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Accession Number
365300092
Title
Basal insulin and cardiovascular and other outcomes in dysglycemia.
Source
New England Journal of Medicine. 367(4) (pp 319-328), 2012. Date of
Publication: 26 Jul 2012.
Author
Gerstein H.C.; Bosch J.; Dagenais G.R.; Jung H.; Maggioni A.P.; Pogue J.;
Probstfield J.; Ramachandran A.; Riddle M.C.; Ryden L.E.; Yusuf S.;
Richardson L.; Diaz R.; Johnston P.; Vige R.; Birkeland K.; Budaj A.;
Cardona E.; Chazova I.; Commerford P.; Danilova L.; Davies M.; Fernando
R.; Fodor G.; Gilbert R.; Gomis R.; Hanefeld M.; Hildebrandt P.;
Kacerovsky-Bielesz G.; Keltai M.; Kim J.H.; Krum H.; Lanas F.; Lewis B.S.;
Lonn E.; Lopez-Jaramillo P.; Marin-Neto J.; Marre M.; McKelvie R.; McQueen
M.; Mendoza I.; Morillo C.; Pan C.; Pirags V.; Profozic V.; Ratner R.;
Rosenstock J.; Spinas G.A.; Sreenan S.; Stoel I.; Syvanne M.; Yale J.F.;
Avezum A.; Bahit M.C.; Bogaty P.; Bordeleau L.; Chacomicronn C.; Corson
M.; Harper W.L.; Halon D.; Magloire P.; Mann J.; Pavlova V.; Punthakee Z.;
Silva J.; Tsang B.; Yakubovich N.; Abdallah A.; Ahmad S.; Chandra J.;
Chandra R.; Cukierman-Yaffee T.; Dyal L.; Joldersma L.; MacRae L.; MacRae
S.; Malik S.; Mead A.; Pasha F.; Pazmino-Canizares J.; Pohl K.; Sakalas
A.; Tyrwhitt J.; Ahuad Guerrero R.; Alebuena A.; Alvarez N.; Alzogaray M.;
Amuchastegui M.; Andres M.; Angos M.; Baglivo H.; Barbieri M.; Bassi F.;
Bello F.; Bono J.; Bustamante Labarta M.; Bustos B.; Caccavo A.; Calveira
M.; Camino A.; Cantero M.; Capozzi M.; Cardone M.; Cartasegna L.;
Cassetari A.; Castellanos R.; Chavez Caballero R.; Cipullo M.; Contreras
A.; Coria J.; Corinaldesi F.; Costa G.; Crespo C.; Cruz M.; Cuello J.;
Cuneo C.; Del Corro I.; Diez R.; Dituro C.; Dominguez A.; Facta A.;
Faingold C.; Farah M.; Fares Taie A.; Fernandez A.; Ferrari A.; Ferrari
N.; Garcia Monteverde C.; Garrido M.; Giachello C.; Gonzalez M.; Gutierrez
N.; Guzman L.; Guzman P.; Hasbani E.; Henquin R.; Hershon A.; Hirschon
Alvarez Prado A.; Hominal M.; Hrabar A.; Imposti H.; La Grutta M.;
Lanchiotti P.; Lobo Marquez L.; Lopez Santi R.; Lowenstein J.; Lugo M.;
Luqueci M.; Mainini S.; Majul C.; Manzano R.; Manzur S.; Marcucci G.;
Marino M.; Massari F.; Mendez N.; Molina M.; Montana O.; Mulazzi M.;
Nardone L.; Odetto I.; Orlandini A.; Oviedo A.; Paez O.; Parnas A.; Patron
F.R.; Pedernera C.; Pelagagge M.; Plastino M.; Polari P.; Pomposiello J.;
Porta A.; Prado A.; Quiroz M.; Ramirez A.; Rodriguez M.; Ronderos R.; Sago
L.; Sanchez A.; Sanchez R.; Sandrin A.; Schygiel P.; Sernia V.; Sinay I.;
Smith Casabella T.; Sosa Liprandi A.; Sosa Liprandi M.; Soso L.; Sposetti
G.; Stisman D.; Streitenberger P.; Suarez G.; Tonin H.; Ulla M.; Valdez
J.; Vico M.; Villamil A.; Villarino A.; Viscaya Castro A.; Visco V.; Vogel
D.; Waisman F.; Zaidman C.; Amerena J.; Applebe A.; Aylward P.; Binnekamp
M.; Bruce I.; Burdeniuk C.; Burnet R.; Colman P.; Colquhoun D.; Davis S.;
De Looze F.; De Pasquale C.; D'Emden M.; Eaton H.; Farshid A.; Foulanos
S.; Galanos J.; Gordon G.; Guhu M.; Ho J.; Jeffery I.; Jerums G.; Kwan M.;
Lefkovits J.; Luu S.; MacIsaac R.; Marjason J.; Mohabbati V.; Nankervis
A.; O'Neal D.; Perera N.; Poynten A.; Rahman A.; Razak S.; Roberts T.;
Sebastian M.; Simpson R.; Soldatos G.; Sullivan D.; Teede H.; Tiong F.;
Topliss D.; Torpy D.; Waddell-Smith K.; Waites J.; Wenman J.; Whelan A.;
Williams L.; Yeap B.; Yeow W.; Yong G.; Aczel S.; Azimy N.; Bertha P.;
Blocher J.; Bohnel C.; Brath H.; Breuss J.; De Campo A.; Drexel H.;
Ettmuller Y.; Feder A.; Feinboeck C.; Gulz E.; Hofmann M.; Hoppichler F.;
Jahnel H.; Jankovic V.; Kann T.; Kathrein T.; Kotter T.; Kratz E.;
Kreuzwieser E.; Loreck C.; Ludvik B.; Marte T.; Mellitzer K.; Nistler S.;
Placher-Sorko G.; Prager R.; Rein P.; Riedl M.; Saly C.; Schernthaner G.;
Schichka E.; Seidlhofer C.; Sonnenfeld M.; Stefan H.; Steiner K.; Thomas
B.; Toplak H.; Urstoger K.; Vetter B.; Vonbank A.; Waldschutz W.; Wallner
F.; Winkler F.; Goncharik D.; Lazareva I.; Lichorad N.; Mrochek A.;
Murashko N.; Radyuk D.; Ramanovski A.; Sudzhaeva S.; Sujayeva V.;
Yarashevich N.; Campbell G.; Marshall S.; West A.; Abreu F.; Alves M.;
Ayoub-Aidar J.; Barros M.; Barros-Silveira J.; Blacher M.; Costa E.; Costa
F.; Daltro C.; Delana J.; Eliaschewitz F.; Facanha C.; Feitosa G.;
Figueiredo J.; Forti A.; Franco D.; Franken M.; Freire F.; Garcia V.;
Gouvea-Neto A.; Grofallo S.; Kanedlai N.; Kerr-Saraiva J.; Ladeira R.;
Leaes P.; Lemos M.; Lima F.; Lima Filho M.; Macedo L.; Manenti E.; Monte
O.; Mossman A.; Mothe F.; Mouco O.; Moyses Golbert M.; Nasser Hissa L.;
Nasser-Hissa M.; Nicolau J.; Nigro Maia L.; Ninno T.; Nunes C.; Oliveira
C.; Oliveira O.; Passos da silva R.; Pericles-Esteves J.; Rabelo L.;
Rabelo-Alves Junior A.; Rassi S.; Rech R.; Roldan F.; Salles J.; Sampaio
C.; Seabra A.; Sealissi N.; Seixas A.; Sena R.; Shehadeh I.; Teixeira M.;
Turin H.; Vicente Serrano C.; Vidigal M.; Vilela M.; Wajchenberg B.;
Abbott C.; Abu-Bakare A.; Ardilouze J.; Auersperg E.; Bailey A.; Bailey
G.; Baillargeon J.; Beaurivage C.; Belair J.; Belanger A.; Bellabarba D.;
Berlingieri J.; Bernier F.; Bhargava R.; Bhesania T.; Booth W.; Bose S.;
Boulianne M.; Bourgeois S.; Breton D.; Brossoit R.; Buithieu J.; Campeau
J.; Carlson B.; Carpentier A.; Cavalcanti R.; Cha J.; Chagnon P.; Chan Y.;
Chessex C.; Chiasson J.; Chouinard S.; Clayton D.; Conway J.; Crepeau J.;
Cudmore D.; D'Ignazio G.; Doig G.; Dominguez M.; Dube F.; Dumas R.; Dupuis
R.; Dyrda I.; Eddy D.; Eiley D.; Fox H.; Fratesi S.; Gallant S.; Garceau
C.; Garfield N.; Germain C.; Glazer S.; Gosselin G.; Gould D.; Grills G.;
Halle J.; Hardin P.; Harper W.; Heath J.; Heath V.; Hivert M.; Ho K.;
Houde G.; Hramiak I.; Hutchinson A.; Huynh T.; Ilie-Haynes R.; Imran S.;
Islam A.; Iwanochko M.; Jones C.; Joyce C.; Kirouac I.; Kumar R.; Lamothe
M.; Langlois M.; Lauzon C.; Lavoie M.; Leader R.; Lecours S.; Lepage S.;
Lochnan H.; Ma P.; McLean A.; Mecci S.; Mehta P.; Mercier M.; Miller D.;
Morisset A.; Nawaz S.; Nisker W.; Nyomba G.; O'Keefe D.; Palardy J.;
Parekh P.; Paul T.; Perron P.; Pesant M.; Phillips R.; Pruneau G.; Quintin
I.; Raby K.; Richard C.; Rosenfeld G.; Saulnier D.; Shaban J.; Shah A.;
Shu D.; Sigal R.; Silverman M.; Singh J.; Sivucha W.; Skamene A.;
Sliwowicz D.; Smith R.; St Hilaire R.; Steinson D.; Sussex B.; Tan K.;
Tannous R.; Telner A.; Theroux P.; Tsoukas C.; Tsoukas G.; van Buuren J.;
VanRossum N.; Vexler R.; Vizel S.; Warnica W.; Weingert M.; Wilson R.;
Wong W.; Woo V.; Yale J.; Acevedo M.; Alwyn C.; Baier E.; Baier S.;
Galloso R.; Lahsen R.; Lorenas G.; Montecinos A.; Montecinos M.; Pineda
P.; Pollak F.; Sapunar J.; Serrano V.; Stockins B.; Varleta P.; Yovanovich
J.; Zambra F.; Ba J.; Bao Y.; Bi Y.; Bu S.; Chen B.; Chen H.; Chen J.;
Chen L.; Chen M.; Chen Y.; Cui J.; Dong M.; Feng P.; Feng Z.; Gao C.; Gao
F.; Gao X.; Gao Z.; Gong Y.; Guang L.; Guo X.; Han F.; Han X.; Hou X.; Hu
R.; Ji L.; Jia J.; Jia W.; Jiao X.; Jin X.; Kuang J.; Li M.; Li Q.; Li X.;
Li Y.; Ling Y.; Liu F.; Liu Z.; Lu B.; Lu J.; Lu Z.; Lv X.; Ning G.; Peng
Y.; Ren Y.; Shao Y.; Shi Y.; Shu X.; Sun H.; Sun L.; Sun X.; Tang K.; Tian
H.; Wang C.; Wang F.; Wang L.; Wang Q.; Wang W.; Wang X.; Wang Y.; Wen J.;
Wu C.; Wu H.; Wu J.; Wu M.; Xing X.; Xue Y.; Yan L.; Yan S.; Yang H.; Yang
N.; Yang W.; Yang Z.; Yao J.; Yao L.; Yu D.; Yu H.; Yu M.; Yu X.; Yuan L.;
Yuan M.; Yuan S.; Yuan W.; Yuan Y.; Yuan Z.; Zeng T.; Zhang J.; Zhang R.;
Zhang X.; Zhao L.; Zheng B.; Zheng J.; Zhou W.; Zhu N.; Zhu Y.; Zou D.;
Zou J.; Accini J.L.; Bohorquez R.; Botero R.; Cure C.; Figueredo M.;
Hernandez E.; Kattah W.; Llamas A.; Orozco L.; Pava L.; Perez M.; Pineda
M.; Quintero A.; Quiros R.; Urina M.; Velez S.; Altabas V.; Baotic I.;
Berkovic M.; Goldoni V.; Kerum T.; Mirosevic G.; Tarle D.; Vidovic I.;
Zjacic-Rotkvic V.; Abbas R.; Andersen H.; Auscher S.; Baumbach L.;
Brockstedt H.; Christensen P.; Christiansen M.; Clemmensen K.; Egstrup K.;
Gislason G.; Haar D.; Hansen K.; Heden Andersen P.; Helleberg K.;
Hermansen K.; Holmer J.; Jeppesen J.; Klausen I.; Koustrup-Sonder T.;
Krarup T.; Lerche S.; Lervang H.; Linde B.; Lund P.; Lund S.; Madsbed S.;
Molvig J.; Orskov C.; Ostergaaard O.; Perrild H.; Pietraszek A.; Ralfkjaer
N.; Roenne H.; Rokkedal Nielsen J.; Seibaek M.; Soendergaard H.; Sorensen
L.; Sundahl Mortensen L.; Torp-Pedersen C.; Tuxen C.; Urhammer S.;
Vadstrup E.; Ambos A.; Janson A.; Rudenko P.; Viitas L.; Aranko S.; Badeau
M.; Eriksson J.; Haapamaki H.; Kajander O.; Kuusisto A.; Luukkonen S.;
Makela J.; Nieminen S.; Niskanen L.; Ripatti J.; Ruotsalainen S.; Saltevo
J.; Savela K.; Strand J.; Valle T.; Virkamaki A.; Aboud E.; Alavoine L.;
Bekherraz A.; Bohme P.; Bourezane H.; Catargi B.; Charpentier G.; Clergeot
A.; Courreges J.; Delmas T.; Duengler F.; Feknous C.; Gendre D.; Guerci
B.; Hadjadj S.; Kerlan V.; Laguerre N.; Le Potier J.; Lombardo F.;
Malville E.; Marechaud R.; Mattei C.; Moreira J.; Penfornis A.; Petit C.;
Pinel J.; Piquel X.; Raccah D.; Reznik Y.; Rod A.; Roudaut N.; Rousseau
E.; Schillo F.; Schmitt B.; Sonnet E.; Torremocha F.; Travert F.; Vanhoute
C.; Vimeux M.; Abdollahnia R.; Adamidou A.; Arslan S.; Bach-Kliegel B.;
Bartusch B.; Bauer N.; Bieler T.; Blankenfeld H.; Boeckmann U.; Busch K.;
Butzer R.; Chenchanna-Merzhaeuser M.; Denger R.; Deutsch C.; Diessel S.;
Donati-Hirsch I.; Dornisch M.; Enghofer K.; Fleig T.; Forst T.; Frommherz
M.; Goeller K.; Habbig J.; Hadziselimovic S.; Hamann A.; Hampel T.; Heger
S.; Helmes C.; Hoffman C.; Hohberg C.; Humpert P.; Kamke A.; Kamke W.;
Kindermann P.; Klein C.; Klein D.; Koehler A.; Kuehn A.; Langer K.; Limmer
S.; Loew A.; Maimer A.; Marck C.; Meier G.; Methner-Friederich M.; Metzler
W.; Meyer K.; Miftari N.; Milde J.; Minnich J.; Molkewehrum M.; Morcos M.;
Mueller-Hoff C.; Nguyen M.; Nishwitz M.; Oldenburg J.; Ott P.; Pauli K.;
Pauly B.; Pfeiffer A.; Pfuetzner A.; Pischa U.; Radke R.; Reismann P.;
Riemer M.; Rochlitz H.; Rudofsky G.; Ruhla S.; Sammler A.; Schaper F.;
Schiemenz K.; Scholz G.; Schumm-Draeger P.; Segiet T.; Segner A.; Seissler
J.; Spahn S.; Stier U.; Tonon G.; von Amelunxen S.; von Schacky C.;
Wilhelm B.; Wilhelm K.; Witt K.; Wuechner-Hofmann S.; Baranyai M.; Birkus
Z.; Foldesi I.; Gaal Z.; Harcsa E.; Hati K.; Hohmann Z.; Istenes I.;
Jozsef I.; Juhasz E.; Kempler P.; Keresztes B.; Keresztes K.; Kis-Gombos
P.; Kovacs I.; Kozma T.; Laszlo Z.; Noori E.; Nyirati G.; Papp Z.; Patkay
J.; Poor F.; Pusztai P.; Putz Z.; Rigo E.; Sereg M.; Simon K.; Somogyi A.;
Sumegi J.; Szabo A.; Szabo J.; Szigeti S.; Szilveszter D.; Tarko M.; Varga
C.; Varga Szabo L.; Voros P.; Arathi; Badgandi M.; Balaji M.; Aravind S.;
Chamukuttan S.; Devi Manduva P.; Fatima S.; Ganapathy B.; George O.;
George P.; Jaffar M.; Jain P.; Kamath P.; Karthik V.; Koshy G.; Krishnan
L.; Kumar H.; Lal P.; Mithal A.; Modi S.; Mohan V.; Moses V.; Oomen R.;
Pais P.; Pati P.; Pendsey S.; Rai P.; Rajagopal R.; Ramu M.; Ranjit U.;
Rao P.; Senthil V.; Seshaiah V.; Sethi B.; Shah P.; Sharma R.; Shetty S.;
Shobha A.; Siddharth R.; Sridhar G.; Sudeep K.; Sunil C.; Sunitha S.;
Suresh S.; Thomas N.; Vageesh A.; Anwer Z.; Barton J.; Behan L.; Bell M.;
Cullen M.; Dineen S.; Draman Yusof M.; Dunne F.; Gibney J.; Hussain T.;
Khan M.; Kinsley B.; Kyithar P.; Lavin F.; McGowan A.; McGurk C.; Mirza
A.; Mohammadi B.; O'Brien T.; O'Connell J.; O'Halloran D.; O'Shea D.;
Roberts G.; Tomkin G.; Wan Mahmood W.; Abramod-Ness R.; Adawi F.; Aharon
B.; Backer M.; Beniashvili A.; Berliner A.; Bloch L.; Bugelman D.; Butnaru
A.; Cohen O.; Cohen Y.; Frenkel M.; Glant M.; Gustava B.; Guttman H.;
Halabi S.; Harman-Boehm I.; Ilany J.; Karkabi B.; Khader N.; Khaskia A.;
Khudyak Y.; Klainman E.; Kogan N.; Lender D.; Levin I.; Mardi T.; Marmor
A.; Mosseri M.; Nabriski D.; Omary M.; Orlovsky S.; Peres D.; Quasim M.;
Raz I.; Remesnik M.; Rogowski O.; Rozenfeld I.; Scharr D.; Shnifer I.;
Shuster T.; Solomon R.; Steiner H.; Tzivoni D.; Wolfson N.; Yossef Z.;
Zahger D.; Zeltser D.; Zimlichman R.; Aina F.; Ariatti C.; Bonetti R.;
Cacciatore F.; Calcinaro F.; Corona G.; De Maria P.; Del Prato S.; Derosa
G.; Di Pasquale G.; Falorni A.; Fanelli R.; Fedele D.; Filorizzo G.;
Fogari R.; Furgi G.; Ghio A.; Giorda C.; Gregori G.; Iannuzzi G.; Lapolla
A.; Luciano B.; Lucotti P.; Maggi A.; Marafetti L.; Marchese T.; Martino
G.; Marzotti S.; Miccoli R.; Monti L.D.; Moretti L.; Palvarini M.;
Petacchi R.; Piarulli F.; Piatti P.M.; Rudi S.; Santeusanio F.; Sesti G.;
Setola E.; Sforza A.; Shehaj E.; Veniani M.; Viviani G.; Zigoura E.; Chae
S.; Cho D.; Cho E.; Cho Y.; Choi Y.; Chung M.; Hong E.; Hong Y.; Jeong M.;
Kim B.; Kim D.; Kim H.; Kim I.; Kim J.; Kim P.; Kim S.; Koo B.; Kwok S.;
Kwon H.; Lee J.; Lim J.; Oh S.; Ohn J.; Park C.; Park H.; Park K.; Seung
K.; Son H.; Woo J.; Yoon K.; Ansmite B.; Balcere I.; Bumbure A.; Ducena
K.; Lejnieks A.; Rasa I.; Ritenberga R.; Romanova M.; Salmina I.; Steina
S.; Badariene J.; Gailiuniene S.; Grigonis S.; Juskiene R.; Petrulioniene
Z.; Sakalyte G.; Stasiunas T.; Sulskiene M.; Urbonaite B.; Zarankiene R.;
Ziukaite R.; Arechavaleta R.; Beltran-Jaramillo T.; Calvo-Vargas C.;
Campillo-Cardenas C.; Cardona D.; Carmona-Huerta J.; Cedano-Limon M.;
Comellas-De M.; Dominguez C.; Gomez-Cruz J.; Gonzalez-Perez R.; Illescas
J.; Jimenez-Ramos S.; Lopez-Alvarado A.; Marquez-Rodriguez E.; Martinez
G.; Pascoe S.; Plascencia Vazquez O.; Rodriguez H.; Ruiz-Cornejo M.;
Velasco-Sanchez G.; Vidrio-Velazquez M.; Villeda-Espinosa E.; Badings E.;
Bartels G.; Bruggink-Andre de la Porte P.; Bruijns E.; Cornel J.; De
Milliano P.; De Mulder M.; De Swart J.; Derks A.; Dirkali A.; Droste J.;
Galjee M.; Hautvast R.; Hermans W.; Holwerda N.; Ilmer B.; Kofflard M.;
Kooistra-Huizer J.; Kurvers M.; Langerveld J.; Leenders C.; Liem A.; Lok
D.; Neumann D.; Nierop P.; Plomp K.; Posma J.; Reichert C.; Roeters Van
Lennep H.; Ronner E.; Said S.; Takens L.; Umans V.; Van der Sluis A.A.;
Van der Zwaan C.; Van Dobbenburgh J.; Van Es A.; Van Hessen M.; Van
Mechelen R.; Van Miltenburg-Van Zijl A.; Van Zeijl L.; Veerhoek M.;
Viergever E.; Weijers E.E.; Willems F.; Blix I.; Cooper J.; Debowska A.;
Erichsen K.; Fossum J.; Gjertsen E.; Grill V.; Gudnason S.; Hoye K.; Istad
H.; Winther J.; Joakimsen R.; Jorde R.; Larsen I.; Mella B.; Otterstad J.;
Risberg K.; Skare K.; Skeie S.; Sommervoll L.; Tandberg A.; Whitfield R.;
Wium C.; Cunanan E.; Fernando-Catindig E.; Gomez M.; Jaring C.;
Lantion-Ang F.; Licaros M.; Lim-Abrahan M.; Madronio E.; Panelo A.; Raboca
J.; Ramos G.; Tugna S.; Aksamit-Bialoszewska E.; Bandurska-Stankiewicz E.;
Baranska M.; Bronisz A.; Bronisz M.; Chrustowski W.; Cieslak B.;
Czupryniak L.; Drazkowicz-Gozdzik B.; Galuszka-Bilinska A.; Gmytrasiewicz
M.; Janik K.; Jedynasty K.; Kania G.; Kawka-Urbanek T.; Kinalska I.;
Kincel K.; Kleszczewska U.; Kruszewski J.; Loba J.; Malicka J.;
Mielecka-Kincel M.; Milczarczyk A.; Milosz D.; Mrowczynska A.; Mytnik M.;
Nowakowski A.; Nowakowski P.; Oleskowska L.; Omelanczuk-Wiech E.;
Pawlowski M.; Poplawska A.; Rucinska M.; Rucinski M.; Rutkowska J.;
Saryusz-Wolska M.; Siewko K.; Sikora-Frac M.; Stecka-Wierzbicka J.;
Swiatkowski M.; Swierczynski R.; Szpajer M.; Szymkowiak K.; Tarach J.;
Tarasiewicz U.; Wiatr D.; Wojewoda P.; Woszczak-Marcinkowska H.; Zadrozny
J.; Hancu N.; Albota A.; Bala C.; Barbonta D.; Botnariu G.; Bradescu O.;
Busegeanu M.; Bzduch M.; Catrinoiu D.; Caziuc R.; Cerghizan A.; Cheta D.;
Cif A.; Ciomos D.; Cosma D.; Creteanu G.; Crisan I.; Danciulescu R.;
Dobjanschi C.; Dodan R.; Duma L.; Ferariu I.; Ghenes T.; Ghise G.; Graur
M.; Ilinca M.; Marton R.; Mindrescu N.; Morosanu A.; Morosanu M.; Mota M.;
Nafornita V.; Negrisan G.; Nicodim S.; Nicolau A.; Nita C.; Onaca A.;
Panus C.; Pletea N.; Pop C.; Pop L.; Popa B.; Roman G.; Rosu M.; Sandu N.;
Serban V.; Sima A.; Stamoran L.; Strugariu M.; Suciu G.; Szilagyi I.;
Vacaru G.; Veresiu I.; Vlad A.; Adasheva T.; Ageev F.; Akhmedganov N.;
Akinina A.; Alexandrov A.; Ambatiello L.; Ametov A.; Ausheva A.; Babaeva
L.; Babenko A.; Balyasnikova E.; Bart B.; Belova J.; Berstein L.;
Bondarenko I.; Bondarev E.; Bulkina O.; Chernikova N.; Chumak B.; Deeva
T.; Demicheva O.; Demidova T.; Doskina E.; Duganova A.; Dzhaiani N.;
Egorova I.; Ettinger O.; Feofanova S.; Fofanova T.; Galaktionov P.;
Gavrilova N.; Gilyarevsky S.; Gnidkina N.; Golubev A.; Gornyakova N.;
Grigorova S.; Grineva E.; Gurevich V.; Irtuganov N.; Ivanova L.; Jaiani
N.; Kalashnikova M.; Karpov Y.; Khalimov Y.; Khorocheva G.; Kirillova E.;
Kistner J.; Kobalava Z.; Kochergina I.; Kravchenko T.; Krylov K.; Kulkova
P.; Kuparev I.; Kurbanova E.; Lysenko T.; Markovich A.; Martyanova I.;
Martynyuk T.; Masiinvets M.; Mavlyavieva E.; Maychuk E.; Melnichenko G.;
Mikhailusova M.; Mkrtumyan A.; Mychka V.; Nebieridze D.; Nesterova E.;
Orlov V.; Orlova V.; Orlova Y.; Papov F.; Patroucherva I.; Petunina N.;
Pirozhinskaya S.; Podachina S.; Postnikova S.; Pshikova O.; Rogova L.;
Romashevskiy B.; Runikhina N.; Sadulayeva I.; Safaryan A.; Sakovich E.;
Saprikina T.; Sargsyan V.; Semikozova O.; Shkolnik E.; Shubina A.; Shustov
S.; Sinitsina I.; Solovyeva E.; Storogakov G.; Stovpyuk O.; Sussekov A.;
Telnova M.; Temirov A.; Terekhov V.; Tereschenko S.; Tiourina T.;
Tolkacheva V.; Tsoy U.; Urazgyldeeva S.; Vasyuk Y.; Vinnitskay N.;
Voevodina E.; Volkova A.; Zadionchenko V.; Zalevskaya A.; Zhelninova T.;
Zhukova N.; Zilov A.; Bernatova J.; Duris T.; Markova I.; Martinka E.;
Michalova L.; Minarik P.; Peter L.; Raslova K.; Silvia D.; Subadova M.;
Tisonova J.; Vohnout B.; Adam M.; Badat A.; Bester A.; Bester F.; Blacking
L.; Bouwer D.; Brice B.; Cassimjee S.; Cronje T.; Deftereos J.; Distiller
L.; Ellis G.; Forster O.; Fulat M.; Gani M.; Gibson G.; Hansa S.;
Hendricks N.; Herbst L.; Hitzeroth J.; Joffe B.; Kelbe C.; Kelbe D.; King
J.; Kramer B.; Landau S.; Levitt N.; Meyer-Nell S.; Moore R.; Muller D.;
Nell H.; Omar M.; Randeree H.; Seeber M.; Seedat; Siebert M.; Van den Berg
E.; Van der Walt P.; Van Dyk C.; Van Niekerk F.; Van Zyl L.; Wellman H.;
Bertomeu V.; Botella M.; Buno M.; Calle A.; Cano Perez J.; Coves M.;
Juanatey J.G.; Garcia-Mayor R.; Gaztambide S.; Gippini A.; Goikolea I.;
Gonzalez J.; Hillman N.; Lopez Garcia Aranda V.; Magueda I.; Mato J.;
Mazon P.; Morillas P.; Novials A.; Pallardo L.; Perez L.; Rodriguez J.;
Romero L.; Sagarra E.; Shamagian L.; Soto A.; Torrealday H.; Valero R.;
Agergaard S.; Agewall S.; Andersson K.; Bergstrom O.; Bjornstedt Bennermo
M.; Blomgren J.; Boman K.; Brohall G.; Cherfan C.; Dahlen C.; Dotevall A.;
Enander P.; Ericsson U.; Hallgren P.; Hansson A.; Henareh L.; Henriksson
P.; Herlitz J.; Holmqvist J.; Jarevi G.; Linderfalk C.; Jonasson L.;
Jovinge S.; Kalen J.; Kilstrup M.; Leosdotir M.; Leppert J.; Ljungberg J.;
Lofdahl B.; Lundman P.; Lysell-Bergstrom C.; Mathiesen U.; Mellbin L.;
Morner S.; Nathanson D.; Nilsson L.; Peterson M.; Quittenbaum S.;
Rosengren A.; Ryttberg B.; Scheel S.; Svensson K.; Tenerz A.; Vasko P.;
Waldenstrom A.; Wieloch M.; Spinas G.; Braendle M.; Felix B.; Gerber P.;
Moccetti T.; Pitteloud N.; Kultursay H.; Aydinalp A.; Balci M.; Cayli M.;
Hatipoglu E.; Ilkova H.; Kayikcioglu M.; Koc M.; Muderrisoglu H.; Sari R.;
Saygili F.; Tekin K.; Tutuncu N.; Yurekli B.; Adler A.; Ali A.;
Balasubramanian; Barakat O.; Barnett A.; Borthwick L.; Brookes; Cecil J.;
Chaterjee S.; Clark J.; Collinson D.; Collinson S.; Crasto W.; Donnelly
R.; du Plessis J.; Egan S.; Ellery A.; Evans R.; Ewing J.; Fox C.; Gibson
M.; Hall T.; Higgs E.; Hollway M.; Hughes E.; Jackson N.; Jalihawi H.;
Jones G.; Knights H.; Korsheed S.; Kumar Singh R.; Laithwaite D.; Lawrence
I.; Litchfield J.; Manning G.; McNally P.; Millar-Craig M.; Mohammed I.;
Narayanan R.; Nayani G.; Norris A.; Purohit J.; Quinn M.; Ramtoola; Rea
R.; Reckless J.; Richardson T.; Robertson D.; Robinson A.; Salem K.;
Sampson M.; Savage M.; Shaker J.; Srinivasan T.; Randall J.; Tringham J.;
Viljoen A.; Ward A.; Waterhouse H.; Wijenaike N.; Wiles P.; Ahmann A.;
Ahmed I.; Alam A.; Arakaki R.; Asad S.; Banarer S.; Baum H.; Belew K.;
Bergenstal R.; Bethel M.; Boyer C.; Catton S.; Challans P.; Childs B.;
Christian R.; Clement S.; Cuddihy R.; Dailey G.; Damberg G.; De Bold C.;
De Lemos J.; Donovan D.; Dudl J.; Dunbar J.; Ebner S.; Failor R.; Feinglos
M.; Flaker G.; Freiburghaus M.; Furlong K.; Gardner D.; Gillespie E.;
Goland R.; Goldberg R.; Gotham A.; Guthrie R.; Hamaty M.; Hirsch I.;
Jabbour S.; Janci M.; Javorsky B.; Jones S.; Kamana V.; Kashyap M.;
Kaufman S.; Kearns P.; Khera A.; Klopfenstein B.; Kniffen W.; Kringas P.;
Licata A.; Lopez-Jimenez C.; Madden M.; Marx C.; McCall A.; McCallum J.;
McFarlane S.; McGuire D.; Melish J.; Meneghini L.; Miller S.;
Miranda-Palma B.; Mitchell R.; Nasr C.; Nelson J.; Niblack P.; Nylen E.;
Osei K.; Pandey A.; Papademetriou V.; Pilar Solano M.; Sameshima L.;
Savarese V.; Schnure J.; Schuster D.; Shin J.; Taylor A.; Thomson P.;
Ting-Ryan M.; Trence D.; Vo A.; Weiland K.; Wells K.; Wu P.; Zimering M.;
Zimmerman R.; Ascanio P.; Brajkovich I.; Carrillo E.; Coll J.; Gonzalez
K.; Gonzalez N.; Jimenez E.; Lopez R.; Marante D.; Morr I.; Paolillo M.;
Perche D.; Portillo M.; Valbuena H.; Velarde M.; Vergara G.; Augensen N.;
Azzalina J.; Fidaly S.; Bollero G.; Casiello A.I.; Ferraro F.; Guridi
M.J.; Ines M.; Martin M.E.; Pascual A.; Pereyra J.; Toscanelli M.; Appiah
M.; Grech S.; Pouras S.; Watts C.; Denke E.; Feik C.; Litvinenko M.;
Platonenko O.; Shadur S.; Johnson J.; Bonilla E.; Carraway B.; Faith J.;
Greer C.; Harding A.; Heston J.; Lin Y.; Mecca T.; Schuler M.; Rizk C.;
Sissoko A.; Strickland K.; Andrade A.; Lux L.; Machado D.; Mancin E.;
Aquino J.; Belanger B.; Bourque C.; Gagnier K.; Hagerimana A.; McNeil A.;
Osachoff J.; Richard B.; Rogan J.; Styner L.; Maturana X.; Naranjo M.E.;
Li E.; Liu Q.; Shuai M.; Tan Z.; Tang M.; Zhao J.; Ardila M.; Gomez A.M.;
Uscategui A.M.; Marinkovic N.; Miocevic V.V.; Pezo S.; Andersen I.;
Bastrup-Larsen B.; Jeppesen E.; Kofoed-Djursner M.; Joe H.; Hiironen V.;
Tarvainen M.; Von Hedenberg H.; Guillarme C.; Rastelli O.; Roy P.; Igel
L.; Lenz T.; Leptich A.; Peikert S.; Domokos S.; Szotyorine-Polcza G.;
Wenczl M.; Chaudhary S.; Jaiswal G.; Khatri P.; Shah K.; Gibson S.; Bechar
Y.; Erdheim D.; Eyal N.; Frankel M.; Shimoni S.; Tsuri J.; Bianco L.; Cali
R.; Sganga P.; Jang M.; Kim J.M.; Kim Y.; Lim S.; Park J.S.; Song Y.;
Kalve E.; Dienyte E.; Alvarado F.; Rodriguez R.; Bar J.; Lijfering-Lorie
K.; Palstra M.; Van der Kuijl K.; Van de Wetering A.; Eriksen S.;
Hejazifar S.; Jendeberg A.; Johannessen G.; Khammari I.; Meredith E.L.;
Dayag A.M.; Figueroa P.; Hoffmann Korpalska A.; Przemyk M.; Craciunescu
A.; Lupu D.; Osanu A.; Popscu L.; Toader C.; Kirsanova T.; Timoshina E.;
Gomez B.; Jankularova I.; Brett S.; Meyer A.; Pereira V.; Vawda N.;
Castano B.; Farre Avella J.M.; Jimenez I.; Turet N.; Froberg M.; Reppert
E.; Wessman S.; Boschung Y.; Carrozzino F.; Gerstl K.; Cetin Z.; Demirci
S.; Ovalioglu S.; Lenehan A.; McLean H.; Mutsaers K.; Redfern P.; Scoggins
A.; Isea Y.; Alvarez M.; Alvarez D'Amelio A.; Aqueveque S.; Argenta M.;
Aviles A.; Barreiro E.; Battistessa Y.; Bergamo S.; Bertran B.; Bocanera
M.; Bowen L.; Brescia H.; Caceres M.; Cappi A.; Cardelli A.; Carolini E.;
Carpintero S.; Carrique A.; Carrique P.; Casquero M.; Castro M.; Cendali
G.; Chatelain M.; Costanzi A.; Cristofaro C.; Crunger P.; Ehrich S.;
Espinosa M.; Esposito L.; Flenche M.; Fracaro V.; Funosas C.; Garrido I.;
Gomez Garrido A.; Guzman A.; Izzicupo M.; Luca S.; Luciani C.; Majul S.;
Moreno Cepeda I.; Moschin Y.; Niemann G.; Novas V.; Olmi M.; Palma F.;
Peralta A.; Puig A.; Rodera Vigil M.; Ronderos G.; Rosell M.; Samudio M.;
Santicchia C.; Szczygiel V.; Takla M.; Tinnirello C.; Tonin S.; Tristan
A.; Troncoso C.; Vignau S.; Yanez K.; Zarate M.; Appeldorf R.; Batrouney
B.; Bonner A.; Bonner M.; Cahill P.; Carr J.; Caruana M.; Chare J.; Doran
A.; Flavel; Griek S.; Hulley A.; Keays P.; Kent S.; Lai N.; Legg H.; Long
A.; Lynch L.; Maxwell V.; McNamara K.; Nairn J.; Nichols V.; Gein J.;
Phillips J.; Price-Smith S.; Ryan S.; Stockle P.; Tapp E.; Taverner P.;
Tulloch G.; Viola V.; Wilson L.; Beck A.; Damon S.; Drexel V.; Grabner E.;
Hofurthner A.; Kivioja P.; Kretschmer S.; Lener P.; Maiweg J.; Tscherner
D.; Weichelt H.; Winkler J.; Jones D.; Alves L.; Batista R.; Bernardes A.;
Demore de Souza A.; Ferraz R.; Ferreira A.; Freitas E.; Guanaes D.;
Kuschel K.; Muniz R.; Nasser-Hissa V.; Nhan P.; Osorio R.; Queirantes C.;
Reboucas R.; Souza C.; Tonani M.; Vicente C.; Zilli A.; Andersen K.; Aro
L.; Barber C.; Barnable B.; Berard L.; Bernier A.; Boudreault C.;
Bourbonnais A.; Bourgeois L.; Boutin D.; Boyer D.; Branco N.; Briol L.;
Brousseau M.; Burke M.; Chambers C.; Champoux A.; Chan S.; Colborne C.;
Coles K.; Couture M.; Cryderman C.; DeCurtis D.; Dewar C.; Drown J.; Dunn
P.; Eichmann D.; Eikel L.; Fox B.; Gauthier S.; Gibbons D.; Hicks R.; Ho
V.; Kitagawa H.; Kooistra L.; Landry F.; Lapointe F.; Larrivee L.; Leonard
P.; Louch D.; MacNair D.; Magennis L.; Mallette D.; Marchand C.; McLean
S.; Meilleur M.; Murdock H.; Naud M.; Olson K.; Otis J.; Ouimet F.;
Paquette H.; Peck C.; Pelletier A.; Perkins L.; Petrie F.; Pockett S.;
Poulin F.; Poulin M.; Primbas K.; Renton J.; Rouatt S.; Roy M.; Scarcelli
D.; Schellenberg S.; Schellevis K.; Schmidt N.; Scott L.; Skarpinsky B.;
Smith B.; Smith E.; Stafford C.; Stata C.; Sternberg B.; St-Jean N.;
Stoger S.; Thibodeau C.; Toupin A.; Ullyatt L.; Velonas J.; Vienneau R.;
Wall C.; Zaniol D.; Arau M.; Fuentes J.; Hidalgo J.; Landaeta O.; Padilla
I.; Sanzana S.; Tellos G.; Toro F.; Vergara R.; Che T.; Du Y.; He Y.;
Huang C.; Li H.; Liu S.; Luo X.; Ma Y.; Pan S.; Wan Q.; Wang H.; Wang S.;
Xie Y.; Xu X.; Xu Y.; Zhao F.; Zhou M.; Accini M.; Bello O.; Caceres A.;
Camargo S.; Figueroa J.; Florez M.; Gomez Morales K.; Granados L.;
Martinez M.; Medina Ramos M.; Mejia C.; Montoya L.; Ramos C.; Restrepo P.;
Rodriguez D.; Santamaria A.; Valencia T.; Spanic V.; Borre Hansen A.;
Bulow M.; Ehlers G.; Frederiksen A.; Gottschalck H.; Hejlskov B.; Holm
Fruesnsgaard Pedersen L.; Hornum H.; Jansen S.; Johansen A.; Jorgensen A.;
Kjaeulff Svaneborg T.; Kruse A.; Lund K.; Lundgaard M.; Madsen J.; Meier
A.; Muurholm A.; Nedergaard A.; Nielsen S.; Norgaard D.; Olsen A.; Raae
D.; Reiter P.; Sigsgaard U.; Vestergaar I.; Witt A.; Mitt T.; Timmusk P.;
Heikkila E.; Heiskanen R.; Huotari E.; Keskitalo A.; Kylmala L.; Laitinen
M.; Laukkanen M.; Leskinen S.; Liesivuori J.; Lukkari-Kuronen L.; Merisalo
P.; Muurinen E.; Nikkanen P.; Niskanen T.; Pasanen P.; Pekkonen L.; Retsu
A.; Soppela A.; Andreu N.; Ankotche A.; Bairras C.; Boch C.; Camachon L.;
Cherchouly A.; Coudret S.; Demer C.; Gilg R.; Lemonade L.; Madec O.;
Pinotti D.; Poirier I.; Tenne N.; Vogler C.; Amman M.; Andratschke-Gentsch
B.; Beckmann H.; Bischoff S.; Bleich B.; Bueschges G.; Busch E.;
Deigentasch S.; Dietze S.; Dollinger M.; El-Bahay C.; Flehmig G.; Frenzel
I.; Geissler K.; Guerro J.; Heike B.; Holler D.; Inhoffen C.; Klein K.;
Kraehe I.; Kress P.; Krueger H.; Lenz R.; Linnebach B.; Lueck A.; Markhof
P.; Matthies K.; Meier C.; Metzler E.; Moor E.; Noll I.; Paulsen S.;
Pfeffer B.; Promnitz N.; Saljew B.; Schad S.; Schoner C.; Sellmann R.;
Tanis M.; Vogelbusch J.; Wagner E.; Winkler S.; Zenker K.; Zvork S.;
Balogh E.; Buncsikne Molnar S.; Gulyasne Gaspar E.; Herold M.; Kovacs E.;
Kozmane Paszternak A.; Maarne Nagy S.; Nagyne Zoltan A.; Nemeth Z.; Roth
T.; Rozsa I.; Szalai M.; Anuradha M.; Bawa T.; Bhaskar B.; Chalkhore S.;
Choudhary D.; Dhanalaxmi T.; Dhingra V.; Gayatri R.; Gnanasundram R.;
Gopal U.; Govindaraj S.; Indira P.; James S.; Karkuzhli K.; Koppikar V.;
Malhotra N.; Manmohan B.; Mazher A.; Menon R.; Nalini S.; Panda M.; Patel
K.; Poongothai S.; Ramanathan S.; Ramu I.; Sangeetha K.; Sankar K.;
Savitha; Shrinivas K.; Sudha S.; Tripathi S.; Vaseem A.; Yamuna A.;
Banques R.; Chong J.; Courcy M.; Donnelly E.; Fauzi A.; Gately M.; Hanlon
G.; Kelly-Conroy M.; McAteer S.; McGovern G.; Meaney E.; Storey S.; Todd
M.; Aharonof-Segal M.; Aliazarov N.; Arbeli S.; Butbul E.; Chagai E.;
Confino K.; Domb L.; Dvir R.; Erez N.; Foiening O.; Frishberg A.; Genin
I.; Gertman R.; Golan L.; Grosberd A.; Hadad D.; Israeli S.; Kaplunski Y.;
Karpf D.; Katzir A.; Kivity Z.; Li L.; Livshitz L.; Nachmias A.; Orr I.;
Peer E.; Platner N.; Pritulo L.; Rojansky A.; Rosenblat T.; Saranga H.;
Schterchman G.; Shenhar S.; Shkliar T.; Stam T.; Stinmann S.; Suliman A.;
Tsirulnikov E.; Uziel K.; Weinshtock S.; Yedid-Am S.; Yuval R.; Zuker S.;
Brunella L.; Durante A.; Nada E.; Pugolotti M.; Robusto A.; Testa M.;
Toniato R.; Ha I.; Jung S.; Kim C.; Mi Ran K.; Song B.; Wi Y.; Yang K.;
You J.; Gaisute R.; Ozolina L.; Dzagajeva N.; Kasperaviciene V.;
Krikstaponiene Z.; Montviliene R.; Morkunaite K.; Piepoliene L.; Stoniene
E.; Stonkus S.; Ulpaityte I.; Arenas-Vanhorn M.; Espitia-Serrato L.;
Garcia-Munoz E.; Nunez V.; Sainz T.; Bakker H.; Danse I.; De Greef S.; De
Jong C.; De Wit M.; Didden E.; Dommerholt R.; Goddrie M.; Haazer C.;
Havenaar J.; Hendriks-Van Woerden M.; Jongenotter M.; Kort I.; Koster L.;
Kramer H.; Maarssen E.; Posthuma-Visscher M.; Reijnierse-Buitenwerf H.;
Rood P.; Swets E.; Tousain W.A.; Van Buchem-Damming G.; Van
Buijsen-Nutters A.; Van de Loo R.; Van den Hondel M.; Van den Berg A.; Van
der Knaap-van Keulen M.; Van der Zeijst M.; Van Setten-Van der Meer L.;
Von Bannisseht E.E.; Wouda Z.; Aarsland T.; Amlie L.; Andresen B.;
Bakketun A.; Bognaes A.; Botten C.; Coucheron S.; Halsne A.; Hansen H.;
Holthe T.; Husby E.; Iversen E.; Kvalvik A.; Landbakk T.; Lovseth E.; Moen
S.; Orvik E.; Ovrehus G.; Salater S.; Sorgard B.; Sorstrom A.; Tandberg
L.; Veiding B.; Vinje G.; Winge A.; Abquina G.; Patena B.; Reyes R.;
Tamondong A.; Vega A.; Vitug L.; Makuch M.; Torun A.; Adam A.; Basaraba
M.; Chira C.; Darida C.; Haica C.; Nedelcu A.; Patru D.; Patrut L.; Rau
I.; Rotaru N.; Szabo L.; Vrinceanu G.; Sovenko T.; Zatsevskaya O.;
Horynova Z.; Vankova L.; Barkhuizen M.; Barnard L.; Bekker D.; Botha D.;
Commerford A.; de Klerk A.; De Waal A.; Devchand S.; Drummond F.; Du Toit
A.; Du Toit S.; Ellis T.; Engelbrecht M.; Eramus T.; Fonda K.; Goosen A.;
Gopel E.; Govender P.; Hodge E.; Ismael F.; Jonker E.; Jonker L.; Joubert
A.; Kilian M.; Koegenlenberg N.; Lehner L.; Lingham R.; Llyod T.; Mangoeng
P.; Mapele S.; Meiring J.; Methusi P.; Mmethi M.; Mohamed K.; Moore A.;
Ndiweni H.; Parker F.; Schoneman J.; Smit M.; Steyn A.; Van Dongren J.;
Van Schalkwyk S.; Van Staden L.; van Wyngaard G.; Wolf A.; Ashbaugh R.;
Bande C.; Barquero R.; Gaspar R.; Martin E.; Megia B.; Rodriguez C.;
Seoane A.; Viaplana J.; Akesson Jacobsson I.; Andersson C.; Asperen M.;
Backlund M.; Berglund M.; Bjorck L.; Borjesson M.; Brolin G.; Danielsson
Frojd M.; Duckert A.; Eriksson K.; Fehling K.; Glaas A.; Hage C.; Hoglund
K.; Jernhed H.; Johansson K.; Johansson S.; Lidin M.; Lundell L.; Lundgren
C.; Magnusson K.; Matsson E.; Norman J.; Nystrom K.; Ojutkangas M.;
Olofsson M.; Olsson C.; Pettersson U.; Pramberg E.; Raschperger A.; Sjolin
M.; Soderlund M.; Stensgaard Nake E.; Torebo E.; Uggeldahl I.; Walldin C.;
Welin-Berger B.; Dwyer A.; Meyer-Lazzarini V.; Morello R.; Schefer M.;
Oney S.; Seker T.; Tavlayan S.; Appleby M.; Astin J.; Baker M.; Brann H.;
Brennan C.; Bryan L.; Campbell D.; Carey J.; Cox K.; Davis C.; Dyson B.;
Everdell R.; Gammon B.; Godden J.; Gray T.; Griffiths E.; Grimes Y.; Hall
D.; Hall K.; Holme A.; Howe J.; Lambley-Burke R.; Nation M.; Norcott K.;
Mitchell K.; Poxon S.; Quick C.; Shute C.; Thomas J.; Vinnell T.; Bawa S.;
Bogan C.; Fallye O.; Ginsberg J.; Gregory B.; House B.; Isonaga M.;
Keanne-Richmond P.; Kelly C.; Kimpel J.; Leiby A.; Lyons L.; McCoy B.;
Monk A.; Pelayo E.; Perron M.; Posey D.; Rehan M.; Suarez R.; Tilton L.;
Waite K.; White G.; Chacon R.; Meza Y.; Misticchio F.; Torres M.; Urbaneja
H.
Institution
(Gerstein, Yusuf) Department of Medicine, Population Health Research
Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Bosch) Population Health Research Institute and School of Rehabilitation
Science, McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Dagenais) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec, QC, Canada
(Diaz) Estudios Clinicos Latino America, Rosario, Argentina
(Jung) McMaster University and Hamilton Health Sciences, Hamilton, ON,
Canada
(Maggioni) Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
Research Center, Florence, Italy
(Pogue) Population Health Research Institute, McMaster University and
Hamilton Health Sciences, Hamilton, ON, Canada
(Probstfield) University of Washington, Seattle, United States
(Ramachandran) India Diabetes Research Foundation, Chennai, India
(Riddle) Oregon Health and Science University, Portland, United States
(Ryden) Department of Medicine, Karolinska Institute, Stockholm, Sweden
Publisher
Massachussetts Medical Society
Abstract
Background: The provision of sufficient basal insulin to normalize fasting
plasma glucose levels may reduce cardiovascular events, but such a
possibility has not been formally tested. Method(s): We randomly
assigned 12,537 people (mean age, 63.5 years) with cardiovascular risk
factors plus impaired fasting glucose, impaired glucose tolerance, or type
2 diabetes to receive insulin glargine (with a target fasting blood
glucose level of <=95 mg per deciliter [5.3 mmol per liter]) or standard
care and to receive n-3 fatty acids or placebo with the use of a 2-by-2
factorial design. The results of the comparison between insulin glargine
and standard care are reported here. The coprimary outcomes were nonfatal
myocardial infarction, nonfatal stroke, or death from cardiovascular
causes and these events plus revascularization or hospitalization for
heart failure. Microvascular outcomes, incident diabetes, hypoglycemia,
weight, and cancers were also compared between groups. Result(s): The
median follow-up was 6.2 years (interquartile range, 5.8 to 6.7). Rates of
incident cardiovascular outcomes were similar in the insulin-glargine and
standard-care groups: 2.94 and 2.85 per 100 person-years, respectively,
for the first coprimary outcome (hazard ratio, 1.02; 95% confidence
interval [CI], 0.94 to 1.11; P = 0.63) and 5.52 and 5.28 per 100
person-years, respectively, for the second coprimary outcome (hazard
ratio, 1.04; 95% CI, 0.97 to 1.11; P = 0.27). New diabetes was diagnosed
approximately 3 months after therapy was stopped among 30% versus 35% of
1456 participants without baseline diabetes (odds ratio, 0.80; 95% CI,
0.64 to 1.00; P = 0.05). Rates of severe hypoglycemia were 1.00 versus
0.31 per 100 person-years. Median weight increased by 1.6 kg in the
insulin-glargine group and fell by 0.5 kg in the standard-care group.
There was no significant difference in cancers (hazard ratio, 1.00; 95%
CI, 0.88 to 1.13; P = 0.97). Conclusion(s): When used to target
normal fasting plasma glucose levels for more than 6 years, insulin
glargine had a neutral effect on cardiovascular outcomes and cancers.
Although it reduced new-onset diabetes, insulin glargine also increased
hypoglycemia and modestly increased weight. Copyright © 2012
Massachusetts Medical Society.

<2>
Accession Number
2013485175
Title
Atrial Fibrillation in Patients with Chronic Kidney Disease.
Source
Cardiology Clinics. 39(3) (pp 435-446), 2021. Date of Publication: August
2021.
Author
Kotalczyk A.; Ding W.Y.; Wong C.F.; Rao A.; Gupta D.; Lip G.Y.H.
Institution
(Kotalczyk, Ding, Gupta, Lip) Liverpool Centre for Cardiovascular Science,
University of Liverpool and Liverpool Heart & Chest Hospital, Thomas
Drive, Liverpool L14 3PE, United Kingdom
(Kotalczyk) Department of Cardiology, Congenital Heart Diseases and
Electrotherapy, Medical University of Silesia, Silesian Centre for Heart
Diseases, M. Sklodowskiej-Curie 7, Zabrze 41-800, Poland
(Wong, Rao) Department of Renal Medicine, Liverpool University Hospital,
Prescot Street, Liverpool L7 8XP, United Kingdom
(Lip) Aalborg Thrombosis Research Unit, Department of Clinical Medicine,
Aalborg University, Sondre Skovvej 15, Aalborg 9000, Denmark
Publisher
W.B. Saunders

<3>
Accession Number
2013092215
Title
Leukocyte count and the risk of adverse outcomes in patients with HFpEF.
Source
BMC Cardiovascular Disorders. 21(1) (no pagination), 2021. Article Number:
333. Date of Publication: December 2021.
Author
Zhu Z.; Zhou S.
Institution
(Zhu, Zhou) Department of Cardiovascular Medicine, The Second Xiangya
Hospital, Central South University, Changsha, Hunan 410011, China
Publisher
BioMed Central Ltd
Abstract
Background: Inflammation is a key feature of heart failure including
HFpEF. The leukocyte count is a marker of inflammation that is widely used
in clinical practice. However, there is little available evidence for the
relationship between leukocyte count and the outcomes of HFpEF.
 Method(s): We analyzed data from the TOPCAT (Treatment of Preserved
Cardiac Function Heart Failure with an Aldosterone Antagonist) trial. The
primary outcome was all-cause mortality, the secondary outcome was
composite cardiovascular events and hospitalization for heart failure.
Multivariable Cox proportional hazard models were used to compare the risk
profiles of patients with leukocyte quartiles, subgroup study divided by
sex was also analyzed. Result(s): The present study included 2898
patients with HFpEF.429 deaths, 671 composite cardiovascular events and
386 hospitalization for heart failure occurred during a mean 3.4 years
follow-up. The association between leukocyte count and adverse outcomes
followed a U-shaped curve. After multivariable adjustment, the patients
with the lowest leukocyte count (Q1) and the highest leukocyte count (Q4)
faced higher risk of all-cause death(Q1 vs. Q2, adjusted HR: 1.439; 95%
CI: 1.060-1.953, p = 0.020; Q4 vs. Q2, adjusted HR, 1.901; 95%CI:
1.424-2.539, p < 0.001). The subgroup analysis showed a consistent result
in female but not male patients. Conclusion(s): The association
between leukocyte count and risk of adverse outcomes followed a U-shaped
curve. Both higher and lower leukocyte count are associated with worse
outcomes in patients with HFpEF, which may be attributed to the two sides
of inflammation in cardiac remodeling. Copyright © 2021, The
Author(s).

<4>
Accession Number
2012039905
Title
Commentary: Beyond the horizon of evidence in robotic totally endoscopic
coronary artery bypass grafting.
Source
JTCVS Techniques. 10 (pp 160-161), 2021. Date of Publication: December
2021.
Author
Weiss A.J.; Frankel W.C.; Bakaeen F.G.
Institution
(Weiss, Frankel, Bakaeen) Department of Thoracic and Cardiovascular
Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
Publisher
Elsevier Inc.

<5>
Accession Number
2014395484
Title
Computed tomography coronary angiography for patients with heart failure
(CTA-HF): A randomized controlled trial (IMAGE-HF 1C).
Source
European Heart Journal Cardiovascular Imaging. 22(9) (pp 1083-1090), 2021.
Date of Publication: 01 Sep 2021.
Author
Chow B.J.W.; Coyle D.; Hossain A.; Laine M.; Hanninen H.; Ukkonen H.;
Rajda M.; Larose E.; Hartikainen J.; Mielniczuk L.; Kass M.; Connelly
K.A.; O'Meara E.; Garrard L.; Bishop H.; Small G.; Hedman M.; Coyle K.;
Yla-Herttuala S.; Knuuti J.; Wells G.A.; Beanlands R.S.
Institution
(Chow, Hossain, Mielniczuk, Garrard, Small, Beanlands) Department of
Medicine (Cardiology), The University of Ottawa, Heart Institute,
University of Ottawa, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada
(Chow, Small, Beanlands) Department of Radiology, University of Ottawa,
Ottawa, Canada
(Coyle, Hossain, Wells) School of Epidemiology and Public Health,
University of Ottawa, Ottawa, Canada
(Laine, Hanninen) Helsinki University, Central Hospital, Helsinki, Finland
(Ukkonen, Knuuti) Heart Centre and Turku PET Centre, Turku University
Hospital, University of Turku, Turku, Finland
(Rajda, Bishop) Dalhousie University, Halifax, Canada
(Larose) Laval University, Quebec City, Canada
(Hartikainen, Hedman, Yla-Herttuala) Heart Centre, Kuopio University
Hospital, Kuopio, Finland
(Kass) University of Manitoba, Winnipeg, Canada
(Connelly) Department of Cardiology, Keenan Research Centre for Biomedical
Science, St. Michael's Hospital, University of Toronto, Toronto, Canada
(O'Meara) Montreal Heart Institute, Universite de Montreal, Montreal,
Canada
(Coyle) Health Economics Research Group, Institute of Environment, Health
and Societies, Brunel University London, London, United Kingdom
Publisher
Oxford University Press
Abstract
Aims: This randomized controlled trial sought to determine the financial
impact of an initial diagnostic strategy of coronary computed tomography
angiography (CCTA) in patients with heart failure (HF) of unknown
aetiology. Invasive coronary angiography (ICA) is used to investigate HF
patients. CCTA may be a non-invasive cost-effective alternative to ICA.
This randomized controlled trial sought to determine the financial impact
of an initial diagnostic strategy of coronary computed tomography
angiography (CCTA) in patients with heart failure (HF) of unknown
aetiology. Methods and Results: This multicentre, international trial
enrolled patients with HF of unknown aetiology. The primary outcome was
the cost of CCTA vs. ICA strategies at 12 months. Clinical outcomes were
also collected. An 'intention-to-diagnose' analysis was performed and a
secondary 'as-tested' analysis was based on the modality received. Two
hundred and forty-six patients were randomized (age = 57.8 +/- 11.0 years,
ejection fraction = 30.1 +/- 10.1%). The severity of coronary artery
disease was similar in both groups. In the 121 CCTA patients, 93 avoided
ICA. Rates of downstream ischaemia and viability testing were similar for
both arms. There were no significant differences in the composite clinical
outcomes or quality of life measures. The cost of CCTA trended lower than
ICA [CDN -$871 (confidence interval, CI -$4116 to $3028)]. Using an
'as-tested' analysis, CCTA was associated with a decrease in healthcare
costs (CDN -$2932, 95% CI -$6248 to $746). Conclusion(s): In patients
with HF of unknown aetiology, costs were not statistically different
between the CCTA and ICA strategies. Clinical Trials.gov:
NCT01283659 Copyright © 2020 Published on behalf of the European
Society of Cardiology. All rights reserved.

<6>
Accession Number
2014925240
Title
Aromatherapy with lavender essential oil in patients with surgery-related
anxiety: A systematic review.
Source
Research Journal of Pharmacognosy. 8(4) (pp 101-111), 2021. Date of
Publication: Autumn 2021.
Author
Moradifar N.; Amraei M.; Karami K.; Shahijan M.K.; Nadri S.; Amin A.
Institution
(Moradifar, Amin) Cardiovascular Research Center, Lorestan University of
Medical Sciences, Khorramabad, Iran, Islamic Republic of
(Amraei) Department of Health Information Technology, School of
Paramedical Sciences, Lorestan University of Medical Sciences,
Khorramabad, Iran, Islamic Republic of
(Karami) Department of Nursing, School of Nursing and Midwifery, Lorestan
University of Medical Sciences, Khorramabad, Iran, Islamic Republic of
(Shahijan) Student Research Committee, Lorestan University of Medical
Sciences, Khorramabad, Iran, Islamic Republic of
(Nadri) Depertmant of Anesthesiology, School of Medicine, Lorestan
University of Medical Sciences, Khorramabad, Iran, Islamic Republic of
Publisher
Iranian Society of Pharmacognosy
Abstract
Today, complementary and alternative treatment strategies, including
massage therapy, and aromatherapy, are extensively applied to reduce and
manage anxiety in the patients with various diseases. Aromatherapy as one
of the main therapeutic strategies has gained significant attention in
most countries compared to other complementary treatments for
surgery-related anxiety treatment. Here, we decided to conduct a
systematic review and report the results about the effects of aromatherapy
with lavender (Lavandula angustifolia L.) in patients undergoing various
types of surgery. Five English databases including Web of Science, Scopus,
PubMed, ScienceDirect, and Google Scholar were used to find published
clinical papers related to the effects of aromatherapy with lavender in
patients undergoing various types of surgery without time limitation. All
searches were based on the 06-PRISMA guideline and registered in the
CAMARADES-NC3Rs Preclinical Systematic Review and Meta-Analysis Facility
(SyRF) database. Out of 3974 papers, 20 papers from the year 2000 up to
April 2021, met the inclusion criteria for discussion in this systematic
review with the data extracted. The most studies were carried out on the
effect of aromatherapy with lavender on the anxiety of patients with
coronary artery bypass surgery (8 papers, 40%). Based on the results of
the articles reviewed, it can be suggested that aromatherapy management
particularly with lavender, has the potential to be used as a
complementary therapy to reduce anxiety and stress in patients undergoing
various types of surgery. However, more studies are required to confirm
the accurate mechanisms and side effects of the complementary
treatment. Copyright © 2021. Open access. This article is
distributed under the terms of the Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by-nc/4.0/).

<7>
Accession Number
2013026302
Title
Biomarkers of Cerebral Injury for Prediction of Postoperative Cognitive
Dysfunction in Patients Undergoing Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(1) (pp 125-132),
2022. Date of Publication: January 2022.
Author
Wiberg S.; Holmgaard F.; Zetterberg H.; Nilsson J.-C.; Kjaergaard J.;
Wanscher M.; Langkilde A.R.; Hassager C.; Rasmussen L.S.; Blennow K.;
Vedel A.G.
Institution
(Wiberg, Kjaergaard, Hassager) Department of Cardiology, Rigshospitalet,
University of Copenhagen, Copenhagen, Denmark
(Holmgaard, Nilsson, Wanscher, Vedel) Department of Cardiothoracic
Anesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
(Zetterberg, Blennow) Department of Psychiatry and Neurochemistry,
Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the
University of Gothenburg, Molndal, Sweden
(Zetterberg, Blennow) Clinical Neurochemistry Laboratory, Sahlgrenska
University Hospital, Molndal, Sweden
(Zetterberg) Department of Neurodegenerative Disease, UCL Institute of
Neurology, London, United Kingdom
(Zetterberg) UK Dementia Research Institute at UCL, London, United Kingdom
(Langkilde) Department of Radiology, Rigshospitalet, University of
Copenhagen, Copenhagen, Denmark
(Hassager, Rasmussen) Department of Clinical Medicine, University of
Copenhagen, Copenhagen, Denmark
(Rasmussen) Department of Anesthesia, Center of Head and Orthopedics,
Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Publisher
W.B. Saunders
Abstract
Objectives: To assess the ability of the biomarkers neuron-specific
enolase (NSE), tau, neurofilament light chain (NFL), and glial fibrillary
acidic protein (GFAP) to predict postoperative cognitive dysfunction
(POCD) at discharge in patients who underwent cardiac surgery.
 Design(s): Post hoc analyses (with tests being prespecified before
data analyses) from a randomized clinical trial. Setting(s):
Single-center study from a primary heart center in Denmark.
 Participant(s): Adult patients undergoing elective or subacute
on-pump coronary artery bypass grafting and/or aortic valve replacement.
 Intervention(s): Blood was collected before induction of anesthesia,
after 24 hours, after 48 hours, and at discharge from the surgical ward.
The International Study of Postoperative Cognitive Dysfunction test
battery was applied to diagnose POCD at discharge and after three months.
Linear mixed models of covariance were used to assess whether repeated
measurements of biomarker levels were associated with POCD. Receiver
operating characteristic (ROC) curves were applied to assess the
predictive value of each biomarker measurement for POCD. Measurements
and Main Results: A total of 168 patients had biomarkers measured at
baseline, and 47 (28%) fulfilled the POCD criteria at discharge. Patients
with POCD at discharge had significantly higher levels of tau (p = 0.02)
and GFAP (p = 0.01) from baseline to discharge. The biomarker measurements
achieving the highest area under the ROC curve for prediction of POCD at
discharge were NFL measured at discharge (AUC, 0.64; 95% confidence
interval [CI], 0.54-0.73), GFAP measured 48 hours after induction (AUC,
0.64; 95% CI, 0.55-0.73), and GFAP measured at discharge (AUC, 0.64; 95%
CI, 0.54-0.74), corresponding to a moderate predictive ability.
 Conclusion(s): Postoperative serum levels of tau and GFAP were
significantly elevated in cardiac surgery patients with POCD at discharge,
however, the biomarkers achieved only modest predictive abilities for POCD
at discharge. Postoperative levels of NSE were not associated with POCD at
discharge. Copyright © 2021 Elsevier Inc.

<8>
Accession Number
2014814923
Title
Surgical techniques for the treatment of anomalous origin of right
coronary artery from the left sinus: A comparative review.
Source
Journal of the American Heart Association. 10(22) (no pagination), 2021.
Article Number: e022377. Date of Publication: 16 Nov 2021.
Author
Gharibeh L.; Rahmouni K.; Hong S.J.; Crean A.M.; Grau J.B.
Institution
(Gharibeh, Grau) Division of Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Gharibeh, Rahmouni) Department of Biochemistry, Microbiology and
Immunology, University of Ottawa, Ottawa, ON, Canada
(Crean) Division of Cardiology, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Hong, Grau) Division of Cardiothoracic Surgery, The Valley Hospital,
Ridgewood, NJ, United States
Publisher
American Heart Association Inc.
Abstract
The anomalous aortic origin of the right coronary artery (AAORCA) from the
left sinus is a congenital anomaly affecting both the origin and course of
the right coronary artery. AAORCA is nowadays easily and increasingly
recognized by several cardiac imaging modalities. In most cases, patients
remain asymptomatic; however, in some, and especially in young athletes,
symptoms start to appear following exertion. A literature review was
conducted on the surgical management of AAORCA by searching the Pubmed and
Google Scholar databases. The inclusion criteria included manuscripts
reporting surgical outcomes of AAORCA for >=1 of the 3 techniques of
interest (unroofing, reimplantation, and coronary artery bypass grafting)
and manuscripts written in English and that were published between 2010
and 2020. The surgical management of AAORCA can be done through several
techniques, most commonly the unroofing of the intramural segment of the
AAORCA, the reimplantation of the native right coronary artery onto the
right sinus of the aortic root, and coronary artery bypass grafting with
either arterial or venous graft conduits with or without ligation of the
proximal right coronary artery. Superiority of one surgical technique has
not yet been formally proven because of the rare nature of this condition
and the lack of any prospective randomized controlled trial or robust
prospective observational studies. Copyright © 2021 The Authors.

<9>
Accession Number
2015769494
Title
A Scoping Review of Alternative Anticoagulation Strategies for
Hemodialysis Patients with a Mechanical Heart Valve.
Source
American Journal of Nephrology. 52(10-11) (pp 861-870), 2021. Date of
Publication: 01 Dec 2021.
Author
Thomson B.K.A.; Pilkey N.G.; Monteith B.; Holden R.M.
Institution
(Thomson) Bloomberg School of Public Health, Johns Hopkins University,
Baltimore, MD, United States
(Thomson, Pilkey, Holden) Division of Nephrology, Department of Medicine,
Queen's University, Kingston, ON, Canada
(Monteith) Division of Hematology, Department of Medicine, Queen's
University, Kingston, ON, Canada
Publisher
S. Karger AG
Abstract
Introduction: Patients with end-stage renal disease (ESRD) have high rates
of cardiac valvulopathy but can develop contraindications for vitamin K
antagonist (VKA) therapy. We explored the evidence for alternative
anticoagulation strategies in patients with ESRD with a contraindication
for VKA therapy. Method(s): A scoping review was completed, searching
MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of
Science, and Conference abstracts from inception to March 30, 2021. The
study population was patients with ESRD who were on VKA therapy and
developed a contraindication to VKA therapy use. All data regarding
studies, patient characteristics, anticoagulation strategy, and clinical
outcomes were summarized. Result(s): Twenty-three articles met
inclusion criteria. These articles included 57 patients. Contraindications
to VKA therapy included calcific uremic arteriolopathy (CUA) (n = 55) and
warfarin-induced skin necrosis (n = 2). All studies were either case
reports or case series. There were 10 anticoagulation strategies
identified. Continuation of VKA therapy was associated with increased
death and decreased rates of CUA resolution (80.0% and 10.0%,
respectively), compared to apixaban (24.0% and 70.8%), subcutaneous (SC)
low-molecular-weight heparin (LMWH) (14.3%, 85.7%), and SC unfractionated
heparin (0.0%, 100.0%). While only 5 patient cases were reported with
mechanical heart valves, SC LMWH use has been reported in this context
with good outcomes. Conclusion(s): In patients with ESRD who develop
a contraindication to VKA therapy, several alternative anticoagulation
strategies have been reported with superior outcomes to VKA continuation.
While outcomes appear superior to continuation of VKA therapy, more data
are required before definitive recommendations can be made for the patient
with ESRD and a mechanical heart valve. Copyright © 2021 S.
Karger AG, Basel.

<10>
Accession Number
2014101907
Title
Should asymptomatic cervical stenosis be treated in the setting of
progressive thoracic myelopathy? A systematic review of the literature.
Source
European Spine Journal. (no pagination), 2021. Date of Publication: 2021.
Author
Dowlati E.; Mualem W.; Black J.; Nunez J.; Girish A.; Fayed I.; McGrail
K.M.; Voyadzis J.-M.
Institution
(Dowlati, Fayed, McGrail, Voyadzis) Department of Neurosurgery, MedStar
Georgetown University Hospital, 3800 Reservoir Rd. NW, PHC 7, Washington,
DC 20007, United States
(Mualem, Black, Nunez, Girish) Georgetown University School of Medicine,
3900 Reservoir Rd. NW, Washington, DC, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Unlike tandem stenosis of the cervical and lumbar spine, tandem
cervical and thoracic stenosis (TCTS) of the spine is less common, and the
approach and order of intervention are controversial. We aim to review the
literature to evaluate the incidence and interventions for patients with
cervical and thoracic stenosis. We provide illustrative cases to
demonstrate that thoracic myelopathy in the setting of asymptomatic
cervical stenosis can be treated safely. Method(s): A systematic
review of the literature through electronic databases of PubMed, EMBASE,
Web of Science, and Cochrane Library was performed to present the current
literature that evaluates TCTS as it relates to incidence and surgical
interventions. We also present two cases of patients undergoing operative
intervention for thoracic myelopathy in the setting of concurrent cervical
stenosis. Result(s): A total of 26 English original studies and case
reports were identified. Nine studies evaluated the incidence of TCTS. 20
studies with a total of 168 patients with TCTS presented information on
surgical intervention options. There is an overall aggregate incidence of
11.6% (530/4751) based on incidence studies. 165 patients underwent
thoracic intervention. Of these patients, 63 patients underwent cervical
intervention first, 29 underwent thoracic intervention first, and 73
underwent simultaneous, single-stage intervention. Conclusion(s): In
patients presenting with myelopathy, both cervical and thoracic spine
should be evaluated for TCTS. Order of operative intervention is tailored
to clinical and radiographic information. In cases of thoracic myelopathy
with asymptomatic cervical stenosis, thoracic intervention can be pursued
with precautions to prevent further cervical cord injury. Copyright
© 2021, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<11>
Accession Number
2014089962
Title
Cardiorenal outcomes in eligible patients referred for bariatric surgery.
Source
Obesity. 29(12) (pp 2035-2043), 2021. Date of Publication: December 2021.
Author
Dash S.; Everett K.; Jackson T.; Okrainec A.; Urbach D.R.; Sockalingam S.;
Shah B.R.; Farkouh M.E.
Institution
(Dash) Division of Endocrinology, University Health Network, Toronto, ON,
Canada
(Dash, Shah, Farkouh) Department of Medicine, University of Toronto,
Toronto, ON, Canada
(Dash, Jackson, Okrainec, Urbach, Sockalingam) Bariatric Program,
University Health Network, Toronto, ON, Canada
(Everett, Shah) Division of Endocrinology, Sunnybrook Health Sciences
Centre Toronto, Toronto, ON, Canada
(Jackson, Okrainec) Department of Surgery, Faculty of Medicine, University
of Toronto, Toronto, ON, Canada
(Urbach) Department of Surgery, Women's College Hospital, Toronto, ON,
Canada
(Sockalingam) Centre for Addiction, & Mental Health, Toronto, ON, Canada
(Sockalingam) Department of Psychiatry, University of Toronto, Toronto,
ON, Canada
(Shah) ICES, Toronto, ON, Canada
(Farkouh) Peter Munk Cardiac Centre, University Health Network, Toronto,
ON, Canada
(Farkouh) St. Michael's Hospital Research Institute, Toronto, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Objective: Bariatric surgery is associated with reduced atherosclerotic
cardiovascular disease (CVD) and heart failure hospitalization in people
with type 2 diabetes (T2D) and those with prior CVD. Most patients
undergoing bariatric surgery do not have T2D or CVD. Many otherwise
eligible patients do not have surgery because of self-exclusion. Clinical
outcomes in these groups are less established. Method(s): This study
retrospectively assessed cardiorenal outcomes in 8,568 patients after
acceptance of referral for surgery. Result(s): A total of 63.8%
patients did not undergo surgery. After multivariate adjustment for sex,
age, BMI, income quintile, distance from hospital, hypertension, T2D, and
CVD, hazard ratios (HR) for the primary (incident myocardial infarction,
stroke, heart failure hospitalization, and death; HR = 0.52, 95% CI:
0.4-0.66) and secondary CVD outcomes (primary outcomes and
coronary/carotid revascularization; HR = 0.53, 95% CI: 0.42-0.67) were
lower in the surgery cohort. This reduction was seen in those with
(primary: HR = 0.45, 95% CI: 0.32-0.63, secondary: HR = 0.47, 95% CI:
0.34-0.65) and without T2D (primary: HR = 0.61, 95% CI: 0.42-0.88,
secondary: HR = 0.53, 95% CI: 0.42-0.67). Reduced kidney disease (HR =
0.46, 95% CI: 0.22-0.92) but increased liver disease hospitalization (HR =
2.5, 95% CI: 1.45-4.27) was observed with surgery. Conclusion(s):
Non-progression to surgery associates with increased CVD despite low
baseline prevalence of CVD. The cardiorenal benefits of bariatric surgery
warrant confirmation in a well-powered randomized clinical
trial. Copyright © 2021 The Obesity Society

<12>
Accession Number
636661806
Title
Effect of ventilation strategy during cardiopulmonary bypass on
postoperative pulmonary complications after cardiac surgery: a randomized
clinical trial.
Source
Journal of cardiothoracic surgery. 16(1) (pp 319), 2021. Date of
Publication: 30 Oct 2021.
Author
Zhang M.-Q.; Liao Y.-Q.; Li X.-F.; Shi W.; Jing W.-W.; Wang Z.-L.; Xu Y.;
Yu H.
Institution
(Zhang, Yu, Li, Shi, Jing, Wang, Xu, Yu) Department of Anesthesiology,
West China Hospital, Sichuan University and The Research Units of West
China (2018RU012), Chinese Academy of Medical Sciences, Chengdu 610041,
China
(Liao) Department of Anesthesiology, Third People's Hospital of Chengdu,
Chengdu 610041, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: To determine whether maintaining ventilation during
cardiopulmonary bypass (CPB) with a different fraction of inspired oxygen
(FiO2) had an impact on the occurrence of postoperative pulmonary
complications (PPCs). METHOD(S): A total of 413 adult patients
undergoing elective cardiac surgery with CPB were randomly assigned into
three groups: 138 in the NoV group (received no mechanical ventilation
during CPB), 138 in the LOV group (received a tidal volume (VT) of 3-4
ml/kg of ideal body weight with the respiratory rate of 10-12 bpm, and the
positive end-expiratory pressure of 5-8 cmH2O during CPB; the FiO2 was
30%), and 137 in the HOV group (received the same ventilation parameters
settings as the LOV group while the FiO2 was 80%). RESULT(S): The
primary outcomes were the incidence and severity of PPCs during
hospitalization. The composite incidence of PPCs did not significantly
differ between the NoV (63%), LOV (49%) and HOV (57%) groups (P=0.069).
And there was also no difference regarding the incidence of PPCs between
the non-ventilation (NoV) and ventilation (the combination of LOV and HOV)
groups. The LOV group was observed a lower proportion of moderate and
severe pulmonary complications (grade>=3) than the NoV group (23.1% vs.
44.2%, P=0.001). CONCLUSION(S): Maintaining ventilation during CPB
did not reduce the incidence of PPCs in patients undergoing cardiac
surgery. TRIAL REGISTRATION: Chinese Clinical Trial Registry
ChiCTR1800015261. Prospectively registered 19 March 2018.
http://www.chictr.org.cn/showproj.aspx?proj=25982. Copyright ©
2021. The Author(s).

<13>
Accession Number
2006926377
Title
Commentary: The left main controversy: Is this a real subgroup requiring
custom clinical recommendations?.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(1) (pp 108-110), 2022.
Date of Publication: January 2022.
Author
Gaudino M.; Pagano D.; Freemantle N.
Institution
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Pagano) Department of Cardiothoracic Surgery, University Hospital
Birmingham, University of Birmingham, Birmingham, United Kingdom
(Freemantle) Institute of Clinical Trials and Methodology, University
College London, London, United Kingdom
Publisher
Elsevier Inc.

<14>
Accession Number
2015940242
Title
Sex differences in outcomes following coronary artery bypass grafting: A
meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 33(6) (pp 841-847), 2021.
Date of Publication: 01 Dec 2021.
Author
Robinson N.B.; Naik A.; Rahouma M.; Morsi M.; Wright D.; Hameed I.; Di
Franco A.; Girardi L.N.; Gaudino M.
Institution
(Robinson, Naik, Rahouma, Morsi, Hameed, Di Franco, Girardi, Gaudino)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York,
NY, United States
(Wright) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell Medicine, New York, NY, United States
Publisher
Oxford University Press
Abstract
OBJECTIVES: Previous reports have found females are a higher risk of
morbidity and mortality following isolated coronary artery bypass grafting
(CABG). Here, we describe the differences in outcomes following isolated
CABG between males and females. METHOD(S): Following a systematic
literature search, studies reporting sex-related outcomes following
isolated CABG were pooled in a meta-analysis performed using the generic
inverse variance method. The primary outcome was operative mortality.
Secondary outcomes included rates of stroke, repeat revascularization,
myocardial infarction, major adverse cardiac events, and late mortality.
Subgroup analyses were performed for studies published before and after
the year 2000 and for the type of risk adjustment. RESULT(S):
Eighty-four studies were included with a total of 903 346 patients.
Females were at higher risk for operative mortality (odds ratio: 1.77, 95%
confidence interval [CI]: 1.64-1.92, P < 0.001). At subgroup analysis,
there was no difference in operative or late mortality between studies
published prior and after 2000 or between studies using risk adjustment.
Females were at a higher risk of late mortality (incidence rate ratio
[IRR]: 1.16, 95% CI: 1.06-1.26, P < 0.001), major adverse cardiac events
(IRR: 1.40, 95% CI: 1.19-1.66, P < 0.001), myocardial infarction (IRR:
1.28, 95% CI: 1.13-1.45, P < 0.001) and stroke (IRR: 1.31, 95% CI:
1.15-1.51, P > 0.001) but not repeat revascularization (IRR: 0.99, 95% CI:
0.76-1.29, P = 0.95). The use of the off-pump technique or multiple
arterial grafts was not associated with the primary outcome.
 CONCLUSION(S): Females undergoing CABG are at higher risk for
operative and late mortality as well as postoperative events including
major adverse cardiac events, myocardial infarction and stroke. PROSPERO
registration: CRD42020187556. Copyright © 2021 The Author(s)
2021. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<15>
Accession Number
2015816317
Title
Outcome of parapneumonic empyema managed surgically or by fibrinolysis: A
multicenter study.
Source
Journal of Thoracic Disease. 13(11) (pp 6381-6389), 2021. Date of
Publication: November 2021.
Author
Federici S.; Bedat B.; Hayau J.; Gonzalez M.; Triponez F.; Krueger T.;
Karenovics W.; Perentes J.Y.
Institution
(Federici, Hayau, Gonzalez, Krueger, Perentes) Division of Thoracic
Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
(Federici, Bedat, Hayau, Gonzalez, Triponez, Krueger, Karenovics,
Perentes) University Center of Thoracic Surgery of Western Switzerland,
Switzerland
(Bedat, Triponez, Karenovics) Division of Thoracic and Endocrine Surgery,
University Hospital of Geneva, Geneva, Switzerland
Publisher
AME Publishing Company
Abstract
Background: Parapneumonic empyema (PPE) management remains debated. Here
we present the outcome of a comparable population with PPE treated over a
4-year period in two Thoracic Surgery University Centers with different
approaches: One with an early "surgical" and the other with a
"fibrinolytic" approach. Method(s): All operable patients with PPE
managed in both centers between January 2014 and January 2018 were
reviewed. Patients with persistent pleural effusion/loculations following
drainage were managed by a "surgical" approach in one center and by
"fibrinolytic" approach in the other. For each patient, we recorded the
age, sex, hospital stay, morbidity/mortality and change in pleural opacity
on chest X-ray before and at the end of the treatment. Result(s):
During the study period, 66 and 93 patients underwent PPE management in
the "surgical" and "fibrinolytic" centers respectively. The population
characteristics were comparable. Infection was controlled in all patients.
In the "fibrinolytic" group, 20 patients (21.5%) underwent an additional
drain placement while 12 patients (12.9%) required surgery to correct PPE.
In the "surgical" group, 4 patients (6.1%) developed postoperative
arrhythmia while 2 patients (3%) underwent a second surgery to evacuate a
hemothorax. Median drainage {3 [2-4] vs. 5 [4-7] days} and hospital {7
[5-10] vs. 11 [7-19] days} durations were significantly lower in the
"surgical" compared to the "fibrinolytic" center. Pleural opacity
regression with therapy was significantly more important in the "surgical"
compared to the "fibrinolytic" group (-22%+/-18% vs. -16%+/-17%, P=0.035).
 Conclusion(s): Surgical management of PPE was associated with shorter
chest tube and hospital duration and better pleural space control.
Prospective randomized studies are mandatory. Copyright © 2021
AME Publishing Company. All rights reserved.

<16>
Accession Number
636513453
Title
Quality of life after transcatheter or surgical aortic valve replacement
using the Toronto Aortic Stenosis Quality of Life Questionnaire.
Source
Open Heart. 8(2) (no pagination), 2021. Article Number: e001821. Date of
Publication: 22 Nov 2021.
Author
Kennon S.; Styra R.; Bonaros N.; Stastny L.; Romano M.; Lefevre T.; Di
Mario C.; Stefano P.; Ribichini F.L.; Himbert D.; Urena-Alcazar M.;
Salgado-Fernandez J.; Cuenca Castillo J.J.; Garcia B.; Deutsch C.;
Sykorova L.; Kurucova J.; Thoenes M.; Luske C.; Bramlage P.; Frank D.
Institution
(Kennon) Department of Cardiology, Barts Heart Centre, St Bartholomew's
Hospital, London, United Kingdom
(Styra) Department of Psychiatry, University Health Network, Toronto, ON,
Canada
(Bonaros, Stastny) Department of Cardiac Surgery, Innsbruck Medical
University, Innsbruck, Austria
(Romano) Department of Thoracic and Cardiovascular Surgery, Hopital Prive
Jacques Cartier, Massy, France
(Lefevre) Institut Jacques Cartier, Massy, France
(Di Mario, Stefano) Department of Structural Interventional Cardiology,
Department of Cardiac Surgery, Careggi University Hospital, Florence,
Italy
(Ribichini) Division of Cardiology, Department of Medicine, University of
Verona, Verona, Italy
(Himbert, Urena-Alcazar) Department of Cardiology, Bichat-Claude Bernard
Hospital, Paris, France
(Salgado-Fernandez, Cuenca Castillo) Department of Cardiology, Department
of Cardiovascular Surgery, Hospital Juan Canalejo, Coruna, Spain
(Garcia) Department of Cardiology, Hospital Vall d'Hebron, CIBER CV,
Barcelona, Spain
(Deutsch, Luske, Bramlage) Clinical Studies and Registries, Institute for
Pharmacology and Preventive Medicine, Cloppenburg, Germany
(Sykorova, Kurucova) Medical Affairs, Edwards Lifesciences, Prague,
Czechia
(Thoenes) Medical Affairs, Edwards Lifesciences, Nyon, Switzerland
(Frank) Department of Internal Medicine III (Cardiology, Angiology and
Critical Care), Germany and DZHK (German Centre for Cardiovascular
Research), Kiel, Germany
Publisher
BMJ Publishing Group
Abstract
Background The Toronto Aortic Stenosis Quality of Life Questionnaire
(TASQ) is a validated instrument for assessing quality of life (QoL) in
patients with severe aortic stenosis (AS). In this study, we evaluated
health status outcomes, based on the TASQ, in patients with severe AS
undergoing transcatheter aortic valve replacement (TAVR) or surgical
aortic valve replacement (SAVR). Methods The TASQ registry was a
prospective observational registry. Patients with severe AS from nine
centres in Europe and one in Canada underwent either SAVR or transfemoral
TAVR. Patients completed the TASQ, Kansas City Cardiomyopathy
Questionnaire and Short Form-12 V.2 prior to the intervention,
predischarge, and at 30-day and 3-month follow-ups. Primary end point was
the TASQ score. Results In both the TAVR (n=137) and SAVR (n=137) cohorts,
significant increases were observed in all three scores. The overall TASQ
score improved as did all but one of the individual domains at 3 months
after the intervention (p<0.001). TASQ health expectations were the only
domain which worsened (p<0.001). Across TASQ subscores, significant
changes were evident from the time of discharge in the TAVR and 30-day
follow-up in the SAVR cohort. In a categorical analysis of the TASQ, 39.7%
of the TAVR group and 35.0% of the SAVR group had a substantially improved
health status at 3 months compared with baseline. Conclusions The TASQ
captured changes in QoL among patients with severe AS who were treated
with TAVR or SAVR. QoL improved substantially after either intervention,
as indicated by changes in the TASQ overall score at 3 months. Trial
registration number NCT03186339. Copyright ©

<17>
Accession Number
635900511
Title
Nasal High-Frequency Oscillatory Ventilation vs. Nasal Continuous Positive
Airway Pressure as Therapy for Postextubation Respiratory Failure in
Infants After Congenital Heart Surgery.
Source
Frontiers in Pediatrics. 9 (no pagination), 2021. Article Number: 700632.
Date of Publication: 16 Aug 2021.
Author
Wu H.-L.; Lei Y.-Q.; Xie W.-P.; Chen Q.; Zheng Y.-R.
Institution
(Wu, Lei, Xie, Chen, Zheng) Department of Cardiac Surgery, Fujian Branch
of Shanghai Children's Medical Center, Fuzhou, China
(Wu, Lei, Xie, Chen, Zheng) Fujian Children's Hospital, Fuzhou, China
(Wu, Lei, Xie, Chen, Zheng) Fujian Maternity and Child Health Hospital,
Affiliated Hospital of Fujian Medical University, Fuzhou, China
(Wu, Lei, Xie, Chen, Zheng) Fujian Key Laboratory of Women and Children's
Critical Diseases Research, Fujian Maternity and Child Health Hospital,
Fuzhou, China
Publisher
Frontiers Media S.A.
Abstract
Objective: This study aimed to evaluate the effects of nasal
high-frequency oscillatory ventilation (NHFOV) vs. nasal continuous
positive airway pressure (NCPAP) on postextubation respiratory failure
(PRF) in infants after congenital heart surgery (CHS). Method(s):
Eighty infants underwent postoperative invasive mechanical ventilation for
more than 12 h and planned extubation. The infants were randomized to
undergo either NHFOV or NCPAP after extubation. Primary outcomes were the
incidence of PRF and reintubation, the average PaCO<inf>2</inf> level, the
average oxygenation index (OI), and pulmonary recruitment in the early
extubation phase. Secondary outcomes included the NCPAP/NHFOV time, length
of hospital stay, treatment intolerance, signs of discomfort,
pneumothorax, adverse hemodynamic effects, nasal trauma, and mortality.
 Result(s): Except for PaCO<inf>2</inf> within 12 after extubation
(39.3 +/- 5.8 vs. 43.6 +/- 7.3 mmHg, p = 0.05), there was no statistically
significant difference for any of the primary outcome measure (PRF,
reintubation within 12 h after extubation, oxygenation index within 12 h
after extubation, or lung volumes on X-ray after extubation) or secondary
outcome measures (duration of non-invasive ventilation, duration of
hospital stay, ventilation intolerance, signs of discomfort, pneumothorax,
nasal trauma, adverse hemodynamic effects, or death prior to discharge), p
> 0.1 for each comparison. Conclusion(s): NHFOV therapy after
extubation in infants after CHS was more efficient in improving
CO<inf>2</inf> cleaning than NCPAP therapy, but there was no difference in
other outcomes (PRF, reintubation, oxygenation index, and pulmonary
recruitment). © Copyright © 2021 Wu, Lei, Xie, Chen and
Zheng.

<18>
Accession Number
2013477804
Title
Ambulatory management of secondary spontaneous pneumothorax: a mirage, or
a solution on the horizon?.
Source
European Respiratory Journal. 57(6) (no pagination), 2021. Article Number:
2100003. Date of Publication: 01 Jun 2021.
Author
Mummadi S.R.; Porcel J.M.
Institution
(Porcel) Respiratory Institute, Cleveland Clinic Foundation, Cleveland,
OH, United States
(Mummadi) Pleural Medicine Unit, Dept of Internal Medicine, Arnau de
Vilanova University Hospital, IRBLleida, University of Lleida, Lleida,
Spain
Publisher
European Respiratory Society

<19>
Accession Number
2011276100
Title
CARotid plaqUe StabilizatiOn and regression with evolocumab: Rationale and
design of the CARUSO study.
Source
Catheterization and Cardiovascular Interventions. 98(1) (pp E115-E121),
2021. Date of Publication: 01 Jul 2021.
Author
Aranzulla T.C.; Piazza S.; Ricotti A.; Musumeci G.; Gaggiano A.
Institution
(Aranzulla) Interventional Cardiology Unit, A. O. Ordine Mauriziano di
Torino, Turin, Italy
(Piazza, Gaggiano) Vascular Surgery Department, A. O. Ordine Mauriziano di
Torino, Turin, Italy
(Ricotti) Health Department, A. O. Ordine Mauriziano di Torino, Turin,
Italy
(Musumeci) Cardiology Department, A. O. Ordine Mauriziano di Torino,
Turin, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: While the experience with PCSK9i in patients with coronary
artery disease has been wide, and coronary plaque regression has been
documented, little is known regarding the role of these drugs on carotid
plaque regression. The CARotid plaqUe StabilizatiOn and regression with
evolocumab (CARUSO) study is a randomized, single-center,
investigator-initiated trial aiming at evaluating carotid plaque
morphological stabilization and regression following, respectively, 6 and
12 months of therapy with evolocumab. Method(s): Asymptomatic
patients with uni- or bilateral de novo carotid artery stenosis >=50% and
LDL-C values >=100 mg/dl despite maximum tolerated lipid lowering therapy
(LLT) will be randomized to evolocumab 140 mg s.c. every 2 weeks on top of
ongoing LLT, or no additional treatment. 100 patients (50 in each arm)
will be enrolled. Serial carotid duplex ultra-sonography will be performed
to monitor the carotid plaque morphology and stenosis over time.
 Result(s): The primary end point of the study is, (a) carotid plaque
morphological stabilization at 6 months, defined as defined as the
disappearance of ulcerations and fluffy components and the achievement of
a regular plaque morphology with prevalence of fibrous atheroma and/or (b)
carotid plaque regression at 12 months, defined as reduction of the entity
of the stenosis and/or peak systolic velocity by at least 5%, as compared
with baseline. Conclusion(s): The CARUSO trial will test the
superiority of evolocumab on top of ongoing LLT versus ongoing LLT alone
regarding carotid plaque morphological stabilization and regression. The
data that support the findings of this study are available on request from
the corresponding author. The data are not publicly available due to
privacy or ethical restrictions. Copyright © 2021 Wiley
Periodicals LLC.

<20>
Accession Number
2011247284
Title
Immune checkpoint inhibitors-associated pericardial disease: a systematic
review of case reports.
Source
Cancer Immunology, Immunotherapy. 70(10) (pp 3041-3053), 2021. Date of
Publication: October 2021.
Author
Inno A.; Maurea N.; Metro G.; Carbone A.; Russo A.; Gori S.
Institution
(Inno, Gori) Oncologia Medica, IRCCS Ospedale Sacro Cuore Don Calabria,
Via don A. Sempreboni 5, Negrar di Valpolicella, Verona 37024, Italy
(Maurea, Carbone) Divisione di Cardiologia, IRCCS Fondazione G. Pascale,
Napoli, Italy
(Metro) Oncologia Medica, Ospedale Santa Maria della Misericordia, Azienda
Ospedaliera Di Perugia, Perugia, Italy
(Russo) Oncologia Medica, Dipartimento di Discipline Chirurgiche,
Oncologiche E Stomatologiche, Policlinico Universitario "A. Giaccone",
Palermo, Italy
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Treatment with immune checkpoint inhibitors (ICIs) can be complicated by
cardiovascular toxicity, including pericardial disease. To date, no
prospective studies specifically investigated the optimal treatment of
ICI-associated pericardial disease, and the available evidence is based on
case reports and series only. We performed a systematic review of case
reports and series including 20 publications for a total of 28 cases of
ICI-associated pericardial disease. In this review, pericardial disease
was reversible in the majority of cases (75%), although 2 deaths were
reported. The majority of cases were life-threatening (G4, 53.6%) or
severe (G3, 21.4%), requiring pericardiocentesis. Higher rates of
improvement were associated with administration of corticosteroids (86.7%
vs 61.5%), presence of other immune-related adverse events (90.9% vs.
64.7%), and non-malignant effusions (86.7% vs 42.8%). ICIs were
discontinued in the majority of cases and then restarted in 7 patients
with no recurrence of pericardial disease. Based on these results,
ICI-associated G3-G4 pericardial disease as well as G2 pericardial disease
with moderate-severe effusion should be treated with ICIs discontinuation
and high-dose steroids, also performing pericardiocentesis, pericardial
drainage or pericardial window in case of cardiac tamponade. For G2 with
small effusion or G1 pericardial disease, ICIs might be continued and
colchicine or NSAIDs could be considered. For patients requiring ICIs
discontinuation, a rechallenge with ICIs seems to be feasible after
resolution or meaningful improvement of pericardial disease. Copyright
© 2021, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<21>
Accession Number
2011602419
Title
Biomarkers of acute kidney injury in pediatric cardiac surgery.
Source
Pediatric Nephrology. 37(1) (pp 61-78), 2022. Date of Publication: January
2022.
Author
Cavalcante C.T.M.B.; Cavalcante M.B.; Castello Branco K.M.P.; Chan T.;
Maia I.C.L.; Pompeu R.G.; de Oliveira Telles A.C.; Brito A.K.M.; Liborio
A.B.
Institution
(Cavalcante, Castello Branco, Maia, Pompeu, de Oliveira Telles, Brito)
Pediatric Cardiac Center of the Messejana Hospital Dr. Carlos Alberto
Studart Gomes, Fortaleza, CE, Brazil
(Cavalcante) Department of Pediatrics, Fortaleza University (UNIFOR), Av.
Washington Soares, 1321 - Edson Queiroz, CEP, Fortaleza, CE 60811-905,
Brazil
(Cavalcante) Department of Obstetrics and Gynecology, Fortaleza University
(UNIFOR), Av. Washington Soares, 1321 - Edson Queiroz, CEP, Fortaleza, CE
60811-905, Brazil
(Chan) The Heart Center, Seattle Children's Hospital, University of
Washington, Seattle, WA, United States
(Cavalcante, Liborio) Medical Sciences Postgraduate Program, Fortaleza
University (UNIFOR), Av. Washington Soares, 1321 - Edson Queiroz, CEP,
Fortaleza, CE 60811-905, Brazil
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Acute kidney injury (AKI) is characterized by a sudden decrease in kidney
function. Children with congenital heart disease are a special group at
risk of developing AKI. We performed a systematic review of the literature
to search for studies reporting the usefulness of novel urine, serum, and
plasma biomarkers in the diagnosis and progression of AKI and their
association with clinical outcomes in children undergoing pediatric
cardiac surgery. In thirty studies, we analyzed the capacity to predict
AKI and poor outcomes of five biomarkers: Cystatin C, Neutrophil
gelatinase-associated lipocalin, Interleukin-18, Kidney injury molecule-1,
and Liver fatty acid-binding protein. In conclusion, we suggest the need
for further meta-analyses with the availability of additional
studies. Copyright © 2021, IPNA.

<22>
Accession Number
2007404360
Title
Efficacy of Transcutaneous Electrical Nerve Stimulation for Postoperative
Pain, Pulmonary Function, and Opioid Consumption Following Cardiothoracic
Procedures: A Systematic Review.
Source
Neuromodulation. 24(8) (pp 1439-1450), 2021. Date of Publication: December
2021.
Author
Cardinali A.; Celini D.; Chaplik M.; Grasso E.; Nemec E.C.
Institution
(Cardinali, Celini, Chaplik, Grasso, Nemec) Sacred Heart University,
Fairfield, CT, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Transcutaneous electrical nerve stimulation (TENS) is a
minimally invasive method for treating pain. In the most recent review
published in 2012, TENS was associated with increased pain relief
following cardiothoracic surgery when compared to standard multimodal
analgesia. The purpose of this systematic review and meta-analysis is to
determine if adding TENS to current pain management practices decreases
pain and analgesic use and improves pulmonary function for
postcardiothoracic surgery patients. Material(s) and Method(s):
CINAHL, MEDLINE, Cochrane Database of Systematic Reviews, PubMed, and
ClinicalTrials.gov were searched using specific keywords. Covidence was
used to screen, select studies, and extract data by two independent
reviewers. The Cochrane Risk of Bias tool assessed risk of bias. Visual
analog scale (VAS) and pulmonary function data were exported for
meta-analysis using a random effects model. Result(s): The search
yielded 38 articles. Eight randomized controlled trials met inclusion
criteria for the literature review. Five studies were included in the
meta-analysis of pain at 24, 48, and 72 hours postoperatively. Data were
analyzed using the standard mean difference (SMD). TENS had a significant
impact on VAS at rest (-0.76 SMD [95% confidence interval, CI = -1.06 to
-0.49], p < 0.00001) and with coughing (-1.11 SMD [95% CI = -1.64 to
-0.56], p < 0.0001). FEV1 improved after 72 hours (1.00 SMD [95% CI =
0.66-1.35], p < 0.00001), as did forced vital capacity (1.16 SMD [95% CI =
0.23-2.10], p = 0.01). Conclusion(s): The addition of TENS therapy to
multimodal analgesia significantly decreases pain following cardiothoracic
surgery, increases the recovery of pulmonary function, and decreases the
use of analgesics. Copyright © 2020 International Neuromodulation
Society

<23>
Accession Number
636227076
Title
Comparison of plasma concentrations of levobupivacaine with and without
epinephrine for thoracic paravertebral block: A randomised trial.
Source
Anaesthesia, critical care & pain medicine. 40(5) (pp 100952), 2021. Date
of Publication: 01 Oct 2021.
Author
Yamazaki A.; Fujii K.; Aratani Y.; Kuriyama T.; Kawamata T.
Institution
(Yamazaki, Fujii, Aratani, Kuriyama, Kawamata) Department of
Anaesthesiology, Wakayama Medical University School of Medicine, 811-1
Kimiidera, Wakayama 641-8509, Japan
Publisher
NLM (Medline)
Abstract
BACKGROUND: Thoracic paravertebral block (TPVB) is effective for analgesia
for unilateral thoracic surgery. However, since the paravertebral space is
highly vascular, injection of local anaesthetics into the paravertebral
space may induce systemic local anaesthetic toxicity. We examined the
effect of addition of epinephrine to paravertebral levobupivacaine on its
plasma concentration. METHOD(S): In a randomised single blind trial,
twenty-four male patients who were scheduled to undergo elective
unilateral pulmonary lobectomy or segmentectomy under general anaesthesia
combined with TPVB were enrolled in this study. They were randomly divided
into two groups: one group received a single bolus thoracic paravertebral
injection of 1mg/kg of 0.25% levobupivacaine with 5mug/mL epinephrine and
the other group received a single bolus thoracic paravertebral injection
of 1mg/kg of 0.25% levobupivacaine alone. Arterial blood samples were
obtained for plasma levobupivacaine assay after injection. The peak plasma
concentration (Cmax) and the time to peak plasma concentration (Tmax), for
levobupivacaine were calculated. RESULT(S): There were no significant
differences in patients' characteristics between the two groups. The mean
arterial Cmax values of levobupivacaine were 0.48+/-0.11mug/mL with
epinephrine and 0.71+/-0.31mug/mL without epinephrine (P=0.041). The mean
arterial Tmax values of levobupivacaine were 46.0+/-35.6min with
epinephrine and 12.0+/-7.2min without epinephrine (P=0.005).
 CONCLUSION(S): The addition of 5-mug/mL epinephrine to a single bolus
thoracic paravertebral injection of 1-mg/kg levobupivacaine significantly
decreased Cmax and delayed Tmax of levobupivacaine. The addition of
epinephrine to levobupivacaine may be a useful strategy to reduce systemic
levobupivacaine toxicity. CLINICAL TRIAL REGISTRATION NUMBER: UMIN
000021942. Copyright © 2021 The Author(s). Published by Elsevier
Masson SAS.. All rights reserved.

<24>
Accession Number
614502036
Title
One-Lung Ventilation with Additional Ipsilateral Ventilation of Low Tidal
Volume and High Frequency in Lung Lobectomy.
Source
Medical science monitor : international medical journal of experimental
and clinical research. 22 (pp 1589-1592), 2016. Date of Publication: 11
May 2016.
Author
Feng Y.; Wang J.; Zhang Y.; Wang S.
Institution
(Feng) Department of Anesthesiology, Affiliated Hospital of Qingdao
University, Qingdao, Shandong, China (mainland)
(Wang) Department of Anesthesiology, Binzhou City People's Hospital,
Binzhou, Shandong, China (mainland)
(Zhang) Department of Anesthesiology, Binzhou City People's Hospital,
Binzhou, Shandong, China (mainland)
(Wang) Department of Anesthesiology, Affiliated Hospital of Qingdao
University, Qingdao, Shandong, China (mainland)
Abstract
BACKGROUND To investigate the protective effects of additional ipsilateral
ventilation of low tidal volume and high frequency on lung functions in
the patients receiving lobectomy. MATERIAL AND METHODS Sixty patients
receiving lung lobectomy were randomized into the conventional one-lung
ventilation (CV) group (n=30) and the ipsilateral low tidal volume high
frequency ventilation (LV) group (n=30). In the CV group, patients
received only contralateral OLV. In the LV group, patients received
contralateral ventilation and additional ipsilateral ventilation of low
tidal volume of 1-2 ml/kg and high frequency of 40 times/min. Normal lung
tissues were biopsied for the analysis of lung injury. Lung injury was
scored by evaluating interstitial edema, alveolar edema, neutrophil
infiltration, and alveolar congestion. RESULTS At 30 min and 60 min after
the initiation of one-lung ventilation and after surgery, patients in the
LV group showed significantly higher ratio of the partial pressure of
arterial oxygen to the fraction of inspired oxygen than those in the CV
group (P<0.001). Lung injury was significantly less severe (2.7+/-0.7) in
the LV group than in the CV group (3.1+/-0.7) (P=0.006). CONCLUSIONS
Additional ipsilateral ventilation of low tidal volume and high frequency
can decrease the risk of hypoxemia and alleviate lung injury in patients
receiving lobectomy.

<25>
Accession Number
636611041
Title
Transcatheter aortic valve implantation versus surgical aortic valve
replacement in patients with severe aortic stenosis: A systematic review
and meta-Analysis.
Source
BMJ Open. 11(12) (no pagination), 2021. Article Number: e054222. Date of
Publication: 06 Dec 2021.
Author
Swift S.L.; Puehler T.; Misso K.; Lang S.H.; Forbes C.; Kleijnen J.;
Danner M.; Kuhn C.; Haneya A.; Seoudy H.; Cremer J.; Frey N.; Lutter G.;
Wolff R.; Scheibler F.; Wehkamp K.; Frank D.
Institution
(Swift, Misso, Lang, Forbes, Kleijnen, Wolff) Kleijnen Systematic Reviews
Ltd, York, United Kingdom
(Puehler, Haneya, Cremer, Lutter) Department of Cardiac and Vascular
Surgery, Universitatsklinikum Schleswig-Holstein, Kiel, Germany
(Puehler, Kuhn, Seoudy, Lutter, Frank) German Centre for Cardiovascular
Research, Kiel, Germany
(Danner, Scheibler) National Competency Center for Shared Decision Making,
Universitatsklinikum Schleswig-Holstein, Kiel, Germany
(Kuhn, Seoudy, Frank) Department of Cardiology and Angiology,
Universitatsklinikum Schleswig-Holstein, Kiel, Germany
(Frey) Department of Cardiology, Angiology, and Pneumology, University
Hospital Heidelberg, Heidelberg, Germany
(Wehkamp) Department of Internal Medicinei, Universitatsklinikum
Schleswig-Holstein, Kiel, Germany
Publisher
BMJ Publishing Group
Abstract
Objectives Patients undergoing surgery for severe aortic stenosis (SAS)
can be treated with either transcatheter aortic valve implantation (TAVI)
or surgical aortic valve replacement (SAVR). The choice of procedure
depends on several factors, including the clinical judgement of the heart
team and patient preferences, which are captured by actively informing and
involving patients in a process of shared decision making (SDM). We
synthesised the most up-To-date and accessible evidence on the benefits
and risks that may be associated with TAVI versus SAVR to support SDM in
this highly personalised decision-making process. Design Systematic review
and meta-Analysis. Data sources MEDLINE (Ovid), Embase (Ovid) and the
Cochrane Central Register of Controlled Trials (CENTRAL; Wiley) were
searched from January 2000 to August 2020 with no language restrictions.
Reference lists of included studies were searched to identify additional
studies. Eligibility criteria Randomised controlled trials (RCTs) that
compared TAVI versus SAVR in patients with SAS and reported on all-cause
or cardiovascular mortality, length of stay in intensive care unit or
hospital, valve durability, rehospitalisation/reintervention, stroke (any
stroke or major/disabling stroke), myocardial infarction, major vascular
complications, major bleeding, permanent pacemaker (PPM) implantation,
new-onset or worsening atrial fibrillation (NOW-AF), endocarditis, acute
kidney injury (AKI), recovery time or pain were included. Data extraction
and synthesis Two independent reviewers were involved in data extraction
and risk of bias (ROB) assessment using the Cochrane tool (one reviewer
extracted/assessed the data, and the second reviewer checked it).
Dichotomous data were pooled using the Mantel-Haenszel method with
random-effects to generate a risk ratio (RR) with 95% CI. Continuous data
were pooled using the inverse-variance method with random-effects and
expressed as a mean difference (MD) with 95% CI. Heterogeneity was
assessed using the I 2 statistic. Results 8969 records were retrieved and
nine RCTs (61 records) were ultimately included (n=8818 participants). Two
RCTs recruited high-risk patients, two RCTs recruited intermediate-risk
patients, two RCTs recruited low-risk patients, one RCT recruited
high-risk (>=70 years) or any-risk (>=80 years) patients; and two RCTs
recruited all-risk or a operable' patients. While there was no overall
change in the risk of dying from any cause (30 day: RR 0.89, 95% CI 0.65
to 1.22; <=1 year: RR 0.90, 95% CI 0.79 to 1.03; 5 years: RR 1.09, 95% CI
0.98 to 1.22), cardiovascular mortality (30 day: RR 1.03, 95% CI 0.77 to
1.39; <=1 year: RR 0.90, 95% CI 0.76 to 1.06; 2 years: RR 0.96, 95% CI
0.83 to 1.12), or any type of stroke (30 day: RR 0.83, 95% CI 0.61 to
1.14;<=1 year: RR 0.94, 95% CI 0.72 to 1.23; 5 years: RR 1.07, 95% CI 0.88
to 1.30), the risk of several clinical outcomes was significantly
decreased (major bleeding, AKI, NOW-AF) or significantly increased (major
vascular complications, PPM implantation) for TAVI vs SAVR. TAVI was
associated with a significantly shorter hospital stay vs SAVR (MD-3.08
days, 95% CI-4.86 to-1.29; 4 RCTs, n=2758 participants). Subgroup analysis
generally favoured TAVI patients receiving implantation via the
transfemoral (TF) route (vs non-TF); receiving a balloon-expandable (vs
self-expanding) valve; and those at low-intermediate risk (vs high risk).
All RCTs were rated at high ROB, predominantly due to lack of blinding and
selective reporting. Conclusions No overall change in the risk of death
from any cause or cardiovascular mortality was identified but 95% CIs were
often wide, indicating uncertainty. TAVI may reduce the risk of certain
side effects while SAVR may reduce the risk of others. Most long-Term
(5-year) results are limited to older patients at high surgical risk (ie,
early trials), therefore more data are required for low risk populations.
Ultimately, neither surgical technique was considered dominant, and these
results suggest that every patient with SAS should be individually engaged
in SDM to make evidence-based, personalised decisions around their care
based on the various benefits and risks associated with each treatment.
PROSPERO registration number CRD42019138171. Copyright © 2021
BMJ Publishing Group. All rights reserved.

<26>
Accession Number
2014936783
Title
Efficacy of pulsatile flow perfusion in adult cardiac surgery: Hemodynamic
energy and vascular reactivity.
Source
Journal of Clinical Medicine. 10(24) (no pagination), 2021. Article
Number: 5934. Date of Publication: December-2 2021.
Author
Dodonov M.; Onorati F.; Luciani G.B.; Francica A.; Tessari M.; Menon T.;
Gottin L.; Milano A.D.; Faggian G.
Institution
(Dodonov, Onorati, Luciani, Francica, Tessari, Menon, Faggian) Cardiac
Surgery, Department of Surgery, University of Verona Medical School,
Verona 37126, Italy
(Gottin) Anesthesiology, Department of Surgery, University of Verona
Medical School, Verona 37126, Italy
(Milano) Cardiac Surgery, Department of Emergency and Organ Transplants,
University of Bari Medical School, Bari 70124, Italy
Publisher
MDPI
Abstract
Background: The role of pulsatile (PP) versus non-pulsatile (NP) flow
during a cardiopulmonary bypass (CPB) is still debated. This study's aim
was to analyze hemodynamic effects, endothelial reactivity and
erythrocytes response during a CPB with PP or NP. Method(s):
Fifty-two patients undergoing an aortic valve replacement were
prospectively randomized for surgery with either PP or NP flow.
Pulsatility was evaluated in terms of energy equivalent pressure (EEP) and
surplus hemodynamic energy (SHE). Systemic (SVRi) and pulmonary (PVRi)
vascular resistances, endothelial markers levels and erythrocyte
nitric-oxide synthase (eNOS) activity were collected at different
perioperative time-points. Result(s): In the PP group, the resultant
EEP was 7.3% higher than the mean arterial pressure (MAP), which
corresponded to 5150 +/- 2291 ergs/cm3 of SHE. In the NP group,
the EEP and MAP were equal; no SHE was produced. The PP group showed lower
SVRi during clamp-time (p = 0.06) and lower PVRi after protamine
administration and during first postoperative hours (p = 0.02). Lower SVRi
required a higher dosage of norepinephrine in the PP group (p = 0.02).
Erythrocyte eNOS activity results were higher in the PP patients (p =
0.04). Renal function was better preserved in the PP group (p = 0.001),
whereas other perioperative variables were comparable between the groups.
 Conclusion(s): A PP flow during a CPB results in significantly lower
SVRi, PVRi and increased eNOS production. The clinical impact of increased
perioperative vasopressor requirements in the PP group deserves further
evaluation. Copyright © 2021 by the authors. Licensee MDPI,
Basel, Switzerland.

<27>
Accession Number
2014389923
Title
Effects of percutaneous balloon mitral valvuloplasty in patients with
mitral stenosis and atrial fibrillation: a systematic review and
meta-analysis.
Source
Acta Cardiologica. (no pagination), 2021. Date of Publication: 2021.
Author
Liu B.; Wang Y.; Liu Y.; Wu P.; Li T.
Institution
(Liu, Wang, Liu, Wu, Li) Heart Central, Third Central Hospital of Tianjin,
Tianjin, China
(Liu) TianjinChina
(Liu) Artificial Cell Engineering Technology Research Center, Tianjin,
China
(Liu) Tianjin Institute of Hepatobiliary Disease, Tianjin, China
Publisher
Taylor and Francis Ltd.
Abstract
Objective: The study aimed to systematically review the existing
literature and assess the effects of percutaneous balloon mitral
valvuloplasty (PBMV) in patients with mitral stenosis and atrial
fibrillation (AF) as opposed to sinus rhythm (SR). Method(s):
Eligible studies were identified from six electronic databases before June
2021. The primary outcome was mitral valve area (MVA), and secondary
outcomes were hemodynamic measurements, in-hospital complications, and
long-term outcomes. Relative risks (RRs) or weighted mean differences
(WMDs) with 95% confidence intervals (CIs) were used as effect sizes.
 Result(s): Fifteen studies were included involving 6351 patients. For
the primary outcome, the AF group obtained less favourable changes in MVA
(WMD: -0.10, 95%CI: -0.14, -0.06) and a significantly smaller
postoperative and long-term MVA (WMD: -0.13, 95%CI: -0.18, -0.08 and WMD:
-0.10, 95%CI: -0.17, -0.03, respectively) compared to the SR group. For
secondary outcome, the AF group was associated with suboptimal outcomes as
following (WMD/RR, [95%CI]): higher LAP (1.37, [0.86, 1.87]), more
embolism (2.85, [1.44, 5.63]), lower event-free survival (0.89, [0.80,
1.00]), higher incidences of mitral valve replacement (2.20, [1.40,
3.46]), re-PBMV (2.28, [1.63, 3.19]), and mortality (3.28, [2.42, 4.44]).
No significant differences were found in other outcomes.
 Conclusion(s): The currently available evidence suggests that PBMV
may be less effective in patients with AF than in those with SR. However,
early treatment and appropriate management of AF patients undergoing PBMV
may benefit the immediate and long-term outcomes. Copyright ©
2021 Belgian Society of Cardiology.

<28>
Accession Number
636664333
Title
Effect of Positive Expiratory Pressure Therapy on Lung Volumes and Health
Outcomes in Adults with Chest Trauma: A Systematic Review and
Meta-Analysis.
Source
Physical therapy. (no pagination), 2021. Date of Publication: 30 Oct
2021.
Author
Saliba K.A.; Blackstock F.; McCarren B.; Tang C.Y.
Institution
(Saliba, Blackstock, Tang) Physiotherapy, School of Health Sciences,
Western Sydney University, NSW, Australia
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The purposes of this study were to evaluate the effect of
positive expiratory pressure (PEP) therapy on lung volumes and health
outcomes in adults with chest trauma and to investigate any adverse
effects and optimal dosages leading to the greatest positive impact on
lung volumes and recovery. METHOD(S): Data sources were
MEDLINE/PubMed, Embase, Cochrane Library, Physiotherapy Evidence Database,
CINAHL, Open Access Thesis/Dissertations, EBSCO Open Dissertations, and
OpenSIGLE/Open Grey. Randomized controlled trials investigating PEP
therapy compared with usual care or other physical therapist interventions
were included. Participants were>18 years old and who were admitted to the
hospital with any form of chest trauma, including lung or cardiac surgery,
blunt chest trauma, and rib fractures. Methodological quality was assessed
using the Physiotherapy Evidence Database Scale, and the level of evidence
was downgraded using the Grading of Recommendations Assessment,
Development and Evaluation approach. RESULT(S): Eleven studies
involving 661 participants met inclusion eligibility. There was very
low-level evidence that PEP improved forced vital capacity (standardized
mean difference [SMD]=-0.50; 95% CI=-0.79 to -0.21), forced expiratory
volume in 1 second (SMD=-0.38; 95% CI=-0.62 to -0.13) and reduced the
incidence of pneumonia (relative risk=0.16; 95% CI=0.03 to 0.85).
Respiratory muscle strength also significantly improved in all 3 studies
reporting this outcome. There was very low-level evidence that PEP did not
improve other lung function measures, arterial blood gases, atelectasis,
or hospital length of stay. Both PEP devices and dosages varied among the
studies, and no adverse events were reported. CONCLUSION(S): PEP
therapy is a safe intervention with very low-level evidence showing
improvements in forced vital capacity, forced expiratory volume in 1
second, respiratory muscle strength, and incidence of pneumonia. It does
not improve arterial blood gases, atelectasis, or hospital length of stay.
As the evidence is very low level, more rigorous physiological and
dose-response studies are required to understand the true impact of PEP on
the lungs after chest trauma. Copyright © The Author(s) 2021.
Published by Oxford University Press on behalf of the American Physical
Therapy Association. All rights reserved. For permissions, please email:
journals.permissions@oup.com.

<29>
Accession Number
636664079
Title
Sublingual microcirculatory alterations during the immediate and early
postoperative period: A systematic review and meta-analysis.
Source
Clinical hemorheology and microcirculation. (no pagination), 2021. Date
of Publication: 26 Oct 2021.
Author
Chalkias A.; Papagiannakis N.; Mavrovounis G.; Kolonia K.; Mermiri M.;
Pantazopoulos I.; Laou E.; Arnaoutoglou E.
Institution
(Chalkias, Kolonia, Mermiri, Laou, Arnaoutoglou) Department of
Anesthesiology, University ofThessaly, Faculty of Medicine, Larisa, Greece
(Chalkias) Outcomes Research Consortium, Cleveland, OH, USA
(Papagiannakis) First Department of Neurology, National and Kapodistrian
University of Athens, Medical School, Athens, Greece
(Mavrovounis, Pantazopoulos) Department of Emergency Medicine, University
of Thessaly, Faculty of Medicine, Larisa, Greece
Publisher
NLM (Medline)
Abstract
BACKGROUND: The incidence of postoperative microcirculatory flow
alterations and their effect on outcome have not been studied extensively.
 OBJECTIVE(S): This systematic review and meta-analysis was designed
to investigate the presence of sublingual microcirculatory flow
alterations during the immediate and early postoperative period and their
correlation with complications and survival. METHOD(S): A systematic
search of PubMed, Scopus, Embase, PubMed Central, and Google Scholar was
conducted for relevant articles from January 2000 to March 2021.
Eligibility criteria were randomized controlled and non-randomized trials.
Case reports, case series, review papers, animal studies and non-English
literature were excluded. The primary outcome was the assessment of
sublingual microcirculatory alterations during the immediate and early
postoperative period in adult patients undergoing surgery. Risk of bias
was assessed with the Ottawa-Newcastle scale. Standard meta-analysis
methods (random-effects models) were used to assess the difference in
microcirculation variables. RESULT(S): Thirteen studies were
included. No statistically significant difference was found between
preoperative and postoperative total vessel density (p = 0.084;
Standardized Mean Difference (SMD): -0.029; 95%CI: -0.31 to 0.26; I2 =
22.55%). Perfused vessel density significantly decreased postoperatively
(p = 0.035; SMD: 0.344; 95%CI: 0.02 to 0.66; I2 = 65.66%), while perfused
boundary region significantly increased postoperatively (p = 0.031; SMD:
-0.415; 95%CI: -0.79 to -0.03; I2 = 37.21%). Microvascular flow index
significantly decreased postoperatively (p = 0.028; SMD: 0.587; 95%CI:
0.06 to 1.11; I2 = 86.09%), while no statistically significant difference
was found between preoperative and postoperative proportion of perfused
vessels (p = 0.089; SMD: 0.53; 95%CI: -0.08 to 1.14; I2 = 70.71%). The
results of the non-cardiac surgery post-hoc analysis were comparable
except that no statistically significant difference in perfused vessel
density was found (p = 0.69; SMD: 0.07; 95%CI: -0.26 to 0.39; I2 = 0%).
LIMITATIONS: The included studies investigate heterogeneous groups of
surgical patients. There were no randomized controlled trials.
 CONCLUSION(S): Significant sublingual microcirculatory flow
alterations are present during the immediate and early postoperative
period. Further research is required to estimate the correlation of
sublingual microcirculatory flow impairment with complications and
survival.

<30>
Accession Number
636663915
Title
Predictors of cognitive dysfunction after cardiac surgery: a systematic
review.
Source
European journal of cardiovascular nursing : journal of the Working Group
on Cardiovascular Nursing of the European Society of Cardiology. (no
pagination), 2021. Date of Publication: 27 Oct 2021.
Author
Bowden T.; Hurt C.S.; Sanders J.; Aitken L.M.
Institution
(Bowden, Hurt, Aitken) School of Health Sciences, City, University of
London, Northampton Square, London EC1V 0HB, UK
(Sanders) St Bartholomew's Hospital, Barts Health NHS Trust, West
Smithfield, London EC1V 0HB, UK
(Sanders) William Harvey Research Institute, Queen Mary University London,
Barts & the London School of Medicine & DentistryCharterhouse Square,
London EC1M 6BQ, United Kingdom
(Aitken) School of Nursing and Midwifery, Griffith University, 170 Kessels
Road ,Nathan, Australia
Publisher
NLM (Medline)
Abstract
AIMS: Postoperative cognitive dysfunction (POCD) is often experienced by
cardiac surgery patients; however, it is not known if some groups of
patients experience this more frequently or severely than others.The aim
of this systematic review was to identify preoperative and postoperative
predictors of cognitive dysfunction in adults following cardiac surgery.
METHODS AND RESULTS: Eight bibliographic databases were searched (January
2005 to March 2021) in relation to cardiac surgery and cognition. Studies
including adult patients who had undergone open cardiac surgery and using
a validated measurement of cognitive function were included. Full-text
review for inclusion, quality assessment, and data extraction were
undertaken independently by two authors.A total of 2870 papers were
identified, of which 36 papers met the inclusion criteria and were
included in the review. The majority were prospective observational
studies [n = 28 (75.7%)]. In total, 61 independent predictors (45
preoperative and 16 postoperative) were identified as significant in at
least one study; advancing age and education level appear important. Age
has emerged as the most common predictor of cognitive outcome.
 CONCLUSION(S): Although a number of predictors of POCD have been
identified, they have inconsistently been reported as significantly
affecting cognitive outcome. Consistent with previous research, our
findings indicate that older patients and those with lower educational
levels should be prioritized when developing and trialling interventions
to improve cognitive function. These findings are less than surprising if
we consider the methodological shortcomings of included studies. It is
evident that further high-quality research exploring predictors of POCD is
required. Copyright © The Author(s) 2021. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<31>
Accession Number
2010694517
Title
One-year results of the first-in-man study investigating the Atrial Flow
Regulator for left atrial shunting in symptomatic heart failure patients:
the PRELIEVE study.
Source
European Journal of Heart Failure. 23(5) (pp 800-810), 2021. Date of
Publication: May 2021.
Author
Paitazoglou C.; Bergmann M.W.; Ozdemir R.; Pfister R.; Bartunek J.; Kilic
T.; Lauten A.; Schmeisser A.; Zoghi M.; Anker S.D.; Sievert H.; Mahfoud F.
Institution
(Paitazoglou, Bergmann) Interventional Cardiology, Cardiologicum Hamburg,
Hamburg, Germany
(Ozdemir) Department of Cardiology, Bezmialem Vakif University, Istanbul,
Turkey
(Pfister) Department of Cardiology, Pulmonology, Angiology and Intensive
Care Medicine, Heart Center University Clinic Koln, Koln, Germany
(Bartunek) Cardiovascular Center, Onze-Lieve-Vrouw Hospital, Aalst,
Belgium
(Kilic) Department of Cardiology, Kocaeli University Medical Faculty,
Kocaeli, Turkey
(Lauten, Anker) Department of Cardiology (CVK) and Berlin Institute of
Health Center for Regenerative Therapies (BCRT), German Centre for
Cardiovascular Research (DZHK) partner site Berlin, Charite
Universitatsmedizin Berlin, Berlin, Germany
(Schmeisser) Department of Cardiology and Angiology,
University clinic Magdeburg A.o.R, Magdeburg, Germany
(Zoghi) Department of Cardiology, Ege University Medical Faculty,
Bornova/Izmir, Turkey
(Sievert) Cardiovascular Center Frankfurt, Frankfurt, Germany
(Mahfoud) Department of Internal Medicine, Cardiology, Angiology and
Intensive Care Medicine, University Clinic Saarland, Homburg, Germany
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Attenuating exercise-induced elevated left atrial pressure with an
atrial shunt device is under clinical investigation for treatment of
symptomatic heart failure (HF). Methods and Results: PRELIEVE was a
prospective, non-randomised, multicentre, first-in-man study in
symptomatic HF patients with reduced (HFrEF) or preserved (HFpEF) ejection
fraction and pulmonary capillary wedge pressure (PCWP) >=15 mmHg at rest
or >=25 mmHg during exercise. Here, we provide follow-up data up to 1 year
after implantation of the Atrial Flow Regulator (AFR) device. The AFR was
successfully implanted in 53 patients (HFrEF n = 24 and HFpEF n = 29). Two
patients were not enrolled due to an unsuccessful transseptal puncture.
There was one device embolisation into the left atrium, which required
surgical removal. One patient experienced a serious procedure-related
adverse event (post-procedural bleeding and syncope). All patients with
sufficient echocardiography readout confirmed device patency with
left-right shunt both at 3 (n = 47/51, 92%) and 12 (n = 45/49, 92%)
months. At 3 months, rest PCWP decreased by 5 (-12, 0) mmHg (P = 0.0003,
median Q1, Q3). No patient developed a stroke, worsening of right heart
function or significant increase of pulmonary artery pressure. Six (6/53,
11%) patients were hospitalised for worsening of HF and three (3/53, 6%)
patients died. We observed improvements in New York Heart Association
functional class, 6-min walking distance and quality of life (Kansas City
Cardiomyopathy Questionnaire) in certain patients. Conclusion(s):
Implantation of the AFR device in HF patients was feasible. No shunt
occlusion, stroke or new right HF was observed during the 1-year
follow-up, with clinical improvements in certain patients. Copyright
© 2021 The Authors. European Journal of Heart Failure published by
John Wiley & Sons Ltd on behalf of European Society of Cardiology.

<32>
Accession Number
635266114
Title
Alternatives for Vitamin K Antagonists as Thromboprophylaxis for
Mechanical Heart Valves and Mechanical Circulatory Support Devices: A
Systematic Review.
Source
Seminars in Thrombosis and Hemostasis. 47(6) (pp 724-734), 2021. Date of
Publication: 01 Sep 2021.
Author
Liesdek O.C.D.; Urbanus R.T.; De Heer L.M.; Fischer K.; Suyker W.J.L.;
Schutgens R.E.G.
Institution
(Liesdek, De Heer, Suyker) Department of Cardiothoracic Surgery,
University Medical Center Utrecht, Utrecht University, Utrecht,
Netherlands
(Liesdek, Urbanus, Fischer, Schutgens) Van Creveldkliniek, University
Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
Publisher
Thieme Medical Publishers, Inc.
Abstract
The holy grail of anticoagulation in patients with intracardiac devices,
such as mechanical heart valves (MHVs) and left ventricular assist devices
(LVADs), comprises safe prevention of thrombosis without interrupting
normal hemostasis. Device-induced thrombosis and anticoagulant-related
bleeding problems are dreaded complications that may cause a significantly
reduced quality of life and increased morbidity and mortality. Vitamin K
antagonists are the current standard for oral anticoagulation therapy in
patients with MHVs and LVADs. Even within the therapeutic range,
hemorrhage is the primary complication of these drugs, which emphasizes
the need for safer anticoagulants for the prevention of device-induced
thrombosis. Device-induced thrombosis is a complex multifactorial
phenomenon that likely requires anticoagulant therapy targeting multiple
pathways. Here, we review the preclinical and clinical data describing the
efficacy of a variety of anticoagulants as thromboprophylaxis after
implantation of intracardiac devices. Copyright © 2021 American
Institute of Physics Inc.. All rights reserved.

<33>
Accession Number
2014262646
Title
Role of coronary angiogram before transcatheter aortic valve implantation.
Source
World Journal of Cardiology. 13(8) (pp 361-371), 2021. Date of
Publication: 26 Aug 2021.
Author
Beska B.; Manoharan D.; Mohammed A.; Das R.; Edwards R.; Zaman A.;
Alkhalil M.
Institution
(Beska, Manoharan, Mohammed, Das, Edwards, Zaman, Alkhalil) Cardiothoracic
Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, United Kingdom
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Coexistent coronary artery disease is commonly seen in patients
undergoing transcatheter aortic valve implantation (TAVI). Previous
studies showed that pre-TAVI coronary revascularisation was not associated
with improved outcomes, challenging the clinical value of routine coronary
angiogram (CA). AIM To assess whether a selective approach to perform
pre-TAVI CA is safe and feasible. METHODS This was a retrospective
non-randomised single-centre analysis of consecutive patients undergoing
TAVI. A selective approach for performing CA tailored to patient clinical
need was developed. Clinical outcomes were compared based on whether
patients underwent CA. The primary endpoint was a composite of all-cause
mortality, myocardial infraction, repeat CA, and re-admission with heart
failure. RESULTS Of 348 patients (average age 81 +/- 7 and 57% male) were
included with a median follow up of 19 (9-31) mo. One hundred and
fifty-four (44%) patients, underwent CA before TAVI procedure. Patients
who underwent CA were more likely to have previous myocardial infarction
(MI) and previous percutaneous revascularisation. The primary endpoint was
comparable between the two group (22.6% vs 22.2%; hazard ratio 1.05,
95%CI: 0.67-1.64, P = 0.82). Patients who had CA were less likely to be
readmitted with heart failure (P = 0.022), but more likely to have repeat
CA (P = 0.002) and MI (P = 0.007). In those who underwent CA, the presence
of flow limiting lesions did not affect the incidence of primary endpoint,
or its components, except for increased rate of repeat CA. CONCLUSION
Selective CA is a feasible and safe approach. The clinical value of
routine CA should be challenged in future randomised trials Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc.
All rights reserved.

<34>
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. 79(2) (pp 291-298), 2022. Date of Publication:
February 2022.
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

<35>
Accession Number
2015687629
Title
Racial Disparities in Acute Coronary Syndrome Management Within a
Universal Healthcare Context: Insights From the AMI-OPTIMA Trial.
Source
CJC Open. 3(12 Supplement) (pp S28-S35), 2021. Date of Publication:
December 2021.
Author
d'Entremont M.-A.; Wee C.C.; Nguyen M.; Couture E.L.; Lemaire-Paquette S.;
Kouz S.; Afilalo M.; Rinfret S.; Schampaert E.; Mansour S.; Montigny M.;
Eisenberg M.; Lauzon C.; Dery J.-P.; L'Allier P.; Tardif J.-C.; Huynh T.
Institution
(d'Entremont, Nguyen, Couture, Lemaire-Paquette) Sherbrooke University
Hospital Centre (CHUS), Department of Medicine, Division of Cardiology,
Sherbrooke, QC, Canada
(d'Entremont) Harvard T.H. Chan School of Public Health, Boston, MA,
United States
(Wee) Beth Israel Deaconess Medical Centre, Department of Medicine,
Division of General Medicine, Boston, MA, United States
(Wee) Harvard Medical School, Boston, MA, United States
(Kouz) Centre Hospitalier Regional de Lanaudiere, Department of Medicine,
Saint-Charles-Borromee, QC, Canada
(Afilalo) Jewish General Hospital, Department of Emergency Medicine,
Montreal, QC, Canada
(Rinfret, Eisenberg, Huynh) McGill Health University Centre, Department of
Medicine, Division of Cardiology, Montreal, QC, Canada
(Schampaert) Hopital du Sacre-Coeur de Montreal, Department of Medicine,
Division of Cardiology, Montreal, QC, Canada
(Mansour) Montreal University Hospital Centre (CHUM), Department of
Medicine, Division of Cardiology, Montreal, QC, Canada
(Montigny) Cite-de-la-Sante, Department of Medicine, Division of
Cardiology, Laval, QC, Canada
(Lauzon) Centre Hospitalier Regional de l'Amiante, Department of Medicine,
Thetford Mines, QC, Canada
(Dery) Quebec Heart and Lung Institute, Department of Medicine, Division
of Cardiology, Quebec City, QC, Canada
(L'Allier, Tardif) Montreal Heart Institute, Department of Medicine,
Division of Cardiology, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: Although prior studies have demonstrated racial disparities
regarding acute coronary syndrome (ACS) care within private or mixed
healthcare systems, few researchers have explored such disparities within
universal healthcare systems. We aimed to evaluate the quality and
outcomes of in-hospital ACS management for White patients vs patients of
colour, within a universal healthcare context. Method(s): We
performed a post hoc analysis of the Acute Myocardial Infarction -
Knowledge Translation to Optimize Adherence to Evidence-Based Therapy
study, a cluster-randomized trial evaluating a knowledge-translation
intervention at 24 hospitals in Quebec, Canada (years: 2009 and 2012). The
primary endpoint was coronary catheterization. The secondary endpoints
included in-hospital mortality, percutaneous and surgical coronary
revascularization, major bleeding, total stroke, and discharge
prescription of evidence-based medical therapy. Result(s): Of 3444
included patients, 2738 were White, and 706 were people of colour. The
mean age was 68.2 years (33.3% women) among White patients and 69.5 years
(36.0% women) among patients of colour. Patients of colour were less
likely to undergo in-hospital coronary catheterization than were White
patients (74.5% vs 80.3%, P = 0.001). This difference was attenuated after
adjusting for patient-level characteristics (odds ratio 0.89; 95%
confidence interval 0.73-1.09), and it was eliminated after adjusting for
hospital-level characteristics (odds ratio 1.04; 95% confidence interval
0.73-1.49). Conclusion(s): Racial disparity in coronary
catheterization for ACS persists within a universal healthcare context.
Patients' comorbidities and hospital-level factors may be partially
responsible for this inequality. Future research on cardiovascular
healthcare in patients with diverse racial/ethnic backgrounds in universal
healthcare systems is needed to remediate racial inequality in ACS
management. Copyright © 2021 The Authors

<36>
Accession Number
635756199
Title
The efficacy of three-dimensional video-assisted thoracic surgery on
treating lung cancer: An exploratory meta-analysis.
Source
Asian journal of surgery. 44(11) (pp 1400-1401), 2021. Date of
Publication: 01 Nov 2021.
Author
Lin H.-H.; Zhou K.; Peng Z.-Y.; Mei J.-D.
Institution
(Lin, Zhou, Peng, Mei) Department of Thoracic Surgery, West China
Hospital, Sichuan University, Chengdu, 610041, PR China; Western China
Collaborative Innovation Center for Early Diagnosis and Multidisciplinary
Therapy of Lung Cancer, Sichuan University, Chengdu, China
Publisher
NLM (Medline)

<37>
Accession Number
635203837
Title
Normal saline and lung recruitment with paediatric endotracheal suction
(NARES): A pilot, factorial, randomised controlled trial.
Source
Australian critical care : official journal of the Confederation of
Australian Critical Care Nurses. 34(6) (pp 530-538), 2021. Date of
Publication: 01 Nov 2021.
Author
Schults J.A.; Cooke M.; Long D.; Schibler A.; Ware R.S.; Charles K.; Irwin
A.; Mitchell M.L.
Institution
(Schults, Long) Paediatric Intensive Care Unit, Queensland Children's
Hospital, South Brisbane, Queensland, Australia; Menzies Health Institute
Queensland, School of Nursing and Midwifery, Griffith University,
Queensland, Australia; Paediatric Critical Care Research Group, Centre for
Children's Health Research, The University of Queensland, South Brisbane,
Queensland, Australia
(Cooke, Charles) Menzies Health Institute Queensland, School of Nursing
and Midwifery, Griffith University, QLD, Australia
(Schibler) Paediatric Intensive Care Unit, Queensland Children's Hospital,
South Brisbane, Queensland, Australia; Paediatric Critical Care Research
Group, Centre for Children's Health Research, The University of
Queensland, South Brisbane, Queensland, Australia
(Ware) Menzies Health Institute Queensland, Griffith University, Nathan,
QLD, Australia
(Irwin) UQ Centre for Clinical Research, The University of Queensland,
Australia; Infection Management and Prevention Service, Queensland
Children's Hospital, South Brisbane, Queensland, Australia
(Mitchell) Menzies Health Institute Queensland, School of Nursing and
Midwifery, Griffith University, Queensland, Australia; Intensive Care
Unit, Princess Alexandra Hospital, Queensland, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND/OBJECTIVE: Endotracheal suction is one of the most common and
harmful procuedres performed on mechanically ventilated children. The aim
of the study was to establish the feasibility of a randomised controlled
trial (RCT) examining the effectiveness of normal saline instillation
(NSI) and a positive end-expiratory pressure recruitment manoeuvre (RM)
with endotracheal suction in the paediatric intensive care unit.
 METHOD(S): Pilot 2 x 2 factorial RCT. The study was conducted at a
36-bed tertiary paediatric intensive care unit in Australia. Fifty-eight
children aged less than 16 years undergoing tracheal intubation and
invasive mechanical ventilation. (i) NSI or no NSI and (ii) RM or no RM
with endotracheal suction . The primary outcome was feasibility; secondary
outcomes were ventilator-associated pneumonia (VAP), change in
end-expiratory lung volume assessed by electrical impedance tomography,
dynamic compliance, and oxygen saturation-to-fraction of inspired oxygen
(SpO2/FiO2) ratio. RESULTS/FINDINGS: Recruitment, retention, and missing
data feasibility criteria were achieved. Eligibility and protocol
adherence criteria were not achieved, with 818 patients eligible and 58
enrolled; cardiac surgery was the primary reason for exclusion.
Approximately 30% of patients had at least one episode of nonadherence.
Children who received NSI had a reduced incidence of VAP; however, this
did not reach statistical significance (incidence rate ratio = 0.12, 95%
confidence interval = 0.01-1.10; p = 0.06). NSI was associated with a
significantly reduced SpO2/FiO2 ratio up to 10 min after suction. RMs were
not associated with a reduced VAP incidence (incidence rate ratio = 0.31,
95% confidence interval = 0.05-1.88), but did significantly improve
end-expiratory lung volume at 2 and 5 min after suction, dynamic
compliance, and SpO2/FiO2 ratio. CONCLUSION(S): RMs provided
short-term improvements in end-expiratory lung volume and oxygenation. NSI
with suction led to a reduced incidence of VAP; however, a definitive RCT
is needed to test statistical differences. A RCT of study interventions is
worthwhile and may be feasible with protocol modifications including the
widening of participant eligibility. Copyright © 2021 Australian
College of Critical Care Nurses Ltd. All rights reserved.

<38>
Accession Number
634636368
Title
The association between preoperative length of hospital stay and deep
sternal wound infection: A scoping review.
Source
Australian critical care : official journal of the Confederation of
Australian Critical Care Nurses. 34(6) (pp 620-633), 2021. Date of
Publication: 01 Nov 2021.
Author
Storey A.; MacDonald B.; Rahman M.A.
Institution
(Storey) Alfred Heart & Lung, The Alfred Hospital, 55 Commercial Road,
Melbourne, VIC 3004, Australia; School of Nursing and Midwifery, La Trobe
University, Plenty Rd & Kingsbury Dr, Bundoora, Melbourne, VIC 3086,
Australia
(MacDonald) Alfred Heart & Lung, The Alfred Hospital, 55 Commercial Road,
Melbourne, VIC 3004, Australia; Ward 2.2, Box Hill Hospital, Eastern
Health, 8 Arnold St, Box Hill, Melbourne, Victoria, 3128, Australia
(Rahman) School of Health, Federation University Australia, Berwick,
Melbourne, VIC 3806, Australia; Australian Institute of Primary Care and
Ageing, La Trobe University, Melbourne, VIC 3086, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Deep sternal wound infection (DSWI) is a serious complication
of cardiac surgery, associated with a significantly longer hospital stay,
an increased mortality, and an almost doubling of treatment costs. The
preoperative length of hospital stay has been suggested in a small number
of studies as a modifiable risk factor yet is not included in surgical
site infection prevention guidelines. The aim of this scoping review was
to review the existing evidence on the association between preoperative
length of hospital stay and DSWI, and to identify established risk factors
for DSWI. METHOD(S): A literature search of six electronic databases
yielded 2297 results. Titles concerning risk factors for DSWI, sternal or
surgical wound infection, or poststernotomy complications were included.
Abstracts relating to preoperative length of stay as a risk factor for
DSWI proceeded to full article review. Articles regarding paediatric
surgery, DSWI management or unavailable in English were excluded.
 RESULT(S): The review identified 11 observational cohort studies.
DSWI prevalence was between 0.9% and 6.8%. Preoperative length of stay
ranged from 0-15.5 days and was found to be associated with DSWI in all
studies. Preoperative length of stay and DSWI were inconsistently defined.
Other risk factors for DSWI included diabetes, obesity, respiratory
disease, heart failure, renal impairment, complex surgery, and reoperation
(p < 0.05). CONCLUSION(S): In this scoping review, an association
between preoperative length of stay and the development of DSWI following
cardiac surgery was identified. Thus, preoperative length of stay as a
modifiable risk factor for DSWI should be considered for inclusion in
cardiothoracic surgical infection prevention guidelines. Copyright
© 2021 Australian College of Critical Care Nurses Ltd. Published by
Elsevier Ltd. All rights reserved.

<39>
Accession Number
636658734
Title
Tight glycaemic control and surgical site infections post cardiac surgery:
A systematic review.
Source
Journal of Wound Care. 30(Supplement 12) (pp S22-S28), 2021. Date of
Publication: 01 Dec 2021.
Author
Hweidi I.M.; Zytoo A.M.; Hayajneh A.
Institution
(Hweidi, Zytoo, Hayajneh) Jordan University of Science and Technology,
Faculty of Nursing, P.O. Box 3030, Irbid 22110, Jordan
Publisher
MA Healthcare Ltd
Abstract
Objective: Surgical site infection (SSI) is one of the most serious
potential complications post cardiac surgery among patients with diabetes
and has a number of adverse health outcomes. The literature shows
discrepancies regarding the effect of different glycaemic control
protocols on reducing adverse health outcomes including SSIs. The aim of
this study was to conduct a systematic review that investigated the effect
of the optimal range of tight glycaemic control protocols using a
continuous insulin infusion on reducing the incidence of SSIs in adult
patients with diabetes undergoing cardiac surgery. Method(s): A
systematic review was conducted following the PRISMA statement and
guidelines. Search terms were used to identify research studies published
between 2000 and 2019 across five key databases, including CINAHL,
Medline, PubMed, Cochrane Database and Google Scholar. Result(s): A
total of 12 studies met the review inclusion criteria. The reviewed
literature tended to support the implementation of a tight glycaemic
control protocol, particularly in the postoperative phase, that
demonstrated fewer potential complications associated with cardiac
surgery. On the other hand, the literature also supported the application
of a moderate glycaemic control protocol in the intraoperative phase to
obtain better glycaemic stability with fewer potential complications among
those patients with diabetes undergoing cardiac surgery.
 Conclusion(s): This analysis concludes that tight glycaemic control
is more effective than moderate glycaemic control intraoperatively in
terms of glycaemic stability among patients with diabetes undergoing
cardiac surgery. Results also emphasised the importance of time-based
protocol implementation to ensure better health outcomes and better
quality of care for patients. Declaration of interest: The authors have no
conflicts of interest to declare. Copyright © 2021 MA Healthcare
Ltd

<40>
Accession Number
2016000501
Title
Patient and caregiver preferences and prioritized outcomes for cardiac
surgery: A scoping review and consultation workshop.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2021.
Date of Publication: 2021.
Author
Oravec N.; Arora R.C.; Bjorklund B.; Gregora A.; Monnin C.; Dave M.G.;
Duhamel T.A.; Kent D.E.; Schultz A.S.H.; Chudyk A.M.
Institution
(Oravec, Arora) Section of Cardiac Surgery, Department of Surgery, Max
Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
(Arora, Dave, Kent) Department of Cardiac Sciences, St Boniface General
Hospital, Winnipeg, MB, Canada
(Bjorklund, Gregora) Enhanced Recovery Protocols for Cardiac Surgery
Patient Researcher Group, St Boniface General Hospital, Winnipeg, MB,
Canada
(Monnin) Neil John Maclean Health Sciences Library, University of
Manitoba, Winnipeg, MB, Canada
(Dave, Duhamel) Faculty of Kinesiology and Recreation Management,
University of Manitoba, Winnipeg, MB, Canada
(Duhamel) Institute of Cardiovascular Sciences, St Boniface General
Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
(Schultz, Chudyk) Rady Faculty of Health Sciences, College of Nursing,
University of Manitoba, Winnipeg, MB, Canada
(Schultz, Chudyk) Health Services & Structural Determinants of Health
Research Group, St Boniface General Hospital Albrechtsen Research Centre,
Winnipeg, MB, Canada
Publisher
Elsevier Inc.
Abstract
Objective(s): In light of the absence of patient and caregiver input in
Enhanced Recovery After Surgery Cardiac Surgery guideline development, we
conducted a scoping review to identify patient and caregiver preferences
and prioritized outcomes related to perioperative care in cardiac surgery
and its lifelong impact. Method(s): Five electronic databases were
searched to retrieve studies investigating patient or caregiver
preferences and prioritized outcomes. Information was charted in duplicate
and analyzed using descriptive statistics or thematic analysis. A patient
and caregiver consultation workshop validated scoping review findings and
solicited novel preferences and outcomes. Result(s): Of the 5292
articles retrieved, 43 met inclusion criteria. Most were from Europe (n =
19, 44%) or North America (n = 15, 35%) and qualitative and quantitative
designs were represented in equal proportions. Fifty-two methods were used
to obtain stakeholder preferences and prioritized outcomes, the majority
being qualitative in nature (n = 32, 61%). Based on the collective
preferences of 3772 patients and caregivers from the review and 17 from
the consultation workshop, a total of 108 patient preferences, 32
caregiver preferences, and 19 prioritized outcomes were identified. The
most commonly identified theme was "information and education." Improved
quality of life was the most common patient-prioritized outcome, and all
caregiver-prioritized outcomes were derived from the consultation
workshop. Conclusion(s): Patient and caregiver preferences overlap
with Enhanced Recovery After Surgery Cardiac Surgery recommendations
targeting preoperative risk reduction strategies, prehabilitation, patient
engagement technology, and intra- and postoperative strategies to reduce
discomfort. To support clinical practice, future research should
investigate associations with key surgical outcomes. Copyright ©
2021 The American Association for Thoracic Surgery

<41>
Accession Number
612326844
Title
Effects of paroxetine-mediated inhibition of GRK2 expression on depression
and cardiovascular function in patients with myocardial infarction.
Source
Neuropsychiatric Disease and Treatment. 12 (pp 2333-2341), 2016. Date of
Publication: 13 Sep 2016.
Author
Tian X.; Wang Q.; Guo R.; Xu L.; Chen Q.M.; Hou Y.
Institution
(Tian, Wang, Hou) Department of Cardiology, Qianfoshan Hospital of
Shandong University, Jinan City, China
(Guo) Department of Physiology, Nanjing University of Chinese Medicine,
Nanjing City, China
(Xu) College of Medicine, Weifang Medical University, Weifang City, China
(Chen) Department of Pharmacology, College of Medicine, University of
Arizona, Tucson, AZ, United States
Publisher
Dove Medical Press Ltd
Abstract
Background: Paroxetine is a selective serotonin reuptake inhibitor
utilized in the treatment of depression and anxiety disorders. Recent
studies have identified paroxetine as a G protein-coupled receptor
kinase-2 (GRK2) inhibitor capable of reversing cardiac dysfunction and
remodeling in experimental models of acute myocardial infarction (AMI). We
determine the clinical importance of paroxetine on cardiac functions in
patients having AMI with depression (AMID) in comparison with fluoxetine,
an unrelated selective serotonin reuptake inhibitor that does not inhibit
GRK2. Method(s): Diagnosis of depression was based on the 17-item
Hamilton Depression Scale and Self-rating Depression Scale in AMI patients
after hospital admission. AMID patients were randomly assigned to
paroxetine or fluoxetine for treatment of depression. Heart rate
variability and cardiac function were evaluated. GRK2 protein levels were
measured using peripheral lymphocytes and Western blot. Result(s):
GRK2 expression in AMID patients was significantly higher than that in AMI
patients without depression. In AMID patients, GRK2 levels were positively
correlated with the 17-item Hamilton Depression Scale and the Self-rating
Depression Scale scores, and negatively correlated with heart rate
variability. Treatment of AMID patients with paroxetine significantly
reduced the expression of GRK2, normalized the autonomic nervous system
function, and improved cardiac performance. In contrast, fluoxetine
normalized the autonomic nervous system but did not reduce the expression
of GRK2 nor improved cardiac performance. Conclusion(s): This study
suggests that paroxetine is effective for improving cardiac function in
patients with AMID and such effect correlates with GRK2
reduction. Copyright © 2016 Tian et al.

<42>
Accession Number
2007596702
Title
The efficacy and safety of chinese medicine fufang zhenzhu tiaozhi capsule
(Ftz) in the treatment of diabetic coronary heart disease: Study protocol
for multicenter, randomized, double-blind, placebo-controlled clinical
trial.
Source
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 14 (pp
2651-2659), 2021. Date of Publication: 2021.
Author
Wang L.; Xiang L.; Piao S.; Gong X.; Zhou W.; Feng W.; Li H.; Li L.; Wei
A.; Zhu Q.; Rong X.; Guo J.
Institution
(Wang, Xiang, Piao, Zhu, Rong, Guo) Guangdong Metabolic Diseases Research
Center of Integrated Chinese and Western Medicine, Key Laboratory of
Glucolipid Metabolic Disorder, Ministry of Education of China, Institute
of Chinese Medicine, Guangdong Pharmaceutical University, Guangdong TCM
Key Laboratory for Metabolic Diseases, Guangzhou, China
(Xiang, Guo) The First Affiliated Hospital of Guangdong Pharmaceutical
University, Guangzhou, China
(Gong) School of Public Health, Guangdong Pharmaceutical University,
Guangzhou, China
(Zhou) Department of Internal Cardiology, The First Affiliated Hospital of
Guangdong Pharmaceutical University, Guangzhou, China
(Feng) Famous Doctor's Studio, Qingyuan Hospital of Traditional Chinese
Medicine, Qingyuan, China
(Li) Department of Endocrinology, Shenzhen Traditional Chinese Medicine
Hospital, The Fourth Clinical Medical College of Guangzhou University of
Chinese Medicine, Shenzhen, China
(Li) Department of Endocrinology, Zhongshan Hospital of Traditional
Chinese Medicine, Zhongshan, China
(Wei) Department of Endocrinology, Foshan Hospital of Traditional Chinese
Medicine, Foshan, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Diabetic coronary heart disease (DCHD), the main macrovascular
complication of type 2 diabetes mellitus (T2DM), is greatly harmful to
T2DM patients. Traditional Chinese medicine (TCM) is an alternative and
effective therapy to delay the development of macro-vascular diseases, but
the existing evidence of its efficacy and safety is insufficient. The aim
of this multicenter, randomized, double-blind, placebo-controlled trial is
to evaluate the efficacy and safety of Chinese Medicine Fufang Zhenzhu
Tiaozhi capsule (FTZ) in treating DCHD. Patients and Methods: This
study includes a 2-week run-in, 52-week treatment, and 52-week
post-treatment follow-up. A total of 160 participants will be recruited
and randomized into two groups. The treatment group will receive FTZ and
basic treatment, while the control group will receive the placebo and
basic treatment. The primary outcome is the combined outcome including the
major adverse cardiovascular events, coronary restenosis, and unplanned
revascularization. The combined secondary outcomes include all-cause
mortality, acute coronary syndrome, ischemic stroke, heart failure,
unplanned re-hospitalization mainly caused by acute complications of
diabetes, other thromboembolic events, and TCM symptom indicators. The
safety outcomes and adverse events will also be evaluated in this trial.
 Discussion(s): This trial evaluates the clinical effectiveness and
safety of FTZ in patients with DCHD. The results are important to further
explore the effectiveness of the comprehensive strategy "Tiao Gan Qi Shu
Hua Zhuo" (modulating Gan, trigging key metabolic system to resolve
pathogenic factors such as phlegm retention and dampness) in the
prevention and control of glucolipid metabolic disorders (GLMD) including
DCHD and T2DM. On the other hand, this study is the first trial of FTZ to
observe cardiovascular outcomes through long-term follow-up after
treatment of DCHD, which is of great value. Trial Registration: This trial
was registered in the Chinese Clinical Trial Registry on April 07, 2019
(No. ChiCTR1900022345). Copyright © 2021 Wang et al.

<43>
Accession Number
2015850561
Title
Role of stent oversizing in patients undergoing primary percutaneous
coronary intervention. An open-labeled randomized controlled trial.
Source
Minerva Cardiology and Angiology. 69(5) (pp 513-521), 2021. Date of
Publication: October 2021.
Author
BANIFATEMEH S.A.; SADEGHIPOUR P.; ALEMZADEH-ANSARI M.J.; FAKHRABADI A.A.;
ZOLFAGHARI F.; ZAHEDMEHR A.; MOHEBBI B.; KIANI R.; SHAKERIAN F.;
RASHIDINEJAD A.; HOSSEINI Z.; FIROUZI A.
Institution
(BANIFATEMEH, SADEGHIPOUR, ALEMZADEH-ANSARI, FAKHRABADI, ZOLFAGHARI,
ZAHEDMEHR, MOHEBBI, KIANI, SHAKERIAN, RASHIDINEJAD, HOSSEINI, FIROUZI)
Cardiovascular Intervention Research Center, Rajaie Cardiovascular,
Medical, and Research, Center, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(BANIFATEMEH) Department of Cardiovascular Medicine, Rasoul-e-Akram
Hospital, Iran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(SADEGHIPOUR) Clinical Trial Center, Rajaie Cardiovascular, Medical, and
Research Center, Iran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: In patients with ST-segment-elevation myocardial infarction
(STEMI), primary percutaneous coronary intervention (PPCI) is the
treatment of choice. Stent undersizing might occur due to catecholamine
release and coronary spasm. Although routine oversizing has been promising
in several investigations, it has never been tested in randomized clinical
trials. In this single-center open-label randomized clinical trial, we
evaluated the role of stent oversizing in PPCI. METHOD(S): Candidates
for PPCIwere randomly divided into oversized and non-oversized groups. In
the oversized group, the stent was oversized by 10% according to the mean
lumen diameter, retrieved from the quantitative coronary analysis. Primary
composite endpoints were defined as the occurrence of complete total
ST-segment (STR)resolution and postprocedural thrombolysis in myocardial
infarction (TIMI) flow grade III. RESULT(S): The study population was
comprised of 122 patients, allocated to the oversized group (N.=61) and
the non-oversized group (N.=61). There was no significant difference
between the 2 groups regarding the final TIMI flow grade. Complete STRwas
marginally more favorable in the non-oversized group (56.05+/-55.12 vs.
64.64+/-23.28; P=0.056). The troponin ratio, CK-MB ratio, and 6-month
follow-up outcome - defined as target lesion revascularization, heart
failure, and cardiovascular death - were comparable between the 2 groups.
 CONCLUSION(S): Our study showed that routine oversizing in patients
undergoing PPCI had no benefit regarding ST-segment resolution and the
final TIMI flow, as well as hard cardiac events, during the
follow-up. Copyright © 2021 Edizioni Minerva Medica. All right
reserved.

<44>
Accession Number
2015810754
Title
Posterior left pericardiotomy for the prevention of atrial fibrillation
after cardiac surgery: an adaptive, single-centre, single-blind,
randomised, controlled trial.
Source
The Lancet. 398(10316) (pp 2075-2083), 2021. Date of Publication: 04 Dec
2021.
Author
Gaudino M.; Sanna T.; Ballman K.V.; Robinson N.B.; Hameed I.; Audisio K.;
Rahouma M.; Di Franco A.; Soletti G.J.; Lau C.; Rong L.Q.; Massetti M.;
Gillinov M.; Ad N.; Voisine P.; DiMaio J.M.; Chikwe J.; Fremes S.E.; Crea
F.; Puskas J.D.; Girardi L.
Institution
(Gaudino, Robinson, Hameed, Audisio, Rahouma, Di Franco, Soletti, Lau,
Girardi) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, NY, United States
(Rong) Department of Anesthesiology, Weill Cornell Medicine, New York, NY,
United States
(Sanna, Massetti, Crea) Department of Cardiovascular Medicine, Fondazione
Policlinico Universitario A Gemelli IRCCS, Rome, Italy
(Sanna, Massetti, Crea) Department of Cardiovascular and Pulmonary
Sciences, Catholic University of the Sacred Heart, Rome, Italy
(Ballman) Alliance Statistics and Data Center, Weill Medical College of
Cornell University, New York, NY, United States
(Gillinov) Department of Thoracic and Cardiovascular Surgery, Heart and
Vascular Institute, Cleveland Clinic, Cleveland, OH, United States
(Ad) Division of Cardiothoracic Surgery, Washington Adventist Hospital and
University of Maryland, Tacoma Park, MD, United States
(Voisine) Division of Cardiac Surgery, Department of Cardiology, Institut
Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec
City, QC, Canada
(DiMaio) Department of Cardiothoracic Surgery, Baylor Scott & White The
Heart Hospital, Plano, TX, United States
(Chikwe) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Morningside,
New York, NY, United States
Publisher
Elsevier B.V.
Abstract
Background: Atrial fibrillation is the most common complication after
cardiac surgery and is associated with extended in-hospital stay and
increased adverse outcomes, including death and stroke. Pericardial
effusion is common after cardiac surgery and can trigger atrial
fibrillation. We tested the hypothesis that posterior left pericardiotomy,
a surgical manoeuvre that drains the pericardial space into the left
pleural cavity, might reduce the incidence of atrial fibrillation after
cardiac surgery. Method(s): In this adaptive, randomised, controlled
trial, we recruited adult patients (aged >=18 years) undergoing elective
interventions on the coronary arteries, aortic valve, or ascending aorta,
or a combination of these, performed by members of the Department of
Cardiothoracic Surgery from Weill Cornell Medicine at the New York
Presbyterian Hospital in New York, NY, USA. Patients were eligible if they
had no history of atrial fibrillation or other arrhythmias or
contraindications to the experimental intervention. Eligible patients were
randomly assigned (1:1), stratified by CHA<inf>2</inf>DS<inf>2</inf>-VASc
score and using a mixed-block randomisation approach (block sizes of 4, 6,
and 8), to posterior left pericardiotomy or no intervention. Patients and
assessors were blinded to treatment assignment. Patients were followed up
until 30 days after hospital discharge. The primary outcome was the
incidence of atrial fibrillation during postoperative in-hospital stay,
which was assessed in the intention-to-treat (ITT) population. Safety was
assessed in the as-treated population. This study is registered with
ClinicalTrials.gov, NCT02875405, and is now complete. Finding(s):
Between Sept 18, 2017, and Aug 2, 2021, 3601 patients were screened and
420 were included and randomly assigned to the posterior left
pericardiotomy group (n=212) or the no intervention group (n=208; ITT
population). The median age was 61.0 years (IQR 53.0-70.0), 102 (24%)
patients were female, and 318 (76%) were male, with a median
CHA<inf>2</inf>DS<inf>2</inf>-VASc score of 2.0 (IQR 1.0-3.0). The two
groups were balanced with respect to clinical and surgical
characteristics. No patients were lost to follow-up and data completeness
was 100%. Three patients in the posterior left pericardiotomy group did
not receive the intervention. In the ITT population, the incidence of
postoperative atrial fibrillation was significantly lower in the posterior
left pericardiotomy group than in the no intervention group (37 [17%] of
212 vs 66 [32%] of 208 [p=0.0007]; odds ratio adjusted for the
stratification variable 0.44 [95% CI 0.27-0.70; p=0.0005]). Two (1%) of
209 patients in the posterior left pericardiotomy group and one (<1%) of
211 in the no intervention group died within 30 days after hospital
discharge. The incidence of postoperative pericardial effusion was lower
in the posterior left pericardiotomy group than in the no intervention
group (26 [12%] of 209 vs 45 [21%] of 211; relative risk 0.58 [95% CI
0.37-0.91]). Postoperative major adverse events occurred in six (3%)
patients in the posterior left pericardiotomy group and in four (2%) in
the no intervention group. No posterior left pericardiotomy related
complications were seen. Interpretation(s): Posterior left
pericardiotomy is highly effective in reducing the incidence of atrial
fibrillation after surgery on the coronary arteries, aortic valve, or
ascending aorta, or a combination of these without additional risk of
postoperative complications. Funding(s): None Copyright ©
2021 Elsevier Ltd

<45>
Accession Number
2014739823
Title
Serum prolidase activity in cardiovascular disease.
Source
Erciyes Medical Journal. 43(6) (pp 537-540), 2021. Date of Publication:
2021.
Author
Askin L.; Tanriverdi O.
Institution
(Askin, Tanriverdi) Department of Cardiology, Adiyaman Training and
Research Hospital, Adiyaman, Turkey
Publisher
Kare Publishing
Abstract
Serum prolidase activity (SPA) plays a vital role in plaque stabilization
in collagen turnover in atherosclerotic plaques. Thus, SPA has an
essential role in the diagnosis and prevention of coronary artery disease.
SPA values may be higher in hypertension, atrial fibrillation, coronary
artery ectasia, and aneurysmatic diseases than average values due to
collagen turnover and oxidative stress. We aimed to present a review to
show the role of SPA based on cardiovascular diseases and how it will
contribute to prognosis with the most recent data. Copyright ©
2021 by Erciyes University Faculty of Medicine.

<46>
Accession Number
2012120935
Title
Risk factors associated with longer stays in cardiovascular surgical
intensive care unit after CABG.
Source
Journal of the Formosan Medical Association. Part 2. 121(1) (pp 304-313),
2022. Date of Publication: January 2022.
Author
Kao K.-D.; Lee S.-Y.K.C.; Liu C.-Y.; Chou N.-K.
Institution
(Kao) Department of Nursing, National Taiwan University Hospital, Taiwan
(Republic of China)
(Kao, Lee) School of Nursing, National Taipei University of Nursing and
Health Sciences, Taiwan (Republic of China)
(Liu) Department of Speech Language Pathology and Audiology, National
Taipei University of Nursing and Health Sciences, Taiwan (Republic of
China)
(Chou) Department of Cardiovascular Surgery, National Taiwan University
Hospital, Taiwan (Republic of China)
Publisher
Elsevier B.V.
Abstract
Background/Purpose: Monitoring ICU length of stay (LOS) after CABG and
examining its risk factors can guide initiatives on the improvement of
care. But few have evaluated this issue to include personal and clinical
factors, and demands of ICU care. This study applied Donabedian model to
identify risk factors for longer ICU stays after CABG. Lifestyle, clinical
factors during and after CABG, TISS were viewed as structure factors, and
infection and organ failures during ICU did as process factors.
 Method(s): This retrospective cohort study used data via medical
records at a medical center. A stratified randomized sample of 230 adults
from a cohort of 690 isolated CABGs was to reflect the rate of 34.7%
longer than 3-day-ICU LOS. The sample comprised of longer-stay group (n =
150) and shorter-stay group (n = 80). Result(s): Hierarchical
logistic regression analysis revealed that potential signs of infection
(3-day average WBC higher than 10,000/muL, OR: 3.41 and the body
temperature higher than 38 degreeC, OR:5.67) and acute renal failure (OR:
8.97) remained as the most significant predicted factors of stay longer
than 3 ICU days. Along with higher TISS score within 24 hours (OR:1.06),
structure factors of female gender (OR:4.16) smoking(OR: 4.87), higher CCI
before surgery(OR:1.49), bypass during CABG (OR:3.51) had higher odds of
risk to stay longer. Conclusion(s): Further quality improvement
initiatives to shorten ICU stay after CABG may include the promotion of a
smoking cessation program in clinical practice, and better management of
the manpower allocation, infection control and renal
failure. Copyright © 2021

<47>
Accession Number
2014701401
Title
Persistent under-representation of female patients in United States trials
of common vascular diseases from 2008 to 2020.
Source
Journal of Vascular Surgery. 75(1) (pp 30-36), 2022. Date of Publication:
January 2022.
Author
Mayor J.M.; Preventza O.; McGinigle K.; Mills J.L.; Montero-Baker M.;
Gilani R.; Pallister Z.; Chung J.
Institution
(Mayor, Mills, Montero-Baker, Gilani, Pallister, Chung) Division of
Vascular Surgery and Endovascular Therapy, Michael E DeBakey Department of
Surgery, Baylor College of Medicine, Houston, Tex, United States
(Preventza) Division of Cardiothoracic Surgery, Michael E DeBakey
Department of Surgery, Baylor College of Medicine, Houston, Tex, United
States
(McGinigle) Division of Vascular Surgery, Department of Surgery,
University of North Carolina, Chapel Hill, NC, United States
Publisher
Elsevier Inc.
Abstract
Background: Women have been historically under-represented in vascular
surgery and cardiovascular medicine trials. The rate and change in
representation of women in trials of common vascular diseases over the
last decade is not understood completely. Method(s): We used publicly
available data from ClinicalTrials.gov to evaluate trials pertaining to
carotid artery stenosis (CAS), peripheral arterial disease (PAD), thoracic
and abdominal aortic aneurysms (TAA and AAA), and type B aortic
dissections (TBAD) from 2008 to the present. We evaluated representation
of women in these trials based on the participation-to-prevalence ratios
(PPR), which are calculated by dividing the percentage of women among
trial participants by the percentage of women in the disease population.
Values of 0.8 to 1.2 reflect similar representation. Result(s): The
sex distribution was reported in all 97 trials, including 11 CAS trials,
68 PAD trials, 16 TAA/AAA trials, and 2 TBAD trials. The total number of
participants in these trials was 41,622 and the median number of
participants per trial was 150.5 (interquartile range [IQR], 50-252). The
percentage of women in the disease population was 51.9% for CAS, 53.1% for
PAD, 34.1% for TAA/AAA, and 30.9% for TBAD. Industry sources funded 76 of
the trials (77.6%), and the Veterans Affairs Administration (n = 4
[4.1%]), unspecified university (n = 7 [7.1%]), and extramural sources (n
= 11 [11.2%]) funded the remainder of the trials. The overall median PPR
for all four diseases was 0.65 (IQR, 0.51-0.80). Women were
under-represented for all four conditions studied (CAS, 0.73 [IQR,
0.62-0.96]; PAD, 0.65 [IQR, 0.53-0.77]; TAA/AAA, 0.59 [IQR, 0.38-1.20];
and TBAD, 0.74 [IQR, 0.65-0.84]). There was no significant difference in
PPR among the diseases (P =.88). From 2008 to the present, there was no
significant change in PPR values over time overall (r2 = 0.002;
P =.70). When examined individually, PPR did not change significantly over
time for any of the diseases studied (for each, r2 < 0.04; P
>.45). The PPR did not vary significantly over time for any of the funding
sources (for each, r2 < 0.85, P >.08). There was appropriate
representation (PPR of 0.8-1.2) in a minority of trials for each disease
except TBAD (CAS, 27.3%; PAD, 15.9%; TAA/AAA, 18.8%; and TBAD, 50%).
Trials that were primarily funded from university sources had the highest
median PPR (1.04; IQR, 0.21-1.27), followed by industry-funded (0.67; IQR,
0.54-0.81), and extramurally funded (0.60; IQR, 0.34-0.73). Studies funded
by Veterans Affairs had the lowest PPR (0.02; IQR, 0.00-0.11; P =.004).
 Conclusion(s): Participation of women in US trials of common vascular
diseases remains low and has not improved since 2008. Therefore, the
generalizability of recent trial results to women with these vascular
diseases remains unknown. An improved understanding of the underlying root
causes for poor female trial participation, advocacy, and education are
required to improve the generalizability of trial results for female
vascular patients. Copyright © 2021 Society for Vascular Surgery

<48>
Accession Number
2014068463
Title
Safety and efficacy of concomitant ablation for atrial fibrillation in
rheumatic mitral valve surgery: A meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2021. Date of Publication:
2021.
Author
Ma J.; Wei P.; Yan Q.; Liu J.; Yao X.; Chen Z.; Zhuang J.; Guo H.-M.
Institution
(Ma, Wei, Liu, Chen, Zhuang, Guo) Department of Cardiovascular Surgery,
Guangdong Provincial Key Laboratory of South China Structural Heart
Disease, Guangdong Provincial People's Hospital, Guangdong Cardiovascular
Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
(Yan, Yao) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese
Academy of Medical Sciences, Shenzhen, China
Publisher
John Wiley and Sons Inc
Abstract
Objectives: This review aimed to evaluate the safety and efficacy of
concomitant surgical ablation (SA) for patients with atrial fibrillation
(AF) undergoing rheumatic mitral valve (MV) surgery. Method(s): A
systematic search of relevant studies focusing on SA for patients with AF
undergoing rheumatic MV surgery was performed. The primary outcomes
included mortality, efficacy, and complications. Result(s): Four
randomized controlled trials (RCTs) and four observational studies
covering 1931 patients met the inclusion criteria. In RCTs, no significant
differences in reoperation for bleeding, low cardiac output syndrome,
thromboembolic events, and early (risk ratio [RR], 2.07; 95% confidence
intervals [CI], 0.37-11.40; p =.41) and midterm all-cause death (RR, 1.07;
95% CI, 0.40-2.88; p =.89) were noted between the SA group and the
nonablation group. These results were similar to those obtained from
observational studies. However, ablation was associated with a higher
incidence of permanent pacemaker implantation (RR, 2.44; 95% CI,
1.15-5.18; p =.02) in observational studies but not in RCTs (RR, 2.03; 95%
CI, 0.19-21.26; p =.56). Furthermore, additional SA was significantly more
effective in sinus rhythm (SR) restoration than MV surgery alone at
discharge and at the 12-month and 3-year follow-ups. Conclusion(s):
Concomitant SA during rheumatic MV surgery does not increase perioperative
adverse events. In addition, SA promotes considerable restoration of SR.
Although some evidence exists that permanent pacemaker implantation is
more common after ablation, not all studies support this
notion. Copyright © 2021 Wiley Periodicals LLC

<49>
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

<50>
Accession Number
635166874
Title
Pulmonary effects of dexmedetomidine infusion in thoracic aortic surgery
under hypothermic circulatory arrest: a randomized placebo-controlled
trial.
Source
Scientific reports. 11(1) (pp 10975), 2021. Date of Publication: 26 May
2021.
Author
Kim S.; Park S.J.; Nam S.B.; Song S.-W.; Han Y.; Ko S.; Song Y.
Institution
(Kim, Park, Nam, Han, Ko) Department of Anesthesiology and Pain Medicine,
Yonsei University College of Medicine, Seoul, South Korea
(Nam) Anesthesia and Pain Research Institute, Yonsei University College of
Medicine, Seoul, South Korea
(Song) Department of Cardiovascular Surgery, Yonsei University College of
Medicine, Seoul, South Korea
(Song) Department of Anesthesiology and Pain Medicine, Yonsei University
College of Medicine, Seoul, South Korea
(Song) Anesthesia and Pain Research Institute, Yonsei University College
of Medicine, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
Dexmedetomidine has emerged as a promising organ protective agent. We
performed prospective randomized placebo-controlled trial investigating
effects of perioperative dexmedetomidine infusion on pulmonary function
following thoracic aortic surgery with cardiopulmonary bypass and moderate
hypothermic circulatory arrest. Fifty-two patients were randomized to two
groups: the dexmedetomidine group received 1 microg/kg of dexmedetomidine
over 20 min after induction of anesthesia, followed by 0.5 microg/kg/h
infusion until 12 h after aortic cross clamp (ACC)-off, while the control
group received the same volume of normal saline. The primary endpoints
were oxygenation indices including arterial O2 partial pressure (PaO2) to
alveolar O2 partial pressure ratio (a/A ratio), (A-a) O2 gradient,
PaO2/FiO2 and lung mechanics including peak inspiratory and plateau
pressures and compliances, which were assessed after anesthesia induction,
1 h, 6 h, 12 h, and 24 h after ACC-off. The secondary endpoints were serum
biomarkers including interleukin-6, tumor necrosis factor-alpha,
superoxide dismutase, and malondialdehyde (MDA). As a result,
dexmedetomidine did not confer protective effects on the lungs, but
inhibited elevation of serum MDA level, indicative of anti-oxidative
stress property, and improved urine output and lower requirements of
vasopressors.

<51>
Accession Number
636648825
Title
The effect of different anaesthetic agents in postsurgical inflammatory
response in thoracic surgery: A systematic review.
Source
British Journal of Surgery. Conference: Association of Surgeons of Great
Britain and Ireland Congress. Virtual. 108(SUPPL 7) (pp vii143), 2021.
Date of Publication: October 2021.
Author
Aquilina J.; Geropoulos G.; Loufopoulos I.; Gupte A.; Mitsos S.;
Panagiotopoulos N.
Institution
(Aquilina, Geropoulos, Loufopoulos, Gupte, Mitsos, Panagiotopoulos)
University College London Hospitals NHS Foundation Trust, London, United
Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Post-operative systemic inflammatory reaction is part of the stress
response caused by major thoracic surgery. Different anaesthetic agents
used affect different immunological phenomena. This systematic review
evaluates the impact of anaesthetic agents on the immunological profile
and the associated clinical significance. Method(s): A systematic
review of MEDLINE, EMBASE and Cohrane databases to explore how different
anaesthetic agents affect post-operative inflammatory response.
 Result(s): A total of nine studies were included in our analysis.
Peri-operative use of dexmedetomidine, propofol, sevoflurane, isoflurane,
ropivacaine, sufentanil, naloxone and clonidine were compared, based on
their effect on the systemic release of inflammatory markers. Variance on
the levels of the circulating inflammatory molecules such as interleukins,
interferon-c, tumor necrosis factor a and on the cellular response
including natural killer, CD4 and CD8 T cells, were observed among
different anaesthetic agents. Conclusion(s): Inflammation improves
immunity and regenerative cell recruitment, however excessive responses
can lead to delayed wound healing, organ dysfunction and increased
morbidity and mortality. There is still uncertainty regarding the role of
immune changes on clinical outcomes of patients undergoing thoracic
surgery, and more research is needed to explore other immunological
effects related to anaesthetic agents.

<52>
Accession Number
636648693
Title
A meta-analysis on the impact of bariatric surgery on lower urinary tract
symptoms in men.
Source
British Journal of Surgery. Conference: Association of Surgeons of Great
Britain and Ireland Congress. Virtual. 108(SUPPL 7) (pp vii33-vii34),
2021. Date of Publication: October 2021.
Author
Stefanova I.; Currie A.; Newton R.; Albon L.; Hawkins W.; Pring C.
Institution
(Stefanova) East Surrey Hospital
(Currie) Ashford and St Peters Hospital
(Newton, Albon, Hawkins, Pring) St Richard's Hospital
Publisher
John Wiley and Sons Ltd
Abstract
Background: Obesity is a chronic disease with multisystem morbidity. There
are multiple studies reporting the effect of bariatric surgery on
cardiovascular and metabolic disease but only few examine its impact on
lower urinary tract symptoms. This article aims to perform a systematic
review with meta-analysis in order to determine the effects of bariatric
surgery on lower urinary tract symptoms in male patients. Method(s):
Medline, Embase, conference proceeding and reference lists were searched
for studies reporting the quantative measurement of lower urinary tract
symptoms score pre- and post-weight loss surgery. The primary outcome was
International Prostate Symptom Score (IPSS) before and after bariatric
surgery. Secondary outcomes were change in Body Mass Index (BMI) and Total
Body Weight (TBW). Weighted mean differences (MD) were calculated for
continuous outcomes. Result(s): Seven studies were included in the
analysis of 334 patients undergoing bariatric surgery. Mean study
follow-up was between 3 and 36 months. There was a statistically
significant improvement in the IPSS score following bariatric surgery (MD
2.82, 95% CI 0.96 to 4.69, p=0.003). Bariatric surgery also resulted in
statistically significant reduction of BMI and TBW. Conclusion(s):
Bariatric surgery produces a significant improvement on lower urinary
tract symptoms in men with obesity. This may be due to improvement of
insulin sensitivity, testosterone levels or lipid profile associated with
weight loss. Further studies are necessary to investigate in detail the
pathophysiological mechanisms through which lower urinary tract symptoms
develop in obese patients, and their improvement following weight loss
surgery.

<53>
Accession Number
636648482
Title
Management of boerhaave syndrome.
Source
British Journal of Surgery. Conference: Association of Surgeons of Great
Britain and Ireland Congress. Virtual. 108(SUPPL 7) (pp vii150), 2021.
Date of Publication: October 2021.
Author
Florance C.; Jones K.; Singh K.
Institution
(Florance) Conquest Hospital, Hastings, United Kingdom
(Jones, Singh) Royal Sussex County Hospital, Brighton, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Aim: Boerhaave's Syndrome is a rare and fatal condition, characterised by
a distal oesophageal tear induced by an abrupt rise in intra-luminal
pressure. Treatment remains controversial; we present a recent case and
review relevant literature. Method(s): A retrospective analysis of
case-notes was performed, and a literature review undertaken on PubMed.
 Result(s): A 58-year-old male presented as an emergency with severe
chest pain, having choked and vomited following the ingestion of steak.
Computed tomograpy scan of the thorax demonstrated a large
pneumomediastinum associated with an oesophageal perforation on the
anterior wall and bilateral pleural effusions. A primary laparoscopic
repair was performed with jejunostomy placement for feeding. The
post-operative period was complicated by a prolonged stay on intensive
care with sepsis secondary to mediastinitis. A contrast swallow performed
eleven days post-surgery confirmed no persistent leak and the patient was
discharged five days later. Boerhaave's syndrome accounts for 10% of
oesophageal perforations and is typically associated with a history of
overindulgence and vomiting. Stable patients with a contained disruption
and minimal contamination, can be managed conservatively. Endoscopic
therapies include clipping small perforations, self-expanding stents for
larger defects, and endoluminal vacuum therapy. Operative interventions
comprise primary repair, debridement and drainage of thoracic cavity,
diversion operations and single stage resection with or without primary
reconstruction. Conclusion(s): Boerhaave's Syndrome is associated
with significant morbidity and mortality, but with early recognition and
prompt intervention, patients can be successfully managed. Options include
conservative, endoscopic and surgical, depending upon the site and size of
the perforation.

<54>
[Use Link to view the full text]
Accession Number
2015904110
Title
Prophylactic dialysis improves short-term clinical outcome in patients
with non-dialysis-dependent chronic kidney disease undergoing cardiac
surgery: A meta-analysis of randomized controlled trials.
Source
Coronary Artery Disease. 31(1) (pp E73-E79), 2022. Date of Publication: 01
Jan 2022.
Author
An X.; Ye N.; Bian W.; Cheng H.
Institution
(An, Ye, Bian, Cheng) Division of Nephrology, Beijing Anzhen Hospital,
Capital Medical University, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Several studies have reported that prophylactic dialysis can
reduce the mortality of non-dialysis-dependent chronic kidney disease
(CKD) patients after cardiac surgery. However, the results of
complications in these randomized controlled trials (RCTs) were not
consistent. We aimed to perform a meta-analysis to systematically evaluate
the effect of prophylactic dialysis in these non-dialysis-dependent CKD
patients. Method(s): We systematically searched Medline, Embase,
Cochrane's Library and other online sources for related RCTs. Effects of
prophylactic dialysis on the incidence of 30 days' mortality and
postoperative complications were analyzed. Result(s): Four RCTs
comprising 395 patients were included, all of them treated by coronary
artery bypass grafting. Treatment of preoperative and intraoperative
prophylactic dialysis significantly reduced the rate of 30-day all-cause
mortality (risk ratio [RR]: 0.27, 95% confidence interval [CI], 0.13-0.58,
P < 0.001, I2 = 0%) and the incidence of pulmonary complications (RR:
0.39, 95% CI, 0.20-0.77, P = 0.007, I2 = 0%), low cardiac output (RR:
0.29, 95% CI, 0.09-0.99, P = 0.05, I2 = 0%), and acute kidney injury (RR:
0.19, 95% CI: 0.07-0.52, P = 0.001, I2 = 0%). However, there were no
statistically significant differences between the dialysis group and the
control group in gastrointestinal bleeding, sepsis or multiple organ
failure, wound infection, arrhythmia, transient neurologic deficit, stroke
and re-exploration for bleeding. Conclusion(s): Prophylactic dialysis
can improve the 30-day clinical outcomes of non-dialysis-dependent CKD
patients undergoing cardiac surgery, it was associated with the 30-day
mortality benefit and led to a decrease in the incidence of pulmonary
complications, as well as low cardiac output, and acute kidney injury.
 Copyright © 2021 The Author(s). Published by Wolters Kluwer
Health, Inc.

<55>
[Use Link to view the full text]
Accession Number
2015904086
Title
White blood cell count and clinical outcomes after left main coronary
artery revascularization: Insights from the EXCEL trial.
Source
Coronary Artery Disease. 31(1) (pp 45-51), 2022. Date of Publication: 01
Jan 2022.
Author
Claessen B.E.; Ben-Yehuda O.; Mehran R.; Sorrentino S.; Guedeney P.; Chen
S.; Dressler O.; Kini A.S.; Sharma S.K.; Mansour S.; Noiseux N.; Li D.;
Kappetein A.P.; Sabik J.F.; Serruys P.W.; Stone G.W.
Institution
(Claessen, Mehran, Sorrentino, Guedeney, Kini, Sharma, Stone) The Zena and
Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at
Mount Sinai
(Ben-Yehuda, Mehran, Chen, Dressler, Li) Clinical Trials Center,
Cardiovascular Research Foundation
(Ben-Yehuda) Center for Interventional Vascular Therapy, Division of
Cardiology, NewYork-Presbyterian Hospital, Columbia University Irving
Medical Center, New York, NY, United States
(Ben-Yehuda) Division of Cardiology, University of California - San Diego,
San Diego, CA, United States
(Mansour, Noiseux) Centre Hospitalier de l'Universite de Montreal,
Montreal, QC, Canada
(Kappetein) Erasmus Medical Center, Rotterdam, Netherlands
(Sabik) Department of Surgery, UH Cleveland Medical Center, Cleveland, OH,
United States
(Serruys) Department of Cardiology, National University of Ireland Galway
(NUIG), Galway, Ireland
(Serruys) Imperial College of London, London, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Prior studies have reported an association between elevated
white blood cell count (WBCc) and worse clinical outcomes after coronary
artery bypass grafting (CABG) and percutaneous coronary intervention
(PCI). We assessed the prognostic impact of WBCc in patients undergoing
revascularization for left main coronary artery disease (LMCAD).
 Method(s): In Evaluation of XIENCE Versus Coronary Artery Bypass
Surgery for Effectiveness of Left Main Revascularization (EXCEL), 1905
patients with LMCAD and low or intermediate SYNTAX scores were randomized
to PCI with everolimus-eluting stents versus CABG. The 1895 patients with
baseline WBCc available were grouped in tertiles of WBCc (mean 5.6 +/-
0.8, 7.5 +/- 0.5, and 10.1 +/- 1.6 x 109/L). Result(s): Five-year
rates of the primary endpoint (death, myocardial infarction or stroke)
were similar across increasing WBCc tertiles (21.2, 18.9, and 21.6%; P =
0.46). Individual components of the primary endpoint, Bleeding Academic
Research Consortium (BARC) 3-5 bleeding, stent thrombosis or graft
occlusion and ischemia-driven revascularization were all similar across
WBCc tertiles. By multivariable analysis, WBCc as a continuous variable
was not an independent predictor of adverse events (hazard radio per 1 x
109/L: 1.02; 95% CI, 0.97-1.08; P = 0.43). Results were consistent in the
PCI and CABG arms individually. Conclusion(s): There was no
association between baseline WBCc and 30-day or 5-year clinical outcomes
after PCI or CABG. The absence of a clear incremental increase in events
with increasing WBCc in the current analysis indicates that WBCc should
not routinely be used as a prognostic marker or to guide revascularization
decisions in patients with LMCAD. Copyright © 2021 Wolters
Kluwer Health, Inc. All rights reserved.

<56>
Accession Number
636571752
Title
Post-thymectomy myasthenia gravis: A case report and systematic review of
literature.
Source
BMJ Case Reports. 14(12) (no pagination), 2021. Article Number: e246005.
Date of Publication: 02 Dec 2021.
Author
Gurowich L.; Yiin G.; Maxwell A.; Rice A.
Institution
(Gurowich) General Surgery, Taunton and Somerset Nhs Foundation Trust,
Taunton, United Kingdom
(Gurowich, Yiin, Maxwell) Neurology, Swindon and Marlborough Nhs Trust,
Swindon, United Kingdom
(Rice) Histopathology, Royal Brompton Hospital, London, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Myasthenia gravis (MG) is an autoimmune condition affecting the
neuromuscular junction characterised by weakness and fatiguability,
carrying a high morbidity if treatment is delayed. A clear association
with thymoma has led to management with thymectomy as a common practice,
but MG presenting post-thymectomy has rarely been reported. We present a
case of an 82-year-old woman developing fatigue, ptosis and dysarthria 3
months after thymectomy. After a clinical diagnosis of MG was made, she
responded well to prompt treatment with prednisolone and pyridostigmine.
Her anti-acetylcholine receptor antibody (anti-AChR) subsequently came
back positive. Our systematic review reveals that post-thymectomy MG can
be categorised as early-onset or late-onset form with differing aetiology,
and demonstrated correlation between preoperative anti-AChR titres and
post-thymectomy MG. The postulated mechanisms for post-thymectomy MG
centre around long-lasting peripheral autoantibodies. Clinicians should
actively look for MG symptoms in thymoma patients and measure anti-AChR
preoperatively to aid prognostication. Copyright © BMJ
Publishing Group Limited 2021. No commercial re-use. See rights and
permissions. Published by BMJ.

<57>
Accession Number
2015978516
Title
Percutaneous coronary intervention with drug-eluting stents versus
coronary artery bypass grafting in left main coronary artery disease: an
individual patient data meta-analysis.
Source
The Lancet. 398(10318) (pp 2247-2257), 2021. Date of Publication: 18 Dec
2021.
Author
Sabatine M.S.; Bergmark B.A.; Murphy S.A.; O'Gara P.T.; Smith P.K.;
Serruys P.W.; Kappetein A.P.; Park S.-J.; Park D.-W.; Christiansen E.H.;
Holm N.R.; Nielsen P.H.; Stone G.W.; Sabik J.F.; Braunwald E.
Institution
(Sabatine, Bergmark, Murphy, Braunwald) Thrombolysis in Myocardial
Infarction Study Group, Brigham and Women's Hospital and Harvard Medical
School, Boston, MA, United States
(Sabatine, Bergmark, Murphy, O'Gara, Braunwald) Division of Cardiovascular
Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston,
MA, United States
(Smith) Department of Surgery (Cardiothoracic), Duke University School of
Medicine, Duke Clinical Research Institute, Durham, NC, United States
(Serruys) Department of Cardiology, National University of Ireland Galway,
Galway, Ireland
(Serruys) National Heart and Lung Institute, Imperial College London,
London, UK, United Kingdom
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University
Medical Centre, Rotterdam, Netherlands
(Kappetein) Medtronic, Maastricht, Netherlands
(Park, Park) Department of Cardiology, Asan Medical Center, Seoul, South
Korea
(Christiansen, Holm) Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark
(Nielsen) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Aarhus, Denmark
(Stone) The Zena and Michael A Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Stone) Cardiovascular Research Foundation, New York, NY, United States
(Sabik) Department of Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, United States
Publisher
Elsevier B.V.
Abstract
Background: The optimal revascularisation strategy for patients with left
main coronary artery disease is uncertain. We therefore aimed to evaluate
long-term outcomes for patients treated with percutaneous coronary
intervention (PCI) with drug-eluting stents versus coronary artery bypass
grafting (CABG). Method(s): In this individual patient data
meta-analysis, we searched MEDLINE, Embase, and the Cochrane database
using the search terms "left main", "percutaneous coronary intervention"
or "stent", and "coronary artery bypass graft*" to identify randomised
controlled trials (RCTs) published in English between database inception
and Aug 31, 2021, comparing PCI with drug-eluting stents with CABG in
patients with left main coronary artery disease that had at least 5 years
of patient follow-up for all-cause mortality. Two authors (MSS and BAB)
identified studies meeting the criteria. The primary endpoint was 5-year
all-cause mortality. Secondary endpoints were cardiovascular death,
spontaneous myocardial infarction, procedural myocardial infarction,
stroke, and repeat revascularisation. We used a one-stage approach; event
rates were calculated by use of the Kaplan-Meier method and treatment
group comparisons were made by use of a Cox frailty model, with trial as a
random effect. In Bayesian analyses, the probabilities of absolute risk
differences in the primary endpoint between PCI and CABG being more than
0.0%, and at least 1.0%, 2.5%, or 5.0%, were calculated. Finding(s):
Our literature search yielded 1599 results, of which four RCTs-SYNTAX,
PRECOMBAT, NOBLE, and EXCEL-meeting our inclusion criteria were included
in our meta-analysis. 4394 patients, with a median SYNTAX score of 25.0
(IQR 18.0-31.0), were randomly assigned to PCI (n=2197) or CABG (n=2197).
The Kaplan-Meier estimate of 5-year all-cause death was 11.2% (95% CI
9.9-12.6) with PCI and 10.2% (9.0-11.6) with CABG (hazard ratio 1.10, 95%
CI 0.91-1.32; p=0.33), resulting in a non-statistically significant
absolute risk difference of 0.9% (95% CI -0.9 to 2.8). In Bayesian
analyses, there was an 85.7% probability that death at 5 years was greater
with PCI than with CABG; this difference was more likely than not less
than 1.0% (<0.2% per year). The numerical difference in mortality was
comprised more of non-cardiovascular than cardiovascular death.
Spontaneous myocardial infarction (6.2%, 95% CI 5.2-7.3 vs 2.6%, 2.0-3.4;
hazard ratio [HR] 2.35, 95% CI 1.71-3.23; p<0.0001) and repeat
revascularisation (18.3%, 16.7-20.0 vs 10.7%, 9.4-12.1; HR 1.78,
1.51-2.10; p<0.0001) were more common with PCI than with CABG. Differences
in procedural myocardial infarction between strategies depended on the
definition used. Overall, there was no difference in the risk of stroke
between PCI (2.7%, 2.0-3.5) and CABG (3.1%, 2.4-3.9; HR 0.84, 0.59-1.21;
p=0.36), but the risk was lower with PCI in the first year after
randomisation (HR 0.37, 0.19-0.69). Interpretation(s): Among patients
with left main coronary artery disease and, largely, low or intermediate
coronary anatomical complexity, there was no statistically significant
difference in 5-year all-cause death between PCI and CABG, although a
Bayesian approach suggested a difference probably exists (more likely than
not <0.2% per year) favouring CABG. There were trade-offs in terms of the
risk of myocardial infarction, stroke, and revascularisation. A heart team
approach to communicate expected outcome differences might be useful to
assist patients in reaching a treatment decision. Funding(s): No
external funding. Copyright © 2021 Elsevier Ltd

<58>
Accession Number
2015987644
Title
Prehabilitation in adult patients undergoing surgery: an umbrella review
of systematic reviews.
Source
British Journal of Anaesthesia. (no pagination), 2021. Date of
Publication: 2021.
Author
McIsaac D.I.; Gill M.; Boland L.; Hutton B.; Branje K.; Shaw J.;
Grudzinski A.L.; Barone N.; Gillis C.; Akhtar S.; Atkins M.; Aucoin S.;
Auer R.; Basualdo-Hammond C.; Beaule P.; Brindle M.; Bittner H.; Bryson
G.; Carli F.; Eskander A.; Fata P.; Fergusson D.; Fiore J.; Forster A.;
Gillam M.; Gramlich L.; Holroyd-Leduc J.; Jackson T.; Jacobsohn E.;
Khadaroo R.; Lalu M.; Love C.; Martel G.; McCartney C.; McKeen D.;
Meliambro A.; Moloo H.; Moore R.; Muscedere J.; Nantel J.; Poitras S.;
Scheede-Bergdahl C.; Taljaard M.; Wallace T.; Wijeysundera D.
Institution
(McIsaac, Hutton, Branje, Shaw, Grudzinski) Department of Anesthesiology
and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
(McIsaac, Branje, Shaw) Clinical Epidemiology Program, Ottawa Hospital
Research Institute, Ottawa, ON, Canada
(McIsaac, Hutton) School of Epidemiology and Public Health, University of
Ottawa, Ottawa, ON, Canada
(Gill) Patient and Community Engagement Research Program, University of
Calgary, Calgary, AB, Canada
(Boland) Centre for Practice-Changing Research, Ottawa Hospital Research
Institute, Ottawa, ON, Canada
(Barone) Department of Medicine, McGill University, Montreal, QC, Canada
(Gillis) Department of Anesthesia, McGill University, Montreal, QC, Canada
(Akhtar) Yale University, School of Medicine, New Haven, United States
(Atkins, Basualdo-Hammond, Gillam, Holroyd-Leduc, Moore) Alberta Health
Services, Edmonton, Canada
(Aucoin, Bryson, McCartney) The Ottawa Hospital, Department of
Anesthesiology and Pain Medicine, Ottawa, Canada
(Auer, Moloo) The Ottawa Hospital, Department of Surgery, Ottawa, Canada
(Beaule) University of Ottawa, Department of Surgery, Ottawa, Canada
(Bittner, Love) The Ottawa Hospital, Ottawa, Canada
(Brindle) The University of Calgary, Calgary, Canada
(Carli) McGill University, Department of Anesthesiology, Montreal, Canada
(Eskander) Sunnybrook Hospital, Toronto, Canada
(Fata, Fiore) McGill University, Division of General Surgery, Montreal,
Canada
(Fergusson, Forster, Lalu, Martel, Taljaard) Ottawa Hospital Research
Institute, Clinical Epidemiology Program, Ottawa, Canada
(Gramlich) University of Alberta, Edmonton, Canada
(Jackson) University Health Network, Toronto, Canada
(Jacobsohn) University of Manitoba, Faculty of Medicine, Winnipeg, Canada
(Khadaroo) University of Alberta, Department of Surgery, Edmonton, Canada
(McKeen) Memorial University of Newfoundland, St. John's, Canada
(Meliambro) Carleton University, Ottawa, Canada
(Muscedere) Kingston General Hospital, Department of Critical Care,
Kingston, Canada
(Nantel, Poitras) University of Ottawa, Faculty of Health Sciences,
Ottawa, Canada
(Scheede-Bergdahl) Montreal General Hospital, Department of
Anesthesiology, Montreal, Canada
(Wallace) University of British Columbia, Department of Surgery, Kamloops,
Canada
(Wijeysundera) St. Michael's Hospital, Department of Anesthesia, Toronto,
Canada
Publisher
Elsevier Ltd
Abstract
Background: The certainty that prehabilitation improves postoperative
outcomes is not clear. The objective of this umbrella review (i.e.
systematic review of systematic reviews) was to synthesise and evaluate
evidence for prehabilitation in improving health, experience, or cost
outcomes. Method(s): We performed an umbrella review of
prehabilitation systematic reviews. MEDLINE, Embase, Cochrane, Cumulative
Index to Nursing and Allied Health Literature, PsycINFO, Joanna Briggs
Institute's database, and Web of Science were searched (inception to
October 20, 2020). We included all systematic reviews of elective, adult
patients undergoing surgery and exposed to a prehabilitation intervention,
where health, experience, or cost outcomes were reported. Evidence
certainty was assessed using Grading of Recommendations Assessment,
Development and Evaluation. Primary syntheses of any prehabilitation were
stratified by surgery type. Result(s): From 1412 titles, 55
systematic reviews were included. For patients with cancer undergoing
surgery who participate in any prehabilitation, moderate certainty
evidence supports improvements in functional recovery. Low to very low
certainty evidence supports reductions in complications (mixed,
cardiovascular, and cancer surgery), non-home discharge (orthopaedic
surgery), and length of stay (mixed, cardiovascular, and cancer surgery).
There was low to very low certainty evidence that exercise prehabilitation
reduces the risk of complications, non-home discharge, and length of stay.
There was low to very low certainty evidence that nutritional
prehabilitation reduces risk of complications, mortality, and length of
stay. Conclusion(s): Low certainty evidence suggests that
prehabilitation may improve postoperative outcomes. Future low risk of
bias, randomised trials, synthesised using recommended standards, are
required to inform practice. Optimal patient selection, intervention
design, and intervention duration must also be determined. Copyright
© 2021 British Journal of Anaesthesia

<59>
Accession Number
2015972717
Title
The perioperative management of small animals with previously implanted
pacemakers undergoing anaesthesia.
Source
Veterinary Anaesthesia and Analgesia. (no pagination), 2021. Date of
Publication: 2021.
Author
de Carellan Mateo A.G.; Casamian-Sorrosal D.
Institution
(de Carellan Mateo) Anaesthesia and Analgesia Service, Teaching Veterinary
Hospital, Department of Animal Medicine and Surgery, School of Veterinary
Science, Catholic University of Valencia, Valencia, Spain
(Casamian-Sorrosal) Cardiology and Interventional Cardiology Service,
Teaching Veterinary Hospital, Department of Animal Medicine and Surgery,
School of Veterinary Science, Catholic University of Valencia, Valencia,
Spain
Publisher
Association of Veterinary Anaesthetists and American College of Veterinary
Anesthesia and Analgesia
Abstract
Objective: There is little information in the veterinary literature about
the perioperative management of small animal patients with previously
implanted pacemakers undergoing elective or emergency non-cardiac
procedures. The purpose of this article is to review the current
literature with regard to human patients, with previously implanted
pacemakers, undergoing general anaesthesia. Using this and the current
information on pacemakers and anaesthesia in dogs and cats, we provide
recommendations for small animal patients in this situation. Databases
used: Google Scholar, PubMed and CAB Abstracts using and interlinking and
narrowing the search terms: "dog", "cat", "small animals", "anaesthesia",
"pacemaker", "perioperative", "transvenous pacing", "temporary pacing".
Scientific reports and human and small animal studies from the reference
lists of the retrieved papers were reviewed. In addition, related human
and veterinary cardiology and anaesthesia textbooks were also included to
create a narrative review of the subject. Conclusion(s): The best
perioperative care for these animals comes from a multidisciplinary
approach involving the anaesthetist, cardiologist, surgeon and intensive
care unit team. When such an approach is not feasible, the anaesthetist
should be familiar with pacemaker technology and how to avoid
perioperative complications such as electromagnetic interference, lead
damage and reprogramming of the device. The preanaesthetic assessment
should be thorough. Information regarding the indication for pacemaker
placement, complications during the procedure, location, type and
programming of the pacemaker should be readily available. The anaesthetic
management of these veterinary patients aims to preserve cardiovascular
function while avoiding hypotension, and backup pacing should be available
during the perioperative period. Further prospective studies are needed to
describe the best perioperative care in small animals with a previously
implanted pacemaker. Copyright © 2021 Association of Veterinary
Anaesthetists and American College of Veterinary Anesthesia and Analgesia

<60>
Accession Number
636654580
Title
Comparing Single- and Dual Antiplatelet Therapies Following Transcatheter
Aortic Valve Implantation.
Source
The Annals of thoracic surgery. (no pagination), 2021. Date of
Publication: 26 Oct 2021.
Author
Chiu H.-T.; Jhou H.-J.; Chen P.-H.; Lee C.-H.; Lin C.-Y.
Institution
(Chiu) Department of Surgery, Tri-Service General Hospital, National
Defense Medical Center, ROC, Taipei, Taiwan (Republic of China)
(Jhou) Department of Neurology, Changhua Christian Hospital, Changhua,
Taiwan, ROC; School of Medicine, Kaohsiung Medical University, Kaohsiung,
Taiwan, ROC
(Chen) Department of Internal Medicine, Tri-Service General Hospital,
National Defense Medical Center, ROC, Taipei, Taiwan (Republic of China)
(Lee) Division of Hematology and Oncology Medicine, Department of Internal
Medicine, Tri-Service General Hospital, National Defense Medical Center,
ROC, Taipei, Taiwan (Republic of China)
(Lin) Division of Cardiovascular Surgery, Department of Surgery,
Tri-Service General Hospital, National Defense Medical Center, ROC,
Taipei, Taiwan (Republic of China)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic valve implantation has been an
established treatment in patients with symptomatic severe aortic stenosis.
However, the postoperative antiplatelet regimen after transcatheter aortic
valve implantation was not established certainly. The aim of this
meta-analysis is to compare the safety and efficacy of single- (SAPT) and
dual-antiplatelet therapies (DAPT) in patients undergoing transcatheter
aortic valve implantation. METHOD(S): Eligible randomized controlled
trials and cohort studies published before February 2021 were retrieved
from PubMed, Embase, and the Cochrane Library. We calculated odds ratios
with 95% confidence intervals. RESULT(S): Nine articles, involving
19,277 patients, met the selection criteria. In the short-term outcome,
compared with SAPT, DAPT was associated with a significantly higher rate
of bleeding (odds ratios, 95% confidence intervals: 3.00, 1.67-5.38) and
showed no significant differences in thrombotic events (odds ratios, 95%
confidence intervals: 1.25, 0.74-2.11) and all-cause mortality (odds
ratios, 95% confidence intervals: 0.84; 0.42-1.69). In the long-term
outcome, DAPT was associated with a significantly higher bleeding rate
(odds ratios, 95% confidence intervals: 1.85, 1.24-2.78) and showed no
differences in thrombotic events (odds ratios, 95% confidence intervals:
1.13, 0.86-1.48) and all-cause mortality (odds ratios, 95% confidence
intervals: 1.12, 0.95-1.32). Our trial sequential analysis confirmed DAPT
didn't confer any benefit for reducing all-cause mortality and thrombotic
events, and carried a higher risk of bleeding than SAPT.
 CONCLUSION(S): SAPT should be a sufficient antiplatelet strategy in
post- transcatheter aortic valve implantation patients without indications
for oral anticoagulation medication, especially in the long-term follow-up
period. Copyright © 2021. Published by Elsevier Inc.

<61>
Accession Number
636641506
Title
Preoperative Sucrosomial Iron Supplementation Increases Haemoglobin and
Reduces Transfusion Requirements in Elective Heart Surgery Patients: A
Prospective Randomized Study.
Source
Surgical technology international. 39 (no pagination), 2021. Date of
Publication: 28 Oct 2021.
Author
Pierelli L.; De Rosa A.; Falco M.; Papi E.; Rondinelli M.B.; Turani F.;
Weltert L.
Institution
(Pierelli) Dipartimento di Medicina Sperimentale, Sapienza University,
Rome, Italy
(Pierelli, De Rosa, Rondinelli) Transfusion Medicine, San Camillo
Forlanini Hospital, Rome, Italy
(Falco, Papi) Department of Anesthesiology, European Hospital, Rome, Italy
(Papi, Turani) Department of Anesthesiology, Aurelia Hospital, Rome, Italy
(Papi, Weltert) San Camillus International University for Health Sciences,
Rome, Italy
Publisher
NLM (Medline)
Abstract
BACKGROUND: Low preoperative haemoglobin is frequently observed in heart
surgery patients and is associated with a significant decrease in
haemoglobin between post-operative days 2 and 3, known as haemoglobin
drift. Overall, these patients tend to receive many RBC transfusions.
Since iron homeostasis is often impaired in these patients, restoration of
iron availability might override iron-restricted erythropoiesis. However,
reduced tolerance to oral iron salts has limited this strategy to
intravenous iron administration. STUDY DESIGN AND METHODS: The purpose of
this study was to assess whether preoperative supplementation with oral
sucrosomial iron, a new iron-delivery technology with improved tolerance
and bioavailability, might be an effective strategy for this patient
population. One thousand consecutive patients were randomized and received
either a one-month course of sucrosomial iron (60 mg/day) or no treatment
prior to elective heart surgery at a single high-volume centre
(ClinicalTrials.gov NCT03560687). Primary end-points were haemoglobin
concentration on the day of hospital admittance and number of blood
transfusions. Secondary end-points were haemoglobin drift, tolerance of
treatment and cost-effectiveness of sucrosomial iron administration.
 RESULT(S): Baseline haemoglobin in the treatment group was higher (by
0.67 g/dL; p<0.001) than that in the control group. The percentage of
patients in the treatment group who required transfusion (35.4%) was half
that in the control group (64.6%). The average number of transfused units
per operation was 0.95 vs. 2.03 in the treatment and control groups,
respectively. Haemoglobin drift was substantially similar in the two
groups, and the tolerability of treatment was excellent (98%). The overall
cost of treatment was 156 Euros less in the treatment group, expressed as
a raw cost of transfusion. CONCLUSION(S): In elective heart surgery,
routine preoperative sucrosomial iron administration seems to be a safe,
well-tolerated and cost-effective strategy to increase preoperative
haemoglobin and reduce the need for allogeneic blood transfusions.

<62>
Accession Number
636640660
Title
Icosapent Ethyl Reduces Ischemic Events in Patients with a History of
Prior Coronary Artery Bypass Grafting: REDUCE-IT CABG.
Source
Circulation. (no pagination), 2021. Date of Publication: 28 Oct 2021.
Author
Verma S.; Bhatt D.L.; Steg P.G.; Miller M.; Brinton E.A.; Jacobson T.A.;
Dhingra N.K.; Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.; Granowitz
C.; Gibson C.M.; Pinto D.; Giugliano R.P.; Budoff M.J.; Mason R.P.; Tardif
J.-C.; Ballantyne C.M.
Institution
(Verma, Dhingra) Division of Cardiac Surgery, St Michael's Hospital,
University of Toronto, ON, Canada
(Bhatt, Giugliano) Brigham and Women's Hospital Heart and Vascular Center,
Harvard Medical School, Boston MA
(Steg) Universite de Paris, AP-HP (Assistance Publique-Hopitaux de Paris),
Hopital Bichat, FACT (French Alliance for Cardiovascular Trials), INSERM
U-1148, Paris, France
(Miller) Department of Medicine, University of Maryland School of
Medicine, MD, Baltimore, United States
(Brinton) Utah Lipid Center, UT, Salt Lake City, United States
(Jacobson) Office of Health Promotion and Disease Prevention, Department
of Medicine, Emory University School of Medicine, Atlanta, United States
(Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma, Inc. (Amarin),
Bridgewater, United States
(Gibson, Pinto) Baim Clinical Research Institute, MA, Boston
(Budoff) David Geffen School of Medicine, Lundquist Institute, Torrance,
CA
(Mason) Elucida Research, MA, Beverly, United States
(Tardif) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Ballantyne) Department of Medicine, Baylor College of Medicine; Center
for Cardiovascular Disease Prevention, Methodist DeBakey Heart and
Vascular Center, Houston, TX
Publisher
NLM (Medline)
Abstract
Background: Despite advances in surgery and pharmacotherapy, there remains
significant residual ischemic risk following coronary artery bypass
grafting (CABG) surgery. Method(s): In the multicenter,
placebo-controlled, double-blind trial REDUCE-IT, statin-treated patients
with controlled low-density lipoprotein cholesterol (LDL-C) and mild to
moderate hypertriglyceridemia were randomized to 4g daily of icosapent
ethyl or placebo. They experienced a 25% reduction in risk of a primary
efficacy endpoint (cardiovascular death, myocardial infarction, stroke,
coronary revascularization, or hospitalization for unstable angina) and a
26% reduction in risk of a key secondary efficacy endpoint (cardiovascular
death, myocardial infarction, or stroke) when compared with placebo. The
present analysis reports on the subgroup of patients from the trial with a
history of CABG. Result(s): Of the 8,179 patients randomized in
REDUCE-IT, a total of 1,837 (22.5%) had a history of CABG, with 897
patients randomized to icosapent ethyl and 940 to placebo. Baseline
characteristics were similar between treatment groups. Randomization to
icosapent ethyl was associated with a significant reduction in the primary
endpoint (hazard ratio [HR], 0.76; 95% confidence interval [CI],
0.63-0.92; P=0.004), in the key secondary endpoint (HR, 0.69; 95% CI,
0.56-0.87; P=0.001), and in total (first plus subsequent or recurrent)
ischemic events (rate ratio, 0.64; 95% CI, 0.50-0.81; P=0.0002) compared
with placebo. This yielded an absolute risk reduction of 6.2% (95% CI,
2.3%-10.2%) in first events, with a number needed to treat of 16 (95% CI,
10-44) over a median follow-up time of 4.8 years. Safety findings were
similar to the overall study: beyond an increased rate of atrial
fibrillation/flutter requiring hospitalization for at least 24 hours (5.0%
vs. 3.1%; P=0.03) and a non-significant increase in bleeding, occurrences
of adverse events were comparable between groups. Conclusion(s): In
REDUCE-IT patients with a history of CABG, treatment with icosapent ethyl
was associated with significant reductions in first and recurrent ischemic
events.

<63>
Accession Number
2006096658
Title
Nitric oxide added to the sweep gas of the oxygenator during
cardiopulmonary bypass in infants: A pilot randomized controlled trial.
Source
Artificial Organs. 45(1) (pp 22-28), 2021. Date of Publication: January
2021.
Author
Niebler R.A.; Chiang-Ching H.; Daley K.; Janecke R.; Jobe S.M.; Mitchell
M.E.; Varner C.; Woods K.; Scott J.P.
Institution
(Niebler, Jobe, Woods) Departments of Pediatrics, Medical College of
Wisconsin, Milwaukee, WI, United States
(Niebler, Daley, Mitchell, Varner, Scott) Herma Heart Institute,
Children's Wisconsin, Milwaukee, WI, United States
(Chiang-Ching) School of Public Health, University of Wisconsin,
Milwaukee, WI, United States
(Janecke, Jobe) Versiti Blood Research Institute, Milwaukee, WI, United
States
(Mitchell) Departments of Cardiothoracic Surgery, Medical College of
Wisconsin, Milwaukee, WI, United States
(Scott) Departments of Anesthesia, Medical College of Wisconsin,
Milwaukee, WI, United States
Publisher
John Wiley and Sons Inc
Abstract
Our objective was to assess the effect of nitric oxide added to the sweep
gas of the oxygenator during cardiopulmonary bypass (CPB) in infants on
platelet count, platelet function, clinical outcomes, and safety. A
randomized, double-blinded, placebo-controlled clinical trial in infants
less than a year of age undergoing cardiac surgery requiring CPB was
undertaken. Nitric oxide at a dose of 20 ppm was added to the sweep gas in
the treatment group. Blood was collected at baseline and prior to
separation from CPB to measure platelet count and function as determined
by responsiveness to specific agonists. Clinical outcomes were observed
through hospital discharge. Methemoglobin levels were measured
preoperatively, at the conclusion of CPB, and upon admission to the ICU.
Forty patients consented and were randomized in the trial. Eighteen
patients were randomized to the treatment group and 22 were included in
the placebo group. The groups were similar in terms of age, weight,
gender, and surgical complexity. No significant differences were found in
measures of platelet count, platelet response to agonist, or clinical
outcomes. Patients in the treatment group had higher methemoglobin levels
after receiving nitric oxide, but no levels approached toxicity (maximum
2.4%). Nitric oxide added to the sweep gas of the oxygenator during CPB in
infants did not have an appreciable effect on the preservation of platelet
count, platelet responsiveness to agonist, or clinical outcomes.
Methemoglobin levels were increased after receiving nitric oxide but were
far below a toxic level of 15%. Copyright © 2020 International
Center for Artificial Organ and Transplantation (ICAOT) and Wiley
Periodicals LLC.

<64>
Accession Number
2007411144
Title
Right ventricular outflow tract reconstruction with Medtronic Freestyle
valve in the Ross procedure: A systematic review with meta-analysis.
Source
Artificial Organs. 45(4) (pp 338-345), 2021. Date of Publication: April
2021.
Author
Van den Eynde J.; Michel Pompeu B. O. S.A.; Callahan C.P.; Dimagli A.;
Vervoort D.; Kampaktsis P.N.; Zhigalov K.; Ruhparwar A.; Weymann A.
Institution
(Van den Eynde) Department of Cardiovascular Diseases, Unit of Cardiac
Surgery, University Hospitals Leuven, Leuven, Belgium
(Michel Pompeu B. O.) Division of Cardiovascular Surgery of Pronto Socorro
Cardiologico de Pernambuco, PROCAPE, University of Pernambuco, Recife,
Brazil
(Callahan) Hospital for Sick Children, University of Toronto, Toronto, ON,
Canada
(Dimagli) School of Clinical Sciences, Bristol Heart Institute, University
of Bristol, Bristol, United Kingdom
(Vervoort) Department of Health Policy and Management, Johns Hopkins
Bloomberg School of Public Health, Baltimore, MD, United States
(Kampaktsis) Department of Medicine, New York University Langone Medical
Center, New York, NY, United States
(Zhigalov, Ruhparwar, Weymann) 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
Cryopreserved pulmonary homografts (PH) are the current gold standard for
right ventricular outflow tract (RVOT) reconstruction in the Ross
procedure. Unfortunately, their use is limited by a relatively scarce
availability and high cost. Porcine stentless xenografts (SX) such as the
Medtronic Freestyle SX are increasingly being used, although it is unclear
whether the hemodynamic performance and the long-term durability are
satisfactory. The present systematic review followed the Preferred
Reporting Items for Systematic reviews and Meta-Analysis statement. The
pooled treatment effects were calculated using a weighted
DerSimonian-Laird random-effects model. We also evaluated the effect of
time after RVOT reconstruction on valve gradients using meta-regression.
Six studies with a total of 156 patients met the inclusion criteria. The
pooled estimates for the pooled follow-up of 37 months were: 1.3%
operative mortality, 94.8% overall survival, 7.5% structural valve
deterioration, 5.2% reintervention, 73.3% asymptomatic, and 1.5% moderate
or severe pulmonary insufficiency. Peak valve gradients were significantly
correlated with time after RVOT, increasing during follow-up. Three
studies compared PH with SX, one concluded that the SX is an acceptable
alternative for RVOT reconstruction, whereas two concluded that this
valvular substitute had inferior performance. The Freestyle SX can be
considered as an alternative to PH, although it might be associated with
more reinterventions, higher peak valve pressure gradients, and pulmonary
valve dysfunction. Copyright © 2020 International Center for
Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC

<65>
Accession Number
2013054432
Title
The effect of perioperative hemadsorption in patients operated for acute
infective endocarditis-A randomized controlled study.
Source
Artificial Organs. 45(11) (pp 1328-1337), 2021. Date of Publication:
November 2021.
Author
Asch S.; Kaufmann T.P.; Walter M.; Leistner M.; Danner B.C.; Perl T.;
Kutschka I.; Niehaus H.
Institution
(Asch, Kaufmann, Walter, Leistner, Danner, Kutschka, Niehaus) Department
of Thoracic- and Cardiovascular Surgery, University Hospital,
Georg-August-University, Gottingen, Germany
(Asch) Department of Cardiac and Thoracic Surgery, Hospital Fulda, Fulda,
Germany
(Leistner) Department of Anesthesiology, University Hospital Wurzburg,
Wurzburg, Germany
(Perl) Department of Anaesthesiology, University Hospital,
Georg-August-University, Gottingen, Germany
(Niehaus) Department of Cardiothoracic, Transplant and Vascular Surgery,
Hanover Medical School, Hannover, Germany
Publisher
John Wiley and Sons Inc
Abstract
Patients operated for infective endocarditis (IE) are at high risk of
developing an excessive systemic hyperinflammatory state, resulting in
systemic inflammatory response syndrome and septic shock. Hemoadsorption
(HA) by cytokine adsorbers has been successfully applied to remove
inflammatory mediators. This randomized controlled trial investigates the
effect of perioperative HA therapy on inflammatory parameters and
hemodynamic status in patients operated for IE. A total of 20 patients
were randomly assigned to either HA therapy or the control group. HA
therapy was initiated intraoperatively and continued for 24 hours
postoperatively. Cytokine levels (IL-6, IL-1b, TNF-alpha), leukocytes,
C-reactive protein (CRP), and Procalcitonin (PCT) as well as catecholamine
support, and volume requirement were compared between both groups.
Operative procedures included aortic (n = 7), mitral (n = 6), and multiple
valve surgery (n = 7). All patients survived to discharge. No significant
differences concerning median cytokine levels (IL-6 and TNF-alpha) were
observed between both groups. CRP and PCT baseline levels were
significantly higher in the HA group (59.5 vs. 26.3 mg/dL, P =.029 and
0.17 vs. 0.05 microg/L, P =.015) equalizing after surgery. Patients in the
HA group required significantly higher doses of vasopressors (0.093 vs.
0.025 microg/kg/min norepinephrine, P =.029) at 12 hours postoperatively
as well as significantly more overall volume replacement (7217 vs. 4185 mL
at 12 hours, P =.015; 12 021 vs. 4850 mL at 48 hours, P =.015). HA therapy
did neither result in a reduction of inflammatory parameters nor result in
an improvement of hemodynamic parameters in patients operated for IE. For
a more targeted use of HA therapy, appropriate selection criteria are
required. Copyright © 2021 The Authors. Artificial Organs
published by International Center for Artificial Organ and Transplantation
(ICAOT) and Wiley Periodicals LLC.

<66>
Accession Number
2010832436
Title
Is vacuum-assisted closure therapy feasible for children with deep sternal
wound infection after cardiac surgery? The pooling results from current
literature.
Source
Artificial Organs. 45(8) (pp 827-837), 2021. Date of Publication: August
2021.
Author
Wu Y.; Wang J.; Dai J.; Wang G.; Li H.; Li Y.; Wu C.; Wei G.
Institution
(Wu, Dai, Wang, Li, Li, Wu) Department of Cardiothoracic Surgery,
Children's Hospital of Chongqing Medical University, Chongqing, China
(Wu, Wang, Dai, Wang, Li, Li, Wu, Wei) Ministry of Education Key
Laboratory of Child Development and Disorders, China International Science
and Technology Cooperation Base of Child Development and Critical
Disorders, National Clinical Research Center for Child Health and
Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
Publisher
John Wiley and Sons Inc
Abstract
Vacuum-assisted closure (VAC) has been used for children with deep sternal
wound infections (DSWI); however, the safety and efficiency have not been
determined. A meta-analysis was performed for outcomes of VAC therapy in
children with DSWI after cardiac surgery. Electronic databases, including
PubMed, Scopus, and Cochrane Library CENTRAL were searched systematically
from January 1990 to October 2020 for the literature which reported the
outcomes of VAC therapy for children with DSWI after cardiac surgery.
Meta-regression and subgroup analyses were performed to find risk factors
for prolonged length of VAC therapy and hospital stay. Eleven studies were
included in this study, involving 217 subjects. VAC therapy was performed
due to mediastinitis after congenital heart diseases (CHD) repair. In
children with DSWI after cardiac surgery, length of VAC therapy, and
hospital stay were 11.1 days (95% CI, 9.6-12.5 days) and 29.8 days (95%
CI, 22.8-36.9 days), respectively. Incidence of infectious and
wound-related complications was 8.5% (95% CI, 4.1%-13.0%). Overall
mortality in this setting was 5.8% (95% CI, 2.5%-9.1%). In conclusion, in
children with DSWI after cardiac surgery, length of VAC therapy and
hospital stay were 11.1 and 29.8 days, respectively. Overall mortality was
5.8%. Although not significant, delayed chest closure, complex CHD, and
Gram-negative bacilli/fungal infections may potentially contribute to
prolonged duration of VAC treatment. Copyright © 2021
International Center for Artificial Organs and Transplantation and Wiley
Periodicals, Inc.

<67>
Accession Number
2010541373
Title
Driveline damage and repair in continuous-flow left ventricular assist
devices: A systematic review.
Source
Artificial Organs. 45(8) (pp 819-826), 2021. Date of Publication: August
2021.
Author
D'Antonio N.D.; Maynes E.J.; Tatum R.T.; Prochno K.W.; Saxena A.; Maltais
S.; Samuels L.E.; Morris R.J.; Massey H.T.; Tchantchaleishvili V.
Institution
(D'Antonio, Maynes, Tatum, Prochno, Saxena, Samuels, Morris, Massey,
Tchantchaleishvili) Division of Cardiac Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Maltais) Division of Cardiac Surgery, Centre Hospitalie de l'Universite
de Montreal, Montreal, QC, Canada
Publisher
John Wiley and Sons Inc
Abstract
With mounting time on continuous-flow left ventricular assist device
(CF-LVAD) support, patients occasionally sustain damage to the device
driveline. Outcomes associated with external and internal driveline damage
and repair are currently not well documented. We sought to evaluate the
outcomes of driveline damage and its repair. Electronic search was
performed to identify all relevant studies published over the past 20
years. Fifteen studies were selected for analysis comprising of 55
patients with CF-LVAD dysfunction due to driveline damage. Demographic and
perioperative variables along with outcomes including survival rates were
extracted and pooled for the systematic review. Most patients (53/55) were
supported on HeartMate II LVAD (Abbott Laboratories, Abbott Park, IL).
Internal damage was more commonly reported than external damage [69.1%
(38/55) vs. 30.9% (17/55), P =.01]. Median time to driveline damage was
1.9 years [IQR 1.0, 2.5]. Most patients presented with a CF-LVAD alarm
[94.5% (52/55)] and patients with internal driveline damage had a
significantly higher rate of alarm activation compared to that observed
for those with external damage [38/38 (100%) vs. 14/17 (82.4%), P =.04].
Patients with internal driveline dysfunction were more likely to
experience component wear compared to those with external driveline
dysfunction [10/38 (26.3%) vs. 0/17 (0%), P =.05]; 14.5% of patients
(8/55) underwent external repair of the driveline, 5.5% (3/55) were
treated with rescue tape, and 5.5% (3/55) were placed on an ungrounded
cable, indicating a short-to-shield event had occurred. A total of 49.1%
of patients (27/55) underwent CF-LVAD exchange, 5.5% (3/55) were weaned
off the CF-LVAD to explant, and 5.5% (3/55) underwent emergent heart
transplantation. The median length of hospital stay was 12 days [IQR 7,
12] and 30-day mortality rate was 14.5% (8/55). Driveline damage was more
commonly reported at an internal location and despite being a
well-recognized complication, mortality still appears high. Copyright
© 2021 International Center for Artificial Organs and Transplantation
and Wiley Periodicals LLC.

<68>
Accession Number
2004382434
Title
Ventricular arrhythmias following continuous-flow left ventricular assist
device implantation: A systematic review.
Source
Artificial Organs. 44(8) (pp E313-E325), 2020. Date of Publication: 01 Aug
2020.
Author
Gordon J.S.; Maynes E.J.; Choi J.H.; Wood C.T.; Weber M.P.; Morris R.J.;
Massey H.T.; Tchantchaleishvili V.
Institution
(Gordon, Maynes, Choi, Wood, Weber, Morris, Massey, Tchantchaleishvili)
Division of Cardiac Surgery, Thomas Jefferson University Hospital,
Philadelphia, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Ventricular arrhythmias (VA) are not uncommon after continuous-flow left
ventricular assist device (CF-LVAD) implantation. In this systematic
review, we sought to identify the patterns of VA that occurred following
CF-LVAD implantation and evaluate their outcomes. An electronic search was
performed to identify all articles reporting the development of VA
following CF-LVAD implantation. VA was defined as any episode of
ventricular fibrillation (VF) or sustained (>30 seconds) ventricular
tachycardia (VT). Eleven studies were pooled for the analysis that
included 393 CF-LVAD patients with VA. The mean patient age was 57 years
[95%CI: 54; 61] and 82% [95%CI: 73; 88] were male. Overall, 37% [95%CI:
19; 60] of patients experienced a new onset VA after CF-LVAD implantation,
while 60% [95%CI: 51; 69] of patients had a prior history of VA. Overall,
88% of patients [95%CI: 78; 94] were supported on HeartMate II CF-LVAD, 6%
[95%CI: 3; 14] on HeartWare HVAD, and 6% [95%CI: 2; 13] on other CF-LVADs.
VA was symptomatic in 47% [95%CI: 28; 68] of patients and in 50% [95%CI:
37; 52], early VA (<30 days from CF-LVAD) was observed. The 30-day
mortality rate was 7% [95%CI: 5; 11]. Mean follow-up was 22.9 months
[95%CI: 4.8; 40.8], during which 27% [95%CI: 17; 39] of patients underwent
heart transplantation. In conclusion, approximately a third of patients
had new VA following CF-LVAD placement. VA in CF-LVAD patients is often
symptomatic, necessitates treatment, and carries a worse
prognosis. Copyright © 2020 International Center for Artificial
Organs and Transplantation and Wiley Periodicals, Inc.

<69>
Accession Number
2003447321
Title
Effect of two different colloid priming strategies in infants weighing
less than 5 kg undergoing on-pump cardiac surgeries.
Source
Artificial Organs. 44(1) (pp 58-66), 2020. Date of Publication: 01 Jan
2020.
Author
Zhou C.; Tong Y.; Feng Z.; Cui Y.; Zhao M.; Hu J.; Liu K.; Zhao J.; Liu J.
Institution
(Zhou, Tong, Feng, Cui, Zhao, Hu, Liu, Zhao, Liu) State Key Laboratory of
Cardiovascular Disease, Department of Cardiopulmonary Bypass, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Our aim was to explore the effect of two different priming strategies
(artificial colloid only vs. artificial colloid combined with human serum
albumin) on the prognosis of children weighing less than 5 kg undergoing
on-pump congenital heart disease (CHD) surgery. A total of 65 children
weighing less than 5 kg who underwent on-pump CHD surgery in our hospital
from September 2016 to December 2017 were enrolled in this study. The
children were randomly divided into two groups: artificial colloid priming
group (AC group, n = 33) and artificial colloid combined albumin priming
group (ACA group, n = 32). The primary clinical endpoint was the peri-CPB
colloid osmotic pressure (COP). Secondary clinical endpoints included
perioperative blood product and hemostatic drug consumption, postoperative
renal function, coagulation function, postoperative renal function, and
postoperative recovery parameters. COP values were not significant in the
priming system as well as peri-CPB time points between the two groups (P
>.05). Platelet consumption in the AC group was significantly lower than
that in the ACA group (P <.05). There were no significant differences in
the use of other blood products and hemostatic drugs as well as
perioperative coagulation parameters between the two groups (P >.05).
Postoperative length of stay in the AC group was significantly lower than
that in the ACA group (P <.05). There were no significant differences in
mortality, postoperative mechanical ventilation time, ICU time, and
perioperative adverse events (including postoperative AKI) occurrences
between the two groups (P >.05). In the on-pump cardiac surgeries of
patients weighing less than 5 kg, total colloidal priming would not affect
peri-CPB COP values, postoperative coagulation function, and blood
products consumption. Total artificial colloidal priming strategy is
feasible in low-weight patients. Copyright © 2019 International
Center for Artificial Organs and Transplantation and Wiley Periodicals,
Inc.

<70>
Accession Number
2005972998
Title
Characteristics and outcomes of gastrointestinal bleeding in patients with
continuous-flow left ventricular assist devices: A systematic review.
Source
Artificial Organs. 44(11) (pp 1150-1161), 2020. Date of Publication: 01
Nov 2020.
Author
Carlson L.A.; Maynes E.J.; Choi J.H.; Hallett A.M.; Horan D.P.; Weber
M.P.; Deb A.K.; Patel S.; Samuels L.E.; Morris R.J.; Entwistle J.W.; Todd
Massey H.; Tchantchaleishvili V.
Institution
(Carlson, Maynes, Choi, Hallett, Horan, Weber, Patel, Samuels, Morris,
Entwistle, Todd Massey, Tchantchaleishvili) Division of Cardiac Surgery,
Thomas Jefferson University, Philadelphia, PA, United States
(Deb) Philadelphia College of Osteopathic Medicine, Philadelphia, PA,
United States
Publisher
John Wiley and Sons Inc
Abstract
Gastrointestinal bleeding (GIB) is a common adverse event after
continuous-flow left ventricular assist device (CF-LVAD) implantation. We
sought to evaluate patterns of GIB development and related outcomes in
CF-LVAD recipients. An electronic search was performed to identify all
articles related to GIB in the setting of CF-LVAD implantation. A total of
34 studies involving 1087 patients were pooled for analysis. Mean patient
age was 60 years (95% CI 57-64) and 24% (95% CI 21-28%) were female. The
mean time from CF-LVAD implantation to the first GIB was 54 days (95% CI
24-84) with 40% (95% CI 34-45%) of patients having multiple episodes of
GIB. Anemia was present in 75% (95% CI 41-93%) and the most common
etiology of bleeding was arteriovenous malformations (36% [95% CI
24-50%]). The mean duration of follow-up was 14.6 months (95% CI 6.9-22.3)
during which the all-cause mortality rate was 21% (95% CI 12-36%) and the
mortality rate from GIB was 4% (95% CI 2-9%). Thromboembolic events
occurred in 32% (95% CI 22-44%) of patients with an ischemic stroke rate
of 16% (95% CI 3-51%) and a pump thrombosis rate of 8% (95%CI 3-22%).
Heart transplantation was performed in 31% (95% CI 18-47%) of patients,
after which 0% (95% CI 0-10%) experienced recurrent GIB. GIB is a major
source of morbidity among CF-LVAD recipients. While death due to GIB is
rare, cessation of anticoagulation during treatment increases the risk of
subsequent thrombotic events. Heart transplant in these patients appears
to reliably resolve the risk of future GIB. Copyright © 2020
International Center for Artificial Organs and Transplantation and Wiley
Periodicals, Inc.

<71>
Accession Number
624224548
Title
Zero-Balance Ultrafiltration of Priming Blood Attenuates Procalcitonin and
Improves the Respiratory Function in Infants After Cardiopulmonary Bypass:
A Randomized Controlled Trial.
Source
Artificial Organs. 43(2) (pp 167-172), 2019. Date of Publication: February
2019.
Author
Gholampour Dehaki M.; Niknam S.; Azarfarin R.; Bakhshandeh H.; Mahdavi M.
Institution
(Gholampour Dehaki, Niknam, Azarfarin, Bakhshandeh, Mahdavi) Rajaie
Cardiovascular, Medical & Research Center-Perfusion, Tehran Province,
Tehran, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Blood priming is needed for cardiopulmonary bypass (CPB) in neonates and
infants to avoid exceeding hemodilution; however, transfusion-related
inflammation affects post-CPB outcomes in infant open-heart surgery.
Procalcitonin, a newly detected inflammatory moderator and a sensitive
parameter for predicting pulmonary dysfunction secondary to CPB, rises
after CPB. We hypothesized that the hemofiltration of priming blood before
CPB might decrease inflammatory mediators in the blood and post-CPB
inflammatory replications, thereby improving the respiratory function
after CPB in infants. Sixty infants with a weight below 10 kg were divided
randomly into two equal groups of CPB with the zero-balance
ultrafiltration (Z-BUF) of priming blood and CPB without it. The
procalcitonin level was measured before anesthesia, after admission to the
intensive care unit (ICU), and 24 h afterward. The respiratory index and
pulmonary compliance were measured after anesthesia, at the end of CPB,
and 2 h after admission to the ICU. Additionally, time to extubation was
recorded. The Z-BUF of priming blood maintained electrolytes within a
physiologic level, and procalcitonin had a slighter rise in the Z-BUF
Group at 24 h after admission to the ICU (P = 0.05). The respiratory index
was decreased in the Z-BUF Group, but the difference with the control
group did not reach statistical significance (P > 0.05). The change in
pulmonary compliance was significantly increased in the cyanotic patients
in the intervention group, but there was no significant difference between
the two groups. The time to extubation and the ICU stay were shorter in
the Z-BUF Group (P < 0.05). A positive correlation was found between the
peak procalcitonin concentration and the time to extubation directly and
pulmonary compliance reversely. These results suggest that the Z-BUF of
priming blood may have some beneficial clinical effects such as improved
respiratory function and attenuated procalcitonin. Copyright ©
2018 International Center for Artificial Organs and Transplantation and
Wiley Periodicals, Inc.

<72>
Accession Number
623897589
Title
Impact of Concomitant Mitral Valve Surgery With LVAD Placement: Systematic
Review and Meta-Analysis.
Source
Artificial Organs. 42(12) (pp 1139-1147), 2018. Date of Publication:
December 2018.
Author
Choi J.H.; Luc J.G.Y.; Moncho Escriva E.; Phan K.; Rizvi S.S.A.; Patel S.;
Entwistle J.W.; Morris R.J.; Massey H.T.; Tchantchaleishvili V.
Institution
(Choi, Rizvi, Patel, Entwistle, Morris, Massey, Tchantchaleishvili)
Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia,
PA, United States
(Luc) Division of Cardiovascular Surgery, Department of Surgery,
University of British Columbia, Vancouver, BC, Canada
(Moncho Escriva) Department of Statistics, University of Granada, Granada,
Spain
(Phan) Faculty of Medicine, University of New South Wales, Sydney, NSW,
Australia
Publisher
John Wiley and Sons Inc
Abstract
The aim of this systematic review and meta-analysis was to evaluate the
outcomes of concomitant mitral valve surgery for significant preexisting
mitral regurgitation (MR) in patients undergoing continuous-flow left
ventricular assist device (CF-LVAD) implantation. Electronic search was
performed to identify all studies in the English literature examining
concurrent mitral valve surgery in patients with CF-LVAD implantation.
Identified articles were systematically assessed for inclusion and
exclusion criteria. Of 2319 studies identified, 8 studies were included.
Among 445 patients with moderate to severe or severe MR, 113 (25.4%)
patients received concurrent mitral valvular intervention during CF-LVAD
implantation. There were no significant differences in cardiopulmonary
bypass time (MR Surgery 154 min vs. no MR Surgery 119 min, P = 0.64) or
hospital length of stay (MR Surgery 21 days vs. no MR Surgery 18 days, P =
0.93). On follow-up, there were no significant differences in freedom from
greater than moderate MR (MR Surgery 100% vs. no MR Surgery 74%, P = 0.12)
or left ventricular end-diastolic diameter (MR Surgery: 60 mm vs. no MR
Surgery 65 mm, P = 0.51). Survival was comparable at 6-months (MR Surgery
77% vs. no MR Surgery 81%, P = 0.75), 1-year (MR Surgery 72% vs. no MR
Surgery 80%, P = 0.36), and 2-years of follow-up (MR Surgery 65% vs. no MR
Surgery 70%, P = 0.56). The results of our systematic review and
meta-analysis of 8 studies consisting of 445 patients demonstrates that
the addition of mitral valve intervention to CF-LVAD implantation appears
to be safe with comparable survival to those undergoing CF-LVAD
implantation alone. Large prospective randomized clinical trials are
needed to elucidate whether concomitant mitral valve intervention during
CF-LVAD implantation in patients with severe MR is
necessary. Copyright © 2018 International Center for Artificial
Organs and Transplantation and Wiley Periodicals, Inc.

<73>
Accession Number
620683046
Title
Type II Minimal-Invasive Extracorporeal Circuit for Aortic Valve
Replacement: A Randomized Controlled Trial.
Source
Artificial Organs. 42(6) (pp 620-629), 2018. Date of Publication: June
2018.
Author
Gygax E.; Kaeser H.-U.; Stalder M.; Gahl B.; Rieben R.; Carrel T.; Erdoes
G.
Institution
(Gygax, Kaeser, Stalder, Carrel) Department of Cardiovascular Surgery,
Inselspital, University Hospital Bern, University of Bern, Bern,
Switzerland
(Gahl) Clinical Trials Unit, Inselspital, University Hospital Bern,
University of Bern, Bern, Switzerland
(Rieben) Department for Biomedical Research, Inselspital, University
Hospital Bern, University of Bern, Bern, Switzerland
(Erdoes) Department of Anesthesiology and Pain Therapy, Inselspital,
University Hospital Bern, University of Bern, Bern, Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Extracorporeal circulation triggers systemic inflammatory response and
coagulation disorders which may lead to unfavorable clinical outcome. A
type II minimally-invasive extracorporeal circuit (MiECC) is a closed
system with markedly reduced artificial surface as compared to
conventional extracorporeal circuits (CECC). The aim of this study was to
investigate and compare inflammatory responses, complement activation and
selected clinical end-points in isolated surgical aortic valve replacement
(SAVR) performed with a type II MiECC circuit or a CECC. Fifty patients
were prospectively randomized to MiECC or CECC perfusion regimen.
Complement activation (sC5b-9), inflammation (IL-6, TNF-alpha,
sCD40-ligand) and activation of the coagulation system (D-dimer,
TAT-complex) were determined before operation, at 2 hours and 24 hours
after surgery. Clinical end-points included perfusion time, transfusion of
allogeneic blood products, postoperative bleeding, sepsis, new onset of
atrial fibrillation, stroke and in-hospital mortality. Patient
characteristics and baseline plasma markers were similar in both groups.
Levels for sC5b-9, TNF-alpha, sCD40 ligand, TAT-complex and D-dimers were
not significantly different between MiECC and CECC at 2 hours and 24 hours
after surgery. The IL-6 plasma concentration was lower in the CECC group
at 24 hours (P = 0.026, vs. MiECC). Comparisons of the baseline level to
values at 2 hours and 24 hours, adjusted for the type of oxygenator and
hemoglobin, showed a significantly lower sC5b-9 in MiECC at 2 hours (P =
0.013), but no difference at 24 hours (P=0.990). Compared with CECC, MiECC
patients had a shorter perfusion time (P = 0.037) and less transfusion
requirements (P = 0.04). In this selected cohort of SAVR patients, the
type II MiECC was not inferior to CECC in terms of inflammatory response
and complement activation. Thus, MiECC might be an alternative perfusion
strategy to conventional. Copyright © 2018 International Center
for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

<74>
Accession Number
617557334
Title
Carbon Dioxide Flush of an Integrated Minimized Perfusion Circuit Prior to
Priming Prevents Spontaneous Air Release Into the Arterial Line During
Clinical Use.
Source
Artificial Organs. 41(11) (pp 997-1003), 2017. Date of Publication:
November 2017.
Author
Stehouwer M.C.; de Vroege R.; Hoohenkerk G.J.F.; Hofman F.N.; Kelder J.C.;
Buchner B.; de Mol B.A.; Bruins P.
Institution
(Stehouwer) Department of Extracorporeal Circulation, St Antonius
Hospital, Nieuwegein, Netherlands
(de Vroege, Buchner) Department of Extracorporeal Circulation, HAGA
Hospital, The Hague, Netherlands
(Hoohenkerk) Department of Cardiothoracic Surgery, HAGA Hospital, The
Hague, Netherlands
(Hofman) Department of Cardiothoracic Surgery, St Antonius Hospital,
Nieuwegein, Netherlands
(Kelder) Department of Cardiology, St Antonius Hospital, Nieuwegein,
Netherlands
(de Mol) Section Cardiovascular Biomechanics, Faculty of Biomedical
Technology, University of Technology, Eindhoven, Netherlands
(Bruins) Department of Anaesthesiology, Intensive Care and Pain
Management, St Antonius Hospital, Nieuwegein, Netherlands
Abstract
Recently, an oxygenator with an integrated centrifugal blood pump (IP) was
designed to minimize priming volume and to reduce blood foreign surface
contact even further. The use of this oxygenator with or without
integrated arterial filter was compared with a conventional oxygenator and
nonintegrated centrifugal pump. To compare the air removal characteristics
60 patients undergoing coronary artery bypass grafting were alternately
assigned into one of three groups to be perfused with a minimized
extracorporeal circuit either with the conventional oxygenator, the
oxygenator with IP, or the oxygenator with IP plus integrated arterial
filter (IAF). Air entering and leaving the three devices was measured
accurately with a bubble counter during cardiopulmonary bypass. No
significant differences between all groups were detected, considering air
entering the devices. Our major finding was that in both integrated
devices groups incidental spontaneous release of air into the arterial
line in approximately 40% of the patients was observed. Here, detectable
bolus air (>500 microm) was shown in the arterial line, whereas in the
minimal extracorporeal circulation circuit (MECC) group this phenomenon
was not present. We decided to conduct an amendment of the initial design
with METC-approval. Ten patients were assigned to be perfused with an
oxygenator with IP and IAF. Importantly, the integrated perfusion systems
used in these patients were flushed with carbon dioxide (CO<inf>2</inf>)
prior to priming of the systems. In the group with CO<inf>2</inf> flush no
spontaneous air release was observed in all cases and this was
significantly different from the initial study with the group with the
integrated device and IAF. This suggests that air spilling may be caused
by residual air in the integrated device. In conclusion, integration of a
blood pump may cause spontaneous release of large air bubbles (>500
microm) into the arterial line, despite the presence of an integrated
arterial filter. CO<inf>2</inf> flushing of an integrated cardiopulmonary
bypass system prior to priming may prevent spontaneous air release and is
strongly recommended to secure patient safety. Copyright © 2017
International Center for Artificial Organs and Transplantation and Wiley
Periodicals, Inc.

<75>
Accession Number
617548707
Title
Remote Ischemic Preconditioning and Clinical Outcomes in On-Pump Coronary
Artery Bypass Grafting: A Meta-Analysis of 14 Randomized Controlled
Trials.
Source
Artificial Organs. 41(12) (pp 1173-1182), 2017. Date of Publication:
December 2017.
Author
Yi B.; Wang J.; Yi D.; Zhu Y.; Jiang Y.; Li Y.; Mo S.; Liu Y.; Rong J.
Institution
(Yi) Department of Cardiothoracic Surgery, Heart Center, the First
Affiliated Hospital, Sun Yat-Sen University, and Key Laboratory on
Assisted Circulation, Ministry of Health, Guangzhou, China
(Yi, Zhu, Jiang, Li, Mo, Rong) Department of Extracorporeal Circulation,
Heart Center, the First Affiliated Hospital, Sun Yat-Sen University, and
Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou,
China
(Wang) Department of Anesthesiology, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular
Disease, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Yi) Department of Cardiac Surgery, the Second Xiangya Hospital, Central
South University, Changsha, China
(Liu) Department of Anesthesiology, the First Affiliated Hospital, Sun
Yat-Sen University, Guangzhou, China
Abstract
The purpose of this article is to perform the first pooled analysis on
remote ischemic preconditioning (RIPC) used for the improvement of
clinical outcomes of patients only undergoing on-pump coronary artery
bypass grafting (CABG) in randomized controlled trials (RCTs). A
systematic search was performed using PubMed, the Cochrane Library, and
the Web of Science to identify studies that described the effect of RIPC
on postoperative mortality in patients only undergoing on-pump CABG. The
outcomes included postoperative mortality, postoperative morbidity
(including incidence of myocardial infarction, atrial fibrillation,
stroke, acute kidney injury, and renal replacement therapy), mechanical
ventilation (MV), intensive care unit length of stay (ICU LOS), and
hospital length of stay (HLOS). A total of 14 RCTs (2830 participants)
were included. Our meta-analysis found that RIPC failed to reduce the
postoperative mortality in patients only undergoing on-pump CABG compared
with control individuals (odds ratio, 0.81; 95% confidence interval,
[0.40, 1.64]; P = 0.55; I2 = 25%). Moreover, there were no
differences in postoperative morbidity, ICU LOS, and HLOS between the two
groups. However, MV in the RIPC group was shorter than that in control
individuals (standard mean difference, -0.41; 95% confidence interval,
[-0.80, -0.01]; P = 0.04; I2 = 73%). The present meta-analysis
found that RIPC failed to improve most of clinical outcomes in patients
only undergoing on-pump CABG; however, MV was reduced. Adequately powered
trials are warranted to provide more evidence in the future. Copyright
© 2017 International Center for Artificial Organs and Transplantation
and Wiley Periodicals, Inc.

<76>
Accession Number
607220730
Title
A Pilot Study of Antithrombin Replacement Prior to Cardiopulmonary Bypass
in Neonates.
Source
Artificial Organs. 40(1) (pp 80-85), 2016. Date of Publication: 01 Jan
2016.
Author
Niebler R.A.; Woods K.J.; Murkowski K.; Ghanayem N.S.; Hoffman G.;
Mitchell M.E.; Punzalan R.C.; Scott J.P.; Simpson P.; Tweddell J.S.
Institution
(Niebler, Woods, Murkowski, Ghanayem) Section of Critical Care, Medical
College of Wisconsin, Milwaukee, WI, United States
(Punzalan, Scott) Section of Hematology, Medical College of Wisconsin,
Milwaukee, WI, United States
(Simpson) Section of Quantitative Health Sciences, Department of
Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
(Hoffman) Department of Anesthesiology, Medical College of Wisconsin,
Milwaukee, WI, United States
(Mitchell, Tweddell) Department of Cardiothoracic Surgery, Medical College
of Wisconsin, Milwaukee, WI, United States
(Niebler, Ghanayem, Hoffman, Mitchell, Tweddell) Herma Heart Center at
Children's Hospital of Wisconsin, Milwaukee, WI, United States
Abstract
Neonates have low levels of antithrombin. Inadequate anticoagulation
during cardiopulmonary bypass (CPB) due to low antithrombin activity may
result in a poor preservation of the coagulation system during bypass. We
hypothesize that antithrombin replacement to neonates prior to CPB will
preserve the hemostatic system and result in less postoperative bleeding.
A randomized, double-blinded, placebo-controlled pilot study of
antithrombin replacement to neonates prior to CPB was conducted.
Preoperative antithrombin levels determined the dose of recombinant
antithrombin or placebo to be given. Antithrombin levels were measured
following the dosing of the antithrombin/placebo, after initiation of
bypass, near the completion of bypass, and upon intensive care unit
admission. Eight subjects were enrolled. No subject had safety concerns.
Mediastinal exploration occurred in two antithrombin subjects and one
placebo subject. Antithrombin activity levels were significantly higher in
the treated group following drug administration; levels continued to be
higher than preoperatively but not different from the placebo group at all
other time points. Total heparin administration was less in the
antithrombin group; measurements of blood loss were similar in both
groups. A single dose of recombinant antithrombin did not maintain 100%
activity levels throughout the entire operation. Although no safety
concerns were identified in this pilot study, a larger trial is necessary
to determine clinical efficacy. Copyright © 2016 Wiley
Periodicals, Inc. and International Center for Artificial Organs and
Transplantation.

<77>
Accession Number
607178254
Title
Three Preservation Solutions for Cold Storage of Heart Allografts: A
Systematic Review and Meta-Analysis.
Source
Artificial Organs. 40(5) (pp 489-496), 2016. Date of Publication: 01 May
2016.
Author
Li Y.; Guo S.; Liu G.; Yuan Y.; Wang W.; Zheng Z.; Hu S.; Ji B.
Institution
(Li, Guo, Liu, Yuan, Ji) Department of Cardiopulmonary Bypass, State Key
Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for
Cardiovascular Disease, Chinese Academy of Medical Science and Peking
Union Medical College, Beijing, China
(Wang, Zheng, Hu) Department of Cardiac Surgery, State Key Laboratory of
Cardiovascular Medicine, Fuwai Hospital, National Center for
Cardiovascular Disease, Chinese Academy of Medical Science and Peking
Union Medical College, Beijing, China
(Li) Department of Cardiac Surgery, Lanzhou University Second Hospital,
Lanzhou, China
Abstract
Organ preservation solution has been designed to attenuate the detrimental
effects during the ischemic period. The aim of this study was to
systematically evaluate the evidence comparing preservation solutions for
heart preservation. Studies were searched in PubMed, Embase, the Cochrane
Library, the Transplant Library, and the International Clinical Trials
Registry Platform. The primary outcomes were patient survival and donor
heart dysfunction. The secondary outcomes were in-hospital mortality and
enzyme gene expression. The University of Wisconsin solution (UW) was
associated with a significantly improved survival at 30 days and 90 days
(hazard ratio=1.16, 95% confidence interval [CI]=1.11-1.22, P<0.00001;
risk difference [RD]=0.03, 95% CI=0.01-0.05, P=0.002), compared with
Celsior. Hearts preserved with UW exhibited less ischemic necrosis than
those preserved with Celsior (RD=-0.07, 95% CI=-0.08 to 0.05, P<0.00001).
UW was associated with better survival compared with
histidine-tryptophan-ketoglutarate solution (HTK). There was no
statistical difference in donor heart dysfunction and in-hospital
mortality outcomes when comparing HTK with Celsior solution. During static
cold storage preservation, this study suggests that UW solution has better
clinical outcomes for heart transplantation compared with the other two
organ preservation solutions. Besides, the protective effect of Celsior
solution is similar to HTK solution in donor heart
preservation. Copyright © 2016 Wiley Periodicals, Inc. and
International Center for Artificial Organs and Transplantation.

<78>
Accession Number
606992249
Title
Hypothermia During Cardiopulmonary Bypass Increases Need for Inotropic
Support but Does Not Impact Inflammation in Children Undergoing Surgical
Ventricular Septal Defect Closure.
Source
Artificial Organs. 40(5) (pp 470-479), 2016. Date of Publication: 01 May
2016.
Author
Schmitt K.R.L.; Fedarava K.; Justus G.; Redlin M.; Bottcher W.; Delmo
Walter E.M.; Hetzer R.; Berger F.; Miera O.
Institution
(Schmitt, Fedarava, Justus, Berger, Miera) Department of Congenital Heart
Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin,
Germany
(Redlin) Department of Anesthesiology, Deutsches Herzzentrum Berlin,
Berlin, Germany
(Bottcher, Delmo Walter, Hetzer) Department of Cardiothoracic and Vascular
Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
(Berger) Department of Pediatrics, Division of Cardiology,
Charite-Universitatsmedizin, Berlin, Germany
Abstract
Minimizing the systemic inflammatory response caused by cardiopulmonary
bypass is a major concern. It has been suggested that the perfusion
temperature affects the inflammatory response. The aim of this prospective
study was to compare the effects of moderate hypothermia (32degreeC) and
normothermia (36degreeC) during cardiopulmonary bypass on markers of the
inflammatory response and clinical outcomes (time on ventilator) after
surgical closure of ventricular septal defects. During surgical closure of
ventricular septal defects under cardiopulmonary bypass, 20 children
(median age 4.9 months, range 2.3-38 months; median weight 7.2kg, range
5.2-11.7kg) were randomized to a perfusion temperature of either 32degreeC
(Group 1, n=10) or 36degreeC (Group 2, n=10). The clinical data and blood
samples were collected before cardiopulmonary bypass, directly after
aortic cross-clamp release, and 4 and 24h after weaning from
cardiopulmonary bypass. Time on ventilation as primary outcome did not
differ between the two groups. Other clinical outcome parameters like
fluid balance or length of stay in the intensive care were also similar in
the two groups. Compared with Group 2, Group 1 needed significantly higher
and longer inotropic support (P<0.001). In Group 1, two infants had
junctional ectopic tachycardia, and another had a pulmonary hypertensive
crisis. Perfusion temperature did not influence cytokine release, organ
injury, or coagulation. Cardiopulmonary bypass temperature does not
influence time on ventilation or inflammatory marker release. However, in
the present study, with a small patient cohort, patients operated under
hypothermic bypass needed higher and longer inotropic support. The use of
hypothermic cardiopulmonary bypass in infants and children should be
approached with care. Copyright © 2016 Wiley Periodicals, Inc.
and International Center for Artificial Organs and Transplantation.

<79>
Accession Number
611158362
Title
Cerebral Microembolization During Aortic Valve Replacement Using Minimally
Invasive or Conventional Extracorporeal Circulation: A Randomized Trial.
Source
Artificial Organs. 40(12) (pp E280-E291), 2016. Date of Publication: 01
Dec 2016.
Author
Basciani R.; Kroninger F.; Gygax E.; Jenni H.; Reineke D.; Stucki M.;
Hagenbuch N.; Carrel T.; Eberle B.; Erdoes G.
Institution
(Basciani, Kroninger, Stucki, Eberle, Erdoes) Department of Anesthesiology
and Pain Therapy, Inselspital, Bern University Hospital, University of
Bern, Bern, Switzerland
(Gygax, Jenni, Reineke, Carrel) Department of Cardiovascular Surgery,
Swiss Cardiovascular Center, Inselspital, Bern University Hospital,
University of Bern, Bern, Switzerland
(Hagenbuch) Private Statistician, Spiez, Switzerland
Abstract
To compare intraoperative cerebral microembolic load between minimally
invasive extracorporeal circulation (MiECC) and conventional
extracorporeal circulation (CECC) during isolated surgical aortic valve
replacement (SAVR), we conducted a randomized trial in patients undergoing
primary elective SAVR at a tertiary referral hospital. The primary outcome
was the procedural phase-related rate of high-intensity transient signals
(HITS) on transcranial Doppler ultrasound. HITS rate was used as a
surrogate of cerebral microembolism in pre-defined procedural phases in
SAVR using MiECC or CECC with (+F) or without (-F) an oxygenator with
integrated arterial filter. Forty-eight patients were randomized in a 1:1
ratio to MiECC or CECC. Due to intraprocedural Doppler signal loss (n =
3), 45 patients were included in final analysis. MiECC perfusion regimen
showed a significantly increased HITS rate compared to CECC (by a factor
of 1.75; 95% confidence interval, 1.19-2.56). This was due to different
HITS rates in procedural phases from aortic cross-clamping until
declamping [phase 4] (P = 0.01), and from aortic declamping until stop of
extracorporeal perfusion [phase 5] (P = 0.05). Post hoc analysis revealed
that MiECC-F generated a higher HITS rate than CECC+F (P = 0.005), CECC-F
(P = 0.05) in phase 4, and CECC-F (P = 0.03) in phase 5, respectively. In
open-heart surgery, MiECC is not superior to CECC with regard to gaseous
cerebral microembolism. When using MiECC for SAVR, the use of oxygenators
with integrated arterial line filter appears highly advisable. Only with
this precaution, MiECC confers a cerebral microembolic load comparable to
CECC during this type of open heart surgery. Copyright © 2016
International Center for Artificial Organs and Transplantation and Wiley
Periodicals, Inc.

<80>
Accession Number
602682509
Title
Similar cerebral protective effectiveness of antegrade and retrograde
cerebral perfusion during deep hypothermic circulatory arrest in aortic
surgery: A meta-analysis of 7023 patients.
Source
Artificial Organs. 39(4) (pp 300-308), 2015. Date of Publication: 01 Apr
2015.
Author
Guo S.; Sun Y.; Ji B.; Liu J.; Wang G.; Zheng Z.
Institution
(Guo, Sun, Ji, Liu) Department of Cardiopulmonary Bypass, State Key
Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for
Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union
Medical College, Beijing, China
(Wang) Department of Anesthesiology, State Key Laboratory of
Cardiovascular Medicine, Fuwai Hospital, National Center for
Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union
Medical College, Beijing, China
(Zheng) Department of Cardiovascular Surgery, State Key Laboratory of
Cardiovascular Medicine, Fuwai Hospital, National Center for
Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union
Medical College, Beijing, China
Abstract
In aortic arch surgery, deep hypothermic circulatory arrest (DHCA)
combined with cerebral perfusion is employed worldwide as a routine
practice. Even though antegrade cerebral perfusion (ACP) is more widely
used than retrograde cerebral perfusion (RCP), the difference in benefit
and risk between ACP and RCP during DHCA is uncertain. The purpose of this
meta-analysis is to compare neurologic outcomes and early mortality
between ACP and RCP in patients who underwent aortic surgery during DHCA.
PubMed, EMBASE, and the Cochrane Library were searched using the key words
"antegrade," "retrograde," "cerebral perfusion," "cardiopulmonary bypass,"
"extracorporeal circulation," and "cardiac surgery" for studies reporting
on clinical endpoints including early mortality, stroke, temporary
neurologic dysfunction (TND), and permanent neurologic dysfunction (PND)
in aortic surgery requiring DHCA with ACP or RCP. Heterogeneity was
analyzed with the Cochrane Q statistic and I2 statistic.
Publication bias was tested with Begg's funnel plot and Egger's test.
Thirty-four studies were included in this meta-analysis, with 4262
patients undergoing DHCA+ACP and 2761 undergoing DHCA+RCP. The overall
pooled relative risk for TND was 0.722 (95% CI=[0.579, 0.900]), and the
z-score for overall effect was 2.9 (P=0.004). There was low heterogeneity
(I2=18.7%). The analysis showed that patients undergoing
DHCA+ACP had better outcomes than those undergoing DHCA+RCP in terms of
TND, while there were no significant differences between groups in terms
of PND, stroke, and early mortality. This meta-analysis indicates that
DHCA+ACP has an advantage over DHCA+RCP in terms of TND, while the two
methods show similar results in terms of PND, early mortality, and
stroke. Copyright © 2015 International Center for Artificial
Organs and Transplantation and Wiley Periodicals, Inc.

<81>
Accession Number
602682475
Title
Minimally Invasive Ventricular Assist Device Surgery.
Source
Artificial Organs. 39(6) (pp 473-479), 2015. Date of Publication: 01 Jun
2015.
Author
Rojas S.V.; Avsar M.; Hanke J.S.; Khalpey Z.; Maltais S.; Haverich A.;
Schmitto J.D.
Institution
(Rojas, Avsar, Hanke, Haverich, Schmitto) Department of Cardiothoracic,
Transplantation, and Vascular Surgery, Hannover Medical School, Hannover,
Germany
(Khalpey) Division of Cardiothoracic Surgery, College of Medicine,
University of Arizona, Tucson, AZ, United States
(Maltais) Heart and Vascular Institute, Vanderbilt University, Nashville,
TN, United States
Abstract
The use of mechanical circulatory support to treat patients with
congestive heart failure has grown enormously, recently surpassing the
number of annual heart transplants worldwide. The current generation of
left ventricular assist devices (LVADs), as compared with older devices,
is characterized by improved technologies and reduced size. The result is
that minimally invasive surgery is now possible for the implantation,
explantation, and exchange of LVADs. Minimally invasive procedures improve
surgical outcome; for example, they lower the rates of operative
complications (such as bleeding or wound infection). The miniaturization
of LVADs will continue, so that minimally invasive techniques will be used
for most implantations in the future. In this article, we summarize and
describe minimally invasive state-of-the-art implantation techniques, with
a focus on the most common LVAD systems in adults. Copyright ©
2015 International Center for Artificial Organs and Transplantation and
Wiley Periodicals, Inc.

<82>
Accession Number
602221227
Title
A Meta-Analysis of Pulmonary Function With Pulsatile Perfusion in Cardiac
Surgery.
Source
Artificial Organs. 39(2) (pp 110-117), 2015. Date of Publication: 01 Feb
2015.
Author
Lim C.-H.; Nam M.-J.; Lee J.-S.; Kim H.-J.; Kim J.-Y.; Shin H.-W.; Lee
H.-W.; Sun K.
Institution
(Lim, Shin, Lee) Department of Anesthesiology and Pain Medicine, Korea
University Medical Center, Seoul, South Korea
(Nam) College of Medicine, Korea University, Seoul, South Korea
(Lee) Biostatistical Consulting Unit, Soonchunhyang University Medical
Center, Seoul, South Korea
(Kim) Department of Preventive Medicine, College of Medicine, Korea
University, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, Ilsan Paik Hospital,
Inje University, Seoul, South Korea
(Sun) Department of Thoracic and Cardiovascular Surgery, Korea University
Medical Center, Seoul, South Korea
Abstract
The aim of this study was to determine whether pulsatile or nonpulsatile
perfusion had a greater effect on pulmonary dysfunction in randomized
controlled trials. MEDLINE, EMBASE, and the Cochrane Central Register of
Controlled Trials were used to identify available articles published
before April 13, 2013. A meta-analysis was conducted on the effects of
pulsatile perfusion on postoperative pulmonary function, intubation time,
and the lengths of intensive care unit (ICU) and hospital stays. Eight
studies involving 474 patients who received pulsatile perfusion and 496
patients who received nonpulsatile perfusion during cardiopulmonary bypass
(CPB) were considered in the meta-analysis. Patients receiving pulsatile
perfusion had a significantly greater PaO<inf>2</inf>/FiO<inf>2</inf>
ratio 24h and 48h post-operation (P<0.00001, both) and significantly lower
chest radiograph scores at 24h and 48h post-operation (P<0.00001 and
P=0.001, respectively) compared with patients receiving nonpulsatile
perfusion. The incidence of noninvasive ventilation for acute respiratory
insufficiency was significantly lower (P<0.00001), and intubation time and
ICU and hospital stays were shorter (P=0.004, P<0.00001, and P<0.00001,
respectively) in patients receiving pulsatile perfusion during CPB
compared with patients receiving nonpulsatile perfusion. In conclusion,
our meta-analysis suggests that the use of pulsatile flow during CPB
results in better postoperative pulmonary function and shorter ICU and
hospital stays. Copyright © 2014 International Center for
Artificial Organs and Transplantation and Wiley Periodicals, Inc.

<83>
Accession Number
603795324
Title
A Meta-Analysis of Renal Function After Adult Cardiac Surgery With
Pulsatile Perfusion.
Source
Artificial Organs. 39(9) (pp 788-794), 2015. Date of Publication: 01 Sep
2015.
Author
Nam M.J.; Lim C.H.; Kim H.-J.; Kim Y.H.; Choi H.; Son H.S.; Lim H.J.; Sun
K.
Institution
(Nam) School of Medicine, Korea University, Seoul, South Korea
(Lim, Kim, Lim) Anesthesiology and Pain Medicine, College of Medicine,
Korea University, Seoul, South Korea
(Kim) Department of Preventive Medicine, College of Medicine, Korea
University, Seoul, South Korea
(Choi) Department of Medical Science, Graduate School of Medicine, Korea
University, Seoul, South Korea
(Son, Sun) Thoracic and Cardiovascular Surgery, Korea University, Seoul,
South Korea
Abstract
The aim of this meta-analysis was to determine whether pulsatile perfusion
during cardiac surgery has a lesser effect on renal dysfunction than
nonpulsatile perfusion after cardiac surgery in randomized controlled
trials. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled
Trials were used to identify available articles published before April 25,
2014. Meta-analysis was conducted to determine the effects of pulsatile
perfusion on postoperative renal functions, as determined by creatinine
clearance (CrCl), serum creatinine (Cr), urinary neutrophil
gelatinase-associated lipocalin (NGAL), and the incidences of acute renal
insufficiency (ARI) and acute renal failure (ARF). Nine studies involving
674 patients that received pulsatile perfusion and 698 patients that
received nonpulsatile perfusion during cardiopulmonary bypass (CPB) were
considered in the meta-analysis. Stratified analysis was performed
according to effective pulsatility or unclear pulsatility of the pulsatile
perfusion method in the presence of heterogeneity. NGAL levels were not
significantly different between the pulsatile and nonpulsatile groups.
However, patients in the pulsatile group had a significantly higher CrCl
and lower Cr levels when the analysis was restricted to studies on
effective pulsatile flow (P<0.00001, respectively). The incidence of ARI
was significantly lower in the pulsatile group (P<0.00001), but incidences
of ARF were similar. In conclusion, the meta-analysis suggests that the
use of pulsatile flow during CPB results in better postoperative renal
function. Copyright © 2015 International Center for Artificial
Organs and Transplantation and Wiley Periodicals, Inc.

<84>
Accession Number
52700174
Title
Anti-inflammatory strategies to reduce acute kidney injury in cardiac
surgery patients: A meta-analysis of randomized controlled trials.
Source
Artificial Organs. 38(2) (pp 101-112), 2014. Date of Publication: February
2014.
Author
Scrascia G.; Guida P.; Rotunno C.; de Luca Tupputi Schinosa L.; Paparella
D.
Institution
(Scrascia, Guida, Rotunno, de Luca Tupputi Schinosa, Paparella) Department
of Emergency and Organ Transplant, Division of Cardiac Surgery, University
of Bari Aldo Moro, Bari, Italy
Abstract
Acute kidney injury (AKI) after cardiac operations is a serious
complication associated with postoperative mortality. Multiple factors
contribute to AKI development, principally ischemia-reperfusion injury and
inflammatory response. It is well proven that glucocorticoid
administration, leukocyte filter application, and miniaturized
extracorporeal circuits (MECC) modulate inflammatory response. We
conducted a systematic review of randomized controlled trials (RCTs) in
which one of these inflammatory system modulation strategies was used,
with the aim to evaluate the effects on postoperative AKI. MEDLINE and
Cochrane Library were screened through November 2011 for RCTs in which an
inflammatory system modulation strategy was adopted. Included were trials
that reported data about postoperative renal outcomes. Because AKI was
defined by different criteria, including biochemical determinations, urine
output, or dialysis requirement, we unified renal outcome as worsening
renal function (WRF). We identified 14 trials for steroids administration
(931 patients, WRF incidence [treatment vs. placebo]: 2.7% vs. 2.4%; OR:
1.13; 95% CI: 0.53-2.43; P=0.79), 9 trials for MECC (947 patients, WRF
incidence: 2.4% vs. 0.9%; OR: 0.47; 95% CI: 0.18-1.25; P=0.13), 6 trials
for leukocyte filters (374 patients, WRF incidence: 1.1% vs. 7.5%; OR:
0.18; 95% CI: 0.05-0.64; P=0.008). Only leukocyte filters effectively
reduced WRF incidence. Not all cardiopulmonary bypass-related
anti-inflammatory strategies analyzed reduced renal damage after cardiac
operations. In adult patients, probably other factors are predominant on
inflammation in determining AKI, and only leukocyte filters were
effective. Large multicenter RCTs are needed in order to better evaluate
the role of inflammation in AKI development after cardiac operations.
© 2013, the Authors.

<85>
Accession Number
52949496
Title
Comparison of sustained low-efficiency dialysis with acetate-free and
acetate-containing bicarbonate dialysate in unstable patients.
Source
Artificial Organs. 38(10) (pp 883-888), 2014. Date of Publication: 01 Oct
2014.
Author
Unarokov Z.M.; Mukhoedova T.V.; Shuvaeva O.V.
Institution
(Unarokov, Mukhoedova) Department of Anesthesiology and Critical Care,
Academician E.N. Meshalkin Novosibirsk State Research Institute of
Circulation Pathology, Novosibirsk, Russian Federation
(Shuvaeva) Analytical Laboratory, Nikolaev Institute of Inorganic
Chemistry, Siberian Branch of Russian Academy of Sciences, Novosibirsk,
Russian Federation
Abstract
This work is focused on the problem of maintenance of intradialytic
hemodynamic safety in unstable patients with acute kidney injury (AKI). A
hypothesis that "small" quantities of acetate in standard bicarbonate
dialysate can cause pronounced acetatemia and exacerbate cardiovascular
instability was tested. In this prospective randomized study, a group of
patients with AKI after cardiac surgery was treated with sustained
low-efficiency dialysis with either acetate-containing bicarbonate
dialysate or acetate-free dialysate, where acetate is replaced by
hydrochloric acid. It was demonstrated that application of
acetate-containing bicarbonate dialysate results in blood acetate levels
up to 12 times the normal level. Additionally, it is associated with a
3.8-fold-increased risk of hemodynamic complications in comparison with
acetate-free dialysate. The choice of acetate-free or acetate-containing
bicarbonate dialysate does not influence adequacy of correction of the
acid-base and electrolyte content of blood. Copyright © 2014
Wiley Periodicals, Inc.

<86>
Accession Number
52668947
Title
Effect of the Neutrophil Elastase Inhibitor Sivelestat on Perioperative
Inflammatory Response After Pediatric Heart Surgery With Cardiopulmonary
Bypass: A Prospective Randomized Study.
Source
Artificial Organs. 37(12) (pp 1027-1033), 2013. Date of Publication:
December 2013.
Author
Kohira S.; Oka N.; Inoue N.; Itatani K.; Hanayama N.; Kitamura T.; Fujii
M.; Takeda A.; Oshima H.; Tojo K.; Yoshitake S.; Miyaji K.
Institution
(Kohira, Fujii, Takeda, Oshima, Tojo) Medical Engineer Center, Kitasato
University School of Medicine, Sagamihara, Japan
(Oka, Inoue, Itatani, Hanayama, Kitamura, Miyaji) Department of
Cardiovascular Surgery, Kitasato University School of Medicine,
Sagamihara, Japan
(Yoshitake) Department of Clinical Engineer, Kyushu University of Health
and Welfare, Miyazaki, Japan
Abstract
Cardiopulmonary bypass (CPB) elicits a systemic inflammatory response. The
neutrophil elastase inhibitor sivelestat is known to suppress this
systemic inflammatory response, which can eventually result in acute organ
failure. The prophylactic effect of sivelestat on acute lung injury,
especially in pediatric cardiac surgery, remains unclear. This prospective
double-blind, randomized study evaluated the perioperative prophylactic
effect of sivelestat in patients undergoing elective pediatric open heart
surgery with CPB. Thirty consecutive patients, weighing 5-10kg and
undergoing open heart surgery with CPB, were assigned to sivelestat (n=15)
or control (n=15) groups. From CPB initiation to 24h after surgery,
patients in the sivelestat group received a continuous intravenous
infusion of 0.2mg/kg/h sivelestat, whereas patients in the control group
received the same volume of 0.9% saline. Blood samples were collected, and
levels of interleukin (IL)-6, IL-8, tumor necrosis factor alpha,
polymorphonuclear elastase (PMN-E), C-reactive protein (CRP), as well as
the white blood cell (WBC) count, platelet count, and neutrophil count
(NC) were measured. PMN-E levels, IL-8 levels, WBC count, NC, and CRP
levels were significantly lower, and platelet count was significantly
higher in the sivelestat group, according to repeated two-way analysis of
variance. The activated coagulation time was significantly shorter in the
sivelestat group, similarly, blood loss was significantly less in the
sivelestat group. In conclusion, Sivelestat attenuates perioperative
inflammatory response and clinical outcomes in patients undergoing
pediatric heart surgery with CPB. © 2013 Wiley Periodicals, Inc. and
International Center for Artificial Organs and Transplantation.

<87>
Accession Number
368126110
Title
Impact of Pulsatile Perfusion on Clinical Outcomes of Neonates and Infants
With Complex Pathologies Undergoing Cardiopulmonary Bypass Procedures.
Source
Artificial Organs. 37(1) (pp 82-86), 2013. Date of Publication: January
2013.
Author
Alkan-Bozkaya T.; Akcevin A.; Turkoglu H.; Undar A.
Institution
(Alkan-Bozkaya, Akcevin, Turkoglu) Department of Cardiovascular Surgery,
Istanbul Medipol University, Istanbul, Turkey
(Undar) Departments of Pediatrics, Surgery and Bioengineering, Penn State
Hershey College of Medicine, Pediatric Cardiovascular Research Center,
Hershey, PA, United States
Abstract
The aim of this clinical trial was to evaluate the pulsatile perfusion
mode in pediatric patients who had complex cardiac pathologies according
to Jenkins stratifications (category 4) undergoing cardiopulmonary bypass
procedures (CPB). Patients with transposition of great arteries (TGA) and
ventricular septal defect (VSD) were included in this clinical study.
Eighty-nine consecutive pediatric patients undergoing open heart surgery
for repair of TGA-VSD were prospectively entered into the study and were
randomly assigned to either the pulsatile perfusion group (Group P, n=58)
or the nonpulsatile perfusion group (Group NP, n=31). There were no
differences between groups in terms of demographical and intraoperative
parameters. The pulsatile group needed significantly less inotropic
support (P<0.05) and had lower lactate levels (P<0.001), higher urine
output (P<0.01), and higher albumin levels (P<0.05). In addition, the
pulsatile group had less ICU (P<0.01) and hospital stays (P<0.001). We
conclude that the use of pulsatile flow is a better option and should be
considered for repair of the complex congenital heart defects. ©
2013, The Authors. Artificial Organs © 2013, International Center for
Artificial Organs and Transplantation and Wiley Periodicals, Inc.

<88>
Accession Number
52501612
Title
Efficacy of Carbon Dioxide Insufflation for Cerebral and Cardiac
Protection During Open Heart Surgery: A Systematic Review and
Meta-Analysis.
Source
Artificial Organs. 37(5) (pp 439-446), 2013. Date of Publication: May
2013.
Author
Sun Y.; Ji B.; Zhu X.; Zheng Z.
Institution
(Sun, Ji, Zhu) Department of Cardiopulmonary Bypass, State Key Laboratory
of Cardiovascular Disease, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Zheng) Department of Cardiovascular Surgery, State Key Laboratory of
Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
Abstract
In spite of widespread application around the world, there has been
controversy on the cerebral and cardiac protection efficacy of carbon
dioxide insufflation (CDI) during open heart surgery. To make a
comprehensive evaluation, we screened all relevant published randomized
controlled trials to perform the first systematic review and meta-analysis
for CDI during open heart surgery. We searched PubMed, EMBASE, the
Cochrane Controlled Clinical Trial register, WANFAN, CQVIP, and CNKI
database for published articles. Randomized controlled trials were
included when the research provided data of neurological complications
postoperatively, creatinine kinase, MB isoenzyme (CK-MB) on the first
postoperative day, or all-cause mortality. We chose a fixed-effects model
when the trials showed low heterogeneity, otherwise a random effects model
was used. The quality of studies was assessed by modified Jadad scale.
Four studies were included in this meta-analysis. The overall pooled
relative risk (RR) for neurological complications was 1.59, 95% confidence
interval (CI)=[0.57, 4.46], and the z-score for overall effect was 0.89
(P=0.37). The standardized mean difference of the CK-MB between groups was
1.15, 95% CI=[-1.27, 3.56], and the z-score for overall effect was 0.93
(P=0.35). The overall pooled RR for all-cause mortality was 0.5, 95%
CI=[0.16, 1.64], and the z-score for overall effect was 1.14 (P=0.25).
There was no significant difference between groups. Because of the
insufficiency of powerful evidences, the cerebral and cardiac protection
efficacy of CDI during open heart surgery needs to be further verified by
more high-quality trials. © 2013, International Center for Artificial
Organs and Transplantation and Wiley Periodicals, Inc.

<89>
Accession Number
52117450
Title
Centrifugal Pump and Roller Pump in Adult Cardiac Surgery: A Meta-Analysis
of Randomized Controlled Trials.
Source
Artificial Organs. 36(8) (pp 668-676), 2012. Date of Publication: August
2012.
Author
Saczkowski R.; Maklin M.; Mesana T.; Boodhwani M.; Ruel M.
Institution
(Saczkowski, Maklin, Mesana, Boodhwani, Ruel) Department of Cardiac
Surgery, Royal Columbian Hospital, New Westminster, BC, Canada
Abstract
Centrifugal pump (CP) and roller pump (RP) designs are the dominant main
arterial pumps used in cardiopulmonary bypass (CPB). Trials reporting
clinical outcome measures comparing CP and RP are controversial.
Therefore, a meta-analysis was undertaken to evaluate clinical variables
from randomized controlled trials (RCTs). Keyword searches were performed
on Medline (1966-2011), EmBase (1980-2011), and CINAHL (1981-2011) for
studies comparing RP and CP as the main arterial pump in adult CPB. Pooled
fixed-effects estimates for dichotomous and continuous data were
calculated as an odds ratio and weighted-mean difference, respectively.
The P value was utilized to assess statistical significance (P<0.05)
between CP and RP groups. Eighteen RCTs met inclusion criteria, which
represented 1868 patients (CP=961, RP=907). The prevailing operation was
isolated coronary artery bypass graft surgery (CP=88%, RP=87%).
Fixed-effects pooled estimates were performed for end-of-CPB (ECP) and
postoperative day one (PDO) for platelet count (ECP: P=0.51, PDO: P=0.16),
plasma free hemoglobin (ECP: P=0.36, PDO: P=0.24), white blood cell count
(ECP: P=0.21, PDO: P=0.66), and hematocrit (ECP: P=0.06, PDO: P=0.51). No
difference was demonstrated for postoperative blood loss (P=0.65) or red
blood cell transfusion (P=0.71). Intensive care unit length of stay
(P=0.30), hospital length of stay (P=0.33), and mortality (P=0.91) were
similar between the CP and RP groups. Neurologic outcomes were not
amenable to pooled analysis; nevertheless, the results were inconclusive.
There was no reported pump-related malfunction or mishap. The
meta-analysis of RCTs comparing CP and RP in adult cardiac surgery
suggests no significant difference for hematological variables,
postoperative blood loss, transfusions, neurological outcomes, or
mortality. © 2012, the Authors. Artificial Organs © 2012,
International Center for Artificial Organs and Transplantation and Wiley
Periodicals, Inc.

<90>
Accession Number
361279426
Title
The Effects of Reactive Hyperemia on Stimulation of Endothelium-Derived
Nitric Oxide in On-Pump and Off-Pump Coronary Artery Bypass Surgeries.
Source
Artificial Organs. 35(2) (pp 131-136), 2011. Date of Publication: February
2011.
Author
Sasmazel A.; Erkilic A.; Buyukbayrak F.; Baysal A.; Tigen K.; Tuncer A.;
Tuncer E.; Bugra O.; Ozkokeli M.; Kucukcerit T.; Sunar H.; Zeybek R.
Institution
(Sasmazel, Buyukbayrak, Tuncer, Tuncer, Bugra, Ozkokeli, Sunar, Zeybek)
Department of Cardiac Surgery, Istanbul, Turkey
(Erkilic, Baysal, Kucukcerit) Department of Anaesthesiology, Istanbul,
Turkey
(Tigen) Department of Cardiology, Kartal Kosuyolu Heart and Research
Center, Istanbul, Turkey
Abstract
The purpose of this study is to compare the effects of cardiopulmonary
bypass (CPB) on the endothelium-derived nitric oxide (NO) levels in
on-pump and off-pump coronary artery bypass surgeries. Forty consecutive
patients were divided randomly into two groups depending on use of CPB in
coronary artery bypass graft surgery (group 1: n=20, off-pump, and group
2: n=20, on-pump). The plasma endothelium-derived NO levels were
determined at baseline and after reactive hyperemia before and after
surgery. Reactive hyperemia was induced by inflating a blood pressure cuff
placed on the upper forearm, for 5min at 250mmHg followed by a rapid
deflation. Blood was collected at 1min after cuff deflation from the
radial artery on the same side. Preoperative use of all medications was
recorded. The baseline plasma NO levels before operation were 17.10+/-7.58
in group 1 and 15.49+/-5.26nmol/L in group 2. Before operation after
reactive hyperemia, the plasma NO levels were 26.97+/-11.49 in group 1 and
26.57+/-12.87nmol/L in group 2. Two hours after surgery, the plasma NO
levels at baseline and after reactive hyperemia were not significantly
different from each other (group 1: 18.03+/-6.37 and group 2:
19.89+/-9.83nmol/L; group 1: 27.89+/-18.36 and group 2:
39.13+/-23.60nmol/L, respectively; P>0.05). A positive correlation was
shown between preoperative nitroglycerine use and the postoperative plasma
NO levels after reactive hyperemia (r=0.51, P=0.001). Linear regression
analysis was performed (F=4.10, R=0.56, R2=0.32, P= 0.008) and
the only independent parameter that had an effect on postoperative plasma
NO levels after reactive hyperemia was found to be preoperative
nitroglycerine use (t=3.68, P=0.001). Coronary artery bypass surgery with
CPB does not have significant effect on plasma endothelial derived NO
levels. The postoperative plasma NO levels after reactive hyperemia
significantly correlated with preoperative nitroglycerine use. ©
2010, Copyright the Authors. Journal compilation © 2010,
International Center for Artificial Organs and Transplantation and Wiley
Periodicals, Inc..

<91>
Accession Number
355085076
Title
Reduction of early postoperative morbidity in cardiac surgery patients
treated with continuous veno-venous hemofiltration during cardiopulmonary
bypass.
Source
Artificial Organs. 33(8) (pp 654-657), 2009. Date of Publication: August
2009.
Author
Luciani R.; Goracci M.; Simon C.; Principe F.; Fazzari L.; Punzo G.; Mene
P.
Institution
(Luciani, Principe, Fazzari, Punzo, Mene) Department of Nephrology,
Sant'Andrea Hospital, University of Rome la Sapienza, Via di Grottarossa
1035-1039, 00189 Rome, Italy
(Goracci, Simon) Cardiac Surgery, Sant'Andrea University Hospital,
University of Rome la Sapienza, Rome, Italy
Publisher
Blackwell Publishing Inc.
Abstract
Cardiac surgery with cardiopulmonary bypass is associated with a systemic
inflammatory response syndrome. The major clinical features of this
include a reduction of pulmonary compliance and increased extracellular
fluids, with increased pulmonary shunt fraction similar to acute
respiratory distress syndrome, thus resulting in prolonged mechanical
ventilation time (VAM) and intensive care unit length of stay (ICU STAY).
We evaluated the feasibility of an intraoperatory cardiopulmonary bypass
(CPB) circuit connected with a monitor for continuous veno-venous
hemofiltration (CVVH) to ameliorate pulmonary function after open heart
surgery reducing VAM and ICU STAY. Forty patients undergoing elective
coronary artery bypass grafting were randomized at the time of surgery
into a control group (20 patients who received standard cardiopulmonary
bypass) and a study group (20 patients who received CVVH during
cardiopulmonary bypass). The analysis of postoperative variables showed a
significative reduction of VAM in treated group (CVVH group mean 3.55 h
+/- 0.85, control group 5.8 h +/- 0.94, P < 0.001) and ICU STAY (CVVH
group mean 29.5 h +/- 6.7, control group 40.5 h +/- 6.67, P < 0.001). In
our experience, the use of intraoperatory CVVH during cardiopulmonary
bypass is associated with lower early postoperative morbidity. ©
2009, International Center for Artificial Organs and Transplantation and
Wiley Periodicals, Inc.

<92>
Accession Number
2013272886
Title
OUTpatient intravenous LASix Trial in reducing hospitalization for acute
decompensated heart failure (OUTLAST).
Source
PLoS ONE. 16(6 June) (no pagination), 2021. Article Number: e0253014. Date
of Publication: June 2021.
Author
Hamo C.E.; Abdelmoneim S.S.; Han S.Y.; Chandy E.; Muntean C.; Khan S.A.;
Sunkesula P.; Meykler M.; Ramachandran V.; Rosenberg E.; Klem I.; Sacchi
T.J.; Heitner J.F.
Institution
(Hamo) Division of Cardiology, Johns Hopkins University, Baltimore, MD,
United States
(Abdelmoneim, Han, Chandy, Muntean, Khan, Sunkesula, Meykler,
Ramachandran, Rosenberg, Sacchi, Heitner) Division of Cardiology, Brooklyn
New York-Presbyterian Hospital, Brooklyn, NY, United States
(Klem) The Duke Clinical Research Institute, Durham, NC, United States
Publisher
Public Library of Science
Abstract
Background Hospitalization for acute decompensated heart failure (ADHF)
remains a major source of morbidity and mortality. The current study aimed
to investigate the feasibility, safety, and efficacy of outpatient
furosemide intravenous (IV) infusion following hospitalization for ADHF.
Methods In a single center, prospective, randomized, double-blind study,
100 patients were randomized to receive standard of care (Group 1), IV
placebo infusion (Group 2), or IV furosemide infusion (Group 3) over 3h,
biweekly for a one-month period following ADHF hospitalization. Patients
in Groups 2/3 also received a comprehensive HF-care protocol including
bi-weekly clinic visits for dose-adjusted IV-diuretics, medication
adjustment and education. Echocardiography, quality of life and depression
questionnaires were performed at baseline and 30-day follow-up. The
primary outcome was 30-day re-hospitalization for ADHF. Results Overall, a
total of 94 patients were included in the study (mean age 64 years, 56%
males, 69% African American). There were a total of 14 (15%)
hospitalizations for ADHF at 30 days, 6 (17.1%) in Group 1, 7 (22.6%) in
Group 2, and 1 (3.7%) in Group 3 (overall p = 0.11; p = 0.037 comparing
Groups 2 and 3). Patients receiving IV furosemide infusion experienced
significantly greater urine output and weight loss compared to those
receiving placebo without any significant increase creatinine and no
significant between group differences in echocardiography parameters, KCCQ
or depression scores. Conclusion The use of a standardized protocol of
outpatient IV furosemide infusion for a one-month period following
hospitalization for ADHF was found to be safe and efficacious in reducing
30-day re-hospitalization. Copyright © 2021 Hamo et al. This is
an open access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are
credited.

<93>
Accession Number
2011631697
Title
Meta-Analysis Comparing Valve in Valve Transcatheter Mitral Valve
Replacement Versus Redo Surgical Mitral Valve Replacement for Degenerating
Bioprosthetic Valves.
Source
American Journal of Cardiology. 149 (pp 155-156), 2021. Date of
Publication: 15 Jun 2021.
Author
Zahid S.; Ullah W.; Khan M.U.; Sarvepalli D.; Inayat A.; Salman F.; Khan
M.Z.
Institution
(Zahid) Rochester General Hospital, NY, United States
(Ullah) Abington Jefferson, PA, United States
(Khan, Khan) West Virginia University, WV, United States
(Sarvepalli) Gunter Medical College, India
(Inayat) Sisters of Charity Hospital, NY, United States
(Salman) St. Vincent Medical Center, Toledo, OH, United States
Publisher
Elsevier Inc.

<94>
Accession Number
2015857241
Title
Undetectable High-Sensitivity Troponin T as a Gatekeeper for Coronary
Computed Tomography Angiography in Patients Suspected of Acute Coronary
Syndrome.
Source
Cardiology (Switzerland). 146(6) (pp 713-719), 2021. Date of Publication:
01 Dec 2021.
Author
Arslan M.; Schaap J.; Rood P.P.M.; Nieman K.; Budde R.P.J.; Van Dalen
B.M.; Attrach M.; Dubois E.A.; Dedic A.
Institution
(Arslan, Nieman, Budde, Van Dalen, Dubois, Dedic) Department of
Cardiology, Erasmus Medical Centre, Rotterdam, Netherlands
(Arslan, Nieman, Budde, Attrach, Dedic) Department of Radiology and
Nuclear Medicine, Erasmus Medical Centre, Rotterdam, Netherlands
(Schaap) Department of Cardiology, Amphia Ziekenhuis, Breda, Netherlands
(Rood) Department of Emergency Medicine, Erasmus Medical Centre,
Rotterdam, Netherlands
(Van Dalen) Department of Cardiology, Franciscus Gasthuis, Rotterdam,
Netherlands
(Dubois) Department of Intensive Care, Erasmus University Medical Centre,
Rotterdam, Netherlands
Publisher
S. Karger AG
Abstract
Objectives: The aim of this study was to characterize the safety and
efficiency of a strategy employing the limit of detection (LoD) of
high-sensitivity troponin T (hs-TnT) as a gatekeeper for coronary computed
tomography angiography (CCTA) in suspected acute coronary syndrome (ACS)
patients in the emergency department (ED). Method(s): We included
suspected ACS patients who underwent CCTA and were evaluated with hs-TnT.
Patients were categorized as below the LoD and at or above the LoD. The
primary outcome was 30-day major adverse cardiac events (MACEs), defined
as all-cause mortality, ACS, or coronary revascularization.
 Result(s): The study population consisted of 177 patients (mean age
55 +/- 10 years, 50.3% women), and 16 (9.0%) patients reached the primary
outcome. None of the patients died, while 13 had an adjudicated diagnosis
of ACS, and 3 underwent elective coronary revascularization. There were 77
patients (44%) with an hs-TnT value below the LoD (MACEs; n = 1 [1.3%])
and 100 (56%) with at or above the LoD levels (MACEs; n = 15 [15%]). None
of 67 patients with an hs-TnT value below the LoD and <50% stenosis on
CCTA experienced MACEs. Out of the 10 patients with an hs-TnT value below
the LoD and >=50% stenosis on CCTA, 1 patient underwent elective
percutaneous coronary revascularization. In patients with an hs-TnT value
at or above the LoD, 74 patients had <50% stenosis on CCTA, and 2 patients
(3%) were diagnosed with myocardial infarction without obstructive
coronary artery disease confirmed on invasive angiography. Thirteen (50%)
patients with an hs-TnT value at or above the LoD and >=50% stenosis on
CCTA experienced MACEs (11 ACS and 2 elective percutaneous coronary
revascularizations). Conclusion(s): Our findings support that
implementing the LoD of hs-TnT as a gatekeeper may reduce the need for
CCTA in suspected ACS patients in the ED. Copyright © 2021

<95>
Accession Number
2015857240
Title
Age, Serum Creatinine, and Left Ventricular Ejection Fraction Improved the
Performance of the CatLet Angiographic Scoring System in Terms of Outcome
Predictions for Patients with Acute Myocardial Infarction: A Median
4.3-Year Follow-Up Study.
Source
Cardiology (Switzerland). 146(6) (pp 690-697), 2021. Date of Publication:
01 Dec 2021.
Author
Teng R.-L.; Liu M.; Sun B.-C.; Xu J.-P.; He Y.; He Y.-M.
Institution
(Teng, Liu, Sun, Xu, He) Division of Cardiology, The First Affiliated
Hospital of Soochow University, Suzhou, China
(He) Division of Critical Care Medicine, The First Affiliated Hospital of
Soochow University, Suzhou, China
Publisher
S. Karger AG
Abstract
Background: We recently developed the Coronary Artery Tree description and
Lesion EvaluaTion (CatLet) angiographic scoring system. Our preliminary
study demonstrated that the CatLet score better predicted clinical
outcomes than the SYNTAX score. The current study aimed at assessing
whether 3 clinical variables (CVs) - age, serum creatinine, and left
ventricular ejection fraction (LVEF) - improved the performance of the
CatLet score in outcome predictions in patients with acute myocardial
infarction (AMI). Method(s): This study was a post hoc study of the
CatLet score validation trial. Primary endpoint was major adverse cardiac
or cerebrovascular events (MACCEs), and secondary endpoints were all-cause
deaths and cardiac deaths. Result(s): Over 1,185 person-years (median
[interquartile range], 4.3 [3.8-4.9] years), there were 64 MACCEs (20.8%),
56 all-cause deaths (18.2%), and 47 cardiac deaths (15.2%). The addition
of the 3 CVs to the stand-alone CatLet score significantly increased the
Harrell's C-index by 0.0967 (p = 0.002) in MACCEs, by 0.1354 (p < 0.001)
in all-cause deaths, and by 0.1187 (p = 0.001) in cardiac deaths. When
compared with the stand-alone CatLet score, improved discrimination and
better calibration led to a significantly refined risk stratification,
particularly at the intermediate-risk category. Conclusion(s): CatLet
score had a predicting value for clinical outcome in AMI patients. This
predicting value can be improved through a combination with age, serum
creatinine, and LVEF (http://www.chictr.org.cn; unique identifier:
ChiCTR-POC-17013536). Copyright © 2021

<96>
Accession Number
2015793740
Title
Predictors of unplanned 30-day readmissions after coronary artery bypass
graft: A systematic review and meta-analysis of cohort studies.
Source
European Journal of Cardiovascular Nursing. 20(7) (pp 717-725), 2021. Date
of Publication: 01 Oct 2021.
Author
Son Y.-J.; Lee H.-J.; Lim S.-H.; Hong J.; Seo E.J.
Institution
(Son) Red Cross College of Nursing, Chung-Ang University, Seoul 06974,
South Korea
(Lee) Department of Nursing, Tongmyoung University, Busan 48520, South
Korea
(Lim) Department of Thoracic and Cardiovascular Surgery, Ajou University,
Suwon 16499, South Korea
(Hong) Department of Thoracic and Cardiovascular Surgery, Chung-Ang
University, Seoul 06974, South Korea
(Seo) Ajou University, College of Nursing and Research Institute of
Nursing Science, 164, Worldcup-Ro, Yeongtong-Gu, Suwon 16499, South Korea
Publisher
Oxford University Press
Abstract
Aims: Coronary artery bypass graft (CABG) is one of the most performed
cardiac surgery globally. CABG is known to have a high rate of short-term
readmissions. The 30-day unplanned readmission rate as a quality measure
is associated with adverse health outcomes. This study aimed to identify
and synthesize the perioperative risk factors for 30-day unplanned
readmission after CABG. Methods and Results: We systematically
searched seven databases and reviewed studies to identify all eligible
English articles published from 1 October 1999 to 30 September 2019.
Random-effect models were employed to perform pooled analyses. Odds ratio
and 95% confidence interval were used to estimate the risk factors for
30-day unplanned readmission. The 30-day hospital readmission rates after
CABG ranged from 9.2% to 18.9% in 14 cohort studies. Among preoperative
characteristics, older adults, female, weight loss, high serum creatinine,
anticoagulant use or dialysis, and comorbidities were found to be
statistically significant. Postoperative complications, prolonged length
of hospital stay, and mechanical ventilation were revealed as the
postoperative risk factors for 30-day unplanned readmission. However,
intraoperative risk factors were not found to be significant in this
review. Conclusion(s): Our findings emphasize the importance of a
comprehensive assessment during the perioperative period of CABG.
Healthcare professionals can perform a readmission risk stratification and
develop strategies to reduce readmission rates after CABG using the risk
factors identified in this review. Future studies with prospective cohort
samples are needed to identify the personal or psychosocial factors
influencing readmission after CABG, including perioperative risk
factors. Copyright © 2021 Published on behalf of the European
Society of Cardiology. All rights reserved.

<97>
Accession Number
2014798162
Title
Clot composition analysis as a diagnostic tool to gain insight into
ischemic stroke etiology: A systematic review.
Source
Journal of Stroke. 23(3) (pp 327-342), 2021. Date of Publication:
September 2021.
Author
Aliena-Valero A.; Baixauli-Martin J.; Torregrosa G.; Tembl J.I.; Salom
J.B.
Institution
(Aliena-Valero, Torregrosa, Salom) Joint Cerebrovascular Research Unit, La
Fe Health Research Institute, University of Valencia, Valencia, Spain
(Baixauli-Martin, Salom) Department of Physiology, University of Valencia,
Valencia, Spain
(Tembl) Stroke Unit, Neurology Service, La Fe University and Polytechnic
Hospital, Valencia, Spain
Publisher
Korean Stroke Society
Abstract
Mechanical thrombectomy renders the occluding clot available for analysis.
Insights into thrombus composition could help establish the stroke cause.
We aimed to investigate the value of clot composition analysis as a
complementary diagnostic tool in determining the etiology of large vessel
occlusion (LVO) ischemic strokes (International Prospective Register of
Systematic Reviews [PROSPERO] registration # CRD42020199436). Following
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines, we ran searches on Medline (using the PubMed
interface) and Web of Science for studies reporting analyses of thrombi
retrieved from LVO stroke patients subjected to mechanical thrombectomy
(January 1, 2006 to September 21, 2020). The PubMed search was updated
weekly up to February 22, 2021. Reference lists of included studies and
relevant reviews were hand-searched. From 1,714 identified studies, 134
eligible studies (97 cohort studies, 31 case reports, and six case series)
were included in the qualitative synthesis. Physical, histopathological,
biological, and microbiological analyses provided information about the
gross appearance, mechanical properties, structure, and composition of the
thrombi. There were non-unanimous associations of thrombus size,
structure, and composition (mainly proportions of fibrin and blood formed
elements) with the Trial of Org 10172 in Acute Stroke Treatment (TOAST)
etiology and underlying pathologies, and similarities between cryptogenic
thrombi and those of known TOAST etiology. Individual thrombus analysis
contributed to the diagnosis, mainly in atypical cases. Although cohort
studies report an abundance of quantitative rates of main thrombus
components, a definite clot signature for accurate diagnosis of stroke
etiology is still lacking. Nevertheless, the qualitative examination of
the embolus remains an invaluable tool for diagnosing individual cases,
particularly regarding atypical stroke causes. Copyright © 2021
Korean Stroke Society.

<98>
Accession Number
2015627842
Title
Mechanical active compression-decompression versus standard mechanical
cardiopulmonary resuscitation: A randomised haemodynamic out-of-hospital
cardiac arrest study.
Source
Resuscitation. 170 (pp 1-10), 2022. Date of Publication: January 2022.
Author
Berve P.O.; Hardig B.M.; Skalhegg T.; Kongsgaard H.; Kramer-Johansen J.;
Wik L.
Institution
(Berve, Kramer-Johansen) Institute of Clinical Medicine, University of
Oslo, Oslo, Norway
(Berve, Kongsgaard, Kramer-Johansen, Wik) Norwegian National Advisory Unit
on Prehospital Emergency Medicine, Oslo University Hospital, Oslo, Norway
(Berve, Skalhegg, Kramer-Johansen, Wik) Air Ambulance Department, Division
of Prehospital Services, Oslo University Hospital, Oslo, Norway
(Berve, Wik) Department of Anaesthesiology, Oslo University Hospital,
Oslo, Norway
(Hardig) Clinical Sciences, Helsingborg, Section II, Faculty of Medicine,
Lund University, Sweden
(Hardig) Stryker/Jolife AB, Lund, Sweden
Publisher
Elsevier Ireland Ltd
Abstract
Background: Active compression-decompression cardiopulmonary resuscitation
(ACD-CPR) utilises a suction cup to lift the chest-wall actively during
the decompression phase (AD). We hypothesised that mechanical ACD-CPR
(Intervention), with AD up to 30 mm above the sternal resting position,
would generate better haemodynamic results than standard mechanical CPR
(Control). Method(s): This out-of-hospital adult non-traumatic
cardiac arrest trial was prospective, block-randomised and non-blinded. We
included intubated patients with capnography recorded during mechanical
CPR. Exclusion criteria were pregnancy, prisoners, and prior chest
surgery. The primary endpoint was maximum tidal carbon dioxide partial
pressure (p<inf>MT</inf>CO<inf>2</inf>) and secondary endpoints were
oxygen saturation of cerebral tissue (SctO<inf>2</inf>), invasive arterial
blood pressures and CPR-related injuries. Intervention device lifting
force performance was categorised as Complete AD (>=30 Newtons) or
Incomplete AD (<=10 Newtons). Haemodynamic data, analysed as one
measurement for each parameter per ventilation (Observation Unit, OU) with
non-linear regression statistics are reported as mean (standard
deviation). A two-sided p-value < 0.05 was considered as statistically
significant. Result(s): Of 221 enrolled patients, 210 were deemed
eligible (Control 109, Intervention 101). The Control vs. Intervention
results showed no significant differences for
p<inf>MT</inf>CO<inf>2</inf>: 29(17) vs 29(18) mmHg (p = 0.86), blood
pressures during compressions: 111(45) vs. 101(68) mmHg (p = 0.93) and
decompressions: 21(20) vs. 18(18) mmHg (p = 0.93) or for
SctO<inf>2</inf>%: 55(36) vs. 57(9) (p = 0.42). The 48 patients who
received Complete AD in > 50% of their OUs had higher SctO<inf>2</inf>
than Control patients: 58(11) vs. 55(36)% (p < 0.001). Conclusion(s):
Mechanical ACD-CPR provided similar haemodynamic results to standard
mechanical CPR. The Intervention device did not consistently provide
Complete AD. Clinical trial registration: ClinicalTrials.gov identifier
(NCT number): NCT02479152. The Haemodynamic Effects of Mechanical Standard
and Active Chest Compression-decompression During Out-of-hospital
CPR. Copyright © 2021 Elsevier B.V.

<99>
Accession Number
631655743
Title
Dexmedetomidine versus propofol for prolonged sedation in critically ill
trauma and surgical patients.
Source
The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and
Ireland. 19(3) (pp 129-134), 2021. Date of Publication: 01 Jun 2021.
Author
Winings N.A.; Daley B.J.; Bollig R.W.; Roberts R.F.; Radtke J.; Heidel
R.E.; Taylor J.E.; McMillen J.C.
Institution
(Winings) 1924 Alcoa Highway, Box 41, Department of Pharmacy, The
University of Tennessee Medical Center Knoxville, Tennessee, 37920 USA
(Daley, Bollig, Roberts, Radtke, Taylor) 1924 Alcoa Highway, Box U-11,
Department of Surgery, Division of Trauma & Critical Care Surgery the
University of Tennessee Medical Center, Knoxville, TN, 37920 USA
(Heidel) University of Tennessee Graduate School of Medicine, TN, 1924
Alcoa Highway, Knoxville 37920, United States
(McMillen) 1924 Alcoa Highway, Box 41, Department of Pharmacy, The
University of Tennessee Medical Center Knoxville, Tennessee, 37920 USA.
Electronic address: jc.mcmil@gmail.com
Publisher
NLM (Medline)
Abstract
BACKGROUND: and Purpose: Currently, dexmedetomidine versus propofol has
primarily been studied in medical and cardiac surgery patients with
outcomes indicating safe and effective sedation. The purpose of this study
was to assess the efficacy of dexmedetomidine versus propofol for
prolonged sedation in trauma and surgical patients. METHOD(S): This
was a single-center prospective study conducted in the Trauma/Surgical
Intensive Care Unit (ICU) at a Level I academic trauma center. It included
patients 18 years of age or older requiring mechanical ventilation who
were randomly assigned based on unit bed location to receive either
dexmedetomidine or propofol. The primary outcome was duration of
mechanical ventilation. Secondary outcomes included mortality; proportion
of time in target sedation; incidence of delirium, hypotension, and
bradycardia; and ICU and hospital length of stay (LOS). RESULT(S): A
total of 57 patients were included. Baseline characteristics were similar
between groups. There was no significant difference in duration of
mechanical ventilation (median [IQR]) between the dexmedetomidine
(78.5[125] hours) and propofol (105[130] hours; p = 0.15) groups. There
was no difference between groups in ICU mortality, ICU and hospital LOS,
or incidence of delirium. Safety outcomes were also similar. Patients in
the dexmedetomidine group spent a significantly greater percentage of time
in target sedation (98[8] %) compared to propofol group (92[10] %; p =
0.02). CONCLUSION(S): Our results suggest that, similar to medical
and cardiac surgery patients, dexmedetomidine and propofol are safe and
effective sedation agents in critically ill trauma and surgical patients;
however, dexmedetomidine achieves target sedation better than propofol for
this specific population. Copyright © 2020 Royal College of
Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College
of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

<100>
Accession Number
631335637
Title
Treatment-related complications in patients with esophageal cancer: A
systematic review and network meta-analysis.
Source
The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and
Ireland. 19(1) (pp 37-48), 2021. Date of Publication: 01 Feb 2021.
Author
Holakouie-Naieni K.; Mansournia M.A.; Doosti-Irani A.; Rahimi-Foroushani
A.; Haddad P.
Institution
(Holakouie-Naieni, Mansournia, Rahimi-Foroushani) Department of
Epidemiology and Biostatistics, School of Public Health, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Doosti-Irani) Department of Epidemiology, School of Public Health,
Hamadan University of Medical Sciences, Hamadan, Iran; Department of
Epidemiology and Biostatistics, School of Public Health, Tehran University
of Medical Sciences, Tehran, Iran. Electronic address:
a.doosti@umsha.ac.ir
(Haddad) Radiation Oncology Research Center, Cancer Institute, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
BACKGROUND: The aim of this review was to compare the available treatments
of esophageal cancer, in terms of pulmonary, cardiovascular complications,
anastomotic leakage, and esophagitis after treatment in patients with
esophageal squamous cell carcinoma (SCC). METHOD(S): Medline, Web of
Science, Scopus, the Cochrane Library and Embase were searched. The
randomized controlled trials (RCT) that had compared the treatment
-related complications of treatments for esophageal SCC were included. We
included 39 randomized control trials in a network meta-analysis. The
Chi2-test was used to assess of heterogeneity. The loop-specific and
design-by-treatment interaction methods were used for assessment of
consistency assumption. The risk ratio with 95% confidence interval (CI)
was used to report the effect-sizes in the network meta-analysis.
 RESULT(S): The pulmonary complication, cardiac complication,
anastomotic leakage, and esophagitis were reported in 31, 11, 17, and 15
RCTs respectively. Video-assisted thoracoscopy + laparoscopy (VATS) was
rank as the first and second treatment in terms of lower risk for
pulmonary complication and anastomotic leakage. There was no statistically
significant difference between treatments in terms of lower risk of
cardiovascular complications. However, Surgery + Cisplatin + Fluorouracil
(SCF) was ranked as better treatment. 3-dimensional conformal radiotherapy
+ Docetaxel + Cisplatin (3DCRTDC) was the best treatment in terms of lower
risk for esophagitis. CONCLUSION(S): According to the results of this
study, it seems the risk of pulmonary, cardiovascular, anastomotic leakage
and esophagitis complications for VATS, SCF, surgery + radiotherapy (SRT),
and 3DCRTDC was lower than other treatments respectively in the
networks. Copyright © 2020 Royal College of Surgeons of Edinburgh
(Scottish charity number SC005317) and Royal College of Surgeons in
Ireland. Published by Elsevier Ltd. All rights reserved.

<101>
Accession Number
2015121358
Title
Targeting Higher Intraoperative Blood Pressures Does Not Reduce Adverse
Cardiovascular Events Following Noncardiac Surgery.
Source
Journal of the American College of Cardiology. 78(18) (pp 1753-1764),
2021. Date of Publication: 02 Nov 2021.
Author
Wanner P.M.; Wulff D.U.; Djurdjevic M.; Korte W.; Schnider T.W.; Filipovic
M.
Institution
(Wanner, Djurdjevic, Schnider, Filipovic) Division of Anaesthesiology,
Intensive Care, Rescue and Pain Medicine, Cantonal Hospital St. Gallen,
St. Gallen, Switzerland
(Wulff) University of Basel, Basel, Switzerland and Max Planck Institute
for Human Development, Berlin, Germany
(Korte) Center for Laboratory Medicine, St. Gallen, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: Intraoperative arterial hypotension is strongly associated
with postoperative major adverse cardiovascular events (MACE); however,
whether targeting higher intraoperative mean arterial blood pressures
(MAPs) may prevent adverse events remains unclear. Objective(s): This
study sought to determine whether targeting higher intraoperative MAP
lowers the incidence of postoperative MACE. Method(s): This
single-center randomized controlled trial assigned adult patients at
cardiovascular risk undergoing major noncardiac surgery to an
intraoperative MAP target of >=60 mm Hg (control) or >=75 mm Hg (MAP
>=<inf>75</inf>). The primary outcome was acute myocardial injury on
postoperative days 0-3 and/or 30-day MACE/acute kidney injury (AKI) (acute
coronary syndrome, congestive heart failure, coronary revascularization,
stroke, AKI, and all-cause mortality). The secondary outcome was 1-year
MACE. Result(s): In total, 458 patients were randomized
(intention-to-treat population: 451). The cumulative intraoperative
duration with MAP <65 mm Hg was significantly shorter in the MAP
>=<inf>75</inf> group (median 9 minutes [interquartile range: 3 to 24
minutes] vs 23 minutes [interquartile range: 8-49 minutes]; P < 0.001).
The primary outcome incidence was 48% for MAP >=<inf>75</inf> and 52% for
control (risk difference -4.2%; 95% CI: -13% to +5%), the primary
contributor being AKI (incidence 44%). Acute myocardial injury occurred in
15% (MAP >=<inf>75</inf>) and 19% (control) of patients. The secondary
outcome incidence was 17% for MAP >=<inf>75</inf> and 15% for control
(risk difference +2.7; 95% CI: -4% to +9.5%). Conclusion(s): These
findings do not support universally targeting higher intraoperative blood
pressures to reduce postoperative complications. Despite a 60% reduction
in hypotensive time with MAP <65 mm Hg, no significant reductions in acute
myocardial injury or 30-day MACE/AKI could be found. (Biomarkers, Blood
Pressure, BIS: Risk Stratification/Management of Patients at Cardiac Risk
in Major Noncardiac Surgery [BBB]; NCT02533128) Copyright © 2021
The Authors

<102>
Accession Number
2013716635
Title
Prognostic implications of atrial fibrillation in patients with stable
coronary artery disease: A systematic review and meta-analysis of adjusted
observational studies.
Source
Reviews in Cardiovascular Medicine. 22(2) (pp 439-444), 2021. Date of
Publication: 30 Jun 2021.
Author
Saglietto A.; Varbella V.; Ballatore A.; Xhakupi H.; de Ferrari G.M.;
Anselmino M.
Institution
(Saglietto, Varbella, Ballatore, Xhakupi, de Ferrari, Anselmino) Division
of Cardiology, "Citta della Salute e della Scienza di Torino" Hospital,
Department of Medical Sciences, University of Turin, Turin 10126, Italy
Publisher
IMR Press Limited
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered
in clinical practice. Despite the frequent coexistence with coronary
artery disease (CAD), the prognostic independent implication of AF in
patients with stable CAD remains controversial. Our aim was to perform a
pairwise meta-analysis of adjusted observational studies comparing
cardiovascular outcomes in patients with stable CAD with and without
concomitant AF, in search of AF-specific prognostic implications. We
performed random effect meta-analysis of binary outcome events in studies
comparing stable CAD patients with versus without AF providing risk
estimates adjusted for confounding variables. Literature search was
performed in PubMed/MEDLINE and Google Scholar. Death was the primary
endpoint of the analysis, while myocardial infarction, coronary
revascularization and stroke secondary endpoints. 5 studies were included
in the meta-analysis, encompassing a total of 30230 stable CAD patients
(2844 with AF, 27386 without AF). Stable CAD patients with AF presented an
independent increased risk of death (HR 1.39, 95% CI: 1.17-1.66) and
stroke (HR 1.88, 95% CI: 1.45-2.45) compared to those without AF. Instead,
risk of myocardial infarction (HR 0.90, 95% CI: 0.66-1.22) and coronary
revascularization (HR 0.96, 95% CI: 0.79-1.16) did not differ in stable
CAD patients with and without the arrhythmia. In patients with stable CAD,
AF exerts an independent negative prognostic effect, increasing the risk
of death and stroke. However, the small number of eligible studies
included in this analysis highlights the astonishing lack of data
regarding prognostic implications of concomitant AF in patients with
stable CAD. Copyright © 2021 The Author(s). Published by IMR
Press.

<103>
Accession Number
634750264
Title
Therapeutic approach comparison in bicuspid aortic valve aortopathy and
clinical practice implications.
Source
Romanian journal of morphology and embryology = Revue roumaine de
morphologie et embryologie. 61(3) (pp 863-870), 2020. Date of Publication:
01 Jul 2020.
Author
Dima C.N.; Streian C.G.; Gaspar M.; Suciu S.C.; Caraion C.; Boldu E.O.;
Cerbu S.; Iacob E.R.; Luca C.T.; Petrescu L.
Institution
(Dima) Department of Pediatric Surgery, Department of Radiology and
Medical Imaging, Victor Babes University of Medicine and Pharmacy,
Timisoara, Romania; radueiacob@umft.ro, radueiacob@yahoo.com,
cerbusimona@yahoo.com
Publisher
NLM (Medline)
Abstract
Bicuspid aortic valve (BAV) is the most common heart valve malformation,
and it may be associated with the development of long-term complications,
such as aortic stenosis (AS) secondary to valvular calcification and
aortic insufficiency (AI), with or without ascending aortic aneurysm
(AAA). This study was performed at the Institute of Cardiovascular
Diseases, Timisoara, Romania, from 2015 through 2018 and included a total
of 105 patients with BAV. Out of the 105 BAV patients, 14 displayed AAA,
alongside either AS or AI, and were selected undergo aortic valve
replacement (AVR) alongside surgical replacement or aortoplasty of the
ascending aorta, and the elastic fiber loss in the ascending aortic wall
was evaluated for each patient. Two surgical interventions used alongside
AVR in BAV patients with AAA and AS or AI were compared in this study:
reduction ascending aortoplasty (RAA) and ascending aorta replacement
(AAR). Postoperative follow-ups have shown RAA is useful short-term but
that, in contrast to AAR, it leads to aortic redilatation over time. These
results can contribute to a major future meta-analysis with the goal of
improving the current clinical practice guidelines for BAV aortopathy.

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