We identified one randomized and 78
observational studies (n = 60,689; SuAVR vs. SAVR = 39,171, vs. TAVR =
21,518). All studies were at high or unclear risk of bias, with very-low
certainty in effect estimates. Compared to TAVR, SuAVR demonstrates no
significant difference in mortality at 30-days (odds ratio [OR]: 0.52, 95%
confidence interval [CI: 0.85, 1.16], I² = 0%), but decreased
odds at 2-years (OR: 0.39, 95% CI [0.17, 0.88], I² = 0%). SuAVR
also reduced odds of mild paravalvular regurgitation (OR: 0.11, 95% CI
[0.06, 0.21], I² = 50%). Compared to SAVR, SuAVR was associated
with a similar mortality at 30-days (OR: 0.99, 95% CI [0.85, 1.16],
I² = 0%) and 2-years (OR: 0.99, 95% CI [0.43-2.30],
I² = 7%). SuAVR significantly increased odds of permanent
pacemaker implantation (OR: 2.5, 95% CI [2.25, 2.77], I² = 0%).
Pooled effect estimates were consistent with results from the randomized
trial comparing SuAVR and SAVR. <br/>Conclusion(s): Based on very-low
quality evidence, SuAVR is associated with similar short- and midterm
outcomes compared to TAVR and SAVR. Comparative randomized data with
long-term follow-up are required to clarify the role of
SuAVR.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC

<81>
Accession Number
2010832647
Title
Percutaneous coronary intervention in saphenous vein grafts after coronary
artery bypass grafting: a systematic review and meta-analysis.
Source
Scandinavian Cardiovascular Journal. 55(4) (pp 245-253), 2021. Date of
Publication: 2021.
Author
Ferrari G.; Geijer H.; Cao Y.; Souza D.; Samano N.
Institution
(Ferrari, Samano) Department of Cardiothoracic and Vascular Surgery and
University Health Care Research Center, Faculty of Medicine and Health,
Orebro University, Orebro, Sweden
(Geijer) Department of Radiology, Faculty of Medicine and Health, Orebro
University, Orebro, Sweden
(Cao) Clinical Epidemiology and Biostatistics, School of Medical Sciences,
Orebro University, Orebro, Sweden
(Souza) Department of Cardiothoracic and Vascular Surgery, Faculty of
Medicine and Health, Orebro University, Orebro, Sweden
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: To investigate the results of percutaneous coronary
intervention (PCI) in saphenous vein grafts after coronary artery bypass
grafting (CABG). Design. MEDLINE, Embase, and the Cochrane library were
searched for relevant articles published between 1 January 2000 and 29
February 2020. The PICO (population, intervention, comparison, outcome)
model was applied in constructing the clinical question. Two independent
researchers performed the literature search. Thirty-six articles were
identified and subjected to a quality assessment. The primary outcomes of
the meta-analysis were long-term in-stent restenosis and long-term major
adverse cardiac events (MACE). Results. In-stent restenosis was 9.4% (95%
CI: 4.2-14.7%) and MACE was 35.3% (95% CI: 27-43.7%) at mean time 2.7 +/-
1.0 years. The secondary outcomes were the unsuccessful PCI rate (7.7%;
95% CI: 2.9-12.5%), 30-day MACE (4.3%; 95% CI: 2.5-6.1%), and 1-year MACE
(15.5%; 95% CI: 11.7-19.3%). The use of drug-eluting stents resulted in
better outcomes at least in term of in-stent restenosis, while the benefit
of using embolic protection devices was questionable. Conclusions. PCI of
a stenosed or occluded saphenous vein graft is a challenge for
interventional cardiologists, and is still associated with relatively high
rates of restenosis, MACE, and procedural failure. All efforts to enhance
the results are warranted, including improved quality of the venous grafts
used during CABG.<br/>Copyright &#xa9; 2021 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<82>
Accession Number
2010082674
Title
Intraoperative Three-dimensional Imaging of Ventricular Septal Defects in
Children Using Epicardial Echocardiography: A Novel Approach.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35(10) (pp 2892-2899),
2021. Date of Publication: October 2021.
Author
Pillai M.N.; Suneel P.R.; Menon S.; Unnikrishnan K.P.; Baruah S.D.; Mathew
T.; Lovhale S.P.; Dharan B.S.
Institution
(Pillai, Suneel, Unnikrishnan, Lovhale) Department of Cardiac
Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and
Technology, Trivandrum, India
(Menon, Baruah, Mathew, Dharan) Department of Cardiothoracic and Vascular
Surgery, Sree Chitra Tirunal Institute for Medical Sciences and
Technology, Trivandrum, India
Publisher
W.B. Saunders
Abstract
Objective: To assess the feasibility and accuracy of intraoperative
three-dimensional (3D) epicardial en face images of ventricular septal
defects (VSD) in children using the 3D transesophageal echocardiography
(TEE) probe as an epicardial probe. <br/>Design(s): This was a prospective
nonrandomized blinded observational study. <br/>Setting(s): The study was
conducted at a single tertiary cardiac care center. <br/>Participant(s):
Fifty pediatric patients, weighing between 5.0 kg and 20 kg, who were
scheduled for elective surgical closure of their VSDs, prospectively were
recruited for this study. <br/>Intervention(s): Epicardial 3D images were
acquired using the full-volume mode. VSD location and size were determined
from the 3D data sets using multiplanar reconstruction mode (QLAB 9) by a
blinded investigator. The accuracy in terms of location and size was
compared with surgical findings. <br/>Measurements and Main Results: In 50
study subjects, 54 VSDs were located by epicardial 3D echocardiography
(3DE): 12 perimembranous, 17 inlet, eight muscular, 15 malaligned, and two
outlet. Average image acquisition time was 4.96 (+/-1.47) minutes. Average
image reconstruction time was 6.18 (+/-1.93) minutes. Good en face views
of the VSD could be rendered in all patients (100% feasibility). The
highest image quality was for perimembranous and malaligned VSDs. The
location of VSD by 3DE corresponded precisely with surgical findings (100%
accuracy). With linear regression analysis, excellent correlation was
observed between the diameters measured by surgery and that measured by
3DE from the right ventricle side (r² = 0.97, p < 0.001).
<br/>Conclusion(s): The authors' study demonstrated that diagnostic
quality 3D en face images of VSD can be obtained intraoperatively using 3D
epicardial echocardiography. The short acquisition and reconstruction
times make this technique clinically applicable.<br/>Copyright &#xa9; 2020
Elsevier Inc.

<83>
Accession Number
635086361
Title
Efficacy of parasternal block to decrease intraoperative opioid use in
coronary artery bypass surgery via sternotomy: A randomized controlled
trial.
Source
Regional Anesthesia and Pain Medicine. 46(8) (pp 671-678), 2021. Date of
Publication: 01 Aug 2021.
Author
Bloc S.; Perot B.P.; Gibert H.; Law Koune J.-D.; Burg Y.; Leclerc D.;
Vuitton A.-S.; De La Jonquiere C.; Luka M.; Waldmann T.; Vistarini N.;
Aubert S.; Menager M.M.; Merzoug M.; Naudin C.; Squara P.
Institution
(Bloc, Gibert, Law Koune, Burg, Leclerc, Vuitton, De La Jonquiere)
Anesthesiology Department, Cmc Ambroise Pare, Neuilly-sur-Seine, France
(Bloc, Merzoug, Naudin, Squara) Clinical Research Department, Cmc Ambroise
Pare, Neuilly-sur-Seine, France
(Perot, Luka, Menager) Laboratory of Inflammatory Responses and
Transcriptomic Networks in Diseases, Imagine Institute Inserm Umr 1163,
ATIP-Avenir Team, Universite de Paris, Paris, France
(Waldmann, Vistarini, Aubert) Cardiac Surgery Department, Cmc Ambroise
Pare, Neuilly-sur-Seine, France
(Squara) Critical Care Medicine Department, Cmc Ambroise Pare,
Neuilly-sur-Seine, France
Publisher
BMJ Publishing Group
Abstract
Objective This study aims to assess the effect of a preoperative
parasternal plane block (PSB) on opioid consumption required to maintain
hemodynamic stability during sternotomy for coronary artery bypass graft
surgery. Methods This double-blind, randomized, placebo-controlled trial
prospectively enrolled 35 patients scheduled for coronary artery bypass
graft surgery under general anesthesia with propofol and remifentanil.
Patients were randomized to receive preoperative PSB using either
ropivacaine (PSB group) or saline solution (placebo group) (1:1 ratio).
The primary endpoint was the maximal effect-site concentration of
remifentanil required to maintain heart rate and blood pressure within the
recommended ranges during sternotomy. Results Median maximum concentration
of remifentanil necessary to maintain adequate hemodynamic status during
sternotomy was significantly reduced in PSB group (4.2 (2.5-6.0) ng/mL)
compared with placebo group (7.0 (5.2-8.0) ng/mL) (p=0.02). Mean maximum
concentration of propofol used to control depth of anesthesia was also
reduced (3.9+/-1.1 mug/mL vs 5.0+/-1.5 mug/mL, PSB vs placebo,
respectively; p=0.02). This reduction in propofol consumption during
sternotomy enabled a more adequate level of sedation to be maintained in
patients (minimum patient state index was 11.7+/-8.7 in placebo group and
18.3+/-6.8 in PSB group; p=0.02). PSB reduced postoperative inflammatory
response by limiting concentrations of proinflammatory cytokines IL-8,
IL-18, IL-23, IL-33 and MCP-1 measured in the first 7-day after surgery
(p<0.05). Conclusions Preoperative PSB reduced the maximum concentrations
of remifentanil and propofol required to maintain hemodynamic stability
and depth of anesthesia during sternotomy. Trial registration number
NCT03734159. Sebastien Bloc, M.D. 1,2; Brieuc P. Perot, Ph.D. 3; Hadrien
Gibert, M.D. 1; Jean-Dominique Law Koune, M.D. 1; Yannick Burg, M.D. 1;
Didier Leclerc, M.D. 1; Anne-Sophie Vuitton, M.D. 1; Christophe De La
Jonquiere, M.D. 1; Marine Luka, L.S. 3; Thierry Waldmann, M.D. 4; Nicolas
Vistarini, M.D. 4; Stephane Aubert, M.D. 4; Mickael M. Menager, Ph.D. 3;
Messaouda Merzoug, Ph.D. 2; Cecile Naudin, Ph.D. 2; Pierre Squara, M.D.
2,5<br/>Copyright &#xa9;

<84>
Accession Number
2013613076
Title
A Systematic Review of Multiple Linear Regression-Based Limited Sampling
Strategies for Mycophenolic Acid Area Under the Concentration-Time Curve
Estimation.
Source
European Journal of Drug Metabolism and Pharmacokinetics. 46(6) (pp
721-742), 2021. Date of Publication: November 2021.
Author
Sobiak J.; Resztak M.
Institution
(Sobiak, Resztak) Department of Physical Pharmacy and Pharmacokinetics,
Poznan University of Medical Sciences, 6 Swiecickiego Street, Poznan
60-781, Poland
Publisher
Adis
Abstract
Background and Objective: One approach of therapeutic drug monitoring in
the case of mycophenolic acid (MPA) is a limited sampling strategy (LSS),
which allows the evaluation of the area under the concentration-time curve
(AUC) based on few concentrations. The aim of this systematic review was
to review the MPA LSSs and define the most frequent time points for MPA
determination in patients with different indications for mycophenolate
mofetil (MMF) administration. <br/>Method(s): The literature was
comprehensively searched in July 2021 using PubMed, Scopus, and Medline
databases. Original articles determining multiple linear regression
(MLR)-based LSSs for MPA and its free form (fMPA) were included. Studies
on enteric-coated mycophenolic sodium, previously established LSS,
Bayesian estimator, and different than twice a day dosing were excluded.
Data were analyzed separately for (1) adult renal transplant recipients,
(2) adults with other than renal transplantation indication, and (3) for
pediatric patients. <br/>Result(s): A total of 27, 17, and 11 studies were
found for groups 1, 2, and 3, respectively, and 126 MLR-based LSS formulae
(n = 120 for MPA, n = 6 for fMPA) were included in the review. Three
time-point equations were the most frequent. Four MPA LSSs: 2.8401 +
5.7435 x C0 + 0.2655 x C0.5 + 1.1546 x C1 + 2.8971 x C4 for adult renal
transplant recipients, 1.783 + 1.248 x C1 + 0.888 x C2 + 8.027 x C4 for
adults after islet transplantation, 0.10 + 11.15 x C0 + 0.42 x C1 + 2.80 x
C2 for adults after heart transplantation, and 8.217 + 3.163 x C0 + 0.994
x C1 + 1.334 x C2 + 4.183 x C4 for pediatric renal transplant recipients,
plus one fMPA LSS, 34.2 + 1.12 x C1 + 1.29 x C2 + 2.28 x C4 + 3.95 x C6
for adult liver transplant recipients, seemed to be the most promising and
should be validated in independent patient groups before introduction into
clinical practice. The LSSs for pediatric patients were few and not fully
characterized. There were only a few fMPA LSSs although fMPA is a
pharmacologically active form of the drug. <br/>Conclusion(s): The review
includes updated MPA LSSs, e.g., for different MPA formulations
(suspension, dispersible tablets), generic form, and intravenous
administration for adult and pediatric patients, and emphasizes the need
of individual therapeutic approaches according to MMF indication. Five
MLR-based MPA LSSs might be implemented into clinical practice after
evaluation in independent groups of patients. Further studies are
required, e.g., to establish fMPA LSS in pediatric patients.<br/>Copyright
&#xa9; 2021, The Author(s).

<85>
[Use Link to view the full text]
Accession Number
636451209
Title
Cardiac cirrhosis and hepatocellular carcinoma.
Source
American Journal of Gastroenterology. Conference: 80th Annual Scientific
Meeting of the American College of Gastroenterology. Honolulu, HI United
States. 110(Supplement 1) (pp S898-S899), 2015. Date of Publication:
October 2015.
Author
Adnan M.M.; Yanchak T.; Fathima N.; Nusrat S.
Institution
(Adnan) University of New Mexico, Albuquerque, NM, United States
(Yanchak, Nusrat) University of Oklahoma, Health Sciences Center, Oklahoma
City, OK, United States
(Fathima) Sri Siddhartha Medical College, Bolingbrook, IL, United States
Publisher
Nature Publishing Group
Abstract
Introduction: Cardiac cirrhosis is a known complication of chronic venous
congestion that arises in patients with right sided heart failure. This
association has most commonly been described in patients with congenital
heart disease who underwent surgical correction of heart defects, most
notably the Fontan procedure. There has been increased reporting of HCC
development in patients with chronic cardiac cirrhosis. Hepatocellular
cancer (HCC) is an aggressive malignancy with median survival of 6-20
months from diagnosis. No screening guidelines for detection of HCC have
been established in patients with chronic heart failure with venous
congestion. We aim to describe the clinical characteristics of patients
with Hepatocellular cancer (HCC) secondary to underlying cardiac cirrhosis
Methods: Using key words cardiac cirrhosis and hepatocellular cancer and
heart failure and hepatocellular cancer PUBMED, MEDLINE and EMBASE
databases were searched by two independent investigators for English
language publications between 1990 and 2015. A total of 257 publications
were initially identified. These were reviewed to identify studies that
provided information on patients who developed HCC secondary to underlying
cardiac cirrhosis and other predisposing condition (alcoholism, hepatitis
B, hepatitis C, Nonalcoholic steatohepatitis or autoimmune liver diseases)
were excluded. <br/>Result(s): Seven studies met our inclusion criteria
and provided information on 9 patients. Age of these patients ranged from
13 to 50 years and 5 were males. Congenital heart defects were the
underlying cause of congestive heart disease in majority (7) of these
patients and all of these had undergone surgical correction. The mean time
from onset of heart failure to development of HCC was 16.5 years, and the
median size of liver lesion reported was 4 cm. Three had hepatic lobe
resections, 2 patients had transarterial chemoembolization, 1 patient
received systemic chemotherapy with 5-FU and cisplatin, and 1 patient was
started on a sorafenib trial. Death was reported in 4 of the 9 patients.
<br/>Conclusion(s): The incidence of HCC in patients with chronic venous
congestion is likely to increase in the future as patients survive longer
with improved medical management after surgical correction of congenital
heart defects. We believe this particular patient population is at
increased risk for HCC and should be regularly screened for liver fibrosis
and cirrhosis.

<86>
Accession Number
2015576671
Title
Effectiveness and adverse effects of tranexamic acid in bleeding during
adenotonsillectomy: A randomized, controlled, double-blind clinical trial.
Source
International Archives of Otorhinolaryngology. 25(4) (pp E557-E562), 2021.
Date of Publication: October 2021.
Author
Fornazieri M.A.; Lima Kubo H.K.; de Farias L.C.; da Silva A.M.F.; Duarte
Garcia E.C.; de Alcantara Lopes dos Santos G.; de Rezende Pinna F.;
Voegels R.L.
Institution
(Fornazieri, da Silva, Duarte Garcia) Department of Surgery, Universidade
Estadual de Londrina, PR, Londrina, Brazil
(Fornazieri, Lima Kubo, de Farias, da Silva) Department of Medicine,
Pontificia Universidade Catolica do Parana, PR, Londrina, Brazil
(Fornazieri, de Rezende Pinna, Voegels) Department of Otorhinolaryngology,
Universidade de Sao Paulo, SP, Sao Paulo, Brazil
(Fornazieri, de Alcantara Lopes dos Santos) Centro Londrinense de
Otorrinolaringologia, PR, Londrina, Brazil
Publisher
Georg Thieme Verlag
Abstract
Introduction Intra and postoperative bleeding are the most frequent and
feared complications in adenotonsillectomy (AT). Tranexamic acid (TXA),
which is known for its antifibrinolytic effects, has a proven benefit in
reducing bleeding in hemorrhagic trauma and cardiac surgery; however, the
effectiveness and timing of its application in AT have not yet been
established. Objectives We aimed to evaluate the efficacy of TXA in
controlling bleeding during and after AT and assess its possible adverse
effects in children. Methods The present randomized, controlled,
double-blind clinical trial included 63 children aged 2 to 12 years. They
were randomly assigned to receive either intravenous TXA (10 mg/kg) or
placebo 10 minutes before surgery. The volume of intraoperative bleeding,
presence of postoperative bleeding, and adverse effects during and 8 hours
after the surgery were assessed. Results No difference in bleeding volume
was noted between the 2 groups (mean, 122.7 ml in the TXA group versus
115.5 ml in the placebo group, p 1/4 0.36). No intraoperative or
postoperative adverse effects were noted because of TXA use. Furthermore,
no primary or secondary postoperative bleeding was observed in any of the
participants. Conclusion In our pediatric sample, TXA (10 mg/kg)
administration before AT was safely used, without any adverse effects. It
did not reduce the bleeding volume in children during this type of
surgery. Future studies should assess the use of higher doses of TXA and
its administration at other time points before or during
surgery.<br/>Copyright &#xa9; 2021. Fundacao Otorrinolaringologia. All
rights reserved.

<87>
Accession Number
2014525317
Title
Effectiveness of a real-time x-ray dosimetry monitor in reducing radiation
exposure in coronary procedures: The ESPRESSO-raysafe randomized trial.
Source
Journal of Clinical Medicine. 10(22) (no pagination), 2021. Article
Number: 5350. Date of Publication: November-2 2021.
Author
Olschewski M.; Ullrich H.; Brandt M.; Steven S.; Ahoopai M.; Blessing R.;
Petrescu A.; Wenzel P.; Munzel T.; Gori T.
Institution
(Olschewski, Ullrich, Brandt, Steven, Ahoopai, Blessing, Petrescu, Wenzel,
Munzel, Gori) Department of Cardiology, Cardiology 1, University Medical
Center Mainz and Deutsches Zentrum fur Herz und Kreislauf Forschung,
Standort Rhein-Main, Mainz 55131, Germany
Publisher
MDPI
Abstract
Background-Several methods to reduce radiation exposure in the setting of
coronary procedures are available on the market, and we previously showed
that additional radiation shields reduce operator exposure during radial
interventions. We set out to examine the efficacy of real-time personal
dosimetry monitoring in a real-world setting of radial artery
catheterization. Methods and Results-In an all-comer prospective, parallel
study, consecutive coronary diagnostic and intervention procedures were
performed with the use of standard radiation shield alone (control group)
or with the addition of a real-time dosimetry monitoring system (Raysafe,
Billdal, Sweden, monitoring group). The primary outcome was the difference
in exposure of the primary operator among groups. Additional endpoints
included patient, nurse, second operator exposure and fluoroscopy time. A
total of 700 procedures were included in the analysis (n = 369 in the
monitoring group). There were no differences among groups in patients'
body mass index (p = 0.232), type of procedure (intervention vs.
diagnostic, p = 0.172), and patient sex (p = 0.784). Fluoroscopy time was
shorter in the monitoring group (5.6 (5.1-6.2) min vs. 7.0 (6.1-7.7) min,
p = 0.023). Radiation exposure was significantly lower in the monitoring
group for the patient (135 (115-151) microSv vs. 208 (176-245) microSv, p
< 0.0001) but not for the first operator (9 (7-11) microSv vs. 10 (8-11),
p = 0.70) and the assistant (2 (1-2) microSv vs. 2 (1-2) microSv, p =
0.121). Conclusions-In clinical daily practice, the use of a real-time
dosimetry monitoring device reduces patient radiation exposure and
fluoroscopy time without an effect on operator radiation
exposure.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI, Basel,
Switzerland.

<88>
Accession Number
2014514097
Title
One-year hemodynamic performance of three cardiac aortic bioprostheses: A
randomized comparative clinical trial.
Source
Journal of Clinical Medicine. 10(22) (no pagination), 2021. Article
Number: 5340. Date of Publication: November-2 2021.
Author
Montero-cruces L.; Carnero-alcazar M.; Reguillo-lacruz F.J.;
Cobiella-carnicer F.J.; Perez-camargo D.; Campelos-fernandez P.;
Maroto-castellanos L.C.
Institution
(Montero-cruces, Carnero-alcazar, Reguillo-lacruz, Cobiella-carnicer,
Perez-camargo, Campelos-fernandez, Maroto-castellanos) Department of
Cardiac Surgery, Cardiovascular Institute, Hospital Clinico San Carlos,
Madrid 28940, Spain
Publisher
MDPI
Abstract
Background: We aimed to compare 1 year the hemodynamic in-vivo performance
of three biological aortic prostheses (Carpentier Perimount Magna EaseTM,
Crown PRTTM, and TrifectaTM). <br/>Method(s): The sample used in this
study comes from the "BEST-VALVE" clinical trial, which is a phase IV
single-blinded randomized clinical trial with the three above-mentioned
prostheses. <br/>Result(s): 154 patients were included. Carpentier
Perimount Magna EaseTM (n = 48, 31.2%), Crown PRTTM (n = 51, 32.1%) and
TrifectaTM (n = 55, 35.7%). One year after the surgery, the mean aortic
gradient and the peak aortic velocity was 17.5 (IQR 11.3-26) and 227.1
(IQR 202.0-268.8) for Carpentier Perimount Magna EaseTM, 21.4 (IQR
14.5-26.7) and 237.8 (IQR 195.9-261.9) for Crown PRTTM, and 13 (IQR
9.6-17.8) and 209.7 (IQR 176.5-241.4) for TrifectaTM, respectively.
Pairwise comparisons demonstrated improved mean gradients and maximum
velocity of TrifectaTM as compared to Crown PRTTM. Among patients with
nominal prosthesis sizes <=21, the mean and peak aortic gradient was
higher for Crown PRTTM compared with TrifectaTM, and in patients with an
aortic annulus measured with metric Hegar dilators less than or equal to
22 mm. <br/>Conclusion(s): One year after surgery, the three prostheses
presented a different hemodynamic performance, being TrifectaTM superior
to Crown PRTTM.<br/>Copyright &#xa9; 2021 by the authors. Licensee MDPI,
Basel, Switzerland.

<89>
Accession Number
2014199640
Title
Comparison of the analgesic effect of ultrasound-guided paravertebral
block and ultrasound-guided retrolaminar block in Uniportal video-assisted
Thoracoscopic surgery: a prospective, randomized study.
Source
BMC Cancer. 21(1) (no pagination), 2021. Article Number: 1229. Date of
Publication: December 2021.
Author
Wang Q.; Wei S.; Li S.; Yu J.; Zhang G.; Ni C.; Sun L.; Zheng H.
Institution
(Wang, Wei, Li, Yu, Zhang, Ni, Zheng) Department of Anesthesiology,
National Cancer Center/National Clinical Research Center for Cancer/Cancer
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, No. 17, Panjiayuannanli, Chaoyang District, Beijing 100021, China
(Sun) Department of Anesthesiology, National Cancer Center/National
Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Shenzhen 518116, China
Publisher
BioMed Central Ltd
Abstract
Background: The optimal modality for postoperative analgesia after
uniportal video-assisted thoracoscopic surgery (UVATS) for the treatment
of lung cancer has not yet been determined. Both ultrasound-guided
paravertebral block (PVB) and retrolaminar block (RLB) have been reported
to be successful in providing analgesia after UVATS. However, which block
technique provides superior analgesia after UVATS is still unclear. This
randomized study was designed to compare the postoperative analgesic
effects and adverse events associated with ultrasound-guided PVB and RLB
after UVATS. <br/>Method(s): Sixty patients with lung cancer were
randomized to undergo ultrasound-guided PVB (group P) or ultrasound-guided
RLB (group R). In group P, 30 mL of 0.5% ropivacaine was injected at the
T3 and T5 levels via ultrasound-guided PVB (15 mL at each level on the
operative side). In group R, 30 mL of 0.5% ropivacaine was injected at the
T3 and T5 levels via ultrasound-guided RLB (15 mL at each level on the
operative side). The primary outcome was the numerical rating scale (NRS)
score within 48 h after surgery. The secondary outcomes were total
postoperative sufentanil consumption, time to first analgesic request and
adverse events. <br/>Result(s): At 3, 6, 12, 24, 36 and 48 h
postoperatively, the NRS score at rest in group P was lower than that in
group R (p < 0.05). At 3, 6, 12, 24 and 36 h postoperatively, the NRS
score while coughing in group P was lower than that in group R (p < 0.05).
The total postoperative sufentanil consumption in group P was
significantly lower than that in group R (p < 0.001). Additionally, the
time to first analgesic request was longer in group R than in group P (p <
0.0001). The incidence of nausea in group R was higher than that in group
P (p < 0.05). <br/>Conclusion(s): In patients with lung cancer undergoing
UVATS, ultrasound-guided PVB with 0.5% ropivacaine provides better
analgesia and results in less nausea than ultrasound-guided RLB. Compared
with ultrasound-guided RLB, ultrasound-guided PVB seems to be a better
technique for analgesia in UVATS. Trial registration: The name of this
study is the Effect And Mechanism Of Ultrasound-guided Multimodal Regional
Nerve Block On Acute And Chronic Pain After Thoracic Surgery. This study
was registered in the Chinese Clinical Trial Registry (ChiCTR2100044060).
The date of registration was March 9, 2021.<br/>Copyright &#xa9; 2021, The
Author(s).

<90>
Accession Number
2015524217
Title
The association between mean arterial pressure and outcomes in patients
with cardiogenic shock: Insights from the DOREMI trial.
Source
European Heart Journal: Acute Cardiovascular Care. 10(7) (pp 712-720),
2021. Date of Publication: 01 Sep 2021.
Author
Parlow S.; Di Santo P.; Mathew R.; Jung R.G.; Simard T.; Gillmore T.; Mao
B.; Abdel-Razek O.; Ramirez F.D.; Marbach J.A.; Dick A.; Glover C.; Russo
J.J.; Froeschl M.; Labinaz M.; Fernando S.M.; Hibbert B.
Institution
(Parlow, Di Santo, Mathew, Jung, Simard, Abdel-Razek, Ramirez, Marbach,
Dick, Glover, Russo, Froeschl, Labinaz, Fernando, Hibbert) CAPITAL
Research Group, University of Ottawa Heart Institute, 40 Ruskin Street,
H-4238, Ottawa, ON K1Y 4W7, Canada
(Parlow, Di Santo, Mathew, Abdel-Razek, Ramirez, Dick, Glover, Russo,
Froeschl, Labinaz, Hibbert) Division of Cardiology, University of Ottawa
Heart Institute, 40 Ruskin Street, H-4238, Ottawa, ON K1Y 4W7, Canada
(Di Santo) School of Epidemiology and Public Health, Faculty of Medicine,
University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON K1G
5Z3, Canada
(Jung, Gillmore, Mao) Faculty of Medicine, University of Ottawa, Roger
Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada
(Jung, Simard, Hibbert) Department of Cellular and Molecular Medicine,
Faculty of Medicine, University of Ottawa, 451 Smyth Road, Room #3206,
Ottawa, ON K1H 8M5, Canada
(Simard) Department of Cardiovascular Diseases, Mayo Clinic School of
Medicine, 200 First St. SW, Rochester, MN 55905, United States
(Marbach) Division of Pulmonary, Critical Care, and Sleep Medicine, Tufts
Medical Center, 800 Washington Street, Boston, MA 02111, United States
(Fernando) Division of Critical Care, Department of Medicine, University
of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
Publisher
Oxford University Press
Abstract
Aims: Cardiogenic shock (CS) is a state of low cardiac output resulting in
end-organ hypoperfusion. Despite high in-hospital mortality rates, little
evidence exists regarding the optimal mean arterial pressure (MAP) target
in CS. We therefore evaluated the relationship between achieved MAP and
clinical outcomes in patients with CS. <br/>Methods and Results: We
performed a post hoc analysis of the CAPITAL DOREMI trial: a randomized,
double-blind trial comparing dobutamine to milrinone in patients with CS.
We divided patients into a high MAP group (average MAP >= 70 mmHg over the
36 h following randomization), and a low MAP group (average MAP < 70
mmHg). Our primary outcome included in-hospital all-cause mortality,
resuscitated cardiac arrest, need for cardiac transplantation or
mechanical circulatory support, non-fatal myocardial infarction, transient
ischaemic attack or stroke, or initiation of renal replacement therapy. In
total, 71 (37.0%) patients achieved an average MAP < 70 mmHg, and 121
(63.0%) achieved an average MAP >= 70 mmHg. The primary outcome occurred
in 48 (67.6%) patients in the low MAP group and 51 (42.2%) patients in the
high MAP group [adjusted relative risk (aRR) 0.70; 95% confidence interval
(CI) 0.53-0.92; P = 0.01]. All-cause mortality occurred in 41 (57.8%) and
35 (28.9%) patients in the low and high MAP groups, respectively (aRR
0.56; 95% CI 0.40-0.79; P < 0.01). There were no significant differences
in any secondary outcomes between each group. <br/>Conclusion(s): In
patients with CS treated with inotrope therapy, low MAP is associated with
worse clinical outcomes. Randomized data evaluating optimal MAP targets in
CS is needed to guide medical therapy. <br/>Copyright &#xa9; 2021
Published on behalf of the European Society of Cardiology. All rights
reserved.

<91>
Accession Number
2015524213
Title
'Ticagrelor alone vs. dual antiplatelet therapy from 1 month after
drug-eluting coronary stenting among patients with STEMI': A post hoc
analysis of the randomized GLOBAL LEADERS trial.
Source
European Heart Journal: Acute Cardiovascular Care. 10(7) (pp 756-773),
2021. Date of Publication: 01 Sep 2021.
Author
Gamal A.S.; Hara H.; Tomaniak M.; Lunardi M.; Gao C.; Ono M.; Kawashima
H.; Juni P.; Vranckx P.; Windecker S.; Hamm C.; Steg P.G.; Onuma Y.;
Serruys P.W.
Institution
(Gamal, Hara, Lunardi, Gao, Ono, Kawashima, Onuma, Serruys) Department of
Cardiology, National University of Ireland, Galway (NUIG), University
Road, Galway H91 TK33, Ireland
(Gamal) Department of Cardiology, North Cumbria University Hospital NHS
Trust, Newtown Road, Cumbria CA2 7HY, United Kingdom
(Gamal) Department of Cardiology, Zagazig University, Zagazig, Sharkia
44519, Egypt
(Hara, Ono, Kawashima) Department of Cardiology, Academic Medical Center,
University of Amsterdam, Meibergdreef 9, Amsterdam 1105 AZ, Netherlands
(Tomaniak) Department of Cardiology, Erasmus University MC, Dr.
Molewaterplein 40 Street, Rotterdam 3015 GD, Netherlands
(Tomaniak) First Department of Cardiology, Medical University of Warsaw,
Banacha 1a Street, Warsaw 02-097, Poland
(Lunardi) Division of Cardiology, University of Verona, Piazzale Stefani
1, Verona 37100, Italy
(Gao) Department of Cardiology, Radboud University Medical Center, Geert
Grooteplein Zuid 8, Nijmegen 6525 GA, Netherlands
(Juni) Applied Health Research Centre, Li Ka Shing Knowledge Institute ,
St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Stadsomvaart 11, Hasselt 3500, Belgium
(Windecker) Department of Cardiology, Bern University Hospital,
Freiburgstrasse 4, Bern 3010, Switzerland
(Hamm) Department of Cardiology, Campus Kerckhoff of the University of
Giessen, Kerckhoff Heart and Thorax Center, Benekestrasse 2-8, Bad Nauheim
61231, Germany
(Steg) Universite de Paris, FACT, Assistance Publique-Hopitaux de Paris
Hopital Bichat, AP-HP, 46 rue Henri Huchard, Paris 75018, France
(Serruys) Department of Cardiology, Imperial College London, Exhibition
Road, London SW7 2BX, United Kingdom
Publisher
Oxford University Press
Abstract
Aim: To evaluate the efficacy and safety of ticagrelor monotherapy beyond
1 month and up to 24 months vs. standard 12-month dual antiplatelet
therapy (DAPT) with aspirin and ticagrelor followed by aspirin monotherapy
among ST-elevation myocardial infarction (STEMI) patients undergoing
percutaneous coronary intervention (PCI) in the GLOBAL LEADERS trial.
<br/>Methods and Results: We performed a post hoc analysis of STEMI
patients in the GLOBAL LEADERS trial comparing experimental ticagrelor
monotherapy (1062 patients) with standard 12-month DAPT (1030 patients).
We evaluated predefined primary and secondary endpoints in both treatment
arms. Rates of net adverse clinical events (NACE), patient-oriented
composite endpoints (POCE), and bleeding academic research consortium
(BARC)-defined bleeding Type 3 or 5 were also evaluated. At 2 years, there
were no significant differences in rates of primary endpoints in patients
who had STEMI [0.89 (0.61-1.31)]. There were similar rates of NACE and
POCE in both experimental and reference treatment groups at 2 years
post-PCI [hazard ratio (HR) 0.96 (0.77-1.20) and 0.96 (0.77-1.21),
respectively]. BARC 3 or 5 bleeding events were numerically less in
experimental compared to reference treatment groups at 1 year [HR 0.55
(0.27-1.13)] and 2 years [0.61 (0.32-1.16)]. <br/>Conclusion(s):
Presentation with STEMI has not influenced the incidence of GLOBAL LEADERS
defined primary endpoints. There were no significant differences in rates
of NACE, POCE, and BARC bleeding between the two treatment groups up to 2
years of follow-up. Although these findings should be viewed as
exploratory, they expand the evidence on potential safety of aspirin-free
antiplatelet strategies after PCI in STEMI. <br/>Copyright &#xa9; 2021 The
Author(s) 2021. Published by Oxford University Press on behalf of the
European Society of Cardiology.

<92>
Accession Number
2014198948
Title
Effect of routine preoperative screening for aortic calcifications using
noncontrast computed tomography on stroke rate in cardiac surgery: the
randomized controlled CRICKET study.
Source
European Radiology. (no pagination), 2021. Date of Publication: 2021.
Author
Knol W.G.; Simon J.; Den Harder A.M.; Bekker M.W.A.; Suyker W.J.L.; de
Heer L.M.; de Jong P.A.; Leiner T.; Merkely B.; Polos M.; Krestin G.P.;
Boersma E.; Koudstaal P.J.; Maurovich-Horvat P.; Bogers A.J.J.C.; Budde
R.P.J.
Institution
(Knol, Bekker, Bogers) Department of Cardiothoracic Surgery, Erasmus
University Medical Center, Rotterdam, Netherlands
(Knol, Krestin, Budde) Department of Radiology and Nuclear Medicine,
Erasmus University Medical Center, PO BOX 2040, Rotterdam ND-547, 3000-CA,
Netherlands
(Simon, Merkely, Maurovich-Horvat) Department of Cardiology, Heart and
Vascular Center, Semmelweis University, Budapest, Hungary
(Den Harder, de Jong, Leiner) Department of Radiology, University Medical
Center Utrecht and Utrecht University, Utrecht, Netherlands
(Suyker, de Heer) Department of Cardiothoracic Surgery, University Medical
Center Utrecht, Utrecht, Netherlands
(Polos) Department of Cardiovascular Surgery, Heart and Vascular Center,
Semmelweis University, Budapest, Hungary
(Boersma) Department of Clinical Epidemiology, Erasmus University Medical
Center, Rotterdam, Netherlands
(Koudstaal) Department of Neurology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Maurovich-Horvat) Department of Radiology, Medical Imaging Centre,
Semmelweis University, Budapest, Hungary
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objectives: To evaluate if routine screening for aortic calcification
using unenhanced CT lowers the risk of stroke and alters the surgical
approach in patients undergoing general cardiac surgery compared with
standard of care (SoC). <br/>Method(s): In this prospective, multicenter,
randomized controlled trial, adult patients scheduled for cardiac surgery
from September 2014 to October 2019 were randomized 1:1 into two groups:
SoC alone, including chest radiography, vs. SoC plus preoperative
noncontrast CT. The primary endpoint was in-hospital perioperative stroke.
Secondary endpoints were preoperative change of the surgical approach,
in-hospital mortality, and postoperative delirium. The trial was halted
halfway for expected futility, as the conditional power analysis showed a
chance < 1% of finding the hypothesized effect. <br/>Result(s): A total of
862 patients were evaluated (SoC-group: 433 patients (66 +/- 11 years;
74.1% male) vs. SoC + CT-group: 429 patients (66 +/- 10 years; 69.9%
male)). The perioperative stroke rate (SoC + CT: 2.1%, 9/429 vs. SoC:
1.2%, 5/433, p = 0.27) and rate of changed surgical approach (SoC + CT:
4.0% (17/429) vs. SoC: 2.8% (12/433, p = 0.35) did not differ between
groups. In-hospital mortality and postoperative delirium were comparable
between groups. In the SoC + CT group, aortic calcification was observed
on CT in the ascending aorta in 28% (108/380) and in the aortic arch in
70% (265/379). <br/>Conclusion(s): Preoperative noncontrast CT in cardiac
surgery candidates did not influence the surgical approach nor the
incidence of perioperative stroke compared with standard of care. Aortic
calcification is a frequent finding on the CT scan in these patients but
results in major surgical alterations to prevent stroke in only few
patients. Key Points: * Aortic calcification is a frequent finding on
noncontrast computed tomography prior to cardiac surgery. * Routine use of
noncontrast computed tomography does not often lead to a change of the
surgical approach, when compared to standard of care. * No effect was
observed on perioperative stroke after cardiac surgery when using routine
noncontrast computed tomography screening on top of standard of
care.<br/>Copyright &#xa9; 2021, The Author(s).