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<1>
Accession Number
365787657
Title
Prasugrel versus clopidogrel for acute coronary syndromes without
revascularization.
Source
New England Journal of Medicine. 367(14) (pp 1297-1309), 2012. Date of
Publication: 04 Oct 2012.
Author
Roe M.T.; Armstrong P.W.; Fox K.A.A.; White H.D.; Prabhakaran D.; Goodman
S.G.; Cornel J.H.; Bhatt D.L.; Clemmensen P.; Martinez F.; Ardissino D.;
Nicolau J.C.; Boden W.E.; Gurbel P.A.; Ruzyllo W.; Dalby A.J.; McGuire
D.K.; Leiva-Pons J.L.; Parkhomenko A.; Gottlieb S.; Topacio G.O.; Hamm C.;
Pavlides G.; Goudev A.R.; Oto A.; Tseng C.-D.; Merkely B.; Gasparovic V.;
Corbalan R.; Cinteza M.; McLendon R.C.; Winters K.J.; Brown E.B.;
Lokhnygina Y.; Aylward P.E.; Huber K.; Hochman J.S.; Ohman E.M.
Institution
(Roe, McLendon, Lokhnygina, Ohman) Duke Clinical Research Institute, Duke
University Medical Center, 2400 Pratt St, Durham, NC 27705, United States
(Roe, Ohman) Division of Cardiology, Department of Medicine, Duke
University Medical Center, Durham, NC, United States
(Armstrong) Division of Cardiology, University of Alberta, Edmonton, AB,
Canada
(Goodman) Division of Cardiology, St. Michael's Hospital, University of
Toronto, Toronto, ON, Canada
(Fox) Centre for Cardiovascular Science, University of Edinburgh,
Edinburgh, United Kingdom
(White) Auckland City Hospital, Green Lane Cardiovascular Service,
Auckland, New Zealand
(Prabhakaran) Center for Chronic Disease Control, New Delhi, India
(Cornel) Department of Cardiology, Medical Center Alkmaar, Alkmaar,
Netherlands
(Bhatt) VA Boston Healthcare System, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Clemmensen) Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Martinez) Department of Cardiology, Cordoba National University, Cordoba,
Argentina
(Ardissino) Division of Cardiology, Azienda Ospedaliero-Universitaria di
Parma, Parma, Italy
(Nicolau) Heart Institute (InCor), University of Sao Paulo Medical School,
Sao Paulo, Brazil
(Boden) Department of Medicine, Stratton VA Medical Center, Albany Medical
College, Albany, NY, United States
(Hochman) Leon H. Charney Division of Cardiology, New York University
School of Medicine, NYU Langone Medical Center, NY, United States
(Gurbel) Sinai Center for Thrombosis Research, Sinai Hospital of
Baltimore, Baltimore, United States
(Ruzyllo) Department of Coronary Artery Disease, Institute of Cardiology,
Warsaw, Poland
(Dalby) Milpark Hospital, Johannesburg, South Africa
(McGuire) University of Texas-Southwestern Medical Center, Dallas, TX,
United States
(Leiva-Pons) Cardiology Department, Hospital Central Dr. Morones Prieto,
San Luis Potosi, Mexico
(Parkhomenko) Emergency Cardiology, Institute of Cardiology, Kiev, Ukraine
(Gottlieb) Department of Cardiology, Bikur Cholim Hospital, Jerusalem,
Israel
(Topacio) Department of Medicine, Medical Center Manila, Manila,
Philippines
(Hamm) Kerckhoff Heart Center, Bad Nauheim, Germany
(Pavlides) Cardiology Division, Onassis Cardiac Surgery Center, Kallithea,
Greece
(Goudev) Cardiology Department, Queen Giovanna University Hospital, Sofia,
Bulgaria
(Oto) Department of Cardiology, Hacettepe University Faculty of Medicine,
Ankara, Turkey
(Tseng) Division of Cardiology, National Taiwan University College of
Medicine, Taipei, Taiwan (Republic of China)
(Merkely) Heart Center, Semmelweis University, Budapest, Hungary
(Gasparovic) Department of Intensive Care Medicine, Clinical Hospital
Center Zagreb, Zagreb, Croatia
(Corbalan) Cardiovascular Division, Faculty of Medicine, Pontificia
Universidad Catolica de Chile, Santiago, Chile
(Cinteza) Division of Cardiology, Emergency University Hospital of
Bucharest, Bucharest, Romania
(Winters, Brown) Eli Lilly, Indianapolis, IN, United States
(Aylward) South Australian Health and Medical Research Institute, Flinders
University Medical Centre, Adelaide, SA, Australia
(Huber) Third Department of Medicine, Cardiology and Emergency Medicine,
Wilhelminenhospital, Vienna, Austria
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND: The effect of intensified platelet inhibition for patients
with unstable angina or myocardial infarction without ST-segment elevation
who do not undergo revascularization has not been delineated.
 METHOD(S): In this double-blind, randomized trial, in a primary
analysis involving 7243 patients under the age of 75 years receiving
aspirin, we evaluated up to 30 months of treatment with prasugrel (10 mg
daily) versus clopidogrel (75 mg daily). In a secondary analysis involving
2083 patients 75 years of age or older, we evaluated 5 mg of prasugrel
versus 75 mg of clopidogrel. RESULT(S): At a median follow-up of 17
months, the primary end point of death from cardiovascular causes,
myocardial infarction, or stroke among patients under the age of 75 years
occurred in 13.9% of the prasugrel group and 16.0% of the clopidogrel
group (hazard ratio in the prasugrel group, 0.91; 95% confidence interval
[CI], 0.79 to 1.05; P = 0.21). Similar results were observed in the
overall population. The prespecified analysis of multiple recurrent
ischemic events (all components of the primary end point) suggested a
lower risk for prasugrel among patients under the age of 75 years (hazard
ratio, 0.85; 95% CI, 0.72 to 1.00; P = 0.04). Rates of severe and
intracranial bleeding were similar in the two groups in all age groups.
There was no significant between-group difference in the frequency of
nonhemorrhagic serious adverse events, except for a higher frequency of
heart failure in the clopidogrel group. CONCLUSION(S): Among patients
with unstable angina or myocardial infarction without ST-segment
elevation, prasugrel did not significantly reduce the frequency of the
primary end point, as compared with clopidogrel, and similar risks of
bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY
ACS ClinicalTrials.gov number, NCT00699998.) Copyright © 2012
Massachusetts Medical Society.

<2>
Accession Number
2005500230
Title
Remote ischaemic conditioning in patients with ST-elevation myocardial
infarction treated with percutaneous coronary intervention: an updated
meta-analysis of clinical outcomes.
Source
Acta Cardiologica. 76(6) (pp 623-631), 2021. Date of Publication: 2021.
Author
Borracci R.A.; Amrein E.; Alvarez Gallesio J.M.; Trucksass S.; Higa C.C.
Institution
(Borracci) Biostatistics, School of Medicine, Austral University, Buenos
Aires, Argentina
(Amrein, Alvarez Gallesio, Trucksass, Higa) Department of Cardiology,
Deutsches Hospital, Buenos Aires, Argentina
Publisher
Taylor and Francis Ltd.
Abstract
Background: All previous meta-analyses including clinical outcomes after
remote ischaemic conditioning (RIC) in patients with ST-elevation
myocardial infarction (STEMI) treated with percutaneous coronary
intervention (PCI) demonstrated that RIC significantly reduced all-cause
mortality and major adverse cardiovascular events (MACE). Following the
publication of these meta-analyses, three new randomised controlled
clinical trials (RCT) including 5712 patients were reported. The objective
of this study was to perform an updated meta-analysis about the
effectiveness of RIC in reducing MACE in patients with STEMI undergoing
PCI. Method(s): The search strategy included only RCT identified in
MEDLINE, Embase, SCOPUS, and Cochrane (up to February 2020). Eligible
studies included any type of RIC. The study adhered to the Preferred
Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA)
statement. The studies quality was evaluated with Cochrane Risk of Bias
tool and Jadad score. Result(s): Twelve RCT were included in the
analysis (Q = 18.8, p = 0.065, I 2 = 41.5%, 95%CI 0.0-70.3).
Globally, 8239 STEMI patients with 816 MACE were reported with follow-ups
between 1 and 45 months. Random effects model showed no significant effect
of RIC on composite clinical endpoints (OR = 0.77, 95%CI 0.59-1.01, p =
0.105). Sensitivity analysis demonstrated that only the exclusion of
CONDI-2/ERIC PPCI trial modified the significance of the global effect (OR
0.66, 95%CI 0.47-0.93), favouring RIC intervention. Conclusion(s):
The current updated meta-analysis showed that use of RIC around the time
of PCI for STEMI treatment added no significant benefit for clinical
outcomes assessed between 6 and 45 months after the procedure. These
conclusions are in direct contrast to previously published
meta-analyses. Copyright © 2021 Belgian Society of Cardiology.

<3>
Accession Number
2007745324
Title
Effects of intravenous and transdermal photobiomodulation on the
postoperative complications of coronary artery bypass grafting surgery: a
randomized, controlled clinical trial.
Source
Lasers in Medical Science. 36(9) (pp 1891-1896), 2021. Date of
Publication: December 2021.
Author
Kazemikhoo N.; Kyavar M.; Razzaghi Z.; Ansari F.; Maleki M.; Ghavidel
A.A.; Gholampour M.; Ghaffarinejad M.H.
Institution
(Kazemikhoo) Skin and Stem Cell Research Center, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Kazemikhoo) Department of Dermatology at St George Hospital, University
of NSW, Sydney, Australia
(Kyavar, Maleki, Ghavidel, Gholampour, Ghaffarinejad) Rajaie
Cardiovascular Medical and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Razzaghi) Laser Application in Medical Sciences Research Center, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ansari) Research Center for Evidence-Based Medicine, Health Management
and Safety Promotion Research Institute, Tabriz University of Medical
Sciences, Tabriz, Iran, Islamic Republic of
(Ansari) Razi Vaccine and Serum Research Institute, Agricultural Research,
Education and Extension Organization (AREEO), Tehran, Iran, Islamic
Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Although coronary artery bypass graft (CABG) surgery is one of the most
worldwide commonly performed cardiac surgeries to enhance myocardial
perfusion in high-grade myocardial occlusion, it remains a high-risk
procedure. Photobiomodulation (PBM) is one of the methods which have been
shown to have positive effects on the healing process after CABG and
postoperative complications. The aim of this study was to evaluate the
efficacy of PBM in patients who underwent a coronary artery bypass graft
(CABG). Ths study was conducted with 192 volunteers who electively
submitted to CABG. The volunteers were randomly allocated into two groups:
laser-treated (transdermal: 980 nm, 200 mW, continuous, average energy
fluency of 6 J/cm2 and intravenous: 405 nm, 1.5 mW, continuous
for 30 min) and standard treatment and control group (standard treatment
only). Intravenous laser was illuminated the day before the surgery,
immediately after transferring the patient to CCU post-operation and IV
laser in addition to transdermal laser was applied every day after surgery
for 6 days. A total of 170 out of 192 participants completed the study, 82
(48.2%) in the PBM group and 88 (51.8%) in the control group. Level of LDH
and CPK was significantly lower in the PBM group (P < 0.05) in the 4th day
postoperatively. The PBM group also showed significantly lower
post-surgery complications, including pericardial effusion, ejection
fraction, pathologic ST changes, pathologic Q, rehospitalization, heart
failure, and mediastinitis (P < 0.05). Likewise, the VAS pain score after
surgery was significantly lower in patients in the laser group (P < 0.05).
PBM seems a promising, safe, cost-benefit therapeutic modality to reduce
postoperative complications of CABG. Trial registration number:
IRCT2016052926069N4. Copyright © 2021, The Author(s), under
exclusive licence to Springer-Verlag London Ltd. part of Springer Nature.

<4>
Accession Number
2005714493
Title
Transcatheter mitral valve repair for functional mitral regurgitation:
Evaluating the evidence.
Source
Journal of Thoracic and Cardiovascular Surgery. 162(5) (pp 1504-1511),
2021. Date of Publication: November 2021.
Author
Gelijns A.C.; Moskowitz A.J.; O'Gara P.T.; Giustino G.; Mack M.J.; Mancini
D.M.; Bagiella E.; Hung J.; Ailawadi G.; Leon M.B.; Acker M.A.; Alexander
J.H.; Dickert N.W.; Taddei-Peters W.C.; Miller M.A.
Institution
(Gelijns, Moskowitz, Giustino, Mancini, Bagiella) Population Health
Science and Policy, Icahn School of Medicine at Mount Sinai, NY, United
States
(O'Gara) Cardiovascular Division, Brigham and Women's Hospital, Boston,
MA, United States
(Mack) Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott &
White Health, Plano, Tex, United States
(Hung) Division of Cardiology, Massachusetts General Hospital, Boston, MA,
United States
(Ailawadi) Section of Adult Cardiac Surgery, University of Virginia,
Charlottesville, Va, United States
(Leon) Center for Interventional Vascular Therapy, Columbia University
Medical Center/New York-Presbyterian Hospital and Cardiovascular Research
Foundation, New York, NY, United States
(Acker) Cardiovascular Surgery, Surgery, University of Pennsylvania School
of Medicine, Philadelphia, Pa, United States
(Alexander) Division of Cardiology, Duke Clinical Research Institute, Duke
University School of Medicine, Durham, NC, United States
(Dickert) Division of Cardiology, Emory University School of Medicine,
Atlanta, Ga, United States
(Taddei-Peters, Miller) Division of Cardiovascular Sciences, National
Heart, Lung, and Blood Institute, Bethesda, Md, United States
Publisher
Elsevier Inc.
Abstract
Objectives: Two trials (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients with Functional
Mitral Regurgitation Trial and Percutaneous Repair with the MitraClip
Device for Severe Functional/Secondary Mitral Regurgitation Trial) were
published in 2018 evaluating the effectiveness and safety of transcatheter
repair for patients with heart failure with significant functional mitral
regurgitation, which yielded different results. This article reviews the
strength of the evidence, differences in trial designs, ethical and
implementation implications, and delineates future research needs to help
guide the appropriate dissemination of transcatheter repair for functional
patients with mitral regurgitation. Method(s): The National Heart,
Lung, and Blood Institute convened a workshop of interdisciplinary experts
to address these objectives. Result(s): Transcatheter repair of
functional mitral regurgitation can provide significant benefits in terms
of heart failure hospitalizations, survival, and quality of life when
appropriate heart failure candidates with moderate to severe or severe
mitral regurgitation while on optimal guideline-directed medical therapy
can be identified. Key ingredients for success are preoperative evaluation
and management and postoperative care by an interdisciplinary heart team.
 Conclusion(s): Given the discordance observed between trials, ongoing
innovation in patient management, and potential expansion of indications
for use, the evidence base must be expanded to optimize appropriate
implementation of this complex therapy. This will require more complete
capture of outcome data in real-world settings for all eligible candidates
whether or not they receive this therapy. Inevitably, the indications for
use of this therapy will expand, as will the devices and therapeutic
approaches for this population, necessitating the study of comparative
effectiveness through randomized trials or observational studies.
Moreover, given the substantial variations in care delivery, conducting
implementation research to delineate characteristics of the optimal care
model would be of benefit. Copyright © 2020

<5>
Accession Number
2015172304
Title
Preoperative Anemia and Risk for Perioperative Neurocognitive Dysfunction
in Cardiac Surgery Patients: A Retrospective Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Shayan S.; Okocha O.; Srdanovic N.; Balmert L.; Grafman J.; Madhan A.S.;
Samra S.S.; Brown I.C.H.; Sweitzer B.; Hogue C.W.
Institution
(Shayan, Okocha, Sweitzer, Hogue) Department of Anesthesiology,
Northwestern University Feinberg School of Medicine, Chicago, IL, United
States
(Srdanovic, Balmert) Department of Preventative Medicine, Northwestern
University Feinberg School of Medicine, Chicago, IL, United States
(Grafman) Department of Physical Medicine & Rehabilitation, Neurology,
Cognitive Neurology and Alzheimer's Center, Department of Psychiatry,
Feinberg School of Medicine & Department of Psychology, Weinberg College
of Arts and Sciences, Northwestern University, Chicago, IL, United States
(Madhan, Samra) Northwestern University Feinberg School of Medicine
(Brown) Department of Anesthesiology & Critical Care Medicine, The Johns
Hopkins University School of Medicine, Baltimore, MD, United States
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate whether there is a relationship between
preoperative anemia and domain-specific cognitive performance in patients
undergoing cardiac surgery. Design(s): Retrospective analysis of data
collected from a randomized study. Setting(s): Tertiary care
university hospital. Participant(s): A total of 436 patients age >=55
years undergoing cardiac surgery. Intervention(s): None.
 Measurements and Main Results: Neuropsychological testing was
performed before and one month after surgery, using a standard battery.
Individual Z-scores calculated from the mean and standard deviation of
tests at baseline were combined into domain-specific scores. Anemia
(hemoglobin <130 g/L for men, <120 g/L for women) was present in 41% of
patients. Preoperative anemia had little impact on preoperative cognition.
There were no differences in the change in cognitive performance one month
after surgery from baseline between patients with and without preoperative
anemia. However, in a sensitivity analysis using multiple imputation for
missing cognitive test scores, significant associations were observed
between preoperative anemia and change in postoperative processing speed
(p = 0.016), change in executive function (p = 0.049), and change in fine
motor speed (p = 0.016). Nadir hemoglobin during cardiopulmonary bypass,
which was lower in anemic than nonanemic patients, was associated with
decrements in performance on tests of verbal fluency (p = 0.007),
processing speed (p = 0.042), and executive function (p = 0.10) one month
after surgery but not delayed neurocognitive recovery (p = 0.06).
 Conclusion(s): Preoperative anemia may be associated with impairment
of selective cognitive domains after surgery. Any effect of preoperative
anemia may have on cognition after surgery might be related to lower nadir
hemoglobin during cardiopulmonary bypass. Copyright © 2021

<6>
Accession Number
2015172292
Title
Effects of neuromuscular electrical stimulation on functional capacity and
quality of life among patients after cardiac surgery: A systematic review
and meta-analysis.
Source
Journal of Cardiology. (no pagination), 2021. Date of Publication: 2021.
Author
Zhang X.; Peng Y.; Zhong F.; Li S.; Huang X.; Huang Q.; Chen L.; Lin Y.
Institution
(Zhang) School of Nursing, Fujian Medical University, Fuzhou, China
(Peng, Li, Huang, Huang, Chen) Department of Cardiac Surgery, Fujian
Medical University Union Hospital, Fuzhou, China
(Zhong, Lin) Department of Nursing, Fujian Medical University Union
Hospital, Fuzhou, China
(Chen, Lin) Fujian Heart Medicine Research Center, Fuzhou, China
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Neuromuscular electrical stimulation (NMES) is a possible
adjunctive therapy applied to cardiac surgery patients to improve physical
function, but the results are still controversial. A systematic review and
meta-analysis was conducted to investigate the effects of NMES on
functional capacity and quality of life (QoL) in cardiac surgery patients.
 Method(s): The following databases PubMed, Embase, Medicine, CINAHL,
and the Cochrane Central Register of Controlled Trials were searched for
the English language from inception up to March 2021. A systematic
targeted literature search evaluating the effects of NMES on physical
function and QoL in cardiac surgery patients. The effect size of NMES was
presented as the mean difference (MD)/standardized mean difference (SMD)
and its 95% confidence interval using fixed/random effect models according
to heterogeneity. Two reviewers independently screened and appraised each
study by using the Cochrane Risk of Bias Tool. Result(s): Six studies
were included involving 400 cardiac surgery patients. The meta-analysis
showed that NMES had effect on knee extensor strength (SMD=1.68; p=0.05),
but had no effects on 6-minute walking distance (MD=44.08; p=0.22),
walking speed (MD=0.05; p=0.24), grip strength (MD=3.01; p=0.39), or QoL
(SMD=0.53; p=0.19). Conclusion(s): NMES use in cardiac surgery
patients is limited by low to moderate quality. Existing evidence shows
that NMES is safe and effective for improving knee extensor
strength. Copyright © 2021

<7>
Accession Number
2015172289
Title
Colchicine-new horizons for an ancient drug.
Source
European Journal of Internal Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Schattner A.
Institution
(Schattner) The Faculty of Medicine, Hebrew University and Hadassah
Medical School, Jerusalem, Israel
Publisher
Elsevier B.V.
Abstract
Colchicine is an old, inexpensive, and relatively safe anti-inflammatory
drug traditionally used in gout and over the last 50 years in familial
Mediterranean fever. A search of all high-hierarchy studies (randomized
controlled trials [RCTs], systematic reviews and meta-analysis of RCTs)
over the last 20 years revealed myriad other evidence-based applications.
Colchicine seems efficacious in the treatment of acute pericarditis and
prevention of recurrences and the prevention of postcardiac injury
syndrome and atrial fibrillation following cardiac surgery or percutaneous
interventions. In patients already fully treated with statins and
antiplatelet agents following acute coronary syndromes or stable coronary
disease, adding low-dose colchicine achieved secondary prevention of major
cardiovascular events (myocardial infarction, stroke, or cardiovascular
death) with pooled risk reduction 0.75. Colchicine may also be useful in
Behcet's syndrome and most recently, in improving outcomes of COVID-19
disease. Colchicine in the low doses used in most trials (<= 1 mg/d) was
generally safe and well-tolerated, excepting diarrhea (~x223C 10%) which
sometimes led to drug discontinuation. Further RCTs are required to
confirm these results, and will likely lead to expanding indications for
low-dose colchicine. Increasing numbers of patients will be treated with
colchicine in the near future, with improved health outcomes, as long as
basic caveats are heeded. Copyright © 2021

<8>
Accession Number
2015124749
Title
Auto-Pericardial Mitral Valve Implantation: A Pilot Study.
Source
Heart Lung and Circulation. (no pagination), 2021. Date of Publication:
2021.
Author
Manohar P.; Naik L R.; Mohan Rao P.S.
Institution
(Manohar, Naik L, Mohan Rao) Department of Cardiothoracic and Vascular
Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research,
Bangalore, Karnataka, India
Publisher
Elsevier Ltd
Abstract
Introduction: Developing nations continue to grapple with rheumatic heart
disease, particularly in the young. There is a need for an alternative to
prosthetic mitral valve replacement in irreparable mitral valves, which
avoids the need for anticoagulation and risks of thromboembolism.
 Method(s): Twelve (12) patients with irreparable severe mitral valve
disease underwent auto-pericardial mitral valve implantation from August
2020 to February 2021. The mitral valve leaflets were excised. Autologous
pericardium treated with 0.5% glutaraldehyde for 8 minutes was fashioned
into anterior and posterior mitral leaflets as per the dimensions on an
indigenously designed template based on the studies by Ranganathan and
Lam. The pericardial leaflets were sutured onto an appropriately sized
mitral annuloplasty ring. The ring with the leaflets was implanted onto
the mitral annulus. The leaflets were supported with neo-chordae prepared
with Gore-Tex (W L Gore and Associates, Inc. Newark, DE, USA) and
polyester sutures to mimic a repaired mitral valve in its structure and
dynamics. Result(s): The mean cross-clamp time was 138+/-21.7
minutes. None of the patients required re-exploration. On the third
postoperative day, a mean mitral valve orifice area of 3+/-0.47 cm and
mean mitral valve gradient of 2+/-1.04 were observed. None of the patients
had any more than 1+ mitral regurgitation. None of them have required a
re-intervention for mitral insufficiency to date. Discussion(s):
Auto-pericardial mitral valve re-implantation is a safe and effective
procedure for severe, irreparable, mitral valve pathologies. However, the
mid-term and long-term results need to be compared with conventional
mitral valve replacement with a prosthetic valve in a randomised
controlled trial. Copyright © 2021 Australian and New Zealand
Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society
of Australia and New Zealand (CSANZ)

<9>
Accession Number
2015124708
Title
Effect of Levosimendan Treatment in Pediatric Patients With Cardiac
Dysfunction: An Update of a Systematic Review and Meta-Analysis of
Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Silvetti S.; Belletti A.; Bianzina S.; Momeni M.
Institution
(Silvetti, Bianzina) Neonatal and Pediatric Intensive Care Unit,
Department of Critical Care and Perinatal Medicine, IRCCS Istituto
Giannina Gaslini, Genova, Italy
(Belletti) Department of Anesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Momeni) Department of Anesthesiology, Cliniques Universitaires Saint Luc,
Universite Catholique de Louvain, Institut de Recherche Experimentale et
Clinique (IREC), Brussels, Belgium
Publisher
W.B. Saunders
Abstract
Levosimendan increasingly has been used to treat heart failure and cardiac
dysfunction in pediatric patients. Currently, there is only limited
evidence that this drug positively affects outcomes. The authors' aim was
to investigate the effects of levosimendan on hemodynamic parameters and
outcomes in pediatric patients in all clinical settings. The study design
was a systematic review of randomized and nonrandomized studies.
Randomized clinical trials (RCTs) were included in a meta-analysis. The
primary outcome of the meta-analysis was the effect of levosimendan on
central venous oxygen saturation (ScvO<inf>2</inf>) and lactate values as
surrogate markers of low-cardiac-output syndrome. The study setting was
any acute care setting. Study participants were pediatric patients (age
<18 years) receiving levosimendan, and the intervention was levosimendan
versus any control treatment. The authors identified 44 studies published
from 2004 to 2020, including a total of 1,131 pediatric patients. Nine
studies (enrolling 547 patients) were RCTs, all performed in a pediatric
cardiac surgery setting. Three RCTs were judged to carry a low risk of
bias. In the RCTs, levosimendan administration was associated with a
significant improvement of ScvO<inf>2</inf> (p = 0.03) and a trend toward
lower postoperative lactate levels (p = 0.08). No differences could be
found for secondary outcomes. Levosimendan use in pediatric patients is
not associated with major side effects and may lead to hemodynamic
improvement after cardiac surgery. However, its impact on major clinical
outcomes remains to be determined. Overall, the quality of evidence for
levosimendan use in pediatric patients is low, and further high-quality
RCTs are needed. Copyright © 2021 Elsevier Inc.

<10>
Accession Number
2014504860
Title
Postoperative Atrial Fibrillation After Cardiac Surgery: A Meta-Analysis.
Source
Annals of Thoracic Surgery. 112(6) (pp 2084-2093), 2021. Date of
Publication: December 2021.
Author
Woldendorp K.; Farag J.; Khadra S.; Black D.; Robinson B.; Bannon P.
Institution
(Woldendorp, Farag, Khadra, Black, Bannon) Faculty of Health and Medicine,
University of Sydney, Sydney, Australia
(Woldendorp, Farag, Robinson, Bannon) Cardiothoracic Surgical Department,
Royal Prince Alfred Hospital, Sydney, Australia
(Woldendorp, Black, Robinson, Bannon) Baird Institute of Applied Heart and
Lung Research, Sydney, Australia
Publisher
Elsevier Inc.
Abstract
Background: Postoperative atrial fibrillation (POAF) is common after
cardiac surgery and linked to poorer short-term and long-term outcomes;
however, conflicting evidence exists on stroke risk and how the index
procedure affects outcomes. This study aims to provide a comprehensive
review of the published outcomes of POAF after cardiac surgery, examined
as a whole and by index procedure. Method(s): A systematic review of
POAF after cardiac surgery was conducted. Outcomes related to POAF were
analyzed in a meta-analysis, and aggregate survival data were derived to
examine long-term survival. Result(s): Sixty-one studies with 239,018
patients were identified, the majority (78.7%) undergoing coronary
surgery. POAF occurred in 25.5% of patients and was associated with
significantly higher rates of early mortality and stroke (odds ratio [OR],
1.74; P <.001; and OR, 2.21, P <.001, respectively) along with longer
intensive care and overall hospital length of stay (mean difference 0.8
days, P =.008; and mean difference 2.8 days, P <.001, respectively). After
a median of 6.6 years (range, 0.5-20 years), mortality and stroke remained
significantly higher for those with POAF (OR, 1.57, P <.001; and OR, 1.81,
P =.001). Pooled hazard ratio for long-term mortality was significantly
higher for patients who underwent coronary surgery compared with isolated
valve surgery. Conclusion(s): POAF is common after cardiac surgery
and is associated with significantly higher rates of both short-term and
long-term stroke and mortality as well as increased hospital stay.
Differences in hazard for long-term survival may be due to the underlying
pathophysiological risk factors for POAF, which differ by surgical
procedure. Copyright © 2021 The Society of Thoracic Surgeons

<11>
Accession Number
2013959776
Title
Adhesion barriers in cardiac surgery: A systematic review of efficacy.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Head W.T.; Paladugu N.; Kwon J.H.; Gerry B.; Hill M.A.; Brennan E.A.;
Kavarana M.N.; Rajab T.K.
Institution
(Head, Paladugu, Kwon, Gerry, Hill, Kavarana, Rajab) Department of
Surgery, Medical University of South Carolina, Charleston, SC, United
States
(Brennan) Department of Research & Education Services (Libraries), Medical
University of South Carolina, Charleston, SC, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Postoperative pericardial adhesions have been associated with
increased morbidity, mortality, and surgical difficulty. Barriers exist to
limit adhesion formation, yet little is known about their use in cardiac
surgery. The study presented here provides the first major systematic
review of adhesion barriers in cardiac surgery. Method(s): Scopus and
PubMed were assessed on November 20, 2020. Inclusion criteria were
clinical studies on human subjects, and exclusion criteria were studies
not published in English and case reports. Risk of bias was evaluated with
the Cochrane Risk of Bias Tool. Barrier efficacy data was assessed with
Excel and GraphPad Prism 5. Result(s): Twenty-five studies were
identified with a total of 13 barriers and 2928 patients.
Polytetrafluoroethylene (PTFE) was the most frequently evaluated barrier
(13 studies, 67% of patients) with adhesion formation rate of 37.31% and
standardized tenacity score of 26.50. Several barriers had improved
efficacy. In particular, Cova CARD had a standardized tenacity score of
15.00. Conclusion(s): Overall, the data varied considerably in terms
of study design and reporting bias. The amount of data was also limited
for the non-PTFE studies. PTFE has historically been effective in
preventing adhesions. More recent barriers may be superior, yet the
current data is nonconfirmatory. No ideal adhesion barrier currently
exists, and future barriers must focus on the requirements unique to
operating in and around the heart. Copyright © 2021 Wiley
Periodicals LLC

<12>
Accession Number
2015568740
Title
Association between perioperative hypotension and postoperative delirium
and atrial fibrillation after cardiac surgery: A post-hoc analysis of the
DECADE trial.
Source
Journal of Clinical Anesthesia. 76 (no pagination), 2022. Article Number:
110584. Date of Publication: February 2022.
Author
Wang J.; Mao G.; Malackany N.; Marciniak D.; Donaldson C.; Wakefield B.;
Hassan M.; Ruetzler K.; Sessler D.I.; Turan A.
Institution
(Wang, Mao, Hassan, Ruetzler, Sessler, Turan) Department of Outcomes
Research, Cleveland Clinic, Cleveland, OH, United States
(Malackany, Marciniak, Donaldson, Wakefield) Department of Cardiovascular
Anesthesiology, Cleveland Clinic, Cleveland, OH, United States
(Ruetzler, Turan) Department of General Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Mao) Department of Quantitative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
(Wang) Department of Anesthesiology, Shanghai Ninth People's Hospital,
Shanghai JiaoTong University School of Medicine, Shanghai, China
Publisher
Elsevier Inc.
Abstract
Study objective: To test the hypotheses that in adults having cardiac
surgery with cardio-pulmonary bypass, perioperative hypotension increases
the risk of delirium and atrial fibrillation during the initial five
postoperative days. Design(s): Sub-analysis of the DECADE
multi-center randomized trial. Setting(s): Patients who had cardiac
surgery with cardiopulmonary bypass at the Cleveland Clinic.
 Intervention(s): In the underlying trial, patients were randomly
assigned 1:1 to dexmedetomidine or normal saline placebo. Measurements:
Intraoperative mean arterial pressures were recorded at 1-min intervals
from arterial catheters or at 1-5-min intervals oscillometrically.
Postoperative blood pressures were recorded every half-hour or more often.
The co-primary outcomes were atrial fibrillation and delirium occurring
between intensive care unit admission and the earlier of postoperative day
5 or hospital discharge. Delirium was assessed twice daily during the
initial 5 postoperative days while patients remained hospitalized with the
Confusion Assessment Method for the intensive care unit. Assessments were
made by trained research fellows who were blinded to the dexmedetomidine
administration. Main Result(s): There was no significant association
between intraoperative hypotension and delirium, with an adjusted odds
ratio of 0.94 (95% CI: 0.81, 1.09; P = 0.419) for a doubling in AUC of
mean arterial pressure (MAP) <60 mmHg. An increase in intraoperative AUC
of MAP <60 mmHg was not significantly associated with the odds of atrial
fibrillation (adjusted odds ratio = 0.99; 95% CI: 0.87, 1.11; P = 0.819).
Postoperative MAP <70 mmHg per hour 1.14 (97.5% CI: 1.04,1.26; P = 0.002)
and MAP <80 mmHg per hour 1.05 (97.5%: 1.01, 1.10; P = 0.010) were
significantly associated with atrial fibrillation. Conclusion(s): In
patients having cardiac surgery with cardio-pulmonary bypass, neither
intraoperative nor postoperative hypotension were associated with
delirium. Postoperative hypotension was associated with atrial
fibrillation, although intraoperative hypotension was not. Copyright
© 2021 Elsevier Inc.

<13>
Accession Number
2015527063
Title
Data quality of longitudinally collected patient-reported outcomes after
thoracic surgery: Comparison of paper- And web-based assessments.
Source
Journal of Medical Internet Research. 23(11) (no pagination), 2021.
Article Number: e28915. Date of Publication: November 2021.
Author
Yu H.; Yu Q.; Nie Y.; Xu W.; Pu Y.; Dai W.; Wei X.; Shi Q.
Institution
(Yu, Yu, Xu, Pu, Shi) School of Public Health and Management, Chongqing
Medical University, Chonqqing, China
(Nie, Shi) State Key Laboratory of Ultrasound in Medicine and Engineering,
College of Biomedical Engineering, Chongqing Medical University,
Chongqing, China
(Dai, Wei, Shi) Department of Thoracic Surgery, Sichuan Cancer Hospital
and Institute, Sichuan Cancer Center, School of Medicine, University of
Electronic Science and Technology of China, Sichuan, Chengdu, China
Publisher
JMIR Publications Inc.
Abstract
Background: High-frequency patient-reported outcome (PRO) assessments are
used to measure patients' symptoms after surgery for surgical research;
however, the quality of those longitudinal PRO data has seldom been
discussed. Objective(s): The aim of this study was to determine data
quality-influencing factors and to profile error trajectories of data
longitudinally collected via paper-and-pencil (P&P) or web-based
assessment (electronic PRO [ePRO]) after thoracic surgery. Method(s):
We extracted longitudinal PRO data with 678 patients scheduled for lung
surgery from an observational study (n=512) and a randomized clinical
trial (n=166) on the evaluation of different perioperative care
strategies. PROs were assessed by the MD Anderson Symptom Inventory Lung
Cancer Module and single-item Quality of Life Scale before surgery and
then daily after surgery until discharge or up to 14 days of
hospitalization. Patient compliance and data error were identified and
compared between P&P and ePRO. Generalized estimating equations model and
2-piecewise model were used to describe trajectories of error incidence
over time and to identify the risk factors. Result(s): Among 678
patients, 629 with at least 2 PRO assessments, 440 completed 3347 P&P
assessments and 189 completed 1291 ePRO assessments. In total, 49.4% of
patients had at least one error, including (1) missing items (64.69%,
1070/1654), (2) modifications without signatures (27.99%, 463/1654), (3)
selection of multiple options (3.02%, 50/1654), (4) missing patient
signatures (2.54%, 42/1654), (5) missing researcher signatures (1.45%,
24/1654), and (6) missing completion dates (0.30%, 5/1654). Patients who
completed ePRO had fewer errors than those who completed P&P assessments
(ePRO: 30.2% [57/189] vs. P&P: 57.7% [254/440]; P<.001). Compared with
ePRO patients, those using P&P were older, less educated, and sicker.
Common risk factors of having errors were a lower education level (P&P:
Odds ratio [OR] 1.39, 95% CI 1.20-1.62; P<.001; ePRO: OR 1.82, 95% CI
1.22-2.72; P=.003), treated in a provincial hospital (P&P: OR 3.34, 95% CI
2.10-5.33; P<.001; ePRO: OR 4.73, 95% CI 2.18-10.25; P<.001), and with
severe disease (P&P: OR 1.63, 95% CI 1.33-1.99; P<.001; ePRO: OR 2.70, 95%
CI 1.53-4.75; P<.001). Errors peaked on postoperative day (POD) 1 for P&P,
and on POD 2 for ePRO. Conclusion(s): It is possible to improve data
quality of longitudinally collected PRO through ePRO, compared with P&P.
However, ePRO-related sampling bias needs to be considered when designing
clinical research using longitudinal PROs as major outcomes. Copyright
© 2021 Journal of Medical Internet Research. All rights reserved.

<14>
Accession Number
2014497934
Title
Evaluation of the analgesic efficacy of bilateral ultrasound-guided
transversus thoracic muscle plane block on post-sternotomy pain: A
randomized controlled trial.
Source
Local and Regional Anesthesia. 14 (pp 145-152), 2021. Date of Publication:
2021.
Author
Shokri H.; Ali I.; Kasem A.A.
Institution
(Shokri, Kasem) Department of Anesthesiology, Ain Shams University, Cairo,
Egypt
(Ali) Department of Cardiothoracic Surgery, Ain Shams University, Cairo,
Egypt
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Transverse thoracic block is a new perioperative analgesic method
for post-sternotomy discomfort. This study discusses the efficacy of an
ultrasound-guided transversus thoracic muscle plane block (TTPB) in
patients undergoing heart surgery, including sternotomy. Patients and
Methods: In this prospective trial, 60 patients were randomly assigned to
two groups: transversus (T) or general anesthesia (GA). Patients in the T
group received TTPB with GA and 15 mL of 0.25% bupivacaine was
administered on either side. Patients in the GA group received TTPB along
with GA, but 15 mL saline was injected on either side instead. The
patients were followed up postoperatively. The percentage of patients
receiving additional opioids, extubation time, intensive care unit (ICU)
length, postoperative morphine dose, and adverse events were documented.
 Result(s): The percentage of patients requiring additional morphine
was significantly lower in the T group (p<0.015). Pain scores were
comparable between the groups at extubation time and 18 h postoperatively.
At 8, 12, and 24 h after surgery, pain scores in the T group were
significantly lower (P<0.001). The total amount of morphine required after
surgery was much lower in the T group (8+/-0.74 mg), and the duration to
initial analgesic necessity was significantly greater in the GA group
(P<0.001). Patients in the GA group had a considerably longer ventilation
time (11.07+/-0.64) (P<0.001). The ICU stay in the T group was
substantially shorter (P<0.001), and postoperative complications were
comparable. Conclusion(s): For patients undergoing heart surgery,
TTPB offers sufficient postoperative pain control, resulting in lower pain
scores, lower postoperative analgesic doses, shorter extubation times, and
shorter ICU stay lengths. Copyright © 2021 Shokri et al.

<15>
Accession Number
2014182969
Title
Transcatheter Aortic Valve Leaflet Thrombosis: Prevalence, Management, and
Future Directions.
Source
Current Cardiology Reports. 23(12) (no pagination), 2021. Article Number:
186. Date of Publication: December 2021.
Author
Nakashima M.; Jilaihawi H.
Institution
(Nakashima, Jilaihawi) Heart Valve Center, NYU Langone Health, 530 1st
Avenue, Suite 9V, New York, NY 10016, United States
Publisher
Springer
Abstract
Purpose of Review: We review the pathology, prevalence, diagnosis,
hemodynamics, risk factors, prognosis, and treatment of leaflet thrombosis
(LT), and suggest future directions in this field. Recent Findings: The
latest meta-analysis showed the prevalence of overall LT is 5.4% (clinical
LT of 1.2% and subclinical LT of 15.1%). Either subclinical or clinical LT
is not associated with risk of mortality; however, clinical LT is
associated with increased risk of stroke. Although LT can be reduced by
oral anticoagulation therapy (OAT), routine use of OAT as primary
prevention for high-risk patients is not recommended due to increased risk
of mortality. Summary: Four-dimensional computed tomography plays an
important role in the diagnosis of LT and the accumulation of qualitative
or qualitative assessments of hypoattenuated leaflet thickening would
provide more clues to clarify effective OAT strategies. In addition,
further studies are warranted to evaluate the efficacy of other
anticoagulants in low-intermediate risk patients. Copyright ©
2021, The Author(s), under exclusive licence to Springer Science+Business
Media, LLC, part of Springer Nature.

<16>
Accession Number
2015593501
Title
Non-Vitamin K Antagonists Versus Warfarin in Patients with Atrial
Fibrillation and Bioprosthetic Valves: A Systematic Review and
Meta-Analysis.
Source
American Journal of Medicine. (no pagination), 2021. Date of Publication:
2021.
Author
Cardoso R.; Ternes C.M.P.; Justino G.B.; Fernandes A.; Rocha A.V.; Knijnik
L.; d'Avila A.; Lopes R.D.
Institution
(Cardoso) Heart and Vascular Center, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Ternes, Justino) Department of Medicine, Federal University of Santa
Catarina, Florianopolis, Brazil
(Ternes, d'Avila) Cardiac Arrhythmia Service, Hospital SOS Cardio,
Florianopolis, Brazil
(Fernandes, Knijnik) Division of Medicine, University of Miami, Miami,
Fla, United States
(Rocha) Division of Medicine, Federal University of Goias, Brazil
(d'Avila) Harvard-Thorndike Electrophysiology Institute, Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, MA, United
States
(Lopes) Duke Clinical Research Institute, Duke University School of
Medicine, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: Patients with atrial fibrillation and bioprosthetic valves are
at high risk for thromboembolic events. The pooled efficacy and safety of
non-vitamin K oral anticoagulants (NOACs), as a class, relative to
warfarin in this population is not well-known. We aimed to compare the
efficacy and safety of NOACs relative to warfarin in patients with
bioprosthetic valves or valve repair. Method(s): We systematically
searched EMBASE, PubMed, and Cochrane databases for randomized controlled
trials comparing NOACs to warfarin in patients with atrial fibrillation
and bioprosthetic valves or valve repair. We pooled outcomes for stroke or
systemic embolism, ischemic stroke, hemorrhagic stroke, and major
bleeding. Result(s): We included 4 trials with 1379 patients, of whom
723 (52.4%) received a NOAC. Mean follow-up ranged from 90 days to 2.8
years. In the pooled analysis, stroke or systemic embolism was
significantly lower in patients treated with NOACs (1.9%) compared with
warfarin (3.7%) (odds ratio [OR] 0.43; 95% confidence interval [CI]
0.22-0.85; P = .02). Ischemic stroke (OR 0.72; 95% CI 0.18-2.93),
hemorrhagic stroke (OR 0.18; 95% CI 0.03-1.05), cardiovascular death (OR
0.78; 95% CI 0.38-1.62), and all-cause mortality (OR 0.94; 95% CI
0.55-1.62) were not significantly different among groups. Major bleeding
was significantly lower in patients treated with NOAC (2.8%) compared with
warfarin (4.7%) (OR 0.49; 95% CI 0.28-0.88; P = .02). Conclusion(s):
In patients with atrial fibrillation and bioprosthetic valves or valve
repair, NOACs are associated with a reduced incidence of thromboembolic
events and major bleeding as compared with warfarin. Thus, NOACs may be
considered a preferred option for this patient population. Copyright
© 2021

<17>
Accession Number
2010878042
Title
Efficacy and Safety of Ticagrelor Monotherapy in Patients Undergoing
Percutaneous Coronary Intervention: A Meta-Analysis.
Source
Clinical Pharmacology and Therapeutics. 110(2) (pp 424-431), 2021. Date of
Publication: August 2021.
Author
Gelbenegger G.; Schoergenhofer C.; Jilma B.; Gager G.M.; Dizdarevic A.M.;
Mamas M.A.; Parapid B.; Velagapudi P.; Siller-Matula J.M.
Institution
(Gelbenegger, Schoergenhofer, Jilma, Gager) Department of Clinical
Pharmacology, Medical University of Vienna, Vienna, Austria
(Gager, Dizdarevic, Siller-Matula) Division of Cardiology, Department of
Internal Medicine II, Medical University of Vienna, Vienna, Austria
(Mamas) Keele Cardiovascular Research Group, Keele University, Keele,
United Kingdom
(Mamas) Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
(Parapid) Division of Cardiology, Faculty of Medicine, Clinical Center of
Serbia, University of Belgrade, Belgrade, Serbia
(Velagapudi) Division of Cardiology, University of Nebraska Medical
Center, Omaha, NE, United States
(Siller-Matula) Department of Experimental and Clinical Pharmacology,
Centre for Preclinical Research and Technology, Medical University of
Warsaw, Warsaw, Poland
Publisher
John Wiley and Sons Inc
Abstract
Dual antiplatelet therapy (DAPT) and subsequent P2Y<inf>12</inf> inhibitor
monotherapy, particularly ticagrelor, is an emerging treatment strategy in
patients undergoing percutaneous coronary intervention (PCI). This
meta-analysis was designed to investigate whether short-term DAPT followed
by ticagrelor monotherapy is associated with a favorable outcome as
compared with standard DAPT (1-3 months of DAPT was termed "short-term"
DAPT, 6-12 months DAPT was termed "standard" DAPT). The primary outcome
was the composite of major adverse cardiovascular events (MACE) comprising
myocardial infarction, stroke, and cardiovascular death. Secondary
outcomes included all-cause mortality and net adverse clinical events
(NACE; myocardial infarction, stroke, all-cause death, stent thrombosis,
and major bleeding). The primary safety outcome was major bleeding. Three
studies comprising 26,143 patients were included. The risk of MACE was
similar between the two treatment groups (risk ratio (RR) 0.86, 95%
confidence interval (CI), 0.72-1.02, P = 0.08, I2 = 22%).
Short-term DAPT followed by ticagrelor monotherapy resulted in a 20%
relative risk reduction of all-cause mortality (RR 0.80, 95% CI,
0.65-0.98, P = 0.03, I2 = 0%) and an 18% relative risk
reduction of NACE (RR 0.82, 95% CI, 0.71-0.94, P = 0.005, I2 =
33%) as compared with standard DAPT. Short-term DAPT followed by
ticagrelor monotherapy significantly decreased the risk of major bleeding
(RR 0.67, 95% CI, 0.49-0.92, P = 0.01, I2 = 65%). In patients
with acute coronary syndrome, short-term DAPT followed by ticagrelor
monotherapy resulted in an unchanged ischemic risk but a significantly
lower bleeding risk compared with standard DAPT. Short-term DAPT followed
by ticagrelor monotherapy compared with standard DAPT resulted in a
favorable safety and efficacy profile. Direct comparisons of aspirin vs.
ticagrelor monotherapy following PCI are needed. Copyright © 2021
The Authors. Clinical Pharmacology & Therapeutics published by Wiley
Periodicals LLC on behalf of American Society for Clinical Pharmacology
and Therapeutics.

<18>
Accession Number
2012324775
Title
Computed tomography derived predictors of permanent pacemaker implantation
after transcatheter aortic valve replacement: A meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 98(6) (pp E897-E907),
2021. Date of Publication: 15 Nov 2021.
Author
Maier O.; Piayda K.; Afzal S.; Polzin A.; Westenfeld R.; Jung C.; Zeus T.;
Antoch G.; Kelm M.; Veulemans V.
Institution
(Maier, Piayda, Afzal, Polzin, Westenfeld, Jung, Zeus, Kelm, Veulemans)
Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich
Heine University, Medical Faculty, Dusseldorf, Germany
(Antoch) Department of Diagnostic and Interventional Radiology, Heinrich
Heine University, Medical Faculty, Dusseldorf, Germany
(Kelm) Heinrich Heine University, Medical Faculty, CARID (Cardiovascular
Research Institute Dusseldorf), Dusseldorf, Germany
Publisher
John Wiley and Sons Inc
Abstract
Objectives: This meta-analysis sought to assess predictors of permanent
pacemaker implantation (PPI) after transcatheter aortic valve replacement
(TAVR) with focus on preprocedural multi-slice computed tomography (MSCT)
derived data. Background(s): Transcatheter aortic valve replacement
(TAVR) has expanded to a well-established treatment for severe symptomatic
aortic stenosis at high and intermediate surgical risk. PPI after TAVR
remains one of the most frequent procedure-related complications and
appears to be influenced by several factors. Method(s): The authors
conducted a literature search in PubMed/MEDLINE and EMBASE databases to
identify studies that investigated preprocedural MSCT data and the rate of
PPI following TAVR with new-generation devices. Result(s): Ten
observational studies (n = 2707) met inclusion criteria for the final
analysis. PPI was performed in 387 patients (14.3%) after TAVR. Patients
requiring PPI had a larger annulus perimeter (MD: 1.66 mm; p <.001) and a
shorter membranous septum length (MD: -1.1 mm; p <.05). Concerning
calcification distribution, patients with requirement for new pacemaker
implantation showed increased calcification of the left coronary cusp (MD:
47.6 mm3; p <.001), and the total left ventricular outflow
tract (MD: 24.42 mm3; p <.01). Lower implantation depth (MD:
0.95 mm; p <.05) and oversizing (MD: 1.52%; p <.05) were procedural
predictors of PPI following TAVR. Conclusion(s): Besides the
well-known impact of electrocardiographic and procedure-related factors on
conduction disturbances, MSCT derived distribution of the aortic valve and
left ventricular outflow tract calcification, as well as membranous septum
length, are associated with an increased risk of PPI following
TAVR. Copyright © 2021 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<19>
Accession Number
2011488061
Title
Impact of anemia on short-term outcomes after TAVR: A subgroup analysis
from the BRAVO-3 randomized trial.
Source
Catheterization and Cardiovascular Interventions. 98(6) (pp E870-E880),
2021. Date of Publication: 15 Nov 2021.
Author
Razuk V.; Camaj A.; Cao D.; Nicolas J.; Hengstenberg C.; Sartori S.; Zhang
Z.; Power D.; Beerkens F.; Chiarito M.; Meneveau N.; Tron C.; Dumonteil
N.; Widder J.D.; Ferrari M.; Violini R.; Stella P.R.; Jeger R.;
Anthopoulos P.; Mehran R.; Dangas G.D.
Institution
(Razuk, Camaj, Cao, Nicolas, Sartori, Zhang, Power, Beerkens, Chiarito,
Mehran, Dangas) The Zena and Michael A. Wiener Cardiovascular Institute,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Hengstenberg) Department of Internal Medicine II, Division of Cardiology,
Medical University of Vienna, Vienna, Austria
(Meneveau) Department of Cardiology, University Hospital Jean Minjoz,
Besancon, France
(Tron) Division of Cardiology, Rouen University Hospital, Rouen, France
(Dumonteil) Groupe CardioVasculaire Interventionnel, Clinique Pasteur,
Toulouse, France
(Widder) Department of Cardiology and Angiology, Hannover Medical School,
Hannover, Germany
(Ferrari) Interventional Cardiology, Helios Dr. Horst Schmidt Kliniken
Wiesbaden, Wiesbaden, Germany
(Violini) Interventional Cardiology Unit, San Camillo Hospital, Rome,
Italy
(Stella) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Jeger) Department of Cardiology, University Hospital Basel, University of
Basel, Switzerland
(Anthopoulos) European Medical, Arena Pharmaceuticals Inc, Zurich,
Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To determine the prognostic impact of anemia in patients
randomized to bivalirudin or unfractionated heparin (UFH) during
transcatheter aortic valve replacement (TAVR). Background(s): Whether
the periprocedural use of bivalirudin as compared with UFH in anemic
patients undergoing TAVR has an impact on outcomes remains unknown.
 Method(s): The BRAVO-3 trial compared the use of bivalirudin versus
UFH in 802 high risk patients undergoing transfemoral TAVR for severe
symptomatic aortic stenosis. Patients were stratified according to the
presence (defined as hemoglobin levels <13 g/dl in men and <12 g/dl in
women) or absence of anemia. The primary outcomes were net adverse cardiac
events (NACE; a composite of all-cause mortality, myocardial infarction,
stroke, or bleeding) and major bleeding (Bleeding Academic Research
Consortium >=3b) at 30 days. Result(s): Among 798 patients with
available baseline hemoglobin levels, 427 (54%) were anemic of whom 221
(52%) received bivalirudin. There were no significant differences in NACE
and major bleeding at 30 days between patients with and without anemia,
irrespective of the type of anticoagulant used (p<inf>interaction</inf> =
0.71 for NACE, p<inf>interaction</inf> = 1.0 for major bleeding). However,
anemic patients had a higher risk of major vascular complications
(adjusted OR 2.43, 95% CI 1.42-4.16, p = 0.001), and acute kidney injury
(adjusted OR 1.74, 95% CI 1.16-2.59, p = 0.007) compared to non-anemic
patients at 30 days. Conclusion(s): Anemia was not associated with a
higher risk of NACE or major bleeding at 30 days after TAVR without
modification of the treatment effects of periprocedural anticoagulation
with bivalirudin versus UFH. Copyright © 2021 Wiley Periodicals
LLC.

<20>
Accession Number
636444069
Title
Long-term clinical impact of permanent pacemaker implantation in patients
undergoing transcatheter aortic valve intervention: A systematic review
and meta-analysis.
Source
Giornale Italiano di Cardiologia. Conference: 42. Congresso Nazionale
della Societa Italiana di Cardiologia Interventistica - GISE 2021. Milano
Italy. 22(SUPPL 1) (pp e24), 2021. Date of Publication: October 2021.
Author
Zito A.; Princi G.; Lombardi M.; D'Amario D.; Vergallo R.; Aurigemma C.;
Romagnoli E.; Pelargonio G.; Bruno P.; Trani C.; Burzotta F.; Crea F.
Institution
(Zito, Princi, Lombardi, Vergallo, Romagnoli, Bruno) Department of
Cardiovascular and Thoracic Sciences, Catholic University of Sacred Heart,
Roma, Italy
(D'Amario, Aurigemma, Pelargonio, Trani, Burzotta, Crea) Department of
Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli
Irccs, Roma, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction. The clinical impact of permanent pacemaker implantation
(PPMI) after transcatheter aortic valve intervention (TAVI) has not been
fully established since available data are conflicting. We performed an
updated meta-analysis to assess the clinical outcomes related to PPM I
post-TAVI at long-term (>12 months) follow-up (LTF). Methods. A systematic
and comprehensive literature research was performed on PubMed and EMBASE
databases. The primary endpoint was all-cause death at LTF. Secondary
endpoints were rehospitalization for heart failure, stroke, and myocardial
infarction. A subgroup analysis was performed according to Society of
Thoracic Surgeon-Predicted Risk of mortality (STS-PROM) score. This study
is registered with PROSPERO (CRD42021243301). Results. A total of 30
studies were identified, providing data on 47649 patients. The mean
duration of follow-up was 22 months. At LTF, PPMI post-TAVI was associated
with a higher risk of all-cause death [risk ratio (RR), 1.16, 95%
confidence interval (CI), 1.09-1.24] and rehospitalization for heart
failure (RR, 1.25; 95% CI, 1.08-1.44). In contrast, risks of stroke and
myocardial infarction were not significantly affected. Among the 20
studies that reported surgical risk, the association between PPMI and LTF
all-cause death risk was statistically significant only in studies
enrolling patients with high STS-PROM score (RR, 1.25; 95% CI, 1.12-1.40).
Conclusion. Patients necessitating PPMI after TAVI have a higher long-term
risk of all-cause death and rehospitalization for heart failure as
compared to those who do not receive PPMI. Thus, strategies aimed at
reducing need for PPMI might improve survival after TAVI.

<21>
Accession Number
636443995
Title
Comparison of ecmo vs ecpella in patients with non post-pericardiotomy
cardiogenic shock: An updated meta-analysis.
Source
Giornale Italiano di Cardiologia. Conference: 42. Congresso Nazionale
della Societa Italiana di Cardiologia Interventistica - GISE 2021. Milano
Italy. 22(SUPPL 1) (pp e17-e18), 2021. Date of Publication: October 2021.
Author
Venuti G.; Lannaccone M.; Simone E.D.; Filippo O.D.; Bertaina M.;
Colangelo S.; Boccuzzi G.; Piero M.E.D.; Attisani M.; Zanini P.; Livigni
S.; Noussan P.; D'Ascenzo F.; Ferrari G.M.D.; Porto I.; Truesdell A.
Institution
(Venuti) Division of Cardiology, Papardo Hospital, Messina, Italy
(Lannaccone, Simone, Bertaina, Colangelo, Boccuzzi, Zanini, Noussan)
Division of Cardiology, San Giovanni Bosco Hospital, ASL Citta di Torino,
Torino, Italy
(Filippo) Division of Cardiology, Citta della Scienza e della Salute,
University of Turin, Torino, Italy
(Piero, Livigni) San Giovanni Bosco Hospital, Dipartment of Anesthesiology
and Intensive Care, Asl Citta di Torino, Torino, Italy
(Attisani, D'Ascenzo, Ferrari) Division of Cardiology Citta della Scienza
e della Salute, University of Turin, Torino, Italy
(Porto) Cardiovascular Disease Unit, Irccs Policlinic Hospital San
Martino, Genova, Italy
(Truesdell) Virginia Heart/lnova Heart and Vascular Institute, Falls
Church, United States
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction. The impact of Impella and ECMO (ECPELLA) in cardiogenic
shock (CS) remains to be defined. The aim of this metaanalysis is to
evaluate the benefit of ECPELLA compared to VA-ECMO in patients with non
post-pericardiotomy CS. Methods. All studies reporting short term outcomes
of ECpella or VA ECMO in non post-pericardiotomy CS were included. The
primary endpoint was 30-day mortality. Vascular and bleeding complications
and LVAD implantation/heart transplant within 30-days were assessed as
secondary outcomes. Results. Of 407 studies identified, 13 observational
studies (13682 patients, 13270 with ECMO and 412 with ECpella) were
included in this analysis. 30-day mortality was 55.8% (51.6-59.9) in the
VA-ECMO group and 58.3% (53.5-63.0) in the ECpella group. At
meta-regression analysis the implantation of IABP did not affect mortality
in the ECMO group. The rate of major bleeding in patients on VA-ECMO and
ECpella support were 21.3% (16.9-26.5) and 33.1% (25.9-41.2) respectively,
while the rates of the composite outcome of LVAD implantation and heart
transplantation within 30-days in patients on VA-ECMO and ECpella support
were 14.4% (9.0-22.2) and 10.8%. When directly compared in 3 studies,
ECpella showed a positive effect on 30-day mortality compared to ECMO (OR:
1.81:1.039-3.159).Conclusions. Our data suggest that ECpella may reduce
30-day mortality and increase left ventricle recovery, despite increased
of bleeding rates.

<22>
Accession Number
2014513484
Title
Predictive factors of prolonged ventilation following cardiac surgery with
cardiopulmonary bypass.
Source
Brazilian Journal of Cardiovascular Surgery. 36(6) (pp 780-787), 2021.
Date of Publication: 2021.
Author
Aksoy R.; Karakoc A.Z.; Cevirme D.; Elibol A.; Yigit F.; Yilmaz U.; Rabus
M.B.
Institution
(Aksoy, Karakoc, Cevirme, Elibol, Yigit, Yilmaz, Rabus) Department of
Cardiovascular Surgery, University of Health Sciences, Kosuyolu Heart
Education and Research Hospital, Istanbul, Turkey
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: In this trial, we initially aimed to investigate the major
predictive factors for prolonged mechanical ventilation (PMV) following
cardiac surgery with cardiopulmonary bypass (CPB) in our center and,
secondarily, we tried to find out the effects of the independent factors
on mortality. Method(s): Between July 2017 and August 2018, 207
patients who underwent cardiac surgery with CPB were retrospectively
investigated. The patients were randomly divided into two subgroups
according to the duration of ventilator dependence (group 1 <24 hours,
n=164, 79%; group 2 >24 hours, n=43, 21%). Result(s): 207 patients
(mean age 59.47+/-10.56) who underwent cardiac surgery with CPB were
enrolled in this study (n=145, 70% of male patients; n=62, 30% of female
patients). Amid these patients, 43 (n=43, 20.77%) had prolonged intubation
time. After multivariate logistic regression analysis among preoperative
factors, female gender (OR=2.321, P=0.028), leukocytosis (OR=1.233,
P=0.006), perioperative lactate level (OR=1.224, P=0.027), CPB time
(OR=1.012, P=0.012) and postoperative revision for bleeding (OR=23.125,
P=0.040) were significantly detected. The effect of predictive factors on
mortality after cardiac surgery was determined and found that PMV did not
affect hospital mortality (OR=1.979, P=0.420). Conclusion(s): In our
report, we revealed, differently from previous studies, that
intraoperative lactate levels which manifest organ perfusion and
oxygenation were included and were significantly different in the early
extubation group compared to the PMV group. Female gender, preoperative
leukocytosis, intraoperative CPB time, lactate levels and postoperative
revision for bleeding were the independent predictive factors for PMV.
Moreover, PMV did not affect the early-term mortality during hospital
stay. Copyright © 2021, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<23>
Accession Number
2014160216
Title
Rationale and design of the Dapagliflozin after Transcatheter Aortic Valve
Implantation (DapaTAVI) randomized trial.
Source
European Journal of Heart Failure. (no pagination), 2021. Date of
Publication: 2021.
Author
Amat-Santos I.J.; Sanchez-Luna J.P.; Abu-Assi E.; Melendo-Viu M.;
Cruz-Gonzalez I.; Nombela-Franco L.; Munoz-Garci A.J.; Blas S.G.; de la
Torre Hernandez J.M.; Romaguera R.; Sanchez-Recalde A.; Diez-Gil J.L.;
Lopez-Otero D.; Gheorge L.; Ibanez B.; Iniguez-Romo A.; Raposeiras-Roubin
S.
Institution
(Amat-Santos, Sanchez-Luna, Munoz-Garci, Lopez-Otero, Ibanez) CIBERCV,
Madrid, Spain
(Amat-Santos, Sanchez-Luna) Cardiology Department, Hospital Clinico
Universitario, Valladolid, Spain
(Abu-Assi, Melendo-Viu, Iniguez-Romo, Raposeiras-Roubin) Department of
Cardiology, Hospital Alvaro Cunqueiro, Vigo, Spain
(Cruz-Gonzalez) Cardiology Department, Hospital Clinico Universitario,
Salamanca, Spain
(Nombela-Franco) Cardiology Department, Hospital Clinico San Carlos,
Madrid, Spain
(Munoz-Garci) Cardiology Department, Hospital Virgen de la Victoria,
Malaga, Spain
(Blas) Cardiology Department, Hospital Clinico Universitario, Valencia,
Spain
(de la Torre Hernandez) Cardiology Department, Hospital Universitario
Marques de Valdecilla, Santander, Spain
(Romaguera) Cardiology Department, Hospital Universitario de Bellvitge,
Barcelona, Spain
(Sanchez-Recalde) Cardiology Department, Hospital Universitario Ramon y
Cajal, Madrid, Spain
(Diez-Gil) Cardiology Department, Hospital Universitario La Fe, Valencia,
Spain
(Lopez-Otero) Cardiology Department, Hospital Clinico Universitario de
Santiago de Compostela, Madrid, Spain
(Gheorge) Cardiology Department, Hospital Universitario Puerta del Mar,
Cadiz, Spain
(Ibanez) IIS-Department of Cardiology, Hospital Fundacion Jimenez Diaz,
Madrid, Spain
(Ibanez, Raposeiras-Roubin) Centro Nacional de Investigaciones
Cardiovasculares (CNIC), Madrid, Spain
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Despite aortic stenosis (AS) relief, patients undergoing
transcatheter aortic valve implantation (TAVI) are at increased risk of
developing heart failure (HF) within first months of intervention.
Sodium-glucose co-transporter 2 (SGLT-2) inhibitors have been shown to
reduce the risk of HF hospitalization in individuals with diabetes
mellitus, reduced left ventricular ejection fraction and chronic kidney
disease. However, the effect of SGLT-2 inhibitors on outcomes after TAVI
is unknown. The Dapagliflozin after Transcatheter Aortic Valve
Implantation (DapaTAVI) trial is designed to assess the clinical benefit
and safety of the SGLT-2 inhibitor dapagliflozin in patients undergoing
TAVI. Method(s): DapaTAVI is an independent pragmatic, controlled,
prospective, randomized, open-label blinded endpoint, multicentre trial
conducted in Spain, evaluating the effect of dapagliflozin 10 mg/day on
the risk of death and worsening HF in patients with severe AS undergoing
TAVI. Candidate patients should have prior history of HF admission plus
>=1 of the following criteria: (i) diabetes mellitus, (ii) left
ventricular ejection fraction <=40%, or (iii) estimated glomerular
filtration rate between 25 and 75 ml/min/1.73 m2. A total of
1020 patients will be randomized (1:1) to dapagliflozin vs. no
dapagliflozin. Key secondary outcomes include: (i) incidence rate of
individual components of the primary outcome; (ii) cardiovascular
mortality; (iii) the composite of HF hospitalization or cardiovascular
death; and (iv) total number of HF rehospitalizations. Conclusion(s):
DapaTAVI will determine the efficacy and safety of dapagliflozin in a
broad spectrum of frail patients after AS relief by TAVI. Copyright
© 2021 European Society of Cardiology

<24>
Accession Number
2011475457
Title
Leaflet fusion length is associated with aortic dilation and flow
alterations in non-dysfunctional bicuspid aortic valve.
Source
European Radiology. 31(12) (pp 9262-9272), 2021. Date of Publication:
December 2021.
Author
Guala A.; Evangelista A.; Teixido-Tura G.; La Mura L.; Dux-Santoy L.;
Ruiz-Munoz A.; Valente F.; Galian-Gay L.; Gutierrez L.; Gonzalez-Alujas
T.; Dentamaro I.; Johnson K.M.; Wieben O.; Sao Aviles A.;
Ferreira-Gonzalez I.; Rodriguez-Palomares J.F.
Institution
(Guala, Evangelista, Teixido-Tura, La Mura, Sao Aviles, Ferreira-Gonzalez,
Rodriguez-Palomares) Vall d'Hebron Institut de Recerca (VHIR), Barcelona,
Spain
(Guala, Evangelista, Teixido-Tura, Ruiz-Munoz, Rodriguez-Palomares)
CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
(Evangelista, Teixido-Tura, La Mura, Dux-Santoy, Valente, Galian-Gay,
Gutierrez, Gonzalez-Alujas, Dentamaro, Ferreira-Gonzalez,
Rodriguez-Palomares) Department of Cardiology, Hospital Universitari Vall
d'Hebron, Barcelona, Spain
(Evangelista) Instituto del Corazon, Quironsalud-Teknon, Barcelona, Spain
(Evangelista, Ferreira-Gonzalez) Universitat Autonoma de Barcelona,
Bellaterra, Spain
(La Mura) Department of Advanced Biomedical Sciences, University Federico
II, Naples, Italy
(Dentamaro) Department of Cardiology, Hospital "F. Miulli", Acquaviva
delle Fonti, Italy
(Johnson, Wieben) Departments of Medical Physics & Radiology, University
of Wisconsin, Madison, WI, United States
(Ferreira-Gonzalez) CIBER-ESP, Instituto de Salud Carlos III, Madrid,
Spain
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: Bicuspid aortic valve (BAV), the most common congenital valve
defect, is associated with increased risk of aortic dilation and related
complications; however, current risk assessment is not effective. Most of
BAV have three leaflets with a fusion between two of them of variable
length. This study aimed to ascertain whether the extent of leaflet fusion
(often called raphe) is related to aortic dilation and flow abnormalities
in BAV with no significant valvular dysfunction. Method(s): One
hundred and twenty BAV patients with no significant valvular dysfunction
or history of surgical repair or aortic valve replacement were
consecutively and prospectively enrolled (September 2014-October 2018).
Cardiac magnetic resonance protocol included a 4D flow sequence for
haemodynamic assessment. Moreover, a stack of double-oblique cine images
of the aortic valve were used to quantify fusion length (in systole) and
leaflet length (diastole). Inter- and intra-observer reproducibility was
tested in 30 randomly selected patients. Result(s): Aortic valve
leaflet fusion was measurable in 112 of 120 (93%) cases with good
reproducibility (ICC = 0.826). Fusion length varied greatly (range:
2.3-15.4 mm; mean: 7.8 +/- 3.2 mm). After correction for demographic and
clinical conditions, fusion length was independently associated with
diameter and z-score at the sinus of Valsalva (p = 0.002 and p = 0.002,
respectively) and ascending aorta (p = 0.028 and p = 0.046). Fusion length
was positively related to flow asymmetry, vortices and circumferential
wall shear stress, thereby possibly providing a pathophysiological link
with aortic dilation. Conclusion(s): Aortic valve fusion length is
related to aortic dilation and flow abnormalities in BAV patients. Key
Points: * The length of the fusion between leaflets in non-dysfunctional
bicuspid aortic valves varies substantially and can be reliably measured
by cine CMR. * Aortic valve leaflet fusion length is independently related
to aortic sinus and ascending aorta diameter. * Increased flow asymmetry,
circumferential wall shear stress and presence of vortices are positively
related to aortic valve leaflet fusion length. Copyright © 2021,
European Society of Radiology.

<25>
Accession Number
2007157250
Title
Venous or arterial samples for activated clotting time measurements: a
systematic review.
Source
Perfusion (United Kingdom). 36(8) (pp 845-852), 2021. Date of Publication:
November 2021.
Author
Iddawela S.; Swamy P.; Member S.; Harky A.
Institution
(Iddawela) Department of Respiratory Medicine, University Hospitals
Birmingham, Birmingham, United Kingdom
(Swamy) GKT School of Medical Education, King's College London, London,
United Kingdom
(Member) Lancashire School of Medicine and Dentistry, University of
Central Lancashire, Greenbank Building, Preston, Lancashire, United
Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Health and life
sciences, University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
(Harky) Department of Cardiac Surgery, Alder Hey Children Hospital,
Liverpool, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Objective: The systematic review aims to investigate the effect of
sampling source on activated clotting time (ACT) measurement within
cardiovascular surgery and cardiac catheterisation. It also examines the
evidence surrounding novel clot assessment techniques and associated
sampling variation. Method(s): A comprehensive electronic search was
conducted using PubMed, MEDLINE, Scopus, Cochrane database, and Google
Scholar until 20th June 2020. All studies reporting sampling source
variability of ACT in cardiac surgery, vascular surgery and cardiac
catheterisation were included. Result(s): Fourteen studies were
included in the systematic review. Inconsistent reports of variability
were seen in cardiac surgery and cardiac catheterisation. There were no
studies directly examining ACT variability in vascular surgery. Novel clot
assessment techniques have been validated in cardiac surgery, but
measurements vary depending on sampling source. Conclusion(s):
Sampling source should be kept consistent to facilitate effective
haemostatic strategies. More research is needed regarding variability in
vascular surgery and novel clot assessment techniques. Copyright
© The Author(s) 2020.

<26>
Accession Number
2014088720
Title
The effect of the family presence on anxiety and agitation of patients
under mechanical ventilation after open heart surgery: a randomized
clinical trial.
Source
Perioperative Medicine. 10(1) (no pagination), 2021. Article Number: 40.
Date of Publication: December 2021.
Author
Nouri J.M.; Safaeipour L.; Vafadar Z.; Moradian S.T.
Institution
(Nouri) Quran and Hadith Research Center, Nursing Faculty, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Safaeipour) Baqiyatallah University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Vafadar) Health Management Research Center, Baqiyatallah University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Moradian) Atherosclerosis Research Center, Baqiyatallah University of
Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Family-centered care has been considered as a philosophy of
care. Family presence in intensive care units (ICUs), especially in the
acute phase of the disease is controversial. This study has been carried
out in order to determine the effect of the family presence on anxiety and
agitation in patients undergoing coronary artery bypass grafting (CABG).
 Material(s) and Method(s): In a clinical trial, 70 patients were
randomly allocated into groups of experimental and control. In the
experimental group, during the weaning process from the mechanical
ventilation, a family member was present at the bedside. The degree of
anxiety and Richmond's Agitation and Sedation Scale (RASS) were compared
in seven consecutive time stages, including the time of entry into the
ICU, the first respiratory drive, the family entrance, 20 min and 1 h
after the presence of the family member, the time of extubation, and 1 h
after extubation. Result(s): There was a significant difference
between the two groups in the mean scores of the anxiety scale in the
first (P =0.008), second (P=0.002), and third stages (P =0.005). This
difference was not significant in the fourth to seventh stages (P>0.05).
As the baseline anxiety levels were different, a covariate adjustment was
used for comparisons between treatments, adjusting the main analyses for
baseline anxiety levels. Analysis showed that groups were not different.
Also, there was no significant difference in the mean scores of RASS
between the two experimental and control groups at any of the seven stages
(P> 0.05). Conclusion(s): According to the findings of the present
study, the presence of a family member does not reduce the level of
anxiety and agitation of patients undergoing cardiac surgery. However, it
can be concluded that this intervention is feasible in acute and complex
situations after open heart surgeries. Trial registration: This study has
been registered in the Iranian Registry of Clinical Trials with the code
IRCT201609014299N4. Copyright © 2021, The Author(s).

<27>
Accession Number
2007712966
Title
Optimal Duration of Dual Antiplatelet Therapy After Percutaneous Coronary
Intervention in Patients With Acute Coronary Syndrome: Insights From a
Network Meta-Analysis of Randomized Trials.
Source
Cardiovascular Revascularization Medicine. 28 (pp 50-56), 2021. Date of
Publication: July 2021.
Author
Kuno T.; Ueyama H.; Takagi H.; Fox J.; Bangalore S.
Institution
(Kuno, Ueyama) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Beth Israel, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Fox) Department of Cardiology, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, NY, United States
(Bangalore) Division of Cardiovascular Medicine, New York University
School of Medicine, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: With newer generation drug eluting stents (DES), the minimal
duration of dual antiplatelet therapy (DAPT) recommended by guidelines has
been reduced to 6 months in patients with stable coronary artery disease.
Whether shorter duration of DAPT is safe in patients presenting with acute
coronary syndrome (ACS) remains controversial. Our aim of this study was
to investigate the optimal DAPT duration (<=3 months vs. 6 months vs. 12
months vs. >12 months) among patients with ACS undergoing percutaneous
coronary intervention (PCI). Method(s): PUBMED and EMBASE were
searched through January 2020 for randomized controlled trials of DAPT
duration in patients with ACS. The ischemic outcomes were all-cause death,
myocardial infarction, and stent thrombosis. The safety outcome was major
and/or clinically relevant bleeding. Result(s): Our search identified
14 eligible trials enrolling a total of 31,837 patients comparing
different DAPT duration in patients with ACS. Short-term DAPT (<=3 months
or 6 months) did not increase ischemic outcomes compared to long-term DAPT
(12 months and >12 months). For bleeding outcomes, <=3 months DAPT was
associated with significant reduction in bleeding compared to 6 months, 12
months or >12 months DAPT (OR [95% CI]: 0.60 [0.37-0.98]; 0.68 [0.54-0.85]
and 0.43 [0.34-0.54], respectively). These findings were similar when
limited to 2nd generation DES. Conclusion(s): Data from this
meta-analysis of randomized trials support short-term (<=3 months and 6
months) DAPT in patients with ACS undergoing PCI. Guidelines might need to
consider short-term DAPT even in patients presenting with ACS, especially
in this era of newer generation DES. Copyright © 2020 Elsevier
Inc.

<28>
Accession Number
635476708
Title
Comparison of the Effect of Breast Milk and Sodium Bicarbonate Solution
for Oral Care in Infants with Tracheal Intubation after Cardiothoracic
Surgery.
Source
Breastfeeding Medicine. 16(7) (pp 568-572), 2021. Date of Publication:
July 2021.
Author
Yu X.-R.; Huang S.-T.; Xu N.; Dai W.-S.; Wang Z.-C.; Cao H.; Chen Q.
Institution
(Yu, Huang, Xu, Dai, Wang, Cao, Chen) Department of Cardiac Surgery,
Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian
Medical University, Fuzhou, China
(Yu, Huang, Xu, Dai, Wang, Cao, Chen) Fujian Key Laboratory of Women,
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
(Wang, Chen) Department of Cardiovascular Surgery, Union Hospital, Fujian
Medical University, Fuzhou, China
Publisher
Mary Ann Liebert Inc.
Abstract
Background: This study aimed to explore the effect of breast milk and
sodium bicarbonate solution used in oral care of infants with tracheal
intubation after cardiothoracic surgery. Method(s): A randomized
clinical controlled trial was conducted in a provincial hospital in China.
Fifty infantile patients were randomly divided into two groups: the
patients in the study group (n = 25) used breast milk for oral care and
the patients in the control group (n = 25) used sodium bicarbonate
solution for oral care. The relevant clinical data were recorded,
including the mechanical ventilation duration, length of intensive care
unit (ICU) stay, length of hospital stay, and complications.
 Result(s): The length of ICU stay, length of hospital stay, and
duration of mechanical ventilation were shorter in the study group, but
the difference was not statistically significant (p > 0.05). However, the
incidence of thrush and ventilator-associated pulmonary infection in the
study group was significantly lower than that in the control group (p <
0.05). Conclusion(s): The use of breast milk for oral care has a
positive effect on the prevention of thrush and ventilator-associated
pulmonary infection in infants with tracheal intubation after
cardiothoracic surgery. Copyright © 2021, Mary Ann Liebert, Inc.,
publishers.

<29>
Accession Number
2015400163
Title
In patients with AMI and anemia, a restrictive vs. Liberal blood
transfusion strategy was noninferior for 30-d MACE.
Source
Annals of Internal Medicine. 174(7) (pp JC77), 2021. Date of Publication:
01 Jul 2021.
Author
Jiang D.; Garcia D.
Institution
(Jiang, Garcia) University of Washington, Seattle, WA, United States
Publisher
American College of Physicians

<30>
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.
 Copyright © 2021 Author(s). Published by BMJ.

<31>
Accession Number
2014348340
Title
Efficacy of single-shot thoracic paravertebral block combined with
intravenous analgesia versus continuous thoracic epidural analgesia for
chronic pain after thoracotomy.
Source
Pain Physician. 24(6) (pp E753-E759), 2021. Date of Publication: September
2021.
Author
Li X.-L.; Zhang J.; Wan L.; Wang J.
Institution
(Li, Zhang, Wan) Department of Anesthesiology, Beijing Friendship
Hospital, Capital Medical University, Beijing, China
(Wang) The Pain Department, Zao Zhuang Municipal Hospital, Shandong
Province, Zaozhuang, China
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: Patients undergoing thoracic surgery frequently suffer from
chronic pain after thoracotomy. Chronic pain can lead to a significant
decline in a patient's quality of life. However, the effect of single-shot
thoracic paravertebral block (TPVB) combined with intravenous analgesia on
chronic pain incidence is unclear. Objective(s): The objective was to
evaluate the impact of single-shot TPVB combined with intravenous
analgesia versus continuous thoracic epidural analgesia (TEA) on chronic
pain incidence after thoracotomy. Study Design: A randomized
controlled study. Setting(s): Hospital department in China.
 Method(s): Ninety-six patients undergoing thoracotomy were randomly
assigned to 2 groups: single-shot TPVB combined with intravenous analgesia
(Group P) and continuous TEA (Group E). The pain intensity was assessed
using the Verbal Rating Scale (VRS). The outcome measures were chronic
pain incidence and the acute and chronic pain intensity. Result(s):
The chronic pain incidence at rest in Group P was significantly higher
than that in Group E at 3 months and 12 months postoperation (55.2% versus
28.6%, P = 0.019; 34.5% versus 14.3%, P = 0.027). The patients in Group E
showed less pain intensity at rest compared with those in Group P at 3
months postoperation (0.0 versus 1.0, P = 0.034). At 6 hours and 24 hours
postoperation, the acute pain intensity at coughing and at rest in Group E
was lower than that in group P (VRS at coughing: 6 hours: 0.0 versus 2.0,
P = 0.001; 24 hours: 3.0 versus 5.0, P = 0.010. VRS at rest: 6 hours: 0.0
versus 2.0, P = 0.000; 24 hours: 1.0versus. 2.0, P = 0.001).
 Limitation(s): An important limitation of this study is that it is
not a double-blind study. Conclusion(s): In patients undergoing
thoracotomy, continuous TEA significantly reduced the chronic pain
incidence at rest at 3 months and 12 months after operation and provided
better acute pain relief up to 24 hours after operation compared with
single-shot TPVB combined with intravenous analgesia. Copyright ©
2021, American Society of Interventional Pain Physicians. All rights
reserved.

<32>
Accession Number
2013802934
Title
Bioprosthetic valve fracture for valve-in-valve transcatheter aortic valve
implantation in patients with structural valve degeneration: Systematic
review with meta-analysis.
Source
Journal of Cardiac Surgery. 36(12) (pp 4722-4731), 2021. Date of
Publication: December 2021.
Author
Michel Pompeu S.A.; Rayol S.C.; Van den Eynde J.; Cavalcanti L.R.P.;
Escorel Neto A.C.; Perazzo A.M.; Weymann A.; Ruhparwar A.; Torregrossa G.;
Sicouri S.; Ramlawi B.
Institution
(Michel Pompeu, Torregrossa, Ramlawi) Department of Cardiothoracic
Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line
Health, Wynnewood, PA, United States
(Michel Pompeu, Torregrossa, Sicouri, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
Wynnewood, PA, United States
(Rayol, Cavalcanti, Escorel Neto, Perazzo) Division of Cardiovascular
Surgery, Pronto Socorro Cardiologico de Pernambuco (PROCAPE), Recife,
Brazil
(Rayol, Cavalcanti, Escorel Neto, Perazzo) University of Pernambuco (UPE),
Recife, Brazil
(Rayol) Nucleus of Postgraduate and Research in Health Sciences of Faculty
of Medical Sciences and Biological Sciences Institute (FCM/ICB), Recife,
Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To determine the outcomes of bioprosthetic valve fracture
(BVF) in valve-in-valve transcatheter aortic valve implantation (ViV-TAVI)
for patients with structural valve degeneration (SVD) of bioprosthetic
surgical valves (BSV) implanted during surgical aortic valve replacement
(SAVR). Method(s): A systematic review was conducted including
studies published by May 2021. The primary endpoints of the study were
30-day mortality, annular rupture, stroke, paravalvular leak, pacemaker
implantation, and coronary obstruction. The secondary endpoints were mean
valve gradients (mmHg) and aortic valve area (AVA-cm2). A
meta-analysis was conducted using the software R, version 3.6.3 (R
Foundation for Statistical Computing). Result(s): Four studies
including 242 patients met our eligibility criteria. The overall
proportions for 30-day mortality, annular rupture, stroke, paravalvular
leak, pacemaker implantation and coronary obstruction were 2.1%, <1.0%,
<1.5%, <1.0%, <1.0%, and <1.5%, respectively. After ViV-TAVI with BVF, the
difference in means for mean valve gradients showed a significant
reduction (random-effects model: -26.7; -28.8 to -24.7; p <.001), whereas
the difference in means for AVA showed a significant increase
(random-effects model: 0.55 cm2; 0.13-0.97; p =.029). Despite
the improvement in AVA means, these remain too low after the procedure
highly likely due to the small size of the bioprosthetic valves implanted
during the index SAVR. Conclusion(s): ViV-TAVI with BVF has proven to
be a promising option but data are still too scarce to enable us to draw
definitive conclusions. Despite the decrease in gradients, postprocedural
AVA remains worrisome. Studies with better designs and larger sample sizes
are needed to advance this treatment option. Copyright © 2021
Wiley Periodicals LLC

<33>
Accession Number
2013787537
Title
Intrinsic left ventricular impairment in Marfan syndrome: A systematic
review and meta-analysis.
Source
Journal of Cardiac Surgery. 36(12) (pp 4715-4721), 2021. Date of
Publication: December 2021.
Author
Xu H.; Ma N.; Guo R.; Luo H.; Zhang L.; Liu D.; Zang S.; Zhao L.; Zhang
X.; Qiao C.
Institution
(Xu, Ma, Guo, Luo, Zhang, Liu, Zang, Zhao, Zhang, Qiao) Department of
Cardiac Surgery, The First Affiliated Hospital of Zhengzhou University,
Zhengzhou University, Zhengzhou, Henan, China
(Xu, Ma, Guo, Luo, Zhang, Liu, Zang, Zhao, Zhang, Qiao) Heart
Transplantation Center, The First Affiliated Hospital of Zhengzhou
University, Zhengzhou University, Zhengzhou, Henan, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Intrinsic cardiac impairment in Marfan syndrome (MFS) has been
explored in many clinical studies; however, their results have been
inconsistent. This meta-analysis aimed to assess the difference in cardiac
structure and function between Marfan patients and healthy individuals,
and to verify the hypothesis of intrinsic cardiac impairment in MFS.
 Method(s): Electronic searches for studies were performed in the
PubMed, Embase, and Cochrane Library databases. Nine studies with 490
patients with MFS and 478 controls were included in the analysis. Age and
sex were strictly matched between Marfan patients and healthy controls in
every study. Result(s): There was no difference in the left
ventricular end systolic diameter index (mean difference [MD]: 0.33; 95%
confidence interval [CI]: (-0.24, 0.89); p = 0.26) and left ventricular
end diastolic diameter index (MD: 0.18; 95% CI: [-0.47, 0.83]; p = 0.58)
between Marfan patients and controls. Marfan patients showed larger left
ventricular end systolic volume index (MD: 2.62; 95% CI: [0.27, 4.97]; p =
0.03) and left ventricular end diastolic volume index (MD: 4.16; 95% CI:
[2.70, 5.63]; p < 0.01) than the control group. Furthermore, Marfan
patients showed a lower left ventricular ejection fraction than healthy
people (MD: -2.59%; 95% CI: [-4.64%, -0.54%]; p = 0.01).
 Conclusion(s): Intrinsic cardiac impairment was observed in MFS. MFS
patients showed the larger left ventricular volume and poorer left
ventricular function than matched controls. Considering the potentially
adverse impact on cardiac function, intrinsic cardiac impairment in MFS
should be considered during the cardiac surgery. Copyright © 2021
Wiley Periodicals LLC

<34>
Accession Number
2013617537
Title
Relation of renal function to mid-term prognosis of stable angina patients
with high- or low-dose pitavastatin treatment: REAL-CAD substudy.
Source
American Heart Journal. 240 (pp 89-100), 2021. Date of Publication:
October 2021.
Author
Abe M.; Ozaki Y.; Takahashi H.; Ishii M.; Masunaga N.; Ismail T.F.; Iimuro
S.; Fujita R.; Iwata H.; Sakuma I.; Nakagawa Y.; Hibi K.; Hiro T.;
Fukumoto Y.; Hokimoto S.; Miyauchi K.; Ogawa H.; Daida H.; Shimokawa H.;
Saito Y.; Matsuzaki M.; Akao M.; Kimura T.; Nagai R.
Institution
(Abe, Ishii, Masunaga, Akao) Department of Cardiology, National Hospital
Organization Kyoto Medical Center, Kyoto, Japan
(Ozaki) Department of Cardiology, Fujita Health University (FHU) Hospital
& FHU Okazaki MC, Toyoake, Japan
(Takahashi) Division of Medical Statistics, Fujita Health University
School of Medicine, Toyoake, Japan
(Ismail) School of Biomedical Engineering and Imaging Sciences, King's
College London, London, United Kingdom
(Iimuro, Fujita) Innovation and Research Support Center, International
University of Health and Welfare, Tokyo, Japan
(Iwata, Miyauchi, Daida) Department of Cardiovascular Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan
(Sakuma) Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
(Nakagawa) Department of Cardiovascular Medicine, Shiga University of
Medical Science Hospital, Otsu, Japan
(Hibi) Division of Cardiology, Yokohama City University Medical Center,
Yokohama, Japan
(Hiro) Division of Cardiology, Department of Medicine, Nihon University
School of Medicine, Tokyo, Japan
(Fukumoto) Division of Cardiovascular Medicine, Department of Internal
Medicine, Kurume University School of Medicine, Kurume, Japan
(Hokimoto) Department of Cardiovascular Medicine, Kumamoto University
Hospital, Kumamoto, Japan
(Ogawa) Kumamoto University, Kumamoto, Japan
(Shimokawa) Department of Cardiovascular Medicine, Tohoku University
Graduate School of Medicine, Sendai, Japan
(Saito) Chiba University, Chiba, Japan
(Matsuzaki) St. Hill Hospital, Ube, Japan
(Kimura) Kyoto University Graduate School of Medicine, Kyoto, Japan
(Nagai) Jichi Medical University, Shimotsuke, Japan
Publisher
Mosby Inc.
Abstract
Background: It has not yet been established whether higher-dose statins
have beneficial effects on cardiovascular events in patients with stable
coronary artery disease (CAD) and renal dysfunction. Method(s): The
REAL-CAD study is a prospective, multicenter, open-label trial. As a
substudy, we categorized patients by an estimated glomerular filtration
rate (eGFR) as follows: eGFR >=60 (n = 7,768); eGFR >=45 and <60 (n =
3,176); and eGFR <45 mL/Min/1.73 m2 (n = 1,164), who were
randomized to pitavastatin 4mg or 1mg therapy. The primary endpoint was a
composite of cardiovascular death, non-fatal myocardial infarction,
non-fatal ischemic stroke, or unstable angina, and was assessed by the
log-rank test and Cox proportional hazards model. Result(s): The
baseline characteristics and medications were largely well-balanced
between two groups. The magnitude of low-density lipoprotein cholesterol
(LDL-C) reduction at 6 months in high- and low-dose pitavastatin groups
was comparable among all eGFR categories. During a median follow-up of 3.9
years, high- compared with low-dose pitavastatin significantly reduced
cardiovascular events in patients with eGFR >=60 (hazard ratio (HR) 0.73;
95% confidence interval (CI) 0.58-0.91; P = .006), and reduced but not
significant for patients with eGFR >=45 and <60 (HR 0.85; 95% CI,
0.63-1.14; P = .27) or eGFR <45 mL/Min/1.73 m2 (HR 0.90; 95% CI
0.62-1.33; P = .61). An interaction test of treatment by eGFR category was
not significant (P value for interaction = .30). Conclusion(s):
Higher-dose pitavastatin therapy reduced LDL levels and cardiovascular
events in stable CAD patients irrespective of eGFR level, although the
effect on events appeared to be numerically lower in patients with lower
eGFR. Copyright © 2021

<35>
Accession Number
2013003711
Title
Thrombosis Prevention and Anticoagulation Management in the Pediatric
Patient with Congenital Heart Disease.
Source
Cardiology and Therapy. 10(2) (pp 325-348), 2021. Date of Publication:
December 2021.
Author
Abdelghani E.; Cua C.L.; Giver J.; Rodriguez V.
Institution
(Abdelghani, Giver, Rodriguez) Division of Pediatric Hematology/Oncology,
Nationwide Children's Hospital, Columbus, OH, United States
(Cua) Heart Center, Nationwide Children's Hospital, 700 Children's Drive,
Columbus, OH, United States
(Abdelghani, Cua, Giver, Rodriguez) Department of Pediatrics, The Ohio
State University, Columbus, OH, United States
Publisher
Adis
Abstract
Thrombosis is one of the most frequent complications affecting children
with congenital heart disease (CHD). Palliative and reparative cardiac
surgeries are some of the main players contributing to the thrombosis risk
in this patient population. Additional risk factors related to the CHD
itself (e.g., cardiac dysfunction, arrhythmias, and polycythemia in
cyanotic cardiac disorders) can contribute to thrombogenicity alone or
combined with other factors. Thrombotic complications have been recognized
as a significant cause of morbidity and mortality in this patient
population. Here, we provide an overview of the pathophysiology and risk
factors for thrombosis as well as the indications for and use of different
anticoagulation, antiplatelet, and thrombolytic agents. In addition, we
describe some of most common thrombotic complications and their management
in the pediatric CHD population. Copyright © 2021, The Author(s).

<36>
Accession Number
2012311009
Title
Expert Consensus on Sizing and Positioning of SAPIEN 3/Ultra in Bicuspid
Aortic Valves.
Source
Cardiology and Therapy. 10(2) (pp 277-288), 2021. Date of Publication:
December 2021.
Author
Blackman D.; Gabbieri D.; Del Blanco B.G.; Kempfert J.; Laine M.;
Mascherbauer J.; Parma R.; Tchetche D.
Institution
(Blackman) Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
(Gabbieri) Hesperia Hospital, Modena, Italy
(Del Blanco) Hospital Vall D'hebron, Barcelona, Spain
(Kempfert) German Heart Center Berlin, Berlin, Germany
(Laine) Helsinki University Central Hospital, Helsinki, Finland
(Mascherbauer) University of Vienna, Vienna, Austria
(Mascherbauer) Karl Landsteiner University of Health Sciences, Krems,
Austria
(Parma) Department of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
(Tchetche) Clinique Pasteur, Toulouse, France
Publisher
Adis
Abstract
Severe aortic stenosis patients with bicuspid anatomy have been excluded
from the major transcatheter aortic valve replacement (TAVI) randomized
clinical trials. As a result, there is no official recommendation on
bicuspid TAVI. A panel of bicuspid experts was created to fill this gap.
In this consensus statement, an algorithm is proposed to guide the choice
of surgery or TAVI within this complex patient population, depending on
aortic dilatation, age, surgical risk score, and anatomy. A step-by-step
guide for sizing and positioning of the SAPIEN 3/Ultra TAVI bioprostheses
is presented. Annular sizing remains the primary strategy in most bicuspid
patients. However, some anatomies may require sizing at the supra-annular
level, for which patients the panel recommends the circle method, a
dedicated sizing and positioning approach for SAPIEN 3/Ultra. The
consensus provides valuable pre-operative insights on the interactions
between SAPIEN 3/Ultra and the bicuspid anatomy; understanding the
valve-anatomy relationship is critical to avoid complications and to
optimize outcomes for patients. Copyright © 2021, The Author(s).

<37>
Accession Number
2012275176
Title
The effect of foot reflexology massage on delirium and sleep quality
following cardiac surgery: A randomized clinical trial.
Source
Complementary Therapies in Medicine. 60 (no pagination), 2021. Article
Number: 102738. Date of Publication: August 2021.
Author
Fazlollah A.; Babatabar Darzi H.; Heidaranlu E.; Moradian S.T.
Institution
(Fazlollah) Baqiyatallah University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Babatabar Darzi) Atherosclerosis Research Center & Nursing Faculty,
Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Heidaranlu) Trauma Research Center, Nursing Faculty, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Moradian) Atherosclerosis Research Center, Baqiyatallah University of
Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Churchill Livingstone
Abstract
Background: Delirium is the most common neurologic disorder after cardiac
surgery and affects both short and long-term outcomes. This study was
conducted to evaluate the effect of foot reflexology massage on the
incidence of delirium and sleep quality in patients undergoing cardiac
surgery. Method(s): In this randomized clinical trial, 60 patients
who were candidates for CABG surgery were randomly assigned into two equal
groups (n = 30); intervention and control groups. In the intervention
group, foot reflexology massage was done on each foot for 15 min, for two
consecutive days. Delirium observation screening scale, the Richard
Campbell sleep questionnaire (RSCQ), and pain intensity using VAS were
compared. Result(s): in the second postoperative day, delirium was
observed in 8 (26.7 %) and 7 (23.3 %) of patients in the intervention and
control groups, respectively (p > 0.05). The measured odds ratio for the
effect of massage on delirium is 0.83 (95 %CI 0.71-2.69, p = 0.76). The
difference in RSCQ scores was not significant between groups of
intervention and control (68.32 +/- 10.41 VS. 62.80 +/- 11.86, P = 0.06).
The pain intensity was lower in the intervention group (P < 0.001).
 Conclusion(s): Foot reflexology was not effective in reducing
delirium and improving the sleep quality, but the pain intensity was
decreased. It seems that the precise pathology and predicting model of
delirium should be identified, and appropriate interventions should be
planned accordingly. Copyright © 2021

<38>
Accession Number
2012269326
Title
Ventilation design conditions associated with airborne bacteria levels
within the wound area during surgical procedures: a systematic review.
Source
Journal of Hospital Infection. 113 (pp 85-95), 2021. Date of Publication:
July 2021.
Author
Aganovic A.; Cao G.; Fecer T.; Ljungqvist B.; Lytsy B.; Radtke A.;
Reinmuller B.; Traversari R.
Institution
(Aganovic) Department of Automation and Process Engineering, The Arctic
University of Norway, Norway
(Cao) Department of Energy and Process Engineering, Norwegian University
of Science and Technology - NTNU, Norway
(Fecer) Department of Computer Aided Engineering and Computer Science,
Faculty of Civil Engineering, Brno University of Technology, Czechia
(Ljungqvist, Reinmuller) Department of Civil and Environmental
Engineering, Chalmers University of Technology, Sweden
(Lytsy) Department of Medical Sciences, Clinical Microbiology, Uppsala
University, Sweden
(Radtke) Department of Clinical and Molecular Medicine, Norwegian
University of Science and Technology, Norway
(Traversari) Netherlands Organization for Applied Scientific Research,
Netherlands
Publisher
W.B. Saunders Ltd
Abstract
Background: Without confirmation of the ventilation design conditions
(typology and airflow rate), the common practice of identifying
unidirectional airflow (UDAF) systems as equivalent to ultra-clean air
ventilation systems may be misleading, but also any claims about the
ineffectiveness of UDAF systems should be doubted. The aim of this review
was to assess and compare ventilation system design conditions for which
ultra-clean air (mean <10 cfu/m3) within 50 cm from the wound
has been reported. Six medical databases were systematically searched to
identify and select studies reporting intraoperative airborne levels
expressed as cfu/m3 close to the wound site, and ventilation
system design conditions. Available data on confounding factors such as
the number of persons present in the operating room, number of door
openings, and clothing material were also included. Predictors for
achieving mean airborne bacteria levels within <10 cfu/m3 were
identified using a penalized multivariate logistic regression model.
Twelve studies met the eligibility criteria and were included for
analysis. UDAF systems considered had significantly higher air volume
flows compared with turbulent ventilation (TV) systems considered.
Ultra-clean environments were reported in all UDAF-ventilated (N = 7)
rooms compared with four of 11 operating rooms equipped with TV. On
multivariate analysis, the total number of air exchange rates (P=0.019;
odds ratio (OR) 95% confidence interval (CI): 0.66-0.96) and type of
clothing material (P=0.031; OR 95% CI: 0.01-0.71) were significantly
associated with achieving mean levels of airborne bacteria <10
cfu/m3. High-volume UDAF systems complying with DIN 1946-4:2008
standards for the airflow rate and ceiling diffuser size unconditionally
achieve ultra-clean air close to the wound site. In conclusion, the
studied articles demonstrate that high-volume UDAF systems perform as
ultra-clean air systems and are superior to TV systems in reducing
airborne bacteria levels close to the wound site. Copyright ©
2021 The Author(s)

<39>
Accession Number
2012058387
Title
Surgical Risk Scoring in TAVR: Still Needed? A Metaregression Analysis.
Source
Current Problems in Cardiology. 46(12) (no pagination), 2021. Article
Number: 100875. Date of Publication: December 2021.
Author
Baro R.; Cura F.; Belardi J.; Brugaletta S.; Lamelas P.
Institution
(Baro, Cura, Belardi, Lamelas) Instituto Cardiovascular de Buenos Aires,
Buenos Aires, Argentina
(Brugaletta) Clinic Cardiovascular Institute, Hospital Clinic, IDIBAPS,
Barcelona, Spain
(Lamelas) Health Research Methods, Evidence, and Impact, McMaster
University, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Several randomized controlled trials evaluating the effectiveness of
transcatheter aortic valve replacement (TAVR) against surgical aortic
valve replacement have been published to date. The fact that higher risk
populations were implemented first does not necessarily mean that they
benefit more from a TAVR procedure. We performed meta-analysis of the 8
randomized clinical trials performing TAVR for both mortality and stroke
outcomes. Meta-regression was used to evaluate the association between
mean surgical risk using the Society of Thoracic Surgeons (STS) score and
hazard ratio observed in each of the trials. Overall, TAVR was associated
with a significant reduction of both mortality and stroke across the whole
spectrum of patients enrolled, with no evidence of significant
heterogeneity. Metaregression analysis does not suggest a statistically
significant association between STS score and hazard ratio for both
mortality and stroke. This observation suggests reconsidering the use of
risk scores to prioritize TAVR utilization in higher risk patients, while
more focus should be done on patient's life expectancy related to TAVR
durability. Copyright © 2021 Elsevier Inc.

<40>
Accession Number
2011933593
Title
Does bariatric surgery improve cardiac autonomic modulation assessed by
heart rate variability? A systematic review.
Source
Surgery for Obesity and Related Diseases. 17(8) (pp 1497-1509), 2021. Date
of Publication: August 2021.
Author
Benjamim C.J.R.; Pontes Y.M.D.M.; de Sousa Junior F.W.; Porto A.A.; Bueno
Junior C.R.; Marcelino da Silva A.A.; Ferro Cavalcante T.C.; Garner D.M.;
Valenti V.E.
Institution
(Benjamim, Marcelino da Silva, Ferro Cavalcante) Development, Nutrition,
Phytotherapy and Hygiene Research Group, University of Pernambuco,
Petrolina, Brazil
(Benjamim, Porto, Valenti) Autonomic Nervous System Center, Sao Paulo
State University, Marilia, Brazil
(Pontes, de Sousa Junior) Physiological and Collective Sciences Nucleus,
School of Juazeiro do Norte, Juazeiro do Norte, Brazil
(Porto) Department of Physical Therapy, Faculty of Sciences and
Technologies, UNESP, Presidente Prudente, Brazil
(Bueno Junior) Ribeirao Preto Medical School, Department of Medical
Clinic, University of Sao Paulo, Ribeirao Preto, Brazil
(Garner) Cardiorespiratory Research Group, Department of Biological and
Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes
University, Headington Campus, Oxford, United Kingdom
Publisher
Elsevier Inc.
Abstract
Our study aimed to explore the influence of bariatric surgery (BS) on
heart rate (HR) variability (HRV) through a systematic review. Manuscripts
were selected based on electronic searches of the MEDLINE, EMBASE, and
CINAHL databases from the inception of each database up to year 2020, and
followed the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) protocol. Searching of these studies was
systematized using the Population Intervention Comparison Outcome Study
Design strategy. We selected randomized and nonrandomized controlled
trials and cohorts from prospective studies that reported the influence of
BS on HRV. We assessed the quality rating using the Black and Downs
questionnaire. Following the screening and eligibility stages, 14 studies
were included in the review. All studies agreed that BS promotes an
increase in parasympathetic HR control and HRV and a decrease in HR. Yet
the literature does not provide evidence that these outcomes are directly
caused by the surgical procedure. There is limited evidence to support
that patients with type 2 diabetes have greater improvement in HRV as an
interim measure, to individuals without. The decrease in insulin
resistance was correlated with the increase in HRV in some studies, but,
other studies are unsupportive of this outcome. Improvements in 2
metabolic parameters (e.g., leptin, N-terminal pro B-type natriuretic
peptide) were connected with superior increases in HRV. This review
demonstrated that BS promotes an increase in HRV, indicating improved
autonomic control of HR. Copyright © 2021 American Society for
Bariatric Surgery

<41>
Accession Number
2011863847
Title
A randomized prospective multicenter trial for stroke prevention by
prophylactic surgical closure of the left atrial appendage in patients
undergoing bioprosthetic aortic valve surgery--LAA-CLOSURE trial protocol.
Source
American Heart Journal. 237 (pp 127-134), 2021. Date of Publication: July
2021.
Author
Kiviniemi T.; Bustamante-Munguira J.; Olsson C.; Jeppsson A.; Halfwerk
F.R.; Hartikainen J.; Suwalski P.; Zindovic I.; Copa G.R.; van Schaagen
F.R.N.; Hanke T.; Cebotari S.; Malmberg M.; Fernandez-Gutierrez M.;
Bjurbom M.; Schersten H.; Speekenbrink R.; Riekkinen T.; Ek D.; Vasankari
T.; Lip G.Y.H.; Airaksinen K.E.J.; van Putte B.
Institution
(Kiviniemi, Malmberg, Vasankari, Airaksinen) Turku University Hospital and
University of Turku, Finland
(Kiviniemi) Brigham and Women's Hospital, Harvard Medical School, Boston,
MA, United States
(Bustamante-Munguira, Fernandez-Gutierrez) Hospital Clinico Universitario
de Valladolid, Valladolid, Spain
(Olsson, Bjurbom) Karolinska University Hospital and The Karolinska
Institutet, Stockholm, Sweden
(Jeppsson, Schersten) Sahlgrenska University Hospital, Gothenburg, Sweden;
and Department of Molecular and Clinical Medicine, Institute of Medicine.
Sahlgrenska Academy, University of Gothenburg, Sweden
(Halfwerk, Speekenbrink) Medisch Spectrum Twente, Thoraxcentrum Twente,
Enschede, Netherlands
(Hartikainen, Riekkinen) Kuopio University Hospital, University of Eastern
Finland, Kuopio, Finland
(Suwalski) Central Clinical Hospital of the Ministry of the Interior and
Administration in Warsaw, Warsaw, Poland
(Zindovic, Ek) Lund University, Skane University Hospital, Department of
Clinical Sciences, Lund, Department of Cardiothoracic Surgery, Lund,
Sweden
(Copa) Hospital Universitario La Princesa, Madrid, Spain
(van Putte) St. Antonius Ziekenhuis, Nieuwegein, Netherlands
(van Schaagen) University Medical Center Rotterdam, Rotterdam, Netherlands
(Hanke) Asklepios Klinik Harburg, Hamburg, Germany
(Cebotari) Medizinische Hochschule, Hannover, Germany
(Lip) Liverpool Centre for Cardiovascular Science, University of Liverpool
and Liverpool Heart & Chest Hospital, Department of Clinical Medicine,
Aalborg University, LiverpoolAalborg, United Kingdom
Publisher
Mosby Inc.
Abstract
Patients undergoing surgical aortic valve replacement (SAVR) are at high
risk for atrial fibrillation (AF) and stroke after surgery. There is an
unmet clinical need to improve stroke prevention in this patient
population. The LAA-CLOSURE trial aims to assess the efficacy and safety
of prophylactic surgical closure of the left atrial appendage for stroke
and cardiovascular death prevention in patients undergoing bioprosthetic
SAVR. This randomized, open-label, prospective multicenter trial will
enroll 1,040 patients at 13 European sites. The primary endpoint is a
composite of cardiovascular mortality, stroke and systemic embolism at 5
years. Secondary endpoints include cardiovascular mortality, stroke,
systemic embolism, bleed fulfilling academic research consortium (BARC)
criteria, hospitalization for decompensated heart failure and health
economic evaluation. Sample size is based on 30% risk reduction in time to
event analysis of primary endpoint. Prespecified reports include 30-day
safety analysis focusing on AF occurrence and short-term outcomes and
interim analyses at 1 and 3 years for primary and secondary outcomes.
Additionally, substudies will be performed on the completeness of the
closure using transesophageal echocardiography/cardiac computed tomography
and long-term ECG recording at one year after the operation. Copyright
© 2021 The Author(s)

<42>
Accession Number
2011320992
Title
The Use of Colchicine in Cardiovascular Diseases: A Systematic Review.
Source
American Journal of Medicine. 134(6) (pp 735-744.e1), 2021. Date of
Publication: June 2021.
Author
Siak J.; Flint N.; Shmueli H.G.; Siegel R.J.; Rader F.
Institution
(Siak) Department of Medicine, Cedars-Sinai Medical Center, Los Angeles,
Calif, United States
(Flint, Shmueli) Department of Cardiology, Tel Aviv Sourasky Medical
Center affiliated to the Sackler Faculty of Medicine, Tel Aviv University,
Israel
(Siegel, Rader) Smidt Heart Institute, Department of Cardiology,
Cedars-Sinai Medical Center, Los Angeles, Calif, United States
Publisher
Elsevier Inc.
Abstract
The medicinal properties of colchicine have been recognized for centuries.
Although previously used for gout and familial Mediterranean fever, its
immune-modulating, anti-inflammatory, and antifibrotic effects are
increasingly recognized as beneficial in the treatment of cardiovascular
disorders. In this systematic review, we summarize the current evidence on
colchicine's effectiveness in 1) pericarditis, 2) coronary artery disease,
and 3) atrial fibrillation. We also discuss the safety, potential adverse
effects, and common drug interactions that should be considered during
use. Copyright © 2021 Elsevier Inc.

<43>
Accession Number
2010983557
Title
6-year results of BiOSS stents in coronary bifurcation treatment.
Source
European Journal of Clinical Investigation. 51(8) (no pagination), 2021.
Article Number: e13555. Date of Publication: August 2021.
Author
Gil R.J.; Kern A.; Formuszewicz R.; Inigo Garcia L.A.; Dobrzycki S.;
Vassilev D.; Bil J.
Institution
(Gil, Bil) Department of Invasive Cardiology, Centre of Postgraduate
Medical Education, Warsaw, Poland
(Kern) Department of Cardiology and Internal Medicine, Medical Faculty,
University of Warmia and Mazury, Olsztyn, Poland
(Formuszewicz) Department of Invasive Cardiology, Central Clinical
Hospital of the Ministry of Interior and Administration, Warsaw, Poland
(Inigo Garcia) Costa del Sol Hospital, Marbella, Spain
(Dobrzycki) Department of Invasive Cardiology, Medical University in
Bialystok, Bialystok, Poland
(Vassilev) Alexandrovska University Hospital, Sofia, Bulgaria
Publisher
John Wiley and Sons Inc
Abstract
Background: The wide variation in bifurcation anatomy has generated an
ongoing search for stents explicitly designed for coronary bifurcations,
and to date, results have been underachieved. Method(s): The POLBOS I
and POLBOS II were international, multicentre, randomized, open-label,
controlled trials. Patients were randomly assigned to BiOSS Expert (in
POLBOS I, biodegradable polymer eluting paclitaxel)/BiOSS LIM (in POLBOS
II, biodegradable polymer eluting sirolimus) stent implantation or regular
drug-eluting stent (rDES) deployment. A provisional T-stenting strategy
was the default treatment option. The primary endpoint of this pooled data
study was the cumulative rate of major adverse cardiovascular events
(MACE) consisting of cardiac death, myocardial infarction (MI) and target
lesion revascularization (TLR). Telephone follow-up was performed annually
up to 72 months. (ClinicalTrials.gov Identifier: POLBOS I-NCT02192840,
POLBOS II-NCT02198300). Result(s): The total study population
consisted of 445 patients, 222 patients in the BiOSS group and 223
patients in the rDES group. The follow-up rate was 93.7% in the BiOSS
group and 91.9% in the rDES group. At 72 months, there was no significant
difference between BiOSS and rDES groups regarding MACE (25.7% vs 25.1%,
HR 1.06, 95% CI 0.73-1.52), cardiac death (3.1% vs 4.0%, HR 0.94, 95% CI
0.43-2.34), MI (3.6% vs 4.9%, HR 0.76, 95% CI 0.32-2.89), TLR (18.9% vs
16.1%, HR 1.17, 95% CI 0.75-1.83) and stent thrombosis rates (0.9% vs
0.5%, HR 1.21, 95CI 0.75-2.09). Conclusion(s): At the 6-year
follow-up, clinically significant clinical events did not differ between
BiOSS stents and rDES. Copyright © 2021 Stichting European
Society for Clinical Investigation Journal Foundation. Published by John
Wiley & Sons Ltd

<44>
Accession Number
2010543371
Title
Minimally invasive (mini-thoracotomy) versus median sternotomy in redo
mitral valve surgery: A meta-analysis of observational studies.
Source
Asian Cardiovascular and Thoracic Annals. 29(9) (pp 893-902), 2021. Date
of Publication: November 2021.
Author
Hussain A.; Chacko J.; Uzzaman M.; Hamid O.; Butt S.; Zakai S.B.; Khan H.
Institution
(Hussain, Chacko, Hamid, Butt, Khan) Department of Cardiothoracic Surgery,
King's College Hospital, London, United Kingdom
(Uzzaman) Department of Cardiac Surgery, Queen Elizabeth Hospital,
Birmingham, United Kingdom
(Zakai) National Institute of Cardiovascular Diseases, Karachi, Pakistan
Publisher
SAGE Publications Inc.
Abstract
Objective: Redo mitral valve surgery has traditionally been performed via
a median sternotomy. It is often challenging and is associated with
increased perioperative mortality. Advances in cardiac surgical techniques
over the last two decades have led to an increase in the use of a
minimally invasive approach via a right anterolateral mini-thoracotomy as
opposed to a repeat median sternotomy. However, despite these advances,
there is no general consensus on the best form of entry, and as of yet,
there are no randomized controlled trials. We performed a meta-analysis of
observational studies to aid in determining the best approach for redo
mitral valve surgery. Method(s): The MEDLINE and EMBASE databases
were conducted up until 1 June 2020. Data regarding mortality, stroke,
reoperation for bleeding and length of hospital stay, wound infection and
cardiopulmonary bypass time were extracted and submitted to a
meta-analysis using random effects modelling and the I2-test
for heterogeneity. Seven retrospective observational studies were
included, enrolling a total of 1070 patients. Result(s): There were a
total of 1070 patients. Of these 364 had non-sternotomy approach compared
with 707 patients who had median sternotomy. Further subgroup analysis
revealed that 327 of the 364 patients had a mini-thoracotomy approach
while the remaining 37 patients had a full thoracotomy approach.
In-hospital mortality and length of stay were less in non-sternotomy group
compared to median sternotomy group. There were no differences in stroke,
CPB time and wound infections between the two groups. Conclusion(s):
Redo mitral valve surgery can be performed safely with satisfactory
outcomes via a mini-thoracotomy approach. This meta-analysis shows
comparable results with reduced in-hospital mortality and hospital length
of stay with a mini-thoracotomy approach. Copyright © The
Author(s) 2021.

<45>
Accession Number
2010533659
Title
Chinese clinical practice guidelines for perioperative blood glucose
management.
Source
Diabetes/Metabolism Research and Reviews. 37(7) (no pagination), 2021.
Article Number: e3439. Date of Publication: October 2021.
Author
Jinjing W.; Xufei L.; Xueqiong L.; Xinye J.; Ping A.; Haibin W.; Xian J.;
Zhaoqing L.; Bin B.; Han W.; Yiming M.; Jingtao D.; Jianming B.; Zhaohui
L.; Weijun G.; Yu P.; Kang C.; Linong J.; Xianghai Z.; Tianpei H.; Xiaohui
G.; Junqing Z.; Xiaoyan X.; Bo Z.; Jinping Z.; Xinhua X.; Miao Y.; Yaolong
C.; Liyong Z.; Quanmin L.; Lixin G.; Xiaoying L.; Qiang L.; Zhongyan S.;
Qiuhe J.; Yuqian B.; Yan L.; Guijun Q.; Bing C.; Lixin S.; Jianying L.;
Zilin S.; Dajin Z.; Lulu C.; Jiajun Z.; Tao Y.; Yongquan S.; Xuefeng Y.;
Qifu L.; Yuping G.; Wei C.; Hailong L.; Junren K.; Xiaoting W.; Wei D.;
Haidong T.
Institution
(Jinjing, Kang, Xinye, Zhaohui, Jingtao, Yiming) Department of
Endocrinology, the First Medical Center, Chinese PLA General Hospital,
Beijing, China
(Jinjing) Department of Endocrinology, Fifth Medical Centre, Chinese PLA
General Hospital, Beijing, China
(Xufei) School of Public Health, Lanzhou University, Lanzhou, China
(Xueqiong) Department of Dry Therapy, First Affiliated Hospital of Kunming
Medical University, Kunming, China
(Xinye) Department of Nephrology, Hainan Hospital of Chinese PLA General
Hospital, the Hainan Academician Team Innovation Center, Hainan, China
(Miao) Department of EndocrinologyKey Laboratory of EndocrinologyNational
Health Commission, Peking Union Medical College Hospital, Peking Union
Medical College and Chinese Academy of Medical Sciences, Beijing, China
(Jinping) Department of Endocrinology, China-Japan Friendship Hospital,
Beijing, China
(Yaolong) Institute of Health Data Science, Lanzhou University, Lanzhou,
China
(Yaolong) Evidence-Based Medicine Center, School of Basic Medical
Sciences, Lanzhou University, Lanzhou, China
(Yaolong) WHO Collaborating Centre for Guideline Implementation and
Knowledge Translation, Lanzhou, China
(Linong) Department of Endocrinology and Metabolism, Peking University
people's Hospital, Peking University Diabetes Center, Beijing, China
(Jinjing) Department of Endocrinology, the First Medical Center, Chinese
PLA General Hospital, Beijing, China
(Jinjing) Department of Endocrinology, Fifth Medical Centre, Chinese PLA
General Hospital, Beijing, China
(Jinjing) School of Public Health, Lanzhou University, Lanzhou, China
(Xufei) Lanzhou University GRADE Center, Lanzhou, China
(Xueqiong) WHO Collaborating Centre for Guideline Implementation and
Knowledge Translation, Lanzhou, China
(Xueqiong) Department of Dry Therapy, First Affiliated Hospital of Kunming
Medical University, Kunming, China
(Xinye) Department of Endocrinology, the First Medical Center, Chinese PLA
General Hospital, Beijing, China
(Xinye) Department of Nephrology, Hainan Hospital of Chinese PLA General
Hospital, the Hainan Academician Team Innovation Center, Hainan, China
(Ping, Haibin) Department of Endocrinology, the First Medical Center,
Chinese PLA General Hospital, Beijing, China
(Xian, Zhaoqing) Department of Endocrinology, China-Japan Friendship
Hospital, Beijing, China
(Bin, Han) Department of Endocrinology, Peking Union Medical College
Hospital, Beijing, China
(Yiming, Jingtao, Jianming, Zhaohui, Weijun, Yu, Kang) Department of
Endocrinology, the First Medical Center, Chinese PLA General Hospital,
Beijing, China
(Linong, Xianghai) Department of Endocrinology and Metabolism, Peking
University people's Hospital, Peking University Diabetes Center, Beijing,
China
(Tianpei) Department of Endocrinology, Peking University Third Hospital,
Beijing, China
(Xiaohui, Junqing) Department of Endocrinology, Peking University First
Hospital, Beijing, China
(Xiaoyan, Bo, Jinping) Department of Endocrinology, China-Japan Friendship
Hospital, Beijing, China
(Xinhua, Miao) Department of Endocrinology, Key Laboratory of
Endocrinology, National Health Commission, Peking Union Medical College
Hospital, Peking Union Medical College and Chinese Academy of Medical
Sciences, Beijing, China
(Yaolong) Institute of Health Data Science, Lanzhou University, Lanzhou,
China
(Yaolong) Evidence-Based Medicine Center, School of Basic Medical
Sciences, Lanzhou University, Lanzhou, China
(Yaolong) Chinese GRADE Center, Lanzhou, China
(Yaolong) WHO Collaborating Centre for Guideline Implementation and
Knowledge Translation, Lanzhou, China
(Liyong) Department of Endocrinology, Beijing Tian Tan Hospital, Capital
Medical University, Beijing, China
(Quanmin) Department of Endocrinology, PLA Rocket Force General Hospital,
Beijing, China
(Lixin) Department of Endocrinology, Beijing Hospital, Beijing, China
(Xiaoying) Department of Endocrinology, Zhongshan Hospital Affiliated to
Fudan University, Shanghai, China
(Qiang) Department of Endocrinology, the 2nd Affiliated Hospital of Harbin
Medical University, Harbin, China
(Zhongyan) Department of Endocrinology, the First Hospital of China
Medical University, Shenyang, China
(Qiuhe) Department of Endocrinology, Xijing Hospital, Xi'an, China
(Yuqian) Department of Endocrinology, the Sixth People's Hospital,
Jiaotong University, Shanghai, China
(Yan) Department of Endocrinology, Sun Yet-sen Memorial Hospital, Sun
Yet-sen University, Guangzhou, China
(Guijun) Department of Endocrinology, the First Affiliated Hospital of
Zhengzhou University, Zhengzhou, China
(Bing) Department of Endocrinology, the Southwest Hospital of the Army
Medical University, Chongqing, China
(Lixin) Department of Endocrinology, the Affiliated Hospital of Guizhou
Medical University, Guizhou, China
(Jianying) Department of Endocrinology, the Affiliated Hospital of
Nanchang University, Nanchang, China
(Zilin) Department of Endocrinology, Zhongda Hospital Southeast
University, Nanjing, China
(Dajin) Tongji University Tenth People's Hospital, Shanghai, China
(Dajin) Department of Endocrinology, Changhai Hospital Affiliated to
Shanghai Second Military Medical University, Shanghai, China
(Lulu) Department of Endocrinology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
(Jiajun) Department of Endocrinology, Shandong Provincial Hospital,
Ji'nan, China
(Tao) Department of Endocrinology, Jiangsu Province Hospital, Nanjing,
China
(Yongquan) Department of Endocrinology, Long March Hospital Affiliated to
Naval Military Medical University, Shanghai, China
(Xuefeng) Department of Endocrinology, Tongji Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
(Qifu) Department of Endocrinology, the First Affiliated Hospital of
Chongqing Medical University, Chongqing, China
(Yuping) Department of Endocrinology, Pingxiang People's Hospital,
Pingxiang, China
(Wei, Hailong, Junren) Department of Parenteral and Enteral Nutrition,
Peking Union Medical College Hospital, Beijing, China
(Xiaoting, Wei) ICU, Peking Union Medical College Hospital, Beijing, China
(Haidong) Department of Hepatobiliary Surgery, China-Japan Friendship
Hospital, Beijing, China
Publisher
John Wiley and Sons Ltd
Abstract
With the increased incidence of diabetes, the number of diabetic patients
who require surgical treatment is also increasing. Unfortunately,
practices in this area lack standardisation. The purpose of this
multidisciplinary, evidence-based guidelines for perioperative blood
glucose management is to provide a comprehensive set of recommendations
for clinicians treating diabetes with different types of surgery. The
intended audience comprises Chinese endocrinologists, surgeons,
anaesthetists, clinical pharmacists, nurses and professionals involved in
perioperative blood glucose management. The guidelines were formulated as
follows. First, a multidisciplinary expert group was established to
identify and formulate key research questions on topics of priority
according to the Population, Intervention, Comparator and Outcomes (PICO)
process. We conducted a meta-analysis of available studies using Review
Manager version 5.3, as appropriate. We pooled crude estimates as odds
ratios with 95% confidence intervals using a random-effects model, and
used the Grading of Recommendations Assessment, Development, and
Evaluation methods to assess the quality of the retrieved evidence.
Finally, 32 recommendations were gathered that covered 11
fields-management and coordination, endocrinologists' consultation,
diabetes diagnosis, surgery timing and anaesthesia method, blood glucose
target values and monitoring frequency, hypoglycaemia treatment, oral
administration of blood glucose lowering drugs, use of insulin, enteral
and parenteral nutritional, postoperative treatment and medication and
education and training. Twenty-five systematic reviews and meta-analyses
were conducted for these guidelines to address the PICO questions. These
guidelines are intended to improve perioperative blood glucose management
and help doctors in specifying medical diagnosis and treatment, and will
be implemented / disseminated extensively in China. Copyright ©
2021 John Wiley & Sons Ltd.

<46>
Accession Number
2013836987
Title
Use of Incentive Spirometry in Adults following Cardiac, Thoracic, and
Upper Abdominal Surgery to Prevent Post-Operative Pulmonary Complications:
A Systematic Review and Meta-Analysis.
Source
Respiration. 100(11) (pp 1114-1127), 2021. Date of Publication: 01 Nov
2021.
Author
Sullivan K.A.; Churchill I.F.; Hylton D.A.; Hanna W.C.
Institution
(Sullivan, Churchill, Hylton, Hanna) Department of Health Research Methods
Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Sullivan, Churchill, Hylton, Hanna) Division of Thoracic Surgery, St.
Joseph's Healthcare Hamilton, Hamilton, ON, Canada
Publisher
S. Karger AG
Abstract
Background: Currently, consensus on the effectiveness of incentive
spirometry (IS) following cardiac, thoracic, and upper abdominal surgery
has been based on randomized controlled trials (RCTs) and systematic
reviews of lower methodological quality. To improve the quality of the
research and to account for the effects of IS following thoracic surgery,
in addition to cardiac and upper abdominal surgery, we performed a
meta-analysis with thorough application of the Grading of Recommendations
Assessment, Development and Evaluation scoring system and extensive
reference to the Cochrane Handbook for Systematic Reviews of
Interventions. Objective(s): The objective of this study was to
determine, with rigorous methodology, whether IS for adult patients (18
years of age or older) undergoing cardiac, thoracic, or upper abdominal
surgery significantly reduces30-day post-operative pulmonary complications
(PPCs), 30-day mortality, and length of hospital stay (LHS) when compared
to other rehabilitation strategies. Method(s): The literature was
searched using Cochrane Central Register of Controlled Trials, MEDLINE,
EMBASE, CINAHL, and Web of Science for RCTs between the databases'
inception and March 2019. A random-effect model was selected to calculate
risk ratios (RRs) with 95% confidence intervals (CIs). Result(s):
Thirty-one RCTs involving 3,776 adults undergoing cardiac, thoracic, or
upper abdominal surgery were included. By comparing the use of IS to other
chest rehabilitation strategies, we found that IS alone did not
significantly reduce 30-day PPCs (RR = 1.00, 95% CI: 0.88-1.13) or 30-day
mortality (RR = 0.73, 95% CI: 0.42-1.25). Likewise, there was no
difference in LHS (mean difference =-0.17,95% CI:-0.65 to 0.30) between IS
and the other rehabilitation strategies. None of the included trials
significantly impacted the sensitivity analysis and publication bias was
not detected. Conclusion(s): This meta-analysis showed that IS alone
likely results in little to no reduction in the number of adult patients
with PPCs, in mortality, or in the LHS, following cardiac, thoracic, and
upper abdominal surgery. © 2021 S. Karger AG, Basel. Copyright:
All rights reserved.

<47>
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). 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.
 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. 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. Copyright © 2021, The Author(s).

<48>
Accession Number
2015373847
Title
Definition and assessment of high risk in patients considered for
lobectomy for stage I non-small cell lung cancer: The American Association
for Thoracic Surgery expert panel consensus document.
Source
Journal of Thoracic and Cardiovascular Surgery. 162(6) (pp 1605-1618.e6),
2021. Date of Publication: December 2021.
Author
Pennathur A.; Brunelli A.; Criner G.J.; Keshavarz H.; Mazzone P.; Walsh
G.; Luketich J.; Liptay M.; Wafford Q.E.; Murthy S.; Marshall M.B.; Tong
B.; Lanuti M.; Wolf A.; Pettiford B.; Loo B.W.; Merritt R.E.; Rocco G.;
Schuchert M.; Varghese T.K.; Swanson S.J.
Institution
(Pennathur, Luketich, Schuchert) Department of Cardiothoracic Surgery,
University of Pittsburgh School of Medicine, University of Pittsburgh
Medical Center, and UPMC Hillman Cancer Center, Pittsburgh, Pa, United
States
(Brunelli) Department of Thoracic Surgery, St. James University Hospital,
Leeds, United Kingdom
(Criner) Department of Thoracic Medicine and Surgery, Lewis Katz School of
Medicine at Temple University, Philadelphia, Pa, United States
(Keshavarz, Wafford) The American Association for Thoracic Surgery,
Beverly, MA, United States
(Mazzone) Department of Pulmonology, Cleveland Clinic, Cleveland, OH,
United States
(Liptay) Department of Thoracic Surgery, University of Texas M.D. Anderson
Cancer Center, Houston, Tex, United States
(Murthy) Department of Cardiovascular and Thoracic Surgery, Rush
University Medical Center, Chicago, Ill, United States
(Marshall) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Walsh) Division of Thoracic Surgery, Brigham and Women's Hospital,
Boston, MA, United States
(Tong) Department of Thoracic Surgery, Duke University Hospital, Durham,
NC, United States
(Lanuti) Department of Thoracic Surgery, Massachusetts General Hospital,
Boston, MA, United States
(Wolf) The Icahn School of Medicine at Mount Sinai and Mount Sinai
Hospital, New York, NY, United States
(Pettiford) Section of Cardiothoracic Surgery, Ochsner Health System, New
Orleans, La, United States
(Loo) Department of Radiation Oncology & Stanford Cancer Institute,
Stanford University School of Medicine, Stanford, Calif, United States
(Merritt) Division of Thoracic Surgery, The Ohio State University-Wexner
Medical Center, Columbus, Ohio
(Rocco) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, NY, United States
(Varghese) Division of Thoracic Surgery, University of Utah, Huntsman
Cancer Institute, Salt Lake City, UT, United States
(Swanson) Division of Thoracic Surgery, Harvard Medical School and Brigham
and Women's Hospital, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Objective: Lobectomy is a standard treatment for stage I non-small cell
lung cancer, but a significant proportion of patients are considered at
high risk for complications, including mortality, after lobectomy and
might not be candidates. Identifying who is at risk is important and in
evolution. The objective of The American Association for Thoracic Surgery
Clinical Practice Standards Committee expert panel was to review important
considerations and factors in assessing who is at high risk among patients
considered for lobectomy. Method(s): The American Association for
Thoracic Surgery Clinical Practice Standards Committee assembled an expert
panel that developed an expert consensus document after systematic review
of the literature. The expert panel generated a priori a list of important
risk factors in the determination of high risk for lobectomy. A survey was
administered, and the expert panel was asked to grade the relative
importance of each risk factor. Recommendations were developed using
discussion and a modified Delphi method. Result(s): The expert panel
survey identified the most important factors in the determination of high
risk, which included the need for supplemental oxygen because of severe
underlying lung disease, low diffusion capacity, the presence of frailty,
and the overall assessment of daily activity and functional status. The
panel determined that factors, such as age (as a sole factor), were less
important in risk assessment. Conclusion(s): Defining who is at high
risk for lobectomy for stage I non-small cell lung cancer is challenging,
but remains critical. There was impressive strong consensus on
identification of important factors and their hierarchical ranking of
perceived risk. The panel identified several key factors that can be
incorporated in risk assessment. The factors are evolving and as the
population ages, factors such as neurocognitive function and frailty
become more important. A minimally invasive approach becomes even more
critical in this older population to mitigate risk. The determination of
risk is a clinical decision and judgement, which should also take into
consideration patient perspectives, values, preferences, and quality of
life. Copyright © 2021

<49>
Accession Number
2011621400
Title
A Randomized Double-Blind Controlled Trial to Assess the Efficacy of
Ultrasound-Guided Erector Spinae Plane Block in Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 35(12) (pp 3574-3580),
2021. Date of Publication: December 2021.
Author
Athar M.; Parveen S.; Yadav M.; Siddiqui O.A.; Nasreen F.; Ali S.; Haseen
M.A.
Institution
(Athar, Parveen, Siddiqui, Nasreen, Ali) Department of Anaesthesiology and
Critical Care, Jawaharlal Nehru Medical College, Aligarh Muslim
University, Aligarh, Uttar Pradesh, India
(Yadav, Haseen) Department of Cardiothoracic and Vascular Surgery,
Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh,
Uttar Pradesh, India
Publisher
W.B. Saunders
Abstract
Objective: Cardiac surgical pain is of moderate-to-severe intensity.
Ineffective pain control may lead to increased cardiopulmonary
complications and poor surgical outcomes. This study aimed to assess the
efficacy of ultrasound-guided erector spinae plane block in providing
analgesia in adult cardiac surgeries. Design(s): Prospective,
randomized, double-blinded clinical trial. Setting(s): Single-center,
tertiary care hospital with university affiliation. Participant(s):
Thirty patients of either sex, aged 18-to-60 years, body mass index
19-to-30 kg/m2, undergoing elective on-pump single-vessel
coronary artery bypass grafting or valve replacement under general
anesthesia. Intervention(s): Patients were randomly categorized into
two groups of 15 patients each to receive bilateral erector spinae plane
block with 20 mL per side of 0.25% levobupivacaine (group E) or sham block
with 20 mL of normal saline (group C). Main Result(s): Mean analgesic
requirement in terms of fentanyl equivalents (microg) in the first 24
hours postoperatively was 225 +/- 112 in group E and 635 +/- 145 in group
C (95% confidence interval, 313.10-506.90; p < 0.05). Mean time to first
rescue analgesia was 356.9 +/- 34.5 in group E and 123.9 +/- 13.1 minutes
in group C (p < 0.05). Cox proportional hazard ratio for rescue analgesic
requirement in group E-to-group C was 5.0. Duration of mechanical
ventilation was 88.4 +/- 17 and 103.5 +/- 18 minutes in groups E and C,
respectively (p < 0.05). Ramsay sedation score at six hours postextubation
was 1.45 +/- 0.53 in group E and 3.19 +/- 0.62 in group C (p < 0.05). Mean
numerical rating score was 3.67 +/- 1.41 in group E and 4.50 +/- 1.00 in
group C (p = 0.17). No significant differences were observed in the
incidences of postoperative nausea vomiting, pruritus, and erector spinae
plane block-related infection and pneumothorax. Conclusion(s):
Single-shot erector spinae plane block provides superior analgesia as
compared with sham block. It decreased the first 24-hour postoperative
analgesic consumption by 64.5% and risk of pain by five times in the
authors' population. It also reduced the sedation and duration of
mechanical ventilation in postcardiac surgery patients. Copyright
© 2021 Elsevier Inc.

<50>
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 23th 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. Copyright © 2021 Edizioni Scientifi che per
l'Informazione su Farmaci e Terapia.

<51>
Accession Number
636426357
Title
Continuous erector spinae plane block for postoperative analgesia as an
alternative to epidural catheter in thoracic surgery for patients with
empyema: A case series.
Source
Regional Anesthesia and Pain Medicine. Conference: Annual European Society
of Regional Anesthesia Congress, ESRA 2021. Virtual. 70(SUPPL 1) (pp
A122), 2021. Date of Publication: September 2021.
Author
Simon C.; Parisi N.; Samouri G.
Institution
(Simon, Parisi, Samouri) Clinique Saint-Pierre, Ottignies, Belgium
Publisher
BMJ Publishing Group
Abstract
Background and Aims We present a case series of five patients undergoing
video-assisted thoracoscopic surgery for empyema. In this infectious
state, we chose to perform a continuous ESP because of the relative
contraindication of epidural catheter. We performed it to prevent and
relieve the thoracic pain but also to limit the opioids consumption and
their side effects in our frailty patients. Methods The plan was general
anaesthesia combined with a continuous unilateral ESP block. Postoperative
analgesia was achieved by continuous infusion + bolus of L-Bupivacaine
0.125%. Complementary analgesia was done with paracetamol and when
possible NSAID. Patients received iv doses of piritramide in the recovery
room, but no patient-controlled analgesia or other intravenous opioids was
administered subsequently. Results Most of the patients maintained a
Numeric pain Rating Scale (NRS) between 0 and 3. We removed the catheters
the same day than the pleural drains, usually at day 4. In the
postoperative period, no side effects (motor blockade, urinary retention
or hypotension) were noticed and patients attested high satisfaction
scores. We emphasize the fact that none of them requested additional
opioids. Conclusions In cases of empyema, the ESP catheter combined with
multimodal analgesia seems to be a safe and effective alternative to
epidural analgesia for VATS surgery. This technique, easy to perform,
allows an early mobilization of the patient regarding the low pain scores
and the absence of side effects. Prospective randomized trials are needed
to confirm the benefits of the ESPB compared to epidural or paravertebral
bloc.

<52>
Accession Number
636426310
Title
Methadone in pain management.
Source
Regional Anesthesia and Pain Medicine. Conference: Annual European Society
of Regional Anesthesia Congress, ESRA 2021. Virtual. 70(SUPPL 1) (pp
A41-A42), 2021. Date of Publication: September 2021.
Author
Senderovich H.
Institution
(Senderovich) Baycrest, University of Toronto, Toronto, Canada
Publisher
BMJ Publishing Group
Abstract
Background and Aims Adequate analgesia can be challenging, as
pharmacological options are not necessarily effective for all types of
pain and have various side effects. Methadone is increasingly being
considered in the management of both cancer- and non-cancer-related pain.
 Objective(s): To summarize the evidence on the effectiveness of
methadone and review the side effects and cost of this drug. Methods
PubMed, Medline, Embase, and Google Scholar databases were searched to
identify Randomized Controlled Trials (RCTs) assessing methadone and a
comparison drug. Results A total of 40 RCTs were included. The majority
compared methadone to morphine or fentanyl. Methadone was effective in
certain orthopedic, spinal, and cardiac surgeries. It was superior to
fentanyl in the management of head-and-neck cancer pain. There was
variability in the limited data on the management of neuropathic pain.
Side effects experienced with methadone use were similar to a comparison
drug. The effectiveness of methadone in the management of postsurgical and
cancer pain was dependent on the procedure and cancer type, respectively.
Methadone may be useful as an adjunctive analgesic, to lower the dose of
another drug Conclusions Methadone may be a valuable in the management of
post-surgical, cancer, or nociceptive pain, and in patients with renal
impairment. Prescribers should consult a specialist prior to starting or
discontinuing methadone. Future Research: Reported outcomes for measuring
analgesia must be standardized. Patients should be stratified by procedure
and cancer type in future RCTs.

<53>
Accession Number
636431214
Title
The complications of anesthesia in pediatric population to cardiological
surgeries: alpha literature review.
Source
Signa Vitae. Conference: 1st Hellenic Conference of PeriAnaesthesia Care.
Athens Greece. 17(5) (pp 4), 2021. Date of Publication: September 2021.
Author
Manolis O.; Michopoulos C.; Mitro A.; Patelarou A.; Bastaki M.
Institution
(Manolis, Michopoulos, Mitro, Patelarou, Bastaki) Department of Nursing,
Faculty of Health Sciences, Hellenic Mediterranean University, Crete
71410, Greece
Publisher
Pharmamed Mado Ltd
Abstract
Introduction: General anesthesia in cardiac surgery was first performed in
1925 in a patient undergoing mitral valve plastic surgery. Anesthesia in
children undergoing heart surgery is considered as a stressful and
difficult process due to the special pathophysiological characteristics of
children and the specialized training of the medical staff required.
Although much has changed since then in anesthesia, general anesthesia in
cardiac surgery in the pediatric population is still considered a
challenge. Aim(s): The aim of the present study was to explore the
complications of general anesthesia in the pediatric population undergoing
cardiac surgery. Method(s): A descriptive review was performed that
examined the bibliographic databases of Pubmed, Google Scholar, IATROTEK
and Oxford journals. The filters used for data collection were the time
period (2010-2021) and the language of the articles (Greek and English).
In addition, the following algorithm was used for English terminology:
("Pediatric" IR "Pediatric population" OR "Children") AND ("Heart Surgery"
OR "Cardiac Surgery") AND ("Anesthesia" OR "General anesthesia" OR
"Endotracheal Intubation" OR "Mask Ventilation") AND ("Complications" OR
"Difficulties" OR "Adverse Events") AND ("Nurse" OR "Nurse Anesthetist" OR
"Anesthesiologist" OR "Doctor"). Result(s): According to the
ten-article study, the pediatric population undergoing cardiac surgery had
higher mortality rates associated with general anesthesia than the
pediatric population undergoing other surgeries. In addition, the main
side effects of dexmedetomidine were found to be bradycardia and
hypotension. However, the dexmedetomidine-ketamine combination appeared to
be safer with fewer side effects. Dexmedetomidine in combination with a
low dose of fentanyl, also, helped to eliminate stress hormones. Airway
obstruction was common after pediatric cardiac surgery, especially when
large doses of dexmedetomidine and vecuron were administered during
anesthesia. Conclusion(s): Complications of anesthesia in children
undergoing heart surgery are now minimal and treatable with the help of a
specially trained anesthesiology team and the existence of appropriate
infrastructure.

<54>
Accession Number
2014492991
Title
Cardiac rehabilitation early after sternotomy using new assistive
vr-enhanced robotic exoskeleton-study protocol for a randomised controlled
trial.
Source
International Journal of Environmental Research and Public Health. 18(22)
(no pagination), 2021. Article Number: 11922. Date of Publication:
November-2 2021.
Author
Mocan M.; Vlaicu S.I.; Farcas A.D.; Feier H.; Dragan S.; Mocan B.
Institution
(Mocan, Vlaicu) Department of Internal Medicine, University of Medicine
and Pharmacy Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca 400012, Romania
(Farcas) Department of Cardiology, University of Medicine and Pharmacy
Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca 400012, Romania
(Feier) Department of Thoracic Surgery, Institute of Cardiovascular
Diseases Timisoara, University of Medicine and Pharmacy Victor Babes,
Timisoara 300041, Romania
(Dragan) Department of Cardiology, Clinic of Cardiovascular Prevention and
Rehabilitation, University of Medicine and Pharmacy Victor Babes,
Timisoara 300041, Romania
(Mocan) Department of Industrial Engineering and Robotics, Technical
University of Cluj-Napoca, Cluj-Napoca 400020, Romania
Publisher
MDPI
Abstract
(1) Background and objective: Cardiac rehabilitation (CR) means delivering
health education by structured exercises with the means of risk reduction,
in a cost-effective manner. Wellconducted CR improves functional capacity,
decreases re-hospitalization, and reduces mortality up to 25%. We bring to
attention the protocol of a randomised control trial with the aim of
validating the prototype of an assistive upper-body robotic exoskeleton
system enhanced with a non-immersive virtual reality exergame
(CardioVR-ReTone) in patients who undergone cardiac surgery. (2) Methods:
Description of the CardioVR-ReTone system and the technical specification,
followed by the group selection, randomization and evaluated variables.
(3) Expected results: The primary outcome measurement is the modification
of life quality at the end of the CR exercise training program. Secondary
outcomes will encompass measurements of sternal stability, muscular
activity, cardiac response to exercise, pain level and
compliance/adherence to CR. (4) Conclusion(s): Implementing these
novel features of the CardioVR-ReTone system, addressability, and efficacy
of CR, so problematic in certain situations and especially in cardiac
surgery, will be greatly facilitated, being independent of the skills and
availability of the rehabilitation therapist. Copyright © 2021 by
the authors. Licensee MDPI, Basel, Switzerland. This article is an open
access article.

<55>
Accession Number
2015526628
Title
The Use of Non-Vitamin K Antagonist Oral Anticoagulants in Post-Kidney
Transplantation, Single-Center Experience.
Source
Transplantation Proceedings. (no pagination), 2021. Date of Publication:
2021.
Author
Zaitoun M.F.; Sheikh M.E.; Faifi A.S.A.; Mahedy A.W.; Nazer W.E.; El
Hennawy H.M.
Institution
(Zaitoun, Sheikh) Pharmaceutical Care Services, Armed Forces
Hospital-Southern Regions, Khamis Mushayt, Saudi Arabia
(Faifi, El Hennawy) Transplant Surgery Section, Surgery Department, Armed
Forces Hospital-Southern Regions, Khamis Mushayt, Saudi Arabia
(Mahedy, Nazer) Nephrology Department, Armed Forces Hospital-Southern
Regions, Khamis Mushayt, Saudi Arabia
(Mahedy) Internal Medicine Department, Faculty of Medicine, Benah
University, Egypt
Publisher
Elsevier Inc.
Abstract
Background: Novel oral anticoagulants (NOACs) are widely used alternatives
to warfarin, because they do not require routine monitoring and have
better safety profile. There is limited experience for NOACs in organ
transplant recipients. Method(s): This study assessed NOAC safety and
efficacy among renal transplant recipients in a single center. A
retrospective matched cohort study was conducted among the adult renal
transplant recipients concomitantly administered calcineurin inhibitors
(tacrolimus or cyclosporin) and NOACs between November 2015 and December
2019. Result(s): The study included 16 patients divided into 2 equal
groups on NOACs and warfarin. Male patients constitute 50% and 75% of the
NOAC group and warfarin group, respectively, and 75% and 87.5% of cases
are post living donor transplants in the NOAC group and warfarin group,
respectively. In the NOAC group, the most common indication for
anticoagulation was atrial fibrillation (62.5%), followed by deep vein
thrombosis (37.5%), whereas in the warfarin group, the most common
indication was atrial fibrillation (50%), followed by valve replacement
(25%). In the NOAC group, 6 patients (75%) received rivaroxaban, 1 patient
(12.5%) received dabigatran, and 1 patient (12.5%) received apixaban;
68.75% of patients were on a tacrolimus-based regimen. There were no
thromboembolic events, rejection episodes, bleeding, or admissions due to
NOAC adverse events. There were 3 cases of bleeding in the warfarin group.
Calcineurin inhibitor levels and estimated glomerular filtration rate did
not change significantly in the NOAC group (P =.34 and.96, respectively).
 Conclusion(s): Compared to warfarin, NOACs are well tolerated and
effective for preventing and treating thromboembolic events in renal
transplant recipients. A larger randomized controlled study is
required. Copyright © 2021 Elsevier Inc.

<56>
Accession Number
2015508266
Title
Aortic Valve Repair Decreases Risks of VRE in AI at 10 Years: A Propensity
Score-Matched Analysis.
Source
Annals of Thoracic Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Jabagi H.; Chan V.; Ruel M.; Mesana T.G.; Boodhwani M.
Institution
(Jabagi, Chan, Ruel, Mesana, Boodhwani) Division of Cardiac Surgery,
University of Ottawa Heart Institute, Ottawa, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Aortic valve repair (AVr) has emerged as a feasible and
effective alternative to AV replacement (AVR) in patients with aortic
insufficiency (AI); however, little data exist comparing outcomes. Thus,
the objective of this study was to compare early and long-term
valve-related complications between AVr and AVR in the treatment of AI.
 Method(s): This was a single-center, retrospective study of all
patients (n = 417) undergoing AVr (n = 264) or AVR (n = 153) for primary
AI. Propensity matching using a 1:1 greedy matching algorithm identified
140 patients using 6 covariates (age, sex, left ventricular function,
size, presence of aortopathy, and urgency of operation) for comparison.
The primary outcome was a composite of all valve-related events (VREs),
including endocarditis, myocardial infarction stroke, transient ischemic
attack, thromboembolisms, bleeding, and AV reoperation. VREs were defined
as per published guidelines. Survival and freedom from VREs were reported
using the Kaplan-Meier method. Result(s): Propensity matching
identified 70 well-matched pairs with no major differences in baseline
demographics, comorbidities, or AI severity (P =.57). Perioperative
outcomes showed no significant differences in VREs (AVR 8 vs AVr 7; P
=.78) or mortality (AVR 3 vs AVr 1; P =.62). Event-free survival from the
primary outcome at 10 years was significantly better after AVr than after
AVR (82% vs 68%; P =.024), with no significant differences in 10-year
overall survival between groups (82% vs 72%; P =.29). No significant
differences in AI severity (P =.07) or reoperation rate (P =.44) were
detected between groups. Conclusion(s): This study demonstrated a
lower long-term risk of VREs with repair compared with replacement, with
low mortality and comparable durability. Further prospective randomized
control trials are necessary to formally compare outcomes and determine
superiority. Copyright © 2021 The Society of Thoracic Surgeons

<57>
Accession Number
2015508193
Title
Impact of High-Frequency Oscillatory Ventilation Combined With Volume
Guarantee on Lung Inflammatory Response in Infants With Acute Respiratory
Distress Syndrome After Congenital Heart Surgery: A Randomized Controlled
Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Zheng Y.-R.; Xie W.-P.; Liu J.-F.; Wu H.-L.; Xu N.; Huang S.-T.; Cao H.;
Chen Q.
Institution
(Zheng, Xie, Liu, Wu, Xu, Huang, Cao, Chen) Department of Cardiac Surgery,
Fujian branch of Shanghai Children's Medical Center, Fuzhou, China
(Zheng, Xie, Liu, Wu, Xu, Huang, Cao, Chen) Fujian Children's Hospital,
Fuzhou, China
(Zheng, Xie, Liu, Wu, Xu, Huang, Cao, Chen) Fujian Maternity and Child
Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou,
China
(Zheng, Xie, Liu, Wu, Xu, Huang, Cao, Chen) Fujian Key Laboratory of Women
and Children's Critical Diseases Research, Fujian Maternity and Child
Health Hospital, Fuzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: Congenital heart disease (CHD) after cardiopulmonary bypass
can cause systemic inflammation, and its degree is closely related to the
incidence of acute respiratory distress syndrome (ARDS). The purpose of
this study was to determine the effectiveness of high-frequency
oscillatory ventilation (HFOV) combined with volume guarantee (VG) in
reducing systemic inflammation in infants with ARDS after cardiopulmonary
bypass for congenital heart surgery. Design(s): A randomized
controlled trial. Setting(s): Single-center study in a tertiary
teaching hospital. Participant(s): A total of 58 infants with ARDS
after congenital heart surgery were eligible and were randomized to the
HFOV (n = 29) or the HFOV-VG (n = 29) between January 2020 and January
2021. Intervention(s): Tracheal aspirate samples for the measurement
of interleukin (IL)-6, IL-8, and tumor necrosis factor-alpha (TNF-alpha)
were obtained on days one, two, and three of HFOV or HFOV-VG ventilation.
 Measurements and Main Results: The authors found a significantly
increasing trend in the HFOV group mean values of IL-6, IL-8, and
TNF-alpha (p < 0.05 on days two and three v day one), and IL-6, IL-8, and
TNF-alpha levels were significantly higher on day three in the HFOV group
versus the HFOV+VG group (p < 0.05). In addition, the incidences of
hypocapnia and hypercapnia in infants supported with HFOV-VG were
significantly lower (p < 0.05). Furthermore, the postoperative mechanical
ventilation duration in the HFOV-VG group also was shorter than that in
the HFOV group (p < 0.05). Conclusion(s): Compared with HFOV alone,
HFOV-VG reduced proinflammatory systemic reactions after congenital
cardiac surgery, decreased the incidences of hypercapnia and hypocapnia,
and shortened the postoperative mechanical ventilation
duration. Copyright © 2021 Elsevier Inc.

<58>
Accession Number
2015507120
Title
Meta-Analysis Evaluating High-Sensitivity Cardiac Troponin T Kinetics
after Coronary Artery Bypass Grafting in Relation to the Current
Definitions of Myocardial Infarction.
Source
American Journal of Cardiology. (no pagination), 2021. Date of
Publication: 2021.
Author
Heuts S.; Denessen E.J.S.; Daemen J.H.T.; Vroemen W.H.M.; Sels J.-W.;
Segers P.; Bekers O.; van 't Hof A.W.J.; Maessen J.G.; van der Horst
I.C.C.; Mingels A.M.A.
Institution
(Heuts, Segers, Maessen) Department of Cardiothoracic Surgery
(Denessen, Vroemen, Bekers, Mingels) Department of Central Diagnostic
Laboratory
(Sels, van der Horst) Department of Intensive Care Medicine, and
(Sels, van 't Hof) Department of Cardiology, Maastricht University Medical
Center, Maastricht, Netherlands
(Denessen, Bekers, van 't Hof, Maessen, van der Horst, Mingels)
Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Daemen) Department of Surgery, and
(van 't Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
Elsevier Inc.
Abstract
Various definitions of myocardial infarction type 5 after coronary artery
bypass grafting (CABG) have been proposed (myocardial infarction [MI-5],
also known as peri-procedural MI), using different biomarkers and
different and arbitrary cut-off values. This meta-analysis aims to
determine the expected release of high-sensitivity cardiac troponin T
(hs-cTnT) after CABG in general and after uncomplicated surgery and
off-pump CABG in particular. A systematic search was applied to 3
databases. Studies on CABG as a single intervention and reporting on
postoperative hs-cTnT concentrations on at least 2 different time points
were included. All data on hs-cTnT concentrations were extracted, and mean
concentrations at various points in time were stratified. Eventually, 15
studies were included, encompassing 2,646 patients. Preoperative hs-cTnT
was 17 ng/L (95% confidence interval [CI] 13 to 20 ng/L). Hs-cTnT peaked
at 6 to 8 hours postoperatively (628 ng/L, 95% CI 400 to 856 ng/L; 45x
upper reference limit [URL]) and was still increased after 48 hours. In
addition, peak hs-cTnT concentration was 614 ng/L (95% CI 282 to 947 ng/L)
in patients with a definite uncomplicated postoperative course (i.e.,
without MI). For patients after off-pump CABG compared to on-pump CABG,
the mean peak hs-cTnT concentration was 186 ng/L (95% CI 172 to 200 ng/L,
13 x URL) versus 629 ng/L (95% CI 529 to 726 ng/L, 45 x URL),
respectively. In conclusion, postoperative hs-cTnT concentrations surpass
most of the currently defined cut-off values for MI-5, even in perceived
uncomplicated surgery, suggesting thorough reassessment. Hs-cTnT release
differences following on-pump CABG versus off-pump CABG were observed,
implying the need for different cut-off values for different surgical
strategies. Copyright © 2021 The Author(s)

<59>
Accession Number
2015506449
Title
Inconsistent Methodology as a Barrier to Meaningful Research Outputs From
Studies of Atrial Fibrillation After Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2021.
Date of Publication: 2021.
Author
Campbell N.G.; Wollborn J.; Fields K.G.; Lip G.Y.H.; Ruetzler K.;
Muehlschlegel J.D.; O'Brien B.
Institution
(Campbell) Division of Cardiovascular Sciences, University of Manchester,
Manchester Academic Health Science Centre, Manchester, United Kingdom
(Wollborn, Fields, Muehlschlegel) Department of Anesthesiology,
Perioperative and Pain Medicine, Brigham, and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Lip) Liverpool Centre for Cardiovascular Science, University of Liverpool
and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
(Lip) Department of Clinical Medicine, Aalborg University, Aalborg,
Denmark
(Ruetzler) Anesthesiology Institute, Departments of Outcomes Research and
General Anesthesiology, Cleveland Clinic, Cleveland, OH, United States
(Ruetzler, O'Brien) Outcomes Research Consortium, Cleveland, OH, United
States
(O'Brien) Department of Cardiac Anesthesiology and Intensive Care
Medicine, German Heart Center Berlin, Berlin, Germany
(O'Brien) Department of Cardiac Anesthesiology and Intensive Care
Medicine, Charite Universitatsmedizin, Berlin, Germany
(O'Brien) Department of Perioperative Medicine, St. Bartholomew's
Hospital, London, United Kingdom
Publisher
W.B. Saunders
Abstract
Atrial fibrillation after cardiac surgery (AFACS) is a serious
postoperative complication. There is significant research interest in this
field but also relevant heterogeneity in reported AFACS definitions and
approaches used for its identification. Few data exist on the extent of
this variation in clinical studies. The authors reviewed the literature
since 2001 and included manuscripts reporting outcomes of AFACS in adults.
They excluded smaller studies and studies in which patients did not
undergo a sternotomy. The documented protocol in each manuscript was
analyzed according to six different categories to determine how AFACS was
defined, which techniques were used to identify it, and the inclusion
and/or exclusion criteria. They also noted when a category was not
described in the documented protocol. The authors identified 302 studies,
of which 92 were included. Sixty-two percent of studies were randomized
controlled trials. There was significant heterogeneity in the manuscripts,
including the exclusion of patients with preoperative AF, the definition
and duration of AF needed to meet the primary endpoint, the type of
screening approach (continuous, episodic, or opportunistic), the duration
of monitoring during the study period in days, the diagnosis with
predefined electrocardiogram criteria, and the requirement for independent
confirmation by study investigators. Furthermore, the definitions of these
criteria frequently were not described. Consistent reporting standards for
AFACS research are needed to advance scientific progress in the field. The
authors here propose pragmatic standards for trial design and reporting
standards. These include adequate sample size estimation, a clear
definition of the AFACS endpoints, and a protocol for AFACS
detection. Copyright © 2021 Elsevier Inc.

<60>
Accession Number
2013604510
Title
Effect of music therapy on infants who underwent mechanical ventilation
after cardiac surgery.
Source
Journal of Cardiac Surgery. 36(12) (pp 4460-4464), 2021. Date of
Publication: December 2021.
Author
Huang Y.-L.; Lei Y.-Q.; Xie W.-P.; Cao H.; Yu X.-R.; Chen Q.
Institution
(Huang, Lei, Xie, Cao, Yu, Chen) Department of Cardiac Surgery, Fujian
Branch of Shanghai Children's Medical Center, Fuzhou, China
(Huang, Lei, Xie, Cao, Yu, Chen) Fujian Children's Hospital, Fuzhou, China
(Huang, Lei, Xie, Cao, Yu, Chen) Fujian Maternity and Child Health
Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
(Huang, Lei, Xie, Cao, Yu, Chen) Fujian Key Laboratory of Women and
Children's Critical Diseases Research, Fujian Maternity and Child Health
Hospital, Fuzhou, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: To investigate the effect of music therapy on infants who
underwent mechanical ventilation after cardiac surgery. Method(s): A
prospective randomized controlled study was conducted in a provincial
hospital in southeast China. The subjects were randomly divided into the
music therapy (MT) group and the control group. Both groups were given
standardized sedation treatment and routine nursing. Infants in the MT
group received 60 min of MT three times a day. The sedation medication,
Richmond sedation agitation scale (RASS) score, incidence of delirium,
mechanical ventilation duration, length of cardiac intensive care unit
(CICU) stay, restraint belt use time, and successful ventilation
withdrawal rate were collected. Result(s): Infants in the control
group had a higher total amount of on-demand midazolam (p =.039). Infants
in the MT group had a significantly lower incidence of delirium, shorter
mechanical ventilation duration, and restraint band use time (p =.047, p
=.046, and p =.038, respectively). Although infants in the MT group had a
higher success rate of ventilation withdrawal, lower RASS scores, and
shorter ICU stay, the difference was not statistically significant (p
=.427, p =.585, and p =.068, respectively). Conclusion(s): MT in the
ICU can reduce the use of on-demand sedative drugs, shorten mechanical
ventilation, and reduce the occurrence of delirium in infants who
underwent mechanical ventilation after cardiac surgery. MT is a safe and
reliable treatment and worthy of clinical application. Copyright
© 2021 Wiley Periodicals LLC

<61>
Accession Number
2013550184
Title
Effect of variability of central venous pressure values to prevent atrial
fibrillation after coronary bypass grafting.
Source
Caspian Journal of Internal Medicine. 12(3) (pp 299-306), 2021. Date of
Publication: 2021.
Author
Hamidi S.H.; Faghanzadeh-Ganji G.; Baghaeian A.; Bijani A.; Pourkia R.
Institution
(Hamidi, Faghanzadeh-Ganji, Bijani, Pourkia) Clinical Research Development
Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol,
Iran, Islamic Republic of
(Baghaeian) Department of Obstetrics and Gynecology, Babol University of
Medical Sciences, Babol, Iran, Islamic Republic of
Publisher
Babol University of Medical Sciences
Abstract
Background: Atrial fibrillation is an arrhythmia that results from
abnormal depolarization of the atrium. Atrial fibrillation occurs in 5-40%
of patients with cardiovascular bypass surgery, usually occurs on 2 to 4
days postoperatively. The aim of this study was Effect of variability of
central venous pressure values to prevent atrial fibrillation after
coronary bypass grafting. Method(s): The present clinical trial study
was performed on 150 patients undergoing cardiac surgery referred to
Ayatollah Rohani Hospital of Babol. Patients were divided into 3 groups,
with normal range pressure (8 to 12 mmHg), low pressure (less than 8),
high pressure (greater than 12) based on central venous pressure
measurements. Patients were evaluated every 4 hours to 72 hours for
central venous pressure, AF incidence and urine output. Finally, the data
are analyzed by spss statistical software. Result(s): In this study
79 (52.7%) patients were male and 71 (47.3%) were female. In examining
changes in central venous pressure, the time effect also significantly
increased central venous pressure. The results of independent t-test
showed that the mean of central venous pressure changes in subjects with
at day 16, second day at 16, 20, 24, third day at 4, 8, 12, 16, 20 and 24
hours Atrial fibrillation. Significantly more than those without
atrialfibrillation (P<0.05). Conclusion(s): In the study, central
venous pressure changes the effect of time significantly increases the
central venous pressure. Individuals with atrial fibrillation also had
significantly greater central venous pressure changes than those without
atrial fibrillation. Copyright © 2020, Babol University of
Medical Sciences.

<62>
Accession Number
2011488260
Title
Comparative Trial of the Effects of Left Ventricular and Biventricular
Pacing on Indices of Cardiac Function and Clinical Course of Patients With
Heart Failure: Rationale and Design of the READAPT Randomized Trial.
Source
Angiology. 72(10) (pp 961-970), 2021. Date of Publication: November 2021.
Author
Dilaveris P.; Antoniou C.-K.; Chrysohoou C.; Xydis P.; Konstantinou K.;
Manolakou P.; Kordalis A.; Gatzoulis K.; Tsioufis C.
Institution
(Dilaveris, Antoniou, Chrysohoou, Xydis, Konstantinou, Manolakou,
Kordalis, Gatzoulis, Tsioufis) First University, Department of Cardiology,
Hippokration Hospital, Athens, Greece
Publisher
SAGE Publications Inc.
Abstract
Nonresponse to cardiac resynchronization therapy (CRT) has been related
with right ventricular dysfunction. Ventriculoarterial coupling (VAC)
assesses energy efficiency of the failing heart and stroke work
maximization for a given contractility, for both systemic and pulmonary
circulations. Preferential left ventricular pacing (pLVP) can overcome
iatrogenic right ventricular dysfunction by achieving left ventricle
resynchronization and by allowing for intrinsic activation of the right
side, with ramifications extending beyond cardiac output and atrial
fibrillation occurrence. In the present article, we detail the design of a
single-center randomized clinical trial to evaluate the effects of a pLVP
algorithm. More specifically, following randomization of 220 CRT-eligible
patients to standard biventricular pacing and pLVP, their clinical course
will be followed for 12 months, through echocardiography to study indices
of systolic and diastolic function of ventricles, left and right side VAC
to evaluate efficiency, and cardiopulmonary exercise test to objectively
document improvements in functional status, as well as a self-reported
quality of life questionnaire. Device programming will be based on
echocardiography-evaluated maximization of stroke volume and subsequent
interventricular and atrioventricular delay adjustments delegated to the
device. Findings of this trial may provide evidence for alternative
programming of the devices, linking pLVP to improved clinical
outcomes. Copyright © The Author(s) 2021.

<63>
Accession Number
635085858
Title
Frequency of Preoperative Advance Care Planning for Older Adults
Undergoing High-risk Surgery: A Secondary Analysis of a Randomized
Clinical Trial.
Source
JAMA Surgery. 156(7) (no pagination), 2021. Date of Publication: July
2021.
Author
Kalbfell E.; Kata A.; Buffington A.S.; Marka N.; Brasel K.J.; Mosenthal
A.C.; Cooper Z.; Finlayson E.; Schwarze M.L.
Institution
(Kalbfell, Buffington, Marka, Schwarze) Department of Surgery, University
of Wisconsin-Madison, United States
(Kata) Department of Surgery, Georgetown University Hospital, Washington,
DC, United States
(Brasel) Department of Surgery, Oregon Health and Science University,
Portland, United States
(Mosenthal) Department of Surgery, Rutgers New Jersey Medical School,
Newark, NJ, United States
(Cooper) Department of Surgery, Brigham and Women's Hospital, Boston, MA,
United States
(Finlayson) Department of Surgery, University of California, San
Francisco, United States
Publisher
American Medical Association
Abstract
Importance: For patients facing major surgery, surgeons believe
preoperative advance care planning (ACP) is valuable and routinely
performed. How often preoperative ACP occurs is unknown.
 Objective(s): To quantify the frequency of preoperative ACP
discussion and documentation for older adults undergoing major surgery.
 Design, Setting, and Participant(s): This secondary analysis of data
from a multisite randomized clinical trial testing the effects of a
question prompt list intervention on preoperative communication for older
adults considering major surgery was performed at 5 US academic medical
centers. Participants included surgeons who routinely perform high-risk
surgery and patients 60 years or older with at least 1 comorbidity and an
oncological or vascular (cardiac, peripheral, or neurovascular) problem.
Data were collected from June 1, 2016, to November 30, 2018.
 Intervention(s): Patients received a question prompt list brochure
with 11 questions that they might ask their surgeon. Main Outcomes
and Measures: For patients who had major surgery, any statement related to
ACP from the surgeon, patient, or family member during the audiorecorded
preoperative consultation was counted. The presence of a written advance
directive (AD) in the medical record at the time of the initial
consultation or added preoperatively was recorded. Open-ended interviews
with patients who experienced postoperative complications and family
members were conducted. Result(s): Among preoperative consultations
with 213 patients (122 men [57%]; mean [SD] age, 72 [7] years), only 13
conversations had any discussion of ACP. In this cohort of older patients
with at least 1 comorbid condition, 141 (66%) did not have an AD on file
before major surgery; there was no significant association between the
presence of an AD and patient age (60-69 years, 26 [31%]; 70-79 years, 31
[33%]; >=80 years, 15 [42%]; P =.55), number of comorbidities (1, 35
[32%]; 2, 18 [33%]; >=3, 19 [40%]; P =.62), or type of procedure
(oncological, 53 [32%]; vascular, 19 [42%]; P =.22). There was no
difference in preoperative communication about ACP or documentation of an
AD for patients who were mailed a question prompt list brochure
(intervention, 38 [35%]; usual care, 34 [33%]; P =.77). Patients with
complications were enthusiastic about ACP but did not think it was
important to discuss their preferences for life-sustaining treatments with
their surgeon preoperatively. Conclusions and Relevance: Although
surgeons believe that preoperative discussion of patient preferences for
postoperative life-sustaining treatments is important, these preferences
are infrequently explored, addressed, or documented preoperatively. Trial
Registration: ClinicalTrials.gov Identifier: NCT02623335. Copyright
© 2021 American Medical Association. All rights reserved.

<64>
Accession Number
2015109159
Title
Comparison of ECMO vs ECpella in patients with non post-pericardiotomy
cardiogenic shock: An updated meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2021. Date of
Publication: 2021.
Author
Iannaccone M.; Venuti G.; di Simone E.; De Filippo O.; Bertaina M.;
Colangelo S.; Boccuzzi G.; de Piero M.E.; Attisani M.; Barbero U.; Zanini
P.; Livigni S.; Noussan P.; D'Ascenzo F.; de Ferrari G.M.; Porto I.;
Truesdell A.G.
Institution
(Iannaccone, di Simone, Bertaina, Colangelo, Boccuzzi, Zanini, Noussan)
Division of Cardiology, San Giovanni Bosco Hospital, ASL Citta di Torino,
Turin, Italy
(Venuti) Division of Cardiology, A.O. Papardo, Messina, Italy
(De Filippo, Attisani, D'Ascenzo, de Ferrari) Division of Cardiology,
Citta della Scienza e della Salute, University of Turin, Turin, Italy
(de Piero, Livigni) Department of Anesthesiology and Intensive Care, San
Giovanni Bosco Hospital, ASL Citta di Torino, Turin, Italy
(Barbero) Division of Cardiology, Sevigliano ASL CN1, Italy
(Porto) Cardiovascular Disease Unit, IRCCS Policlinic Hospital San
Martino, Genova, Italy
(Truesdell) Virginia Heart/Inova Heart and Vascular Institute, Falls
Church, VA, United States
Publisher
Elsevier Inc.
Abstract
Introduction: The impact of Impella and ECMO (ECPELLA) in cardiogenic
shock (CS) remains to be defined. The aim of this meta-analysis is to
evaluate the benefit of ECPELLA compared to VA-ECMO in patients with non
post-pericardiotomy CS. Method(s): All studies reporting short term
outcomes of ECpella or VA ECMO in non post-pericardiotomy CS were
included. The primary endpoint was 30-day mortality. Vascular and bleeding
complications and LVAD implantation/heart transplant within 30-days were
assessed as secondary outcomes. Result(s): Of 407 studies identified,
13 observational studies (13,682 patients, 13,270 with ECMO and 412 with
ECpella) were included in this analysis. 30-day mortality was 55.8%
(51.6-59.9) in the VA-ECMO group and 58.3% (53.5-63.0) in the ECpella
group. At meta-regression analysis the implantation of IABP did not affect
mortality in the ECMO group. The rate of major bleeding in patients on
VA-ECMO and ECpella support were 21.3% (16.9-26.5) and 33.1% (25.9-41.2)
respectively, while the rates of the composite outcome of LVAD
implantation and heart transplantation within 30-days in patients on
VA-ECMO and ECpella support were 14.4% (9.0-22.2) and 10.8%. When directly
compared in 3 studies, ECpella showed a positive effect on 30-day
mortality compared to ECMO (OR: 1.81: 1.039-3.159). Conclusion(s):
Our data suggest that ECpella may reduce 30-day mortality and increase
left ventricle recovery, despite increased of bleeding
rates. Copyright © 2021 Elsevier Inc.

<65>
Accession Number
2014077915
Title
Safety of direct oral anticoagulants in solid organ transplant recipients:
A meta-analysis.
Source
Clinical Transplantation. (no pagination), 2021. Date of Publication:
2021.
Author
Zakko J.; Ganapathi A.M.; Whitson B.A.; Mokadam N.A.; Henn M.C.; Lampert
B.; Kahwash R.; Franco V.; Haas G.; Emani S.; Hasan A.; Vallakati A.
Institution
(Zakko) Department of Surgery, The Ohio State University Wexner Medical
Center, Columbus, OH, United States
(Ganapathi, Whitson, Mokadam, Henn) Department of Surgery, Division of
Cardiac Surgery, The Ohio State University Wexner Medical Center,
Columbus, OH, United States
(Lampert, Kahwash, Franco, Haas, Emani, Hasan, Vallakati) Department of
Internal Medicine, Division of Cardiology, The Ohio State University
Wexner Medical Center, Columbus, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
There is limited evidence comparing direct oral anticoagulants (DOACs) and
warfarin in solid organ transplant (SOT) recipients. We performed a pooled
analysis to study the safety and efficacy of DOACs in this patient
population. We searched PubMed, Embase, and Scopus databases using the
search terms "heart transplant" or "lung transplant" or "liver transplant"
or "kidney transplant" or "pancreas transplant" and "direct oral
anticoagulant" for literature search. Random effects model with
Mantel-Haenszel method was used to pool the outcomes. Pooled analysis
included 489 patients, of which 259 patients received DOACs and 230
patients received warfarin. When compared to warfarin, the use of DOACs
was associated with decreased risk of composite bleed (RR.49, 95%
CI.32-.76, p =.002). There were no differences in rates of major bleeding
(RR.55, 95% CI.20-1.49, p =.24) or venous thromboembolism (RR.65, 95%
CI.25-1.70, p =.38) between the two groups. Evidence from pooled analysis
suggests that DOACs are comparable to warfarin in terms of safety in SOT
recipients. Further research is warranted to conclusively determine
whether DOACs are safe alternatives to warfarin for anticoagulation in SOT
recipients. Copyright © 2021 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<66>
Accession Number
2010407138
Title
Balloon versus self-expandable transcatheter aortic valve implantation for
bicuspid aortic valve stenosis: A meta-analysis of observational studies.
Source
Catheterization and Cardiovascular Interventions. 98(5) (pp E746-E757),
2021. Date of Publication: 01 Nov 2021.
Author
Michel Pompeu B.O. S.a.; Simonato M.; Van den Eynde J.; Cavalcanti L.R.P.;
Alsagheir A.; Tzani A.; Fovino L.N.; Kampaktsis P.N.; Gallo M.; Laforgia
P.L.; Ruhparwar A.; Weymann A.; Hirji S.A.; Kaneko T.; H. L. Tang G.
Institution
(Michel Pompeu B.O., Cavalcanti) Division of Cardiovascular Surgery of
Pronto Socorro Cardiologico de Pernambuco-PROCAPE, University of
Pernambuco, Recife, Pernambuco, Brazil
(Simonato) Division of Cardiac Surgery, Escola Paulista de
Medicina-UNIFESP, Sao Paulo, Sao Paulo, Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Alsagheir) Division of Cardiac Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Alsagheir) Division of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Tzani) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Fovino) Department of Cardiac, Thoracic and Vascular Sciences and Public
Health, University of Padova, Padova, Italy
(Kampaktsis) NYU Langone Medical Center, United States
(Gallo) Department of Cardiac Surgery, Cardiocentro Ticino, Lugano,
Switzerland
(Laforgia) I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan,
Italy
(Ruhparwar, Weymann) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University Duisburg-Essen, Essen, Germany
(Hirji, Kaneko) Division of Cardiac Surgery, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(H. L. Tang) Department of Cardiovascular Surgery, Mount Sinai Medical
Center, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: There is a rising trend for transcatheter aortic valve
implantation (TAVI) in bicuspid aortic stenosis patients. Data on the use
of self-expandable (SEV) vs. balloon-expandable (BEV) valves in these
patients are scarce. Therefore, we systematically compared clinical
outcomes in bicuspid aortic stenosis patients treated with SEV and BEV.
 Method(s): Data were extracted from PubMed/MEDLINE, EMBASE,
CENTRAL/CCTR, ClinicalTrials.gov, SciELO, LILACS, Google Scholar and
reference lists of relevant articles. Eight studies published from 2013 to
2020 including a total of 1,080 patients (BEV: n = 620; SEV: n = 460) were
selected. Primary endpoints were procedural, 30-day and 1-year mortality.
Secondary endpoints were new pacemaker implantation, annular rupture,
coronary obstruction, moderate-to-severe paravalvular leak, need of second
valve, stroke and acute kidney injury. Result(s): We found no
statistically significant difference in mortality between patients treated
with BEV vs. SEV during index procedure, at 30 days and at 1 year. BEVs
showed a statistically significant higher risk of annulus rupture (2.5%)
in comparison with SEV (0%) (OR 5.81 [95% CI, 3.78-8.92], p <.001). New
generation BEVs were also associated with significantly less paravalvular
leak when compared to new generation SEVs (OR 0.08 [95% CI, 0.02-0.35], p
=.001). Conclusion(s): This meta-analysis of observational studies of
TAVI for bicuspid valves, showed no difference in short- and mid-term TAVI
mortality with BEVs and SEVs. BEVs presented a higher risk of annular
rupture in comparison with SEV. Copyright © 2021 Wiley
Periodicals LLC.

<67>
Accession Number
636355839
Title
Transcatheter mitral valve replacement for degenerated mitral valve
bioprostheses, failure of mitral valvuloplasty and native valve with
severe mitral annulus calcification: a systematic review and
meta-analysis.
Source
Journal of cardiothoracic surgery. 16(1) (pp 293), 2021. Date of
Publication: 10 Oct 2021.
Author
You T.; Wang W.; Yi K.; Gao J.; Zhang X.; He S.-E.; Xu X.-M.; Ma Y.-H.; Li
X.-Y.
Institution
(You, Yi) Department of Cardiovascular Surgery, Gansu Provincial Hospital,
No. 204, Donggang West RoadGansu Province 730000, China
(You, Wang, Yi, Gao, Zhang, He, Xu, Ma, Li) Gansu International Scientific
and Technological Cooperation Base of Diagnosis and Treatment of
Congenital Heart Disease, Lanzhou, China
(Wang, Gao, Xu, Ma, Li) First Clinical Medical College of Lanzhou
University, Lanzhou, China
(Zhang) First School of Clinical Medical of Gansu University of Chinese
Medicine, Lanzhou, China
(He) Second Clinical Medical College of Lanzhou University, Lanzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Although transcatheter technology has achieved some success in
the field of mitral valves, the feasibility of applying it to patients
with degenerated mitral valve bioprostheses (valve-in-valve, ViV), failure
of mitral valvuloplasty (valve-in-ring, ViR) and serious mitral annulus
calcification (vale-in-MAC, ViMAC) has not been effectively evaluated.
 METHOD(S): By searching published literature before December 5, 2020
in four databases, we found all the literature related to the evaluation
of feasibility assessment of TMViV, TMViR and TMViMAC. Outcomes focused on
all-cause mortality within 30 days, bleeding and LVOT obstruction.
 RESULT(S): A total of six studies were included, and all of them were
followed up for at least 30 days. After analysis of the ViV-ViR group, we
obtained the following results: the all-cause mortality within 30 days of
the ViV group was lower than that of the ViR group. Life-threatening or
fatal bleeding was more likely to occur in the ViR group after surgery. At
the same time, the ViR group was more prone to left ventricular outflow
tract obstruction. However, in the ViMAC-ViR group, only the all-cause
mortality within 30 days and stroke were statistically significant. In the
indirect comparison, we found that TMViV had the best applicability,
followed by TMViR. There were few TMViMAC available for analysis, and it
requires further studies to improve the accuracy of the results.
 CONCLUSION(S): TMViV and TMViR had good applicability and could
benefit patients who underwent repeat valve surgery. The feasibility of
TMViMAC needs to be further explored and improved. Copyright ©
2021. The Author(s).

<68>
Accession Number
2014448980
Title
Short-term pre-operative protein caloric restriction in elective vascular
surgery patients: A randomized clinical trial.
Source
Nutrients. 13(11) (no pagination), 2021. Article Number: 4024. Date of
Publication: November 2021.
Author
Kip P.; Sluiter T.J.; Moore J.K.; Hart A.; Ruske J.; O'leary J.; Jung J.;
Tao M.; Macarthur M.R.; Heindel P.; de Jong A.; de Vries M.R.; Burak M.F.;
Mitchell S.J.; Mitchell J.R.; Ozaki C.K.
Institution
(Kip, Sluiter, Hart, Ruske, O'leary, Tao, Heindel, Burak, Ozaki)
Department of Surgery and the Heart and Vascular Center, Brigham & Women's
Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115,
United States
(Kip, Sluiter, Jung, Macarthur, Burak, Mitchell, Mitchell) Department of
Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston,
MA 02115, United States
(Kip, Sluiter, de Jong, de Vries) Einthoven Laboratory for Experimental
Vascular Medicine, Department of Surgery, Leiden University Medical
Center, Leiden 2333 ZC, Netherlands
(Moore) Department of Systems Biology, Harvard Medical School, Boston, MA
02115, United States
(Jung) School of Medicine, University of Glasgow, Glasgow G12 8QF, United
Kingdom
(Macarthur, Mitchell, Mitchell) Department of Health Sciences and
Technology, ETH Zurich, Zurich 8092, Switzerland
Publisher
MDPI
Abstract
(1) Background: Vascular surgery operations are hampered by high failure
rates and frequent occurrence of peri-operative cardiovascular
complications. In pre-clinical studies, pre-operative restriction of
proteins and/or calories (PCR) has been shown to limit
ischemia-reperfusion damage, slow intimal hyperplasia, and improve
metabolic fitness. However, whether these dietary regimens are feasible
and safe in the vascular surgery patient population remains unknown. (2)
Methods: We performed a randomized controlled trial in patients scheduled
for any elective open vascular procedure. Participants were randomized in
a 3:2 ratio to either four days of outpatient pre-operative PCR (30%
calorie, 70% protein restriction) or their regular ad-libitum diet. Blood
was drawn at baseline, pre-operative, and post-operative day 1 timepoints.
A leukocyte subset flow cytometry panel was performed at these timepoints.
Subcutaneous/perivascular adipose tissue was sampled and analyzed.
Follow-up was one year post-op. (3) Results: 19 patients were enrolled, of
whom 11 completed the study. No diet-related reasons for non-completion
were reported, and there was no intervention group crossover. The PCR diet
induced weight loss and BMI decrease without malnutrition. Insulin
sensitivity was improved after four days of PCR (p = 0.05). Between diet
groups, there were similar rates of re-intervention, wound infection, and
cardiovascular complications. Leukocyte populations were maintained after
four days of PCR. (4) Conclusion(s): Pre-operative PCR is safe and
feasible in elective vascular surgery patients. Copyright © 2021
by the authors. Licensee MDPI, Basel, Switzerland.

<69>
Accession Number
2014158266
Title
Sugammadex, neostigmine and postoperative pulmonary complications: an
international randomised feasibility and pilot trial.
Source
Pilot and Feasibility Studies. 7(1) (no pagination), 2021. Article Number:
200. Date of Publication: December 2021.
Author
Leslie K.; Chan M.T.V.; Darvall J.N.; De Silva A.P.; Braat S.; Devlin
N.J.; Peyton P.J.; Radnor J.; Lam C.K.M.; Sidiropoulos S.; Story D.A.
Institution
(Leslie, Darvall, Peyton, Sidiropoulos, Story) Department of Critical
Care, Melbourne Medical School, University of Melbourne, Melbourne,
Australia
(Leslie, Darvall) Department of Anaesthesia and Pain Management, Royal
Melbourne Hospital, Melbourne, Australia
(Chan) Department of Anaesthesia and Intensive Care, Chinese University of
Hong Kong, The Prince of Wales Hospital, Hong Kong
(De Silva, Braat) Centre for Epidemiology and Biostatistics, Melbourne
School of Population and Global Health, University of Melbourne,
Melbourne, Australia
(De Silva, Braat) Methods and Implementation Support for Clinical and
Health (MISCH) Research Hub, Faculty of Medicine, Dentistry and Health
Sciences, University of Melbourne, Melbourne, Australia
(Devlin) Health Economics Unit, Melbourne School of Population and Global
Health, Melbourne, Australia
(Peyton, Sidiropoulos, Story) Department of Anaesthesia, Austin Health,
Melbourne, Australia
(Radnor) Department of Anaesthesia and Pain Management, Northeast Health
Wangaratta, Wangaratta, Australia
(Lam) Department of Anaesthesia and Operating Room Services, Tuen Mun
Hospital, Hong Kong
Publisher
BioMed Central Ltd
Abstract
Background: Sugammadex reduces residual neuromuscular blockade after
anaesthesia, potentially preventing postoperative pulmonary complications.
However, definitive evidence is lacking. We therefore conducted a
feasibility and pilot trial for a large randomised controlled trial of
sugammadex, neostigmine, and postoperative pulmonary complications.
 Method(s): Patients aged >=40 years having elective or expedited
abdominal or intrathoracic surgery were recruited in Australia and Hong
Kong. Perioperative care was at the discretion of clinicians, except for
the use of rocuronium and/or vecuronium for neuromuscular blockade and the
randomised intervention (sugammadex or neostigmine) for reversal.
Feasibility measurements included recruitment, crossover, acceptability,
completeness, and workload. Trial coordinator feedback was systematically
sought. Patient-reported quality of life was measured using the EQ-5D-5L
score. The primary pilot outcome was the incidence of new pulmonary
complications up to hospital discharge (or postoperative day 7 if still in
hospital). Result(s): Among 150 eligible patients, 120 consented to
participate (recruitment rate 80%, 95% confidence interval [CI] 73 to
86%). The randomised intervention was administered without crossover to
115 of 117 patients who received reversal (98%, 95% CI 94 to 100%). The
protocol was acceptable or highly acceptable to the anaesthetist in 108 of
116 cases (93%, 95% CI 87 to 97%; missing = 4). Four patients of the 120
patients were lost to follow-up at 3 months (3.3%, 95% CI 0.9 to 8.3%).
Case report forms were complete at 3 months for all remaining patients.
The median time to complete trial processes was 3.5 h (range 2.5-4.5 h).
Trial coordinators reported no barriers to trial processes. Patients were
aged 64 (standard deviation 11) years, 70 (58%) were male and 50 (42%)
were female, and planned surgeries were thoracic (23 [19%]), upper
abdominal (41 [34%]), and lower abdominal (56 [47%]). The primary outcome
was observed in 5 (8.5%) of the 59 sugammadex patients and 5 (8.2%) of the
61 neostigmine patients (odds ratio 1.02, 95% CI 0.28 to 3.67).
 Conclusion(s): A large international randomised controlled trial of
sugammadex, neostigmine and postoperative pulmonary complications in adult
patients having abdominal and intrathoracic surgery, including collection
of cost-effectiveness evidence for Health Technology Appraisal, is
feasible. Trial registration: Prospectively registered at the Australian
and New Zealand Clinical Trials Registry (ACTRN12620001313921) on December
7, 2020.
www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380645&isReview=t
rue. Copyright © 2021, The Author(s).

<70>
Accession Number
2014142068
Title
Decellularized versus cryopreserved pulmonary allografts for right
ventricular outflow tract reconstruction during the Ross procedure: a
meta-analysis of short- and long-term outcomes.
Source
Egyptian Heart Journal. 73(1) (no pagination), 2021. Article Number: 100.
Date of Publication: December 2021.
Author
Ahmed A.; Ahmed S.; Varghese K.S.; Mathew D.M.; Pandey R.; Rogando D.O.;
Salazar S.A.; Fusco P.J.; Levy K.H.
Institution
(Ahmed, Varghese, Mathew, Rogando, Salazar, Fusco, Levy) CUNY School of
Medicine, 1589 Amsterdam Avenue, New York, NY 10031, United States
(Ahmed) New Dorp High School, New York, NY, United States
(Pandey) CUNY City College of New York, New York, NY, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The ideal conduit for repair of the right ventricular outflow
tract (RVOT) during the Ross procedure remains unclear and has yet to be
fully elucidated. We perform a pairwise meta-analysis to compare the
short-term and long-term outcomes of decellularized versus cryopreserved
pulmonary allografts for RVOT reconstruction during the Ross procedure.
Main body: After a comprehensive literature search, studies comparing
decellularized and cryopreserved allografts for patients undergoing RVOT
reconstruction during the Ross procedure were pooled to perform a pairwise
meta-analysis using the random-effects model. Primary outcomes were early
mortality and follow-up allograft dysfunction. Secondary outcomes were
reintervention rates and follow-up endocarditis. A total of 4 studies
including 1687 patients undergoing RVOT reconstruction during the Ross
procedure were included. A total of 812 patients received a decellularized
pulmonary allograft, while 875 received a cryopreserved pulmonary
allograft. Compared to cryopreserved allografts, the decellularized group
showed similar rates of early mortality (odds ratio, 0.55, 95% confidence
interval, 0.21-1.41, P = 0.22). At a mean follow-up period of 5.89 years,
no significant difference was observed between the two groups for
follow-up allograft dysfunction (hazard ratio, 0.65, 95% confidence
interval, 0.20-2.14, P = 0.48). Similarly, no difference was seen in
reintervention rates (hazard ratio, 0.54, 95% confidence interval,
0.09-3.12, P = 0.49) nor endocarditis (hazard ratio, 0.30, 95% confidence
interval, 0.07-1.35, P = 0.12) at a mean follow-up of 4.85 and 5.75 years,
respectively. Conclusion(s): Decellularized and cryopreserved
pulmonary allografts are associated with similar postoperative outcomes
for RVOT reconstruction during the Ross procedure. Larger
propensity-matched and randomized control trials are necessary to
elucidate the efficacy of decellularized allografts compared to
cryopreserved allografts in the setting of the Ross. Copyright ©
2021, The Author(s).

<71>
Accession Number
2014127445
Title
Mortality probabilities after revascularization and medical therapy in CAD
patients under 60 years old: a meta-analysis study.
Source
Egyptian Heart Journal. 73(1) (no pagination), 2021. Article Number: 99.
Date of Publication: December 2021.
Author
Afrouzi M.; Azar F.E.F.; Aboutorabi A.; Hajahmadi M.; Ebadi S.J.
Institution
(Afrouzi, Aboutorabi) Department of Health Economics, School of Health
Management and Information Sciences, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Azar) Health Promotion Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Hajahmadi) Cardiovascular Department, Rasoul Akram General Hospital, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ebadi) Qazvin Army Hospital 553, Qazvin, Iran, Islamic Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
To estimate death probabilities after coronary artery bypass graft (CABG),
percutaneous coronary intervention (PCI), and medical therapy (MT) in
patients under 60 years old. We conducted a search systematic on PubMed,
Embase, Cochrane Library, and Web of Science up to January 2021. The study
included three parts. In the probabilities part (A), Comprehensive
Meta-Analysis, and in the comparison parts (B and C), Review Manager was
used in conducting meta-analyses. Nine studies consisting of 16,410 people
with a mean age of 51.2 +/- 6 years were included in the meta-analysis.
Over a mean follow-up of 3.7 +/- 2 years, overall mortality after CABG,
PCI and MT was 3.6% (95% CI 0.021-0.061), 4.3% (95% CI 0.023-0.080) and
9.7% (95% CI 0.036-0.235), respectively. The length of follow-up periods
was almost the same and did not differ much (p = 0.19). In Part B (without
adjustment of baseline characteristics), 495 (4.0%) of 12,198 patients
assigned to CABG died compared with 748 (4.5%) of 16,458 patients assigned
to PCI (risk ratio [RR]: 0.77, 95% CI 0.50-1.20; p = 0.25). Seventy-four
(3.5%) of 2120 patients assigned to CABG and 68 (4.2%) of 1621 patients
assigned to PCI died compared with 103 (9.5%) of 1093 patients assigned to
MT in equal follow-up periods (CABG-MT: RR 0.34; 95% CI 0.23-0.51; p <
0.002) (PCI-MT: RR 0.40; 95% CI 0.30-0.53; p = 0.02). In Part C, overall
mortality after PCI in PACD patients with STEMI was higher in elderly
versus young (RR 2.64; 95% CI 2.11-3.30) and is lower in men versus women
(RR 0.61; 95% CI 0.44-0.83). Mortality probabilities obtained are one of
the most important factors of effectiveness in the economic evaluation
studies; these rates can be used to determine the cost-effectiveness of
procedures in CAD patients aged < 60 years. Copyright © 2021, The
Author(s).

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